Envíe este artículo por correo electrónico (Inicie sesión)
Enviar un correo electrónico al autor/a (Inicie sesión) Open Journal Systems
El diagnóstico de hiperlipidemia basado en el fenotipo
Resumen
Objetivo: determinar diferencias clínicas de los pacientes dislipidémicos de varios estratos sociales, agrupados en fenotipos lipídicos, y su relación con factores de riesgo para aterosclerosis.
Métodos: encuesta de oportunidad a población universitaria y urbana, mediante entrevista y obtención de muestras sanguíneas para medir perfil lipídico y glucosa a personas consideradas sanas.
Resultados: 1286 pacientes, 437 de medio socioeconómico bajo, 162 medio y 133 alto, originarios y residentes de la zona estudiada; y 554 universitarios del eje conurbado; 61.7 %, mujeres; 86 % de las muestras sanguíneas se tomó en ayunas. Fenotipos más frecuentes: hipoalfalipoproteinemia y dislipidemia mixta. La hipercolesterolemia aislada prevaleció en la clase media-alta y la mayor concentración de glucosa en ayunas y un nivel menor de c-HDL en la baja (p < 0.05). Edad y sexo masculino fueron predictores para hipercolesterolemia; índice de masa corporal para hipertrigliceridemia (OR = 10.089, IC 95 % = 10.03-1.14). Edad > 55 años (OR = 2.6, IC 95 % = 0.993-7.1), sexo masculino (OR = 1.6, IC 95 % = 1.2-2.1) y sedentarismo (OR = 1.35, IC 95 % = 1-1.85), para hipoalfalipoproteinemia.
Conclusiones: el fenotipo lipídico más frecuente fue hipoalfalipoproteinemia.
Palabras clave
Texto completo:
PDFReferencias
Dirección General de Epidemiología, México. Secretaría de Salud, 2004.
Meaney E, Lara-Esqueda A, Ceballos-Reyes GM, Asbun J, Vela A, Martínez-Marroquín Y, et al. Cardiovascular risk factors in the urban Mexican population: The FRIMEX Study. Public Health 2007;121(5):378-384.
Sánchez-Castillo CP, Velásquez-Monroy O, Lara-Esqueda A, Berber A, Sepúlveda J, Tapia-Conyer R, et al. Diabetes and hypertension increases in a society with abdominal obesity: results of the Mexican National Health Survey 2000. Public Health Nutr 2005;8(1):53-60.
Lerman IG, Villa AR, Martínez CL, Cervantes-Turrubiatez L, Aguilar-Salinas CA, Wong B, et al. The prevalence of diabetes and associated coronary risk factors in urban and rural older Mexican populations. J Am Geriatr Soc 1998;46:1387-1395.
Muñoz-de Chávez MA, Chávez-Villasana, M, Chávez-Muñoz, Eichin I. Sale of street food in Latin America. The Mexican case; joy or jeopardy? World Rev Nutr Diet 2000;86:138-154.
Dhingra R, Sullivan L, Jacques PF, Wang TJ, Fox CS, Meigs JB, D’Agostino RB, et al. Soft drink consumption and risk of developing cardiometabolic risk factors and the metabolic syndrome in middle-aged adults in the community. Circulation 2007;116(5):480-488.
Macdiarmid JI, Vail A, Cade JE, Blundell JE. The sugar-fat relationship revisited: differences in consumption between men and women of varying BMI. Int J Obes Relat Metab Disord 1998;22(11):1053-1061.
Fager G, Wilklung O. Cholesterol reduction and clinical benefit. Are there limits to our expectations? Artherioscler Thromb Vasc Biol 1997;17(12):3527-3533.
Grundy SM, Hansen B, Smith SC Jr, Cleeman JI, Kahn RA. Clinical management of metabolic syndrome: report of the American Heart Association/National Heart, Lung, and Blood Institute/American Diabetes Association Conference on Scientific Issues Related to Management. Circulation 2004;109(4):551-556.
Alberti KG, Zimmet P, Shaw J; The IDF Epidemiology Task Force Consensus Group. The metabolic syndrome: a new worldwide definition. Lancet 2005;366 (9491):1059-1062.
García-García G, Avilés-Gómez R, Luquín-Arellano VH, Padilla-Ochoa R, Lepe-Murillo L, Ibarra-Hernández M, et al. Cardiovascular risk factors in the Mexican population. Ren Fail 2006;28(8):677-687.
Wei M, Mitchell BD, Haffner SM, Stern MP. Effects of cigarette smoking, diabetes, high cholesterol, and hypertension on all-cause mortality and cardiovascular disease mortality in Mexican Americans. The San Antonio Heart Study. Am J Epidemiol 1996;44(11):1058-1065.
Quibrera-Infante R, Hernández-Rodríguez HG, Aradillas-García C, González-Rodríguez S, Calles-Escandón J. Prevalences of diabetes, glucose intolerance, hyperlipemia and risk factors as a function of socioeconomic level. Rev Invest Clin 1994;46(1):25-36.
Aguilar-Salinas CA, Rojas R, Gómez-Pérez FJ, Valles V, Ríos-Torres JM, Franco A, et al. High prevalence of metabolic syndrome in Mexico. Arch Med Res 2004;35(1):76-81.
Yamamoto-Kimura L, Zamora-González J, Huerta-Alvarado S, Fajardo-Gutiérrez A, Cardoso-Saldaña G, Posadas-Romero C. High blood pressure and cardiovascular risk factors in an adult population of Mexico City. Characteristics of the studied population. Arch Med Res 1996;27(2):213-222.
Aguilar-Salinas CA, Olaiz G, Valles V, Ríos-Torres JM, Gómez-Pérez FJ, Rull JA, et al. High prevalence of low HDL cholesterol concentrations and mixed hyperlipidemia in a Mexican nation-wide survey. J Lipid Res 2001;42(8):1298-1307.
Lara A, Rosas M, Pastelín G, Aguilar C, Attié F, Velázquez-Monroy O. Hypercholesterolemia and hypertension in Mexico: urban conjunctive consolidation with obesity, diabetes and smoking. Arch Cardiol Mex 2004;74(3):231-245. Spanish. Erratum in: Arch Cardiol Mex 2005;75(2):221.
Posadas-Romero C, Tapia-Conyer R, Lerman-Garber I, Zamora-González J, Cardoso-Saldaña G, Salvatierra-Izaba B, et al. Cholesterol levels and prevalence of hypercholesterolemia in a Mexican adult population. Atherosclerosis 1995;118(2):275-284.
Posadas-Romero C, Sepúlveda J, Tapia-Conyer R, Magos C, Cardoso-Saldaña G, Zamora-González J, et al. Values of serum cholesterol in the Mexican population. Salud Publica Mex 1992;34(2):157-167.
Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults. Executive summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 2001;285(19):2486-2497.
The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care 2003;26(Suppl 1):S5-S20.
The American Association of Clinical Endocrinologist (AACE) 2000. Lipid guidelines. Endocr Pract 2006:164-213.
Wood D, De Backer G, Faergeman O, Graham I, Mancia G, Pyorala K. Prevention of coronary heart diseases in clinical practice. Summary of recommendations of the Second Joint Task Force of European and other Societies on Coronary Prevention. Blood Press 1998;7(5-6):262-269.
McPherson R, Frohlich J, Fodor G, Genest J; Canadian Cardiovascular Society. Canadian Cardiovascular Society position statement —recommendations for the diagnosis and treatment of dyslipidemia and prevention of cardiovascular disease. Can J Cardiol 2006;22(11):913-97.
Farmer JA. Diabetic dyslipidemia and atherosclerosis: evidence from clinical trials. Curr Atheroscler Rep 2007;9(2):162-168.
National Heart Lung and Blood Institute. Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure. The JNC 7 Report. Disponible en http://www.nhlbi.nih.gov/guidelines/hypertension/jnc7full.pdf
Singh RB, Beegom R, Mehta AS, Niaz MA, De AK, Mitra RK, et al. Social class, coronary risk factors and undernutrition, a double burden of diseases, in women during transition, in five Indian cities. Int J Cardiol 1999;69(2):139-147.
Aguilar-Salinas CA, Huertas A, Tusi’r TM, Gómez-Pérez FJ, Rull JA Hiperlipidemia familiar combinada: caracterización en población mexicana. Rev End Nutr 2002;10(2):58-62.
Barquera S, Flores M, Olaiz-Fernández G, Monterrubio E, Villalpando S, Gonzalez C, et al. Dyslipidemias and obesity in México. Salud Publica Mex 2007;49(Suppl 3):S338-S347.
Windler E, Schöffauer M, Zyriax BC. The significance of low HDL-cholesterol levels in an ageing society at increased risk for cardiovascular disease. Diab Vasc Dis Res 200;47(2):136-142.
Goldbourt U, Yaari S, Medalie JH. Isolated low HDL cholesterol as a risk factor for coronary heart disease mortality: a 21-year follow-up of 8000 men. Arterioscler Thromb Vasc Biol 1997;17(1): 107-113.
Despres JP, Lemieux I, Dagenais GR, Cantin B, Lamarche B HDL-cholesterol as a marker of coronary heart disease risk: the Quebec Cardiovascular Study. Atherosclerosis 2000;153(2):263-272.
Gordon T, Castelli, WP, Hjartland, MC, Kannel, WD, Dawber, TR. High density lipoprotein as a protective factor against coronary artery disease. The Fram-ingham Study. Am J Med 1977;62(5):707-714.
Genest JJ, Martin-Munley, SS, McNamara, JR, Ordovas JM, Jenner J, Myers RH, et al. Familial lipoprotein disorders in patients with premature coronary artery disease. Circulation 1992;85(6):2025-2033.
Lipids and lipoproteins in symptomatic coronary heart disease. Distribution, intercorrelations, and significance for risk classification in 6,700 men and 1,500 women. The Bezafibrate Infarction Prevention (BIP) Study Group, Israel. Circulation 1992;86(3):839-848.
Instituto Nacional de Salud Pública. Encuesta Nacional de Salud y Nutrición 2006. Cuernavaca, México: Instituto Nacional de Salud Pública; 2006.
Lloyd-Jones D, Wilson P, Larson M, Leip E, Beiser A, et al. Lifetime risk of coronary heart disease by cholesterol levels at selected ages. Arch Intern Med 2003;163(16):1966-1972.
Robin-S, Bloomfield-Rubins H, Faas F, Schaefer E, Elam M, Anderson J, Collins D. Insuline resistance and cardiovascular events with low HDL cholesterol: the Veterans Affairs HDL Intervention Trial (VA-HIT). Diabetes Care 2003;268(5):1513-1517.
Aguilar-Salina C, Gómez-Diaz R, Gómez-Pérez FJ. Dislipidemias. De lo clínico a lo molecular: México: Intersistemas; 2008.
Enlaces refback
- No hay ningún enlace refback.