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La aterosclerosis coronaria en los Tsimane indígenas de América del Sur: un estudio de cohorte transversal
Hillard Kaplan1, Randall C Thompson2, Benjamin C Trumble3
1Department of Anthropology, University of New Mexico, Albuquerque, NM, USA.
Lancet (London, England)
|March 22, 2017
Resumen
El pueblo Tsimane en Bolivia presenta los niveles más bajos de enfermedad arterial coronaria a nivel mundial, a pesar de la alta inflamación. Un estilo de vida con LDL bajo, IMC normal y no fumar puede prevenir la aterosclerosis coronaria.
Área de la Ciencia:
- Salud cardiovascular
- Epidemiología
- Antropología
Sus antecedentes:
- Los factores de riesgo de la enfermedad arterial coronaria (CAD) están bien establecidos en las poblaciones industrializadas.
- Los Tsimane, un grupo indígena boliviano, mantienen un estilo de vida de subsistencia con una baja prevalencia de factores de riesgo de CAD pero una alta carga de enfermedades infecciosas.
Objetivo del estudio:
- Investigar la asociación entre un estilo de vida preindustrial y la prevalencia de factores de riesgo de enfermedad arterial coronaria en la población Tsimane.
- Para comparar los niveles de aterosclerosis coronaria en los Tsimane con las poblaciones industrializadas.
Principales métodos:
- Un estudio transversal de cohorte de adultos Tsimane de 40 años o más.
- Calificación del calcio de la arteria coronaria (CAC) mediante tomografías computarizadas sin contraste.
- Comparación de las puntuaciones de CAC y los biomarcadores lipídicos/inflamatorios con la cohorte del estudio multiétnico de la aterosclerosis (MESA).
Principales resultados:
- El 85% de los individuos Tsimane no tenían calcio en la arteria coronaria (CAC), lo que indica una aterosclerosis mínima.
- Solo el 8% de los Tsimane mayores de 75 años tenían puntuaciones CAC de 100 o más, significativamente más bajas que las poblaciones industrializadas.
- Se observaron niveles bajos de colesterol LDL, obesidad rara, hipertensión, azúcar alta en la sangre y tabaquismo, a pesar de los altos niveles de proteína C reactiva.
Conclusiones:
- La población Tsimane exhibe los niveles más bajos reportados de enfermedad arterial coronaria a nivel mundial.
- Un estilo de vida caracterizado por LDL muy bajo, presión arterial normal, niveles saludables de glucosa, IMC normal, no fumar y actividad física pueden prevenir la aterosclerosis coronaria.
- Se necesita más investigación para determinar las contribuciones relativas de estos factores.
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