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BACKGROUND: Metabolic syndrome (MS) is one of the conditions that increase the risk of developing cardiovascular diseases (CVD) and type-2 diabetes in the early future if it appears during childhood or adolescence. The purpose of the study to compare the MS prevalence of MS estimated in a representative sample of school-age population in Bucaramanga, Colombia, and the MS prevalence estimated in a subsample from the same population in the adolescent stage. METHODS: An analytical cross-sectional survey (in the adolescent stage) (n=494) was carried out, nested in a population-based cohort assembled when children were of school age (n=1,282). Selection employed a bi-stage randomized sampling per neighborhoods and houses across the city. Sociodemographic and anthropometric variables, as well as cardiometabolic factors were analyzed in accordance with their distribution, and statistical significance tests were applied according to each case. MS was determined using the Adult Treatment Panel III (ATP III) and International Diabetes Federation (IDF) criteria. RESULTS: Estimated MS prevalence in school age according to the ATP III criteria was 9.5% (95% CI: 8.0-11.3%) and according to the IDF criteria it was 8.0% (95% CI: 6.6-9.7%). At the time of follow up the prevalence of MS was 13.2% and 14.8% according to the ATP III and IDF criteria, respectively. CONCLUSIONS: MS prevalence of MS increased in 4% from the school age (9.5%) to the adolescence (13.1%).

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OBJECTIVE: To compare BMI with abdominal skinfold thickness (ASF), waist circumference and waist-to-height ratio in the prediction of insulin resistance (IR) in prepubertal Colombian children. DESIGN: We calculated age- and sex-specific Z-scores for BMI, ASF, waist circumference, waist-to-height ratio and three other skinfold-thickness sites. Logistic regression with stepwise selection (P = 0·80 for entry and P = 0·05 for retention) was performed to identify predictors of IR and extreme IR, which were determined by age- and sex-specific Z-scores to identify the ≥ 90th and ≥ 95th percentile of homeostasis model assessment (HOMAIR), respectively. We used receiver operating characteristic curves to compare the area under the curve between models. SETTING: Bucaramanga, Colombia. SUBJECTS: Children (n 1261) aged 6-10 years in Tanner stage 1 from a population-based study. RESULTS: A total of 127 children (seventy girls and fifty-seven boys) were classified with IR, including sixty-three children (thirty-three girls and thirty boys) classified with extreme IR. Only ASF and BMI Z-scores were retained as predictors of IR by stepwise selection. Adding ASF Z-score to BMI Z-score improved the area under the curve from 0·794 (95 % CI 0·752, 0·837) to 0·811 (95 % CI 0·770, 0·851; P for contrast = 0·01). In predicting extreme IR, the addition of ASF Z-score to BMI Z-score improved the area under the curve from 0·837 (95 % CI 0·790, 0·884) to 0·864 (95 % CI 0·823, 0·905; P for contrast = 0·01). CONCLUSIONS: ASF Z-score predicted IR independent of BMI Z-score in our population of prepubertal children. ASF and BMI Z-scores together improved IR risk stratification compared with BMI Z-score alone, opening new perspectives in the prediction of cardiometabolic risk in prepubertal children.

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BACKGROUND: Obesity and metabolic syndrome are strongly associated with type 2 diabetes mellitus and cardiovascular diseases, thus the increasing trend in their prevalence among children and adolescents from developing countries requires a further understanding of their epidemiology and determinants. METHODS AND DESIGN: A cross-sectional study was designed to determine the prevalence of metabolic syndrome among 6-10 year-old children from Bucaramanga, Colombia. A two-stage random-cluster (neighborhoods, houses) sampling process was performed based on local city maps and local statistics. The study involves a domiciliary survey; including a comprehensive socio-demographic, nutritional and physical activity characterization of the children that participated in the study, followed by a complete clinical examination; including blood pressure, anthropometry, lipid profile determination, fasting glucose and insulin levels. The prevalence of metabolic syndrome will be determined using definitions and specific percentile cut-off points for this population. Finally, the association between components of metabolic syndrome and higher degrees of insulin resistance will be analyzed through a multivariable logistic regression model. This study protocol was designed in compliance with the Helsinki declaration and approved by the local ethics board. Consent was obtained from the children and their parents/guardians. DISCUSSION: A complete description of the environmental and non-environmental factors underlying the burden of metabolic syndrome in children from a developing country like Colombia will provide policy makers, health care providers and educators from similar settings with an opportunity to guide primary and secondary preventive initiatives at both individual and community levels. Moreover, this description may give an insight into the pathophysiological mechanisms mediating the development of cardio-metabolic diseases early in life.

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BACKGROUND AND AIM: Currently, more than 30% of the caloric intake in the Colombian population comes from vegetable oil consumption mainly by the ingestion of deep-fried foods. Recently, it has been reported that unsaturated fatty acid rich oils have a beneficial effect on the endothelial function. Nevertheless, it is well know that the deep-frying process alters the chemical composition of vegetable oils and can produce adverse effects in the endothelial function. OBJECTIVE: To evaluate the acute effect of the ingestion of large amounts of olive, soybean and palm oils, fresh and at two different deep-fry levels, on the glucose and lipid profiles and the endothelial function. METHODS AND RESULTS: Ten healthy young volunteers were included in the study. After performing a baseline evaluation of cardiovascular risk factors and drawing a fasting blood sample, subjects were exposed to a randomly assigned potato soup meal containing 60 mL of one of three different vegetable oils (olive, soybean and palm), either fresh or at one of two different deep-fry levels (10 and 20 fries, respectively). Flow-mediated vasodilation (FMD) was performed in fasting conditions and 3h after the intake of the oil rich meal. Furthermore, blood samples were taken at these stages for the lipid profiles and plasma glucose determinations. All the meals resulted in a similar acute endothelial impairment (FMD decrease of 32.1%, confidence interval [CI] 95%, 28.0-36.2) and postprandial increase in triglycerides (27.03%, CI 95%, 20.5-33.3), independently of the type of oil ingested (p=0.44) and regardless of its deep-fry level (p=0.62). No correlation was found between endothelial impairment and postprandial triglyceride increment (r=-0.22, p=0.09). CONCLUSIONS: No difference was found in the acute adverse effect of the ingestion of different vegetable oils on the endothelial function. All the vegetable oils, fresh and deep-fried, produced an increase in the triglyceride plasma levels in healthy subjects.

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Antecedentes: desde el 2004, el Área de Investigación en Pediatría de la Fundación Cardiovascular de Colombia, ha desarrollado la línea de investigación: factores de riesgo cardiovascular en la infancia, a través del planteamiento de un modelo clínico investigativo. Objetivo: describir la experiencia de la Fundación Cardiovascular de Colombia en el desarrollo de actividades clínico-investigativas orientadas al estudio y la prevención primaria de las enfermedades cardiovasculares. Método: no aplica.Resultados: no aplican.Conclusiones: a partir de este modelo se han desarrollado diversas actividades de investigación encaminadas a la cuantificación de la magnitud del problema que representan estos factores de riesgo en la población pediátrica de Bucaramanga, pasando de estudios de tamizaje a estudios de carácter poblacional, y derivando de sus resultados la creación de programas clínicos y comunitarios enfocados a la sensibilización de la población general y a la prevención e intervención oportuna de las enfermedades cardiovasculares.

Antecedents: since 2004, the Pediatric Area of Research from the Colombian Cardiovascular Foundation has developed the investigation line: cardiovascular risk factors in infancy, through a clinical-investigative model. Objective: to describe the Colombian Cardiovascular Foundation experience in the development of clinical-investigative activities oriented to the study and primary prevention of cardiovascular diseases. Method: does not apply. Results: do not apply. Conclusions: several investigative activities have been developed based on this model, tending to quantify the magnitude of the problem represented by these risk factors in the pediatric population of Bucaramanga, passing from screening studies to population-based studies, allowing by its results the creation of clinical and communitarian programs focused in the awareness of the general population and the prevention and opportune intervention of cardiovascular diseases.

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Antecedentes. La presencia de diabetes mellitus tipo II (DM2) está asociada a un incremento del riesgo de presentar enfermedad coronaria de dos a cuatro veces con respecto a sujetos no diabéticos. Recientemente la Asociación Americana de Diabetes definió la DM2 con una glicemia 126 mg/dl debido al alto riesgo de presentar microvasculopatía en estos niveles. Sin embargo, los niveles de glicemia en ayunas alterada (100 mg/dl y <126 mg/dl) han estado asociados a un riesgo aumentado de mortalidad y morbilidad por enfermedad cardiovascular. El presente estudio evalúa la relación entre la glicemia en ayunas alterada y la presencia de enfermedad aterosclerótica coronaria establecida por angiografía coronaria. Métodos. Estudio de casos y controles que incluyen pacientes que ingresan al servicio de hemodinamia para la realización de angiografía coronaria electiva para el estudio de dolor torácico. Se consideró enfermedad coronaria a los pacientes con 30 porciento de oclusión en una coronaria principal o 50 porciento de oclusión en una coronaria secundaria. A todos los pacientes se les tomó historia clínica completa, medidas antropométricas y muestras sanguíneas en ayunas para determinaciones bioquímicas. Resultados. Se incluyeron 141 pacientes, 64 casos y 77 controles, 69 mujeres (48.9 porciento) y 72 hombres (51.1 porciento). Los casos fueron más viejos (64.1 años ± 8.6 vs 58.5 años ± 10.4, p= 0.0016), presentaron una mayor presión arterial sistólica (130.5 mmHg ± 20.9 vs 130.0 mmHg ± 18.4, p=0.0283), mayor perímetro abdominal (91.5 cm ± 10.7 vs. 86.2 cm ± 12.9, p=0.005) y relación cintura cadera (0.94 ± 0.122 vs. 0.91 ± 0.142, p= 0.016). La glicemia en ayunas fue mayor en los casos (112.0 mg/dl ± 38.35 vs. 96.0 mg/dl ± 25.0, p= 0.0003). En el modelo de regresión logística una glicemia mayor a 100 mg/dl fue el único factor de riesgo que de manera independiente se asoció a enfermedad coronaria. Conclusión. En la población colombiana la glicemia en ayunas alterada (>10...

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