Clustering and combining pattern of metabolic syndrome components in a rural Brazilian adult population / Agregacao e padrao de combinacao dos componentes da sindrome metabolica em uma populacao rural adulta brasileira

CONTEXT AND OBJECTIVE Metabolic syndrome is characterized by clustering of cardiovascular risk factors such as obesity, dyslipidemia, insulin resistance, hyperinsulinemia, glucose intolerance and arterial hypertension. The aim of this study was to estimate the probability of clustering and the combination pattern of three or more metabolic syndrome components in a rural Brazilian adult population. DESIGN AND SETTING This was a cross-sectional study conducted in two rural communities located in the Jequitinhonha Valley, Minas Gerais, Brazil. METHODS The sample was composed of 534 adults (both sexes). Waist circumference, blood pressure and demographic, lifestyle and biochemical characteristics were assessed. The prevalences of metabolic syndrome and its components were estimated using the definitions of the National Cholesterol Education Program – Adult Treatment Panel III. A binomial distribution equation was used to evaluate the probability of clustering of metabolic syndrome components. The statistical significance level was set at 5% (P < 0.05). RESULTS Metabolic syndrome was more frequent among women (23.3%) than among men (6.5%). Clustering of three or more metabolic syndrome components was greater than expected by chance. The commonest combinations of three metabolic syndrome components were: hypertriglyceridemia + low levels of HDL-c + arterial hypertension and abdominal obesity + low levels of HDL-c + arterial hypertension; and of four metabolic syndrome components: abdominal obesity + hypertriglyceridemia + low levels of HDL-c + arterial hypertension. CONCLUSION The population studied presented high prevalence of metabolic syndrome among women and clustering of its components greater than expected by chance, suggesting that the combination pattern was non-random. .

CONTEXTO E OBJETIVO A síndrome metabólica é caracterizada pela agregação de fatores de risco cardiovasculares como obesidade, dislipidemia, resistência à insulina, hiperinsulinemia, intolerância à glicose e hipertensão arterial. Este estudo objetivou estimar a probabilidade de agregação e o padrão de combinação de três ou mais componentes da síndrome metabólica em população rural adulta brasileira. TIPO DE ESTUDO E LOCAL Estudo transversal, conduzido em duas comunidades rurais da região do Vale do Jequitinhonha, Minas Gerais. MÉTODOS A amostra foi constituída de 534 adultos, de ambos os sexos, dos quais foram aferidas a circunferência da cintura, a pressão arterial e características demográficas, do estilo de vida e bioquímicas. Prevalências da síndrome metabólica e seus componentes foram estimados usando a definição da National Cholesterol Education Program – Adult Treatment Panel III. A equação da distribuição binomial foi utilizada para avaliar a probabilidade de agregação dos componentes da síndrome metabólica. O nível de significância estatística estabelecido foi 5% (P < 0,05). RESULTADOS Síndrome metabólica foi mais frequente em mulheres (23,3%) que homens (6,5%). A agregação de três ou mais componentes da síndrome metabólica foi maior do que esperada ao acaso. Combinações mais comuns para três componentes da síndrome metabólica foram hipertrigliceridemia + baixos níveis de HDL-c + hipertensão arterial, obesidade abdominal + baixos níveis de HDL-c + hipertensão arterial. Para quatro componentes, obesidade abdominal + hipertrigliceridemia + baixos níveis de HDL-c + hipertensão arterial. CONCLUSÃO Na po...

Perfil lipídico em escolares de Recife - PE / Lipid profile of schoolchildren from Recife, PE

FUNDAMENTO: A ocorrência de dislipidemias é crescente na população infanto-juvenil. Níveis alterados do perfil lipídico estão relacionados com maior incidência de hipertensão e doença aterosclerótica. OBJETIVO: Avaliar a magnitude das dislipidemias e investigar a relação do perfil lipídico com o excesso de peso e a obesidade abdominal em adolescentes escolares da cidade do Recife - PE. MÉTODOS: Foram coletados dados pessoais, situação socioeconômica, medidas antropométricas e perfil lipídico de 470 adolescentes de 10 a 14 anos, de ambos os sexos, da rede pública de ensino de Recife - PE. A análise estatística foi realizada com os programas Epi-info 6.04 e SPSS 13.0. Adotou-se o nível de significância de 5 por cento. RESULTADOS: A maior parte da população era dislipidêmica (63,8 por cento, IC95 por cento 59,3 - 68,2), sendo a hipoalfalipoproteinemia a dislipidemia mais prevalente (56 por cento, IC95 por cento 51,3 - 60,5). Adolescentes com excesso de peso ou com obesidade abdominal apresentaram valores mais elevados de triglicerídeos e mais baixos de HDL-colesterol (p < 0,05). As concentrações do colesterol total e frações não diferiram em relação ao sexo. CONCLUSÃO: Ficou demonstrada a elevada ocorrência do perfil lipídico desfavorável, o que faz alertar para a necessidade da dosagem do perfil lipídico já nessa faixa etária. Medidas de estilo de vida saudável devem ser incentivadas nessa população.

BACKGROUND: The occurrence of dyslipidemia is increasing in pediatric populations. Altered lipid profiles are related to a higher incidence of hypertension and atherosclerotic disease. OBJECTIVE: To evaluate the extent of dyslipidemia and investigate its association with overweight and abdominal obesity in adolescent students from Recife, Brazil. METHODS: Personal data, socioeconomic level, anthropometric measurements and lipid profile of 470 adolescents, aged 10 to 14 years, of both sexes, students at the Public School system in the city of Recife, state of Pernambuco, Brazil, were obtained. The statistical analysis was carried out using the Epi-info 6.04 and SPSS 13.0 software. The level of significance was set at 5 percent. RESULTS: The majority of the population was dyslipidemic (63.8 percent; 95 percentCI: 59.3 - 68.2), with hypoalphalipoproteinemia being the most prevalent dyslipidemia (56 percent; 95 percentCI: 51.3 - 60.5). Adolescents who were overweight or who had abdominal obesity presented higher levels of triglycerides and lower levels of HDL-cholesterol (p < 0.05). Levels of total cholesterol and fractions were not different between sexes. CONCLUSION: A high incidence of unfavorable lipid profile was shown in this series, demonstrating the necessity to measure the lipid profile as early as this age range. Healthy lifestyle measures should be encouraged in this population.

Prevalence of dyslipidemias in the Mexican National Health and Nutrition Survey 2006 / Prevalencia de las dislipidemias en la Encuesta Nacional de Salud y Nutrición 2006

OBJECTIVE: To describe the prevalence of lipid abnormalities found in the Mexican National Health and Nutrition Survey 2006 (ENSANut 2006). MATERIAL AND METHODS: Information was obtained from 4 040 subjects aged 20 to 69 years, studied after a 9- to 12-hour fast. RESULTS: Median lipid concentrations were: cholesterol 198.5 mg/dl, triglycerides 139.6 mg/dl, HDL-cholesterol 39.0 mg/dl, non-HDL-cholesterol 159.5 mg/dl and LDL-cholesterol 131.5 mg/dl. The most frequent abnormality was HDL-cholesterol below 40 mg/dl with a prevalence of 60.5 percent (95 percentCI 58.2-62.8 percent). Hypercholesterolemia (> 200 mg/dl) had a frequency of abnormality of 43.6 percent (95 percentCI 41.4-46.0 percent). Only 8.6 percent of the hypercholesterolemic subjects knew their diagnosis. Hypertriglyceridemia (> 150 mg/dl) was observed in 31.5 percent (IC 95 percent 29.3-33.9 percent) of the population. CONLUSIONS: The ENSANUT 2006 data confirm that the prevalence of hypoalphalipoproteinemia and other forms of dyslipidemia in Mexican adults is very high.

OBJETIVO: Presentar la prevalencia de las dislipidemias observada en la Encuesta Nacional de Salud y Nutrición 2006 (ENSANUT 2006). MATERIAL Y MÉTODOS: Se incluyeron 4040 individuos con edad entre 20 y 69 años estudiados bajo un ayuno de 9 a 12 horas. RESULTADOS: Las concentraciones medias de los lípidos sanguíneos fueron colesterol 198.5 mg/dl, triglicéridos 139.6 mg/dl, colesterol HDL 39.0 mg/dl, colesterol noHDL 159.5 mg/dl y colesterol LDL 131.5 mg/dl. La anormalidad más común fue la hipoalfalipoproteinemia (colesterol HDL< 40 mg/dl); su prevalencia fue 60.5 por ciento (IC95 por ciento 58.2-62.8 por ciento). La hipercolesterolemia (colesterol > 200 mg/dl) fue la segunda anormalidad en frecuencia, con 43.6 por ciento (IC95 por ciento 41.4-46.0 por ciento). Sólo el 8.6 por ciento de los casos conocía su diagnóstico. La hipertrigliceridemia (> 150 mg/dl) fue observada en 31.5 por ciento (IC95 por ciento 29.3-33.9 por ciento) de la población en estudio. CONCLUSIONES: Los datos de la ENSANUT 2006 confirman que la prevalencia de hipoalfalipoproteinemia y otras formas de dislipidemia es muy alta en los adultos mexicanos.

Prevalencia de dislipidemias en una población de sujetos en apariencia sanos y su relación con la resistencia a la insulina / Dyslipidemia prevalence and its relationship with insulin resistance on a population of apparently healthy subjects

OBJETIVO: Conocer la prevalencia de las dislipidemias en una población de sujetos en apariencia sanos y su relación con la resistencia a la insulina (RI). MATERIAL Y MÉTODOS: Este es un estudio transversal que incluyó a 1 179 individuos, donadores voluntarios de 35 a 65 años. Se obtuvo el historial clínico y se realizaron examen físico, determinación del perfil de lípidos, glucemia y niveles de insulina en ayuno. RESULTADOS: La edad promedio fue de 44 ± 7 años; 836 (71 por ciento) correspondían al género masculino. La prevalencia de hipertrigliceridemia fue de 57.3 por ciento, hipoalfalipoproteinemia de 52.4 por ciento e hipercolesterolemia de 48.7 por ciento. De los sujetos con obesidad (perímetro de cintura aumentado), 36.8 por ciento tenía hipertrigliceridemia/hipoalfalipoproteinemia, 35.2 por ciento dislipidemia mixta y 33.4 por ciento hipertrigliceridemia. La prevalencia de los patrones de dislipidemias fue mayor en sujetos con RI. CONCLUSIONES: La hipertrigliceridemia e hipoalfalipoproteinemia, vinculadas con RI, son comunes en la población mexicana; empero, una considerable proporción de casos carece de diagnóstico.

OBJECTIVE: Evaluate dyslipidemia prevalence and its association with insulin resistance in a cohort of apparently healthy subjects. MATERIAL AND METHODS: A cross-sectional study was conducted with 1 179 donors ages 35 to 65 years. The sample population was comprised of 71 percent men, with an average age of 44 ± 7. Clinical records, anthropometric data, lipid profile, fasting glycaemia, and insulin levels were obtained. RESULTS: Prevalence of hypertriglyceridemia was 57.3 percent, C-HDL under normal limits was 52.4 percent, and hypercholesterolemia was 48.7 percent. In addition, 36.8 percent of the obese individuals (as measured by waist perimeter) had hypertriglyceridemia/hypoalphalipoproteinemia, 35.2 percent had mixed dyslipidemia, and 33.4 percent had hypertriglyceridemia. Patterns of dyslipidemia were higher in subjects diagnosed with insulin resistance. CONCLUSIONS: Insulin resistance associated with hypertriglyceridemia and hypoalphalipoproteinemia was common among our studied population. However, a significant proportion of cases of apparent healthy individuals continue to go undiagnosed.