ABSTRACT
El síndrome de quilomicronemia familiar (SQF) es unaenfermedad autosómica recesiva rara, con una prevalencia1:200 000 - 1:1 000 000, y se caracteriza por quilomicronemiaen ayunas y niveles muy elevados de triglicéridos (> 880 mg/dl). LPL es el gen más frecuentemente afectado, luego APOC2,GPIHBP1, APOA5 y LMF1; todos ellos comprometen la función de la lipoproteinlipasa endotelial. El SQF suele presentarseen la infancia con dolor abdominal recurrente, xantomaseruptivos, retraso del crecimiento, pancreatitis y, en ocasiones,asintomático. El tratamiento convencional es la restriccióndietética de grasas. Se muestra el resultado clínico de 20 pacientes pediátricoscon SQF reclutados de 4 hospitales en Argentina.
Familial chylomicronemia syndrome (FCS) is a rare autosomalrecessive disease, prevalence 1:200,000 - 1:1,000,000, andis characterized by fasting chylomicrons and very hightriglycerides > 880 mg/dl. LPL is the most frequentlyaffected gene, then APOC2, GPIHBP1, APOA5, LMF1, all ofthem compromising the function of lipoproteinlipase. FCScommonly presents in childhood with recurrent abdominalpain, eruptive xanthomas, failure to thrive, pancreatitis, andsometimes asymptomatic. The conventional treatment isdietetic fat restriction. The clinical outcome of 20 pediatric patients with FCS recruited from 4 hospitals in Argentina is reported.
Subject(s)
Humans , Infant , Child, Preschool , Child , Pancreatitis/diagnosis , Pancreatitis/etiology , Pancreatitis/therapy , Hypertriglyceridemia/genetics , Hyperlipoproteinemia Type I/diagnosis , Hyperlipoproteinemia Type I/genetics , Hyperlipoproteinemia Type I/therapyABSTRACT
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.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Prevalence , Adult , Dyslipidemias/epidemiology , Hypertriglyceridemia/epidemiology , Epidemiology , Cross-Sectional Studies/methods , Diabetes Mellitus/epidemiology , Hypercholesterolemia/epidemiology , Hyperlipidemias/epidemiology , Hypertension/epidemiology , Obesity/epidemiologyABSTRACT
INTRODUCCIÓN: La enfermedad arterial periférica (EAP) es más frecuente en pacientes conDiabetes Mellitus tipo 2 (DM2) que en la población general, convirtiéndolos en un grupo de alto riesgo de morbimortalidad. El objetivo del presente estudio fue determinar la frecuencia de EAP, mediante la medición del ITB y la frecuencia de sus factores de riesgo en los pacientes con Diabetes Mellitus tipo 2 del Hospital José Carrasco Arteaga. MATERIALES Y MÉTODOS: Estudio descriptivo, de corte transversal, con una muestra aleatoria simple de pacientes con diagnóstico de DM2 que acudieron a consulta externa del Hospital José Carrasco Arteaga, Cuenca-Ecuador, en el año 2017 (315 pacientes).Se aplicó una entrevista a los pacientes con datos sobre las características sociodemográficas y ciertos antecedentes médicos de importancia para el estudio; se determinó el ITB; se valoraron los exámenes complementarios de laboratorio realizados en los seis meses previos al estudio. Finalmente, se describieron frecuencias y porcentajes de cada una de las variables, se utilizó el programa IBM SPSS versión 22. RESULTADOS: Del total de pacientes se observó un promedio de edad de 62.9 años, con predominio del sexo femenino. Se determinó que la frecuencia de EAP en los pacientes con DM2 fue del 35.30%. LA EAP fue más frecuente en: el grupo de edad mayor a 50 años (38.8%), el sexo masculino (43.9%), en el grupo de pacientes con tiempo de evolución de la DM2 ≥ a 5 años (35.5%), en los pacientes con tabaquismo (38.4%), en los pacientes con niveles elevados de hemoglobina glicosilada (HbA1c ≥7%) (40.6%), los pacientes con hipertrigliceridemia, en los pacientes con LDL elevado y en hombres con HDL por debajo de valores normales. CONCLUSIÓN: Podemos concluir que la frecuencia de enfermedad arterial periférica en los pacientes con Diabetes Mellitus tipo 2, en el Hospital José Carrasco Arteaga, utilizando el índice tobillo brazo como método diagnóstico fue del 35.30%.(au)
BACKGROUND: Peripheral arterial disease (PAD) is more common in patients with type 2 Diabetes Mellitus (DM2) than in the general population, making them a high-risk group for morbidity and mortality. The aim of this study was to determine the frequency of peripheral arterial disease, by measuring ankle-brachial index, and the frequency of its risks factors in patients with type 2 Diabetes Mellitus at Hospital José Carrasco Arteaga. METHODOS: descriptive, cross-sectional study, with a simply randomized sample of patients diagnosed with Type 2 Diabetes Mellitus, who attended the outpatient clinic of Hospital José Carrasco Arteaga, Cuenca - Ecuador, in 2017 ( 315 patients). An interview was applied to the patients, to collect data on sociodemographic characteristics and certain important medical history; ankle-brachial index was determined; complementary laboratory tests made six months prior to the study were evaluated. Finally, frequencies and percentages of each variable were described; we used IMB SPSS version 22 software. RESULTS: Of the total number of patients, the average age was 62.9 years, with a predominance of the female sex. The frequency of PAD in patients with DM2 was 35.30%. PAD was more frequent in: age group over 50 years (38.8%), male sex (43.9%), disease evolution time ≥ 5 years (35.5%), in smoking patients(38.4%), in patients with elevated glycosylated hemoglobin levels (HbA1c ≥7%)(40.6%),in patients with hypertriglyceridemia, in patients with elevated LDL and in men with low HDL values. CONCLUSION: we can conclude that the peripheral arterial disease frequency in patients with type 2 Diabetes Mellitus, at Hospital José Carrasco Arteaga, using the ankle-brachial index as a diagnostic method was 35.50%.(au)
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Diabetes Mellitus , Diabetes Mellitus, Type 2 , Ankle Brachial Index , Peripheral Arterial Disease , World Health Organization , Hypertriglyceridemia , Age GroupsABSTRACT
During aging, an increase in sedentary behaviour and a decrease in physical activity levels are observed. These factors may increase abdominal adiposity and triglyceride levels, which characterizes the hypertriglyceridemic waist (HW) phenotype, providing a high risk for cardiometabolic diseases. This study aimed to analyze the association between hypertriglyceridemic waist, physical activity level and sedentary behaviour in community-dwelling elderly. A population-based cross-sectional study was carried out, involving 316 elderlies (≥ 60 years) of both genders. The hypertriglyceridemic waist was diagnosed using high triglycerides (≥ 150 mg/dl) and increased waist circumference ≥ 88 and ≥ 102 cm values for women and men, respectively. The physical activity level and sedentary behaviour were evaluated using the IPAQ. The study included 173 women (54.7%) and 143 men (45.3%), with a mean age of 74.2 ± 9.8 years. The prevalence of HW was 27.1%, 47.7% insufficiently active and 24.1% high sedentary behaviour. The insufficiently active elderly (OR= 2.48; 95% CI: 1.31 - 4.71; p= 0.005) and with high sedentary behaviour (OR= 2.21; 95% CI: 1.04 - 4.32; p= 0.038) were associated positively with HW, indicating that elderly with insufficient physical activity levels and high sedentary behaviour showed themselves to approximately 2.5 and 2.2 times more likely to develop HW, respectively. Low physical activity level and high sedentary behaviour are associated with hypertriglyceridemic waist in community-dwelling elderly.(AU)
Durante o envelhecimento, observa-se aumento do comportamento sedentário e diminuições dos níveis de atividade física. Esses fatore podem aumentar a adiposidade abdominal e os níveis de triglicerídeos, o que caracteriza o fenótipo cintura hipertrigliceridêmica (CH), proporcionando um elevado risco para doenças cardiometabólicas. O objetivo deste estudo foi analisar a associação entre cintura hiper- trigliceridêmica, nível de atividade física e comportamento sedentário em idosos. Trata-se de um estudo epidemiológico, com delineamento transversal, de base populacional e domiciliar, realizado com 316 idosos (≥ 60 anos) de ambos os sexos. A cintura hipertrigliceridêmica foi definida a partir dos triglicérideos elevados (≥ 150 mg/dl) e circunferência da cintura alterada (≥ 88 cm para mulheres e ≥ 102 cm para homens). O nível de atividade física e o comportamento sedentário foram avaliados por meio do Questionário Internacional de Atividade Física (IPAQ). Participaram do estudo 173 mulheres (54,7%) e 143 homens (45,3%) com idade média de 74,2 ± 9,8 anos. A prevalência de CH foi 27,1%, 47,7% eram insuficientemente ativos e 24,1% tinham elevado comportamento sedentário. Os idosos insuficientemente ativos (OR= 2,48; IC95%:1,31 - 4,71; p= 0,005) e com elevado comportamento sedentário (OR= 2,21; IC95%:1,04 - 4,32; p= 0,038) foram positivamente associados à CH, indicando que os idosos com níveis de atividade física insuficientes e com elevado comportamento sedentário apresentaram, aproximadamente, 2,5 e 2,2 vezes mais chances de desenvolverem a CH, respectivamente. A inatividade física e o elevado comportamento sedentário estiveram associados à CH em idosos residentes em comunidade.(AU)
Subject(s)
Aging , Exercise , Hypertriglyceridemia , Sedentary BehaviorABSTRACT
Introducción: El síndrome de ovario poliquístico se asocia con frecuencia a alteraciones cardiometabólicas; y su asociación con el fenotipo hipertrigliceridemia-obesidad abdominal ha sido poco estudiada en Cuba. Objetivo: Identificar la frecuencia del fenotipo hipertrigliceridemia-obesidad abdominal en mujeres de edad mediana con síndrome de ovario poliquístico y su asociación con la resistencia a la insulina, trastornos del metabolismo de la glucosa y ateroesclerosis subclínica. Método: Estudio descriptivo, transversal, en 30 mujeres. Se tomaron variables clínicas: edad, peso, talla, índice de masa corporal, circunferencia de cintura y cadera, índice cintura/cadera, tensión arterial, además de concentraciones de glucosa, insulina, colesterol total, triglicéridos, HDL-c y LDL-c, e índice HOMA-IR. La aterosclerosis subclínica se evaluó por doppler carotideo y ecocardiograma (hipertrofia ventricular izquierda y grasa epicárdica). El fenotipo hipertrigliceridemia-obesidad abdominal se definió como triglicéridos elevados (≥ 1,7 mmol/L) y circunferencia de la cintura ≥ 80 cm. Resultados: La frecuencia del fenotipo hipertrigliceridemia-obesidad abdominal fue 43,3 por ciento (13/30). Los valores medios de circunferencia abdominal, tensión arterial, así como de glucemia (p < 0,003), insulinemia (p = 0,028), triglicéridos (p < 0,0001), e índice HOMA-IR (p = 0,012) fueron más elevados en el grupo de mujeres con esa condición. A pesar de no haber diferencias significativas la frecuencia de mujeres con incremento del grosor íntima-media carotídeo y de grasa epicárdica fue superior en aquellas con el fenotipo. Conclusiones: La presencia del fenotipo hipertrigliceridemia-obesidad abdominal es frecuente en mujeres con síndrome de ovario poliquístico, y se asocia con alteraciones del metabolismo de la glucosa y la resistencia a la insulina. Este pudiera ser utilizado en la práctica clínica como un marcador de riesgo para alteraciones cardiometabólicas(AU)
Introduction: The polycystic ovary syndrome is frequently associated to cardiometabolic alterations; and its relation with the hypertriglyceridemic waist phenotype has been poorly studied in Cuba. Objective: Identify the frequency of the hypertriglyceridemic waist phenotype in middle age women with polycystic ovary syndrome and its association with insulin resistance, disorders in the glucose metabolism and subclinical atherosclerosis. Methods: Descriptive, cross-sectional study in 30 women. As clinical variables there were used: age, weight, size, body mass index, waist-hip circumference, waist/hip index, blood pressure; glucose, insulin, total cholesterol, triglycerides, HDL-c and LDL-c concentrations, and HOMA-IR index. Subclinical atherosclerosis was assessed by a carotid doppler and an echocardiogram (left ventricular hypertrophy and epicardial fat). The hypertriglyceridemic waist phenotype was defined as high triglycerides levels (≥ 1.7 mmol/L) and CC ≥ 80 cm. Results: The frequency of the hypertriglyceridemic waist phenotype was 43.3 percent (13/30). The mean values of abdominal circumference, blood pressure, as well as glycemia (p < 0.003), insulinaemia (p = 0.028), triglycerides (p < 0.0001), and HOMA-IR index (p = 0.012) were higher in the group of women with that condition. Although there were not significant differences, the frequency of women with increase of the carotid intima-media thickness and epicardical fat was higher in those with the phenotype. Conclusions: The presence of the hypertriglyceridemic waist phenotype is frequent in women with the polycystic ovary syndrome, and it is associated with alterations of the glucose metabolism and insulin resistance. This can be used in the clinical practice as a marker of risk for cardiometabolic alterations(AU)
Subject(s)
Humans , Female , Adult , Middle Aged , Polycystic Ovary Syndrome/diagnosis , Hypertriglyceridemia/diagnosis , Obesity, Abdominal/etiology , Insulin Resistance , Body Mass Index , Epidemiology, Descriptive , Cross-Sectional StudiesABSTRACT
Abstract Case description: Case of lipemia retinalis secondary to hyperchylomicronemia in a 40-year-old man with a history of total body irradiation and immunosuppressive treatment that was attended in this hospital due to decreased visual acuity and abdominal pain. Clinical findings: Hyperchylomicronemia caused the development of acute pancreatitis and lipemia retinalis. The latter is an infrequent ocular manifestation that reflects excessive triglyceride blood levels in the organism (>2,000 mg/dL). Lipemia retinalis is characterized by the accumulation of chylomicrons in the retinal vessels, which gives them a white and creamy appearance in direct retinal ophthalmoscopy. The initial clinical suspicion of hyperchylomicronemia was based on the visualization of the supernatant in the analytical tube. Treatment and result: In the absence of definitive biochemical results, and owing to the need for special processing of the sample, lipid-lowering treatment and serum therapy were established after ophthalmological confirmation of lipemia retinalis, with subsequent full recovery of visual acuity. Clinical relevance: Given the initial difficulty to determine the accurate triglyceride levels in this kind of patient, early visualization of milky-colored retinal vessels on a salmon-colored eye fundus can help develop an early clinical suspicion of severe hyperchylomicronemia and contribute to limit the severity of complications.
Resumen Descripción del caso: Caso de lipemia retinalis secundaria a hiperquilomicronemia en varón de 40 años con antecedentes de irradiación corporal total y medicación inmunosupresora que acude al hospital por disminución de agudeza visual y dolor abdominal. Hallazgos clínicos: La hiperquilomicronemia contribuyó al desarrollo de pancreatitis aguda y lipemia retinalis. Esta última es una manifestación ocular infrecuente que refleja unos parámetros excesivos de triglicéridos en el organismo (>2,000 mg/dL). La Lipemia Retinalis consiste en la acumulación de quilomicrones en los vasos retinianos lo que les confiere un aspecto blanco y cremoso en la oftalmoscopia retiniana directa. La sospecha clínica inicial de hiperquilomicronemia se produjo por la visualización de sobrenadante en el tubo analítico. Tratamiento y resultado: Sin tener resultados definitivos bioquímicos, por necesidad de procesamiento especial de la muestra, se instauró tratamiento hipolipemiante y sueroterapia tras la confirmación oftalmológica de Lipemia Retinalis con recuperación total de la agudeza visual. Relevancia clínica: Dada la dificultad inicial para determinar las cifras reales de triglicéridos en este tipo de pacientes, la visualización precoz de vasos retinianos de color lechoso sobre lecho de color asalmonado en el fondo de ojo puede ser de ayuda para elaborar una sospecha clínica temprana de hiperquilomicronemia severa que contribuya a limitar la gravedad de las complicaciones.
Subject(s)
Adult , Humans , Male , Pancreatitis , Retinal Diseases , Hypertriglyceridemia , Hyperlipidemias , Retinal Diseases/diagnosis , Retinal Diseases/etiology , Acute DiseaseABSTRACT
Hemophagocytic lymphohistiocytosis (HLH) is a rare and potentially fatal syndrome resulting from a hyperactivated immune system. Diverse patient profiles and clinical presentations often result in misdiagnosis. This article describes the varied clinical presentations and autopsy findings in three patients with this entity. The etiopathogenesis of HLH, its disparate and confounding clinical features, the diagnostic criteria, and management principles are also briefly reviewed.
Subject(s)
Humans , Male , Adult , Middle Aged , Lymphohistiocytosis, Hemophagocytic/pathology , Autopsy , Hypertriglyceridemia , Macrophage Activation Syndrome , Ferritins , Immune SystemABSTRACT
Resumen La pancreatitis aguda se considera un proceso inflamatorio del páncreas, el cual resulta de la activación de enzimas digestivas liberadas por esta glándula. Esta entidad patológica está asociada con múltiples etiologías. Caso: varón de 37 años de edad con cuadro de dolor abdominal en hipogastrio irradiado a la espalda. En el examen físico se encontró taquicárdico, hipertenso, con dolor abdominal a la palpación profunda sin signos de irritación peritoneal. Los paraclínicos mostraban una elevación de los reactantes de fase aguda y amilasa pancreática, los estudios imagenológicos mostraban signos de pancreatitis aguda. Discusión: la pancreatitis asociada con hipertrigliceridemia se presenta entre el 0,5 % al 1 % de los casos. La tríada inicial del manejo es dieta absoluta, hidratación intravenosa y analgésicos. En el caso de la hipertrigliceridemia, se puede manejar con hipolipemiantes orales o, en caso de niveles mayores de 1000 mg/dL, se puede usar el recambio plasmático, el cual tiene buena efectividad y disminuye los valores a rangos de normalidad en el 80 % de los casos con la primera sesión.
Abstract Introduction: Acute pancreatitis is considered an inflammatory process of the pancreas, which results from the activation of digestive enzymes released by this gland. This pathological entity is associated with multiple etiologies. Case: 37-year-old male with hypogastrium pain irradiated to the back. On physical examination, the patient was tachycardic, hypertensive, with abdominal pain on deep palpation without signs of peritoneal irritation. Laboratory tests showed an elevation of acute phase reactants and pancreatic amylase, and imaging studies showed signs of acute pancreatitis. Discussion: Pancreatitis associated with hypertriglyceridemia occurs in 0.5 to 1% of cases. The initial management triad is a clear liquid diet, intravenous hydration, and analgesics. Hypertriglyceridemia can be managed with oral hypolipidemic drugs. When levels are higher than 1 000 mg/dL, plasma exchange can be used due to its good effectiveness, decreasing the values to normal ranges in 80% of the cases with the first session.
Subject(s)
Humans , Male , Adult , Pancreatitis , Hypertriglyceridemia , Abdominal PainABSTRACT
Diversos estudios evidencian la asociación entre los niveles elevados del colesterol de LDL (cLDL) y el riesgo de desarrollar enfermedad cardiovascular aterosclerótica. Con el objetivo de comparar los valores de cLDL obtenidos mediante la medición directa y los valores estimados por las ecuaciones de Friedewald tradicional, modificada y de regresión, se valoró el cLDL de 4.621 pacientes mediante el ensayo directo en el autoanalizador ADVIA 1800. Dichos resultados se agruparon en los estados de normolipemia, hipercolesterolemia, hiperlipemia mixta e hipertrigliceridemia y se establecieron diferencias de estimación con las mencionadas fórmulas en el total de la muestra y en los niveles de decisión clínica para el cLDL. Las tres fórmulas presentaron correlación significativa con el método directo en la totalidad de la muestra; sin embargo, cuando los niveles de triglicéridos de las muestras superaron los 200 mg/dL, la diferencia entre la fórmula de Friedewald y el método directo resultó -11,94%, y llegó a -19,13% para el nivel de triglicéridos mayor de 400 mg/dL. Por otro lado, las ecuaciones de Friedewald modificada y de regresión se vieron afectadas en menor cuantía por el nivel de triglicéridos. Las fórmulas de regresión y de Friedewald modificada se constituyen como alternativas razonables para estimar el cLDL y presentan buena concordancia con el método directo, incluso en niveles altos de colesterol y triglicéridos.
Several studies show the association between high LDL cholesterol (LDLc) levels and the risk of developing atherosclerotic cardiovascular disease. In order to compare the LDLc values obtained by direct measurement and the values estimated by the traditional, modified and regression Friedewald equations, the LDLc of 4,621 patients was assessed by means of the direct test in the ADVIA 1800 autoanalyzer.These results were grouped into the states of normolipemia, hypercholesterolemia, mixed hyperlipemia and hypertriglyceridemia, establishing differences in estimation with the aforementioned formulas in the total sample and in clinical decision levels for LDLc. The three formulas showed a significant correlation with the direct method in the entire sample; however, when the triglyceride levels of the samples exceeded 200 mg/dL, the difference between Friedewald's formula and the direct method was -11.94% reaching -19,13% for the triglyceride level greater than 400 mg/dL, while the modified Friedewald and regression equations were affected to a lesser extent by the triglyceride level. Regression and modified Friedewald formulas are constituted as reasonable alternatives to estimate LDLc and have good agreement with the direct method, even at high cholesterol and triglyceride levels.
Varios estudos evidenciam a associacao entre niveis elevados do colesterol LDL (cLDL) e o risco de desenvolver doenca cardiovascular aterosclerotica. Visando comparar os valores de cLDL obtidos atraves da medicao direta e os valores estimados pelas equacoes de Friedewald tradicional, modificada e de regressao, o cLDL de 4.621 pacientes foi avaliado por meio do teste direto no analisador automatico ADVIA 1800. Tais resultados foram agrupados nos estados de normolipemia, hipercolesterolemia, hiperlipemia mista e hipertrigliceridemia, estabelecendo-se diferencas na estimativa com as formulas mencionadas no total da amostra e nos niveis de decisao clinica para cLDL. As tres formulas apresentaram correlacao significativa com o metodo direto em toda a amostra, no entanto, quando os niveis de triglicerideos das amostras excederam 200 mg/dL, a diferenca entre a formula de Friedewald e o metodo direto foi de -11,94% atingindo -19,13% para o nivel de triglicerideos superior a 400 mg/dL. Por outra parte, as equacoes de Friedewald modificada e de regressao foram afetadas em menor grau pelo nivel de triglicerideos. As formulas de regressao e de Friedewald modificada se constituem como alternativas razoaveis para estimar o cLDL, e apresentam boa concordancia com o metodo direto, mesmo em niveis elevados de colesterol e triglicerideos.
Subject(s)
Triglycerides , Hypertriglyceridemia , Cholesterol , Hypercholesterolemia , Hyperlipidemias , Hyperlipoproteinemia Type V , Cholesterol, LDL , Cholesterol, LDL/blood , Patients , Association , Cardiovascular Diseases , Disease , Risk , Minors , MethodsABSTRACT
Severe Hypertriglyceridemia (HTG) is associated with complications such as acute pancreatitis (AP) with high morbidity and mortality rates. We report a 42 years-old man with refractory HTG diagnosed at 19 years of age, and multiple episodes of AP, admitted with the suspicion of a new AP episode. Serum triglycerides were over 2000 mg/dl. His body mass index was 18 kg/m2, there was no evidence of xanthomas or xanthelasmas, but lipemia retinalis was found. Management included heparin and insulin, added to his usual treatment with fibrates, statins, omega-3 fatty acids, and orlistat. Due to lack of response, apheresis was started. After five sessions, triglycerides decreased to 588 mg/dl (82% reduction) and levels remained below 1000 mg/dl with daily apheresis. The patient continued with weekly sessions as outpatient with a sustained good response.
Subject(s)
Adult , Humans , Male , Pancreatitis , Blood Component Removal , Hypertriglyceridemia , Hyperlipidemias , Pancreatitis/therapy , Triglycerides , Hypertriglyceridemia/therapy , Acute DiseaseABSTRACT
Resumen Introducción: la pancreatitis aguda es una entidad de alta incidencia e impacto a nivel mundial. Presenta múltiples causas dentro de las cuales las más frecuentes son la obstrucción de la vía biliar, el consumo de alcohol y, en tercer orden, la hipertrigliceridemia. Esta última se entiende como aquellos niveles séricos de triglicéridos >1000 mg/dL. Dicho escenario representa entre el 1 y el 7 % del total de los casos. Metodología: presentamos un caso de pancreatitis aguda secundaria a hipertrigliceridemia severa, manejada con plasmaféresis. Se realiza una revisión de la literatura sobre las condiciones, indicaciones y ventajas de esta estrategia terapéutica. Conclusiones: en casos escogidos, la plasmaféresis es una estrategia de manejo segura y efectiva en el tratamiento de pacientes con pancreatitis aguda secundaria a hipertrigliceridemia severa.
Abstract Introduction: Globally, acute pancreatitis has a high incidence and a large. Among its numerous causes, the most frequent are obstructions of the bile duct, alcohol consumption and hypertriglyceridemia (triglyceride serum levels higher than 1000 mg/dL). Hypertriglyceridemia accounts for 1% to 7% of the total cases. Methodology: We present a case of acute pancreatitis secondary to severe hypertriglyceridemia which was managed with plasmapheresis. We include a review of the literature on the conditions, indications and advantages of this therapeutic strategy. Conclusions: In selected cases, plasmapheresis is a safe and effective management strategy for patients with acute pancreatitis secondary to severe hypertriglyceridemia.
Subject(s)
Humans , Male , Adult , Pancreatitis , Therapeutics , Hypertriglyceridemia , Plasmapheresis , Incidence , LiteratureABSTRACT
Introducción: La hipertrigliceridemia es una forma de dislipidemia frecuentemente asociada con enfermedad ateroesclerótica. La obesidad se encuentra entre los factores de riesgo implicados en la aceleración del proceso ateroesclerótico. El desorden fisiopatológico provocado por el tejido adiposo disfuncionante es causa de afectaciones cardiovasculares, endocrinometabólicas y neoplásicas. Objetivo: Identificar la relación entre la presencia de hipertrigliceridemia con la circunferencia de la cintura en adultos mayores, a partir de la evaluación del índice de masa corporal, cintura-cadera y la presencia de hipertrigliceridemia, según la edad y el sexo. Métodos: Estudio descriptivo transversal realizado entre 2015-2017, con una muestra de 386 adultos de ambos sexos. La recogida de datos se realizó según el modelo de recolección del dato primario del Centro de Investigación y Referencias de Aterosclerosis de La Habana. El análisis de los datos se realizó con el programa SPSS v16- y las técnicas de Chi-Square. Resultados: La edad media de la muestra fue de 55,5 años y el 70,6 por ciento eran mujeres. El 57 por ciento presentaba hipertrigliceridemia y el 63,4 por ciento un índice de masa corporal aumentado, un 37,8 por ciento de personas con sobrepeso y un 26,5 por ciento con obesidad. El índice de masa corporal fue superior en mujeres perimenopáusicas, en las que tuvieron el predominio de cintura hipertrigliceridémica. Se observó un incremento de obesidad abdominal con la edad. Conclusiones: Los factores de riesgo cardiovascular, así como, la asociación existente entre los triglicéridos y la medida de la circunferencia de cintura, requiere una valoración sistemática por sexo y edad. La consulta de enfermería de la Atención Primaria es un lugar ideal para promover estrategias de intervención para monitorizar el riesgo clínico cardiovascular a través de los diferentes parámetros antropométricos(AU)
Introduction: Hypertriglyceridemia is a form of dyslipidemia frequently associated with the atherosclerotic disease. Obesity is among the risk factors involved in the acceleration of the atherosclerotic process. The pathophysiologic disorder caused by the dysfuncional adipose tissue is the cause of cardiovascular, endocrinometabolic and neoplastic diseases. Objective: To identify the relationship between the presence of hypertriglyceridemia and waist circumference in older adults from the assessment of the body mass index, waist-hip ratio and the presence of hypertriglyceridemia, according to age and gender. Methods: Descriptive, cross-sectional study conducted from 2015 to 2017, with a sample of 386 adults of both sexes. Data collection was performed according to the model of primary data collection of the Center for Research and of Atherosclerosis References of Havana. The data analysis was performed with the SPSS v16- software and the Chi-Square techniques. Results: The average age of the sample was 55.5 years and 70.6 percent were women. The 57 percent had hypertriglyceridemia and 63.4 percent an increased body mass index; 37.8 percent of the people had overweight and 26.5 percent had obesity. Body mass index was higher in perimenopausal women, who had a predominance of hypertriglyceridemic waist. It was noticed an increase of the abdominal obesity with aging. Conclusions: The cardiovascular risk factors as well as the association between triglycerides and the measure of waist circumference require a systematic assessment by sex and age. The nursing consultation in Primary Care is an ideal place to promote intervention strategies to monitor the cardiovascular clinical risk through the different anthropometric parameters(AU)
Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Primary Health Care , Hypertriglyceridemia/epidemiology , Obesity, Abdominal/epidemiology , Obesity/epidemiology , Chi-Square Distribution , Epidemiology, Descriptive , Cross-Sectional StudiesABSTRACT
It is estimated that more than 1 billion people worldwide have vitamin D insufficiency or deficiency. Vitamin D participates in bone mineralization, and is therefore important in osteoporosis, osteomalacia and rickets prevention. However, vitamin D deficiency could also be associated with several other pathologies. The present study aimed to investigate the relationships between vitamin D deficiency and vitamin D deficiency-related disorders in patients. In addition, this study aims to verify if countries with low solar incidence have higher extraskeletal disease death rates when compared to countries with high solar incidence. The vitamin D concentrations were obtained from the Heart Hospital database (Natal/Brazil). The relationship between solar incidenceand death rate for vitamin D deficiency-related disorders was verified. Death rate data were extracted from the 'World Life Expectancy' repository and data about solar incidence were obtained from NASA's Surface Meteorology and Solar Energy project. Thesedata were statistically processed with IBM SPSS v23.0 software and R programming language. Our results showed that patients with vitamin D insufficiency/deficiency showed significantly more bone diseases, thyroid diseases, hypercholesterolemy, hypertriglyceridemia, cancers, diabetes, hepatobiliary diseases, and urinary system diseases. Moreover, countries with high solar incidence have low cancer and multiple sclerosis death rates. This work suggests the participation of vitamin D and sunlight incidence inseveral diseases.
Subject(s)
Male , Female , Adolescent , Adult , Middle Aged , Aged , Sunlight , Vitamin D Deficiency/mortality , Bone Diseases/mortality , Thyroid Gland/abnormalities , Urologic Diseases , Hypertriglyceridemia/complications , Life Expectancy/trends , Diabetes Mellitus , Digestive System Diseases/complications , Hypercholesterolemia/complications , NeoplasmsABSTRACT
OBJECTIVE@#To investigate the triglyceride (TG)-lowering effects of PCSK9 inhibitor in patients with in different baseline triglyceride levels.@*METHODS@#Between February, 2019 and March, 2020, a total of 59 patients were treated with PCSK9 inhibitor (Evolocumab) in 5 hospitals, including Nanfang Hospital, Guangdong Provincial People's Hospital, First Affiliated Hospital of Sun Yat-sen University, Foshan Nanhai District People's Hospital and Yulin First People's Hospital. According to baseline triglyceride levels, the patients were divided into normal TG group (< 1.70 mmol/L, =24), mild hypertriglyceridemia group (1.70-2.29 mmol/L, =11), moderate hypertriglyceridemia group (2.30-5.63 mmol/L, =13), and severe hypertriglyceridemia group (≥5.64 mmol/L, =11), and the changes in TG level after the treatment were compared among the 4 groups.@*RESULTS@#In the groups with normal and mildly elevated baseline TG level, the patients did not show significant changes in TG levels after the treatment. In patients with moderately and severely elevated baseline TG levels, treatment with PCSK9 inhibitor significantly reduced their TG levels ( < 0.005).@*CONCLUSIONS@#PCSK9 inhibitor has a significant TG-lowering effect in patients with moderate to severe hypertriglyceridemia but not in patients with only mildly elevated baseline TG level.
Subject(s)
Humans , Hypertriglyceridemia , Hypolipidemic Agents , Proprotein Convertase 9 , TriglyceridesABSTRACT
BACKGROUND: Cardiovascular risk remains increased despite optimal low density lipoprotein cholesterol (LDL-C) level induced by intensive statin therapy. Therefore, recent guidelines recommend non-high density lipoprotein cholesterol (non-HDL-C) as a secondary target for preventing cardiovascular events. The aim of this study was to assess the efficacy and tolerability of omega-3 fatty acids (OM3-FAs) in combination with atorvastatin compared to atorvastatin alone in patients with mixed dyslipidemia.METHODS: This randomized, double-blind, placebo-controlled, parallel-group, and phase III multicenter study included adults with fasting triglyceride (TG) levels ≥200 and <500 mg/dL and LDL-C levels <110 mg/dL. Eligible subjects were randomized to ATOMEGA (OM3-FAs 4,000 mg plus atorvastatin calcium 20 mg) or atorvastatin 20 mg plus placebo groups. The primary efficacy endpoints were the percent changes in TG and non-HDL-C levels from baseline at the end of treatment.RESULTS: After 8 weeks of treatment, the percent changes from baseline in TG (−29.8% vs. 3.6%, P<0.001) and non-HDL-C (−10.1% vs. 4.9%, P<0.001) levels were significantly greater in the ATOMEGA group (n=97) than in the atorvastatin group (n=103). Moreover, the proportion of total subjects reaching TG target of <200 mg/dL in the ATOMEGA group was significantly higher than that in the atorvastatin group (62.9% vs. 22.3%, P<0.001). The incidence of adverse events did not differ between the two groups.CONCLUSION: The addition of OM3-FAs to atorvastatin improved TG and non-HDL-C levels to a significant extent compared to atorvastatin alone in subjects with residual hypertriglyceridemia.
Subject(s)
Adult , Atorvastatin , Cholesterol , Cholesterol, LDL , Dyslipidemias , Fasting , Fatty Acids, Omega-3 , Humans , Hydroxymethylglutaryl-CoA Reductase Inhibitors , Hypertriglyceridemia , Incidence , Lipoproteins , TriglyceridesABSTRACT
BACKGROUND: Soybean food consumption has been considered as a possible way to lower incidence of cardiometabolic syndrome (CMS) among Asians. However, results from studies investigating its efficacy on CMS in Asians have been inconsistent.METHODS: We analyzed the association between soybean intake frequency and prevalence of CMS based on data from the Korea National Health and Nutrition Examination Survey 2007 to 2011. Data of 9,287 women aged 20 to 64 years were analyzed. Food frequency questionnaire was used to assess soybean food consumption frequency. General linear model and multivariable logistic regression model were used to examine the association of soybean intake quintile with CMS and its risk factors. Least square means of metabolic factors mostly showed no significant relevance except liver indexes.RESULTS: Compared to participants in the 1st quintile (<2 times/week of soybean food), odds ratios (OR) for CMS and abdominal obesity (AO) in the 4th quintile (8.5 times/week<soybean food≤17 times/week) were 0.73 (95% confidence interval [CI], 0.57 to 0.95) and 0.72 (95% CI, 0.58 to 0.90), respectively. After excluding Tofu products, ORs of CMS, AO, high blood pressure, and hypertriglyceridemia were lower than those without excluding Tofu products. However, results still did not show significant inverse linear trend across frequency quintiles.CONCLUSION: Our findings suggest that soybean intake of 8.5 to 17 times/week was inversely associated with CMS in Korean women. The relation between soybean intake >17 times/week and CMS varied depending on soybean food items.
Subject(s)
Asian People , Diabetes Mellitus , Eating , Female , Humans , Hypertension , Hypertriglyceridemia , Incidence , Korea , Linear Models , Liver , Logistic Models , Nutrition Surveys , Obesity, Abdominal , Odds Ratio , Prevalence , Risk Factors , Soy Foods , SoybeansABSTRACT
Introducción: El perfil lipídico mínimo está relacionado con la enfermedad vascular de tipo aterosclerótica, pero se desconoce cuál es el tipo de perfil más frecuente en los adultos y el tipo de riesgo que representan para la enfermedad vascular periférica de los miembros inferiores. Objetivo: Determinar si el perfil lipídico mínimo sirve para diagnosticar el riesgo de enfermedad vascular periférica de los miembros inferiores. Métodos: Se trabajó con 533 muestra sanguíneas de personas adultas de diferentes municipios de la provincia La Habana. Se cuantificaron las concentraciones de colesterol total y de triglicéridos. Se calculó la media y la desviación estándar. Se diagnosticó y clasificó la hiperlipemia, se identificó el riesgo de enfermedad vascular periférica de los miembros inferiores y su asociación con la hiperlipemia. Se trabajó con un nivel de confiabilidad del 95 por ciento (a=0,05). Resultados: Los perfiles lipídicos mínimos más frecuentes fueron: el hipercolesterolemia leve (46,0 por ciento) y la hipertrigliceridemia (22,6 por ciento). El 53,8 por ciento presentó riesgo de enfermedad vascular periférica de los miembros inferiores entre potencial (24,8 por ciento) y alto (29,0 por ciento). Existió una asociación entre la hiperlipemia y la presencia de enfermedades vasculares periféricas de los miembros inferiores (chi cuadrada= 120,4; p= 0,00000). Se detectó que el 50 por ciento de las personas requería de un tratamiento hipolipemiante. Conclusión: El perfil lipídico mínimo sirve para diagnosticar el tipo de riesgo de enfermedad vascular periférica de los miembros inferiores. Se observó una fuerte asociación de dicha enfermedad con la presencia de hiperlipemia(AU)
Introduction: The minimum lipid profile is related to atherosclerotic vascular disease, but it is not known what is the most common type in adults and the kind of risk it represent for peripheral vascular disease of the lower limbs. Objective: To determine if the minimum lipid profile is used to diagnose the risk of peripheral vascular disease of the lower limbs. Methods: It was carried out a study with 533 blood sample of adults from different municipalities in Havana province. Concentrations of total cholesterol and triglycerides were quantified. Average and standard deviation were calculated. Hyperlipidemia was diagnosed and classified, the risk of peripheral vascular disease of the lower limbs and the association of the latter with hyperlipidemia were identified. The level of reliability used was of 95 percent (a= 0.05). Results: The most common minimum lipid profiles were: mild hypercholesterolemia (46 percent) and hypertriglyceridemia (22.6 percent). 53.8 percent presented a risk of peripheral vascular disease of the lower limbs between potential (24.8 percent) and high (29 percent). There was a relation between the hyperlipidemia and the presence of peripheral vascular diseases of the lower limbs (chi-cudrada= 120.4, p= 0.00000). It was detected that 50 percent of the people required a hypolipidemic treatment. Conclusion: The minimum lipid profile is used to diagnose the risk's type of peripheral vascular disease of the lower limbs, observing a strong relation of the latter with the presence of hyperlipidemia(AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Vascular Diseases , Peripheral Vascular Diseases , Lower Extremity , Hypercholesterolemia , Triglycerides , Hypertriglyceridemia , HyperlipidemiasSubject(s)
Humans , Cardiovascular Diseases/etiology , Hypercholesterolemia/complications , Hypertension/complications , Brazil , Cardiovascular Diseases/prevention & control , Hypertriglyceridemia/complications , Hypertriglyceridemia/prevention & control , Risk Factors , Hypercholesterolemia/prevention & control , Hypertension/prevention & controlABSTRACT
INTRODUCCIÓN. El hipotiroidismo e hipertiroidismo, constituyen patologías tiroideas, que si no reciben tratamiento apropiado llegan a provocar alteraciones sistémicas, siendo una de las principales las cardiovasculares. OBJETIVO. Conocer la influencia que tiene el hipotiroidismo e hipertiroidismo como factores de riesgo para el desarrollo de enfermedad cardiovascular. MATERIALES Y MÉTODOS. Estudio retrospectivo de enfoque cuantitati-vo; desarrollado en una población y muestra conocida de 111 pacientes, que acudieron al Servicio de Endocrinología del Hospital Manuel Ygnacio Monteros Valdivieso de la ciudad de Loja, atendidos en el año 2015. RESULTADOS. Predominó el sexo femenino, con un 20,72% (23; 69) en el grupo etario de 61 a 70 años de las pacientes hipotiroideas; y las de 51 a 60 años en 5,40% (6; 11) de las hipertiroideas. De acuerdo a los parámetros que pue-den condicionar mayor riesgo cardiovascular, el sobrepeso y obesidad presentaron una mayor frecuencia para hipotiroidismo en 67,70% (65; 111) e hipertiroidismo en un 66,67% (10; 111). El riesgo bajo cardiovascular prevaleció en 75,00% (72; 96) de la población hipo-tiroidea y 93,33% (14; 15) de la hipertiroidea. La hipertensión arterial fue la patología car-diovascular diagnosticada con mayor frecuencia sobre todo en los pacientes hipotiroideos representado por el 14,58% (14; 19). CONCLUSIÓN. Estas patologías, de no controlarse pudieran condicionar en la población de estudio un mayor riesgo cardiovascular.
INTRODUCTION. Hypothyroidism and hyperthyroidism, constitute thyroid pathologies, that if they do not received appropriate treatment, cause systematic alterations, treatment, cause systematic cardiovascular diseases being one of the main ones. OBJECTIVE. Know the influence of hypothyroidism and hyperthyroidism as risk factors for the development of cardiovascular disease. MATERIALS AND METHODS. Retrospective study of quantitative approach; developed in a population and known sample of 111 patients, who went to the Endocrinology Service of the Manuel Ygnacio Monteros Valdivieso Hospital in the city of Loja, attended in 2015. RESULTS. The female sex predominated, with 20,72% (23; 69) in the age group predominated 61 to 70 years of age in 5,40% (6; 11) of hyperthyroids. According to the parameters that may condition higher cardiovascular risk, overweight and obesity presented a higher frequency for hypothyroidism in 67,70% (65; 111) and hyperthyroidism in 66,67% (10; 111). Low cardiovascular risk prevailed in 75,00% (72; 96) of the hypothyroid population and 93,33% (14; 15) of the hyperthyroid population. Arterial hypertension was the most frequently diagnosed cardiovascular disease, especially in hypothyroid patients by 14,58% (14; 19). CONCLUSION. These pathologies, if not controlled, could condition a higher cardiovascular risk in the study population.
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Cardiovascular Diseases , Body Mass Index , Risk Factors , Essential Hypertension , Hyperthyroidism , Hypothyroidism , Thyroid Diseases , Hypertriglyceridemia , Overweight , Hypercholesterolemia , ObesityABSTRACT
Introducción: la artritis reumatoide es una enfermedad sistémica, de etiología desconocida, caracterizada por provocar inflamación crónica, cursa con manifestaciones articulares, extrarticulares y comportamiento clínico variable. Objetivo: caracterizar los factores de riesgo para la aparición de aterosclerosis en pacientes con artritis reumatoide e identificar su relación con el tiempo de diagnóstico, actividad inflamatoria y tratamiento. Método: se realizó estudio descriptivo transversal, en pacientes con artritis reumatoide atendidos en el Centro de Reumatología del Hospital Docente Clínico Quirúrgico 10 de Octubre entre febrero 2016 y junio 2017. Resultados: la mayor frecuencia fue para el sexo femenino, el rango etario 45-54 años. Se observó placa ateromatosa en 37.2 por ciento y engrosamiento complejo íntima media en el 15.4 por ciento. Los factores de riesgo que mostraron asociación con la presencia de placa fueron: hipertrigliceridemia (p= 0.000), hipercolesterolemia (p= 0.000), Diabetes Mellitus (p= 0.027) y los niveles elevados de proteína C Reactiva (p= 0.003). Conclusiones: los factores de riesgo tradicionales que presentaron significación estadística fueron la hipercolesterolemia, hipertrigliceridemia y la Diabetes Mellitus. La presencia de más de un factor elevó la frecuencia de alteraciones en el eco doppler; existió asociación entre la elevación de los niveles de PCR y la presencia de alteraciones del eco doppler. Se constató en aquellos pacientes con alteraciones eco doppler carotídeo relación con el tiempo de evolución, actividad de la enfermedad y dosis acumulada de esteroides(AU)
Introduction: rheumatoid arthritis is a systemic disease, of unknown etiology, characterized by chronic inflammation; It presents with joint, extra-articular manifestations and variable clinical behavior. Objective: to characterize the risk factors for the appearance of atherosclerosis in patients with rheumatoid arthritis and to identify their relationship with the time of diagnosis, inflammatory activity and treatment. Method: a cross-sectional, descriptive study was conducted in patients with rheumatoid arthritis treated at the Rheumatology Center of the Surgical Clinical Teaching Hospital 10 de Octubre in the period between February 2016 and June 2017. Results: the highest frequency was for the female sex, the age range 45-54 years. Atheromatous plaque was observed in 37.2 percent and intimal complex thickening in 15.4 percent. The risk factors that showed association with the presence of plaque were: hypertriglyceridemia (p= 0.000), hypercholesterolemia (p= 0.000), Diabetes Mellitus (p= 0.027) and high levels of C-reactive protein (p= 0.003) Conclusions: the traditional risk factors that presented statistical significance were hypercholesterolemia, hypertriglyceridemia and Diabetes Mellitus. The presence of more than one traditional risk factor increased the frequency of alterations in Doppler echo; There was an association between the elevation of C-Reactive Protein levels and the presence of Doppler echo alterations. It was found in those patients with carotid echo Doppler alterations, relationship with the time of evolution, activity of the disease and cumulative dose of steroids(AU)