Cintura hipertrigliceridêmica e sua associação com fatores de risco metabólicos

Abstract

Recent evidences have been suggested different factors such as altered lipid profile asatherosclerosis predictors. Metabolic triad, for example, includes apolipoprotein B levelsincreased, hyperinsulinemia and high levels of small, dense LDL particles. Various studiespropose hyperapolipoprotein B as a significant predictor of coronary artery disease.Hyperinsulinemia in non diabetic individuals reveals insulin resistance and increases theatherosclerosis risk, especially in men. On the other hand, small, dense LDL particles aremore atherogenic than low density and large particles. Thus, researchers concluded metabolictriad could be used to predict cardiovascular diseases risk more efficiently. Although access tothese factors implies higher costs, along with its complex assessment, researchers propose thehypertriglyceridemic waist (HW) phenotype as an indirect and efficient predictor of themetabolic triad. This study was conducted to investigate HW phenotype prevalence inpopulation of two rural communities from Jequitinhonha Valley, Minas Gerais, as well as itsrelations to other cardiovascular risk factors. This is a population based cross-sectional studywith a sample of 506 individuals, both sexes, aged between 18 and 75 years-old.Hypertriglyceridemic waist was determined at the fourth quartile of waist circumference(WC) and triglycerides (TG). Logistic Regression was used to build the multivariate model.Significance level of 5% was determined. SPSS version 15.0 was used for data analysis.Individuals with the HW phenotype were also hypertensive (78.6%) and hypercholesterolemic(64.3%), presented a positive smoking habit (48.2%) and higher BMI (71.4%), distinguishedinto overweight (50%) and obese (21.4%) individuals. They also presented low levels of HDLcholesterol (55.4%), increased levels of LDL cholesterol (25%), increased levels of fastingglucose (26.8%) and 53.1% presented fasting insulin and HOMA-IR in the forth quartile. Inmultivariate logistic regression, women (OR = 2.190; IC 95% 1.082 4.436), each year ofage (OR=1.028; IC 95% 1.006 1.052), BMI 30 Kg/m2 (OR 4.348; IC 95% 1.587 11.911), total cholesterol 200 mg/dl (OR = 3.607; IC 95% 1.776 7.326) and HOMA-IR 4º quartile (OR = 4.528; IC 95% 2.202 9.309) remained independently associated to the HWphenotype at the final model. Classification and regression trees showed age, HOMA-IR, totalcholesterol and HDL cholesterol as fundamental variables to discriminate individuals with thephenotype. Hypertriglyceridemic waist was independently associated to important markers ofmetabolic imbalance suggesting this phenotype as discriminant as other metabolic riskcalculators and, therefore, could be used as an initial approach to identify individuals withdeteriorated cardiometabolic risk markers.