National Survey Of Risk Factors Research Articles

The burden of premature coronary heart disease among adults with low socioeconomic status in Argentina: A modeling study.

The well-established inverse relationship between socioeconomic status (SES) and risk of developing coronary heart disease (CHD) cannot be explained solely by differences in traditional risk factors. To model the role SES plays in the burden of premature CHD in Argentina. We used the Cardiovascular Disease Policy Model-Argentina to project incident CHD events and mortality in low and high-SES Argentinean adults 35 to 64 years of age from 2015 to 2024. Using data from the 2018 National Risk Factor Survey, we defined low SES as not finishing high-school and/or reporting a household income in quintiles 1 or 2. We designed simulations to apportion CHD outcomes in low SES adults to: (1) differences in the prevalence of traditional risk factors between low and high SES adults; (2) nontraditional risk associated with low SES status; (3) preventable events if risk factors were improved to ideal levels; and (4) underlying age- and sex-based risk. 56% of Argentina´s 35- to 64-year-old population has low SES. Both high and low SES groups have poor control of traditional risk factors. Compared with high SES population, low SES population had nearly 2-fold higher rates of incident CHD and CHD deaths per 10 000 person-years (incident CHD: men 80.8 [95%CI 76.6-84.9] vs 42.9 [95%CI 37.4-48.1], women 39.0 [95%CI 36.-41.2] vs 18.6 [95%CI 16.3-20.9]; CHD deaths: men 10.0 [95%CI 9.5-10.5] vs 6.0 [95%CI 5.6-6.4], women 3.2 [95%CI 3.0-3.4] vs 1.8 [95%CI 1.7-1.9]). Nontraditional low SES risk accounts for 73.5% and 70.4% of the event rate gap between SES levels for incident CHD and CHD mortality rates, respectively. CHD prevention policies in Argentina should address contextual aspects linked to SES, such as access to education or healthcare, and should also aim to implement known clinical strategies to achieve better control of CHD risk factors in all socioeconomic levels.

Encuesta de factores de riesgo de enfermedades crónicas no transmisibles en la Universidad Nacional de La Matanza, Argentina. Año 2019

Chronic noncommunicable diseases (NCDs) account for leading causes of death in Argentina and early identification of their risk factors (RF) is key to prevention. A cross-sectional study was performed, using a self-reported survey adapted from the “National survey of risk factors”, to describe risk factors and their association with sociodemographic characteristics. A total of 130 students participated; 6.9% identified their health as "fair” and 48.5% referred some degree of anxiety or depression, 26.2% reported a low level of physical activity and almost all respondents ate less than 5 fruits or vegetables per day, 6.2% were smokers and 38.5% were exposed to tobacco smoke. The prevalence of overweight and obesity was 23.2% and 6.4% respectively. Occasional high cholesterol and blood pressure were reported by 20.4% and 16.8% of respondents, respectively. The university is an ideal setting for activities aimed at the promotion and prevention of these RF.

Missed Cystic Fibrosis Newborn Screening Cases due to Immunoreactive Trypsinogen Levels below Program Cutoffs: A National Survey of Risk Factors.

Testing immunoreactive trypsinogen (IRT) is the first step in cystic fibrosis (CF) newborn screening. While high IRT is associated with CF, some cases are missed. This survey aimed to find factors associated with missed CF cases due to IRT levels below program cutoffs. Twenty-nine states responded to a U.S-wide survey and 13 supplied program-related data for low IRT false screen negative cases (CFFN) and CF true screen positive cases (CFTP) for analysis. Rates of missed CF cases and odds ratios were derived for each factor in CFFNs, and two CFFN subgroups, IRT above ("high") and below ("low") the CFFN median (39 ng/mL) compared to CFTPs for this entire sample set. Factors associated with "high" CFFN subgroup were Black race, higher IRT cutoff, fixed IRT cutoff, genotypes without two known CF-causing variants, and meconium ileus. Factors associated with "low" CFFN subgroup were older age at specimen collection, Saturday birth, hotter season of newborn dried blood spot collection, maximum ≥ 3 days laboratories could be closed, preterm birth, and formula feeding newborns. Lowering IRT cutoffs may reduce "high" IRT CFFNs. Addressing hospital and laboratory factors (like training staff in collection of blood spots, using insulated containers during transport and reducing consecutive days screening laboratories are closed) may reduce "low" IRT CFFNs.

Contemporary and dynamic effects of socio-economic factors on physical (in)activity: Does intensity matter?

ObjectiveThis paper identifies varying contemporary and dynamic effects of socio-economic factors on individuals' decisions to allocate their time to physical activities when the intensity of these activities comes into play.MethodsBased on repeated cross-sectional data sourced from the Argentinean National Risk Factor Surveys of 2005, 2009, and 2013, we developed 18 fictitious cohorts to set up a pseudo panel. To address endogeneity problems, four econometric specifications were estimated: OLS, Heckman two-stage model, fixed- and random-effects models.ResultsWe find that changes in the opportunity cost of time are highly significant and provide shifts in individuals' decisions regarding the allocation of their time to physical activity consumption. When considering the intensity at which physical activities are consumed, increased income impacts less, suggesting that individuals faced with a wage increase reduce the time of consumption but increase its intensity. An interesting finding is that employed people consume more physical activity than inactive individuals. This indicates that the substitution effect produced by an increase in the wage rate is less than the income effect. Additionally, the increase in the coefficient of employed persons is greater when the intensity factor is considered, indicating that for employed individuals a trade-off between time and intensity is generated. We also found that higher levels of education increase the probability of participating in physical activities, but decrease the time spent in such activities. Furthermore, there are heterogeneous impacts on physical activity consumption between males and females, which can be observed in the strong effect of household production for women with at least one child. Finally, such impacts remain in a variety of estimated specifications.ConclusionsThese results may be useful in order to suggest some tools for the design of interventions that are aimed at increasing participation in physical activities.

Socioeconomic Inequalities in the Prevalence of Diabetes in Argentina: A Repeated Cross-Sectional Study in Urban Women and Men.

This study measured the socioeconomic inequalities in the prevalence of diabetes between 2005 and 2018 in an urban Argentinian population. Data were obtained from the repeated cross-sectional surveys “National Survey of Risk Factors” (ENFR is its acronym in Spanish). From 2005 to 2018, four rounds of ENFR were administered to men and women over 18 years of age. Concentration curves (CC) and the Erreygers concentration index (ECI) were used to describe the socioeconomic inequalities in diabetes’ prevalence. A decomposition analysis was performed to determine the contribution of each variable to inequality in diabetes’ prevalence. Data from 41,219 (2005), 34,583 (2009), 32,232 (2013), and 29,094 (2018) individuals were analyzed. Women reported a greater prevalence of diabetes compared with men for all the years included. According to the CC and ECI, we found no evidence of inequality in men throughout all study years. For women, throughout all years, the CCs were above the line of equity, and the ECIs during all the years were negative and different from zero (p < 0.01). For women, we found no evidence of a reduction in inequalities between 2005 and 2018 (p = 0.475). The socioeconomic inequality for women was largely driven by public insurance, primary and secondary education, and employment. Diabetes’ prevalence was not associated with socioeconomic status in men, while the prevalence of diabetes in women was more concentrated among poorer women. During the 13 years, there was no evidence of a reduction of inequality in women, noting that interventions must prioritize and should focus on the main contribution of inequalities, such as education and employment.

Estimating life expectancy free of anxiety/depression in Argentina: trends and decomposition of demographic change, 2005-2018

This study presents estimates of life expectancy free of anxiety/depression (a health expectancy) for the adult population in Argentina and observes its evolution during the 2005-2018 period. Given that life expectancy and health expectancy are strongly correlated indicators, we decomposed the change of the latter over time to establish not only which component causes its variation, but also which age groups contributed the most to this change. We analyzed cross-sectional data of the presence of anxiety/depression symptoms using multiple waves (2005, 2009, 2013 and 2018) of the Argentine National Risk Factor Survey (ENFR) and computed a series of anxiety/depression free life expectancies (conditional on those who reached age 20), by using the Sullivan method. Later we applied a stepwise algorithm decomposition technique to determine if the change in the health expectancy was due to a mortality change or a morbidity change. We obtained that the health expectancies increased between 2005 and 2013, and decreased for 2013-2018. This variation was larger for females, where a change in morbidity was responsible for almost all improvements before 2013. The decomposition also suggested that the net impact on morbidity would be larger if not for an increase in overall life expectancy between 2013-2018, with a one-year decline in health expectancy for males and 1.7 years for females, driven mainly by the younger age groups. It is not clear yet if such negative change is transitory or the beginning of a new trend in mental health for the Argentinian population.

PESQUISA DE HÁBITOS ALIMENTARIOS Y FACTORES DE RIESGO CARDIOVASCULARES EN ADULTOS EN ISLA SANTIAGO, BUENOS AIRES

Introduction: There is evidence about the close relationship between chronic non-communicable diseases, eating habits and physical activity. Based on the results of the 4th National Survey of Risk Factors (ENFR), an island territory in the province of Buenos Aires was sought where it was assumed that the way of life could have a positive influence. Objectives: to analyze the frequency of habits, the frequency of chronic pathologies and the relationship between them; assuming that a lifestyle away from the big cities would lead to healthier habits, and with it, better health indicators. Material and methods: Prevalence study. A house-to-house survey of 42 homes on Santiago Island, where a survey and physical examination were applied, which included: anthropometric measurements, blood pressure, and capillary blood glucose. Results: Most of the dwellings (71.4%) had fruit trees or orchards in their homes at the time of data collection. However, when making the comparison with the 4th ENFR, the results showed that it was a population in which physical inactivity, poor diet and problematic consumption of alcohol and tobacco exceeded the national average. Chronic diseases resulted in a trend similar to the national one. Conclusions: Although accessibility to resources should be considered an important element, this characteristic is added to87 others due to associated factors such as sociocultural, advertising and aspects of health education. The importance of working deeply on population habits is highlighted, as well as emphasizing the need to implement efficient educational programs with a local perspective. Key words: Cardiovascular risk factors; chronic non-communicable diseases; nutritional habits.

Estimates of major non-communicable disease risk factors for India, 2010 & 2015: A summary of evidence.

The National Monitoring Framework for the prevention and control of NCDs in India has set targets for reduction of risk factors relative to the measure recorded in 2010. Estimates for 2010 and 2015 were established using meta-analyses in the absence of a national risk factor survey till 2017. We searched national survey reports and also articles published in English from India between 2008 and 2017 in PubMed, Google Scholar and Cochrane review databases for specific risk factors among 18-69 yr Indians. Quality of studies was evaluated using Joanna-Briggs tool, but all studies were included in analyses. Estimates for each of the eight strata by age, gender and place of residence, respectively, were generated. MetaXL was used to calculate the pooled estimate for 2010 and 2015 using a random effects model. Strata-specific estimates were combined to arrive at national estimate using population weight of each stratum. The credibility of the estimates was determined using four parameters - average Briggs score; representativeness of the contributing studies and precision and stability of the estimates. The estimates [95% confidence interval (CI)] for 2010 for different risk factors were as follows: current alcohol use, 15.7 per cent (13.2-18.2); current tobacco use, 27 per cent (21.4-32.6); household solid fuel use, 61.5 per cent (50.2-72.5); physical inactivity, 44.2 per cent (37.8-50.6); obesity, seven per cent (3.8-10.2) and raised blood pressure, 20.2 per cent (18.4-22.1). In 2015, compared to 2010, tobacco use showed a relative decline of 18 per cent, household solid fuel use of nine per cent and physical inactivity of 15 per cent. The estimates were stable for alcohol use, raised blood pressure and obesity between 2010 and 2015. All estimates varied between moderate and high degrees of credibility. The estimates are consistent with other available estimates and with current national-level initiatives focused on tobacco control and improving access to clean fuel. These estimates can be used to monitor progress on non-communicable disease risk factor targets for India.

Prevalence of arterial hypertension and cardiovascular risk factors in a rural population exposed to arsenic in Argentina.

To determine the prevalence of arterial hypertension and cardiovascular risk factors (CRF) in a rural population exposed to arsenic (As) in drinking water in the province of Tucumán, Argentina. A total of 352 adult inhabitants participated. Consumption of arsenic in drinking water was measured. Blood pressure, smoking, risk and harmful alcohol consumption, salt intake, physical activity, body mass index, glycemia and dyslipidemia were evaluated. Cardiovascular risk was calculated using the Framingham score. The population was divided into Exposed Group (EG) n=90 and Non-Exposed Group (NEG) n=262. The prevalence of hypertension was 48.9 and 51.1% in each group, respectively; for smoking it was 31.1 and 39.7%; for risky alcohol consumption, 22.2 and 17.9%; for harmful alcohol consumption, 36.6 and 36.6%; for salt intake, 100 and 100%; for physical activity, 16.7 and 18.7%; for being overweight, 43.3 and 43.9%; for obesity, 25.5 and 25.6%; for diabetes, 24.4 and 32.8%; and for dyslipidemia, 58.9 and 66.4%. The scores for low, moderate, or high-risk were 50; 21.1; and 28.9% in the EG, and 54.6; 19.1 and 26.3% in the NEG, respectively. Exposure to As does not affect the prevalence of CRFs. We identified a rural population in a vulnerable condition with high CRFs. The National Risk Factor Survey does not reflect what happens in rural areas. The Framingham scale is consistent with the found CRFs. The implementation of health promotion policies is required to improve the prognosis of suffering cardiovascular events in the short and medium term.

Sociodemographic disparities and contextual factors in obesity: updated evidence from a National Survey of Risk Factors for Chronic Diseases.

To assess the association of sociodemographic and environmental factors with the obesity occurrence in Argentina from a sex- and age-comparative perspective and a multilevel approach. Cross-sectional study based on secondary data from the National Survey of Chronic Diseases Risk Factors (CDRF) 2018, Argentina. Two-level logistic regression models stratified by sex and age were used. The nationwide probabilistic sample of the CDRF survey and twenty-four geographical units. 16 410 adult people, living in Argentine towns of at least 5000 people, nested into 24 geographical units. Sex and age groups were defined as young (aged 18-44 years), middle-aged (45-64 years) and older (65 years and older) men and women. Single men (all age groups) and divorced/widowed men (aged 45 years or older) had a lower obesity risk compared to married ones. In the middle-aged group, men with higher education showed a lower risk than men with incomplete primary education. In young women, a marked social gradient by educational level was observed. A low-income level coupled with highly urbanised contexts represents an unfavourable scenario for young and middle-aged women. Having a multi-person household was a risk factor for obesity (OR = 1·26, P = 0·038) in middle-aged women. Contextual factors linked to the availability of socially constructed recreational resources and green spaces were associated with obesity among young adults. Socio-environmental determinants of obesity seem to operate differently according to sex and age in Argentina. This entails the need to address the obesity epidemic considering gender inequalities and the socio-environmental context at each stage of life.

1311. Population-based Mortality Rates of Clinical Syndromes Potentially Associated with Pneumococcal Disease in Argentina from 2008-2018

Abstract Background In 2012, the 13-valent conjugate vaccine (PCV13) for children &amp;lt; 2 years was introduced in the Argentinean National Immunization Program (NIP) with sustained coverage &amp;gt;80% since then. The 23-valent polysaccharide vaccine (PPSV23) has been available for ≥65 years and at-risk populations in NIP since 2001 and in 2017, it was replaced by the sequential regimen(PCV13/PPSV23). The 2013 National Survey of Risk Factors estimated a coverage of 23.1% for ≥65 years and 16.2% for at-risk populations. We evaluated mortality rates of clinical syndromes potentially associated with pneumococcal disease (PPD)in a 10-year period by age groups, before (2008-2011) and after childhood PCV introduction (2013-2018) in the NIP in Argentina. Methods All-age death cases related to clinical syndromes PPD were obtained from Dirección de Estadísticas e Información de la Salud between 2008-2018. ICD-10 codes were used to define PPD: pneumonia (J13-J18) and invasive disease (sepsis – A.40.*, A41.*, A49.*; meningitis – G00.*, G03.9; and other - M00.1, J86.*, J90-J91, B95.3). The yearly mortality rate was calculated per 100,000 people, estimated by the national census, and stratified by age groups. The percentage of change was the difference between the average rate in the pre (2008-2011) and post-vaccination (2013-2018) periods. Results In total, 65,947 deaths due to pneumonia (56.7%) and invasive disease (43.3%) occurred from 2008 and 2018. In the younger age groups (&amp;lt; 1, 1-4, 5-17), a 44% reduction was seen in both invasive disease and pneumonia compared to pre-childhood vaccination period, mainly in infants (from 22.2 to 10.2 per 100,000 people). In adult population, a less pronounced reduction was noted in mortality by invasive disease, however an inverse trend occurred in pneumonia in the age groups 18-49 years, 50-59 years, and 60-69 years, from 1.9 to 2.1 (7%), 9.3 to 10.2 (10%) and 18.3 to 19.2 (5%) per 100,00 people, respectively (Fig 1). Mortality rate change (%) pre and post- pneumococcal childhood introduction Figure 1. Mortality rate change (%) of clinical syndromes potentially associated with pneumococcal disease before (2008-2011) and after infant vaccination introduction (2013-2018) in Argentina. Conclusion Mortality rates declined mostly for infants, and despite the differences observed for the older population, it remains significant. Evaluation of mortality trends are key for decision-making process on current and future prevention strategies using pneumococcal vaccines. Disclosures Norberto Giglio, MD, Merck Sharp &amp; Dohme Corp (Consultant)Pfizer (Other Financial or Material Support, Speaker)Sanofi (Other Financial or Material Support, Speaker)SEQUIRUS (Other Financial or Material Support, Speaker) Marina Gabriela Birck, n/a, IQVIA (Independent Contractor) Guilherme Julian, BSc, MSc, iQVIA (Independent Contractor) Virginia Verdaguer Babic, MD, MSD Argentina (Employee) Cintia Parellada, MD, PhD, MSD Brazil (Employee, Shareholder)

The Impact of Educational Assortative Mating on Income Inequality: Evidence from Argentina

This paper seeks to quantify the impact of educational assortative mating on income inequality among households in Argentina. We use microdata from two household surveys conducted by the National Institute of Statistics and Census: The Permanent Household Survey and the National Survey of Risk Factors. We construct contingency tables and perform a regression analysis to study the existence of educational assortative mating. We also present counterfactual simulations of random re-matching of observations. The results show that a sizeable proportion of couples are educationally homogamous (45%). Comparing the Gini coefficients calculated in the real matching and the simulated scenarios, we observe a reduction of up to 4 points. Thus, the educational assortative mating represents a relevant dimension to explain income inequality. Our results recommend considering this matching pattern when defining optimal income taxes; this is, if there is a high positive covariance between the income of both members of the couple, it seems appropriate, from a redistributive point of view, to define income taxes at the household level and not at the individual level (as is currently the case in most countries, including Argentina).

Performance evaluation and ranking of regional primary health care and public health Systems in Iran

BackgroundThe present study has been undertaken with the aim to evaluate performance and ranking of various universities of medical sciences that are responsible for providing public health services and primary health care in Iran.MethodsFour models; Weighted Factor Analysis (WFA), Equal Weighting (EW), Stochastic Frontier Analysis (SFA), and Data Envelopment Analysis (DEA) have been applied for evaluating the performance of universities of medical sciences. This study was commenced based on the statistical reports of the Ministry of Health and Medical Education (MOHME), census data from the Statistical Center of Iran, indicators of Vital Statistics, results of Multiple Indicator of Demographic and Health Survey 2010, and results of the National Survey of Risk Factors of non-communicable diseases.ResultsThe average performance scores in WFA, EW, SFA, and DEA methods for the universities were 0.611, 0.663, 0.736 and 0.838, respectively. In all 4 models, the performance scores of universities were different (range from 0.56–1, 0.53–1, 0.73–1 and 0.83–1 in WFA, EW, SFA and DEA models, respectively). Gilan and Rafsanjan universities with the average ranking score of 4.75 and 41 had the highest and lowest rank among universities, respectively. The universities of Gilan, Ardabil and Bojnourd in all four models had the highest performance among the top 15 universities, while the universities of Rafsanjan, Ahvaz, Kerman and Jiroft showed poor performance in all models.ConclusionsThe average performance scores have varied based on different measurement methods, so judging the performance of universities based solely on the results of a model can be misleading. In all models, the performance of universities has been different, which indicates the need for planning to balance the performance improvement of universities based on learning from the experiences of well-performing universities.

Socioeconomic Determinants of Participation in Cancer Screening in Argentina: A Cross-Sectional Study.

Low socioeconomic status is associated with late cancer diagnosis and mortality in Argentina. It is important that cancer screening services are accessible to the whole population so that cancer can be detected early. Our aim in this study was to investigate socioeconomic determinants for the disparities in the use of breast, cervical, and colorectal cancer screening services in Argentina, and to measure the country progress in reducing differences in cancer screening participation across socioeconomic levels. We performed a secondary analysis of cross-sectional data from the 2018 National Survey of Risk Factors of Argentina. The sample included data from 49,170 households. We also compared the results with data from the 2013 wave of the same survey in order to assess progress on cancer screening participation across income and education categories. Income, education, health insurance, disability, and marital status were associated with cancer screening underuse in Argentina. Comparison between 2013 and 2018 demonstrated that there has been some progress toward increasing cancer screening uptake, but this increase is not equitably distributed across the population. To further reduce disparities in cancer participation across socioeconomic levels, cancer screening programs in Argentina should reinforce strategies to become more accessible. It is important to proactively reach those populations that are underusers of cancer screening and ensure that barriers that stop people from accessing cancer screening are explored and adequately addressed.

Urban social determinants of non-communicable diseases risk factors in Argentina.

We examined associations of individual-, neighborhood- and city-level education -as proxies of SES at different levels-, with diabetes, hypertension, obesity, smoking and binge drinking (non-communicable disease risk factors -NCD/RF) among Argentinian adults. We estimated mixed models based on 21,415 individuals from the 2013 National Survey of Risk Factors, living in 2,698 neighborhoods and 33 cities. Gradients by individual-level education differed by gender and NCD/RF, and some were modified by city education. In addition, we identified contextual effects of neighborhood and city education on some NCD/RF. Urban efforts to tackle NCD/RF in Argentina should be context- and gender-sensitive, and mainly focused on socially disadvantaged groups.

Staff and participant perceptions of optimal recruitment and retention strategies for biomedical cohort studies in the Caribbean.

PurposeTo identify staff and participants perspectives of best practices that facilitate achieving enrollment and retention targets in biomedical cohort studies in Caribbean populations.MethodsEight focus group discussions (FGDs) were held with research stakeholders including research (i) nurses/study supervisors, (ii) field staff/data collectors, and (iii) rural and urban participants of the Third Jamaica Health and Lifestyle Survey (a national NCD risk factor survey with biospecimen collection) to capture qualitative data on experiences with recruitment, training, retention challenges and potential solutions or strategies for strengthening future efforts.ResultsOur findings indicate that trained, experienced study staff with good interpersonal communication skills enhanced the proficiency of field operations and attracted study participants. Targeted community and stakeholder engagement alongside strong support from the coordinating center increased the reach and efficiency of the data collectors. Timely participant feedback, gender-appropriate approaches, and socioeconomic balance enhanced equitable enrollment and retention of participants of cohort studies particularly the hard to reach groups.ConclusionWell-functioning research teams using traditional and social media promotion, applying gender-appropriate and personalized approaches together with strategies for reaching the less accessible socioeconomic groups, are effective for recruiting and retaining members of a Caribbean cohort. These strategies may also enhance the recruitment of other Black populations in the Diaspora including the US and Caribbean into biomedical studies including cancer research.

Abstract PO-073: A qualitative study of research staff centered approaches for optimizing recruitment and retention in biomedical cohort studies in the Caribbean

Abstract Objective: To identify the best practices of research staff that facilitate achieving enrollment and retention targets in biomedical cohort studies in Black Caribbean populations. Design and Methods: Eight focus group discussions (FGDs) were held with research stakeholders including research (i) nurses/ study supervisors, (ii) field staff/data collectors and (iii) rural and urban participants of the Third Jamaica Health and Lifestyle Survey (a national NCD risk factor survey with biospecimen collection) to capture qualitative data on experiences with recruitment, training, logistical issues in the field, retention challenges and potential solutions or strategies for strengthening future efforts. Results: Our findings suggest that ongoing training and supervision with clearly defined roles and responsibilities of the study staff enhanced the adeptness of field operations and attracted volunteers. Targeted community engagement and strong support in the field from the coordinating center increased the reach and efficiency of the data collectors. The need for gender appropriate approaches and socioeconomic balance to enhance equitable enrollment and participation in all aspects of the study was emphasized. Conclusion: Enrollment and retention in Jamaican studies is improved by creating and sustaining well-functioning research teams and applying community and gender appropriate approaches. These strategies may also enhance the recruitment of other Black populations in the Diaspora including the US and Caribbean into biomedical studies including cancer research. Citation Format: Althea Bailey, Ishtar Govia, Joette McKenzie, Sade Richards, Sheldon Coleman, Marshall Tulloch-Reid, Camille Ragin, Kimlin Ashing. A qualitative study of research staff centered approaches for optimizing recruitment and retention in biomedical cohort studies in the Caribbean [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-073.

P45 Encuesta de detección de factores de riesgo cardiovascular y alteraciones en el metabolismo de los hidratos de carbono en el marco del Día Internacional de la Diabetes

Introducción: la diabetes constituye una entidad que aumenta significativamente la morbimortalidad cardiovascular. De acuerdo con los datos de la Cuarta Encuesta Nacional de Factores de Riesgo (ENFR), la prevalencia de glucemia elevada o diabetes aumentó de 9,8% en 2013 a 12,7% en 2018, siendo la obesidad uno de los principales factores de riesgo asociados, cuya prevalencia incrementó más del 70% en los últimos 15 años. Se pronostica acorde a la Federación Internacional de Diabetes (IDF) que al menos 578 millones de personas tendrán diabetes en el año 2030.Objetivos: describir los datos hallados en una encuesta de detección de factores de riesgo cardiovascular y alteraciones en el metabolismo de los hidratos de carbono en el marco del Día Internacional de la Diabetes realizada el día 14 de noviembre de 2019.Materiales y métodos: estudio descriptivo de corte transversal de los datos obtenidos durante la campaña realizada el 14 de noviembre de 2019 en una institución de Buenos Aires, la cual se desarrolló de manera interdisciplinaria entre personal médico del servicio de diabetes, personal de enfermería y estudiantes del servicio de nutrición.La misma que consistió en invitar a participar voluntariamente a sujetos ambulatorios que se encontraban en la cercanía del centro médico y brindaron su consentimiento verbal, a quienes: 1)se realizó una encuesta (sobre hábitos, antecedentes de diabetes, hipertensión arterial (HTA), enfermedad cardiovascular (ECV), enfermedad renal (ER); 2)se tomaron medidas antropométricas (peso, talla, circunferencia de cintura [CC]); 3) se realizó medición capilar de glucemia mediante un refractómetros para glucosa. Para este reporte se incluyeron los sujetos que cumplieron con la realización de los procedimientos 1 y 2 enlistados previamente. Las variables categóricas se describen como porcentaje, las variables cuantitativas como mediana/RIQ acorde la distribución de los datos.

P34 Descripción de un modelo murino de desarrollo y reversión de síndrome metabólico inducido por dieta

Introducción: la diabetes tipo 2 (DM2) es una enfermedad con una elevada prevalencia a nivel mundial y en constante crecimiento. Según datos de la última ENFR, en Argentina su prevalencia es del 12,7%. Diversos estudios en humanos determinaron que la progresión a DM2 puede prevenirse hasta un 58% mediante la adopción de estilos de vida saludables en forma costo-efectiva. Esta enfermedad es precedida por un estado de prediabetes donde en menor magnitud los principales signos ya están presentes. Por esto, es razonable pensar que la forma más eficaz de mejorar la situación actual es retrasar el paso de prediabetes a DM2, es decir abordar el tratamiento en sus estadios tempranos. Para facilitar dichos estudios suele recurrirse a modelos experimentales que simulan dicho estado mediante la administración a ratas normales de dietas desbalanceadas. Objetivos: evaluar la posible reversión del estado de prediabetes inducida por el consumo de una dieta rica en fructosa en ratas mediante el reemplazo por una dieta balanceada. Materiales y métodos: como modelo experimental se emplearon ratas Sprague Dawley macho adultas (60 días) y se establecieron 4 grupos de tratamientos: dieta comercial estándar y agua corriente sacrificados a los 21 (C-21) y a los 42 días (C-42); la misma dieta comercial con el agregado de fructosa al 10% en el agua de bebida sacrificados a los 21 días (F-21) y alimentados por otros 21 días con dieta comercial estándar y agua corriente (FC-42). Finalizado el experimento se calcularon los incrementos en peso, las calorías ingeridas totales y el porcentaje de peso del hígado respecto del peso total del animal (%hig). Luego de los sacrificios se determinó glucemia, trigliceridemia (TG) y la relación entre los niveles de aspartato y alanina aminotranferasas (AST/ALT) en sangre. Se calculó la insulinorresistencia (IR) utilizando el índice descrito por Unger, et al (2014). A fin de enriquecer la descripción del estado prediabético (F-21), se determinaron los valores hepáticos de triglicéridos (hTG), colesterol total y la expresión génica de los marcadores lipogénicos GPAT y FAS. El análisis estadístico de los datos expresados como la media±error estándar se realizó empleando ANOVA y comparaciones múltiples (Tukey, alfa=0,05).

Interseccionalidad en las desigualdades sociales para la realización de actividad física en Argentina

Introduction: The aim of this article is to analyze inequalities in the practice of physical activity for enhancing physical conditions or for doing sports, generated by different social, geographical and demographical determinants, as well as some of their interactions. Development: A quantitative analysis of secondary data was conducted. The source is the National Survey of Risk Factors, based on a probabilistic sample of urban households in Argentina, in 2009. Firstly, it is presented a escriptive bivariate analysis and, secondly, binary logistic regressions to test hypotheses on the net effect of different independent variables are shown and incorporated interactions within them to observe their intersectionality. Conclusions: Findings show the importance of considering an intersectional approach to account for the multiplicative nature of inequalities in the practice of physical activity, which most used multivariate models fail to show.