RESUMO
Objetivos. Estimar la incidencia y los factores de riesgo de diabetes tipo2 en la población adulta de Madrid (España) y comparar los modelos predictivos de diabetes tipo2 basados en los criterios de prediabetes de la American Diabetes Association (ADA) y la Organización Mundial de la Salud (OMS). Material y métodos. Estudio prospectivo de una cohorte poblacional formada por 2048 individuos de entre 30 y 74años sin diabetes. Al inicio del estudio se realizó una encuesta epidemiológica y se midió la glucemia basal, la HbA1c, el índice de masa corporal y el perímetro de la cintura. Se realizó un seguimiento de 6,4años. Los casos nuevos de diabetes tipo2 se identificaron a través de la historia clínica electrónica de atención primaria. Resultados. La incidencia de diabetes tipo2 fue 3,5 casos/1.000 personas-año. En el análisis multivariante las variables que se asociaron con la aparición de diabetes tipo2 fueron la edad, los antecedentes familiares de diabetes, la glucemia basal (100-125mg/dl), la HbA1c (5,7-6,4%) y el perímetro de la cintura (≥94cm en hombres y ≥80cm en mujeres). De estas, las más significativamente asociadas fueron la glucemia basal y la HbA1c. Los criterios de la ADA y la OMS para definir prediabetes tuvieron la misma capacidad predictiva. Conclusión. La incidencia de diabetes tipo2 estimada en Madrid fue inferior a la encontrada en otros estudios poblacionales, siendo el estado glucometabólico el principal factor asociado a la progresión a diabetes tipo2. No se han detectado diferencias entre la prediabetes definida por la ADA y la OMS para predecir la aparición de la enfermedad (AU)
Objectives. Determine the incidence and risk factors of type2 diabetes in the adult population of Madrid (Spain) and compare the predictive models of type2 diabetes based on the prediabetes criteria of the American Diabetes Association (ADA) and the World Health Organisation (WHO). Material and methods. A prospective study was conducted on a population cohort composed of 2048 individuals between 30 and 74years of age with no diabetes. At the start of the study, an epidemiological survey was performed, and baseline glycaemia, HbA1c, body mass index and waist circumference were measured. A follow-up of 6.4years was conducted. New cases of type2 diabetes were identified using the electronic primary care medical history. Results. The incidence of type2 diabetes was 3.5 cases/1000 person-years. In the multivariate analysis, the variables that were associated with the onset of type2 diabetes were age, family history of diabetes, baseline glycaemia (100-125mg/dL), HbA1c (5.7-6.4%) and waist circumference (≥94cm for men and ≥80cm for women). Of these, the most significantly associated variables were baseline glycaemia and HbA1c. The ADA and WHO criteria for defining prediabetes had the same predictive capacity. Conclusion. The incidence of type2 diabetes measured in Madrid was lower than that found in other population studies, with the glucometabolic state the main factor associated with progression to type2 diabetes. There were no differences between the prediabetes defined by the ADA and the WHO for predicting the onset of the disease (AU)
Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/prevenção & controle , Fatores de Risco , Estado Pré-Diabético/epidemiologia , Estado Pré-Diabético/prevenção & controle , Glicemia/análise , Glicemia/metabolismo , Estudos de Coortes , Enquete Socioeconômica , Índice de Massa Corporal , Atenção Primária à Saúde/métodos , Estudos ProspectivosRESUMO
OBJECTIVES: Determine the incidence and risk factors of type2 diabetes in the adult population of Madrid (Spain) and compare the predictive models of type2 diabetes based on the prediabetes criteria of the American Diabetes Association (ADA) and the World Health Organisation (WHO). MATERIAL AND METHODS: A prospective study was conducted on a population cohort composed of 2048 individuals between 30 and 74years of age with no diabetes. At the start of the study, an epidemiological survey was performed, and baseline glycaemia, HbA1c, body mass index and waist circumference were measured. A follow-up of 6.4years was conducted. New cases of type2 diabetes were identified using the electronic primary care medical history. RESULTS: The incidence of type2 diabetes was 3.5 cases/1000 person-years. In the multivariate analysis, the variables that were associated with the onset of type2 diabetes were age, family history of diabetes, baseline glycaemia (100-125mg/dL), HbA1c (5.7-6.4%) and waist circumference (≥94cm for men and ≥80cm for women). Of these, the most significantly associated variables were baseline glycaemia and HbA1c. The ADA and WHO criteria for defining prediabetes had the same predictive capacity. CONCLUSION: The incidence of type2 diabetes measured in Madrid was lower than that found in other population studies, with the glucometabolic state the main factor associated with progression to type2 diabetes. There were no differences between the prediabetes defined by the ADA and the WHO for predicting the onset of the disease.
RESUMO
INTRODUCTION: In the last few decades mortality from cancer among children and adolescents has not decreased homogeneously in industrialized countries. The aim of this study was to determine the epidemiological pattern and temporal trend of mortality from cancer in individuals aged less than 20 years old living in the Autonomous Community of Madrid from 1977 to 2001. MATERIAL AND METHODS: Data on deaths from cancer among children and adolescents were obtained from Spain's National Institute of Statistics and from the Mortality Registry of Madrid. Populations were obtained from official publications of the Institute of Statistics of Madrid. Variables analyzed were sex, 5-year age groups, 5-year death periods and underlying cause of death. The epidemiological pattern was studied and a Poisson's regression model was used to analyze cancer mortality trends in children and adolescents from 1977 to 2001. RESULTS: Cancer mortality among children and adolescents decreased by 41 % from 1977 to 2001. The decrease in mortality differed according to sex (46 % in boys and 33 % in girls) and type of cancer (leukemias: 38 %, non-Hodgkin's lymphomas: 58 %, malignant brain tumors: 45 %, malignant bone tumors: 19 %, ill-defined malignant tumors: 78 %). Moreover, the annual decrease was much greater in the last 5 years (4. 7 %) than during the entire period (2. 2 %). CONCLUSIONS: Cancer mortality among children and adolescents decreased between 1977 and 2001 and our results are similar to those observed in other European and North American regions. To improve knowledge of the epidemiology of cancer among children and adolescents in the Autonomous Community of Madrid, future assessments including mortality, incidence, and survival indicators are required.
Assuntos
Neoplasias/mortalidade , Adolescente , Área Programática de Saúde , Criança , Feminino , Humanos , Incidência , Masculino , Neoplasias/classificação , Prevalência , Espanha/epidemiologiaRESUMO
Introducción: La mortalidad por cáncer en niños y adolescentes ha disminuido de modo desigual en los diferentes países desarrollados en las últimas décadas. El objetivo del estudio es conocer el patrón y la tendencia de la mortalidad por cáncer en menores de 20 años residentes en la Comunidad de Madrid entre 1977 y 2001. Material y métodos: Las defunciones fueron cedidas por el Instituto Nacional de Estadística y por el Registro de Mortalidad de la Comunidad de Madrid y las poblaciones se tomaron a partir de publicaciones oficiales del Instituto de Estadística de la Comunidad de Madrid. Las variables estudiadas fueron: sexo, grupo quinquenal de edad, período quinquenal de defunción y causa básica de defunción. Se describe el patrón epidemiológico y se analiza la evolución temporal de la mortalidad por cáncer infantil entre 1977 y 2001 mediante el ajuste de un modelo de Poisson log-lineal. Resultados: La mortalidad por cáncer infantil ha disminuido un 41 % a lo largo del período de estudio. El descenso ha sido desigual para los distintos sexos (varones: 46%; mujeres: 33%) y tipos tumorales (leucemias: 38 %; linfomas no hodgkinianos: 58 %; tumores malignos encefálicos: 45 %; tumores malignos osteoarticulares: 19 %; tumores malignos mal definidos: 78 %). El porcentaje de disminución anual de la mortalidad ha sido mucho mayor para el último quinquenio (4,7 %) que para el período completo (2,2 %). Conclusiones: La mortalidad infantil por cáncer ha descendido entre 1977 y 2001, acercando la situación de nuestra región a la de otras regiones europeas y norteamericanas. Serán necesarias futuras evaluaciones que integren indicadores de mortalidad, incidencia y supervivencia para un mejor conocimiento de la epidemiología del cáncer infantil en la Comunidad de Madrid
Introduction: In the last few decades mortality from cancer among children and adolescents has not decreased homogeneously in industrialized countries. The aim of this study was to determine the epidemiological pattern and temporal trend of mortality from cancer in individuals aged less than 20 years old living in the Autonomous Community of Madrid from 1977 to 2001. Material and methods: Data on deaths from cancer among children and adolescents were obtained from Spains National Institute of Statistics and from the Mortality Registry of Madrid. Populations were obtained from official publications of the Institute of Statistics of Madrid. Variables analyzed were sex, 5-year age groups, 5-year death periods and underlying cause of death. The epidemiological pattern was studied and a Poissons regression model was used to analyze cancer mortality trends in children and adolescents from 1977 to 2001. Results: Cancer mortality among children and adolescents decreased by 41% from 1977 to 2001. The decrease in mortality differed according to sex (46 % in boys and 33 % in girls) and type of cancer (leukemias: 38 %, non-Hodgkins lymphomas: 58 %, malignant brain tumors: 45 %, malignant bone tumors: 19 %, ill-defined malignant tumors: 78 %). Moreover, the annual decrease was much greater in the last 5 years (4. 7 %) than during the entire period (2. 2 %). Conclusions: Cancer mortality among children and adolescents decreased between 1977 and 2001 and our results are similar to those observed in other European and North American regions. To improve knowledge of the epidemiology of cancer among children and adolescents in the Autonomous Community of Madrid, future assessments including mortality, incidence, and survival indicators are required
Assuntos
Criança , Adolescente , Humanos , Neoplasias/mortalidade , Incidência , Prevalência , Área Programática de Saúde , Neoplasias/classificaçãoRESUMO
OBJECTIVES: To describe the frequency, clinical features and therapeutic management of diagnosed diabetics not dependent on insulin, who were controlled in Primary Care in the Community of Madrid. DESIGN: The study was performed through a network of sentinel doctors, which covered about 2% of Madrid's total population. The sentinel doctors had to notify on each known diabetic patient once (new cases), on their first consultation during the study period. SETTING: Community of Madrid. Information on 1,449 diabetic patients not dependent on insulin and diagnosed in Primary Care was obtained. Their personal and clinical data and prior history of chronic complications were gathered. RESULTS: Average number of notified diabetics was 28.4 per doctor (18.7 per 1,000 registered patients > 14 years old). About 4.1 new cases (1.46 per 1,000) were diagnosed each year. CONCLUSIONS: Diabetic patients not dependent on insulin represent an enormous burden on Primary Health Care in the Community of Madrid.
