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ORIGINAL
Evaluación del perfil cardiometabólico en profesionales de salud de Latinoamérica
Evaluation of cardiometabolic profile in Health Professionals of Latin America
Ivetteh Gaibor-Santosa, Jennifer Garaya, Daniela A. Esmeral-Ordoñeza, Diana Rueda-Garcíaa, Daniel D. Cohena,c, Paul A. Camachoa,b, Patricio Lopez-Jaramilloa,c,d,
Autor para correspondencia
jplopezj@gmail.com

Autor para correspondencia.
a Dirección de Investigaciones, Fundación Oftalmológica de Santander (FOSCAL), Floridablanca, Colombia
b Facultad de Ciencias de la Salud, Universidad Autónoma de Bucaramanga (UNAB), Bucaramanga, Colombia
c Instituto MASIRA, Universidad de Santander (UDES), Bucaramanga, Colombia
d Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito, Ecuador
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introducci&#243;n</span><p id="par0005" class="elsevierStylePara elsevierViewall">Las primeras causas de muerte a nivel mundial seg&#250;n reportes de la Organizaci&#243;n Mundial de la Salud &#40;OMS&#41; son el infarto agudo de miocardio &#40;IAM&#41; y el accidente cerebro vascular &#40;ACV&#41;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">1</span></a>&#46; Los estudios INTERHEART<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">2</span></a> e INTERSTROKE<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">3</span></a> identificaron los factores de riesgo modificables para IAM y ACV &#40;hipertensi&#243;n arterial&#44; obesidad abdominal&#44; tabaquismo&#44; diabetes mellitus&#44; dislipidemia&#44; depresi&#243;n&#44; ansiedad&#44; bajo consumo de frutas y verduras y falta de ejercicio&#41;&#46; En Latinoam&#233;rica&#44; la hipertensi&#243;n arterial &#40;HTA&#41; es particularmente relevante dada su alta prevalencia&#44; llegando a ser de m&#225;s del 50&#37; en personas mayores de 35 a&#241;os<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">4-7</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Los profesionales de salud son claves para la implementaci&#243;n de estrategias de educaci&#243;n&#44; informaci&#243;n&#44; prevenci&#243;n y control de los factores de riesgo para enfermedad cardiovascular &#40;ECV&#41;<a class="elsevierStyleCrossRefs" href="#bib0245"><span class="elsevierStyleSup">8-10</span></a>&#59; no obstante&#44; en Latinoam&#233;rica&#44; poco se conoce sobre la prevalencia de estos factores y de la adherencia a las recomendaciones de estilos de vida saludable en miembros del equipo de salud<a class="elsevierStyleCrossRefs" href="#bib0260"><span class="elsevierStyleSup">11-14</span></a>&#46; Por tanto&#44; el objetivo de este estudio fue evaluar la presencia de factores de riesgo para ECV y diabetes mellitus tipo 2 &#40;DM2&#41; en un grupo de trabajadores de la salud que asistieron a un congreso m&#233;dico donde se abordaron esos temas&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Material y m&#233;todo</span><p id="par0015" class="elsevierStylePara elsevierViewall">Estudio observacional&#44; descriptivo de corte transversal avalado por la Sociedad Latinoamericana de Medicina Interna &#40;SOLAMI&#41; dentro del marco del X Congreso Latinoamericano de Medicina Interna realizado en agosto del 2017&#44; en la ciudad de Cartagena&#44; Colombia&#46; Se invit&#243; a participar de forma libre y voluntaria a todos los asistentes&#46; Se instalaron seis estaciones de atenci&#243;n durante los cuatro d&#237;as del congreso&#44; con personal m&#233;dico y de enfermer&#237;a&#46; En la primera estaci&#243;n se obtuvo un informe de consentimiento verbal y se pregunt&#243; sobre los antecedentes m&#233;dicos personales&#44; farmacol&#243;gicos&#44; familiares y h&#225;bitos de vida saludable&#46; En la segunda estaci&#243;n se realiz&#243; la medida de presi&#243;n arterial&#46; Esta medici&#243;n fue la &#250;nica que requer&#237;a ser tomada antes de pasar por las otras estaciones&#46; En la tercera estaci&#243;n se registraron las medidas de composici&#243;n corporal&#46; En la cuarta estaci&#243;n fueron registradas las medidas antropom&#233;tricas&#46; En la quinta estaci&#243;n se realiz&#243; y registr&#243; la fuerza prensil&#46; En la sexta estaci&#243;n se tom&#243; una muestra de sangre capilar para la determinaci&#243;n de colesterol total&#44; triglic&#233;ridos&#44; colesterol-HDL&#44; colesterol-LDL&#44; glucosa al azar y hemoglobina glucosilada &#40;HbA1c&#41;&#46; En la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a> se resume la definici&#243;n y valores de referencia de las principales variables a utilizar&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">La presi&#243;n arterial fue medida con el participante en reposo de al menos cinco minutos&#44; con un oscil&#243;metro digital &#40;Omron&#174; HEM-7220&#41;&#44; en el brazo derecho apoyado sobre una superficie estable&#44; a la altura del coraz&#243;n&#44; en tres ocasiones con intervalos de dos minutos entre cada medici&#243;n&#46; Se utiliz&#243; el promedio de las tres mediciones para los an&#225;lisis estad&#237;sticos&#46; Las medidas antropom&#233;tricas obtenidas fueron peso&#44; talla&#44; circunferencia de cintura y circunferencia de cadera&#44; con &#233;stas se calcularon la relaci&#243;n cintura-cadera &#40;RCC&#41; y el &#237;ndice de masa corporal &#40;IMC&#41;&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">La circunferencia de la cintura se midi&#243; en el punto medio entre el margen inferior de la &#250;ltima costilla palpable y la parte superior de la cresta il&#237;aca&#44; utilizando una cinta resistente al estiramiento&#59; el valor normal reportado en poblaci&#243;n sudamericana en hombres es 88-90 cm y en mujeres 83-84 cm&#46; La circunferencia de la cadera se midi&#243; alrededor de la parte m&#225;s ancha de los gl&#250;teos&#44; con la cinta paralela al piso&#46; La RCC se obtuvo dividiendo la circunferencia de la cintura por la circunferencia de la cadera&#44; con ambos valores reportados en cent&#237;metros&#46; El valor normal de la RCC en poblaci&#243;n sudamericana reportada es 0&#44;85-0&#44;95 en hombres y 0&#44;80-1&#44;18 en mujeres<a class="elsevierStyleCrossRefs" href="#bib0280"><span class="elsevierStyleSup">15-17</span></a>&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Los valores de referencia para definir obesidad y sobrepeso seg&#250;n el IMC son los recomendados por la OMS&#44; siendo normal un IMC 18&#44;5-20 kg&#47;</p><p id="par0120" class="elsevierStylePara elsevierViewall">m<span class="elsevierStyleSup">2</span>&#44; sobrepeso un IMC 25-29&#44;9 kg&#47;m<span class="elsevierStyleSup">2</span> y obesidad un IMC &#62;&#160;30 kg&#47;m<span class="elsevierStyleSup">2</span><a class="elsevierStyleCrossRefs" href="#bib0280"><span class="elsevierStyleSup">15-17</span></a>&#46; Para las medidas de composici&#243;n corporal y el peso se utiliz&#243; una b&#225;scula de bioimpedancia el&#233;ctrica &#40;Tanita&#174; IRONMAN BC-554&#41;&#44; que calcul&#243; peso en kilos&#44; porcentaje de grasa corporal&#44; masa muscular en kilos y porcentaje de grasa visceral&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">La fuerza muscular es la capacidad de un m&#250;sculo o un grupo de m&#250;sculos para producir una fuerza contra una resistencia externa<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">18</span></a> y su disminuci&#243;n&#44; en especial del segmento superior&#44; ha sido postulada como nuevo marcador de riesgo para enfermedad cardiovascular<a class="elsevierStyleCrossRef" href="#bib0380"><span class="elsevierStyleSup">35</span></a>&#46; La fuerza muscular del segmento superior fue evaluada a trav&#233;s de la fuerza de empu&#241;adura &#40;FE&#41;&#44; que es la capacidad cuantificable para ejercer una presi&#243;n con la mano y con los dedos<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">19</span></a>&#59; la fuerza de empu&#241;adura-pico y la fuerza de empu&#241;adura ajustada a la edad utilizando un dinam&#243;metro manual &#40;Jamar&#174; hidr&#225;ulico modelo 5030J1&#41;&#46; Se realizaron tres medidas por cada mano y se obtuvo un promedio&#44; la fuerza de empu&#241;adura pico hace referencia a la mejor medici&#243;n&#46; La fuerza de empu&#241;adura tambi&#233;n se ajust&#243; por el peso&#46; Los resultados promedio reportados en varios estudios en poblaci&#243;n colombiana para los hombres han sido 42&#44;8 kg y 40&#44;9 kg en FE derecha e izquierda respectivamente&#46; Para las mujeres 25&#44;3 kg y 24&#44;0 kg respectivamente<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">20</span></a>&#46; La fuerza muscular del segmento inferior se evalu&#243; por el salto alto&#46; El salto alto es la capacidad de levantar el centro de gravedad lo m&#225;s alto en la direcci&#243;n vertical &#250;nicamente con el uso de los propios m&#250;sculos<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">21</span></a>&#46; Los valores promedios se han reportado para hombres entre 41 y 50 cm&#44; y para mujeres entre 31 y 40 cm<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">22</span></a>&#46; Esta fuerza muscular es expresada en cent&#237;metros&#44; y calculada a trav&#233;s de la plataforma ForceDecks &#40;VALD Performance&#44; United Kigndom&#41; dise&#241;ada por uno de los autores &#40;DDC&#41;&#44; para lo cual se solicit&#243; a los participantes realizar un salto vertical desde el piso tan alto como sea posible&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">La HTA se defini&#243; cuando el individuo declar&#243; tener antecedentes de hipertensi&#243;n para lo cual tomaba medicamentos antihipertensivos&#44; o que registr&#243; cifras tensionales &#8805; 140&#47;90 mmHg&#46; La DM2 se defini&#243; cuando el participante report&#243; que era diab&#233;tico y tomaba medicinas hipoglucemiantes&#44; o present&#243; una hemoglobina glucosilada &#8805; 6&#44;5&#37;&#46; Para calcular el riesgo de desarrollar DM2 se aplic&#243; la escala FINDRISC&#44; la cual ha demostrado en Colombia&#44; tener una sensibilidad del 74&#37; y una especificidad del 60&#37; para categorizar a la poblaci&#243;n sin riesgo &#40;&#60; 12 puntos&#41; y con riesgo &#40;&#8805;12 puntos&#41;<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">23</span></a>&#46; Se eval&#250;o el perfil lip&#237;dico definiendo a la dislipidemia aterog&#233;nica a la presencia de triglic&#233;ridos &#8805; 150 mg&#47;dL&#44; Colesterol-LDL 130 mg&#47;dL y Colesterol-HDL &#60; 40 mg&#47;dL en hombres y &#60; 50 mg&#47;dL en mujeres&#46; Para la medici&#243;n bioqu&#237;mica se utiliz&#243; el equipo Accutrend&#174; Plus &#40;Roche Diagnostics GmbH&#44; Mannheim&#44; Germany&#41;&#44; el cual se encuentra validado para su uso<a class="elsevierStyleCrossRefs" href="#bib0325"><span class="elsevierStyleSup">24&#44;25</span></a>&#46; De la muestra se excluyeron 27 y 26 personas en las variables de dislipemia y diabetes&#44; respectivamente&#44; debido a que estos participantes no dieron su consentimiento para participar del registro de esta variable por considerarla invasiva&#46; El riesgo de enfermedad cardiovascular fue calculado seg&#250;n el cuestionario INTERHEART&#44; tomando como valor de corte significativo de riesgo una puntuaci&#243;n igual o mayor a 10 puntos &#40;tertil m&#225;s alto&#41;&#44; el cual en un estudio poblacional previo se asoci&#243; con un aumento de 5&#44;7 veces en la probabilidad de presentar un IAM&#44; en comparaci&#243;n con una puntuaci&#243;n de 0 a 4 &#40;tertil m&#225;s bajo&#41;<a class="elsevierStyleCrossRefs" href="#bib0335"><span class="elsevierStyleSup">26&#44;27</span></a>&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">El an&#225;lisis estad&#237;stico se realiz&#243; en el software STATA VE 11&#46;2 &#40;StataCorp LLC&#44; Texas&#44; USA&#41;&#46; Las variables categ&#243;ricas se resumen con frecuencias absolutas y relativas&#44; las medidas de frecuencia se presentan con su intervalo de confianza del 95&#37;&#46; A las variables cuantitativas se estimaron las medidas de tendencia central y dispersi&#243;n seg&#250;n la distribuci&#243;n de frecuencias&#46; La independencia de las variables explicativas y la presencia de HTA se evalu&#243; con prueba de <span class="elsevierStyleItalic">X</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">2</span></span> o exacto de Fischer&#44; seg&#250;n el n&#250;mero de observaciones por categor&#237;a&#46; La relaci&#243;n de las medidas antropom&#233;tricas&#44; de composici&#243;n corporal&#44; aptitud f&#237;sica y control metab&#243;lico y la presencia de HTA se evaluaron con la prueba de <span class="elsevierStyleItalic">t</span> de Student o Mann-Whitney seg&#250;n la distribuci&#243;n de frecuencias&#46; El nivel de significaci&#243;n del estudio fue del 5&#37;&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Resultados</span><p id="par0050" class="elsevierStylePara elsevierViewall">De los 186 participantes&#44; 101 &#40;54&#44;3&#37;&#41; fueron hombres y la edad promedio fue 37&#44;9 &#177; 14&#44;7 a&#241;os &#40;rango&#58; 18-80 a&#241;os&#41;&#46; 175 fueron m&#233;dicos &#40;94&#37;&#41;&#44; de los cuales 98 &#40;52&#44;7&#37;&#41; fueron especialistas en Medicina Interna y los otros 77 &#40;41&#44;4&#37;&#41; eran m&#233;dicos de atenci&#243;n primaria&#59; el 5&#44;9&#37; restante inclu&#237;a a personal de enfermer&#237;a y estudiantes de medicina&#46; 39 &#40;20&#44;9&#37;&#41; hab&#237;an fumado o eran fumadores actuales y 113 &#40;60&#44;8&#37;&#41; reportaban ser sedentarios&#46; El IMC medio fue de 26&#44;5 &#177; 4&#44;5 kg&#47;m<span class="elsevierStyleSup">2</span> &#40;rango&#58; 15&#44;5-41&#44;9 kg&#47;m<span class="elsevierStyleSup">2</span>&#41; y la circunferencia de cintura media fue de 87&#44;9 &#177; 13&#44;1 cm &#40;rango&#58; 63&#44;4-126 cm&#41;&#44; siendo el promedio en las mujeres 79&#44;3 cm y en los hombres 95&#44;2 cm&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">La prevalencia de HTA fue 20&#44;43&#37; &#91;IC&#160;95&#37;&#58; 14&#44;6-26&#44;3&#37;&#93;&#44; observ&#225;ndose que la edad &#40;p &#60; 0&#44;001&#41; y el tabaquismo &#40;p &#61; 0&#44;004&#41; fueron los dos factores que se asociaron con su presencia &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41;&#46; La prevalencia de sobrepeso &#40;IMC &#62;&#160;25-30&#41; fue 40&#44;32&#37; &#91;IC&#160;95&#37;&#58; 33&#44;20-47&#44;4&#37;&#93;&#44; de obesidad &#40;IMC &#62; 30&#41; fue 19&#44;89&#37; &#91;IC&#160;95&#37;&#58; 14&#44;1-25&#44;68&#37;&#93;&#46; El 67&#44;5&#37; &#91;IC&#160;95&#37;&#58; 60&#44;3-74&#44;7&#37;&#93; present&#243; dislipidemia aterog&#233;nica&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a> se detallan las caracter&#237;sticas antropom&#233;tricas&#44; de fuerza muscular y los resultados de las pruebas bioqu&#237;micas seg&#250;n la presencia o no de hipertensi&#243;n&#46; Los hipertensos presentaron cifras significativamente mayores de peso&#44; IMC&#44; circunferencia de cintura&#44; relaci&#243;n cintura&#47;cadera y mayores porcentajes de grasa corporal y visceral&#46; Hubo una tendencia de la fuerza muscular a ser menor en el grupo de hipertensos&#46; El salto alto alcanz&#243; significaci&#243;n estad&#237;stica en los hipertensos&#46; No hubo diferencias en las determinaciones bioqu&#237;micas&#44; con excepci&#243;n de la hemoglobina glucosilada que fue mayor en los hipertensos &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">Al realizar el an&#225;lisis de los par&#225;metros de fuerza de acuerdo con el sexo se encontr&#243; que en los hombres con HTA la fuerza de empu&#241;adura y el salto alto fueron significativamente menores que los observados en los hombres normotensos&#44; diferencia que no se observ&#243; en las mujeres &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">Ochenta y una personas &#40;44&#44;3&#37; &#91;IC&#160;95&#37;&#58; 37-51&#44;5&#37;&#93;&#41; tuvieron una puntuaci&#243;n mayor de 10 en el cuestionario INTERHEART significativo de riesgo cardiovascular alto&#46; La presencia de hipertensi&#243;n arterial se asoci&#243; a mayor riesgo cardiovascular de manera significativa &#91;p &#61; 0&#44;005&#93;&#44; tanto en hombres como en mujeres&#44; aumentando con la edad &#40;<a class="elsevierStyleCrossRef" href="#fig0010">fig&#46; 2</a>&#41;&#46; La prevalencia de DM2 fue 6&#44;59&#37;&#46; Cuarenta y cuatro participantes &#40;23&#44;7&#37;&#41; presentaron riesgo de DM2&#44; por obtener puntuaciones mayores de 12 en la escala FINDRISC&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discusi&#243;n</span><p id="par0075" class="elsevierStylePara elsevierViewall">El principal hallazgo de este estudio fue que la mayor&#237;a de los participantes&#44; m&#233;dicos especialistas j&#243;venes que asisten a un Congreso M&#233;dico Latinoamericano&#44; en el cual se discuti&#243; la importancia de un estilo de vida saludable y de la identificaci&#243;n y control de los factores de riesgo cardiovascular&#44; presentan prevalencias de los factores de riesgo para ECV y DM2 similares a las reportadas para la poblaci&#243;n general de Latinoam&#233;rica<a class="elsevierStyleCrossRefs" href="#bib0345"><span class="elsevierStyleSup">28-31</span></a>&#46; El hecho de que estos trabajadores de la salud tengan acceso a la informaci&#243;n&#44; educaci&#243;n y comunicaci&#243;n sobre la importancia de la prevenci&#243;n y control de esos factores de riesgo hac&#237;a presumir que la prevalencia de estos podr&#237;a ser menor&#46; Sin embargo&#44; nuestros resultados demuestran que esta presunci&#243;n no es verdadera&#44; a pesar del conocimiento que este grupo tiene&#44; su nivel de riesgo es muy similar al del resto de la poblaci&#243;n&#44; situaci&#243;n que ya ha sido reportada en otros estudios en trabajadores de salud de nuestra regi&#243;n<a class="elsevierStyleCrossRefs" href="#bib0260"><span class="elsevierStyleSup">11-14</span></a>&#46; As&#237;&#44; la prevalencia de HTA&#44; sedentarismo&#44; sobrepeso&#47;obesidad&#44; dislipidemia y tabaquismo&#44; es comparable a lo reportado en la poblaci&#243;n general&#44; dando como resultado que las puntuaciones de riesgo cardiovascular y de DM2 sean altas&#44; tambi&#233;n similares a lo reportado en poblaci&#243;n no m&#233;dica<a class="elsevierStyleCrossRefs" href="#bib0345"><span class="elsevierStyleSup">28-31</span></a>&#46; Estos resultados son de preocupaci&#243;n&#44; porque en principio son estos profesionales quienes deben orientar y aconsejar a sus pacientes sobre la importancia de la identificaci&#243;n&#44; prevenci&#243;n y control de los factores de riesgo cardiovascular&#44; mediante la pr&#225;ctica de h&#225;bitos de vida saludable&#44; y si es necesario&#44; de la adherencia adecuada a medicamentos probadamente &#250;tiles para su control&#46; Otro aspecto de preocupaci&#243;n es la alta prevalencia de sobrepeso y de obesidad abdominal entre los participantes&#44; sobre todo en los hipertensos&#44; quienes adem&#225;s en su mayor&#237;a se declararon sedentarios&#46; Tambi&#233;n&#44; los m&#233;dicos hipertensos tuvieron disminuidos valores de fuerza muscular&#44; tanto de segmento superior como inferior&#44; lo que da soporte a la reciente propuesta de que una alteraci&#243;n en la relaci&#243;n entre adiposidad y masa&#47;fuerza muscular es un factor que se asocia a mayor riesgo de HTA<a class="elsevierStyleCrossRefs" href="#bib0370"><span class="elsevierStyleSup">33&#44;34</span></a>&#44; de mortalidad total&#44; de mortalidad cardiovascular y de eventos cardiovasculares<a class="elsevierStyleCrossRefs" href="#bib0380"><span class="elsevierStyleSup">35-37</span></a>&#46; Llama la atenci&#243;n la alta prevalencia de dislipidemia aterog&#233;nica observada en este grupo de m&#233;dicos latinoamericanos&#44; situaci&#243;n que ha sido reportada en la poblaci&#243;n general<a class="elsevierStyleCrossRefs" href="#bib0355"><span class="elsevierStyleSup">30&#44;32&#44;38</span></a>&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">La presencia concomitante de HTA&#44; tabaquismo&#44; sedentarismo&#44; sobrepeso y menor fuerza muscular en un porcentaje alto de estos j&#243;venes m&#233;dicos&#44; posiblemente se asocian con la prevalencia de DM2 similar a la de la poblaci&#243;n general &#40;m&#225;s de 6&#44;5&#37;&#41; y con una puntuaci&#243;n de riesgo alto para desarrollar DM2 en m&#225;s de uno de cada cuatro participantes<a class="elsevierStyleCrossRefs" href="#bib0400"><span class="elsevierStyleSup">39&#44;40</span></a>&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Entre las nueve recomendaciones de la Asamblea Mundial de la Salud que vienen siendo implementadas por la OMS&#44; todas encaminadas a alcanzar las metas de disminuir en 25&#37; la mortalidad cardiovascular prematura hasta el a&#241;o 2025&#44; se encuentran la de disminuir el tabaquismo&#44; mejorar la conciencia&#44; el tratamiento y control de la HTA&#44; reducir el consumo exagerado de sal y aumentar la actividad f&#237;sica<a class="elsevierStyleCrossRef" href="#bib0410"><span class="elsevierStyleSup">41</span></a>&#44; acciones que en su mayor&#237;a demandan una importante toma de conciencia del equipo de salud para implementar estas recomendaciones a trav&#233;s de una efectiva consejer&#237;a&#46; Nuestros resultados sugieren que es necesario&#44; con car&#225;cter prioritario&#44; implementar programas entre los m&#233;dicos de Latinoam&#233;rica&#44; que permitan mejorar su conciencia de la importancia de mejorar sus propios h&#225;bitos de vida&#44; antes de asumir el papel de consejeros de estilos de vida saludables&#44; rol que es fundamental en perspectiva de alcanzar las metas de reducci&#243;n de mortalidad cardiovascular a las cuales se han comprometido todos los gobiernos de los pa&#237;ses de la regi&#243;n&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Una de las principales limitaciones de nuestro estudio es el tama&#241;o de la muestra&#44; pero los hallazgos deben interpretarse en este contexto&#59; sin embargo&#44; el comportamiento de la muestra y los hallazgos son comparables con la literatura&#46; El presente estudio revela la importancia de involucrar a esta poblaci&#243;n espec&#237;fica &#40;profesionales de la salud&#41;&#44; como participantes al momento de estudiar la enfermedad cardiovascular&#46; Otra limitaci&#243;n del estudio podr&#237;a ser la ausencia de un perfil de h&#225;bitos alimenticios en los profesionales de la salud&#44; pero no era un objetivo del estudio&#46; Finalmente&#44; el estudio minimiz&#243; los potenciales sesgos de medici&#243;n&#44; utilizando las t&#233;cnicas y est&#225;ndares internacionales para la tamizaci&#243;n de marcadores antropom&#233;tricos y biol&#243;gicos de enfermedad cardiovascular&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Conclusi&#243;n</span><p id="par0095" class="elsevierStylePara elsevierViewall">La prevalencia de factores de riesgo para ECV entre los m&#233;dicos latinoamericanos estudiados fue similar a la reportada en la poblaci&#243;n general&#46; La prevalencia de puntuaci&#243;n de alto riesgo para ECV y DM2 fue alta y los h&#225;bitos de vida saludables fueron bajos&#46; Es necesario mejorar la adherencia a estilos de vida saludable entre estos m&#233;dicos encargados del control de esos factores en la poblaci&#243;n general&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Financiaci&#243;n</span><p id="par0100" class="elsevierStylePara elsevierViewall">El presente trabajo ha sido financiado por Laboratorio Merck&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Conflicto de intereses</span><p id="par0105" class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
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    "fechaAceptado" => "2020-11-11"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Evaluar la presencia de factores de riesgo para enfermedades cardiovasculares &#40;ECV&#41; y diabetes mellitus tipo 2 &#40;DM2&#41; en un grupo de trabajadores de la salud&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">M&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Durante el X Congreso Latinoamericano de Medicina Interna realizado en agosto del 2017&#44; en Cartagena&#44; Colombia&#44; se invit&#243; a los asistentes a participar del estudio que incluy&#243; encuesta sobre antecedentes m&#233;dicos&#44; farmacol&#243;gicos&#44; familiares&#44; h&#225;bitos de vida&#44; medici&#243;n de presi&#243;n arterial&#44; antropometr&#237;a&#44; fuerza muscular y laboratorios&#46; Se utilizaron las escalas INTERHEART y FINDRISC para calcular el riesgo de ECV y diabetes&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">En 186 participantes con edad promedio de 37&#44;9 a&#241;os&#44; 94&#37; m&#233;dicos &#40;52&#44;7&#37; especialistas&#41; la prevalencia de hipertensi&#243;n fue 20&#44;4&#37;&#44; sobrepeso 40&#44;3&#37;&#44; obesidad 19&#44;9&#37; y dislipidemia 67&#44;3&#37;&#46; El 20&#44;9&#37; eran fumadores actuales o hab&#237;an fumado y 60&#44;8&#37; eran sedentarios&#46; Los hipertensos tuvieron mayor edad&#44; &#237;ndice de masa corporal &#40;IMC&#41;&#44; circunferencia de cintura&#44; relaci&#243;n cintura&#47;cadera&#44; porcentaje de grasa corporal&#44; grasa visceral&#44; fueron m&#225;s fumadores y tuvieron menor fuerza muscular &#40;salto alto&#58; 0&#44;38 vs&#46; 0&#44;42&#778;cm&#59; p&#778;&#61;&#778;0&#44;01&#41;&#46; El 44&#44;3&#37; presentaron riesgo cardiovascular alto&#46; La prevalencia de diabetes fue 6&#44;59&#37; y 27&#44;7&#37; estaban en riesgo&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusi&#243;n</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La prevalencia de factores de riesgo para ECV entre los m&#233;dicos Latinoamericanos estudiados fue similar a la reportada en la poblaci&#243;n general&#46; La prevalencia de puntuaci&#243;n de alto riesgo para ECV y DM2 fue alta y los h&#225;bitos de vida saludables fueron bajos&#46; Es necesario mejorar la adherencia a estilos de vida saludable entre estos m&#233;dicos encargados del control de esos factores en la poblaci&#243;n general&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objective</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To evaluate presence of risk factors for cardiovascular diseases &#40;CVD&#41; and type 2 diabetes mellitus &#40;DM2&#41; in a group of health care workers&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">During the X Latin American Congress of Internal Medicine held in August 2017&#44; in Cartagena&#44; Colombia&#44; attendees were invited to participate in the study that included a survey on medical&#44; pharmacological and family history&#44; lifestyle habits&#44; blood pressure measurement&#44; anthropometry&#44; muscle strength and laboratory studies&#46; The INTERHEART and FINDRISC scales were used to calculate the risk of CVD and diabetes&#44; respectively&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Among 186 participants with an average age of 37&#46;9 years&#44; 94&#37; physicians &#40;52&#46;7&#37; specialists&#41;&#44; the prevalence of hypertension was 20&#46;4&#37;&#44; overweight 40&#46;3&#37;&#44; obesity 19&#46;9&#37;&#44; and dyslipidemia 67&#46;3&#37;&#46; 20&#46;9&#37; were current smokers or had smoked&#44; and 60&#46;8&#37; were sedentary&#46; Hypertensive patients were found to be older&#44; had higher Body Mass Index &#40;BMI&#41;&#44; higher waist circumference&#44; higher waist-to-hip ratio&#44; higher of body fat and visceral fat&#44; smoked more and had lower muscle strength &#40;high jump&#58; 0&#46;38 vs&#46; 0&#46;42&#778;cm&#59; p&#778;&#61;&#778;0&#46;01&#41;&#46; In 44&#46;3&#37; of participants was observed a high-risk score for CVD&#46; The prevalence of diabetes was 6&#46;59&#37; and 27&#46;7&#37; were at risk&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusion</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">The prevalence of risk factors for CVD among the Latin American physicians studied was similar to that reported in the general population&#46; The prevalence of high-risk scores for CVD and DM2 was high and healthy lifestyle habits were low&#46; It is necessary to improve adherence to healthy lifestyles among these physicians in charge of controlling these factors in the general population&#46;</p></span>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Variable&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Definici&#243;n&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Valores de referencia &#40;Normal&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">Hipertensi&#243;n arterial &#40;HTA&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Historia previa o tratamiento farmacol&#243;gicoTA&#58; &#8805;140&#47;90 mmHg&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">120&#47;80 mmHg&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Diabetes mellitus tipo 2 &#40;DM2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Historia previa o tratamiento farmacol&#243;gicoHemoglobina glucosilada &#40;HbA1C &#62; 6&#44;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HbA1C &#60; 5&#44;6&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Circunferencia de cintura&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Circunferencia medida en el punto medio entre el margen inferior de la &#250;ltima costilla palpable&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hombres&#58; 88-90 cmMujeres&#58; 83-84 cm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Relaci&#243;n cintura-cadera &#40;RCC&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Circunferencia de la cintura &#40;cm&#41;&#47;Circunferencia de la cadera &#40;cm&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hombres&#58; 0&#44;85-0&#44;95Mujeres&#58; 0&#44;80-1&#44;18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">&#205;ndice de masa corporal &#40;IMC&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Peso &#40;kg&#41;&#47;talla &#40;m<span class="elsevierStyleSup">2</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">20-24&#44;9 kg&#47;m<span class="elsevierStyleSup">2</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Fuerza de empu&#241;adura &#40;FE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Capacidad cuantificable para ejercer una presi&#243;n con la mano y con los dedos&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Hombres&#58; 42&#44;8-40&#44;9 kgMujeres 25&#44;3-24&#44;0 kg&#40;Derecha e izquierda&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">Salto alto&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">Capacidad de levantar el centro de gravedad lo m&#225;s alto en direcci&#243;n vertical s&#243;lo con el uso de los m&#250;sculos&#46;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Hombres&#58; 41-50 cmMujeres&#58; 31-40 cm&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>NO&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>S&#205;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Diabetes</span><a class="elsevierStyleCrossRef" href="#tblfn0015">&#42;&#42;&#42;</a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>NO&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>S&#205;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">6 &#40;19&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Tipo de especialidad</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;435&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>M&#233;dico especialista&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">80 &#40;54&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">18 &#40;47&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>M&#233;dico de atenci&#243;n primaria&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Otro &#40;enfermer&#237;a&#44; estudiante de medicina&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">10 &#40;6&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1 &#40;2&#44;6&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Tabaquismo</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;004&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Nunca&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">147 &#40;79&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">122 &#40;82&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">25 &#40;65&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Exfumador&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">31 &#40;16&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Actual&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">8 &#40;4&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">8 &#40;5&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Diabetes mellitus&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Enfermedad coronaria&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
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            "rol" => "short"
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            0 => array:2 [
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">DS&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">12&#44;54&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>RCC&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">184&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="9" align="left" valign="\n
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                  \t\t\t\t  " colspan="9" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Composici&#243;n corporal</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Grasa corporal &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Masa muscular &#40;kg&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Fuerza Muscular</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Colesterol total &#40;mg&#47;dL&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>HDL &#40;mg&#47;dL&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;777&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Colesterol no HDL&#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
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Información del artículo
ISSN: 02149168
Idioma original: Español
DOI:10.1016/j.arteri.2020.11.002
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