Examinando por Autor "Lameda, Victor"
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Ítem Diagnostic criteria and management of metabolic syndrome: Evolution overtime(Saber UCV, Universidad Central de Venezuela, 2020) Rojas, Edward; Castro, Ana; Manzano, Alexander; Suarez, Maria Karina; Lameda, Victor; Carrasquero, Ruben; Nava, Manuel; Bermúdez, ValmoreThe beginnings of the Metabolic Syndrome (MetS) as a suspected, not yet recognized entity can be traced back to 1923 when a study concerning a particularly common clustering of metabolic entities observed in diabetic patients was first published. Years of research and endless debate yielded the currently accepted MetS definition and diagnostic criteria, even if some components and their cut-off points are still up for discussion. To date, MetS are defined as a clustering of metabolic risk factors that greatly increase the incidence of cardiovascular disease (CVD) and type 2 diabetes (T2D), while also being closely related to various potentially deadly comorbidities. Furthermore, since early detection and management of MetS have been shown to decrease the risk for CVD and T2D, current research has focused on unifying diagnostic criteria and proposing novel parameters to facilitate MetS identification, while also promoting a healthy lifestyle as a preventive measure. With a deeper understanding of MetS pathophysiology comes the broadening of therapeutic targets open for study, thus expanding and enhancing the treatment methods currently in use. This review aims to summarize the evolution of MetS as a concept, development of the diagnostic criteria, current management, and future directions.Ítem Non-HDL cholesterol is better than LDL-c at predicting atherosclerotic cardiovascular disease risk factors clustering, even in subjects with near-to-normal triglycerides: A report from a Venezuelan population(F1000 Research Ltd., 2018-09-20) Bermúdez, Valmore; Torres, Wheeler; Salazar, Juan; Martínez, María Sofía; Rojas, Edward; Olivar, Luis Carlos; Lameda, Victor; Ortega, Ángel; Ramírez, Paola; Rojas, Milagros; Rastogi, Sheena; D’Addosio, Rosanna; Hoedebecke, Kyle; Graterol, Modesto; Graterol, Resemily; Wilches, Sandra; Cabrera de Bravo, Mayela; Rojas-Quintero, JoselynBackground: Non-high density lipoprotein cholesterol (non-HDL-c) has emerged as an important tool in primary prevention of atherosclerotic cardiovascular disease (ASCVD), especially among those at high risk. The main objective of this study was to evaluate the predictive value of non-HDL-c for the coexistence aggregation of multiple ASCVD risk factors and compare this with LDL-c in general subjects with normal or near normal triglycerides from Maracaibo city in Venezuela. Methods: This is a descriptive, cross-sectional study with a randomized multistage sampling. 2026 subjects were selected for this study, all were adults ≥18 years old of both genders and inhabitants of Maracaibo city, Venezuela. A complete history and physical medical assessment was performed. A multivariate logistic regression model was used to determine the odds ratio (CI95%) for the coexistence of multiple risk factors for ASCVD. Results: The median (p25-p75) of non-HDL-c was 143 mg/dL (114-174 mg/dL). 52.1% (n=1056) of the sample were women, with a median of 144 mg/dL (115-174 mg/dL) among women and 143 mg/dL (114-17 4mg/dL) among men; p=0.740. Individuals ≥50 years old, smokers, those with hypertension, obesity, diabetes, high waist circumference and elevated hs-C Reactive Protein, all had higher levels of non-HDL-c. A lower median was observed among those <30 years of age with elevated physical activity levels in their leisure time. Non-HDL-c between 130-159 mg/dL (OR=2.44; CI 95%=1.48-4.02; p<0.001) and ≥160 mg/dL (OR=3.28; CI 95%=1.72-6.23; p<0.001) was associated with greater risk of coexistent multiple risk factors for ASCVD, albeit LDL-c was not significant in the multivariate model. Conclusions: Elevated non-HDL-c was associated with conglomeration of multiple risk factors for ASCVD. This suggests evaluation of non-HDL-c may be of better utility in primary care for early identification of subjects for high risk of ASCVD. Future research might focus on the influence of non-HDL-c in cardiovascular mortality.