Nuestros investigadores

Alejandro Fernández Montero

Publicaciones científicas más recientes (desde 2010)

Autores: Roncal, Carmen; Martinez-Aguilar, E.; Orbe, J; et al.
ISSN 2045-2322  Vol. 9  2019  págs. 15580
Peripheral artery disease (PAD) is a major cause of acute and chronic illness, with extremely poor prognosis that remains underdiagnosed and undertreated. Trimethylamine-N-Oxide (TMAO), a gut derived metabolite, has been associated with atherosclerotic burden. We determined plasma levels of TMAO by mass spectrometry and evaluated their association with PAD severity and prognosis. 262 symptomatic PAD patients (mean age 70 years, 87% men) categorized in intermittent claudication (IC, n = 147) and critical limb ischemia (CLI, n = 115) were followed-up for a mean average of 4 years (min 1-max 102 months). TMAO levels were increased in CLI compared to IC (P < 0.001). Receiver operating characteristic (ROC) curves for severity (CLI) rendered a cutoff of 2.26 mu mol/L for TMAO (62% sensitivity, 76% specificity). Patients with TMAO > 2.26 mu mol/L exhibited higher risk of cardiovascular death (sub-hazard ratios >= 2, P < 0.05) that remained significant after adjustment for confounding factors. TMAO levels were associated to disease severity and CV-mortality in our cohort, suggesting an improvement of PAD prognosis with the measurement of TMAO. Overall, our results indicate that the intestinal bacterial function, together with the activity of key hepatic enzymes for TMA oxidation (FMO3) and renal function, should be considered when designing therapeutic strategies to control gut-derived metabolites in vascular patients.
Autores: Garralda-Del-Villar, M. ; Carlos, Silvia; et al.
ISSN 2072-6643  Vol. 11  Nº 1  2019  págs. E65
We assessed the relationship between a healthy lifestyle and the subsequent risk of developing metabolic syndrome. The "Seguimiento Universidad de Navarra" (SUN) Project is a prospective cohort study, focused on nutrition, lifestyle, and chronic diseases. Participants (n = 10,807, mean age 37 years, 67% women) initially free of metabolic syndrome were followed prospectively for a minimum of 6 years. To evaluate healthy lifestyle, nine habits were used to derive a Healthy Lifestyle Score (HLS): Never smoking, moderate to high physical activity (>20 MET-h/week), Mediterranean diet (>= 4/8 adherence points), moderate alcohol consumption (women, 0.1-5.0 g/day; men, 0.1-10.0 g/day), low television exposure (<2 h/day), no binge drinking (<= 5 alcoholic drinks at any time), taking a short afternoon nap (<30 min/day), meeting up with friends >1 h/day, and working at least 40 h/week. Metabolic syndrome was defined according to the harmonizing definition. The association between the baseline HLS and metabolic syndrome at follow-up was assessed with multivariable-adjusted logistic regressions. During follow-up, we observed 458 (4.24%) new cases of metabolic syndrome. Participants in the highest category of HLS adherence (7-9 points) enjoyed a significantly reduced risk of developing metabolic syndrome compared to those in the lowest category (0-3 points) (adjusted odds ratio (OR) = 0.66, 95% confidence interval (CI) = 0.47-0.93). Higher adherence to the Healthy Lifestyle Score was associated with a lower risk of developing metabolic syndrome. The HLS may be a simple metabolic health promotion tool.
Autores: de Cuevillas, B.; Alvarez, Ismael; Cuervo, M; et al.
ISSN 0212-1611  Vol. 36  Nº 4  2019  págs. 862 - 874
Background: there are numerous approaches to assess nutritional status, which are putatively applied to nutritionally classify diseased people, but less information is available to study the role of environmental factors on nutritional well-being. A qualitative (nutritypes) and quantitative (nutrimeter) nutritional categorization based on dietary, lifestyle and disease criteria can be a useful nutritional approach to personalize health interventions and identify at risk individuals. Methods: cross-sectional study conducted on 102 patients (60 women), evaluating quality of life using the Short-Form 36 questionnaire (SF-36) and lifestyle factors with a general questionnaire, the Mediterranean Diet Adherence Screener (MEDAS) and the Global Physical Activity Questionnaire (GPAQ). A nutrimeter based on physical activity, fat mass, diet and diseases (hypertension, prediabetes, obesity and dyslipidemia) data was defined with an equation to quantitatively score the nutritive well-being of the participants, and classify them into two (proto)nutritypes. Results: participants were categorized into two groups (lower/higher global health) according to quality of life. Significant or marginal statistical differences in physical activity, fat mass, diet and disease were found (all p < 0.1). Two (proto)nutritypes were identified based on participant's age, sex, fat mass, physical activity, diet and diseases. Participants classified as high nutritional well-being nutritype showed higher value
Autores: Marcos-Jubilar, María; Orbe, J; Roncal, Carmen; et al.
ISSN 0214-9168  Vol. 31  Nº 4  2019  págs. 152 - 159
Introduction: Monocytes play an important role in atherosclerotic progression having both pro and anti-inflammatory effects depending on different circulating monocyte subpopulations. The objective of this study is to characterize these subpopulations and their association with cardiovascular risk factors. Methods: Transversal study including 102 selected patients, mean age: 65 years-old (range 41-86), 69% males. A set of specific antibodies against classical monocytes (Mont, CD14+CD16- CD300e+HLADR+), intermediate (Mon2, CD14+CD16+CD300e+HLADR+) and nonclassical (Mon3, CD14 CD16+CD300e+HLADR+) was assayed. Three groups of patients were included: 17 asymptomatic with more than one cardiovascular risk factor (group 1), 56 subjects asymptomatic but with vascular pathology assessed by ultrasound or microalbuminuria (group 2) and 19 patients with a previous atherothrombotic event (group 3). The cardiovascular risk was determined by Framingham and REGICOR scores. Results: An association between study groups and the percentage of Mon1 and Mon2 was observed (ANOVA, p <.05), being independent of age and sex for Mon2. Likewise Mont and Mon2 subpopulations were associated with cardiovascular adverse events (beta=0.86, p=.02 beta-0.1 p=.002, respectively), independently of age and sex in the case of Mon2. Moreover the percentage of Mon3 was associated with the presence of several cardiovascular risk factors ((3 = 0.21, p =.04) in the univariate analysis. In addition, there was a correlation between the levels of Mon1 and Mon2 and leukocytes (r =0.7, p <.001 and r =0.26, p =.01, respectively). Conclusions: The analysis of monocyte subpopulations may be clinically useful to stratify the inflammatory profile related to the different cardiovascular risk groups.
Autores: Molero, Patricio, (Autor de correspondencia); Lahortiga F, (Autor de correspondencia); et al.
ISSN 0165-0327  Vol. 247  2019  págs. 161 - 167
Background: The potential effect of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) to prevent depression remains largely unknown, in spite of the implication of inflammation in depression. This study aimed to investigate whether the habitual intake of aspirin and other NSAIDs was prospectively associated with a reduction in the observed incidence of depression. Methods: A dynamic cohort including 22,564 Spanish university graduates (mean age: 37 years) initially free of depression was followed during an average of 8.7 years. Exposure to NSAIDs was assessed with specific repeated questionnaires throughout follow-up, starting in the 2-year follow-up questionnaire. Incident cases of depression were defined as either a new validated medical diagnosis of depression or reporting the initiation of habitual use of antidepressants. Results: We identified 772 incident cases of depression. Regular intake of aspirin and other NSAIDs was not associated with depression risk. Only in secondary sensitivity analyses using a definition of the outcome with higher specificity (a validated medical diagnosis of depression), an inverse association of aspirin with depression was found [HR (95%CI): 0.20 (0.04-0.87)]. However, these results were non-significant after adjustment for multiple testing. Limitations: A possible underestimation of incident depression and a limited ability to detect all possible residual confounding. Conclusions: Regular use of NSAIDs was not associated with the incidence of depression. Further longitudinal controlled studies are necessary to clarify a potential role of aspirin use in depression risk.
Autores: Marcos-Jubilar, María; Pastrana, Juan Carlos; Orbe, J; et al.
ISSN 0390-6078  Vol. 104  2019  págs. 144 - 144
Autores: Roncal, Carmen; Martinez-Aguilar, E.; Orbe, J.; et al.
ISSN 0021-9150  Vol. 287  2019  págs. E233 - E233
Autores: Alvarez, Ismael; Zazpe I; Pérez de Rojas, J.; et al.
ISSN 0091-7435  Vol. 106  2018  págs. 45 - 52
The health benefits of the Mediterranean diet (MedDiet) and of physical activity (PA) have been widely documented. However, no longitudinal studies have investigated their combined effect on mortality. We assessed the individual and combined effects of adherence to the MedDiet and PA on all-cause mortality. We used data from 19,467 participants from a prospective cohort of Spanish university graduates, the SUN cohort, followed-up between December 1999 and February 2016. Adherence to the MedDiet was assessed using four different dietary scores, categorizing the quantitative scores into tertiles of adherence. To assess multiple dimensions of PA, an 8-item score was built. Multivariable Cox regression models were used to study the individual and combined relationship of adherence to the MedDiet and PA with all-cause mortality. During a median follow-up of 10.3 years, we registered 305 deaths. Compared with the lowest adherence to the MedDiet (< 20 in the modified Mediterranean diet score), better adherence (23¿30 points) was associated with lower mortality (multivariable-adjusted hazard ratio [HR] = 0.66, 95% confidence interval [CI]: 0.46¿0.96). Engaging in moderate or high levels of PA (versus lower levels) was associated with 44% and 52% relative reductions in mortality, respectively. High adherence to the MedDiet combined with engaging in higher amounts of PA showed a HR = 0.36 (95% CI: 0.19¿0.67). We documented that the combined effect of better adherence to the MedDiet and increased PA had multiplicative effects on mortality risk reduction.
Autores: Alvarez, Ismael; de Rojas, J. P.; Fernández-Montero, Alejandro; et al.
ISSN 2047-4873  Vol. 25  Nº 11  2018  págs. 1186 - 1197
Background Inverse associations of the Mediterranean diet (MedDiet) and physical activity with cardiovascular disease have been previously reported. We investigated the individual and combined contributions of both to this inverse association in a Mediterranean cohort. Design We used data from 19,536 participants from a prospective cohort of Spanish university graduates, the 'Seguimiento Universidad de Navarra' (SUN) cohort, followed up between December 1999 and December 2016. Methods Adherence to the MedDiet was obtained from a 136-item validated food-frequency questionnaire and categorized in tertiles using four previously reported dietary scores. A validated questionnaire assessed the physical activity levels according to volume, intensity and frequency. Results Participants were followed up during a median time of 10.4 years. Compared with the lowest category of adherence to the MedDiet (¿3 in the Mediterranean Diet Score), higher adherence (6-9 points) was strongly inversely associated with cardiovascular disease (multivariable adjusted hazard ratio¿=¿0.33; 95% confidence interval (CI) 0.20-0.55). Also, engaging in an active lifestyle (6-8 points in an eight-item score) compared with low activity (<2 points) was associated with a reduced risk of incident cardiovascular disease (hazard ratio¿=¿0.43; 95% CI 0.20-0.90). Greater adherence to the MedDiet and engaging in high levels of active lifestyle showed a 75% relatively reduced risk of cardiovascular disease (hazard ratio¿=¿0.25; 95% CI 0.13-0.48). Conclusions The combined effect of adherence to the MedDiet and adopting an active lifestyle showed a synergistic inverse association with cardiovascular disease risk.
Autores: Hidalgo-Santamaría, María; Bes-Rastrollo, Maira; Martínez, Miguel Ángel; et al.
ISSN 0002-9149  Vol. 122  Nº 11  2018  págs. 1871 - 1878
The association between the intensity of physical activity and the incidence of cardiovascular diseases (CVD), irrespective of energy expenditure (EE), requires further study. Our objective is to examine this relationship using data from a large Spanish cohort. The Seguimiento Universidad de Navarra cohort is formed of university graduates recruited from March 1999 to October 2015. We included 18,737 adults free of CVD (mean age 38 years, 61 % women), with a median follow-up of 10.3 years. We estimated the average intensity of leisure time physical activity (LTPA) using a validated questionnaire. We classified respondents into 3 groups: Inactive, < 6 average metabolic equivalents (METs) and >= 6 average METs. We used Cox proportional hazards models adjusted by the EE in LTPA (MET-h/week) and other confounding factors, to examine this association. During 1,72,299 person-years of follow-up, we registered 127 cases of CVD (myocardial infarction, stroke, and death due to cardiovascular causes). The adjusted hazard ratio for CVD was 0.76 (95% CI 0.48 to 1.21) in the lower intensity group, and 0.31 (95% CI 0.12 to 0.79) in the higher intensity group, compared with the inactive, with a linear trend (p = 0.03). In conclusion, given the same level of EE, those respondents engaged in higher intensity LTPA, had a lower risk of CVD.
Autores: Alvarez, Ismael; Zazpe I; de Rojas, J. P.; et al.
ISSN 0014-2972  Vol. 48  Nº Supl 1  2018  págs. 170
Autores: Leone, A.; Fernández-Montero, Alejandro; de la Fuente-Arrillaga, Carmen; et al.
ISSN 0272-6386  Vol. 70  Nº 6  2017  págs. 778 - 786
Background: Diet plays an important role in the pathogenesis of nephrolithiasis. Limited data are available to investigate the association between a Mediterranean dietary pattern and risk for nephrolithiasis. Study Design: Prospective cohort study. Setting & Participants: 16,094 men and women without a history of nephrolithiasis who participated in the Seguimiento Universidad de Navarra Follow-up (SUN) Project. Predictors: A validated 136-item food frequency questionnaire was used to assess baseline adherence to a Mediterranean dietary pattern that is high in fruits, vegetables, nuts, fish, and legumes, but moderate in alcohol and low in meats, saturated fats, and sugars. A Mediterranean dietary pattern score was calculated and categorized into 3 groups (0-3, 4-6, and 7-9 points). Additional factors included in statistical models were sex, age, body mass index, smoking, physical activity, time spent watching television, following a medical nutritional therapy, water and energy intake, calcium and vitamin D supplementation, and history of hypertension or diabetes. Outcomes: Incidence of nephrolithiasis. Participants were classified as having incident nephrolithiasis if they reported a physician-made diagnosis of nephrolithiasis during follow-up. Results: After a mean follow-up of 9.6 years, 735 new cases of nephrolithiasis were identified. The multivariable HRs of nephrolithiasis for the 2 highest categories of adherence to the Mediterranean dietary pattern, using the lowest category as the reference, were 0.93 (95% CI, 0.79-1.09) and 0.64 (95% CI, 0.48-0.87); P for trend = 0.01. The risk for nephrolithiasis was lower with greater consumption of dairy products and vegetables and greater with higher monounsaturated fatty acid to saturated fatty acid ratio. Limitations: No information for kidney stone composition. Conclusions: Greater adherence to a Mediterranean dietary pattern was associated with reduced risk for incident nephrolithiasis. Additional longitudinal studies are needed. (C) 2017 by the National Kidney Foundation, Inc.
Autores: Ayestarán Aldaz, A.; Garcia-Ros, D; Sánchez Tainta, Ana; et al.
ISSN 1132-6255  Vol. 26  Nº 4  2017  págs. 247 - 256
The aim of this study is to analyse the correlation between the main components of physical activity (strength, flexibility and resistance) and quality of life examined in a work environment. Method: In a randomized, controlled trial throughout one year of follow-up patients were evaluated by their quality of life (SF-36 health survey) and their physical exercise (resistance measured by cardiopulmonary stress test; strength and flexibility based on Eurofit Fitness Test Battery). The intervention group received a personalized exercise plan and the control group attended an informative talk with general guidelines. Results: Both groups improved their physical activity, however, Intervention group had better results 48,7 than Control group 40,87 (p=0,03). Workers with better physical activity proved a greater quality of life (OR:6,69; IC95%:1,48-30,20), being the resistance the major contributing component (OR:8,64; IC95%:1,69-44,04). Conclusion: Workers with a higher level of physical exercise are associated with improved quality of life.
Autores: Martinez-Aguilar, E.; Orbe, J; Fernández-Montero, Alejandro; et al.
ISSN 0741-5214  Vol. 66  Nº 5  2017  págs. 1527 - 1533
Objective The prognosis of patients with peripheral arterial disease (PAD) is characterized by an exceptionally high risk for myocardial infarction, ischemic stroke, and death; however, studies in search of new prognostic biomarkers in PAD are scarce. Even though low levels of high-density lipoprotein cholesterol (HDL-C) have been associated with higher risk of cardiovascular (CV) complications and death in different atherosclerotic diseases, recent epidemiologic studies have challenged its prognostic utility. The aim of this study was to test the predictive value of HDL-C as a risk factor for ischemic events or death in symptomatic PAD patients. Methods Clinical and demographic parameters of 254 symptomatic PAD patients were recorded. Amputation, ischemic coronary disease, cerebrovascular disease, and all-cause mortality were recorded during a mean follow-up of 2.7 years. Results Multivariate analyses showed that disease severity (critical limb ischemia) was significantly reduced in patients with normal HDL-C levels compared with the group with low HDL-C levels (multivariate analysis odds ratio, 0.09; 95% confidence interval [CI], 0.03-0.24). A decreased risk for mortality (hazard ratio, 0.46; 95% CI, 0.21-0.99) and major adverse CV events (hazard ratio, 0.38; 95% CI, 0.16-0.86) was also found in patients with normal vs reduced levels of HDL-C in both Cox proportional hazards models and Kaplan-Meier estimates, after adjustment for confounding factors. Conclusions Reduced HDL-C levels were significantly associated with higher risk for development of CV complications as well as with mortality in PAD patients. These findings highlight the usefulness of this simple test for early identification of PAD patients at high risk for development of major CV events.
Autores: Sánchez-Iñigo, L.; Navarro-González, D.; Fernández-Montero, Alejandro; et al.
ISSN 1747-4930  Vol. 12  Nº 2  2017  págs. 187 - 191
Background Whether obesity is a major risk factor for cardiovascular disease in the absence of metabolic comorbidities remains under debate. Indeed, some obese individuals may be at low risk of metabolic-related complications, while normal-weight individuals may not be "healthy." Aims To assess the incidence of ischemic stroke according to the metabolic health and obesity states of 5171 participants from the Vascular-Metabolic CUN cohort. Methods A Cox proportional-hazard analysis was conducted to estimate the hazard ratio and their 95% confidence interval of stroke according to the metabolic health and obesity states based on TyG index and Adult Treatment Panel-III criteria, during 9.1 years of follow-up. Results After 50,056.2 person-years of follow-up, 162 subjects developed an ischemic stroke (incidence rate 3.23 per 1000 person-years). Metabolically healthy obese subjects did not show greater risk of stroke, while metabolically unhealthy participants, obese and non-obese, had an increased risk of stroke, compared with healthy non-obese. The hazard ratios for the multivariable adjusted model were 1.55 (95% CI: 1.36-1.77) and 1.86 (95% CI: 1.57-2.21), respectively. Conclusions Metabolically unhealthy individuals exhibited a greater risk of ischemic stroke than metabolically healthy obese individuals.
Autores: Pérez-de-Arcelus, M.; Toledo, Estefanía Ainhoa; Martínez, Miguel Ángel; et al.
ISSN 0025-7974  Vol. 96  Nº 1  2017  págs. e5761
Smoking is a serious global public health concern that has been related to many chronic diseases. However, the effect of smoking on eye disorders has been less studied. The aim of this cohort study was to assess the association between current tobacco smokers and the risk of developing glaucoma and furthermore to evaluate the relationship between passive or former smokers and glaucoma. In this prospective and dynamic cohort, 16,797 participants initially who were found not to have glaucoma were followed up for a median of 8.5 years. Validated data on lifestyle, including tobacco consumption, were assessed at baseline. Information about new diagnosis of glaucoma was collected by follow-up questionnaires every 2 years. The outcome was the incidence of self-reported glaucoma during the follow-up. A subsample was used to validate the glaucoma diagnosis. During the 8.5 years of follow-up, 184 new glaucoma cases were identified. Current smokers had a significantly higher risk of glaucoma compared to participants who had never smoked after controlling for potential confounders (Hazard ratio [HR] 1.88 [95% coefficient interval (CI): 1.26-2.81]; P=0.002). A nonsignificant increased risk was found among former smokers (HR 1.27 [95% CI: 0.88-1.82]; P=0.198). When we assessed the exposure as per the number of cigarette pack-years, a dose-response relationship between pack-years and the risk of glaucoma was found (HR for the 5th quintile versus the 1st quintile: 1.70 [95% IC: 1.10-2.64], P for trend, 0.009). However, no relationship was found between passive smokers and glaucoma. (HR 0.67 [95% CI: 0.37-1.21]; P=0.189). Our results suggest a direct association between current smokers and the incidence of glaucoma. In particular, this association was related to the number of pack-years, which was not found in the case of former smokers nor in the case of passive smokers.
Autores: Bastarrika, Gorka; et al.
Revista: CHEST
ISSN 0012-3692  Vol. 151  Nº 2  2017  págs. 358 - 365
BACKGROUND: The clinical characteristics of patients with emphysema but without airway limitations remain unknown. The goal of this study was to compare the clinical features of current and former smokers without airflow limitation who have radiologic emphysema on chest CT scans vs a control group of current and ex-smokers without emphysema. METHODS: Subjects enrolled had anthropometric characteristics recorded, provided a medical history, and underwent low-dose chest CT scanning. The following parameters were also evaluated: pulmonary function tests including diffusion capacity for carbon monoxide (D-LCO), the modified Medical Research Council dyspnea score, COPD assessment test (CAT), and 6-min walk test (6MWT). Acomparison was conducted between those with and withoutCT-confirmedemphysema. RESULTS: Of the 203 subjects, 154 had emphysema, and 49 did not. Adjusted group comparisons revealed that a higher proportion of patients with emphysema according to low-dose chest CT scanning had an abnormal DLCO value (< 80%) (46% vs 19%; P = .02), a decrease in percentage of oxygen saturation > 4% during the 6MWT (8.5% vs 0; P = .04), and an altered quality of life (CAT score >= 10) (32% vs 14%; P = .01). A detailed analysis of the CAT questionnaire items revealed that more patients with emphysema had a score >= 1 in the "chest tightness" (P = .05) and "limitation when doing activities at home" (P < .01) items compared with those with no emphysema. They also experienced significantly more exacerbations in the previous year (0.19 vs 0.04; P = .02). CONCLUSIONS: A significant proportion of smokers with emphysema according to low-dose chest CT scanning but without airway limitation had alterations in their quality of life, number of exacerbations, DLCO values, and oxygen saturation during the 6MWT test.
Autores: Elizalde, Arlette María; et al.
ISSN 0284-1851  Vol. 58  Nº 6  2017  págs. 645 - 651
Background: Digital breast tomosynthesis (DBT) and ultrasound (US) can detect additional cancers after negative mammography. However, not all cancers are visible by both techniques. Purpose: To study the role of the amount of peritumoral fat in the detection of additional cancers with DBT or US. Material and Methods: One reader retrospectively reviewed 142 breast cancers in 109 women who underwent mammography, DBT, US, and magnetic resonance imaging (MRI). Two readers in consensus evaluated the additional cancers detected by US, DBT, or MRI, and classified them into four groups according to the amount of peritumoral adipose tissue: group I, > 75% of peritumoral fat; group II, 50-74%; group III, 25-49%, and group IV, 0-24%. The detection of additional cancers by US and DBT with respect to the other imaging techniques was evaluated. Results: Seventy-eight cancers were detected by mammography and the remaining 64 cancers were detected by DBT, US, or MRI. US and DBT detected 46 (71.8%) and 25 (39.06%) additional tumors, respectively. Statistical significance was only found in group IV (P < 0.01). Conclusion: US detected more tumors than DBT in lesions surrounded by a small amount of fat. No significant differences were found between US and DBT in the detection of additional cancers in the other groups.
Autores: Hidalgo-Santamaría, María; Fernández-Montero, Alejandro; Martínez, Miguel Ángel; et al.
ISSN 0749-3797  Vol. 52  Nº 4  2017  págs. e95 - e101
INTRODUCTION: Emerging evidence suggests that vigorous physical activity may be associated with higher cardioprotective benefits than moderate physical activity. This study aimed to assess the long-term relationship between the intensity of leisure time physical activity (LTPA) and the risk of developing metabolic syndrome (MS) in a prospective cohort study. METHODS: The Seguimiento Universidad de Navarra (SUN) Project comprises Spanish university graduates. Participants (n=10,145) initially free of MS were followed for a minimum of 6 years (2008-2014). Analysis was conducted in 2015. Physical activity was assessed though a validated questionnaire. The intensity of each physical activity was measured in METs. The intensity of LTPA was estimated by the ratio between total METs/week and total hours of LTPA/week, obtaining the mean METs/hour of LTPA. MS was defined according to the harmonizing definition. The association between the intensity of LTPA (METs/hour) and MS was assessed with logistic regression models adjusting for potential confounders. RESULTS: Among 10,145 participants initially free of any MS criteria, 412 new MS cases were observed. Vigorous LTPA was associated with a 37% relatively lower risk (AOR=0.63, 95% CI=0.44, 0.89) compared with light LTPA. For a given total energy expenditure, independent of the time spent on it, participants who performed vigorous LTPA exhibited a higher reduction in the risk of MS than those who performed light to moderate LTPA. CONCLUSIONS: Vigorous LTPA was significantly associated with lower risk of developing MS after a 6-year follow-up period.
Autores: Garcia-Velloso, Maria Jose; Rodríguez-Fraile, M; et al.
ISSN 0938-7994  Vol. 27  Nº 8  2017  págs. 3190-3198
Our aim was to evaluate the diagnostic accuracy of magnetic resonance imaging (MRI) fused with prone 2-[fluorine-18]-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) in primary tumour staging of patients with breast cancer. METHODS: This retrospective study evaluated 45 women with 49 pathologically proven breast carcinomas. MRI and prone PET-CT scans with time-of-flight and point-spread-function reconstruction were performed with the same dedicated breast coil. The studies were assessed by a radiologist and a nuclear medicine physician, and evaluation of fused images was made by consensus. The final diagnosis was based on pathology (90 lesions) or follow-up¿¿¿24 months (17 lesions). RESULTS: The study assessed 72 malignant and 35 benign lesions with a median size of 1.8 cm (range 0.3-8.4 cm): 31 focal, nine multifocal and nine multicentric cases. In lesion-by-lesion analysis, sensitivity, specificity, positive and negative predictive values were 97%, 80%, 91% and 93% for MRI, 96%, 71%, 87%, and 89% for prone PET, and 97%. 94%, 97% and 94% for MRI fused with PET. Areas under the curve (AUC) were 0.953, 0.850, and 0.983, respectively (p¿<¿0.01). CONCLUSIONS: MRI fused with FDG-PET is more accurate than FDG-PET in primary tumour staging of breast cancer patients and increases the specificity of MRI.
Autores: Fernández-Montero, Alejandro; Bes-Rastrollo, Maira; Moreno, Javier; et al.
Revista: EYE
ISSN 0950-222X  Vol. 31  Nº 7  2017  págs. 1085 - 1092
Purpose Previous studies have suggested that pregnancy may induce myopia progression. However, no longitudinal study with a large sample size and long-term follow-up has assessed this association. Our objective was to investigate whether pregnancy was related to mid-or long-term myopic refraction changes. Patients and methods A prospective study was conducted in a Mediterranean cohort. The study included 10 401 women (20-50 years old) from the SUN Project. SUN project is a multipurpose, prospective, and dynamic cohort of university graduates conducted in Spain. The recruitment of participants started in 1999 and it is permanently open. All participants in this cohort had university studies. Participants were followed up for a period of up to 14 years, and pregnancy and refractive changes were assessed through baseline and biennial questionnaires. Pregnancies and myopia were repeatedly assessed in each biennial follow-up questionnaire during a total of 14 years of follow-up. Results Pregnancy was inversely associated with the risk of myopia development or progression during each of the 2 years periods, with fully adjusted hazard ratio = 0.61; (95% confidence interval = 0.49-0.75) after adjusting for known potential confounders. Conclusion To our knowledge this is the first large-longitudinal assessment in young adult women, showing that pregnancy is inversely associated with myopia development or progression. Further studies are needed to confirm these epidemiological findings.
Autores: Sánchez-Íñigo, L.; Navarro-González, D.; Fernández-Montero, Alejandro; et al.
ISSN 0014-2972  Vol. 46  Nº 2  2016  págs. 189 - 197
Background: Cardiovascular disease (CVD) is the worldwide leading cause of morbidity and mortality. An early risk detection of apparently healthy people before CVD onset has clinical relevance in the prevention of cardiovascular events. We evaluated the association between the product of fasting plasma glucose and triglycerides (TyG index) and CVD. Material and Methods: A total of 5014 patients of the Vascular Metabolic CUN cohort (VMCUN cohort) were followed up during a median period of 10 years. We used a Cox proportional-hazard ratio with repeated measures to estimate the risk of incidence of CVD across quintiles of the TyG index, calculated as ln[fasting triglycerides (mg/dL) × fasting plasma glucose (mg(dL)/2], and plotted a receiver-operating characteristics (ROC) curve to compare a prediction model fitted on the variables used in the Framingham risk score, a new model containing the Framingham variables with the TyG index, and the risk of coronary heart disease. Results: A higher level of TyG index was significantly associated with an increased risk of developing CVD independent of confounding factors with a value of 2·32 (95% CI: 1·65-3·26) for those in the highest quintile and 1·52 (95% CI: 1·07-2·16) for those in the fourth quintile. The areas under the curve (AUC) of the ROC plots were 0·708 (0·68-0·73) for the Framingham model and 0·719 (0·70-0·74) for the Framingham + TyG index model (P = 0·014). Conclusions: The TyG index, a simple measure reflecting insulin resistance, might be useful to early identify individuals at a high risk of developing a cardiovascular event.
Autores: Navarro-González, D.; Sánchez-Íñigo, L.; Fernández-Montero, Alejandro; et al.
ISSN 0025-7974  Vol. 95  Nº 19  2016  págs. e3646
The risk of type 2 diabetes associated with obesity appears to be influenced by other metabolic abnormalities, and there is controversy about the harmless condition of the metabolically healthy obese (MHO) state. The aim of this study is to assess the risk of diabetes and the impact of changes in weight and in triglyceride-glucose index (TyG index), according to the metabolic health and obesity states.We analyzed prospective data of the Vascular Metabolic CUN cohort, a population-based study among a White European population (mean follow-up, 8.9 years). Incident diabetes was assessed in 1923 women and 3016 men with a mean age at baseline of 55.33¿±¿13.68 and 53.78¿±¿12.98 years old.A Cox proportional-hazard analysis was conducted to estimate the hazard ratio (HR) of diabetes on metabolically healthy nonobese (MHNO), metabolically healthy obese, metabolically unhealthy nonobese (MUNO), and metabolically unhealthy obese (MUO). A continuous standardized variable (z-score) was derived to compute the HR for diabetes per 1-SD increment in the body mass index (BMI) and the TyG index.MHO, MUNO, and MUO status were associated with the development of diabetes, HR of 2.26 (95% CI: 1.25-4.07), 3.04 (95% CI: 1.69-5.47), and 4.04 (95% CI: 2.14-7.63), respectively. MUNO individuals had 1.82 greater risk of diabetes compared to MHO subjects (95% CI: 1.04-3.22). The HRs for incident diabetes per 1-SD increment in BMI and TyG indexes were 1.23 (95% CI: 1.04-1.44) and 1.54 (95% CI: 1.40-1.68). The increase in BMI did not raise the risk of developing diabetes among metabolically unhealthy subjects, whereas increasing the TyG index significantly affect the risk in all metabolic health categories.Metabolic health is more important determinant for diabetes onset than weight gain. The increase in weight does not raise the risk of developing diabetes among metabolically unhealthy subjects.
Autores: Sánchez Íñigo L; Navarro González D; Pastrana, Juan Carlos; et al.
ISSN 1473-5598  Vol. 34  Nº 7  2016  págs. 1257-1265
Triglycerides and high-density lipoprotein cholesterol (HDL-C) are known to be risk factors for cardiovascular disease. However, there has been limited knowledge on the relationship between triglycerides and incident hypertension. The associations of incident hypertension with triglycerides and triglycerides-related indices such as triglycerides to HDL-C ratio (TG/HDL-C) and triglyceride-glucose index (TyG) were evaluated.
Autores: Fernández-Montero, Alejandro; Alonso-Alvarez, A; Rodríguez, Ana Belén; et al.
ISSN 1132-6255  Vol. 25  Nº 2  2016  págs. 58-72
La PT en la consulta de Medicina del Trabajo está justificada al tratarse de una prueba diagnóstica con alta sensibilidad, pero al generar un gran número de falsos positivos, precisa posteriormente de una prueba con una alta especificidad como el QTF-GIT para evitar la quimioprofilaxis innecesaria.
Autores: Navarro-González, D. , (Autor de correspondencia); Sánchez-Íñigo, L.; Fernández-Montero, Alejandro; et al.
Revista: OBESITY
ISSN 1930-7381  Vol. 24  Nº 12  2016  págs. 2615 - 2623
Objective: To examine the risk of diabetes and the development of an unhealthy status according to metabolic health. To assess the effect of changes in metabolic health among participants with metabolically healthy obesity (MHO) on the risk of diabetes. Methods: A total of 4,340 subjects were included. Unhealthy metabolic status was defined as having three or more risk factors of the Adult Treatment Panel-III criteria. A Cox proportional-hazard analysis was conducted to estimate the hazard ratio (HR) of developing diabetes across the change in the metabolic status of subjects with MHO. Results: After 40,622 person-years of follow-up, the risk of becoming unhealthy was 1.53 times higher for participants with MHO, compared with lean or overweight healthy subjects. A greater risk of diabetes was found in MHO, but it was attributable to those who progressed to an unhealthier status over time: HR of 4.78 (95% CI: 3.38-6.78). The combination of being metabolically unhealthy and obesity heightened the risk of diabetes: HR of 10.09 (95% CI: 4.82-21.55). Conclusions: The increased risk of diabetes in MHO is attributed to the progression to an unhealthier state. "Healthy obesity" is not a permanent situation but a transitory state.
Autores: Navarro-González D; Sánchez-Íñigo L; Pastrana, Juan Carlos; et al.
ISSN 0091-7435  Vol. 86  2016  págs. 99-105
Our data suggest that the TyG index is useful for the early identification of individuals at risk of type 2 diabetes. The TyG index seems to be a better predictor than FPG or triglycerides of the potential development of type 2 diabetes in normoglycemic patients.
Autores: Artaiz, M; Salterain, Nahikari; Fernández-Montero, Alejandro; et al.
ISSN 1137-6627  Vol. 39  Nº 1  2016  págs. 87-97
Aunque el alto volumen intervencionista ha demostrado ser importante para tener una baja tasa de complicaciones y una buena evolución a largo plazo, hay centros con bajo volumen intervencionista que por sus características pueden obtener resultados equiparables a los de alto volumen
Autores: Busto-Crespo, O; Uzcanga Lacabe, M; Abad Marco, A; et al.
ISSN 0892-1997  Vol. 30  Nº 6  2016  págs. 767.e9-767e15.
Voice therapy is effective in patients with UVFP and its benefits are sustained over time. Early referral for voice therapy seems to be associated with greater benefit, but quality of life also improves for patients despite delayed treatment.
Autores: Fernández-Montero, Alejandro; Zazpe I; Sánchez Tainta, Ana; et al.
ISSN 1888-5438  Vol. 138  2015  págs. 32 - 40
Autores: Fernández-Montero, Alejandro; Olmo-Jimenez JM; et al.
ISSN 0091-7435  Vol. 71  2015  págs. 67 - 71
Objective Many subjects, especially highly educated subjects, are increasingly exposed to computer use. This exposure might represent an explanation for the growing rates of myopia. Methods We assessed 17,217 Spanish university graduates from the SUN project, an open-recruitment cohort. Their mean age was 38.5 years (SD 12.1), and their mean time of exposure to computers was 14.3 h/week (SD 14.6). We estimated multivariable-adjusted odds ratios (OR) for the risk of myopia development and/or progression (¿ 0.5 diopters) according to baseline exposure to computer and to changes in exposure. Results The age and sex-adjusted OR comparing > 40 h/week of exposure versus < 10 h/week was 1.34 (95% confidence interval (CI): 1.12¿1.60). This association remained essentially unchanged after additional adjustments. Comparing participants who increased their exposure to computers, versus those with no change, the age and sex-adjusted OR was 1.49 (1.34¿1.66). This result was unchanged after additional adjustments. Conclusions To our knowledge this is the first large longitudinal assessment in young adults, showing that exposure to computer use is associated with myopia development or progression in a cohort of Spanish university graduates. Further studies are needed to confirm these epidemiological findings.
Autores: Fernández-Montero, Alejandro; Martínez, Miguel Ángel; Moreno-Galarraga, Laura;
ISSN 0899-9007  Vol. 31  Nº 10  2015  págs. 1299 - 1300
Autores: Esteban-Fernández, Alberto; Salterain, Nahikari; et al.
ISSN 1205-6626  Vol. 20  Nº 10   2014  págs. 6176 - 6186
The conjoint consumption of food with beer has an interactive influence on metabolic oxidative fates and may have impact on alcoholaemia. The objective of this is study is to characterize the impact of alcohol in macronutrient oxidation and blood alcohol oncentrations in healthy people, depending on sex, age, body mass and ¿tapas¿ different nutrient composition, as well as the relationship with alcohol in breath test and respiratory quotient. The trial included seventy-one people who drank a beer jointly with some food (bread, nuts or ham) in controlled conditions, where macronutrients oxidation during 3 hours and the behavior of other parameters such as glucose and lipids, blood pressure and heart rate were assessed. The analysis of the experimental groups concluded that there are not differences in blood alcohol levels according to the food consumed with beer, but there are depending on sex and body composition (p<0.05). Also, there are differences in blood glucose levels at 120 minutes in bread group compared with the rest of the groups (p<0.01). Finally, there is a strong correlation between respiratory quotient and alcohol in breath test which may be useful for practical purposes.
Autores: Azcona-Salvatierra, A.; Zazpe I; Santiago, Susana; et al.
ISSN 1132-6255  Vol. 23  Nº 2  2014  págs. 318 - 325
El objetivo del trabajo es valorar el impacto y los resultados de una campaña encaminada a promover hábitos de alimentación saludable entre los trabajadores de un centro universitario. Material y Métodos: Estudio epidemiológico descriptivo de tipo transversal que evalúa en 343 trabajadores de la Universidad de Navarra los hábitos alimentarios basales y tras la intervención, así como el impacto mediático y el grado de satisfacción de la campaña. Resultados: La mayoría de los hábitos alimentarios mejoran tras un año de implantación de la campaña, aunque ninguno de forma significativa. Por otro lado, el 38% IC95% (29%-47%) de los trabajadores cree que la campaña ha servido para mejorar su alimentación en cafeterías o comedores universitarios. Aunque los resultados no son significativos, se puede decir que se ha encontrado una tendencia hacia el cambio en los hábitos alimentarios. La valoración por parte de los trabajadores ha sido muy positiva, hecho que anima a continuar con la campaña (AU)
Autores: Fernández-Montero, Alejandro; Bes-Rastrollo, Maira; et al.
ISSN 0899-9007  Vol. 30  Nº 9  2014  págs. 1022 - 1027
Objective: The aim of this study was to assess the association between nut consumption and all-cause mortality after 5-y follow-up in a Spanish cohort. Methods: The SUN (Seguimiento Universidad de Navarra, University of Navarra Follow-up) project is a prospective cohort study, formed by Spanish university graduates. Information is gathered by mailed questionnaires collected biennially. In all, 17 184 participants were followed for up to 5 y. Baseline nut consumption was collected by self-reported data, using a validated 136-item semi-quantitative food frequency questionnaire. Information on mortality was collected by permanent contact with the SUN participants and their families, postal authorities, and the National Death Index. The association between baseline nut consumption and all-cause mortality was assessed using Cox proportional hazards models to adjust for potential confounding. Baseline nut consumption was categorized in two ways. In a first analysis energy-adjusted quintiles of nut consumption (measured in g/d) were used. To adjust for total energy intake the residuals method was used. In a second analysis, participants were categorized into four groups according to pre-established categories of nut consumption (servings/d or servings/wk). Both analyses were adjusted for potential confounding factors. Results: Participants who consumed nuts ¿2/wk had a 56% lower risk for all-cause mortality than those who never or almost never consumed nuts (adjusted hazard ratio, 0.44; 95% confidence intervals, 0.23-0.86). Conclusion: Nut consumption was significantly associated with a reduced risk for all-cause mortality after the first 5 y of follow-up in the SUN project.
Autores: Zazpe I; Sánchez Tainta, Ana; et al.
ISSN 0212-1611  Vol. 28  Nº 5  2013  págs. 1673 - 1680
Introduction: Universities and workplaces are important targets for the promotion of the nutritional interventions in adult population. Objectives: The aim of this study was to assess the dietary habits and attitudes towards change in workers and university students from different academic fields. Methods: The study data came from a cross-sectional study of a Spanish University population of 1,429 participants. We analyzed the dietary habits and the attitudes toward dietary change. Results: The mean age of workers and students was 37 and 23 years, respectively. Both groups reported eating four meals per day. Among students, the consumption of vegetables, wine, fish and nuts was less frequent whereas carbonated beverages, commercial bakery, fast food and red meat was higher. On the other hand, overall dietary pattern of science students was healthier than other students. Although no significant differences were found between students and workers in attitudes towards change, 32% of employees and 39% of students said they were seriously considering changing them. Conclusions: The dietary pattern was healthier among workers than among students, particularly those participants that studied social sciences degrees. They constituted the most vulnerable segment of the university population from a nutritional point of view. About a third of workers and students considered changing their habits.
Autores: Martínez, Miguel Ángel; Fernández-Montero, Alejandro; et al.
ISSN 0007-1145  Vol. 110  Nº 9  2013  págs. 1722 - 1731
The incidence of the metabolic syndrome (MetS) is increasing and lifestyle behaviours may play a role. The aim of the present study was to prospectively assess the association between changes in the consumption of sugar-sweetened beverages (SSB) and the incidence of the MetS and its components in a Spanish cohort of university graduates. We included 8157 participants initially free of the MetS and followed up during at least 6 years. SSB consumption was collected by a FFQ previously validated in Spain. The change in SSB consumption was calculated as the difference between SSB consumption at a 6-year follow-up and baseline consumption. The MetS was defined according to the International Diabetes Federation and the American Heart Association/National Heart, Lung, and Blood Institute's new definition of the MetS that had harmonised previous definitions. The associations between changes in SSB intake and the MetS were examined using multiple logistic regression. We observed 361 incident cases of the MetS. Participants who increased their consumption of SSB (upper v. lower quintile) had a significantly higher risk of developing the MetS (adjusted OR 2·2, 95 % CI 1·4, 3·5; P for trend = 0·003). Similarly, they presented a significantly higher risk of developing high blood pressure (adjusted OR 1·6, 95 % CI 1·3, 2·1), central obesity (adjusted OR 2·3, 95 % CI 1·9, 2·7), hypertriacylglycerolaemia (adjusted OR 1·7, 95 % CI 1·1, 2·6) or impaired fasting glucose (adjusted OR 1·6, 95 % CI 1·1, 2·2). In conclusion, an increase in SSB consumption was associated with a higher risk of developing the MetS and other metabolic disorders after 6 years of follow-up in a Mediterranean cohort of university graduates.
Autores: Fernández-Montero, Alejandro; Bes-Rastrollo, Maira; et al.
ISSN 1368-9800  Vol. 16  Nº 11  2013  págs. 2064 - 2072
Objective To assess the long-term relationship between tree nut consumption and the risk of developing metabolic syndrome (MetS). Design Nut consumption was collected using a validated 136-item FFQ. The MetS was defined according to the International Diabetes Federation and American Heart Association/National Heart, Lung, and Blood Institute harmonizing definition. The association between nut consumption and MetS was assessed with logistic regression models adjusting for potential confounders. We compared the incidence of MetS between extreme categories of nut intake (¿2 servings/week v. never/almost never) after 6 years of follow-up. Setting The SUN Project (Seguimiento Universidad de Navarra, University of Navarra Follow-up) is a prospective cohort study, formed of Spanish university graduates. Information is gathered by mailed questionnaires collected biennially. Nut consumption and MetS information was collected by self-reported data. Subjects Participants (n 9887) initially free of MetS or diabetes and followed up for a minimum of 6 years were included. Results We observed 567 new cases of MetS during follow-up. Participants who consumed nuts ¿2 servings/week presented a 32 % lower risk of developing MetS than those who never/almost never consumed (adjusted OR = 0·68, 95 % CI 0·50, 0·92). The inverse association was stronger among participants who were health professionals. Conclusions Nut consumption was significantly associated with lower risk of developing MetS after a 6-year follow-up period in a cohort of Spanish graduates.
Autores: Bes-Rastrollo, Maira; et al.
ISSN 0261-5614  Vol. 32  Nº 5  2013  págs. 797-804
We observed 341 incident cases of MS. Consumers of ¿7 drinks/wk presented a significantly higher risk of developing MS (aOR: 1.80; 95% CI: 1.22-2.66; p < 0.001) compared with non-drinkers. In addition, alcohol drinkers (¿7 drinks/wk) had higher risk of hypertriglyceridemia (aOR: 2.07; 95% CI: 1.46-2.93) and impaired fasting glucose (aOR: 1.54; 95% CI: 1.16-2.04). Beer consumption was associated with higher risk for MS (p for trend = 0.027) and higher risk of hypertriglyceridemia (aOR: 1.81; 95% CI: 1.02-3.20), but with lower risk of low HDL-cholesterol criterion (aOR: 0.21; 95% CI: 0.05-0.89) for ¿7 drinks/wk versus no consumption. Non-significant association was observed between wine or liquor consumption and MS. CONCLUSIONS: Consumption of at least seven alcoholic drinks per week was associated with a higher risk of developing MS among subjects initially free of any MS criteria.
Autores: Bes-Rastrollo, Maira; et al.
ISSN 1471-2458  Vol. 11  2011  págs. 867
The objective of this study was to evaluate the validity of self reported criteria of Metabolic Syndrome (MS) in the SUN (Seguimiento Universidad de Navarra) cohort using their medical records as the gold standard. METHODS: We selected 336 participants and we obtained MS related data according to Adult Treatment Panel III (ATP III) and International Diabetes Federation (IDF). Then we compared information on the self reported diagnosis of MS and MS diagnosed in their medical records. We calculated the proportion of confirmed MS, the proportion of confirmed non-MS and the intraclass correlation coefficients for each component of the MS. RESULTS: From those 336 selected participants, we obtained sufficient data in 172 participants to confirm or reject MS using ATP III criteria. The proportion of confirmed MS was 91.2% (95% CI: 80.7- 97.1) and the proportion of confirmed non-MS was 92.2% (95% CI: 85.7-96.4) using ATP III criteria. The proportion of confirmed MS using IDF criteria was 100% (95% CI: 87.2-100) and the proportion of confirmed non-MS was 97.1% (95% CI: 85.1-99.9). Kappa Index was 0.82 in the group diagnosed by ATP III criteria and 0.97 in the group diagnosed by IDF criteria. Intraclass correlation coefficients for the different component of MS were: 0.93 (IC 95%:0.91- 0.95) for BMI; 0.96 (IC 95%: 0.93-0.98) for waist circumference; 0.75 (IC 95%: 0.66-0.82) for fasting glucose; 0.50 (IC 95%:0.35-0.639) for HDL cholesterol; 0.78 (IC 95%: 0.70-0.84) for triglycerides; 0.49 (IC 95%:0.34-0.61) for systolic blood pressure and 0.55 (IC 95%: 0.41-0.65) for diastolic blood pressure. CONCLUSIONS: Self-reported MS based on self reported components of the SM in a Spanish cohort of university graduates was sufficiently valid as to be used in epidemiological studies.
Autores: Fernández-Montero, Alejandro; Bes-Rastrollo, Maira; et al.
ISSN 0213-9111  Vol. 25  Nº 4  2011  págs. 303 - 307
Objetivos Valorar la validez de los datos autodeclarados sobre los criterios de síndrome metabólico, en la cohorte SUN (Seguimiento Universidad de Navarra). Métodos El proyecto SUN es una cohorte abierta multidisciplinaria formada por más de 20.000 graduados universitarios seguidos mediante cuestionarios enviados por correo cada 2 años. En una muestra de 287 participantes de la cohorte se valoró el acuerdo entre sus datos autodeclarados para el perímetro de la cintura, la presión arterial, los triglicéridos, el colesterol HDL y la glucemia, con los datos obtenidos por análisis de muestras biológicas o medidos por personal médico especializado. Para cada variable se calcularon coeficientes de correlación intraclase (CCI) con intervalos de confianza del 95% (IC95%), el error relativo medio y el porcentaje de valores dentro de los límites de acuerdo al 95% según el método de Altman y Bland. Resultados Se encontraron correlaciones intraclase altas para los valores del perímetro de la cintura (CCI = 0,86, IC95%: 0,80-0,90) y la trigliceridemia (CCI = 0,71, IC95%: 0,61-0,79). Se halló una consistencia moderada (CCI entre 0,46 y 0,63) para el resto de los factores que se usan como criterios para definir el síndrome metabólico. Los errores relativos medios nunca superaron el 2,5%, y el porcentaje de valores dentro de los límites de acuerdo superó en todos los casos el 91%. Conclusiones Los resultados obtenidos sugieren que los valores autodeclarados sobre los criterios del síndrome metabólico obtenidos en la cohorte SUN poseen una validez moderada y pueden tenerse en cuenta, aunque con ciertas precauciones, en estudios epidemiológicos.