Evaluation of Anthropometric Indices and Lipid Parameters to Predict Metabolic Syndrome Among Adults in Mexico.

BACKGROUND: Metabolic syndrome (MetS) is a cluster of conditions that increases the risk of cardiovascular disease (CVD) and is related to genetic background, dietary habits, and lifestyle. Anthropometric indices and lipid parameters have been shown to be simple and useful tools in clinical practice for predicting MetS. The aim of the present study was to evaluate the differential magnitudes of anthropometric characteristics (waist circumference and body mass index [BMI]) and lipid parameters, namely, lipid accumulation product (LAP), cardiometabolic index (CMI), and Castelli Risk Index (CRI-I), to estimate MetS, usingappropriate cut-off values, among adults from a public hospital in Yucatan, Mexico. METHODS: A cross-sectional study among 250 adults (77 men, 173 women) was carried out in the Regional High Speciality Hospital of the Yucatan Peninsula (HRAEPY) in Merida, Yucatan. MetS was diagnosed using standard criteria (central obesity, arterial hypertension, hyperglycemia, and dyslipidemia), and derived parameters (LAP, CMI, and CRI-I) were calculated. Binary logistic regression analysis-based receiver operating characteristics (ROC) curves were used to predict MetS. RESULTS: Of the 250 participants, 48% had MetS. High prevalences of overweight (35.2%) and obesity (48.8%) were found in the sample. The CMI and LAP were found to be the best parameters in the prediction of MetS in men and women. The optimal cut-off values of the parameters were higher in men and decreased with advancing age. CONCLUSION: The CMI and LAP were shown to be the most effective indicators to diagnose MetS among adults from Yucatan, Mexico.

Prevalence of Metabolic Syndrome in Mexico: A Systematic Review and Meta-Analysis.

BACKGROUND: Metabolic syndrome (MetS) is closely linked with type 2 diabetes mellitus (T2DM) and cardiovascular diseases. The T2DM is one of the major causes of mortality and public health concern in Mexico. Some studies reported MetS prevalence in different regions from Mexico. However, a systematic report or meta-analysis on MetS prevalence is not available. The aim of this study was to estimate the pooled prevalence of MetS among apparently healthy Mexican adults. METHODS: A systematic review was done of scientific articles published and available from different sources, including MEDLINE/PubMed, Web of Science, Cochrane Library, LILACS, and SCIELO. The overall prevalence of MetS and prevalence based on different diagnostic criteria [National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III), International Diabetes Federation (IDF), American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI), and World Health Organization (WHO)] were pooled using a random-effects model, and the results were presented in a forest plot. The study was performed based on the criteria of Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). RESULTS: Altogether, 15 studies were included in the systematic meta-analysis. The estimated prevalence of MetS, based on different criteria, was as follows: IDF 54% (95% CI 0.44-0.63), AHA/NHLBI 48% (95% CI 0.34-0.62), ATP III 36% (95% CI 0.30-0.42), and WHO 31% (95% CI 0.04-0.81). According to the Der Simonian-Laird random-effects model, a pooled prevalence of MetS in Mexico was 41% (95% CI 0.34-0.47). CONCLUSIONS: This study reported a high prevalence of MetS among healthy Mexican adults, in comparison with reports from other countries, including United States and Latin America. An urgent need to control and prevent MetS and its consequent health complications in Mexican populations is recommended.

[Comparison of normal delivery care in the hospital and traditional care systems]. / Comparación de la atención del parto normal en los sistemas hospitalario y tradicional.

OBJECTIVE: To compare vaginal delivery hospital and traditional care systems to identify resources and practices, as well as maternal and neonatal complications related to each system. MATERIAL AND METHODS: Between 1989 and 1990, a cross-sectional study was conducted in three hospitals of Merida City and four municipalities of the state of Yucatan. The study sample consisted of 205 women who had a normal vaginal delivery. Delivery procedures were observed and a questionnaire to identify complications was applied 15 days after childbirth. Data analysis consisted in comparison of proportions with the chi-squared test. RESULTS: Maternal and neonatal complications were identified in both systems; however, maternal complications were more frequent in hospital care, whereas neonatal complications were more frequent in traditional delivery care. The total number of complications was similar in the two systems. CONCLUSIONS: No difference was found in the quality of care between the hospital and the traditional systems. Observed complications may be attributable to resources and practices of each system. Additional studies should be conducted to evaluate the advantages and disadvantages of each system, as well as to improve the quality of maternal and child care. The English version of this paper is available at: http://www.insp.mx/salud/index.html.

Comparación de la atención del parto normal en los sistemas hospitalario y tradicional / Comparison of normal delivery care in the hospital and traditional care systems

OBJECTIVE: To compare vaginal delivery hospital and traditional care systems to identify resources and practices, as well as maternal and neonatal complications related to each system. MATERIAL AND METHODS: Between 1989 and 1990, a cross-sectional study was conducted in three hospitals of Merida City and four municipalities of the state of Yucatan. The study sample consisted of 205 women who had a normal vaginal delivery. Delivery procedures were observed and a questionnaire to identify complications was applied 15 days after childbirth. Data analysis consisted in comparison of proportions with the chi-squared test. RESULTS: Maternal and neonatal complications were identified in both systems; however, maternal complications were more frequent in hospital care, whereas neonatal complications were more frequent in traditional delivery care. The total number of complications was similar in the two systems. CONCLUSIONS: No difference was found in the quality of care between the hospital and the traditional systems. Observed complications may be attributable to resources and practices of each system. Additional studies should be conducted to evaluate the advantages and disadvantages of each system, as well as to improve the quality of maternal and child care.