RESUMO
RESUMEN Introducción: El perímetro de cuello en la actualidad es una medida útil asociada de manera significativa a la resistencia a la insulina y al riesgo cardiometabólico. Objetivo: Determinar la relación entre el perímetro de cuello y los factores de riesgo cardiometabólico en mujeres de 45 a 60 años de edad. Métodos: Se realizó un estudio en 270 mujeres aparentemente sanas, de 45 a 60 años de edad. Se tomaron medidas antropométricas como peso corporal, índice de masa corporal, perímetro de cintura, perímetro de cuello y el tejido adiposo visceral por bioimpedancia. Se determinaron niveles séricos de glucosa, perfil lipídico (colesterol, triglicéridos, HDL-colesterol, LDL-colesterol), HbA1c, insulina y proteína C reactiva. Resultados: El índice de masa corporal de las participantes fue de 28,2 ± 4,2. Se encontró que 38,1 por ciento de las mujeres presentaban síndrome metabólico y mayor perímetro de cuello, en comparación con las participantes sin síndrome (36,8 + 2,1 vs 35,1 + 1,6 cm, respectivamente, p< 0,0001). El perímetro de cuello se asoció positivamente con índice de masa corporal (r= 0,690, p= 0,0001), tejido adiposo visceral (r= 0,548, p= 0,0001), circunferencia de Cintura (r= 0,640, p< 0,0001), glucosa (r= 0,251, p= 0,0001), triglicéridos (r= 0,143, p= 0,019), HbA1c (r= 0,160, p= 0,010) y proteína C reactiva (r= 0,342, p= 0,001). Conclusiones: Las mujeres con incremento en el perímetro de cuello presentan un perfil de riesgo cardiometabólico aumentado. La medición del perímetro de cuello representa un método útil y práctico en la predicción del riesgo cardiometabólico(AU)
ABSTRACT Introduction: Neck´s perimeter is nowadays a useful measure significantly associated to insulin resistance and to cardiometabolic risk. Objective: To determine the relation between the neck´s perimeter and the cardiometabolic risk factors in women from 45 to 60 years old. Methods: A study was performed in 270 apparently healthy women, aging 45 to 60 years old. Anthropometric measurements were taken such as weight, body mass index, waist circumference, neck´s perimeter and visceral adipose tissue by bioelectrical impedance analysis. There were identified serum levels of glucose, lipid profile (cholesterol, triglycerides, HDL-cholesterol, LDL-cholesterol), HbA1c, insulin and C-reactive protein. Results: The body mass index of the participants was 28.2 ± 4.2. It was found that 38.1 percent of the women had a metabolic syndrome and a higher perimeter of neck, in comparison with participants without the syndrome (36.8 + 2.1 vs 35.1 + 1.6 cm, respectively, p< 0.0001). The neck´s perimeter was positively associated with body mass index (r = 0.690, p= 0.0001), visceral adipose tissue (r = 0.548, p= 0.0001), waist circumference (r = 0.640, p< 0.0001), glucose (r = 0.251, p= 0.0001), triglycerides (r = 0.143, p = 0.019), HbA1c (r = 0.160, p = 0.010) and C-reactive protein (r = 0.342, p = 0.001). Conclusions: Women with an increase in the neck´s perimeter have a profile of increased cardiometabolic risk. The measurement of neck´s perimeter represents a useful and practical method for the prediction of cardiometabolic risk(AU)
Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Fatores de Risco , Síndrome Metabólica/epidemiologia , Circunferência da Cintura , Pescoço/crescimento & desenvolvimento , Índice de Massa Corporal , Gordura Intra-AbdominalRESUMO
INTRODUCTION: Cardiovascular disease is the main cause of mortality worldwide. In women, its incidence increases at the sixth decade of life, coinciding with postmenopause. Whether this effect is due to menopause-related hormonal changes is not known. OBJECTIVE: To evaluate the differences in cardiovascular risk in pre- and postmenopausal women by means of the Globorisk risk scale, the triglyceride/high-density lipoproteins cholesterol (Tg/HDL-C) ratio and metabolic syndrome (MS) criteria. METHOD: Cross-sectional study that included 408 women from 40 to 60 years of age; anthropometric measurements and biochemical determinations were performed. The participants were classified as premenopausal and postmenopausal. Cardiovascular risk was assessed using the MS criteria, the Globorisk risk calculator and the Tg/HDL-C ratio. RESULTS: Postmenopausal women showed a significant increase in waist circumference, total cholesterol and triglycerides in comparison with premenopausal women. Significant associations were found between hormonal state and Globorisk measured cardiovascular risk (OR = 2.50; 95 % CI = 1.67-3.74) and the Tg/HDL-C ratio (OR = 1.66; 95 % CI = 1.09-2.52). CONCLUSION: Cardiovascular risk factors have a higher prevalence in postmenopause. The Globorisk scale and Tg/HDL-C ratio identify cardiovascular risk in postmenopausal women.
INTRODUCCIÓN: La enfermedad cardiovascular es la principal causa de mortalidad en el mundo. En la mujer se incrementa en la sexta década de la vida, coincidiendo con la posmenopausia. Se desconoce si este efecto se debe a cambios hormonales relacionados con la menopausia. OBJETIVO: Evaluar diferencias del riesgo cardiovascular en mujeres pre y posmenopáusicas mediante la escala de riesgo Globorisk, el índice triglicéridos/c-HDL (Tg/c-HDL) y los criterios de síndrome metabólico (SM). MÉTODOS: Estudio transversal que incluyó a 408 mujeres de 40 a 60 años; se realizaron mediciones antropométricas y bioquímicas. Las participantes se clasificaron en premenopáusicas y posmenopáusicas. El riesgo cardiovascular se evaluó utilizando los criterios de SM, calculadora de riesgo Globorisk y el índice Tg/c-HDL. RESULTADOS: Las mujeres en etapa posmenopáusica presentaron incremento significativo en la circunferencia de cintura, de colesterol total y triglicéridos, en comparación con las mujeres premenopáusicas. Se encontraron asociaciones significativas del estado hormonal con el riesgo cardiovascular evaluado por Globorisk (RM = 2.50, IC 95 % = 1.67-3.74) y con el índice Tg/c-HDL (RM = 1.66, IC 95 % = 1.09-2.52). CONCLUSIÓN: Los factores de riesgo cardiovascular tienen mayor prevalencia en la posmenopausia. La escala Globorisk y el índice Tg/c-HDL identifican el riesgo cardiovascular en la mujer posmenopáusica.
Assuntos
Doenças Cardiovasculares/epidemiologia , Síndrome Metabólica/epidemiologia , Pós-Menopausa , Pré-Menopausa , Adulto , Doenças Cardiovasculares/etiologia , Colesterol/sangue , HDL-Colesterol/sangue , Estudos Transversais , Feminino , Humanos , México/epidemiologia , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Triglicerídeos/sangue , Circunferência da Cintura/fisiologiaRESUMO
ResumenIntroducción: en las últimas décadas la diabetes mellitus 2 (DM2) ha tenido un incremento notable en México. En el año 2000 la Encuesta Nacional de Salud reportó 2.1 millones de personas afectadas; en 2006, 3.7 millones; y en 2012, 6.4 millones. Aunada a la enfermedad cardiovascular la DM2 representa la primera causa de mortalidad con tendencia al incremento progresivo en los últimos años. Objetivo: identificar y describir los factores de riesgo metabólico y no metabólico en personas adultas matriculadas en un centro de salud del Estado de México.Metodología: en una muestra no probabilística de 586 personas de ambos sexos, se formaron tres grupos con glucosa normal (GN), glucosa alterada en ayuno (GAA) y DM2. Se midieron variables no metabólicas (peso, estatura y circunferencia de cintura) y metabólicas (triglicéridos, c-HDL, c-LDL, tensión arterial sistólica y diastólica).Resultados: las medias del nivel de colesterol total en los tres grupos fueron más elevadas en el grupo con GN: 203.6 ± 36.7 mg/dl_ frente a 199.4 ± 39.7 mg/dL del grupo de GAA y 200.6 ± 44.7 mg/dL del de DM2. Los niveles séricos de c-LDL en los grupos GN y GAA fueron similares con 120.7 ± 32.3 frente a 120.5 ± 33.7, respectivamente. En el grupo de DM2 disminuyó la concentración sérica de c-LDL, con un resultado de 114.6 ± 36.5 mg/dL.Conclusiones: se encontró una alta frecuencia de alteraciones en el perfil lipídico y la presión arterial diastólica, así como obesidad abdominal en las personas con DM2 y en la población sin diabetes.
AbstractIntroduction: In the last decades, type 2 diabetes mellitus (T2DM) has increased considerably in Mexico. In 2000 the National Health Survey reported 2.1 millions of people affected; in 2006, 3.7 millions; and in 2012, 6.4 millions. Acting together, T2DM and cardiovascular disease are the leading cause of mortality with a trend that is increasing progressively in recent years.Objective: To identify and describe metabolic and non-metabolic risk factors in adults enrolled in a health center in the Estado de México.Methods: A non-random sampling of 586 male and female patients was divided into three groups: normal glucose (NG), impaired fasting glucose (IFG) and T2DM. Metabolic (triglycerides, HDL-cholesterol, LDL-cholesterol, as well as systolic and diastolic blood pressure) and non-metabolic (weight, height and waist circumference) variables were measured.Results: Mean levels of total cholesterol in the three groups were higher in the GN group with 203.6 ± 36.7 mg/dL vs. 199.4 ± 39.7mg/dL vs. 200.6 ± 44.7mg/dL, respectively. Serum levels of LDL-cholesterol in the GN and GAA groups were similar with 120.7 ± 32.3 vs. 120.5 ± 33.7, respectively; in the T2DM group, the serum level of LDL-C decreased (114.6 ± 36.5 mg/dL).Conclusions: Our findings show that patients with T2DM along with patients without diabetes show high frequency of alterations in lipid profiles and diastolic blood pressure, as well as abdominal obesity.
Assuntos
Centros de Saúde , Doença Crônica , Fatores de Risco , Fenômenos Fisiológicos da Nutrição , México , HumanosRESUMO
BACKGROUND: PAI-1 is the main inhibitor of fibrinolysis. Increase in PAI-1 levels has been associated with the risk of coronary disease; however, there are few studies on the relationship between subclinical atherosclerosis and PAI-1 levels. OBJECTIVE: The aim of this study was to analyze the relationship between PAI-1 level and carotid intima-media thickness in premenopausal and postmenopausal women without apparent cardiovascular disease. MATERIAL AND METHODS: A cross-sectional study was conducted in 142 women aged 45 to 60 years with no history of cardiovascular disease. Anthropometric and laboratory measurements were performed, including PAI-1 levels. All participants underwent a B-Mode ultrasound to measure intima-media thickness. Subclinical atherosclerosis was considered when intima-media thickness was ≥ 0.7 mm and/or an atheromatous plaque was observed. RESULTS: Postmenopausal women had greater intima-media thickness than premenopausal women (0.688 ± 0.129 vs. 0.621 ± 0.113 mm; p < 0.05). Compared to women with normal intima-media thickness, women with subclinical atherosclerosis had higher PAI-1 levels (23.2 ± 13.7 vs. 30.4 ± 20.7 ng/ml; p < 0.05). In all participants, intima-media thickness correlated with PAI-1 (r = 0.302; p = 0.01) and with age (r = 0.358; p = 0001). CONCLUSIONS: An increase in intima-media thickness was observed in postmenopausal women compared with premenopausal women. Asymptomatic women with increased intima-media thickness had higher PAI-1 levels. These findings suggest that fibrinolytic activity is low in the subclinical stage of atherosclerosis.
Assuntos
Aterosclerose/patologia , Espessura Intima-Media Carotídea , Inibidor 1 de Ativador de Plasminogênio/sangue , Pós-Menopausa , Aterosclerose/epidemiologia , Estudos Transversais , Feminino , Fibrinólise/fisiologia , Humanos , Pessoa de Meia-Idade , Pré-MenopausaRESUMO
INTRODUCTION AND OBJECTIVES: Epicardial adipose tissue has been associated with several obesity-related parameters and with insulin resistance. Echocardiographic assessment of this tissue is an easy and reliable marker of cardiometabolic risk. However, there are insufficient studies on the relationship between epicardial fat and insulin resistance during the postmenopausal period, when cardiovascular risk increases in women. The objective of this study was to examine the association between epicardial adipose tissue and visceral adipose tissue, waist circumference, body mass index, and insulin resistance in postmenopausal women. METHODS: A cross sectional study was conducted in 34 postmenopausal women with and without metabolic syndrome. All participants underwent a transthoracic echocardiogram and body composition analysis. RESULTS: A positive correlation was observed between epicardial fat and visceral adipose tissue, body mass index, and waist circumference. The values of these correlations of epicardial fat thickness overlying the aorta-right ventricle were r = 0.505 (P < .003), r = 0.545 (P < .001), and r = 0.515 (P < .003), respectively. Epicardial adipose tissue was higher in postmenopausal women with metabolic syndrome than in those without this syndrome (mean [standard deviation], 544.2 [122.9] vs 363.6 [162.3] mm(2); P = .03). CONCLUSIONS: Epicardial fat thickness measured by echocardiography was associated with visceral adipose tissue and other obesity parameters. Epicardial adipose tissue was higher in postmenopausal women with metabolic syndrome. Therefore, echocardiographic assessment of epicardial fat may be a simple and reliable marker of cardiovascular risk in postmenopausal women.