Factors associated with metabolic syndrome and quality of life of adults in a northeast brazilian municipality

Introduction: Metabolic Syndrome (MS) is currently considered a multi-factorial disease related to the asymptomatic, insidious, and deleterious inflammation that predisposes the individual to vulnerability by aggregating cardiovascular risk markers. Objective: to analyze the factors associated with Metabolic Syndrome and Quality of Life (QOL) in adult users of a health unit. Material and Methods: a cross-sectional study carried out with 108 adult users. Data collection was performed using a sociodemographic, clinical, and metabolic structured questionnaire and The Medical Outcomes Study 36-item Short-Form Health Survey (SF-36) questionnaire. For the diagnosis of Metabolic Syndrome, the following criteria were used: increased abdominal circumference and arterial hypertension, diabetes, hypertriglyceridemia, and low HDL-cholesterol. Statistical analysis was performed using the Statistical Package for Social Sciences (SPSS) 21.0 software. Results: Metabolic Syndrome was identified in 88.0% of the adults. Of this total of users evaluated with the syndrome, 87.4% of the individuals were female; 71.7% had diabetes; 87.0% had arterial hypertension; sedentary lifestyle was identified in 53.7%. In the assessment of the BMI, overweight and obesity predominated in 68.4% and 24.9%, respectively. The domains with the lowest quality of life scores were General Health and Vitality. Conclusions: The study made it possible to identify the Metabolic Syndrome in most of the adults evaluated. There was a low perception of quality of life among adults in all domains, except for physical aspects and vitality. Thus, there is a need for surveillance and health education for the studied population and improvement of their quality of life.

Introducción: El Síndrome Metabólico (SM) se considera actualmente una enfermedad multifactorial relacionada con la inflamación asintomática, insidiosa y deletérea que predispone al individuo a la vulnerabilidad al agregar marcadores de riesgo cardiovascular. Objetivo: analizar los factores asociados al síndrome metabólico y calidad de vida en adultos usuarios de una unidad de salud. Materiales y Métodos: estudio transversal realizado con 108 usuarios adultos. La recogida de datos se realizó mediante un cuestionario sociodemográfico, clínico y metabólico, estructurado y mediante el cuestionario The Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). Para el diagnóstico de Síndrome Metabólico se utilizaron los siguientes criterios: aumento de la circunferencia abdominal e hipertensión arterial, diabetes, hipertrigliceridemia y colesterol HDL bajo. El análisis estadístico se realizó utilizando el software Statistical Package for Social Sciences (SPSS) 21.0. Resultados: Se identificó síndrome metabólico en el 88,0% de los adultos. De este total de usuarios evaluados con el síndrome, el 87,4% de los individuos eran mujeres; 71,7% con diabetes; 87,0% tenía hipertensión arterial; Se identificó sedentarismo en 53,7%. En la valoración del IMC, predominaron el sobrepeso y la obesidad en 68,4% y 24,9%, respectivamente. Los dominios con las puntuaciones más bajas de calidad de vida fueron Salud general y Vitalidad. Conclusiones: el estudio permitió identificar el Síndrome Metabólico en la mayoría de los adultos evaluados. Hubo una baja percepción de la calidad de vida entre los adultos en todos los dominios, excepto en los aspectos físicos y vitalidad. Por tanto, es necesaria la vigilancia y educación sanitaria de la población estudiada y la mejora de su calidad de vida.

Introdução: A Síndrome Metabólica (SM) é atualmente considerada uma doença multifatorial relacionada à inflamação assintomática, insidiosa e deletéria que predispõe o indivíduo à vulnerabilidade por agregar marcadores de risco cardiovascular. Objetivo: analisar os fatores associados à Síndrome Metabólica e a Qualidade de Vida (QV) em adultos, usuários de uma unidade de saúde. Materiales e Métodos: estudo transversal realizado com 108 usuários, adultos. A coleta de dados foi realizada por meio de um questionário sociodemográfico, clínico e metabólico, estruturado e pelo questionário The Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). Para diagnóstico da Síndrome Metabólica utilizou-se como critérios: a circunferência abdominal aumentada e hipertensão arterial, Diabetes, hipertrigliceridemia e baixo HDL-colesterol. A análise estatística foi realizada com auxílio do software Statistical Package for Social Sciences (SPSS) 21.0. Resultados: a Síndrome Metabólica foi identificada em 88,0% dos adultos. Desse total de usuários avaliados com a síndrome, 87,4% dos indivíduos eram do sexo feminino; 71,7% com Diabetes; 87,0% apresentaram hipertensão arterial; o sedentarismo foi identificado em 53,7%. Na avaliação do IMC preponderou o excesso de peso e a obesidade em 68,4% e 24,9%, respectivamente. Os domínios com menores escores da qualidade de vida foram Estado Geral de Saúde e Vitalidade. Conclusões: o estudo possibilitou a identificação da Síndrome Metabólica na maioria dos adultos avaliados. Observou-se, em todos os domínios, uma baixa percepção da qualidade de vida entre os adultos, exceto nos aspectos físicos e vitalidade. Assim, faz-se necessária vigilância e educação em saúde para a população estudada e melhoria de sua qualidade de vida.

Descripción de los Efectos Cardiovasculares Generales del COVID-19 y sus Efectos sobre Diabetes Mellitus, Hipertensión y Obesidad/sobrepeso: Revisión Exploratoria / Description of the General Cardiovascular Effects of COVID-19 and the Effects on Diabetes Mellitus, Hypertension and Obesity / Overweight: Exploratory Review

Introducción: Debido al impacto mundial del COVID-19, la fisiopatología respiratoria del SARS-COV-2 ha sido ampliamente estudiada, no así la fisiopatología cardiovascular ni su relación con diabetes mellitus, hipertensión, obesidad/sobrepeso y actividad física. Objetivo: Conocer la información disponible en la literatura científica sobre fisiopatología cardiovascular del COVID-19 y su relación con comorbilidades cardiovasculares y actividad física. Métodos: Revisión exploratoria. Se aplicaron estrategias de búsqueda para Pubmed, Google Scholar, LILACS y Scielo, incluyendo términos como "COVID-19", "factores de riesgo cardiovascular" y "actividad física". Se seleccionaron artículos en inglés y español publicados hasta septiembre 2020 incluyendo fisiopatología cardiovascular COVID-19, comorbilidades y actividad física. Artículos sobre tratamientos, diagnósticos u otras enfermedades crónicas fueron excluidos. La extracción de datos se organizó en una matriz con las variables de interés. Resultados: Se incluyeron 66 artículos, 84,8% corresponden a estudios secundarios y 81,8% fueron escritos en inglés. La fisiopatología cardiovascular del COVID-19 y sus complicaciones abarcan desde daños estructurales en el corazón hasta alteraciones microvasculares. La enzima convertidora angiotensina 2 es el principal mediador de entrada del coronavirus (72,7% artículos). Alteraciones en la inmunidad basal, desencadenamiento de la "tormenta de citoquinas" y estado inflamatorio crónico basal, son mecanismos reportados que favorecerían el desarrollo de cuadros severos de COVID-19 en personas con diabetes mellitus, hipertensión y obesidad/sobrepeso. Un 33,3% de los artículos hace mención sobre actividad física y COVID-19. Conclusión: La ECA2 es la principal vía de entrada del SARS-CoV-2 al organismo y la presencia de comorbilidades podría estar relacionada con cuadros clínicos severos de COVID-19.

Introduction: Due to the global impact of COVID-19, the respiratory physiopathology of SARS-COV-2 has been extensively studied, not so the cardiovascular physiopathology or its relationship to diabetes mellitus, hypertension, or obesity/overweight and physical activity. Objective: To know the available information in scientific literature on cardiovascular physiopathology of COVID-19 and its relationship with cardiovascular comorbidities and physical activity. Methods: Scoping review. Different research strategies were applied in Pubmed, Google Scholar, LILACS, and Scielo including terms such as "COVID-19", "cardiovascular risk factors" and "physical activity". English and Spanish articles published until September 2020 were selected describing COVID-19 cardiovascular physiopathology and studies on comorbidities, physical activity, and COVID-19. Articles about treatments, diagnoses or other chronic diseases were excluded. Data extraction was organized into an array with variables of interest. Results: 66 articles were included, 84.8% were from secondary studies and 81.8% were written in English. Cardiovascular physiopathology of COVID-19 and its complications range from structural damage to the heart to microvascular alterations. The angiotensin converting enzyme 2 is the main mediator of coronavirus entry (72.7% articles). Alterations in basal immunity, triggering of the "cytokine storm" and chronic basal inflammatory state, are reported mechanisms that would favor the development of severe COVID-19 in people with diabetes mellitus, hypertension and obesity/overweight. A 33.3% of the articles mentioned physical activity and COVID-19. Conclusion: ECA2 is the main route of entry of SARS-CoV-2 into the body and the presence of comorbidities could be related to severe clinical cases of COVID-19.

Factores relacionados con hipertrofia ventricular izquierda en personas adultas que viven en altura / Factors Related To Left Ventricular Hypertrophy In Adult Persons Living At Altitude

Objetivo: determinar los factores relacionados a hipertrofia ventricular izquierda (HVI) en personas adultas que viven en altura. Metodos: Se realizó un estudio observacional, transversal y analítico en el Laboratorio de Ecocardiografía del Hospital Regional Docente Clínico (HRDCQ) Daniel Alcides Carrión (HRDCQ) de Huancayo, Perú a 3,259 m.s.n.m. La muestra se determinó con formula y el muestreo fue aleatorio simple. Los criterios de inclusión fueron: poseer 18 o más años de edad; tener estudio de ecocardiografía con diagnóstico de HVI. Los criterios de exclusión fueron: presentar enfermedad valvular, cardiopatía congénita, cardiomiopatía dilatada, evento cardiovascular agudo, y arritmia cardiaca. Los datos fueron recolectados en una ficha. Para el análisis estadístico se aplicó la prueba X2, t student, regresión logística binaria y multivariada, odds ratio, intervalo de confianza al 95%. Se consideró significativo p < 0,050. Resultados: Se incluyeron 488 pacientes, el promedio de edad fue de 64 años (rango: 18-98). En el 58,9% (370) fueron mujeres. Los factores relacionados a HVI fueron la hipertensión arterial (OR=5,90; IC95% = 3,57-9,75), la edad de 60 a más años (OR=3,13; IC95% = 2,04-4,81), diabetes mellitus (OR=2,92; IC95% = 1,03-8,21), y la obesidad (OR=2,25; IC95% = 1,16-4,35) en comparación a los pacientes sin HVI. En pacientes con HVI se encontró mayor índice del volumen auricular izquierdo y disfunción diastólica del ventrículo izquierdo. Conclusiones: los factores relacionados a HVI en personas adultas que viven en altura fueron la hipertensión arterial, la edad avanzada, diabetes mellitus y obesidad.

Objective: to determine the factors related to left ventricular hypertrophy (LVH) in adults living high. Methods: An observational, cross-sectional and analytical study was carried out in the Echocardiography Laboratory of the Hospital Regional Docente Clínico (HRDCQ) Daniel Alcides Carrión (HRDCQ) of Huancayo, Peru at 3,259 m.s.n.m. The sample was determined with a formula and the sampling was simple random. The inclusion criteria were: be 18 years of age or older; have an echocardiography study with a diagnosis of LVH. The exclusion criteria were: having valvular disease, congenital heart disease, dilated cardiomyopathy, acute cardiovascular event, and cardiac arrhythmia. The data were collected in a file. For the statistical analysis, the X2 test, student's t test, binary and multivariate logistic regression, odds ratio, 95% confidence interval were applied. P <0.050 was considered significant. Results: 488 patients were included, the average age was 64 years (range: 18-98). In 58.9% (370) they were women. The factors related to LVH were arterial hypertension (OR = 5.90; 95% CI = 3.57-9.75), age 60 years and older (OR = 3.13; 95% CI = 2.04-4 , 81), diabetes mellitus (OR = 2.92; 95% CI = 1.03-8.21), and obesity (OR = 2.25; 95% CI = 1.16-4.35) compared to patients without LVH. In patients with LVH, a higher left atrial volume index and left ventricular diastolic dysfunction were found. Conclusions: the factors related to LVH in adults living at height were arterial hypertension, advanced age, diabetes mellitus and obesity.

Factores asociados a hipertrofia ventricular izquierda en personas adultas en una ciudad de altura en el Perú / Factors associated with left ventricular hypertrophy in adults living at a high altitude city in Peru

RESUMEN Introducción: La hipertrofia ventricular izquierda se ha descrito en personas que viven a gran altura. Objetivo: Determinar los factores relacionados a hipertrofia ventricular izquierda (HVI) en personas adultas. Métodos: Se realizó un estudio observacional, transversal y analítico en el Laboratorio de Ecocardiografía del Hospital Regional Docente Clínico (HRDCQ) Daniel Alcides Carrión (HRDCQ) de Huancayo, Perú a 3,259 m.s.n.m. La muestra se determinó con formula y el muestreo fue aleatorio simple. Los criterios de inclusión fueron: poseer 18 o más años de edad; tener estudio de ecocardiografía con diagnóstico de HVI. Los criterios de exclusión fueron: presentar enfermedad valvular, cardiopatía congénita, cardiomiopatía dilatada, evento cardiovascular agudo, y arritmia cardiaca. Los datos fueron recolectados en una ficha. Para el análisis estadístico se aplicó la prueba X2, t student, regresión logística binaria y multivariada, odds ratio, intervalo de confianza al 95%. Se consideró significativo p < 0,050. Resultados: Se incluyeron 488 pacientes, el promedio de edad fue de 64 años (rango: 18-98). En el 58,9% (370) fueron mujeres. Los factores relacionados a HVI fueron la hipertensión arterial (OR=5,31; IC95%=3 ,27 - 8,61), la edad mayor a 60 años (OR=2,94; IC95%=1 ,93 - 4,50), la diabetes mellitus (OR=3 ,33 ; IC95%=1 ,15 - 9,79), y la obesidad (OR=2,21; IC95%=1 ,16 - 4,19) en comparación a los pacientes sin HVI. En pacientes con HVI se encontró mayor índice del volumen auricular izquierdo y disfunción diastólica del ventrículo izquierdo. Conclusiones: Los factores relacionados a HVI en personas adultas fueron la hipertensión arterial, la edad avanzada, diabetes mellitus y obesidad.

ABSTRACT Introduction: Left ventricular hypertrophy has been described in people who live at high altitudes. Objective: To determine the factors related to left ventricular hypertrophy (LVH) in adults. Methods: An observational, cross-sectional and analytical study was carried out in the Echocardiography Laboratory of the Hospital Regional Docente Clínico (HRDCQ) Daniel Alcides Carrión (HRDCQ) of Huancayo, Peru at 3,259 m.a.s.l. The sample was determined with a formula and the sampling was simple random. The inclusion criteria were: be 18 years of age or older; have an echocardiography study with a diagnosis of LVH. The exclusion criteria were: having valvular disease, congenital heart disease, dilated cardiomyopathy, acute cardiovascular event, and cardiac arrhythmia. The data were collected in a file. For the statistical analysis, the X2 test, student's t test, binary and multivariate logistic regression, odds ratio, 95% confidence interval were applied. P <0.050 was considered significant. Results: 488 patients were included, the average age was 64 years (range: 18-98). In 58.9% (370) they were women. The factors related to LVH were arterial hypertension (OR=5 .31; 95% CI=3 .27 - 8.61), age older than 60 years (OR=2 .94; 95% CI=1 .93 - 4, 50), diabetes mellitus (OR=3 .33; 95% CI=1 .15 - 9.79), and obesity (OR=2 .21; 95% CI=1 .16 - 4.19) compared to patients without LVH. In patients with LVH, a higher left atrial volume index and left ventricular diastolic dysfunction were found. Conclusions: The factors related to LVH in adults were arterial hypertension, advanced age, diabetes mellitus and obesity.

The Association of Food Insecurity with Type 2 Diabetes and Hypertension: A Multicenter Case-Control Study in Urban Population

@#Introduction: The household food insecurity (FI) is still one of global health issues, which is related to various health and developmental problems. The aim of this study was to evaluate the relationship of the FI with type 2 diabetes and hypertension in a city in North-West of Iran. Methods: Study population was the Khoy city’s households which refer to the primary health-care centers. The US Department of Agriculture (USDA) six-item Household Food Security Scale was used to determine food insecurity. Sample size for each case group (type 2 diabetic and hypertensive) was calculated to be 110 subjects and was doubled to be 220 subjects in the control group. Multi-stage random sampling method was applied. To control the confounding variables, the logistic regression was used. Results: In total, 210 subjects (47.7%) had food security and 52.3% were insecure. Seventeen percent of the study population had normal BMI (Body Mass Index) and 83% were obese or overweight (42.7% obese, 40.5% overweight). In multivariate analysis the age (p<0.001), BMI (p=0.002), and education (p=0.002) were significantly related to hypertension. However, food insecurity was not significantly related to diabetes and hypertension. Conclusion: High prevalence of FI, obesity and overweight in the population necessitate the educational interventions about healthy nutrition in families, especially from childhood. Financial and nutritional support is needed for the families with FI. Considering the indirect relationship between FI and hypertension shown in this study, it is recommended to implement interventions to reduce the FI as a risk factor of hypertension.

Hipertensión y obesidad en niños de un centro de educación preescolar de la ciudad de Popayán­Colombia: Un estudio descriptivo / Hypertension and obesity in children of a pre-school education center in the city of Popayán-Colombia: A descriptive study

Objetivo: el objetivo de la presente investigación es describir la prevalencia de hipertensión y obesidad, como factores de riesgo cardiovascular en niños pertenecientes a un centro de educación preescolar la ciudad de Popayán- Colombia. Materiales y métodos: Estudio descriptivo, de corte transversal. Se estimaron medidas antropométricas y de presión arterial en 45 preescolares. Resultados: la obesidad, de acuerdo a IMC, se presentó en un 11.1% de los preescolares, mientras que 6.6% de los individuos evaluados tuvieron mediciones de tensión arterial sistólica o diastólica, en rango de hipertensión arterial. Conclusiones: los hallazgos de la presente investigación sugieren que la aparición de factores de riesgo para la enfermedad cardiovascular, tiene lugar en edades muy tempranas. La generación de hábitos saludables podría prevenir la aparición y persistencia de dichos factores..(AU)

Objective: the aim of current investigation is to describe the prevalence of hypertension and obesity, as the cardiovascular risk factors in children belonging to a pre-school education center in the City of Popayán- Colombia. Materials and methods: Descriptive, cross-sectional study. Anthropometric measurements and blood pressure were estimated in 45 preschoolers. Results: obesity, according to IMC, was presented in 11.11% of the preschool children, while 6.66% of the individuals evaluated had blood pressure, systolic or diastolic blood pressure in the range of arterial hypertension. Conclusions: the findings of the present investigation suggest that the appearance of risk factors for cardiovascular disease occurs at very young ages. The generation of healthy habits could prevent the appearance and persistence of these factors..(AU)

Factores de riesgo de los accidentes cerebrovasculares durante un bienio / Risk factors of strokes during a biennium

Se realizó un estudio analítico, observacional de casos y controles en pacientes del Policlínico Docente "Carlos Montalbán" del municipio de Palma Soriano, provincia de Santiago de Cuba, a fin de determinar los principales factores de riesgo de los accidentes cerebrovasculares, desde enero de 2014 hasta diciembre de 2015. Fueron seleccionados 2 grupos: uno de 90 integrantes (casos) y otro de 180 (controles). Se calcularon la oportunidad relativa y el intervalo de confianza; se aplicó la prueba de Ji al cuadrado con 95 % de confiabilidad y se utilizó el porcentaje como medida resumen para variables cualitativas. Las condiciones predisponentes que predominaron en la serie fueron: edad, hipertensión arterial, obesidad, sedentarismo, tabaquismo y dislipidemia, las cuales ponen en riesgo la vida del afectado.

An analytic observational case-control study in patients of "Carlos Montalbán" Teaching Polyclinic in Palma Soriano, Santiago de Cuba, was carried out in order to determine the main risk factors of strokes, from January, 2014 to December, 2015. Two groups were selected: one with 90 members (case) and another one with 180 (control). The relative opportunity and the confidence interval were calculated; the Chi-square test was applied with 95% of confidence and the percentage was used as summary measure for qualitative variables. The predisposing conditions that prevailed in the series were: age, hypertension, obesity, sedentary lifestyle, nicotine addiction and dyslipemia, which put at risk the life of the ones affected.