https://hdl.handle.net/11000/412 2026-08-03T07:33:27Z https://hdl.handle.net/11000/40292 Título : Diet, lifestyle, metabolic markers, and socioeconomic status are associated with cognitive function in school-aged children from a population-based cohort. Autor : Gómez-Vilarrubla, Ariadna; Sanchez Fernández , Mario José; Puerto-Carranza, Elsa; Martínez-Calcerrada, Jose Maria; Mas-Parés, Berta; Rivero, María José; Nso-Roca, Ana Pilar; Alvarez-Monell, Adam; Contreras Rodríguez, Oren; Garre-Olmo, Josep ; Lopez-Bermejo, Abel; Bassols, Judit Resumen : BackgroundCognitive development is associated with diet, activity, sleep, metabolic health, and socioeconomic status. However, evidence remains limited, as most studies have focused on clinical groups or single factors. We examined the combined associations of these variables with cognitive function in school-aged children from the general population.MethodsWe evaluated 170 school-aged children from a population-based cohort (mean age 6.33 ± 0.03 years; 49% female). Children were evaluated after an overnight fast (>8 h), and anthropometric, metabolic, and socioeconomic variables were evaluated. Diet and physical activity were assessed using validated questionnaires (Vioque FFQ and enKid). Cognitive function was assessed using NEPSY-II and TONI-2 subsets. Correlation and regression analyses were performed.ResultsCognitive function was positively associated with Mediterranean diet adherence, sleep duration, socioeconomic status, and negatively associated with ultra-processed food intake, TV viewing, and metabolic markers including insulin resistance (HOMA-IR), C-reactive protein, and gamma-glutamyltransferase (all p < 0.05). Multivariate analyses showed that Mediterranean diet adherence (OR 2.18, 95%CI 1.08–4.40), economic status (OR 2.50, 95%CI 1.13–5.49), sleep duration (OR 2.90, 95%CI 1.42–5.92), and HOMA-IR (OR 0.47, 95%CI 0.23–0.96) as independently associated with cognitive outcomes, particularly in attention, language, and memory.ConclusionsLifestyle factors and socioeconomic conditions are independently associated with cognitive function in children.ImpactKey message: Diet, sleep, metabolic health, and socioeconomic status are associated with cognitive function in school-aged children.Novelty: Simultaneously examines multiple factors associated with cognition in school-aged children from a population-based cohort.Impact on cognition: Mediterranean diet adherence, sleep duration, and metabolic health were positively associated with several cognitive domains, including attention, language, and memory.Practical use: Highlights the potential relevance of healthy lifestyles and social equity in relation to cognitive development.Broader significance: Highlights the multifactorial nature of cognitive development in children. 2026-07-29T12:21:46Z https://hdl.handle.net/11000/40291 Título : Phase angle and triglyceride-glucose index as biomarkers of glycemic control, body composition and cardiovascular risk in adolescents with type 1 diabetes: a cross-sectional study. Autor : García Poblet, Marta; Martínez Sanz, José Miguel; Alberola-Chazarra, Manuel Antonio ; Soler Climent, Esther; Nso-Roca, Ana Pilar; Sospedra, Isabel Resumen : Purpose Traditional markers such as HbA1c and BMI are commonly used to assess metabolic risk in adolescents with type 1 diabetes mellitus (T1DM), but novel biomarkers like the triglyceride-glucose (TyG) index and phase angle (PA) may provide a more comprehensive evaluation of metabolic risk. However, their potential role in this population remains unclear. We aimed (1) to evaluate the association of the TyG index and PA with glycemic control, cardiovascular risk and body composition in adolescents with T1DM, and (2) to determine optimal cut-off points for these biomarkers to predict metabolic risk. Methods Seventy-three adolescents (46.6% female, 10–19 years) with T1DM from two hospitals were included in this cross-sectional study. Sociodemographic, bioelectrical impedance (BIA) and clinical data were collected during routine visits. The TyG index was calculated from fasting triglyceride and glucose levels, and PA was measured via BIA. Correlations were analyzed using Pearson or Spearman coefficients, and ROC curve analyses were used to determine optimal cut-off points. Results PA correlated positively with skeletal muscle and fat-free mass and inversely with cardiovascular risk indicators. TyG was strongly associated with adiposity, glycemic variability and cardiovascular risk markers. A preliminary TyG threshold of 8.09 was identified, while no PA cut-off could be established. Conclusions PA and the TyG index are promising, non-invasive biomarkers that complement traditional measures in assessing metabolic risk in adolescents with T1DM. Integrating these biomarkers into routine evaluation may enhance early risk detection and support holistic management in this population. Trial registration number NCT07021326. 2026-07-29T12:21:08Z https://hdl.handle.net/11000/40164 Título : Exposure to Obesogenic Endocrine Disruptors in Childhood. Impact on Biomarkers of Metabolic Status. Autor : Nso-Roca, Ana Pilar; Tortajada-Genaro, Luis A.; Pons Fernández, Natividad; Sánchez Ferrer, Francisco Resumen : Childhood obesity is an escalating global health concern, partly driven by environmental factors such as endocrine disruptors (EDs), which can alter metabolism and promote adiposity. This cross-sectional study examined exploratory associations between exposure to obesogenic EDs (bisphenols, parabens and benzophenones) and body composition in 72 children aged 3 to 15 years (53 with obesity and 19 normal-weight controls) recruited from two hospitals in Spain. Metabolic status, body composition and urinary levels of EDs were evaluated using tandem mass spectrometry. The findings, which are pioneering in evaluating multiple exposure to chemicals, identify exploratory associations between the presence of EDs in 100% of the participants, with parabens the most frequently detected. Higher methylparaben levels were observed in the group with obesity. Correlational analyses revealed positive associations between specific EDs and adiposity parameters, including triponderal mass index and visceral fat percentage. These results suggest a potential link between exposure to EDs and the development of childhood obesity. The massive and early exposure to EDs underscores the urgent need for preventive policies and longitudinal studies to evaluate their effects. These preliminary findings provide exploratory insights for developing effective strategies to combat childhood obesity. 2026-07-09T10:54:54Z https://hdl.handle.net/11000/40163 Título : Evolutive study of children with diffuse mesangial sclerosis. Autor : Nso-Roca, Ana Pilar; Peña Carrión, Antonia; Benito Gutiérrez, Marta; GARCÍA POSE, ARACELI; Navarro, Mercedes Resumen : Diffuse mesangial sclerosis (DMS) is a renal disease that usually presents as a nephrotic syndrome. It is characterized by early onset and rapid progression to endstage renal disease, and can occur as an isolated finding or as part of the Denys-Drash syndrome. The aim of this study was to characterize clinical features and outcomes of DMS in a cohort of children. We retrospectively analyzed all cases of DMS diagnosed in our hospital between 1973 and 2008 and evaluated the progression of the disease in relation to different variables. We studied 14 patients, four with incomplete Denys-Drash syndrome and one with Frasier syndrome. All patients developed renal failure. Eight patients received a renal transplant with no relapse of the disease. Bilateral nephrectomy was performed in nine patients with end-stage renal disease. Seven patients died, with sepsis being the main cause of death. Diffuse mesangial sclerosis must be suspected in a child that presents with early onset proteinuria and/or rapidly progressive renal failure. Karyotype and WT1 gene analysis should be performed because of the predisposition of patients to develop different types of tumors. This nephropathy has a poor prognosis, but the survival rate has improved in the last decade. 2026-07-09T10:54:09Z https://hdl.handle.net/11000/40162 Título : HIV-infected adolescents: relationship between atazanavir plasma levels and bilirubin concentrations. Autor : Nso-Roca, Ana Pilar; Larru Martinez, Beatriz; Bellón Cano, José María; Mellado Peña, Maria José; Ramos, José Tomás; Gonzalez Tome, Maria Isabel; Navarro, Maria Luisa; MUÑOZ, MARIA ANGELES; de José, Maria Isabel Resumen : Theuseofatazanavir(ATV)inadolescentsinfectedwithhumanimmunodeficiencyviruswasanalyzedinthis study. ATV morning plasma concentrations were determined during regular visits to the outpatient department. Results showed that bilirubin levels were higher among patients with higher ATV plasma concentrations (p .018). Monitoring plasma levels of ATV could avoid toxicity in these patients. 2026-07-09T10:52:42Z https://hdl.handle.net/11000/39260 Título : Hiperinsulinismo congénito en tres pacientes de la misma familia. Ampliando el genotipo de esta enfermedad Autor : Herrera Azabache, Katia; Muñoz Bermúdez, Zoraya; Ferrández Mengual, David; Nso-Roca, Ana Pilar 2026-02-13T08:23:54Z https://hdl.handle.net/11000/38932 Título : Klinefelter syndrome in childhood language delay as an early warning sign for diagnosis Autor : Nso-Roca, Ana Pilar; Carratalá, Francisco; Andreo, Patricia; Aguirre Balsalobre, Fernando Resumen : Klinefelter syndrome (KS), the most common sex chromosome aneuploidy in males, is often underdiagnosed until adolescence, delaying early intervention. We describe 11 pediatric patients with KS who were followed between 2005 and 2025 to identify early markers. Three were diagnosed prenatally; the remaining eight were diagnosed at a median age of 6.1 years, mainly due to neurodevelopmental problems. Of the total of 11 patients, 9 had delayed language acquisition, followed by 8 with psychomotor delay, 5 with behavioral disorders, 3 with sleep disorders, and 2 with epilepsy. Endocrinological comorbidities were less frequent in childhood. Delayed language development emerges as a crucial early indicator. Active detection, along with other neurodevelopmental comorbidities, is essential to address underdiagnosis and enable early, multidisciplinary intervention, thereby significantly improving patients' developmental outcomes and quality of life in KS. 2026-01-19T17:21:45Z https://hdl.handle.net/11000/38904 Título : Inteligencia artificial en la interacción sexo/ género para una analgesia personalizada en el dolor crónico Autor : Peiro, Ana; Noelia, Serrano-Gadea; Allouti, Hichem; Zorrilla-Muñoz, Vanesa; Bernal Salcedo, Joshua; de la Iglesia, María Resumen : La interacción entre sexo y género desempeña un papel clave en la percepción y el tratamiento del dolor crónico. A los factores biológicos (como las variaciones en los genes relacionados con la metabolización de analgésicos, OPRM1 y CYP2D6 y la influencia de las hormonas sexuales), se suman factores socioculturales asociados a las normas y roles de género. Estos pueden impactar en la equidad en el acceso a tratamientos y a la interpretación del dolor por parte de los profesionales sanitarios. Además, pueden modificar la selección de medicamentos y el riesgo de efectos adversos, sobre todo en mujeres. Comprender la interacción entre sexo y género en la medicina del dolor es esencial para desarrollar estrategias terapéuticas más personalizadas. En este campo, la inteligencia artificial y el procesamiento del lenguaje natural podrían ayudarnos a prevenir este tipo de sesgos mediante el análisis de registros médicos y testimonios de pacientes, identificando patrones de tratamiento diferenciados por sexo, comprendiendo mejor las experiencias de lo/as pacientes y evidenciando desigualdades existentes, hoy en día, en la medicina del dolor.; The interaction between sex and gender plays a key role in the perception and treatment of chronic pain. In addition to biological factors (such as variations in genes related to the metabolism of analgesics, including OPRM1 and CYP2D6, and the influence of sex hormones), sociocultural factors associated with gender norms and roles also contribute significantly. These factors can impact equity in access to treatments and the interpretation of pain by healthcare professionals. Moreover, they can influence medication selection and the risk of adverse effects, particularly in women. Understanding the interaction between sex and gender in pain medicine is essential for developing more personalized therapeutic strategies. In this field, artificial intelligence and natural language processing could help prevent such biases by analyzing medical records and patient testimonies, identifying sex-based treatment patterns, gaining deeper insight into patient experiences, and highlighting existing inequalities in pain medicine today. 2026-01-16T13:50:47Z https://hdl.handle.net/11000/38903 Título : Predictive modelling links exercise dependence to associated psychological and behavioral risk factors Autor : Zandonai, Thomas; Bertamini, Giulio; Lozano, Juan José; Mallia, Luca; De Maria, Alessandra; GALLI, FEDERICA; Monteagudo, Pablo; Lucidi, Fabio; Venuti, Paola; Furlanello, Cesare; Peiro, Ana Resumen : Exercise Dependence (ED) refers to uncontrollable, excessive exercise with harmful effects on life. This study used machine learning to identify behavioral and psychological factors contributing to ED risk. A multi-step procedure was implemented for model construction and validation, utilizing controlled feature selection and bootstrapping. Data were collected over three time points in diverse contexts (GR2021-22-23), recruiting 1099 participants (707 males, 64.3 %; 392 females, 35.7 %) with an average age of 24.8 ± 7.8 years. Based on the Exercise Dependence Scale-Revised (EDS-R), 5.6 % (n = 62) were classified as "At Risk" of ED, 50.9 % (n = 559) as "Non-Dependent-Symptomatic," and 43.5 % (n = 478) as "Non-Dependent-Asymptomatic." The final model predicted the GR2023 dataset with MAE = 6.90, R2 = 0.59, and RE = 9.08 %. Predictive performance on the GR2022 dataset was MAE = 5.65, R2 = 0.79, and RE = 6.73 %, while performance on the GR2021 dataset achieved MAE = 7.60, R2 = 0.58, and RE = 7.24 %. Perfectionism consistently emerged as the most important predictors, followed by Drive for Thinness, Drive for Muscularity, and sport characteristics. Result generalization was confirmed by a complementary, whole-data analysis. This study establishes a foundation for developing quantitative risk profiles for ED by analyzing multidimensional constructs and their contributions through interpretable machine learning. The methodology offers insights into how personality, psychological, and behavioral dimensions shape risk attitudes and provides robust predictive tools for assessing ED risk in sports contexts. 2026-01-16T13:50:09Z https://hdl.handle.net/11000/38887 Título : Sleep-Wake Cycle and Circadian Misalignment in People With Autism Across the Lifespan With an Emphasis on Living Conditions Autor : Martinez-Cayuelas, Elena; García Muñoz, Ana María; Sánchez de Ocaña Moreno, Maria Luisa; Richdale, Amanda L.; Gisbert Gustemps, Laura; Lugo Marín, Jorge; Rodriguez Morillas, Beatriz; Peiro, Ana; Victoria-Montesinos, Desirée; LOPEZ ANGUAS, CRISTINA; Meseguer Illán, María Dolores; Ballester, Pura Resumen : Sleep problems among individuals with autism spectrum disorder (ASD) are a persistent issue that spans from early childhood to adulthood. The present study aimed to objectively investigate sleep continuity and alignment using ambulatory circadian monitoring (ACM) in a group of autistic individuals, with and without intellectual disabilities. We studied 214 participants. Sleep continuity and alignment were assessed using a minimum of 3 days of ACM. Participants were divided into four groups: (1) age < 10 years (n = 40, 87.5% males, M = 6.78 ± 1.40 years), (2) age 10-17 years (n = 53, 90.6% males, M = 12.62 ± 2.04 years), (3) age 18-27 years (n = 59, 74.6% males, M = 23.50 ± 2.60 years), and (4) age 28-65 years (n = 62, 74.2% males, M = 39.04 ± 9.49 years). All groups had significantly impaired sleep outcomes, except for TST. Adults had longer SOL and WASO duration, than children and adolescents. However, those differences were attenuated if participants 'percentages of sleep parameters within normal range' were compared. When evaluating circadian misalignment, sleep M5 is delayed in children and adolescents (2:56 am and 3:00 am, respectively), and strongly advanced in the older adults (group 4). Sleep problems that manifest in autism during childhood can endure throughout adulthood. Furthermore, there is a necessity to investigate how living conditions, such as enforced schedules in residential facilities, can influence the timing of the sleep midpoint. 2026-01-15T10:54:56Z