Salud Pública de Méxicohttps://scielosp.org/feed/spm/2010.v52suppl1/2021-01-13T00:10:00ZVol. 52 - 2010WerkzeugEditorialS0036-363420100007000012021-01-13T00:10:00Z2017-01-20T00:02:00ZÁvila, Mauricio Hernández
<em>Ávila, Mauricio Hernández</em>;
<br/><br/>
The status of non-transmissible chronic disease in Mexico based on the National Health and Nutrition Survey 2006S0036-363420100007000022021-01-13T00:10:00Z2017-01-20T00:02:00ZVillalpando, SalvadorRodrigo, Juan Rull
<em>Villalpando, Salvador</em>;
<em>Rodrigo, Juan Rull</em>;
<br/><br/>
Methodology for the analysis of type 2 diabetes, metabolic syndrome and cardiovascular disease risk indicators in the ENSANUT 2006S0036-363420100007000032021-01-13T00:10:00Z2017-01-20T00:02:00ZBarquera, SimónCampos-Nonato, IsmaelCarrión-Rábago, CitlaliVillalpando, SalvadorLópez-Ridaura, RuyRojas, RosalbaAguilar-Salinas, Carlos A
<em>Barquera, Simón</em>;
<em>Campos-Nonato, Ismael</em>;
<em>Carrión-Rábago, Citlali</em>;
<em>Villalpando, Salvador</em>;
<em>López-Ridaura, Ruy</em>;
<em>Rojas, Rosalba</em>;
<em>Aguilar-Salinas, Carlos A</em>;
<br/><br/>
OBJECTIVE: To describe: a) the methods used to quantify biochemical indicators of Type 2 Diabetes (T2D), and other cardiovascular risk indicators in the Mexican National Health and Nutrition Survey 2006 (ENSANUT 2006) and b) compare the sub-sample with the non-selected participants in diverse socio-demographic, anthropometric and health characteristics. MATERIAL AND METHODS: A sub-sample of 6 021 fasting adult participants was randomly selected from the total fasting participants (n=39 425). We compared diverse socio-demographic, anthropometric and health parameters between this sub-sample and the rest of the participants. RESULTS: No differences were found in sociodemographics characteristics, except age, between the sub-sample and from the rest of the fasting adults. In addition no difference were found between prevalences of overweight and obesity, central obesity, and previously diagnosed high blood pressure, T2D or hypertrigliceridemia. CONCLUSIONS: The randomly selected sub-sample was not essentially different from the rest of the fasting subjects. Thus, no bias is expected in the interpretation of cardiovascular risk indicators derived from these data.Metabolic syndrome in Mexican adults: results from the National Health and Nutrition Survey 2006S0036-363420100007000042021-01-13T00:10:00Z2017-01-20T00:02:00ZRojas, RosalbaAguilar-Salinas, Carlos AJiménez-Corona, AídaShamah-Levy, TeresaRauda, JuanÁvila-Burgos, LeticiaVillalpando, SalvadorLazcano Ponce, Eduardo
<em>Rojas, Rosalba</em>;
<em>Aguilar-Salinas, Carlos A</em>;
<em>Jiménez-Corona, Aída</em>;
<em>Shamah-Levy, Teresa</em>;
<em>Rauda, Juan</em>;
<em>Ávila-Burgos, Leticia</em>;
<em>Villalpando, Salvador</em>;
<em>Lazcano Ponce, Eduardo</em>;
<br/><br/>
OBJECTIVE: To examine the prevalence of metabolic syndrome (MS) and its associated risk factors in Mexican adults aged 20 years or older, using data derived from the National Health and Nutrition Survey 2006 (ENSANUT 2006). MATERIAL AND METHODS: The ENSANUT 2006 was conducted between October 2005 and May 2006. Questionnaires were administered to 45 446 adult subjects aged 20 years or older who were residents from urban and rural areas. Anthropometric and blood pressure measurements were obtained from all subjects and fasting blood specimens were provided by 30% of participants. We randomly selected a sub-sample of 6 613 from which laboratory measurements were carried out for glucose, insulin, triglycerides, total cholesterol and HDL-cholesterol. For this analysis, we included only results from eight or more hours of fasting samples (n=6 021). We used individual weighted factors in the statistical analysis and considered the survey's complex sampling design to obtain variances and confidence intervals. All analyses were done using SPSS 15.0. RESULTS: In accordance with definitions by the National Cholesterol Education Program Adult Treatment Panel III (ATP III), the American Heart Association/National Heart, Lung and Blood Institute (AHA/NHLBI), and the International Diabetes Federation (IDF), the prevalence of MS in Mexican adults aged 20 years or older was 36.8, 41.6 and 49.8%, respectively. Women were more affected than men due to the higher prevalence of central obesity among females. Prevalence of MS increased with age and was higher among populations living in metropolitan areas, in the west-central region, and those with lower education. DISCUSSION: Regardless of the MS definition, a large proportion of Mexican adults has the condition, so preventive measures are needed to decrease the prevalence of the MS components in this population. MS can predict type 2 diabetes and cardiovascular disease, two of the main causes of death in the adult population in Mexico. The intentional search of MS components allows stratifying the population according to risk levels. Treatment for each component should be implemented properly to prevent or delay onset of type 2 diabetes and cardiovascular disease.Prevalence and distribution of type 2 diabetes mellitus in Mexican adult population: a probabilistic surveyS0036-363420100007000052021-01-13T00:10:00Z2017-01-20T00:02:00ZVillalpando, Salvadorde la Cruz, VanessaRojas, RosalbaShamah-Levy, TeresaÁvila, Marco AntonioGaona, BereniceRebollar, RosarioHernández, Lucia
<em>Villalpando, Salvador</em>;
<em>De La Cruz, Vanessa</em>;
<em>Rojas, Rosalba</em>;
<em>Shamah-Levy, Teresa</em>;
<em>Ávila, Marco Antonio</em>;
<em>Gaona, Berenice</em>;
<em>Rebollar, Rosario</em>;
<em>Hernández, Lucia</em>;
<br/><br/>
OBJECTIVE: To describe the prevalence, distribution and degree of control of type 2 diabetes (T2D) in Mexican population. MATERIAL AND METHODS: Subjects were classified as previously diagnosed T2D (PD); or as "finding of the survey" (FS) (glucose >126 mg/dL). Hemoglobin A1c was measured in PD-subjects. RESULTS: The prevalence for PD-T2D was 7.34% (95%CI 6.3, 8.5) and for FS 7.07% (95%CI 6.1, 8.1), summing 14.42%; (7.3 million diabetics). 5.3% of PD-T2D were in good, 38.4% in poor and 56.2% very poor control. Older age (OR=0.96, 95%CI 0.94, 0.97), lower BMI (OR=0.95, 95%CI 0.91, 1.0), were protective for poor control. Affiliation to private services (OR=1.77, 95%CI 0.98, 3.13), larger T2D duration (OR=1.05, 95%CI 1.01, 1.08), and combining oral medication and insulin (OR=16.1, 95%CI 1.61, 161) were riskier. CONCLUSIONS: We found an alarming prevalence of T2D in Mexican population; the majority of PD diabetics are in poor control. Research on the latter is warranted.Early-onset type 2 diabetes in a Mexican survey: results from the National Health and Nutrition Survey 2006S0036-363420100007000062021-01-13T00:10:00Z2017-01-20T00:02:00ZJiménez-Corona, AídaRojas, RosalbaGómez-Pérez, Francisco JAguilar-Salinas, Carlos A
<em>Jiménez-Corona, Aída</em>;
<em>Rojas, Rosalba</em>;
<em>Gómez-Pérez, Francisco J</em>;
<em>Aguilar-Salinas, Carlos A</em>;
<br/><br/>
OBJECTIVE: To describe the characteristics of patients with type 2 diabetes diagnosed before age 40 (early-onset type 2 diabetes) identified in a nation-wide, population-based study. MATERIALS AND METHODS: The survey was done in Mexico during 2006. Medical history, anthropometric and biochemical measurements were obtained in every subject. RESULTS: Cases diagnosed before (n=181) and after age 40 (n=659) were included. Early-onset type 2 diabetes was present in 13.1% of the previously diagnosed, 30.3% of the cases identified during the survey and 21.5% of the whole population with diabetes. These individuals had a greater prevalence of obesity and hypertriglyceridemia compared to the cases diagnosed after age 40. CONCLUSIONS: Early-onset type 2 diabetes was present in 21.5 % of patients with type 2 diabetes in Mexico. Close to 70% of them were obese or overweight and had the clinical profile of the metabolic syndrome.The status of diabetes care in Mexican population: are we making a difference? Results of the National Health and Nutrition Survey 2006S0036-363420100007000072021-01-13T00:10:00Z2017-01-20T00:02:00ZGonzález-Villalpando, ClicerioLópez-Ridaura, RuyCampuzano, Julio CésarGonzález-Villalpando, María Elena
<em>González-Villalpando, Clicerio</em>;
<em>López-Ridaura, Ruy</em>;
<em>Campuzano, Julio César</em>;
<em>González-Villalpando, María Elena</em>;
<br/><br/>
OBJECTIVE: Examine clinical indicators to evaluate diabetes care in Mexico. MATERIAL AND METHODS: Diabetics (self reported, with therapy) were examined with standardized questionnaires, anthropometry, glucose, lipids and glycohemoglobin. Data were analyzed statistically. RESULTS: There were 2 644 patients, 677 cases without access to medical care (73% women), most lived in rural communities and spoke aboriginal dialect. Prevalence of obesity for private access group was 21.2%, for other or non access group was between 31 and 65%. The group without or basic education was most common, 76% of the cases had HDL <40 mg/dl and 36% had hypertriglyceridemia. Only 6.6% of patients had HbA1c <7%. There was no significant difference between HbA1c values observed in the group with or without access. Most patients were treated with oral agents. A significant group was without therapy. Assessments for complications was infrequent. CONCLUSIONS: Current model for diabetes care in Mexico is inefficacious and a paradigm change is necessary.Prevalence of dyslipidemias in the Mexican National Health and Nutrition Survey 2006S0036-363420100007000082021-01-13T00:10:00Z2017-01-20T00:02:00ZAguilar-Salinas, Carlos AGómez-Pérez, Francisco JRull, JuanVillalpando, SalvadorBarquera, SimónRojas, Rosalba
<em>Aguilar-Salinas, Carlos A</em>;
<em>Gómez-Pérez, Francisco J</em>;
<em>Rull, Juan</em>;
<em>Villalpando, Salvador</em>;
<em>Barquera, Simón</em>;
<em>Rojas, Rosalba</em>;
<br/><br/>
OBJECTIVE: To describe the prevalence of lipid abnormalities found in the Mexican National Health and Nutrition Survey 2006 (ENSANut 2006). MATERIAL AND METHODS: Information was obtained from 4 040 subjects aged 20 to 69 years, studied after a 9- to 12-hour fast. RESULTS: Median lipid concentrations were: cholesterol 198.5 mg/dl, triglycerides 139.6 mg/dl, HDL-cholesterol 39.0 mg/dl, non-HDL-cholesterol 159.5 mg/dl and LDL-cholesterol 131.5 mg/dl. The most frequent abnormality was HDL-cholesterol below 40 mg/dl with a prevalence of 60.5% (95%CI 58.2-62.8%). Hypercholesterolemia (> 200 mg/dl) had a frequency of abnormality of 43.6% (95%CI 41.4-46.0%). Only 8.6% of the hypercholesterolemic subjects knew their diagnosis. Hypertriglyceridemia (> 150 mg/dl) was observed in 31.5% (IC 95% 29.3-33.9%) of the population. CONLUSIONS: The ENSANUT 2006 data confirm that the prevalence of hypoalphalipoproteinemia and other forms of dyslipidemia in Mexican adults is very high.Prevention of cardiovascular disease based on lipid lowering treatment: a challenge for the Mexican health systemS0036-363420100007000092021-01-13T00:10:00Z2017-01-20T00:02:00ZGómez-Pérez, Francisco JRojas, RosalbaVillalpando, SalvadorBarquera, SimónRull, JuanAguilar-Salinas, Carlos A
<em>Gómez-Pérez, Francisco J</em>;
<em>Rojas, Rosalba</em>;
<em>Villalpando, Salvador</em>;
<em>Barquera, Simón</em>;
<em>Rull, Juan</em>;
<em>Aguilar-Salinas, Carlos A</em>;
<br/><br/>
OBJECTIVE: To estimate the percentage of Mexican adults that may require lipid-lowering treatment according to National Cholesterol Education Program-III guidelines, using data from the National Health and Nutrition Survey 2006 (ENSANut 2006). MATERIAL AND METHODS: Information was obtained from 4 040 subjects aged 20 to 69 years, studied after a 9 to 12 hours fast. RESULTS: A cardiovascular risk equivalent was found in 13.8% and >2 risk factors were present in 31.5% of the population. LDL-C concentrations were above the treatment goal in 70% of the high-risk group and in 38.6% of subjects with >2 risk factors. Nearly 12 million Mexicans should be taught how to change their lifestyles and close to 8 million individuals require drug therapy to decrease their cardiovascular risk. CONCLUSIONS: Thirty percent of Mexican adults require some form of lipid-lowering treatment (lifestyle modifications in 36.25%, drug therapy in 24.19%).Hypertension in Mexican adults: results from the National Health and Nutrition Survey 2006S0036-363420100007000102021-01-13T00:10:00Z2017-01-20T00:02:00ZBarquera, SimónCampos-Nonato, IsmaelHernández-Barrera, LucíaVillalpando, SalvadorRodríguez-Gilabert, CésarDurazo-Arvizú, RamónAguilar-Salinas, Carlos A
<em>Barquera, Simón</em>;
<em>Campos-Nonato, Ismael</em>;
<em>Hernández-Barrera, Lucía</em>;
<em>Villalpando, Salvador</em>;
<em>Rodríguez-Gilabert, César</em>;
<em>Durazo-Arvizú, Ramón</em>;
<em>Aguilar-Salinas, Carlos A</em>;
<br/><br/>
OBJECTIVE: To describe the prevalence of hypertension among Mexican adults, and to compare to that observed among Mexican-Americans living in the US. MATERIAL AND METHOD: The primary data source came from adults (>20 years) sampled (n=33366) in the Mexican National Health and Nutrition Survey 2006 (ENSANUT 2006). Hypertension was defined when systolic blood pressure was >140 and/or diastolic was >90 or patients previously diagnosed. RESULTS: A total of 43.2% of participants were classified as having hypertension. We found a positive statistically significant association (p<0.05) between hypertension and BMI, abdominal obesity, previous diagnosis of diabetes and hypercholesterolemia. Subjects with hypertension had a significantly higher odd of having a history of diabetes or hypercholesterolemia. Hypertension had a higher prevalence in Mexico than among Mexican-Americans living in the US. CONCLUSIONS: Hypertension is one of the most prevalent chronic diseases in Mexico. In the last six years in Mexico, a substantial increase (25%) has been observed in contrast to the reduction seen among Mexican-Americans (-15%).Trends for type 2 diabetes and other cardiovascular risk factors in Mexico from 1993-2006S0036-363420100007000112021-01-13T00:10:00Z2017-01-20T00:02:00ZVillalpando, SalvadorShamah-Levy, TeresaRojas, RosalbaAguilar-Salinas, Carlos A.
<em>Villalpando, Salvador</em>;
<em>Shamah-Levy, Teresa</em>;
<em>Rojas, Rosalba</em>;
<em>Aguilar-Salinas, Carlos A.</em>;
<br/><br/>
OBJECTIVE: To describe the trends in the prevalence of type 2 diabetes (T2D), and other cardiovascular risk factors in three national health surveys (1993, 2000 and 2006). MATERIALS AND METHODS: The databases of three surveys: ENEC 1993, ENSA 2000 and ENSANUT 2006 were gathered. Calculations of published data were reprocessed to do appropriate adjustments to assure comparability among surveys. RESULTS: From 1993 to 2006 the prevalence of type 2 diabetes (6.7-14.4%), metabolic syndrome (26.6-36.8%), hypertension (23.8-30.7%), hypercholesterolemia (27-43.6%), and high LDL-cholesterol (31.6-46%) increased rapidly. The prevalence of low HDL cholesterol was very high (60.5-63%) in all surveys and remained remarkably unchanged among surveys. CONCLUSIONS: This increasing trends for the prevalence of T2D and cardiovascular risk factors predicts larger increments in the near future for T2D and cardiovascular morbidity and mortality. Intensification of the preventive and remedy strategies is mandatory in order curve the foreseen dramatic increment in the disease burden.And now what? Time for daring innovationS0036-363420100007000122021-01-13T00:10:00Z2017-01-20T00:02:00ZGonzález Villalpando, ClicerioLópez Ridaura, RuyLazcano Ponce, EduardoGonzález Villalpando, Ma Elena
<em>González Villalpando, Clicerio</em>;
<em>López Ridaura, Ruy</em>;
<em>Lazcano Ponce, Eduardo</em>;
<em>González Villalpando, Ma Elena</em>;
<br/><br/>