Asociación entre el índice triglicéridos/colesterol HDL y la glucosa alterada en ayuno en pacientes normotensos con obesidad y sobrepeso
Resumen
Antecedentes: recientemente se describió la relación entre la concentración sérica de triglicéridos y colesterol de alta densidad como marcador equiparable de resistencia a la insulina, con la ventaja de ser una herramienta sencilla y ampliamente disponible. El índice triglicéridos colesterol HDL aplicado a pacientes con sospecha de resistencia a la insulina puede resultar útil en nuestra población.
Objetivo: determinar la asociación entre el índice triglicéridos colesterol HDL y la glucosa alterada en ayuno en pacientes con sobrepeso y obesidad con presión arterial normal.
Material y método: estudio descriptivo, observacional, transversal y prolectivo, en el que se determinó una muestra de participantes, 50% con glucosa alterada en ayuno y el resto, glucosa normal. Todos los pacientes eran normotensos, con sobrepeso u obesidad; se determinó la concentración sérica en ayuno de glucosa, triglicéridos séricos y colesterol total, HDL y LDL. Se usó estadística descriptiva para la caracterización de la población. El análisis estadístico inferencial se realizó mediante razón de momios y x2 para variables cualitativas dicotómicas. El valor de p se calculó mediante t de Student para variables cuantitativas continuas. Se consideró una diferencia estadísticamente significativa con valor de p<0.05.
Resultados: de los 68 pacientes incluidos, 48 eran hombres. El promedio de edad fue de 41.13±11.70 años. La mayoría de los pacientes (42 de 68) tuvo elevación del índice TG/C-HDL. Se contrastaron la variable independiente (índice TG/HDL-C) y la dependiente (glucosa alterada en ayuno), se encontró mayor proporción de glucosa alterada en ayuno en el grupo de pacientes con índice TG/HDL-C elevado. Se evaluó la asociación entre el índice TG/C-HDL (elevado o no) y la glucosa alterada en ayuno (presente o ausente) con la prueba x2, que arrojó un valor de 3.98 y un valor de p=.046.
Conclusiones: se encontró una asociación estadísticamente significativa entre el índice TG/C-HDL elevado y la glucosa alterada en ayuno con valor de p<.05, que se confirmó con el cálculo de la razón de momios: RM = 2.77 (IC 95%,1.006, 7.673). El índice TG/C-HDL elevado es un factor de riesgo de glucosa alterada en ayuno.
Palabras clave: glucosa alterada en ayuno, índice triglicéridos-colesterol HDL, sobrepeso, obesidad, resistencia a la insulina, síndrome metabólico.
Abstract
Background: Currently within the scientific health research it has been established the importance of early identification and prevention of cardiovascular and metabolic entities. According to the pathophysiology of diabetes mellitus 2, this is a late submission of events that can be associated with metabolic syndrome, pathological condition related to insulin resistance and hyperinsulinemia which presents a high risk of developing type 2 diabetes mellitus and atherosclerotic cardiovascular disease. Various diagnostic criteria have been established for metabolic syndrome, with modifications according to the type of population studied. These criteria include obesity, waist circumference, dyslipidemia, hyperglycemia and hypertension. Both the concentrations of HDLcholesterol (HDL-C) and triglyceride (TG) levels were independently associated with insulin sensitivity. Recently described the relationship between serum triglycerides (TG) and high density cholesterol (HDL-C) as marker comparable of insulin resistance, with the advantage of being simple, readily available tool. It’s necessary to establish parameters in order to identify in a timely and accessible way people whom are in early stages of insulin resistance, to make medical interventions and modify their prognosis. Thus, the triglycerides/HDL cholesterol (TG/ HDL-C) ratio applied to patients who are suspected to have insulin resistancet would be useful in our population.
Objective: To determine the association between triglyceride/HDLcholesterol ratio (TG/HDL-C) and impaired fasting glucose in obese and overweight patients with normal blood pressure.
Material and method: A cross-sectional, descriptive, observational, and prolective study was done with a sample of 68 participants, 50% of these showed impaired fasting glucose while remaining 50% showed normal glucose, all patients were normotensive, obese or overweight and serum fasting glucose, triglycerides and total cholesterol, HDL and LDL were determined. Descriptive statistics were used to characterize the population. The inferential statistical analysis was performed using tests of association (odds ratio) and x2 for dichotomous qualitative variables. Also p was calculated using T-test for continuous quantitative variables. It was considered a statistically significant difference with p <0.05.
Results: Of 68 patients, 48 were male. The average age was 41.13±11.70 years. Most patients (n=42) had elevated TG/HDL-C ratio. Were contrasted the independent variable (TG/HDL-C ratio) and dependent variable (impaired fasting glucose), finding a higher proportion of impaired fasting glucose in the group of patients with high TG/HDL-C. Assessment of association was made between TG/HDL-CL ratio (elevated or not) and impaired fasting glucose (present or absent) using the x2 test which gave a value of 3.98 and a value of p=.046.
Conclusions: It was found a statistically significant association between the high TG/HDL-C ratio and the presence of impaired fasting glucose with a value of p<.05, which was confirmed through odds ratio: OR=2.77 (95% CI 1.006, 7.673), concluding that the TG/HDL-C ratio is high risk factor for having impaired fasting glucose.
Keywords: impaired fasting glucose, triglycerides/HDL cholesterol index, overweight, obesity, insulin resistance, metabolic syndrome.
Sin comentarios