High prevalence of cholelithiasis in a low income mexican population: An ultrasonographic syrvey

The authors present the result of a population based survey of cholelititasis carried out in a low income area of Mexico city using high resolution gallbladder ultrasound. The purpose of the study was to estimate the prevalence and selected associated risk factors of cholelithiasis (CL). The population of the studied area was 15,532 subjects, of whom 3,505 (22.6 percent) were eligible for the baseline survey (men and non-pregnant women between 35-64 years of age). Of this group, 1,735 (76.03 percent, 702 men and 1,033 women) were located for a follow-up study. Ultrasonography was performed on all except for 100 subjects who had undergone previous cholecystectomy. Crude prevalence of CL was 14.1 percent (95 percent CI 12.5-15.5). The prevalence was 5.8 percent (95 percent CI 4.1-7.5) in men and 19.7 percent (95 percent CI 17-3-22.1) in women. Presence of gallstones was associated with age, sex (men p<0.006, women p<0.001), and multiparity (p<0.002). Centrality index in men and body mass index in women were positive and significantly associated with CL when compared with subjects without CL. High levels of fasting and post glucose load insulin in women and men respectively were associated with CL. The authors conclude that the population of this study has a high prevalence of CL and confirm some know risk factors such as age, sex, BMI and multiparity. Proper assessment of the magnitude problem and characterization of potentially modifiable risk factors will play a major role in preventing this pathology

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

Prevalence and detection of hypertension in Mexico

The aim of this study was to characterize the prevalence and detection of systemic hypertension in a low income urban area of Mexico City. The population of the studied area was 15,532 inhabitants, of whom 3505 (22.6 per cent) were eligible for study (men aged 35 - 64 years and non-pregnant women). Home interviews were obtained on 2810 (80.2 per cent) and physical and laboratory examination was performed on 2282 individuals (941 men, 1341 women, 81.2 per cent of those interviewed and 65.1 per cent of all the eligibles). Blood pressure (BP) was measured using a randomzero sphygmomanometer (Hawksley, London). Three measurements were made on the right arm after a 5 min rest, with the patient seated. The average of the last two determinations was taken as the patient's BP. High blood pressure (HBP) was defined as systolic BP > or = 160 and/or diastolic BP > or = 95 mmHg, or if the patinet was taking antihypertensive therapy regardless of the blood pressure value. A total of 216 subjects (77 men, 139 women) met criteria for HBP. In the 35.44 age group, prevalence for men was 4.16 per cent and for women 3.06 per cent. In the 44 - 55 age groups the prevalence for men was 7.81 per cent and for women 12.55 per cent. In the 55 - 64 year group the prevalence for men was 16.51 per cent and for women 22.2 per cent. Obesity was associated with HBP (body mass index in men with HBP was 28.9 kg/m² vs. without 26.9 kg/m², p < 0.001; women with HBP, 30.8 kg/m² vs. without 28.5 kg/m², p < 0.001. Fat distribution was upper body in patients with HBP (waist/hip circumferences in men with HBP (body mass index in men with HBP was 28.9 kg/m² vs. without 26.9 kg/m², p<0.001; women with HBP, 30.8 kg/m² vs. without 28.5 kg/m², p<0.001. Fat distribution was upper body in patients with HBP (waist/hip circumferences in men with HBP was 1.02 vs. men without HBP, 0.97, p<0.001, women with HBP, 1.0 vs. without 0.97, p<0.001). In both sexes patients with HBP showed a tendency to higher glucose and insuline values. Women with HBP exihited higher total and LDL cholesterol as well as higher triglicerides when compared to women without HBP. In 14.7 per cent of hypertensive individuals (35 subjects, 21 men and 14 women) HBP was newly diagnosed. The clinical characteristics of this group were not different than in the patients with previously diagnosed HBP. We conclude that the prevalence of HBP is significant in the Mexican population, increases with age, is associated with obesity.

Niveles de lípidos sanguíneos y riesgo aterogénico en población abierta urbana / Serum lipids, population based survey increased atherogenic risk

Se presentan los resultados de una investigación realizada en población abierta, urbana de nivel económico bajo de la ciudad de México. Se miden los principales lípidos sanguíneos y las siguientes variables antropométricas: peso, talla, circunferencias de cintura y cadera así como la de los pliegues subcutáneos tricipital y subescapular. La región estudiada comprende tres áreas geoestadísticas básicas con una población total de 2253 individuos entre 35 y 64 años de edad. Se procedió a entrevistar a estos sujetos en el domicilio lográmdose la encuesta domiciliaria en el 94.8 por ciento de los casos. Posteriormente se invitó a los participantes a realizarse un examen físico con toma de muestras de sangre. Para esta fase del estudio se obtuvo una tasa de respuesta global de 62.6 por ciento. El total del paciente estudiado fue 1411 de los cuales 846 fueron mujeres y 565 hombres. La distribución por grupos de edad y por sexo es la siguiente: hombres grupo 1 (33-44 años) 235 casos; grupo 2 (45-54 años) 203 casos; grupo 3 (55-64 años) 127 casos. Para las mujeres grupo 1 367; grupo 2 289; y grupo 3 190 casos. Se encontró que el índice de masa corporal promedio en las mujeres es de 28.9 kg/m* lo que demuestra una prevalencia de obesidad muy elevada, mayor en las mujeres que en los hombres. Utilizando la relación entre los pliegues subescapular/tricipital, se demostró que la distribución de la adiposidad corporal es de predominio central (mayor en el tronco que en las extremidades) tanto en hombres como mujeres. Se encontró que la adiposidad tiende a distribuirse en el segmento inferior del cuerpo en hombres y mujeres. Cuando se incrementa el peso, esta distribución tiende a revertirse predominando en el segmento superior, lo que se asocia a mayor riesgo aterogénico. Los niveles promedio (ñ DE) de colesterol total sanguíneo (en mg/dL) fueron: hombres grupo 1 200 ñ 42, grupo 2 193 ñ 38, grupo 3 189 ñ 42. Para las mujeres los valores fueron 186 ñ 44, 198 ñ 43 y 209 ñ 46 mg/dL para cada grupo de edad respectivamente. Las cifras de HDL-colesterol encontradas en los hombres fueron 30.4 mg/dL y en las mujeres 35.0 mg/dL. En cuanto a los valores de LDL-colesterol, el promedio para los hombres fue de 125 mg/dL y para las mujeres de 128 mg/dL. Las cifras promedio de VLDL-colesterol para los hombres fue de 38 mg/dL; para las mujeres de 35 mg/dL. Las cifras promedio de triglicéridos en los hombres fue de 203 mg/dL y en las mujeres de 169 mg/dL. Concluimos que en la población a

Prevalencia de diabetes e intolerancia a la glucosa en una población urbana de nivel económico bajo / Prevalence of type II diabetes and impaired glucose tolerance in a low income urban population

Se presentan los resultados de un estudio epidemiológico en población abierta, en medio urbano, de nivel económico bajo, con el propósito de establecer la prevalencia de diabetes mellitus tipo II (DM) e intolerancia a la glucosa (IG) en este sector de la población. Se seleccionó una zona equivalente a un área geoestadística básica, de acuerdo al Instituto Naccional de Estadística, Geografía e Informática. Se obtuvo un plano de la colonia con sus 39 manzanas. Se seleccionaron aleatoriamente empleando el paquete estadístico Systat. Se enumeraron todos los hogares de cada manzana, listando a todos sus habitantes y definiendo como elegibles a los que tuvieran 35 a 64 años de edad que no estuvieran embarazadas. Se entrevistó en el domicilio a todos los elegibles. Se investigó si padecían o no DM. Después se les invitó a realizarse un exàmen físico con curva de tolerancia a la glucosa. El total de habitantes en la zona fue de 4411. De estos 931 resultaron elegibles: 452 hombres (48.5 porciento) y 479 mujeres (51.5 porciento). La taza de respuesta de la encuesta domiciliaria fue 91.7 porciento y la del exámen físico 69.8 porciento utilizando los criterios de diagnóstico recomendados por la Organización Mundial de la Salud, la taza cruda de prevalencia de DM fue: en hombres 10.6 porciento y en mujeres 14.8 porciento. La taza cruda de prevalencia de IG en hombres resultó 12.8 porciento y en mujeres 12.3 porciento. Estos datos manifiestan que nuestra población tiene un alto grado de susceptibilidad a la DM e IG: ubican en nuestro país entre las poblaciones con mayor prevalencia de DM.