Impaired fasting glucose, ancestry and waist-to-height ratio: main predictors of incident diagnosed diabetes in the Canary Islands.

AIMS: To estimate the incidence rate and risk factors for diabetes in the Canary Islands. METHODS: A total of 5521 adults without diabetes were followed for a median of 3.5 years. Incident cases of diabetes were self-declared and validated in medical records. The following factors were assessed by Cox regression to estimate the hazard ratios for diabetes: impaired fasting glucose (5.6 mmol/l ≤ fasting glucose ≤ 6.9 mmol/l), BMI, waist-to-height ratio (≥ 0.55), insulin resistance (defined as triglycerides/HDL cholesterol ≥ 3), familial antecedents of diabetes, Canarian ancestry, smoking, alcohol intake, sedentary lifestyle, Mediterranean diet, social class and the metabolic syndrome. RESULTS: The incidence rate was 7.5/10(3) person-years (95% CI 6.4-8.8). The greatest risks were obtained for impaired fasting glucose (hazard ratio 2.6; 95% CI 1.8-3.8), Canarian ancestry (hazard ratio 1.9; 95% CI 1.0-3.4), waist-to-height ratio (hazard ratio 1.7; 95% CI 1.1-2.5), insulin resistance (hazard ratio 1.5; 95% CI 1.0-2.2) and paternal history of diabetes (hazard ratio 1.5; 95% CI 1.0-2.3). The metabolic syndrome (hazard ratio 1.9; 95% CI 1.3-2.8) and BMI ≥ 30 kg/m(2) (hazard ratio 1.7; 95% CI 1.0-2.7) were significant only when their effects were not adjusted for impaired fasting glucose and waist-to-height ratio, respectively. CONCLUSIONS: The incidence of diabetes in the Canary Islands is 1.5-fold higher than that in continental Spain and 1.7-fold higher than in the UK. The main predictors of diabetes were impaired fasting glucose, Canarian ancestry, waist-to-height ratio and insulin resistance. The metabolic syndrome predicted diabetes only when its effect was not adjusted for impaired fasting glucose. In individuals with Canarian ancestry, genetic susceptibility studies may be advisable. In order to propose preventive strategies, impaired fasting glucose, waist-to-height ratio and triglyceride/HDL cholesterol should be used to identify subjects with an increased risk of developing diabetes.

Cytokine profile in collagen-induced arthritis: differences between syngeneic and allogeneic pregnancy.

OBJECTIVE: To identify the differences in cytokine profile between allogeneic and syngeneic pregnancy in mice with collagen-induced arthritis (CIA). METHODS: Mice (strain B10.RIII) were injected with bovine collagen. Females were mated with males of the same strain (syngeneic pregnancy) or with males of strain B10. Q (allogeneic pregnancy). Concentrations of cytokines were measured during pregnancy and after delivery, and the onset and evolution of arthritis was followed in all female animals throughout the study period. RESULTS: In female mice that developed CIA, cytokine concentrations were lower in allogeneic pregnancies than syngeneic pregnancies. When paired cytokine concentrations were compared in each animal during and after pregnancy, MCP-1 was lower during gestation than after delivery in both groups of pregnant mice, IL-6 was lower during gestation than after delivery only in allogeneic pregnancies, and IL-10 was lower during gestation than after delivery in allogeneic pregnancies, whereas in syngeneic pregnancies IL-10 was higher during gestation than after delivery. CONCLUSIONS: Allogeneic pregnancy was associated with less arthritis because of lower concentrations of proinflammatory cytokines (IL-6 and others), not because of an increase in the concentration of antiinflammatory cytokines (IL-10).

[Epidural spinal abscesses. Review of a clinical serie]. / Abscesos espinales epidurales. Revisión de una serie clínica.

INTRODUCTION: The spinal abscess is an infrequent infectious complication whose diagnosis is often delayed, therefore bringing about significant morbidity and death rates. In the last years, its incidence has raised progressively. The objective of this work is to present the clinical features of a series of spinal abscesses. METHOD: The clinical histories of all patients diagnosed of spinal cord abscess were evaluated retrospectively. RESULTS: We obtained seven cases, with a 5/2 male/female proportion, all subjects being over 50 years old. Incidence was 0.58/10,000 admissions per year. All patients debuted with local pains, but only 6/7 (90%) had fever. Focal neurological signs appeared in all patients within the first 0-5 day-period; they were weakness (86%) and sensitive alterations (43%). The most frequent germ was Staphylococcus aureus ( 5 0%). Diabetes mellitus existed in 5/7 cases (71.5%). Four patients were treated by surgery; three of them (75%) had flaccid motor deficit as sequel and the other died. Medical treatment alone was maintained in 3/7 (43%); two experienced partial improvement without recovery of the motor functions and another died. CONCLUSIONS: Spinal epidural abscess is a rare, although serious, disease. For this reason, we should maintain a high level of suspicion when a patient has spinal or radicular pain associated with systemic symptoms such as fever or deterioration in the general state of health, especially in patients >50 years under weakening situations.