Pérez Durillo FT , et al - SÍNDROME METABÓLICO . ASOCIACIÓN ENTRE GLP-1 Y FACTORES DE RIESGO CARDIOVASCULAR
Key words
Metabolic syndrome , cardiovascular risk factors , glucagon-like peptide-1 , dipeptidyl peptidase-4 ( DPP4 ), mediterranean diet . activity were identified in males and females diagnosed with metabolic syndrome . Decreased plasma activity might be related to higher central obesity , greater cardiovascular risk factors , and unhealthy nutritional habits .
SUMMARY
Title : metabolic syndrome . The association between glucagon-like peptide-1 levels ( GLP-1 ) and cardiovascular risk factors .
Aims : analyze possible variations in blood plasma levels of GLP-1 and dipeptidyl peptidase-4 ( DPP4 ) activity in male and female patients with metabolic syndrome and compare them with patients unaffected by that syndrome . Study the possible association between those levels and patients ’ anthropometric and nutritional parameters , while also taking into account their glucose tolerance , lipoprotein levels , and cardiovascular risk factors .
Design : descriptive transversal study .
Setting : a rural health center with a population of over 18,200 according to the most recent census .
Population and sample : the population was divided into two groups between the ages of 50 and 65 : one group diagnosed with metabolic syndrome in accordance with the 2001 ATPIII guidelines and a second group unaffected by the syndrome .
Interventions : study anthropometric characteristics , nutritional habits , biochemical levels , hormones , peptides and plasma activity obtained through a blood sample .
Results : 46 subjects between 50 and 65 years of age , 21 of them were diagnosed with metabolic syndrome ( 10 male and 11 female ); the remaining 25 were unaffected by that syndrome ( 11 males and 14 females ). Postprandial levels of GLP-1 were higher among men with metabolic syndrome ( 53.6 ± 8.3 pg / ml ) than among women with the syndrome ( 48.4 ± 5.4 pg / ml ). In contrast , women who did not suffer from metabolic syndrome presented higher levels ( 68.0 ± 9.7 pg / ml ) than men ( 34.7 ± 4.2 pg / ml ). Patients of both genders diagnosed with metabolic syndrome presented loweraverage DPP4 activity levels :( 4857.0 ± 203.2 pmoles / ml among females and 4713.3 ± 171.7 pmoles / ml among males ) compared with patients unaffected by the syndrome ( 5807.6 ± 223.2 pmoles / ml in females and 5208.5 ± 239.5 pmoles / ml in males ). DPP4 activity proved to be negatively associated with the waist / hip index and the SCORE index ; it was positively associated with following a Mediterranean diet .
Conclusions : there were differences in GLP-1 levels for men and women unaffected by metabolic syndrome ; differences in the behavior of this peptide and DPP4
INTRODUCCIÓN
En España , más del 30 % de los fallecimientos se deben a las enfermedades cardiovasculares ( ECV ) 1 . Concretamente , las ECV han sido la responsables del 30,5 % de los fallecimientos producidos en España durante 2011 , lo que se traduce en un total de 118.327 fallecimientos . Entre las ECV , las de mayor prevalencia han sido las enfermedades cerebrovasculares y la cardiopatía isquémica ; las primeras , principal causa de muerte en mujeres y la segunda , en hombres . Concretamente , las patologías isquémicas del corazón ( infarto , angor pectoris , etc .) y las cerebrovasculares volvieron a ocupar el primer y segundo lugar en número de muertes , con 34.837 y 28.855 fallecidos respectivamente . No obstante , por sexos , solo en las mujeres la ECV es la primera causa de muerte ( en los varones es la segunda causa de muerte tras los tumores ), y por grupos específicos de edad , las ECV son la primera causa de muerte solo a partir de los 80 años de edad , situándose en segunda posición , detrás de los tumores , en personas de edades medias .
En el desarrollo de las ECV son múltiples los factores de riesgo y la asociación de éstos multiplica el riesgo cardiovascular global de los individuos en los que están presentes . En un estudio realizado por Marrugat 2 en atención primaria , un 31 % de los pacientes de 35-65 años que acuden a la consulta de atención primaria tienen dos factores de riesgo cardiovascular , y un 6 % tres factores de riesgo cardiovascular , considerando la HTA , la hipercolesterolemia y el tabaquismo 3 . Esta prevalencia es incluso más importante en individuos que han presentado algún evento cardiovascular 2 .
El síndrome metabólico se caracteriza por la presencia de resistencia a la insulina e hiperinsulinismo compensador junto a trastornos del metabolismo hidrocarbonado , elevación de las cifras de presión arterial , alteraciones lipídicas ( incremento de triglicéridos plasmáticos , de co-
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