Luis Lozano

Síndrome metabólico en España: prevalencia y riesgo coronario asociado a la definición armonizada y a la propuesta por la OMS. Estudio DARIOS

INTRODUCTION AND OBJECTIVES To update the prevalence of metabolic syndrome and associated coronary risk in Spain, using the harmonized definition and the new World Health Organization proposal (metabolic premorbid syndrome), which excludes diabetes mellitus and cardiovascular disease. METHODS Individual data pooled analysis study of 24,670 individuals from 10 autonomous communities aged 35 to 74 years. Coronary risk was estimated using the REGICOR function. RESULTS Prevalence of metabolic syndrome was 31% (women 29% [95% confidence interval, 25%-33%], men 32% [95% confidence interval, 29%-35%]). High blood glucose (P=.019) and triglycerides (P<.001) were more frequent in men with metabolic syndrome, but abdominal obesity (P<.001) and low high-density lipoprotein cholesterol (P=.001) predominated in women. Individuals with metabolic syndrome showed moderate coronary risk (8% men, 5% women), although values were higher (P<.001) than in the population without the syndrome (4% men, 2% women). Women and men with metabolic syndrome had 2.5 and 2 times higher levels of coronary risk, respectively (P<.001). Prevalence of metabolic premorbid syndrome was 24% and the increase in coronary risk was also proportionately larger in women than in men (2 vs 1.5, respectively; P<.001). CONCLUSIONS Prevalence of metabolic syndrome is 31%; metabolic premorbid syndrome lowers this prevalence to 24% and delimits the population for primary prevention. The increase in coronary risk is proportionally larger in women, in both metabolic syndrome and metabolic premorbid syndrome.

Prevalence of left-ventricular hypertrophy by multiple electrocardiographic criteria in general population: Hermex study.

Objectives: To determine the prevalence of left-ventricular hypertrophy (LVH) in the general population by means of multiple electrocardiographic criteria and those variables independently associated. Methods: Random-sample cross-sectional study of the general population aged between 25 and 79 years, representative of a health area, was conducted. An electrocardiogram was recorded ‘on line’ in the Electropres project website; 17 LVH criteria together with two combined criteria were used. By multivariate analysis we examined those variables independently associated with the presence of electrocardiographic LVH. Results: We recruited 2564 individuals, mean age 50.9 [standard deviation (SD) 14.7] years, 45.7% men. The criteria more prevalent were: Dalfó 19.4%, RV6/V5 14.5%, Perugia 10.9%, any combination with at least three positive criteria (Combined 3) 9.4%, Romhilt 7.5%, Lewis 6.2% and the recommended criteria of the European Society of Hypertension 4%. The best prevalence ratio between hypertensive and normotensive individuals was achieved with Lewis, Dalfó and Perugia criteria. The least prevalence was Sokolow 0.7%. The variables that were independently associated with the presence of LVH by Combined 3 criterion were pulse pressure at least 50 [odds ratio (OR) 2.13, 95% confidence interval (CI) 1.47–3.09], arterial hypertension (OR 1.75, 95% CI 1.21–2.53) and smoking (OR 0.69, 95% CI 0.50–0.95). Conclusions: The detection ability of the electrocardiogram with regard to the LVH may improve with the use of other criteria than those currently recommended by the guidelines. The presence of LVH is positively associated with hypertension and elevated pulse pressure and negatively with a history of smoking.

Prevalence of abnormal urinary albumin excretion in a population‐based study in Spain: results from the HERMEX Study

Eur J Clin Invest 2012; 42 (12): 1272–1277

Prevalence of metabolic syndrome estimated with the new World Health Organization recommendations: The HERMEX study

OBJECTIVES The unification of criteria for the diagnosis of metabolic syndrome, together with the subsequent World Health Organization (WHO) proposal to eliminate diabetes and cardiovascular diseases from the diagnostic criteria, will change estimates of the known prevalence of this syndrome. The aim of this study was to determine the prevalence of metabolic syndrome in a health area of Badajoz (Spain) using the latest consensus criteria and eliminating diabetes and cardiovascular disease. METHODS We performed a cross-sectional population-wide study of randomly selected individuals aged between 25 and 79 years old in a health area of Badajoz. In all patients, data on their history of cardiovascular risk factors were gathered, waist circumference and blood pressure were measured and a fasting blood sample was collected. The prevalence of metabolic syndrome, following recent criteria, was compared by age and gender. RESULTS We recruited 2,833 individuals (46.5% men). The mean age was 51.2 years The prevalence of metabolic syndrome was 33.6% and was significantly higher in men (36.7% vs 30.9%; p < 0.001). The prevalence of metabolic syndrome fell significantly after exclusion of patients with diabetes or cardiovascular disease (20.8%; p < 0.001). The difference in prevalence between the distinct criteria was significant for the whole population and by sex (p < 0.000). A significant difference in prevalence between genders was observed from the age of 45-54 years in men and 55-64 years in women CONCLUSIONS The prevalence of metabolic syndrome in a health area of Badajoz is among the highest reported in population-based studies in Spain. Although estimates of the prevalence are decreased by the new international recommendations, a considerable proportion of the young population requires preventive measures.

[PP.07.12] HEMATOCRIT UREA AND GENDER (H.U.G.E.) FORMULA AND THE CKD PROGNOSIS CONSORTIUM EQUATION: CORRELATION WITH KDIGO RISK TABLE IN SPANISH POPULATION

Objective: To compare, in the HERMEX survey sample, the results of the use of the CKD Prognosis Consortium equation to calculate the risk of end-stage renal disease with the results of the KDIGO Progression Risk Table and the HUGE formula. Design and method: From a sample of 2,813 subjects, 113 ones have an estimated glomerular filtration rate < 60 ml/min. Hematocrit, urea, creatinine and microalbuminuria were analyzed and then they were estimated the risk of progression to end-stage renal disease using the CKD Progression Consortium on line (http://www.kidneyfailurerisk.com), the risk of progression from the KDIGO Risk Table and the HUGE formula score. Results: Using the KDIGO Risk Table 83 (73.5%) of subjects were at medium risk, 23 (20.4%) ones at high risk and 7 (6.19%) patients at very high risk of progression of chronic kidney disease. Using the estimation from the CKD Consortium equation that calculate the risk of progression to end-stage renal failure 108 (95.6%) subjects were at low risk of progression, 2 (1.7%) ones had a medium risk and the three left (2.65%) had a high risk. Compared with KDIGO Risk Table, the sensitivity was 0.23 (95%CI 0.10–0.43) and the specificity was 1.0 (95%CI 0.94–1.00). The positive predictive value was 1.00 (95%CI 0.56–1.00) and the negative predictive value was 0.78 (95%CI 0.69–0.85). From the HUGE formula score only 33 (29.2%) patients had renal failure of them five have risk of progression to end-stage renal disease. The sensitivity was 1.00 (95%CI 0.46–1.00) and the specificity 0.74 (95%CI 0.65–0.82). The positive predictive value was 0.15 (95%CI 0.06–0.33) and the negative predictive value was 0.85 (95%CI 0.67–0.94). When H.U.GE formula results were compared with KDIGO Risk Table outcomes the sensitivity was 1.00 (95%CI 0.86–1.00) and the specificity was 0.96 (95%CI 0.89–0.99). Conclusions: There was not a good correlation between the KDIGO progression Risk Table and the equation to estimate end-stage renal disease risk. The KDIGO table must be used for nephrologists referral. Contrariwise, the HUGE formula got a good correlation with the KDIGO table.