ABSTRACT
Introducción. El síndrome metabólico (SM) aumenta el ingreso hospitalario y el riesgo de desarrollar COVID-19, los fármacos utilizados para su tratamiento ocasionan efectos secundarios por lo que se ha optado por la búsqueda de alternativas terapéuticas a base de compuestos bioactivos contenidos en plantas medicinales. La canela se utiliza como agente terapéutico debido a sus propiedades comprobadas con diversos mecanismos de acción reportados en el tratamiento de varias patologías. Objetivo. Documentar los estudios in vitro, in vivo, estudios clínicos y los mecanismos de acción reportados del efecto de la administración de extractos y polvo de canela en las comorbilidades relacionadas con el SM. Materiales y métodos. Revisión sistemàtica de artículos en bases de datos electrónicas, incluyendo estudios de canela en polvo, extractos acuosos, de acetato de etilo y metanol de la corteza de canela, período de 5 años, excluyendo todo artículo relacionado a su efecto antimicrobiano, antifúngico y aceite de canela. Resultados. Las evidencias de los principales compuestos bioactivos contenidos en la canela validan su potencial en el tratamiento de enfermedades relacionadas al SM, con limitados estudios que indagan en los mecanismos de acción correspondientes a sus actividades biológicas. Conclusiones. Las evidencias de las investigaciones validan su potencial en el tratamiento de estas patologías, debido a sus principales compuestos bioactivos: cinamaldehído, transcinamaldehído, ácido cinámico, eugenol y, antioxidantes del tipo proantocianidinas A y flavonoides, los cuales participan en diversos mecanismos de acción que activan e inhiben enzimas, con efecto hipoglucemiante (quinasa y fosfatasa), antiobesogénico (UPC1), antiinflamatorio (NOS y COX), hipolipemiante (HMG-CoA) y antihipertensivo (ECA)(AU)
Introduction. Metabolic syndrome (MS) increases hospital admission and the risk of developing COVID-19. Due to the side effects caused by the drugs used for its treatment, the search for therapeutic alternatives based on bioactive compounds contained in medicinal plants has been chosen. Cinnamon is used as a therapeutic agent due to its proven properties with various mechanisms of action reported in the treatment of various pathologies. Objective. To document the in vitro and in vivo studies, clinical studies and the mechanisms of action reported on the effect of the administration of cinnamon extracts and powder on comorbidities related to MS. Materials and methods. Systematic review of articles in electronic databases, including studies of cinnamon powder, aqueous extracts, ethyl acetate and methanol from cinnamon bark, over a period of 5 years, excluding all those articles related to its antimicrobial, antifungal and antimicrobial effect. cinnamon oil. Results. The evidence of the main bioactive compounds contained in cinnamon validates its potential in the treatment of diseases related to MS, with limited studies that investigate the mechanisms of action corresponding to its biological activities. Conclusions. Research evidence validates its potential in the treatment of these pathologies, due to its main bioactive compounds: cinnamaldehyde, transcinnamaldehyde, cinnamic acid, eugenol, and antioxidants of the proanthocyanidin A type and flavonoids, which participate in various mechanisms of action that activate and they inhibit enzymes, with hypoglycemic (kinase and phosphatase), antiobesogenic (UPC1), anti-inflammatory (NOS and COX), lipid-lowering (HMG-CoA) and antihypertensive (ACE) effects(AU)
Subject(s)
Humans , Male , Female , Cinnamomum zeylanicum , Metabolic Syndrome , Diabetes Mellitus , Phytochemicals , Obesity , Body Weight , Hypoglycemic Agents , Anti-Inflammatory AgentsABSTRACT
Introducción. El Síndrome Metabólico (SM) comprende un conjunto de factores de riesgo cardiometabólico representado por obesidad central, dislipidemia, hipertensión arterial y glucosa alterada, se ha evidenciado que el consumo adecuado de calcio representa una disminución del riesgo para este síndrome. Objetivo. Analizar la relación entre el consumo de calcio total, de origen animal y vegetal con el SM y sus indicadores. Materiales y métodos. Estudio transversal de eje correlacional, con una muestra de 100 adultos de la región amazónica ecuatoriana, durante el último trimestre del 2020. La ingesta dietética de calcio se determinó mediante un recordatorio de 24 horas y el SM según los criterios de Adult Treatment Panel-IV (ATP-IV). Resultados. La población estuvo conformada por adultos maduros (40 a 60 años) que evidenciaron una ingesta de calcio deficiente (182,50 mg y 228,60 mg en mujeres y hombres respectivamente). Se evidenció, además, una relación directamente proporcional entre la circunferencia abdominal (r=0,391 p=0,000), presión arterial sistólica (r=0,290 p=0,000) y glucosa en ayuno (r=0,326 p=0,000) con la edad. La ingesta de calcio total se relacionó positivamente con los triglicéridos, (r=0,221 p=0,027). Conclusiones. La ingesta dietética de calcio en ambos sexos no alcanza el requerimiento diario y se relaciona positivamente con los triglicéridos(AU)
Introduction. The Metabolic Syndrome (MS) comprises a set of cardiometabolic risk factors represented by central obesity, dyslipidemia, high blood pressure and altered glucose, it has been shown that adequate calcium intake represents a decreased risk for this syndrome. Objective. To analyze the relationship between the consumption of total calcium, animal and vegetable origin, with MS and its indicators. Materials and methods. Cross-sectional study of correlational axis, with a sample of 100 adults from the Ecuadorian Amazon region, during the last quarter of 2020. Dietary calcium intake was determined through a 24-hour recall and the diagnosis of MS according to the Adult Treatment Panel- IV (ATP-IV) criteria. Results. The population consisted of mature adults (40 to 60 years) who showed a deficient calcium intake in both sexes (182.50 mg and 228.60 mg in women and men respectively). There is also evidence of a directly proportional relationship between abdominal circumference (r=0.391 - p=0.000), systolic blood pressure (r=0.290 - p=0.000) and fasting glucose (r=0.326 - p=0.000) with age. Total calcium intake was positively related to triglycerides (r=0.221 p=0.027). Conclusions. Calcium dietary intake in both sexes does not reach the daily requirement and is positively related to triglycerides(AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Calcium/administration & dosage , Risk Factors , Metabolic Syndrome/complications , Diabetes Mellitus , Abdominal Circumference , Dyslipidemias , Hypertension , ObesityABSTRACT
Introdução: o estresse percebido foi sugerido como um fator de risco para o desenvolvimento da Síndrome Metabólica (SM). No entanto, pouco se sabe desta associação entre mulheres. Objetivo: avaliar o estresse percebido em mulheres com SM. Materiais e Métodos: estudo transversal, a partir do recorte de um ensaio clínico não-randomizado, com pacientes de um centro de saúde público (RBR-43K52N). A variável de desfecho foi a SM, utilizando os critérios do NCEP/ATPIII. Foram coletados dados sociodemográficos, antropométricos, bioquímicos, hemodinâmicos e aplicação da PSS. Resultados: A amostra constituiu-se de 75 mulheres acometidas por SM (47,69±8,15 anos de idade; 155,65±0,07 cm; 82,43±17,79 kg; IMC de 33,54±7,28). Encontrou-se valores elevados de RCQ entre as mulheres estressadas e não-estressadas. A pontuação média da PSS foi de 27,73±9,17. Nos agrupamentos, verificou-se diferença significativa para PSS entre as mulheres estressadas e não-estressadas (35,24±5,22 e 20,42±5,53, respectivamente; p=0,001). Observou-se também que mulheres estressadas tinham níveis mais elevados de triglicerídeos e níveis mais baixos de HDL-c quando comparadas com mulheres não estressadas, embora sem diferença estatística. Discussões: Os achados sugerem que as mulheres categorizadas como estressadas tinham maior pontuação da PSS, níveis mais elevados de triglicerídeos e níveis mais baixos de HDL-c quando comparadas com mulheres não estressadas. Conclusões: a pontuação da PSS foi significativamente maior entre mulheres com parâmetros lipídicos da SM alterados, com menores níveis de HDL- e aumento de triglicerídeos.
Introduction: Perceived stress has been suggested as a risk factor for the development of Metabolic Syndrome (MS). However, little is known about this association among women. Objective: to evaluate perceived stress in women with Metabolic Syndrome (MS). Materials and Methods: cross-sectional study, based on a non-randomized clinical trial, with patients from a public health center (RBR-43K52N). The outcome variable was MS, using the NCEP/ATPIII criteria. Sociodemographic, anthropometric, biochemical, hemodynamic data and PSS application were collected. Results: The sample consisted of 75 women affected by MetS (47.69± 8.15 years old; 155.65±0.07 cm; 82.43±17.79 kg; BMI of 33.96±6 ,42). High WHR values were found among stressed and non-stressed women. The average PSS score was 27.73±9.17. In the groups, there was a significant difference for PSS between stressed and non-stressed women (35.24±5.22 and 20.42±5.53, respectively; p=0.001). It was also observed that stressed women had higher levels of triglycerides and lower levels of HDL-c when compared to non-stressed women, although without statistical difference. Discussions: The findings suggest that women categorized as stressed had higher PSS scores, higher levels of triglycerides and lower levels of HDL-c when compared to non-stressed women. Conclusions: the PSS score was significantly higher among women with altered MS lipid parameters, with lower levels of HDL- and increased triglycerides.
Introducción: El estrés percibido ha sido sugerido como un factor de riesgo para el desarrollo del Síndrome Metabólico (SM). Sin embargo, poco se sabe sobre esta asociación entre las mujeres. Objetivo: evaluar el estrés percibido en mujeres con Síndrome Metabólico (SM). Materiales y Métodos: estudio transversal, basado en un ensayo clínico no aleatorizado, con pacientes de un centro de salud pública (RBR-43K52N). La variable resultada fue SM, utilizando los criterios NCEP/ATPIII. Se recogieron datos sociodemográficos, antropométricos, bioquímicos, hemodinámicos y aplicación de PSS. Resultados: La muestra estuvo compuesta por 75 mujeres afectadas por SMet (47,69± 8,15 años; 155,65±0,07 cm; 82,43±17,79 kg; IMC de 33,96±6,42). Se encontraron valores altos de WHR entre mujeres estresadas y no estresadas. La puntuación media de PSS fue de 27,73±9,17. En los grupos, hubo una diferencia significativa para PSS entre mujeres estresadas y no estresadas (35,24±5,22 y 20,42±5,53, respectivamente; p=0,001). También se observó que las mujeres estresadas tenían niveles más altos de triglicéridos y niveles más bajos de HDL-c en comparación con las mujeres no estresadas, aunque sin diferencia estadística. Discusiones: Los hallazgos sugieren que las mujeres categorizadas como estresadas tenían puntajes PSS más altos, niveles más altos de triglicéridos y niveles más bajos de HDL-c en comparación con mujeres no estresadas. Conclusiones: la puntuación de PSS fue significativamente mayor entre las mujeres con parámetros lipídicos de SM alterados, con niveles de HDL más bajos y triglicéridos elevados.
Subject(s)
Women , Metabolic Syndrome , Dyslipidemias , Obesity, AbdominalABSTRACT
Introdução: a hipertensão arterial sistêmica (HAS) está associada a fatores de risco metabólicos e pode ser definida como uma doença crônica multifatorial, com valores persistentes de pressão arterial sistólica (PAS) e (ou) pressão arterial diastólica (PAD) maiores ou iguais a 140 mmHg x 90 mmHg, respectivamente. A HAS é um dos fatores que compõem a síndrome metabólica (SM) juntamente com a hiperglicemia, dislipidemia e (ou) obesidade central. Modificações no estilo de vida, como a alimentação e perda de peso, demonstraram melhorar os parâmetros cardiometabólicos nos pacientes com HAS e SM. Objetivo: verificar o efeito de uma dieta hipocalórica na antropometria, na pressão arterial e em outros cofatores da síndrome metabólica. Metodologia: trata-se de um ensaio clínico não randomizado, retrospectivo, com dados secundários, em que o mesmo grupo foi de "intervenção" e "comparador", e cujos dados foram coletados antes (baseline) e após a intervenção. A pesquisa foi realizada com 84 pacientes, adultos, com síndrome metabólica, de ambos os sexos. Os pacientes seguiram dieta com restrição calórica de 200 a 500kcal/dia, com cálculo energético em torno de 20kcal/kg de peso, valor energético total não inferior a 1200kcal, durante um período de dois meses. Foi utilizada estatística descritiva e o teste t pareado ou Wilcoxon-Sign-Rank intragrupo para analisar as variações ao longo do tempo (p < 0,05). Resultado:houve uma redução na antropometria (índice de massa corporal, circunferência da cintura, circunferência do braço e circunferência do quadril), PAS e PAD, glicemia de jejum e triglicerídeos com p< 0,05 dos pacientes após a intervenção, mas não houve melhora no HDL (p > 0,05). Conclusão: a dieta hipocalórica reduziu as medidas antropométricas, a pressão arterial e os demais cofatores da SM nos pacientes avaliados após o acompanhamento de dois meses.
Introduction: systemic arterial hypertension (SAH) is associated with metabolic risk factors and can be defined as a multifactorial chronic disease, with persistent values of systolic blood pressure (SBP) and (or) diastolic blood pressure (DBP) greater than or equal to 140 mmHg x 90 mmHg, respectively. SAH is one of the factors that make up the metabolic syndrome (MS) along with hyperglycemia, dyslipidemia and (or) central obesity. Lifestyle modifications, such as diet and weight loss, have been shown to improve cardiometabolic parameters in patients with SAH and MS. Objective: to verify the effect of a hypocaloric diet on anthropometry, blood pressure and other cofactors of the metabolic syndrome. Methodology: this is a non-randomized, retrospective clinical trial, with secondary data, in which the same group was "intervention" and "comparator", and whose data were collected before (baseline) and after the intervention. Research was carried out with 84 patients, adults, with metabolic syndrome, of both sexes. Patients followed a calorie-restricted diet of 200 to 500kcal/day, with energy calculation around 20kcal/kg of weight, total energy value not less than 1200kcal, during a period of two months. Descriptive statistics and the paired t test or intragroup Wilcoxon-Sign-Rank were used to analyze variations over time (p < 0.05). Result: there was a reduction in anthropometry (body mass index, waist circumference, arm circumference and hip circumference), SBP and DBP, fasting glucose and triglycerides with p<0.05 of patients after the intervention, but there was no improvement in HDL (p > 0.05). Conclusion: the hypocaloric diet reduced anthropometric measurements, blood pressure and other MS cofactors in the patients evaluated after a two-month follow-up.
Subject(s)
Humans , Male , Female , Adult , Aged , Cardiovascular Diseases , Anthropometry , Metabolic Syndrome , Caloric Restriction , Cardiometabolic Risk Factors , Hyperglycemia , Hypertension , ObesityABSTRACT
Introducción: El Síndrome Metabólico es de alta prevalencia en la población adulta y comprende un conjunto de factores de riesgo para el desarrollo de diabetes mellitus tipo 2 y cardiopatía isquémica. Objetivos: Determinar la frecuencia, componentes más frecuentes y la diferencia de las mediciones entre hombres y mujeres de Síndrome metabólico en pacientes jóvenes del ambulatorio de la Primera Cátedra de Clínica Médica del Hospital de Clínicas. Materiales y métodos: Diseño observacional, descriptivo, retrospectivo de corte transversal, que incluyó a pacientes adultos de 18 a 40 años que consultaron en el ambulatorio de la Primera Cátedra de Clínica Médica del Hospital de Clínicas de enero a diciembre de 2019. Se determinaron las variables demográficas (edad, sexo, procedencia), perímetro de cintura, presión arterial, c-HDL, triglicéridos y la glicemia. El Síndrome Metabólico se determinó de acuerdo a las definiciones de la NCEP-ATP III. Resultados: Se incluyeron en el estudio 312 pacientes, la edad media fue de 27,5± 6,2 años, en el sexo masculino fue de 27,4 ± 6,6 años y en sexo femenino de 27,9 ± 6,4 años. El 10,5% de los pacientes cumplieron con los criterios para el diagnóstico de Síndrome Metabólico, de los cuales 60,6% pacientes son del sexo femenino. Los componentes individuales más frecuentes son el perímetro de cintura aumentada y el c-HDL bajo. Conclusión: La frecuencia de Síndrome Metabólico es similar a otro estudio realizado en adultos jóvenes e inferior que, en adultos mayores, más en mujeres que en hombres y los componentes individuales más frecuentes fueron la obesidad y la dislipidemia.
Introduction: Metabolic syndrome is highly prevalent in the adult population and includes a set of risk factors for the development of type 2 diabetes mellitus and ischemic heart disease. Objectives: To determine the frequency, most frequent components and the difference of the measurements between men and women of Metabolic Syndrome in young patients of the ambulatory of the First Chair of Medical Clinic of the Hospital of Clinics. Materials and methods: Observational, descriptive, retrospective cross-sectional design, which included adult patients aged 18 to 40 who consulted in the outpatient clinic of the First Chair of Medical Clinic of the Hospital de Clínicas from January to December 2019. The demographic variables (age, sex, origin), waist circumference, blood pressure, HDL-C, triglycerides and glycemia. Metabolic syndrome was determined according to the NCEP-ATP III definitions. Results: 312 patients were included in the study, the mean age was 27.5 ± 6.2 years, in males it was 27.4 ± 6.6 years and in females 27.9 ± 6.4. years. 10.5% of the patients met the criteria for the diagnosis of metabolic syndrome, of which 60.6% patients are female. The most frequent individual components are increased waist circumference and low HDL-C. Conclusion: Frequency of metabolic syndrome similar to another study carried out in young adults and lower than in older adults, more in women than in men and the most frequent individual components were obesity and dyslipidemia.
Subject(s)
Metabolic Syndrome , Diabetes Mellitus, Type 2 , Dyslipidemias , Clinical Medicine , Risk FactorsABSTRACT
La resistencia a la insulina es una condición patológica de expresión variable asociada a riesgo cardiovascular, diabetes mellitus tipo 2, hígado graso de etiología no alcohólica, lipodistrofias, síndrome de ovario poliquístico y algunos cánceres. El propósito de esta revisión bibliográfica es brindar información actualizada al lector sobre algunos de los avances actuales de la resistencia a la insulina. Se realizó una búsqueda de literatura en PUBMED de enero 2014-octubre 2021, obteniéndose 1,354 referencias, seleccionando 39 publicaciones. Aunque continúe la discusión sobre la definición clínica y laboratorial, se ha determinado que el manejo terapéutico y preventivo para casos de resistencia a la insulina se debe basar en cambios de estilo de vida con apoyo farmacológico individualizado. El impacto actual y potencial en el futuro inmediato de la epidemiología de la resistencia a la insulina está en los estudios clínico-terapéuticos en curso y en las políticas públicas dirigidas a fomentar el estilo de vida saludable...(AU)
Subject(s)
Humans , Insulin Resistance , Metabolic Syndrome , Diabetes Mellitus , HyperglycemiaABSTRACT
Introducción: El estrés académico resulta de la confrontación de un individuo con las demandas del medio universitario, lo cual puede producir cambios a nivel neuro-endocrino-inmunológico y generar un estado de inflamación crónica en donde los niveles de proteína C-reactiva aumentan. Objetivo: Determinar los niveles de estrés académico y proteína C-reactiva en estudiantes de medicina y su posible asociación con síndrome metabólico. Métodos: Se realizó un estudio observacional descriptivo de corte longitudinal que determinó el estrés académico en 68 estudiantes de medicina (41 mujeres y 27 hombres). Se obtuvo información sociodemográfica y clínica de cada estudiante. Se aplicó un cuestionario para la evaluación del estrés académico y se obtuvieron dos muestras de sangre para realizar dos pruebas de proteína C-reactiva de alta sensibilidad en dos tiempos diferentes. Resultados: Pese a que se observaron niveles altos de estrés académico y proteína C-reactiva, no hubo una asociación directa; sin embargo, se encontraron relaciones significativas entre proteína C-reactiva y las variables clínicas, además de un riesgo alto de desarrollar síndrome metabólico. Conclusiones: Se observaron altos niveles de estrés académico asociado a las demandas y exigencias de un programa de medicina con acreditación de alta calidad. Los altos niveles de proteína C-reactiva fueron asociados a los altos niveles de obesidad abdominal, lo que hace que un número significativo de estudiantes se encuentre en riesgo de desarrollar enfermedades cardiovasculares y diabetes mellitus tipo 2, sobre todo aquellos en los que se detectó prehipertensión. No se encontró una relación significativa entre el estrés académico y los niveles de proteína C-reactiva(AU)
Introduction: Academic stress results from the confrontation of an individual with the demands of the university environment, which can produce changes at the neuro-endocrine-immunological level and generate a state of chronic inflammation where the levels of C-reactive protein increase. Objective: To determine the levels of academic stress and C-reactive protein in medical students and their possible association with metabolic syndrome. Methods: A longitudinal descriptive observational study was conducted to determine academic stress in 68 medical students (41 women and 27 men). Sociodemographic and clinical information was obtained from each student. A questionnaire was applied to assess academic stress and two blood samples were obtained to perform two high-sensitivity C-reactive protein tests at two different times. Results: Although high levels of academic stress and C-reactive protein were observed, there was no direct association; however, significant relationships were found between C-reactive protein and clinical variables, in addition to a high risk of developing metabolic syndrome. Conclusions: High levels of academic stress associated with the demands and requirements of a medicine program with high quality accreditation were observed. High levels of C-reactive protein were associated with high levels of abdominal obesity, which means that a significant number of students are at risk of developing cardiovascular diseases and type 2 diabetes mellitus, especially those in whom prehypertension was detected. No significant relationship was found between academic stress and C-reactive protein levels(AU)
Subject(s)
Humans , Male , Female , Young Adult , Stress, Psychological/psychology , C-Reactive Protein/drug effects , Metabolic Syndrome/epidemiology , Education, Medical , Epidemiology, Descriptive , Longitudinal Studies , Colombia , Observational StudyABSTRACT
Abstract Introduction: Cirrhosis of the liver is a significant cause of morbidity and mortality in Latin America; the increased prevalence of metabolic syndrome in our population could be changing the epidemiological profile of patients with advanced chronic liver disease. Aim: To characterize a group of patients with cirrhosis of the liver at an outpatient hepatology care center in Cartagena de Indias, Colombia, and determine the contribution of nonalcoholic steatohepatitis (NASH) as an etiological factor in this population. Materials and methods: Retrospective, cross-sectional, analytical study. All patients who attended the hepatology follow-up with a diagnosis of cirrhosis of the liver were in the six-monthly follow-up protocol that included screening for hepatocellular carcinoma (HCC) and esophageal varices. Results: 346 patients were included, most were women (54.3 %). The first and second causes of cirrhosis were cryptogenic (35 %) and NASH (30.9 %), respectively, followed by viral hepatitis (17 %) and autoimmune diseases (9 %). Of these patients, 87.4 % were within categories A and B of the Child-Turcotte-Pugh score, and only 12.5 % (33 patients) were in stage C. Also, 60 % had at least one clinical decompensation, 38 % a history of variceal hemorrhage, and 4 % a diagnosis of HCC; 80.6 % of patients with NASH cirrhosis had diabetes, and 46.7 % were overweight. Conclusion: NASH cirrhosis is an emerging cause of advanced chronic liver disease in Colombia.
Resumen Introducción: la cirrosis hepática es una importante causa de morbimortalidad en América Latina; el incremento de la prevalencia del síndrome metabólico en nuestra población podría estar cambiando el perfil epidemiológico de los pacientes con enfermedad hepática crónica avanzada. Objetivos: caracterizar un grupo de pacientes con cirrosis hepática y determinar la contribución de la esteatohepatitis no alcohólica (NASH) como factor etiológico de esta población en la ciudad de Cartagena de Indias, Colombia, en un centro de atención ambulatoria de hepatología. Métodos: estudio retrospectivo, transversal, analítico. Se incluyeron todos los pacientes que acudieron al seguimiento de hepatología con diagnóstico de cirrosis hepática que se encontraban en el protocolo de seguimiento semestral que incluía el cribado de hepatocarcinoma y várices esofágicas. Resultados: se incluyeron 346 pacientes. La mayoría fueron mujeres (54,3 %). La primera y segunda causa de cirrosis fue la criptogénica (35 %) y la NASH (30,9 %), respectivamente; seguidas de las hepatitis virales (17 %) y enfermedades autoinmunes (9 %). De estos pacientes, el 87,4 % se encontraba dentro de las categorías A y B de la escala pronóstica de Child-Turcotte-Pugh, y solo el 12,5 % (33 pacientes) en estadio C. El 60 % había presentado al menos una descompensación clínica, 38 % tenía antecedentes de hemorragia por várices y 4 %, diagnóstico de hepatocarcinoma. El 80,6 % de los pacientes con cirrosis NASH era diabético y el 46,7 % tenía exceso de peso. Conclusión: La cirrosis NASH es una causa emergente de enfermedad hepática crónica avanzada en Colombia.
Subject(s)
Humans , Male , Female , Metabolic Syndrome , Non-alcoholic Fatty Liver Disease , Liver , Liver Cirrhosis , Varicose Veins , Hepatitis , Liver DiseasesABSTRACT
OBJETIVO: Determinar la prevalencia de diabetes tipo 2, síndrome metabólico, sobrepeso, obesidad, riesgo de diabetes tipo 2 y factores asociados en comerciantes de cinco mercados populares de la ciudad de La Paz, gestión 2017. MATERIAL Y MÉTODOS: Estudio transversal analítico, en comerciantes de un mercado por cada red urbana de salud, de ambos sexos y con edad mayor o igual a 18 años. En 4 de los 5 mercados se trabajó con la totalidad de la población, en la red 1 se calculó una muestra de 273. Las mediciones que se tomaron fueron datos generales, test de FINDRISC, antropometría, pruebas laboratoriales, presión arterial y recordatorio de 24 horas. RESULTADOS: Se obtuvo la información de 807 comerciantes, con edad de 49.21±14.2 años, el 90.42% mujeres, la prevalencia de diabetes fue 19.5%, síndrome metabólico 47%, sobrepeso 37.5%, obesidad 41.7%; riesgo de tener diabetes en 10 años es del 32.7%, de fumar por lo menos 1 cigarrillo al día, durante los últimos 6 meses es del 12.7% en mujeres y del 25.3% en varones; de consumo de riesgo de alcohol es del 20.8%, de sedentarismo del 58.6%; la dieta en mujeres es hipercalórica, hiperlipídica e hiperglusídica.CONCLUSIONES: La prevalencia de diabetes es 3 veces mayor al estimado del 2015 para Bolivia, la de síndrome metabólico más alta que la estimada en Sudamérica; los hábitos de vida son inadecuados y de riesgo.
OBJECTIVE: To determine the prevalence of type 2 diabetes, metabolic syndrome, overweight, obesity, risk of type 2 diabetes and associated factors in merchants of five popular markets in the city of La Paz, management 2017. MATERIAL AND METHODS: Analytical cross-sectional study of merchants in one market for each urban health network, of both sexes and aged 18 years or older. In 4 of the 5 markets we worked with the entire population, in network 1 a sample of 273 was calculated. The measurements that were taken were general data, FINDRISC test, anthropometry, laboratory tests, blood pressure and 24 recall hours. RESULTS: Information was obtained from 807 merchants, aged 49.21 ± 14.2 years, 90.42% women, the prevalence of diabetes was 19.5%, metabolic syndrome 47%, overweight 37.5%, obesity 41.7%; risk of having diabetes in 10 years is 32.7%, of smoking at least 1 cigarette a day, during the last 6 months it is 12.7% in women and 25.3% in men; risk consumption of alcohol is 20.8%, sedentary lifestyle is 58.6%; the diet in women is hypercaloric, hyperlipidic and hyperglusidic. CONCLUSIONS: The prevalence of diabetes is 3 times higher than the 2015 estimate for Bolivia, the metabolic syndrome prevalence higher than that estimated in South America; lifestyle habits are inappropriate and risky.
Subject(s)
Female , Adolescent , Prevalence , Metabolic Syndrome , Sedentary Behavior , Cross-Sectional Studies , Ethanol , Overweight , Habits , ObesityABSTRACT
Abstract Background: Due to the growing concern about work-related social and health aspects, occupational health and safety has become relevant. Objective: This work aims to develop a model to assist cardiovascular risk management in a team of haul truck operators, who work in rotating shifts at a mining company in Brazil. Methods: This longitudinal study evaluated risk factors for cardiovascular diseases of 191 mineworkers at three times points - 2010, 2012, and 2015. In addition, the risk of developing cardiovascular diseases was calculated, and the risk factors were analyzed using the chi-square test, the U Mann-Whitney test, and binary logistic regression. The significance level was set at 5%. Results: In the study period, body weight, body mass index (BMI), waist-to-height ratio (WHR), systolic (SBP), and diastolic blood pressure (DBP), total cholesterol, high-density lipoprotein cholesterol (HDL-C), and triglycerides levels of the study group increased. In 2015, there was a high prevalence of alcohol intake, overweight or obesity, central obesity, inadequate WHR, high blood pressure, total cholesterol above 190 mg/dL, and triglycerides above 150 mg/dL. An association was identified between increased cardiovascular risk and age, SBP, HDL-C, low-density lipoprotein cholesterol (LDL-C), and elevated glucose levels. Conclusion: Intense interventions for reduction and prevention of elevated alcohol intake, blood pressure levels, WHR, metabolic syndrome, blood glucose, and LDL-C levels, and low HDL-C levels are needed. In addition, a close monitoring of mine workers over 38 years of age who smoke, consume alcoholic beverages, and have altered blood glucose levels is important.
Subject(s)
Humans , Male , Female , Occupational Health , Miners , Heart Disease Risk Factors , Tobacco Use Disorder , Alcohol Drinking , Cardiovascular Diseases/prevention & control , Longitudinal Studies , Metabolic Syndrome , Metabolic Syndrome/complications , Shift Work Schedule , HypercholesterolemiaABSTRACT
INTRODUCTION: The anthropometric indicators of obesity may be important in predicting metabolic syndrome (MS). OBJECTIVE: To evaluate the anthropometric indicators as predictors of MS and verify the association of these indicators with MS in older adult individuals of both sexes. METHODS: Cross-sectional epidemiological study was carried out with 222 individuals aged 60 years or older residents in the urban area of Aiquara, Bahia state, Brazil. Older adults were measured for anthropometric indicators: body mass index (BMI), waist-to-height ratio (WHtR), waist circumference, conicity index, the sum of skinfolds; blood pressure; biochemical variables: fasting glucose, triglycerides, total cholesterol, and fractions. For the diagnosis of MS, the definition of the International Diabetes Federation was used. Descriptive and inferential data analysis was tested using correlation, the Poisson regression technique, and the Receiver Operating Characteristic (ROC) curve. RESULTS: The prevalence of MS was 62.3%. There was a correlation of all anthropometric indicators with MS in both sexes. The indicators of visceral fat had a strong association in that these indicators had an area under the ROC curve higher than 0.76 (CI95% 0.660.85). Thus, most results showed a weak correlation. CONCLUSION: All anthropometric indicators can be used to predict MS in older adults for both sexes, however, BMI and WHtR showed the best predictions.
INTRODUÇÃO: Os indicadores antropométricos de obesidade podem ser importantes na predição da síndrome metabólica (SM). OBJETIVO: Avaliar os indicadores antropométricos como preditores da SM, bem como verificar a associação desses indicadores com a SM em idosos de ambos os sexos. MÉTODOS: Estudo epidemiológico transversal realizado com 222 indivíduos com 60 anos ou mais residentes na zona urbana de Aiquara-BA, Brasil. Os idosos foram avaliados quanto aos indicadores antropométricos: índice de massa corporal (IMC), razão cintura-estatura (RCEst), circunferência da cintura, índice de conicidade, soma de dobras cutâneas; pressão sanguínea; bioquímicos: glicemia em jejum, triglicérides, colesterol total e frações. Foram classificados quanto à presença de SM de acordo com a Federação Internacional de Diabetes. A análise descritiva e inferencial dos dados foi testada utilizando correlação, a técnica de regressão de Poisson e a curva Receiver Operating Characteristic (ROC). RESULTADOS: A prevalência de SM foi de 62,3%. Houve correlação de todos os indicadores antropométricos com a SM em ambos os sexos. Os indicadores de gordura visceral apresentaram forte associação, pois possuem área abaixo da curva ROC superior a 0,76 (IC95% 0,66-0,85). Assim, a maioria dos resultados apresentou correlação fraca. CONCLUSÃO: Todos os indicadores antropométricos podem ser usados para rastrear a SM em idosos de ambos os sexos, no entanto, o IMC e a RCEst apresentaram as melhores previsões.
Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Anthropometry , Health of the Elderly , Metabolic Syndrome , Obesity , Cross-Sectional Studies , ROC CurveABSTRACT
Introducción: Por los beneficios demostrados de este proceder, la cirugía bariátrica es una opción de tratamiento para el síndrome metabólico. Objetivo: Describir los efectos de las técnicas gástricas restrictivas laparoscópicas en pacientes obesos con síndrome metabólico asociado. Métodos: Estudio descriptivo y prospectivo en 22 pacientes con índice de masa corporal mayor o igual a 35 Kg/m2 y diagnóstico de síndrome metabólico, intervenidos por técnicas restrictivas laparoscópicas en el Hospital Universitario "General Calixto García" entre noviembre de 2018 y enero de 2020. Se estudió el grado de obesidad, el perímetro de cintura, el porcentaje de sobrepeso perdido, el porcentaje del exceso de índice de masa corporal perdido, las cifras de glucosa, el colesterol, los triglicéridos y el tratamiento antihipertensivo e hipoglicemiante. Resultados: La edad promedio fue de 41,8±10,6 años, con predominio de las mujeres. El índice de masa corporal disminuyó al año, al igual que el perímetro de la cintura. La media al año del porcentaje de sobrepeso perdido y del porcentaje del exceso de índice de masa corporal perdido fue de 75 y 83 por ciento, respectivamente. Las cifras de glucemia, colesterol y los triglicéridos disminuyeron respecto a los valores preoperatorios. El 78,6 por ciento de los diabéticos y el 81,2 por ciento de los hipertensos lograron suspender toda medicación. Conclusiones: Disminuyó significativamente el grado de obesidad, el porcentaje de sobrepeso perdido, el porcentaje del exceso de índice de masa corporal perdido y el perímetro de la cintura. Los valores de glucemia, triglicéridos y colesterol descendieron significativamente respecto a los basales, con una disminución en el uso de fármacos hipoglicemiantes y antihipertensivos(AU)
Introduction: Due to the proven benefits of this procedure, bariatric surgery is a treatment option for metabolic syndrome. Objective: To describe the effects of laparoscopic gastric restrictive techniques in obese patients with associated metabolic syndrome. Methods: A descriptive and prospective study was performed in 22 patients with a body mass index higher than or equal to 35 Kg/m2 and with diagnosis of metabolic syndrome; they had undergone surgery by laparoscopic restrictive techniques at the General Calixto García University Hospital, from November 2018 to January 2018 2020. The degree of obesity, waist circumference, percentage of overweight lost, percentage of excess body mass index lost, glucose, cholesterol, triglycerides, and antihypertensive and hypoglycemic treatment were studied. Results: The average age was 41.8±10.6 years, with predominance of women. Body mass index decreased at one year, as did waist circumference. The mean per year of the percentage of overweight lost and the percentage of excess body mass index lost was 75 percent and 83 percent, respectively. Blood glucose, cholesterol and triglyceride levels decreased compared to preoperative values. 78.6 percent of diabetics managed to suspend all medication and 81.2 percent hypertensive. Conclusions: The degree of obesity, the percentage of overweight lost, the percentage of excess body mass index lost and the waist circumference decreased significantly. Blood glucose, triglycerides, and cholesterol values decreased significantly compared to baseline, with a decrease in the use of hypoglycemic and antihypertensive drugs(AU)
Subject(s)
Humans , Male , Middle Aged , Laparoscopy/methods , Metabolic Syndrome/diagnosis , Bariatric Surgery/methods , Body Mass Index , Epidemiology, Descriptive , Prospective StudiesABSTRACT
Introducción: La lipodistrofia congénita de Berardinelli-Seip es un síndrome genético autosómico recesivo, caracterizado por la ausencia generalizada del tejido adiposo, el déficit de leptina y las alteraciones metabólicas incluidas la resistencia a la insulina, la esteatohepatitis y la hipertrigliceridemia. Objetivo: Definir los diferentes espectros clínicos y fisiopatológicos del síndrome y su relación con el fenotipo definiendo las estrategias terapéuticas actuales. Métodos: Se realizó una búsqueda bibliográfica no sistemática en las bases de datos Science Direct, EMBASE, LILACS, Redalyc, SciELO y PubMed. Los criterios de inclusión fueron publicaciones en inglés, portugués o español, en las que el título y las palabras clave, abordaban el tema planteado con una vigencia de 10 años. Se obtuvieron 50 artículos relacionados con el síndrome, de los cuales 30 fueron seleccionados para su revisión. Conclusiones: El diagnóstico de la enfermedad es principalmente clínico. Se establece en presencia de tres criterios mayores o la combinación de dos mayores con dos menores y/o por la identificación de variantes patogénicas por medio del estudio genético y molecular. La dieta y el ejercicio conjuntamente con la administración de la metreleptina son pilares fundamentales en el manejo de estos pacientes. El reconocimiento temprano del síndrome es esencial para prevenir las complicaciones, y brindar asesoría genética y reproductiva a los pacientes y familiares(AU)
Introduction: Berardinelli-Seip congenital lipodystrophy is an autosomal recessive genetic syndrome, characterized by the general absence of adipose tissue, leptin deficiency and metabolic alterations including insulin resistance, steatohepatitis and hypertriglyceridemia. Objective: To present the different clinical and pathophysiological spectra of the syndrome, its relationship with the phenotype, defining the current therapeutic strategies. Methods: A non-systematic bibliographic search was carried out in Science Direct, EMBASE, LILACS, Redalyc, SciELO and PubMed databases. The inclusion criteria were publications in English, Portuguese and Spanish, in which the title and keywords included information pertinent to the stated objective with a periodicity of 10 years, 50 articles were retrieved, and 30 of them were selected. Conclusions: The diagnosis of the disease is mainly clinical. It is established in the presence of three major criteria or the combination of two major and two minor criteria and/or by the identification of pathogenic variants through genetic and molecular studies. Diet and exercise together with the administration of metreleptin are fundamental pillars in the management of these patients. Early recognition of the syndrome is essential to prevent complications, allowing genetic and reproductive counseling to be provided to patients and their families(AU)
Subject(s)
Humans , Metabolic Syndrome/prevention & control , Lipodystrophy, Congenital Generalized/physiopathology , Insulin Resistance , Review Literature as Topic , Databases, Bibliographic , Health StrategiesABSTRACT
Introducción: La disbiosis conocida como la alteración de la relación simbiótica entre la microbiota intestinal y el huésped están implicados en la patogenia de la enfermedad cardiovascular aterosclerótica. Objetivo: Realizar una revisión documental sobre los mecanismos fisiopatológicos que relacionan los metabolitos bioactivos generados por la disbiosis intestinal con el desarrollo y progresión de la enfermedad cardiovascular aterosclerótica. Métodos: Se utilizó el motor de búsqueda Google Académico y se consultaron artículos de libre acceso en las bases de datos Pubmed, SciELO, Lilacs, Cumed y Hinari desde septiembre 2020 hasta el mes de marzo 2021. Las palabras clave utilizadas para esta revisión fueron:microbioma, microbiota intestinal, disbiosis, aterosclerosis, enfermedad cardiovascular y sus equivalentes en inglés, según el descriptor de Ciencias de la Salud (DeCS). Se consideraron artículos originales, de revisión, revisiones sistemáticas y metaanálisis posteriores al año 2015. Se revisaron un total de 73 artículos. Desarrollo: Las relaciones fisiopatológicas entre la disbiosis intestinal y las enfermedades cardiovasculares son complejas, ya que se influyen mutuamente a través de los sus toxinas endógenas (metabolitos bioactivos), el sistema circulatorio, las respuestas inmunitarias y los cambios metabólicos. Las investigaciones futuras deberían centrarse en dilucidar los actores moleculares subyacentes e identificar si las vías que interconectan la disbiosis intestinal con la ECA son causales, correlacionales o consecuentes. Conclusiones: La evidencia acumulada sostiene que la disbiosis de la microbiota intestinal está involucrada en la síntesis de metabolitos proaterogénicos los cuales modulan los mecanismos implicados en la fisiopatología de la ECA(AU)
Introduction: Dysbiosis is known as the alteration of the symbiotic relationship between the intestinal microbiota and the host is involved in the pathogenesis of atherosclerotic cardiovascular disease. Objective: To carry out a documentary review on the pathophysiological mechanisms that relate the bioactive metabolites generated by intestinal dysbiosis with the development and progression of atherosclerotic cardiovascular disease. Methods: The Google Scholar search engine was used and free access articles were consulted in Pubmed, SciELO, Lilacs, Cumed and Hinari databases from September 2020 to March 2021. The keywords used for this review were microbiome, gut microbiota, dysbiosis, atherosclerosis, cardiovascular disease and their English equivalents, according to the Health Sciences (DeCS) descriptor. Original articles, review articles, systematic reviews and meta-analyses after 2015 were considered. A total of 73 articles were reviewed. Findings: The pathophysiological relationships between intestinal dysbiosis and cardiovascular diseases are complex, since they influence each other through their endogenous toxins (bioactive metabolites), the circulatory system, immune responses and metabolic changes. Future research should focus on elucidating the underlying molecular players and on identifying whether the pathways that interconnect gut dysbiosis with ACE are causal, correlational, or consequential. Conclusions: The accumulated evidence supports that the dysbiosis of the intestinal microbiota is involved in the synthesis of proatherogenic metabolites which modulate the mechanisms involved in the pathophysiology of ACE(AU)
Subject(s)
Humans , Male , Female , Cardiovascular Diseases/epidemiology , Metabolic Syndrome/epidemiology , Atherosclerosis/epidemiology , Dysbiosis , Gastrointestinal Microbiome/physiologyABSTRACT
Estimado director: Hemos leído con interés el artículo Prevalencia del síndrome metabólico en la población dos consultorios del Policlínico Primero de Enero, de los autores Rivero Sabournin y otros.1 Dicho trabajo demuestra el potencial investigativo en la Atención Primaria de Salud, así como la pertinencia de este escenario en los estudios epidemiológicos. Para el desarrollo de la investigación sus autores se basan en los criterios de síndrome metabólico (SM) del National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III),1 aunque resulta imprescindible evaluar los criterios de la Clasificación Consensuada o Armonizada de Alberti y otros del año 2009,2 los cuales constituyen la guía más importante para la evaluación por parte del médico de cabecera de los pacientes que pudieran padecer de SM. Otro elemento importante en esta investigación es que se resalta la relación SM y envejecimiento, aunque no se argumenta cuáles pudieran ser los nexos entre ellos. Actualmente se considera que sea el endotelio (END) y la disfunción endotelial (DISF) la vía común de cada una de estas alteraciones como lo han propuesto varios autores: niveles elevados de ácidos grasos,3 envejecimiento,4 oxidación de LDL,5 hiperglucemia,6 niveles séricos de adipoquinas7,8 y las especies reactivas del oxígeno.9 Para un abordaje de esta relación SM-E-END sería necesario analizar que la base fisiopatológica del SM es la insulinorresistencia (IR) y que, precisamente, el endotelio tiene una función importante, donde la insulina (INS) logra desempeñar su función.8 En el endotelio se produce el factor de crecimiento similar a la INS (IGF, según sus siglas en inglés)9 y es donde se encuentran proteínas de membrana que sirven de transportadores a la INS. Una vez que se instaura el daño endotelial o la disfunción endotelial (DE), la pérdida...(AU)
Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Primary Health Care , Aging/physiology , Metabolic Syndrome/epidemiologyABSTRACT
INTRODUCCIÓN: Se ha postulado la relación entre la presencia de enfermedades cardiometabólicas con problemas de salud mental, en particular la depresión. OBJETIVOS: Determinar la asociación entre la presencia de enfermedades cardiometabólicas y la presencia de sintomatología depresiva evaluada mediante el cuestionario PHQ-9 en pacientes atendidos en consultorios externos de medicina interna del Hospital Nacional Hipólito Unanue. METODOLOGÍA: Estudio observacional, analítico, transversal. Se definió enfermedad cardiometabólica como la presencia de diabetes mellitus, hipertensión arterial, dislipidemia, y/u obesidad. Se utilizó el cuestionario PHQ-9 para evaluar la presencia de síntomas sugerentes de depresión. Se evaluó la asociación cruda y ajustada a posibles confusores. Para el análisis multivariado se utilizó un modelo de regresión de Poisson para hallar razones de prevalencia con sus respectivos intervalos de confianza al 95%. Se consideró un p<0,05 como estadísticamente significativo. Resultados: Se incluyeron 252 pacientes, de los que 205 (81,4%) presentaron enfermedades cardiometabólicas y 181 (71,9%) presentaron síntomas consistentes con algún grado de depresión. La presencia de enfermedades cardiometabólicas se asoció a síntomas depresivos tanto en el análisis crudo (RPc 1,43; IC 95% 1,08-1,89; p=0,012) como en el ajustado (RPa 1,31; IC 95% 1,00-1,71; p=0,048). Adicionalmente se encontró asociación entre el sexo femenino y sintomatología depresiva (RPa 1,35; IC 95% 1,11-1,63; p=0,002). CONCLUSIONES: La presencia de enfermedades cardiometabólicas se asoció con la presencia de síntomas depresivos en pacientes atendidos en la consulta externa de medicina interna. El abordaje de la salud mental debe ser parte integral del manejo multidisciplinario del paciente con enfermedad cardiometabólica.
INTRODUCTION: It has been postulated the relationship between presence of cardiometabolic diseases with mental health problems, particularly depression. Objectives: To determine the association between cardiometabolic diseases and presence of depressive symptoms, evaluated by PHQ-9 questionnaire, in patients attended at the outpatient clinic of internal medicine service at Hospital Nacional Hipolito Unanue. METHODS: Observational analytical cross-sectional study. Cardiometabolic disease was defined as the presence of diabetes mellitus, high blood pressure, dyslipidemia, and/or obesity. The PHQ-9 questionnaire was used to evaluate the presence of symptoms suggestive of depression. The association was evaluated crude and adjusted for possible confounders. For the multivariate analysis, a Poisson regression model was used to find prevalence ratios with their respective 95% confidence intervals. A p<0.05 was considered statistically significant. RESULTS: 252 patients were included, of which 205 (81,4%) presented cardiometabolic diseases and 181 (71,9%) presented symptoms consistent with some grade of depression. The presence of cardiometabolic diseases was associated with depressive symptoms both in the crude analysis (PRc 1.43; CI 95% 1.08-1.89; p=0.012) and in the adjusted one (PRa 1.31; CI 95% 1.00-1.71; p=0.048). Additionally, an association was found between female sex and depressive symptoms (PRa 1,35; CI 95% 1,11-1,63; p=0,002). CONCLUSIONS: The presence of cardiometabolic diseases was associated with the presence of depressive symptoms in patients seen at the outpatient clinic of internal medicine. The mental health approach should be an integral part of the multidisciplinary management for the patient with cardiometabolic disease.
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Cardiovascular Diseases/psychology , Cardiovascular Diseases/epidemiology , Metabolic Syndrome/psychology , Metabolic Syndrome/epidemiology , Depression/epidemiology , Peru , Cross-Sectional Studies , Multivariate Analysis , Surveys and Questionnaires , Diabetes Mellitus/psychology , Diabetes Mellitus/epidemiology , Dyslipidemias/psychology , Dyslipidemias/epidemiology , Hospitals , Hypertension/psychology , Hypertension/epidemiology , Obesity/psychology , Obesity/epidemiologyABSTRACT
RESUMEN Objetivo. Estimar el efecto de una intervención educativa basada en nutrición y estilos de vida saludables para incrementar la proporción de adolescentes libres de componentes del síndrome metabólico. Materiales y métodos. Se realizó un estudio preexperimental en una muestra representativa de adolescentes de dos escuelas de un distrito altoandino del Perú (ciudad de Cajamarca); 388 estudiantes completaron la intervención, así como la medición basal y la posintervención. La intervención tuvo nueve ejes temáticos, cada uno fue desarrollado en una sesión educativa de 45 min cada dos semanas. Se usó los criterios del National Cholesterol Education Program Expert Panel and Adult Treatment Panel III para el síndrome metabólico. Se realizó la comparación de proporciones pareadas (prueba de McNemar) para determinar el impacto de la intervención. Resultados. En la medición basal, el 20,4% (IC95%: 16,2 a 24,5) no tenía componentes de SM, posintervención dicha proporción se incrementó a 32,5% (IC95%: 27,7 a 37,3), la diferencia de proporciones fue 12,1% (IC95%: 7,5 a 16,8; p<0,001). La prevalencia de síndrome metabólico fue 4,6% (IC95%: 2,4 a 6,9) basalmente; posintervención fue 2,3% (IC95%: 0,7 a 3,9). La diferencia de proporciones fue 2,3%, (IC95%: 0,3 a 3,2; p=0,022). Entre los componentes, la mayor reducción fue en la proporción de hipertrigliceridemia (diferencia de proporciones: 21,9%, IC95%: 16,9 a 26,9; p<0,001), también se observó una reducción significativa de la hipertensión arterial (diferencia de proporciones: 3,1%, IC95%: 0,6 a 5,6; p=0,025). En los demás componentes no hubo diferencias significativas. Conclusiones. La intervención educativa incrementó en un 59,3% la proporción de estudiantes libres de algún componente del síndrome metabólico.
ABSTRACT Objective. To estimate the impact of a school-based nutritional and healthy lifestyle intervention to increase the proportions of adolescents free of components of the metabolic syndrome. Materials and methods. We conducted a pre-experimental study in a representative sample of adolescents from two schools in a high Andean district of Peru (Cajamarca city); 388 students completed the intervention and the baseline and post-intervention measurement. The intervention had nine thematic modules; each module was developed in an educational session of 45 minutes every two weeks. We used the National Cholesterol Education Program Expert Panel and Adult Treatment Panel III criteria for metabolic syndrome. We used paired proportions comparison (McNemar test) to determine the impact of the intervention. Results. At baseline, 20.4% (95% CI: 16.2 to 24.5) students had no metabolic syndrome components, post-intervention this proportion increased to 32,5% (95% CI: 27.7 to 37.3), the difference in proportions was 12.1% (95% CI: 7.5 to 16.8; p<0.001). The prevalence of metabolic syndrome was 4.6% (95% CI: 2.4 to 6.9) at baseline, while post-intervention was 2.3% (95%CI: 0.7 to 3.9). During the analysis of components, the greatest reduction was observed in the proportion of hypertriglyceridemia (difference in proportions: 21.9%, 95%CI: 16.9 to 26.9, p <0.001); we also found a significant reduction in arterial hypertension (difference in proportions: 3.1%, 95% CI: 0.6 to 5.6, p=0.025). In the other components, there were no significant differences. Conclusions. The school-based intervention increased in 59.3% the proportion of students free of any component of the metabolic syndrome.
Subject(s)
Humans , Male , Female , Food and Nutrition Education , Metabolic Syndrome , Healthy Lifestyle , Life Style , Primary Prevention , School Health Services , Schools , Adolescent , Andean EcosystemABSTRACT
Abstract Background: Vitiligo is an acquired and progressive mucocutaneous disease resulting from the loss of active epidermal melanocytes. Metabolic syndrome (MetS) affects about 25% of the world's population and is linked to inflammatory skin diseases including vitiligo. Fatty AcidBinding Protein 4 (FABP4) is an intracellular lipid chaperone. FABP4 is closely associated with MetS. Objectives: To evaluate the serum level of FABP4 in vitiligo patients and its relation to MetS in the investigated cases. Methods: This case control study was conducted on 45 patients having non segmental vitiligo and 45 matched controls. Their lipid profile, blood glucose and serum FABP4 levels were measured. Results: There were significant elevations in FABP4 (p < 0.001), cholesterol (p < 0.001), triglycerides (p = 0.005), and glucose (fasting [p = 0.001] and 2 hours post prandial [p < 0.001]) levels in patients in comparison with controls. MetS was significantly more prevalent among vitiligo patients (p < 0.001) and associated with high FABP4 serum levels (p = 0.037). In vitiligo patients, there were significant positive correlations between FABP4 serum levels and triglycerides (p = 0.047), cholesterol (p = 0.001) and LDL (p = 0.001) levels and negative correlation regarding HDL level (p = 0.009). FABP4 level was a significantly good diagnostic test for early detection of vitiligo (p < 0.001). Study limitations: The small number of studied subjects. Conclusions: FABP4 may play an active role in the disease process of vitiligo that could be mediated through associated dyslipidemia and hyperglycemia. FABP4 may be a marker of vitiligo helping in its early diagnosis, but it does not appear to be useful for determining vitiligo severity, activity or associated MetS.
Subject(s)
Humans , Metabolic Syndrome , Fatty Acid-Binding Proteins/blood , Triglycerides , Vitiligo , Case-Control StudiesABSTRACT
SUMMARY OBJECTIVE: The metabolic syndrome involves both metabolic and cardiovascular risk factors and is associated with cardiovascular mortality. Epicardial fat tissue plays a crucial role in deleterious effects of metabolic syndrome on the heart, including myocardial fibrosis. The fragmented QRS reflects heterogeneous depolarization of the myocardium and occurs as a result of fibrosis. Thus, we aimed to investigate whether there is an association between fragmented QRS and epicardial fat tissue in patients with metabolic syndrome. METHODS: This study enrolled 140 metabolic syndrome patients, of whom 35 patients with fragmented QRS (+) and 105 patients with fragmented QRS (−). The two groups were compared with respect to clinical, laboratory, electrocardiographic, and echocardiographic indexes. RESULTS: Fragmented QRS (+) patients had higher waist circumference, red cell distribution width, creatinine, left ventricular end-systolic diameter, left atrium diameter, septal a velocity, QRS duration, and epicardial fat tissue compared with fragmented QRS (−) patients. Waist circumference, red cell distribution width, QRS duration, left ventricular end-systolic diameter, left atrium diameter, septal a velocity, and epicardial fat tissue were significantly associated with the presence of fragmented QRS. The QRS duration and epicardial fat tissue were independently associated with the presence of fragmented QRS on surface electrocardiographic in metabolic syndrome patients. CONCLUSIONS: Epicardial fat tissue and QRS duration were independently associated with the presence of fragmented QRS. Basic echocardiographic and electrocardiographic parameters might be used for the risk stratification in metabolic syndrome patients.