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Seguimiento de los pacientes con diabetes tipo 2 durante la pandemia por COVID-19: un estudio multicéntrico en Atención Primaria
Follow-up of patients with type 2 diabetes during the COVID-19 pandemic: A multicentre study in Primary Care
F.J. Cuevas Fernándeza,b, O.T. Gómez Lópeza,b, M. Dorta Espiñeiraa,b, S. Farrais Villalbaa, A. Cabrera de Leónb,c,
Autor para correspondencia
acableon@gmail.com

Autor para correspondencia.
, Armando Aguirre-Jaimed
a Gerencia de Atención Primaria de Tenerife, Servicio Canario de la Salud, Santa Cruz de Tenerife, España
b Área de Medina Preventiva y Salud Pública, Universidad de La Laguna, Santa Cruz de Tenerife, España
c Unidad de Investigación de la Gerencia de Atención Primaria y del Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, España
d Servicio de Investigación en Cuidados del Colegio de Enfermer@s, Santa Cruz de Tenerife, España
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hipertensi&#243;n arterial&#44; diabetes tipo 2 &#40;DM2&#41; y obesidad&#44; que presentan mayor susceptibilidad a desarrollar formas graves y con peor pron&#243;stico de COVID-19<a class="elsevierStyleCrossRefs" href="#bib0160"><span class="elsevierStyleSup">6-8</span></a> en el caso de la DM2&#59; son especialmente los pacientes que tienen peor control gluc&#233;mico<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">7-9</span></a> y los m&#225;s j&#243;venes<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">10</span></a>&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">En el &#225;mbito del Servicio Canario de la Salud &#40;SCS&#41; se tomaron medidas temporales seg&#250;n la evoluci&#243;n local de la pandemia&#44; tales como la suspensi&#243;n de las consultas programadas con la enfermera comunitaria &#40;EC&#41; y el m&#233;dico de familia &#40;MF&#41;&#44; la suspensi&#243;n de realizaci&#243;n de retinograf&#237;as y electrocardiogramas&#44; o la limitaci&#243;n de anal&#237;ticas a los casos considerados no demorables&#44; siendo actividades recogidas en el Programa de Prevenci&#243;n y Control de la Enfermedad Vascular Ateroescler&#243;tica &#40;pEVA&#41;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">11</span></a>&#46; As&#237; los profesionales sanitarios de AP&#44; especialmente las enfermeras&#44; se dedicaron a tareas como los test diagn&#243;sticos de COVID-19 &#40;PCR y ant&#237;genos&#41;&#44; cribado poblacional&#44; rastreo y seguimiento de casos y contactos estrechos&#44; o a la vacunaci&#243;n&#46; Los efectos colaterales de todas estas medidas han sido estudiados durante el periodo de confinamiento domiciliario en pacientes con DM1<a class="elsevierStyleCrossRefs" href="#bib0013"><span class="elsevierStyleSup">12&#44;13</span></a> y DM2<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">14</span></a>&#44; respecto a aspectos como su control metab&#243;lico&#44; actividad f&#237;sica&#44; alimentaci&#243;n&#44; o &#237;ndice de masa corporal &#40;IMC&#41;<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">13-20</span></a>&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Este estudio parte de la hip&#243;tesis de que en zonas de salud que no disponen de un protocolo de actuaci&#243;n espec&#237;fica en los pacientes con DM2 se produce su desatenci&#243;n durante la pandemia COVID-19&#44; tanto en su seguimiento como en la consecuci&#243;n de los objetivos de control en 2020&#44; que se recupera en 2021&#44; pero sin llegar a los niveles prepand&#233;micos de 2019&#46; El objetivo del estudio entonces ser&#225; explorar la repercusi&#243;n de la rotura de la continuidad asistencial en AP durante 2020 y 2021 sobre los pacientes con DM2 respecto al a&#241;o prepand&#233;mico 2019&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Metodolog&#237;a</span><p id="par0035" class="elsevierStylePara elsevierViewall">La muestra del estudio est&#225; conformada por pacientes con DM2 de los 7<span class="elsevierStyleHsp" style=""></span>CS universitarios de AP en Tenerife&#44; Islas Canarias&#44; Espa&#241;a&#44; ninguno de los cuales dispon&#237;a durante la pandemia COVID-19 de un protocolo espec&#237;fico de seguimiento y control de pacientes con DM2&#46; El criterio de inclusi&#243;n para la selecci&#243;n de los pacientes fue el disponer de historia cl&#237;nica informatizada en el Programa Drago-AP del SCS durante los a&#241;os 2019&#44; 2020 y 2021 con datos del pEVA&#46; La inclusi&#243;n se realiz&#243; en cada centro por extracci&#243;n sorteada del listado informatizado hasta completar el tama&#241;o muestral asignado a cada uno de los centros participantes&#46; El sorteo se realiz&#243; escogiendo de manera aleatoria el n&#250;mero que identifica a cada paciente en el listado de casos DM2 de cada CS hasta completar el tama&#241;o de muestra requerido&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Este estudio fue aprobado por el Comit&#233; de Bio&#233;tica del Hospital Universitario de Canarias &#40;c&#243;digo CHUNSC&#95;2022&#95;53&#41; y la Gerencia de AP de Tenerife&#44; garantizando la protecci&#243;n y confidencialidad de los datos personales seg&#250;n la Ley Org&#225;nica 15&#47;1999 y el Real Decreto 994&#47;1999&#46; Para su realizaci&#243;n obtuvo financiaci&#243;n parcial de la Fundaci&#243;n Canaria del Instituto para Investigaci&#243;n Sanitaria &#40;FIISC-ST22&#47;14&#41;&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">De las historias cl&#237;nicas se extrajeron los siguientes datos&#58; sexo y edad del paciente&#44; IMC&#44; h&#225;bito tab&#225;quico&#44; alimentaci&#243;n&#44; actividad f&#237;sica&#44; hemoglobina glicada &#40;A1c&#41;&#44; colesterol total&#44; lipoprote&#237;na de alta densidad &#40;HDL&#41;&#44; lipoprote&#237;na de baja densidad &#40;LDL&#41;&#44; triglic&#233;ridos &#40;TG&#41;&#44; presi&#243;n arterial sist&#243;lica &#40;PAS&#41; y diast&#243;lica &#40;PAD&#41;&#44; electrocardiograma &#40;ECG&#41;&#44; retinograf&#237;a&#44; revisi&#243;n de pies&#44; y consultas anuales presenciales y telef&#243;nicas al MF y EC&#46; El alcance de los objetivos de seguimiento se estableci&#243; acorde con los criterios del pEVA&#46; La determinaci&#243;n del cumplimiento de los objetivos de control respecto a IMC&#44; h&#225;bito tab&#225;quico&#44; alimentaci&#243;n&#44; actividad f&#237;sica&#44; A1c&#44; HDL&#44; LDL&#44; triglic&#233;ridos&#44; PAS y PAD sigui&#243; los criterios del pEVA y redGDPS-2018<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">21</span></a>&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">An&#225;lisis estad&#237;stico</span><p id="par0050" class="elsevierStylePara elsevierViewall">El tama&#241;o de la muestra del estudio le confiere una potencia del 98&#37; en la estimaci&#243;n de diferencias relevantes para frecuencias relativas de al menos un 5&#37; y para medianas de al menos una unidad considerando dispersiones m&#225;ximas de 10 en pruebas bilaterales de hip&#243;tesis a un nivel de significaci&#243;n alfa del 5&#37;&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Las caracter&#237;sticas de la muestra&#44; cuando la variable que la representa es nominal&#44; se describen con la frecuencia absoluta &#40;frecuencia relativa&#41; de sus categor&#237;as componentes&#44; y cuando es de escala num&#233;rica&#44; pero no sigue una distribuci&#243;n normal&#44; con mediana &#40;P<span class="elsevierStyleInf">5</span>-P<span class="elsevierStyleInf">95</span>&#41;&#46; El no seguimiento de normalidad fue verificado con la prueba de Kolmogorov-Smirnov&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">La comparaci&#243;n de variables nominales independientes se realiz&#243; con la prueba chi al cuadrado de Pearson&#44; de las variables apareadas entre 2<span class="elsevierStyleHsp" style=""></span>grupos con la prueba de McNemar&#44; y de las variables apareadas entre m&#225;s de 2<span class="elsevierStyleHsp" style=""></span>grupos con la Q de Cochran&#46; La comparaci&#243;n de las variables de escala num&#233;rica independientes entre 2<span class="elsevierStyleHsp" style=""></span>grupos se realiz&#243; con la prueba U de Mann-Whitney&#44; de las variables apareadas entre 2<span class="elsevierStyleHsp" style=""></span>grupos con la prueba de Wilcoxon&#44; y de las variables apareadas entre m&#225;s de 2<span class="elsevierStyleHsp" style=""></span>grupos con la de prueba de Friedman&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Todas las pruebas de contraste de hip&#243;tesis fueron bilaterales a un nivel de significaci&#243;n p &#60; 0&#44;05 y las operaciones involucradas en su c&#225;lculo se ejecutaron con ayuda del paquete estad&#237;stico informatizado SPSS 25&#46;0&#8482; de IBMCo&#174;&#46;</p></span></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Resultados</span><p id="par0070" class="elsevierStylePara elsevierViewall">La muestra qued&#243; conformada por 3&#46;543 pacientes con la siguiente distribuci&#243;n por CS&#58; 506 &#40;14&#44;3&#37;&#41; CS Tacoronte&#44; 512 &#40;14&#44;5&#37;&#41; CS La Laguna-San Benito&#44; 500 &#40;14&#44;1&#37;&#41; CS La Laguna Universidad&#44; 500 &#40;14&#44;1&#37;&#41; CS Taco&#44; 525 &#40;14&#44;8&#37;&#41; CS Ofra&#44; 500 &#40;14&#44;1&#37;&#41; CS Barrio de La Salud y 500 &#40;14&#44;1&#37;&#41; CS Barranco Grande&#46; Seg&#250;n sexo&#44; qued&#243; repartida al 50&#37; en hombres y mujeres&#44; edad de 70 &#40;49-87&#41; a&#241;os&#44; con 1&#46;339 pacientes &#40;38&#37;&#41; de hasta 65 a&#241;os y 2204 &#40;62&#37;&#41; mayores de 65 a&#241;os&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a> se muestran las mediciones de las actividades de seguimiento seg&#250;n a&#241;o&#46; Todas las actividades registradas disminuyeron de 2019 a 2020 y se recuperaron de 2020 a 2021&#44; sin alcanzar los niveles de 2019&#44; a excepci&#243;n de la revisi&#243;n de pies que mejor&#243;&#46; Los registros de A1c fueron inferiores a los del perfil lip&#237;dico en todos los a&#241;os&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a> se presenta la frecuentaci&#243;n anual por consultas presenciales y telef&#243;nicas a MF y EC&#46; Como se observa&#44; en 2020 se produjo un aumento de las consultas telef&#243;nicas a expensas de una disminuci&#243;n de las presenciales&#46; Esta tendencia se mantuvo en 2021 para las telef&#243;nicas&#44; no as&#237; para las presenciales&#44; que tambi&#233;n aumentaron&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a> se expone el logro por a&#241;o del objetivo para los diferentes par&#225;metros de control de la DM2&#46; Se observa un gran descenso en todos los objetivos durante 2020 con posterior recuperaci&#243;n en 2021&#44; sin alcanzar los niveles de 2019 salvo para el HDL&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall">La <a class="elsevierStyleCrossRef" href="#tbl0020">tabla 4</a> muestra las mediciones de las actividades de seguimiento seg&#250;n a&#241;o&#44; estratificadas por sexo y edad&#46; Las mujeres y los mayores de 65 a&#241;os presentaron mayor frecuencia de registro que los hombres en la mayor&#237;a de los par&#225;metros&#46; En la relaci&#243;n interanual para cada grupo dentro de cada estrato todos los registros disminuyeron de 2019 a 2020&#44; recuper&#225;ndose de 2020 a 2021 sin alcanzar los niveles de 2019&#46; La revisi&#243;n de pies constituy&#243; la excepci&#243;n pues mejor&#243; en 2021 respecto a 2019&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#tbl0025">tabla 5</a> se exponen las consultas anuales por tipo&#44; seg&#250;n sexo y edad&#46; Mujeres y mayores de 65 a&#241;os presentaron una mayor frecuentaci&#243;n para todo tipo de consultas&#46; En el 2019 apenas se utilizaron las consultas telef&#243;nicas a la EC&#44; aumentando en 2020 y consolid&#225;ndose en 2021 para ambos sexos y edad&#46;</p><elsevierMultimedia ident="tbl0025"></elsevierMultimedia><p id="par0100" class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#tbl0030">tabla 6</a> se muestra la consecuci&#243;n de los objetivos de control por a&#241;o&#44; seg&#250;n sexo y edad&#46; Las mujeres presentaron mejores resultados en h&#225;bito tab&#225;quico&#44; A1c&#44; HDL&#44; PAS y PAD&#44; mientras los mayores de 65 a&#241;os lo hicieron en h&#225;bito tab&#225;quico&#44; alimentaci&#243;n&#44; A1c&#44; HDL&#44; LDL&#44; triglic&#233;ridos y PAD&#46; En la progresi&#243;n interanual se observ&#243; un descenso en la consecuci&#243;n de pr&#225;cticamente todos los objetivos en 2020&#44; con recuperaci&#243;n en 2021 aunque sin alcanzar los niveles de 2019&#46;</p><elsevierMultimedia ident="tbl0030"></elsevierMultimedia></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Discusi&#243;n</span><p id="par0105" class="elsevierStylePara elsevierViewall">El resultado principal de este estudio apoya la hip&#243;tesis de que en el &#225;mbito de la AP sin protocolo de seguimiento y control espec&#237;fico de los pacientes con DM2 durante la pandemia de COVID-19 se produjo una desatenci&#243;n en su seguimiento y un descenso en la consecuci&#243;n de los objetivos de control en 2020&#44; recuperado en 2021 aunque sin llegar a los niveles prepand&#233;micos&#46; Al margen de este enunciado&#44; se ha visibilizado que antes de la pandemia COVID-19 se atend&#237;a m&#225;s y con mejores resultados a las mujeres y mayores de 65 a&#241;os<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">22</span></a>&#44; y esa tendencia se ha mantenido en 2020 y 2021&#44; as&#237; como que las consultas telef&#243;nicas al MF y la EC aumentaron de manera sostenida en 2020 y 2021&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">La consistencia de los datos que proporcionan nuestros resultados se ve apoyada por el hecho de que en una muestra elegida al azar se obtiene un aporte predominante de pacientes mayores de 65 a&#241;os siguiendo el patr&#243;n que se observa en Espa&#241;a para DM2<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">23</span></a>&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">La frecuentaci&#243;n muestra consultas telef&#243;nicas que se incrementaron y presenciales que disminuyeron en 2020 como consecuencia directa de las medidas restrictivas de acceso y de las reticencias de los pacientes a acudir al CS por miedo al contagio<a class="elsevierStyleCrossRefs" href="#bib0250"><span class="elsevierStyleSup">24&#44;25</span></a>&#46; La suspensi&#243;n de estas medidas explica la recuperaci&#243;n de las consultas presenciales en 2021&#46; El mantenimiento de las consultas telef&#243;nicas en 2021 apunta a que se han mostrado &#250;tiles para la atenci&#243;n al paciente en determinadas circunstancias&#44; como la renovaci&#243;n del tratamiento&#44; en que no es imprescindible su presencia f&#237;sica&#46; La infrautilizaci&#243;n que se mantiene en las consultas telef&#243;nicas a la EC&#44; a pesar de su mostrada utilidad para el control de pacientes con DM2 durante la pandemia por COVID-19<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">26</span></a>&#44; constituye una oportunidad de mejora&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">El seguimiento acorde con el pEVA<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">11</span></a> se corresponde con la frecuentaci&#243;n&#44; disminuyendo ambos en 2020&#44; efecto ya observado en otros &#225;mbitos<a class="elsevierStyleCrossRefs" href="#bib0140"><span class="elsevierStyleSup">2&#44;3&#44;23</span></a>&#46; La ejecuci&#243;n de estas actividades y la frecuentaci&#243;n presencial al MF&#44; a pesar de haber aumentado en 2021&#44; no han recuperado los niveles prepand&#233;micos&#44; lo que deber&#237;a llevar a una reflexi&#243;n a los gestores sanitarios de la AP&#46; Se ha detectado una menor cantidad de determinaciones de A1c que de perfiles lip&#237;dicos&#44; lo que puede atribuirse a una menos indicaci&#243;n de esta determinaci&#243;n por parte del MF&#44; o a una falta de extracci&#243;n de muestra suficiente para realizar esta determinaci&#243;n porque seg&#250;n protocolo el tubo de A1c es el &#250;ltimo en ser recolectado&#44; pero&#44; en todo caso&#44; este d&#233;ficit constituye una oportunidad de mejora&#46; La mejora de la revisi&#243;n de pies en 2021 puede atribuirse a una especial atenci&#243;n de los profesionales sanitarios a esta tarea dados sus bajos niveles prepand&#233;micos&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">La consecuci&#243;n de objetivos durante 2019-2021 muestra un comportamiento similar al de la realizaci&#243;n de actividades de seguimiento en ese periodo&#46; La no recuperaci&#243;n de los niveles prepand&#233;micos puede tener su origen en que los pacientes con peores controles gluc&#233;micos son los que han tenido un menor seguimiento durante la pandemia<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">4</span></a>&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">La frecuentaci&#243;n fue superior en las mujeres y en mayores de 65 a&#241;os para cada a&#241;o del periodo estudiado en las 4<span class="elsevierStyleHsp" style=""></span>modalidades de consulta&#44; salvo para las telef&#243;nicas a la EC en 2019 que fueron pr&#225;cticamente inexistentes&#46; En la evoluci&#243;n interanual de las visitas presenciales al MF por sexo y edad se observ&#243; un comportamiento similar al general&#46; Respecto a las presenciales a la EC&#44; se recuperaron en 2021 para hombres y mayores de 65 a&#241;os&#44; lo que podr&#237;a explicarse por una menor sobrecarga asistencial ese a&#241;o respecto a tareas espec&#237;ficas de lucha frente a la pandemia por COVID-19 que ha permitido una mayor dedicaci&#243;n a la atenci&#243;n del paciente DM2&#46; El incremento interanual de las consultas telef&#243;nicas al MF y a la EC se produjo en ambos sexos y grupos de edad&#44; lo que apunta a que es un recurso ampliamente aceptado&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">El seguimiento present&#243; una mayor cumplimentaci&#243;n tanto en mujeres como en mayores de 65 a&#241;os&#44; que son los grupos con mayor frecuentaci&#243;n&#46; En la evoluci&#243;n interanual se replic&#243; el empeoramiento en 2020 y mejora en 2021 sin llegar a los niveles prepand&#233;micos de 2019 en ambos sexos y grupos de edad&#44; salvo para la revisi&#243;n de pies en hombres&#44; que se mantuvo&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">En la consecuci&#243;n de objetivos de control por estratos se observ&#243; la misma pauta interanual general&#44; con mujeres y mayores de 65 a&#241;os que presentaron los mejores resultados&#46; Como excepci&#243;n&#44; los hombres presentaron un mejor control de HDL&#44; lo que puede atribuirse a que a las mujeres se les exige un nivel m&#225;s elevado para alcanzar este objetivo&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">Este estudio est&#225; afectado por varias limitaciones&#46; La primera de ellas es que el registro de h&#225;bitos se ha realizado por declaraci&#243;n de los pacientes&#44; con un posible sesgo de infraestimaci&#243;n del descontrol&#44; lo que dibujar&#237;a un cuadro mejor del real&#44; pero que no distorsionar&#237;a las comparaciones anuales e interanuales&#44; al no tener fundamento una distribuci&#243;n heterog&#233;nea de este sesgo&#46; La segunda limitaci&#243;n viene dada por una p&#233;rdida de informaci&#243;n durante los a&#241;os 2020 y 2021&#44; producto de la situaci&#243;n an&#243;mala que se vivi&#243; en los CS durante la pandemia de COVID-19&#44; que podr&#237;a esconder un empeoramiento del paciente que no acude&#44; por lo que para intentar enmendar este sesgo se etiquet&#243; como fuera de control al paciente al que no se le hab&#237;a realizado la medici&#243;n&#46; Otra limitaci&#243;n del estudio es la no consideraci&#243;n para el establecimiento de la diana prioritaria de la atenci&#243;n otros factores importantes como el tiempo transcurrido desde la &#250;ltima consulta o las comorbilidades del paciente&#44; entre otras&#44; lo cual pudiera constituir un sesgo de clasificaci&#243;n para el establecimiento de dichas prioridades&#46; Sin embargo&#44; no nos consta que la pandemia COVID-19 haya modificado de forma sustancial estos factores&#44; como s&#237; lo ha hecho sobre la frecuentaci&#243;n y el control del paciente DM2&#46; La generalizaci&#243;n de nuestros resultados est&#225; afectada por el &#225;mbito insular en que se obtienen&#44; lo que dificulta su extensi&#243;n a &#225;mbitos continentales&#44; pero hemos constatado la similitud del predominio del paciente mayor de 65 a&#241;os con DM2 en nuestra muestra&#44; similar a la del resto de Espa&#241;a&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">Nuestro estudio tambi&#233;n presenta varias fortalezas&#44; como su car&#225;cter multic&#233;ntrico&#44; su ejecuci&#243;n bajo condiciones reales de no disponibilidad de programas espec&#237;ficos para la atenci&#243;n del paciente con DM2 durante la pandemia&#44; el periodo estudiado&#44; que no abarca solo el confinamiento&#44; y la aplicabilidad de sus resultados para afrontar futuras posibles situaciones de urgencia similares&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">Concluimos que la pandemia COVID-19 supuso una sobrecarga de la AP que ha afectado a la atenci&#243;n a los pacientes DM2 y que a finales del a&#241;o 2021 no se hab&#237;a logrado recuperar los niveles prepand&#233;micos&#44; por lo que se debe intensificar la atenci&#243;n de estos pacientes&#46; Los hombres y los m&#225;s j&#243;venes siguen siendo dianas para priorizar la atenci&#243;n&#46; Las medidas frente a la pandemia han aumentado la consulta telef&#243;nica&#44; siendo un recurso &#250;til que debe potenciarse&#46; Se requieren m&#225;s estudios de seguimiento en otros &#225;mbitos para poder confirmar estos extremos&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Financiaci&#243;n</span><p id="par0160" class="elsevierStylePara elsevierViewall">Fundaci&#243;n Canaria del Instituto de Investigaci&#243;n Sanitaria &#40;FIISC-ST22&#47;14&#41;&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Conflicto de intereses</span><p id="par0165" class="elsevierStylePara elsevierViewall">Los autores declaran que no existe ning&#250;n conflicto de intereses&#46;</p></span></span>"
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      "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall"><ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">&#8226;</span><p id="par0005" class="elsevierStylePara elsevierViewall">La pandemia COVID-19 ha afectado la atenci&#243;n a los pacientes con DM2 sin lograrse recuperar los niveles de seguimiento y control prepand&#233;micos&#46;</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">&#8226;</span><p id="par0010" class="elsevierStylePara elsevierViewall">Se debe intensificar la atenci&#243;n de estos pacientes&#44; especialmente en hombres j&#243;venes&#46;</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">&#8226;</span><p id="par0015" class="elsevierStylePara elsevierViewall">Las medidas antipand&#233;micas aumentaron las consultas telef&#243;nicas&#44; un recurso que por &#250;til que debe potenciarse&#46;</p></li></ul></p></span>"
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        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Antecedentes</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">La pandemia de COVID-19 oblig&#243; a tomar medidas que implicaban la desatenci&#243;n a los pacientes con diabetes tipo 2 &#40;DM2&#41;&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Objetivos</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Explorar la repercusi&#243;n de la discontinuidad asistencial sobre los pacientes con DM2&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Dise&#241;o</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Estudio observacional retrospectivo multic&#233;ntrico&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Emplazamiento</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Cinco centros de atenci&#243;n primaria &#40;AP&#41;&#44; que no ten&#237;an protocolo de actuaci&#243;n espec&#237;fica para ellos&#44; durante 2020 y 2021&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Participantes</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Pacientes con DM2 en Tenerife&#44; Islas Canarias&#44; Espa&#241;a&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Mediciones principales</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">De las historias cl&#237;nicas se extrajeron el sexo y la edad&#44; las variables de seguimiento del programa de detecci&#243;n y control de la enfermedad vascular ateroescler&#243;tica &#40;pEVA&#41;&#44; de cumplimiento de los objetivos de control y frecuentaci&#243;n al m&#233;dico de familia y enfermera comunitaria&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Se incluy&#243; a 3&#46;543 pacientes&#44; 1&#46;772 &#40;50&#37;&#41; mujeres&#44; de ellos 2&#46;204 &#40;62&#37;&#41; mayores de 65 a&#241;os&#46; La gran mayor&#237;a de actividades registradas y objetivos de control disminuyeron en 2020&#44; recuper&#225;ndose en 2021 sin alcanzar los niveles de 2019&#46; En 2020 aumentaron las consultas telef&#243;nicas y disminuyeron las presenciales&#44; tendencia mantenida en 2021 para las telef&#243;nicas&#46; Las mujeres y los mayores de 65 a&#241;os presentaron mayor frecuentaci&#243;n&#44; m&#225;s registros de actividades y logros de objetivos de control en la mayor&#237;a de los par&#225;metros&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">La pandemia supuso una sobrecarga de la AP que ha afectado a la atenci&#243;n de los pacientes con DM2&#44; que no ha logrado restablecerse a los niveles prepand&#233;micos&#46; Los hombres j&#243;venes conforman la diana de priorizaci&#243;n de esta atenci&#243;n&#46; Las medidas antipand&#233;micas han aumentado la consulta telef&#243;nica&#44; un recurso que debe potenciarse&#46;</p></span>"
        "secciones" => array:8 [
          0 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Antecedentes"
          ]
          1 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Objetivos"
          ]
          2 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Dise&#241;o"
          ]
          3 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Emplazamiento"
          ]
          4 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Participantes"
          ]
          5 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Mediciones principales"
          ]
          6 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Resultados"
          ]
          7 => array:2 [
            "identificador" => "abst0045"
            "titulo" => "Conclusiones"
          ]
        ]
      ]
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Background</span><p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">The COVID-19 pandemic meant measures had to be taken that implied the neglect of patients with type 2 diabetes &#40;T2D&#41;&#46;</p></span> <span id="abst0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Objectives</span><p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">to explore the impact of care discontinuity on patients with T2D in Primary Care &#40;PC&#41; centres&#44; who did not have a specific action protocol for them&#44; during 2020 and 2021&#46;</p></span> <span id="abst0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Design</span><p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">Multicenter retrospective observational study&#46;</p></span> <span id="abst0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Participants</span><p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">Patients with T2D in Tenerife&#44; Canary Islands&#44; Spain&#46;</p></span> <span id="abst0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Main Measurements</span><p id="spar0105" class="elsevierStyleSimplePara elsevierViewall">Sex and age&#44; follow-up variables of atherosclerotic vascular disease detection and control programme &#40;pEVA&#41;&#44; compliance with the control objectives and visits to the family practitioner and community nurse were extracted from their medical records&#46;</p></span> <span id="abst0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Results</span><p id="spar0110" class="elsevierStyleSimplePara elsevierViewall">3&#44;543 participants took part in the study&#44; 1&#44;772 &#40;50&#37;&#41; women&#44; 2&#44;204 &#40;62&#37;&#41; of whom were older than 65 years of age&#46; The vast majority of registered activities and control objectives decreased in 2020&#44; recovering in 2021 without reaching 2019 levels&#46; In 2020&#44; telephone consultations increased and in-person consultations decreased&#44; a trend that remained unchanged in 2021 for telephone consultations&#46; Women and those over 65 years of age presented higher frequentation&#44; more activity records and achievement of control objectives in most of the parameters&#46;</p></span> <span id="abst0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conclusions</span><p id="spar0115" class="elsevierStyleSimplePara elsevierViewall">The pandemic caused an overload in the PCs that affected the care of patients with T2D&#44; which has not returned to pre-pandemic levels&#46; Young men are the target for prioritization of this care&#46; Anti-pandemic measures have led to an increase in telephone consultations&#44; a resource that should be strengthened&#46;</p></span>"
        "secciones" => array:7 [
          0 => array:2 [
            "identificador" => "abst0050"
            "titulo" => "Background"
          ]
          1 => array:2 [
            "identificador" => "abst0055"
            "titulo" => "Objectives"
          ]
          2 => array:2 [
            "identificador" => "abst0060"
            "titulo" => "Design"
          ]
          3 => array:2 [
            "identificador" => "abst0065"
            "titulo" => "Participants"
          ]
          4 => array:2 [
            "identificador" => "abst0070"
            "titulo" => "Main Measurements"
          ]
          5 => array:2 [
            "identificador" => "abst0075"
            "titulo" => "Results"
          ]
          6 => array:2 [
            "identificador" => "abst0080"
            "titulo" => "Conclusions"
          ]
        ]
      ]
    ]
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t" scope="col">Medida registrada&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Frecuencia &#40;&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> anual de mediciones registradas</th><th class="td" title="\n
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                  \t\t\t\t" scope="col">pvalor<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">2019&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">IMC&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">a&#44; b&#44; c&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">H&#225;bito tab&#225;quico&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;981 &#40;55&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Alimentaci&#243;n&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">Actividad f&#237;sica&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  " align="left" valign="\n
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                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&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">a&#44; b&#44; c&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  " align="left" valign="\n
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                  \t\t\t\t">3&#46;123 &#40;88&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">a&#44; b&#44; c&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&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">a&#44; b&#44; c&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;072 &#40;30&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">a&#44; b&#44; c&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Presencial al m&#233;dico de familia&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">7 &#40;2-19&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">5 &#40;0-16&#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">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&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">a&#44; b&#44; c&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">Telef&#243;nica al m&#233;dico de familia&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0 &#40;0-2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2 &#40;0-10&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">2 &#40;0-10&#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">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&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">a&#44; b&#44; c&nbsp;\t\t\t\t\t\t\n
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                  \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">Presencial a la enfermera comunitaria&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">2 0-12&#41;&nbsp;\t\t\t\t\t\t\n
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                  \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">3 &#40;0-16&#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">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&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">a&#44; b&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">Telef&#243;nica a la enfermera comunitaria&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0 &#40;0-0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">a&#44; b&#44; c&nbsp;\t\t\t\t\t\t\n
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                  """
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">A&#241;oEn objetivo &#40;&#37;<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">a</span></a>&#41;</th><th class="td" title="\n
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                  \t\t\t\t" scope="col">pvalor<a class="elsevierStyleCrossRef" href="#tblfn0040"><span class="elsevierStyleSup">c</span></a>entre a&#241;os&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\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">a&#44; b&#44; c&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">H&#225;bito tab&#225;quico&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;663 &#40;46&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">a&#44; b&#44; c&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">1&#46;360 &#40;38&#44;4&#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
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&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">a&#44; b&#44; c&nbsp;\t\t\t\t\t\t\n
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                  \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">Actividad f&#237;sica&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">1&#46;319 &#40;37&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">783 &#40;22&#44;1&#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">1&#46;069 &#40;30&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&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">a&#44; b&#44; c&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">Hemoglobina glicada&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  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;070 &#40;58&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;634 &#40;46&#44;1&#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">1&#46;783 &#40;50&#44;3&#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">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&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">a&#44; b&#44; c&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">Colesterol HDL&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">1&#46;637 &#40;46&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;433 &#40;40&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;648 &#40;46&#44;5&#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">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&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">a&#44; b&#44; c&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">Colesterol LDL&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">1&#46;862 &#40;52&#44;6&#41;&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  " align="left" valign="\n
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                  \t\t\t\t">1&#46;613 &#40;45&#44;5&#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">1&#46;779 &#40;50&#44;2&#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">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&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">a&#44; b&#44; c&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">Triglic&#233;ridos&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">1&#46;801 &#40;50&#44;8&#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">1&#46;492 &#40;42&#44;1&#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">1&#46;670 &#40;47&#44;1&#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">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&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">Presi&#243;n arterial diast&#243;lica&nbsp;\t\t\t\t\t\t\n
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                  """
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">a&#44; b&#44;ca&#44; b&#44; c&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>H&#225;bito tab&#225;quico&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">&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Alimentaci&#243;n&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">MujerHombre&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;155&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">762 &#40;43&#41;687 &#40;39&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Actividad f&#237;sica&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Hemoglobina glicada&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0003&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">MujerHombre&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\ttop\n
                  \t\t\t\t">116 &#40;7&#41;126 &#40;7&#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">0&#44;503&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Alimentaci&#243;n&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">a&#44; b&#44; c&#47;a&#44; b&#44; ca&#44; b&#44; c&#47;a&#44; b&#44; c&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Telef&#243;nica al m&#233;dico de familia&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#47;&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#47;&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">a&#44; b&#44; c&#47;a&#44; b&#44; ca&#44; b&#44; c&#47;a&#44; b&#44; c&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#47;&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#47;&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">a&#44; b&#44; c&#47;a&#44; ba&#44; b&#44; c&#47;a&#44; b&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">pvalor<a class="elsevierStyleCrossRef" href="#tblfn0090"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><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">2020&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><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">pvalor<a class="elsevierStyleCrossRef" href="#tblfn0090"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><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">2021&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><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">pvalor<a class="elsevierStyleCrossRef" href="#tblfn0090"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="10" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Estrato sexo</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>IMC&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">MujerHombre&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">480 &#40;27&#41;502 &#40;28&#41;&nbsp;\t\t\t\t\t\t\n
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                  \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">0&#44;403&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">310 &#40;18&#41;321 &#40;18&#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">0&#44;624&nbsp;\t\t\t\t\t\t\n
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                  \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">393 &#40;22&#41;405 &#40;23&#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">0&#46;623&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">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&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">a&#44; b&#44; ca&#44; b&#44; c&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"><span class="elsevierStyleHsp" style=""></span>H&#225;bito tab&#225;quico&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">MujerHombre&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">918 &#40;52&#41;745 &#40;42&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&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  " align="left" valign="\n
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                  \t\t\t\t">469 &#40;31&#41;200 &#40;25&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&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">743 &#40;42&#41;580 &#40;33&#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">&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&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">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&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">a&#44; b&#44; ca&#44; b&#44; c&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"><span class="elsevierStyleHsp" style=""></span>Alimentaci&#243;n&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">MujerHombre&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">818 &#40;46&#41;789 &#40;45&#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">0&#44;335&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">523 &#40;30&#41;464 &#40;26&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;028&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">722 &#40;41&#41;638 &#40;36&#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">0&#46;004&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">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&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">a&#44; b&#44; ca&#44; b&#44; c&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>Actividad f&#237;sica&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">MujerHombre&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">629 &#40;36&#41;690 &#40;39&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">382 &#40;22&#41;401 &#40;23&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;436&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">545 &#40;31&#41;524 &#40;30&#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>Hemoglobina glicada&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">MujerHombre&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">1&#46;072 &#40;61&#41;998 &#40;56&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;012&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">853 &#40;48&#41;781 &#40;44&#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">0&#44;016&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">940 &#40;53&#41;843 &#40;48&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Colesterol HDL&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">MujerHombre&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">733 &#40;41&#41;904 &#40;51&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">649 &#40;37&#41;784 &#40;44&#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  " align="left" valign="\n
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                  \t\t\t\t">738 &#40;42&#41;910 &#40;51&#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">&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&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>Alimentaci&#243;n&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Actividad f&#237;sica&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Hemoglobina glicada&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">434 &#40;32&#41;735 &#40;33&#41;&nbsp;\t\t\t\t\t\t\n
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