Fernández Ruiz, Virginia Esperanza

Person:
Fernández Ruiz, Virginia Esperanza

Name

Fernández Ruiz, Virginia Esperanza

publication.page.department

Universidad de Murcia. Departamento de Enfermería

Full item page

Search Results

Now showing 1 - 8 of 8

Open Access
Corporal composition and gut microbiome modification through exclusion dietary intervention in adult patients with Crohn’s disease: protocol for a prospective, interventional, controlled, randomized clinical trial
(MDPI, 2025-06-05) Cano-Mármol, Rosario Paloma; Fernández Ruiz, Virginia Esperanza; Martínez-Pascual, Cristina; Ros-Madrid, Inmaculada; Martín-Pozuelo del Pozo, Gala; Oliva-Bolarín, Alba; Martínez-Sánchez, María Antonia; Egea Valenzuela, Juan; Núñez-Sánchez, María Ángeles; Ramos-Molina, Bruno; Ruiz Alcaraz, Antonio José; Ferrer Gómez, Mercedes; Bioquímica y Biología Molecular B e Inmunología; Facultad de Biología
Background: Crohn’s disease (CD) is an inflammatory bowel disease in which there is an alteration in the homeostasis and functionality of the intestinal mucosa accompanied by a dysbiosis of the commensal microbiota. The analysis of different dietary strategies to achieve CD remission and reduce gastrointestinal symptoms concludes that it is necessary to restrict the intake of ultra-processed products and to promote the consumption of those with anti-inflammatory effects that improve intestinal permeability and dysbiosis. Methods: Based on previous studies conducted in other cohorts, mainly pediatric, we propose an experimental, prospective, randomized study in patients with active CD who do not show improvement with conventional pharmacological treatment. The control group will receive standard nutritional recommendations while the intervention group will be prescribed an exclusion diet supplemented with enteral nutrition. Results: Patients in the intervention group are expected to exhibit increased lean body mass and reduced visceral fat, as measured by bioelectrical impedance analysis (BIA), alongside higher rates of clinical remission (CDAI), decreased inflammatory markers, and improved gut microbiota composition. Additionally, improvements in health-related quality of life are anticipated, as assessed by validated questionnaires. Conclusions: In the present project, we plan to conduct a detailed study to determine the potential of the exclusion diet for the treatment and remission of CD in adult patients, with the hypothesis that this nutritional intervention will be able to modify and improve intestinal dysbiosis, inflammatory status, and clinical and body composition markers in these patients.
Open Access
Mid-term changes in quality of life and nutritional habits following gastric bypass: a 24-month follow-up study
(MDPI, 2026-01-16) Martínez-Sánchez, María Antonia; Ros Madrid, Inmaculada; Fernández Ruiz, Virginia Esperanza; Cano-Mármol, Rosario Paloma; Hernández-Morante, Juan José; Núñez-Sánchez, María Ángeles; Balaguer-Román, Andrés; Frutos Bernal, María Dolores; Ruiz Alcaraz, Antonio José; Queipo-Ortuño, María Isabel; Ferrer Gómez, Mercedes; Ramos-Molina, Bruno; Bioquímica y Biología Molecular B e Inmunología; Facultad de Biología
Background/Objectives: Obesity is an increasingly concerning public health issue due to its high prevalence and its association with multiple comorbidities. A significant proportion of patients with obesity who undergo bariatric surgery could exhibit suboptimal mid-term outcomes. This study aims to comprehensively assess anthropometric, clinical, biochemical, nutritional, and quality of life parameters in patients with severe obesity undergoing bariatric surgery, with a particular focus on outcomes at 24 months post-surgery to capture mid-term effects that may not be apparent during the first year of follow-up. Methods: A prospective study was conducted in 95 patients with obesity undergoing bariatric surgery (Roux-en Y gastric bypass; RYGB) at the Virgen de la Arrixaca University Clinical Hospital (Murcia, Spain) between 2020 and 2023. Participants were followed up at 6, 12, and 24 months after RYGB. The study incorporated anthropometric assessments (BMI, body composition via bioelectrical impedance), full biochemical profiling, dietary analysis (using a validated food frequency questionnaire), and quality of life assessment (SF-36 questionnaire). Results: Our results showed significant weight loss after the intervention, accompanied by improvements in metabolic parameters, and dietary habits. Regarding quality of life, significant improvements were observed in both the physical (baseline: 39.62%; 6 months: 52.40%; 12 months: 53.12%) and mental components (baseline: 42.08; 6 months: 53.40; 12 months: 52.14%) at 6 and 12 months post-surgery. However, our prospective 24-month follow-up revealed that, despite these initial benefits, mental health significantly declined compared with the 12-month follow-up (24 months: 46.85%). In contrast, the physical component remained relatively stable at 24 months (24 months: 50.91%). However, our prospective 24-month follow-up revealed that, despite these initial benefits, there was a decline in mental health compared to the 12-month follow-up. Conclusions: While bariatric surgery is associated with improvements in anthropometric measures and some aspects of quality of life, our findings underscore the need for continued mid-term support to address emerging challenges in mental well-being.
Restricted
Lipidomic analysis reveals alterations in hepatic FA profile associated with MASLD stage in patients with obesity
(Oxford University Press, 2024-01-13) Núñez-Sánchez, María Ángeles; Martínez-Sánchez, María Antonia; Martínez-Montoro, José Ignacio; Balaguer-Román, Andrés; Murcia-García, Elena; Fernández Ruiz, Virginia Esperanza; Ferrer Gómez, Mercedes; Martínez Cáceres, Carlos Manuel; Sledzinski, Tomasz; Frutos Bernal, María Dolores; Hernández-Morante, Juan José; Fernández-García, José Carlos; Queipo-Ortuño, María Isabel; Ruiz Alcaraz, Antonio José; Mika, Adriana; Ramos-Molina, Bruno; Bioquímica y Biología Molecular B e Inmunología; Facultad de Biología
Context. Metabolic dysfunction–associated steatotic liver disease (MASLD) is characterized by the intracellular lipid accumulation in hepatocytes. Excess caloric intake and high-fat diets are considered to significantly contribute to MASLD development. Objective. To evaluate the hepatic and serum fatty acid (FA) composition in patients with different stages of MASLD, and their relationship with FA dietary intake and MASLD-related risk factors. Methods. This was a case–control study in patients with obesity undergoing bariatric surgery at a university hospital between January 2020 and December 2021. Participants were distributed in 3 groups: no MASLD (n = 26), steatotic liver disease (n = 33), and metabolic dysfunction–associated steatohepatitis (n = 32). Hepatic and serum FA levels were determined by gas chromatography-mass spectrometry. Nutritional status was evaluated using validated food frequency questionnaires. The hepatic expression of genes involved in FA metabolism was analyzed by reverse transcription quantitative polymerase chain reaction. Results. The hepatic, but not serum, FA profiles were significantly altered in patients with MASLD compared with those without MASLD. No differences were observed in FA intake between the groups. Levels of C16:0, C18:1, and the C18:1/C18:0 ratio were higher, while C18:0 levels and C18:0/C16:0 ratio were lower in patients with MASLD, being significantly different between the 3 groups. Hepatic FA levels and ratios correlated with histopathological diagnosis and other MASLD-related parameters. The expression of genes involved in the FA metabolism was upregulated in patients with MASLD. Conclusion. Alterations in hepatic FA levels in MASLD patients were due to enhancement of de novo lipogenesis in the liver.
Open Access
Dynamics of the epigenome, microbiome, and metabolome in relation to early adiposity in the maternal–infant axis: protocol for a prospective, observational pilot study in the spanish NEMO cohort
(MDPI, 2025-09-23) Suárez Cortés, María; Juan-Pérez, Almudena; Molina Rodríguez, Alonso; Araújo de Castro, Julia; Castaño Molina, María de los Ángeles; Fernández Ruiz, Virginia Esperanza; Jiménez-Méndez, Almudena; Pérez-Munar, Paula Martínez; Rico-Chazarra, Sara; Ramos-Molina, Bruno; Sánchez-Solís de Querol, Manuel; Blanco Carnero, José Eliseo; Ruiz Alcaraz, Antonio José; Núñez-Sánchez, María Ángeles; Bioquímica y Biología Molecular B e Inmunología; Facultad de Biología
Background: Childhood obesity has reached epidemic levels in developed countries and is an emerging concern in developing regions. Children with excess weight are more likely to maintain this condition over time into adulthood and face a higher risk of developing metabolic disorders such as type 2 diabetes, hypertension, metabolic dysfunction-associated liver disease, and dyslipidemia. Early identification of obesity risk is, therefore, a key public health challenge. Methods: This is an observational, prospective, single-center cohort pilot study in 66 mother–infant dyads recruited at the Gynecology and Obstetrics Service of the Virgen de la Arrixaca University Hospital (Murcia, Spain). The primary objective is to identify early-life, non-invasive biomarkers associated with increased adiposity by integrating multi-omics approaches and analyzing maternal–infant interactions. Pregnant women will be enrolled during the third trimester and will undergo a baseline visit at 38 weeks of gestation for clinical and anthropometric assessment. Buccal swabs and fecal samples will be collected at baseline and in the peripartum period for epigenetic (DNA methylation), metagenomic, and metabolomic analyses. Infants will be evaluated at birth and followed at 6 months, 1 year, 2 years, and 3 years. Each visit will include detailed anthropometric measurements, along with collection of buccal swabs and fecal samples for multi-omics profiling. Conclusions: This multidisciplinary study aims to assess how maternal factors influence infant epigenetic and microbial patterns, and their relation to adiposity development. Early identification of such biomarkers may guide personalized prevention strategies and reduce the long-term burden of obesity-related comorbidities.
Open Access
Plasma short-chain fatty acid changes after bariatric surgery in patients with severe obesity
(Elsevier, 2023-01-31) Marıa Antonia, Martínez-Sánchez; Balaguer-Roman, Andrés; Fernández Ruiz, Virginia Esperanza; Almansa-Saura, Sonia; García-Zafra, Victoria; Ferrer Gómez, Mercedes; Frutos Bernal, María Dolores; Queipo-Ortuño, María I.; Ruiz Alcaraz, Antonio José; Nuñez-Sánchez, María A.; Ramos-Molina, Bruno; Bioquímica y Biología Molecular B e Inmunología; Facultad de Biología
Background: Obesity has reached epidemic dimensions in recent decades. Bariatric surgery (BS) is one of the most effective interventions for weight loss and metabolic improvement in patients with obesity. Short-chain fatty acids (SCFA) are gut microbiota-derived metabolites with a key role in body weight control and insulin sensitivity. Although BS is known to induce significant changes in the gut microbiota composition, its impact on the circulating levels of certain metabolites produced by the gut microbiota such as SCFA remains poorly understood. Objective: To determine the impact of BS on the circulating SCFA levels in patients with severe obesity. Setting University hospital. Methods: An observational, prospective study was performed on 51 patients undergoing Roux-en-Y gastric bypass. Plasma samples were collected at baseline (1 day before surgery) and at 6 and 12 months after BS. Plasma SCFA levels were determined by liquid chromatography–mass spectrometry. Results: The results revealed significant changes in the circulating levels of SCFA after BS. A marked increase in propionate, butyrate, isobutyrate, and isovalerate levels and a decrease in acetate, valerate, hexanoate, and heptanoate levels were observed 12 months after BS. Furthermore, the changes in the levels of propionate, butyrate, and isobutyrate negatively correlated with changes in body mass index, while those of isobutyrate correlated negatively with changes in the homeostatic model assessment for insulin resistance index. Conclusion: These results suggest that propionate, butyrate, and isobutyrate levels could be related to weight loss and improved insulin sensitivity in patients with severe obesity after BS.
Open Access
Hepatic and serum branched-chain fatty acid profile in patients with nonalcoholic fatty liver disease: A case–control study
(2023-04-01) María Ángeles Núñez-Sánchez; José Ignacio Martínez-Montoro; María Antonia Martinez-Sanchez; Andrés Balaguer-Román; Fernández Ruiz, Virginia Esperanza; Tomasz Sledzinski; María Dolores Frutos; José Carlos Fernández-García; Adriana Mika; Bruno Ramos-Molina; Ferrer Gómez, Mercedes; Enfermería
Objective: Alterations in the hepatic lipidome are a crucial factor involved in the pathophysiology of nonalcoholic fatty liver disease (NAFLD). The aim of this study was to evaluate the serum and hepatic profile of branched-chain fatty acids (BCFAs) in patients with different stages of NAFLD. Methods: This was a case-control study performed in 27 patients without NAFLD, 49 patients with nonalcoholic fatty liver, and 17 patients with nonalcoholic steatohepatitis, defined by liver biopsies. Serum and hepatic levels of BCFAs were analyzed by gas chromatography-mass spectrometry. The hepatic expression of genes involved in the endogenous synthesis of BCFAs was analyzed by real-time quantitative polymerase chain reaction (RT-qPCR). Results: A significant increase in hepatic BCFAs was found in subjects with NAFLD compared with those without NAFLD; no differences were observed in serum BCFAs between study groups. Trimethyl BCFAs, iso-BCFAs, and anteiso-BCFAs were increased in subjects with NAFLD (either nonalcoholic fatty liver or nonalcoholic steatohepatitis) compared with those without NAFLD. Correlation analysis showed a relationship between hepatic BCFAs and the histopathological diagnosis of NAFLD, as well as other histological and biochemical parameters related to this disease. Gene expression analysis in liver showed that the mRNA levels of BCAT1, BCAT2, and BCKDHA were upregulated in patients with NAFLD. Conclusions: These results suggest that the increased production of liver BCFAs might be related to NAFLD development and progression.
Open Access
Analysis of Quality of Life and Nutritional Status in Elderly Patients with Dysphagia in Order to Prevent Hospital Admissions in a COVID-19 Pandemic
(2020-12-31) Paredes-Ibáñez, Rocío; Fernández Ruiz, Virginia Esperanza; Armero Barranco, David; Sánchez Romera, Juan Francisco; Ferrer Gómez, Mercedes; Enfermería
Background: Oropharyngeal dysphagia (OD) is currently recognized as one of the geriatric syndromes due to its high frequency in older people and its associated complications, which have a direct impact on quality of life. The main objective is to determine the effectiveness of telehealth consultation for the re-evaluation of nutritional status and quality of life assessment in older people diagnosed with OD associated with active use of thickeners to prevent hospital admissions in a COVID-19 pandemic. (2) Methods: an observational, descriptive, and longitudinal study that included a sample of 33 subjects with age equal or superior to 65 years diagnosed with OD with conserved cognitive capacity. The nutritional status was evaluated through the Mini-Nutritional Assessment (MNA) questionnaire and biochemical parameters and, the quality of life was determined through the Swallowing Quality of Life (SWAL-QOL) questionnaire. (3) Results: Thirty-three older patients with OD were recruited (54.5% women), with a mean age of 83.5 ± 7.6 years. The main cause of OD in the study population was neurodegenerative disease (51.5%), followed by cerebrovascular disease (33.3%), and other causes (15.2%). Sixty point six percent of patients were found to be at risk of malnutrition. The MNA score was significantly correlated to albumin (r: 0.600, p < 0.001) and total proteins (r: 0.435, p = 0.015), but not to total cholesterol (r: −0.116, p = 0.534) or lymphocytes (r: −0.056, p = 0.758). The mean total score of the SWAL-QOL was 75.1 ± 16.4 points. (4) Conclusions: the quality of life of the subjects related to the use of a thickener is good. Although the body mass index (BMI) and average biochemical, nutritional parameters of the subjects are within the range of normality, the MNA has detected a high percentage of subjects with the risk of malnutrition, which suggests the need for continuous re-evaluation in these patients, demonstrating the viability of the telematic route in this research.
Open Access
The role of PCSK9 in metabolic dysfunction-associated steatotic liver disease and its impact on bariatric surgery outcomes
(2024-07-01) Nuñez-Sánchez, María Ángeles; Balaguer-Román, Andrés; Martínez-Sánchez, María Antonia; Castellano-Castillo, Daniel; Ferrer Gómez, Mercedes; Manuel Martínez, Carlos; Dolores Frutos, María; Queipo-Ortuño, María Isabel; Cardona, Fernando; Ramos-Molina, Bruno; Fernández Ruiz, Virginia Esperanza; Enfermería
Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is closely tied to obesity. The degree ranges from steatosis (MASL) and steatohepatitis (MASH) to liver cirrhosis. PCSK9 controls cholesterol and lipid particle transport to the liver. PCSK9 might interfere with the pathophysiology of MASLD and bariatric surgery (BS) outcomes of patients with MASLD. Objectives: Evaluate the relationship between serum and hepatic PCSK9 levels with the degree of MASLD and the metabolic outcome of BS. Setting: University Hospital, Spain. Methods: A total of 110 patients with obesity undergoing BS were classified according to liver histology as controls, MAS, and MASH. PCSK9 levels in serum were measured before and 6 months after BS using enzyme-linked immunosorbent assay. PCSK9 protein and mRNA levels in liver tissue were analyzed by immunohistochemistry and reverse transcriptase-polymerase chain reaction, respectively. Results: Hepatic PCSK9 protein levels were diminished in MASL and MASH compared with patients without MASLD and showed a strong negative association with MASLD severity scores. Liver PCSK9 mRNA was higher in MASH compared with controls and MASL and showed positive associations with MASLD severity scores. There were no differences in serum PCSK9 pre or postBS between the groups. Pre- and postsurgery serum PCSK9 positively correlated with cholesterol fold-changes and body mass index (BMI), cholesterol, and low-density lipoprotein -cholesterol fold-changes, respectively. PCSK9 fold-change positively correlated with BMI changes and was the sole variable explaining BMI fold changes in a regression model. Conclusions: PCSK9 mRNA and protein in the liver might be associated with the degree of MASLD. Serum PCSK9 may be associated with cholesterol and/or BMI fold changes. Serum changes of PCSK9 after BS could explain BMI loss outcome.