Geospatialization of cardiometabolic diseases and risk factors related to built environment in Córdoba

Abstract

The ecological approach by the built environment (BE) analisis is an important tool for a comprehensive approach to cardiometabolic diseases (CMD), with the use of space technologies as an innovative way. The aim was to spatialize the presence of CMD and its risk factors in relation to BE, in patients of the Hospital Nacional de Clínicas (HNC), Córdoba city, period 2015-2020. 

Observational, descriptive and cross-sectional study, including a non-probabilistic sample, (n=345), age over 35 years old, both sexes, and who attended the HNC Cardiology Service. Data related to CMD was collected through medical records, blood samples, anthropometric measurements, and validated questionnaires of physical activity and food intake. Through remote sensing, BE variables (products of vegetation, humidity and construction) were obtained based on a Landsat 8 satellite image. An exploratory analysis of the variables related to CMD and BE was carried out, comparing according to sex, location, and presence or not from CMD; calculating differences by Test-t. A purely spatial analysis (clusters) was performed to characterize the distribution of the presence of CMD and risk factors (Stata 15, Qgis, and SatScan). 

55.32% of the sample showed obesity, 41.03% metabolic syndrome (MS) and 22.58% type 2 diabetes mellitus (DM2). Women had significantly higher serum values ​​of total cholesterol, LDL and HDL than men (p=0.0001, p=0.01 and p<0.00001, respectively). Likewise, the daily intake of energy, proteins and lipids was significantly higher in men compared to women (p=0.009, p=0.004 and p=0.0005, respectively). 83.64% presented low/intermediate levels of physical activity. In BE households with vegetation cover, the absence of DM2 was greater (p=0.004). Towards the northwest of the city, a significant cluster (p=0.02) of DM2 cases was identified, coinciding with the MS cases. 

The multidimensional study of the CMD with the inclusion of geomatic tools constitutes an innovative contribution in the public health field.