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1.
Salud Publica Mex ; 48 Suppl 2: S232-8, 2006.
Article in Spanish | MEDLINE | ID: mdl-16884161

ABSTRACT

OBJECTIVE: To identify the prevalence of violence against females among those who are health service beneficiaries in Mexico. MATERIAL AND METHODS: The National Survey on Violence against Women (ENVIM, per its Spanish abbreviation) was applied in 2003 to female users of public primary and secondary health care services. The sampling framework was based on a stratified, probabilistic sample in two stages. First the health care units were selected with probability proportional to the number of physicians' offices in the unit, from a list of possible care units. Second, women 15 years and older who sought care at the health care unit were selected for participation in the study through systematic sampling. Univariate analysis and then bivariate analysis were carried out on the data collected with a questionnaire. RESULTS: The sample included 26 042 women between 15 and 92 years of age, with a mean age of 35.8 years. Physical violence during childhood was reported by 42% of the women. Only 7.8% answered yes to a general question about whether they experienced domestic partner violence, but 21.5% reported experiencing violence of any type during the last 12 months as measured by a scale including specific acts of psychological, economic, physical and sexual violence. The most frequently reported type of violence was psychological (19.6%). Of the women who had been pregnant, 14.1% reported having experienced violence during pregnancy, and 4.4% reported being hit in the abdomen. The prevalence of sexual violence was 17.3% and close to half reported being victims of this type of violence before age 15. Higher prevalence of violence was found among women with lower levels of formal education, living in a rented home, in areas with higher overcrowding indices, and users of Ministry of Health care services. CONCLUSIONS: Identifying and measuring violence is complex, given the diverse types of violence and how they are perceived and therefore reported by women themselves. This is an important public health problem, in view of the high frequency observed in this study and the immediate implications. These findings indicate the urgent need for interventions to prevent and treat violence.


Subject(s)
Battered Women/classification , Battered Women/statistics & numerical data , Spouse Abuse/classification , Spouse Abuse/statistics & numerical data , Adolescent , Adult , Aged , Aged, 80 and over , Female , Health Services , Humans , Mexico , Middle Aged , Prevalence
2.
Salud Publica Mex ; 48 Suppl 2: S259-67, 2006.
Article in Spanish | MEDLINE | ID: mdl-16884164

ABSTRACT

OBJECTIVE: To increase the knowledge of health care providers' understanding of and practices on domestic violence, in order to improve care. MATERIALS AND METHODS: This study was conducted between May and November 2003, In Quintana Roo, Coahuila, and Mexico City, three Mexican states with a high prevalence of domestic violence. Sixty in-depth interviews with health care providers in public health institutions and key informants of health service provision were completed. RESULTS: Health care providers were categorized based on the extent to which they reproduced four"discourses about violence". These discourses influence their daily practice and are related to the informants' gender values and social positions. Most informants expressed their willingness to address the issue of domestic violence. CONCLUSIONS. Attention to and care for domestic violence is insufficient in health services; this may be due more closely related to a predominant discourse tolerating domestic violence among decision-makers, than to the attitudes of health care providers; the latter demonstrated greater awareness of women's rights.


Subject(s)
Denial, Psychological , Health Personnel , Helplessness, Learned , Professional Practice , Spouse Abuse/psychology , Female , Humans , Mexico , Spouse Abuse/rehabilitation
3.
Salud Publica Mex ; 48 Suppl 2: S328-35, 2006.
Article in Spanish | MEDLINE | ID: mdl-16884171

ABSTRACT

OBJECTIVE: To describe the methodology, the research designs used, the estimation and sample selection, variable definitions, collection instruments, and operative design and analytical procedures for the National Survey Violence Against Women in Mexico. MATERIAL AND METHODS: A complex (two-step) cross-sectional study was designed and the qualitative design was carried out using in-depth interviews and participant observation in health care units. RESULTS: We obtained for the quantitative study a total of 26 240 interviews in women users of health services and 2 636 questionnaires for health workers; the survey is representative of the 32 Mexican states. For the qualitative study 26 in-depth interviews were conducted with female users and 60 interviews with health workers in the States of Quintana Roo, Coahuila and the Federal District.


Subject(s)
Battered Women/statistics & numerical data , Interviews as Topic , Spouse Abuse/statistics & numerical data , Cross-Sectional Studies , Data Collection/methods , Female , Humans , Mexico
4.
Salud pública Méx ; 48(supl.2): s232-s238, 2006. tab
Article in Spanish | LILACS | ID: lil-436453

ABSTRACT

OBJETIVO: Identificar la prevalencia de la violencia contra las mujeres en usuarias del sector salud en México. MATERIAL Y MÉTODOS: En 2003 se levantó la Encuesta Nacional sobre Violencia contra las Mujeres 2003 (ENVIM 2003) en usuarias de los servicios médicos de primer y segundo nivel. El esquema de muestreo se basó en una muestra probabilística estratificada en dos etapas: a) de un listado de unidades médicas elegibles, se seleccionaron aquellas con probabilidad proporcional al número de consultorios de la unidad; b) mediante muestreo sistemático se seleccionó a mujeres de 15 años y más que acudieron a la unidad médica. Se realizó un análisis univariado y posteriormente uno bivariado. RESULTADOS: Participaron 26 042 mujeres de 15 a 92 años de edad. La media de edad fue de 35.8 años. La violencia física durante la niñez, notificada, fue de 42.2 por ciento. Sólo 7.8 por ciento de las mujeres respondieron afirmativamente a la pregunta general de violencia de pareja. Sin embargo, al aplicar la escala de violencia, la prevalencia de cualquier tipo de violencia en los últimos 12 meses fue de 21.5 por ciento. El tipo de violencia más frecuente fue la psicológica (19.6 por ciento). De las mujeres que tuvieron antecedente de embarazo, 14.1 por ciento señalaron violencia y 4.4 por ciento refirieron haber sido golpeadas en el abdomen. La prevalencia de violencia sexual fue de 17.3 por ciento y cerca de la mitad de este porcentaje la padecieron antes de los 15 años de edad. La violencia se presenta en mayor prevalencia en las usuarias de la SSA, entre las de menor escolaridad, entre aquellas que no viven en casa propia y entre las que viven en mayor hacinamiento. CONCLUSIONES: La identificación y la medición de la violencia constituyen un fenómeno complejo en consideración a los diversos tipos de violencia que existen y a la manera en que las mujeres mismas la perciben y la notifican. La violencia es un problema importante de salud, tanto por la alta prevalencia como por sus consecuencias inmediatas y acumulativas sobre la salud. Los resultados indican la necesidad urgente de prevenir y atender este problema.


OBJECTIVE: To identify the prevalence of violence against females among those who are health service beneficiaries in Mexico. MATERIAL AND METHODS: The National Survey on Violence against Women (ENVIM, per its Spanish abbreviation) was applied in 2003 to female users of public primary and secondary health care services. The sampling framework was based on a stratified, probabilistic sample in two stages. First the health care units were selected with probability proportional to the number of physicians' offices in the unit, from a list of possible care units. Second, women 15 years and older who sought care at the health care unit were selected for participation in the study through systematic sampling. Univariate analysis and then bivariate analysis were carried out on the data collected with a questionnaire. RESULTS: The sample included 26 042 women between 15 and 92 years of age, with a mean age of 35.8 years. Physical violence during childhood was reported by 42 percent of the women. Only 7.8 percent answered yes to a general question about whether they experienced domestic partner violence, but 21.5 percent reported experiencing violence of any type during the last 12 months as measured by a scale including specific acts of psychological, economic, physical and sexual violence. The most frequently reported type of violence was psychological (19.6 percent). Of the women who had been pregnant, 14.1 percent reported having experienced violence during pregnancy, and 4.4 percent reported being hit in the abdomen. The prevalence of sexual violence was 17.3 percent and close to half reported being victims of this type of violence before age 15. Higher prevalence of violence was found among women with lower levels of formal education, living in a rented home, in areas with higher overcrowding indices, and users of Ministry of Health care services. CONCLUSIONS: Identifying and measuring violence is complex, given the diverse types of violence and how they are perceived and therefore reported by women themselves. This is an important public health problem, in view of the high frequency observed in this study and the immediate implications. These findings indicate the urgent need for interventions to prevent and treat violence.


Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Middle Aged , Battered Women/classification , Battered Women/statistics & numerical data , Spouse Abuse/classification , Spouse Abuse/statistics & numerical data , Health Services , Mexico , Prevalence
5.
Salud pública Méx ; 48(supl.2): s259-s267, 2006. tab
Article in Spanish | LILACS | ID: lil-436456

ABSTRACT

OBJETIVO: Conocer los significados y prácticas respecto a la violencia doméstica entre prestadores de servicios de salud, para mejorar la atención. MATERIAL Y MÉTODOS: Entre mayo y noviembre de 2003 se aplicaron 60 entrevistas en profundidad a prestadores de servicios públicos de salud y a informantes clave, en unidades de atención en tres entidades de alta prevalencia de violencia doméstica Quintana Roo, Coahuila y el Distrito Federal. RESULTADOS: Los prestadores fueron clasificados por su grado de adhesión a cuatro tipos de "discursos sobre la violencia" que orientan su práctica cotidiana y que están relacionados con sus valores de género y sus posiciones sociales. La mayoría manifestó disposición a atender el problema. CONCLUSIONES: La atención de la violencia doméstica es insuficiente en los servicios de salud, pero esto parece deberse más a que el discurso tolerante de la violencia predominó entre los tomadores de decisiones, que a las actitudes de los propios prestadores de servicios; éstos demostraron mayor conciencia de los derechos de las mujeres.


OBJECTIVE: To increase the knowledge of health care providers´ understanding of and practices on domestic violence, in order to improve care. MATERIALS AND METHODS: This study was conducted between May and November 2003, In Quintana Roo, Coahuila, and Mexico City, three Mexican states with a high prevalence of domestic violence. Sixty in-depth interviews with health care providers in public health institutions and key informants of health service provision were completed. RESULTS: Health care providers were categorized based on the extent to which they reproduced four "discourses about violence". These discourses influence their daily practice and are related to the informants' gender values and social positions. Most informants expressed their willingness to address the issue of domestic violence. CONCLUSIONS: Attention to and care for domestic violence is insufficient in health services; this may be due more closely related to a predominant discourse tolerating domestic violence among decision-makers, than to the attitudes of health care providers; the latter demonstrated greater awareness of women's rights.


Subject(s)
Female , Humans , Denial, Psychological , Health Personnel , Helplessness, Learned , Professional Practice , Spouse Abuse/psychology , Mexico , Spouse Abuse/rehabilitation
6.
Salud pública Méx ; 48(supl.2): s328-s335, 2006.
Article in Spanish | LILACS | ID: lil-436463

ABSTRACT

OBJETIVO: Describir la metodología utilizada en la Encuesta Nacional sobre Violencia contra las Mujeres 2003 (ENVIM 2003) en México, junto con el diseño de investigación, la estimación y la selección de muestras, la definición de variables, los instrumentos de recolección, el diseño operativo para su instrumentación y los procedimientos de análisis. MATERIAL Y MÉTODOS: En la parte cuantitativa se recurrió a un diseño transversal en dos etapas. En el componente cualitativo se realizaron entrevistas en profundidad y observación participante en unidades médicas. RESULTADOS: Se obtuvo un total de 26 240 entrevistas, aplicadas a usuarias de los servicios de salud; y 2 636 cuestionarios correspondientes a proveedores, que abarcaron los 32 estados de la República. En el estudio cualitativo se llevó a cabo un total de 26 entrevistas de profundidad a usuarias y 60 entrevistas de profundidad a prestadores de servicios de salud en los estados de Quintana Roo, Coahuila y el Distrito Federal.


OBJECTIVE: To describe the methodology, the research designs used, the estimation and sample selection, variable definitions, collection instruments, and operative design and analytical procedures for the National Survey Violence Against Women in Mexico. MATERIAL AND METHODS: A complex (two-step) cross-sectional study was designed and the qualitative design was carried out using in-depth interviews and participant observation in health care units. RESULTS: We obtained for the quantitative study a total of 26 240 interviews in women users of health services and 2 636 questionnaires for health workers; the survey is representative of the 32 Mexican states. For the qualitative study 26 in-depth interviews were conducted with female users and 60 interviews with health workers in the States of Quintana Roo, Coahuila and the Federal District.


Subject(s)
Female , Humans , Battered Women/statistics & numerical data , Interviews as Topic , Spouse Abuse/statistics & numerical data , Cross-Sectional Studies , Data Collection/methods , Mexico
7.
Rev Invest Clin ; 57(1): 28-37, 2005.
Article in English | MEDLINE | ID: mdl-15981956

ABSTRACT

We assessed the impact of the NCEP-III recommendations in a population-based, nation-wide Mexican survey. Information was obtained from 15,607 subjects aged 20 to 69 years. In this report, only samples obtained after a 9 to 12 hours fast are included (2,201 cases). A cardiovascular risk equivalent was found in 10.5% and > or = 2 risk factors were present in 41.7% of the population. In 10% of cases, the LDL-C concentration was high enough to be an indication for a lipid-lowering drug (> 160 mg/dL), independent of the presence of risk factors. A quarter of the population was eligible for some form of treatment (lifestyle modifications in 15.9%, drug therapy in an additional 11.7%). Among cases with > or = 2 risk factors, a small percentage (1.8%) were identified as having a 10 year-risk > 20% and 86.3% were considered as having a 10 year-risk < 10%. The majority of the metabolic syndrome cases (84%) were identified as low-risk subjects. As a result, only 17.6% of them qualified for drug-based LDL-C lowering. Our data helps to estimate of the magnitude of the burden imposed on the Mexican health system, of lowering LDL-C for cardiovascular prevention. If we apply our results to the 2,000 Mexican population census more than 5.8 million cases nationwide may require LDL lowering drug therapy following the NCEP-III criteria.


Subject(s)
Dyslipidemias/drug therapy , Practice Guidelines as Topic , Adult , Aged , Cross-Sectional Studies , Dyslipidemias/ethnology , Female , Humans , Male , Mexico , Middle Aged
8.
Arch Med Res ; 36(3): 223-31, 2005.
Article in English | MEDLINE | ID: mdl-15925012

ABSTRACT

The metabolic syndrome integrates, in a single diagnosis, the manifestations of insulin resistance that may lead to increased cardiovascular morbidity and precedes type 2 diabetes. Here we discuss the strengths and limitations of the definitions of the metabolic syndrome and the epidemiology of the syndrome including information from non-Caucasian populations. The definitions proposed by the World Health Organization (WHO) and the National Cholesterol Education Program (NCEP) are the most frequently used. The relative risk of having long-term complications is greater for the WHO definition; this is explained by the inclusion of the insulin resistance criteria. The cut-off points used in these definitions should be, but are not, adjusted for ethnicity; as a result, in non-Caucasian subjects, there is lack of agreement among these criteria. In a Mexican population-based survey the prevalence was 13.61% using the WHO definition and 26.6% using the NCEP-III criteria. Cases identified by the WHO criteria had a more severe form of the disease. We propose that the metabolic syndrome should be viewed as a progressive long-term process that leads to major complications. Its definition should reflect the continuous nature of the disease; the categorical approach of the current criteria oversimplifies the complexity of the syndrome. The threshold for defining abnormality should be based on the associated risk of the identified phenotype. Refinement of the definition of both affected and nonaffected subjects is required. The available definitions include, in each of these categories, heterogeneous groups with a broad range of risk of future complications.


Subject(s)
Insulin Resistance , Metabolic Syndrome/diagnosis , Adult , Aged , Cholesterol/metabolism , Diabetes Mellitus, Type 2/complications , Humans , Inflammation , Metabolic Syndrome/epidemiology , Mexico , Middle Aged , Obesity , Phenotype , Risk , Syndrome , Time Factors , World Health Organization
9.
Rev. invest. clín ; 57(1): 28-37, ene.-feb. 2005. tab
Article in English | LILACS | ID: lil-632437

ABSTRACT

We assessed the impact of the NCEP-III recommendations in a population-based, nation-wide Mexican survey. Information was obtained from 15,607 subjects aged 20 to 69 years. In this report, only samples obtained after a 9 to 12 hours fast are included (2,201 cases). A cardiovascular risk equivalent was found in 10.5% and > 2 risk factors were present in 41.7% of the population. In 10% of cases, the LDL-C concentration was high enough to be an indication for a lipid-lowering drug (> 160 mg/dL), independent of the presence of risk factors. A quarter of the population was eligible for some form of treatment (lifestyle modifications in 15.9%, drug therapy in an additional 11.7%). Among cases with > 2 risk factors, a small percentage (1.8%) were identified as having a 10 year-risk > 20% and 86.3% were considered as having alO year-risk < 10%. The majority of the metabolic syndrome cases (84%) were identified as low-risk subjects. As a result, only 17.6% of them qualified for drug-based LDL-C lowering. Our data helps to estimate of the magnitude of the burden imposed on the Mexican health system, of lowering LDL-C for cardiovascular prevention. If we apply our results to the 2,000 Mexican population census more than 5.8 million cases nationwide may require LDL lowering drug therapy following the NCEP-III criteria.


Evaluamos el impacto de las recomendaciones del Programa Nacional de Educación en Colesterol (NCEP-III) en muestra poblacíonal. La información proviene de 2,201 sujetos de 20 a 69 años cuyas muestras se obtuvieron después de un ayuno de 9 a 12 horas. Una condición con riesgo cardiovascular equivalente al de la cardiopatía isquémica se encontró en 10.5%; > 2 factores de riesgo se encontraron en 41.7%. El colesterol LDL (LDL-C) fue suficientemente alto (> 160 mg/dL) para indicarse tratamiento hipolipemiante con medicamentos, en ausencia de otros factores de riesgo en 10% de los participantes. El 25% de la población calificó para recibir tratamiento hipolipemiante (cambios del estilo de vida 15.9% y tratamiento farmacológico en 11.7%). En casos con > 2 factores de riesgo, un pequeño porcentaje (1.8%) fue identificado con riesgo mayor a > 20% de tener un evento cardiovascular a 10 años; 86.3% fue identificado con bajo riesgo (< 10% a 10 años). La mayoría de los casos con síndrome metabólíco (84%) fueron identificados en el grupo de bajo riesgo. Como resultado, sólo 17.6% de ellos calificó para disminuir su LDL-C con medicamentos. Nuestros datos demuestran el reto que representa la prevención de complicaciones cardiovasculares por medio de la reducción de la concentración del LDL-C. Extrapolando nuestros datos al censo 2000, más de 5.8 millones de mexicanos califican para recibir tratamiento farmacológico de acuerdo con los criterios del NCEP-III.


Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Dyslipidemias/drug therapy , Practice Guidelines as Topic , Cross-Sectional Studies , Dyslipidemias/ethnology , Mexico
10.
Arch Med Res ; 35(1): 76-81, 2004.
Article in English | MEDLINE | ID: mdl-15036804

ABSTRACT

BACKGROUND: Our objective was to describe the prevalence of the metabolic syndrome using World Health Organization (WHO) and National Cholesterol Education Program (NCEP-III) definitions in a population-based survey. METHODS: We performed an analysis of data from a Mexican nationwide, population-based study. The population was composed of 2,158 men and women aged 20-69 years sampled after a 9-12 h fasting period. Prevalence of the metabolic syndrome as defined by the NCEP-III definition and WHO criteria was estimated and case characteristics were assessed. RESULTS: Age-adjusted prevalence was 13.61% for WHO criteria and 26.6% for the NCEP-III definition. Prevalence was 9.2 and 21.4%, respectively, in subjects without diabetes. Thirty five percent of affected cases were <40 years of age. In addition to criteria used for diagnosis, ca. 90% were either overweight or obese. In cases detected using WHO criteria, antihypertensive treatment or blood pressure reading >140/90 was found in 61.8%. The proportion of subjects who qualified for hypolipemiant treatment was lower: lifestyle modifications were needed in 42.1% and drug therapy was required in 18.9%. The same trends were found for cases detected using the NCEP definition. CONCLUSIONS: Prevalence of the metabolic syndrome in Mexico is high. A large proportion of affected cases qualify for preventive actions for complications of the metabolic syndrome (i.e., weight loss, antihypertensive or hypolipemiant treatment). These results provide data for planning therapeutic programs for Mexican patients with the metabolic syndrome.


Subject(s)
Metabolic Syndrome/diagnosis , Metabolic Syndrome/epidemiology , Adult , Aged , Cross-Sectional Studies , Female , Humans , Male , Metabolic Syndrome/prevention & control , Mexico/epidemiology , Middle Aged , Surveys and Questionnaires , World Health Organization
11.
Gac Med Mex ; 140 Suppl 2: S41-8, 2004.
Article in Spanish | MEDLINE | ID: mdl-15641471

ABSTRACT

The concept metabolic syndrome intends to incorporate in a single disorder all biologic consequences of insulin resistance and associated conditions. The objective of this paper was to discuss strengths and limitations of current definitions of the metabolic syndrome, its epidemiology, and its association with non-alcoholic steatohepatitis (NASH). Definitions proposed by the World Health Organization (WHO) and the National Cholesterol Education Program (NCEP) are specific but possess low sensitivity for detecting insulin resistance. Cut-off points used in these definitions should be "but are not" adjusted for ethnicity; as a result, in non-Caucasian subjects there is lack of agreement among these. For example, in a Mexican population-based survey prevalence was 13.61% using the WHO definition and 26.6% employing NCEP-III criteria. Cases identified with WHO criteria have a more severe form of the disease. NASH is the most common cause of abnormal levels of serum aminotransferases. It shares some aspects of its pathophysiology with the metabolic syndrome and its prevalence is higher among cases with metabolic syndrome compared to with general population. NASH appears to be the hepatic manifestation of the metabolic syndrome.


Subject(s)
Metabolic Syndrome , Fatty Liver/etiology , Humans , Metabolic Syndrome/complications , Metabolic Syndrome/epidemiology , Mexico/epidemiology , Terminology as Topic
13.
Am J Med ; 113(7): 569-74, 2002 Nov.
Article in English | MEDLINE | ID: mdl-12459403

ABSTRACT

OBJECTIVE: To investigate the prevalence and characteristics of patients with type 2 diabetes diagnosed before the age of 40 years (early-onset disease) in a nationwide, population-based study. METHODS: Using a multistage sampling procedure, we enrolled a representative sample of Mexican urban adults aged 20 to 69 years. Weight, height, blood pressure, and plasma levels of glucose, insulin, and other metabolic parameters were measured in all subjects. RESULTS: We identified 993 subjects with type 2 diabetes, including 143 subjects aged 20 to 39 years (14% of those with diabetes). Subjects with early-onset diabetes had a greater prevalence of obesity and higher plasma insulin and lipid levels than did age-matched controls, and a greater prevalence of high-density lipoprotein cholesterol levels <35 mg/dL and severe hypertriglyceridemia than did older subjects with diabetes. Those (n = 32) with a normal body mass index (20 to 25 kg/m(2)) tended to have insulin deficiency as the main abnormality, whereas the "metabolic syndrome" characterized the remaining 111 subjects with early-onset diabetes. CONCLUSION: Most patients with early-onset type 2 diabetes in Mexico are obese or overweight, suggesting that obesity treatment and prevention programs may be effective in reducing the prevalence of this disease.


Subject(s)
Diabetes Mellitus, Type 2/diagnosis , Diabetes Mellitus, Type 2/epidemiology , Adult , Age Factors , Age of Onset , Aged , Body Mass Index , Case-Control Studies , Diabetes Mellitus, Type 2/blood , Diabetes Mellitus, Type 2/etiology , Female , Humans , Incidence , Insulin/blood , Lipids/blood , Male , Mexico/epidemiology , Middle Aged , Obesity/complications , Obesity/epidemiology , Prevalence , Risk Factors , Socioeconomic Factors
14.
Salud pública Méx ; 44(6): 546-553, nov. 2002. tab
Article in Spanish | LILACS | ID: lil-328232

ABSTRACT

Objetivo. Describir las características de los pacientes con hiperlipidemia mixta de acuerdo con los datos derivados de la Encuesta Nacional de Enfermedades Crónicas. Material y métodos. Se realizó una entrevista en 1993, en 417 ciudades del país, y se midieron las concentraciones sanguíneas de lípidos séricos, glucosa e insulina en 2 206 casos en un estudio poblacional. La diferencia entre los pacientes con dislipidemias mixtas y el resto de la población se estableció utilizando análisis de varianza o la prueba de ji cuadrada. Resultados. La hiperlipidemia mixta se encontró en 282 casos (12.8 por ciento). Los individuos afectados tenían 42.7 ± 12.6 años. El 56 por ciento eran hombres; 46.4 por ciento tenían un colesterol HDL < 0.9 mmol/l. La presencia de otros factores de riesgo fue común. La prevalencia de las hiperlipidemias mixtas fue alta aun en adultos jóvenes. Por medio de un modelo de regresión logística fue posible identificar la obesidad, la edad, el género, la región del país en donde residía el sujeto, la presencia de diabetes o de hipertensión arterial y la concentración de insulina de ayuno >21 mU/ml como anormalidades asociadas a las dislipidemias mixtas. Conclusiones. La dislipidemia mixta es muy frecuente en adultos mexicanos. Se observa predominantemente en hombres mayores de 30 años y los casos tienen otros factores de riesgo cardiovascular. Los datos sugieren que el síndrome metabólico participa en la génesis de la dislipidemia mixta


Subject(s)
Adult , Female , Humans , Male , Hyperlipidemias/epidemiology , Cross-Sectional Studies , Health Surveys , Hyperlipidemias/blood , Mexico
15.
Metabolism ; 51(5): 560-8, 2002 May.
Article in English | MEDLINE | ID: mdl-11979386

ABSTRACT

The apolipoprotein (apo) B and A-I distribution found in a survey performed in 417 Mexican cities is described. Information was obtained from 15,607 subjects aged 20 to 69 years. In this report, only samples obtained after a 9- to 12-hour fast were included (1,674 cases, 652 men and 1,022 women). The population is representative of the Mexican urban adults. Mean lipid concentrations were: cholesterol,182.7 mg/dL; triglycerides, 213 mg/dL; high-density lipoprotein (HDL) cholesterol, 38.3 mg/dL; and low-density lipoprotein (LDL) cholesterol, 116 mg/dL. The mean concentration of apo B was 77.8 +/- 25.9 mg/dL and 71 +/- 22.8 in men and women, respectively. A continuous increase of apo B was observed as subjects got older. A tendency to decrease after age 60 was observed in men, but not in women. The body mass index (BMI) is a major determinant for the apo B concentrations. The 90th percentile of the apo B concentration identifies a similar proportion of abnormal subjects than the LDL cholesterol concentration of 160 mg/dL. The 120 mg/dL concentration, upper normal limit level used in other populations, identified as abnormal only 3.8% of the cases. Regardless of the lipid abnormality, an apo B above the 90th percentile was associated with higher levels of glucose, cholesterol, triglycerides, and non-HDL cholesterol, despite a similar age and BMI. The overall mean concentration of apo A-I was 122.3 +/- 31 mg/dL and 129 +/- 34 in men and women, respectively. In conclusion, our data show that the apo B and apo A-I concentrations in Mexican urban adults are lower compared with the levels reported in other ethnic groups. Previously used reference ranges are not useful in the population report herein. These observations strengthen the need for obtaining data in population-based studies worldwide.


Subject(s)
Apolipoprotein A-I/blood , Apolipoproteins B/blood , Adult , Aged , Aging , Body Mass Index , Cholesterol/blood , Cholesterol, HDL/blood , Cholesterol, LDL/blood , Fasting , Female , Humans , Male , Mexico , Middle Aged , Reference Values , Sex Characteristics , Triglycerides/blood , Urban Population
16.
Salud Publica Mex ; 44(6): 546-53, 2002.
Article in Spanish | MEDLINE | ID: mdl-20383457

ABSTRACT

OBJECTIVE: To describe the characteristics of mixed hyperlipidemia cases, using data derived from the Encuesta Nacional de Enfermedades Crónicas (Mexican National Survey of Chronic Diseases, ENEC). MATERIAL AND METHODS: The ENEC was conducted in 1993, in 417 Mexican cities. Blood measurements of lipids, glucose, and insulin were obtained from 2206 cases. Differences between dyslipidemia patients and non cases were obtained using analysis of variance or the chi-squared test. RESULTS: Mixed hyperlipidemia was diagnosed in 282 subjects (12.8%). Cases were 42.7+/-12.6 years old. Fifty six percent were males and 46.4% had HDL cholesterol levels < 0.9 mmol/l. Other cardiovascular risk factors were also present. The prevalence of mixed hyperlipidemia was high even among young adults. A logistic regression model showed that obesity, age, male gender, residence in some regions of Mexico, diabetes, arterial hypertension, and fasting insulin levels >21 mU/ml, were factors associated with mixed hyperlipidemia. CONCLUSIONS: Mixed hyperlipidemia is a very common condition in Mexican adults. It is more common in males older than 30 years, with additional cardiovascular risk factors. Study findings suggest that the metabolic syndrome plays a role in the pathogenesis of this disorder.


Subject(s)
Hyperlipidemias/epidemiology , Adult , Cross-Sectional Studies , Female , Health Surveys , Humans , Hyperlipidemias/blood , Male , Mexico
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