Progresión de los componentes de la presión arterial y la correlación con las medidas antropométricas y laboratoriales en adultos jóvenes / Progression of blood pressure components and correlation with anthropometric and laboratory measurements in young adults

Introducción: La presencia de hipertensión arterial en población joven aumenta el riesgo de eventos cardiovasculares en la mediana edad y como consecuencia una morbimortalidad prematura. El propósito de este estudio es evaluar la progresión de los componentes de la presión arterial y la correlación con las medidas antropométricas y laboratoriales en estudiantes de la Universidad Nacional de Asunción- Paraguay. Materiales y métodos: Se realizó un estudio descriptivo correlacional, longitudinal, prospectivo, desde el año 2013 hasta el año 2017 evaluando al inicio 284 universitarios y 240 al final de las carreras. Se midieron variables sociodemográficas, antropométricas, presión arterial, determinaciones bioquímicas. La progresión de los componentes de la presión arterial, de las variables antropométricas y clínicas se calcularon mediante la prueba T de muestras relacionadas. La correlación de la presión arterial sistólica y presión arterial diastólica con las variables antropométricas y laboratoriales con la correlación de Pearson. Resultados: La progresión de los componentes de la presión arterial presentó una diferencia estadísticamente significativa en la presión arterial sistólica, presión arterial diastólica y presión de pulso. En relación con las características antropométricas y clínicas de los estudiantes se encontró una diferencia estadísticamente significativa entre la medición inicial y final en el peso, perímetro abdominal, glicemia, insulina, colesterol total, colesterol de alta densidad, colesterol de baja densidad, triglicéridos y proteína C reactiva. La correlación más importante encontrada entre las medidas antropométricas con la presión arterial sistólica y presión arterial diastólica fue la circunferencia abdominal. Conclusión: Se encontró aumento de la tendencia de la presión arterial y de otros factores de riesgo cardiovascular en universitarios.

Introduction: The presence of arterial hypertension in young population increases the risk of cardiovascular events in middle age and as a consequence premature morbimortality. The purpose of this study was to evaluate the progression of blood pressure components and the correlation with anthropometric and laboratory measurements in students of the National University of Asuncion, Paraguay. Materials and methods: A descriptive correlational, longitudinal, prospective, descriptive study was conducted from 2013 to 2017 evaluating at the beginning 284 undergraduates and 240 at the end of the careers. Sociodemographic variables, anthropometric variables, blood pressure, biochemical determinations were measured. The progression of blood pressure components, anthropometric and clinical variables were calculated using the related samples t-test. The correlation of systolic blood pressure and diastolic blood pressure with anthropometric and laboratory variables was correlated with Pearson's correlation. Results: The progression of blood pressure components presented a statistically significant difference in systolic blood pressure, diastolic blood pressure and pulse pressure. In relation to the anthropometric and clinical characteristics of the students, a statistically significant difference was found between the initial and final measurements in weight, abdominal perimeter, glycemia, insulin, total cholesterol, high-density cholesterol, low-density cholesterol, triglycerides, and C-reactive protein. The most important correlation found between anthropometric measurements with systolic blood pressure and diastolic blood pressure was abdominal circumference. Conclusion: An increase in the trend of blood pressure and other cardiovascular risk factors was found in university students.

Vulnerabilidad de la obesidad definida por el índice de masa corporal, perímetro abdominal y porcentaje de grasa corporal / Vulnerability of obesity as defined by body mass index, waist circumference, and body fat percentage

Objetivo: Averiguar en qué medida es posible dejar de tener obesidad (normalizar el índice de masa corporal [IMC], el perímetro abdominal [PA] y/o el porcentaje de grasa corporal [PGC]). Diseño: Estudio de observación longitudinal y retrospectiva. Emplazamiento: Once centros de salud españoles. Participantes: Hombres y mujeres con IMC≥30kg/m2 (n=1.246) u obesidad general (OG), con PA>102cm y >88cm, respectivamente (n=2.122) u obesidad abdominal (OA) y con PGC>25% y >35%, respectivamente (n=2.436) o exceso de grasa corporal (EGC), de la cohorte del Estudio PEPAF de 4.927 participantes de 20 a 80años de edad. Mediciones principales: Datos procedentes del Estudio PEPAF de la captación y de 6, 12 y 24meses: sexo, edad, diagnósticos de diabetes, hipertensión arterial y dislipemia, hábito tabáquico, niveles y cumplimiento de las recomendaciones de actividad física, consumo máximo de oxígeno, peso, talla, PA y tres pliegues grasos cutáneos (torácico, umbilical y muslo anterior para hombres y tríceps, suprailíaco y muslo anterior para mujeres). Resultados: De 2.054 participantes con cualquier tipo de obesidad en la captación y datos válidos a los 2años, 240 (11,6%) habían normalizado todos sus índices diagnósticos de obesidad en ese tiempo. El 19,5% (intervalo de confianza al 95% (IC95%): 17,6-21,4) habían dejado de tener EGC, el 12,0% (IC95%: 10,4-13,7) habían dejado de tener OA y el 10,5% (IC95%: 8,5-12,7) habían dejado de tener OG. Conclusiones: La obesidad se diferencia de las demás enfermedades crónicas en que es posible «curarse» de ella normalizando la cantidad de grasa corporal.(AU)

Aim: To ascertain to what extent it is possible to stop being obese (to normalize body mass index [BMI], waist circumference [WC] and/or body fat percentage [BFP]). Design: Longitudinal observational and retrospective study. Site: Eleven Spanish health centers. Participants: Men and women with BMI≥30kg/m2 (n=1246) or general obesity (GO), with WC>102cm and >88cm, respectively (n=2122) or abdominal obesity (AO) and with BFP>25% and >35%, respectively (n=2436) or excess body fat (EBF), from the PEPAF Study cohort of 4927 participants aged 20-80years. Main measurements: Data from the PEPAF study at baseline and at 6, 12 and 24months: gender, age, diagnoses of diabetes, hypertension and dyslipidemia, smoking, levels of and compliance with physical activity recommendations, maximum oxygen consumption, weigh, height, WC and three skin-folds (thoracic, umbilical and anterior thigh for men and triceps, suprailiac and anterior thigh for women). Results: Of 2054 participants with any type of obesity at baseline and valid data at 2years, 240 (11.6%) had normalized all of their obesity diagnostic indexes. 19.5% (95% confidence interval (95%CI: 17.6-21.4) ceased to have EBF, 12.0% (95%CI: 10.4-13.7) ceased to have AO and 10.5% (95%CI: 8.5-12.7) ceased to have GO. Conclusions: Obesity differs from other chronic diseases in that it can be «cured» by normalizing the amount of body fat.(AU)

[Vulnerability of obesity as defined by body mass index, waist circumference, and body fat percentage]. / Vulnerabilidad de la obesidad definida por el índice de masa corporal, perímetro abdominal y porcentaje de grasa corporal.

AIM: To ascertain to what extent it is possible to stop being obese (to normalize body mass index [BMI], waist circumference [WC] and/or body fat percentage [BFP]). DESIGN: Longitudinal observational and retrospective study. SITE: Eleven Spanish health centers. PARTICIPANTS: Men and women with BMI≥30kg/m2 (n=1246) or general obesity (GO), with WC>102cm and >88cm, respectively (n=2122) or abdominal obesity (AO) and with BFP>25% and >35%, respectively (n=2436) or excess body fat (EBF), from the PEPAF Study cohort of 4927 participants aged 20-80years. MAIN MEASUREMENTS: Data from the PEPAF study at baseline and at 6, 12 and 24months: gender, age, diagnoses of diabetes, hypertension and dyslipidemia, smoking, levels of and compliance with physical activity recommendations, maximum oxygen consumption, weigh, height, WC and three skin-folds (thoracic, umbilical and anterior thigh for men and triceps, suprailiac and anterior thigh for women). RESULTS: Of 2054 participants with any type of obesity at baseline and valid data at 2years, 240 (11.6%) had normalized all of their obesity diagnostic indexes. 19.5% (95% confidence interval (95%CI: 17.6-21.4) ceased to have EBF, 12.0% (95%CI: 10.4-13.7) ceased to have AO and 10.5% (95%CI: 8.5-12.7) ceased to have GO. CONCLUSIONS: Obesity differs from other chronic diseases in that it can be «cured¼ by normalizing the amount of body fat.

Factores del síndrome metabólico en el riesgo cardiovascular en pobladores peruanos / Factors of Metabolic Syndrome in Cardiovascular Risk among Peruvian Populations

Objetivo: Determinar la incidencia de los factores del síndrome metabólico en el riesgo cardiovascular en pobladores del distrito de Ayacucho en Perú. Método: Enfoque cuantitativo, diseño correlacional causal. La muestra fue de 140 pobladores mayores de 18 años a quienes se les realizó el dosaje serológico y se tomaron las medidas antropométricas necesarias mediante el uso de equipos biomédicos calibrados y específicos para cada parámetro. Se utilizó como instrumento la Tabla de cálculo de Síndrome Metabólico (ALAD) y la tabla de Framinghan. Resultados: Se determinó que el Síndrome Metabólico incide significativamente (0,000) en el Riesgo Cardiovascular con un J2= 15,432 (1) y una influencia de 16,8 por ciento enfatizado por el coeficiente de Pseudo-R2 Nagelkerke. Conclusión: Se concluye que el síndrome metabólico incide en el riesgo cardiovascular de los pobladores evaluados, debido a que presentaron niveles bajo de colesterol HDL, triglicéridos altos, un incremento de perímetro abdominal y hábitos de fumar, siendo estos factores determinantes para incrementar el riesgo cardiovascular (AU)

Objective: To determine the incidence of metabolic syndrome factors on cardiovascular risk in inhabitants of the district of Ayacucho in Peru. Methods: Quantitative approach, causal correlational design. The sample consisted of 140 inhabitants over 18 years of age who underwent serological dosage and the necessary anthropometric measurements were taken using calibrated and specific biomedical equipment for each parameter. The Metabolic Syndrome Calculation Table (ALAD) and the Framinghan table were used as instruments. Results: It was determined that the Metabolic Syndrome has a significant influence (0.000) on Cardiovascular Risk with a J2= 15.432 (1) and an influence of 16.8 percent emphasized by the Pseudo-R2 Nagelkerke coefficient. Conclusion: It is concluded that the metabolic syndrome has an impact on the cardiovascular risk of the population evaluated, because they presented low HDL cholesterol levels, high triglycerides, an increase in abdominal perimeter and smoking habits, these being determining factors to increase cardiovascular risk(AU)

Correlación y concordancia del índice de masa corporal con el perímetro abdominal y el índice cintura-talla en adultos peruanos de 18 a 59 años / Correlation and concordance between the body mass index and abdominal perimeter with the waist-to-height ratio in peruvian adults aged 18 to 59 years

Objetivos. Determinar la correlación y concordancia diagnóstica del índice de masa corporal (IMC), con el perímetro abdominal (PA) y el índice cintura-talla (ICT). Materiales y métodos. Se realizó un estudio descriptivo, transversal, de datos secundarios usando las bases de datos antropométricos de la Encuesta Vigilancia Alimentaria y Nutricional por Etapas de Vida Adulto de 18 a 59 años 2017-2018 que incluyó 1084 personas para los dominios geográficos Lima Metropolitana, resto urbano y rural. Se estimaron las prevalencias de obesidad según IMC, PA e ICT y se empleó el coeficiente de correlación de Lin y Kappa de Cohen para determinar la correlación y concordancia entre las tres mediciones antropométricas. Resultados. Según los criterios de IMC, PA e ICT las prevalencias de obesidad fueron de 26,8%, 50,4% y 85,4%, respectivamente; las prevalencias fueron mayores en mujeres y en mayores de 30 años. La correlación entre IMC vs. PA e IMC vs. ICT fue pobre y de PA con ICT fue moderada, con diferencias entre hombres y mujeres. Además, la concordancia entre IMC y PA fue aceptable, mientras que la concordancia entre IMC vs. ICT fue leve. Conclusiones . Los resultados de la correlación y concordancia son limitados y sugieren que no son medidas intercambiables, por lo que es necesario evaluar la suficiencia de emplear solo IMC para el diagnóstico de obesidad en el Perú. Esta limitada correlación y concordancia se refleja en las diferentes proporciones de obesidad que oscilan entre 26,8% a 85,4% al aplicar los tres criterios.

Objective. To determine the correlation and diagnostic agreement of body mass index (BMI) and abdominal perimeter (AP) with the waist-to-height ratio (WHtR). Materials and methods. A descriptive, cross-sectional, secondary data study was conducted using the anthropometric databases of the Food and Nutrition Surveillance Survey by Adult Life Stages from 18 to 59 years old, 2017-2018, which included 1084 individuals for the geographic domains of Metropolitan Lima, other urban areas, and rural regions. The prevalence of obesity was estimated according to BMI, AP and WHtR. Lin's correlation coefficient and Cohen's Kappa were used to determine the correlation and agreement between the three anthropometric measurements. Results. According to the BMI, AP, and WHtR criteria, the prevalence of obesity was 26.8%, 50.4% and 85.4%, respectively; the prevalence was higher in women and in those over 30 years of age. The correlation between BMI and AP, as well as between BMI and WHtR was poor; it was moderate between AP and WHtR, with differences between men and women. Furthermore, the agreement between BMI and AP was acceptable, whereas the agreement between BMI vs. WHtR was mild. Conclusions. The results regarding correlation and agreement are limited and suggest that they are not interchangeable measures, so it is necessary to evaluate the adequacy of using BMI alone for the diagnosis of obesity in Peru. The limited correlation and agreement was reflected in the different proportions of obesity that range from 26.8% to 85.4% when applying the three criteria.

Hypertriglyceridaemic waist phenotype for Chronic Kidney Disease population: NEFRONA cohort. / Fenotipo de Cintura Hipertrigliceridémica en la población con Enfermedad Renal Crónica. Cohorte NEFRONA.

BACKGROUND AND OBJECTIVE: The hypertriglyceridaemic waist (HTW) phenotype is defined for the general population. Chronic kidney disease (CKD) tends to bring on changes in body composition, is associated with higher comorbidity than the general population and, furthermore, shows reverse epidemiology with related prognostic variables like cholesterol and body mass index. Our objective was to identify cut-off points in the population with CKD and to analyse its relationship with cardiovascular risk (CVR). METHODS: We included 2271 CKD patients from the NEFRONA cohort. Triglyceride and waist cut-off points were selected through quintiles analysis and receiver operating characteristic (ROC) curves evaluation, using the presence of moderate to severe atherosclerosis score (AS 2-3) as outcome variable. Then, we analysed HTW prevalence and its association with other cardiovascular risk factors, and we measured the magnitude of its effect on AS 2-3 and cardiovascular event or death (CVEoD) by multivariate regression analysis. RESULTS: We selected the cut-off points: triglyceride concentrations ≥143 mg/dl with waist circumference values>102cm in men and 94cm in women (sensitivity 26%; specificity 87%). Specific HTW prevalence was 22.4%, without significative differences between CKD stages. The multivariate regression analysis shows specific HTW as an independent AS 2-3 (OR 1.61; 95% CI: 1.12-2.32, p=0.011) and CVEoD (HR 3.08; 95% CI: 1.66-5.72, p=0.000) risk factor. An interaction between phosphorus level and specific HTW was identified. CONCLUSIONS: Adapting the HTW definition might improve specificity to assess cardiovascular risk in the population with CKD. It identifies an additional CVR in a population in which other screening methods have not proven to be useful, and it is easily clinically accessible. Its interaction with phosphorus levels suggests an association between HTW and bone-mineral metabolism regulation.

Índice cintura talla un marcador de obesidad visceral relacionado a cistitis no complicada / Index Waist Size A Visceral Obesity Marker Related To Non-Complicated Cystitis

Objetivo: Determinar la relación entre el índice cintura-talla y la presencia de cistitis no complicada en los pacientes de consulta externa en un centro de atención primaria de Lima en el año 2018. Métodos: Se realizó un diseño observacional analítico, tipo casos y controles. Con una muestra de 131 casos y 131 controles, por muestreo aleatorio simple, sometidos a criterios de selección. Se revisó historias clínicas para la obtención retrospectiva de los datos. Se calculó el Odds Ratio como medida de asociación. Resultados: La media del índice cintura talla para cistitis no complicada fue de 61,91 ± 6.39 para los casos y 58.12 ± 3.87 para los controles. Se encontró asociación estadísticamente significativa entre la presencia de cistitis y el índice- cintura talla (OR 5,27; IC95% 3,10 ­ 8,95; p <0,001). Asimismo, se encontró asociación con el perímetro abdominal (OR 2,11 IC 95% 1,26 ­ 3,55; p=0,005) e IMC (OR 2,02; IC95% 1,20 ­ 3,37; p=0,007). Conclusión: El índice cintura talla tuvo una fuerte asociación con la presencia de cistitis no complicada. Se sugieren estudios prospectivos para corroborar la asociación entre marcadores de obesidad visceral y el desarrollo de infección de tracto urinario.

Objective: The aim of this study was to determine the association between waist to height ratio and uncomplicated cystitis in a primary health care center in Lima, during the year 2018. Methods: We conducted an observational, analytical, case-control study, in which a total of 131 cases and 131 controls were obtained by simple random sample, applying exclusion and inclusion criteria. Retrospective recollection of the data was performed using the medical record of each selected patient. Odds ratio was calculated to measure the strength of association. Results: the waist to height ratio mean for uncomplicated cystitis was 61,9 ± 6.39 and 58.12 ± 3.87 for the controls. We found an statistical significant association between uncomplicated cystitis and waist to height ratio (OR 5,27; 95%CI 3,10 ­ 8,95; p <0,001). Waist circumference (OR 2,11 95%CI;1,26 ­ 3,55; p=0,005) and body mass index (OR 2,02; 95%CI 1,20 ­ 3,37; p=0,007) were also associated. Conclusion: we found a strong association between waist to height ratio and uncomplicated cystitis, prospective studies are suggested to confirm the association between visceral obesity and the appearance of urinary tract infections

Utilidad de la ecografía en el diagnóstico de esteatosis hepática en niños con sobrepeso u obesidad que concurren al Hospital Regional de Encarnación de marzo a junio de 2019

RESUMEN La obesidad infantil va en aumento, relacionado a los malos hábitos alimentarios y el sedentarismo; puede desembocar en el desarrollo del síndrome metabólico, incrementando el riesgo de enfermedades crónicas, entre ellas, la esteatosis hepática. El objetivo de este estudio fue determinar la utilidad de la ecografía en la detección de esteatosis hepática en niños con sobrepeso u obesidad que concurrieron al Hospital Regional de Encarnación de marzo a junio de 2019. Se estudiaron a 50 niños de ambos sexos de 5 a 14 años con sobrepeso u obesidad, mediante examen clínico, antropometría, ecografía y marcadores bioquímicos. Se encontraron 18 pacientes (36%) con esteatosis hepática, mediante ecografía, predominando en varones, con obesidad severa de tipo visceral. La Acantosis nigricans, el perímetro abdominal por encima del percentil 90, GPT y triglicéridos séricos elevados, fueron los hallazgos más relevantes asociados a esteatosis hepática. La ecografía simple en modo B, resultó ser un método útil para la detección de esteatosis hepática en niños obesos, asociado a la presencia de perímetro abdominal por encima del percentil 90, Acantosis Nigricans, GPT y triglicéridos elevados. Este esquema de manejo inicial sería muy útil y de fácil aplicación en la evaluación y control de esta afección que va en aumento en la población pediátrica.

ABSTRACT Childhood obesity is increasing, related to bad eating habits and sedentary lifestyle; It can lead to the development of metabolic syndrome, increasing the risk of chronic diseases, including liver steatosis. The objective of this study was to determine the usefulness of ultrasound in the detection of hepatic steatosis in overweight or obese children who attended the Regional Hospital of Encarnación from March to June 2019. Fifty children of both sexes from 5 to 14 years old were studied with overweight or obesity, through clinical examination, anthropometry, ultrasound and biochemical markers. 18 patients (36%) were found with hepatic steatosis, by ultrasound, predominantly in men, with severe obesity of visceral type. Acanthosis nigricans, the abdominal perimeter above the 90th percentile, GPT and elevated serum triglycerides, were the most relevant findings associated with hepatic steatosis. Simple B-mode ultrasound proved to be a useful method for the detection of hepatic steatosis in obese children, associated with the presence of abdominal perimeter above the 90th percentile, Acanthosis nigricans, GPT and elevated triglycerides. This initial management scheme would be very useful and easy to apply in the evaluation and control of this condition that is increasing in the pediatric population.

[Long-term effects of intensive intervention on changes in lifestyle in patients with hyperfibrinogenaemia and moderate-high cardiovascular risk]. / Efectos a largo plazo de una intervención intensiva sobre cambios en los estilos de vida en pacientes con hiperfibrinogenemia y riesgo cardiovascular moderado-alto.

OBJECTIVES: To determine whether the benefit on cardiovascular risk factors (CVRF) persists 5 years after an intensive intervention in lifestyle (LS) that lasted 2 years, in patients with hyperfibrinogenaemia and moderate or high cardiovascular risk. DESIGN: multicentre prospective observational study. LOCATION: 13 Primary Care Centres in Barcelona and Baix Llobregat. PARTICIPANTS: A total of 300 patients who completed the EFAP study (146 intervention group, 154 control group). INTERVENTIONS: The EFAP study, conducted on patients with normal cholesterol and elevated fibrinogen showed that lifestyle interventions are effective in reducing CVRF. After the EFAP study, the 2 groups followed the usual controls, and re-assessed after 5 years. MAIN MEASUREMENTS: Age, gender, cardiovascular diseases (CVD) (diabetes, dyslipidaemia, hypertension, obesity), laboratory parameters (fibrinogen, glucose, full blood count, cholesterol, triglycerides), blood pressure, weight, height, body mass index (BMI), tobacco and alcohol use, REGICOR. RESULTS: At 5 years, the intervention group had a lower abdominal circumference (98 and 101cm, respectively, P=.043), a lower weight (76.30 and 75.04kg, respectively, P<.001), and BMI (29.5 and 30.97kg/m2, P=.018). Fibrinogen level was lower in the intervention group (330.33 and 320.27 mg/dl respectively, P < .001), and REGICOR risk was also lower in the intervention group (5.65 and 5.59 respectively, P < .06). CONCLUSION: The benefit of an intensive intervention in LS for 2 years to reduce CVRF persists at 5 years, but decreases its intensity over time. It is recommended to repeat the interventions periodically to maintain the beneficial effect on LS.

[Not Available]. / Valores de normalidad de índice de masa corporal y perímetro abdominal en población española desde el nacimiento a los 28 años de edad.

Introducción: saber diagnosticar y tratar la obesidad se ha convertido en el mayor reto del siglo XXI, debido al aumento de su prevalencia.Objetivos: determinar los valores de normalidad de perímetro abdominal (PA) e índice de masa corporal (IMC) según edad y sexo en población española sana.Métodos: estudio longitudinal observacional realizado entre 1980 y 2014. Se incluyeron 165 niños y 169 niñas recién nacidas, recogiendo datos de forma anual hasta los 18 años (74 varones y 92 mujeres), y posteriormente a los 28 años (42 varones y 45 mujeres). Se realizó medición de peso, longitud/talla y perímetro abdominal. Se calcularon los percentiles (P3, P10, P25, P50, P75, P90, P97) de IMC y PA según edad y sexo.Resultados: se presentan datos evolutivos de IMC y PA durante la infancia, destacando cómo aumentan los valores entre los 18 y 28 años de los percentiles superiores al p50, sobre todo en mujeres. Existe una correlación positiva en relación al PA entre el valor obtenido a los 3 años con el valor de los 18 años y de los 28 años tanto en varones (r = 0,722 y r = 0,605, p = 0,000, respectivamente) como en mujeres(r = 0,922, r = 0,857, p = 0,000, respectivamente). Y entre los 18 y 28 años (r = 0,731, p = 0,000 para varones y r = 0,961, p = 0,000 para mujeres).Conclusión: se presentan valores de normalidad de PA e IMC según edad y sexo, que podrán utilizarse como herramienta de referencia para identificar a personas con riesgo de desarrollar enfermedades cardiovasculares o diabetes.

The relationship between risk factors for metabolic syndrome in the physically active elderly / A relação entre os fatores de risco para a síndrome metabólica em idosos fisicamente ativos

Aging has a significant impact on the decrease of lean body mass and physical activity level, being related to the reduction in basal metabolic rate and the increase of overweight and obesity in the elderly. The aim of this study is to identify correlations among the risk factors of metabolic syndrome (MS) from the measurement of abdominal perimeter (AP) and body mass index (BMI) with blood parameters for fasting blood glucose (FBG), total cholesterol (TC) and triglycerides (TG) in active elderly people. Measurements of weight and height were adopted to classify criteria by the World Health Organization (WHO) and to calculate BMI. The measurement of AP was done in centimeters. Blood parameters for FBG, TC, and TG were assessed by collecting blood from the fingertip and analyzing it using the Accutrend Plus (Roche) equipment. For data analysis, the Pearson correlation coefficient between anthropometric measures (independent variables) and blood parameters (dependent variables) was calculated. Simple linear regression was applied to the significant variables (0.05%). The BMI assessment shows 71% of the elderly were overweight and 34% were obese. Over the cut-off point recommended, 57% of the sample was indicated by AP. The correlation test shows evidence regarding the existence of a significant association between FBG and AP and also between AP and TG as compared to the use of BMI. The AP measurement seems to be an efficient indication of the relationship between risk factors for MS and should be incorporated into routines to assess the elderly as an indicator of abdominal obesity. (AU)

O envelhecimento tem um impacto significativo na diminuição de massa magra e do nível de atividade física, estando relacionado à redução na taxa metabólica basal e ao aumento de sobrepeso e obesidade em idosos. O objetivo deste estudo foi identificar correlações entre os fatores de risco da síndrome metabólica (SM) e a medição do perímetro abdominal (PA) e do índice de massa corporal (IMC) com os parâmetros sanguíneos de glicemia de jejum (GJ), colesterol total (CT) e triglicerídeos (TG) em idosos ativos. Para cálculo do IMC, foram coletadas medidas de peso e altura e adotados os critérios de classificação da Organização Mundial da Saúde (OMS). A medida do PA foi efetuada em centímetros. Os parâmetros sanguíneos de GJ, CT e TGL foram avaliados pelo método de coleta de sangue na ponta de dedo com leitura em equipamento Accutrend Plus (Roche). Para análise dos resultados, foi realizado o cálculo do coeficiente de correlação de Pearson entre as medidas antropométricas (variáveis independentes) e parâmetros sanguíneos (variáveis dependentes). A regressão linear simples foi aplicada sobre as variáveis significativas (0.05%). A avaliação do IMC mostrou que 71% dos idosos estavam acima do peso e 34% eram obesos. No ponto de corte recomendado, 57% da amostra foram indicados por PA. O teste de correlação mostrou evidências sobre a existência de uma associação significativa entre GJ e PA e também entre PA e TG em comparação ao uso do IMC. A medição de PA parece seruma indicação eficaz da relação entre os fatores de risco para a SM e deve ser incorporada nas rotinas para avaliar idosos como um indicador de obesidade abdominal. (AU)

The relationship between risk factors for metabolic syndrome in the physically active elderly / A relação entre os fatores de risco para a síndrome metabólica em idosos fisicamente ativos

Aging has a significant impact on the decrease of lean body mass and physical activity level, being related to the reduction in basal metabolic rate and the increase of overweight and obesity in the elderly. The aim of this study is to identify correlations among the risk factors of metabolic syndrome (MS) from the measurement of abdominal perimeter (AP) and body mass index (BMI) with blood parameters for fasting blood glucose (FBG), total cholesterol (TC) and triglycerides (TG) in active elderly people. Measurements of weight and height were adopted to classify criteria by the World Health Organization (WHO) and to calculate BMI. The measurement of AP was done in centimeters. Blood parameters for FBG, TC, and TG were assessed by collecting blood from the fingertip and analyzing it using the Accutrend Plus (Roche) equipment. For data analysis, the Pearson correlation coefficient between anthropometric measures (independent variables) and blood parameters (dependent variables) was calculated. Simple linear regression was applied to the significant variables (0.05%). The BMI assessment shows 71% of the elderly were overweight and 34% were obese. Over the cut-off point recommended, 57% of the sample was indicated by AP. The correlation test shows evidence regarding the existence of a significant association between FBG and AP and also between AP and TG as compared to the use of BMI. The AP measurement seems to be an efficient indication of the relationship between risk factors for MS and should be incorporated into routines to assess the elderly as an indicator of abdominal obesity.

O envelhecimento tem um impacto significativo na diminuição de massa magra e do nível de atividade física, estando relacionado à redução na taxa metabólica basal e ao aumento de sobrepeso e obesidade em idosos. O objetivo deste estudo foi identificar correlações entre os fatores de risco da síndrome metabólica (SM) e a medição do perímetro abdominal (PA) e do índice de massa corporal (IMC) com os parâmetros sanguíneos de glicemia de jejum (GJ), colesterol total (CT) e triglicerídeos (TG) em idosos ativos. Para cálculo do IMC, foram coletadas medidas de peso e altura e adotados os critérios de classificação da Organização Mundial da Saúde (OMS). A medida do PA foi efetuada em centímetros. Os parâmetros sanguíneos de GJ, CT e TGL foram avaliados pelo método de coleta de sangue na ponta de dedo com leitura em equipamento Accutrend Plus (Roche). Para análise dos resultados, foi realizado o cálculo do coeficiente de correlação de Pearson entre as medidas antropométricas (variáveis independentes) e parâmetros sanguíneos (variáveis dependentes). A regressão linear simples foi aplicada sobre as variáveis significativas (0.05%). A avaliação do IMC mostrou que 71% dos idosos estavam acima do peso e 34% eram obesos. No ponto de corte recomendado, 57% da amostra foram indicados por PA. O teste de correlação mostrou evidências sobre a existência de uma associação significativa entre GJ e PA e também entre PA e TG em comparação ao uso do IMC. A medição de PA parece seruma indicação eficaz da relação entre os fatores de risco para a SM e deve ser incorporada nas rotinas para avaliar idosos como um indicador de obesidade abdominal.

Measurement of waist circumference for retrospective studies - prospective validation of use of CT images to assess abdominal circumference.

INTRODUCTION: To validate the use of supine position and CT images for assessing abdominal circumference (AC). METHOD: A prospective study in consecutive patients undergoing scheduled abdominal CT at our center between 17 and 25 September 2012. AC was measured four times: Measurements 1 and 2 were sequentially done by the same trained nurse before abdominal CT just above the iliac crest, while measurements 3 and 4 were done on the last abdominal CT slice not showing the iliac bone. Student's t tests and Q-Q and Bland-Altman plots were used for statistical analysis. RESULTS: A total of 102 patients were recruited. Mean age, 60 (35-78) years. Mean BMI, 25 (18-39) kg/m(2). Mean AC, 93.2 (73-135) cm. No significant differences were found between the four ACs measured (Student's t test, P=0.83). Q-Q and Bland-Altman plots showed good overlapping for the low and central values (73-110 cm) with a greater scatter for extremely high values. For the ellipse estimation, R(2) was 0.987 with a mean error of 0.4 cm and a stretch dispersion between 1.1 and -0.3 cm. CONCLUSION: Supine (either measured or estimated on CT images by free hand elliptical ROI or ellipse formula) and standing measurements appear to be equivalent for abdominal circumferences <110 cm.

Comparação entre perímetro abdominal e índice de massa corpórea como preditores de hipertensão arterial / Comparison between waist circumference and body mass index as predictors of hypertension

A obesidade é um relevante fator de risco para desenvolvimento de hipertensão arterial. Dentre as variáveis antropométricas disponíveispara avaliação do excesso de peso, o índice de massa corpórea e a circunferência abdominal são as mais utilizadas.

Obesity is a major risk factor for the development of hypertension. Among the anthropometric variables available to measure body weight excess, the body mass index and waist circumference are the mostfrequently used.

Evaluación de la distribución de los criterios diagnósticos para síndrome metabólico, en Pereira, Colombia / Evaluation of diagnostic criteria distribution for metabolic syndrome, in Pereira, Colombia / Avaliação da distribuição dos criterios diagnósticos para síndrome metabólico, en Pereira, Colombia

Introducción: el síndrome metabólico (SM) es una agrupación de múltiples factores de riesgo cardiovascular, que se ha tornado mundialmente epidémico.Objetivo: comparar los criterios actuales para su diagnóstico, en pacientes con SM, familiares sanos en primer grado de consanguinidad (FS) y controles sanos (S), en Pereira, Colombia. Metodología: estudio descriptivo de corte transversal. Se seleccionaron 116 personas para evaluar los parámetros de química sanguínea, perímetro abdominaly presión arterial. Resultados: la población de estudio se clasificó en los grupos SM (n=53), FS (n=36) y S (n=27). El criterio más prevalente fue el perímetro abdominal, en losgrupos SM (96,2%) y FS (38,8%), mientras que en el grupo S fue el HDLc (25,9%). La diferencia en el perímetro abdominal entre el grupo FS (38,8%) y el S (14,8%) fue significativa (0.24, IC: 95% 0,04 - 0,44). Conclusión: este estudio encontró que el criterio perímetro abdominal podría emplearse para la detección temprana de personas con riesgo de desarrollar SM.

Introduction: the metabolic syndrome (MS) is a cluster of multiple cardiovascular risk factors which has become epidemic around the world.Objective: compare the currently accepted MS diagnosis criteria among patients with MS (SM), first-degree healthy relatives (FS) and healthy controls (S) in the city of Pereira (Colombia).Methods: this was a cross-sectional study in which 116 persons were evaluated for blood chemistry, waist circumference and blood pressure.Results: population was classified as SM (n=53), FS (n=36) and S (n=27) groups. The most prevalent criterion was waist circumference (96.2%) for SM and FS (38.8%) groups, but for S was HDLc (25.9%). The waist circumference difference between FS (38.8%) and S (14.8%) groups was significant (0.24, CI 95% 0.04 to 0.44).Conclusion: this study found that waist circumference criterion could be used for early detection of people at risk for developing MS.

Introdução: a síndrome metabólico (SM) é uma agrupação de múltiplos fatores de risco cardiovascular, que se tornou mundialmente epidémico.Objetivo: comparar os criterios atuais para diagnosticar SM em pacientes com SM, familiares sãos em primeir grau de consanguinidade (FS) e controles sãos (S), em Pereira, Colômbia.Metodologia: estudo descritivo de corte transversal. Se seleccionaram 116 pessoas para avaliar os parámetros de química sanguínea, perímetro abdominal e presão arterial.Resultados: a população estudada foi classificada em dois grupos grupos SM (n=53), FS (n=36) e S (n=27). O critério mais importante foi o perímetro abdominal, nos grupos SM (96,2%) e FS (38,8%), emquamto que no grupo S foi o HDLc (25,9%). A diferença no perímetro abdominal entre o grupo FS (38,8%) e o S (14,8%) foi significativa (0.24, IC: 95% 0,04 - 0,44).Conclusão: este estudo constatou que o critério perímetro abdominal podería ser empregado para a detecção precoce de pessoas com risco de desenvolver SM.

Prevalencia de factores de riesgo cardiometabólico en estudiantes universitarios de la región centro-occidente, en la Universidad Michoacana de San Nicolás de Hidalgo, México / Prevalence of cardiometabolics factors of risk in university students of the region the center west of Mexico, in Universidad Michoacana de San Nicolas de Hidalgo México

Introducción: Las enfermedades cardiometabólicas son causa de 30% de las muertes en el mundo, siete de cada 10 mexicanos tienen sobrepeso u obesidad, condicionantes de diabetes mellitus, hipertensión arterial y enfermedades cardiovasculares. Objetivo: Estudiar la prevalencia de factores de riesgo cardiometabólico en estudiantes de la Facultad de Ciencias Médicas y Biológicas ''Dr. Ignacio Chávez'' de la Universidad Michoacana de San Nicolás de Hidalgo en Morelia, Michoacán. Material y métodos: se realizó un estudio epidemiológico, transversal, descriptivo, aleatorio y voluntario. Se evaluaron factores de riesgo cardiovascular como edad, sexo, antecedentes heredofamiliares, hipertensión arterial, diabetes mellitus, tabaquismo, obesidad, cardiopatía isquémica prematura y actividad física. Resultados: De 141 estudiantes, 67 (47.5%) fueron hombres y 74 (52.5%) mujeres, el promedio de edad (homogéneo 22.66 ± 0.18 varones y 22.23 ± 0.10 mujeres). Fumadores mujeres 9 (6.38%) y hombres 15 (10.63%); el perímetro abdominal en 5 hombres (3.5 %) fue > 102 cm, y en 13 mujeres (9.20%) > 88 cm. El valor de colesterol total normal en mujeres fue de 73 (51.80%) y en hombres de 64 (45.40%). Conclusiones: Un porcentaje elevado de universitarios presentaron sobrepeso, obesidad, tabaquismo, hipertensión arterial y alteración del perfil lipídico. Algunos factores de riesgo son modificables con cambios de estilo de vida. Es necesario que autoridades en salud y educación tomen medidas para establecer estilos de vida saludables.

Introduction: The cardiometabolics diseases cause 30% of deaths in the world, seven of ten Mexicans have overweight or obesity, conditioners of diabetes mellitus, arterial hypertension and cardiovascular diseases. Objective: To study prevalence of cardiometabolics factors of risk in students of the Faculty of Medical Sciences and Biological ''Dr. Ignacio Chávez'', in Morelia, Michoacán. Material and Methods: Study cross-sectional, descriptive, random and voluntary epidemiologist, familiars here to factors of cardiometabolics risk like the age, sex, antecedents, arterial hypertension, diabetes mellitus, tobacco addiction, obesity, premature ischemic cardiopathy and physical activity were evaluated. Results: Of 141 students 67 (47.5%) men and 74 (52.5%) women, homogenous average of age men 22.66 ± 0.10 women, 22.23 ± 0.18 women 9 (6.38%) and men 15 (10.63%) are smokers. The abdominal risk in man 5 (3.50) of ( > 102 cm), and women 13 (9.20%) ( > 88 cm). The value of normal total cholesterol was in women 73 (51.80%) and in men 64 (45.40%). Conclusions: A lifted percentage of college students presented/displayed overweight, obesity, tobacco addiction, arterial hypertension and alteration of the lipoid profile. Some factors of risk are modifiable with changes of life style, is necessary that authorities in health and education take measures to establish healthful styles of life.