Padrões alimentares e escore de síndrome metabólica em crianças de 8 e 9 anos do município de Viçosa, Minas Gerais
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2014-07-18
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Universidade Federal de Viçosa
Resumo
A síndrome metabólica (SM) é determinada por uma série de fatores que resultam em maior risco de desenvolvimento de doença cardiovascular (DCV) e diabetes mellitus tipo 2 (DMZ). Seu diagnóstico e' realizado com base em anormalidades metabólicas, que incluem obesidade abdominal, pressão arterial elevada e alterações nos metabolismos lipídico e glicídico. Para adultos, a SM e' amplamente estudada e os critérios para sua definição nesta faixa etária são bem definidos. No entanto, não há uma definição universal para crianças, bem como permanecem pouco explorados determinantes alimentares desta síndrome para esta faixa etária. Trata-se de um estudo transversal que teve como objetivo avaliar o risco cardiometabólico por meio de um escore de SM e verificar sua associação com os padrões alimentares de crianças de 8 e 9 anos do município de Viçosa, Minas Gerais. Para selecionar as variáveis de risco cardiovascular que iriam compor o escore de SM, foi verificado o padrão de agrupamento das diversas variáveis antropométricas, bioquímicas e clínicas, por meio da análise fatorial por componentes principais. As variáveis de risco estudadas foram: perímetro da cintura (PC), modelo homeostático de resistência à insulina (HOMA), lipoproteína de alta densidade (HDL), triacilglicerol (TAG) e pressão arterial média (PAM). Para cada criança, foram criados escores-z de cada variável selecionada, e a soma desses escores-z originou o escore de SM. A curva receiver operating characteristic (ROC) foi utilizada para identificar o ponto de corte do escore de SM, utilizando-se como variável classificatória o diagnóstico de SM segundo critérios modificados para a idade. O escore de SM pressupõe que todos os componentes da SM contribuem de forma semelhante para o risco cardiometabólico conjunto e que escores mais elevados indicam perfil metabólico menos favorável. O escore de SM foi associado ao consumo alimentar das crianças estudadas. O consumo alimentar foi avaliado por registros alimentares de três dias não consecutivos, sendo um dia de fim de semana, e quantificado em gramas de grupos alimentares. Análise fatorial por componentes principais e subsequente rotação ortogonal (varimax) foram utilizadas para determinar os padrões alimentares. Regressão de Poisson foi utilizada para estimar a associação entre a prevalência de SM, determinada pelo ponto de corte do escore de SM, e os padrões alimentares das crianças. Cinco padrões alimentares foram extraídos, sendo estes: “Tradicional”, “Bebidas adoçadas e lanches”, “Monótono”, “Saudável” e “Ovo-lacto”. O padrão alimentar “Bebidas adoçadas e lanches” foi o único associado à SM na amostra. Escolaridade materna também se associou de forma direta ao risco cardiovascular na amostra. Não foram observadas associações entre os padrões “Tradicional”, “Monótono”, “Saudável” e “Ovo-lacto” e a SM. O padrão “Saudável” foi associado de forma direta e 0 “Bebidas adoçadas e lanches” de forma inversa ao conteúdo dietético de calorias, de proteínas, lipídios e ácidos graxos monoinsaturados, poliinsaturados e saturados.
Metabolic syndrome (MetS) is determined by a number of factors that result in increased risk of developing cardiovascular disease and type 2 diabetes mellitus. lts diagnosis is made on the basis of metabolic alterations that include abdominal obesity, high blood pressure and changes in lipid and glucose metabolisms. For adults, MetS is widely studied and the criteria for its definition in this age group are well defined. However, there is no universal definition for MetS in children as well as their dietary factors are still poorly explored in this age group. The aim of this cross-sectional study was to assess cardiometabolic risk by a MetS score and its association with dietary patterns of children aged 8 and 9 years of Viçosa, Minas Gerais. To select the risk fators that would compose the score of SM, was verified the Clustering pattern of diverse anthropometric, biochemical, and clinical variables through factor analysis by.principal components analysis (PCA). The selected risk factors were: waist circumference (WC), homeostatic model assessment of insulin resistance (HOMA), high density lipoprotein (HDL), triacylglycerol (TAG) and mean arterial pressure (MAP). Z-scores of each selected variable was calculated for each child, and the sum of these z-scores originated the SM score. The receiver operating characteristic (ROC) curve was used to identify the cutoff of MetS score, using the MetS diagnosis according to criteria modified for age as the classification variable. The MetS score assumes that all components of MetS contribute similarly to cardiometabolic risk and that higher scores indicate less favorable metabolic profile. The MetS score was associated with dietary intake of children studied. Dietary intake was assessed by non-consecutive 3-day food records, including one day of the weekend, and quantified in grams of food groups. PCA and subsequent orthogonal rotation (varimax) were used to determine dietary patterns. Poisson regression was used to estimate the association between the prevalence of MetS, determined by the cutoff MetS score, and dietary patterns of children. Five dietary patterns were extracted, namely: "Traditional", "Sweetened beverages and snacks", "Monotonous", "Healthy" and "Egg-dairy". The dietary pattern "Sweetened beverages and snacks" was the only one associated with MetS in the sample. Maternal education was also associated directly with cardiovascular risk. No associations between the dietary patterns "Traditional", "Monotonous", "Healthy" and "Egg-dairy" and MetS were observed. The "Healthy" pattern was associated directly and the Sweetened beverages and snacks" was inversely associated to dietary content of calories, protein, total fat and monounsaturated polyunsaturated and saturated fatty acids.
Metabolic syndrome (MetS) is determined by a number of factors that result in increased risk of developing cardiovascular disease and type 2 diabetes mellitus. lts diagnosis is made on the basis of metabolic alterations that include abdominal obesity, high blood pressure and changes in lipid and glucose metabolisms. For adults, MetS is widely studied and the criteria for its definition in this age group are well defined. However, there is no universal definition for MetS in children as well as their dietary factors are still poorly explored in this age group. The aim of this cross-sectional study was to assess cardiometabolic risk by a MetS score and its association with dietary patterns of children aged 8 and 9 years of Viçosa, Minas Gerais. To select the risk fators that would compose the score of SM, was verified the Clustering pattern of diverse anthropometric, biochemical, and clinical variables through factor analysis by.principal components analysis (PCA). The selected risk factors were: waist circumference (WC), homeostatic model assessment of insulin resistance (HOMA), high density lipoprotein (HDL), triacylglycerol (TAG) and mean arterial pressure (MAP). Z-scores of each selected variable was calculated for each child, and the sum of these z-scores originated the SM score. The receiver operating characteristic (ROC) curve was used to identify the cutoff of MetS score, using the MetS diagnosis according to criteria modified for age as the classification variable. The MetS score assumes that all components of MetS contribute similarly to cardiometabolic risk and that higher scores indicate less favorable metabolic profile. The MetS score was associated with dietary intake of children studied. Dietary intake was assessed by non-consecutive 3-day food records, including one day of the weekend, and quantified in grams of food groups. PCA and subsequent orthogonal rotation (varimax) were used to determine dietary patterns. Poisson regression was used to estimate the association between the prevalence of MetS, determined by the cutoff MetS score, and dietary patterns of children. Five dietary patterns were extracted, namely: "Traditional", "Sweetened beverages and snacks", "Monotonous", "Healthy" and "Egg-dairy". The dietary pattern "Sweetened beverages and snacks" was the only one associated with MetS in the sample. Maternal education was also associated directly with cardiovascular risk. No associations between the dietary patterns "Traditional", "Monotonous", "Healthy" and "Egg-dairy" and MetS were observed. The "Healthy" pattern was associated directly and the Sweetened beverages and snacks" was inversely associated to dietary content of calories, protein, total fat and monounsaturated polyunsaturated and saturated fatty acids.
Descrição
Palavras-chave
Síndrome metabólica, Crianças, Alimentos, Nutrição
Citação
VILLA, Julia Khéde Dourado. Padrões alimentares e escore de síndrome metabólica em crianças de 8 e 9 anos do município de Viçosa, Minas Gerais. 2014. 112f. Dissertação (Mestrado em Ciência da Nutrição) - Universidade Federal de Viçosa, Viçosa. 2014.