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Impact of plant-based diets and associations with health, lifestyle and healthcare utilisation: a population-based survey study.
(Cambridge University Press (CUP), 2025-07-17) Echiburu, Natalia; Also Fontanet, María Antonieta; Sisó Almirall, Antoni; González de Paz, Luis
Objective: To determine the prevalence and characteristics of plant-based patterns in the Spanish population and assess their potential impact on individuals with similar socio-demographic backgrounds. Design: We estimated vegetarian and vegan individuals' national and regional prevalence and analysed their socio-demographic characteristics and weekly dietary intake patterns. Individuals with a plant-based dietary pattern were matched to a control group (1:4) with similar socio-demographic characteristics. Associations with the prevalence risk of common chronic diseases, self-reported health status, lifestyle and healthcare use were analysed with unadjusted and adjusted logistic regression models. Setting: A population-based survey of individuals residing in Spain. Participants: Data from 22 072 participants were examined. Results: The prevalence of plant-based diets was 5·62‰ (95 % CI: 4·33, 7·28), and adherents were female (68·6 %), single (62·3 %) and university-educated 41·8 %) (P < 0·001). They reported higher rates of 'never' consuming snacks (50 % v. 35 %), fast food (58 % v. 36 %) and sweets (33 % v. 14 %). Lifestyle factors did not differ between the plant-based and omnivorous groups; however, adherence to plant-based diets was associated with a prevalence risk of depressive symptoms (OR 2·58, 95 % CI: 1·00, 6·65), stroke (OR 7·08, 95 % CI: 1·27, 39·46) and increased consultations for mental health and complementary medicine (OR 3·21, 95 % CI: 1·38, 7·43). Conclusions: Plant-based diets are uncommon and are associated with specific socio-demographic profiles, particularly sex. When comparing individuals with similar socio-demographic characteristics, individuals with plant-based diets and omnivores had similar lifestyles. Addressing patient concerns regarding diet and personal well-being might prioritise healthy behaviours over specific dietary patterns.
Obstetric complications, cortical gyrification, and cognition in first-episode psychosis
(Cambridge University Press (CUP), 2025-07-22) Penadés Rubio, Rafael; Valli, Isabel; Amoretti Guadall, Silvia; PEPs Group; Costas Carrera, Ana; Verdolini, Norma; Mezquida Mateos, Gisela; Forte, Maria Florencia; Janssen, Joost; García Rizo, Clemente; Martínez-Arán, Anabel, 1971-; Andrés Camazón, Pablo; Sánchez Torres, Ana M.; Bergé, Daniel; Serna, Elena de la, 1978-
Obstetric complications (OCs) are associated with cognitive and brain abnormalities observed in patients with schizophrenia. Gyrification, a measure of cortical integrity sensitive to events occurring during the prenatal and perinatal periods, is also altered in first-episode psychosis (FEP). We examined the relationship between OCs and gyrification in FEP, as well as whether gyrification mediates the relationship between OCs and cognition.
Association between the GMI/HbA1c ratio and preclinical carotid atherosclerosis in type 1 diabetes: Impact of the fast-glycator phenotype across age groups.
(BioMed Central, 2025-02-14) Puig-Jové, Carlos; Viñals, Clara; Conget, Ignacio; Quirós López, Carmen; Vinagre, Irene; Berrocal, Belén; Blanco Carrasco, Antonio Jesús; Granados, Montserrat; Mesa, Alex; Serés Noriega, Tonet; Giménez, Marga; Perea, Verónica; Amor Fernandez, Antonio
Background: Since the arrival of continuous glucose monitoring (CGM), the relationship between the glucose management indicator (GMI) and HbA1c has been a topic of considerable interest in diabetes research. This study aims to explore the association between the GMI/HbA1c ratio and the presence of preclinical carotid atherosclerosis in type 1 diabetes (T1D). Methods: Individuals with T1D and no prior history of cardiovascular disease were recruited from two centers. Carotid ultrasonography was performed using a standardized protocol and carotid plaques were defined as intima-media thickness ≥ 1.5 mm. CGM-derived data were collected from a 14-day report. A GMI/HbA1c ratio < 0.90 was selected to identify "fast-glycator" phenotype. Results: A total of 584 participants were included (319 women, 54.6%), with a mean age of 48.8 ± 10.7 years and a mean diabetes duration of 27.5 ± 11.4 years. Carotid plaques were present in 231 subjects (39.6%). Approximately 43.7% and 13.4% of participants showed absolute differences of ≥ 0.5 and ≥ 1.0 between 14-day GMI and HbA1c, respectively. Among patients ≥ 48 years, the fast-glycator phenotype was independently associated with presence of plaques (OR 2.27, 95%CI: 1.06-4.87), even after adjusting for non-specific and T1D-specific risk factors and statin treatment. No significant association was observed in younger subjects (p for interaction < 0.05). Conclusions: Fast-glycator phenotype is independently associated with atherosclerosis in T1D individuals aged ≥ 48 years, suggesting an age-related increase in the glycation risk. These findings highlight the potential of the GMI/HbA1c ratio for cardiovascular risk stratification in this population.
Long-lasting antibody B-cell responses to SARS-CoV-2 three years after the onset of the pandemic
(Elsevier, 2025-04-22) Molinos Albert, Luis M.; Rubio Bodí, Rocío; Martín Pérez, Carla; Pradenas Saavedra, Edwards; Torres, Cèlia; Jiménez, Alfons; Canyelles, Mar; Vidal, Marta; Barrios, Diana; Marfil, Silvia; Aparicio, Ester; Ramírez Morros, Anna; Trinité, Benjamin; Vidal Alaball, Josep; Santamaria i Vilanova, Pere, 1960-; Serra, Pau; Izquierdo Lázaro, Luis; Aguilar, Ruth; Ruiz Comellas, Anna; Blanco, Julià; Dobaño, Carlota, 1969-; Moncunill Piñas, Gemma
Immune memory is essential for the effectiveness of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination. In the current context of the pandemic, with a diminished vaccine efficacy against emerging variants, it remains crucial to perform long-term studies to evaluate the durability and quality of immune responses. Here, we examined the antibody and memory B-cell responses in a cohort of 113 healthcare workers with distinct exposure histories over a 3-year period. Previously infected and naive participants developed comparable humoral responses by 17 months after receiving a full three-dose mRNA vaccination. In addition, both maintained a substantial SARS-CoV-2-reactive memory B-cell pool, associated with a lower incidence of breakthrough infections in naive participants. Of note, previously infected participants developed an expanded SARS-CoV-2-reactive CD27-CD21- atypical B-cell population that remained stable throughout the follow-up period. Thus, previous SARS-CoV-2 infection differentially imprints the memory B-cell compartment without compromising the development of long-lasting humoral responses.
Obsessive-Compulsive Spectrum Symptoms Are Associated With Functional Impairment in Children and Adolescents With Psychosis Risk Syndrome: The CAPRIS Study.
(Physicians Postgraduate Press, 2023-10-16) Vergara, Laura; Serna, Elena de la, 1978-; Sugranyes, Gisela; Puig, Olga; Ilzarbe, Daniel; Fortea, Adriana; Tor, Jordina; Muñoz-Samons, Daniel; Rodriguez Pascual, Marta; Alvarez Subiela, Javier; Dolz, Montserrat; Baeza, Inmaculada, 1970-
Objective: To compare clinical and functional variables among 3 groups of children and adolescents: subjects at clinical high risk for psychosis (CHR-P) who also have obsessive-compulsive symptoms (OCS), CHR-P patients without OCS, and healthy controls (HC). Methods: A total of 128 CHR-P patients and 98 HC between the ages of 10 and 17 years were recruited as part of a multicenter prospective longitudinal study conducted in Spain between January 1, 2011, and December 31, 2018, with diagnoses made for CHR-P using the Scale of Prodromal Symptoms (SOPS). Two groups were obtained based on Leyton Obsessional Inventory–Child Version (LOI-CV) scores: 64 CHR-P patients with OCS (OCS+) and 64 CHR-P patients without OCS (OCS–). Clinical variables were analyzed with a generalized linear model. Results: Overall, 128 CHR-P patients, 64 (50%) with OCS (mean ± SD age = 15.5 ± 1.4 years, 34.4% male), 64 CHR-P patients without OCS (mean ± SD age = 15.1 ± 1.9 years, 34.4% male), and 98 HC (mean ± SD age = 15.5 ± 1.5 years, 42.9% male), of whom 19 (19.5%) had OCS, were included. Generalized linear model analysis revealed significant differences between the groups. The OCS+ group showed more severe prodromal symptoms (P = .007), worse functioning at baseline (P = .044) and during the previous year (P = .004), and more dysmorphophobic symptoms (P < .001) compared to the OCS– group. OCS+ patients were also more frequently treated with antidepressants (P = .004) than were OCS– patients. Conclusions: In our sample, among children and adolescents with CHR-P, the prevalence of OCS was high (50%). OCS+ subjects had a more severe clinical and functional profile than OCS– subjects. Early detection and treatment of these symptoms can lead to better outcomes for these patients.
Spatial architecture contributes to failure of bulk biomarker-guided neoadjuvant immunotherapy selection in bladder cancer: The DUTRENEO study
(Cell Press, 2026-07-21) Grande, Enrique; Sibai, Mustafa; Grases, Daniela; Andrada, Elena; Reig Torras, Oscar; Escobosa, Marc; Azueta Etxebarria, Ainara; Castellano, Daniel; Puente, Javier; Martínez de Villarreal, Jaime; Font, Albert; Alonso Gordoa, Teresa; Benítez, Raquel; Moreno-Oya, Ane; Álvarez-Maestro, Mario; Burgos, Javier; Climent, Miguel Ángel; Domínguez Esteban, Mario; Galván, Patricia; Galante, Isabel; García, Juan F.; Pérez, María Elena; García del Muro Solans, Xavier; Guerrero Ramos, Felix; Marqués, Miriam; Maroto, Pablo; Paramio, Jesús M.; Pinto Marín, Álvaro; Prat Aparicio, Aleix; Malats, Núria; Durán Martínez, Ignacio; Porta Pardo, Eduard; Real, Francisco X.
Predictive biomarkers for immune checkpoint inhibitors (ICIs) are largely identified retrospectively, but their prospective clinical utility remains unproven. Here, we report DUTRENEO, a prospective randomized phase 2 trial testing whether a retrospectively validated 18-gene bulk tumor inflammation signature (TIS) can guide neoadjuvant ICI therapy in muscle-invasive bladder cancer. The trial does not meet its primary endpoint, and this demonstrates that bulk gene-expression stratification does not sufficiently enrich for responders. To define the biology underlying this failure, we generate single-cell spatial transcriptomic profiles of 377 genes in ∼5.4 million cells across large tissue areas. Response is governed by spatial architectures invisible to bulk assays, including CD8+ T cell proximity to cancer cells, localized checkpoint co-expression within epithelial cancer-rich neighborhoods, and fibroblast-rich immune-excluded communities in non-responders. We provide a quantitative framework showing that ≥77 genes and ≥3-mm tissue diameter regions preserve predictive spatial signal at scalable throughput. The registration details of the trial are EudraCT 2017-002246-68
Intrinsic connectivity networks from childhood to late adolescence: Effects of age and sex
(Elsevier Ltd., 2016-02) Solé Padullés, Cristina; Castro Fornieles, Josefina; Serna, Elena de la, 1978-; Calvo Escalona, Rosa; Baeza, Inmaculada, 1970-; Moya, Jaime; Lázaro García, Luisa; Rosa, Mireia; Bargalló Alabart, Núria; Sugranyes, Gisela
There is limited evidence on the effects of age and sex on intrinsic connectivity of networks underlying cognition during childhood and adolescence. Independent component analysis was conducted in 113 subjects aged 7-18; the default mode, executive control, anterior salience, basal ganglia, language and visuospatial networks were identified. The effect of age was examined with multiple regression, while sex and 'age×sex' interactions were assessed by dividing the sample according to age (7-12 and 13-18 years). As age increased, connectivity in the dorsal and ventral default mode network became more anterior and posterior, respectively, while in the executive control network, connectivity increased within frontoparietal regions. The basal ganglia network showed increased engagement of striatum, thalami and precuneus. The anterior salience network showed greater connectivity in frontal areas and anterior cingulate, and less connectivity of orbitofrontal, middle cingulate and temporoparietal regions. The language network presented increased connectivity of inferior frontal and decreased connectivity within the right middle frontal and left inferior parietal cortices. The visuospatial network showed greater engagement of inferior parietal and frontal cortices. No effect of sex, nor age by sex interactions was observed. These findings provide evidence of strengthening of cortico-cortical and cortico-subcortical networks across childhood and adolescence
Analysis of the 'Educational Climate' in Spanish Public Schools of Dentistry using the Dundee Ready Education Environment Measure: a multicenter study
(John Wiley & Sons, 2013-01-30) Tomás Carmona, Inmaculada; Millan, U.; Casares de Cal, María Ángeles; Abad, María; Ceballos García, Laura; Gómez-Moreno, Gerardo; Hidalgo, J. J.; Llena Puy, Carmen; López-Jornet, María Pía; Machuca Portillo, María del Carmen; Monticelli, Francesca; Palés, J. L. (Jorge Luis)
Aim: To analyse the 'Educational Climate' (EC) of dental students in Spain. Methods: The study group consisted of 1391 students from nine Spanish Public Schools of Dentistry, who responded to the questionnaire based on 'Dundee Ready Education Environment Measure' (DREEM). This questionnaire has 50 items that are grouped into five domains: Learning, Teachers, Academic, Atmosphere and Social. Results: The global score on the EC was 123.1 (interpretation: 'EC more positive than negative'). The scores obtained in the different domains were: 28.0 in Learning (interpretation: 'a generally positive perception of learning'), 26.8 in Teachers (interpretation: 'teachers are going in the right direction'), 20.8 in Academic (interpretation: 'feeling more on the positive side'), 29.7 in Atmosphere (interpretation: 'a generally positive atmosphere') and 17.7 in Social (interpretation: 'social perception acceptable'). In seven items (14%), an average of <2 was detected, showing that there are some educational problem areas. Regarding the EC in the different Schools of Dentistry, an average of >100 was achieved in all of them, although there were two centres that showed significantly higher values of EC. Conclusions: Spanish dental students felt that their EC was more positive than negative and considered that the different domains were positive and acceptable. However, they pointed out the existence of several educational problem areas associated with the development of a traditional curriculum. Accordingly, and in parallel with the implementation of an innovative curriculum in all Spanish Dental Schools in the coming years, immediate educational goals must address the problem areas identified, thereby further promoting a more positive perception of EC.
Epidemiology and antimicrobial resistance trends in Haemophilus parainfluenzae in a tertiary care hospital (2018–2022)
(American Society for Microbiology, 2026-07-15) Saiz Escobedo, Lucía; Cadenas Jiménez, Irene; Sánchez, David; Camprubí Márquez, Xènia; Calvo-Silveria, Sara; López de Egea, Guillem; Berbel, Dàmaris; Costa Primo, Rosa Maria; Càmara Mas, Jordi; Domínguez Luzón, Ma. Ángeles (María Ángeles); Ardanuy Tisaire, María Carmen; Imaz, Arkaitz; González-Díaz, Aida; Martí Martí, Sara
Haemophilus parainfluenzae is increasingly recognized as a reservoir of antimicrobial resistance in urogenital infections. We conducted a retrospective laboratory-based study including all H. parainfluenzae isolates collected at a tertiary hospital in Barcelona between 2018 and 2022. Antimicrobial susceptibility testing was performed for all isolates, and whole-genome sequencing was conducted for multidrug-resistant (MDR) and capsulated strains. A total of 529 isolates from 504 individuals were analyzed (258 respiratory, 223 urogenital, and 48 other sources). Overall, 85/529 (16.1%) isolates were MDR, with a significantly higher prevalence among urogenital compared with respiratory samples (30.5% vs 6.2%). Among symptomatic urogenital episodes caused by MDR isolates, H. parainfluenzae was the only sexually transmitted infection (STI)-associated urogenital pathogen organism recovered in 65.3% of cases. Resistance was mediated by acquired genes and target-site substitutions, including β-lactamases (blaTEM-1, blaROB-1, and blaCTX-M-15), PBP3 substitutions, macrolide efflux determinants, quinolone resistance-determining regions mutations, and determinants conferring resistance to chloramphenicol, folate pathway inhibitors, and tetracyclines. Mobile genetic elements were frequent, including diverse integrative and conjugative elements, chromosomal insertions, and small β-lactamase plasmids distributed across genetically diverse lineages, with no evidence of a dominant MDR clone. Capsular operons were detected in 6.6% of the isolates, mainly urogenital, including two operons not observed previously at our center; 26/35 capsulated isolates were MDR, and capsular loci occurred across multiple lineages. These findings support H. parainfluenzae as an STI-associated urogenital pathogen and highlight the widespread distribution of mobile resistance determinants, reinforcing the need for continued genomic surveillance.
Gray Matter Volume Decrease Distinguishes Schizophrenia From Bipolar Offspring During Childhood and Adolescence
(Elsevier, 2015-08) Sugranyes, Gisela; Serna, Elena de la, 1978-; Romero Cela, S.; Sánchez Gistau, Vanessa; Calvo, Ana; Moreno, Dolores; Baeza, Inmaculada, 1970-; Díaz Caneja, Covadonga M.; Sanchez Gutierrez, Teresa; Janssen, Joost; Bargalló Alabart, Núria; Castro Fornieles, Josefina
OBJECTIVE: There is increasing support toward the notion that schizophrenia and bipolar disorder share neurodevelopmental underpinnings, although areas of divergence remain. We set out to examine gray matter volume characteristics of child and adolescent offspring of patients with schizophrenia or bipolar disorder comparatively. METHOD: In this 2-center study, magnetic resonance structural neuroimaging data were acquired in 198 children and adolescents (aged 6-17 years): 38 offspring of patients with schizophrenia, 77 offspring of patients with bipolar disorder, and 83 offspring of community controls. Analyses of global brain volumes and voxel-based morphometry (using familywise error correction) were conducted. RESULTS: There was an effect of group on total cerebral gray matter volume (F = 3.26, p = .041), driven by a decrease in offspring of patients with schizophrenia relative to offspring of controls (p = .035). At a voxel-based level, we observed an effect of group in the left inferior frontal cortex/anterior insula (F = 14.7, p < .001), which was driven by gray matter volume reduction in offspring of patients with schizophrenia relative to both offspring of controls (p = .044) and of patients with bipolar disorder (p < .001). No differences were observed between offspring of patients with bipolar disorder and offspring of controls in either global or voxel-based gray matter volumes. CONCLUSION: This first comparative study between offspring of patients with schizophrenia and bipolar disorder suggests that gray matter volume reduction in childhood and adolescence may be specific to offspring of patients with schizophrenia; this may index a greater neurodevelopmental impact of risk for schizophrenia relative to bipolar disorder during youth.
Cortical Morphology Characteristics of Young Offspring of Patients With Schizophrenia or Bipolar Disorder
(Elsevier B.V., 2017-01) Sugranyes, Gisela ; Solé Padullés, Cristina ; de la Serna Gómez, Elena; Borras Amoraga, Roger; Romero Cela, Soledad; Sanchez-Gistau, V.; García Rizo, Clemente; Goikolea Alberdi, José Manuel; Bargalló Alabart, Núria; Moreno, D.; Baeza Pertegaz, Inmaculada; Castro Fornieles, Josefina
Cortical surface area and thickness abnormalities have been observed in patients with schizophrenia and bipolar disorders; however, no study thus far has examined cortical morphologic measurements in children and adolescents at genetic risk for the disorders comparatively.One hundred thirty-seven participants, including 36 offspring of patients with schizophrenia (SzO), 54 offspring of patients with bipolar disorder (BpO), and 47 offspring of community controls (CcO), 6 to 17 years old, were assessed with clinical and neuroimaging methods. Sixty-nine percent of the sample was reassessed at a 27.6-month (mean) follow-up. Cortical surface reconstruction was applied to measure cortical area and thickness using FreeSurfer; mixed-effects models were used to investigate cross-sectional and longitudinal differences in global and lobar morphologic measurements.The SzO group exhibited a cross-sectional decrease in global, parietal, and occipital lobe surface area compared with the CcO group, and in the occipital lobe compared with the BpO group. In the SzO group, global and parietal surface area values were inversely associated with attenuated positive and negative prodromal symptom scores. No cross-sectional differences in cortical thickness were observed. Division of the sample by pubertal status showed group-by-time interactions in the pubertal and postpubertal SzO subgroup, with less longitudinal decrease in cortical surface area and thickness than in the CcO and BpO subgroups, respectively.The SzO, but not the BpO, group was characterized by cross-sectional decreases in surface area, and this was associated with prodromal symptoms. Longitudinal changes in cortical morphology associated with risk for schizophrenia may be expressed differently according to developmental stage.Copyright © 2016 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.
Cohort profile: the CORDELIA study (Collaborative cOhorts Reassembled Data to study mEchanisms and Longterm Incidence of chronic diseAses)
(Springer Verlag, 2025-05-12) Hernáez Camba, Álvaro; Camps Vilaró, Anna; Polo Alonso, Sara; Subirana Cachinero, Isaac; Ramos, Rafel; Cid, Rafael de; Rodríguez-Artalejo, Fernando; Elosua, Roberto; Chirlaque López, María Dolores; Amiano, Pilar; Bermúdez López, Marcelino; Guevara, Marcela; Cinza Sanjurjo, Sergio; Sánchez Pérez, María José; Cabrera de León, Antonio; Laclaustra, Martín; Rojo Martínez, Gemma; Guembe-Suescun, María J.; Pérez Gómez, Beatriz; Vega Alonso, Tomás; Torán Monserrat, Pere; Lora Pablos, David; Huerta Castaño, José María; Valdivielso, José Manuel; Degano, Irene R.; Félix Redondo, Francisco J.; Gandarillas, Ana María; Valdés, Sergio; Mundet Tudurí, Xavier; Sánchez Fernández, Pedro Luis; Martín Sánchez, Vicente; Rigo, Fernando; Alonso Sampedro, Manuela; Moreno Iribas, Conchi; Martín Escudero, Juan Carlos; Delgado Álvarez, Elías; Grau, Maria; Urrutia, Inés; Ovejero, Diana; Quintela, Inés; Martí Lluch, Ruth; Blay, Natalia; Banegas Banegas, Jose Ramón; Tizón Marcos, Helena; Gómez Gómez, Jesús Humberto; Aizpurua Atxega, Amaia; Castro Boqué, Eva; Delfrade, Josu; Prieto Díaz, Miguel Ángel; Rodriguez-Barranco, Miguel; Almeida González, Delia; Moreno Franco, Belén; Oualla Bachiri, Wasima; Sayón Orea, Carmen; Plans Beriso, Elena; Lozano, José Eugenio; López-Lifante, Victor M.; Cancelas Navia, Pilar; Cabrera Castro, Natalia; Cambray, Serafí; Zacarías Pons, Lluís; Fernández Bergés, Daniel; Donoso Navarro, Encarnación; Maldonado Araque, Cristina; Franch Nadal, Josep; Dorado Díaz, Pedro Ignacio; Villarín Castro, Alejandro; Frontera, Guillem; Gude, Francisco; Andueza, Naroa; Téllez Plaza, María; Ares, Jessica; Cruz, Raquel; Ribas Aulinas, Marc; Barretina, Jordi; Guallar Castillón, Pilar; Cainzos Achirica, Miguel; Colorado-Yohar, Sandra; Aginagalde Llorente, Adrian Hugo; Díaz Tocados, Juan Miguel; Ardanaz, Eva; Micó Pérez, Rafael Manuel; Fernández Martínez, Nicolás Francisco; Rodríguez Pérez, María del Cristo; Cenarro, Ana; Calle Pascual, Alfonso L.; Marrugat, Jaume, 1954-
The CORDELIA Study (Collaborative Cohorts Reassembled Data to Study Mechanisms and Long-term Incidence of Chronic Diseases) combines 35 Spanish population cohorts to investigate the clinical, environmental, genetic, and omics determinants of cardiovascular disease in the Southern European population. It aims to conduct the largest genome-wide association study to date on cardiovascular disease in this population, improve predictions of cardiovascular incidence using genomic and clinical data, and identify subgroups that would benefit most from targeted pharmacological and lifestyle interventions. CORDELIA includes 196,632 individuals (ages 18–84, 54% female, 96% born in Spain, 20% with higher education, recruited from 1989 to 2020, with follow-up periods ranging from 5 to 30 years), with DNA samples available for 117,342 participants (60%). Of the participants, 24% were current smokers, 43% hypertensive, 11% diabetic, 15% medicated with lipid-lowering drugs, 44% overweight, and 27% obese. If not already available, genotyping is being performed using the Axiom™ Spain Biobank array (~ 750,000 variants, including 115,000 specific and 50,000 rare functional variants from the Spanish population). The cohort also includes incident events (coronary heart disease, stroke, heart failure, peripheral artery disease, hypertension, diabetes); date and cause of death; and harmonized data on risk factors (body mass index, waist circumference, lipid profile, blood pressure, glucose, creatinine), lifestyle (smoking, physical activity, diet, alcohol), and socioeconomic status. 99,019 participants (50%) also provide plasma samples. CORDELIA will significantly contribute to understanding the complex interplay of risk factors contributing to cardiovascular disease and advance the fields of precision medicine and public health in Southern European individuals.
Prevalence of lower extremity peripheral arterial disease in individuals with chronic immune mediated inflammatory disorders
(Elsevier B.V., 2015-09-01) Agüero, Fernando H.; González Zobl, Griselda; Baena Díez, José Miguel; Degano, Irene R.; García Gil, Maria del Mar; Alzamora, María Teresa; Marrugat, Jaume; Comas Cufí, Marc; Pera, Guillem; Elosua, Roberto; Ramos, Rafel; Grau, Maria
Objective To compare the prevalence of lower extremity peripheral artery disease (PAD) and to assess whether age-associated progression in ankle-brachial index (ABI) differs between individuals with chronic immune-mediated inflammatory diseases (CIID) and the general population. Methods Pooled analysis with data from individuals aged 50 years and older with ABI measurements, obtained from population-based cross-sectional studies conducted in Catalonia (Spain). Information on three CIID diagnoses (i.e., inflammatory bowel disease, systemic connective tissue disorders, and inflammatory polyarthropathies and spondylopathies, considered as one entity for purposes of analysis) was obtained from electronic medical records. To ascertain the statistical association between PAD and CIID, logistic regression models were fitted and adjusted for age, sex, and cardiovascular risk factors. We tested the interaction between age and CIID diagnosis for ABI values. Results We included 8799 individuals, 312 (3.6%) with CIID. The age-standardized prevalence of PAD was higher in the CIID group (12% vs. 6% in general population, p = 0.001), and the model adjusted for age, sex, and cardiovascular risk factors also showed higher risk in individuals with CIID [Odds Ratio (95% confidence interval) = 1.65 (1.15–2.38); p = 0.007]. The inflammatory polyarthropathies/spondylopathies diagnosis was significantly associated with PAD in the fully adjusted model [1.80 (1.18–2.75); p = 0.006]. The atherosclerotic process was accelerated in individuals with CIID, compared to the general population (p for interaction<0.001). Conclusion In individuals with CIID, age-standardized prevalence of PAD was significantly higher than in the general population and the atherosclerotic process was accelerated. However, only inflammatory polyarthropathies/spondylopathies was associated with significant risk of PAD.
The association between education and cardiovascular disease incidence is mediated by hypertension, diabetes, and body mass index
(Nature Publishing Group, 2017-09-28) Degano, Irene R.; Marrugat, Jaume; Grau, Maria; Salvador González, Betlem; Ramos, Rafel; Zamora, Alberto; Martí Lluch, Ruth; Elosua, Roberto
Education and cardiovascular disease (CVD) are inversely associated but the mediating factors have not been totally elucidated. Our aim was to analyze the mediating role of modifiable risk factors. Cohort study using the REGICOR population cohorts. Participants without previous CVD were included (n = 9226). Marginal structural models were used to analyze the association between education and CVD incidence at 6 years of follow-up. Mediation by modifiable risk factors (diabetes, dyslipidemia, hypertension, smoking, body mass index, and physical activity) was assessed using the counterfactual framework. Participants with a university degree had a CVD incidence hazard ratio (HR) of 0.51 (95% confidence interval (CI) = 0.30, 0.85), compared to those with primary or lower education. Only hypertension, BMI, and diabetes mediated the association between education and CVD incidence, accounting for 26% of the association (13.9, 6.9, and 5.2%, respectively). Sensitivity analyses showed that hypertension was the strongest mediator (average causal mediation effect [95% CI] = increase of 2170 days free of CVD events [711, 4520]). The association between education and CVD incidence is partially mediated by hypertension, BMI, and diabetes. Interventions to decrease the prevalence of these risk factors could contribute to diminish the CVD inequalities associated with educational level.
Anthropometric variables as mediators of the association of changes in diet and physical activity with inflammatory profile.
(Gerontological Society of America, 2021-11) Cárdenas Fuentes, Gabriela; Lassale, Camille; Martínez-González, Miguel Ángel, 1957-; Grau, Maria; Salas Salvadó, Jordi; Corella Piquer, Dolores; Serra Majem, Lluís; Wärnberg, Julia; Konieczna, Jadwiga; Estruch Riba, Ramon; Pintó Sala, Xavier; Martínez, J. Alfredo, 1957-; Vázquez, Clotilde; Vidal i Cortada, Josep; Tur Marí, Josep A. (Josep Antoni); Díaz López, Andrés; Lancova, Hana; Fitó Colomer, Montserrat; Schröder, Helmut, 1958-
Background: Mechanisms underlying the associations of high levels of physical activity (PA) and adherence to the Mediterranean diet (MedDiet) with a better inflammatory profile remain unclear. Our objective was to assess the mediating role of changes in body mass index (BMI) and waist circumference (WC), as markers of body fat in the association of changes in PA and adherence to the MedDiet, with changes in the inflammatory profile. Method: This study included 489 adults, aged 55-75 years, from the PREDIMED-Plus multicenter lifestyle intervention trial. An inflammatory score was calculated, based on 8 blood biomarkers: high-sensitivity C-reactive protein, interleukin 6, interleukin 8, interleukin 18, monocyte chemo-attractant protein-1, C-peptide, leptin, and regulated on activation, normal T-cell-expressed and secreted chemokine. Biomarkers, levels of PA, score of MedDiet adherence, BMI, and WC were measured at baseline and at 1-year follow-up. Linear regression models were fitted according to the Baron and Kenny framework for mediation analysis. Results: Changes in BMI and WC mediated the association of both changes in PA and changes in the MedDiet adherence with the inflammatory score. Body mass index mediated 26% of the association of changes in total PA with the inflammatory profile, and 27% of the association of changes in the MedDiet, while WC mediated 13% and 12% of these associations, respectively. Conclusion: In older adults at high cardiovascular risk, increasing PA levels and adherence to a MedDiet during 1 year were associated with a lower inflammatory score, which was partly mediated by a reduction in body fat. Clinical trials registration number: International Standard Randomized Controlled Trial Number: ISRCTN89898870; registration date July 24, 2014, retrospectively registered.
Clinical impact of [18F]FDG-PET/CT in ARI0002h treatment, a CAR-T against BCMA for relapsed/refractory multiple myeloma
(American Society of Hematology, 2025-02-11) Zugasti, Inés; Tormo Ratera, Marta; Oliver Caldés, Aina; Soler Perromat, Juan Carlos; González Calle, Verónica; Moreno Fajardo, David Fernando; Cabañas, Valentín; López Muñoz, Nieves; Bartolomé Solanas, Álvaro; Español Rego, Marta; Reguera Ortega, Juan Luis; Rosiñol Dachs, Laura; López Corral, Lucía; Tovar Gomis, Natalia; Rodríguez Lobato, Luis Gerardo; Alvarez Perez, Rosa María; Varea, Sara; Olesti Muñoz, Eulàlia; Gómez Grande, Aldofo; Frutos, Laura; Tamayo, Pilar; Juan, Manel; Urbano Ispizua, Álvaro; Moraleda, José María; González Navarro, E. Azucena; Martínez López, Joaquín; Mateos, María Victoria; Tomás Batlle, Xavier; Setoain Perego, Xavier; Fernández de Larrea, Carlos José
Multiple myeloma (MM) remains incurable, with poor outcomes in heavily pretreated patients. Chimeric antigen receptor (CAR) T-cell therapy has emerged as a promising treatment; however, outcomes after such therapy in patients with soft-tissue plasmacytomas and other bone lesions remain poorly understood. This study included 63 patients with relapsed/refractory MM treated either in the CARTBCMA-HCB-01 clinical trial (ARI0002h; academic B-cell maturation antigen [BCMA]–targeted CAR T-cell therapy) or in compassionate use. The aim was to evaluate the impact of soft-tissue involvement (extramedullary [EMD] and paraskeletal [PS] plasmacytomas) in response, survival and safety. Baseline [18F]fluorodeoxyglucose (FDG)–positron emission tomography (PET)/computed tomography (CT) from 5 participating centers were reviewed centrally. Of 63 patients, 52.4% presented plasmacytomas at the time of inclusion (21 PS, exclusively; and 12 EMD). Per responses, there were no significant differences between patients with and without plasmacytomas. A correlation was present between International Myeloma Working Group responses and those obtained by [18F]FDG-PET/CT at day 100 (Bologna criteria). No differences were observed in progression-free survival (PFS) or overall survival (OS) between patients with or without plasmacytomas. However, both PFS and OS were significantly shorter in patients with EMD. Interestingly, [18F]FDG-PET/CT response assessed on day 100, in accordance with the Bologna criteria, was predictive of survival outcomes. A metabolic tumor volume of ≥25 cm3 at baseline [18F]FDG-PET/CT was associated with earlier disease progression and shorter OS. These results highlight the importance of EMD evaluation by [18F]FDG-PET/CT before and after CAR T-cell infusion. This trial was registered at www.ClinicalTrials.gov as #NCT04309981; and EudraCT, 2019-001472-11.
Changes in Emergency Care During the COVID-19 Pandemic at a University Hospital in Barcelona
(Biomedical Journal of Scientific & Technical Research (BJSTR) Publishers, 2024-05-08) Redondo, Ana; Raba Parodi, Carla; Oliva, Patricia; Pericas Escale, Carles; Grau, Maria
Purpose: To determinate the impact of the COVID-19 pandemic on emergency department (ED) attendance in 2020 compared to 2019, and to analyze the trend of this change across different waves. Methods: Descriptive study of ED visits (January 1st, 2019 – December 31st, 2020) at university hospital in Barcelona. The number of emergency cases was analyzed by age, sex, socioeconomic index, triage level, type of discharge, and diagnosis. Three periods were compared: pre-pandemic, first wave, and second wave with the corresponding periods in 2019. The Chi-square test compared proportions. Results: 84,826 episodes were analyzed. The number of emergencies decreased significantly during both waves, (41.09% and 27.60% respectively) affecting both sexes (p=0.439), all age groups (p<0.001) but in socioeconomic groups, no differences were found. Throughout 2020, non-urgent and less-urgent cases decreased (p <0.001). Visits related to ophthalmological-otorhinolaryngological, and musculoskeletal cases decreased (-41.97% and -36.09% respectively). Conversely, infectious, and parasitic diseases increased substantially (225.39%) due to COVID-19 cases. Conclusion: The SARS-CoV-2 pandemic reduced in ED attendance among both sexes, across all age and socioeconomic groups, irrespective of the type of pathology being treated.
Impact of Long-Term Statin Therapy on Influenza Incidence and Overall Mortality: A Real-World Data Analysis
(MDPI, 2026-06-26) Toledo Zavaleta, Diana Isabel; Cartanyà Hueso, Àurea; Pagès Fernández, Constança; Morros Pedrós, Rosa; Giner Soriano, Maria; Domínguez García, Àngela; Vilaplana Carnerero, Carles; Tor Roca, Alba; Grau, Maria
Background/Objectives: The study’s goal is to assess the association between long-term statin therapy and influenza incidence, influenza severity, and all-cause mortality. Methods: Two population-based dynamic cohorts (exposed and unexposed to statins) were followed from 2010 to 2019. Participants were 60 years or older; frail patients were excluded. The primary outcomes were influenza incidence, influenza-related intensive care unit (ICU) admission as a proxy for severity, and all-cause mortality. The exposed cohort comprised new statin users with a minimum of two pharmacy invoices within 90 days of enrollment. Adjusted risk ratios (aRRs) for influenza incidence, ICU admission, and mortality rate were calculated using Poisson regression. Results: The initial study population of 639,564 individuals was evenly split into exposed (319,782) and unexposed (319,782) cohorts; mean age was 71 years (standard deviation: 8 years), and 57% were women. Compared to non-users, new statin users showed a higher influenza incidence [9.39 (95% confidence interval: 9.36–9.42) vs. 7.64 (7.61–7.66) per 1000 person-years], ICU admission [1.65 (1.65–1.66) vs. 1.36 (1.35–1.36) per 1000 person-years], and overall mortality rate [97.09 (96.75–97.43) vs. 94.15 (93.82–94.47) per 1000 person-years]. Adjusted analysis revealed no significant association between statin use and influenza incidence [aRR: 1.04 (0.98–1.10)] or influenza-related ICU admission [aRR: 1.03 (0.89–1.19)] and shifted the effect on mortality from harmful to beneficial [aRR: 0.88 (0.87–0.89)]. Conclusions: Despite new users’ greater vulnerability at the start of treatment, our findings indicate that statins do not influence influenza incidence or severity but reduce all-cause mortality, warranting further exploration of their anti-inflammatory properties.
Differences in cardio-ankle vascular index in a general Mediterranean population depending on the presence or absence of metabolic cardiovascular risk factors
(Elsevier B.V., 2017-09-01) Martí Lluch, Ruth; Ramos, Rafel; García Gil, Maria del Mar; Camós, Lourdes; Comas Cufí, Marc; Elosua Bayés, Marc; Blanch, Jordi; Ponjoan Thäns, Anna; Alves-Cabratosa, Lia; Elosua, Roberto; Grau, Maria; Marrugat, Jaume
Background and aims: The main aim of this study is to describe the differences in the cardio-ankle vascular index (CAVI) in individuals with metabolic cardiovascular risk factors or a previous history of vascular diseases (WCVRF) compared to healthy individuals (free of risk factors and previous history of vascular diseases; FCVRF) in a general Mediterranean population. The secondary aim is to describe the proportion of CAVI≥9 depending on the cardiovascular risk category in both CVRF groups by sex. Methods: The study is a descriptive analysis of 2613 participants randomly selected in the Girona province (Catalonia, Spain). Results: CAVI mean differences between sexes and age categories in both CVRF groups followed the same pattern, the FCVRF group (men 25.2%; women 14.4%) in turn had a lower prevalence of CAVI≥9 than the WCVRF group (men 57.9%; women 51.8%). The percentage of men and women with CAVI≥9 with low risk was 13.9% and 11.3% in the FCVRF group, and 31.8% and 42.0% in the WCVRF group; with moderate risk, it was 55.8% and 10.0% in the FCVRF group and 60.3% and 49.0% in the WCVRF group. Conclusions: In both sexes, FCVRF groups had a lower prevalence of CAVI≥9 as well as lower mean CAVI scores, across all 10 year-age categories from 40 to 69 years, than WCVRF groups. Moreover, CAVI≥9 was frequent in individuals with low and moderate coronary risk in the WCVRF group but also in the FCVRF group. These results suggest that CAVI assessment to detect asymptomatic arteriosclerosis could be a useful tool to improve cardiovascular risk stratification.
Control of cardiovascular risk factors with tailored recommendations: A randomized controlled trial
(Elsevier, 2020-11-02) Barroso, María; Zomeño Fajardo, María Dolores; Díaz, Jorge Luis; Pérez-Fernández, Silvia; Martí Lluch, Ruth; Cordón Granados, Ferran; Ramos, Rafel; Cabezas Peña, Carmen; Salvador, Gemma; Castell, Contxa; Schröder, Helmut, 1958-; Grau, Maria
This study analyzed the efficacy of tailored recommendations to control cardiovascular risk factors at 1-year follow-up in a population-based randomized controlled trial in individuals aged 35-74 years with no history of cardiovascular disease at baseline. Total, low-density lipoprotein (LDL), and high-density lipoprotein cholesterol and systolic and diastolic blood pressure (BP) were measured at baseline and at 1-year follow-up. The primary outcome was the quantitative change in total cholesterol. To estimate the differences within and between groups, McNemar and Student t-tests were applied according to an intention-to-treat strategy. We enrolled 955 individuals [52.3% women; mean age, 50 years (standard deviation 10)]. Finally, 1 participant in each group presented a cardiovascular event and 768 were reexamined at 1-year follow-up. Intervention and control groups showed significant increases in total cholesterol [5.49 (standard deviation 1.02) to 5.56 (1.06) mmol/L and 5.34 (0.94) to 5.43 (0.93) mmol/L, respectively]. Men in the intervention group showed significant decreases in systolic and diastolic BP [117.2 (14.6) to 115.6 mmHg (14.1) and 77.9 (9.7) to 76.5 mmHg (9.7), respectively]; no changes were found in the rates of total cholesterol <5.2 mmol/L and LDL cholesterol <3.0 mmol/L. In the control group, both values were significantly decreased (43.5 to 36.4% and 26.4 to 20.8%, respectively) in men. In the stratified analysis, women showed no differences in any of the outcomes. In conclusion, an intervention with tailored recommendations increased mean total cholesterol values. The intervention effect was higher in men who maintained blood lipids at optimal levels and had decreased BP values.

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