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Prim Care Diabetes ; 12(6): 517-525, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30131300


AIMS: To assess the diagnostic accuracy of the Finnish Diabetes Risk Score (FINDRISC) for undiagnosed T2DM and to compare its performance with the Latin-American FINDRISC (LA-FINDRISC) and the Peruvian Risk Score. MATERIALS AND METHODS: A population-based study was conducted. T2DM and undiagnosed T2DM were defined using oral glucose tolerance test (OGTT). Risk scores assessed were FINDRISC, LA-FINDRISC and Peruvian Risk Score. Diagnostic accuracy of risk scores was estimated using the c-statistic and the area under the ROC curve (aROC). A simplified version of FINDRISC was also derived. RESULTS: Data from 1609 individuals, mean age 48.2 (SD: 10.6), 810 (50.3%) women, were collected. A total of 176 (11.0%; 95%CI: 9.4%-12.5%) were classified as having T2DM, and 71 (4.7%; 95%CI: 3.7%-5.8%) were classified as having undiagnosed T2DM. Diagnostic accuracy of the FINDRISC (aROC=0.69), LA-FINDRISC (aROC=0.68), and Peruvian Risk Score (aROC=0.64) was similar (p=0.15). The simplified FINDRISC, with 4 variables, had a slightly better performance (aROC=0.71) than the other scores. CONCLUSION: The performance of FINDRISC, LA-FINDRISC and Peruvian Risk Score for undiagnosed T2DM was similar. A simplified FINDRISC can perform as well or better for undiagnosed T2DM. The FINDRISC may be useful to detect cases of undiagnosed T2DM in resource-constrained settings.

Heart ; 104(15): 1251-1256, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29326111


BACKGROUND: The prevalence of and factors associated with ideal cardiovascular health (ICH) by sociodemographic characteristics in Peru is not well known. METHODS: The American Heart Association's ICH score comprised 3 ideal health factors (blood pressure, untreated total cholesterol and glucose) and 4 ideal health behaviours (smoking, body mass index, high physical activity and fruit and vegetable consumption). ICH was having 5 to 7 of the ideal health metrics. Baseline data from the Center of Excellence in Chronic Diseases, a prospective cohort study in adults aged ≥35 years in 4 Peruvian settings, was used (n=3058). RESULTS: No one met all 7 of ICH metrics while 322 (10.5%) had ≤1 metric. Fasting plasma glucose was the most prevalent health factor (72%). Overall, compared with ages 35-44 years, the 55-64 years age group was associated with a lower prevalence of ICH (prevalence ratio 0.54, 95% CI 0.40 to 0.74, P<0.001). Compared with those in the lowest tertile of socioeconomic status, those in the middle and highest tertiles were less likely to have ICH after adjusting for sex, age and education (P<0.001). CONCLUSION: There is a low prevalence of ICH. This is a benchmark for the prevalence of ICH factors and behaviours in a resource-poor setting.

Geriatr Gerontol Int ; 18(2): 293-300, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29076226


AIM: To determine the association between multimorbidity and gait speed in a population-based sample of older people without functional dependency. METHODS: Data were obtained from a previously made cross-sectional population-based study of individuals aged >60 years carried out in San Martin de Porres, the second most populous district in Lima, Peru. We included well-functioning, independent older people. Exclusion criteria emphasized removing conditions that would impair gait. The exposure of interest was non-communicable chronic disease multimorbidity, and the outcome was gait speed determined by the time required for the participant to walk a distance of 8 m out of a total distance of 10 m. Generalized linear models were used to estimate adjusted gait speed by multimorbidity status. RESULTS: Data from 265 older adults with a median age of 68 years (IQR 63-75 years) and 54% women were analyzed. The median gait speed was 1.06 m/s (SD 0.27) and the mean number of chronic conditions per adult was 1.1 (SD ±1). The difference in mean gait speed between older adults without a chronic condition and those with ≥3 chronic conditions was 0.24 m/s. In crude models, coefficients decreased by a significant exponential factor for every increase in the number of chronic conditions. Further adjustment attenuated these estimates. CONCLUSIONS: Slower speed gaits are observed across the spectrum of multimorbidity in older adults without functional dependency. The role of gait speed as a simple indicator to evaluate and monitor general health status in older populations is expanded to include older adults without dependency. Geriatr Gerontol Int 2018; 18: 293-300.

Curr Obes Rep ; 3(2): 150-5, 2014 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26626601


In Latin American countries, obesity prevalence has increased significantly as a result of rapid urbanization and an improvement in socioeconomic conditions. We report the prevalence of overweight and/or obesity and prevention efforts in five countries: Mexico, Colombia, Brazil, Peru, and Chile. In children, the highest and lowest rates of obesity are found in Chile (23 % in 6-year-olds) and Peru (1.8 % in those <5 years), respectively. In adults, Mexico and Chile present similar high rates of obesity (around 35 %), whereas in Brazil and Colombia, the rates are around 20 % and 16.5 %, respectively. In general, the highest prevalence occurs in low-income women. Every country has developed initiatives to target obesity, from the government to the private sector and academia, mainly at the health sector and school settings. Food labeling is being addressed, but has not been implemented yet. Two interventions are described, a community-based in Mexico and a school-based in Chile. Because the increase in chronic diseases, especially diabetes, has paralleled that of obesity, effective prevention efforts are urgently needed.

J Hypertens ; 27(2): 259-65, 2009 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-19155783


BACKGROUND: Diarrhoeal illness is a major public health problem for children worldwide, particularly among developing countries, and is a proxy condition for severe dehydration. It has been hypothesized that severe dehydration in the first 6 months of life could be associated with increased blood pressure later in life. This study aimed to explore whether frequency of diarrhoea is associated with elevated blood pressure in children in a setting with a high incidence of diarrhoeal disease. METHODS: The present study is a cross-sectional study of blood pressure among children from a longitudinal child diarrhoeal disease cohort in Lima, Peru. From 2001 to 2006, daily diarrhoeal surveillance was made. Children were revisited in 2006 and blood pressure was measured. Diarrhoeal exposures were evaluated in terms of total number of diarrhoea days, number of episodes of diarrhoea, persistent diarrhoeal episodes and by the quartiles of daily incidence and episode incidence of diarrhoea. RESULTS: The overall incidence of diarrhoeal episodes at age under 1 year was 4.35 (95% confidence interval: 3.79-4.98) and under 5 years was 2.80 (95% confidence interval: 2.69-2.92). No association was observed between the total number of diarrhoeal days, diarrhoeal episodes or diarrhoeal incidence rates with childhood blood pressure. There was weak evidence that hospital admission due to severe dehydration in the first year of life showed a gradient towards an increase in both, systolic and diastolic blood pressure. CONCLUSION: In the first study to date to examine the association in a setting with a high incidence of diarrhoeal disease, diarrhoeal frequency did not show an association with increased blood pressure. Our observations of elevated levels of blood pressure among those admitted into hospitals in the first year of life are in line with the original hypothesis of dehydration in early infancy and high blood pressure. However, the effect of episodes of severe dehydration on later blood pressure remains uncertain.

Pressão Sanguínea , Diarreia Infantil/epidemiologia , Adolescente , Criança , Pré-Escolar , Estudos Transversais , Desidratação/complicações , Diarreia Infantil/complicações , Feminino , Humanos , Hipertensão/etiologia , Lactente , Peru/epidemiologia
Eur J Cardiovasc Prev Rehabil ; 15(3): 362-4, 2008 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-18525395


OBJECTIVE: To compare oscillometric blood pressure devices with mercury sphygmomanometry in children. PATIENTS AND METHODS: Blood pressure measurements were obtained with a mercury sphygmomanometer and one of two oscillometric devices. Correlations within each device and agreement between the two devices were evaluated. RESULTS: In children, blood pressure measured by the oscillometric device was poorly correlated and had wide limits of agreements with the sphygmomanometer. Furthermore, the oscillometric devices overestimated systolic blood pressure in children with higher readings. CONCLUSION: The applicability of automated blood pressure measuring devices in children has limitations and cannot be recommended.

Determinação da Pressão Arterial/instrumentação , Oscilometria/instrumentação , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Recursos em Saúde/provisão & distribução , Humanos , Masculino , Variações Dependentes do Observador , Peru , Reprodutibilidade dos Testes , Serviços Urbanos de Saúde