Optimal Definitions for Abdominal Obesity and the Metabolic Syndrome in Andean Hispanics: The PREVENCION Study

Medina‐Lezama, Josefina; Pastorius, Catherine A.; Zea‐Diaz, Humberto; Bernabé‐Ortiz, Antonio; Corrales-Medina, Fernando F.; Morey-Vargas, Oscar L.; Chirinos, Diana A.; Muñoz-Atahualpa, Edgar; Chirinos-Pacheco, Julio; Chirinos, Julio A.

doi:10.2337/dc09-2353

Cited by 41 publications

(41 citation statements)

References 11 publications

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“…We studied 1639 adults aged 18 to 80 years enrolled in the PREVENCION (Estudio Peruano de Prevalencia de Enfermedades Cardiovasculares, for Peruvian Study of the Prevalence of Cardiovascular diseases) study 8, 9, 10, 11, 12, 13, 14. PREVENCION is a study undertaken in Arequipa, the second largest city in Peru, which occurred in 2 phases: the first phase, which focused on population‐based prevalence estimates of cardiovascular disease/risk factors, and the second phase, which focused on increasing the sample size for prospective analyses regarding the relationship between baseline cardiovascular phenotypes and mortality.…”

Section: Methodsmentioning

confidence: 99%

Hemodynamic Patterns Identified by Impedance Cardiography Predict Mortality in the General Population: The PREVENCION Study

Medina‐Lezama

Narvaez‐Guerra

Herrera‐Enriquez

et al. 2018

JAHA

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BackgroundBlood pressure is determined by the interactions between the heart and arterial properties, and subjects with identical blood pressure may have substantially different hemodynamic determinants. Whether arterial hemodynamic indices quantified by impedance cardiography (ICG), a simple operator‐independent office procedure, independently predict all‐cause mortality in adults from the general population, and specifically among those who do not meet criteria for American College of Cardiology/American Heart Association stage 2 hypertension, is currently unknown.Methods and ResultsWe studied 1639 adults aged 18 to 80 years from the general population. We used ICG to measure hemodynamic parameters and metrics of cardiac function. We assessed the relationship between hemodynamic parameters measured at baseline and all‐cause mortality over a mean follow‐up of 10.9 years. Several ICG parameters predicted death. The strongest predictors were total arterial compliance index (standardized hazard ratio=0.38; 95% confidence interval=0.31–0.46; P<0.0001) and indices of cardiac contractility: velocity index (standardized hazard ratio=0.45; 95% confidence interval=0.37–0.55; P<0.0001) and acceleration index (standardized hazard ratio=0.44; 95% confidence interval=0.35–0.55; P<0.0001). These remained independently predictive of death after adjustment for multiple confounders, as well as systolic and diastolic blood pressure. Among subjects without stage 2 hypertension (n=1563), indices of cardiac contractility were independently predictive of death and identified a subpopulation (25% of non‐stage‐2 hypertensives) that demonstrated a high 10‐year mortality risk, equivalent to that of stage 2 hypertensives.ConclusionsHemodynamic patterns identified by ICG independently predict mortality in the general population. The predictive value of ICG applies even in the absence of American College of Cardiology/American Heart Association stage 2 hypertension and identifies higher‐risk individuals who are in earlier stages of the hypertension continuum.

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Section: Methodsmentioning

confidence: 99%

Hemodynamic Patterns Identified by Impedance Cardiography Predict Mortality in the General Population: The PREVENCION Study

Medina‐Lezama

Narvaez‐Guerra

Herrera‐Enriquez

et al. 2018

JAHA

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“…Results from other Hispanic subgroups are still scarce; however, recently published (and ongoing) studies are providing important data regarding the prevalence and patterns of metabolic syndrome in different Hispanic subgroups, including those from Andean countries. Results from our group, [18][19][20][21][22][23] and other large epidemiological studies conducted in Venezuela, 10 Chile, 24 and Colombia, 25 have provided evidence of a different phenotypic pattern of the metabolic syndrome among Andean Hispanics. This pattern is characterized by a high prevalence of abdominal obesity and dyslipidemia, with low HDL-C levels being particularly prevalent in women and hypertriglyceridemia being particularly prevalent in men.…”

Section: Introductionmentioning

confidence: 93%

Metabolic Syndrome As an Underlying Disease Entity and Its Relationship to Subclinical Atherosclerosis in Andean Hispanics

Chirinos

Medina‐Lezama

Argüelles

et al. 2014

Metabolic Syndrome and Related Disorders

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Background: The question of whether the metabolic syndrome truly reflects a single disease entity with a common underlying pathology remains unclear. In this study, we assess whether metabolic syndrome represents an underlying disease construct in a large population-based sample of Andean Hispanic adults and examine its relationship to subclinical atherosclerosis. Methods: The study sample was comprised of 2513 participants. Confirmatory factor analysis (CFA) was used to identify a metabolic syndrome latent factor using waist circumference, systolic and diastolic blood pressure, high-density lipoprotein cholesterol (HDL-C), triglycerides (TGs), and glucose levels as indicators. The relationship with subclinical atherosclerosis, measured by carotid intima media thickness (cIMT), was assessed using structural equation modeling. Results: Results supported the proposed structure of the metabolic syndrome latent factor evidenced by adequate fit indexes. HDL-C did not significantly load on the metabolic syndrome latent factor (standardized factor loading = 0.01, P = 0.88). The metabolic syndrome latent factor was significantly associated with cIMT in women (B = 0.007, P < 0.001) and men (B = 0.008, P < 0.001) after controlling for age, low-density lipoprotein cholesterol and smoking. Conclusions: Our findings suggest that metabolic syndrome components, such as waist circumference, blood pressure, TGs, and glucose levels, but not HDL-C, share a common underlying pathophysiology that may contribute to the progression of atherosclerosis in Andean Hispanics. Its longitudinal association with cardiovascular disease should be the focus of future research.

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“…Para evaluar el ti po y magnitud de la obesidad, el índice de masa corporal (IMC) o índice de Quetelet y la medición de la circunferencia abdominal (CA) son los instrumentos antropométricos más apropiados (3) (tabla 1). En relación a la CA, tomamos en cuenta el trabajo nacional de Medina-Lezama y col. que establece como medidas de corte normal 97 cm para varones y 87 cm para las mujeres (4) , por encima de las cuales se defi ne como obesidad central.…”

Section: Introductionunclassified

Obesidad y dislipoproteinemia

Garmendia

2017

An Fac med

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Resumen En esta revisión se define la obesidad, sus causas generales, cuantificación y distribución corporal. Se hace una revisión general de la bioquímica de las fracciones lipoproteicas de la sangre, así como la forma de realizar el diagnóstico de las dislipoproteinemias. La dislipoproteinemia de la obesidad es una forma secundaria a la resistencia a la insulina y disminución de la actividad de la lipasa lipoproteica, con elevación de los triglicéridos, disminuye el colesterol HDL y se constituye el síndrome metabólico. Se describe su fisiopatología, así como el desarrollo de las morbilidades conexas. Se caracteriza la dislipoproteinemia de la obesidad no solo en condiciones basales sino también en el período posprandial. Se intenta estimar la prevalencia de dislipoproteinemia en la obesidad. Se delinea el tratamiento de la obesidad y de la dislipoproteinemia, considerando el cambio de estilo de vida mediante el régimen alimenticio y la actividad física, la farmacoterapia y la cirugía bariátrica, así como el uso de hipolipemiantes. Palabras clave: Obesidad; Dislipoproteinemia; Resistencia a la Insulina. Abstract The definition, main general causes, quantification and body distribution of obesity are described. A general review of the different blood lipoprotein fractions as well as the procedure for the diagnosis of dyslipoproteinemia is done. Dyslipoproteinemia of obesity is a secondary form of insulin resistance as a result of lowering of lipoprotein lipase activity resulting in increase of triglycerides, decrease of HDL cholesterol, and establishment of the metabolic syndrome. Its pathophysiology and the development of obesity related morbidities are described. Dyslipoproteinemia of obesity is present in both the basal and postprandial status. An attempt is made to estimate the prevalence of dyslipoproteinemia. Treatment is outlined and includes change in lifestyle regarding diet and physical activity, pharmacotherapy, and bariatric surgery, as well as the hypolipidemic treatment.

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Optimal Definitions for Abdominal Obesity and the Metabolic Syndrome in Andean Hispanics: The PREVENCION Study

Cited by 41 publications

References 11 publications

Hemodynamic Patterns Identified by Impedance Cardiography Predict Mortality in the General Population: The PREVENCION Study

Hemodynamic Patterns Identified by Impedance Cardiography Predict Mortality in the General Population: The PREVENCION Study

Metabolic Syndrome As an Underlying Disease Entity and Its Relationship to Subclinical Atherosclerosis in Andean Hispanics

Obesidad y dislipoproteinemia

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