Asociación entre enfermedades cardiometabólicas y depresión en un hospital de referencia peruano / Association between cardiometabolic diseases and depression in a Peruvian reference hospital

INTRODUCCIÓN: Se ha postulado la relación entre la presencia de enfermedades cardiometabólicas con problemas de salud mental, en particular la depresión. OBJETIVOS: Determinar la asociación entre la presencia de enfermedades cardiometabólicas y la presencia de sintomatología depresiva evaluada mediante el cuestionario PHQ-9 en pacientes atendidos en consultorios externos de medicina interna del Hospital Nacional Hipólito Unanue. METODOLOGÍA: Estudio observacional, analítico, transversal. Se definió enfermedad cardiometabólica como la presencia de diabetes mellitus, hipertensión arterial, dislipidemia, y/u obesidad. Se utilizó el cuestionario PHQ-9 para evaluar la presencia de síntomas sugerentes de depresión. Se evaluó la asociación cruda y ajustada a posibles confusores. Para el análisis multivariado se utilizó un modelo de regresión de Poisson para hallar razones de prevalencia con sus respectivos intervalos de confianza al 95%. Se consideró un p<0,05 como estadísticamente significativo. Resultados: Se incluyeron 252 pacientes, de los que 205 (81,4%) presentaron enfermedades cardiometabólicas y 181 (71,9%) presentaron síntomas consistentes con algún grado de depresión. La presencia de enfermedades cardiometabólicas se asoció a síntomas depresivos tanto en el análisis crudo (RPc 1,43; IC 95% 1,08-1,89; p=0,012) como en el ajustado (RPa 1,31; IC 95% 1,00-1,71; p=0,048). Adicionalmente se encontró asociación entre el sexo femenino y sintomatología depresiva (RPa 1,35; IC 95% 1,11-1,63; p=0,002). CONCLUSIONES: La presencia de enfermedades cardiometabólicas se asoció con la presencia de síntomas depresivos en pacientes atendidos en la consulta externa de medicina interna. El abordaje de la salud mental debe ser parte integral del manejo multidisciplinario del paciente con enfermedad cardiometabólica.

INTRODUCTION: It has been postulated the relationship between presence of cardiometabolic diseases with mental health problems, particularly depression. Objectives: To determine the association between cardiometabolic diseases and presence of depressive symptoms, evaluated by PHQ-9 questionnaire, in patients attended at the outpatient clinic of internal medicine service at Hospital Nacional Hipolito Unanue. METHODS: Observational analytical cross-sectional study. Cardiometabolic disease was defined as the presence of diabetes mellitus, high blood pressure, dyslipidemia, and/or obesity. The PHQ-9 questionnaire was used to evaluate the presence of symptoms suggestive of depression. The association was evaluated crude and adjusted for possible confounders. For the multivariate analysis, a Poisson regression model was used to find prevalence ratios with their respective 95% confidence intervals. A p<0.05 was considered statistically significant. RESULTS: 252 patients were included, of which 205 (81,4%) presented cardiometabolic diseases and 181 (71,9%) presented symptoms consistent with some grade of depression. The presence of cardiometabolic diseases was associated with depressive symptoms both in the crude analysis (PRc 1.43; CI 95% 1.08-1.89; p=0.012) and in the adjusted one (PRa 1.31; CI 95% 1.00-1.71; p=0.048). Additionally, an association was found between female sex and depressive symptoms (PRa 1,35; CI 95% 1,11-1,63; p=0,002). CONCLUSIONS: The presence of cardiometabolic diseases was associated with the presence of depressive symptoms in patients seen at the outpatient clinic of internal medicine. The mental health approach should be an integral part of the multidisciplinary management for the patient with cardiometabolic disease.

Overview of Cardiovascular Disease Risk Factors in Adults in São Paulo, Brazil: Prevalence and Associated Factors in 2008 and 2015

Abstract Background Cardiovascular diseases (CVDs) are the main cause of morbidity and mortality in Brazil. Objective To provide population-based data on prevalence and factors associated with CVD risk factors. Methods Individuals aged ≥20 years from two editions of the cross-sectional Health Survey of São Paulo focusing on Nutrition (ISA-Nutrition), performed in Sao Paulo city in 2008 (n=590) and 2015 (n=610), were evaluated for: obesity, central obesity, waist/height ratio, high blood pressure (HBP), dyslipidemia, diabetes, and number of CVD risk factors ≥3. Prevalence was estimated according to complex survey procedures. Factors associated with cardiovascular risk factors were assessed using logistic regression, with statistical significance of p<0.05. Results Obesity and older age were associated with higher odds of all cardiovascular risk factors investigated, except for dyslipidemia. HBP was positively associated with being Black/Brown and negatively associated with being physicaly active in leisure time. Women were more likely to have increased adiposity indicators and three or more cardiovascular risk factors than men. Those with higher education had lower chances of having diabetes, HBP and dyslipidemia, and those with higher income had higher chances of having three or more risk factors. Former smokers had higher odds of diabetes, obesity, and high waist/height ratio, and smokers had higher odds of high non-HDL cholesterol levels. From 2008 to 2015, there was an increase (p<0.001) in the prevalence of diabetes (6.9% to 17.3%), HBP (31.9% to 41.8%), dyslipidemia (51.3% to 67.6%), and number of CVD risk factors ≥3 (18.9% to 34.1%). Conclusion This study shows increasing prevalence of CVD risk factors in adult population in Sao Paulo and may support the definition of target groups and priority actions on CVD prevention and treatment.

Frequência e fatores associados à dislipidemia entre pessoas com diabetes mellitus tipo 2 / Frequency and factors associated with dyslipidemia among people with type 2 diabetes mellitus / Frecuencia y factores asociados con la dislipidemia entre las personas con diabetes mellitus tipo 2

Objetivo: avaliar a frequência e os fatores associados à dislipidemia em pessoas com Diabetes Mellitus Tipo 2. Método: estudo transversal, desenvolvido com 45 pessoas diagnosticadas com diabetes e acompanhadas por uma Unidade Básica de Saúde. Foram investigadas variáveis sociodemográficas, relacionadas ao estilo de vida e referentes à análise do perfil lipídico. Resultados: a prevalência de dislipidemia foi de 82,2%, significativamente associada ao sexo feminino (p=0,005), ao tabagismo (p=0,002) e ao sedentarismo (p=0,050). Nos componentes da dislipidemia, as taxas de colesterol total, triglicérides e LDL se mostraram elevados em 68,9%, 57,8%, 11,1%, respectivamente. Já a taxa de HDL se mostrou diminuída em 2,2% dos investigados. Conclusão: a prevalência de dislipidemia mostrou-se elevada nos pacientes analisados. A existência de associação significativa entre a ocorrência de dislipidemia e variáveis como o sexo feminino, os hábitos de tabagismo e sedentarismo chama a atenção para a necessidade de melhores condutas para essa população

Objective: to evaluate the frequency and factors associated with dyslipidemia in people with type 2 Diabetes Mellitus. Method: cross-sectional study, carried out with 45 people diagnosed with diabetes and followed up at a Basic Health Unit. Sociodemographic variables related to lifestyle and related to lipid profile analysis were investigated. Results: the prevalence of dyslipidemia was 82.2%, significantly associated with female gender (p = 0.005), smoking (p = 0.002) and sedentary lifestyle (p = 0.050). The components of dyslipidemia, total cholesterol, triglycerides and low-density lipoproteins were elevated in 68.9%, 57.8% and 11.1%, respectively. Conclusion: the prevalence of dyslipidemia was high in the patients analyzed. The existence of a significant association between the occurrence of dyslipidemia and different types of females, smoking habits and sedentary lifestyle calls attention to the need for better conduct for this population

Objetivo: evaluar la frecuencia y los factores asociados a la dislipidemia en personas con Diabetes Mellitus tipo 2. Método: estudio transversal, desarrollado con 45 personas diagnosticadas con diabetes y acompañadas por una Unidad Básica de Salud. Se investigaron las variables sociodemográficas, de estilo de vida y de análisis del perfil lipídico. Resultados: la prevalencia de dislipidemia fue del 82,2%, asociada significativamente al sexo femenino (p=0,005), al tabaquismo (p=0,002) y al sedentarismo (p=0,050). En los componentes de la dislipidemia, las tasas de colesterol total, triglicéridos y lipoproteínas de baja densidad estaban elevadas en el 68,9%, 57,8% y 11,1%, respectivamente. Conclusión: la prevalencia de la dislipidemia fue elevada en los pacientes analizados. La existencia de una asociación significativa entre la ocurrencia de dislipidemia y variables como el sexo femenino, los hábitos de tabaquismo y el sedentarismo hace que se preste atención a la necesidad de mejores conductas para esta población

Ocorrência de dislipidemias e fatores associados em adultos: um estudo de prevalência / Incidencia de dislipidemias y factores asociados en adultos: un estudio de prevalencia / Occurrence of dyslipidemia and associated factors in adults: a prevalence study

RESUMO Objetivo: estimar a prevalência de dislipidemias e os fatores associados em adultos de Rio Branco, Acre. Métodos: estudo de delineamento seccional, populacional, que avaliou adultos (18 a 59 anos) residentes nas zonas urbana e rural de Rio Branco em 2014. As dislipidemias foram definidas conforme os critérios da Atualização da Diretriz Brasileira de Dislipidemias e Prevenção da Ateroscle rose. Empregou-se regressão logística para estimar as odds ratio (OR) e intervalos de confiança de 95% (IC95%). Resultados: a prevalência de dislipidemia, HDL-c baixo, hipertrigliceridemia isolada, hipercolesterolemia isolada e hiperlipidemia mista foi de 56,1%, 37,4%, 23,6%, 9,8% e 3,5%, respectivamente. No modelo final multivariado, apenas a obesidade (OR = 1,86; IC95%: 1,12;3,10) manteve associação estatisticamente significativa com a dislipidemia. Entre os subtipos de dislipidemias, associaram-se à hipertrigliceridemia isolada as variáveis: faixa etária de 40 a 49 anos (OR = 2,17; IC95%: 1,53;4,80); hipercolesterolemia isolada (OR = 2,52; IC95%: 1,23;5,15); HDL-c baixo (OR = 2,53; IC95%: 1,65;3,86); obesidade (OR = 2,10; IC95%: 1,25;3,53); e diabetes mellitus (OR = 5,41; IC95%: 1,46;20,4). Conclusão: a prevalência de alterações lipídicas foi elevada entre adultos. Estratégias de intervenções para diagnóstico, tratamento e intensificação de medidas preventivas e orientações de estilo de vida saudáveis são importantes nessa população.

RESUMEN Objetivo: estimar la prevalencia de dislipidemias y los factores asociados en adultos de Rio Branco, Acre-Brasil. Métodos: estudio de investigación seccional, poblacional, que evaluó adultos (18 a 59 años) residentes en las zonas urbana y rural de Rio Branco en 2014. Las dislipidemias fueron definidas conforme a los criterios de la Actualización de la Directriz Brasileña de Dislipidemias y Prevención de la Aterosclerosis. Se empleó regresión logística para estimar las odds ratio (OR) e intervalos de confianza del 95% (IC95%). Resultados: la prevalencia de dislipidemia, HDL-c bajo, hipertrigliceridemia aislada, hipercolesterolemia aislada e hiperlipidemia mixta fue de 56,1%, 37,4%, 23,6%, 9,8% y 3,5%, respectivamente. En el modelo final multivariado, solo la obesidad (OR = 1,86; IC95%: 1,12;3,10) mantuvo una asociación estadísticamente significativa con la dislipidemia. Entre los subtipos de dislipidemias, se asociaron a la hipertrigliceridemia aislada las variables: franja etaria de 40 a 49 años (OR = 2,17; IC95%: 1,53;4,80); hipercolesterolemia aislada (OR = 2,52; IC95%: 1,23;5,15); HDL-c bajo (OR = 2,53; IC95%: 1,65;3,86); obesidad (OR = 2,10; IC95%: 1,25;3,53); y diabetes mellitus (OR = 5,41; IC95%: 1,46;20,4). Conclusión: la prevalencia de cambios lipídicos fue elevada entre adultos. Estrategias de intervenciones para el diagnóstico, tratamiento e intensificación de medidas preventivas y orientaciones de estilo de vida saludables son importantes en esa población.

ABSTRACT Objective: to estimate the prevalence of dyslipidemia and associated factors in adults in Rio Branco, Acre. Methods: a cross-sectional, population-based study that assessed adults (age 18 to 59 years) living in urban and rural areas of Rio Branco in 2014. Dyslipidemias were defined according to the criteria of the Brazilian Guidelines Update on Dyslipidemias and Prevention of Atherosclerosis. Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI95%). Results: the prevalence of dyslipidemia, low HDL-c, isolated hypertriglyceridemia, isolated hypercholesterolemia and mixed hyperlipidemia was 56.1%, 37.4%, 23.6%, 9.8% and 3.5%, respectively. In the final multivariate model, only obesity (OR = 1.86; CI95%: 1.12; 3.10) maintained a statistically significant association with dyslipidemia. Among the dyslipidemia subtypes, the following variables were associated with isolated hypertriglyceridemia: age group 40 to 49 years (OR = 2.17; CI95%: 1.53; 4.80); isolated hypercholesterolemia (OR = 2.52; CI95%: 1.23; 5.15); low HDL-c (OR = 2.53; CI95%: 1.65; 3.86); obesity (OR = 2.10; CI95%: 1.25;3.53); and diabetes mellitus (OR = 5.41; CI95%: 1.46; 20.4). Conclusion: the prevalence of lipid alterations was high among adults. Intervention strategies for diagnosis, treatment and intensification of preventive measures and healthy lifestyle guidelines are important in this population.

Prevalência e fatores associados ao diagnóstico autorreferido de colesterol alto na população adulta brasileira: Pesquisa Nacional de Saúde 2019 / Prevalencia y factores asociados con el diagnóstico autoinformado de colesterol alto en la población adulta brasileña: Investigación Nacional de Salud 2019 / Prevalence and factors associated with self-reported diagnosis of high cholesterol in the Brazilian adult population: National Health Survey 2019

Objetivo: Estimar a prevalência de diagnóstico autorreferido de colesterol alto e analisar os fatores associados à prevalência na população adulta brasileira. Métodos: Estudo transversal utilizando a Pesquisa Nacional de Saúde 2019. O diagnóstico de colesterol alto foi autorreferido. Modelos de regressão de Poisson originaram as razões de prevalência (RP) e intervalos de confiança de 95% (IC95%). Resultados: Nos 88.531 adultos, a prevalência de colesterol alto foi de 14,6%. Associaram-se positivamente: sexo feminino (RP = 1,44; IC95% 1,40;1,52), idade ≥ 60 anos (RP = 3,80; IC95% 3,06;4,71), ter plano de saúde (RP = 1,33; IC95% 1,24;1,42), autoavaliação de saúde ruim ou muito ruim (RP = 1,75; IC95% 1,60;1,90), ter hipertensão (RP = 1,78; IC95% 1,68;1,89), ter diabetes (RP = 1,54; IC95% 1,45;1,65), ter insuficiência renal (RP = 1,33; IC95% 1,15;1,53), ter obesidade (RP = 1,27; IC95% 1,18;1,36), ser ex-fumante (RP = 1,13; IC95% 1,07;1,20), consumir álcool abusivamente (RP = 1,11; IC95% 1,01;1,21), ser ativo no lazer (RP = 1,22; IC95% 1,15;1,30). Conclusão: O colesterol alto associou-se a condições sociodemográficas, de saúde e estilo de vida.

Objetivo: Estimar la prevalencia de colesterol alto autodeclarado y analizar factores asociados la prevalencia en adultos brasileños. Métodos: Estudio transversal utilizando la Encuesta Nacional de Salud de 2019. El diagnóstico de colesterol alto fue autodeclarado. Los modelos de regresión de Poisson produjeron razón de prevalencia (RP) e intervalos de confianza del 95% (IC95%). Resultados: En 88.531 adultos, la prevalencia fue 14,6%. Asociaron positivamente: sexo feminino (RP = 1,44; IC95% 1,40;1,52), edad ≥ 60 años (RP = 3,80; IC95% 3,06;4,71), seguro salud (RP = 1,33; IC95% 1,24;1,42), autoevaluación de salud mala o muy mala (RP = 1,75; IC95% 1,60;1,90), hipertensión (RP = 1,78; IC95% 1,68;1,89), diabetes (RP = 1,54; IC95% 1,45;1,65), insuficiencia renal (RP = 1,33; IC95% 1,15;1,53), obesidad (RP = 1,27; IC95% 1,18;1,36), exfumador (RP = 1,13; IC95% 1,07;1,20), abuso de alcohol (RP = 1,11; IC95% 1,01;1,21), estar activo en el tiempo libre (RP = 1,22; IC95% 1,15;1,30). Conclusión: Colesterol alto se asoció con condiciones sociodemográficas, de salud y estilo de vida.

Objective: To estimate the prevalence of self-reported high cholesterol diagnosis and to analyze the factors associated with the prevalence in the Brazilian adult population. Methods: Cross-sectional study, using data from the 2019 National Health Survey. The diagnosis of high cholesterol was self-reported. Poisson regression models yielded prevalence ratios (PR) and 95% confidence intervals (95%CI). Results: In the 88,531 adults, the prevalence of high cholesterol was 14.6%. Positively associated: female sex (PR = 1.44; 95%CI 1.40;1.52), age ≥ 60 years (PR = 3.80; 95%CI 3.06;4.71), health insurance (PR = 1.33; 95%CI 1.24;1.42), poor or very poor self-rated health (PR = 1.75; 95%CI 1.60;1.90), hypertension (PR = 1.78; 95%CI 1.68;-1.89), diabetes (RP = 1.54; 95%CI 1.45;1.65), renal failure (PR = 1.33; 95%CI 1.15;1.53), obesity (PR = 1.27; 95%CI 1.18;1.36), former smoker (PR = 1.13; 95%CI 1.07;1.20), alcohol abuse (PR = 1.11; 95%CI 1.01;1.21), physically active during leisure time (PR = 1.22; 95%CI 1.15;1.30). Conclusion: High cholesterol was associated with sociodemographic characteristics, health condition and lifestyle.

Incidence and cause of abnormal cholesterol in children aged 2-18 years in a single center / 北京大学学报(医学版)

OBJECTIVE@#To investigate the abnormality and distribution of plasma cholesterol levels in single-center hospitalized children.@*METHODS@#The blood lipid levels of children aged 2-18 years who had blood lipid test results in Peking University First Hospital from June 2016 to June 2019 were etrospectively analyzed. Cholesterol oxidase method was used for total cholesterol, and high-density lipoprotein cholesterol and low-density lipoprotein cholesterol were detected by clearance method. The counting data were compared with chi-square test.@*RESULTS@#The survey had involved 11 829 children (7 087 were boys and 4 742 were girls). 1 822 (15.4%) children were with elevated total cholesterol, 1 371 (11.6%) children with elevated low-density lipoprotein cholesterol, and 2 798 (23.7%) children with high-density lipoprotein cholesterol reduction. The total number of the children with abnormal cholesterol levels was 4 427 (37.4%). Among the 7 835 children who visited hospital due to the disease not commonly inducing dyslipidemia, 731 (9.3%) had elevated TC, 561 (7.2%) had elevated LDL-C, 1 886 (24.1%) had decreased HDL-C, and 2 576 (32.9%) had abnormal cholesterol levels. Among the children with different diseases, the difference in the incidence of abnormal cholesterol was statistically significant. The top three main groups of the children with increased total cholesterol and low-density lipoprotein cholesterol were "dyslipidemia", "urinary tract disease", and "nutritional disease"; The top three main groups of the children with reduced high-density lipoprotein cholesterol were "respiratory diseases", "dyslipidemia", "hematological diseases and malignant tumors". Among the 1 257 blood li-pid test results sent by other departments, 300 cases had abnormal cholesterol levels (23.8%). Among them, there were 70 children with hypercholesterolemia (5.6%), 44 children with increased low-density lipoprotein cholesterol (3.5%), and 224 children with reduced high-density lipoprotein cholesterol (17.8%). There were 365 (4.6%) children with low-density lipoprotein cholesterol ≥140 mg/dL (3.6 mmol/L) who needed to further exclude familiar hypercholesterolemia among the children who visited hospitals due to the disease not commonly inducing dyslipidemia.@*CONCLUSION@#Children in hospitals have a high incidence of cholesterol abnormalities. Doctors need to pay more attention to the cholesterol diagnosis and management regardless of the discipline, which not only helps to control secondary hypercholesterolemia, but also provides the possibility of detecting familial hypercholesterolemia in time.

Investigation on status of dyslipidemia in Chinese females aged 35 years or above / 中华心血管病杂志

Objective: To investigate the prevalence, awareness, treatment and control status of dyslipidemia among females aged ≥35 years old across China. Methods: Participants were selected by stratified multistage random sampling method in the "Twelfth Five-Year Plan" National Science and Technology Support Project "Survey on the Prevalence of Important Cardiovascular Diseases and Key Technology Research in China" project. This study is a retrospective, cross-sectional study. A total of 17 418 females aged 35 years and over were included in the current study. The basic information such as age, medical history and menopause was collected by questionnaire. The blood lipid parameters were derived from clinical laboratory examinations. The prevalence of dyslipidemia and the rate of awareness, treatment, and control of dyslipidemia were analyzed in females aged 35 years and over. Results: The age of participants was (56.2±13.0) years old, and the prevalence of dyslipidemia was 33.1% (5 765/17 418). The prevalence rates of high total cholesterol, hypertriglyceridemia, low HDL-C and high LDL-C were 9.7% (1 695/17 418), 11.1% (1 925/17 418), 10.9% (1 889/17 418) and 7.3% (1 262/17 418), respectively. The prevalence of dyslipidemia increased with age and the prevalence of dyslipidemia in women who were not married, Han, menarche age>16 years, obesity, central obesity, alcohol consumption, diabetes, hypertension and family history of cardiovascular disease were higher than those without such characteristics (P<0.05). There were 10 432 (59.9%) menopausal females in this cohort and prevalence of dyslipidemia of these participants was 38.8% (4 048/10 432), which was higher than that of non-postmenopausal females (24.6%, 1 717/6 986) (P<0.05). The awareness rates, treatment rates and control rates of dyslipidemia were 33.9% (1 953/5 765), 15.1% (870/5 765) and 2.5% (143/5 765) respectively among females aged 35 years and over in China. Conclusion: The prevalence of dyslipidemia in Chinese females aged 35 years and over is high, and its awareness, treatment, and control rates need to be optimized.

Prevalência de dislipidemias e consumo alimentar: um estudo de base populacional / Prevalence of dyslipidemias and food consumption: a population-based study

Resumo O presente artigo objetivou estimar a prevalência de dislipidemias e sua associação e adequação da ingestão de gorduras saturadas, monoinsaturadas, trans, ômega-3 e carboidratos, em adultos de Viçosa-MG. Trata-se de um estudo transversal com 884 adultos com idades entre 20 e 59 anos. Foram coletados dados sociodemográficos, de consumo alimentar, antropométricos e bioquímicos da população. As associações entre as variáveis foram verificadas utilizando-se o teste qui-quadrado. Verificou-se elevada prevalência de dislipidemias na população (64,25%), com pelo menos um dos lipídeos séricos alterados. Houve predomínio de inadequação na ingestão de gorduras saturadas, trans, monoinsaturadas e carboidratos. Ressalta-se que a ingestão de ômega-3 esteve adequado para a maioria dos indivíduos. Adultos eutróficos apresentaram maiores prevalências de ingestão excessiva de gorduras saturadas e trans. Observou-se que 38,7% dos indivíduos com HDL-c reduzido apresentaram ingestão acima do recomendado de gordura saturada. A maioria dos indivíduos com triglicerídeos e razão TG/HDL-c elevada possuíam ingestão insatisfatória de gordura monoinsaturada. Faz-se necessária a avaliação de outros fatores que podem influenciar o padrão alimentar.

Abstract This study aimed to assess the prevalence of dyslipidemia and its association with an adequate intake of carbohydrates, saturated, monounsaturated, trans, and omega-3 fats among adults living in Viçosa, Minas Gerais, Brazil. This is a cross-sectional study with 884 adults aged 20 to 59 years. Sociodemographic, food intake, anthropometric, and biochemical data were collected. Associations between study variables were investigated by the chi-square test. There was a high prevalence of dyslipidemia in the study population (64.25%), with most individuals having abnormal levels of at least one serum lipid component. Inadequate intakes of saturated, trans, and monounsaturated fats and carbohydrates were predominant. It is noteworthy that omega-3 intake levels were adequate in most individuals. Eutrophic adults showed a higher prevalence of excessive intake of saturated and trans fats. It was found that 38.7% of individuals with low levels of High Density Lipoprotein cholesterol (HDL-c) had an excessive intake of saturated fat. Most individuals with high triglyceride levels or high triglyceride/HDL-c ratios had an insufficient intake of monounsaturated fat. Further studies are needed to evaluate other factors that may influence dietary patterns.

Prevalencia del síndrome metabólico en adolescentes de tres institutos de educación diversificada del Municipio Iribarren, Barquisimeto, Estado Lara, Venezuela / Prevalence of metabolic syndrome in adolescents from three institutes of diversified education in Iribarren Municipality, Barquisimeto, Lara State, Venezuela

INTRODUCCIÓN: la obesidad infantil es un importante problema de salud pública, por su prevalencia y consecuencias sobre las expectativas y la calidad de vida. En población infantil y adolescente, no hay consenso para diagnosticar el síndrome metabólico, esto explica las diferentes prevalencias reportadas. OBJETIVO: Determinar la prevalencia del síndrome metabólico en estudiantes de tres instituciones de educación diversificada del Municipio Iribarren Barquisimeto Estado Lara mediante los criterios establecidos por Adult Treatment Panel III. MATERIAL Y MÉTODO: se realizó una investigación transversal, descriptiva, donde se evaluó las medidas antropométricas, los parámetros clínicos y paraclínicos que se incluyen en los criterios establecidos para el diagnóstico de síndrome metabólico. La muestra estuvo conformada por 108 adolescentes pertenecientes a la U.E. Colegio "Inmaculada Concepción", U.E. "Rafael Villavicencio" y "Escuela Técnica Industrial Lara". Los resultados obtenidos fueron analizados mediante frecuencias absolutas y porcentajes. RESULTADOS: Se encontró que 4,6% de adolescentes presentó 3 o más criterios establecidos para el diagnóstico de síndrome metabólico. La dislipidemia (27,78%) y la hipertensión (19,4%) fueron los factores más frecuentes, seguidos por la obesidad abdominal. CONCLUSIÓN: la prevalencia de síndrome metabólico en adolescentes fue de 4,6% lo que refleja la importancia de identificar los factores de riesgo en edades tempranas para promover cambios de estilos de vida más saludable con el fin de prevenir enfermedades cardiometabólicas en la edad adulta.

INTRODUCTION: childhood obesity is an important public health problem, due to its prevalence and consequences on expectations and quality of life. In children and adolescents, there is no consensus to diagnose metabolic syndrome, this explains the different reported prevalences. OBJECTIVE: To determine the prevalence of metabolic syndrome in students from three diversified educational institutions in the Municipality of Iribarren Barquisimeto, Lara State, using the criteria established by Adult Treatment Panel III. METHODS: a cross-sectional, descriptive investigation was carried out, where the anthropometric measures, the clinical and paraclinical parameters that are included in the criteria established for the diagnosis of metabolic syndrome were evaluated. The sample consisted of 108 adolescents belonging to the U.E. Colegio "Inmaculada Concepción", U.E. "Rafael Villavicencio" and "Lara Industrial Technical School". The results obtained were analyzed using absolute frequencies and percentages. RESULTS: It was found that 4.6% of adolescents presented 3 or more established criteria for the diagnosis of metabolic syndrome. Dyslipidemia (27.78%) and hypertension (19.4%) were the most frequent factors, followed by abdominal obesity. CONCLUSION: the prevalence of metabolic syndrome in adolescents was 4.6%, which reflects the importance of identifying risk factors at an early age to promote healthier lifestyle changes in order to prevent cardiometabolic diseases in adulthood.

Factores de riesgo asociados a la enfermedad arterial periférica en pacientes diagnosticados mediante índice tobillo brazo / Risk factors associated with peripheral arterial disease in patients diagnosed using the ankle-brachial index

Introducción: La enfermedad arterial periférica es bien conocida como predictor de morbilidad y mortalidad cardiovascular y cerebrovascular, de ahí la importancia de reconocer sus factores de riesgo. Objetivo: Determinar los factores de riesgo asociados a la enfermedad arterial periférica en pacientes diagnosticados por el índice tobillo brazo. Métodos: Se realizó un estudio observacional analítico transversal, entre el 1ro de septiembre y 30 de noviembre de 2019. El universo fue de 290 pacientes, se trabajó con una muestra de 120, determinada por un muestreo aleatorio simple. Se emplearon estadígrafos descriptivos e inferenciales: prueba t de Student, el odds ratio de prevalencia y la regresión logística binomial. Resultados: Fueron categorizados con índice tobillo brazo < 0,9 un total de 43 pacientes (35,8 por ciento). La media de edad de la población fue de 58,43 ± 16,69. El sexo femenino predominó con 61 pacientes (50,8 por ciento). El índice de masa corporal promedio fue de 24,29 ± 3,29 kg/m2. La hipertensión arterial fue el factor de riesgo más frecuente presentándose en 67,5 por ciento de los pacientes. Se identificaron como factores de riesgo de índice tobillo brazo < 0,9 a la edad ≥ 60 años (OR: 6,41; IC 95 por ciento: 2,04-20,1; p=0,001); la hipertensión arterial (OR: 2,99; IC 95 por ciento: 1,02-8,73; p=0,045); la diabetes mellitus (OR: 3,89; IC 95 por ciento: 1,34-11,3; p=0,012) y la dislipidemia (OR: 4,35; IC 95 por ciento: 1,27-14,8; p=0,019). Conclusiones: La edad avanzada, la hipertensión arterial, la diabetes mellitus y la dislipidemia constituyeron factores de riesgo asociados a la enfermedad arterial periférica(AU)

Introduction: Peripheral arterial disease is well known as a predictor of cardiovascular and cerebrovascular morbidity and mortality, hence the importance of recognizing its risk factors. Objective: To determine the risk factors associated with peripheral arterial disease in patients diagnosed by the ankle brachial index. Methods: A cross-sectional analytical observational study was carried out from September 1 to November 30, 2019. The universe consisted of 290 patients, a sample of 120 was used, determined by simple random sampling. Descriptive and inferential statistics were used: Student's t test, prevalence odds ratio, and binomial logistic regression. Results: A total of 43 patients (35.8%) were categorized with ankle brachial index <0.9. The mean age of the population was 58.43 ± 16.69. The female sex predominated with 61 patients (50.8 percent). The average body mass index was 24.29 ± 3.29 kg / m2. Hypertension was the most frequent risk factor in 67.5 percent of the patients. Risk factors were identified in ankle brachial index <0.9 at age ≥60 years (OR: 6.41; 95 percent CI: 2.04-20.1; p = 0.001); arterial hypertension (OR: 2.99; 95 percent CI: 1.02-8.73; p = 0.045); diabetes mellitus (OR: 3.89; 95 percent CI: 1.34-11.3; p = 0.012) and dyslipidemia (OR: 4.35; 95 percent CI: 1.27-14.8; p = 0.019). Conclusions: Advanced age, arterial hypertension, diabetes mellitus and dyslipidemia were risk factors associated with peripheral arterial disease(AU)

Controle dos níveis pressóricos em hipertensos / Pressure level control in hypertensive patients

Objetivos: Identificar o controle pressórico em hipertensos acompanhados por uma equipe da Saúde da Família. Métodos: Trata-se de um estudo longitudinal, realizado por meio da análise de prontuários de 134 indivíduos hipertensos maiores de 18 anos com, no mínimo, três aferições de pressão arterial ao longo do período citado, em uma Unidade Básica da Saúde da Família, durante o ano de 2017, no município de Itajaí (SC). Resultados: Da amostra total, 60,5% eram do sexo feminino. A faixa etária predominante foi dos 60 aos 69 anos (33,6%), e 80,7% tinham até 8 anos de escolaridade. Em relação ao número de medicações utilizadas, 34,3% estavam em monoterapia, 41,8% em terapia dupla, 17,9% em terapia tripla e 6% em terapia quádrupla. A taxa de controle pressórico foi de 28,4%. Apenas 9% da amostra apresentava índice de massa corporal dentro do ideal. No grupo compensado, 52,7% dos indivíduos apresentavam sobrepeso, enquanto 65,6% do grupo descompensado apresentavam obesidade (p<0,05). Da amostra total, 47,8% dos indivíduos eram portadores de diabetes mellitus, correspondendo a 53,1% do grupo descompensado (p<0,05). Ainda nesse grupo, 46,9% apresentavam níveis inadequados de LDL-colesterol (p<0,05), bem como 35,4% dos hipertensos descompensados apresentavam alto risco cardiovascular (p<0,05). Conclusão: Menos de um terço dos hipertensos apresentou níveis pressóricos adequados, sendo que os fatores que mostraram associação significativa com o controle da pressão arterial foram diabetes mellitus, dislipidemia, elevado índice de massa corporal e risco cardiovascular intermediário e alto.

Objectives: To identify pressure control in hypertensive patients followed by a Family Health Team. Methods: This is a longitudinal study carried out through the analysis of medical records of 134 hypertensive patients over 18 years of age, with at least three blood pressure measurements during the period mentioned, in a Primary Family Health Unit, during 2017 in the municipality of Itajaí (SC). Results: Of the total sample, 60.5% were women. The predominant age group was between 60 and 69 years (33.6%) and 80.7% had up to 8 years of schooling. Regarding the number of medications used, 34.3% were in monotherapy, 41.8% in double therapy, 17.9% in triple therapy, and 6% in quadruple therapy. The pressure control rate was 28.4%. Only 9% of the sample had optimal body mass index. In the compensated group, 52.7% of the individuals were overweight, while 65.6% of the decompensated group were obese (p<0.05). Of the total sample, 47.8% of the individuals had diabetes mellitus, corresponding to 53.1% of the decompensated group (p<0.05). Still in this group, 46.9% had inadequate LDL levels (p<0.05), as well as 35.4% of the decompensated hypertensive patients presented high cardiovascular risk (p<0.05). Conclusion: Less than one-third of hypertensive patients presented adequate blood pressure levels, and the factors showing a significant association with blood pressure control were diabetes mellitus, dyslipidemia, high body mass index, and intermediate and high cardiovascular risk

Prevalence trends and related factors of hypertension patients complicating with dyslipidemia in community of Guandong province between 2013 and 2018 / 中华心血管病杂志

Objective: To analyze the prevalence trends and related factors of hypertension patients complicating with dyslipidemia in community. Methods: This was a cross-sectional survey, patients with hypertension were selected from the different communities of Guangdong province in 2013 and 2018 respectively. General clinical characteristics, including demographic information, past history, family history, and medication history, were collected. Dyslipidemia was defined as follows: at least 1 item elevation of total cholesterol (TC)≥5.2 mmol/L, triglyceride (TG) ≥1.7 mmol/L, low-density lipoprotein cholesterol (LDL-C)≥3.4 mmol/L, or reduced high-density lipoprotein cholesterol (HDL-C)<1.0 mmol/L. The incidence of dyslipidemia was standardized based on the 2010 China Census data, and further subgroup analysis was performed according to age (<50, 50-60, ≥60 years old) and sex (male, female). Multivariate logistic regression was used to analyze the related factors of dyslipidemia. Results: In 2013 and 2018, 7 866 (4 148 (52.7%) females, with the age of (62.4±13.6) years) and 11 611 (6 692 (57.6%) females, with the age of (58.2±9.3)years) patients with hypertension were enrolled for data analysis, respectively. In 2013, the total prevalence rate of dyslipidemia in patients with hypertension in the community of Guangdong province was 56.3%, among which the prevalence rates of hypercholesterolemia, hypertriglyceridemia, high LDL-Cemia, and low HDL-Cemia were 17.1. %, 21.3%, 2.3% and 24.4%, respectively. The total prevalence of dyslipidemia in patients with hypertension in the community of Guangdong in 2018 was 47.3%, prevalence of hypercholesterolemia, hypertriglyceridemia, high LDL-Cemia and low HDL-Cemia was 14.1%, 20.3%, 12.0% and 19.4%, respectively. Subgroup analysis showed that the total prevalence of dyslipidemia in male patients with hypertension in the community of Guangdong in 2013 and 2018 was 59.0% and 50.7%, respectively, among which hypercholesterolemia was 13.8% and 8.0%, and hypertriglyceridemia was 22.3%, 20.9%, high LDL-Cemia was 1.7%, 8.1%, low HDL-Cemia was 32.9%, 30.3%, respectively. In 2013 and 2018, the total prevalence of dyslipidemia in female patients with hypertension in the community of Guangdong province was 53.9% and 44.8%, among which prevalence of hypercholesterolemia was 20.5% and 18.5%, hypertriglyceridemia was 20.4% and 19.8%, and high LDL-Cemia was 2.7% and 14.9%, and hypo-HDL-Cemia was 16.8% and 11.3%, respectively. Age subgroup analysis showed that the prevalence of dyslipidemia among hypertensive patients aged<50, 50-60, and ≥60 years in Guangdong community in 2013 were 60.1%, 60.6%, and 53.7%, respectively; and 46.2%, 49.3% and 46.5% in 2018, respectively. Multivariate logistic regression analysis showed that women (OR=0.860,95%CI 0.761-0.973,P=0.017), obese (OR=2.295,95%CI 2.007-2.624,P<0.001), diabetes (OR=1.314,95%CI 1.090-1.583,P=0.004), stroke (OR=1.894,95%CI 1.227-2.924,P=0.004) and the level of fasting blood glucose (OR=1.105,95%CI 1.066-1.146,P<0.001) were independently related with the occurrence of dyslipidemia. Conclusions: The prevalence of dyslipidemia in patients with hypertension in the communities of Guangdong province is relatively high, and the prevalence differs in sex and age. Between 2013 and 2018, the total prevalence of dyslipidemia, hyper-TCemia, and hypo-HDL-Cemia in hypertensive patients shows a downward trend. The prevalence of hyper-TGemia remains unchanged, but the prevalence of high LDL-C shows an upward trend. Several factors are related to the prevalence of dislipidemia in hypertension patients in Guandong community.

Cross sectional study of familial hypercholesterolemia in dyslipidemia patients receiving lipid-lowering therapy: DYSIS-China subgroup analysis / 中华心血管病杂志

Objectives: To analyze the incidence, blood lipid levels and cardiovascular disease of familial hypercholesterolemia (FH) in dyslipidemia patients receiving lipid-lowing therapy from the DYSIS-China. Methods: Dyslipidemia International Study-China (DYSIS-China) database was re-analyzed according to the criteria of "Chinese guidelines for prevention and treatment of dyslipidemia in adults-2016 version". DYSIS-China database included 25 317 dyslipidemia out-patients who received at least one lipid-lowering drug for at least three months. All the patients were divided into three groups: unlikely HF, possible FH and definite FH according to the Dutch Lipid Clinic Network diagnostic criteria. Age, gender, lipids levels, drug use and complications were compared among the three groups. Factors were compared between Possible FH group and definite FH group in terms of age stratification. Results: A total of 23 973 patients with dyslipidemia were included. The average age was (64.8±9.9) years, 11 757 patients were females (49.0%). The proportion of unlikely FH in the total population was 20 561 (85.7%), possible FH was 3294 (13.7%), and the definite FH was 118(0.5%). Patients in the definite FH group (58.3±8.5 years) was younger than in unlikely HF(65.3±9.8 years) and possible FH(61.8±9.9 years) group. LDL-C ((5.6±1.9) mmol/L) levels were significantly higher in definite FH group than in unlikely HF ((2.5±0.9) mmol/L) and possible FH ((4.3±1.0) mmol/L) group. TC ((7.4±1.8) mmol/L) levels were also significantly higher in definite FH group than in unlikely HF ((4.3±1.0) mmol/L) and possible FH ((6.0±1.0) mmol/L) group. Percent of female sex, sedentary lifestyle and systolic blood pressure value were significantly higher in definite FH group than in other two groups (all P<0.05). Statin use was similar among the 3 groups. Prevalence of ischemic cardiomyopathy (70(59.3%)) was significantly higher in the definite FH group than in unlikely FH group7519 (36.6%) and possible FH group1149 (34.9%). The rate of hypertension (82 (69.5%)) was also significantly higher in the definite FH group than in unlikely FH group (2 063 (62.6%) and in possible FH group (13 928 (67.7%)). The possible FH group had the highest proportion of patients aged 55-64 years (1 146 (34.8%)), and the prevalence of hypertension 358 (76.8%), diabetes 189 (40.6%), ischemic heart disease 186 (39.9%), cerebrovascular disease 149 (32.0%) and heart failure 28 (6.0%) was the highest in patients over 75 years old. The definite FH group had the highest proportion of patients aged 55-64 years (49 (41.52%)), and the prevalence of ischemic heart disease (70 (59.3%)) was the highest in patients aged 45-54 years old group, there was no significant difference in the prevalence of diabetes,hypertension,heart failure,peripheral artery disease and cerebrovascular disease among different age groups. Conclusion: The detection rate of FH in Chinese patients with dyslipidemia is not low, the blood lipid level is poorly controlled, and the risk of cardiovascular disease is high in Chinses FH patients.

Associação de índices hematológicos com fatores de risco, gravidade e complexidade da lesão no infarto agudo do miocárdio / Association of hematological índices with risk factors, severity and complexity of lesion in the acute myocardium infarction

Objetivo: Avaliar a associação entre os índices hematológicos e os fatores de risco, a complexidade e a gravidade do infarto em relação aos desfechos cardiovasculares. Métodos: Trata-se de uma coorte prospectiva, aninhada ao Catarina Heart Study e realizada em um hospital público da Grande Florianópolis. Resultados: Entre 2016 e 2019, foram analisados 580 participantes. Os indivíduos diabéticos apresentaram valores de hemoglobina de 13,0g/dL (12,0 a 14,1g/dL), inferior aos não diabéticos, com valores de 14,0g/dL (12,7 a 15,0g/dL; p<0,001). Indivíduos dislipidêmicos apresentavam valores de hemoglobina e segmentados, respectivamente, de 13,3g/dL (12,1 a 14,4g/dL) e 6.910mm³ (5.990 a 7.807mm³), inferiores aos sem dislipidemia, que possuíam, respectivamente, 14,0g/dL (12,8 a 15,0g/dL; p<0,001) e 7.205mm³ (6.300 a 8.030mm³; p=0,038). A contagem de plaquetas foi maior nos que possuíam dislipidemia, 224.000mm³ (178.000 a 273.500mm³), quando comparados aos que não possuíam, 210.000mm³ (173.000 a 255.000mm³; p=0,029). Houve correlação entre o SYNTAX e a contagem de leucócitos (r=0,143; p=0,001) e segmentados (r=0,222; p<0,001). Houve correlação negativa entre a fração de ejeção ventricular e a contagem de leucócitos (r=-0,173; p<0,001) e dos segmentados (r=-0,255; p<0,001). Indivíduos reinternados em 30 dias apresentaram valores de segmentados de 7.440mm³ (6.590 a 8.360mm³), maior em relação aos não reinternados, com 7.100mm³ (6.100 a 8.022mm³), sendo p=0,05. Os participantes que morreram por qualquer causa possuíam hemoglobina de 12,0g/dL (11,4 a 13,7g/dL), inferior aos indivíduos que permaneceram vivos em 30 dias, cujos valores foram de 13,7g/dL (12,5 a 14,9g/dL), sendo p=0,021. Conclusão: A contagem maior de plaquetas está associada à dislipidemia. Valores de hemoglobina baixas estão associados a um pior prognóstico em 30 dias e aos fatores de risco cardiovasculares, como diabetes mellitus e dislipidemia. A contagem maior de leucócitos está associada à reinternação em 30 dias e correlacionada à gravidade e à complexidade da lesão do infarto.

Objective: To evaluate the association of hematological indices with risk factors, complexity, and severity of the acute myocardial infarction regarding cardiovascular outcomes. Methods: This is a prospective cohort, nested to Catarina Heart Study, performed in a public hospital of Florianópolis. Results: Between 2016 and 2019, 580 participants were analyzed. Diabetic individuals had hemoglobin levels of 13.0g/dL (12.0 to 14.1g/dL), lower than those in non-diabetic individuals, with values of 14.0g/dL (12.7 to 15.0g/dL; p<0.001). Individuals with dyslipidemia had hemoglobin and segmented leukocytes of, respectively, 13.3g/dL (12.1 to 14.4g/dL) and 6,910mm³ (5,990 to 7,807mm³), lower than in non-dyslipidemic individuals, who had, respectively, 14.0g/dL (12.8 to 15.0g/dL; p<0.001) and 7,205mm³ (6,300 to 8,030mm³; p=0.038). Platelet count was higher in those who had dyslipidemia, 224,000mm³ (178,000 to 273,500mm³), when compared to non-dyslipidemic, 210,000mm³ (173,000 to 255,000mm³; p=0.029). There was a correlation between Syntax and leukocyte count (r=0.143, p=0.001) and segmented (r=0.222; p<0.001). There was a negative correlation between ventricular ejection fraction and leukocytes count (r=-0.173; p<0.001) and segmented (r=-0.255; p<0.001). Individuals readmitted in 30 days had segmented values of 7,440mm³ (6,590 to 8,360mm³), higher compared to non-readmitted, with 7,100mm³ (6,100 to 8,022mm³), p=0,05. Individuals who died of any cause had hemoglobin of 12.0g/dL (11.4 to 13.7g/dL), lower than those that remained alive in 30 days, with values of 13.7g/dL (12.5 to 14.9g/dL), p=0.021. Conclusion: Higher platelet count is associated with dyslipidemia. Low hemoglobin values are associated with worse outcomes in 30 days and with cardiovascular risk factors, such as diabetes mellitus and dyslipidemia. Higher leukocyte count is associated with readmission in 30 days and is also correlated to the severity and complexity of acute myorcardial infarction.

Treatment Eligibility and Therapeutic Responses of an Ecuadorian Population at High Cardiovascular Risk Based on the ATP III Guidelines

Abstract Background The Adult Treatment Panel III (ATPIII) guidelines aim to reduce cardiovascular morbidity and mortality. In Ecuador, 20% of people have high LDL cholesterol levels, and 39% have high triglyceride levels. Objective To analyze lipid-lowering regimens in Ecuadorian patients and determine the achievement rate of the ATPIII goals for lipid profile. Methods Using a retrospective analysis, 385 subjects older than 30 years, who received pharmacological treatment for dyslipidemia for at least three months was randomly selected from institutions at two large cities in Ecuador. Data were collected from patients' medical records and analyzed by chi-square test or paired t-test; p-values less than 0.05 were considered significant. Results Baseline total cholesterol values were above 200 mg/dL in 75% of subjects, LDL-c values above 129 mg/dL in 83% of subjects and triglycerides values above 150 mg/dL in 79% of subjects. Most (n = 253, 95.8%) patients at very high cardiovascular risk were taking statins, 50% of them atorvastatin. Considering the ATPIII guidelines' goals, only 24 subjects (19%) at high CV risk achieved an LDL-c < 100 mg/dl, while a significantly lower percentage (p = 0.04) of patients at very high risk reached an LDL-c < 70mg/dl (11%; n = 30). Conclusion These data indicate a low rate of compliance with the ATPIII guidelines, independent of the medication used or duration of the treatment. This may be attributed to the prescription of low doses of medication and a therapy targeting isolated lipid fractions rather than a complete lipid profile. (Int J Cardiovasc Sci. 2020; 33(4):371-376)

Prevalencia de dislipidemias en pacientes obesos / Dylispidemia prevalence in obese patients

Introducción: Las dislipidemias asociadas a la obesidad constituyen factores de riesgo de varias enfermedades especialmente del sistema cardiovascular. Objetivo: Determinar la prevalencia de dislipidemias en pacientes obesos. Métodos: Se realizó un estudio correlacional, retrospectivo y transversal de150 pacientes obesos, quienes acudieron a la consulta externa de la Clínica Medina del Hospital Básico de Guayaquil, desde el 2018 hasta el 2019. Las variables analizadas fueron edad, sexo, índice de masa corporal y resultados de laboratorio, tales como colesterol total, triglicéridos, colesterol LDL y dislipidemia mixta (colesterol HDL y VLDL). Resultados: En la serie predominaron el sexo masculino (62,6%), los pacientes con más de 65 años de edad (42,0 %), los niveles entre rango crítico y alto riesgo (66 pacientes); 16,0 % se clasificaron de alto riesgo con niveles de colesterol superior a 240 mg/dL. Mostraron resultados anormales en cuanto a los triglicéridos 62 afectados, en un rango mayor de 150 con niveles y limítrofe altos. Conclusiones: Se observó una correspondencia entre las dislipidemias y la obesidad, pues todos los pacientes presentaron algún tipo de alteración en los lípidos.

Introduction: Dyslipidemias associated to obesity constitute risk factors of several diseases specially from the cardiovascular system. Objective: To determine the prevalence of dyslipidemias in obese patients Methods: A correlational restrospective and cross-sectional study of 150 obese patients, who visited the outpatients department of Medina Clinic from Hospital Básico in Guayaquil, from 2018 to 2019. Variables used were age, sex, body mass index and laboratory results such as total cholesterol, triglycerids. LDL colesterol and mixed dyslipidemias (cholesterol HDL and VLDL). Results: In the serie, male sex (62.6 %), patients over 65 years (42.0 %), levels between critical and high risk (66 patients) prevailed, 16.0 % were classified as high risk patients with cholesterol level over 240 mg/dL. Sixty two patients showed subnormal results regarding triglycerids, in a rank higher than 150 with high limits and levels. Conclusions: A correspondance between dyslipidemias and obesity was observed, as all patients presented some type of change in lipids.

Dyslipidemia prevalence, awareness, treatment and control in Mexico: results of the Ensanut 2012 / Prevalencia de dislipidemias, diagnóstico previo, tratamiento y control: resultados de la Ensanut 2012

Abstract: Objective: To describe in a national sample 1) the prevalence, awareness, treatment and control of dyslipidemias 2) the prevalence of dyslipidemias through previous national surveys. Materials and methods: We analyzed data of the National Health and Nutrition Survey 2012, a representative cross-sectional study. Serum samples of 9 566 adults ≥20 years old with fasting ≥8 hours were analyzed for lipid fractions. Age-adjusted prevalences were calculated, by sociodemographic variables. Prevalence of awareness, treatment and control was estimated. A description of the dyslipidemia prevalence reported in previous surveys is reported. Results: Hypoalphalipoproteinemia and elevated LDL-C are the most prevalent dyslipidemias in Mexican adults. One in four adults had hypercholesterolemia at the moment of the interview without previous diagnosis. Awareness, treatment and control of dyslipidemia were 12.6, 3.7 and 3.1%, respectively. Conclusions: Dyslipidemias are the most prevalent risk factor for cardiovascular diseases in Mexico. Public policies to increase awareness, access to therapy and sustained control are urgently needed.

Resumen: Objetivo: Describir en una muestra nacional 1) la prevalencia de dislipidemias, su diagnóstico previo, tratamiento y control, y 2) la prevalencia de dislipidemias en las encuestas previas. Material y métodos: Se analizaron datos de la Encuesta Nacional de Salud y Nutrición 2012 con representatividad nacional. Se analizaron fracciones de lípidos séricos de 9 566 adultos ≥20 años con ayuno ≥8 horas. Se estimaron las prevalencias de dislipidemias, diagnóstico previo (DP), tratamiento y control, ajustadas por edad. Se presenta un análisis comparativo de las prevalencias de dislipidemias reportadas previamente. Resultados: Las dislipidemias más prevalentes en adultos mexicanos fueron hipoalfalipoproteinemia y LDL-C elevado. Uno de cada cuatro adultos tenía hipercolesterolemia al momento de la entrevista, sin DP. El DP, tratamiento y control de dislipidemias fue de 12.6, 3.7 y 3.1%, respectivamente. Conclusiones: Las dislipidemias son el factor de riesgo para enfermedades cardiovasculares más prevalente en adultos mexicanos. Se necesitan políticas públicas para incrementar el diagnóstico, acceso a terapia y control.

Trastornos lipídicos en pacientes hispanoamericanos en el primer nivel de atención sanitaria de Lima, Perú / Lipid disorders in Hispanic Americans patients in the primary health care level in Lima, Peru

Introducción: Las dislipidemias constituyen un factor de riesgo para el desarrollo de las enfermedades cardiovasculares, las que se consideran la principal causa de muerte a nivel mundial. Objetivos: Evaluar los trastornos lipídicos en pacientes hispanoamericanos en el primer nivel de atención sanitaria de Lima. Métodos: En el periodo de 2015-2016 se realizó una investigación prospectiva en 117 pacientes del Servicio de Laboratorio Clínico, Policlínico La Fe en Lima. Se tuvieron en cuenta las guías National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III), US Preventive Services Task Force y la guía de práctica clínica del Instituto Mexicano del Seguro Social. De acuerdo con cada guía se establecieron las variables lipídicas: triglicéridos (TG) elevados (TG ≥ 150 mg/dl) y colesterol total elevado (CT ≥ 200 mg/dl), colesterol LDL-C elevado (LDL-C ≥ 130 mg/dl) y HDL-C disminuido (HDL-C ≤ 40 mg/dl). Resultados: El 71 por ciento de los pacientes presentaron HDL-C disminuido, el 41 por ciento hipertriacilgliceridemia, el 35,9 por ciento hipercolesterolemia y el 33,3 por ciento LDL-C elevado. Según la guía US Preventive Services Task Force se determinaron 9 pacientes con dislipidemia grado B, por la guía National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III), 99 pacientes en 4 grupos de dislipidemia y 5 pacientes sin trastornos lipídicos según la guía de práctica clínica del Instituto Mexicano del Seguro Social. Conclusiones: Se observa una alta frecuencia de pacientes con trastornos lípidos principalmente por HDL-C disminuido y se evidencia las ventajas de la guía de práctica clínica en el primer nivel de atención sanitaria(AU)

Introduction: Dyslipidemia is a risk factor for the development of cardiovascular diseases, which are considered to be the main cause of death at the global level. Objectives: To assess lipid disorders in Hispanic Americans patients in the primary health care level in Lima. Methods: In the period 2015-2016 a prospective research was made in 117 patients of the Service of Clinical Laboratory, La Fe Policlinic in Lima. There were used the guides named National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III), US Preventive Services Task Force, and the clinical practice guidelines of the Mexican Institute of Social Security. The lipid variables were established in accordance with each guide: High Triglycerides (TG) (TG ≥150 mg/dl) and high total cholesterol (CT ≥ 200 mg/dl), High LDL-C cholesterol (LDL-C ≥ 130 mg/dl) and decreased HDL-C (HDL-C ≤ 40 mg/dl). Results: 71 percent of the patients presented decreased HDL-C, 41 percent hypertriacilglyceridemia, 35.9 percent hypercholesterolemia and 33.3 percent high LDL-C. According to the US Preventive Services Task Force guide 9 patients with dyslipidemia grade B were identified by the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) guide, and 99 patients in 4 groups of dyslipidemia and 5 patients without lipid disorders were identified according to the clinical practice guidelines of the Mexican Institute of Social Security. Conclusions: It is observed a high frequency of patients with lipid disorders mainly by decreased HDL-C and there is evidence of the advantages of the clinical practice guidelines in the primary level of health care(AU)

Insuficiencia renal oculta y factores asociados en pacientes con enfermedades crónicas / Occult renal failure and associated factors in patients with chronic conditions

Resumen Introducción: El diagnóstico oportuno y la intervención terapéutica temprana disminuyen la mortalidad prematura asociada con insuficiencia renal crónica. Objetivo: Identificar la prevalencia y factores asociados con insuficiencia renal oculta en pacientes con enfermedades crónicas. Método: Estudio transversal de 1268 pacientes con diabetes mellitus tipo 2 e hipertensión arterial sistémica. Se usó un instrumento de medición con preguntas sobre factores asociados como artrosis, tratamiento de padecimiento crónico, tabaquismo, ingesta de analgésicos, alcoholismo, índice de masa corporal, actividad física y niveles séricos de glucosa, colesterol y triglicéridos. Resultados: La prevalencia de insuficiencia renal oculta fue de 13.2 % (167/1268), 13.4 % en pacientes diabéticos (117/876) y 14.9 % en hipertensos (150/1010). En el analisis multivariado, los factores asociados con insuficiencia renal oculta fueron edad > 60 años (RMa = 1.96, IC 95 % = 1.22-2.49), sexo femenino (RMa = 2.17, IC 95 % = 1.30-2.82), padecer hipertensión arterial sistémica (RMa = 1.96, IC 95 % = 1.22-2.50) y no tener sobrepeso u obesidad (RMa = 0.49, IC 95 % = 0.41-0.8). Conclusiones: La prevalencia de insuficiencia renal oculta fue de 13 %. Los pacientes mayores de 60 años, con sobrepeso u obesidad e hipertensión arterial sistémica deben ser examinados detalladamente por el médico familiar para la detección temprana de insuficiencia renal oculta.

Abstract Introduction: Timely diagnosis and early therapeutic intervention reduce premature mortality associated with chronic renal failure. Objective: To identify the prevalence and factors associated with occult renal failure in patients with chronic diseases. Method: Cross-sectional study of 1268 patients with type 2 diabetes mellitus and systemic arterial hypertension. A measuring instrument with questions about associated factors such as osteoarthritis, treatment of chronic conditions, smoking, analgesic consumption, alcoholism, body mass index, physical activity and serum glucose, cholesterol and triglyceride levels was used. Results: The prevalence of occult renal failure was 13.2 % (167/1,268), 13.4 % in diabetic patients (117/876) and 14.9 % in hypertensive patients (150/1,010). In the multivariate analysis, the factors associated with occult renal failure were being older than 60 years (aOR = 1.96, 95 % CI = 1.22-2.49), belonging to the female gender (aOR = 2.17, 95 % CI = 1.30-2.82), suffering from systemic arterial hypertension (aOR = 1.96, 95% CI = 1.22-2.50) and not having overweight/obesity (aOR = 0.49, 95 % CI = 0.41-0.8). Conclusions: The prevalence of occult renal failure was 13 %. Female patients older than 60 years with overweight/obesity and systemic arterial hypertension should be examined in detail by the family doctor for occult renal failure early detection.

Relationship between anthropometric indicators and risk factors for cardiovascular disease in adults and older adults of Rio Branco, Acre / Relação de indicadores antropométricos com fatores de risco para doença cardiovascular em adultos e idosos de Rio Branco, Acre

ABSTRACT OBJECTIVE To analyze the association between anthropometric variables and cardiovascular risk factors in adults and older adults of Rio Branco, Acre. METHODS A population-based cross-sectional study with 641 adults and 957 older adults was conducted. The statistical analyses consisted of the distribution of anthropometric variables according to the cardiovascular risk factors by frequency and dispersion measures. Pearson's correlation coefficient and prevalence ratios (PR) were estimated with their respective 95% confidence intervals (95%CI) using the SPSS ® version 20.0. RESULTS Moderate correlations were obtained in adult men for waist-hip ratio and total cholesterol (r = 0.486; p < 0.001) and for waist-hip and triglyceride ratios (r = 0.484; p < 0.001). The highest prevalence of hypertension and diabetes in adults were observed in men; in the older adults, the prevalence of hypertension was above 65% in both sexes. The prevalence of dyslipidemia was above 78% in obese adults and older adults. When analyzing the associations, a higher strength of association was found between arterial hypertension and waist-to-stature ratio (PR = 13.42; 95%CI 12.58-14.31) and body mass index greater than 30 kg/m 2 (PR = 6.61; 95%CI 6.34-6.89) in adult men. In the analysis of diabetes, the waist-hip ratio presented greater robustness in the association for women (PR = 7.53; 95%CI 6.92-8.20) and men (PR = 9.79; 95%CI 9.14-10.49). CONCLUSION Anthropometric variables are important predictors of cardiovascular risk; however, their assessments should be performed independently, according to sex and age group.

RESUMO OBJETIVO Analisar a associação entre variáveis antropométricas e os fatores de risco cardiovascular na população de adultos e idosos de Rio Branco, Acre. MÉTODOS Estudo transversal de base populacional com 641 adultos e 957 idosos. As análises estatísticas consistiram na distribuição das variáveis antropométricas segundo os fatores de risco cardiovascular por medidas de frequência e dispersão. Foram calculadas a correlação de Pearson e razões de prevalência (RP) com seus respectivos intervalos de confiança de 95% (IC5%), empregando as rotinas do SPSS ® versão 20.0. RESULTADOS Correlações moderadas foram obtidas nos adultos homens para relação cintura-quadril e colesterol total (r = 0,486; p < 0,001) e para relação cintura-quadril e triglicerídeos (r = 0,484; p < 0,001). As maiores prevalências de hipertensão arterial e diabetes nos adultos foram observadas nos homens; já nos idosos, as prevalências de hipertensão ficaram acima de 65% em ambos os sexos. As prevalências de dislipidemia ficaram acima de 78% nos indivíduos obesos adultos e idosos. Ao analisar as associações, constatou-se maior força de associação entre hipertensão arterial e relação cintura-estatura (RP = 13,42; IC95% 12,58-14,31) e com índice de massa corporal maior que 30 kg/m 2 (RP = 6,61; IC95% 6,34-6,89) nos homens adultos. Na análise para diabetes, a relação cintura-quadril apresentou maior robustez na associação para mulheres (RP = 7,53; IC95% 6,92-8,20) e homens (RP = 9,79; IC95% 9,14-10,49). CONCLUSÃO As variáveis antropométricas são importantes preditores de risco cardiovascular; no entanto, suas avaliações devem ser feitas de forma independente, segundo sexo e grupo etário.