Impacto de las nuevas definiciones en la prevalencia del síndrome metabólico en una población adulta de Bucaramanga, Colombia
Palabras clave:
coronariopatía, resistencia a la insulina, obesidad, diagnóstico
Resumen
Introducción. La prevalencia de síndrome metabólico depende de los criterios de clasificación empleados, como son los de la International Diabetes Federation y el Adult Treatment Panel o su modificación.Objetivo. Comparar la prevalencia del síndrome metabólico generada por cada una de las tres definiciones en una población de adultos.
Materiales y métodos. Se estudiaron 155 personas (54,2% varones, edad promedio de 40,9 años). Se aplicaron las tres definiciones y se comparó la prevalencia con la prueba de Wilcoxon y la concordancia con kappa de Cohen.
Resultados. La prevalencia de síndrome metabólico según el Adult Treatment Panel-III (ATPIII) fue 12,3% (IC95% 7,5-18,5), según el Adult Treatment Panel-IIIa (ATP-IIIa), 34,8% (IC95% 27,4-42,9) y según la International Diabetes Federation (IDF), 32,9% (IC95% 25,6-40,9). La prevalencia por ATP-III es inferior a la vista por ATP-IIIa e IDF (p<0,001), pero entre estas dos últimas es similar (p=0,083). Hay pobre concordancia entre ATP-III y ATP-IIIa (k=0,414, IC95% 0,409-0,420), y entre ATP-III e IDF (k=0,374, IC95% 0,368-0,379), pero muy buena entre ATPIIIa e IDF (k=0,957, IC95% 0,950-0,963).
Conclusión. Las nuevas definiciones para el síndrome metabólico (ATP-IIIa e IDF) aumentan tres veces la prevalencia del diagnóstico, sin encontrar diferencias entre ellas, a pesar de que la última organización incluye la obesidad central como un criterio necesario para el diagnóstico, cuando en la primera no se hace igual ponderación.
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la Salud; 2000.
2. Cubillos-Garzón LA, Casas JP, Morillo CA, Bautista LE. Congestive heart failure in Latin America: the next epidemic. Am Heart J. 2004;147:412-7.
3. Pearson TA. Cardiovascular disease in developing countries: myths, realities, and opportunities. Cardiovasc Drugs Ther. 1999;13:95-104.
4. Isomaa B, Almgren P, Tuomi T, Forsen B, Lahti K, Nissen M, et al. Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care. 2001;24:683-9.
5. Sattar N, Gaw A, Scherbakova O, Ford I, O'Reilly DS, Haffner SM, et al. Metabolic syndrome with and without C-reactive protein as a predictor of coronary heart disease and diabetes in the West of Scotland Coronary Prevention Study. Circulation. 2003;108:414-9.
6. Ridker PM, Buring JE, Cook NR, Rifai N. C-reactive protein, the metabolic syndrome, and risk of incident cardiovascular events: an 8-year follow-up of 14719 initially healthy American women. Circulation. 2003;107:391-7.
7. Bautista LE, Morillo CA, Casas JP, Arenas IA, Ardila E. Estudio global de casos y controles para identificar factores de riesgo para infarto agudo del miocardio in diferentes poblaciones étnicas. INTERHEARTColombia. Reporte técnico. Bogotá D.C: Colciencias; 2002.
8. Haffner SM, D'Agostino R, Saad MF, Rewers M, Mykkanen L, Selby J, et al. Increased insulin resistance and insulin secretion in nondiabetic African-Americans and Hispanics compared with non-hispanic whites. The Insulin Resistance Atherosclerosis Study. Diabetes. 1996;45:742-8.
9. Han TS, Sattar N, Williams K, Gonzalez-Villalpando C, Lean ME, Haffner SM. Prospective study of Creactive protein in relation to the development of diabetes and metabolic syndrome in the Mexico City Diabetes Study. Diabetes Care. 2002;25:2016-21.
10. 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;285:2486-97.
11. Ford E, Giles W, Dietz W. Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey. JAMA. 2002;287:356-9.
12. Aschner P. Diabetes trends in Latin America. Diabetes Metab Res Rev. 2002; 18 (Suppl 3):S27-31.
13. Villegas A, Botero LF. Prevalencia de síndrome metabólico en la población de El Retiro. Rev ALAD. 2004;12:20.
14. Flórez H, Silva E, Fernández V, Ryder E, Sulbarán T, Campos G, et al. Prevalence and risk factors associated with the metabolic syndrome and dyslipidemia in White, Black, Amerindian and Mixed Hispanics in Zulia State, Venezuela. Diabetes Res Clin Pract. 2005;69:63-77.
15. Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, et al. Diagnosis and management of the metabolic syndrome. An American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation. 2005;112:2735-52.
16. Alberti KG, Zimmet P, Shaw J. Metabolic syndrome - a new world-wide definition. A Consensus Statement from the International Diabetes Federation. Diabet Med. 2006;23:469-80.
17. Pickering TG. For the American Society of Hypertension Ad Hoc Panel. Recommendations for the use of Home (Self) and Ambulatory Blood Pressure Monitoring. Am J Hypertens. 1996;9:1-12.
18. Marks GC, Habickt JP, Mueller WH. Reliability, dependability, and precision of anthropometric measurements, The Second National Health and Nutrition Examination Survey 1976-1980. Am J
Epidemiol. 1989;130:578-87.
19. Wilcoxon F. Individual comparisons by ranking methods. Biometrics. 1945;1:80-3.
20. Cohen J. A coefficient of agreement for nominal scales. Educ Psychol Measur. 1960;20:37-46.
21. StataCorp. Stata statistical software: release 9,2. College Station: StataCorp LP; 2005.
22. Kahn R, Buse J, Ferrannini E, Stern M, American Diabetes Association, European Association for the Study of Diabetes. The metabolic syndrome: Time for a critical appraisal: joint statement from the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care. 2005;28:2289-304.
23. Matsuzawa Y, Funahashi T, Kihara S, Shimomura I. Adiponectin and metabolic syndrome. Arterioscler Thromb Vasc Biol 2004;24:29-33.
24. Karter AJ, D'Agostino RB Jr, Mayer-Davis EJ, Wagenknecht LE, Hanley AJ, Hamman RF, et al. Abdominal obesity predicts declining insulin sensitivity in nonobese diabetes. Obes Metabolism. 2005;7:230-8.
25. Perez M, Casas JP, Cubillos-Garzon LA, Serrano NC, Silva F, Morillo CA, et al. Using waist circumference as a screening tool to identify Colombian subjects at cardiovascular risk. Eur J Cardiovasc Prev Rehabil. 2003;10:328-35.
26. Lorenzo C, Serrano-Rios M, Martínez-Larrad MT, Gabriel R, Williams K, Gómez-Gerique JA, et al. Central adiposity determines prevalence differences of the metabolic syndrome. Obes Res 2003;11:1480-7.
27. Mendivil C, Sierra I, Pérez C. Valoración del riesgo cardiovascular global y prevalencia de dislipemias según los criterios del NCEP-ATPIII en una población adulta de Bogotá, Colombia. Clin Invest Arterioscl. 2004;16:99-107
28. Guerrero-Romero F, Rodríguez-Morán M. Concordance between the 2005 International Diabetes Federation Definition for Diagnosing Metabolic Syndrome With the National Cholesterol Education Program Adult Treatment Panel III and the World Health Organization definitions. Diabetes Care. 2005;28:2588-9.
29. Ford ES. Prevalence of the metabolic syndrome defined by the International Diabetes Federation among adults in the U.S. Diabetes Care. 2005;28:2745-9.
30. Adams RJ, Appleton S, Wilson DH, Taylor AW, Dal Grande E, Chittleborough C, et al. Population comparison of two clinical approaches to the metabolic syndrome implications of the new International Diabetes Federation consensus definition. Diabetes Care. 2005;28:2777-9.
31. Carnethon MR, Loria CM, Hill JO, Sidney S, Savage P, Liu K. Risk factors for the metabolic syndrome: The Coronary Artery Risk Development in Young Adults (CARDIA) study, 1985-2001. Diabetes Care. 2004;27:2707-15.
Cómo citar
1.
Pinzón JB, Serrano NC, Díaz LA, Mantilla G, Velasco HM, Martínez LX, et al. Impacto de las nuevas definiciones en la prevalencia del síndrome metabólico en una población adulta de Bucaramanga, Colombia. biomedica [Internet]. 1 de junio de 2007 [citado 26 de abril de 2024];27(2):172-9. Disponible en: https://revistabiomedica.org/index.php/biomedica/article/view/213
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