Análise de métodos antropométricos na determinação da obesidade e fatores de risco cardiovascular em mulheres
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2011-07-06
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Universidade Federal de Viçosa
Resumo
Doenças cardiovasculares (DCV) são as principais causas de morte no mundo moderno. A prática regular de atividade física é relatada como uma forma de prevenção e tratamento dessas doenças. Apesar dos benefícios, os exercícios físicos não são acompanhados de uma avaliação dos fatores de risco cardiovasculares (FRC). A obesidade, um importante FRC, considerada uma doença de prevalência elevada e crescente, deve ser diagnosticada com precisão para ser precocemente tratada, evitando dessa forma agravos à saúde. Métodos tradicionais de avaliação do estado nutricional como o índice de massa corporal (IMC) e métodos recentes como o índice de adiposidade corporal (IAC) têm sido propostos, entretanto devem ser analisados para verificar a adequação, especialmente em grupos populacionais específicos. Desta forma, foram desenvolvidos os seguintes estudos: Estudo 1 - Objetivo: Analisar a presença de FRC em um grupo de mulheres praticantes de ginástica. Método: Foram coletados dados sobre o estado nutricional, nível de atividade física, parâmetros sanguíneos e padrão alimentar. Resultados: O estado nutricional avaliado pelo IMC, o percentual de gordura corporal mensurado pelo DXA e a circunferência abdominal mostraram elevadas prevalências de obesidade. O número médio de passos classifica as avaliadas como fisicamente ativas. Observaram-se valores inadequados para colesterol total em 58,4% das avaliadas, LDL-c em 20,8%, HDL-c em 43,8% e 29,2% para os triglicerídeos. A avaliação nutricional apresentou elevada inadequação no consumo de carboidratos e lipídeos, sobretudo de ácidos graxos saturados. Conclusão: Apesar da prática regular de exercício físico, a amostra avaliada apresentou elevada prevalência de vários FRC. A adoção de outras estratégias para promoção da saúde, aliadas à atividade física, mostra-se necessária para redução desses fatores de risco. Estudo 2 - Objetivo: Verificar a validade do IMC ≥ 30 kg/m2 para diagnóstico de obesidade e determinar os pontos de corte de maior sensibilidade e especificidade para obesidade em mulheres adultas e idosas. Métodos: Foram obtidas curvas ROC para determinar os valores de IMC com melhor relação entre sensibilidade e especificidade para o valor de critério de obesidade. O padrão ouro para determinação da gordura corporal foi a DXA. Resultados: O IMC apresentou boa correlação com a gordura corporal avaliado por DXA tanto em mulheres adultas quanto em idosas. Entretanto, o valor de IMC ≥ 30 kg/m2 apresentou baixa sensibilidade para detecção de obesidade nos dois grupos. Conclusão: O valor de IMC de 30 kg/m2 mostrou-se inadequado para diagnosticar obesidade, e os valores de 25,36 e 27,01 kg/m2 foram melhores pontos de corte para obesidade para adultas e idosas respectivamente. Estudo 3 - Objetivo: Verificar a validade do IAC para predição da gordura corporal em mulheres brasileiras. Métodos: Foi utilizada a DXA como método padrão ouro para determinação da gordura corporal. A concordância entre o percentual de gordura medido por DXA e estimado por IAC foi obtida através do coeficiente de Lin e da análise de Bland-Altman. Resultados: O coeficiente de Lin e a análise de Bland-Altman apontaram uma baixa concordância entre os métodos. Conclusão: O IAC mostrou-se inadequado para a predição da gordura corporal para mulheres brasileiras.
Cardiovascular diseases (CVD) are the leading causes of death in the modern world. The practice of regular physical activity is reported as a form of prevention and treatment of these diseases. Despite the benefits, exercise is not accompanied by an assessment of cardiovascular risk factors (CRF). Obesity is a major coronary risk factor with high and growing prevalence and should be accurately diagnosed to be treated early to prevent health problems. Traditional methods of assessment of nutritional status such as body mass index (BMI) and new methods as the body adiposity index (BAI) have been proposed, however they must be analyzed to verify the suitability, especially in specific population groups. Thus, we developed the following studies: Study 1 - Objective: Analyze the presence of CRF in a group of women who practice gymnastics. Method: Data were collected on nutritional status, physical activity, blood parameters and dietary pattern. Results: The nutritional status assessed by BMI, fat percentage measured by DXA and waist circumference showed a high prevalence of obesity. The average number of steps per day classifies the sample as physically active. Inappropriate values were observed for total cholesterol, LDL-C, HDL-C and triglycerides. Nutritional assessment showed inadequate intake of carbohydrates and fats, especially saturated fatty acids. Conclusion: Despite of regular exercise, the sample studied showed a high prevalence of various CRF. The adoption of other strategies for health promotion, combined with physical activity, appears to be required to reduce these risk factors. Study 2 - Objective: To assess the validity of BMI ≥ 30 kg/m2 for the diagnosis of obesity and determine the cut-off points of greater sensitivity and specificity for obesity in adult and elderly women. Methods: ROC curves were established to determine the values of BMI with the best relationship between sensitivity and specificity for the criteria value for obesity. The gold standard for determining body fat was the DXA. Results: BMI showed good correlation with body fat measured by DXA in both adults and in elderly women. However, the value of BMI ≥ 30 kg/m2 had a low sensitivity to detect obesity in both groups. Conclusion: The value of BMI of 30 kg/m2 was inadequate to diagnose obesity, and the values of 25.36 and 27.01 kg/m2 were considered the best cut-off points for obesity in adults and elderly, respectively. Study 3 - Objective: To assess the validity of the BAI to predict body fat in Brazilian women. Methods: DXA was used as a gold standard for determining body fat. The concordance between the percentage of fat measured by DXA and estimated by BAI was obtained through the correlation coefficient of Lin and Bland-Altman analysis. Results: The coefficient of Lin and Bland-Altman analysis showed a low concordance between the methods. Conclusion: The BAI was inadequate for the prediction of body fat for Brazilian women.
Cardiovascular diseases (CVD) are the leading causes of death in the modern world. The practice of regular physical activity is reported as a form of prevention and treatment of these diseases. Despite the benefits, exercise is not accompanied by an assessment of cardiovascular risk factors (CRF). Obesity is a major coronary risk factor with high and growing prevalence and should be accurately diagnosed to be treated early to prevent health problems. Traditional methods of assessment of nutritional status such as body mass index (BMI) and new methods as the body adiposity index (BAI) have been proposed, however they must be analyzed to verify the suitability, especially in specific population groups. Thus, we developed the following studies: Study 1 - Objective: Analyze the presence of CRF in a group of women who practice gymnastics. Method: Data were collected on nutritional status, physical activity, blood parameters and dietary pattern. Results: The nutritional status assessed by BMI, fat percentage measured by DXA and waist circumference showed a high prevalence of obesity. The average number of steps per day classifies the sample as physically active. Inappropriate values were observed for total cholesterol, LDL-C, HDL-C and triglycerides. Nutritional assessment showed inadequate intake of carbohydrates and fats, especially saturated fatty acids. Conclusion: Despite of regular exercise, the sample studied showed a high prevalence of various CRF. The adoption of other strategies for health promotion, combined with physical activity, appears to be required to reduce these risk factors. Study 2 - Objective: To assess the validity of BMI ≥ 30 kg/m2 for the diagnosis of obesity and determine the cut-off points of greater sensitivity and specificity for obesity in adult and elderly women. Methods: ROC curves were established to determine the values of BMI with the best relationship between sensitivity and specificity for the criteria value for obesity. The gold standard for determining body fat was the DXA. Results: BMI showed good correlation with body fat measured by DXA in both adults and in elderly women. However, the value of BMI ≥ 30 kg/m2 had a low sensitivity to detect obesity in both groups. Conclusion: The value of BMI of 30 kg/m2 was inadequate to diagnose obesity, and the values of 25.36 and 27.01 kg/m2 were considered the best cut-off points for obesity in adults and elderly, respectively. Study 3 - Objective: To assess the validity of the BAI to predict body fat in Brazilian women. Methods: DXA was used as a gold standard for determining body fat. The concordance between the percentage of fat measured by DXA and estimated by BAI was obtained through the correlation coefficient of Lin and Bland-Altman analysis. Results: The coefficient of Lin and Bland-Altman analysis showed a low concordance between the methods. Conclusion: The BAI was inadequate for the prediction of body fat for Brazilian women.
Descrição
Palavras-chave
Atividade física, IMC, IAC, Physical activity, BMI, BAI
Citação
CERQUEIRA, Matheus Santos. Analysis of anthropometric methods for the determination of obesity and cardiovascular risk factors in women. 2011. 77 f. Dissertação (Mestrado em Aspectos sócio-culturais do movimento humano; Aspectos biodinâmicos do movimento humano) - Universidade Federal de Viçosa, Viçosa, 2011.