Características del síndrome metabólico en una población del noroccidente de Colombia
Palabras clave:
diabetes mellitus, hipertensión, salud pública, síndrome metabólico
Resumen
Introducción: el síndrome metabólico representa un problema de salud pública importante debido a su asociación con enfermedades crónicas no transmisibles como hipertensión, diabetes y dislipidemia.
Objetivo: describir las características del síndrome metabólico y sus factores asociados en una población inscrita en un programa de control de enfermedades crónicas, identificando oportunidades para mejorar su diagnóstico, tratamiento y manejo.
Metodología: se realizó un estudio observacional con 2.482 pacientes inscritos en el programa 2023 en el marco del programa público de control de enfermedades crónicas de Bucaramanga, Colombia. Se recolectaron datos sobre características demográficas, comorbilidades (hipertensión, diabetes, hipercolesterolemia, hipertrigliceridemia) y criterios diagnósticos de síndrome metabólico, incluida la obesidad abdominal. Se evaluó la adherencia al tratamiento y el control adecuado del síndrome metabólico mediante indicadores establecidos.
Resultados: de los participantes, el 55,2% fueron mujeres. La obesidad abdominal fue el criterio diagnóstico más prevalente para síndrome metabólico. Las comorbilidades más frecuentes fueron hipertensión, diabetes, hipercolesterolemia e hipertrigliceridemia. La adherencia al tratamiento fue del 48,5% y el control adecuado se logró en el 44,4% de los casos.
Conclusiones: los hallazgos subrayan la necesidad de fortalecer la atención primaria con un enfoque multidisciplinario para mejorar el diagnóstico y el manejo de síndrome metabólico y sus complicaciones. Se recomienda implementar un plan de mejora institucional, coordinar esfuerzos con el Ministerio de Salud y promover estudios multicéntricos a nivel nacional para intervenciones más efectivas.
Citas
1. World Health Organization. Obesity and overweight [Internet]. World Health Organization; 2024. [cited 2024 Jun 10]. Available from: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
2. Mancilla-Escobar J, Rojas-Mercedes E, Pedraza-Medina Y. La obesidad: aspectos fisiopatológicos y clínicos. Arch Cardiol Mex [Internet]. 2022 [cited 2024 Jun 10]; 92(1):147-155. Disponible en: https://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S2448-57052022000100147. doi: 10.24875/ACM.21000023.
3. Castillo-Martínez L, López-Alvarenga JC, Rodríguez-Morán M, Guerrero-Romero F. Obesidad: ¿Factor de riesgo o enfermedad? Rev Med Chil [Internet]. 2019 [cited 2024 Jun 10]; 147(4):470-479. Disponible en: https://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872019000400470. doi: 10.4067/S0034-98872019000400470.
4. Misra A, Bhardwaj S. Obesity and the metabolic syndrome in developing countries: focus on South Asians. Nestle Nutr Inst Workshop Ser. 2014; 78:133-40. doi: 10.1159/000354952
5. Misra A, Khurana L. Obesity and the metabolic syndrome in developing countries. J Clin Endocrinol Metab. 2008;93(11 Supl 1): S9–S30. doi: 10.1210/jc.2008-1595
6. Ranasinghe P, Mathangasinghe Y, Jayawardena R, Hills AP, Misra A. Prevalence and trends of metabolic syndrome among adults in the Asia-pacific region: a systematic review. BMC Public Health [Internet]. 2017 [cited 2024 Jun 10]; 17(1):101. Available from: https://pubmed.ncbi.nlm.nih.gov/28109251/. doi: 10.1186/s12889-017-4041-1
7. Ansarimoghaddam A, Adineh HA, Zareban I, Iranpour S, HosseinZadeh A, Kh F. Prevalence of metabolic syndrome in Middle-East countries: meta-analysis of cross-sectional studies. Diabetes Metab Syndr. 2018;12(2):195-201. doi: 10.1016/j.dsx.2017.11.004
8. Lemus-Lemus F, Díaz Quijano DM, Rincón-Rodríguez CJ, Huertas-Moreno ML. Avances en la comprensión de la transición nutricional colombiana. Rev Gerenc Polit Salud [Internet]. 2012 [citado 10 Jun 2024];11(23):121-133. Disponible en: http://www.scielo.org.co/pdf/rgps/v11n23/v11n23a08.pdf
9. Mendoza-Romero D, Urbina A, Cristancho-Montenegro A, Rombaldi A. Impact of smoking and physical inactivity on self-rated health in women in Colombia. Prev Med Rep [Internet]. 2019 [cited 2024 Jun 10]; 16:100976. doi: 10.1016/j.pmedr.2019.100976
10. Departamento Administrativo Nacional de Estadística - DANE. Resultados censo nacional de población y vivienda 2018. [Internet]. Bogotá: DANE; 2018. [citado 15 Mar 2024]. Disponible en: https://www.dane.gov.co/index.php/estadisticas-por-tema/demografia-y-poblacion/censo-nacional-de-poblacion-y-vivenda-2018
11. Suarez-Ortegón MF, Aguilar-de Plata C. Prevalence of metabolic syndrome in children aged 5–9 years from southwest Colombia: a cross-sectional study. World J Pediatr. 2016;12(4):477-83. doi: 10.1007/s12519-016-0008-z
12. Rodríguez-Miranda CD, Jojoa-Ríos JD, Orozco-Acosta LF, Nieto-Cárdenas OA. Síndrome metabólico en conductores de servicio público en Armenia, Colombia. Rev salud pública [Internet]. 2017 [citado 15 Mar 2024];19(4):499-505. Disponible en: http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S0124-00642017000400499&lng=en&nrm=iso&tlng=es. doi: https://doi.org/10.15446/rsap.v19n4.69758
13. Márquez-Sandoval F, Macedo-Ojeda G, Viramontes-Hörner D, Fernández Ballart JD, Salas Salvadó J, Vizmanos B. The prevalence of metabolic syndrome in Latin America: a systematic review. Public Health Nutr [Internet]. 2011 [cited 2024 Jun 10];14(10):1702–13. Available from: https://pubmed.ncbi.nlm.nih.gov/21486521/. doi: 10.1017/S1368980010003320
14. de Siqueira Valadares LT, de Souza LSB, Salgado Júnior VA, de Freitas Bonomo L, de Macedo LR, Silva M. Prevalence of metabolic syndrome in Brazilian adults in the last 10 years: a systematic review and meta-analysis. BMC Public Health [Internet]. 2022 [cited 2024 Jun 10];22(1):327. Available from: https://pubmed.ncbi.nlm.nih.gov/35172790/. doi: 10.1186/s12889-022-12753-5
15. Salas R, Bibiloni MM, Ramos E, Villarreal JZ, Pons A, Tur JA, Sureda A. Metabolic syndrome prevalence among Northern Mexican adult population. PLoS One [Internet]. 2014 [cited 2024 Jun 10];9(8):e105581. Available from: https://pubmed.ncbi.nlm.nih.gov/25141255/. doi: 10.1371/journal.pone.0105581
16. Gulayin PE, Irazola V, Gutierrez L, Elorriaga N, Lanas F, Mores N, et al. Association between drinking patterns and cardiovascular risk: a population-based study in the Southern Cone of Latin America. J Public Health (Oxf) [Internet]. 2020 [cited 2024 Jun 10];42(1):107-117. Available from: https://pubmed.ncbi.nlm.nih.gov/30649400/. doi: 10.1093/pubmed/fdy226
17. Ruiz-Beltran AM, Alcaraz-Guzman A, Campos-Franco DR, Jimenez-Lopez CD, Ruiz-Beltran SM, Delgadillo-Rodriguez HE. Risk factors control after an acute coronary syndrome and association with major adverse cardiovascular events: A single center experience in Latin-America. High Blood Press Cardiovasc Prev. 2023;30(2):183-9. doi: 10.1007/s40292-023-00560-x
18. Lopez-Jaramillo P, Lopez-Lopez J, Cohen D, Alarcon-Ariza N, Mogollon-Zehr M. Epidemiology of hypertension and diabetes mellitus in Latin America. Curr Hypertens Rev. 2021;17(2):112-20. doi: 10.2174/1573402116999200917152952
19. Marzá-Florensa A, Gutierrez L, Gulayin P, Vaartjes I, Grobbee DE, Klipstein-Grobusch K, Irazola V. Risk factor clustering in men and women with CHD in the Southern Cone of Latin America. Int J Cardiol Cardiovasc Risk Prev [Internet]. 2023 [cited 2024 Jun 10]; 16:200172. Available from: https://pubmed.ncbi.nlm.nih.gov/36874043/. doi: 10.1016/j.ijcrp.2023.200172
20. Sisa I, Abeyá-Gilardon E, Fisberg RM, Jackson MD, Mangialavori GL, Sichieri R, et al. Impact of diet on CVD and diabetes mortality in Latin America and the Caribbean: a comparative risk assessment analysis. Public Health Nutr [Internet]. 2021 [cited 2024 Jun 10];24(9):2577-91. Available from: https://pubmed.ncbi.nlm.nih.gov/32489172/. doi: 10.1017/S1368980020000646
21. Pacheco-Barrios K, Giannoni-Luza S, Navarro-Flores A, Rebello-Sanchez I, Parente J, Balbuena A, et al. Burden of stroke and population-attributable fractions of risk factors in Latin America and the Caribbean. J Am Heart Assoc [Internet]. 2022 [cited 2024 Jun 10];11(21): e027044. Available from: https://pubmed.ncbi.nlm.nih.gov/36285788/. doi: 10.1161/JAHA.122.027044
22. Harumi Higuchi Dos Santos M, Sharma A, Sun JL, Pieper K, McMurray JJV, Holman RR, Lopes RD. International variation in outcomes among people with cardiovascular disease or cardiovascular risk factors and impaired glucose tolerance: Insights from the NAVIGATOR trial. J Am Heart Assoc [Internet]. 2017 [cited 2024 Jun 10];6(1): e003892. Available from: https://pubmed.ncbi.nlm.nih.gov/28087508/. doi: 10.1161/JAHA.116.003892
2. Mancilla-Escobar J, Rojas-Mercedes E, Pedraza-Medina Y. La obesidad: aspectos fisiopatológicos y clínicos. Arch Cardiol Mex [Internet]. 2022 [cited 2024 Jun 10]; 92(1):147-155. Disponible en: https://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S2448-57052022000100147. doi: 10.24875/ACM.21000023.
3. Castillo-Martínez L, López-Alvarenga JC, Rodríguez-Morán M, Guerrero-Romero F. Obesidad: ¿Factor de riesgo o enfermedad? Rev Med Chil [Internet]. 2019 [cited 2024 Jun 10]; 147(4):470-479. Disponible en: https://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872019000400470. doi: 10.4067/S0034-98872019000400470.
4. Misra A, Bhardwaj S. Obesity and the metabolic syndrome in developing countries: focus on South Asians. Nestle Nutr Inst Workshop Ser. 2014; 78:133-40. doi: 10.1159/000354952
5. Misra A, Khurana L. Obesity and the metabolic syndrome in developing countries. J Clin Endocrinol Metab. 2008;93(11 Supl 1): S9–S30. doi: 10.1210/jc.2008-1595
6. Ranasinghe P, Mathangasinghe Y, Jayawardena R, Hills AP, Misra A. Prevalence and trends of metabolic syndrome among adults in the Asia-pacific region: a systematic review. BMC Public Health [Internet]. 2017 [cited 2024 Jun 10]; 17(1):101. Available from: https://pubmed.ncbi.nlm.nih.gov/28109251/. doi: 10.1186/s12889-017-4041-1
7. Ansarimoghaddam A, Adineh HA, Zareban I, Iranpour S, HosseinZadeh A, Kh F. Prevalence of metabolic syndrome in Middle-East countries: meta-analysis of cross-sectional studies. Diabetes Metab Syndr. 2018;12(2):195-201. doi: 10.1016/j.dsx.2017.11.004
8. Lemus-Lemus F, Díaz Quijano DM, Rincón-Rodríguez CJ, Huertas-Moreno ML. Avances en la comprensión de la transición nutricional colombiana. Rev Gerenc Polit Salud [Internet]. 2012 [citado 10 Jun 2024];11(23):121-133. Disponible en: http://www.scielo.org.co/pdf/rgps/v11n23/v11n23a08.pdf
9. Mendoza-Romero D, Urbina A, Cristancho-Montenegro A, Rombaldi A. Impact of smoking and physical inactivity on self-rated health in women in Colombia. Prev Med Rep [Internet]. 2019 [cited 2024 Jun 10]; 16:100976. doi: 10.1016/j.pmedr.2019.100976
10. Departamento Administrativo Nacional de Estadística - DANE. Resultados censo nacional de población y vivienda 2018. [Internet]. Bogotá: DANE; 2018. [citado 15 Mar 2024]. Disponible en: https://www.dane.gov.co/index.php/estadisticas-por-tema/demografia-y-poblacion/censo-nacional-de-poblacion-y-vivenda-2018
11. Suarez-Ortegón MF, Aguilar-de Plata C. Prevalence of metabolic syndrome in children aged 5–9 years from southwest Colombia: a cross-sectional study. World J Pediatr. 2016;12(4):477-83. doi: 10.1007/s12519-016-0008-z
12. Rodríguez-Miranda CD, Jojoa-Ríos JD, Orozco-Acosta LF, Nieto-Cárdenas OA. Síndrome metabólico en conductores de servicio público en Armenia, Colombia. Rev salud pública [Internet]. 2017 [citado 15 Mar 2024];19(4):499-505. Disponible en: http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S0124-00642017000400499&lng=en&nrm=iso&tlng=es. doi: https://doi.org/10.15446/rsap.v19n4.69758
13. Márquez-Sandoval F, Macedo-Ojeda G, Viramontes-Hörner D, Fernández Ballart JD, Salas Salvadó J, Vizmanos B. The prevalence of metabolic syndrome in Latin America: a systematic review. Public Health Nutr [Internet]. 2011 [cited 2024 Jun 10];14(10):1702–13. Available from: https://pubmed.ncbi.nlm.nih.gov/21486521/. doi: 10.1017/S1368980010003320
14. de Siqueira Valadares LT, de Souza LSB, Salgado Júnior VA, de Freitas Bonomo L, de Macedo LR, Silva M. Prevalence of metabolic syndrome in Brazilian adults in the last 10 years: a systematic review and meta-analysis. BMC Public Health [Internet]. 2022 [cited 2024 Jun 10];22(1):327. Available from: https://pubmed.ncbi.nlm.nih.gov/35172790/. doi: 10.1186/s12889-022-12753-5
15. Salas R, Bibiloni MM, Ramos E, Villarreal JZ, Pons A, Tur JA, Sureda A. Metabolic syndrome prevalence among Northern Mexican adult population. PLoS One [Internet]. 2014 [cited 2024 Jun 10];9(8):e105581. Available from: https://pubmed.ncbi.nlm.nih.gov/25141255/. doi: 10.1371/journal.pone.0105581
16. Gulayin PE, Irazola V, Gutierrez L, Elorriaga N, Lanas F, Mores N, et al. Association between drinking patterns and cardiovascular risk: a population-based study in the Southern Cone of Latin America. J Public Health (Oxf) [Internet]. 2020 [cited 2024 Jun 10];42(1):107-117. Available from: https://pubmed.ncbi.nlm.nih.gov/30649400/. doi: 10.1093/pubmed/fdy226
17. Ruiz-Beltran AM, Alcaraz-Guzman A, Campos-Franco DR, Jimenez-Lopez CD, Ruiz-Beltran SM, Delgadillo-Rodriguez HE. Risk factors control after an acute coronary syndrome and association with major adverse cardiovascular events: A single center experience in Latin-America. High Blood Press Cardiovasc Prev. 2023;30(2):183-9. doi: 10.1007/s40292-023-00560-x
18. Lopez-Jaramillo P, Lopez-Lopez J, Cohen D, Alarcon-Ariza N, Mogollon-Zehr M. Epidemiology of hypertension and diabetes mellitus in Latin America. Curr Hypertens Rev. 2021;17(2):112-20. doi: 10.2174/1573402116999200917152952
19. Marzá-Florensa A, Gutierrez L, Gulayin P, Vaartjes I, Grobbee DE, Klipstein-Grobusch K, Irazola V. Risk factor clustering in men and women with CHD in the Southern Cone of Latin America. Int J Cardiol Cardiovasc Risk Prev [Internet]. 2023 [cited 2024 Jun 10]; 16:200172. Available from: https://pubmed.ncbi.nlm.nih.gov/36874043/. doi: 10.1016/j.ijcrp.2023.200172
20. Sisa I, Abeyá-Gilardon E, Fisberg RM, Jackson MD, Mangialavori GL, Sichieri R, et al. Impact of diet on CVD and diabetes mortality in Latin America and the Caribbean: a comparative risk assessment analysis. Public Health Nutr [Internet]. 2021 [cited 2024 Jun 10];24(9):2577-91. Available from: https://pubmed.ncbi.nlm.nih.gov/32489172/. doi: 10.1017/S1368980020000646
21. Pacheco-Barrios K, Giannoni-Luza S, Navarro-Flores A, Rebello-Sanchez I, Parente J, Balbuena A, et al. Burden of stroke and population-attributable fractions of risk factors in Latin America and the Caribbean. J Am Heart Assoc [Internet]. 2022 [cited 2024 Jun 10];11(21): e027044. Available from: https://pubmed.ncbi.nlm.nih.gov/36285788/. doi: 10.1161/JAHA.122.027044
22. Harumi Higuchi Dos Santos M, Sharma A, Sun JL, Pieper K, McMurray JJV, Holman RR, Lopes RD. International variation in outcomes among people with cardiovascular disease or cardiovascular risk factors and impaired glucose tolerance: Insights from the NAVIGATOR trial. J Am Heart Assoc [Internet]. 2017 [cited 2024 Jun 10];6(1): e003892. Available from: https://pubmed.ncbi.nlm.nih.gov/28087508/. doi: 10.1161/JAHA.116.003892
