Prevalência de excesso de peso e sua associação com os fatores de risco cardiovascular e síndrome metabólica em adolescentes da rede pública estadual de ensino da região metropolitana da Grande Vitória ES

Abstract

Objective: To identify the prevalence of overweight and their association with the cardiovascular risk factors and metabolic syndrome in adolescents. Methods: Epidemiological study, cross-sectional, probabilistic and representative sample of adolescents (ten to 14 years) who go to the public schools in the metropolitan region of Vitoria, ES. Obtained anthropometric data (weight and height) and body composition (body circumferences, skinfold thickness and body fat by bioelectrical impedance analysis and isotope dilution with deuterium oxide). In the nutritional assessment, the indices were considered height/age and BMI/age, z score, referring to the standard WHO (2007). Held Blood pressure and collecting 10 mL of venous blood after fasting for 12 hours for analysis the glycemia and fasting insulin, lipid profile and PCR-us. The following cardiovascular risk factors were investigated, considering indicative cutoffs of abnormalities: waist circumference (p90), total cholesterol (150mg/dL), LDL-C (100mg/dL), triglycerides (100mg/dL), HDL cholesterol (<45 mg/dL) glucose (100mg/dL) insulin (15 UI/mL) HOMA-IR (3,16) compared glucose / insulin (<7), PCR-us (>3mg/L), blood pressure (p90), inadequate food intake (score>100), sedentary leisure time (2 hours/day), physical inactivity (<300 minutes/week), smoking and alcohol consumption. It was, also, clustering of cardiovascular risk factors (2 risk factors). Metabolic syndrome was defined by the criteria proposed by Cook et al. (2003). For statistical analysis, the chi-square test and Student (Mann-Whitney test for non-normal distribution) and a significance level of p <0.05. This study was approved by the Ethics Committee of Institutional Research. Results: This study assessed 818 children (58.3% female) with a mean age of 12.8±1.1 years; the predominant color was brown race (41.7%), post-pubertal stage (53.4%) and socioeconomic class C (59.5%). It was identified low stature in 2.2% of the sample. Overweight was diagnosed in 227 (27.7%) students, represented by overweight (18.7%) and obesity (9.0%). We observed increased waist circumference (9.3%), arm (6.6%) and neck (23.8%), besides the skinfold thickness of the triceps (3.9%) and subscapularis (2.2%). Excess body fat by bioelectrical impedance and thermal bipolar was observed in 128/390 (32.8%) and 133/390 (34.1%) adolescents, respectively, while the isotopic dilution with deuterium oxide identified 41.5% (162/390) change. Of students with complete exams, was diagnosed 3.9% (27/699) of metabolic syndrome, a condition associated with excess weight (p=0.000). Among the individual cardiovascular risk factors, the most prevalent were sedentary leisure time 2 hours / day (96.1%), physical inactivity (89.0%), increased total cholesterol (65.9%) and LDL-C increased (45.7%), while the smoking habit (0.3%) and increased blood glucose (0.4%) were less prevalent. It was evident, although the simultaneous presence of two or more cardiovascular risk factors in 96.3% of the sample (673/699), a condition which is also associated with overweight (p=0.004). Conclusion: There was a 27.7% prevalence of overweight among adolescents, with association between anthropometric data, metabolic syndrome and most cardiovascular risk factors.