RESUMO
BACKGROUND AND OBJECTIVES: To identify the anthropometric index that best detects cardiovascular risk (CVR) and type 2 diabetes (DM2) in the adult Spanish population and to determine its cut-off point. SUBJECTS AND METHODS: Cross-sectional study in the general population (n=6279). Sensitivity and specificity were estimated for the anthropometric indexes: abdominal waist, body mass index, waist to hip ratio and waist to height ratio (WtHR). The areas of these indexes under ROC curve (AUC) were obtained for the following CVR factors: high coronary risk computed with Framingham model, Hypertension, Hyperlipemia, DM2, Metabolic Syndrome (MS) and Impaired Fasting Glucose (IFG). The odds ratio, with 95% confidence interval (CI(95%)), was calculated. RESULTS: WtHR was the index showing the highest AUC for DM2 and the remaining CVR factors, varying between 0.65 (CI(95%)=0.63-0.68) for IFG in men and 0.87 (CI(95%)=0.86-0.89) for MS in women. RA/E reached the maximum sensitivity (0.91) and specificity (0.70) in SM and its optimal cut-off point was 0.55, which displayed the highest risks amongst indexes, varying from 2.30 (1.96-2.70) in IFG to 16'20 (13.68-19.20) in MS. CONCLUSIONS: RA/E is the index presenting the best ability to detect DM2 and CVR in this population, and it shows the stronger association with them. Its cut-off point, 0.55, confirms the convenience of keeping the abdominal waist to less than half the height.
Assuntos
Estatura , Doenças Cardiovasculares/epidemiologia , Diabetes Mellitus/epidemiologia , Circunferência da Cintura , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Medição de RiscoRESUMO
Fundamento: la población canaria sufre la mayor mortalidadpor diabetes tipo 2 (DM2) en España. El objetivo de esteestudio es conocer el estilo de vida de las personas diabéticasdel archipiélago y su adherencia al tratamiento, así como laDM2 desconocida.Métodos: estudio transversal de 6.729 personas de la poblacióngeneral participantes en la cohorte CDC de Canarias(edad 18-75 años). Se obtuvieron sus antecedentes médicos,dieta, actividad física, medicamentos consumidos, tabaco, etc.Resultados: la prevalencia de DM2 fue 12% en varones y10% en mujeres (p=0,005). El 22% de varones y 9% de mujeresdesconocían su enfermedad (p<0,001). Sumando DM2desconocida, DM2 no tratada e incumplimiento terapéutico, el48% de los hombres y 28% en mujeres no seguían tratamientocorrecto. Los varones diabéticos eran más obesos que los nodiabéticos (45 versus 25%; p<0,001) pero no presentaban diferenciasen tabaquismo (28%; IC95%=23-33) o sedentarismo(62%; IC95%=56-68). Las mujeres diabéticas también eran másobesas (54 versus 27%; p<0,001) y, aunque fumaban menos(11 versus 22%; p<0,001), eran igual de sedentarias (75%;IC95%=70-79). La ingesta calórica era menor en quienes sufríanDM2 (p<0,001), pero el 93% (IC95%=91-95) superaba elconsumo recomendado de grasas saturadas y el 69%(IC95%=65-72) padecía síndrome metabólico.Conclusiones: la población diabética en Canarias essedentaria y obesa, muestra un consumo alto de grasas saturadasy gran prevalencia de síndrome metabólico. El porcentajeque sigue tratamiento regular es muy bajo, sobretodo en varones,que además mantienen el tabaquismo(AU)
Background: The Canary Islands population experiencesthe highest type 2 diabetes (DM2) mortality in Spain. We studiedlifestyle, unknown DM2 and treatment adherence in diabeticsof these islands.Methods: cross-sectional study of 6729 subjects from thegeneral population (age 18-75) that participate in the cohortstudy CDC of the Canary Islands. We found out their medicalproblems, diet, physical activity, medications, smoking, etc.Results: Prevalence of DM2 was 12% in men and 10% inwomen (p=0.005). The disease was unknown in 22% of menand 9% of women (p<0.001). Considering unknown DM2, lackof treatment and lack of adherence, 48% of men and 28% ofwomen did not follow a regular treatment. Diabetics men prevalencesof smoking (28%; CI95%=23-33) and sedentariness(62%; CI95%=56-68) were similar to non diabetic men, but obesitywas more frequent in diabetics (45 versus 25%; p<0.001).Diabetics women showed a higher obesity (54 versus 27%;p<0.001) and a lower smoking prevalence (11 versus 22%;p<0,001) than non diabetics, but they presented a similar sedentariness(75%; CI95%=70-79). In both sexes, energy intake waslower in diabetics (p<0.001), but 93% of them (CI95%=91-95)showed a high consumption of calories from saturated fat and69% (CI95%=65-72) presented metabolic syndrome.Conclusions: The Canarian diabetics are a sedentary andobese population that show a high consumption of saturatedfats and high prevalence of metabolic syndrome. The proportionof them following regular treatment is low, specially indiabetic men that, in addition, still smoke(AU)
