Cintura hipertrigliceridémica en adultos pertenecientes al Policlínico Héroes del Moncada, en La Habana / Hypertriglyceridemic waist in adult patients belonging to Héroes del Moncada Polyclinic in Havana

Introducción: La hipertrigliceridemia es una forma de dislipidemia frecuentemente asociada con enfermedad ateroesclerótica. La obesidad se encuentra entre los factores de riesgo implicados en la aceleración del proceso ateroesclerótico. El desorden fisiopatológico provocado por el tejido adiposo disfuncionante es causa de afectaciones cardiovasculares, endocrinometabólicas y neoplásicas. Objetivo: Identificar la relación entre la presencia de hipertrigliceridemia con la circunferencia de la cintura en adultos mayores, a partir de la evaluación del índice de masa corporal, cintura-cadera y la presencia de hipertrigliceridemia, según la edad y el sexo. Métodos: Estudio descriptivo transversal realizado entre 2015-2017, con una muestra de 386 adultos de ambos sexos. La recogida de datos se realizó según el modelo de recolección del dato primario del Centro de Investigación y Referencias de Aterosclerosis de La Habana. El análisis de los datos se realizó con el programa SPSS v16- y las técnicas de Chi-Square. Resultados: La edad media de la muestra fue de 55,5 años y el 70,6 por ciento eran mujeres. El 57 por ciento presentaba hipertrigliceridemia y el 63,4 por ciento un índice de masa corporal aumentado, un 37,8 por ciento de personas con sobrepeso y un 26,5 por ciento con obesidad. El índice de masa corporal fue superior en mujeres perimenopáusicas, en las que tuvieron el predominio de cintura hipertrigliceridémica. Se observó un incremento de obesidad abdominal con la edad. Conclusiones: Los factores de riesgo cardiovascular, así como, la asociación existente entre los triglicéridos y la medida de la circunferencia de cintura, requiere una valoración sistemática por sexo y edad. La consulta de enfermería de la Atención Primaria es un lugar ideal para promover estrategias de intervención para monitorizar el riesgo clínico cardiovascular a través de los diferentes parámetros antropométricos(AU)

Introduction: Hypertriglyceridemia is a form of dyslipidemia frequently associated with the atherosclerotic disease. Obesity is among the risk factors involved in the acceleration of the atherosclerotic process. The pathophysiologic disorder caused by the dysfuncional adipose tissue is the cause of cardiovascular, endocrinometabolic and neoplastic diseases. Objective: To identify the relationship between the presence of hypertriglyceridemia and waist circumference in older adults from the assessment of the body mass index, waist-hip ratio and the presence of hypertriglyceridemia, according to age and gender. Methods: Descriptive, cross-sectional study conducted from 2015 to 2017, with a sample of 386 adults of both sexes. Data collection was performed according to the model of primary data collection of the Center for Research and of Atherosclerosis References of Havana. The data analysis was performed with the SPSS v16- software and the Chi-Square techniques. Results: The average age of the sample was 55.5 years and 70.6 percent were women. The 57 percent had hypertriglyceridemia and 63.4 percent an increased body mass index; 37.8 percent of the people had overweight and 26.5 percent had obesity. Body mass index was higher in perimenopausal women, who had a predominance of hypertriglyceridemic waist. It was noticed an increase of the abdominal obesity with aging. Conclusions: The cardiovascular risk factors as well as the association between triglycerides and the measure of waist circumference require a systematic assessment by sex and age. The nursing consultation in Primary Care is an ideal place to promote intervention strategies to monitor the cardiovascular clinical risk through the different anthropometric parameters(AU)

Prevalence of metabolic syndrome in pre- and postmenopausal women

ABSTRACT Objective The objective of this study was to determine the prevalence of metabolic syndrome (MS) and its components among pre- and postmenopausal women, as well as the association between menopausal status and MS. Materials and methods A retrospective study was conducted at a reference cardiology outpatient clinic in a city located in Northwestern Paraná State, Brazil. A total of 958 medical records of symptomatic climacteric women evaluated between 2010 and 2014 were analyzed. The study consisted of two groups: pre- and post-menopausal women. MS was characterized according to the criteria of the National Cholesterol Education Program’s Adult Treatment Panel III – NCEP-ATP III-2005. Results MS was observed in 18.5% of the total study population; 9.4% of the premenopausal women and 22.2% of the postmenopausal women displayed MS, corresponding to a relative risk of 2.75. In addition, the frequency of MS increased with age. Regarding the components of MS, postmenopausal women were more likely to have high density lipoprotein (HDL-C) levels < 50 mg/dL; systolic blood pressure (SBP) values ≥ 130 mmHg or diastolic blood pressure (DBP) values ≥ 85 mmHg; and fasting glucose levels ≥ 100 mg/dL. Conclusion MS was more prevalent among postmenopausal women than among premenopausal women.

The prevalence of the metabolic syndrome increases through the quartiles of thyroid stimulating hormone in a population-based sample of euthyroid subjects / Prevalência de síndrome metabólica aumenta em quartis de hormônio tireoestimulante em uma amostra de sujeitos eutiroides baseada na população

Objective The aim of the study was to assess the prevalence and characteristics of metabolic syndrome (MetS) and its elements in relation to TSH in euthyroid subjects. Materials and methods In the cross-sectional study, 2,153 euthyroid adults, 47.2 ± 14.5 years (20-94) with no current antithyroid or thyroid replacement therapy were enrolled. All participants filled a questionnaire on past and current morbidities, medication and smoking. Body weight, height, waist circumference, serum TSH, glucose and lipids were measured. The subjects were stratified by quartiles of TSH (QTSH) and the prevalence of the MetS elements was calculated. MetS was determined by the IDF 2005 criteria. Results Overweight prevalence was 37.2% (35.2-39.2), obesity in 25.1% (23.3-26.9), abdominal obesity – 61.4% (59.3-63.5), hypertension – 42.1% (38.9-43.1), diabetes/increased fasting glucose – 13.6% (12.1-15), low HDL-cholesterol – 27.6% (25.7-29.5), hypertriglyceridemia – 24.1% (22.3-25.9), MetS – 32.2% (30.2-34.2). MetS was more prevalent in the highest QTSH (34.9%, 30.9-38.9) than the lowest (27%, 23.3-30.9), p < 0.001, as were low HDL-C (32%, 28-35.9 vs. 25%, 21.3-28.7, p < 0.001) and hypertriglyceridemia (26.8%, 23-30.5 vs. 20.4%, 17-23.8, p = 0.015). Each QTSH increased the risk of MetS by 14%, p < 0.001, of hypertriglyceridemia by 20%, p = 0.001 and of low LDL-C by 9%, p = 0.042. Other significant factors for MetS were age, male gender and obesity. Conclusion The prevalence of MetS increased with higher QTSH within the euthyroid range, mostly by an increase in the dyslipidemia. Arq ...

Objetivo O objetivo deste estudo foi avaliar a prevalência e características da síndrome metabólica (MetS) e seus elementos em relação ao TSH em sujeitos eutireoides. Materiais e métodos Foram analisados, em um estudo transversal, 2.153 adultos eutiroides, de 47,2 ± 14,5 anos (20-94) sem terapia antitiroidiana ou de reposição. Todos os participantes preencheram um questionário sobre doenças atuais e passadas, medicações e tabagismo. O peso corporal, altura, circunferência da cintura, TSH, glicose e lipídios séricos foram medidos. Os sujeitos foram estratificados em quartis de TSH (QTSH) e a prevalência dos elementos da MetS foram calculados. Os critérios da MetS foram determinados pela IDF 2005. Resultados A prevalência de sobrepeso foi de 37,2% (35,2-39,2), de obesidade – 25,1% (23,3-26,9), obesidade abdominal – 61,4% (59,3-63,5), hipertensão – 42,1% (38,9-43,1), diabetes/aumento da glicose de jejum – 13,6% (12,1-15), baixo colesterol HDL – 27,6% (25,7-29,5), hipertrigliceridemia – 24,1% (22,3-25,9), MetS – 32,2% (30,2-34,2). A MetS foi mais prevalente no QTSH mais alto (34,9%; 30,9-38,9) do que no mais baixo (27%; 23,3-30,9), p < 0,001, assim como o baixo HDL-C (32%, 28-35,9 contra 25%, 21,3-28,7; p < 0,001) e hipertrigliceridemia (26,8%; 23-30,5 contra 20,4%, 17-23,8; p = 0,015). Cada QTSH aumentou o risco MetS em 14%, p < 0,001, de hipertrigliceridemia em 20%, p = 0,001 e de baixo LDL-C em 9%, p = 0,042. Outros fatores significativos para a MetS foram idade, sexo masculino e obesidade. ...

The hypertriglyceridemic waist phenotype in young adults from the Southern Region of Brazil / Cintura hipertrigliceridêmica em adultos jovens no Sul do Brasil / Cintura hipertrigliceridémica en adultos jóvenes en el sur de Brasil

The present study aimed to assess the prevalence of the hypertriglyceridemic waist phenotype and its associated factors among subjects that have been followed up from birth. In 1982, all maternity hospitals in the city of Pelotas, in the Southern Region of Brazil, were visited and all births were recorded. Babies whose parents lived in the urban area of Pelotas were subsequently followed up on several occasions. A 22 to 23-year follow-up of this birth cohort was carried out in 2004 and 2005. The presence of the hypertriglyceridemic waist phenotype was defined as waist circumference ≥ 90cm and triglyceride levels ≥ 177mg/dL for males, and waist circumference ≥ 85cm and triglyceride levels ≥ 133mg/dL for females. The prevalence of the hypertriglyceridemic waist phenotype was 5.9% and 4.5% among men and women, respectively. Among males, a sedentary lifestyle during leisure time, smoking and obesity were associated with the presence of the hypertriglyceridemic waist phenotype, whereas among females the condition was positively associated with skin color, family income, obesity and dietary fat intake.

O presente estudo teve como objetivo determinar a prevalência do fenótipo da cintura hipertrigliceridêmica e seus fatores associados entre indivíduos que foram seguidos desde o nascimento. Em 1982, as maternidades de Pelotas, sul do Brasil, foram visitadas e todos os nascimentos foram identificados. Em 2004-2005, buscou-se acompanhar toda a coorte. A presença de fenótipo da cintura hipertrigliceridêmica foi definida como circunferência da cintura ≥ 90cm e triglicerídeos ≥ 177mg/dL para o sexo masculino, e circunferência da cintura ≥ 85cm e triglicerídeos ≥ 133mg/dL para as mulheres. A prevalência de fenótipo da cintura hipertrigliceridêmica foi de 5,9% e 4,5% entre os homens e mulheres, respectivamente. Para os homens, o sedentarismo no lazer, tabagismo e obesidade estiveram associados com fenótipo da cintura hipertrigliceridêmica. Por outro lado, entre as mulheres, fenótipo da cintura hipertrigliceridêmica foi positivamente associado com a cor da pele, renda familiar, obesidade e consumo de gordura.

El presente estudio tuvo como objetivo determinar la prevalencia del fenotipo de la cintura hipertrigliceridémica y sus factores asociados entre individuos que fueron observados desde su nacimiento. En 1982, las maternidades de Pelotas, sur de Brasil, fueron visitadas y todos los nacimientos fueron identificados. En 2004-2005, se decidió realizar un seguimiento de toda la cohorte. La presencia del fenotipo de la cintura hipertrigliceridémica se definió como una circunferencia de la cintura ≥ 90cm y triglicéridos ≥ 177mg/dL para el sexo masculino y circunferencia de la cintura ≥ 85cm y triglicéridos ≥ 133mg/dL para las mujeres. La prevalencia del fenotipo de la cintura hipertrigliceridémica fue de un 5,9% y un 4,5% entre los hombres y mujeres, respectivamente. Para los hombres, el sedentarismo en el ocio, tabaquismo y obesidad estuvo asociado con el fenotipo de la cintura hipertrigliceridémica. Por otro lado, entre las mujeres, el fenotipo de la cintura hipertrigliceridémica fue positivamente asociado con el color de la piel, renta familiar, obesidad y consumo de grasa.

Fenótipo cintura hipertrigliceridêmica: associação com alterações metabólicas em adolescentes / Hypertriglyceridemic waist phenotype: association with metabolic abnormalities in adolescents

OBJETIVO: O presente estudo objetivou identificar a prevalência do fenótipo cintura hipertrigliceridêmica (CHT) e avaliar sua associação com alterações metabólicas em adolescentes de baixa condição econômica. MÉTODO: Estudo transversal com amostra probabilística de 1.076 adolescentes entre 11 e 17 anos, de ambos os sexos, estudantes de escolas públicas. Os participantes foram submetidos à avaliação antropométrica (peso, altura e circunferência da cintura) e à dosagem dos níveis de colesterol total, LDL-C, HDL-C, colesterol não HDL, triglicérides (TG) e glicemia de jejum. Foram obtidas informações referentes às condições econômicas das famílias dos participantes.O fenótipo CHT foi definido pela presença simultânea da circunferência da cintura aumentada (> percentil 90 por idade e sexo) e dos níveis séricos de triglicérides elevados (> 100 mg/dL). A análise de regressão logística foi utilizada para avaliação das associações de interesse. RESULTADOS: A prevalência do fenótipo CHT foi de 7,2% entre os adolescentes, sendo mais elevada na presença de obesidade (63,4%), do colesterol não HDL (16,6%) e do LDL-C (13,7%) altos. A análise bivariada indicou que, das variáveis metabólicas, apenas a glicemia não se associou ao fenótipo CHT. A análise multivariada, ajustada por sexo e idade, indicou que o fenótipo CHT se associou positivamente com o colesterol não HDL alto (odds ratio, 7,0; IC 95% 3,9-12,6) e com o HDL-C baixo (odds ratio, 2,7; IC 95%, 1,5-4,8). CONCLUSÕES: Este estudo mostrou que o fenótipo CHT se associou com um perfil lipídico aterogênico e sugere esse fenótipo como uma ferramenta de screening que pode ser utilizada para identificar adolescentes com alterações metabólicas.

OBJECTIVE: This study aimed to identify the prevalence of hypertriglyceridemic waist (HTW) phenotype, and to evaluate its association with metabolic abnormalities in adolescents of low socioeconomic status. METHOD: This was a cross-sectional study with a random sample of 1,076 adolescents between 11 and 17 years, of both genders, from public schools. The participants underwent anthropometric measurements (weight, height, and waist circumference), and levels of total cholesterol, low-density-lipoprotein cholesterol (LDL-C), high-density-lipoprotein cholesterol (HDL-C), non-HDL cholesterol triglyceride (TG), and fasting glucose were measured. Information regarding the socioeconomic status of the participants' families was obtained. The HTW phenotype was defined by the simultaneous presence of increased waist circumference (> 90th percentile for age and gender) and serum triglyceride levels (> 100 mg/dL). A logistic regression analysis was used to evaluate the associations of interest. RESULTS: The prevalence of HTW phenotype was 7.2% among the adolescents, being higher in the presence of obesity (63.4%) and high levels of non-HDL cholesterol (16.6%) and LDL-C (13.7%). The bivariate analysis indicated that, of the metabolic variables, only blood glucose was not associated with the HTW phenotype. Multivariate analysis adjusted for age and gender indicated that the HTW phenotype was positively associated with high non-HDL cholesterol (odds ratio: 7.0; 95% CI: 3.9-12.6) and low HDL-C levels (odds ratio: 2.7; 95% CI: 1.5-4.8). CONCLUSIONS: This study demonstrated that the HTW phenotype was associated with an atherogenic lipid profile, and this phenotype is suggested as a screening tool to identify adolescents with metabolic alterations.

Clustering and combining pattern of metabolic syndrome components in a rural Brazilian adult population / Agregacao e padrao de combinacao dos componentes da sindrome metabolica em uma populacao rural adulta brasileira

CONTEXT AND OBJECTIVE Metabolic syndrome is characterized by clustering of cardiovascular risk factors such as obesity, dyslipidemia, insulin resistance, hyperinsulinemia, glucose intolerance and arterial hypertension. The aim of this study was to estimate the probability of clustering and the combination pattern of three or more metabolic syndrome components in a rural Brazilian adult population. DESIGN AND SETTING This was a cross-sectional study conducted in two rural communities located in the Jequitinhonha Valley, Minas Gerais, Brazil. METHODS The sample was composed of 534 adults (both sexes). Waist circumference, blood pressure and demographic, lifestyle and biochemical characteristics were assessed. The prevalences of metabolic syndrome and its components were estimated using the definitions of the National Cholesterol Education Program – Adult Treatment Panel III. A binomial distribution equation was used to evaluate the probability of clustering of metabolic syndrome components. The statistical significance level was set at 5% (P < 0.05). RESULTS Metabolic syndrome was more frequent among women (23.3%) than among men (6.5%). Clustering of three or more metabolic syndrome components was greater than expected by chance. The commonest combinations of three metabolic syndrome components were: hypertriglyceridemia + low levels of HDL-c + arterial hypertension and abdominal obesity + low levels of HDL-c + arterial hypertension; and of four metabolic syndrome components: abdominal obesity + hypertriglyceridemia + low levels of HDL-c + arterial hypertension. CONCLUSION The population studied presented high prevalence of metabolic syndrome among women and clustering of its components greater than expected by chance, suggesting that the combination pattern was non-random. .

CONTEXTO E OBJETIVO A síndrome metabólica é caracterizada pela agregação de fatores de risco cardiovasculares como obesidade, dislipidemia, resistência à insulina, hiperinsulinemia, intolerância à glicose e hipertensão arterial. Este estudo objetivou estimar a probabilidade de agregação e o padrão de combinação de três ou mais componentes da síndrome metabólica em população rural adulta brasileira. TIPO DE ESTUDO E LOCAL Estudo transversal, conduzido em duas comunidades rurais da região do Vale do Jequitinhonha, Minas Gerais. MÉTODOS A amostra foi constituída de 534 adultos, de ambos os sexos, dos quais foram aferidas a circunferência da cintura, a pressão arterial e características demográficas, do estilo de vida e bioquímicas. Prevalências da síndrome metabólica e seus componentes foram estimados usando a definição da National Cholesterol Education Program – Adult Treatment Panel III. A equação da distribuição binomial foi utilizada para avaliar a probabilidade de agregação dos componentes da síndrome metabólica. O nível de significância estatística estabelecido foi 5% (P < 0,05). RESULTADOS Síndrome metabólica foi mais frequente em mulheres (23,3%) que homens (6,5%). A agregação de três ou mais componentes da síndrome metabólica foi maior do que esperada ao acaso. Combinações mais comuns para três componentes da síndrome metabólica foram hipertrigliceridemia + baixos níveis de HDL-c + hipertensão arterial, obesidade abdominal + baixos níveis de HDL-c + hipertensão arterial. Para quatro componentes, obesidade abdominal + hipertrigliceridemia + baixos níveis de HDL-c + hipertensão arterial. CONCLUSÃO Na po...

Cintura hipertrigliceridêmica e risco cardiometabólico em mulheres hipertensas / Hypertriglyceridemic waist and cardiometabolic risk in hypertensive women

OBJETIVO: Avaliar a associação entre cintura hipertrigliceridêmica (CH) e fatores de risco cardiometabólicos em mulheres portadoras de hipertensão arterial. MÉTODOS: Foi realizado um estudo transversal em 218 pacientes acompanhadas pelo Programa do Sistema de Cadastramento e Acompanhamento de Hipertensos e Diabéticos (HiperDia), em duas unidades de saúde de São Luís, MA, Brasil. A variável dependente foi CH e as variáveis independentes foram sociodemográficas, estilo de vida, antropométricas e agravos à saúde. RESULTADOS: A CH esteve presente em 33% da amostra e foi predominante na idade > 60 anos (56,4%), não brancas (81,7%), com oito anos ou menos de estudo (57,3%) e pertencentes à classe C (49%). Observaram-se excesso de peso (68,8%) e hipercolesterolemia (68,8%). A CH associou-se a: tabagismo (RP: 2,08; p = 0,017), sobrepeso (RP: 2,46; p = 0,010), obesidade (RP: 4,13; p < 0,001), hipercolesterolemia (RP: 1,87; p = 0,015), HDL (high density lipoproteins) colesterol alto (RP: 3,41; p < 0,001) e glicemia de jejum > 100 mg/dL ou ser diabética (RP: 1,86; p = 0,006). Após ajustamento, permaneceram associados o colesterol total (RP = 1,78; p = 0,012), HDL colesterol (RP: 3,03; p < 0,001), IMC > 25 a < 30 kg/m² (RP = 2,60; p = 0,005) e IMC > 30 kg/m² (RP = 3,61; p < 0,001). CONCLUSÃO: Observou-se elevada prevalência de CH e sua associação com perfil lipídico alterado e excesso de peso corporal. A CH se mostrou um importante instrumento diagnóstico para o acompanhamento de hipertensas com risco metabólico, de fácil obtenção e menor custo, útil na prática clínica, em especial, na atenção básica do Sistema Único de Saúde (SUS).

OBJECTIVE: To evaluate the association between hypertriglyceridemic waist (HW) and cardiometabolic risk factors in women with hypertension. METHODS: A cross-sectional study was performed in 218 patients monitored by HiperDia (Enrollment and Monitoring Program for Hypertensive and Diabetic Individuals) in two health units in São Luis, MA, Brazil. The dependent variable was HW and the independent variables were sociodemographics, lifestyle, anthropometrics, and health problems. RESULTS: HW was present in 33% of the sample and was predominant in women aged > 60 years (56.4%), non-whites (81.7%), those with eight or fewer years of schooling (57.3%), and those belonging to socioeconomic class C (49%). Excess weight (68.8%) and hypercholesterolemia (68.8%) were observed. HW was associated with: smoking (PR: 2.08; p = 0.017), overweight (PR: 2.46; p = 0.010), obesity (PR: 4.13; p < 0.001), hypercholesterolemia (PR: 1.87; p = 0.015), high levels of high-density lipoproteins (HDL) cholesterol (PR: 3.41; p < 0.001), and fasting glycemia > 100 mg/dL or being diabetic (PR: 1.86; p = 0.006). After adjustment, total cholesterol (PR = 1.78; p = 0.012), HDL-cholesterol (PR: 3.03; p < 0.001), body mass index (BMI) > 25 to < 30 kg/m² (PR = 2.60; p = 0.005), and BMI > 30 kg/m² (PR = 3.61; p < 0.001) remained associated. CONCLUSION: A high prevalence of HW and its association with altered lipid profile and excess body weight was observed. HW showed to be an important diagnostic tool for the monitoring of hypertensive women with metabolic risk, which is low cost, easily accessible, and useful in clinical practice, especially in primary health care in the Brazilian Unified Health System (Sistema Único de Saúde - SUS).

Codificación geométrica y análisis de conglomerados para evaluar el control metabólico de pacientes con diabetes mellitus tipo 2 / Geometric coding and cluster analysis to assess metabolic control of patients with type 2 diabetes mellitus

Objetivo: Determinar la frecuencia de las combinaciones de los parámetros de control metabólico por arriba de lo normal, usando la codificación geométrica y el análisis jerárquico de conglomerados, en pacientes con diabetes mellitus tipo 2 (DM2). Métodos: Se desarrolló en México un estudio transversal descriptivo para evaluar a un grupo de 1 051 pacientes con DM2, cuyos criterios de inclusión eran tener uno o más de los siguientes valores: glucosa en ayunas > 130 mg/dL, colesterol total > 240 mg/dL, triglicéridos totales > 200 mg/dL, índice de masa corporal > 27 kg/m², y presión arterial sistólica mayor de 130 mmHg o presión arterial diastólica mayor de 85 mmHg. Por medio de codificaciones geométricas se obtuvieron las frecuencias de todas las combinaciones. Para definir similitudes entre las combinaciones se utilizó el método de análisis de conglomerados. Resultados: Utilizando el instrumento propuesto, se observó que la combinación en pares con mayor número de sujetos estuvo representada por hiperglucemia-hipertrigliceridemia (7,3 por ciento) e hiperglucemia-hipercolesterolemia (3,6 por ciento). Las policombinaciones de mayor frecuencia fueron hiperglucemia-hipercolesterolemia-hipertrigliceridemia (13,2 por ciento) e hiperglucemia- hipertrigliceridemia-hipercolesterolemia-hipertensión (10,5 por ciento). Conclusiones: La codificación geométrica y el análisis por conglomerados podrían llegar a ser un instrumento idóneo para evaluar el control metabólico de los pacientes con DM2, así como para identificar parámetros que contribuyan a mejorar su monitoreo y su tratamiento.

Objective: Determine the frequency of combinations of higher-than-normal metabolic control parameters, using geometric coding and hierarchical cluster analysis, in patients with type 2 diabetes (DM2) Methodology: A descriptive cross-sectional study was conducted in Mexico to assess a group of 1 051 patients with DM2. The inclusion criteria were to have one or more of the following values: fasting glucose of 130 mg/dL, total cholesterol of 240 mg/dL, total triglycerides of 200 mg/dL, Body Mass Index of 27 kg/m², and systolic blood pressure higher than 130 mmHg or diastolic blood pressure higher than 85 mmHg. Through geometric coding, the frequencies of all combinations were obtained. Cluster analysis was used to determine similarities among the combinations. Results: Using the proposed instrument, it was observed that the paired combinations with the highest number of subjects were hyperglycemia-hypertriglyceridemia (7.3 percent) and hyperglycemia-hypercholesterolemia (3.6 percent). The most frequent polycombinations were hyperglycemia-hypercholesterolemia-hypertriglyceridemia (13.2 percent) and hyperglycemia-hypertriglyceridemia-hypercholesterolemia-hypertension (10.5 percent). Conclusiones: Geometric coding and cluster analysis could become a suitable instrument for assessing the metabolic control of patients with DM2, as well as for identifying parameters that will help improve their monitoring and treatment.

Methodology for the analysis of type 2 diabetes, metabolic syndrome and cardiovascular disease risk indicators in the ENSANUT 2006 / Metodologia para el análisis de diabetes tipo 2, síndrome metabólico e indicadores de riesgo cerdiovascular en la ENSANUT 2006

OBJECTIVE: To describe: a) the methods used to quantify biochemical indicators of Type 2 Diabetes (T2D), and other cardiovascular risk indicators in the Mexican National Health and Nutrition Survey 2006 (ENSANUT 2006) and b) compare the sub-sample with the non-selected participants in diverse socio-demographic, anthropometric and health characteristics. MATERIAL AND METHODS: A sub-sample of 6 021 fasting adult participants was randomly selected from the total fasting participants (n=39 425). We compared diverse socio-demographic, anthropometric and health parameters between this sub-sample and the rest of the participants. RESULTS: No differences were found in sociodemographics characteristics, except age, between the sub-sample and from the rest of the fasting adults. In addition no difference were found between prevalences of overweight and obesity, central obesity, and previously diagnosed high blood pressure, T2D or hypertrigliceridemia. CONCLUSIONS: The randomly selected sub-sample was not essentially different from the rest of the fasting subjects. Thus, no bias is expected in the interpretation of cardiovascular risk indicators derived from these data.

OBJETIVO: Describir: a) los métodos usados para definir Diabetes tipo 2 (T2D), y otros indicadores de riesgo cardiovascular en la submuestra de la Encuesta Nacional de Salud y Nutrición 2006 (ENSANUT 2006) y b) comparar en características sociodemográficas, antropométricas y otros determinantes de salud a los participantes de la submuestra con los no seleccionados. MATERIAL Y MÉTODOS: Una submuestra de 6 021 adultos fue seleccionada aleatoriamente de la totalidad de participantes en ayuno (n= 39 425). Se compararon parámetros sociodemográficos, antropométricos y de salud entre la submuestra y el resto de los participantes. RESULTADOS: No se encontraron diferencias en ninguna de las variables sociodemográficas, a excepción de la edad; ni en la prevalencia de sobrepeso, obesidad abdominal, diagnóstico previo de hipertensión, T2D, hipercolestrolemia e hipertrigliceridemia entre los adultos de la submuestra y los no seleccionados. CONCLUSIONES: La submuestra no fue estadísticamente diferente del resto de los sujetos no seleccionados. Por ello, no se espera un sesgo en la interpretación de los indicadores de riesgo cardiovascular derivados del análisis de estos datos.

Prevalence of dyslipidemias in the Mexican National Health and Nutrition Survey 2006 / Prevalencia de las dislipidemias en la Encuesta Nacional de Salud y Nutrición 2006

OBJECTIVE: To describe the prevalence of lipid abnormalities found in the Mexican National Health and Nutrition Survey 2006 (ENSANut 2006). MATERIAL AND METHODS: Information was obtained from 4 040 subjects aged 20 to 69 years, studied after a 9- to 12-hour fast. RESULTS: Median lipid concentrations were: cholesterol 198.5 mg/dl, triglycerides 139.6 mg/dl, HDL-cholesterol 39.0 mg/dl, non-HDL-cholesterol 159.5 mg/dl and LDL-cholesterol 131.5 mg/dl. The most frequent abnormality was HDL-cholesterol below 40 mg/dl with a prevalence of 60.5 percent (95 percentCI 58.2-62.8 percent). Hypercholesterolemia (> 200 mg/dl) had a frequency of abnormality of 43.6 percent (95 percentCI 41.4-46.0 percent). Only 8.6 percent of the hypercholesterolemic subjects knew their diagnosis. Hypertriglyceridemia (> 150 mg/dl) was observed in 31.5 percent (IC 95 percent 29.3-33.9 percent) of the population. CONLUSIONS: The ENSANUT 2006 data confirm that the prevalence of hypoalphalipoproteinemia and other forms of dyslipidemia in Mexican adults is very high.

OBJETIVO: Presentar la prevalencia de las dislipidemias observada en la Encuesta Nacional de Salud y Nutrición 2006 (ENSANUT 2006). MATERIAL Y MÉTODOS: Se incluyeron 4040 individuos con edad entre 20 y 69 años estudiados bajo un ayuno de 9 a 12 horas. RESULTADOS: Las concentraciones medias de los lípidos sanguíneos fueron colesterol 198.5 mg/dl, triglicéridos 139.6 mg/dl, colesterol HDL 39.0 mg/dl, colesterol noHDL 159.5 mg/dl y colesterol LDL 131.5 mg/dl. La anormalidad más común fue la hipoalfalipoproteinemia (colesterol HDL< 40 mg/dl); su prevalencia fue 60.5 por ciento (IC95 por ciento 58.2-62.8 por ciento). La hipercolesterolemia (colesterol > 200 mg/dl) fue la segunda anormalidad en frecuencia, con 43.6 por ciento (IC95 por ciento 41.4-46.0 por ciento). Sólo el 8.6 por ciento de los casos conocía su diagnóstico. La hipertrigliceridemia (> 150 mg/dl) fue observada en 31.5 por ciento (IC95 por ciento 29.3-33.9 por ciento) de la población en estudio. CONCLUSIONES: Los datos de la ENSANUT 2006 confirman que la prevalencia de hipoalfalipoproteinemia y otras formas de dislipidemia es muy alta en los adultos mexicanos.

Prevalência de síndrome metabólica em estudo de base populacional, Vitória, ES - Brasil / Prevalence of metabolic syndrome in population-based study, Vitória, ES - Brazil

Síndrome Metabólica (SM) é um transtorno representado pela agregação de fatores predisponentes para desenvolvimento de doenças cardiovasculares e diabetes. Apesar da importância da SM, há carência de dados sobre as características epidemiológicas desta condição na população brasileira. Determinamos a prevalência da SM por sexo, faixa etária e nível socioeconômico na população da cidade de Vitória, ES, Brasil, utilizando os critérios do NCEP/ATPIII. Foram coletados dados socioeconômicos, bioquímicos, antropométricos e hemodinâmicos em 1.663 indivíduos de amostra randômica da população (25-64 anos) de Vitória. A prevalência foi de 29,8 por cento (IC95 = 28-32 por cento), sem diferença entre sexos. De 25 a 34 anos, a prevalência foi 15,8 por cento, alcançando 48,3 por cento na faixa de 55 a 64 anos. Verificou-se aumento progressivo de prevalência em mulheres do maior para o menor nível socioeconômico. O parâmetro da SM mais freqüente em homens foi hipertensão, seguido de hipertrigliceridemia, baixo HDL-colesterol, hiperglicemia e obesidade abdominal. Nas mulheres, hipertensão em primeiro lugar, seguida do baixo HDL-colesterol, obesidade abdominal, hipertrigliceridemia e hiperglicemia. Conclui-se que a prevalência de SM é elevada, inclusive nos mais jovens, com grande contribuição da hipertensão para o seu diagnóstico. Controle dos fatores de risco deve ser promovido visando reduzir o impacto das doenças cardiovasculares na mortalidade geral.

Metabolic Syndrome (MS) is a complex disorder including several factors predisposing to development of cardiovascular diseases and diabetes. Despite the importance of MS for the health system, the epidemiological characteristics of this condition in the Brazilian population are still scarce. The prevalence of MS as a function of gender, age and socioeconomic level was determined in a population-based study in Vitória, ES, Brazil, by using the NCEP-ATPIII diagnosis criteria. Socioeconomic, biochemical, anthropometric, and hemodynamic data were obtained in 1,663 individuals from a random sample of Vitória population (25-64 y). The estimated prevalence of MS was 29,8 percent (CI95 = 28-32 percent). No significant sex-related differences were observed. Prevalence increased from the youngest (26-34 y) to the oldest (55-64 y) group (15.8 percent and 48.3 percent, respectively). A progressive increase of MS frequency was observed in women from the higher to the lowest socioeconomic level. The most frequent trait of MS in males was high blood pressure, followed by hypertriglyceridemia, low HDL-c levels, hyperglycemia, and central obesity. In females, hypertension was also the most frequent factor, followed by low HDL-c levels, abdominal obesity, hypertriglyceridemia and hyperglycemia. Our data show that prevalence of MS is high in the studied population, even in the youngest group. Moreover, high blood pressure gives a significant contribution to the diagnosis of this syndrome in both sexes. The precocious control of risk factors is necessary to reduce the impact of cardiovascular morbidity and mortality.

Doenças cardiovasculares ateroscleróticas, dislipidemias, hipertensäo, obesidade e diabetes metilo em populaçäo da área metropolitana da regiäo Sudeste do Brasil: II - Dislipidemias / Atherosclerotic cardiovascular disease, lipemic disorders, hypertension, obesity and diabetes millitus in the population of a metropolitan area of southeastern Brazil. II - Lipemic disorders

Objetivou-se caracterizar a prevalência de dislipidemias e outros fatores de risco em grupos populacionais, do Município de Cotia, "Area Metropolitana" de Säo Paulo, Brasil. Os grupos populacionais foram definidos a partir de características socioeconômicas e de localizaçäo geográfica no Município. Foram abordados os seguintes fatores de risco: hábitos alimentares aterogênicos (consumo de proteína de origem animal, gorduras saturadas e de colesterol), tabagismo, etilismo, sedentarismo, dislipidemias, obesidade, hipertensäo e diabetes melito. Os resultados encontrados foram os seguintes: 1 - O número médio de fatores de risco foi significantemente maior nos homens (p<0,01), comparado às mulheres, para as faixas etárias menores de 50 anos; entre 50-55 anos as médias se igualam para ambos os sexos, atingindo o valor máximo aos 60 anos com reduçäo acentuada após essa idade, no que se refere aos homens e apresentando um aumento constante e gradativo nas mulheres; 2 - O número médio de fatores de risco aumenta com a idade (p<0,01), para ambos os sexos; 3 - As prevalências de hipercolesteolemia de "alto risco" mais hipertrigliceridemia foram significantemente maiores nas classes de maior nível socioeconômico; 4 - Os perfis lipêmicos associados às dislipidemias demostraram que raramente os desarranjos lipêmicos ocorreram com um constituinte isoladamente; 5 - Somando-se as hipercolesterolemias de "alto risco", as "limítroes acompanhadas de dois ou mais fatores de risco" e as hipertrigliceridemias têm-se que 39,2 por cento dos homens e 32,8 por cento das mulheres, ou seja, 35,4 por cento da populaçäo amostrada necessária de imediata intervençäo clínico-educativa

Nutritional status of institutionalized elderly in south Florida

To assess the nutritional status of an elderly nursing home population of South Florida, forty-seven persons with ages ranging from 65 to 96 years were studied. Complete clinical examination and anthropometric measures were performed, along with blood cell count, biochemical blood parameters and assessment of water-soluble vitamins levels. The most common clinical finding were edentulous (67%), general pallor (44%), hyperpigmentation (33%), dry skin (26%) and arcus corneitis (26%). Thirty-five percent of the studied population had cholesterol levels greater than 220 mg/dl. Triglyceride levels were also significantly elevated in a considerable subset of our subjects, with 30% having levels above threshold value of 150 mg/dl. Small proportions of subjects showed low levels of albumin (6%), total protein (28%), ascorbic acid (2%), and thiamin (9%). Forty-five percent of males were pyridoxine deficient, while 63% of the females presented such deficiency. This study underscores the need to define, with greater precision, the nutritional status of aged populations as well as improve our inadequate standards associated with the normal aging process. Nutritional intervention--only possible when appropriate standards are defined--can potentially serve not only to prevent the occurrence of significant morbidity and mortality, but can also be employed to enhance quality of life in the elderly individuals