IntroductionMetabolic Syndrome (MetS) is considered a major cause of cardiovascular and other chronic diseases. Advanced glycation end products (AGEs) increase in dysmetabolic conditions. Lifestyle, ...including diet, has shown be effective in preventing the development of MetS.HypothesisWe investigated whether AGEs metabolism is affected by diets with different fat quantity and quality in MetS patients.MethodsSeventy-five patients from LIPGENE cohort were randomly assigned to one of four dietshigh saturated fatty acids (HSFA); high monounsaturated fatty acids (HMUFA) and two low-fat, high complex carbohydrate diets, with or without supplemented with long-chain n-3 polyunsaturated fatty acids (LFHCC n-3 and LFHCC), for 12 weeks each. Total dietary AGEs consumed, serum AGEs methylglyoxal (MG) and N-carboxymethyllysine (CML) levels and AGER1, RAGE, GloxI and Sirt1 mRNA levels were determined after a 12-hour fast and 4 hours after a test meal at the end of the intervention.ResultsHMUFA diet had the lowest and HSFA provided the highest levels of dietary AGEs with an intermediate effect for LFHCC and LFHCC n-3 diets. Fasting and postprandial serum AGEs and mRNA levels of AGER1, GloxI and Sirt1 were lower after HMUFA diet and higher after HSFA diet and were intermediate after both LFHCC and LFHCC n-3 diets (all p < 0.05). Multiple regression analyses showed that sMG and AGER1 mRNA appeared as significant predictors of parameters related to oxidative stress and inflammation.ConclusionsThe low AGEs content in HMUFA diet reduces circulating AGEs and modulates the gene expression related to AGEs metabolism in MetS patients, which may be used as a therapeutic approach to reduce the incidence of MetS and related chronic diseases.
Coronary heart disease (CHD) represents a major global health burden. However, despite the well-known influence that dietary habits exert over the progression of this disease, there are no ...well-established and scientifically sound dietary approaches to prevent the onset of clinical outcomes in secondary prevention. The objective of the CORonary Diet Intervention with Olive oil and cardiovascular PREVention study (CORDIOPREV study, clinical trials number NCT00924937) is to compare the ability of a Mediterranean diet rich in virgin olive oil versus a low-fat diet to influence the composite incidence of cardiovascular events after 7 years in subjects with documented CHD at baseline. For this purpose, we enrolled 1,002 coronary patients from Spain. Baseline assessment (2009-2012) included detailed interviews and measurements to assess dietary, social, and biological variables. Results of baseline characteristics: The CORDIOPREV study in Spain describes a population with a high body mass index (37.2% overweight and 56.3% obesity) and with a median of low-density lipoprotein cholesterol of 88.5 mg/dL (70.6% of the patients having <100 mg/dL and 20.3% patients <70 mg/dL). A total of 9.6% of the participants were active smokers, and 64.4% were former smokers. Metabolic syndrome was present in 58% of this population. To sum up, we describe here the rationale, methods, and baseline characteristics of the CORDIOPREV study, which will test for the first time the efficacy of a Mediterranean diet rich in extra virgin olive oil as compared with a low-fat diet on the incidence of CHD recurrence in a long-term follow-up study.
Background
Ageing and biological senescence, both related to cardiovascular disease, are mediated by oxidative stress and inflammation. We aim to develop a predictive tool to evaluate the degree of ...biological senescence in coronary patients.
Methods
Relative telomere length (RTL) of 1002 coronary patients from the CORDIOPREV study (NCT00924937) was determined at baseline in addition to markers of inflammatory response (hs‐C‐Reactive Protein, monocyte chemoattractant protein‐1, IL‐6, IL‐1β, TNF‐α, adiponectin, resistin and leptin) and oxidative stress (nitric oxide, lipid peroxidation products, carbonylated proteins, catalase, total glutathione, reduced glutathione, oxidized glutathione, superoxide dismutase and peroxidated glutathione). Biological senescence was defined using the cut‐off value defined by the lower quintile of relative telomere length in our population (RTL = 0.7629). We generated and tested different predictive models based on logistic regression analysis to identify biological senescence. Three models were designed to be used with different sets of information.
Results
We selected those patients with all the variables proposed to develop the predictive models (n = 353). Statistically significant differences between both groups (Biological senescence vs. Nonbiological senescence) were found for total cholesterol, catalase, superoxide dismutase, IL‐1β, resistin and leptin. The area under the curve of receiver‐operating characteristic to predict biological senescence for our models was 0.65, 0.75 and 0.72.
Conclusions
These predictive models allow us to calculate the degree of biological senescence in coronary patients, identifying a subgroup of patients at higher risk and who may require more intensive treatment.
Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with ...increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12 months, as compared with usual care.
Design: pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient.
PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain).
patients aged 65-74 years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3 months).
n = 400 (200 per study arm).
complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview.
MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables.
primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle.
It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes.
Clinicaltrials.gov, NCT02866799.
Abstract Coronary heart disease (CHD) represents a major global health burden. However, despite the well-known influence that dietary habits exert over the progression of this disease, there are no ...well-established and scientifically sound dietary approaches to prevent the onset of clinical outcomes in secondary prevention. The objective of the CORonary Diet Intervention with Olive oil and cardiovascular PREVention study (CORDIOPREV study, clinical trials number NCT00924937) is to compare the ability of a Mediterranean diet rich in virgin olive oil versus a low-fat diet to influence the composite incidence of cardiovascular events after 7 years, in subjects with documented CHD at baseline. For this purpose, we enrolled 1002 coronary patients from Spain. Baseline assessment (2009–12) included detailed interviews and measurements to assess dietary, social and biological variables. Results of baseline characteristics: The CORDIOPREV study in Spain describes a population with a high BMI (37.2% overweight and 56.3% obesity), with a median of LDL-cholesterol of 88.5 mg/dL (70.6% of the patients having <100 mg/dL, and 20.3% patients < 70 mg/dL). 9.6% of the participants were active smokers, and 64.4% were former smokers. Metabolic Syndrome was present in 58% of this population. To sum up, we describe here the rationale, methods and baseline characteristics of the CORDIOPREV study, which will test for the first time the efficacy of a Mediterranean Diet rich in extra virgin olive oil as compared with a low-fat diet on the incidence of CHD recurrence in a long term follow-up study.
Acquired von Willebrand syndrome ALVAREZ, M. T.; JIMENEZ-YUSTE, V.; GRACIA, J. ...
Haemophilia : the official journal of the World Federation of Hemophilia,
07/2008, Letnik:
14, Številka:
4
Journal Article
This chapter contains sections titled:
Introduction
Why do haemophiliac's joints bleed while those of patients with other coagulation disorders seldom do?
Clinical features of haemophilic arthropathy
...Treatment of haemophilic arthropathy
Acquired von Willebrand syndrome Alvarez, M T; Jimenez-Yuste, V; Gracia, J ...
Haemophilia : the official journal of the World Federation of Hemophilia,
07/2008, Letnik:
14, Številka:
4
Report
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