Arterioesclerosis subclinica, factores de riesgo cardiovascular clásicos y emergentes en niños obesos chilenos / Subclinical atherosclerosis, traditional cardiovascular risk factors in obese children and emerging Chilean

La arteriosclerosis puede comenzar en la niñez y desarrollarse crónicamente dependiendo de la carga de factores de riesgo (FR) cardiovascular. Comparar niños obesos con eutrófilos en cuanto a FR clásicos, emergentes (proteina C Reactiva ultrasensible: PCRus) y arteriosclerosis subclínica, mediante dos nuevas técnicas no invasivas.

Arterioesclerosis subclínica, factores de riesgo cardiovascular clásicos y emergentes en niños obesos chilenos / Subclinical atherosclerosis: classic and emerging cardiovascular risk factors in Chilean obese children

La arteriosclerosis puede comenzar en la niñez y desarrollarse crónicamente dependiendo de la carga de factores de riesgo (FR) cardiovascular. Objetivo: Comparar niños obesos con eutróficos en cuanto a FR clásicos, emergentes (Proteína C Reactiva ultrasensible: PCRus) y arteriosclerosis subclínica, mediante dos nuevas técnicas no invasivas: dilatación mediada por flujo de la arteria braquial (DMF) y grosor de la íntima-media carotídea (IMT). Método: Se estudiaron 26 niños obesos (IMC ³ Pc95) y 57 eutróficos (IMC: Pc10 - Pc85). Se evaluó antropometría, presión arterial (PA), DMF, IMT, y se determinó de PCRus, perfil lipídico y glicemia de ayunas. Resultados: El 50 por ciento fueron mujeres y 41 por ciento prepúberes. Con edad de 9,9 + - 1,6 y 9,8 + - 1,8 años (ns), zIMC: 2,0 + - 0 2 y 1,7 + - 0,6, perímetro de cintura (por ciento Media): 133,5 + - 16 y 100,5 + -1 0 por ciento en obesos y eutróficos respectivamente. Los obesos tuvieron mayor Colesterol Total, CLDL, Triglicéridos, PCRus y menor CHDL (p < 0,005). No hubo diferencia significativa en DMF: 9,03 + - 5,2 por ciento vs 9,3 + - 4,2 por ciento, IMT: 0,49 + - 0,03 vs 0,50 + - 0,03 mm, glicemia ni PA. Conclusión: Este grupo de niños obesos chilenos presenta mayor carga de FR clásicos y nivel de PCRus que los eutróficos, pero no se encontró diferencia significativa en marcadores sustitutos de arteriosclerosis subclínica.

Historia natural de la colelitiasis: incidencia de colecistectomía en un área urbana y una rural mapuche, en la última década / Natural history of cholelithiasis and incidence of cholecystectomy in an urban and a Mapuche rural area

Background: Cholelithiasis is the second cause of hospital admissions in Chile. Aim: To study the prevalence of symptomatic gallstone disease and opportunity of cholecystectomy in La Florida, Santiago and among Mapuche Indians in Huapi Island. Patients and methods: In the period 2000-2001, we contacted to 71 percent (1127 subjects) and to 61 percent (145 subjects) patients of La Florida and Huapi Island, respectively, that had previously participated in an epidemiological study on cholelithiasis in 1993. We defined symptomatic gallstone patients as those with a history of biliary colic. Each patient was subjected to gallbladder ultrasound. Results: In 1993, 30-35 percent of gallstone patients were symptomatic (&70 percent women). During the lapse 1993-2001, only 50 percent of subjects from La Florida and 25 percent of patients from Huapi Island were cholecystectomized (p <0.05). Fifty percent of cholecystectomies were emergency operations. In 38 symptomatic Mapuche Indians from Huapi, cholecystectomy was indicated in 2001. After five months of the indication, only one of these subjects had been operated. Laparoscopic cholecystectomy represented 40 percent of all cholecystectomies performed in the National Health Service Hospitals. Conclusions: This study demonstrates an unacceptable high prevalence of symptomatic gallstone patients remaining non-operated in both the urban and rural communities. This reciprocally correlates with the high frequency of emergency cholecystectomies and the high incidence of gallbladder cancer among Chileans. This study contrasts negatively with the situation of Scotland, where 73.5 percent of cholecystectomies were laparoscopic in 1998-1999. To reach Scotland standards, the Chilean Public Health System should increase the number of cholecystectomies from 27,000 in 2001 to 57,510