Share
array:24 [ "pii" => "S2254887416300923" "issn" => "22548874" "doi" => "10.1016/j.rceng.2016.12.003" "estado" => "S300" "fechaPublicacion" => "2017-03-01" "aid" => "1332" "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI)" "copyrightAnyo" => "2016" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Rev Clin Esp. 2017;217:71-8" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 5 "formatos" => array:2 [ "HTML" => 1 "PDF" => 4 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0014256516301904" "issn" => "00142565" "doi" => "10.1016/j.rce.2016.11.003" "estado" => "S300" "fechaPublicacion" => "2017-03-01" "aid" => "1332" "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI)" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Rev Clin Esp. 2017;217:71-8" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 99 "formatos" => array:2 [ "HTML" => 60 "PDF" => 39 ] ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">ORIGINAL</span>" "titulo" => "Prevalencia de obesidad según la estadificación de Edmonton en las consultas de Medicina Interna. Resultados del estudio OBEMI" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "71" "paginaFinal" => "78" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Prevalence of obesity according to Edmonton staging in the Internal Medicine consultations. Results of the OBEMI study" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2293 "Ancho" => 1583 "Tamanyo" => 146868 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Diagrama de flujo del estudio.</p> <p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">EOSS: sistema de estadificación de la obesidad de Edmonton; IMC: índice de masa corporal.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J. Carretero Gómez, J.C. Arévalo Lorido, R. Gómez Huelgas, M.T. Sánchez Vidal, M. Suárez Tembra, J.M. Varela Aguilar, I. Munielo Voces, E. Fernández Pérez, J.M. Fernández Rodríguez, J. Ena Muñoz" "autores" => array:10 [ 0 => array:2 [ "nombre" => "J." "apellidos" => "Carretero Gómez" ] 1 => array:2 [ "nombre" => "J.C." "apellidos" => "Arévalo Lorido" ] 2 => array:2 [ "nombre" => "R." "apellidos" => "Gómez Huelgas" ] 3 => array:2 [ "nombre" => "M.T." "apellidos" => "Sánchez Vidal" ] 4 => array:2 [ "nombre" => "M." "apellidos" => "Suárez Tembra" ] 5 => array:2 [ "nombre" => "J.M." "apellidos" => "Varela Aguilar" ] 6 => array:2 [ "nombre" => "I." "apellidos" => "Munielo Voces" ] 7 => array:2 [ "nombre" => "E." "apellidos" => "Fernández Pérez" ] 8 => array:2 [ "nombre" => "J.M." "apellidos" => "Fernández Rodríguez" ] 9 => array:2 [ "nombre" => "J." "apellidos" => "Ena Muñoz" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2254887416300923" "doi" => "10.1016/j.rceng.2016.12.003" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2254887416300923?idApp=WRCEE" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0014256516301904?idApp=WRCEE" "url" => "/00142565/0000021700000002/v1_201702250108/S0014256516301904/v1_201702250108/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2254887416300935" "issn" => "22548874" "doi" => "10.1016/j.rceng.2016.12.004" "estado" => "S300" "fechaPublicacion" => "2017-03-01" "aid" => "1320" "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI)" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Rev Clin Esp. 2017;217:79-86" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 2 "PDF" => 2 ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Behavior of health professionals concerning the recommendations for prophylaxis for infectious endocarditis in our setting: Are the guidelines followed?" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "79" "paginaFinal" => "86" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Conducta de los profesionales sanitarios ante las recomendaciones de profilaxis de endocarditis infecciosa en nuestro medio: ¿se siguen las guías?" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "P. Anguita, F. Castillo, P. Gámez, F. Carrasco, R. Roldán, B. Jurado, J.C. Castillo, E. Martín, M. Anguita" "autores" => array:9 [ 0 => array:2 [ "nombre" => "P." "apellidos" => "Anguita" ] 1 => array:2 [ "nombre" => "F." "apellidos" => "Castillo" ] 2 => array:2 [ "nombre" => "P." "apellidos" => "Gámez" ] 3 => array:2 [ "nombre" => "F." "apellidos" => "Carrasco" ] 4 => array:2 [ "nombre" => "R." "apellidos" => "Roldán" ] 5 => array:2 [ "nombre" => "B." "apellidos" => "Jurado" ] 6 => array:2 [ "nombre" => "J.C." "apellidos" => "Castillo" ] 7 => array:2 [ "nombre" => "E." "apellidos" => "Martín" ] 8 => array:2 [ "nombre" => "M." "apellidos" => "Anguita" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0014256516301606" "doi" => "10.1016/j.rce.2016.10.005" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0014256516301606?idApp=WRCEE" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2254887416300935?idApp=WRCEE" "url" => "/22548874/0000021700000002/v1_201702250054/S2254887416300935/v1_201702250054/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2254887416300911" "issn" => "22548874" "doi" => "10.1016/j.rceng.2016.12.002" "estado" => "S300" "fechaPublicacion" => "2017-03-01" "aid" => "1318" "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI)" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Rev Clin Esp. 2017;217:63-70" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 2 "PDF" => 2 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "High-sensitivity troponin T and the risk of recurrent readmissions after hospitalization for acute heart failure" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "63" "paginaFinal" => "70" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Troponina T de alta sensibilidad y riesgo de hospitalizaciones recurrentes tras un ingreso por insuficiencia cardíaca aguda" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 953 "Ancho" => 2741 "Tamanyo" => 106049 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Incidence of recurrent hospitalizations according to hs-TnT values. (A) All-cause hospitalizations. (B) Hospitalizations for heart failure. Abbreviations: hs-TnT, high-sensitivity troponin T; TnT-Q, troponin T quartiles.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "D. Escribano, E. Santas, G. Miñana, A. Mollar, S. García-Blas, E. Valero, A. Payá, F.J. Chorro, J. Sanchis, J. Núñez" "autores" => array:10 [ 0 => array:2 [ "nombre" => "D." "apellidos" => "Escribano" ] 1 => array:2 [ "nombre" => "E." "apellidos" => "Santas" ] 2 => array:2 [ "nombre" => "G." "apellidos" => "Miñana" ] 3 => array:2 [ "nombre" => "A." "apellidos" => "Mollar" ] 4 => array:2 [ "nombre" => "S." "apellidos" => "García-Blas" ] 5 => array:2 [ "nombre" => "E." "apellidos" => "Valero" ] 6 => array:2 [ "nombre" => "A." "apellidos" => "Payá" ] 7 => array:2 [ "nombre" => "F.J." "apellidos" => "Chorro" ] 8 => array:2 [ "nombre" => "J." "apellidos" => "Sanchis" ] 9 => array:2 [ "nombre" => "J." "apellidos" => "Núñez" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0014256516301588" "doi" => "10.1016/j.rce.2016.10.003" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0014256516301588?idApp=WRCEE" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2254887416300911?idApp=WRCEE" "url" => "/22548874/0000021700000002/v1_201702250054/S2254887416300911/v1_201702250054/en/main.assets" ] "en" => array:22 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Prevalence of obesity according to Edmonton staging in the Internal Medicine consultations. Results of the OBEMI study" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "71" "paginaFinal" => "78" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "J. Carretero Gómez, J.C. Arévalo Lorido, R. Gómez Huelgas, M.T. Sánchez Vidal, M. Suárez Tembra, J.M. Varela Aguilar, I. Munielo Voces, E. Fernández Pérez, J.M. Fernández Rodríguez, J. Ena Muñoz" "autores" => array:10 [ 0 => array:4 [ "nombre" => "J." "apellidos" => "Carretero Gómez" "email" => array:1 [ 0 => "juanicarretero@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "J.C." "apellidos" => "Arévalo Lorido" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "R." "apellidos" => "Gómez Huelgas" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "M.T." "apellidos" => "Sánchez Vidal" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 4 => array:3 [ "nombre" => "M." "apellidos" => "Suárez Tembra" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] 5 => array:3 [ "nombre" => "J.M." "apellidos" => "Varela Aguilar" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">e</span>" "identificador" => "aff0025" ] ] ] 6 => array:3 [ "nombre" => "I." "apellidos" => "Munielo Voces" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">f</span>" "identificador" => "aff0030" ] ] ] 7 => array:3 [ "nombre" => "E." "apellidos" => "Fernández Pérez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">f</span>" "identificador" => "aff0030" ] ] ] 8 => array:3 [ "nombre" => "J.M." "apellidos" => "Fernández Rodríguez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">g</span>" "identificador" => "aff0035" ] ] ] 9 => array:3 [ "nombre" => "J." "apellidos" => "Ena Muñoz" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">h</span>" "identificador" => "aff0040" ] ] ] ] "afiliaciones" => array:8 [ 0 => array:3 [ "entidad" => "Servicio de Medicina Interna, Hospital Comarcal de Zafra, Zafra, Badajoz, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Medicina Interna, Complejo Hospitalario Universitario de Málaga, Málaga, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Medicina Interna, Fundación Hospital de Jové, Gijón, Asturias, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Servicio de Medicina Interna, Hospital San Rafael, A Coruña, Spain" "etiqueta" => "d" "identificador" => "aff0020" ] 4 => array:3 [ "entidad" => "Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERSAM), Hospital Virgen del Rocío, Sevilla, Spain" "etiqueta" => "e" "identificador" => "aff0025" ] 5 => array:3 [ "entidad" => "Servicio de Medicina Interna, Complejo Asistencial Universitario de León, León, Spain" "etiqueta" => "f" "identificador" => "aff0030" ] 6 => array:3 [ "entidad" => "Servicio de Medicina Interna, Hospital Carmen y Severo Ochoa, Cangas del Narcea, Asturias, Spain" "etiqueta" => "g" "identificador" => "aff0035" ] 7 => array:3 [ "entidad" => "Servicio de Medicina Interna, Hospital Marina Baixa, La Vila Joiosa, Alicante, Spain" "etiqueta" => "h" "identificador" => "aff0040" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Prevalencia de obesidad según la estadificación de Edmonton en las consultas de Medicina Interna. Resultados del estudio OBEMI" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2293 "Ancho" => 1583 "Tamanyo" => 150669 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Study flow diagram. BMI, body mass index; EOS, Edmonton Obesity Staging System.</p>" ] ] ] "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, obesity has reached worldwide epidemic proportions. Twenty percent of the population has excess weight, and 10% have obesity, with figures for 2030 estimated at 2.16 million individuals with excess weight and 1.12 million with obesity.<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%.<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">2</span></a> Most epidemiological studies have used the body mass index (BMI) (weight in kg/height in meters<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">2</span></a>) to classify obesity.<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>≥30<span class="elsevierStyleHsp" style=""></span>kg/m<span class="elsevierStyleSup">2</span> is considered to have obesity. However, obesity can also be defined by other criteria, such as an excess of adipose tissue (25% in men and 30% in women) of sufficient magnitude to cause an increase in the individual's morbidity and mortality (loss of 3–10 life-years in the most severe cases<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">4</span></a>), due to its role in the development of other comorbidities such as arterial hypertension (AHT), type 2 diabetes mellitus (DM2) and dyslipidemia,<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">5,6</span></a> as well as severe functional limitations in the quality of life. Therefore, classifying obesity solely on anthropometric measures has numerous limitations and marked variability,<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. BMI is also a poor predictor of mortality, especially in the patients treated in departments of internal medicine (IM) who are older and have more comorbidity. The Edmonton Obesity Staging System (EOSS) provides an obesity classification system that is independent of BMI,<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">8</span></a> incorporating the presence and severity of comorbidities, the gradation of functional limitations and their impact on the quality of life of patients with obesity. The EOSS is therefore more useful in clinical terms for making therapeutic decisions.<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">9</span></a> The EOSS is also a possible predictor of mortality,<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">10</span></a> even after adjusting for other adiposity assessment methods such as abdominal circumference.</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. The secondary objective was to analyze the clinical–epidemiological characteristics of the participants with obesity stratified according to EOSS.</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, 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.</p><p id="par0025" class="elsevierStylePara elsevierViewall">The EOSS classification defines the following stages: (a) stage 0: no risk factors (blood pressure, lipid and baseline glucose levels within normal ranges), no psychopathology, physical symptoms, functional limitation or impairment in wellbeing related to obesity; (b) stage 1: the presence of obesity-related subclinical risk factors (pre-AHT, abnormal baseline glucose levels, high hepatic enzyme levels), mild physical symptoms (moderate effort dyspnea, fatigue and occasional joint pain), mild psychopathology, functional limitation or mildly impaired wellbeing; (c) stage 2: presence of established chronic obesity-related diseases (AHT, DM2, obstructive sleep apnea syndrome, osteoarthritis), moderate limitation in daily life activities and moderately impaired wellbeing; (d) stage 3: established organ damage (acute myocardial infarction, heart failure, stroke, diabetic complications) significant psychopathology (severe depression, suicidal ideation), functional limitation or significantly impaired wellbeing; and (e) stage 4: chronic obesity-related diseases with severe dysfunction (potentially terminal damage), psychopathology, functional limitation or severely impaired wellbeing.</p><p id="par0030" class="elsevierStylePara elsevierViewall">We conducted a study in 38 national centers. The participating centers conducted a 1-day cross-section between the 1st and 14th of February, 2016, to consecutively select patients. The data were collected in an electronic and anonymous registry. We followed the ethical principles of human research as laid out in the Declaration of Helsinki, updated in the General Assembly of Brazil (2013). We respected the confidentiality and secrecy of personal information according to the Data Protection Law of 15/1999 (BOE 1999, no. 289). The study was approved by the Clinical Research Ethics Committee of the University Hospital of Badajoz.</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: BMI<span class="elsevierStyleHsp" style=""></span>>30<span class="elsevierStyleHsp" style=""></span>kg/m<span class="elsevierStyleSup">2</span> and older than 18 years. The study excluded patients who refused to sign the informed consent document.</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.<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.<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">3</span></a> We obtained demographic, clinicians, anthropometric and laboratory data from the included patients. In terms of the demographic variables, we determined the following: educational level (no studies, basic studies, secondary/professional training and university), employment status active or not, rural (fewer than 10,000 inhabitants) or urban origin (more than 10,000 inhabitants) and marital status (single or living with a partner). Lastly, 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/week. As clinical variables, we included active smoking and excessive alcohol consumption (intake<span class="elsevierStyleHsp" style=""></span>>60<span class="elsevierStyleHsp" style=""></span>g/day in men and<span class="elsevierStyleHsp" style=""></span>>40<span class="elsevierStyleHsp" style=""></span>g/day in women). We also recorded the previous presence of chronic obstructive pulmonary disease (COPD), asthma and active cancer (excluding skin cancer, except for melanoma).</p><p id="par0045" class="elsevierStylePara elsevierViewall">To calculate comorbidity, we employed the Charlson index<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">11</span></a> (absence of comorbidity, 0–1; low comorbidity, 2; high comorbidity, ≥3). To measure functional capacity, we used the Barthel index<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">12</span></a> (total dependence, 0–20 points; severe dependence, 21–60 points; moderate dependence, 61–90 points; low dependence, 91–99 points; independence, 100 points). For depression, we employed Beck's scale<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">13</span></a> (0–9 points, no depression; 10–15, mild depression; 16–24 points, moderate depression; and 25–62 points, severe depression).</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%,<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">2</span></a> a 2% error and a 95% confidence interval, the calculated minimum sample size was 250 patients.</p><p id="par0055" class="elsevierStylePara elsevierViewall">To calculate the prevalence, we used the total number of patients who met the inclusion criteria, analyzing the variables grouped according to EOSS. The qualitative variables are expressed as the total number and percentage referring to EOSS. To compare the variables, we employed the Chi-squared test. The quantitative variables are expressed as median and interquartile range. To comparing the variables, we employed the Kruskal–Wallis test. We performed a two-dimensional analysis of correspondence to observe significant groupings among the qualitative variables, determining coordinates that allow the representation of classes of the study variables. In the first model, we used the EOSS groups, employment status, education level, Charlson index and Barthel index as the variables. In the second model, we substituted the EOSS groups by BMI, according to the Spanish Society for the Study of Obesity criteria.<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">3</span></a> To determine the coordinates, we used the Chi-squared distance. Finally, we performed a multivariate logistic regression analysis to observe the dependence among the variables. The dependent variable was belonging or not an EOSS group ≥2. For the model, we chose the covariates considered significant “a priori”, based on previous studies on patients with obesity. We also chose those covariates that dictated the clinical experience, as well as those that were significant in the univariate analysis. In the final model, we analyzed age, BMI, Charlson index, creatinine clearance (Chronic Kidney Disease Epidemiology Collaboration, CKD-EPI), glucose, uric acid, total cholesterol, leukocytes and albumin/creatinine ratio. We employed the R program (version 3.2.4, Free Software Foundation's, GNU General Public License). Differences with a <span class="elsevierStyleItalic">p</span>-value <.05 were considered significant.</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, we initially included 298 patients with obesity, 33 of whom were later excluded due to lack of data or consent to use the data. Ultimately, we analyzed 265 patients with obesity (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>), 135 of whom were men. The mean age (±SD) was 62.47<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>15.27 years, and the BMI (±SD) was 36.1<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>5.3<span class="elsevierStyleHsp" style=""></span>kg/m<span class="elsevierStyleSup">2</span>. The prevalence of obesity by BMI was 23.62%. By EOSS stages 0, 1, 2, 3 and 4, the prevalence was 4.9%, 14.7%, 62.3%, 15.5% and 2.64%, respectively.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> lists the patients’ clinical and demographic characteristics according to the EOSS. For the patients with EOSS 2, 3 and 4, we observed a significant increase in age (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.0000), DM2 (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.0001), dyslipidemia (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.0003), obstructive sleep apnea syndrome (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.0027) and heart failure (p<.0001), which determined a significant increase in the Charlson index by group (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.0000). In the laboratory variables (<a class="elsevierStyleCrossRef" href="#sec0050">Table 1 available in the supplementary material of the online version of this article</a>), we observed an increase in glucose levels (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.0003), leukocyte counts (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.0000), uric acid levels (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.02) and urea levels (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.004), as well as a reduction in the glomerular filtration rate (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.02) in the upper EOSS categories. We observed significant differences in all drug groups employed, except for the sulfonylureas, nonsteroidal anti-inflammatory drugs, antidepressants and anxiolytic agents, which were used equally by all EOSS groups (<a class="elsevierStyleCrossRef" href="#sec0050">Table 2, available in the supplementary material of the online version of this article</a>).</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">In terms of the analysis of correspondence (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>), in the first model with a cumulative explanatory percentage of 78.2%, we observed a first patient group clustered around EOSS 0 and 1, with secondary or university education, who were employed, and who had no dependence or comorbidity. We observed another group around EOSS 2, with basic or no education, who were unemployed, who had little dependence and low comorbidity. We also observed a third group around EOSS 3 with moderate or severe dependence and high comorbidity, with no relation to education level or employment status. Finally, we observed an EOSS 4 group with no association with any of the prior conditions. In the second model (replacing EOSS with BMI) with a lower cumulative explanatory percentage (70.6%), there were no clusters as defined as in the first model. Type 2 and 4 obesity showed no grouping. Type 1 could be grouped with independent patients with no comorbidity, and type 3 could be grouped with unemployed patients with basic or no education.</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">In the logistic regression model (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>), the variables that ultimately were related with an EOSS stage ≥2 were BMI (odds ratio [OR], 1.07; 95% CI 0.99–1.16; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.06), age (OR, 1.06; 95% CI 1.03–1.08; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.0003), glucose levels (OR 1.04, 95% CI 1.01–1.07; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.0006), total cholesterol levels (OR, 0.98; 95% CI 0.97–0.99; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.2) and uric acid levels (OR, 1.32; 95% CI 1.03–1.68; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.02).</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, 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 (ENRICA) study (23%)<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">14</span></a> and the Spanish Cardiovascular Risk Equation (ERICE)<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">15</span></a> study (22.7%), both of which had a mean BMI of 26.9.<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">16</span></a> This prevalence increases with age, reaching 35% between 65 and 70 years of age.<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">17,18</span></a> In our study, most of the patients were included in the age range between 60 and 80 years. A relationship was shown between a higher EOSS (mainly 2 and 3), a progressive reduction in height, weight and, less significantly, BMI (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.28) with increasing age (<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>). The use of BMI to define obesity in the elderly is controversial due to the reduction in height while maintaining a stable weight (reduction estimated at 0–0.65<span class="elsevierStyleHsp" style=""></span>kg/year),<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 (“sarcopenic obesity”). This increase in adiposity is responsible for mobility-related disability, greater functional impairment, increased cardiovascular risk, arthritis and greater obesity-attributable mortality, estimated at 28,000 deaths annually, even after adjusting for abdominal adiposity.<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">20</span></a> Engelmann et al. and other authors have reported a <span class="elsevierStyleItalic">J</span> curve between BMI and mortality.<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">21</span></a> In contrast, the so-called “obesity paradox” reports lower mortality, 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, in the elderly with obesity. Nevertheless, there are numerous confounding factors, such as the degree of inflammation and renal dysfunction, which can influence this paradox.<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 ≥2, which was associated with greater age and functional impairment and more comorbidity (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>). Most studies on the prevalence of obesity have been based on the BMI and age, while there are few references to comorbidity<a class="elsevierStyleCrossRefs" href="#bib0275"><span class="elsevierStyleSup">25,26</span></a> and functional capacity. It is therefore difficult in this context to recognize obesity as a complex chronic condition and, accordingly, 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, with the ultimate objective of improving health and overall quality of life.<a class="elsevierStyleCrossRefs" href="#bib0285"><span class="elsevierStyleSup">27,28</span></a></p><p id="par0090" class="elsevierStylePara elsevierViewall">As shown by the analysis of correspondence (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>), the EOSS can discriminate those patients with greater comorbidity and lower functional capacity, facilitating a comprehensive approach to the problem and can do so better than the BMI. 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.<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.</p><p id="par0095" class="elsevierStylePara elsevierViewall">Moreover, in the adjusted multivariate analysis, we observed a direct association between an EOSS stage >2 and a number of metabolic traits such as blood glucose (OR, 1.04; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.0006) and uric acid (OR, 1.32; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.02) levels. An inverse association was observed with serum cholesterol levels (OR, 0.98; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.02), which was possibly due to the increased use of statins in the groups with higher EOSS stages (see <a class="elsevierStyleCrossRef" href="#sec0050">supplementary material available in the online version</a>). Obesity is the main modifiable risk factor for the onset of hyperuricemia and gout. The relationship between hyperuricemia and cardiovascular disease is controversial and not uniform between the sexes. Marotta et al., in one of the few studies on elderly patients, found a linear relationship between uric acid levels higher than 5.5<span class="elsevierStyleHsp" style=""></span>mg/dL and the onset of obesity, AHT and DM2 in women older than 60 years.<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">30</span></a></p><p id="par0100" class="elsevierStylePara elsevierViewall">This study had some limitations. The treated population and the type of IM consultations were highly heterogeneous, which could have resulted in a patient selection bias. However, we can consider the patients as representative of the general adult population. Although the sample may seem small, it is consistent with the initially estimated size, considering that the design was cross-sectional (only 1 day within the inclusion period). Moreover, this design does not let us establish casual relationships between the variables. The described associations should therefore be subsequently evaluated.</p><p id="par0105" class="elsevierStylePara elsevierViewall">In conclusion, the prevalence of obesity among the patients treated in the IM consultations is similar to that described for the general population. However, the patients treated in IM departments are older, have higher BMIs and greater comorbidity, both metabolic and functional. EOSS is useful for conducting a comprehensive approach for patients with obesity, regardless of BMI, which can help achieve better health and quality-of-life results.</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.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:11 [ 0 => array:3 [ "identificador" => "xres806059" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objectives" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Material and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec804160" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres806060" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivos" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Material y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec804159" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Background" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Material and methods" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Patients" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Variables" ] 2 => array:2 [ "identificador" => "sec0025" "titulo" => "Statistical analysis" ] ] ] 6 => array:2 [ "identificador" => "sec0030" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0035" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0040" "titulo" => "Conflicts of interest" ] 9 => array:2 [ "identificador" => "xack269932" "titulo" => "Acknowledgements" ] 10 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2016-07-20" "fechaAceptado" => "2016-11-03" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec804160" "palabras" => array:4 [ 0 => "Obesity" 1 => "Edmonton" 2 => "Prevalence" 3 => "Comorbidities" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec804159" "palabras" => array:4 [ 0 => "Obesidad" 1 => "Edmonton" 2 => "Prevalencia" 3 => "Comorbilidades" ] ] ] ] "tieneResumen" => true "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 (EOSS).</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, descriptive cross-sectional study included outpatients older than 18 years, with a body mass index (BMI)<span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>30, from 38 hospitals between the 1st and 14th of February, 2016. We classified the patients according to the EOSS and analyzed their clinical, laboratory and demographic variables. A value of <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.05 was considered statistically significant.</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, we recruited 298 and analyzed 265. The prevalence of obesity was 23.6%, the mean age was 62.47<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>15.27 years, and the mean BMI was 36.1<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>5.3<span class="elsevierStyleHsp" style=""></span>kg/m<span class="elsevierStyleSup">2</span>. According to EOSS stage (0, 1, 2, 3 and 4), the prevalence was 4.9, 14.7, 62.3, 15.5 and 2.64%, respectively. Those patients with EOSS<span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>2 were significantly older and had significantly more comorbidities. The multivariate analysis related age (OR 1.06; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.0003), blood glucose (OR 1.04; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.0006), total cholesterol (OR 0.98; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.02) and uric acid (OR 1.32; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>.02) levels with an EOSS<span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>2. An analysis of correspondence grouped, with an explanatory percentage of 78.2%, the patients according to their EOSS, comorbidity, education level, employment status and functional capacity.</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, although the patients are older and have a higher BMI. EOSS is useful for implementing a comprehensive approach for patients with obesity, regardless of the BMI, which can help achieve better health and quality-of-life results.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objectives" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Material and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "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 según la estadificación de Edmonton (EOSS) en pacientes atendidos por Medicina Interna.</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material y métodos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudio observacional, descriptivo y transversal. Incluyó pacientes ambulatorios mayores de 18 años con un índice de masa corporal (IMC) > 30, procedentes de 38 hospitales, entre el 1 y el 14 de febrero de 2016. Se clasificaron según EOSS y se analizaron variables clínicas, analíticas y sociodemográficas. Se consideró significación estadística con p < 0,05.</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">De 1.262 pacientes vistos en las consultas se seleccionaron 298 y se analizaron 265. La prevalencia de obesidad fue del 23,6%, la edad, de 62,47 ± 15,27 años y el IMC, de 36,1 ± 5,3 kg/m<span class="elsevierStyleSup">2</span>. Por EOSS (0, 1, 2, 3 y 4) la prevalencia fue de 4,9, 14,7, 62,3, 15,5 y 2,64%, respectivamente. Aquellos pacientes con EOSS > 2 tenían significativamente más edad y comorbilidades. El análisis multivariante relacionó la edad (OR 1,06, p < 0,0003), la glucemia (OR 1,04, p < 0,0006), el colesterol total (OR 0,98, p < 0,02) y el ácido úrico (OR 1,32, p < 0,02) con un EOSS > 2. Un análisis de correspondencias agrupó, con un porcentaje explicativo del 78,2%, a los pacientes según su EOSS, comorbilidad, nivel de estudios, situación laboral y capacidad funcional.</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 población general, aunque los pacientes son de mayor edad e IMC. El EOSS es útil para hacer una aproximación integral de los pacientes obesos, independientemente del IMC, lo que puede posibilitar la obtención de mejores resultados en salud y en calidad de vida.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivos" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Material y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Carretero Gómez J, Arévalo Lorido JC, Gómez Huelgas R, Sánchez Vidal MT, Suárez Tembra M, Varela Aguilar JM, et al. Prevalencia de obesidad según la estadificación de Edmonton en las consultas de Medicina Interna. Resultados del estudio OBEMI. Rev Clin Esp. 2017;217:71–78.</p>" ] ] "apendice" => array:1 [ 0 => array:1 [ "seccion" => array:2 [ 0 => array:4 [ "apendice" => "<p id="par0125" class="elsevierStylePara elsevierViewall">Alonso Peña, Javier. Hospital Virgen del Puerto. Plasencia. Arévalo Lorido, José Carlos. Regional Hospital of Zafra. Badajoz. Argüello Martín, Carlota. Central Hospital of Asturias. Bonilla Hernández, María. Hospital Reina Sofía. Tudela. Campo López Cristina. Hospital La Fe. Valencia. Carabantes Rueda, Juan Jesús. Hospital of Antequera, Antequera. Carretero Gómez, Juana. Regional Hospital of Zafra. Badajoz. Castiella Herrero, Jesús. Foundation Hospital of Calahorra, Calahorra, La Rioja. Chimeno Viñas, María Montserrat. Healthcare Complex of Zamora. De Escalante Yangüela, Begoña. Clinic Hospital Zaragoza. Dueñas Gutierrez, Carlos. Hospital of Burgos. Ena Muñoz, Javier. Hospital of la Marina Baixa. Alicante. Fernández Rodríguez, José María. Hospital Carmen y Severo Ochoa. Cangas de Narcea. Asturias. Fernández Pérez, Ester. Hospital of León. Freixas Descarregas, Pere. Regional Hospital Morá dÉbre. Tarragona. García Contreras, Rosa. Hospital Virgen del Rocío. Seville. García Ledesma, Luis. Hospital Virgen del Puerto, Plasencia. García Ordoñez, Miguel Ángel, Hospital of Antequera, Antequera. González Aguirre, José Manuel. Hospital la Mancha Centro, Alcázar de San Juan, Ciudad Real. González Hernández, Carmen. Hospital Gómez Ulla. Madrid. González Sarmiento, Enrique. Clinic Hospital. Valladolid. Gracia Tello, Borja. Clinic Hospital of Zaragoza. Hurtado, Roberto. Hospital of la Vega Baja. Alicante. Inglada Galiana, Luis. Hospital Río Hortega. Valladolid. Jaén Águila, Fernando. University Hospital Complex of Granada. Jiménez Hidalgo, Alicia. Hospital Juan Ramón Jiménez. Huelva. Lacal Martínez, Ana. Hospital of Vendrell. Tarragona. López Carmona, María Dolores. Hospital Carlos Haya. Malaga. Lucena Calvet, Paloma. Hospital Gómez Ulla. Madrid. Maciá Botejara, Enrique. Hospital Perpetúo Socorro. Badajoz. Mateos Polo, Lourdes, University Hospital of Salamanca. Mediavilla García, Juan Diego. University Hospital Complex of Granada. Mejías, Inma. Hospital of Cabra. Méndez Bailón, Manuel. Clinic Hospital San Carlos. Madrid. Michán Doña, Alfredo. Hospital of Jerez, Jerez de la Frontera, Cadiz. Moya Mateo, Eva. Hospital Infanta Leonor. Madrid. Munielo Voces, Isabel. Hospital of León. Muñoz López, Juan José. High-resolution Hospital Utrera. Muñoz Rivas, Nuria. Hospital Infanta Leonor, Madrid. Naranjo Velasco, Virginia. Hospital of Jerez, Jerez de la Frontera, Cadiz. Nobilia Gigena, Laura. Hospital of Vendrell. Tarragona. Pérez Bernalte, Rosa. Hospital of Vendrell. Tarragona. Pérez Soto, María Isabel. Hospital of Vinalopo. Elche. Puchades, Francesc. Hospital Pare Jofré and Hospital Casa Salud. Valencia. Sánchez Lora, Javier. Hospital Virgen de la Victoria. Malaga. Sánchez Vidal, María Teresa. Foundation Hospital of Jové. Gijón. Suárez Tembra, Manuel. Hospital San Rafael. A Coruña. Toro Parodo, Aythami. Hospital of Ceuta, Ceuta. Varela Aguilar, José Manuel. Epidemiology and Public Health CIBER. Hospital Virgen del Rocío. Seville. Vigueras Pérez, Juan Francisco. Hospital Santa Catalina. Las Palmas. Zambón Radós, Daniel. Hospital Clinic. Barcelona.</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:<elsevierMultimedia ident="upi0005"></elsevierMultimedia></p>" "etiqueta" => "Appendix B" "titulo" => "Supplementary data" "identificador" => "sec0055" ] ] ] ] "multimedia" => array:6 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2293 "Ancho" => 1583 "Tamanyo" => 150669 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Study flow diagram. BMI, body mass index; EOS, Edmonton Obesity Staging System.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 3482 "Ancho" => 2450 "Tamanyo" => 296307 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Analysis of correspondence. Upper part has the analysis with the Edmonton groups. The lower part has the analysis with the obesity classification according to the body mass index. BI, Barthel Index; BMI, body mass index; CI, Charlson index; EOSS, Edmonton Obesity Staging System; Stds, studies.</p>" ] ] 2 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Abbreviations</span>: AHT, systemic arterial hypertension; COPD, chronic obstructive pulmonary disease; DM, diabetes mellitus; EOSS, Edmonton Obesity Staging System; GERD, gastroesophageal reflux disease; OSAHS, obstructive sleep apnea/hypopnea syndrome.</p><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">The quantitative variables are expressed as median (interquartile range). The qualitative variables are expressed as absolute numbers (percentage).</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \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 \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 0 \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 1 \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 \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 \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 \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> \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> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">39 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">165 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">41 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \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, y</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">50.12 (13.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">50.33 (16.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">64.95 (14.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">65.27 (10.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">78 (6.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.0000 \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, m</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6 (46.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">22 (56.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">84 (50.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">20 (48.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 (42.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.93 \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, kg</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">88.9 (73.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">92.9 (69.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">92 (94) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">96.9 (86.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">87 (43) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.58 \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, kg/m</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">2</span></span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">33.59 (20) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">34.25 (21) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">34.76 (25.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">35.56 (28.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">32.23 (14.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.25 \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, cm</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">114.46 (14.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">110.97 (11.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">115.64 (13.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">117.23 (12.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">114.57 (16.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.27 \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> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 (2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 (2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (11) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 (6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 (8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.0000 \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 (n</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">=</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">259)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 (4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7 (15) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7 (11) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10 (11) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">11 (11) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.53 \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> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 (38.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">17 (43.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">122 (73.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">31 (75.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6 (85.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.0003 \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 (degree of dependence)</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 (100) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13 (100) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">35 (89.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">114 (69.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">25 (60.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 (0.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.001 \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 (91–99) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 (0.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (5.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">35 (21.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7 (17.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 (42.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.001 \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 (61–90) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 (0.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (2.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">12 (7.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7 (17.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 (42.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.001 \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 (21–60) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 (0.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (2.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 (1.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (4.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (14.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.001 \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 (0–20) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 (0.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 (0.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 (0.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 (0.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 (0.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.001 \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> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7 (53.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">20 (51.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">112 (67.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">29 (70.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7 (100) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.06 \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> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 (23.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13 (33.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">58 (35.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">15 (36.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (28.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.9 \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> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3(23.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6 (15.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">22 (13.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 (12.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 (0.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.6 \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> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 (0.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (2.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13 (7.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 (12.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (14.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.77 \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> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 (0.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 (0.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">145 (87.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">34 (82.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 (57.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.0001 \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> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 (0.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 (0.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">86 (52.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">24 (58.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 (71.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.0001 \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">Dyslipidemia</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 (0.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">19 (48.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">111 (67.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">30 (73.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 (57.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.0003 \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> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 (0.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 (12.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">42 (25.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">15 (36.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (14.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.027 \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">GERD</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 (38.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8 (20.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">27 (16.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10 (24.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (14.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.3 \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">COPD</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 (23.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 (10.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">22 (13.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6 (14.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 (42.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.19 \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> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 (0.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (2.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">35 (21.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">17 (41.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 (57.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.0001 \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">Fatty liver</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 (0.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">17 (43.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">52 (31.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">15 (36.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (14.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.04 \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> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 (0.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 (0.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13 (7.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">18 (43.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 (0.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.0001 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1352717.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Clinical and demographic variables according to the Edmonton Obesity Staging System.</p>" ] ] 3 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Abbreviations</span>: BMI, body mass index; CI, confidence interval; EOSS, Edmonton Obesity Staging System; OR, odds ratio.</p><p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Logistic regression. The model reflects the variables that independently influence having an EOSS ≥2. For the analysis, we included age, sex, body mass index, Charlson index, creatinine clearance, glycemia, total cholesterol, uric acid, leukocyte number and albumin/creatinine ratio.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \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 \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">OR \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">95% CI \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> \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">Age \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.06 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.03–1.08 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.0003 \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 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.07 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.99–1.16 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.06 \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">Glycemia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.04 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.01–1.07 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.0006 \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">Total cholesterol \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.98 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.97–0.99 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.02 \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">Uric acid \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.32 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.03–1.68 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.02 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1352716.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Multivariate analysis of logistic regression for the probability of an Edmonton obesity stage >2.</p>" ] ] 4 => array:8 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at3" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Abbreviations</span>: BMI, body mass index; EOSS, Edmonton Obesity Staging System.</p><p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">The quantitative variables are expressed as median (interquartile range). The qualitative variables are expressed as absolute numbers (percentage).</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \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 \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"><30 years \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">31–40 years \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">41–50 years \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">51–60 years \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">61–70 years \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">71–80 years \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">>80 years \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> \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> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">29 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">65 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">52 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">68 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">30 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \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">Height, cm \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">168 (11) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">168 (16) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">168 (9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">165 (11) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">160 (13) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">158 (14.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">155.5 (13) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.0001 \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, kg \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">109.4 (43.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">105.15 (35.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">101 (22.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">96.65 (25.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">90.15 (17.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">88.75 (16.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">84.5 (23) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.0001 \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, kg/m<span class="elsevierStyleSup">2</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">38.99 (9.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">33.05 (9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">35.36 (4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">34.25 (6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">33.42 (7.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">33.34 (4.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">33.9 (3.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.28 \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 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (20) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (10) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (6.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 (7.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 (5.8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 (0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 (0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">.0001 \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 1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 (50) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 (40) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8 (27.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">12 (18.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6 (11.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 (5.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 (0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \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 2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 (30) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 (50) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">18 (62.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">34 (52.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">32 (61.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">46 (67.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">26 (86.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \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 3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 (0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 (0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (3.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">14 (21.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10 (19.2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">14 (20.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (6.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \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 4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 (0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 (0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 (0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 (0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1 (1.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 (5.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (6.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1352715.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Patient distribution by age group.</p>" ] ] 5 => array:5 [ "identificador" => "upi0005" "tipo" => "MULTIMEDIAECOMPONENTE" "mostrarFloat" => false "mostrarDisplay" => true "Ecomponente" => array:2 [ "fichero" => "mmc1.pdf" "ficheroTamanyo" => 86520 ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:30 [ 0 => array:3 [ "identificador" => "bib0155" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "National, regional, and global trends in body-mass index since 1980: systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9.1 million participants" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.M. Finucane" 1 => "G.A. Stevens" 2 => "M.J. Cowan" 3 => "G. Danaei" 4 => "J.K. Lin" 5 => "C.J. Paciorek" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S0140-6736(10)62037-5" "Revista" => array:6 [ "tituloSerie" => "Lancet" "fecha" => "2011" "volumen" => "377" "paginaInicial" => "557" "paginaFinal" => "567" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21295846" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0160" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Factores asociados al padecimiento de obesidad en muestras representativas de la población española" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "R.M. Ortega Anta" 1 => "A.M. López-Solaber" 2 => "N. Pérez-Farinós" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3305/nh.2013.28.sup5.6918" "Revista" => array:6 [ "tituloSerie" => "Nutr Hosp" "fecha" => "2013" "volumen" => "28" "paginaInicial" => "56" "paginaFinal" => "62" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24010744" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0165" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Consenso SEEDO 2007 para la evaluación del sobrepeso y la obesidad y el establecimiento de criterios de intervención terapéutica" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.A. Rubio" 1 => "J. Sala-Salvadó" 2 => "M. Barbany" 3 => "B. Moreno" 4 => "J. Aranceta" 5 => "D. Bellido" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Esp Obes" "fecha" => "2007" "volumen" => "128" "paginaInicial" => "184" "paginaFinal" => "196" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0170" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Achievement of goals in U.S. diabetes care, 1999–2010" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M.K. Ali" 1 => "K.M. Bullard" 2 => "J.B. Saaddine" 3 => "C.C. Cowie" 4 => "G. Imperatore" 5 => "E.W. Gregg" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMsa1213829" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "2013" "volumen" => "368" "paginaInicial" => "1613" "paginaFinal" => "1624" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23614587" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0175" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Global trend in overweight and obesity and its association with cardiovascular disease incidence" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "H. Yatsuya" 1 => "Y. Li" 2 => "E.H. Hilawe" 3 => "A. Ota" 4 => "C. Wang" 5 => "C. Chiang" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Circ J" "fecha" => "2014" "volumen" => "78" "paginaInicial" => "2807" "paginaFinal" => "2818" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25391910" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0180" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Obesity and cardiovascular disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "C.M. Apovian" 1 => "N. Gokce" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1161/CIRCULATIONAHA.111.022541" "Revista" => array:6 [ "tituloSerie" => "Circulation" "fecha" => "2012" "volumen" => "125" "paginaInicial" => "1178" "paginaFinal" => "1182" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22392865" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0185" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Body mass index classification misses subjects with increased cardiometabolic risk factors related to elevated adiposity" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Gómez-Ambrosi" 1 => "C. Silva" 2 => "J.C. Galofré" 3 => "J. Escalada" 4 => "S. Santos" 5 => "D. Millán" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Int J Obes (Lond)" "fecha" => "2012" "volumen" => "36" "paginaInicial" => "286" "paginaFinal" => "294" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0190" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A proposed clinical staging system for obesity" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A.M. Sharma" 1 => "R.F. Kushner" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Int J Obes (Lond)" "fecha" => "2009" "volumen" => "33" "paginaInicial" => "289" "paginaFinal" => "295" ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0195" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The potential role of the Edmonton obesity staging system in determining indications for bariatric surgery" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "R.S. Gill" 1 => "S. Karmali" 2 => "A.M. Sharma" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s11695-011-0533-8" "Revista" => array:6 [ "tituloSerie" => "Obes Surg" "fecha" => "2011" "volumen" => "21" "paginaInicial" => "1947" "paginaFinal" => "1949" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22002510" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0200" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Using the Edmonton obesity staging system to predict mortality in a population-representative cohort of people with overweight and obesity" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "R.S. Padwal" 1 => "N.M. Pajewski" 2 => "D.B. Allison" 3 => "A.M. Sharma" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "CMAJ" "fecha" => "2011" "volumen" => "14" "paginaInicial" => "1059" "paginaFinal" => "1066" ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0205" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A new method of classifying prognostic comorbidity in longitudinal studies: development and validation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M.E. Charlson" 1 => "P. Pompei" 2 => "K.L. Ales" 3 => "C.R. MacKenzie" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Chronic Dis" "fecha" => "1987" "volumen" => "40" "paginaInicial" => "373" "paginaFinal" => "383" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3558716" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0210" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Valoración de la discapacidad física: el índice de Barthel" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J. Cid-Ruzafa" 1 => "J. Damián-Moreno" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Rev Esp Salud Publica" "fecha" => "1997" "volumen" => "71" "paginaInicial" => "127" "paginaFinal" => "137" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9546856" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0215" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prevalencia y detección de los trastornos depresivos en atención primaria" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "E. Gabarrón Hortal" 1 => "J.M. Vidal Royo" 2 => "J.M. Haro Abad" 3 => "I. Boix Soriano" 4 => "A. Jover Blanca" 5 => "M. Arenas Prat" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Aten Primaria" "fecha" => "2002" "volumen" => "29" "paginaInicial" => "329" "paginaFinal" => "337" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11996711" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0220" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prevalece of general and abdominal obesity in the adult population of Spain, 2008–2010: the ENRICA study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J.L. Gutiérrez-Fisac" 1 => "P. Guallar-Castillón" 2 => "L.M. León-Muñoz" 3 => "A. Graciani" 4 => "J.R. Banegas" 5 => "F. Rodríguez-Artalejo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1467-789X.2011.00964.x" "Revista" => array:6 [ "tituloSerie" => "Obes Rev" "fecha" => "2012" "volumen" => "13" "paginaInicial" => "388" "paginaFinal" => "392" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22151906" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0225" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prevalencia, distribución y variabilidad geográfica de los principales factores de riesgo cardiovascular en España. Análisis agrupado de datos individuales de estudios epidemiológicos poblacionales: estudio ERICE" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R. Gabriel" 1 => "M. Alonso" 2 => "A. Segura" 3 => "M.J. Tormo" 4 => "L.M. Artigao" 5 => "J.R. Banegas" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Rev Esp Cardiol" "fecha" => "2008" "volumen" => "61" "paginaInicial" => "1030" "paginaFinal" => "1040" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18817679" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0230" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nutrición y salud en personas de edad avanzada en Europa. Estudio SENECA's FINALE en España. 2. Estilo de vida. Estado de salud y nutricional. Funcionalidad física y mental" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "B. Beltrá" 1 => "A. Carbajal" 2 => "C. Cuadrado" 3 => "G. Varela-Moreiras" 4 => "B. Ruiz-Roso" 5 => "M.L. Martín" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Esp Geriatr Gerontol" "fecha" => "2001" "volumen" => "36" "paginaInicial" => "82" "paginaFinal" => "93" ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0235" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prevalencia de obesidad en España" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J. Aranceta-Bartrina" 1 => "L. Serra-Majem" 2 => "M. Foz-Sala" 3 => "B. Moreno-Esteban" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Med Clin (Barc)" "fecha" => "2005" "volumen" => "125" "paginaInicial" => "460" "paginaFinal" => "466" ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0240" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prevalence of overweight and obesity in elderly people in Spain" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "J.L. Gutiérrez-Fisac" 1 => "E. López" 2 => "J.R. Banegas" 3 => "A. Graciani" 4 => "F. Rodríguez-Artalejo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1038/oby.2004.83" "Revista" => array:6 [ "tituloSerie" => "Obes Res" "fecha" => "2004" "volumen" => "12" "paginaInicial" => "710" "paginaFinal" => "715" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15090641" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0245" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Obesity in the elderly" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "M. Elia" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Obes Res" "fecha" => "2001" "volumen" => "9" "paginaInicial" => "244" "paginaFinal" => "248" ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0250" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "General and abdominal adiposity and risk of death in Europe" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "T. Pischon" 1 => "H. Boeing" 2 => "K. Hoffmann" 3 => "M. Bergmann" 4 => "M.B. Schulze" 5 => "K. Overvad" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMoa0801891" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "2008" "volumen" => "359" "paginaInicial" => "2105" "paginaFinal" => "2120" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19005195" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0255" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Determinants of mortality in patients with type 2 diabetes: a review" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Engelmann" 1 => "U. Manuwald" 2 => "C. Rubach" 3 => "J. Kugler" 4 => "A.L. Birkenfeld" 5 => "M. Hanefeld" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s11154-016-9349-0" "Revista" => array:6 [ "tituloSerie" => "Rev Endocr Metab Disord" "fecha" => "2016" "volumen" => "17" "paginaInicial" => "129" "paginaFinal" => "137" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27068710" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0260" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Weight loss in obese patients with heart failure" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E. Zamora" 1 => "C. Díez-López" 2 => "J. Lupón" 3 => "M. de Antonio" 4 => "M. Domingo" 5 => "J. Santesmases" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1161/JAHA.115.002468" "Revista" => array:5 [ "tituloSerie" => "J Am Heart Assoc" "fecha" => "2016" "volumen" => "5" "paginaInicial" => "e002468" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27013541" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0265" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The dual roles of obesity in chronic kidney disease: a review of the current literature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "C.M. Rhee" 1 => "S.F. Ahmadi" 2 => "K. Kalantar-Zadeh" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/MNH.0000000000000212" "Revista" => array:6 [ "tituloSerie" => "Curr Opin Nephrol Hypertens" "fecha" => "2016" "volumen" => "25" "paginaInicial" => "208" "paginaFinal" => "216" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26999023" "web" => "Medline" ] ] ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0270" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Adipose tissue, muscle, and function: Potential mediators of associations between body weight and mortality in older adults with type 2 diabetes" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R.A. Murphy" 1 => "I. Reinders" 2 => "M.E. Garcia" 3 => "G. Eiriksdottir" 4 => "L.J. Launer" 5 => "R. Benediktsson" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2337/dc14-0293" "Revista" => array:6 [ "tituloSerie" => "Diabetes Care" "fecha" => "2014" "volumen" => "37" "paginaInicial" => "3213" "paginaFinal" => "3219" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25315206" "web" => "Medline" ] ] ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib0275" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Multimorbidity in a prospective cohort: prevalence and associations with weight loss and health status in severely obese patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "C.B. Agborsangaya" 1 => "S.R. Majumdar" 2 => "A.M. Sharma" 3 => "E.W. Gregg" 4 => "R.S. Padwal" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Obesity (Silver Spring)" "fecha" => "2015" "volumen" => "23" "paginaInicial" => "707" "paginaFinal" => "712" ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib0280" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Comorbidity associated with obesity in a large population: the APNA study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "E. Martin-Rodriguez" 1 => "F. Guillen Grima" 2 => "A. Martí" 3 => "A. Brugos Larumbe" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.orcp.2015.04.003" "Revista" => array:6 [ "tituloSerie" => "Obes Res Clin Pract" "fecha" => "2015" "volumen" => "9" "paginaInicial" => "435" "paginaFinal" => "447" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25979684" "web" => "Medline" ] ] ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib0285" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Reviewers of the AACE/ACE Obesity Clinical Practice Guidelines. American Association of Clinical Endocrinologist and American College of Endocrinology comprehensive clinical practice guidelines for medical care of patients with obesity" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "T.W. Garvey" 1 => "J.I. Mechanick" 2 => "M.B. Elise" 3 => "A.J. Garber" 4 => "L. Daniel" 5 => "A.M. Hurley" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.4158/EP161356.ESGL" "Revista" => array:6 [ "tituloSerie" => "Endocr Pract" "fecha" => "2016" "volumen" => "22" "paginaInicial" => "842" "paginaFinal" => "884" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27472012" "web" => "Medline" ] ] ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib0290" "etiqueta" => "28" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Hacia un manejo integral del paciente con diabetes y obesidad" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "R. Gómez Huelgas" 1 => "F. Gómez Peralta" 2 => "L. Carrillo Fernández" 3 => "E. Galve" 4 => "F.F. Casanueva" 5 => "M. Puig Domingo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.rce.2015.07.003" "Revista" => array:6 [ "tituloSerie" => "Rev Clin Esp" "fecha" => "2015" "volumen" => "215" "paginaInicial" => "505" "paginaFinal" => "514" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26363771" "web" => "Medline" ] ] ] ] ] ] ] ] 28 => array:3 [ "identificador" => "bib0295" "etiqueta" => "29" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Bariatric surgery as urate-lowering therapy in severe obesity" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "H.K. Choi" 1 => "Y. Zhang" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/annrheumdis-2013-204861" "Revista" => array:6 [ "tituloSerie" => "Ann Rheum Dis" "fecha" => "2014" "volumen" => "73" "paginaInicial" => "791" "paginaFinal" => "793" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24706555" "web" => "Medline" ] ] ] ] ] ] ] ] 29 => array:3 [ "identificador" => "bib0300" "etiqueta" => "30" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Association of hyperuricemia with conventional cardiovascular risk factors in elderly patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "T. Marotta" 1 => "M. Liccardo" 2 => "F. Schettini" 3 => "F. Verde" 4 => "L. Ferrara Aldo" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Clin Hypertens (Greenwich)" "fecha" => "2015" "volumen" => "17" "paginaInicial" => "27" "paginaFinal" => "32" ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack269932" "titulo" => "Acknowledgements" "texto" => "<p id="par0115" class="elsevierStylePara elsevierViewall">The authors wish to thank all the participating centers whose names appear in the appendix, as well as the Spanish Society of Internal Medicine, the Diabetes and Obesity workgroup of FEMI and Dr. José Manuel Casas Rojas, the author of the case report forms, for his professionalism and invaluable assistance throughout the development of this study.</p>" "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/22548874/0000021700000002/v1_201702250054/S2254887416300923/v1_201702250054/en/main.assets" "Apartado" => array:4 [ "identificador" => "1901" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Original Articles" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/22548874/0000021700000002/v1_201702250054/S2254887416300923/v1_201702250054/en/main.pdf?idApp=WRCEE&text.app=https://revclinesp.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2254887416300923?idApp=WRCEE" ]
