Early microvascular changes in patients with prediabetes evaluated by optical coherence tomography angiography.

BACKGROUND: Timely detection of early microvascular changes in patients with prediabetes could help reduce the likelihood of progression of diabetes-related retinal complications. AIM: To determine early microvascular changes in patients with prediabetes using optical coherence tomography angiography (OCT-A). METHODS: In this single-center retrospective case-control study, macular OCT-A images of superficial capillary plexus (SCP) and deep capillary plexus (DCP) were analyzed in non-diabetic controls, and prediabetic and diabetic subjects. A quantitative analysis was performed using ImageJ software of the foveal avascular zone (FAZ) area, acircularity index (AI), perfusion density (PD), and vascular length density (VLD). RESULTS: A total of 94 eyes of 53 patients were included in this study. The global mean age was 57.7 years, 39.6% men and 60.4% women. In SCP, the mean PD was 0.283 ± 0.15, 0.186 ± 0.720, and 0.186 ± 0.07 in non-diabetic controls, and prediabetic and diabetic groups, respectively. The mean VLD was 8.728 ± 3.425 in non-diabetic controls, 6.147 ± 1.399 in prediabetic group, and 6.292 ± 1.997 in patients with diabetes. The comparison of prediabetic patients and controls shows statistical differences between PD and VLD in both plexus SCP (p = 0.002 and p = 0.001, respectively) and DCP (p = 0.005 and p = 0.002, respectively). The mean area of FAZ in patients with diabetes and normal individuals was 0.281 and 0.196 mm2, respectively (p < 0.001). AI was higher in the control group (0.87 ± 0.14) and prediabetic group (0.80 ± 0.17) compared to diabetic patients (0.64 ± 0.19). There were no differences in FAZ area and AI between prediabetic and non-diabetic controls. CONCLUSION: PD and VLD demonstrated to be early microvascular changes in prediabetic patients evaluated by OCT-A. No alterations of FAZ were evidenced in this group.

Evaluación del perfil cardiometabólico en profesionales de salud de Latinoamérica / Evaluation of cardiometabolic profile in Health Professionals of Latin America

Objetivo: Evaluar la presencia de factores de riesgo para enfermedades cardiovasculares (ECV) y diabetes mellitus tipo 2 (DM2) en un grupo de trabajadores de la salud. Métodos: Durante el X Congreso Latinoamericano de Medicina Interna realizado en agosto del 2017, en Cartagena, Colombia, se invitó a los asistentes a participar del estudio que incluyó encuesta sobre antecedentes médicos, farmacológicos, familiares, hábitos de vida, medición de presión arterial, antropometría, fuerza muscular y laboratorios. Se utilizaron las escalas INTERHEART y FINDRISC para calcular el riesgo de ECV y diabetes. Resultados: En 186 participantes con edad promedio de 37,9 años, 94% médicos (52,7% especialistas) la prevalencia de hipertensión fue 20,4%, sobrepeso 40,3%, obesidad 19,9% y dislipidemia 67,3%. El 20,9% eran fumadores actuales o habían fumado y 60,8% eran sedentarios. Los hipertensos tuvieron mayor edad, índice de masa corporal (IMC), circunferencia de cintura, relación cintura/cadera, porcentaje de grasa corporal, grasa visceral, fueron más fumadores y tuvieron menor fuerza muscular (salto alto: 0,38 vs. 0,42̊cm; p̊=̊0,01). El 44,3% presentaron riesgo cardiovascular alto. La prevalencia de diabetes fue 6,59% y 27,7% estaban en riesgo. Conclusión: La prevalencia de factores de riesgo para ECV entre los médicos Latinoamericanos estudiados fue similar a la reportada en la población general. La prevalencia de puntuación de alto riesgo para ECV y DM2 fue alta y los hábitos de vida saludables fueron bajos. Es necesario mejorar la adherencia a estilos de vida saludable entre estos médicos encargados del control de esos factores en la población general.(AU)

Objective: To evaluate presence of risk factors for cardiovascular diseases (CVD) and type 2 diabetes mellitus (DM2) in a group of health care workers. Methods: During the X Latin American Congress of Internal Medicine held in August 2017, in Cartagena, Colombia, attendees were invited to participate in the study that included a survey on medical, pharmacological and family history, lifestyle habits, blood pressure measurement, anthropometry, muscle strength and laboratory studies. The INTERHEART and FINDRISC scales were used to calculate the risk of CVD and diabetes, respectively. Results: Among 186 participants with an average age of 37.9 years, 94% physicians (52.7% specialists), the prevalence of hypertension was 20.4%, overweight 40.3%, obesity 19.9%, and dyslipidemia 67.3%. 20.9% were current smokers or had smoked, and 60.8% were sedentary. Hypertensive patients were found to be older, had higher Body Mass Index (BMI), higher waist circumference, higher waist-to-hip ratio, higher of body fat and visceral fat, smoked more and had lower muscle strength (high jump: 0.38 vs. 0.42̊cm; p̊=̊0.01). In 44.3% of participants was observed a high-risk score for CVD. The prevalence of diabetes was 6.59% and 27.7% were at risk. Conclusion: The prevalence of risk factors for CVD among the Latin American physicians studied was similar to that reported in the general population. The prevalence of high-risk scores for CVD and DM2 was high and healthy lifestyle habits were low. It is necessary to improve adherence to healthy lifestyles among these physicians in charge of controlling these factors in the general population.(AU)

Evaluation of cardiometabolic profile in Health Professionals of Latin America. / Evaluación del perfil cardiometabólico en profesionales de salud de Latinoamérica.

OBJECTIVE: To evaluate presence of risk factors for cardiovascular diseases (CVD) and type 2 diabetes mellitus (DM2) in a group of health care workers. METHODS: During the X Latin American Congress of Internal Medicine held in August 2017, in Cartagena, Colombia, attendees were invited to participate in the study that included a survey on medical, pharmacological and family history, lifestyle habits, blood pressure measurement, anthropometry, muscle strength and laboratory studies. The INTERHEART and FINDRISC scales were used to calculate the risk of CVD and diabetes, respectively. RESULTS: Among 186 participants with an average age of 37.9 years, 94% physicians (52.7% specialists), the prevalence of hypertension was 20.4%, overweight 40.3%, obesity 19.9%, and dyslipidemia 67.3%. 20.9% were current smokers or had smoked, and 60.8% were sedentary. Hypertensive patients were found to be older, had higher Body Mass Index (BMI), higher waist circumference, higher waist-to-hip ratio, higher of body fat and visceral fat, smoked more and had lower muscle strength (high jump: 0.38 vs. 0.42̊cm; p̊=̊0.01). In 44.3% of participants was observed a high-risk score for CVD. The prevalence of diabetes was 6.59% and 27.7% were at risk. CONCLUSION: The prevalence of risk factors for CVD among the Latin American physicians studied was similar to that reported in the general population. The prevalence of high-risk scores for CVD and DM2 was high and healthy lifestyle habits were low. It is necessary to improve adherence to healthy lifestyles among these physicians in charge of controlling these factors in the general population.