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1.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31501071

RESUMO

Serum phosphorus levels range from 2.5 and 4.5mg/dL (0.81-1.45 mmol/L) in adults, with higher levels in childhood, adolescence, and pregnancy. Intracellular phosphate is involved in intermediary metabolism and other essential cell functions, while extracellular phosphate is essential for bone matrix mineralization. Plasma phosphorus levels are maintained within a narrow range by regulation of intestinal absorption, redistribution, and renal tubular absorption of the mineral. Hypophosphatemia and hyperphosphatemia are common clinical situations, although changes are most often mild and oligosymptomatic. However, acute and severe conditions that require specific treatment may occur. In this document, members of the Mineral and Bone Metabolism Working Group of the Spanish Society of Endocrinology and Nutrition review phosphate disorders and provide algorithms for adequate clinical management of hypophosphatemia and hyperphosphatemia.

2.
Endocrinol. diabetes nutr. (Ed. impr.) ; 66(7): 443-458, ago.-sept. 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-182864

RESUMO

Objetivo: El tratamiento de la diabetes tipo 2 (DM2) es complejo y su propósito es reducir la morbimortalidad, por lo que su manejo tiene que incluir: un control glucémico individualizado precoz (mediante una adecuada educación diabetológica, modificaciones del estilo de vida y tratamiento farmacológico), el control de los factores de riesgo cardiovascular (CV), la detección y tratamiento precoz de las complicaciones y la evaluación de las comorbilidades asociadas. El objetivo fue elaborar un documento para unificar los aspectos necesarios para el abordaje integral de las personas con DM2. Participantes: Miembros del Grupo de trabajo de Diabetes Mellitus de la Sociedad Española de Endocrinología y Nutrición. Métodos: Se realizó una revisión de la evidencia disponible relativa a cada aspecto del manejo de la diabetes: objetivos de control glucémico, dieta y ejercicio, tratamiento farmacológico, tratamiento y control de factores de riesgo, detección de complicaciones y manejo del paciente frágil con DM2. Las recomendaciones se formularon según los grados de evidencia recogidos en los Standards of Medical Care in Diabetes 2018. Tras la formulación de las recomendaciones el documento fue consensuado por los miembros del Grupo de trabajo de Diabetes Mellitus de la Sociedad Española de Endocrinología y Nutrición. Conclusiones: El objetivo de este documento es proporcionar, desde el punto de vista del endocrinólogo clínico, unas recomendaciones prácticas basadas en la evidencia acerca de todos los aspectos necesarios para el abordaje integral de la DM2


Objective: Treatment of type 2 diabetes mellitus (T2DM) is complex and is intended to decrease morbidity and mortality. Management should therefore include adequate diabetes education, lifestyle changes, drug treatment to achieve early blood glucose control and reduction of cardiovascular (CV) risk factors, early detection and treatment of complications, and assessment of associated comorbidities. The objective was to prepare a document including all aspects required for a comprehensive approach to T2DM. Participants: Members of the Diabetes Mellitus Working Group of the Spanish Society of Endocrinology. Methods: The available evidence regarding each aspect of diabetes management (blood glucose control goals, diet and exercise, drug treatment, risk factor management and control, detection of complications, and management of frail patients) was reviewed. Recommendations were formulated based on the grades of evidence stated in the 2018 Standards of Medical Care in Diabetes. Recommendations were discussed and agreed by the working group members. Conclusions: This document is intended to provide evidence-based practical recommendations for comprehensive management of T2DM by clinical endocrinologists


Assuntos
Humanos , Diabetes Mellitus Tipo 2/terapia , Diabetes Mellitus Tipo 2/complicações , Fatores de Risco , Sociedades Médicas/normas , Documentos , Índice Glicêmico , Estilo de Vida , Sociedades Médicas/organização & administração , Estratégias de eSaúde , Exercício/fisiologia
3.
Prim Care Diabetes ; 2019 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-31171461

RESUMO

AIM: Liraglutide and lixisenatide improved glycemic control, weight and cardiovascular risk factors (CVRF) in type 2 diabetes mellitus (T2DM) patients. Our objective was to analyze clinical efficacy and safety differences in routine clinical practice. METHODS: A 24-week prospective observational study to compare the effect of liraglutide versus lixisenatide in obese T2DM patients in routine clinical practice. The main objective was to analyze between-group glycosylated hemoglobin (HbA1c) differences at the end of the study. Secondary objectives included differences in body weight, other CVRF, changes in medication, side effects, satisfaction and safety. RESULTS: A total of 100 patients (50 liraglutide, 50 lixisenatide) were included. Both groups experienced a decrease in HbA1c values (liraglutide, -1.4%, CI 95% -2, -0.8, P < 0.001 vs. lixisenatide, -0.8%, 95% CI -1.2, -0.5, P < 0.001). No differences were found in final HbA1c values between both groups (liraglutide 7.3 ±â€¯0.9% vs. lixisenatide 7.2 ±â€¯1.5%, P = 0.7). We did not detect between groups differences in anthropometric variables or CVRF at the study end. A lower proportion of patients received treatment with a maximum dose of liraglutide compared with lixisenatide (27% vs. 95%, P < 0.001). In contrast, a greater percentage of patients in the lixisenatide group than in liraglutide group (29% vs. 9%, P = 0.026) intensified treatment by the addition of sodium-glucose transporter type 2 inhibitors. Adverse events were less frequently reported in liraglutide treated patients compared with lixisentatide (80% vs. 96%, P = 0.014). No serious adverse events were detected. CONCLUSIONS: These results confirm the efficacy and safety of liraglutide and lixisenatide in routine clinical practice. Moreover, a different therapeutic effect between liraglutide and lixisenatide was detected.

4.
Endocrinol Diabetes Nutr ; 66(7): 443-458, 2019.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-30827909

RESUMO

OBJECTIVE: Treatment of type 2 diabetes mellitus (T2DM) is complex and is intended to decrease morbidity and mortality. Management should therefore include adequate diabetes education, lifestyle changes, drug treatment to achieve early blood glucose control and reduction of cardiovascular (CV) risk factors, early detection and treatment of complications, and assessment of associated comorbidities. The objective was to prepare a document including all aspects required for a comprehensive approach to T2DM. PARTICIPANTS: Members of the Diabetes Mellitus Working Group of the Spanish Society of Endocrinology. METHODS: The available evidence regarding each aspect of diabetes management (blood glucose control goals, diet and exercise, drug treatment, risk factor management and control, detection of complications, and management of frail patients) was reviewed. Recommendations were formulated based on the grades of evidence stated in the 2018 Standards of Medical Care in Diabetes. Recommendations were discussed and agreed by the working group members. CONCLUSIONS: This document is intended to provide evidence-based practical recommendations for comprehensive management of T2DM by clinical endocrinologists.

5.
PLoS One ; 13(6): e0199504, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29928063

RESUMO

Cardiovascular diseases are a health problem throughout the world, especially in people with diabetes. The identification of cardiovascular disease biomarkers can improve risk stratification. Sclerostin is a modulator of the Wnt/ß-catenin signalling pathway in different tissues, and it has recently been linked to vascular biology. The current study aimed to evaluate the relationship between circulating sclerostin levels and cardiovascular and non-cardiovascular mortality in individuals with and without type 2 diabetes. We followed up a cohort of 130 participants (mean age 56.8 years; 48.5% females; 75 with type 2 diabetes; 46 with prevalent cardiovascular disease) in which serum sclerostin levels were measured at the baseline. Time to death (both of cardiovascular and non-cardiovascular causes) was assessed to establish the relationship between sclerostin and mortality. We found that serum sclerostin concentrations were significantly higher in patients with prevalent cardiovascular disease (p<0.001), and independently associated with cardiovascular mortality (p = 0.008), showing sclerostin to be a stronger predictor of mortality than other classical risk factors (area under the curve = 0.849 vs 0.823). The survival analysis showed that an increase of 10 pmol/L in the serum sclerostin level resulted in a 31% increase in cardiovascular mortality. However, no significant association was observed between sclerostin levels and non-cardiovascular mortality (p = 0.346). From these results, we conclude that high sclerostin levels are related to mortality due to cardiovascular causes. The clinical implication of these findings is based on the possible use of serum sclerostin as a new biomarker of cardiovascular mortality risk in order to establish preventive strategies.


Assuntos
Proteínas Morfogenéticas Ósseas/sangue , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/mortalidade , Estudos de Coortes , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/mortalidade , Feminino , Marcadores Genéticos , Humanos , Incidência , Estimativa de Kaplan-Meier , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Curva ROC , Fatores de Risco
6.
Endocrinol Diabetes Nutr ; 65 Suppl 1: 9-16, 2018 Mar.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-29530627

RESUMO

OBJECTIVE: To provide practical recommendations to assess and treat osteoporosis in males. PARTICIPANTS: Members of the Bone Metabolism Working Group of the Spanish Society of Endocrinology. METHODS: Recommendations were formulated using the GRADE system (Grading of Recommendations, Assessment, Development, and Evaluation) to describe both the strength of recommendations and the quality of evidence. A systematic search was made in Medline (PubMed) using the following associated terms: «osteoporosis¼, «men¼, «fractures¼, «bone mineral density¼, «treatment¼, «hypogonadism¼, and «prostate cancer¼. Papers in English and Spanish with publication date before 30 August 2017 were included. Current evidence for each disease was reviewed by 2group members. Finally, recommendations were discussed in a meeting of the working group. CONCLUSIONS: The document provides evidence-based practical recommendations for diagnosis, assessment, and management of osteoporosis in men and special situations such as hypogonadism and prostate cancer.


Assuntos
Osteoporose/diagnóstico , Osteoporose/tratamento farmacológico , Humanos , Masculino
7.
Endocrinol. diabetes nutr. (Ed. impr.) ; 65(supl.1): 9-16, mar. 2018. tab
Artigo em Espanhol | IBECS | ID: ibc-172972

RESUMO

Objetivo. Proporcionar unas recomendaciones prácticas para la evaluación y tratamiento de la osteoporosis del varón. Participantes. Miembros del Grupo de Metabolismo Mineral de la Sociedad Española de Endocrinología y Nutrición. Métodos. Las recomendaciones se formularon de acuerdo con el sistema Grading of Recommendations, Assessment, Development and Evaluation (GRADE) para establecer tanto la fuerza de las recomendaciones como el grado de evidencia. Se realizó una búsqueda sistemática en Medline de la evidencia disponible sobre la osteoporosis del varón usando las siguientes palabras claves asociadas: osteoporosis, men, fractures, bone mineral density, treatment, hypogonadism y prostate cancer. Se revisaron artículos escritos en inglés y español con fecha de inclusión hasta el 30 de agosto del 2017; cada tema fue revisado por 2personas del grupo. Tras la formulación de las recomendaciones, estas se discutieron en una reunión conjunta del grupo de trabajo. Conclusiones. El documento establece unas recomendaciones prácticas basadas en la evidencia acerca del diagnóstico, evaluación y tratamiento de la osteoporosis del varón y situaciones especiales como el hipogonadismo y el tratamiento con terapia de déficit androgénico en el carcinoma de próstata


Objective. To provide practical recommendations to assess and treat osteoporosis in males. Participants. Members of the Bone Metabolism Working Group of the Spanish Society of Endocrinology. Methods. Recommendations were formulated using the GRADE system (Grading of Recommendations, Assessment, Development, and Evaluation) to describe both the strength of recommendations and the quality of evidence. A systematic search was made in Medline (PubMed) using the following associated terms: «osteoporosis», «men», «fractures», «bone mineral density», «treatment», «hypogonadism», and «prostate cancer». Papers in English and Spanish with publication date before 30 August 2017 were included. Current evidence for each disease was reviewed by 2group members. Finally, recommendations were discussed in a meeting of the working group. Conclusions. The document provides evidence-based practical recommendations for diagnosis, assessment, and management of osteoporosis in men and special situations such as hypogonadism and prostate cancer


Assuntos
Humanos , Masculino , Osteoporose/tratamento farmacológico , Antagonistas de Androgênios/efeitos adversos , Padrões de Prática Médica , Osteoporose/etiologia , Neoplasias da Próstata/complicações , Hipogonadismo/complicações , Fraturas por Osteoporose/prevenção & controle
8.
Endocrinol Diabetes Nutr ; 64 Suppl 1: 1-6, 2017 Mar.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-28440761

RESUMO

OBJECTIVE: To provide recommendations on the effect of antidiabetic drugs on bone fragility to help select the most adequate antidiabetic treatment, especially in diabetic patients with high risk of fracture. PARTICIPANTS: Members of the Bone Metabolism Working Group of the Spanish Society of Endocrinology. METHODS: The GRADE system (Grading of Recommendations, Assessment, Development, and Evaluation) was used to establish both the strength of recommendations and the quality of evidence. A systematic search was made in MEDLINE (Pubmed) using the following terms associated to the name of each antidiabetic drug: AND "osteoporosis", "fractures", "bone mineral density", "bone markers", "calciotropic hormones". Papers in English with publication date before 30 April 2016 were reviewed. Recommendations were jointly discussed by the Working Group. CONCLUSIONS: The document summaries the data on the potential effects of antidiabetic drugs on bone metabolism and fracture risk.


Assuntos
Diabetes Mellitus Tipo 2/tratamento farmacológico , Fraturas Espontâneas/prevenção & controle , Hipoglicemiantes/farmacologia , Idoso , Remodelação Óssea/efeitos dos fármacos , Reabsorção Óssea/induzido quimicamente , Reabsorção Óssea/prevenção & controle , Contraindicações de Medicamentos , Diabetes Mellitus Tipo 2/complicações , Inibidores da Dipeptidil Peptidase IV/farmacologia , Inibidores da Dipeptidil Peptidase IV/uso terapêutico , Feminino , Fraturas Espontâneas/epidemiologia , Fraturas Espontâneas/etiologia , Peptídeo 1 Semelhante ao Glucagon/agonistas , Humanos , Hipoglicemiantes/efeitos adversos , Hipoglicemiantes/uso terapêutico , Insulina/efeitos adversos , Insulina/farmacologia , Insulina/uso terapêutico , Masculino , Metformina/farmacologia , Metformina/uso terapêutico , Pessoa de Meia-Idade , Osteoporose/complicações , Osteoporose/tratamento farmacológico , Osteoporose/prevenção & controle , Ensaios Clínicos Controlados Aleatórios como Assunto , Inibidores do Transportador 2 de Sódio-Glicose/efeitos adversos , Inibidores do Transportador 2 de Sódio-Glicose/farmacologia , Inibidores do Transportador 2 de Sódio-Glicose/uso terapêutico , Compostos de Sulfonilureia/efeitos adversos , Compostos de Sulfonilureia/farmacologia , Compostos de Sulfonilureia/uso terapêutico , Tiazolidinedionas/efeitos adversos , Tiazolidinedionas/farmacologia , Tiazolidinedionas/uso terapêutico
9.
Endocrinol Diabetes Nutr ; 64 Suppl 1: 7-14, 2017 Mar.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-28440763

RESUMO

OBJECTIVE: To provide recommendations based on evidence on the management of vitaminD deficiency in the general population. PARTICIPANTS: Members of the Bone Metabolism Working Group of the Spanish Society of Endocrinology. METHODS: Recommendations were formulated using the GRADE system (Grading of Recommendations, Assessment, Development, and Evaluation) to describe both the strength of recommendations and the quality of evidence. A systematic search was made in MEDLINE (Pubmed) using the term VitaminD and the name of each issue. Papers in English and Spanish with publication date before 17 March 2016 were included. Recommendations were jointly discussed by the Working Group. CONCLUSIONS: This document summarizes the data about vitaminD deficiency in terms of prevalence, etiology, screening indications, adequate levels and effects of supplementation on bone and non-skeletal health outcomes.


Assuntos
Vitamina D , Acidentes por Quedas/prevenção & controle , Idoso , Doenças Ósseas/complicações , Suplementos Nutricionais , Medicina Baseada em Evidências , Feminino , Fraturas Ósseas/prevenção & controle , Humanos , Nefropatias/complicações , Hepatopatias/complicações , Síndromes de Malabsorção/complicações , Masculino , Metanálise como Assunto , Pessoa de Meia-Idade , Debilidade Muscular/etiologia , Debilidade Muscular/prevenção & controle , Necessidades Nutricionais , Obesidade/complicações , Osteoporose/prevenção & controle , Fatores de Risco , Vitamina D/análogos & derivados , Vitamina D/sangue , Deficiência de Vitamina D/etiologia , Deficiência de Vitamina D/prevenção & controle , Deficiência de Vitamina D/terapia
10.
Endocrinol. diabetes nutr. (Ed. impr.) ; 64(supl.1): 1-6, mar. 2017.
Artigo em Espanhol | IBECS | ID: ibc-171735

RESUMO

Objetivo: Proporcionar recomendaciones sobre el efecto de las diferentes terapias antidiabéticas en la fragilidad ósea con el fin de ayudar a seleccionar el tratamiento antidiabético más adecuado, especialmente en pacientes diabéticos con elevado riesgo de fractura. Participantes: Miembros del Grupo de trabajo de Osteoporosis y Metabolismo Mineral de la SEEN. Métodos: Se empleó el sistema Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) para establecer tanto la fuerza de las recomendaciones como el grado de evidencia. Se realizó una búsqueda sistemática en PubMed usando las siguientes palabras clave asociadas al nombre de cada tratamiento antidiabético: AND 'osteoporosis', 'fractures', 'bone mineral density', 'bone markers', 'calciotropic hormones'. Se revisaron artículos escritos en inglés con fecha de inclusión hasta 30 de abril de 2016. Tras la formulación de las recomendaciones, estas se discutieron de forma conjunta por el Grupo de Trabajo. Conclusiones: Este documento resume los datos acerca de los potenciales efectos de los diferentes tratamientos antidiabéticos sobre el metabolismo óseo y el riesgo de fractura (AU)


Objective: To provide recommendations on the effect of antidiabetic drugs on bone fragility to help select the most adequate antidiabetic treatment, especially in diabetic patients with high risk of fracture. Participants: Members of the Bone Metabolism Working Group of the Spanish Society of Endocrinology. Methods: The GRADE system (Grading of Recommendations, Assessment, Development, and Evaluation) was used to establish both the strength of recommendations and the quality of evidence. A systematic search was made in MEDLINE (Pubmed) using the following terms associated to the name of each antidiabetic drug: AND 'osteoporosis', 'fractures', 'bone mineral density', 'bone markers', 'calciotropic hormones'. Papers in English with publication date before 30 April 2016 were reviewed. Recommendations were jointly discussed by the Working Group. Conclusions: The document summaries the data on the potential effects of antidiabetic drugs on bone metabolism and fracture risk (AU)


Assuntos
Humanos , Conferências de Consenso como Assunto , Hipoglicemiantes/uso terapêutico , Osso e Ossos , Osteogênese Imperfeita/tratamento farmacológico , Densidade Óssea , Osteoporose/complicações , Osteoporose/tratamento farmacológico , Metformina/uso terapêutico , Compostos de Sulfonilureia/uso terapêutico , Estudos Prospectivos , Insulina/uso terapêutico
14.
Talanta ; 148: 135-43, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26653434

RESUMO

Type 2 diabetes mellitus (T2DM) patients have an increased risk of cardiovascular disease (CVD) that represents one of the main causes of mortality in this population. The knowledge of the underlie factors involved in the development of CVD and the discovery of new biomarkers of the disease could help to early identification of high-risk patients. Using liquid chromatography coupled to high resolution mass spectrometry (LC-HRMS) we analyzed the serum metabolomic profile of 30 subject distributed according three groups: (i) T2DM patients with CVD; (ii) T2DM patients without CVD; (iii) non-diabetic subjects as controls (C) in order to identify potential biomarkers of the CVD related to T2DM. A partial least squares discriminant analysis (PLS-DA) and one-way analysis of variance (ANOVA) were applied to identify differential metabolites between different groups. Four glycerophospholipids were further identified as potential biomarkers of CVD in T2DM patients. Specifically, a reduction in phosphatidylcholine, lysophosphatidylcholine and lysophosphatidylethanolamine (LPE) serum levels were found in T2DM patients compared to controls, presenting the patients with CVD the lowest serum levels of these metabolites. These results show a generalized reduction of circulating phospholipids species in T2DM patients which is more pronounced in those with CVD providing information of the pathways involved in the pathogenesis and progression of CVD associated to T2DM.


Assuntos
Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/diagnóstico , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/diagnóstico , Metabolômica/métodos , Espectrometria de Massas em Tandem/métodos , Doenças Cardiovasculares/epidemiologia , Cromatografia Líquida de Alta Pressão/métodos , Estudos Transversais , Diabetes Mellitus Tipo 2/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto
15.
Endocrine ; 52(1): 54-62, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26438394

RESUMO

Myostatin and irisin are two myokines related to energy metabolism, acting on skeletal muscle and recently suggested on adipose tissue in mice. However, the exact role of these myokines in humans has not been fully established. Our aim was to evaluate the relationship between serum levels of myostatin and irisin in type 2 diabetes mellitus patients and non-diabetic controls and to explore its links with metabolic parameters. Case-control study including 73 type 2 diabetes mellitus patients and 55 non-diabetic subjects as control group. Circulating myostatin and irisin levels were measured by enzyme-linked immunosorbent assays. Type 2 diabetes mellitus patients showed significantly lower myostatin levels (p = 0.001) and higher irisin levels (p = 0.036) than controls. An inverse relationship was observed between myostatin and irisin levels (p = 0.002). Moreover, in type 2 diabetes mellitus patients, after adjusting by confounder factors, myostatin was negatively related to fasting plasma glucose (p = 0.005) and to triglyceride levels (p = 0.028) while irisin showed a positive association with these variables (p = 0.017 and p = 0.006 respectively). A linear regression analysis showed that irisin and fasting plasma glucose levels were independently associated to myostatin levels and that myostatin and triglyceride levels were independently associated to irisin concentrations in type 2 diabetes mellitus patients. Our results suggest that serum levels of myostatin and irisin are related in patients with type 2 diabetes. Triglyceride and glucose levels could modulate myostatin and irisin concentrations as a compensatory mechanism to improve the metabolic state in these patients although further studies are needed to elucidate whether the action of these myokines represents an adaptative response.


Assuntos
Diabetes Mellitus Tipo 2/sangue , Fibronectinas/sangue , Miostatina/sangue , Adulto , Idoso , Glicemia/análise , Glicemia/metabolismo , Índice de Massa Corporal , Estudos de Casos e Controles , Metabolismo Energético , Exercício , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Triglicerídeos/sangue
16.
Endocrinol. nutr. (Ed. impr.) ; 62(6): e73-e93, jun.-jul. 2015. tab
Artigo em Espanhol | IBECS | ID: ibc-140174

RESUMO

La práctica de deporte con un nivel de exigencia alto es cada vez más habitual en pacientes con diabetes mellitus (DM). Esta situación aconseja realizar tanto una valoración previa como una amplia serie de modificaciones en el tratamiento, escasamente referidas en la literatura médica habitual. Objetivo: Elaborar una guía clínica que oriente sobre la actitud médica a seguir ante un paciente con DM que realiza deporte de forma habitual. Métodos: Un grupo de expertos del Grupo de Trabajo de DM de la Sociedad Española de Endocrinología y Nutrición (SEEN) ha revisado la literatura médica relevante en cada uno de los apartados. En base a esta revisión, y con los datos aportados por la experiencia de una serie de deportistas con DM, se han consensuado una serie de recomendaciones dentro de cada apartado. Tras la formulación de las recomendaciones, estas se han discutido conjuntamente por el Grupo de Trabajo y por representantes de la SEEN. Conclusión: La guía ofrece unas pautas que abarcan desde la valoración previa a la práctica deportiva en paciente con DM, como a la actuación durante y después del deporte, pasando por aspectos como la repercusión del deporte en el control de la DM, pautas de entrenamiento o situaciones de especial riesgo (AU)


Sporting activity is becoming a common practice in patients with diabetes mellitus (DM). This situation requires both a preliminary medical assessment and a wide range of changes in treatment which have scarcely been addressed in medical literature. Objective: To prepare a clinical guideline on the medical approach to patients with diabetes who practice sport regularly. Methods: An expert panel from the Diabetes Mellitus Working Group of the Spanish Society of Endocrinology and Nutrition (SEEN) reviewed the most relevant literature in each of the sections. Based both on this review and on data from the experience of a number of athletes with DM, a number of recommendations were agreed within each section. Finally, the Working Group and representatives of the SEEN jointly discussed all these recommendations. Conclusion: The guideline provides recommendations ranging from medical assessment before patients with DM start to practice sport to actions during and after physical activity. Recommendations are also given on aspects such as the impact of sport on blood glucose control, training schemes, or special risk situations (AU)


Assuntos
Feminino , Humanos , Masculino , Diabetes Mellitus/patologia , Diabetes Mellitus/prevenção & controle , Diabetes Mellitus/terapia , Espirometria , Glicemia/análise , Hipoglicemia/prevenção & controle
17.
Endocrinol Nutr ; 62(6): e73-93, 2015.
Artigo em Espanhol | MEDLINE | ID: mdl-25840764

RESUMO

UNLABELLED: Sporting activity is becoming a common practice in patients with diabetes mellitus (DM). This situation requires both a preliminary medical assessment and a wide range of changes in treatment which have scarcely been addressed in medical literature. OBJECTIVE: To prepare a clinical guideline on the medical approach to patients with diabetes who practice sport regularly. METHODS: An expert panel from the Diabetes Mellitus Working Group of the Spanish Society of Endocrinology and Nutrition (SEEN) reviewed the most relevant literature in each of the sections. Based both on this review and on data from the experience of a number of athletes with DM, a number of recommendations were agreed within each section. Finally, the Working Group and representatives of the SEEN jointly discussed all these recommendations. CONCLUSION: The guideline provides recommendations ranging from medical assessment before patients with DM start to practice sport to actions during and after physical activity. Recommendations are also given on aspects such as the impact of sport on blood glucose control, training schemes, or special risk situations.


Assuntos
Diabetes Mellitus , Esportes , Complicações do Diabetes/fisiopatologia , Diabetes Mellitus/fisiopatologia , Humanos , Fatores de Risco , Esportes/fisiologia
18.
Int J Mol Sci ; 16(5): 9469-83, 2015 Apr 27.
Artigo em Inglês | MEDLINE | ID: mdl-25923078

RESUMO

Type 2 diabetes mellitus patients are at significant risk of cardiovascular disease, however, the pathophysiology of these complications is complex and incompletely known in this population. The aim of this study was to compare the serum proteome of patients with type 2 diabetes mellitus presenting or not presenting cardiovascular disease with non-diabetic subjects to find essential proteins related to these cardiovascular complications. This cross-sectional study compares the serum proteome by a combination of protein depletion with 2D-DIGE (2-dimension Difference Gel Electrophoresis) methodology. The proteins differentially expressed were identified by MALDI TOF/TOF (Matrix-assisted laser desorption/ionization and Time-Of-Flight ion detector) or LC-MS/MS (Liquid Chromatography coupled to Mass-Mass Spectrometry). Type 2 diabetes mellitus patients with cardiovascular disease showed higher expression of plasma retinol binding protein and glutathione peroxidase-3 compared to those without cardiovascular disease and non-diabetic controls. These results show that proteins related to the inflammatory and redox state appear to play an important role in the pathogenesis of the cardiovascular disease in the type 2 diabetes mellitus patients.


Assuntos
Antioxidantes/metabolismo , Doenças Cardiovasculares/sangue , Diabetes Mellitus Tipo 2/sangue , Inflamação/sangue , Adulto , Antropometria , Biomarcadores/sangue , Doenças Cardiovasculares/complicações , Cromatografia Líquida , Estudos Transversais , Complicações do Diabetes/sangue , Diabetes Mellitus Tipo 2/complicações , Eletroforese em Gel Bidimensional , Glutationa Peroxidase/sangue , Humanos , Masculino , Pessoa de Meia-Idade , Oxirredução , Estresse Oxidativo , Prognóstico , Proteômica , Proteínas Celulares de Ligação ao Retinol/sangue , Índice de Gravidade de Doença , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz , Espectrometria de Massas em Tandem
19.
Endocrinol Nutr ; 62(5): e47-56, 2015 May.
Artigo em Espanhol | MEDLINE | ID: mdl-25797189

RESUMO

OBJECTIVE: To update previous recommendations developed by the Working Group on Osteoporosis and Mineral Metabolism of the Spanish Society of Endocrinology and Nutrition for the evaluation and treatment of osteoporosis associated to different endocrine and nutritional diseases. PARTICIPANTS: Members of the Working Group on Osteoporosis and Mineral Metabolism of the Spanish Society of Endocrinology and Nutrition. METHODS: Recommendations were formulated according to the GRADE system (Grading of Recommendations, Assessment, Development, and Evaluation) to describe both the strength of recommendations and the quality of evidence. A systematic search was made in MEDLINE (Pubmed) using the following terms associated to the name of each condition: AND "osteoporosis", "fractures", "bone mineral density", and "treatment". Papers in English with publication date between 18 October 2011 and 30 October 2014 were included. The recommendations were discussed and approved by all members of the Working Group. CONCLUSIONS: This update summarizes the new data regarding evaluation and treatment of osteoporosis associated to endocrine and nutritional conditions.


Assuntos
Doenças do Sistema Endócrino/complicações , Doenças Metabólicas/complicações , Minerais/metabolismo , Osteoporose/etiologia , Absorciometria de Fóton , Anorexia Nervosa/complicações , Antineoplásicos Hormonais/efeitos adversos , Densidade Óssea , Osso e Ossos/metabolismo , Neoplasias da Mama/complicações , Neoplasias da Mama/tratamento farmacológico , Complicações do Diabetes , Doenças do Sistema Endócrino/induzido quimicamente , Doenças do Sistema Endócrino/terapia , Feminino , Fraturas Espontâneas/etiologia , Fraturas Espontâneas/prevenção & controle , Humanos , Doenças Inflamatórias Intestinais/complicações , Masculino , Desnutrição/complicações , Doenças Metabólicas/terapia , Osteoporose/diagnóstico por imagem , Osteoporose/terapia , Neoplasias da Próstata/complicações , Neoplasias da Próstata/tratamento farmacológico
20.
PLoS One ; 9(11): e111703, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25369286

RESUMO

OBJECTIVES: Dickkopf-1 (DKK1) is a potent inhibitor of Wnt signalling, which exerts anabolic effects on bone and also takes part in the regulation of vascular cells. Our aims were to evaluate serum DKK1 in type 2 diabetes (T2DM) patients and to analyze its relationships with cardiovascular disease (CVD). We also evaluated the relationship between DKK1 and bone metabolism. DESIGN: We conducted a cross-sectional study in which we measured serum DKK1 (ELISA, Biomedica) in 126 subjects: 72 patients with T2DM and 54 non-diabetic subjects. We analysed its relationship with clinical CVD, preclinical CVD expressed as carotid intima media thickness (IMT), and bone metabolism. RESULTS: T2DM patients with CVD (P = 0,026) and abnormal carotid IMT (P = 0,038) had higher DKK1 concentrations. DKK1 was related to the presence of CVD in T2DM, independently of the presence of risk factors for atherosclerosis. Therefore, for each increase of 28 pg/ml of serum DKK1 there was a 6,2% increase in the risk of CVD in T2DM patients. The ROC curve analysis to evaluate the usefulness of DKK1 as a marker for high risk of CVD showed an area under the curve of 0,667 (95% CI: 0,538-0,795; P = 0,016). In addition, there was a positive correlation between serum DKK1 and spine bone mineral density in the total sample (r =  0,183; P = 0,048). CONCLUSION: In summary, circulating DKK1 levels are higher in T2DM with CVD and are associated with an abnormal carotid IMT in this cross-sectional study. DKK1 may be involved in vascular disease of T2DM patients.


Assuntos
Densidade Óssea , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/complicações , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/complicações , Peptídeos e Proteínas de Sinalização Intercelular/sangue , Doenças Cardiovasculares/metabolismo , Espessura Intima-Media Carotídea , Estudos Transversais , Diabetes Mellitus Tipo 2/metabolismo , Feminino , Humanos , Peptídeos e Proteínas de Sinalização Intercelular/metabolismo , Masculino , Pessoa de Meia-Idade
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