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Instituto Nacional de Salud Pública

2025, Number 6

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salud publica mex 2025; 67 (6)

Prevalence of cardio-metabolic risk factors in Mexico, Ensanut 2021

Flores-Luna L, Rojas-Martínez R, Escamilla-Núñez C, Castro-Porras L, Hernández-Cadena L, Romero-Martínez M, Aguilar-Salinas CA

Language: Spanish
References: 67
Page: 644-657
PDF size: 350.62 Kb.


ABSTRACT

Objective. To determine the prevalence of cardiometabolic risk factors (CMRF) in adults, by sex and locality size, to provide evidence to support the planning of preventive and care programs for cardiometabolic diseases. Materials and methods. Data were analyzed from 1 880 adults aged 20 years and older participants in the Encuesta Nacional de Salud y Nutrición Continua 2021, a nationally and locally representative study. The analysis considered the complex survey design. Results. Abdominal obesity was the most prevalent CMRF, affecting 74% of men and 88% of women. Among women, 63% had hypoalphalipoproteinemia, 60% had elevated LDL cholesterol, and 32% of those aged 40 to 59 had between 6 and 11 CMRFs. Among men, 52% had hypertriglyceridemia, 51% had elevated LDL-C, and 29% of those aged 40 to 59 had 6 to 11 MCRFs. By locality, rural men had a higher prevalence of elevated LDL-C (70%), and urban women had low HDLC levels. Conclusion. Our results show differences in the prevalence of MCRFs by sex and locality size, and the need for differentiated preventive strategies.


REFERENCES

  1. Di Cesare M, Perel P, Taylor S, Kabudula C, Bixby H, Gaziano TA,et al. The heart of the world. Glob Heart. 2024;19(1):11. https://doi.org/10.5334/gh.1288

  2. Lancellotti P. Focus on cardiometabolic risk factors. Acta Cardiol.2023;78(5):515-8. https://doi.org/10.1080/00015385.2023.2231702

  3. Després JP, Cartier A, Côté M, Arsenault BJ. The concept of cardiometabolicrisk: bridging the fields of diabetology and cardiology. Ann Med.2008;40(7):514-23. https://doi.org/10.1080/07853890802004959

  4. Chatterjee A, Harris SB, Leiter LA, Fitchett DH, Teoh H, Bhattacharyya OK.Managing cardiometabolic risk in primary care: summary of the 2011 consensusstatement. Can Fam Physician. 2012;58(4):389-93 [citado febrero 7, 2025].Disponible en: https://pmc.ncbi.nlm.nih.gov/articles/PMC3325449/

  5. Organización Mundial de la Salud. Obesity and overweight. Ginebra:OMS, 2025 [citado febrero 7, 2025]. Disponible en: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight

  6. Alberti KGMM, Zimmet P, Shaw J. Metabolic syndrome—a new worldwidedefinition. A consensus statement from the International DiabetesFederation. Diabet Med. 2006;23(5):469-80. https://doi.org/10.1111/j.1464-5491.2006.01858.x

  7. Whelton PK, Carey RM, Mancia G, Kreutz R, Bundy JD, Williams B.Harmonization of the American College of Cardiology/American HeartAssociation and European Society of Cardiology/European Society ofHypertension Blood Pressure/Hypertension Guidelines: comparisons, reflections,and recommendations. Circulation. 2022;146(11):868-77. https://doi.org/10.1161/CIRCULATIONAHA.121.054602

  8. ElSayed NA, Aleppo G, Aroda VR, Bannuru RR, Brown FM, Bruemmer D,et al. 2. Classification and diagnosis of diabetes: standards of care in diabetes—2023. Diabetes Care. 2023;46(supl 1):s19-40. https://doi.org/10.2337/dc23-S002

  9. Litwack G. Lipids. Human biochemistry. 2022:227-85. https://doi.org/10.1016/B978-0-323-85718-5.00004-2

  10. Bello-Chavolla OY, Almeda-Valdes P, Gomez-Velasco D, Viveros-Ruiz T,Cruz-Bautista I, Romo-Romo A, et al. METS-IR, a novel score to evaluateinsulin sensitivity, is predictive of visceral adiposity and incident type 2diabetes. Eur J Endocrinol. 2018;178(5):533-44. https://doi.org/10.1530/EJE-17-0883

  11. Work Group Membership Kidney International Supplements. Chapter1: definition and classification of CKD. Kidney Int Suppl. 2013;3(1):19-62.https://doi.org/10.1038/kisup.2012.64

  12. Hajifathalian K, Ueda P, Lu Y, Woodward M, Ahmadvand A, Aguilar-Salinas CA, et al. A novel risk score to predict cardiovascular diseaserisk in national populations (Globorisk): a pooled analysis of prospectivecohorts and health examination surveys. Lancet Diabetes Endocrinol.2015;3(5):339-55. https://doi.org/10.1016/S2213-8587(15)00081-9

  13. Alberti KGMM, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JA,Donato KA, et al. Harmonizing the metabolic syndrome: a joint interimstatement of the International Diabetes Federation Task Force onEpidemiology and Prevention; National Heart, Lung, and Blood Institute;American Heart Association; World Heart Federation; InternationalAtherosclerosis Society; and International Association for the Study ofObesity. Circulation. 2009;120(16):1640-5. https://doi.org/10.1161/CIRCULATIONAHA.109.192644

  14. Leiter LA, Fitchett DH, Gilbert RE, Gupta M, Mancini J, McFarlanePA, et al. Cardiometabolic risk in Canada: a detailed analysis and positionpaper by the Cardiometabolic Risk Working Group. Can J Cardiol.2011;27(2):e1-33. https://doi.org/10.1016/j.cjca.2010.12.054

  15. Hamo CE, Schlamp F, Drenkova K, Jindal M, Fadzan M, Akinlonu A, etal. Burden of cardiometabolic risk factors and vascular health. Am Heart J.2024;269:201-4. https://doi.org/10.1016/j.ahj.2023.11.004

  16. Institute for Health Metrics and Evaluation. Global Burden of Diseases2021. IHME, 2025 [citado febrero 7, 2025]. Disponible en: https://vizhub.healthdata.org/gbd-results/

  17. Barquera S, Hernández-Barrera L, Oviedo-Solís C, Rodríguez-RamírezS, Monterrubio-Flores E, Trejo-Valdivia B, et al. Obesidad en adultos. SaludPublica Mex. 2024;66(4):414-24. https://doi.org/10.21149/15863

  18. Basto-Abreu A, López-Olmedo N, Rojas-Martínez R, Aguilar-SalinasCA, Moreno-Banda GL, Carnalla M, et al. Prevalencia de prediabetes y diabetesen México: Ensanut 2022. Salud Publica Mex. 2023;65(supl 1):s163-8.https://doi.org/10.21149/14832

  19. Rao GHR. Cardiometabolic diseases: risk factors and novel approachesfor the management of risks. Cardiometabolic Diseases. 2025:3-26. https://doi.org/10.1016/B978-0-323-95469-3.00022-X

  20. Romero-Martínez M, Barrientos-Gutiérrez T, Cuevas-Nasu L, Bautista-Arredondo S, Colchero MA, Gaona-Pineda EB, et al. Metodología dela Encuesta Nacional de Salud y Nutrición 2021. Salud Publica Mex.2021;63(6):813-8. https://doi.org/10.21149/13348

  21. Escamilla-Nuñez C. Material suplementario: Flujograma del tamañode muestra, selección de submuestras y número de participantes coninformación completa de los indicadores cardiometabólicos. México,Ensanut Continua 2021. figshare; 2025. https://doi.org/10.6084/M9.FIGSHARE.30162196

  22. Kolenikov S, Angeles G. The use of discrete data in principal componentanalysis: theory, simulations, and applications to socioeconomicindices. Carolina: MEASURE Evaluation, 2004 [citado febrero 7, 2025].Disponible en: https://www.measureevaluation.org/resources/publications/wp-04-85.html

  23. Instituto Nacional de Estadística y Geografía. Población de 12 años ymás. México: Inegi, 2020 [citado septiembre 30, 2025]. Disponible en: https://www.inegi.org.mx/sistemas/Olap/Proyectos/bd/censos/cpv2020/P12Mas.asp

  24. Organización Mundial de la Salud. World population prospects.Ginebra: OMS, 2024 [citado septiembre 30, 2025]. Disponible en:https://population.un.org/wpp/downloads?folder=Standard%20Projections&group=Population

  25. Escamilla-Nuñez C. Material suplementario. Cuadro S3. Prevalencia defactores de riesgo cardiometabólico ajustadas por edad en adultos de 20años y más por sexo y tamaño de localidad. México, Ensanut Continua2021. 2025;14666. https://doi.org/10.6084/m9.figshare.30239566

  26. Escamilla-Nuñez C. Material suplementario: diagrama de resumende los resultados estratificados por tamaño de localidad y sexo. México,Ensanut Continua 2021. México: figshare; 2025. https://doi.org/10.6084/M9.FIGSHARE.30162388

  27. Barquera S, Hernández-Barrera L, Trejo B, Shamah T, Campos-NonatoI, Rivera-Dommarco J. Obesidad en México, prevalencia y tendencias enadultos. Ensanut 2018-19. Salud Publica Mex. 2020;62(6):682-92. https://doi.org/10.21149/11630

  28. Campos-Nonato I, Galván-Valencia Ó, Hernández-Barrera L, Oviedo-Solís C, Barquera S. Prevalencia de obesidad y factores de riesgo asociadosen adultos mexicanos: resultados de la Ensanut 2022. Salud PublicaMex. 2023;65(supl 1):s238-47. https://doi.org/10.21149/14809

  29. Medina C, Jáuregui A, Hernández C, Shamah T, Barquera S. Physicalinactivity and sitting time prevalence and trends in Mexican adults. Resultsfrom three national surveys. PLoS ONE. 2021;16(7):e0253137. https://doi.org/10.1371/journal.pone.0253137

  30. Popkin BM, Reardon T. Obesity and the food system transformationin Latin America. Obes Rev. 2018;19(8):1028-64. https://doi.org/10.1111/obr.12694

  31. Pérez-Ferrer C, McMunn A, Zaninotto P, Brunner EJ. The nutritiontransition in Mexico 1988-2016: the role of wealth in the social patterningof obesity by education. Public Health Nutr. 2018;21(13):2394-2401.https://doi.org/10.1017/s1368980018001167

  32. Madise NJ, Letamo G. Complex association between rural/urbanresidence, household wealth and women’s overweight: evidence from30 cross-sectional national household surveys in Africa. BMC Obes.2017;4(1):5. https://doi.org/10.1186/s40608-016-0141-1

  33. Kanter R, Caballero B. Global gender disparities in obesity: a review.Adv Nutr. 2012;3(4):491-8. https://doi.org/10.3945/an.112.002063

  34. Alston L, Nichols M, Allender S, Versace V, Brown LJ, Schumacher T, etal. Dietary patterns in rural and metropolitan Australia: a cross-sectionalstudy exploring dietary patterns, inflammation and association withcardiovascular disease risk factors. BMJ Open. 2023;13(6):e069475. https://doi.org/10.1136/bmjopen-2022-069475

  35. Taddei C, Zhou B, Bixby H, Carrillo-Larco RM, Danaei G, Jackson RT,et al. Repositioning of the global epicentre of non-optimal cholesterol.Nature. 2020;582(7810):73-7. https://doi.org/10.1038/s41586-020-2338-1

  36. Organización Mundial de la Salud. Cholesterol, HDL, mean (crudeestimate). Ginebra: OMS [citado septiembre 30, 2025]. Disponible en:https://www.who.int/data/gho/data/indicators/indicator-details/GHO/ghomean-hdl-cholesterol-crude

  37. Escobedo-de la Peña J, de Jesús-Pérez R, Schargrodsky H, ChampagneB. Prevalence of dyslipidemias in Mexico city and Its relation to othercardiovascular risk factors. Results from the CARMELA study. Gac MedMex. 2014;150(2):128-36 [citado febrero 7, 2025]. Disponible en: https://pubmed.ncbi.nlm.nih.gov/24603993/

  38. Pavía-López AA, Alcocer-Gamba MA, Ruiz-Gastélum ED, Mayorga-Butrón JL, Mehta R, Díaz-Aragón FA. Guía de práctica clínica mexicanapara el diagnóstico y tratamiento de las dislipidemias y enfermedadcardiovascular aterosclerótica. Arch Cardiol Mex. 2022;92(supl):1-62.https://doi.org/10.24875/acm.m22000081

  39. Aguilar-Salinas CA, Olaiz G, Valles V, Torres JM, Gómez-Pérez FJ, Rull JA.High prevalence of low HDL cholesterol concentrations and mixed hyperlipidemiain a Mexican nationwide survey. J Lipid Res. 2001;42(8):1298-307[citado febrero 7, 2025]. Disponible en: https://www.jlr.org/article/S0022-2275(20)31581-9/fulltext

  40. Barquera S, Hernández-Barrera L, Tolentino ML, Espinosa J, Shuwen Ng,Rivera JA. Energy Intake from beverages is increasing among Mexican adolescentsand adults. J Nutr. 2008;138(12):2454-61. https://doi.org/10.3945/jn.108.092163

  41. Carr MC. The Emergence of the metabolic syndrome with menopause.J Clin Endocrinol Metab. 2003;88(6):2404-11. https://doi.org/10.1210/jc.2003-030242

  42. Wild RA, Carmina E, Diamanti-Kandarakis E, Dokras A, Escobar-Morreale HF, Futterweit W, et al. Assessment of cardiovascular risk andprevention of cardiovascular disease in women with the polycysticovary syndrome: a consensus statement by the Androgen Excess andPolycystic Ovary Syndrome (AE-PCOS) Society. J Clin Endocrinol Metab.2010;95(5):2038-49. https://doi.org/10.1210/jc.2009-2724

  43. Shamah-Levy T, Romero-Martínez M, Barrientos-Gutiérrez T, Cuevas-Nasu L, Bautista-Arredondo S, Colchero MA, et al. Encuesta Nacionalde Salud y Nutrición 2021 Sobre Covid-19. Resultados Nacionales.Cuernavaca, México: INSP, 2022 [citado febrero 7, 2025]. Disponible en:https://ensanut.insp.mx/encuestas/ensanutcontinua2021/doctos/informes/220804_Ensa21_digital_4ago.pdf

  44. Shamah-Levy T, Romero-Martínez M, Cuevas-Nasu L, MéndezGómez-Humaran I, Avila-Arcos MA, Rivera-Dommarco JA. The MexicanNational Health and Nutrition Survey as a basis for public policyplanning: overweight and obesity. Nutrients. 2019;11(8):1727. https://doi.org/10.3390/nu11081727

  45. Institute for Health Metrics and Evaluation. Global burden of diseases2021.IHME, 2025 [citado febrero 7, 2025]. Disponible en: https://vizhub.healthdata.org/gbd-results/

  46. Lopez-Neyman SM, Davis K, Zohoori N, Broughton KS, Moore CE,Miketinas D. Racial disparities and prevalence of cardiovascular diseaserisk factors, cardiometabolic risk factors, and cardiovascular health metricsamong US adults: NHANES 2011-2018. Sci Rep. 2022;12(1):19475. https://doi.org/10.1038/s41598-022-21878-x

  47. Seidell JC, Björntorp P, Sjöström L, Kvist H, Sannerstedt R. Visceralfat accumulation in men is positively associated with insulin, glucose, andC-peptide levels, but negatively with testosterone levels. Metabolism.1990;39(9):897-901. https://doi.org/10.1016/0026-0495(90)90297-p

  48. Risérus U, Ingelsson E. Alcohol intake, insulin resistance, and abdominalobesity in elderly men. Obesity. 2007;15(7):1766-73. https://doi.org/10.1038/oby.2007.210

  49. Ottarsdottir K, Nilsson AG, Hellgren M, Lindblad U, Daka B. Theassociation between serum testosterone and insulin resistance: a longitudinalstudy. Endocrine Connections. 2018;7(12):1491-500. https://doi.org/10.1530/ec-18-0480

  50. Li W, Yi G, Chen Z, Dai X, Wu J, Peng Y, et al. Is job strain associatedwith a higher risk of type 2 diabetes mellitus? A systematic review andmeta-analysis of prospective cohort studies. Scand J Work Environ Health.2021;47(4):249-57. https://doi.org/10.5271/sjweh.3938

  51. Kautzky-Willer A, Harreiter J, Pacini G. Sex and gender differencesin risk, pathophysiology and complications of type 2 diabetes mellitus.Endocr Rev. 2016;37(3):278-316. https://doi.org/10.1210/er.2015-1137

  52. Congdon P. Obesity and urban environments. IJERPH. 2019;16(3):464.https://doi.org/10.3390/ijerph16030464

  53. Barquera S, Campos-Nonato I, Aguilar-Salinas C, Lopez-Ridaura R,Arredondo A, Rivera-Dommarco J. Diabetes in Mexico: cost and managementof diabetes and its complications and challenges for health policy.Global Health. 2013;9(1):3. https://doi.org/10.1186/1744-8603-9-3

  54. Pérez Gil-Romo SE, Romero-Juárez AG, Candiani-Rodríguez I,Martínez-Pimentel LM. Obesidad en México: un acercamiento a la miradasocial en los últimos 16 años. Interdisciplina. 2021;10(26):91. https://doi.org/10.22201/ceiich.24485705e.2022.26.80970

  55. Heredia-Pi IB, Orozco-Núñez E, Guerrero-López CM, Cerecer-Ortiz N,Ojeda-Arroyo E, Allen-Leigh B, et al. Gendered experience of people livingwith type 2 diabetes in rural and urban Mexico: an ethnographic study. Int JEquity Health. 2025;24:157. https://doi.org/10.1186/s12939-025-02523-1

  56. Fajardo-Dolci GE, Vicuña-De Anda FJ, Ortiz-Vázquez P, Olaiz-Fernández G. The burden of cardiovascular disease in Mexico 1990-2021.Summary of the Global Burden of Disease 2021 study. Gac Med Mex.2023;159:557-64. https://doi.org/10.24875/gmm.m24000837

  57. Gaziano TA, Abrahams-Gessel S, Denman CA, Mendoza-Montano C,Khanam M, Puoane T, et al. An assessment of community health workers’ability to screen for cardiovascular disease risk with a simple, non-invasiverisk assessment instrument in Bangladesh, Guatemala, Mexico, and SouthAfrica: an observational study. Lancet Glob Health.2015;3(9):e556-63.https://doi.org/10.1016/s2214-109x(15)00143-6

  58. Agudelo-Botero M, Dávila-Cervantes CA, Giraldo-Rodríguez L.Cardiometabolic multimorbidity in Mexican adults: a cross-sectionalanalysis of a national survey. Front Med. 2024;11. https://doi.org/10.3389/fmed.2024.1380715

  59. Bautista-Arredondo S, Vargas-Flores A, Moreno-Aguilar LA, ColcheroMA. Utilización de servicios de salud en México: cascada de atenciónprimaria en 2022. Salud Publica Mex. 2023;65(supl 1):s15-22. https://doi.org/10.21149/14813

  60. Niccoli T, Partridge L. Ageing as a risk factor for disease. Curr Biol.2012;22(17):R741-52. https://doi.org/10.1016/j.cub.2012.07.024

  61. Muka T, Oliver-Williams C, Kunutsor S, Laven JSE, Fauser B,Chowdhury R, et al. Association of age at onset of menopause and timesince onset of menopause with cardiovascular outcomes, intermediatevascular traits, and all-cause mortality: a systematic review andmeta-analysis. JAMA Cardiol. 2016;1(7):767-76. https://doi.org/10.1001/jamacardio.2016.2415

  62. Alcalde-Rabanal JE, Orozco-Núñez E, Espinosa-Henao OE, Arredondo-López A, Alcayde-Barranco L. The complex scenario of obesity, diabetesand hypertension in the area of influence of primary healthcare facilities inMexico. PLoS ONE. 2018;13(1):e0187028. https://doi.org/10.1371/journal.pone.0187028

  63. Campos-Nonato I, Oviedo-Solís C, Vargas-Meza J, Ramírez-VillalobosD, Medina-García C, Gómez-Álvarez E, et al. Prevalencia, tratamiento ycontrol de la hipertensión arterial en adultos mexicanos: resultados dela Ensanut 2022. Salud Publica Mex. 2023;65(supl 1):s169-80. https://doi.org/10.21149/14779

  64. Rivera-Dommarco J, Colchero MA, Fuentes ML, González de Cosío-Martínez T, Aguilar-Salinas CA, Hernández-Licona G, Barquera S, (eds.). Laobesidad en México: estado de la política pública y recomendaciones parasu prevención y control. México: Instituto Nacional de Salud Publica, 2018[citado febrero 7, 2025]. Disponible en: https://www.insp.mx/images/stories/2019/Docs/190213_LaObesidadenMexico.pdf

  65. Aguilar-Salinas CA, Tusie-Luna T, Pajukanta P. Genetic and environmentaldeterminants of the susceptibility of Amerindian derived populationsfor having hypertriglyceridemia. Metabolism. 2014;63(7):887-94. https://doi.org/10.1016/j.metabol.2014.03.012

  66. Presidencia de la República, Estados Unidos Mexicanos. ProgramaSectorial de Salud 2025-2030. México: Secretaría de Gobernación, 2025[citado septiembre 30, 2025]. Disponible en: https://sidof.segob.gob.mx/notas/5767240

  67. Organización Mundial de la Salud. Everyday actions for better health– WHO recommendations. Ginebra: OMS, 2025 [citado septiembre 30,2025]. Disponible en: https://www.who.int/europe/news-room/fact-sheets/item/everyday-actions-for-better-health-who-recommendations




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