Fatores associados à Síndrome Metabólica em área rural de Minas Gerais

Abstract

Metabolic syndrome is recognized worldwide as an important Public Health concern, strongly associated with type 2 diabetes mellitus and cardiovascular diseases. This epidemiological, observational, cross-sectional and populational based study was carried out to identify the factors associated with a metabolic syndrome in Virgem das Graças and Caju, respectively, in rural areas of the City Ponto dos Volantes and Jequitinhonha, both of which are located in Jequitinhonha Valley, Minas Gerais, Brazil. The sample consisted of 534 individuals of both sexes, aged 18 to 94, whose demographic, lifestyle, anthropometric, biochemical and hemodynamic characteristics were assessed. The prevalences of metabolic syndrome and its components were estimated according to the modified definition of the National Cholesterol Education Program - Adult Treatment Panel III (NCEP-ATP III). The binomial distribution equation was used to assess the probability of cluster of metabolic syndrome components. A multivariate model was crated using the Poisson regression. The strength of association was measured by Prevalence Ratio (PR) and its 95% confidence intervals (95% CI). The statistical level of significance was set at 5% (p<0.05). Metabolic syndrome was diagnosed in 14.9% (95% CI: 11.9 to 18.4) of the subjects, and was statistically more frequent among women (23.3%, 95% CI: 18.1 to 29.1) than men (6.5%, 95% CI: 3.8 to 10.3). The most frequent components of the metabolic syndrome were hypertension and low concentration of high-density lipoprotein cholesterol (HDL-c). The most common combinations of three components of the metabolic syndrome were: hypertriglyceridemia, low concentration of HDL-c, and hypertension; abdominal obesity, low concentration of HDL-c, and hypertension. The cluster of three or more components of metabolic syndrome was greater than that expected by chance. Women (PR = 2.20; 95% CI: 1.33 to 3.62), obesity (BMI 30 kg/m2; PR = 3.03; 95% CI: 2.05 to 4.48), C-reactive protein 4th quartile (PR = 1.56; 95% CI: 1.05 to 2.31), Homeostasis Model Assessment - Insulin Resistance 4th quartile (PR = 1.92; 95% CI: 1.28 to 2.88), age (PR = 7.06; 95% CI: 2.62 to 19.04, as a comparison between participants 60 years versus those 18 to 29 years old), and moderate alcohol consumption (3.1 to 20.0 grams of ethanol/day; PR = 0.26; 95% CI: 0.09 to 0.73) were independently associated with metabolic syndrome. In a rural population studied, metabolic syndrome is a significant Public Health problem. Obesity, insulin resistance, and chronic inflammation remained independently associated with metabolic syndrome. The NCEP-ATP III definition is recommended as diagnosis criteria of metabolic syndrome, relatively simple to be used in clinical practice and epidemiological studies.