429 resultados para Malalties coronàries-Factor de risc, Metabolisme-Malalties


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Ensuring the accuracy of dietary assessment instruments is paramount for interpreting diet-disease relationships. The present study assessed the relative and construct validity of the 14-point Mediterranean Diet Adherence Screener (MEDAS) used in the Prevencio´n con Dieta Mediterra´nea (PREDIMED) study, a primary prevention nutrition-intervention trial. A validated FFQ and the MEDAS were administered to 7146 participants of the PREDIMED study. The MEDASderived PREDIMED score correlated significantly with the corresponding FFQ PREDIMED score (r = 0.52; intraclass correlation coefficient = 0.51) and in the anticipated directions with the dietary intakes reported on the FFQ. Using Bland Altman"s analysis, the average MEDAS Mediterranean diet score estimate was 105% of the FFQ PREDIMED score estimate. Limits of agreement ranged between 57 and 153%. Multiple linear regression analyses revealed that a higher PREDIMED score related directly (P , 0.001) to HDL-cholesterol (HDL-C) and inversely (P , 0.038) to BMI, waist circumference, TG, the TG:HDL-C ratio, fasting glucose, and the cholesterol:HDL-C ratio. The 10-y estimated coronary artery disease risk decreased as the PREDIMED score increased (P , 0.001). The MEDAS is a valid instrument for rapid estimation of adherence to the Mediterranean diet and may be useful in clinical practice.

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Adherence to aMediterranean diet (MD) is associated with a reduced risk of coronary heart disease. However, themolecular mechanisms involved are not fully understood. The aim of this studywas to compare the effects of 2MD with those of a lowfat- diet (LFD) on circulating inflammatory biomarkers related to atherogenesis. A total of 516 participants included in the PreventionwithMediterraneanDiet Studywere randomized into 3 intervention groups [MD supplementedwith virgin olive oil (MD-VOO); MD supplemented with mixed nuts (MD-Nuts); and LFD]. At baseline and after 1 y, participants completed FFQ and adherence to MD questionnaires, and plasma concentrations of inflammatory markers including intercellular adhesion molecule-1(ICAM-1), IL-6, and 2 TNF receptors (TNFR60 and TNFR80) were measured by ELISA. At 1 y, the MD groups had lower plasma concentrations of IL-6, TNFR60, and TNFR80 (P , 0.05), whereas ICAM-1, TNFR60, and TNFR80 concentrations increased in the LFD group (P , 0.002). Due to between-group differences, participants in the 2 MD groups had lower plasma concentrations of ICAM-1, IL-6, TNFR60, and TNFR80 compared to those in the LFD group (P # 0.028). When participants were categorized in tertiles of 1-y changes in the consumption of selected foods, those in the highest tertile of virgin olive oil (VOO) and vegetable consumption had a lower plasma TNFR60 concentration compared with those in tertile 1 (P,0.02).Moreover, the only changes in consumption thatwere associated with 1-y changes in the geometricmean TNFR60 concentrations were those of VOO and vegetables (P = 0.01). This study suggests that a MD reduces TNFR concentrations in patients at high cardiovascular risk.

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Ensuring the accuracy of dietary assessment instruments is paramount for interpreting diet-disease relationships. The present study assessed the relative and construct validity of the 14-point Mediterranean Diet Adherence Screener (MEDAS) used in the Prevencio´n con Dieta Mediterra´nea (PREDIMED) study, a primary prevention nutrition-intervention trial. A validated FFQ and the MEDAS were administered to 7146 participants of the PREDIMED study. The MEDASderived PREDIMED score correlated significantly with the corresponding FFQ PREDIMED score (r = 0.52; intraclass correlation coefficient = 0.51) and in the anticipated directions with the dietary intakes reported on the FFQ. Using Bland Altman"s analysis, the average MEDAS Mediterranean diet score estimate was 105% of the FFQ PREDIMED score estimate. Limits of agreement ranged between 57 and 153%. Multiple linear regression analyses revealed that a higher PREDIMED score related directly (P , 0.001) to HDL-cholesterol (HDL-C) and inversely (P , 0.038) to BMI, waist circumference, TG, the TG:HDL-C ratio, fasting glucose, and the cholesterol:HDL-C ratio. The 10-y estimated coronary artery disease risk decreased as the PREDIMED score increased (P , 0.001). The MEDAS is a valid instrument for rapid estimation of adherence to the Mediterranean diet and may be useful in clinical practice.

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Background: Epidemiologic studies have suggested that flavonoid intake plays a critical role in the prevention of coronary heart disease. Because atherosclerosis is considered a low-grade inflammatory disease, some feeding trials have analyzed the effects of cocoa (an important source of flavonoids) on inflammatory biomarkers, but the results have been controversial. Objective: The objective was to evaluate the effects of chronic cocoa consumption on cellular and serum biomarkers related to atherosclerosis in high-risk patients. Design: Forty-two high-risk volunteers (19 men and 23 women; mean 6 SD age: 69.7 6 11.5 y) were included in a randomized crossover feeding trial. All subjects received 40 g cocoa powder with 500 mL skim milk/d (C+M) or only 500 mL skim milk/d (M) for 4 wk. Before and after each intervention period, cellular and serum inflammatory biomarkers related to atherosclerosis were evaluated. Results: Adherence to the dietary protocol was excellent. No significant changes in the expression of adhesion molecules on T lymphocyte surfaces were found between the C+M and M groups. However, in monocytes, the expression of VLA-4, CD40, and CD36 was significantly lower (P = 0.005, 0.028, and 0.001, respectively) after C+M intake than after M intake. In addition, serum concentrations of the soluble endothelium-derived adhesion molecules P-selectin and intercellular adhesion molecule-1 were significantly lower (both P = 0.007) after C+M intake than after M intake. Conclusions: These results suggest that the intake of cocoa polyphenols may modulate inflammatory mediators in patients at high risk of cardiovascular disease. These antiinflammatory effects may contribute to the overall benefits of cocoa consumption against atherosclerosis. This trial was registered in the Current Controlled Trials at London, International Standard Randomized Controlled Trial Number, at controlled-trials.com as ISRCTN75176807.

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Liver is unique in its capacity to regenerate in response to injury or tissue loss. Hepatocytes and other liver cells are able to proliferate and repopulate the liver. However, when this response is impaired, the contribution of hepatic progenitors becomes very relevant. Here, we present an update of recent studies on growth factors and cytokine-driven intracellular pathways that govern liver stem/progenitor cell expansion and differentiation, and the relevance of these signals in liver development, regeneration and carcinogenesis. Tyrosine kinase receptor signaling, in particular, c-Met, epidermal growth factor receptors or fibroblast growth factor receptors, contribute to proliferation, survival and differentiation of liver stem/progenitor cells. Different evidence suggests a dual role for the transforming growth factor (TGF)-β signaling pathway in liver stemness and differentiation. On the one hand, TGF-β mediates progression of differentiation from a progenitor stage, but on the other hand, it contributes to the expansion of liver stem cells. Hedgehog family ligands are necessary to promote hepatoblast proliferation but need to be shut off to permit subsequent hepatoblast differentiation. In the same line, the Wnt family and β-catenin/T-cell factor pathway is clearly involved in the maintenance of liver stemness phenotype, and its repression is necessary for liver differentiation during development. Collectively, data indicate that liver stem/progenitor cells follow their own rules and regulations. The same signals that are essential for their activation, expansion and differentiation are good candidates to contribute, under adequate conditions, to the paradigm of transformation from a pro-regenerative to a pro-tumorigenic role. From a clinical perspective, this is a fundamental issue for liver stem/progenitor cell-based therapies.

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L"augment en l"esperança de vida va associat a un increment significatiu en la incidència de determinades malalties, entre les quals cal destacar les malalties neurodegeneratives per l"alt cost personal, social i econòmic que representen.

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AIMS: Mitofusin-2 (Mfn2) expression is dysregulated in vascular proliferative disorders and its overexpression attenuates the proliferation of vascular smooth muscle cells (VSMCs) and neointimal lesion development after balloon angioplasty. We sought to gain insight into the mechanisms that control Mfn2 expression in VSMCs. METHODS AND RESULTS: We cloned and characterized 2 kb of the 5'-flanking region of the human Mfn2 gene. Its TATA-less promoter contains a CpG island. In keeping with this, 5'-rapid amplification of cDNA ends revealed six transcriptional start sites (TSSs), of which TSS2 and TSS5 were the most frequently used. The strong CpG island was found to be non-methylated under conditions characterized by large differences in Mfn2 gene expression. The proximal Mfn2 promoter contains six putative Sp1 motifs. Sp1 binds to the Mfn2 promoter and its overexpression activates the Mfn2 promoter in VSMCs. Chemical inhibition of Sp1 reduced Mfn2 expression, and Sp1 silencing reduced transcriptional activity of the Mfn2 promoter. In keeping with this view, Sp1 and Mfn2 mRNA levels were down-regulated in the aorta early after an atherogenic diet in apolipoprotein E-knockout mice or in VSMCs cultured in the presence of low serum. CONCLUSION: Sp1 is a key factor in maintaining basal Mfn2 transcription in VSMCs. Given the anti-proliferative actions of Mfn2, Sp1-induced Mfn2 transcription may represent a mechanism for prevention of VSMC proliferation and neointimal lesion and development.

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AIMS: Mitofusin-2 (Mfn2) expression is dysregulated in vascular proliferative disorders and its overexpression attenuates the proliferation of vascular smooth muscle cells (VSMCs) and neointimal lesion development after balloon angioplasty. We sought to gain insight into the mechanisms that control Mfn2 expression in VSMCs. METHODS AND RESULTS: We cloned and characterized 2 kb of the 5'-flanking region of the human Mfn2 gene. Its TATA-less promoter contains a CpG island. In keeping with this, 5'-rapid amplification of cDNA ends revealed six transcriptional start sites (TSSs), of which TSS2 and TSS5 were the most frequently used. The strong CpG island was found to be non-methylated under conditions characterized by large differences in Mfn2 gene expression. The proximal Mfn2 promoter contains six putative Sp1 motifs. Sp1 binds to the Mfn2 promoter and its overexpression activates the Mfn2 promoter in VSMCs. Chemical inhibition of Sp1 reduced Mfn2 expression, and Sp1 silencing reduced transcriptional activity of the Mfn2 promoter. In keeping with this view, Sp1 and Mfn2 mRNA levels were down-regulated in the aorta early after an atherogenic diet in apolipoprotein E-knockout mice or in VSMCs cultured in the presence of low serum. CONCLUSION: Sp1 is a key factor in maintaining basal Mfn2 transcription in VSMCs. Given the anti-proliferative actions of Mfn2, Sp1-induced Mfn2 transcription may represent a mechanism for prevention of VSMC proliferation and neointimal lesion and development.

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L'obesitat és un dels principals factors de risc per a moltes patologies, com la diabetis de tipus II, la cirrosi no alcohòlica, les malalties cardiovasculars i diversos tipus de càncer. La major part de tractaments contra l'obesitat i de recomanacions per evitar el sobrepès se centren en la dieta, principalment en la quantitat i el contingut nutricional del menjar, i en el nombre d'àpats diaris. Però l'investigador Satchidananda Panda i els seus col·laboradors, del departament de gastroenterologia de la Universitat de Califòrnia a San Diego (EUA), han identificat un altre factor que és també molt important: el temps que passa entre el primer i l'últim àpat del dia. Segons han publicat a Cell Metabolism, aquest interval no hauria de superar les dotze hores.

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La major part dels habitants de països desenvolupats vivim a grans ciutats, amb una gran densitat de població, entre multitud de persones desconegudes, dependents per a gairebé qualsevol activitat d'una tecnologia que ens fa la vida més fàcil, ens desplacem còmodament en vehicles que ens eviten qualsevol esforç físic i els nostres àpats són abundants. No obstant això, presentem un excés de sucres refinats, sal i greixos i estem totalment desconnectats del medi natural en el qual evolucionem. Estem tan habituats a aquesta vida que, a la majoria no se'ns passa pel cap qüestionar-la i pensem que la nostra manera de viure és la correcta i hauria de ser un model a seguir per qualsevol societat que aspiri a descriure's com a avançada [...]

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Estudi elaborat a partir d’una estada al National Research Institute for Food and Nutrition, Itàlia, des de novembre del 2006 fins a febrer del 2007. La capacitat antioxidant total (TAC) en plasma pot ser un bon biomarcador del estat antioxidant dels humans. Prenent les mostres de dos projectes diferents de recerca s’ha mesurat la TAC mitjançant el FRAP (ferric reductant antioxidant potencial) i el TRAP (total radical-trapping antioxidant parameter ). D’una banda el PREDIMED, és un estudi prospectiu aleatoritzat i controlat, amb una cohort d’ individus sense patología vascular coneguda, però amb un alt risc de patir-la. En aquest es valora la utilitat d’una intervenció dietética del tipus mediterrània en la prevenció primària de la malaltia cardiovascular. L’altre és el de biodisponibilitat en humans dels metabòlits dels polifenols presents en els solubles de cacau, un estudi crònic (28 dies) on es vol mesurar la influència de la llet en l’absorció dels polifenols del cacau, en voluntaris amb elevat risc de sofrir patologia cardiovascular.

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L’anàlisi de l’efecte dels gens i els factors ambientals en el desenvolupament de malalties complexes és un gran repte estadístic i computacional. Entre les diverses metodologies de mineria de dades que s’han proposat per a l’anàlisi d’interaccions una de les més populars és el mètode Multifactor Dimensionality Reduction, MDR, (Ritchie i al. 2001). L’estratègia d’aquest mètode és reduir la dimensió multifactorial a u mitjançant l’agrupació dels diferents genotips en dos grups de risc: alt i baix. Tot i la seva utilitat demostrada, el mètode MDR té alguns inconvenients entre els quals l’agrupació excessiva de genotips pot fer que algunes interaccions importants no siguin detectades i que no permet ajustar per efectes principals ni per variables confusores. En aquest article il•lustrem les limitacions de l’estratègia MDR i d’altres aproximacions no paramètriques i demostrem la conveniència d’utilitzar metodologies parametriques per analitzar interaccions en estudis cas-control on es requereix l’ajust per variables confusores i per efectes principals. Proposem una nova metodologia, una versió paramètrica del mètode MDR, que anomenem Model-Based Multifactor Dimensionality Reduction (MB-MDR). La metodologia proposada té com a objectiu la identificació de genotips específics que estiguin associats a la malaltia i permet ajustar per efectes marginals i variables confusores. La nova metodologia s’il•lustra amb dades de l’Estudi Espanyol de Cancer de Bufeta.

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Durant les darreres dècades, i degut, principalment, a un canvi en els hàbits alimentaris, hi ha hagut un augment a nivell mundial de malalties cròniques (l’obesitat, malalties cardiovasculars, etc.). En els països mediterranis hi ha menys incidència d’aquestes malalties i sembla ser que això es deu a l’anomenada dieta mediterrània. La dieta mediterrània es caracteritza per una combinació d’oli d’oliva com a grassa principal, verdures, hortalisses i fruites en abundància, lleguminoses, fruits secs, formatges i iogurt, peix, pa, pasta, cereals i els seus derivats i un consum moderat de vi i carns. Aquest model alimentari, ric en tocoferols, fitosterols i fitoestanols que ajuden a reduir el contingut de colesterol en sang, fa que en les poblacions mediterrànies hi hagi menys incidència de malalties cardiovasculars. Aquests compostos inhibeixen el deteriorament oxidatiu dels olis, actuen com agent antipolimerització per olis de fregir. Tenen capacitat de reduir els nivells de colesterol, evitant la incidència de malalties cardiovasculars. Els fitoesterols y fitoestanols es poden trobar en forma lliure o esterificada amb àcids grassos, àcids fenòlics i glucosa. Els objectius d’ aquest treball han estat, primer en el desenvolupament de mètodes d'anàlisi ràpids, fiables i robusts dels tocoferols, fitoesterols i fitoestanols i la seva aplicació en fruits sec, oli de segó, oli de pinyol de raïm i productes que els continguin. El primer mètode va estar basat en la cromatografía líquida (HPLC-DAD) amb extracció en fase sòlida (SPE) com tècnica alternativa a la saponificació para la determinació de fitoesterols lliures. Aquest mètode va estar aplicada a mostres de bombons que contenia fitoesterols. El segon mètode va estar basat en la cromatografia de gasos (GCFID) amb aponificació i SPE per quantificar fitoesterols i fitoestanols lliures, esterificats i totals. En els documents annexos es descriuen a profunditat els mètodes desenvolupats.

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Casi han pasado 20 años desde la primera detección del virus del bronceado del tomate (TSWV) en las Islas Canarias y, aunque la situación ha ido cambiando durante estas dos décadas, la problemática de la enfermedad sigue vigente en nuestro país. La epidemiología de la enfermedad determinó una rápida expansión llegando a ser, en pocos años, un factor limitante para el cultivo de algunas de las principales especies hortícola como son el tomate y el pimiento. La incorporación de genes de resistencias en los híbridos comerciales de estas especies, mediante programas de mejora genética, se mostró como el único método eficaz para el control de la enfermedad, una década después de su detección. Desde entonces y debido a la rápida aceptación de estos híbridos por parte de los agricultores, la enfermedad del bronceado en términos generales pasó a un segundo plano. Sin embargo, la variabilidad y gran capacidad de cambio que poseen los virus y, en concreto el TSWV, ha dado lugar a que en el transcurso de unos pocos años hayan aparecido cepas o variantes del virus que son capaces de sobrepasar dichas resistencias. La superación de esas resistencias está originando una gran problemática, no sólo por las pérdidas económicas que se han producido o se lleguen a producir, sino también desde el punto de vista legal por el enfrentamiento de los agricultores con las empresas productoras de semilla que publicitan semillas híbridas resistentes a la enfermedad del bronceado.

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Durante las primeras décadas del s. XX se contempló un importante aumento de las enfermedades coronarias, este hecho estimuló la investigación sobre las causas de dichas enfermedades. En 1978, y para investigar este fenómeno se inició el estudio REGICOR en el Hospital Josep Trueta de Girona. En el s. XX también se contempló un creciente problema de contaminación de las atmósferas urbanas, esto hizo que diferentes científicos estudiaran las relaciones entre las enfermedades coronarias y la contaminación atmosférica en áreas urbanas (Godish, 1997; Krupa & Legge, 2000; Brook et al., 2004 y Krewski et al., 2004). El proyecto realizado está situado en el contexto del primer estudio realizado en España que investiga los efectos sobre la salud de la contaminación atmosférica (REGICOR 2000-AIR). En el proyecto se pretende investigar la influencia de diferentes factores (distancia de los tubos a la calle, altura de los tubos, anchura de la calle, tráfico y densidad de tráfico) sobre la contaminación atmosférica de las ciudades de Girona y Salt, con el fin de poder caracterizar lo mejor posible la exposición a contaminación atmosférica. Para este fin se utilizará el NO2 como marcador de contaminación atmosférica y se seleccionaran varios puntos de muestreo en las dos ciudades dónde se pondrán captadores de NO2 para la medición de dicha contaminación. Después, y mediante un análisis estadístico, se podrá determinar la influencia de los factores en la variación de concentración de NO2 en el área seleccionada.