Parámetros antropométricos como predictores de resistencia a la insulina en adultos con sobrepeso y obesidad

ResumenObjetivoEvaluar cuál(es) de los parámetros antropométricos que estiman sobrepeso y obesidad son los mejores predictores de la resistencia a la insulina (RI) en la población adulta de la Unidad de Medicina Familiar N.o 80 del Instituto Mexicano del Seguro Social en Morelia, Michoacán, México.DiseñoEstudio transversal descriptivo.EmplazamientoUnidad de Medicina Familiar N.o 80, del Instituto Mexicano del Seguro Social en Morelia, Michoacán, México.ParticipantesMuestra aleatorizada simple de 147 pacientes con sobrepeso u obesidad.Mediciones principalesEdad y sexo. Antropométricas: peso, índice de masa corporal (IMC), circunferencia abdominal y del brazo, porcentaje de grasa corporal; plicometría: pliegues subcutáneos bicipital, tricipital, subescapular y abdominal; analíticas: glucosa, perfil de lípidos, insulina; clínicas: presión arterial sistólica y diastólica, RI con un valor de HOMA≥2,5.ResultadosEl 41,49% de los pacientes en estudio reunieron criterio para la RI. Se realizaron las received operating curves donde el pliegue bicipital≥4,50mm y la circunferencia del brazo≥27,50 cm predicen en un 97,4% la RI, y el IMC≥25kg/m2 en un 92,3% predice la RI; por regresión lineal éstos parámetros resultaron ser los mejores predictores de la RI.ConclusionesCon un punto de corte de HOMA≥2,5 se identificó al 41,49% de la población en estudio con RI. El IMC, el pliegue bicipital y la circunferencia del brazo son buenos predictores de la RI. Se requerirá realizar estudios específicos para determinar el punto de corte óptimo de las diferentes medidas para estimar sobrepeso y obesidad en cada sector de la población de México.AbstractObjectiveTo evaluate which of the anthropometric parameters that estimate overweight and obesity are the best predictors of insulin resistance (IR) in adults from Family Medicine Unit N° 80 of IMSS in Morelia, Michoacán, México.DesignDescriptive cross-sectional study.SettingFamily Medicine Unit N 80 of Mexican Social Security Institute in Morelia, Michoacán, Mexico.ParticipantsA random sample of 147 adults with overweight or obesity.Main measurementsAge and sex. Anthropometrics: weight, body mass index (BMI), waist and mid arm circumference, % corporal fat; Skin folds thickness: bicipital, tricipital, subscapularis, abdominal skin folds; analyses: glucose, lipid profile, insulin; clinical: diastolic and systolic pressure, cardiovascular risk and insulin resistance by HOMA ≥2.5.ResultsIR was found in 41.49% of patients. ROC curves were made and the cut off point of bicipital skin fold ≥4.50mm, mid arm ≥27.50 cm were predictors of IR in 97.4%; BMI ≥25kg/m2 was a predictor of IR in 92.3%, and by linear regression these parameters were the better predictors of IR.ConclusionsA total of 41.49% of patients were identified with IR (HOMA ≥2.5). BMI, bicipital skins fold and mid arm were the better predictors of IR. Specific studies are needed to determine the optimum cut off point of different parameters for estimating overweight and obesity in each sector in México

Behavior of Eosinophil Counts in Recovered and Deceased COVID-19 Patients over the Course of the Disease

Knowledge about the immune responses against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, particularly regarding the function of eosinophils, has been steadily emerging recently. There exists controversy regarding the implications of eosinophils in the coronavirus disease 2019 (COVID-19)’s pathology. We report a retrospective cohort study including the comparison of leukocyte counts in COVID-19 patients, considering the outcomes of recovery (n = 59) and death (n = 60). Among the different types of leukocytes, the eosinophil counts were those that showed the greatest difference between recovered and deceased patients. Eosinopenia (eosinophil count < 0.01 × 109/L) was more frequently observed in deceased than recovered patients (p = 0.0012). The eosinophil counts more rapidly increased and showed a greater proportion over the course of the disease in the recovered than deceased patients. Furthermore, the estimated survival rate was greater in patients without eosinopenia than in patients with eosinopenia (p = 0.0070) during hospitalization. Importantly, recovered but not deceased patients showed high negative correlations of the eosinophils with the neutrophil-to-lymphocyte ratio (NLR) and neutrophil counts at Day 9 of the onset of clinical symptoms (p ≤ 0.0220). Our analysis suggests that eosinopenia may be associated with unfavorable disease outcomes and that the eosinophils have a beneficial function in COVID-19 patients, probably contributing by controlling the exacerbated inflammation induced by neutrophils

Prevalence and characterization of undiagnosed arterial hypertension in the eastern zone of Mexico

Abstract Arterial hypertension is considered a public health problem with severe consequences at an individual and public health levels. However, there is a lack of information regarding its characterization in Mexico. The objective of this study is to estimate the proportion of undiagnosed arterial hypertension (UAH) and the overall prevalence and clinical management of arterial hypertension within the Eastern Zone of Mexico. Additionally, we explore associated factors related with both UAH and uncontrolled arterial hypertension. We obtained information from the May Measure Month (MMM) 2019 study. People were asked for cardiovascular risk factors and blood pressure was measured according to the protocols of the European Society of Hypertension (ESH). Data from 5901 subjects were extracted: 76.04% from the Eastern Zone of the State of Mexico. The overall prevalence of hypertension was 32.4% (95% CI 31.2‐33.6). From all subjects living with hypertension, 28.3% had UAH, 22.1% had previous diagnosis but were untreated; 29.3% were treated but had uncontrolled hypertension. Younger men adults living in the State of Michoacán had increased proportion of UAH and untreated hypertension. We observed that male sex, age, obesity, living at Michoacán were risk factors for UAH. Finally, male sex, diabetes, and living at Michoacán were related risk conditions for having uncontrolled arterial hypertension. In summary, there is a high proportion of UAH in Easter Zone of Mexico. Younger adults had higher proportion of UAH and untreated hypertension profiles. Efficient actions are required to make a timely diagnosis in the young adult population to prevent long‐term complications