In December 2019, 27 cases of pneumonia were reported in Wuhan. In 2020, the causative agent was identified as a virus called SARS-CoV-2. The disease was called "coronavirus disease 2019" (COVID-19) ...and was determined as a Public Health Emergency. The main measures taken to cope with this included a state of lockdown. The aim of this study was to assess how the unhealthy lifestyles that ensued influenced different parameters. A prospective study was carried out on 6236 workers in a Spanish population between March 2019 and March 2021. Anthropometric, clinical, and analytical measurements were performed, revealing differences in the mean values of anthropometric and clinical parameters before and after lockdown due to the pandemic, namely increased body weight (41.1 ± 9.9-43.1 ± 9.9), BMI (25.1 ± 4.7-25.9 ± 4.7), and percentage of body fat (24.5 ± 9.1-26.9 ± 8.8); higher total cholesterol levels, with a statistically significant increase in LDL levels and a reduction in HDL; and worse glucose levels (90.5 ± 16.4-95.4 ± 15.8). Lockdown can be concluded to have had a negative effect on health parameters in both sexes in all age ranges, causing a worsening of cardiovascular risk factors.
ObjectiveThe main aim of the study was to evaluate the association between non-alcoholic fatty liver disease (NAFLD), estimated by fatty liver index (FLI), and the development of type 2 diabetes ...(T2D) in a large cohort of adult workers with pre-diabetes.DesignProspective cohort study.SettingOccupational health services from Spain.Participants16 648 adult workers (aged 20–65 years) with pre-diabetes (fasting plasma glucose (FPG) of 100–125 mg/dL).Outcome and measuresFLI was calculated based on measurements of triglycerides, body mass index, waist circumference and γ-glutamyltransferase. The population was classified into three categories: FLI<30 (no hepatic steatosis), FLI 30–60 (intermediate status) and FLI>60 (hepatic steatosis). Sociodemographic, anthropometric, dietary habits, physical activity and clinical data were collected from all subjects. The incidence rate of T2D was determined after 5 years of follow-up.ResultsAfter 5 years of follow-up, 3706 of the 16 648 participants (22.2%) were diagnosed with T2D, corresponding to an annual rate of progression of 4.5%. FLI was strongly associated with T2D conversion. The incidence rates of T2D in the FLI<30, FLI 30–60 and FLI>60 groups were significantly different after 5 years of follow-up were 19/6,421 (0.3%), 338/4,318 (7.8%) and 3,349/5,909 (56.7%), respectively. This association remained significant for FLI>60 after adjustment for, age, diet, physical activity, FPG, blood pressure, social class and smoking habits (adjusted HR=6.879; 95% CI 5.873 to 8.057 for men, and HR=5.806; 95% CI 4.863 to 6.932 for women).ConclusionNAFLD assessed by FLI independently predicted the risk of conversion to T2D among people with pre-diabetes. FLI may be an easily determined and valuable early predictor for T2D in people with pre-diabetes. FLI-based assessment of NAFLD in subjects with pre-diabetes in routine clinical practice could allow the adoption of effective measures to prevent and reduce their progression to T2D.
Myo-inositol hexaphosphate (phytate; IP6) is a natural compound that is abundant in cereals, legumes, and nuts, and it can bind to crystal surfaces and disturb crystal development, acting as ...crystallization inhibitor. The adsorption of such inhibitors to crystal faces can also inhibit crystal dissolution. The binding of phytate to metal cofactors suggests that it could be used for treatment of osteoporosis. Our in-vitro study showed that phytate inhibits dissolution of hydroxyapatite (HAP). The effect of phytate was similar to that of alendronate and greater than that of etidronate. This led us to perform a cross-sectional study to investigate the impact of consumption of IP6 on bone mineral density (BMD) in post-menopausal women. Our data indicate that BMD and t-score of lumbar spine increased with increasing phytate consumption, and a phytate consumption higher than 307 mg/day was associated with a normal BMD (t-score > −1). These data suggest that phytate may have a protective effect in bone decalcification by adsorbing on the surfaces of HAP, and a daily consumption of phytate-rich foods (at least one serving/day of legumes or nuts) may help to prevent or minimize bone-loss disorders, such as osteoporosis. However, further studies are needed to gain a better understanding about the mechanism of inhibition of phytate in bone-related diseases (see graphical abstract).
Atherogenic dyslipidaemia (AD) and lipid triad (LT) are characterised by high triglyceride levels together with low HDL and normal or high LDL cholesterol and are favoured by a persistent state of ...insulin resistance (IR), which increases the release of free fatty acids from abdominal adipose tissue. This alteration in the lipid profile favours the accelerated development of atherosclerosis, which is the most important cause of morbidity and mortality in all countries in the developed and developing world. One of the elements that plays a major role in the genesis of AD is IR. The aim of this study was to determine the relationship between variables that assess atherogenic risk (AD and LT) and scales that assess the risk of presenting insulin resistance.
A descriptive cross-sectional study of 418,343 workers was conducted to evaluate atherogenic dyslipidaemia and lipid triad; a relationship with three insulin resistance risk scales (Triglycerides/HDL, TyG index, METS-IR) was established. The usefulness of IR risk scales for predicting AD and LT was calculated by applying ROC curves, obtaining the area under the curve (AUC) and cut-off points with their sensitivity, specificity, and Youden index. Multivariate analysis was performed by binary logistic regression.
The prevalence of high-risk values for insulin resistance with all of the scales is much higher in people with AD and LT compared to those without. The ROC curves present us with an AUC with the three insulin resistance risk scales for the two dyslipidaemias studied with figures ranging between 0.856 and 0.991, which implies that the results are good/very good.
A relationship between atherogenic dyslipidaemia and the three insulin resistance risk scales assessed is revealed, with higher IR mean values and prevalence in people with atherogenic dyslipidaemia and lipid triad. The three scales make it possible to adequately classify the presence of AD and LT. The highest AUC is presented by the triglycerides/HDL scale, with a result close to 1. METS-IR is the most recommended formula to estimate insulin resistance.
A significant number of health care professionals subjected to high-risk situations have been infected by Covid-19 due to the lack of adequate protection equipment or the deficient safety margins ...that these present. The aim of this study was to investigate whether the use of a personal peripheral sealing device (PSD) on surgical face masks (SM) allows them to achieve double mask properties, by providing two-way protection to professionals or users. The proposed device is a thermoplastic resin ring composed of a reusable and biodegradable polylactic acid (PLA) designed to be used in a healthcare setting. Since it is a thermoplastic device, it can be molded and adapted to each individual, becoming personalized and ensuring a correct adjustment to the user's face. First, a qualitative fit test was performed using a saccharin solution (SS) to evaluate respiratory protective equipment in recruited professionals exposed to high-risk situations of infection by Covid-19. Individuals were divided into an intervention group, who used SM with the PSD, and a control group, who used SM without the PSD. In addition, a quantitative inward air leakage fit test was performed using a 2% sodium chloride (NaCl) aerosol in a sealed cabinet with probes sensitive to this substance, in order to validate the SM with the PSD as a Face Filtering Mask (FFP). Only 5% of the individuals who performed the qualitative fit test with the PSD perceived the sweet taste of the SS, while 100% of the individuals who performed the test without the PSD sensed it (p = 0.0001). In the quantitative fit test, the percentage of air leakage of 2% NaCl aerosol into the SM with the PSD was 6.5%, achieving the same range of air leakage as a FFP mask. Thus, the use of a personalized PLA thermoplastic PSD, together with an inexpensive and widely available SM, could have a significant impact in terms of preventive safety by providing bi-directional protection to its user.
This study tests the relationships between workaholism (i.e. working excessively and compulsively), sleep problems and cardiovascular risk in 537 employees from five Spanish hospitals. Four types of ...worker (i.e. workaholics, positive workers, compulsive workers and hard workers) were distinguished, and their health indicators were compared. The results showed that workaholics experienced significantly more sleep problems (i.e. morning tiredness, sleeping while driving and sleeping fewer hours both on weekdays and at weekends, with poorer quality), had higher relative risk scores, and consumed more caffeine and alcohol than the other patterns of worker (positive, compulsive and hard workers). Further analyses revealed that sleep problems fully mediated the relationship between workaholism (i.e. working excessively and compulsively) and cardiovascular risk. The study emphasizes the fact that being a workaholic might be a significant risk factor for having sleep problems and cardiovascular disease.
There are multiple formulas for estimating the percentage of body fat (BF%). Clínica Universidad de Navarra-Body Adiposity Estimator (CUN-BAE) is one of the most used formulas because of its accuracy ...and its association with cardiovascular pathologies. Equation Córdoba for Estimation of Body Fat (ECORE-BF) was developed to simplify the calculation of BF% while maintaining a similar level of accuracy. The objective was to compare ECORE-BF in a large sample of Spanish workers using CUN-BAE as a reference. A cross-sectional study was carried out on 196,844 participants. The BF% was estimated using different formulas: relative fat mass (RFM), Palafolls, Deurenberg, and ECORE-BF. The accuracy of the estimation was determined using Lin's concordance correlation coefficient (CCC) and the Bland-Altman method, using CUN-BAE as the reference method. ECORE-BF reached the highest concordance (CCC = 0.998). It also showed the lowest mean difference (-0.0077) and the tightest agreement limits (-0.9723, 0.9569) in the Bland-Altman test. In both analyses, it remained robust even when separating the analyses by sex, nutritional status, or age. ECORE-BF presented as the most straightforward and most accurate equation for the estimation of BF%, remaining robust regardless of population characteristics.
ObjectivesA non-invasive method for the early detection of metabolic syndrome (NIM-MetS) using only waist-to-height ratio (WHtR) and blood pressure (BP) has recently been published, with fixed ...cut-off values for gender and age. The aim of this study was to validate this method in a large sample of Spanish workers.DesignA diagnostic test accuracy to assess the validity of the method was performed.SettingOccupational health services.ParticipantsThe studies were conducted in 2012–2016 on a sample of 60 799 workers from the Balearic Islands (Spain).InterventionsThe NCEP-ATP III criteria were used as the gold standard. NIM-MetS has been devised using classification trees (the χ2 automatic interaction detection method).Main outcome measuresAnthropometric and biochemical variables to diagnose MetS. Sensitivity, specificity, validity index and Youden Index were determined to analyse the accuracy of the diagnostic test (NIM-MetS).ResultsWith regard to the validation of the method, sensitivity was 54.7%, specificity 94.9% and the Validity Index 91.2%. The cut-off value for WHtR was 0.54, ranging from 0.51 (lower age group) to 0.56 (higher age group). Variables more closely associated with MetS were WHtR (area under the curve (AUC)=0.85; 95% CI 0.84 to 0.86) and systolic BP (AUC=0.79; 95% CI 0.78 to 0.80)). The final cut-off values for the non-invasive method were WHtR ≥0.56 and BP ≥128/80 mm Hg, which includes four levels of MetS risk (very low, low, moderate and high).ConclusionsThe analysed method has shown a high validity index (higher than 91%) for the early detection of MetS. It is a non-invasive method that is easy to apply and interpret in any healthcare setting. This method provides a scale of MetS risk which allows more accurate detection and more effective intervention.
Fatty Liver Index (FLI) is strongly associated with changes in glycemic status and incident Type 2 Diabetes (T2D). The probability of reverting to normoglycemia from a state prediabetes could be ...determined by FLI, however such relationship remains poorly understood.
To determine the clinical interest of using FLI to estimate prediabetes reversion at 5 years in patients with impaired fasting plasma glucose at baseline, and identify those factors associated with changes in FLI, that could contribute to the reversion of prediabetes.
This 5-year cohort study included 16,648 Spanish working adults with prediabetes. Prediabetes was defined as fasting plasma glucose (FPG) between 100 and 125 mg/dl according to the ADA criteria, while prediabetes reversion was defined as a FPG <100 mg/dL. The population was classified as: FLI <30 (no hepatic steatosis), FLI 30-59 (intermediate status), and FLI ≥60 (hepatic steatosis).
At 5 years follow-up, 33.7% of subjects reverted to normoglycemia (annual rate of 6.7%). The adjusted binomial logistic regression model showed that scoring FLI <30 (OR 1.544; 95% CI 1.355-1.759), performing at least 150 min/week of physical activity (OR 4.600; 95% CI 4.088-5.177) and consuming fruits and vegetables daily (OR 1.682; 95% CI 1.526-1.855) were associated with the probability of reverting form prediabetes to normoglycemia. The ROC curve for prediction of reversion showed that FLI (AUC 0.774;95% CI 0.767-0.781) was a better predictor than FPG (AUC 0.656; 95% CI 0.648-0.664).
Regular physical activity, healthy dietary habits and absence of hepatic steatosis are independently associated with the probability of reversion to normoglycemia in adult workers with prediabetes at baseline. Low FLI values (especially FLI< 30) may be useful to predict the probability of prediabetes reversion, especially in active subjects with healthy eating habits, and thus identify those who might benefit from early lifestyle intervention.
Type 2 diabetes is considered a worldwide public health problem due to its high prevalence and the important complications it causes.
To assess the influence of healthy habits, especially physical ...activity and diet, on the risk of type 2 diabetes.
Descriptive and cross-sectional study in 1457 Spanish workers in which the influence of different sociodemographic variables and lifestyle habits such as tobacco consumption, physical activity and adherence to the Mediterranean diet in relation to the risk of presenting type 2 diabetes assessed with the Finrisk and Leicester scales was evaluated.
The prevalence of moderate and high values of the Finrisk and Leicester scales decreased as the level of physical activity assessed with the IPAQ questionnaire increased and as adherence to the Mediterranean diet increased. In the multivariate analysis by binary logistic regression, high age, male sex, less favoured social class, low level of physical activity and low adherence to the Mediterranean diet influence the increase in the prevalence of high diabetes risk values, while tobacco consumption shows a protective effect.
Physical exercise and the Mediterranean diet have a beneficial effect on the risk of presenting type 2 diabetes with Finrisk and Leicester scales.
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