Riesgo cardiovascular, dislipemias e indicación de estatinas en una población de obesos mórbidos

Introducción: La obesidad se relaciona con un riesgo cardiovascular (RCV) elevado. Esto nos obliga a tomar conductas terapéuticas y prevencionistas. El objetivo de este trabajo es evaluar el riesgo cardiovascular en una población de obesos mórbidos y valorar la correcta indicación de estatinas. Metodología: Estudio transversal, descriptivo, observacional, con la población obesos mórbidos del Programa de Obesidad y Cirugía Bariátrica (POCB) del Hospital Maciel, desde noviembre del 2014 a marzo del 2020. El RCV se valoró con la calculadora de la organización panamericana de la salud. La indicación de estatinas se consideró según RCV o diagnóstico de dislipemia. Resultados: Se analizaron 478 pacientes, el 84.3% fueron mujeres, la mediana para la edad fue de 44 años, y para el IMC 50 kg/m2. Se calculó un RCV bajo para el 57% de los pacientes; y alto o muy alto para un 37%. La prevalencia de las dislipemias fue 84,3%, a predominio de hipercolesterolemia (33,7%) y dislipemia aterogénica (19,5%). El 60.6% (290) de los pacientes presenta indicación de tratamiento con estatinas, solo el 38.9%. (113) las recibe. El 38.1% (43) alcanzan los objetivos terapéuticos. Conclusiones : La obesidad presenta múltiples comorbilidades que aumentan el RCV, aun así se encuentra subestimada por las calculadoras de riesgo. Queda en evidencia un infratratamiento farmacológico de estos pacientes, no logrando los objetivos terapéuticos propuestos.

Introduction: Obesity is related to a high cardiovascular risk (CVR). This forces us to take therapeutic and preventive behaviors. The objective of this work is to evaluate cardiovascular risk in a morbidly obese population and assess the correct indication of statins. Methodology: Cross-sectional, descriptive, observational study, with the morbidly obese population of the Obesity and Bariatric Surgery Program (POCB) of the Maciel Hospital, from November 2014 to March 2020. CVR was assessed with the calculator of the Pan-American health organization. The indication for statins was considered according to CVR or diagnosis of dyslipidemia. Results: 478 patients were analyzed, 84.3% were women, the median age was 44 years, and the BMI was 50 kg/m2. A low CVR was calculated for 57% of patients; and high or very high for 37%. The prevalence of dyslipidemia was 84.3%, with a predominance of hypercholesterolemia (33.7%) and atherogenic dyslipidemia (19.5%). 60.6% (290) of patients have an indication for treatment with statins, only 38.9%. (113) receives them. 38.1% (43) achieved therapeutic objectives. Conclusions: Obesity presents multiple comorbidities that increase CVR, yet it is underestimated by risk calculators. Pharmacological undertreatment of these patients is evident, not achieving the proposed therapeutic objectives.

Introdução : A obesidade está relacionada a um alto risco cardiovascular (RCV). Isso nos obriga a adotar comportamentos terapêuticos e preventivos. O objetivo deste trabalho é avaliar o risco cardiovascular em uma população com obesidade mórbida e avaliar a correta indicação de estatinas. Metodologia: Estudo transversal, descritivo, observacional, com a população com obesidade mórbida do Programa de Obesidade e Cirurgia Bariátrica (POCB) do Hospital Maciel, no período de novembro de 2014 a março de 2020. O RCV foi avaliado com a calculadora da organização pan-americana de saúde. A indicação de estatinas foi considerada de acordo com RCV ou diagnóstico de dislipidemia. Resultados: Foram analisados ​​478 pacientes, 84,3% eram mulheres, a mediana de idade foi de 44 anos e o IMC foi de 50 kg/m2. Um RCV baixo foi calculado para 57% dos pacientes; e alto ou muito alto para 37%. A prevalência de dislipidemia foi de 84,3%, com predomínio de hipercolesterolemia (33,7%) e dislipidemia aterogênica (19,5%). 60,6% (290) dos pacientes têm indicação de tratamento com estatinas, apenas 38,9%. (113) os recebe. 38,1% (43) alcançaram objetivos terapêuticos. Conclusões: A obesidade apresenta múltiplas comorbidades que aumentam o RCV, mas é subestimada pelas calculadoras de risco. É evidente o subtratamento farmacológico destes pacientes, não atingindo os objetivos terapêuticos propostos.

Impacto de la diabetes en el riesgo cardiovascular en pacientes con dislipidemia / Impact of diabetes on cardiovascular risk in patients with dyslipidemia

Resumen Objetivo: Determinar el impacto de la diabetes en el riesgo cardiovascular en pacientes con dislipidemia. Método: Estudio observacional, transversal y comparativo, en el que se determinó el riesgo cardiovascular en 100 pacientes con dislipidemia, de los cuales 50 eran diabéticos, sin complicaciones crónicas. Resultados: Ambos grupos tenían características similares en cuanto a edad, presión arterial, índice de masa corporal, niveles de c-HDL y c-LDL. Sin embargo, al comparar el porcentaje de riesgo cardiovascular, observamos que el grupo de diabéticos tenía casi el doble de riesgo cardiovascular, 13.7 contra 7.9 (p = 0.014), y la edad del corazón calculada también fue mayor en los pacientes con diabetes, 80 contra 66 años (p = 0.003). Incluso, en los pacientes diabéticos la diferencia entre la edad real y la edad del corazón fue mayor, 24 años contra 15 años (p = 0.000). Conclusión: Padecer diabetes y dislipidemia duplica el riesgo cardiovascular. En la población estudiada se encontró poco control metabólico, lo que aumenta significativamente las complicaciones en edades tempranas y la carga económica al sistema de salud y a las familias de los pacientes; por tanto, es necesario replantear las estrategias de tratamiento para mejorar el control metabólico y el pronóstico del paciente a largo plazo.

Abstract Objective: To determine the impact of diabetes on cardiovascular risk in patients with dyslipidemia. Method: Observational, cross-sectional and comparative study in which cardiovascular risk was determined at 10 years in 100 patients with dyslipidemia, of these, 50 non-diabetic patients and 50 diabetic patients. Results: Both groups had similar characteristics in terms of age, blood pressure figures, average body mass index, and HDL and LDL levels. It was observed that the diabetic group has almost double the risk compared to the dyslipidemia group, 13.7 vs. 7.9 (p = 0.014), and the calculated heart age is also higher in patients with diabetes, 80 vs. 66 years (p = 0.003). Even in patients with diabetes there is a greater difference between the real age and the age of the heart, 24 years vs. 15 years of patients without diabetes (p = 0.000). Conclusion: Having diabetes and dyslipidemia doubles the cardiovascular risk of patients. Little metabolic control was found in the population studied, which significantly increases complications at an early age and the economic burden on the health system and the families of patients, so it is necessary to rethink treatment strategies to improve metabolic control and with it the prognosis for the patient in the long term.

Caracterización del infarto agudo de miocardio con elevación del segmento st en pacientes atendidos en un centro de referencia. Periodo 2021-2023

Introducción: el riesgo de aparición del infarto agudo de miocardio está relacionada con varias comorbilidades, muchas de las cuales son prevenibles y tratables. El infarto agudo de miocardio tiene un impacto relevante en términos de mortalidad y número de hospitalizaciones. Objetivos: determinar las características clínica-epidemiológicas del infarto agudo de miocardio con elevación del segmento ST en pacientes atendidos en el Centro Médico Nacional-Hospital Nacional, durante el periodo 2021-2023. Metodología: el diseño del estudio fue observacional, descriptivo de corte transversal, sobre las características clínica-epidemiológicas del infarto agudo de miocardio con elevación del segmento ST en pacientes mayores de edad atendidos en el Centro Médico Nacional-Hospital Nacional, durante el periodo 2021-2023. Resultados: se analizaron 102 expedientes de pacientes con diagnóstico de infarto agudo de miocardio con elevación del segmento ST con una media de 64 ± 12 años; el 68 % (n = 69) correspondió al sexo masculino, con una edad promedio de 62 años, y en relación a las mujeres el promedio fue de 64 años. El motivo de consulta principal fue el dolor precordial y la cara miocárdica más afectada de acuerdo con el electrocardiograma inicial fue la cara anteroseptal. La mortalidad intrahospitalaria fue del 16 %, el 68 % correspondió a varones. La comorbilidad más frecuente fue la hipertensión arterial. Conclusión: La hipertensión arterial es la patología más prevalente. Asimismo, son habituales la obesidad, el tabaquismo y la diabetes mellitus. Las comorbilidades están en relación directa con la edad y prevalecen en mayores de 60 años. El infarto agudo de miocardio con elevación del segmento ST es más frecuente en el sexo masculino.

Introduction: the risk of acute myocardial infarction is related to several comorbidities, many of which are preventable and treatable. Acute myocardial infarction has a relevant impact in terms of mortality and number of hospitalizations. Objectives: the design of the study was observational, descriptive, cross-sectional, on the clinical characteristics of ST-segment elevation myocardial infarction, in adult patients treated at the Centro Médico Nacional-Hospital Nacional, during the period 2021-2023. Methodology: the design of the study was observational, descriptive, cross-sectional, on the clinical-epidemiological characteristics of acute myocardial infarction with ST segment elevation in adult patients treated at the National Medical Center-National Hospital, during the period 2021-2023. Results: 102 records of patients with a diagnosis of ST-segment elevation myocardial infarction with a mean age of 64 ± 12 years were analyzed; 68 % (n = 69) were male, with an average age of 62 years, and in relation to women the average was 64 years. The main reason for consultation was precordial pain and the most affected myocardial aspect according to the initial electrocardiogram was the anteroseptal aspect. In-hospital mortality was 16 %, 68 % of which were men. The most frequent comorbidity was arterial hypertension. Conclusion: high blood pressure is the most prevalent pathology. Likewise, obesity, smoking and diabetes mellitus are common. Comorbidities are directly related to age and prevail in those over 60 years of age. ST-segment elevation myocardial infarction is more common in males.

Analysis of the metabolic profile and comorbidities in women with endometriosis before and after surgical treatment / Análise do perfil metabólico e comorbidades em mulheres com endometriose antes e depois do tratamento cirúrgico

Aim: this study aimed to evaluate the effects of surgical treatment for endometriosis on the metabolic profile of women diagnosed with deep endometriosis. Methods: we conducted a prospective observational study with a sample of 30 women in the menacme diagnosed with deep endometriosis who underwent videolaparoscopic surgery in a reference center in Brazil between October 2020 and December 2021. A total of 30 women performed clinical and laboratory tests regarding their metabolic profile on two occasions, during preoperative tests and six months after video-laparoscopy. Results: patients had lower average levels of Total Cholesterol (TC), Low-Density Cholesterol (LDL-c), Triglycerides (TGC), and Fasting Glycemia (FG) after the surgical procedure. The average TC level was 8.2% lower after surgery, LDL-c was 12.8% lower, TGC was 10.9% lower, and FG was 7.3% lower. The results showed a statistically significant difference for all these parameters (p < 0.001). Conclusions: video-laparoscopy was associated with a favorable lipid profile compared to the preoperative lipid profile, with a significant improvement in the average levels of LDL-c, HDL-c, TC, TGC, and FG. Long-term follow-up studies are needed to determine whether surgical treatment for endometriosis can improve the metabolic parameters of women with endometriosis and favor a lower predisposition to atherogenesis.

Objetivo: Aeste estudo teve como objetivo avaliar os efeitos do tratamento cirúrgico da endometriose no perfil metabólico de mulheres com diagnóstico de endometriose profunda. Métodos: foi realizado um estudo observacional prospectivo com uma amostra de 30 mulheres na menacme, com diagnóstico de endometriose profunda, que foram submetidas à videolaparoscopia em um centro de referência no Brasil, entre outubro de 2020 e dezembro de 2021. As mulheres realizaram exames clínicos e laboratoriais quanto ao seu perfil metabólico em duas ocasiões, durante exames pré-operatórios e seis meses após a videolaparoscopia. Resultados: as pacientes apresentaram níveis médios mais baixos de Colesterol Total (CT), Colesterol de Baixa Densidade (LDL-c), Triglicerídeos (TGC) e Glicemia de Jejum (GJ) após o procedimento cirúrgico. O nível médio de CT foi 8,2% menor após a cirurgia, o LDL-c foi 12,8% menor, o TGC foi 10,9% menor e a GJ foi 7,3% menor. Os resultados mostraram diferença estatisticamente significativa para todos esses parâmetros (p < 0,001). Conclusões: a videolaparoscopia foi associada a um perfil lipídico favorável em comparação ao perfil lipídico pré-operatório, com melhora significativa nos níveis médios de LDL-c, HDL-c, CT, TGC e GJ. Estudos de acompanhamento a longo prazo são necessários para determinar se o tratamento cirúrgico da endometriose pode melhorar os parâmetros metabólicos de mulheres com endometriose e favorecer uma menor predisposição à aterogênese.

Riesgo cardiovascular en pacientes con esclerosis sistémica / Cardiovascular Risk in Patients with Systemic Sclerosis

Introducción: El riesgo cardiovascular es importante en la evaluación de los pacientes con esclerosis sistémica. Objetivo: Determinar el riesgo cardiovascular en pacientes con esclerosis sistémica. Métodos: Se realizó un estudio transversal y descriptivo en pacientes protocolizados del Servicio de Reumatología, en el período de enero 2020 a enero 2022. Se recogieron variables demográficas, clínicas, y se aplicó la calculadora de riesgo cardiovascular Framingham. Resultados: Se incluyeron 105 pacientes con edad media de 48,6 ± 15,3 años, el grupo más frecuente de 50 a 59 años (36,2 por ciento), predominó el sexo femenino 92,2 por ciento el color de piel blanca (74,3 por ciento), el tiempo de evolución fue mayor a 5 años (66,7 por ciento) con una media de 10,5 ± 9,3. El valor promedio de la escala de gravedad modificada de Medsger fue 5,1 ± 2,7 y el 72,4 por ciento con afectación leve. El fenómeno de Raynaud y la fibrosis pulmonar fueron más frecuentes con un 89,5 por ciento y 55,2 por ciento. El índice de Rodnan en promedio fue de 13,1 ± 8,0 y los reactantes de fase aguda normales en la mayoría. Los factores de riesgo cardiovascular más frecuentes fueron la HTA (30,2 por ciento) y dislipidemia (19,9 por ciento). El índice de masa corporal que predominó fue de peso adecuado (54,3 por ciento). Predominó el riesgo cardiovascular bajo según score de Framingham (86 por ciento). Existieron diferencias significativas entre las medias del tiempo de evolución y el riesgo cardiovascular (10 ± 6,9 frente a 9,6 ± 8,8 frente a 16,9 ± 10,8; p = 0,032). Conclusiones: El riesgo cardiovascular en los pacientes con esclerosis sistémica fue bajo(AU)

Introduction: Cardiovascular risk is important in the evaluation of patients with systemic sclerosis. Objective: To determine the cardiovascular risk in patients with systemic sclerosis. Methods: A cross-sectional and descriptive study was carried out in protocolized patients of Rheumatology Service, from January 2020 to January 2022. Demographic and clinical variables were collected, and Framingham cardiovascular risk calculator was used. Results: One hundred five patients were included with a mean age of 48.6 ± 15.3 years, the most frequent group was 50 to 59 years (36.2percent), female sex (92.2percent) predominated, as well as white skin color (74.3percent). The evolution time was greater than 5 years (66.7percent) with a mean of 10.5 ± 9.3. The average value of modified Medsger severity scale was 5.1 ± 2.7 and 72.4percent had mild involvement. Raynaud's phenomenon and pulmonary fibrosis were more common at 89.5percent and 55.2percent. Rodnan index on average was 13.1 ± 8.0 and the acute phase reactants were normal in the majority. The most frequent cardiovascular risk factors were HBP (30.2percent) and dyslipidemia (19.9percent). The predominant body mass index was adequate weight (54.3percent). Low cardiovascular risk according to Framingham score prevailed (86percent). There were significant differences between the mean duration of evolution and cardiovascular risk (10 ± 6.9 vs. 9.6 ± 8.8 vs. 16.9 ± 10.8; p = 0.032). Conclusions: The cardiovascular risk in patients with systemic sclerosis was low(AU)

Enfermedades asociadas e indicadores metabólicos en personas con esquizofrenia / Associated Diseases and Metabolic Indicators in Schizophrenic Individuals

La esquizofrenia es una enfermedad que está caracterizada por su complejidad psicopatológica agravada por una frecuente asociación de enfermedades físicas como la obesidad, la intolerancia a la glucosa, la diabetes y la dislipidemia. Además, indicadores metabólicos como la glucemia, el colesterol y los triglicéridos en sangre, así como la obesidad, tienen relevancia en estos pacientes, según lo planteado en la literatura especializada sobre el tema. Por otra parte, las enfermedades físicas asociadas como los indicadores metabólicos, tienen su impacto en el sistema nervioso central con independencia de la esquizofrenia. La suma de los trastornos mentales y físicos implica la necesidad de atender ambos problemas simultáneamente y se recomienda la intervención interdisciplinaria. El protocolo de actuación para la atención de los pacientes con esquizofrenia y psicosis relacionadas en el Hospital Clínico Quirúrgico Hermanos Ameijeiras es un ejemplo del abordaje señalado(AU)

Schizophrenia is a disease characterized by a psychopathological complexity, aggravated by frequent association of physical diseases such as obesity, glucose intolerance, diabetes and dyslipidemia. In addition, there are other metabolic indicators such as blood glucose, cholesterol and triglycerides which are relevant in these patients, and the international literature has been suggested so. On the other hand, both associated physical diseases and metabolic indicators have their impact on the central nervous system in addition to schizophrenia. The sum of mental and physical disorders implies the need to address both problems simultaneously, which is why interdisciplinary intervention is recommended. Hermanos Ameijeiras Clinical Surgical Hospital is an example of the action protocol for patients with schizophrenia and psychosis(AU)

Management of hypertension and dyslipidemia in Mexico: evidence, gaps, and approach / Manejo de la hipertensión y dislipidemia en México: evidencia, brechas y aproximaciones

Abstract Hypertension and dyslipidemia are key risk factors for cardiovascular disorders and mortality worldwide. To understand the local health system challenges faced in the management of the two conditions, a semi-systematic approach was adopted for quantifying stages of the journey of care of adult Mexican patients, namely, awareness, screening, diagnosis, treatment, adherence, and control. A structured literature search was conducted for articles published in English from 2010 to 2019 in EMBASE and MEDLINE databases. The articles restricted to patient subgroups, or not having national representativeness, thesis abstracts, letters to the editor, editorials, or case studies were excluded. In addition, an unstructured unrestricted literature search was conducted, on websites of Incidence and Prevalence Database, World Health Organization, Country's Ministry of Health, and Google. Last search was run on 28 August 2020 for Hypertension and 12 November 2019 for Dyslipidemia. Weighted or simple means were calculated for the pooled data. Seven articles of 647 retrievals for hypertension and 11 articles of 1265 retrievals for dyslipidemia were included in the review. The prevalence of hypertension was estimated to be 24.1%, while 59.9% of patients had awareness, 97.5% underwent screening, 18.4% had diagnosis, 50% received treatment, 50% were adherent to treatment, and 49.9% had disease control. Prevalence of dyslipidemia was estimated as 36.7%, while 8.6% of patients had awareness, 48.1% underwent screening, 28% had diagnosis, 68.9% received treatment, 50% were adherent to treatment, and 30% had disease control. The study suggested that addressing the synergistic effect of hypertension and dyslipidemia could reduce cardiovascular risk associated with these conditions.

Resumen La hipertensión y la dislipidemia -especialmente la hipercolesterolemia- son factores de riesgo cardiovascular que impactan directamente en la prevalencia e incidencia de enfermedades cardiovasculares en todo el mundo y México no es la excepción. Para comprender los desafíos que enfrenta el sistema de salud de nuestro país, especialmente en lo relacionado con el diagnóstico, tratamiento y control de los factores de riesgo cardiovascular mencionados, realizamos un análisis semi-sistemático de la literatura con el objetivo de evaluar las fases del proceso de atención de pacientes adultos mexicanos en lo relacionado con el conocimiento, detección, diagnóstico, tratamiento, adherencia y control de hipertensión y dislipidemia. Se llevó a cabo una investigación bibliográfica semi-sistemática de los artículos publicados en inglés del año 2010 al año 2019; las bases de datos exploradas fueron EMBASE y MEDLINE. Se excluyeron del análisis los artículos sin representatividad nacional, así como los resúmenes de tesis, cartas al editor, editoriales o estudios de casos. Además, se realizó una búsqueda bibliográfica sin restricciones, en los sitios Web de las bases de datos sobre Incidencia y Prevalencia, Organización Mundial de la Salud, Secretaría de Salud de México y Google. La última búsqueda sobre hipertensión se realizó el 28 de agosto del 2020 y sobre dislipidemia el 12 de noviembre del 2019. Se calcularon las medias ponderadas o simples para la recolección de datos. En la revisión, se incluyeron 7 artículos de 647 sobre hipertensión y 11 artículos de 1,265 sobre dislipidemia. Se estimó que la prevalencia de hipertensión en México es de 24.1%; 97.5% de la población reportó haber sido sometida a alguna prueba de detección; 59.9% tuvo conocimiento del diagnóstico; 18.4 % se reconocen con hipertensión; 50% reciben tratamiento; 50% es adherente al mismo, y finalmente solo un 49.9 % tienen control de la hipertensión. Se estimó que la prevalencia de dislipidemia en México es de 36.7%; 48.1% de la población reportó haber sido sometida a alguna prueba de detección; 8.6% tuvo conocimiento del diagnóstico; 28% se conocen con dislipidemia; 68.9% reciben tratamiento; 50% es adherente al mismo, y finalmente solo 30% tuvo control de la dislipidemia. La evidencia revisada hace evidente una gran área de oportunidad para mejorar los índices de diagnóstico, tratamiento y control de estos dos factores sinérgicos para el riesgo de enfermedades cardiovasculares.

Riscos de infecção por SARS-CoV-2 e COVID-19 em mulheres com síndrome dos ovários policísticos / Risks of SARS-CoV-2 and COVID-19 infection in women with polycystic ovary syndrome

Esta revisão narrativa teve como objetivo avaliar possíveis riscos da associação entre a infecção por SARS-CoV-2 (causa da COVID-19) e as características metabólicas e endócrinas frequentemente encontradas em mulheres com a síndrome dos ovários policísticos (SOP). A COVID-19 é mais grave em indivíduos com obesidade, diabetes mellitus, dislipidemia e hipertensão arterial. Como essas condições são comorbidades comumente associadas à SOP, foi hipotetizado que mulheres com SOP teriam maior risco de adquirir COVID-19 e desenvolver formas clínicas mais graves da doença. Considerando vários estudos epidemiológicos, a presente revisão mostra que mulheres com SOP têm risco 28% a 50% maior de serem infectadas pelo vírus SARS-CoV-2 em todas as idades e que, nessas mulheres, a COVID-19 está associada a maiores taxas de hospitalização, morbidade e mortalidade, especialmente naquelas com alterações no metabolismo de carboidratos e lipídios, hiperandrogenemia e aumento do tecido adiposo visceral. Os mecanismos que explicam o maior risco de infecção por COVID-19 em mulheres com SOP são considerados.(AU)

Utilidad de los índices aterogénicos del perfil lipídico en el diagnóstico de aterosclerosis subclínica / Utility of the atherogenic indices of the lipid profile in the diagnosis of subclinical atherosclerosis

Introducción: Los índices aterogénicos hacen referencia a un conjunto de indicadores bioquímicos que a partir de la relación entre variables lipídicas permiten predecir el riesgo de daño aterosclerótico. Objetivo: Evaluar la utilidad de los índices aterogénicos en el diagnóstico de aterosclerosis subclínica en pacientes con dislipidemia. Métodos: Se realizó un estudio descriptivo en 812 pacientes con diagnóstico clínico de dislipidemia en el Hospital Clínico Quirúrgico Hermanos Ameijeiras, en el período 2015-2020. Resultados: La edad media de los pacientes fue de 56,79 ± 10,24 años, predominó el grupo de 60 y más años con un 40,9 por ciento y el sexo femenino para un 73,8 por ciento. El 61,2 por ciento de los pacientes tienen presente algún tipo de obesidad. La presencia de HTA y el consumo de tabaco afectan el 52 por ciento y 24,6 por ciento de la población estudiada. El 74,8 por ciento (607 casos) fue clasificado como riesgo cardiovascular medio según los criterios de Framingham, mientras que el 12,9 por ciento fue clasificado como riesgo alto. Se identificaron 323 (39,8 por ciento) pacientes con presencia de aterosclerosis subclínica. Las diferencias de los valores medios de los índices aterogénicos entre los grupos con presencia de aterosclerosis subclínica fueron estadísticamente significativas para los índices cCtotal/ cHDL y cLDL/cHDL (p<0,05). En el análisis multivariado los índices asociados al riesgo de presentar aterosclerosis subclínica fueron la relación cCtotal/cHDL (R=1,11) y cLDL/cHDL (R=1,12) (p<0,05). Conclusiones: Los índices aterogénicos son de utilidad en el diagnóstico de aterosclerosis subclínica, los cocientes cCtotal/cHDL y cLDL/cHDL son los que están asociados significativamente con la probabilidad de presentar daño aterosclerótico carotideo(AU)

Introduction: Atherogenic indices refer to a set of biochemical indicators that, based on the relationship between lipid variables, allow predicting the risk of atherosclerotic damage. Objective: To evaluate the usefulness of atherogenic indices in the diagnosis of subclinical atherosclerosis in patients with dyslipidemia. Methods: A descriptive study was carried out in 812 patients with clinical diagnosis of dyslipidemia at Hermanos Ameijeiras Surgical Clinical Hospital, from 2015 to 2020. Results: The mean age of the patients was 56.79 ± 10.24 years, the group of 60 and over predominated with 40.9percent and the female sex with 73.8percent. Some type of obesity was present in 61.2percent of the patients. The presence of hypertension and tobacco consumption affect 52percent and 24.6percent of the population studied, respectively. 74.8percent (607 cases) were classified as medium cardiovascular risk according to Framingham criteria, while 12.9percent were classified as high risk. Three hundred twenty three (39.8percent) patients with subclinical atherosclerosis were identified. The differences in the mean values of the atherogenic indices between the groups with subclinical atherosclerosis were statistically significant for the total C/HDLc and LDLc/HDLc indices (p<0.05). In the multivariate analysis, the indices associated with the risk of subclinical atherosclerosis were the ratio of Total C/HDLc (R=1.11) and LDLc/HDLc (R=1.12) (p<0.05). Conclusions: The atherogenic indices are useful in the diagnosis of subclinical atherosclerosis; cCtotal/cHDL and cLDL/cHDL ratios are those that are significantly associated with the probability of carotid atherosclerotic damage(AU)

Relación de riesgo entre dislipidemia y COVID-19 / Risk relationship between dyslipemia and COVID-19

La presencia de dislipidemia en pacientes con la COVID-19 parece agravar el curso clínico de la enfermedad. En esta revisión bibliográfica se describen los principales mecanismos que las vinculan y sus implicaciones en el tratamiento de los pacientes afectados. Para realizar este trabajo se efectuó una búsqueda bibliográfica en bases de datos, tales como Google académico, SciELO, Annual Reviews y PMC. Los descriptores analizados fueron COVID-19, SARS-CoV-2, dislipidemia, LDL-colesterol, HDL-colesterol, triglicéridos, hipercolesterolemia y lipoproteínas VLDL. Se revisaron preferentemente artículos de revistas arbitradas por pares y disponibles a texto completo, publicados en inglés y español. A pesar de las controversias, la dislipidemia es un factor de riesgo de pronóstico desfavorable en afectados con la COVID-19 y el tratamiento para los pacientes con esa condición desfavorable mejora dicho pronóstico.

The presence of dyslipemia in patients with COVID-19 seems to increase the clinical course of the disease. In this literature review the main mechanisms that link them and their implications in the treatment of the affected patients are described. To carry out this work a literature search was made in databases, such as academic Google, SciELO, Annual Reviews and PMC. The analyzed describers were COVID-19, SARS-CoV-2, dyslipemia, LDL-cholesterol, HDL-cholesterol, triglycerides, hypercholesterolemia and VLDL lipoproteins. Articles of magazines arbitrated by pairs and available to complete text, published in English and Spanish were preferably revised. In spite of the controversies, dyslipemia is a risk factor of unfavorable prognosis in patients affected with COVID-19 and the treatment for the patients with that unfavourable condition improve this prognosis.

Frecuencia de Síndrome Metabólico y sus componentes en pacientes jóvenes del ambulatorio de la Primera Cátedra de Clínica Médica del Hospital de Clínicas / Frequency of Metabolic Syndrome and its components in young patients of the Ambulatory Care of the First Department of Internal Medicine, Clínicas Hospital

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.

Criterios predictores en el diagnóstico de la hipercolesterolemia familiar / Predictive criteria in the diagnosis of familial hypercholesterolemia

Introducción: La hipercolesterolemia familiar es una enfermedad con alta prevalencia, no tratada acorta la esperanza de vida, por lo que el diagnóstico a edades tempranas resulta fundamental. Las pruebas genéticas constituyen el gold standard para el diagnóstico de hipercolesterolemia familiar, sin embargo, la no disponibilidad del test genético no debe constituir un impedimento para la adecuada conducta en estos casos. Objetivo: Identificar criterios clínicos predictores en el diagnóstico por pesquisa de la hipercolesterolemia familiar. Métodos: Se realizó un estudio descriptivo prospectivo a partir de una muestra de 393 pacientes (casos índices) de HF en el Hospital Clínico Quirúrgico Hermanos Ameijeiras; durante el período 2008-2018. Resultados: En la pesquisa familiar fueron identificados 177 (15,66 por ciento) nuevos casos de hipercolesterolemia familiar, de ellos se clasifican como casos positivos 35 (19,77 por ciento), casos probables 58 (32,77 por ciento) y casos posibles 84 (47,46 por ciento). Las categorías del estrato Make early diagnosis to prevent early death MEDPED y la edad del caso índice resultaron ser las variables clínicas de interés con mayor probabilidad para identificar nuevos casos de hipercolesterolemia familiar. Conclusiones: los criterios clínicos estandarizados de la escala make early diagnosis to prevent early death P y la edad del caso índice resultaron ser indicadores predictivos de gran valor para identificar y estratificar casos con variantes fenotípicas de hipercolesterolemia familiar(AU)

Introduction: Familial hypercholesterolemia is a disease with high prevalence; it shortens life expectancy if it is not treated, so early diagnosis is essential. Genetic tests are the gold standard for the diagnosis of familial hypercholesterolemia, however, the unavailability of the genetic test should not be an obstacle to proper conduct in these cases. Objective: To identify predictive clinical criteria in the diagnosis by screening of familial hypercholesterolemia. Methods: A prospective descriptive study was carried out from a sample of 393 patients (index cases) of FH at Hermanos Ameijeiras Surgical Clinical Hospital from 2008 to 2018. Results: In the family investigation, 177 (15.66 percent) new cases of familial hypercholesterolemia were identified, 35 of them (19.77 percent) are classified as positive cases, 58 (32.77 percent) as probable cases and 84 as possible cases (47.46 percent)The stratum categories of Make Early Diagnosis to Prevent Early Death (MEDPED) and the age of the index case turned out to be the clinical variables of interest with the greatest probability to identify new cases of familial hypercholesterolemia. Conclusions: The standardized clinical criteria of the make early diagnosis to prevent early death P scale and the age of the index case turned out to be highly valuable predictive indicators to identify and stratify cases with phenotypic variants of familial hypercholesterolemia(AU)

Anthropometric markers of abdominal adiposity and its relation to dyslipidemia and insulin resistance among overweight/obese schoolchildren and adolescents / Marcadores antropométricos de adiposidade abdominal e sua relação com dislipidemia e resistência à insulina em escolares e adolescentes com sobrepeso/obesidade

Objective: to assess the relationship between anthropometric indicators and laboratorial markers of cardiovascular risk in overweight/obese children and adolescents, in order to verify whether any anthropometric indicator has a better potential for use in screening cardiovascular risk in the population. Method: retrospective cross-sectional study enrolling 237 individuals aged 7 to 18 years. Body mass index (BMI), waist circumference (WC), waist circumference/height index (WC/H), glucose, HOMA-IR, total cholesterol (TC), LDL, HDL, triglycerides and TC/HDL and LDL/HDL indexes were obtained. Associations between anthropometric and laboratory markers were tested in contingency tables using the chi-square test. Correlations were tested by Spearman's correlation. Results: higher WC (Freedman cutoffs) was associated with lower levels of HDL and higher score in the TC/HDL and LDL/HDL indexes, but, using +2 z-scores as the cutoff, there were associations with low HDL and higher HOMA-IR. WC/H indicator (0.5 cutoff) was not associated with any of the outcomes, but, using +2 z-scores, an association was found with HOMA-IR. Z-scores of WC, WC/H and BMI showed positive correlation with HOMA-IR, TC/HDL and HOMA-IR, respectively. Negative correlations were found between WC and WC/H z-scores with HDL. WC and WC/H z-score were related to changes in HDL and HOMA-IR. Conclusions: there seems to be an advantage in using WC alone as a possible predictor of dyslipidemia and insulin resistance in children and adolescents. It is not possible to state that WC, WC/H or BMI measurements differ in their abilities to identify Brazilian children and adolescents with risk factors for cardiovascular diseases (AU)

Objetivo: avaliar a relação entre indicadores antropométricos e marcadores laboratoriais de risco cardiovascular em crianças e adolescentes com sobrepeso / obesidade, a fim de verificar se algum indicador antropométrico tem melhor potencial para uso no rastreamento de risco cardiovascular na população. Método: estudo transversal retrospectivo com 237 indivíduos com idades entre 7 e 18 anos. Índice de massa corporal (IMC), circunferência da cintura (CC), índice de circunferência da cintura / altura (CC / H), glicose, HOMA-IR, colesterol total (CT), LDL, HDL, triglicerídeos e índices CT/HDL e LDL/HDL foram obtidos. As associações entre marcadores antropométricos e laboratoriais foram testadas em tabelas de contingência por meio do teste do qui-quadrado. As correlações foram testadas pela correlação de Spearman. Resultados: CC mais elevado (pontos de corte de Freedman) foi associado a níveis mais baixos de HDL e maior pontuação nos índices TC/HDL e LDL/HDL, mas, usando +2 escores z como ponto de corte, houve associações com HDL baixo e HOMA-IR mais alto. O indicador CC/H (0,5 ponto de corte) não foi associado a nenhum dos desfechos, mas, usando +2 escores z, foi encontrada associação com o HOMA-IR. Os escores Z de CC, CC/E e IMC mostraram correlação positiva com HOMA-IR, TC/HDL e HOMA-IR, respectivamente. Correlações negativas foram encontradas entre CC e escores z de CC/H com HDL. CC e escore z de CC/H foram relacionados a mudanças em HDL e HOMA-IR. Conclusões: parece haver vantagem em usar a CC isoladamente como possível preditor de dislipidemia e resistência à insulina em crianças e adolescentes. Não é possível afirmar que as medidas de CC, CC/E ou IMC diferem na capacidade de identificar crianças e adolescentes brasileiros com fatores de risco para doenças cardiovasculares (AU)

Asociación entre enfermedades cardiometabólicas y depresión en un hospital de referencia peruano / Association between cardiometabolic diseases and depression in a Peruvian reference hospital

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.

Anthropometric markers of abdominal adiposity and its relation to dyslipidemia and insulin resistance among overweight/obese schoolchildren and adolescents / Marcadores antropométricos de adiposidade abdominal e sua relação com dislipidemia e resistência à insulina em escolares e adolescentes com sobrepeso/obesidade

ABSTRACT: Objective: to assess the relationship between anthropometric indicators and laboratorial markers of cardiovascular risk in overweight/obese children and adolescents, in order to verify whether any anthropometric indicator has a better potential for use in screening cardiovascular risk in the population. Method: retrospective cross-sectional study enrolling 237 individuals aged 7 to 18 years. Body mass index (BMI), waist circumference (WC), waist circumference/height index (WC/H), glucose, HOMA-IR, total cholesterol (TC), LDL, HDL, triglycerides and TC/HDL and LDL/HDL indexes were obtained. Associations between anthropometric and laboratory markers were tested in contingency tables using the chi-square test. Correlations were tested by Spearman's correlation. Results: higher WC (Freedman cutoffs) was associated with lower levels of HDL and higher score in the TC/HDL and LDL/HDL indexes, but, using +2 z-scores as the cutoff, there were associations with low HDL and higher HOMA-IR. WC/H indicator (0.5 cutoff) was not associated with any of the outcomes, but, using +2 z-scores, an association was found with HOMA-IR. Z-scores of WC, WC/H and BMI showed positive correlation with HOMA-IR, TC/HDL and HOMA-IR, respectively. Negative correlations were found between WC and WC/H z-scores with HDL. WC and WC/H z-score were related to changes in HDL and HOMA-IR. Conclusions: there seems to be an advantage in using WC alone as a possible predictor of dyslipidemia and insulin resistance in children and adolescents. It is not possible to state that WC, WC/H or BMI measurements differ in their abilities to identify Brazilian children and adolescents with risk factors for cardiovascular diseases. (AU)

RESUMO:Objetivo: avaliar a relação entre indicadores antropométricos e marcadores laboratoriais de risco cardiovascular em crianças e adolescentes com sobrepeso / obesidade, a fim de verificar se algum indicador antropométrico tem melhor potencial para uso no rastreamento de risco cardiovascular na população. Método: estudo transversal retrospectivo com 237 indivíduos com idades entre 7 e 18 anos. Índice de massa corporal (IMC), circunferência da cintura (CC), índice de circunferência da cintura / altura (CC / H), glicose, HOMA-IR, colesterol total (CT), LDL, HDL, triglicerídeos e índices CT/HDL e LDL/HDL foram obtidos. As associações entre marcadores antropométricos e laboratoriais foram testadas em tabelas de contingência por meio do teste do qui-quadrado. As correlações foram testadas pela correlação de Spearman. Resultados: CC mais elevado (pontos de corte de Freedman) foi associado a níveis mais baixos de HDL e maior pontuação nos índices TC/HDL e LDL/HDL, mas, usando +2 escores z como ponto de corte, houve associações com HDL baixo e HOMA-IR mais alto. O indicador CC/H (0,5 ponto de corte) não foi associado a nenhum dos desfechos, mas, usando +2 escores z, foi encontrada associação com o HOMA-IR. Os escores Z de CC, CC/E e IMC mostraram correlação positiva com HOMA-IR, TC/HDL e HOMA-IR, respectivamente. Correlações negativas foram encontradas entre CC e escores z de CC/H com HDL. CC e escore z de CC/H foram relacionados a mudanças em HDL e HOMA-IR. Conclusões: parece haver vantagem em usar a CC isoladamente como possível preditor de dislipidemia e resistência à insulina em crianças e adolescentes. Não é possível afirmar que as medidas de CC, CC/E ou IMC diferem na capacidade de identificar crianças e adolescentes brasileiros com fatores de risco para doenças cardiovasculares. (AU)

Dislipidemias en pacientes diabéticos internados en el Hospital Vicente Corral Moscoso / Dyslipidemias in diabetic patients hospitalized at the Vicente Corral Moscoso Hospital / Dislipidemias em doentes diabéticos hospitalizados no Hospital Vicente Corral Moscoco

La Diabetes Mellitus tipo 2 como una enfermedad endocrino metabólica puede generar alteraciones importantes en el perfil lipídico del paciente, por tanto, un importante riesgo cardiovascular. OBJETIVO: caracterizar las dislipidemias en pacientes diabéticos internados en el área de clínica del Hospital Vicente Corral Moscoso de Cuenca durante el año 2019. MATERIALES Y MÉTODOS: investigación cuantitativa, no experimental, transversal, observacional de tipo descriptivo y documental, de 137 pacientes diabéticos. Se analizaron variables sociodemográficas, cuantificación del lipidograma, HbA1c, IMC, adherencia al tratamiento, años de diagnóstico, tipo de tratamiento, presencia de hipotiroidismo e hipertensión. Se realizó análisis de frecuencias, medidas de tendencia central, chi cuadrado, Odds ratio y Riesgo Relativo. Para los análisis se consideró p<0,05. Resultados. La media de edad fue de 65,73±15,11 años, correspondiendo al grupo etario adulto mayor; con predominio de mujeres. Alrededor del 46% presentaban IMC normal y 52,2% obesidad y sobrepeso. El 51% tenía tiempo de diagnóstico menor o igual a 10 años. El 76,7% de pacientes presentaron dislipidemia, 43,6% hipercolesterolemia, 57,9% hipertrigliceridemia; 60,9% disminución de HDL; 50,4% valores elevados de LDL; y 74,4% VLDL elevado. El 83,3% de pacientes presentaron hemoglobina glicosilada elevada, con falta de adherencia al tratamiento del 66,2%. CONCLUSIÓN: los pacientes diabéticos presentan dentro del transtorno metabólico dislipidemias, con hipertrigliceridemia mantenida, hipercolesterolemia, disminución de HDL y aumento de LDL. La asociación de dislipidemias con la hemoglobina glicosilada la convierte en un valor predictor de presentar enfermedades cardiovasculares.

Diabetes Mellitus type 2 as an endocrine metabolic disease can generate important alterations in the lipid profile of the patient, therefore, an important cardiovascular risk. OBJECTIVE: to characterize dyslipidemias in diabetic patients hospitalized in the clinical area of the Vicente Corral Moscoso Hospital of Cuenca during 2019. MATERIALS AND METHODS: quantitative, non-experimental, cross-sectional, observational, descriptive and documentary research of 137 diabetic patients. Sociodemographic variables, lipidogram quantification, HbA1c, BMI, adherence to treatment, years of diagnosis, type of treatment, presence of hypothyroidism and hypertension were analyzed. Frequency analysis, measures of central tendency, chi-square, Odds ratio and Relative Risk were performed. For the analyses, p<0.05 was considered. RESULTS: the mean age was 65.73±15.11 years, corresponding to the older adult age group; with a predominance of women. About 46% had normal BMI and 52.2% had obesity and overweight. Fifty-one percent of the patients had been diagnosed less than or equal to 10 years. 76.7% of patients presented dyslipidemia, 43.6% hypercholesterolemia, 57.9% hypertriglyceridemia; 60.9% decreased HDL; 50.4% elevated LDL values; and 74.4% elevated VLDL. A total of 83.3% of patients had elevated glycosylated hemoglobin, with a lack of adherence to treatment of 66.2%. CONCLUSIONS: diabetic patients present dyslipidemias within the metabolic disorder, with maintained hypertriglyceridemia, hypercholesterolemia, decreased HDL and increased LDL. The association of dyslipidemia with glycosylated hemoglobin makes it a predictor of cardiovascular disease.

Diabetes Mellitus tipo 2 como doença endócrino-metabólica pode gerar alterações importantes no perfil lipídico do paciente, portanto, um risco cardiovascular importante. OBJETIVO: caracterizar dislipidemias em pacientes diabéticos internados na área clínica do Hospital Vicente Corral Moscoso em Cuenca durante 2019. MATERIAIS E MÉTODOS: pesquisa quantitativa, não-experimental, transversal, observacional, descritiva e documental de 137 pacientes diabéticos. Foram analisadas variáveis sociodemográficas, quantificação lipidográfica, HbA1c, IMC, aderência ao tratamento, anos de diagnóstico, tipo de tratamento, presença de hipotireoidismo e hipertensão. Foram realizadas análises de freqüência, medidas de tendência central, qui-quadrado, razão de chances e risco relativo. P<0,05 foi considerado para as análises. RESULTADOS: a idade média foi de 65,73±15,11 anos, correspondendo à faixa etária dos adultos mais velhos; com predomínio das mulheres. Cerca de 46% tinham um IMC normal e 52,2% eram obesos ou acima do peso. Cinqüenta e um por cento haviam sido diagnosticados menos ou igual a 10 anos antes do diagnóstico. 76,7% dos pacientes apresentavam dislipidemia, 43,6% hipercolesterolemia, 57,9% hipertrigliceridemia; 60,9% diminuíram o HDL; 50,4% elevaram os valores de LDL; e 74,4% elevaram o VLDL. 83,3% dos pacientes tinham hemoglobina glicosilada elevada, com 66,2% de não aderência ao tratamento. CONCLUSÃO: os pacientes diabéticos apresentam dislipidemias dentro do distúrbio metabólico, com hipertrigliceridemia sustentada, hipercolesterolemia, diminuição do HDL e aumento do LDL. A associação de dislipidemia com a hemoglobina glicosilada faz dela um preditor de doenças cardiovasculares.

Perfil Lipídico como factor de riesgo de Preeclampsia en mujeres embarazadas / Lipid profile as a risk factor for preeclampsia in pregnant women / rfil lipídico como fator de risco para pré-eclâmpsia em gestantes

La preeclampsia es una complicación del embarazo, cuya prevalencia se calcula entre 4 y 7% de los embarazos en el mundo. En Ecuador los trastornos hipertensivos fueron causantes del 20,6% de mortalidad materna (años 2017-2018). De allí la importancia de estudios de su diagnóstico oportuno. OBJETIVO: asociar el perfil lipídico como factor de riesgo en el padecimiento de preeclampsia de mujeres embarazadas que acudieron al Hospital Sagrado Corazón de Jesús, durante los años 2020-2021. MATERIALES Y MÉTODOS: el tipo de diseño utilizado para la investigación, en una población de 300 embarazadas, fue no experimental, documental, de cohorte, observacional, correlacional y cuantitativo. En el análisis de diferencias significativas entre variables categóricas se usó la prueba Chi cuadrado. Para calcular la relación el padecimiento de Preeclampsia o no en el embarazo con las variables que conforman el perfil lipídico se usó la técnica U de Mann-Whitney. RESULTADOS: el 35,33% de la población de estudio padece preeclampsia. En las variables analizadas como parte del perfil lipídico, mediante la técnica U de Mann-Whitney, se obtuvo un p-valor inferior a 0,5, como se describe a continuación: para triglicéridos <,001; para colesterol HDL 0,421; para colesterol LDL 0,003; y para Colesterol Total <,001. En análisis comparativos con otros estudios se describen resultados similares, pero no en todos coinciden los promedios de comparación. CONCLUSIONES: Existe diferencia estadísticamente significativa en el perfil lipídico de mujeres con preeclampsia, en comparación con el perfil lipídico de mujeres que no padecen preeclampsia.

Preeclampsia is a complication of pregnancy, whose prevalence is estimated between 4 and 7% of pregnancies worldwide. In Ecuador, hypertensive disorders were responsible for 20.6% of maternal mortality (years 2017-2018). Hence the importance of studies of their timely diagnosis.OBJECTIVE: to associate the lipid profile as a risk factor in the suffering of preeclampsia in pregnant women who attended the Hospital Sagrado Corazón de Jesús, during the years 2020-2021. MATERIALS AND METHODS: the type of design used for the research, in a population of 300 pregnant women, was non-experimental, documentary, cohort, observational, correlational and quantitative. The Chi-square test was used in the analysis of significant differences between categorical variables. The Mann-Whitney U test was used to calculate the relationship between preeclampsia or not during pregnancy and the variables that make up the lipid profile. RESULTS: preeclampsia was found in 35.33% of the study population. In the variables analyzed as part of the lipid profile, using the Mann-Whitney U technique, a p-value of less than 0.5 was obtained, as described below: for triglycerides <.001; for HDL cholesterol 0.421; for LDL cholesterol 0.003; and for total cholesterol <.001. In comparative analyses with other studies, similar results are described, but not in all the comparison averages coincide. CONCLUSIONS: there is a statistically significant difference in the lipid profile of women with preeclampsia compared to the lipid profile of women without preeclampsia

A pré-eclâmpsia é uma complicação da gravidez, cuja prevalência é estimada entre 4 e 7% das gestações em todo o mundo. No Equador, as doenças hipertensivas foram responsáveis por 20,6% da mortalidade materna (2017-2018). Daí a importância dos estudos de seu diagnóstico oportuno. OBJETIVO: associar o perfil lipídico como fator de risco para pré-eclâmpsia em gestantes que freqüentaram o Hospital Sagrado Corazón de Jesús, durante os anos de 2020-2021. MATERIAIS E MÉTODOS: o tipo de projeto de pesquisa utilizado em uma população de 300 mulheres grávidas foi não-experimental, documentário, coorte, observacional, correlacional e quantitativo. O teste Qui-quadrado foi utilizado para analisar diferenças significativas entre as variáveis categóricas. O teste Mann-Whitney U foi usado para calcular a relação entre a pré-eclâmpsia ou não durante a gravidez e as variáveis que compõem o perfil lipídico. RESULTADOS: a pré-eclâmpsia foi encontrada em 35,33% da população do estudo. Nas variáveis analisadas como parte do perfil lipídico, usando a técnica Mann-Whitney U, foi obtido um valor p inferior a 0,5, como segue: para triglicerídeos <,001; para colesterol HDL 0,421; para colesterol LDL 0,003; e para colesterol total <,001. Resultados semelhantes são descritos em análises comparativas com outros estudos, mas nem todas as médias comparativas estão de acordo. CONCLUSÕES: ha uma diferença estatisticamente significativa no perfil lipídico das mulheres com pré-eclâmpsia em comparação com o perfil lipídico das mulheres sem pré-eclâmpsia