Prevalência e fatores associados à dislipidemia em idosos de Viçosa/MG
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2014-02-20
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Universidade Federal de Viçosa
Resumo
O envelhecimento populacional constitui um dos maiores desafios para a saúde pública contemporânea. Tornam-se predominantes as doenças crônicas não transmissíveis (DCNT) e suas complicações, como a perda da sua autonomia e independência funcional, que, além de demandarem maiores custos para os serviços de saúde, exigem um reordenamento das suas ações prioritárias. O elevado consumo de lipídios, ácidos graxos saturados, baixa quantidade de fibra alimentar e gorduras insaturadas são características do comportamento alimentar dos idosos que contribuem para o aumento dos diferentes tipos de dislipidemias nessa parcela populacional. O conhecimento de perfil alimentar da população idosa e de seu estado nutricional, é necessário para um melhor entendimento dos aspectos associados a mudanças de comportamento alimentar e os diferentes tipos de dislipidemia. Objetivou-se avaliar a prevalência dos diferentes tipos de dislipidemia e seus fatores associados, em idosos atendidos na Estratégia Saúde da Família do município de Viçosa (MG). A amostra incluiu 402 participantes atendidos na Estratégia Saúde da Família, Viçosa (MG), aos quais foi aplicado um questionário com informações sócio-demográficas, comportamentais e de estilo de vida. Foram aplicados dois recordatórios 24 horas de consumo alimentar, sendo um referente a um dia da semana e outro do final de semana. Coletou-se amostra sanguínea para obtenção das frações lipídicas, e foram aferidos peso, estatura, circunferência da cintura e percentual de gordura corporal. O teste ANOVA foi realizado para testar diferenças das variáveis contínuas entre os tercis e utilizou-se o teste Qui-Quadrado de tendência linear para comparar proporções entre o consumo alimentar e as variáveis categóricas. A análise bivariada foi realizada para identificação de associação entre as variáveis exploratórias de interesse (sexo, idade) e a variável resposta (tipos de dislipidemia). Nesta etapa foi realizada regressão linear múltipla para identificar os fatores independentemente associados a alterações em cada uma das frações lipídicas selecionadas. Os fatores independentemente associados ao aumento dos níveis de colesterol total foram a presença de comportamento sedentário, elevado percentual de gordura corporal, maior relação cintura estatura e maior circunferência da cintura. O consumo de bebidas alcoólicas e uma maior relação cintura quadril, mantiveram-se independentemente associados a diminuição dos níveis da lipoproteína de alta densidade. A circunferência da cintura elevada esteve independentemente associada aos valores elevados dos níveis da lipoproteína de baixa densidade. O valor de triglicerídeos aumentado foi independentemente associado à maior relação cintura quadril, maior índice de massa corporal e ao hábito de fumar. Com relação a caracterização da amostra do estudo com relação ao tipo de dislipidemia apresentada, foi estabelecida relação estatisticamente significante entre o sexo feminino e à presença de hipercolesterolemia isolada e a hiperlipidemia mista, sendo 66,3% e 77,2%, respectivamente. Foi possível observar que a presença de HDL-coleterol baixo aumentou estatisticamente com o aumento da faixa etária dos idosos, embora nos demais tipos de dislipidemia não foi possível estabelecer tal associação. No que diz respeito ao consumo alimentar, apresentam associação estatística com acorrência de HDL-colesterol baixo, o maior consumo de carboidratos, proteínas e sódio. Fatores de risco modificáveis associados à um perfil lipídico alterado devem ser priorizados dentre as ações a serem consideradas na estruturação de programas de saúde para idosos.
Population aging is one of the biggest challenges for contemporary public health. Become prevalent chronic non-communicable diseases (NCDs) and its complications, such as loss of autonomy and functional independence, which in addition to demand it higher costs for health services , require a reordering of its priority actions. The high consumption of fat, saturated fatty acids, low in dietary fiber and unsaturated fats are characteristics of the dietary behavior of elderly contributing to the increase in different types of dyslipidemia in this population parcel. Knowledge of dietary profile of the elderly population and their nutritional status , it is necessary for a better understanding of the issues associated with changes in eating behavior and the different types of dyslipidemia. This study aimed to assess the prevalence of different types of dyslipidemia and its associated factors in elderly patients in the Family Health Strategy of Viçosa (MG). The sample included 402 participants attended the Family Health Strategy, Viçosa (MG), to which a questionnaire with socio- demographic, behavioral and lifestyle information was applied. Two 24-hour dietary intake recalls were applied, one related to a day of the week and other weekend. Blood sample was collected to obtain the lipid fractions, and weight were measured, height, waist circumference and body fat percentage. The ANOVA test was performed to test differences in continuous variables between tertiles and used the chi-square test for linear trend to compare proportions between food consumption and categorical variables. A bivariate analysis was performed to identify the association between the explanatory variables of interest (gender,age) and response types (dyslipidemia) variable. In this step multiple linear regression was performed to identify factors independently associated with changes in each of the selected lipid fractions. Factors independently associated with increased levels of total cholesterol were the presence of sedentary behavior, high body fat percentage, waist-high height and larger waist circumference. The consumption of alcoholic beverages and a greater waist-hip ratio, remained independently associated with decreased levels of high density lipoprotein. The high waist circumference was independently associated with high levels of values of low-density lipoprotein. The value of increased triglycerides was independently associated with higher waist- hip ratio, higher body mass index and smoking. Regarding the characterization of the study sample with respect to the type of dyslipidemia presented statistically significant relationship was established between the female and the presence of isolated hypercholesterolemia and mixed hyperlipidemia, and 66.3 % and 77.2 %, respectively. It was observed that the presence of low HDL - coleterol increased significantly with increasing age of the elderly, while in other types of dyslipidemia has not been possible to establish such an association. With regard to food consumption, have statistical association with acorrência low HDL - cholesterol, high intake of carbohydrates, protein and sodium. Modifiable risk factors associated with a lipid profile changes should be prioritized among the actions to be considered in structuring health programs for the elderly.
Population aging is one of the biggest challenges for contemporary public health. Become prevalent chronic non-communicable diseases (NCDs) and its complications, such as loss of autonomy and functional independence, which in addition to demand it higher costs for health services , require a reordering of its priority actions. The high consumption of fat, saturated fatty acids, low in dietary fiber and unsaturated fats are characteristics of the dietary behavior of elderly contributing to the increase in different types of dyslipidemia in this population parcel. Knowledge of dietary profile of the elderly population and their nutritional status , it is necessary for a better understanding of the issues associated with changes in eating behavior and the different types of dyslipidemia. This study aimed to assess the prevalence of different types of dyslipidemia and its associated factors in elderly patients in the Family Health Strategy of Viçosa (MG). The sample included 402 participants attended the Family Health Strategy, Viçosa (MG), to which a questionnaire with socio- demographic, behavioral and lifestyle information was applied. Two 24-hour dietary intake recalls were applied, one related to a day of the week and other weekend. Blood sample was collected to obtain the lipid fractions, and weight were measured, height, waist circumference and body fat percentage. The ANOVA test was performed to test differences in continuous variables between tertiles and used the chi-square test for linear trend to compare proportions between food consumption and categorical variables. A bivariate analysis was performed to identify the association between the explanatory variables of interest (gender,age) and response types (dyslipidemia) variable. In this step multiple linear regression was performed to identify factors independently associated with changes in each of the selected lipid fractions. Factors independently associated with increased levels of total cholesterol were the presence of sedentary behavior, high body fat percentage, waist-high height and larger waist circumference. The consumption of alcoholic beverages and a greater waist-hip ratio, remained independently associated with decreased levels of high density lipoprotein. The high waist circumference was independently associated with high levels of values of low-density lipoprotein. The value of increased triglycerides was independently associated with higher waist- hip ratio, higher body mass index and smoking. Regarding the characterization of the study sample with respect to the type of dyslipidemia presented statistically significant relationship was established between the female and the presence of isolated hypercholesterolemia and mixed hyperlipidemia, and 66.3 % and 77.2 %, respectively. It was observed that the presence of low HDL - coleterol increased significantly with increasing age of the elderly, while in other types of dyslipidemia has not been possible to establish such an association. With regard to food consumption, have statistical association with acorrência low HDL - cholesterol, high intake of carbohydrates, protein and sodium. Modifiable risk factors associated with a lipid profile changes should be prioritized among the actions to be considered in structuring health programs for the elderly.
Descrição
Palavras-chave
Nutrição, Dislipidemia, Idosos, Nutrition, Dyslipidemia, Senior citizens
Citação
SOUZA, Jacqueline Danesio de. Prevalence and factors associated with dyslipidemia in elderly Viçosa / MG.. 2014. 105 f. Dissertação (Mestrado em Valor nutricional de alimentos e de dietas; Nutrição nas enfermidades agudas e crônicas não transmis) - Universidade Federal de Viçosa, Viçosa, 2014.