Relación del consumo de calcio con el síndrome metabólico en adultos de la Amazonía Ecuatoriana / Relationship of calcium consumption with metabolic syndrome in adults from the Ecuadorian Amazon

Introducción. El Síndrome Metabólico (SM) comprende un conjunto de factores de riesgo cardiometabólico representado por obesidad central, dislipidemia, hipertensión arterial y glucosa alterada, se ha evidenciado que el consumo adecuado de calcio representa una disminución del riesgo para este síndrome. Objetivo. Analizar la relación entre el consumo de calcio total, de origen animal y vegetal con el SM y sus indicadores. Materiales y métodos. Estudio transversal de eje correlacional, con una muestra de 100 adultos de la región amazónica ecuatoriana, durante el último trimestre del 2020. La ingesta dietética de calcio se determinó mediante un recordatorio de 24 horas y el SM según los criterios de Adult Treatment Panel-IV (ATP-IV). Resultados. La población estuvo conformada por adultos maduros (40 a 60 años) que evidenciaron una ingesta de calcio deficiente (182,50 mg y 228,60 mg en mujeres y hombres respectivamente). Se evidenció, además, una relación directamente proporcional entre la circunferencia abdominal (r=0,391 ­ p=0,000), presión arterial sistólica (r=0,290 ­ p=0,000) y glucosa en ayuno (r=0,326 ­ p=0,000) con la edad. La ingesta de calcio total se relacionó positivamente con los triglicéridos, (r=0,221 ­ p=0,027). Conclusiones. La ingesta dietética de calcio en ambos sexos no alcanza el requerimiento diario y se relaciona positivamente con los triglicéridos(AU)

Introduction. The Metabolic Syndrome (MS) comprises a set of cardiometabolic risk factors represented by central obesity, dyslipidemia, high blood pressure and altered glucose, it has been shown that adequate calcium intake represents a decreased risk for this syndrome. Objective. To analyze the relationship between the consumption of total calcium, animal and vegetable origin, with MS and its indicators. Materials and methods. Cross-sectional study of correlational axis, with a sample of 100 adults from the Ecuadorian Amazon region, during the last quarter of 2020. Dietary calcium intake was determined through a 24-hour recall and the diagnosis of MS according to the Adult Treatment Panel- IV (ATP-IV) criteria. Results. The population consisted of mature adults (40 to 60 years) who showed a deficient calcium intake in both sexes (182.50 mg and 228.60 mg in women and men respectively). There is also evidence of a directly proportional relationship between abdominal circumference (r=0.391 - p=0.000), systolic blood pressure (r=0.290 - p=0.000) and fasting glucose (r=0.326 - p=0.000) with age. Total calcium intake was positively related to triglycerides (r=0.221 ­ p=0.027). Conclusions. Calcium dietary intake in both sexes does not reach the daily requirement and is positively related to triglycerides(AU)

Research progress in the association of peri-implant diseases and metabolic syndrome / 中华口腔医学杂志

Peri-implant disease, an important group of diseases that cause implant failure, are associated with metabolic abnormality. Metabolic syndrome (MetS) is a common metabolic disorder comprising abdominal obesity, hyperglycemia, systemic hypertension and atherogenic dyslipidemia. Previous studies had reported that MetS and its diversified clinical manifestations might be associated with peri-implant diseases, but the relationship and underlying mechanisms were unclear. This review aims to explore the relationship between MetS and peri-implant disease, in order to provide beneficial reference for the prevention and treatment of peri-implant disease in patients with MetS.

Cardiovascular Risk Factors in Haul Truck Operators of the Mining Sector Working a Rotational Schedule

Abstract Background: Due to the growing concern about work-related social and health aspects, occupational health and safety has become relevant. Objective: This work aims to develop a model to assist cardiovascular risk management in a team of haul truck operators, who work in rotating shifts at a mining company in Brazil. Methods: This longitudinal study evaluated risk factors for cardiovascular diseases of 191 mineworkers at three times points - 2010, 2012, and 2015. In addition, the risk of developing cardiovascular diseases was calculated, and the risk factors were analyzed using the chi-square test, the U Mann-Whitney test, and binary logistic regression. The significance level was set at 5%. Results: In the study period, body weight, body mass index (BMI), waist-to-height ratio (WHR), systolic (SBP), and diastolic blood pressure (DBP), total cholesterol, high-density lipoprotein cholesterol (HDL-C), and triglycerides levels of the study group increased. In 2015, there was a high prevalence of alcohol intake, overweight or obesity, central obesity, inadequate WHR, high blood pressure, total cholesterol above 190 mg/dL, and triglycerides above 150 mg/dL. An association was identified between increased cardiovascular risk and age, SBP, HDL-C, low-density lipoprotein cholesterol (LDL-C), and elevated glucose levels. Conclusion: Intense interventions for reduction and prevention of elevated alcohol intake, blood pressure levels, WHR, metabolic syndrome, blood glucose, and LDL-C levels, and low HDL-C levels are needed. In addition, a close monitoring of mine workers over 38 years of age who smoke, consume alcoholic beverages, and have altered blood glucose levels is important.

The epicardial fat thickness is associated with fragmented QRS in patients with newly diagnosed metabolic syndrome

SUMMARY OBJECTIVE: The metabolic syndrome involves both metabolic and cardiovascular risk factors and is associated with cardiovascular mortality. Epicardial fat tissue plays a crucial role in deleterious effects of metabolic syndrome on the heart, including myocardial fibrosis. The fragmented QRS reflects heterogeneous depolarization of the myocardium and occurs as a result of fibrosis. Thus, we aimed to investigate whether there is an association between fragmented QRS and epicardial fat tissue in patients with metabolic syndrome. METHODS: This study enrolled 140 metabolic syndrome patients, of whom 35 patients with fragmented QRS (+) and 105 patients with fragmented QRS (−). The two groups were compared with respect to clinical, laboratory, electrocardiographic, and echocardiographic indexes. RESULTS: Fragmented QRS (+) patients had higher waist circumference, red cell distribution width, creatinine, left ventricular end-systolic diameter, left atrium diameter, septal a velocity, QRS duration, and epicardial fat tissue compared with fragmented QRS (−) patients. Waist circumference, red cell distribution width, QRS duration, left ventricular end-systolic diameter, left atrium diameter, septal a velocity, and epicardial fat tissue were significantly associated with the presence of fragmented QRS. The QRS duration and epicardial fat tissue were independently associated with the presence of fragmented QRS on surface electrocardiographic in metabolic syndrome patients. CONCLUSIONS: Epicardial fat tissue and QRS duration were independently associated with the presence of fragmented QRS. Basic echocardiographic and electrocardiographic parameters might be used for the risk stratification in metabolic syndrome patients.

Cardiometabolic risk profile in relation to the practice of healthy habits in a sample of Spanish workers

Insulin resistance is a pathological entity that can lead to alterations in lipid metabolism and can increase cardiovascular risk. Objective. The aim of this study was to assess the influence of different sociodemographic variables such as age, sex and social class and healthy habits such as smoking, physical activity and adherence to the Mediterranean diet on the cardiometabolic profile of Spanish workers. Material and methods. A descriptive, cross-sectional study was carried out in 1457 Spanish workers in an attempt to evaluate the effect of healthy habits (physical exercise determined with the IPAQ questionnaire, Mediterranean diet and tobacco consumption) and sociodemographic variables (age, sex and social class) on the values of different insulin resistance scales. Results. The progressive increase in the level of physical activity and high adherence to the Mediterranean diet achieved an improvement in the mean values and in the prevalence of elevated values in all the insulin resistance scales analyzed in this study. Age over 50 years and belonging to the least favored social classes (social classes II-III) were the variables that increased the risk of presenting insulin resistance. Male sex also increased the risk of presenting insulin resistance. Conclusions. The different healthy habits such as vigorous physical exercise and high adherence to the Mediterranean diet improve the values of the different scales that assess insulin resistance(AU)

La resistencia a la insulina es una entidad patológica que puede provocar alteraciones en el metabolismo de los lípidos y puede aumentar el riesgo cardiovascular. Objetivo. En este trabajo se pretende valorar la influencia de diferentes variables sociodemográficas como la edad, el sexo y la clase social y hábitos saludables como el consumo de tabaco, la actividad física y la adherencia a la dieta mediterránea en el perfil cardiometabólico de trabajadores españoles. Material y métodos. Se realizó un estudio descriptivo y transversal en 1457 trabajadores españoles intentando evaluar el efecto de los hábitos saludables (ejercicio físico determinado con el cuestionario IPAQ, dieta mediterránea y consumo de tabaco) y las variables sociodemográficas (edad, sexo y clase social) sobre los valores de diferentes escalas de resistencia a la insulina. Resultados. El aumento progresivo del nivel de actividad física y la alta adherencia a la dieta mediterránea consiguieron una mejoría en los valores medios y en la prevalencia de los valores elevados en todas las escalas de resistencia a la insulina analizadas en este estudio. La edad por encima de los 50 años y la pertenencia a las clases sociales menos favorecidas (clases sociales II-III) fueron las variables que aumentaron el riesgo de presentar resistencia a la insulina. El sexo masculino también incrementó el riesgo de presentar resistencia a la insulina. Conclusiones. Los diferentes hábitos saludables como el ejercicio físico vigoroso y la alta adherencia a la dieta mediterránea mejoran los valores de las diferentes escalas que valoran resistencia a la insulina(AU)

Hepatitis aguda por virus E. Presentación de dos casos con evolución clínica diferente / Acute hepatitis due to E virus. Presentation of two cases with different clinical evolution

RESUMEN El virus de la hepatitis E tiene una amplia distribución a nivel mundial. Se presentaron dos casos clínicos en la provincia de Matanzas, con diagnóstico confirmado de hepatitis E mediante la determinación del ARN viral en heces fecales congeladas; a pesar de proceder de áreas de salud distantes, coincidieron en el mismo período de tiempo. El primero de ellos, una gestante asintomática diagnosticada fortuitamente a partir de elevación de enzimas hepáticas de citolisis. Evolucionó satisfactoriamente sin repercusión en su bienestar materno, trasmisión fetal, ni complicaciones perinatales. El segundo, una paciente portadora de síndrome metabólico, con evolución tórpida de su cuadro infeccioso viral, que la llevó a la insuficiencia hepática y a la muerte. Con estos casos se reflejó el amplio espectro de esta enfermedad en cuanto a formas clínicas de presentación y evolución. Se demostró que pueden ocurrir complicaciones en cualquier grupo poblacional, de ahí la importancia de considerarla en el diagnóstico diferencial de las enfermedades infecciosas hepáticas (AU).

ABSTRACT Hepatitis E virus is widely distributed around the world. Two clinical cases occurring in the province of Matanzas were presented, both with diagnosis of E hepatitis confirmed through viral RNA determination in frozen stool; although patients came from faraway health areas, they coincided in the same time period. The first patient, a pregnant asymptomatic woman, was incidentally diagnosed due to an increase of cytolysis liver enzymes. Her evolution was satisfactory without repercussion on maternal wellbeing, fetal transmission, nor perinatal complications. The second patient, a metabolic syndrome carrier, had torpid evolution of a viral infectious disease leading her to liver failure and death. These cases highlighted the wide range of this disease according to its clinical forms of presentation and evolution. It was showed that complications may occur in any population group, in consequence it is important to consider this disease when making the differential diagnosis of liver infectious diseases (AU).

Obesidade Visceral e Hipertensão Sistólica como Substratos da Disfunção Endotelial em Adolescentes Obesos / Visceral Obesity and High Systolic Blood Pressure as the Substrate of Endothelial Dysfunction in Obese Adolescents

Resumo Fundamento: A obesidade afeta a adolescência, podendo levar à síndrome metabólica (SM) e disfunção endotelial, um marcador precoce de risco cardiovascular. Apesar de a obesidade ser fortemente associada à síndrome da apneia obstrutiva do sono (SAOS), ainda não está claro o papel da SAOS na função endotelial em adolescentes obesos. Objetivo: Investigar se a obesidade durante a adolescência leva à SM e/ou SAOS e causa disfunção endotelial nesses indivíduos. Além disso, estudamos a possível associação dos fatores de risco para SM e do índice de apneia e hipopneia (IAH) com disfunção endotelial. Métodos: Estudamos 20 adolescentes obesos sedentários (AO; 14,2±1,6 anos, 100,9±20,3kg), e 10 adolescentes eutróficos (AE, 15,2±1,2 anos, 54,4±5,3kg) pareados por sexo. Avaliamos os fatores de risco para SM (critérios da Federação Internacional de Diabetes), função vascular (dilatação mediada pelo fluxo, DMF), capacidade funcional (VO2pico) e presença de SAOS (IAH > 1 evento/hora, pela polissonografia). Consideramos um p<0,05 como estatisticamente significativo. Resultados: AO apresentaram maior circunferência da cintura (CC), gordura corporal, triglicerídeos, pressão arterial sistólica (PAS) e diastólica (PAD), maiores níveis de LDL e menores HDL e VO2pico em comparação a AE. Não houve diferença no IAH entre os grupos. AO apresentaram menor DMF que AE (6,17±2,72 vs. 9,37±2,20%, p=0,005). Observou-se uma associação entre DMF e CC (R=-0,506, p=0,008) e entre DMF e PAS (R=-0,493, p=0,006). Conclusão: Em adolescentes, a obesidade associou-se à SM e causou disfunção endotelial. CC e PAS aumentadas poderiam estar envolvidas nessa alteração. SAOS foi detectada na maioria dos adolescentes independentemente de obesidade. (Arq Bras Cardiol. 2021; 116(4):795-803)

Abstract Background: Obesity affects adolescence and may lead to metabolic syndrome (MetS) and endothelial dysfunction, an early marker of cardiovascular risk. Albeit obesity is strongly associated with obstructive sleep apnea (OSA), it is not clear the role of OSA in endothelial function in adolescents with obesity. Objective: To investigate whether obesity during adolescence leads to MetS and/or OSA; and causes endothelial dysfunction. In addition, we studied the possible association of MetS risk factors and apnea hypopnea index (AHI) with endothelial dysfunction. Methods: We studied 20 sedentary obese adolescents (OA; 14.2±1.6 years, 100.9±20.3kg), and 10 normal-weight adolescents (NWA, 15.2±1.2 years, 54.4±5.3kg) paired for sex. We assessed MetS risk factors (International Diabetes Federation criteria), vascular function (Flow-Mediated Dilation, FMD), functional capacity (VO2peak) and the presence of OSA (AHI>1event/h, by polysomnography). We considered statistically significant a P<0.05. Results: OA presented higher waist (WC), body fat, triglycerides, systolic (SBP) and diastolic blood pressure (DBP), LDL-c and lower HDL-c and VO2peak than NWA. MetS was presented in the 35% of OA, whereas OSA was present in 86.6% of OA and 50% of EA. There was no difference between groups in the AHI. The OA had lower FMD than NWA (6.17±2.72 vs. 9.37±2.20%, p=0.005). There was an association between FMD and WC (R=-0.506, p=0.008) and FMD and SBP (R=-0.493, p=0.006). Conclusion: In adolescents, obesity was associates with MetS and caused endothelial dysfunction. Increased WC and SBP could be involved in this alteration. OSA was observed in most adolescents, regardless of obesity. (Arq Bras Cardiol. 2021; 116(4):795-803)

Complicaciones cardiovasculares en relación con la programación fetal / Cardiovascular complications related to fetal programming

Introducción: la programación fetal ofrece nuevas perspectivas sobre el origen de las enfermedades cardiovasculares, relacionando su aparición con factores perinatales. Objetivo: exponer evidencia que vincule las alteraciones gestacionales con las enfermedades cardiovasculares en la vida adulta del feto. Metodología: búsqueda en las bases de datos EBSCO, COCHRANE, MEDLINE, PROQUEST y SciELO de los artículos de revisión e investigaciones originales en inglés publicados en los últimos diez años. Se utilizaron términos MeSH para búsqueda controlada y se evaluaron los estudios con STROBE y PRISMA según correspondía. Resultados: los hallazgos sugieren que nacer con menos de 2600 k guarda relación con diabetes mellitus (OR de 1.607 IC 95% 1.324-1.951), hipertensión arterial (OR de 1.15 IC 95% 1.043-1.288) y menor función endotelial (1.94+0.37 vs 2.68+0.41, p: 0.0001) en la adultez. La prematuridad se asocia con mayores presiones arteriales sistólicas (4.2 mmHg IC 95%; 2.8 - 5.7 p 0.001) y diastólicas (2.6 mmHg IC 95%; 1.2-4.0; p 0.001). Las alteraciones nutricionales maternas y la diabetes gestacional aumentan el riesgo de síndrome metabólico (OR 1.2 IC 95% 0.9-1.7) y sobrepeso en la edad escolar (OR 1.81 IC 95% 1.18 - 2.86). Conclusión: los resultados adversos en la gestación están relacionados con el desarrollo de enfermedades cardiovasculares en la vida adulta del feto expuesto.

Introduction: fetal programming offers new perspectives on the origin of cardiovascular diseases, relating their appearance with perinatal factors. Objective: to show the evidence associating gestational alterations with cardiovascular diseases in the offspring in adult life. Methodology: an EBSCO, COCHRANE, MEDLINE, PROQUEST and SciELO databases search of original review and research articles published in English in the last ten years was conducted. MeSH terms were used to perform a controlled search. The studies were analyzed accordingly using the STROBE and PRISMA reporting guidelines. Results:The findings suggest that a birth weight of less than 2600 kg is related with diabetes mellitus (OR = 1.607, 95% CI 1.324 to 1.951), hypertension (OR = 1.15, 95% CI 1.043 to 1.288) and impaired endothelial function (1.94+0.37 vs 2.68+0.41, p: 0.0001) in adulthood. Prematurity is related with higher systolic blood pressure (4.2 mmHg 95% CI; 2.8 to 5.7 p 0.001) and diastolic blood pressure (2.6 mmHg 95% CI; 1.2 to 4.0; p 0.001). Maternal nutritional alterations and gestational diabetes increase the risk of metabolic syndrome (OR = 1.2 95% CI 0.9 to 1.7) and overweight in school-age (OR = 1.81 95% CI 1.18 to 2.86). Conclusion: adverse results during pregnancy are related with the development of cardiovascular diseases in the exposed fetus in adult life.

Correlation between metabolic syndrome and adverse events after internal fixation of femoral intertrochanteric fracture in the elderly / 中国骨伤

OBJECTIVE@#To explore the effect of metabolic syndrome on 15 days postoperative adverse events of femoral intertrochanteric fractures with internal fixation.@*METHODS@#From January 2011 to June 2019, 986 elderly patients with intertrochanteric fracture were treated with internal fixation, including 312 males and 674 females, with an average age of(77.71± 7.58) years old. And there were 97 patients with metabolic syndrome and 889 patients without metabolic syndrome. Through the electronic medical record system, the patient's age, gender, fracture type, cause of trauma, body mass index, smoking history, preoperative comorbidities, preoperative bloodtransfusion, operation timing, ASA classification, anesthesia method, internal fixation type, operation duration, and 15 days postoperative adverse events, which include surgical site infection, acute heart failure, acute respiratory failure, pulmonary infection, acute renal failure, DVT, embolism in important organs, urinary tract infection, death, and blood transfusion after surgery were collected. The differences of preoperative and intraoperative baseline datas and 15 days postoperative adverse events between the two groups were compared and analyzed by t text or univariate @*RESULTS@#There were statistical differences in age, body mass index, history of cardiac insufficiency, history of COPD, history of renal insufficiency, operation timing, ASA classification, operation duration, surgical site infection, acute heart failure, DVT, urinary tract infection and blood transfusion between two groups (@*CONCLUSION@#Elderly patients with intertrochanteric fracture with metabolic syndrome had higher postoperative surgical site infection rate, DVT incidence rate, urinary tract infection rate, and postoperative blood transfusion rate. Therefore, the orthopedic treatment team should give more attentionand optimize the treatment plan during the perioperative period with the cooperation of internal physician and anesthesiologist.

Hallazgo necrópsico de nefroblastoma asociado a síndrome metabólico experimental / Necropsic finding of nephroblastoma associated to experimental metabolic syndrome

Introducción: El síndrome metabólico presenta entre sus manifestaciones la obesidad, la cual se encuentra relacionada con el desarrollo de cáncer. Sin embargo, no habíamos encontrado en cuatro años ningún caso de neoplasias malignas en animales con síndrome metabólico. Objetivo: Describir el desarrollo de un tumor maligno a nivel renal en modelo experimental de síndrome metabólico. Métodos: El biomodelo experimental se logró por la aplicación de una solución de sacarosa al 35 por ciento, durante 20 semanas a 50 ratas machos Wistar destetados. El diagnóstico de nefroblastoma se realizó mediante necropsia con observación morfológica de la lesión renal. Resultados: Confirmado el síndrome metabólico se detectó en un caso, una masa palpable en abdomen. En la inspección macroscópica se observó un tumor en el polo inferior del riñón derecho, color pardo grisáceo, con hemorragia y cambios quísticos. Histológicamente se observaron alteraciones propias de un nefroblastoma mixto con componentes del blastema, mesenquimal y epitelial. Conclusiones: Se describe por vez primera, en estudio anatomopatológico, la presencia de un caso de nefroblastoma en rata con síndrome metabólico experimental(AU)

Introduction: One of the manifestations of metabolic syndrome is obesity, which is in turn related to the development of cancer. However, in four years we had not found any case of malignant neoplasms in animals with metabolic syndrome. Objective: Describe the development of a malignant renal tumor in an experimental metabolic syndrome model. Methods: The experimental biomodel was made applying a 35 percent saccharose solution to 50 male weaned Wistar rats for 20 weeks. The diagnosis of nephroblastoma was achieved by necropsy with morphological observation of the renal lesion. Results: Upon metabolic syndrome confirmation, a palpable mass was detected in the abdomen of one of the cases. Macroscopic observation revealed a grayish brown tumor in the lower pole of the right kidney with hemorrhaging and cystic changes. Histological examination found alterations typical of mixed nephroblastoma with blastema, mesenchymal and epithelial components. Conclusions: This is the first time a description is provided in an anatomopathological study of a case of nephroblastoma in a rat with experimental metabolic syndrome(AU)

Factores de riesgo asociados a las complicaciones cardiovasculares en mujeres de edad mediana con diabetes mellitus tipo 2 / Risk Factors Associated with Cardiovascular Complications in Middle-Aged Women with Type 2 Diabetes Mellitus

RESUMEN Introducción: En la mujer con diabetes de edad mediana confluyen una serie de factores aterogénicos que favorecen la aparición de complicaciones cardiovasculares. Objetivo: Identificar los factores de riesgo asociados a las complicaciones cardiovasculares en mujeres con diabetes mellitus tipo 2 de edad mediana. Métodos: Se realizó un estudio analítico de tipo casos y controles con mujeres con diabetes tipo 2 en edad mediana (40-59 años) que ingresaron en el Centro de Atención al Diabético de Bayamo, Granma, desde el año 2010 al 2017. Se excluyeron las mujeres con menopausia artificial. El tamaño de la muestra quedó constituido por 375 pacientes, las que fueron escogidas por muestreo aleatorio simple: 125 con complicaciones cardiovasculares (casos) y 250 no complicadas (controles). Resultados: El número de mujeres con complicaciones cardiovasculares se incrementó con la menopausia y con el tiempo de haber ocurrido este evento (p = 0,0125). El análisis univariado expuso que siete factores incrementaron el riesgo de presentar complicaciones cardiovasculares, entre ellos, la menopausia (OR = 1,88, IC: 1,1- 3,0, p = 0,0077); mientras que el multivariado exhibió que solo tres de ellos lo hicieron de forma independiente, los cuales fueron: el tiempo de evolución de la diabetes mayor de 10 años (OR = 4,97, IC: 2,35-10,54, p = 0,000), la hipertensión arterial (OR = 3,58, IC: 1,71-7.48, p = 0,001) y el tabaquismo (OR = 2,605, IC: 1,47-4,59, p = 0,001). Conclusiones: Los principales factores de riesgo asociados a las complicaciones cardiovasculares en mujeres con diabetes mellitus tipo 2 de edad mediana fueron el tiempo de evolución de la diabetes mayor de 10 años, la hipertensión arterial y el tabaquismo(AU)

ABSTRACT Introduction: In middle-aged diabetic women, a series of atherogenic factors converge that favor the appearance of cardiovascular complications. Objective: To identify the risk factors associated with cardiovascular complications in middle-aged women with type 2 diabetes mellitus. Methods: An analytical case-control study was carried out with middle-aged (40-49 years old) women with type 2 diabetes and who were admitted to the Diabetic Care Center in Bayamo City, Granma, from 2010 to 2017. Women with artificial menopause were not part of the study. The sample was made up of 375 patients, who were selected by simple randomized sampling: 125 presented cardiovascular complications (cases) and 250 presented no complications (controls). Results: The number of women with cardiovascular complications was correspondingly higher with menopause and with the time after the occurrence of this event (p = 0.0125). Univariate analysis showed that seven factors increased the risk for presenting cardiovascular complications, among them menopause (OR = 1.88, CI: 1.1-3.0, p = 0.0077); while multivariate analysis showed that only three of them did so independently, which were time of evolution of diabetes over ten years (OR = 4.97, CI: 2.35-10.54, p = 0.000), arterial hypertension (OR = 3.58, CI: 1.71-7.48, p = 0.001), and smoking (OR=2.605, CI: 1.47-4.59, p = 0.001). Conclusions: The main risk factors associated with cardiovascular complications among middle-aged women with type 2 diabetes mellitus were time of evolution of diabetes over ten years, arterial hypertension, and smoking(AU)

Higher incidence of metabolic syndrome components in vitiligo patients: a prospective cross-sectional study

Abstract Background/Objectives: To investigate the association between vitiligo and metabolic syndrome. Methods: A prospective cross-sectional study was conducted between 2014 and 2016. Study (n = 155) and control groups (n = 155) were evaluated for metabolic syndrome according to National Cholesterol Education Program Adult Treatment Panel III and the International Diabetes Federation criteria. Study group was divided into three groups according to their vitiligo area severity index and vitiligo disease activity score values (Group 1: 6.89 for VASI score, Group A: −1-0, Group B: 1-2 and Group C: 3-4 for vitiligo disease activity score respectively). MetS rates according to both criteria were compared between the vitiligo disease activity score and vitiligo area severity index groups. Results: Metabolic syndrome rates were 37.4% and 40% in the study group and 19.4% and 26.5% in the control group according to National CholesterolEducation Program Adult Treatment Panel III and International Diabetes Federation criteria, respectively (p < 001 and p = 0.011). Metabolic syndrome was more frequent in vitiligo area severity index Groups 2 and 3 compared to vitiligo area severity index Group 1, and in vitiligo disease activity score Group C compared to vitiligo disease activity score Groups A and B. Study limitations: Single center experience, absence of more specific oxidative-stress markers and lack of long-term follow-up of the patients. Conclusions: Frequency of metabolic syndrome was higher in patients with non-segmental vitiligo and the rate was higher in active/severe form of the disease.

Estudio de la prevalencia del síndrome metabólico en pacientes con hidradenitis supurativa. Estudio retrospectivo de los últimos 2 años en el Hospital Alejandro Posadas / Study of metabolic syndrome prevalence in pacients with suppurative hidradenitis. A retrospective study of the last 2 years in Hospital Alejandro Posadas

Antecedentes: La hidradenitis supurativa (HS) es una enfermedad inflamatoria crónica relacionada con el síndrome metabólico (SM), con un mayor riesgo de comorbilidades cardiovasculares; por lo tanto, se debe mantener un alto grado de sospecha clínica frente al hallazgo de alguno de sus componentes. Objetivo: Evaluar la prevalencia del SM en los pacientes con diagnóstico de HS en comparación con la población general. Diseño: Estudio retrospectivo descriptivo. Métodos: Se revisaron las historias clínicas y el archivo fotográfico de los pacientes con diagnóstico de HS que consultaron entre el 1/9/2017 y el 31/8/2019. Se analizaron las variables: sexo, edad, antecedentes familiares, tiempo de evolución, índice de masa corporal, obesidad abdominal, laboratorio (glucemia y perfil lipídico), presión arterial, tabaquismo, número y localización de las lesiones, gravedad clinicoecográfica, respuesta al tratamiento y evolución clínica. Resultados: Se evaluaron 30 pacientes con HS valorados en nuestro servicio en los últimos 2 años; 23 mujeres y 7 varones. Predominó el grupo etario de 31-40 años. De ellos, 19 pacientes (63,3%) cumplieron con los criterios necesarios para diagnosticar el SM, hallazgo que no se relacionó con el grado de severidad de la HS. Conclusiones: La prevalencia del SM en nuestros pacientes con HS fue del 63,3% con respecto al 27,5% de la población general. La importancia de este hallazgo radica en detectar de forma temprana y oportuna la presencia de este síndrome en los pacientes con HS para evitar el riesgo de comorbilidades cardiovasculares en el futuro. (AU)

Background: Suppurative hidradenitis (SH) is a chronic, inflammatory disease, closely related to metabolic syndrome (MS), with an increased risk of cardiovascular comorbidities; for that reason we should keep a high level of clinical suspicion when one of its components is found. Objective: To evaluate MS prevalence in patients with diagnosis of SH in comparison with general population. Design: Descriptive retrospective study. Methods: We reviewed clinical and photographical files of patients with diagnosis of suppurative hidradenitis who consulted from 1/9/2017 until 31/8/2019. Variables analyzed were: sex, age, familial history, time of evolution, body mass index, abdominal obesity, glycemia, lipid profile, blood pressure, smoking, number and location of lesions, clinicalechographic severity, response to treatment and clinical evolution. Results: Thirty patients with SH were evaluated, 23 females and 7 males. The age group between 31-40 years prevailed; of these, 19 patients (63.3%) meet necessary criteria for diagnosis of MS, this finding did not correlate to the severity degree of SH. Conclusions: The MS prevalence in our SH patients was 63.3%, compared to 27.5% in the general population. The importance of this finding lays on detecting in an early and opportune way, the presence of MS in patients with SH, and to avoid the risk of future cardiovascular comorbidities. (AU)

Síndrome dos ovários policísticos, complicações metabólicas, cardiovasculares, psíquicas e neoplásicas de longo prazo: uma revisão sistematizada / Polycystic ovary syndrome and long-term metabolic, cardiovascular, psychic, and neoplastic health consequences: a systematized review

A Síndrome dos Ovários Policísticos (SOP) é uma das disfunções endócrinas mais comuns em mulheres em idade reprodutiva, com uma prevalência que varia entre 6 e 16%, sendo motivo frequente de consulta em um ambulatório de Ginecologia e Obstetrícia. Esta revisão enfoca alguns dos principais riscos tardios para a saúde das pacientes com SOP na meia idade e após a menopausa. A busca da literatura foi realizada no Pubmed utilizando-se as seguintes palavras-chave: Polycystic Ovary Syndrome; time. Identificou-se 229 artigos relacionando SOP e suas consequências tardias que foram publicados em periódicos indexados no Pubmed entre 1o de janeiro de 2010 e 19 de junho de 2020. Desses, excluiu-se 3 por não estarem em língua inglesa (2 em chinês, 1 em russo), 177 pelo título e pelo abstract, e 27 com base na análise do texto. Os 22 artigos restantes estão contemplados nesta revisão sistematizada. Evidenciam-se complicações metabólicas, cardiovasculares, neoplásicas e psíquicas, bem como uma complexa, e ainda não totalmente elucidada, relação com a obesidade. Apesar das complicações cardiovasculares, não existem evidências de que estas levem a maior mortalidade em pacientes com SOP, tampouco de que a mortalidade por todas as causas seja maior nessas mulheres. (AU)

Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women of reproductive age, with a prevalence of 6-16%. It is also one of the most frequent reasons for encounter at Obstetrics and Gynecology clinics. This review focuses on some of the main late health impacts of PCOS in middle-aged and postmenopausal patients. A literature search with the keywords "polycystic ovary syndrome" and "time" was conducted in PubMed, and 229 articles related to PCOS and late health consequences published between January 1, 2010, and June 19, 2020, were analyzed. Three articles were excluded because they did not meet the language criterion (being written in English), 177 were excluded based on the title and abstract, and 27 were excluded based on the analysis of the text, resulting in the inclusion of 22 articles in this systematized review. Metabolic, cardiovascular, neoplastic, and psychic complications were made evident, as well as a complex, not yet fully elucidated relationship between PCOS and obesity. Despite cardiovascular complications, there is no evidence that they lead to higher mortality in patients with PCOS, or that all- cause mortality is higher in women with the syndrome. (AU)

The relationship between mitral annular calcification, metabolic syndrome and thromboembolic risk

Abstract Introduction: Metabolic syndrome (MetS) is defined as an association between diabetes, hypertension, obesity and dyslipidemia and an increased risk of cardiovascular disease. Mitral annular calcification (MAC) is associated with several cardiovascular disorders, including coronary artery disease, atrial fibrillation (AF), heart failure, ischemic stroke and increased mortality. The CHA2DS2-VASc score is used to estimate thromboembolic risk in AF. However, the association among MAC, MetS and thromboembolic risk is unknown and was evaluated in the current study. Methods: The study group consisted of 94 patients with MAC and 86 patients with MetS. Patients were divided into two groups: those with and those without MAC. Results: Patients with MAC had a higher MetS rate (P<0.001). In patients with MAC, the CHA2DS2-VASc scores and the rate of cerebrovascular accident and AF were significantly higher compared to those without MAC (P<0.001, for both parameters). The results of the multivariate regression analysis showed that history of smoking, presence of MetS and high CHA2DS2-VASc scores were associated with the development of MAC. ROC curve analyses showed that CHA2DS2-VASc scores were significant predictors for MAC (C-statistic: 0.78; 95% CI: 0.706-0.855, P<0.001). Correlation analysis indicated that MAC was positively correlated with the presence of MetS and CHA2DS2-VASc score (P=0.001, r=0.264; P<0.001, r=0.490). Conclusion: We have shown that CHA2DS2-VASc score and presence of MetS rates were significantly higher in patients with MAC compared without MAC. Presence of MAC was correlated with CHA2DS2-VASc score, presence of MetS, AF and left atrial diameter and negatively correlated with left ventricular ejection fraction.

Neuropatía precoz: Importancia de la evaluación neurofisiológica en el sindrome metabólico con o sin disregulación glucémica / Early neuropathy. Importance of neurophysiological assessment in cases of metabolic syndrome with or without hyperglycemia

La neuropatía periférica y autonómica es una de las complicaciones más comunes en pacientes con diabetes. La lesión nerviosa comienza tempranamente, en aquellos con diabetes mellitus de tipo II puede comenzar antes de la disregulación glucémica, en la etapa del síndrome metabólico. En un primer momento puede ser asintomática, por lo que es fundamental la realización de técnicas electrofisiológicas para su detección temprana, para implementar medidas terapéuticas que impidan su progresión. Se presentan nueve casos, tres con síndrome metabólico y alteración del metabolismo de la glucosa, uno con síndrome metabólico sin hiperglucemia y cinco con alteración del metabolismo de la glucemia sin otros criterios diagnósticos de síndrome metabólico. Todos estaban asintomáticos y el examen neurológico fue normal. Se realizaron técnicas de detección de neuropatía periférica temprana (razón sural/radial, ondas F, reflejo H, respuestas simpáticas de la piel, período silente cutáneo y variabilidad del intervalo RR). Ocho pacientes tuvieron neuropatía autonómica cardíaca incipiente y uno neuropatía autonómica establecida. Ocho presentaron neuropatía somática incipiente (siete con alteración de la razón sural/radial, y uno con alteración de las ondas F). Un paciente tuvo alteración sublínica de las fibras finas (alteración de las respuestas simpáticas de la piel y del período silente cutáneo). Es importante la detección de la neuropatía temprana antes de su manifestación clínica ya que existen tratamientos para detenerla e incluso revertirla.