Genetic association analysis of vitamin D receptor gene polymorphisms and obesity-related phenotypes.

Vitamin D has been established as a key factor in the development of obesity through the vitamin D receptor (VDR). The aim of this study was to investigate the contribution of the VDR gene to obesity-related phenotypes in a population of Caucasian young adults. The study population consisted of 701 healthy Spanish young adults (mean age 20.41±2.48). Three single-nucleotide polymorphisms (SNPs) of VDR (TaqI, BsmI and FokI) were selected as genetic markers. Body composition measurements including weight, body mass index (BMI), fat mass (FM), percentage of fat mass (PFM), fat-free mass (FFM) and visceral fat level (VFL) were analysed. Differences in obesity traits across the genotypes were determined using analysis of covariance (ANCOVA). The FokI polymorphism showed a significant association with PFM across the whole population after adjusting for age and sex (p=0.022). Age-adjusted analysis revealed an association between body weight and the TaqI and BsmI SNPs in males (p=0.033 and p=0.028, respectively). However, these positive findings did not remain significant after applying the Bonferroni correction for multiple testing. Our findings suggest that VDR genetic variants are unlikely to play a major role in obesity-related phenotypes in a population of Caucasian young adults.

LMS tables for waist circumference and waist-height ratio in Colombian adults: analysis of nationwide data 2010.

BACKGROUND/OBJECTIVES: Indices predictive of central obesity include waist circumference (WC) and waist-to-height ratio (WHtR). These data are lacking for Colombian adults. This study aims at establishing smoothed centile charts and LMS tables for WC and WHtR; appropriate cutoffs were selected using receiver-operating characteristic analysis based on data from the representative sample. SUBJECTS/METHODS: We used data from the cross-sectional, national representative nutrition survey (ENSIN, 2010). A total of 83 220 participants (aged 20-64) were enroled. Weight, height, body mass index (BMI), WC and WHtR were measured and percentiles calculated using the LMS method (L (curve Box-Cox), M (curve median), and S (curve coefficient of variation)). Receiver operating characteristics curve analyses were used to evaluate the optimal cutoff point of WC and WHtR for overweight and obesity based on WHO definitions. RESULTS: Reference values for WC and WHtR are presented. Mean WC and WHtR increased with age for both genders. We found a strong positive correlation between WC and BMI (r=0.847, P< 0.01) and WHtR and BMI (r=0.878, P<0.01). In obese men, the cutoff point value is 96.6 cm for the WC. In women, the cutoff point value is 91.0 cm for the WC. Receiver operating characteristic curve for WHtR was also obtained and the cutoff point value of 0.579 in men, and in women the cutoff point value was 0.587. A high sensitivity and specificity were obtained. CONCLUSIONS: This study presents first reference values of WC and WHtR for Colombians aged 20-64. Through LMS tables for adults, we hope to provide quantitative tools to study obesity and its complications.

Effectiveness of different exercises and stretching physiotherapy on pain and movement in patellofemoral pain syndrome: a randomized controlled trial.

OBJECTIVE: To compare the effectiveness of proprioceptive neuromuscular facilitation combined with exercise, classic stretching physiotherapy intervention, and educational intervention at improving patient function and pain in patients with patellofemoral pain syndrome. DESIGN: Randomized, controlled, blind trial over four months. SETTING: Urban population, Spain. PARTICIPANTS: Patients undergoing primary care for retropatellar pain. INTERVENTION: Subjects were allocated on three different treatment options: a proprioceptive neuromuscular facilitation and aerobic exercise group, a classic stretching group, and a control treatment were applied over four months under the supervision of a physiotherapist. MAIN OUTCOME: Knee Society Score, pain reported (Visual analogue scale) and knee range of motion. Assessments were completed at baseline and after four months. RESULTS: 74 patients were enrolled in the study and distributed between groups. Both the proprioceptive neuromuscular facilitation and classic stretching group showed significant changes in all variables after four months intervention (p < 0.001). The difference in mean Kujala knee score changes between groups (classic stretching group vs. proprioceptive neuromuscular facilitation group vs. control group) at four months was -24.05 (95% confidence interval (CI) -30.19, -17.90), p ≤ 0.001; vs. -39.03 (95% confidence interval (CI) -42.5, -35.5), p ≤ 0.001; vs. -0.238 (95% confidence interval (CI) -1.2, 0.726), p = 0.621, respectively. CONCLUSIONS: A proprioceptive neuromuscular facilitation intervention protocol combined with aerobic exercise showed a better outcome than a classic stretching protocol after four months.

Regulación de la ingesta alimentaria y del balance energético; factores y mecanismos implicados / Regulation of dietary intake and energy balance; factors and mechanisms involved

La regulación de la ingesta energética representa un proceso de vital importancia en el organismo ya que posibilita el mantenimiento de un equilibrio entre la cantidad de energía almacenada en forma de grasa corporal y el catabolismo de la misma. Objetivo: El objetivo de este trabajo ha sido analizar los principales factores implicados en la regulación de la ingesta alimentaria, el balance energético y su fisiopatología. Metodología: Se realizó una búsqueda en Medline y Ebsco de artículos publicados en inglés y español en el período comprendido entre enero de 2009 y enero de 2012. Los términos de búsqueda fueron "food intake", "energy balance", "regulation", "nutritional homeostasis". Resultados: Se encontraron un total de 198 estudios científicos, de los cuales únicamente 70 cumplían los requisitos de la búsqueda. Todos los estudios consultados coinciden en la importancia de las hormonas gastrointestinales como principales agentes moduladores de la homeostasis energética. Dicho efecto modulador sobre el apetito y la saciedad tiene lugar mediante su acción directa sobre el hipotálamo o el núcleo del tracto solitario a nivel del tronco encefálico (sistema nervioso vegetativo). Únicamente la ghrelina, ha sido relacionada con el inicio de la ingesta considerándola una de las principales señales orexigénicas en los modelos animales estudiados y en humanos. Discusión: La regulación de la ingesta alimentaria y el balance energético constituye un proceso extremadamente complejo cuyo funcionamiento y equilibrio es posible gracias a la acción de las distintas señales endocrinas del tracto gastrointestinal (AU)

The regulation of energy intake is a vital process in the body as possible to maintain a balance between the amount of energy stored as body fat and the catabolism of the same. Objective: The objective of this study was to analyze the main factors involved in regulating food intake, energy balance and pathophysiology. Methods: We searched Medline and Ebsco of articles published in English and Spanish in the period between January 2009 and January 2012. Search terms were "food intake", "energy balance", "regulation", "nutritional homeostasis." Results: There were a total of 198 scientific studies, of which only 70 met the requirements of the search. All studies consulted agree on the importance of gastrointestinal hormones modulating agents as primary energy homeostasis. Such a modulatory effect on appetite and satiety is mediated by direct action on the hypothalamus or the nucleus of the solitary tract at the brainstem (autonomic nervous system). Only ghrelin has been linked to the start of the intake considering a major orexigenicas signals studied in animal models and humans. Discussion: The regulation of food intake and energy balance is an extremely complex process whose operation and balance is made possible by the action of various endocrine signals of the gastrointestinal tract (AU)

Análisis del estado nutricional en escolares; estudio por áreas geográficas de la provincia de Granada (España) / Analysis of the nutritional state of school children in different districts of the province of Granada (Spain)

Introducción: En España la prevalencia de obesidad muestra un patrón de distribución norte-sur. En la provincia de Granada se desconoce su distribución. Objetivos: Los objetos del presente trabajo son estudiar la prevalencia de sobrepeso y obesidad en una población de escolares representativa de toda la provincia de Granada. Verificar diferencias significativas entre las comarcas de la provincia. Comprobar una correlación entre el estado nutricional de los alumnos y el de sus progenitores. Métodos: 977 escolares de entre 9 y 17 años de edad, pertenecientes a 13 centros educativos públicos de la provincia de Granada (España). Estudio analítico y multicéntrico, en el que se realizó una valoración del estado nutricional mediante antropometría. Además, mediante un cuestionario, se evaluó la existencia de antecedentes familiares de sobrepeso u obesidad. Resultados: Se encontró una elevada prevalencia de sobrepeso y obesidad entre la población estudiada. En chicas, la mayor prevalencia tanto de sobrepeso como de obesidad se situaba entre los 12 y los 14 años de edad. En los chicos, se observó un repunte en la prevalencia de sobrepeso a los 12 años. Respecto de la obesidad, sus tasas fueron considerablemente inferiores a las descritas entre las chicas. Se encontraron diferencias estadísticamente significativas para el peso (F = 4,154; p = 0,003), pero no para la estatura (F = 1,928; p = 0,105). En cambio, para la variable IMC se observaron diferencias estadísticamente significativas (F = 5,037; p < 0,001) entre las diferentes comarcas geográficas estudiadas. Aquellos alumnos con antecedentes familiares de obesidad mostraron un significativo (p < 0,01) peor estado nutricional. Discusión: Existe una elevada prevalencia de obesidad, especialmente entre las chicas. Existe un patrón de distribución geográfico posiblemente derivado de las características socioeconómicas de cada comarca. La existencia de antecedentes familiares de obesidad constituye un factor determinante para su desarrollo entre los jóvenes (AU)

Background: In Spain the prevalence of obesity shows a north-south distribution. In the province of Granada its distribution is unknown. Objectives: (1) To study the prevalence of overweight and obesity in a sample population of school children and adolescents from different districts in the province of Granada. (2) To verify whether there are significant differences, depending on the district where the students reside. (3) To find a possible correlation between the nutritional state of the students and that of their parents. Methods: The population sample was composed of 977 school children and adolescents from 9 to 17 years of age, attending 13 public elementary schools and high schools in the city and province of Granada (Spain). In this analytical and multicentric study, the nutritional state of the subjects was evaluated by means of anthropometric measurements. Furthermore, data were collected by means of questionnaire to discover whether the respondents had a family history of overweight or obesity. Results: We found a high prevalence of overweight and obesity among the studied population. In girls, the greater prevalence of both overweight and obesity ranged from 12 to 14 years of age. In boys, there was an increase in the prevalence of overweight at twelve years of age. Regarding obesity, their rates were significantly lower than those described among girls. There were statistically significant differences for weight (F = 4,154; p = 0,003) but not for height (F = 1,928; p =0,105). But for the variable BMI was statistically significant difference (F = 5.037; P < 0.001) between the studied geographical areas. The results showed that the nutritional state of students with a family history of obesity was significantly worse (p < 0.01). Discussion: A high prevalence of obesity was found in the sample, especially among the girls. There exists a geographical distribution pattern, possibly derived from the socioeconomic characteristics of each area in the province. The existence of a family history of obesity is an important factor that can determine whether the child will also become obese in the future (AU)

[Anthropometric study and evaluation of the nutritional status of a population school children in Granada; comparison of national and international reference standards]. / Estudio antropométrico y valoración del estado nutricional de una población de escolares de Granada; comparación con los estándares nacionales e internacionales de referencia.

Recent studies show an alarming increase in levels of overweight and obesity among children and adolescents. The main objectives of this research were the following: (i) to carry out an anthropometric evaluation of the nutritional status and body composition of school children in the city and province of Granada; (ii) to compare the nutritional status of this population sample with national and international reference standards. The results obtained in this study showed that the general prevalence of overweight in both sexes was 22.03% and that 9.12% of the children were obese. Statistically significant differences were found between the variable, weight for age and sex (p < 0.05) and the variable, height for age and sex (p < 0.05). Regarding the body mass index, no statistically significant differences were found for the variable, sex (p = 0.182). This contrasted with the variable, age, which did show statistically significant differences (p < 0.05). As a conclusion, the results of our study highlighted the fact that these anthropometric values were much higher than national and international reference standards.

[Obesity and seric levels of strogens; the importance of early development of breast cancer]. / Obesidad y niveles séricos de estrógenos; importancia en el desarrollo precoz del cáncer de mama.

Many studies have analyzed the possible association between the development of obesity and hormone levels, as well as their relation with the early development of breast cancer. As part of this study, we performed a retrospective collection of data from the clinical histories of 524 women in Granada (Spain), who had been diagnosed with breast cancer. The objectives were to verify an association between the nutritional state of the women and their age at breast cancer diagnosis as well as a possible relation between their nutritional state and seric levels of estrogens. The results obtained in this study show that obesity and the levels of certain hormones, such as estrogens, are closely associated with the early development of breast cancer.

[Overweight and obesity as a prognosis factor of desmotivation in children and adolescents]. / Sobrepeso y obesidad como factor pronóstico de la desmotivación en el niño y el adolescente.

Spain has become the country in the European Union with the fourth highest number of overweight and obese children. This condition directly affects physical health as well as mental health. The objective of this research study was to evaluate motivational aspects in one group of obese or overweight adolescents and another group of normal-weight adolescents. For this purpose a descriptive observational study was carried out in an educational institution in Guadix (Granada). The universe was composed of 200 children of ages 10 to 14. A sample of 24 children was selected by means of proportional random sampling with an error of 0.19, and was divided into the following groups (i) 12 normal-weight children; (ii) 12 obese children. Motivation was measured by means of the School Motivation Analysis Test (SMAT), a multidimensional measuring instrument based on Cattell's dynamic model of motivation and emotions. Our study evaluated five motivational parameters: TAO (total autism-optimism), TGI (total general information), TIN (total integration), TPI (total personal interest), and TCO (total conflict). Our results showed that for each of the SMAT variables, the overweight and obese children obtained an average value of 4.5 in contrast to the normal-weight children, who obtained an average value of 5.9. This indicates that overweight and obese children have low motivational states and a higher level of frustration. They also tend to distort reality by alleging the existence of obstacles that prevent them from achieving their goals.

[Risk factors for metabolic syndrome in a population with sleep apnea; evaluation in a population of Granada; the Granada study]. / Factores de riesgo para el síndrome metabólico en una población con apnea del sueño; evaluación en un grupo de pacientes de Granada y provincia; estudio GRANADA.

INTRODUCTION: The Metabolic Syndrome is one of the first health problems in the public health of the century. It's consider that the beginning of the syndrome is determined by numerous factors that developed two main metabolic disturbances: the insulin resistance and the central obesity. This relationship is concentrating the scientific world. As the cause-effect relationship has to be answered, the epidemiologic research has focused on without results. MATERIAL AND METHODS: 1,016 subjects were recruited in the sleep disorders laboratory in San Cecilio Hospital with sleep apnea suspicion. RESULTS: Significant correlation (p < 0,001) was found between sleep apnea severity and nocturnal saturation values and the different metabolic disturbances related to the metabolic syndrome (Hypertension, Diabetes and obesity). By the contrary, we doesn't found significant differences between No-Sleep apnea group and moderate sleep apnea group in the majority of the variables. CONCLUSIONS: Subjects with sleep apnea have significantly more possibilities to develop metabolic syndrome, and cardiovascular pathology. These subjects had to be evaluated in this sense to reduce the impact associated to this pathology.

Análisis del estado nutricional y composición corporal de una población de escolares de Granada / Analysis of the nutritional state and body composition of school children in Granada (Spain)

Los objetivos de este estudio fueron determinar el estado nutricional de la población de escolares estudiada. En segundo lugar, analizar el patrón de distribución de la grasa subcutánea entre dicha población. La muestra estaba constituida por 977 escolares de Granada capital y provincia (524 chicas y 452 chicos), todos ellos con edades comprendidas entre los 9 y los 17 años. Para el estudio del estado nutricional y distribución del componente graso subcutáneo se realizó una evaluación antropométrica completa incluyendo una valoración del peso, estatura, índice de masa corporal, pliegues cutáneos y perímetros corporales. Los resultados obtenidos muestran la existencia de una prevalencia de sobrepeso del 23,01% en chicas frente a un 20,81% en chicos. Asimismo, se encontró una prevalencia de obesidad del 12,70% entre las chicas frente a un 4,98% en chicos. El análisis del patrón de distribución de la grasa subcutánea evidenció una distribución del componente graso de predominio eminentemente central. La existencia de una prevalencia importante de sobrepeso y obesidad unida al desarrollo de un patrón de distribución graso de predominio central, ponen de manifiesto el potencial riesgo cardiovascular al que se encuentran expuestos dichos alumnos (AU)

The objective of this study was to first determine the nutritional state of a sample population of school children, and then analyze the distribution pattern of their subcutaneous fat layer. The sample was composed of 977 school children from the city and province of Granada (Spain). All of the children (524 girls and 452 boys) were 9-17 years of age. To study their nutritional state and the distribution of the subcutaneous fat layer, they were given a complete anthropometric evaluation, which included measuring their weight, height, body mass index, skin folds, and body perimeters. The results obtained showed a 23.01% prevalence of overweight in the female subjects and 20.81% in the male subjects. Furthermore, the female subjects had an obesity prevalence of 12.70% in comparison to the male subjects, whose obesity prevalence was 4.98%. The distribution pattern of subcutaneous fat was found to be mainly located in the central part of body. The high percentage of overweight and obesity along with the development of a central fat distribution pattern (neck, chest, and abdomen) in these school children is clear evidence of potential cardiovascular risk (AU)

[Monogenic human obesity: role of the leptin-melanocortin system in the regulation of food intake and body weight in humans]. / Obesidad monogénica humana: papel del sistema leptina-melanocortina en la regulación de la ingesta de alimentos y el peso corporal en humanos.

Human obesity is a disorder of multifactorial origin in which genetic and environmental factors are involved. To understand the mechanisms regulating energy intake and fat accumulation in the body, it is important to study the genetic alterations causing monogenic obesity. Most of the genes involved in monogenic obesity are associated with the leptin-melanocortin system; hence the importance of studying this system by analysing natural mutations in mice. Previous studies have described mutations in leptin and its receptor, proopiomelanocortin and prohormone convertase 1 associated with human obesity of monogenic origin. The aim of this study is to provide an updated review of the main characteristics and functioning of the leptin-melanocortin system, and its implications and potentialities in regulating food intake and body weight.

Estudio antropométrico y valoración del estado nutricional de una población de escolares de Granada; comparación con los estándares nacionales e internacionales de referencia / Anthropometric study and evaluation of the nutritional status of a population school children in Granada; comparison of national and international reference standards

Estudios recientes muestran un incremento alarmante en las tasas de sobrepeso y obesidad entre la población infantil y juvenil. Los objetivos de este trabajo fueron realizar una valoración del estado nutricional y composición corporal mediante antropometría en una población de escolares de Granada capital y provincia, así como comparar el estado nutricional de la población escolar estudiada con los estándares nacionales e internacionales de referencia. La prevalencia general de sobrepeso encontrado en ambos sexos fue del 22,03% y la tasa de obesidad del 9,12%. Se encontraron diferencias estadísticamente significativas entre la variable peso para la edad y el sexo (p < 0,05) y la variable estatura para la edad y sexo (p < 0,05). Respecto del índice de masa corporal, no se encontraron diferencias estadísticamente significativas para la variable sexo (p = 0,182) pero sí respecto de la variable edad (p < 0,05). Por último, cabe resaltar como los valores de antropometría estimados, se sitúan muy por encima de los estándares de referencia tanto nacionales como internacionales (AU)

Recent studies show an alarming increase in levels of overweight and obesity among children and adolescents. The main objectives of this research were the following: (i) to carry out an anthropometric evaluation of the nutritional status and body composition of school children in the city and province of Granada; (ii) to compare the nutritional status of this population sample with national and international reference standards. The results obtained in this study showed that the general prevalence of overweight in both sexes was 22.03% and that 9.12% of the children were obese. Statistically significant differences were found between the variable, weight for age and sex (p < 0.05) and the variable, height for age and sex (p < 0.05). Regarding the body mass index, no statistically significant differences were found for the variable, sex (p = 0.182). This contrasted with the variable, age, which did show statistically significant differences (p < 0.05). As a conclusion, the results of our study highlighted the fact that these anthropometric values were much higher than national and international reference standards (AU)

Obesidad y niveles séricos de estrógenos; importancia en el desarrollo precoz del cáncer de mama / Obesity and seric levels of strogens; the importance of early development of breast cancer

Numerosos estudios han analizado la posible asociación entre el desarrollo de obesidad, niveles hormonales y su relación con el desarrollo precoz de cáncer de mama. Se llevó a cabo una recogida de datos retrospectiva a partir de las historias clínicas de 524 mujeres de Granada (España) diagnosticadas de cáncer de mama. Los objetivos fueron verificar una asociación entre el estado nutricional y la edad de diagnóstico, así como una posible relación entre el estado nutricional de las pacientes y los niveles séricos de estrógenos. Los resultados obtenidos en este estudio muestran que la obesidad y los niveles de ciertas hormonas como los estrógenos se encuentran íntimamente asociados con el desarrollo precoz del cáncer de mama (AU)

Many studies have analyzed the possible association between the development of obesity and hormone levels, as well as their relation with the early development of breast cancer. As part of this study, we performed a retrospective collection of data from the clinical histories of 524 women in Granada (Spain), who had been diagnosed with breast cancer. The objectives were to verify an association between the nutritional state of the women and their age at breast cancer diagnosis as well as a possible relation between their nutritional state and seric levels of estrogens. The results obtained in this study show that obesity and the levels of certain hormones, such as estrogens, are closely associated with the early development of breast cancer (AU)

Sobrepeso y obesidad como factor pronóstico de la desmotivación en el niño y el adolescente / Overweight and obesity as a prognosis factor of desmotivation in children and adolescents

España se ha convertido en el cuarto país de la Unión Europea con mayor número de niños con sobrepeso y obesidad. Esta enfermedad afecta directamente tanto aspectos de salud físicos como psicológicos. El objetivo es evaluar el grado de motivación existente en dos grupos de adolescentes, uno cuyos sujetos se encuentran en normo-peso y un segundo grupo integrado por adolescentes con sobrepeso u obesidad. Se realizó un estudio observacional, descriptivo en un centro educativo de Guadix (Granada). El universo estuvo constituido por 200 niños con edades comprendidas entre los 10 y 14 años, de los que fueron seleccionados una muestra de 24 niños mediante el muestreo Aleatorio Simple de Proporciones con error de 0.19 distribuidos en: Grupo de niños normopeso: 12 y Grupo de niños obesos: 12. Para medir la motivación se utilizó el Test de Motivaciones en Adolescentes (SMAT) que pertenece a los instrumentos de medida derivados del modelo dinámico cattelliano. Evaluó cinco parámetros relacionados con la motivación: TAO (total autismo-optimismo), TIG (total información general), TIN (total integración), TIP (total interés personal) y TCO (total conflicto). De entre los resultados obtenidos, cabe destacar como en cada una de las variables del SMAT los niños incluidos en el grupo de sobrepeso y obesidad mostraron un resultado promedio de (4,5) con respecto a un resultado promedio en los niños normopesos de (5,9) lo que pone de manifiesto que los sujetos que padecen sobrepeso y obesidad presentan un nivel de motivación más bajo, circunstancia que se manifiesta por una mayor tendencia hacia la frustración y mayores dificultades para alcanzar sus metas (AU)

Spain has become the country in the European Union with the fourth highest number of overweight and obese children. This condition directly affects physical health as well as mental health. The objective of this research study was to evaluate motivational aspects in one group of obese or overweight adolescents and another group of normal-weight adolescents. For this purpose a descriptive observational study was carried out in an educational institution in Guadix (Granada). The universe was composed of 200 children of ages 10 to 14. A sample of 24 children was selected by means of proportional random sampling with an error of 0.19, and was divided into the following groups (i) 12 normal-weight children; (ii) 12 obese children. Motivation was measured by means of the School Motivation Analysis Test (SMAT), a multidimensional measuring instrument based on Cattell's dynamic model of motivation and emotions. Our study evaluated five motivational parameters: TAO (total autism-optimism), TGI (total general information), TIN (total integration), TPI (total personal interest), and TCO (total conflict). Our results showed that for each of the SMAT variables, the overweight and obese children obtained an average value of 4.5 in contrast to the normal-weight children, who obtained an average value of 5.9. This indicates that overweight and obese children have low motivational states and a higher level of frustration. They also tend to distort reality by alleging the existence of obstacles that prevent them from achieving their goals (AU)

Factores de riesgo para el síndrome metabólico en una población con apnea del sueño; evaluación en un grupo de pacientes de Granada y provincia; estudio GRANADA / Risk factors for metabolic syndrome in a population with sleep apnea; evaluation in a population of Granada; the Granada study

Introducción: El síndrome metabólico se está convirtiendo en uno de los principales problemas de salud pública del siglo XXI. Se considera que la aparición del síndrome metabólico está determinada por la interacción de factores genéticos, ambientales y nerviosos centrales (disfunción de los centros hipotalámicos de hambre y saciedad) que generan dos alteraciones metabólicas importantes: la resistencia a la acción de la insulina y la obesidad visceral. La relación de este síndrome, que concentra en la actualidad al mundo científico, con las alteraciones del sueño sigue siendo un punto sin esclarecer. Aunque se ha teorizado sobre la relación causa efecto, se desconoce aún su interrelación convirtiéndose su estudio en un objetivo primario de la investigación epidemiológica. Muestra y métodos: Se reclutaron 1016 sujetos que acudieron al servicio de Fisiología Respiratoria del Hospital Universitario "San Cecilio" de Granada (España) por sospecha de Apnea de Sueño. Resultados: Se encontró una correlación significativa (p < 0,001) entre los valores de apneas hipopneas y los valores de saturación de Oxigeno nocturna con las diferentes alteraciones metabólicas asociadas al síndrome metabólico (Hipertensión, Diabetes y Obesidad). Por el contrario, no se encontraron diferencias estadísticamente significativas test (t-Student) en la mayoría de las variables entre el grupo NO-Apnea y el grupo Apnea moderada. Conclusiones: Los sujetos con apnea de sueño poseen significativamente más riesgo de desarrollar síndrome metabólico, y por lo tanto de presentar patología cardiovascular. Estos sujetos deben ser evaluados en este sentido para reducir la morbimortalidad asociada a estas patologías (AU)

Introduction: The Metabolic Syndrome is one of the first health problems in the public health of the century. It's consider that the beginning of the syndrome is determined by numerous factors that developed two main metabolic disturbances: the insulin resistance and the central obesity. This relationship is concentrating the scientific world. As the cause-effect relationship has to be answered, the epidemiologic research has focused on without results. Material and methods: 1,016 subjects were recruited in the sleep disorders laboratory in San Cecilio Hospital with sleep apnea suspicion. Results: Significant correlation (p < 0,001) was found between sleep apnea severity and nocturnal saturation values and the different metabolic disturbances related to the metabolic syndrome (Hypertension, Diabetes and obesity). By the contrary, we doesn't found significant differences between No-Sleep apnea group and moderate sleep apnea group in the majority of the variables. Conclusions: Subjects with sleep apnea have significantly more possibilities to develop metabolic syndrome, and cardiovascular pathology. These subjects had to be evaluated in this sense to reduce the impact associated to this pathology (AU)

Obesidad monogénica humana: papel del sistema leptina-melanocortina en la regulación de la ingesta de alimentos y el peso corporal en humanos / Monogenic human obesity: role of the leptin-melanocortin system in the regulation of food intake and body weight in humans

La obesidad humana es un trastorno de origen multifactorial en el que intervienen factores tanto genéticos como ambientales. La existencia de alteraciones genéticas que dan origen a obesidades monogénicas resulta muy interesante para el estudio de los mecanismos que contribuyen a un aumento de la ingesta de energía y la acumulación de grasa en el cuerpo. La mayoría de los genes implicados en obesidad monogénica se relacionan con el sistema de la leptina-melanocortinas, de ahí la importancia de su estudio a través de mutaciones naturales en ratones. Así, se han descrito mutaciones relacionadas con obesidad humana de tipo monogénica en la leptina y su receptor, propio melanocortina y prohormona convertasa 1. El objetivo de este trabajo ha sido ofrecer una revisión actualizada acerca de las principales características y funcionamiento del sistema leptina-melanocortinas, así como de sus implicaciones y potencialidades en el proceso de regulación de la ingesta alimentaria y control del peso corporal(AU)

Human obesity is a disorder of multifactorial origin in which genetic and environmental factors are involved. To understand the mechanisms regulating energy intake and fat accumulation in the body, it is important to study the genetic alterations causing monogenic obesity. Most of the genes involved in monogenic obesity are associated with the leptin-melanocortin system; hence the importance of studying this system by analyzing natural mutations in mice. Previous studies have described mutations in leptin and its receptor, proopiomelanocortin and prohormone convertase 1 associated with human obesity of monogenic origin. The aim of this study is to provide an updated review of the main characteristics and functioning of the leptin-melanocortin system, and its implications and potentialities in regulating food intake and body weight(AU)

[Influence of family environment of the development of obesity and overweight in a population of school children in Granada (Spain)]. / Influencia del entorno familiar en el desarrollo del sobrepeso y la obesidad en una población de escolares de Granada (España).

According to recent research, eating behaviour should be understand as a cyclical and interactive process in which parental eating habits cause children to develop specific eating strategies as well as their own eating habits. Needless to say, this interactive process is reflected and has a direct impact on the nutritional indicators of the children in a family. The objectives of this study were the following: (i) to verify the existence of a significant association between the educational level of parents and the nutritional state of children in the same family; (ii) to discover if there is a direct relation between the nutritional state of children and the person that decides the menu and/or prepares family meals; (iii) to determine if there is a link between the nutritional state of children and the time that they spend on sedentary leisure activities. The sample population was composed of 718 school children and adolescents, 9-17 years of age, who A descriptive, transversal, and multicentric study was performed that evaluated the nutritional state of the entire sample by using anthropometric techniques to assess weight, height, and body mass index.

[Obesity and its relation with markers of inflammation and erythrocyte fatty acids in a group of overweight adolescents]. / Obesidad y su relación con marcadores de inflamación y ácidos grasos de eritrocito en un grupo de adolescentes obesos.

There is a general consensus that obesity is an eminently inflammatory process. This is justified by alterations observed in obese patients, which affect the secretion of certain cytokines such as ceruloplasmin, leptin, adiponectin, and interleukin-6 (IL-6), among others. In a parallel way, other research has also pointed out alterations in the composition of fatty acids in the erythrocyte membrane of overweight adults. The results obtained in our study confirm the existence of a significant correlation between the serum levels of some of the cytokines studied and the nutritional state of the sample studied. This means that for the population of children evaluated in our study, the serum concentrations of these biomolecules can be an important tool for the prediction of cardiovascular risk when they become adults. Furthermore significant differences were found regarding the composition of saturated fatty acids in the erythrocyte membrane.

[Comparative study of the effectiveness of body mass index and the body-fat percentage as methods for the diagnosis of overweight and obesity in children]. / Estudio comparativo de la eficacia del índice de masa corporal y el porcentaje de grasa corporal como métodos para el diagnóstico de sobrepeso y obesidad en población pediátrica.

The World Health Organization (WHO) regards obesity as one of the most serious public health problems in the world that can affect young children and adolescents. Accordingly, a major priority is to find ways to more effectively study and analyze the various methods used to diagnose and evaluate the nutritional state of the pediatric and adolescent population. The nutritional indicators currently employed for this purpose are the body mass index and body-fat percentage. However, there is a certain controversy related to the body-fat percentage since it tends to overestimate overweight and obesity. The main objectives of this study were the following: (i) to determine the prevalence of overweight and obesity in a population of primary and secondary school children between 9-17 years of age at 13 educational centers in the city and province of Granada; (ii) to verify possible differences regarding the accuracy of the body mass index and the body-fat percentage in the diagnosis of overweight and obesity.

Protocolo de intervención de enfermería para favorecer el vínculo afectivo entre el bebé recién nacido con síndrome de Down y su familia / Nursing intervention protocol to help establish affective ties between the newborn infant with Down’s syndrome and his/her family

El establecimiento del vínculo afectivo entre madre e hijo representa un hecho universal en todas las culturas. A pesar de ello, su equilibrio puede verse perturbado por factores tanto ambientales, como de la madre o del recién nacido. La llegada de un recién nacido supone un acontecimiento familiar de alegría. Sin embargo, esta situación puede verse alterada cuando el recién nacido presenta alguna diferencia respecto a la normalidad, resultando en ocasiones en una ruptura en el proceso de vinculación afectiva en la familia, principalmente entre los padres y el bebé. Este tipo de situaciones se intensifi can cuando los padres no aceptan en los primeros días a su bebé con síndrome de Down. Los profesionales de enfermería elaboramos estrategias para facilitar el vínculo desde el momento del diagnóstico y en los primeros días posparto. La enfermera tendrá un papel esencial en la información a la familia. Debemos dar apoyo emocional e informar sobre el contacto piel con piel y las ventajas de la lactancia materna. Las posibilidades futuras de estos niños dependerán del nivel de estimulación y la aceptación de los padres. Debemos respetar las etapas emocionales por las que atraviesa la familia, especialmente los padres, pues de ellos dependerá la integración correcta del bebé. El objetivo de este trabajo fue establecer un protocolo de actuación de enfermería estandarizado para favorecer el vínculo afectivo entre el recién nacido con síndrome de Down y su familia (AU)

The establishment of affective ties between mother and child is a universal phenomenon in all cultures. However, this process can be disrupted by contextual factors of the mother and her newborn child. The arrival of a baby is generally a joyful event in all families. Nevertheless, this situation can change when the newborn baby is not regarded as normal. This can sometimes cause a breach in the affective ties within the family, mainly between the parents and their child. Situations of this type are intensifi ed when parents refuse to accept their Down’s syndrome baby from the very beginning. Nursing professionals prepare strategies help in the emotional bonding from the time of diagnosis, and in the period immediately after childbirth. In this respect, nurses have a crucial role as information providers for the family. More specifi cally, they give parents emotional support and tell them about the importance of skin to skin contact, as well as the advantages of breastfeeding. The emotional process that the family is going through must be respected, especially the parents since they are responsible for the integration of the baby into the family unit. The objective of this research was to establish a standard nursing intervention protocol that helps to establish affective ties and bonding between the Down’s syndrome baby and the family (AU)