title: Prevalence of Obesity and its Association with Chronic Kidney Disease, Hypertension and Diabetes Mellitus. Isle of Youth Study (ISYS), Cuba.
abstract: Obesity is a social disease constituting a global pandemic. It is present in 90% of diabetic and 65% of hypertensive patients. It is associated with cardiometabolic syndrome and with damaging physiopathological mechanisms, particularly for the vascular system and the kidneys. On Cuba's Isle of Youth, a community-based epidemiological study of chronic kidney disease (CKD), hypertension (HTN), diabetes mellitus (DM) and cardio-cerebral vascular disease was carried out in total population, including an examination of common risk factors.
  
  
  
  Based on the Isle of Youth Study (ISYS) data, determine prevalence of obesity and overweight, and their association with CKD, HTN, DM, and shared risk factors for all these conditions in total population of the Isle of Youth, Cuba.
  
  
  
  Phase 1: Population diagnosis (November 2004-April 2006): 96.6% of the Isle of Youth’s total population (80,117) was studied, including all ages and both sexes. Information was offered to the public, and written informed consent obtained. Screening was conducted by participant questionnaire including risk factors, physical measurements (weight, height, blood pressure and body mass index), and a single first-morning urine sample to determine the presence of vascular-renal damage markers – proteinuria and hematuria (Combur 10 Test, Roche), and microalbuminuria (Micral Test, Roche). When results were positive, serum creatinine was determined and glomerular filtration rate (GFR) estimated with Modification of Diet in Renal Disease (MDRD) formula for adults and Schwartz formula for children <15 years. Data obtained were analyzed to determine association of participants’ nutritional status with prevalence of chronic kidney disease, hypertension and diabetes mellitus, as well as a set of common risk factors.
  
  
  
  Population <20 years: Obesity prevalence 3.2%; positive urine markers in 56.9% of obese and 8.9% of non-obese participants; positive albuminuria in 38% of obese and 3% of non-obese. Obese participants were found to be hyperfiltrating. DM prevalence was 9.5% in obese and 1.1% in non-obese participants. Population ≥20 years: Overweight, 31.3%; obese, 13.4%. Positive markers in normal-weight, overweight and obese individuals were 18.3%, 21.2% and 32.7%, respectively; microalbuminuria values increased with weight. Obese individuals were found to be hyperfiltrating. HTN prevalence in normal-weight, overweight and obese individuals was 18.3%, 31.5%, and 51.0% respectively; DM rates were 2.8%, 5.2% y 11.3%, respectively.
  
  
  
  In Cuba, obesity poses significant risk for vascular and renal damage and should be the focus of increased prevention efforts.
authors.affiliation: Institute of Nephrology, Havana, Cuba. raul.herrera@infomed.sld.cu.
authors.forename: Raúl
authors.initials: R
authors.lastname: Herrera-Valdés
authors.forename: Miguel
authors.initials: M
authors.lastname: Almaguer
authors.forename: José
authors.initials: J
authors.lastname: Chipi
authors.forename: Xidix
authors.initials: X
authors.lastname: Toirac
authors.forename: Orquídea
authors.initials: O
authors.lastname: Martínez
authors.forename: Osvaldo
authors.initials: O
authors.lastname: Castellanos
authors.forename: Jorge
authors.initials: J
authors.lastname: Bacallao
authors.forename: Rosa M
authors.initials: RM
authors.lastname: Licourt
authors.forename: Pedro
authors.initials: P
authors.lastname: Mulet
authors.forename: Luisa
authors.initials: L
authors.lastname: Diéguez
authors.forename: Israel
authors.initials: I
authors.lastname: Velásquez
authors.forename: María C
authors.initials: MC
authors.lastname: Hernández
authors.forename: Walfrido
authors.initials: W
authors.lastname: Caballero
authors.forename: Pedro
authors.initials: P
authors.lastname: Urra
authors.forename: Néstor
authors.initials: N
authors.lastname: Rodríguez