medigraphic.com
Instituto Nacional de Salud Pública

2024, Número 6

<< Anterior Siguiente >>

salud publica mex 2024; 66 (6)


Asociaciones entre diabesidad y mortalidad por todas las causas: un análisis prospectivo de la Encuesta Nacional de Salud de Chile 2009-2010

Lanuza F, Díaz-Toro F, Troncoso-Pantoja C, Leiva AM, Nazar G, Concha-Cisternas Y, Martorell M, Labraña AM, Parra-Soto S, Ramírez-Alarcón K, Villagrán M, Lasserre-Laso N, Ochoa-Rosales C, Mardones L, Carrasco-Marín F, Martínez-Maturana N, Celis-Morales C, Petermann-Rocha F

Idioma: Ingles.
Referencias bibliográficas: 46
Paginas: 798-806.
Archivo PDF: 413.22 Kb.


RESUMEN

Objetivo. Investigar si los pacientes con diabesidad (la combinación de ambas condiciones) tienen un mayor riesgo de mortalidad que la obesidad aislada o la diabetes tipo 2, especialmente cuando se utiliza la circunferencia de la cintura (CC) como criterio para la obesidad. Material y métodos. Este estudio longitudinal incluyó a 4 514 participantes chilenos de la Encuesta Nacional de Salud de Chile 2009 y 2010. Los participantes se categorizaron en cuatro grupos según la CC y el diagnóstico de diabetes: a) normal; b) sólo obesidad abdominal; c) sólo diabetes tipo 2, y d) diabesidad. Se realizaron modelos de riesgos proporcionales de Cox para investigar las asociaciones entre la diabesidad y la mortalidad por todas las causas. También, se replicaron los análisis utilizando categorías de índice de masa corporal (IMC). Resultados. Después de un seguimiento mediano de 10.9 años, fallecieron 445 (9.9%) participantes. En el modelo completamente ajustado, en comparación con los participantes con condiciones normales, aquellos con diabe- sidad tenían 1.37 (IC95%: 1.01,1.85) veces mayor riesgo de mortalidad por todas las causas. Además, esta asociación fue significativa únicamente en el grupo de solo diabetes tipo 2 dentro de las categorías de IMC de la diabesidad (HR: 1.62 [IC95%: 1.07,2.45]), pero no fue significativa para la diabesidad basada en el IMC (HR: 0.98 [IC95%: 0.66,1.45]). Conclusiones. Las personas con diabesidad tenían un mayor riesgo de mortalidad en comparación con sus pares. La CC, en lugar del IMC, puede ser un predictor más sensible del riesgo de mortalidad en la población chilena.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Chan JCN, Lim LL, Wareham NJ, Shaw JE, Orchard TJ, Zhang P, et al.The Lancet Commission on diabetes: Using data to transform diabetescare and patient lives. Lancet. 2020;396(10267):2019-82. https://doi.org/10.1016/S0140-6736(20)32374-6

  2. International Diabetes Federation. IDF Diabetes Atlas 10th ed. Brussels:International Diabetes Federation, 2021 [cited March 2024]. Availablefrom: https://diabetesatlas.org/atlas/tenth-edition/

  3. The Lancet Gastroenterology & Hepatology. Obesity: another ongoingpandemic. Lancet Gastroenterol Hepatol. 2021;6(6):411. https://doi.org/10.1016/S2468-1253(21)00143-6

  4. Ng ACT, Delgado V, Borlaug BA, Bax JJ. Diabesity: the combined burdenof obesity and diabetes on heart disease and the role of imaging. Nat RevCardiol. 2021;18(4):291-304. https://doi.org/10.1038/s41569-020-00465-5

  5. Ford JH, Lage MJ, Boye KS, Bae JP, Terrell KA, Bunck MC. Five-yearmorbidity and mortality rates in a U.S. population with obesity with andwithout prediabetes. J Diabetes Complications. 2023;37(5):108454. https://doi.org/10.1016/j.jdiacomp.2023.108454

  6. Flegal KM, Kit BK, Orpana H, Graubard BI. Association of all-causemortality with overweight and obesity using standard body mass indexcategories. A systematic review and meta-analysis. JAMA. 2013;309(1):71-82. https://doi.org/10.1001/jama.2012.113905

  7. Di Angelantonio E, Bhupathiraju SN, Wormser D, Gao P, KaptogeS, de Gonzalez AB, et al. Body-mass index and all-cause mortality:individual-participant-data meta-analysis of 239 prospective studies infour continents. Lancet. 2016;388(10046):776-86. https://doi.org/10.1016/S0140-6736(16)30175-1

  8. Michaelidou M, Pappachan JM, Jeeyavudeen MS. Management of diabesity:Current concepts. World J Diabetes. 2023;14(4):396-411. https://doi.org/10.4239/wjd.v14.i4.396

  9. Udhaya-Kumar S, Rajan B, Thirumal-Kumar D, Anu-Preethi V, AbunadaT, Younes S, et al. Involvement of essential signaling cascades and analysisof gene networks in diabesity. Genes. 2020;11(11):1-19. https://doi.org/10.3390/genes11111256

  10. Mehrabani-Zeinabad K, Haghighatdoost F, Mohammadifard N, NajafianJ, Sadeghi M, Boshtam M, et al. Impact of diabesity phenotype on cardiovasculardiseases, major cardiovascular events and all-cause mortality. Sci Rep.2023;13(1):1-11. https://doi.org/10.1038/s41598-023-38221-7

  11. Milani SA, Lopez DS, Downer B, Samper-Ternent R, Wong R. Effectsof diabetes and obesity on cognitive impairment and mortality in oldermexicans. Arch Gerontol Geriatr. 2022;99:1-15. https://doi.org/10.1016/j.archger.2021.104581

  12. Ministerio de Salud, Gobierno de Chile. Encuesta Nacional de Salud2009-2010 [cited March 2024]. Santiago: Ministerio de Salud. Availablefrom: http://epi.minsal.cl/resultados-encuestas/

  13. Minsalcl. Bases de datos. Chile: Ministerio de Salud [cited March 2024].Available from: https://epi.minsal.cl/bases-de-datos/

  14. Petermann-Rocha F, Martínez-Sanguinetti MA, Ho FK, Celis-Morales C,Pizarro A. Optimal cut-off points for waist circumference in the definitionof metabolic syndrome in Chile. Public Health Nutr. 2020;23(16):2898-903. https://doi.org/10.1017/S1368980020001469

  15. Villanueva B, Arteaga A, Maiz A, Cortés VA. Abdominal obesity is acommon finding in normal and overweight subjects of Chile and is associatedwith increased frequency of cardiometabolic risk factors. PLoS One.2018;13(3):1-12. https://doi.org/10.1371/journal.pone.0194644

  16. Alberti KGMM, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, DonatoKA, et al. Harmonizing the metabolic syndrome: A joint interim statementof the international diabetes federation task force on epidemiologyand prevention; National heart, lung, and blood institute; Americanheart association; World heart federation; International Atherosclerosis Society; and International Association for the Study of Obesity.Circulation. 2009;120(16):1640-5. https://doi.org/10.1161/CIRCULATIONAHA.109.192644

  17. World Health Organization. Obesity: Preventing and managingthe global epidemic. Report of a WHO consultation. Geneva:WHO, 2000 [cited March 2024]. Available from: https://iris.who.int/handle/10665/42330

  18. Pan American Health Organization. Clinical evaluation modules. Module5: Nutritional Assessment of older adults. Washington DC, USA: PAHO,2003 [cited March 2024]. Available from: http:paho.org/en/publications.

  19. Alvarado ME, Garmendia ML, Acuña G, Santis R, Arteaga O. Assessmentof the alcohol use disorders identification test (AUDIT) to detectproblem drinkers. Rev Med Chil. 2009;137(11):1463-8.

  20. World Health Organization. Global Physical Activity Questionnaire:GPAQ version 2.0. Geneva: WHO 2009 [cited March 2024]. Availablefrom: https://www.who.int/publications/m/item/global-physical-activityquestionnaire

  21. Concha-Cisternas Y, Lanuza F, Waddell H, Sillars A, Leiva AM, TroncosoC, et al. Association between adiposity levels and cognitive impairmentin the Chilean older adult population. J Nutr Sci. 2019;8:e33. https://doi.org/10.1017/jns.2019.24

  22. Leiva AM, Petermann-Rocha F, Martínez-Sanguinetti MA, Troncoso-PantojaC, Concha Y, Garrido-Méndez A, et al. Asociación de un índice de estilosde vida saludable con factores de riesgo cardiovascular en poblaciónchilena. Rev Med Chil. 2018;146(12):1405-14. https://doi.org/10.4067/s0034-98872018001201405

  23. Cai X, Zhang Y, Li M, Wu JHY, Mai L, Li J, et al. Association between prediabetesand risk of all cause mortality and cardiovascular disease: Updatedmeta-analysis. BMJ. 2020;370:848-9. https://doi.org/10.1136/bmj.m2297

  24. Wu H, Lau ESH, Yang A, Zhang X, Fan B, Ma RCW, et al. Age-specificpopulation attributable risk factors for all-cause and cause-specific mortalityin type 2 diabetes: An analysis of a 6-year prospective cohort studyof over 360,000 people in Hong Kong. PLoS Med. 2023;20(1):e1004173.https://doi.org/10.1371/journal.pmed.1004173

  25. Carnethon MR, De Chavez PJD, Biggs ML, Lewis CE, Pankow JS,Bertoni AG, et al. Association of weight status with mortality in adultswith incident diabetes. JAMA. 2012;308(6):581-90. https://doi.org/10.1001/jama.2012.9282

  26. Lanuza F, Díaz-Toro F, Troncoso-Pantoja C, Leiva A, Nazar G, Concha-Cisternas Y, et al. Supplementary Material. Associations between diabesityand all-cause mortality: a prospective analysis of the Chilean NationalHealth Survey 2009-2010. Figshare, 2023. https://doi.org/10.6084/m9.figshare.25483393.v1

  27. Berrigan D, Troiano RP, Graubard BI. BMI and mortality: the limits ofepidemiological evidence. Lancet. 2016;388(10046):734-6. https://doi.org/10.1016/S0140-6736(16)30949-7

  28. Hong S, Park JH, Han K, Lee CB, Kim DS, Yu SH. Association betweenobesity and cardiovascular disease in elderly patients with diabetes:a retrospective cohort study. JCEM. 2022;107(2):e515-27. https://doi.org/10.1210/clinem/dgab714

  29. Ma W, Zhu H, Yu X, Zhai X, Li S, Huang N, et al. Association betweenandroid fat mass, gynoid fat mass and cardiovascular and all-cause mortalityin adults: NHANES 2003-2007. Front Cardiovasc Med. 2023;10. https://doi.org/10.3389/fcvm.2023.1055223

  30. Wang JS, Xia PF, Ma MN, Li Y, Geng TT, Zhang YB, et al. Trends in theprevalence of metabolically healthy obesity among US adults, 1999-2018.JAMA Netw Open. 2023;6(3):e232145. https://doi.org/10.1001/jamanetworkopen.2023.2145

  31. Veronese N, Cereda E, Solmi M, Fowler SA, Manzato E, Maggi S, et al.Inverse relationship between body mass index and mortality in oldernursing home residents: A meta-analysis of 19,538 elderly subjects. ObesityReviews. 2015;16(11):1001-15. https://doi.org/10.1111/obr.12309

  32. Bhaskaran K, dos-Santos-Silva I, Leon DA, Douglas IJ, SmeethL. Association of BMI with overall and cause-specific mortality: apopulation-based cohort study of 3.6 million adults in the UK. LancetDiabetes Endocrinol. 2018;6(12):944-53. https://doi.org/10.1016/S2213-8587(18)30288-2

  33. Song R, Chen X, He K, Hu X, Bai K, Shi W, et al. Associations of BMI withall-cause mortality in normoglycemia, impaired fasting glucose and type 2diabetes mellitus among an elderly Chinese population: a cohort study. BMCGeriatr. 2022;22(1):690. https://doi.org/10.1186/s12877-022-03382-z

  34. Yang Z, Shen P, Qu Y, Xu L, Li T, Zhu Z, et al. Baseline and longitudinaltrajectories of body-mass index and all-cause mortality among patientswith type 2 diabetes. Diabetes Metab. 2023;49(3):101426. https://doi.org/10.1016/j.diabet.2023.101426

  35. Xing Z, Chai X. Changes in fat mass and lean body mass and outcomesin type 2 diabetes mellitus. Intern Emerg Med. 2022;17(4):1073-80. https://doi.org/10.1007/s11739-021-02916-4

  36. Tobias DK, Pan A, Jackson CL, O’Reilly EJ, Ding EL, Willett WC, et al.Body-mass index and mortality among adults with incident type 2 diabetes.N Engl J Med. 2014;370(3):233-44. https://doi.org/10.1056/NEJMoa1304501

  37. Kwon Y, Kim HJ, Park S, Park YG, Cho KH. Body mass indexrelatedmortality in patients with type 2 diabetes and heterogeneityin obesity paradox studies: a dose-response meta-analysis. PLoS One.2017;12(1):e0168247. https://doi.org/10.1371/journal.pone.0168247

  38. Liu XM, Liu YJ, Zhan J, He QQ. Overweight, obesity and risk ofall-cause and cardiovascular mortality in patients with type 2 diabetesmellitus: A dose-response meta-analysis of prospective cohort studies. EurJ Epidemiol. 2015;30(1):35-45. https://doi.org/10.1007/s10654-014-9973-5

  39. Brown OI, Drozd M, McGowan H, Giannoudi M, Conning-RowlandM, Gierula J, et al. Relationship among diabetes, obesity, and cardiovasculardisease phenotypes: a UK Biobank cohort study. Diabetes Care.2023;46(8):1531-40. https://doi.org/10.2337/dc23-0294

  40. Salehidoost R, Mansouri A, Amini M, Yamini SA, Aminorroaya A. Bodymass index and the all-cause mortality rate in patients with type 2 diabetesmellitus. Acta Diabetol. 2018;55(6):569-77. https://doi.org/10.1007/s00592-018-1126-y

  41. Suemoto CK, Lebrao ML, Duarte YA, Danaei G. Effects of body mass index,abdominal obesity, and type 2 diabetes on mortality in community-dwellingelderly in Sao Paulo, Brazil: analysis of prospective data from the SABE Study. JGerontol. 2015;70(4):503-10. https://doi.org/10.1093/gerona/glu165

  42. Hou L, Wang Q, Pan B, Li R, Li Y, He J, et al. Exercise modalities for type 2diabetes: A systematic review and network metaanalysis of randomized trials.Diabetes Metab Res Rev. 2023;39(1):e3591. https://doi.org/10.1002/dmrr.3591

  43. Viguiliouk E, Kendall CWC, Kahleová H, Rahelić D, Salas-SalvadóJ, Choo VL, et al. Effect of vegetarian dietary patterns on cardiometabolicrisk factors in diabetes: A systematic review and meta-analysis ofrandomized controlled trials. Clin Nutr. 2019;38(3):1133-45. https://doi.org/10.1016/j.clnu.2018.05.032

  44. Lanuza F, Meroño T, Zamora-Ros R, Bondonno NP, Rostgaard-HansenAL, Sánchez-Pla A, et al. Plasma metabolomic profiles of plant-baseddietary indices reveal potential pathways for metabolic syndrome associations.Atherosclerosis. 2023;382:117285. https://doi.org/10.1016/j.atherosclerosis.2023.117285

  45. Wang F, Baden MY, Guasch-Ferré M, Wittenbecher C, Li J, Li Y, et al.Plasma metabolite profiles related to plant-based diets and the risk oftype 2 diabetes. Diabetologia. 2022;65(7):1119-32. https://doi.org/10.1007/s00125-022-05692-8

  46. De Hollander EL, Bemelmans WJ, Boshuizen HC, Friedrich N,Wallaschofski H, Guallar-Castillón, et al. The association between waistcircumference and risk of mortality considering body mass index in 65- to74-year-olds: A meta-analysis of 29 cohorts involving more than 58 000elderly persons. Int J Epidemiol. 2012;41(3):805-17. https://doi.org/10.1093/ije/dys008




2020     |     www.medigraphic.com