Irisin is more strongly associated with leisure-time physical activity than resistin and high-density lipoprotein cholesterol are.

Obectives: Irisin is a myokine with a potential role in cardiometabolic diseases, but previous studies have described inconsistencies between serum irisin and physical activity (PA). Our aim was to analyze the relationship between serum irisin and leisure-time PA (LTPA) in a large sample of the general adult population, and secondarily, to evaluate its relationship with two PA-related biomarkers (HDL cholesterol and resistin). Design: A cross-sectional study was nested in the "CDC of the Canary Islands" cohort participants (n = 3827, 18-75 years, 60% women). Methods: PA was collected by administering the Minnesota leisure-time physical activity questionnaire, and physical examination and blood tests (irisin, resistin, HDL-cholesterol) were performed. Results: Irisin inversely correlated with BMI (p < 0.001 in women) and resistin (p = 0.038 in women, p = 0.004 in men), and directly with HDL cholesterol (p < 0.001in women). There was a direct association of irisin with leisure-time and energy expenditure in light, moderate and vigorous LTPA, which was stronger in women than men. The distribution of leisure-time and PA variables across irisin quintiles showed a significant trend, except for light LPTA in men. Adjusting for age, sex and BMI, the association of irisin with leisure-time and LTPA variables was stronger than the association of these variables with resistin and HDL cholesterol, reaching the strongest association for irisin with the 80th percentile of time of LTPA (OR = 2.57; 95% CI = 2.00-3.31). Conclusions: There is a direct and independent association between serum irisin levels and LTPA in the general adult population, which is stronger than other biomarkers of PA. Findings on exercise-related irisin support the possibility of irisin health benefits.

Abordaje terapéutico de la diabetes inestable / Management of brittle diabetes

El manejo de la diabetes inestable constituye un indudable reto tanto para pacientes como para profesionales. Las oscilaciones glucémicas impredecibles que la caracterizan, además de dificultar enormemente el control metabólico del paciente, también condicionan un deterioro importante en su calidad de vida y determinan que el abordaje terapéutico de este cuadro sea complejo y a menudo frustrante. Sin embargo, tenemos hoy en día en nuestras manos múltiples herramientas que, junto a la adecuada colaboración entre médicos, enfermería y los propios pacientes, nos permitirán enfrentarnos a esta entidad con ciertas garantías de éxito. En este artículo se repasan las características generales de la diabetes inestable, así como las distintas opciones terapéuticas disponibles para su abordaje

Management of brittle diabetes is undoubtedly a challenge for both patients and professionals. The unpredictable glycemic variations that characterize it, and also greatly hinder the patient's metabolic control, cause a significant deterioration in their quality of life and makes the therapeutic approach complex and often frustrating. However, we now have multiple tools in our hands that, in conjunction with the appropriate cooperation between doctors, nurses and patients themselves, will enable us to deal with this condition with high chances of success. This article reviews the general characteristics of brittle diabetes and the various treatment options available to manage it