Relação entre os marcadores não tradicionais e o risco cardiometabólico em crianças (Estudo PASE)
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2018-07-16
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Universidade Federal de Viçosa
Resumo
Introdução: A exposição ao perfil lipídico aterogênico é capaz de induzir alterações na artéria e contribuir para o desenvolvimento da aterosclerose, podendo iniciar na infância. Diante disso faz-se importante mensurar lipídios séricos na infância como prevenção de doenças cardiovasculares e da aterosclerose. Por outro lado, apesar dos progressos realizados na compreensão das causas e mecanismos envolvidos nas doenças cardiovasculares e diabetes, as estratégias de prevenção têm sido insuficientes. É por isso que avaliar a resistência à insulina (RI) é uma questão cada vez mais importante para identificação precoce das crianças em risco, além dos esforços que devem ser concentrados na redução de peso corporal. Objetivos: Determinar marcadores não tradicionais e avaliar sua relação com outros fatores de risco cardiometabólico em crianças. Metodologia: Trata-se de um estudo transversal realizado com 258 crianças de 8 a 9 anos, em todas as escolas urbanas de Viçosa. A avaliação antropométrica, de composição corporal e bioquímica foi realizada com crianças em visita agendada. As variáveis sócioeconômicas e o sedentarismo foram avaliados por questionário semiestruturado. Resultados: Das crianças avaliadas, 35,2% apresentaram excesso de peso, 10,5% de adiposidade abdominal e 15,6% de gordura corporal. Neste estudo, 51,8% e 19,8% das crianças apresentaram triglicerídeos aumentados. Crianças com excesso de peso e de gordura total e central apresentaram maiores prevalências de maior razão ApoB/ApoA1, bem como as com perfil lipídico aterogênico (LDL-c e triglicerídeos aumentados e baixo HDL-c). Foi encontrada associação direta entre o número de fatores de risco cardiovascular e a razão ApoB/ApoA1 (p=0,001), independentemente da idade e renda. A prevalência de TyG aumentado foi significativamente maior entre crianças com perímetro de pescoço (PP), colesterol total (CT) e ácido úrico elevados, e baixo lipoproteína colesterol de baixa densidade (HDL- c). Por outro lado, a prevalência da resistência à insulina, avaliada pelo índice de homeostase de resistência à inuslina (HOMA-IR), foi maior entre aquelas com PP e leptina elevados. Foi observada associação direta entre o número de fatores de risco cardiometabólico e o índice TyG (β=0,16; IC 95%: 0,11-0,21; p<0,001), independente do IMC. Para o HOMA-IR, esta associação não foi observada. Conclusão: Marcadores não tradicionais, como a razão ApoB/ApoA1 e o índice TyG, estiveram associados a um maior número de fatores de risco cardiometabólico em crianças. Ressalta-se a importância do uso da razão ApoB/ApoA1 e do índice TyG na prática clínica, por serem importantes parâmetros complementares para a avaliação do risco cardiometabólico já na infância.
Introduction: Exposure to the atherogenic lipid profile is capable of inducing changes in the artery and contributing to the development of atherosclerosis, which may begin in childhood. Therefore, it is important to measure serum lipids in childhood as a prevention of cardiovascular diseases and atherosclerosis. On the other hand, despite the progress made in understanding the causes and mechanisms involved in cardiovascular diseases and diabetes, prevention strategies have been insufficient. That assessing insulin resistance (IR) is an increasingly important issue identification of at-risk children, in addition to efforts that should be is for focused why early on reducing body weight. Objectives: To determine non-traditional markers and to evaluate their relationship with other cardiometabolic risk factors in children. Methodology: This is a cross-sectional study with 258 children aged 8 to 9 years, in all urban schools in Viçosa. The anthropometric evaluation of body composition and biochemistry was performed with children on a scheduled visit. Socioeconomic variables and sedentary lifestyle were evaluated by semi-structured questionnaire. Results: Of the children evaluated, 35.2% were overweight, 10.5% were abdominal adiposity and 15.6% were body fat. In this study, 51.8% and 19.8% of the children presented increased triglycerides. Overweight and total and central fat children had higher prevalences of higher ApoB / ApoA1 ratio, as well as those with atherogenic lipid profile (LDL-c and increased triglycerides and low HDL-c). A direct association was found between the number of cardiovascular risk factors and the ApoB / ApoA1 ratio (p = 0.001), regardless of age and income. The prevalence of increased TyG was significantly higher among children with neck circumference (PP), total cholesterol (TC) and high uric acid, and low-density lipoprotein cholesterol (HDL- c). On the other hand, the prevalence of insulin resistance, evaluated by homeostatic mode assessment (HOMA-IR), was higher among those with elevated PP and leptin. A direct association between the number of cardiometabolic risk factors and the TyG index (β = 0.16, 95% CI: 0.11-0.21, p <0.001) was observed, independent of BMI. For HOMA-IR, this association was not observed. Conclusion: Non-traditional markers, such as ApoB/ ApoA1 ratio and TyG index, were associated with a higher number of cardiometabolic risk factors in children. The importance of using the ApoB/ApoA1 ratio and the TyG index in clinical practice is important, as complementary parameters are important for the evaluation of cardiometabolic risk in childhood.
Introduction: Exposure to the atherogenic lipid profile is capable of inducing changes in the artery and contributing to the development of atherosclerosis, which may begin in childhood. Therefore, it is important to measure serum lipids in childhood as a prevention of cardiovascular diseases and atherosclerosis. On the other hand, despite the progress made in understanding the causes and mechanisms involved in cardiovascular diseases and diabetes, prevention strategies have been insufficient. That assessing insulin resistance (IR) is an increasingly important issue identification of at-risk children, in addition to efforts that should be is for focused why early on reducing body weight. Objectives: To determine non-traditional markers and to evaluate their relationship with other cardiometabolic risk factors in children. Methodology: This is a cross-sectional study with 258 children aged 8 to 9 years, in all urban schools in Viçosa. The anthropometric evaluation of body composition and biochemistry was performed with children on a scheduled visit. Socioeconomic variables and sedentary lifestyle were evaluated by semi-structured questionnaire. Results: Of the children evaluated, 35.2% were overweight, 10.5% were abdominal adiposity and 15.6% were body fat. In this study, 51.8% and 19.8% of the children presented increased triglycerides. Overweight and total and central fat children had higher prevalences of higher ApoB / ApoA1 ratio, as well as those with atherogenic lipid profile (LDL-c and increased triglycerides and low HDL-c). A direct association was found between the number of cardiovascular risk factors and the ApoB / ApoA1 ratio (p = 0.001), regardless of age and income. The prevalence of increased TyG was significantly higher among children with neck circumference (PP), total cholesterol (TC) and high uric acid, and low-density lipoprotein cholesterol (HDL- c). On the other hand, the prevalence of insulin resistance, evaluated by homeostatic mode assessment (HOMA-IR), was higher among those with elevated PP and leptin. A direct association between the number of cardiometabolic risk factors and the TyG index (β = 0.16, 95% CI: 0.11-0.21, p <0.001) was observed, independent of BMI. For HOMA-IR, this association was not observed. Conclusion: Non-traditional markers, such as ApoB/ ApoA1 ratio and TyG index, were associated with a higher number of cardiometabolic risk factors in children. The importance of using the ApoB/ApoA1 ratio and the TyG index in clinical practice is important, as complementary parameters are important for the evaluation of cardiometabolic risk in childhood.
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Palavras-chave
Crianças - Avaliação de risco de saúde, Doenças cardiovasculares - Fatores de risco, Apolipoproteínas, Resistência à insulina
Citação
CASTRO, Ana Paula Pereira. Relação entre os marcadores não tradicionais e o risco cardiometabólico em crianças (Estudo PASE). 2018. 73 f. Tese (Doutorado em Ciência da Nutrição) - Universidade Federal de Viçosa, Viçosa. 2018.