Carlos Morillas Ariño

Síndrome metabólico en pacientes con cardiopatía isquémica. Resultados obtenidos con la utilización de diferentes criterios

Carecemos de un criterio unico para definir el sindrome metabolico, considerado como aglutinador del riesgo cardiovascular. Con objeto de comparar su prevalencia en pacientes con cardiopatia isquemica, utilizando los criterios del Grupo Europeo de Resistencia a la Insulina y los del National Colesterol Education Program, se diseno un estudio observacional, transversal, de los factores integrantes del sindrome metabolico en pacientes con cardiopatia isquemica. Se estudio a 169 pacientes (129 varones y 40 mujeres) con edades entre 35 y 79 anos. La prevalencia del sindrome metabolico con los criterios del grupo europeo fue del 43,7% y con los del grupo americano, del 40,8% (sin diferencias significativas). La prevalencia del sindrome metabolico entre pacientes con cardiopatia isquemica es elevada. Los criterios diagnosticos utilizados son similares y sin diferencias significativas entre ellos, aunque la concordancia diagnostica fue del 50%.

Factores de riesgo cardiovascular en pacientes con obesidad mórbida: influencia de la pérdida de peso

Fundamento Analizar la presencia de factores de riesgo cardiovascular (FRCV) en pacientes conobesidad morbida y la influencia de la reduccion ponderal mediante intervencion dietetica sobreestos FRCV. Asimismo, valorar la influencia del sexo en la presencia de FRCV y en la respuestaa la intervencion dietetica. Pacientes y metodo A todos los pacientes con obesidad morbida (23 varones y 36 mujeres) seles efectuo una valoracion antropometrica y de los FRCV (fibrinogeno, presion arterial, estudiodel metabolismo hidrocarbonado mediante la realizacion de sobrecarga oral de glucosa, perfillipidico completo, presencia de sindrome de apneas del sueno), antes y despues de una intervenciondietetica alternando dietas de muy bajo contenido calorico con dietas hipocaloricasconvencionales. Se compararon los resultados antes y despues de la intervencion dietetica mediantela prueba de la t de Student para muestras apareadas (tras comprobar que se cumplianlas condiciones de aplicacion). Resultados Se consiguio una reduccion ponderal muy significativa, principalmente en varones(reduccion de 33,4 kg; intervalo de confianza (IC) del 95%, 26,9-39,8), que se acompano deuna reduccion de los FRCV asociados, especialmente en el sexo masculino, en el que mejorode forma significativa la distribucion de grasa (reduccion de cintura de 24,8 cm; IC del 95%,18,4-36,5) y el perfil lipidico: trigliceridos (IC del 95%, 25,4-90), colesterol HDL y apoproteinaB100. Conclusiones En pacientes con obesidad morbida existe una elevada presencia de FRCV asociados.Con la reduccion ponderal obtenida mediante intervencion dietetica durante un ano hemosconseguido una reduccion significativa de los mismos. Esta mejoria es especialmente importanteen los varones.BACKGROUND: We studied the presence of cardiovascular risk factors in patients with morbid obesity and analyzed the influence of weight loss achieved through diet on these factors. We also evaluated the influence of gender on the presence of cardiovascular risk factors and on its response to diet. PATIENTS AND METHODS: An anthropometric evaluation was performed in patients with morbid obesity (23 men and 36 women). The presence of cardiovascular risk factors was evaluated (fibrinogen, blood pressure, glucose metabolism determination by means of oral glucose tolerance test, complete lipid profile, sleep apnea syndrome), before and after following, on an alternative fashion, very-low calorie and low-calorie diets. The comparison was made with the t-test for paired samples. RESULTS: A very significant weight loss was achieved in our patients, particularly in men (decrease of 33.4 kg, 95% CI: 26.9 to 39.8). This was accompanied by a reduction in the presence of cardiovascular risk factors, particularly in men, in whom the body fat distribution improved significantly (decrease in waist: 24.8 cm, 95% CI 18.4 to 36.5), as well as the lipid profile including triglycerides, VLDLc, HDLc and B100 apoprotein. CONCLUSIONS: Patients with morbid obesity have a high prevalence of cardiovascular risk factors. A significant reduction of this prevalence can be achieved with diet during one year. This improvement is particularly significant in men.

Metabolic Syndrome in Patients With Coronary Heart Disease. Results of Using Different Diagnostic Criteria

A unified definition of metabolic syndrome, considered a common feature of cardiovascular risk, is lacking. The aim of this study was to compare the prevalence of this syndrome in patients with ischemic heart disease using two diagnostic criteria: the European Group of Resistance to Insulin and the National Cholesterol Education Program. We designed an observational, crosssectional study of the factors that make up metabolic syndrome in subjects diagnosed with coronary heart disease. A total of 169 patients aged 35 to 79 years were studied (129 men and 40 women). With the European group criterion the percentage of patients with metabolic syndrome was 43.7%, whereas the American group criterion yielded a prevalence of 40.8% (no significant difference). The prevalence of metabolic syndrome among patients with ischemic heart disease is high. The diagnostic criteria used are similar and do not differ significantly, although diagnostic concordance was only 50%.

A syndrome of sleep apnea in morbid obesity

Received: May 26, 2017; Accepted: June 23, 2017; Published: June 26, 2017 Abbreviations : NP: nocturnal pulse oximetry, BMI: body mass index, ESS: Epworth sleepiness scale, SBP: Systolic blood pressure (mmHg), DAP: Diastolic blood pressure (mmHg), LM: Lean mass (Kg), FM: Fat mass (Kg), % BF: Percentage of body fat, Glyc: Basal glycemia (mg/dl), Ins: Basal Insulin (IU), Chol: Cholesterol (mg/dl), Tgc: Triglycerides (mg/dl), DLCO: Diffusion of CO (%), KCO: DLCO/ alveolar ventilation (%), PIM: Inspiratory mouth pressure at residual volume (cm H2O), PEM: Expiratory pressure in the mouth at total lung capacity (cmH2O), PO2 and PCO2: Partial pressures in arterial blood of O2 and CO2 (mmHg), SO2: O2 arterial saturation (%), Neck: perimeter of neck (cm),W/H: waist/hip index, LM: Lean mass (Kg), % BF: Percentage of body fat (%), FVC: forced vital capacity (%), FEV1: Forced expiratory volume in the first second (%), TLC: Total lung capacity (%), FRC: Functional residual capacity (%), RV: Residual volume (%), PO2: Blood pressure of oxygen (mmHg), PCO2: Blood pressure of carbon dioxide (mmHg), SO2: arterial oxygen saturation (%), Min SO2: Minimum night oxygen saturation (%), Noct SO2: Basal nocturnal oxygen saturation (%), ODI: Number of nocturnal oxygen desaturations greater than 4% per hour, Insp Pres: Continuous inspiratory pressure in the airway (cm H2O), Expi Pres: Continuous expiratory pressure in the airway (cmH2O). Introduction