Alfonso L Calle-Pascual

• MDPhD
• Head of Department at Hospital Clínico San Carlos

Background/Objectives: Although evidence suggests that miR-484 and several fruit components are involved in glucose metabolism and insulin resistance metabolic pathways, the relationship between serum miR-484 levels and fruit consumption in relation to the risk of Type 2 diabetes (T2DM) remains elusive. The aim of this study was to evaluate the pos...

Background/Objectives: Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD) increases the risk of Type-2 Diabetes (T2DM). The Mediterranean diet (MD) has shown advantages in the management of MAFLD and preventing co-morbidities; however, its relationship with T2DM development in MAFLD has been less investigated. We aimed to evaluate the ass...

Gestational diabetes mellitus (GDM) pathophysiology comprises clinical and genetic factors. In fact, GDM has been associated with several single nucleotide polymorphisms (SNPs). This study aimed to build a prediction model of GDM combining clinical and genetic risk factors. A total of 1588 pregnant women from the San Carlos Cohort participated in t...

Background and Aims We aimed to assess the associations of exposure to air pollutants and standard and advanced lipoprotein measures, in a nationwide sample representative of the adult population of Spain. Methods We included 4647 adults (>18 years), participants in the national, cross‐sectional, population‐based di@bet.es study, conducted in 2008...

Introduction Hypoaldosteronism can be congenital or acquired, isolated or part of primary adrenal insufficiency, and caused by an aldosterone deficit, resistance, or a combination of both. Reduced mineralocorticoid action can induce a decrease in urine K+ and H+ excretion and an increase in urine Na+ excretion, leading to hyperkalemia, and/or hypon...

Background/Objectives Although vascular endothelial growth factor b (VEGFb) might have an impact on the development of obesity, diabetes and related disorders, the possible relationship between VEGFb serum levels and the incidence of these metabolic complications in humans is still unknown. The aim of our study was to evaluate the association betwe...

Background Recent reports have suggested that air pollution may impact thyroid function, although the evidence is still scarce and inconclusive. In this study we evaluated the association of exposure to air pollutants to thyroid function parameters in a nationwide sample representative of the adult population of Spain. Methods The Di@bet.es study...

Objective: It has been proposed that a mild form of acquired resistance to thyroid hormone may occur in the general population. Its clinical significance remains largely unknown. The objective was to explore whether a newly described thyroid hormone resistance index is associated with the risk of mortality in a sample of community-dwelling euthyroi...

Exposure to air particulate matter has been linked with hypertension and blood pressure levels. The metabolic risks of air pollution could vary according to the specific characteristics of each area, and has not been sufficiently evaluated in Spain. We analyzed 1103 individuals, participants in a Spanish nationwide population based cohort study (di...

Dysnatremia is associated with increased mortality in patients with community-acquired pneumonia. SARS-COV2 (Severe-acute-respiratory syndrome caused by Coronavirus-type 2) pneumonia can be fatal. The aim of this study was to ascertain whether admittance dysnatremia is associated with mortality, sepsis, or intensive therapy (IT) in patients hospita...

Background: Overcorrection of serum sodium (SNa) during therapy of hyponatremia can result in osmotic demyelination syndrome. Our aim was to determine the relationship between the isotonic saline solution dose (ISSD) administered and the 24‐h SNa increase (24SNa) in patients with hypovolemic hyponatremia (HH). Methods: Retrospective study of HH pat...

INTRODUCCION La clasificación volémica de la hiponatremia es esencial para su diagnóstico y tratamiento. Diferenciar entre la hiponatremia hipovolémica (HH) y la hiponatremia euvolémica (HE) puede representar un reto. Fundamentalmente cuando el sodio urinario (NaU) es >30mmol/L como sucede en el hipoaldosteronismo y el Síndrome de inadecuada antidi...

Abstract. Endocrinol Diabetes Nutr. 2020;67(Espec Cong 2):5 Available in: https://www.elsevier.es/es-revista-endocrinologia-diabetes-nutricion-13-congresos-congreso-seen-2020-112-sesion-neuroendocrinologia-y-suprarrenal-6100-comunicacion-hiponatremia-en-el-hipoaldosteronismo-caracteristicas-72804

Introduction: Clinical trials indicate that Tolvaptan is safe and effective in the treatment of patients with sustained mild/moderate SIADH-induced euvolemic hyponatremia. Tolvaptan doses are often modified during chronic use. We present the weekly doses of a series of patients on chronic therapy, followed up in outpatient clinic. Methods: Retrosp...

Background: Longitudinal data assessing the impact of Iodine deficiency on mortality are scarce. We aimed to study the association between the state of iodine nutrition and the risk of total and cause-specific mortality in a representative sample of the Spanish adult population. Methods: We performed a longitudinal observational study to estimat...

This study reveals the usefulness of the serum Na-Creatinine relationship for the determination of volume status in hyponatremic patients. Available in: https://www.elsevier.es/es-revista-endocrinologia-diabetes-nutricion-13-pdf-X2530016419002510

Objective: The activity of brown adipose tissue is sensitive to changes in ambient temperature. A lower exposure to cold could result in an increased risk of developing diabetes at population level, although this factor has not yet been sufficiently studied. Design: We studied 5072 subjects, participants in a national, cross sectional, population b...

To date it is not clear what the role of dairy products is in metabolic diseases like diabetes, obesity, and hypertension. Therefore, the aim of this study is to test the association between dairy product consumption and those pathologies. A cross-sectional study was conducted with 5081 adults included in the di@bet.es study, from 100 health center...

A prenatal diet affects materno-foetal outcomes. This is a post hoc analysis of the St. Carlos gestational diabetes mellitus (GDM) Prevention Study. It aims to evaluate the effect of a late first-trimester (>12 gestational weeks) degree of adherence to a MedDiet pattern—based on six food targets—on a composite of materno-foetal outcomes (CMFCs). Th...

Previous studies have suggested that iron deficiency (ID) may impair thyroid hormone metabolism, however replication in wide samples of the general adult population has not been performed. We studied 3846 individuals free of thyroid disease, participants in a national, cross sectional, population based study representative of the Spanish adult popu...

Background/objectives: Hyponatremia is the most common electrolyte disorder, and is associated with high-morbimortality rates. The true prevalence of hyponatremia in patients on parenteral nutrition (PN) is unknown, and the relationship between PN composition and development of hyponatremia has yet to be studied. Hypoproteinemia, a common finding...

Background Gestational diabetes mellitus (GDM) prevalence is increasing and becoming a major public health concern. Whether a Mediterranean diet can help prevent GDM in unselected pregnant women has yet to be studied. Methods We conducted a prospective, randomized controlled trial to evaluate the incidence of GDM with two different dietary models....

We aimed to corroborate glycemic control after bariatric surgery (BS) using continuous glucose monitoring (CGM) and analyze if data could predict long-term outcome. We evaluated 24 of our patients with type 2 diabetes who underwent BS (12 Roux-en-Y gastric bypass, RYGB, and 12 single-anastomosis duodeno-ileal bypass with sleeve gastrectomy, SADI-S)...

Background: The objective of the study was to determine the prevalence of hyponatremia (HN) and its associated morbimortality in hospitalized patients receiving parenteral nutrition (PN). Methods: A retrospective study including 222 patients receiving total PN (parenteral nutrition group [PNG]) over a 7-month period in a tertiary hospital and 17...

Objective: To analyze the reference range of thyroid-stimulating hormone (TSH) in different BMI categories and its impact on the classification of hypothyroidism. Methods: The study included 3,928 individuals free of thyroid disease (without previous thyroid disease, no interfering medications, TSH <10 µUI/mL and thyroid peroxidase antibodies [T...

Background: Fluid restriction is recommended as first line therapy for Syndrome of Inappropriate Antidiuresis (SIAD), despite of lack of good evidence base to support its use, and poor efficacy in clinical practice and in the literature. Aim: We set out to determine how many patients with well-defined SIAD had pre-treatment criteria which would...

Background Obesity and gestational diabetes mellitus (GDM) increase the morbidity of the mother and newborn, which could increase further should they coexist. We aimed to determine the risk of adverse pregnancy and neonatal outcomes associated with excess weight (EW), and within this group identify potential differences between those with and witho...

Background: The aim of this study was to investigate the national prevalence of thyroid dysfunction in Spain, and its association with various clinical, environmental and demographic variables. Methods: The present report includes 4554 people (42.4% men) with a mean age of 50 years (range 18-93 years) participants in a national, cross-sectional,...

Low physical activity (PA), or sedentary lifestyle, is associated with the development of several chronic diseases. We aimed to investigate current prevalence of sedentariness and its association with diabetes and other cardiovascular risk factors. PA was evaluated in a population-based, cross-sectional, randomly sampled study conducted in 2009–201...

Diabetes Study Questionnaire in original Spanish-language. (PDF)

Diabetes Study Questionnaire, English translation. (PDF)

Introduction: Hyponatremia is the most frequent electrolyte disorder found in clinical practice, and has been associated with increased morbimortalty. Hyponatremia is even more common among patients receiving parenteral nutricion(PN), a therapy increasingly in use. However, the morbimortality of hyponatremic patients on PN is unknown. Methods: Retr...

Aims: To compare rates of FPG-HbA1C-based postpartum-glucose disorder (PGD) of women with prior gestational diabetes mellitus (GDM) by Carpenter-Coustan criteria (CCc) versus International Association of Diabetes and Pregnancy Study Groups criteria (IADPSGc). Methods: 1620 women with GDM were divided into CCc group (2007-March 2012, n=915), and...

Introduction and objectives: Di@bet.es is a national study designed to estimate the prevalence of diabetes mellitus and other cardiovascular risk factors in the Spanish adult population. The prevalence of hypertension and the degree to which it is recognized, treated, and controlled are described. Methods: The study included a sample of the Span...

El Di@bet.es es un estudio nacional diseñado con el objetivo de estimar la prevalencia de diabetes mellitus y otros factores de riesgo cardiovascular en la población adulta española. Se presenta la prevalencia de hipertensión arterial y en qué grado se reconoce, se trata y se controla.

The beneficial effects of fish consumption in both children and adults are well known. However, the intake of methylmercury, mainly from contaminated fish and shellfish, can have adverse health effects. The study group on the prevention of exposure to methylmercury (GEPREM-Hg), made up of representatives from different Spanish scientific societies,...

MicroRNA (miR) expression in endothelial progenitor cells (EPCs) in type 1 diabetes (DM1) and its relation with different stages of diabetic retinopathy (DR) have not been reported to date. Our aim was to analyze miR-222, miR-221, and miR-126 expression in EPCs from DM1 patients with and without DR. We included 41 patients with DR, 35 without DR, a...

Early-pregnancy lifestyle (EPL) could influence the development of gestational diabetes mellitus(GDM), depending on the diagnostic criteria used. We studied EPL in 1750 pregnant women using Carpenter-Coustan criteria(CCc), and in 1526 with the International Association of Diabetes and Pregnancy Study Groups criteria(IADPSGc). GDM risk factors were...

Introduction: Some authors consider aldosteronism to be a spectrum, ranging from aldosterone-associated (or low-renin) hypertension (AAH) to primary hyperaldosteronism (PHA) due to bilateral adrenal hyperplasia. Thus, blood pressure (BP) response to mineralocorticoid-receptor blockade (MRB) could be similar. Methods: Retrospective analysis of 60 pa...

Introduction: Chronic tolvaptan (TV) therapy has been found to be safe and effective in the treatment of chronic SIADH. However, experience with modification of doses over time is limited. Methods: We conducted a retrospective analysis of weekly TV doses (mg) in 41 patients with chronic SIADH treated for a minimum of 3 months, seen a week following...

In a majority of Spanish hospitals, serum sodium levels (SNa) are determined by indirect electrode methodology (sodium in the liquid fraction of serum) divided by the total serum volume (mmol/L). To avoid over/underestimating SNa, a formula can be applied: SNa corrected for total proteins (TP) = SNa x 93 divided by (99.1-(0.7 x TP)). Hypoproteinemi...

To analyze the available information about continuous subcutaneous insulin infusion (CSII) and continuous glucose monitoring (CGM) systems in the public health care system of the Community of Madrid. A survey consisting of 31 items was sent to the 28 endocrinology department of the Madrid public hospitals. Items focused on CSII and CGM and included...

There are no nationwide, population-based studies in Spain assessing overall cardiovascular risk. We aimed to describe cardiovascular risk and achievement of treatment goals following the 2012 European Guidelines on cardiovascular disease prevention strategy. We also investigated clinical characteristics (non-classical risk factors) associated with...

There are no nationwide, population-based studies in Spain assessing overall cardiovascular risk. We aimed to describe cardiovascular risk and achievement of treatment goals following the 2012 European Guidelines on cardiovascular disease prevention strategy. We also investigated clinical characteristics (non-classical risk factors) associated with...

The benefit of fish consumption in children and adults is well-known. However, it has been pointed out that excessive methylmercury intake due to consumption of contaminated fish leads to neurological toxicity in children, affecting cognitive function, memory, visual-motor function and language. After the intoxications in Minamata and Iraq, wide-ra...

Mercury is an environmental toxicant that causes numerous adverse effects on human health and natural ecosystems. The factors that determine the existance of adverse effects, as well as their severity are, among others: the chemical form of mercury (elemental, inorganic, organic), dosis, age, period of exposure, pathways of exposure and environment...

Background & aims: Women with prior gestational diabetes mellitus (GDM) have a high risk of developing type 2 diabetes mellitus (DM2) in later life. The study aim was to evaluate the efficacy of a lifestyle intervention for the prevention of glucose disorders (impaired fasting glucose, impaired glucose tolerance or DM2) in women with prior GDM. M...

Background Prevalence rates of “Metabolically healthy Obese” (MHO) subjects vary depending on the criteria used. This study examined the prevalence and characteristics of MHO subjects and metabolically abnormal normal-weight subjects and compared the findings with the NHANES 1999-2004 study. Methods Di@bet.es study is a national, cross-sectional p...

Diabetes mellitus type 2 (T2DM) is a global pandemic that will affect 300 million people in the next decade. It has been shown that early and aggressive treatment of T2DM from the onset decreases complications, and the patient's active role is necessary to achieve better glycemic control. In order to achieve glycemic control targets, an active atti...

Objective The aim of this study was to examine possible associations between ambient temperature and obesity in the Spanish population using an ecological focus.Methods The Di@bet.es study is a national, cross-sectional, population-based survey of cardiometabolic risk factors and their association with lifestyle. Sample: 5,061 subjects in 100 clust...

Objective: The use of the new International Association of the Diabetes and Pregnancy Study Groups criteria (IADPSGC) for the diagnosis of gestational diabetes mellitus (GDM) results in an increased prevalence of GDM. Whether their introduction improves pregnancy outcomes has yet to be established. We sought to evaluate the cost-effectiveness of o...

Introduction and objectives The aim of this study was to compare the prevalences of obesity, diabetes and other cardiovascular risk factors in the region of Andalusia with those in the rest of Spain. Methods The Di@bet.es study is a national, cross-sectional, population-based survey of cardiometabolic risk factors and their association with lifest...

Introduction and objectives The aim of this study was to compare the prevalences of obesity, diabetes and other cardiovascular risk factors in the region of Andalusia with those in the rest of Spain. Methods The [email protected] /* */ study is a national, cross-sectional, population-based survey of cardiometabolic risk factors and their associatio...

Context: Primary hyperparathyroidism (PHPT) is a common endocrine disease, characterized by the chronic elevation of serum calcium (Ca) levels induced by a long-standing increase of PTH concentrations. PHPT includes mild-asymptomatic and symptomatic forms. Cinacalcet is effective in lowering serum Ca levels in PHPT, but is indicated solely in mild-...

Introduction: Fatal insomnia is a neurodegenerative spongiform prion disease. Presentation can be sporadic or hereditary (autonomal dominant). The latter, FFI, is caused by a mutation in the human prion protein gene on chromosome 20. Affected individuals present a disorderd sleep-wake cycle, dysautonomia and motor signs, with a predominance of lesi...

Introduction: Hyponatremia(HN) is frequent in the emergency room(ER), yet often ignored, or poorly studied/managed. Our objective was to determine the characteristics of patients presenting HN at the ER of a general hospital. Methods: Retrospective analysis of all 347 patients(AllP) presenting/developing non-translocational HN (serum sodium (SNa)<1...

The aim of the study was to analyze the association between aging and insulin resistance estimated by the homeostasis model assessment of insulin resistance (HOMA-IR). This work involved two studies: (1) the [email protected] /* */ study is a cross-sectional study including 4,948 subjects, comprising a representative sample of the adult Spanish pop...

Dyslipidemia is a significant contributor to the elevated CVD risk observed in type 2 diabetes mellitus. We assessed the prevalence of dyslipidemia and its association with glucose metabolism status in a representative sample of the adult population in Spain and the percentage of subjects at guideline-recommended LDL-C goals. The di@bet.es study is...

Type 2 diabetes (T2D) remission may be achieved after bariatric surgery (BS), but rates vary according to patients' baseline characteristics. This study evaluates the relevance of several preoperative factors and develops statistical models to predict T2D remission 1 year after BS. We retrospectively studied 141 patients (57.4% women), with a preop...

Objective: To assess lifestyle patterns associated with weight loss in newly-diagnosed type 2 diabetic patients (T2DM) in the St Carlos Study. Design: A 3-year, randomized, interventional study with three parallel groups. Setting: A single-center, outpatient clinic-based study. Participants: 195 newly-diagnosed T2DM were randomized to either the in...

Introduction and objectives Intensive glucose control with insulin in patients with an acute coronary syndrome reduces platelet reactivity during hospitalization, compared to conventional control. However, the effect of strict, long-term glucose control on platelet reactivity in these patients remains uncertain. Methods This is a prospective, rand...

The beneficial effects of fish consumption in both children and adults are well known. However, the intake of methylmercury, mainly from contaminated fish and shellfish, can have adverse health effects. the study group on the prevention of exposure to methylmercury (GEPREM-Hg), made up of representatives from different Spanish scientific societies,...

The aims are to define the regression rate in newly diagnosed type 2 diabetes after lifestyle intervention and pharmacological therapy based on a SMBG (self-monitoring of blood glucose) strategy in routine practice as compared to standard HbA1c-based treatment and to assess whether a supervised exercise program has additional effects. St Carlos stu...

Diabetes Mellitus is caused by an insulin secreting deficit and/or by a defect in its glucose lowering action, which occurs with chronically elevated glucose values that cause vascular damage. It is considered to be a global pandemic that will affect 300 million persons in the next decade. It has been demonstrated that its early treatment can decre...

Objective Compared two strategies initiating, intensifying insulin treatment and tested for noninferiority of premixed insulin to basal ± mealtime insulin analogue in patients eating light breakfasts.Research Design and Methods This randomized, open-label, 48-week study compared 2 algorithms. Up to 3 injections of insulin lispro mix 25 and/or insul...

Intensive glucose control with insulin in patients with an acute coronary syndrome reduces platelet reactivity during hospitalization, compared to conventional control. However, the effect of strict, long-term glucose control on platelet reactivity in these patients remains uncertain. This is a prospective, randomized trial evaluating the effects o...

To assess the patterns of use of 8 therapeutic drug groups for the treatment of diabetes mellitus and other cardiovascular risk factors, and to identify sociodemographic and health determinants of their use in the overall Spanish population. A representative sample of the Spanish population within the Di@bet.es study, a cross-sectional population-b...

Remission of type 2 diabetes (T2D) is a desired outcome after bariatric surgery (BS). Even if this goal is not achieved, individuals who do not strictly fulfill remission criteria experience an overall improvement. The aim of this study was to evaluate the metabolic control status in patients considered as diabetes "non-remitters." A retrospective...

Background: Despite the marked increase in cardiovascular risk factors in Spain in recent years, the prevalence and incidence of cardiovascular diseases have not risen as expected. Our objective is to examine the association between consumption of olive oil and the presence of cardiometabolic risk factors in the context of a large study representa...

Background and aims: Mediterranean diet (MedDiet) is causally related to diabetes and is a dietary pattern recommended to individuals with diabetes. We investigated MedDiet adherence in individuals with prediabetes and unknown (PREDM/UKDM) or known diabetes (KDM) compared to those with normal glucose metabolism (NORMAL). Methods: This was a nati...

Background: Controversy exists regarding type 2 diabetes (T2D) remission rates after bariatric surgery (BS) due to heterogeneity in its definition and patients' baseline features. We evaluate T2D remission using recent criteria, according to preoperative characteristics and insulin therapy (IT). Methods: We performed a retrospective study from a...

Introduction: Hyponatremia is the most frequent electrolyte alteration in hospitalized patients, and is associated with increased morbimortality. Hyponatremia in patients receiving parenteral nutrition (PN) is generally overlooked. Our objective was to classify the types of hyponatremia observed in patients on PN, and to describe the prescribed tre...