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AimResistin is a cytokine related with inflammation and ischemic heart disease. Physical activity (PA) prevents chronic inflammation and ischemic heart disease. We studied the relationship of serum concentration of resistin with HDL cholesterol, a known biomarker of PA, and with different measures of PA, in a large sample of the general adult population in the Canary Islands.MethodsCross-sectional study of 6636 adults recruited randomly. We analyzed the correlation of resistin and HDL cholesterol with PA (as metabolic equivalent level [MET]), and fitted the results with linear and logistic regression models using adjustment for age, alcohol consumption and smoking.ResultsMean resistin level was higher in women (p<0.001), correlated inversely with age, HDL cholesterol (p<0.001) and alcohol consumption (p<0.001 in men), and correlated directly with smoking (p<0.001). Resistin correlated inversely with the duration of leisure time PA (p<0.001), leisure time MET (p<0.001) and moderate leisure time PA (p<0.001), with some differences between sexes. Men (OR = 0.78 [0.61–0.99; p<0.05]) and women (OR = 0.75 [0.61–0.92; p<0.01]) in the upper quintile of leisure time PA had a lower risk of elevated resistin. In contrast, a high degree of sedentarism was associated with an increased risk elevated resistin in women (OR = 1.24 [1.04–1.47; p<0.05] and in men (OR = 1.40 [1.01–1.82; p<0.05]).ConclusionsIn our sample of the general population, resistin was inversely associated with measures and levels of PA and HDL cholesterol. The association of resistin with PA was stronger than the association of HDL cholesterol with PA, making resistin a potentially useful biomarker of PA.

BackgroundThere is an increasing prevalence of obesity and metabolic syndrome (MS) in developing countries. It has been shown the relationship between social class and MS in developed countries. The objective of our study was to compare the association of social class with the prevalence of MS in a developing country (Tunisia, region of Cap-Bon) and a developed one (Spain, Canary Islands).MethodsCross-sectional study of 6729 Canarian and 393 Tunisian individuals. Social class was measured with the income, crowding and education (ICE) model, which includes family income, household crowding and education level. Logistic regression models adjusted by age estimated the risk by odds ratio (OR) and confidence interval (CI 95 %) of MS according to social class.ResultsMS prevalence was higher in Tunisian (50 %) than in Canarian women (29 %; p = 0.002), with no significant differences between men. For Canarian women, being in the highest social class was a protective factor against MS (OR = 0.39; CI 95 % 0.29–0.53) and all its components. The Canarian population and the Tunisian women, showed a significant linear trend (p < 0.001) of MS to decrease when social class increased.ConclusionHigh social class is a protective factor from MS and its components within the Canarian population and the Tunisian women. Our results suggest that the socioeconomic transition in a developing country like Tunisia can improve the population health in a sex-specific manner.

Aims: To evaluate the effect of obesity associated or not with Metabolic Syndrome (MS) on leptinemia, insulinemia and lipid profile in subjects from the region of Cap-Bon in northeastern Tunisia. Methods: Ninety seven individuals were included in this study. Anthropometric parameters (Body Mass Index (BMI), Waist Circumference (WC) and Hip Circumference (HC), metabolic parameters (Total Cholesterol (TC), LDL-C, HDL-C, Non-Esterified Fatty Acids (NEFA), Triglycerides (TG), C˗Reactive Protein (CRP), glucose) and hormones (insulin and leptin) were determined. Insulin resistance was estimated by Homeostasis Model Assessment of Insulin Resistance (HOMA-IR). Metabolic syndrome was identified with the International Diabetes Federation (IDF) criteria. Results: Obese patients with and without MS, Ob-MS and Ob groups, have significantly increased plasma levels of glucose, TG, TC, LDL-C and decreased HDL-C. In obese subjects Ob and Ob-MS, plasma levels of insulin and the HOMA-IR index were increased especially when obesity is associated with MS, conversely to leptin which decreases slightly in the presence of MS. Leptinemia was positively correlated with BMI in the whole population. But, we did not find any correlation between leptinemia and HOMA-IR. In controls, plasma leptin concentrations were positively correlated to LDL-C (p<0.05). Conclusion: Our findings support the link between leptinemia in obesity, associated or not with MS. However, in the Tunisian population plasma leptin was not associated to insulin profile.

Objectives. To analyze mortality in Spain and the United States before and after these countries implemented divergent policies in response to the financial crisis of 2008. Methods. We examined mortality statistics in both countries in the years 2000 to 2015. Spain started austerity policies in 2010. We compared differences in mortality ratios, on the basis of trends and effect size analysis. Results. During 2000 to 2010, overall mortality rates (r = 0.98; P < .001; Cohen’s d = −0.228) decreased in both countries. In 2011, this trend changed abruptly in Spain, where observed mortality surpassed expected mortality by 29% in 2011 and by 41% in 2015. By contrast, observed mortality surpassed expected mortality in the United States by only 8% in 2015. As the mortality statistics diverged, the effect size greatly increased (d = 7.531). During this 5-year period, there were 505 559 more deaths in Spain than the expected number, while in the United States the difference was 431 501 more deaths despite the 7-fold larger population in the United States compared with Spain. Conclusions. The marked excess mortality in 2011 to 2015 in Spain is attributable to austerity policies.

Euglycemic patients with e-IR present an unfavorable serum lipid and inflammatory biomarker profile. Measuring C-peptide in euglycemic patients with elevated triglycerides identifies e-IR.

AimsTo perform a validation of DIABSCORE in a sample of Tunisian adults and find out the optimal cut-off point for screening of Type 2 diabetes (T2D) and prediabetes.Methods225 adults 18–75 years and a subgroup of 138 adults (18–54 years), with undiagnosed T2D from the region of Cap-Bon, Tunisia were included in the present study. The DIABSCORE was calculated based on: age, waist/height ratio, family history of T2D and gestational diabetes. Receiver operating characteristics (ROC) curves and areas under curve (AUC) were obtained. The T2D and prediabetes prevalences odds ratios (OR) between patients exposed and not exposed to DIABSCORE≥90 and DIABSCORE≥80, respectively were calculated in both age ranges.ResultsFor screening of T2D the best value was DIABSCORE = 90 with a highest sensitivity (Se), negative predictive value (NPV) and lower negative likelihood ratio in participants aged 18–75 yr (Se = 97%; NPV = 97%) when compared to participants aged 18–54 yr (Se = 95%; NPV = 97%); for prediabetes, the best Se and NPV were for DIABSCORE = 80 in both age groups, but it showed a disbalanced sensitivity-specificity. The ROC curves for T2D showed a similar AUC in both age ranges (AUC = 0.62 and AUC = 0.61 respectively). The ROC curves for prediabetes showed a highest AUC in those aged 18–54 years than the older ones (AUC = 0.62 and AUC = 0.57, respectively). The prevalences OR of T2D for DIABSCORE≥90 was higher than for DIABSCORE≥80 in both age ranges. Nevertheless, the prevalences OR of prediabetes for DIABSCORE≥90 was half of the detected for DIABSCORE≥80 in both age ranges.ConclusionThe DIABSCORE is a simple clinical tool and accurate method in screening for T2D and prediabetes in the adult Tunisian population.

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