Abstract
Evaluation of a ‘life reform’ program for the metabolic syndrome in Lima, Peru
Yolanda Angulo-Bazán, MD, MSc (c)1, Martha Villar2, Yessica Ballinas2 and César Gutierrez3
(1)Universidad de La Frontera, Temuco, Chile, (2)Peruvian Social Health Insurance (EsSalud), Lima, Peru, (3)School of Medicine. University of Piura (UDEP), Lima, Peru
APHA 2017 Annual Meeting & Expo (Nov. 4 - Nov. 8)
Introduction: Lifestyle change is the first-line therapy for the metabolic syndrome. It is recommended that each country implements socially and culturally accepted strategies, as well as cost-effective. To evaluate the decrease in the frequency of parameters of Metabolic Syndrome in workers who have received the health-promotion program "Reform of Life" from Social Health Insurance (EsSalud) from January to December 2015.
Methods: A non-concurrent study was conducted and the medical records of health centers with the largest amount of workers that received the intervention in the first quarter of 2015 were selected. Data from patients with premorbid Metabolic Syndrome was selected for statistical analysis. Demographic characteristics, systolic and diastolic blood pressure, abdominal circumference were evaluated at the beginning and after twelve weeks of the "Life Reform" intervention. In addition, laboratory tests (HDL, triglycerides, and fasting blood glucose) were also registered at the beginning and after twelve weeks of intervention. The difference between baseline and final values was analyzed with Student t test for paired data and Z test for difference of proportions.
Results: Between January and December 2015, 3,709 workers were screened with a median age of 36 years (interquartile range: 19 years). 66.1% were male. 43.5% were overweight at the time of the first evaluation; 902 workers (24.3%) met the criteria for pre-morbid metabolic syndrome and entered the Life Reform program; 247 workers completed the twelve sessions of the intervention, with an attendance rate of 27.3%. Significant differences were observed in mean glucose levels (p <0.001), abdominal perimeter (p <0.001), systolic pressure (p=0.002), diastolic pressure (p=0.012), triglyceride levels (p<0.001) and HDL cholesterol (p=0.016) in workers who completed the Life Reform program. After Life Reform program, 114 workers (46.4% of intervened workers) didn’t met criteria of pre-morbid metabolic syndrome. The percentage of metabolic syndrome indicators before and after the intervention was compared and the indicators with the largest decreases were hypertriglyceridemia (∆ 30.0%; CI95%: 23.6%-36.2%) and HDL (∆ 19.4%; CI95%: 12.9%-25.9%)
Conclusions: During the January-December period of 2015, the Life Reform program decreased all indicators for the metabolic syndrome, especially hypertriglyceridemia and low HDL-cholesterol, among workers recipients of the intervention in Lima, Peru. The main recommendation is to conduct a prospective study with a larger and more representative population to evaluate other intervening variables such as place of birth and occupation.
Chronic disease management and prevention Diversity and culture Implementation of health education strategies, interventions and programs Planning of health education strategies, interventions, and programs Public health or related research Social and behavioral sciences