Endocrinólogo y oncólogo, una amistad en construcción a propósito de la obesidad / Endocrinologist and oncologist, a friendship under construction about obesity

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Obesidad y cáncer: «las amistades peligrosas» / Obesity and cancer: «Dangerous friendship»

Obesidad y cáncer son 2 problemas sanitarios de primera magnitud en España. La obesidad afecta al 23-28% de la población adulta española, y el sobrepeso y la obesidad abdominal al 39 y 36%, respectivamente. Es bien conocida la relación entre obesidad y diabetes mellitus tipo 2, hipertensión arterial, dislipidemia, y apnea obstructiva del sueño. Menos conocida es en cambio la asociación con el cáncer, porque la evidencia es más reciente. Numerosos estudios prospectivos han demostrado en los últimos años, con un alto grado de evidencia científica, una asociación clara entre la obesidad y los cánceres de colon y recto, mama en mujeres pos-menopáusicas, endometrio, riñón, esófago y páncreas. Esta asociación es también probable con los tumores de hígado, vesícula biliar, cardias, tiroides, y hematológicos, para los que se requieren más estudios. Un mejor conocimiento de la relación entre obesidad y cáncer puede permitir mejorar las estrategias de prevención del cáncer, así como una más eficiente detección precoz, y un tratamiento más adecuado de la obesidad y el sobrepeso. Aunque los mecanismos por los cuales la obesidad induce los distintos tipos de cánceres no son suficientemente conocidos, evitar el sobrepeso y la obesidad es hoy una de las medidas más efectivas para reducir el riesgo de cáncer, por lo que es necesario concienciar a la población general sobre uno de los mayores peligros que entraña la actual epidemia de obesidad (AU)

Obesity and cancer are one of the most important health problems is Spain. Between 23 and 28% of the adult population in Spain are obese, 39% are overweight and 36% have abdominal obesity. The association between obesity and type 2 diabetes mellitus, hypertension, dyslipidemia and sleep obstructive apnea is well known. On the contrary, the association between obesity and cancer is less known, because the recent evidence on it. Several prospective studies have shown during the last years the strong relationship between obesity and cancer of colon, breast in post-menopausal women, endometrial, kidney and pancreas as well as esophageal adenocarcinoma. Furthermore there is recent evidence showing that liver, gallbladder, thyroid and ovarian cancer as well as leukemia, multiple myeloma and Hodgkin lymphomas are probably associated with obesity, yet more studies are needed. A better knowledge of the relation between cancer and obesity will allow improving the prevention strategies against cancer, a more efficient early detection, and a more suitable treatment of obesity and overweight. Although the mechanisms of carcinogenesis of obesity are not well established, avoiding overweight and obesity are considered one of the best approaches to reduce the risk of cancer. Therefore the general population must be aware that cancer is one of the most important hazards associated with the current obesity epidemic in our society (AU)

[Obesity and cancer: «Dangerous friendship¼]. / Obesidad y cáncer: «las amistades peligrosas¼.

Obesity and cancer are one of the most important health problems is Spain. Between 23 and 28% of the adult population in Spain are obese, 39% are overweight and 36% have abdominal obesity. The association between obesity and type 2 diabetes mellitus, hypertension, dyslipidemia and sleep obstructive apnea is well known. On the contrary, the association between obesity and cancer is less known, because the recent evidence on it. Several prospective studies have shown during the last years the strong relationship between obesity and cancer of colon, breast in post-menopausal women, endometrial, kidney and pancreas as well as esophageal adenocarcinoma. Furthermore there is recent evidence showing that liver, gallbladder, thyroid and ovarian cancer as well as leukemia, multiple myeloma and Hodgkin lymphomas are probably associated with obesity, yet more studies are needed. A better knowledge of the relation between cancer and obesity will allow improving the prevention strategies against cancer, a more efficient early detection, and a more suitable treatment of obesity and overweight. Although the mechanisms of carcinogenesis of obesity are not well established, avoiding overweight and obesity are considered one of the best approaches to reduce the risk of cancer. Therefore the general population must be aware that cancer is one of the most important hazards associated with the current obesity epidemic in our society.

Epidemiología de la diabetes. La apasionante aventura de investigación de un diabetólogo / Epidemiology of diabetes. The fascinating adventure of a diabetologist

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Alta prevalencia de obesidad en una poblacion laboral en España / High prevalence of obesity in a Spanish working population

Antecedentes y objetivo Describir la prevalencia de la obesidad y su evolucion reciente en una poblacion laboral en España. Material y (..) (AU)

Background and objectives To report the prevalence of obesity in a Spanish working population and its changes in recent years. Material and methods Data were collected from routine medical examinations performed on workers by a national mutual insurance society for occupational accidents and diseases (Ibermutuamur). A structured (..) (AU)

High prevalence of obesity in a Spanish working population.

BACKGROUND AND OBJECTIVES: To report the prevalence of obesity in a Spanish working population and its changes in recent years. MATERIAL AND METHODS: Data were collected from routine medical examinations performed on workers by a national mutual insurance society for occupational accidents and diseases (Ibermutuamur). A structured questionnaire was completed and physical examinations were performed. Overweight was defined as BMI ranging from 25 and 29.9, obesity as BMI of 30-39.9, and morbid obesity as BMI ≥ 40 kg/m(2). RESULTS: Data from 1,336,055 medical examinations performed from May 2004 to November 2007 were collected. Prevalence rates in the population examined in 2004 (n=230,684; 73% males; average age, 36.4 years) were: morbid obesity, 0.5% (0.6% males, 0.5% females); obesity, 14.5% (17.0% males, 7.7% females); overweight, 38.4% (44.8% males, 21.3% females). Prevalence rates of obesity and overweight were higher in blue-collar workers (16.4% and 40.5% respectively) as compared to white-collar workers (10.9% and 34.4% respectively). There was a progressive increase in prevalence of obesity during the 4-year study (2004-2007) in both males (17.0%, 17.6%, 17.9%, 18.2%) and females (7.6%, 8.0%, 8.4%, 8.7%). CONCLUSIONS: Prevalence of obesity and overweight in the Spanish working population is high, especially in male blue-collar workers, and is increasing. There is a need to promote early prevention programs and specific treatments for obesity.

Síndrome de Down: un reto médico en el siglo XXI / Down syndrome: a 21st Century medical challenge

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Hyperthyroidism in a population with Down syndrome (DS).

BACKGROUND: Thyroid disorders are frequent in patients with Down syndrome (DS). It is well-known that the prevalence of hypothyroidism is high but data on hyperthyroidism are scarce. OBJECTIVES: To assess the prevalence, aetiology, clinical characteristics, evolution and treatment of hyperthyroidism in a population with DS attending a specialized medical centre. METHODS: Data were gathered by systematic review of 1832 medical records from the Catalan DS Foundation, in Spain, registered between January 1991 and February 2006. Patients with the diagnosis of hyperthyroidism were identified and data on clinical features, physical examination, laboratory and imaging tests, treatment and evolution were collected. RESULTS: Twelve patients with hyperthyroidism were recorded (6.5 cases/1000 patients with DS). There were 5 males and 7 females, with a mean age at diagnosis of 16.8 years. The most common presenting symptoms were decreased heat tolerance, sweating, increased irritability and weight loss. All patients had diffuse goitre at physical examination and two patients presented with exophthalmia. Clinical diagnosis was confirmed biochemically. Thyroid-stimulating immunoglobulin levels were raised (mean 128.1 U/l) and imaging tests confirmed the diagnosis of Graves' disease in all cases. Patients started treatment with carbimazole at diagnosis and after a mean period of 40 months without clinical remission, they required definitive therapy with radioactive iodine. Subjects developed hypothyroidism after radio-iodine therapy and replacement therapy with levothyroxine was necessary. CONCLUSIONS: Hyperthyroidism is more prevalent in patients with DS than in the general population and has no gender predominance. It is caused mainly by Graves' disease. Anti-thyroid drugs were not effective in achieving remission and radioactive iodine as a definitive treatment was required in all cases.

COMBO. Actualización 2004. Criterios y pautas de terapia combinada en la diabetes tipo 2

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