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F J Castro Alonso

Publications and source records attributed to F J Castro Alonso.

5 recordsLinked to original sources
PubMed2003

[Microalbuminuria and clinical proteinuria as the main predictive factors of cardiovascular morbidity and mortality in patients with type 2 diabetes].

CONTEXT: [corrected] The principal objective was that of evaluating the independent contribution of microalbuminuria and clinical proteinuria to the cardiovascular morbidity and mortality in patients with type 2 diabetes. METHODS: A prospective cohort study with selection of patients with type 2 diabetes evaluated in hospital outpatient consultations. Through the Cox proportional risks model the predictive importance of the presence of microalbuminuria and clinical proteinuria on the appearance of fatal and non-fatal cardiovascular complications (angina, fatal and non-fatal myocardial infarction, sudden death, transitory ischemic attack, fatal and non-fatal stroke, or amputation of lower limbs) was analyzed. RESULTS: The monitoring of 463 patients was done during an average period of 4.64 years (SD: 1.56). There were 330 patients (71.3%) with normoalbuminuria, 106 (22.9%) with microalbuminuria and 27 (5.8%) with proteinuria. The global cardiovascular morbidity and mortality rate was 3.7% annual (2.46% annual for the patients with normoalbuminuria, 5.6% for the patients with microalbuminuria and 14.42% for the patients with proteinuria; p < 0.0001). After multiple adjustment, both microalbuminuria (RR: 1.91; 95% CI: 1.05-3.48; p = 0.032) and proteinuria (RR: 4.15; 95% CI: 1.77-9.75; p = 0.0011) were the main independent predictive factores of appearance of cardiovascular complications. Other predictive variables were age (RR: 1.06; 95% CI: 1.02-1.10; p = 0.0014), HDL cholesterol (RR = 0.96; 95% CI: 0.93-0.98; p = 0.001), LDL cholesterol (RR: 1.01; 95% CI: 1.002-1.02; p = 0.016) and initial presence of ischemic cardiopathy (RR: 1.97; 95% CI: 1.03-3.76; p = 0.041). CONCLUSIONS: The increase in the rate of excretion of urinary albumin is the main independent predictive factor of cardiovascular morbidity and mortality in patiens with type 2 diabetes.

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PubMed2003

[Glycemic control related factors in type 2 diabetes mellitus patients].

OBJECTIVES: To describe metabolic, lipidic and blood pressure control and to identify blood glucose control predictive factors in patients with type 2 diabetes. MATERIAL AND METHODS: Retrospective cohort study. Ambulatory type 2 diabetic patients were selected from 2/1/00 to 14/11/01 if they had been visited yearly at least three years previously. They were classified into three groups: a) initial and final treatment with diet and/or oral glucose-lowering drugs; b) insulinized patients during follow-up; and c) initial and final therapy with insulin. BODY MASS INDEX: (BMI), blood pressure, HbA1c and lipid profile were determined at start and at the end of the study. A multiple regression model was used to predict mean HbA1c through follow-up. RESULTS: 320 patients were selected, 199 women (62.2%) and 121 men (37.8%) with mean age of 69 years (SD: 9). Mean follow-up was 5.2 years (SD: 1.1). 106 patients (33.8%) were included into A group, 70 patients (22.4%) into B group and 137 (43.8%) into C group. 63% of patients had values of HbA1c > 7.5%, 36% blood pressure > 140/85 mmHg and 8.5% LDL values > 155 mg/dl. HbA1c mean through follow-up was of 8.2% and its independent predictors were baseline HbA1c (0.37; IC 95% 0.31-0.43; p < 0.001), baseline BMI (0.023; IC 95% 0.004-0.042; p = 0.017), baseline treatment with insulin (0.67; IC 95% 0.45-0.88; p < 0.001) and insulinization during follow-up (0.46; IC 95% 0.21-0.71; p < 0.001). CONCLUSIONS: It's difficult to achieve an acceptable blood glucose control. Mean HbA1c predictive factors include baseline HbA1c and BMI and insulin therapy.

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PubMed2002

[Mortality in a cohort of patients with type 2 diabetes mellitus in Alcañiz, Spain].

OBJECTIVE: The aim of this study was to compare the mortality rate of type 2 diabetic patients with the mortality rate of the background population. Also was assessed the impact of baseline variables on mortality. METHODS: Prospective cohort study. Patients with type 2 diabetes were included from june 1994 to june 1998. The life status was ascertained on october 2001. Excess mortality, compared with the background population, was assessed in terms of standardised mortality ratio (SMR) for the whole group, for males and for females. The Cox's model was used to investigate the influence of baseline risk factors on mortality. RESULTS: 463 patients were included. The mean follow-up was of 5 years. The life status was ascertained for the 99% of the cohort. The mortality rate of the whole group was 21.75 per 1000 (31.4 per 1000 males and 16.4 per 1000 females). The SMR of the whole group was 147% (IC 95%: 109-194; p < 0.05), the SMR of males 167% (IC 95%: 107-246; p < 0.05) and the SMR of females 147% (IC 95%: 95-217; p = ns). The independent predictors of early mortality on multivariate survival analysis were age (HR = 1.13; IC 95%: 1.08-1.18; p < 0.0001) and proteinuria (HR = 4.72; IC 95%: 2.15-10.35; p = 0.0001). CONCLUSIONS: Diabetic patients in our population have increased their mortality risk in 47%. The main risk factor of mortality was the presence of proteinuria.

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