Circunferencia de la cintura como predictor de resistencia insulínica en varones jóvenes

Association between cardiovascular risk factors and triglyceride to high-density lipoprotein ratio: a single-center experience

Introduction

We aimed to investigate associations between triglycerides (Tg)/high-density lipoprotein (HDL) and age, body mass index (BMI), waist circumference (WC), systolic and diastolic blood pressure (SBP, DBP), fasting blood glucose (FBG), and smoking in patients without diabetes mellitus.

Material and methods

The study included 91 patients between 18 and 65 years old age, with no diagnosis of diabetes mellitus. Laboratory parameters of Tg, low-density lipoprotein (LDL), HDL cholesterol, FBG, BMI (kg/m²), WC (cm), SBP and DBP (mm Hg), smoking status, and demographic data were collected from patients' electronic records. Patients whose Tg/HDL was under 3 were grouped as group A; those whose ratio was over 3 were grouped as group B.

Results

The mean age, BMI, WC, SBP, and DBP were higher in the group in which Tg/HDL was higher. Although total cigarette exposure and FBG were higher in group B, the difference between the 2 groups was not statistically significant. Tg/HDL was positively correlated with BMI and positively correlated with WC in correlation analyses. It was observed that every 1-point increase in BMI caused a 0.1-point increase in Tg/HDL and smoking caused a 1.09-point increase in Tg/HDL in multivariate regression analysis.

Conclusions

The WC, BMI, SBP, and DBP are higher in the group in which Tg/HDL is higher. Further, high BMI and smoking are also related to high Tg/HDL in our study.Key words: smoking, body mass index, triglyceride, waist circumference, HDL cholesterol.

Adiponectin and waist circumference as predictors of insulin-resistance in women

BACKGROUND AND AIMS

The initial disturbance of insulin resistance seems to focus on adipose tissue is a dynamic organ involved in many physiological and metabolic processes. Expresses and secretes a variety of active peptides, adipocytokines. To evaluate the prevalence of insulin-resistance in an healthy urban middle age population and to explore the role of adiponectin, inflammatory biomarkers (hs-CRP) and traditional cardiovascular risk factors as predictors of the insulin-resistance state.

MATERIALS AND METHODS

We studied of 176 participants (117 women and 59 men, 25-74 years), individuals with diabetes, hypothyroidism or hyperthyroidism, infectious disease, renal, or hepatic neoplasms and pregnant women were excluded. We evaluated glucose, insulin, adiponectin and hs-CRP.

RESULTS

We found that 17.2% of individuals presented insulin-resistance. Correlation was found between waist circumference, body mass index, blood pressure and HOMA index (p<0.01). Adiponectin was associated with the insulin-resistance (p<0.001) but not hs-CRP. Adiponectin (β=0.385, p=0.004) and waist circumference (β=0.116, p=0.02) were predictors of IR only in women, meanwhile none of the analyzed biomarkers predicted insulin-resistance in men. Besides, postmenopausal women presented higher adiponectin levels than premenopausal 7.63 (4.46-9.58) vs 5.50 (3.83-7.40) μg/ml, p=0.01.

CONCLUSIONS

Adiponectin and waist circumference are important predictors of insulin-resistance even in healthy non-diabetic women, they may open a new opportunity to improve current risk estimation.

[Association of insulin resistance to different anthropometric measures and cardiovascular risk factors in a non-diabetic population]

BACKGROUND AND OBJECTIVE

Insulin resistance (IR) has been directly related to obesity, particularly central obesity, and to other cardiovascular risk factors (CVRFs). Direct IR quantification is difficult in clinical practice, and indirect methods such as HOMA (homeostasis model assessment) have therefore been developed. The aim of this study was to assess the association of IR, as measured by HOMA, with different anthropometric measures and some CVRFs.

MATERIALS AND METHODS

A cross-sectional, observational study was carried out in a general population sample older than 18 years in the province of Albacete, Spain. Sample size was 678 subjects. Participants completed a survey and underwent physical examinations and laboratory tests. Obesity measures included body mass index, waist perimeter, and sagittal abdominal diameter. Data analysis was performed using SPSS 15.0 software.

RESULTS

Mean values of obesity measures were higher in males as compared to females and increased with age. IR prevalence was 39.8%. All assessed anthropometric measures, decreased HDL (high density lipoprotein) cholesterol and increased non-HDL cholesterol were independently associated to the risk of IR.

CONCLUSIONS

A clear association exists between different anthropometrical measures and IR in the general population. There is also an association between lipid profile cahnges and the risk of experiencing IR.

[Nutrition alterations in internal medicine. Body composition analysis with bioelectrical impedance]

OBJECTIVES

To determine the prevalence of malnutrition in patients in Internal Medicine. To describe the changes of corporal composition depending on body mass index (BMI). To evaluate validity of the different screening tools for the estimation of body composition.

MATERIAL AND METHODS

Prospective observational cross-sectional study of the prevalence of malnutrition in 300 patients (sample 1); these were chosen 136 patients (sample 2), classifying in four groups: BMI < 20: 30 patients; BMI = 20-25: 46 patients; BMI = 25-30: 30 patients, and BMI > 30: 30 patients. In the patients of sample 2, we carried out a protocol of nutritional evaluation with anthropometry, laboratory and bioelectrical impedance analysis.

RESULTS

The prevalence of desnutrition was 9.3% and the obesity was 22.3%. In undernourished patients, the measure of body compartments with bioelectrical impedance, expressed in percentage of body weight, were: fat mass 20.5%, fat-free mass 79.4% and total body mater 58.3%. The body composition in obeses was: fat mass 40.1%, fat-free mass 60.6% and total body water 44.3%. The patients with normal BMI, the meta index (impedance at 50 kHz/BMI) was 25.9 +/- 5.21; in undernourished the index was higher (36.7) and obeses lower (15.5). The meta index (30-20) estimates desnutrition-obesity with high sensibility and specificity. The prevalence of desnutrition varies from 6% to 69% and obesity from 23% to 74%, using different methods and criterions for the estimation of body composition.

CONCLUSIONS

In Internal Medicine, the overweight (BMI > 25) is the most prevalent nutritional alteration. The bioelectrical impedance analysis helps for estimation of body composition and meta index is a very useful indicator of malnutrition (desnutrition-obesity).