Page 20 - MEMOCiberobn014-ENG

P3. COMPLICATIONS OF OBESITY AND CHILDHOOD OBESITY
Several milestones have been communicated in 2014 in the form of publications resulting from innovative studies with a high clinical applicability .
The changes in microbiota that have been taking place over the past few decades as a result of the change in lifestyles is an environmental factor which as of right now is being gauged as the factor that is responsible for causing obesity and metabolic diseases . It has been found that a factor such as intermittent hypoxia, which occurs in many obese patients with sleep apnoea syndrome, is able to modify microbiota, reducing species diversity (Moreno-Indias I et al . Eur Respir J 2014) . This loss of diversity has been associated with insulin resistance .
Clinical trials are necessary to obtain evidence as to which is the best therapeutic strategy for patients . When oral therapy fails in type 2 diabetes patients, basal insulin therapy is started . When this therapy also fails, there were two options for treating these patients: adding ultra-fast acting insulin to the main meal or taking two insulin mixtures with basal insulin and fast-acting insulin at breakfast and dinner . There was no evidence as to which of these strategies was better . As a result of a clinical trial in which CIBERobn collaborated in designing it, the two therapeutic alternatives were compared, showing that the two are equally safe and that use of two mixtures has a discreet increase in the efficacy of reducing glycated hemoglobin (Tinahones FJ et al . Diabetes Obes Metab . 2014) .
Postprandial hypertriglyceridemia contributes more to cardiovascular risk than fasting triglycerides do, because it is associated with a postprandial inflammatory state, among others reasons . Patients suffering obesity usually have atherogenic dyslipidemia which includes postprandial hypertriglyceridemia, and it has been shown that use of olive oil as a source of fat reduces postprandial inflammation compared to other oils and that it also reduces endotoxemia, a factor that is closely linked to inflammation (Camargo A et al . Food Chem . 2014) .
Aging and obesity is one of the lines of research included in this programme . In a multicentre study in which CIBERobn participates (LIPGENE), it has been shown that telomere length is closely related to endothelial dysfunction (González-Guardia L et al . Age (Dordr) . 2014) .
The study of childhood obesity is a subprogramme within this programme .
Important strides were made this year in this in this area . A prospective study has shown that the weight of children when they are born and postnatal weight gain predict the value of cardio-metabolic parameters assessed at 5 years . This study stresses the importance of excess weight from birth and in the first few months of life, and that the increase is related to cardiovascular risk variables at very early ages of life (E Lurbe et al . Hypertension 2014) .
The discovery of a mutation in compound heterozygosity in the RNPC3 gene, affecting the minor spliceosome, generating obesity and familial isolated growth hormone deficiency (EMBO Mol Med 2014), has entailed describing a new syndrome . Specific diagnosis and treatment with biosynthetic growth hormone provides a solution to obesity in patients studied .
The obesity-cancer association right now is undeniable . Within this programme there is a obesity and cancer subprogramme . The recruitment of the series of patients with colon cancer ended in 2014, and colon tumour and healthy tissue samples together with visceral adipose tissue were included in a biobank for epigenetic analysis .
Collaboration with the enterprise GENDIAG in generating a tool, marketed under the name of “Nutri CODE”, which applies to clinical practice existing knowledge about the nutrigenomics of obesity and of metabolic syndrome (Dr . López Miranda) .
20 CIBEROBN » Annual report 2014