Prevalence rates of chronic kidney disease and its association with cardiometabolic factors and cardiovascular diseases. SIMETAP-CKD study. / Tasas de prevalencia de enfermedad renal crónica y su asociación con factores cardiometabólicos y enfermedades cardiovasculares. Estudio SIMETAP-ERC.

INTRODUCTION: Chronic kidney disease (CKD) is a major health problem that contributes to the development of cardiovascular disorders such as heart failure and arteriosclerotic cardiovascular disease (ACVD). The aims of this study were to determine the prevalence of CKD and to assess its association with ACVD and cardiometabolic risk factors. METHODS: Cross-sectional observational study conducted in primary care setting. Population-based random sample: 6,588 people between 18 and 102 years old (response rate: 66%). Crude and sex- and age-adjusted prevalence rates of CKD according to KDIGO were determined by assessing albuminuria and estimated glomerular filtration rate according to CKD-EPI, and their associations with cardiometabolic factors and ACVD were determined. RESULTS: The crude prevalence of CKD was 11.48% (95%CI: 10.72-12.27%), without significant difference between men (11.64% [95%CI: 10.49-12.86%]) and women (11.35% [95%CI: 10.34-12.41%]). The age- and sex-adjusted prevalence rate of CKD was 9.16% (men: 8.61%; women: 9.69%). The prevalence of low estimated glomerular filtration rate (<60mL/min/1.73m2) and albuminuria (≥30mg/g) were 7.95% (95%CI: 7.30-8.61) and 5.98% (95%CI: 5.41-6.55), respectively. Hypertension, diabetes, prediabetes, increased waist-to-height ratio, heart failure, atrial fibrillation, and ACVD were independently associated with CKD (P<.001). Very high cardiovascular risk according to SCORE was found in 77.51% (95%CI: 74.54-80.49) of the population with CKD. CONCLUSIONS: The adjusted prevalence of CKD was 9.2% (low estimated glomerular filtration rate: 8.0%; albuminuria: 6.0%). Most of the patients with CKD had very high cardiovascular risk. Hypertension, diabetes, prediabetes, increased waist-to-height ratio and ACVD were independently associated with CKD.

Prevalence of prediabetes and association with cardiometabolic and renal factors. SIMETAP-PRED study. / Prevalencia de prediabetes y asociación con factores cardiometabólicos y renales. Estudio SIMETAP-PRED.

INTRODUCTION: Prediabetes is a major public health problem. The aims of the SIMETAP-PRED study were to determine the prevalence rates of prediabetes according to two diagnostic criteria, and to compare the association of cardiometabolic and renal risk factors between populations with and without prediabetes. METHODS: Cross-sectional observational study conducted in Primary Care. Based random sample: 6,588 study subjects (response rate: 66%). Two diagnostic criteria for prediabetes were used: 1) prediabetes according to the Spanish Diabetes Society (PRED-SDS): Fasting plasma glucose (FPG) 110-125mg/dL or HbA1c 6.0% -6.4%; 2) prediabetes according to the American Diabetes Association (PRED-ADA): FPG 100-125mg/dL or HbA1c 5.7%-6.4%. The crude and sex- and age-adjusted prevalence rates, and cardiometabolic and renal variables associated with prediabetes were assessed. RESULTS: The crude prevalence rates of PRED-SDS and PRED-ADA were 7.9% (95% CI 7.3-8.6%), and 22.0% (95% CI 21.0-23.0%) respectively, their age-adjusted prevalence rates were 6.6% and 19.1 respectively. The high or very high cardiovascular risk of the PRED-SDS or PRED-ADA populations were 68.6% (95%CI 64.5-72.6%) and 61.7% (95%CI 59.1-64.1%) respectively. Hypertension, hypertriglyceridemia, overweight, obesity, and increased waist-to-height ratio were independently associated with PRED-SDS. In addition to these factors, low glomerular filtration rate and hypercholesterolemia were also independently associated with PRED-ADA. CONCLUSIONS: The prevalence of PRED-ADA triples that of PRED-SDS. Two thirds of the population with prediabetes had a high cardiovascular risk. Several cardiometabolic and renal risk factors were associated with prediabetes. Compared to the SDS criteria, the ADA criteria make the diagnosis of prediabetes easier.

Related cardiometabolic factors and prevalence of low HDL-cholesterol levels and atherogenic dyslipidemia. SIMETAP-AD study. / Factores cardiometabólicos asociados y prevalencia de concentraciones bajas de colesterol HDL y de dislipidemia aterogénica. Estudio SIMETAP-DA.

AIM: To determine the crude and sex- and age-adjusted prevalence rates of atherogenic dyslipidemia (AD) and low HDL-cholesterol levels (low-HDLc), and to assess their associations with cardiovascular risk factors, chronic kidney disease, cardiovascular and cardiometabolic diseases. METHODS: Population-based cross-sectional study conducted in Primary Care, with randomly selected adult subjects. The AD was considered if the patients had hypertriglyceridemia (triglycerides≥150mg/dL) and low-HDLc (<40mg/dL [men];<50mg/dL [women]). Crude and sex- and age-adjusted prevalence rates were determined, and univariate and multivariate analysis were performed to assess related cardiometabolic factors. RESULTS: Study population with 6,588 adults (55.9% women) with mean age 55.1 (±17.5) years. The mean HDLc levels were 49.2 (±12.6) mg/dL in men and 59.2 (±14.7) mg/dL in women. The crude prevalence rates of low-HDLc and AD were 30.8% (95%CI: 29.7-31.9), and 14.3% (95%CI: 13.5-15.2), respectively. The adjusted prevalence rates of low-HDLc were 28.0% in men and 31.0% in women, and AD were 16.4% in men and 10.6% in women. Seventy-three percent of the population with AD had high or very high cardiovascular risk. The independent factors associated with low HDLc or with AD were diabetes, smoking, abdominal obesity, and obesity. The major factors associated with low HDLc and AD were hypertriglyceridemia and diabetes, respectively. CONCLUSIONS: Almost a third of the adult population had low HDL-C and half of them met AD criteria. Cardiometabolic factors were associated with low HDL-C and AD, highlighting hypertriglyceridemia with low HDLc, and DM with AD.

Prevalencia de prediabetes y asociación con factores cardiometabólicos y renales. Estudio SIMETAP-PRED / Prevalence of prediabetes and association with cardiometabolic and renal factors. SIMETAP-PRED study

Introducción: La prediabetes constituye un importante problema de salud pública. Los objetivos del estudio fueron determinar la prevalencia de prediabetes según dos criterios diagnósticos, y comparar la asociación de factores de riesgo cardiometabólicos y renales entre las poblaciones con y sin prediabetes. Métodos: Estudio observacional transversal realizado en el ámbito de Atención Primaria. Muestra aleatoria de base poblacional: 6.588 sujetos de estudio (tasa de respuesta: 66%). Se utilizaron dos criterios diagnósticos: 1) prediabetes según la Sociedad Española de Diabetes (PRED-SED): glucosa plasmática en ayunas 110–125mg/dL o HbA1c 6,0%–6,4%; 2) prediabetes según la Asociación Americana de Diabetes (PRED-ADA): glucosa plasmática en ayunas 100–125mg/dL o HbA1c 5,7%–6,4%. Se evaluaron las prevalencias crudas y ajustadas por edad y sexo, y las variables cardiometabólicas y renales asociadas con prediabetes. Resultados: Las prevalencias crudas de PRED-SED y PRED-ADA fueron 7,9% (IC95% 7,3–8,6%), y 22,0% (IC95% 21,0–23,0%) respectivamente, y sus prevalencias ajustadas fueron 6,6% y 19,1% respectivamente. El riesgo cardiovascular alto o muy alto de las poblaciones PRED-SED y PRED-ADA fueron 68,6% (IC95% 64,5–72,6%) y 61,7% (IC95% 59,1–64,1%) respectivamente. La hipertensión, hipertrigliceridemia, sobrepeso, obesidad y el índice cintura-talla aumentado se asociaban independientemente con PRED-SED. Además de estos factores, el filtrado glomerular bajo y la hipercolesterolemia también se asociaban independientemente con PRED-ADA. Conclusiones: La prevalencia de PRED-ADA triplica a la PRED-SED. Dos tercios de la población con prediabetes tenían un riesgo cardiovascular elevado. Varios factores de riesgo cardiometabólicos y renales se asociaban con la prediabetes. En comparación con los criterios de la SED, los criterios de la ADA facilitan más el diagnóstico de la prediabetes. (AU)

Introduction: Prediabetes is a major public health problem. The aims of the SIMETAP-PRED study were to determine the prevalence rates of prediabetes according to two diagnostic criteria, and to compare the association of cardiometabolic and renal risk factors between populations with and without prediabetes. Methods: Cross-sectional observational study conducted in Primary Care. Based random sample: 6,588 study subjects (response rate: 66%). Two diagnostic criteria for prediabetes were used: 1) prediabetes according to the Spanish Diabetes Society (PRED-SDS): Fasting plasma glucose (FPG) 110–125mg/dL or HbA1c 6.0% –6.4%; 2) prediabetes according to the American Diabetes Association (PRED-ADA): FPG 100–125mg/dL or HbA1c 5.7%–6.4%. The crude and sex- and age-adjusted prevalence rates, and cardiometabolic and renal variables associated with prediabetes were assessed. Results: The crude prevalence rates of PRED-SDS and PRED-ADA were 7.9% (95% CI 7.3–8.6%), and 22.0% (95% CI 21.0–23.0%) respectively, their age-adjusted prevalence rates were 6.6% and 19.1 respectively. The high or very high cardiovascular risk of the PRED-SDS or PRED-ADA populations were 68.6% (95%CI 64.5–72.6%) and 61.7% (95%CI 59.1–64.1%) respectively. Hypertension, hypertriglyceridemia, overweight, obesity, and increased waist-to-height ratio were independently associated with PRED-SDS. In addition to these factors, low glomerular filtration rate and hypercholesterolemia were also independently associated with PRED-ADA. Conclusions: The prevalence of PRED-ADA triples that of PRED-SDS. Two thirds of the population with prediabetes had a high cardiovascular risk. Several cardiometabolic and renal risk factors were associated with prediabetes. Compared to the SDS criteria, the ADA criteria make the diagnosis of prediabetes easier. (AU)

Tasas de prevalencia de enfermedad renal crónica y su asociación con factores cardiometabólicos y enfermedades cardiovasculares. Estudio SIMETAP-ERC / Prevalence rates of chronic kidney disease and its association with cardiometabolic factors and cardiovascular diseases. SIMETAP-CKD study

Introducción: La enfermedad renal crónica (ERC) constituye un importante problema de salud que contribuye al desarrollo de alteraciones cardiovasculares como la insuficiencia cardíaca y la enfermedad cardiovascular arteriosclerótica (ECVA). Los objetivos de este estudio fueron determinar la prevalencia de ERC y evaluar su asociación con factores de riesgo cardiometabólicos y la ECVA. Métodos: Estudio observacional transversal realizado en el ámbito de atención primaria. Muestra aleatoria de base poblacional: 6.588 personas entre 18 y 102 años (tasa de respuesta: 66%). Se determinaron las tasas de prevalencia brutas y ajustadas por sexo y edad de ERC según KDIGO valorando albuminuria y filtrado glomerular estimado según CKD-EPI, y sus asociaciones con factores cardiometabólicos y ECVA. Resultados: La prevalencia cruda de ERC fue 11,48% (IC95%: 10,72–12,27%), sin diferencia significativa entre hombres (11,64% [IC95%: 10,49–12,86%]) y mujeres (11,35% [IC95%: 10,34–12,41%]). La tasa de prevalencia ajustada por edad y sexo de ERC fue 9,16% (hombres: 8,61%; mujeres: 9,69%). La prevalencia del filtrado glomerular estimado reducido (<60mL/min/1,73m2) y de albuminuria (≥30mg/g) fueron 7,95% (IC95%: 7,30–8,61) y 5,98% (IC95%: 5,41–6,55), respectivamente. Hipertensión, diabetes, prediabetes, índice cintura-talla aumentado, insuficiencia cardíaca, fibrilación auricular y ECVA se asociaban independientemente con ERC (p<0,001). El 77,51% (IC95%: 74,54–80,49) de la población con ERC tenía un riesgo cardiovascular muy alto según SCORE. Conclusiones: La prevalencia ajustada de ERC era del 9,2% (filtrado glomerular estimado reducido: 8%; albuminuria: 6%). La mayoría de los pacientes con ERC tenía riesgo cardiovascular muy alto. Hipertensión, diabetes, prediabetes, índice cintura-talla aumentado y ECVA se asociaban independientemente con la ERC.(AU)

Introduction: Chronic kidney disease (CKD) is a major health problem that contributes to the development of cardiovascular disorders such as heart failure and arteriosclerotic cardiovascular disease (ACVD). The aims of this study were to determine the prevalence of CKD and to assess its association with ACVD and cardiometabolic risk factors. Methods: Cross-sectional observational study conducted in primary care setting. Population-based random sample: 6,588 people between 18 and 102 years old (response rate: 66%). Crude and sex- and age-adjusted prevalence rates of CKD according to KDIGO were determined by assessing albuminuria and estimated glomerular filtration rate according to CKD-EPI, and their associations with cardiometabolic factors and ACVD were determined. Results: The crude prevalence of CKD was 11.48% (95%CI: 10.72–12.27%), without significant difference between men (11.64% [95%CI: 10.49–12.86%]) and women (11.35% [95%CI: 10.34–12.41%]). The age- and sex-adjusted prevalence rate of CKD was 9.16% (men: 8.61%; women: 9.69%). The prevalence of low estimated glomerular filtration rate (<60mL/min/1.73m2) and albuminuria (≥30mg/g) were 7.95% (95%CI: 7.30–8.61) and 5.98% (95%CI: 5.41–6.55), respectively. Hypertension, diabetes, prediabetes, increased waist-to-height ratio, heart failure, atrial fibrillation, and ACVD were independently associated with CKD (P<.001). Very high cardiovascular risk according to SCORE was found in 77.51% (95%CI: 74.54–80.49) of the population with CKD. Conclusions: The adjusted prevalence of CKD was 9.2% (low estimated glomerular filtration rate: 8.0%; albuminuria: 6.0%). Most of the patients with CKD had very high cardiovascular risk. Hypertension, diabetes, prediabetes, increased waist-to-height ratio and ACVD were independently associated with CKD.(AU)

Factores cardiometabólicos asociados y prevalencia de concentraciones bajas de colesterol HDL y de dislipidemia aterogénica. Estudio SIMETAP-DA / Related cardiometabolic factors and prevalence of low HDL-cholesterol levels and atherogenic dyslipidemia. SIMETAP-AD study

OBJETIVO: Determinar las prevalencias ajustadas por edad y sexo de concentraciones bajas de colesterol HDL (cHDL-bajo) y de dislipidemia aterogénica (DA), y valorar sus asociaciones con factores de riesgo cardiovascular, enfermedad renal crónica, enfermedades cardiovasculares y cardiometabólicas. MÉTODOS: Estudio observacional transversal de base poblacional realizado en atención primaria, con sujetos adultos seleccionados aleatoriamente. Se consideró DA si los pacientes tenían hipertrigliceridemia (triglicéridos≥150mg/dL) y cHDL-bajo (<40mg/dL [hombres],<50mg/dL [mujeres]). Se determinaron las tasas de prevalencia crudas y ajustadas por edad y sexo, y se realizó análisis univariado y multivariante para evaluar los factores cardiometabólicos relacionados. RESULTADOS: Población de estudio con 6.588 adultos (55,9% mujeres) con edad media de 55,1 (±17,5) años. Las medias de cHDL fueron 49,2 (±12,6) mg/dL en hombres y 59,2 (±14,7) mg/dL en mujeres. Las prevalencias crudas de cHDL-bajo y de DA fueron 30,8% (IC95%: 29,7-31,9), y 14,3% (IC95%: 13,5-15,2), respectivamente. Las prevalencias ajustadas de cHDL-bajo fueron 28% en hombres y 31% en mujeres, y de DA fueron 16,4% en hombres y 10,6% en mujeres. El 73% de la población con DA tenía riesgo cardiovascular alto o muy alto. Los factores independientes asociados con cHDL-bajo o con DA fueron diabetes, tabaquismo, obesidad abdominal y obesidad. Los principales factores asociados con cHDL-bajo y con DA fueron hipertrigliceridemia y diabetes, respectivamente. CONCLUSIONES: Casi un tercio de la población adulta presentaba cHDL-bajo y la mitad de ellos cumplía criterios de DA. Los factores cardiometabólicos se asociaban con cHDL-bajo y DA, destacando la hipertrigliceridemia con el cHDL-bajo, y la DM con la DA

AIM: To determine the crude and sex- and age-adjusted prevalence rates of atherogenic dyslipidemia (AD) and low HDL-cholesterol levels (low-HDLc), and to assess their associations with cardiovascular risk factors, chronic kidney disease, cardiovascular and cardiometabolic diseases. METHODS: Population-based cross-sectional study conducted in Primary Care, with randomly selected adult subjects. The AD was considered if the patients had hypertriglyceridemia (triglycerides≥150mg/dL) and low-HDLc (<40mg/dL [men];<50mg/dL [women]). Crude and sex- and age-adjusted prevalence rates were determined, and univariate and multivariate analysis were performed to assess related cardiometabolic factors. RESULTS: Study population with 6,588 adults (55.9% women) with mean age 55.1 (±17.5) years. The mean HDLc levels were 49.2 (±12.6) mg/dL in men and 59.2 (±14.7) mg/dL in women. The crude prevalence rates of low-HDLc and AD were 30.8% (95%CI: 29.7-31.9), and 14.3% (95%CI: 13.5-15.2), respectively. The adjusted prevalence rates of low-HDLc were 28.0% in men and 31.0% in women, and AD were 16.4% in men and 10.6% in women. Seventy-three percent of the population with AD had high or very high cardiovascular risk. The independent factors associated with low HDLc or with AD were diabetes, smoking, abdominal obesity, and obesity. The major factors associated with low HDLc and AD were hypertriglyceridemia and diabetes, respectively. CONCLUSIONS: Almost a third of the adult population had low HDL-C and half of them met AD criteria. Cardiometabolic factors were associated with low HDL-C and AD, highlighting hypertriglyceridemia with low HDLc, and DM with AD