OBJECTIVE -The aim of this study was to define the incidence of type 2 diabetes in a low-risk Caucasian population in northern Spain and its association with various risk factors. RESEARCH DESIGN AND METHODS -The AsturiasStudy is a prospective, population-based survey of diabetes and cardiovascular risk factors. The baseline examination was carried out during 1998 -1999 when 1,034 individuals, aged 30 -75 years, were randomly selected to determine the prevalence of type 2 diabetes and pre-diabetes in the Principality of Asturias (northern Spain). In 2004 -2005, these same subjects were invited for a follow-up examination; 700 participated. This study includes only those individuals who did not have diabetes at baseline. We used the World Health Organization 1999 criteria to classify glucose metabolism at both baseline and follow-up.RESULTS -The incidence of diabetes adjusted for the age and sex structure of Asturias was 10.8 cases/1,000 person-years (95% CI 8.1-14.8). The incidence rates were 5 cases/1,000 person-years in individuals with normoglycemia, 21 cases/1,000 person-years in individuals with isolated impaired glucose tolerance (IGT), 34.7 cases/1,000 person-years in individuals with isolated impaired fasting glucose (IFG), and 95.2 cases/1,000 person-years in individuals with combined IFG-IGT. Stepwise multiple logistic regression analysis showed that, together with fasting plasma glucose (FPG) and 2-h plasma glucose, which were the strongest predictors of diabetes, triglycerides and BMI were also independently associated with progression to diabetes.CONCLUSIONS -In this 6-year prospective population-based study, we found an incidence of type 2 diabetes of 10.8 cases/1,000 person-years. Both FPG and 2-h plasma glucose were strongly predictive of diabetes, and their effect was additive. Diabetes Care 30:2258-2263, 2007T ype 2 diabetes is currently one of the most costly and worrying chronic diseases and represents a serious health care problem worldwide. The number of individuals with diabetes is increasing alarmingly owing to the aging of the population, obesity, and lack of exercise. Estimates indicate that by the year 2030 diabetes will affect 366 million people worldwide (1). In practically all societies, diabetes has become a leading cause of blindness, renal failure, lower limb amputation, and cardiovascular disease. The increased prevalence of diabetes has led to an increasing number of disabled individuals, a decrease in life expectancy, and huge health care costs (2). In Spain, too, the situation is a cause for concern, and recent cross-sectional studies indicated an increase in the prevalence of type 2 diabetes that does not appear to be due to changes in the criteria for diabetes (3-13). Therefore, interest in identifying individuals at high risk of developing diabetes and in planning preventive strategies has increased considerably because several studies have demonstrated that diabetes can be prevented with changes in lifestyle and/or use of drugs (14 -18).The incidence of diabetes is strong...
BACKGROUND: Acute rejection (AR) is a key conditioning factor for long-term graft function and survival in renal transplantation patients. The standard care with creatinine measurements and biopsy upon allograft dysfunction implies that AR is usually detected at advanced stages. Rapid noninvasive biomarkers of rejection are needed to improve the management of these patients. We assessed whether total cell-free DNA (tCF-DNA) and donor-derived cell-free DNA (ddCF-DNA) were useful markers for this purpose, both in plasma and in urine.
Background: Circulating nucleic acids were discovered more than 60 y ago. With the recent developments in the study of circulating nucleic acids, its application in the diagnostic field has increased. The objective of this study was to assess the usefulness of the quantification of cell-free plasma DNA (CF-DNA) concentration in the diagnosis of infections in febrile patients and as a prognostic marker in septic patients. Methods: Concentrations of CF-DNA, procalcitonin (PCT) and C-reactive protein (CRP) were measured in 110 febrile patients who were clinically diagnosed with fever of unknown origin, localized infection, sepsis or septic shock. Results: Concentrations of CF-DNA increase according to the severity of the infection. The best cut-off point for predicting infection was 2800 GE (genome equivalents)/mL (sensitivity: 95.0%; specificity: 96.7%) and 14,000 GE/mL for sepsis prediction (sensitivity: 77.8%; specificity: 94.6%). Higher concentrations of CF-DNA were found in exitus septic patients than in survivors. The diagnostic efficiency of CF-DNA was similar to PCT and higher than CRP in infectious processes. Conclusions: Normal concentrations of CF-DNA can exclude the presence of an infection in febrile patients, and very high concentrations (.10-fold over the normal reference range) stratify the severity of infections, showing a high prognostic value to predict mortality in the absence of other causes for elevated CF-DNA.
The new cut-off values for the sFlt-1/PlGF ratio adjusted by the gestational age at clinical presentation can be used to rule out PE at obstetric triage and to predict imminent delivery with better accuracy than the cutpoint currently accepted.
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