Screening de síndrome metabólico y nuevos factores de riesgo cardiovascular en una muestra de pacientes obesos sanos / Screening of metabolic syndrome and new cardiovascular risk factors in a sample of healthy obese patients

RESUMEN

OBJETIVOS. Estudiar la proporción de pacientes con índice de cintura (IC) elevado que tienen síndrome metabólico (SM) previamente no diagnosticado. Analizar la asociación entre IC elevado con otras variables no definitorias de SM. Medición de resistencia a insulina (RI) y riesgo cardiovascular (RCV). DISEÑO, EMPLAZAMIENTO Y PARTICIPANTES. Estudio observacional descriptivo de una serie de casos, prospectivo. Se seleccionaron aleatoriamente pacientes con IC mayor de 102 cm en varones y de 88 cm en mujeres, no diagnosticados previamente de SM y que no recibían tratamiento médico. Se les midió peso, talla, IC, índice de masa corporal (IMC), consumo de tabaco, tensión arterial (TA), glucemia basal (GB), triglicéridos (TG), colesterol ligado a lipoproteínas de alta densidad (c-HDL), uricemia, proteína C reactiva (PCR), insulinemia, homocisteína, apolipoproteína B (APO B). Posteriormente de determinó la RI mediante escala HOMA y el RCV con tablas de riesgo coronario adaptadas a población española. Finalmente se emplearon criterios ATP III para evaluar el diagnóstico de SM. RESULTADOS. Se recogieron datos de 98 pacientes. Un 45,9% reunían al menos 3 criterios para el diagnóstico de SM. El RCV fue alto 4,1%, moderado 14,3%, ligero 40,8%, y bajo 40,8%. Se hallaron diferencias significativas (p < 0,05) en los siguientes parámetros estudiados con respecto al SM sexo, tabaco, TA, IMC, TG, c-HDL, insulinemia y RCV. CONCLUSIONES. Predominaron todos los factores de riesgo cardiovascular (FRCV) excepto PCR e insulinemia. Se detectó un RCV moderado/alto en gran parte de la población estudiada

ABSTRACT

OBJECTIVES. Study the proportion of patients with elevated waist index (WI) who have previously undiagnosed metabolic syndrome (MS). Analyze the association between elevated WI with other none-defining variables of MS. Measurement of insulin resistance (IR) and cardiovascular risk (CR). DESIGN, SITE AND PARTICIPANTS. Observational, descriptive study of a series of prospective cases. Patients with WI greater than 102 cm in men and 88 cm in women, not previously diagnosed of MS and who had not received medical treatment were randomly selected. The following were measured weight, height, WI, body mass index (BMI), tobacco consumption, blood pressure (BP), basal glycemia (BG), triglycerides (TG), high density lipoprotein (c-HDL), uricemia, C-reactive protein (CRP), insulinemia, homocysteine, apolypoprotein B (APO B). After, IR was determined using the HOMA scale and CVR with coronary risk tables adapted to the Spanish population. Finally, ATP III criteria were used to evaluate the diagnosis of MS. RESULTS. Data of 98 patients were collected. A total of 45.9% had at least 3 criteria for the diagnosis of MS. CVR was high in 4.1%, moderate in 14.3%, mild in 40.8% and low in 40.8%. Significant differences were found (p < 0.05) in the following parameters studied in regards to MS gender, tobacco, BP, BMI, TG, c-HDL, insulinemia and CVR. CONCLUSIONS. All the cardiovascular risk factors (CVRF) predominate except CRP and insulinemia. Moderate/high CVR was detected in a large part of the population studied