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1. Prediction of outcomes in subjects with type 2 diabetes and diabetic foot ulcers in Catalonian primary care centers: a multicenter observational study

Author

Magdalena Bundó, Bogdan Vlacho, Judit Llussà, Isabel Bobé, Meritxell Aivar, Carmen Ciria, Ana Martínez‐Sánchez, Jordi Real, Manel Mata‐Cases, Xavier Cos, Montserrat Dòria, Jordi Viade, Josep Franch‐Nadal, and Dídac Mauricio

Subjects
Diseases of the musculoskeletal system, RC925-935
Abstract

Abstract Background Diabetic foot and lower limb complications are an important cause of morbidity and mortality among persons with diabetes mellitus. Very few studies have been carried out in the primary care settings. The main objective was to assess the prognosis of diabetic foot ulcer (DFU) in patients from primary care centers in Catalonia, Spain, during a 12‐month follow‐up period. Methods We included participants with type 2 diabetes and a new DFU between February 2018 and July 2019. We estimated the incidence of mortality, amputations, recurrence and healing of DFU during the follow‐up period. A multivariable analysis was performed to assess the association of these outcomes and risk factors. Results During the follow‐up period, 9.7% of participants died, 12.1% required amputation, 29.2% had a DFU recurrence, and 73.8% healed. Having a caregiver, ischemia or infection were associated with higher mortality risk (hazard ratio [HR]:3.63, 95% confidence interval [CI]:1.05; 12.61, HR: 6.41, 95%CI: 2.25; 18.30, HR: 3.06, 95%CI: 1.05; 8.94, respectively). Diabetic retinopathy was an independent risk factor for amputation events (HR: 3.39, 95%CI: 1.37; 8.39). Increasing age decreased the risk for a DFU recurrence, while having a caregiver increased the risk for this event (HR: 0.97, 95%CI: 0.94; 0.99). The need for a caregiver and infection decreased the probability of DFU healing (HR: 0.57, 95%CI: 0.39; 0.83, HR: 0.64, 95%CI: 0.42; 0.98, respectively). High scores for PEDIS (≥7) or SINBAD (≥3) were associated with an increased risk for DFU recurrence and a lower probability of DFU healing, respectively. Conclusions We observed high morbidity among subjects with a new DFU in our primary healthcare facilities. Peripheral arterial disease, infection, and microvascular complications increased the risk of poor clinical outcomes among subjects with DFU.

Published
2023
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2. Asociación de obesidad general y abdominal con hipertensión, dislipemia y presencia de prediabetes en el estudio PREDAPS

Author

Jaime Innerárity, Manuel Sánchez, Francisco Carlos Pérez, Ángel M. Alonso Gómez, Rafael Colás, J. Rubio, Alicia Monzón, Dimas Igual, Francisca Paniagua, Luis Prieto, Laura Romera, Ángeles Jurado, Carolina Giráldez-García, Remei Bosch, Josep Franch, Belén Benito, Rosario Martínez, José Luis Torres, J. Carles González, M. Soledad Mayayo, Jesús Torrecilla, Ana Casorrán, Mercedes Ibáñez, M. Isabel Bobé, Luis Mendo, F. Javier García-Soidán, Julio Sagredo, Gabriel Cuatrecasas, José L. Ramos Martín, Ramon M. Pujol, J. Joaquín Antón, Javier Díez, Fernando Villar Álvarez, M. José Mansilla, Beatriz Álvarez, Irene Ruiz, Marti Birules, Fernando Malo, Jorge A. R. Navarro, Luis Ávila, Sara Artola, José Luis Pardo, Riánsares López, J. José Cabré, M. del Mar Álvarez, Nuria Porta, F. Javier Sangrós, Pedro P. Pérez, Esteban Granero, Albert Goday, Rosario Iglesias, Rosario Serrano, Pilar Buil, Carmen Babace, Pilar Roura, Ángela Trinidad Gutiérrez, Pedro Nogales, Juan J. Rodriguez, Francisco José Castro García, Paula Gabriel, Francisco Carbonell, A. María de Santiago, M. Teresa Marín, Mercedes del Castillo, J. Carlos Álvarez, Blanca Cordero, Oriol Armengol, Ainhoa Cambra, Mercè Villaró, Ana M. Hernández, Isabel Sáenz, Teresa Mur, Francisco Javier Ortega, Gloria Sanz, Santiago Poveda, Eduard Tarragó, F. Javier Martínez, Juan Gabriel Martínez Martínez, Jazmín Ripoll, J. Carlos Obaya, Patxi Ezkurra, Alejandro Salanova, Antonio Rodríguez, Javier Gamarra, Lourdes Carrillo, Yon Iriarte, Pedro Muñoz, Antonio Ruiz, Francisco Carramiñana, Dulce Suárez, Raquel Plana, Ramón Macía, María del Carmen Gómez, L. Gabriel Sánchez, Flora López, Ana Moreno, J. Javier Mediavilla, J. Manuel Millaruelo, Carmen Losada, Emma Navarro, Rosa Mar de Miguel, Rafael Llanes, Luis García-Giralda, Manuel Antonio Ruiz, Enrique Regidor, María L. González, José Mancera, Concepción Blanco, M. Carmen Durán, M. Ángeles Rollán, M. Teresa Gijón, Ángela Lorenzo, M. Jesús Brito, Mateu Seguí, Beatriz Bilbeny, Cristina de Castro, M. Jesús Bedoya, Neus Piulats, M. Mata, Antonia Borras, Lourdes Barutell, Xavier Mundet, Xavier Cos, Margarita Alonso, Luisa Gutiérrez, Félix Gutiérrez, Carmen Boente, Manuel de la Flor, M. Ángel Gutiérrez, and Carlos de la Sen

Subjects
Gynecology, 03 medical and health sciences, medicine.medical_specialty, 0302 clinical medicine, business.industry, medicine, 030212 general & internal medicine, 030204 cardiovascular system & hematology, Cardiology and Cardiovascular Medicine, business
Abstract

Resumen Introduccion y objetivos Algunas medidas antropometricas muestran mayor capacidad que otras para discriminar la presencia de factores de riesgo cardiovascular. Este trabajo estima la magnitud de la asociacion de diversos indicadores antropometricos de obesidad con hipertension, dislipemia y prediabetes (glucemia basal o glucohemoglobina alteradas). Metodos Analisis transversal de la informacion recogida en 2.022 sujetos del estudio PREDAPS (etapa basal). Se definio obesidad general como indice de masa corporal ≥ 30 kg/m2 y obesidad abdominal con 2 criterios: a) perimetro de cintura (PC) ≥ 102 cm en varones/PC ≥ 88 cm en mujeres, y b) indice cintura/estatura (ICE) ≥ 0,55. La magnitud de la asociacion se estimo mediante regresion logistica. Resultados La hipertension arterial mostro la asociacion mas alta con la obesidad general en mujeres (OR = 3,01; IC95%, 2,24-4,04) y con la obesidad abdominal segun el criterio del ICE en varones (OR = 3,65; IC95%, 2,66-5,01). La hipertrigliceridemia y los valores bajos de colesterol unido a lipoproteinas de alta densidad mostraron la asociacion mas alta con obesidad abdominal segun el criterio del ICE en mujeres (OR = 2,49; IC95%, 1,68-3,67 y OR = 2,70; IC95%, 1,89-3,86) y la obesidad general en varones (OR = 2,06; IC95%, 1,56-2,73 y OR = 1,68; IC95%, 1,21-2,33). La prediabetes mostro la asociacion mas alta con obesidad abdominal segun el criterio del ICE en mujeres (OR = 2,48; IC95%, 1,85-3,33) y con obesidad abdominal segun el criterio del PC en varones (OR = 2,33; IC95%, 1,75-3,08). Conclusiones Los indicadores de obesidad abdominal mostraron la mayor asociacion con la presencia de prediabetes. La relacion de los indicadores antropometricos con hipertension y con dislipemia mostro resultados heterogeneos.

Published
2018
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3. Association of General and Abdominal Obesity With Hypertension, Dyslipidemia and Prediabetes in the PREDAPS Study

Author

Jaime Innerárity, José Luis Pardo, Jazmín Ripoll, Rafael Colás, Manuel Sánchez, Antonio Rodríguez, José Luis Torres, Riánsares López, J. Javier Mediavilla, Josep Franch, Ángela Trinidad Gutiérrez, Blanca Cordero, Alejandro Salanova, Félix Gutiérrez, J. Rubio, Mercedes Ibáñez, Laura Romera, Javier Gamarra, Lourdes Carrillo, M. Ángel Gutiérrez, M. Isabel Bobé, Pedro P. Pérez, María L. González, Francisco Carbonell, Carmen Boente, Xavier Mundet, L. Gabriel Sánchez, Francisco Javier Ortega, Ángel M. Alonso Gómez, J. Carles González, Santiago Poveda, Beatriz Álvarez, Ana M. Hernández, Carlos de la Sen, Manuel de la Flor, Xavier Cos, Juan Gabriel Martínez Martínez, Ainhoa Cambra, Julio Sagredo, María del Carmen Gómez, Ángeles Jurado, Nuria Porta, Pilar Roura, Francisca Paniagua, Irene Ruiz, Pedro Muñoz, Antonio Ruiz, Patxi Ezkurra, Albert Goday, Sara Artola, Fernando Villar Álvarez, M. José Mansilla, F. Javier Sangrós, Eduard Tarragó, Luisa Gutiérrez, M. Soledad Mayayo, Luis Prieto, J. Manuel Millaruelo, Jesús Torrecilla, Luis Ávila, Gabriel Cuatrecasas, Remei Bosch, Fernando Malo, M. Carmen Durán, Jorge A. R. Navarro, Rosario Martínez, Luis García-Giralda, Raquel Plana, Ramón Macía, Flora López, Marti Birules, Margarita Alonso, J. Joaquín Antón, M. Ángeles Rollán, Carmen Losada, Emma Navarro, Antonia Borras, Mercè Villaró, M. Teresa Gijón, Rosario Iglesias, Manuel Antonio Ruiz, Enrique Regidor, José L. Ramos Martín, M. Teresa Marín, Ramon M. Pujol, J. José Cabré, Isabel Sáenz, Mateu Seguí, Esteban Granero, Francisco Carramiñana, José Mancera, Beatriz Bilbeny, Pedro Nogales, Lourdes Barutell, Ana Moreno, Cristina de Castro, Juan J. Rodriguez, Rosa Mar de Miguel, Rafael Llanes, Ángela Lorenzo, Concepción Blanco, A. María de Santiago, M. Jesús Brito, Gloria Sanz, M. Mata, M. Jesús Bedoya, Luis Mendo, F. Javier García-Soidán, Neus Piulats, Francisco Carlos Pérez, Ana Casorrán, Paula Gabriel, Teresa Mur, F. Javier Martínez, J. Carlos Obaya, Belén Benito, Javier Díez, Rosario Serrano, Pilar Buil, Francisco José Castro García, J. Carlos Álvarez, M. del Mar Álvarez, Alicia Monzón, Oriol Armengol, Dimas Igual, Carolina Giráldez-García, Yon Iriarte, Dulce Suárez, Carmen Babace, and Mercedes del Castillo

Subjects
Adult, Male, medicine.medical_specialty, Cardiovascular risk factors, Disorder of lipid metabolism, Trastorno del metabolismo de los lípidos, Obesidad, 030209 endocrinology & metabolism, Risk Assessment, Prediabetic State, Obesidad abdominal, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Internal medicine, Hipertensión, medicine, Humans, 030212 general & internal medicine, Prediabetes, Obesity, Abdominal obesity, Aged, Dyslipidemias, Plasma glucose, Anthropometry, business.industry, Incidence, Estado prediabético, General Medicine, Middle Aged, Prognosis, medicine.disease, Cross-Sectional Studies, Endocrinology, Medidas antropométricas, Spain, Obesity, Abdominal, Hypertension, Female, Hemoglobin, medicine.symptom, Anthropometric measurements, business, Dyslipidemia
Abstract

INTRODUCTION AND OBJECTIVES: Some anthropometric measurements show a greater capacity than others to identify the presence of cardiovascular risk factors. This study estimated the magnitude of the association of different anthropometric indicators of obesity with hypertension, dyslipidemia, and prediabetes (altered fasting plasma glucose and/or glycosylated hemoglobin). METHODS: Cross-sectional analysis of information collected from 2022 participants in the PREDAPS study (baseline phase). General obesity was defined as body mass index = 30kg/m(2) and abdominal obesity was defined with 2 criteria: a) waist circumference (WC) = 102cm in men/WC = 88cm in women, and b) waist-height ratio (WHtR) = 0.55. The magnitude of the association was estimated by logistic regression. RESULTS: Hypertension showed the strongest association with general obesity in women (OR, 3.01; 95%CI, 2.24-4.04) and with abdominal obesity based on the WHtR criterion in men (OR, 3.65; 95%CI, 2.66-5.01). Hypertriglyceridemia and low levels of high-density lipoprotein cholesterol showed the strongest association with abdominal obesity based on the WHtR criterion in women (OR, 2.49; 95%CI, 1.68-3.67 and OR, 2.70; 95%CI, 1.89-3.86) and with general obesity in men (OR, 2.06; 95%CI, 1.56-2.73 and OR, 1.68; 95%CI, 1.21-2.33). Prediabetes showed the strongest association with abdominal obesity based on the WHtR criterion in women (OR, 2.48; 95%CI, 1.85-3.33) and with abdominal obesity based on the WC criterion in men (OR, 2.33; 95%CI, 1.75-3.08). CONCLUSIONS: Abdominal obesity indicators showed the strongest association with the presence of prediabetes. The association of anthropometric indicators with hypertension and dyslipidemia showed heterogeneous results.

Published
2018

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