[Asociación del estado hormonal con el riesgo cardiovascular evaluado por Globorisk en mujeres mexicanas].

INTRODUCTION: Cardiovascular disease is the main cause of mortality worldwide. In women, its incidence increases at the sixth decade of life, coinciding with postmenopause. Whether this effect is due to menopause-related hormonal changes is not known. OBJECTIVE: To evaluate the differences in cardiovascular risk in pre- and postmenopausal women by means of the Globorisk risk scale, the triglyceride/high-density lipoproteins cholesterol (Tg/HDL-C) ratio and metabolic syndrome (MS) criteria. METHOD: Cross-sectional study that included 408 women from 40 to 60 years of age; anthropometric measurements and biochemical determinations were performed. The participants were classified as premenopausal and postmenopausal. Cardiovascular risk was assessed using the MS criteria, the Globorisk risk calculator and the Tg/HDL-C ratio. RESULTS: Postmenopausal women showed a significant increase in waist circumference, total cholesterol and triglycerides in comparison with premenopausal women. Significant associations were found between hormonal state and Globorisk measured cardiovascular risk (OR = 2.50; 95 % CI = 1.67-3.74) and the Tg/HDL-C ratio (OR = 1.66; 95 % CI = 1.09-2.52). CONCLUSION: Cardiovascular risk factors have a higher prevalence in postmenopause. The Globorisk scale and Tg/HDL-C ratio identify cardiovascular risk in postmenopausal women.

INTRODUCCIÓN: La enfermedad cardiovascular es la principal causa de mortalidad en el mundo. En la mujer se incrementa en la sexta década de la vida, coincidiendo con la posmenopausia. Se desconoce si este efecto se debe a cambios hormonales relacionados con la menopausia. OBJETIVO: Evaluar diferencias del riesgo cardiovascular en mujeres pre y posmenopáusicas mediante la escala de riesgo Globorisk, el índice triglicéridos/c-HDL (Tg/c-HDL) y los criterios de síndrome metabólico (SM). MÉTODOS: Estudio transversal que incluyó a 408 mujeres de 40 a 60 años; se realizaron mediciones antropométricas y bioquímicas. Las participantes se clasificaron en premenopáusicas y posmenopáusicas. El riesgo cardiovascular se evaluó utilizando los criterios de SM, calculadora de riesgo Globorisk y el índice Tg/c-HDL. RESULTADOS: Las mujeres en etapa posmenopáusica presentaron incremento significativo en la circunferencia de cintura, de colesterol total y triglicéridos, en comparación con las mujeres premenopáusicas. Se encontraron asociaciones significativas del estado hormonal con el riesgo cardiovascular evaluado por Globorisk (RM = 2.50, IC 95 % = 1.67-3.74) y con el índice Tg/c-HDL (RM = 1.66, IC 95 % = 1.09-2.52). CONCLUSIÓN: Los factores de riesgo cardiovascular tienen mayor prevalencia en la posmenopausia. La escala Globorisk y el índice Tg/c-HDL identifican el riesgo cardiovascular en la mujer posmenopáusica.

El incremento de la grasa epicárdica en mujeres se asocia a riesgo trombótico / An increase in epicardial fat in women is associated with thrombotic risk

Introducción: En pacientes con enfermedad coronaria se ha observado una disminución de la actividad fibrinolítica y aumento del grosor del tejido adiposo epicárdico. El objetivo del estudio fue determinar la relación entre la grasa epicárdica y la actividad fibrinolítica, midiendo la concentración del inhibidor del activador del plasminógeno tipo-1 (PAI-1). Métodos: Estudio transversal que incluyó a 56 mujeres aparentemente sanas, con edad de 45-60 años. A las participantes se les realizaron mediciones antropométricas y bioquímicas, la actividad fibrinolítica se determinó midiendo PAI-1 por la técnica de ELISA. El grosor epicárdico se evaluó por ecocardiografía transtorácica. Resultados: La concentración de PAI-1 se asoció directamente con el grosor del tejido adiposo epicárdico (r = .475, p = .001), glucosa, triglicéridos, resistencia a la insulina, IMC, tejido adiposo visceral y grasa corporal total. El análisis de regresión multivariado indicó que la grasa epicárdica predice en forma independiente el valor de PAI-1. Conclusiones: Las mujeres con incremento de tejido adiposo epicárdico muestran menor actividad fibrinolítica por presentar niveles aumentados de PAI-1 y, en consecuencia, un posible mayor riesgo trombótico

Introduction: A decrease in fibrinolytic activity and an increase in the thickness of the epicardial adipose tissue have been observed in patients with coronary artery disease. The aim of this study was to determine the association between epicardial adipose tissue and fibrinolytic activity by measuring the concentration of plasminogen activator inhibitor-1 (PAI-1). Methods: A cross-sectional study was conducted on 56 apparently healthy women aged 45 to 60 years. Anthropometric measurements and biochemical determinations were performed on all participants. The fibrinolytic activity was determined by measuring PAI-1 by ELISA. Epicardial thickness was assessed by transthoracic echocardiography. Results: The concentration of PAI-1 was directly associated with the thickness of the epicardial adipose tissue (r = 0.475, P = .001), body mass index (BMI), visceral adipose tissue, insulin resistance, glucose, and HDL-cholesterol. The multivariate regression analysis indicated that epicardial fat independently predicts the concentrations of PAI-1. Conclusions: Women with thicker epicardial adipose tissue have reduced fibrinolytic activity, and consequently greater thrombotic risk

An increase in epicardial fat in women is associated with thrombotic risk. / El incremento de la grasa epicárdica en mujeres se asocia a riesgo trombótico.

INTRODUCTION: A decrease in fibrinolytic activity and an increase in the thickness of the epicardial adipose tissue have been observed in patients with coronary artery disease. The aim of this study was to determine the association between epicardial adipose tissue and fibrinolytic activity by measuring the concentration of plasminogen activator inhibitor-1 (PAI-1). METHODS: A cross-sectional study was conducted on 56 apparently healthy women aged 45 to 60 years. Anthropometric measurements and biochemical determinations were performed on all participants. The fibrinolytic activity was determined by measuring PAI-1 by ELISA. Epicardial thickness was assessed by transthoracic echocardiography. RESULTS: The concentration of PAI-1 was directly associated with the thickness of the epicardial adipose tissue (r=0.475, P=.001), body mass index (BMI), visceral adipose tissue, insulin resistance, glucose, and HDL-cholesterol. The multivariate regression analysis indicated that epicardial fat independently predicts the concentrations of PAI-1. CONCLUSIONS: Women with thicker epicardial adipose tissue have reduced fibrinolytic activity, and consequently greater thrombotic risk.

Grasa epicárdica y factores de riesgo cardiometabólico en la posmenopausia / Epicardial fat and cardiometabolic risk in postmenopausal women

Objetivo. El riesgo cardiovascular aumenta en la etapa posmenopáusica. El tejido adiposo epicárdico ha mostrado utilidad para la identificación del riesgo cardiovascular, sin embargo, la información es aún escasa en la mujer posmenopáusica. El objetivo de este estudio fue analizar la relación entre el tejido adiposo epicárdico y los componentes del síndrome metabólico en mujeres posmenopáusicas. Sujetos y métodos. Estudio transversal comparativo en 50 mujeres posmenopáusicas, se midieron los factores de riesgo cardiometabólico, se les realizó ecocardiograma transtorácico y análisis de composición corporal. Resultados. La grasa epicárdica es más elevada en mujeres con síndrome metabólico en comparación a aquellas sin síndrome metabólico (515,6 ± 130,9 vs. 358,0 ± 138,7, p < 0,001) y presenta un incremento proporcional con el número de componentes del síndrome metabólico (p < 0,001). Conclusiones. El tejido adiposo epicárdico tiene relación con los componentes del síndrome metabólico en la posmenopausia, etapa que se caracteriza por mayor vulnerabilidad a la trombosis (AU)

Objective. Postmenopausal women have an increased risk of cardiovascular disease. Epicardial adipose tissue has been shown to be useful in identifying cardiovascular risk but there is little information in postmenopausal women. The objective of this study was to examine the association between epicardial fat and components of metabolic syndrome in postmenopausal women. Subjects and methods. A cross sectional study was conducted in 50 postmenopausal women. All participants underwent transthoracic echocardiography and body composition analysis. Results. A greater amount of epicardial adipose tissue was found in postmenopausal women with metabolic syndrome than in those without this syndrome (515.6 ± 130.9 vs 358.0 ± 138.7, p < 0.001). The amount of epicardial adipose tissue increased with a greater number of metabolic components (p < 0.001). Conclusions. There is a direct relationship between epicardial fat and cardiometabolic risk after menopause, a period when there is a higher risk of thrombosis (AU)