Person: Rubio Herrera, Miguel Ángel
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First Name
Miguel Ángel
Last Name
Rubio Herrera
Affiliation
Universidad Complutense de Madrid
Faculty / Institute
Medicina
Department
Medicina
Area
Medicina
Identifiers
5 results
Search Results
Now showing 1 - 5 of 5
Item Mixed Meal Tolerance Test Versus Continuous Glucose Monitoring for an Effective Diagnosis of Persistent Post-Bariatric Hypoglycemia(Journal of Clinical Medicine, 2023) Ramos-Levi, Ana; Marcuello, Clara; Rubio Herrera, Miguel Ángel; Matía Martín, María Del Pilar; Pérez Ferré, Natalia; Sánchez Pernaute, Andrés; Torres García, Antonio José; Calle Pascual, Alfonso LuisGastric bypass determines an increase in incretin secretion and glucose excursions throughout the day and may sometimes entail the development of severe post-bariatric hypoglycemia (PBH). However, there is no consensus on the gold standard method for its diagnosis. In this study, we evaluated the usefulness of a mixed meal tolerance test (MMTT) and continuous glucose monitoring (CGM) for the diagnosis of PBH, defined as glucose levels <54 mg/dL (3.0 mmol/L). We found that hypoglycemia occurred in 60% of patients after the MMTT and in 75% during CGM, and it was predominantly asymptomatic. The MMTT confirmed the diagnosis of PBH in 88.9%of patients in whom surgery had been performed more than three years ago, in comparison to 36.4% in cases with a shorter postsurgical duration. CGM diagnosed nocturnal asymptomatic hypoglycemia in 70% of patients, and daytime postprandial hypoglycemia in 25% of cases. The mean duration of asymptomatic hypoglycemia was more than 30 min a day. Patients with ≥2% of their CGM readings with hypoglycemia exhibited a higher degree of glucose variability than those with <1% of the time in hypoglycemia. Our results show that the MMTT may be a useful dynamic test to confirm the occurrence of hypoglycemia in a large number of patients with persistent and recurrent PBH during long-term follow-up after gastric bypass. CGM, on its part, helps identify hypoglycemia in the real-world setting, especially nocturnal asymptomatic hypoglycemia, bringing to light that PBH is not always postprandial.Item Combined Effect of Genetic Variants on Long-Term Weight Response after Bariatric Surgery(Journal of Clinical Medicine, 2023) Torrego-Ellacuría, Macarena; Barabash Bustelo, Ana; Matía Martín, María Del Pilar; Sánchez Pernaute, Andrés; Torres García, Antonio José; Calle Pascual, Alfonso Luis; Rubio Herrera, Miguel ÁngelThe pathophysiology of body weight control involves complex interactions between hormonal, environmental, behavioral and genetic factors. The purpose of this study was to analyze the association between single nucleotide polymorphisms (SNPs) of 13 genes encoding gastrointestinal peptides, their receptors or the proteins involved in their expression, with long-term weight response in a cohort of 375 patients undergoing bariatric surgery (BS). To evaluate weight response, we combined several variables to define specific response phenotypes six years after surgery. The study protocol was registered in ISRCTN (ID80961259). The analysis of the selected SNPs was performed via allelic discrimination using Taqman® probes (Applied Biosystems, Foster City, CA, USA). The genotype association study was performed using the SNPstat program, with comparisons adjusted for sex, age, initial body mass index, type 2 diabetes, hypertension diagnosis and the type of surgery. We identified eight genetic variants associated with the weight response to BS, independently of the presurgery patient profile and the type of surgical technique, from which we calculated the unweighted risk score (RS) for each phenotype. The highest scoring category in each RS was significantly associated with lower weight loss (p = 0.0001) and greater weight regain (p = 0.0012) at the end of the follow-up.Item Long-Term Results of Single-Anastomosis Duodeno-ileal Bypass with Sleeve Gastrectomy (SADI-S)(Obesity Surgery, 2022) Sánchez Pernaute, Andrés; Rubio Herrera, Miguel Ángel; Pérez Ferré, Natalia; Sáez Rodríguez, Carlos; Marcuello, Clara; Pañella, Clara; Lopez Antoñanzas, Leyre; Torres, Antonio; Pérez Aguirre, EliaBackground Single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) is a simplification of the duodenal switch (DS) in which the alimentary limb is eliminated, and the common channel is lengthened from 200 to 300 cm. Short-term results have demonstrated that SADI-S is safe and reproducible and that weight loss and comorbidities resolution are comparable to biliopancreatic diversion or DS. Objective To analyze the long-term outcomes of SADI-S. Methods From May 2007 to December 2015, 164 patients were consecutively submitted to a one-step SADI-S. The mean age was 47 years, and the mean body mass index (BMI) was 45.8 kg/m2. A total of 101 patients had type 2 diabetes, 91 arterial hypertension, 81 obstructive apnea, and 118 dyslipidemia. Limb length was 200 cm in 50 cases, 250 cm in 99, and 300 cm in 15. Results There was no mortality. One patient had a gastric leak, and 2 patients had an anastomotic leak. A total of 25% of the patients were lost to follow-up at 10 years. Excess weight loss and total weight loss were 87% and 38% at 5 years and 80% and 34% at 10 years. A total of 12 patients were submitted to revisional surgery for hypoproteinemia. Preoperatively 41 diabetics were under insulin treatment; at 5 years, 7 remained with insulin and 12 at 10 years. Mean glycemia was 104 mg/dL at 5 years and 118 mg/dL at 10 years. Mean HbA1c was 5.51% at 5 years and 5.86 at 10 years. Conclusion In the long term, SADI-S offers satisfactory weight loss and comorbidities resolution.Item An Early Mediterranean-Based Nutritional Intervention during Pregnancy Reduces Metabolic Syndrome and Glucose Dysregulation Rates at 3 Years Postpartum(Nutrients, 2023) Melero, Verónica; Arnoriaga, Maria; Barabash Bustelo, Ana; Valerio, Johanna; del Valle, Laura; Martín O'Connor, Rocío; De Miguel Novoa, María De La Paz; Díaz Pérez, José Ángel; Familiar, Cristina; Moraga, Inmaculada; Durán Rodríguez-Hervada, Alejandra; Cuesta, Martín; Torrejón, María José; Martínez Novillo, Mercedes; Moreno, María; Romera, Gisela; Runkle De La Vega, Isabel Ana; Pazos, Mario; Rubio Herrera, Miguel Ángel; Matía Martín, María Del Pilar; Calle Pascual, Alfonso LuisA Mediterranean diet (MedDiet)-based intervention reduces the rate of immediate postpartum maternal metabolic disorders. Whether these effects persist long-term remains to be determined. A total of 2526 normoglycemic women were randomized before the 12th gestational week (GW). IG women followed a MedDiet with extra virgin olive oil (EVOO) (>40 mL/day) and a handful of nuts daily, whereas CG women had to restrict all kinds of dietary fat. At 3 months postpartum, a motivational lifestyle interview was held. The endpoint of the study evaluated the rate of abnormal glucose regulation (AGR) and metabolic syndrome (MetS) at 3 years postpartum in women of the San Carlos cohort. A total of 369/625 (59%) CG women and 1031/1603 (64.3%) IG women were finally analyzed. At 3 months and 3 years postdelivery, the IG women showed higher adherence to the MedDiet, which was associated with lower values of body mass index (BMI) and lipid and glycemic profiles. Body weight change and waist circumference were lower in the IG women. After applying multiple regression analysis, the ORs (95%CI) resulted in AGR (3.18 (2.48–4.08); p < 0.001)/MetS (3.79 (1.81–7.95); p = 0.001) for women with GDM and higher OR for development of MetS in CG women (3.73 (1.77–7.87); p = 0.001). A MedDiet-based intervention early in pregnancy demonstrated persistent beneficial effects on AGR and MetS rates at 3 years postpartum.Item Modifiable Risk Factors and Trends in Changes in Glucose Regulation during the First Three Years Postdelivery: The St Carlos Gestational Diabetes Mellitus Prevention Cohort(Nutrients, 2023) Arnoriaga Rodríguez, María; Melero, Verónica; Barabash Bustelo, Ana; Valerio, Johanna; Valle, Laura del; Martín O'Connor, Rocío; De Miguel Novoa, María De La Paz; Díaz Pérez, José Ángel; Familiar, Cristina; Moraga, Inmaculada; Durán Rodríguez-Hervada, Alejandra; Jiménez, Inés; Cuesta, Martín; Torrejón, María José; Martínez-Novillo González, Mercedes; Runkle De La Vega, Isabel Ana; Pazos, Mario; Rubio Herrera, Miguel Ángel; Matía Martín, María Del Pilar; Calle Pascual, Alfonso LuisObjective: Evaluation of the influence of potential risk factors (RFs) on glycemic changes at 3 years postpartum. Methods: The glycemic status of 1400 women, in absence of a new pregnancy, was evaluated at 3 months (3 m) and 3 years (3 y) postpartum, after participation in the St. Carlos Gestational Study (2228 normoglycemic pregnant women followed from before gestational week 12 to delivery, from 2015–2017). Abnormal glucose regulation (AGR) was defined as fasting serum glucose ≥ 100 mg/dL and/or HbA1c ≥ 5.7% and/or 2 h 75 g OGTT glucose ≥ 140 mg/dL. In total, 12 modifiable and 3 unmodifiable RFs were analyzed. Results: 3 m postpartum, 110/1400 (7.9%) women had AGR; 3 y postpartum, 137 (9.8%) women exhibited AGR (110 with 3 m normal glucose tolerance [NGT]); 1263 (90.2%) had NGT (83 with 3 m AGR). More women with gestational diabetes mellitus (GDM) progressed to AGR at 3 y (OR: 1.60 [1.33–1.92]) than women without GDM. Yet, most women with 3 m and/or 3 y AGR had no GDM history. Having ≥2 unmodifiable RFs was associated with increased risk for progression to AGR (OR: 1.90 [1.28–2.83]) at 3 y postpartum. Having >5/12 modifiable RFs was associated with increased progression from NGT to AGR (OR: 1.40 [1.00–2.09]) and AGR persistence (OR: 2.57 [1.05–6.31]). Pregestational BMI ≥ 25 kg/m2 (OR: 0.59 [0.41–0.85]), postdelivery weight gain (OR: 0.53 [0.29–0.94]), and waist circumference > 89.5 cm (OR: 0.54 [0.36–0.79]) reduced the likelihood of NGT persisting at 3 y. Conclusions: 3-month and/or 3-year postpartum AGR can be detected if sought in women with no prior GDM. Modifiable and unmodifiable RF predictors of AGR at 3 y postpartum were identified. Universal screening for glycemic alterations should be considered in all women following delivery, regardless of prior GDM. These findings could be useful to design personalized strategies in women with risk factors for 3 y AGR.