ObjectivesWe aimed to estimate the prevalences of diabetes and impaired fasting glucose (IFG) in a national sample in Peru and assess the relationships with selected sociodemographic variables.MethodsWe estimated prevalence in PERUDIAB study participants, a nationwide, stratified urban and suburban population selected by random cluster sampling. Between 2010 and 2012, questionnaires were completed and blood tests obtained from 1677 adults ≥25 years of age. Known diabetes was defined as participants having been told so by a doctor or nurse and/or receiving insulin or oral antidiabetic agents. Newly diagnosed diabetes was defined as fasting plasma glucose ≥126 mg/dL determined during the study and without a previous diabetes diagnosis. IFG was defined as fasting plasma glucose of 100–125 mg/dL.ResultsThe estimated national prevalence of diabetes was 7.0% (95% CI 5.3% to 8.7%) and it was 8.4% (95% CI 5.6% to 11.3%) in metropolitan Lima. No gender differences were detected. Known and newly diagnosed diabetes prevalences were estimated as 4.2% and 2.8%, respectively. A logistic regression response surface model showed a complex trend for an increased prevalence of diabetes in middle-aged individuals and in those with no formal education. Diabetes prevalence was higher in coastal (8.2%) than in highlands (4.5%; p=0.03), and jungle (3.5%; p<0.02) regions. The estimated national prevalence of IFG was 22.4%, higher in males than in females (28.3% vs 19.1%; p<0.001), and higher in coastal (26.4%) than in highlands (17.4%; p=0.03), but not jungle regions (14.9%; p=0.07).ConclusionsThis study confirms diabetes as an important public health problem, especially for middle-aged individuals and those with no formal education. 40% of the affected individuals were undiagnosed. The elevated prevalence of IFG shows that nearly a quarter of the adult population of Peru has an increased risk of diabetes.

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Some studies have found different distribution patterns for the lipid profile of high altitude populations, having found the majority of them a more favorable one in these subjects. The objective of this study is to describe the lipid profile of a high altitude population and relate it to the waist circumference, body mass index, gender, and age. A descriptive study was done in an adult population, 30 yr old and above, of the town of San Pedro de Cajas (SPC), Peru, located at 4100 m (13,450 ft) above sea level. One hundred and two representative individuals (38 males and 64 females) were included. HDL cholesterol and triglyceride means were elevated, whereas total cholesterol means were average, and LDL cholesterol means were low. The BMI mean was 25.4 +/- 3.7. We observed a high prevalence of hypercholesterolemia (34.3%) and hypertriglyceridemia (53.9%) in both genders. Higher prevalences of low HDL (45.3%), abnormal waist circumference (64%), and obesity (14.1%) were found in women (p < 0.001). A higher prevalence of low HDL in overweight/obese (74.2%) and abnormal waist circumference (77.4%) subjects was evident (p < 0.001). We found high prevalences of hypercholesterolemia and hypertriglyceridemia for both genders and important prevalences of risk factors for cardiovascular disease and coronary heart disease, such as hypertriglyceridemia, low HDL, abnormal waist circumference, and obesity, in high altitude natives, especially in women.

We found an overwhelming predominance of females with the metabolic syndrome in both populations due to high prevalences of abdominal obesity and low highdensity lipoprotein (HDL) Hypertriglyceridemia prevalence was elevated in both men and women of high altitude. Lower prevalence of high blood pressure and of high fasting glucose was found in the high-altitude natives. The prevalence and characteristics of the metabolic syndrome apparently varies among different ethnic groups and this indicates the need for more epidemiologic studies.

OBJECTIVE -We have carried out international comparisons of the metabolic syndrome using the International Diabetes Federation (IDF) and National Cholesterol Education ProgramAdult Treatment Panel III (ATP III) definitions. This analysis could help to discern the applicability of these definitions across populations.RESEARCH DESIGN AND METHODS -Nondiabetic subjects aged 35-64 years were eligible for analysis in population-based studies from San Antonio (Mexican Americans and non-Hispanic whites, n ϭ 2,473), Mexico City (n ϭ 1,990), Spain (n ϭ 2,540), and Peru (n ϭ 346). Statistics examined the agreement between metabolic syndrome definitions.RESULTS -Because of the lower cutoff points for elevated waist circumference, the IDF definition of the metabolic syndrome generated greater prevalence estimates than the ATP III definition. Prevalence difference between definitions was more significant in Mexican-origin and Peruvian men than in Europid men from San Antonio and Spain because the IDF definition required ethnic group-specific cutoff points for elevated waist circumference. ATP III and IDF definitions disagreed in the classification of 13-29% of men and 3-7% of women. In men, agreement between these definitions was 0.54 in Peru, 0.43 in Mexico City, 0.62 in San Antonio Mexican Americans, 0.69 in San Antonio non-Hispanic whites, and 0.64 in Spain. In women, agreement between definitions was 0.87, 0.89, 0.86, 0.87, and 0.93, respectively. CONCLUSIONS -The IDF definition of the metabolic syndrome generates greater prevalence estimates than the ATP III definition. Agreement between ATP III and IDF definitions was lower for men than for women in all populations and was relatively poor in men from Mexico City. Diabetes Care 29:685-691, 2006C ardiovascular diseases accounted for 29.3% (16.7 of 57 million) of the world's deaths in 2002, and more than one-third of these deaths occured in middle-aged adults (1). Many cardiovascular risk factors are related to the adoption of a sedentary lifestyle (2). The metabolic syndrome is characterized by a clustering of central obesity, insulin resistance, glucose intolerance, hypertension, atherogenic dyslipidemia, hypercoagulability, and proinflammatory state (2). The etiology of the metabolic syndrome is unknown, but predisposing factors include aging, obesity, sedentary lifestyle, and genetics. This syndrome predicts cardiovascular disease and type 2 diabetes (3). However, concept and definition of the metabolic syndrome are subject to debate (4,5), including the applicability of a single definition to people of different ethnic origin (6).The analysis of geographic variations of the metabolic syndrome could generate new insights since similar analyses on cardiovascular risk factors have improved our knowledge of cardiovascular disease (7). Studies on geographic variations of the metabolic syndrome are few (8 -10). They are often difficult because of differences in aims, survey protocols, assessment period, and definition of the metabolic syndrome.We examined two definitions of...