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Adem&#225;s&#44; la inflamaci&#243;n cr&#243;nica de bajo grado asociado a la DM2 contribuye tanto a la aparici&#243;n y mantenimiento de la DRE como a la p&#233;rdida de masa muscular<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">6&#44;7</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Los &#250;ltimos documentos de consenso ponen especial &#233;nfasis en el efecto delet&#233;reo de dicha inflamaci&#243;n sist&#233;mica sobre el estado nutricional y muscular<a class="elsevierStyleCrossRefs" href="#bib0365"><span class="elsevierStyleSup">8&#44;9</span></a>&#46; El m&#250;sculo es uno de los principales metabolizadores perif&#233;ricos de glucosa&#59; adem&#225;s&#44; la resistencia a la insulina reduce la s&#237;ntesis proteica&#44; contribuyendo al c&#237;rculo vicioso de la p&#233;rdida de masa muscular<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">10</span></a>&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">A partir de los 60 a&#241;os la masa muscular&#44; fundamentalmente la esquel&#233;tica&#44; disminuye un 3&#37; anual<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">11&#44;12</span></a>&#46; La sarcopenia asociada a la edad o sarcopenia primaria<a class="elsevierStyleCrossRef" href="#bib0365"><span class="elsevierStyleSup">8</span></a>&#44; se manifiesta en mayor medida si coexisten enfermedades cr&#243;nicas como la diabetes &#40;sarcopenia secundaria&#41;&#44; especialmente asociada al sexo femenino&#44; al mal control metab&#243;lico y a la presencia de comorbilidades<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">13</span></a>&#46; Adem&#225;s&#44; la sarcopenia es una enfermedad muscular donde no solo es importante la cantidad&#44; sino la funci&#243;n o fuerza muscular<a class="elsevierStyleCrossRef" href="#bib0365"><span class="elsevierStyleSup">8</span></a>&#46; Su prevalencia en adultos var&#237;a del 8 al 36&#37;&#46; De hecho&#44; la DM2 aumenta hasta por 1&#44;59 el riesgo de desarrollo de sarcopenia<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">14</span></a> y su prevalencia asociada a la DM2 var&#237;a entre el 8&#44;2&#37; y el 15&#44;1&#37; seg&#250;n los estudios analizados<a class="elsevierStyleCrossRefs" href="#bib0255"><span class="elsevierStyleSup">15&#44;16</span></a>&#46; Por ello&#44; la EWGSOP-2 recomienda valorar la presencia de sarcopenia mediante test de <span class="elsevierStyleItalic">screening</span> como el SARC-F<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">17</span></a> y la fuerza mediante la dinamometr&#237;a de mano&#44; siendo esta el mejor predictor de eventos adversos y fragilidad<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">18</span></a>&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">En 2019<span class="elsevierStyleItalic">&#44;</span> Global Leadership Initiative on Malnutrition &#40;GLIM&#41; public&#243; un documento de consenso sobre el diagn&#243;stico de la DRE&#44; basado en criterios fenot&#237;picos &#40;p&#233;rdida involuntaria de peso&#44; bajo &#237;ndice de masa corporal o disminuci&#243;n de la masa o funci&#243;n muscular&#41; y 2<span class="elsevierStyleHsp" style=""></span>criterios etiol&#243;gicos&#58; disminuci&#243;n de la ingesta y presencia de inflamaci&#243;n<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">9</span></a>&#46; En los pacientes hospitalizados en medicina interna&#44; el binomio DRE-sarcopenia representar&#237;a un problema sanitario importante&#44; siendo necesario una correcta sensibilizaci&#243;n por parte de los profesionales<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">19</span></a>&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Por ello&#44; nuestro objetivo es analizar en una cohorte de pacientes hospitalizados en medicina interna&#44; si existen diferencias desde un punto de vista nutricional y muscular&#44; entre pacientes con y sin DM2&#44; as&#237; como valorar c&#243;mo influyen ambas sobre el pron&#243;stico a corto y largo plazo de unos y otros&#46; Nuestra hip&#243;tesis se basa en que el binomio desnutrici&#243;n-sarcopenia es m&#225;s prevalente en pacientes con DM2 y que estas 3<span class="elsevierStyleHsp" style=""></span>condiciones imprimen un peor pron&#243;stico a los pacientes&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Material y m&#233;todos</span><p id="par0030" class="elsevierStylePara elsevierViewall">Estudio observacional de cohortes prospectivo&#44; unic&#233;ntrico&#44; que incluy&#243; a pacientes ingresados de forma consecutiva en el servicio de Medicina Interna&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Poblaci&#243;n y per&#237;odo de estudio</span><p id="par0035" class="elsevierStylePara elsevierViewall">Con el fin de homogeneizar los datos de la muestra se incluye a aquellos correspondientes al primer d&#237;a de ingreso siempre que se cumplieran los criterios de inclusi&#243;n &#40;mayores de 18 a&#241;os&#44; con consentimiento informado firmado&#41;&#46; En ese primer d&#237;a&#44; se obtuvieron los cuestionarios de desnutrici&#243;n &#40;Mini-Nutritional Assessment-Short Form &#91;MNA-SF&#93;&#41;<a class="elsevierStyleCrossRefs" href="#bib0280"><span class="elsevierStyleSup">20&#44;21</span></a> y de sarcopenia &#40;SARC-F&#44; que eval&#250;a 5<span class="elsevierStyleHsp" style=""></span>dominios&#58; fuerza&#44; asistencia para la deambulaci&#243;n&#44; levantarse de una silla&#44; subir escaleras y ca&#237;das&#41;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">17</span></a>&#46; La dinamometr&#237;a de mano se realiz&#243; igualmente en las primeras 24 h de ingreso&#44; mediante un dinam&#243;metro Jamar 12-0604 Plus&#174; &#40;Manufactured for Performance Heatlh Supply&#44; INC&#46; W68N158 Evergreen Blvd&#46; Cedarburg&#44; WI 53012&#41; &#40;10 repeticiones aportando la media y el coeficiente de variaci&#243;n entre ellas&#41; por defecto en la mano dominante&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Se excluy&#243; a pacientes que no firmaron el consentimiento&#44; pacientes con diabetes tipo 1 o aquellos a los que no se pudieron realizar los test iniciales &#40;MNA-SF&#44; SARC-F y dinamometr&#237;a&#41; en las primeras 24 h &#40;ingreso en el fin de semana o v&#237;spera de festivo&#41;&#46; Los pacientes se reclutaron durante 2<span class="elsevierStyleHsp" style=""></span>per&#237;odos diferentes &#40;meses de mayo y octubre de 2021&#41; y recibieron el cuidado y tratamiento estandarizado&#46; Este estudio se aprob&#243; por el comit&#233; &#233;tico regional previo al comienzo de la inclusi&#243;n de los pacientes y se ha llevado a cabo de acuerdo con la Declaraci&#243;n de Helsinki&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Variables del estudio</span><p id="par0045" class="elsevierStylePara elsevierViewall">Por cada paciente incluido&#44; se obtuvieron variables antropom&#233;tricas &#40;edad&#44; sexo e IMC &#8212;o su estimaci&#243;n&#44; mediante la f&#243;rmula de Chumlea&#8212;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">22</span></a>&#41;&#44; antecedentes m&#233;dicos&#44; comorbilidad &#40;&#237;ndice de Charlson<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">23</span></a>&#41; y datos de laboratorio&#46; Los resultados del SARC-F se categorizaron de acuerdo con un punto de corte mayor o igual a 4 puntos que defini&#243; un <span class="elsevierStyleItalic">screening</span> positivo para sarcopenia&#46; Igualmente&#44; la dinamometr&#237;a de mano se categoriz&#243; de acuerdo con unos puntos de corte de menos de 27<span class="elsevierStyleHsp" style=""></span>kg para hombres y menos de 16<span class="elsevierStyleHsp" style=""></span>kg para mujeres que determinaron la presencia de sarcopenia por esta t&#233;cnica<a class="elsevierStyleCrossRef" href="#bib0365"><span class="elsevierStyleSup">8</span></a>&#46; Finalmente&#44; se recogieron datos relacionados con el alta y el diagn&#243;stico principal al alta&#44; as&#237; como la mortalidad intrahospitalaria&#46; La situaci&#243;n vital del paciente posterior al alta&#44; as&#237; como los reingresos durante 120 d&#237;as de seguimiento se recogieron a partir de los datos de la historia cl&#237;nica electr&#243;nica local&#44; o mediante contacto telef&#243;nico de los investigadores con el paciente o sus familiares&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Agrupaci&#243;n de pacientes para el an&#225;lisis &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;</span><p id="par0050" class="elsevierStylePara elsevierViewall">Con el objetivo de describir de forma detallada las caracter&#237;sticas de los pacientes en funci&#243;n de la presencia de DM2 y de su estado nutricional&#44; se establecieron 6 grupos&#46; Por un lado&#44; se dividi&#243; a la muestra en funci&#243;n de la presencia o no de DM2 y de otro en la categorizaci&#243;n del resultado del cuestionario MNA-SF &#40;&#8804;<span class="elsevierStyleHsp" style=""></span>7 puntos paciente desnutrido&#44; entre 8 y 11 puntos en riesgo de desnutrici&#243;n y<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>12 puntos sin riesgo de desnutrici&#243;n&#41;&#46; Por lo tanto&#44; se analizaron 6 grupos &#40;2&#215;3&#41;&#46; Grupo 1&#58; pacientes sin DM2 y sin riesgo de desnutrici&#243;n&#44; grupo 2&#58; pacientes sin DM2 en riesgo de desnutrici&#243;n&#44; grupo 3&#58; pacientes sin DM2 con desnutrici&#243;n&#44; grupo 4&#58; pacientes con DM2 sin riesgo de desnutrici&#243;n&#44; grupo 5&#58; pacientes con DM2 en riesgo de desnutrici&#243;n y grupo 6&#58; pacientes con DM2 y desnutridos&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Objetivos del estudio</span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Objetivo primario</span><p id="par0055" class="elsevierStylePara elsevierViewall">Observar las diferencias en t&#233;rminos de prevalencia del estado nutricional entre pacientes con y sin DM2&#44; atendiendo adem&#225;s a su situaci&#243;n de sarcopenia y de fragilidad&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Objetivo secundario</span><p id="par0060" class="elsevierStylePara elsevierViewall">Observar si existen diferencias en el pron&#243;stico en cada uno de los grupos preespecificados&#44; considerando de un lado la mortalidad intrahospitalaria y de otro la mortalidad o reingreso a 120 d&#237;as del ingreso &#237;ndice&#46;</p></span></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">An&#225;lisis estad&#237;stico</span><p id="par0065" class="elsevierStylePara elsevierViewall">Los 6 grupos fueron analizados en primer lugar de forma univariante&#46; Las variables cualitativas y categ&#243;ricas se expresaron como n&#250;mero absoluto y porcentaje&#44; y se compararon mediante la prueba de la chi al cuadrado&#46; Las variables cuantitativas se expresaron como media &#40;desviaci&#243;n est&#225;ndar&#41; si cumpl&#237;an criterios de normalidad&#44; o como mediana &#40;rango intercuart&#237;lico&#41; si no eran normales&#46; Se compararon mediante an&#225;lisis de la varianza si eran param&#233;tricas o mediante la prueba de Kruskal-Wallis si no lo eran&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Para completar el an&#225;lisis descriptivo entre pacientes con y sin DM2&#44; se analizaron las correlaciones entre desnutrici&#243;n&#44; sarcopenia y comorbilidad para cada grupo de pacientes con y sin DM2 mediante un an&#225;lisis de correlaci&#243;n de Spearman&#44; cuyo resultado se represent&#243; mediante un <span class="elsevierStyleItalic">heatmap</span> &#40;mapa de calor&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0010">fig&#46; 2</a> A y B&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">En cuanto al an&#225;lisis del pron&#243;stico referido a la mortalidad intrahospitalaria se construy&#243; un modelo de regresi&#243;n log&#237;stica incluyendo de nuevo la sarcopenia mediante el resultado de la dinamometr&#237;a&#44; la comorbilidad &#40;&#237;ndice de Charlson&#41;&#44; la inflamaci&#243;n &#40;mediante el &#237;ndice prote&#237;na C reactiva&#47;alb&#250;mina &#91;IPA&#93;&#41; y los grupos preespecificados &#40;<a class="elsevierStyleCrossRef" href="#fig0015">fig&#46; 3</a>&#41;&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">Finalmente&#44; y con el fin de observar el pron&#243;stico a 120 d&#237;as&#44; se construyeron unas curvas de Kaplan-Meier para un objetivo primario que inclu&#237;a mortalidad o reingreso por cualquier causa y se compararon mediante log rank test &#40;<a class="elsevierStyleCrossRef" href="#fig0020">fig&#46; 4</a>&#41;&#46;</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia></span></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Resultados</span><p id="par0085" class="elsevierStylePara elsevierViewall">Se analiz&#243; a 511 pacientes&#44; 252 &#40;49&#44;1&#37;&#41; varones&#44; con edad media de 75&#44;2<span class="elsevierStyleHsp" style=""></span>&#177; 15 a&#241;os&#46; De ellos 210 &#40;41&#44;1&#37;&#41; ten&#237;an DM2&#46; La prevalencia de desnutrici&#243;n entre los pacientes con DM2 fue del 39&#44;5&#37; y en los que no ten&#237;an DM2 del 39&#44;4&#37;&#46; Las caracter&#237;sticas de los pacientes de acuerdo con los 6 grupos preespecificados se muestran en la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall">En resumen&#44; los grupos de pacientes con DM2 &#40;grupos 4 a 6&#41; tuvieron mayor edad y prevalencia de otras comorbilidades asociadas a la DM2 como son la hipertensi&#243;n arterial&#44; dislipidemia&#44; insuficiencia card&#237;aca&#44; enfermedad cerebrovascular y de &#250;lceras por presi&#243;n&#46; El binomio desnutrici&#243;n-sarcopenia fue especialmente relevante en los grupos 3 &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&#41; y 6&#44; siendo especialmente manifiesta&#44; tanto por SARC-F como por dinamometr&#237;a&#44; en este &#250;ltimo &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;0003&#41;&#46; Frente a un 49&#44;5&#37; en personas sin diabetes&#44; un 63&#44;8&#37; de las personas con diabetes tuvo una puntuaci&#243;n<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleUnderline">&#62;</span> 4 en el SARC-F &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;002&#41;&#46; De igual manera&#44; la prevalencia de sarcopenia en funci&#243;n de la dinamometr&#237;a fue del 71&#44;3&#37; vs&#46; 79&#44;5&#37; en personas sin&#47;con diabetes&#44; respectivamente&#44; &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#46; Anal&#237;ticamente destac&#243; una disminuci&#243;n significativa de los niveles de transferrina s&#233;rica&#44; de alb&#250;mina y de hemoglobina entre los pacientes con DM2&#46; Con respecto a la inflamaci&#243;n&#44; evaluada mediante el IPA&#44; el grupo 6 fue el que mayor inflamaci&#243;n present&#243;&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;008&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Mediante el an&#225;lisis de correlaci&#243;n de Spearman&#44; se encontraron asociaciones significativas entre la malnutrici&#243;n&#44; sarcopenia&#44; comorbilidad e inflamaci&#243;n&#44; especialmente en el caso de los pacientes con DM2 &#40;fig&#46; 2<span class="elsevierStyleHsp" style=""></span>A y B&#41;&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Con relaci&#243;n al pron&#243;stico&#44; no hubo diferencias significativas entre los grupos en la incidencia de mortalidad hospitalaria&#46; En el modelo de regresi&#243;n log&#237;stica &#40;<a class="elsevierStyleCrossRef" href="#fig0015">fig&#46; 3</a>&#41;&#44; fueron la comorbilidad&#44; la sarcopenia y el grado de inflamaci&#243;n lo que determin&#243; de forma significativa un incremento de esta mortalidad&#46; En este modelo&#44; el grupo 6 &#40;pacientes con DM2 y desnutrici&#243;n&#41; tuvo significativamente menos mortalidad con respecto al grupo 1 &#40;pacientes sin DM2 ni desnutrici&#243;n&#41;&#44; con OR 0&#44;04&#44; IC del 95&#37;&#44; 0&#44;00-0&#44;32&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#46; Finalmente&#44; con respecto al pron&#243;stico a 120 d&#237;as&#44; el grupo de pacientes con DM2 y desnutrici&#243;n fue el que peor evolucion&#243; atendiendo a la mortalidad y reingresos por cualquier causa &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;042&#59; <a class="elsevierStyleCrossRef" href="#fig0020">fig&#46; 4</a>&#41;&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Discusi&#243;n</span><p id="par0105" class="elsevierStylePara elsevierViewall">Nuestros resultados ponen en evidencia la influencia delet&#233;rea del binomio desnutrici&#243;n-sarcopenia sobre el pron&#243;stico de los pacientes con diabetes ingresados en planta de Medicina Interna&#46; La presencia de sarcopenia&#44; determinada mediante una baja puntuaci&#243;n de la dinamometr&#237;a &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;056&#41; o una puntaci&#243;n<span class="elsevierStyleHsp" style=""></span>&#62; 4 en el SARC-F &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;007&#41; v&#237;a inflamaci&#243;n &#40;IPA&#41; &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41; son los principales determinantes de mortalidad intrahospitalaria&#46; Estudios previos han demostrado una relaci&#243;n directa entre la mortalidad hospitalaria en pacientes desnutridos con tener una puntuaci&#243;n<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleUnderline">&#62;</span><span class="elsevierStyleHsp" style=""></span>4 en el test SARCF-F&#44; principalmente relacionado con la incapacidad para subir escaleras<a class="elsevierStyleCrossRefs" href="#bib0275"><span class="elsevierStyleSup">19&#44;24</span></a>&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">No encontramos diferencias en dicha mortalidad en t&#233;rminos de desnutrici&#243;n &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;29&#41;&#44; siendo asombrosamente menor en pacientes con DM2 desnutridos &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#59; <a class="elsevierStyleCrossRef" href="#fig0015">fig&#46; 3</a>&#41;&#46; Estos resultados podr&#237;an deberse al azar&#44; al tama&#241;o muestral o probablemente&#44; dadas las caracter&#237;sticas de este grupo&#44; con mayor comorbilidad y desnutrici&#243;n&#44; a que recibieran un soporte nutricional y una especial asistencia que los pacientes de otros grupos&#46; En relaci&#243;n con la probabilidad de supervivencia o reingreso a 120 d&#237;as&#44; el pron&#243;stico es claramente desfavorable en personas desnutridas &#40;grupos 3 y 6&#41;&#44; especialmente si coexiste la DM2 &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;042&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0020">fig&#46; 4</a>&#41;&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">La prevalencia de desnutrici&#243;n entre nuestros pacientes fue del 39&#44;5&#37;&#44; y del 39&#44;4&#37; en pacientes con y sin DM2 respectivamente&#46; Sanz Paris et al&#46;&#44; en un estudio multic&#233;ntrico observacional&#44; inform&#243; de una prevalencia del 39&#37; de riesgo nutricional y un 21&#37; de desnutrici&#243;n en adultos con diabetes hospitalizados<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">25</span></a>&#46; Adem&#225;s&#44; el estudio VIDA sobre 159 pacientes con DM2 de medicina interna&#44; detect&#243;&#44; mediante los criterios GLIM&#44; una prevalencia de desnutrici&#243;n moderada del 35&#44;8&#37; y severa del 16&#44;3&#37;&#44; asociada esta &#250;ltima a un aumento de la mortalidad a largo plazo &#40;OR 2&#44;09&#59; IC del 95&#37;&#44; 1&#44;29-3&#44;38&#41;&#44; como nuestros hallazgos&#44; en relaci&#243;n principalmente con una alb&#250;mina s&#233;rica disminuida<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">26</span></a>&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">La DRE&#44; como la DM2&#44; aboca a un deterioro tanto de la masa como de la funci&#243;n muscular&#44; mayor al esperado para la reducci&#243;n de la masa muscular&#44; especialmente a partir de los 60-70 a&#241;os&#44; en relaci&#243;n con la calidad muscular<a class="elsevierStyleCrossRefs" href="#bib0370"><span class="elsevierStyleSup">27&#44;28</span></a>&#46; Est&#225; en estrecha relaci&#243;n con la inflamaci&#243;n sist&#233;mica la resistencia a la insulina o la infiltraci&#243;n grasa del m&#250;sculo<a class="elsevierStyleCrossRefs" href="#bib0325"><span class="elsevierStyleSup">29&#44;30</span></a>&#46; En nuestro estudio&#44; el 79&#44;5&#37; de las personas con diabetes presentaban una baja fuerza muscular&#44; pero tambi&#233;n el 71&#44;3&#37; de los pacientes sin diabetes&#46; La evidencia disponible apoya la hip&#243;tesis a favor de medir la fuerza muscular en lugar de la cantidad total de masa muscular en los pacientes com&#243;rbidos&#44; como los ingresados en medicina interna&#44; tal como aconsejan los criterios GLIM y como muestran nuestros resultados<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">9&#44;19</span></a>&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">La puntuaci&#243;n de la dinamometr&#237;a tiene&#44; en la diabetes&#44; una relaci&#243;n significativa con la mortalidad&#44; con la enfermedad cardiovascular&#44; con otras comorbilidades y con las fluctuaciones en el control gluc&#233;mico<a class="elsevierStyleCrossRef" href="#bib0375"><span class="elsevierStyleSup">31</span></a>&#46; Por cada 10<span class="elsevierStyleHsp" style=""></span>kg de descenso en la fuerza muscular se asocia un aumento de riesgo de mortalidad a 30 y 180 d&#237;as<a class="elsevierStyleCrossRefs" href="#bib0340"><span class="elsevierStyleSup">32&#44;33</span></a>&#46; Diversos estudios observacionales han demostrado el efecto delet&#233;reo que la sarcopenia tiene en el pron&#243;stico&#44; en t&#233;rminos de morbimortalidad y reingresos&#44; de los pacientes con diabetes ingresados por diversas enfermedades<a class="elsevierStyleCrossRefs" href="#bib0350"><span class="elsevierStyleSup">34-36</span></a>&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Nuestros hallazgos&#44; aun siendo el estudio unic&#233;ntrico&#44; podr&#237;an extrapolarse al &#225;mbito de la Medicina Interna&#44; por la variedad de los pacientes incluidos&#44; fiel imagen de los ingresos habituales en las plantas de medicina interna&#44; y por la selecci&#243;n de los pacientes en 2<span class="elsevierStyleHsp" style=""></span>diferentes &#233;pocas del a&#241;o&#44; que evitan la tendencia estacional de determinadas enfermedades&#46;</p><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Limitaciones</span><p id="par0135" class="elsevierStylePara elsevierViewall">Este estudio tiene varias limitaciones&#46; En primer lugar&#44; es un estudio observacional y&#44; por tanto&#44; puede haber varias variables que no se controlen a priori&#46; Dado que este trabajo se basa en la pr&#225;ctica cl&#237;nica habitual&#44; no se dispone de datos sobre ning&#250;n tratamiento nutricional activo que pueda haber sido prescrito por el m&#233;dico ni durante el ingreso ni en la evoluci&#243;n&#46; Las medidas antropom&#233;tricas de algunos pacientes discapacitados se estimaron con base en una f&#243;rmula validada&#44; lo que puede subestimarlas&#46; Este estudio tambi&#233;n tiene varios puntos fuertes como la utilizaci&#243;n de herramientas de diagn&#243;stico validadas para determinar la desnutrici&#243;n y la sarcopenia&#46; Adem&#225;s&#44; el per&#237;odo de seguimiento de 120 d&#237;as fue lo suficientemente largo como para obtener resultados s&#243;lidos sobre el pron&#243;stico&#46;</p></span></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Conclusiones</span><p id="par0140" class="elsevierStylePara elsevierViewall">En personas con diabetes&#44; el binomio desnutrici&#243;n&#47;sarcopenia al ingreso se asoci&#243; con peores resultados a corto y largo plazo en pacientes ingresados en Medicina Interna&#46; Es especialmente relevante la asociaci&#243;n entre sarcopenia&#44; comorbilidad e inflamaci&#243;n en la mortalidad intrahospitalaria&#46; Los factores que m&#225;s influyeron en el pron&#243;stico a corto plazo fueron la presencia de sarcopenia medida por la puntuaci&#243;n SARC-F y por dinamometr&#237;a y la inflamaci&#243;n&#44; medida por el IPA&#46; A los 120 d&#237;as&#44; tanto la sarcopenia como la desnutrici&#243;n disminuyeron la probabilidad de supervivencia libre de reingresos&#46; Por tanto&#44; la identificaci&#243;n temprana y proactiva de la desnutrici&#243;n y&#44; sobre todo&#44; de la sarcopenia al momento del ingreso hospitalario&#44; son elementos importantes de la atenci&#243;n a los pacientes ingresados en medicina interna&#44; especialmente en este caso&#44; a los pacientes con diabetes&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Autor&#237;a</span><p id="par0145" class="elsevierStylePara elsevierViewall">Todos los autores conocen y aceptan los criterios del International Committee of Medical Journal Editors &#40;ICMJE&#41; para la autor&#237;a de este art&#237;culo&#44; y han revisado y aprobado esta versi&#243;n definitiva&#46;</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Financiaci&#243;n</span><p id="par0150" class="elsevierStylePara elsevierViewall">Este trabajo de investigaci&#243;n no ha recibido ninguna beca o fondo de investigaci&#243;n de agencias p&#250;blicas o privadas&#44; comerciales ni cualquier otro perfil&#46;</p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Conflicto de intereses</span><p id="par0155" class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
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    "fechaRecibido" => "2023-04-25"
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        "titulo" => "Resumen"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Describir los pacientes hospitalizados en medicina interna en t&#233;rminos de desnutrici&#243;n y sarcopenia&#44; en funci&#243;n de la presencia o no de diabetes mellitus tipo 2 &#40;DM2&#41;&#44; as&#237; como evaluar la mortalidad a corto y largo plazo relacionada con ambas&#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 de cohortes&#44; unic&#233;ntrico&#44; que recoge pacientes consecutivos ingresados en Medicina Interna en mayo y octubre del 2021&#46; La desnutrici&#243;n se determin&#243; mediante el Mini Nutritional Assessment-Short Form &#40;MNA-SF&#41; y la sarcopenia mediante SARC-F y dinamometr&#237;a&#46; Se excluy&#243; a los pacientes hospitalizados m&#225;s de 48 h&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se analiza a 511 pacientes&#44; 49&#44;1&#37; varones&#44; edad media de 75&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>15 a&#241;os&#44; 210 &#40;41&#44;1&#37;&#41; DM2&#46; Se generan 6 grupos &#40;dise&#241;o 2 &#215; 3&#41; en funci&#243;n de la presencia de DM2 y del estado nutricional acorde con el resultado del MNA-SF&#58; 12-14 puntos&#44; sin riesgo&#59; MNA-SF 8-12 puntos&#44; alto riesgo&#59; MNA-SF 0-7 puntos&#44; desnutridos&#46; Los pacientes con DM2 y desnutridos ten&#237;an significativamente mayor sarcopenia&#44; comorbilidad&#44; inflamaci&#243;n y &#250;lceras por presi&#243;n&#46; Los principales determinantes de mortalidad intrahospitalaria fueron la sarcopenia &#40;OR 1&#44;27&#44; IC del 95&#37;&#44; 1&#44;06-1&#44;54&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#44; la comorbilidad &#40;OR 1&#44;27&#44; IC del 95&#37;&#44; 1&#44;08-1&#44;49&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;003&#41; y la inflamaci&#243;n &#40;OR 1&#44;01&#44; IC del 95&#37;&#44; 1&#44;00-1&#44;02&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;02&#41;&#46; El pron&#243;stico a 120 d&#237;as fue peor entre los pacientes desnutridos &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;042&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusi&#243;n</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Los pacientes ingresados con DM2 presentan similar grado de desnutrici&#243;n que el resto&#44; pero con mayor sarcopenia&#46; Esta sarcopenia&#44; junto a la inflamaci&#243;n y la comorbilidad determinan un peor pron&#243;stico&#46; La identificaci&#243;n activa y temprana de la desnutrici&#243;n y la sarcopenia&#44; y su abordaje posterior podr&#237;an mejorar el pron&#243;stico de los pacientes&#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">To describe patients hospitalized in internal medicine in terms of malnutrition and sarcopenia&#44; depending on the presence or absence of type 2 diabetes mellitus &#40;DM2&#41;&#44; as well as to evaluate short- and long-term mortality related to both&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Cross-sectional&#44; single-center study&#44; which included consecutive patients admitted to internal medicine in May and October 2021&#46; Malnutrition was determined using the Mini Nutritional Assessment-Short Form &#40;MNA-SF&#41; and sarcopenia using SARC-F and handgrip strength&#46; Patients hospitalized for more than 48<span class="elsevierStyleHsp" style=""></span>h are excluded&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Five hundred and 11<span class="elsevierStyleHsp" style=""></span>patients were analyzed&#44; 49&#46;1&#37; male&#44; mean age 75&#46;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>15 years&#44; 210 &#40;41&#46;1&#37;&#41; DM2&#46; Six groups &#40;2<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>3 design&#41; are generated based on the presence of DM2 and the nutritional status according to the result of the MNA-SF&#58; 12&#8211;14 points&#44; without risk&#59; MNA-SF 8&#8211;12 points&#44; high risk&#59; MNA-SF 0&#8211;7 points&#44; malnourished&#46; Malnourished patients with DM2 had significantly higher sarcopenia&#44; comorbidity&#44; inflammation&#44; and pressure ulcers&#46; The main determinants of in-hospital mortality were sarcopenia &#40;OR 1&#46;27&#44; 95&#37; CI&#58; 1&#46;06&#8211;1&#46;54&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#41;&#44; comorbidity &#40;OR 1&#46;27&#44; 95&#37; CI&#58; 1&#46;08&#8211;1&#46;49&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;003&#41; and inflammation &#40;OR 1&#46;01&#44; 95&#37; CI&#58; 1&#46;00&#8211;1&#46;02&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;02&#41;&#46; The 120-day prognosis was worse among malnourished patients &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;042&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusion</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Patients admitted with DM2 have a similar degree of malnutrition than the rest&#44; but with greater sarcopenia&#46; This sarcopenia&#44; together with inflammation and comorbidity determine a worse prognosis&#46; The active and early identification of malnutrition and sarcopenia and their subsequent approach could improve the prognosis of patients&#46;</p></span>"
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          "leyenda" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Los datos se expresan como mediana<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>RIQ y media<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>SD&#46;</p><p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">La dinamometr&#237;a cuantificada es la referida a los valores de referencia&#44; 27 kg en varones y 16 kg en mujeres para el diagn&#243;stico de sarcopenia&#46;</p><p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">HbA1c&#58; hemoglobina glicosilada&#59; IMC&#58; &#237;ndice de masa corporal&#59; IPA&#58; &#237;ndice prote&#237;na C reactiva&#47;alb&#250;mina&#46;</p>"
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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">Variable&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">Grupo 1&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">Grupo 2&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">Grupo 3&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">Grupo 4&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">Grupo 5&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">Grupo 6&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">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">N&#46;&#176;&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">69&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">113&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">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">47&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&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&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">Edad &#40;a&#241;os&#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">74 &#40;12&#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">76&#44;5 &#40;20&#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">79 &#40;17&#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">76 &#40;17&#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">81 &#40;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">82 &#40;11&#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">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;00&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">Sexo &#40;hombre&#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">43 &#40;61&#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">49 &#40;43&#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">54 &#40;45&#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">30 &#40;63&#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">38 &#40;47&#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">38 &#40;45&#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">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">IMC &#40;kg&#47;m<span class="elsevierStyleSup">2</span>&#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">27 &#40;6&#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">24&#44;6 &#40;7&#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">22&#44;4 &#40;8&#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">28&#44;2 &#40;7&#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">26&#44;3 &#40;7&#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">22&#44;2 &#40;6&#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">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;00&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">Hipertensi&#243;n arterial&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">50 &#40;71&#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">63 &#40;56&#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">76 &#40;63&#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">43 &#40;91&#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">74 &#40;92&#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">72 &#40;86&#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">Dislipidemia&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">34 &#40;48&#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">45 &#40;40&#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">43 &#40;36&#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">40 &#40;85&#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">58 &#40;72&#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">60 &#40;72&#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&#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">Alcoholismo&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;15&#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">15 &#40;13&#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">5 &#40;4&#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">9 &#40;19&#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">6 &#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">6 &#40;7&#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">0&#44;01&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">Disfagia&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">3 &#40;4&#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">10 &#40;8&#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">16 &#40;13&#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">1 &#40;2&#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">5 &#40;6&#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">14 &#40;16&#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">0&#44;01&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">Insuficiencia cardiaca&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">14 &#40;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">24 &#40;21&#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">26 &#40;21&#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">23 &#40;48&#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">38 &#40;47&#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">18 &#40;21&#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">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">10 &#40;14&#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">26 &#40;23&#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">21 &#40;17&#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">17 &#40;36&#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">20 &#40;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
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23 &#40;27&#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;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">Enfermedad cerebrovascular&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">25 &#40;35&#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">27 &#40;24&#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">27 &#40;22&#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">28 &#40;59&#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">31 &#40;38&#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">32 &#40;38&#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;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">Neoplasia&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">15 &#40;21&#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">22 &#40;19&#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">28 &#40;23&#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">6 &#40;12&#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">15 &#40;18&#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">21 &#40;25&#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&#44;59&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">Vive en residencia&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;2&#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;8&#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">20 &#40;16&#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 &#40;2&#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">11 &#40;13&#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">23 &#40;27&#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">&#218;lcera por presi&#243;n&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;5&#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">10 &#40;8&#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">20 &#40;16&#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 &#40;2&#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">11 &#40;13&#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">23 &#40;27&#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">Sarcopenia&#40;SARC-F&#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">17 &#40;24&#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">51 &#40;45&#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">82 &#40;68&#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">18 &#40;38&#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">44 &#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">72 &#40;86&#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">Sarcopenia &#40;dinamometr&#237;a&#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">52 &#40;75&#44;4&#41;N<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>69&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;82&#44;2&#41;N<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>101&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">82 &#40;95&#44;3&#41;N<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>86&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">40 &#40;90&#44;0&#41;N<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>44&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">67 &#40;90&#44;5&#41;N<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>74&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">60 &#40;96&#44;8&#41;N<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>62&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">Dinamometr&#237;a cuantificada &#40;kg&#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
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                  \t\t\t\t">Transferrina &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Alb&#250;mina &#40;g&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Colesterol &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Prote&#237;na C reactiva &#40;mg&#47;l&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Hemoglobina &#40;g&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">HbA1c &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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