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Introduction and Objective: Excess weight can cause structural and functional cardiac disorders. The presence of left ventricular hypertrophy in the obese patient is an independent predictor of cardiovascular morbidity and mortality. The major aim of the present study is to know the prevalence of cardiac morphofunctional disorders in obese patients, before and after weight loss due to bariatric surgery (BS)., Patients and Methods: Prospective cohort study of 75 patients with obesity without known heart disease referred to gastric bypass. Anthropometric, analytical and echocardiographic parameters were measured before and after 6 and 12 months after BS., Results: The study included 75 patients (66.6% women, mean age 39.3 [9.7] years and BMI 47.8 [7.1] kg/m 2 ). At 6 and 12 months after BS there was a significant reduction in body weight and an improvement in metabolic, inflammatory and prothrombotic parameters and in cardiovascular risk factors associated with obesity (hypertension, type 2 diabetes, dyslipidemia and obstructive sleep apnea-hypopnea syndrome). Before surgery, cardiac remodeling was present in 62.7%, most frequently in the form of concentric remodeling (38.7%). Diastolic dysfunction occurred in 50.7% of the patients. One year after surgery, the ventricular pattern was normal in 92% of cases and the diastolic function improved significantly., Conclusions: Our results support the negative effect of obesity on cardiac geometry and function and the potential reversibility of these cardiac alterations after marked weight loss due to BS., (Copyright © 2021 Elsevier España, S.L.U. All rights reserved.)

Background: The relationship between asthma and vitamin D deficiency has been known for some time. However, interventional studies conducted in this regard have shown conflicting results., Objective: To evaluate the efficacy of vitamin D supplementation in asthmatic patients in improving the degree of control of asthma., Methods: Randomised, triple-blind, placebo-controlled, parallel-group study in adult asthmatic patients with serum 25-hydroxyvitamin-D 3 <30 ng/mL. The intervention group received oral supplementation with 16 000 IU of calcifediol per week, and the control group had placebo added to their usual asthma treatment. The study period was 6 months. The primary endpoint was the degree of asthma control as determined by the asthma control test (ACT). Secondary endpoints included quality of life measured using the mini Asthma Quality of Life Questionnaire, the number of asthma attacks, oral corticosteroid cycles, the dose of inhaled corticosteroids, number of emergency visits, unscheduled consultations with the primary care physician and hospitalisations for asthma., Results: One hundred and twelve patients were randomised (mean age 55 years, with 87 (78%) being women). Of the 112 patients, 106 (95%) completed the trial. Half the patients (56) were assigned to the intervention group and the other half to the control group. A statistically significant clinical improvement was observed in the intervention group (+3.09) compared with the control group (-0.57) (difference 3.66 (95% CI 0.89 to 5.43); p<0.001) as measured using ACT scores. Among the secondary endpoints, a significant improvement in the quality of life was found in the intervention group (5.34), compared with the control group (4.64) (difference 0.7 (95% CI 0.15 to 1.25); p=0.01)., Conclusion: Among adults with asthma and vitamin D deficiency, supplementation with weekly oral calcifediol compared with placebo improved asthma control over 6 months. Further research is needed to assess long-term efficacy and safety., Trial Registration Number: NCT02805907., Competing Interests: Competing interests: All authors have completed and submitted the ICMJE for disclosure of potential conflict of interest. Outside the submitted work, RA-E reports personal fees and non-financial support from AstraZeneca, personal fees and non-financial support from Boehringer Ingelheim, personal fees and non-financial support from Chiesi, personal fees and non-financial support from Orion Pharma, personal fees and non-financial support from MundiPharma, personal fees and non-financial support from Novartis, personal fees and non-financial support from Menarini, personal fees and non-financial support from FAES Pharma, personal fees from Ferrer, personal fees and non-financial support from Zambon. Outside the submitted work, LS-G reports personal fees and non-financial support from Lilly, personal fees and non-financial support from Novo Nordisk, personal fees from AstraZeneca, personal fees and non-financial support from Sanofi, personal fees from Lacer, personal fees from Casen Recordati, personal fees and non-financial support from Jansen-Cilag, personal fees and non-financial support from Nutricia, personal fees and non-financial support from Nestlé, personal fees from Abbott and personal fees and non-financial support from Fresenius-Kabi. Outside the submitted work, FI-G reports non-financial support from Novo Nordisk, personal fees and non-financial support from Lilly, personal fees and non-financial support from Sanofi, personal fees from Abbott and personal fees from AstraZeneca. MC-M reports personal fees from AstraZeneca and Chiesi. CH-Y reports personal fees from Boehringer Ingelheim, outside the submitted work., (© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.)

Background and Objectives: Resistin was originally suggested to be a potential mediator of obesity-related insulin resistance in rodents. However, in humans, the role of resistin in obesity and insulin resistance has not yet been demonstrated. The present study investigates whether there are differences in resistin levels between patients with morbid obesity and lean subjects, and analyzes changes in resistin levels after significant weight loss secondary to bariatric surgery., Methods: Sixty-eight patients with morbid obesity (body mass index [BMI] ≥ 40 kg/m2) and 31 lean subjects (BMI < 25 kg/m2) were selected. The study variables were: weight, height, BMI, waist-hip ratio (WHR), fat mass, family history of cardiovascular disease (CVD), type 2 diabetes mellitus (DM), hypertension, dyslipidemia, smoking, glucose, glycated hemoglobin (HbA1c), insulin, high-sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6), adiponectin and resistin. Homoeostasis model assessment (HOMA) and quantitative insulin sensitivity check index (QUICKI) were calculated. The obese patients underwent gastric bypass surgery, and the above mentioned variables were reassessed after 12 months and major weight loss., Results: There were no significant differences in resistin levels between morbidly obese patients and healthy subjects of normal weight, or between obese patients before and after weight loss. Resistin levels in morbidly obese patients were not correlated to adiposity anthropometric measures, insulin, glucose, HOMA, QUICKI, hsCRP, IL-6 or adiponectin. In the morbid obesity group, after one year of weight loss, the only study parameter correlated to resistin levels was IL-6., Conclusion: Our results do not support a relationship among resistin levels, obesity and insulin resistance in humans.

Objective: Obesity is associated with a high risk for atherosclerotic cardiovascular disease. There is a causal association between obesity, inflammation, insulin resistance (IR) and endothelial dysfunction. The aim of this study was to evaluate changes in IR, proinflammatory state and markers of endothelial dysfunction in morbidly obese patients after weight loss following bariatric surgery., Methods: In this study, we measured the levels of soluble intracellular adhesion molecule-1 (sICAM1), plasminogen activator inhibitor 1 (PAI-1), high-sensitivity C-reactive protein (hs-CRP), and interleukin-6 (IL-6) in 79 morbidly obese patients at baseline and 3, 6 and 12 months after gastric bypass. Also, we evaluated changes in IR., Results: Twelve months after surgery, there was a significant decrease in plasma levels of sICAM1 (p < 0.001), PAI-1 (p < 0.05), hs-CRP (p < 0.001), IL-6 (p < 0.001) and homeostasis model assessment (HOMA) (p < 0.001) and a significant increase of McAuley index (McAuley) (p < 0.001). Baseline levels of hs-PCR were positively correlated with sICAM-1 (r = 0.450, p < 0.01) and IL-6 (r = 0.451, p < 0.01). Significant correlations were also found between the decrease of PAI-1 and the decrease of hs-PCR (r = 0.425, p < 0.01) and tryglicerides (r = 0.351, p < 0.01)., Conclusions: In patients with morbid obesity, substantial surgically induced weight loss is followed by a significant improvement in the endothelial function, inflammatory state and insulin sensitivity, that may reduce their cardiovascular risk. A relationship exists between improved inflammatory profile and endothelial function.

Background and Objective: Thyroid cancer may be clinically evident as a tumor mass in the neck or as a histopathological incidental finding after thyroid surgery for an apparent benign condition. Our objective was to assess the differences in clinical signs, surgical management, and course between incidental and clinically diagnosed thyroid tumors., Methods: A retrospective study was conducted on patients operated on for benign or malignant thyroid disease from January 2000 to March 2014. Among the 1415 patients who underwent any thyroid surgery, 264 neoplasms were found, of which 170 were incidental. A comparison was made of incidental versus non-incidental carcinomas. Among incidental carcinomas, cases whose indication for surgery was Graves' disease were compared to those with multinodular goiter., Results: Incidental carcinomas were in earlier stages and required less aggressive surgery. There were no differences in surgical complications between incidental and clinical tumors, but mortality and relapses were markedly higher in non-incidental cancers (4.4% vs 0% and 13.2% vs 4.8% respectively). Carcinomas developing on Graves' disease showed no differences from all other incidental tumors in terms of complications, mortality, or relapse after surgery., Conclusions: Early stage thyroid cancer has better survival and prognosis after surgical treatment., (Copyright © 2016 SEEN. Publicado por Elsevier España, S.L.U. All rights reserved.)

Background: Obesity is associated with a low-grade inflammatory state. A causal association between inflammation and atherosclerosis has been suggested. The aim of this study was to evaluate changes in the proinflammatory profile of morbidly obese patients after weight loss following bariatric surgery., Methods: In this study, we measured levels of adiponectin, high-sensitivity C-reactive protein (hs-CRP), tumour necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) and their relation to insulin resistance and lipid parameters in 60 morbidly obese women at baseline and 3, 6 and 12 months after gastric bypass., Results: Twelve months after surgery, there was a significant increase in plasma levels of adiponectin (p < 0.001) and high-density lipoprotein cholesterol (p < 0.01) and a significant decrease in levels of IL-6 (p < 0.001), hs-CRP (p < 0.001), cholesterol (p < 0.001), triglycerides (p < 0.001), low-density lipoprotein cholesterol (p < 0.001), glucose (p < 0.001), insulin (p < 0.001) and homeostasis model assessment (HOMA; p < 0.001). At 12 months, correlations were seen between IL-6 levels and the following: body mass index (BMI) (r = 0.53, p < 0.001), insulin (r = 0.51, p < 0.001) and HOMA (r = 0.55, p < 0.001). Also, hs-CRP levels correlated with BMI (r = 0.40, p = 0. 004), triglycerides (r = 0.34, p = 0.017), insulin (r = 0.50, p = 0.001) and HOMA (r = 0.46, p = 0.002)., Conclusions: In patients with morbid obesity, significant weight loss is followed by a significant improvement in the inflammatory state, insulin sensitivity and lipid profile. A relationship exists between improved inflammatory profile and insulin sensitivity.

Background and Objectives: Obesity is associated with a state of chronic low-grade inflammation. A causal association between inflammatory processes and atherogenesis has been proposed. The aim of this study was to evaluate changes in the proinflammatory profile of morbidly obese patients who underwent bariatric surgery. Serum C-reactive protein (CRP) and soluble intercellular adhesion molecule-1 (sICAM-1) concentrations were measured before and after massive weight loss due to gastric bypass., Methods: In this prospective study we measured CRP and sICAM-1 concentrations in 50 morbidly obese patients (19 men and 31 women) at baseline and 3, 6 and 12 months after gastric bypass., Results: Body mass index (BMI), CRP, and sICAM-1 decreased significantly. BMI correlated with CRP but not with sICAM-1., Conclusions: The improvement in vascular risk profile after weight loss in morbidly obese patients could be partially explained by changes in inflammatory status., (Copyright 2009 SEEN. Published by Elsevier Espana. All rights reserved.)

Thyrotropin secreting adenomas (TSH-omas) account for less than 1% of all pituitary adenomas and are a rare cause of hyperthyroidism. Most cases correspond to macroadenomas, microadenomas being exceptional. Differential diagnosis should be made with resistance to thyroid hormones. The first line treatment is transphenoidal surgery. When surgery is unsuccessful, somatostatin analogues are a therapeutic alternative. We report a patient with a TSH-secreting microadenoma. The microadenoma was resected through the transsphenoidal route. Because surgery was unsuccessful, medical therapy with somatostatin analogue was initiated. Currently, 9 years later, the patient continues to be under treatment with somatostatin analogue therapy, which has controlled the hyperthyroidism and tumoral growth. We describe successful long-term treatment of a TSH-oma with somatostatin analogue therapy when surgery is unsuccessful., (Copyright © 2008 Sociedad Española de Endocrinología y Nutrición. Published by Elsevier Espana. All rights reserved.)

Background and Objective: Type 2 diabetes mellitus is associated with an augmented risk for cardiovascular disease. The levels of C-reactive protein (CRP), the prototypic marker of inflammation, are associated with an increased risk for cardiovascular events. The statins have direct anti-inflammatory effects. Thus, we tested the effects of atorvastatin on levels of CRP on patients with type 2 diabetes., Patients and Method: We evaluated CRP in baseline and 6 months after onset of 20 mg daily atorvastatin therapy of 30 patients with type 2 diabetes with hyperlipidemia. Clinical and biochemical data were obtained., Results: CRP-levels were significantly decreased after treatment with atorvastatin compared with baseline (median change: -4,99 mg/l; p < 0.001). We observed an correlation between CRP baseline with body mass index (r = 0.429; p = 0.018), serum fibrinogen (r = 0.607; p = 0.001) and microalbuminuria (r = 0.470; p = 0.01). Conversely, there was no significant correlation between CRP baseline with LDL cholesterol. The CRP reduction was significantly correlated with fasting glucose (r = -0.457; p = 0.019) and glycosylated hemoglobin at 6 months (r = -0.421; p = 0.03)., Conclusions: These results confirm findings from previous studies that atorvastatin reduce CRP levels in a largely LDL cholesterol independent manner.

Background: The aim of this study was to know the anthropometric study of school children in Murcia in order to obtain parameters of present reference for our country and region., Methods: A transversal study of the school population of the community of Murcia at Preschool, EGB, BUP and Technical School levels was carried out including 1,930 children between the ages of 4 and 17. These children were selected from a total of 242,596 proportionally chosen with respect to demography of each of the twelve regions in the area with weight, height and bicipital, tricipital, subscapular and abdominal skin folds being measured., Results: The values obtained and classified by age, sex and regions of the autonomic community of Murcia exposed in tables, demonstrate the differences existing in all the parameters measured with those routinely used at an international and national level., Conclusions: The differences found clearly justify the need to compare the regional antropometric alterations with the "reference parameters" obtained in Spain and Murcia for which other studies concerning the same would be advisable.