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        "titulo" => "Prevalencia de obesidad seg&#250;n la estadificaci&#243;n de Edmonton en las consultas de Medicina Interna&#46; Resultados del estudio OBEMI"
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          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Study flow diagram&#46; BMI&#44; body mass index&#59; EOS&#44; Edmonton Obesity Staging System&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Background</span><p id="par0005" class="elsevierStylePara elsevierViewall">In recent decades&#44; obesity has reached worldwide epidemic proportions&#46; Twenty percent of the population has excess weight&#44; and 10&#37; have obesity&#44; with figures for 2030 estimated at 2&#46;16 million individuals with excess weight and 1&#46;12 million with obesity&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The prevalence of obesity in the adult population in Spain is approximately 23&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">2</span></a> Most epidemiological studies have used the body mass index &#40;BMI&#41; &#40;weight in kg&#47;height in meters<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">2</span></a>&#41; to classify obesity&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">3</span></a> An individual over the age of 18 years with a BMI<span class="elsevierStyleHsp" style=""></span>&#8805;30<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span> is considered to have obesity&#46; However&#44; obesity can also be defined by other criteria&#44; such as an excess of adipose tissue &#40;25&#37; in men and 30&#37; in women&#41; of sufficient magnitude to cause an increase in the individual&#39;s morbidity and mortality &#40;loss of 3&#8211;10 life-years in the most severe cases<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">4</span></a>&#41;&#44; due to its role in the development of other comorbidities such as arterial hypertension &#40;AHT&#41;&#44; type 2 diabetes mellitus &#40;DM2&#41; and dyslipidemia&#44;<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">5&#44;6</span></a> as well as severe functional limitations in the quality of life&#46; Therefore&#44; classifying obesity solely on anthropometric measures has numerous limitations and marked variability&#44;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">7</span></a> because individuals with the same body weight can have various health problems that affect their vital prognosis&#46; BMI is also a poor predictor of mortality&#44; especially in the patients treated in departments of internal medicine &#40;IM&#41; who are older and have more comorbidity&#46; The Edmonton Obesity Staging System &#40;EOSS&#41; provides an obesity classification system that is independent of BMI&#44;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">8</span></a> incorporating the presence and severity of comorbidities&#44; the gradation of functional limitations and their impact on the quality of life of patients with obesity&#46; The EOSS is therefore more useful in clinical terms for making therapeutic decisions&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">9</span></a> The EOSS is also a possible predictor of mortality&#44;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">10</span></a> even after adjusting for other adiposity assessment methods such as abdominal circumference&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">The aim of this study was to determine the prevalence of obesity and classify it according to the Edmonton stages in patients treated at IM departments&#46; The secondary objective was to analyze the clinical&#8211;epidemiological characteristics of the participants with obesity stratified according to EOSS&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Material and methods</span><p id="par0020" class="elsevierStylePara elsevierViewall">An observational&#44; descriptive cross-sectional study was conducted to assess the prevalence of obesity and its classification according to the EOSS in patients treated in outpatient IM clinics&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">The EOSS classification defines the following stages&#58; &#40;a&#41; stage 0&#58; no risk factors &#40;blood pressure&#44; lipid and baseline glucose levels within normal ranges&#41;&#44; no psychopathology&#44; physical symptoms&#44; functional limitation or impairment in wellbeing related to obesity&#59; &#40;b&#41; stage 1&#58; the presence of obesity-related subclinical risk factors &#40;pre-AHT&#44; abnormal baseline glucose levels&#44; high hepatic enzyme levels&#41;&#44; mild physical symptoms &#40;moderate effort dyspnea&#44; fatigue and occasional joint pain&#41;&#44; mild psychopathology&#44; functional limitation or mildly impaired wellbeing&#59; &#40;c&#41; stage 2&#58; presence of established chronic obesity-related diseases &#40;AHT&#44; DM2&#44; obstructive sleep apnea syndrome&#44; osteoarthritis&#41;&#44; moderate limitation in daily life activities and moderately impaired wellbeing&#59; &#40;d&#41; stage 3&#58; established organ damage &#40;acute myocardial infarction&#44; heart failure&#44; stroke&#44; diabetic complications&#41; significant psychopathology &#40;severe depression&#44; suicidal ideation&#41;&#44; functional limitation or significantly impaired wellbeing&#59; and &#40;e&#41; stage 4&#58; chronic obesity-related diseases with severe dysfunction &#40;potentially terminal damage&#41;&#44; psychopathology&#44; functional limitation or severely impaired wellbeing&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">We conducted a study in 38 national centers&#46; The participating centers conducted a 1-day cross-section between the 1st and 14th of February&#44; 2016&#44; to consecutively select patients&#46; The data were collected in an electronic and anonymous registry&#46; We followed the ethical principles of human research as laid out in the Declaration of Helsinki&#44; updated in the General Assembly of Brazil &#40;2013&#41;&#46; We respected the confidentiality and secrecy of personal information according to the Data Protection Law of 15&#47;1999 &#40;BOE 1999&#44; no&#46; 289&#41;&#46; The study was approved by the Clinical Research Ethics Committee of the University Hospital of Badajoz&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Patients</span><p id="par0035" class="elsevierStylePara elsevierViewall">The study included patients who met the following inclusion criteria&#58; BMI<span class="elsevierStyleHsp" style=""></span>&#62;30<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span> and older than 18 years&#46; The study excluded patients who refused to sign the informed consent document&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Variables</span><p id="par0040" class="elsevierStylePara elsevierViewall">The primary endpoint was the categories established by EOSS&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">8</span></a> Obesity classification by BMI was conducted according to the consensus of the Spanish Society for the Study of Obesity&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">3</span></a> We obtained demographic&#44; clinicians&#44; anthropometric and laboratory data from the included patients&#46; In terms of the demographic variables&#44; we determined the following&#58; educational level &#40;no studies&#44; basic studies&#44; secondary&#47;professional training and university&#41;&#44; employment status active or not&#44; rural &#40;fewer than 10&#44;000 inhabitants&#41; or urban origin &#40;more than 10&#44;000 inhabitants&#41; and marital status &#40;single or living with a partner&#41;&#46; Lastly&#44; we considered that the patients engaged in physical exercise if they performed more than 30<span class="elsevierStyleHsp" style=""></span>min of aerobic exercise more than 5 days&#47;week&#46; As clinical variables&#44; we included active smoking and excessive alcohol consumption &#40;intake<span class="elsevierStyleHsp" style=""></span>&#62;60<span class="elsevierStyleHsp" style=""></span>g&#47;day in men and<span class="elsevierStyleHsp" style=""></span>&#62;40<span class="elsevierStyleHsp" style=""></span>g&#47;day in women&#41;&#46; We also recorded the previous presence of chronic obstructive pulmonary disease &#40;COPD&#41;&#44; asthma and active cancer &#40;excluding skin cancer&#44; except for melanoma&#41;&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">To calculate comorbidity&#44; we employed the Charlson index<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">11</span></a> &#40;absence of comorbidity&#44; 0&#8211;1&#59; low comorbidity&#44; 2&#59; high comorbidity&#44; &#8805;3&#41;&#46; To measure functional capacity&#44; we used the Barthel index<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">12</span></a> &#40;total dependence&#44; 0&#8211;20 points&#59; severe dependence&#44; 21&#8211;60 points&#59; moderate dependence&#44; 61&#8211;90 points&#59; low dependence&#44; 91&#8211;99 points&#59; independence&#44; 100 points&#41;&#46; For depression&#44; we employed Beck&#39;s scale<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">13</span></a> &#40;0&#8211;9 points&#44; no depression&#59; 10&#8211;15&#44; mild depression&#59; 16&#8211;24 points&#44; moderate depression&#59; and 25&#8211;62 points&#44; severe depression&#41;&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Statistical analysis</span><p id="par0050" class="elsevierStylePara elsevierViewall">Assuming an expected prevalence of obesity of 23&#37;&#44;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">2</span></a> a 2&#37; error and a 95&#37; confidence interval&#44; the calculated minimum sample size was 250 patients&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">To calculate the prevalence&#44; we used the total number of patients who met the inclusion criteria&#44; analyzing the variables grouped according to EOSS&#46; The qualitative variables are expressed as the total number and percentage referring to EOSS&#46; To compare the variables&#44; we employed the Chi-squared test&#46; The quantitative variables are expressed as median and interquartile range&#46; To comparing the variables&#44; we employed the Kruskal&#8211;Wallis test&#46; We performed a two-dimensional analysis of correspondence to observe significant groupings among the qualitative variables&#44; determining coordinates that allow the representation of classes of the study variables&#46; In the first model&#44; we used the EOSS groups&#44; employment status&#44; education level&#44; Charlson index and Barthel index as the variables&#46; In the second model&#44; we substituted the EOSS groups by BMI&#44; according to the Spanish Society for the Study of Obesity criteria&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">3</span></a> To determine the coordinates&#44; we used the Chi-squared distance&#46; Finally&#44; we performed a multivariate logistic regression analysis to observe the dependence among the variables&#46; The dependent variable was belonging or not an EOSS group &#8805;2&#46; For the model&#44; we chose the covariates considered significant &#8220;a priori&#8221;&#44; based on previous studies on patients with obesity&#46; We also chose those covariates that dictated the clinical experience&#44; as well as those that were significant in the univariate analysis&#46; In the final model&#44; we analyzed age&#44; BMI&#44; Charlson index&#44; creatinine clearance &#40;Chronic Kidney Disease Epidemiology Collaboration&#44; CKD-EPI&#41;&#44; glucose&#44; uric acid&#44; total cholesterol&#44; leukocytes and albumin&#47;creatinine ratio&#46; We employed the R program &#40;version 3&#46;2&#46;4&#44; Free Software Foundation&#39;s&#44; GNU General Public License&#41;&#46; Differences with a <span class="elsevierStyleItalic">p</span>-value &#60;&#46;05 were considered significant&#46;</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Results</span><p id="par0060" class="elsevierStylePara elsevierViewall">From a total of 1262 patients treated in consultations&#44; we initially included 298 patients with obesity&#44; 33 of whom were later excluded due to lack of data or consent to use the data&#46; Ultimately&#44; we analyzed 265 patients with obesity &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#44; 135 of whom were men&#46; The mean age &#40;&#177;SD&#41; was 62&#46;47<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>15&#46;27 years&#44; and the BMI &#40;&#177;SD&#41; was 36&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#46;3<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span>&#46; The prevalence of obesity by BMI was 23&#46;62&#37;&#46; By EOSS stages 0&#44; 1&#44; 2&#44; 3 and 4&#44; the prevalence was 4&#46;9&#37;&#44; 14&#46;7&#37;&#44; 62&#46;3&#37;&#44; 15&#46;5&#37; and 2&#46;64&#37;&#44; respectively&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> lists the patients&#8217; clinical and demographic characteristics according to the EOSS&#46; For the patients with EOSS 2&#44; 3 and 4&#44; we observed a significant increase in age &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;0000&#41;&#44; DM2 &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;0001&#41;&#44; dyslipidemia &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;0003&#41;&#44; obstructive sleep apnea syndrome &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;0027&#41; and heart failure &#40;p&#60;&#46;0001&#41;&#44; which determined a significant increase in the Charlson index by group &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;0000&#41;&#46; In the laboratory variables &#40;<a class="elsevierStyleCrossRef" href="#sec0050">Table 1 available in the supplementary material of the online version of this article</a>&#41;&#44; we observed an increase in glucose levels &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;0003&#41;&#44; leukocyte counts &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;0000&#41;&#44; uric acid levels &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;02&#41; and urea levels &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;004&#41;&#44; as well as a reduction in the glomerular filtration rate &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;02&#41; in the upper EOSS categories&#46; We observed significant differences in all drug groups employed&#44; except for the sulfonylureas&#44; nonsteroidal anti-inflammatory drugs&#44; antidepressants and anxiolytic agents&#44; which were used equally by all EOSS groups &#40;<a class="elsevierStyleCrossRef" href="#sec0050">Table 2&#44; available in the supplementary material of the online version of this article</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">In terms of the analysis of correspondence &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#44; in the first model with a cumulative explanatory percentage of 78&#46;2&#37;&#44; we observed a first patient group clustered around EOSS 0 and 1&#44; with secondary or university education&#44; who were employed&#44; and who had no dependence or comorbidity&#46; We observed another group around EOSS 2&#44; with basic or no education&#44; who were unemployed&#44; who had little dependence and low comorbidity&#46; We also observed a third group around EOSS 3 with moderate or severe dependence and high comorbidity&#44; with no relation to education level or employment status&#46; Finally&#44; we observed an EOSS 4 group with no association with any of the prior conditions&#46; In the second model &#40;replacing EOSS with BMI&#41; with a lower cumulative explanatory percentage &#40;70&#46;6&#37;&#41;&#44; there were no clusters as defined as in the first model&#46; Type 2 and 4 obesity showed no grouping&#46; Type 1 could be grouped with independent patients with no comorbidity&#44; and type 3 could be grouped with unemployed patients with basic or no education&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">In the logistic regression model &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#44; the variables that ultimately were related with an EOSS stage &#8805;2 were BMI &#40;odds ratio &#91;OR&#93;&#44; 1&#46;07&#59; 95&#37; CI 0&#46;99&#8211;1&#46;16&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;06&#41;&#44; age &#40;OR&#44; 1&#46;06&#59; 95&#37; CI 1&#46;03&#8211;1&#46;08&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;0003&#41;&#44; glucose levels &#40;OR 1&#46;04&#44; 95&#37; CI 1&#46;01&#8211;1&#46;07&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;0006&#41;&#44; total cholesterol levels &#40;OR&#44; 0&#46;98&#59; 95&#37; CI 0&#46;97&#8211;0&#46;99&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;2&#41; and uric acid levels &#40;OR&#44; 1&#46;32&#59; 95&#37; CI 1&#46;03&#8211;1&#46;68&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;02&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Discussion</span><p id="par0080" class="elsevierStylePara elsevierViewall">In this study&#44; the prevalence of obesity in the IM consultations was similar to that found in other epidemiological studies in the general population such as the Nutrition and Cardiovascular Risk in Spain &#40;ENRICA&#41; study &#40;23&#37;&#41;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">14</span></a> and the Spanish Cardiovascular Risk Equation &#40;ERICE&#41;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">15</span></a> study &#40;22&#46;7&#37;&#41;&#44; both of which had a mean BMI of 26&#46;9&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">16</span></a> This prevalence increases with age&#44; reaching 35&#37; between 65 and 70 years of age&#46;<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">17&#44;18</span></a> In our study&#44; most of the patients were included in the age range between 60 and 80 years&#46; A relationship was shown between a higher EOSS &#40;mainly 2 and 3&#41;&#44; a progressive reduction in height&#44; weight and&#44; less significantly&#44; BMI &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;28&#41; with increasing age &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46; The use of BMI to define obesity in the elderly is controversial due to the reduction in height while maintaining a stable weight &#40;reduction estimated at 0&#8211;0&#46;65<span class="elsevierStyleHsp" style=""></span>kg&#47;year&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">19</span></a> to the reduction in muscle mass and to the redistribution of adipose deposits in the abdomen and perivisceral area &#40;&#8220;sarcopenic obesity&#8221;&#41;&#46; This increase in adiposity is responsible for mobility-related disability&#44; greater functional impairment&#44; increased cardiovascular risk&#44; arthritis and greater obesity-attributable mortality&#44; estimated at 28&#44;000 deaths annually&#44; even after adjusting for abdominal adiposity&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">20</span></a> Engelmann et al&#46; and other authors have reported a <span class="elsevierStyleItalic">J</span> curve between BMI and mortality&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">21</span></a> In contrast&#44; the so-called &#8220;obesity paradox&#8221; reports lower mortality&#44; by cardiovascular<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">22</span></a> and noncardiovascular<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">23</span></a> diseases&#44; in the elderly with obesity&#46; Nevertheless&#44; there are numerous confounding factors&#44; such as the degree of inflammation and renal dysfunction&#44; which can influence this paradox&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">24</span></a></p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">Eighty percent of the patients in this study had an EOSS stage &#8805;2&#44; which was associated with greater age and functional impairment and more comorbidity &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; Most studies on the prevalence of obesity have been based on the BMI and age&#44; while there are few references to comorbidity<a class="elsevierStyleCrossRefs" href="#bib0275"><span class="elsevierStyleSup">25&#44;26</span></a> and functional capacity&#46; It is therefore difficult in this context to recognize obesity as a complex chronic condition and&#44; accordingly&#44; address it from a comprehensive perspective based not only on anthropometric measures but also on the treatment of the complications related to weight and adiposity&#44; with the ultimate objective of improving health and overall quality of life&#46;<a class="elsevierStyleCrossRefs" href="#bib0285"><span class="elsevierStyleSup">27&#44;28</span></a></p><p id="par0090" class="elsevierStylePara elsevierViewall">As shown by the analysis of correspondence &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#44; the EOSS can discriminate those patients with greater comorbidity and lower functional capacity&#44; facilitating a comprehensive approach to the problem and can do so better than the BMI&#46; The few published studies based on EOSS agree on its role as a predictor of mortality<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">10</span></a> and its usefulness for prioritizing treatments such as bariatric surgery&#46;<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">29</span></a> This is the first national study of the prevalence of obesity in patients in standard clinical practice classified according to the associated comorbidities&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Moreover&#44; in the adjusted multivariate analysis&#44; we observed a direct association between an EOSS stage &#62;2 and a number of metabolic traits such as blood glucose &#40;OR&#44; 1&#46;04&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;0006&#41; and uric acid &#40;OR&#44; 1&#46;32&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;02&#41; levels&#46; An inverse association was observed with serum cholesterol levels &#40;OR&#44; 0&#46;98&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;02&#41;&#44; which was possibly due to the increased use of statins in the groups with higher EOSS stages &#40;see <a class="elsevierStyleCrossRef" href="#sec0050">supplementary material available in the online version</a>&#41;&#46; Obesity is the main modifiable risk factor for the onset of hyperuricemia and gout&#46; The relationship between hyperuricemia and cardiovascular disease is controversial and not uniform between the sexes&#46; Marotta et al&#46;&#44; in one of the few studies on elderly patients&#44; found a linear relationship between uric acid levels higher than 5&#46;5<span class="elsevierStyleHsp" style=""></span>mg&#47;dL and the onset of obesity&#44; AHT and DM2 in women older than 60 years&#46;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">30</span></a></p><p id="par0100" class="elsevierStylePara elsevierViewall">This study had some limitations&#46; The treated population and the type of IM consultations were highly heterogeneous&#44; which could have resulted in a patient selection bias&#46; However&#44; we can consider the patients as representative of the general adult population&#46; Although the sample may seem small&#44; it is consistent with the initially estimated size&#44; considering that the design was cross-sectional &#40;only 1 day within the inclusion period&#41;&#46; Moreover&#44; this design does not let us establish casual relationships between the variables&#46; The described associations should therefore be subsequently evaluated&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">In conclusion&#44; the prevalence of obesity among the patients treated in the IM consultations is similar to that described for the general population&#46; However&#44; the patients treated in IM departments are older&#44; have higher BMIs and greater comorbidity&#44; both metabolic and functional&#46; EOSS is useful for conducting a comprehensive approach for patients with obesity&#44; regardless of BMI&#44; which can help achieve better health and quality-of-life results&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Conflicts of interest</span><p id="par0110" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest with this article&#46;</p></span></span>"
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          "titulo" => "Background"
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              "titulo" => "Patients"
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              "titulo" => "Variables"
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          "identificador" => "sec0040"
          "titulo" => "Conflicts of interest"
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          "titulo" => "References"
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    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2016-07-20"
    "fechaAceptado" => "2016-11-03"
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          "clase" => "keyword"
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          "palabras" => array:4 [
            0 => "Obesity"
            1 => "Edmonton"
            2 => "Prevalence"
            3 => "Comorbidities"
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          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec804159"
          "palabras" => array:4 [
            0 => "Obesidad"
            1 => "Edmonton"
            2 => "Prevalencia"
            3 => "Comorbilidades"
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    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objectives</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To estimate the prevalence of obesity in patients treated by departments of Internal Medicine and to classify the patients according to the Edmonton Obesity Staging System &#40;EOSS&#41;&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Material and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">An observational&#44; descriptive cross-sectional study included outpatients older than 18 years&#44; with a body mass index &#40;BMI&#41;<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>30&#44; from 38 hospitals between the 1st and 14th of February&#44; 2016&#46; We classified the patients according to the EOSS and analyzed their clinical&#44; laboratory and demographic variables&#46; A value of <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;05 was considered statistically significant&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Of the 1262 patients treated in consultations&#44; we recruited 298 and analyzed 265&#46; The prevalence of obesity was 23&#46;6&#37;&#44; the mean age was 62&#46;47<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>15&#46;27 years&#44; and the mean BMI was 36&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#46;3<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span>&#46; According to EOSS stage &#40;0&#44; 1&#44; 2&#44; 3 and 4&#41;&#44; the prevalence was 4&#46;9&#44; 14&#46;7&#44; 62&#46;3&#44; 15&#46;5 and 2&#46;64&#37;&#44; respectively&#46; Those patients with EOSS<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>2 were significantly older and had significantly more comorbidities&#46; The multivariate analysis related age &#40;OR 1&#46;06&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;0003&#41;&#44; blood glucose &#40;OR 1&#46;04&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;0006&#41;&#44; total cholesterol &#40;OR 0&#46;98&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;02&#41; and uric acid &#40;OR 1&#46;32&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;02&#41; levels with an EOSS<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>2&#46; An analysis of correspondence grouped&#44; with an explanatory percentage of 78&#46;2&#37;&#44; the patients according to their EOSS&#44; comorbidity&#44; education level&#44; employment status and functional capacity&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The prevalence of obesity in the patients treated by Internal Medicine departments is similar to that of the general population&#44; although the patients are older and have a higher BMI&#46; EOSS is useful for implementing a comprehensive approach for patients with obesity&#44; regardless of the BMI&#44; which can help achieve better health and quality-of-life results&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Objectives"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Material and methods"
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          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Results"
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          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusions"
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        "titulo" => "Resumen"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivos</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Estimar la prevalencia de obesidad y clasificarla seg&#250;n la estadificaci&#243;n de Edmonton &#40;EOSS&#41; en pacientes atendidos por Medicina Interna&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material y m&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudio observacional&#44; descriptivo y transversal&#46; Incluy&#243; pacientes ambulatorios mayores de 18 a&#241;os con un &#237;ndice de masa corporal &#40;IMC&#41; &#62; 30&#44; procedentes de 38 hospitales&#44; entre el 1 y el 14 de febrero de 2016&#46; Se clasificaron seg&#250;n EOSS y se analizaron variables cl&#237;nicas&#44; anal&#237;ticas y sociodemogr&#225;ficas&#46; Se consider&#243; significaci&#243;n estad&#237;stica con p &#60; 0&#44;05&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">De 1&#46;262 pacientes vistos en las consultas se seleccionaron 298 y se analizaron 265&#46; La prevalencia de obesidad fue del 23&#44;6&#37;&#44; la edad&#44; de 62&#44;47 &#177; 15&#44;27 a&#241;os y el IMC&#44; de 36&#44;1 &#177; 5&#44;3 kg&#47;m<span class="elsevierStyleSup">2</span>&#46; Por EOSS &#40;0&#44; 1&#44; 2&#44; 3 y 4&#41; la prevalencia fue de 4&#44;9&#44; 14&#44;7&#44; 62&#44;3&#44; 15&#44;5 y 2&#44;64&#37;&#44; respectivamente&#46;&#160;Aquellos pacientes con EOSS &#62; 2 ten&#237;an significativamente m&#225;s edad y comorbilidades&#46; El an&#225;lisis multivariante relacion&#243; la edad &#40;OR 1&#44;06&#44; p &#60; 0&#44;0003&#41;&#44; la glucemia &#40;OR 1&#44;04&#44; p &#60; 0&#44;0006&#41;&#44; el colesterol total &#40;OR 0&#44;98&#44; p &#60; 0&#44;02&#41; y el &#225;cido &#250;rico &#40;OR 1&#44;32&#44; p &#60; 0&#44;02&#41; con un EOSS &#62; 2&#46; Un an&#225;lisis de correspondencias agrup&#243;&#44; con un porcentaje explicativo del 78&#44;2&#37;&#44; a los pacientes seg&#250;n su EOSS&#44; comorbilidad&#44; nivel de estudios&#44; situaci&#243;n laboral y capacidad funcional&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">La prevalencia de obesidad en pacientes atendidos por Medicina Interna es similar a la de la poblaci&#243;n general&#44; aunque los pacientes son de mayor edad e IMC&#46; El EOSS es &#250;til para hacer una aproximaci&#243;n integral de los pacientes obesos&#44; independientemente del IMC&#44; lo que puede posibilitar la obtenci&#243;n de mejores resultados en salud y en calidad de vida&#46;</p></span>"
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            "titulo" => "Material y m&#233;todos"
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            "titulo" => "Resultados"
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            "titulo" => "Conclusiones"
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    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Carretero G&#243;mez J&#44; Ar&#233;valo Lorido JC&#44; G&#243;mez Huelgas R&#44; S&#225;nchez Vidal MT&#44; Su&#225;rez Tembra M&#44; Varela Aguilar JM&#44; et al&#46; Prevalencia de obesidad seg&#250;n la estadificaci&#243;n de Edmonton en las consultas de Medicina Interna&#46; Resultados del estudio OBEMI&#46; Rev Clin Esp&#46; 2017&#59;217&#58;71&#8211;78&#46;</p>"
      ]
    ]
    "apendice" => array:1 [
      0 => array:1 [
        "seccion" => array:2 [
          0 => array:4 [
            "apendice" => "<p id="par0125" class="elsevierStylePara elsevierViewall">Alonso Pe&#241;a&#44; Javier&#46; Hospital Virgen del Puerto&#46; Plasencia&#46; Ar&#233;valo Lorido&#44; Jos&#233; Carlos&#46; Regional Hospital of Zafra&#46; Badajoz&#46; Arg&#252;ello Mart&#237;n&#44; Carlota&#46; Central Hospital of Asturias&#46; Bonilla Hern&#225;ndez&#44; Mar&#237;a&#46; Hospital Reina Sof&#237;a&#46; Tudela&#46; Campo L&#243;pez Cristina&#46; Hospital La Fe&#46; Valencia&#46; Carabantes Rueda&#44; Juan Jes&#250;s&#46; Hospital of Antequera&#44; Antequera&#46; Carretero G&#243;mez&#44; Juana&#46; Regional Hospital of Zafra&#46; Badajoz&#46; Castiella Herrero&#44; Jes&#250;s&#46; Foundation Hospital of Calahorra&#44; Calahorra&#44; La Rioja&#46; Chimeno Vi&#241;as&#44; Mar&#237;a Montserrat&#46; Healthcare Complex of Zamora&#46; De Escalante Yang&#252;ela&#44; Bego&#241;a&#46; Clinic Hospital Zaragoza&#46; Due&#241;as Gutierrez&#44; Carlos&#46; Hospital of Burgos&#46; Ena Mu&#241;oz&#44; Javier&#46; Hospital of la Marina Baixa&#46; Alicante&#46; Fern&#225;ndez Rodr&#237;guez&#44; Jos&#233; Mar&#237;a&#46; Hospital Carmen y Severo Ochoa&#46; Cangas de Narcea&#46; Asturias&#46; Fern&#225;ndez P&#233;rez&#44; Ester&#46; Hospital of Le&#243;n&#46; Freixas Descarregas&#44; Pere&#46; Regional Hospital Mor&#225; d&#201;bre&#46; Tarragona&#46; Garc&#237;a Contreras&#44; Rosa&#46; Hospital Virgen del Roc&#237;o&#46; Seville&#46; Garc&#237;a Ledesma&#44; Luis&#46; Hospital Virgen del Puerto&#44; Plasencia&#46; Garc&#237;a Ordo&#241;ez&#44; Miguel &#193;ngel&#44; Hospital of Antequera&#44; Antequera&#46; Gonz&#225;lez Aguirre&#44; Jos&#233; Manuel&#46; Hospital la Mancha Centro&#44; Alc&#225;zar de San Juan&#44; Ciudad Real&#46; Gonz&#225;lez Hern&#225;ndez&#44; Carmen&#46; Hospital G&#243;mez Ulla&#46; Madrid&#46; Gonz&#225;lez Sarmiento&#44; Enrique&#46; Clinic Hospital&#46; Valladolid&#46; Gracia Tello&#44; Borja&#46; Clinic Hospital of Zaragoza&#46; Hurtado&#44; Roberto&#46; Hospital of la Vega Baja&#46; Alicante&#46; Inglada Galiana&#44; Luis&#46; Hospital R&#237;o Hortega&#46; Valladolid&#46; Ja&#233;n &#193;guila&#44; Fernando&#46; University Hospital Complex of Granada&#46; Jim&#233;nez Hidalgo&#44; Alicia&#46; Hospital Juan Ram&#243;n Jim&#233;nez&#46; Huelva&#46; Lacal Mart&#237;nez&#44; Ana&#46; Hospital of Vendrell&#46; Tarragona&#46; L&#243;pez Carmona&#44; Mar&#237;a Dolores&#46; Hospital Carlos Haya&#46; Malaga&#46; Lucena Calvet&#44; Paloma&#46; Hospital G&#243;mez Ulla&#46; Madrid&#46; Maci&#225; Botejara&#44; Enrique&#46; Hospital Perpet&#250;o Socorro&#46; Badajoz&#46; Mateos Polo&#44; Lourdes&#44; University Hospital of Salamanca&#46; Mediavilla Garc&#237;a&#44; Juan Diego&#46; University Hospital Complex of Granada&#46; Mej&#237;as&#44; Inma&#46; Hospital of Cabra&#46; M&#233;ndez Bail&#243;n&#44; Manuel&#46; Clinic Hospital San Carlos&#46; Madrid&#46; Mich&#225;n Do&#241;a&#44; Alfredo&#46; Hospital of Jerez&#44; Jerez de la Frontera&#44; Cadiz&#46; Moya Mateo&#44; Eva&#46; Hospital Infanta Leonor&#46; Madrid&#46; Munielo Voces&#44; Isabel&#46; Hospital of Le&#243;n&#46; Mu&#241;oz L&#243;pez&#44; Juan Jos&#233;&#46; High-resolution Hospital Utrera&#46; Mu&#241;oz Rivas&#44; Nuria&#46; Hospital Infanta Leonor&#44; Madrid&#46; Naranjo Velasco&#44; Virginia&#46; Hospital of Jerez&#44; Jerez de la Frontera&#44; Cadiz&#46; Nobilia Gigena&#44; Laura&#46; Hospital of Vendrell&#46; Tarragona&#46; P&#233;rez Bernalte&#44; Rosa&#46; Hospital of Vendrell&#46; Tarragona&#46; P&#233;rez Soto&#44; Mar&#237;a Isabel&#46; Hospital of Vinalopo&#46; Elche&#46; Puchades&#44; Francesc&#46; Hospital Pare Jofr&#233; and Hospital Casa Salud&#46; Valencia&#46; S&#225;nchez Lora&#44; Javier&#46; Hospital Virgen de la Victoria&#46; Malaga&#46; S&#225;nchez Vidal&#44; Mar&#237;a Teresa&#46; Foundation Hospital of Jov&#233;&#46; Gij&#243;n&#46; Su&#225;rez Tembra&#44; Manuel&#46; Hospital San Rafael&#46; A Coru&#241;a&#46; Toro Parodo&#44; Aythami&#46; Hospital of Ceuta&#44; Ceuta&#46; Varela Aguilar&#44; Jos&#233; Manuel&#46; Epidemiology and Public Health CIBER&#46; Hospital Virgen del Roc&#237;o&#46; Seville&#46; Vigueras P&#233;rez&#44; Juan Francisco&#46; Hospital Santa Catalina&#46; Las Palmas&#46; Zamb&#243;n Rad&#243;s&#44; Daniel&#46; Hospital Clinic&#46; Barcelona&#46;</p>"
            "etiqueta" => "Appendix A"
            "titulo" => "OBEMI Registry Participants"
            "identificador" => "sec0045"
          ]
          1 => array:4 [
            "apendice" => "<p id="par0135" class="elsevierStylePara elsevierViewall">The following are the supplementary data to this article&#58;<elsevierMultimedia ident="upi0005"></elsevierMultimedia></p>"
            "etiqueta" => "Appendix B"
            "titulo" => "Supplementary data"
            "identificador" => "sec0055"
          ]
        ]
      ]
    ]
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      0 => array:7 [
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        "etiqueta" => "Figure 1"
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          0 => array:4 [
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        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Study flow diagram&#46; BMI&#44; body mass index&#59; EOS&#44; Edmonton Obesity Staging System&#46;</p>"
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        "etiqueta" => "Figure 2"
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          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Analysis of correspondence&#46; Upper part has the analysis with the Edmonton groups&#46; The lower part has the analysis with the obesity classification according to the body mass index&#46; BI&#44; Barthel Index&#59; BMI&#44; body mass index&#59; CI&#44; Charlson index&#59; EOSS&#44; Edmonton Obesity Staging System&#59; Stds&#44; studies&#46;</p>"
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          "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Abbreviations</span>&#58; AHT&#44; systemic arterial hypertension&#59; COPD&#44; chronic obstructive pulmonary disease&#59; DM&#44; diabetes mellitus&#59; EOSS&#44; Edmonton Obesity Staging System&#59; GERD&#44; gastroesophageal reflux disease&#59; OSAHS&#44; obstructive sleep apnea&#47;hypopnea syndrome&#46;</p><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">The quantitative variables are expressed as median &#40;interquartile range&#41;&#46; The qualitative variables are expressed as absolute numbers &#40;percentage&#41;&#46;</p>"
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                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">EOSS 1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">EOSS 2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">EOSS 3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">EOSS 4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">N</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">39&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">165&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">41&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Age&#44; y</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">50&#46;33 &#40;16&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">64&#46;95 &#40;14&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">65&#46;27 &#40;10&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;0000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Sex&#44; m</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;46&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">22 &#40;56&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">84 &#40;50&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20 &#40;48&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;42&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;93&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Weight&#44; kg</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">88&#46;9 &#40;73&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">92&#46;9 &#40;69&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">92 &#40;94&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">96&#46;9 &#40;86&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">87 &#40;43&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;58&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">BMI&#44; kg&#47;m</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">2</span></span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&#46;59 &#40;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">34&#46;25 &#40;21&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">34&#46;76 &#40;25&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">35&#46;56 &#40;28&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">32&#46;23 &#40;14&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Abdominal circumference&#44; cm</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">114&#46;46 &#40;14&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">110&#46;97 &#40;11&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">115&#46;64 &#40;13&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">117&#46;23 &#40;12&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">114&#46;57 &#40;16&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Charlson index</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;0000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Test de Beck Depression Test &#40;n</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#61;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">259&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7 &#40;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7 &#40;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10 &#40;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11 &#40;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;53&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Unemployed</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;38&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17 &#40;43&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">122 &#40;73&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">31 &#40;75&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;85&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;0003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="7" align="left" valign="top"><span class="elsevierStyleItalic">Barthel index &#40;degree of dependence&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Independent &#40;100&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13 &#40;100&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">35 &#40;89&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">114 &#40;69&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">25 &#40;60&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Mild &#40;91&#8211;99&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;5&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">35 &#40;21&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7 &#40;17&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;42&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Moderate &#40;61&#8211;90&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;2&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12 &#40;7&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7 &#40;17&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;42&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Severe &#40;21&#8211;60&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;2&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;1&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;4&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;14&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Total &#40;0&#8211;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Physical inactivity</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7 &#40;53&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20 &#40;51&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">112 &#40;67&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">29 &#40;70&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7 &#40;100&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;06&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Resident in rural area</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;23&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13 &#40;33&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">58 &#40;35&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15 &#40;36&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;28&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Smoking</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#40;23&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;15&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">22 &#40;13&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;12&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Alcohol</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;2&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13 &#40;7&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;12&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;14&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;77&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">AHT</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">145 &#40;87&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">34 &#40;82&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;57&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Type 2 DM</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">86 &#40;52&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24 &#40;58&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;71&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;0001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19 &#40;48&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">111 &#40;67&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">30 &#40;73&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;57&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;0003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">OSAHS</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;12&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">42 &#40;25&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15 &#40;36&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;14&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;027&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;38&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8 &#40;20&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">27 &#40;16&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10 &#40;24&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;14&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;3&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;23&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;10&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">22 &#40;13&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;14&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;42&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Heart failure</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;2&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">35 &#40;21&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17 &#40;41&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;57&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;0001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17 &#40;43&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">52 &#40;31&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15 &#40;36&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;14&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;04&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Ischemic heart disease</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13 &#40;7&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18 &#40;43&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;0001&nbsp;\t\t\t\t\t\t\n
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          "leyenda" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Abbreviations</span>&#58; BMI&#44; body mass index&#59; CI&#44; confidence interval&#59; EOSS&#44; Edmonton Obesity Staging System&#59; OR&#44; odds ratio&#46;</p><p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Logistic regression&#46; The model reflects the variables that independently influence having an EOSS &#8805;2&#46; For the analysis&#44; we included age&#44; sex&#44; body mass index&#44; Charlson index&#44; creatinine clearance&#44; glycemia&#44; total cholesterol&#44; uric acid&#44; leukocyte number and albumin&#47;creatinine ratio&#46;</p>"
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                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">OR&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Uric acid&nbsp;\t\t\t\t\t\t\n
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          "leyenda" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Abbreviations</span>&#58; BMI&#44; body mass index&#59; EOSS&#44; Edmonton Obesity Staging System&#46;</p><p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">The quantitative variables are expressed as median &#40;interquartile range&#41;&#46; The qualitative variables are expressed as absolute numbers &#40;percentage&#41;&#46;</p>"
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                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variable&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">41&#8211;50 years&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">29&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">65&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">52&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">68&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">168 &#40;16&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">168 &#40;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">165 &#40;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">160 &#40;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">158 &#40;14&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">155&#46;5 &#40;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Weight&#44; kg&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">109&#46;4 &#40;43&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">105&#46;15 &#40;35&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">101 &#40;22&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">96&#46;65 &#40;25&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">90&#46;15 &#40;17&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">88&#46;75 &#40;16&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">84&#46;5 &#40;23&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">BMI&#44; kg&#47;m<span class="elsevierStyleSup">2</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">38&#46;99 &#40;9&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&#46;05 &#40;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">35&#46;36 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">34&#46;25 &#40;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&#46;42 &#40;7&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&#46;34 &#40;4&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&#46;9 &#40;3&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#46;28&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">EOSS 0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;6&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;7&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;5&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">EOSS 1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;40&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8 &#40;27&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12 &#40;18&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;5&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">EOSS 2&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;50&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26 &#40;86&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14 &#40;21&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">EOSS 4&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;5&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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                      "titulo" => "Factores asociados al padecimiento de obesidad en muestras representativas de la poblaci&#243;n espa&#241;ola"
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                          "etal" => true
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                  "host" => array:1 [
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                    0 => array:1 [
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                      "titulo" => "The potential role of the Edmonton obesity staging system in determining indications for bariatric surgery"
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                    0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "A new method of classifying prognostic comorbidity in longitudinal studies&#58; development and validation"
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