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Gastroenterología y Hepatología 04/2013; · 0.73 Impact Factor
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Cleveland Clinic Journal of Medicine 07/2012; 79(7):465-7. · 3.77 Impact Factor
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ABSTRACT: The incidence of hypertension is high in the elderly and is present in 2/3 of the patients older than 65 years. Prevalence can reach 90% in patients older than 80 years. The presence of isolated systolic hypertension (ISH) is characteristic of this population. However, the prevalence of hypertension by ambulatory blood pressure monitoring (ABPM) is not well known. In this study, we analyzed the special characteristics of hypertension in this population, giving special emphasis on ABPM readings.
International journal of hypertension. 01/2012; 2012:548286.
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Medicina Clínica 11/2011; 137(14):670. · 1.38 Impact Factor
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María Teruel,
Jose-Ezequiel Martin,
Norberto Ortego-Centeno, Juan Jiménez-Alonso,
Julio Sánchez-Román,
Enrique de Ramón,
M Francisca Gonzalez-Escribano,
Bernardo A Pons-Estel,
Sandra D'Alfonso,
Gian Domenico Sebastiani,
Torsten Witte,
Nunzio Bottini,
Miguel A González-Gay,
Marta E Alarcón-Riquelme,
Javier Martin
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ABSTRACT: The red cell acid phosphatase (ACP1) gene, which encodes a low-molecular-weight phosphotyrosine phosphatase, has been suggested as a common genetic factor of autoimmunity. In the present study, we aim to investigate the possible association of ACP1 with the susceptibility of systemic lupus erythematosus (SLE). A total of 1,546 SLE patients and 1,947 healthy individuals from 4 Caucasians populations were included in the present study. Four single-nucleotide polymorphisms (SNPs) were genotyped in this study: rs10167992, rs11553742, rs7576247, and rs3828329. ACP1*A, ACP1*B, and ACP1*C codominant ACP1 alleles were determined using 2 of the SNPs and analyzed. After the meta-analysis test was performed, a significant association of rs11553742*T was observed (p(pooled) = 0.005, odds ratios = 1.37 [1.10-1.70]), retaining significance after multiple testing was applied (p(FDR) = 0.019). Our data indicate for first time the association of rs11553742*T with increased susceptibility in SLE patients.
Human immunology 10/2011; 73(1):107-10. · 2.55 Impact Factor
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Lina-Marcela Díaz-Gallo,
Sonia Garcia,
Norberto Ortego-Centeno, Juan Jiménez-Alonso,
Julio Sánchez-Román,
Enrique de Ramón,
María F González-Escribano,
Alejandro Balsa,
Benjamín Fernández-Gutierrez,
Isidoro González-Alvaro,
Miguel A González-Gay,
Javier Martin
Annals of the rheumatic diseases 08/2011; 71(2):314-6. · 8.11 Impact Factor
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ABSTRACT: Hypertension (HT) is more prevalent in patients with systemic lupus erythematosus (SLE) than among the general population and it has been associated with atherosclerotic cardiovascular diseases in these patients. We examined the proportion of HT and factors associated with it in young and old women with SLE.
Participants (112 women with SLE and 223 healthy age-matched women) were categorized as young (age ≤ 40 years) or old (age > 40 years). We compared cardiovascular and specific SLE-related variables and inflammatory markers in hypertensive and normotensive women with SLE for each age range. We also assessed the factors independently associated with HT in the entire cohort and in each age range by means of a multivariate regression analysis.
The prevalence of HT was higher in women with SLE than in controls (56% vs 29%; p < 0.001), and was proportionally higher in younger women with SLE (40% vs 11%; p < 0.001) than in older women with SLE (74% vs 47%; p = 0.001). After adjustment for potential confounders, HT was associated with renal involvement and higher nonobesity-related insulin levels in younger women with SLE. In older patients, HT was associated with age, renal involvement, and obesity. Finally, in the entire cohort, HT was associated with age, insulin, renal involvement, and the Systemic Lupus Erythematosus Disease Activity Index score.
An association between HT and insulin has been identified in women with SLE, particularly younger ones. Factors associated with HT in women with SLE differed depending on their age. HT was more prevalent in women with SLE than in control subjects, being proportionally higher in young women with SLE.
The Journal of Rheumatology 03/2011; 38(6):1026-32. · 3.69 Impact Factor
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Medicina Clínica 02/2011; 138(12):550. · 1.38 Impact Factor
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Medicina Clínica 09/2010; 135(7):341. · 1.38 Impact Factor
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Medicina Clínica 10/2009; 135(14):680. · 1.38 Impact Factor
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ABSTRACT: Aortic pulse wave velocity (PWV) is an independent predictor of risk for atherosclerotic cardiovascular disease. Metabolic syndrome (MetS) is more prevalent in patients with systemic lupus erythematosus (SLE) compared with matched healthy subjects. Aortic PWV is increased in MetS. The purpose of this cross-sectional study was to determine the association between MetS and aortic PWV and other surrogate biomarkers of subclinical atherosclerosis in SLE.
One hundred twenty-eight patients with SLE were studied. We established the presence of MetS according to the National Cholesterol Education Program Adult Treatment Panel III definition and we measured PWV, glucose, insulin, glycosylated hemoglobin (HbA(1c)), insulin sensitivity (HOMA index), lipid levels, uric acid, homocysteine, fibrinogen, D-dimer, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), interleukin 6 (IL-6), IL-8, IL-10, C3, C4, autoantibodies, SLE Disease Activity Index (SLEDAI), and Systemic Lupus International Collaborating Clinics/ACR Damage Index. Duration of SLE and treatment was also recorded. Multivariate logistic regression analysis was used to identify independent determinants of increased PWV.
SLE patients with MetS had higher aortic PWV (9.8 +/- 2.4 vs 8.5 +/- 1.7 m/s; p = 0.002) and increased biomarkers of subclinical atherosclerosis such as CRP, IL-6, C3, uric acid, homocysteine, fibrinogen and D-dimer, compared to those without MetS. HOMA index and insulin and HbA(1c) levels were also higher in this group. No differences were found in variables related to lupus activity (ESR, C4, SLEDAI, IL-8, IL-10, and treatment for SLE). In the multivariate model, increased PWV was associated with age, male sex, MetS, duration of SLE, and CRP.
MetS may contribute to the development of accelerated atherosclerosis in SLE.
The Journal of Rheumatology 10/2009; 36(10):2204-11. · 3.69 Impact Factor
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Elena Sánchez,
Rogelio J Palomino-Morales,
Norberto Ortego-Centeno, Juan Jiménez-Alonso,
Miguel A González-Gay,
Miguel A López-Nevot,
Julio Sánchez-Román,
Enrique de Ramón,
M Francisca González-Escribano,
Bernardo A Pons-Estel,
Sandra D'Alfonso,
Gian Domenico Sebastiani,
Marta E Alarcón-Riquelme,
Javier Martín
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ABSTRACT: Interleukin-18 (IL-18) is a proinflammatory cytokine that plays an important role in chronic inflammation and autoimmune disorders. In this study, we aimed to determine the potential role of the IL18 gene in SLE. To define the genetic association of the IL18 and SLE, we have genotyped nine SNPs in an independent set of Spanish cases and controls. The IL18 polymorphisms were genotyped by PCR, using a predeveloped TaqMan allele discrimination assay. Two SNPs were still significant after fine mapping of the IL18 gene. The SNP (rs360719) surviving correction for multiple tests was genotyped in two replication cohorts from Italy and Argentina. After the analysis, a significance with rs360719 C-allele remained across the sets and after the meta-analysis (Pooled OR = 1.37, 95% CI 1.21-1.54, combined P = 3.8E-07, Pc = 1.16E-06). Quantitative real-time PCR was performed to assess IL18 mRNA expression in PBMC from subjects with different IL18 rs360719 genotypes. We tested the effect of the IL18 rs360719 polymorphism on the transcription of IL18 by electrophoretic mobility shift assay and western blot. We found a significant increase in the relative expression of IL18 mRNA in individuals carrying the rs360719 C-risk allele; in addition we show that the polymorphism creates a binding site for the transcriptional factor OCT-1. These findings suggest that the novel IL18 rs360719 variant may play an important role in determining the susceptibility to SLE and it could be a key factor in the expression of the IL18 gene.
Human Molecular Genetics 08/2009; 18(19):3739-48. · 7.64 Impact Factor
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Medicina Clínica 03/2009; 132(5):184-5. · 1.38 Impact Factor
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ABSTRACT: Besides reducing blood pressure, it is important to think about the blood pressure variability that hypertensive patients may present. Indeed, studies suggest that target organ damage is greater in hypertensive people with high blood pressure variability. The purpose of the present study was to determine the blood pressure variability in patients who had not been treated with antihypertensive medication, as well as its relationship with the glomerular filtration.
We included 702 patients with clinical indication for 24h ambulatory blood pressure monitoring.
43.6% of patients had high variability of the blood pressure. These patients had greater levels of 24-h systolic blood pressure, diurnal and night blood pressure and a lower glomerular filtration. The main factors associated with high blood pressure variability were age, years from diagnosis of arterial hypertension, systolic blood pressure and a glomerular filtration smaller than 60ml/min.
A high variability of blood pressure is frequent among hypertensive patients. Since it is not possible to perform ambulatory blood pressure measurement in all them, we should mainly suspect it in old patients and in those with reduced glomerular filtration.
Medicina Clínica 03/2009; 132(5):180-3. · 1.38 Impact Factor
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ABSTRACT: The purpose of this paper was to examine memory performance in patients with SLE by studying the overall deterioration in memory, analyzing the differences and frequency of impairment in the variables from the visual and verbal memory tests, and studying the alterations in the memory. This study included 59 patients with a diagnosis of systemic lupus erythematosus (SLE) and 18 with a diagnosis of chronic discoid lupus (CDL), who were administered the Spanish complutense verbal learning test (TAVEC) and the Rey complex figure test (RCFT). Statistically significant differences were detected between the two groups on the immediate visual recall and delayed visual recall variables, with the mean of the SLE group being lower than that of the CDL group. The difference between the frequency of verbal and visual impairment could be explained by various factors, one of which would be a lateralization of memory impairment.
Archives of Clinical Neuropsychology 04/2008; 23(2):157-64. · 2.18 Impact Factor
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Medicina Clínica 02/2008; 130(1):15-6. · 1.38 Impact Factor
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Elena Sánchez,
Anna-Karin Abelson,
Jose M Sabio,
Miguel A González-Gay,
Norberto Ortego-Centeno, Juan Jiménez-Alonso,
Enrique de Ramón,
Julio Sánchez-Román,
Miguel A López-Nevot,
Iva Gunnarsson,
Elisabet Svenungsson,
Gunnar Sturfelt,
Lennart Truedsson,
Andreas Jönsen,
Maria Francisca González-Escribano,
Torsten Witte,
Marta E Alarcón-Riquelme,
Javier Martín
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ABSTRACT: To determine the potential role of the CD24 A57V gene polymorphism in systemic lupus erythematosus (SLE).
We studied 3 cohorts of Caucasian patients and controls. The Spanish cohort included 696 SLE patients and 539 controls, the German cohort included 257 SLE patients and 317 controls, and the Swedish cohort included 310 SLE patients and 247 controls. The CD24 A57V polymorphism was genotyped by polymerase chain reaction, using a predeveloped TaqMan allele discrimination assay. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated.
In the Spanish cohort there was a statistically significant difference in the distribution of the CD24 V allele between SLE patients and controls (OR 3.6 [95% CI 2.13-6.16], P < 0.0001). In addition, frequency of the CD24 V/V genotype was increased in SLE patients compared with controls (OR 3.7 [95% CI 2.16-6.34], P < 0.00001). We sought to replicate this association with SLE in a German population and a Swedish population. A similar trend was found in the German group. The CD24 V/V genotype and the CD24 V allele were more frequent in SLE patients than in controls, although this difference was not statistically significant. No differences were observed in the Swedish group. A meta-analysis of the Spanish and German cohorts demonstrated that the CD24 V allele has a risk effect in SLE patients (pooled OR 1.25 [95% CI 1.08-1.46], P = 0.003). In addition, homozygosity for the CD24 V risk allele significantly increased the effect (pooled OR 2.19 [95% CI 1.50-3.22], P = 0.00007).
These findings suggest that the CD24 A57V polymorphism plays a role in susceptibility to SLE in a Spanish population.
Arthritis & Rheumatism 10/2007; 56(9):3080-6. · 7.87 Impact Factor
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Elena Sánchez,
Behrooz Z Alizadeh,
Gustavo Valdigem,
Norberto Ortego-Centeno, Juan Jiménez-Alonso,
Enrique de Ramón,
Antonio García,
Miguel A López-Nevot,
Cisca Wijmenga,
Javier Martín,
Bobby P C Koeleman
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ABSTRACT: The aim of the study was to test MYO9B gene polymorphisms for association with three autoimmune diseases, systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), and celiac disease (CD), in a Spanish population. We analyzed three SNPs (rs2305767, rs1457092, and rs2305764) in a case-control cohort composed of 349 SLE patients, 356 RA patients, 90 CD patients, and 345 healthy controls. All three SNPs showed a consistent increased frequency of the A allele in SLE, RA, and CD patients compared with healthy controls. An association was observed between CD and rs2305764 (p=0.01, OR=2.3), between SLE and rs1457092 (p=0.002, OR=1.4), and between RA and rs1457092 (p=0.02, OR=1.3). The three autoimmune diseases combined showed significant association with rs1457092 and rs2305764 and with the AAA haplotype (p haplotype=0.005, OR=1.3). Our data demonstrate consistent association with the A allele and AAA haplotype of three SNPs in the MYO9B gene, which were previously reported to be associated with CD in the Dutch population. This suggests that genetic variation in MYO9B is associated with CD, SLE, and RA and that MYO9B is a general risk factor for autoimmunity.
Human Immunology 08/2007; 68(7):610-5. · 2.84 Impact Factor
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ABSTRACT: Arterial stiffness is one of the early lesions of the arteries in patients with cardiovascular risk factors. Pulse wave velocity (PWV) is one form of measurement of arterial stiffness. The renin-angiotensin system seems to be involved in the inflammatory mechanisms that take place at level of the vascular wall. The aim of this study is to investigate the effect of olmesartan (angiotensin II type 1 receptor antagonist) in the arterial stiffness, measuring the PWV. Another secondary objective is to determine the antihypertensive efficacy with ambulatory blood pressure monitoring (ABPM).
Seventy-one patients with mild-to-moderate essential hypertension were consecutively included. Clinical blood pressure (CBP), ABPM and PWV, automatized measurement between the carotid and femoral arteries using the Complior device (Colson, Paris, France), were determined in a baseline and after 16 weeks of treatment with 10-40 mg of olmesartan.
Sixty-four patients completed the study. The mean (standard deviation) age was 48.31 (9.69) years and 44.9% were men. A significant reduction of the PWV was observed. The basal PWV was 10.50 (1.87) m/s and after treatment was 9.26 (1.84) m/s (p < 0.0001). We found only a positive correlation between the decline of PWV and diastolic blood pressure (BP). We could not find such correlation with systolic BP. The reduction degree was higher in the youngest patients where BP decrease was less evident. The BP decreased in a significant way (p < 0.0001) doing so in CBP and in the periods of 24 h, diurnal and nocturnal.
Olmesartan has shown effective to decrease the arterial stiffness, mainly in young patients. This effect seems to be independent of the decrease of the systolic BP. Olmesartan reduces effectively the BP during the 24 h.
Medicina Clínica 05/2007; 128(19):726-9. · 1.38 Impact Factor
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Enfermedades Infecciosas y Microbiología Clínica 05/2006; 24(4):277-9. · 1.49 Impact Factor
