Impacto de factores de riesgo vascular sobre la frecuencia de insuficiencia renal crónica / Impact of vascular risk factors on the frequency of chronic renal failure

Introducción: La insuficiencia renal crónica se relaciona con múltiples factores de riesgo vascular. La prevalencia de estas entidades se ha incrementado en Cuba en las últimas décadas, asociado al envejecimiento de la población. Objetivo: Identificar la relación entre la insuficiencia renal crónica, diagnosticada según los estadios de filtrado glomerular, con factores de riesgo vascular (obesidad, hipertensión arterial, diabetes mellitus, hiperlipoproteinemia, tabaquismo) y la enfermedad cardiovascular establecida. Métodos: Se realizó un estudio descriptivo, transversal, en 2 913 pacientes. Se recolectaron datos generales, antropométricos, factores de riesgo vascular y hemoquímica. Se consideraron portadores de insuficiencia renal crónica aquellos con filtrado glomerular inferior a 60 mL/min/1,73 m2. Se identificó la relación entre la insuficiencia renal crónica y los factores de riesgo vascular mediante el odds ratio. Los valores medios de las variables hemoquímicas se compararon con ANOVA de un factor. Resultados: Se encontró 10,8 por ciento de insuficiencia renal crónica (15,3 por ciento en las mujeres), su frecuencia aumentó con la edad y se asoció con los factores de riesgo seleccionados (enfermedad cardiovascular establecida, OR = 3,58; hiperlipoproteinemia, OR = 2,96; hipertensión arterial, OR = 2,95; diabetes mellitus, OR = 2,70 y obesidad, OR = 1,33). La frecuencia de insuficiencia renal crónica así como los valores de glucemia, colesterol, triglicéridos y HbA1c aumentaron con la suma de factores de riesgo. Conclusiones: La insuficiencia renal crónica fue muy frecuente en esta serie. Predominó en el sexo femenino y en los grupos de edad más avanzada. Se constató una significativa relación con los factores de riesgo seleccionados, que fue mayor en pacientes con enfermedad cardiovascular establecida(AU)

Introduction: Chronic renal insufficiency is related to multiple vascular risk factors. The prevalence of these entities has increased in Cuba in recent decades, associated with population aging. Objective: To identify the relationship between chronic renal failure, diagnosed according to glomerular filtration stages, with vascular risk factors (obesity, high blood pressure, diabetes mellitus, hyperlipoproteinemia, smoking) and established cardiovascular disease. Methods: A descriptive, cross-sectional study was carried out in 2913 patients. General, anthropometric data, vascular risk factors, and hemochemistry were collected. Carriers of chronic renal insufficiency were considered those with glomerular filtration rate lower than 60 mL / min / 1.73 m2. The relationship between chronic renal insufficiency and vascular risk factors was identified using the Odds Ratio. The mean values of the hemochemical variables were compared with one-way ANOVA. Results: 10.8 percent of chronic renal insufficiency (15.3 percent in women) was found, its frequency increased with age and was associated with the selected risk factors (established cardiovascular disease: OR 3,58; hyperlipoproteinemia: OR 2,96; hypertension: OR 2,95; diabetes mellitus: OR 2,70 and obesity: OR 1,33). The frequency of chronic renal insufficiency as well as blood glucose, cholesterol, triglyceride and HbA1c levels increased with the sum of risk factors. Conclusions: chronic renal insufficiency was very frequent in this series. It prevailed in the female sex and in the most advanced age groups. A significant relationship with the selected risk factors was found, which was higher in patients with established cardiovascular disease(AU)

Factores de riesgo metabólico y enfermedad cardiovascular asociados a obesidad en una población laboralmente activa / Metabolic Risk Factors and Cardiovascular Disease Associated with Obesity in an Actively Working Population

Introducción: La obesidad se relaciona con múltiples consecuencias adversas para la salud, como hipertensión, diabetes, hiperlipoproteinemia, enfermedad cardiovascular y otras. La prevalencia de estas entidades se ha incrementado en Cuba en las últimas décadas, muy asociadas a la ganancia ponderal. Objetivo: Describir la relación de la obesidad con la enfermedad cardiovascular y los factores de riesgo metabólicos como hipertensión arterial, hiperlipoproteinemia y diabetes mellitus. Métodos: Se realizó un estudio descriptivo, de corte transversal, en 2902 pacientes que acudieron a chequeo médico en el Hospital Militar Central Dr. Carlos J. Finlay. Se recolectaron datos generales, antropométricos y factores de riesgo metabólico de enfermedad cardiovascular. Se realizó glucemia en ayunas, colesterol, triglicéridos, creatinina y prueba de tolerancia a la glucosa oral en casos indicados. Se calculó el filtrado glomerular. Los pacientes fueron clasificados en bajo peso, normo peso, sobrepeso y obeso, se identificó la relación entre el estado nutricional y los factores de riesgo metabólico y la enfermedad cardiovascular. Resultados: Se encontró 44,5 por ciento de sobrepeso, más frecuente entre los hombres (45,5 por ciento) y 29,2 por ciento de obesidad, más frecuente entre las mujeres (31,6 por ciento). El índice de masa corporal aumentó progresivamente con la edad. Los valores de glucemia, colesterol, triglicéridos, HbA1c y filtrado glomerular aumentaron con el estado nutricional, así como la frecuencia de diabetes, hipertensión, hiperlipoproteinemia y enfermedad cardiovascular. Conclusiones: La obesidad fue muy frecuente en este grupo de pacientes, en los cuales se relacionaron directamente los factores de riesgo metabólico hipertensión arterial, hiperlipoproteinemia, diabetes mellitus y enfermedad cardiovascular(AU)

Introduction: Obesity is associated with multiple adverse health consequences, such as hypertension, diabetes, hyperlipoproteinemia, cardiovascular disease, and others. The prevalence of these conditions has increased in Cuba in recent decades, closely associated with ponderal gain. Objective: To describe the relationship of obesity with cardiovascular disease and metabolic risk factors such as hypertension, hyperlipoproteinemia, and diabetes mellitus. Methods: A descriptive, cross-sectional study was carried out with 2902 patients who went for a medical check-up at Dr. Carlos J. Finlay Central Military Hospital. General, anthropometric and metabolic risk factors for cardiovascular disease were gathered. The tests of fasting blood glucose, cholesterol, triglycerides, creatinine and oral glucose tolerance were performed in indicated cases. Glomerular filtrate was calculated. Patients were classified as low weight, normal weight, overweight, and obese. The relationship between nutritional status and metabolic risk factors and cardiovascular disease was identified. Results: 44.5 percent were found in overweight, more frequent among men (45.5 percent). 29.2 percent were found in obesity, more frequent among women (31.6 percent). The body mass index increased progressively with age. Blood glucose, cholesterol, triglycerides, HbA1c, and glomerular filtration levels increased with nutritional status, as well as the frequency of diabetes, hypertension, hyperlipoproteinemia, and cardiovascular disease. Conclusions: Obesity was very frequent in this group of patients, in which the metabolic risk factors were directly associated with high blood pressure, hyperlipoproteinemia, diabetes mellitus, and cardiovascular disease(AU)

Estudio Descriptivo: Prevalencia de Dislipidemia en Adultos de 40 - 64 Años, Cuenca - Ecuador, Enero a Julio 2014 / Cross-Sectional Study: Prevalence of Dyslipidemias in Adults Between 40 and 64 Years Old, Cuenca ­ Ecuador, January to July 2014

INTRODUCCIÓN: Las dislipidemias son enfermedades asintomáticas causadas por concentraciones anormalmente elevadas de las lipoproteínas sanguíneas; aumentan el riesgo de morbilidad y mortalidad, representan un problema de salud pública a nivel mundial como reportan los organismos sanitarios, su detección es de utilidad para la prevención de las enfermedades cardiovasculares. El objetivo de este estudio fue determinar la prevalencia de dislipidemia en adultos del área urbana del cantón Cuenca. MÉTODOS: Se realizó un estudio descriptivo transversal; el universo lo conformaron 69 039 habitantes del área urbana de la ciudad de Cuenca. La muestra fue de tipo probabilístico, conformado por 384 personas. Se realizaron exámenes de sangre que incluían: colesterol total, colesterol HDL, LDL y triglicéridos en ayunas, en el laboratorio de la Fundación DONUM. La información se obtuvo por entrevista y observación directa previo consentimiento informado. Los datos fueron analizados en el software SPSS Versión 15, mediante medidas de frecuencias y tendencia central con un intervalo de confianza del 95%. RESULTADOS: El promedio de edad fue 51 años, de los cuales el 71.9% fueron mujeres. La prevalencia de hipercolesterolemia fue 38.5%; en relación al sexo existió predominio en las mujeres con 34.4%, en los hombres el 28.7%. La prevalencia de hipertrigliceridemia fue de 58.5%. CONCLUSIONES: Los resultados de este estudio permiten tener una visión real y actualizada de la prevalencia de este padecimiento a nivel local, lo que posibilitará plantear acciones de promoción de estilos de vida saludables priorizando la importancia del ejercicio y una alimentación saludable, así como actividades de prevención a fin de evitarla aparición de complicaciones.

BACKGROUND: Dyslipidemias are asymptomatic diseases caused by abnormally high blood lipoprotein levels; these entities significantly increase morbidity and mortality risk, representing a global public health problem. Early detection is useful for cardiovascular disease prevention. The aim of this study was to determine the prevalence of dyslipidemia in adults belonging to urban area of Cuenca. METHODS: A cross-sectional study was performed; the universe included 69.039 habitants of the urban area of Cuenca. The sample was probabilistic and conformed by 384 people. Fasting lipid panel were evaluated, including total cholesterol, HDL, LDL and triglycerides. After informed consent information were obtained by interview and direct observation. The data were analyzed in SPSS Version 15, using frequencies and central tendency measures with 95% confidence interval. RESULTS: The average age was 51 years, 71.9% were women. The hypercholesterolemia prevalence was 38.5%, with a predominance in female patients 34.4% versus 28.7% in males. The prevalence of hypertriglyceridemia was 58.5%. CONCLUSIONS: The results gives a real and updated view of the local prevalence, this information allows proposing actions that promote healthy lifestyles, prioritizing the importance of exercise and diet, in order to avoid the complications.

Interaction between Glucose and Lipid Metabolism: More than Diabetic Dyslipidemia

Glucose and lipid metabolism are linked to each other in many ways. The most important clinical manifestation of this interaction is diabetic dyslipidemia, characterized by elevated triglycerides, low high density lipoprotein cholesterol (HDL-C), and predominance of small-dense LDL particles. However, in the last decade we have learned that the interaction is much more complex. Hypertriglyceridemia and low HDL-C cannot only be the consequence but also the cause of a disturbed glucose metabolism. Furthermore, it is now well established that statins are associated with a small but significant increase in the risk for new onset diabetes. The underlying mechanisms are not completely understood but modulation of 3-hydroxy-3-methylglutaryl-coenzyme A (HMG CoA)-reductase may play a central role as genetic data indicate that mutations resulting in lower HMG CoA-reductase activity are also associated with obesity, higher glucose concentrations and diabetes. Very interestingly, this statin induced increased risk for new onset type 2 diabetes is not detectable in subjects with familial hypercholesterolemia. Furthermore, patients with familial hypercholesterolemia seem to have a lower risk for type 2 diabetes, a phenomenon which seems to be dose-dependent (the higher the low density lipoprotein cholesterol, the lower the risk). Whether there is also an interaction between lipoprotein(a) and diabetes is still a matter of debate.

Survey on the levels of high density lipoprotein and low density lipoprotein among the staff in a college / 中国基层医药

Objective To analyze the levels of high density lipoprotein ( HDL) and low density lipoprotein ( LDL) among the staff in a college .Methods Fasting serum samples were collected from 2 234 paticipants .The lev-els of HDL and LDL in different sex and ages were estimated .Results The average value and abnormal rate of LDL in males were 3.20mmol/L and 49.1%,respectively.The average value of LDL in males was higher than normal val-ue.The average value and abnormal rate of LDL in females were 3.03mmol/L and 42.3%,respectively.The value of LDL in females who less than 54 years old was lower than that in males of the same age ( t=5.33,10.56,all P<0.01).Conclusion The abnormal rate of LDL had significant increase and the level in males was higher than that in females.The health education is necessary to prevent and control the abnormal level of LDL .

Efecto del aceite de sacha inchi (plukenetia volúbilis l) sobre el perfil lipídico en pacientes con hiperlipoproteinemia / Effect of sacha inchi oil (plukenetia volúbilis l) on the lipid profile of patients with hyperlipoproteinemia

El presente es un trabajo experimental piloto, abierto, para conocer el efecto, dosis efectiva y efectos secundarios del aceite de sacha inchi (Plukenetia volúbilis L) en el perfil lipídico de pacientes con hipercolesterolemia; para ello, se incluyó a 24 pacientes de 35 a 75 años, en quienes se determinó los valores sanguíneos de colesterol total (CT), HDL, triglicéridos (Tg), glucosa, ácidos grasos no esterificados (AGNE) e insulina Se aleatorizó a los participantes para recibir 5 mL o 10 mL de una suspensión conteniendo 2gr/5ml de aceite de sacha inchi, durante cuatro meses. La ingesta del aceite produjo caída en los valores promedio del CT, y AGNE con elevación del c-HDL en ambos grupos. La dosis de 10 mL se asoció a mayores niveles de insulina en el grupo aleatorizado a recibir 10 ml. El aceite de sacha inchi parece tener efectos benéficos sobre el perfil lipídico en pacientes con dislipidemia, requiriéndose la evaluación de su eficacia y seguridad en ensayos clínicos aleatorizados.

We performed a pilot, experimental, open study in order to know the effect, effective dosage and secondary effects of sacha inchi´s (Plukenetia volúbilis L) oil on the lipid profiles of patients with hypercholesterolemia. We included 24 patients of ages 35 to 75, to whom we measured total cholesterol (TC), HDL, triglycerides (Tg), glucose (G), non-esterified fatty acids (NEFA) and insulin (I) levels in blood, then we randomized them to receive sacha inchi oil orally 5 ml or 10 ml of a suspension of sacha inchi oil (2gr/5ml) for four months. The oil intake produced a decrease in the mean values of TC, and NEFA, and a rise in HDL in both subgroups. The subgroup receiving 10 ml was associated to an increase in the insulin levels. Sacha inchi oil appears to have beneficial effects on the lipid profile of patients with dyslipidemia, but their efficacy and security should be evaluated in randomized clinical trials.

Lipoprotein Analysis in the Elderly Men with Tinnitus / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Tinnitus is the conscious experience of sound that originates in the head or neck, and without voluntary origin obvious to that person. The aim of this study was to evaluate the prevalence of dyslipoproteinemias and its correlation with subjective tinnitus in the healthy elderly men (especially in men older than 60 years). SUBJECTS AND METHOD: From January 2007 to January 2008, we randomly selected 150 men at our office visit. Of these men, only 102 complained of subjective tinnitus. All men underwent pure tone audiogram, pitch-match and loudness-balance test for tinnitus, simple X-ray (mastoid series), blood sampling such as total cholesterol, LDL cholesterol, HDL cholesterol, triglyceride and lipoprotein(a) etc, and if necessary, temporal bone imaging study, and vestibular function test. Statistical analyses were performed using the SPSS version 15.0, and the p-value was considered significant when less than 5%. RESULTS: The prevalence of hyperlipoproteinemia had no significant difference between the tinnitus group and the control group. Although there was no correlation between loudness (r=0.008, p>0.05) and pitch (r=0.026, p>0.05) for tinnitus with the serum lipoprotein(a) level, the mean value of serum lipoprotein(a) was significantly different between the two groups (p<0.05). CONCLUSION: The high level of serum lipoprotein(a) may have influence on the subjective tinnitus as a risk or aggravation factor in the healthy elderly men.