Person: Matía Martín, María Del Pilar
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First Name
María Del Pilar
Last Name
Matía Martín
Affiliation
Universidad Complutense de Madrid
Faculty / Institute
Medicina
Department
Medicina
Area
Medicina
Identifiers
8 results
Search Results
Now showing 1 - 8 of 8
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 Variety in fruits and vegetables, diet quality and lifestyle in an older adult Mediterranean population(Clinical Nutrition, 2021) López González, Leyre; Becerra Tomás, Nerea; Babio Nancy; Martínez González, Miguel Ángel; Díaz López, Andrés; Corella, Dolores; Goday, Albert; Romaguera, Dora; Vioque, Jesús; Alonso Gómez, Ángel M.; Wärnberg, Julia; Martínez, J. Alfredo; Serra Majem, Luis; Estruch, Ramón; Tinahones, Francisco; Lapetra, José; Pintó, Xavier; Tur, Josep A.; López Miranda, José; Bueno Cavanillas, Aurora; Delgado Rodríguez, Miguel; Matía Martín, María Del Pilar; Daimiel, Lidia; Álvarez Álvarez, Laura; Vidal, Josep; Vázquez, Clotilde; Ros, Emilio; Vázquez Ruiz, Zenaida; Canudas, Silvia; Fernández Carrión, Rebeca; Castañer, Olga; Zulet, M. Ángeles; Tojal Sierra, Lucas; Ajejas Bazán, María Julia; Carmen M. López García; Martín, Marian; García Ríos, Antonio; Casas, Rosa; Gómez Pérez, Ana M.; Santos Lozano, José Manuel; Goñi, Estíbaliz; Guillem Saiz, Patricia; Lassale, Camile; Abete, Itziar; Salaverria Lete, Itziar; Eguaras, Sonia; Schröder, Helmut; Salas Salvadó, JordiSummary Background and aims Previous studies, mainly focused on quantity rather than variety, have shown beneficial associations between the amount of fruit and vegetable consumed, diet quality and healthy lifestyle. The aim is to evaluate the association between fruit and vegetable consumption, diet quality and lifestyle in an elderly Mediterranean population, considering both variety and the combination of quantity and variety (QV). Methods A cross-sectional analysis of 6647 participants (51.6% of males) was conducted in the framework of the PREDIMED-Plus study. A variety score was created as the sum of vegetables and/or fruits consumed at least once per month using food frequency questionnaires. Dietary Reference Intakes (EAR and IA values) were used to estimate the prevalence of inadequate intake of dietary fiber and micronutrients. Logistic regression models were performed to examine the association between fruit and vegetable consumption and not meeting the DRIs, by tertiles of fruit and vegetable variety and QV categories. Results Participants with higher fruit and vegetable variety score reported a significant higher intake of fiber, vitamins, minerals and flavonoids and were significantly more likely to be physically active and non-smoker. Besides, higher variety in fruit and vegetable consumption was associated with lower prevalence of having an inadequate intake of fiber [(0.13 (0.11–0.16)], two or more [(0.17 (0.14–0.21)], three or more [(0.15 (0.13–0.18)] and four or more [(0.11 (0.10–0.14)] micronutrients in our participants. Higher quantity and variety in fruit and vegetable consumption was associated with lower prevalence of having an inadequate intake of fiber [(0.05 (0.04–0.06)], two or more [(0.08 (0.06–0.10)], three or more [(0.08 (0.06–0.09)] and four or more [(0.06 (0.05–0.07)] micronutrients. Conclusion Greater variety in fruit and vegetable intake was associated with better nutrient adequacy, diet quality and healthier lifestyle in an elderly Mediterranean population.Item Results of the survey on care units and caring for eating disorders in Spain. SENPE Working Group on Eating Disorders(Nutrición Hospitalaria, 2023) Matía Martín, María Del Pilar; Loria Kohen, Viviana Constanza; Carrillo Lozano, Elena; Gómez Candela, CarmenIntroduction: eating disorders (EDs) entail a therapeutic challenge. Objective: to describe ED care from the perspective of Nutrition Units (NU) in relation to human and care resources, the activities carried out, and satisfaction with care in Spain; to collect demands from professionals to improve assistance. Methods: a cross-sectional, observational study based on a questionnaire sent online to members of the Spanish Society of Clinical Nutrition and Metabolism (SENPE) and to the Nutrition Area of the Spanish Society of Endocrinology and Nutrition (SEEN). The data were analyzed according to number of beds of the hospitals surveyed (< 500/≥ 500). Results: 23 responses from 8 autonomous communities. In 87 % of NUs care was given to eating disorders; 65.2 % had a specific process; 91.3 % collaborated with Psychiatry; 34.8 % had their own hospitalization area; 56.5 % had a day hospital, but 21.7 % participated in it; 39.1 % had a monographic consultation office; nutritional education was carried out in 87 %, especially by nursing; individualized diets and oral supplements were frequently prescribed in 39.1 % and 56.5 %, respectively; only the largest hospitals participated in research on EDs (62.5 %), and 21.7 % collaborated with patient associations. Hospitals with ≥ 500 beds had more resources and were more satisfied. Professionals demanded resources and processes agreed with Psychiatry. Conclusions: resources and care practices are uneven in the NUs surveyed, as well as multidisciplinary collaboration. The collected evidence allows us to design improvement strategies in this area.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 Consenso del grupo de trabajo de los trastornos de la conducta alimentaria de SENPE (GTTCA-SENPE). Evaluación y tratamiento médico-nutricional en la anorexia nerviosa. Actualización 2023(Nutrición Hospitalaria, 2024) Campos Del Portillo, Rocío; Matía Martín, María Del Pilar; Loria Kohen, Viviana Constanza; Carrillo Lozano, Elena; Pita, FranciscoAnorexia nervosa (AN) is a multifactorial disorder. A possible role of the social network and the gut microbiota in pathogenesis has been added. Exogenous shocks such as the COVID19 pandemic have had a negative impact on patients with AN. The potential medical and nutritional impact of malnutrition and/or compensatory behaviors gives rise to a complex disease with a wide range of severity, the management of which requires a multidisciplinary team with a high level of subject matter expertise. Coordination between levels of care is necessary as well as understanding how to transition the patient from pediatric to adult care is essential. A proper clinical evaluation can detect possible complications, as well as establish the organic risk of the patient. This allows caregivers to tailor the medical-nutritional treatment for each patient. Reestablishing adequate nutritional behaviors is a fundamental pillar of treatment in AN. The design of a personalized nutritional treatment and education program is necessary for this purpose. Depending on the clinical severity, artificial nutrition may be necessary. Although the decision regarding the level of care necessary at diagnosis or during follow-up depends on a number of factors (awareness of the disease, medical stability, complications, suicidal risk, outpatient treatment failure, psychosocial context, etc.), outpatient treatment is the most frequent and most preferred choice. However, more intensive care (total or partial hospitalization) may be necessary in certain cases. In severely malnourished patients, the appearance of refeeding syndrome should be prevented during renourishment. The presence of AN in certain situations (pregnancy, vegetarianism, type 1 diabetes mellitus) requires specific care. Physical activity in these patients must also be addressed correctly.Item Expert Consensus on Morphofunctional Assessment in Disease-Related Malnutrition. Grade Review and Delphi Study(Nutrients, 2023) García-Almeida, José Manuel; García-García, Cristina; Ballesteros-Pomar, María D.; Olveira, Gabriel; López-Gómez, Juan J.; Bellido, Virginia; Bretón Lesmes, Irene; Burgos, Rosa; Sanz-Paris, Alejandro; Matía Martín, María Del Pilar; Botella Romero, Francisco; Ocon Bretón, Julia; Zugasti Murillo, Ana; Bellido, DiegoDisease-related malnutrition (DRM) affects approximately a third of hospitalized patients and is associated with an increased risk of morbimortality. However, DRM is often underdiagnosed and undertreated. Our aim is to evaluate the prognostic value of morphofunctional tools and tests for nutritional assessment in clinical practice. A systematic literature review was conducted to identify studies relating to the morphofunctional assessment of nutritional status and mortality or complications. Evidence was evaluated using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) method. Twelve GRADE recommendations were made and divided into seven topics: food intake and nutrient assimilation, anthropometry, biochemical analysis, hand grip strength, phase angle, muscle imaging, and functional status and quality of life. From these recommendations, 37 statements were developed and scored in a two-survey Delphi method by 183 experts. A consensus was reached on accepting 26/37 statements. Surveys had high internal consistency and high inter-rater reliability. In conclusion, evidence-based recommendations were made on the prognostic value of morphofunctional assessment tools and tests to assess malnutrition, most of which were found to be feasible in routine clinical practice, according to expert opinions.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.