Keywords
Overweight
Metabolic risk
Cardiovascular risk
FINDRISK
PAHO
Prevention
How to Cite
Abstract
Introduction: Cardiovascular diseases (CVD) and diabetes mellitus are significant public health concerns in Colombia, contributing largely to morbidity and mortality. Early identification of individuals at cardiometabolic risk is essential for implementing preventive interventions. This study aims to analyze the relationship between the FINDRISK and PAHO tools in a large sample of the Colombian population.
Methodology: A descriptive and observational study was conducted from July 2019 to June 2022, involving 126,113 individuals aged 18 from Medellín, Colombia. FINDRISK scale was used to assess the type 2 diabetes risk and PAHO score to evaluate cardiovascular risk in as low, moderate, and high categories. Anthropometric measurements, such as BMI and waist circumference, were measured. Descriptive statistics and the Chi-square test were applied to explore examine the association among risk categories. Additionally, an ordinal logistic regression model was used to assess the association among FINDRISK and PAHO cardiovascular risk levels.
Results: The median age was 43 years (IQR: 29-58), and the median BMI was 26.08 kg/m². The median waist circumference was 87 cm. Most participants (62.56%) exhibited a low risk of developing diabetes (FINDRISK), while 8.86% were classified with high cardiovascular risk (PAHO). The Chi-square analysis revealed significant associations among FINDRISK and PAHO risk categories (p < 0.001), with a very significant strong correlation at both ends of the risk levels. The ordinal regression showed an adequate convergence and a moderate predictive capacity (pseudo-R-squared = 0.1195). FINDRISK was positively associated with PAHO risk levels, increasing the likelihood of belonging to the “Moderate Risk” category by 22.9% and to the “High Risk” category by 20.5% for each additional FINDRISK point (OR: 1.229 and 1.205, respectively). Intersections were significant, capturing the differences among the risk levels.
Conclusions: The combination of the FINDRISK and PAHO tools allows for a more comprehensive assessment of cardiometabolic risk, improving the identification of individuals at higher risk of both type 2 diabetes mellitus and cardiovascular events.
References
Escobar Diaz GL, Orozco Molina AM, Nunez Montes JR, Muñoz FL. Mortality from cardiovascular diseases in Colombia. An analysis of public policies. Salud Uninorte. 2020;36(3):558-70. https://doi.org/10.14482/sun.36.3.616.12
Vargas-Uricoechea H, Casas-Figueroa LÁ. An epidemiologic analysis of diabetes in Colombia. Ann Glob Health. 2015;81(6):742-53. https://doi.org/10.1016/j.aogh.2015.11.001
Tuesca Molina R, Ríos García AL, Acosta Vergara T, Florez-Garcia VA, Rodríguez Gutierrez V, Florez Lozano K, et al. Predictors of diabetes risk in urban and rural areas in Colombia. Heliyon. 2021;8(1):e08653. https://doi.org/10.1016/j.heliyon.2021.e08653
Benziger CP, Roth GA, Moran AE. The global burden of disease study and the preventable burden of NCD. Glob Heart. 2016;11(4):393-7. http://dx.doi.org/10.1016/j.gheart.2016.10.024
Murray CJL, Lopez AD. What is the Global Burden of Disease. N Engl J Med. 2013;369(5):448-57. https://doi.org/10.1056/NEJMra1201534
Tremmel M, Gerdtham UG, Nilsson PM, Saha S. Economic burden of obesity: a systematic literature review. Int J Environ Res Public Health. 2017;14(4):435. https://doi.org/10.3390/ijerph14040435
Lucumí DI, Mentz G, González C, Valenzuela L, Veira M, Tello K. Cardiovascular disease prevention capacity in Colombian local health departments. Glob Public Health. 2023;18(1):2267632. https://doi.org/10.1080/17441692.2023.2267632
Lim HM, Chia YC, Koay ZL. Performance of the Finnish Diabetes Risk Score (FINDRISC) and Modified Asian FINDRISC (ModAsian FINDRISC) for screening of undiagnosed type 2 diabetes mellitus and dysglycaemia in primary care. Prim Care Diabetes. 2020;14(5):494-500. https://doi.org/10.1016/j.pcd.2020.02.008
Nieto-Martinez R, Barengo NC, Restrepo M, Grinspan A, Assefi A, Mechanick JI. Large scale application of the Finnish diabetes risk score in Latin American and Caribbean populations: a descriptive study. Front Endocrinol (Lausanne). 2023;14:1188784. https://doi.org/10.3389/fendo.2023.1188784
Ordunez P, Tajer C, Gaziano T, Rodríguez YA, Rosende A, Jaffe MG. La aplicación HEARTS: una herramienta clínica para el manejo del riesgo cardiovascular y la hipertensión en la atención primaria de salud. Rev Panam Salud Pública. 2022;46:e46. https://doi.org/10.26633/RPSP.2022.46
Carrillo-Larco RM, Aparcana-Granda DJ, Mejia JR, Bernabé-Ortiz A. FINDRISC in Latin America: a systematic review of diagnosis and prognosis models. BMJ Open Diabetes Res Care. 2020;8(1):e001169. https://doi.org/10.1136/bmjdrc-2019-001169
Rodgers JL, Jones J, Bolleddu SI, Vanthenapalli S, Rodgers LE, Shah K, et al. Cardiovascular risks associated with gender and aging. J Cardiovasc Dev Dis. 2019;6(2):19. https://doi.org/10.3390/jcdd6020019
Rosero RJ, Polanco JP, Ciro V, Uribe A, Manrique H, Sánchez PE. Proposal for a multidisciplinary clinical approach to obesity. J Med Clin Res Rev. 2020;4(12):1047-60. https://doi.org/10.33425/2639-944X.1185
Abraham TM, Pedley A, Massaro JM, Hoffmann U, Fox CS. Association between visceral and subcutaneous adipose depots and incident cardiovascular disease risk factors. Circulation. 2015;132(17):1639-47. https://doi.org/10.1161/circulationaha.114.015000
Ruiz-Castell M, Samouda H, Bocquet V, Fagherazzi G, Stranges S, Huiart L. Estimated visceral adiposity is associated with risk of cardiometabolic conditions in a population based study. Sci Rep. 2021;11(1):9121. https://doi.org/10.1038/s41598-021-88587-9
Wang Z, Chen J, Zhu L, Jiao S, Chen Y, Sun Y. Metabolic disorders and risk of cardiovascular diseases: a two-sample mendelian randomization study. BMC Cardiovasc Disord. 2023;23(1):529. https://doi.org/10.1186/s12872-023-03567-3
Rus M, Crisan S, Andronie-Cioara FL, Indries M, Marian P, Pobirci OL, et al. Prevalence and risk factors of metabolic syndrome: a prospective study on cardiovascular health. Medicina. 2023;59(10):1711. https://doi.org/10.3390/medicina59101711
Després JP. Body fat distribution and risk of cardiovascular disease: an update. Circulation. 2012;126(10):1301-13. https://doi.org/10.1161/circulationaha.111.067264
Sattar N, Gill JMR. Type 2 diabetes as a disease of ectopic fat? BMC Med. 2014;12:123. https://doi.org/10.1186/s12916-014-0123-4
Haffner SM, Lehto S, Rönnemaa T, Pyörälä K, Laakso M. Mortality from coronary heart disease in subjects with type 2 diabetes and in nondiabetic subjects with and without prior myocardial infarction. N Engl J Med. 1998;339(4):229-34. https://doi.org/10.1056/nejm199807233390404
Gupta A, Gupta V. Metabolic syndrome: what are the risks for humans? Biosci Trends. 2010;4(5):204-12.
Martinez-Millana A, Argente-Pla M, Valdivieso Martinez B, Traver Salcedo V, Merino-Torres JF. Driving type 2 diabetes risk scores into clinical practice: performance analysis in hospital settings. J Clin Med. 2019;8(1):107. https://doi.org/10.3390/jcm8010107
Chamnan P, Simmons RK, Sharp SJ, Griffin SJ, Wareham NJ. Cardiovascular risk assessment scores for people with diabetes: a systematic review. Diabetologia. 2009;52(10):2001-14. https://doi.org/10.1007/s00125-009-1454-0
Motamed N, Ajdarkosh H, Karbalaie Niya MH, Panahi M, Farahani B, Rezaie N, et al. Scoring systems of metabolic syndrome and prediction of cardiovascular events: a population based cohort study. Clin Cardiol. 2022;45(6):641-9. https://doi.org/10.1002/clc.23827
Grundy SM, Stone NJ, Bailey AL, Beam C, Birtcher KK, Blumenthal RS, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2019;73(24):3168-3209. https://doi.org/10.1016/j.jacc.2018.11.002
Visseren F, Mach F, Smulders YM, Carballo D, Koskinas KC, Bäck M, et al. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice. Eur Heart J. 2021;42(34):3227-3337. https://doi.org/10.1093/eurheartj/ehab484
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Copyright (c) 2025 Revista Colombiana de Endocrinología, Diabetes & Metabolismo