Research

2026

• 
  [Association between sociodemographic factors and health habits and the risk of MASLD assessed by FLI, HSI, and LAP in Spanish workers from the commerce and industry sectors]. Fernández-Figares Vicioso, M. P.; Vicente-Herrero, M. T.; Ramírez Gallegos, A.; Ramírez-Manent, J. I.; Tárraga López, P. J.; Del Barrio Fernández, J. L.; López-González, Á A. (2026). 52(1) 102671.

  AbstractBibTeXEndNoteDOIBibSonomy

  INTRODUCTION: Metabolic dysfunction-associated steatotic liver disease (MASLD) has become a growing public health concern. Identifying associated sociodemographic and lifestyle factors is essential for implementing effective preventive strategies. OBJECTIVE: To analyze the association between sociodemographic variables (age, sex, educational level, and employment sector), health habits (physical activity, adherence to the Mediterranean diet, and smoking), and the risk of MASLD assessed through three non-invasive indexes: Fatty Liver Index (FLI), Hepatic Steatosis Index (HSI), and Lipid Accumulation Product (LAP), in a large cohort of Spanish workers from the commerce and industry sectors. METHODS: A cross-sectional study involving 56,856 workers (34,448 men and 22,408 women). FLI, HSI, and LAP were calculated, and their associations with the independent variables were analyzed using descriptive statistics, group comparisons, and multinomial logistic regression. RESULTS: High MASLD risk was significantly associated with male sex, older age, lower education, employment in the industrial sector, physical inactivity, poor adherence to the Mediterranean diet, and smoking (all p\textless0.001). Physical inactivity and a non-Mediterranean diet showed the strongest associations with elevated scores in FLI, HSI, and LAP. CONCLUSIONS: Preventive interventions should prioritize high-risk subgroups. The combined use of FLI, HSI, and LAP allows accurate identification of MASLD risk in occupational settings.

  @article{fernandez-figares_vicioso_association_2026,
  abstract = {INTRODUCTION: Metabolic dysfunction-associated steatotic liver disease (MASLD) has become a growing public health concern. Identifying associated sociodemographic and lifestyle factors is essential for implementing effective preventive strategies. OBJECTIVE: To analyze the association between sociodemographic variables (age, sex, educational level, and employment sector), health habits (physical activity, adherence to the Mediterranean diet, and smoking), and the risk of MASLD assessed through three non-invasive indexes: Fatty Liver Index (FLI), Hepatic Steatosis Index (HSI), and Lipid Accumulation Product (LAP), in a large cohort of Spanish workers from the commerce and industry sectors. METHODS: A cross-sectional study involving 56,856 workers (34,448 men and 22,408 women). FLI, HSI, and LAP were calculated, and their associations with the independent variables were analyzed using descriptive statistics, group comparisons, and multinomial logistic regression. RESULTS: High MASLD risk was significantly associated with male sex, older age, lower education, employment in the industrial sector, physical inactivity, poor adherence to the Mediterranean diet, and smoking (all p\textless0.001). Physical inactivity and a non-Mediterranean diet showed the strongest associations with elevated scores in FLI, HSI, and LAP. CONCLUSIONS: Preventive interventions should prioritize high-risk subgroups. The combined use of FLI, HSI, and LAP allows accurate identification of MASLD risk in occupational settings.},
  author = {Fernández-Figares Vicioso, M. P. and Vicente-Herrero, M. T. and Ramírez Gallegos, A. and Ramírez-Manent, J. I. and Tárraga López, P. J. and Del Barrio Fernández, J. L. and López-González, Á A.},
  journal = {Semergen},
  keywords = {grapp-caib},
  number = 1,
  pages = 102671,
  title = {[Association between sociodemographic factors and health habits and the risk of MASLD assessed by FLI, HSI, and LAP in Spanish workers from the commerce and industry sectors]},
  volume = 52,
  year = 2026
  }
  

  %0 Journal Article
  %1 fernandez-figares_vicioso_association_2026
  %A Fernández-Figares Vicioso, M. P.
  %A Vicente-Herrero, M. T.
  %A Ramírez Gallegos, A.
  %A Ramírez-Manent, J. I.
  %A Tárraga López, P. J.
  %A Del Barrio Fernández, J. L.
  %A López-González, Á A.
  %D 2026
  %J Semergen
  %N 1
  %P 102671
  %R 10.1016/j.semerg.2025.102671
  %T [Association between sociodemographic factors and health habits and the risk of MASLD assessed by FLI, HSI, and LAP in Spanish workers from the commerce and industry sectors]
  %V 52
  %X INTRODUCTION: Metabolic dysfunction-associated steatotic liver disease (MASLD) has become a growing public health concern. Identifying associated sociodemographic and lifestyle factors is essential for implementing effective preventive strategies. OBJECTIVE: To analyze the association between sociodemographic variables (age, sex, educational level, and employment sector), health habits (physical activity, adherence to the Mediterranean diet, and smoking), and the risk of MASLD assessed through three non-invasive indexes: Fatty Liver Index (FLI), Hepatic Steatosis Index (HSI), and Lipid Accumulation Product (LAP), in a large cohort of Spanish workers from the commerce and industry sectors. METHODS: A cross-sectional study involving 56,856 workers (34,448 men and 22,408 women). FLI, HSI, and LAP were calculated, and their associations with the independent variables were analyzed using descriptive statistics, group comparisons, and multinomial logistic regression. RESULTS: High MASLD risk was significantly associated with male sex, older age, lower education, employment in the industrial sector, physical inactivity, poor adherence to the Mediterranean diet, and smoking (all p\textless0.001). Physical inactivity and a non-Mediterranean diet showed the strongest associations with elevated scores in FLI, HSI, and LAP. CONCLUSIONS: Preventive interventions should prioritize high-risk subgroups. The combined use of FLI, HSI, and LAP allows accurate identification of MASLD risk in occupational settings.
  

• 
  Insulin resistance risk in domestic workers: a sex-specific assessment using TyG, METS-IR, and SPISE indices in a large Mediterranean cohort. Ramírez-Gallegos, Alberto; Tárraga López, Pedro Juan; Ramírez Manent, José Ignacio; Del Amo Ríos, Andrea; Coll-Campayo, Irene; García-Samuelson, Miguel; López González, Ángel Arturo (2026).

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  INTRODUCTION: insulin resistance is a key contributor to cardiometabolic diseases, yet it remains understudied among domestic workers. This study evaluates the usefulness of the TyG, METS-IR, and SPISE indices as non-invasive tools to estimate insulin resistance risk in this population. BACKGROUND: insulin resistance (IR) is a major precursor of type 2 diabetes and cardiovascular disease, yet its prevalence and associated factors remain underexplored in informal labor sectors. This study aimed to evaluate the prevalence of elevated IR scores using validated non-invasive indices (TyG, METS-IR, and SPISE) and their association with sociodemographic and lifestyle variables in a large cohort of Spanish female domestic workers. METHODS: a cross-sectional analysis was conducted using health examination data from 6,321 adult female domestic workers in Spain. IR was assessed using three surrogate indices: the triglyceride-glucose index (TyG), the metabolic score for insulin resistance (METS-IR), and the single-point insulin sensitivity estimator (SPISE). Participants were classified into quartiles based on each index. Associations with age, smoking status, physical activity (IPAQ-SF), and adherence to the Mediterranean diet were evaluated using logistic regression models adjusted for potential confounders. RESULTS: a high proportion of participants were in the highest-risk quartile for TyG (25.3 \%), METS-IR (24.9 \%), and the lowest-risk quartile for SPISE (26.8 \%). Older age, smoking, low physical activity, and low Mediterranean diet adherence were significantly associated with unfavorable IR profiles across all three indices. Multivariate logistic regression showed that physical inactivity was strongly associated with high TyG (OR = 3.12), high METS-IR (OR = 3.28), and low SPISE (OR = 4.07) scores. The prevalence of high IR scores increased with age and was notably higher among smokers and individuals with poor dietary habits. CONCLUSIONS: this study reveals a concerning prevalence of elevated insulin resistance among female domestic workers in Spain and identifies modifiable lifestyle factors associated with metabolic risk. The use of simple, cost-effective indices such as TyG, METS-IR, and SPISE offers a valuable opportunity for early identification of cardiometabolic risk in underserved labour populations. Targeted interventions promoting physical activity, dietary improvement, and smoking cessation are urgently needed to reduce long-term health disparities in this occupational group.

  @article{ramirez-gallegos_insulin_2026,
  abstract = {INTRODUCTION: insulin resistance is a key contributor to cardiometabolic diseases, yet it remains understudied among domestic workers. This study evaluates the usefulness of the TyG, METS-IR, and SPISE indices as non-invasive tools to estimate insulin resistance risk in this population. BACKGROUND: insulin resistance (IR) is a major precursor of type 2 diabetes and cardiovascular disease, yet its prevalence and associated factors remain underexplored in informal labor sectors. This study aimed to evaluate the prevalence of elevated IR scores using validated non-invasive indices (TyG, METS-IR, and SPISE) and their association with sociodemographic and lifestyle variables in a large cohort of Spanish female domestic workers. METHODS: a cross-sectional analysis was conducted using health examination data from 6,321 adult female domestic workers in Spain. IR was assessed using three surrogate indices: the triglyceride-glucose index (TyG), the metabolic score for insulin resistance (METS-IR), and the single-point insulin sensitivity estimator (SPISE). Participants were classified into quartiles based on each index. Associations with age, smoking status, physical activity (IPAQ-SF), and adherence to the Mediterranean diet were evaluated using logistic regression models adjusted for potential confounders. RESULTS: a high proportion of participants were in the highest-risk quartile for TyG (25.3 \%), METS-IR (24.9 \%), and the lowest-risk quartile for SPISE (26.8 \%). Older age, smoking, low physical activity, and low Mediterranean diet adherence were significantly associated with unfavorable IR profiles across all three indices. Multivariate logistic regression showed that physical inactivity was strongly associated with high TyG (OR = 3.12), high METS-IR (OR = 3.28), and low SPISE (OR = 4.07) scores. The prevalence of high IR scores increased with age and was notably higher among smokers and individuals with poor dietary habits. CONCLUSIONS: this study reveals a concerning prevalence of elevated insulin resistance among female domestic workers in Spain and identifies modifiable lifestyle factors associated with metabolic risk. The use of simple, cost-effective indices such as TyG, METS-IR, and SPISE offers a valuable opportunity for early identification of cardiometabolic risk in underserved labour populations. Targeted interventions promoting physical activity, dietary improvement, and smoking cessation are urgently needed to reduce long-term health disparities in this occupational group.},
  author = {Ramírez-Gallegos, Alberto and Tárraga López, Pedro Juan and Ramírez Manent, José Ignacio and Del Amo Ríos, Andrea and Coll-Campayo, Irene and García-Samuelson, Miguel and López González, Ángel Arturo},
  journal = {Nutricion Hospitalaria},
  keywords = {grapp-caib},
  month = {feb},
  title = {Insulin resistance risk in domestic workers: a sex-specific assessment using TyG, METS-IR, and SPISE indices in a large Mediterranean cohort},
  year = 2026
  }
  

  %0 Journal Article
  %1 ramirez-gallegos_insulin_2026
  %A Ramírez-Gallegos, Alberto
  %A Tárraga López, Pedro Juan
  %A Ramírez Manent, José Ignacio
  %A Del Amo Ríos, Andrea
  %A Coll-Campayo, Irene
  %A García-Samuelson, Miguel
  %A López González, Ángel Arturo
  %D 2026
  %J Nutricion Hospitalaria
  %R 10.20960/nh.06313
  %T Insulin resistance risk in domestic workers: a sex-specific assessment using TyG, METS-IR, and SPISE indices in a large Mediterranean cohort
  %X INTRODUCTION: insulin resistance is a key contributor to cardiometabolic diseases, yet it remains understudied among domestic workers. This study evaluates the usefulness of the TyG, METS-IR, and SPISE indices as non-invasive tools to estimate insulin resistance risk in this population. BACKGROUND: insulin resistance (IR) is a major precursor of type 2 diabetes and cardiovascular disease, yet its prevalence and associated factors remain underexplored in informal labor sectors. This study aimed to evaluate the prevalence of elevated IR scores using validated non-invasive indices (TyG, METS-IR, and SPISE) and their association with sociodemographic and lifestyle variables in a large cohort of Spanish female domestic workers. METHODS: a cross-sectional analysis was conducted using health examination data from 6,321 adult female domestic workers in Spain. IR was assessed using three surrogate indices: the triglyceride-glucose index (TyG), the metabolic score for insulin resistance (METS-IR), and the single-point insulin sensitivity estimator (SPISE). Participants were classified into quartiles based on each index. Associations with age, smoking status, physical activity (IPAQ-SF), and adherence to the Mediterranean diet were evaluated using logistic regression models adjusted for potential confounders. RESULTS: a high proportion of participants were in the highest-risk quartile for TyG (25.3 \%), METS-IR (24.9 \%), and the lowest-risk quartile for SPISE (26.8 \%). Older age, smoking, low physical activity, and low Mediterranean diet adherence were significantly associated with unfavorable IR profiles across all three indices. Multivariate logistic regression showed that physical inactivity was strongly associated with high TyG (OR = 3.12), high METS-IR (OR = 3.28), and low SPISE (OR = 4.07) scores. The prevalence of high IR scores increased with age and was notably higher among smokers and individuals with poor dietary habits. CONCLUSIONS: this study reveals a concerning prevalence of elevated insulin resistance among female domestic workers in Spain and identifies modifiable lifestyle factors associated with metabolic risk. The use of simple, cost-effective indices such as TyG, METS-IR, and SPISE offers a valuable opportunity for early identification of cardiometabolic risk in underserved labour populations. Targeted interventions promoting physical activity, dietary improvement, and smoking cessation are urgently needed to reduce long-term health disparities in this occupational group.
  

• 
  Diagnostic accuracy of non-invasive fatty liver indexes and their association with ECORE-BF scale in a cohort of 386,924 Spanish workers. Marina Arroyo, Marta; Ramírez Gallegos, Ignacio; López-González, Ángel Arturo; Busquets-Cortés, Carla; Obrador de Hevia, Joan; Tárraga López, Pedro Juan; Ramírez-Manent, José Ignacio (2026). 502656.

  AbstractBibTeXEndNoteDOIBibSonomy

  OBJECTIVE: To evaluate the diagnostic accuracy of five non-invasive fatty liver indices and their association with obesity in a large cohort of Spanish workers, stratified by sex. PATIENTS AND METHODS: A cross-sectional analysis was conducted on 386,924 workers (232,814 men and 154,110 women) who underwent routine occupational health assessments between 2009 and 2019. Anthropometric, clinical, and biochemical parameters were collected following standardized procedures. Physical activity and adherence to the Mediterranean diet were assessed using validated IPAQ and PREDIMED questionnaires. Diagnostic performance was evaluated using ROC curves and area under the curve (AUC) values for each fatty liver index. RESULTS: All indices showed significant sex-based differences. FLI and LAP presented the highest AUC values for identifying obesity in both sexes (FLI: AUC 0.907 in men and 0.972 in women; LAP: AUC 0.836 in men and 0.878 in women). FLI also demonstrated the strongest association with higher obesity prevalence across tertiles. ZJU showed good performance, whereas HSI and FLD exhibited lower accuracy, particularly among men. Lifestyle factors and education level influenced index values, with sedentary behavior, low adherence to the Mediterranean diet, and lower educational attainment associated with worse index performance. CONCLUSIONS: FLI and LAP are the most accurate non-invasive indices for identifying obesity-associated fatty liver in this large Spanish working population. Their performance varies by sex and is influenced by sociodemographic and lifestyle factors. These findings support the relevance of FLI and LAP for large-scale screening and highlight the importance of integrating lifestyle assessments into occupational health evaluations. .

  @article{marina_arroyo_diagnostic_2026,
  abstract = {OBJECTIVE: To evaluate the diagnostic accuracy of five non-invasive fatty liver indices and their association with obesity in a large cohort of Spanish workers, stratified by sex. PATIENTS AND METHODS: A cross-sectional analysis was conducted on 386,924 workers (232,814 men and 154,110 women) who underwent routine occupational health assessments between 2009 and 2019. Anthropometric, clinical, and biochemical parameters were collected following standardized procedures. Physical activity and adherence to the Mediterranean diet were assessed using validated IPAQ and PREDIMED questionnaires. Diagnostic performance was evaluated using ROC curves and area under the curve (AUC) values for each fatty liver index. RESULTS: All indices showed significant sex-based differences. FLI and LAP presented the highest AUC values for identifying obesity in both sexes (FLI: AUC 0.907 in men and 0.972 in women; LAP: AUC 0.836 in men and 0.878 in women). FLI also demonstrated the strongest association with higher obesity prevalence across tertiles. ZJU showed good performance, whereas HSI and FLD exhibited lower accuracy, particularly among men. Lifestyle factors and education level influenced index values, with sedentary behavior, low adherence to the Mediterranean diet, and lower educational attainment associated with worse index performance. CONCLUSIONS: FLI and LAP are the most accurate non-invasive indices for identifying obesity-associated fatty liver in this large Spanish working population. Their performance varies by sex and is influenced by sociodemographic and lifestyle factors. These findings support the relevance of FLI and LAP for large-scale screening and highlight the importance of integrating lifestyle assessments into occupational health evaluations. .},
  author = {Marina Arroyo, Marta and Ramírez Gallegos, Ignacio and López-González, Ángel Arturo and Busquets-Cortés, Carla and Obrador de Hevia, Joan and Tárraga López, Pedro Juan and Ramírez-Manent, José Ignacio},
  journal = {Gastroenterologia Y Hepatologia},
  keywords = {grapp-caib},
  month = {jan},
  pages = 502656,
  title = {Diagnostic accuracy of non-invasive fatty liver indexes and their association with ECORE-BF scale in a cohort of 386,924 Spanish workers},
  year = 2026
  }
  

  %0 Journal Article
  %1 marina_arroyo_diagnostic_2026
  %A Marina Arroyo, Marta
  %A Ramírez Gallegos, Ignacio
  %A López-González, Ángel Arturo
  %A Busquets-Cortés, Carla
  %A Obrador de Hevia, Joan
  %A Tárraga López, Pedro Juan
  %A Ramírez-Manent, José Ignacio
  %D 2026
  %J Gastroenterologia Y Hepatologia
  %P 502656
  %R 10.1016/j.gastrohep.2026.502656
  %T Diagnostic accuracy of non-invasive fatty liver indexes and their association with ECORE-BF scale in a cohort of 386,924 Spanish workers
  %X OBJECTIVE: To evaluate the diagnostic accuracy of five non-invasive fatty liver indices and their association with obesity in a large cohort of Spanish workers, stratified by sex. PATIENTS AND METHODS: A cross-sectional analysis was conducted on 386,924 workers (232,814 men and 154,110 women) who underwent routine occupational health assessments between 2009 and 2019. Anthropometric, clinical, and biochemical parameters were collected following standardized procedures. Physical activity and adherence to the Mediterranean diet were assessed using validated IPAQ and PREDIMED questionnaires. Diagnostic performance was evaluated using ROC curves and area under the curve (AUC) values for each fatty liver index. RESULTS: All indices showed significant sex-based differences. FLI and LAP presented the highest AUC values for identifying obesity in both sexes (FLI: AUC 0.907 in men and 0.972 in women; LAP: AUC 0.836 in men and 0.878 in women). FLI also demonstrated the strongest association with higher obesity prevalence across tertiles. ZJU showed good performance, whereas HSI and FLD exhibited lower accuracy, particularly among men. Lifestyle factors and education level influenced index values, with sedentary behavior, low adherence to the Mediterranean diet, and lower educational attainment associated with worse index performance. CONCLUSIONS: FLI and LAP are the most accurate non-invasive indices for identifying obesity-associated fatty liver in this large Spanish working population. Their performance varies by sex and is influenced by sociodemographic and lifestyle factors. These findings support the relevance of FLI and LAP for large-scale screening and highlight the importance of integrating lifestyle assessments into occupational health evaluations. .
  

• 
  Atherogenic risk in 44,939 Spanish healthcare workers: Associated variables. Tárraga Marcos, Pedro Javier; López-González, Ángel Arturo; Martínez-Almoyna Rifá, Emilio; Paublini Oliveira, Hernán; Martorell Sánchez, Cristina; Tárraga López, Pedro Juan; Ramírez-Manent, José Ignacio (2026). 38(1) 500821.

  AbstractBibTeXEndNoteDOIBibSonomy

  The article evaluates the atherogenic risk in 44,939 Spanish healthcare professionals by identifying the variables associated with this risk. It explains atherogenesis as the key pathological process in the development of cardiovascular diseases, characterized by the formation of atherosclerotic plaques resulting from atherogenic dyslipidemia. To quantify this risk, lipid indices (total cholesterol/HDL-c, LDL-c/HDL-c, and triglycerides/HDL-c ratios) were analyzed and related to factors such as age, sex, professional category, smoking, physical activity, and adherence to the Mediterranean diet. The results indicate that increasing age, male sex, smoking, and the lack of physical activity or adherence to a healthy diet are associated with higher atherogenic risk values. Furthermore, the study discusses its strengths (such as the large sample size and rigorous methodological design) and limitations, emphasizing the importance of comprehensive interventions and public health policies for the prevention and management of cardiovascular disease.

  @article{tarraga_marcos_atherogenic_2026,
  abstract = {The article evaluates the atherogenic risk in 44,939 Spanish healthcare professionals by identifying the variables associated with this risk. It explains atherogenesis as the key pathological process in the development of cardiovascular diseases, characterized by the formation of atherosclerotic plaques resulting from atherogenic dyslipidemia. To quantify this risk, lipid indices (total cholesterol/HDL-c, LDL-c/HDL-c, and triglycerides/HDL-c ratios) were analyzed and related to factors such as age, sex, professional category, smoking, physical activity, and adherence to the Mediterranean diet. The results indicate that increasing age, male sex, smoking, and the lack of physical activity or adherence to a healthy diet are associated with higher atherogenic risk values. Furthermore, the study discusses its strengths (such as the large sample size and rigorous methodological design) and limitations, emphasizing the importance of comprehensive interventions and public health policies for the prevention and management of cardiovascular disease.},
  author = {Tárraga Marcos, Pedro Javier and López-González, Ángel Arturo and Martínez-Almoyna Rifá, Emilio and Paublini Oliveira, Hernán and Martorell Sánchez, Cristina and Tárraga López, Pedro Juan and Ramírez-Manent, José Ignacio},
  journal = {Clinica E Investigacion En Arteriosclerosis: Publicacion Oficial De La Sociedad Espanola De Arteriosclerosis},
  keywords = {grapp-caib},
  number = 1,
  pages = 500821,
  title = {Atherogenic risk in 44,939 Spanish healthcare workers: Associated variables},
  volume = 38,
  year = 2026
  }
  

  %0 Journal Article
  %1 tarraga_marcos_atherogenic_2026
  %A Tárraga Marcos, Pedro Javier
  %A López-González, Ángel Arturo
  %A Martínez-Almoyna Rifá, Emilio
  %A Paublini Oliveira, Hernán
  %A Martorell Sánchez, Cristina
  %A Tárraga López, Pedro Juan
  %A Ramírez-Manent, José Ignacio
  %D 2026
  %J Clinica E Investigacion En Arteriosclerosis: Publicacion Oficial De La Sociedad Espanola De Arteriosclerosis
  %N 1
  %P 500821
  %R 10.1016/j.arteri.2025.500821
  %T Atherogenic risk in 44,939 Spanish healthcare workers: Associated variables
  %V 38
  %X The article evaluates the atherogenic risk in 44,939 Spanish healthcare professionals by identifying the variables associated with this risk. It explains atherogenesis as the key pathological process in the development of cardiovascular diseases, characterized by the formation of atherosclerotic plaques resulting from atherogenic dyslipidemia. To quantify this risk, lipid indices (total cholesterol/HDL-c, LDL-c/HDL-c, and triglycerides/HDL-c ratios) were analyzed and related to factors such as age, sex, professional category, smoking, physical activity, and adherence to the Mediterranean diet. The results indicate that increasing age, male sex, smoking, and the lack of physical activity or adherence to a healthy diet are associated with higher atherogenic risk values. Furthermore, the study discusses its strengths (such as the large sample size and rigorous methodological design) and limitations, emphasizing the importance of comprehensive interventions and public health policies for the prevention and management of cardiovascular disease.
  

• 
  Clinical and bacteriological effectiveness of three different short-course antibiotic regimens and single-dose fosfomycin for uncomplicated lower urinary tract infections in women (SCOUT): a pragmatic, multicentre, open-label, randomised clinical trial. Llor, Carl; Monfà, Ramon; Garcia-Sangenís, Ana; Leiva, Alfonso; Marín-Cañada, Jaime; Sánchez-Calavera, María Antonia; Moragas, Ana; Aguilar-Sánchez, Mercedes; Troncoso-Mariño, Amelia; Rodríguez-Barrientos, Ricardo; Molero, José M.; Ouchi, Dan; Miranda-Jiménez, Cristina; Fernández-García, Silvia; Morros, Rosa (2026). 407(10539) 1603–1613.

  AbstractBibTeXEndNoteDOIBibSonomy

  BACKGROUND: Most guidelines recommend nitrofurantoin, fosfomycin, and sometimes pivmecillinam for uncomplicated urinary tract infections (UTIs), but direct comparisons between these antibiotics are needed. This study evaluated the effectiveness and safety of a single dose of fosfomycin compared with two doses of fosfomycin and short-course regimens of nitrofurantoin and pivmecillinam in women with UTI symptoms. METHODS: This phase 4, pragmatic, multicentre, parallel-group, open-label, randomised clinical trial was conducted in Spanish primary care centres from 2022 to 2024. Women aged 18 years or older with at least one UTI-specific symptom (dysuria, urinary urgency, urinary frequency, or suprapubic tenderness) and a positive urine dipstick test for either nitrites or leukocyte esterase were randomly assigned (1:1:1:1) to one of four treatments: a single 3 g dose of fosfomycin, two 3 g doses of fosfomycin, nitrofurantoin (100 mg three times per day for 5 days), or pivmecillinam (400 mg three times per day for 3 days). Doctors and patients were not masked to group assignment. The primary outcome was the proportion of patients with clinical resolution (defined as the disappearance of all infection symptoms) at day 7. This trial is registered with ClinicalTrials.gov (NCT04959331) and EudraCT (2021-001332-26) and is completed. FINDINGS: Of the 804 patients assessed for eligibility between April 4, 2022 and Nov 14, 2024, 768 patients were randomly allocated (191 to the single-dose fosfomycin group, 194 to the two-dose fosfomycin group, 190 to the nitrofurantoin group, and 193 to the pivmecillinam group). Patients had a median age of 48 years (IQR 34-63). Race and ethnicity data were not collected. Among the 720 women with available data included in the primary analysis, single-dose fosfomycin had the lowest proportion of clinical resolution (109 [59\%] of 185 patients), while nitrofurantoin had the highest (128 [74\%] of 172 patients; difference 15·5 percentage points [95\% CI 5·9 to 25·1] vs single-dose fosfomycin; p=0·0168), followed by pivmecillinam (127 [70\%] of 182; difference 10·9 percentage points [1·1 to 20·6]; p=0·2352) and the two-dose fosfomycin group (122 [67\%] of 181; difference 8·5 percentage points [-1·4 to 18·3]; p=0·6935). Adverse events occurred in 38 (19·9\% [95\% CI 14·9 to 26·1) of 191 patients who received single-dose fosfomycin, 51 (26·3\% [20·6 to 32·9]) of 194 who received two-dose fosfomycin, 51 (26·8\% [21·0 to 33·6]) of 190 who received nitrofurantoin, and 41 (21·2\% [16·1 to 27·5]) of 193 who received pivmecillinam. Most adverse events were mild and self-limiting, primarily gastrointestinal. Four serious adverse events occurred, of which one was related to the study treatment (one case of pyelonephritis in the pivmecillinam group). INTERPRETATION: Nitrofurantoin was the most effective treatment and single-dose fosfomycin the least effective treatment for UTIs. Adverse events were mild. The role of fosfomycin as a first-line antibiotic for uncomplicated UTI should be re-evaluated. FUNDING: Carlos III Institute of Health, Spanish Ministry of Science and Innovation, and European Regional Development Fund.

  @article{llor_clinical_2026,
  abstract = {BACKGROUND: Most guidelines recommend nitrofurantoin, fosfomycin, and sometimes pivmecillinam for uncomplicated urinary tract infections (UTIs), but direct comparisons between these antibiotics are needed. This study evaluated the effectiveness and safety of a single dose of fosfomycin compared with two doses of fosfomycin and short-course regimens of nitrofurantoin and pivmecillinam in women with UTI symptoms. METHODS: This phase 4, pragmatic, multicentre, parallel-group, open-label, randomised clinical trial was conducted in Spanish primary care centres from 2022 to 2024. Women aged 18 years or older with at least one UTI-specific symptom (dysuria, urinary urgency, urinary frequency, or suprapubic tenderness) and a positive urine dipstick test for either nitrites or leukocyte esterase were randomly assigned (1:1:1:1) to one of four treatments: a single 3 g dose of fosfomycin, two 3 g doses of fosfomycin, nitrofurantoin (100 mg three times per day for 5 days), or pivmecillinam (400 mg three times per day for 3 days). Doctors and patients were not masked to group assignment. The primary outcome was the proportion of patients with clinical resolution (defined as the disappearance of all infection symptoms) at day 7. This trial is registered with ClinicalTrials.gov (NCT04959331) and EudraCT (2021-001332-26) and is completed. FINDINGS: Of the 804 patients assessed for eligibility between April 4, 2022 and Nov 14, 2024, 768 patients were randomly allocated (191 to the single-dose fosfomycin group, 194 to the two-dose fosfomycin group, 190 to the nitrofurantoin group, and 193 to the pivmecillinam group). Patients had a median age of 48 years (IQR 34-63). Race and ethnicity data were not collected. Among the 720 women with available data included in the primary analysis, single-dose fosfomycin had the lowest proportion of clinical resolution (109 [59\%] of 185 patients), while nitrofurantoin had the highest (128 [74\%] of 172 patients; difference 15·5 percentage points [95\% CI 5·9 to 25·1] vs single-dose fosfomycin; p=0·0168), followed by pivmecillinam (127 [70\%] of 182; difference 10·9 percentage points [1·1 to 20·6]; p=0·2352) and the two-dose fosfomycin group (122 [67\%] of 181; difference 8·5 percentage points [-1·4 to 18·3]; p=0·6935). Adverse events occurred in 38 (19·9\% [95\% CI 14·9 to 26·1) of 191 patients who received single-dose fosfomycin, 51 (26·3\% [20·6 to 32·9]) of 194 who received two-dose fosfomycin, 51 (26·8\% [21·0 to 33·6]) of 190 who received nitrofurantoin, and 41 (21·2\% [16·1 to 27·5]) of 193 who received pivmecillinam. Most adverse events were mild and self-limiting, primarily gastrointestinal. Four serious adverse events occurred, of which one was related to the study treatment (one case of pyelonephritis in the pivmecillinam group). INTERPRETATION: Nitrofurantoin was the most effective treatment and single-dose fosfomycin the least effective treatment for UTIs. Adverse events were mild. The role of fosfomycin as a first-line antibiotic for uncomplicated UTI should be re-evaluated. FUNDING: Carlos III Institute of Health, Spanish Ministry of Science and Innovation, and European Regional Development Fund.},
  author = {Llor, Carl and Monfà, Ramon and Garcia-Sangenís, Ana and Leiva, Alfonso and Marín-Cañada, Jaime and Sánchez-Calavera, María Antonia and Moragas, Ana and Aguilar-Sánchez, Mercedes and Troncoso-Mariño, Amelia and Rodríguez-Barrientos, Ricardo and Molero, José M. and Ouchi, Dan and Miranda-Jiménez, Cristina and Fernández-García, Silvia and Morros, Rosa},
  journal = {Lancet},
  keywords = {grapp-caib},
  month = {apr},
  number = 10539,
  pages = {1603--1613},
  title = {Clinical and bacteriological effectiveness of three different short-course antibiotic regimens and single-dose fosfomycin for uncomplicated lower urinary tract infections in women (SCOUT): a pragmatic, multicentre, open-label, randomised clinical trial},
  volume = 407,
  year = 2026
  }
  

  %0 Journal Article
  %1 llor_clinical_2026
  %A Llor, Carl
  %A Monfà, Ramon
  %A Garcia-Sangenís, Ana
  %A Leiva, Alfonso
  %A Marín-Cañada, Jaime
  %A Sánchez-Calavera, María Antonia
  %A Moragas, Ana
  %A Aguilar-Sánchez, Mercedes
  %A Troncoso-Mariño, Amelia
  %A Rodríguez-Barrientos, Ricardo
  %A Molero, José M.
  %A Ouchi, Dan
  %A Miranda-Jiménez, Cristina
  %A Fernández-García, Silvia
  %A Morros, Rosa
  %D 2026
  %J Lancet
  %N 10539
  %P 1603--1613
  %R 10.1016/S0140-6736(25)02171-3
  %T Clinical and bacteriological effectiveness of three different short-course antibiotic regimens and single-dose fosfomycin for uncomplicated lower urinary tract infections in women (SCOUT): a pragmatic, multicentre, open-label, randomised clinical trial
  %V 407
  %X BACKGROUND: Most guidelines recommend nitrofurantoin, fosfomycin, and sometimes pivmecillinam for uncomplicated urinary tract infections (UTIs), but direct comparisons between these antibiotics are needed. This study evaluated the effectiveness and safety of a single dose of fosfomycin compared with two doses of fosfomycin and short-course regimens of nitrofurantoin and pivmecillinam in women with UTI symptoms. METHODS: This phase 4, pragmatic, multicentre, parallel-group, open-label, randomised clinical trial was conducted in Spanish primary care centres from 2022 to 2024. Women aged 18 years or older with at least one UTI-specific symptom (dysuria, urinary urgency, urinary frequency, or suprapubic tenderness) and a positive urine dipstick test for either nitrites or leukocyte esterase were randomly assigned (1:1:1:1) to one of four treatments: a single 3 g dose of fosfomycin, two 3 g doses of fosfomycin, nitrofurantoin (100 mg three times per day for 5 days), or pivmecillinam (400 mg three times per day for 3 days). Doctors and patients were not masked to group assignment. The primary outcome was the proportion of patients with clinical resolution (defined as the disappearance of all infection symptoms) at day 7. This trial is registered with ClinicalTrials.gov (NCT04959331) and EudraCT (2021-001332-26) and is completed. FINDINGS: Of the 804 patients assessed for eligibility between April 4, 2022 and Nov 14, 2024, 768 patients were randomly allocated (191 to the single-dose fosfomycin group, 194 to the two-dose fosfomycin group, 190 to the nitrofurantoin group, and 193 to the pivmecillinam group). Patients had a median age of 48 years (IQR 34-63). Race and ethnicity data were not collected. Among the 720 women with available data included in the primary analysis, single-dose fosfomycin had the lowest proportion of clinical resolution (109 [59\%] of 185 patients), while nitrofurantoin had the highest (128 [74\%] of 172 patients; difference 15·5 percentage points [95\% CI 5·9 to 25·1] vs single-dose fosfomycin; p=0·0168), followed by pivmecillinam (127 [70\%] of 182; difference 10·9 percentage points [1·1 to 20·6]; p=0·2352) and the two-dose fosfomycin group (122 [67\%] of 181; difference 8·5 percentage points [-1·4 to 18·3]; p=0·6935). Adverse events occurred in 38 (19·9\% [95\% CI 14·9 to 26·1) of 191 patients who received single-dose fosfomycin, 51 (26·3\% [20·6 to 32·9]) of 194 who received two-dose fosfomycin, 51 (26·8\% [21·0 to 33·6]) of 190 who received nitrofurantoin, and 41 (21·2\% [16·1 to 27·5]) of 193 who received pivmecillinam. Most adverse events were mild and self-limiting, primarily gastrointestinal. Four serious adverse events occurred, of which one was related to the study treatment (one case of pyelonephritis in the pivmecillinam group). INTERPRETATION: Nitrofurantoin was the most effective treatment and single-dose fosfomycin the least effective treatment for UTIs. Adverse events were mild. The role of fosfomycin as a first-line antibiotic for uncomplicated UTI should be re-evaluated. FUNDING: Carlos III Institute of Health, Spanish Ministry of Science and Innovation, and European Regional Development Fund.
  

• 
  Waist-to-Height Ratio as a Simple Anthropometric Marker for Identifying Individuals at High Risk of MASLD: A Large Population-Based Analysis Using the Fatty Liver Index. López-González, Ángel Arturo; Tárraga López, Pedro Juan; Piña Dabreu, Mónica Silu; Rodas Cañellas, Lluis; Busquets-Cortés, Carla; Ramírez-Manent, José Ignacio (2026). 16(4) 246.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common chronic liver disease worldwide and represents a major component of the global burden of metabolic disorders. Simple anthropometric markers capable of identifying individuals at increased risk of hepatic steatosis are of considerable interest for population-level screening. METHODS: In this cross-sectional population-based study, we evaluated the performance of waist-to-height ratio (WtHR) for identifying individuals with a high Fatty Liver Index (FLI ≥ 60), a widely used surrogate marker of hepatic steatosis. The study included 146,318 adult participants with available anthropometric and biochemical data. Discriminatory performance was assessed using receiver operating characteristic (ROC) curve analysis. Optimal WtHR thresholds were determined using the Youden index. Associations between WtHR and high FLI were evaluated using age-adjusted logistic regression models. Non-linear relationships were explored using restricted cubic spline models. Additional analyses included a comparison with body mass index (BMI) and waist circumference, decision curve analysis, and subgroup analyses across age and BMI strata. RESULTS: The prevalence of high FLI in the study population was 18.1%. WtHR demonstrated excellent discriminatory performance, with area under the ROC curve (AUC) values of 0.908 (95\% CI 0.906-0.910) in men and 0.972 (95\% CI 0.971-0.974) in women. Optimal WtHR thresholds for identifying individuals with high FLI were 0.52 in men and 0.53 in women. Each 0.01 increase in WtHR was strongly associated with higher odds of high FLI (OR 1.56 in men and 1.69 in women). Restricted cubic spline analysis demonstrated a non-linear relationship, with a marked increase in predicted probability of high FLI above WtHR values of approximately 0.50-0.52. WtHR showed discriminatory performance comparable to BMI and waist circumference and maintained strong associations with high FLI across age groups and BMI categories. CONCLUSIONS: Waist-to-height ratio is a simple anthropometric marker strongly associated with a high Fatty Liver Index in a large population-based cohort. Given its simplicity, low cost, and ease of calculation, WtHR may represent a practical screening indicator for identifying individuals at increased risk of MASLD-related phenotypes in both clinical practice and population health strategies.

  @article{lopez-gonzalez_waist--height_2026,
  abstract = {BACKGROUND: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common chronic liver disease worldwide and represents a major component of the global burden of metabolic disorders. Simple anthropometric markers capable of identifying individuals at increased risk of hepatic steatosis are of considerable interest for population-level screening. METHODS: In this cross-sectional population-based study, we evaluated the performance of waist-to-height ratio (WtHR) for identifying individuals with a high Fatty Liver Index (FLI ≥ 60), a widely used surrogate marker of hepatic steatosis. The study included 146,318 adult participants with available anthropometric and biochemical data. Discriminatory performance was assessed using receiver operating characteristic (ROC) curve analysis. Optimal WtHR thresholds were determined using the Youden index. Associations between WtHR and high FLI were evaluated using age-adjusted logistic regression models. Non-linear relationships were explored using restricted cubic spline models. Additional analyses included a comparison with body mass index (BMI) and waist circumference, decision curve analysis, and subgroup analyses across age and BMI strata. RESULTS: The prevalence of high FLI in the study population was 18.1%. WtHR demonstrated excellent discriminatory performance, with area under the ROC curve (AUC) values of 0.908 (95\% CI 0.906-0.910) in men and 0.972 (95\% CI 0.971-0.974) in women. Optimal WtHR thresholds for identifying individuals with high FLI were 0.52 in men and 0.53 in women. Each 0.01 increase in WtHR was strongly associated with higher odds of high FLI (OR 1.56 in men and 1.69 in women). Restricted cubic spline analysis demonstrated a non-linear relationship, with a marked increase in predicted probability of high FLI above WtHR values of approximately 0.50-0.52. WtHR showed discriminatory performance comparable to BMI and waist circumference and maintained strong associations with high FLI across age groups and BMI categories. CONCLUSIONS: Waist-to-height ratio is a simple anthropometric marker strongly associated with a high Fatty Liver Index in a large population-based cohort. Given its simplicity, low cost, and ease of calculation, WtHR may represent a practical screening indicator for identifying individuals at increased risk of MASLD-related phenotypes in both clinical practice and population health strategies.},
  author = {López-González, Ángel Arturo and Tárraga López, Pedro Juan and Piña Dabreu, Mónica Silu and Rodas Cañellas, Lluis and Busquets-Cortés, Carla and Ramírez-Manent, José Ignacio},
  journal = {Metabolites},
  keywords = {grapp-caib},
  month = {apr},
  number = 4,
  pages = 246,
  title = {Waist-to-Height Ratio as a Simple Anthropometric Marker for Identifying Individuals at High Risk of MASLD: A Large Population-Based Analysis Using the Fatty Liver Index},
  volume = 16,
  year = 2026
  }
  

  %0 Journal Article
  %1 lopez-gonzalez_waist--height_2026
  %A López-González, Ángel Arturo
  %A Tárraga López, Pedro Juan
  %A Piña Dabreu, Mónica Silu
  %A Rodas Cañellas, Lluis
  %A Busquets-Cortés, Carla
  %A Ramírez-Manent, José Ignacio
  %D 2026
  %J Metabolites
  %N 4
  %P 246
  %R 10.3390/metabo16040246
  %T Waist-to-Height Ratio as a Simple Anthropometric Marker for Identifying Individuals at High Risk of MASLD: A Large Population-Based Analysis Using the Fatty Liver Index
  %V 16
  %X BACKGROUND: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common chronic liver disease worldwide and represents a major component of the global burden of metabolic disorders. Simple anthropometric markers capable of identifying individuals at increased risk of hepatic steatosis are of considerable interest for population-level screening. METHODS: In this cross-sectional population-based study, we evaluated the performance of waist-to-height ratio (WtHR) for identifying individuals with a high Fatty Liver Index (FLI ≥ 60), a widely used surrogate marker of hepatic steatosis. The study included 146,318 adult participants with available anthropometric and biochemical data. Discriminatory performance was assessed using receiver operating characteristic (ROC) curve analysis. Optimal WtHR thresholds were determined using the Youden index. Associations between WtHR and high FLI were evaluated using age-adjusted logistic regression models. Non-linear relationships were explored using restricted cubic spline models. Additional analyses included a comparison with body mass index (BMI) and waist circumference, decision curve analysis, and subgroup analyses across age and BMI strata. RESULTS: The prevalence of high FLI in the study population was 18.1%. WtHR demonstrated excellent discriminatory performance, with area under the ROC curve (AUC) values of 0.908 (95\% CI 0.906-0.910) in men and 0.972 (95\% CI 0.971-0.974) in women. Optimal WtHR thresholds for identifying individuals with high FLI were 0.52 in men and 0.53 in women. Each 0.01 increase in WtHR was strongly associated with higher odds of high FLI (OR 1.56 in men and 1.69 in women). Restricted cubic spline analysis demonstrated a non-linear relationship, with a marked increase in predicted probability of high FLI above WtHR values of approximately 0.50-0.52. WtHR showed discriminatory performance comparable to BMI and waist circumference and maintained strong associations with high FLI across age groups and BMI categories. CONCLUSIONS: Waist-to-height ratio is a simple anthropometric marker strongly associated with a high Fatty Liver Index in a large population-based cohort. Given its simplicity, low cost, and ease of calculation, WtHR may represent a practical screening indicator for identifying individuals at increased risk of MASLD-related phenotypes in both clinical practice and population health strategies.
  

• 
  Associations of sociodemographic factors, healthy habits, and weight stigma with non-alcoholic fatty liver disease risk in obese workers: Findings from a large occupational cohort. Egea Sancho, Mónica; Ramírez-Manent, José Ignacio; López, Pedro Juan Tárraga; Coll Campayo, Irene; Vicente-Herrero, María Teófila; López-González, Ángel Arturo (2026). 49(1) 502560.

  AbstractBibTeXEndNoteDOIBibSonomy

  BACKGROUND: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a growing global health concern, particularly among individuals with obesity. While metabolic and behavioral risk factors have been well described, the role of psychosocial determinants, such as weight stigma, remains underexplored. OBJECTIVES: To assess the association between sociodemographic variables, healthy lifestyle behaviors, and internalized weight stigma with MASLD risk in a large cohort of obese workers across Spain. PATIENTS AND METHODS: This cross-sectional study analyzed data from 26,816 obese employees who underwent occupational health screenings between January 2021 and December 2024. MASLD risk was assessed using three validated indices: the Fatty Liver Index (FLI), Hepatic Steatosis Index (HSI), and Lipid Accumulation Product (LAP). Sociodemographic characteristics, adherence to the Mediterranean diet, physical activity, smoking status, and weight stigma (assessed by the Weight Bias Internalization Scale) were evaluated. Multivariable logistic regression models were used to estimate associations. RESULTS: Weight stigma was significantly associated with higher risk of MASLD across all three indices, independent of age, sex, social class, and health behaviors. Participants with internalized weight stigma were 1.6-2.3times more likely to present with high-risk scores. Sociodemographic disparities and unhealthy lifestyle factors also contributed to elevated MASLD risk. CONCLUSIONS: Beyond metabolic and behavioral determinants, internalized weight stigma emerges as a strong independent factor associated with MASLD risk. These findings underscore the importance of incorporating psychosocial components into liver disease prevention strategies in occupational settings.

  @article{egea_sancho_associations_2026,
  abstract = {BACKGROUND: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a growing global health concern, particularly among individuals with obesity. While metabolic and behavioral risk factors have been well described, the role of psychosocial determinants, such as weight stigma, remains underexplored. OBJECTIVES: To assess the association between sociodemographic variables, healthy lifestyle behaviors, and internalized weight stigma with MASLD risk in a large cohort of obese workers across Spain. PATIENTS AND METHODS: This cross-sectional study analyzed data from 26,816 obese employees who underwent occupational health screenings between January 2021 and December 2024. MASLD risk was assessed using three validated indices: the Fatty Liver Index (FLI), Hepatic Steatosis Index (HSI), and Lipid Accumulation Product (LAP). Sociodemographic characteristics, adherence to the Mediterranean diet, physical activity, smoking status, and weight stigma (assessed by the Weight Bias Internalization Scale) were evaluated. Multivariable logistic regression models were used to estimate associations. RESULTS: Weight stigma was significantly associated with higher risk of MASLD across all three indices, independent of age, sex, social class, and health behaviors. Participants with internalized weight stigma were 1.6-2.3times more likely to present with high-risk scores. Sociodemographic disparities and unhealthy lifestyle factors also contributed to elevated MASLD risk. CONCLUSIONS: Beyond metabolic and behavioral determinants, internalized weight stigma emerges as a strong independent factor associated with MASLD risk. These findings underscore the importance of incorporating psychosocial components into liver disease prevention strategies in occupational settings.},
  author = {Egea Sancho, Mónica and Ramírez-Manent, José Ignacio and López, Pedro Juan Tárraga and Coll Campayo, Irene and Vicente-Herrero, María Teófila and López-González, Ángel Arturo},
  journal = {Gastroenterologia Y Hepatologia},
  keywords = {grapp-caib},
  month = {jan},
  number = 1,
  pages = 502560,
  title = {Associations of sociodemographic factors, healthy habits, and weight stigma with non-alcoholic fatty liver disease risk in obese workers: Findings from a large occupational cohort},
  volume = 49,
  year = 2026
  }
  

  %0 Journal Article
  %1 egea_sancho_associations_2026
  %A Egea Sancho, Mónica
  %A Ramírez-Manent, José Ignacio
  %A López, Pedro Juan Tárraga
  %A Coll Campayo, Irene
  %A Vicente-Herrero, María Teófila
  %A López-González, Ángel Arturo
  %D 2026
  %J Gastroenterologia Y Hepatologia
  %N 1
  %P 502560
  %R 10.1016/j.gastrohep.2025.502560
  %T Associations of sociodemographic factors, healthy habits, and weight stigma with non-alcoholic fatty liver disease risk in obese workers: Findings from a large occupational cohort
  %V 49
  %X BACKGROUND: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a growing global health concern, particularly among individuals with obesity. While metabolic and behavioral risk factors have been well described, the role of psychosocial determinants, such as weight stigma, remains underexplored. OBJECTIVES: To assess the association between sociodemographic variables, healthy lifestyle behaviors, and internalized weight stigma with MASLD risk in a large cohort of obese workers across Spain. PATIENTS AND METHODS: This cross-sectional study analyzed data from 26,816 obese employees who underwent occupational health screenings between January 2021 and December 2024. MASLD risk was assessed using three validated indices: the Fatty Liver Index (FLI), Hepatic Steatosis Index (HSI), and Lipid Accumulation Product (LAP). Sociodemographic characteristics, adherence to the Mediterranean diet, physical activity, smoking status, and weight stigma (assessed by the Weight Bias Internalization Scale) were evaluated. Multivariable logistic regression models were used to estimate associations. RESULTS: Weight stigma was significantly associated with higher risk of MASLD across all three indices, independent of age, sex, social class, and health behaviors. Participants with internalized weight stigma were 1.6-2.3times more likely to present with high-risk scores. Sociodemographic disparities and unhealthy lifestyle factors also contributed to elevated MASLD risk. CONCLUSIONS: Beyond metabolic and behavioral determinants, internalized weight stigma emerges as a strong independent factor associated with MASLD risk. These findings underscore the importance of incorporating psychosocial components into liver disease prevention strategies in occupational settings.
  

• 
  Purpose in Life and Estimated Type 2 Diabetes Risk: Cross-Sectional Associations Across Three Validated Risk Scores in 93,077 Spanish Working Adults. García Pertegaz, Pilar; Tárraga López, Pedro Juan; Coll Campayo, Irene; Busquets-Cortés, Carla; López-González, Ángel Arturo; Ramírez-Manent, José Ignacio (2026). 14(1) 113.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  Background: Psychosocial well-being has been increasingly recognized as a relevant factor in cardiometabolic health; however, evidence linking Purpose in Life with type 2 diabetes risk across validated prediction tools remains limited. This study examined the association between Purpose in Life and estimated diabetes risk using three established risk scores. Methods: A cross-sectional analysis was performed in 93,077 Spanish working adults aged 18-69 years participating in routine occupational health assessments. Purpose in Life was measured with the 10-item Purpose in Life scale and categorized into high, moderate, and low levels. Estimated type 2 diabetes risk was evaluated using QDScore, FINDRISC, and CANRISK. Multivariable logistic regression models were applied to calculate odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for age, sex, occupational social class, smoking status, dietary pattern, physical activity, and body mass index. Results: Lower levels of Purpose in Life were consistently associated with greater likelihood of high estimated diabetes risk across all three instruments. Compared with participants reporting high Purpose in Life, those with low Purpose in Life showed increased odds of high-risk classification for QDScore (OR 2.38; 95\% CI 2.19-2.57), FINDRISC (OR 2.49; 95\% CI 2.08-2.89), and CANRISK (OR 2.79; 95\% CI 2.50-3.09). Clear dose-response patterns were observed across Purpose in Life categories, and associations were similar in men and women as well as across lifestyle strata. Conclusions: Reduced Purpose in Life is strongly associated with higher estimated type 2 diabetes risk across multiple validated screening tools. Although causal direction cannot be inferred from this cross-sectional design, these findings suggest that psychosocial dimensions may provide complementary information for cardiometabolic risk assessment and prevention strategies.

  @article{garcia_pertegaz_purpose_2026,
  abstract = {Background: Psychosocial well-being has been increasingly recognized as a relevant factor in cardiometabolic health; however, evidence linking Purpose in Life with type 2 diabetes risk across validated prediction tools remains limited. This study examined the association between Purpose in Life and estimated diabetes risk using three established risk scores. Methods: A cross-sectional analysis was performed in 93,077 Spanish working adults aged 18-69 years participating in routine occupational health assessments. Purpose in Life was measured with the 10-item Purpose in Life scale and categorized into high, moderate, and low levels. Estimated type 2 diabetes risk was evaluated using QDScore, FINDRISC, and CANRISK. Multivariable logistic regression models were applied to calculate odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for age, sex, occupational social class, smoking status, dietary pattern, physical activity, and body mass index. Results: Lower levels of Purpose in Life were consistently associated with greater likelihood of high estimated diabetes risk across all three instruments. Compared with participants reporting high Purpose in Life, those with low Purpose in Life showed increased odds of high-risk classification for QDScore (OR 2.38; 95\% CI 2.19-2.57), FINDRISC (OR 2.49; 95\% CI 2.08-2.89), and CANRISK (OR 2.79; 95\% CI 2.50-3.09). Clear dose-response patterns were observed across Purpose in Life categories, and associations were similar in men and women as well as across lifestyle strata. Conclusions: Reduced Purpose in Life is strongly associated with higher estimated type 2 diabetes risk across multiple validated screening tools. Although causal direction cannot be inferred from this cross-sectional design, these findings suggest that psychosocial dimensions may provide complementary information for cardiometabolic risk assessment and prevention strategies.},
  author = {García Pertegaz, Pilar and Tárraga López, Pedro Juan and Coll Campayo, Irene and Busquets-Cortés, Carla and López-González, Ángel Arturo and Ramírez-Manent, José Ignacio},
  journal = {Medical Sciences},
  keywords = {grapp-caib},
  month = {feb},
  number = 1,
  pages = 113,
  title = {Purpose in Life and Estimated Type 2 Diabetes Risk: Cross-Sectional Associations Across Three Validated Risk Scores in 93,077 Spanish Working Adults},
  volume = 14,
  year = 2026
  }
  

  %0 Journal Article
  %1 garcia_pertegaz_purpose_2026
  %A García Pertegaz, Pilar
  %A Tárraga López, Pedro Juan
  %A Coll Campayo, Irene
  %A Busquets-Cortés, Carla
  %A López-González, Ángel Arturo
  %A Ramírez-Manent, José Ignacio
  %D 2026
  %J Medical Sciences
  %N 1
  %P 113
  %R 10.3390/medsci14010113
  %T Purpose in Life and Estimated Type 2 Diabetes Risk: Cross-Sectional Associations Across Three Validated Risk Scores in 93,077 Spanish Working Adults
  %V 14
  %X Background: Psychosocial well-being has been increasingly recognized as a relevant factor in cardiometabolic health; however, evidence linking Purpose in Life with type 2 diabetes risk across validated prediction tools remains limited. This study examined the association between Purpose in Life and estimated diabetes risk using three established risk scores. Methods: A cross-sectional analysis was performed in 93,077 Spanish working adults aged 18-69 years participating in routine occupational health assessments. Purpose in Life was measured with the 10-item Purpose in Life scale and categorized into high, moderate, and low levels. Estimated type 2 diabetes risk was evaluated using QDScore, FINDRISC, and CANRISK. Multivariable logistic regression models were applied to calculate odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for age, sex, occupational social class, smoking status, dietary pattern, physical activity, and body mass index. Results: Lower levels of Purpose in Life were consistently associated with greater likelihood of high estimated diabetes risk across all three instruments. Compared with participants reporting high Purpose in Life, those with low Purpose in Life showed increased odds of high-risk classification for QDScore (OR 2.38; 95\% CI 2.19-2.57), FINDRISC (OR 2.49; 95\% CI 2.08-2.89), and CANRISK (OR 2.79; 95\% CI 2.50-3.09). Clear dose-response patterns were observed across Purpose in Life categories, and associations were similar in men and women as well as across lifestyle strata. Conclusions: Reduced Purpose in Life is strongly associated with higher estimated type 2 diabetes risk across multiple validated screening tools. Although causal direction cannot be inferred from this cross-sectional design, these findings suggest that psychosocial dimensions may provide complementary information for cardiometabolic risk assessment and prevention strategies.
  

• 
  Interplay of Lifestyle Social Determinants and Isolation in the Risk of Metabolic Syndrome Among Spanish Workers. Riutord, Pere; Tarraga, Pedro J.; Lopez-Gonzalez, Angel A.; Coll-Campayo, Irene; Busquets, Carla; Ramirez-Manent, Jose I. (2026). 18(1) e101624.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: Metabolic syndrome (MetS) is a cluster of cardiometabolic abnormalities linked to cardiovascular disease and type 2 diabetes mellitus. While lifestyle and sociodemographic determinants are well established, the role of social isolation in MetS is less explored. METHODS: A nationwide cross-sectional study included 117,298 Spanish workers from multiple occupational sectors (2021-2024). MetS was defined using National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III, International Diabetes Federation (IDF), and Joint Interim Statement (JIS) criteria. Sociodemographic, lifestyle, and psychosocial variables were assessed with standardized questionnaires, including the ENRICHD Social Support Instrument. Logistic regression estimated associations with MetS prevalence. RESULTS: MetS prevalence was 28.7% (NCEP ATP III), 32.1% (IDF), and 33.5% (JIS). Men had consistently higher prevalence than women (p\textless0.001). Prevalence rose with age, exceeding 40% in workers ≥55 years. Low socioeconomic status was linked to a higher prevalence (p\textless0.001). Lifestyle factors were strongly associated: physical inactivity doubled the odds of MetS (OR≈2.0); poor Mediterranean diet adherence and smoking increased risk, while regular activity and high dietary adherence were protective (all p\textless0.001). Low social support independently increased the odds of MetS across all definitions, even after adjustment. CONCLUSIONS: In this large cohort, MetS was highly prevalent and strongly influenced by lifestyle, sociodemographic, and psychosocial factors. Social isolation emerged as an independent determinant, underscoring the need for workplace strategies integrating lifestyle promotion with social support.

  @article{riutord_interplay_2026,
  abstract = {BACKGROUND: Metabolic syndrome (MetS) is a cluster of cardiometabolic abnormalities linked to cardiovascular disease and type 2 diabetes mellitus. While lifestyle and sociodemographic determinants are well established, the role of social isolation in MetS is less explored. METHODS: A nationwide cross-sectional study included 117,298 Spanish workers from multiple occupational sectors (2021-2024). MetS was defined using National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III, International Diabetes Federation (IDF), and Joint Interim Statement (JIS) criteria. Sociodemographic, lifestyle, and psychosocial variables were assessed with standardized questionnaires, including the ENRICHD Social Support Instrument. Logistic regression estimated associations with MetS prevalence. RESULTS: MetS prevalence was 28.7% (NCEP ATP III), 32.1% (IDF), and 33.5% (JIS). Men had consistently higher prevalence than women (p\textless0.001). Prevalence rose with age, exceeding 40% in workers ≥55 years. Low socioeconomic status was linked to a higher prevalence (p\textless0.001). Lifestyle factors were strongly associated: physical inactivity doubled the odds of MetS (OR≈2.0); poor Mediterranean diet adherence and smoking increased risk, while regular activity and high dietary adherence were protective (all p\textless0.001). Low social support independently increased the odds of MetS across all definitions, even after adjustment. CONCLUSIONS: In this large cohort, MetS was highly prevalent and strongly influenced by lifestyle, sociodemographic, and psychosocial factors. Social isolation emerged as an independent determinant, underscoring the need for workplace strategies integrating lifestyle promotion with social support.},
  author = {Riutord, Pere and Tarraga, Pedro J. and Lopez-Gonzalez, Angel A. and Coll-Campayo, Irene and Busquets, Carla and Ramirez-Manent, Jose I.},
  journal = {Cureus},
  keywords = {grapp-caib},
  month = {jan},
  number = 1,
  pages = {e101624},
  title = {Interplay of Lifestyle Social Determinants and Isolation in the Risk of Metabolic Syndrome Among Spanish Workers},
  volume = 18,
  year = 2026
  }
  

  %0 Journal Article
  %1 riutord_interplay_2026
  %A Riutord, Pere
  %A Tarraga, Pedro J.
  %A Lopez-Gonzalez, Angel A.
  %A Coll-Campayo, Irene
  %A Busquets, Carla
  %A Ramirez-Manent, Jose I.
  %D 2026
  %J Cureus
  %N 1
  %P e101624
  %R 10.7759/cureus.101624
  %T Interplay of Lifestyle Social Determinants and Isolation in the Risk of Metabolic Syndrome Among Spanish Workers
  %V 18
  %X BACKGROUND: Metabolic syndrome (MetS) is a cluster of cardiometabolic abnormalities linked to cardiovascular disease and type 2 diabetes mellitus. While lifestyle and sociodemographic determinants are well established, the role of social isolation in MetS is less explored. METHODS: A nationwide cross-sectional study included 117,298 Spanish workers from multiple occupational sectors (2021-2024). MetS was defined using National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III, International Diabetes Federation (IDF), and Joint Interim Statement (JIS) criteria. Sociodemographic, lifestyle, and psychosocial variables were assessed with standardized questionnaires, including the ENRICHD Social Support Instrument. Logistic regression estimated associations with MetS prevalence. RESULTS: MetS prevalence was 28.7% (NCEP ATP III), 32.1% (IDF), and 33.5% (JIS). Men had consistently higher prevalence than women (p\textless0.001). Prevalence rose with age, exceeding 40% in workers ≥55 years. Low socioeconomic status was linked to a higher prevalence (p\textless0.001). Lifestyle factors were strongly associated: physical inactivity doubled the odds of MetS (OR≈2.0); poor Mediterranean diet adherence and smoking increased risk, while regular activity and high dietary adherence were protective (all p\textless0.001). Low social support independently increased the odds of MetS across all definitions, even after adjustment. CONCLUSIONS: In this large cohort, MetS was highly prevalent and strongly influenced by lifestyle, sociodemographic, and psychosocial factors. Social isolation emerged as an independent determinant, underscoring the need for workplace strategies integrating lifestyle promotion with social support.
  

• 
  Evaluation of the effectiveness of SOM-RIU, a multifaceted, school-based, suicide prevention intervention targeted to Spanish adolescents: study protocol for a cluster-randomised controlled trial. Riera-Serra, Pau; Serrano-Ripoll, Maria Jesús; Fiol deRoque, Maria Antònia; García-Pazo, Patricia; Bennasar-Veny, Miquel; Yánez-Juan, Aina; Leiva-Rus, Alfonso; Ginard-Puigserver, Miquel; García-Toro, Mauro; Sitges, Carolina; Balle, Maria; Gervilla, Elena; Gonzalez-Garcia, Xandra; García-Buades, M. Esther; Blanes, Maria Wei; Zamanillo-Campos, Rocío; Andreu-Rodrigo, Pilar; Ricci-Cabello, Ignacio (2026). 26(1) 56.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: Adolescent suicide is a major public health concern and the third leading cause of death among young people worldwide. Schools are widely recognized as effective settings for universal mental health promotion and suicide prevention. This study aims to evaluate the effectiveness of SOM-RIU, a multifaceted school-based intervention involving pupils and gatekeepers (teachers and parents) in preventing suicidal behaviour and promoting adolescent mental health. METHODS: We will conduct a six-month, two-arm, cluster-randomised controlled trial. We will recruit 2,280 pupils from 114 classrooms in 38 secondary schools across the Balearic Islands (Spain). Eligible pupils will be aged 12–16 and enrolled in the 2nd and 3rd years of compulsory secondary education. Schools will be randomly assigned (1:1) to either the intervention or control group. Schools in the intervention group will implement the SOM-RIU programme, which includes four weekly psychoeducational sessions for pupils, delivered by trained educational psychologists. These sessions focus on mental health literacy, emotional regulation, suicide risk detection and management, and help-seeking strategies. In parallel, gatekeepers (teachers and parents) will receive a digital educational co-intervention consisting in four multimedia modules to strengthen their role in suicide prevention. Schools in the control group will receive a minimal intervention consisting of educational posters on mental health and suicide prevention displayed within school premises. The primary outcome will be suicidal ideation (Paykel Suicide Scale). Secondary outcomes will include suicide attempts, depression symptoms, well-being, self-harm, substance use, internet addiction, bullying, and cognitive disconnection. Teachers and parents will report on suicide-related knowledge, self-efficacy, and student referrals. Data will be collected at baseline and six-month follow-up. Analyses will be conducted using generalized linear mixed models to account for clustering, and multiple imputation will be used for missing data. A qualitative process evaluation will explore implementation, acceptability, and perceived impact of the intervention, while also examining contextual factors and potential mechanisms of action that may have influenced the outcomes. DISCUSSION: This trial will generate evidence on the effectiveness of multifaceted, school-based suicide prevention interventions for adolescents. If effective, the SOM-RIU programme could serve as a practical model for enhancing mental health support within educational settings in Spain. TRIAL REGISTRATION: NCT06996054 (clinicaltrials.gov). Registration date: 2025-05-30. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12888-025-07570-0.

  @article{riera-serra_evaluation_2026,
  abstract = {BACKGROUND: Adolescent suicide is a major public health concern and the third leading cause of death among young people worldwide. Schools are widely recognized as effective settings for universal mental health promotion and suicide prevention. This study aims to evaluate the effectiveness of SOM-RIU, a multifaceted school-based intervention involving pupils and gatekeepers (teachers and parents) in preventing suicidal behaviour and promoting adolescent mental health. METHODS: We will conduct a six-month, two-arm, cluster-randomised controlled trial. We will recruit 2,280 pupils from 114 classrooms in 38 secondary schools across the Balearic Islands (Spain). Eligible pupils will be aged 12–16 and enrolled in the 2nd and 3rd years of compulsory secondary education. Schools will be randomly assigned (1:1) to either the intervention or control group. Schools in the intervention group will implement the SOM-RIU programme, which includes four weekly psychoeducational sessions for pupils, delivered by trained educational psychologists. These sessions focus on mental health literacy, emotional regulation, suicide risk detection and management, and help-seeking strategies. In parallel, gatekeepers (teachers and parents) will receive a digital educational co-intervention consisting in four multimedia modules to strengthen their role in suicide prevention. Schools in the control group will receive a minimal intervention consisting of educational posters on mental health and suicide prevention displayed within school premises. The primary outcome will be suicidal ideation (Paykel Suicide Scale). Secondary outcomes will include suicide attempts, depression symptoms, well-being, self-harm, substance use, internet addiction, bullying, and cognitive disconnection. Teachers and parents will report on suicide-related knowledge, self-efficacy, and student referrals. Data will be collected at baseline and six-month follow-up. Analyses will be conducted using generalized linear mixed models to account for clustering, and multiple imputation will be used for missing data. A qualitative process evaluation will explore implementation, acceptability, and perceived impact of the intervention, while also examining contextual factors and potential mechanisms of action that may have influenced the outcomes. DISCUSSION: This trial will generate evidence on the effectiveness of multifaceted, school-based suicide prevention interventions for adolescents. If effective, the SOM-RIU programme could serve as a practical model for enhancing mental health support within educational settings in Spain. TRIAL REGISTRATION: NCT06996054 (clinicaltrials.gov). Registration date: 2025-05-30. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12888-025-07570-0.},
  author = {Riera-Serra, Pau and Serrano-Ripoll, Maria Jesús and Fiol deRoque, Maria Antònia and García-Pazo, Patricia and Bennasar-Veny, Miquel and Yánez-Juan, Aina and Leiva-Rus, Alfonso and Ginard-Puigserver, Miquel and García-Toro, Mauro and Sitges, Carolina and Balle, Maria and Gervilla, Elena and Gonzalez-Garcia, Xandra and García-Buades, M. Esther and Blanes, Maria Wei and Zamanillo-Campos, Rocío and Andreu-Rodrigo, Pilar and Ricci-Cabello, Ignacio},
  journal = {BMC psychiatry},
  keywords = {grapp-caib},
  month = {jan},
  number = 1,
  pages = 56,
  title = {Evaluation of the effectiveness of SOM-RIU, a multifaceted, school-based, suicide prevention intervention targeted to Spanish adolescents: study protocol for a cluster-randomised controlled trial},
  volume = 26,
  year = 2026
  }
  

  %0 Journal Article
  %1 riera-serra_evaluation_2026
  %A Riera-Serra, Pau
  %A Serrano-Ripoll, Maria Jesús
  %A Fiol deRoque, Maria Antònia
  %A García-Pazo, Patricia
  %A Bennasar-Veny, Miquel
  %A Yánez-Juan, Aina
  %A Leiva-Rus, Alfonso
  %A Ginard-Puigserver, Miquel
  %A García-Toro, Mauro
  %A Sitges, Carolina
  %A Balle, Maria
  %A Gervilla, Elena
  %A Gonzalez-Garcia, Xandra
  %A García-Buades, M. Esther
  %A Blanes, Maria Wei
  %A Zamanillo-Campos, Rocío
  %A Andreu-Rodrigo, Pilar
  %A Ricci-Cabello, Ignacio
  %D 2026
  %J BMC psychiatry
  %N 1
  %P 56
  %R 10.1186/s12888-025-07570-0
  %T Evaluation of the effectiveness of SOM-RIU, a multifaceted, school-based, suicide prevention intervention targeted to Spanish adolescents: study protocol for a cluster-randomised controlled trial
  %V 26
  %X BACKGROUND: Adolescent suicide is a major public health concern and the third leading cause of death among young people worldwide. Schools are widely recognized as effective settings for universal mental health promotion and suicide prevention. This study aims to evaluate the effectiveness of SOM-RIU, a multifaceted school-based intervention involving pupils and gatekeepers (teachers and parents) in preventing suicidal behaviour and promoting adolescent mental health. METHODS: We will conduct a six-month, two-arm, cluster-randomised controlled trial. We will recruit 2,280 pupils from 114 classrooms in 38 secondary schools across the Balearic Islands (Spain). Eligible pupils will be aged 12–16 and enrolled in the 2nd and 3rd years of compulsory secondary education. Schools will be randomly assigned (1:1) to either the intervention or control group. Schools in the intervention group will implement the SOM-RIU programme, which includes four weekly psychoeducational sessions for pupils, delivered by trained educational psychologists. These sessions focus on mental health literacy, emotional regulation, suicide risk detection and management, and help-seeking strategies. In parallel, gatekeepers (teachers and parents) will receive a digital educational co-intervention consisting in four multimedia modules to strengthen their role in suicide prevention. Schools in the control group will receive a minimal intervention consisting of educational posters on mental health and suicide prevention displayed within school premises. The primary outcome will be suicidal ideation (Paykel Suicide Scale). Secondary outcomes will include suicide attempts, depression symptoms, well-being, self-harm, substance use, internet addiction, bullying, and cognitive disconnection. Teachers and parents will report on suicide-related knowledge, self-efficacy, and student referrals. Data will be collected at baseline and six-month follow-up. Analyses will be conducted using generalized linear mixed models to account for clustering, and multiple imputation will be used for missing data. A qualitative process evaluation will explore implementation, acceptability, and perceived impact of the intervention, while also examining contextual factors and potential mechanisms of action that may have influenced the outcomes. DISCUSSION: This trial will generate evidence on the effectiveness of multifaceted, school-based suicide prevention interventions for adolescents. If effective, the SOM-RIU programme could serve as a practical model for enhancing mental health support within educational settings in Spain. TRIAL REGISTRATION: NCT06996054 (clinicaltrials.gov). Registration date: 2025-05-30. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12888-025-07570-0.
  

• 
  Qualitative evaluation of a community intervention in educational centres: Opinion of the professionals involved. Vidal-Thomàs, Maria Clara; Ripoll Amengual, Joana; Cacereño Jiménez, Maria Belén; Sempere Andrés, Pau; Urbina Sampedro, Elisa; March Llull, Sebastiá (2026). 49(1) e1150.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: Consulta Joven is a community intervention developed in primary care to address adolescents´ health needs. It offers open health consultations in secondary schools within a context of trust and confidentiality and is complemented by additional health promotion activities. This study explores the perceptions of professionals involved in the programme regarding challenges and key elements influencing its implementation. METHODS: A qualitative, descriptive-interpretive approach study was conducted in primary care in Mallorca (Spain) in 2017. Participants were recruited by Consulta Joven coordinators using purposive theoretical sampling. Three focus groups were conducted with ten nurses, four physicians, and six teachers. Two researchers independently coded transcripts using a general inductive approach. Categories were developed through content analysis and refined through team discussion. RESULTS: Four categories emerged: Perceived value and usefulness of Consulta Joven, Barriers to implementation, Key elements for programme development, and Proposals for improvement. Participants described Consulta Joven as an effective strategy to reach adolescents, promote healthy behaviours, and identify health problems before they seek medical care. Trust and confidentiality are highlighted as essential for its success, along with intersectoral collaboration with community stakeholders. Conclusions, Professionals perceive Consulta Joven as a useful intervention to adolescent health promotion. Strengthening institutional support and collaboration between the health and education sectors, and introducing the programme at earlier educational stages, may enhance its preventive impact.

  @article{vidal-thomas_qualitative_2026,
  abstract = {BACKGROUND: Consulta Joven is a community intervention developed in primary care to address adolescents´ health needs. It offers open health consultations in secondary schools within a context of trust and confidentiality and is complemented by additional health promotion activities. This study explores the perceptions of professionals involved in the programme regarding challenges and key elements influencing its implementation. METHODS: A qualitative, descriptive-interpretive approach study was conducted in primary care in Mallorca (Spain) in 2017. Participants were recruited by Consulta Joven coordinators using purposive theoretical sampling. Three focus groups were conducted with ten nurses, four physicians, and six teachers. Two researchers independently coded transcripts using a general inductive approach. Categories were developed through content analysis and refined through team discussion. RESULTS: Four categories emerged: Perceived value and usefulness of Consulta Joven, Barriers to implementation, Key elements for programme development, and Proposals for improvement. Participants described Consulta Joven as an effective strategy to reach adolescents, promote healthy behaviours, and identify health problems before they seek medical care. Trust and confidentiality are highlighted as essential for its success, along with intersectoral collaboration with community stakeholders. Conclusions, Professionals perceive Consulta Joven as a useful intervention to adolescent health promotion. Strengthening institutional support and collaboration between the health and education sectors, and introducing the programme at earlier educational stages, may enhance its preventive impact.},
  author = {Vidal-Thomàs, Maria Clara and Ripoll Amengual, Joana and Cacereño Jiménez, Maria Belén and Sempere Andrés, Pau and Urbina Sampedro, Elisa and March Llull, Sebastiá},
  journal = {Anales Del Sistema Sanitario De Navarra},
  keywords = {grapp-caib},
  month = {apr},
  number = 1,
  pages = {e1150},
  title = {Qualitative evaluation of a community intervention in educational centres: Opinion of the professionals involved},
  volume = 49,
  year = 2026
  }
  

  %0 Journal Article
  %1 vidal-thomas_qualitative_2026
  %A Vidal-Thomàs, Maria Clara
  %A Ripoll Amengual, Joana
  %A Cacereño Jiménez, Maria Belén
  %A Sempere Andrés, Pau
  %A Urbina Sampedro, Elisa
  %A March Llull, Sebastiá
  %D 2026
  %J Anales Del Sistema Sanitario De Navarra
  %N 1
  %P e1150
  %R 10.23938/ASSN.1150
  %T Qualitative evaluation of a community intervention in educational centres: Opinion of the professionals involved
  %V 49
  %X BACKGROUND: Consulta Joven is a community intervention developed in primary care to address adolescents´ health needs. It offers open health consultations in secondary schools within a context of trust and confidentiality and is complemented by additional health promotion activities. This study explores the perceptions of professionals involved in the programme regarding challenges and key elements influencing its implementation. METHODS: A qualitative, descriptive-interpretive approach study was conducted in primary care in Mallorca (Spain) in 2017. Participants were recruited by Consulta Joven coordinators using purposive theoretical sampling. Three focus groups were conducted with ten nurses, four physicians, and six teachers. Two researchers independently coded transcripts using a general inductive approach. Categories were developed through content analysis and refined through team discussion. RESULTS: Four categories emerged: Perceived value and usefulness of Consulta Joven, Barriers to implementation, Key elements for programme development, and Proposals for improvement. Participants described Consulta Joven as an effective strategy to reach adolescents, promote healthy behaviours, and identify health problems before they seek medical care. Trust and confidentiality are highlighted as essential for its success, along with intersectoral collaboration with community stakeholders. Conclusions, Professionals perceive Consulta Joven as a useful intervention to adolescent health promotion. Strengthening institutional support and collaboration between the health and education sectors, and introducing the programme at earlier educational stages, may enhance its preventive impact.
  

• 
  Metabolic age as a marker of cardiometabolic risk: Relationships with metabolic syndrome, hypertriglyceridemic waist, and hypertensive waist phenotypes in a large occupational cohort. Ramírez-Gallegos, I.; Tárraga López, P. J.; Marina Arroyo, M.; López-González, Á A.; Coll Campayo, I.; Busquets-Cortés, C.; Ramírez-Manent, J. I. (2026). 52(4) 102725.

  AbstractBibTeXEndNoteDOIBibSonomy

  BACKGROUND: Metabolic age (MA) has been proposed as an integrative, clinically intuitive indicator of physiological aging that may capture clustered cardiometabolic risk better than single traits. OBJECTIVE: We examined the association and discriminative performance of MA with metabolic syndrome (MetS) defined by NCEP ATP III, IDF, and Joint Interim Statement (JIS) criteria, and with the hypertriglyceridemic waist (HTGW) and hypertensive waist (HTAW) phenotypes, in a large occupational cohort. METHODS: Cross-sectional analytic study of Spanish workers attending routine occupational health examinations (January-June 2022). A total of 8590 employees (4104 men; 4486 women), aged 18-69 years, with standardized anthropometry, blood pressure, and fasting laboratory testing were included. MA was obtained via multifrequency bioelectrical impedance analysis; high MA was defined as MA ≥chronological age. Negative MA values (metabolic age lower than chronological age) indicate a metabolically younger or healthier profile, while positive values reflect accelerated metabolic aging and higher cardiometabolic risk. Five multivariable logistic models estimated adjusted odds ratios (ORs, 95\% CI) for high MA across the five phenotypes; covariates included sex, age group, social class, smoking, physical activity, and Mediterranean diet adherence. Sex-stratified ROC analyses assessed discrimination (AUC); optimal thresholds were derived using Youden's index. RESULTS: High MA showed strong, independent associations with all phenotypes: MetS NCEP ATP III, OR 8.01 (95\% CI 6.79-9.24); MetS IDF, OR 10.96 (9.23-12.80); MetS JIS, OR 7.94 (6.78-9.10); HTGW, OR 7.44 (6.10-8.79); HTAW, OR 13.97 (11.82-16.13). Behavioral and socioeconomic gradients were coherent across models (e.g., physical inactivity OR range 3.99-4.60; low Mediterranean diet adherence 2.38-2.61; smoking 1.17-1.23; lower social class III 2.27-2.42; men vs women 1.07-1.18). Sex-specific ROC analyses indicated good discrimination: AUCs (women/men) were 0.836/0.825 (NCEP ATP III), 0.835/0.833 (IDF), 0.819/0.807 (JIS), 0.813/0.849 (HTGW), and 0.827/0.865 (HTAW). Optimal MA cut-offs (difference MA-chronological age) ranged from -2 to +2 years across phenotypes and sex, yielding balanced sensitivity (∼75-82\%) and specificity (∼75-77\%). CONCLUSIONS: In a large occupational cohort, MA - derived from bioimpedance - was strongly and consistently associated with MetS (across three definitions) and with HTGW and HTAW, and it discriminated these phenotypes with AUCs ∼0.81-0.87. MA appears to be a feasible, low-burden metric that complements waist-based screening to prioritize preventive actions in workplace health programs. Longitudinal and interventional studies are warranted to confirm temporal relationships, refine MA thresholds by sex and age, and quantify incremental prognostic value beyond established risk indices.

  @article{ramirez-gallegos_metabolic_2026,
  abstract = {BACKGROUND: Metabolic age (MA) has been proposed as an integrative, clinically intuitive indicator of physiological aging that may capture clustered cardiometabolic risk better than single traits. OBJECTIVE: We examined the association and discriminative performance of MA with metabolic syndrome (MetS) defined by NCEP ATP III, IDF, and Joint Interim Statement (JIS) criteria, and with the hypertriglyceridemic waist (HTGW) and hypertensive waist (HTAW) phenotypes, in a large occupational cohort. METHODS: Cross-sectional analytic study of Spanish workers attending routine occupational health examinations (January-June 2022). A total of 8590 employees (4104 men; 4486 women), aged 18-69 years, with standardized anthropometry, blood pressure, and fasting laboratory testing were included. MA was obtained via multifrequency bioelectrical impedance analysis; high MA was defined as MA ≥chronological age. Negative MA values (metabolic age lower than chronological age) indicate a metabolically younger or healthier profile, while positive values reflect accelerated metabolic aging and higher cardiometabolic risk. Five multivariable logistic models estimated adjusted odds ratios (ORs, 95\% CI) for high MA across the five phenotypes; covariates included sex, age group, social class, smoking, physical activity, and Mediterranean diet adherence. Sex-stratified ROC analyses assessed discrimination (AUC); optimal thresholds were derived using Youden's index. RESULTS: High MA showed strong, independent associations with all phenotypes: MetS NCEP ATP III, OR 8.01 (95\% CI 6.79-9.24); MetS IDF, OR 10.96 (9.23-12.80); MetS JIS, OR 7.94 (6.78-9.10); HTGW, OR 7.44 (6.10-8.79); HTAW, OR 13.97 (11.82-16.13). Behavioral and socioeconomic gradients were coherent across models (e.g., physical inactivity OR range 3.99-4.60; low Mediterranean diet adherence 2.38-2.61; smoking 1.17-1.23; lower social class III 2.27-2.42; men vs women 1.07-1.18). Sex-specific ROC analyses indicated good discrimination: AUCs (women/men) were 0.836/0.825 (NCEP ATP III), 0.835/0.833 (IDF), 0.819/0.807 (JIS), 0.813/0.849 (HTGW), and 0.827/0.865 (HTAW). Optimal MA cut-offs (difference MA-chronological age) ranged from -2 to +2 years across phenotypes and sex, yielding balanced sensitivity (∼75-82\%) and specificity (∼75-77\%). CONCLUSIONS: In a large occupational cohort, MA - derived from bioimpedance - was strongly and consistently associated with MetS (across three definitions) and with HTGW and HTAW, and it discriminated these phenotypes with AUCs ∼0.81-0.87. MA appears to be a feasible, low-burden metric that complements waist-based screening to prioritize preventive actions in workplace health programs. Longitudinal and interventional studies are warranted to confirm temporal relationships, refine MA thresholds by sex and age, and quantify incremental prognostic value beyond established risk indices.},
  author = {Ramírez-Gallegos, I. and Tárraga López, P. J. and Marina Arroyo, M. and López-González, Á A. and Coll Campayo, I. and Busquets-Cortés, C. and Ramírez-Manent, J. I.},
  journal = {Semergen},
  keywords = {grapp-caib},
  month = {feb},
  number = 4,
  pages = 102725,
  title = {Metabolic age as a marker of cardiometabolic risk: Relationships with metabolic syndrome, hypertriglyceridemic waist, and hypertensive waist phenotypes in a large occupational cohort},
  volume = 52,
  year = 2026
  }
  

  %0 Journal Article
  %1 ramirez-gallegos_metabolic_2026
  %A Ramírez-Gallegos, I.
  %A Tárraga López, P. J.
  %A Marina Arroyo, M.
  %A López-González, Á A.
  %A Coll Campayo, I.
  %A Busquets-Cortés, C.
  %A Ramírez-Manent, J. I.
  %D 2026
  %J Semergen
  %N 4
  %P 102725
  %R 10.1016/j.semerg.2026.102725
  %T Metabolic age as a marker of cardiometabolic risk: Relationships with metabolic syndrome, hypertriglyceridemic waist, and hypertensive waist phenotypes in a large occupational cohort
  %V 52
  %X BACKGROUND: Metabolic age (MA) has been proposed as an integrative, clinically intuitive indicator of physiological aging that may capture clustered cardiometabolic risk better than single traits. OBJECTIVE: We examined the association and discriminative performance of MA with metabolic syndrome (MetS) defined by NCEP ATP III, IDF, and Joint Interim Statement (JIS) criteria, and with the hypertriglyceridemic waist (HTGW) and hypertensive waist (HTAW) phenotypes, in a large occupational cohort. METHODS: Cross-sectional analytic study of Spanish workers attending routine occupational health examinations (January-June 2022). A total of 8590 employees (4104 men; 4486 women), aged 18-69 years, with standardized anthropometry, blood pressure, and fasting laboratory testing were included. MA was obtained via multifrequency bioelectrical impedance analysis; high MA was defined as MA ≥chronological age. Negative MA values (metabolic age lower than chronological age) indicate a metabolically younger or healthier profile, while positive values reflect accelerated metabolic aging and higher cardiometabolic risk. Five multivariable logistic models estimated adjusted odds ratios (ORs, 95\% CI) for high MA across the five phenotypes; covariates included sex, age group, social class, smoking, physical activity, and Mediterranean diet adherence. Sex-stratified ROC analyses assessed discrimination (AUC); optimal thresholds were derived using Youden's index. RESULTS: High MA showed strong, independent associations with all phenotypes: MetS NCEP ATP III, OR 8.01 (95\% CI 6.79-9.24); MetS IDF, OR 10.96 (9.23-12.80); MetS JIS, OR 7.94 (6.78-9.10); HTGW, OR 7.44 (6.10-8.79); HTAW, OR 13.97 (11.82-16.13). Behavioral and socioeconomic gradients were coherent across models (e.g., physical inactivity OR range 3.99-4.60; low Mediterranean diet adherence 2.38-2.61; smoking 1.17-1.23; lower social class III 2.27-2.42; men vs women 1.07-1.18). Sex-specific ROC analyses indicated good discrimination: AUCs (women/men) were 0.836/0.825 (NCEP ATP III), 0.835/0.833 (IDF), 0.819/0.807 (JIS), 0.813/0.849 (HTGW), and 0.827/0.865 (HTAW). Optimal MA cut-offs (difference MA-chronological age) ranged from -2 to +2 years across phenotypes and sex, yielding balanced sensitivity (∼75-82\%) and specificity (∼75-77\%). CONCLUSIONS: In a large occupational cohort, MA - derived from bioimpedance - was strongly and consistently associated with MetS (across three definitions) and with HTGW and HTAW, and it discriminated these phenotypes with AUCs ∼0.81-0.87. MA appears to be a feasible, low-burden metric that complements waist-based screening to prioritize preventive actions in workplace health programs. Longitudinal and interventional studies are warranted to confirm temporal relationships, refine MA thresholds by sex and age, and quantify incremental prognostic value beyond established risk indices.
  

• 
  Lung ultrasound performed by primary care physicians as a predictive and diagnostic tool in COVID-19 patients. Oliva-Fanlo, Bernardino; Esteva, Magdalena; Ramírez-Manent, José Ignacio; Albaladejo-Dávalos, Antonio; Corcoll-Reixach, Josep; Gadea-Ruiz, Mª Cristina; Morán-Bayón, Álvaro; Bulilete, Oana (2026).

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  To assess the value of abnormal findings of lung POCUS performed by PCPs in patients with SARS-CoV-2 virus infection in predicting hospitalisations, intensive care admissions, and mortality. Additionally, this study aims to assess the validity of lung POCUS performed by PCPs for COVID-19 pneumonia diagnosis. This prospective observational study, conducted in Mallorca and Salamanca, Spain, during 2021, assessed 624 consecutive adult patients with confirmed SARS-CoV-2 infection and worsening symptoms. Eight PCPs with 5-hour standardized training performed 12-zone lung POCUS. POCUS was considered positive if pleural abnormalities with ≥3 B-lines, subpleural consolidation, or lobar consolidation were present. Patients were followed for 30 days to confirm pneumonia diagnosis via chest X-ray or CT scan. Multivariate models using Poisson regression were performed to identify independent predictors for hospitalization and ICU admission/death. Abnormal POCUS findings were observed in 58.8% of patients, of whom 50.3% presented pleural abnormalities with 3 or more B-lines in at least one scanned area, 27.6% subpleural consolidations, and 3.4% lobar consolidations. Patients with positive POCUS were referred to the hospital more frequently (72.4\% vs. 22.8\%; OR = 8.83). Abnormal lung POCUS was independently associated with an increased risk of hospitalization (RR 1.34; 95\% CI 1.07-1.67), along with age textgreater50 years, SpO2 textless95%, hypertension, and diabetes. POCUS was not independently associated with the composite outcome of ICU admission or death (RR 1.27; 95\% CI 0.62-2.61). For the diagnosis of COVID-19 pneumonia, overall POCUS sensitivity was 68.3%, specificity 43.6%, positive predictive value 78.7%, and negative predictive value 31.1%. Lung POCUS performed by PCPs is a valuable independent predictor for hospitalization in COVID-19 patients within community settings. While its incremental prognostic benefit over simple clinical variables is modest and its diagnostic accuracy for pneumonia is limited compared to conventional imaging, it could remain as a useful tool for risk stratification in resource-limited environments or home-based care. These findings support its use in resource-limited environments and highlight the need for standardised scanning protocols and training.

  @article{oliva-fanlo_lung_2026,
  abstract = {To assess the value of abnormal findings of lung POCUS performed by PCPs in patients with SARS-CoV-2 virus infection in predicting hospitalisations, intensive care admissions, and mortality. Additionally, this study aims to assess the validity of lung POCUS performed by PCPs for COVID-19 pneumonia diagnosis. This prospective observational study, conducted in Mallorca and Salamanca, Spain, during 2021, assessed 624 consecutive adult patients with confirmed SARS-CoV-2 infection and worsening symptoms. Eight PCPs with 5-hour standardized training performed 12-zone lung POCUS. POCUS was considered positive if pleural abnormalities with ≥3 B-lines, subpleural consolidation, or lobar consolidation were present. Patients were followed for 30 days to confirm pneumonia diagnosis via chest X-ray or CT scan. Multivariate models using Poisson regression were performed to identify independent predictors for hospitalization and ICU admission/death. Abnormal POCUS findings were observed in 58.8% of patients, of whom 50.3% presented pleural abnormalities with 3 or more B-lines in at least one scanned area, 27.6% subpleural consolidations, and 3.4% lobar consolidations. Patients with positive POCUS were referred to the hospital more frequently (72.4\% vs. 22.8\%; OR = 8.83). Abnormal lung POCUS was independently associated with an increased risk of hospitalization (RR 1.34; 95\% CI 1.07-1.67), along with age textgreater50 years, SpO2 textless95%, hypertension, and diabetes. POCUS was not independently associated with the composite outcome of ICU admission or death (RR 1.27; 95\% CI 0.62-2.61). For the diagnosis of COVID-19 pneumonia, overall POCUS sensitivity was 68.3%, specificity 43.6%, positive predictive value 78.7%, and negative predictive value 31.1%. Lung POCUS performed by PCPs is a valuable independent predictor for hospitalization in COVID-19 patients within community settings. While its incremental prognostic benefit over simple clinical variables is modest and its diagnostic accuracy for pneumonia is limited compared to conventional imaging, it could remain as a useful tool for risk stratification in resource-limited environments or home-based care. These findings support its use in resource-limited environments and highlight the need for standardised scanning protocols and training.},
  author = {Oliva-Fanlo, Bernardino and Esteva, Magdalena and Ramírez-Manent, José Ignacio and Albaladejo-Dávalos, Antonio and Corcoll-Reixach, Josep and Gadea-Ruiz, Mª Cristina and Morán-Bayón, Álvaro and Bulilete, Oana},
  journal = {NPJ primary care respiratory medicine},
  keywords = {grapp-caib},
  month = {apr},
  title = {Lung ultrasound performed by primary care physicians as a predictive and diagnostic tool in COVID-19 patients},
  year = 2026
  }
  

  %0 Journal Article
  %1 oliva-fanlo_lung_2026
  %A Oliva-Fanlo, Bernardino
  %A Esteva, Magdalena
  %A Ramírez-Manent, José Ignacio
  %A Albaladejo-Dávalos, Antonio
  %A Corcoll-Reixach, Josep
  %A Gadea-Ruiz, Mª Cristina
  %A Morán-Bayón, Álvaro
  %A Bulilete, Oana
  %D 2026
  %J NPJ primary care respiratory medicine
  %R 10.1038/s41533-026-00515-4
  %T Lung ultrasound performed by primary care physicians as a predictive and diagnostic tool in COVID-19 patients
  %X To assess the value of abnormal findings of lung POCUS performed by PCPs in patients with SARS-CoV-2 virus infection in predicting hospitalisations, intensive care admissions, and mortality. Additionally, this study aims to assess the validity of lung POCUS performed by PCPs for COVID-19 pneumonia diagnosis. This prospective observational study, conducted in Mallorca and Salamanca, Spain, during 2021, assessed 624 consecutive adult patients with confirmed SARS-CoV-2 infection and worsening symptoms. Eight PCPs with 5-hour standardized training performed 12-zone lung POCUS. POCUS was considered positive if pleural abnormalities with ≥3 B-lines, subpleural consolidation, or lobar consolidation were present. Patients were followed for 30 days to confirm pneumonia diagnosis via chest X-ray or CT scan. Multivariate models using Poisson regression were performed to identify independent predictors for hospitalization and ICU admission/death. Abnormal POCUS findings were observed in 58.8% of patients, of whom 50.3% presented pleural abnormalities with 3 or more B-lines in at least one scanned area, 27.6% subpleural consolidations, and 3.4% lobar consolidations. Patients with positive POCUS were referred to the hospital more frequently (72.4\% vs. 22.8\%; OR = 8.83). Abnormal lung POCUS was independently associated with an increased risk of hospitalization (RR 1.34; 95\% CI 1.07-1.67), along with age textgreater50 years, SpO2 textless95%, hypertension, and diabetes. POCUS was not independently associated with the composite outcome of ICU admission or death (RR 1.27; 95\% CI 0.62-2.61). For the diagnosis of COVID-19 pneumonia, overall POCUS sensitivity was 68.3%, specificity 43.6%, positive predictive value 78.7%, and negative predictive value 31.1%. Lung POCUS performed by PCPs is a valuable independent predictor for hospitalization in COVID-19 patients within community settings. While its incremental prognostic benefit over simple clinical variables is modest and its diagnostic accuracy for pneumonia is limited compared to conventional imaging, it could remain as a useful tool for risk stratification in resource-limited environments or home-based care. These findings support its use in resource-limited environments and highlight the need for standardised scanning protocols and training.
  

• 
  Atherogenic Risk in Commerce and Industry Workers: Associations with Sociodemographic and Lifestyle Factors in a Large Spanish Occupational Cohort. Fernández-Figares Vicioso, María Pilar; Vicente-Herrero, María Teófila; Sbert, Pere Riutord; Ramírez-Manent, José Ignacio; Tárraga Marcos, Pedro Juan; Del Barrio Fernández, José Luis; López-González, Ángel Arturo (2026). 500873.

  AbstractBibTeXEndNoteDOIBibSonomy

  BACKGROUND: Atherogenic dyslipidemia (AD) and associated lipid ratios are critical markers for cardiovascular risk, yet little is known about how these markers vary by occupational sector and sociodemographic or lifestyle factors in working populations. OBJECTIVE: To evaluate the prevalence and determinants of elevated atherogenic risk according to total cholesterol/HDL-c (TC/HDL-c), LDL-c/HDL-c, triglycerides/HDL-c (TG/HDL-c), and AD in workers from the commerce and industry sectors, stratified by sex, age, education, physical activity, diet, and smoking. METHODS: This cross-sectional study included 56,856 Spanish workers (39,448 men and 17,408 women) from commerce (n=27,448) and industry (n=29,408). Sociodemographic, clinical, and lifestyle data were collected, and atherogenic risk was assessed using TC/HDL-c, LDL-c/HDL-c, TG/HDL-c ratios, and AD presence. Mean values and prevalence were compared by group, and multinomial logistic regression was used to estimate the association between risk markers and covariates. RESULTS: Workers in the industry sector showed higher mean values and prevalence of all atherogenic risk scales compared to those in commerce, particularly among men and older age groups. Male sex, older age, lower education, physical inactivity, absence of Mediterranean diet, and smoking were consistently associated with higher odds of elevated lipid ratios and AD. Notably, the absence of physical activity was strongly associated with all outcomes, with ORs ranging from 3.08 to 11.66. The industrial sector was independently associated with increased risk: TC/HDL-c (OR=1.23), LDL-c/HDL-c (OR=1.15), TG/HDL-c (OR=1.16), and AD (OR=1.19). CONCLUSIONS: Atherogenic risk profiles are less favorable among industrial workers and are significantly influenced by modifiable lifestyle factors. These findings support the need for preventive strategies tailored to the occupational context, with emphasis on promoting physical activity, smoking cessation, and healthier dietary habits, in order to reduce cardiovascular risk in these populations.

  @article{fernandez-figares_vicioso_atherogenic_2026,
  abstract = {BACKGROUND: Atherogenic dyslipidemia (AD) and associated lipid ratios are critical markers for cardiovascular risk, yet little is known about how these markers vary by occupational sector and sociodemographic or lifestyle factors in working populations. OBJECTIVE: To evaluate the prevalence and determinants of elevated atherogenic risk according to total cholesterol/HDL-c (TC/HDL-c), LDL-c/HDL-c, triglycerides/HDL-c (TG/HDL-c), and AD in workers from the commerce and industry sectors, stratified by sex, age, education, physical activity, diet, and smoking. METHODS: This cross-sectional study included 56,856 Spanish workers (39,448 men and 17,408 women) from commerce (n=27,448) and industry (n=29,408). Sociodemographic, clinical, and lifestyle data were collected, and atherogenic risk was assessed using TC/HDL-c, LDL-c/HDL-c, TG/HDL-c ratios, and AD presence. Mean values and prevalence were compared by group, and multinomial logistic regression was used to estimate the association between risk markers and covariates. RESULTS: Workers in the industry sector showed higher mean values and prevalence of all atherogenic risk scales compared to those in commerce, particularly among men and older age groups. Male sex, older age, lower education, physical inactivity, absence of Mediterranean diet, and smoking were consistently associated with higher odds of elevated lipid ratios and AD. Notably, the absence of physical activity was strongly associated with all outcomes, with ORs ranging from 3.08 to 11.66. The industrial sector was independently associated with increased risk: TC/HDL-c (OR=1.23), LDL-c/HDL-c (OR=1.15), TG/HDL-c (OR=1.16), and AD (OR=1.19). CONCLUSIONS: Atherogenic risk profiles are less favorable among industrial workers and are significantly influenced by modifiable lifestyle factors. These findings support the need for preventive strategies tailored to the occupational context, with emphasis on promoting physical activity, smoking cessation, and healthier dietary habits, in order to reduce cardiovascular risk in these populations.},
  author = {Fernández-Figares Vicioso, María Pilar and Vicente-Herrero, María Teófila and Sbert, Pere Riutord and Ramírez-Manent, José Ignacio and Tárraga Marcos, Pedro Juan and Del Barrio Fernández, José Luis and López-González, Ángel Arturo},
  journal = {Clinica E Investigacion En Arteriosclerosis: Publicacion Oficial De La Sociedad Espanola De Arteriosclerosis},
  keywords = {grapp-caib},
  month = {jan},
  pages = 500873,
  title = {Atherogenic Risk in Commerce and Industry Workers: Associations with Sociodemographic and Lifestyle Factors in a Large Spanish Occupational Cohort},
  year = 2026
  }
  

  %0 Journal Article
  %1 fernandez-figares_vicioso_atherogenic_2026
  %A Fernández-Figares Vicioso, María Pilar
  %A Vicente-Herrero, María Teófila
  %A Sbert, Pere Riutord
  %A Ramírez-Manent, José Ignacio
  %A Tárraga Marcos, Pedro Juan
  %A Del Barrio Fernández, José Luis
  %A López-González, Ángel Arturo
  %D 2026
  %J Clinica E Investigacion En Arteriosclerosis: Publicacion Oficial De La Sociedad Espanola De Arteriosclerosis
  %P 500873
  %R 10.1016/j.arteri.2025.500873
  %T Atherogenic Risk in Commerce and Industry Workers: Associations with Sociodemographic and Lifestyle Factors in a Large Spanish Occupational Cohort
  %X BACKGROUND: Atherogenic dyslipidemia (AD) and associated lipid ratios are critical markers for cardiovascular risk, yet little is known about how these markers vary by occupational sector and sociodemographic or lifestyle factors in working populations. OBJECTIVE: To evaluate the prevalence and determinants of elevated atherogenic risk according to total cholesterol/HDL-c (TC/HDL-c), LDL-c/HDL-c, triglycerides/HDL-c (TG/HDL-c), and AD in workers from the commerce and industry sectors, stratified by sex, age, education, physical activity, diet, and smoking. METHODS: This cross-sectional study included 56,856 Spanish workers (39,448 men and 17,408 women) from commerce (n=27,448) and industry (n=29,408). Sociodemographic, clinical, and lifestyle data were collected, and atherogenic risk was assessed using TC/HDL-c, LDL-c/HDL-c, TG/HDL-c ratios, and AD presence. Mean values and prevalence were compared by group, and multinomial logistic regression was used to estimate the association between risk markers and covariates. RESULTS: Workers in the industry sector showed higher mean values and prevalence of all atherogenic risk scales compared to those in commerce, particularly among men and older age groups. Male sex, older age, lower education, physical inactivity, absence of Mediterranean diet, and smoking were consistently associated with higher odds of elevated lipid ratios and AD. Notably, the absence of physical activity was strongly associated with all outcomes, with ORs ranging from 3.08 to 11.66. The industrial sector was independently associated with increased risk: TC/HDL-c (OR=1.23), LDL-c/HDL-c (OR=1.15), TG/HDL-c (OR=1.16), and AD (OR=1.19). CONCLUSIONS: Atherogenic risk profiles are less favorable among industrial workers and are significantly influenced by modifiable lifestyle factors. These findings support the need for preventive strategies tailored to the occupational context, with emphasis on promoting physical activity, smoking cessation, and healthier dietary habits, in order to reduce cardiovascular risk in these populations.
  

• 
  Association between sociodemographic variables, lifestyle factors, and stress with lipoprotein ratio values. López-González, Ángel Arturo; Ramírez-Manent, José Ignacio; Martínez-Almoyna Rifá, Emilio; Paublini Oliveira, Hernán; Martorell Sánchez, Cristina; Tárraga López, Pedro Juan (2026). 38(2) 500803.

  AbstractBibTeXEndNoteDOIBibSonomy

  INTRODUCTION: Atherosclerosis is a multifactorial process underlying major cardiovascular diseases (CVDs). Among the associated risk factors, lipoprotein ratios have been identified as key indicators of atherogenic risk. However, the influence of sociodemographic variables, lifestyle factors, and stress levels on lipoprotein ratios remains underexplored. OBJECTIVE: To analyze the relationship between sociodemographic variables, healthy lifestyle habits, and stress levels with lipoprotein ratios and atherogenic risk in a large cohort of Spanish workers. MATERIALS AND METHODS: A cross-sectional study was conducted in 24,244 Spanish workers. The association between age, gender, socioeconomic status, tobacco and alcohol consumption, physical activity, adherence to the Mediterranean diet, and stress levels with atherogenic risk scales, including atherogenic dyslipidemia (AD) and atherogenic índices, was evaluated. RESULTS: A significant association was found between all analyzed variables and lipoprotein ratios. The strongest associations were observed with age and gender, followed by occupational status, tobacco and alcohol consumption, physical activity, diet, and stress levels. Men exhibited a higher atherogenic risk compared to women (OR 2.36; 95\% CI 2.18-2.55). The risk increased significantly with age, peaking in the 50-69 age group (OR 5.00; 95\% CI 3.70-6.31). Manual workers had a higher prevalence of atherogenic dyslipidemia compared to non-manual workers (OR 1.35; 95\% CI 1.27-1.41). Furthermore, smoking (OR 1.84; 95\% CI 1.71-1.97) and alcohol consumption (OR 1.45; 95\% CI 1.36-1.55), physical inactivity (OR 1.90; 95\% CI 1.76-2.05), and low adherence to the Mediterranean diet (OR 1.72; 95\% CI 1.60-1.84) were associated with higher atherogenic index values. CONCLUSIONS: The presence of an adverse lipoprotein profile is strongly influenced by sociodemographic factors, lifestyle habits, and stress. Identifying these determinants may enable the implementation of preventive strategies aimed at reducing atherogenic risk and improving cardiovascular health in working populations.

  @article{lopez-gonzalez_association_2026,
  abstract = {INTRODUCTION: Atherosclerosis is a multifactorial process underlying major cardiovascular diseases (CVDs). Among the associated risk factors, lipoprotein ratios have been identified as key indicators of atherogenic risk. However, the influence of sociodemographic variables, lifestyle factors, and stress levels on lipoprotein ratios remains underexplored. OBJECTIVE: To analyze the relationship between sociodemographic variables, healthy lifestyle habits, and stress levels with lipoprotein ratios and atherogenic risk in a large cohort of Spanish workers. MATERIALS AND METHODS: A cross-sectional study was conducted in 24,244 Spanish workers. The association between age, gender, socioeconomic status, tobacco and alcohol consumption, physical activity, adherence to the Mediterranean diet, and stress levels with atherogenic risk scales, including atherogenic dyslipidemia (AD) and atherogenic índices, was evaluated. RESULTS: A significant association was found between all analyzed variables and lipoprotein ratios. The strongest associations were observed with age and gender, followed by occupational status, tobacco and alcohol consumption, physical activity, diet, and stress levels. Men exhibited a higher atherogenic risk compared to women (OR 2.36; 95\% CI 2.18-2.55). The risk increased significantly with age, peaking in the 50-69 age group (OR 5.00; 95\% CI 3.70-6.31). Manual workers had a higher prevalence of atherogenic dyslipidemia compared to non-manual workers (OR 1.35; 95\% CI 1.27-1.41). Furthermore, smoking (OR 1.84; 95\% CI 1.71-1.97) and alcohol consumption (OR 1.45; 95\% CI 1.36-1.55), physical inactivity (OR 1.90; 95\% CI 1.76-2.05), and low adherence to the Mediterranean diet (OR 1.72; 95\% CI 1.60-1.84) were associated with higher atherogenic index values. CONCLUSIONS: The presence of an adverse lipoprotein profile is strongly influenced by sociodemographic factors, lifestyle habits, and stress. Identifying these determinants may enable the implementation of preventive strategies aimed at reducing atherogenic risk and improving cardiovascular health in working populations.},
  author = {López-González, Ángel Arturo and Ramírez-Manent, José Ignacio and Martínez-Almoyna Rifá, Emilio and Paublini Oliveira, Hernán and Martorell Sánchez, Cristina and Tárraga López, Pedro Juan},
  journal = {Clinica E Investigacion En Arteriosclerosis: Publicacion Oficial De La Sociedad Espanola De Arteriosclerosis},
  keywords = {grapp-caib},
  number = 2,
  pages = 500803,
  title = {Association between sociodemographic variables, lifestyle factors, and stress with lipoprotein ratio values},
  volume = 38,
  year = 2026
  }
  

  %0 Journal Article
  %1 lopez-gonzalez_association_2026
  %A López-González, Ángel Arturo
  %A Ramírez-Manent, José Ignacio
  %A Martínez-Almoyna Rifá, Emilio
  %A Paublini Oliveira, Hernán
  %A Martorell Sánchez, Cristina
  %A Tárraga López, Pedro Juan
  %D 2026
  %J Clinica E Investigacion En Arteriosclerosis: Publicacion Oficial De La Sociedad Espanola De Arteriosclerosis
  %N 2
  %P 500803
  %R 10.1016/j.arteri.2025.500803
  %T Association between sociodemographic variables, lifestyle factors, and stress with lipoprotein ratio values
  %V 38
  %X INTRODUCTION: Atherosclerosis is a multifactorial process underlying major cardiovascular diseases (CVDs). Among the associated risk factors, lipoprotein ratios have been identified as key indicators of atherogenic risk. However, the influence of sociodemographic variables, lifestyle factors, and stress levels on lipoprotein ratios remains underexplored. OBJECTIVE: To analyze the relationship between sociodemographic variables, healthy lifestyle habits, and stress levels with lipoprotein ratios and atherogenic risk in a large cohort of Spanish workers. MATERIALS AND METHODS: A cross-sectional study was conducted in 24,244 Spanish workers. The association between age, gender, socioeconomic status, tobacco and alcohol consumption, physical activity, adherence to the Mediterranean diet, and stress levels with atherogenic risk scales, including atherogenic dyslipidemia (AD) and atherogenic índices, was evaluated. RESULTS: A significant association was found between all analyzed variables and lipoprotein ratios. The strongest associations were observed with age and gender, followed by occupational status, tobacco and alcohol consumption, physical activity, diet, and stress levels. Men exhibited a higher atherogenic risk compared to women (OR 2.36; 95\% CI 2.18-2.55). The risk increased significantly with age, peaking in the 50-69 age group (OR 5.00; 95\% CI 3.70-6.31). Manual workers had a higher prevalence of atherogenic dyslipidemia compared to non-manual workers (OR 1.35; 95\% CI 1.27-1.41). Furthermore, smoking (OR 1.84; 95\% CI 1.71-1.97) and alcohol consumption (OR 1.45; 95\% CI 1.36-1.55), physical inactivity (OR 1.90; 95\% CI 1.76-2.05), and low adherence to the Mediterranean diet (OR 1.72; 95\% CI 1.60-1.84) were associated with higher atherogenic index values. CONCLUSIONS: The presence of an adverse lipoprotein profile is strongly influenced by sociodemographic factors, lifestyle habits, and stress. Identifying these determinants may enable the implementation of preventive strategies aimed at reducing atherogenic risk and improving cardiovascular health in working populations.
  

• 
  Meta-analysis of genome-wide association studies of food allergy and IgE sensitization. Maier, Lisa; Sun, Yidan; Kronberg, Jaanika; Abner, Erik; Metspalu, Andres; Esko, Tõnu; Coley, Kayesha; Marenholz, Ingo; Weiss, Stefan; Foraita, Ronja; Karramass, Tarik; Mykkänen, Juha; Hernandez-Pacheco, Natalia; Wang, Carol A.; Kitaba, Negusse T.; Pechlivanis, Sonali; Bouzigon, Emmanuelle; Pedersen, Casper-Emil Tingskov; Schoos, Ann-Marie M.; Curtin, John A.; Kress, Sara; Hernangomez-Laderas, Alba; Foppiano, Francesco; Ashley, Sarah; Batini, Chiara; Bryant, Luke; Homuth, Georg; Gieger, Christian; Gilles, Stefanie; Lyytikäinen, Leo-Pekka; Rovio, Suvi; Pahkala, Katja; Vernet, Raphaël; Valenta, Rudolf; Llop, Sabrina; Torrent, Maties; Böck, Andreas; Tang, Mimi L. K.; Schmidt-Weber, Carsten B.; Metspalu, Andres; Esko, Tõnu; Sprikkelman, Aline B.; John, Catherine; Lee, Young-Ae; Beyer, Kirsten; Völzke, Henry; Pigeot, Iris; Traidl-Hoffmann, Claudia; Duijts, Liesbeth; Lu, Haojie; Raitakari, Olli T.; Lehtimäki, Terho; Kähönen, Mika; Thio, Chris H. L.; Melén, Erik; Pennell, Craig E.; Holloway, John W.; Mutius, Erika von; Siroux, Valérie; Bønnelykke, Klaus; Custovic, Adnan; Simpson, Angela; Schikowski, Tamara; Bilbao, Jose Ramon; Schaub, Bianca; Peters, Rachel; Kersten, Elin T. G.; Vonk, Judith M.; Thiering, Elisabeth; Peters, Annette; Koppelman, Gerard H.; Standl, Marie (2026).

  URLBibTeXEndNoteDOIBibSonomyDownload

  @article{maier_meta-analysis_2026,
  author = {Maier, Lisa and Sun, Yidan and Kronberg, Jaanika and Abner, Erik and Metspalu, Andres and Esko, Tõnu and Coley, Kayesha and Marenholz, Ingo and Weiss, Stefan and Foraita, Ronja and Karramass, Tarik and Mykkänen, Juha and Hernandez-Pacheco, Natalia and Wang, Carol A. and Kitaba, Negusse T. and Pechlivanis, Sonali and Bouzigon, Emmanuelle and Pedersen, Casper-Emil Tingskov and Schoos, Ann-Marie M. and Curtin, John A. and Kress, Sara and Hernangomez-Laderas, Alba and Foppiano, Francesco and Ashley, Sarah and Batini, Chiara and Bryant, Luke and Homuth, Georg and Gieger, Christian and Gilles, Stefanie and Lyytikäinen, Leo-Pekka and Rovio, Suvi and Pahkala, Katja and Vernet, Raphaël and Valenta, Rudolf and Llop, Sabrina and Torrent, Maties and Böck, Andreas and Tang, Mimi L. K. and Schmidt-Weber, Carsten B. and Metspalu, Andres and Esko, Tõnu and Sprikkelman, Aline B. and John, Catherine and Lee, Young-Ae and Beyer, Kirsten and Völzke, Henry and Pigeot, Iris and Traidl-Hoffmann, Claudia and Duijts, Liesbeth and Lu, Haojie and Raitakari, Olli T. and Lehtimäki, Terho and Kähönen, Mika and Thio, Chris H. L. and Melén, Erik and Pennell, Craig E. and Holloway, John W. and Mutius, Erika von and Siroux, Valérie and Bønnelykke, Klaus and Custovic, Adnan and Simpson, Angela and Schikowski, Tamara and Bilbao, Jose Ramon and Schaub, Bianca and Peters, Rachel and Kersten, Elin T. G. and Vonk, Judith M. and Thiering, Elisabeth and Peters, Annette and Koppelman, Gerard H. and Standl, Marie},
  journal = {Journal of Allergy and Clinical Immunology},
  keywords = {grapp-caib},
  month = {feb},
  note = {Publisher: Elsevier},
  title = {Meta-analysis of genome-wide association studies of food allergy and IgE sensitization},
  year = 2026
  }
  

  %0 Journal Article
  %1 maier_meta-analysis_2026
  %A Maier, Lisa
  %A Sun, Yidan
  %A Kronberg, Jaanika
  %A Abner, Erik
  %A Metspalu, Andres
  %A Esko, Tõnu
  %A Coley, Kayesha
  %A Marenholz, Ingo
  %A Weiss, Stefan
  %A Foraita, Ronja
  %A Karramass, Tarik
  %A Mykkänen, Juha
  %A Hernandez-Pacheco, Natalia
  %A Wang, Carol A.
  %A Kitaba, Negusse T.
  %A Pechlivanis, Sonali
  %A Bouzigon, Emmanuelle
  %A Pedersen, Casper-Emil Tingskov
  %A Schoos, Ann-Marie M.
  %A Curtin, John A.
  %A Kress, Sara
  %A Hernangomez-Laderas, Alba
  %A Foppiano, Francesco
  %A Ashley, Sarah
  %A Batini, Chiara
  %A Bryant, Luke
  %A Homuth, Georg
  %A Gieger, Christian
  %A Gilles, Stefanie
  %A Lyytikäinen, Leo-Pekka
  %A Rovio, Suvi
  %A Pahkala, Katja
  %A Vernet, Raphaël
  %A Valenta, Rudolf
  %A Llop, Sabrina
  %A Torrent, Maties
  %A Böck, Andreas
  %A Tang, Mimi L. K.
  %A Schmidt-Weber, Carsten B.
  %A Metspalu, Andres
  %A Esko, Tõnu
  %A Sprikkelman, Aline B.
  %A John, Catherine
  %A Lee, Young-Ae
  %A Beyer, Kirsten
  %A Völzke, Henry
  %A Pigeot, Iris
  %A Traidl-Hoffmann, Claudia
  %A Duijts, Liesbeth
  %A Lu, Haojie
  %A Raitakari, Olli T.
  %A Lehtimäki, Terho
  %A Kähönen, Mika
  %A Thio, Chris H. L.
  %A Melén, Erik
  %A Pennell, Craig E.
  %A Holloway, John W.
  %A Mutius, Erika von
  %A Siroux, Valérie
  %A Bønnelykke, Klaus
  %A Custovic, Adnan
  %A Simpson, Angela
  %A Schikowski, Tamara
  %A Bilbao, Jose Ramon
  %A Schaub, Bianca
  %A Peters, Rachel
  %A Kersten, Elin T. G.
  %A Vonk, Judith M.
  %A Thiering, Elisabeth
  %A Peters, Annette
  %A Koppelman, Gerard H.
  %A Standl, Marie
  %D 2026
  %J Journal of Allergy and Clinical Immunology
  %R 10.1016/j.jaci.2026.02.012
  %T Meta-analysis of genome-wide association studies of food allergy and IgE sensitization
  %U https://www.jacionline.org/article/S0091-6749(26)00093-X/fulltext
  

• 
  Work engagement and its association with obesity and lifestyle factors in a large working population: a sex-stratified analysis. Sepúlveda, Lucía Garrido; López, Pedro Juan Tárraga; Vicente-Herrero, María Teófila; Cañellas, Lluis Rodas; González, Ángel Arturo López; Ramírez-Manent, José Ignacio (2026). 13(1) 306–326.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: Work engagement, defined as a positive, fulfilling psychological state characterized by vigor, dedication, and absorption, has been proposed as a potential protective factor for cardiometabolic health. However, its relationship with obesity-particularly visceral adiposity-remains poorly understood. This study aimed to examine the association between work engagement and different adiposity indicators and to explore the mediating role of lifestyle behaviors in a large sample of Spanish workers. METHODS: A cross-sectional analysis was conducted among employees attending occupational health evaluations between 2021 and 2022. After applying inclusion and exclusion criteria, 111,612 participants (60.1\% men) were included. Work engagement was assessed using the Utrecht Work Engagement Scale (UWES-9) and categorized into very high, high, moderate, and low levels. Obesity and adiposity were evaluated through BMI, waist-to-height ratio (WtHR), CUN-BAE, and METS-VF. Logistic regression models estimated odds ratios (OR) and 95% confidence intervals (CI) for obesity outcomes across engagement levels, with progressive adjustment for sociodemographic and lifestyle covariates. Mediation analyses evaluated the indirect effects of physical activity, Mediterranean diet adherence, and smoking. RESULTS: Lower engagement levels were independently associated with higher odds of adiposity across all indices, particularly visceral fat (METS-VF). Participants with low engagement had an adjusted OR = 2.59 (95\% CI 2.34-2.85) for high METS-VF compared with those with very high engagement (p-trend \textless 0.001). Approximately 40% of this association was mediated by lifestyle factors, mainly physical activity. The results remained robust across sensitivity analyses, including nonlinear modeling, imputation, and cluster adjustment. CONCLUSIONS: Lower work engagement is strongly associated with increased visceral adiposity among Spanish workers, partly through behavioral mechanisms. Enhancing engagement may represent an effective psychosocial strategy to improve both psychological well-being and metabolic health in occupational settings.

  @article{sepulveda_work_2026,
  abstract = {BACKGROUND: Work engagement, defined as a positive, fulfilling psychological state characterized by vigor, dedication, and absorption, has been proposed as a potential protective factor for cardiometabolic health. However, its relationship with obesity-particularly visceral adiposity-remains poorly understood. This study aimed to examine the association between work engagement and different adiposity indicators and to explore the mediating role of lifestyle behaviors in a large sample of Spanish workers. METHODS: A cross-sectional analysis was conducted among employees attending occupational health evaluations between 2021 and 2022. After applying inclusion and exclusion criteria, 111,612 participants (60.1\% men) were included. Work engagement was assessed using the Utrecht Work Engagement Scale (UWES-9) and categorized into very high, high, moderate, and low levels. Obesity and adiposity were evaluated through BMI, waist-to-height ratio (WtHR), CUN-BAE, and METS-VF. Logistic regression models estimated odds ratios (OR) and 95% confidence intervals (CI) for obesity outcomes across engagement levels, with progressive adjustment for sociodemographic and lifestyle covariates. Mediation analyses evaluated the indirect effects of physical activity, Mediterranean diet adherence, and smoking. RESULTS: Lower engagement levels were independently associated with higher odds of adiposity across all indices, particularly visceral fat (METS-VF). Participants with low engagement had an adjusted OR = 2.59 (95\% CI 2.34-2.85) for high METS-VF compared with those with very high engagement (p-trend \textless 0.001). Approximately 40% of this association was mediated by lifestyle factors, mainly physical activity. The results remained robust across sensitivity analyses, including nonlinear modeling, imputation, and cluster adjustment. CONCLUSIONS: Lower work engagement is strongly associated with increased visceral adiposity among Spanish workers, partly through behavioral mechanisms. Enhancing engagement may represent an effective psychosocial strategy to improve both psychological well-being and metabolic health in occupational settings.},
  author = {Sepúlveda, Lucía Garrido and López, Pedro Juan Tárraga and Vicente-Herrero, María Teófila and Cañellas, Lluis Rodas and González, Ángel Arturo López and Ramírez-Manent, José Ignacio},
  journal = {AIMS public health},
  keywords = {grapp-caib},
  number = 1,
  pages = {306--326},
  title = {Work engagement and its association with obesity and lifestyle factors in a large working population: a sex-stratified analysis},
  volume = 13,
  year = 2026
  }
  

  %0 Journal Article
  %1 sepulveda_work_2026
  %A Sepúlveda, Lucía Garrido
  %A López, Pedro Juan Tárraga
  %A Vicente-Herrero, María Teófila
  %A Cañellas, Lluis Rodas
  %A González, Ángel Arturo López
  %A Ramírez-Manent, José Ignacio
  %D 2026
  %J AIMS public health
  %N 1
  %P 306--326
  %R 10.3934/publichealth.2026017
  %T Work engagement and its association with obesity and lifestyle factors in a large working population: a sex-stratified analysis
  %V 13
  %X BACKGROUND: Work engagement, defined as a positive, fulfilling psychological state characterized by vigor, dedication, and absorption, has been proposed as a potential protective factor for cardiometabolic health. However, its relationship with obesity-particularly visceral adiposity-remains poorly understood. This study aimed to examine the association between work engagement and different adiposity indicators and to explore the mediating role of lifestyle behaviors in a large sample of Spanish workers. METHODS: A cross-sectional analysis was conducted among employees attending occupational health evaluations between 2021 and 2022. After applying inclusion and exclusion criteria, 111,612 participants (60.1\% men) were included. Work engagement was assessed using the Utrecht Work Engagement Scale (UWES-9) and categorized into very high, high, moderate, and low levels. Obesity and adiposity were evaluated through BMI, waist-to-height ratio (WtHR), CUN-BAE, and METS-VF. Logistic regression models estimated odds ratios (OR) and 95% confidence intervals (CI) for obesity outcomes across engagement levels, with progressive adjustment for sociodemographic and lifestyle covariates. Mediation analyses evaluated the indirect effects of physical activity, Mediterranean diet adherence, and smoking. RESULTS: Lower engagement levels were independently associated with higher odds of adiposity across all indices, particularly visceral fat (METS-VF). Participants with low engagement had an adjusted OR = 2.59 (95\% CI 2.34-2.85) for high METS-VF compared with those with very high engagement (p-trend \textless 0.001). Approximately 40% of this association was mediated by lifestyle factors, mainly physical activity. The results remained robust across sensitivity analyses, including nonlinear modeling, imputation, and cluster adjustment. CONCLUSIONS: Lower work engagement is strongly associated with increased visceral adiposity among Spanish workers, partly through behavioral mechanisms. Enhancing engagement may represent an effective psychosocial strategy to improve both psychological well-being and metabolic health in occupational settings.
  

• 
  Lipid profile and atherogenic risk in metabolically healthy and unhealthy obese individuals: A cohort analysis by sex and sociodemographic factors. García Samuelsson, Miguel; Tárraga López, Pedro Juan; López González, Ángel Arturo; Busquets-Cortés, Carla; Obrador de Hevia, Joan; Ramírez Manent, José Ignacio (2026). 38(3) 500840.

  AbstractBibTeXEndNoteDOIBibSonomy

  OBJECTIVE: To analyze lipid profiles and sociodemographic factors associated with atherogenic risk in obese workers classified as metabolically healthy (MHO) or unhealthy (MNHO). METHODS: Cross-sectional study of 68,884 obese workers. Atherogenic lipid indices (total cholesterol/HDL-c, LDL-c/HDL-c, triglycerides/HDL-c) and prevalence of atherogenic dyslipidemia were assessed. Multinomial logistic regression identified factors linked to lipid risk. RESULTS: MNHO individuals exhibited significantly higher atherogenic indices across sexes and diagnostic criteria. Atherogenic dyslipidemia and lipid triad were more prevalent in MNHO. Male sex, older age, lower educational level, lower social class, physical inactivity, low adherence to the Mediterranean diet, and smoking were associated with higher lipid risk. CONCLUSION: Although MHO individuals show a more favorable lipid profile than MNHO, this advantage weakens with less stringent definitions. Sociodemographic and lifestyle factors strongly modulate atherogenic risk.

  @article{garcia_samuelsson_lipid_2026,
  abstract = {OBJECTIVE: To analyze lipid profiles and sociodemographic factors associated with atherogenic risk in obese workers classified as metabolically healthy (MHO) or unhealthy (MNHO). METHODS: Cross-sectional study of 68,884 obese workers. Atherogenic lipid indices (total cholesterol/HDL-c, LDL-c/HDL-c, triglycerides/HDL-c) and prevalence of atherogenic dyslipidemia were assessed. Multinomial logistic regression identified factors linked to lipid risk. RESULTS: MNHO individuals exhibited significantly higher atherogenic indices across sexes and diagnostic criteria. Atherogenic dyslipidemia and lipid triad were more prevalent in MNHO. Male sex, older age, lower educational level, lower social class, physical inactivity, low adherence to the Mediterranean diet, and smoking were associated with higher lipid risk. CONCLUSION: Although MHO individuals show a more favorable lipid profile than MNHO, this advantage weakens with less stringent definitions. Sociodemographic and lifestyle factors strongly modulate atherogenic risk.},
  author = {García Samuelsson, Miguel and Tárraga López, Pedro Juan and López González, Ángel Arturo and Busquets-Cortés, Carla and Obrador de Hevia, Joan and Ramírez Manent, José Ignacio},
  journal = {Clinica E Investigacion En Arteriosclerosis: Publicacion Oficial De La Sociedad Espanola De Arteriosclerosis},
  keywords = {grapp-caib},
  number = 3,
  pages = 500840,
  title = {Lipid profile and atherogenic risk in metabolically healthy and unhealthy obese individuals: A cohort analysis by sex and sociodemographic factors},
  volume = 38,
  year = 2026
  }
  

  %0 Journal Article
  %1 garcia_samuelsson_lipid_2026
  %A García Samuelsson, Miguel
  %A Tárraga López, Pedro Juan
  %A López González, Ángel Arturo
  %A Busquets-Cortés, Carla
  %A Obrador de Hevia, Joan
  %A Ramírez Manent, José Ignacio
  %D 2026
  %J Clinica E Investigacion En Arteriosclerosis: Publicacion Oficial De La Sociedad Espanola De Arteriosclerosis
  %N 3
  %P 500840
  %R 10.1016/j.arteri.2025.500840
  %T Lipid profile and atherogenic risk in metabolically healthy and unhealthy obese individuals: A cohort analysis by sex and sociodemographic factors
  %V 38
  %X OBJECTIVE: To analyze lipid profiles and sociodemographic factors associated with atherogenic risk in obese workers classified as metabolically healthy (MHO) or unhealthy (MNHO). METHODS: Cross-sectional study of 68,884 obese workers. Atherogenic lipid indices (total cholesterol/HDL-c, LDL-c/HDL-c, triglycerides/HDL-c) and prevalence of atherogenic dyslipidemia were assessed. Multinomial logistic regression identified factors linked to lipid risk. RESULTS: MNHO individuals exhibited significantly higher atherogenic indices across sexes and diagnostic criteria. Atherogenic dyslipidemia and lipid triad were more prevalent in MNHO. Male sex, older age, lower educational level, lower social class, physical inactivity, low adherence to the Mediterranean diet, and smoking were associated with higher lipid risk. CONCLUSION: Although MHO individuals show a more favorable lipid profile than MNHO, this advantage weakens with less stringent definitions. Sociodemographic and lifestyle factors strongly modulate atherogenic risk.
  

2025

• 
  Assessment of the Risk of Insulin Resistance in Workers Classified as Metabolically Healthy Obese. García Samuelsson, Miguel; Tárraga López, Pedro Juan; López-González, Ángel Arturo; Paublini, Hernán; Martínez-Almoyna Rifá, Emilio; Ramírez-Manent, José Ignacio (2025). 17(8) 1345-.

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Introduction and Objectives: Obesity constitutes a significant public health concern and is frequently linked to metabolic dysfunctions, particularly insulin resistance (IR). Nevertheless, a subset of obese individuals, referred to as metabolically healthy obese (MHO), do not exhibit overt metabolic abnormalities. The present study aims to assess the risk of developing IR among MHO workers and to explore the determinants contributing to this risk. Methods: This cross-sectional investigation utilized data from a cohort of 68,884 obese workers across multiple occupational sectors in Spain. The classification of participants as MHO was based on the number of metabolic syndrome components, in accordance with the criteria established by the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATPIII). Anthropometric, clinical, and biochemical parameters-including body mass index (BMI), waist circumference, lipid profile, glycemic levels, and blood pressure-were systematically assessed. The likelihood of developing IR was estimated through various validated risk assessment models. Results: The analysis indicates that, despite having a relatively favorable metabolic profile, individuals classified as MHO also show signs of metabolic deterioration, such as an increased risk of insulin resistance. Key risk factors such as physical inactivity, low adherence to the Mediterranean diet, and socioeconomic disparities were identified as significant contributors to the transition from the MHO phenotype to a metabolically unhealthy state. Logistic regression analyses corroborated that insufficient physical activity and suboptimal dietary habits were strongly associated with an elevated risk of IR. Conclusions: The findings underscore the dynamic and potentially transient nature of the MHO phenotype, emphasizing the necessity of proactive monitoring and early preventive strategies. Encouraging physical activity, promoting adherence to a nutritionally balanced diet, and implementing workplace health initiatives emerge as critical measures to attenuate the risk of IR and metabolic deterioration in MHO individuals. Future longitudinal studies are warranted to enhance risk stratification and to formulate tailored preventive interventions.

  @article{garciasamuelsson2025assessment,
  abstract = {Introduction and Objectives: Obesity constitutes a significant public health concern and is frequently linked to metabolic dysfunctions, particularly insulin resistance (IR). Nevertheless, a subset of obese individuals, referred to as metabolically healthy obese (MHO), do not exhibit overt metabolic abnormalities. The present study aims to assess the risk of developing IR among MHO workers and to explore the determinants contributing to this risk. Methods: This cross-sectional investigation utilized data from a cohort of 68,884 obese workers across multiple occupational sectors in Spain. The classification of participants as MHO was based on the number of metabolic syndrome components, in accordance with the criteria established by the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATPIII). Anthropometric, clinical, and biochemical parameters-including body mass index (BMI), waist circumference, lipid profile, glycemic levels, and blood pressure-were systematically assessed. The likelihood of developing IR was estimated through various validated risk assessment models. Results: The analysis indicates that, despite having a relatively favorable metabolic profile, individuals classified as MHO also show signs of metabolic deterioration, such as an increased risk of insulin resistance. Key risk factors such as physical inactivity, low adherence to the Mediterranean diet, and socioeconomic disparities were identified as significant contributors to the transition from the MHO phenotype to a metabolically unhealthy state. Logistic regression analyses corroborated that insufficient physical activity and suboptimal dietary habits were strongly associated with an elevated risk of IR. Conclusions: The findings underscore the dynamic and potentially transient nature of the MHO phenotype, emphasizing the necessity of proactive monitoring and early preventive strategies. Encouraging physical activity, promoting adherence to a nutritionally balanced diet, and implementing workplace health initiatives emerge as critical measures to attenuate the risk of IR and metabolic deterioration in MHO individuals. Future longitudinal studies are warranted to enhance risk stratification and to formulate tailored preventive interventions.},
  address = {Switzerland},
  author = {García Samuelsson, Miguel and Tárraga López, Pedro Juan and López-González, Ángel Arturo and Paublini, Hernán and Martínez-Almoyna Rifá, Emilio and Ramírez-Manent, José Ignacio},
  journal = {Nutrients},
  keywords = {grapp-caib},
  month = {apr},
  number = 8,
  pages = {1345--},
  title = {Assessment of the Risk of Insulin Resistance in Workers Classified as Metabolically Healthy Obese},
  volume = 17,
  year = 2025
  }
  

  %0 Journal Article
  %1 garciasamuelsson2025assessment
  %A García Samuelsson, Miguel
  %A Tárraga López, Pedro Juan
  %A López-González, Ángel Arturo
  %A Paublini, Hernán
  %A Martínez-Almoyna Rifá, Emilio
  %A Ramírez-Manent, José Ignacio
  %C Switzerland
  %D 2025
  %J Nutrients
  %N 8
  %P 1345--
  %R 10.3390/nu17081345
  %T Assessment of the Risk of Insulin Resistance in Workers Classified as Metabolically Healthy Obese
  %U https://pubmed.ncbi.nlm.nih.gov/40284209
  %V 17
  %X Introduction and Objectives: Obesity constitutes a significant public health concern and is frequently linked to metabolic dysfunctions, particularly insulin resistance (IR). Nevertheless, a subset of obese individuals, referred to as metabolically healthy obese (MHO), do not exhibit overt metabolic abnormalities. The present study aims to assess the risk of developing IR among MHO workers and to explore the determinants contributing to this risk. Methods: This cross-sectional investigation utilized data from a cohort of 68,884 obese workers across multiple occupational sectors in Spain. The classification of participants as MHO was based on the number of metabolic syndrome components, in accordance with the criteria established by the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATPIII). Anthropometric, clinical, and biochemical parameters-including body mass index (BMI), waist circumference, lipid profile, glycemic levels, and blood pressure-were systematically assessed. The likelihood of developing IR was estimated through various validated risk assessment models. Results: The analysis indicates that, despite having a relatively favorable metabolic profile, individuals classified as MHO also show signs of metabolic deterioration, such as an increased risk of insulin resistance. Key risk factors such as physical inactivity, low adherence to the Mediterranean diet, and socioeconomic disparities were identified as significant contributors to the transition from the MHO phenotype to a metabolically unhealthy state. Logistic regression analyses corroborated that insufficient physical activity and suboptimal dietary habits were strongly associated with an elevated risk of IR. Conclusions: The findings underscore the dynamic and potentially transient nature of the MHO phenotype, emphasizing the necessity of proactive monitoring and early preventive strategies. Encouraging physical activity, promoting adherence to a nutritionally balanced diet, and implementing workplace health initiatives emerge as critical measures to attenuate the risk of IR and metabolic deterioration in MHO individuals. Future longitudinal studies are warranted to enhance risk stratification and to formulate tailored preventive interventions.
  

• 
  Nitrate and nitrite bioavailability in plasma and saliva: Their association with blood pressure — A systematic review and meta-analysis. Bescos, Raul; Gallardo-Alfaro, Laura; Ashor, Ammar; Rizzolo-Brime, Lucia; Siervo, Mario; Casas-Agustench, Patricia (2025). 226 70–83.

  AbstractURLBibTeXEndNoteDOIBibSonomy

  In this study, we conducted a systematic review and meta-analysis to determine plasma and salivary nitrate (NO3−) and nitrite (NO2−) concentrations under resting and fasting conditions in different type of individuals and their association with blood pressure levels. A total of 77 studies, involving 1918 individuals aged 19–74 years (males = 906; females = 1012), which measured plasma and/or salivary NO3− and NO2− using the chemiluminescence technique, were included. Mean plasma NO3− and NO2− concentrations were 33.9 μmol/L and 158.3 nmol/L, respectively. Subgroup analyses revealed lower plasma NO3− and NO2− concentrations in individuals with cardiometabolic risk (NO3−: 21.2 μmol/L; 95 \% CI, 13.4–29.0; NO2−: 122.8 nmol/L; 95 \% CI, 75.3–138.9) compared to healthy (NO3−: 33.9 μmol/L; 95 \% CI, 29.9–37.9; NO2−: 159.5 nmol/L; 95 \% CI, 131.8–187.1; P \textless 0.01) and trained individuals (NO3−: 43.0 μmol/L; 95 \% CI, 13.2–72.9; NO2−: 199.3 nmol/L; 95 \% CI, 117.6–281; P \textless 0.01). Mean salivary NO3− and NO2− concentrations were 546.2 μmol/L and 197.8 μmol/L, respectively. Salivary NO3−, but no NO2−, concentrations were higher in individuals with cardiometabolic risk (680.0 μmol/L; 95 \% CI, 510.2–849.8; P = 0.001) compared to healthy individuals (535.9 μmol/L; 95 \% CI, 384.2–687.6). A significant positive association (coefficient, 15.4 [95 \% CI, 0.255 to 30.5], P = 0.046) was observed between salivary NO3− and diastolic blood pressure (DBP). These findings suggest that the health status is positively associated with plasma NO3− and NO2− concentrations, but the circulatory levels of these anions are not associated with blood pressure. Only salivary NO3− showed a significant positive association with DBP.

  @article{bescos_nitrate_2025,
  abstract = {In this study, we conducted a systematic review and meta-analysis to determine plasma and salivary nitrate (NO3−) and nitrite (NO2−) concentrations under resting and fasting conditions in different type of individuals and their association with blood pressure levels. A total of 77 studies, involving 1918 individuals aged 19–74 years (males = 906; females = 1012), which measured plasma and/or salivary NO3− and NO2− using the chemiluminescence technique, were included. Mean plasma NO3− and NO2− concentrations were 33.9 μmol/L and 158.3 nmol/L, respectively. Subgroup analyses revealed lower plasma NO3− and NO2− concentrations in individuals with cardiometabolic risk (NO3−: 21.2 μmol/L; 95 \% CI, 13.4–29.0; NO2−: 122.8 nmol/L; 95 \% CI, 75.3–138.9) compared to healthy (NO3−: 33.9 μmol/L; 95 \% CI, 29.9–37.9; NO2−: 159.5 nmol/L; 95 \% CI, 131.8–187.1; P \textless 0.01) and trained individuals (NO3−: 43.0 μmol/L; 95 \% CI, 13.2–72.9; NO2−: 199.3 nmol/L; 95 \% CI, 117.6–281; P \textless 0.01). Mean salivary NO3− and NO2− concentrations were 546.2 μmol/L and 197.8 μmol/L, respectively. Salivary NO3−, but no NO2−, concentrations were higher in individuals with cardiometabolic risk (680.0 μmol/L; 95 \% CI, 510.2–849.8; P = 0.001) compared to healthy individuals (535.9 μmol/L; 95 \% CI, 384.2–687.6). A significant positive association (coefficient, 15.4 [95 \% CI, 0.255 to 30.5], P = 0.046) was observed between salivary NO3− and diastolic blood pressure (DBP). These findings suggest that the health status is positively associated with plasma NO3− and NO2− concentrations, but the circulatory levels of these anions are not associated with blood pressure. Only salivary NO3− showed a significant positive association with DBP.},
  author = {Bescos, Raul and Gallardo-Alfaro, Laura and Ashor, Ammar and Rizzolo-Brime, Lucia and Siervo, Mario and Casas-Agustench, Patricia},
  journal = {Free Radical Biology and Medicine},
  keywords = {grapp-caib},
  month = {jan},
  pages = {70--83},
  title = {Nitrate and nitrite bioavailability in plasma and saliva: Their association with blood pressure — A systematic review and meta-analysis},
  volume = 226,
  year = 2025
  }
  

  %0 Journal Article
  %1 bescos_nitrate_2025
  %A Bescos, Raul
  %A Gallardo-Alfaro, Laura
  %A Ashor, Ammar
  %A Rizzolo-Brime, Lucia
  %A Siervo, Mario
  %A Casas-Agustench, Patricia
  %D 2025
  %J Free Radical Biology and Medicine
  %P 70--83
  %R 10.1016/j.freeradbiomed.2024.11.010
  %T Nitrate and nitrite bioavailability in plasma and saliva: Their association with blood pressure — A systematic review and meta-analysis
  %U https://www.sciencedirect.com/science/article/pii/S0891584924010335
  %V 226
  %X In this study, we conducted a systematic review and meta-analysis to determine plasma and salivary nitrate (NO3−) and nitrite (NO2−) concentrations under resting and fasting conditions in different type of individuals and their association with blood pressure levels. A total of 77 studies, involving 1918 individuals aged 19–74 years (males = 906; females = 1012), which measured plasma and/or salivary NO3− and NO2− using the chemiluminescence technique, were included. Mean plasma NO3− and NO2− concentrations were 33.9 μmol/L and 158.3 nmol/L, respectively. Subgroup analyses revealed lower plasma NO3− and NO2− concentrations in individuals with cardiometabolic risk (NO3−: 21.2 μmol/L; 95 \% CI, 13.4–29.0; NO2−: 122.8 nmol/L; 95 \% CI, 75.3–138.9) compared to healthy (NO3−: 33.9 μmol/L; 95 \% CI, 29.9–37.9; NO2−: 159.5 nmol/L; 95 \% CI, 131.8–187.1; P \textless 0.01) and trained individuals (NO3−: 43.0 μmol/L; 95 \% CI, 13.2–72.9; NO2−: 199.3 nmol/L; 95 \% CI, 117.6–281; P \textless 0.01). Mean salivary NO3− and NO2− concentrations were 546.2 μmol/L and 197.8 μmol/L, respectively. Salivary NO3−, but no NO2−, concentrations were higher in individuals with cardiometabolic risk (680.0 μmol/L; 95 \% CI, 510.2–849.8; P = 0.001) compared to healthy individuals (535.9 μmol/L; 95 \% CI, 384.2–687.6). A significant positive association (coefficient, 15.4 [95 \% CI, 0.255 to 30.5], P = 0.046) was observed between salivary NO3− and diastolic blood pressure (DBP). These findings suggest that the health status is positively associated with plasma NO3− and NO2− concentrations, but the circulatory levels of these anions are not associated with blood pressure. Only salivary NO3− showed a significant positive association with DBP.
  

• 
  Evaluation of an intervention based on lifestyle modification and coping with chronic pain and stress in reducing pain in hotel housekeepers: a cluster-randomised clinical trial in primary health care. Sánchez Rodríguez, Cristian; Chela Álvarez, Xenia; Llobera, Joan; Terrer, Estela; Vidal Thomas, María Clar; Zarzosa, Carmen; Bulilete, Oana (2025). 40(6)

  URLBibTeXEndNoteBibSonomyDownload

  @article{sanchez_rodriguez_evaluation_2025,
  author = {Sánchez Rodríguez, Cristian and Chela Álvarez, Xenia and Llobera, Joan and Terrer, Estela and Vidal Thomas, María Clar and Zarzosa, Carmen and Bulilete, Oana},
  journal = {Academic Journal of Health Sciences 2025, vol. 40, n.6 pp. 66-77},
  keywords = {grapp-caib},
  number = 6,
  title = {Evaluation of an intervention based on lifestyle modification and coping with chronic pain and stress in reducing pain in hotel housekeepers: a cluster-randomised clinical trial in primary health care},
  volume = 40,
  year = 2025
  }
  

  %0 Journal Article
  %1 sanchez_rodriguez_evaluation_2025
  %A Sánchez Rodríguez, Cristian
  %A Chela Álvarez, Xenia
  %A Llobera, Joan
  %A Terrer, Estela
  %A Vidal Thomas, María Clar
  %A Zarzosa, Carmen
  %A Bulilete, Oana
  %D 2025
  %J Academic Journal of Health Sciences 2025, vol. 40, n.6 pp. 66-77
  %N 6
  %T Evaluation of an intervention based on lifestyle modification and coping with chronic pain and stress in reducing pain in hotel housekeepers: a cluster-randomised clinical trial in primary health care
  %U https://ibdigital.uib.es/greenstone/library/collection/medicinaBalear/document/AJHS_Medicina_Balear_2025v40n6p066
  %V 40
  

• 
  Prevalence of obesity: Comparison of commerce vs. industry sector and associated variables. Fernández-Figares Vicioso, M. P.; López-González, Á. A.; Ramírez-Manent, J. I.; Del Barrio Fernández, J. L.; Tárraga López, P. J.; Vicente-Herreros, M. T. (2025). 42(4) 276–288.

  AbstractURLBibTeXEndNoteDOIBibSonomy

  Introduction and objectives Obesity has been considered the pandemic of the 21st century due to its high prevalence and the significant morbidity and mortality it entails. The aim of this study is to assess the prevalence of obesity in two occupational sectors and to determine the variables associated with it. Methodology This is a cross-sectional and descriptive study involving 56,856 workers from the commerce and industrial sectors. Anthropometric, clinical, analytical, and sociodemographic data were collected during medical examinations conducted between 2017 and 2019. Results The prevalence of obesity was found to be significantly higher in the industrial sector compared to the commerce sector. Factors such as age, sex, educational level, physical activity, adherence to the Mediterranean diet, and smoking showed significant associations with the four scales of excess weight evaluated. Among these, age, physical activity level, and adherence to the Mediterranean diet demonstrated the strongest associations. In the industrial sector, obesity may be related to work-related stress, prolonged shifts, and limited access to healthy food, whereas in the commerce sector, sedentary behaviour and poor dietary habits were identified as key contributing factors. Conclusions Specific strategies tailored to each occupational sector are recommended, including active breaks, the promotion of physical activity, and access to healthy foods. While the study has strengths such as its large sample size and multivariate analysis, the cross-sectional design and lack of control for certain confounding variables limit its ability to establish causality. The findings underscore the need for preventive policies adapted to workplace environments to mitigate the impact of obesity. Resumen Introducción y objetivos La obesidad se ha considerado como la pandemia del siglo xxi por su elevada prevalencia y la gran morbimortalidad que acarrea. El objetivo es valorar la prevalencia de obesidad en dos sectores laborales y determinar qué variables se asocian con ella. Metodología Estudio transversal y descriptivo en 56.856 trabajadores de los sectores comercio e industrial. Se recolectaron datos antropométricos, clínicos, analíticos y sociodemográficos durante exámenes médicos realizados entre 2017 y 2019. Resultados Se observa una prevalencia de obesidad significativamente mayor en el sector industrial en comparación con el comercio. Factores como edad, sexo, nivel educativo, actividad física, dieta mediterránea y tabaquismo presentaron asociaciones relevantes con las cuatro escalas de exceso de peso evaluadas. La edad, el nivel de actividad física y la dieta mediterránea fueron las variables con mayor asociación. En el sector industrial, la obesidad podría relacionarse con estrés laboral, turnos prolongados y acceso limitado a alimentos saludables, mientras que en el sector comercio el sedentarismo y los hábitos alimentarios inadecuados son factores destacados. Conclusiones Se recomienda desarrollar estrategias específicas para cada sector laboral, incluyendo pausas activas, promoción de actividad física y acceso a alimentos saludables. Aunque el estudio presenta fortalezas, como su amplio tamaño muestral y el análisis multivariado, el diseño transversal y la falta de control de algunas variables de confusión limitan su capacidad para establecer causalidad. Los hallazgos subrayan la necesidad de políticas preventivas adaptadas al entorno laboral para mitigar el impacto de la obesidad.

  @article{fernandez-figares_vicioso_prevalence_2025,
  abstract = {Introduction and objectives Obesity has been considered the pandemic of the 21st century due to its high prevalence and the significant morbidity and mortality it entails. The aim of this study is to assess the prevalence of obesity in two occupational sectors and to determine the variables associated with it. Methodology This is a cross-sectional and descriptive study involving 56,856 workers from the commerce and industrial sectors. Anthropometric, clinical, analytical, and sociodemographic data were collected during medical examinations conducted between 2017 and 2019. Results The prevalence of obesity was found to be significantly higher in the industrial sector compared to the commerce sector. Factors such as age, sex, educational level, physical activity, adherence to the Mediterranean diet, and smoking showed significant associations with the four scales of excess weight evaluated. Among these, age, physical activity level, and adherence to the Mediterranean diet demonstrated the strongest associations. In the industrial sector, obesity may be related to work-related stress, prolonged shifts, and limited access to healthy food, whereas in the commerce sector, sedentary behaviour and poor dietary habits were identified as key contributing factors. Conclusions Specific strategies tailored to each occupational sector are recommended, including active breaks, the promotion of physical activity, and access to healthy foods. While the study has strengths such as its large sample size and multivariate analysis, the cross-sectional design and lack of control for certain confounding variables limit its ability to establish causality. The findings underscore the need for preventive policies adapted to workplace environments to mitigate the impact of obesity. Resumen Introducción y objetivos La obesidad se ha considerado como la pandemia del siglo xxi por su elevada prevalencia y la gran morbimortalidad que acarrea. El objetivo es valorar la prevalencia de obesidad en dos sectores laborales y determinar qué variables se asocian con ella. Metodología Estudio transversal y descriptivo en 56.856 trabajadores de los sectores comercio e industrial. Se recolectaron datos antropométricos, clínicos, analíticos y sociodemográficos durante exámenes médicos realizados entre 2017 y 2019. Resultados Se observa una prevalencia de obesidad significativamente mayor en el sector industrial en comparación con el comercio. Factores como edad, sexo, nivel educativo, actividad física, dieta mediterránea y tabaquismo presentaron asociaciones relevantes con las cuatro escalas de exceso de peso evaluadas. La edad, el nivel de actividad física y la dieta mediterránea fueron las variables con mayor asociación. En el sector industrial, la obesidad podría relacionarse con estrés laboral, turnos prolongados y acceso limitado a alimentos saludables, mientras que en el sector comercio el sedentarismo y los hábitos alimentarios inadecuados son factores destacados. Conclusiones Se recomienda desarrollar estrategias específicas para cada sector laboral, incluyendo pausas activas, promoción de actividad física y acceso a alimentos saludables. Aunque el estudio presenta fortalezas, como su amplio tamaño muestral y el análisis multivariado, el diseño transversal y la falta de control de algunas variables de confusión limitan su capacidad para establecer causalidad. Los hallazgos subrayan la necesidad de políticas preventivas adaptadas al entorno laboral para mitigar el impacto de la obesidad.},
  author = {Fernández-Figares Vicioso, M. P. and López-González, Á. A. and Ramírez-Manent, J. I. and Del Barrio Fernández, J. L. and Tárraga López, P. J. and Vicente-Herreros, M. T.},
  journal = {Hipertensión y Riesgo Vascular},
  keywords = {grapp-caib},
  month = {oct},
  number = 4,
  pages = {276--288},
  title = {Prevalence of obesity: Comparison of commerce vs. industry sector and associated variables},
  volume = 42,
  year = 2025
  }
  

  %0 Journal Article
  %1 fernandez-figares_vicioso_prevalence_2025
  %A Fernández-Figares Vicioso, M. P.
  %A López-González, Á. A.
  %A Ramírez-Manent, J. I.
  %A Del Barrio Fernández, J. L.
  %A Tárraga López, P. J.
  %A Vicente-Herreros, M. T.
  %D 2025
  %J Hipertensión y Riesgo Vascular
  %N 4
  %P 276--288
  %R 10.1016/j.hipert.2025.04.002
  %T Prevalence of obesity: Comparison of commerce vs. industry sector and associated variables
  %U https://www.sciencedirect.com/science/article/pii/S1889183725000492
  %V 42
  %X Introduction and objectives Obesity has been considered the pandemic of the 21st century due to its high prevalence and the significant morbidity and mortality it entails. The aim of this study is to assess the prevalence of obesity in two occupational sectors and to determine the variables associated with it. Methodology This is a cross-sectional and descriptive study involving 56,856 workers from the commerce and industrial sectors. Anthropometric, clinical, analytical, and sociodemographic data were collected during medical examinations conducted between 2017 and 2019. Results The prevalence of obesity was found to be significantly higher in the industrial sector compared to the commerce sector. Factors such as age, sex, educational level, physical activity, adherence to the Mediterranean diet, and smoking showed significant associations with the four scales of excess weight evaluated. Among these, age, physical activity level, and adherence to the Mediterranean diet demonstrated the strongest associations. In the industrial sector, obesity may be related to work-related stress, prolonged shifts, and limited access to healthy food, whereas in the commerce sector, sedentary behaviour and poor dietary habits were identified as key contributing factors. Conclusions Specific strategies tailored to each occupational sector are recommended, including active breaks, the promotion of physical activity, and access to healthy foods. While the study has strengths such as its large sample size and multivariate analysis, the cross-sectional design and lack of control for certain confounding variables limit its ability to establish causality. The findings underscore the need for preventive policies adapted to workplace environments to mitigate the impact of obesity. Resumen Introducción y objetivos La obesidad se ha considerado como la pandemia del siglo xxi por su elevada prevalencia y la gran morbimortalidad que acarrea. El objetivo es valorar la prevalencia de obesidad en dos sectores laborales y determinar qué variables se asocian con ella. Metodología Estudio transversal y descriptivo en 56.856 trabajadores de los sectores comercio e industrial. Se recolectaron datos antropométricos, clínicos, analíticos y sociodemográficos durante exámenes médicos realizados entre 2017 y 2019. Resultados Se observa una prevalencia de obesidad significativamente mayor en el sector industrial en comparación con el comercio. Factores como edad, sexo, nivel educativo, actividad física, dieta mediterránea y tabaquismo presentaron asociaciones relevantes con las cuatro escalas de exceso de peso evaluadas. La edad, el nivel de actividad física y la dieta mediterránea fueron las variables con mayor asociación. En el sector industrial, la obesidad podría relacionarse con estrés laboral, turnos prolongados y acceso limitado a alimentos saludables, mientras que en el sector comercio el sedentarismo y los hábitos alimentarios inadecuados son factores destacados. Conclusiones Se recomienda desarrollar estrategias específicas para cada sector laboral, incluyendo pausas activas, promoción de actividad física y acceso a alimentos saludables. Aunque el estudio presenta fortalezas, como su amplio tamaño muestral y el análisis multivariado, el diseño transversal y la falta de control de algunas variables de confusión limitan su capacidad para establecer causalidad. Los hallazgos subrayan la necesidad de políticas preventivas adaptadas al entorno laboral para mitigar el impacto de la obesidad.
  

• 
  Associations of Sociodemographic Factors, Lifestyle Habits, and Insomnia Severity with Obesity Indices in Spanish Workers: Sex-Specific Differences. Ribes Valles, José Luis; Tárraga López, Pedro Juan; López González, Ángel Arturo; Coll Campayo, Irene; Busquets-Cortés, Carla; Ramírez-Manent, José Ignacio (2025). 13(4) 271.

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Background: Obesity and insomnia are prevalent public health issues with shared behavioral and physiological pathways. However, their interplay remains understudied in occupational cohorts. Obesity and insomnia are prevalent public health issues with shared behavioral and physiological pathways. However, their interplay remains understudied in occupational cohorts. This study aimed to evaluate the associations of sociodemographic factors, lifestyle habits, and insomnia severity with multiple obesity indices in a large population of Spanish workers. Methods: We conducted a cross-sectional analysis of 84,898 workers (2021–2024). Data were obtained from annual occupational health assessments conducted across multiple Spanish regions between 2020 and 2024. Insomnia severity was assessed using the Insomnia Severity Index (ISI), dietary quality using the 14-item Mediterranean Diet Adherence Screener (MEDAS-14), and physical activity using the International Physical Activity Questionnaire—Short Form (IPAQ-SF). Adiposity was measured using Body Mass Index (BMI), waist-to-height ratio (WtHR), the Clínica Universidad de Navarra–Body Adiposity Estimator (CUN-BAE), and the Metabolic Score for Visceral Fat (METS-VF). Multivariable logistic regression models were used to examine associations adjusted for age, sex, education, and occupational social class. Results: Higher ISI scores were significantly and independently associated with elevated adiposity across all indices, with the strongest association observed for METS-VF (odds ratio = 1.19, 95\% CI 1.14–1.25, p \textless 0.001). Women showed higher mean CUN-BAE and METS-VF values than men (CUN-BAE: 37.4 ± 6.2 vs. 25.6 ± 6.4; p \textless 0.001; METS-VF: 5.7 ± 0.7 vs. 6.4 ± 0.6; p \textless 0.001), despite lower BMI (25.3 ± 4.8 vs. 26.8 ± 4.3; p \textless 0.001). Lower physical activity (OR = 5.70; 95\% CI 4.91–6.50), poor adherence to the Mediterranean diet (OR = 3.29; 95\% CI 2.88–3.70), smoking (OR = 1.29; 95\% CI 1.22–1.36), and lower occupational class (Class III: OR = 1.77; 95\% CI 1.56–1.97) were also significantly associated with higher obesity markers. Associations were more pronounced among women and participants with severe insomnia symptoms. Conclusions: Insomnia severity, sociodemographic disadvantage, and unhealthy behaviors (low physical activity, poor diet, smoking) were all independent correlates of general and visceral adiposity. The findings underscore the need for comprehensive workplace health programs that integrate sleep quality assessment, dietary improvement, and physical activity promotion to prevent obesity and its metabolic consequences.

  @article{ribes_valles_associations_2025,
  abstract = {Background: Obesity and insomnia are prevalent public health issues with shared behavioral and physiological pathways. However, their interplay remains understudied in occupational cohorts. Obesity and insomnia are prevalent public health issues with shared behavioral and physiological pathways. However, their interplay remains understudied in occupational cohorts. This study aimed to evaluate the associations of sociodemographic factors, lifestyle habits, and insomnia severity with multiple obesity indices in a large population of Spanish workers. Methods: We conducted a cross-sectional analysis of 84,898 workers (2021–2024). Data were obtained from annual occupational health assessments conducted across multiple Spanish regions between 2020 and 2024. Insomnia severity was assessed using the Insomnia Severity Index (ISI), dietary quality using the 14-item Mediterranean Diet Adherence Screener (MEDAS-14), and physical activity using the International Physical Activity Questionnaire—Short Form (IPAQ-SF). Adiposity was measured using Body Mass Index (BMI), waist-to-height ratio (WtHR), the Clínica Universidad de Navarra–Body Adiposity Estimator (CUN-BAE), and the Metabolic Score for Visceral Fat (METS-VF). Multivariable logistic regression models were used to examine associations adjusted for age, sex, education, and occupational social class. Results: Higher ISI scores were significantly and independently associated with elevated adiposity across all indices, with the strongest association observed for METS-VF (odds ratio = 1.19, 95\% CI 1.14–1.25, p \textless 0.001). Women showed higher mean CUN-BAE and METS-VF values than men (CUN-BAE: 37.4 ± 6.2 vs. 25.6 ± 6.4; p \textless 0.001; METS-VF: 5.7 ± 0.7 vs. 6.4 ± 0.6; p \textless 0.001), despite lower BMI (25.3 ± 4.8 vs. 26.8 ± 4.3; p \textless 0.001). Lower physical activity (OR = 5.70; 95\% CI 4.91–6.50), poor adherence to the Mediterranean diet (OR = 3.29; 95\% CI 2.88–3.70), smoking (OR = 1.29; 95\% CI 1.22–1.36), and lower occupational class (Class III: OR = 1.77; 95\% CI 1.56–1.97) were also significantly associated with higher obesity markers. Associations were more pronounced among women and participants with severe insomnia symptoms. Conclusions: Insomnia severity, sociodemographic disadvantage, and unhealthy behaviors (low physical activity, poor diet, smoking) were all independent correlates of general and visceral adiposity. The findings underscore the need for comprehensive workplace health programs that integrate sleep quality assessment, dietary improvement, and physical activity promotion to prevent obesity and its metabolic consequences.},
  author = {Ribes Valles, José Luis and Tárraga López, Pedro Juan and López González, Ángel Arturo and Coll Campayo, Irene and Busquets-Cortés, Carla and Ramírez-Manent, José Ignacio},
  journal = {Medical Sciences},
  keywords = {grapp-caib},
  month = {nov},
  number = 4,
  pages = 271,
  title = {Associations of Sociodemographic Factors, Lifestyle Habits, and Insomnia Severity with Obesity Indices in Spanish Workers: Sex-Specific Differences},
  volume = 13,
  year = 2025
  }
  

  %0 Journal Article
  %1 ribes_valles_associations_2025
  %A Ribes Valles, José Luis
  %A Tárraga López, Pedro Juan
  %A López González, Ángel Arturo
  %A Coll Campayo, Irene
  %A Busquets-Cortés, Carla
  %A Ramírez-Manent, José Ignacio
  %D 2025
  %J Medical Sciences
  %N 4
  %P 271
  %R 10.3390/medsci13040271
  %T Associations of Sociodemographic Factors, Lifestyle Habits, and Insomnia Severity with Obesity Indices in Spanish Workers: Sex-Specific Differences
  %U https://pmc.ncbi.nlm.nih.gov/articles/PMC12641970/
  %V 13
  %X Background: Obesity and insomnia are prevalent public health issues with shared behavioral and physiological pathways. However, their interplay remains understudied in occupational cohorts. Obesity and insomnia are prevalent public health issues with shared behavioral and physiological pathways. However, their interplay remains understudied in occupational cohorts. This study aimed to evaluate the associations of sociodemographic factors, lifestyle habits, and insomnia severity with multiple obesity indices in a large population of Spanish workers. Methods: We conducted a cross-sectional analysis of 84,898 workers (2021–2024). Data were obtained from annual occupational health assessments conducted across multiple Spanish regions between 2020 and 2024. Insomnia severity was assessed using the Insomnia Severity Index (ISI), dietary quality using the 14-item Mediterranean Diet Adherence Screener (MEDAS-14), and physical activity using the International Physical Activity Questionnaire—Short Form (IPAQ-SF). Adiposity was measured using Body Mass Index (BMI), waist-to-height ratio (WtHR), the Clínica Universidad de Navarra–Body Adiposity Estimator (CUN-BAE), and the Metabolic Score for Visceral Fat (METS-VF). Multivariable logistic regression models were used to examine associations adjusted for age, sex, education, and occupational social class. Results: Higher ISI scores were significantly and independently associated with elevated adiposity across all indices, with the strongest association observed for METS-VF (odds ratio = 1.19, 95\% CI 1.14–1.25, p \textless 0.001). Women showed higher mean CUN-BAE and METS-VF values than men (CUN-BAE: 37.4 ± 6.2 vs. 25.6 ± 6.4; p \textless 0.001; METS-VF: 5.7 ± 0.7 vs. 6.4 ± 0.6; p \textless 0.001), despite lower BMI (25.3 ± 4.8 vs. 26.8 ± 4.3; p \textless 0.001). Lower physical activity (OR = 5.70; 95\% CI 4.91–6.50), poor adherence to the Mediterranean diet (OR = 3.29; 95\% CI 2.88–3.70), smoking (OR = 1.29; 95\% CI 1.22–1.36), and lower occupational class (Class III: OR = 1.77; 95\% CI 1.56–1.97) were also significantly associated with higher obesity markers. Associations were more pronounced among women and participants with severe insomnia symptoms. Conclusions: Insomnia severity, sociodemographic disadvantage, and unhealthy behaviors (low physical activity, poor diet, smoking) were all independent correlates of general and visceral adiposity. The findings underscore the need for comprehensive workplace health programs that integrate sleep quality assessment, dietary improvement, and physical activity promotion to prevent obesity and its metabolic consequences.
  

• 
  Comparative Accuracy of the ECORE-BF Index Versus Non-Insulin-Based Insulin Resistance Markers in over 400,000 Spanish Adults. Marina Arroyo, Marta; Obrador de Hevia, Joan; López-González, Ángel Arturo; Tárraga López, Pedro J.; Busquets-Cortés, Carla; Ramírez-Manent, José Ignacio (2025). 6(11) 130.

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Background: The early detection of insulin resistance (IR) is critical for the prevention of type 2 diabetes and cardiometabolic diseases. The ECORE-BF index is a simple anthropometric tool for estimating body fat percentage and overweight. However, its potential utility as a predictor of IR risk has not been previously evaluated in large populations using validated IR indices. Methods: This cross-sectional study included 418,343 Spanish workers (172,282 women and 246,061 men) who underwent occupational health evaluations. The ECORE-BF index was calculated for all participants, and its association with four validated surrogate markers of IR was analyzed: the triglyceride–glucose index (TyG), TyG-BMI, METS-IR, and SPISE. Subjects were classified into normal or high-risk IR groups based on established cut-off values. We evaluated the mean ECORE-BF values across groups, the prevalence of ECORE-BF-defined obesity, and the diagnostic performance of ECORE-BF using receiver operating characteristic (ROC) curve analysis. Results: Participants with elevated IR index values had significantly higher mean ECORE-BF scores than those with normal values (p \textless 0.001). The prevalence of ECORE-BF-defined obesity was substantially higher in all high-risk IR groups, exceeding 99% for METS-IR and SPISE in both sexes. ROC analysis demonstrated the high diagnostic accuracy of ECORE-BF in predicting elevated IR risk, with area under the curve (AUC) values ranging from 0.698 (TyG in men) to 0.992 (METS-IR in women). Sensitivity and specificity were also high, particularly for TyG-BMI, SPISE, and METS-IR, with optimal Youden indices above 0.75. Conclusions: ECORE-BF demonstrated high accuracy as a non-invasive tool for identifying individuals at increased insulin resistance risk; however, due to the cross-sectional design, predictive value for incident disease cannot be inferred. Its simplicity, cost-effectiveness, and high diagnostic accuracy support its potential utility in large-scale screening programs for early detection of metabolic risk.

  @article{marina_arroyo_comparative_2025,
  abstract = {Background: The early detection of insulin resistance (IR) is critical for the prevention of type 2 diabetes and cardiometabolic diseases. The ECORE-BF index is a simple anthropometric tool for estimating body fat percentage and overweight. However, its potential utility as a predictor of IR risk has not been previously evaluated in large populations using validated IR indices. Methods: This cross-sectional study included 418,343 Spanish workers (172,282 women and 246,061 men) who underwent occupational health evaluations. The ECORE-BF index was calculated for all participants, and its association with four validated surrogate markers of IR was analyzed: the triglyceride–glucose index (TyG), TyG-BMI, METS-IR, and SPISE. Subjects were classified into normal or high-risk IR groups based on established cut-off values. We evaluated the mean ECORE-BF values across groups, the prevalence of ECORE-BF-defined obesity, and the diagnostic performance of ECORE-BF using receiver operating characteristic (ROC) curve analysis. Results: Participants with elevated IR index values had significantly higher mean ECORE-BF scores than those with normal values (p \textless 0.001). The prevalence of ECORE-BF-defined obesity was substantially higher in all high-risk IR groups, exceeding 99% for METS-IR and SPISE in both sexes. ROC analysis demonstrated the high diagnostic accuracy of ECORE-BF in predicting elevated IR risk, with area under the curve (AUC) values ranging from 0.698 (TyG in men) to 0.992 (METS-IR in women). Sensitivity and specificity were also high, particularly for TyG-BMI, SPISE, and METS-IR, with optimal Youden indices above 0.75. Conclusions: ECORE-BF demonstrated high accuracy as a non-invasive tool for identifying individuals at increased insulin resistance risk; however, due to the cross-sectional design, predictive value for incident disease cannot be inferred. Its simplicity, cost-effectiveness, and high diagnostic accuracy support its potential utility in large-scale screening programs for early detection of metabolic risk.},
  author = {Marina Arroyo, Marta and Obrador de Hevia, Joan and López-González, Ángel Arturo and Tárraga López, Pedro J. and Busquets-Cortés, Carla and Ramírez-Manent, José Ignacio},
  journal = {Diabetology},
  keywords = {grapp-caib},
  month = {nov},
  number = 11,
  pages = 130,
  title = {Comparative Accuracy of the ECORE-BF Index Versus Non-Insulin-Based Insulin Resistance Markers in over 400,000 Spanish Adults},
  volume = 6,
  year = 2025
  }
  

  %0 Journal Article
  %1 marina_arroyo_comparative_2025
  %A Marina Arroyo, Marta
  %A Obrador de Hevia, Joan
  %A López-González, Ángel Arturo
  %A Tárraga López, Pedro J.
  %A Busquets-Cortés, Carla
  %A Ramírez-Manent, José Ignacio
  %D 2025
  %J Diabetology
  %N 11
  %P 130
  %R 10.3390/diabetology6110130
  %T Comparative Accuracy of the ECORE-BF Index Versus Non-Insulin-Based Insulin Resistance Markers in over 400,000 Spanish Adults
  %U https://www.mdpi.com/2673-4540/6/11/130
  %V 6
  %X Background: The early detection of insulin resistance (IR) is critical for the prevention of type 2 diabetes and cardiometabolic diseases. The ECORE-BF index is a simple anthropometric tool for estimating body fat percentage and overweight. However, its potential utility as a predictor of IR risk has not been previously evaluated in large populations using validated IR indices. Methods: This cross-sectional study included 418,343 Spanish workers (172,282 women and 246,061 men) who underwent occupational health evaluations. The ECORE-BF index was calculated for all participants, and its association with four validated surrogate markers of IR was analyzed: the triglyceride–glucose index (TyG), TyG-BMI, METS-IR, and SPISE. Subjects were classified into normal or high-risk IR groups based on established cut-off values. We evaluated the mean ECORE-BF values across groups, the prevalence of ECORE-BF-defined obesity, and the diagnostic performance of ECORE-BF using receiver operating characteristic (ROC) curve analysis. Results: Participants with elevated IR index values had significantly higher mean ECORE-BF scores than those with normal values (p \textless 0.001). The prevalence of ECORE-BF-defined obesity was substantially higher in all high-risk IR groups, exceeding 99% for METS-IR and SPISE in both sexes. ROC analysis demonstrated the high diagnostic accuracy of ECORE-BF in predicting elevated IR risk, with area under the curve (AUC) values ranging from 0.698 (TyG in men) to 0.992 (METS-IR in women). Sensitivity and specificity were also high, particularly for TyG-BMI, SPISE, and METS-IR, with optimal Youden indices above 0.75. Conclusions: ECORE-BF demonstrated high accuracy as a non-invasive tool for identifying individuals at increased insulin resistance risk; however, due to the cross-sectional design, predictive value for incident disease cannot be inferred. Its simplicity, cost-effectiveness, and high diagnostic accuracy support its potential utility in large-scale screening programs for early detection of metabolic risk.
  

• 
  [Metabolically healthy obesity and cardiovascular risk: Analysis of risk scores in a large population cohort]. García Samuelsson, M.; Tárraga López, P. J.; López González, A. A.; Busquets-Cortés, C.; Obrador de Hevia, J.; Ramírez Manent, J. I. (2025). 51(8) 102580.

  AbstractBibTeXEndNoteDOIBibSonomy

  INTRODUCTION: Metabolically healthy obesity (MHO) describes obese individuals without evident metabolic disturbances. However, its relationship with cardiovascular risk remains controversial. OBJECTIVE: To assess cardiovascular risk using different risk scores among MHO individuals compared to metabolically unhealthy obese (MUO) and normal-weight subjects in a large cohort of Spanish workers. METHODS: Cross-sectional study including 68,884 obese workers (45,498 men and 23,386 women). MHO and MUO were classified according to NCEP-ATPIII criteria. Cardiovascular risk was estimated using SCORE2, REGICOR, ERICE, DORICA, vascular age, and avoidable years of life lost. RESULTS: MHO individuals exhibited a better risk profile than MUO subjects but significantly worse than normal-weight individuals. Across all evaluated scores, MUO individuals showed the highest risk values, particularly among men. Lower educational attainment, low social class, physical inactivity, and smoking were independently associated with increased cardiovascular risk. CONCLUSIONS: Although considered intermediate risk, MHO is not a clinically benign phenotype. Targeted preventive strategies are necessary to reduce the progression toward metabolically unhealthy states in this subgroup.

  @article{garcia_samuelsson_metabolically_2025,
  abstract = {INTRODUCTION: Metabolically healthy obesity (MHO) describes obese individuals without evident metabolic disturbances. However, its relationship with cardiovascular risk remains controversial. OBJECTIVE: To assess cardiovascular risk using different risk scores among MHO individuals compared to metabolically unhealthy obese (MUO) and normal-weight subjects in a large cohort of Spanish workers. METHODS: Cross-sectional study including 68,884 obese workers (45,498 men and 23,386 women). MHO and MUO were classified according to NCEP-ATPIII criteria. Cardiovascular risk was estimated using SCORE2, REGICOR, ERICE, DORICA, vascular age, and avoidable years of life lost. RESULTS: MHO individuals exhibited a better risk profile than MUO subjects but significantly worse than normal-weight individuals. Across all evaluated scores, MUO individuals showed the highest risk values, particularly among men. Lower educational attainment, low social class, physical inactivity, and smoking were independently associated with increased cardiovascular risk. CONCLUSIONS: Although considered intermediate risk, MHO is not a clinically benign phenotype. Targeted preventive strategies are necessary to reduce the progression toward metabolically unhealthy states in this subgroup.},
  author = {García Samuelsson, M. and Tárraga López, P. J. and López González, A. A. and Busquets-Cortés, C. and Obrador de Hevia, J. and Ramírez Manent, J. I.},
  journal = {Semergen},
  keywords = {grapp-caib},
  number = 8,
  pages = 102580,
  title = {[Metabolically healthy obesity and cardiovascular risk: Analysis of risk scores in a large population cohort]},
  volume = 51,
  year = 2025
  }
  

  %0 Journal Article
  %1 garcia_samuelsson_metabolically_2025
  %A García Samuelsson, M.
  %A Tárraga López, P. J.
  %A López González, A. A.
  %A Busquets-Cortés, C.
  %A Obrador de Hevia, J.
  %A Ramírez Manent, J. I.
  %D 2025
  %J Semergen
  %N 8
  %P 102580
  %R 10.1016/j.semerg.2025.102580
  %T [Metabolically healthy obesity and cardiovascular risk: Analysis of risk scores in a large population cohort]
  %V 51
  %X INTRODUCTION: Metabolically healthy obesity (MHO) describes obese individuals without evident metabolic disturbances. However, its relationship with cardiovascular risk remains controversial. OBJECTIVE: To assess cardiovascular risk using different risk scores among MHO individuals compared to metabolically unhealthy obese (MUO) and normal-weight subjects in a large cohort of Spanish workers. METHODS: Cross-sectional study including 68,884 obese workers (45,498 men and 23,386 women). MHO and MUO were classified according to NCEP-ATPIII criteria. Cardiovascular risk was estimated using SCORE2, REGICOR, ERICE, DORICA, vascular age, and avoidable years of life lost. RESULTS: MHO individuals exhibited a better risk profile than MUO subjects but significantly worse than normal-weight individuals. Across all evaluated scores, MUO individuals showed the highest risk values, particularly among men. Lower educational attainment, low social class, physical inactivity, and smoking were independently associated with increased cardiovascular risk. CONCLUSIONS: Although considered intermediate risk, MHO is not a clinically benign phenotype. Targeted preventive strategies are necessary to reduce the progression toward metabolically unhealthy states in this subgroup.
  

• 
  Changes in daily routines and health-related quality of life among Spanish older adults after the COVID-19 pandemic: analysis from a gender perspective. Cameselle-Lago, Candela; Rico-Blázquez, Milagros; Sánchez-Ruano, Raquel; Ayala, Alba; Pascual-García, Marcos; Solé-Agustí, María; Gimeno-Pi, Iraida; Echevarria-Echevarria, Aitziber; González-Chordá, Víctor M.; Esteban-Sepúlveda, Silvia; Pedraz-Marcos, Azucena; Company-Sancho, María Consuelo; Cidoncha-Moreno, María Ángeles; Vidal-Thomas, María Clara; Taltavull-Aparicio, Joana Maria; Moreno-Casbas, María Teresa (2025). 13 1678003.

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Aims To examine the association between perceived changes in daily routines due to the COVID-19 pandemic and health-related quality of life (HRQoL) among community-dwelling adults aged 75 and older in Spain, through a gender-stratified analysis. Design Cross-sectional, community-based, multicentre study using baseline data from the CUIDAMOS+75 cohort. Methods A total of 1,072 older adults over 75 from 11 Spanish regions were interviewed between June 2022 and June 2023. Data on SARS-CoV-2 exposure, sociodemographic and clinical characteristics and perceived changes in daily routines (basic-needs, healthcare and social routines) were collected. HRQoL was measured using the EQ-5D-5L utility index. Gender-stratified linear regression models were used to examine associations between changes in routines and HRQoL. Results Over half of the participants (52\%) reported considerable changes in their daily routines due to the pandemic, especially in social routines (48\%). Women reported more frequent changes across all routine types. Although women had lower overall HRQoL scores, changes in routines were more strongly associated with poorer HRQoL among men, particularly when healthcare routines were affected. Among women, significant associations were observed for disruptions in combined basic and social routines as well as when all three routine types were simultaneously affected. Notably, COVID-19 infection status was not associated with HRQoL after adjustment. Conclusion The COVID-19 pandemic led to substantial and persistent changes in daily routines among older adults in Spain, with gender-specific patterns in their association with HRQoL. These findings highlight the importance of incorporating a gender perspective in public health responses to health crises, particularly in strategies aimed at preserving daily routines to support autonomy and wellbeing in older populations.

  @article{cameselle-lago_changes_2025,
  abstract = {Aims To examine the association between perceived changes in daily routines due to the COVID-19 pandemic and health-related quality of life (HRQoL) among community-dwelling adults aged 75 and older in Spain, through a gender-stratified analysis. Design Cross-sectional, community-based, multicentre study using baseline data from the CUIDAMOS+75 cohort. Methods A total of 1,072 older adults over 75 from 11 Spanish regions were interviewed between June 2022 and June 2023. Data on SARS-CoV-2 exposure, sociodemographic and clinical characteristics and perceived changes in daily routines (basic-needs, healthcare and social routines) were collected. HRQoL was measured using the EQ-5D-5L utility index. Gender-stratified linear regression models were used to examine associations between changes in routines and HRQoL. Results Over half of the participants (52\%) reported considerable changes in their daily routines due to the pandemic, especially in social routines (48\%). Women reported more frequent changes across all routine types. Although women had lower overall HRQoL scores, changes in routines were more strongly associated with poorer HRQoL among men, particularly when healthcare routines were affected. Among women, significant associations were observed for disruptions in combined basic and social routines as well as when all three routine types were simultaneously affected. Notably, COVID-19 infection status was not associated with HRQoL after adjustment. Conclusion The COVID-19 pandemic led to substantial and persistent changes in daily routines among older adults in Spain, with gender-specific patterns in their association with HRQoL. These findings highlight the importance of incorporating a gender perspective in public health responses to health crises, particularly in strategies aimed at preserving daily routines to support autonomy and wellbeing in older populations.},
  author = {Cameselle-Lago, Candela and Rico-Blázquez, Milagros and Sánchez-Ruano, Raquel and Ayala, Alba and Pascual-García, Marcos and Solé-Agustí, María and Gimeno-Pi, Iraida and Echevarria-Echevarria, Aitziber and González-Chordá, Víctor M. and Esteban-Sepúlveda, Silvia and Pedraz-Marcos, Azucena and Company-Sancho, María Consuelo and Cidoncha-Moreno, María Ángeles and Vidal-Thomas, María Clara and Taltavull-Aparicio, Joana Maria and Moreno-Casbas, María Teresa},
  journal = {Frontiers in Public Health},
  keywords = {grapp-caib},
  month = {oct},
  pages = 1678003,
  title = {Changes in daily routines and health-related quality of life among Spanish older adults after the COVID-19 pandemic: analysis from a gender perspective},
  volume = 13,
  year = 2025
  }
  

  %0 Journal Article
  %1 cameselle-lago_changes_2025
  %A Cameselle-Lago, Candela
  %A Rico-Blázquez, Milagros
  %A Sánchez-Ruano, Raquel
  %A Ayala, Alba
  %A Pascual-García, Marcos
  %A Solé-Agustí, María
  %A Gimeno-Pi, Iraida
  %A Echevarria-Echevarria, Aitziber
  %A González-Chordá, Víctor M.
  %A Esteban-Sepúlveda, Silvia
  %A Pedraz-Marcos, Azucena
  %A Company-Sancho, María Consuelo
  %A Cidoncha-Moreno, María Ángeles
  %A Vidal-Thomas, María Clara
  %A Taltavull-Aparicio, Joana Maria
  %A Moreno-Casbas, María Teresa
  %D 2025
  %J Frontiers in Public Health
  %P 1678003
  %R 10.3389/fpubh.2025.1678003
  %T Changes in daily routines and health-related quality of life among Spanish older adults after the COVID-19 pandemic: analysis from a gender perspective
  %U https://pmc.ncbi.nlm.nih.gov/articles/PMC12554437/
  %V 13
  %X Aims To examine the association between perceived changes in daily routines due to the COVID-19 pandemic and health-related quality of life (HRQoL) among community-dwelling adults aged 75 and older in Spain, through a gender-stratified analysis. Design Cross-sectional, community-based, multicentre study using baseline data from the CUIDAMOS+75 cohort. Methods A total of 1,072 older adults over 75 from 11 Spanish regions were interviewed between June 2022 and June 2023. Data on SARS-CoV-2 exposure, sociodemographic and clinical characteristics and perceived changes in daily routines (basic-needs, healthcare and social routines) were collected. HRQoL was measured using the EQ-5D-5L utility index. Gender-stratified linear regression models were used to examine associations between changes in routines and HRQoL. Results Over half of the participants (52\%) reported considerable changes in their daily routines due to the pandemic, especially in social routines (48\%). Women reported more frequent changes across all routine types. Although women had lower overall HRQoL scores, changes in routines were more strongly associated with poorer HRQoL among men, particularly when healthcare routines were affected. Among women, significant associations were observed for disruptions in combined basic and social routines as well as when all three routine types were simultaneously affected. Notably, COVID-19 infection status was not associated with HRQoL after adjustment. Conclusion The COVID-19 pandemic led to substantial and persistent changes in daily routines among older adults in Spain, with gender-specific patterns in their association with HRQoL. These findings highlight the importance of incorporating a gender perspective in public health responses to health crises, particularly in strategies aimed at preserving daily routines to support autonomy and wellbeing in older populations.
  

• 
  Obesity indices and their sociodemographic, lifestyle, and social isolation correlates in a large Spanish working population. Riutord-Sbert, Pere; Tárraga López, Pedro Juan; López-González, Ángel Arturo; Coll Campayo, Irene; Busquets-Cortés, Carla; Ramírez Manent, José Ignacio (2025). 16 1695705.

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Background Obesity is a multifactorial condition shaped by biological, behavioral, socioeconomic, and psychosocial determinants. While lifestyle correlates are well documented, the impact of social isolation on obesity in occupational settings remains insufficiently explored. This study examined associations between sociodemographic variables, health behaviors, and social isolation with multiple obesity indices in a large cohort of Spanish workers. Methods We analyzed 117298 employees across Spain (2021–2024). Obesity was defined using body mass index (BMI), waist-to-height ratio (WtHR), Clínica Universidad de Navarra–Body Adiposity Estimator (CUN-BAE), and Metabolic Score for Visceral Fat (METS-VF). Sociodemographic data, lifestyle habits, and social isolation (ENRICHD Social Support Instrument, ESSI) were obtained through standardized protocols. Multivariable logistic regression estimated adjusted odds ratios (OR) and 95% confidence intervals (CI). Results Obesity prevalence ranged from 20.4% (BMI) to 39.6% (METS-VF). Male sex (OR up to 2.11, 95\% CI 2.05–2.18), older age (OR 2.83, 95\% CI 2.71–2.96 for ≥55 years vs. \textless35), and lower social class (OR 1.62, 95\% CI 1.54–1.71) were consistently associated with obesity across all indices. Poor adherence to the Mediterranean diet and physical inactivity increased the likelihood of obesity (OR 1.35 and 1.41, respectively). Social isolation independently predicted higher obesity risk (OR 1.27, 95\% CI 1.21–1.33), even after adjusting for sociodemographic and lifestyle factors. Associations remained robust in sensitivity analyses. Conclusions Obesity in Spanish workers is strongly associated with sociodemographic disadvantage, unhealthy lifestyles, and psychosocial vulnerability. Social isolation emerged as a novel determinant, reinforcing the need for multidimensional public health strategies that integrate lifestyle promotion, reduction of socioeconomic inequalities, and enhancement of social connectedness.

  @article{riutord-sbert_obesity_2025,
  abstract = {Background Obesity is a multifactorial condition shaped by biological, behavioral, socioeconomic, and psychosocial determinants. While lifestyle correlates are well documented, the impact of social isolation on obesity in occupational settings remains insufficiently explored. This study examined associations between sociodemographic variables, health behaviors, and social isolation with multiple obesity indices in a large cohort of Spanish workers. Methods We analyzed 117298 employees across Spain (2021–2024). Obesity was defined using body mass index (BMI), waist-to-height ratio (WtHR), Clínica Universidad de Navarra–Body Adiposity Estimator (CUN-BAE), and Metabolic Score for Visceral Fat (METS-VF). Sociodemographic data, lifestyle habits, and social isolation (ENRICHD Social Support Instrument, ESSI) were obtained through standardized protocols. Multivariable logistic regression estimated adjusted odds ratios (OR) and 95% confidence intervals (CI). Results Obesity prevalence ranged from 20.4% (BMI) to 39.6% (METS-VF). Male sex (OR up to 2.11, 95\% CI 2.05–2.18), older age (OR 2.83, 95\% CI 2.71–2.96 for ≥55 years vs. \textless35), and lower social class (OR 1.62, 95\% CI 1.54–1.71) were consistently associated with obesity across all indices. Poor adherence to the Mediterranean diet and physical inactivity increased the likelihood of obesity (OR 1.35 and 1.41, respectively). Social isolation independently predicted higher obesity risk (OR 1.27, 95\% CI 1.21–1.33), even after adjusting for sociodemographic and lifestyle factors. Associations remained robust in sensitivity analyses. Conclusions Obesity in Spanish workers is strongly associated with sociodemographic disadvantage, unhealthy lifestyles, and psychosocial vulnerability. Social isolation emerged as a novel determinant, reinforcing the need for multidimensional public health strategies that integrate lifestyle promotion, reduction of socioeconomic inequalities, and enhancement of social connectedness.},
  author = {Riutord-Sbert, Pere and Tárraga López, Pedro Juan and López-González, Ángel Arturo and Coll Campayo, Irene and Busquets-Cortés, Carla and Ramírez Manent, José Ignacio},
  journal = {Frontiers in Endocrinology},
  keywords = {grapp-caib},
  month = {oct},
  pages = 1695705,
  title = {Obesity indices and their sociodemographic, lifestyle, and social isolation correlates in a large Spanish working population},
  volume = 16,
  year = 2025
  }
  

  %0 Journal Article
  %1 riutord-sbert_obesity_2025
  %A Riutord-Sbert, Pere
  %A Tárraga López, Pedro Juan
  %A López-González, Ángel Arturo
  %A Coll Campayo, Irene
  %A Busquets-Cortés, Carla
  %A Ramírez Manent, José Ignacio
  %D 2025
  %J Frontiers in Endocrinology
  %P 1695705
  %R 10.3389/fendo.2025.1695705
  %T Obesity indices and their sociodemographic, lifestyle, and social isolation correlates in a large Spanish working population
  %U https://pmc.ncbi.nlm.nih.gov/articles/PMC12549272/
  %V 16
  %X Background Obesity is a multifactorial condition shaped by biological, behavioral, socioeconomic, and psychosocial determinants. While lifestyle correlates are well documented, the impact of social isolation on obesity in occupational settings remains insufficiently explored. This study examined associations between sociodemographic variables, health behaviors, and social isolation with multiple obesity indices in a large cohort of Spanish workers. Methods We analyzed 117298 employees across Spain (2021–2024). Obesity was defined using body mass index (BMI), waist-to-height ratio (WtHR), Clínica Universidad de Navarra–Body Adiposity Estimator (CUN-BAE), and Metabolic Score for Visceral Fat (METS-VF). Sociodemographic data, lifestyle habits, and social isolation (ENRICHD Social Support Instrument, ESSI) were obtained through standardized protocols. Multivariable logistic regression estimated adjusted odds ratios (OR) and 95% confidence intervals (CI). Results Obesity prevalence ranged from 20.4% (BMI) to 39.6% (METS-VF). Male sex (OR up to 2.11, 95\% CI 2.05–2.18), older age (OR 2.83, 95\% CI 2.71–2.96 for ≥55 years vs. \textless35), and lower social class (OR 1.62, 95\% CI 1.54–1.71) were consistently associated with obesity across all indices. Poor adherence to the Mediterranean diet and physical inactivity increased the likelihood of obesity (OR 1.35 and 1.41, respectively). Social isolation independently predicted higher obesity risk (OR 1.27, 95\% CI 1.21–1.33), even after adjusting for sociodemographic and lifestyle factors. Associations remained robust in sensitivity analyses. Conclusions Obesity in Spanish workers is strongly associated with sociodemographic disadvantage, unhealthy lifestyles, and psychosocial vulnerability. Social isolation emerged as a novel determinant, reinforcing the need for multidimensional public health strategies that integrate lifestyle promotion, reduction of socioeconomic inequalities, and enhancement of social connectedness.
  

• 
  A Multifaceted Digital Intervention for the Prevention of Type 2 Diabetes Mellitus in Primary Care (PREDIABETEXT): Cluster Randomized Trial. Mira-Martínez, Sofía; Malih, Narges; Angullo-Martínez, Escarlata; Zamanillo-Campos, Rocío; Yañez, Aina M.; Bennasar-Veny, Miquel; Gómez-Juanes, Rocío; Konieczna, Jadwiga; Jiménez, Rafael; Serrano-Ripoll, Maria J.; Fiol deRoque, Maria Antonia; Leiva, Alfonso; Galmes-Panades, Aina M.; Miralles-Xamena, Jerónima; Vidal-Thomàs, Maria Clara; Gómez-Cobo, Cristina; Gervilla, Elena; Oña-Gil, José Iván; Ricci-Cabello, Ignacio (2025). 27(1) e70981.

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Background: The diabetes epidemic continues to surge worldwide, demanding urgent and innovative solutions. Digital health interventions, particularly those targeting behavior change, hold promise due to their affordability and scalability. However, research in this field remains in its early stages. Objective: This study aimed to evaluate the effectiveness of PREDIABETEXT (Prediabetes Text Message Digital Intervention for the Prevention of Type 2 Diabetes Mellitus), a digital health intervention, in reducing glycated hemoglobin (HbA1c) and in improving secondary clinical, physiological, and behavioral outcomes. Methods: We conducted a 6-month, 3-arm, pragmatic cluster randomized clinical trial. We recruited patients with prediabetes (HbA1c levels between 6\% and 6.4\% in the previous 3 months or 2 consecutive fasting plasma glucose measurements of 110-125 mg/dL) registered at primary care centers in the Balearic Islands, Spain. The PREDIABETEXT intervention consisted of 3 personalized SMS text messages per week aimed at supporting lifestyle behavior changes and online training for their primary health care professionals. A total of 58 professionals (clusters) from 16 centers participated in the study and were randomized (1:1:1) to intervention group A (patient SMS text messaging), intervention group B (patient SMS text messaging+health care professional web-based training), or the control group (usual care). Following the 6-month intervention period, we conducted individual qualitative interviews with 8 patients and 7 health care professionals to evaluate their experiences with the intervention in terms of utility, satisfaction, and implementation barriers. Results: In total, 58 health care professionals (clusters) were included, allocated to the control group (n=20, 34\%; 119/365, 32.6\% patients), intervention group A (SMS text messaging only; n=18, 31\%; 106/365, 29\% patients), and intervention group B (SMS text messaging+training; n=20, 34\%; 140/365, 38.4\% patients). The mean age of the patients was 59.79 (SD 9.75) years, and 54.5% (199/365) were female. The results of the intention-to-treat analysis at the 6-month time point showed that intervention A led to a small, nonsignificant reduction in HbA1c levels compared to the control group (β=−0.05, 95\% CI −0.21 to 0.10; P=.50), whereas intervention B showed a similar nonsignificant reduction (β=−0.04, 95\% CI −0.12 to 0.10; P=.56). No substantial differences were observed in the remaining secondary outcomes. Interviews revealed positive feedback from patients, who appreciated the intervention’s dietary messages and their frequency and practicality. Participants suggested enhancements such as increased personalization, links to recipes, and nursing follow-ups. Health care professionals valued the online training but highlighted time constraints, suggesting shorter or blended formats to improve accessibility. Conclusions: While PREDIABETEXT did not significantly improve HbA1c levels, it demonstrated potential benefits for patient engagement. Further studies involving more intensive interventions are warranted to confirm the clinical impact on diabetes prevention. Trial Registration: ClinicalTrials.gov NCT05110625; https://www.clinicaltrials.gov/study/NCT05110625

  @article{mira-martinez_multifaceted_2025,
  abstract = {Background: The diabetes epidemic continues to surge worldwide, demanding urgent and innovative solutions. Digital health interventions, particularly those targeting behavior change, hold promise due to their affordability and scalability. However, research in this field remains in its early stages. Objective: This study aimed to evaluate the effectiveness of PREDIABETEXT (Prediabetes Text Message Digital Intervention for the Prevention of Type 2 Diabetes Mellitus), a digital health intervention, in reducing glycated hemoglobin (HbA1c) and in improving secondary clinical, physiological, and behavioral outcomes. Methods: We conducted a 6-month, 3-arm, pragmatic cluster randomized clinical trial. We recruited patients with prediabetes (HbA1c levels between 6\% and 6.4\% in the previous 3 months or 2 consecutive fasting plasma glucose measurements of 110-125 mg/dL) registered at primary care centers in the Balearic Islands, Spain. The PREDIABETEXT intervention consisted of 3 personalized SMS text messages per week aimed at supporting lifestyle behavior changes and online training for their primary health care professionals. A total of 58 professionals (clusters) from 16 centers participated in the study and were randomized (1:1:1) to intervention group A (patient SMS text messaging), intervention group B (patient SMS text messaging+health care professional web-based training), or the control group (usual care). Following the 6-month intervention period, we conducted individual qualitative interviews with 8 patients and 7 health care professionals to evaluate their experiences with the intervention in terms of utility, satisfaction, and implementation barriers. Results: In total, 58 health care professionals (clusters) were included, allocated to the control group (n=20, 34\%; 119/365, 32.6\% patients), intervention group A (SMS text messaging only; n=18, 31\%; 106/365, 29\% patients), and intervention group B (SMS text messaging+training; n=20, 34\%; 140/365, 38.4\% patients). The mean age of the patients was 59.79 (SD 9.75) years, and 54.5% (199/365) were female. The results of the intention-to-treat analysis at the 6-month time point showed that intervention A led to a small, nonsignificant reduction in HbA1c levels compared to the control group (β=−0.05, 95\% CI −0.21 to 0.10; P=.50), whereas intervention B showed a similar nonsignificant reduction (β=−0.04, 95\% CI −0.12 to 0.10; P=.56). No substantial differences were observed in the remaining secondary outcomes. Interviews revealed positive feedback from patients, who appreciated the intervention’s dietary messages and their frequency and practicality. Participants suggested enhancements such as increased personalization, links to recipes, and nursing follow-ups. Health care professionals valued the online training but highlighted time constraints, suggesting shorter or blended formats to improve accessibility. Conclusions: While PREDIABETEXT did not significantly improve HbA1c levels, it demonstrated potential benefits for patient engagement. Further studies involving more intensive interventions are warranted to confirm the clinical impact on diabetes prevention. Trial Registration: ClinicalTrials.gov NCT05110625; https://www.clinicaltrials.gov/study/NCT05110625},
  author = {Mira-Martínez, Sofía and Malih, Narges and Angullo-Martínez, Escarlata and Zamanillo-Campos, Rocío and Yañez, Aina M. and Bennasar-Veny, Miquel and Gómez-Juanes, Rocío and Konieczna, Jadwiga and Jiménez, Rafael and Serrano-Ripoll, Maria J. and Fiol deRoque, Maria Antonia and Leiva, Alfonso and Galmes-Panades, Aina M. and Miralles-Xamena, Jerónima and Vidal-Thomàs, Maria Clara and Gómez-Cobo, Cristina and Gervilla, Elena and Oña-Gil, José Iván and Ricci-Cabello, Ignacio},
  journal = {Journal of Medical Internet Research},
  keywords = {grapp-caib},
  month = {oct},
  number = 1,
  pages = {e70981},
  title = {A Multifaceted Digital Intervention for the Prevention of Type 2 Diabetes Mellitus in Primary Care (PREDIABETEXT): Cluster Randomized Trial},
  volume = 27,
  year = 2025
  }
  

  %0 Journal Article
  %1 mira-martinez_multifaceted_2025
  %A Mira-Martínez, Sofía
  %A Malih, Narges
  %A Angullo-Martínez, Escarlata
  %A Zamanillo-Campos, Rocío
  %A Yañez, Aina M.
  %A Bennasar-Veny, Miquel
  %A Gómez-Juanes, Rocío
  %A Konieczna, Jadwiga
  %A Jiménez, Rafael
  %A Serrano-Ripoll, Maria J.
  %A Fiol deRoque, Maria Antonia
  %A Leiva, Alfonso
  %A Galmes-Panades, Aina M.
  %A Miralles-Xamena, Jerónima
  %A Vidal-Thomàs, Maria Clara
  %A Gómez-Cobo, Cristina
  %A Gervilla, Elena
  %A Oña-Gil, José Iván
  %A Ricci-Cabello, Ignacio
  %D 2025
  %J Journal of Medical Internet Research
  %N 1
  %P e70981
  %R 10.2196/70981
  %T A Multifaceted Digital Intervention for the Prevention of Type 2 Diabetes Mellitus in Primary Care (PREDIABETEXT): Cluster Randomized Trial
  %U https://www.jmir.org/2025/1/e70981
  %V 27
  %X Background: The diabetes epidemic continues to surge worldwide, demanding urgent and innovative solutions. Digital health interventions, particularly those targeting behavior change, hold promise due to their affordability and scalability. However, research in this field remains in its early stages. Objective: This study aimed to evaluate the effectiveness of PREDIABETEXT (Prediabetes Text Message Digital Intervention for the Prevention of Type 2 Diabetes Mellitus), a digital health intervention, in reducing glycated hemoglobin (HbA1c) and in improving secondary clinical, physiological, and behavioral outcomes. Methods: We conducted a 6-month, 3-arm, pragmatic cluster randomized clinical trial. We recruited patients with prediabetes (HbA1c levels between 6\% and 6.4\% in the previous 3 months or 2 consecutive fasting plasma glucose measurements of 110-125 mg/dL) registered at primary care centers in the Balearic Islands, Spain. The PREDIABETEXT intervention consisted of 3 personalized SMS text messages per week aimed at supporting lifestyle behavior changes and online training for their primary health care professionals. A total of 58 professionals (clusters) from 16 centers participated in the study and were randomized (1:1:1) to intervention group A (patient SMS text messaging), intervention group B (patient SMS text messaging+health care professional web-based training), or the control group (usual care). Following the 6-month intervention period, we conducted individual qualitative interviews with 8 patients and 7 health care professionals to evaluate their experiences with the intervention in terms of utility, satisfaction, and implementation barriers. Results: In total, 58 health care professionals (clusters) were included, allocated to the control group (n=20, 34\%; 119/365, 32.6\% patients), intervention group A (SMS text messaging only; n=18, 31\%; 106/365, 29\% patients), and intervention group B (SMS text messaging+training; n=20, 34\%; 140/365, 38.4\% patients). The mean age of the patients was 59.79 (SD 9.75) years, and 54.5% (199/365) were female. The results of the intention-to-treat analysis at the 6-month time point showed that intervention A led to a small, nonsignificant reduction in HbA1c levels compared to the control group (β=−0.05, 95\% CI −0.21 to 0.10; P=.50), whereas intervention B showed a similar nonsignificant reduction (β=−0.04, 95\% CI −0.12 to 0.10; P=.56). No substantial differences were observed in the remaining secondary outcomes. Interviews revealed positive feedback from patients, who appreciated the intervention’s dietary messages and their frequency and practicality. Participants suggested enhancements such as increased personalization, links to recipes, and nursing follow-ups. Health care professionals valued the online training but highlighted time constraints, suggesting shorter or blended formats to improve accessibility. Conclusions: While PREDIABETEXT did not significantly improve HbA1c levels, it demonstrated potential benefits for patient engagement. Further studies involving more intensive interventions are warranted to confirm the clinical impact on diabetes prevention. Trial Registration: ClinicalTrials.gov NCT05110625; https://www.clinicaltrials.gov/study/NCT05110625
  

• 
  Determinants of Atherogenic Dyslipidemia and Lipid Ratios: Associations with Sociodemographic Profile, Lifestyle, and Social Isolation in Spanish Workers. Riutord-Sbert, Pere; Tárraga López, Pedro Juan; López-González, Ángel Arturo; Coll Campayo, Irene; Busquets-Cortés, Carla; Ramírez Manent, José Ignacio (2025). 14(19) 7039.

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Background: Atherogenic dyslipidemia is defined by the coexistence of high triglyceride concentrations, low levels of high-density lipoprotein cholesterol (HDL-C), and an excess of small, dense particles of low-density lipoprotein cholesterol (LDL-C). This lipid profile is strongly associated with an increased burden of cardiovascular disease and represents a leading cause of global morbidity and mortality. To better capture this risk, composite lipid ratios—including total cholesterol to HDL-C (TC/HDL-C), LDL-C to HDL-C (LDL-C/HDL-C), triglycerides to HDL-C (TG/HDL-C), and the atherogenic dyslipidemia index (AD)—have emerged as robust markers of cardiometabolic health, frequently demonstrating superior predictive capacity compared with isolated lipid measures. Despite extensive evidence linking these ratios to cardiovascular disease, few large-scale studies have examined their association with sociodemographic characteristics, lifestyle behaviors, and social isolation in working populations. Methods: We conducted a cross-sectional analysis of a large occupational cohort of Spanish workers evaluated between January 2021 and December 2024. Anthropometric, biochemical, and sociodemographic data were collected through standardized clinical protocols. Indices of atherogenic risk—namely the ratios TC/HDL-C, LDL-C/HDL-C, TG/HDL-C, and the atherogenic dyslipidemia index (AD)—were derived from fasting lipid measurements. The assessment of lifestyle factors included tobacco use, physical activity evaluated through the International Physical Activity Questionnaire (IPAQ), adherence to the Mediterranean dietary pattern using the MEDAS questionnaire, and perceived social isolation measured by the Lubben Social Network Scale. Socioeconomic classification was established following the criteria proposed by the Spanish Society of Epidemiology. Logistic regression models were fitted to identify factors independently associated with moderate-to-high risk for each lipid indicator, adjusting for potential confounders. Results: A total of 117,298 workers (71,384 men and 45,914 women) were included. Men showed significantly higher odds of elevated TG/HDL-C (OR 4.22, 95\% CI 3.70–4.75) and AD (OR 2.95, 95\% CI 2.70–3.21) compared with women, whereas LDL-C/HDL-C ratios were lower (OR 0.86, 95\% CI 0.83–0.89). Advancing age was positively associated with all lipid ratios, with the highest risk observed in participants aged 60–69 years. Lower social class, smoking, physical inactivity, poor adherence to the Mediterranean diet, and low social isolation scores were consistently linked to higher atherogenic risk. Physical inactivity showed the strongest associations across all indicators, with ORs ranging from 3.54 for TC/HDL-C to 7.12 for AD. Conclusions: Atherogenic dyslipidemia and elevated lipid ratios are strongly associated with male sex, older age, lower socioeconomic status, unhealthy lifestyle behaviors, and reduced social integration among Spanish workers. These findings highlight the importance of workplace-based cardiovascular risk screening and targeted prevention strategies, particularly in high-risk subgroups. Interventions to promote physical activity, healthy dietary patterns, and social connectedness may contribute to lowering atherogenic risk in occupational settings.

  @article{riutord-sbert_determinants_2025,
  abstract = {Background: Atherogenic dyslipidemia is defined by the coexistence of high triglyceride concentrations, low levels of high-density lipoprotein cholesterol (HDL-C), and an excess of small, dense particles of low-density lipoprotein cholesterol (LDL-C). This lipid profile is strongly associated with an increased burden of cardiovascular disease and represents a leading cause of global morbidity and mortality. To better capture this risk, composite lipid ratios—including total cholesterol to HDL-C (TC/HDL-C), LDL-C to HDL-C (LDL-C/HDL-C), triglycerides to HDL-C (TG/HDL-C), and the atherogenic dyslipidemia index (AD)—have emerged as robust markers of cardiometabolic health, frequently demonstrating superior predictive capacity compared with isolated lipid measures. Despite extensive evidence linking these ratios to cardiovascular disease, few large-scale studies have examined their association with sociodemographic characteristics, lifestyle behaviors, and social isolation in working populations. Methods: We conducted a cross-sectional analysis of a large occupational cohort of Spanish workers evaluated between January 2021 and December 2024. Anthropometric, biochemical, and sociodemographic data were collected through standardized clinical protocols. Indices of atherogenic risk—namely the ratios TC/HDL-C, LDL-C/HDL-C, TG/HDL-C, and the atherogenic dyslipidemia index (AD)—were derived from fasting lipid measurements. The assessment of lifestyle factors included tobacco use, physical activity evaluated through the International Physical Activity Questionnaire (IPAQ), adherence to the Mediterranean dietary pattern using the MEDAS questionnaire, and perceived social isolation measured by the Lubben Social Network Scale. Socioeconomic classification was established following the criteria proposed by the Spanish Society of Epidemiology. Logistic regression models were fitted to identify factors independently associated with moderate-to-high risk for each lipid indicator, adjusting for potential confounders. Results: A total of 117,298 workers (71,384 men and 45,914 women) were included. Men showed significantly higher odds of elevated TG/HDL-C (OR 4.22, 95\% CI 3.70–4.75) and AD (OR 2.95, 95\% CI 2.70–3.21) compared with women, whereas LDL-C/HDL-C ratios were lower (OR 0.86, 95\% CI 0.83–0.89). Advancing age was positively associated with all lipid ratios, with the highest risk observed in participants aged 60–69 years. Lower social class, smoking, physical inactivity, poor adherence to the Mediterranean diet, and low social isolation scores were consistently linked to higher atherogenic risk. Physical inactivity showed the strongest associations across all indicators, with ORs ranging from 3.54 for TC/HDL-C to 7.12 for AD. Conclusions: Atherogenic dyslipidemia and elevated lipid ratios are strongly associated with male sex, older age, lower socioeconomic status, unhealthy lifestyle behaviors, and reduced social integration among Spanish workers. These findings highlight the importance of workplace-based cardiovascular risk screening and targeted prevention strategies, particularly in high-risk subgroups. Interventions to promote physical activity, healthy dietary patterns, and social connectedness may contribute to lowering atherogenic risk in occupational settings.},
  author = {Riutord-Sbert, Pere and Tárraga López, Pedro Juan and López-González, Ángel Arturo and Coll Campayo, Irene and Busquets-Cortés, Carla and Ramírez Manent, José Ignacio},
  journal = {Journal of Clinical Medicine},
  keywords = {grapp-caib},
  month = {jan},
  number = 19,
  pages = 7039,
  title = {Determinants of Atherogenic Dyslipidemia and Lipid Ratios: Associations with Sociodemographic Profile, Lifestyle, and Social Isolation in Spanish Workers},
  volume = 14,
  year = 2025
  }
  

  %0 Journal Article
  %1 riutord-sbert_determinants_2025
  %A Riutord-Sbert, Pere
  %A Tárraga López, Pedro Juan
  %A López-González, Ángel Arturo
  %A Coll Campayo, Irene
  %A Busquets-Cortés, Carla
  %A Ramírez Manent, José Ignacio
  %D 2025
  %J Journal of Clinical Medicine
  %N 19
  %P 7039
  %R 10.3390/jcm14197039
  %T Determinants of Atherogenic Dyslipidemia and Lipid Ratios: Associations with Sociodemographic Profile, Lifestyle, and Social Isolation in Spanish Workers
  %U https://www.mdpi.com/2077-0383/14/19/7039
  %V 14
  %X Background: Atherogenic dyslipidemia is defined by the coexistence of high triglyceride concentrations, low levels of high-density lipoprotein cholesterol (HDL-C), and an excess of small, dense particles of low-density lipoprotein cholesterol (LDL-C). This lipid profile is strongly associated with an increased burden of cardiovascular disease and represents a leading cause of global morbidity and mortality. To better capture this risk, composite lipid ratios—including total cholesterol to HDL-C (TC/HDL-C), LDL-C to HDL-C (LDL-C/HDL-C), triglycerides to HDL-C (TG/HDL-C), and the atherogenic dyslipidemia index (AD)—have emerged as robust markers of cardiometabolic health, frequently demonstrating superior predictive capacity compared with isolated lipid measures. Despite extensive evidence linking these ratios to cardiovascular disease, few large-scale studies have examined their association with sociodemographic characteristics, lifestyle behaviors, and social isolation in working populations. Methods: We conducted a cross-sectional analysis of a large occupational cohort of Spanish workers evaluated between January 2021 and December 2024. Anthropometric, biochemical, and sociodemographic data were collected through standardized clinical protocols. Indices of atherogenic risk—namely the ratios TC/HDL-C, LDL-C/HDL-C, TG/HDL-C, and the atherogenic dyslipidemia index (AD)—were derived from fasting lipid measurements. The assessment of lifestyle factors included tobacco use, physical activity evaluated through the International Physical Activity Questionnaire (IPAQ), adherence to the Mediterranean dietary pattern using the MEDAS questionnaire, and perceived social isolation measured by the Lubben Social Network Scale. Socioeconomic classification was established following the criteria proposed by the Spanish Society of Epidemiology. Logistic regression models were fitted to identify factors independently associated with moderate-to-high risk for each lipid indicator, adjusting for potential confounders. Results: A total of 117,298 workers (71,384 men and 45,914 women) were included. Men showed significantly higher odds of elevated TG/HDL-C (OR 4.22, 95\% CI 3.70–4.75) and AD (OR 2.95, 95\% CI 2.70–3.21) compared with women, whereas LDL-C/HDL-C ratios were lower (OR 0.86, 95\% CI 0.83–0.89). Advancing age was positively associated with all lipid ratios, with the highest risk observed in participants aged 60–69 years. Lower social class, smoking, physical inactivity, poor adherence to the Mediterranean diet, and low social isolation scores were consistently linked to higher atherogenic risk. Physical inactivity showed the strongest associations across all indicators, with ORs ranging from 3.54 for TC/HDL-C to 7.12 for AD. Conclusions: Atherogenic dyslipidemia and elevated lipid ratios are strongly associated with male sex, older age, lower socioeconomic status, unhealthy lifestyle behaviors, and reduced social integration among Spanish workers. These findings highlight the importance of workplace-based cardiovascular risk screening and targeted prevention strategies, particularly in high-risk subgroups. Interventions to promote physical activity, healthy dietary patterns, and social connectedness may contribute to lowering atherogenic risk in occupational settings.
  

• 
  Health-related quality of life and lifestyle in long-term survivors of colorectal cancer and a matched non-cancer reference group. Esteva, Magdalena; March, Sebastià; Martín-Rabadan, María; Torres-Solera, Elena; Ripoll, Joana (2025). 27(10) 3993–4002.

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Objective To compare the long-term health status of a group of survivors of colorectal cancer (CRC) with a reference group of individuals who did not have cancer. We determined the physical, mental, and general health-related quality of life (HRQoL); overall morbidities and CRC-specific morbidities related to the delayed effects of treatment; and maintenance of a healthy lifestyle in these two groups. Methods This descriptive cross-sectional study was conducted from 2016 to 2019 in the Balearic Islands (Spain). CRC patients who were diagnosed from 2011 to 2012 and survived at least 5 years were randomly selected from the Majorca and Eivissa-Formentera cancer registries. The reference group consisted of individuals matched for gender and age who had no history of cancer. Results We examined 201 CRC survivors and 199 matched individuals without cancer. The global analysis showed that the two groups had similar scores in the physical and mental components of the Short Form 12 (SF-12) HRQoL scale and in general health status. The CRC survivors had significantly higher prevalence of general comorbidity and CRC-specific comorbidity. Multivariate analyses and calculation of odds ratios (ORs) showed that the groups had similar physical HRQoL (Model 1, OR: 1.01, 95\% CI: 0.99–1.03), mental HRQoL (Model 2, OR: 0.99, 95\% CI: 0.66–1.01), and general HRQoL (Model 3, OR: 1.67, 95\% CI: 0.39–1.13). However, the long-term CRC survivors had significantly greater ORs for an increased overall comorbidity index, number of CRC-specific comorbidity, and obesity in all three models (P \textless 0.05). Conclusions The CRC survivors and individuals without cancer had similar HRQoL, suggesting that CRC survivors do not need additional services that aim to improve HRQoL. Nonetheless, health care providers should be pro-active when caring for CRC survivors, because they are more likely to present with certain comorbidity and less likely to follow a healthy lifestyle.

  @article{esteva_health-related_2025,
  abstract = {Objective To compare the long-term health status of a group of survivors of colorectal cancer (CRC) with a reference group of individuals who did not have cancer. We determined the physical, mental, and general health-related quality of life (HRQoL); overall morbidities and CRC-specific morbidities related to the delayed effects of treatment; and maintenance of a healthy lifestyle in these two groups. Methods This descriptive cross-sectional study was conducted from 2016 to 2019 in the Balearic Islands (Spain). CRC patients who were diagnosed from 2011 to 2012 and survived at least 5 years were randomly selected from the Majorca and Eivissa-Formentera cancer registries. The reference group consisted of individuals matched for gender and age who had no history of cancer. Results We examined 201 CRC survivors and 199 matched individuals without cancer. The global analysis showed that the two groups had similar scores in the physical and mental components of the Short Form 12 (SF-12) HRQoL scale and in general health status. The CRC survivors had significantly higher prevalence of general comorbidity and CRC-specific comorbidity. Multivariate analyses and calculation of odds ratios (ORs) showed that the groups had similar physical HRQoL (Model 1, OR: 1.01, 95\% CI: 0.99–1.03), mental HRQoL (Model 2, OR: 0.99, 95\% CI: 0.66–1.01), and general HRQoL (Model 3, OR: 1.67, 95\% CI: 0.39–1.13). However, the long-term CRC survivors had significantly greater ORs for an increased overall comorbidity index, number of CRC-specific comorbidity, and obesity in all three models (P \textless 0.05). Conclusions The CRC survivors and individuals without cancer had similar HRQoL, suggesting that CRC survivors do not need additional services that aim to improve HRQoL. Nonetheless, health care providers should be pro-active when caring for CRC survivors, because they are more likely to present with certain comorbidity and less likely to follow a healthy lifestyle.},
  author = {Esteva, Magdalena and March, Sebastià and Martín-Rabadan, María and Torres-Solera, Elena and Ripoll, Joana},
  journal = {Clinical & Translational Oncology},
  keywords = {grapp-caib},
  number = 10,
  pages = {3993--4002},
  title = {Health-related quality of life and lifestyle in long-term survivors of colorectal cancer and a matched non-cancer reference group},
  volume = 27,
  year = 2025
  }
  

  %0 Journal Article
  %1 esteva_health-related_2025
  %A Esteva, Magdalena
  %A March, Sebastià
  %A Martín-Rabadan, María
  %A Torres-Solera, Elena
  %A Ripoll, Joana
  %D 2025
  %J Clinical & Translational Oncology
  %N 10
  %P 3993--4002
  %R 10.1007/s12094-025-03930-0
  %T Health-related quality of life and lifestyle in long-term survivors of colorectal cancer and a matched non-cancer reference group
  %U https://pmc.ncbi.nlm.nih.gov/articles/PMC12460565/
  %V 27
  %X Objective To compare the long-term health status of a group of survivors of colorectal cancer (CRC) with a reference group of individuals who did not have cancer. We determined the physical, mental, and general health-related quality of life (HRQoL); overall morbidities and CRC-specific morbidities related to the delayed effects of treatment; and maintenance of a healthy lifestyle in these two groups. Methods This descriptive cross-sectional study was conducted from 2016 to 2019 in the Balearic Islands (Spain). CRC patients who were diagnosed from 2011 to 2012 and survived at least 5 years were randomly selected from the Majorca and Eivissa-Formentera cancer registries. The reference group consisted of individuals matched for gender and age who had no history of cancer. Results We examined 201 CRC survivors and 199 matched individuals without cancer. The global analysis showed that the two groups had similar scores in the physical and mental components of the Short Form 12 (SF-12) HRQoL scale and in general health status. The CRC survivors had significantly higher prevalence of general comorbidity and CRC-specific comorbidity. Multivariate analyses and calculation of odds ratios (ORs) showed that the groups had similar physical HRQoL (Model 1, OR: 1.01, 95\% CI: 0.99–1.03), mental HRQoL (Model 2, OR: 0.99, 95\% CI: 0.66–1.01), and general HRQoL (Model 3, OR: 1.67, 95\% CI: 0.39–1.13). However, the long-term CRC survivors had significantly greater ORs for an increased overall comorbidity index, number of CRC-specific comorbidity, and obesity in all three models (P \textless 0.05). Conclusions The CRC survivors and individuals without cancer had similar HRQoL, suggesting that CRC survivors do not need additional services that aim to improve HRQoL. Nonetheless, health care providers should be pro-active when caring for CRC survivors, because they are more likely to present with certain comorbidity and less likely to follow a healthy lifestyle.
  

• 
  Sociodemographic, Lifestyle, and Quality of Life Determinants of Atherogenic Risk: A Cross-Sectional Study in a Large Cohort of Spanish Workers. Marzoa Jansana, María Dolores; Tárraga López, Pedro Juan; Guarro Miquel, Juan José; López-González, Ángel Arturo; Riutord Sbert, Pere; Busquets-Cortés, Carla; Ramírez-Manent, José Ignacio (2025). 14(19) 6876.

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Background: Atherosclerosis is a leading cause of cardiovascular morbidity and mortality worldwide. Although lipid-derived atherogenic indices are widely used for cardiovascular risk assessment, their relationship with sociodemographic factors, lifestyle behaviors, and health-related quality of life (HRQoL) in occupational populations remains insufficiently explored. This study aimed to evaluate the association between atherogenic risk, measured by total cholesterol/high-density lipoprotein cholesterol (TC/HDL-c), low-density lipoprotein cholesterol/high-density lipoprotein cholesterol (LDL-c/HDL-c), triglyceride/high-density lipoprotein cholesterol (TG/HDL-c), and atherogenic dyslipidemia (AD) and sociodemographic, lifestyle, and HRQoL variables in a large cohort of Spanish workers. Methods: We conducted a cross-sectional analysis of 100,014 Spanish workers aged 18–69 years, of whom 39.9% were women, with a mean age of 38.2 years (SD 10.2 or IQR) and 38.9 years (SD 10.3 or IQR) for men, during the health examinations carried out between 2021 and 2024. Sociodemographic variables included sex, age group, and occupational social class. Lifestyle factors comprised smoking status, adherence to the Mediterranean diet (MEDAS score), and physical activity (IPAQ categories). HRQoL was assessed using the 12-item Short Form Survey (SF-12), stratified into good vs. poor categories. Logistic regression models were applied to estimate odds ratios (OR) and 95% confidence intervals (CI) for moderate-to-high atherogenic risk across indices, adjusting for potential confounders. Results: Men exhibited a lower likelihood of moderate-to-high TC/HDL-c and LDL-c/HDL-c but a markedly higher probability of elevated TG/HDL-c and AD compared to women (OR range: 0.42–3.67, p \textless 0.001). A clear age-related gradient was observed across all indices, with participants aged 60–69 showing the highest risk (OR range: 2.28–7.84, p \textless 0.001). Lower social class, smoking, physical inactivity, poor diet, and poor SF-12 scores were significantly associated with increased atherogenic risk, with physical inactivity (OR up to 8.61) and poor diet (OR up to 4.98) emerging as the strongest predictors. Conclusions: Atherogenic risk in this large working cohort is strongly influenced by both traditional cardiovascular risk factors and HRQoL. Integrating lifestyle modification and quality-of-life improvement strategies into workplace health programs could substantially reduce the atherogenic burden. Longitudinal research is needed to confirm these associations and guide targeted interventions.

  @article{marzoa_jansana_sociodemographic_2025,
  abstract = {Background: Atherosclerosis is a leading cause of cardiovascular morbidity and mortality worldwide. Although lipid-derived atherogenic indices are widely used for cardiovascular risk assessment, their relationship with sociodemographic factors, lifestyle behaviors, and health-related quality of life (HRQoL) in occupational populations remains insufficiently explored. This study aimed to evaluate the association between atherogenic risk, measured by total cholesterol/high-density lipoprotein cholesterol (TC/HDL-c), low-density lipoprotein cholesterol/high-density lipoprotein cholesterol (LDL-c/HDL-c), triglyceride/high-density lipoprotein cholesterol (TG/HDL-c), and atherogenic dyslipidemia (AD) and sociodemographic, lifestyle, and HRQoL variables in a large cohort of Spanish workers. Methods: We conducted a cross-sectional analysis of 100,014 Spanish workers aged 18–69 years, of whom 39.9% were women, with a mean age of 38.2 years (SD 10.2 or IQR) and 38.9 years (SD 10.3 or IQR) for men, during the health examinations carried out between 2021 and 2024. Sociodemographic variables included sex, age group, and occupational social class. Lifestyle factors comprised smoking status, adherence to the Mediterranean diet (MEDAS score), and physical activity (IPAQ categories). HRQoL was assessed using the 12-item Short Form Survey (SF-12), stratified into good vs. poor categories. Logistic regression models were applied to estimate odds ratios (OR) and 95% confidence intervals (CI) for moderate-to-high atherogenic risk across indices, adjusting for potential confounders. Results: Men exhibited a lower likelihood of moderate-to-high TC/HDL-c and LDL-c/HDL-c but a markedly higher probability of elevated TG/HDL-c and AD compared to women (OR range: 0.42–3.67, p \textless 0.001). A clear age-related gradient was observed across all indices, with participants aged 60–69 showing the highest risk (OR range: 2.28–7.84, p \textless 0.001). Lower social class, smoking, physical inactivity, poor diet, and poor SF-12 scores were significantly associated with increased atherogenic risk, with physical inactivity (OR up to 8.61) and poor diet (OR up to 4.98) emerging as the strongest predictors. Conclusions: Atherogenic risk in this large working cohort is strongly influenced by both traditional cardiovascular risk factors and HRQoL. Integrating lifestyle modification and quality-of-life improvement strategies into workplace health programs could substantially reduce the atherogenic burden. Longitudinal research is needed to confirm these associations and guide targeted interventions.},
  author = {Marzoa Jansana, María Dolores and Tárraga López, Pedro Juan and Guarro Miquel, Juan José and López-González, Ángel Arturo and Riutord Sbert, Pere and Busquets-Cortés, Carla and Ramírez-Manent, José Ignacio},
  journal = {Journal of Clinical Medicine},
  keywords = {grapp-caib},
  month = {sep},
  number = 19,
  pages = 6876,
  title = {Sociodemographic, Lifestyle, and Quality of Life Determinants of Atherogenic Risk: A Cross-Sectional Study in a Large Cohort of Spanish Workers},
  volume = 14,
  year = 2025
  }
  

  %0 Journal Article
  %1 marzoa_jansana_sociodemographic_2025
  %A Marzoa Jansana, María Dolores
  %A Tárraga López, Pedro Juan
  %A Guarro Miquel, Juan José
  %A López-González, Ángel Arturo
  %A Riutord Sbert, Pere
  %A Busquets-Cortés, Carla
  %A Ramírez-Manent, José Ignacio
  %D 2025
  %J Journal of Clinical Medicine
  %N 19
  %P 6876
  %R 10.3390/jcm14196876
  %T Sociodemographic, Lifestyle, and Quality of Life Determinants of Atherogenic Risk: A Cross-Sectional Study in a Large Cohort of Spanish Workers
  %U https://pmc.ncbi.nlm.nih.gov/articles/PMC12524400/
  %V 14
  %X Background: Atherosclerosis is a leading cause of cardiovascular morbidity and mortality worldwide. Although lipid-derived atherogenic indices are widely used for cardiovascular risk assessment, their relationship with sociodemographic factors, lifestyle behaviors, and health-related quality of life (HRQoL) in occupational populations remains insufficiently explored. This study aimed to evaluate the association between atherogenic risk, measured by total cholesterol/high-density lipoprotein cholesterol (TC/HDL-c), low-density lipoprotein cholesterol/high-density lipoprotein cholesterol (LDL-c/HDL-c), triglyceride/high-density lipoprotein cholesterol (TG/HDL-c), and atherogenic dyslipidemia (AD) and sociodemographic, lifestyle, and HRQoL variables in a large cohort of Spanish workers. Methods: We conducted a cross-sectional analysis of 100,014 Spanish workers aged 18–69 years, of whom 39.9% were women, with a mean age of 38.2 years (SD 10.2 or IQR) and 38.9 years (SD 10.3 or IQR) for men, during the health examinations carried out between 2021 and 2024. Sociodemographic variables included sex, age group, and occupational social class. Lifestyle factors comprised smoking status, adherence to the Mediterranean diet (MEDAS score), and physical activity (IPAQ categories). HRQoL was assessed using the 12-item Short Form Survey (SF-12), stratified into good vs. poor categories. Logistic regression models were applied to estimate odds ratios (OR) and 95% confidence intervals (CI) for moderate-to-high atherogenic risk across indices, adjusting for potential confounders. Results: Men exhibited a lower likelihood of moderate-to-high TC/HDL-c and LDL-c/HDL-c but a markedly higher probability of elevated TG/HDL-c and AD compared to women (OR range: 0.42–3.67, p \textless 0.001). A clear age-related gradient was observed across all indices, with participants aged 60–69 showing the highest risk (OR range: 2.28–7.84, p \textless 0.001). Lower social class, smoking, physical inactivity, poor diet, and poor SF-12 scores were significantly associated with increased atherogenic risk, with physical inactivity (OR up to 8.61) and poor diet (OR up to 4.98) emerging as the strongest predictors. Conclusions: Atherogenic risk in this large working cohort is strongly influenced by both traditional cardiovascular risk factors and HRQoL. Integrating lifestyle modification and quality-of-life improvement strategies into workplace health programs could substantially reduce the atherogenic burden. Longitudinal research is needed to confirm these associations and guide targeted interventions.
  

• 
  Diagnostic Accuracy of Anthropometric and Metabolic Indicators for Predicting MASLD: Evidence from a Large Cohort of Spanish Workers Using FLI and LAP. Guarro Miguel, Juan José; Tárraga López, Pedro Juan; Marzoa Jansana, María Dolores; López-González, Ángel Arturo; Riutord Sbert, Pere; Busquets-Cortés, Carla; Ramirez-Manent, José Ignacio (2025). 13(3) 160.

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Background: Metabolic-dysfunction-associated steatotic liver disease (MASLD) is a major global health concern associated with insulin resistance, metabolic syndrome, and cardiovascular morbidity. Early identification of at-risk individuals through simple, non-invasive methods is essential, particularly in working populations. Objectives: This study aimed to assess and compare the diagnostic accuracy of four widely used anthropometric and metabolic indicators—body mass index (BMI), waist-to-height ratio (WtHR), triglyceride–glucose index (TyG), and waist–triglyceride index (WTI)—in identifying individuals at risk of metabolic-dysfunction-associated steatotic liver disease (MASLD), as determined by the Fatty Liver Index (FLI) and the Lipid Accumulation Product (LAP), within a large sample of Spanish workers. Methods: A cross-sectional analysis was performed on data from 386,924 Spanish employees aged between 18 and 69 years. Standardized anthropometric and laboratory measurements were obtained as part of routine occupational medical examinations conducted from 2021 to 2023. The presence of NAFLD was inferred using two validated surrogate markers: FLI and LAP. Receiver operating characteristic (ROC) curves and area under the curve (AUC) values were used to assess the discriminatory ability of each index, stratified by sex. Results: WTI and TyG demonstrated the highest diagnostic accuracy for both FLI- and LAP-defined NAFLD, with AUC values textgreater0.95 in both sexes. WTI showed the best overall performance, followed closely by TyG. WtHR outperformed BMI but was less accurate than the metabolic indices. Sex-stratified analyses confirmed consistent patterns, with slightly higher AUCs for TyG and WTI in women. BMI consistently yielded the lowest discriminatory performance. Conclusions: WTI and TyG are superior to BMI and WtHR for non-invasive screening of MASLD in occupational settings. Their simplicity, low cost, and strong predictive value support their integration into routine workplace health surveillance. Sex-specific thresholds and prospective validation are warranted to enhance clinical application.

  @article{guarro_miguel_diagnostic_2025,
  abstract = {Background: Metabolic-dysfunction-associated steatotic liver disease (MASLD) is a major global health concern associated with insulin resistance, metabolic syndrome, and cardiovascular morbidity. Early identification of at-risk individuals through simple, non-invasive methods is essential, particularly in working populations. Objectives: This study aimed to assess and compare the diagnostic accuracy of four widely used anthropometric and metabolic indicators—body mass index (BMI), waist-to-height ratio (WtHR), triglyceride–glucose index (TyG), and waist–triglyceride index (WTI)—in identifying individuals at risk of metabolic-dysfunction-associated steatotic liver disease (MASLD), as determined by the Fatty Liver Index (FLI) and the Lipid Accumulation Product (LAP), within a large sample of Spanish workers. Methods: A cross-sectional analysis was performed on data from 386,924 Spanish employees aged between 18 and 69 years. Standardized anthropometric and laboratory measurements were obtained as part of routine occupational medical examinations conducted from 2021 to 2023. The presence of NAFLD was inferred using two validated surrogate markers: FLI and LAP. Receiver operating characteristic (ROC) curves and area under the curve (AUC) values were used to assess the discriminatory ability of each index, stratified by sex. Results: WTI and TyG demonstrated the highest diagnostic accuracy for both FLI- and LAP-defined NAFLD, with AUC values textgreater0.95 in both sexes. WTI showed the best overall performance, followed closely by TyG. WtHR outperformed BMI but was less accurate than the metabolic indices. Sex-stratified analyses confirmed consistent patterns, with slightly higher AUCs for TyG and WTI in women. BMI consistently yielded the lowest discriminatory performance. Conclusions: WTI and TyG are superior to BMI and WtHR for non-invasive screening of MASLD in occupational settings. Their simplicity, low cost, and strong predictive value support their integration into routine workplace health surveillance. Sex-specific thresholds and prospective validation are warranted to enhance clinical application.},
  author = {Guarro Miguel, Juan José and Tárraga López, Pedro Juan and Marzoa Jansana, María Dolores and López-González, Ángel Arturo and Riutord Sbert, Pere and Busquets-Cortés, Carla and Ramirez-Manent, José Ignacio},
  journal = {Medical Sciences},
  keywords = {grapp-caib},
  month = {sep},
  number = 3,
  pages = 160,
  title = {Diagnostic Accuracy of Anthropometric and Metabolic Indicators for Predicting MASLD: Evidence from a Large Cohort of Spanish Workers Using FLI and LAP},
  volume = 13,
  year = 2025
  }
  

  %0 Journal Article
  %1 guarro_miguel_diagnostic_2025
  %A Guarro Miguel, Juan José
  %A Tárraga López, Pedro Juan
  %A Marzoa Jansana, María Dolores
  %A López-González, Ángel Arturo
  %A Riutord Sbert, Pere
  %A Busquets-Cortés, Carla
  %A Ramirez-Manent, José Ignacio
  %D 2025
  %J Medical Sciences
  %N 3
  %P 160
  %R 10.3390/medsci13030160
  %T Diagnostic Accuracy of Anthropometric and Metabolic Indicators for Predicting MASLD: Evidence from a Large Cohort of Spanish Workers Using FLI and LAP
  %U https://www.mdpi.com/2076-3271/13/3/160
  %V 13
  %X Background: Metabolic-dysfunction-associated steatotic liver disease (MASLD) is a major global health concern associated with insulin resistance, metabolic syndrome, and cardiovascular morbidity. Early identification of at-risk individuals through simple, non-invasive methods is essential, particularly in working populations. Objectives: This study aimed to assess and compare the diagnostic accuracy of four widely used anthropometric and metabolic indicators—body mass index (BMI), waist-to-height ratio (WtHR), triglyceride–glucose index (TyG), and waist–triglyceride index (WTI)—in identifying individuals at risk of metabolic-dysfunction-associated steatotic liver disease (MASLD), as determined by the Fatty Liver Index (FLI) and the Lipid Accumulation Product (LAP), within a large sample of Spanish workers. Methods: A cross-sectional analysis was performed on data from 386,924 Spanish employees aged between 18 and 69 years. Standardized anthropometric and laboratory measurements were obtained as part of routine occupational medical examinations conducted from 2021 to 2023. The presence of NAFLD was inferred using two validated surrogate markers: FLI and LAP. Receiver operating characteristic (ROC) curves and area under the curve (AUC) values were used to assess the discriminatory ability of each index, stratified by sex. Results: WTI and TyG demonstrated the highest diagnostic accuracy for both FLI- and LAP-defined NAFLD, with AUC values textgreater0.95 in both sexes. WTI showed the best overall performance, followed closely by TyG. WtHR outperformed BMI but was less accurate than the metabolic indices. Sex-stratified analyses confirmed consistent patterns, with slightly higher AUCs for TyG and WTI in women. BMI consistently yielded the lowest discriminatory performance. Conclusions: WTI and TyG are superior to BMI and WtHR for non-invasive screening of MASLD in occupational settings. Their simplicity, low cost, and strong predictive value support their integration into routine workplace health surveillance. Sex-specific thresholds and prospective validation are warranted to enhance clinical application.
  

• 
  Sociodemographic, Lifestyle, and Social Isolation Correlates of TyG, METS-IR, and SPISE-IR Scores in a Large Spanish Working Population. Riutord-Sbert, Pere; Tárraga López, Pedro Juan; López-González, Ángel Arturo; Coll Campayo, Irene; Busquets-Cortés, Carla; Ramírez Manent, José Ignacio (2025). 13(3) 171.

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Background: Insulin resistance (IR) is a central feature in the pathophysiology of type 2 diabetes and a major determinant of cardiovascular morbidity. While sociodemographic and lifestyle factors are established contributors, the role of social isolation as a potential determinant of IR remains underexplored in working populations. Objectives: To assess the association between sociodemographic variables, lifestyle habits, and social isolation with three validated insulin resistance indexes—Triglyceride–Glucose (TyG), Metabolic Score for Insulin Resistance (METS-IR), and Single Point Insulin Sensitivity Estimator (SPISE-IR)—in a large cohort of Spanish workers. Methods: A cross-sectional study was conducted involving 117,298 workers from occupational health centers across Spain. Sociodemographic data, lifestyle factors (Mediterranean diet adherence, physical activity, and smoking), and social support levels (ENRICHD Social Support Instrument) were recorded. Biochemical and anthropometric parameters were obtained through standardized protocols. Logistic regression models estimated the odds ratios (ORs) and 95% confidence intervals (CIs) for high IR risk across the three indexes, adjusting for potential confounders. Results: Male sex, older age, lower social class, smoking, low Mediterranean diet adherence, physical inactivity, and low social support were independently associated with higher odds of IR in all three indexes. The strongest associations were observed for physical inactivity (OR range 6.21–9.95) and low social support (OR range 1.98–3.76). Although effect sizes varied by index, patterns of association were consistent. Conclusions: Sociodemographic, lifestyle, and psychosocial factors, including social isolation, are strongly associated with insulin resistance in working populations. Integrating social support assessment into occupational health strategies may enhance early detection and prevention of IR and related cardiometabolic diseases.

  @article{riutord-sbert_sociodemographic_2025,
  abstract = {Background: Insulin resistance (IR) is a central feature in the pathophysiology of type 2 diabetes and a major determinant of cardiovascular morbidity. While sociodemographic and lifestyle factors are established contributors, the role of social isolation as a potential determinant of IR remains underexplored in working populations. Objectives: To assess the association between sociodemographic variables, lifestyle habits, and social isolation with three validated insulin resistance indexes—Triglyceride–Glucose (TyG), Metabolic Score for Insulin Resistance (METS-IR), and Single Point Insulin Sensitivity Estimator (SPISE-IR)—in a large cohort of Spanish workers. Methods: A cross-sectional study was conducted involving 117,298 workers from occupational health centers across Spain. Sociodemographic data, lifestyle factors (Mediterranean diet adherence, physical activity, and smoking), and social support levels (ENRICHD Social Support Instrument) were recorded. Biochemical and anthropometric parameters were obtained through standardized protocols. Logistic regression models estimated the odds ratios (ORs) and 95% confidence intervals (CIs) for high IR risk across the three indexes, adjusting for potential confounders. Results: Male sex, older age, lower social class, smoking, low Mediterranean diet adherence, physical inactivity, and low social support were independently associated with higher odds of IR in all three indexes. The strongest associations were observed for physical inactivity (OR range 6.21–9.95) and low social support (OR range 1.98–3.76). Although effect sizes varied by index, patterns of association were consistent. Conclusions: Sociodemographic, lifestyle, and psychosocial factors, including social isolation, are strongly associated with insulin resistance in working populations. Integrating social support assessment into occupational health strategies may enhance early detection and prevention of IR and related cardiometabolic diseases.},
  author = {Riutord-Sbert, Pere and Tárraga López, Pedro Juan and López-González, Ángel Arturo and Coll Campayo, Irene and Busquets-Cortés, Carla and Ramírez Manent, José Ignacio},
  journal = {Medical Sciences},
  keywords = {grapp-caib},
  month = {sep},
  number = 3,
  pages = 171,
  title = {Sociodemographic, Lifestyle, and Social Isolation Correlates of TyG, METS-IR, and SPISE-IR Scores in a Large Spanish Working Population},
  volume = 13,
  year = 2025
  }
  

  %0 Journal Article
  %1 riutord-sbert_sociodemographic_2025
  %A Riutord-Sbert, Pere
  %A Tárraga López, Pedro Juan
  %A López-González, Ángel Arturo
  %A Coll Campayo, Irene
  %A Busquets-Cortés, Carla
  %A Ramírez Manent, José Ignacio
  %D 2025
  %J Medical Sciences
  %N 3
  %P 171
  %R 10.3390/medsci13030171
  %T Sociodemographic, Lifestyle, and Social Isolation Correlates of TyG, METS-IR, and SPISE-IR Scores in a Large Spanish Working Population
  %U https://pmc.ncbi.nlm.nih.gov/articles/PMC12452687/
  %V 13
  %X Background: Insulin resistance (IR) is a central feature in the pathophysiology of type 2 diabetes and a major determinant of cardiovascular morbidity. While sociodemographic and lifestyle factors are established contributors, the role of social isolation as a potential determinant of IR remains underexplored in working populations. Objectives: To assess the association between sociodemographic variables, lifestyle habits, and social isolation with three validated insulin resistance indexes—Triglyceride–Glucose (TyG), Metabolic Score for Insulin Resistance (METS-IR), and Single Point Insulin Sensitivity Estimator (SPISE-IR)—in a large cohort of Spanish workers. Methods: A cross-sectional study was conducted involving 117,298 workers from occupational health centers across Spain. Sociodemographic data, lifestyle factors (Mediterranean diet adherence, physical activity, and smoking), and social support levels (ENRICHD Social Support Instrument) were recorded. Biochemical and anthropometric parameters were obtained through standardized protocols. Logistic regression models estimated the odds ratios (ORs) and 95% confidence intervals (CIs) for high IR risk across the three indexes, adjusting for potential confounders. Results: Male sex, older age, lower social class, smoking, low Mediterranean diet adherence, physical inactivity, and low social support were independently associated with higher odds of IR in all three indexes. The strongest associations were observed for physical inactivity (OR range 6.21–9.95) and low social support (OR range 1.98–3.76). Although effect sizes varied by index, patterns of association were consistent. Conclusions: Sociodemographic, lifestyle, and psychosocial factors, including social isolation, are strongly associated with insulin resistance in working populations. Integrating social support assessment into occupational health strategies may enhance early detection and prevention of IR and related cardiometabolic diseases.
  

• 
  General population-based lung function trajectories over the life course: an accelerated cohort study. Garcia-Aymerich, Judith; de las Heras, Martí; Carsin, Anne-Elie; Accordini, Simone; Agustí, Alvar; Bui, Dinh; Dharmage, Shyamali C; Dodd, James W; Eze, Ikenna; Gehring, Ulrike; Gislason, Thorarinn; Granell, Raquel; Imboden, Medea; Íñiguez, Carmen; Jeong, Ayoung; Koch, Sarah; Koppelman, Gerard H; Leynaert, Bénédicte; Melén, Erik; Perret, Jennifer; Probst-Hensch, Nicole; Santa-Marina, Loreto; Torrent, Maties; Vicendese, Don; Vonk, Judith M; de Vries, Maaike; Walters, E Haydn; Wang, Gang; Wedzicha, Jadwiga A; Jarvis, Deborah; Faner, Rosa (2025). 13(7) 611–622.

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Background Lung function is a key determinant of health, but current knowledge on lung function growth and decline over the life course is based on fragmented, potentially biased data. We aimed to empirically derive general population-based life course lung function trajectories, and to identify breakpoints and plateaus. Methods We created an accelerated cohort by pooling data from eight general population-based child and adult cohort studies from Europe and Australia. We included all participants with information on lung function, smoking status, BMI, and asthma diagnosis status from at least two visits. We used cross-classified three-level linear mixed models to derive sex-specific life course trajectories of FEV1, forced vital capacity (FVC), and FEV1/FVC ratio based on observations at ages 4–80 years, and Bayesian time-series decomposition to identify breakpoints and plateaus. We repeated sex-specific analyses with separate stratification for asthma status (never had asthma vs persistent asthma, where persistent was defined as the risk factor being present at all participant visits) and smoking status (never smoker vs persistent smoker). Findings The accelerated cohort included 30 438 participants born between 1901 and 2006 (15 703 [51·6\%] female and 14 735 [48·4\%] male; mean age 26 [SD 16] years), who provided a total of 87 666 observations (range 2–8 observations per participant). In female participants, FEV1 increased non-linearly in two phases, at a mean of 234 (95\% CI 223 to 245) mL/year until age 13 (95\% credible interval [CrI] 12 to 15) years, then at 99 (76 to 122) mL/year until a peak at age 20 (18 to 22) years, and subsequently decreased throughout the rest of adulthood (−26 [−27 to −25] mL/year). In male participants, the pattern was similar, with an increase in FEV1 of 271 (263 to 280) mL/year until age 16 (14 to 18) years, which slowed to 108 (93 to 124) mL/year until reaching a maximum at age 23 (21 to 25) years, decreasing thereafter (−38 [−39 to −37] mL/year), representing a later peak than in female participants. In female participants, FVC increased non-linearly in two phases, at 232 (95\% CI 222 to 243) mL/year until age 14 (95\% CrI 12 to 15) years, then at 77 (59 to 94) mL/year until peaking at age 20 (19 to 22) years, after which it decreased throughout the rest of adulthood (−26 [−27 to −25] mL/year). In male participants, FVC also increased in two phases, at 326 (315 to 337) mL/year until age 15 (13 to 17) years, then at 156 (144 to 168) mL/year until a peak at 23 (19 to 30) years, and subsequently declined in two phases (−22 [−29 to −14] mL/year until age 42 [38 to 50] years, then −36 [−38 to −34] mL/year thereafter). No plateau after the peak was observed for either lung function parameter in both sexes. FEV1/FVC ratio decreased throughout life from the starting age of 4 years in both sexes with some distinct patterns. Stratified analysis showed that persistent asthma (vs never had asthma) was related to an earlier FEV1 peak, lower FEV1 throughout adulthood, and lower FEV1/FVC ratio across the life course in both sexes. Persistent smoking (vs never smoking) was related to an accelerated decrease in FEV1 and FEV1/FVC ratio during adulthood in both sexes. No statistically significant plateau was observed in any lung function parameter across the strata of asthma or smoking status. Interpretation In both sexes, FEV1 and FVC increased in two phases, with a fast increase until around age 13–16 years, and then a slower increase until a peak. Neither parameter showed a plateau phase after the peak, and decreases started earlier than previously described. FEV1/FVC ratio decreased throughout life. These observations provide an essential, but previously unavailable, framework to assess and monitor lung health over the life course. Funding EU Horizon 2020, Wellcome, European Respiratory Society, AstraZeneca, Chiesi, GSK, Menarini Group, and Sanofi.

  @article{garcia-aymerich_general_2025,
  abstract = {Background Lung function is a key determinant of health, but current knowledge on lung function growth and decline over the life course is based on fragmented, potentially biased data. We aimed to empirically derive general population-based life course lung function trajectories, and to identify breakpoints and plateaus. Methods We created an accelerated cohort by pooling data from eight general population-based child and adult cohort studies from Europe and Australia. We included all participants with information on lung function, smoking status, BMI, and asthma diagnosis status from at least two visits. We used cross-classified three-level linear mixed models to derive sex-specific life course trajectories of FEV1, forced vital capacity (FVC), and FEV1/FVC ratio based on observations at ages 4–80 years, and Bayesian time-series decomposition to identify breakpoints and plateaus. We repeated sex-specific analyses with separate stratification for asthma status (never had asthma vs persistent asthma, where persistent was defined as the risk factor being present at all participant visits) and smoking status (never smoker vs persistent smoker). Findings The accelerated cohort included 30 438 participants born between 1901 and 2006 (15 703 [51·6\%] female and 14 735 [48·4\%] male; mean age 26 [SD 16] years), who provided a total of 87 666 observations (range 2–8 observations per participant). In female participants, FEV1 increased non-linearly in two phases, at a mean of 234 (95\% CI 223 to 245) mL/year until age 13 (95\% credible interval [CrI] 12 to 15) years, then at 99 (76 to 122) mL/year until a peak at age 20 (18 to 22) years, and subsequently decreased throughout the rest of adulthood (−26 [−27 to −25] mL/year). In male participants, the pattern was similar, with an increase in FEV1 of 271 (263 to 280) mL/year until age 16 (14 to 18) years, which slowed to 108 (93 to 124) mL/year until reaching a maximum at age 23 (21 to 25) years, decreasing thereafter (−38 [−39 to −37] mL/year), representing a later peak than in female participants. In female participants, FVC increased non-linearly in two phases, at 232 (95\% CI 222 to 243) mL/year until age 14 (95\% CrI 12 to 15) years, then at 77 (59 to 94) mL/year until peaking at age 20 (19 to 22) years, after which it decreased throughout the rest of adulthood (−26 [−27 to −25] mL/year). In male participants, FVC also increased in two phases, at 326 (315 to 337) mL/year until age 15 (13 to 17) years, then at 156 (144 to 168) mL/year until a peak at 23 (19 to 30) years, and subsequently declined in two phases (−22 [−29 to −14] mL/year until age 42 [38 to 50] years, then −36 [−38 to −34] mL/year thereafter). No plateau after the peak was observed for either lung function parameter in both sexes. FEV1/FVC ratio decreased throughout life from the starting age of 4 years in both sexes with some distinct patterns. Stratified analysis showed that persistent asthma (vs never had asthma) was related to an earlier FEV1 peak, lower FEV1 throughout adulthood, and lower FEV1/FVC ratio across the life course in both sexes. Persistent smoking (vs never smoking) was related to an accelerated decrease in FEV1 and FEV1/FVC ratio during adulthood in both sexes. No statistically significant plateau was observed in any lung function parameter across the strata of asthma or smoking status. Interpretation In both sexes, FEV1 and FVC increased in two phases, with a fast increase until around age 13–16 years, and then a slower increase until a peak. Neither parameter showed a plateau phase after the peak, and decreases started earlier than previously described. FEV1/FVC ratio decreased throughout life. These observations provide an essential, but previously unavailable, framework to assess and monitor lung health over the life course. Funding EU Horizon 2020, Wellcome, European Respiratory Society, AstraZeneca, Chiesi, GSK, Menarini Group, and Sanofi.},
  author = {Garcia-Aymerich, Judith and de las Heras, Martí and Carsin, Anne-Elie and Accordini, Simone and Agustí, Alvar and Bui, Dinh and Dharmage, Shyamali C and Dodd, James W and Eze, Ikenna and Gehring, Ulrike and Gislason, Thorarinn and Granell, Raquel and Imboden, Medea and Íñiguez, Carmen and Jeong, Ayoung and Koch, Sarah and Koppelman, Gerard H and Leynaert, Bénédicte and Melén, Erik and Perret, Jennifer and Probst-Hensch, Nicole and Santa-Marina, Loreto and Torrent, Maties and Vicendese, Don and Vonk, Judith M and de Vries, Maaike and Walters, E Haydn and Wang, Gang and Wedzicha, Jadwiga A and Jarvis, Deborah and Faner, Rosa},
  journal = {The Lancet Respiratory Medicine},
  keywords = {grapp-caib},
  month = {jul},
  number = 7,
  pages = {611--622},
  title = {General population-based lung function trajectories over the life course: an accelerated cohort study},
  volume = 13,
  year = 2025
  }
  

  %0 Journal Article
  %1 garcia-aymerich_general_2025
  %A Garcia-Aymerich, Judith
  %A de las Heras, Martí
  %A Carsin, Anne-Elie
  %A Accordini, Simone
  %A Agustí, Alvar
  %A Bui, Dinh
  %A Dharmage, Shyamali C
  %A Dodd, James W
  %A Eze, Ikenna
  %A Gehring, Ulrike
  %A Gislason, Thorarinn
  %A Granell, Raquel
  %A Imboden, Medea
  %A Íñiguez, Carmen
  %A Jeong, Ayoung
  %A Koch, Sarah
  %A Koppelman, Gerard H
  %A Leynaert, Bénédicte
  %A Melén, Erik
  %A Perret, Jennifer
  %A Probst-Hensch, Nicole
  %A Santa-Marina, Loreto
  %A Torrent, Maties
  %A Vicendese, Don
  %A Vonk, Judith M
  %A de Vries, Maaike
  %A Walters, E Haydn
  %A Wang, Gang
  %A Wedzicha, Jadwiga A
  %A Jarvis, Deborah
  %A Faner, Rosa
  %D 2025
  %J The Lancet Respiratory Medicine
  %N 7
  %P 611--622
  %R 10.1016/S2213-2600(25)00043-8
  %T General population-based lung function trajectories over the life course: an accelerated cohort study
  %U https://www.sciencedirect.com/science/article/pii/S2213260025000438
  %V 13
  %X Background Lung function is a key determinant of health, but current knowledge on lung function growth and decline over the life course is based on fragmented, potentially biased data. We aimed to empirically derive general population-based life course lung function trajectories, and to identify breakpoints and plateaus. Methods We created an accelerated cohort by pooling data from eight general population-based child and adult cohort studies from Europe and Australia. We included all participants with information on lung function, smoking status, BMI, and asthma diagnosis status from at least two visits. We used cross-classified three-level linear mixed models to derive sex-specific life course trajectories of FEV1, forced vital capacity (FVC), and FEV1/FVC ratio based on observations at ages 4–80 years, and Bayesian time-series decomposition to identify breakpoints and plateaus. We repeated sex-specific analyses with separate stratification for asthma status (never had asthma vs persistent asthma, where persistent was defined as the risk factor being present at all participant visits) and smoking status (never smoker vs persistent smoker). Findings The accelerated cohort included 30 438 participants born between 1901 and 2006 (15 703 [51·6\%] female and 14 735 [48·4\%] male; mean age 26 [SD 16] years), who provided a total of 87 666 observations (range 2–8 observations per participant). In female participants, FEV1 increased non-linearly in two phases, at a mean of 234 (95\% CI 223 to 245) mL/year until age 13 (95\% credible interval [CrI] 12 to 15) years, then at 99 (76 to 122) mL/year until a peak at age 20 (18 to 22) years, and subsequently decreased throughout the rest of adulthood (−26 [−27 to −25] mL/year). In male participants, the pattern was similar, with an increase in FEV1 of 271 (263 to 280) mL/year until age 16 (14 to 18) years, which slowed to 108 (93 to 124) mL/year until reaching a maximum at age 23 (21 to 25) years, decreasing thereafter (−38 [−39 to −37] mL/year), representing a later peak than in female participants. In female participants, FVC increased non-linearly in two phases, at 232 (95\% CI 222 to 243) mL/year until age 14 (95\% CrI 12 to 15) years, then at 77 (59 to 94) mL/year until peaking at age 20 (19 to 22) years, after which it decreased throughout the rest of adulthood (−26 [−27 to −25] mL/year). In male participants, FVC also increased in two phases, at 326 (315 to 337) mL/year until age 15 (13 to 17) years, then at 156 (144 to 168) mL/year until a peak at 23 (19 to 30) years, and subsequently declined in two phases (−22 [−29 to −14] mL/year until age 42 [38 to 50] years, then −36 [−38 to −34] mL/year thereafter). No plateau after the peak was observed for either lung function parameter in both sexes. FEV1/FVC ratio decreased throughout life from the starting age of 4 years in both sexes with some distinct patterns. Stratified analysis showed that persistent asthma (vs never had asthma) was related to an earlier FEV1 peak, lower FEV1 throughout adulthood, and lower FEV1/FVC ratio across the life course in both sexes. Persistent smoking (vs never smoking) was related to an accelerated decrease in FEV1 and FEV1/FVC ratio during adulthood in both sexes. No statistically significant plateau was observed in any lung function parameter across the strata of asthma or smoking status. Interpretation In both sexes, FEV1 and FVC increased in two phases, with a fast increase until around age 13–16 years, and then a slower increase until a peak. Neither parameter showed a plateau phase after the peak, and decreases started earlier than previously described. FEV1/FVC ratio decreased throughout life. These observations provide an essential, but previously unavailable, framework to assess and monitor lung health over the life course. Funding EU Horizon 2020, Wellcome, European Respiratory Society, AstraZeneca, Chiesi, GSK, Menarini Group, and Sanofi.
  

• 
  Association of Shift Work, Health Behaviors, and Socioeconomic Status with Diabesity in over 53,000 Spanish Employees. Tosoratto, Javier; Tárraga López, Pedro Juan; López-González, Ángel Arturo; Obrador de Hevia, Joan; Busquets-Cortés, Carla; Ramírez-Manent, José Ignacio (2025). 14(17) 5969.

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Background: Diabesity, the coexistence of obesity and type 2 diabetes, is a major public health concern. Shift work and unhealthy lifestyle behaviors may exacerbate its prevalence, particularly in working populations. Objective: This study aims to evaluate the association between sociodemographic characteristics, health behaviors, and shift work and the prevalence of diabesity, using both BMI and the CUN-BAE estimator, in a large cohort of Spanish workers. Methods: This cross-sectional study included 53,053 workers (59.8\% men) aged 18–69 years who underwent occupational health examinations. Diabesity was defined as obesity (BMI ≥ 30 kg/m2 or high CUN-BAE) plus fasting glucose ≥ 100 mg/dL or prior diagnosis of diabetes. Adherence to the Mediterranean diet was assessed by the MEDAS questionnaire, physical activity by the IPAQ, alcohol intake by standard drink units (UBEs), and socioeconomic class by the CNAE-11 classification. Shift work was defined according to ILO criteria. Logistic regression was used to assess associations, adjusting for potential confounders. Results: Shift work was independently associated with increased odds of diabesity both in men and women. Diabesity prevalence was higher when assessed by CUN-BAE compared with BMI. Age, male sex, lower socioeconomic class, physical inactivity, smoking, poor diet adherence, and alcohol intake were all significantly associated with higher risk. The CUN-BAE index showed superior sensitivity in identifying individuals at risk. Conclusions: Shift work and unhealthy behaviors are key determinants of diabesity among Spanish workers. The use of adiposity estimators beyond BMI, such as CUN-BAE, should be encouraged in occupational health surveillance. Workplace-targeted interventions are urgently needed to address this growing metabolic burden.

  @article{tosoratto_association_2025,
  abstract = {Background: Diabesity, the coexistence of obesity and type 2 diabetes, is a major public health concern. Shift work and unhealthy lifestyle behaviors may exacerbate its prevalence, particularly in working populations. Objective: This study aims to evaluate the association between sociodemographic characteristics, health behaviors, and shift work and the prevalence of diabesity, using both BMI and the CUN-BAE estimator, in a large cohort of Spanish workers. Methods: This cross-sectional study included 53,053 workers (59.8\% men) aged 18–69 years who underwent occupational health examinations. Diabesity was defined as obesity (BMI ≥ 30 kg/m2 or high CUN-BAE) plus fasting glucose ≥ 100 mg/dL or prior diagnosis of diabetes. Adherence to the Mediterranean diet was assessed by the MEDAS questionnaire, physical activity by the IPAQ, alcohol intake by standard drink units (UBEs), and socioeconomic class by the CNAE-11 classification. Shift work was defined according to ILO criteria. Logistic regression was used to assess associations, adjusting for potential confounders. Results: Shift work was independently associated with increased odds of diabesity both in men and women. Diabesity prevalence was higher when assessed by CUN-BAE compared with BMI. Age, male sex, lower socioeconomic class, physical inactivity, smoking, poor diet adherence, and alcohol intake were all significantly associated with higher risk. The CUN-BAE index showed superior sensitivity in identifying individuals at risk. Conclusions: Shift work and unhealthy behaviors are key determinants of diabesity among Spanish workers. The use of adiposity estimators beyond BMI, such as CUN-BAE, should be encouraged in occupational health surveillance. Workplace-targeted interventions are urgently needed to address this growing metabolic burden.},
  author = {Tosoratto, Javier and Tárraga López, Pedro Juan and López-González, Ángel Arturo and Obrador de Hevia, Joan and Busquets-Cortés, Carla and Ramírez-Manent, José Ignacio},
  journal = {Journal of Clinical Medicine},
  keywords = {grapp-caib},
  month = {aug},
  number = 17,
  pages = 5969,
  title = {Association of Shift Work, Health Behaviors, and Socioeconomic Status with Diabesity in over 53,000 Spanish Employees},
  volume = 14,
  year = 2025
  }
  

  %0 Journal Article
  %1 tosoratto_association_2025
  %A Tosoratto, Javier
  %A Tárraga López, Pedro Juan
  %A López-González, Ángel Arturo
  %A Obrador de Hevia, Joan
  %A Busquets-Cortés, Carla
  %A Ramírez-Manent, José Ignacio
  %D 2025
  %J Journal of Clinical Medicine
  %N 17
  %P 5969
  %R 10.3390/jcm14175969
  %T Association of Shift Work, Health Behaviors, and Socioeconomic Status with Diabesity in over 53,000 Spanish Employees
  %U https://pmc.ncbi.nlm.nih.gov/articles/PMC12429148/
  %V 14
  %X Background: Diabesity, the coexistence of obesity and type 2 diabetes, is a major public health concern. Shift work and unhealthy lifestyle behaviors may exacerbate its prevalence, particularly in working populations. Objective: This study aims to evaluate the association between sociodemographic characteristics, health behaviors, and shift work and the prevalence of diabesity, using both BMI and the CUN-BAE estimator, in a large cohort of Spanish workers. Methods: This cross-sectional study included 53,053 workers (59.8\% men) aged 18–69 years who underwent occupational health examinations. Diabesity was defined as obesity (BMI ≥ 30 kg/m2 or high CUN-BAE) plus fasting glucose ≥ 100 mg/dL or prior diagnosis of diabetes. Adherence to the Mediterranean diet was assessed by the MEDAS questionnaire, physical activity by the IPAQ, alcohol intake by standard drink units (UBEs), and socioeconomic class by the CNAE-11 classification. Shift work was defined according to ILO criteria. Logistic regression was used to assess associations, adjusting for potential confounders. Results: Shift work was independently associated with increased odds of diabesity both in men and women. Diabesity prevalence was higher when assessed by CUN-BAE compared with BMI. Age, male sex, lower socioeconomic class, physical inactivity, smoking, poor diet adherence, and alcohol intake were all significantly associated with higher risk. The CUN-BAE index showed superior sensitivity in identifying individuals at risk. Conclusions: Shift work and unhealthy behaviors are key determinants of diabesity among Spanish workers. The use of adiposity estimators beyond BMI, such as CUN-BAE, should be encouraged in occupational health surveillance. Workplace-targeted interventions are urgently needed to address this growing metabolic burden.
  

• 
  Self-reported health and depression among EIRA cohort: a moderated mediation model of sex and perceived social support. Sánchez-Recio, Raquel; Oliván-Blázquez, Bárbara; Méndez-López, Fátima; Gascón-Santos, Santiago; Martí-Lluch, Ruth; Zabaleta-Del-Olmo, Edurne; Tamayo-Morales, Olaya; Maderuelo-Fernández, José A.; Casajuana, Marc; López-Jiménez, Tomas; Motrico, Emma; Gómez-Gómez, Irene; Sánchez-Pérez, Álvaro; Rodero-Cosano, María Luisa; Llobera, Joan; Bellón, Juan A.; Moreno-Peral, Patricia; Bolíbar, Bonaventura; Recio-Rodríguez, José I.; Ramos, Rafel; Clavería, Ana (2025). 16 1540530.

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Background The positive relationship between health and good perceived social support has been widely demonstrated in the scientific literature. It is known that having a good social support influences the proper maintenance of health even as a protective factor, besides being a good predictor in the recovery of health during a disease process, influencing differently men and women. Aim This project aims to study the moderating effects of perceived social support in the relationship between depression and self-perceived health according to gender, after a complex multiple-risk intervention was carried out in patients of primary health care with low social support. Methods A cluster randomized clinical trial was developed in the subgroup of patients included in phase 3 of the EIRA project. CONSORT recommendations were followed to present the results. To determine the mediating effect between social support and self-perceived health, three regression analyses were carried out using the procedure designed by Hayes through the PROCESS macro for SPSS. Results 3,062 people (54.9\% women) participated in the study. Men reported experiencing more social support and self-perceived health (p \textless 0.001) than women at the beginning of the study, but women reported higher social support at post-intervention. Moderation analyses showed that, post-intervention, those women (bsimple = −2.9867, p \textless 0.001) and males (bsimple = −1.4337, p \textless 0.001) who scored lower in depression reported higher social support. Conclusion In primary care, it is necessary to encourage intervention strategies that promote social networks as a key element of positive action aimed at maintaining and improving the population’s health, especially in adults and more specifically in women. Clinical trial registration ClinicalTrials.gov, identifier NCT03136211.

  @article{sanchez-recio_self-reported_2025,
  abstract = {Background The positive relationship between health and good perceived social support has been widely demonstrated in the scientific literature. It is known that having a good social support influences the proper maintenance of health even as a protective factor, besides being a good predictor in the recovery of health during a disease process, influencing differently men and women. Aim This project aims to study the moderating effects of perceived social support in the relationship between depression and self-perceived health according to gender, after a complex multiple-risk intervention was carried out in patients of primary health care with low social support. Methods A cluster randomized clinical trial was developed in the subgroup of patients included in phase 3 of the EIRA project. CONSORT recommendations were followed to present the results. To determine the mediating effect between social support and self-perceived health, three regression analyses were carried out using the procedure designed by Hayes through the PROCESS macro for SPSS. Results 3,062 people (54.9\% women) participated in the study. Men reported experiencing more social support and self-perceived health (p \textless 0.001) than women at the beginning of the study, but women reported higher social support at post-intervention. Moderation analyses showed that, post-intervention, those women (bsimple = −2.9867, p \textless 0.001) and males (bsimple = −1.4337, p \textless 0.001) who scored lower in depression reported higher social support. Conclusion In primary care, it is necessary to encourage intervention strategies that promote social networks as a key element of positive action aimed at maintaining and improving the population’s health, especially in adults and more specifically in women. Clinical trial registration ClinicalTrials.gov, identifier NCT03136211.},
  author = {Sánchez-Recio, Raquel and Oliván-Blázquez, Bárbara and Méndez-López, Fátima and Gascón-Santos, Santiago and Martí-Lluch, Ruth and Zabaleta-Del-Olmo, Edurne and Tamayo-Morales, Olaya and Maderuelo-Fernández, José A. and Casajuana, Marc and López-Jiménez, Tomas and Motrico, Emma and Gómez-Gómez, Irene and Sánchez-Pérez, Álvaro and Rodero-Cosano, María Luisa and Llobera, Joan and Bellón, Juan A. and Moreno-Peral, Patricia and Bolíbar, Bonaventura and Recio-Rodríguez, José I. and Ramos, Rafel and Clavería, Ana},
  journal = {Frontiers in Psychology},
  keywords = {grapp-caib},
  month = {jun},
  pages = 1540530,
  title = {Self-reported health and depression among EIRA cohort: a moderated mediation model of sex and perceived social support},
  volume = 16,
  year = 2025
  }
  

  %0 Journal Article
  %1 sanchez-recio_self-reported_2025
  %A Sánchez-Recio, Raquel
  %A Oliván-Blázquez, Bárbara
  %A Méndez-López, Fátima
  %A Gascón-Santos, Santiago
  %A Martí-Lluch, Ruth
  %A Zabaleta-Del-Olmo, Edurne
  %A Tamayo-Morales, Olaya
  %A Maderuelo-Fernández, José A.
  %A Casajuana, Marc
  %A López-Jiménez, Tomas
  %A Motrico, Emma
  %A Gómez-Gómez, Irene
  %A Sánchez-Pérez, Álvaro
  %A Rodero-Cosano, María Luisa
  %A Llobera, Joan
  %A Bellón, Juan A.
  %A Moreno-Peral, Patricia
  %A Bolíbar, Bonaventura
  %A Recio-Rodríguez, José I.
  %A Ramos, Rafel
  %A Clavería, Ana
  %D 2025
  %J Frontiers in Psychology
  %P 1540530
  %R 10.3389/fpsyg.2025.1540530
  %T Self-reported health and depression among EIRA cohort: a moderated mediation model of sex and perceived social support
  %U https://pmc.ncbi.nlm.nih.gov/articles/PMC12202560/
  %V 16
  %X Background The positive relationship between health and good perceived social support has been widely demonstrated in the scientific literature. It is known that having a good social support influences the proper maintenance of health even as a protective factor, besides being a good predictor in the recovery of health during a disease process, influencing differently men and women. Aim This project aims to study the moderating effects of perceived social support in the relationship between depression and self-perceived health according to gender, after a complex multiple-risk intervention was carried out in patients of primary health care with low social support. Methods A cluster randomized clinical trial was developed in the subgroup of patients included in phase 3 of the EIRA project. CONSORT recommendations were followed to present the results. To determine the mediating effect between social support and self-perceived health, three regression analyses were carried out using the procedure designed by Hayes through the PROCESS macro for SPSS. Results 3,062 people (54.9\% women) participated in the study. Men reported experiencing more social support and self-perceived health (p \textless 0.001) than women at the beginning of the study, but women reported higher social support at post-intervention. Moderation analyses showed that, post-intervention, those women (bsimple = −2.9867, p \textless 0.001) and males (bsimple = −1.4337, p \textless 0.001) who scored lower in depression reported higher social support. Conclusion In primary care, it is necessary to encourage intervention strategies that promote social networks as a key element of positive action aimed at maintaining and improving the population’s health, especially in adults and more specifically in women. Clinical trial registration ClinicalTrials.gov, identifier NCT03136211.
  

• 
  Associations Between Shift Work, Sociodemographic and Lifestyle Characteristics, Body Measurements, and MASLD. Tosoratto, Javier; Tárraga López, Pedro Juan; López-González, Ángel Arturo; Busquets-Cortes, Carla; Obrador de Hevia, Joan; Ramirez-Manent, José Ignacio (2025). 15(6) 961.

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent chronic liver disorder worldwide and is closely linked to the components of metabolic syndrome. Shift work, through its disruption of circadian rhythms and the promotion of adverse behavioral patterns, has been proposed as a potential contributor to metabolic dysfunction and liver disease, yet evidence on its association with MASLD remains limited in large, heterogeneous occupational populations. Objectives: To investigate the association between shift work and MASLD risk using multiple validated non-invasive indices in a large sample of Spanish workers, and to explore the influence of sociodemographic characteristics, lifestyle behaviors, and sex on these associations. Methods: This cross-sectional study analyzed data from 53,053 employed adults across diverse sectors in Spain, including 31,753 men and 21,300 women. The participants underwent standardized occupational health assessments between 2019 and 2020. The MASLD risk was evaluated using seven indices: fatty liver index (FLI), hepatic steatosis index (HSI), ZJU index, fatty liver disease (FLD) index, Framingham steatosis index (FSI), lipid accumulation product (LAP), and BARD score. Sociodemographic, anthropometric, clinical, biochemical, and lifestyle data were collected. Multinomial logistic regression models were used to assess independent associations between shift work and high-risk MASLD scores. Results: Shift workers exhibited significantly higher mean values and prevalence of elevated MASLD scores across all indices compared to non-shift workers, in both sexes. In men, the prevalence of high BARD scores increased from 43.5% (non-shift) to 71.5% (shift), while in women it rose from 49.9% to 85.7%. Multivariate analysis confirmed that shift work was independently associated with an increased MASLD risk, particularly for HSI (OR: 7.83; 95\% CI: 7.40–8.26) and ZJU (OR: 5.91; 95\% CI: 5.60–6.22). Male sex, older age, smoking, and blue-collar status were also consistently associated with elevated risk scores. Conclusions: Shift work is significantly associated with an increased MASLD risk, independent of sociodemographic and lifestyle factors. Women and blue-collar workers may be especially vulnerable to the hepatic consequences of circadian disruption. These findings support the inclusion of liver health screening in occupational health programs and highlight the need for targeted interventions to reduce the MASLD risk among shift-working populations. Cross-sectional design limits causality; longitudinal studies are needed to confirm temporal relationships.

  @article{tosoratto_associations_2025,
  abstract = {Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent chronic liver disorder worldwide and is closely linked to the components of metabolic syndrome. Shift work, through its disruption of circadian rhythms and the promotion of adverse behavioral patterns, has been proposed as a potential contributor to metabolic dysfunction and liver disease, yet evidence on its association with MASLD remains limited in large, heterogeneous occupational populations. Objectives: To investigate the association between shift work and MASLD risk using multiple validated non-invasive indices in a large sample of Spanish workers, and to explore the influence of sociodemographic characteristics, lifestyle behaviors, and sex on these associations. Methods: This cross-sectional study analyzed data from 53,053 employed adults across diverse sectors in Spain, including 31,753 men and 21,300 women. The participants underwent standardized occupational health assessments between 2019 and 2020. The MASLD risk was evaluated using seven indices: fatty liver index (FLI), hepatic steatosis index (HSI), ZJU index, fatty liver disease (FLD) index, Framingham steatosis index (FSI), lipid accumulation product (LAP), and BARD score. Sociodemographic, anthropometric, clinical, biochemical, and lifestyle data were collected. Multinomial logistic regression models were used to assess independent associations between shift work and high-risk MASLD scores. Results: Shift workers exhibited significantly higher mean values and prevalence of elevated MASLD scores across all indices compared to non-shift workers, in both sexes. In men, the prevalence of high BARD scores increased from 43.5% (non-shift) to 71.5% (shift), while in women it rose from 49.9% to 85.7%. Multivariate analysis confirmed that shift work was independently associated with an increased MASLD risk, particularly for HSI (OR: 7.83; 95\% CI: 7.40–8.26) and ZJU (OR: 5.91; 95\% CI: 5.60–6.22). Male sex, older age, smoking, and blue-collar status were also consistently associated with elevated risk scores. Conclusions: Shift work is significantly associated with an increased MASLD risk, independent of sociodemographic and lifestyle factors. Women and blue-collar workers may be especially vulnerable to the hepatic consequences of circadian disruption. These findings support the inclusion of liver health screening in occupational health programs and highlight the need for targeted interventions to reduce the MASLD risk among shift-working populations. Cross-sectional design limits causality; longitudinal studies are needed to confirm temporal relationships.},
  author = {Tosoratto, Javier and Tárraga López, Pedro Juan and López-González, Ángel Arturo and Busquets-Cortes, Carla and Obrador de Hevia, Joan and Ramirez-Manent, José Ignacio},
  journal = {Life},
  keywords = {grapp-caib},
  month = {jun},
  number = 6,
  pages = 961,
  title = {Associations Between Shift Work, Sociodemographic and Lifestyle Characteristics, Body Measurements, and MASLD},
  volume = 15,
  year = 2025
  }
  

  %0 Journal Article
  %1 tosoratto_associations_2025
  %A Tosoratto, Javier
  %A Tárraga López, Pedro Juan
  %A López-González, Ángel Arturo
  %A Busquets-Cortes, Carla
  %A Obrador de Hevia, Joan
  %A Ramirez-Manent, José Ignacio
  %D 2025
  %J Life
  %N 6
  %P 961
  %R 10.3390/life15060961
  %T Associations Between Shift Work, Sociodemographic and Lifestyle Characteristics, Body Measurements, and MASLD
  %U https://www.mdpi.com/2075-1729/15/6/961
  %V 15
  %X Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent chronic liver disorder worldwide and is closely linked to the components of metabolic syndrome. Shift work, through its disruption of circadian rhythms and the promotion of adverse behavioral patterns, has been proposed as a potential contributor to metabolic dysfunction and liver disease, yet evidence on its association with MASLD remains limited in large, heterogeneous occupational populations. Objectives: To investigate the association between shift work and MASLD risk using multiple validated non-invasive indices in a large sample of Spanish workers, and to explore the influence of sociodemographic characteristics, lifestyle behaviors, and sex on these associations. Methods: This cross-sectional study analyzed data from 53,053 employed adults across diverse sectors in Spain, including 31,753 men and 21,300 women. The participants underwent standardized occupational health assessments between 2019 and 2020. The MASLD risk was evaluated using seven indices: fatty liver index (FLI), hepatic steatosis index (HSI), ZJU index, fatty liver disease (FLD) index, Framingham steatosis index (FSI), lipid accumulation product (LAP), and BARD score. Sociodemographic, anthropometric, clinical, biochemical, and lifestyle data were collected. Multinomial logistic regression models were used to assess independent associations between shift work and high-risk MASLD scores. Results: Shift workers exhibited significantly higher mean values and prevalence of elevated MASLD scores across all indices compared to non-shift workers, in both sexes. In men, the prevalence of high BARD scores increased from 43.5% (non-shift) to 71.5% (shift), while in women it rose from 49.9% to 85.7%. Multivariate analysis confirmed that shift work was independently associated with an increased MASLD risk, particularly for HSI (OR: 7.83; 95\% CI: 7.40–8.26) and ZJU (OR: 5.91; 95\% CI: 5.60–6.22). Male sex, older age, smoking, and blue-collar status were also consistently associated with elevated risk scores. Conclusions: Shift work is significantly associated with an increased MASLD risk, independent of sociodemographic and lifestyle factors. Women and blue-collar workers may be especially vulnerable to the hepatic consequences of circadian disruption. These findings support the inclusion of liver health screening in occupational health programs and highlight the need for targeted interventions to reduce the MASLD risk among shift-working populations. Cross-sectional design limits causality; longitudinal studies are needed to confirm temporal relationships.
  

• 
  Associations Between Shift Work and Insulin Resistance Markers in 53,053 Spanish Workers: A Sex-Stratified Cross-Sectional Analysis Using TyG, TyG-BMI, METS-IR, and SPISE-IR Indices. Tosoratto, Javier; Tárraga López, Pedro Juan; López-González, Ángel Arturo; Busquets-Cortés, Carla; Obrador de Hevia, Joan; Ramírez-Manent, José Ignacio (2025).

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Background/Objective: Shift work has been increasingly associated with adverse metabolic outcomes, including insulin resistance (IR), a key contributor to cardiometabolic diseases. However, few large-scale studies have explored the association between shift work and validated IR indices across sociodemographic and lifestyle variables, stratified by sex. To investigate the relationship between shift work and four surrogate markers of insulin resistance-TyG índex, TyG-BMI, METS-IR (Metabolic score for insulin resistance), and SPISE-IR (Single-Point insulin Sensitivity estimator)-in a large Spanish working population and to assess how sociodemographic and behavioral factors modify these associations. Methods: This cross-sectional study included 53,053 employed adults (31,753 men and 21,300 women) across various regions and labor sectors in Spain. Participants were classified as shift or non-shift workers based on their work schedules. Data were collected during routine occupational health assessments and included anthropometric, clinical, biochemical, and behavioral variables. IR indices were calculated using standard formulas. Statistical analyses included t-tests, chi-square tests, and multivariable logistic regression, with stratification by sex. Results: Shift workers exhibited significantly higher levels of TyG, TyG-BMI, and METS-IR, and lower SPISE values compared to non-shift workers (all p \textless 0.001). These differences persisted after stratification by sex, age, education, and lifestyle factors. Logistic regression analyses confirmed that shift work independently predicted high IR risk across all indices, with adjusted ORs ranging from 1.49 to 1.89. Physical inactivity, low adherence to the Mediterranean diet, and alcohol consumption were the strongest modifiable predictors. Men exhibited a higher burden of IR than women across all indices. Conclusions: Shift work is independently associated with elevated insulin resistance in both men and women. These findings emphasize the importance of workplace health interventions targeting physical activity, diet, and substance use, particularly in populations engaged in non-standard work schedules.

  @article{tosoratto_associations_2025,
  abstract = {Background/Objective: Shift work has been increasingly associated with adverse metabolic outcomes, including insulin resistance (IR), a key contributor to cardiometabolic diseases. However, few large-scale studies have explored the association between shift work and validated IR indices across sociodemographic and lifestyle variables, stratified by sex. To investigate the relationship between shift work and four surrogate markers of insulin resistance-TyG índex, TyG-BMI, METS-IR (Metabolic score for insulin resistance), and SPISE-IR (Single-Point insulin Sensitivity estimator)-in a large Spanish working population and to assess how sociodemographic and behavioral factors modify these associations. Methods: This cross-sectional study included 53,053 employed adults (31,753 men and 21,300 women) across various regions and labor sectors in Spain. Participants were classified as shift or non-shift workers based on their work schedules. Data were collected during routine occupational health assessments and included anthropometric, clinical, biochemical, and behavioral variables. IR indices were calculated using standard formulas. Statistical analyses included t-tests, chi-square tests, and multivariable logistic regression, with stratification by sex. Results: Shift workers exhibited significantly higher levels of TyG, TyG-BMI, and METS-IR, and lower SPISE values compared to non-shift workers (all p \textless 0.001). These differences persisted after stratification by sex, age, education, and lifestyle factors. Logistic regression analyses confirmed that shift work independently predicted high IR risk across all indices, with adjusted ORs ranging from 1.49 to 1.89. Physical inactivity, low adherence to the Mediterranean diet, and alcohol consumption were the strongest modifiable predictors. Men exhibited a higher burden of IR than women across all indices. Conclusions: Shift work is independently associated with elevated insulin resistance in both men and women. These findings emphasize the importance of workplace health interventions targeting physical activity, diet, and substance use, particularly in populations engaged in non-standard work schedules.},
  author = {Tosoratto, Javier and Tárraga López, Pedro Juan and López-González, Ángel Arturo and Busquets-Cortés, Carla and Obrador de Hevia, Joan and Ramírez-Manent, José Ignacio},
  keywords = {grapp-caib},
  month = {jun},
  title = {Associations Between Shift Work and Insulin Resistance Markers in 53,053 Spanish Workers: A Sex-Stratified Cross-Sectional Analysis Using TyG, TyG-BMI, METS-IR, and SPISE-IR Indices},
  year = 2025
  }
  

  %0 Journal Article
  %1 tosoratto_associations_2025
  %A Tosoratto, Javier
  %A Tárraga López, Pedro Juan
  %A López-González, Ángel Arturo
  %A Busquets-Cortés, Carla
  %A Obrador de Hevia, Joan
  %A Ramírez-Manent, José Ignacio
  %D 2025
  %R 10.3390/jcm14134604
  %T Associations Between Shift Work and Insulin Resistance Markers in 53,053 Spanish Workers: A Sex-Stratified Cross-Sectional Analysis Using TyG, TyG-BMI, METS-IR, and SPISE-IR Indices
  %U https://hdl.handle.net/20.500.13003/25413
  %X Background/Objective: Shift work has been increasingly associated with adverse metabolic outcomes, including insulin resistance (IR), a key contributor to cardiometabolic diseases. However, few large-scale studies have explored the association between shift work and validated IR indices across sociodemographic and lifestyle variables, stratified by sex. To investigate the relationship between shift work and four surrogate markers of insulin resistance-TyG índex, TyG-BMI, METS-IR (Metabolic score for insulin resistance), and SPISE-IR (Single-Point insulin Sensitivity estimator)-in a large Spanish working population and to assess how sociodemographic and behavioral factors modify these associations. Methods: This cross-sectional study included 53,053 employed adults (31,753 men and 21,300 women) across various regions and labor sectors in Spain. Participants were classified as shift or non-shift workers based on their work schedules. Data were collected during routine occupational health assessments and included anthropometric, clinical, biochemical, and behavioral variables. IR indices were calculated using standard formulas. Statistical analyses included t-tests, chi-square tests, and multivariable logistic regression, with stratification by sex. Results: Shift workers exhibited significantly higher levels of TyG, TyG-BMI, and METS-IR, and lower SPISE values compared to non-shift workers (all p \textless 0.001). These differences persisted after stratification by sex, age, education, and lifestyle factors. Logistic regression analyses confirmed that shift work independently predicted high IR risk across all indices, with adjusted ORs ranging from 1.49 to 1.89. Physical inactivity, low adherence to the Mediterranean diet, and alcohol consumption were the strongest modifiable predictors. Men exhibited a higher burden of IR than women across all indices. Conclusions: Shift work is independently associated with elevated insulin resistance in both men and women. These findings emphasize the importance of workplace health interventions targeting physical activity, diet, and substance use, particularly in populations engaged in non-standard work schedules.
  

• 
  Atherogenic Risk and Its Association with Alcohol Consumption, Lifestyle Habits, and Sociodemographic Factors in a Population of Spanish Workers. Obrador de Hevia, Joan; López-González, Ángel Arturo; Ramírez-Manent, José Ignacio; Busquets-Cortes, Carla; Tárraga López, Pedro Juan; García Samuelsson, Miguel; Riutord-Sbert, Pere (2025). 15(6) 923.

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Atherogenic dyslipidemia is a major contributor to cardiovascular disease, the leading cause of morbidity and mortality worldwide. While lipid abnormalities are well-established clinical risk factors, growing evidence highlights the influence of sociodemographic and lifestyle determinants on lipid profiles. However, large-scale epidemiological data addressing these associations within occupational settings remain limited. Objective: To assess the cross-sectional and longitudinal associations between atherogenic risk—measured through TC/HDL-c, LDL-c/HDL-c, TG/HDL-c ratios, and atherogenic dyslipidemia (AD)—and sociodemographic variables, health behaviors, and alcohol consumption in a large cohort of Spanish workers. Methods: A dual-phase study was conducted. The first phase was a cross-sectional analysis of 139,634 workers (83,282 men; 56,352 women) from multiple employment sectors undergoing routine occupational health assessments. The second phase was a longitudinal study of a subsample (n = 40,431) with complete data from 2009 and 2019. Clinical, anthropometric, and biochemical data were collected using standardized protocols. Lifestyle factors (smoking, physical activity, Mediterranean diet adherence, alcohol intake) and socioeconomic indicators (education, occupational class) were recorded. Multinomial logistic regression was used to determine independent associations with high-risk atherogenic profiles. Results: Higher atherogenic indices and prevalence of AD were associated with advancing age, lower educational level, lower social class, smoking, physical inactivity, poor diet quality, and alcohol consumption. Men exhibited higher TG/HDL-c and AD values, whereas women had higher TC/HDL-c and LDL-c/HDL-c. Physical inactivity showed the strongest association with TG/HDL-c (OR: 36.23; 95\% CI: 32.12–40.35) and AD (OR: 16.86; 95\% CI: 14.80–18.93). Alcohol intake also independently predicted higher TG/HDL-c (OR: 1.60) and AD (OR: 1.79). Over the decade, a general increase in atherogenic risk was observed, especially among older adults, socially disadvantaged groups, and those with unhealthy behaviors. Conclusions: Sociodemographic and lifestyle factors, particularly physical inactivity and alcohol consumption, are strongly associated with adverse atherogenic profiles in the working population. The observed rise in lipid-related cardiovascular risk over the past decade emphasizes the urgent need for workplace-based health promotion strategies targeting modifiable behaviors and structural health inequalities.

  @article{obrador_de_hevia_atherogenic_2025,
  abstract = {Atherogenic dyslipidemia is a major contributor to cardiovascular disease, the leading cause of morbidity and mortality worldwide. While lipid abnormalities are well-established clinical risk factors, growing evidence highlights the influence of sociodemographic and lifestyle determinants on lipid profiles. However, large-scale epidemiological data addressing these associations within occupational settings remain limited. Objective: To assess the cross-sectional and longitudinal associations between atherogenic risk—measured through TC/HDL-c, LDL-c/HDL-c, TG/HDL-c ratios, and atherogenic dyslipidemia (AD)—and sociodemographic variables, health behaviors, and alcohol consumption in a large cohort of Spanish workers. Methods: A dual-phase study was conducted. The first phase was a cross-sectional analysis of 139,634 workers (83,282 men; 56,352 women) from multiple employment sectors undergoing routine occupational health assessments. The second phase was a longitudinal study of a subsample (n = 40,431) with complete data from 2009 and 2019. Clinical, anthropometric, and biochemical data were collected using standardized protocols. Lifestyle factors (smoking, physical activity, Mediterranean diet adherence, alcohol intake) and socioeconomic indicators (education, occupational class) were recorded. Multinomial logistic regression was used to determine independent associations with high-risk atherogenic profiles. Results: Higher atherogenic indices and prevalence of AD were associated with advancing age, lower educational level, lower social class, smoking, physical inactivity, poor diet quality, and alcohol consumption. Men exhibited higher TG/HDL-c and AD values, whereas women had higher TC/HDL-c and LDL-c/HDL-c. Physical inactivity showed the strongest association with TG/HDL-c (OR: 36.23; 95\% CI: 32.12–40.35) and AD (OR: 16.86; 95\% CI: 14.80–18.93). Alcohol intake also independently predicted higher TG/HDL-c (OR: 1.60) and AD (OR: 1.79). Over the decade, a general increase in atherogenic risk was observed, especially among older adults, socially disadvantaged groups, and those with unhealthy behaviors. Conclusions: Sociodemographic and lifestyle factors, particularly physical inactivity and alcohol consumption, are strongly associated with adverse atherogenic profiles in the working population. The observed rise in lipid-related cardiovascular risk over the past decade emphasizes the urgent need for workplace-based health promotion strategies targeting modifiable behaviors and structural health inequalities.},
  author = {Obrador de Hevia, Joan and López-González, Ángel Arturo and Ramírez-Manent, José Ignacio and Busquets-Cortes, Carla and Tárraga López, Pedro Juan and García Samuelsson, Miguel and Riutord-Sbert, Pere},
  journal = {Life},
  keywords = {grapp-caib},
  month = {jun},
  number = 6,
  pages = 923,
  title = {Atherogenic Risk and Its Association with Alcohol Consumption, Lifestyle Habits, and Sociodemographic Factors in a Population of Spanish Workers},
  volume = 15,
  year = 2025
  }
  

  %0 Journal Article
  %1 obrador_de_hevia_atherogenic_2025
  %A Obrador de Hevia, Joan
  %A López-González, Ángel Arturo
  %A Ramírez-Manent, José Ignacio
  %A Busquets-Cortes, Carla
  %A Tárraga López, Pedro Juan
  %A García Samuelsson, Miguel
  %A Riutord-Sbert, Pere
  %D 2025
  %J Life
  %N 6
  %P 923
  %R 10.3390/life15060923
  %T Atherogenic Risk and Its Association with Alcohol Consumption, Lifestyle Habits, and Sociodemographic Factors in a Population of Spanish Workers
  %U https://pmc.ncbi.nlm.nih.gov/articles/PMC12194332/
  %V 15
  %X Atherogenic dyslipidemia is a major contributor to cardiovascular disease, the leading cause of morbidity and mortality worldwide. While lipid abnormalities are well-established clinical risk factors, growing evidence highlights the influence of sociodemographic and lifestyle determinants on lipid profiles. However, large-scale epidemiological data addressing these associations within occupational settings remain limited. Objective: To assess the cross-sectional and longitudinal associations between atherogenic risk—measured through TC/HDL-c, LDL-c/HDL-c, TG/HDL-c ratios, and atherogenic dyslipidemia (AD)—and sociodemographic variables, health behaviors, and alcohol consumption in a large cohort of Spanish workers. Methods: A dual-phase study was conducted. The first phase was a cross-sectional analysis of 139,634 workers (83,282 men; 56,352 women) from multiple employment sectors undergoing routine occupational health assessments. The second phase was a longitudinal study of a subsample (n = 40,431) with complete data from 2009 and 2019. Clinical, anthropometric, and biochemical data were collected using standardized protocols. Lifestyle factors (smoking, physical activity, Mediterranean diet adherence, alcohol intake) and socioeconomic indicators (education, occupational class) were recorded. Multinomial logistic regression was used to determine independent associations with high-risk atherogenic profiles. Results: Higher atherogenic indices and prevalence of AD were associated with advancing age, lower educational level, lower social class, smoking, physical inactivity, poor diet quality, and alcohol consumption. Men exhibited higher TG/HDL-c and AD values, whereas women had higher TC/HDL-c and LDL-c/HDL-c. Physical inactivity showed the strongest association with TG/HDL-c (OR: 36.23; 95\% CI: 32.12–40.35) and AD (OR: 16.86; 95\% CI: 14.80–18.93). Alcohol intake also independently predicted higher TG/HDL-c (OR: 1.60) and AD (OR: 1.79). Over the decade, a general increase in atherogenic risk was observed, especially among older adults, socially disadvantaged groups, and those with unhealthy behaviors. Conclusions: Sociodemographic and lifestyle factors, particularly physical inactivity and alcohol consumption, are strongly associated with adverse atherogenic profiles in the working population. The observed rise in lipid-related cardiovascular risk over the past decade emphasizes the urgent need for workplace-based health promotion strategies targeting modifiable behaviors and structural health inequalities.
  

• 
  Cross-Sectional and Longitudinal Assessment of Sociodemographic and Lifestyle Determinants of Metabolic Syndrome and Hypertriglyceridemic Waist Phenotypes in 139,634 Spanish Workers. Obrador de Hevia, Joan; López-González, Ángel Arturo; Ramírez-Manent, José Ignacio; Busquets-Cortés, Carla; Tárraga López, Pedro Juan; Riutord-Sbert, Pere (2025). 15(7) 474.

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Objective: The objective of this study was to analyze the prevalence and key sociodemographic and lifestyle determinants of metabolic syndrome (MetS) and the hypertriglyceridemic waist (HTGW) phenotype in a large occupational cohort. Background: Metabolic syndrome (MetS) and the hypertriglyceridemic waist (HTGW) phenotype, defined as the simultaneous presence of elevated waist circumference and high triglyceride levels, are major predictors of cardiometabolic morbidity and mortality. Despite their clinical relevance, data on their distribution and determinants in large occupational populations remain limited. Methods: A cross-sectional analysis was conducted on 139,634 employed adults (56,352 women and 83,282 men) across Spain, based on standardized clinical evaluations and validated questionnaires assessing physical activity, diet, smoking, alcohol consumption, education, and occupational class. Logistic regression models were used to estimate associations with MetS and HTGW. A longitudinal subsample of 40,431 individuals was followed over a 10-year period (2009–2019) to assess trends in metabolic risk phenotypes. Results: Male sex, older age, lower educational attainment, and unhealthy lifestyle behaviors were associated with a higher prevalence of both MetS and the HTGW phenotype. Physical inactivity, low adherence to the Mediterranean diet, and alcohol consumption were significantly associated with increased risk. The HTGW phenotype proved useful in identifying high-risk individuals, with a steadily increasing prevalence over time. Conclusions: Sociodemographic disparities and modifiable lifestyle factors significantly influence the prevalence and progression of MetS and HTGW in the Spanish workforce. Preventive strategies should emphasize early workplace screening, promotion of healthy behaviors, and reduction in educational and socioeconomic inequalities to mitigate cardiometabolic risk.

  @article{obrador_de_hevia_cross-sectional_2025,
  abstract = {Objective: The objective of this study was to analyze the prevalence and key sociodemographic and lifestyle determinants of metabolic syndrome (MetS) and the hypertriglyceridemic waist (HTGW) phenotype in a large occupational cohort. Background: Metabolic syndrome (MetS) and the hypertriglyceridemic waist (HTGW) phenotype, defined as the simultaneous presence of elevated waist circumference and high triglyceride levels, are major predictors of cardiometabolic morbidity and mortality. Despite their clinical relevance, data on their distribution and determinants in large occupational populations remain limited. Methods: A cross-sectional analysis was conducted on 139,634 employed adults (56,352 women and 83,282 men) across Spain, based on standardized clinical evaluations and validated questionnaires assessing physical activity, diet, smoking, alcohol consumption, education, and occupational class. Logistic regression models were used to estimate associations with MetS and HTGW. A longitudinal subsample of 40,431 individuals was followed over a 10-year period (2009–2019) to assess trends in metabolic risk phenotypes. Results: Male sex, older age, lower educational attainment, and unhealthy lifestyle behaviors were associated with a higher prevalence of both MetS and the HTGW phenotype. Physical inactivity, low adherence to the Mediterranean diet, and alcohol consumption were significantly associated with increased risk. The HTGW phenotype proved useful in identifying high-risk individuals, with a steadily increasing prevalence over time. Conclusions: Sociodemographic disparities and modifiable lifestyle factors significantly influence the prevalence and progression of MetS and HTGW in the Spanish workforce. Preventive strategies should emphasize early workplace screening, promotion of healthy behaviors, and reduction in educational and socioeconomic inequalities to mitigate cardiometabolic risk.},
  author = {Obrador de Hevia, Joan and López-González, Ángel Arturo and Ramírez-Manent, José Ignacio and Busquets-Cortés, Carla and Tárraga López, Pedro Juan and Riutord-Sbert, Pere},
  journal = {Metabolites},
  keywords = {grapp-caib},
  month = {jul},
  number = 7,
  pages = 474,
  title = {Cross-Sectional and Longitudinal Assessment of Sociodemographic and Lifestyle Determinants of Metabolic Syndrome and Hypertriglyceridemic Waist Phenotypes in 139,634 Spanish Workers},
  volume = 15,
  year = 2025
  }
  

  %0 Journal Article
  %1 obrador_de_hevia_cross-sectional_2025
  %A Obrador de Hevia, Joan
  %A López-González, Ángel Arturo
  %A Ramírez-Manent, José Ignacio
  %A Busquets-Cortés, Carla
  %A Tárraga López, Pedro Juan
  %A Riutord-Sbert, Pere
  %D 2025
  %J Metabolites
  %N 7
  %P 474
  %R 10.3390/metabo15070474
  %T Cross-Sectional and Longitudinal Assessment of Sociodemographic and Lifestyle Determinants of Metabolic Syndrome and Hypertriglyceridemic Waist Phenotypes in 139,634 Spanish Workers
  %U https://pmc.ncbi.nlm.nih.gov/articles/PMC12298749/
  %V 15
  %X Objective: The objective of this study was to analyze the prevalence and key sociodemographic and lifestyle determinants of metabolic syndrome (MetS) and the hypertriglyceridemic waist (HTGW) phenotype in a large occupational cohort. Background: Metabolic syndrome (MetS) and the hypertriglyceridemic waist (HTGW) phenotype, defined as the simultaneous presence of elevated waist circumference and high triglyceride levels, are major predictors of cardiometabolic morbidity and mortality. Despite their clinical relevance, data on their distribution and determinants in large occupational populations remain limited. Methods: A cross-sectional analysis was conducted on 139,634 employed adults (56,352 women and 83,282 men) across Spain, based on standardized clinical evaluations and validated questionnaires assessing physical activity, diet, smoking, alcohol consumption, education, and occupational class. Logistic regression models were used to estimate associations with MetS and HTGW. A longitudinal subsample of 40,431 individuals was followed over a 10-year period (2009–2019) to assess trends in metabolic risk phenotypes. Results: Male sex, older age, lower educational attainment, and unhealthy lifestyle behaviors were associated with a higher prevalence of both MetS and the HTGW phenotype. Physical inactivity, low adherence to the Mediterranean diet, and alcohol consumption were significantly associated with increased risk. The HTGW phenotype proved useful in identifying high-risk individuals, with a steadily increasing prevalence over time. Conclusions: Sociodemographic disparities and modifiable lifestyle factors significantly influence the prevalence and progression of MetS and HTGW in the Spanish workforce. Preventive strategies should emphasize early workplace screening, promotion of healthy behaviors, and reduction in educational and socioeconomic inequalities to mitigate cardiometabolic risk.
  

• 
  Comparison of Anthropometric and Metabolic Indexes in the Diagnosis of Metabolic Syndrome: A Large-Scale Analysis of Spanish Workers. Guarro Miquel, Juan José; Tárraga López, Pedro Juan; Marzoa Jansana, María Dolores; López-González, Ángel Arturo; Riutord Sbert, Pere; Busquets-Cortés, Carla; Ramirez-Manent, José Ignacio (2025). 15(8) 495.

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Background: Metabolic syndrome (MS) is a major public health concern linked to an elevated risk of type 2 diabetes and cardiovascular disease. Simple, reliable screening tools are needed for early identification, especially in working populations. Objective: To compare the diagnostic accuracy of body mass index (BMI), waist-to-height ratio (WtHR), triglyceride–glucose index (TyG), and waist–triglyceride index (WTI) for detecting MS based on NCEP ATP III and IDF criteria in a large cohort of Spanish workers. Methods: This cross-sectional study analyzed data from 386,924 Spanish workers. MS was diagnosed using NCEP ATP III and IDF definitions. The four indexes were evaluated by sex using a receiver operating characteristic (ROC) curve analysis. Area under the curve (AUC), optimal cut-off points, and Youden’s index were calculated. Results: TyG and WTI had the highest AUC values in men (0.911 and 0.901, respectively) for NCEP ATP III-defined MS, while WtHR and WTI achieved the best performance in women (0.955 and 0.953, respectively). WtHR outperformed BMI in all subgroups. Optimal cut-off values were identified according to sex and the definition of MS: TyG (8.95 men, 8.51 women), WtHR (0.54 men, 0.51 women), and WTI (170.6 men, 96.5 women), supporting their practical implementation in occupational health programs. All indexes showed significant discriminatory capacity (p \textless 0.001). Conclusions: TyG, WtHR, and WTI are more effective than BMI in detecting MS among Spanish workers, with sex-specific patterns. Their ease of use and diagnostic strength support their adoption in occupational health programs for early cardiometabolic risk detection.

  @article{guarro_miquel_comparison_2025,
  abstract = {Background: Metabolic syndrome (MS) is a major public health concern linked to an elevated risk of type 2 diabetes and cardiovascular disease. Simple, reliable screening tools are needed for early identification, especially in working populations. Objective: To compare the diagnostic accuracy of body mass index (BMI), waist-to-height ratio (WtHR), triglyceride–glucose index (TyG), and waist–triglyceride index (WTI) for detecting MS based on NCEP ATP III and IDF criteria in a large cohort of Spanish workers. Methods: This cross-sectional study analyzed data from 386,924 Spanish workers. MS was diagnosed using NCEP ATP III and IDF definitions. The four indexes were evaluated by sex using a receiver operating characteristic (ROC) curve analysis. Area under the curve (AUC), optimal cut-off points, and Youden’s index were calculated. Results: TyG and WTI had the highest AUC values in men (0.911 and 0.901, respectively) for NCEP ATP III-defined MS, while WtHR and WTI achieved the best performance in women (0.955 and 0.953, respectively). WtHR outperformed BMI in all subgroups. Optimal cut-off values were identified according to sex and the definition of MS: TyG (8.95 men, 8.51 women), WtHR (0.54 men, 0.51 women), and WTI (170.6 men, 96.5 women), supporting their practical implementation in occupational health programs. All indexes showed significant discriminatory capacity (p \textless 0.001). Conclusions: TyG, WtHR, and WTI are more effective than BMI in detecting MS among Spanish workers, with sex-specific patterns. Their ease of use and diagnostic strength support their adoption in occupational health programs for early cardiometabolic risk detection.},
  author = {Guarro Miquel, Juan José and Tárraga López, Pedro Juan and Marzoa Jansana, María Dolores and López-González, Ángel Arturo and Riutord Sbert, Pere and Busquets-Cortés, Carla and Ramirez-Manent, José Ignacio},
  journal = {Metabolites},
  keywords = {grapp-caib},
  month = {jul},
  number = 8,
  pages = 495,
  title = {Comparison of Anthropometric and Metabolic Indexes in the Diagnosis of Metabolic Syndrome: A Large-Scale Analysis of Spanish Workers},
  volume = 15,
  year = 2025
  }
  

  %0 Journal Article
  %1 guarro_miquel_comparison_2025
  %A Guarro Miquel, Juan José
  %A Tárraga López, Pedro Juan
  %A Marzoa Jansana, María Dolores
  %A López-González, Ángel Arturo
  %A Riutord Sbert, Pere
  %A Busquets-Cortés, Carla
  %A Ramirez-Manent, José Ignacio
  %D 2025
  %J Metabolites
  %N 8
  %P 495
  %R 10.3390/metabo15080495
  %T Comparison of Anthropometric and Metabolic Indexes in the Diagnosis of Metabolic Syndrome: A Large-Scale Analysis of Spanish Workers
  %U https://pmc.ncbi.nlm.nih.gov/articles/PMC12388431/
  %V 15
  %X Background: Metabolic syndrome (MS) is a major public health concern linked to an elevated risk of type 2 diabetes and cardiovascular disease. Simple, reliable screening tools are needed for early identification, especially in working populations. Objective: To compare the diagnostic accuracy of body mass index (BMI), waist-to-height ratio (WtHR), triglyceride–glucose index (TyG), and waist–triglyceride index (WTI) for detecting MS based on NCEP ATP III and IDF criteria in a large cohort of Spanish workers. Methods: This cross-sectional study analyzed data from 386,924 Spanish workers. MS was diagnosed using NCEP ATP III and IDF definitions. The four indexes were evaluated by sex using a receiver operating characteristic (ROC) curve analysis. Area under the curve (AUC), optimal cut-off points, and Youden’s index were calculated. Results: TyG and WTI had the highest AUC values in men (0.911 and 0.901, respectively) for NCEP ATP III-defined MS, while WtHR and WTI achieved the best performance in women (0.955 and 0.953, respectively). WtHR outperformed BMI in all subgroups. Optimal cut-off values were identified according to sex and the definition of MS: TyG (8.95 men, 8.51 women), WtHR (0.54 men, 0.51 women), and WTI (170.6 men, 96.5 women), supporting their practical implementation in occupational health programs. All indexes showed significant discriminatory capacity (p \textless 0.001). Conclusions: TyG, WtHR, and WTI are more effective than BMI in detecting MS among Spanish workers, with sex-specific patterns. Their ease of use and diagnostic strength support their adoption in occupational health programs for early cardiometabolic risk detection.
  

• 
  Association Between Sociodemographic and Lifestyle Factors and Type 2 Diabetes Risk Scores in a Large Working Population: A Comparative Study Between the Commerce and Industry Sectors. Fernández-Figares Vicioso, María Pilar; Riutord Sbert, Pere; Ramírez-Manent, José Ignacio; López-González, Ángel Arturo; del Barrio Fernández, José Luis; Vicente Herrero, María Teófila (2025). 17(15) 2420.

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Background: Type 2 diabetes (T2D) is a major global health concern influenced by sociodemographic and lifestyle factors. This study compared T2D risk scores between commerce and industry sectors and assessed the associations of age, sex, education, physical activity, diet, and smoking with elevated risk. Methods: This cross-sectional study included 56,856 men and 12,872 women employed in the commerce (n = 27,448) and industry (n = 42,280) sectors across Spain. Anthropometric, clinical, and biochemical data were collected. Four validated T2D risk scores (QDscore, Finrisk, Canrisk, and TRAQ-D) were calculated. Multinomial logistic regression models estimated adjusted odds ratios (ORs) for high-risk categories by sociodemographic and lifestyle characteristics. Results: Women in the industrial sector had significantly higher age, BMI, waist circumference, and lipid levels than those in commerce; differences among men were less marked. Across all participants, higher T2D risk scores were independently associated with physical inactivity (OR up to 12.49), poor Mediterranean diet adherence (OR up to 6.62), industrial employment (OR up to 1.98), and older age. Male sex was strongly associated with high Canrisk scores (OR = 6.31; 95\% CI: 5.12–7.51). Conclusions: Employment in the industrial sector, combined with sedentary behavior and poor dietary habits, is independently associated with higher predicted T2D risk. Workplace prevention strategies should prioritize multicomponent interventions targeting modifiable risk factors, especially in high-risk subgroups such as older, less-educated, and inactive workers.

  @article{fernandez-figares_vicioso_association_2025,
  abstract = {Background: Type 2 diabetes (T2D) is a major global health concern influenced by sociodemographic and lifestyle factors. This study compared T2D risk scores between commerce and industry sectors and assessed the associations of age, sex, education, physical activity, diet, and smoking with elevated risk. Methods: This cross-sectional study included 56,856 men and 12,872 women employed in the commerce (n = 27,448) and industry (n = 42,280) sectors across Spain. Anthropometric, clinical, and biochemical data were collected. Four validated T2D risk scores (QDscore, Finrisk, Canrisk, and TRAQ-D) were calculated. Multinomial logistic regression models estimated adjusted odds ratios (ORs) for high-risk categories by sociodemographic and lifestyle characteristics. Results: Women in the industrial sector had significantly higher age, BMI, waist circumference, and lipid levels than those in commerce; differences among men were less marked. Across all participants, higher T2D risk scores were independently associated with physical inactivity (OR up to 12.49), poor Mediterranean diet adherence (OR up to 6.62), industrial employment (OR up to 1.98), and older age. Male sex was strongly associated with high Canrisk scores (OR = 6.31; 95\% CI: 5.12–7.51). Conclusions: Employment in the industrial sector, combined with sedentary behavior and poor dietary habits, is independently associated with higher predicted T2D risk. Workplace prevention strategies should prioritize multicomponent interventions targeting modifiable risk factors, especially in high-risk subgroups such as older, less-educated, and inactive workers.},
  author = {Fernández-Figares Vicioso, María Pilar and Riutord Sbert, Pere and Ramírez-Manent, José Ignacio and López-González, Ángel Arturo and del Barrio Fernández, José Luis and Vicente Herrero, María Teófila},
  journal = {Nutrients},
  keywords = {grapp-caib},
  month = {jul},
  number = 15,
  pages = 2420,
  title = {Association Between Sociodemographic and Lifestyle Factors and Type 2 Diabetes Risk Scores in a Large Working Population: A Comparative Study Between the Commerce and Industry Sectors},
  volume = 17,
  year = 2025
  }
  

  %0 Journal Article
  %1 fernandez-figares_vicioso_association_2025
  %A Fernández-Figares Vicioso, María Pilar
  %A Riutord Sbert, Pere
  %A Ramírez-Manent, José Ignacio
  %A López-González, Ángel Arturo
  %A del Barrio Fernández, José Luis
  %A Vicente Herrero, María Teófila
  %D 2025
  %J Nutrients
  %N 15
  %P 2420
  %R 10.3390/nu17152420
  %T Association Between Sociodemographic and Lifestyle Factors and Type 2 Diabetes Risk Scores in a Large Working Population: A Comparative Study Between the Commerce and Industry Sectors
  %U https://pmc.ncbi.nlm.nih.gov/articles/PMC12348608/
  %V 17
  %X Background: Type 2 diabetes (T2D) is a major global health concern influenced by sociodemographic and lifestyle factors. This study compared T2D risk scores between commerce and industry sectors and assessed the associations of age, sex, education, physical activity, diet, and smoking with elevated risk. Methods: This cross-sectional study included 56,856 men and 12,872 women employed in the commerce (n = 27,448) and industry (n = 42,280) sectors across Spain. Anthropometric, clinical, and biochemical data were collected. Four validated T2D risk scores (QDscore, Finrisk, Canrisk, and TRAQ-D) were calculated. Multinomial logistic regression models estimated adjusted odds ratios (ORs) for high-risk categories by sociodemographic and lifestyle characteristics. Results: Women in the industrial sector had significantly higher age, BMI, waist circumference, and lipid levels than those in commerce; differences among men were less marked. Across all participants, higher T2D risk scores were independently associated with physical inactivity (OR up to 12.49), poor Mediterranean diet adherence (OR up to 6.62), industrial employment (OR up to 1.98), and older age. Male sex was strongly associated with high Canrisk scores (OR = 6.31; 95\% CI: 5.12–7.51). Conclusions: Employment in the industrial sector, combined with sedentary behavior and poor dietary habits, is independently associated with higher predicted T2D risk. Workplace prevention strategies should prioritize multicomponent interventions targeting modifiable risk factors, especially in high-risk subgroups such as older, less-educated, and inactive workers.
  

• 
  Gene–Environment Interaction Affects Risk of Atopic Eczema: Population and In Vitro Studies. Standl, Marie; Budu‐Aggrey, Ashley; Johnston, Luke J.; Elias, Martina S.; Arshad, S. Hasan; Bager, Peter; Bataille, Veronique; Blakeway, Helena; Bønnelykke, Klaus; Boomsma, Dorret; Brumpton, Ben M.; Bustamante Pineda, Mariona; Campbell, Archie; Curtin, John A.; Eliasen, Anders; Fadista, João P. S.; Feenstra, Bjarke; Gerner, Trine; Medina‐Gomez, Carolina; Grosche, Sarah; Gutzkow, Kristine B.; Halling, Anne‐Sofie; Hayward, Caroline; Henderson, John; Herrera‐Luis, Esther; Holloway, John W.; Hottenga, Joukejan; O’B Hourihane, Jonathan; Hu, Chen; Hveem, Kristian; Irizar, Amaia; Jacquemin, Bénédicte; Jessen, Leon; Kress, Sara; Kurukulaaratchy, Ramesh J.; Lau, Susanne; Llop, Sabrina; Løset, Mari; Marenholz, Ingo; Mason, Dan; McCartney, Daniel L.; Melbye, Mads; Melén, Erik; Minica, Camelia; Murray, Clare S.; Nijsten, Tamar; Pardo, Luba M.; Pasmans, Suzanne; Pennell, Craig E.; Rinnov, Maria R.; Santorelli, Gillian; Schikowski, Tamara; Sheehan, Darina; Simpson, Angela; Söderhäll, Cilla; Thomas, Laurent F.; Thyssen, Jacob P.; Torrent, Maties; van Beijsterveldt, Toos; Visconti, Alessia; Vonk, Judith M.; Wang, Carol A.; Xu, Cheng‐Jian; Ziyab, Ali H.; Custovic, Adnan; Di Meglio, Paola; Duijts, Liesbeth; Flohr, Carsten; Irvine, Alan D.; Koppelman, Gerard H.; Lee, Young‐Ae; Reynolds, Nick J.; Smith, Catherine; Langan, Sinéad M.; Paternoster, Lavinia; Brown, Sara J. (2025). 80(8) 2201–2212.

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Atopic eczema is a complex trait resulting from multiple genetic and environmental factors. This study investigated evidence for interaction between 24 established eczema genetic risk variants and 18 environmental factors. One variant‐environmental pair showed nominally significant interaction in discovery, replication and meta‐analyses: early‐life dog exposure modulates the increased risk of rs10214237 and preliminary work suggests a mechanistic effect via IL‐7R. CCL2, C‐C motif chemokine ligand 2; chr 5, chromosome 5; CSF2, colony stimulating factor 2 (granulocyte‐macrophage); CXCL8, C‐X‐C motif chemokine ligand 8 (IL‐8); ELISA, enzyme‐linked immunosorbent assay; FLG, filaggrin; GWAS, genome‐wide association study; IL, interleukin; n, number of participants; OR, odds ratio; RT‐qPCR, reverse transcription quantitative polymerase chain reaction; TNF, tumour necrosis factor; TSLP, thymic stromal lymphopoietin.

  @article{standl_geneenvironment_2025,
  abstract = {Atopic eczema is a complex trait resulting from multiple genetic and environmental factors. This study investigated evidence for interaction between 24 established eczema genetic risk variants and 18 environmental factors. One variant‐environmental pair showed nominally significant interaction in discovery, replication and meta‐analyses: early‐life dog exposure modulates the increased risk of rs10214237 and preliminary work suggests a mechanistic effect via IL‐7R. CCL2, C‐C motif chemokine ligand 2; chr 5, chromosome 5; CSF2, colony stimulating factor 2 (granulocyte‐macrophage); CXCL8, C‐X‐C motif chemokine ligand 8 (IL‐8); ELISA, enzyme‐linked immunosorbent assay; FLG, filaggrin; GWAS, genome‐wide association study; IL, interleukin; n, number of participants; OR, odds ratio; RT‐qPCR, reverse transcription quantitative polymerase chain reaction; TNF, tumour necrosis factor; TSLP, thymic stromal lymphopoietin.},
  author = {Standl, Marie and Budu‐Aggrey, Ashley and Johnston, Luke J. and Elias, Martina S. and Arshad, S. Hasan and Bager, Peter and Bataille, Veronique and Blakeway, Helena and Bønnelykke, Klaus and Boomsma, Dorret and Brumpton, Ben M. and Bustamante Pineda, Mariona and Campbell, Archie and Curtin, John A. and Eliasen, Anders and Fadista, João P. S. and Feenstra, Bjarke and Gerner, Trine and Medina‐Gomez, Carolina and Grosche, Sarah and Gutzkow, Kristine B. and Halling, Anne‐Sofie and Hayward, Caroline and Henderson, John and Herrera‐Luis, Esther and Holloway, John W. and Hottenga, Joukejan and O’B Hourihane, Jonathan and Hu, Chen and Hveem, Kristian and Irizar, Amaia and Jacquemin, Bénédicte and Jessen, Leon and Kress, Sara and Kurukulaaratchy, Ramesh J. and Lau, Susanne and Llop, Sabrina and Løset, Mari and Marenholz, Ingo and Mason, Dan and McCartney, Daniel L. and Melbye, Mads and Melén, Erik and Minica, Camelia and Murray, Clare S. and Nijsten, Tamar and Pardo, Luba M. and Pasmans, Suzanne and Pennell, Craig E. and Rinnov, Maria R. and Santorelli, Gillian and Schikowski, Tamara and Sheehan, Darina and Simpson, Angela and Söderhäll, Cilla and Thomas, Laurent F. and Thyssen, Jacob P. and Torrent, Maties and van Beijsterveldt, Toos and Visconti, Alessia and Vonk, Judith M. and Wang, Carol A. and Xu, Cheng‐Jian and Ziyab, Ali H. and Custovic, Adnan and Di Meglio, Paola and Duijts, Liesbeth and Flohr, Carsten and Irvine, Alan D. and Koppelman, Gerard H. and Lee, Young‐Ae and Reynolds, Nick J. and Smith, Catherine and Langan, Sinéad M. and Paternoster, Lavinia and Brown, Sara J.},
  journal = {Allergy},
  keywords = {grapp-caib},
  month = {aug},
  number = 8,
  pages = {2201--2212},
  title = {Gene–Environment Interaction Affects Risk of Atopic Eczema: Population and In Vitro Studies},
  volume = 80,
  year = 2025
  }
  

  %0 Journal Article
  %1 standl_geneenvironment_2025
  %A Standl, Marie
  %A Budu‐Aggrey, Ashley
  %A Johnston, Luke J.
  %A Elias, Martina S.
  %A Arshad, S. Hasan
  %A Bager, Peter
  %A Bataille, Veronique
  %A Blakeway, Helena
  %A Bønnelykke, Klaus
  %A Boomsma, Dorret
  %A Brumpton, Ben M.
  %A Bustamante Pineda, Mariona
  %A Campbell, Archie
  %A Curtin, John A.
  %A Eliasen, Anders
  %A Fadista, João P. S.
  %A Feenstra, Bjarke
  %A Gerner, Trine
  %A Medina‐Gomez, Carolina
  %A Grosche, Sarah
  %A Gutzkow, Kristine B.
  %A Halling, Anne‐Sofie
  %A Hayward, Caroline
  %A Henderson, John
  %A Herrera‐Luis, Esther
  %A Holloway, John W.
  %A Hottenga, Joukejan
  %A O’B Hourihane, Jonathan
  %A Hu, Chen
  %A Hveem, Kristian
  %A Irizar, Amaia
  %A Jacquemin, Bénédicte
  %A Jessen, Leon
  %A Kress, Sara
  %A Kurukulaaratchy, Ramesh J.
  %A Lau, Susanne
  %A Llop, Sabrina
  %A Løset, Mari
  %A Marenholz, Ingo
  %A Mason, Dan
  %A McCartney, Daniel L.
  %A Melbye, Mads
  %A Melén, Erik
  %A Minica, Camelia
  %A Murray, Clare S.
  %A Nijsten, Tamar
  %A Pardo, Luba M.
  %A Pasmans, Suzanne
  %A Pennell, Craig E.
  %A Rinnov, Maria R.
  %A Santorelli, Gillian
  %A Schikowski, Tamara
  %A Sheehan, Darina
  %A Simpson, Angela
  %A Söderhäll, Cilla
  %A Thomas, Laurent F.
  %A Thyssen, Jacob P.
  %A Torrent, Maties
  %A van Beijsterveldt, Toos
  %A Visconti, Alessia
  %A Vonk, Judith M.
  %A Wang, Carol A.
  %A Xu, Cheng‐Jian
  %A Ziyab, Ali H.
  %A Custovic, Adnan
  %A Di Meglio, Paola
  %A Duijts, Liesbeth
  %A Flohr, Carsten
  %A Irvine, Alan D.
  %A Koppelman, Gerard H.
  %A Lee, Young‐Ae
  %A Reynolds, Nick J.
  %A Smith, Catherine
  %A Langan, Sinéad M.
  %A Paternoster, Lavinia
  %A Brown, Sara J.
  %D 2025
  %J Allergy
  %N 8
  %P 2201--2212
  %R 10.1111/all.16605
  %T Gene–Environment Interaction Affects Risk of Atopic Eczema: Population and In Vitro Studies
  %U https://pmc.ncbi.nlm.nih.gov/articles/PMC12368900/
  %V 80
  %X Atopic eczema is a complex trait resulting from multiple genetic and environmental factors. This study investigated evidence for interaction between 24 established eczema genetic risk variants and 18 environmental factors. One variant‐environmental pair showed nominally significant interaction in discovery, replication and meta‐analyses: early‐life dog exposure modulates the increased risk of rs10214237 and preliminary work suggests a mechanistic effect via IL‐7R. CCL2, C‐C motif chemokine ligand 2; chr 5, chromosome 5; CSF2, colony stimulating factor 2 (granulocyte‐macrophage); CXCL8, C‐X‐C motif chemokine ligand 8 (IL‐8); ELISA, enzyme‐linked immunosorbent assay; FLG, filaggrin; GWAS, genome‐wide association study; IL, interleukin; n, number of participants; OR, odds ratio; RT‐qPCR, reverse transcription quantitative polymerase chain reaction; TNF, tumour necrosis factor; TSLP, thymic stromal lymphopoietin.
  

• 
  Sociodemographic Factors, Healthy Habits, and Quality of Life in Relation to Insulin Resistance Risk in a Large Cohort of Spanish Workers. Marzoa Jansana, María Dolores; Tárraga López, Pedro Juan; Guarro Miquel, Juan José; López-González, Ángel Arturo; Riutord Sbert, Pere; Busquets-Cortés, Carla; Ramírez-Manent, José Ignacio (2025). 13(3) 122.

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Background: Insulin resistance (IR) is a key pathogenic mechanism underlying numerous cardiometabolic disorders. While sociodemographic and lifestyle determinants of IR are well-established, their association with health-related quality of life (HRQoL) remains understudied. This study explores the relationship between IR risk, as measured by TyG, METS-IR, and SPISE-IR indices, and HRQoL in a large cohort of Spanish workers. Methods: This cross-sectional study included 100,014 Spanish workers aged 18–69 years evaluated between January 2021 and December 2023. Exclusion criteria included incomplete clinical, laboratory, or questionnaire data. IR was assessed using TyG, METS-IR, and SPISE-IR indices. HRQoL was measured using the SF-12 questionnaire. Sociodemographic factors, physical activity (IPAQ), dietary habits (MEDAS-14), and social class (based on CNAE-11 and Spanish Society of Epidemiology criteria) were also evaluated. Statistical analysis was conducted using SPSS v29.0. Results: Higher IR risk was consistently associated with older age, male sex, lower social class, current smoking, low adherence to the Mediterranean diet, and physical inactivity. Lower HRQoL scores (both physical and mental components) were significantly associated with higher IR indices, particularly with METS-IR and SPISE-IR. These associations persisted after adjusting for sociodemographic and behavioral covariates. Conclusions: This study demonstrates a robust association between insulin resistance risk and diminished health-related quality of life. The integration of validated IR indices and subjective health perception tools such as the SF-12 may enhance early identification of at-risk individuals in occupational health settings.

  @article{marzoa_jansana_sociodemographic_2025,
  abstract = {Background: Insulin resistance (IR) is a key pathogenic mechanism underlying numerous cardiometabolic disorders. While sociodemographic and lifestyle determinants of IR are well-established, their association with health-related quality of life (HRQoL) remains understudied. This study explores the relationship between IR risk, as measured by TyG, METS-IR, and SPISE-IR indices, and HRQoL in a large cohort of Spanish workers. Methods: This cross-sectional study included 100,014 Spanish workers aged 18–69 years evaluated between January 2021 and December 2023. Exclusion criteria included incomplete clinical, laboratory, or questionnaire data. IR was assessed using TyG, METS-IR, and SPISE-IR indices. HRQoL was measured using the SF-12 questionnaire. Sociodemographic factors, physical activity (IPAQ), dietary habits (MEDAS-14), and social class (based on CNAE-11 and Spanish Society of Epidemiology criteria) were also evaluated. Statistical analysis was conducted using SPSS v29.0. Results: Higher IR risk was consistently associated with older age, male sex, lower social class, current smoking, low adherence to the Mediterranean diet, and physical inactivity. Lower HRQoL scores (both physical and mental components) were significantly associated with higher IR indices, particularly with METS-IR and SPISE-IR. These associations persisted after adjusting for sociodemographic and behavioral covariates. Conclusions: This study demonstrates a robust association between insulin resistance risk and diminished health-related quality of life. The integration of validated IR indices and subjective health perception tools such as the SF-12 may enhance early identification of at-risk individuals in occupational health settings.},
  author = {Marzoa Jansana, María Dolores and Tárraga López, Pedro Juan and Guarro Miquel, Juan José and López-González, Ángel Arturo and Riutord Sbert, Pere and Busquets-Cortés, Carla and Ramírez-Manent, José Ignacio},
  journal = {Medical Sciences},
  keywords = {grapp-caib},
  month = {aug},
  number = 3,
  pages = 122,
  title = {Sociodemographic Factors, Healthy Habits, and Quality of Life in Relation to Insulin Resistance Risk in a Large Cohort of Spanish Workers},
  volume = 13,
  year = 2025
  }
  

  %0 Journal Article
  %1 marzoa_jansana_sociodemographic_2025
  %A Marzoa Jansana, María Dolores
  %A Tárraga López, Pedro Juan
  %A Guarro Miquel, Juan José
  %A López-González, Ángel Arturo
  %A Riutord Sbert, Pere
  %A Busquets-Cortés, Carla
  %A Ramírez-Manent, José Ignacio
  %D 2025
  %J Medical Sciences
  %N 3
  %P 122
  %R 10.3390/medsci13030122
  %T Sociodemographic Factors, Healthy Habits, and Quality of Life in Relation to Insulin Resistance Risk in a Large Cohort of Spanish Workers
  %U https://pmc.ncbi.nlm.nih.gov/articles/PMC12371977/
  %V 13
  %X Background: Insulin resistance (IR) is a key pathogenic mechanism underlying numerous cardiometabolic disorders. While sociodemographic and lifestyle determinants of IR are well-established, their association with health-related quality of life (HRQoL) remains understudied. This study explores the relationship between IR risk, as measured by TyG, METS-IR, and SPISE-IR indices, and HRQoL in a large cohort of Spanish workers. Methods: This cross-sectional study included 100,014 Spanish workers aged 18–69 years evaluated between January 2021 and December 2023. Exclusion criteria included incomplete clinical, laboratory, or questionnaire data. IR was assessed using TyG, METS-IR, and SPISE-IR indices. HRQoL was measured using the SF-12 questionnaire. Sociodemographic factors, physical activity (IPAQ), dietary habits (MEDAS-14), and social class (based on CNAE-11 and Spanish Society of Epidemiology criteria) were also evaluated. Statistical analysis was conducted using SPSS v29.0. Results: Higher IR risk was consistently associated with older age, male sex, lower social class, current smoking, low adherence to the Mediterranean diet, and physical inactivity. Lower HRQoL scores (both physical and mental components) were significantly associated with higher IR indices, particularly with METS-IR and SPISE-IR. These associations persisted after adjusting for sociodemographic and behavioral covariates. Conclusions: This study demonstrates a robust association between insulin resistance risk and diminished health-related quality of life. The integration of validated IR indices and subjective health perception tools such as the SF-12 may enhance early identification of at-risk individuals in occupational health settings.
  

• 
  Evaluation of Type 2 Diabetes Risk in Individuals With or Without Metabolically Healthy Obesity. García Samuelsson, Miguel; Tárraga López, Pedro Juan; López-González, Ángel Arturo; Busquets-Cortés, Carla; Obrador de Hevia, Joan; Ramírez-Manent, José Ignacio (2025). 14(6) 608.

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Not all people with obesity are equally at risk for type 2 diabetes. Some individuals, although obese, do not show the typical signs of poor metabolic health—like high blood pressure, high blood sugar, or abnormal cholesterol levels. These individuals are known as “metabolically healthy obese” (MHO). This study looked at over 68,000 Spanish workers and compared MHO individuals to those with unhealthy obesity (MNHO). Researchers used several tools to estimate the risk of developing type 2 diabetes. They found that while MHO people had a lower risk than MNHO ones, their risk was still higher than people of normal weight with good metabolic health. The study also showed that lack of physical activity, poor diet, smoking, and low education levels were linked to higher diabetes risk. In short, even if someone with obesity appears healthy now, they may still face serious health risks later. The study highlights the importance of healthy habits and shows that weight alone is not enough to determine a person’s risk for diabetes., Background: The concept of metabolically healthy obesity (MHO) has emerged as a controversial yet clinically relevant phenotype, challenging the traditional view that all obese individuals are uniformly at high metabolic risk. However, the long-term health implications of MHO, particularly its association with type 2 diabetes mellitus (T2DM), remain poorly defined. Objective: To assess the risk of T2DM in individuals with MHO compared to those with metabolically non-healthy obesity (MNHO), using multiple validated diabetes risk scales across a large population-based cohort. Methods: This cross-sectional study analyzed data from over 68,884 adults stratified by sex and BMI-defined obesity status. Metabolic health was categorized using three progressively inclusive definitions based on the number of metabolic syndrome components. Diabetes risk was estimated using Finrisk, Canrisk, TRAQ-D, Thai, Oman, and QD-score tools. Multinomial logistic regression assessed associations between MHO/MNHO phenotypes and high-risk diabetes scores, adjusting for demographic, socioeconomic, and lifestyle variables. Results: Across all definitions and scales, MNHO individuals exhibited significantly higher mean diabetes risk scores and greater prevalence of high-risk categories compared to MHO participants (p \textless 0.001). Nevertheless, MHO individuals consistently showed elevated diabetes risk relative to non-obese, metabolically healthy controls. Physical inactivity, low educational level, lower socioeconomic status, smoking, and absence of a Mediterranean diet were independently associated with higher diabetes risk. MNHO phenotype was a strong and consistent predictor of high-risk classification across all models. Conclusions: While MHO individuals present a comparatively lower risk of T2DM than their MNHO counterparts, their risk remains substantially higher than that of non-obese individuals. These findings highlight the need to refine risk stratification approaches beyond BMI alone, and to consider metabolic health status in guiding prevention strategies for T2DM.

  @article{garcia_samuelsson_evaluation_2025,
  abstract = {Not all people with obesity are equally at risk for type 2 diabetes. Some individuals, although obese, do not show the typical signs of poor metabolic health—like high blood pressure, high blood sugar, or abnormal cholesterol levels. These individuals are known as “metabolically healthy obese” (MHO). This study looked at over 68,000 Spanish workers and compared MHO individuals to those with unhealthy obesity (MNHO). Researchers used several tools to estimate the risk of developing type 2 diabetes. They found that while MHO people had a lower risk than MNHO ones, their risk was still higher than people of normal weight with good metabolic health. The study also showed that lack of physical activity, poor diet, smoking, and low education levels were linked to higher diabetes risk. In short, even if someone with obesity appears healthy now, they may still face serious health risks later. The study highlights the importance of healthy habits and shows that weight alone is not enough to determine a person’s risk for diabetes., Background: The concept of metabolically healthy obesity (MHO) has emerged as a controversial yet clinically relevant phenotype, challenging the traditional view that all obese individuals are uniformly at high metabolic risk. However, the long-term health implications of MHO, particularly its association with type 2 diabetes mellitus (T2DM), remain poorly defined. Objective: To assess the risk of T2DM in individuals with MHO compared to those with metabolically non-healthy obesity (MNHO), using multiple validated diabetes risk scales across a large population-based cohort. Methods: This cross-sectional study analyzed data from over 68,884 adults stratified by sex and BMI-defined obesity status. Metabolic health was categorized using three progressively inclusive definitions based on the number of metabolic syndrome components. Diabetes risk was estimated using Finrisk, Canrisk, TRAQ-D, Thai, Oman, and QD-score tools. Multinomial logistic regression assessed associations between MHO/MNHO phenotypes and high-risk diabetes scores, adjusting for demographic, socioeconomic, and lifestyle variables. Results: Across all definitions and scales, MNHO individuals exhibited significantly higher mean diabetes risk scores and greater prevalence of high-risk categories compared to MHO participants (p \textless 0.001). Nevertheless, MHO individuals consistently showed elevated diabetes risk relative to non-obese, metabolically healthy controls. Physical inactivity, low educational level, lower socioeconomic status, smoking, and absence of a Mediterranean diet were independently associated with higher diabetes risk. MNHO phenotype was a strong and consistent predictor of high-risk classification across all models. Conclusions: While MHO individuals present a comparatively lower risk of T2DM than their MNHO counterparts, their risk remains substantially higher than that of non-obese individuals. These findings highlight the need to refine risk stratification approaches beyond BMI alone, and to consider metabolic health status in guiding prevention strategies for T2DM.},
  author = {García Samuelsson, Miguel and Tárraga López, Pedro Juan and López-González, Ángel Arturo and Busquets-Cortés, Carla and Obrador de Hevia, Joan and Ramírez-Manent, José Ignacio},
  journal = {Biology},
  keywords = {grapp-caib},
  month = {may},
  number = 6,
  pages = 608,
  title = {Evaluation of Type 2 Diabetes Risk in Individuals With or Without Metabolically Healthy Obesity},
  volume = 14,
  year = 2025
  }
  

  %0 Journal Article
  %1 garcia_samuelsson_evaluation_2025
  %A García Samuelsson, Miguel
  %A Tárraga López, Pedro Juan
  %A López-González, Ángel Arturo
  %A Busquets-Cortés, Carla
  %A Obrador de Hevia, Joan
  %A Ramírez-Manent, José Ignacio
  %D 2025
  %J Biology
  %N 6
  %P 608
  %R 10.3390/biology14060608
  %T Evaluation of Type 2 Diabetes Risk in Individuals With or Without Metabolically Healthy Obesity
  %U https://pmc.ncbi.nlm.nih.gov/articles/PMC12189814/
  %V 14
  %X Not all people with obesity are equally at risk for type 2 diabetes. Some individuals, although obese, do not show the typical signs of poor metabolic health—like high blood pressure, high blood sugar, or abnormal cholesterol levels. These individuals are known as “metabolically healthy obese” (MHO). This study looked at over 68,000 Spanish workers and compared MHO individuals to those with unhealthy obesity (MNHO). Researchers used several tools to estimate the risk of developing type 2 diabetes. They found that while MHO people had a lower risk than MNHO ones, their risk was still higher than people of normal weight with good metabolic health. The study also showed that lack of physical activity, poor diet, smoking, and low education levels were linked to higher diabetes risk. In short, even if someone with obesity appears healthy now, they may still face serious health risks later. The study highlights the importance of healthy habits and shows that weight alone is not enough to determine a person’s risk for diabetes., Background: The concept of metabolically healthy obesity (MHO) has emerged as a controversial yet clinically relevant phenotype, challenging the traditional view that all obese individuals are uniformly at high metabolic risk. However, the long-term health implications of MHO, particularly its association with type 2 diabetes mellitus (T2DM), remain poorly defined. Objective: To assess the risk of T2DM in individuals with MHO compared to those with metabolically non-healthy obesity (MNHO), using multiple validated diabetes risk scales across a large population-based cohort. Methods: This cross-sectional study analyzed data from over 68,884 adults stratified by sex and BMI-defined obesity status. Metabolic health was categorized using three progressively inclusive definitions based on the number of metabolic syndrome components. Diabetes risk was estimated using Finrisk, Canrisk, TRAQ-D, Thai, Oman, and QD-score tools. Multinomial logistic regression assessed associations between MHO/MNHO phenotypes and high-risk diabetes scores, adjusting for demographic, socioeconomic, and lifestyle variables. Results: Across all definitions and scales, MNHO individuals exhibited significantly higher mean diabetes risk scores and greater prevalence of high-risk categories compared to MHO participants (p \textless 0.001). Nevertheless, MHO individuals consistently showed elevated diabetes risk relative to non-obese, metabolically healthy controls. Physical inactivity, low educational level, lower socioeconomic status, smoking, and absence of a Mediterranean diet were independently associated with higher diabetes risk. MNHO phenotype was a strong and consistent predictor of high-risk classification across all models. Conclusions: While MHO individuals present a comparatively lower risk of T2DM than their MNHO counterparts, their risk remains substantially higher than that of non-obese individuals. These findings highlight the need to refine risk stratification approaches beyond BMI alone, and to consider metabolic health status in guiding prevention strategies for T2DM.
  

• 
  Association Between Bioimpedance-Determined Metabolic Age and MASLD Risk Scores in Spanish Workers. Ramírez-Gallegos, Ignacio; Busquets-Cortes, Carla; Paublini, Hernán; López-González, Ángel Arturo; Martínez-Almoyna-Rifá, Emilio; Tárraga López, Pedro Juan; Ramírez-Manent, José Ignacio (2025). 15(5) 343.

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a prevalent liver disorder with significant metabolic implications. Metabolic age, determined through bioimpedance analysis, has emerged as a potential indicator of overall metabolic health. The objective of this study is to evaluate the association between metabolic age and MASLD risk scores in a cohort of Spanish workers. Methods: A cross-sectional study was conducted on 8590 Spanish workers who underwent annual occupational health examinations between 2019 and 2020. Metabolic age was determined using bioelectrical impedance analysis, and the Avoidable Lost Life Years (ALLY) index was calculated as the difference between their metabolic and chronological age. MASLD risk was assessed using various validated scales, including the Fatty Liver Index (FLI), Hepatic Steatosis Index (HSI), Zhejiang University Index (ZJU), Fatty Liver Disease Index (FLD), and Lipid Accumulation Product (LAP). A multinomial logistic regression analysis was performed to examine the association between metabolic age and MASLD risk scores, adjusting for sociodemographic and lifestyle variables. Results: Higher metabolic age values were observed in individuals with greater MASLD risk across all evaluated scales. The mean metabolic age was consistently lower in women compared to men, and these differences were statistically significant (p \textless 0.01). Multinomial logistic regression analysis revealed that the strongest associations with increased metabolic age were found for MASLD risk scores, physical inactivity, and poor adherence to the Mediterranean diet. ROC curve analysis demonstrated a high predictive capacity for the FLD (AUC: 0.935 in women and 0.917 in men) and FLI (AUC: 0.900 in women and 0.833 in men), with high Youden index values. Conclusions: Metabolic age is significantly associated with MASLD risk, suggesting its potential as a non-invasive biomarker for identifying individuals with a higher risk for metabolic liver disease. Lifestyle factors, including physical activity and dietary patterns, play a crucial role in modulating metabolic age, highlighting the importance of targeted interventions for MASLD prevention. Further research is warranted to validate metabolic age as a prognostic tool in MASLD risk assessment.

  @article{ramirez-gallegos_association_2025,
  abstract = {Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a prevalent liver disorder with significant metabolic implications. Metabolic age, determined through bioimpedance analysis, has emerged as a potential indicator of overall metabolic health. The objective of this study is to evaluate the association between metabolic age and MASLD risk scores in a cohort of Spanish workers. Methods: A cross-sectional study was conducted on 8590 Spanish workers who underwent annual occupational health examinations between 2019 and 2020. Metabolic age was determined using bioelectrical impedance analysis, and the Avoidable Lost Life Years (ALLY) index was calculated as the difference between their metabolic and chronological age. MASLD risk was assessed using various validated scales, including the Fatty Liver Index (FLI), Hepatic Steatosis Index (HSI), Zhejiang University Index (ZJU), Fatty Liver Disease Index (FLD), and Lipid Accumulation Product (LAP). A multinomial logistic regression analysis was performed to examine the association between metabolic age and MASLD risk scores, adjusting for sociodemographic and lifestyle variables. Results: Higher metabolic age values were observed in individuals with greater MASLD risk across all evaluated scales. The mean metabolic age was consistently lower in women compared to men, and these differences were statistically significant (p \textless 0.01). Multinomial logistic regression analysis revealed that the strongest associations with increased metabolic age were found for MASLD risk scores, physical inactivity, and poor adherence to the Mediterranean diet. ROC curve analysis demonstrated a high predictive capacity for the FLD (AUC: 0.935 in women and 0.917 in men) and FLI (AUC: 0.900 in women and 0.833 in men), with high Youden index values. Conclusions: Metabolic age is significantly associated with MASLD risk, suggesting its potential as a non-invasive biomarker for identifying individuals with a higher risk for metabolic liver disease. Lifestyle factors, including physical activity and dietary patterns, play a crucial role in modulating metabolic age, highlighting the importance of targeted interventions for MASLD prevention. Further research is warranted to validate metabolic age as a prognostic tool in MASLD risk assessment.},
  author = {Ramírez-Gallegos, Ignacio and Busquets-Cortes, Carla and Paublini, Hernán and López-González, Ángel Arturo and Martínez-Almoyna-Rifá, Emilio and Tárraga López, Pedro Juan and Ramírez-Manent, José Ignacio},
  journal = {Metabolites},
  keywords = {grapp-caib},
  month = {may},
  number = 5,
  pages = 343,
  title = {Association Between Bioimpedance-Determined Metabolic Age and MASLD Risk Scores in Spanish Workers},
  volume = 15,
  year = 2025
  }
  

  %0 Journal Article
  %1 ramirez-gallegos_association_2025
  %A Ramírez-Gallegos, Ignacio
  %A Busquets-Cortes, Carla
  %A Paublini, Hernán
  %A López-González, Ángel Arturo
  %A Martínez-Almoyna-Rifá, Emilio
  %A Tárraga López, Pedro Juan
  %A Ramírez-Manent, José Ignacio
  %D 2025
  %J Metabolites
  %N 5
  %P 343
  %R 10.3390/metabo15050343
  %T Association Between Bioimpedance-Determined Metabolic Age and MASLD Risk Scores in Spanish Workers
  %U https://pmc.ncbi.nlm.nih.gov/articles/PMC12113834/
  %V 15
  %X Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a prevalent liver disorder with significant metabolic implications. Metabolic age, determined through bioimpedance analysis, has emerged as a potential indicator of overall metabolic health. The objective of this study is to evaluate the association between metabolic age and MASLD risk scores in a cohort of Spanish workers. Methods: A cross-sectional study was conducted on 8590 Spanish workers who underwent annual occupational health examinations between 2019 and 2020. Metabolic age was determined using bioelectrical impedance analysis, and the Avoidable Lost Life Years (ALLY) index was calculated as the difference between their metabolic and chronological age. MASLD risk was assessed using various validated scales, including the Fatty Liver Index (FLI), Hepatic Steatosis Index (HSI), Zhejiang University Index (ZJU), Fatty Liver Disease Index (FLD), and Lipid Accumulation Product (LAP). A multinomial logistic regression analysis was performed to examine the association between metabolic age and MASLD risk scores, adjusting for sociodemographic and lifestyle variables. Results: Higher metabolic age values were observed in individuals with greater MASLD risk across all evaluated scales. The mean metabolic age was consistently lower in women compared to men, and these differences were statistically significant (p \textless 0.01). Multinomial logistic regression analysis revealed that the strongest associations with increased metabolic age were found for MASLD risk scores, physical inactivity, and poor adherence to the Mediterranean diet. ROC curve analysis demonstrated a high predictive capacity for the FLD (AUC: 0.935 in women and 0.917 in men) and FLI (AUC: 0.900 in women and 0.833 in men), with high Youden index values. Conclusions: Metabolic age is significantly associated with MASLD risk, suggesting its potential as a non-invasive biomarker for identifying individuals with a higher risk for metabolic liver disease. Lifestyle factors, including physical activity and dietary patterns, play a crucial role in modulating metabolic age, highlighting the importance of targeted interventions for MASLD prevention. Further research is warranted to validate metabolic age as a prognostic tool in MASLD risk assessment.
  

• 
  Evaluating SinergiAPS, an intervention based on patient feedback to improve patient safety in primary care: a cluster randomized trial. Fiol deRoque, Maria Antònia; Valderas, José María; Serrano-Ripoll, María Jesús; Gens-Barbarà, Montserrat; Martín-Luján, Francisco; Sánchez-Freire, Encarna; Montaño, Juan José; Mira-Martínez, Sofía; Pastor-Moreno, Guadalupe; Zamanillo-Campos, Rocío; Riera-Serra, Pau; Ricci-Cabello, Ignacio (2025). 23(1) 202–202.

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: Patient safety, defined by the WHO as the absence of preventable harm, is a critical component of healthcare quality and poses a significant challenge globally. This study aimed to evaluate the effectiveness of SinergiAPS, a patient-centred audit and feedback intervention, in improving patient safety in primary healthcare (PHC) centres. METHODS: We conducted a 12-month cluster randomized controlled, multicentre trial. Fifty-nine PHC centres (1053 PHC professionals) in Spain were recruited and randomly allocated (1:1) to usual care or SinergiAPS intervention. The SinergiAPS intervention comprised: a bespoke feedback report with results from audits of patient safety based on the Patient Reported Experiences and Outcomes of Safety in Primary Care (PREOS-PC) questionnaire, administered to 75 patients/centre; a set of educational materials, and a structured template to record safety improvement plans. The primary outcome (at the PHC professional level) was patient safety culture (Medical Office Survey on Patient Safety Culture (MOSPSC) questionnaire). Secondary outcomes (at the centre level) were patient-reported safety (six PREOS-PC scales), and rate of avoidable hospital admissions. After a 12-month follow-up, we conducted 15 semi-structured interviews with PHC professionals to explore their perceptions of the intervention. RESULTS: During the 12-month follow-up, 10 of the 30 centres in the intervention group held action plan team meetings and eight registered 57 safety improvement action plans. The plans aimed to improve patient activation, address treatment-related incidents, enhance communication between patients and providers, and strengthen patient safety culture. At 12 months, no significant differences were observed in MOSPSC mean score (intervention: 3.60 [95% CI 3.55 to 3.64] vs. control: 3.64 [3.60 to 3.68]). Similarly, no differences were observed in the secondary outcomes, with both groups experiencing a decline in patient-reported safety and avoidable hospital admissions. The qualitative interviews evidenced that the onset of the COVID-19 pandemic 6-9 weeks after initiating the follow-up period severely limited PHC's capacity of developing and implementing safety improvement action plans, despite high levels of acceptability and perceived utility of the SinergiAPS intervention. CONCLUSIONS: In the context of the health emergency caused by the COVID-19 pandemic, SinergiAPS did not improve patient safety in Spanish PHC centres. TRIAL REGISTRATION: ClinicalTrials.gov (NCT03837912).

  @article{fiolderoque2025evaluating,
  abstract = {BACKGROUND: Patient safety, defined by the WHO as the absence of preventable harm, is a critical component of healthcare quality and poses a significant challenge globally. This study aimed to evaluate the effectiveness of SinergiAPS, a patient-centred audit and feedback intervention, in improving patient safety in primary healthcare (PHC) centres. METHODS: We conducted a 12-month cluster randomized controlled, multicentre trial. Fifty-nine PHC centres (1053 PHC professionals) in Spain were recruited and randomly allocated (1:1) to usual care or SinergiAPS intervention. The SinergiAPS intervention comprised: a bespoke feedback report with results from audits of patient safety based on the Patient Reported Experiences and Outcomes of Safety in Primary Care (PREOS-PC) questionnaire, administered to 75 patients/centre; a set of educational materials, and a structured template to record safety improvement plans. The primary outcome (at the PHC professional level) was patient safety culture (Medical Office Survey on Patient Safety Culture (MOSPSC) questionnaire). Secondary outcomes (at the centre level) were patient-reported safety (six PREOS-PC scales), and rate of avoidable hospital admissions. After a 12-month follow-up, we conducted 15 semi-structured interviews with PHC professionals to explore their perceptions of the intervention. RESULTS: During the 12-month follow-up, 10 of the 30 centres in the intervention group held action plan team meetings and eight registered 57 safety improvement action plans. The plans aimed to improve patient activation, address treatment-related incidents, enhance communication between patients and providers, and strengthen patient safety culture. At 12 months, no significant differences were observed in MOSPSC mean score (intervention: 3.60 [95% CI 3.55 to 3.64] vs. control: 3.64 [3.60 to 3.68]). Similarly, no differences were observed in the secondary outcomes, with both groups experiencing a decline in patient-reported safety and avoidable hospital admissions. The qualitative interviews evidenced that the onset of the COVID-19 pandemic 6-9 weeks after initiating the follow-up period severely limited PHC's capacity of developing and implementing safety improvement action plans, despite high levels of acceptability and perceived utility of the SinergiAPS intervention. CONCLUSIONS: In the context of the health emergency caused by the COVID-19 pandemic, SinergiAPS did not improve patient safety in Spanish PHC centres. TRIAL REGISTRATION: ClinicalTrials.gov (NCT03837912).},
  address = {England},
  author = {Fiol deRoque, Maria Antònia and Valderas, José María and Serrano-Ripoll, María Jesús and Gens-Barbarà, Montserrat and Martín-Luján, Francisco and Sánchez-Freire, Encarna and Montaño, Juan José and Mira-Martínez, Sofía and Pastor-Moreno, Guadalupe and Zamanillo-Campos, Rocío and Riera-Serra, Pau and Ricci-Cabello, Ignacio},
  journal = {BMC medicine},
  keywords = {evisap grapp-caib},
  month = {apr},
  number = 1,
  pages = {202--202},
  title = {Evaluating SinergiAPS, an intervention based on patient feedback to improve patient safety in primary care: a cluster randomized trial},
  volume = 23,
  year = 2025
  }
  

  %0 Journal Article
  %1 fiolderoque2025evaluating
  %A Fiol deRoque, Maria Antònia
  %A Valderas, José María
  %A Serrano-Ripoll, María Jesús
  %A Gens-Barbarà, Montserrat
  %A Martín-Luján, Francisco
  %A Sánchez-Freire, Encarna
  %A Montaño, Juan José
  %A Mira-Martínez, Sofía
  %A Pastor-Moreno, Guadalupe
  %A Zamanillo-Campos, Rocío
  %A Riera-Serra, Pau
  %A Ricci-Cabello, Ignacio
  %C England
  %D 2025
  %J BMC medicine
  %N 1
  %P 202--202
  %R 10.1186/s12916-025-04029-7
  %T Evaluating SinergiAPS, an intervention based on patient feedback to improve patient safety in primary care: a cluster randomized trial
  %U https://pubmed.ncbi.nlm.nih.gov/40189506
  %V 23
  %X BACKGROUND: Patient safety, defined by the WHO as the absence of preventable harm, is a critical component of healthcare quality and poses a significant challenge globally. This study aimed to evaluate the effectiveness of SinergiAPS, a patient-centred audit and feedback intervention, in improving patient safety in primary healthcare (PHC) centres. METHODS: We conducted a 12-month cluster randomized controlled, multicentre trial. Fifty-nine PHC centres (1053 PHC professionals) in Spain were recruited and randomly allocated (1:1) to usual care or SinergiAPS intervention. The SinergiAPS intervention comprised: a bespoke feedback report with results from audits of patient safety based on the Patient Reported Experiences and Outcomes of Safety in Primary Care (PREOS-PC) questionnaire, administered to 75 patients/centre; a set of educational materials, and a structured template to record safety improvement plans. The primary outcome (at the PHC professional level) was patient safety culture (Medical Office Survey on Patient Safety Culture (MOSPSC) questionnaire). Secondary outcomes (at the centre level) were patient-reported safety (six PREOS-PC scales), and rate of avoidable hospital admissions. After a 12-month follow-up, we conducted 15 semi-structured interviews with PHC professionals to explore their perceptions of the intervention. RESULTS: During the 12-month follow-up, 10 of the 30 centres in the intervention group held action plan team meetings and eight registered 57 safety improvement action plans. The plans aimed to improve patient activation, address treatment-related incidents, enhance communication between patients and providers, and strengthen patient safety culture. At 12 months, no significant differences were observed in MOSPSC mean score (intervention: 3.60 [95% CI 3.55 to 3.64] vs. control: 3.64 [3.60 to 3.68]). Similarly, no differences were observed in the secondary outcomes, with both groups experiencing a decline in patient-reported safety and avoidable hospital admissions. The qualitative interviews evidenced that the onset of the COVID-19 pandemic 6-9 weeks after initiating the follow-up period severely limited PHC's capacity of developing and implementing safety improvement action plans, despite high levels of acceptability and perceived utility of the SinergiAPS intervention. CONCLUSIONS: In the context of the health emergency caused by the COVID-19 pandemic, SinergiAPS did not improve patient safety in Spanish PHC centres. TRIAL REGISTRATION: ClinicalTrials.gov (NCT03837912).
  

• 
  Association between sociodemographic variables, healthy habits and stress with vascular age and SCORE2. López González, Ángel Arturo; Martínez-Almoyna Rifá, Emilio; Paublini, Hernán; Martorrel Sánchez, Cristina; Tárraga López, Pedro Juan; Ramírez-Manent, José Ignacio (2025). 10.20960/nh.05629-.

  AbstractURLBibTeXEndNoteDOIBibSonomy

  INTRODUCTION: Cardiovascular diseases are a global public health concern due to their high morbidity, mortality, and prevalence. Numerous scales based on different risk factors have been used to assess cardiovascular risk (CVR). The aim of this study is to evaluate how various sociodemographic variables, healthy habits, and stress are associated with the values of two CVR scales. MATERIALS AND METHODS: a descriptive cross-sectional study was conducted with 22,976 Spanish workers, analyzing the association between sociodemographic variables (age, gender, socioeconomic status), healthy habits (smoking, alcohol consumption, adherence to the Mediterranean diet, and physical activity), and stress with two CVR scales: vascular age (VA) and the Systematic Coronary Risk Evaluation-2 (SCORE2). RESULTS: all the scales analyzed show an association with elevated VA and SCORE2 values. The variables with the strongest associations (highest odds ratios) are age, type of occupation, and smoking. CONCLUSIONS: the profile of individuals most at risk of having high VA and SCORE2 values is a male over 50 years old, belonging to lower socioeconomic strata (manual laborer), a smoker, a regular alcohol consumer, sedentary, with low adherence to the Mediterranean diet, and high stress levels.

  @article{lopezgonzalez2025association,
  abstract = {INTRODUCTION: Cardiovascular diseases are a global public health concern due to their high morbidity, mortality, and prevalence. Numerous scales based on different risk factors have been used to assess cardiovascular risk (CVR). The aim of this study is to evaluate how various sociodemographic variables, healthy habits, and stress are associated with the values of two CVR scales. MATERIALS AND METHODS: a descriptive cross-sectional study was conducted with 22,976 Spanish workers, analyzing the association between sociodemographic variables (age, gender, socioeconomic status), healthy habits (smoking, alcohol consumption, adherence to the Mediterranean diet, and physical activity), and stress with two CVR scales: vascular age (VA) and the Systematic Coronary Risk Evaluation-2 (SCORE2). RESULTS: all the scales analyzed show an association with elevated VA and SCORE2 values. The variables with the strongest associations (highest odds ratios) are age, type of occupation, and smoking. CONCLUSIONS: the profile of individuals most at risk of having high VA and SCORE2 values is a male over 50 years old, belonging to lower socioeconomic strata (manual laborer), a smoker, a regular alcohol consumer, sedentary, with low adherence to the Mediterranean diet, and high stress levels.},
  address = {Spain},
  author = {López González, Ángel Arturo and Martínez-Almoyna Rifá, Emilio and Paublini, Hernán and Martorrel Sánchez, Cristina and Tárraga López, Pedro Juan and Ramírez-Manent, José Ignacio},
  journal = {Nutricion hospitalaria},
  keywords = {grapp-caib},
  month = {mar},
  pages = {10.20960/nh.05629--},
  title = {Association between sociodemographic variables, healthy habits and stress with vascular age and SCORE2},
  year = 2025
  }
  

  %0 Journal Article
  %1 lopezgonzalez2025association
  %A López González, Ángel Arturo
  %A Martínez-Almoyna Rifá, Emilio
  %A Paublini, Hernán
  %A Martorrel Sánchez, Cristina
  %A Tárraga López, Pedro Juan
  %A Ramírez-Manent, José Ignacio
  %C Spain
  %D 2025
  %J Nutricion hospitalaria
  %P 10.20960/nh.05629--
  %R 10.20960/nh.05629
  %T Association between sociodemographic variables, healthy habits and stress with vascular age and SCORE2
  %U https://pubmed.ncbi.nlm.nih.gov/40066594
  %X INTRODUCTION: Cardiovascular diseases are a global public health concern due to their high morbidity, mortality, and prevalence. Numerous scales based on different risk factors have been used to assess cardiovascular risk (CVR). The aim of this study is to evaluate how various sociodemographic variables, healthy habits, and stress are associated with the values of two CVR scales. MATERIALS AND METHODS: a descriptive cross-sectional study was conducted with 22,976 Spanish workers, analyzing the association between sociodemographic variables (age, gender, socioeconomic status), healthy habits (smoking, alcohol consumption, adherence to the Mediterranean diet, and physical activity), and stress with two CVR scales: vascular age (VA) and the Systematic Coronary Risk Evaluation-2 (SCORE2). RESULTS: all the scales analyzed show an association with elevated VA and SCORE2 values. The variables with the strongest associations (highest odds ratios) are age, type of occupation, and smoking. CONCLUSIONS: the profile of individuals most at risk of having high VA and SCORE2 values is a male over 50 years old, belonging to lower socioeconomic strata (manual laborer), a smoker, a regular alcohol consumer, sedentary, with low adherence to the Mediterranean diet, and high stress levels.
  

• 
  Describing the initial results of a pragmatic, cluster randomized clinical trial to examine the impact of a multifaceted digital intervention for the prevention of type 2 diabetes mellitus in the primary care setting: intervention design, recruitment strategy and participants’ baseline characteristics of the PREDIABETEXT trial. Mira-Martínez, Sofía; Zamanillo-Campos, Rocío; Malih, Narges; Fiol deRoque, Maria Antonia; Angullo-Martínez, Escarlata; Jimenez, Rafael; Serrano-Ripoll, Maria Jesús; Leiva, Alfonso; Oña, José Iván; Galmes-Panades, Aina M; Bennasar-Veny, Miquel; Yañez, Aina Maria; Gómez-Juanes, Rocío; Konieczna, Jadwiga; Miralles, Jerónima; Romaguera, Dora; Vidal-Thomasa, María Clara; Llobera-Canaves, Joan; García-Toro, Mauro; Gervilla-García, Elena; Vicens, Catalina; Bulilete, Oana; Montaño, Juan José; Gili, Margalida; Roca, Miquel; Colom, Antoni; Ricci-Cabello, Ignacio (2025). 16 1524336–1524336.

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  INTRODUCTION: i) to describe PREDIABETEXT, a novel digital intervention for the prevention of type 2 diabetes; ii) to examine the performance of a strategy for virtual recruitment of participants in a trial to assess its impact, and; iii) to determine the baseline characteristics of the enrolled participants. METHODS: We developed PREDIABETEXT in a multistage process involving systematic literature reviews and qualitative research with end users (primary care patients and professionals). We combined multiple virtual strategies (SMS, phone calls, promotional videos) to recruit healthcare professionals and their patients. We collected baseline data from patients (sociodemographic, behavioral and clinical) and healthcare professionals (sociodemographic and professional experience). RESULTS: The intervention consisted in delivering personalized short text messages supporting lifestyle behavior changes to people at risk of type 2 diabetes; and online training to their primary healthcare professionals. We recruited 58/133 (43.6%) professionals (30 doctors; 28 nurses) from 16 centers. Most professionals (83%) were women [mean (SD) age 49.69 (10.15)]. We recruited 365/976 (37.4%) patients (54.5% women, 59.82 (9.77) years old. Around half (55.3%) presented obesity (BMI ≥25), 65% hypertension, 43.3% hypercholesterolemia, and 14.8% hypertriglyceridemia. CONCLUSIONS: The PREDIABETEX trial successfully recruited a representative sample of patients at risk of type 2 diabetes and their healthcare providers.

  @article{miramartinez2025describing,
  abstract = {INTRODUCTION: i) to describe PREDIABETEXT, a novel digital intervention for the prevention of type 2 diabetes; ii) to examine the performance of a strategy for virtual recruitment of participants in a trial to assess its impact, and; iii) to determine the baseline characteristics of the enrolled participants. METHODS: We developed PREDIABETEXT in a multistage process involving systematic literature reviews and qualitative research with end users (primary care patients and professionals). We combined multiple virtual strategies (SMS, phone calls, promotional videos) to recruit healthcare professionals and their patients. We collected baseline data from patients (sociodemographic, behavioral and clinical) and healthcare professionals (sociodemographic and professional experience). RESULTS: The intervention consisted in delivering personalized short text messages supporting lifestyle behavior changes to people at risk of type 2 diabetes; and online training to their primary healthcare professionals. We recruited 58/133 (43.6%) professionals (30 doctors; 28 nurses) from 16 centers. Most professionals (83%) were women [mean (SD) age 49.69 (10.15)]. We recruited 365/976 (37.4%) patients (54.5% women, 59.82 (9.77) years old. Around half (55.3%) presented obesity (BMI ≥25), 65% hypertension, 43.3% hypercholesterolemia, and 14.8% hypertriglyceridemia. CONCLUSIONS: The PREDIABETEX trial successfully recruited a representative sample of patients at risk of type 2 diabetes and their healthcare providers.},
  address = {Switzerland},
  author = {Mira-Martínez, Sofía and Zamanillo-Campos, Rocío and Malih, Narges and Fiol deRoque, Maria Antonia and Angullo-Martínez, Escarlata and Jimenez, Rafael and Serrano-Ripoll, Maria Jesús and Leiva, Alfonso and Oña, José Iván and Galmes-Panades, Aina M and Bennasar-Veny, Miquel and Yañez, Aina Maria and Gómez-Juanes, Rocío and Konieczna, Jadwiga and Miralles, Jerónima and Romaguera, Dora and Vidal-Thomasa, María Clara and Llobera-Canaves, Joan and García-Toro, Mauro and Gervilla-García, Elena and Vicens, Catalina and Bulilete, Oana and Montaño, Juan José and Gili, Margalida and Roca, Miquel and Colom, Antoni and Ricci-Cabello, Ignacio},
  journal = {Frontiers in endocrinology},
  keywords = {evisap grapp-caib},
  month = {mar},
  pages = {1524336--1524336},
  title = {Describing the initial results of a pragmatic, cluster randomized clinical trial to examine the impact of a multifaceted digital intervention for the prevention of type 2 diabetes mellitus in the primary care setting: intervention design, recruitment strategy and participants' baseline characteristics of the PREDIABETEXT trial},
  volume = 16,
  year = 2025
  }
  

  %0 Journal Article
  %1 miramartinez2025describing
  %A Mira-Martínez, Sofía
  %A Zamanillo-Campos, Rocío
  %A Malih, Narges
  %A Fiol deRoque, Maria Antonia
  %A Angullo-Martínez, Escarlata
  %A Jimenez, Rafael
  %A Serrano-Ripoll, Maria Jesús
  %A Leiva, Alfonso
  %A Oña, José Iván
  %A Galmes-Panades, Aina M
  %A Bennasar-Veny, Miquel
  %A Yañez, Aina Maria
  %A Gómez-Juanes, Rocío
  %A Konieczna, Jadwiga
  %A Miralles, Jerónima
  %A Romaguera, Dora
  %A Vidal-Thomasa, María Clara
  %A Llobera-Canaves, Joan
  %A García-Toro, Mauro
  %A Gervilla-García, Elena
  %A Vicens, Catalina
  %A Bulilete, Oana
  %A Montaño, Juan José
  %A Gili, Margalida
  %A Roca, Miquel
  %A Colom, Antoni
  %A Ricci-Cabello, Ignacio
  %C Switzerland
  %D 2025
  %J Frontiers in endocrinology
  %P 1524336--1524336
  %R 10.3389/fendo.2025.1524336
  %T Describing the initial results of a pragmatic, cluster randomized clinical trial to examine the impact of a multifaceted digital intervention for the prevention of type 2 diabetes mellitus in the primary care setting: intervention design, recruitment strategy and participants' baseline characteristics of the PREDIABETEXT trial
  %U https://pubmed.ncbi.nlm.nih.gov/40230484
  %V 16
  %X INTRODUCTION: i) to describe PREDIABETEXT, a novel digital intervention for the prevention of type 2 diabetes; ii) to examine the performance of a strategy for virtual recruitment of participants in a trial to assess its impact, and; iii) to determine the baseline characteristics of the enrolled participants. METHODS: We developed PREDIABETEXT in a multistage process involving systematic literature reviews and qualitative research with end users (primary care patients and professionals). We combined multiple virtual strategies (SMS, phone calls, promotional videos) to recruit healthcare professionals and their patients. We collected baseline data from patients (sociodemographic, behavioral and clinical) and healthcare professionals (sociodemographic and professional experience). RESULTS: The intervention consisted in delivering personalized short text messages supporting lifestyle behavior changes to people at risk of type 2 diabetes; and online training to their primary healthcare professionals. We recruited 58/133 (43.6%) professionals (30 doctors; 28 nurses) from 16 centers. Most professionals (83%) were women [mean (SD) age 49.69 (10.15)]. We recruited 365/976 (37.4%) patients (54.5% women, 59.82 (9.77) years old. Around half (55.3%) presented obesity (BMI ≥25), 65% hypertension, 43.3% hypercholesterolemia, and 14.8% hypertriglyceridemia. CONCLUSIONS: The PREDIABETEX trial successfully recruited a representative sample of patients at risk of type 2 diabetes and their healthcare providers.
  

• 
  Engaging Primary Care Professionals and People at Risk of Type 2 Diabetes in the Design of PREDIABETEXT, a Multifaceted Digital Intervention Aimed at Preventing Type 2 Diabetes: A Qualitative Study. Serrano-Ripoll, Maria J.; Zamanillo-Campos, Rocío; Mira Martínez, Sofía; Fiol deRoque, Maria A.; Malih, Narges; Angullo-Martínez, Escarlata; Ricci-Cabello, Ignacio (2025). 6

  AbstractBibTeXEndNoteBibSonomyDownload

  Objectives: This study aims to explore perspectives and opinions from healthcare professionals and people at risk of type 2 diabetes mellitus (T2DM) to inform the design of PREDIABETEXT, a new digital multifaceted intervention to prevent T2DM. Methods: in this qualitative study, we purposefully recruited 15 healthcare professionals (doctors and nurses) working in primary healthcare centers in Mallorca (Spain), and 15 of their patients at risk of T2DM (HbA1c 6–6.4%, and/or fasting plasma glucose 110–125 mg/dL). We collected the data through semi-structured phone interviews, using an interview guide aimed at gathering participants’ views about the two PREDIABETEXT proposed co-interventions (educational intervention targeted at professionals and delivered as an online training course, and behavioral intervention targeted at individuals at risk of T2DM and delivered using SMS short text messages). The interviews were audio-recorded, verbatim transcribed, and analyzed using a thematic analysis approach. Results: Primary healthcare professionals valued a prediabetes training course for standardizing care and supporting diabetes prevention. They preferred a blended format with content on early detection, intervention, and monitoring. They perceived SMS reminders to their patients as potentially useful for reinforcing guidelines and improving care. Individuals at risk of T2DM, who faced challenges maintaining a healthy diet and exercise routine, viewed SMS as potentially motivational and informative, offering suggestions on content, format, and frequency to enhance its intended benefits. Conclusions: This qualitative study provided valuable insights from primary care professionals and people at risk of T2DM that will inform the user-centered design of the PREDIABETEXT intervention.

  @article{serranoripoll2025engaging,
  abstract = {Objectives: This study aims to explore perspectives and opinions from healthcare professionals and people at risk of type 2 diabetes mellitus (T2DM) to inform the design of PREDIABETEXT, a new digital multifaceted intervention to prevent T2DM. Methods: in this qualitative study, we purposefully recruited 15 healthcare professionals (doctors and nurses) working in primary healthcare centers in Mallorca (Spain), and 15 of their patients at risk of T2DM (HbA1c 6–6.4%, and/or fasting plasma glucose 110–125 mg/dL). We collected the data through semi-structured phone interviews, using an interview guide aimed at gathering participants’ views about the two PREDIABETEXT proposed co-interventions (educational intervention targeted at professionals and delivered as an online training course, and behavioral intervention targeted at individuals at risk of T2DM and delivered using SMS short text messages). The interviews were audio-recorded, verbatim transcribed, and analyzed using a thematic analysis approach. Results: Primary healthcare professionals valued a prediabetes training course for standardizing care and supporting diabetes prevention. They preferred a blended format with content on early detection, intervention, and monitoring. They perceived SMS reminders to their patients as potentially useful for reinforcing guidelines and improving care. Individuals at risk of T2DM, who faced challenges maintaining a healthy diet and exercise routine, viewed SMS as potentially motivational and informative, offering suggestions on content, format, and frequency to enhance its intended benefits. Conclusions: This qualitative study provided valuable insights from primary care professionals and people at risk of T2DM that will inform the user-centered design of the PREDIABETEXT intervention.},
  author = {Serrano-Ripoll, Maria J. and Zamanillo-Campos, Rocío and Mira Martínez, Sofía and Fiol deRoque, Maria A. and Malih, Narges and Angullo-Martínez, Escarlata and Ricci-Cabello, Ignacio},
  booktitle = {Diabetology},
  keywords = {evisap grapp-caib},
  series = 1,
  title = {Engaging Primary Care Professionals and People at Risk of Type 2 Diabetes in the Design of PREDIABETEXT, a Multifaceted Digital Intervention Aimed at Preventing Type 2 Diabetes: A Qualitative Study},
  volume = 6,
  year = 2025
  }
  

  %0 Journal Article
  %1 serranoripoll2025engaging
  %A Serrano-Ripoll, Maria J.
  %A Zamanillo-Campos, Rocío
  %A Mira Martínez, Sofía
  %A Fiol deRoque, Maria A.
  %A Malih, Narges
  %A Angullo-Martínez, Escarlata
  %A Ricci-Cabello, Ignacio
  %B Diabetology
  %D 2025
  %T Engaging Primary Care Professionals and People at Risk of Type 2 Diabetes in the Design of PREDIABETEXT, a Multifaceted Digital Intervention Aimed at Preventing Type 2 Diabetes: A Qualitative Study
  %V 6
  %X Objectives: This study aims to explore perspectives and opinions from healthcare professionals and people at risk of type 2 diabetes mellitus (T2DM) to inform the design of PREDIABETEXT, a new digital multifaceted intervention to prevent T2DM. Methods: in this qualitative study, we purposefully recruited 15 healthcare professionals (doctors and nurses) working in primary healthcare centers in Mallorca (Spain), and 15 of their patients at risk of T2DM (HbA1c 6–6.4%, and/or fasting plasma glucose 110–125 mg/dL). We collected the data through semi-structured phone interviews, using an interview guide aimed at gathering participants’ views about the two PREDIABETEXT proposed co-interventions (educational intervention targeted at professionals and delivered as an online training course, and behavioral intervention targeted at individuals at risk of T2DM and delivered using SMS short text messages). The interviews were audio-recorded, verbatim transcribed, and analyzed using a thematic analysis approach. Results: Primary healthcare professionals valued a prediabetes training course for standardizing care and supporting diabetes prevention. They preferred a blended format with content on early detection, intervention, and monitoring. They perceived SMS reminders to their patients as potentially useful for reinforcing guidelines and improving care. Individuals at risk of T2DM, who faced challenges maintaining a healthy diet and exercise routine, viewed SMS as potentially motivational and informative, offering suggestions on content, format, and frequency to enhance its intended benefits. Conclusions: This qualitative study provided valuable insights from primary care professionals and people at risk of T2DM that will inform the user-centered design of the PREDIABETEXT intervention.
  

• 
  The Use of Antibiotics for Uncomplicated Urinary Tract Infections in Adult Women: Qualitative Findings From the SCOUT Trial. Munné-Barellas, Berta; Monfà, Ramon; Llor, Carl; Garcia-Sangenís, Ana; Miranda-Jiménez, Cristina; Morros, Rosa; Moragas, Ana; Alvarez-Greciano, Pablo; Leiva, Alfonso; Lozano-Del Hoyo, Mª Luisa; Sánchez-Calavera, Maria Antonia; Marín-Cañada, Jaime; Sánchez-Ruano, Raquel (2025). 19 2673–2685.

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Background This paper focuses on women’s subjective experiences with UTIs and antibiotic use. Uncomplicated urinary tract infections (UTI) are among the most common infections treated in primary care, however, there is limited evidence regarding the experiences and their antibiotic treatment preferences. Objective The aim of this study is to gather experiences, beliefs, and attitudes regarding the use of antibiotics and the participation in the clinical trial. Methods This qualitative sub-study is part of the SCOUT project, which, through a clinical trial, aims to assess the effectiveness of four short antibiotic regimens (a single 3g dose of fosfomycin; 3g of fosfomycin for two days; 400mg of pivmecillinam for three days; and 100mg of nitrofurantoin for five days). A total of 68 semi-structured interviews were conducted in four regions of Spain (Catalonia N=19, Aragón N=19, Madrid N=15, and the Balearic Islands N=15). A purposive and theoretical sampling approach was employed. Participants were recruited after taking part in the clinical trial. Data collection took place between March and July 2024 and analysed using Thematic Analysis. Results UTI did not cause excessive concern, except in cases where the antibiotic was ineffective or when participants had experienced multiple infections in the past. Fosfomycin was the most widely recognized antibiotic, and the two-dose regimen was generally well-regarded for being easy to take while also being more effective than the single-dose treatment. Longer regimens could cause some side effects, but in certain cases, they were perceived as more effective. Participation in the clinical trial was viewed positively, as it contributed to increasing overall knowledge about UTI and the antibiotics used to treat them, as well as ensuring closer monitoring of each specific case. Conclusion This study gathers experiences related to UTI, antibiotic treatment regimens, and participation in the SCOUT clinical trial. It highlights the need to document the realities of UTI in order to improve future clinical trials.

  @article{munne-barellas_use_2025,
  abstract = {Background This paper focuses on women’s subjective experiences with UTIs and antibiotic use. Uncomplicated urinary tract infections (UTI) are among the most common infections treated in primary care, however, there is limited evidence regarding the experiences and their antibiotic treatment preferences. Objective The aim of this study is to gather experiences, beliefs, and attitudes regarding the use of antibiotics and the participation in the clinical trial. Methods This qualitative sub-study is part of the SCOUT project, which, through a clinical trial, aims to assess the effectiveness of four short antibiotic regimens (a single 3g dose of fosfomycin; 3g of fosfomycin for two days; 400mg of pivmecillinam for three days; and 100mg of nitrofurantoin for five days). A total of 68 semi-structured interviews were conducted in four regions of Spain (Catalonia N=19, Aragón N=19, Madrid N=15, and the Balearic Islands N=15). A purposive and theoretical sampling approach was employed. Participants were recruited after taking part in the clinical trial. Data collection took place between March and July 2024 and analysed using Thematic Analysis. Results UTI did not cause excessive concern, except in cases where the antibiotic was ineffective or when participants had experienced multiple infections in the past. Fosfomycin was the most widely recognized antibiotic, and the two-dose regimen was generally well-regarded for being easy to take while also being more effective than the single-dose treatment. Longer regimens could cause some side effects, but in certain cases, they were perceived as more effective. Participation in the clinical trial was viewed positively, as it contributed to increasing overall knowledge about UTI and the antibiotics used to treat them, as well as ensuring closer monitoring of each specific case. Conclusion This study gathers experiences related to UTI, antibiotic treatment regimens, and participation in the SCOUT clinical trial. It highlights the need to document the realities of UTI in order to improve future clinical trials.},
  author = {Munné-Barellas, Berta and Monfà, Ramon and Llor, Carl and Garcia-Sangenís, Ana and Miranda-Jiménez, Cristina and Morros, Rosa and Moragas, Ana and Alvarez-Greciano, Pablo and Leiva, Alfonso and Lozano-Del Hoyo, Mª Luisa and Sánchez-Calavera, Maria Antonia and Marín-Cañada, Jaime and Sánchez-Ruano, Raquel},
  journal = {Patient preference and adherence},
  keywords = {grapp-caib},
  month = {aug},
  pages = {2673--2685},
  title = {The Use of Antibiotics for Uncomplicated Urinary Tract Infections in Adult Women: Qualitative Findings From the SCOUT Trial},
  volume = 19,
  year = 2025
  }
  

  %0 Journal Article
  %1 munne-barellas_use_2025
  %A Munné-Barellas, Berta
  %A Monfà, Ramon
  %A Llor, Carl
  %A Garcia-Sangenís, Ana
  %A Miranda-Jiménez, Cristina
  %A Morros, Rosa
  %A Moragas, Ana
  %A Alvarez-Greciano, Pablo
  %A Leiva, Alfonso
  %A Lozano-Del Hoyo, Mª Luisa
  %A Sánchez-Calavera, Maria Antonia
  %A Marín-Cañada, Jaime
  %A Sánchez-Ruano, Raquel
  %D 2025
  %J Patient preference and adherence
  %P 2673--2685
  %R 10.2147/PPA.S531582
  %T The Use of Antibiotics for Uncomplicated Urinary Tract Infections in Adult Women: Qualitative Findings From the SCOUT Trial
  %U https://pmc.ncbi.nlm.nih.gov/articles/PMC12410387/
  %V 19
  %X Background This paper focuses on women’s subjective experiences with UTIs and antibiotic use. Uncomplicated urinary tract infections (UTI) are among the most common infections treated in primary care, however, there is limited evidence regarding the experiences and their antibiotic treatment preferences. Objective The aim of this study is to gather experiences, beliefs, and attitudes regarding the use of antibiotics and the participation in the clinical trial. Methods This qualitative sub-study is part of the SCOUT project, which, through a clinical trial, aims to assess the effectiveness of four short antibiotic regimens (a single 3g dose of fosfomycin; 3g of fosfomycin for two days; 400mg of pivmecillinam for three days; and 100mg of nitrofurantoin for five days). A total of 68 semi-structured interviews were conducted in four regions of Spain (Catalonia N=19, Aragón N=19, Madrid N=15, and the Balearic Islands N=15). A purposive and theoretical sampling approach was employed. Participants were recruited after taking part in the clinical trial. Data collection took place between March and July 2024 and analysed using Thematic Analysis. Results UTI did not cause excessive concern, except in cases where the antibiotic was ineffective or when participants had experienced multiple infections in the past. Fosfomycin was the most widely recognized antibiotic, and the two-dose regimen was generally well-regarded for being easy to take while also being more effective than the single-dose treatment. Longer regimens could cause some side effects, but in certain cases, they were perceived as more effective. Participation in the clinical trial was viewed positively, as it contributed to increasing overall knowledge about UTI and the antibiotics used to treat them, as well as ensuring closer monitoring of each specific case. Conclusion This study gathers experiences related to UTI, antibiotic treatment regimens, and participation in the SCOUT clinical trial. It highlights the need to document the realities of UTI in order to improve future clinical trials.
  

• 
  Usefulness of the Córdoba Equation for Estimating Body Fat When Determining the Level of Risk of Developing Diabetes Type 2 or Prediabetes. Marina Arroyo, Marta; Ramírez Gallegos, Ignacio; Paublini, Hernán; López-González, Ángel Arturo; Tárraga López, Pedro J; Martorell Sánchez, Cristina; Sastre-Alzamora, Tomás; Ramírez-Manent, José Ignacio (2025). 61(4) 613-.

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Background and Objectives: Type 2 diabetes (T2D) and prediabetes represent major global health concerns, with obesity being a key risk factor. However, recent evidence suggests that the adipose tissue composition and distribution play a more critical role in metabolic dysfunction than the total body weight or body mass index (BMI). This study evaluates the predictive capacity of the Córdoba Equation for Estimating Body Fat (ECORE-BF) for identifying individuals at high risk of developing T2D and prediabetes. Materials and Methods: A cross-sectional study was carried out involving 418,343 Spanish workers. Body fat percentage was estimated using the ECORE-BF equation, and diabetes risk was assessed using validated predictive models, including the Finnish Diabetes Risk Score (FINDRISC), QDiabetes score (QD-score), and others. The discriminatory power of ECORE-BF in predicting T2D and prediabetes was assessed using receiver operating characteristic (ROC) curve analysis. Results: ECORE-BF showed a strong correlation with high-risk classifications across all diabetes risk scales. The area under the ROC curve (AUC) exceeded 0.95 for both men and women, demonstrating high predictive accuracy. Conclusions: Adipose tissue distribution, particularly visceral adiposity, is a central factor in metabolic dysfunction. ECORE-BF provides a cost-effective alternative for large-scale T2D and prediabetes risk assessment. Future research should explore the impact of visceral adipose tissue reduction on diabetes prevention and the integration of estimation scales into clinical and public health strategies.

  @article{marinaarroyo2025usefulness,
  abstract = {Background and Objectives: Type 2 diabetes (T2D) and prediabetes represent major global health concerns, with obesity being a key risk factor. However, recent evidence suggests that the adipose tissue composition and distribution play a more critical role in metabolic dysfunction than the total body weight or body mass index (BMI). This study evaluates the predictive capacity of the Córdoba Equation for Estimating Body Fat (ECORE-BF) for identifying individuals at high risk of developing T2D and prediabetes. Materials and Methods: A cross-sectional study was carried out involving 418,343 Spanish workers. Body fat percentage was estimated using the ECORE-BF equation, and diabetes risk was assessed using validated predictive models, including the Finnish Diabetes Risk Score (FINDRISC), QDiabetes score (QD-score), and others. The discriminatory power of ECORE-BF in predicting T2D and prediabetes was assessed using receiver operating characteristic (ROC) curve analysis. Results: ECORE-BF showed a strong correlation with high-risk classifications across all diabetes risk scales. The area under the ROC curve (AUC) exceeded 0.95 for both men and women, demonstrating high predictive accuracy. Conclusions: Adipose tissue distribution, particularly visceral adiposity, is a central factor in metabolic dysfunction. ECORE-BF provides a cost-effective alternative for large-scale T2D and prediabetes risk assessment. Future research should explore the impact of visceral adipose tissue reduction on diabetes prevention and the integration of estimation scales into clinical and public health strategies.},
  address = {Switzerland},
  author = {Marina Arroyo, Marta and Ramírez Gallegos, Ignacio and Paublini, Hernán and López-González, Ángel Arturo and Tárraga López, Pedro J and Martorell Sánchez, Cristina and Sastre-Alzamora, Tomás and Ramírez-Manent, José Ignacio},
  journal = {Medicina (Kaunas, Lithuania)},
  keywords = {grapp-caib},
  month = {mar},
  number = 4,
  pages = {613--},
  title = {Usefulness of the Córdoba Equation for Estimating Body Fat When Determining the Level of Risk of Developing Diabetes Type 2 or Prediabetes},
  volume = 61,
  year = 2025
  }
  

  %0 Journal Article
  %1 marinaarroyo2025usefulness
  %A Marina Arroyo, Marta
  %A Ramírez Gallegos, Ignacio
  %A Paublini, Hernán
  %A López-González, Ángel Arturo
  %A Tárraga López, Pedro J
  %A Martorell Sánchez, Cristina
  %A Sastre-Alzamora, Tomás
  %A Ramírez-Manent, José Ignacio
  %C Switzerland
  %D 2025
  %J Medicina (Kaunas, Lithuania)
  %N 4
  %P 613--
  %R 10.3390/medicina61040613
  %T Usefulness of the Córdoba Equation for Estimating Body Fat When Determining the Level of Risk of Developing Diabetes Type 2 or Prediabetes
  %U https://pubmed.ncbi.nlm.nih.gov/40282904
  %V 61
  %X Background and Objectives: Type 2 diabetes (T2D) and prediabetes represent major global health concerns, with obesity being a key risk factor. However, recent evidence suggests that the adipose tissue composition and distribution play a more critical role in metabolic dysfunction than the total body weight or body mass index (BMI). This study evaluates the predictive capacity of the Córdoba Equation for Estimating Body Fat (ECORE-BF) for identifying individuals at high risk of developing T2D and prediabetes. Materials and Methods: A cross-sectional study was carried out involving 418,343 Spanish workers. Body fat percentage was estimated using the ECORE-BF equation, and diabetes risk was assessed using validated predictive models, including the Finnish Diabetes Risk Score (FINDRISC), QDiabetes score (QD-score), and others. The discriminatory power of ECORE-BF in predicting T2D and prediabetes was assessed using receiver operating characteristic (ROC) curve analysis. Results: ECORE-BF showed a strong correlation with high-risk classifications across all diabetes risk scales. The area under the ROC curve (AUC) exceeded 0.95 for both men and women, demonstrating high predictive accuracy. Conclusions: Adipose tissue distribution, particularly visceral adiposity, is a central factor in metabolic dysfunction. ECORE-BF provides a cost-effective alternative for large-scale T2D and prediabetes risk assessment. Future research should explore the impact of visceral adipose tissue reduction on diabetes prevention and the integration of estimation scales into clinical and public health strategies.
  

• 
  Association Between Alcohol Consumption, Other Healthy Habits and Sociodemographic Variables and the Values of Different Insulin Resistance Risk Scales in 139,634 Spanish Workers. Obrador de Hevia, Joan; López-González, Ángel Arturo; Ramírez-Manent, José Ignacio; Paublini, Hernán; Tárraga López, Pedro Juan; Martorell Sánchez, Cristina; Riutord-Sbert, Pere (2025). 13(8) 921.

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Background: Alcohol consumption is a major public health concern, influencing metabolic health and insulin resistance (IR). While moderate alcohol intake has been associated with potential metabolic benefits, excessive consumption is linked to IR and related disorders. This study examines the association between sociodemographic variables, health habits, and IR risk using validated metabolic indices. Methods: A dual-phase study was conducted, including a cross-sectional analysis of 139,634 Spanish workers and a retrospective longitudinal follow-up of 40,431 participants (2009-2019). Data on sociodemographic factors (age, sex and socioeconomic status) and health habits (smoking, alcohol consumption, diet and physical activity) were collected through standardized occupational health assessments. IR risk was assessed using the Triglyceride-Glucose Index (TyG), Metabolic Score for Insulin Resistance (METS-IR), and Single-Point Insulin Sensitivity Estimator (SPISE-IR). Binary logistic regression was used for statistical analysis. Results: Age, male sex, lower socioeconomic status, smoking, alcohol consumption, physical inactivity and low adherence to the Mediterranean diet were significantly associated with higher IR risk across all indices (p < 0.001). Alcohol consumption exhibited a dose-dependent relationship with IR, with excessive intake significantly increasing the risk of IR. Longitudinal data revealed a worsening IR profile over time, particularly among older, low-income and physically inactive individuals. Conclusions: Sociodemographic factors and lifestyle habits strongly influence IR. Preventive strategies focused on reducing alcohol consumption, smoking cessation and promoting physical activity and dietary improvements are essential to mitigate the risk of IR, especially in vulnerable populations. Further longitudinal studies are needed to establish causal relationships and refine intervention strategies.

  @article{obradordehevia2025association,
  abstract = {Background: Alcohol consumption is a major public health concern, influencing metabolic health and insulin resistance (IR). While moderate alcohol intake has been associated with potential metabolic benefits, excessive consumption is linked to IR and related disorders. This study examines the association between sociodemographic variables, health habits, and IR risk using validated metabolic indices. Methods: A dual-phase study was conducted, including a cross-sectional analysis of 139,634 Spanish workers and a retrospective longitudinal follow-up of 40,431 participants (2009-2019). Data on sociodemographic factors (age, sex and socioeconomic status) and health habits (smoking, alcohol consumption, diet and physical activity) were collected through standardized occupational health assessments. IR risk was assessed using the Triglyceride-Glucose Index (TyG), Metabolic Score for Insulin Resistance (METS-IR), and Single-Point Insulin Sensitivity Estimator (SPISE-IR). Binary logistic regression was used for statistical analysis. Results: Age, male sex, lower socioeconomic status, smoking, alcohol consumption, physical inactivity and low adherence to the Mediterranean diet were significantly associated with higher IR risk across all indices (p < 0.001). Alcohol consumption exhibited a dose-dependent relationship with IR, with excessive intake significantly increasing the risk of IR. Longitudinal data revealed a worsening IR profile over time, particularly among older, low-income and physically inactive individuals. Conclusions: Sociodemographic factors and lifestyle habits strongly influence IR. Preventive strategies focused on reducing alcohol consumption, smoking cessation and promoting physical activity and dietary improvements are essential to mitigate the risk of IR, especially in vulnerable populations. Further longitudinal studies are needed to establish causal relationships and refine intervention strategies.},
  address = {Switzerland},
  author = {Obrador de Hevia, Joan and López-González, Ángel Arturo and Ramírez-Manent, José Ignacio and Paublini, Hernán and Tárraga López, Pedro Juan and Martorell Sánchez, Cristina and Riutord-Sbert, Pere},
  journal = {Healthcare (Basel, Switzerland)},
  keywords = {grapp-caib},
  month = {apr},
  number = 8,
  pages = 921,
  title = {Association Between Alcohol Consumption, Other Healthy Habits and Sociodemographic Variables and the Values of Different Insulin Resistance Risk Scales in 139,634 Spanish Workers},
  volume = 13,
  year = 2025
  }
  

  %0 Journal Article
  %1 obradordehevia2025association
  %A Obrador de Hevia, Joan
  %A López-González, Ángel Arturo
  %A Ramírez-Manent, José Ignacio
  %A Paublini, Hernán
  %A Tárraga López, Pedro Juan
  %A Martorell Sánchez, Cristina
  %A Riutord-Sbert, Pere
  %C Switzerland
  %D 2025
  %J Healthcare (Basel, Switzerland)
  %N 8
  %P 921
  %R 10.3390/healthcare13080921
  %T Association Between Alcohol Consumption, Other Healthy Habits and Sociodemographic Variables and the Values of Different Insulin Resistance Risk Scales in 139,634 Spanish Workers
  %U https://pubmed.ncbi.nlm.nih.gov/40281870
  %V 13
  %X Background: Alcohol consumption is a major public health concern, influencing metabolic health and insulin resistance (IR). While moderate alcohol intake has been associated with potential metabolic benefits, excessive consumption is linked to IR and related disorders. This study examines the association between sociodemographic variables, health habits, and IR risk using validated metabolic indices. Methods: A dual-phase study was conducted, including a cross-sectional analysis of 139,634 Spanish workers and a retrospective longitudinal follow-up of 40,431 participants (2009-2019). Data on sociodemographic factors (age, sex and socioeconomic status) and health habits (smoking, alcohol consumption, diet and physical activity) were collected through standardized occupational health assessments. IR risk was assessed using the Triglyceride-Glucose Index (TyG), Metabolic Score for Insulin Resistance (METS-IR), and Single-Point Insulin Sensitivity Estimator (SPISE-IR). Binary logistic regression was used for statistical analysis. Results: Age, male sex, lower socioeconomic status, smoking, alcohol consumption, physical inactivity and low adherence to the Mediterranean diet were significantly associated with higher IR risk across all indices (p < 0.001). Alcohol consumption exhibited a dose-dependent relationship with IR, with excessive intake significantly increasing the risk of IR. Longitudinal data revealed a worsening IR profile over time, particularly among older, low-income and physically inactive individuals. Conclusions: Sociodemographic factors and lifestyle habits strongly influence IR. Preventive strategies focused on reducing alcohol consumption, smoking cessation and promoting physical activity and dietary improvements are essential to mitigate the risk of IR, especially in vulnerable populations. Further longitudinal studies are needed to establish causal relationships and refine intervention strategies.
  

• 
  A Multifaceted Digital Intervention for the Prevention of Type 2 Diabetes Mellitus in Primary Care (PREDIABETEXT): Cluster Randomized Trial. Mira-Martínez, Sofía; Malih, Narges; Angullo-Martínez, Escarlata; Zamanillo-Campos, Rocío; Yañez, Aina M; Bennasar-Veny, Miquel; Gómez-Juanes, Rocío; Konieczna, Jadwiga; Jiménez, Rafael; Serrano-Ripoll, Maria J; Fiol deRoque, Maria Antonia; Leiva, Alfonso; Galmes-Panades, Aina M; Miralles-Xamena, Jerónima; Vidal-Thomàs, Maria Clara; Gómez-Cobo, Cristina; Gervilla, Elena; Oña-Gil, José Iván; Ricci-Cabello, Ignacio (2025). 27 e70981-e70981.

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: The diabetes epidemic continues to surge worldwide, demanding urgent and innovative solutions. Digital health interventions, particularly those targeting behavior change, hold promise due to their affordability and scalability. However, research in this field remains in its early stages. OBJECTIVE: This study aimed to evaluate the effectiveness of PREDIABETEXT (Prediabetes Text Message Digital Intervention for the Prevention of Type 2 Diabetes Mellitus), a digital health intervention, in reducing glycated hemoglobin (HbA(1c)) and in improving secondary clinical, physiological, and behavioral outcomes. METHODS: We conducted a 6-month, 3-arm, pragmatic cluster randomized clinical trial. We recruited patients with prediabetes (HbA(1c) levels between 6% and 6.4% in the previous 3 months or 2 consecutive fasting plasma glucose measurements of 110-125 mg/dL) registered at primary care centers in the Balearic Islands, Spain. The PREDIABETEXT intervention consisted of 3 personalized SMS text messages per week aimed at supporting lifestyle behavior changes and online training for their primary health care professionals. A total of 58 professionals (clusters) from 16 centers participated in the study and were randomized (1:1:1) to intervention group A (patient SMS text messaging), intervention group B (patient SMS text messaging+health care professional web-based training), or the control group (usual care). Following the 6-month intervention period, we conducted individual qualitative interviews with 8 patients and 7 health care professionals to evaluate their experiences with the intervention in terms of utility, satisfaction, and implementation barriers. RESULTS: In total, 58 health care professionals (clusters) were included, allocated to the control group (n=20, 34%; 119/365, 32.6% patients), intervention group A (SMS text messaging only; n=18, 31%; 106/365, 29% patients), and intervention group B (SMS text messaging+training; n=20, 34%; 140/365, 38.4% patients). The mean age of the patients was 59.79 (SD 9.75) years, and 54.5% (199/365) were female. The results of the intention-to-treat analysis at the 6-month time point showed that intervention A led to a small, nonsignificant reduction in HbA(1c) levels compared to the control group (β=-0.05, 95% CI -0.21 to 0.10; P=.50), whereas intervention B showed a similar nonsignificant reduction (β=-0.04, 95% CI -0.12 to 0.10; P=.56). No substantial differences were observed in the remaining secondary outcomes. Interviews revealed positive feedback from patients, who appreciated the intervention's dietary messages and their frequency and practicality. Participants suggested enhancements such as increased personalization, links to recipes, and nursing follow-ups. Health care professionals valued the online training but highlighted time constraints, suggesting shorter or blended formats to improve accessibility. CONCLUSIONS: While PREDIABETEXT did not significantly improve HbA(1c) levels, it demonstrated potential benefits for patient engagement. Further studies involving more intensive interventions are warranted to confirm the clinical impact on diabetes prevention. TRIAL REGISTRATION: ClinicalTrials.gov NCT05110625; https://www.clinicaltrials.gov/study/NCT05110625. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.3390/ijerph192214706.

  @article{miramartinez2025multifaceted,
  abstract = {BACKGROUND: The diabetes epidemic continues to surge worldwide, demanding urgent and innovative solutions. Digital health interventions, particularly those targeting behavior change, hold promise due to their affordability and scalability. However, research in this field remains in its early stages. OBJECTIVE: This study aimed to evaluate the effectiveness of PREDIABETEXT (Prediabetes Text Message Digital Intervention for the Prevention of Type 2 Diabetes Mellitus), a digital health intervention, in reducing glycated hemoglobin (HbA(1c)) and in improving secondary clinical, physiological, and behavioral outcomes. METHODS: We conducted a 6-month, 3-arm, pragmatic cluster randomized clinical trial. We recruited patients with prediabetes (HbA(1c) levels between 6% and 6.4% in the previous 3 months or 2 consecutive fasting plasma glucose measurements of 110-125 mg/dL) registered at primary care centers in the Balearic Islands, Spain. The PREDIABETEXT intervention consisted of 3 personalized SMS text messages per week aimed at supporting lifestyle behavior changes and online training for their primary health care professionals. A total of 58 professionals (clusters) from 16 centers participated in the study and were randomized (1:1:1) to intervention group A (patient SMS text messaging), intervention group B (patient SMS text messaging+health care professional web-based training), or the control group (usual care). Following the 6-month intervention period, we conducted individual qualitative interviews with 8 patients and 7 health care professionals to evaluate their experiences with the intervention in terms of utility, satisfaction, and implementation barriers. RESULTS: In total, 58 health care professionals (clusters) were included, allocated to the control group (n=20, 34%; 119/365, 32.6% patients), intervention group A (SMS text messaging only; n=18, 31%; 106/365, 29% patients), and intervention group B (SMS text messaging+training; n=20, 34%; 140/365, 38.4% patients). The mean age of the patients was 59.79 (SD 9.75) years, and 54.5% (199/365) were female. The results of the intention-to-treat analysis at the 6-month time point showed that intervention A led to a small, nonsignificant reduction in HbA(1c) levels compared to the control group (β=-0.05, 95% CI -0.21 to 0.10; P=.50), whereas intervention B showed a similar nonsignificant reduction (β=-0.04, 95% CI -0.12 to 0.10; P=.56). No substantial differences were observed in the remaining secondary outcomes. Interviews revealed positive feedback from patients, who appreciated the intervention's dietary messages and their frequency and practicality. Participants suggested enhancements such as increased personalization, links to recipes, and nursing follow-ups. Health care professionals valued the online training but highlighted time constraints, suggesting shorter or blended formats to improve accessibility. CONCLUSIONS: While PREDIABETEXT did not significantly improve HbA(1c) levels, it demonstrated potential benefits for patient engagement. Further studies involving more intensive interventions are warranted to confirm the clinical impact on diabetes prevention. TRIAL REGISTRATION: ClinicalTrials.gov NCT05110625; https://www.clinicaltrials.gov/study/NCT05110625. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.3390/ijerph192214706.},
  address = {Canada},
  author = {Mira-Martínez, Sofía and Malih, Narges and Angullo-Martínez, Escarlata and Zamanillo-Campos, Rocío and Yañez, Aina M and Bennasar-Veny, Miquel and Gómez-Juanes, Rocío and Konieczna, Jadwiga and Jiménez, Rafael and Serrano-Ripoll, Maria J and Fiol deRoque, Maria Antonia and Leiva, Alfonso and Galmes-Panades, Aina M and Miralles-Xamena, Jerónima and Vidal-Thomàs, Maria Clara and Gómez-Cobo, Cristina and Gervilla, Elena and Oña-Gil, José Iván and Ricci-Cabello, Ignacio},
  journal = {Journal of medical Internet research},
  keywords = {evisap grapp-caib},
  month = {oct},
  pages = {e70981--e70981},
  title = {A Multifaceted Digital Intervention for the Prevention of Type 2 Diabetes Mellitus in Primary Care (PREDIABETEXT): Cluster Randomized Trial},
  volume = 27,
  year = 2025
  }
  

  %0 Journal Article
  %1 miramartinez2025multifaceted
  %A Mira-Martínez, Sofía
  %A Malih, Narges
  %A Angullo-Martínez, Escarlata
  %A Zamanillo-Campos, Rocío
  %A Yañez, Aina M
  %A Bennasar-Veny, Miquel
  %A Gómez-Juanes, Rocío
  %A Konieczna, Jadwiga
  %A Jiménez, Rafael
  %A Serrano-Ripoll, Maria J
  %A Fiol deRoque, Maria Antonia
  %A Leiva, Alfonso
  %A Galmes-Panades, Aina M
  %A Miralles-Xamena, Jerónima
  %A Vidal-Thomàs, Maria Clara
  %A Gómez-Cobo, Cristina
  %A Gervilla, Elena
  %A Oña-Gil, José Iván
  %A Ricci-Cabello, Ignacio
  %C Canada
  %D 2025
  %J Journal of medical Internet research
  %P e70981--e70981
  %R 10.2196/70981
  %T A Multifaceted Digital Intervention for the Prevention of Type 2 Diabetes Mellitus in Primary Care (PREDIABETEXT): Cluster Randomized Trial
  %U https://pubmed.ncbi.nlm.nih.gov/41067715
  %V 27
  %X BACKGROUND: The diabetes epidemic continues to surge worldwide, demanding urgent and innovative solutions. Digital health interventions, particularly those targeting behavior change, hold promise due to their affordability and scalability. However, research in this field remains in its early stages. OBJECTIVE: This study aimed to evaluate the effectiveness of PREDIABETEXT (Prediabetes Text Message Digital Intervention for the Prevention of Type 2 Diabetes Mellitus), a digital health intervention, in reducing glycated hemoglobin (HbA(1c)) and in improving secondary clinical, physiological, and behavioral outcomes. METHODS: We conducted a 6-month, 3-arm, pragmatic cluster randomized clinical trial. We recruited patients with prediabetes (HbA(1c) levels between 6% and 6.4% in the previous 3 months or 2 consecutive fasting plasma glucose measurements of 110-125 mg/dL) registered at primary care centers in the Balearic Islands, Spain. The PREDIABETEXT intervention consisted of 3 personalized SMS text messages per week aimed at supporting lifestyle behavior changes and online training for their primary health care professionals. A total of 58 professionals (clusters) from 16 centers participated in the study and were randomized (1:1:1) to intervention group A (patient SMS text messaging), intervention group B (patient SMS text messaging+health care professional web-based training), or the control group (usual care). Following the 6-month intervention period, we conducted individual qualitative interviews with 8 patients and 7 health care professionals to evaluate their experiences with the intervention in terms of utility, satisfaction, and implementation barriers. RESULTS: In total, 58 health care professionals (clusters) were included, allocated to the control group (n=20, 34%; 119/365, 32.6% patients), intervention group A (SMS text messaging only; n=18, 31%; 106/365, 29% patients), and intervention group B (SMS text messaging+training; n=20, 34%; 140/365, 38.4% patients). The mean age of the patients was 59.79 (SD 9.75) years, and 54.5% (199/365) were female. The results of the intention-to-treat analysis at the 6-month time point showed that intervention A led to a small, nonsignificant reduction in HbA(1c) levels compared to the control group (β=-0.05, 95% CI -0.21 to 0.10; P=.50), whereas intervention B showed a similar nonsignificant reduction (β=-0.04, 95% CI -0.12 to 0.10; P=.56). No substantial differences were observed in the remaining secondary outcomes. Interviews revealed positive feedback from patients, who appreciated the intervention's dietary messages and their frequency and practicality. Participants suggested enhancements such as increased personalization, links to recipes, and nursing follow-ups. Health care professionals valued the online training but highlighted time constraints, suggesting shorter or blended formats to improve accessibility. CONCLUSIONS: While PREDIABETEXT did not significantly improve HbA(1c) levels, it demonstrated potential benefits for patient engagement. Further studies involving more intensive interventions are warranted to confirm the clinical impact on diabetes prevention. TRIAL REGISTRATION: ClinicalTrials.gov NCT05110625; https://www.clinicaltrials.gov/study/NCT05110625. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.3390/ijerph192214706.
  

• 
  Relationship Between Metabolic Age Determined by Bioimpedance and Insulin Resistance Risk Scales in Spanish Workers. Ramírez-Gallegos, Ignacio; Tárraga López, Pedro Juan; Paublini Oliveira, Hernán; López-González, Ángel Arturo; Martorell Sánchez, Cristina; Martínez-Almoyna-Rifá, Emilio; Ramírez-Manent, José Ignacio (2025). 17(6) 945.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  Introduction: Metabolic age (MA) is the difference between an individual's actual age and the age of their body based on physiological and biological factors. It is an indicator that reflects a person's physical and biological state, regardless of chronological age. Insulin resistance (IR) is a health disorder in which tissues exhibit a reduced response to the circulating glucose uptake stimulated by insulin. Objective: The aim of this study is to evaluate the association between MA, determined through bioelectrical impedance analysis, and the risk of IR, assessed using validated scales, in a cohort of Spanish workers. Methodology: A descriptive cross-sectional study was conducted on 8590 Spanish workers to assess the association between MA and a set of sociodemographic variables, health habits, and IR risk scales such as the Triglyceride-Glucose Index (TyG Index), Metabolic Score for Insulin Resistance (METS-IR), and Single Point Insulin Sensitivity Estimator (SPISE). Results: All analyzed variables were associated with MA values, with the strongest associations observed for IR risk scale values (OR 4.88 [95\% CI 4.12-5.65] for METS-IR, 4.42 [95\% CI 3.70-5.15] for SPISE, and 3.42 [95\% CI 2.97-3.87] for the TyG Index) and physical activity. Conclusions: Metabolic age is influenced by sociodemographic variables such as age, sex, and social class; health habits such as smoking, physical activity, and adherence to the Mediterranean diet; and by IR risk scale values.

  @article{ramirez-gallegos_relationship_2025,
  abstract = {Introduction: Metabolic age (MA) is the difference between an individual's actual age and the age of their body based on physiological and biological factors. It is an indicator that reflects a person's physical and biological state, regardless of chronological age. Insulin resistance (IR) is a health disorder in which tissues exhibit a reduced response to the circulating glucose uptake stimulated by insulin. Objective: The aim of this study is to evaluate the association between MA, determined through bioelectrical impedance analysis, and the risk of IR, assessed using validated scales, in a cohort of Spanish workers. Methodology: A descriptive cross-sectional study was conducted on 8590 Spanish workers to assess the association between MA and a set of sociodemographic variables, health habits, and IR risk scales such as the Triglyceride-Glucose Index (TyG Index), Metabolic Score for Insulin Resistance (METS-IR), and Single Point Insulin Sensitivity Estimator (SPISE). Results: All analyzed variables were associated with MA values, with the strongest associations observed for IR risk scale values (OR 4.88 [95\% CI 4.12-5.65] for METS-IR, 4.42 [95\% CI 3.70-5.15] for SPISE, and 3.42 [95\% CI 2.97-3.87] for the TyG Index) and physical activity. Conclusions: Metabolic age is influenced by sociodemographic variables such as age, sex, and social class; health habits such as smoking, physical activity, and adherence to the Mediterranean diet; and by IR risk scale values.},
  author = {Ramírez-Gallegos, Ignacio and Tárraga López, Pedro Juan and Paublini Oliveira, Hernán and López-González, Ángel Arturo and Martorell Sánchez, Cristina and Martínez-Almoyna-Rifá, Emilio and Ramírez-Manent, José Ignacio},
  journal = {Nutrients},
  keywords = {grapp-caib},
  month = {mar},
  number = 6,
  pages = 945,
  title = {Relationship Between Metabolic Age Determined by Bioimpedance and Insulin Resistance Risk Scales in Spanish Workers},
  volume = 17,
  year = 2025
  }
  

  %0 Journal Article
  %1 ramirez-gallegos_relationship_2025
  %A Ramírez-Gallegos, Ignacio
  %A Tárraga López, Pedro Juan
  %A Paublini Oliveira, Hernán
  %A López-González, Ángel Arturo
  %A Martorell Sánchez, Cristina
  %A Martínez-Almoyna-Rifá, Emilio
  %A Ramírez-Manent, José Ignacio
  %D 2025
  %J Nutrients
  %N 6
  %P 945
  %R 10.3390/nu17060945
  %T Relationship Between Metabolic Age Determined by Bioimpedance and Insulin Resistance Risk Scales in Spanish Workers
  %V 17
  %X Introduction: Metabolic age (MA) is the difference between an individual's actual age and the age of their body based on physiological and biological factors. It is an indicator that reflects a person's physical and biological state, regardless of chronological age. Insulin resistance (IR) is a health disorder in which tissues exhibit a reduced response to the circulating glucose uptake stimulated by insulin. Objective: The aim of this study is to evaluate the association between MA, determined through bioelectrical impedance analysis, and the risk of IR, assessed using validated scales, in a cohort of Spanish workers. Methodology: A descriptive cross-sectional study was conducted on 8590 Spanish workers to assess the association between MA and a set of sociodemographic variables, health habits, and IR risk scales such as the Triglyceride-Glucose Index (TyG Index), Metabolic Score for Insulin Resistance (METS-IR), and Single Point Insulin Sensitivity Estimator (SPISE). Results: All analyzed variables were associated with MA values, with the strongest associations observed for IR risk scale values (OR 4.88 [95\% CI 4.12-5.65] for METS-IR, 4.42 [95\% CI 3.70-5.15] for SPISE, and 3.42 [95\% CI 2.97-3.87] for the TyG Index) and physical activity. Conclusions: Metabolic age is influenced by sociodemographic variables such as age, sex, and social class; health habits such as smoking, physical activity, and adherence to the Mediterranean diet; and by IR risk scale values.
  

• 
  Major abnormalities of the electrocardiogram and cardiovascular risk in a medium and high-risk Mediterranean population. Pou Bordoy, Joan; Leiva, Alfonso; Albendín Ariza, Maria José; Llanos, Roberto Elosúa; Rigo Carratalà, Fernando; Romaguera, Dora; Salas-Salvadó, Jordi; Babio, Nancy; Martinez-González, Miguel Angel; Toledo, Estefanía; Fitó, Montserrat; Aros, Fernando; Estruch, Ramon; Fiol Sala, Miquel (2025). 164(6) 277–286.

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  INTRODUCTION: Major electrocardiogram abnormalities (MECG) are common in middle-aged and older individuals and could be an important factor in predicting cardiovascular events. OBJECTIVE: To analyse the association between MECG (Minnesota classification) and CVE independently of classic cardiovascular risk factors (CVRF), and to assess whether they improve the prediction according to the Spanish Coronary Event Risk Function (FRESCO). METHOD: 1.752 participants included in three nodes of the PREDIMED study aged between 55 and 80 years with medium or high CVRF. Mean follow-up time was 5.1 years. Cumulative CVE incidence was estimated by sex with and without MECG, and hazard ratios by sex were estimated using multivariate Cox regressions adjusted for randomization group and CCRF (FRESCO). Harrel's C Indices, Nam d'Agostino, Net Reclassification Improvement, and Integrated Discrimination Improvement were calculated. RESULTS: At baseline, 25% of the participants shows major electrocardiogram abnormalities (AMECG). During follow-up, there were 112 cardiovascular events (16 cardiovascular deaths, 15 acute myocardial infarctions, 38 anginas, 43 strokes). MECG were significantly associated with the onset of CVE. In men, left ventricular hypertrophy (LVH) criteria were associated with T-wave inversion (HR: 17.88, 95% CI: 5.51-58.03, pvalor<.001) and QT interval prolongation (HR: 2.41, 95% CI: 1.38-4.21, pvalor=.002); in women, atrial fibrillation (HR: 5.7, 95% CI: 1.76-18.72, pvalor=.006) and ST-segment depression (HR: 3.24, 95% CI: 1.36-7.71, pvalor<.001) were associated. No significant improvement in MECG prediction compared to FRESCO was observed. CONCLUSIONS: MECG are independently associated with the occurrence of CVE, but do not improve risk prediction beyond traditional risk factors.

  @article{poubordoy2025major,
  abstract = {INTRODUCTION: Major electrocardiogram abnormalities (MECG) are common in middle-aged and older individuals and could be an important factor in predicting cardiovascular events. OBJECTIVE: To analyse the association between MECG (Minnesota classification) and CVE independently of classic cardiovascular risk factors (CVRF), and to assess whether they improve the prediction according to the Spanish Coronary Event Risk Function (FRESCO). METHOD: 1.752 participants included in three nodes of the PREDIMED study aged between 55 and 80 years with medium or high CVRF. Mean follow-up time was 5.1 years. Cumulative CVE incidence was estimated by sex with and without MECG, and hazard ratios by sex were estimated using multivariate Cox regressions adjusted for randomization group and CCRF (FRESCO). Harrel's C Indices, Nam d'Agostino, Net Reclassification Improvement, and Integrated Discrimination Improvement were calculated. RESULTS: At baseline, 25% of the participants shows major electrocardiogram abnormalities (AMECG). During follow-up, there were 112 cardiovascular events (16 cardiovascular deaths, 15 acute myocardial infarctions, 38 anginas, 43 strokes). MECG were significantly associated with the onset of CVE. In men, left ventricular hypertrophy (LVH) criteria were associated with T-wave inversion (HR: 17.88, 95% CI: 5.51-58.03, pvalor<.001) and QT interval prolongation (HR: 2.41, 95% CI: 1.38-4.21, pvalor=.002); in women, atrial fibrillation (HR: 5.7, 95% CI: 1.76-18.72, pvalor=.006) and ST-segment depression (HR: 3.24, 95% CI: 1.36-7.71, pvalor<.001) were associated. No significant improvement in MECG prediction compared to FRESCO was observed. CONCLUSIONS: MECG are independently associated with the occurrence of CVE, but do not improve risk prediction beyond traditional risk factors.},
  address = {Spain},
  author = {Pou Bordoy, Joan and Leiva, Alfonso and Albendín Ariza, Maria José and Llanos, Roberto Elosúa and Rigo Carratalà, Fernando and Romaguera, Dora and Salas-Salvadó, Jordi and Babio, Nancy and Martinez-González, Miguel Angel and Toledo, Estefanía and Fitó, Montserrat and Aros, Fernando and Estruch, Ramon and Fiol Sala, Miquel},
  journal = {Medicina clinica},
  keywords = {grapp-caib},
  month = {mar},
  number = 6,
  pages = {277--286},
  title = {Major abnormalities of the electrocardiogram and cardiovascular risk in a medium and high-risk Mediterranean population},
  volume = 164,
  year = 2025
  }
  

  %0 Journal Article
  %1 poubordoy2025major
  %A Pou Bordoy, Joan
  %A Leiva, Alfonso
  %A Albendín Ariza, Maria José
  %A Llanos, Roberto Elosúa
  %A Rigo Carratalà, Fernando
  %A Romaguera, Dora
  %A Salas-Salvadó, Jordi
  %A Babio, Nancy
  %A Martinez-González, Miguel Angel
  %A Toledo, Estefanía
  %A Fitó, Montserrat
  %A Aros, Fernando
  %A Estruch, Ramon
  %A Fiol Sala, Miquel
  %C Spain
  %D 2025
  %J Medicina clinica
  %N 6
  %P 277--286
  %R 10.1016/j.medcli.2024.10.010
  %T Major abnormalities of the electrocardiogram and cardiovascular risk in a medium and high-risk Mediterranean population
  %U https://pubmed.ncbi.nlm.nih.gov/39706740
  %V 164
  %X INTRODUCTION: Major electrocardiogram abnormalities (MECG) are common in middle-aged and older individuals and could be an important factor in predicting cardiovascular events. OBJECTIVE: To analyse the association between MECG (Minnesota classification) and CVE independently of classic cardiovascular risk factors (CVRF), and to assess whether they improve the prediction according to the Spanish Coronary Event Risk Function (FRESCO). METHOD: 1.752 participants included in three nodes of the PREDIMED study aged between 55 and 80 years with medium or high CVRF. Mean follow-up time was 5.1 years. Cumulative CVE incidence was estimated by sex with and without MECG, and hazard ratios by sex were estimated using multivariate Cox regressions adjusted for randomization group and CCRF (FRESCO). Harrel's C Indices, Nam d'Agostino, Net Reclassification Improvement, and Integrated Discrimination Improvement were calculated. RESULTS: At baseline, 25% of the participants shows major electrocardiogram abnormalities (AMECG). During follow-up, there were 112 cardiovascular events (16 cardiovascular deaths, 15 acute myocardial infarctions, 38 anginas, 43 strokes). MECG were significantly associated with the onset of CVE. In men, left ventricular hypertrophy (LVH) criteria were associated with T-wave inversion (HR: 17.88, 95% CI: 5.51-58.03, pvalor<.001) and QT interval prolongation (HR: 2.41, 95% CI: 1.38-4.21, pvalor=.002); in women, atrial fibrillation (HR: 5.7, 95% CI: 1.76-18.72, pvalor=.006) and ST-segment depression (HR: 3.24, 95% CI: 1.36-7.71, pvalor<.001) were associated. No significant improvement in MECG prediction compared to FRESCO was observed. CONCLUSIONS: MECG are independently associated with the occurrence of CVE, but do not improve risk prediction beyond traditional risk factors.
  

• 
  Relationship between diabesity and elevated values of metabolic-associated steatotic liver disease risk scales in Spanish workers using body mass index and the body adiposity estimator criteria of Clínica de Navarra. Martínez-Almoyna Rifá, Emilio; López González, Ángel Arturo; Tárraga López, Pedro Juan; Paublini, Hernán; Vallejos, Daniela; Ramírez Manent, José Ignacio (2025). 10.20960/nh.05441-.

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  INTRODUCTION: diabesity (coexistence of diabetes and obesity) and metabolic associated steatotic liver disease (MASLD) are two very frequent pathologies whose prevalence is increasing every day. OBJECTIVE: to find out how these two pathological entities are associated in a group of Spanish workers. METHODOLOGY: a descriptive, cross-sectional study was carried out in 219477 workers to assess the association between diabesity (applying a double criterion, the body mass index BMI and the Clínica Universitaria de Navarra body adiposity estimator CUN BAE) and different risk scales for MASLD and liver fibrosis. RESULTS: all MASH and liver fibrosis risk scales show higher values in people with diabesity applying the two criteria compared to people without diabesity. CONCLUSION: diabesity and MASLD and liver fibrosis risk scales show a significant association in our study.

  @article{martinezalmoynarifa2025relationship,
  abstract = {INTRODUCTION: diabesity (coexistence of diabetes and obesity) and metabolic associated steatotic liver disease (MASLD) are two very frequent pathologies whose prevalence is increasing every day. OBJECTIVE: to find out how these two pathological entities are associated in a group of Spanish workers. METHODOLOGY: a descriptive, cross-sectional study was carried out in 219477 workers to assess the association between diabesity (applying a double criterion, the body mass index BMI and the Clínica Universitaria de Navarra body adiposity estimator CUN BAE) and different risk scales for MASLD and liver fibrosis. RESULTS: all MASH and liver fibrosis risk scales show higher values in people with diabesity applying the two criteria compared to people without diabesity. CONCLUSION: diabesity and MASLD and liver fibrosis risk scales show a significant association in our study.},
  address = {Spain},
  author = {Martínez-Almoyna Rifá, Emilio and López González, Ángel Arturo and Tárraga López, Pedro Juan and Paublini, Hernán and Vallejos, Daniela and Ramírez Manent, José Ignacio},
  journal = {Nutricion hospitalaria},
  keywords = {grapp-caib},
  month = {mar},
  pages = {10.20960/nh.05441--},
  title = {Relationship between diabesity and elevated values of metabolic-associated steatotic liver disease risk scales in Spanish workers using body mass index and the body adiposity estimator criteria of Clínica de Navarra},
  year = 2025
  }
  

  %0 Journal Article
  %1 martinezalmoynarifa2025relationship
  %A Martínez-Almoyna Rifá, Emilio
  %A López González, Ángel Arturo
  %A Tárraga López, Pedro Juan
  %A Paublini, Hernán
  %A Vallejos, Daniela
  %A Ramírez Manent, José Ignacio
  %C Spain
  %D 2025
  %J Nutricion hospitalaria
  %P 10.20960/nh.05441--
  %R 10.20960/nh.05441
  %T Relationship between diabesity and elevated values of metabolic-associated steatotic liver disease risk scales in Spanish workers using body mass index and the body adiposity estimator criteria of Clínica de Navarra
  %U https://pubmed.ncbi.nlm.nih.gov/40195779
  %X INTRODUCTION: diabesity (coexistence of diabetes and obesity) and metabolic associated steatotic liver disease (MASLD) are two very frequent pathologies whose prevalence is increasing every day. OBJECTIVE: to find out how these two pathological entities are associated in a group of Spanish workers. METHODOLOGY: a descriptive, cross-sectional study was carried out in 219477 workers to assess the association between diabesity (applying a double criterion, the body mass index BMI and the Clínica Universitaria de Navarra body adiposity estimator CUN BAE) and different risk scales for MASLD and liver fibrosis. RESULTS: all MASH and liver fibrosis risk scales show higher values in people with diabesity applying the two criteria compared to people without diabesity. CONCLUSION: diabesity and MASLD and liver fibrosis risk scales show a significant association in our study.
  

• 
  Association between sociodemographic variables, healthy habits and stress with metabolic syndrome. A descriptive, cross-sectional study. López-González, Á A; Martínez-Almoyna Rifá, E; Paublini Oliveira, H; Martorell Sánchez, C; Tárraga López, P J; Ramírez-Manent, J I (2025). 51(6) 102455–102455.

  AbstractURLBibTeXEndNoteDOIBibSonomy

  INTRODUCTION: Metabolic syndrome (MS) is a pathological condition that encompasses various cardiometabolic risk factors, such as obesity, dyslipidemia, hyperglycemia, and elevated blood pressure levels. It is considered a multifactorial pathological condition. The aim of this study is to assess how variables such as age, sex, socioeconomic status, tobacco and alcohol consumption, physical activity, adherence to the Mediterranean diet, and stress are associated with the prevalence of MS, determined using two different criteria. MATERIALS AND METHODS: This is a descriptive, cross-sectional study conducted on 24,224 Spanish workers, evaluating the association between sociodemographic variables, health habits, and stress with MS, determined using two criteria: the National Cholesterol Education Program, Adult Treatment Panel III (NCEP ATP-III), and the International Diabetes Federation (IDF). RESULTS: All the variables analyzed showed an association with the presence of MS when applying both criteria. Among them, the variables with the strongest association were age: odds ratio 5.55 (95% CI: 4.80-6.30) for MS using the NCEP ATP-III criteria and 6.71 (95% CI: 5.30-8.13) for IDF criteria; and type of job: odds ratio 3.42 (95% CI: 2.95-3.90) for NCEP ATP-III and 3.57 (95% CI: 3.12-4.03) for IDF. CONCLUSIONS: The profile of an individual at higher risk of developing MS under both criteria would be an older male, manual laborer, smoker, habitual alcohol consumer, sedentary, with low adherence to the Mediterranean diet, and experiencing high levels of stress.

  @article{lopezgonzalez2025association,
  abstract = {INTRODUCTION: Metabolic syndrome (MS) is a pathological condition that encompasses various cardiometabolic risk factors, such as obesity, dyslipidemia, hyperglycemia, and elevated blood pressure levels. It is considered a multifactorial pathological condition. The aim of this study is to assess how variables such as age, sex, socioeconomic status, tobacco and alcohol consumption, physical activity, adherence to the Mediterranean diet, and stress are associated with the prevalence of MS, determined using two different criteria. MATERIALS AND METHODS: This is a descriptive, cross-sectional study conducted on 24,224 Spanish workers, evaluating the association between sociodemographic variables, health habits, and stress with MS, determined using two criteria: the National Cholesterol Education Program, Adult Treatment Panel III (NCEP ATP-III), and the International Diabetes Federation (IDF). RESULTS: All the variables analyzed showed an association with the presence of MS when applying both criteria. Among them, the variables with the strongest association were age: odds ratio 5.55 (95% CI: 4.80-6.30) for MS using the NCEP ATP-III criteria and 6.71 (95% CI: 5.30-8.13) for IDF criteria; and type of job: odds ratio 3.42 (95% CI: 2.95-3.90) for NCEP ATP-III and 3.57 (95% CI: 3.12-4.03) for IDF. CONCLUSIONS: The profile of an individual at higher risk of developing MS under both criteria would be an older male, manual laborer, smoker, habitual alcohol consumer, sedentary, with low adherence to the Mediterranean diet, and experiencing high levels of stress.},
  address = {Spain},
  author = {López-González, Á A and Martínez-Almoyna Rifá, E and Paublini Oliveira, H and Martorell Sánchez, C and Tárraga López, P J and Ramírez-Manent, J I},
  journal = {Semergen},
  keywords = {grapp-caib},
  month = {feb},
  number = 6,
  pages = {102455--102455},
  title = {Association between sociodemographic variables, healthy habits and stress with metabolic syndrome. A descriptive, cross-sectional study},
  volume = 51,
  year = 2025
  }
  

  %0 Journal Article
  %1 lopezgonzalez2025association
  %A López-González, Á A
  %A Martínez-Almoyna Rifá, E
  %A Paublini Oliveira, H
  %A Martorell Sánchez, C
  %A Tárraga López, P J
  %A Ramírez-Manent, J I
  %C Spain
  %D 2025
  %J Semergen
  %N 6
  %P 102455--102455
  %R 10.1016/j.semerg.2025.102455
  %T Association between sociodemographic variables, healthy habits and stress with metabolic syndrome. A descriptive, cross-sectional study
  %U https://pubmed.ncbi.nlm.nih.gov/39922044
  %V 51
  %X INTRODUCTION: Metabolic syndrome (MS) is a pathological condition that encompasses various cardiometabolic risk factors, such as obesity, dyslipidemia, hyperglycemia, and elevated blood pressure levels. It is considered a multifactorial pathological condition. The aim of this study is to assess how variables such as age, sex, socioeconomic status, tobacco and alcohol consumption, physical activity, adherence to the Mediterranean diet, and stress are associated with the prevalence of MS, determined using two different criteria. MATERIALS AND METHODS: This is a descriptive, cross-sectional study conducted on 24,224 Spanish workers, evaluating the association between sociodemographic variables, health habits, and stress with MS, determined using two criteria: the National Cholesterol Education Program, Adult Treatment Panel III (NCEP ATP-III), and the International Diabetes Federation (IDF). RESULTS: All the variables analyzed showed an association with the presence of MS when applying both criteria. Among them, the variables with the strongest association were age: odds ratio 5.55 (95% CI: 4.80-6.30) for MS using the NCEP ATP-III criteria and 6.71 (95% CI: 5.30-8.13) for IDF criteria; and type of job: odds ratio 3.42 (95% CI: 2.95-3.90) for NCEP ATP-III and 3.57 (95% CI: 3.12-4.03) for IDF. CONCLUSIONS: The profile of an individual at higher risk of developing MS under both criteria would be an older male, manual laborer, smoker, habitual alcohol consumer, sedentary, with low adherence to the Mediterranean diet, and experiencing high levels of stress.
  

• 
  Examining the influence of mental health and structural determinants of health on the stage of motivational readiness for health behaviour changes: A path analysis study. Gómez-Gómez, Irene; Rodero-Cosano, María Luisa; Bellón, Juan Á; Zabaleta-Del-Olmo, Edurne; Maderuelo-Fernandez, José A; Moreno-Peral, Patricia; Magallón-Botaya, Rosa; Oliván-Blázquez, Bárbara; Casajuana-Closas, Marc; López-Jiménez, Tomàs; Bolíbar, Bonaventura; Llobera, Joan; Clavería, Ana; Sanchez-Perez, Alvaro; Motrico, Emma (2025). 30(3) 470–485.

  AbstractURLBibTeXEndNoteDOIBibSonomy

  This study explores the influence of mental health and structural determinants of health on motivational readiness for health behaviour change in 1462 Spanish primary healthcare users. Chi-square test and structural equation modelling were performed. Results showed that depression and anxiety were negatively associated with being in the action stages of motivational readiness for a healthy diet and physical activity. This association was statistically significant only for motivational readiness for a healthy diet and depression (β =  - 0.076; p = 0.046). Furthermore, women and workers were more likely to be in the action stages of motivational readiness for a healthy diet while older adults and adults with higher health-related quality of life were more likely to be in the action stages of motivational readiness for physical activity. The present study suggests that structural (being older, being a woman and being employed) and intermediary (suffering from depression and higher health-related quality of life) determinants of health influence motivational readiness for health behaviour changes.

  @article{gomezgomez2025examining,
  abstract = {This study explores the influence of mental health and structural determinants of health on motivational readiness for health behaviour change in 1462 Spanish primary healthcare users. Chi-square test and structural equation modelling were performed. Results showed that depression and anxiety were negatively associated with being in the action stages of motivational readiness for a healthy diet and physical activity. This association was statistically significant only for motivational readiness for a healthy diet and depression (β =  - 0.076; p = 0.046). Furthermore, women and workers were more likely to be in the action stages of motivational readiness for a healthy diet while older adults and adults with higher health-related quality of life were more likely to be in the action stages of motivational readiness for physical activity. The present study suggests that structural (being older, being a woman and being employed) and intermediary (suffering from depression and higher health-related quality of life) determinants of health influence motivational readiness for health behaviour changes.},
  address = {England},
  author = {Gómez-Gómez, Irene and Rodero-Cosano, María Luisa and Bellón, Juan Á and Zabaleta-Del-Olmo, Edurne and Maderuelo-Fernandez, José A and Moreno-Peral, Patricia and Magallón-Botaya, Rosa and Oliván-Blázquez, Bárbara and Casajuana-Closas, Marc and López-Jiménez, Tomàs and Bolíbar, Bonaventura and Llobera, Joan and Clavería, Ana and Sanchez-Perez, Alvaro and Motrico, Emma},
  journal = {Journal of health psychology},
  keywords = {grapp-caib},
  month = {mar},
  number = 3,
  pages = {470--485},
  title = {Examining the influence of mental health and structural determinants of health on the stage of motivational readiness for health behaviour changes: A path analysis study},
  volume = 30,
  year = 2025
  }
  

  %0 Journal Article
  %1 gomezgomez2025examining
  %A Gómez-Gómez, Irene
  %A Rodero-Cosano, María Luisa
  %A Bellón, Juan Á
  %A Zabaleta-Del-Olmo, Edurne
  %A Maderuelo-Fernandez, José A
  %A Moreno-Peral, Patricia
  %A Magallón-Botaya, Rosa
  %A Oliván-Blázquez, Bárbara
  %A Casajuana-Closas, Marc
  %A López-Jiménez, Tomàs
  %A Bolíbar, Bonaventura
  %A Llobera, Joan
  %A Clavería, Ana
  %A Sanchez-Perez, Alvaro
  %A Motrico, Emma
  %C England
  %D 2025
  %J Journal of health psychology
  %N 3
  %P 470--485
  %R 10.1177/13591053241241015
  %T Examining the influence of mental health and structural determinants of health on the stage of motivational readiness for health behaviour changes: A path analysis study
  %U https://pubmed.ncbi.nlm.nih.gov/38605575
  %V 30
  %X This study explores the influence of mental health and structural determinants of health on motivational readiness for health behaviour change in 1462 Spanish primary healthcare users. Chi-square test and structural equation modelling were performed. Results showed that depression and anxiety were negatively associated with being in the action stages of motivational readiness for a healthy diet and physical activity. This association was statistically significant only for motivational readiness for a healthy diet and depression (β =  - 0.076; p = 0.046). Furthermore, women and workers were more likely to be in the action stages of motivational readiness for a healthy diet while older adults and adults with higher health-related quality of life were more likely to be in the action stages of motivational readiness for physical activity. The present study suggests that structural (being older, being a woman and being employed) and intermediary (suffering from depression and higher health-related quality of life) determinants of health influence motivational readiness for health behaviour changes.
  

• 
  Association Between Mediterranean Diet and Other Healthy Habits and Sociodemographic Variables with the Values of Vascular and Heart Age in Spanish Workers. Montero Muñoz, Natalia; Tárraga López, Pedro Juan; López-González, Ángel Arturo; Paublini, Hernán; Martorell Sánchez, Cristina; Marínez-Almoyna Rifá, Emilio; Ramírez-Manent, José Ignacio (2025). 17(5) 903-.

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Introduction: The assessment of cardiovascular risk has traditionally relied on validated scales designed to estimate the likelihood of experiencing a cardiovascular event within a specific timeframe. In recent years, novel methodologies have emerged, offering a more objective evaluation of this risk through indicators such as vascular age (VA) and heart age (HA). Objective: This study aimed to investigate the relationship between sociodemographic factors, lifestyle behaviors, and their impact on VA and HA. Materials and Methods: A dual study design, encompassing both cross-sectional and longitudinal retrospective approaches, was conducted among a cohort of employees. The variables assessed included sociodemographic characteristics (age, sex, and socioeconomic status) and health-related habits (smoking, physical activity, adherence to the Mediterranean diet, and alcohol consumption). Results: The findings revealed that all analyzed variables were significantly associated with elevated VA and HA values. Among these, age demonstrated the strongest association, with odds ratios (OR) of 114.91 (95% CI: 100.45-131.43) for high HA and 34.48 (95% CI: 31.41-37.56) for high VA. Conclusions: The profile of individuals most at risk for elevated VA and HA encompasses males of advanced age, characterized by low socioeconomic status, a sedentary lifestyle, poor adherence to the Mediterranean diet, and regular alcohol consumption.

  @article{monteromunoz2025association,
  abstract = {Introduction: The assessment of cardiovascular risk has traditionally relied on validated scales designed to estimate the likelihood of experiencing a cardiovascular event within a specific timeframe. In recent years, novel methodologies have emerged, offering a more objective evaluation of this risk through indicators such as vascular age (VA) and heart age (HA). Objective: This study aimed to investigate the relationship between sociodemographic factors, lifestyle behaviors, and their impact on VA and HA. Materials and Methods: A dual study design, encompassing both cross-sectional and longitudinal retrospective approaches, was conducted among a cohort of employees. The variables assessed included sociodemographic characteristics (age, sex, and socioeconomic status) and health-related habits (smoking, physical activity, adherence to the Mediterranean diet, and alcohol consumption). Results: The findings revealed that all analyzed variables were significantly associated with elevated VA and HA values. Among these, age demonstrated the strongest association, with odds ratios (OR) of 114.91 (95% CI: 100.45-131.43) for high HA and 34.48 (95% CI: 31.41-37.56) for high VA. Conclusions: The profile of individuals most at risk for elevated VA and HA encompasses males of advanced age, characterized by low socioeconomic status, a sedentary lifestyle, poor adherence to the Mediterranean diet, and regular alcohol consumption.},
  address = {Switzerland},
  author = {Montero Muñoz, Natalia and Tárraga López, Pedro Juan and López-González, Ángel Arturo and Paublini, Hernán and Martorell Sánchez, Cristina and Marínez-Almoyna Rifá, Emilio and Ramírez-Manent, José Ignacio},
  journal = {Nutrients},
  keywords = {grapp-caib},
  month = {mar},
  number = 5,
  pages = {903--},
  title = {Association Between Mediterranean Diet and Other Healthy Habits and Sociodemographic Variables with the Values of Vascular and Heart Age in Spanish Workers},
  volume = 17,
  year = 2025
  }
  

  %0 Journal Article
  %1 monteromunoz2025association
  %A Montero Muñoz, Natalia
  %A Tárraga López, Pedro Juan
  %A López-González, Ángel Arturo
  %A Paublini, Hernán
  %A Martorell Sánchez, Cristina
  %A Marínez-Almoyna Rifá, Emilio
  %A Ramírez-Manent, José Ignacio
  %C Switzerland
  %D 2025
  %J Nutrients
  %N 5
  %P 903--
  %R 10.3390/nu17050903
  %T Association Between Mediterranean Diet and Other Healthy Habits and Sociodemographic Variables with the Values of Vascular and Heart Age in Spanish Workers
  %U https://pubmed.ncbi.nlm.nih.gov/40077773
  %V 17
  %X Introduction: The assessment of cardiovascular risk has traditionally relied on validated scales designed to estimate the likelihood of experiencing a cardiovascular event within a specific timeframe. In recent years, novel methodologies have emerged, offering a more objective evaluation of this risk through indicators such as vascular age (VA) and heart age (HA). Objective: This study aimed to investigate the relationship between sociodemographic factors, lifestyle behaviors, and their impact on VA and HA. Materials and Methods: A dual study design, encompassing both cross-sectional and longitudinal retrospective approaches, was conducted among a cohort of employees. The variables assessed included sociodemographic characteristics (age, sex, and socioeconomic status) and health-related habits (smoking, physical activity, adherence to the Mediterranean diet, and alcohol consumption). Results: The findings revealed that all analyzed variables were significantly associated with elevated VA and HA values. Among these, age demonstrated the strongest association, with odds ratios (OR) of 114.91 (95% CI: 100.45-131.43) for high HA and 34.48 (95% CI: 31.41-37.56) for high VA. Conclusions: The profile of individuals most at risk for elevated VA and HA encompasses males of advanced age, characterized by low socioeconomic status, a sedentary lifestyle, poor adherence to the Mediterranean diet, and regular alcohol consumption.
  

• 
  Factors modulating the impact of the COVID-19 pandemic on posttraumatic stress symptomatology of the Spanish healthcare workers: A cohort study. Arregui-Gallego, Beatriz; Orts-Cortés, María Isabel; Moreno-Casbas, María Teresa; Abad-Corpa, Eva; Camacho-Bejarano, Rafaela; Cidoncha-Moreno, Mª Ángeles; Feria-Raposo, Isabel; Iruzubieta-Barragán, Javier; Carmona, Montserrat; Cristóbal-Domínguez, Estíbaliz; Bernués-Caudillo, Leticia; Casado-Ramírez, Elvira; Recas-Martin, Alda; Sánchez-López, Dolores; Company-Sancho, M. Consuelo; Rascón, Noelia López; Esteban-Sepúlveda, Silvia; Vidal-Thomàs, María Clara; Alonso, Isabel; Muñoz-Jiménez, Daniel; Segura-Heras, José Vicente; Moncho, Joaquín; Rich-Ruiz, Manuel (2025). 20(6) e0323777.

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Introduction The COVID-19 pandemic generated a global health crisis that significantly impacted healthcare systems and professionals. Healthcare workers were exposed to high levels of psychological distress, including posttraumatic stress symptomatology (PTSS). Aim Analyse the evolution of PTSS among Spanish healthcare workers during the COVID-19 pandemic, and to identify associated factors. Method A multicenter prospective cohort study with a 12-month follow-up was conducted. PTSS was the primary outcome. Secondary variables included sociodemographic, occupational, psychological, and coping-related factors. Statistical analyses comprised bivariate comparisons and multivariate modelling, such as generalized linear models and linear mixed models. Results Of the 428 participants, 180 completed the 12-month follow-up. At baseline, changes in work posts, negative family-work relations, avoidant coping, burnout symptoms, and emotional intelligence were associated with PTSS levels. Linear mixed models showed a significant decrease in PTSS over the 12-month period, regardless of gender, age, household type, occupational role, contract type, job title, level of care or type of service (p \textless 0.001). The generalised linear model explained 25.5% of the variance in PTSS levels at baseline, highlighting the role of psychological and coping factors over sociodemographic or occupational characteristics. Conclusions This study highlights the need for early identification and intervention focused on psychological and coping mechanisms. Promoting emotional regulation, reducing burnout, and addressing maladaptive coping may help mitigate long-term psychological effects among healthcare workers during public health crises.

  @article{arregui-gallego_factors_2025,
  abstract = {Introduction The COVID-19 pandemic generated a global health crisis that significantly impacted healthcare systems and professionals. Healthcare workers were exposed to high levels of psychological distress, including posttraumatic stress symptomatology (PTSS). Aim Analyse the evolution of PTSS among Spanish healthcare workers during the COVID-19 pandemic, and to identify associated factors. Method A multicenter prospective cohort study with a 12-month follow-up was conducted. PTSS was the primary outcome. Secondary variables included sociodemographic, occupational, psychological, and coping-related factors. Statistical analyses comprised bivariate comparisons and multivariate modelling, such as generalized linear models and linear mixed models. Results Of the 428 participants, 180 completed the 12-month follow-up. At baseline, changes in work posts, negative family-work relations, avoidant coping, burnout symptoms, and emotional intelligence were associated with PTSS levels. Linear mixed models showed a significant decrease in PTSS over the 12-month period, regardless of gender, age, household type, occupational role, contract type, job title, level of care or type of service (p \textless 0.001). The generalised linear model explained 25.5% of the variance in PTSS levels at baseline, highlighting the role of psychological and coping factors over sociodemographic or occupational characteristics. Conclusions This study highlights the need for early identification and intervention focused on psychological and coping mechanisms. Promoting emotional regulation, reducing burnout, and addressing maladaptive coping may help mitigate long-term psychological effects among healthcare workers during public health crises.},
  author = {Arregui-Gallego, Beatriz and Orts-Cortés, María Isabel and Moreno-Casbas, María Teresa and Abad-Corpa, Eva and Camacho-Bejarano, Rafaela and Cidoncha-Moreno, Mª Ángeles and Feria-Raposo, Isabel and Iruzubieta-Barragán, Javier and Carmona, Montserrat and Cristóbal-Domínguez, Estíbaliz and Bernués-Caudillo, Leticia and Casado-Ramírez, Elvira and Recas-Martin, Alda and Sánchez-López, Dolores and Company-Sancho, M. Consuelo and Rascón, Noelia López and Esteban-Sepúlveda, Silvia and Vidal-Thomàs, María Clara and Alonso, Isabel and Muñoz-Jiménez, Daniel and Segura-Heras, José Vicente and Moncho, Joaquín and Rich-Ruiz, Manuel},
  journal = {PLOS One},
  keywords = {grapp-caib},
  month = {jun},
  number = 6,
  pages = {e0323777},
  title = {Factors modulating the impact of the COVID-19 pandemic on posttraumatic stress symptomatology of the Spanish healthcare workers: A cohort study},
  volume = 20,
  year = 2025
  }
  

  %0 Journal Article
  %1 arregui-gallego_factors_2025
  %A Arregui-Gallego, Beatriz
  %A Orts-Cortés, María Isabel
  %A Moreno-Casbas, María Teresa
  %A Abad-Corpa, Eva
  %A Camacho-Bejarano, Rafaela
  %A Cidoncha-Moreno, Mª Ángeles
  %A Feria-Raposo, Isabel
  %A Iruzubieta-Barragán, Javier
  %A Carmona, Montserrat
  %A Cristóbal-Domínguez, Estíbaliz
  %A Bernués-Caudillo, Leticia
  %A Casado-Ramírez, Elvira
  %A Recas-Martin, Alda
  %A Sánchez-López, Dolores
  %A Company-Sancho, M. Consuelo
  %A Rascón, Noelia López
  %A Esteban-Sepúlveda, Silvia
  %A Vidal-Thomàs, María Clara
  %A Alonso, Isabel
  %A Muñoz-Jiménez, Daniel
  %A Segura-Heras, José Vicente
  %A Moncho, Joaquín
  %A Rich-Ruiz, Manuel
  %D 2025
  %J PLOS One
  %N 6
  %P e0323777
  %R 10.1371/journal.pone.0323777
  %T Factors modulating the impact of the COVID-19 pandemic on posttraumatic stress symptomatology of the Spanish healthcare workers: A cohort study
  %U https://pmc.ncbi.nlm.nih.gov/articles/PMC12169526/
  %V 20
  %X Introduction The COVID-19 pandemic generated a global health crisis that significantly impacted healthcare systems and professionals. Healthcare workers were exposed to high levels of psychological distress, including posttraumatic stress symptomatology (PTSS). Aim Analyse the evolution of PTSS among Spanish healthcare workers during the COVID-19 pandemic, and to identify associated factors. Method A multicenter prospective cohort study with a 12-month follow-up was conducted. PTSS was the primary outcome. Secondary variables included sociodemographic, occupational, psychological, and coping-related factors. Statistical analyses comprised bivariate comparisons and multivariate modelling, such as generalized linear models and linear mixed models. Results Of the 428 participants, 180 completed the 12-month follow-up. At baseline, changes in work posts, negative family-work relations, avoidant coping, burnout symptoms, and emotional intelligence were associated with PTSS levels. Linear mixed models showed a significant decrease in PTSS over the 12-month period, regardless of gender, age, household type, occupational role, contract type, job title, level of care or type of service (p \textless 0.001). The generalised linear model explained 25.5% of the variance in PTSS levels at baseline, highlighting the role of psychological and coping factors over sociodemographic or occupational characteristics. Conclusions This study highlights the need for early identification and intervention focused on psychological and coping mechanisms. Promoting emotional regulation, reducing burnout, and addressing maladaptive coping may help mitigate long-term psychological effects among healthcare workers during public health crises.
  

• 
  Psychosocial Work Factors, Job Stress, and Self-Rated Health Among Hotel Housekeepers. García-Buades, M Esther; Montañez-Juan, Maribel; Blahopoulou, Joanna; Ortiz-Bonnin, Silvia; Chela-Alvarez, Xènia; Bulilete, Oana; Llobera, Joan (2025). 73(3) 116–130.

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: Hotel housekeeping is widely recognized as a poor-quality job due to its high demands and limited resources. Hotel housekeepers (HHs) face both hard physical work and mentally demanding conditions, yet psychosocial factors in this feminized and precarious occupation remain under-researched. To address this gap, this study examines HHs' exposure to psychosocial factors at work and their impact on job stress and self-rated health. METHODS: A cross-sectional survey of a random sample of 926 HHs in the Balearic Islands (Spain) assessed job stress, self-rated health, psychosocial factors (job demands and resources), and sociodemographic variables using the Copenhagen Psychosocial Questionnaire II (COPSOQ-II) and the National Health Survey. Descriptive analysis and hierarchical linear regression models were applied. RESULTS: The prevalence of job stress was 61.1% (95% confidence interval [CI] = [57.8%, 64.1%]), while the prevalence of poor self-rated health was 59.9% (95% CI = [56.6%, 62.9%]). Hotel housekeepers were highly exposed to job demands such as intense work pace, job-specific stressors, work-life conflict, and emotional demands; highly available job resources were role clarity, task meaning, and social support. Regression models revealed work pace, work-life conflict, nationality, and weak leader support as key predictors of job stress; and work-life conflict and leadership quality as key predictors of self-rated health. CONCLUSION/APPLICATION TO PRACTICE: Although considered an eminently physical job, psychosocial work factors play a key role in explaining HHs' job stress and self-rated health. Occupational health professionals should design workplace interventions to reduce work pace, mitigate work-life conflict, and enhance resources such as leader support, sense of community, and leadership quality.

  @article{garciabuades2025psychosocial,
  abstract = {BACKGROUND: Hotel housekeeping is widely recognized as a poor-quality job due to its high demands and limited resources. Hotel housekeepers (HHs) face both hard physical work and mentally demanding conditions, yet psychosocial factors in this feminized and precarious occupation remain under-researched. To address this gap, this study examines HHs' exposure to psychosocial factors at work and their impact on job stress and self-rated health. METHODS: A cross-sectional survey of a random sample of 926 HHs in the Balearic Islands (Spain) assessed job stress, self-rated health, psychosocial factors (job demands and resources), and sociodemographic variables using the Copenhagen Psychosocial Questionnaire II (COPSOQ-II) and the National Health Survey. Descriptive analysis and hierarchical linear regression models were applied. RESULTS: The prevalence of job stress was 61.1% (95% confidence interval [CI] = [57.8%, 64.1%]), while the prevalence of poor self-rated health was 59.9% (95% CI = [56.6%, 62.9%]). Hotel housekeepers were highly exposed to job demands such as intense work pace, job-specific stressors, work-life conflict, and emotional demands; highly available job resources were role clarity, task meaning, and social support. Regression models revealed work pace, work-life conflict, nationality, and weak leader support as key predictors of job stress; and work-life conflict and leadership quality as key predictors of self-rated health. CONCLUSION/APPLICATION TO PRACTICE: Although considered an eminently physical job, psychosocial work factors play a key role in explaining HHs' job stress and self-rated health. Occupational health professionals should design workplace interventions to reduce work pace, mitigate work-life conflict, and enhance resources such as leader support, sense of community, and leadership quality.},
  address = {United States},
  author = {García-Buades, M Esther and Montañez-Juan, Maribel and Blahopoulou, Joanna and Ortiz-Bonnin, Silvia and Chela-Alvarez, Xènia and Bulilete, Oana and Llobera, Joan},
  journal = {Workplace health & safety},
  keywords = {grapp-caib},
  month = {mar},
  number = 3,
  pages = {116--130},
  title = {Psychosocial Work Factors, Job Stress, and Self-Rated Health Among Hotel Housekeepers},
  volume = 73,
  year = 2025
  }
  

  %0 Journal Article
  %1 garciabuades2025psychosocial
  %A García-Buades, M Esther
  %A Montañez-Juan, Maribel
  %A Blahopoulou, Joanna
  %A Ortiz-Bonnin, Silvia
  %A Chela-Alvarez, Xènia
  %A Bulilete, Oana
  %A Llobera, Joan
  %C United States
  %D 2025
  %J Workplace health & safety
  %N 3
  %P 116--130
  %R 10.1177/21650799241282787
  %T Psychosocial Work Factors, Job Stress, and Self-Rated Health Among Hotel Housekeepers
  %U https://pubmed.ncbi.nlm.nih.gov/39475436
  %V 73
  %X BACKGROUND: Hotel housekeeping is widely recognized as a poor-quality job due to its high demands and limited resources. Hotel housekeepers (HHs) face both hard physical work and mentally demanding conditions, yet psychosocial factors in this feminized and precarious occupation remain under-researched. To address this gap, this study examines HHs' exposure to psychosocial factors at work and their impact on job stress and self-rated health. METHODS: A cross-sectional survey of a random sample of 926 HHs in the Balearic Islands (Spain) assessed job stress, self-rated health, psychosocial factors (job demands and resources), and sociodemographic variables using the Copenhagen Psychosocial Questionnaire II (COPSOQ-II) and the National Health Survey. Descriptive analysis and hierarchical linear regression models were applied. RESULTS: The prevalence of job stress was 61.1% (95% confidence interval [CI] = [57.8%, 64.1%]), while the prevalence of poor self-rated health was 59.9% (95% CI = [56.6%, 62.9%]). Hotel housekeepers were highly exposed to job demands such as intense work pace, job-specific stressors, work-life conflict, and emotional demands; highly available job resources were role clarity, task meaning, and social support. Regression models revealed work pace, work-life conflict, nationality, and weak leader support as key predictors of job stress; and work-life conflict and leadership quality as key predictors of self-rated health. CONCLUSION/APPLICATION TO PRACTICE: Although considered an eminently physical job, psychosocial work factors play a key role in explaining HHs' job stress and self-rated health. Occupational health professionals should design workplace interventions to reduce work pace, mitigate work-life conflict, and enhance resources such as leader support, sense of community, and leadership quality.
  

• 
  Usefulness of body and visceral fat determined by bioimpedancemetry versus body mass index and waist circumference in the identification of elevated values of different atherogenesis risk scales. Gordito Soler, María; Ramírez-Manent, José Ignacio; Tárraga López, Pedro Juan; Martínez-Almoyna Rifá, Emilio; Paublini, Hernán; López González, Ángel Arturo (2025). 37 500772–500772.

  AbstractURLBibTeXEndNoteDOIBibSonomy

  INTRODUCTION: Obesity and atherogenesis are two highly prevalent pathological processes worldwide that also share several pathophysiological mechanisms. OBJECTIVES: Descriptive and cross-sectional study in 8,590 Spanish workers (4,104 men and 4,486 women) with an average age of 41.5years, in which the usefulness of four scales of overweight and obesity such as body mass index (BMI), waist circumference and percentages of body and visceral fat determined by bioimpedance measurement to identify high levels of atherogenic risk determined by atherogenic dyslipidemia (AD), lipid triad (LT) and several atherogenic indices is assessed. RESULTS: All the overweight and obesity scales show a predictive value between moderate and good, determined by the AUC of the ROC curves, with values ranging from 0.727 to 0.886 in women and 0.676 to 0.885 in men. Of all of them, the one with the highest AUC is visceral fat with values exceeding 0.800 and the lowest are for BMI. In all cases, the AUC is higher in women. CONCLUSIONS: The overweight and obesity scales analysed (BMI, waist circumference and percentage of body and visceral fat) show AUCs for predicting atherogenic risk between moderate and high, with visceral fat being the most useful of all.

  @article{gorditosoler2025usefulness,
  abstract = {INTRODUCTION: Obesity and atherogenesis are two highly prevalent pathological processes worldwide that also share several pathophysiological mechanisms. OBJECTIVES: Descriptive and cross-sectional study in 8,590 Spanish workers (4,104 men and 4,486 women) with an average age of 41.5years, in which the usefulness of four scales of overweight and obesity such as body mass index (BMI), waist circumference and percentages of body and visceral fat determined by bioimpedance measurement to identify high levels of atherogenic risk determined by atherogenic dyslipidemia (AD), lipid triad (LT) and several atherogenic indices is assessed. RESULTS: All the overweight and obesity scales show a predictive value between moderate and good, determined by the AUC of the ROC curves, with values ranging from 0.727 to 0.886 in women and 0.676 to 0.885 in men. Of all of them, the one with the highest AUC is visceral fat with values exceeding 0.800 and the lowest are for BMI. In all cases, the AUC is higher in women. CONCLUSIONS: The overweight and obesity scales analysed (BMI, waist circumference and percentage of body and visceral fat) show AUCs for predicting atherogenic risk between moderate and high, with visceral fat being the most useful of all.},
  address = {Spain},
  author = {Gordito Soler, María and Ramírez-Manent, José Ignacio and Tárraga López, Pedro Juan and Martínez-Almoyna Rifá, Emilio and Paublini, Hernán and López González, Ángel Arturo},
  journal = {Clinica e investigacion en arteriosclerosis : publicacion oficial de la Sociedad Espanola de Arteriosclerosis},
  keywords = {grapp-caib},
  month = {mar},
  pages = {500772-500772},
  title = {Usefulness of body and visceral fat determined by bioimpedancemetry versus body mass index and waist circumference in the identification of elevated values of different atherogenesis risk scales},
  volume = 37,
  year = 2025
  }
  

  %0 Journal Article
  %1 gorditosoler2025usefulness
  %A Gordito Soler, María
  %A Ramírez-Manent, José Ignacio
  %A Tárraga López, Pedro Juan
  %A Martínez-Almoyna Rifá, Emilio
  %A Paublini, Hernán
  %A López González, Ángel Arturo
  %C Spain
  %D 2025
  %J Clinica e investigacion en arteriosclerosis : publicacion oficial de la Sociedad Espanola de Arteriosclerosis
  %P 500772-500772
  %R 10.1016/j.arteri.2025.500772
  %T Usefulness of body and visceral fat determined by bioimpedancemetry versus body mass index and waist circumference in the identification of elevated values of different atherogenesis risk scales
  %U https://pubmed.ncbi.nlm.nih.gov/40037953
  %V 37
  %X INTRODUCTION: Obesity and atherogenesis are two highly prevalent pathological processes worldwide that also share several pathophysiological mechanisms. OBJECTIVES: Descriptive and cross-sectional study in 8,590 Spanish workers (4,104 men and 4,486 women) with an average age of 41.5years, in which the usefulness of four scales of overweight and obesity such as body mass index (BMI), waist circumference and percentages of body and visceral fat determined by bioimpedance measurement to identify high levels of atherogenic risk determined by atherogenic dyslipidemia (AD), lipid triad (LT) and several atherogenic indices is assessed. RESULTS: All the overweight and obesity scales show a predictive value between moderate and good, determined by the AUC of the ROC curves, with values ranging from 0.727 to 0.886 in women and 0.676 to 0.885 in men. Of all of them, the one with the highest AUC is visceral fat with values exceeding 0.800 and the lowest are for BMI. In all cases, the AUC is higher in women. CONCLUSIONS: The overweight and obesity scales analysed (BMI, waist circumference and percentage of body and visceral fat) show AUCs for predicting atherogenic risk between moderate and high, with visceral fat being the most useful of all.
  

• 
  Risk of Insulin Resistance in 44,939 Spanish Healthcare Workers: Association with Sociodemographic Variables and Healthy Habits. Tárraga Marcos, Pedro Javier; López-González, Ángel Arturo; Martínez-Almoyna Rifá, Emilio; Paublini Oliveira, Hernán; Martorell Sánchez, Cristina; Tárraga López, Pedro Juan; Ramírez-Manent, José Ignacio (2025). 13(2) 33-.

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Introduction: Insulin resistance (IR) is a highly prevalent pathophysiological entity implicated in the development of a wide variety of metabolic, cardiovascular, and endocrine disorders. The aim of this study is to assess the association between sociodemographic variables and healthy habits with IR risk scales. Methodology: This dual study, incorporating both longitudinal-retrospective and cross-sectional designs, analyzed healthcare workers across four professional categories (physicians, nurses, healthcare technicians, and auxiliary personnel). It examined the association of age, sex, professional category, smoking status, physical activity, and adherence to the Mediterranean diet with elevated scores on insulin resistance risk scales. Results: All the variables analyzed were associated with the presence of elevated values of the IR scales, with age, sex, and physical activity showing the strongest association (reflected in the odds ratio values). Conclusions: The profile of an individual with a higher risk of presenting elevated values of the IR risk scales would be an elderly male auxiliary health worker who is a smoker and is physically inactive, with a low adherence to the Mediterranean diet.

  @article{tarragamarcos2025insulin,
  abstract = {Introduction: Insulin resistance (IR) is a highly prevalent pathophysiological entity implicated in the development of a wide variety of metabolic, cardiovascular, and endocrine disorders. The aim of this study is to assess the association between sociodemographic variables and healthy habits with IR risk scales. Methodology: This dual study, incorporating both longitudinal-retrospective and cross-sectional designs, analyzed healthcare workers across four professional categories (physicians, nurses, healthcare technicians, and auxiliary personnel). It examined the association of age, sex, professional category, smoking status, physical activity, and adherence to the Mediterranean diet with elevated scores on insulin resistance risk scales. Results: All the variables analyzed were associated with the presence of elevated values of the IR scales, with age, sex, and physical activity showing the strongest association (reflected in the odds ratio values). Conclusions: The profile of an individual with a higher risk of presenting elevated values of the IR risk scales would be an elderly male auxiliary health worker who is a smoker and is physically inactive, with a low adherence to the Mediterranean diet.},
  address = {Switzerland},
  author = {Tárraga Marcos, Pedro Javier and López-González, Ángel Arturo and Martínez-Almoyna Rifá, Emilio and Paublini Oliveira, Hernán and Martorell Sánchez, Cristina and Tárraga López, Pedro Juan and Ramírez-Manent, José Ignacio},
  journal = {Diseases (Basel, Switzerland)},
  keywords = {grapp-caib},
  month = {jan},
  number = 2,
  pages = {33--},
  title = {Risk of Insulin Resistance in 44,939 Spanish Healthcare Workers: Association with Sociodemographic Variables and Healthy Habits},
  volume = 13,
  year = 2025
  }
  

  %0 Journal Article
  %1 tarragamarcos2025insulin
  %A Tárraga Marcos, Pedro Javier
  %A López-González, Ángel Arturo
  %A Martínez-Almoyna Rifá, Emilio
  %A Paublini Oliveira, Hernán
  %A Martorell Sánchez, Cristina
  %A Tárraga López, Pedro Juan
  %A Ramírez-Manent, José Ignacio
  %C Switzerland
  %D 2025
  %J Diseases (Basel, Switzerland)
  %N 2
  %P 33--
  %R 10.3390/diseases13020033
  %T Risk of Insulin Resistance in 44,939 Spanish Healthcare Workers: Association with Sociodemographic Variables and Healthy Habits
  %U https://pubmed.ncbi.nlm.nih.gov/39997040
  %V 13
  %X Introduction: Insulin resistance (IR) is a highly prevalent pathophysiological entity implicated in the development of a wide variety of metabolic, cardiovascular, and endocrine disorders. The aim of this study is to assess the association between sociodemographic variables and healthy habits with IR risk scales. Methodology: This dual study, incorporating both longitudinal-retrospective and cross-sectional designs, analyzed healthcare workers across four professional categories (physicians, nurses, healthcare technicians, and auxiliary personnel). It examined the association of age, sex, professional category, smoking status, physical activity, and adherence to the Mediterranean diet with elevated scores on insulin resistance risk scales. Results: All the variables analyzed were associated with the presence of elevated values of the IR scales, with age, sex, and physical activity showing the strongest association (reflected in the odds ratio values). Conclusions: The profile of an individual with a higher risk of presenting elevated values of the IR risk scales would be an elderly male auxiliary health worker who is a smoker and is physically inactive, with a low adherence to the Mediterranean diet.
  

• 
  Estimation of Cardiovascular Risk Using SCORE2, REGICOR and Vascular Age Scales in Spanish Healthcare Workers: A Retrospective Longitudinal Study. Marcos, Pedro Javier Tárraga; López, Pedro Juan Tárraga; López-González, Ángel Arturo; Rifá, Emilio Martínez-Almoyna; Oliveira, Hernán Paublini; Sánchez, Cristina Martorell; Ramírez-Manent, José Ignacio (2025). 13(4) 375-.

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Background/Objectives: Cardiovascular diseases (CVD) are one of the major public health concerns worldwide due to their high morbidity and mortality rates. This situation has necessitated the development of tools to assess cardiovascular risk (CVR) in order to prevent the onset of CVD. The aim of this study is to assess how sociodemographic variables and health habits are associated with the values of CVR scales, such as REGICOR, SCORE2, and vascular age. Methodology: This is a descriptive and cross-sectional study involving 44,939 Spanish healthcare workers, where the association between age, sex, type of work, smoking, physical activity, and Mediterranean diet with CVR scales such as REGICOR, SCORE2, and vascular age was evaluated. Results: All the variables analyzed showed an association with the occurrence of moderate-high values in all three CVR scales. Age was the variable that showed the highest odds ratio values: 13.446 (95% CI 11.16-14.77) for REGICOR, 13.90 (95% CI 12.01-15.81) for vascular age, and 14.12 (95% CI 12.01-16.23) for SCORE2. Conclusions: The profile of a healthcare worker with the highest risk of presenting moderate-high values on all three CVR scales would be a male over 60 years old, a nursing assistant or orderly, a smoker, sedentary, and with low adherence to the Mediterranean diet.

  @article{marcos2025estimation,
  abstract = {Background/Objectives: Cardiovascular diseases (CVD) are one of the major public health concerns worldwide due to their high morbidity and mortality rates. This situation has necessitated the development of tools to assess cardiovascular risk (CVR) in order to prevent the onset of CVD. The aim of this study is to assess how sociodemographic variables and health habits are associated with the values of CVR scales, such as REGICOR, SCORE2, and vascular age. Methodology: This is a descriptive and cross-sectional study involving 44,939 Spanish healthcare workers, where the association between age, sex, type of work, smoking, physical activity, and Mediterranean diet with CVR scales such as REGICOR, SCORE2, and vascular age was evaluated. Results: All the variables analyzed showed an association with the occurrence of moderate-high values in all three CVR scales. Age was the variable that showed the highest odds ratio values: 13.446 (95% CI 11.16-14.77) for REGICOR, 13.90 (95% CI 12.01-15.81) for vascular age, and 14.12 (95% CI 12.01-16.23) for SCORE2. Conclusions: The profile of a healthcare worker with the highest risk of presenting moderate-high values on all three CVR scales would be a male over 60 years old, a nursing assistant or orderly, a smoker, sedentary, and with low adherence to the Mediterranean diet.},
  address = {Switzerland},
  author = {Marcos, Pedro Javier Tárraga and López, Pedro Juan Tárraga and López-González, Ángel Arturo and Rifá, Emilio Martínez-Almoyna and Oliveira, Hernán Paublini and Sánchez, Cristina Martorell and Ramírez-Manent, José Ignacio},
  journal = {Healthcare (Basel, Switzerland)},
  keywords = {grapp-caib},
  month = {feb},
  number = 4,
  pages = {375--},
  title = {Estimation of Cardiovascular Risk Using SCORE2, REGICOR and Vascular Age Scales in Spanish Healthcare Workers: A Retrospective Longitudinal Study},
  volume = 13,
  year = 2025
  }
  

  %0 Journal Article
  %1 marcos2025estimation
  %A Marcos, Pedro Javier Tárraga
  %A López, Pedro Juan Tárraga
  %A López-González, Ángel Arturo
  %A Rifá, Emilio Martínez-Almoyna
  %A Oliveira, Hernán Paublini
  %A Sánchez, Cristina Martorell
  %A Ramírez-Manent, José Ignacio
  %C Switzerland
  %D 2025
  %J Healthcare (Basel, Switzerland)
  %N 4
  %P 375--
  %R 10.3390/healthcare13040375
  %T Estimation of Cardiovascular Risk Using SCORE2, REGICOR and Vascular Age Scales in Spanish Healthcare Workers: A Retrospective Longitudinal Study
  %U https://pubmed.ncbi.nlm.nih.gov/39997250
  %V 13
  %X Background/Objectives: Cardiovascular diseases (CVD) are one of the major public health concerns worldwide due to their high morbidity and mortality rates. This situation has necessitated the development of tools to assess cardiovascular risk (CVR) in order to prevent the onset of CVD. The aim of this study is to assess how sociodemographic variables and health habits are associated with the values of CVR scales, such as REGICOR, SCORE2, and vascular age. Methodology: This is a descriptive and cross-sectional study involving 44,939 Spanish healthcare workers, where the association between age, sex, type of work, smoking, physical activity, and Mediterranean diet with CVR scales such as REGICOR, SCORE2, and vascular age was evaluated. Results: All the variables analyzed showed an association with the occurrence of moderate-high values in all three CVR scales. Age was the variable that showed the highest odds ratio values: 13.446 (95% CI 11.16-14.77) for REGICOR, 13.90 (95% CI 12.01-15.81) for vascular age, and 14.12 (95% CI 12.01-16.23) for SCORE2. Conclusions: The profile of a healthcare worker with the highest risk of presenting moderate-high values on all three CVR scales would be a male over 60 years old, a nursing assistant or orderly, a smoker, sedentary, and with low adherence to the Mediterranean diet.
  

• 
  Body Fat and Visceral Fat Values in Spanish Healthcare Workers: Associated Variables. Tárraga Marcos, Pedro Javier; López-González, Ángel Arturo; Martínez-Almoyna Rifá, Emilio; Paublini Oliveira, Hernán; Martorell Sánchez, Cristina; Tárraga López, Pedro Juan; Ramírez-Manent, José Ignacio (2025). 17(4) 649-.

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND/OBJECTIVES: Excessive body adiposity is a significant public health challenge on a global scale. This study aimed to investigate the association between various sociodemographic factors and healthy lifestyle habits and the presence or absence of elevated body adiposity levels. METHODOLOGY: Two studies were conducted, a retrospective longitudinal study and a cross-sectional descriptive study. The analysis included 44,939 healthcare workers, categorised into four professional groups, to explore the relationship between age, sex, smoking, physical activity, and adherence to the Mediterranean diet and body adiposity, assessed as elevated body fat (BF) and visceral fat (VF) levels. Descriptive statistics encompassed categorical and quantitative variables, analysed using frequencies, Student's t-tests, chi-square tests, and multinomial logistic regression models. Associations, concordances, and correlations were further examined using logistic regression and Cohen's and Pearson's kappa coefficients. RESULTS: Age, sex, and physical activity were the factors most strongly associated with elevated BF and VF levels. Odds ratios (ORs) indicated the following significant associations: individuals aged 60 years and older exhibited ORs of 6.71 (95% CI: 5.68-7.74) for BF and 12.18 (95% CI: 10.01-14.26) for VF; male sex was associated with ORs of 2.21 (95% CI: 2.06-2.36) for BF and 12.51 (95% CI: 11.29-13.74) for VF. Sedentary behaviour was linked to ORs of 3.69 (95% CI: 3.41-3.97) for BF and 4.20 (95% CI: 3.78-4.63) for VF. Among healthcare professionals, nursing assistants and orderlies demonstrated the highest levels of adipose tissue accumulation. CONCLUSIONS: Elevated BF and VF levels among healthcare personnel are significantly associated by lifestyle factors, sex, and age, with the most pronounced risk observed in nursing assistants and orderlies. Further research focusing on the causal relationships between lifestyle behaviours and adiposity in this population will provide valuable insights and support the design of targeted preventive strategies to mitigate its prevalence.

  @article{tarragamarcos2025visceral,
  abstract = {BACKGROUND/OBJECTIVES: Excessive body adiposity is a significant public health challenge on a global scale. This study aimed to investigate the association between various sociodemographic factors and healthy lifestyle habits and the presence or absence of elevated body adiposity levels. METHODOLOGY: Two studies were conducted, a retrospective longitudinal study and a cross-sectional descriptive study. The analysis included 44,939 healthcare workers, categorised into four professional groups, to explore the relationship between age, sex, smoking, physical activity, and adherence to the Mediterranean diet and body adiposity, assessed as elevated body fat (BF) and visceral fat (VF) levels. Descriptive statistics encompassed categorical and quantitative variables, analysed using frequencies, Student's t-tests, chi-square tests, and multinomial logistic regression models. Associations, concordances, and correlations were further examined using logistic regression and Cohen's and Pearson's kappa coefficients. RESULTS: Age, sex, and physical activity were the factors most strongly associated with elevated BF and VF levels. Odds ratios (ORs) indicated the following significant associations: individuals aged 60 years and older exhibited ORs of 6.71 (95% CI: 5.68-7.74) for BF and 12.18 (95% CI: 10.01-14.26) for VF; male sex was associated with ORs of 2.21 (95% CI: 2.06-2.36) for BF and 12.51 (95% CI: 11.29-13.74) for VF. Sedentary behaviour was linked to ORs of 3.69 (95% CI: 3.41-3.97) for BF and 4.20 (95% CI: 3.78-4.63) for VF. Among healthcare professionals, nursing assistants and orderlies demonstrated the highest levels of adipose tissue accumulation. CONCLUSIONS: Elevated BF and VF levels among healthcare personnel are significantly associated by lifestyle factors, sex, and age, with the most pronounced risk observed in nursing assistants and orderlies. Further research focusing on the causal relationships between lifestyle behaviours and adiposity in this population will provide valuable insights and support the design of targeted preventive strategies to mitigate its prevalence.},
  address = {Switzerland},
  author = {Tárraga Marcos, Pedro Javier and López-González, Ángel Arturo and Martínez-Almoyna Rifá, Emilio and Paublini Oliveira, Hernán and Martorell Sánchez, Cristina and Tárraga López, Pedro Juan and Ramírez-Manent, José Ignacio},
  journal = {Nutrients},
  keywords = {grapp-caib},
  month = {feb},
  number = 4,
  pages = {649--},
  title = {Body Fat and Visceral Fat Values in Spanish Healthcare Workers: Associated Variables},
  volume = 17,
  year = 2025
  }
  

  %0 Journal Article
  %1 tarragamarcos2025visceral
  %A Tárraga Marcos, Pedro Javier
  %A López-González, Ángel Arturo
  %A Martínez-Almoyna Rifá, Emilio
  %A Paublini Oliveira, Hernán
  %A Martorell Sánchez, Cristina
  %A Tárraga López, Pedro Juan
  %A Ramírez-Manent, José Ignacio
  %C Switzerland
  %D 2025
  %J Nutrients
  %N 4
  %P 649--
  %R 10.3390/nu17040649
  %T Body Fat and Visceral Fat Values in Spanish Healthcare Workers: Associated Variables
  %U https://pubmed.ncbi.nlm.nih.gov/40004977
  %V 17
  %X BACKGROUND/OBJECTIVES: Excessive body adiposity is a significant public health challenge on a global scale. This study aimed to investigate the association between various sociodemographic factors and healthy lifestyle habits and the presence or absence of elevated body adiposity levels. METHODOLOGY: Two studies were conducted, a retrospective longitudinal study and a cross-sectional descriptive study. The analysis included 44,939 healthcare workers, categorised into four professional groups, to explore the relationship between age, sex, smoking, physical activity, and adherence to the Mediterranean diet and body adiposity, assessed as elevated body fat (BF) and visceral fat (VF) levels. Descriptive statistics encompassed categorical and quantitative variables, analysed using frequencies, Student's t-tests, chi-square tests, and multinomial logistic regression models. Associations, concordances, and correlations were further examined using logistic regression and Cohen's and Pearson's kappa coefficients. RESULTS: Age, sex, and physical activity were the factors most strongly associated with elevated BF and VF levels. Odds ratios (ORs) indicated the following significant associations: individuals aged 60 years and older exhibited ORs of 6.71 (95% CI: 5.68-7.74) for BF and 12.18 (95% CI: 10.01-14.26) for VF; male sex was associated with ORs of 2.21 (95% CI: 2.06-2.36) for BF and 12.51 (95% CI: 11.29-13.74) for VF. Sedentary behaviour was linked to ORs of 3.69 (95% CI: 3.41-3.97) for BF and 4.20 (95% CI: 3.78-4.63) for VF. Among healthcare professionals, nursing assistants and orderlies demonstrated the highest levels of adipose tissue accumulation. CONCLUSIONS: Elevated BF and VF levels among healthcare personnel are significantly associated by lifestyle factors, sex, and age, with the most pronounced risk observed in nursing assistants and orderlies. Further research focusing on the causal relationships between lifestyle behaviours and adiposity in this population will provide valuable insights and support the design of targeted preventive strategies to mitigate its prevalence.
  

• 
  [Usefullness of different scales of overweight and obesity to predict the presence of atherogenic dyslipidemia and lipid triad in 418,343 spanish workers]. Paublini, H.; Arturo López-González, Á; Tárraga López, P. J.; Martínez-Almoyna Rifá, E.; Vallejos, D.; Ignacio Ramírez-Manent, J. (2025). 51(4) 102428.

  AbstractURLBibTeXEndNoteDOIBibSonomy

  INTRODUCTION AND OBJECTIVES: Obesity and atherogenesis are two highly prevalent pathological processes that are closely related to the increase in cardiometabolic diseases. The aim of this study is to assess the relationship between obesity and two parameters that measure the risk of atherogenesis: atherogenic dyslipidaemia (AD) and the lipid triad (TL). MATERIAL AND METHODS: Descriptive and cross-sectional study in 418,343 Spanish workers in which the possible association between AD and TL with different scales of overweight and obesity such as body mass index (BMI), waist/height index, Clínica Universitaria de Navarra Body Adiposity Estimator (CUN BAE), relative fat mass (RFM), Palafolls and Deuremberg formulas, body surface index (BSI), normalized weight-adjusted index (NWAI) and body roundness index (BRI) was assessed. RESULTS: The values of all overweight-obesity scales are higher in people with AD and LBP and the prevalence of AD and LBP increases as the values of these overweight-obesity scales increase. The overweight-obesity scales that best predict the occurrence of AD are Deuremberg and CUN BAE (AUC 0.813 and 0.811 in men and 0.810 and 0.802 in women) while for TL they are also Deuremberg and CUN BAE (AUC 0.793 and 0.786 in men and 0.802 and 0.786 in women). CONCLUSIONS: The different scales that assess excess weight, especially those that predict body fat such as the Deuremberg formula and CUN BAE, are good predictors of AD and LD.

  @article{paublini_usefullness_2025,
  abstract = {INTRODUCTION AND OBJECTIVES: Obesity and atherogenesis are two highly prevalent pathological processes that are closely related to the increase in cardiometabolic diseases. The aim of this study is to assess the relationship between obesity and two parameters that measure the risk of atherogenesis: atherogenic dyslipidaemia (AD) and the lipid triad (TL). MATERIAL AND METHODS: Descriptive and cross-sectional study in 418,343 Spanish workers in which the possible association between AD and TL with different scales of overweight and obesity such as body mass index (BMI), waist/height index, Clínica Universitaria de Navarra Body Adiposity Estimator (CUN BAE), relative fat mass (RFM), Palafolls and Deuremberg formulas, body surface index (BSI), normalized weight-adjusted index (NWAI) and body roundness index (BRI) was assessed. RESULTS: The values of all overweight-obesity scales are higher in people with AD and LBP and the prevalence of AD and LBP increases as the values of these overweight-obesity scales increase. The overweight-obesity scales that best predict the occurrence of AD are Deuremberg and CUN BAE (AUC 0.813 and 0.811 in men and 0.810 and 0.802 in women) while for TL they are also Deuremberg and CUN BAE (AUC 0.793 and 0.786 in men and 0.802 and 0.786 in women). CONCLUSIONS: The different scales that assess excess weight, especially those that predict body fat such as the Deuremberg formula and CUN BAE, are good predictors of AD and LD.},
  author = {Paublini, H. and Arturo López-González, Á and Tárraga López, P. J. and Martínez-Almoyna Rifá, E. and Vallejos, D. and Ignacio Ramírez-Manent, J.},
  journal = {Semergen},
  keywords = {grapp-caib},
  number = 4,
  pages = 102428,
  title = {[Usefullness of different scales of overweight and obesity to predict the presence of atherogenic dyslipidemia and lipid triad in 418,343 spanish workers]},
  volume = 51,
  year = 2025
  }
  

  %0 Journal Article
  %1 paublini_usefullness_2025
  %A Paublini, H.
  %A Arturo López-González, Á
  %A Tárraga López, P. J.
  %A Martínez-Almoyna Rifá, E.
  %A Vallejos, D.
  %A Ignacio Ramírez-Manent, J.
  %D 2025
  %J Semergen
  %N 4
  %P 102428
  %R 10.1016/j.semerg.2024.102428
  %T [Usefullness of different scales of overweight and obesity to predict the presence of atherogenic dyslipidemia and lipid triad in 418,343 spanish workers]
  %U https://europepmc.org/article/med/39693830
  %V 51
  %X INTRODUCTION AND OBJECTIVES: Obesity and atherogenesis are two highly prevalent pathological processes that are closely related to the increase in cardiometabolic diseases. The aim of this study is to assess the relationship between obesity and two parameters that measure the risk of atherogenesis: atherogenic dyslipidaemia (AD) and the lipid triad (TL). MATERIAL AND METHODS: Descriptive and cross-sectional study in 418,343 Spanish workers in which the possible association between AD and TL with different scales of overweight and obesity such as body mass index (BMI), waist/height index, Clínica Universitaria de Navarra Body Adiposity Estimator (CUN BAE), relative fat mass (RFM), Palafolls and Deuremberg formulas, body surface index (BSI), normalized weight-adjusted index (NWAI) and body roundness index (BRI) was assessed. RESULTS: The values of all overweight-obesity scales are higher in people with AD and LBP and the prevalence of AD and LBP increases as the values of these overweight-obesity scales increase. The overweight-obesity scales that best predict the occurrence of AD are Deuremberg and CUN BAE (AUC 0.813 and 0.811 in men and 0.810 and 0.802 in women) while for TL they are also Deuremberg and CUN BAE (AUC 0.793 and 0.786 in men and 0.802 and 0.786 in women). CONCLUSIONS: The different scales that assess excess weight, especially those that predict body fat such as the Deuremberg formula and CUN BAE, are good predictors of AD and LD.
  

• 
  Association of Sociodemographic Variables and Healthy Habits with Body and Visceral Fat Values in Spanish Workers. Gordito Soler, María; López-González, Ángel Arturo; Tárraga López, Pedro Juan; Martínez-Almoyna Rifá, Emilio; Martorell Sánchez, Cristina; Vicente-Herrero, María Teófila; Paublini, Hernan; Ramírez-Manent, José Ignacio (2025). 61(1) 150-.

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Background and Objectives: The accumulation of fat in the body, especially visceral fat, is associated with various cardiometabolic conditions such as diabetes mellitus and fatty liver. The reasons for the accumulation of this fat are diverse. Some studies, also in the working population, have shown a clear association between sociodemographic variables and health habits with scales that assess overweight and obesity. This study aims to determine how certain sociodemographic variables, such as age, gender, and socioeconomic level, as well as certain healthy habits like physical activity and tobacco consumption, affect the levels of body and visceral fat. Materials and Methods: We conducted a descriptive and cross-sectional study involving 8590 Spanish workers. The percentage of body and visceral fat was measured using a bioimpedance analysis with a Tanita DC 430MA device. Results: Both the average values and the prevalence of elevated body and visceral fat increase with age and decrease with social class and lower levels of physical activity. These values are higher in smokers. A multivariate analysis shows that the variables most influential in increasing the risk of high levels of both body and visceral fat are age and low levels of physical activity. Conclusions: The profile of a person at high risk of having elevated body and visceral fat levels is an older male with a low socioeconomic status who smokes and leads a sedentary lifestyle.

  @article{gorditosoler2025association,
  abstract = {Background and Objectives: The accumulation of fat in the body, especially visceral fat, is associated with various cardiometabolic conditions such as diabetes mellitus and fatty liver. The reasons for the accumulation of this fat are diverse. Some studies, also in the working population, have shown a clear association between sociodemographic variables and health habits with scales that assess overweight and obesity. This study aims to determine how certain sociodemographic variables, such as age, gender, and socioeconomic level, as well as certain healthy habits like physical activity and tobacco consumption, affect the levels of body and visceral fat. Materials and Methods: We conducted a descriptive and cross-sectional study involving 8590 Spanish workers. The percentage of body and visceral fat was measured using a bioimpedance analysis with a Tanita DC 430MA device. Results: Both the average values and the prevalence of elevated body and visceral fat increase with age and decrease with social class and lower levels of physical activity. These values are higher in smokers. A multivariate analysis shows that the variables most influential in increasing the risk of high levels of both body and visceral fat are age and low levels of physical activity. Conclusions: The profile of a person at high risk of having elevated body and visceral fat levels is an older male with a low socioeconomic status who smokes and leads a sedentary lifestyle.},
  address = {Switzerland},
  author = {Gordito Soler, María and López-González, Ángel Arturo and Tárraga López, Pedro Juan and Martínez-Almoyna Rifá, Emilio and Martorell Sánchez, Cristina and Vicente-Herrero, María Teófila and Paublini, Hernan and Ramírez-Manent, José Ignacio},
  journal = {Medicina (Kaunas, Lithuania)},
  keywords = {grapp-caib},
  month = {jan},
  number = 1,
  pages = {150--},
  title = {Association of Sociodemographic Variables and Healthy Habits with Body and Visceral Fat Values in Spanish Workers},
  volume = 61,
  year = 2025
  }
  

  %0 Journal Article
  %1 gorditosoler2025association
  %A Gordito Soler, María
  %A López-González, Ángel Arturo
  %A Tárraga López, Pedro Juan
  %A Martínez-Almoyna Rifá, Emilio
  %A Martorell Sánchez, Cristina
  %A Vicente-Herrero, María Teófila
  %A Paublini, Hernan
  %A Ramírez-Manent, José Ignacio
  %C Switzerland
  %D 2025
  %J Medicina (Kaunas, Lithuania)
  %N 1
  %P 150--
  %R 10.3390/medicina61010150
  %T Association of Sociodemographic Variables and Healthy Habits with Body and Visceral Fat Values in Spanish Workers
  %U https://pubmed.ncbi.nlm.nih.gov/39859131
  %V 61
  %X Background and Objectives: The accumulation of fat in the body, especially visceral fat, is associated with various cardiometabolic conditions such as diabetes mellitus and fatty liver. The reasons for the accumulation of this fat are diverse. Some studies, also in the working population, have shown a clear association between sociodemographic variables and health habits with scales that assess overweight and obesity. This study aims to determine how certain sociodemographic variables, such as age, gender, and socioeconomic level, as well as certain healthy habits like physical activity and tobacco consumption, affect the levels of body and visceral fat. Materials and Methods: We conducted a descriptive and cross-sectional study involving 8590 Spanish workers. The percentage of body and visceral fat was measured using a bioimpedance analysis with a Tanita DC 430MA device. Results: Both the average values and the prevalence of elevated body and visceral fat increase with age and decrease with social class and lower levels of physical activity. These values are higher in smokers. A multivariate analysis shows that the variables most influential in increasing the risk of high levels of both body and visceral fat are age and low levels of physical activity. Conclusions: The profile of a person at high risk of having elevated body and visceral fat levels is an older male with a low socioeconomic status who smokes and leads a sedentary lifestyle.
  

• 
  The Prevalence of Metabolic Syndrome and Hypertriglyceridemic Waist Based on Sociodemographic Variables and Healthy Habits in Healthcare Workers: A Retrospective Study. Tárraga Marcos, Pedro Javier; López-González, Ángel Arturo; Martínez-Almoyna Rifá, Emilio; Paublini Oliveira, Hernán; Martorell Sánchez, Cristina; Tárraga López, Pedro Juan; Ramírez-Manent, José Ignacio (2025). 15(1) 81-.

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Introduction: Metabolic syndrome (MetS) and hypertriglyceridemic waist (HTW) are two multifactorial pathological conditions that have been increasing in prevalence worldwide. The objective of this study was to evaluate how various sociodemographic variables and healthy habits are associated with the presence or absence of MetS and HTW. Methodology: This study employed a mixed-methods approach, consisting of a retrospective longitudinal study and a cross-sectional descriptive study, analyzing 44,939 healthcare workers with MS and HTW across four professional categories to evaluate the relationship between age, sex, smoking, physical activity, and adherence to the Mediterranean diet using three diagnostic criteria. Descriptive analysis included categorical and quantitative variables, which were assessed through frequencies, Student's t-test, chi-square, and binary logistic regression models. Logistic regression and Cohen's kappa were used to evaluate associations and concordances. Age, sex, and lack of physical activity showed the strongest associations with MetS (OR: 2.65-2.84). The results highlight the importance of physical activity and other factors in metabolic prevention. Results: Age, sex, and physical activity were the variables most strongly associated with MetS and HTW across the three evaluated diagnostic criteria. The odds ratios revealed significant values: age (9.07-13.71 for MetS and 13.42 for HTW), sex (2.82-3.31 for MetS and 3.72 for HTW), and physical activity (2.65-2.84 for MetS and 2.40 for HTW). Conclusions: The risk of developing MetS and HTW among healthcare personnel is influenced by lifestyle habits, sex, and age, with the highest ORs observed in nursing assistants and orderlies. Future research that delves deeper into the causal relationship between lifestyle factors and the severity of MetS and HTW in healthcare personnel will improve understanding and facilitate the development of preventive activities to reduce their incidence.

  @article{tarragamarcos2025prevalence,
  abstract = {Introduction: Metabolic syndrome (MetS) and hypertriglyceridemic waist (HTW) are two multifactorial pathological conditions that have been increasing in prevalence worldwide. The objective of this study was to evaluate how various sociodemographic variables and healthy habits are associated with the presence or absence of MetS and HTW. Methodology: This study employed a mixed-methods approach, consisting of a retrospective longitudinal study and a cross-sectional descriptive study, analyzing 44,939 healthcare workers with MS and HTW across four professional categories to evaluate the relationship between age, sex, smoking, physical activity, and adherence to the Mediterranean diet using three diagnostic criteria. Descriptive analysis included categorical and quantitative variables, which were assessed through frequencies, Student's t-test, chi-square, and binary logistic regression models. Logistic regression and Cohen's kappa were used to evaluate associations and concordances. Age, sex, and lack of physical activity showed the strongest associations with MetS (OR: 2.65-2.84). The results highlight the importance of physical activity and other factors in metabolic prevention. Results: Age, sex, and physical activity were the variables most strongly associated with MetS and HTW across the three evaluated diagnostic criteria. The odds ratios revealed significant values: age (9.07-13.71 for MetS and 13.42 for HTW), sex (2.82-3.31 for MetS and 3.72 for HTW), and physical activity (2.65-2.84 for MetS and 2.40 for HTW). Conclusions: The risk of developing MetS and HTW among healthcare personnel is influenced by lifestyle habits, sex, and age, with the highest ORs observed in nursing assistants and orderlies. Future research that delves deeper into the causal relationship between lifestyle factors and the severity of MetS and HTW in healthcare personnel will improve understanding and facilitate the development of preventive activities to reduce their incidence.},
  address = {Switzerland},
  author = {Tárraga Marcos, Pedro Javier and López-González, Ángel Arturo and Martínez-Almoyna Rifá, Emilio and Paublini Oliveira, Hernán and Martorell Sánchez, Cristina and Tárraga López, Pedro Juan and Ramírez-Manent, José Ignacio},
  journal = {Life (Basel, Switzerland)},
  keywords = {grapp-caib},
  month = {jan},
  number = 1,
  pages = {81--},
  title = {The Prevalence of Metabolic Syndrome and Hypertriglyceridemic Waist Based on Sociodemographic Variables and Healthy Habits in Healthcare Workers: A Retrospective Study},
  volume = 15,
  year = 2025
  }
  

  %0 Journal Article
  %1 tarragamarcos2025prevalence
  %A Tárraga Marcos, Pedro Javier
  %A López-González, Ángel Arturo
  %A Martínez-Almoyna Rifá, Emilio
  %A Paublini Oliveira, Hernán
  %A Martorell Sánchez, Cristina
  %A Tárraga López, Pedro Juan
  %A Ramírez-Manent, José Ignacio
  %C Switzerland
  %D 2025
  %J Life (Basel, Switzerland)
  %N 1
  %P 81--
  %R 10.3390/life15010081
  %T The Prevalence of Metabolic Syndrome and Hypertriglyceridemic Waist Based on Sociodemographic Variables and Healthy Habits in Healthcare Workers: A Retrospective Study
  %U https://pubmed.ncbi.nlm.nih.gov/39860021
  %V 15
  %X Introduction: Metabolic syndrome (MetS) and hypertriglyceridemic waist (HTW) are two multifactorial pathological conditions that have been increasing in prevalence worldwide. The objective of this study was to evaluate how various sociodemographic variables and healthy habits are associated with the presence or absence of MetS and HTW. Methodology: This study employed a mixed-methods approach, consisting of a retrospective longitudinal study and a cross-sectional descriptive study, analyzing 44,939 healthcare workers with MS and HTW across four professional categories to evaluate the relationship between age, sex, smoking, physical activity, and adherence to the Mediterranean diet using three diagnostic criteria. Descriptive analysis included categorical and quantitative variables, which were assessed through frequencies, Student's t-test, chi-square, and binary logistic regression models. Logistic regression and Cohen's kappa were used to evaluate associations and concordances. Age, sex, and lack of physical activity showed the strongest associations with MetS (OR: 2.65-2.84). The results highlight the importance of physical activity and other factors in metabolic prevention. Results: Age, sex, and physical activity were the variables most strongly associated with MetS and HTW across the three evaluated diagnostic criteria. The odds ratios revealed significant values: age (9.07-13.71 for MetS and 13.42 for HTW), sex (2.82-3.31 for MetS and 3.72 for HTW), and physical activity (2.65-2.84 for MetS and 2.40 for HTW). Conclusions: The risk of developing MetS and HTW among healthcare personnel is influenced by lifestyle habits, sex, and age, with the highest ORs observed in nursing assistants and orderlies. Future research that delves deeper into the causal relationship between lifestyle factors and the severity of MetS and HTW in healthcare personnel will improve understanding and facilitate the development of preventive activities to reduce their incidence.
  

• 
  Association Between Sociodemographic Variables, Healthy Habits, and Stress with Risk Scales for Liver Disease Associated with Metabolic Dysfunction. López-González, Ángel Arturo; Martínez-Almoyna Rifá, Emilio; Oliveira, Hernán Paublini; Sánchez, Cristina Martorell; Tárraga López, Pedro Juan; Ramírez-Manent, José Ignacio (2025). 15(1) 116-.

  AbstractURLBibTeXEndNoteDOIBibSonomy

  Metabolic dysfunction-associated fatty liver disease (MAFLD) is the most common cause of chronic liver disease worldwide, with a multifactorial etiology. This study aims to evaluate the associations between various sociodemographic variables, healthy habits, and stress with risk scale values for MAFLD. MATERIALS AND METHODS: A descriptive, cross-sectional study was conducted on 16,708 Spanish workers to assess how sociodemographic variables (age, gender, and socioeconomic status), healthy habits (smoking, Mediterranean diet adherence, and physical activity), and stress correlate with values from three MAFLD risk scales: fatty liver index (FLI), hepatic steatosis index (HSI), and lipid accumulation product (LAP). RESULTS: All analyzed variables were associated with the values of the three MAFLD risk scales. Among them, the variables showing the strongest associations (represented by odds ratio values) were age and physical activity. CONCLUSIONS: The profile of an individual at higher risk of elevated MAFLD risk scale values is a male, aged 50 or older, belonging to lower socioeconomic levels (manual laborers), a smoker, sedentary, with low adherence to the Mediterranean diet, and with high stress scale scores.

  @article{lopezgonzalez2025association,
  abstract = {Metabolic dysfunction-associated fatty liver disease (MAFLD) is the most common cause of chronic liver disease worldwide, with a multifactorial etiology. This study aims to evaluate the associations between various sociodemographic variables, healthy habits, and stress with risk scale values for MAFLD. MATERIALS AND METHODS: A descriptive, cross-sectional study was conducted on 16,708 Spanish workers to assess how sociodemographic variables (age, gender, and socioeconomic status), healthy habits (smoking, Mediterranean diet adherence, and physical activity), and stress correlate with values from three MAFLD risk scales: fatty liver index (FLI), hepatic steatosis index (HSI), and lipid accumulation product (LAP). RESULTS: All analyzed variables were associated with the values of the three MAFLD risk scales. Among them, the variables showing the strongest associations (represented by odds ratio values) were age and physical activity. CONCLUSIONS: The profile of an individual at higher risk of elevated MAFLD risk scale values is a male, aged 50 or older, belonging to lower socioeconomic levels (manual laborers), a smoker, sedentary, with low adherence to the Mediterranean diet, and with high stress scale scores.},
  address = {Switzerland},
  author = {López-González, Ángel Arturo and Martínez-Almoyna Rifá, Emilio and Oliveira, Hernán Paublini and Sánchez, Cristina Martorell and Tárraga López, Pedro Juan and Ramírez-Manent, José Ignacio},
  journal = {Life (Basel, Switzerland)},
  keywords = {grapp-caib},
  month = {jan},
  number = 1,
  pages = {116--},
  title = {Association Between Sociodemographic Variables, Healthy Habits, and Stress with Risk Scales for Liver Disease Associated with Metabolic Dysfunction},
  volume = 15,
  year = 2025
  }
  

  %0 Journal Article
  %1 lopezgonzalez2025association
  %A López-González, Ángel Arturo
  %A Martínez-Almoyna Rifá, Emilio
  %A Oliveira, Hernán Paublini
  %A Sánchez, Cristina Martorell
  %A Tárraga López, Pedro Juan
  %A Ramírez-Manent, José Ignacio
  %C Switzerland
  %D 2025
  %J Life (Basel, Switzerland)
  %N 1
  %P 116--
  %R 10.3390/life15010116
  %T Association Between Sociodemographic Variables, Healthy Habits, and Stress with Risk Scales for Liver Disease Associated with Metabolic Dysfunction
  %U https://pubmed.ncbi.nlm.nih.gov/39860055
  %V 15
  %X Metabolic dysfunction-associated fatty liver disease (MAFLD) is the most common cause of chronic liver disease worldwide, with a multifactorial etiology. This study aims to evaluate the associations between various sociodemographic variables, healthy habits, and stress with risk scale values for MAFLD. MATERIALS AND METHODS: A descriptive, cross-sectional study was conducted on 16,708 Spanish workers to assess how sociodemographic variables (age, gender, and socioeconomic status), healthy habits (smoking, Mediterranean diet adherence, and physical activity), and stress correlate with values from three MAFLD risk scales: fatty liver index (FLI), hepatic steatosis index (HSI), and lipid accumulation product (LAP). RESULTS: All analyzed variables were associated with the values of the three MAFLD risk scales. Among them, the variables showing the strongest associations (represented by odds ratio values) were age and physical activity. CONCLUSIONS: The profile of an individual at higher risk of elevated MAFLD risk scale values is a male, aged 50 or older, belonging to lower socioeconomic levels (manual laborers), a smoker, sedentary, with low adherence to the Mediterranean diet, and with high stress scale scores.
  

• 
  Association between sociodemographic variables, healthy habits and stress with diabesity. López-González, Ángel Arturo; Martínez-Almoyna Rifá, Emilio; Paublini Oliveira, Hernán; Martorell Sánchez, Cristina; Tárraga López, Pedro Juan; Ramírez-Manent, José Ignacio (2025). 500754–500754.

  AbstractURLBibTeXEndNoteDOIBibSonomy

  INTRODUCTION: Diabesity is a pathological condition that combines obesity and type 2 diabetes in the same individual. Due to the current rise in both conditions, the prevalence of diabesity is increasing worldwide. Its etiology is known to be multifactorial; therefore, the aim of this study is to understand how diabesity is associated with various sociodemographic variables, healthy habits, and stress. MATERIALS AND METHODS: A descriptive, cross-sectional study was conducted on 24,224 Spanish workers to evaluate the association between diabesity and various factors such as age, gender, socioeconomic status, smoking, alcohol consumption, physical activity, adherence to the Mediterranean diet, and stress. The criteria used to define diabesity included body mass index (BMI), body fat (BF), and visceral fat (VF). RESULTS: All the aforementioned variables were found to be associated with diabesity. The highest odds ratios (OR) were observed for age, with values ranging from 5.57 (95% CI: 4.48-6.67) when BF was used as the diabesity criterion to 6.89 (95% CI: 5.60-8.19) when VF was the criterion. Similarly, elevated ORs were observed for male gender, with ORs of 6.77 (95% CI: 5.31-8.24) for VF and 3.34 (95% CI: 2.77-3.94) for BF. CONCLUSIONS: In our study, the profile of a person at highest risk of diabesity is a man over 50 years old from a lower socioeconomic status, who is a smoker, regular alcohol consumer, sedentary, with low adherence to the Mediterranean diet, and experiencing high stress levels.

  @article{lopezgonzalez2025association,
  abstract = {INTRODUCTION: Diabesity is a pathological condition that combines obesity and type 2 diabetes in the same individual. Due to the current rise in both conditions, the prevalence of diabesity is increasing worldwide. Its etiology is known to be multifactorial; therefore, the aim of this study is to understand how diabesity is associated with various sociodemographic variables, healthy habits, and stress. MATERIALS AND METHODS: A descriptive, cross-sectional study was conducted on 24,224 Spanish workers to evaluate the association between diabesity and various factors such as age, gender, socioeconomic status, smoking, alcohol consumption, physical activity, adherence to the Mediterranean diet, and stress. The criteria used to define diabesity included body mass index (BMI), body fat (BF), and visceral fat (VF). RESULTS: All the aforementioned variables were found to be associated with diabesity. The highest odds ratios (OR) were observed for age, with values ranging from 5.57 (95% CI: 4.48-6.67) when BF was used as the diabesity criterion to 6.89 (95% CI: 5.60-8.19) when VF was the criterion. Similarly, elevated ORs were observed for male gender, with ORs of 6.77 (95% CI: 5.31-8.24) for VF and 3.34 (95% CI: 2.77-3.94) for BF. CONCLUSIONS: In our study, the profile of a person at highest risk of diabesity is a man over 50 years old from a lower socioeconomic status, who is a smoker, regular alcohol consumer, sedentary, with low adherence to the Mediterranean diet, and experiencing high stress levels.},
  address = {Spain},
  author = {López-González, Ángel Arturo and Martínez-Almoyna Rifá, Emilio and Paublini Oliveira, Hernán and Martorell Sánchez, Cristina and Tárraga López, Pedro Juan and Ramírez-Manent, José Ignacio},
  journal = {Clinica e investigacion en arteriosclerosis : publicacion oficial de la Sociedad Espanola de Arteriosclerosis},
  keywords = {grapp-caib},
  month = {jan},
  pages = {500754--500754},
  title = {Association between sociodemographic variables, healthy habits and stress with diabesity},
  year = 2025
  }
  

  %0 Journal Article
  %1 lopezgonzalez2025association
  %A López-González, Ángel Arturo
  %A Martínez-Almoyna Rifá, Emilio
  %A Paublini Oliveira, Hernán
  %A Martorell Sánchez, Cristina
  %A Tárraga López, Pedro Juan
  %A Ramírez-Manent, José Ignacio
  %C Spain
  %D 2025
  %J Clinica e investigacion en arteriosclerosis : publicacion oficial de la Sociedad Espanola de Arteriosclerosis
  %P 500754--500754
  %R 10.1016/j.arteri.2024.500754
  %T Association between sociodemographic variables, healthy habits and stress with diabesity
  %U https://pubmed.ncbi.nlm.nih.gov/39824668
  %X INTRODUCTION: Diabesity is a pathological condition that combines obesity and type 2 diabetes in the same individual. Due to the current rise in both conditions, the prevalence of diabesity is increasing worldwide. Its etiology is known to be multifactorial; therefore, the aim of this study is to understand how diabesity is associated with various sociodemographic variables, healthy habits, and stress. MATERIALS AND METHODS: A descriptive, cross-sectional study was conducted on 24,224 Spanish workers to evaluate the association between diabesity and various factors such as age, gender, socioeconomic status, smoking, alcohol consumption, physical activity, adherence to the Mediterranean diet, and stress. The criteria used to define diabesity included body mass index (BMI), body fat (BF), and visceral fat (VF). RESULTS: All the aforementioned variables were found to be associated with diabesity. The highest odds ratios (OR) were observed for age, with values ranging from 5.57 (95% CI: 4.48-6.67) when BF was used as the diabesity criterion to 6.89 (95% CI: 5.60-8.19) when VF was the criterion. Similarly, elevated ORs were observed for male gender, with ORs of 6.77 (95% CI: 5.31-8.24) for VF and 3.34 (95% CI: 2.77-3.94) for BF. CONCLUSIONS: In our study, the profile of a person at highest risk of diabesity is a man over 50 years old from a lower socioeconomic status, who is a smoker, regular alcohol consumer, sedentary, with low adherence to the Mediterranean diet, and experiencing high stress levels.
  

• 
  Cohort profile: the CORDELIA study (Collaborative cOhorts Reassembled Data to study mEchanisms and Longterm Incidence of chronic diseAses). Hernáez, Álvaro; Camps-Vilaró, Anna; Polo-Alonso, Sara; Subirana, Isaac; Ramos, Rafel; de Cid, Rafael; Rodríguez-Artalejo, Fernando; Elosua, Roberto; Chirlaque, M. Dolores; Amiano, Pilar; Bermúdez-López, Marcelino; Guevara, Marcela; Cinza-Sanjurjo, Sergio; Sánchez, María-José; de León, Antonio Cabrera; Laclaustra, Martín; Rojo-Martínez, Gemma; Guembe-Suescun, María J.; Pérez-Gómez, Beatriz; Vega-Alonso, Tomás; Torán-Monserrat, Pere; Lora-Pablos, David; Huerta, José María; Valdivielso, José M.; Dégano, Irene R.; Félix-Redondo, Francisco J.; Gandarillas, Ana María; Valdés, Sergio; Mundet-Tuduri, Xavier; Sánchez, Pedro L.; Martín-Sánchez, Vicente; Rigo, Fernando; Alonso-Sampedro, Manuela; Moreno-Iribas, Conchi; Martín-Escudero, Juan Carlos; Delgado, Elías; Grau, Maria; Urrutia, Inés; Ovejero, Diana; Quintela, Inés; Martí-Lluch, Ruth; Blay, Natalia; Banegas, José R.; Tizón-Marcos, Helena; Gómez, Jesús Humberto; Aizpurua, Amaia; Castro-Boqué, Eva; Delfrade, Josu; Prieto-Díaz, Miguel Ángel; Rodríguez-Barranco, Miguel; Almeida-González, Delia; Moreno-Franco, Belén; Oualla-Bachiri, Wasima; Sayón-Orea, Carmen; Plans-Beriso, Elena; Lozano, José Eugenio; López-Lifante, Víctor M.; Cancelas-Navia, Pilar; Cabrera-Castro, Natalia; Cambray, Serafí; Zacarías-Pons, Lluís; Fernández-Bergés, Daniel; Donoso-Navarro, Encarnación; Maldonado-Araque, Cristina; Franch-Nadal, Josep; Dorado-Díaz, Pedro Ignacio; Villarín-Castro, Alejandro; Frontera-Juan, Guillem; Gude, Francisco; Andueza, Naroa; Téllez-Plaza, María; Ares-Blanco, Jessica; Cruz, Raquel; Ribas-Aulinas, Marc; Barretina, Jordi; Guallar-Castillón, Pilar; Caínzos-Achirica, Miguel; Colorado-Yohar, Sandra Milena; Llorente, Adrián; Diaz-Tocados, Juan Miguel; Ardanaz, Eva; Micó-Pérez, Rafael Manuel; Fernandez-Martinez, Nicolás Francisco; del Cristo Rodríguez-Pérez, María; Cenarro, Ana; Calle-Pascual, Alfonso L.; Marrugat, Jaume (2025). 40(5) 581–599.

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  The CORDELIA Study (Collaborative Cohorts Reassembled Data to Study Mechanisms and Long-term Incidence of Chronic Diseases) combines 35 Spanish population cohorts to investigate the clinical, environmental, genetic, and omics determinants of cardiovascular disease in the Southern European population. It aims to conduct the largest genome-wide association study to date on cardiovascular disease in this population, improve predictions of cardiovascular incidence using genomic and clinical data, and identify subgroups that would benefit most from targeted pharmacological and lifestyle interventions. CORDELIA includes 196,632 individuals (ages 18–84, 54\% female, 96\% born in Spain, 20\% with higher education, recruited from 1989 to 2020, with follow-up periods ranging from 5 to 30 years), with DNA samples available for 117,342 participants (60\%). Of the participants, 24% were current smokers, 43% hypertensive, 11% diabetic, 15% medicated with lipid-lowering drugs, 44% overweight, and 27% obese. If not already available, genotyping is being performed using the Axiom™ Spain Biobank array (\textasciitilde 750,000 variants, including 115,000 specific and 50,000 rare functional variants from the Spanish population). The cohort also includes incident events (coronary heart disease, stroke, heart failure, peripheral artery disease, hypertension, diabetes); date and cause of death; and harmonized data on risk factors (body mass index, waist circumference, lipid profile, blood pressure, glucose, creatinine), lifestyle (smoking, physical activity, diet, alcohol), and socioeconomic status. 99,019 participants (50\%) also provide plasma samples. CORDELIA will significantly contribute to understanding the complex interplay of risk factors contributing to cardiovascular disease and advance the fields of precision medicine and public health in Southern European individuals.

  @article{hernaez_cohort_2025,
  abstract = {The CORDELIA Study (Collaborative Cohorts Reassembled Data to Study Mechanisms and Long-term Incidence of Chronic Diseases) combines 35 Spanish population cohorts to investigate the clinical, environmental, genetic, and omics determinants of cardiovascular disease in the Southern European population. It aims to conduct the largest genome-wide association study to date on cardiovascular disease in this population, improve predictions of cardiovascular incidence using genomic and clinical data, and identify subgroups that would benefit most from targeted pharmacological and lifestyle interventions. CORDELIA includes 196,632 individuals (ages 18–84, 54\% female, 96\% born in Spain, 20\% with higher education, recruited from 1989 to 2020, with follow-up periods ranging from 5 to 30 years), with DNA samples available for 117,342 participants (60\%). Of the participants, 24% were current smokers, 43% hypertensive, 11% diabetic, 15% medicated with lipid-lowering drugs, 44% overweight, and 27% obese. If not already available, genotyping is being performed using the Axiom™ Spain Biobank array (\textasciitilde 750,000 variants, including 115,000 specific and 50,000 rare functional variants from the Spanish population). The cohort also includes incident events (coronary heart disease, stroke, heart failure, peripheral artery disease, hypertension, diabetes); date and cause of death; and harmonized data on risk factors (body mass index, waist circumference, lipid profile, blood pressure, glucose, creatinine), lifestyle (smoking, physical activity, diet, alcohol), and socioeconomic status. 99,019 participants (50\%) also provide plasma samples. CORDELIA will significantly contribute to understanding the complex interplay of risk factors contributing to cardiovascular disease and advance the fields of precision medicine and public health in Southern European individuals.},
  author = {Hernáez, Álvaro and Camps-Vilaró, Anna and Polo-Alonso, Sara and Subirana, Isaac and Ramos, Rafel and de Cid, Rafael and Rodríguez-Artalejo, Fernando and Elosua, Roberto and Chirlaque, M. Dolores and Amiano, Pilar and Bermúdez-López, Marcelino and Guevara, Marcela and Cinza-Sanjurjo, Sergio and Sánchez, María-José and de León, Antonio Cabrera and Laclaustra, Martín and Rojo-Martínez, Gemma and Guembe-Suescun, María J. and Pérez-Gómez, Beatriz and Vega-Alonso, Tomás and Torán-Monserrat, Pere and Lora-Pablos, David and Huerta, José María and Valdivielso, José M. and Dégano, Irene R. and Félix-Redondo, Francisco J. and Gandarillas, Ana María and Valdés, Sergio and Mundet-Tuduri, Xavier and Sánchez, Pedro L. and Martín-Sánchez, Vicente and Rigo, Fernando and Alonso-Sampedro, Manuela and Moreno-Iribas, Conchi and Martín-Escudero, Juan Carlos and Delgado, Elías and Grau, Maria and Urrutia, Inés and Ovejero, Diana and Quintela, Inés and Martí-Lluch, Ruth and Blay, Natalia and Banegas, José R. and Tizón-Marcos, Helena and Gómez, Jesús Humberto and Aizpurua, Amaia and Castro-Boqué, Eva and Delfrade, Josu and Prieto-Díaz, Miguel Ángel and Rodríguez-Barranco, Miguel and Almeida-González, Delia and Moreno-Franco, Belén and Oualla-Bachiri, Wasima and Sayón-Orea, Carmen and Plans-Beriso, Elena and Lozano, José Eugenio and López-Lifante, Víctor M. and Cancelas-Navia, Pilar and Cabrera-Castro, Natalia and Cambray, Serafí and Zacarías-Pons, Lluís and Fernández-Bergés, Daniel and Donoso-Navarro, Encarnación and Maldonado-Araque, Cristina and Franch-Nadal, Josep and Dorado-Díaz, Pedro Ignacio and Villarín-Castro, Alejandro and Frontera-Juan, Guillem and Gude, Francisco and Andueza, Naroa and Téllez-Plaza, María and Ares-Blanco, Jessica and Cruz, Raquel and Ribas-Aulinas, Marc and Barretina, Jordi and Guallar-Castillón, Pilar and Caínzos-Achirica, Miguel and Colorado-Yohar, Sandra Milena and Llorente, Adrián and Diaz-Tocados, Juan Miguel and Ardanaz, Eva and Micó-Pérez, Rafael Manuel and Fernandez-Martinez, Nicolás Francisco and del Cristo Rodríguez-Pérez, María and Cenarro, Ana and Calle-Pascual, Alfonso L. and Marrugat, Jaume},
  journal = {European Journal of Epidemiology},
  keywords = {grapp-caib},
  number = 5,
  pages = {581--599},
  title = {Cohort profile: the CORDELIA study (Collaborative cOhorts Reassembled Data to study mEchanisms and Longterm Incidence of chronic diseAses)},
  volume = 40,
  year = 2025
  }
  

  %0 Journal Article
  %1 hernaez_cohort_2025
  %A Hernáez, Álvaro
  %A Camps-Vilaró, Anna
  %A Polo-Alonso, Sara
  %A Subirana, Isaac
  %A Ramos, Rafel
  %A de Cid, Rafael
  %A Rodríguez-Artalejo, Fernando
  %A Elosua, Roberto
  %A Chirlaque, M. Dolores
  %A Amiano, Pilar
  %A Bermúdez-López, Marcelino
  %A Guevara, Marcela
  %A Cinza-Sanjurjo, Sergio
  %A Sánchez, María-José
  %A de León, Antonio Cabrera
  %A Laclaustra, Martín
  %A Rojo-Martínez, Gemma
  %A Guembe-Suescun, María J.
  %A Pérez-Gómez, Beatriz
  %A Vega-Alonso, Tomás
  %A Torán-Monserrat, Pere
  %A Lora-Pablos, David
  %A Huerta, José María
  %A Valdivielso, José M.
  %A Dégano, Irene R.
  %A Félix-Redondo, Francisco J.
  %A Gandarillas, Ana María
  %A Valdés, Sergio
  %A Mundet-Tuduri, Xavier
  %A Sánchez, Pedro L.
  %A Martín-Sánchez, Vicente
  %A Rigo, Fernando
  %A Alonso-Sampedro, Manuela
  %A Moreno-Iribas, Conchi
  %A Martín-Escudero, Juan Carlos
  %A Delgado, Elías
  %A Grau, Maria
  %A Urrutia, Inés
  %A Ovejero, Diana
  %A Quintela, Inés
  %A Martí-Lluch, Ruth
  %A Blay, Natalia
  %A Banegas, José R.
  %A Tizón-Marcos, Helena
  %A Gómez, Jesús Humberto
  %A Aizpurua, Amaia
  %A Castro-Boqué, Eva
  %A Delfrade, Josu
  %A Prieto-Díaz, Miguel Ángel
  %A Rodríguez-Barranco, Miguel
  %A Almeida-González, Delia
  %A Moreno-Franco, Belén
  %A Oualla-Bachiri, Wasima
  %A Sayón-Orea, Carmen
  %A Plans-Beriso, Elena
  %A Lozano, José Eugenio
  %A López-Lifante, Víctor M.
  %A Cancelas-Navia, Pilar
  %A Cabrera-Castro, Natalia
  %A Cambray, Serafí
  %A Zacarías-Pons, Lluís
  %A Fernández-Bergés, Daniel
  %A Donoso-Navarro, Encarnación
  %A Maldonado-Araque, Cristina
  %A Franch-Nadal, Josep
  %A Dorado-Díaz, Pedro Ignacio
  %A Villarín-Castro, Alejandro
  %A Frontera-Juan, Guillem
  %A Gude, Francisco
  %A Andueza, Naroa
  %A Téllez-Plaza, María
  %A Ares-Blanco, Jessica
  %A Cruz, Raquel
  %A Ribas-Aulinas, Marc
  %A Barretina, Jordi
  %A Guallar-Castillón, Pilar
  %A Caínzos-Achirica, Miguel
  %A Colorado-Yohar, Sandra Milena
  %A Llorente, Adrián
  %A Diaz-Tocados, Juan Miguel
  %A Ardanaz, Eva
  %A Micó-Pérez, Rafael Manuel
  %A Fernandez-Martinez, Nicolás Francisco
  %A del Cristo Rodríguez-Pérez, María
  %A Cenarro, Ana
  %A Calle-Pascual, Alfonso L.
  %A Marrugat, Jaume
  %D 2025
  %J European Journal of Epidemiology
  %N 5
  %P 581--599
  %R 10.1007/s10654-025-01229-6
  %T Cohort profile: the CORDELIA study (Collaborative cOhorts Reassembled Data to study mEchanisms and Longterm Incidence of chronic diseAses)
  %U https://pmc.ncbi.nlm.nih.gov/articles/PMC12170779/
  %V 40
  %X The CORDELIA Study (Collaborative Cohorts Reassembled Data to Study Mechanisms and Long-term Incidence of Chronic Diseases) combines 35 Spanish population cohorts to investigate the clinical, environmental, genetic, and omics determinants of cardiovascular disease in the Southern European population. It aims to conduct the largest genome-wide association study to date on cardiovascular disease in this population, improve predictions of cardiovascular incidence using genomic and clinical data, and identify subgroups that would benefit most from targeted pharmacological and lifestyle interventions. CORDELIA includes 196,632 individuals (ages 18–84, 54\% female, 96\% born in Spain, 20\% with higher education, recruited from 1989 to 2020, with follow-up periods ranging from 5 to 30 years), with DNA samples available for 117,342 participants (60\%). Of the participants, 24% were current smokers, 43% hypertensive, 11% diabetic, 15% medicated with lipid-lowering drugs, 44% overweight, and 27% obese. If not already available, genotyping is being performed using the Axiom™ Spain Biobank array (\textasciitilde 750,000 variants, including 115,000 specific and 50,000 rare functional variants from the Spanish population). The cohort also includes incident events (coronary heart disease, stroke, heart failure, peripheral artery disease, hypertension, diabetes); date and cause of death; and harmonized data on risk factors (body mass index, waist circumference, lipid profile, blood pressure, glucose, creatinine), lifestyle (smoking, physical activity, diet, alcohol), and socioeconomic status. 99,019 participants (50\%) also provide plasma samples. CORDELIA will significantly contribute to understanding the complex interplay of risk factors contributing to cardiovascular disease and advance the fields of precision medicine and public health in Southern European individuals.
  

• 
  A pharmacist-led educational and audit & feedback strategy to reduce antibiotic prescription in primary care: the AFA study. Soler, A.; Huguet, A.; Leiva, A.; Vicens, C.; Bejarano-Romero, F.; Sempere, E.; Izquierdo, T.; Parera, M. M.; Seco, R.; Fages, M.; Medina, A.; Castillo-Palomares, L.; López-Guerrero, E.; Ferrer, B. A.; Ugarriza, L.; Llarena, M.; Gallardo-Alfaro, L. (2025). 26 228.

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  Introduction The increasing emergence of bacteria resistant to antibiotic treatments has become a global public health concern and one of the leading causes of death worldwide. This growing threat demands urgent and coordinated action from health systems across the globe. A key driver of antimicrobial resistance is the inappropriate and excessive use of antibiotics, which accelerates the development of resistant strains. At the same time, the lack of new antibiotics in development exacerbates the crisis. In this context, promoting the appropriate and prudent use of antibiotics is essential to limit the emergence and spread of resistance. Methods A randomized, multicentre, parallel-group clinical trial with a hybrid type I (effectiveness-implementation) design to reduce antibiotic prescriptions in primary care. General practitioners from three regional health systems in Spain will be randomly assigned (1:1) to an intervention or active control group. The intervention includes a monthly Audit & Feedback report, pharmacist-led consultations, clinical messages, patient information sheets, and an online training module. The primary outcome is the rate of antibiotic prescriptions per 100 patient visits at 12-month follow-up. Implementation outcomes will be assessed using the RE-AIM framework. All analyses will follow the intention-to-treat principle. Ethics and dissemination The study was approved by the Balearic island, Valencia and IDIAP Jordi Gol Ethical Committee, follows the Declaration of Helsinki, Good Clinical Practice guidelines, and applicable national and European regulations concerning clinical trials and data protection. Trial registration ISRCTN11175879, registration date: 11/12/2024.

  @article{soler_pharmacist-led_2025,
  abstract = {Introduction The increasing emergence of bacteria resistant to antibiotic treatments has become a global public health concern and one of the leading causes of death worldwide. This growing threat demands urgent and coordinated action from health systems across the globe. A key driver of antimicrobial resistance is the inappropriate and excessive use of antibiotics, which accelerates the development of resistant strains. At the same time, the lack of new antibiotics in development exacerbates the crisis. In this context, promoting the appropriate and prudent use of antibiotics is essential to limit the emergence and spread of resistance. Methods A randomized, multicentre, parallel-group clinical trial with a hybrid type I (effectiveness-implementation) design to reduce antibiotic prescriptions in primary care. General practitioners from three regional health systems in Spain will be randomly assigned (1:1) to an intervention or active control group. The intervention includes a monthly Audit & Feedback report, pharmacist-led consultations, clinical messages, patient information sheets, and an online training module. The primary outcome is the rate of antibiotic prescriptions per 100 patient visits at 12-month follow-up. Implementation outcomes will be assessed using the RE-AIM framework. All analyses will follow the intention-to-treat principle. Ethics and dissemination The study was approved by the Balearic island, Valencia and IDIAP Jordi Gol Ethical Committee, follows the Declaration of Helsinki, Good Clinical Practice guidelines, and applicable national and European regulations concerning clinical trials and data protection. Trial registration ISRCTN11175879, registration date: 11/12/2024.},
  author = {Soler, A. and Huguet, A. and Leiva, A. and Vicens, C. and Bejarano-Romero, F. and Sempere, E. and Izquierdo, T. and Parera, M. M. and Seco, R. and Fages, M. and Medina, A. and Castillo-Palomares, L. and López-Guerrero, E. and Ferrer, B. A. and Ugarriza, L. and Llarena, M. and Gallardo-Alfaro, L.},
  journal = {BMC Primary Care},
  keywords = {grapp-caib},
  month = {jul},
  pages = 228,
  title = {A pharmacist-led educational and audit & feedback strategy to reduce antibiotic prescription in primary care: the AFA study},
  volume = 26,
  year = 2025
  }
  

  %0 Journal Article
  %1 soler_pharmacist-led_2025
  %A Soler, A.
  %A Huguet, A.
  %A Leiva, A.
  %A Vicens, C.
  %A Bejarano-Romero, F.
  %A Sempere, E.
  %A Izquierdo, T.
  %A Parera, M. M.
  %A Seco, R.
  %A Fages, M.
  %A Medina, A.
  %A Castillo-Palomares, L.
  %A López-Guerrero, E.
  %A Ferrer, B. A.
  %A Ugarriza, L.
  %A Llarena, M.
  %A Gallardo-Alfaro, L.
  %D 2025
  %J BMC Primary Care
  %P 228
  %R 10.1186/s12875-025-02933-8
  %T A pharmacist-led educational and audit & feedback strategy to reduce antibiotic prescription in primary care: the AFA study
  %U https://pmc.ncbi.nlm.nih.gov/articles/PMC12275277/
  %V 26
  %X Introduction The increasing emergence of bacteria resistant to antibiotic treatments has become a global public health concern and one of the leading causes of death worldwide. This growing threat demands urgent and coordinated action from health systems across the globe. A key driver of antimicrobial resistance is the inappropriate and excessive use of antibiotics, which accelerates the development of resistant strains. At the same time, the lack of new antibiotics in development exacerbates the crisis. In this context, promoting the appropriate and prudent use of antibiotics is essential to limit the emergence and spread of resistance. Methods A randomized, multicentre, parallel-group clinical trial with a hybrid type I (effectiveness-implementation) design to reduce antibiotic prescriptions in primary care. General practitioners from three regional health systems in Spain will be randomly assigned (1:1) to an intervention or active control group. The intervention includes a monthly Audit & Feedback report, pharmacist-led consultations, clinical messages, patient information sheets, and an online training module. The primary outcome is the rate of antibiotic prescriptions per 100 patient visits at 12-month follow-up. Implementation outcomes will be assessed using the RE-AIM framework. All analyses will follow the intention-to-treat principle. Ethics and dissemination The study was approved by the Balearic island, Valencia and IDIAP Jordi Gol Ethical Committee, follows the Declaration of Helsinki, Good Clinical Practice guidelines, and applicable national and European regulations concerning clinical trials and data protection. Trial registration ISRCTN11175879, registration date: 11/12/2024.
  

2024

• 
  The impact of exposure to tobacco smoke and e-cigarettes on asthma-related outcomes: Systematic review informing the EAACI guidelines on environmental science for allergic diseases and asthma. Agache, Ioana; Ricci-Cabello, Ignacio; Canelo-Aybar, Carlos; Annesi-Maesano, Isabella; Cecchi, Lorenzo; Biagioni, Benedetta; Chung, Kian Fan; D’Amato, Gennaro; Damialis, Athanasios; Del Giacco, Stefano; De Las Vecillas, Leticia; Dominguez-Ortega, Javier; Galán, Carmen; Gilles, Stefanie; Giovannini, Matteo; Holgate, Stephen; Jeebhay, Mohamed; Nadeau, Kari; Papadopoulos, Nikolaos; Quirce, Santiago; Sastre, Joaquin; Traidl-Hoffmann, Claudia; Walusiak-Skorupa, Jolanta; Salazar, Josefina; Sousa-Pinto, Bernardo; Colom, Miquel; Fiol deRoque, Maria A; Gorreto López, Lucía; Malih, Narges; Moro, Laura; Pardo, Marina García; Pazo, Patricia García; Campos, Rocío Zamanillo; Saletti-Cuesta, L; Akdis, Mubeccel; Alonso-Coello, Pablo; Jutel, Marek; Akdis, Cezmi A (2024). 10.1111/all.16151-.

  AbstractURLBibTeXEndNoteDOIBibSonomy

  To inform the clinical practice guidelines' recommendations developed by the European Academy of Allergy and Clinical Immunology systematic reviews (SR) assessed using GRADE on the impact of environmental tobacco smoke (ETS) and active smoking on the risk of new-onset asthma/recurrent wheezing (RW)/low lung function (LF), and on asthma-related outcomes. Only longitudinal studies were included, almost all on combustion cigarettes, only one assessing e-cigarettes and LF. According to the first SR (67 studies), prenatal ETS increases the risk of RW (moderate certainty evidence) and may increase the risk of new-onset asthma and of low LF (low certainty evidence). Postnatal ETS increases the risk of new-onset asthma and of RW (moderate certainty evidence) and may impact LF (low certainty evidence). Combined in utero and postnatal ETS may increase the risk of new-onset asthma (low certainty evidence) and increases the risk of RW (moderate certainty evidence). According to the second SR (24 studies), ETS increases the risk of severe asthma exacerbations and impairs asthma control and LF (moderate certainty evidence). According to the third SR (25 studies), active smoking increases the risk of severe asthma exacerbations and of suboptimal asthma control (moderate certainty evidence) and may impact asthma-related quality-of-life and LF (low certainty evidence).

  @article{agache2024impact,
  abstract = {To inform the clinical practice guidelines' recommendations developed by the European Academy of Allergy and Clinical Immunology systematic reviews (SR) assessed using GRADE on the impact of environmental tobacco smoke (ETS) and active smoking on the risk of new-onset asthma/recurrent wheezing (RW)/low lung function (LF), and on asthma-related outcomes. Only longitudinal studies were included, almost all on combustion cigarettes, only one assessing e-cigarettes and LF. According to the first SR (67 studies), prenatal ETS increases the risk of RW (moderate certainty evidence) and may increase the risk of new-onset asthma and of low LF (low certainty evidence). Postnatal ETS increases the risk of new-onset asthma and of RW (moderate certainty evidence) and may impact LF (low certainty evidence). Combined in utero and postnatal ETS may increase the risk of new-onset asthma (low certainty evidence) and increases the risk of RW (moderate certainty evidence). According to the second SR (24 studies), ETS increases the risk of severe asthma exacerbations and impairs asthma control and LF (moderate certainty evidence). According to the third SR (25 studies), active smoking increases the risk of severe asthma exacerbations and of suboptimal asthma control (moderate certainty evidence) and may impact asthma-related quality-of-life and LF (low certainty evidence).},
  address = {Denmark},
  author = {Agache, Ioana and Ricci-Cabello, Ignacio and Canelo-Aybar, Carlos and Annesi-Maesano, Isabella and Cecchi, Lorenzo and Biagioni, Benedetta and Chung, Kian Fan and D'Amato, Gennaro and Damialis, Athanasios and Del Giacco, Stefano and De Las Vecillas, Leticia and Dominguez-Ortega, Javier and Galán, Carmen and Gilles, Stefanie and Giovannini, Matteo and Holgate, Stephen and Jeebhay, Mohamed and Nadeau, Kari and Papadopoulos, Nikolaos and Quirce, Santiago and Sastre, Joaquin and Traidl-Hoffmann, Claudia and Walusiak-Skorupa, Jolanta and Salazar, Josefina and Sousa-Pinto, Bernardo and Colom, Miquel and Fiol deRoque, Maria A and Gorreto López, Lucía and Malih, Narges and Moro, Laura and Pardo, Marina García and Pazo, Patricia García and Campos, Rocío Zamanillo and Saletti-Cuesta, L and Akdis, Mubeccel and Alonso-Coello, Pablo and Jutel, Marek and Akdis, Cezmi A},
  journal = {Allergy},
  keywords = {evisap grapp-caib},
  month = {may},
  pages = {10.1111/all.16151--},
  title = {The impact of exposure to tobacco smoke and e-cigarettes on asthma-related outcomes: Systematic review informing the EAACI guidelines on environmental science for allergic diseases and asthma},
  year = 2024
  }
  

  %0 Journal Article
  %1 agache2024impact
  %A Agache, Ioana
  %A Ricci-Cabello, Ignacio
  %A Canelo-Aybar, Carlos
  %A Annesi-Maesano, Isabella
  %A Cecchi, Lorenzo
  %A Biagioni, Benedetta
  %A Chung, Kian Fan
  %A D'Amato, Gennaro
  %A Damialis, Athanasios
  %A Del Giacco, Stefano
  %A De Las Vecillas, Leticia
  %A Dominguez-Ortega, Javier
  %A Galán, Carmen
  %A Gilles, Stefanie
  %A Giovannini, Matteo
  %A Holgate, Stephen
  %A Jeebhay, Mohamed
  %A Nadeau, Kari
  %A Papadopoulos, Nikolaos
  %A Quirce, Santiago
  %A Sastre, Joaquin
  %A Traidl-Hoffmann, Claudia
  %A Walusiak-Skorupa, Jolanta
  %A Salazar, Josefina
  %A Sousa-Pinto, Bernardo
  %A Colom, Miquel
  %A Fiol deRoque, Maria A
  %A Gorreto López, Lucía
  %A Malih, Narges
  %A Moro, Laura
  %A Pardo, Marina García
  %A Pazo, Patricia García
  %A Campos, Rocío Zamanillo
  %A Saletti-Cuesta, L
  %A Akdis, Mubeccel
  %A Alonso-Coello, Pablo
  %A Jutel, Marek
  %A Akdis, Cezmi A
  %C Denmark
  %D 2024
  %J Allergy
  %P 10.1111/all.16151--
  %R 10.1111/all.16151
  %T The impact of exposure to tobacco smoke and e-cigarettes on asthma-related outcomes: Systematic review informing the EAACI guidelines on environmental science for allergic diseases and asthma
  %U https://pubmed.ncbi.nlm.nih.gov/38783343
  %X To inform the clinical practice guidelines' recommendations developed by the European Academy of Allergy and Clinical Immunology systematic reviews (SR) assessed using GRADE on the impact of environmental tobacco smoke (ETS) and active smoking on the risk of new-onset asthma/recurrent wheezing (RW)/low lung function (LF), and on asthma-related outcomes. Only longitudinal studies were included, almost all on combustion cigarettes, only one assessing e-cigarettes and LF. According to the first SR (67 studies), prenatal ETS increases the risk of RW (moderate certainty evidence) and may increase the risk of new-onset asthma and of low LF (low certainty evidence). Postnatal ETS increases the risk of new-onset asthma and of RW (moderate certainty evidence) and may impact LF (low certainty evidence). Combined in utero and postnatal ETS may increase the risk of new-onset asthma (low certainty evidence) and increases the risk of RW (moderate certainty evidence). According to the second SR (24 studies), ETS increases the risk of severe asthma exacerbations and impairs asthma control and LF (moderate certainty evidence). According to the third SR (25 studies), active smoking increases the risk of severe asthma exacerbations and of suboptimal asthma control (moderate certainty evidence) and may impact asthma-related quality-of-life and LF (low certainty evidence).
  

• 
  Socioeconomic determinants and self-rated health among hotel housekeepers in the Balearic Islands (Spain). Chela-Alvarez, Xenia; Leiva, Alfonso; Bulilete, Oana; Llobera, Joan (2024). 12 1390582–1390582.

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: Hotel housekeepers constitute an important occupational group in the Balearic Islands (Spain). Housekeeping is considered low-skilled and precarious and typically involves high physical demands and time pressure. The aim of this study is to analyze the association between the socioeconomic determinants of health and hotel housekeepers' self-rated health. METHODS: This is a cross-sectional study conducted in Primary Health Care in the Balearic Islands (November 2018-February 2019). Hotel housekeepers over 18 years of age with free access to the Balearic Public Health System who had been employed during 2018 were eligible. RESULTS: We enrolled 1,043 hotel housekeepers; the mean score of health perceived status was 72.4/100 (SD 19.0). Those with a lower self-perceived health were statistically significant older, had Spanish nationality, lower level of studies, permanent or recurring seasonal contract, financial difficulties, a higher level of occupational stress, an external locus of control, reported work-life balance difficulties, were former smokers, insufficiently physical active and obese. We found lower scores in self-perceived health status score of -7.159 (CI95% -10.20- -4.12) among hotel housekeepers with osteoarthritis; -6.858 (CI95% -11.89- -1.82) among those with chronic depression; -3.697 (CI95% -6.08- -1.31) among those who reported difficulties in work-life balance; -2.414 (CI95% -4.69- -0.13) among participants who performed insufficient physical activity; -2.107 (CI% -4.44- -0.23) among those who reported financial strain. Lower self-rated health was also associated to a higher perceived stress, -1.440 (CI95% -2.09- -0.79); BMI (kg/m(2)), -0.299 (CI95% -0.53- -0.07); and longer time working as HH -0.177 (CI95% -0.33- -0.03). CONCLUSION: Our results underscore the importance of psychosocial (such as difficulties in work-life balance and occupational stress) and material factors (such as financial difficulties) when explaining differences in self-perceived health. Public health interventions aimed at improving health status must consider inequalities in material and working conditions.

  @article{chelaalvarez2024socioeconomic,
  abstract = {BACKGROUND: Hotel housekeepers constitute an important occupational group in the Balearic Islands (Spain). Housekeeping is considered low-skilled and precarious and typically involves high physical demands and time pressure. The aim of this study is to analyze the association between the socioeconomic determinants of health and hotel housekeepers' self-rated health. METHODS: This is a cross-sectional study conducted in Primary Health Care in the Balearic Islands (November 2018-February 2019). Hotel housekeepers over 18 years of age with free access to the Balearic Public Health System who had been employed during 2018 were eligible. RESULTS: We enrolled 1,043 hotel housekeepers; the mean score of health perceived status was 72.4/100 (SD 19.0). Those with a lower self-perceived health were statistically significant older, had Spanish nationality, lower level of studies, permanent or recurring seasonal contract, financial difficulties, a higher level of occupational stress, an external locus of control, reported work-life balance difficulties, were former smokers, insufficiently physical active and obese. We found lower scores in self-perceived health status score of -7.159 (CI95% -10.20- -4.12) among hotel housekeepers with osteoarthritis; -6.858 (CI95% -11.89- -1.82) among those with chronic depression; -3.697 (CI95% -6.08- -1.31) among those who reported difficulties in work-life balance; -2.414 (CI95% -4.69- -0.13) among participants who performed insufficient physical activity; -2.107 (CI% -4.44- -0.23) among those who reported financial strain. Lower self-rated health was also associated to a higher perceived stress, -1.440 (CI95% -2.09- -0.79); BMI (kg/m(2)), -0.299 (CI95% -0.53- -0.07); and longer time working as HH -0.177 (CI95% -0.33- -0.03). CONCLUSION: Our results underscore the importance of psychosocial (such as difficulties in work-life balance and occupational stress) and material factors (such as financial difficulties) when explaining differences in self-perceived health. Public health interventions aimed at improving health status must consider inequalities in material and working conditions.},
  address = {Switzerland},
  author = {Chela-Alvarez, Xenia and Leiva, Alfonso and Bulilete, Oana and Llobera, Joan},
  journal = {Frontiers in public health},
  keywords = {grapp-caib},
  month = {sep},
  pages = {1390582--1390582},
  title = {Socioeconomic determinants and self-rated health among hotel housekeepers in the Balearic Islands (Spain)},
  volume = 12,
  year = 2024
  }
  

  %0 Journal Article
  %1 chelaalvarez2024socioeconomic
  %A Chela-Alvarez, Xenia
  %A Leiva, Alfonso
  %A Bulilete, Oana
  %A Llobera, Joan
  %C Switzerland
  %D 2024
  %J Frontiers in public health
  %P 1390582--1390582
  %R 10.3389/fpubh.2024.1390582
  %T Socioeconomic determinants and self-rated health among hotel housekeepers in the Balearic Islands (Spain)
  %U https://pubmed.ncbi.nlm.nih.gov/39286742
  %V 12
  %X BACKGROUND: Hotel housekeepers constitute an important occupational group in the Balearic Islands (Spain). Housekeeping is considered low-skilled and precarious and typically involves high physical demands and time pressure. The aim of this study is to analyze the association between the socioeconomic determinants of health and hotel housekeepers' self-rated health. METHODS: This is a cross-sectional study conducted in Primary Health Care in the Balearic Islands (November 2018-February 2019). Hotel housekeepers over 18 years of age with free access to the Balearic Public Health System who had been employed during 2018 were eligible. RESULTS: We enrolled 1,043 hotel housekeepers; the mean score of health perceived status was 72.4/100 (SD 19.0). Those with a lower self-perceived health were statistically significant older, had Spanish nationality, lower level of studies, permanent or recurring seasonal contract, financial difficulties, a higher level of occupational stress, an external locus of control, reported work-life balance difficulties, were former smokers, insufficiently physical active and obese. We found lower scores in self-perceived health status score of -7.159 (CI95% -10.20- -4.12) among hotel housekeepers with osteoarthritis; -6.858 (CI95% -11.89- -1.82) among those with chronic depression; -3.697 (CI95% -6.08- -1.31) among those who reported difficulties in work-life balance; -2.414 (CI95% -4.69- -0.13) among participants who performed insufficient physical activity; -2.107 (CI% -4.44- -0.23) among those who reported financial strain. Lower self-rated health was also associated to a higher perceived stress, -1.440 (CI95% -2.09- -0.79); BMI (kg/m(2)), -0.299 (CI95% -0.53- -0.07); and longer time working as HH -0.177 (CI95% -0.33- -0.03). CONCLUSION: Our results underscore the importance of psychosocial (such as difficulties in work-life balance and occupational stress) and material factors (such as financial difficulties) when explaining differences in self-perceived health. Public health interventions aimed at improving health status must consider inequalities in material and working conditions.
  

• 
  Major abnormalities of the electrocardiogram and cardiovascular risk in a medium and high-risk Mediterranean population. Pou Bordoy, Joan; Leiva, Alfonso; Albendín Ariza, Maria José; Llanos, Roberto Elosúa; Rigo Carratalà, Fernando; Romaguera, Dora; Salas-Salvadó, Jordi; Babio, Nancy; Martinez-González, Miguel Angel; Toledo, Estefanía; Fitó, Montserrat; Aros, Fernando; Estruch, Ramon; Fiol Sala, Miquel (2024). S0025–7753(24)00665.

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  INTRODUCTION: Major electrocardiogram abnormalities (MECG) are common in middle-aged and older individuals and could be an important factor in predicting cardiovascular events. OBJECTIVE: To analyse the association between MECG (Minnesota classification) and CVE independently of classic cardiovascular risk factors (CVRF), and to assess whether they improve the prediction according to the Spanish Coronary Event Risk Function (FRESCO). METHOD: 1.752 participants included in three nodes of the PREDIMED study aged between 55 and 80 years with medium or high CVRF. Mean follow-up time was 5.1 years. Cumulative CVE incidence was estimated by sex with and without MECG, and hazard ratios by sex were estimated using multivariate Cox regressions adjusted for randomization group and CCRF (FRESCO). Harrel's C Indices, Nam d'Agostino, Net Reclassification Improvement, and Integrated Discrimination Improvement were calculated. RESULTS: At baseline, 25% of the participants shows major electrocardiogram abnormalities (AMECG). During follow-up, there were 112 cardiovascular events (16 cardiovascular deaths, 15 acute myocardial infarctions, 38 anginas, 43 strokes). MECG were significantly associated with the onset of CVE. In men, left ventricular hypertrophy (LVH) criteria were associated with T-wave inversion (HR: 17.88, 95% CI: 5.51-58.03, pvalor<.001) and QT interval prolongation (HR: 2.41, 95% CI: 1.38-4.21, pvalor=.002); in women, atrial fibrillation (HR: 5.7, 95% CI: 1.76-18.72, pvalor=.006) and ST-segment depression (HR: 3.24, 95% CI: 1.36-7.71, pvalor<.001) were associated. No significant improvement in MECG prediction compared to FRESCO was observed. CONCLUSIONS: MECG are independently associated with the occurrence of CVE, but do not improve risk prediction beyond traditional risk factors.

  @article{poubordoy2024major,
  abstract = {INTRODUCTION: Major electrocardiogram abnormalities (MECG) are common in middle-aged and older individuals and could be an important factor in predicting cardiovascular events. OBJECTIVE: To analyse the association between MECG (Minnesota classification) and CVE independently of classic cardiovascular risk factors (CVRF), and to assess whether they improve the prediction according to the Spanish Coronary Event Risk Function (FRESCO). METHOD: 1.752 participants included in three nodes of the PREDIMED study aged between 55 and 80 years with medium or high CVRF. Mean follow-up time was 5.1 years. Cumulative CVE incidence was estimated by sex with and without MECG, and hazard ratios by sex were estimated using multivariate Cox regressions adjusted for randomization group and CCRF (FRESCO). Harrel's C Indices, Nam d'Agostino, Net Reclassification Improvement, and Integrated Discrimination Improvement were calculated. RESULTS: At baseline, 25% of the participants shows major electrocardiogram abnormalities (AMECG). During follow-up, there were 112 cardiovascular events (16 cardiovascular deaths, 15 acute myocardial infarctions, 38 anginas, 43 strokes). MECG were significantly associated with the onset of CVE. In men, left ventricular hypertrophy (LVH) criteria were associated with T-wave inversion (HR: 17.88, 95% CI: 5.51-58.03, pvalor<.001) and QT interval prolongation (HR: 2.41, 95% CI: 1.38-4.21, pvalor=.002); in women, atrial fibrillation (HR: 5.7, 95% CI: 1.76-18.72, pvalor=.006) and ST-segment depression (HR: 3.24, 95% CI: 1.36-7.71, pvalor<.001) were associated. No significant improvement in MECG prediction compared to FRESCO was observed. CONCLUSIONS: MECG are independently associated with the occurrence of CVE, but do not improve risk prediction beyond traditional risk factors.},
  address = {Spain},
  author = {Pou Bordoy, Joan and Leiva, Alfonso and Albendín Ariza, Maria José and Llanos, Roberto Elosúa and Rigo Carratalà, Fernando and Romaguera, Dora and Salas-Salvadó, Jordi and Babio, Nancy and Martinez-González, Miguel Angel and Toledo, Estefanía and Fitó, Montserrat and Aros, Fernando and Estruch, Ramon and Fiol Sala, Miquel},
  journal = {Medicina clinica},
  keywords = {grapp-caib},
  month = {dec},
  pages = {S0025-7753(24)00665-1--},
  title = {Major abnormalities of the electrocardiogram and cardiovascular risk in a medium and high-risk Mediterranean population},
  year = 2024
  }
  

  %0 Journal Article
  %1 poubordoy2024major
  %A Pou Bordoy, Joan
  %A Leiva, Alfonso
  %A Albendín Ariza, Maria José
  %A Llanos, Roberto Elosúa
  %A Rigo Carratalà, Fernando
  %A Romaguera, Dora
  %A Salas-Salvadó, Jordi
  %A Babio, Nancy
  %A Martinez-González, Miguel Angel
  %A Toledo, Estefanía
  %A Fitó, Montserrat
  %A Aros, Fernando
  %A Estruch, Ramon
  %A Fiol Sala, Miquel
  %C Spain
  %D 2024
  %J Medicina clinica
  %P S0025-7753(24)00665-1--
  %R 10.1016/j.medcli.2024.10.010
  %T Major abnormalities of the electrocardiogram and cardiovascular risk in a medium and high-risk Mediterranean population
  %U https://pubmed.ncbi.nlm.nih.gov/39706740
  %X INTRODUCTION: Major electrocardiogram abnormalities (MECG) are common in middle-aged and older individuals and could be an important factor in predicting cardiovascular events. OBJECTIVE: To analyse the association between MECG (Minnesota classification) and CVE independently of classic cardiovascular risk factors (CVRF), and to assess whether they improve the prediction according to the Spanish Coronary Event Risk Function (FRESCO). METHOD: 1.752 participants included in three nodes of the PREDIMED study aged between 55 and 80 years with medium or high CVRF. Mean follow-up time was 5.1 years. Cumulative CVE incidence was estimated by sex with and without MECG, and hazard ratios by sex were estimated using multivariate Cox regressions adjusted for randomization group and CCRF (FRESCO). Harrel's C Indices, Nam d'Agostino, Net Reclassification Improvement, and Integrated Discrimination Improvement were calculated. RESULTS: At baseline, 25% of the participants shows major electrocardiogram abnormalities (AMECG). During follow-up, there were 112 cardiovascular events (16 cardiovascular deaths, 15 acute myocardial infarctions, 38 anginas, 43 strokes). MECG were significantly associated with the onset of CVE. In men, left ventricular hypertrophy (LVH) criteria were associated with T-wave inversion (HR: 17.88, 95% CI: 5.51-58.03, pvalor<.001) and QT interval prolongation (HR: 2.41, 95% CI: 1.38-4.21, pvalor=.002); in women, atrial fibrillation (HR: 5.7, 95% CI: 1.76-18.72, pvalor=.006) and ST-segment depression (HR: 3.24, 95% CI: 1.36-7.71, pvalor<.001) were associated. No significant improvement in MECG prediction compared to FRESCO was observed. CONCLUSIONS: MECG are independently associated with the occurrence of CVE, but do not improve risk prediction beyond traditional risk factors.
  

• 
  Reporting of Participant Race and Ethnicity from COVID-19 Randomized Controlled Drug and Biologicals Trials: A Scoping Review. Pranić, Shelly Melissa; Estevão, Maria Dulce; Vasanthan, Lenny T; Pérez-Neri, Iván; Pulumati, Anika; de Lima Junior, Fábio Antonio Serra; Malih, Narges; Mishra, Vinayak; Thompson, Jacqueline; Nnate, Daniel (2024). mxae006-.

  AbstractURLBibTeXEndNoteDOIBibSonomy

  Racial and ethnic minorities have been disproportionally burdened by hospitalization and death due to COVID-19. Participation of individuals of diverse races and ethnicities in clinical trials according to study-level characteristics of randomized controlled trials (RCT) that test effectiveness of COVID-19 drugs could be insightful for future researchers. The objective of this scoping review was to describe frequency of race and ethnicity reported as demographic variables and specific reporting of race and ethnicity according to COVID-19 RCT characteristics. We conducted comprehensive searches in Pubmed, ProQuest, WHO Database, and Cochrane Central Register of Controlled Trials, and gray literature via preprint servers from 1/1/2020 to 5/4/2022. We included RCTs on emergency- or conditionally-approved COVID-19 drug interventions (remdesivir, baricitinib, and molnupiravir) with or without comparators. Self-reported race as American Indian/Pacific Islander, Asian, Black/African American, or White, ethnicity as Hispanic/Latinx, study design characteristics, and participant-relevant data were collected. A total of 17 RCTs with 17935 participants was included. Most (n=13, 76%) reported at least one race and ethnicity and were US-based, industry-funded RCTs. Asian, Black, Latinx, and White participants were mostly enrolled in RCTs that studied remdesivir. Native American and Hawaiian participants were mostly assessed for progression to high-flow oxygen/non-invasive ventilation. Time to recovery was assessed predominantly in Black and White participants, while hospitalization or death was mostly assessed in Asian, Latinx, and multi-race participants. Trialists should be aware of RCT-level factors and characteristics that may be associated with low participation of racial and ethnic minorities, which could inform evidence-based interventions to increase minority participation.

  @article{pranic2024reporting,
  abstract = {Racial and ethnic minorities have been disproportionally burdened by hospitalization and death due to COVID-19. Participation of individuals of diverse races and ethnicities in clinical trials according to study-level characteristics of randomized controlled trials (RCT) that test effectiveness of COVID-19 drugs could be insightful for future researchers. The objective of this scoping review was to describe frequency of race and ethnicity reported as demographic variables and specific reporting of race and ethnicity according to COVID-19 RCT characteristics. We conducted comprehensive searches in Pubmed, ProQuest, WHO Database, and Cochrane Central Register of Controlled Trials, and gray literature via preprint servers from 1/1/2020 to 5/4/2022. We included RCTs on emergency- or conditionally-approved COVID-19 drug interventions (remdesivir, baricitinib, and molnupiravir) with or without comparators. Self-reported race as American Indian/Pacific Islander, Asian, Black/African American, or White, ethnicity as Hispanic/Latinx, study design characteristics, and participant-relevant data were collected. A total of 17 RCTs with 17935 participants was included. Most (n=13, 76%) reported at least one race and ethnicity and were US-based, industry-funded RCTs. Asian, Black, Latinx, and White participants were mostly enrolled in RCTs that studied remdesivir. Native American and Hawaiian participants were mostly assessed for progression to high-flow oxygen/non-invasive ventilation. Time to recovery was assessed predominantly in Black and White participants, while hospitalization or death was mostly assessed in Asian, Latinx, and multi-race participants. Trialists should be aware of RCT-level factors and characteristics that may be associated with low participation of racial and ethnic minorities, which could inform evidence-based interventions to increase minority participation.},
  address = {United States},
  author = {Pranić, Shelly Melissa and Estevão, Maria Dulce and Vasanthan, Lenny T and Pérez-Neri, Iván and Pulumati, Anika and de Lima Junior, Fábio Antonio Serra and Malih, Narges and Mishra, Vinayak and Thompson, Jacqueline and Nnate, Daniel},
  journal = {Epidemiologic reviews},
  keywords = {evisap grapp-caib},
  month = {nov},
  pages = {mxae006--},
  title = {Reporting of Participant Race and Ethnicity from COVID-19 Randomized Controlled Drug and Biologicals Trials: A Scoping Review},
  year = 2024
  }
  

  %0 Journal Article
  %1 pranic2024reporting
  %A Pranić, Shelly Melissa
  %A Estevão, Maria Dulce
  %A Vasanthan, Lenny T
  %A Pérez-Neri, Iván
  %A Pulumati, Anika
  %A de Lima Junior, Fábio Antonio Serra
  %A Malih, Narges
  %A Mishra, Vinayak
  %A Thompson, Jacqueline
  %A Nnate, Daniel
  %C United States
  %D 2024
  %J Epidemiologic reviews
  %P mxae006--
  %R 10.1093/epirev/mxae006
  %T Reporting of Participant Race and Ethnicity from COVID-19 Randomized Controlled Drug and Biologicals Trials: A Scoping Review
  %U https://pubmed.ncbi.nlm.nih.gov/39673248
  %X Racial and ethnic minorities have been disproportionally burdened by hospitalization and death due to COVID-19. Participation of individuals of diverse races and ethnicities in clinical trials according to study-level characteristics of randomized controlled trials (RCT) that test effectiveness of COVID-19 drugs could be insightful for future researchers. The objective of this scoping review was to describe frequency of race and ethnicity reported as demographic variables and specific reporting of race and ethnicity according to COVID-19 RCT characteristics. We conducted comprehensive searches in Pubmed, ProQuest, WHO Database, and Cochrane Central Register of Controlled Trials, and gray literature via preprint servers from 1/1/2020 to 5/4/2022. We included RCTs on emergency- or conditionally-approved COVID-19 drug interventions (remdesivir, baricitinib, and molnupiravir) with or without comparators. Self-reported race as American Indian/Pacific Islander, Asian, Black/African American, or White, ethnicity as Hispanic/Latinx, study design characteristics, and participant-relevant data were collected. A total of 17 RCTs with 17935 participants was included. Most (n=13, 76%) reported at least one race and ethnicity and were US-based, industry-funded RCTs. Asian, Black, Latinx, and White participants were mostly enrolled in RCTs that studied remdesivir. Native American and Hawaiian participants were mostly assessed for progression to high-flow oxygen/non-invasive ventilation. Time to recovery was assessed predominantly in Black and White participants, while hospitalization or death was mostly assessed in Asian, Latinx, and multi-race participants. Trialists should be aware of RCT-level factors and characteristics that may be associated with low participation of racial and ethnic minorities, which could inform evidence-based interventions to increase minority participation.
  

• 
  Association of Shift Work, Sociodemographic Variables and Healthy Habits with Obesity Scales. Tosoratto, Javier; Tárraga López, Pedro Juan; López-González, Ángel Arturo; Vallejos, Daniela; Martínez-Almoyna Rifá, Emilio; Ramirez-Manent, José Ignacio (2024). 14(11) 1503-.

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: Shift work has been associated with unhealthy lifestyle habits and a higher prevalence of obesity, which negatively impacts the health of shift workers. The objective of our study was to examine the influence of shift work on obesity, as well as on sociodemographic variables, anthropometric measurements, and lifestyle habits in individuals working this type of schedule. METHODS: An observational, cross-sectional, descriptive study involving 53,053 workers from various labour sectors across several Spanish autonomous communities was conducted. It included 31,753 men (17,527 of them working shifts) and 21,300 women (11,281 of them working shifts). The relationship between shift work and obesity was examined, as well as its association with sex, age, social class, education level, smoking, alcohol consumption, sedentary behaviour, and unhealthy diet. RESULTS: Obesity showed higher prevalence and mean values among shift workers across all four formulas used (BMI obesity, WtHR high, CUN BAE obesity, METS-VF high). All variables related to unhealthy lifestyle habits revealed a significantly greater prevalence among shift workers, with high statistical significance (p < 0.001). Age, sex, and social class affected the risk of obesity, with a greater prevalence observed in shift workers compared to non-shift workers (p < 0.001). Men had a higher risk than women, with an OR ranging from 1.17 (1.12-1.21) for BMI obesity to 7.45 (6.71-8.20) for METS-VF high. CONCLUSIONS: Shift workers exhibit a higher prevalence of obesity and unhealthy lifestyle habits, with men at greater risk. The variables that most significantly increase the risk of obesity include age, physical inactivity, low adherence to the Mediterranean diet, and alcohol consumption.

  @article{tosoratto2024association,
  abstract = {BACKGROUND: Shift work has been associated with unhealthy lifestyle habits and a higher prevalence of obesity, which negatively impacts the health of shift workers. The objective of our study was to examine the influence of shift work on obesity, as well as on sociodemographic variables, anthropometric measurements, and lifestyle habits in individuals working this type of schedule. METHODS: An observational, cross-sectional, descriptive study involving 53,053 workers from various labour sectors across several Spanish autonomous communities was conducted. It included 31,753 men (17,527 of them working shifts) and 21,300 women (11,281 of them working shifts). The relationship between shift work and obesity was examined, as well as its association with sex, age, social class, education level, smoking, alcohol consumption, sedentary behaviour, and unhealthy diet. RESULTS: Obesity showed higher prevalence and mean values among shift workers across all four formulas used (BMI obesity, WtHR high, CUN BAE obesity, METS-VF high). All variables related to unhealthy lifestyle habits revealed a significantly greater prevalence among shift workers, with high statistical significance (p < 0.001). Age, sex, and social class affected the risk of obesity, with a greater prevalence observed in shift workers compared to non-shift workers (p < 0.001). Men had a higher risk than women, with an OR ranging from 1.17 (1.12-1.21) for BMI obesity to 7.45 (6.71-8.20) for METS-VF high. CONCLUSIONS: Shift workers exhibit a higher prevalence of obesity and unhealthy lifestyle habits, with men at greater risk. The variables that most significantly increase the risk of obesity include age, physical inactivity, low adherence to the Mediterranean diet, and alcohol consumption.},
  address = {Switzerland},
  author = {Tosoratto, Javier and Tárraga López, Pedro Juan and López-González, Ángel Arturo and Vallejos, Daniela and Martínez-Almoyna Rifá, Emilio and Ramirez-Manent, José Ignacio},
  journal = {Life (Basel, Switzerland)},
  keywords = {grapp-caib},
  month = {nov},
  number = 11,
  pages = {1503--},
  title = {Association of Shift Work, Sociodemographic Variables and Healthy Habits with Obesity Scales},
  volume = 14,
  year = 2024
  }
  

  %0 Journal Article
  %1 tosoratto2024association
  %A Tosoratto, Javier
  %A Tárraga López, Pedro Juan
  %A López-González, Ángel Arturo
  %A Vallejos, Daniela
  %A Martínez-Almoyna Rifá, Emilio
  %A Ramirez-Manent, José Ignacio
  %C Switzerland
  %D 2024
  %J Life (Basel, Switzerland)
  %N 11
  %P 1503--
  %R 10.3390/life14111503
  %T Association of Shift Work, Sociodemographic Variables and Healthy Habits with Obesity Scales
  %U https://pubmed.ncbi.nlm.nih.gov/39598301
  %V 14
  %X BACKGROUND: Shift work has been associated with unhealthy lifestyle habits and a higher prevalence of obesity, which negatively impacts the health of shift workers. The objective of our study was to examine the influence of shift work on obesity, as well as on sociodemographic variables, anthropometric measurements, and lifestyle habits in individuals working this type of schedule. METHODS: An observational, cross-sectional, descriptive study involving 53,053 workers from various labour sectors across several Spanish autonomous communities was conducted. It included 31,753 men (17,527 of them working shifts) and 21,300 women (11,281 of them working shifts). The relationship between shift work and obesity was examined, as well as its association with sex, age, social class, education level, smoking, alcohol consumption, sedentary behaviour, and unhealthy diet. RESULTS: Obesity showed higher prevalence and mean values among shift workers across all four formulas used (BMI obesity, WtHR high, CUN BAE obesity, METS-VF high). All variables related to unhealthy lifestyle habits revealed a significantly greater prevalence among shift workers, with high statistical significance (p < 0.001). Age, sex, and social class affected the risk of obesity, with a greater prevalence observed in shift workers compared to non-shift workers (p < 0.001). Men had a higher risk than women, with an OR ranging from 1.17 (1.12-1.21) for BMI obesity to 7.45 (6.71-8.20) for METS-VF high. CONCLUSIONS: Shift workers exhibit a higher prevalence of obesity and unhealthy lifestyle habits, with men at greater risk. The variables that most significantly increase the risk of obesity include age, physical inactivity, low adherence to the Mediterranean diet, and alcohol consumption.
  

• 
  PAPPS expert group: Lifestyle recommendations. Córdoba García, Rodrigo; Camarelles Guillem, Francisco; Muñoz Seco, Elena; Gómez Puente, Juana M; San José Arango, Joaquín; Ramírez Manent, Jose Ignacio; Martín Cantera, Carlos; Giménez, María Del Campo; Revenga Frauca, Juan; Egea Ronda, Ana; Cervigón Portaencasa, Raquel; Rodriguez Benito, Laura (2024). 56 Suppl 1 103133–103133.

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  We present the recommendations of the Preventive Activities and Health Promotion Programme (PAPPS) of the semFYC (Spanish Society of Family and Community Medicine) to promote healthy lifestyles using intervention methodology, and preventive actions against tobacco and alcohol use, healthy eating, physical activity in leisure time, prevention of traffic accidents, and child restraint systems. The recommendations have been updated, and new aspects highlighted, such as the definition of low-risk alcohol consumption, and the references have been updated. For the main recommendations, we include specific tables showing the quality of the evidence and the strength of the recommendation.

  @article{cordobagarcia2024papps,
  abstract = {We present the recommendations of the Preventive Activities and Health Promotion Programme (PAPPS) of the semFYC (Spanish Society of Family and Community Medicine) to promote healthy lifestyles using intervention methodology, and preventive actions against tobacco and alcohol use, healthy eating, physical activity in leisure time, prevention of traffic accidents, and child restraint systems. The recommendations have been updated, and new aspects highlighted, such as the definition of low-risk alcohol consumption, and the references have been updated. For the main recommendations, we include specific tables showing the quality of the evidence and the strength of the recommendation.},
  address = {Spain},
  author = {Córdoba García, Rodrigo and Camarelles Guillem, Francisco and Muñoz Seco, Elena and Gómez Puente, Juana M and San José Arango, Joaquín and Ramírez Manent, Jose Ignacio and Martín Cantera, Carlos and Giménez, María Del Campo and Revenga Frauca, Juan and Egea Ronda, Ana and Cervigón Portaencasa, Raquel and Rodriguez Benito, Laura},
  journal = {Atencion primaria},
  keywords = {grapp-caib},
  month = {nov},
  pages = {103133--103133},
  title = {PAPPS expert group: Lifestyle recommendations},
  volume = {56 Suppl 1},
  year = 2024
  }
  

  %0 Journal Article
  %1 cordobagarcia2024papps
  %A Córdoba García, Rodrigo
  %A Camarelles Guillem, Francisco
  %A Muñoz Seco, Elena
  %A Gómez Puente, Juana M
  %A San José Arango, Joaquín
  %A Ramírez Manent, Jose Ignacio
  %A Martín Cantera, Carlos
  %A Giménez, María Del Campo
  %A Revenga Frauca, Juan
  %A Egea Ronda, Ana
  %A Cervigón Portaencasa, Raquel
  %A Rodriguez Benito, Laura
  %C Spain
  %D 2024
  %J Atencion primaria
  %P 103133--103133
  %R 10.1016/j.aprim.2024.103133
  %T PAPPS expert group: Lifestyle recommendations
  %U https://pubmed.ncbi.nlm.nih.gov/39613361
  %V 56 Suppl 1
  %X We present the recommendations of the Preventive Activities and Health Promotion Programme (PAPPS) of the semFYC (Spanish Society of Family and Community Medicine) to promote healthy lifestyles using intervention methodology, and preventive actions against tobacco and alcohol use, healthy eating, physical activity in leisure time, prevention of traffic accidents, and child restraint systems. The recommendations have been updated, and new aspects highlighted, such as the definition of low-risk alcohol consumption, and the references have been updated. For the main recommendations, we include specific tables showing the quality of the evidence and the strength of the recommendation.
  

• 
  Left atrial strain in patients without cardiovascular disease: uncovering influencing and related factors. Forteza-Albertí, José Francisco; Rico, Yolanda; Leiva, Alfonso; Pericas, Pere; Gual-Capllonch, Francisco; Rivas-Catoni, Lisandro; Gutiérrez García-Moreno, Laura; Rodríguez Fernández, Antonio; Peral Disdier, Vicente (2024). 22(1) 15–15.

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: Despite its proven prognostic value in different contexts, the precise implications of left atrial strain (LAS) assessment throughout different phases of the atrial cycle remain uncertain. A direct correlation between left atrial reservoir strain (LARS) and left ventricular global longitudinal strain (GLS) has been consistently demonstrated in several studies involving patients with various heart diseases. The objective of our study is to identify factors directly associated with LARS, left atrial conduction strain (LACS) and left atrial booster strain (LABS) in patients without cardiovascular (CV) disease. METHODS: Transthoracic echocardiographic examinations in patients without CV disease were prospectively selected in two tertiary hospitals echocardiography labs for clinical purposes. LAS, maximal and minimal left atrial (LA) volumes and left atrial ejection fraction (LAEF) were measured using the two-dimensional strain analysis package provided by the EchoPAC Plugging workstation (AFI LA). RESULTS: A total of 196 cases were included, median age of 54 (45-62) with 85 (43%) being men. The mean left ventricular ejection fraction (LVEF) was 61% ± 5, and the median GLS was - 18% (-17 to -20). Median indexed maximum volume of left atrium (LAVI) was 27 ml/m(2) (22-31), and LAEF was 64% (58-70). The mean LARS biplane was 35,1% ± 8. Notably, LARS was greater in the 2-chamber view (36,1% ± 10) compared to the 4-chamber view (34,1% ± 8 p < 0,05). The multivariate analysis of LARS revealed that sex, GLS, LAEF and e'(mean) are independently correlated with LARS. Multivariate analysis of LACS showed independent correlations between LACS and age, GLS, LAEF, E/A ratio and e'(mean). Conversely, the multivariate analysis of LABS demonstrated significant correlations among A wave, e'(mean), and left atrial stiffness index (LASI). CONCLUSIONS: In patients without CV disease, GLS emerges as a crucial determinant of LARS and LACS. LAEF and e'(mean) are directly and independently related to both LARS and LACS. LARS (univariate) and LACS (multivariate) exhibited a decline with older age in individuals without CV disease.

  @article{fortezaalberti2024atrial,
  abstract = {BACKGROUND: Despite its proven prognostic value in different contexts, the precise implications of left atrial strain (LAS) assessment throughout different phases of the atrial cycle remain uncertain. A direct correlation between left atrial reservoir strain (LARS) and left ventricular global longitudinal strain (GLS) has been consistently demonstrated in several studies involving patients with various heart diseases. The objective of our study is to identify factors directly associated with LARS, left atrial conduction strain (LACS) and left atrial booster strain (LABS) in patients without cardiovascular (CV) disease. METHODS: Transthoracic echocardiographic examinations in patients without CV disease were prospectively selected in two tertiary hospitals echocardiography labs for clinical purposes. LAS, maximal and minimal left atrial (LA) volumes and left atrial ejection fraction (LAEF) were measured using the two-dimensional strain analysis package provided by the EchoPAC Plugging workstation (AFI LA). RESULTS: A total of 196 cases were included, median age of 54 (45-62) with 85 (43%) being men. The mean left ventricular ejection fraction (LVEF) was 61% ± 5, and the median GLS was - 18% (-17 to -20). Median indexed maximum volume of left atrium (LAVI) was 27 ml/m(2) (22-31), and LAEF was 64% (58-70). The mean LARS biplane was 35,1% ± 8. Notably, LARS was greater in the 2-chamber view (36,1% ± 10) compared to the 4-chamber view (34,1% ± 8 p < 0,05). The multivariate analysis of LARS revealed that sex, GLS, LAEF and e'(mean) are independently correlated with LARS. Multivariate analysis of LACS showed independent correlations between LACS and age, GLS, LAEF, E/A ratio and e'(mean). Conversely, the multivariate analysis of LABS demonstrated significant correlations among A wave, e'(mean), and left atrial stiffness index (LASI). CONCLUSIONS: In patients without CV disease, GLS emerges as a crucial determinant of LARS and LACS. LAEF and e'(mean) are directly and independently related to both LARS and LACS. LARS (univariate) and LACS (multivariate) exhibited a decline with older age in individuals without CV disease.},
  address = {England},
  author = {Forteza-Albertí, José Francisco and Rico, Yolanda and Leiva, Alfonso and Pericas, Pere and Gual-Capllonch, Francisco and Rivas-Catoni, Lisandro and Gutiérrez García-Moreno, Laura and Rodríguez Fernández, Antonio and Peral Disdier, Vicente},
  journal = {Cardiovascular ultrasound},
  keywords = {grapp-caib},
  month = {nov},
  number = 1,
  pages = {15--15},
  title = {Left atrial strain in patients without cardiovascular disease: uncovering influencing and related factors},
  volume = 22,
  year = 2024
  }
  

  %0 Journal Article
  %1 fortezaalberti2024atrial
  %A Forteza-Albertí, José Francisco
  %A Rico, Yolanda
  %A Leiva, Alfonso
  %A Pericas, Pere
  %A Gual-Capllonch, Francisco
  %A Rivas-Catoni, Lisandro
  %A Gutiérrez García-Moreno, Laura
  %A Rodríguez Fernández, Antonio
  %A Peral Disdier, Vicente
  %C England
  %D 2024
  %J Cardiovascular ultrasound
  %N 1
  %P 15--15
  %R 10.1186/s12947-024-00334-y
  %T Left atrial strain in patients without cardiovascular disease: uncovering influencing and related factors
  %U https://pubmed.ncbi.nlm.nih.gov/39511600
  %V 22
  %X BACKGROUND: Despite its proven prognostic value in different contexts, the precise implications of left atrial strain (LAS) assessment throughout different phases of the atrial cycle remain uncertain. A direct correlation between left atrial reservoir strain (LARS) and left ventricular global longitudinal strain (GLS) has been consistently demonstrated in several studies involving patients with various heart diseases. The objective of our study is to identify factors directly associated with LARS, left atrial conduction strain (LACS) and left atrial booster strain (LABS) in patients without cardiovascular (CV) disease. METHODS: Transthoracic echocardiographic examinations in patients without CV disease were prospectively selected in two tertiary hospitals echocardiography labs for clinical purposes. LAS, maximal and minimal left atrial (LA) volumes and left atrial ejection fraction (LAEF) were measured using the two-dimensional strain analysis package provided by the EchoPAC Plugging workstation (AFI LA). RESULTS: A total of 196 cases were included, median age of 54 (45-62) with 85 (43%) being men. The mean left ventricular ejection fraction (LVEF) was 61% ± 5, and the median GLS was - 18% (-17 to -20). Median indexed maximum volume of left atrium (LAVI) was 27 ml/m(2) (22-31), and LAEF was 64% (58-70). The mean LARS biplane was 35,1% ± 8. Notably, LARS was greater in the 2-chamber view (36,1% ± 10) compared to the 4-chamber view (34,1% ± 8 p < 0,05). The multivariate analysis of LARS revealed that sex, GLS, LAEF and e'(mean) are independently correlated with LARS. Multivariate analysis of LACS showed independent correlations between LACS and age, GLS, LAEF, E/A ratio and e'(mean). Conversely, the multivariate analysis of LABS demonstrated significant correlations among A wave, e'(mean), and left atrial stiffness index (LASI). CONCLUSIONS: In patients without CV disease, GLS emerges as a crucial determinant of LARS and LACS. LAEF and e'(mean) are directly and independently related to both LARS and LACS. LARS (univariate) and LACS (multivariate) exhibited a decline with older age in individuals without CV disease.
  

• 
  Usefulness of Atherogenic Indices for Predicting High Values of Avoidable Lost Life Years Heart Age in 139,634 Spanish Workers. Sastre-Alzamora, Tomás; Tárraga López, Pedro J; López-González, Ángel Arturo; Vallejos, Daniela; Paublini, Hernán; Ramírez Manent, José Ignacio (2024). 14(21) 2388-.

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: Cardiovascular diseases (CVDs) are the leading cause of morbidity and mortality worldwide, accounting for one-third of all global deaths. The World Health Organization (WHO) asserts that prevention is the most effective strategy to combat CVD, emphasizing the need for non-invasive, low-cost tools to identify individuals at high risk of CVD. Atherogenic indices and heart age (HA) are valuable tools for assessing cardiovascular risk (CVR). The aim of our study was to evaluate the association between atherogenic indices and HA. METHODS: A cross-sectional study was conducted involving 139,634 Spanish workers to determine the association between three atherogenic indices and HA. ROC curves were employed to identify the cut-off values for the various atherogenic indices used to estimate high HA. The cut-off points, along with their sensitivity, specificity, and Youden index, were determined, and the area under the curve (AUC) was calculated. RESULTS: As the values of the atherogenic indices increased, so did the risk of having elevated avoidable lost life years (ALLY) HA. In the ROC curve analysis, the AUC with the best results corresponded to the total cholesterol/HDL-c atherogenic index, with an AUC of 0.803 in females and 0.790 in males. The LDL-c/HDL-c atherogenic index showed an AUC of 0.780 in women and 0.750 in men, with Youden indices around 0.4. When analyzing the AUC of the atherogenic index for triglycerides/HDL-c, the results were 0.760 in women and 0.746 in men. CONCLUSIONS: Atherogenic indices and HA show a close relationship, with an increase in these indices leading to a rise in HA values. Raising patient awareness that as their CVR levels increase, so does their HA may be useful in achieving some benefit in reducing CVR.

  @article{sastrealzamora2024usefulness,
  abstract = {BACKGROUND: Cardiovascular diseases (CVDs) are the leading cause of morbidity and mortality worldwide, accounting for one-third of all global deaths. The World Health Organization (WHO) asserts that prevention is the most effective strategy to combat CVD, emphasizing the need for non-invasive, low-cost tools to identify individuals at high risk of CVD. Atherogenic indices and heart age (HA) are valuable tools for assessing cardiovascular risk (CVR). The aim of our study was to evaluate the association between atherogenic indices and HA. METHODS: A cross-sectional study was conducted involving 139,634 Spanish workers to determine the association between three atherogenic indices and HA. ROC curves were employed to identify the cut-off values for the various atherogenic indices used to estimate high HA. The cut-off points, along with their sensitivity, specificity, and Youden index, were determined, and the area under the curve (AUC) was calculated. RESULTS: As the values of the atherogenic indices increased, so did the risk of having elevated avoidable lost life years (ALLY) HA. In the ROC curve analysis, the AUC with the best results corresponded to the total cholesterol/HDL-c atherogenic index, with an AUC of 0.803 in females and 0.790 in males. The LDL-c/HDL-c atherogenic index showed an AUC of 0.780 in women and 0.750 in men, with Youden indices around 0.4. When analyzing the AUC of the atherogenic index for triglycerides/HDL-c, the results were 0.760 in women and 0.746 in men. CONCLUSIONS: Atherogenic indices and HA show a close relationship, with an increase in these indices leading to a rise in HA values. Raising patient awareness that as their CVR levels increase, so does their HA may be useful in achieving some benefit in reducing CVR.},
  address = {Switzerland},
  author = {Sastre-Alzamora, Tomás and Tárraga López, Pedro J and López-González, Ángel Arturo and Vallejos, Daniela and Paublini, Hernán and Ramírez Manent, José Ignacio},
  journal = {Diagnostics (Basel, Switzerland)},
  keywords = {grapp-caib},
  month = {oct},
  number = 21,
  pages = {2388--},
  title = {Usefulness of Atherogenic Indices for Predicting High Values of Avoidable Lost Life Years Heart Age in 139,634 Spanish Workers},
  volume = 14,
  year = 2024
  }
  

  %0 Journal Article
  %1 sastrealzamora2024usefulness
  %A Sastre-Alzamora, Tomás
  %A Tárraga López, Pedro J
  %A López-González, Ángel Arturo
  %A Vallejos, Daniela
  %A Paublini, Hernán
  %A Ramírez Manent, José Ignacio
  %C Switzerland
  %D 2024
  %J Diagnostics (Basel, Switzerland)
  %N 21
  %P 2388--
  %R 10.3390/diagnostics14212388
  %T Usefulness of Atherogenic Indices for Predicting High Values of Avoidable Lost Life Years Heart Age in 139,634 Spanish Workers
  %U https://pubmed.ncbi.nlm.nih.gov/39518356
  %V 14
  %X BACKGROUND: Cardiovascular diseases (CVDs) are the leading cause of morbidity and mortality worldwide, accounting for one-third of all global deaths. The World Health Organization (WHO) asserts that prevention is the most effective strategy to combat CVD, emphasizing the need for non-invasive, low-cost tools to identify individuals at high risk of CVD. Atherogenic indices and heart age (HA) are valuable tools for assessing cardiovascular risk (CVR). The aim of our study was to evaluate the association between atherogenic indices and HA. METHODS: A cross-sectional study was conducted involving 139,634 Spanish workers to determine the association between three atherogenic indices and HA. ROC curves were employed to identify the cut-off values for the various atherogenic indices used to estimate high HA. The cut-off points, along with their sensitivity, specificity, and Youden index, were determined, and the area under the curve (AUC) was calculated. RESULTS: As the values of the atherogenic indices increased, so did the risk of having elevated avoidable lost life years (ALLY) HA. In the ROC curve analysis, the AUC with the best results corresponded to the total cholesterol/HDL-c atherogenic index, with an AUC of 0.803 in females and 0.790 in males. The LDL-c/HDL-c atherogenic index showed an AUC of 0.780 in women and 0.750 in men, with Youden indices around 0.4. When analyzing the AUC of the atherogenic index for triglycerides/HDL-c, the results were 0.760 in women and 0.746 in men. CONCLUSIONS: Atherogenic indices and HA show a close relationship, with an increase in these indices leading to a rise in HA values. Raising patient awareness that as their CVR levels increase, so does their HA may be useful in achieving some benefit in reducing CVR.
  

• 
  Psychosocial Work Factors, Job Stress, and Self-Rated Health Among Hotel Housekeepers. García-Buades, M Esther; Montañez-Juan, Maribel; Blahopoulou, Joanna; Ortiz-Bonnin, Silvia; Chela-Alvarez, Xènia; Bulilete, Oana; Llobera, Joan (2024). 21650799241282787–21650799241282787.

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: Hotel housekeeping is widely recognized as a poor-quality job due to its high demands and limited resources. Hotel housekeepers (HHs) face both hard physical work and mentally demanding conditions, yet psychosocial factors in this feminized and precarious occupation remain under-researched. To address this gap, this study examines HHs' exposure to psychosocial factors at work and their impact on job stress and self-rated health. METHODS: A cross-sectional survey of a random sample of 926 HHs in the Balearic Islands (Spain) assessed job stress, self-rated health, psychosocial factors (job demands and resources), and sociodemographic variables using the Copenhagen Psychosocial Questionnaire II (COPSOQ-II) and the National Health Survey. Descriptive analysis and hierarchical linear regression models were applied. RESULTS: The prevalence of job stress was 61.1% (95% confidence interval [CI] = [57.8%, 64.1%]), while the prevalence of poor self-rated health was 59.9% (95% CI = [56.6%, 62.9%]). Hotel housekeepers were highly exposed to job demands such as intense work pace, job-specific stressors, work-life conflict, and emotional demands; highly available job resources were role clarity, task meaning, and social support. Regression models revealed work pace, work-life conflict, nationality, and weak leader support as key predictors of job stress; and work-life conflict and leadership quality as key predictors of self-rated health. CONCLUSION/APPLICATION TO PRACTICE: Although considered an eminently physical job, psychosocial work factors play a key role in explaining HHs' job stress and self-rated health. Occupational health professionals should design workplace interventions to reduce work pace, mitigate work-life conflict, and enhance resources such as leader support, sense of community, and leadership quality.

  @article{garciabuades2024psychosocial,
  abstract = {BACKGROUND: Hotel housekeeping is widely recognized as a poor-quality job due to its high demands and limited resources. Hotel housekeepers (HHs) face both hard physical work and mentally demanding conditions, yet psychosocial factors in this feminized and precarious occupation remain under-researched. To address this gap, this study examines HHs' exposure to psychosocial factors at work and their impact on job stress and self-rated health. METHODS: A cross-sectional survey of a random sample of 926 HHs in the Balearic Islands (Spain) assessed job stress, self-rated health, psychosocial factors (job demands and resources), and sociodemographic variables using the Copenhagen Psychosocial Questionnaire II (COPSOQ-II) and the National Health Survey. Descriptive analysis and hierarchical linear regression models were applied. RESULTS: The prevalence of job stress was 61.1% (95% confidence interval [CI] = [57.8%, 64.1%]), while the prevalence of poor self-rated health was 59.9% (95% CI = [56.6%, 62.9%]). Hotel housekeepers were highly exposed to job demands such as intense work pace, job-specific stressors, work-life conflict, and emotional demands; highly available job resources were role clarity, task meaning, and social support. Regression models revealed work pace, work-life conflict, nationality, and weak leader support as key predictors of job stress; and work-life conflict and leadership quality as key predictors of self-rated health. CONCLUSION/APPLICATION TO PRACTICE: Although considered an eminently physical job, psychosocial work factors play a key role in explaining HHs' job stress and self-rated health. Occupational health professionals should design workplace interventions to reduce work pace, mitigate work-life conflict, and enhance resources such as leader support, sense of community, and leadership quality.},
  address = {United States},
  author = {García-Buades, M Esther and Montañez-Juan, Maribel and Blahopoulou, Joanna and Ortiz-Bonnin, Silvia and Chela-Alvarez, Xènia and Bulilete, Oana and Llobera, Joan},
  journal = {Workplace health & safety},
  keywords = {grapp-caib},
  month = {oct},
  pages = {21650799241282787--21650799241282787},
  title = {Psychosocial Work Factors, Job Stress, and Self-Rated Health Among Hotel Housekeepers},
  year = 2024
  }
  

  %0 Journal Article
  %1 garciabuades2024psychosocial
  %A García-Buades, M Esther
  %A Montañez-Juan, Maribel
  %A Blahopoulou, Joanna
  %A Ortiz-Bonnin, Silvia
  %A Chela-Alvarez, Xènia
  %A Bulilete, Oana
  %A Llobera, Joan
  %C United States
  %D 2024
  %J Workplace health & safety
  %P 21650799241282787--21650799241282787
  %R 10.1177/21650799241282787
  %T Psychosocial Work Factors, Job Stress, and Self-Rated Health Among Hotel Housekeepers
  %U https://pubmed.ncbi.nlm.nih.gov/39475436
  %X BACKGROUND: Hotel housekeeping is widely recognized as a poor-quality job due to its high demands and limited resources. Hotel housekeepers (HHs) face both hard physical work and mentally demanding conditions, yet psychosocial factors in this feminized and precarious occupation remain under-researched. To address this gap, this study examines HHs' exposure to psychosocial factors at work and their impact on job stress and self-rated health. METHODS: A cross-sectional survey of a random sample of 926 HHs in the Balearic Islands (Spain) assessed job stress, self-rated health, psychosocial factors (job demands and resources), and sociodemographic variables using the Copenhagen Psychosocial Questionnaire II (COPSOQ-II) and the National Health Survey. Descriptive analysis and hierarchical linear regression models were applied. RESULTS: The prevalence of job stress was 61.1% (95% confidence interval [CI] = [57.8%, 64.1%]), while the prevalence of poor self-rated health was 59.9% (95% CI = [56.6%, 62.9%]). Hotel housekeepers were highly exposed to job demands such as intense work pace, job-specific stressors, work-life conflict, and emotional demands; highly available job resources were role clarity, task meaning, and social support. Regression models revealed work pace, work-life conflict, nationality, and weak leader support as key predictors of job stress; and work-life conflict and leadership quality as key predictors of self-rated health. CONCLUSION/APPLICATION TO PRACTICE: Although considered an eminently physical job, psychosocial work factors play a key role in explaining HHs' job stress and self-rated health. Occupational health professionals should design workplace interventions to reduce work pace, mitigate work-life conflict, and enhance resources such as leader support, sense of community, and leadership quality.
  

• 
  Learning, internalisation and integration of the COVID-19 pandemic in healthcare workers: A qualitative document analysis. Abad-Corpa, Eva; Rich-Ruiz, Manuel; Sánchez-López, Dolores; Solano Ruiz, Carmen; Casado-Ramírez, Elvira; Arregui-Gallego, Beatriz; Moreno-Casbas, María Teresa; Muñoz-Jiménez, Daniel; Vidal-Thomàs, M Clara; Company-Sancho, M Consuelo; Orts-Cortés, María Isabel (2024). 31(4) e12673-e12673.

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  The COVID-19 pandemic triggered an unprecedented health crisis that impacted healthcare systems worldwide. This study explores how Spanish healthcare workers learned, internalised and integrated values and work behaviours during the COVID-19 pandemic and their impact on the personal sphere. This documentary research, using images, narratives and audiovisual content, was framed within the interpretative hermeneutic paradigm. Categories and subcategories emerged after a final theoretical sampling that focused on the analysis. Data triangulation between researchers favoured theoretical saturation. A total of 117 images and 27 texts were selected. The analysis identified three stages: bewilderment, seeking functionality in the chaos and integrating chaos into care. The data reflects how the need for security and knowledge, and the exhaustion and frustration caused by the initial working conditions, prompted adaptive responses. These responses involved focusing on problem-solving and strengthening group sentiments and solidarity. Subsequently, the data indicates the acceptance of new structural, organisational and communication aspects. The findings of the analysis will contribute towards finding a framework that can help understand community health crisis events.

  @article{abadcorpa2024learning,
  abstract = {The COVID-19 pandemic triggered an unprecedented health crisis that impacted healthcare systems worldwide. This study explores how Spanish healthcare workers learned, internalised and integrated values and work behaviours during the COVID-19 pandemic and their impact on the personal sphere. This documentary research, using images, narratives and audiovisual content, was framed within the interpretative hermeneutic paradigm. Categories and subcategories emerged after a final theoretical sampling that focused on the analysis. Data triangulation between researchers favoured theoretical saturation. A total of 117 images and 27 texts were selected. The analysis identified three stages: bewilderment, seeking functionality in the chaos and integrating chaos into care. The data reflects how the need for security and knowledge, and the exhaustion and frustration caused by the initial working conditions, prompted adaptive responses. These responses involved focusing on problem-solving and strengthening group sentiments and solidarity. Subsequently, the data indicates the acceptance of new structural, organisational and communication aspects. The findings of the analysis will contribute towards finding a framework that can help understand community health crisis events.},
  address = {Australia},
  author = {Abad-Corpa, Eva and Rich-Ruiz, Manuel and Sánchez-López, Dolores and Solano Ruiz, Carmen and Casado-Ramírez, Elvira and Arregui-Gallego, Beatriz and Moreno-Casbas, María Teresa and Muñoz-Jiménez, Daniel and Vidal-Thomàs, M Clara and Company-Sancho, M Consuelo and Orts-Cortés, María Isabel},
  journal = {Nursing inquiry},
  keywords = {grapp-caib},
  month = {oct},
  number = 4,
  pages = {e12673--e12673},
  title = {Learning, internalisation and integration of the COVID-19 pandemic in healthcare workers: A qualitative document analysis},
  volume = 31,
  year = 2024
  }
  

  %0 Journal Article
  %1 abadcorpa2024learning
  %A Abad-Corpa, Eva
  %A Rich-Ruiz, Manuel
  %A Sánchez-López, Dolores
  %A Solano Ruiz, Carmen
  %A Casado-Ramírez, Elvira
  %A Arregui-Gallego, Beatriz
  %A Moreno-Casbas, María Teresa
  %A Muñoz-Jiménez, Daniel
  %A Vidal-Thomàs, M Clara
  %A Company-Sancho, M Consuelo
  %A Orts-Cortés, María Isabel
  %C Australia
  %D 2024
  %J Nursing inquiry
  %N 4
  %P e12673--e12673
  %R 10.1111/nin.12673
  %T Learning, internalisation and integration of the COVID-19 pandemic in healthcare workers: A qualitative document analysis
  %U https://pubmed.ncbi.nlm.nih.gov/39297396
  %V 31
  %X The COVID-19 pandemic triggered an unprecedented health crisis that impacted healthcare systems worldwide. This study explores how Spanish healthcare workers learned, internalised and integrated values and work behaviours during the COVID-19 pandemic and their impact on the personal sphere. This documentary research, using images, narratives and audiovisual content, was framed within the interpretative hermeneutic paradigm. Categories and subcategories emerged after a final theoretical sampling that focused on the analysis. Data triangulation between researchers favoured theoretical saturation. A total of 117 images and 27 texts were selected. The analysis identified three stages: bewilderment, seeking functionality in the chaos and integrating chaos into care. The data reflects how the need for security and knowledge, and the exhaustion and frustration caused by the initial working conditions, prompted adaptive responses. These responses involved focusing on problem-solving and strengthening group sentiments and solidarity. Subsequently, the data indicates the acceptance of new structural, organisational and communication aspects. The findings of the analysis will contribute towards finding a framework that can help understand community health crisis events.
  

• 
  Impact of an SMS intervention to support type 2 diabetes self-management: DiabeText clinical trial. Zamanillo-Campos, Rocío; Fiol-DeRoque, Maria Antonia; Serrano-Ripoll, Maria Jesús; Llobera, Joan; Taltavull-Aparicio, Joana María; Leiva, Alfonso; Ripoll-Amengual, Joana; Angullo-Martínez, Escarlata; Socias, Isabel; Masmiquel, Luis; Konieczna, Jadwiga; Zaforteza-Dezcallar, María; Boronat-Moreiro, Maria Asunción; Mira-Martínez, Sofía; Gervilla-García, Elena; Ricci-Cabello, Ignacio (2024). BJGP.2024.0206-.

  AbstractURLBibTeXEndNoteDOIBibSonomy

  BACKGROUND: Complications arising from uncontrolled Type 2 Diabetes Mellitus (T2DM) pose a significant burden on individuals' well-being and healthcare resources. Digital interventions may play a key role in mitigating such complications by supporting patients to adequately self-manage their condition. AIM: To assess the impact of DiabeText, a new theory-based, patient-centered, mobile health intervention integrated with electronic health records to send tailored short text messages to support T2DM self-management. DESIGN AND SETTING: Pragmatic, Phase III, 12-month, two-arm randomized clinical trial with T2DM primary care patients in Spain. METHOD: 742 participants with suboptimal glycemic control (HbA1c>7.5) were randomly allocated to a control (usual care) or intervention (DiabeText) group. The DiabeText group received, in addition to usual care, 165 messages focused on healthy lifestyle and medication adherence. PRIMARY OUTCOME: glycated hemoglobin (HbA1c). SECONDARY OUTCOMES: medication possession ratio, quality of life (EQ-5D-5L), diabetes self-efficacy (DSES); and self-reported adherence to medication, Mediterranean diet (MEDAS-14), and physical activity (IPAQ). RESULTS: Over the 12-month period, we observed no significant differences in HbA1c between the intervention and the control groups (Beta=-0.025 (-0.198 to 0.147; p=0.772)). In comparison with the control group, the DiabeText group showed significant (p<0.05) improvements in self-reported medication adherence (OR=1.4; 95%CI: 1.0 to 1.9), DSES (Cohen's d=0.35), and EQ5D-5L (Cohen's d=0.18) scores; but not in the rest of secondary outcomes. CONCLUSION: DiabeText successfully improved quality of life, diabetes self-management, and self-reported medication adherence in primary care patients with T2DM. Further research is needed to enhance its effects on physiological outcomes.

  @article{zamanillocampos2024impact,
  abstract = {BACKGROUND: Complications arising from uncontrolled Type 2 Diabetes Mellitus (T2DM) pose a significant burden on individuals' well-being and healthcare resources. Digital interventions may play a key role in mitigating such complications by supporting patients to adequately self-manage their condition. AIM: To assess the impact of DiabeText, a new theory-based, patient-centered, mobile health intervention integrated with electronic health records to send tailored short text messages to support T2DM self-management. DESIGN AND SETTING: Pragmatic, Phase III, 12-month, two-arm randomized clinical trial with T2DM primary care patients in Spain. METHOD: 742 participants with suboptimal glycemic control (HbA1c>7.5) were randomly allocated to a control (usual care) or intervention (DiabeText) group. The DiabeText group received, in addition to usual care, 165 messages focused on healthy lifestyle and medication adherence. PRIMARY OUTCOME: glycated hemoglobin (HbA1c). SECONDARY OUTCOMES: medication possession ratio, quality of life (EQ-5D-5L), diabetes self-efficacy (DSES); and self-reported adherence to medication, Mediterranean diet (MEDAS-14), and physical activity (IPAQ). RESULTS: Over the 12-month period, we observed no significant differences in HbA1c between the intervention and the control groups (Beta=-0.025 (-0.198 to 0.147; p=0.772)). In comparison with the control group, the DiabeText group showed significant (p<0.05) improvements in self-reported medication adherence (OR=1.4; 95%CI: 1.0 to 1.9), DSES (Cohen's d=0.35), and EQ5D-5L (Cohen's d=0.18) scores; but not in the rest of secondary outcomes. CONCLUSION: DiabeText successfully improved quality of life, diabetes self-management, and self-reported medication adherence in primary care patients with T2DM. Further research is needed to enhance its effects on physiological outcomes.},
  address = {England},
  author = {Zamanillo-Campos, Rocío and Fiol-DeRoque, Maria Antonia and Serrano-Ripoll, Maria Jesús and Llobera, Joan and Taltavull-Aparicio, Joana María and Leiva, Alfonso and Ripoll-Amengual, Joana and Angullo-Martínez, Escarlata and Socias, Isabel and Masmiquel, Luis and Konieczna, Jadwiga and Zaforteza-Dezcallar, María and Boronat-Moreiro, Maria Asunción and Mira-Martínez, Sofía and Gervilla-García, Elena and Ricci-Cabello, Ignacio},
  journal = {The British journal of general practice : the journal of the Royal College of General Practitioners},
  keywords = {evisap grapp-caib},
  month = {oct},
  pages = {BJGP.2024.0206--},
  title = {Impact of an SMS intervention to support type 2 diabetes self-management: DiabeText clinical trial},
  year = 2024
  }
  

  %0 Journal Article
  %1 zamanillocampos2024impact
  %A Zamanillo-Campos, Rocío
  %A Fiol-DeRoque, Maria Antonia
  %A Serrano-Ripoll, Maria Jesús
  %A Llobera, Joan
  %A Taltavull-Aparicio, Joana María
  %A Leiva, Alfonso
  %A Ripoll-Amengual, Joana
  %A Angullo-Martínez, Escarlata
  %A Socias, Isabel
  %A Masmiquel, Luis
  %A Konieczna, Jadwiga
  %A Zaforteza-Dezcallar, María
  %A Boronat-Moreiro, Maria Asunción
  %A Mira-Martínez, Sofía
  %A Gervilla-García, Elena
  %A Ricci-Cabello, Ignacio
  %C England
  %D 2024
  %J The British journal of general practice : the journal of the Royal College of General Practitioners
  %P BJGP.2024.0206--
  %R 10.3399/BJGP.2024.0206
  %T Impact of an SMS intervention to support type 2 diabetes self-management: DiabeText clinical trial
  %U https://pubmed.ncbi.nlm.nih.gov/39362693
  %X BACKGROUND: Complications arising from uncontrolled Type 2 Diabetes Mellitus (T2DM) pose a significant burden on individuals' well-being and healthcare resources. Digital interventions may play a key role in mitigating such complications by supporting patients to adequately self-manage their condition. AIM: To assess the impact of DiabeText, a new theory-based, patient-centered, mobile health intervention integrated with electronic health records to send tailored short text messages to support T2DM self-management. DESIGN AND SETTING: Pragmatic, Phase III, 12-month, two-arm randomized clinical trial with T2DM primary care patients in Spain. METHOD: 742 participants with suboptimal glycemic control (HbA1c>7.5) were randomly allocated to a control (usual care) or intervention (DiabeText) group. The DiabeText group received, in addition to usual care, 165 messages focused on healthy lifestyle and medication adherence. PRIMARY OUTCOME: glycated hemoglobin (HbA1c). SECONDARY OUTCOMES: medication possession ratio, quality of life (EQ-5D-5L), diabetes self-efficacy (DSES); and self-reported adherence to medication, Mediterranean diet (MEDAS-14), and physical activity (IPAQ). RESULTS: Over the 12-month period, we observed no significant differences in HbA1c between the intervention and the control groups (Beta=-0.025 (-0.198 to 0.147; p=0.772)). In comparison with the control group, the DiabeText group showed significant (p<0.05) improvements in self-reported medication adherence (OR=1.4; 95%CI: 1.0 to 1.9), DSES (Cohen's d=0.35), and EQ5D-5L (Cohen's d=0.18) scores; but not in the rest of secondary outcomes. CONCLUSION: DiabeText successfully improved quality of life, diabetes self-management, and self-reported medication adherence in primary care patients with T2DM. Further research is needed to enhance its effects on physiological outcomes.
  

• 
  Learning, internalisation and integration of the COVID-19 pandemic in healthcare workers: A qualitative document analysis. Abad-Corpa, Eva; Rich-Ruiz, Manuel; Sánchez-López, Dolores; Solano Ruiz, Carmen; Casado-Ramírez, Elvira; Arregui-Gallego, Beatriz; Moreno-Casbas, María Teresa; Muñoz-Jiménez, Daniel; Vidal-Thomàs, M Clara; Company-Sancho, M Consuelo; Orts-Cortés, María Isabel (2024). e12673-e12673.

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  The COVID-19 pandemic triggered an unprecedented health crisis that impacted healthcare systems worldwide. This study explores how Spanish healthcare workers learned, internalised and integrated values and work behaviours during the COVID-19 pandemic and their impact on the personal sphere. This documentary research, using images, narratives and audiovisual content, was framed within the interpretative hermeneutic paradigm. Categories and subcategories emerged after a final theoretical sampling that focused on the analysis. Data triangulation between researchers favoured theoretical saturation. A total of 117 images and 27 texts were selected. The analysis identified three stages: bewilderment, seeking functionality in the chaos and integrating chaos into care. The data reflects how the need for security and knowledge, and the exhaustion and frustration caused by the initial working conditions, prompted adaptive responses. These responses involved focusing on problem-solving and strengthening group sentiments and solidarity. Subsequently, the data indicates the acceptance of new structural, organisational and communication aspects. The findings of the analysis will contribute towards finding a framework that can help understand community health crisis events.

  @article{abadcorpa2024learning,
  abstract = {The COVID-19 pandemic triggered an unprecedented health crisis that impacted healthcare systems worldwide. This study explores how Spanish healthcare workers learned, internalised and integrated values and work behaviours during the COVID-19 pandemic and their impact on the personal sphere. This documentary research, using images, narratives and audiovisual content, was framed within the interpretative hermeneutic paradigm. Categories and subcategories emerged after a final theoretical sampling that focused on the analysis. Data triangulation between researchers favoured theoretical saturation. A total of 117 images and 27 texts were selected. The analysis identified three stages: bewilderment, seeking functionality in the chaos and integrating chaos into care. The data reflects how the need for security and knowledge, and the exhaustion and frustration caused by the initial working conditions, prompted adaptive responses. These responses involved focusing on problem-solving and strengthening group sentiments and solidarity. Subsequently, the data indicates the acceptance of new structural, organisational and communication aspects. The findings of the analysis will contribute towards finding a framework that can help understand community health crisis events.},
  address = {Australia},
  author = {Abad-Corpa, Eva and Rich-Ruiz, Manuel and Sánchez-López, Dolores and Solano Ruiz, Carmen and Casado-Ramírez, Elvira and Arregui-Gallego, Beatriz and Moreno-Casbas, María Teresa and Muñoz-Jiménez, Daniel and Vidal-Thomàs, M Clara and Company-Sancho, M Consuelo and Orts-Cortés, María Isabel},
  journal = {Nursing inquiry},
  keywords = {grapp-caib},
  month = {sep},
  pages = {e12673--e12673},
  title = {Learning, internalisation and integration of the COVID-19 pandemic in healthcare workers: A qualitative document analysis},
  year = 2024
  }
  

  %0 Journal Article
  %1 abadcorpa2024learning
  %A Abad-Corpa, Eva
  %A Rich-Ruiz, Manuel
  %A Sánchez-López, Dolores
  %A Solano Ruiz, Carmen
  %A Casado-Ramírez, Elvira
  %A Arregui-Gallego, Beatriz
  %A Moreno-Casbas, María Teresa
  %A Muñoz-Jiménez, Daniel
  %A Vidal-Thomàs, M Clara
  %A Company-Sancho, M Consuelo
  %A Orts-Cortés, María Isabel
  %C Australia
  %D 2024
  %J Nursing inquiry
  %P e12673--e12673
  %R 10.1111/nin.12673
  %T Learning, internalisation and integration of the COVID-19 pandemic in healthcare workers: A qualitative document analysis
  %U https://pubmed.ncbi.nlm.nih.gov/39297396
  %X The COVID-19 pandemic triggered an unprecedented health crisis that impacted healthcare systems worldwide. This study explores how Spanish healthcare workers learned, internalised and integrated values and work behaviours during the COVID-19 pandemic and their impact on the personal sphere. This documentary research, using images, narratives and audiovisual content, was framed within the interpretative hermeneutic paradigm. Categories and subcategories emerged after a final theoretical sampling that focused on the analysis. Data triangulation between researchers favoured theoretical saturation. A total of 117 images and 27 texts were selected. The analysis identified three stages: bewilderment, seeking functionality in the chaos and integrating chaos into care. The data reflects how the need for security and knowledge, and the exhaustion and frustration caused by the initial working conditions, prompted adaptive responses. These responses involved focusing on problem-solving and strengthening group sentiments and solidarity. Subsequently, the data indicates the acceptance of new structural, organisational and communication aspects. The findings of the analysis will contribute towards finding a framework that can help understand community health crisis events.
  

• 
  Evaluation of the effectiveness of cognitive-behavioural therapy for insomnia delivered by nurses and physicians for patients in primary care (the NPD study): protocol for a cluster randomised controlled trial. Torrens-Darder, Maria Del Mar; Torrens-Darder, Isabel; Gonzalez Torrente, Susana; Vicens, Caterina; Leiva, Alfonso; Pizá-Portell, Maria Rosa; Esteva Arrom, Apol Lonia; Lorente, Patricia; Serrano-Ripoll, Maria-Jesus; Vidal-Thomas, Maria Clara; Miralles-Xamena, Jerónima; Ramírez Manent, José Ignacio; Esteva, Magdalena (2024). 14(10) e089158-e089158.

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  INTRODUCTION: Insomnia is the most common sleep disorder, and it adversely impacts daily living and increases the risk of chronic and acute health problems. Of the few individuals who seek treatment for insomnia, most pursue help in primary care settings. The management of insomnia most commonly focuses on the prescription of hypnotics and sleep hygiene recommendations, although these are not the most effective treatments. Conversely, cognitive-behavioural therapy for insomnia (CBT-i), which is considered to be the first-line treatment for persistent insomnia, is seldom prescribed by primary care physicians (PCPs) or primary care nurses (PCNs). The hesitancy of these professionals to provide CBT-i is mainly attributed to their heavy workloads and the difficulties in acquiring the skills needed to administer this intervention. METHODS AND ANALYSIS: A two-arm cluster-randomised study (in which patients are assigned to a PCP or PCN) will be conducted in primary health centres of Majorca Island (Spain). A total of 206 patients will be recruited. Healthcare professionals will be allocated to the intervention or control group in a 1:1 ratio. The intervention group will receive CBT-i and the control group will receive usual care. We will include patients with Insomnia Severity Index scores of 8 or more who also report that insomnia interferes with daily functioning or is noticeable to others. The CBT-i will consist of four individual structured sessions, three in person (20 min each) and one by telephone (10 min) that are administered at intervals of 2-3 weeks. An additional session will be provided for patients taking hypnotic medications. The primary outcome measure is the decrease in sleep latency, which will be measured with the Pittsburg Sleep Quality index at 6 months and 12 months. ETHICS AND DISSEMINATION: This project was approved by the Ethical Committee of the Balearic Islands (IB 4604/21 PI) and the Primary Care Research Committee of the Department of Majorca Primary Care (PI19/24). All participants are required to provide written informed consent and no study-related procedures will be performed until consent is obtained. The trial results will be published in peer-reviewed journals and presented at conferences. TRIAL REGISTRATION NUMBER: ISRCTN10144646.

  @article{torrensdarder2024evaluation,
  abstract = {INTRODUCTION: Insomnia is the most common sleep disorder, and it adversely impacts daily living and increases the risk of chronic and acute health problems. Of the few individuals who seek treatment for insomnia, most pursue help in primary care settings. The management of insomnia most commonly focuses on the prescription of hypnotics and sleep hygiene recommendations, although these are not the most effective treatments. Conversely, cognitive-behavioural therapy for insomnia (CBT-i), which is considered to be the first-line treatment for persistent insomnia, is seldom prescribed by primary care physicians (PCPs) or primary care nurses (PCNs). The hesitancy of these professionals to provide CBT-i is mainly attributed to their heavy workloads and the difficulties in acquiring the skills needed to administer this intervention. METHODS AND ANALYSIS: A two-arm cluster-randomised study (in which patients are assigned to a PCP or PCN) will be conducted in primary health centres of Majorca Island (Spain). A total of 206 patients will be recruited. Healthcare professionals will be allocated to the intervention or control group in a 1:1 ratio. The intervention group will receive CBT-i and the control group will receive usual care. We will include patients with Insomnia Severity Index scores of 8 or more who also report that insomnia interferes with daily functioning or is noticeable to others. The CBT-i will consist of four individual structured sessions, three in person (20 min each) and one by telephone (10 min) that are administered at intervals of 2-3 weeks. An additional session will be provided for patients taking hypnotic medications. The primary outcome measure is the decrease in sleep latency, which will be measured with the Pittsburg Sleep Quality index at 6 months and 12 months. ETHICS AND DISSEMINATION: This project was approved by the Ethical Committee of the Balearic Islands (IB 4604/21 PI) and the Primary Care Research Committee of the Department of Majorca Primary Care (PI19/24). All participants are required to provide written informed consent and no study-related procedures will be performed until consent is obtained. The trial results will be published in peer-reviewed journals and presented at conferences. TRIAL REGISTRATION NUMBER: ISRCTN10144646.},
  address = {England},
  author = {Torrens-Darder, Maria Del Mar and Torrens-Darder, Isabel and Gonzalez Torrente, Susana and Vicens, Caterina and Leiva, Alfonso and Pizá-Portell, Maria Rosa and Esteva Arrom, Apol Lonia and Lorente, Patricia and Serrano-Ripoll, Maria-Jesus and Vidal-Thomas, Maria Clara and Miralles-Xamena, Jerónima and Ramírez Manent, José Ignacio and Esteva, Magdalena},
  journal = {BMJ open},
  keywords = {grapp-caib},
  month = {oct},
  number = 10,
  pages = {e089158--e089158},
  title = {Evaluation of the effectiveness of cognitive-behavioural therapy for insomnia delivered by nurses and physicians for patients in primary care (the NPD study): protocol for a cluster randomised controlled trial},
  volume = 14,
  year = 2024
  }
  

  %0 Journal Article
  %1 torrensdarder2024evaluation
  %A Torrens-Darder, Maria Del Mar
  %A Torrens-Darder, Isabel
  %A Gonzalez Torrente, Susana
  %A Vicens, Caterina
  %A Leiva, Alfonso
  %A Pizá-Portell, Maria Rosa
  %A Esteva Arrom, Apol Lonia
  %A Lorente, Patricia
  %A Serrano-Ripoll, Maria-Jesus
  %A Vidal-Thomas, Maria Clara
  %A Miralles-Xamena, Jerónima
  %A Ramírez Manent, José Ignacio
  %A Esteva, Magdalena
  %C England
  %D 2024
  %J BMJ open
  %N 10
  %P e089158--e089158
  %R 10.1136/bmjopen-2024-089158
  %T Evaluation of the effectiveness of cognitive-behavioural therapy for insomnia delivered by nurses and physicians for patients in primary care (the NPD study): protocol for a cluster randomised controlled trial
  %U https://pubmed.ncbi.nlm.nih.gov/39461854
  %V 14
  %X INTRODUCTION: Insomnia is the most common sleep disorder, and it adversely impacts daily living and increases the risk of chronic and acute health problems. Of the few individuals who seek treatment for insomnia, most pursue help in primary care settings. The management of insomnia most commonly focuses on the prescription of hypnotics and sleep hygiene recommendations, although these are not the most effective treatments. Conversely, cognitive-behavioural therapy for insomnia (CBT-i), which is considered to be the first-line treatment for persistent insomnia, is seldom prescribed by primary care physicians (PCPs) or primary care nurses (PCNs). The hesitancy of these professionals to provide CBT-i is mainly attributed to their heavy workloads and the difficulties in acquiring the skills needed to administer this intervention. METHODS AND ANALYSIS: A two-arm cluster-randomised study (in which patients are assigned to a PCP or PCN) will be conducted in primary health centres of Majorca Island (Spain). A total of 206 patients will be recruited. Healthcare professionals will be allocated to the intervention or control group in a 1:1 ratio. The intervention group will receive CBT-i and the control group will receive usual care. We will include patients with Insomnia Severity Index scores of 8 or more who also report that insomnia interferes with daily functioning or is noticeable to others. The CBT-i will consist of four individual structured sessions, three in person (20 min each) and one by telephone (10 min) that are administered at intervals of 2-3 weeks. An additional session will be provided for patients taking hypnotic medications. The primary outcome measure is the decrease in sleep latency, which will be measured with the Pittsburg Sleep Quality index at 6 months and 12 months. ETHICS AND DISSEMINATION: This project was approved by the Ethical Committee of the Balearic Islands (IB 4604/21 PI) and the Primary Care Research Committee of the Department of Majorca Primary Care (PI19/24). All participants are required to provide written informed consent and no study-related procedures will be performed until consent is obtained. The trial results will be published in peer-reviewed journals and presented at conferences. TRIAL REGISTRATION NUMBER: ISRCTN10144646.
  

• 
  Impact of the COVID-19 pandemic on the self-care and health condition of the older adults. CUIDAMOS+75. A mixed methods study protocol. Rico-Blazquez, Milagros; Esteban-Sepúlveda, Silvia; Sánchez-Ruano, Raquel; Aritztegui-Echenique, Ana María; Artigues-Barbera, Eva María; Brito-Brito, Pedro Ruymán; Casado-Ramirez, Elvira; Cidoncha-Moreno, María Ángeles; Fabregat-Julve, María Inmaculada; Feria-Raposo, Isabel; Hernandez-Pascual, Montserrat; Lozano-Hernández, Cristina; Moreno-Casbas, María Teresa; Otones-Reyes, Pedro; Palmar-Santos, Ana María; Pedraz-Marcos, Azucena; Romero-Rodriguez, Esperanza María; Solé-Agustí, María Cristina; Taltavull-Aparicio, Joana María; Vidal-Thomas, María Clara; Gonzalez-Chorda, Víctor Manuel; Group, Cuidamos+75 (2024). 12 1389641–1389641.

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  AIMS: To assess the impact of the COVID-19 pandemic on the health condition of people ≥75 years of age and on their family caregivers in Spain. DESIGN: Multicentric, mixed method concurrent study. METHODS: This work, which will be conducted within the primary care setting in 11 administrative regions of Spain, will include three coordinated studies with different methodologies. The first is a population-based cohort study that will use real-life data to analyze the rates and evolution of health needs, care provision, and services utilization before, during, and after the pandemic. The second is a prospective cohort study with 18 months of follow-up that will evaluate the impact of COVID-19 disease on mortality, frailty, functional and cognitive capacity, and quality of life of the participants. Finally, the third will be a qualitative study with a critical social approach to understand and interpret the social, political, and economic dimensions associated with the use of health services during the pandemic. We have followed the SPIRIT Checklist to address trial protocol and related documents. This research is being funded by the Instituto de Salud Carlos III since 2021 and was approved by its ethics committee (June 2022). DISCUSSION: The study findings will reveal the long-term impact of the COVID-19 pandemic on the older adults and their caregivers. This information will serve policymakers to adapt health policies to the needs of this population in situations of maximum stress, such as that produced by the COVID-19 pandemic. TRIAL REGISTRATION: Identifier: NCT05249868 [ClinicalTrials.gov].

  @article{ricoblazquez2024impact,
  abstract = {AIMS: To assess the impact of the COVID-19 pandemic on the health condition of people ≥75 years of age and on their family caregivers in Spain. DESIGN: Multicentric, mixed method concurrent study. METHODS: This work, which will be conducted within the primary care setting in 11 administrative regions of Spain, will include three coordinated studies with different methodologies. The first is a population-based cohort study that will use real-life data to analyze the rates and evolution of health needs, care provision, and services utilization before, during, and after the pandemic. The second is a prospective cohort study with 18 months of follow-up that will evaluate the impact of COVID-19 disease on mortality, frailty, functional and cognitive capacity, and quality of life of the participants. Finally, the third will be a qualitative study with a critical social approach to understand and interpret the social, political, and economic dimensions associated with the use of health services during the pandemic. We have followed the SPIRIT Checklist to address trial protocol and related documents. This research is being funded by the Instituto de Salud Carlos III since 2021 and was approved by its ethics committee (June 2022). DISCUSSION: The study findings will reveal the long-term impact of the COVID-19 pandemic on the older adults and their caregivers. This information will serve policymakers to adapt health policies to the needs of this population in situations of maximum stress, such as that produced by the COVID-19 pandemic. TRIAL REGISTRATION: Identifier: NCT05249868 [ClinicalTrials.gov].},
  address = {Switzerland},
  author = {Rico-Blazquez, Milagros and Esteban-Sepúlveda, Silvia and Sánchez-Ruano, Raquel and Aritztegui-Echenique, Ana María and Artigues-Barbera, Eva María and Brito-Brito, Pedro Ruymán and Casado-Ramirez, Elvira and Cidoncha-Moreno, María Ángeles and Fabregat-Julve, María Inmaculada and Feria-Raposo, Isabel and Hernandez-Pascual, Montserrat and Lozano-Hernández, Cristina and Moreno-Casbas, María Teresa and Otones-Reyes, Pedro and Palmar-Santos, Ana María and Pedraz-Marcos, Azucena and Romero-Rodriguez, Esperanza María and Solé-Agustí, María Cristina and Taltavull-Aparicio, Joana María and Vidal-Thomas, María Clara and Gonzalez-Chorda, Víctor Manuel and Group, Cuidamos+75},
  journal = {Frontiers in public health},
  keywords = {grapp-caib},
  month = {jun},
  pages = {1389641--1389641},
  title = {Impact of the COVID-19 pandemic on the self-care and health condition of the older adults. CUIDAMOS+75. A mixed methods study protocol},
  volume = 12,
  year = 2024
  }
  

  %0 Journal Article
  %1 ricoblazquez2024impact
  %A Rico-Blazquez, Milagros
  %A Esteban-Sepúlveda, Silvia
  %A Sánchez-Ruano, Raquel
  %A Aritztegui-Echenique, Ana María
  %A Artigues-Barbera, Eva María
  %A Brito-Brito, Pedro Ruymán
  %A Casado-Ramirez, Elvira
  %A Cidoncha-Moreno, María Ángeles
  %A Fabregat-Julve, María Inmaculada
  %A Feria-Raposo, Isabel
  %A Hernandez-Pascual, Montserrat
  %A Lozano-Hernández, Cristina
  %A Moreno-Casbas, María Teresa
  %A Otones-Reyes, Pedro
  %A Palmar-Santos, Ana María
  %A Pedraz-Marcos, Azucena
  %A Romero-Rodriguez, Esperanza María
  %A Solé-Agustí, María Cristina
  %A Taltavull-Aparicio, Joana María
  %A Vidal-Thomas, María Clara
  %A Gonzalez-Chorda, Víctor Manuel
  %A Group, Cuidamos+75
  %C Switzerland
  %D 2024
  %J Frontiers in public health
  %P 1389641--1389641
  %R 10.3389/fpubh.2024.1389641
  %T Impact of the COVID-19 pandemic on the self-care and health condition of the older adults. CUIDAMOS+75. A mixed methods study protocol
  %U https://pubmed.ncbi.nlm.nih.gov/38952731
  %V 12
  %X AIMS: To assess the impact of the COVID-19 pandemic on the health condition of people ≥75 years of age and on their family caregivers in Spain. DESIGN: Multicentric, mixed method concurrent study. METHODS: This work, which will be conducted within the primary care setting in 11 administrative regions of Spain, will include three coordinated studies with different methodologies. The first is a population-based cohort study that will use real-life data to analyze the rates and evolution of health needs, care provision, and services utilization before, during, and after the pandemic. The second is a prospective cohort study with 18 months of follow-up that will evaluate the impact of COVID-19 disease on mortality, frailty, functional and cognitive capacity, and quality of life of the participants. Finally, the third will be a qualitative study with a critical social approach to understand and interpret the social, political, and economic dimensions associated with the use of health services during the pandemic. We have followed the SPIRIT Checklist to address trial protocol and related documents. This research is being funded by the Instituto de Salud Carlos III since 2021 and was approved by its ethics committee (June 2022). DISCUSSION: The study findings will reveal the long-term impact of the COVID-19 pandemic on the older adults and their caregivers. This information will serve policymakers to adapt health policies to the needs of this population in situations of maximum stress, such as that produced by the COVID-19 pandemic. TRIAL REGISTRATION: Identifier: NCT05249868 [ClinicalTrials.gov].
  

• 
  Usefulness of Body Fat and Visceral Fat Determined by Bioimpedanciometry versus Body Mass Index and Waist Circumference in Predicting Elevated Values of Different Risk Scales for Non-Alcoholic Fatty Liver Disease. Gordito Soler, María; López-González, Ángel Arturo; Vallejos, Daniela; Martínez-Almoyna Rifá, Emilio; Vicente-Herrero, María Teófila; Ramírez-Manent, José Ignacio (2024). 16(13) 2160-.

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: Obesity constitutes a public health problem worldwide and causes non-alcoholic fatty liver disease (MALFD), the leading cause of liver disease in developed countries, which progresses to liver cirrhosis and liver cancer. MAFLD is associated with obesity and can be evaluated by validated formulas to assess MAFLD risk using different parameters such as the body mass index (BMI) and waist circumference (WC). However, these parameters do not accurately measure body fat. As MAFLD is strongly associated with obesity, we hypothesize that measuring body and visceral fat by electrical bioimpedance is an efficient method to predict the risk of MAFLD. The objective of our work was to demonstrate that electrical bioimpedance is a more efficient method than the BMI or WC to predict an elevated risk of MAFLD. METHODS: A cross-sectional, descriptive study involving 8590 Spanish workers in the Balearic Islands was carried out. The study's sample of employees was drawn from those who underwent occupational medicine examinations between January 2019 and December 2020. Five MAFLD risk scales were determined for evaluating very high levels of body fat and visceral fat. The determination of body and visceral fat was performed using bioimpedanciometry. Student's t-test was employed to ascertain the mean and standard deviation of quantitative data. The chi-square test was used to find prevalences for qualitative variables, while ROC curves were used to define the cut-off points for body and visceral fat. The calculations included the area under the curve (AUC), the cut-off points along with their Youden index, sensitivity, and specificity. Correlation and concordance between the various scales were determined using Pearson's correlation index and Cohen's kappa, respectively. RESULTS: As both total body fat and visceral fat increase, the risk of MAFLD increases with a statistically significant result (p < 0.001), presenting a higher risk in men. The areas under the curve (AUC) of the five scales that assess overweight and obesity to determine the occurrence of high values of the different MAFLD risk scales were very high, most of them exceeding 0.9. These AUC values were higher for visceral and body fat than for the BMI or waist circumference. FLD-high presented the best results in men and women with the AUC at around 0.97, both for visceral fat and total body fat, with a high Youden index in all cases (women body fat = 0.830, visceral fat = 0.892; men body fat = 0.780, visceral fat = 0.881). CONCLUSIONS: In our study, all the overweight and obesity scales show a very good association with the scales assessing the risk of MAFLD. These values are higher for visceral and body fat than for waist circumference and the BMI. Both visceral fat and body fat are better associated than the BMI and waist circumference with MAFLD risk scales.

  @article{gorditosoler2024usefulness,
  abstract = {BACKGROUND: Obesity constitutes a public health problem worldwide and causes non-alcoholic fatty liver disease (MALFD), the leading cause of liver disease in developed countries, which progresses to liver cirrhosis and liver cancer. MAFLD is associated with obesity and can be evaluated by validated formulas to assess MAFLD risk using different parameters such as the body mass index (BMI) and waist circumference (WC). However, these parameters do not accurately measure body fat. As MAFLD is strongly associated with obesity, we hypothesize that measuring body and visceral fat by electrical bioimpedance is an efficient method to predict the risk of MAFLD. The objective of our work was to demonstrate that electrical bioimpedance is a more efficient method than the BMI or WC to predict an elevated risk of MAFLD. METHODS: A cross-sectional, descriptive study involving 8590 Spanish workers in the Balearic Islands was carried out. The study's sample of employees was drawn from those who underwent occupational medicine examinations between January 2019 and December 2020. Five MAFLD risk scales were determined for evaluating very high levels of body fat and visceral fat. The determination of body and visceral fat was performed using bioimpedanciometry. Student's t-test was employed to ascertain the mean and standard deviation of quantitative data. The chi-square test was used to find prevalences for qualitative variables, while ROC curves were used to define the cut-off points for body and visceral fat. The calculations included the area under the curve (AUC), the cut-off points along with their Youden index, sensitivity, and specificity. Correlation and concordance between the various scales were determined using Pearson's correlation index and Cohen's kappa, respectively. RESULTS: As both total body fat and visceral fat increase, the risk of MAFLD increases with a statistically significant result (p < 0.001), presenting a higher risk in men. The areas under the curve (AUC) of the five scales that assess overweight and obesity to determine the occurrence of high values of the different MAFLD risk scales were very high, most of them exceeding 0.9. These AUC values were higher for visceral and body fat than for the BMI or waist circumference. FLD-high presented the best results in men and women with the AUC at around 0.97, both for visceral fat and total body fat, with a high Youden index in all cases (women body fat = 0.830, visceral fat = 0.892; men body fat = 0.780, visceral fat = 0.881). CONCLUSIONS: In our study, all the overweight and obesity scales show a very good association with the scales assessing the risk of MAFLD. These values are higher for visceral and body fat than for waist circumference and the BMI. Both visceral fat and body fat are better associated than the BMI and waist circumference with MAFLD risk scales.},
  address = {Switzerland},
  author = {Gordito Soler, María and López-González, Ángel Arturo and Vallejos, Daniela and Martínez-Almoyna Rifá, Emilio and Vicente-Herrero, María Teófila and Ramírez-Manent, José Ignacio},
  journal = {Nutrients},
  keywords = {grapp-caib},
  month = {jul},
  number = 13,
  pages = {2160--},
  title = {Usefulness of Body Fat and Visceral Fat Determined by Bioimpedanciometry versus Body Mass Index and Waist Circumference in Predicting Elevated Values of Different Risk Scales for Non-Alcoholic Fatty Liver Disease},
  volume = 16,
  year = 2024
  }
  

  %0 Journal Article
  %1 gorditosoler2024usefulness
  %A Gordito Soler, María
  %A López-González, Ángel Arturo
  %A Vallejos, Daniela
  %A Martínez-Almoyna Rifá, Emilio
  %A Vicente-Herrero, María Teófila
  %A Ramírez-Manent, José Ignacio
  %C Switzerland
  %D 2024
  %J Nutrients
  %N 13
  %P 2160--
  %R 10.3390/nu16132160
  %T Usefulness of Body Fat and Visceral Fat Determined by Bioimpedanciometry versus Body Mass Index and Waist Circumference in Predicting Elevated Values of Different Risk Scales for Non-Alcoholic Fatty Liver Disease
  %U https://pubmed.ncbi.nlm.nih.gov/38999907
  %V 16
  %X BACKGROUND: Obesity constitutes a public health problem worldwide and causes non-alcoholic fatty liver disease (MALFD), the leading cause of liver disease in developed countries, which progresses to liver cirrhosis and liver cancer. MAFLD is associated with obesity and can be evaluated by validated formulas to assess MAFLD risk using different parameters such as the body mass index (BMI) and waist circumference (WC). However, these parameters do not accurately measure body fat. As MAFLD is strongly associated with obesity, we hypothesize that measuring body and visceral fat by electrical bioimpedance is an efficient method to predict the risk of MAFLD. The objective of our work was to demonstrate that electrical bioimpedance is a more efficient method than the BMI or WC to predict an elevated risk of MAFLD. METHODS: A cross-sectional, descriptive study involving 8590 Spanish workers in the Balearic Islands was carried out. The study's sample of employees was drawn from those who underwent occupational medicine examinations between January 2019 and December 2020. Five MAFLD risk scales were determined for evaluating very high levels of body fat and visceral fat. The determination of body and visceral fat was performed using bioimpedanciometry. Student's t-test was employed to ascertain the mean and standard deviation of quantitative data. The chi-square test was used to find prevalences for qualitative variables, while ROC curves were used to define the cut-off points for body and visceral fat. The calculations included the area under the curve (AUC), the cut-off points along with their Youden index, sensitivity, and specificity. Correlation and concordance between the various scales were determined using Pearson's correlation index and Cohen's kappa, respectively. RESULTS: As both total body fat and visceral fat increase, the risk of MAFLD increases with a statistically significant result (p < 0.001), presenting a higher risk in men. The areas under the curve (AUC) of the five scales that assess overweight and obesity to determine the occurrence of high values of the different MAFLD risk scales were very high, most of them exceeding 0.9. These AUC values were higher for visceral and body fat than for the BMI or waist circumference. FLD-high presented the best results in men and women with the AUC at around 0.97, both for visceral fat and total body fat, with a high Youden index in all cases (women body fat = 0.830, visceral fat = 0.892; men body fat = 0.780, visceral fat = 0.881). CONCLUSIONS: In our study, all the overweight and obesity scales show a very good association with the scales assessing the risk of MAFLD. These values are higher for visceral and body fat than for waist circumference and the BMI. Both visceral fat and body fat are better associated than the BMI and waist circumference with MAFLD risk scales.
  

• 
  Usefulness of the ECORE-BF Scale to Determine Atherogenic Risk in 386,924 Spanish Workers. Marina Arroyo, Marta; Ramírez Gallegos, Ignacio; López-González, Ángel Arturo; Vicente-Herrero, María Teófila; Vallejos, Daniela; Sastre-Alzamora, Tomás; Ramírez Manent, José Ignacio (2024). 16(15) 2434-.

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: Cardiovascular diseases are the leading cause of death worldwide. Obesity and atherosclerosis are considered risk factors for this pathology. There are multiple methods to evaluate obesity, in the same way as there are different formulas to determine atherogenic risk. Since both pathologies are closely related, the objective of our work was to evaluate whether the ECORE-BF scale is capable of predicting atherogenic risk. METHODS: Observational, descriptive, and cross-sectional study in which 386,924 workers from several autonomous communities in Spain participated. The association between the ECORE-BF scale and five atherogenic risk indices was evaluated. The relationship between variables was assessed using the chi-square test and Student's t test in independent samples. Multivariate analysis was performed with the multinomial logistic regression test, calculating the odds ratio and 95% confidence intervals, with the Hosmer-Lemeshow goodness-of-fit test. ROC curves established the cut-off points for moderate and high vascular age and determined the Youden index. RESULTS: The mean values of the ECORE-BF scale were higher in individuals with atherogenic dyslipidemia and the lipid triad, as well as in those with elevated values of the three atherogenic indices studied, with p <0.001 in all cases. As atherogenic risk increased across the five evaluated scales, the prevalence of obesity also significantly increased, with p <0.001 in all cases. In the ROC curve analysis, the AUCs for atherogenic dyslipidemia and the lipid triad were above 0.75, indicating a good association between these scales and the ECORE-BF. Although the Youden indices were not exceedingly high, they were around 0.5. CONCLUSIONS: There is a good association between atherogenic risk scales, atherogenic dyslipidemia, and lipid triad, and the ECORE-BF scale. The ECORE-BF scale can be a useful and quick tool to evaluate atherogenic risk in primary care and occupational medicine consultations without the need for blood tests.

  @article{marinaarroyo2024usefulness,
  abstract = {BACKGROUND: Cardiovascular diseases are the leading cause of death worldwide. Obesity and atherosclerosis are considered risk factors for this pathology. There are multiple methods to evaluate obesity, in the same way as there are different formulas to determine atherogenic risk. Since both pathologies are closely related, the objective of our work was to evaluate whether the ECORE-BF scale is capable of predicting atherogenic risk. METHODS: Observational, descriptive, and cross-sectional study in which 386,924 workers from several autonomous communities in Spain participated. The association between the ECORE-BF scale and five atherogenic risk indices was evaluated. The relationship between variables was assessed using the chi-square test and Student's t test in independent samples. Multivariate analysis was performed with the multinomial logistic regression test, calculating the odds ratio and 95% confidence intervals, with the Hosmer-Lemeshow goodness-of-fit test. ROC curves established the cut-off points for moderate and high vascular age and determined the Youden index. RESULTS: The mean values of the ECORE-BF scale were higher in individuals with atherogenic dyslipidemia and the lipid triad, as well as in those with elevated values of the three atherogenic indices studied, with p <0.001 in all cases. As atherogenic risk increased across the five evaluated scales, the prevalence of obesity also significantly increased, with p <0.001 in all cases. In the ROC curve analysis, the AUCs for atherogenic dyslipidemia and the lipid triad were above 0.75, indicating a good association between these scales and the ECORE-BF. Although the Youden indices were not exceedingly high, they were around 0.5. CONCLUSIONS: There is a good association between atherogenic risk scales, atherogenic dyslipidemia, and lipid triad, and the ECORE-BF scale. The ECORE-BF scale can be a useful and quick tool to evaluate atherogenic risk in primary care and occupational medicine consultations without the need for blood tests.},
  address = {Switzerland},
  author = {Marina Arroyo, Marta and Ramírez Gallegos, Ignacio and López-González, Ángel Arturo and Vicente-Herrero, María Teófila and Vallejos, Daniela and Sastre-Alzamora, Tomás and Ramírez Manent, José Ignacio},
  journal = {Nutrients},
  keywords = {grapp-caib},
  month = {jul},
  number = 15,
  pages = {2434--},
  title = {Usefulness of the ECORE-BF Scale to Determine Atherogenic Risk in 386,924 Spanish Workers},
  volume = 16,
  year = 2024
  }
  

  %0 Journal Article
  %1 marinaarroyo2024usefulness
  %A Marina Arroyo, Marta
  %A Ramírez Gallegos, Ignacio
  %A López-González, Ángel Arturo
  %A Vicente-Herrero, María Teófila
  %A Vallejos, Daniela
  %A Sastre-Alzamora, Tomás
  %A Ramírez Manent, José Ignacio
  %C Switzerland
  %D 2024
  %J Nutrients
  %N 15
  %P 2434--
  %R 10.3390/nu16152434
  %T Usefulness of the ECORE-BF Scale to Determine Atherogenic Risk in 386,924 Spanish Workers
  %U https://pubmed.ncbi.nlm.nih.gov/39125315
  %V 16
  %X BACKGROUND: Cardiovascular diseases are the leading cause of death worldwide. Obesity and atherosclerosis are considered risk factors for this pathology. There are multiple methods to evaluate obesity, in the same way as there are different formulas to determine atherogenic risk. Since both pathologies are closely related, the objective of our work was to evaluate whether the ECORE-BF scale is capable of predicting atherogenic risk. METHODS: Observational, descriptive, and cross-sectional study in which 386,924 workers from several autonomous communities in Spain participated. The association between the ECORE-BF scale and five atherogenic risk indices was evaluated. The relationship between variables was assessed using the chi-square test and Student's t test in independent samples. Multivariate analysis was performed with the multinomial logistic regression test, calculating the odds ratio and 95% confidence intervals, with the Hosmer-Lemeshow goodness-of-fit test. ROC curves established the cut-off points for moderate and high vascular age and determined the Youden index. RESULTS: The mean values of the ECORE-BF scale were higher in individuals with atherogenic dyslipidemia and the lipid triad, as well as in those with elevated values of the three atherogenic indices studied, with p <0.001 in all cases. As atherogenic risk increased across the five evaluated scales, the prevalence of obesity also significantly increased, with p <0.001 in all cases. In the ROC curve analysis, the AUCs for atherogenic dyslipidemia and the lipid triad were above 0.75, indicating a good association between these scales and the ECORE-BF. Although the Youden indices were not exceedingly high, they were around 0.5. CONCLUSIONS: There is a good association between atherogenic risk scales, atherogenic dyslipidemia, and lipid triad, and the ECORE-BF scale. The ECORE-BF scale can be a useful and quick tool to evaluate atherogenic risk in primary care and occupational medicine consultations without the need for blood tests.
  

• 
  Frequency of use and adequacy of Cochrane risk of bias tool 2 in non-Cochrane systematic reviews published in 2020: Meta-research study. Babić, Andrija; Barcot, Ognjen; Visković, Tomislav; Šarić, Frano; Kirkovski, Aleksandar; Barun, Ivana; Križanac, Zvonimir; Ananda, Roshan Arjun; Fuentes Barreiro, Yuli Viviana; Malih, Narges; Dimcea, Daiana Anne-Marie; Ordulj, Josipa; Weerasekara, Ishanka; Spezia, Matteo; Žuljević, Marija Franka; Šuto, Jelena; Tancredi, Luca; Pijuk, Anđela; Sammali, Susanna; Iascone, Veronica; von Groote, Thilo; Poklepović Peričić, Tina; Puljak, Livia (2024). 10.1002/jrsm.1695-.

  AbstractURLBibTeXEndNoteDOIBibSonomy

  Risk of bias (RoB) assessment is essential to the systematic review methodology. The new version of the Cochrane RoB tool for randomized trials (RoB 2) was published in 2019 to address limitations identified since the first version of the tool was published in 2008 and to increase the reliability of assessments. This study analyzed the frequency of usage of the RoB 2 and the adequacy of reporting the RoB 2 assessments in non-Cochrane reviews published in 2020. This meta-research study included non-Cochrane systematic reviews of interventions published in 2020. For the reviews that used the RoB 2 tool, we analyzed the reporting of the RoB 2 assessment. Among 3880 included reviews, the Cochrane RoB 1 tool was the most frequently used (N = 2228; 57.4%), followed by the Cochrane RoB 2 tool (N = 267; 6.9%). From 267 reviews that reported using the RoB 2 tool, 213 (79.8%) actually used it. In 26 (12.2%) reviews, erroneous statements were used to indicate the RoB 2 assessment. Only 20 (9.4%) reviews presented a complete RoB 2 assessment with a detailed table of answers to all signaling questions. The judgment of risk of bias by the RoB 2 tool was not justified by a comment in 158 (74.2%) reviews. Only in 33 (14.5%) of reviews the judgment in all domains was justified in the accompanying comment. In most reviews (81.7%), the RoB was inadequately assessed at the study level. In conclusion, the majority of non-Cochrane reviews published in 2020 still used the Cochrane RoB 1 tool. Many reviews used the RoB 2 tool inadequately. Further studies about the uptake and the use of the RoB 2 tool are needed.

  @article{babic2024frequency,
  abstract = {Risk of bias (RoB) assessment is essential to the systematic review methodology. The new version of the Cochrane RoB tool for randomized trials (RoB 2) was published in 2019 to address limitations identified since the first version of the tool was published in 2008 and to increase the reliability of assessments. This study analyzed the frequency of usage of the RoB 2 and the adequacy of reporting the RoB 2 assessments in non-Cochrane reviews published in 2020. This meta-research study included non-Cochrane systematic reviews of interventions published in 2020. For the reviews that used the RoB 2 tool, we analyzed the reporting of the RoB 2 assessment. Among 3880 included reviews, the Cochrane RoB 1 tool was the most frequently used (N = 2228; 57.4%), followed by the Cochrane RoB 2 tool (N = 267; 6.9%). From 267 reviews that reported using the RoB 2 tool, 213 (79.8%) actually used it. In 26 (12.2%) reviews, erroneous statements were used to indicate the RoB 2 assessment. Only 20 (9.4%) reviews presented a complete RoB 2 assessment with a detailed table of answers to all signaling questions. The judgment of risk of bias by the RoB 2 tool was not justified by a comment in 158 (74.2%) reviews. Only in 33 (14.5%) of reviews the judgment in all domains was justified in the accompanying comment. In most reviews (81.7%), the RoB was inadequately assessed at the study level. In conclusion, the majority of non-Cochrane reviews published in 2020 still used the Cochrane RoB 1 tool. Many reviews used the RoB 2 tool inadequately. Further studies about the uptake and the use of the RoB 2 tool are needed.},
  address = {England},
  author = {Babić, Andrija and Barcot, Ognjen and Visković, Tomislav and Šarić, Frano and Kirkovski, Aleksandar and Barun, Ivana and Križanac, Zvonimir and Ananda, Roshan Arjun and Fuentes Barreiro, Yuli Viviana and Malih, Narges and Dimcea, Daiana Anne-Marie and Ordulj, Josipa and Weerasekara, Ishanka and Spezia, Matteo and Žuljević, Marija Franka and Šuto, Jelena and Tancredi, Luca and Pijuk, Anđela and Sammali, Susanna and Iascone, Veronica and von Groote, Thilo and Poklepović Peričić, Tina and Puljak, Livia},
  journal = {Research synthesis methods},
  keywords = {evisap grapp-caib},
  month = {jan},
  pages = {10.1002/jrsm.1695--},
  title = {Frequency of use and adequacy of Cochrane risk of bias tool 2 in non-Cochrane systematic reviews published in 2020: Meta-research study},
  year = 2024
  }
  

  %0 Journal Article
  %1 babic2024frequency
  %A Babić, Andrija
  %A Barcot, Ognjen
  %A Visković, Tomislav
  %A Šarić, Frano
  %A Kirkovski, Aleksandar
  %A Barun, Ivana
  %A Križanac, Zvonimir
  %A Ananda, Roshan Arjun
  %A Fuentes Barreiro, Yuli Viviana
  %A Malih, Narges
  %A Dimcea, Daiana Anne-Marie
  %A Ordulj, Josipa
  %A Weerasekara, Ishanka
  %A Spezia, Matteo
  %A Žuljević, Marija Franka
  %A Šuto, Jelena
  %A Tancredi, Luca
  %A Pijuk, Anđela
  %A Sammali, Susanna
  %A Iascone, Veronica
  %A von Groote, Thilo
  %A Poklepović Peričić, Tina
  %A Puljak, Livia
  %C England
  %D 2024
  %J Research synthesis methods
  %P 10.1002/jrsm.1695--
  %R 10.1002/jrsm.1695
  %T Frequency of use and adequacy of Cochrane risk of bias tool 2 in non-Cochrane systematic reviews published in 2020: Meta-research study
  %U https://pubmed.ncbi.nlm.nih.gov/38262609
  %X Risk of bias (RoB) assessment is essential to the systematic review methodology. The new version of the Cochrane RoB tool for randomized trials (RoB 2) was published in 2019 to address limitations identified since the first version of the tool was published in 2008 and to increase the reliability of assessments. This study analyzed the frequency of usage of the RoB 2 and the adequacy of reporting the RoB 2 assessments in non-Cochrane reviews published in 2020. This meta-research study included non-Cochrane systematic reviews of interventions published in 2020. For the reviews that used the RoB 2 tool, we analyzed the reporting of the RoB 2 assessment. Among 3880 included reviews, the Cochrane RoB 1 tool was the most frequently used (N = 2228; 57.4%), followed by the Cochrane RoB 2 tool (N = 267; 6.9%). From 267 reviews that reported using the RoB 2 tool, 213 (79.8%) actually used it. In 26 (12.2%) reviews, erroneous statements were used to indicate the RoB 2 assessment. Only 20 (9.4%) reviews presented a complete RoB 2 assessment with a detailed table of answers to all signaling questions. The judgment of risk of bias by the RoB 2 tool was not justified by a comment in 158 (74.2%) reviews. Only in 33 (14.5%) of reviews the judgment in all domains was justified in the accompanying comment. In most reviews (81.7%), the RoB was inadequately assessed at the study level. In conclusion, the majority of non-Cochrane reviews published in 2020 still used the Cochrane RoB 1 tool. Many reviews used the RoB 2 tool inadequately. Further studies about the uptake and the use of the RoB 2 tool are needed.
  

• 
  Validity of nutrition screening tools for risk of malnutrition among hospitalized adult patients: A systematic review and meta-analysis. Cortés-Aguilar, Regina; Malih, Narges; Abbate, Manuela; Fresneda, Sergio; Yañez, Aina; Bennasar-Veny, Miquel (2024). 43(5) 1094–1116.

  AbstractURLBibTeXEndNoteDOIBibSonomy

  BACKGROUNDS & AIMS: Malnutrition is prevalent among hospitalized patients in developed countries, contributing to negative health outcomes and increased healthcare costs. Timely identification and management of malnutrition are crucial. The lack of a universally accepted definition and standardized diagnostic criteria for malnutrition has led to the development of various screening tools, each with varying validity. This complicates early identification of malnutrition, hindering effective intervention strategies. This systematic review and meta-analysis aimed to identify the most valid and reliable nutritional screening tool for assessing the risk of malnutrition in hospitalized adults. METHODS: A systematic literature search was conducted to identify validation studies published from inception to November 2023, in the Pubmed/MEDLINE, Embase, and CINAHL databases. This systematic review was registered in INPLASY (INPLASY202090028). The risk of bias and quality of included studies were assessed using the Quality Assessment of Diagnostic Accuracy Studies version 2 (QUADAS-2). Meta-analyses were performed for screening tools accuracy using the symmetric hierarchical summary receiver operative characteristics models. RESULTS: Of the 1646 articles retrieved, 60 met the inclusion criteria and were included in the systematic review, and 21 were included in the meta-analysis. A total of 51 malnutrition risk screening tools and 9 reference standards were identified. The meta-analyses assessed four common malnutrition risk screening tools against two reference standards (Subjective Global Assessment [SGA] and European Society for Clinical Nutrition and Metabolism [ESPEN] criteria). The Malnutrition Universal Screening Tool (MUST) vs SGA had a sensitivity (95% Confidence Interval) of 0.84 (0.73-0.91), and specificity of 0.85 (0.75-0.91). The MUST vs ESPEN had a sensitivity of 0.97 (0.53-0.99) and specificity of 0.80 (0.50-0.94). The Malnutrition Screening Tool (MST) vs SGA had a sensitivity of 0.81 (0.67-0.90) and specificity of 0.79 (0.72-0.74). The Mini Nutritional Assessment-Short Form (MNA-SF) vs ESPEN had a sensitivity of 0.99 (0.41-0.99) and specificity of 0.60 (0.45-0.73). The Nutrition Universal Screening Tool-2002 (NRS-2002) vs SGA had a sensitivity of 0.76 (0.58-0.87) and specificity of 0.86 (0.76-0.93). CONCLUSIONS: The MUST demonstrated high accuracy in detecting malnutrition risk in hospitalized adults. However, the quality of the studies included varied greatly, possibly introducing bias in the results. Future research should compare tools within a specific patient population using a valid and universal gold standard to ensure improved patient care and outcomes.

  @article{cortesaguilar2024validity,
  abstract = {BACKGROUNDS & AIMS: Malnutrition is prevalent among hospitalized patients in developed countries, contributing to negative health outcomes and increased healthcare costs. Timely identification and management of malnutrition are crucial. The lack of a universally accepted definition and standardized diagnostic criteria for malnutrition has led to the development of various screening tools, each with varying validity. This complicates early identification of malnutrition, hindering effective intervention strategies. This systematic review and meta-analysis aimed to identify the most valid and reliable nutritional screening tool for assessing the risk of malnutrition in hospitalized adults. METHODS: A systematic literature search was conducted to identify validation studies published from inception to November 2023, in the Pubmed/MEDLINE, Embase, and CINAHL databases. This systematic review was registered in INPLASY (INPLASY202090028). The risk of bias and quality of included studies were assessed using the Quality Assessment of Diagnostic Accuracy Studies version 2 (QUADAS-2). Meta-analyses were performed for screening tools accuracy using the symmetric hierarchical summary receiver operative characteristics models. RESULTS: Of the 1646 articles retrieved, 60 met the inclusion criteria and were included in the systematic review, and 21 were included in the meta-analysis. A total of 51 malnutrition risk screening tools and 9 reference standards were identified. The meta-analyses assessed four common malnutrition risk screening tools against two reference standards (Subjective Global Assessment [SGA] and European Society for Clinical Nutrition and Metabolism [ESPEN] criteria). The Malnutrition Universal Screening Tool (MUST) vs SGA had a sensitivity (95% Confidence Interval) of 0.84 (0.73-0.91), and specificity of 0.85 (0.75-0.91). The MUST vs ESPEN had a sensitivity of 0.97 (0.53-0.99) and specificity of 0.80 (0.50-0.94). The Malnutrition Screening Tool (MST) vs SGA had a sensitivity of 0.81 (0.67-0.90) and specificity of 0.79 (0.72-0.74). The Mini Nutritional Assessment-Short Form (MNA-SF) vs ESPEN had a sensitivity of 0.99 (0.41-0.99) and specificity of 0.60 (0.45-0.73). The Nutrition Universal Screening Tool-2002 (NRS-2002) vs SGA had a sensitivity of 0.76 (0.58-0.87) and specificity of 0.86 (0.76-0.93). CONCLUSIONS: The MUST demonstrated high accuracy in detecting malnutrition risk in hospitalized adults. However, the quality of the studies included varied greatly, possibly introducing bias in the results. Future research should compare tools within a specific patient population using a valid and universal gold standard to ensure improved patient care and outcomes.},
  address = {England},
  author = {Cortés-Aguilar, Regina and Malih, Narges and Abbate, Manuela and Fresneda, Sergio and Yañez, Aina and Bennasar-Veny, Miquel},
  journal = {Clinical nutrition (Edinburgh, Scotland)},
  keywords = {evisap grapp-caib},
  month = {mar},
  number = 5,
  pages = {1094--1116},
  title = {Validity of nutrition screening tools for risk of malnutrition among hospitalized adult patients: A systematic review and meta-analysis},
  volume = 43,
  year = 2024
  }
  

  %0 Journal Article
  %1 cortesaguilar2024validity
  %A Cortés-Aguilar, Regina
  %A Malih, Narges
  %A Abbate, Manuela
  %A Fresneda, Sergio
  %A Yañez, Aina
  %A Bennasar-Veny, Miquel
  %C England
  %D 2024
  %J Clinical nutrition (Edinburgh, Scotland)
  %N 5
  %P 1094--1116
  %R 10.1016/j.clnu.2024.03.008
  %T Validity of nutrition screening tools for risk of malnutrition among hospitalized adult patients: A systematic review and meta-analysis
  %U https://pubmed.ncbi.nlm.nih.gov/38582013
  %V 43
  %X BACKGROUNDS & AIMS: Malnutrition is prevalent among hospitalized patients in developed countries, contributing to negative health outcomes and increased healthcare costs. Timely identification and management of malnutrition are crucial. The lack of a universally accepted definition and standardized diagnostic criteria for malnutrition has led to the development of various screening tools, each with varying validity. This complicates early identification of malnutrition, hindering effective intervention strategies. This systematic review and meta-analysis aimed to identify the most valid and reliable nutritional screening tool for assessing the risk of malnutrition in hospitalized adults. METHODS: A systematic literature search was conducted to identify validation studies published from inception to November 2023, in the Pubmed/MEDLINE, Embase, and CINAHL databases. This systematic review was registered in INPLASY (INPLASY202090028). The risk of bias and quality of included studies were assessed using the Quality Assessment of Diagnostic Accuracy Studies version 2 (QUADAS-2). Meta-analyses were performed for screening tools accuracy using the symmetric hierarchical summary receiver operative characteristics models. RESULTS: Of the 1646 articles retrieved, 60 met the inclusion criteria and were included in the systematic review, and 21 were included in the meta-analysis. A total of 51 malnutrition risk screening tools and 9 reference standards were identified. The meta-analyses assessed four common malnutrition risk screening tools against two reference standards (Subjective Global Assessment [SGA] and European Society for Clinical Nutrition and Metabolism [ESPEN] criteria). The Malnutrition Universal Screening Tool (MUST) vs SGA had a sensitivity (95% Confidence Interval) of 0.84 (0.73-0.91), and specificity of 0.85 (0.75-0.91). The MUST vs ESPEN had a sensitivity of 0.97 (0.53-0.99) and specificity of 0.80 (0.50-0.94). The Malnutrition Screening Tool (MST) vs SGA had a sensitivity of 0.81 (0.67-0.90) and specificity of 0.79 (0.72-0.74). The Mini Nutritional Assessment-Short Form (MNA-SF) vs ESPEN had a sensitivity of 0.99 (0.41-0.99) and specificity of 0.60 (0.45-0.73). The Nutrition Universal Screening Tool-2002 (NRS-2002) vs SGA had a sensitivity of 0.76 (0.58-0.87) and specificity of 0.86 (0.76-0.93). CONCLUSIONS: The MUST demonstrated high accuracy in detecting malnutrition risk in hospitalized adults. However, the quality of the studies included varied greatly, possibly introducing bias in the results. Future research should compare tools within a specific patient population using a valid and universal gold standard to ensure improved patient care and outcomes.
  

• 
  Process evaluation of PsyCovidApp, a digital tool for mobile devices aimed at protecting the mental health of healthcare professionals during the COVID-19 pandemic: a mixed method study. Fiol deRoque, Maria A; Serrano-Ripoll, Maria J; Mira-Martínez, Sofia; Pastor-Moreno, Guadalupe; Sitges, Carolina; García-Buades, M Esther; Gervilla, Elena; Garcia-Toro, Mauro; Zamanillo-Campos, Rocío; Ricci-Cabello, Ignacio (2024). 15 1378372–1378372.

  AbstractURLBibTeXEndNoteDOIBibSonomy

  INTRODUCTION: PsyCovidApp, a digital intervention aimed at safeguarding the mental health of healthcare workers during the COVID-19 pandemic, demonstrated in a randomized clinical trial to yield significant improvements solely among healthcare workers undergoing psychotherapy or receiving psychotropic medication. OBJECTIVES: (1) To identify contextual factors and mechanisms of action that influenced the impact of PsyCovidApp during the aforementioned trial; (2) To pinpoint enhancements for optimizing its efficacy. MATERIALS AND METHODS: For the first objective, a process evaluation was conducted, amalgamating quantitative techniques (surveying 216 healthcare professionals who had utilized PsyCovidApp during the trial) and qualitative methods (in-depth interviews with 16 healthcare workers). The second objective involved a panel of seven experts, utilizing the RAND-UCLA methodology. RESULTS: The quantitative study (response rate = 40%) revealed that 22% of respondents had not fully accessed the content of PsyCovidApp. The average usage time was 22.7 min/day, being higher (p < 0.05) among consumers of psychotropic medications. Contents related to relaxation and mindfulness were most highly rated. Acceptability and usefulness scores ranged between 7.3-7.5/10 points, with higher ratings (p < 0.05) among women and older healthcare workers. The qualitative study uncovered that the primary barriers to using PsyCovidApp were workload, lack of time, and exhaustion. Its primary mechanisms of action included emotion identification, mental health regulation (e.g., insomnia, intense emotions), and learning of techniques and skills. The expert panel reached a consensus on 29 proposals to optimize PsyCovidApp. CONCLUSION: The knowledge derived from this study could inform the design and implementation of future similar digital tools.

  @article{fiolderoque2024process,
  abstract = {INTRODUCTION: PsyCovidApp, a digital intervention aimed at safeguarding the mental health of healthcare workers during the COVID-19 pandemic, demonstrated in a randomized clinical trial to yield significant improvements solely among healthcare workers undergoing psychotherapy or receiving psychotropic medication. OBJECTIVES: (1) To identify contextual factors and mechanisms of action that influenced the impact of PsyCovidApp during the aforementioned trial; (2) To pinpoint enhancements for optimizing its efficacy. MATERIALS AND METHODS: For the first objective, a process evaluation was conducted, amalgamating quantitative techniques (surveying 216 healthcare professionals who had utilized PsyCovidApp during the trial) and qualitative methods (in-depth interviews with 16 healthcare workers). The second objective involved a panel of seven experts, utilizing the RAND-UCLA methodology. RESULTS: The quantitative study (response rate = 40%) revealed that 22% of respondents had not fully accessed the content of PsyCovidApp. The average usage time was 22.7 min/day, being higher (p < 0.05) among consumers of psychotropic medications. Contents related to relaxation and mindfulness were most highly rated. Acceptability and usefulness scores ranged between 7.3-7.5/10 points, with higher ratings (p < 0.05) among women and older healthcare workers. The qualitative study uncovered that the primary barriers to using PsyCovidApp were workload, lack of time, and exhaustion. Its primary mechanisms of action included emotion identification, mental health regulation (e.g., insomnia, intense emotions), and learning of techniques and skills. The expert panel reached a consensus on 29 proposals to optimize PsyCovidApp. CONCLUSION: The knowledge derived from this study could inform the design and implementation of future similar digital tools.},
  address = {Switzerland},
  author = {Fiol deRoque, Maria A and Serrano-Ripoll, Maria J and Mira-Martínez, Sofia and Pastor-Moreno, Guadalupe and Sitges, Carolina and García-Buades, M Esther and Gervilla, Elena and Garcia-Toro, Mauro and Zamanillo-Campos, Rocío and Ricci-Cabello, Ignacio},
  journal = {Frontiers in psychology},
  keywords = {evisap grapp-caib},
  month = {mar},
  pages = {1378372--1378372},
  title = {Process evaluation of PsyCovidApp, a digital tool for mobile devices aimed at protecting the mental health of healthcare professionals during the COVID-19 pandemic: a mixed method study},
  volume = 15,
  year = 2024
  }
  

  %0 Journal Article
  %1 fiolderoque2024process
  %A Fiol deRoque, Maria A
  %A Serrano-Ripoll, Maria J
  %A Mira-Martínez, Sofia
  %A Pastor-Moreno, Guadalupe
  %A Sitges, Carolina
  %A García-Buades, M Esther
  %A Gervilla, Elena
  %A Garcia-Toro, Mauro
  %A Zamanillo-Campos, Rocío
  %A Ricci-Cabello, Ignacio
  %C Switzerland
  %D 2024
  %J Frontiers in psychology
  %P 1378372--1378372
  %R 10.3389/fpsyg.2024.1378372
  %T Process evaluation of PsyCovidApp, a digital tool for mobile devices aimed at protecting the mental health of healthcare professionals during the COVID-19 pandemic: a mixed method study
  %U https://pubmed.ncbi.nlm.nih.gov/38577118
  %V 15
  %X INTRODUCTION: PsyCovidApp, a digital intervention aimed at safeguarding the mental health of healthcare workers during the COVID-19 pandemic, demonstrated in a randomized clinical trial to yield significant improvements solely among healthcare workers undergoing psychotherapy or receiving psychotropic medication. OBJECTIVES: (1) To identify contextual factors and mechanisms of action that influenced the impact of PsyCovidApp during the aforementioned trial; (2) To pinpoint enhancements for optimizing its efficacy. MATERIALS AND METHODS: For the first objective, a process evaluation was conducted, amalgamating quantitative techniques (surveying 216 healthcare professionals who had utilized PsyCovidApp during the trial) and qualitative methods (in-depth interviews with 16 healthcare workers). The second objective involved a panel of seven experts, utilizing the RAND-UCLA methodology. RESULTS: The quantitative study (response rate = 40%) revealed that 22% of respondents had not fully accessed the content of PsyCovidApp. The average usage time was 22.7 min/day, being higher (p < 0.05) among consumers of psychotropic medications. Contents related to relaxation and mindfulness were most highly rated. Acceptability and usefulness scores ranged between 7.3-7.5/10 points, with higher ratings (p < 0.05) among women and older healthcare workers. The qualitative study uncovered that the primary barriers to using PsyCovidApp were workload, lack of time, and exhaustion. Its primary mechanisms of action included emotion identification, mental health regulation (e.g., insomnia, intense emotions), and learning of techniques and skills. The expert panel reached a consensus on 29 proposals to optimize PsyCovidApp. CONCLUSION: The knowledge derived from this study could inform the design and implementation of future similar digital tools.
  

• 
  The Effect of a Program to Improve Adherence to the Mediterranean Diet on Cardiometabolic Parameters in 7034 Spanish Workers. Ramírez Gallegos, Ignacio; Marina Arroyo, Marta; López-González, Ángel Arturo; Vicente-Herrero, Maria Teófila; Vallejos, Daniela; Sastre-Alzamora, Tomás; Ramírez-Manent, José Ignacio (2024). 16(7) 1082-.

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: Cardiovascular and metabolic diseases include a large group of pathologies and constitute one of the most serious chronic health problems facing the 21st century, with high rates of morbidity and mortality worldwide. Unhealthy diets influence the development of these pathologies. The Mediterranean diet can be an important part in the treatment of these diseases. The objective of this study was to assess the effect of a program that aims to increase adherence to the Mediterranean diet on the improvement of different cardiometabolic risk parameters. METHODS: A prospective intervention study was carried out on 7034 Spanish workers. Prior to the intervention, 22 cardiometabolic risk scales were evaluated. Participants in this study were informed both orally and in writing of the characteristics and benefits of the Mediterranean diet and were given the website of the Ministry of Health, Consumption and Social Welfare of Spain, which provides advice on nutrition. Adherence to the Mediterranean diet was reinforced by sending a monthly SMS to their mobile phones. After six months of follow-up, the 22 risk scales were re-evaluated to assess changes. Means and standard deviations were calculated using Student's t test to analyse quantitative variables. Prevalence was calculated using the Chi-square test when the variables were qualitative. RESULTS: All the cardiometabolic risk scales studied decreased after implementing a program to improve and enhance adherence to the Mediterranean diet. The number of losses in the sample was very low, standing at 4.31%. CONCLUSIONS: The Mediterranean diet is effective in reducing all cardiovascular risk scales evaluated. The mean values and prevalence of high values of the different cardiometabolic risk scales analysed led to lower values after the implementation of the program to increase adherence to the Mediterranean diet. We observed a significant positive difference in metabolic age in both sexes. We have obtained a significant improvement in the insulin resistance index, especially in the SPISE-IR index, data that we have not found in previous publications. Easy access to the Internet and new information and communication technologies facilitate adherence to a diet and can reduce the number of losses.

  @article{ramirezgallegos2024effect,
  abstract = {BACKGROUND: Cardiovascular and metabolic diseases include a large group of pathologies and constitute one of the most serious chronic health problems facing the 21st century, with high rates of morbidity and mortality worldwide. Unhealthy diets influence the development of these pathologies. The Mediterranean diet can be an important part in the treatment of these diseases. The objective of this study was to assess the effect of a program that aims to increase adherence to the Mediterranean diet on the improvement of different cardiometabolic risk parameters. METHODS: A prospective intervention study was carried out on 7034 Spanish workers. Prior to the intervention, 22 cardiometabolic risk scales were evaluated. Participants in this study were informed both orally and in writing of the characteristics and benefits of the Mediterranean diet and were given the website of the Ministry of Health, Consumption and Social Welfare of Spain, which provides advice on nutrition. Adherence to the Mediterranean diet was reinforced by sending a monthly SMS to their mobile phones. After six months of follow-up, the 22 risk scales were re-evaluated to assess changes. Means and standard deviations were calculated using Student's t test to analyse quantitative variables. Prevalence was calculated using the Chi-square test when the variables were qualitative. RESULTS: All the cardiometabolic risk scales studied decreased after implementing a program to improve and enhance adherence to the Mediterranean diet. The number of losses in the sample was very low, standing at 4.31%. CONCLUSIONS: The Mediterranean diet is effective in reducing all cardiovascular risk scales evaluated. The mean values and prevalence of high values of the different cardiometabolic risk scales analysed led to lower values after the implementation of the program to increase adherence to the Mediterranean diet. We observed a significant positive difference in metabolic age in both sexes. We have obtained a significant improvement in the insulin resistance index, especially in the SPISE-IR index, data that we have not found in previous publications. Easy access to the Internet and new information and communication technologies facilitate adherence to a diet and can reduce the number of losses.},
  address = {Switzerland},
  author = {Ramírez Gallegos, Ignacio and Marina Arroyo, Marta and López-González, Ángel Arturo and Vicente-Herrero, Maria Teófila and Vallejos, Daniela and Sastre-Alzamora, Tomás and Ramírez-Manent, José Ignacio},
  journal = {Nutrients},
  keywords = {grapp-caib},
  month = {apr},
  number = 7,
  pages = {1082--},
  title = {The Effect of a Program to Improve Adherence to the Mediterranean Diet on Cardiometabolic Parameters in 7034 Spanish Workers},
  volume = 16,
  year = 2024
  }
  

  %0 Journal Article
  %1 ramirezgallegos2024effect
  %A Ramírez Gallegos, Ignacio
  %A Marina Arroyo, Marta
  %A López-González, Ángel Arturo
  %A Vicente-Herrero, Maria Teófila
  %A Vallejos, Daniela
  %A Sastre-Alzamora, Tomás
  %A Ramírez-Manent, José Ignacio
  %C Switzerland
  %D 2024
  %J Nutrients
  %N 7
  %P 1082--
  %R 10.3390/nu16071082
  %T The Effect of a Program to Improve Adherence to the Mediterranean Diet on Cardiometabolic Parameters in 7034 Spanish Workers
  %U https://pubmed.ncbi.nlm.nih.gov/38613115
  %V 16
  %X BACKGROUND: Cardiovascular and metabolic diseases include a large group of pathologies and constitute one of the most serious chronic health problems facing the 21st century, with high rates of morbidity and mortality worldwide. Unhealthy diets influence the development of these pathologies. The Mediterranean diet can be an important part in the treatment of these diseases. The objective of this study was to assess the effect of a program that aims to increase adherence to the Mediterranean diet on the improvement of different cardiometabolic risk parameters. METHODS: A prospective intervention study was carried out on 7034 Spanish workers. Prior to the intervention, 22 cardiometabolic risk scales were evaluated. Participants in this study were informed both orally and in writing of the characteristics and benefits of the Mediterranean diet and were given the website of the Ministry of Health, Consumption and Social Welfare of Spain, which provides advice on nutrition. Adherence to the Mediterranean diet was reinforced by sending a monthly SMS to their mobile phones. After six months of follow-up, the 22 risk scales were re-evaluated to assess changes. Means and standard deviations were calculated using Student's t test to analyse quantitative variables. Prevalence was calculated using the Chi-square test when the variables were qualitative. RESULTS: All the cardiometabolic risk scales studied decreased after implementing a program to improve and enhance adherence to the Mediterranean diet. The number of losses in the sample was very low, standing at 4.31%. CONCLUSIONS: The Mediterranean diet is effective in reducing all cardiovascular risk scales evaluated. The mean values and prevalence of high values of the different cardiometabolic risk scales analysed led to lower values after the implementation of the program to increase adherence to the Mediterranean diet. We observed a significant positive difference in metabolic age in both sexes. We have obtained a significant improvement in the insulin resistance index, especially in the SPISE-IR index, data that we have not found in previous publications. Easy access to the Internet and new information and communication technologies facilitate adherence to a diet and can reduce the number of losses.
  

• 
  MAFLD and glomerular hyperfiltration in subjects with normoglycemia, prediabetes and type 2 diabetes: A cross-sectional population study. Abbate, Manuela; Parvanova, Aneliya; López-González, Ángel Arturo; Yañez, Aina M; Bennasar-Veny, Miquel; Ramírez-Manent, José Ignacio; Reseghetti, Elia; Ruggenenti, Piero (2024). 40(4) e3810-e3810.

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: Metabolic dysfunction-associated fatty liver disease (MAFLD, 2020 diagnostic criteria) and glomerular hyperfiltration share common risk factors, including obesity, insulin resistance, impaired glucose tolerance, diabetes, dyslipidemia, and hypertension. AIMS: To assess the prevalence of MAFLD and its association with glomerular hyperfiltration and age-related worsening of kidney function in subjects with normoglycemia, prediabetes and type 2 diabetes mellitus (T2DM). METHODS: We analysed data recorded during occupational health visits of 125,070 Spanish civil servants aged 18-65 years with a de-indexed glomerular filtration rate (GFR) estimated with the chronic-kidney-disease-epidemiological (CKD-EPI) equation (estimated glomerular filtration rate [eGFR]) ≥60 mL/min. Subjects were categorised according to fasting plasma glucose levels <100 mg/dL (normoglycemia), ≥100 and ≤ 125 mg/dL (prediabetes), or ≥126 mg/dL and/or antidiabetic treatment (T2DM). The association between MAFLD and glomerular hyperfiltration, defined as a de-indexed eGFR above the age- and gender-specific 95th percentile, was assessed by multivariable logistic regression. RESULTS: In the whole study group, MAFLD prevalence averaged 19.3%. The prevalence progressively increased from 14.7% to 33.2% and to 48.9% in subjects with normoglycemia, prediabetes and T2DM, respectively (p < 0.001 for trend). Adjusted odds ratio (95% CI) for the association between MAFLD and hyperfiltration was 9.06 (8.53-9.62) in the study group considered as a whole, and 8.60 (8.03-9.21), 9.52 (8.11-11.18) and 8.31 (6.70-10.30) in subjects with normoglycemia, prediabetes and T2DM considered separately. In stratified analyses, MAFLD amplified age-dependent eGFR decline in all groups (p < 0.001). CONCLUSIONS: MAFLD prevalence increases across the glycaemic spectrum. MAFLD is significantly associated with hyperfiltration and amplifies the age-related eGFR decline.

  @article{abbate2024mafld,
  abstract = {BACKGROUND: Metabolic dysfunction-associated fatty liver disease (MAFLD, 2020 diagnostic criteria) and glomerular hyperfiltration share common risk factors, including obesity, insulin resistance, impaired glucose tolerance, diabetes, dyslipidemia, and hypertension. AIMS: To assess the prevalence of MAFLD and its association with glomerular hyperfiltration and age-related worsening of kidney function in subjects with normoglycemia, prediabetes and type 2 diabetes mellitus (T2DM). METHODS: We analysed data recorded during occupational health visits of 125,070 Spanish civil servants aged 18-65 years with a de-indexed glomerular filtration rate (GFR) estimated with the chronic-kidney-disease-epidemiological (CKD-EPI) equation (estimated glomerular filtration rate [eGFR]) ≥60 mL/min. Subjects were categorised according to fasting plasma glucose levels <100 mg/dL (normoglycemia), ≥100 and ≤ 125 mg/dL (prediabetes), or ≥126 mg/dL and/or antidiabetic treatment (T2DM). The association between MAFLD and glomerular hyperfiltration, defined as a de-indexed eGFR above the age- and gender-specific 95th percentile, was assessed by multivariable logistic regression. RESULTS: In the whole study group, MAFLD prevalence averaged 19.3%. The prevalence progressively increased from 14.7% to 33.2% and to 48.9% in subjects with normoglycemia, prediabetes and T2DM, respectively (p < 0.001 for trend). Adjusted odds ratio (95% CI) for the association between MAFLD and hyperfiltration was 9.06 (8.53-9.62) in the study group considered as a whole, and 8.60 (8.03-9.21), 9.52 (8.11-11.18) and 8.31 (6.70-10.30) in subjects with normoglycemia, prediabetes and T2DM considered separately. In stratified analyses, MAFLD amplified age-dependent eGFR decline in all groups (p < 0.001). CONCLUSIONS: MAFLD prevalence increases across the glycaemic spectrum. MAFLD is significantly associated with hyperfiltration and amplifies the age-related eGFR decline.},
  address = {England},
  author = {Abbate, Manuela and Parvanova, Aneliya and López-González, Ángel Arturo and Yañez, Aina M and Bennasar-Veny, Miquel and Ramírez-Manent, José Ignacio and Reseghetti, Elia and Ruggenenti, Piero},
  journal = {Diabetes/metabolism research and reviews},
  keywords = {grapp-caib},
  month = {may},
  number = 4,
  pages = {e3810--e3810},
  title = {MAFLD and glomerular hyperfiltration in subjects with normoglycemia, prediabetes and type 2 diabetes: A cross-sectional population study},
  volume = 40,
  year = 2024
  }
  

  %0 Journal Article
  %1 abbate2024mafld
  %A Abbate, Manuela
  %A Parvanova, Aneliya
  %A López-González, Ángel Arturo
  %A Yañez, Aina M
  %A Bennasar-Veny, Miquel
  %A Ramírez-Manent, José Ignacio
  %A Reseghetti, Elia
  %A Ruggenenti, Piero
  %C England
  %D 2024
  %J Diabetes/metabolism research and reviews
  %N 4
  %P e3810--e3810
  %R 10.1002/dmrr.3810
  %T MAFLD and glomerular hyperfiltration in subjects with normoglycemia, prediabetes and type 2 diabetes: A cross-sectional population study
  %U https://pubmed.ncbi.nlm.nih.gov/38757431
  %V 40
  %X BACKGROUND: Metabolic dysfunction-associated fatty liver disease (MAFLD, 2020 diagnostic criteria) and glomerular hyperfiltration share common risk factors, including obesity, insulin resistance, impaired glucose tolerance, diabetes, dyslipidemia, and hypertension. AIMS: To assess the prevalence of MAFLD and its association with glomerular hyperfiltration and age-related worsening of kidney function in subjects with normoglycemia, prediabetes and type 2 diabetes mellitus (T2DM). METHODS: We analysed data recorded during occupational health visits of 125,070 Spanish civil servants aged 18-65 years with a de-indexed glomerular filtration rate (GFR) estimated with the chronic-kidney-disease-epidemiological (CKD-EPI) equation (estimated glomerular filtration rate [eGFR]) ≥60 mL/min. Subjects were categorised according to fasting plasma glucose levels <100 mg/dL (normoglycemia), ≥100 and ≤ 125 mg/dL (prediabetes), or ≥126 mg/dL and/or antidiabetic treatment (T2DM). The association between MAFLD and glomerular hyperfiltration, defined as a de-indexed eGFR above the age- and gender-specific 95th percentile, was assessed by multivariable logistic regression. RESULTS: In the whole study group, MAFLD prevalence averaged 19.3%. The prevalence progressively increased from 14.7% to 33.2% and to 48.9% in subjects with normoglycemia, prediabetes and T2DM, respectively (p < 0.001 for trend). Adjusted odds ratio (95% CI) for the association between MAFLD and hyperfiltration was 9.06 (8.53-9.62) in the study group considered as a whole, and 8.60 (8.03-9.21), 9.52 (8.11-11.18) and 8.31 (6.70-10.30) in subjects with normoglycemia, prediabetes and T2DM considered separately. In stratified analyses, MAFLD amplified age-dependent eGFR decline in all groups (p < 0.001). CONCLUSIONS: MAFLD prevalence increases across the glycaemic spectrum. MAFLD is significantly associated with hyperfiltration and amplifies the age-related eGFR decline.
  

• 
  Cross-cultural adaptation, reliability and validity of the Spanish version of the long-term quality of life questionnaire. León-Salas, Beatriz; Bilbao-González, Amaia; de Pascual Y Medina, Ana María; Esteva, Magdalena; Toledo-Chávarri, Ana; Fuentes-Sánchez, Claudio; Bohn-Sarmiento, Uriel; Padrón-Peña, Pilar; González-Sánchez, Sonia; Valcárcel-López, Rafael; Trujillo-Martín, María Del Mar (2024). 14 1375125–1375125.

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  PURPOSE: The aim of this study was to translate, culturally adapt, and evaluate the psychometric properties of the Spanish Long-Term Quality of Life (LTQL) questionnaire. METHODS: The LTQL was initially translated into Spanish and cross-culturally adapted based on established guidelines. The Spanish LTQL was administered to patients with breast cancer who had completed their initial treatment 5 years earlier, along with other self-report measures: Quality of Life in Adult Cancer Survivors (QLACS), Hospital Anxiety and Depression Scale (HADS) and EORT-QLQ-BR23. Reliability was evaluated using internal consistency and test-retest. Convergent and known-groups validity were examined. Structural validity as determined by confirmatory factor analysis (CFA) and Rasch analyses was used to assess the unidimensionality and item-functioning of the LTQL domains. RESULTS: Cronbach's alpha were above 0.7 in all domains. Test-retest coefficients were between 0.72 to 0.96 for LTQL domains. LTQL total score was correlated with others total scores of other measures: QLACS (r=-0.39), HADS depression (r=-0.57), HADS anxiety (-0.45) and EORTC-QLQ-BR23 (r=-0.50). CFA provided satisfactory fit indices, with RMSEA value of 0.077 and TLI and CFI values of 0.901 and 0.909, respectively. All factor loadings were higher than 0.40 and statistically significant (P<0.001). Rasch analysis showed that Somatic Concerns domain had 4 misfitting items, and Philosophical/Spiritual View of Life and social Support domains only 1 misfit item. However, unidimensionality was supported for the four domains. CONCLUSION: The findings support the validity and reliability of the Spanish version of LTQL questionnaire to be used in long-term cancer female survivors.

  @article{leonsalas2024crosscultural,
  abstract = {PURPOSE: The aim of this study was to translate, culturally adapt, and evaluate the psychometric properties of the Spanish Long-Term Quality of Life (LTQL) questionnaire. METHODS: The LTQL was initially translated into Spanish and cross-culturally adapted based on established guidelines. The Spanish LTQL was administered to patients with breast cancer who had completed their initial treatment 5 years earlier, along with other self-report measures: Quality of Life in Adult Cancer Survivors (QLACS), Hospital Anxiety and Depression Scale (HADS) and EORT-QLQ-BR23. Reliability was evaluated using internal consistency and test-retest. Convergent and known-groups validity were examined. Structural validity as determined by confirmatory factor analysis (CFA) and Rasch analyses was used to assess the unidimensionality and item-functioning of the LTQL domains. RESULTS: Cronbach's alpha were above 0.7 in all domains. Test-retest coefficients were between 0.72 to 0.96 for LTQL domains. LTQL total score was correlated with others total scores of other measures: QLACS (r=-0.39), HADS depression (r=-0.57), HADS anxiety (-0.45) and EORTC-QLQ-BR23 (r=-0.50). CFA provided satisfactory fit indices, with RMSEA value of 0.077 and TLI and CFI values of 0.901 and 0.909, respectively. All factor loadings were higher than 0.40 and statistically significant (P<0.001). Rasch analysis showed that Somatic Concerns domain had 4 misfitting items, and Philosophical/Spiritual View of Life and social Support domains only 1 misfit item. However, unidimensionality was supported for the four domains. CONCLUSION: The findings support the validity and reliability of the Spanish version of LTQL questionnaire to be used in long-term cancer female survivors.},
  address = {Switzerland},
  author = {León-Salas, Beatriz and Bilbao-González, Amaia and de Pascual Y Medina, Ana María and Esteva, Magdalena and Toledo-Chávarri, Ana and Fuentes-Sánchez, Claudio and Bohn-Sarmiento, Uriel and Padrón-Peña, Pilar and González-Sánchez, Sonia and Valcárcel-López, Rafael and Trujillo-Martín, María Del Mar},
  journal = {Frontiers in oncology},
  keywords = {grapp-caib},
  month = {mar},
  pages = {1375125--1375125},
  title = {Cross-cultural adaptation, reliability and validity of the Spanish version of the long-term quality of life questionnaire},
  volume = 14,
  year = 2024
  }
  

  %0 Journal Article
  %1 leonsalas2024crosscultural
  %A León-Salas, Beatriz
  %A Bilbao-González, Amaia
  %A de Pascual Y Medina, Ana María
  %A Esteva, Magdalena
  %A Toledo-Chávarri, Ana
  %A Fuentes-Sánchez, Claudio
  %A Bohn-Sarmiento, Uriel
  %A Padrón-Peña, Pilar
  %A González-Sánchez, Sonia
  %A Valcárcel-López, Rafael
  %A Trujillo-Martín, María Del Mar
  %C Switzerland
  %D 2024
  %J Frontiers in oncology
  %P 1375125--1375125
  %R 10.3389/fonc.2024.1375125
  %T Cross-cultural adaptation, reliability and validity of the Spanish version of the long-term quality of life questionnaire
  %U https://pubmed.ncbi.nlm.nih.gov/38567161
  %V 14
  %X PURPOSE: The aim of this study was to translate, culturally adapt, and evaluate the psychometric properties of the Spanish Long-Term Quality of Life (LTQL) questionnaire. METHODS: The LTQL was initially translated into Spanish and cross-culturally adapted based on established guidelines. The Spanish LTQL was administered to patients with breast cancer who had completed their initial treatment 5 years earlier, along with other self-report measures: Quality of Life in Adult Cancer Survivors (QLACS), Hospital Anxiety and Depression Scale (HADS) and EORT-QLQ-BR23. Reliability was evaluated using internal consistency and test-retest. Convergent and known-groups validity were examined. Structural validity as determined by confirmatory factor analysis (CFA) and Rasch analyses was used to assess the unidimensionality and item-functioning of the LTQL domains. RESULTS: Cronbach's alpha were above 0.7 in all domains. Test-retest coefficients were between 0.72 to 0.96 for LTQL domains. LTQL total score was correlated with others total scores of other measures: QLACS (r=-0.39), HADS depression (r=-0.57), HADS anxiety (-0.45) and EORTC-QLQ-BR23 (r=-0.50). CFA provided satisfactory fit indices, with RMSEA value of 0.077 and TLI and CFI values of 0.901 and 0.909, respectively. All factor loadings were higher than 0.40 and statistically significant (P<0.001). Rasch analysis showed that Somatic Concerns domain had 4 misfitting items, and Philosophical/Spiritual View of Life and social Support domains only 1 misfit item. However, unidimensionality was supported for the four domains. CONCLUSION: The findings support the validity and reliability of the Spanish version of LTQL questionnaire to be used in long-term cancer female survivors.
  

• 
  Effectiveness of medication self-management, self-monitoring and a lifestyle intervention on hypertension in poorly controlled patients: The MEDICHY randomized trial. Unda Villafuerte, Fabián; Llobera Cànaves, Joan; Estela Mantolan, Andreu; Bassante Flores, Patricia; Rigo Carratalà, Fernando; Requena Hernández, Ana; Oliver Oliver, Bartolomé; Pou Bordoy, Joan; Moreno Sancho, María Lucía; Leiva, Alfonso; Lorente Montalvo, Patricia; Group, MEDICHY (2024). 11 1355037–1355037.

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: Uncontrolled hypertension is a common problem worldwide, despite the availability of many effective antihypertensive drugs and lifestyle interventions. We assessed the efficacy of a multi-component intervention in individuals with uncontrolled hypertension in a primary care setting. METHODS: This study was a randomized, multicenter, parallel, two-arm, single-blind controlled trial performed in primary healthcare centers in Mallorca (Spain). All participants were 35 to 75-years-old and had poorly controlled hypertension. Patients were randomly assigned in a 1:1 ratio to a control group (usual care) or an intervention group (self-monitoring of blood pressure, self-titration of hypertensive medications, dietary interventions, and physical activity interventions). The primary outcome was decrease in the mean SBP at 6 months relative to baseline. RESULTS: A total of 153 participants were randomized to an intervention group (77) or a control group (76). After 6 months, the intervention group had a significantly lower systolic blood pressure (135.1 mmHg [±14.8] vs. 142.7 mmHg [±15.0], adjusted mean difference: 8.7 mmHg [95% CI: 3.4, 13.9], p < 0.001) and a significantly lower diastolic blood pressure (83.5 mmHg [±8.8] vs. 87.00 mmHg [±9.0], adjusted mean difference: 5.4 [95% CI: 2.9, 7.8], p < 0.0001). The intervention group also had significantly more patients who achieved successful blood pressure control (<140/90 mmHg; 54.4% vs. 32.9%, p = 0.011). DISCUSSION: Self-monitoring of blood pressure in combination with self-management of hypertensive medications, diet, and physical activity in a primary care setting leads to significantly lower blood pressure in patients with poorly controlled hypertension.Clinical Trial Registration: ClinicalTrials.gov, identifier ISRCTN14433778.

  @article{undavillafuerte2024effectiveness,
  abstract = {BACKGROUND: Uncontrolled hypertension is a common problem worldwide, despite the availability of many effective antihypertensive drugs and lifestyle interventions. We assessed the efficacy of a multi-component intervention in individuals with uncontrolled hypertension in a primary care setting. METHODS: This study was a randomized, multicenter, parallel, two-arm, single-blind controlled trial performed in primary healthcare centers in Mallorca (Spain). All participants were 35 to 75-years-old and had poorly controlled hypertension. Patients were randomly assigned in a 1:1 ratio to a control group (usual care) or an intervention group (self-monitoring of blood pressure, self-titration of hypertensive medications, dietary interventions, and physical activity interventions). The primary outcome was decrease in the mean SBP at 6 months relative to baseline. RESULTS: A total of 153 participants were randomized to an intervention group (77) or a control group (76). After 6 months, the intervention group had a significantly lower systolic blood pressure (135.1 mmHg [±14.8] vs. 142.7 mmHg [±15.0], adjusted mean difference: 8.7 mmHg [95% CI: 3.4, 13.9], p < 0.001) and a significantly lower diastolic blood pressure (83.5 mmHg [±8.8] vs. 87.00 mmHg [±9.0], adjusted mean difference: 5.4 [95% CI: 2.9, 7.8], p < 0.0001). The intervention group also had significantly more patients who achieved successful blood pressure control (<140/90 mmHg; 54.4% vs. 32.9%, p = 0.011). DISCUSSION: Self-monitoring of blood pressure in combination with self-management of hypertensive medications, diet, and physical activity in a primary care setting leads to significantly lower blood pressure in patients with poorly controlled hypertension.Clinical Trial Registration: ClinicalTrials.gov, identifier ISRCTN14433778.},
  address = {Switzerland},
  author = {Unda Villafuerte, Fabián and Llobera Cànaves, Joan and Estela Mantolan, Andreu and Bassante Flores, Patricia and Rigo Carratalà, Fernando and Requena Hernández, Ana and Oliver Oliver, Bartolomé and Pou Bordoy, Joan and Moreno Sancho, María Lucía and Leiva, Alfonso and Lorente Montalvo, Patricia and Group, MEDICHY},
  journal = {Frontiers in cardiovascular medicine},
  keywords = {grapp-caib},
  month = {may},
  pages = {1355037--1355037},
  title = {Effectiveness of medication self-management, self-monitoring and a lifestyle intervention on hypertension in poorly controlled patients: The MEDICHY randomized trial},
  volume = 11,
  year = 2024
  }
  

  %0 Journal Article
  %1 undavillafuerte2024effectiveness
  %A Unda Villafuerte, Fabián
  %A Llobera Cànaves, Joan
  %A Estela Mantolan, Andreu
  %A Bassante Flores, Patricia
  %A Rigo Carratalà, Fernando
  %A Requena Hernández, Ana
  %A Oliver Oliver, Bartolomé
  %A Pou Bordoy, Joan
  %A Moreno Sancho, María Lucía
  %A Leiva, Alfonso
  %A Lorente Montalvo, Patricia
  %A Group, MEDICHY
  %C Switzerland
  %D 2024
  %J Frontiers in cardiovascular medicine
  %P 1355037--1355037
  %R 10.3389/fcvm.2024.1355037
  %T Effectiveness of medication self-management, self-monitoring and a lifestyle intervention on hypertension in poorly controlled patients: The MEDICHY randomized trial
  %U https://pubmed.ncbi.nlm.nih.gov/38836068
  %V 11
  %X BACKGROUND: Uncontrolled hypertension is a common problem worldwide, despite the availability of many effective antihypertensive drugs and lifestyle interventions. We assessed the efficacy of a multi-component intervention in individuals with uncontrolled hypertension in a primary care setting. METHODS: This study was a randomized, multicenter, parallel, two-arm, single-blind controlled trial performed in primary healthcare centers in Mallorca (Spain). All participants were 35 to 75-years-old and had poorly controlled hypertension. Patients were randomly assigned in a 1:1 ratio to a control group (usual care) or an intervention group (self-monitoring of blood pressure, self-titration of hypertensive medications, dietary interventions, and physical activity interventions). The primary outcome was decrease in the mean SBP at 6 months relative to baseline. RESULTS: A total of 153 participants were randomized to an intervention group (77) or a control group (76). After 6 months, the intervention group had a significantly lower systolic blood pressure (135.1 mmHg [±14.8] vs. 142.7 mmHg [±15.0], adjusted mean difference: 8.7 mmHg [95% CI: 3.4, 13.9], p < 0.001) and a significantly lower diastolic blood pressure (83.5 mmHg [±8.8] vs. 87.00 mmHg [±9.0], adjusted mean difference: 5.4 [95% CI: 2.9, 7.8], p < 0.0001). The intervention group also had significantly more patients who achieved successful blood pressure control (<140/90 mmHg; 54.4% vs. 32.9%, p = 0.011). DISCUSSION: Self-monitoring of blood pressure in combination with self-management of hypertensive medications, diet, and physical activity in a primary care setting leads to significantly lower blood pressure in patients with poorly controlled hypertension.Clinical Trial Registration: ClinicalTrials.gov, identifier ISRCTN14433778.
  

• 
  Exploring personal aptitudes and personality traits that, together with social determinants, shape health behaviors and conduct: a thematic analysis based on the Capability, Opportunity, Motivation and Behavior (COM-B) change system. Young-Silva, Yudy; Berenguera, Anna; Juvinyà-Canal, Dolors; Martí-Lluch, Ruth; Arroyo-Uriarte, Paula; Tamayo-Morales, Olaya; Marcilla-Toribio, Irene; Elizondo-Alzola, Usue; Méndez-López, Fátima; Chela-Àlvarez, Xènia; Motrico, Emma (2024). 12 1387528–1387528.

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  INTRODUCTION: Effective implementation of strategies to promote health and prevent noncommunicable illnesses requires a profound understanding of the interaction between the individual and society. This study brings to health research the consideration of psychosocial factors that influence the maintenance and change of health behaviors and conduct. From a primary care perspective, it is crucial to propose a biopsychosocial approach for the development of health promotion and self-care programs that embrace personal aptitudes as a relevant individual aspect. OBJECTIVES: To explore experiences related to personal aptitudes and personality traits that influence health behaviors and conduct, taking into account the social determinants of health, through a thematic analysis based on the capability-opportunity-motivation and behavior (COM-B) system. METHODS AND ANALYSIS: This qualitative research is carried out from a descriptive phenomenological perspective, based on 17 focus groups in which 156 people participated. Inductive and deductive analysis techniques were used following Lincoln and Guba's criteria of methodological rigor. In addition to 7 different triangulations of analysts, 6 main categories were identified based on the COM-B system: psychological capacity, physical capacity, physical opportunity, social opportunity, reflective motivation, and automatic motivation. The importance of considering these factors to promote healthy behaviors was stressed. DISCUSSION: This study examined how personal experiences related personal aptitudes and personality traits influence health behaviors and conduct in Spain. It was found that personality traits such as health literacy, self-efficacy, activation, and self-determination can influence the adoption of healthy behaviors. Likewise, the need for control, overthinking, and ambivalence made it impossible. Furthermore, social determinants of health and interpersonal relationships also play an important role. TRIAL REGISTRATION: ClinicalTrials.gov, NCT04386135. Registered on April 30, 2020.

  @article{youngsilva2024exploring,
  abstract = {INTRODUCTION: Effective implementation of strategies to promote health and prevent noncommunicable illnesses requires a profound understanding of the interaction between the individual and society. This study brings to health research the consideration of psychosocial factors that influence the maintenance and change of health behaviors and conduct. From a primary care perspective, it is crucial to propose a biopsychosocial approach for the development of health promotion and self-care programs that embrace personal aptitudes as a relevant individual aspect. OBJECTIVES: To explore experiences related to personal aptitudes and personality traits that influence health behaviors and conduct, taking into account the social determinants of health, through a thematic analysis based on the capability-opportunity-motivation and behavior (COM-B) system. METHODS AND ANALYSIS: This qualitative research is carried out from a descriptive phenomenological perspective, based on 17 focus groups in which 156 people participated. Inductive and deductive analysis techniques were used following Lincoln and Guba's criteria of methodological rigor. In addition to 7 different triangulations of analysts, 6 main categories were identified based on the COM-B system: psychological capacity, physical capacity, physical opportunity, social opportunity, reflective motivation, and automatic motivation. The importance of considering these factors to promote healthy behaviors was stressed. DISCUSSION: This study examined how personal experiences related personal aptitudes and personality traits influence health behaviors and conduct in Spain. It was found that personality traits such as health literacy, self-efficacy, activation, and self-determination can influence the adoption of healthy behaviors. Likewise, the need for control, overthinking, and ambivalence made it impossible. Furthermore, social determinants of health and interpersonal relationships also play an important role. TRIAL REGISTRATION: ClinicalTrials.gov, NCT04386135. Registered on April 30, 2020.},
  address = {Switzerland},
  author = {Young-Silva, Yudy and Berenguera, Anna and Juvinyà-Canal, Dolors and Martí-Lluch, Ruth and Arroyo-Uriarte, Paula and Tamayo-Morales, Olaya and Marcilla-Toribio, Irene and Elizondo-Alzola, Usue and Méndez-López, Fátima and Chela-Àlvarez, Xènia and Motrico, Emma},
  journal = {Frontiers in public health},
  keywords = {grapp-caib},
  month = {jun},
  pages = {1387528--1387528},
  title = {Exploring personal aptitudes and personality traits that, together with social determinants, shape health behaviors and conduct: a thematic analysis based on the Capability, Opportunity, Motivation and Behavior (COM-B) change system},
  volume = 12,
  year = 2024
  }
  

  %0 Journal Article
  %1 youngsilva2024exploring
  %A Young-Silva, Yudy
  %A Berenguera, Anna
  %A Juvinyà-Canal, Dolors
  %A Martí-Lluch, Ruth
  %A Arroyo-Uriarte, Paula
  %A Tamayo-Morales, Olaya
  %A Marcilla-Toribio, Irene
  %A Elizondo-Alzola, Usue
  %A Méndez-López, Fátima
  %A Chela-Àlvarez, Xènia
  %A Motrico, Emma
  %C Switzerland
  %D 2024
  %J Frontiers in public health
  %P 1387528--1387528
  %R 10.3389/fpubh.2024.1387528
  %T Exploring personal aptitudes and personality traits that, together with social determinants, shape health behaviors and conduct: a thematic analysis based on the Capability, Opportunity, Motivation and Behavior (COM-B) change system
  %U https://pubmed.ncbi.nlm.nih.gov/38898892
  %V 12
  %X INTRODUCTION: Effective implementation of strategies to promote health and prevent noncommunicable illnesses requires a profound understanding of the interaction between the individual and society. This study brings to health research the consideration of psychosocial factors that influence the maintenance and change of health behaviors and conduct. From a primary care perspective, it is crucial to propose a biopsychosocial approach for the development of health promotion and self-care programs that embrace personal aptitudes as a relevant individual aspect. OBJECTIVES: To explore experiences related to personal aptitudes and personality traits that influence health behaviors and conduct, taking into account the social determinants of health, through a thematic analysis based on the capability-opportunity-motivation and behavior (COM-B) system. METHODS AND ANALYSIS: This qualitative research is carried out from a descriptive phenomenological perspective, based on 17 focus groups in which 156 people participated. Inductive and deductive analysis techniques were used following Lincoln and Guba's criteria of methodological rigor. In addition to 7 different triangulations of analysts, 6 main categories were identified based on the COM-B system: psychological capacity, physical capacity, physical opportunity, social opportunity, reflective motivation, and automatic motivation. The importance of considering these factors to promote healthy behaviors was stressed. DISCUSSION: This study examined how personal experiences related personal aptitudes and personality traits influence health behaviors and conduct in Spain. It was found that personality traits such as health literacy, self-efficacy, activation, and self-determination can influence the adoption of healthy behaviors. Likewise, the need for control, overthinking, and ambivalence made it impossible. Furthermore, social determinants of health and interpersonal relationships also play an important role. TRIAL REGISTRATION: ClinicalTrials.gov, NCT04386135. Registered on April 30, 2020.
  

• 
  Associations Between Metabolic Age, Sociodemographic Variables, and Lifestyle Factors in Spanish Workers. Ramírez-Gallegos, Ignacio; Marina-Arroyo, Marta; López-González, Ángel Arturo; Vallejos, Daniela; Martínez-Almoyna-Rifá, Emilio; Tárraga López, Pedro Juan; Ramírez-Manent, José Ignacio (2024). 16(23) 4207-.

  AbstractURLBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND: Metabolic age is defined as an estimation of a person's age based on their basal metabolic rate (BMR) and other physiological health indicators. Unlike chronological age, which simply measures the number of years lived since birth, metabolic age is based on various health and fitness markers that estimate the body's "true" biological age and can be assessed using various methodologies, including bioimpedance. The aim of this study was to evaluate how age, sex, social class, smoking habits, physical activity, and adherence to the Mediterranean diet influence metabolic age. METHODS: A cross-sectional, descriptive study was conducted on 8590 Spanish workers in the Balearic Islands. A series of sociodemographic variables and health-related habits were assessed, while metabolic age was measured using bioimpedance. A metabolic age exceeding chronological age by 12 years or more was considered high. A descriptive analysis of categorical variables was performed by calculating their frequency and distribution. By applying multivariate models, specifically multinomial logistic regression, we observe that all independent variables (sex, age, social class, physical activity, mediterranean diet, and smoking) show varying levels of association with the occurrence of high metabolic age values. Among these independent variables, those showing the highest degree of association, represented by odds ratios, are physical activity, adherence to the Mediterranean diet, and social class. In all cases, the observed differences demonstrate a high level of statistical significance (p < 0.001). RESULTS: The factors with the greatest influence were physical inactivity, with an OR of 5.07; and low adherence to the Mediterranean diet, with an OR of 2.8; followed by social class, with an OR of 2.51. Metabolic age increased with chronological age and was higher in males, with an OR of 1.38. Smoking also had a negative impact on metabolic age, with an OR of 1.19. CONCLUSIONS: Mediterranean diet is associated with a higher metabolic age. The most influential factors on metabolic age are physical activity and adherence to the Mediterranean diet, followed by the individual's socioeconomic class. Smoking also contributes to increased metabolic age, albeit to a lesser extent.

  @article{ramirezgallegos2024associations,
  abstract = {BACKGROUND: Metabolic age is defined as an estimation of a person's age based on their basal metabolic rate (BMR) and other physiological health indicators. Unlike chronological age, which simply measures the number of years lived since birth, metabolic age is based on various health and fitness markers that estimate the body's "true" biological age and can be assessed using various methodologies, including bioimpedance. The aim of this study was to evaluate how age, sex, social class, smoking habits, physical activity, and adherence to the Mediterranean diet influence metabolic age. METHODS: A cross-sectional, descriptive study was conducted on 8590 Spanish workers in the Balearic Islands. A series of sociodemographic variables and health-related habits were assessed, while metabolic age was measured using bioimpedance. A metabolic age exceeding chronological age by 12 years or more was considered high. A descriptive analysis of categorical variables was performed by calculating their frequency and distribution. By applying multivariate models, specifically multinomial logistic regression, we observe that all independent variables (sex, age, social class, physical activity, mediterranean diet, and smoking) show varying levels of association with the occurrence of high metabolic age values. Among these independent variables, those showing the highest degree of association, represented by odds ratios, are physical activity, adherence to the Mediterranean diet, and social class. In all cases, the observed differences demonstrate a high level of statistical significance (p < 0.001). RESULTS: The factors with the greatest influence were physical inactivity, with an OR of 5.07; and low adherence to the Mediterranean diet, with an OR of 2.8; followed by social class, with an OR of 2.51. Metabolic age increased with chronological age and was higher in males, with an OR of 1.38. Smoking also had a negative impact on metabolic age, with an OR of 1.19. CONCLUSIONS: Mediterranean diet is associated with a higher metabolic age. The most influential factors on metabolic age are physical activity and adherence to the Mediterranean diet, followed by the individual's socioeconomic class. Smoking also contributes to increased metabolic age, albeit to a lesser extent.},
  address = {Switzerland},
  author = {Ramírez-Gallegos, Ignacio and Marina-Arroyo, Marta and López-González, Ángel Arturo and Vallejos, Daniela and Martínez-Almoyna-Rifá, Emilio and Tárraga López, Pedro Juan and Ramírez-Manent, José Ignacio},
  journal = {Nutrients},
  keywords = {grapp-caib},
  month = {dec},
  number = 23,
  pages = {4207--},
  title = {Associations Between Metabolic Age, Sociodemographic Variables, and Lifestyle Factors in Spanish Workers},
  volume = 16,
  year = 2024
  }
  

  %0 Journal Article
  %1 ramirezgallegos2024associations
  %A Ramírez-Gallegos, Ignacio
  %A Marina-Arroyo, Marta
  %A López-González, Ángel Arturo
  %A Vallejos, Daniela
  %A Martínez-Almoyna-Rifá, Emilio
  %A Tárraga López, Pedro Juan
  %A Ramírez-Manent, José Ignacio
  %C Switzerland
  %D 2024
  %J Nutrients
  %N 23
  %P 4207--
  %R 10.3390/nu16234207
  %T Associations Between Metabolic Age, Sociodemographic Variables, and Lifestyle Factors in Spanish Workers
  %U https://pubmed.ncbi.nlm.nih.gov/39683600
  %V 16
  %X BACKGROUND: Metabolic age is defined as an estimation of a person's age based on their basal metabolic rate (BMR) and other physiological health indicators. Unlike chronological age, which simply measures the number of years lived since birth, metabolic age is based on various health and fitness markers that estimate the body's "true" biological age and can be assessed using various methodologies, including bioimpedance. The aim of this study was to evaluate how age, sex, social class, smoking habits, physical activity, and adherence to the Mediterranean diet influence metabolic age. METHODS: A cross-sectional, descriptive study was conducted on 8590 Spanish workers in the Balearic Islands. A series of sociodemographic variables and health-related habits were assessed, while metabolic age was measured using bioimpedance. A metabolic age exceeding chronological age by 12 years or more was considered high. A descriptive analysis of categorical variables was performed by calculating their frequency and distribution. By applying multivariate models, specifically multinomial logistic regression, we observe that all independent variables (sex, age, social class, physical activity, mediterranean diet, and smoking) show varying levels of association with the occurrence of high metabolic age values. Among these independent variables, those showing the highest degree of association, represented by odds ratios, are physical activity, adherence to the Mediterranean diet, and social class. In all cases, the observed differences demonstrate a high level of statistical significance (p < 0.001). RESULTS: The factors with the greatest influence were physical inactivity, with an OR of 5.07; and low adherence to the Mediterranean diet, with an OR of 2.8; followed by social class, with an OR of 2.51. Metabolic age increased with chronological age and was higher in males, with an OR of 1.38. Smoking also had a negative impact on metabolic age, with an OR of 1.19. CONCLUSIONS: Mediterranean diet is associated with a higher metabolic age. The most influential factors on metabolic age are physical activity and adherence to the Mediterranean diet, followed by the individual's socioeconomic class. Smoking also contributes to increased metabolic age, albeit to a lesser extent.
  

2022

• 
  Combined Body Mass Index and Waist-to-Height Ratio and Its Association with Lifestyle and Health Factors among Spanish Children: The PASOS Study. Bibiloni, M. D. M.; Gallardo-Alfaro, L.; Gómez, S. F.; Wärnberg, J.; Osés-Recalde, M.; González-Gross, M.; Gusi, N.; Aznar, S.; Marín-Cascales, E.; González-Valeiro, M.; Serra-Majem, L.; Terrados, N.; Segu, M.; Lassale, C.; Homs, C.; Benavente-Marín, J. C.; Labayen, I.; Zapico, A. G.; Sánchez-Gómez, J.; Jiménez-Zazo, F.; Alcaraz, P. E.; Sevilla-Sánchez, M.; Herrera-Ramos, E.; Pulgar, S.; Sistac, C.; Schröder, H.; Bouzas, C.; Tur, J. A. (2022). 14(2)

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  BACKGROUND AND AIMS: The World Health Organization recommended simultaneous measurement of body mass index (BMI) and waist circumference (WC) and suggested joint use to predict disease risks. The aim of this study was to assess the prevalence of BMI and waist-to-height ratio (WHtR) categories among Spanish children and adolescents, as well as their associations with several lifestyle factors. METHODS: Cross-sectional analysis of 8-16-year-old children and adolescents (n = 3772) were included in the PASOS nationwide representative study. Children/adolescents and their mothers/female caregivers answered a questionnaire on lifestyle and health factors. Child/adolescent anthropometrics were measured. Four combined BMI-WHtR disease risk categories were built. RESULTS: A third of participants showed combined BMI-WHtR categories with high disease risk (12.3% 'increased risk', 9.7% 'high risk', 14.3% 'very high risk'). Participants in the 'very high risk' group were less likely to be females (odds ratio 0.63; 95% CI: 0.52-0.76) and adolescents (0.60; 95% CI: 0.49-0.72), to practice ≥60 min/day of moderate-vigorous physical activity (MVPA) (0.73; 95% CI: 0.57-0.93), and to watch <120 min/day of total screen time on weekdays (0.61; 95% CI: 0.49-0.76). Mothers of participants in the 'very high risk' group were less likely to have a high educational level, be in the overweight or normal range, have never smoked or were former smokers, and watch <120 min/day of total screen time on weekends. Participants in the 'increased' and 'high risk' categories had mothers with normal weight and ≥60 min/day of MVPA. Participants in the 'high risk' group did not achieve ≥60 min/day of MVPA and showed lower adherence to the Mediterranean diet. CONCLUSIONS: Adherence to a healthy lifestyle in children and adolescents, but also in their mothers/female caregivers during offspring's childhood and adolescence, is associated with low BMI-WHtR disease risk.

  @article{RN78,
  abstract = {BACKGROUND AND AIMS: The World Health Organization recommended simultaneous measurement of body mass index (BMI) and waist circumference (WC) and suggested joint use to predict disease risks. The aim of this study was to assess the prevalence of BMI and waist-to-height ratio (WHtR) categories among Spanish children and adolescents, as well as their associations with several lifestyle factors. METHODS: Cross-sectional analysis of 8-16-year-old children and adolescents (n = 3772) were included in the PASOS nationwide representative study. Children/adolescents and their mothers/female caregivers answered a questionnaire on lifestyle and health factors. Child/adolescent anthropometrics were measured. Four combined BMI-WHtR disease risk categories were built. RESULTS: A third of participants showed combined BMI-WHtR categories with high disease risk (12.3% 'increased risk', 9.7% 'high risk', 14.3% 'very high risk'). Participants in the 'very high risk' group were less likely to be females (odds ratio 0.63; 95% CI: 0.52-0.76) and adolescents (0.60; 95% CI: 0.49-0.72), to practice ≥60 min/day of moderate-vigorous physical activity (MVPA) (0.73; 95% CI: 0.57-0.93), and to watch <120 min/day of total screen time on weekdays (0.61; 95% CI: 0.49-0.76). Mothers of participants in the 'very high risk' group were less likely to have a high educational level, be in the overweight or normal range, have never smoked or were former smokers, and watch <120 min/day of total screen time on weekends. Participants in the 'increased' and 'high risk' categories had mothers with normal weight and ≥60 min/day of MVPA. Participants in the 'high risk' group did not achieve ≥60 min/day of MVPA and showed lower adherence to the Mediterranean diet. CONCLUSIONS: Adherence to a healthy lifestyle in children and adolescents, but also in their mothers/female caregivers during offspring's childhood and adolescence, is associated with low BMI-WHtR disease risk.},
  author = {Bibiloni, M. D. M. and Gallardo-Alfaro, L. and Gómez, S. F. and Wärnberg, J. and Osés-Recalde, M. and González-Gross, M. and Gusi, N. and Aznar, S. and Marín-Cascales, E. and González-Valeiro, M. and Serra-Majem, L. and Terrados, N. and Segu, M. and Lassale, C. and Homs, C. and Benavente-Marín, J. C. and Labayen, I. and Zapico, A. G. and Sánchez-Gómez, J. and Jiménez-Zazo, F. and Alcaraz, P. E. and Sevilla-Sánchez, M. and Herrera-Ramos, E. and Pulgar, S. and Sistac, C. and Schröder, H. and Bouzas, C. and Tur, J. A.},
  journal = {Nutrients},
  keywords = {grapp-caib},
  number = 2,
  title = {Combined Body Mass Index and Waist-to-Height Ratio and Its Association with Lifestyle and Health Factors among Spanish Children: The PASOS Study},
  type = {Journal Article},
  volume = 14,
  year = 2022
  }
  

  %0 Journal Article
  %1 RN78
  %A Bibiloni, M. D. M.
  %A Gallardo-Alfaro, L.
  %A Gómez, S. F.
  %A Wärnberg, J.
  %A Osés-Recalde, M.
  %A González-Gross, M.
  %A Gusi, N.
  %A Aznar, S.
  %A Marín-Cascales, E.
  %A González-Valeiro, M.
  %A Serra-Majem, L.
  %A Terrados, N.
  %A Segu, M.
  %A Lassale, C.
  %A Homs, C.
  %A Benavente-Marín, J. C.
  %A Labayen, I.
  %A Zapico, A. G.
  %A Sánchez-Gómez, J.
  %A Jiménez-Zazo, F.
  %A Alcaraz, P. E.
  %A Sevilla-Sánchez, M.
  %A Herrera-Ramos, E.
  %A Pulgar, S.
  %A Sistac, C.
  %A Schröder, H.
  %A Bouzas, C.
  %A Tur, J. A.
  %D 2022
  %J Nutrients
  %N 2
  %R 10.3390/nu14020234
  %T Combined Body Mass Index and Waist-to-Height Ratio and Its Association with Lifestyle and Health Factors among Spanish Children: The PASOS Study
  %V 14
  %X BACKGROUND AND AIMS: The World Health Organization recommended simultaneous measurement of body mass index (BMI) and waist circumference (WC) and suggested joint use to predict disease risks. The aim of this study was to assess the prevalence of BMI and waist-to-height ratio (WHtR) categories among Spanish children and adolescents, as well as their associations with several lifestyle factors. METHODS: Cross-sectional analysis of 8-16-year-old children and adolescents (n = 3772) were included in the PASOS nationwide representative study. Children/adolescents and their mothers/female caregivers answered a questionnaire on lifestyle and health factors. Child/adolescent anthropometrics were measured. Four combined BMI-WHtR disease risk categories were built. RESULTS: A third of participants showed combined BMI-WHtR categories with high disease risk (12.3% 'increased risk', 9.7% 'high risk', 14.3% 'very high risk'). Participants in the 'very high risk' group were less likely to be females (odds ratio 0.63; 95% CI: 0.52-0.76) and adolescents (0.60; 95% CI: 0.49-0.72), to practice ≥60 min/day of moderate-vigorous physical activity (MVPA) (0.73; 95% CI: 0.57-0.93), and to watch <120 min/day of total screen time on weekdays (0.61; 95% CI: 0.49-0.76). Mothers of participants in the 'very high risk' group were less likely to have a high educational level, be in the overweight or normal range, have never smoked or were former smokers, and watch <120 min/day of total screen time on weekends. Participants in the 'increased' and 'high risk' categories had mothers with normal weight and ≥60 min/day of MVPA. Participants in the 'high risk' group did not achieve ≥60 min/day of MVPA and showed lower adherence to the Mediterranean diet. CONCLUSIONS: Adherence to a healthy lifestyle in children and adolescents, but also in their mothers/female caregivers during offspring's childhood and adolescence, is associated with low BMI-WHtR disease risk.
  

2021

• 
  Pluralistic task shifting for a more timely cancer diagnosis. A grounded theory study from a primary care perspective. Thulesius, H.; Sandén, U.; Petek, D.; Hoffman, R.; Koskela, T.; Oliva-Fanlo, B.; Neves, A. L.; Hajdarevic, S.; Harrysson, L.; Toftegaard, B. S.; Vedsted, P.; Harris, M. (2021). 39(4) 486–497.

  AbstractBibTeXEndNoteDOIBibSonomyDownload

  OBJECTIVE: To explore how cancer could be diagnosed in a more timely way. DESIGN: Grounded theory analysis of primary care physicians' free text survey responses to: 'How do you think the speed of diagnosis of cancer in primary care could be improved?'. Secondary analysis of primary care physician interviews, survey responses, literature. SETTING: Primary care in 20 European Örenäs Research Group countries. SUBJECTS: Primary care physicians: 1352 survey respondents (2013-2016), 20 Spanish and 7 Swedish interviewees (2015-2019). MAIN OUTCOME MEASURES: Conceptual explanation of how to improve timeliness of cancer diagnosis. RESULTS: Pluralistic task shifting is a grounded theory of a composite strategy. It includes task sharing - among nurses, physicians, nurse assistants, secretaries, and patients - and changing tasks with cancer screening when appropriate or cancer fast-tracks to accelerate cancer case finding. A pluralistic dialogue culture of comprehensive collaboration and task redistribution is required for effective pluralistic task shifting. Pluralistic task shifting relies on cognitive task shifting, which includes learning more about slow analytic reasoning and fast automatic thinking initiated by pattern recognition; and digital task shifting, which by use of eHealth and telemedicine bridges time and place and improves power symmetry between patients, caregivers, and clinicians. Financial task shifting that involves cost tracking followed by reallocation of funds is necessary for the restructuring and retraining required for successful pluralistic task shifting. A timely diagnosis reduces expensive investigations and waiting times. Also, late-stage cancers are costlier to treat than early-stage cancers. Timing is central to cancer diagnosis: not too early to avoid overdiagnosis, and never too late. CONCLUSIONS: We present pluralistic task shifting as a conceptual summary of strategies needed to optimise the timeliness of cancer diagnosis.Key pointsCancer diagnosis is under-researched in primary care, especially theoretically. Thus, inspired by classic grounded theory, we analysed and conceptualised the field:Pluralistic task shifting is a conceptual explanation of how the timeliness of cancer diagnosis could be improved, with data derived mostly from primary care physicians.This includes task sharing and changing tasks including screening and cancer fast-tracks to accelerate cancer case finding, and requires cognitive task shifting emphasising learning, and digital task shifting involving the use of eHealth and telemedicine.Financial task shifting with cost tracking and reallocation of funds is eventually necessary for successful pluralistic task shifting to happen.

  @article{RN75,
  abstract = {OBJECTIVE: To explore how cancer could be diagnosed in a more timely way. DESIGN: Grounded theory analysis of primary care physicians' free text survey responses to: 'How do you think the speed of diagnosis of cancer in primary care could be improved?'. Secondary analysis of primary care physician interviews, survey responses, literature. SETTING: Primary care in 20 European Örenäs Research Group countries. SUBJECTS: Primary care physicians: 1352 survey respondents (2013-2016), 20 Spanish and 7 Swedish interviewees (2015-2019). MAIN OUTCOME MEASURES: Conceptual explanation of how to improve timeliness of cancer diagnosis. RESULTS: Pluralistic task shifting is a grounded theory of a composite strategy. It includes task sharing - among nurses, physicians, nurse assistants, secretaries, and patients - and changing tasks with cancer screening when appropriate or cancer fast-tracks to accelerate cancer case finding. A pluralistic dialogue culture of comprehensive collaboration and task redistribution is required for effective pluralistic task shifting. Pluralistic task shifting relies on cognitive task shifting, which includes learning more about slow analytic reasoning and fast automatic thinking initiated by pattern recognition; and digital task shifting, which by use of eHealth and telemedicine bridges time and place and improves power symmetry between patients, caregivers, and clinicians. Financial task shifting that involves cost tracking followed by reallocation of funds is necessary for the restructuring and retraining required for successful pluralistic task shifting. A timely diagnosis reduces expensive investigations and waiting times. Also, late-stage cancers are costlier to treat than early-stage cancers. Timing is central to cancer diagnosis: not too early to avoid overdiagnosis, and never too late. CONCLUSIONS: We present pluralistic task shifting as a conceptual summary of strategies needed to optimise the timeliness of cancer diagnosis.Key pointsCancer diagnosis is under-researched in primary care, especially theoretically. Thus, inspired by classic grounded theory, we analysed and conceptualised the field:Pluralistic task shifting is a conceptual explanation of how the timeliness of cancer diagnosis could be improved, with data derived mostly from primary care physicians.This includes task sharing and changing tasks including screening and cancer fast-tracks to accelerate cancer case finding, and requires cognitive task shifting emphasising learning, and digital task shifting involving the use of eHealth and telemedicine.Financial task shifting with cost tracking and reallocation of funds is eventually necessary for successful pluralistic task shifting to happen.},
  author = {Thulesius, H. and Sandén, U. and Petek, D. and Hoffman, R. and Koskela, T. and Oliva-Fanlo, B. and Neves, A. L. and Hajdarevic, S. and Harrysson, L. and Toftegaard, B. S. and Vedsted, P. and Harris, M.},
  journal = {Scand J Prim Health Care},
  keywords = {grapp-caib},
  number = 4,
  pages = {486-497},
  title = {Pluralistic task shifting for a more timely cancer diagnosis. A grounded theory study from a primary care perspective},
  type = {Journal Article},
  volume = 39,
  year = 2021
  }
  

  %0 Journal Article
  %1 RN75
  %A Thulesius, H.
  %A Sandén, U.
  %A Petek, D.
  %A Hoffman, R.
  %A Koskela, T.
  %A Oliva-Fanlo, B.
  %A Neves, A. L.
  %A Hajdarevic, S.
  %A Harrysson, L.
  %A Toftegaard, B. S.
  %A Vedsted, P.
  %A Harris, M.
  %D 2021
  %J Scand J Prim Health Care
  %N 4
  %P 486-497
  %R 10.1080/02813432.2021.2004751
  %T Pluralistic task shifting for a more timely cancer diagnosis. A grounded theory study from a primary care perspective
  %V 39
  %X OBJECTIVE: To explore how cancer could be diagnosed in a more timely way. DESIGN: Grounded theory analysis of primary care physicians' free text survey responses to: 'How do you think the speed of diagnosis of cancer in primary care could be improved?'. Secondary analysis of primary care physician interviews, survey responses, literature. SETTING: Primary care in 20 European Örenäs Research Group countries. SUBJECTS: Primary care physicians: 1352 survey respondents (2013-2016), 20 Spanish and 7 Swedish interviewees (2015-2019). MAIN OUTCOME MEASURES: Conceptual explanation of how to improve timeliness of cancer diagnosis. RESULTS: Pluralistic task shifting is a grounded theory of a composite strategy. It includes task sharing - among nurses, physicians, nurse assistants, secretaries, and patients - and changing tasks with cancer screening when appropriate or cancer fast-tracks to accelerate cancer case finding. A pluralistic dialogue culture of comprehensive collaboration and task redistribution is required for effective pluralistic task shifting. Pluralistic task shifting relies on cognitive task shifting, which includes learning more about slow analytic reasoning and fast automatic thinking initiated by pattern recognition; and digital task shifting, which by use of eHealth and telemedicine bridges time and place and improves power symmetry between patients, caregivers, and clinicians. Financial task shifting that involves cost tracking followed by reallocation of funds is necessary for the restructuring and retraining required for successful pluralistic task shifting. A timely diagnosis reduces expensive investigations and waiting times. Also, late-stage cancers are costlier to treat than early-stage cancers. Timing is central to cancer diagnosis: not too early to avoid overdiagnosis, and never too late. CONCLUSIONS: We present pluralistic task shifting as a conceptual summary of strategies needed to optimise the timeliness of cancer diagnosis.Key pointsCancer diagnosis is under-researched in primary care, especially theoretically. Thus, inspired by classic grounded theory, we analysed and conceptualised the field:Pluralistic task shifting is a conceptual explanation of how the timeliness of cancer diagnosis could be improved, with data derived mostly from primary care physicians.This includes task sharing and changing tasks including screening and cancer fast-tracks to accelerate cancer case finding, and requires cognitive task shifting emphasising learning, and digital task shifting involving the use of eHealth and telemedicine.Financial task shifting with cost tracking and reallocation of funds is eventually necessary for successful pluralistic task shifting to happen.