Índice de adiposidade visceral: fatores associados e capacidade preditiva de fenótipos metabólicos
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2018-04-05
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Universidade Federal de Viçosa
Resumo
O objetivo desta tese foi determinar os fatores associados ao índice de adiposidade visceral (IAV) e seu papel preditivo em relação ao fenótipo metabólico não saudável em adultos brasileiros. Realizou-se um estudo transversal, de base populacional, incluindo 854 adultos, de ambos os sexos, com idades entre 20 e 59 anos, residentes na zona urbana de Viçosa - MG. Foi aplicado questionário no domicílio para obter dados sobre as condições socioeconômicas, demográficas, comportamentais e de consumo alimentar. Foi ainda coletado material biológico e aferidas medidas antropométricas e de composição corporal. As análises estatísticas foram realizadas utilizando o pacote estatístico Stata, versão 13.0, e o Mplus 7.4. Os resultados são apresentados em três artigos originais. No primeiro, o percentual de gordura, a concentração de ácido úrico (Au) e a proteína c-reativa ultra-sensível (PCR-us) foram positivamente associados com o IAV em homens, enquanto o nível de atividade física no lazer foi negativamente associado. Entre as mulheres, o aumento da idade e da circunferência do pescoço, o tempo sentado superior a 300 minutos e a concentração aumentada de Au e PCR-us foram associados com um maior IAV. No segundo artigo, identificou-se que o IAV foi melhor preditor do fenótipo metabólico não saudável do que indicadores tradicionais de adiposidade, tanto entre indivíduos de peso normal de ambos os sexos, quanto entre mulheres com excesso de peso. O IAV também foi identificado como o indicador mais fortemente associado ao fenótipo metabólico não saudável, especialmente entre indivíduos de peso normal. No terceiro artigo, foi evidenciado um efeito direto positivo da adiposidade visceral no fenótipo metabólico não saudável, tanto nos indivíduos de peso normal, quanto nos com excesso de peso. Encontrou-se, ainda, um efeito mediador do IAV na relação da escolaridade e da inatividade física com o fenótipo metabólico não saudável entre indivíduos de peso normal. Conclui-se que o IAV está associado a fatores de risco modificáveis, que é um bom preditor do fenótipo metabólico não saudável, e que atua como um mediador na relação desse fenótipo com a escolaridade e a inatividade física. Desta forma, recomenda-se a utilização do IAV na prática clínica e em estudos epidemiológicos, a fim de identificar indivíduos em risco metabólico.
The aim of this thesis was to determine the factors associated with the visceral adiposity index (VAI), and its predictive role in relation to the unhealthy metabolic phenotype in Brazilian adults. A cross-sectional population-based study was conducted, including 854 adults of both gender, aged between 20 and 59 years, living in the urban area of Viçosa - MG. A questionnaire was applied at home in order to obtain data related to socioeconomic, demographic, behavioral and food consumption conditions. Biological material was also collected as well as anthropometric measurements and body composition were measured. Statistical analyses were performed using Stata (an statistical package version 13.0, and Mplus 7.4). The results have been presented in three original papers. In the first one, the increase of the body fat percentage, the concentration of uric acid (UA) and the ultra-sensitive c-reactive protein (US-CRP) were positively associated with the VAI in men, while the level of physical activity in leisure time was negatively associated with it. Among women, the increase in age, neck circumference, sitting time greater than 300 minutes and the increased concentration of UA and US-CRP were associated with a greater VAI. In the second paper, it was identified that the VAI was a better predictor of unhealthy metabolic phenotype than traditional indicators of adiposity both among normal weight individuals of both genders and among overweight women. The VAI was also identified as the indicator most strongly associated with the unhealthy metabolic phenotype, especially among normal weight individuals. In the third paper, it was evidenced a positive direct effect of visceral adiposity on the unhealthy metabolic phenotype both in normal weight and overweight individuals. It was also found a mediator effect of VAI in the relation between schooling and physical inactivity with the unhealthy metabolic phenotype among normal weight individuals. In conclusion, the VAI is associated with modifiable risk factors, it is a good predictor of unhealthy metabolic phenotype; besides that, it performs as a mediator in the relationship of this phenotype with the schooling and physical inactivity. Therefore, it is recommend the use of VAI in clinical practice and epidemiological studies in order to identify individuals at metabolic risk.
The aim of this thesis was to determine the factors associated with the visceral adiposity index (VAI), and its predictive role in relation to the unhealthy metabolic phenotype in Brazilian adults. A cross-sectional population-based study was conducted, including 854 adults of both gender, aged between 20 and 59 years, living in the urban area of Viçosa - MG. A questionnaire was applied at home in order to obtain data related to socioeconomic, demographic, behavioral and food consumption conditions. Biological material was also collected as well as anthropometric measurements and body composition were measured. Statistical analyses were performed using Stata (an statistical package version 13.0, and Mplus 7.4). The results have been presented in three original papers. In the first one, the increase of the body fat percentage, the concentration of uric acid (UA) and the ultra-sensitive c-reactive protein (US-CRP) were positively associated with the VAI in men, while the level of physical activity in leisure time was negatively associated with it. Among women, the increase in age, neck circumference, sitting time greater than 300 minutes and the increased concentration of UA and US-CRP were associated with a greater VAI. In the second paper, it was identified that the VAI was a better predictor of unhealthy metabolic phenotype than traditional indicators of adiposity both among normal weight individuals of both genders and among overweight women. The VAI was also identified as the indicator most strongly associated with the unhealthy metabolic phenotype, especially among normal weight individuals. In the third paper, it was evidenced a positive direct effect of visceral adiposity on the unhealthy metabolic phenotype both in normal weight and overweight individuals. It was also found a mediator effect of VAI in the relation between schooling and physical inactivity with the unhealthy metabolic phenotype among normal weight individuals. In conclusion, the VAI is associated with modifiable risk factors, it is a good predictor of unhealthy metabolic phenotype; besides that, it performs as a mediator in the relationship of this phenotype with the schooling and physical inactivity. Therefore, it is recommend the use of VAI in clinical practice and epidemiological studies in order to identify individuals at metabolic risk.
Descrição
Palavras-chave
Estado nutricional, Obesidade, Doenças - Fatores de risco, Epidemiologia, Mediação
Citação
FERREIRA, Fabrícia Geralda. Índice de adiposidade visceral: fatores associados e capacidade preditiva de fenótipos metabólicos. 2018. 104 f. Tese (Doutorado em Ciência da Nutrição) - Universidade Federal de Viçosa, Viçosa. 2018.