RESUMEN
BACKGROUND: Telomere Length (TL), a marker of cellular aging, holds promise as a biomarker to elucidate the molecular mechanism of diabetes. This study aimed to investigate whether shorter telomeres are associated with a higher risk of type 2 diabetes mellitus (T2DM) incidence in patients with coronary heart disease; and to determine whether the most suitable dietary patterns, particularly a Mediterranean diet or a low-fat diet, can mitigate the development of diabetes in these patients after a follow-up period of five years. METHODS: The CORonary Diet Intervention with Olive oil and cardiovascular PREVention study (CORDIOPREV study) was a single-centre, randomised clinical trial done at the Reina Sofia University Hospital in Córdoba, Spain. Patients with established coronary heart disease (aged 20-75 years) were randomly assigned in a 1:1 ratio by the Andalusian School of Public Health to receive two healthy diets. Clinical investigators were masked to treatment assignment; participants were not. Quantitative-PCR was used to assess TL measurements. FINDINGS: 1002 patients (59.5 ± 8.7 years and 82.5% men) were enrolled into Mediterranean diet (n = 502) or a low-fat diet (n = 500) groups. In this analysis, we included all 462 patients who did not have T2DM at baseline. Among them, 107 patients developed T2DM after a median of 60 months. Cox regression analyses showed that patients at risk of short telomeres (TL < percentile 20th) are more likely to experience T2DM than those at no risk of short telomeres (HR 1.65, p-value 0.023). In terms of diet, patients at high risk of short telomeres had a higher risk of T2DM incidence after consuming a low-fat diet compared to patients at no risk of short telomeres (HR 2.43, 95CI% 1.26 to 4.69, p-value 0.008), while no differences were observed in the Mediterranean diet group. CONCLUSION: Patients with shorter TL presented a higher risk of developing T2DM. This association could be mitigated with a specific dietary pattern, in our case a Mediterranean diet, to prevent T2DM in patients with coronary heart disease. TRIAL REGISTRATION: Clinicaltrials.gov number NCT00924937.
Asunto(s)
Enfermedades Cardiovasculares , Enfermedad Coronaria , Diabetes Mellitus Tipo 2 , Dieta Mediterránea , Femenino , Humanos , Masculino , Biomarcadores , Enfermedades Cardiovasculares/epidemiología , Enfermedad Coronaria/diagnóstico , Enfermedad Coronaria/epidemiología , Enfermedad Coronaria/genética , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/epidemiología , Diabetes Mellitus Tipo 2/genética , Telómero , Adulto Joven , Adulto , Persona de Mediana Edad , AncianoRESUMEN
BACKGROUND: Cardiovascular diseases (CVD), including coronary heart disease (CHD), display a higher prevalence in men than women. This study aims to evaluate the variations in the intestinal microbiota between men and women afflicted with CHD and delineate these against a non-CVD control group for each sex. METHODS: Our research was conducted in the framework of the CORDIOPREV study, a clinical trial which involved 837 men and 165 women with CHD. We contrasted our findings with a reference group of 375 individuals (270 men, 105 women) without CVD. The intestinal microbiota was examined through 16S metagenomics on the Illumina MiSeq platform and the data processed with Quiime2 software. RESULTS: Our results showed a sex-specific variation (beta diversity) in the intestinal microbiota, while alpha-biodiversity remained consistent across both sexes. Linear discriminant analysis effect size (LEfSe) analysis revealed sex-centric alterations in the intestinal microbiota linked to CVD. Moreover, using random forest (RF) methodology, we identified seven bacterial taxa-g_UBA1819 (Ruminococcaceae), g_Bilophila, g_Subdoligranulum, g_Phascolarctobacterium, f_Barnesiellaceae, g_Ruminococcus, and an unknown genus from the Ruminococcaceae family (Ruminococcaceae incertae sedis)-as key discriminators between men and women diagnosed with CHD. The same taxa also emerged as critical discriminators between CHD-afflicted and non-CVD individuals, when analyzed separately by sex. CONCLUSION: Our findings suggest a sex-specific dysbiosis in the intestinal microbiota linked to CHD, potentially contributing to the sex disparity observed in CVD incidence. Trial registration Clinical Trials.gov.Identifier NCT00924937.
The frequency with which cardiovascular diseases occur differs in men and women as it appears with greater frequency in men. Moreover, it has been known for years that the community of bacteria living in our intestine, also known as the gut microbiota, influences the development of these diseases. Indeed, nowadays it known the influence of the intestinal microbiota in the development of atherosclerosis, the pathological process which is responsible for the three main causes of cardiovascular diseases: coronary heart disease, cerebrovascular disease and peripheral arterial disease. This study shows the differences in the community of bacteria living in the gut of men and those living in the gut of women, so that these differences could explain, at least in part, the differences in the frequency with which cardiovascular diseases appear between men and women. Our results suggest that the dysbiosis of the intestinal microbiota associated with CHD seems to be partially sex-specific, which may influence the sexual dimorphism in its incidence. Moreover, the identification of the mechanisms responsible for sexual dimorphism in the incidence of metabolic and cardiovascular disease is of particular importance when developing effective strategies and therapies aimed at reducing their incidence and recurrence. Indeed, the strategies and therapies used to treat the dysbiosis of the gut microbiota should be sex-specific.
Asunto(s)
Enfermedades Cardiovasculares , Microbioma Gastrointestinal , Masculino , Humanos , Femenino , Enfermedades Cardiovasculares/epidemiología , Caracteres Sexuales , Bacterias , IncidenciaRESUMEN
La interacción de las enfermeras con las demás personas en el desarrollo de suejercicio profesional puede ser una fuente de estrés laboral.Objetivo: describir las dificultades de comunicación percibidas por las enfermerascon los pacientes, familiares y equipos de trabajo.Diseño de estudio descriptivo transversal, con una muestra de 59 enfermeras delComplejo Hospitalario de Ourense, pertenecientes a varios servicios de hospitalizaciónde enfermos agudos.Metodología: cuestionario autoadministrado conteniendo variables demográficasy valoración de los niveles de dificultad percibida en tres áreas de relación, segúnpropuesta de Ulla et al (2002).Resultados: las enfermeras perciben más dificultades para comunicarse con losfamiliares próximos al paciente y menos para la relación con el equipo de trabajo,aunque en este área es mayor la dificultad para comunicarse con el médico.Los hombres perciben menos problemas de comunicación. Con la edad mejora lapercepción de la comunicación con el paciente y familia y empeora con los miembrosdel equipo
The interaction of nurses with other individuals during the performance of their professionalduties can be a source of professional stress.Objective: to describe communication difficulties the nurse may experience withpatients, relatives and their colleagues.This is a cross-sectional, descriptive study conducted on a sample of 59 nurses froma hospital in Ourense, working at hospitalisation wards and Acute Care Unit.Methodology: self-administered questionnaire containing demographic variablesand evaluation of the level of difficulty perceived in three interaction/relationshipareas, according to Ulla et al proposal.Results: nurses find it more difficult to communicate with relatives close to the patientand less difficult to communicate with other members of their team, eventhough it must be mentioned that within this group, communication with thephysician is the hardest. Men perceived fewer communication problems. Withage, communication is perceived to improve with the patient and family and to worse with colleagues (AU)