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BACKGROUND: The Yaquis are an Indigenous group who inhabit in the state of Sonora in northwestern Mexico. This group has experienced changes in their lifestyle, moving from a traditional lifestyle to a more modern one, resulting in an increase of obesity and its comorbidities. However, few studies have been done in this group. The aim of this study was to determine the prevalence of overweight, obesity and central obesity and to identify the factors associated with body mass index (BMI) in a representative sample of Indigenous Yaqui people from Sonora, Mexico. METHODS: A cross-sectional survey with multistage sampling was conducted among adults (N = 351) with residence in Yaqui traditional villages (Vícam, Pótam, Loma de Guamúchil, Loma de Bácum, Tórim, Ráhum, Huiribis or Belem). Anthropometric measurements were taken to diagnose overweight, obesity and central obesity. Food frequency and physical activity (PA) questionnaires designed for the Yaqui population were applied, as well as sociodemographic and clinical history questionnaires. The factors associated with BMI were assessed using multiple linear regression considering the complex design of the sampling. RESULTS: The prevalence of overweight, obesity and central obesity in the population were 36.5%, 35.0% and 76.0%, respectively. Having higher values of the modernization index (ß = 0.20, p = 0.049) was associated with a higher BMI, while having a higher consumption of a "prudent" dietary pattern (traditional dishes, fruits, vegetables and low-fat dairy) (ß = -0.58, p = 0.009) and performing a greater number of hours per week of vigorous PA (ß = -0.14, p = 0.017) were associated with a lower BMI. CONCLUSIONS: The prevalence of the studied abnormalities is high. The evidence presented in this study suggests that interventions are needed and more research is required to determine the appropriate components of such interventions, in order to meet the needs of the Yaqui people.
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Obesidade Abdominal , Sobrepeso , Adulto , Índice de Massa Corporal , Estudos Transversais , Humanos , Obesidade/epidemiologia , Sobrepeso/epidemiologia , PrevalênciaRESUMO
OBJECTIVE: To determine the prevalence of and modifiable factors associated with prediabetes in the Comcáac Indians. DESIGN: Cross-sectional study where prediabetes was defined using fasting plasma glucose, 2 h plasma glucose and glycated Hb (HbA1c). Physical, anthropometric and biochemical measurements, medical record, socio-economic, dietary and physical activity information were collected. The modifiable factors associated with prediabetes were assessed using multiple logistic regression. Settings Comcáac Indian communities of Punta Chueca and El Desemboque, Sonora, Mexico. SUBJECTS: Adults (n 227) aged 20 years or older. RESULTS: The sex- and age-adjusted prevalence (95 % CI) of prediabetes was 47·1 (40·8, 53·5) % in the overall population; age-adjusted prevalence was 47·3 (35·6, 59·0) % in men and 46·7 (39·1, 54·3) % in women. The modifiable factors associated with a risk of prediabetes (OR; 95 % CI) were light-intensity physical activity (per 1 h/week increase: 1·04; 1·01, 1·07) and insulin resistance (homeostasis model assessment of insulin resistance score >6·1 v. <4·1: 4·62; 1·37, 15·51). Increased consumption of a traditional dietary pattern based on fish and seafood, low-fat cereals, fruits and vegetables was a protective factor (0·49; 0·31, 0·79). All variables were modelled together and adjusted for age and sex. CONCLUSIONS: The high prediabetes prevalence found in the Comcáac community is alarming because it represents a large number of people who are at risk for type 2 diabetes. The identification of modifiable factors associated with prediabetes that are specific to this population may be useful for designing effective strategies to prevent prediabetes.
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Indígenas Centro-Americanos , Estado Pré-Diabético/etnologia , Adulto , Antropometria , Glicemia/metabolismo , Estudos Transversais , Exercício Físico , Feminino , Hemoglobinas Glicadas/metabolismo , Humanos , Masculino , México/epidemiologia , Avaliação Nutricional , Prevalência , Fatores de Risco , Fatores Socioeconômicos , Adulto JovemRESUMO
Reducing ≥5% of body weight can decrease the risk of developing chronic diseases in adults with excess weight. Although Intensive Lifestyle Interventions (ILIs) that include cognitive-behavioral techniques to improve physical activity and eating habits are the best approach for losing weight, the failure to retain participants is a barrier to their successful implementation. We aimed to investigate the factors influencing adults to drop out of ILIs for weight loss at six months. We conducted retrospective multiple logistic regression analysis of 268 participants with excess weight (body mass index ≥ 25 kg/m2) from a multicenter study (n = 237, in-person ILI in five clinics, delivered by nutrition interns), and a randomized controlled trial (n = 31, one online ILI, delivered by a master's degree student). The same research team conducted both studies in Northern Mexico, using the same intervention components, and identical instruments and techniques to collect the data. We found that older participants (≥50 years) were less likely to drop out of the ILI for weight loss compared to participants <35 years old (OR = 0.34, 95% CI = 0.16-0.70). For each unit increase in the bodily pain scale of the SF-36 (less perceived pain), the risk of dropping out decreased by 2% (OR = 0.98, 95% CI = 0.97, 0.996), while a change in the interventionist during the 6-month intervention more than doubled the risk of dropping out (OR 2.25, 95% CI = 1.23-4.14). Retention in ILIs may be improved by ensuring that the same interventionist remains during the six-month intervention. In addition, ILIs may need further tailoring for younger ages and for participants with higher perceived pain.
Weight loss is hard. The best way to do it is to enroll in an intervention that includes frequent sessions with a health coach who uses cognitive-behavioral techniques to help participants improve their eating and physical activity habits. Retaining participants in these types of intervention is a challenge for health practitioners and researchers. Our objective was to identify the factors that increase the participants' risk of dropping out of the intervention. We analyzed the data of 268 Mexican adults who participated in studies that evaluated intensive lifestyle interventions for weight loss. We found that participants who are younger, experience more pain, and whose health coaches are replaced before the intervention is completed have a higher risk of dropping out of the intervention. By accounting for these factors when designing the intervention, we could increase the chances that participants stay in the intervention until the end. This way they are more likely to be successful in losing weight.
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Estilo de Vida , Redução de Peso , Humanos , Adulto , Estudos Retrospectivos , Índice de Massa Corporal , Exercício Físico , Aumento de PesoRESUMO
To evaluate the effectiveness of the healthy lifestyle promotion program for Yaquis (PREVISY) on insulin resistance in the short- and medium-term periods in adults who are overweight/obese and have an increased risk for diabetes. Using a translational research design, an intervention program was implemented in a sample of 93 Yaqui adult subjects. The effectiveness of PREVISY was evaluated by comparing the levels of Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) and the Triglycerides-Glucose Index (TyG index) at 6 and 12 months using a paired t-test. Results: In the subjects who completed the program, a decrease in the HOMA-IR index (∆ = -0.91 and ∆ = -1.29, p ≤ 0.05) and the TyG index (∆ = -0.24 y ∆ = -0.20, p ≤ 0.05) was observed in the short- and medium-term period, respectively. Subjects with body weight loss ≥ 10% showed decreased levels of HOMA-IR (∆ = -3.32 and ∆ = -4.89, p ≤ 0.05) and the TyG index (∆ = -0.80 and ∆ = -0.60, p ≤ 0.05) at 6 and 12 months, respectively. A stronger benefit of the program was found in subjects with obesity (vs. overweight) and with high and very high risk of diabetes (vs. moderate risk) in IR markers (p ≤ 0.05). The PREVISY program demonstrated its effectiveness in the improvement of some markers of insulin resistance in Yaqui adults at risk of diabetes.
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Diabetes Mellitus , Resistência à Insulina , Adulto , Humanos , Sobrepeso , México , Glicemia , Obesidade , Triglicerídeos , Glucose , Estilo de VidaRESUMO
OBJECTIVE: To determine if visceral adipose tissue (VAT) area measured through MRI can be used opportunistically to assess the presence of cardiometabolic risk factors and compare its performance to simpler adiposity measures. METHODS: A cross-sectional analysis was carried out on a subset of 1683 participants (856 women) from the Adiposity Phenotype Study (mean age=69.2y; range 59.9-77.4). The association of total VAT area (sum of four cross sections, L1-L2, L2-L3, L3-L4, L4-L5) and each location, as well as BMI and body fat % (per SD) with the metabolic syndrome (MetSx) or its components was evaluated through logistic regression analysis. RESULTS: Total VAT can be accurately predicted using all sites evaluated (R2 range=0.82-0.96). In men, VAT did not show a superior association to MetSx compared to BMI in men. However, in women, VAT was consistently superior to BMI and body fat % in its association to MetSx, independent of ethnicity [odds ratio for BMI, body fat %and total VAT area=2.25 (95% CI: 1.93-2.62); 1.66 (95% CI: 1.36-2.03); 6.20 (95% CI: 4.69-8.21) respectively in all women]. Ethnic-specific odds ratios to MetSx in women ranged from 5.38 to 8.63 for total VAT area and 2.12-4.08 for BMI. CONCLUSION: Total VAT area can be accurately predicted from individual VAT regions in men and women and offers superior association to BMI for MetSx in women but not in men for five ethnicities. Therefore, opportunistic screening for elevated VAT area in women may be warranted across multiple ethnic groups.
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Etnicidade , Síndrome Metabólica , Tecido Adiposo , Idoso , Estudos Transversais , Feminino , Humanos , Gordura Intra-Abdominal/diagnóstico por imagem , Imageamento por Ressonância Magnética , Masculino , Síndrome Metabólica/diagnóstico por imagem , Fatores de RiscoRESUMO
BACKGROUND: Perforated peptic ulcer is a serious complication of peptic ulcer disease and carries high risk for morbidity and mortality. Although the incidence of peptic ulcer disease has decreased in recent decades, the percentage of patients with perforated peptic ulcer requiring emergency surgery remains constant. The use of laparoscopic management as a first choice for the treatment of the perforation is growing but is not routine in many centers. METHODS: Clinical and surgical data on 42 patients underwent surgical treatment for perforated peptic ulcer from January 2012 to December 2016 were collected. Laparoscopic repair of the perforation with a three-port technique was made in all cases. The Boey scoring system was used to predict the prognosis. RESULTS: All patients underwent suture-closure of the ulcer, and omental patch through laparoscopy without conversion to open surgery. Duodenal leakages occurred in 3 patients (7.1%), then treated with a conservative approach and resolved on the 10th postoperative day. Two patients (4.7%) had deep space infections in the first week after surgery, therefore subdiaphragmatic and pelvic abscess were drained by ultrasound guidance. Four patients (9.5%) died up to 30-day post-surgery due to progression of multisystem organ failure in absence of leakages or infections. All these patients were American Society of Anesthesiologists Classification >III and Boey Score 3. CONCLUSIONS: Our data show that a primary laparoscopic approach in patients with peptic ulcer perforation is associated with postoperative advantages and acceptable rates of morbidity and mortality, essentially related to high Boey Score. Therefore, we suggest that the surgical repair of PPU could be always started laparoscopically.
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Laparoscopia/métodos , Úlcera Péptica Perfurada/cirurgia , Abscesso Abdominal/cirurgia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Fístula Anastomótica/epidemiologia , Fístula Anastomótica/terapia , Tratamento Conservador , Emergências , Feminino , Infecções por Helicobacter/tratamento farmacológico , Helicobacter pylori , Humanos , Masculino , Pessoa de Meia-Idade , Insuficiência de Múltiplos Órgãos/mortalidade , Complicações Pós-Operatórias/mortalidade , Prognóstico , Estudos Retrospectivos , Técnicas de Sutura , Técnicas de Fechamento de Ferimentos , Adulto JovemRESUMO
Type 2 diabetes (T2D) is a public health problem worldwide, and the main risk factor for its development is obesity. The Yaqui ethnic group of Sonora has serious obesity problems, resulting in an increased risk of T2D in its inhabitants. The objective of this study was to evaluate the effectiveness of a health promotion program on obesity parameters and cardiovascular risk factors in short- (6 months) and medium-term periods (12 months) in indigenous Yaquis of Sonora. The design is a translational clinical study of a single cohort with prepost intervention measurements in a sample of 93 subjects. The effectiveness of the program was evaluated by comparing obesity parameters, metabolic markers, and physical activity 6 and 12 months with those measured under basal conditions using a paired t-test or Wilcoxon rank-sum test. The short-term retention percentage was 58.0%. There was a decrease in body weight (Δ = -3.9 kg, p ≤ 0.05) and other obesity parameters, and an increase in physical activity and improvements in metabolic markers (p ≤ 0.05) was observed. Similar findings were obtained for the medium-term period; body weight loss was also -3.9 kg (p ≤ 0.05). The short and medium-term results of the program showed improvements in the obesity parameters and other cardiovascular risk factors of the participants. These results support the effectiveness of the program and its translation in this ethnic group.
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Diabetes Mellitus Tipo 2/etnologia , Diabetes Mellitus Tipo 2/epidemiologia , Estilo de Vida , Obesidade/etnologia , Obesidade/epidemiologia , Pesquisa Translacional Biomédica/organização & administração , Adulto , Antropometria , Composição Corporal , Peso Corporal , Complicações do Diabetes/epidemiologia , Complicações do Diabetes/etnologia , Diabetes Mellitus Tipo 2/complicações , Feminino , Humanos , Masculino , México/epidemiologia , México/etnologia , Pessoa de Meia-Idade , Obesidade/complicações , Grupos Populacionais , Projetos de Pesquisa , Risco , Fatores de RiscoRESUMO
Obesity and its comorbidities have become the most important public health problems for Latin America. In Mexico obesity has increased dramatically to the point where the government has declared it an epidemiological emergency. The most recent national data showed overweight and obesity affects 72.5% of adults, or around 56 million Mexicans. Most Mexican adults with obesity are undiagnosed. According to data derived from a national representative survey, only 20% of adults with BMI >30 kg/m2 were diagnosed with obesity by a health provider. Likewise, only 8% of individuals with obesity had received treatment for obesity. Interventions offered in the Mexican health care delivery system generally consist of traditional consultations with recommendations on diet and exercise, visits are monthly to quarterly, and validated behavior change protocols are not used. Evidence from clinical trials has shown that weight loss with this type of treatment is generally less than 1 kg per year. In contrast, intensive lifestyle interventions - protocols focusing on achieving changes in diet, physical activity, and moderate weight loss using behavioral strategies with weekly or bi-weekly sessions for the first 3 to 6 months, and a maintenance phase with trained interventionists - as implemented in the Diabetes Prevention Program and the Look AHEAD studies achieved weight loss of 7-9% at one year. Additionally, translation studies of these interventions to the community and to real-world clinical practice have achieved weight loss of around 4%. Adaptations of intensive lifestyle interventions have been implemented in the United States, both in clinical practice and in the community, and this type of intervention represents a potential model to combat obesity in Mexico and other Latin American countries. It is essential that primary care providers in Mexico implement clinical practice guidelines based on the best evidence available as discussed here to effectively treat obesity. The authors make recommendations to improve the treatment of obesity in the clinical care delivery system in Mexico using intensive lifestyle interventions.
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BACKGROUND: food insecurity occurs when quality and quantity of food is insufficient for maintaining healthy nutritional and food profiles. OBJECTIVES: to determine if food insecurity is associated with dietary and biochemical measures in mothers of the northwest of Mexico, which relies primarily on fisheries for livelihood. METHODS: a cross-sectional study was conducted with 116 mothers of the Northwest of Mexico. A socioeconomic survey, food security scale, andtwo non-consecutive 24-hour recalls were applied. Anthropometric measurements were made and hemoglobin, glucose and cholesterol levelswere measured. The association between key measures and food insecurity was assessed using logistic and linear regression. RESULTS: two-thirds (68%) of households experienced food insecurity. Mothers with mild insecurity had 3.7 and 3.2 times higher odds of not consuming fruits and vegetables, respectively, and 4.9 times higher odds of consuming sweetened non-dairy drinks (p = 0.04; 0.04 and 0.05, respectively). In addition, they consumed less protein (ß = -3.22%; p < 0.01) and more carbohydrates (ß = 6.04%; p = 0.02) compared with mothers with food security. Mothers with severe insecurity consumed less iodine (ß = -24.41 µg; p = 0.03) and had lower levels of HDL cholesterol (ß = -12.01 mg/dl; p = 0.03) than mothers with food security. CONCLUSIONS: food insecurity was associated with low quality diet and low levels of HDL cholesterol in mothers of Northwest Mexico relying on fisheries for livelihood.
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HDL-Colesterol/sangue , Dieta , Emprego/estatística & dados numéricos , Pesqueiros/economia , Abastecimento de Alimentos/estatística & dados numéricos , Mães , Adulto , Bebidas/análise , Estudos Transversais , Carboidratos da Dieta/administração & dosagem , Emprego/economia , Feminino , Qualidade dos Alimentos , Frutas , Humanos , México , Fatores Socioeconômicos , Edulcorantes/administração & dosagem , Edulcorantes/análise , VerdurasRESUMO
INTRODUCTION: Tailgut cyst are congenital cystic lesion arising from remnant of the embryological postnatal gut. Tailgut cyst are multinodular, uncapsulated and usually well-circumscribed. Presacral cysts are rare in adult and most of the lesions are benign. Malignant degeneration can occur, however is extremely rare. CASE REPORT: We present the case of a 74 years old woman with slow increase in size and malignant degeneration of a tailgut cyst. Five years before, during the follow up after mastectomy for cancer, she manifested rise of CA 19-9 tumor marker and a presacral cystic collection on thoraco-abdominal CT. She was followed with CT and MRI that showed that the cyst, with a solid component of the wall, was growing larger. After a five-year evolution, the cyst was resected. The histological examination on the solid component demonstrated intestinal adenocarcinoma. CONCLUSION: MRI ant TC can play essential role in the preoperative detection and characterization for the differential diagnosis, treatment strategies and evaluate neoplastic degeneration. Due to the risk of malignancy surgical resection must be performed after the diagnosis. Surgical therapy is mandatory when the cyst grow larger and a solid component is present. KEY WORDS: Presacral cyst, Retrorectal tumors, Tailgut cyst.
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Adenocarcinoma/patologia , Cistos/patologia , Neoplasias Intestinais/patologia , Adenocarcinoma/sangue , Adenocarcinoma/diagnóstico por imagem , Adenocarcinoma/cirurgia , Idoso , Biomarcadores Tumorais/sangue , Neoplasias da Mama/terapia , Antígeno CA-19-9/sangue , Carcinoma Ductal de Mama/terapia , Transformação Celular Neoplásica , Terapia Combinada , Cistos/sangue , Cistos/congênito , Cistos/cirurgia , Diagnóstico Tardio , Endossonografia , Feminino , Hamartoma/congênito , Hamartoma/patologia , Hamartoma/cirurgia , Humanos , Neoplasias Intestinais/sangue , Neoplasias Intestinais/diagnóstico por imagem , Neoplasias Intestinais/cirurgia , Imageamento por Ressonância Magnética , Segunda Neoplasia Primária/sangue , Segunda Neoplasia Primária/patologia , Tomografia Computadorizada por Raios XRESUMO
Medullary carcinoma (MC) of the large intestine is a relatively new histological type of adenocarcinoma characterized by poor glandular differentiation and an intraepithelial lymphocytic infiltrate. MC can be associated to a defective mechanism for DNA mismatch repair, caused by the so-called microsatellite instability (MSI). We present the case of a 44 years old Caucasian woman, who referred to the Emergency Room with symptoms mimicking an acute appendicitis. Computed tomography and colonoscopy demonstrated an ulcerated and stenotic lesion of the caecum without signs of metastasis and peritoneal carcinosis. Patient underwent a laparoscopic right colectomy. The final pathologic findings provided the diagnosis of medullary carcinoma with MSI. Patient then underwent adjuvant chemotherapy according to the FOLFOX-4 protocol (association of 5-Fluorouracil, Leucovorin, and Oxaliplatin) for twelve cycles. At two-years follow-up, patient is disease free. MC in association with MSI is a non-frequent tumor of the colon characterized by a better prognosis compared to other types of poorly differentiated adenocarcinoma. In the observed case, 24 months after the surgical operation, the patient is in good health and there is no evidence of metastasis or relapse.
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OBJECTIVE: the aim of this study was to compare an Intensive Lifestyle Intervention against Traditional Treatment for obesity management in the primary care setting. SUBJECTS AND METHODS: interventional randomized controlled study with participation of 42 obese adults. Subjects assigned to the Intensive Lifestyle Intervention received a validated behavior change protocol "Group Lifestyle Balance" in 12 sessions, weekly consultations by a nutritionist and meal replacements. Traditional Treatment consisted of monthly consultations with a nutritionist that provided nutritional assessment and physical activity. RESULTS: almost all study participants (97%) were measured after 3 months of intervention. Intensive Lifestyle Intervention and Traditional Treatment subjects showed the following changes in body weight: (Median [25-75th percentile]) (-4.7 kg [-6.5, -3.1]) vs. (+0.4 kg [-0.3, 1.3]). Sixty two percent of Intensive Lifestyle Intervention group participants lost more than 5 % body weight vs. 0 % in the traditional treatment group (p < 0.001). CONCLUSIONS: this preliminary evidence showed that an Intensive Lifestyle Intervention can be an effective strategy for obesity management in the primary care setting.
Objetivo: comparar un Programa Intensivo de Cambio de Estilo de Vida con el Tratamiento Tradicional para el manejo de la obesidad en el primer nivel de atención. Sujetos y métodos: estudio de intervención aleatorizado controlado, en el que participaron 42 adultos con obesidad. Los sujetos asignados al Programa Intensivo de Cambio de Estilo de Vida recibieron un protocolo de cambio de conducta validado "Equilibrio de Estilo de Vida" en 12 sesiones, consultas semanales con un nutriólogo y remplazos de comidas. El Tratamiento Tradicional consistió en consultas mensuales con un nutriólogo que proporcionó orientación nutricional y de actividad física. Resultados: después de tres meses se midió al 97% de los participantes que iniciaron el estudio. Los sujetos del Programa Intensivo de Cambio de Estilo de Vida y del Tratamiento Tradicional mostraron los siguientes cambios en el peso corporal: (mediana [percentil 25-75]) (-4,7 kg [-6,5, -3,1]) vs. (+0,4 kg [-0,3, 1,3]). El 62% de los participantes del Programa Intensivo de Cambio de Estilo de Vida bajaron más de un 5% del peso corporal, contra el 0% en el grupo de Tratamiento Tradicional (p < 0,001). Conclusiones: este estudio es una evidencia preliminar de que un Programa Intensivo de Cambio de Estilo de Vida puede ser una alternativa efectiva para el tratamiento de la obesidad en el primer nivel de atención.
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Estilo de Vida , Obesidade/terapia , Atenção Primária à Saúde/métodos , Adulto , Índice de Massa Corporal , Comportamento Alimentar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação Nutricional , Redução de Peso , Adulto JovemRESUMO
Currently, bone distances are used to predict standing height in adults that might not be able to achieve a correct standing position. Knee length based algorithms for estimating standing height have been proposed and designed for specific populations. However, equations for other populations may not necessarily reflect environmental and genetic factors for the group of interest. The aim of this study was to develop and validate predictive models for standing height in Mexican adults. For this purpose, 240 male and female adults aged 20 to 59 years, with no apparent spine problems were measured. We measured weight, height and knee length, using an anthropometer of our own design and a glass fiber metric measuring tape. A predictive model for each measuring instrument was developed. Model selection and development of equations were carried out by "all possible regressions and multiple regression" procedures. The predictive models for standing height by the anthropometer and by the measuring tape did not show significant differences between measured and estimated height. The R2 for the two models were 0.93 and 0.92, with a standard error of the estimator (EE) of 2.30 and 2.40 cm, for the anthropometer and the measuring tape, respectively. Both methods were acceptable in terms of concordance, accuracy and precision; however, at very high and low predicted height values, both models showed significant bias, which should be considered when applying these algorithms in different populations.
Actualmente las distancias óseas se utilizan para predecir la talla en adultos que no pueden tener una adecuada bipedestación o no cumplen con la posición adecuada para la obtención de la talla. Existen algoritmos para la estimación de la talla basados en la longitud rodilla-talón, diseñados para poblaciones específicas; sin embargo, existen poblaciones que aún no cuentan con esta herramienta, por lo que se usan ecuaciones ya existentes, que no necesariamente reflejan los factores genético-ambientales para la población de interés. El objetivo de este estudio fue desarrollar y validar modelos predictivos para la talla de pie en adultos mexicanos, con antropómetro de diseño propio y cinta métrica. Se midieron 240 adultos de 20 a 59 años, de ambos sexos, sin problemas aparentes en la columna vertebral. Se midió el peso, la talla de pie y la longitud rodilla-talón. Se desarrolló un modelo predictivo para cada instrumento de medición. La selección de modelos y el desarrollo de las ecuaciones se llevó a cabo mediante los métodos de "Todas las Regresiones Posibles" y "Regresión Múltiple". Se obtuvieron dos algoritmos que no mostraron diferencias significativas entre la talla medida y estimada tras un proceso de validación cruzada. Las R2 para los modelos fueron de 0,93 y 0,92, con un error estándar del estimador (EE) de 2,30 y 2,40 cm, para el antropómetro y la cinta respectivamente. Ambos métodos resultaron aceptables en términos de concordancia, exactitud y precisión. A tallas extremas (altas o bajas), ambos modelos presentaron sesgo, lo cual debe considerarse al aplicar estos algoritmos.
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Antropometria/métodos , Estatura , Joelho/anatomia & histologia , Adulto , Envelhecimento , Antropometria/instrumentação , Feminino , Humanos , Masculino , México , Pessoa de Meia-Idade , Modelos Anatômicos , Postura , Reprodutibilidade dos Testes , Adulto JovemRESUMO
Abstract: Introduction: The hypertension (HT) is a public health problem worldwide. This disease is a risk factor for heart diseases and, cerebrovascular and renal failure, which are considered the main causes of mortality. Objective: This study aimed to describe factors associated with a previous diagnosis of HT in a group of Yaqui adults from Sonora, Mexico. Material and methods: We conducted a cross-sectional epidemiological study in which 108 individuals ≥ 18 years of age were included. HT was considered as prior diagnosis. In addition, anthropometric assessment, medical history and sociodemographic questionnaires were also applied. The sex- and age adjusted prevalence was estimated using the direct method of standardization using the studied sample as the standard population. The factors associated with previous diagnosis of HT were determined using multiple logistic regression analysis. Results: The sex- and age-adjusted prevalence of a previous diagnosis of HT was 12.0% (95% CI: 6.3-17.6) in the overall population. The age-adjusted prevalence in men was 7.1%, and it was 14.0% in women with no significant difference between genders. The independent factors associated with HT were increased waist circumference (cm) (OR: 1.07, 95% CI: 1.01-1.14) and a previous diagnosis of diabetes (OR: 4.14, 95% CI: 1.03-16.61). Conclusions: The prevalence of a previous diagnosis of HT was high, and it could be higher after confirmation of new diagnosis cases in the population. The identification of factors associated with HT may be useful for creating programs to prevent chronic diseases in this ethnic group.(AU)
Resumen: Introducción: La hipertensión arterial (HTA) es un problema de salud pública a nivel mundial. Esta enfermedad es un factor de riesgo para enfermedades del corazón, cerebrovasculares y falla renal, las cuales son consideradas entre las principales causas de mortalidad. Objetivo: Describir factores asociados con el diagnóstico previo de HTA en un grupo de adultos Yaquis de Sonora, México. Material y métodos: Llevamos a cabo un estudio epidemiológico con diseño transversal donde fueron estudiados 108 individuos ≥ 18 años de edad. La HTA fue considerada como diagnóstico previo, se hizo una evaluación antropométrica y se aplicaron cuestionarios de historial clínico y sociodemográficos. La prevalencia de HTA ajustada por edad y sexo se estimó por el método directo de estandarización utilizando la población estudiada como población estándar. Los factores asociados con el diagnóstico previo de HTA fueron obtenidos mediante análisis de regresión logística múltiple. Resultados: La prevalencia de diagnóstico previo de HTA fue 12.0% (IC 95%, 6.3-17.6) en la población total. La prevalencia ajustada por edad en hombres fue 7.1 y 14.0% en mujeres; sin diferencias significativas entre sexo. Los factores asociados de manera independiente con HTA fueron una mayor circunferencia de cintura (cm) (RM: 1.07; IC 95%, 1.01-1.14) y el diagnóstico previo de diabetes (RM: 4.14; IC 95%, 1.03-16.61). Conclusiones: La prevalencia de diagnóstico previo de HTA fue alta y podría incrementar con la confirmación de diagnóstico de casos nuevos en la población. La identificación de factores asociados con HTA puede servir para crear programas de prevención de enfermedades crónicas en este grupo étnico.(AU)