Publications by authors named "Elena Martínez-Rosales"

6 Publications

  • Page 1 of 1

Relative Handgrip Strength as Marker of Cardiometabolic Risk in Women with Systemic Lupus Erythematosus.

Int J Environ Res Public Health 2021 Apr 27;18(9). Epub 2021 Apr 27.

Department of Education, Faculty of Education Sciences, University of Almería, 04120 Almería, Spain.

This study aimed to examine the association of relative handgrip strength (rHGS) with cardiometabolic disease risk factors in women with systemic lupus erythematosus (SLE).

Methods: Seventy-seven women with SLE (mean age 43.2, SD 13.8) and clinical stability during the previous six months were included. Handgrip strength was assessed with a digital dynamometer and rHGS was defined as absolute handgrip strength (aHGS) divided by body mass index (BMI). We measured blood pressure, markers of lipid and glucose metabolism, inflammation (high sensitivity C-reactive protein [hs-CRP]), arterial stiffness (pulse wave velocity [PWV]), and renal function. A clustered cardiometabolic risk index (z-score) was computed.

Results: Pearson's bivariate correlations revealed that higher rHGS was associated with lower systolic blood pressure (SBP), triglycerides, hs-CRP, PWV, and lower clustered cardiometabolic risk (r = from -0.43 to -0.23; all < 0.05). Multivariable linear regression analyses adjusted for age, disease activity (SLEDAI), and accrual damage (SDI) confirmed these results (all < 0.05) except for triglycerides.

Conclusions: The findings suggest that higher rHGS is significantly associated with lower cardiometabolic risk in women with SLE.
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http://dx.doi.org/10.3390/ijerph18094630DOI Listing
April 2021

Impact of exercise training after bariatric surgery on cardiometabolic risk factors: a systematic review and meta-analysis of controlled trials.

Rev Endocr Metab Disord 2021 Apr 16. Epub 2021 Apr 16.

Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain.

The purpose of this systematic review was to provide updated evidence synthesis of the effectiveness of exercise training in patients with obesity undergoing bariatric surgery to improve cardio-metabolic risk. We systematically searched the MEDLINE, EMBASE, Scopus, Cochrane, and Web of Science databases. The studies selected were those in which an exercise-based intervention was performed after bariatric surgery, a control group was present, and at least one of the following outcomes was investigated: VO or VO, resting heart rate (RHR), blood pressure, lipid profile, glucose, and insulin. The study quality was assessed using the PEDro scale and the data were meta-analyzed with a random effects model, comparing control groups to intervention groups using standardized measurements. Twenty articles were included in the systematic review and fourteen (70%) in the meta-analysis. Significant differences were observed between the control and intervention groups (always in favor of exercise) for absolute VO / VO (ES = 0.317; 95% CI = 0.065, 0.569; p = 0.014), VO / peak relative to body weight (ES = 0.673; 95% CI = 0.287, 1.060; p = 0.001), HDL cholesterol (ES = 0.22; 95% CI = 0.009, 0.430; p = 0.041) and RHR (ES = -0.438; 95% CI = -0.753, -0.022; p = 0.007). No effects were observed for either systolic or diastolic blood pressure. Exercise training for patients undergoing bariatric surgery appears to be effective in improving absolute and relative VO / VO, HDL cholesterol and reducing the RHR. More intervention studies using (better) exercise interventions are needed before discarding their effects on other cardiometabolic risk factors. This systematic review and meta-analysis has been registered in Prospero (CRD42020153398).
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http://dx.doi.org/10.1007/s11154-021-09651-3DOI Listing
April 2021

Heart Rate Variability in Women with Systemic Lupus Erythematosus: Association with Health-Related Parameters and Effects of Aerobic Exercise.

Int J Environ Res Public Health 2020 12 18;17(24). Epub 2020 Dec 18.

Department of Education, Faculty of Education Sciences, University of Almería, 04120 Almería, Spain.

Abnormal heart rate variability (HRV) has been observed in patients with systemic lupus erythematosus (SLE). In a combined cross-sectional and interventional study approach, we investigated the association of HRV with inflammation and oxidative stress markers, patient-reported outcomes, and the effect of 12 weeks of aerobic exercise in HRV. Fifty-five women with SLE (mean age 43.5 ± 14.0 years) were assigned to either aerobic exercise ( = 26) or usual care ( = 29) in a non-randomized trial. HRV was assessed using a heart rate monitor during 10 min, inflammatory and oxidative stress markers were obtained, psychological stress (Perceived Stress Scale), sleep quality (Pittsburg Sleep Quality Index), fatigue (Multidimensional Fatigue Inventory), depressive symptoms (Beck Depression Inventory), and quality of life (36-item Short-Form Health Survey) were also assessed. Low frequency to high frequency power (LFHF) ratio was associated with physical fatigue ( = 0.019). Sample entropy was inversely associated with high-sensitivity C-reactive protein ( = 0.014) and myeloperoxidase ( = 0.007). There were no significant between-group differences in the changes in HRV derived parameters after the exercise intervention. High-sensitivity C-reactive protein and myeloperoxidase were negatively related to sample entropy and physical fatigue was positively related to LFHF ratio. However, an exercise intervention of 12 weeks of aerobic training did not produce any changes in HRV derived parameters in women with SLE in comparison to a control group.
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http://dx.doi.org/10.3390/ijerph17249501DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7766283PMC
December 2020

Improvements in Heart Rate Variability in Women with Obesity: Short-term Effects of Sleeve Gastrectomy.

Obes Surg 2020 Oct;30(10):4038-4045

Physical Therapy Department, Universidad de Chile, Independencia 1027, 8380453, Santiago, Chile.

Purpose: Obesity has been associated with reduced vagal function and increased sympathetic activity. Cardiac autonomic dysfunction has emerged as a major risk factor in the development of cardiovascular disease. Cardiac autonomic function (CAF) can be assessed by heart rate variability (HRV), an independent predictor of mortality based on changes in time intervals between adjacent heartbeats (RR). Bariatric surgery is considered the most effective treatment for obesity and its comorbidities, with sleeve gastrectomy (SG) being the most frequent bariatric procedure. There are few studies on HRV changes in women with obesity after SG. The aim of this study was to evaluate the short-term impact of SG on CAF and its relationship with weight loss.

Materials And Methods: An observational cohort study was conducted. Twenty-three female patients were assessed before SG and at 1 and 3 months after surgery. CAF was evaluated by analyzing HRV from 5-min records of RR intervals while the subject was supine. HRV was analyzed in time and frequency domains and with a nonlinear method.

Results: Patients (36.0 ± 11.1 years old, BMI 35.1 ± 3.4 kg/m) presented higher HRV values, on average, in all domains both at 1 and 3 months after SG (p < 0.05). In addition, all anthropometric parameters improved (p < 0.001) although there was no relationship between HRV improvements and anthropometric changes.

Conclusion: SG seems to be effective at reducing excess weight and improving HRV at the short term, and these changes are detectable as early as the first month after surgery. HRV assessment appears as a promising low-cost tool that deserves further research.
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http://dx.doi.org/10.1007/s11695-020-04721-yDOI Listing
October 2020

Physical Exercise following bariatric surgery in women with Morbid obesity: Study protocol clinical trial (SPIRIT compliant).

Medicine (Baltimore) 2020 Mar;99(12):e19427

Obstetrics and Gynecology Unit, Torrecárdenas University Hospital, Almería.

Background: Severe and morbid obesity are increasing globally, particularly in women. As BMI increases, the likelihood of anovulation is higher. The primary aim of the EMOVAR clinical trial is to examine, over the short (16 weeks) and medium (12 months) term, the effects of a supervised physical exercise program (focused primarily on aerobic and resistance training) on ovarian function in women with severe/morbid obesity who have undergone bariatric surgery. Secondary objectives are to examine the effects of the intervention on chronic inflammation, insulin resistance, arterial stiffness, physical fitness, and health-related quality of life.

Methods: This is a randomized controlled trial in which ∼40 female bariatric surgery patients, aged between 18 and 45 years old, will be included. Participants assigned to the experimental group will perform a total of 48 sessions of supervised concurrent (strength and aerobic) training (3 sessions/week, 60 min/session) spread over 16 weeks. Patients assigned to the control group will receive lifestyle recommendations. Outcomes will be assessed at baseline, week 16 (i.e., after the exercise intervention) and 12 months after surgery. The primary outcome is ovarian function using the Sex-Hormone Binding Globuline, measured in serum. Secondary outcomes are serum levels of anti-mullerian hormone, TSH, T4, FSH, LH, estradiol, prolactine, and free androgen index, as well as oocyte count, the diameters of both ovaries, endometrial thickness, and uterine arterial pulsatility index (obtained from a transvaginal ultrasound), the duration of menstrual bleeding and menstrual cycle duration (obtained by personal interview) and hirsutism (Ferriman Gallwey Scale). Other secondary outcomes include serum markers of chronic inflammation and insulin resistance (i.e., C-reactive protein, interleukin 6, tumor necrosis factor-alpha, leptin, glomerular sedimentation rate, glucose, insulin and the HOMA-IR), arterial stiffness, systolic, diastolic and mean blood pressure, body composition, and total weight loss. Physical fitness (including cardiorespiratory fitness, muscular strength, and flexibility), health-related quality of life (SF-36 v2) and sexual function (Female Sexual Function Index) will also be measured.

Discussion: This study will provide, for the first time, relevant information on the effects of exercise training on ovarian function and underlying mechanisms in severe/morbid obese women following bariatric surgery.

Trial Registration Number: ISRCTN registry (ISRCTN27697878).
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http://dx.doi.org/10.1097/MD.0000000000019427DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7220774PMC
March 2020

Influence of Body Composition on Arterial Stiffness in Middle-Aged Adults: Healthy UAL Cross-Sectional Study.

Medicina (Kaunas) 2019 Jul 3;55(7). Epub 2019 Jul 3.

Department of Education, Faculty of Education Sciences, University of Almería, 04120 Almería, Spain.

Several anthropometric and body composition parameters have been linked to arterial stiffness (AS) as a biomarker of cardiovascular disease. However, little is known about which of these closely related factors is more strongly associated with AS. The aim of the present study was to analyze the relationship of different anthropometric and body composition parameters with AS in middle-aged adults. This cross-sectional study included 186 middle-aged participants (85 women, 101 men; age = 42.8 ± 12.6 years) evaluated as part of the Healthy UAL study, a population study conducted at the University of Almería with the main purpose of analyzing the etiology and risk factors associated with cardio-metabolic diseases. Anthropometric measures included neck, waist, and hip circumferences, as well as the waist-to-height ratio (WHtr). Bioimpedance-derived parameters included fat-free mass index (FFMI), fat mass index (FMI), and percent of body fat (%BF). AS was measured by pulse wave velocity (PWV). The relationships of interest were examined through stepwise regression analyses in which age and sex were also introduced as potential confounders. Neck circumference (in the anthropometric model; : 0.889; : age = 0.855, neck = 0.204) and FFMI (in the bio-impedance model; : 0.891; : age = 0.906, FFMI = 0.199) emerged as significant cross-sectional predictors of AS. When all parameters were included together (both anthropometry and bio-impedance), both neck circumference and FFMI appeared again as being significantly associated with AS (: 0.894; : age = 0.882, FFMI = 0.126, neck = 0.093). It was concluded that FFMI and neck circumference are correlated with AS regardless of potential confounders and other anthropometric and bioimpedance-derived parameters in middle-aged adults.
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http://dx.doi.org/10.3390/medicina55070334DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6681323PMC
July 2019