La hemoglobina glucosilada como marcador de riesgo de hiperuricemia en la población general / Glycosylated hemoglobin as a hyperuricemia risk marker in general population

Fundamento y objetivo: Evaluar la hipótesis de que valores elevados de glucemia se asocian con menores valores séricos de ácido úrico, en 2 poblaciones independientes. Pacientes y método:La primera población procede del Estudio Pizarra, estudio prospectivo con 1.226 sujetos que se clasificaron según su situación metabólica tras una sobrecarga oral de glucosa. Se midieron variables antropométricas, valores basales de insulina, ácido úrico y resistencia a la insulina según el Homeostasis Model Assessment (HOMA-IR). La segunda muestra procede de la base de datos del Hospital Universitario Carlos Haya (Málaga), que recoge 81.754 sucesivas peticiones analíticas de hemoglobina glucosilada (HbA1c) realizadas a lo largo de 30 meses.Resultados: En el Estudio Pizarra los valores de glucosa se relacionaron con los valores de ácido úrico en ambos sexos. En la segunda muestra los valores de ácido úrico de mujeres siguieron una relación en forma de campana con la HbA1c, incrementándose hasta valores de HbA1c del 7% y descendiendo a medida que la HbA1c aumentaba (p<0,0001). En varones se produjo un descenso lineal de los valores de ácido úrico con el incremento de la HbA1c (r=−0,19; p<0,0001), a partir de valores de HbA1c del 7%. El valor de odds ratio para hiperuricemia descendió de manera continua según aumentaban los valores de HbA1c. Conclusión: Este estudio muestra en ambas poblaciones una correlación no lineal entre los valores séricos de ácido úrico y los de glucosa, HbA1c y HOMA-IR, siendo esta tendencia especialmente marcada en mujeres. El riesgo de hiperuricemia y gota podría ser mayor en las personas con estados prediabéticos o con diabetes mejor controlados que en diabéticos mal controlados (AU)

Background and objectives: To evaluate the association between high levels of glycemia and low serum uric acid levels in two independent population-based samples. Patients and methods: The first sample was taken from the Pizarra Study, a population-based prospective study of 1.226 persons classified according to their glycometabolic status, as measured from an oral glucose tolerance test. Variables recorded included anthropometric data, serum fasting insulin, uric acid (UA) and HOMA-IR. The second sample was obtained from the Central Laboratory Database, which includes 81,754 laboratory requests for HbA1c carried out over 30 months. We selected those that included measurements of UA, triglycerides and albuminuria Results: In the Pizarra Study, the fasting glucose levels showed a bell-shaped relation with serum UA levels in men andmore especially in women (P < 0.0001). In the second sample, the UA levels in women showed a bell-shaped relation with HbA1c, increasing as the HbA1c rose to 7% and then falling with the further increase of HbA1c (P < 0.0001). Men experienced a linear decrease in UA levels as the HbA1c rose (r = 0.19; P < 0.0001), though only with effect from HbA1c values > 7%. The odds ratio for hyperuricemia ( 6 mg/dL in women and 7 mg/dL in men) fell continuously as the HbA1c levels rose. Conclusions: This study, undertaken in two different populations, showed that serum UA levels are nonlinearlycorrelated with the levels of glucose, HbA1c and HOMA-IR, especially in women. The risk ofhyperuricemia and gout may be higher in persons with prediabetic states or with better-controlleddiabetes than in persons with poorly-controlled diabetes (AU)

[Glycosylated hemoglobin as a hyperuricemia risk marker in general population]. / La hemoglobina glucosilada como marcador de riesgo de hiperuricemia en la población general.

BACKGROUND AND OBJECTIVES: To evaluate the association between high levels of glycemia and low serum uric acid levels in two independent population-based samples. PATIENTS AND METHODS: The first sample was taken from the Pizarra Study, a population-based prospective study of 1.226 persons classified according to their glycometabolic status, as measured from an oral glucose tolerance test. Variables recorded included anthropometric data, serum fasting insulin, uric acid (UA) and HOMA-IR. The second sample was obtained from the Central Laboratory Database, which includes 81,754 laboratory requests for HbA(1c) carried out over 30 months. We selected those that included measurements of UA, triglycerides and albuminuria. RESULTS: In the Pizarra Study, the fasting glucose levels showed a bell-shaped relation with serum UA levels in men and more especially in women (P<0.0001). In the second sample, the UA levels in women showed a bell-shaped relation with HbA(1c), increasing as the HbA(1c) rose to 7% and then falling with the further increase of HbA(1c) (P<0.0001). Men experienced a linear decrease in UA levels as the HbA(1c) rose (r=-0.19; P<0.0001), though only with effect from HbA(1c) values > 7%. The odds ratio for hyperuricemia (≥ 6mg/dL in women and ≥ 7mg/dL in men) fell continuously as the HbA(1c) levels rose. CONCLUSIONS: This study, undertaken in two different populations, showed that serum UA levels are non-linearly correlated with the levels of glucose, HbA(1c) and HOMA-IR, especially in women. The risk of hyperuricemia and gout may be higher in persons with prediabetic states or with better-controlled diabetes than in persons with poorly-controlled diabetes.

Intake and home use of olive oil or mixed oils in relation to healthy lifestyles in a Mediterranean population. Findings from the prospective Pizarra study.

Discordances exist in epidemiological studies regarding the association between the intake of nutrients and death and disease. We evaluated the social and health profile of persons who consumed olive oil in a prospective population cohort investigation (Pizarra study) with a 6-year follow-up. A food frequency questionnaire and a 7 d quantitative questionnaire were administered to 538 persons. The type of oil used in food preparation was determined by direct measurement of the fatty acids in samples obtained from the kitchens of the participants at baseline and after follow-up for 6 years. The fatty acid composition of the serum phospholipids was used as an endogenous marker of the type of oil consumed. Total fat intake accounted for a mean 40 % of the energy (at baseline and after follow-up). The concordance in intake of MUFA over the study period was high. The fatty acid composition of the serum phospholipids was significantly associated with the type of oil consumed and with fish intake. The concentration of polar compounds and polymers, indicative of degradation, was greater in oils from the kitchens where sunflower oil or refined olive oil was used, in oils used for deep frying and in oils that had been reused for frying five times or more. Consumption of olive oil was directly associated with educational level. Part of the discordance found in epidemiological studies between diet and health may be due to the handling of oils during food preparation. The intake of olive oil is associated with other healthy habits.

Type 2 diabetes mellitus and other cardiovascular risk factors are no more common during menopause: longitudinal study.

OBJECTIVE: The aim of this study was to undertake a prospective study of the changes in certain risk factors for cardiovascular disease occurring during menopause. METHODS: A longitudinal cohort study of 475 women was followed up for 6 years (Pizarra Study). The final menstrual period was defined after at least 6 months of amenorrhea. The women were classified into three groups: group 1, no menopause at either the first or second study; group 2, no menopause at the first study but menopause at the second study (6 y later); and group 3, menopause at the first study (and also at the second). The following are the main outcome measures used: age; body mass index; waist circumference; waist-to-hip ratio; skinfold thickness; arm circumference; intake of macronutrients (quantitative questionnaire); systolic and diastolic blood pressures; cholesterol, triglycerides; high-density lipoprotein cholesterol; uric acid; homeostasis model assessment of insulin resistance; and the prevalence of obesity, hypertension, type 2 diabetes mellitus, impaired glucose tolerance, and impaired fasting glucose. RESULTS: None of the cardiovascular risk factors studied changed during the passage from premenopause to postmenopause, independently of age or physical activity. CONCLUSIONS: Menopause is a biological condition of the human species, for which has recently received attempts at medicalization that were not always justified. If menopause is not accompanied by any other cardiovascular risk factor independently of age, the stigma of menopause being considered a risk factor should cease. Although the results have the strength of a prospective study, the sample size forced us to consider these findings as preliminary.