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El papel de la grasa disfuncionante en estos pacientes puede estar relacionado con la aparici&#243;n de las complicaciones cardiovasculares antes mencionadas<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">8</span></a>&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">El objetivo de nuestro an&#225;lisis es comprobar si en los pacientes con obesidad de riesgo muy alto&#44; seg&#250;n las gu&#237;as NICE<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">6</span></a>&#44; la variaci&#243;n en su masa grasa medida por bioimpedancia se correlaciona con su rigidez arterial medida mediante &#237;ndices de velocidad de onda de pulso &#40;VOP&#41;&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Material y m&#233;todos</span><p id="par0025" class="elsevierStylePara elsevierViewall">An&#225;lisis transversal de un solo centro de pacientes ambulatorios con obesidad de riesgo muy alto&#44; valorados en nuestra consulta de Medicina Interna desde marzo hasta septiembre de 2021&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Todos los pacientes acud&#237;an por primera vez a la consulta&#44; recibieron tratamiento y cuidados convencionales y fueron incluidos en el estudio si cumpl&#237;an los criterios de inclusi&#243;n&#58; ser pacientes mayores de 18 a&#241;os con capacidad para obtener medidas de estatura y peso&#44; con consentimiento para cesi&#243;n de datos firmado y clasificados como de riesgo muy alto &#40;IMC mayor o igual a 35<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span> o entre 30 y 34&#44;9<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span> con un per&#237;metro abdominal mayor de 102<span class="elsevierStyleHsp" style=""></span>cm en varones o mayor de 88<span class="elsevierStyleHsp" style=""></span>cm en mujeres&#44; seg&#250;n las gu&#237;as NICE antes de su actualizaci&#243;n en septiembre de 2022&#41;&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">En dicha consulta&#44; se obtuvieron datos antropom&#233;tricos&#44; se realiz&#243; una anal&#237;tica y se obtuvieron medidas de su rigidez arterial mediante el dispositivo experimental VOPITB&#44; que permite medir por m&#233;todo oscilom&#233;trico la velocidad de onda de pulso en brazos y piernas<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">9</span></a>&#46; Se colocan 4 manguitos &#40;2 en los brazos&#44; cerca del pliegue de flexi&#243;n del codo&#44; y 2 en las piernas&#44; cerca de los tobillos&#41; y&#44; autom&#225;ticamente&#44; se registran las ondas de pulso con un sensor oscilom&#233;trico incorporado&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">La VOP se calcula mediante la relaci&#243;n distancia&#47;tiempo &#40;cm&#47;s&#41;&#46; El tiempo es el intervalo de tr&#225;nsito desde la salida de la onda de pulso del coraz&#243;n &#40;pico de la onda R en la derivaci&#243;n I de un registro electrocardiogr&#225;fico incorporado en el sistema&#41; hasta su llegada a cada una de las extremidades &#40;inicio de la onda de pulso en el manguito registro&#41;&#46; Para determinar las longitudes de las v&#237;as arteriales&#44; se calcul&#243; la VOP en cada extremidad mediante f&#243;rmulas matem&#225;ticas basadas en la estatura&#58; longitud coraz&#243;n-brazo &#40;Lhb&#41;&#58; Lhb<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;2195<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>estatura &#40;cm&#41; - 2&#44;0734 y longitud coraz&#243;n-pierna &#40;Lhl&#41;&#58; Lhl<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;8129<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>estatura &#40;cm&#41;<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>12&#44;328<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">10</span></a>&#46; La fiabilidad de este dispositivo se ha comprobado compar&#225;ndolo con mediciones invasivas de la VOP<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">9</span></a>&#58; presenta una variabilidad intra- e interobservador del 6&#44;4&#37; y 7&#44;5&#37;&#44; respectivamente&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Por otra parte&#44; para cada paciente se cuantific&#243; la masa grasa&#44; masa libre de grasa y agua corporal mediante bioimpedancia con un dispositivo TANITA BF-350r&#44; que realiza un an&#225;lisis de impedancia bioel&#233;ctrica tetrapolar y utiliza una frecuencia de 50<span class="elsevierStyleHsp" style=""></span>kHz con los 4<span class="elsevierStyleHsp" style=""></span>electrodos distribuidos entre los 2<span class="elsevierStyleHsp" style=""></span>pies&#46; En un estudio de validaci&#243;n de este aparato en personas adultas se encontr&#243; un correlaci&#243;n con m&#233;todos tradicionales de bioimpedancia de r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;84 y p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;00<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">11</span></a>&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Para el an&#225;lisis creamos 3<span class="elsevierStyleHsp" style=""></span>grupos de pacientes basados en los terciles de VOP&#46; Las variables cualitativas se expresan como n&#250;mero absoluto y porcentaje y se comparan mediante el test de chi-cuadradoas&#46; Las variables cuantitativas se expresan mediante su mediana y rango intercuart&#237;lico y se comparan con el test de Kruskall-Wallis&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Para establecer una correlaci&#243;n entre la VOP y el porcentaje de masa magra&#44; se tomaron ambas variables de forma cuantitativa y se correlacionaron mediante el test de Kendal&#46; Finalmente&#44; para comprobar las variables asociadas a una rigidez arterial patol&#243;gica&#44; se ha generado un an&#225;lisis de regresi&#243;n log&#237;stica&#44; con la VOP como variable dependiente&#44; seg&#250;n un punto de corte de 18&#44;30&#160;m&#47;s<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">12</span></a> para pacientes hipertensos y de 17&#44;04&#160;m&#47;s<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">13</span></a> para el resto&#46; Como variables independientes en el modelo se incluyen&#58; la edad&#44; la presencia de hipertensi&#243;n&#44; dislipidemia y diabetes <span class="elsevierStyleItalic">mellitus</span>&#44; as&#237; como el IMC&#44; el contenido de grasa y los niveles de prote&#237;na C reactiva &#40;PCR&#41;&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Resultados</span><p id="par0060" class="elsevierStylePara elsevierViewall">Fueron examinados 59 pacientes&#44; el 53&#44;9&#37; eran mujeres&#44; la edad media fue de 54<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>14&#44;1&#160;a&#241;os&#46; Las principales caracter&#237;sticas por terciles de VOP se muestran en la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#46; En resumen&#44; los pacientes en el tercil de mayor VOP &#40;indicativo de mayor rigidez arterial&#41; tienen significativamente mayor IMC&#44; mayor contenido de masa grasa y mayor elevaci&#243;n de marcadores inflamatorios contrastados &#40;PCR&#41; y tambi&#233;n de los nuevos marcadores &#40;tales como la ratio neutr&#243;filos-linfocitos y ratio linfocitos-PCR&#41;&#44; con similares valores metab&#243;licos&#44; como colesterol&#44; glucemia capilar o &#237;ndice triglic&#233;ridos-glucosa &#40;como aproximaci&#243;n a la resistencia a la insulina&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">Al analizar de forma cuantitativa el contenido de grasa con la VOP &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#44; de forma significativa se observa una correlaci&#243;n positiva entre el contenido de masa grasa y la VOP&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">Finalmente&#44; en el an&#225;lisis multivariante&#44; las variables que se relacionaron de forma independiente con una VOP patol&#243;gica fueron el IMC &#40;<span class="elsevierStyleItalic">odds ratio</span> &#91;OR&#93; 1&#44;36&#59; intervalo de confianza del 95&#37; &#91;IC&#160;95&#37;&#93;&#58; 1&#44;01-1&#44;99&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;04&#41; y el contenido de masa grasa &#40;OR 1&#44;49&#59; IC 95&#37;&#58; 1&#44;06-1&#44;47&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discusi&#243;n</span><p id="par0075" class="elsevierStylePara elsevierViewall">En el presente an&#225;lisis&#44; se observa como en pacientes con obesidad de riesgo alto&#44; seg&#250;n las gu&#237;as NICE<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">6</span></a>&#44; basadas en el IMC y en el per&#237;metro abdominal&#44; existen diferentes perfiles en funci&#243;n de su rigidez arterial establecida mediante la VOP&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">En el estudio ROFEMI<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">7</span></a>&#44; en una muestra de pacientes con obesidad atendidos en consultas de Medicina Interna&#44; se describi&#243; que&#44; aquellos clasificados de riesgo alto seg&#250;n las mencionadas gu&#237;as&#44; pod&#237;an fenotiparse a su vez en 2<span class="elsevierStyleHsp" style=""></span>grupos diferentes&#44; atendiendo a la presencia de ECV y al incremento de indicadores asociados a un estado proinflamatorio&#46; Se acepta que la rigidez arterial es un predictor importante del desarrollo de ECV<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">14</span></a> y&#44; generalmente&#44; se considera como un &#237;ndice del envejecimiento vascular cuantificable por la medici&#243;n de la VOP&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">En estudios previos se ha relacionado la VOP con el IMC<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">15</span></a>&#44; pero no hemos encontrado otros estudios que relacionen la VOP con el contenido de grasa corporal&#46; Este hallazgo es relevante&#44; puesto que relaciona cualitativamente la rigidez arterial&#44; no con factores antropom&#233;tricos &#40;peso&#44; estatura&#41; como en el trabajo de Zuo et al&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">15</span></a>&#44; sino con el ac&#250;mulo de masa grasa &#40;y no de masa magra o de agua&#41; y establece una asociaci&#243;n objetiva de esta masa magra con el deterioro vascular de estos pacientes&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Se sabe que no solo el contenido de grasa sino tambi&#233;n su disposici&#243;n corporal est&#225; relacionada con el desarrollo de ECV&#44; incluso en personas con normopeso<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">16</span></a>&#46; En funci&#243;n de la asociaci&#243;n encontrada en el presente an&#225;lisis&#44; se desprende una potencial relaci&#243;n del contenido de grasa corporal con la presencia de un mayor da&#241;o endotelial&#44; que se asocia a una mayor rigidez de los vasos arteriales &#40;de hecho&#44; el grupo 3 present&#243; un &#237;ndice tobillo-brazo medido de forma cuantitativa m&#225;s elevado e indicativo de una mayor afectaci&#243;n arterial perif&#233;rica que el resto&#44; que alcanz&#243; significaci&#243;n estad&#237;stica en el caso del tobillo izquierdo&#41;&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Resaltamos&#44; adem&#225;s&#44; que dicho aumento de la VOP en relaci&#243;n con la masa grasa corporal se asocia con una mayor carga inflamatoria&#44; medida en nuestro an&#225;lisis mediante los niveles de PCR&#44; as&#237; como con novedosos &#237;ndices&#44; como el ratio neutr&#243;filos-linfocitos &#40;NLR&#41;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">17</span></a> y el ratio linfocitos-prote&#237;na C reactiva &#40;LCR&#41;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">18</span></a>&#46; La obesidad asocia un estado proinflamatorio de bajo grado &#237;ntimamente relacionado con la aparici&#243;n de comorbilidades&#44; entre ellas&#44; las ECV<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">19&#44;20</span></a>&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Debido a que nuestro tama&#241;o muestral es excesivamente peque&#241;o y a que el tipo de estudio es transversal&#44; no podemos determinar causalidad&#46; Sin embargo&#44; s&#237; podemos sentar la base para pr&#243;ximas investigaciones que desarrollen los hallazgos obtenidos en el presente an&#225;lisis&#44; y para hacer una llamada de atenci&#243;n a la globalizaci&#243;n del concepto de obesidad&#44; sin tener en cuenta que estos pacientes pueden tener un mismo IMC pero diferencias importantes en su composici&#243;n corporal que conllevan un deterioro diferente de su sistema vascular y de su estado inflamatorio y que pueden tener implicaciones importantes en su pron&#243;stico&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Conclusiones</span><p id="par0105" class="elsevierStylePara elsevierViewall">En pacientes con obesidad de riesgo alto existen diferencias relativas a su composici&#243;n corporal que se asocian a modificaciones de su rigidez arterial y de su carga inflamatoria&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Financiaci&#243;n</span><p id="par0110" class="elsevierStylePara elsevierViewall">No ha existido financiaci&#243;n para el presente trabajo&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Conflicto de intereses</span><p id="par0115" class="elsevierStylePara elsevierViewall">Los autores manifiestan no tener conflictos de inter&#233;s con respecto al presente trabajo&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Comprobar si la composici&#243;n corporal en los pacientes con obesidad de riesgo alto &#40;&#237;ndice de masa corporal<span class="elsevierStyleHsp" style=""></span>&#62;35 o entre 30 y 34&#44;9<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span> con un per&#237;metro abdominal mayor de 102<span class="elsevierStyleHsp" style=""></span>cm en varones o mayor de 88<span class="elsevierStyleHsp" style=""></span>cm en mujeres&#41; se relaciona con la enfermedad vascular&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">M&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio transversal de pacientes con obesidad de riesgo alto&#46; Se mide su masa grasa mediante bioimpedancia y la rigidez arterial mediante la velocidad de la onda de pulso &#40;VOP&#41;&#46; Se analizan los terciles de pacientes seg&#250;n la distribuci&#243;n de la VOP&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se ha estudiado a 59 pacientes&#46; Con incrementos de la VOP&#44; aumentan el IMC &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;02&#41; y el contenido de masa grasa &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;00&#41;&#46; Existe&#44; adem&#225;s&#44; un incremento significativo de los indicadores de inflamaci&#243;n&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">En pacientes con obesidad de riesgo alto existen diferencias relativas a su composici&#243;n corporal que se asocian a modificaciones de su rigidez arterial y de su carga inflamatoria&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objective</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">The aim is to observe whether body composition in patients with high-risk obesity &#40;body mass index<span class="elsevierStyleHsp" style=""></span>&#62;35 or between 30 and 34&#46;9<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span> with a waist circumference greater than 102<span class="elsevierStyleHsp" style=""></span>cm in men or greater than 88<span class="elsevierStyleHsp" style=""></span>cm in women&#41; is related with vascular disease&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">This is a cross-sectional study of patients with high-risk obesity&#46; Their fat mass was measured through bioimpedance and arterial stiffness through pulse wave velocity &#40;PWV&#41;&#46; Tertiles of patients were analyzed according to PWV distribution&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">A total of 59 patients were analyzed&#46; As PWV increased&#44; BMI &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;02&#41; and fat mass content &#40;p&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;00&#41; increased&#46; There was also a significant increase in inflammation indicators&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">In patients with high-risk obesity&#44; there were differences in their body composition which were associated with changes in arterial stiffness and inflammatory burden&#46;</p></span>"
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          "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Relaci&#243;n de la velocidad de onda de pulso y el contenido corporal de masa grasa&#46; A&#41; Correlaci&#243;n entre la velocidad de onda de pulso en cm&#47;segundo y el contenido corporal de masa grasa&#46; B&#41; Distribuci&#243;n del contenido de masa magra&#44; seg&#250;n los terciles de velocidad de onda de pulso&#46;</p>"
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                  \t\t\t\t" scope="col">Variable&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">20&nbsp;\t\t\t\t\t\t\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">55&#44;5 &#40;24&#41;&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">Sexo&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">14 &#40;70&#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">0&#44;35&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">Hipertensi&#243;n arterial&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">13 &#40;68&#44;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
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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;48&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">Diabetes <span class="elsevierStyleItalic">mellitus</span> tipo 2&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">9 &#40;47&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">13 &#40;65&#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">0&#44;48&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">Dislipidemia&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</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\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">Tabaquismo&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\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;15&#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&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">Enfermedad renal cr&#243;nica&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">2 &#40;10&#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">4 &#40;21&#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">2 &#40;10&#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></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">Cardiopat&#237;a isqu&#233;mica&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">2 &#40;10&#44;5&#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;5&#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">0&#44;78&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">Enfermedad cerebrovascular&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">1 &#40;5&#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;5&#44;3&#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&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;58&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\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">Arteriopat&#237;a perif&#233;rica&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&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;5&#44;3&#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;5&#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;58&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\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">SAHS&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">11 &#40;55&#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">11 &#40;57&#44;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">10 &#40;50&#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;88&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">IMC&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">37&#44;3 &#40;7&#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">37&#44;3 &#40;7&#44;5&#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">42&#44;2 &#40;10&#44;6&#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;02&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">Per&#237;metro abdominal &#40;cm&#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;9&#44;5&#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">120 &#40;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">122 &#40;21&#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;22&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">PAS &#40;mmHg&#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">148 &#40;26&#44;5&#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&#44;5 &#40;27&#44;2&#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;32&#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;58&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\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">PAD &#40;mmHg&#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">80 &#40;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">77 &#40;13&#44;5&#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">83 &#40;15&#44;5&#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;90&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">Glucemia &#40;mg&#47;dL&#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">97&#44;5 &#40;21&#44;5&#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">95 &#40;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">106 &#40;37&#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;67&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">Colesterol total &#40;mg&#47;dL&#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">185 &#40;49&#44;6&#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">177 &#40;64&#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">169&#44;5 &#40;33&#44;7&#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;72&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">Colesterol no-HDL &#40;mg&#47;dL&#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">131&#44;5 &#40;49&#44;5&#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">132 &#40;70&#44;5&#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">123 &#40;30&#44;5&#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;87&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">Triglic&#233;ridos &#40;mg&#47;dL&#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">131 &#40;95&#44;5&#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">102 &#40;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">107&#44;5 &#40;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">0&#44;80&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">PCR &#40;mg&#47;L&#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;55 &#40;1&#44;1&#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&#44;21 &#40;1&#44;2&#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">2&#44;4 &#40;1&#44;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">0&#44;0003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\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">Creatinina &#40;mg&#47;dL&#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;78 &#40;0&#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">0&#44;92 &#40;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">0&#44;77 &#40;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
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;05&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">&#193;cido &#250;rico &#40;mg&#47;dL&#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&#44;3 &#40;1&#44;3&#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">6&#44;5 &#40;2&#44;3&#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&#44;2 &#40;1&#44;7&#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;28&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\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">TyG&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">8&#44;9 &#40;0&#44;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">8&#44;5 &#40;0&#44;8&#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">8&#44;8 &#40;0&#44;7&#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;80&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">NLR&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&#44;9 &#40;0&#44;8&#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&#44;8 &#40;0&#44;8&#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">2&#44;3 &#40;0&#44;7&#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;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\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">LCR&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">3427&#44;8 &#40;7661&#44;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">baPWV &#40;m&#47;s&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Masa muscular &#40;kg&#41;&nbsp;\t\t\t\t\t\t\n
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                      "titulo" => "American Heart Association&#59; Obesity Committee of the Council on Nutrition&#44; Physical Activity&#44; and Metabolism&#46; Obesity and cardiovascular disease&#58; Pathophysiology&#44; evaluation&#44; and effect of weight loss&#58; An update of the 1997 American Heart Association Scientific Statement on Obesity and Heart Disease from the Obesity Committee of the Council on Nutrition&#44; Physical Activity&#44; and Metabolism"
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                      "titulo" => "High-Risk Obesity Phenotypes&#58; Target for Multimorbidity Prevention at the ROFEMI Study"
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                          "colaboracion" => "on behalf of Diabetes Obesity and Nutrition Working Group of Spanish Society of Internal Medicine"
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                            0 => "A&#46;M&#46; Cypess"
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                      "titulo" => "Pulse wave velocity in four extremities for assessing cardiovascular risk using a new device"
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                          "etal" => true
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                            3 => "F&#46; Duque-Carrillo"
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                      "titulo" => "Validity&#44; reproducibility&#44; and clinical significance of noninvasive brachial-ankle pulse wave velocity measurement"
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Vol. 223. Núm. 3.
Páginas 176-180 (marzo 2023)
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Vol. 223. Núm. 3.
Páginas 176-180 (marzo 2023)
ORIGINAL BREVE
Asociación entre rigidez arterial y masa grasa en pacientes con obesidad
Association between arterial stiffness and fat mass in patients with obesity
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121
S. Tolosa-Álvareza, J.C. Arévalo-Loridoa,
Autor para correspondencia
joscarlor@gmail.com

Autor para correspondencia.
, J.F. Sánchez-Muñoz-Torrerob, A. Pijierro-Amadora, L. Nevado López-Alegríaa, J. Carretero-Gómeza
a Servicio de Medicina Interna, Hospital Universitario de Badajoz, Badajoz, España
b Servicio de Medicina Interna, Hospital San Pedro de Alcántara, Cáceres, España
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Resumen
Objetivo

Comprobar si la composición corporal en los pacientes con obesidad de riesgo alto (índice de masa corporal>35 o entre 30 y 34,9kg/m2 con un perímetro abdominal mayor de 102cm en varones o mayor de 88cm en mujeres) se relaciona con la enfermedad vascular.

Métodos

Estudio transversal de pacientes con obesidad de riesgo alto. Se mide su masa grasa mediante bioimpedancia y la rigidez arterial mediante la velocidad de la onda de pulso (VOP). Se analizan los terciles de pacientes según la distribución de la VOP.

Resultados

Se ha estudiado a 59 pacientes. Con incrementos de la VOP, aumentan el IMC (p=0,02) y el contenido de masa grasa (p<0,00). Existe, además, un incremento significativo de los indicadores de inflamación.

Conclusiones

En pacientes con obesidad de riesgo alto existen diferencias relativas a su composición corporal que se asocian a modificaciones de su rigidez arterial y de su carga inflamatoria.

Palabras clave:
Obesidad
Rigidez arterial
Bioimpedancia
Abstract
Objective

The aim is to observe whether body composition in patients with high-risk obesity (body mass index>35 or between 30 and 34.9kg/m2 with a waist circumference greater than 102cm in men or greater than 88cm in women) is related with vascular disease.

Methods

This is a cross-sectional study of patients with high-risk obesity. Their fat mass was measured through bioimpedance and arterial stiffness through pulse wave velocity (PWV). Tertiles of patients were analyzed according to PWV distribution.

Results

A total of 59 patients were analyzed. As PWV increased, BMI (p=0.02) and fat mass content (p<0.00) increased. There was also a significant increase in inflammation indicators.

Conclusions

In patients with high-risk obesity, there were differences in their body composition which were associated with changes in arterial stiffness and inflammatory burden.

Keywords:
Obesity
Arterial stiffness
Bioimpedance

Artículo

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