Prevalência da Síndrome metabólica e de seus componentes em adolescentes com sobrepeso e obesidade

Abstract

The obesity is a serious public health problem, based on the fact that others diseases and syndromes are associated to it. Amongst which called ― "Metabolic Syndrome" (MetSyn) is characterized by the cluster of interrelated risk factors of metabolic origin, these would be directly involved in the development of the atherosclerotic cardiovascular disease. The study objective was evaluated the prevalence of MetSyn and their components in adolescents with overweight and obesity. This is transversal study, separated into two phases, carried through in a public school in Rio de Janeiro. In the first phase was established the nutritional state through body mass index using the cut point proposed by Cole et al. In the second phase evaluated of SynMet components based on two definitions: National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATPIII) modified according with Ferranti et al. proposal and International Diabetes Federation (IDF). In the first phase of study were evaluated 1184 adolescents, with average age of 15 years (standard deviation = 2.04). The prevalence of weight excess (overweight and obesity) in adolescents was 21.9% (IC95%=19.6-24.4; n=260), being 6.6% (IC95%=5.2-8.1; n=78) presented obesity with prevalence significantly increased among girls (8.4%; IC95%=6.6-10.7; n=54) than among boys (4.5%; IC95%=2.4-6.3; n=24) (p=0.01). In the second phase of study were evaluated 106 adolescents with overweight and 57 with obesity. The MetSyn prevalence according to the criterion of NCEP was increased significantly in obese adolescents (40.4%; IC95%=27-54) compared with overweight (9.4%; IC95%=4-16) (p=0.000). According with IDF criterion, the prevalence of MetSyn was 24.6% (IC95%=14-37) in the obese adolescents and 1.9% (IC95%=2-6) with overweight (p=0.000). The adopted definition in this study had presented moderated concordance degree (0.48) evaluated by Kappa index. The presence of only one MetSyn factor was observed in 39.6% and 24.6% and presence of two factors in 42.5% and 33.3% in overweight and obese, respectively in accordance with NCEP-ATPIII criterion. The percentage of body fat had a good capacity to diagnostic of MetSyn (area under curve ROC = 0.80). The chance to obese adolescents to present Metsys is 6.5 times bigger than in adolescents with overweight (OR=6.49; IC95%: 2.80-15.02; p=0.000). The adolescents with corporal fat over 33% present 7 times more the possibility of having MetSyn. The white adolescents had a chance 5 times more possibility of having MetSyn than pardos adolescents and 4 times more than black adolescents. The outcomes showed a high prevalence of MetSyn and its components among obese adolescents. In conclusion our findings suggest that the obesity is a determinant factor for lipid profile changes and increase of blood pressure, demonstrating a necessity of intervention and prevention programs, which allow revert this enormous problem. The schools can be a favorable place to implement policies of these programs, stimulating changes in the life style thus to influence favorably in the high taxes of cardiovascular morbidity and mortality.