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Introducción: La resistencia a la insulina (RI) es una de las principales causas del desarrollo de patologías crónicas. Es indispensable su detección temprana, por ello es importante estudiar métodos más asequibles y menos costosos como los biomarcadores. Objetivo: Determinar la precisión diagnóstica de once biomarcadores para RI en una muestra de pobladores peruanos. Metodología: Estudio de pruebas diagnósticas. Análisis de base de datos secundario del estudio PERU MIGRANT. Para medir RI se utilizó como referencia la evaluación del modelo homeostático (HOMA-IR) ≥ 2,8. Los biomarcadores se basaron en la ratio de lípidos, los indicadores de lípido visceral, los indicadores con triglicéridos y glucosa (TyG), y los indicadores con cintura abdominal. Para la precisión se utilizó el análisis de la curva de características operativas del receptor y el área bajo la curva (AUC) con sus respectivos intervalos de confianza al 95% (IC95%). Resultados: Se estudió a 938 participantes. La prevalencia de RI fue del 9,91%. En relación con el análisis ROC, el índice TyG - índice de masa corporal (TyG - IMC) tuvo el mayor AUC, tanto en hombres: AUC=0,85 (0,81 - 0,90), corte=241,55; sens=92,5 (79,6 - 98,4) y esp=78,3 (73,9 - 82,2); como en mujeres: AUC=0,81 (0,76 - 0,85), corte=258,77; sens=79,2 (70,3 - 86,5) y esp= 82,1 (78,0 - 85,8). Discusión: Según los datos analizados, el índice TyG-IMC es el mejor indicador para medir RI. Es un índice simple que se puede tomar de manera rutinaria en la práctica clínica diaria. Es conveniente añadir futuros estudios prospectivos que confirmen su capacidad predictiva.
Introduction: Insulin resistance (IR) is one of the main causes of chronic disease. Early detection is essential, which is why it is important to study more affordable and less expensive methods, such as biomarkers. Objective: To determine the diagnostic accuracy of 11 biomarkers of IR in a sample of Peruvian residents. Method: diagnostic tests. Secondary Database Analysis of the PERU-MIGRANT Study. To measure RI, a homeostatic model evaluation (HOMA-IR) ≥ 2.8 was used as a reference. Biomarkers were based on the lipid ratio, visceral lipid indicators, indicators of triglycerides and glucose (TyG), and indicators of abdominal waist. For precision, the receiver operating characteristic curve and area under the curve (AUC) with their respective 95% confidence intervals (95%CI) were used. Results: A total of 938 participants were studied. The prevalence of IR was 9.91%. In relation to the ROC analysis, the TyG index - body mass index (TyG - BMI) had the highest AUC, both in men: AUC=0.85 (0.81 - 0.90), cut-off=241.55; sens=92.5 (79.6 - 98.4) and sp=78.3 (73.9 - 82.2); as in women: AUC=0.81 (0.76 - 0.85), cut-off=258.77; sens=79.2 (70.3 - 86.5) and esp= 82.1 (78.0 - 85.8). Discussion: According to the data analyzed, the TyG-IMC index is the best indicator for measuring IR. It is a simple index that can be routinely used in clinical practice. Future prospective studies are needed to confirm its predictive capacity.
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Due to the increase in obesity worldwide, international organizations have promoted the adoption of a healthy lifestyle, as part of which fruit consumption stands out. However, there are controversies regarding the role of fruit consumption in mitigating this disease. The objective of the present study was to analyze the association between fruit intake and body mass index (BMI) and waist circumference (WC) in a representative sample of Peruvians. This is an analytical cross-sectional study. Secondary data analysis was conducted using information from the Demographic and Health Survey of Peru (2019-2021). The outcome variables were BMI and WC. The exploratory variable was fruit intake, which was expressed in three different presentations: portion, salad, and juice. A generalized linear model of the Gaussian family and identity link function were performed to obtain the crude and adjusted beta coefficients. A total of 98,741 subjects were included in the study. Females comprised 54.4% of the sample. In the multivariate analysis, for each serving of fruit intake, the BMI decreased by 0.15 kg/m2 (ß = -0.15; 95% CI -0.24 to -0.07), while the WC was reduced by 0.40 cm (ß = -0.40; 95% CI -0.52 to -0.27). A negative association between fruit salad intake and WC was found (ß = -0.28; 95% CI -0.56 to -0.01). No statistically significant association between fruit salad intake and BMI was found. In the case of fruit juice, for each glass of juice consumed, the BMI increased by 0.27 kg/m2 (ß = 0.27; 95% CI 0.14 to 0.40), while the WC increased by 0.40 cm (ß = 0.40; 95% CI 0.20 to 0.60). Fruit intake per serving is negatively related to general body adiposity and central fat distribution, while fruit salad intake is negatively related to central distribution adiposity. However, the consumption of fruit in the form of juices is positively associated with a significant increase in BMI and WC.
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Adiposidad , Frutas , Femenino , Humanos , Masculino , Estudios Transversales , Perú , Obesidad , Índice de Masa Corporal , Circunferencia de la Cintura , Obesidad AbdominalRESUMEN
INTRODUCTION: Obesity and depression contribute to the global burden of economic cost, morbidity, and mortality. Nevertheless, not all people with obesity develop depression. OBJECTIVE: To determine the factors associated with depressive symptoms among people aged 15 or older with obesity from the National Demographic and Family Health Survey (ENDES in Spanish 2019-2021). METHODS: Cross-sectional analytical study. The outcome of interest was the presence of depressive symptoms, assessed using the Patient Health Questionnaire-9 (PHQ-9). Crude (cPR) and adjusted (aPR) prevalence ratios were estimated using GLM Poisson distribution with robust variance estimates. RESULTS: The prevalence of depression symptoms was 6.97%. In the multivariate analysis, a statistically significant association was found between depressive symptoms and female sex (PRa: 2.59; 95% CI 1.95-3.43); mountain region (PRa: 1.51; 95% CI 1.18-1.92); wealth index poor (PRa: 1.37; 95% CI 1.05-1.79, medium (PRa: 1.49; 95% CI 1.11-2.02), and rich (PRa: 1.65; 95% CI 1.21-2.26); daily tobacco use (PRa: 2.05, 95% CI 1.09-3.87); physical disability (PRa: 1.96, 95% CI 1.07-3.57); and a history of arterial hypertension (PRa: 2.05; 95% CI 1.63-2.55). CONCLUSION: There are several sociodemographic factors (such as being female and living in the Andean region) and individual factors (daily use of tobacco and history of hypertension) associated with depressive symptoms in Peruvian inhabitants aged 15 or older with obesity. In this study, the COVID-19 pandemic was associated with an increase in depressive symptoms.
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COVID-19 , Hipertensión , Humanos , Femenino , Masculino , Depresión/diagnóstico , Perú/epidemiología , Estudios Transversales , Pandemias , COVID-19/epidemiología , Obesidad/epidemiología , Hipertensión/epidemiología , Encuestas y Cuestionarios , PrevalenciaRESUMEN
Las enfermedades asociadas a la atención en el sector salud es una problemática que no solo implica a los pacientes que ingresan al servicio, si no al personal y a los estudiantes que llevan a cabo sus prácticas en las diferentes instituciones. Las infecciones intrahospitalarias están definidas como: "Enfermedades localizadas o sistémicas que resultan de una reacción adversa consecuente a la exposición a un agente infeccioso o a sus toxinas, sin evidencia que la infección estuviera presente o en periodo de incubación en el momento de la atención" . La falta de conocimientos por parte del personal y estudiantes de las ciencias de la salud que están en contacto con los pacientes, además de la realización de prácticas sanitarias sin tomar en cuenta las medidas de bioseguridad pertinentes son los principales motivos para contraer una infección nosocomial.
The diseases associated with care in the health sector is a problem that not only involves patients who enter the service, but also the staff and students who carry out their practices in the different institutions. In-hospital infections are defined as: "Localized or systemic diseases resulting from an adverse reaction resulting from exposure to an infectious agent or its toxins, with no evidence that the infection was present or in the incubation period at the time of care." The lack of knowledge on the part of the personnel and students of the health sciences that are in contact with the patients, in addition to the realization of sanitary practices without taking into account the pertinent biosecurity measures are the main reasons for contracting a nosocomial infection.
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Introducción: Evaluar lLa validez y fiabilidad de un instrumento adaptado al Perú para medir la pre-sencia del Síndrome de Burnout en estudiantes universitarios de la carrera de Medicina Humana en la Universidad Ricardo Palma, tomando como punto de partida el Inventa-rio de Burnout de Maslach - Student Survey (MBI-SS). Métodos: Estudio transversal analítico, con nivel de investigación aplicativo. Se evaluó la validez por análisis de estructura factorial con el método de componentes principales, se apli-caron las pruebas de Kaiser-Meyer Olkin y la rotación Varimax; la confiabilidad por el valor alfa de Cronbach. Resultados: Fueron incluidos 223 estudiantes de la Facultad de Medicina Humana de la Universidad Ricardo Palma, en el periodo noviembre a diciembre del año 2016. La prevalencia de Burnout académico encontrada fue 28,25% (63); La prueba de adecuación de Kaiser-Meyer Olkin tuvo un resultado de 0.813 y la prueba de esfericidad de Barlett de 1007.5 (p<0.000). Se calculó la varianza acumulada explicada por 3 factores fue de 55.4%. El instrumento obtuvo un coeficiente Alfa de Cronbach= 0,794, con correlaciones entre los ítems, Agotamiento Emocional (α= ,855), Cinismo (α=0,623) y Eficacia Académica (α= 0,744). Conclusión: El instrumento adaptado y validado reúne las propiedades psicométricas para ser con-siderado un instrumento útil y fiable inicialmente en estudiantes de medicina humana de la Universidad Ricardo Palma, presentando una adecuada estructura factorial y consis-tencia interna para la determinación del nivel de Síndrome de Burnout Académico.
Introduction: Evaluate the validity and reliability of an instrument adapted to Peru to measure the presence of Burnout Syndrome in university students of the Human Medicine career at the Ricardo Palma University, taking as starting point the Burnout Inventory of Maslach - Student Survey (MBI-SS). Methods: Cross-sectional analytical study, with level of application research. Validity was evaluat-ed by factorial structure analysis with the principal components method, Kaiser-Meyer Olkin tests and Varimax rotation were applied; the reliability by the Cronbach alpha val-ue. Results: 223 students from the Faculty of Human Medicine of the Ricardo Palma University were included, from November to December 2016. The prevalence of academic Burn-out found was 28.25% (63); The Kaiser-Meyer Olkin fitness test had a result of 0.813 and Barlett's sphericity test of 1007.5 (p <0.000). The cumulative variance explained by 3 factors was calculated to be 55.4%. The instrument obtained a Cronbach's Alpha co-efficient = 0.794, with correlations between the items, Emotional Exhaustion (α =, 855), Cynicism (α = 0.623) and Academic Efficiency (α = 0.744). Conclusion: The adapted and validated instrument gathers the psychometric properties to be con-sidered a useful and reliable instrument initially in human medicine students of the Ri-cardo Palma University, presenting an adequate factorial structure and internal con-sistency to determine the level of Academic Burnout Syndrome.