Marcela Vásquez

Evaluation of metabolic syndrome in adults of Talca city, Chile

Objective-Insulin resistance (IR) is an important risk factor for type 2 Diabetes Mellitus (DM2) and cardiovascular disease (CVD). Metabolic Syndrome (MS) is a clustering of metabolic alterations associated to IR; however, there is no international consensus for defining its diagnosis. Our objective was to evaluate the prevalence and characteristics of MS identified by the ATP III and IDF criteria in adults from Talca city.Research and methods-We studied 1007 individuals, aged 18–74, and residents from Talca. MS subjects were defined according to ATP III (three altered factors) and IDF criteria (patients with waist circumference >80/90 cm (W/M) and two others altered factors).Results-The prevalence of metabolic syndrome according to the IDF and ATP III criteria was 36.4% and 29.5%, respectively after adjustment for age and sex. The agreement for both criteria was 89%. The prevalence in men was higher than in women for both MS definitions, although not significant. MS probability increased with age, and the highest risk was in the 57–68 age group (ATP-MS) and 53–72 age group (IDF-MS). Hypertension, high triglycerides and abdominal obesity are the most frequent alterations in MS.Conclusion-MS prevalence in adults was higher when diagnosed with IDF than with ATP criterion; in both, age is directly related with the MS presence. The MS subjects showed higher levels of blood pressure, waist circumference and plasma triglycerides. Considering our results, it is worrisome that one third of our population has a high risk of developing DM2 and CVD in the future.

Intervention with education and exercise reverses the metabolic syndrome in adults

About 29% of the adult population of Talca, Chile, suffers from the metabolic syndrome (MS), a value higher than the national prevalence. Evidence indicates that exercise and nutritional changes reduce the predominance of this syndrome. The goal of this study was to evaluate the effects of a structured interventional program of physical activity and nutritional counseling in adults with MS. Fifty-one subjects were studied: 27 were included in the interventional program (I-MS). The control group was formed by 24 individuals who did not participate in the program (NI-MS). We assessed body weight, corporal composition, arterial pressure, glycemia, and lipid profile at baseline and after 18 weeks of treatment. After this period, the I-SM group showed a significant decrease in triglycerides (geometric mean 202.2 to 110.5 mg/dL, P < .001), diastolic blood pressure (mean 85.4 to 79.6 mm Hg, P = .001), waist circumference (mean men 101.5 to 94.1 cm, P < .001; mean women 107.2 to 96.2 cm, P < .001), weight (mean 81.1 to 77.2 kg, P < .001), and body mass index (mean 31.8 to 30.2 kg/m(2), P < .001). In the NI-MS group, the individual parameters did not change significantly. Our results show that a non-pharmacological treatment based on exercise exerts an important beneficial effect in patients with MS, mainly on the waist circumference, blood pressure, and triglycerides.

Conocimientos y actitudes hacia la donación de sangre en una población universitaria de Chile

OBJETIVOS: Evaluar los conocimientos y actitudes hacia la donacion de sangre voluntaria entre estudiantes, academicos y no academicos de la Universidad de Talca, Chile. METODOS: Entre junio y julio de 2002, se aplico una encuesta, previamente validada, a 487 personas de la comunidad universitaria, para indagar acerca de su percepcion con respecto a algunos aspectos de la donacion de sangre, tales como: conocimientos y motivaciones sobre la donacion, y desmotivaciones y mitos asociados a la donacion de sangre. Para el analisis de los datos se usaron estadigrafos descriptivos. RESULTADOS: De los encuestados solo 14% habian donado sangre y correspondian mayoritariamente al grupo de academicos (43,3%). Los estudiantes fueron quienes, en mayor medida, manifestaron su intencion de donar sangre en el futuro (88,1%). Al comparar la predisposicion a donar sangre en el futuro entre hombres y mujeres, se obtuvieron porcentajes de 90% y 84,2% respectivamente; sin embargo, esta diferencia no fue estadisticamente significativa. Dentro de las desmotivaciones para donar sangre, 73,4% de los encuestados dijo desconfiar de la esterilidad del material empleado en la coleccion de sangre. CONCLUSIONES: La poblacion universitaria es un grupo muy deseable para convertirlo en donantes voluntarios; una adecuada campana de informacion y motivacion podria transformar a 87,3% de las personas con intencion de donar sangre, en donantes voluntarios reales.

Prevalence and isotype distribution of antiphospholipid antibodies in unselected Chilean patients with venous and arterial thrombosis.

Antiphospholipid antibodies (aPL) are a heterogeneous family of antibodies associated with thrombotic events and other complications. The objective of this study was to investigate the prevalence of aPL in a group of Chilean patients with thrombosis. Two hundred and twenty-six patients with venous and arterial thrombosis and 95 healthy controls were studied. Anticardiolipin (aCL), anti-β2 glycoprotein I (anti-β2GPI), and antiprothrombin (aPT) antibodies were determined. Eighty-eight out of 226 (38.9%) patients with thrombosis had some type of aPL. Fifty-seven patients (25.2%) were positive for aCL, 31 (13.7%) for aPT, and 14 (6.2%) for anti-β2GPI antibodies. Twelve patients (5.3%) were positive for more than one aPL. IgG, IgM and IgA isotypes were observed in aCL, anti-β2GPI, and aPT antibodies. Twenty-six out of 92 (28.3%) patients with venous thrombosis and 31/134 (23.1%) patients with arterial thrombosis were positive for aCL antibodies. With regard to the control group (4/95=4.2%), the odd ratios (OR) were 5.2 (1.3–19.8; p0.01) and 5.7 (1.6–22.3; p0.01), respectively. Additionally, we observed statistically significant OR with aPT and anti-β2GPI antibodies; in the first, with venous and arterial thrombosis, and in the second, only with arterial thrombosis. Our results show a significant prevalence of aPL, predominantly aCL and aPT antibodies, in patients with thrombosis. Additionally, aCL and aPT antibodies appear to be a risk factor for venous and arterial thrombosis, and anti-β2GPI antibodies appear to be a risk factor for arterial thrombosis.

Subjects with impaired fasting glucose: evolution in a period of 6 years.

Aim. To study the evolution of impaired fasting glucose (IFG), considering glucose and HbA1c levels and risk factors associated, in a period of 6 years. Methods. We studied 94 subjects with impaired fasting glucose (IFG) that were diagnosed in 2005 and followed up to 2012. Glucose and HbA1c levels were determined. A descriptive analysis of contingence charts was performed in order to study the evolution in the development of type-2 diabetes mellitus (T2DM). Results. Twenty-eight of ninety-four subjects became T2DM; 51/94 remained with IFG; and 20/94 presented normal fasting glucose. From the 28 diabetic subjects, 9 had already developed diabetes and were under treatment with oral hypoglycemic agents; 5 were diagnosed with plasma glucose < 126 mg/dL, but with HbA1c over 6.5%. In those who developed diabetes, 15/28 had a family history of T2DM in first relative degree. Also, diabetic subjects had a BMI significantly higher than nodiabetics (t test: P < 0.01). The individuals that in 2005 had the highest BMI are those who currently have diabetes. Conclusion. The IFG constitutes a condition of high risk of developing T2DM in a few years, especially over 110 mg/dL and in obesity patients.

Case study of complaints on drinking water quality: relationship to copper content?

Several families of Talca city, Chile complained to health authorities for what they attributed to consumption of copper (Cu)-contaminated drinking water. We assessed the situation 6–12 mo after the initiation of complaints by characterizing the symptoms reported, the chemistry of drinking water, and the Cu concentration in stagnant drinking water. After completing a census, 1778 households accepted participation and were categorized as follows: category 1, Cu plumbing for tap water and dwellers reporting health complaints (HC); category 2, Cu plumbing for tap water and dwellers reporting no HC; category 3, plastic plumbing for tap water and dwellers reporting no HC. Questionnaires recorded characteristics of households and symptoms presented by each member of the family in the last 3 mo. The Cu concentration in drinking water was measured in a subsample of 80 homes with Cu pipes. In category 1, participants presented significantly more abdominal pain, diarrhea, and/or vomiting (gastrointestinal [GI] symptoms) in comparison to category 3 and to categories 2 plus 3. The stagnant Cu concentrations measured in drinking water in all houses studied were below the US Environmental Protection Agency guideline value (<1.3 mg Cu/L). In summary, data obtained by interviews suggested that individuals in some areas of Talca city were suffering more GI symptoms potentially related to Cu excess, but measurement of Cu concentration in stagnant tap waters ruled out the association between Cu exposure and GI symptom reports at the time of this study. The dose-response curves for GI symptoms and Cu exposure now available were crucial in the analyses of results.

High levels of hsCRP are associated with carbohydrate metabolism disorder.

Aim: To determine risk parameters associated with high values of high sensitive C‐reactive protein (hsCRP) in subjects with different glucose fasting levels. Methods: Anthropometric parameters, arterial pressure, glycemia, lipid profile, uric acid, and hsCRP were studied in a population of 513 individuals between 40 and 65 years. Results: In total, 349 (68.0%) were normoglycemic (NG); 113 (22.0%) had impaired fasting glucose (IFG); and 51 (9.9%) were diabetic subjects. A multivariate linear regression analysis showed that the natural logarithm of hsCRP was associated significantly with glycemia levels (P = 0.009), uric acid (P = 0.001), diastolic blood pressure (P = 0.011), smoking habit (P = 0.021), BMI (P<0.001), and sex (P<0.001). One‐third of the NG subjects had high hsCRP levels. A multiple logistic regression analysis showed that sex and BMI were variables related to high levels of hsCRP in subjects with IFG and NG. In NG subjects, uric acid levels were associated with risk of presenting high hsCRP levels and were higher in women than men. In NG women, ROC curves analysis identified a uric acid level of 3.9 mg/dl as a cut‐off point to predict a high value of hsCRP. Those individuals with uric acid values higher than 3.9 mg/dl and normal glycemia had 3.5‐fold more risk of having hsCRP levels over 3.0 mg/l. Conclusions: We sustain that high levels of hsCRP are associated with disturbance in carbohydrate metabolism. In addition, we believe that in low cardiovascular risk population, such as NG women, uric acid levels above 3.9 mg/dl might represent a signal of possible pro‐inflammatory state and cardiovascular risk. J. Clin. Lab. Anal. 25:375–381, 2011.

Abastecimiento de sangre durante desastres: la experiencia de Chile en 2010

A review of the management of blood supply and its administration during disasters was conducted based on the experience of several events that occurred primarily from 2000-2010, particularly the earthquake that measured 8.8 on the Richter scale that struck central and southern Chile on 27 February 2010. The objective was to provide information that could be useful in improving response plans and strategies during potential future disasters. The descriptive information on response procedures was obtained from interviews, internal reports, and the computer database from the Maule regional blood production center. The results lead to the conclusion that to respond efficiently and effectively to the need for blood in the immediate wake of a disaster it is essential to have both a centralized management system that facilitates the supply and administration of blood and volunteers with competence in health that are willing to swiftly arrive during these events. A change in the profile of blood donors during such emergencies was also observed. In Chile, for example, during the two weeks after the earthquake, the ratio of male/female donors was reversed. There was 61.1% participation by women, whereas in the week before the event women accounted for only 37%.

Utilidad de una encuesta para identificar donantes de sangre de zonas no endémicas, potencialmente infectados con Trypanosoma cruzi

Un numero importante de inmigrantes provenientes de areas endemicas para enfermedad de Chagas viven en la VII Region. Dado que una de las formas de transmision del Chagas es por transfusion sanguinea, es importante evaluar , en zonas no endemicas, la utilidad de una encuesta de predonacion para identificar donantes de sangre infectados con Trypanosoma cruzi. En este trabajo participaron 7 hospitales de la Region, durante un periodo de 6 meses, 1.581 donantes de sangre fueron encuestados y sus sueros analizados para detectar la presencia de anticuerpos anti-T.cruzi. La efectividad del cuestionario empleado fue evaluada, correlacionando las respuestas a las diferentes preguntas sobre la enfermedad, con el resultado del ensayo inmunoabsorbente ligado a enzima. Las muestras positivas fueron confirmadas por: inmunofluorescencia indirecta y reaccion en cadena de la polimerasa. Solamente un donante fue positivo para enfermedad de Chagas. Este dador no reporto factores de riesgo. Por lo que, donantes de sangre seropositivos y parasitemicos para T. cruzi, estan presentes en la poblacion de donantes de sangre de zonas no endemicas, sin tener los usuales factores de riesgo.