ABSTRACT
@#【Objective】Diabetes mellitus is a risk equivalent for coronary heart disease. This retrospective study was designed to investigate the risk factors of the progression of coronary lesions in patients with type 2 diabetes（T2DM）and Non- diabetes Mellitus（NDM）.【Methods】 526 patients with T2DM and 425 patients with NDM at the Third Affiliated Hospital of Sun Yat-sen University between March 2001 and January 2017 who underwent coronary imaging studies（coronary angiography or coronary CTA）twice during the same period were enrolled. The effects of cardiovascular risk factors on the progression of coronary lesions were analyzed in parallel in these two types of patients.【Results】Risk factors of the progression of coronary lesions in T2DM patients included smoking（OR = 1.836，95% CI：1.030~3.371，P = 0.04），Lp（a） ［OR = 1.001，95% CI：1.000~1.002，P = 0.004（baseline）；OR = 1.001，95% CI：1.000~1.002，P = 0.009（re-examined）］，HbA1c leve［l OR = 1.471，95% CI：1.030~2.100，P = 0.034（re-examined）］，uncontrolled LDL-C（OR = 1.882，95% CI：1.091~3.245，P = 0.023），TC［OR = 2.029，95% CI：1.028~4.008，P = 0.041（re-examined）］and low HDL-C ［OR = 0.017，95% CI：0.040~0.729，P = 0.017（re-examined）］. Comparative risk factors in NDM included BMI［OR =1.746，95%CI：2.462~2.712，P = 0.026（baseline）；OR = 0.001，95%CI：0~0.394，P = 0.025（re-examined）］，uncontrolled LDL-C（OR = 2.875，95%CI：1.669~4.952，P < 0.001）and low ApoA［OR = 0.282，95%CI：0.082~0.971，P = 0.045 （baseline）；OR = 0.117，95%CI：0.038~0.835，P = 0.029（re-examined）］. Lowest level of progression was found in the group with HbA1c<6.5%［0（0~3.4）points/year vs 0.3（0~3.0）points/year vs 1.0（0~5.1）points/year，P = 0.049. 0（-0.4~2.7）points/year vs 0.6（0~4.0）points/year vs 0.9（0~4.2）points/year，P=0.029］in T2DM patients.【Conclusion】Except for achievement of LDL- C goals，there might be some differences in risk factors for progression of coronary lesions between T2DM and NDM patients. Smoking，Lp（a），TC，HDL- C and control levels of HbA1c are independent predictors in T2DM as well as BMI and ApoA in NDM. Lowering HbA1c to less than 6.5% may delay progression of lesion.
ABSTRACT
Las Enfermedades Cardiovasculares (ECV) son la principal causa de mortalidad a nivel mundial y nacional. La persistente prevalencia global de la mortalidad por ECV y su incremento exponencial en poblaciones con crecientes índices de pobreza, han conducido al diseño e implementación de estrategias de prevención, con base en la historia natural de la aterosclerosis, la cual está presente desde la vida fetal. La presencia de factores de riesgo para ECV en la infancia con persistencia hasta la adultez soporta la hipótesis de programación fetal cardiometabólica para explicar el impacto de la nutrición sobre el desarrollo de ECV, desde el inicio de la vida. Con el objeto de establecer los lineamientos nutricionales para niños venezolanos de 0 a 9 años de edad, en el Segundo Consenso Venezolano Pediátrico de Nutrición: nutrición temprana y salud a corto y largo plazo, se evaluó la evidencia epidemiológica publicada a nivel nacional y global sobre factores metabólicos y conductuales para riesgo de ECV relacionados con la nutrición presentes en niños. Se presentan las conclusiones y recomendaciones del grupo de trabajo: crecimiento y nutrición en la infancia y riesgo para enfermedad cardiovascular en la adultez. El análisis de la evidencia revisada permite afirmar que la alimentación del niño de 0 a 9 años tiene impacto en la presencia de factores de riesgo para ECV en el adulto. Se sugieren estrategias para la nutrición del niño con el fin de garantizar un crecimiento y desarrollo adecuado con un estado de salud cardiovascular óptima.
Cardiovascular diseases (CVD) remains the leading cause of death globally and nationally. The global persistent mortality prevalence of CVD and its exponential increase in countries with poverty index increasing have led to design of prevention strategies, based on the natural history of atherosclerosis, which is present from the fetal life. The presence of CVD risk factors in childhood with persistence into adulthood supports cardiometabolic fetal programming hypothesis to explain the impact of dietary habits on the development of CVD, from the beginning of life. In order to establish nutritional guidelines for Venezuelan children of 0-9 years old, in the Second Venezuelan Pediatric Nutrition Consensus: early nutrition and health in the short and long term, the national and global epidemiological evidence published for metabolic and behavioral risk factors for CVD related to nutrition present in children was evaluated. Growth and nutrition in childhood and risk for cardiovascular disease in adulthood working group: findings and recommendations of the working group are presented. The evidence analysis suggest that the nutrition of children from 0 to 9 years has an impact on the presence of risk factors for CVD in adults. Strategies for child nutrition are suggested in order to ensure proper growth and development with a state of optimal cardiovascular health.
ABSTRACT
La aterosclerosis es un proceso de origen multicausal y se acompaña de una gran variedad de manifestaciones clínicas y humorales. Son conocidos los factores de riesgo aterogénicos como dislipidemias, hipertensión arterial, diabetes mellitus, obesidad, tabaquismo, aumento de homocisteína y otros. La aterosclerosis lleva a la cardiopatía isquémica, enfermedad cerebro-vascular, enfermedad renal crónica, enfermedad arterial periférica y aneurismas ateroscleróticos. Es bien conocido que, por estar estrechamente ligada con la sangre y el oxígeno que necesitan todas las células del organismo, deja su huella en casi todos los órganos y tejidos del organismo, produciendo afectación en el sistema nervioso central y por lo tanto, en la esfera cognitiva. Los factores de riesgo ateroscleróticos que pueden afectar la función cognitiva principalmente son: hipertensión arterial, diabetes mellitus, dislipidemia, obesidad, síndrome metabólico, envejecimiento, aumento de la homocisteína sanguínea, aumento del fibrinógeno y tabaquismo. Se hace una revisión actualizada del tema, el cual consideramos de gran interés, para tener en cuenta en la asistencia médica diaria
Atherosclerosis is a process of multicausal origin which is accompanied by a great variety of clinical and humoral manifestations. Atherogenic risk factors are well known. They include dyslipidemias, arterial hypertension, diabetes mellitus, obesity, smoking, increased homocysteine, and others. Atherosclerosis leads to ischemic heart disease, cerebrovascular disease, chronic renal disease, peripheral arterial disease and atherosclerotic aneurysms. As is well known, due to its close relation to the blood and the oxygen required by all cells in the body, the disease leaves an imprint in practically all organs and tissues, affecting the central nervous system and consequently the cognitive sphere as well. The atherosclerotic risk factors that may affect cognitive function are in the first place arterial hypertension, diabetes mellitus, dyslipidemia, obesity, metabolic syndrome, aging, increased blood homocysteine, increased fibrinogen and smoking. An updated review is conducted on the topic, which we consider to be of great interest. The review may be of use in daily medical practice
Subject(s)
Atherosclerosis , Risk Factors , Cognition Disorders/pathologyABSTRACT
La obesidad es la forma más común de malnutrición y ha ido alcanzando proporciones epidémicas tanto en los países desarrollados como en los que se encuentran en vías de desarrollo. Existe en la actualidad una gran preocupación por las consecuencias de los factores de riesgo aterosclerótico desde edades tempranas de la vida, así como de las afectaciones psicosociales y cognitivas presentes en la obesidad. Se ofrece una revisión al respecto, partiendo de la consideración de que es importante que sean del conocimiento del personal responsable de la atención de estos niños y adolescentes
Obesity is the commonest way of malnutrition and has achieved epidemic levels in developed countries and also in those underdeveloped. At the present time there is a great concern by the consequences of atherosclerosis risk factors from early stages of life, as well as of the psychosocial and cognitive affectations present in obesity. In this respect a review is offered from the consideration that all this be of knowledge of staff responsible for the care of these children and adolescents
ABSTRACT
Objetivo - Descrever o perfil lipídico e relacioná-lo com outros fatores de risco para doença coronária aterosclerótica, em funcionários de indústria metalúrgica de Säo Bernardo do Campo, SP. Métodos - De total de 1966 funcionários que tiveram determinados: perfil lipidico após jejum de 12h, peso e altura e responderam a questionário sobre fatores de risco, foram excluídos os diabéticos e hipertensos, restando 1586 casos. Duzentos e dois eram do sexo feminino e 1384 do masculino, idade média de 34 anos. Foram também relacionadas as variáveis do perfil lipidico com outros fatores de risco (sexo, idade, tabagismo, índice de massa corpórea, atividade física no trabalho e no lazer) e consumo de álcool. Resultados - Quinhentos e oitenta indivíduos (36,6//) apresentaram colesterolemia toal ò 200mg/dl, 104(6,4//) trigliceridemia ò 250mg/dl, 273(17,2//) HDL-colesterol < 35mg/dl e 579(36,9//) LDL-colesterol > 130mg/dl, níveis considerados ideais para as diferentes variáveis lipídicas. Encontraram-se relaçöes entre os níveis lipídicos e as outras variáveis estudadas: idade, sexo, índice de massa corpórea, tabagismo, consumo de álcool, atividade física no trabalho e no lazer. Conclusäo - A freqüência de desvios lipídicos é alta na populaçäo estudada, sugerindo a necessidade de medidas para sua modificaçäo, com vistas à prevençäo primária das aterosclerose coronária
Purpose - To study the lipidprofile and its relation with other risk factors for coronary heart disease in a population of metallurgic workers in São Bernardo do Campo, SP. Methods - In 1966 employees wore determined: lipid profile after 12h fasting, height and weight and they answered a questionnary about other risk factors. Diabetic and hypertensive wore excluded, remaining 1586 cases, 1384 males, mean age 34. The variables of the lipid profile were related with other risk factors (sex, age, smoking, body mass index, physical activity at work and at leisure time) and alcohol intake. Results - Five hundred and eighty people (36.6%) had total cholesterol >200mg/dl, 104 (6.4%) triglycerides >250mg/dl, 273 (17.2%) HDL-cholesterol <35mg/dl and 579 (36.9%) LDL-cholesterol >130mg/dl, levels considered ideals for the different lipid variables. The different relations between lipid levels and the other variable analysed: age, sex, body mass index, smoking, alcohol intake, physical activity at work and leisure time were described. Conclusion - The frequency of lipid abnormalities is high in the assessed population. For primary prevention, a strategy has to be taken to modify this