Asociación entre obesidad central, colesterol no-HDL y riesgo cardiovascular en pacientes con diabetes mellitus tipo 2.
Palavras-chave:
Diabetes Mellitus tipo 2, obesidad central, colesterol no-HDL, riesgo cardiovascular, dislipidemia aterogénicaResumo
Objetivo. Evaluar la obesidad central y el perfil lipídico aterogénico, con énfasis en el colesterol no-HDL, como factores determinantes del riesgo cardiovascular en pacientes con diabetes mellitus tipo 2 (DM2). Materiales y métodos. Estudio descriptivo, analítico y transversal realizado en 20 pacientes (40 a 60 años) con DM2 que asistieron al Hospital Militar Universitario Dr. Carlos Arvelo entre septiembre 2021 y febrero 2022. Se evaluaron variables antropométricas, de composición corporal (grasa y masa muscular) y bioquímicas (glucemia, perfil lipídico y colesterol no-HDL por modelo matemático). Resultados. La muestra presentó un IMC promedio de 32,02 ± 3,61 Kg/m2 y una circunferencia de cintura de 104,20 ± 10,24 cm, reflejando adiposidad central. Se identificó el patrón clásico de dislipidemia diabética: triglicéridos elevados (211,70 ± 67,91 mg/dL) y colesterol HDL disminuido (33,29 ± 12,52 mg/dL). El colesterol no-HDL promedio estuvo sustancialmente elevado (169,97± 48,79 mg/dL), superando las metas clínicas recomendadas (< 100 mg/dL). El tiempo de evolución de la DM2 fue de 10,10 ± 6,23 años. Conclusiones. La obesidad de distribución central y la dislipidemia aterogénica, caracterizada por una alta carga de colesterol no-HDL, se interrelacionan estrechamente con la cronicidad de la DM2. Este comportamiento perpetúa un riesgo cardiovascular global críticamente alto, lo que evidencia la necesidad de reorientar el enfoque terapéutico exclusivo de la glucemia hacia intervenciones dirigidas a mejorar la composición corporal y reducir las fracciones lipídicas remanentes. Diabetes Actual, 2025; Vol 3 (3): 135-141.
Objective. To evaluate central obesity and the atherogenic lipid profile, with emphasis on non-HDL cholesterol, as determinants of cardiovascular risk in patients with type 2 diabetes mellitus (T2DM). Materials and methods. A descriptive, analytical, and cross-sectional study was conducted in 20 patients (40 to 60 years old) with T2DM who attended the Dr. Carlos Arvelo Military University Hospital between September 2021 and February 2022. Anthropometric, body composition (fat and muscle mass), and biochemical variables (glycemia, lipid profile, and non-HDL cholesterol calculated by mathematical model) were evaluated. Results. The sample showed an average BMI of 32,02 ± 3,61 Kg/m2 and a mean waist circumference of 104,20 ± 10,24, reflecting central adiposity. The classic pattern of diabetic dyslipidemia was identified: elevated triglycerides (211,70 ± 67,91 mg/dL) and decreased HDL cholesterol (33,29 ± 12,52 mg/dL). Average non-HDL cholesterol was substantially elevated (169,97± 48,79 mg/dL), exceeding recommended clinical targets (< 100 mg/dL). The average time of evolution of T2DM was 10,10 ± 6,23 years. Conclusions. Central obesity and atherogenic dyslipidemia, characterized by a high burden of non-HDL cholesterol, are closely interrelated with the chronicity of T2DM. This pattern perpetuates a critically high global cardiovascular risk, highlighting the need to redirect the therapeutic focus away from exclusive glycemic control toward interventions aimed at improving body composition and reducing remnant lipid fractions. Diabetes Actual, 2025; Vol 3 (3): 135-141.
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