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Martínez-Díaz G, Cruz-Domínguez MP, López Zamora B, Ramirez-Facio J, Medina G, Munguía-Cruz RX, Saavedra-Salinas MA, Arrucha-Cozaya M, Vera-Lastra OL, Peralta-Amaro AL, Florez-Durante ÓI, Gil-Galindo KA. Influence of visceral adiposity on cardiovascular risk in patients with systemic sclerosis. Rheumatol Int 2024; 44:621-630. [PMID: 37684492 DOI: 10.1007/s00296-023-05421-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 08/05/2023] [Indexed: 09/10/2023]
Abstract
Systemic sclerosis (SSc) is an autoimmune disease characterized by systemic inflammation, endothelial dysfunction, generalized fibrosis and high cardiovascular mortality. The evaluation of cardiovascular risk through the visceral adiposity index (VAI) has been helpful due to its direct relationship to the body and visceral fat percentage. We evaluated the influence of body composition and anthropometrics on cardiovascular risk as measured by VAI in healthy controls (HC) and SSc. An analytical cross-sectional study of 66 participants (33 SSc and 33 HC), mean age 52.7 ± 10, 95% women, was conducted from August 2020 to January 2021. Inclusion criteria in cases were consecutive patients with SSc (ACR/EULAR 2013), 63.6% were diffuse cutaneous (dcSS) subtype, and 36.4 were limited cutaneous (lcSS) subtype. HC was matched by age and gender. Serum lipid profiles and InBody anthropometrics were analyzed and compared. We performed descriptive statistics, bivariate analysis with Student's t, or Mann-Whitney U, correlation and chi-square according to the variable type and distribution. Total cholesterol was significantly higher in SSc than HC (345 vs 194, p = < 0.001). The BMI was higher in HC (26.2 vs 28.9, p < 0.001). Kilograms of muscle (19.8 vs 28.9, p < 0.001) and total fat (23.4 vs 28.9, p < 0.001) were lower in SSc patients compared to HC. VAI was similar when BMI < 25, but significantly higher when BMI > 25 in SSc than in HC (3 vs 1.9, p = 0.030). The increase in BMI at overweight or obese in SSc is associated with a significant increase in cardiovascular risk.
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Affiliation(s)
- Gabriela Martínez-Díaz
- Faculty of Medicine, Benemérita Universidad Autónoma de Puebla, Campus Puebla, Puebla, Puebla, Mexico
| | - María Pilar Cruz-Domínguez
- Direction of Education and Research, Instituto Mexicano del Seguro Social, Centro Médico Nacional La Raza, Hospital de Especialidades "Dr. Antonio Fraga Mouret", Mexico City, Mexico.
- Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico.
| | - Berenice López Zamora
- Instituto Mexicano del Seguro Social, Centro Médico Nacional La Raza, Hospital de Especialidades "Dr. Antonio Fraga Mouret", Mexico City, Mexico
- Postgraduate studies section and research, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City, Mexico
| | - Jordan Ramirez-Facio
- Internal Medicine Resident, Instituto Mexicano del Seguro Social, Centro Médico Nacional La Raza, Hospital de Especialidades "Dr. Antonio Fraga Mouret", Mexico City, Mexico
| | - Gabriela Medina
- Clinical Research Unit, Hospital de Especialidades Centro Médico La Raza, IMSS; Universidad Nacional Autónoma de México, Mexico City, Mexico
- Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | | | - Miguel Angel Saavedra-Salinas
- Clinical Research Unit, Hospital de Especialidades Centro Médico La Raza, IMSS; Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Michelle Arrucha-Cozaya
- Faculty of Medicine, Benemérita Universidad Autónoma de Puebla, Campus Puebla, Puebla, Puebla, Mexico
| | - Olga Lidia Vera-Lastra
- Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
- Internal Medicine Department, Instituto Mexicano del Seguro Social, Centro Médico Nacional La Raza, Hospital de Especialidades "Dr. Antonio Fraga Mouret", Mexico City, Mexico
| | - Ana Lilia Peralta-Amaro
- Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
- Internal Medicine Department, Instituto Mexicano del Seguro Social, Centro Médico Nacional La Raza, Hospital de Especialidades "Dr. Antonio Fraga Mouret", Mexico City, Mexico
| | - Óscar Iván Florez-Durante
- Laboratory Department, Instituto Mexicano del Seguro Social, Centro Médico Nacional La Raza, Hospital de Especialidades "Dr. Antonio Fraga Mouret", Mexico City, Mexico
| | - Kybaná Aurora Gil-Galindo
- Postgraduate studies section and research, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City, Mexico
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Manzano-Jurado JDJ, Morales-Gutiérrez J, Gil-Galindo KA, Pérez-Ayala MF, Lira-Tecpa J, Ordoñez-González I, Cruz-Domínguez MP, Vera-Lastra O, López-Zamora B, Medina-García G. [Body composition and physical activity in resident physicians]. Rev Med Inst Mex Seguro Soc 2021; 59:431-439. [PMID: 34919367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 07/14/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Mexico is ranked second in obesity in adults worldwide and resident physicians are not exempt from this problem. Inadequate diet and physical inactivity are associated factors. Bioimpedance has greater precision than anthropometry. OBJECTIVE To analyze the difference between degree of physical activity, caloric intake and body composition in Internal Medicine residents according to their degree of residence. MATERIAL AND METHODS Cross-sectional study. Resident physicians of both sexes, from second, third and fourth degree of training were included; they were fasting. Vital signs were taken; a Rapid Assessment of Physical Activity (RAPA) questionnaire, anthropometry, a 24-hour reminder, and bioelectrical impedance analysis were administered. Descriptive statistics, Kruskal-Wallis and chi squared tests were used. RESULTS 84 resident physicians were included, 48 were male. The median age was of 27 years (26-28). There was a prevalence of 46.4% of overweight and obesity, despite the hypocaloric diet in 89%. Bioelectrical impedance analysis showed that 72.6% of residents had elevated body fat, 71% sub-optimal degree of physical activity and 23.7% arterial hypertension. CONCLUSIONS A high prevalence of overweight and obesity was found with differences in body composition and suboptimal level of physical activity. It is important to correct bad eating habits and improve physical activity to reduce risks in this population.
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Affiliation(s)
- Juan de Jesús Manzano-Jurado
- Instituto Mexicano del Seguro Social. Centro Médico Nacional La Raza, Hospital de Especialidades "Dr. Antonio Fraga Mouret", Servicio de Medicina Interna. Ciudad de México, México
| | - Joel Morales-Gutiérrez
- 2Universidad Juárez Autónoma de Tabasco, Escuela de Medicina, División Académica de Ciencias de la Salud. Villahermosa, Tabasco, México
| | | | - Mayte Fabiola Pérez-Ayala
- Instituto Mexicano del Seguro Social, Centro Médico Nacional La Raza, Hospital de Especialidades "Dr. Antonio Fraga Mouret", División de Educación en Salud. Ciudad de México, México
| | - Josehp Lira-Tecpa
- Universidad Popular Autónoma del Estado de Puebla, Campus Puebla, Facultad de Medicina. Puebla, Puebla, México
| | - Irvin Ordoñez-González
- Universidad Veracruzana, Campus Veracruz, Facultad de Medicina. Veracruz, Veracruz, México
| | - María Pilar Cruz-Domínguez
- Instituto Mexicano del Seguro Social, Centro Médico Nacional La Raza, Hospital de Especialidades "Dr. Antonio Fraga Mouret", División de Investigación en Salud. Ciudad de México, México
| | - Olga Vera-Lastra
- Instituto Mexicano del Seguro Social. Centro Médico Nacional La Raza, Hospital de Especialidades "Dr. Antonio Fraga Mouret", Servicio de Medicina Interna. Ciudad de México, México
| | - Berenice López-Zamora
- 2Universidad Juárez Autónoma de Tabasco, Escuela de Medicina, División Académica de Ciencias de la Salud. Villahermosa, Tabasco, México
| | - Gabriela Medina-García
- Instituto Mexicano del Seguro Social, Hospital de Especialidades, "Dr. Antonio Fraga Mouret", Centro Médico Nacional La Raza, Unidad de Investigación en Medicina Traslacional en Enfermedades Hemato-oncológicas. Ciudad de México, México
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