Factores del síndrome metabólico en el riesgo cardiovascular en pobladores peruanos / Factors of Metabolic Syndrome in Cardiovascular Risk among Peruvian Populations

Objetivo: Determinar la incidencia de los factores del síndrome metabólico en el riesgo cardiovascular en pobladores del distrito de Ayacucho en Perú. Método: Enfoque cuantitativo, diseño correlacional causal. La muestra fue de 140 pobladores mayores de 18 años a quienes se les realizó el dosaje serológico y se tomaron las medidas antropométricas necesarias mediante el uso de equipos biomédicos calibrados y específicos para cada parámetro. Se utilizó como instrumento la Tabla de cálculo de Síndrome Metabólico (ALAD) y la tabla de Framinghan. Resultados: Se determinó que el Síndrome Metabólico incide significativamente (0,000) en el Riesgo Cardiovascular con un J2= 15,432 (1) y una influencia de 16,8 por ciento enfatizado por el coeficiente de Pseudo-R2 Nagelkerke. Conclusión: Se concluye que el síndrome metabólico incide en el riesgo cardiovascular de los pobladores evaluados, debido a que presentaron niveles bajo de colesterol HDL, triglicéridos altos, un incremento de perímetro abdominal y hábitos de fumar, siendo estos factores determinantes para incrementar el riesgo cardiovascular (AU)

Objective: To determine the incidence of metabolic syndrome factors on cardiovascular risk in inhabitants of the district of Ayacucho in Peru. Methods: Quantitative approach, causal correlational design. The sample consisted of 140 inhabitants over 18 years of age who underwent serological dosage and the necessary anthropometric measurements were taken using calibrated and specific biomedical equipment for each parameter. The Metabolic Syndrome Calculation Table (ALAD) and the Framinghan table were used as instruments. Results: It was determined that the Metabolic Syndrome has a significant influence (0.000) on Cardiovascular Risk with a J2= 15.432 (1) and an influence of 16.8 percent emphasized by the Pseudo-R2 Nagelkerke coefficient. Conclusion: It is concluded that the metabolic syndrome has an impact on the cardiovascular risk of the population evaluated, because they presented low HDL cholesterol levels, high triglycerides, an increase in abdominal perimeter and smoking habits, these being determining factors to increase cardiovascular risk(AU)

Correlación y concordancia del índice de masa corporal con el perímetro abdominal y el índice cintura-talla en adultos peruanos de 18 a 59 años / Correlation and concordance between the body mass index and abdominal perimeter with the waist-to-height ratio in peruvian adults aged 18 to 59 years

Objetivos. Determinar la correlación y concordancia diagnóstica del índice de masa corporal (IMC), con el perímetro abdominal (PA) y el índice cintura-talla (ICT). Materiales y métodos. Se realizó un estudio descriptivo, transversal, de datos secundarios usando las bases de datos antropométricos de la Encuesta Vigilancia Alimentaria y Nutricional por Etapas de Vida Adulto de 18 a 59 años 2017-2018 que incluyó 1084 personas para los dominios geográficos Lima Metropolitana, resto urbano y rural. Se estimaron las prevalencias de obesidad según IMC, PA e ICT y se empleó el coeficiente de correlación de Lin y Kappa de Cohen para determinar la correlación y concordancia entre las tres mediciones antropométricas. Resultados. Según los criterios de IMC, PA e ICT las prevalencias de obesidad fueron de 26,8%, 50,4% y 85,4%, respectivamente; las prevalencias fueron mayores en mujeres y en mayores de 30 años. La correlación entre IMC vs. PA e IMC vs. ICT fue pobre y de PA con ICT fue moderada, con diferencias entre hombres y mujeres. Además, la concordancia entre IMC y PA fue aceptable, mientras que la concordancia entre IMC vs. ICT fue leve. Conclusiones . Los resultados de la correlación y concordancia son limitados y sugieren que no son medidas intercambiables, por lo que es necesario evaluar la suficiencia de emplear solo IMC para el diagnóstico de obesidad en el Perú. Esta limitada correlación y concordancia se refleja en las diferentes proporciones de obesidad que oscilan entre 26,8% a 85,4% al aplicar los tres criterios.

Objective. To determine the correlation and diagnostic agreement of body mass index (BMI) and abdominal perimeter (AP) with the waist-to-height ratio (WHtR). Materials and methods. A descriptive, cross-sectional, secondary data study was conducted using the anthropometric databases of the Food and Nutrition Surveillance Survey by Adult Life Stages from 18 to 59 years old, 2017-2018, which included 1084 individuals for the geographic domains of Metropolitan Lima, other urban areas, and rural regions. The prevalence of obesity was estimated according to BMI, AP and WHtR. Lin's correlation coefficient and Cohen's Kappa were used to determine the correlation and agreement between the three anthropometric measurements. Results. According to the BMI, AP, and WHtR criteria, the prevalence of obesity was 26.8%, 50.4% and 85.4%, respectively; the prevalence was higher in women and in those over 30 years of age. The correlation between BMI and AP, as well as between BMI and WHtR was poor; it was moderate between AP and WHtR, with differences between men and women. Furthermore, the agreement between BMI and AP was acceptable, whereas the agreement between BMI vs. WHtR was mild. Conclusions. The results regarding correlation and agreement are limited and suggest that they are not interchangeable measures, so it is necessary to evaluate the adequacy of using BMI alone for the diagnosis of obesity in Peru. The limited correlation and agreement was reflected in the different proportions of obesity that range from 26.8% to 85.4% when applying the three criteria.

Correlations of the rectus abdominis muscle anatomy with anthropometric measurements.

PURPOSE: The anterior abdominal muscle wall has a strong aesthetic connotation, primarily because of the classical anatomical description of the rectus abdominis muscle in the collective consciousness. However, the morphological reality of the general population considerably deviates from this description. Therefore, we investigated the anthropometric characteristics correlated with the anatomy of the rectus abdominis muscle. METHODS: We performed a computed tomography scan anatomical study of recti abdominis muscles in 86 patients with no history of abdominal surgery. We noted the transverse and anteroposterior measurements of the rectus abdominis muscle, the transverse measurement of the linea alba, and the cutaneous and muscular abdominal perimeters. We compared these morphological elements with anthropometric data (sex, age, weight, height, and body mass index [BMI]). RESULTS: BMI was positively correlated with cutaneous abdominal perimeter (r = 0.89, p < 0.001) and muscular abdominal perimeter (r = 0.7, p < 0.001). The correlation of BMI with cutaneous abdominal perimeter was not influenced by sex (r = 0.90 and r = 0.89 in men and women, respectively). The correlation of BMI with muscular abdominal perimeter was greater in men than in women (r = 0.80 vs. r = 0.75). The muscular abdominal perimeter was more strongly correlated with the transverse measurement of the rectus abdominis muscle in men than in women (r = 0.75 vs. r = 0.59). The muscular abdominal perimeter was more strongly correlated with the linea alba in women than in men (r = 0.51 vs. r = 0.31). CONCLUSION: The anatomy of the anterior abdominal wall correlated with anthropometric data, including BMI. Rectus abdominis muscles and linea alba structures differed between men and women.

Utilidad de la ecografía en el diagnóstico de esteatosis hepática en niños con sobrepeso u obesidad que concurren al Hospital Regional de Encarnación de marzo a junio de 2019

RESUMEN La obesidad infantil va en aumento, relacionado a los malos hábitos alimentarios y el sedentarismo; puede desembocar en el desarrollo del síndrome metabólico, incrementando el riesgo de enfermedades crónicas, entre ellas, la esteatosis hepática. El objetivo de este estudio fue determinar la utilidad de la ecografía en la detección de esteatosis hepática en niños con sobrepeso u obesidad que concurrieron al Hospital Regional de Encarnación de marzo a junio de 2019. Se estudiaron a 50 niños de ambos sexos de 5 a 14 años con sobrepeso u obesidad, mediante examen clínico, antropometría, ecografía y marcadores bioquímicos. Se encontraron 18 pacientes (36%) con esteatosis hepática, mediante ecografía, predominando en varones, con obesidad severa de tipo visceral. La Acantosis nigricans, el perímetro abdominal por encima del percentil 90, GPT y triglicéridos séricos elevados, fueron los hallazgos más relevantes asociados a esteatosis hepática. La ecografía simple en modo B, resultó ser un método útil para la detección de esteatosis hepática en niños obesos, asociado a la presencia de perímetro abdominal por encima del percentil 90, Acantosis Nigricans, GPT y triglicéridos elevados. Este esquema de manejo inicial sería muy útil y de fácil aplicación en la evaluación y control de esta afección que va en aumento en la población pediátrica.

ABSTRACT Childhood obesity is increasing, related to bad eating habits and sedentary lifestyle; It can lead to the development of metabolic syndrome, increasing the risk of chronic diseases, including liver steatosis. The objective of this study was to determine the usefulness of ultrasound in the detection of hepatic steatosis in overweight or obese children who attended the Regional Hospital of Encarnación from March to June 2019. Fifty children of both sexes from 5 to 14 years old were studied with overweight or obesity, through clinical examination, anthropometry, ultrasound and biochemical markers. 18 patients (36%) were found with hepatic steatosis, by ultrasound, predominantly in men, with severe obesity of visceral type. Acanthosis nigricans, the abdominal perimeter above the 90th percentile, GPT and elevated serum triglycerides, were the most relevant findings associated with hepatic steatosis. Simple B-mode ultrasound proved to be a useful method for the detection of hepatic steatosis in obese children, associated with the presence of abdominal perimeter above the 90th percentile, Acanthosis nigricans, GPT and elevated triglycerides. This initial management scheme would be very useful and easy to apply in the evaluation and control of this condition that is increasing in the pediatric population.

Prediction of SGA at Birth by Using the Right Portal Vein Diameter Measurement at the 30-35-Week Scan.

OBJECTIVE: This study sought to test the hypothesis that the measurement of the right portal vein (RPV) diameter on the transverse abdominal view at the 32-week ultrasound scan is small in fetuses with growth retardation and to validate the use of this measurement as a tool for detecting small for gestational age (SGA) at birth. METHODS: This was a retrospective cohort study at a single centre. The study population comprised 326 consecutive pregnancies, including 29 SGA at delivery and 297 unaffected cases. Stored images of the transverse view of the abdomen, obtained at the routine third trimester scan, were used to assess the diameters of the umbilical vein, the portal sinus, and the RPV. RESULTS: The portal sinus and RPV diameter were smaller compared with the reference group (P = 0.021 and P < 0.001, respectively). Using a 10th percentile cut-off, the detection rate for SGA at birth was 38% for the RPV diameter versus 45% for the estimated fetal weight. The false-positive rates were 9% versus 8%, respectively. Multiple regression analysis revealed that RPV below the 10th percentile remained an independent four-fold risk factor for SGA (odds ratio [OR] 5.05; 95% confidence interval [CI] 1.94-13.14). Further analysis revealed a higher prevalence of induction of labour for non-reassuring fetal well-being (P = 0.005), fetal acidemia (P = 0.028), and admission to a neonatal intensive care unit (NICU, P = 0.029) in the RPV ≤10th percentile group. CONCLUSION: RPV below the 10th percentile could be a reliable third trimester ultrasound marker of a subnormal fetal environment. This study proposed a new and accessible approach for prediction of SGA.

The relationship between risk factors for metabolic syndrome in the physically active elderly / A relação entre os fatores de risco para a síndrome metabólica em idosos fisicamente ativos

Aging has a significant impact on the decrease of lean body mass and physical activity level, being related to the reduction in basal metabolic rate and the increase of overweight and obesity in the elderly. The aim of this study is to identify correlations among the risk factors of metabolic syndrome (MS) from the measurement of abdominal perimeter (AP) and body mass index (BMI) with blood parameters for fasting blood glucose (FBG), total cholesterol (TC) and triglycerides (TG) in active elderly people. Measurements of weight and height were adopted to classify criteria by the World Health Organization (WHO) and to calculate BMI. The measurement of AP was done in centimeters. Blood parameters for FBG, TC, and TG were assessed by collecting blood from the fingertip and analyzing it using the Accutrend Plus (Roche) equipment. For data analysis, the Pearson correlation coefficient between anthropometric measures (independent variables) and blood parameters (dependent variables) was calculated. Simple linear regression was applied to the significant variables (0.05%). The BMI assessment shows 71% of the elderly were overweight and 34% were obese. Over the cut-off point recommended, 57% of the sample was indicated by AP. The correlation test shows evidence regarding the existence of a significant association between FBG and AP and also between AP and TG as compared to the use of BMI. The AP measurement seems to be an efficient indication of the relationship between risk factors for MS and should be incorporated into routines to assess the elderly as an indicator of abdominal obesity. (AU)

O envelhecimento tem um impacto significativo na diminuição de massa magra e do nível de atividade física, estando relacionado à redução na taxa metabólica basal e ao aumento de sobrepeso e obesidade em idosos. O objetivo deste estudo foi identificar correlações entre os fatores de risco da síndrome metabólica (SM) e a medição do perímetro abdominal (PA) e do índice de massa corporal (IMC) com os parâmetros sanguíneos de glicemia de jejum (GJ), colesterol total (CT) e triglicerídeos (TG) em idosos ativos. Para cálculo do IMC, foram coletadas medidas de peso e altura e adotados os critérios de classificação da Organização Mundial da Saúde (OMS). A medida do PA foi efetuada em centímetros. Os parâmetros sanguíneos de GJ, CT e TGL foram avaliados pelo método de coleta de sangue na ponta de dedo com leitura em equipamento Accutrend Plus (Roche). Para análise dos resultados, foi realizado o cálculo do coeficiente de correlação de Pearson entre as medidas antropométricas (variáveis independentes) e parâmetros sanguíneos (variáveis dependentes). A regressão linear simples foi aplicada sobre as variáveis significativas (0.05%). A avaliação do IMC mostrou que 71% dos idosos estavam acima do peso e 34% eram obesos. No ponto de corte recomendado, 57% da amostra foram indicados por PA. O teste de correlação mostrou evidências sobre a existência de uma associação significativa entre GJ e PA e também entre PA e TG em comparação ao uso do IMC. A medição de PA parece seruma indicação eficaz da relação entre os fatores de risco para a SM e deve ser incorporada nas rotinas para avaliar idosos como um indicador de obesidade abdominal. (AU)

The relationship between risk factors for metabolic syndrome in the physically active elderly / A relação entre os fatores de risco para a síndrome metabólica em idosos fisicamente ativos

Aging has a significant impact on the decrease of lean body mass and physical activity level, being related to the reduction in basal metabolic rate and the increase of overweight and obesity in the elderly. The aim of this study is to identify correlations among the risk factors of metabolic syndrome (MS) from the measurement of abdominal perimeter (AP) and body mass index (BMI) with blood parameters for fasting blood glucose (FBG), total cholesterol (TC) and triglycerides (TG) in active elderly people. Measurements of weight and height were adopted to classify criteria by the World Health Organization (WHO) and to calculate BMI. The measurement of AP was done in centimeters. Blood parameters for FBG, TC, and TG were assessed by collecting blood from the fingertip and analyzing it using the Accutrend Plus (Roche) equipment. For data analysis, the Pearson correlation coefficient between anthropometric measures (independent variables) and blood parameters (dependent variables) was calculated. Simple linear regression was applied to the significant variables (0.05%). The BMI assessment shows 71% of the elderly were overweight and 34% were obese. Over the cut-off point recommended, 57% of the sample was indicated by AP. The correlation test shows evidence regarding the existence of a significant association between FBG and AP and also between AP and TG as compared to the use of BMI. The AP measurement seems to be an efficient indication of the relationship between risk factors for MS and should be incorporated into routines to assess the elderly as an indicator of abdominal obesity.

O envelhecimento tem um impacto significativo na diminuição de massa magra e do nível de atividade física, estando relacionado à redução na taxa metabólica basal e ao aumento de sobrepeso e obesidade em idosos. O objetivo deste estudo foi identificar correlações entre os fatores de risco da síndrome metabólica (SM) e a medição do perímetro abdominal (PA) e do índice de massa corporal (IMC) com os parâmetros sanguíneos de glicemia de jejum (GJ), colesterol total (CT) e triglicerídeos (TG) em idosos ativos. Para cálculo do IMC, foram coletadas medidas de peso e altura e adotados os critérios de classificação da Organização Mundial da Saúde (OMS). A medida do PA foi efetuada em centímetros. Os parâmetros sanguíneos de GJ, CT e TGL foram avaliados pelo método de coleta de sangue na ponta de dedo com leitura em equipamento Accutrend Plus (Roche). Para análise dos resultados, foi realizado o cálculo do coeficiente de correlação de Pearson entre as medidas antropométricas (variáveis independentes) e parâmetros sanguíneos (variáveis dependentes). A regressão linear simples foi aplicada sobre as variáveis significativas (0.05%). A avaliação do IMC mostrou que 71% dos idosos estavam acima do peso e 34% eram obesos. No ponto de corte recomendado, 57% da amostra foram indicados por PA. O teste de correlação mostrou evidências sobre a existência de uma associação significativa entre GJ e PA e também entre PA e TG em comparação ao uso do IMC. A medição de PA parece seruma indicação eficaz da relação entre os fatores de risco para a SM e deve ser incorporada nas rotinas para avaliar idosos como um indicador de obesidade abdominal.

Prevalencia de factores de riesgo cardiometabólico en estudiantes universitarios de la región centro-occidente, en la Universidad Michoacana de San Nicolás de Hidalgo, México / Prevalence of cardiometabolics factors of risk in university students of the region the center west of Mexico, in Universidad Michoacana de San Nicolas de Hidalgo México

Introducción: Las enfermedades cardiometabólicas son causa de 30% de las muertes en el mundo, siete de cada 10 mexicanos tienen sobrepeso u obesidad, condicionantes de diabetes mellitus, hipertensión arterial y enfermedades cardiovasculares. Objetivo: Estudiar la prevalencia de factores de riesgo cardiometabólico en estudiantes de la Facultad de Ciencias Médicas y Biológicas ''Dr. Ignacio Chávez'' de la Universidad Michoacana de San Nicolás de Hidalgo en Morelia, Michoacán. Material y métodos: se realizó un estudio epidemiológico, transversal, descriptivo, aleatorio y voluntario. Se evaluaron factores de riesgo cardiovascular como edad, sexo, antecedentes heredofamiliares, hipertensión arterial, diabetes mellitus, tabaquismo, obesidad, cardiopatía isquémica prematura y actividad física. Resultados: De 141 estudiantes, 67 (47.5%) fueron hombres y 74 (52.5%) mujeres, el promedio de edad (homogéneo 22.66 ± 0.18 varones y 22.23 ± 0.10 mujeres). Fumadores mujeres 9 (6.38%) y hombres 15 (10.63%); el perímetro abdominal en 5 hombres (3.5 %) fue > 102 cm, y en 13 mujeres (9.20%) > 88 cm. El valor de colesterol total normal en mujeres fue de 73 (51.80%) y en hombres de 64 (45.40%). Conclusiones: Un porcentaje elevado de universitarios presentaron sobrepeso, obesidad, tabaquismo, hipertensión arterial y alteración del perfil lipídico. Algunos factores de riesgo son modificables con cambios de estilo de vida. Es necesario que autoridades en salud y educación tomen medidas para establecer estilos de vida saludables.

Introduction: The cardiometabolics diseases cause 30% of deaths in the world, seven of ten Mexicans have overweight or obesity, conditioners of diabetes mellitus, arterial hypertension and cardiovascular diseases. Objective: To study prevalence of cardiometabolics factors of risk in students of the Faculty of Medical Sciences and Biological ''Dr. Ignacio Chávez'', in Morelia, Michoacán. Material and Methods: Study cross-sectional, descriptive, random and voluntary epidemiologist, familiars here to factors of cardiometabolics risk like the age, sex, antecedents, arterial hypertension, diabetes mellitus, tobacco addiction, obesity, premature ischemic cardiopathy and physical activity were evaluated. Results: Of 141 students 67 (47.5%) men and 74 (52.5%) women, homogenous average of age men 22.66 ± 0.10 women, 22.23 ± 0.18 women 9 (6.38%) and men 15 (10.63%) are smokers. The abdominal risk in man 5 (3.50) of ( > 102 cm), and women 13 (9.20%) ( > 88 cm). The value of normal total cholesterol was in women 73 (51.80%) and in men 64 (45.40%). Conclusions: A lifted percentage of college students presented/displayed overweight, obesity, tobacco addiction, arterial hypertension and alteration of the lipoid profile. Some factors of risk are modifiable with changes of life style, is necessary that authorities in health and education take measures to establish healthful styles of life.