[Erectile dysfunction as a marker of silent cardiovascular disease in type-2 diabetic patients in Spain. The DIVA (DIabetes and VAscular disease) study]. / Disfunción eréctil como marcador de vasculopatía en la diabetes mellitus tipo 2 en España. Estudio DIVA.

BACKGROUND AND OBJECTIVES: Erectile dysfunction (ED) is a sign of vascular disease in type 2 diabetic patients. The present subanalysis of the DIVA Registry, whose main objective was to estimate the prevalence of clinical vascular disorder and silent vascular disorder, as well as risk factors in type 2 diabetic patients treated in Spain, aims to analyze the relationship between those data and the prevalence of ED in these patients. PATIENTS AND METHODS: A total of 2444 type 2 diabetic patients (56% male; mean age 65.2 years) attended by 387 cardiologists and endocrinologists at ambulatory care were included. RESULTS: Coronary heart disease was present in 37% of the patients, cerebrovascular disease in 12%, and peripheral arterial disease in 13%. Forty percent of male patients had ED (according to the IIEF criteria), although in this group, as compared to those patients without ED, the prevalence of cardiovascular disease and signs of subclinical vascular disorder (microalbuminuria and abnormal ankle/brachial index (ABI)) was higher. The only independent predictor of ED was left ventricular hypertrophy (OR 5.2; 95% CI: 1.1-24.1; P=.03), with the ABI <0,9 being of borderline significance (OR 5.9; 95% CI: 0.9-39.9; P=.06). Poor glycemic and lipemic control (P<.05 in both cases) as well as cerebrovascular and peripheral arterial disease (P<.01 in both cases) and renal dysfunction (P<.001) were all more frequent among patients with severe ED. CONCLUSIONS: Forty percent of diabetic patients suffer from ED. The results of this study suggest that ED may be considered as an atherosclerosis marker and could be included in algorithms for risk stratification and subclinical vascular disorder detection.

Cushing's disease in 2012.

The aim of this study was to review the literature published and the most important papers presented to meetings on Cushing's disease from October 2011 to September 2012. The selection has been performed according to the authors' criteria. Articles have been classified into five groups: quality of life and perception of the disease, clinical features and pathophysiology, comorbidity conditions, diagnosis, and treatment. The results and conclusions of each publication are discussed.

La enfermedad de Cushing en 2012 / Cushing's disease in 2012

El objetivo de este trabajo es una revisión de los trabajos publicados y las principales comunicaciones a congresos sobre la enfermedad de Cushing desde octubre de 2011 a septiembre de 2012. La selección de los trabajos se ha realizado bajo el criterio de los autores y han sido agrupados en los apartados siguientes: percepción de la enfermedad y calidad de vida, clínica y fisiopatología, comorbilidades, diagnóstico y tratamiento. Se comentan los resultados y las conclusiones de cada trabajo

The aim of this study was to review the literature published and the most important papers presented to meetings on Cushing's disease from October 2011 to September 2012. The selection has been performed according to the authors’ criteria. Articles have been classified into five groups: quality of life and perception of the disease, clinical features and pathophysiology, comorbidity conditions, diagnosis, and treatment. The results and conclusions of each publication are discussed

Disfunción eréctil como marcador de vasculopatía en la diabetes mellitus tipo 2 en España. Estudio DIVA / Erectile dysfunction as a marker of silent cardiovascular disease in type-2 diabetic patients in Spain. The DIVA (Diabetes and Vascular disease) study

Fundamento y objetivo: la disfunción eréctil (DE) es un signo de enfermedad vascular en los sujetos con diabetes mellitus tipo 2 (DM2). El objetivo principal del estudio DIVA (por las letras iniciales de diabetes y vasculopatía) fue estimar la prevalencia de vasculopatía clínica y asintomática, así como la prevalencia de factores de riesgo en los sujetos diabéticos atendidos por especialistas en España; en él se analizó la relación de los datos citados con la prevalencia de DE. Pacientes y método: registro transversal compuesto por 2.444 sujetos consecutivos (56% varones con una edad media de 65,2 años) diagnosticados de DM2, atendidos en consulta por 387 cardiólogos y endocrinólogos. Resultados: el 37% de los sujetos presentaba cardiopatía isquémica, el 12% presentaba enfermedad cerebrovascular (ECRV) y el 13% presentaba arteriopatía periférica. El 40% de los varones tenía DE (según criterios del Índice internacional de la función eréctil), aunque en comparación con los grupos que no presentaban DE, en este grupo la enfermedad cardiovascular era significativamente más prevalente, así como los signos de vasculopatía subclínica (albuminuria e índice tobillo-brazo [ITB] anormal). El único factor predictor de DE independiente de otras variables de confusión fue la hipertrofia ventricular izquierda (riesgo relativo [RR] de 5,2; intervalo de confianza [IC] del 95%: 1,1¿24,1; p=0,03); el ITB fue menor que 0,9 de significación limítrofe (RR de 5,9; IC de 95%: 0,9¿39,9; p=0,06). El mal control glucémico y lipídico (p<0,05 en ambos casos) así como la presencia de ECRV, de enfermedad arterial periférica (p<0,01 en ambos casos) y de disfunción renal (p<0,001) eran más prevalentes en sujetos con DE grave. Conclusiones: el 40% de los varones diabéticos presenta DE. Los resultados de este estudio demuestran que la DE puede considerarse como marcador de aterosclerosis e incluirse en los algoritmos de estratificación de riesgo y detección de vasculopatía asintomática (AU)

Background and objectives: Erectile dysfunction(ED) is a sign of vascular disease in type 2 diabetic patients. The presents ubanalys is of the DIVA Registry, whos emain objective wast o estimate the prevalence of clinical vascular disorder and silent vascular disorder, as well as risk factors in type2diabetic patients treated in Spain, aims to analyze the relationship between those data and the prevalence of ED in these patients. Patients and Methods: A total of 2444 type 2 diabetic patients (56%male; meanage 65.2 years) attended by 387 cardiologists and endocrinologists at ambulatory care were included. Results: Coronary heart disease was present in 37%of the patients, cerebrovascular disease in12%,and peripheral arterial disease in 13%. Forty percent of male patients had ED (according to the IIEF criteria),although in this group, as compared to those patients without ED, the prevalence of cardiovascular disease and signs of subclinical vascular disorder (microalbuminuria and abnormalankle/brachialindex (ABI)) was higher. The only independent predictor of ED was left ventricular hypertrophy (OR5.2;95%CI: 1.1–24.1; P ¼ .03), with the ABI o0,9 being of border line significance (OR5.9;95%CI:0.9–39.9;P ¼ .06).Poor glycemic and lipemic control (Po.05 in both cases)as well as cerebrovascular and peripheral arterial disease (Po.01inbothcases) and renaldys function (Po.001)were all more frequent among patients with severe ED. Conclusions: Forty percent of diabetic patients suffer from ED. The results of this study suggest that EDmay be considered as an at hero sclerosis marker and could be included in algorithms for risk stratification and subclinical vascular disorder detection (AU)