S1409-414220010003 Revista Costarricense de Cardiología Rev. costarric. cardiol 1409-4142 Asociación Costarricense de Cardiología S1409-41422001000300001 Clopidogrel y aspirina en pacientes con síndrome coronario agudo (SCA): lo nuevo, lo bueno y lo de cuidado Chávez Brenes Liliana Speranza Sánchez Mario , 12 2001 2001 3 03 04
S1409-414220010003 Revista Costarricense de Cardiología Rev. costarric. cardiol 1409-4142 Asociación Costarricense de Cardiología S1409-41422001000300002 Impacto de una evaluación e intervención nutricional estricta en diabéticos tipo 2 sobre la glucemia y el perfil lipídico Jiménez Montero José G Vargas Picado Marco A Rojas Graciela Mora Morales Eric ,Hospital CIMA San José ,Hospital San Juan de Dios ,Hospital R.A. Calderón Guardia 12 2001 2001 3 6 11

Con el fin de estudiar las alteraciones en el metabolismo de los lípidos en diabéticos tipo 2 y medir el impacto del control glucémico sobre el perfil lipídico se seleccionaron 34 pacientes diabéticos, a quienes se les realizó una evalución clínica basal. Veinte de ellos fueron estudiados nuevamente seis meses después de una intervención nutricional. Al inicio, la glucemia fue 138.0 ± 43.7 y 136.7 ± 45.2 mg/dl, en hombres y mujeres, respectivamente (X ± DS). En hombres la concentración de los triglicéridos fue 357.9 ± 626.9, el colesterol LDL 119.0 ± 31.2 y el colesterol HDL 34.0 ± 10.8 mg/dl. En las mujeres, la concentración de triglicéridos fue 188.3 ± 31.0, el colesterol LDL 139.4 ± 46.0 y el colesterol HDL de 44.5 ± 7.9 mg/dl. Con intervención nutricional se redujo el consumo de grasa saturada de 22.9 ± 13.5 a 12.1 ± 5.5% (p < 0.03) y de grasas monoinsaturadas de 24.0 ± 13.9 a 13.6 ± 6.4 % (p < 0.04). Los pacientes redujeron 2 kilos, la glucemia en ayunas disminuyó de 148. 8 ± 43.5 a 125.2 ± 21.9 mg/dl (p < 0.06), la glucemia post prandial y la hemoglobina glucosilada se redujeron significativamente. El perfil lípídico bajó no significativamente, manteniendose el colesterol LDL mayor de 130 mg/dl en la mayoría de los pacientes. En conclusión la intervención nutricional mejora el control glucémico en diabéticos tipo 2 pero no produce cambios significativos en el perfil lipídico.

In order to study changes in lipid metabolism of type 2 diabetic patients and as to measure the impact of glycemic control on lipid profile, 34 diabetic patients were selected and taken through a basal clinical evaluation. Twenty patients were revaluated six months after nutritional intervention took place. Initially glycemia was 138.0 +/- 43.7 in men and 136.7 +/- 45.2 mg/dl in women (X +/- DS). In men, triglyceride levels were 357.9 +/- 626.9, LDL cholesterol was 119.0 +/- 31.2, and HDL cholesterol was 34.0 +/- 10.8 mg/dl. In women, triglyceride levels were 188.3 +/- 31.0, LDL cholesterol 139.4 +/- 46.0, and HDL cholesterol 44.5 +/- 7.9 mg/dl. Introducing a nutritional process, reduced the consumption of saturated fat from 22.9 +/- 13.5 to 12.1 +/- 5.5% (p < 0.03) and consumption of monoinsaturated fat was also reduced from 24.0 13.9 to 13.6 6.4% (p < 0.04).Patients also lost 2 kilograms, and fasting glycemia was reduced from 148.8 +/- 43.5 to 125.2 +/- 21.9 mg/dl (p < 0.06). Post-prandial glycemia and the glycosilic hemoglobin were significantly reduced, the lipid profile was not significantly reduced, maintaining LDL cholesterol levels above 130 mg/dl in most patients. To conclude, nutritional intervention improves glycemic control in type 2 diabetics but it does not produce significant changes in the lipid profile.

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