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ABSTRACT Background: Prevalence of the metabolic syndrome has been described in populations with ethnic and cultural differences. The aim of this study was to determine the prevalence of the metabolic syndrome on a population from the... more
ABSTRACT Background: Prevalence of the metabolic syndrome has been described in populations with ethnic and cultural differences. The aim of this study was to determine the prevalence of the metabolic syndrome on a population from the Andes Mountains of Peru and compare it to a sea-level population. Methods: A cross-sectional study of subjects aged 30 years old or more from the high-altitude population of San Pedro de Cajas (SPC) (13,450 feet) and the sea-level population of Rimac (331 feet) was done. The metabolic syndrome was identified according to the revised National Cholesterol Education Program definition. The prevalence of metabolic abnormalities was calculated by gender, age, and population. A multivariate analysis was done with metabolic syndrome as the dependant variable. Results: Ninety-nine subjects from SPC and 172 from Rimac were included. The prevalence of metabolic syndrome was higher in SPC (22.2% versus 16.9%; p = 0.28). Prevalence of hypertriglyceridemia was significantly higher in SPC (56.6% versus 29.7%; p < 0.001) and prevalence of high blood pressure was significantly higher in Rimac (30.8% versus 18.2%; p < 0.05). In the multivariate analysis female gender was a risk factor for metabolic syndrome (odds ratio [OR] = 4.2; 95% confidence interval [CI]: 1.76-9.15). Conclusions: We found an overwhelming predominance of females with the metabolic syndrome in both populations due to high prevalences of abdominal obesity and low highdensity lipoprotein (HDL) Hypertriglyceridemia prevalence was elevated in both men and women of high altitude. Lower prevalence of high blood pressure and of high fasting glucose was found in the high-altitude natives. The prevalence and characteristics of the metabolic syndrome apparently varies among different ethnic groups and this indicates the need for more epidemiologic studies.
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Personas Con Sobrepeso/Obesidad, Antecedentes Familiares De Diabetes, Hipertensión, Hipertrigliceridemia, Adultos Mayores y Mujeres Con Diabetes Gestacional, Deberían Ser Abordados Por Un Programa De Prevención Principalmente en El Nivel Primario, Situación Que No Se Da Actualmente en Nuestro Sis...more
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Research Interests: Humanities and Medicine
The purpose of this study was to estimate the prevalence of diabetes and impaired fasting glucose (IFG) and their associated risk factors in the hypertensive rural Chinese. A cross-sectional survey was conducted during 2004-2006 with a... more
The purpose of this study was to estimate the prevalence of diabetes and impaired fasting glucose (IFG) and their associated risk factors in the hypertensive rural Chinese. A cross-sectional survey was conducted during 2004-2006 with a cluster multistage sampling design. Data from a comprehensive questionnaire, physical examination, and blood tests were obtained from a resident group of 6,412 individuals with hypertension, aged > or = 35 years. The prevalence of diabetes among the hypertensive rural adults was 10.0%. The prevalence of IFG was 26.0%, using the new American Diabetes Association (ADA) criteria (fasting plasma glucose 5.6-6.9 mmol/l); according to the 1997 ADA criteria (fasting plasma glucose 6.1 - 6.9 mmol/l), the prevalence of IFG was 9.7%. By using multivariate logistic regression analysis, age, sex (male gender), systolic blood pressure, overweight or obesity, total cholesterol and triglycerides were determined to be risk factors for diabetes (P < 0.05). This study shows that diabetes and IFG are common among hypertensive rural Chinese. In view of the huge number of hypertensive adults in rural China, the results of this study emphasize the need to improve the early detection and prevention of diabetes in China to prevent the emerging diabetes epidemic.
Research Interests: China, Logistic Regression, Humans, Internal Medicine, Blood Glucose, and 15 moreHypertension, Diabetes mellitus, Blood Pressure, Female, Male, Confidence intervals, Cluster Analysis, Aged, Adult, Cross sectional Study, Cross Sectional Studies, Glucose Intolerance, Logistic Models, Impaired fasting glucose, and Cardiovascular medicine and haematology
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We performed a comprehensive review of recent publications about type 2 diabetes mellitus (T2DM) in Peru, including studies among people living at high altitude above the sea level. An increase in the prevalence of T2DM in Peru has been... more
We performed a comprehensive review of recent publications about type 2 diabetes mellitus (T2DM) in Peru, including studies among people living at high altitude above the sea level. An increase in the prevalence of T2DM in Peru has been reported, the reasons are multifactorial and coinciding with the strong economic growth that our country has experienced over the last 20 years along with migration from the Andean regions to the coast and the adoption of a lifestyle that is a known to be a risk factor for obesity and insulin resistance. Scarce information is available in Peru about the prevalence of chronic complications of T2DM such as retinopathy, neuropathy, and nephropathy. There is a need for a health care plan based on early diagnosis of T2DM to reduce social and economic problems, as recommended by the WHO and the United Nations.
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El presente es un estudio evaluativo de los principales aspectos del desarrollo científico y tecnológico biomédico en el Perú y en el marco del desarrollo global del país, así como latinoamericano y mundial. Se comentan los modelos de... more
El presente es un estudio evaluativo de los principales aspectos del desarrollo científico y tecnológico biomédico en el Perú y en el marco del desarrollo global del país, así como latinoamericano y mundial. Se comentan los modelos de salud empleados para llegar a las desigualdades económico-sociales e inequidades existentes. Se analiza la asociación positiva entre el organismo rector de ciencia y tecnología, el sector salud y la Organización Panamericana de la Salud, para promover la realización de proyectos prioritarios en el Perú, con evaluaciones por pares y decisión a nivel nacional. El artículo incide en aspectos de producción científica y bibliográficos, así como de recursos humanos e inversión en ciencia y tecnología; así mismo, plantea un análisis de fortalezas, debilidades y probables escenarios futuros. Se señala la necesidad de reforzar la información y comunicación a niveles de excelencia y la construcción de una nueva cultura en investigación biomédica. Se destaca la i...
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In order to evaluate clinical presentation and to determinate classification criteria of type I diabetes (I-DM) in the elderly, we carried out a study in 258 patients more than 60 years old of which 40% used insulin by failure to oral... more
In order to evaluate clinical presentation and to determinate classification criteria of type I diabetes (I-DM) in the elderly, we carried out a study in 258 patients more than 60 years old of which 40% used insulin by failure to oral hipoglycemic agents (OHA). The prevalence of ischemic cardiovascular disease was 36%, peripheralvascular disease 34% and stroke 30%; non-proliferative retinopathy 47%, peripheral neurophaty 37% and nephropathy 16%. Obesity (36%), hypertension (33%) and hypercholesterolemia (12%) were evaluated. The average duration of diabetes was 20 years. Postglucagon C-Peptide, HLA-DR antigens and islet cell antibodies (ICA), were measured in 75 older diabetic patients on treatment of which 24 used insulin, 40 OHA and 11 diet. Older patients on insulin had longer duration of disease, less obesity, low basal level of C-Peptide and a low response post glucagon; C-Peptide (0.94+0.5 pmol/ml) compared with patients on diet (1.8+0.9 pmol/ml) and OHA (1.8+0.8 pmol/ml). Old...
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Research Interests: Humanities and Medicine
La presente investigación describe la epidemiología de la diabetes mellitus insulinodependiente (Tipo I) en la población peruana, a través de 3 registros que tomaron como estudio al grupo etáreo menor de 15 años de la provincia de Lima,... more
La presente investigación describe la epidemiología de la diabetes mellitus insulinodependiente (Tipo I) en la población peruana, a través de 3 registros que tomaron como estudio al grupo etáreo menor de 15 años de la provincia de Lima, Cuzco y San Martín queen conjunto representan el 28% de la población peruana menor de 15 años. La fuente primaria de datos fueron los casos ocurridos en 25 hospitales entre 1980-1988, siendo los criterios de selección: haber sido diagnosticado de diabetes (OMS), haber tenido menos de 15 años de edad al diagnóstico, estar en insulino terapia y ser residente de su ciudad. El número de casos encontrados fueron 55, de los cuales 22 tuvieron menos de 15 años en 1988, con una prevalencia de 0.94/100,000 y una incidencia anual de 0.6/100.000. La fuente secundaria de datos fue la Asociación Peruana de Diabetes con 90% de validación de los casos registrados. La baja tasa de prevalencia e incidencia de diabetes mellitas insulina-dependientes (tipo-I) encontrad...
Research Interests: Humanities and Medicine
Se presenta las características clínicas, técnica operatoria, estudio histopatológico y evolución de 173 pacientes con patología tiroidea operada en el Hospital Nacional Cayetano Heredia entre 1976 y 1987, 52.6% presentaron bocio nodular,... more
Se presenta las características clínicas, técnica operatoria, estudio histopatológico y evolución de 173 pacientes con patología tiroidea operada en el Hospital Nacional Cayetano Heredia entre 1976 y 1987, 52.6% presentaron bocio nodular, 63.5% presentaron nódulos fríos y 21.1% nódulos calientes. Las técnicas operatoriasempleadas fueron: lobectomía total más istmectomía (65.8%), tiroidectomía subtotal bilateral (19%), lobectomía total mas istmectomía mas lobectomía parcial contralateral (8%) y tiroidectomía total (4%). La biopsia por congelación se realizó en 95% de los pacientes. Bocio coloide fue el resultado histopatológico más frecuente (67.6%). La patología benigna se encontró en 84.6% y la maligna en 15.4%. Las complicacionesfueron: lesión unilateral del nervio recurrente (4%), hematomas sofocantes (2.3%) e hipoparatiroidismo transitorio (1.7%). La mortalidad fue de 0.5%.
Research Interests: Medicine and Gynecology
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Free radicals constitute an important threat to the organism, in defense, cells have developed several antioxidant enzymes, superoxide dismutase (SOD), catalase and glutathione peroxidase. SOD is in charge of the removal of superoxide... more
Free radicals constitute an important threat to the organism, in defense, cells have developed several antioxidant enzymes, superoxide dismutase (SOD), catalase and glutathione peroxidase. SOD is in charge of the removal of superoxide radicals produced in the mitochondrial electron transport chain. Objective: To determine and compare SOD levels of a high altitude and sea level population. Materials and Methods: This was a descriptive study. Blood samples were taken from blood donors of blood banks of Hospital Nacional Cayetano Heredia in Lima and Hospital Victor Ramos Guardia in Huaraz (3 052 meters above sea level). Ninety seven samples were analyzed using the Minami and Yoshikawa method to determine SOD activity. Results: The means for SOD values were 1 834 U/gr.Hb for Lima and 926.5 U/gr.Hb for Huaraz (p < 0.05). In every age group the high altitude natives had lower levels of SOD than the ones at sea level. There was a significant difference between women from Lima and Huaraz...
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OBJECTIVE—We have carried out international comparisons of the metabolic syndrome using the International Diabetes Federation (IDF) and National Cholesterol Education Program–Adult Treatment Panel III (ATP III) definitions. This analysis... more
OBJECTIVE—We have carried out international comparisons of the metabolic syndrome using the International Diabetes Federation (IDF) and National Cholesterol Education Program–Adult Treatment Panel III (ATP III) definitions. This analysis could help to discern the applicability of these definitions across populations. RESEARCH DESIGN AND METHODS—Nondiabetic subjects aged 35–64 years were eligible for analysis in population-based studies from San Antonio (Mexican Americans and non-Hispanic whites, n = 2,473), Mexico City (n = 1,990), Spain (n = 2,540), and Peru (n = 346). κ Statistics examined the agreement between metabolic syndrome definitions. RESULTS—Because of the lower cutoff points for elevated waist circumference, the IDF definition of the metabolic syndrome generated greater prevalence estimates than the ATP III definition. Prevalence difference between definitions was more significant in Mexican-origin and Peruvian men than in Europid men from San Antonio and Spain because t...