Dra. Mardones-Leiva, Lorena

Introducción: La diabesidad se define como la coexistencia de obesidad y diabetes mellitus tipo 2 (DMT2). En Chile su prevalencia aún no ha sido definida. El objetivo de este estudio fue determinar la prevalencia de prediabesidad y diabesidad en adultos chilenos. Material y Método: Estudio transversal que incluyó 4.985 adultos mayores de 18 años de la Encuesta Nacional de Salud 2016-2017. El estado nutricional fue determinado por índice de masa corporal y DMT2 por una glicemia en ayuno ≥126 mg/dL o auto-reporte médico. Utilizando la combinación de estas dos variables, se definieron 6 fenotipos: normal sin diabetes, normo-diabetes, sobrepeso sin diabetes, prediabesidad, obesidad sin diabetes y diabesidad. La prevalencia de estos fenotipos se estudió según características sociodemográficas y estilos de vida. Resultados: La prevalencia de diabesidad, prediabesidad y normo-diabetes fue de 5,7%, 3,6% y 2,5%, respectivamente. Adicionalmente, la prevalencia de diabesidad fue mayor en mujeres, en personas con menos de 8 años de escolaridad y en aquellos con una edad de diagnóstico entre 45 y 46 años. Conclusión: El 9,3% de la población presentó prediabesidad o diabesidad, con una mayor proporción de los casos de diabesidad en mujeres y personas con bajo nivel de escolaridad. Considerando las proyecciones de aumento de obesidad y DMT2 en Chile, resulta urgente generar acciones y estrategias en esta materia, ya que una gran proporción de los casos de estas patologías pueden ser prevenibles.

Objective: To investigate the association between a lifestyle score and all-cause mortality in the Chilean population. Design: Prospective study. Settings: The score was based on seven modifiable behaviours: salt intake, fruit and vegetable intake, alcohol consumption, sleep duration, smoking, physical activity and sedentary behaviours. 1-point was assigned for each healthy recommendation. Points were summed to create an unweighted score from 0 (less healthy) to 7 (healthiest). According to their score, participants were then classified into: less healthy (0–2 points), moderately healthy (3–4 points) and the healthiest (5–7 points). Associations between the categories of lifestyle score and all-cause mortality were investigated using Cox proportional hazard models adjusted for confounders. Nonlinear associations were also investigated. Participants: 2706 participants from the Chilean National Health Survey 2009–2010. Results: After a median follow-up of 10·9 years, 286 (10·6 %) participants died. In the maximally adjusted model, and compared with the healthiest participants, those less healthy had 2·55 (95 % CI 1·75, 3·71) times higher mortality risk due to any cause. Similar trends were identified for the moderately healthy group. Moreover, there was a significant trend towards increasing the mortality risk when increasing unhealthy behaviours (hazard ratio model 3: 1·61 (95 % CI 1·34, 1·94)). There was no evidence of nonlinearity between the lifestyle score and all-cause mortality. Conclusion: Individuals in the less healthy lifestyle category had higher mortality risk than the healthiest group. Therefore, public health strategies should be implemented to promote adherence to a healthy lifestyle across the Chilean population.

Background: Adiposity and education are two independent risk factors for type 2 diabetes (T2D). However, there is limited evidence whether both education and adiposity are associated with T2D in an additive manner in the Chilean population. Aim: To investigate the joint association between adiposity and education with T2D in the Chilean adult population. Material and Methods: Analysis of data of the Chilean National Health Survey 2016-2017, which included 5,033 participants with a mean age of 43 years, (51% women). Poisson regression analyses with robust standard error were used to investigate the joint association of the education level and general and central adiposity with T2D. The results were reported as Prevalence Ratio and their 95% confidence intervals (PR, 95% CI). Results: Obesity was associated with a higher probability of having T2D in men than in women, however central adiposity was associated with a higher probability of having T2D in women than in men. Compared with men who had higher education (> 12 years) and had normal body weight, those with the same educational level and who were obese had 2.3-times higher probability of having T2D (PR: 2.35 [95% CI: 1.02; 5.39]). For women, having a low education and being obese was associated with 4.4-times higher probability of having T2D compared to those with higher education and normal body mass index (BMI) (PR: 4.47 [95% IC: 2.12; 9.24]). Similar results were observed when waist circumference was used as a marker of obesity rather than BMI. Conclusions: Women and men with higher BMI and low education had a higher risk of T2D. However, this risk was higher in women than in men.