Tabla 3. Características principales de los sujetos y factores cardiometabólicas asociados

< 50 años => 50 años Mujeres Hombres Mujeres Hombres n=2136 n=1167 n=2192 n=1264 Variables sociales Área de residencia

Rural

1087 (72.90)

404 (27.10)

1257 (68.73)

572 (31.27)

Urbano

1049 (57.89)

763 (42.11)

935 (57.47)

692 (42.53)

Nivel educativo

Técnico/ Universitario

334 (68.44)

154 (31.56)

286 (61.90)

176 (38.10)

Bachiller

524 (67.53)

252 (32.47)

376 (68.61)

172 (31.39)

Ninguno/ Primaria/ Desconocido

1269 (62.54)

760 (37.46)

1528 (62.52)

916 (37.48)

Ingresos mensuales (tertiles)

Bajo (<U$ 175)

756 (67.56)

363 (32.44)

786 (63.54)

451 (36.46)

Medio (U$ 175 - 350)

782 (61.87)

482 (38.13)

678 (61.92)

417 (38.08)

Alto (≥ U$350)

598 (65.00)

322 (35.00)

728 (64.77)

396 (35.23)

Factores modificables de riesgo cardiovascular Ingesta alcohol

No ingesta

1498 (82.53)

317 (17.47)

1624 (82.06)

355 (17.94)

Ingesta alcohol

634 (42.72)

850 (57.28)

567 (38.41)

909 (61.59)

Tabaquismo

No tabaquismo

1750 (72.92)

650 (27.08)

1577 (76.29)

490 (23.71)

< 50 años => 50 años Mujeres Hombres Mujeres Hombres n=2136 n=1167 n=2192 n=1264 Tabaquismo

383 (42.79)

512 (57.21)

609 (44.07)

773 (55.93)

Estado del peso n (%)

Normal

866 (41.5)

595 (52.3)

722 (33.8)

621 (50.1)

Sobrepeso

793 (38.0)

404 (35.5)

905 (42.4)

479 (38.6)

Obesidad

427 (20.5)

140 (12.3)

510 (23.9)

140 (11.3)

Relación cintura/cadera

Tertil 1 (<0.85)

1178 (87.58)

167 (12.42)

884 (88.76)

112 (11.24)

Tertil 2 (0.85 - 0.92)

671 (60.40)

440 (39.60)

826 (71.21)

334 (28.79)

Tertil 3 (≥ 0.92 kg/m2)

270 (32.97)

549 (67.03)

468 (36.62)

810 (63.38)

Actividad física

Alto

232 (60.89)

149 (39.11)

241 (60.10)

160 (39.90)

Moderado

690 (70.91)

283 (29.09)

784 (68.71)

357 (31.29)

Bajo

940 (63.47)

541 (36.53)

883 (60.52)

576 (39.48)

Consumo de frutas y verduras

Nunca

124 (57.94)

90 (42.06)

128 (54.24)

108 (45.76)

Consume frutas o verduras al menos una vez al día

400 (62.40)

241 (37.60)

393 (60.74)

254 (39.26)

Consume frutas y verduras mas de una vez al día

1462 (64.92)

790 (35.92)

1550 (64.64)

254 (39.26)

Factores cardiometabólicas Hipertensión arterial

468 (63.76)

266 (36.24)

1176 (66.33)

597 (33.67)

Diabetes Mellitus 2

87 (66.92)

43 (33.08)

207 (65.92)

107 (34.08)

< 50 años => 50 años Mujeres Hombres Mujeres Hombres n=2136 n=1167 n=2192 n=1264 Enfermedad cardiovascular establecida

89 (74.17)

31 (25.83)

169 (63.77)

96 (36.23)

Tabla 4. Medidas antropométricas

< 50 años =>50 años Mujeres Hombres p Mujeres Hombres p n=2136 n=1167 n=2192 n=1264 Edad (años)

42.4 ± 4.33

42.4 ± 4.20

0.716

58.4 ± 5.68

59.1 ± 5.89

0.001

Variable antropométrica

Altura (cm)

155.6 ± 7.01

167.4± 7.33 <0.001

153.3 ± 6.80

164.8 ± 7.11

<0.001 Peso (kg)

64.4 ±13.53

71.2 ± 12.9

<0.001

64.2 ± 13.24

68.9 ± 13.4

<0.001 Índice masa corporal (kg/m2) IMC 26,5 ± 4.89

25.3 ± 4.01

<0.001

27.2 ± 4.78

25.3 ± 4.09

<0.001 Perímetro cintura (cm)

83.2 ± 11.6

87.1 ± 10.9

<0.001

86.5 ± 11.2

89.2 ± 11.3

<0.001 Perímetro cadera (cm)

98.7 ± 10.1

94.8 ± 9.39

<0.001

99.7 ± 10.3

94.4 ± 9.28

<0.001 Relación cintura/cadera RCC

0.84 ± 0.08

0.91 ± 0.07

<0.001

0.86 ± 0.07

0.94 ± 0.07

<0.001 Relación cintura/cadera por fuerza de empuñadura

0.04 ± 0.01

0.03 ± 0.01

<0.001

0.05 ± 0.02

0.03 ± 0.01

<0.001 Índice fuerza empuñadura

Fuerza empuñadura (kg)

23.2 ± 7.44

36.9 ± 9.8

<0.001

20.8 ± 7.07

31.5 ± 9.2

<0.001 FE/peso (kg)

0.37 ± 0.13

0.52 ± 0.15

<0.001

0.33 ± 0.12

0.47 ± 0.14

<0.001 FE/perímetro cintura (cm)

0.28 ± 0.10

0.42 ± 0.12

<0.001

0.24 ± 0.09

0.36 ± 0.11

<0.001 FE/perímetro cadera (cm)

0.24 ± 0.08

0.39 ± 0.10

<0.001

0.21 ± 0.07

0.34 ± 0.10

<0.001

FE/RCC

27.7 ± 9.07

40.45± 11.22 <0.001

24.2 ± 8.46

33.61± 10.27 <0.001

FE/IMC

0.91 ± 0.32

1.49 ± 0.43

<0.001

0.78 ± 0.29

1.27 ± 0.40

<0.001 Test de t de Student, p<0.05

Tabla 5. Relación de la fuerza de empuñadura en relación con las medidas antropométricas y la presencia de enfermedad cardiovascular.

Fuerza empuñadura (kg) FE/peso (kg) FE/perímetro cintura (cm) FE/perímetro cadera (cm)

FE/RCC

FE/IMC

Hipertensión arterial No

27.18 ± 10.75

0.42 ± 0.16

0.32 ± 0.13

0.28 ± 0.12

31.02 ± 11.82

1.09 ± 0.48

Si

25.77 ± 10.42

0.38 ± 0.15

0.29 ± 0.11

0.26 ± 0.11

28.74 ± 11.35

0.96 ± 0.42

Valor p p<0.001 p<0.001 p<0.001 p<0.001 p<0.001 p<0.001 Diabetes Mellitus tipo 2 No

26.37 ± 10.15

0.41 ± 0.15

0.31 ± 0.12

0.27 ± 0.11

29.96 ± 11.14

1.04 ± 0.44

Si

24.07 ± 9.45

0.35 ± 0.13

0.26 ± 0.11

0.24 ± 0.10

26.39 ± 10.18

0.88 ± 0.38

Valor p p<0.001 p<0.001 p<0.001 p<0.001 p<0.001 p<0.001 Enfermedad cardiovascular establecida No

26.76 ± 10.66

0.41 ± 0.16

0.31 ± 0.12

0.27 ± 0.11

30.31 ± 111.72

1.05 ± 0.46

Si

24.81 ± 10.32

0.37 ± 0.15

0.28 ± 0.12

0.25 ± 0.11

27.80 ± 11.12

0.95 ± 0.43

Valor p p<0.001 p<0.001 p<0.001 p<0.001 p<0.001 p<0.001 Test de t de Student, p<0.05

Tabla 6. Asociación cruda entre obesidad, sarcopenia, obesidad-sarcopénica y presencia de enfermedad cardiovascular

Total Mujeres Hombres Jóvenes Mayores RP IC 95% RP IC 95% RP IC 95% RP IC 95% RP IC 95% Hipertensión arterial PA<90§|<94¶/ FA Q4 Ref.

Ref.

Ref.

Ref.

Ref.

PA<90§|< 94¶/ FA Q1-Q3

1.24

[1.10- 1.39]

1.15

[0.90- 1.47]

1.32

[1.14- 1.53]

1.09

[0.90- 1.32]

1.14

[0.99- 1.31] PA>=90§|>= 94¶/ FA Q4

1.66

[1.45- 1.91]

1.44

[1.09- 1.91]

1.72

[1.48- 2.11]

1.76

[1.41- 2.22]

1.45

[1.24- 1.69] PA>=90§|>=94¶/FA Q1-Q3

1.92

[1.70- 2.17]

1.79

[1.40- 2.31]

1.99

[1.71- 2.33]

1.64

[1.32- 2.05]

1.57

[1.36- 1.81]

RCC<0.90/ FA Q4

Ref.

Ref.

Ref.

Ref.

Ref.

RCC<0.90/ FA Q1-Q3

1.20

[1.06- 1.37]

1.10

[0.91- 1.33]

1.13

[0.91- 1.39]

1.06

[0.87- 1.31]

1.11

[0.96- 1.29]

RCC>=0.90/ FA Q4

1.19

[1.04- 1.38]

1.14

[0.84- 1.54]

1.26

[1.06- 1.49]

1.15

[0.92- 1.44]

1.10

[0.93- 1.30]

RCC>= 0.90/ FA Q1-Q3

1.56

[1.37- 1.78]

1.45

[1.19- 1.76]

1.58

[1.34- 1.86]

1.25

[0.99- 1.56]

1.24

[1.06- 1.45]

IMC<30†/ FA Q4

Ref.

Ref.

Ref.

Ref.

Ref.

IMC<30†/ FA Q1-Q3

1.20

[1.10- 1.31]

1.27

[1.03- 1.57]

1.26

[1.12- 1.42]

1.05

[0.88- 1.24]

1.08

[0.98- 1.20]

IMC>=30†/ FA Q4

1.64

[1.39- 1.93]

1.83

[1.37- 2.46]

1.59

[1.33- 1.91]

2.03

[1.54- 2.67]

1.31

[1.10- 1.57]

IMC>=30†/ FA Q1-Q3

1.70

[1.53- 1.89]

1.81

[1.46- 2.27]

1.81

[1.52- 2.15]

1.63

[1.33- 2.02]

1.40

[1.22- 1.59] Diabetes Mellitus 2 PA<90§|<94¶/ FA Q4 Ref.

Ref.

Ref.

Ref.

Ref.

PA<90§|< 94¶/ FA Q1-Q3

1.47

[1.04- 2.09]

1.57

[0.61- 4.05]

1.52

[1.01- 2.27]

1.04

[0.57- 1.85]

1.47

[0.97- 2.22] PA>=90§|>= 94¶/ FA Q4

2.29

[1.53- 3.42]

3.63

[1.27- 10.4]

2.00

[1.27- 3.14]

2.08

[1.06- 4.04]

2.09

[1.21- 3.63]

Total Mujeres Hombres Jóvenes Mayores RP IC 95% RP IC 95% RP IC 95% RP IC 95% RP IC 95% PA>=90§|>=94¶/FA Q1-Q3

3.41

[2.41- 4.81]

3.45

[1.36- 8.82]

4.22

[2.72- 6.56]

3.10

[1.81- 5.30]

2.78

[1.84- 4.23]

RCC<0.90/ FA Q4

Ref.

Ref.

Ref.

Ref.

Ref.

RCC<0.90/ FA Q1-Q3

1.36

[0.91- 2.04]

1.00

[0.52- 2.07]

1.00

[0.48- 2.11]

1.20

[0.64- 2.23]

1.20

[0.70- 2.06]

RCC>=0.90/ FA Q4

1.48

[0.91- 2.41]

1.75

[0.63- 4.86]

1.69

[0.97- 2.95]

1.44

[0.69- 2.97]

1.32

[0.72- 2.40]

RCC>= 0.90/ FA Q1-Q3

2.86

[1.89- 4.33]

2.17

[1.07- 4.41]

3.21

[1.94- 5.32]

2.49

[1.30- 4.78]

2.17

[1.30- 3.65]

IMC<30†/ FA Q4

Ref.

Ref.

Ref.

Ref.

Ref.

IMC<30†/ FA Q1-Q3

1.55

[1.12- 2.14]

1.39

[0.61- 3.17]

1.85

[1.30- 2.63]

1.09

[0.65- 1.81]

1.53

[1.07- 2.18]

IMC>=30†/ FA Q4

2.50

[1.62- 3.86]

3.03

[1.07- 8.61]

2.23

[1.35- 3.67]

2.59

[1.36- 4.93]

2.38

[1.30- 4.27]

IMC>=30†/ FA Q1-Q3

2.64

[1.95- 3.57]

2.42

[1.08- 5.47]

3.31

[2.00- 5.49]

3.03

[1.79- 5.09]

2.00

[1.41- 2.84] Enfermedad cardiovascular establecida

PA<90§|<94¶/ FA Q4 Ref.

Ref.

Ref.

Ref.

Ref.

PA<90§|< 94¶/ FA Q1-Q3

1.65

[1.19- 2.28]

1.40

[0.66- 2.93]

1.88

[1.18- 3.01]

1.66

[0.89- 3.10]

1.61

[1.05- 2.46] PA>=90§|>= 94¶/ FA Q4

1.78

[1.14- 2.79]

1.92

[0.83- 4.46]

1.70

[1.02- 2.86]

1.41

[0.58- 3.37]

2.01

[1.07- 3.80] PA>=90§|>=94¶/FA Q1-Q3

2.45

[1.71- 3.51]

2.03

[0.96- 4.30]

3.08

[1.83- 5.20]

2.89

[1.60- 5.21]

2.14

[1.30- 3.52]

RCC<0.90/ FA Q4

Ref.

Ref.

Ref.

Ref.

Ref.

RCC< 0.90/ FA Q1-Q3

1.35

[0.94- 1.95]

1.17

[0.65- 2.11]

1.41

[0.81- 2.48]

1.26

[0.70- 2.26]

1.67

[0.98- 2.83]

RCC>=0.90/ FA Q4

0.91

[0.58- 1.41]

1.12

[0.44- 2.89]

0.95

[0.57- 1.56]

0.52

[0.23- 1.18]

1.47

[0.79- 2.70]

Total Mujeres Hombres Jóvenes Mayores RP IC 95% RP IC 95% RP IC 95% RP IC 95% RP IC 95%

RCC>=0.90/FA Q1-Q3

1.54

[1.02- 2.33]

1.21

[0.64- 2.27]

1.90

[1.11- 3.25]

1.34

[0.70- 2.59]

1.63

[0.91- 2.96]

IMC<30†/ FA Q4

Ref.

Ref.

Ref.

Ref.

Ref.

IMC<30†/ FA Q1-Q3

1.43

[1.10- 1.87]

1.32

[0.70- 2.46]

1.68

[1.14- 2.48]

1.57

[0.94- 2.63]

1.22

[0.89- 1.70]

IMC>=30†/ FA Q4

1.19

[0.69- 2.06]

1.95

[0.81- 4.72]

0.81

[0.39- 1.70]

0.96

[0.31- 2.91]

1.29

[0.64- 2.63]

IMC>=30†/ FA Q1-Q3

1.85

[1.37- 2.51]

1.70

[0.90- 3.20]

2.58

[1.52- 4.38]

2.52

[1.48- 4.29]

1.55

[1.06- 2.67] §Punto de corte de perímetro abdominal para mujeres, ¶Punto de corte de perímetro abdominal para hombres, †kg/m2, PA= perímetro abdominal, RCC= relación cintura cadera, IMC= índice de masa corporal, FA= fuerza de agarre, Q = cuartil *Ajustado

Tabla 7. Análisis multivariado entre obesidad, sarcopenia, obesidad-sarcopénica y presencia de enfermedad cardiovascular

Modelo 1 Modelo 2 RP IC 95% RP IC 95% Valor p Hipertensión arterial PA<90§|<94¶/ FA Q4 Ref.

Ref.

PA<90§|< 94¶/ FA Q1-Q3

1.24

[1.10-1.39]

1.00

[0.89-1.22]

0.965

PA>=90§|>= 94¶/ FA Q4

1.66

[1.45-1.91]

1.49

[1.31-1.71] <0.001 PA>=90§|>=94¶/FA Q1-Q3

1.92

[1.70-2.17]

1.38

[1.22-1.56] <0.001

RCC<0.90/ FA Q4

Ref.

Ref.

RCC<0.90/ FA Q1-Q3

1.20

[1.06-1.37]

0.94

[0.84-1.09]

0.373

RCC>=0.90/ FA Q4

1.19

[1.04-1.38]

1.14

[0.99-1.32]

0.058

RCC>= 0.90/ FA Q1-Q3

1.56

[1.37-1.78]

1.07

[0.95-1.20]

0.264

IMC<30†/ FA Q4

Ref.

Ref.

IMC<30†/ FA Q1-Q3

1.20

[1.10-1.31]

0.97

[0.88-1.06]

0.556

IMC>=30†/ FA Q4

1.64

[1.39-1.93]

1.51

[1.27-1.78] <0.001

IMC>=30†/ FA Q1-Q3

1.70

[1.53-1.89]

1.30

[1.15-1.47] <0.001 Diabetes Mellitus 2 PA<90§|<94¶/ FA Q4 Ref.

Ref.

PA<90§|< 94¶/ FA Q1-Q3

1.47

[1.04-2.09]

1.21

[0.83-1.76]

0.303

PA>=90§|>= 94¶/ FA Q4

2.29

[1.53-3.42]

1.99

[1.31-2.98] <0.001 PA>=90§|>=94¶/FA Q1-Q3

3.41

[2.41-4.81]

2.55

[1.71-3.78] <0.001

RCC<0.90/ FA Q4

Ref.

Ref.

RCC<0.90/ FA Q1-Q3

1.36

[0.91-2.04]

0.98

[0.65-1.49]

0.945

RCC>=0.90/ FA Q4

1.48

[0.91-2.41]

1.45

[0.91-2.32]

0.114

RCC>= 0.90/ FA Q1-Q3

2.86

[1.89-4.33]

1.93

[1.28-2.92]

0.002

Modelo 1 Modelo 2 RP IC 95% RP IC 95% Valor p

IMC<30†/ FA Q4

Ref.

Ref.

IMC<30†/ FA Q1-Q3

1.55

[1.12-2.14]

1.33

[0.95-1.86]

0.090

IMC>=30†/ FA Q4

2.50

[1.62-3.86]

2.35

[1.51-3.66] <0.001

IMC>=30†/ FA Q1-Q3

2.64

[1.95-3.57]

2.15

[1.51-3.06] <0.001 Enfermedad cardiovascular establecida PA<90§|<94¶/ FA Q4 Ref.

Ref.

PA<90§|< 94¶/ FA Q1-Q3

1.65

[1.19-2.28]

1.54

[1.03-2.31]

0.033

PA>=90§|>= 94¶/ FA Q4

1.78

[1.14-2.79]

1.72

[1.05-2.81]

0.030

PA>=90§|>=94¶/FA Q1-Q3

2.45

[1.71-3.51]

2.19

[1.37-3.49]

0.001

RCC<0.90/ FA Q4

Ref.

Ref.

RCC< 0.90/ FA Q1-Q3

1.35

[0.94-1.95]

1.35

[0.87-2.12]

0.182

RCC>=0.90/ FA Q4

0.91

[0.58-1.41]

0.99

[0.61-1.59]

0.960

RCC>=0.90/FA Q1-Q3

1.54

[1.02-2.33]

1.33

[1.83-2.13]

0.234

IMC<30†/ FA Q4

Ref.

Ref.

IMC<30†/ FA Q1-Q3

1.43

[1.10-1.87]

1.31

[0.94-1.88]

0.107

IMC>=30†/ FA Q4

1.19

[0.69-2.06]

1.15

[0.62-2.11]

0.660

IMC>=30†/ FA Q1-Q3

1.85

[1.37-2.51]

1.80

[1.20-2.71]

0.004

Modelo 1: crudo Modelo 2: ajustado por sexo, edad, nivel educativo, antecedente del consumo de tabaco

Figura 1. Asociación de sarcopenia, obesidad y obesidad-sarcopénica con hipertensión arterial.

Mujeres Hombres <50 años >=50 años

Figura 2. Asociación de sarcopenia, obesidad y obesidad-sarcopénica con diabetes mellitus 2.

Mujeres Hombres <50 años >=50 años

Figura 3. Asociación de sarcopenia, obesidad y obesidad-sarcopénica con antecedente de enfermedad cardiovascular.

Mujeres Hombres <50 años >=50 años