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de las obtenidas en el LCR&#44; los estudios han demostrado una estrecha correlaci&#243;n entre ambas<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">6</span></a>&#46; Esta correlaci&#243;n indica que la concentraci&#243;n s&#233;rica de NfL podr&#237;a sustituir potencialmente a la de LCR como biomarcador&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Estudios recientes han puesto de relieve un aumento de las concentraciones s&#233;ricas de NfL en diversos trastornos neurol&#243;gicos&#44; como la esclerosis lateral amiotr&#243;fica&#44; la enfermedad de Huntington&#44; el accidente isqu&#233;mico transitorio&#44; la demencia&#44; la enfermedad de Parkinson&#44; la esclerosis m&#250;ltiple y la enfermedad de Alzheimer<a class="elsevierStyleCrossRefs" href="#bib0250"><span class="elsevierStyleSup">7&#8211;11</span></a>&#46; Adem&#225;s&#44; se asocia a la gravedad de las enfermedades neurol&#243;gicas<a class="elsevierStyleCrossRefs" href="#bib0275"><span class="elsevierStyleSup">12&#8211;14</span></a>&#46; Algunos estudios tambi&#233;n indican una posible relaci&#243;n entre la concentraci&#243;n s&#233;rica de NfL y la depresi&#243;n&#44; observ&#225;ndose concentraciones s&#233;ricas elevadas de NfL en personas con depresi&#243;n mayor durante la edad media<a class="elsevierStyleCrossRefs" href="#bib0290"><span class="elsevierStyleSup">15&#44;16</span></a>&#46; Adem&#225;s&#44; las concentraciones elevadas de NfL se asocian a un mayor riesgo de depresi&#243;n en los adultos de edad madura y avanzada<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">17</span></a>&#46; Adem&#225;s&#44; incluso en personas sin enfermedades neurol&#243;gicas manifiestas&#44; las concentraciones s&#233;ricas de NfL se correlacionan con la atrofia cerebral y el rendimiento neuropsicol&#243;gico&#44; similares a los encontrados en los pacientes con enfermedades neurodegenerativas<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">18</span></a>&#46; Estos hallazgos justifican una investigaci&#243;n m&#225;s profunda de la funci&#243;n de las concentraciones s&#233;ricas de NfL en la patogenia de los trastornos neurol&#243;gicos y la depresi&#243;n&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Sin embargo&#44; sigue sin estar clara la posibilidad de generalizar estas asociaciones&#44; ya que los estudios anteriores se centraron principalmente en muestras de peque&#241;o tama&#241;o&#46; A fin de conocer mejor c&#243;mo se relacionan las concentraciones s&#233;ricas de NfL con la salud neurol&#243;gica en adultos&#44; llevamos a cabo un estudio transversal con datos del ciclo NHANES de 2013-2014&#46; En este estudio se integraron datos exhaustivos sobre las concentraciones s&#233;ricas de NfL y el estado de salud neurol&#243;gico&#46; Nuestro objetivo era evaluar la posible relaci&#243;n entre las concentraciones s&#233;ricas de NfL y diversas enfermedades neurol&#243;gicas&#44; como la depresi&#243;n&#44; las deficiencias auditivas y visuales graves&#44; el ictus&#44; el deterioro subjetivo de la memoria y los problemas del sue&#241;o&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Materiales y m&#233;todos</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Dise&#241;o y poblaci&#243;n del estudio</span><p id="par0025" class="elsevierStylePara elsevierViewall">Esta investigaci&#243;n se bas&#243; en datos del conjunto de datos NHANES&#44; administrado por el National Center for Health Statistics &#40;NCHS&#41;<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">19</span></a>&#46; El objetivo de NHANES es recopilar informaci&#243;n exhaustiva sobre salud y nutrici&#243;n de la poblaci&#243;n estadounidense&#46; El estudio aplica un m&#233;todo de muestreo probabil&#237;stico avanzado estratificado&#44; de varios niveles y complejo para garantizar que la muestra refleje con exactitud la poblaci&#243;n&#46; Todos los participantes otorgaron su consentimiento por escrito de conformidad con las normas de &#233;tica de la Declaraci&#243;n de Helsinki&#46; Los detalles completos sobre la base de datos NHANES pueden consultarse en su sitio web&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">En este estudio transversal se analizaron los datos del ciclo NHANES de 2013-2014&#44; que abarca numerosos datos demogr&#225;ficos&#44; de exploraci&#243;n&#44; anal&#237;ticos y de cuestionarios&#46; De los 10&#46;175 participantes&#44; solo se determinaron las concentraciones s&#233;ricas de cadenas ligeras de neurofilamentos &#40;sNfL&#41; en los que ten&#237;an entre 20 y 75&#160;a&#241;os&#46; Por consiguiente&#44; el estudio se centr&#243; en participantes con concentraciones s&#233;ricas mensurables de NfL y datos demogr&#225;ficos y de salud neurol&#243;gica completos &#40;incluida informaci&#243;n sobre depresi&#243;n&#44; discapacidad y enfermedades&#41;&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Para garantizar la exactitud e integridad de nuestros datos&#44; excluimos a las personas con arreglo a los siguientes criterios&#58; ausencia de datos sobre las concentraciones s&#233;ricas de NfL<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">1</span></a>&#59; embarazo<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">2</span></a>&#59; y cuestionarios incompletos o datos demogr&#225;ficos cr&#237;ticos omitidos<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">3</span></a> &#40;p&#46;&#160;ej&#46;&#44; nivel educativo&#44; cociente entre ingresos familiares y pobreza &#91;PIR&#93;&#44; &#237;ndice de masa corporal &#91;IMC&#93;&#44; hipertensi&#243;n&#44; consumo de tabaco y consumo de alcohol&#41;&#46; En &#250;ltimo t&#233;rmino&#44; se incluyeron 1&#46;751 participantes en el an&#225;lisis&#46; En la <a class="elsevierStyleCrossRef" href="#sec0135">figura S1 del material suplementario</a> se presenta un resumen detallado del proceso de selecci&#243;n&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Determinaci&#243;n de las concentraciones s&#233;ricas de NfL</span><p id="par0040" class="elsevierStylePara elsevierViewall">Los datos sobre las concentraciones s&#233;ricas de Nfl se obtuvieron de la secci&#243;n &#171;Serum Neurofilament Light Chain-Serum&#187; de la base de datos NHANES&#46; Las muestras de suero del ciclo 2013-2014 se analizaron con un inmunoan&#225;lisis de vanguardia realizado por Siemens Healthineers&#46; En el ensayo se utiliz&#243; quimioluminiscencia de &#233;steres de acridina &#40;EA&#41; y part&#237;culas paramagn&#233;ticas y se utiliz&#243; la plataforma automatizada de alto rendimiento Atellica&#174;&#46; Las muestras se incubaron con anticuerpos marcados con EA espec&#237;ficos de LNf y se a&#241;adieron part&#237;culas paramagn&#233;ticas con anticuerpos de captura para formar complejos ant&#237;geno&#47;anticuerpo&#46; La quimioluminiscencia se inici&#243; a&#241;adiendo &#225;cido y base&#44; y se registr&#243; la producci&#243;n de luz&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">El l&#237;mite inferior de cuantificaci&#243;n &#40;LIC&#41; del an&#225;lisis fue de 3&#44;9<span class="elsevierStyleHsp" style=""></span>pg&#47;ml&#44; con un coeficiente de variaci&#243;n &#8804;<span class="elsevierStyleHsp" style=""></span>20&#37;&#46; El l&#237;mite superior de cuantificaci&#243;n fue de 500<span class="elsevierStyleHsp" style=""></span>pg&#47;ml&#46; Para los resultados por debajo del LIC &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>36&#41;&#44; los valores se interpolaron utilizando el LIC dividido por &#8730;2&#46; Ninguna muestra super&#243; el l&#237;mite superior de detecci&#243;n&#46; Se siguieron procedimientos rigurosos de control de calidad y garant&#237;a de calidad&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Depresi&#243;n</span><p id="par0050" class="elsevierStylePara elsevierViewall">Los datos relativos a la depresi&#243;n se recogieron mediante el cuestionario de salud del paciente &#40;PHQ-9&#41; de la base de datos NHANES&#46; Este instrumento de autoevaluaci&#243;n de nueve &#237;tems&#44; basado en el DSM-IV&#44; eval&#250;a los s&#237;ntomas de depresi&#243;n durante las 2 &#250;ltimas semanas<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">20</span></a>&#46; Cada &#237;tem se punt&#250;a de 0 &#40;&#171;nada en absoluto&#187;&#41; a 3 &#40;&#171;casi todos los d&#237;as&#187;&#41;&#44; con puntuaciones globales comprendidas entre 0 y 27&#46; La gravedad de la depresi&#243;n se clasifica como sin depresi&#243;n &#40;0-4&#41;&#44; leve &#40;5-9&#41;&#44; moderada &#40;10-14&#41;&#44; moderadamente grave &#40;15-19&#41; y grave &#40;20-27&#41;<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">21</span></a>&#46; Una puntuaci&#243;n de 10 o m&#225;s indica un trastorno depresivo cl&#237;nicamente significativo<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">22</span></a>&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Deficiencias auditivas y visuales graves</span><p id="par0055" class="elsevierStylePara elsevierViewall">Los datos sobre dificultades auditivas o visuales graves se obtuvieron de la secci&#243;n &#171;Disability&#187; de la base de datos NHANES&#46; Se pregunt&#243; a los participantes si un m&#233;dico o un profesional sanitario les hab&#237;an dicho alguna vez que ten&#237;an dificultades auditivas o visuales importantes&#46; Una respuesta afirmativa indicaba la presencia de este trastorno&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Ictus</span><p id="par0060" class="elsevierStylePara elsevierViewall">La informaci&#243;n sobre el diagn&#243;stico de ictus se obtuvo de la secci&#243;n &#171;Medical Conditions&#187; de NHANES&#46; Se pregunt&#243; a los participantes si un m&#233;dico o un profesional sanitario les hab&#237;an diagnosticado alguna vez un ictus&#46; Las respuestas afirmativas indicaban pacientes con ictus&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Deterioro subjetivo de la memoria</span><p id="par0065" class="elsevierStylePara elsevierViewall">En este estudio se evalu&#243; el funcionamiento de la memoria en participantes de 60&#160;a&#241;os o m&#225;s&#46; Al indagar acerca del deterioro de la memoria durante los &#250;ltimos 12&#160;meses&#44; a los que dijeron que &#171;nunca&#187; ten&#237;an dificultades de memoria se les clasific&#243; como sin deterioro subjetivo de la memoria a largo plazo&#44; mientras que a los dem&#225;s se les clasific&#243; como con deterioro subjetivo de la memoria a largo plazo&#46; Adem&#225;s&#44; mediante la evaluaci&#243;n de la memoria durante los &#250;ltimos 7&#160;d&#237;as&#44; a los que dijeron que &#171;nunca&#187; ten&#237;an dificultades de memoria se les clasific&#243; como sin deterioro subjetivo de la memoria a corto plazo&#44; mientras que a los dem&#225;s se les clasific&#243; como con deterioro subjetivo de la memoria a corto plazo&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Problemas de sue&#241;o</span><p id="par0070" class="elsevierStylePara elsevierViewall">Para evaluar la duraci&#243;n del sue&#241;o y los trastornos del sue&#241;o&#44; nos remitimos a los datos de la secci&#243;n &#171;Sleep Disorders&#187; del cuestionario NHANES&#46; Primero les preguntamos a los participantes cu&#225;nto dorm&#237;an habitualmente entre semana o los d&#237;as laborables&#46; En funci&#243;n de sus respuestas&#44; clasificamos la duraci&#243;n del sue&#241;o en 3 grupos&#58; menos de 7<span class="elsevierStyleHsp" style=""></span>h se clasific&#243; como sue&#241;o corto&#44; de 7 a 9<span class="elsevierStyleHsp" style=""></span>h como sue&#241;o normal y m&#225;s de 9<span class="elsevierStyleHsp" style=""></span>h como sue&#241;o largo&#46; Estas categor&#237;as siguen las recomendaciones de la American Academy of Sleep Medicine y la Sleep Research Society&#46; Estudios previos han demostrado que tanto la privaci&#243;n de sue&#241;o &#40;p&#46;&#160;ej&#46;&#44; menos de 7<span class="elsevierStyleHsp" style=""></span>h&#41; como el sue&#241;o excesivo &#40;p&#46;&#160;ej&#46;&#44; m&#225;s de 9<span class="elsevierStyleHsp" style=""></span>h&#41; se asocian a enfermedades cr&#243;nicas<a class="elsevierStyleCrossRefs" href="#bib0330"><span class="elsevierStyleSup">23&#44;24</span></a>&#46; Preguntamos a los participantes si un m&#233;dico o profesional sanitario les hab&#237;a diagnosticado alguna vez problemas de sue&#241;o o un trastorno del sue&#241;o&#46; Una respuesta afirmativa indicaba dificultades para dormir&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Covariables</span><p id="par0075" class="elsevierStylePara elsevierViewall">Para comprender plenamente el posible efecto de diversas covariables clave sobre nuestros resultados&#44; examinamos meticulosamente los siguientes factores&#58; sexo &#40;masculino o femenino&#41;&#44; edad &#40;20-59&#160;a&#241;os y &#8805;<span class="elsevierStyleHsp" style=""></span>60&#160;a&#241;os&#41;&#44; raza&#47;origen &#233;tnico &#40;mexicano-estadounidense&#44; otras razas hispanas&#44; blanca no hispana&#44; negra no hispana y otras razas&#41;&#44; nivel educativo &#40;menos de 9&#46;&#176; grado&#44; 9-11&#46;&#176; grado&#44; graduado en secundaria&#44; estudios universitarios y graduado universitario o superior&#41;&#44; estado civil &#40;casado&#47;vive en pareja&#47;divorciado&#47;separado&#47;nunca ha estado casado&#41;&#44; PIR &#40;&#60;<span class="elsevierStyleHsp" style=""></span>1&#44;30&#59; 1&#44;30-3&#44;49&#59; &#8805;<span class="elsevierStyleHsp" style=""></span>3&#44;50&#41;&#44; e IMC &#40;&#60;<span class="elsevierStyleHsp" style=""></span>25&#59; 25<span class="elsevierStyleMonospace">-</span>30&#59; &#62;<span class="elsevierStyleHsp" style=""></span>30<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span>&#41;&#46; Adem&#225;s&#44; consideramos las enfermedades cr&#243;nicas comunicadas por los pacientes&#44; como diabetes&#44; hipertensi&#243;n y c&#225;ncer&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Con respecto a los h&#225;bitos de consumo de alcohol&#44; los bebedores se definieron como aquellos que hab&#237;an consumido al menos 12&#160;bebidas durante el a&#241;o anterior&#46; El consumo de tabaco se clasific&#243; en 3 grupos&#58; no fumador &#40;menos de 100&#160;cigarrillos a lo largo de la vida&#41;&#44; exfumador &#40;m&#225;s de 100&#160;cigarrillos a lo largo de la vida&#44; pero que no fuma ahora&#41; y fumador &#40;m&#225;s de 100&#160;cigarrillos a lo largo de la vida y fumadores ocasionales o diarios&#41;&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">An&#225;lisis estad&#237;sticos</span><p id="par0085" class="elsevierStylePara elsevierViewall">Siguiendo las directrices de an&#225;lisis del NCHS y para reflejar mejor la poblaci&#243;n estadounidense no institucionalizada&#44; utilizamos ponderaciones de muestras en todas nuestras estimaciones&#46; A fin de abordar la distribuci&#243;n sesgada de las concentraciones s&#233;ricas de NfL&#44; se utiliz&#243; una transformaci&#243;n del logaritmo natural &#40;ln&#41; para reducir el &#237;ndice de asimetr&#237;a&#46; Inicialmente&#44; dividimos a los participantes en 4 grupos en funci&#243;n de las concentraciones s&#233;ricas de NfL para las caracter&#237;sticas iniciales y utilizamos pruebas de la Chi-cuadrado ponderadas para estudiar diferencias entre todas las variables categ&#243;ricas&#46; Las caracter&#237;sticas iniciales se presentaron en forma de porcentajes ponderados para los participantes en el estudio&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">A fin de investigar m&#225;s a fondo la relaci&#243;n entre el ln de concentraciones s&#233;ricas de NfL y los trastornos neurol&#243;gicos&#44; como la depresi&#243;n&#44; las dificultades auditivas y visuales graves&#44; el ictus&#44; el deterioro subjetivo de la memoria y los problemas de sue&#241;o&#44; se realiz&#243; un an&#225;lisis de regresi&#243;n lineal m&#250;ltiple ponderado&#46; Para este estudio construimos 3 modelos&#58; El modelo&#160;1 no se ajust&#243;&#44; el modelo&#160;2 se ajust&#243; en funci&#243;n de la edad&#44; el sexo y la raza&#44; y el modelo&#160;3 se ajust&#243; en funci&#243;n del nivel educativo&#44; el estado civil&#44; la PIR&#44; el IMC&#44; el consumo de tabaco&#44; el consumo de alcohol&#44; la diabetes&#44; la hipertensi&#243;n y el c&#225;ncer&#44; bas&#225;ndose en el modelo 2&#46; A fin de investigar m&#225;s a fondo la correlaci&#243;n entre el ln de concentraciones s&#233;ricas de NfL y estos trastornos neurol&#243;gicos en diferentes poblaciones &#40;sexo&#44; IMC&#44; hipertensi&#243;n arterial&#44; diabetes y c&#225;ncer&#41;&#44; se realizaron an&#225;lisis de subgrupos y se analiz&#243; la uniformidad entre los subgrupos mediante pruebas de interacci&#243;n&#46; Adem&#225;s&#44; se utiliz&#243; un m&#233;todo de suavizado de curvas para revelar la tendencia en la asociaci&#243;n entre el ln de concentraciones s&#233;ricas de NfL y estos trastornos neurol&#243;gicos&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Se utilizaron los programas R &#40;versi&#243;n 4&#46;2&#41; y EmpowerStats &#40;versi&#243;n 4&#46;1&#41; para todos los an&#225;lisis estad&#237;sticos realizados en este estudio&#46; La significaci&#243;n estad&#237;stica se defini&#243; como un valor de p bilateral &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#46;</p></span></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Resultados</span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Caracter&#237;sticas iniciales de los participantes incluidos</span><p id="par0100" class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a> se presentan las caracter&#237;sticas demogr&#225;ficas de los participantes del ciclo NHANES 2013-2014&#44; clasificados en 4 grupos en funci&#243;n de sus concentraciones s&#233;ricas de NfL&#46; De los 1&#46;751 participantes&#44; el 50&#44;28&#37; eran varones&#44; el 76&#44;40&#37; ten&#237;an entre 20 y 59&#160;a&#241;os y el 69&#44;96&#37; eran de raza blanca no hispana&#46; Los niveles educativos variaban&#58; El 32&#44;07&#37; ten&#237;a un t&#237;tulo universitario o superior y el 33&#44;71&#37; ten&#237;a alg&#250;n t&#237;tulo universitario o AA&#46; Respecto al estado civil&#44; el 65&#44;55&#37; estaban casados o viv&#237;an en pareja&#44; mientras que el 18&#44;14&#37; nunca hab&#237;an estado casados&#46; En cuanto a la situaci&#243;n econ&#243;mica&#44; el 43&#44;35&#37; ten&#237;a una PIR<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>3&#44;50&#44; lo que indica mayores niveles de ingresos&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0105" class="elsevierStylePara elsevierViewall">Se observa un contraste notable entre los participantes con las concentraciones s&#233;ricas m&#225;s altas de NfL &#40;Q4&#41; y los participantes con las m&#225;s bajas &#40;Q1&#41;&#46; En concreto&#44; los participantes del grupo Q4 eran predominantemente de edad avanzada&#44; con un 46&#44;25&#37; de 60&#160;a&#241;os o m&#225;s&#44; en comparaci&#243;n con solo el 0&#44;45&#37; en el grupo Q1&#46; Este grupo demogr&#225;fico de edad m&#225;s avanzada del grupo Q4 tambi&#233;n mostr&#243; resultados de salud significativamente peores&#44; como una mayor prevalencia de diabetes &#40;18&#44;54 frente al 2&#44;29&#37;&#41;&#44; hipertensi&#243;n &#40;48&#44;25 frente al 15&#44;90&#37;&#41; y c&#225;ncer &#40;14&#44;25 frente al 3&#44;56&#37;&#41;&#46; Adem&#225;s&#44; en el grupo Q4 hab&#237;a una mayor proporci&#243;n de varones &#40;54&#44;07 frente al 44&#44;06&#37;&#41; y personas de raza blanca no hispana &#40;77&#44;41 frente al 59&#44;29&#37;&#41;&#46; Asimismo&#44; los participantes del grupo del Q4 ten&#237;an m&#225;s probabilidades de presentar un mayor IMC&#44; de modo que el 43&#44;38&#37; ten&#237;a un IMC superior a 30<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span>&#44; en comparaci&#243;n con el 41&#44;81&#37; en el grupo Q1&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a> se muestran las caracter&#237;sticas de las concentraciones s&#233;ricas de NfL en diferentes enfermedades neurol&#243;gicas&#46; Los participantes con concentraciones s&#233;ricas m&#225;s altas de NfL mostraron una mayor prevalencia de s&#237;ntomas depresivos graves y puntuaciones PHQ-9 m&#225;s altas&#46; Cabe destacar que en el grupo Q4 se registr&#243; una proporci&#243;n m&#225;s alta de depresi&#243;n grave &#40;puntuaci&#243;n de 20-27&#41; &#40;1&#44;83&#37;&#41;&#46; Adem&#225;s&#44; las concentraciones s&#233;ricas elevadas de NfL guardaron una estrecha relaci&#243;n con deficiencias auditivas y visuales graves&#44; ictus&#44; d&#233;ficits subjetivos de memoria y problemas de sue&#241;o&#46; En resumen&#44; los participantes con concentraciones s&#233;ricas m&#225;s altas de NfL tendieron a tener una edad m&#225;s avanzada&#44; una salud peor y una mayor prevalencia de m&#250;ltiples enfermedades neurol&#243;gicas&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Asociaci&#243;n entre el ln de concentraciones s&#233;ricas de NfL y las puntuaciones del PHQ-9</span><p id="par0115" class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a> se muestra la asociaci&#243;n entre el logaritmo natural de concentraciones s&#233;ricas de NfL y las puntuaciones del PHQ-9&#46; En el modelo&#160;1&#44; las concentraciones s&#233;ricas de NfL mostraron una fuerte correlaci&#243;n positiva con las puntuaciones del PHQ-9 &#40;&#946;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;15&#59; IC del 95&#37;&#58; 0&#44;06-0&#44;23&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; Depresi&#243;n especialmente moderada &#40;&#946;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;26&#59; IC del 95&#37;&#58; 0&#44;13-0&#44;40&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; moderada o grave &#40;&#946;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;37&#59; IC del 95&#37;&#58; 0&#44;14-0&#44;61&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;002&#41; y grave &#40;&#946;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;44&#59; IC del 95&#37;&#58; 0&#44;14-0&#44;74&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;004&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0120" class="elsevierStylePara elsevierViewall">En el modelo&#160;2&#44; la asociaci&#243;n positiva entre las concentraciones s&#233;ricas de NfL y las puntuaciones del PHQ-9 se mantuvo &#40;&#946;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;15&#59; IC del 95&#37;&#58; 0&#44;05-0&#44;24&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;003&#41;&#46; Se observaron asociaciones positivas significativas en la depresi&#243;n moderada &#40;&#946;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;22&#59; IC del 95&#37;&#58; 0&#44;09-0&#44;35&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; moderada o grave &#40;&#946;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;33&#59; IC del 95&#37;&#58; 0&#44;12-0&#44;55&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;002&#41; y grave &#40;&#946;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;36&#59; IC del 95&#37;&#58; 0&#44;08-0&#44;63&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;011&#41;&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">En el modelo&#160;3&#44; la asociaci&#243;n positiva sigue siendo significativa &#40;&#946;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;10&#59; IC del 95&#37;&#58; 0&#44;01-0&#44;20&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;039&#41;&#46; Se mantuvieron asociaciones significativas con la depresi&#243;n moderada &#40;&#946;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;14&#44; IC del 95&#37;&#58; 0&#44;01-0&#44;26&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;035&#41; y la depresi&#243;n moderada o grave &#40;&#946;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;27&#59; IC del 95&#37;&#58; 0&#44;06-0&#44;47&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;011&#41;&#59; aunque depresi&#243;n grave&#46; La asociaci&#243;n con la depresi&#243;n dej&#243; de ser significativa &#40;&#946;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;26&#59; IC del 95&#37;&#58; &#8722;0&#44;01-0&#44;53&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;059&#41;&#44; pero sigui&#243; siendo positiva&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Estos resultados indican que unas concentraciones s&#233;ricas elevadas de NfL se asocian sistem&#225;ticamente a unas puntuaciones del PHQ-9 m&#225;s altas&#44; sobre todo en la depresi&#243;n moderada y moderadamente grave&#46;</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Asociaci&#243;n entre el ln de concentraciones s&#233;ricas de NfL y el estado neurol&#243;gico</span><p id="par0135" class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#tbl0020">tabla 4</a> se muestra la correlaci&#243;n entre las concentraciones s&#233;ricas de NfL y diversos trastornos neurol&#243;gicos&#46; En el modelo&#160;1&#44; cada aumento unitario de la concentraci&#243;n s&#233;rica de NfL se asocia significativamente a la probabilidad de sufrir varias enfermedades&#58; un aumento del 30&#37; de la depresi&#243;n&#44; un aumento del 34&#37; de la deficiencia auditiva grave&#44; un aumento del 29&#37; de la deficiencia visual grave&#44; un aumento del 55&#37; del ictus&#44; un aumento del 28&#37; del deterioro subjetivo de la memoria a largo plazo&#44; un aumento del 18&#37; de las dificultades para dormir y un aumento del 41&#37; de la duraci&#243;n prolongada del sue&#241;o &#40;todos los valores p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0140" class="elsevierStylePara elsevierViewall">En el modelo&#160;2&#44; estas asociaciones siguen siendo significativas&#58; un aumento del 25&#37; de la depresi&#243;n&#44; un aumento del 16&#37; de la deficiencia auditiva grave&#44; un aumento del 20&#37; de la deficiencia visual grave&#44; un aumento del 33&#37; del ictus&#44; un aumento del 30&#37; del deterioro subjetivo de la memoria a largo plazo&#44; un aumento del 14&#37; de las dificultades para dormir y un aumento del 38&#37; de la duraci&#243;n prolongada del sue&#241;o &#40;todos los valores p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">En el modelo&#160;3&#44; las asociaciones significativas siguen siendo depresi&#243;n &#40;17&#37;&#41;&#44; ictus &#40;20&#37;&#41;&#44; deterioro subjetivo de la memoria a largo plazo &#40;27&#37;&#41; y duraci&#243;n prolongada del sue&#241;o &#40;32&#37;&#41; &#40;todos los valores p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">Adem&#225;s&#44; las curvas de ajuste suavizadas validan a&#250;n m&#225;s estas relaciones&#58; Las concentraciones s&#233;ricas de NfL muestran una correlaci&#243;n positiva lineal con la depresi&#243;n y la duraci&#243;n prolongada del sue&#241;o&#44; una relaci&#243;n en forma de U con el ictus y una correlaci&#243;n positiva no lineal con el deterioro subjetivo de la memoria a largo plazo &#40;<a class="elsevierStyleCrossRef" href="#sec0135">fig&#46; S2 del material suplementario</a>&#41;&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">En resumen&#44; estos resultados indican que&#44; incluso despu&#233;s de ajustar respecto a m&#250;ltiples covariables&#44; unas concentraciones s&#233;ricas elevadas de NfL se correlacionan sistem&#225;ticamente con un mayor riesgo de diversos trastornos neurol&#243;gicos&#44; como la depresi&#243;n&#44; el ictus&#44; el deterioro subjetivo de la memoria a largo plazo y la duraci&#243;n prolongada del sue&#241;o&#46;</p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">An&#225;lisis de subgrupos</span><p id="par0160" class="elsevierStylePara elsevierViewall">A fin de validar mejor la correlaci&#243;n entre las concentraciones s&#233;ricas de NfL y la depresi&#243;n&#44; el ictus&#44; el deterioro subjetivo de la memoria a largo plazo y la duraci&#243;n prolongada del sue&#241;o&#44; se realizaron an&#225;lisis de subgrupos y pruebas de interacci&#243;n basadas en factores tales como el sexo&#44; el IMC&#44; la hipertensi&#243;n arterial&#44; la diabetes y el c&#225;ncer &#40;<a class="elsevierStyleCrossRef" href="#tbl0025">tabla 5</a>&#41;&#46; Los resultados mostraron que&#44; aunque exist&#237;a una correlaci&#243;n positiva entre las concentraciones s&#233;ricas de NfL y estos problemas de salud en la mayor&#237;a de los subgrupos&#44; las correlaciones no fueron estad&#237;sticamente significativas en la mayor&#237;a de los casos&#46; En particular&#44; en el subgrupo de IMC&#44; la correlaci&#243;n positiva entre las concentraciones s&#233;ricas de NfL y el deterioro subjetivo de la memoria a largo plazo fue significativa &#40;valor p de la interacci&#243;n &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46; En concreto&#44; los pacientes con un IMC<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>25 mostraron una correlaci&#243;n positiva significativa &#40;&#223;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#44;41&#59; IC del 95&#37;&#58; 0&#44;60-4&#44;21&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;009&#41;&#44; mientras que no se observ&#243; ninguna correlaci&#243;n significativa en otros subgrupos de IMC&#46;</p><elsevierMultimedia ident="tbl0025"></elsevierMultimedia></span></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Discusi&#243;n</span><p id="par0165" class="elsevierStylePara elsevierViewall">En este extenso estudio transversal con 1&#46;751 participantes se observ&#243; una relaci&#243;n significativa entre unas concentraciones s&#233;ricas elevadas de NfL y un mayor riesgo de trastornos neurol&#243;gicos&#44; como depresi&#243;n&#44; ictus&#44; deterioro de la memoria y duraci&#243;n prolongada del sue&#241;o&#46; Cuando las neuronas est&#225;n da&#241;adas&#44; el NfL se libera en el l&#237;quido intersticial&#44; migrando posteriormente hacia el LCR y el torrente sangu&#237;neo&#44; dando lugar a concentraciones elevadas de NfL detectables en estos l&#237;quidos<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">25</span></a>&#46; Curiosamente&#44; este deterioro neuronal y sin&#225;ptico suele ocurrir a&#241;os antes de que los s&#237;ntomas cl&#237;nicos sean evidentes<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">26</span></a>&#46; Por tanto&#44; la monitorizaci&#243;n de las concentraciones de NfL en el LCR o en la sangre podr&#237;a servir como un sistema de alerta precoz&#44; permitiendo intervenciones oportunas para prevenir la aparici&#243;n de trastornos neurol&#243;gicos&#46; Estos hallazgos ponen de relieve el potencial de la concentraci&#243;n s&#233;rica de NfL como biomarcador cr&#237;tico para la detecci&#243;n precoz y la vigilancia de las enfermedades neurol&#243;gicas&#46; A continuaci&#243;n&#44; analizamos en detalle las implicaciones de nuestros hallazgos&#46;</p><span id="sec0090" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0150">Depresi&#243;n</span><p id="par0170" class="elsevierStylePara elsevierViewall">La depresi&#243;n es un trastorno mental complejo con posibles mecanismos como problemas vasculares&#44; inflamaci&#243;n&#44; producci&#243;n excesiva de glucocorticoides y dep&#243;sito de amiloide&#44; todo lo cual puede provocar da&#241;o neuronal<a class="elsevierStyleCrossRefs" href="#bib0350"><span class="elsevierStyleSup">27&#8211;30</span></a>&#46; Numerosos estudios indican que las concentraciones s&#233;ricas de NfL se encuentran significativamente elevadas en los pacientes con trastorno depresivo mayor en comparaci&#243;n con los grupos de control&#44; con una correlaci&#243;n estrecha entre este aumento y todo el espectro depresivo<a class="elsevierStyleCrossRefs" href="#bib0290"><span class="elsevierStyleSup">15&#8211;17</span></a>&#46; Adem&#225;s&#44; las fluctuaciones de las concentraciones s&#233;ricas de NfL pueden actuar como posibles biomarcadores del trastorno bipolar y otros trastornos neuropsiqui&#225;tricos<a class="elsevierStyleCrossRef" href="#bib0370"><span class="elsevierStyleSup">31</span></a>&#46; Investigaciones realizadas en la Universidad de Edimburgo han revelado que los pacientes con depresi&#243;n tienen menor integridad de la sustancia blanca y una transmisi&#243;n de se&#241;al m&#225;s lenta en las regiones cerebrales<a class="elsevierStyleCrossRef" href="#bib0375"><span class="elsevierStyleSup">32</span></a>&#46; En combinaci&#243;n con los resultados de nuestro estudio&#44; la correlaci&#243;n significativa entre unas concentraciones s&#233;ricas elevadas de NfL y un mayor riesgo de depresi&#243;n indica que la concentraci&#243;n s&#233;rica de NfL podr&#237;a ser un biomarcador eficaz para predecir y comprender la depresi&#243;n&#46; Planteamos la hip&#243;tesis de que los mecanismos que vinculan la LNf con la depresi&#243;n son&#58; da&#241;o neuronal causado por neuroinflamaci&#243;n en la depresi&#243;n&#44; lo que da lugar a la liberaci&#243;n de NfL a la sangre&#44; degeneraci&#243;n neuronal en el hipocampo y la corteza prefrontal debida a depresi&#243;n&#44; aumento de las concentraciones de NfL y alteraci&#243;n de la regulaci&#243;n del eje HHS en los pacientes con depresi&#243;n&#44; lo que da lugar a concentraciones elevadas de cortisol&#44; da&#241;o neuronal y liberaci&#243;n de NfL&#46; Estos factores pueden explicar la relaci&#243;n que existe entre la depresi&#243;n y las concentraciones elevadas de NfL&#46;</p></span><span id="sec0095" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0155">Ictus</span><p id="par0175" class="elsevierStylePara elsevierViewall">Nuestra investigaci&#243;n indica una relaci&#243;n s&#243;lida entre concentraciones s&#233;ricas elevadas de NfL y un mayor riesgo de ictus&#46; Especialmente cuando el valor del serum ln &#40;NfL&#41; es superior a 4&#44; la probabilidad de ictus aumenta significativamente&#44; lo que pone de relieve la importancia de las concentraciones de NfL en la evaluaci&#243;n del riesgo de ictus&#46; Cuando se produce un ictus&#44; las neuronas da&#241;adas liberan grandes cantidades de NfL al torrente sangu&#237;neo&#44; lo que eleva las concentraciones s&#233;ricas de NfL&#46; En consecuencia&#44; las variaciones en las concentraciones s&#233;ricas de NfL se correlacionan directamente con el grado de da&#241;o neuronal y las regiones afectadas&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">Los estudios anteriores tambi&#233;n respaldan nuestros resultados&#46; En los estadios iniciales del ictus isqu&#233;mico&#44; las concentraciones sangu&#237;neas de NfL aumentan significativamente y alcanzan su valor m&#225;ximo en un plazo de entre 3 y 6&#160;meses<a class="elsevierStyleCrossRefs" href="#bib0380"><span class="elsevierStyleSup">33&#44;34</span></a>&#46; Otro estudio muestra que durante la fase aguda del ictus&#44; las concentraciones sangu&#237;neas de NfL se correlacionan positivamente con el volumen del infarto y los d&#233;ficits neurol&#243;gicos<a class="elsevierStyleCrossRefs" href="#bib0390"><span class="elsevierStyleSup">35&#44;36</span></a>&#46; Adem&#225;s&#44; las investigaciones indican que las concentraciones elevadas de NfL durante la fase aguda predicen normalmente peores resultados<a class="elsevierStyleCrossRef" href="#bib0400"><span class="elsevierStyleSup">37</span></a>&#46; Las evaluaciones de seguimiento revelan que los pacientes con concentraciones sangu&#237;neas m&#225;s elevadas de NfL tienen un riesgo 1&#44;71 veces mayor de mal pron&#243;stico funcional que aquellos con concentraciones m&#225;s bajas de NfL<a class="elsevierStyleCrossRef" href="#bib0405"><span class="elsevierStyleSup">38</span></a>&#46; Otros estudios han revelado que unas concentraciones m&#225;s altas de NfL en las fases m&#225;s avanzadas del ictus se asocian a deterioros f&#237;sicos y cognitivos m&#225;s graves<a class="elsevierStyleCrossRef" href="#bib0410"><span class="elsevierStyleSup">39</span></a>&#46; Incluso tras el ajuste respecto a factores como la edad&#44; esta asociaci&#243;n sigue siendo significativa&#44; lo que indica que unas concentraciones sangu&#237;neas elevadas de NfL son un factor predictivo fundamental del deterioro funcional en estadio avanzado&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">En resumen&#44; las concentraciones s&#233;ricas de NfL no solo ayudan a identificar precozmente a los pacientes de alto riesgo&#44; sino que tambi&#233;n contribuyen a desarrollar planes de tratamiento m&#225;s precisos&#46; El control de las concentraciones sangu&#237;neas de NfL puede aportar informaci&#243;n esencial para evaluar la gravedad y el pron&#243;stico del ictus&#46;</p></span><span id="sec0100" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0160">Deterioro subjetivo de la memoria a largo plazo</span><p id="par0190" class="elsevierStylePara elsevierViewall">Como indicador precoz de alteraciones cognitivas&#44; el deterioro subjetivo de la memoria puede indicar las primeras fases de enfermedades neurodegenerativas&#46; Observamos una fuerte correlaci&#243;n positiva entre las concentraciones s&#233;ricas de NfL y el deterioro subjetivo de la memoria a largo plazo en las personas de edad avanzada&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">Estudios previos han puesto de manifiesto que unas concentraciones plasm&#225;ticas m&#225;s elevadas de NfL se correlacionan de forma significativamente negativa con unas puntuaciones de recuerdo diferido y memoria global&#44; lo que indica que unas concentraciones elevadas de NfL reflejan da&#241;o neuronal y p&#233;rdida funcional<a class="elsevierStyleCrossRef" href="#bib0415"><span class="elsevierStyleSup">40</span></a>&#46; Adem&#225;s&#44; en personas de edad avanzada con cognici&#243;n normal&#44; unas concentraciones plasm&#225;ticas elevadas de NfL se correlacionan negativamente con puntuaciones combinadas de memoria epis&#243;dica&#44; memoria de trabajo&#44; funci&#243;n ejecutiva y cognici&#243;n global&#44; lo que respalda a&#250;n m&#225;s el posible valor de la NfL como biomarcador de cambios neurodegenerativos<a class="elsevierStyleCrossRef" href="#bib0420"><span class="elsevierStyleSup">41</span></a>&#46;</p><p id="par0200" class="elsevierStylePara elsevierViewall">Cabe destacar que en un estudio reciente de 335&#160;participantes se observ&#243; que las concentraciones s&#233;ricas de NfL son un potente factor predictivo de disminuci&#243;n del volumen cerebral&#44; que suele acompa&#241;arse de deterioro de la memoria<a class="elsevierStyleCrossRef" href="#bib0425"><span class="elsevierStyleSup">42</span></a>&#46; Este hallazgo confirma a&#250;n m&#225;s nuestros resultados y subraya el potencial de la LNf para vigilar y predecir la salud cognitiva en las personas de edad avanzada&#46;</p><p id="par0205" class="elsevierStylePara elsevierViewall">En conclusi&#243;n&#44; nuestra investigaci&#243;n destaca la concentraci&#243;n s&#233;rica de NfL como biomarcador crucial para las enfermedades neurodegenerativas y la evaluaci&#243;n del deterioro cognitivo&#46; Estos hallazgos pueden ayudar al diagn&#243;stico y la intervenci&#243;n precoces&#44; mejorando as&#237; los resultados de los pacientes&#46;</p></span><span id="sec0105" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0165">Problemas de sue&#241;o</span><p id="par0210" class="elsevierStylePara elsevierViewall">Los problemas de sue&#241;o&#44; como el insomnio&#44; la apnea obstructiva del sue&#241;o &#40;AOS&#41; y la duraci&#243;n irregular del sue&#241;o&#44; no consisten &#250;nicamente en sentir sue&#241;o durante el d&#237;a&#46; Se ha demostrado que est&#225;n estrechamente relacionados con el da&#241;o neurol&#243;gico y las enfermedades neurodegenerativas&#44; como el Alzheimer y la enfermedad de Parkinson&#46; Los pacientes con estos trastornos suelen presentar concentraciones s&#233;ricas m&#225;s elevadas de NFL&#44; un biomarcador de lesi&#243;n neurol&#243;gica&#46;</p><p id="par0215" class="elsevierStylePara elsevierViewall">Sorprendentemente&#44; un estudio revel&#243; que los pacientes con insomnio cr&#243;nico ten&#237;an concentraciones s&#233;ricas significativamente mayores de NfL que el grupo de control&#46; Tras un tratamiento adecuado&#44; la concentraci&#243;n s&#233;rica de NfL disminuy&#243;<a class="elsevierStyleCrossRef" href="#bib0430"><span class="elsevierStyleSup">43</span></a>&#46; Sin embargo&#44; nuestro estudio no detect&#243; una relaci&#243;n significativa entre las concentraciones s&#233;ricas de NfL y las dificultades para dormir comunicadas por los pacientes&#46; Esto puede deberse a la limitada variedad de preguntas relacionadas con el sue&#241;o en el conjunto de datos NHANES&#44; lo que pone de relieve la necesidad de desarrollar mejores herramientas para diagnosticar las dificultades para dormir&#46;</p><p id="par0220" class="elsevierStylePara elsevierViewall">Aunque se cree de forma generalizada que una duraci&#243;n breve del sue&#241;o es perjudicial para la salud&#44; algunos estudios se&#241;alan que una duraci&#243;n prolongada del sue&#241;o es igualmente preocupante&#46; La duraci&#243;n prolongada del sue&#241;o puede asociarse a diversos problemas de salud&#44; como depresi&#243;n&#44; enfermedades cardiovasculares y s&#237;ndrome metab&#243;lico&#44; que pueden afectar indirectamente a la salud neurol&#243;gica&#46;</p><p id="par0225" class="elsevierStylePara elsevierViewall">Observamos una correlaci&#243;n positiva significativa entre unas concentraciones s&#233;ricas elevadas de NfL y la probabilidad de una duraci&#243;n prolongada del sue&#241;o&#46; Esto podr&#237;a indicar que las personas con lesiones nerviosas m&#225;s graves tienen m&#225;s probabilidades de referir una duraci&#243;n prolongada del sue&#241;o&#46; Este hallazgo es importante para estudiar la relaci&#243;n entre el da&#241;o neurol&#243;gico y los patrones de sue&#241;o&#46;</p><p id="par0230" class="elsevierStylePara elsevierViewall">En la actualidad&#44; la investigaci&#243;n sobre la correlaci&#243;n directa entre las concentraciones s&#233;ricas de NfL y la duraci&#243;n prolongada del sue&#241;o es limitada&#46; Sin embargo&#44; algunos datos indirectos y posibles mecanismos indican que una duraci&#243;n prolongada del sue&#241;o puede afectar negativamente a la salud neurol&#243;gica y dar lugar a concentraciones s&#233;ricas elevadas de NfL&#46; Se necesitan m&#225;s investigaciones para aclarar esta correlaci&#243;n y explorar sus posibles mecanismos&#46;</p></span><span id="sec0110" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0170">Limitaciones</span><p id="par0235" class="elsevierStylePara elsevierViewall">Investigamos la relaci&#243;n entre las concentraciones s&#233;ricas de NfL y diversos trastornos neurol&#243;gicos&#44; lo que cubri&#243; un vac&#237;o importante en las investigaciones existentes&#46; Utilizando datos fiables de la base de datos NHANES&#44; se reforzaron nuestros resultados&#46; La muestra amplia y diversa aument&#243; la representatividad y generalizabilidad de nuestro estudio&#46;</p><p id="par0240" class="elsevierStylePara elsevierViewall">Sin embargo&#44; debemos reconocer algunas limitaciones&#46; En primer lugar&#44; el dise&#241;o transversal dificulta la determinaci&#243;n de una relaci&#243;n causal entre las concentraciones s&#233;ricas de NfL y los trastornos neurol&#243;gicos&#46; En segundo lugar&#44; los datos limitados de NHANES 2013-2014 pueden haber afectado a la exhaustividad y fiabilidad de nuestro an&#225;lisis&#46; En tercer lugar&#44; a pesar de nuestros esfuerzos por controlar las variables de confusi&#243;n&#44; no puede descartarse totalmente su influencia&#46; Por &#250;ltimo&#44; el diagn&#243;stico de los trastornos neurol&#243;gicos se bas&#243; principalmente en informaci&#243;n facilitada por los pacientes&#44; sin exploraciones neurol&#243;gicas exhaustivas&#44; lo que afecta a la exactitud&#46;</p><p id="par0245" class="elsevierStylePara elsevierViewall">En resumen&#44; nuestro estudio identific&#243; una estrecha correlaci&#243;n entre concentraciones s&#233;ricas elevadas de NfL y varios trastornos neurol&#243;gicos&#44; lo que indica que la concentraci&#243;n s&#233;rica de NfL podr&#237;a ser un factor predictivo fundamental de m&#250;ltiples enfermedades neurol&#243;gicas&#46;</p></span></span><span id="sec0115" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0175">Aprobaci&#243;n &#233;tica y consentimiento para participar</span><p id="par0250" class="elsevierStylePara elsevierViewall">En este estudio se incluyeron datos de NHANES 2013-2014&#44; que obtuvo la aprobaci&#243;n &#233;tica del National Center for Health Statistics&#46; Todos los m&#233;todos se realizaron de conformidad con las directrices y normas pertinentes &#40;Declaraci&#243;n de Helsinki&#41; y todos los participantes otorgaron su consentimiento informado&#46;</p></span><span id="sec0120" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0180">Financiaci&#243;n</span><p id="par0260" class="elsevierStylePara elsevierViewall">Los autores no tienen financiaci&#243;n que declarar&#46;</p></span><span id="sec0125" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0185">Conflicto de intereses</span><p id="par0270" class="elsevierStylePara elsevierViewall">Los autores declaran carecer de conflictos de intereses&#46;</p></span><span id="sec0130" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0190">Disponibilidad de datos y materiales</span><p id="par0275" class="elsevierStylePara elsevierViewall">Todos los datos relevantes para el estudio est&#225;n a disposici&#243;n p&#250;blica en el sitio web de NHANES &#40;<a href="https://wwwn.cdc.gov/nchs/nhanes/Default.aspx">https&#58;&#47;&#47;wwwn&#46;cdc&#46;gov&#47;nchs&#47;nhanes&#47;Default&#46;aspx</a>&#41;&#46;</p></span></span>"
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    "fechaAceptado" => "2024-06-18"
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            1 => "Depresi&#243;n"
            2 => "Cadena ligera de neurofilamentos &#40;NfL&#41;"
            3 => "Estudio transversal"
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            0 => "Neurological diseases"
            1 => "Depression"
            2 => "Neurofilament light chain &#40;NfL&#41;"
            3 => "Cross-sectional study"
            4 => "National Health and Nutrition Examination Survey"
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    "resumen" => array:2 [
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        "titulo" => "Resumen"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Antecedentes</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Mientras que el aumento de las concentraciones de la cadena ligera de neurofilamentos &#40;NfL&#41; en suero est&#225; relacionado con la progresi&#243;n de varias afecciones neurol&#243;gicas&#44; su distribuci&#243;n e implicaciones dentro de la poblaci&#243;n adulta general siguen siendo en gran parte inexploradas&#46; La presente investigaci&#243;n tiene como objetivo aclarar la relaci&#243;n entre los niveles de NfL en suero y los trastornos neurol&#243;gicos en una muestra amplia y representativa de la poblaci&#243;n&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">M&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Utilizamos informaci&#243;n recopilada de 1&#46;751 adultos involucrados en el ciclo 2013-2014 de la Encuesta Nacional de Salud y Nutrici&#243;n &#40;NHANES&#41;&#46; Nuestro enfoque anal&#237;tico incluy&#243; regresi&#243;n log&#237;stica&#44; ajuste de curvas suavizadas y an&#225;lisis de subgrupos para identificar posibles correlaciones entre los niveles de NfL en suero y condiciones neurol&#243;gicas&#44; incluyendo depresi&#243;n&#44; discapacidades auditivas y visuales severas&#44; accidente cerebrovascular&#44; d&#233;ficits de memoria subjetivos y problemas de sue&#241;o&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Despu&#233;s de ajustar por factores de confusi&#243;n&#44; encontramos que mayores concentraciones de NfL en suero se asociaban significativamente con un mayor riesgo de depresi&#243;n&#44; accidente cerebrovascular&#44; d&#233;ficits de memoria subjetivos y mayor duraci&#243;n del sue&#241;o &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46; Los an&#225;lisis de subgrupos respaldaron estos hallazgos&#46; Adem&#225;s&#44; el IMC influy&#243; significativamente en la relaci&#243;n entre los niveles de NfL en suero y los d&#233;ficits de memoria subjetivos&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusi&#243;n</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Nuestra investigaci&#243;n muestra que niveles m&#225;s altos de NfL en suero est&#225;n firmemente relacionados con un mayor riesgo de varios trastornos neurol&#243;gicos&#46; Estos hallazgos destacan el papel del NfL en suero como un marcador cr&#237;tico para la detecci&#243;n temprana y la monitorizaci&#243;n de condiciones neurol&#243;gicas&#44; enfatizando su importancia tanto en entornos cl&#237;nicos como de salud p&#250;blica&#46;</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">&#46;</p></span>"
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      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Background</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">While increased neurofilament light chain &#40;NfL&#41; in serum concentrations are linked to the progression of several neurological conditions&#44; their distribution and implications within the general adult population remain largely unexplored&#46; The current research aims to clarify the relationship among serum NfL levels and neurological disorders in a broad and representative population sample&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Methods</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">We utilized information gathered from 1&#44;751 adults involved in the 2013-2014 cycle of the National Health and Nutrition Examination Survey &#40;NHANES&#41;&#46; Our analytical approach encompassed logistic regression&#44; smoothed curve fitting&#44; and subgroup analyses to identify potential correlations between serum NfL levels and neurological conditions&#44; including depression&#44; severe hearing and visual impairments&#44; stroke&#44; subjective memory deficits&#44; and sleep problems&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">After adjusting for confounders&#44; we found that higher serum NfL concentrations were significantly associated with increased risks of depression&#44; stroke&#44; subjective memory deficits&#44; and longer sleep duration &#40;<span class="elsevierStyleItalic">P</span>&#60;&#46;05&#41;&#46; Subgroup analyses supported these findings&#46; Additionally&#44; BMI significantly influenced the relationship between serum NfL levels and subjective memory deficits&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusion</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Our research shows that higher serum NfL levels are strongly related to an elevated risk for several neurological disorders&#46; These findings highlight the role of serum NfL serving as a critical marker for early detection and monitoring of neurological conditions&#44; emphasizing its importance in both clinical and public health settings&#46;</p></span>"
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          "leyenda" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">&#171;n&#187; representa el tama&#241;o de la muestra y &#171;&#37;&#187; indica el porcentaje&#46; En cuanto a las variables categ&#243;ricas&#44; el valor de p se calcul&#243; mediante la prueba de Chi-cuadrado ponderada&#46;</p><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Cuartiles de cadenas ligeras de neurofilamentos en suero&#58; Q1&#58; &#60;<span class="elsevierStyleHsp" style=""></span>8&#44;2&#59; Q2&#58; 8&#44;3-12&#44;3&#59; Q3&#58; 12&#44;4-19&#44;0&#59; Q4&#58; &#62;<span class="elsevierStyleHsp" style=""></span>19&#44;1&#46;</p><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">IMC&#58; &#237;ndice de masa corporal&#59; NfL&#58; cadena ligera de neurofilamentos&#59; PIR&#58; cociente entre ingresos familiares y pobreza&#46;</p><p id="spar0155" class="elsevierStyleSimplePara elsevierViewall">Los resultados estad&#237;sticamente significativos &#40;p &#60; 0&#44;05&#41; se destacan en negrita&#46;</p>"
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Q3&#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>441&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Q4&#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>438&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Valor de p&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Edad &#40;a&#241;os&#41;&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleBold">&#60;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">0&#44;001</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>20-59&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1&#46;282 &#40;76&#44;40&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">430 &#40;99&#44;55&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">364 &#40;85&#44;28&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">279 &#40;68&#44;00&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">209 &#40;53&#44;75&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#8805;&#160;<span class="elsevierStyleHsp" style=""></span>60&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">469 &#40;23&#44;60&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">6 &#40;0&#44;45&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">72 &#40;14&#44;72&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">162 &#40;32&#44;00&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">229 &#40;46&#44;25&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Sexo&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleBold">0&#44;009</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Masculino&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">851 &#40;50&#44;28&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">180 &#40;44&#44;06&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">224 &#40;53&#44;83&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">215 &#40;48&#44;98&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">232 &#40;54&#44;07&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Femenino&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">900 &#40;49&#44;72&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">256 &#40;55&#44;94&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">212 &#40;46&#44;17&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">226 &#40;51&#44;02&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">206 &#40;45&#44;93&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Raza &#47; origen &#233;tnico&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleBold">&#60;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">0&#44;001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Mexicana-estadounidense&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">239 &#40;8&#44;77&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">82 &#40;14&#44;78&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">62 &#40;8&#44;73&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">42 &#40;5&#44;66&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">53 &#40;6&#44;10&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Otras razas hispanas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">155 &#40;5&#44;29&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">35 &#40;6&#44;22&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">45 &#40;6&#44;47&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">49 &#40;5&#44;81&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">26 &#40;2&#44;71&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Blanca no hispana&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Otras razas&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Estudios universitarios&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleBold">&#60;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">0&#44;001</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Casado&#47;vive en pareja&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">265 &#40;65&#44;52&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">278 &#40;67&#44;12&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">270 &#40;66&#44;09&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Viudo&#47;divorciado&#47;separado&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">68 &#40;14&#44;42&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Nunca ha estado casado&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">49 &#40;12&#44;01&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">PIR&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">144 &#40;23&#44;10&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">148 &#40;24&#44;41&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">153 &#40;22&#44;05&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>1&#44;30-3&#44;49&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">138 &#40;29&#44;87&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">151 &#40;34&#44;41&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>3&#44;50&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">569 &#40;43&#44;35&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">125 &#40;34&#44;94&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">154 &#40;47&#44;03&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">156 &#40;47&#44;70&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">134 &#40;43&#44;54&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">IMC &#40;kg&#47;m</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">&#41;&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleBold">&#60;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">0&#44;001</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>25&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>25-30&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Q4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Valor de p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">PHQ-9&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;748&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">&#60;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">0&#44;001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No &#40;0-4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1&#46;317&#40;77&#44;47&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">340 &#40;79&#44;31&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">330 &#40;78&#44;57&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">343 &#40;82&#44;29&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">304 &#40;69&#44;85&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Leve &#40;5-9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">267 &#40;14&#44;19&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">62 &#40;13&#44;98&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">73 &#40;14&#44;02&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">60 &#40;12&#44;34&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">72 &#40;16&#44;38&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Moderada &#40;10-14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">98 &#40;5&#44;41&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">21 &#40;4&#44;55&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">22 &#40;5&#44;95&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">14 &#40;2&#44;48&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">41 &#40;8&#44;60&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Moderadamente grave &#40;15-19&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">44 &#40;1&#44;85&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">7 &#40;1&#44;61&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">8 &#40;1&#44;06&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">11 &#40;1&#44;36&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">18 &#40;3&#44;33&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Grave &#40;20-27&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">22 &#40;1&#44;08&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">5 &#40;0&#44;55&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3 &#40;0&#44;40&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">8 &#40;1&#44;52&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">6 &#40;1&#44;83&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="7" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Depresi&#243;n&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;748&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleBold">&#60;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">0&#44;001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>S&#237; &#40;&#60;<span class="elsevierStyleHsp" style=""></span>10&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">164 &#40;8&#44;34&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">33 &#40;6&#44;71&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">33 &#40;7&#44;41&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">33 &#40;5&#44;37&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">65 &#40;13&#44;77&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No &#40;&#8805;<span class="elsevierStyleHsp" style=""></span>10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1&#46;584 &#40;91&#44;66&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">402 &#40;93&#44;29&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">403 &#40;92&#44;59&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">403 &#40;94&#44;63&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">376 &#40;86&#44;23&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="7" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Dificultad auditiva grave&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">1&#46;750&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">&#60;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">0&#44;001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">87 &#40;4&#44;60&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">11 &#40;2&#44;49&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">12 &#40;2&#44;63&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">29 &#40;5&#44;53&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">35 &#40;7&#44;62&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1&#46;663 &#40;95&#44;40&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">425 &#40;97&#44;51&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">424 &#40;97&#44;37&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">407 &#40;94&#44;47&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">407 &#40;92&#44;38&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="7" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Dificultad visual grave&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;751&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">&#60;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">0&#44;001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">90 &#40;4&#44;95&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15 &#40;3&#44;29&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;2&#44;31&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26 &#40;5&#44;89&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">36 &#40;8&#44;23&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;661 &#40;95&#44;05&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">421 &#40;96&#44;71&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">423 &#40;97&#44;69&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">415 &#40;94&#44;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">402 &#40;91&#44;77&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="7" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Ictus&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;751&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">&#60;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">0&#44;001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">47 &#40;2&#44;67&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;0&#44;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;1&#44;87&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18 &#40;4&#44;12&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23 &#40;4&#44;43&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;704 &#40;97&#44;33&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">435 &#40;99&#44;80&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">431 &#40;98&#44;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">423 &#40;95&#44;88&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">415 &#40;95&#44;57&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="7" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Deterioro subjetivo de la memoria a largo plazo</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">469&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Duraci&#243;n del sue&#241;o&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>6<span class="elsevierStyleHsp" style=""></span>h&#47;noche&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>9<span class="elsevierStyleHsp" style=""></span>h&#47;noche&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>S&#237;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">513 &#40;30&#44;14&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">102 &#40;23&#44;83&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">125 &#40;30&#44;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">136 &#40;29&#44;67&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">150 &#40;36&#44;76&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1&#46;238 &#40;69&#44;86&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">334 &#40;76&#44;17&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">311 &#40;69&#44;89&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">305 &#40;70&#44;33&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">288 &#40;63&#44;24&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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        "etiqueta" => "Tabla 3"
        "tipo" => "MULTIMEDIATABLA"
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          "leyenda" => "<p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">Modelo&#160;1&#58; no se ajustaron covariables&#46;</p><p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">Modelo&#160;2&#58; ajuste por edad&#44; sexo y raza&#47;origen &#233;tnico&#46;</p><p id="spar0105" class="elsevierStyleSimplePara elsevierViewall">Modelo&#160;3&#58; ajuste por edad&#44; sexo&#44; raza&#47;origen &#233;tnico&#44; nivel educativo&#44; estado civil&#44; PIR&#44; IMC&#44; consumo de tabaco&#44; consumo de alcohol&#44; diabetes&#44; hipertensi&#243;n y c&#225;ncer&#46;</p><p id="spar0110" class="elsevierStyleSimplePara elsevierViewall">IC&#58; intervalo de confianza&#59; IMC&#58; &#237;ndice de masa corporal&#59; ln&#58; logaritmo natural&#59; NfL&#58; cadena ligera de neurofilamentos&#59; PHQ-9&#58; cuestionario de salud del paciente 9&#59; PIR&#58; cociente entre ingresos familiares y pobreza&#46;</p><p id="spar1110" class="elsevierStyleSimplePara elsevierViewall">Los resultados estad&#237;sticamente significativos &#40;p &#60; 0&#44;05&#41; se destacan en negrita&#46;</p>"
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                  <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="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Modelo&#160;1</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Modelo&#160;2</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Modelo&#160;3</th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#223; &#40;IC del 95&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Valor de p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#223; &#40;IC del 95&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Valor de p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#223; &#40;IC del 95&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Valor de p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PHQ-9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;15 &#40;0&#44;06&#59; 0&#44;23&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;15 &#40;0&#44;05&#59; 0&#44;24&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">0&#44;003</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;10 &#40;0&#44;01&#59; 0&#44;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">0&#44;039</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No &#40;0-4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Referencia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Referencia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Referencia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Leve &#40;5-9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;07 &#40;&#8722;0&#44;02&#59; 0&#44;16&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;119&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;06 &#40;&#8722;0&#44;03&#59; 0&#44;14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;180&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;03 &#40;&#8722;0&#44;05&#59; 0&#44;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;445&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Moderada &#40;10-14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;26 &#40;0&#44;13&#59; 0&#44;40&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">&#60;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">0&#44;001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;22 &#40;0&#44;09&#59; 0&#44;35&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">0&#44;001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;14 &#40;0&#44;01&#59; 0&#44;26&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">0&#44;035</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Moderadamente grave &#40;15-19&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;37 &#40;0&#44;14&#44; 0&#44;61&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">0&#44;002</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;33 &#40;0&#44;12&#59; 0&#44;55&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">0&#44;27 &#40;0&#44;06&#59; 0&#44;47&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleBold">0&#44;011</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;26 &#40;&#8722;0&#44;01&#59; 0&#44;53&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;059&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#223; &#40;IC del 95&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#223; &#40;IC del 95&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Valor de p&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#223; &#40;IC del 95&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Valor de p&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;30 &#40;0&#44;19&#59; 0&#44;41&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">0&#44;17 &#40;0&#44;07&#59; 0&#44;28&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleBold">&#60;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">0&#44;001</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;16 &#40;0&#44;03&#59; 0&#44;30&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleBold">0&#44;020</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;08 &#40;&#8722;0&#44;06&#59; 0&#44;21&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;258&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Dificultad visual grave</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;29 &#40;0&#44;15&#59; 0&#44;44&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">&#60;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">0&#44;001</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;20 &#40;0&#44;07&#59; 0&#44;33&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleBold">0&#44;003</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;11&#40;&#8722;0&#44;02&#59; 0&#44;24&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Ictus</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;55 &#40;0&#44;36&#59; 0&#44;74&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleBold">&#60;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">0&#44;001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;33 &#40;0&#44;16&#59; 0&#44;51&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t"><span class="elsevierStyleBold">0&#44;026</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Deterioro subjetivo de la memoria a largo plazo</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleBold">&#60;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">0&#44;001</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t"><span class="elsevierStyleBold">&#60;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">0&#44;001</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleBold">0&#44;001</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Deterioro subjetivo de la memoria a corto plazo</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;00 &#40;&#8722;0&#44;01&#59; 0&#44;01&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;991&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;01 &#40;&#8722;0&#44;09&#59; 0&#44;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;856&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;00 &#40;&#8722;0&#44;10&#59; 0&#44;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;957&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Dificultad para dormir</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;18 &#40;0&#44;12&#59; 0&#44;25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleBold">&#60;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">0&#44;001</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;14 &#40;0&#44;08&#59; 0&#44;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleBold">&#60;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">0&#44;001</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;06 &#40;&#8722;0&#44;01&#59; 0&#44;12&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;077&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Duraci&#243;n del sue&#241;o</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sue&#241;o corto &#40;&#60;<span class="elsevierStyleHsp" style=""></span>7<span class="elsevierStyleHsp" style=""></span>h&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;01 &#40;&#8722;0&#44;06&#59; 0&#44;07&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;907&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;08 &#40;0&#44;02&#59; 0&#44;14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">0&#44;014</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;03 &#40;&#8722;0&#44;03&#59; 0&#44;09&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;257&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sue&#241;o normal &#40;7-9<span class="elsevierStyleHsp" style=""></span>h&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Referencia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Referencia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Referencia&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sue&#241;o largo &#40;&#62;<span class="elsevierStyleHsp" style=""></span>9<span class="elsevierStyleHsp" style=""></span>h&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleBold">&#60;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleBold">0&#44;001</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;38 &#40;0&#44;17&#59; 0&#44;58&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;32 &#40;0&#44;12&#59; 0&#44;52&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleBold">0&#44;002</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\tvoid\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t" scope="col">Subgrupo&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#223; &#40;IC del 95&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Valor de p&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#223; &#40;IC del 95&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Valor de p&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#223; &#40;IC del 95&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Valor de p&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#223; &#40;IC del 95&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Valor de p&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Masculino&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;31 &#40;&#8722;0&#44;12&#59; 0&#44;73&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;156&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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