Showing papers by "Juan F. Ascaso published in 2006"
TL;DR: Differences between groups regarding results of cardiovascular autonomic tests and oesophageal studies were statistically analysed and it was found that increase in simultaneous waves and impaired relaxation of LOS are more frequent in diabetic patients with CVAN.
Abstract: The relationship between cardiovascular autonomic neuropathy (CVAN) and oesophageal dysfunction in diabetes mellitus has not been well established because reports are contradictory. The aim of this study was to assess oesophageal function and its correlation with CVAN in type 1 diabetic patients without oesophageal symptoms. Forty-six type 1 diabetic patients without oesophageal symptoms (DG) and 34 healthy volunteers (CG) were studied. Both groups underwent CVAN tests and oesophageal manometry and pH-metry. Differences between groups regarding results of cardiovascular autonomic tests and oesophageal studies were statistically analysed. Compared with the CG, the DG group showed insufficient lower oesophageal sphincter (LOS) relaxation and a higher percentage of simultaneous waves (P 10%), and the prevalence of simultaneous waves related to the degree of autonomic neuropathy was: 9% of patients without CVAN, 7% of those suspected to have it and 50% of patients with CVAN (P 10%) were the presence of CVAN and duration of diabetes (P < 0.05, logistic regression analysis). Increase in simultaneous waves and impaired relaxation of LOS are more frequent in diabetic patients with CVAN.
21 citations
TL;DR: Moderate aerobic exercise increases insulin sensitivity in nonobese, nondiabetic subjects in the absence of significant changes in weight, BMI, waist-hip ratio, lipid profile, and oxygen consumption.
Abstract: OBJECTIVE: To study the effect of a moderate, aerobic physical exercise program on insulin resistance and its accompanying metabolic changes in a group of healthy, middle-age, nonobese subjects, without modifying oxygen consumption and body weight. DESIGN: The inclusion of subjects was carried out among volunteers from the health personnel of our center, who complied with the inclusion criteria. PARTICIPANTS: Twelve subjects (age 30-60 years, 5 females), nonsmokers, body mass index (BMI) <27 kg/m2 and fasting plasma glucose <6.1 mmol/L. INTERVENTIONS: Insulin resistance was assessed using the Bergmann minimal model modified with insulin, and basal and maximum metabolic rate were measured with standard methods. All subjects completed a 2-month program of aerobic exercise using the American College of Sports Medicine guidelines, consisting of aerobic exercise of moderate, regular, and continual intensity (3 times per week), with a duration of 45 to 50 minutes per session. RESULTS: Following controlled exercise, no significant differences in BMI, waist-hip ratio, blood pressure, lipids, free fatty acids, and leptin plasma values were observed. Plasma glucose and insulin values decreased significantly (-0.37 mmol/L and -16.5 pmol/L, respectively). Insulin sensitivity showed an increase of 2.1 x 10(-4) mU L(-1) min(-1) (P = 0.001). Basal and maximum metabolic rate showed no significant differences after the exercise program. CONCLUSIONS: Moderate aerobic exercise increases insulin sensitivity in nonobese, nondiabetic subjects in the absence of significant changes in weight, BMI, waist-hip ratio, lipid profile, and oxygen consumption.
19 citations
TL;DR: The results indicate that the adequate procedure to identify LDLR sequence variations in outbreed populations should include screening of the entire gene.
Abstract: Background: Familial hypercholesterolemia (FH) is a frequent form of autosomal-dominant hypercholesterolemia that predisposes to premature coronary atherosclerosis. FH is caused by sequence variations in the gene coding for the LDL receptor (LDLR). This gene has a wide spectrum of sequence variations, and genetic diagnosis can be performed by 2 strategies. Methods: Point variations and large rearrangements were screened along all the LDLR gene (promoter, exons, and flanking intron sequences). Results: We screened a sample of 129 FH probands from the Valencian Community, Spain, and identified 54 different LDLR sequence variations. The most frequent (10% of cases) was 111insA, and 60% of the variants had a frequency as low as 1%. A previously described method for detection of known sequence variations in the Spanish population by DNA array analysis allowed the identification of only 50% of patients with a variant LDLR gene and 40% of the screened samples. Conclusion: Our results indicate that the adequate procedure to identify LDLR sequence variations in outbreed populations should include screening of the entire gene.
16 citations
TL;DR: Using the low‐density‐lipoprotein receptor (LDLR) gene, whose mutations are responsible for familial hypercholesterolemia, a procedure to detect large rearrangements in this gene based on semiquantitative PCR is developed, with important improvements as compared to previous methods.
Abstract: Methods presently employed for detection of large rearrangements have several drawbacks, such as the amount of sample and time required, technical difficulty, or the probability of false-negative carriers. Using the low-density-lipoprotein receptor (LDLR) gene, whose mutations are responsible for familial hypercholesterolemia (FH), we have developed a procedure to detect large rearrangements in this gene based on semiquantitative PCR, with important improvements as compared to previous methods. Our method covers the complete LDLR gene and introduces an internal control in the reaction. The procedure discriminates the four different large rearrangements (two deletions and two insertions) that we have used as positive mutation controls (Valencia-1 to -5). All altered exons from each rearrangement are identified. Furthermore, when families from probands carrying these large rearrangements (34 members) were analyzed, our results agreed with those obtained previously with Southern blot. We have also analyzed a sample of 110 unrelated FH probands and the method has correctly identified the two different large rearrangements present and insertions or deletions as small as 1 bp. In conclusion, the method we present allows the identification of large rearrangements affecting exons of the gene, including small insertions or deletions or complete gene deletion. In addition, it constitutes a first characterization step of rearrangements, and is easy to carry out fast, and can be applied to the analysis of any gene.
14 citations
11 citations
TL;DR: Un reciente informe conjunto de la American Diabetes Association and the European Association for the Study of Diabetes, se efectúa una serie of puntualizaciones sobre el concepto of SM2, un precursor identificable y corregible of the diabetes tipo 2 y of the enfermedad cardiovascular1.
8 citations
TL;DR: La definicion del SM segun los criterios IDF o ATP-III identifica por igual a los sujetos con dislipemia aterogenica, con aumento del c-no-HDL, del indice CT:cHDL y of the apolipoproteina B, y that by ello presentan un elevado riesgo cardiovascular.
Abstract: Fundamento y objetivo Averiguar si el diagnostico de sindrome metabolico (SM) definido por los criterios de la International Diabetes Federation (IDF) en 2005 identifica a un mayor numero de sujetos con dislipemia aterogenica de elevado riesgo cardiovascular que los criterios del National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP-III). Pacientes y metodo Estudiamos a una poblacion de 344 sujetos no diabeticos (158 varones y 186 mujeres), de edades comprendidas entre 20 y 70 anos, seleccionados por un metodo de muestreo simple aleatorio entre los que consultaron durante un ano en un centro de salud en el area metropolitana de Valencia (metodo de busqueda oportunista). Se estudiaron parametros antropometricos, cifras de presion arterial, de lipidos plasmaticos –entre ellos, colesterol no unido a lipoproteinas de alta densidad (c-no-HDL), indice colesterol total:colesterol unido a lipoproteinas de alta densidad (CT:cHDL)–, de glucosa e insulina plasmatica y el valor del indice HOMA (Homeostasis Model Assessment). Resultados Al separar a los sujetos basandonos en la definicion del SM segun criterios IDF o ATP-III, identificamos a un grupo con importantes alteraciones lipidicas de riesgo cardiovascular: aumento del c-no-HDL, del CT:cHDL y de la apolipoproteina B. El indice CT:cHDL fue mayor o igual a 6 en el 28,6% de los sujetos con SM-IDF y solo en el 9,4% de los sujetos sin SM-IDF (p Conclusiones La definicion del SM segun los criterios IDF o ATP-III identifica por igual a los sujetos con dislipemia aterogenica, con aumento del c-no-HDL, del indice CT:cHDL y de la apolipoproteina B, y que por ello presentan un elevado riesgo cardiovascular.
6 citations
TL;DR: Estudia la relacion entre sindrome metabolico (SM) e infarto agudo de miocardio (IAM) en la hiperlipidemia familiar combinada (HFC) y determinaron los lipidos, the glucosa y the insulina en plasma y the presencia of SM definido por criterios oficiales de the Organizacion Mundial de the Salud (OMS).
Abstract: Se estudia la relacion entre sindrome metabolico (SM) e infarto agudo de miocardio (IAM) en la hiperlipidemia familiar combinada (HFC). Se comparan 20 sujetos varones con HFC supervivientes a IAM con otras 2 series de sujetos emparejados por edad e indice de masa corporal (IMC): 20 individuos con HFC que no han presentado IAM y 20 controles sanos. Se determinaron los lipidos, la glucosa y la insulina en plasma y la presencia de SM definido por criterios de la Organizacion Mundial de la Salud (OMS) y National Cholesterol Education Program-Adults Treatment Panel (NCEP-ATP-III). El SM definido por criterios OMS se encontro en 19 sujetos con HFC e IAM, en 11 sujetos con HFC sin IAM y en 6 controles (p
4 citations
TL;DR: Investigating the relationship between metabolic syndrome and cardiovascular disease in patients with familial combined hyperlipidemia found presence of the metabolic syndrome, as defined by WHO criteria, is a marker of cardiovascular risk in individuals with FCH.
Abstract: Our aim was to investigate the relationship between metabolic syndrome and cardiovascular disease (i.e., survivors of myocardial infarction) in patients with familial combined hyperlipidemia (FCH). We compared a group of 20 male patients with FCH who had survived a myocardial infarction with two other groups matched for age and body mass index, comprising 20 individuals with FCH who had not had a myocardial infraction and 20 control subjects. Plasma lipid, glucose, and insulin levels were determined. Metabolic syndrome was judged to present on the basis of World Health Organization (WHO) and National Cholesterol Education Program-Adult treatment panel (NCEP-ATPIII) criteria. Differences between the groups were evaluated using non-parametric tests and the association between ischemic coronary disease and other parameters was assessed by logistic regression analysis. According to WHO criteria, the metabolic syndrome was present in 19 FCH patients who had survived a myocardial infarction, in 11 individuals with FCH who had not had a myocardial infraction, and in six control subject (P<.001); the difference between FCH patients with and without myocardial infarction was significant (P<.01). Presence of the metabolic syndrome, as defined by WHO criteria, is a marker of cardiovascular risk in individuals with FCH.
4 citations
TL;DR: Las mujeres sanas normolipidemicas no diabeticas presentaron una menor lipemia posprandial que los hombres, probablemente por el efecto de los estrogenos sobre el metabolismo lipidico.
Abstract: Introduccion Un nuevo metodo basado en la autodeterminacion de trigliceridos (TG) capilares permite un mejor conocimiento de la lipemia posprandial (LP). Los objetivos de nuestro estudio son analizar el efecto del genero y la obesidad sobre la LP valorada por medicion capilar de TG diurnos mediante Accutrend GCT® en sujetos sanos y sujetos con hiperlipemia familiar combinada (HFC). Material y metodos Hemos estudiado a 23 sujetos con HFC no relacionados entre si (10 hombres) y a 45 sujetos (29 hombres) normolipidemicos no diabeticos. Todos ellos realizaron tres perfiles diarios de TG capilares durante una semana. Resultados En los sujetos sanos normolipidemicos no diabeticos encontramos valores significativamente elevados en el perfil de TG capilares y area bajo la curva de TG capilares (ABCTGc) (25,25±9,09 frente a 19,71±6,16 mmolh/l) en el grupo de hombres frente al de las mujeres. En sujetos con HFC no se hallaron estas diferencias y el ABCTGc se correlaciono con el indice de masa corporal (IMC) (r=0,510; p Discusion Las mujeres sanas normolipidemicas no diabeticas presentaron una menor lipemia posprandial que los hombres, probablemente por el efecto de los estrogenos sobre el metabolismo lipidico. La obesidad ejercia un efecto negativo sobre la lipemia posprandial, tanto en sujetos sanos como en sujetos con HFC.
4 citations
TL;DR: El sindrome metabolico es el conjunto de alteraciones metabolicas y cardiovasculares que estan relacionadas with la resistencia a la insulina y the obesidad abdominal, y es evidente that el alto riesgo cardiovascular that tienen estos sujetos requiere medidas energicas globales para reducir the resistencia.