Background. Cardiovascular disease (CVD) is the most prevalent cause of death from disease and disability in the world. Reliable markers are needed to assess and reduce cardiovascular risk. This study aimed to determine if insulin resistance indexes, triglycerides to HDL-cholesterol ratio (TG/HDL-C), and triglyceride glucose index (TyG) are biomarkers for lifetime cardiovascular risk (CVR). Methods. This analytical cross-sectional study was performed on health personnel from Huaycan Hospital in Peru. The QRISK model was used to measure lifetime CVR. The association and diagnostic accuracy for TyG calculated as Ln (TG (mg/dL) × glucose (mg/dL)/2) and TG/HDL-C ratio were determined using Poisson regression models and ROC curves with Youden index. Results. In total, 291 adults (207 women and 84 men) were analyzed. In the adjusted Poisson models, each unit of TG/HDL-C increased 1.22-fold and 1.16-fold the probability of high lifetime CVR in men and women, respectively. However, each unit of TyG increased 1.98-fold in men and 3.25-fold in women the probability of high lifetime CVR. The optimal cutoff values of TG/HDL-C were 2.64 (AUC: 0.77), 3.90 (AUC: 0.80), and 2.64 (AUC: 0.74) for the overall population, men, and women, respectively. Likewise, the optimal cutoff values of TyG were 9.04 (AUC: 0.80), 8.95 (AUC: 0.79), and 9.04 (AUC: 0.80) for the overall population, men, and women, respectively. Conclusion. TG/HDL-C and TyG presented a significant association with lifetime CVR. However, TyG presented a stronger association than TG/HDL-C. Both TG/HDL-C and TyG are shown to be reliable markers for CVR in adults.
Background: The measures taken to contain the COVID-19 pandemic, led to significant changes in university education, resulting in the new normal standard of virtual teaching in many undergraduate medical schools worldwide. Therefore, the aim of this paper was to determine the factors related to academic satisfaction with virtual teaching in medical students during the COVID-19 pandemic. Methods: A cross-sectional-analytical study was conducted on medical students at a private university in Peru, through self-reported questionnaires divided into sociodemographic data and variables of interest that could influence academic satisfaction during the pandemic. To evaluate possible factors related to academic satisfaction, stepwise regression models were performed for both sexes. Results: In total, data from 310 medical students, 117 males and 193 females, were analyzed. Academic satisfaction reached a score of 11.2 ± 2.9, which was similar in both sexes. The best regression model for males (AIC: 544.32; RMSE: 2.42; R2: 0.30) showed that adaptation to university life (favorable change) and depression (unfavorable change) explained 30% of changes in students' academic satisfaction. While in females (AIC: 907.59; RMSE: 2.49; R 2: 0.22) the model integrated favorable factors such as adjustment to college life and anxiety; while depression and poor sleep quality were unfavorable factors. Conclusion: Factors that contributed to academic satisfaction in medical students were determined in this study, which differed by gender. Thus, it is important to take into account the particularities of male and female medical students in order to improve their academic satisfaction during their university careers.
This systematic review aimed to evaluate metabolic syndrome as a risk factor for the development of peripheral arterial disease (PAD). We searched in four databases: (1) PubMed, (2) Web of Science, (3) Scopus, and (4) Embase until March 2021. We included cohort studies that evaluated the risk of PAD in patients with and without metabolic syndrome. Study selection, data extraction, and risk of bias analysis were performed independently by 2 authors. We used a random-effects model to conduct a meta-analysis of effect measures [hazard ratio (HR), risk ratio (RR), and odds ratio (OR)]. Individual analyses were performed according to the diagnostic criterion used for metabolic syndrome. We included 7 cohort studies with a total of 43 824 participants. Most of the studies were performed in the general adult population. The metabolic syndrome and PAD diagnostic criteria used in the individual studies were heterogeneous. Almost all studies using RR found an association between metabolic syndrome and the development of PAD (RR: 1.31; confidence interval 95%: 1.03-1.59; I 2 : 15.6%). On the other hand, almost all the studies that used HR found no association between the two variables. All studies had a low risk of bias. In conclusion, available evidence on the association between metabolic syndrome and the risk of developing PAD is inconsistent. However, given the high prevalence of risk factors that patients with metabolic syndrome have, testing to rule out PAD could be recommended. Future studies should analyze each component of the metabolic syndrome separately and according to the severity of PAD.
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