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Vol. 48. Núm. 6.
Páginas 166-173 (Junio 2001)
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Vol. 48. Núm. 6.
Páginas 166-173 (Junio 2001)
DOI: 10.1016/S1575-0922(01)74384-7
Acceso a texto completo
Factores de riesgo cardiovascular la obesidad
Cardiovascular risk factors in obesity
Visitas
2694
P. Matamorosa, M.A. Rubiob,*, J.A. Gutiérrezc, C. Fernándezd, En Representación Del Grupo De Estudio Epcum
a Servicios de Medicina Interna, Hospital Clínico Universitario San Carlos. Madrid
b Endocrinología y Nutrición. Hospital Clínico Universitario San Carlos. Madrid
c Unidades de Lípidos e Hospital Clínico Universitario San Carlos. Madrid
d Investigación Clínico-Epidemiológica (Servicio de Medicina Preventiva). Hospital Clínico Universitario San Carlos. Madrid
En Representación Del Grupo De Estudio Epcum
(Servicio de Medicina Preventiva). Hospital Clínico Universitario San Carlos. Madrid
Este artículo ha recibido
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Información del artículo
Fundamento

Se describe la relación entre diferentes factores de riesgo cardiovasculares (FRVC) y la obesidad a partir de una muestra representativa de la población adulta de Madrid.

Sujetos y metodos

Un total de 946 sujetos, de 20–59 anos y ambos sexos, seleccionados aleatoriamente a partir del padron municipal, participaron en este estudio epidemiologico. Se les determinaron los siguientes parametros: peso, talla, calculo del indice de masa corporal (IMC), presion arterial (PA), glucemia, colesterol total (CT), cHDL, trigliceridos (TG), cLDL, apoproteinas AI y B100, Lp(a), factor VII y fibrinogeno. Se determinaron las prevalencias globales para cada FRCV en funcion de las categorias de sobrepeso (IMC, 25–29,9 kg/m2) y obesidad (IMC ≥ 30 kg/m2) o segun la distribucion por cuartiles (Q) de IMC. Se estimo por analisis de regresion lineal univariante la variacion de cada FRCV por cada unidad de incremento del IMC. Mediante un analisis de regresion logistica se determino las odds ratio ajustadas (ORaj) de cada una de las variables asociadas a los FRCV y la presencia de obesidad.

Resultados

La comparacion entre el Q4 y el Q1 del IMC demuestra un aumento significativo (p < 0,001) de todos los FRCV evaluados (el cHDL disminuye). El aumento del IMC en 1 kg/m2 implica los siguientes aumentos: CT en 3 mg/dl, TG 6,1 mg/dl, cLDL 2,4 mg/dl, fibrinogeno 4,7 mg/dl, factor VII 2,8 mg/dl, PAS 2,1 mmHg y PAD 1,5 mmHg. Las prevalencias de los FRCV en obesos frente a aquellos con normopeso (p < 0,0001) fueron: CT ≥ 200 mg/dl, 70,4 frente a 43,5%; TG ≥ 200 mg/dl, 16,9 frente a 3,9; cHDL < 35 mg/dl, 13,6 frente a 7,9%; PAS ≥ 140 mmHg, 34,7 frente a 7,8%; PAD ≥ 90 mmHg, 35,6 frente a 5,9%, y diabetes, 7,5 frente a 1,8%. Las ORaj (p < 0,001) para la categoria de sobrepeso fueron: CT ≥ 200 mg/dl, 2,12; cHDL < 35 mg/dl, 0,59; diabetes, 1,17, y PAD ≥ 90 mmHg, 3,7. En la categoria de obesidad se pierde la asociacion con el cHDL y la diabetes, pero aparece la de TG 200–400 mg/dl, con una ORaj de 6,7; TG > 400 mg/dl, 37,5, y la de la PAS ≥ 140 mmHg, 2,6.

Conclusiones

La obesidad se asocia a una alta prevalencia de FRCV, incrementando significativamente la morbilidad cardiovascular potencial.

Palabras clave:
Obesidad
Sobrepeso
Factores de riesgo cardiovasculares
Epidemiología
Background

The relationship among different cardiovascular risk factors (CVRF) and obesity is described in a representative sample of the adult population of Madrid.

Subjects and methods

946 subjects, 20–59 years old and both sexes, randomly selected from the municipal census, participated in this epidemiological survey. Weight and height, body mass index (BMI), blood pressure (BP), glycemia, total cholesterol (TC), HDL-c, triglycerides (TG), LDL-c apoprotein AI and B100, Lp(a), factor VII and fibrinogen were determined. Global prevalences were determined for each CVRF in the categories of overweight (IMC 25–29,9 kg/m2) and obesity (IMC ≥ 30 kg/m2) or according to the distribution for quartiles (Q) of BMI. In a lineal regression analysis, the variation of each CVRF for each unit of increment of the BMI was calculated. By means of an analysis of logistic regression, the adjusted odds ratio (OR) of each one of the variables associated to the CVRF and the presence of obesity was determined.

Results

The comparison Q4 vs Q1 of the BMI shows a significant increase (p < 0,001) of all the evaluated CVRF (HDL-c decreased). A kg/m2 increase in BMI implies an increase of the CT in 3 mg/dl, of TG in 6,1 mg/dl, of LDL-c in 2,4 mg/dl, of fibrinogen 4,7 mg/dl, of Fc. VII in 2,8 mg/dl, of SP in 2,1 mmHg and of DP in 1,5 mmHg. The prevalence of the CVRF in obese vs normal weight subjects (p < 0,0001) were: TC ≥ 200 mg/dl 70,4 vs 43,5%; TG ≥ 200: 16,9 vs 3,9%; HDL-c < 35 mg/dl: 13,6 vs 7,9%, SBP ≥ 140 mmHg: 34,7 vs 7,8%, DBP ≥ 90 mmHg: 35,6 vs 5,9%, diabetes: 7,5 vs 1,8%. The adjusted OR (p < 0,001) in the category of overweight were TC ≥ 200 mg/dl: 2,12; HDL-c < 35 mg/dl: 0,59: diabetes: 1,17 and DP ≥ 90 mmHg: 3,7. In the caterogy of obesity the association with the HDL-c and diabetes was lost; but new ones appear: TG 200-400 mg/dl, with an OR 6,7; TG > 400 mg/dl, OR 37,5 and SBP ≥ 140 mmHg, OR 2,6.

Conclusions

Obesity is associated wiser a high prevalence of CVRF, increasing significantly the potential for cardiovascular morbidity.

Key words:
Obesity
Overweight
Cardiovascular risk factors
Epidemiology
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