Publications by authors named "Gabriel A Martos-Moreno"

Article Synopsis
  • Most patients with type 1 diabetes struggle to meet recommended blood sugar control levels, increasing the risk of complications.
  • Hybrid closed-loop systems, which automate insulin delivery, offer a promising solution to enhance control, improve quality of life, and lessen the psychological burden of the disease.
  • The article reviews the effectiveness and safety of these systems, discusses implementation challenges, and outlines best practices for their use in healthcare settings.
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  • Hypophosphatasia (HPP) is a rare genetic disorder linked to low levels of alkaline phosphatase due to ALPL gene variants, with a focus on data from the Global HPP Registry.
  • Out of 1176 enrolled patients, 814 met the criteria, with the majority located in Europe and North America, and most patients had one known disease-causing variant.
  • The study highlighted distinct regional differences in ALPL variants, particularly in Japan, where more patients had two variants and earlier disease onset; 23 novel variants were also identified mainly in Europe.
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Mouse models of growth hormone deficiency (GHD) have provided important tools for uncovering the various actions of GH. Nearly 100 years of research using these mouse lines has greatly enhanced our knowledge of the GH/IGF-1 axis. Some of the shared phenotypes of the 5 "common" mouse models of GHD include reduced body size, delayed sexual maturation, decreased fertility, reduced muscle mass, increased adiposity, and enhanced insulin sensitivity.

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  • The study examines factors that predict success or early dropout in childhood obesity management, highlighting the need for personalized treatment plans to improve outcomes.
  • Analyzing data from 1,300 patients, the study finds that higher rates of early dropout are associated with Latin ethnicity and compulsive eating, while those with significant weight loss tend to be male and have better dietary control at home.
  • Although some demographic and personal characteristics relate to weight management success or dropout, their predictive value is somewhat limited, indicating a need for more comprehensive strategies.
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Background: Prepubertal children with obesity frequently have enhanced growth, accelerated skeletal maturation and changes in the GH-IGF axis. However, the involvement of pappalysins (PAPP-A, PAPP-A2) and stanniocalcins (STC1, STC2) as regulators of IGF bioavailability has not been studied in obesity.

Objective: We aimed to determine the effects of childhood obesity and weight reduction on serum levels of PAPP-A, PAPP-A2, STC1 and STC2 and their relationship with IGF bioavailability, growth, and other components of the GH-IGF system.

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  • Hypophosphatasia (HPP) is a rare inherited disease that causes chronic pain, fatigue, and mobility issues in adults due to low enzyme activity; enzyme replacement therapy, asfotase alfa, may help alleviate these symptoms.
  • A study using the Global HPP Registry examined the effectiveness of asfotase alfa in adults aged 18 and older who had low alkaline phosphatase levels and received treatment for at least six months.
  • Results showed significant improvements in patients' mobility (6-Minute Walk Test), pain severity, and overall quality of life over the course of 36 months, highlighting the potential benefits of asfotase alfa for those living with HPP.
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Obesity results from an interplay between genetic predisposition and environmental factors such as diet, physical activity, culture, and socioeconomic status. Personalized treatments for obesity would be optimal, thus necessitating the identification of individual characteristics to improve the effectiveness of therapies. For example, genetic impairment of the leptin-melanocortin pathway can result in rare cases of severe early-onset obesity.

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Context: Prader-Willi syndrome (PWS) is associated with impaired growth hormone (GH) secretion and decreased insulin-like growth factor (IGF)-I levels. Pappalysins (PAPP-A, PAPP-A2) and stanniocalcins (STC-1, STC-2) regulate IGF binding-protein (IGFBP) cleavage and IGF bioavailability, but their implication in PWS is unknown.

Objective: We determined serum levels of PAPP-As and STCs in association with IGF axis components in prepubertal and pubertal patients with PWS, also analyzing the effect of GH treatment.

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  • Hypophosphatasia (HPP) is a genetic disorder that affects bone and tooth mineralization, caused by variations in the ALPL gene, which complicates diagnosis due to variants of uncertain significance (VUS).* -
  • An open-access ALPL gene variant database has been created to help interpret the clinical significance of various ALPL mutations, providing details on their pathogenicity and associated genotypes and phenotypes.* -
  • The database supports a project to reclassify VUS by allowing submissions from health professionals and uses a collaboration of experts to follow strict guidelines for a thorough assessment, improving understanding of HPP.*
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Objectives: To study the prevalence and influence on metabolic profile of the prohormone-convertase-1 (PCSK1) N221D variant in childhood obesity, proven its role in the leptin-melanocortin signaling pathway as in proinsulin and other prohormone cleavage.

Methods: Transversal study of 1066 children with obesity (mean age and BMI Z-score 10.38 ± 3.

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Article Synopsis
  • The study aimed to analyze the clinical profiles of children with hypophosphatasia (HPP) before they start enzyme replacement therapy (ERT).
  • Data from 151 children enrolled in the Global HPP Registry showed that HPP affects both skeletal and extraskeletal areas, with significant differences based on the age of first symptoms and geographic location.
  • Findings revealed variations in symptoms and presentations, emphasizing the need for thorough evaluations of HPP children before starting ERT.
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Introduction: Hypophosphatasia (HPP) manifests in adults as fractures/pseudofractures, pain, muscle weakness, and other functional impairments. Better phenotypic disease characterization is needed to help recognize disability and treat patients with HPP.

Methods: Baseline/pretreatment demographic, clinical characteristic, and patient-reported disability/health-related quality-of-life (HRQoL) data from adults (≥18 y) in the Global HPP Registry (NCT02306720) were stratified by presence of overt skeletal manifestations (skeletal group) versus muscular/pain manifestations without skeletal manifestations (muscular/pain group) and summarized descriptively.

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  • The study focuses on hypophosphatasia, a metabolic condition that affects bone mineralization and can influence growth in children, analyzing data from the Global Hypophosphatasia Registry.
  • Results showed that short stature was present in about 16% of children under 2 years old and 20% of those 2 years and older, with significant growth impairment noted in the younger group.
  • The findings suggest that while hypophosphatasia may impact growth during infancy, height alone does not reliably indicate the severity of the condition, as various clinical manifestations occur regardless of height percentiles.
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  • Bardet-Biedl syndrome is a rare genetic disorder causing severe obesity and hyperphagia, and its impact on quality of life has not been well studied.
  • In a Phase 3 trial of 52 weeks of setmelanotide treatment, both children and adults showed significant improvements in health-related quality of life, as measured by the PedsQL for kids and the IWQOL-Lite for adults.
  • The results indicated that after treatment, children had a mean improvement of +11.2 in PedsQL scores, while adults had a mean improvement of +12.0 in IWQOL-Lite scores, with notable correlations found between quality of life and changes in body weight and BMI.
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Article Synopsis
  • Impaired cilial signaling in the MC4R pathway is linked to obesity in patients with Bardet-Biedl and Alström syndromes, prompting a study on the weight-loss effects of setmelanotide in these groups.
  • The study was a multicenter, double-blind, placebo-controlled trial involving 38 patients over 14 weeks, followed by 52 weeks of open-label treatment, assessing the impact of setmelanotide on body weight.
  • Results indicated that 32.3% of patients aged 12 years or older with Bardet-Biedl syndrome experienced at least a 10% weight reduction after 52 weeks on setmelanotide, with skin hyperpigmentation and injection
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Introduction: Development of cystic fibrosis-related diabetes (CFRD) is associated with worsening of nutritional status and lung function, as well as increased mortality. The relevance of diagnosing the «pre-diabetic» status in these patients has not been addressed and the utility of HbA1c measurement in these patients is under discussion.

Aim: To study and characterise the different categories of carbohydrate metabolism impairment in paediatric patients with cystic fibrosis.

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  • Embryonic development relies on precise DNA processes, and mutations in repair genes can cause neurodevelopmental disorders with symptoms like microcephaly and short stature.
  • Researchers identified genetic variants in SLF2 and SMC5 from the RAD18-SLF1/2-SMC5/6 pathway in patients with developmental issues, including abnormal chromosomes and anemia.
  • The new disorder, named Atelís Syndrome, demonstrates heightened replication stress and difficulties with specific DNA structures, emphasizing the crucial role of the SLF2-SMC5/6 pathway in preserving genome stability.
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Context: Pappalysins (PAPP-A, PAPP-A2) modulate body growth by increasing insulin-like growth factor I (IGF-I) bioavailability through cleavage of insulin-like growth factor binding proteins (IGFBPs) and are inhibited by stanniocalcins (STC1, STC2). Normative data on these novel factors, as well as on free IGF-I and uncleaved fractions of IGFBPs, are not well established.

Objective: This work aimed to determine serum concentrations of PAPP-A, PAPP-A2, STC1, and STC2 in relationship with other growth hormone (GH)-IGF axis parameters during development.

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Background: The clinical signs and symptoms of hypophosphatasia (HPP) can manifest during any stage of life. The age at which a patient's symptoms are reported can impact access to targeted treatment with enzyme replacement therapy (asfotase alfa), as this treatment is indicated for patients with pediatric-onset HPP in most countries. As such, many patients reported to have adult-onset HPP typically do not receive treatment.

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Anorexia nervosa (AN) is a mental disorder characterized by an intense fear of weight gain that affects mainly young women. It courses with a negative body image leading to altered eating behaviors that have devastating physical, metabolic, and psychological consequences for the patients. Although its origin is postulated to be multifactorial, the etiology of AN remains unknown, and this increases the likelihood of chronification and relapsing.

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Purpose: We aimed to investigate the molecular basis underlying a novel phenotype including hypopituitarism associated with primary ovarian insufficiency.

Methods: We used next-generation sequencing to identify variants in all pedigrees. Expression of Rnpc3/RNPC3 was analyzed by in situ hybridization on murine/human embryonic sections.

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Limited therapeutic tools and an overwhelming clinical demand are the major limiting factors in pediatric obesity management. The optimal protocol, environment, body mass index (BMI) change targets and duration of obesity-oriented interventions remain to be elucidated. We aimed to characterize the singularities of follow-up, anthropometric and metabolic evolution of a large cohort of pediatric patients with obesity in a specialized university hospital outpatient obesity unit.

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Summary: Congenital isolated ACTH deficiency (IAD) is a rare condition characterised by low plasma ACTH and serum cortisol with normal production of other pituitary hormones. TBX19 (also known as TPIT) is a T-box pituitary restricted transcription factor important for POMC gene transcription and terminal differentiation of POMC-expressing cells. TBX19 gene mutations have been shown to cause neonatal-onset congenital IAD.

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PAPP-A2 deficiency is a novel syndrome characterized by short stature due to low IGF bioactivity, skeletal abnormalities and decreased bone mineral density (BMD). Treatment with recombinant human IGF-1 (rhIGF-1) for 1 year demonstrated to increase growth velocity and BMD, without reported adverse effects, but data regarding the long-term efficacy and safety of rhIGF-1 administration in this entity has not yet been reported. Two Spanish siblings with short stature due to a homozygous loss-of-function mutation in the PAPP-A2 gene (p.

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The present study longitudinally evaluated growth, bone mineral density, body composition, and metabolic health outcome in very low birth weight (VLBW) infants whose in-hospital target nutrient intake was within recent recommendations. From six months to three years, bone mineral density (dual-energy X-ray absorptiometry, DXA), body composition, and metabolic health outcome were compared with a reference group of term infants. The aim was to test whether in-hospital achieved weight gain until 36 weeks of gestation (light or appropriate for term equivalent age; LTEA or ATEA) predicts later growth, bone mineral density (BMD), abdominal obesity, or metabolic health outcomes such as insulin resistance, relative to term infants, during the first three years of life.

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