Validation of the IberScore model in a primary care population

BACKGROUND

This study aimed to validate the IberScore cardiovascular risk model in a population attended in the primary care setting.

METHODS

A cohort of patients with no history of cardiovascular disease visited in a primary care center during the years 2008 and/or 2009 and followed up until 2018 was selected. Cardiovascular risk was calculated with the IberScore formula for all the subjects of the cohort and the model was calibrated, graphically represented by risk deciles the proportion of expected events and proportion of observed events at 10-year follow-up, stratified by sex. The area under the ROC curve was calculated to assess the discrimination of the model.

RESULTS

A total of 10,085 patients visited during the years 2008 and/or 2009 were included in the study. Men showed a mean 10-year risk of suffering a fatal or non-fatal cardiovascular events according to IberScore of 17.07% (SD 20.13), with a mean estimated vascular age of more than 4 years higher than the biological age; while women had a mean 10-year risk of 7.91% (SD 9.03), with an estimated vascular age of more than 2 years above the biological age. The area under the ROC curve showed a discrimination index of the model of 0.86 (95% CI 0.84-0.88) in men and 0.82 (95% CI 0.79-0.85) in women.

CONCLUSION

IberScore model discriminates well in the population attended in primary care but the model overestimates the risk.

[Prevalence of non-alcoholic fatty liver disease and associated risk factors among managers from the community of Madrid]

OBJECTIVE

To determine the prevalence of non-alcoholic fatty liver disease (NAFLD) and associated risk factors in a group of managers from the Community of Madrid.

METHODS

Retrospective cross-sectional study of 1838 workers (78.5% male) who underwent medical examination between January 1, 2010 and December 31, 2010 as part of a worker health surveillance program. Data were collected from medical records, laboratory results, anthropometric measurements and hepatic ultrasound.

RESULTS

The prevalence of NAFLD was 44.0%: 54.0% in men and 7.3% in women (p<0.001). In both sexes, NAFLD was associated with increasing age, higher weight, shorter stature, higher body mass index, waist circumference and metabolic syndrome, as well as higher levels of uric acid and blood glucose. In the multivariate logistic regression analysis, the risk of NAFLD risk was associated with an abdominal circumference ≥ 102cm for men and ≥ 88cm in women (OR=5.2; 95%CI 3.8-7.1 ), age ≥ 40 years (OR : 3.0; 95%CI 2.3-4.0), triglycerides ≥ 150mg/dl (OR=2.1; 95%CI 1.5-2.8), HDL cholesterol <45mg/dl in women and <40mg/dl in men (OR=1.6; 95%CI 1.1-2.2), and total cholesterol >200/dl mg (OR=1.4; 95%CI 1.0-1.9).

CONCLUSIONS

NAFLD prevalence is notably different among sexes and is associated with hypertriglyceridemia, hypercholesterolemia, low HDL cholesterol, abdominal obesity and metabolic syndrome. Screening programs for NAFLD in worker medical surveillance programs could be of interest in occupational medicine.

[Prevalence of tobacco consumption among working population after the law 42/2010, Spain]

BACKGROUND

The aim of this study was to analyze the impact on tobacco consumption among working population of the Law 42/2010, which amends smoking regulations in Spain.

METHODS

Data were obtained from 413,473 Occupational Health check-ups, conducted between July of 2009 and June of 2011, in the Society for Prevention of a Mutual Insurance Company. We analyzed changes in the biannual percentage of smokers and the magnitude of tobacco consumption among smokers in the overall set of medical check-ups, by gender, age, occupational level (manual vs. non-manual workers), and in the specific occupational subgroup of waiters, barmen and similar workers (chi-square test).

RESULTS

In the overall set of medical check-ups, the percentage of smokers decreased by 5% (from 40.3% to 35.3%) over the period of study (p <0.001) and the group of smokers with lower daily consumption (< 10 cigarettes) became the most frequent (p <0.001). In the group of waiters, barmen and similar workers the differences in the biannual percentage of smokers did not reach statistical significance (p =0.07). In this group, smokers of < 10 cigarretes/ day also became the most common consumption group (increasing from 40.5% to 48.8%) and the percentage of 21-40 cigarretes/day decreased from 10.6% to 4% (p =0.008).

CONCLUSIONS

These results suggest that the new regulation has been accompanied by a significant reduction in smoking among Spanish workers and strongly support population-level measures against tobacco consumption.