Contribuição da obesidade isolada ou associada à síndrome metabólica sobre fatores de risco tradicionais e emergentes para doença coronariana

Abstract

Obesity has increased worldwide, including Brazil, and is a risk factor for insulin resistance, diabetes mellitus, dyslipidemia, hypertension, systemic inflammation, thrombosis and mortality. When multiple cardiometabolic risk factors are associated leads to metabolic syndrome (MS). Although there is controversy about the pathophysiology and clinical utility of MS, it has been associated with increased cardiovascular risk, especially in women. Although many studies show an association between obesity and increased risk of cardiovascular disease (CVD) in women, few have evaluated the role of obesity without the MS. Objectives: The aim of this study was to assess the effect of obesity on cardiovascular risk in 20-40 year old women with and without MS. Women without previous CVD (n=99) were classified by presence or absence of MS and body mass index (BMI). Non-obese (18,5 < BMI <29,0 n=41) and obese (BMI 30) women with (n=28) and without (n=30) MS were compared regarding risk factors for coronary heart disease. Obese women without MS had metabolic and risk factor profiles similar to those of non-obese women. Almost 64% of women with MS had two or more risk factors compared to only 20% of those without MS or those who were non -obese (p<0.01). The Framingham risk score revealed that 25% of women with MS were at high risk for coronary heart disease compared to 2.4% in the non-obese group (p<0.01), while obese women without MS presented an intermediate frequency (6.7%). Obese women, regardless of MS, showed higher concentrations of high-sensitivity C-reactive protein, which was associated with adiposity and diastolic blood pressure. Thus, obese women without MS exhibited metabolic and cardiovascular characteristics that were more similar to those seen in non-obese women. Compared to non-obese women, only obese women with MS had a higher Framingham risk score.