F F Casanueva

Instituto de Salud Carlos III, Madrid, Madrid, Spain

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Publications (508)1732.07 Total impact

  • AB Crujeiras, M Pardo, FF Casanueva
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    ABSTRACT: Soon after the discovery of the muscle-derived factor irisin, a great controversy arose in the literature regarding certain inconsistencies in the regulation of the fibronectin type III domain containing 5 protein (FNDC5/irisin) after exercise, as well as the unpredicted association of circulating irisin levels with parameters of adiposity in humans. Due to these questionable findings, doubts as to the identity of the soluble portion of FNDC5 as well as the real role of irisin and its possible therapeutic applications in the treatment of obesity and diabetes have proliferated.We recently postulated that FNDC5/irisin is an adipokine expressed and secreted by white adipose tissue (WAT) in rats and humans. Its circulating concentration correlates with adiposity in humans among independent cohorts of patients. Further analysis, focused on obesity-related metabolic disorders, has shown that irisin could play a role in promoting insulin resistance or act as an adaptive response to counteract disturbances in glucose and lipid homeostasis in obesity. Overall, this leads us to raise the question whether the new factor, increased in circulation of obese patients, is really irisin reflecting fat mass or it is an artefact. Therefore, the current review is focused on the potential participation of adipose tissue in irisin circulating levels and the role of irisin in metabolic pathologies associated with obesity in an attempt to clarify the controversy generated by these recently published reports.This article is protected by copyright. All rights reserved.
    Clinical Endocrinology 10/2014; · 3.40 Impact Factor
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    ABSTRACT: Background: Endocannabinoids and temperament traits have been linked to both physical activity and body mass index (BMI) however no study has explored how these factors interact in females. The aims of this cross-sectional study were to 1) examine differences among distinct BMI groups on daytime physical activity and time spent in moderate-vigorous physical activity (MVPA), temperament traits and plasma endocannabinoid concentrations; and 2) explore the association and interaction between MVPA, temperament, endocannabinoids and BMI.
    PLoS ONE 08/2014; 9(8):e104534. · 3.53 Impact Factor
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    ABSTRACT: Although the concept of ‘food addiction’ (FA) has raised growing interest because of evidence for similarities between substance dependence and excessive food intake, there is a lack of studies that explore this construct among the wide spectrum of eating disorders (EDs). Besides providing validation scores of a Spanish version of the Yale FA Scale (YFAS-S), this study examined the prevalence of ‘FA’ among ED subtypes compared with healthy-eating controls (HCs) and the association between ‘FA’ scores, eating symptomatology and general psychopathology. A sample of 125 adult women with ED, diagnosed according to Diagnostic and Statistical Manual of Mental Disorders 5 criteria, and 82 healthy-eating women participated in the study. All participants were assessed with the YFAS-S, the ED Inventory-2 and the Symptom Checklist-Revised. Results showed that the internal structure of the one-dimensional solution for the YFAS-S was very good (α = 0.95). The YFAS-S has a good discriminative capacity to differentiate between ED and controls (specificity = 97.6% and sensitivity (Se) = 72.8%; area under receiver operating characteristic curve = 0.90) and a good Se to screen for specific ED subtypes. YFAS-S scores were associated with higher levels of negative affect and depression, higher general psychopathology, more severe eating pathology and greater body mass index. When comparing the prevalence of ‘FA’ between ED subtypes, the lowest prevalence of ‘FA’, measured with the YFAS-S, was for the anorexia nervosa (AN) restrictive subtype with 50%, and the highest was for the AN binge–purging subtype (85.7%), followed by bulimia nervosa (81.5%) and binge eating disorder (76.9%). In conclusion, higher YFAS-S scores are associated with bingeing ED-subtype patients and with more eating severity and psychopathology. Although the ‘FA’ construct is able to differentiate between ED and HC, it needs to be further explored. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.
    European Eating Disorders Review 08/2014; · 1.38 Impact Factor
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    ABSTRACT: Background Androgens acting via the androgen receptor (AR) stimulate production of prostate specific antigen (PSA), which is a clinical marker of prostate cancer (PCa). Since genetic variants in the AR may have a significant impact on the risk of being diagnosed with PCa, the aim was to investigate if AR-variants were associated with the risk of having PSA above clinically used cut-off thresholds of 3 or 4 ng/mL in men without PCa. Methods Men without PCa history (n=1744) were selected from the European Male Ageing Study (EMAS) cohort of 40-80 year old men from 8 different European centers. Using linear and logistic regression models, with age and center as covariates, we investigated whether AR-variants (CAG repeat-length and/or SNP genotype) were associated with having serum PSA concentrations above 3 or 4 ng/mL, which often are set as cut-off concentrations for further investigation of PCa. Results Carriers of the SNP rs1204038 A-allele (16% of the men) were more likely to have PSA>3 and 4 ng/mL (OR; 95%CI 1.65; 1.13-2.40 and 1.87; 1.18-2.96, respectively) than G-allele carriers. They also had shorter CAG-repeats (median 20 vs. 23, p<0.0005), but CAG repeat length per se did not affect the PSA concentrations. Conclusion The A-allele of the SNP rs1204038 gives a 65% higher risk of having PSA above 3 ng/mL than the G-allele in men without PCa, and thereby an increased risk of being referred for further examination on suspicion of PCa. Impact Serum PSA as a clinical marker could be improved by adjustment for AR-genotype.
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    ABSTRACT: Certain clinical conditions and markers have recently been demonstrated to modify the natural history of acromegaly in affected patients. Thus, some clinical, histological, radiological and molecular factors are associated with more aggressive pituitary tumors that have higher biochemical activity, higher tumor volumes and decreased tumoral and biochemical responses to current therapies. However, these factors do not seem to have an equal influence on the prognosis of patients with acromegaly. We present a review of the factors that influence the clinical course of patients with acromegaly and propose a risk value for each factor that will allow prognostic scoring for affected patients by considering a combination of these factors.
    Pituitary 05/2014; · 2.67 Impact Factor
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    ABSTRACT: The treatment of adults with GH deficiency (GHD) with human recombinant growth hormone has interindividual variability and several factors influence it. The aims of this study were : 1-to analyze the GH receptor (GHR) genotype in terms of exon 3 deletion GHR (d3-GHR) in adults with GHD; 2-to assess the effects of d3-GHR on initial IGF-I levels; 3-to evaluate whether d3-GHR and/or initial IGF-I levels were associated with adverse effects and/or treatment discontinuation. Forty-four adult patients with GHD were included. Demographic, clinical and biochemical characteristics were retrospectively evaluated at baseline and 6 months, 1 and 3 years after the initiation of treatment. d3-GHR was analyzed in 35 patients. 37.1 % of patients were d3-GHR carriers (31.4 % heterozygous, 5.7 % homozygous). IGF-I at baseline was low in 64 % of patients and was not related to d3-GHR status. There was no association between the d3-GHR allele and baseline IGF-I (p = 0.14). Although adverse events were more frequent in the d3-GHR carriers (30.7 vs. 18.2 % in fl/fl) and in patients with normal IGF-I levels at diagnosis (43.7 vs. 17.8 % in patients with low IGF-I levels), this association was not statistically significant. d3-GHR status was not related to the incidence of adverse events (p = 0.4) or treatment discontinuation (p = 0.47). Baseline IGF-I levels were neither associated with adverse events (p = 0.08) nor treatment discontinuation (p = 0.75). The d3-GHR allele was not related to baseline levels of IGF-I. Neither d3-GHR nor baseline IGF-I level was related to adverse events or treatment discontinuation.
    Pituitary 04/2014; · 2.67 Impact Factor
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    ABSTRACT: The global prevalence of obesity has significantly increased in most industrialized countries. Anti-obesity drugs are scarce, and indications to change their life style are impractical. Therefore, to identify diets able to produce significantly and maintained weight loss is mandatory. The present work evaluated the efficacy of a very low-calorie-ketogenic (VLCK) diet in obesity. A group of obese patients were randomized into two groups: the VLCK diet group and a standard low-calorie diet (LC group). The follow-up period was 12 months. Both groups received external support, counseling, to perform physical activity and adhered to the diet. The VLCK diet induced a 30-45 days of mild ketosis and significant effects on body weight within 15 days. At 2 months, the weight reductions in the VLCK diet and LC diet groups were 13.6 ± 3.9 and 4.8 ± 2.7 kg, respectively (p < 0.0001). At the end of the study, at 12 months, the weight reductions were 19.9 ± 12.3 and 7.0 ± 5.6 kg, respectively (p < 0.0001), and more than 88 % of patients in the VLCK diet group lost more of 10 % of their initial weight. Lean mass was practically unaffected. The VLCK diet was well tolerated and the side effects were moderate and transitory. In a group of obese patients, the VLCK diet was significantly more effective than a standard LC diet. At one year follow-up in the group with VLCK diet, most of the patients loss more than 10 % of their initial weight and lean mass was well preserved.
    Endocrine 03/2014; · 3.53 Impact Factor
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    ABSTRACT: FNDC5/irisin protein has been recently postulated as beneficial in the treatment of obesity and diabetes because it is induced by exercise and is able to increase energy expenditure. However, recent reports have shown that WAT also secretes irisin, and that circulating irisin is elevated in obese subjects. The aim of this study was to evaluate the circulating levels of irisin in conditions of extreme BMI, such as anorexia and obesity, and the correlations of irisin with basal metabolism and daily activity. Materials and methods: The study involved 145 female patients, including 96 patients with extreme BMIs [30 anorexic (AN) and 66 obese (OB) patients] and 49 healthy normal weight control patients (NW) to assess the circulating irisin levels. Biochemical, anthropometric and body composition measurements, daily physical activity and resting energy expenditure (REE) were analysed in the subjects. Results: The plasma irisin levels were significantly elevated in the OB patients compared with the AN and NW patients. Irisin also correlated positively with body weight, BMI and fat mass. The OB patients exhibited the highest REE and higher daily physical activity compared with the AN patients but lower activity compared with the NW patients. The irisin levels were inversely correlated with daily physical activity and directly correlated with REE. Fat mass contributed to most of the variability of the irisin plasma levels independently of the other studied parameters. Conclusions: Irisin plasma levels are influenced by energy expenditure independently of daily physical activity but fat mass is the main contributing factor
    International Journal of Endocrinology 02/2014; · 2.52 Impact Factor
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    ABSTRACT: In March 2013, the Acromegaly Consensus Group met to revise and update guidelines for the medical treatment of acromegaly. The meeting comprised experts skilled in the medical management of acromegaly. The group considered treatment goals covering biochemical, clinical and tumour volume outcomes, and the place in guidelines of somatostatin receptor ligands, growth hormone receptor antagonists and dopamine agonists, and alternative modalities for treatment including combination therapy and novel treatments. This document represents the conclusions of the workshop consensus.
    Nature Reviews Endocrinology 02/2014; · 11.03 Impact Factor
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    ABSTRACT: Irisin is assumed to be a relevant link between muscle and weight maintenance as well as to mediate exercise benefits on health. The aim of this study was to assess the possible associations between irisin levels and glucose homeostasis in obese subjects with metabolic syndrome (MetS) following an energy-restricted treatment. Ninety-six adults with excessive body weight and MetS features underwent a hypocaloric dietary pattern for 8 weeks, within the RESMENA randomized controlled trial (www.clinicaltrials.gov; NCT01087086). After the intervention, dietary restriction significantly reduced body weight and evidenced a dietary-induced decrease in circulating levels of irisin in parallel with improvements on glucose homeostasis markers. Interestingly, participants with higher irisin values at baseline (above the median) showed a greater reduction on glucose (P=0.022) and insulin (P=0.021) concentrations as well as on the homeostasis model assessment index (P=0.008) and triglycerides (P=0.006) after the dietary intervention, compared with those presenting low-irisin baseline values (below the median). Interestingly, a positive correlation between irisin and carbohydrate intake was found at the end of the experimental period. In conclusion, irisin appears to be involved in glucose metabolism regulation after a dietary-induced weight loss.
    Nutrition & Diabetes 02/2014; 4:e110.
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    ABSTRACT: Leptin and ghrelin appear to play a role in weight regain after a successful weight loss. The pre-treatment plasma levels of leptin/ghrelin ratio (L/G) could have power to predict this clinically relevant issue in the obesity treatment. To evaluate the ability of the L/G as a non-invasive tool for the early discrimination of obese patients who are more likely to regain weight after an energy restriction program (regainers) from those who maintain the lost weight (non-regainers). Fasting leptin and ghrelin levels were evaluated in 88 overweight/obese patients who followed an 8-week hypocaloric diet program and were categorized as regainers (≥10 % weight-lost regain) and non-regainers (<10 % weight-lost regain) 6 months (32 weeks) after finishing the dietary treatment. A receiver operating characteristic (ROC) curve analysis was employed to evaluate the diagnostic value of the L/G ratio and to establish a cut-off point to differentiate regainers from non-regainers. Regainers showed a statistically higher baseline (week 0) and after treatment (week 8) L/G ratio than non-regainers. The baseline L/G ratio was associated with an increased risk for weight regain (odds ratio 1.051; p = 0.008). Using the area under the ROC curve (AUC), the L/G ratio significantly identified female (AUC = 0.69; p = 0.040) and male regainers (AUC = 0.68; p = 0.030). The maximum combination of sensitivity and specificity was shown at the cut-off point of 26.0 for women and 9.5 for men. The pre-intervention fasting leptin/ghrelin ratio could be a useful non-invasive approach to personalize obesity therapy and avoid unsuccessful treatment outcomes.
    Journal of endocrinological investigation 02/2014; 37(2):119-26. · 1.65 Impact Factor
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    ABSTRACT: Objectives: Eating styles have been studied in both obesity (OB) and eating disorders (ED), but they have not been examined in these two weight conditions together. The present study explores differences in eating styles in an Anorexia Nervosa (AN) and OB sample, compared to healthy controls (HC), and it analyses their relationship with Body Mass Index (BMI) and personality traits. Method: The total sample consisted of 291 female participants (66 AN, 79 OB and 146 HC). Evaluation: Assessment measures included the Dutch Eating Behaviour Questionnaire -DEBQ- and the Temperament and Character Inventory–revised -TCI-R-. Results: The MANCOVA test showed significant differences among the three groups for all eating styles, with emotional eating being more typical in the OB group and restrained eating more typical in the AN group. Partial correlation analyses showed relationships between emotional and external eating and BMI, as well as relationships with different temperament and character traits. The stepwise discriminant function analysis showed that the DEBQ correctly classified 65.6% of the sample into the three weight categories; when combined with the TCI-R, correct classification increased to 72.6%. Conclusions: Weight conditions showed different eating behaviour patterns. Temperament and character traits were related to eating behaviours. DEBQ and TCI-R were able to discriminate between groups. Differences in eating styles in the weight groups can have implications for understanding the development and maintenance of OB and ED.
    Appetite 01/2014; 76:76-83. · 2.54 Impact Factor
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    ABSTRACT: Cushing's disease is a rare chronic disease caused by a pituitary adenoma, which leads to excess secretion of adrenocorticotropic hormone (ACTH). The over-production of ACTH leads to hyperstimulation of the adrenal glands and a chronic excess of cortisol, resulting in the signs and symptoms of a severe clinical state (Cushing's syndrome) that leads to significant morbidity, negative impacts on the patient's quality of life, and, if untreated, increased mortality. The management of patients with Cushing's disease is complicated by the heterogeneity of the condition, with signs and symptoms that overlap with those of other diseases, and high subclinical incidence rates. Controversies surrounding the tests used for screening and identifying patients with Cushing's disease add to the challenge of patient management. Surgical intervention to remove the adenoma is the first-line treatment for patients with Cushing's disease, but medical therapies are useful in patients who relapse or are unsuitable for surgery. The recent introduction of pasireotide, the first pituitary-directed medical therapy, expands the number of treatment options available for patients with Cushing's disease. This state-of-the-art review aims to provide an overview of the most recent scientific research and clinical information regarding Cushing's disease. Continuing research into improving the diagnosis and treatment of Cushing's disease will help to optimize patient management.
    Endocrine 01/2014; · 3.53 Impact Factor
  • Ana B Crujeiras, Felipe F Casanueva
    Expert Review of Endocrinology &amp Metabolism 01/2014; 7(2).
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    ABSTRACT: This study aimed to analyse the association, commonalities and differences between obesity and eating disorders (ED). A total of 150 female patients [50 obese with bulimia nervosa (OB + BN), 50 obese with binge eating disorders (OB + BED), 50 obese without eating disorders (OB)] and 50 female healthy-eating/weight control (CG) volunteers participated in this study. All participants were assessed by the Eating Disorders Inventory-2 (EDI-2), the Symptom Checklist-Revised (SCL-90-R) and the Temperament and Character Inventory-Revised. In general, all the groups differed significantly and showed linear trends (OB + BN > OB + BED > OB > CG) on general and eating psychopathology (SCL-90-R and EDI-2). Regarding personality traits, statistically significant differences across all four groups were found on Harm Avoidance and Self-Directedness. Whereas some symptoms were shared in extreme weight conditions, others were specifically related to ED. The presence of binge and purge symptomatology in obese patients is clinically relevant. These findings help to understand the relationship between Obesity and ED. Copyright © 2013 John Wiley & Sons, Ltd and Eating Disorders Association.
    European Eating Disorders Review 01/2014; 22(1):25-31. · 1.38 Impact Factor
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    ABSTRACT: We previously reported that in male patients consulting for sexual dysfunction, low prolactin (PRL) levels were associated with metabolic syndrome (MetS), arteriogenic erectile dysfunction, and incident major cardiovascular events. The aim of this study is to assess the clinical associations of PRL levels in the European Male Ageing Study (EMAS). EMAS is a prospective, observational cohort of community-dwelling men aged 40-79 years old (mean age 60 ± 11 years old). PRL was available for 2,948 men. Different parameters were evaluated including the Short Form-36 questionnaire, Becks Depression Inventory, the Adverse Life Events Scale, the Physical Activity Scale for the Elderly, and the EMAS sexual function questionnaire (EMAS-SFQ). After the adjustment for confounders, PRL levels were inversely related with worsening of sexual function as compared with the previous year, as derived from change in sexual functioning domain of the EMAS-SFQ (adj. r = -0.043; P = 0.029). The strongest correlation (Wald = 6.840; P = 0.009) was observed between lower PRL levels and reduced enjoyment of orgasmic experiences. Furthermore, an inverse relationship between PRL levels and stressful life events or depressive symptoms was observed. Low PRL was also negatively associated with an unhealthy metabolic phenotype as well as with the MetS (Wald = 5.229; P = 0.022). In line with these data, low PRL was associated with a lower level of physical activity and feeling unhealthier. Low PRL is related to several metabolic, psychological, and sexual unhealthy characteristics in European men. Checking PRL might be useful to stratify men for cardiovascular risk and to encourage appropriate lifestyle changes.
    Journal of Sexual Medicine 01/2014; 11:240. · 3.51 Impact Factor
  • C Folgueira, L M Seoane, F F Casanueva
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    ABSTRACT: The stomach-brain connection has been revealed to be one of the most promising targets in treating obesity. The stomach plays a key role in the homeostatic mechanism implicating stomach-brain communication regulated under neural and hormonal control. The present review explores specific topics related to gut-brain interactions focus on the stomach-brain connection through the different known systems implied in energy balance control as ghrelin, and nesfatin. Moreover, novel mechanisms for energy balance regulation involving gastric-brain communication are described including the role of the gastric intracellular mTOR/S6K1 pathway mediating the interaction among ghrelin, nesfatin and endocannabinoid gastric systems to modulate metabolism. © 2014 S. Karger AG, Basel.
    Frontiers of hormone research 01/2014; 42:83-92. · 1.24 Impact Factor
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    ABSTRACT: Background: vitamin D deficiency has been associated with an increased risk of mortality, but whether this relationship is causal or linked to co-existent comorbidity and adverse life factors remains uncertain. Our objective was to determine whether endogenous 25-hydroxyvitamin D (25(OH)D), 1,25-dihydroxyvitamin D (1,25(OH)2D) and parathyroid hormone (PTH) levels predicted all-cause, cardiovascular and cancer mortality independently of health and lifestyle factors.Setting: prospective cohort analysis within the European Male Ageing Study.Participants: 2,816 community-dwelling men aged 40-79 years at baseline.Methods: Cox regression was used to examine the association of all-cause mortality with 25(OH)D, 1,25(OH)2D and PTH; cardiovascular and cancer mortality were modelled using competing-risks regression. Results were expressed as hazard ratios (HR) and 95% confidence intervals (CIs) for Cox models; sub-hazard ratios (SHR) and 95% CIs for competing-risks models.Results: a total of 187 men died during a median of 4.3 years of follow-up. Serum levels of 25(OH)D (per 1 SD decrease: HR = 1.45; 95% CI = 1.16, 1.81) and 1,25(OH)2D (per 1 SD decrease: HR = 1.20; 95% CI = 1.00, 1.44) were associated with an increased risk of all-cause mortality after adjusting for age, centre, smoking, self-reported morbidities, physical activity and functional performance. Only levels of 25(OH)D <25 nmol/l predicted cancer mortality (SHR = 3.33; 95% CI = 1.38, 8.04).Conclusion: lower 25(OH)D and 1,25(OH)2D levels independently predicted all-cause mortality in middle-aged and older European men. Associations with cancer mortality were only observed among men with very low levels of 25(OH)D. These associations were only partially explained by the range of adverse health and lifestyle factors measured here.
    Age and Ageing 12/2013; · 3.82 Impact Factor
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    ABSTRACT: Objective Weight regain is associated with the promotion of insulin resistance. The newly discovered myokine irisin, which was proposed to be involved in the management of insulin sensitivity, could play a role in this process. This study aimed to investigate the association between irisin and reduced insulin sensitivity induced by weight regain. Materials/Methods Insulin sensitivity was evaluated according to the homeostasis model assessment of insulin resistance (HOMA-IR) in 136 obese patients who followed an eight-week hypocaloric diet (30% reduced energy expenditure) to lose weight and were re-evaluated four or six months after treatment. Irisin plasma levels, as well as the levels of leptin, adiponectin, ghrelin and TNF-α, were quantified in a sub-cohort (n=73) from the initially studied patients at baseline (T0), at the diet endpoint (T1) and after the follow-up period (T2). Results After a successful dietary intervention to lose weight, 50% of the patients who regained the lost weight during the follow-up period were categorized as insulin resistant (HOMA-IR≥2.5) compared with only 25% of patients who maintained the weight loss (p=0.018). Importantly, in addition to the well-studied hormones leptin and adiponectin, irisin plasma levels were statistically associated with several risk factors for insulin resistance. Indeed, the increased risk of insulin resistance during the follow-up period was related to high irisin levels at baseline (odds ratio=4.2; p=0.039). Conclusions Circulating irisin predicts the insulin resistance onset in association with weight regain. Therefore, irisin could be secreted as an adaptive response to counteract the deleterious effect of excess adiposity on glucose homeostasis.
    Metabolism 12/2013; · 3.10 Impact Factor
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    ABSTRACT: A recently discovered myokine, irisin, may have an important role in energy metabolism. This study aimed to evaluate the relationship between this hormone and the lipid profile of Metabolic Syndrome (MetS) patients following a hypocaloric diet. Ninety-three Caucasian adults (52 men/41 women) diagnosed with MetS followed an 8-week-long energy restricted programme (-30% of the energy requirements). Anthropometric measurements, biochemical markers and plasma irisin levels were analysed before and after the nutritional intervention. Global plasma irisin levels were significantly reduced at the end of the study (-72·0 ± 100·9 ng/mL, p < 0·001) accompanying the weight loss (-6·9%). The depletion of irisin significantly correlated with changes in some atherogenic-related variables: total cholesterol (B = 0·106, p = 0·018), total cholesterol/high density lipoprotein-cholesterol ratio (B = 0·002, p = 0·036), low density lipoprotein-cholesterol (B = 0·085, p = 0·037) and apolipoprotein B (B = 0·052, p = 0·002), independently of changes in body weight. An association between the reduction of plasma irisin levels and the depletion of important lipid metabolism biomarkers was observed in patients with MetS undergoing an energy restricted programme. This article is protected by copyright. All rights reserved.
    Clinical Endocrinology 12/2013; · 3.40 Impact Factor

Publication Stats

14k Citations
1,732.07 Total Impact Points


  • 2008–2014
    • Instituto de Salud Carlos III
      Madrid, Madrid, Spain
    • University of Patras
      • Division of Paediatrics and Obstetrics – Gynaecology
      Patrís, Kentriki Makedonia, Greece
  • 1996–2014
    • Complejo Hospitalario Universitario de Santiago
      • Department of Medicine
      Santiago, Galicia, Spain
  • 1986–2014
    • University of Santiago de Compostela
      • • Department of Medicine
      • • Departamento de Fisiología
      Santiago, Galicia, Spain
  • 2013
    • Hospital Sierrallana
      Torrelavega, Cantabria, Spain
    • University of Naples Federico II
      • Department of Clinical Medicine and Surgery
      Napoli, Campania, Italy
    • IDIBELL Bellvitge Biomedical Research Institute
      • Programa de Epigenética y Biología del Cáncer - PEBC
      Barcelona, Catalonia, Spain
    • Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y la Nutrición (CIBERobn)
      Santiago, Galicia, Spain
  • 2010–2013
    • Instituto de Investigación Sanitaria de Santiago de Compostela
      Santiago, Galicia, Spain
    • University of Pavia
      Ticinum, Lombardy, Italy
  • 2004–2013
    • Erciyes Üniversitesi
      • Department of Endocrinology
      Melikgazi, Kayseri, Turkey
  • 2012
    • University of Oxford
      Oxford, England, United Kingdom
  • 2008–2012
    • Imperial College London
      • Department of Surgery and Cancer
      London, ENG, United Kingdom
    • The University of Manchester
      Manchester, England, United Kingdom
  • 2011
    • Hospital Comarcal del Bierzo
      Pomeriada, Castille and León, Spain
  • 2008–2011
    • University of Leeds
      • Institute of Psychological Sciences
      Leeds, ENG, United Kingdom
  • 2000–2010
    • Università degli Studi di Brescia
      • Department of Medicine and Surgery
      Brescia, Lombardy, Italy
    • Centro Informático Científico de Andalucía
      Hispalis, Andalusia, Spain
  • 1993–2010
    • Klinički centar Srbije
      • • Institute of Neurology
      • • Institute of Endocrinology, Diabetes and Diseases of Metabolism
      Beograd, Central Serbia, Serbia
    • University of Vigo
      • Faculty of Science
      Vigo, Galicia, Spain
  • 2009
    • University of Florence
      • Dipartimento di Scienze Biomediche, Sperimentali e Cliniche
      Florence, Tuscany, Italy
  • 2000–2008
    • Università degli Studi di Torino
      • Dipartimento di Scienze Mediche
      Torino, Piedmont, Italy
  • 1990–2008
    • Hospital Universitario Virgen del Rocío
      • Division of Endocrinology
      Hispalis, Andalusia, Spain
    • Facultad de Medicina
      Madrid, Madrid, Spain
  • 2007
    • Hospital General Universitario Gregorio Marañón
      Madrid, Madrid, Spain
  • 2006
    • Santiago University of Technology
      Santiago, Santiago, Dominican Republic
    • Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center
      Torrance, California, United States
  • 1999–2006
    • University of Cordoba (Spain)
      • • Facultad de Medicina
      • • Departamento de Biología Celular, Fisiología e Inmunología
      Córdoba, Andalusia, Spain
  • 1993–2006
    • University of Belgrade
      • Institute of Endocrinology
      Belgrade, SE, Serbia
  • 2003
    • University of A Coruña
      La Corogne, Galicia, Spain
    • Sapienza University of Rome
      Roma, Latium, Italy
  • 2002
    • Istituto Regina Elena - Istituti Fisioterapici Ospitalieri
      Roma, Latium, Italy
    • Children's Hospital Los Angeles
      Los Angeles, California, United States
  • 1989–2001
    • University of Santiago, Chile
      CiudadSantiago, Santiago, Chile
  • 1997
    • Azienda Ospedaliera Santa Maria Nuova di Reggio Emilia
      Reggio nell'Emilia, Emilia-Romagna, Italy
  • 1990–1992
    • Hospital Universitario Cruces
      Bilbo, Basque Country, Spain
  • 1989–1990
    • Port of Spain General Hospital
      City of Port-of-Spain, City of Port of Spain, Trinidad and Tobago
  • 1987
    • Complutense University of Madrid
      Madrid, Madrid, Spain
  • 1983
    • The University of Winnipeg
      Winnipeg, Manitoba, Canada