Gaceta Médica Boliviana
Print version ISSN 1012-2966
GUZMAN DUCHEN, Héctor and GRAGEDA RICALDI, José A.. SINDROME METABOLICO EN DOS CONSULTORIOS DE MEDICINA FAMILIAR, POLICLINICO 32, CAJA NACIONAL DE SALUD, COCHABAMBA. Gac Med Bol [online]. 2007, vol.30, n.2, pp. 18-26. ISSN 1012-2966.
The metabolic syndrome is associate with obesity, arterial hypertension, diabetes mellitus and alterations of the lipidie profile. It has as the resistance to the involved insulin bases fisiopatologhy on these comorbidities by several metabolic routes; this alteration is expressed by genetic characteristics and, more and more, environmental factors. The Adult Treatment Panel (ATP III) of the National Cholesterol Education Program has defined the criteria diagnoses, of easy application, that associated to markers of resistance to the insulin, constitute an effective tool for the tamizaje of carríers of this syndrome. Its handling is multifactorial, with base in the modification of the life style that implies changes in the nourishing habits, toxic suppression, regular physical activity and drugs for the comorbidities. In two Familiar Medicine doctor's offices of Policlinico 32 of the National Box of Cochabamba Health, the tamizaje of carríers of metabolic syndrome between June of 2006 and August of 2007 was made; 174 patients correspond to the syndrome, with frank predominance of women and greater groups to the 45 years; in each patient weight was registered, arterial pressure, circumference of the waist; in laboratory glicemia was dosed, lipidic profile, basal insulin, microalbuminury and PCR. To each patient poor diet in calones was indicated, recommended long walk of 30 minutes 3 times to the week; in diabetes it was prescribed metformina and in arterial, enalapril hypertension, in addition to estatinas or gemfibrozilo in dislipidemias. More most frequently found comorbidity is the obesity, followed of hiperinsulinism and reduction of cholesterol HDL. The personal antecedents are related to sedentarism and the relatives with visceroportal obesity; whereas in laboratory the finding but frequents is the hiperínsulinismo, followed of cHDL low. The cardiovascular risk according to lists of Framingham, is present in almost all the studied cases, which justifies the tamizaje and integral handling of the syndrome. The results to the year of the integral handling show a reduction of weight, that statistically is significant, with remarkable reductions of insulinemia. The first level of attention in health is constituted in an excellent opportunity for the integral handling of patients with metabolic syndrome, making emphasis in the modification of the life style as it bases.
Keywords : resistance to the insulin; diabetes; hyper-tension trigliceridos; cholesterol HDL; style of life; cardiovascular risk.