Undiagnosed hypercholesterolemia: a serious health challenge: the Mexico City Diabetes Study

In this report we present the results of a population based survey designed to characterize the prevalence of hypercholesterolemia (HCL: total cholesterol > or = 240 mg/dl) in a low income urban area of Mexico City (The Mexico City Diabetes Study). In an area of 15,532 inhabitants, 3505 (22.57 per cent) were found to be study eligible (all 35 -64 year-old men and nonpregnant women residing in the area permanently). A home interview was obtained in 2813 (80.26 per cent) subjects. A physical exam and oral glucose tolerance test was performed on 2282 (81.2 per cent of the individuals that gave the interview and 65.1 per cent of all study eligibles, 941 men and 1341 women). The crude prevalence of HCL for men in this group was 12.3 per cent and for women 12.5 per cent. Severe HCL (total cholesterol > or = 260 mg/dl) was found in 6.6 per cent of men and 6.5 per cent of women. In the older age group (55 - 64 years) prevalence in women reached 21.1 per cent. Of the individuals with HCL this abnormality was previously diagnosed in only 15.9 per cent of men and in 7.8 per cent of women. Despite having been diagnosed, the abnormality remained untreated in all cases. HCL was associated with higher mena systolic blood pressure (in women), higher mean diastolic blood pressure (in men) and higher mean fasting and 2 h post-glucose load glycemia as weel as post-challenge insulinemia in both sexes. Mean TG was found high in both groups (with and without HCL), but in subjects with HCL the values were significantly higher. We conclude that HCL is very common in this population. The majority of the cases remained undiagnosed and of the small fraction of subjects that have been diagnosed, virtually none is under medical care. It is necessary to design and implement a national program to reduce the impact of this serious health problem

Prevalence of gallbladder disease and associated clinical variables in a low income population of Mexico City

We present the results of a population-bases syrvery carried out in a low income area of Mexico City. The aim of this study is to characterize the prevalence of clinically significant gallbladder disease (CSGD) using the self-reported history of cholecystectomy (CG) or cholelithiasis (CL) demonstrated by cholecystography and/or ultrasonography. The population of the studied area was 15,532 ihabitants, of whom 3505 (22.6 percent) were age elegible (35 - 64 year-old men and non-pregnant women). Home interview were obtained in 2810 (80.2 percent). A physical and laboratory examination was performed in 2282 individuals (65.1 percent; 941 men and 1341 women). The prevalence of CSGD in men was 2.0 percent (95 percent confidence intervals 1.1 - 2.9 percent) and 9.2 percent in women (95 percent confidence intervals 7.7 - 10.7 percent). Patients with CSGD were older, emn (p <0.003) and women (p <0.001). Women with CSGD had higher waist to hip circumference ratio (p <0.06), higher fasting glucose (p <0.03) as well as 2 h post challenge glycemia (p <0.04) and insulinemia (p <0.03) In the multiple logistic regression model only age (p <0.001) and sex (p <0.001) remained significantly associated. We conclude that CSGD is quite prevalent in this population. Is is associated with age in both genders and in women, higher glucose and insulin levels. The prospective follow-up of this cohort is important since it copuld generate the information needed to implement a preventive program to diminish the impact of this condition