Predicción del riesgo cardiovascular y su relación con el síndrome metabólico y los niveles de marcadores serológicos emergentes en vigilancia de la salud de los trabajadores

espanolObjetivos: Calcular el riesgo cardiovascular segun los metodos americano Framingham Coronary Risk Score (FCRS), y europeo Systematic Coronary Risk Evaluation (SCORE) en una poblacion laboral comparar los resultados con la presencia de sindrome metabolico (segun niveles de glucemia, trigliceridemia, colesterolemia, perimetro abdominal y tension arterial) y con los niveles de tres marcadores sericos emergentes: proteina C reactiva ultrasensible (PCRus), homocisteina (Hhcy) y lipoproteina (a) (lp(a) ). Metodos: Los datos fueron recogidos en los examenes de salud rutinarios de trabajadores mayoritariamente del sector servicios en FREMAP Prevencion Alcobendas entre 2004 y 2006 (n=248). Se siguieron los protocolos de Vigilancia de la Salud del Ministerio de Sanidad, anadiendo a la practica habitual la obtencion de una muestra serica adicional y la medicion del perimetro abdominal Resultados: Ninguno de los 248 empleados fue considerado de riesgo alto segun FCRS, frente al 44,8% segun SCORE. Se observo asociacion alta (r=O,78, p Conclusiones: Segun nuestra experiencia, para la prevencion de patologia cardiovascular en la rutina de la vigilancia de la salud laboral creemos justificada la estimacion del riesgo segun metodos FCRS y/o SCORE y la medicion del perimetro abdominal para evaluar la presencia de sindrome metabolico, por su optima relacion coste-beneficio. Sin embargo, no consideramos justificada la determinacion de ninguno de los marcadores biologicos emergentes analizados en este estudio. EnglishObjectives: To calculate cardiovascular risk according to the American Framingham Coronary Risk Score (FCRS) and the European Systematic Coronary Risk Evaluation (SCORE) methods. To correlate the results with the presence of metabolic syndrome (glycemia, triglyceridemia, cholesterolemia, abdominal circumference and blood pressure) and with serum levels of three emerging biomarkers [ultrasensitive reactive C protein (PCRus), homocysteine (Hcy) and lipoprotein (a) (lp (a)]. Methods: Data were gathered during routine medical surveillance of mostly white collar workers in FREMAP Alcobendas from 2004 to 2006 (n=248). We followed standardized health surveillance protocols as established by the Spanish Health Ministry, along with inclusion of an additional blood sample and measurement of the abdominal circumference. Results: None of the 248 workers included in our sample was classified as having high or very high risk according to FCRS in contrast to 44.8 % according to SCORE. We observed a strong correlation (r=O.78, p Conclusions: Our results suggest that the inclusion of risk predictions based on FCRS and/or SCORE could be recommended for the primary prevention of cardiovascular disease, because of their excellent cost-benefit relationship. However, we do not recommend routine measurement of the biological markers included in this study.