It is a secondary analysis, descriptive and cross-sectional of the information obtained in the Survey on Health, Well-Being, and Aging in Colombia (SABE) 2015, which was financed by the Ministry of Health and Social Protection of Colombia (Minsalud), and the Administrative Department of Science, Technology and Innovation, (Colciencias) and carried out during the years 2014 to 2015 in 3824 elders aged between 60 and 101 years. This survey is a cross-sectional measurement, carried out to explore and evaluate interdisciplinarily and in depth, several aspects that intervene in the phenomenon of aging and old age of the Colombian population(14).
The sample for the SABE (2015) was of regional representativeness, self-representation of large cities, with urban-rural stratification of the sample and selection by stages in accordance with the existing municipal cartography in Minsalud, in the following order: Municipalities, urban segments or rural, dwellings or sidewalks, homes and people. The study included the Colombian population aged 60 and over, and the indicators are disaggregated by age ranges, sex, ethnicity and socioeconomic level. This cross-sectional survey was carried out to find out about the current situation, in rural and urban areas, of the population of older adults in Colombia, through interdisciplinary exploration and evaluation and at the depth of old age and aging, in the framework of the Determinants of Active Aging and from the model of the Social Determinants of Health. Details of the survey have been published elsewhere(15).
The universe of study was constituted by 99% of the population residing in private homes in the urban and rural areas. A total of 23,694 surveys were carried out at the national level with a non-response rate of 34%, 6,365 total population segments for the sample investigation; in 246 municipalities. Bogotá, being the capital, was independently selected with a total of 545 urban segments and a rural segment. The average number of adults found per segment was 4.2(14).
The estimation of means or proportions was made with a level of precision of up to 6% of the maximum expected error, at a level of national disaggregation only. The selection of the participants was by systematic selection and according to the sampling fraction with respect to the general SABE sample (14).
Collection of information and measurement processes
The SABE Colombia Survey was applied in the households of the country selected in the sample and with the presence of older adults. The basic procedure for the application of the population survey was the face-to-face interviewer-older adults adult interview, using a structured questionnaire. The interviewers visited the selected homes door to door, carrying distinctive elements and identifiers of the study. The standardized process of the survey in each visited home involved the identification of the participants, the registration of the demographic data, the signing of the informed consent, the application of the established filters and the selection criteria, the signing of assent when necessary and the completion of questionnaire questions by the interviewer(14).
Blood pressure was taken with an electronic manometer (HEM 7113, Omron Healthcare Co., Ltd., Kyoto, Japan) that met the calibration requirements. The values were recorded after 5 minutes of rest in the sitting position and three consecutive measurements were obtained, waiting at least 30 seconds between the readings(15).
The anthropometric data of height and weight of this study use the methodology of a previously published work and are in accordance with the population surveys approved by Minsalud.(15); the circumference of the waist was measured at the midpoint between the inferior border of the ribs and the iliac crest in the midaxillary plane by a tape Inelastic anthropometric(15).
Analysis of glycemia, total cholesterol and triglycerides: After an overnight fast, blood samples were collected in the morning. The blood samples were centrifuged for 10 minutes at 3000 rpm, 30 min after sample collection. All samples were delivered to a single central laboratory (Dinamica Laboratories, Bogotá, Colombia) for analysis within 24 hours. Residual samples were stored at -80∘C for future analyzes(15).
All the questions that were applied in the questionnaire were made in textual form to each person surveyed without any interpretations or clarifications of any kind by the interviewer. When the respondent did not understand any of the questions, despite the fact that the interviewer repeated it verbatim, no clarification was given and the questions of the following domain were passed on.
The HTGW phenotype was defined as the outcome variable(16), those people who presented with abdominal obesity (the cut points used were abdominal circumference> 80 cm for women and> 90 cm for men (17)) and hypertriglyceridemia (cut-off point used was triglycerides ≥ 150 mg / dl (16)).
Sociodemographic variables: Age: between 60 and 64 years old, between 65 and 69 years old, between 70 and 74 years old, between 75 and 79 years old and 80 and over; sex: men and women; schooling: none, basic primary, basic secondary and secondary, and technical or technological, university or postgraduate; Accompaniment at home: live with others and live alone; the socioeconomic position was determined according to the housing stratum (1 to 6), with level 1 being the one with the highest poverty and level 6 with the highest wealth, this classification is a measure developed by the Colombian National Government, which takes into account physical characteristics of the dwellings and their surroundings, the classification in any of the six strata is an approximation to the hierarchical socioeconomic difference, read poverty to wealth or vice versa(17) area or origin: urban or rural.
Lifestyle: smoking, current smoker and former smoker, never smoked; intake of alcoholic beverages, one day or less a week and two days or more a week.
Health conditions: body mass index (BMI): weight cut off points: BMI <18.50, normal weight BMI 18.50 to 24.99, overweight: BMI ≥ 25 and <30 and obesity: BMI ≥ 30 (19); and abdominal obesity: cutting points used abdominal perimeter> 80 cm for women and> 90 cm for men(18).
Biological markers in blood: Fasting glucose increase: cut-off points ≥ 100mg / dL(19), Total cholesterol increase: cut-off points ≥ 200 mg / dL (18,19); High-density lipoprotein cholesterol (HDL-c) reduced: cutoff <40 mg / dL in men and <50 mg / dL in women(19); low-density lipoprotein cholesterol (LDL-c) increased ≥ 160 mg / dL(19) increased triglycerides: cut-off point ≥ 150 mg / dl (3.10); decrease in the concentration of hemoglobin (Hb): cut-off points <13 g / dl in men and <12 g / dl in women in places at sea level(20).
The categorical and / or ordinal variables were expressed as frequencies. Chi square tests (X2) were applied in the categorical variables, with or without Yates correction. Subsequently, an exploratory analysis was conducted to determine the percentage distribution for each of the associated factors. To estimate the relationship between the hypertriglyceridemic waist phenotype and the independent variables, a logistic regression was used. Simple logistic regressions were performed individually for each independent variables to analyze the association with HTGW. HTGW was included in each simple logistic regression as the dependent variable (reference: to have HTGW). Group reference in the simple logistic regressions were: Male (Sex), 60 – 64 years (Age), Technical or university (Scholarship), Live alone (Accompaniment at home), Level IV or more (Socioeconomic level), Rural (Geographic área), No smoker (Smoke), One day or less a week (Ingestion of alcoholic beverages), Normal weight (18.5-24.9 kg/m2) (Nutritional Status), < 100 mg/dL (Glycemia), < 200 mg/dL (Total-Cholesterol) ≥ 40 mg/dL male or ≥ 50 mg/dL female (HDL-Cholesterol) < 160 mg/dl (LDL-Cholesterol), ≥13 g/dl male or ≥12 g/dl female (Hemoglobin)
The analyzes were performed in the Statistical Package for Social Science® software, version 20 (SPSS, Chicago, IL, United States), and a p value <0.05 was considered significant. The STROBE checklist for cross-sectional studies was applied in this paper(21–23) (see Supplementary File 1)