Prevalencia de obesidad y síndrome metabólico en adolescentes de la ciudad de Posadas, Misiones / Prevalence of obesity and metabolic syndrome in adolescents from Posadas, Misiones, Argentina

RESUMEN

Los objetivos del presente trabajo fueron: estimar la prevalencia de síndrome metabólico (SM) y obesidad, su distribución por edad y sexo. Además evaluar el riesgo del SM según el grado de obesidad y correlacionar esta última con los componentes del SM en adolescentes de la ciudad de Posadas, provincia de Misiones. Se realizó un muestreo por conglomerados en el año 2005, tomando una muestra representativa de 532 alumnos (NC=95 %) con edades comprendidas entre 11 y 20 años. El SM fue definido según el Adult Treatment Panel III y modificado para edad según Cook. El 4,5 % presentó SM y evidenciaron mayor riesgo los varones, el grupo comprendido entre 15 y 20 años y los que presentaban obesidad y sobrepeso. El 11,7 % presentó sobrepeso y el 3,4 % obesidad. El 44,7 % tenía algún componente del SM, siendo el orden de frecuencia triglicéridos aumentados, colesterol HDL disminuido, presión arterial elevada y circunferencia de cintura aumentada. Según estimaciones poblacionales, 1.400 alumnos, de la ciudad de Posadas, serían portadores del síndrome metabólico, con la probabilidad de persistir sus componentes en la edad adulta y el riesgo consiguiente de desarrollar diabetes tipo 2 y enfermedad cardiovascular. La modificación de hábitos alimentarios y el incremento de la actividad física a través de programas conjuntos entre estado y comunidad podrían revertir esta situación.

ABSTRACT

The Metabolic Syndrome (MS) results from an association of metabolic abnormalities that could lead to DBT 2 and Cardiovascular Disease (CVD). Atherosclerosis begins during childhood and progresses into adolescence depending on cardiovascular risk factors (1-5). The aim of this study was: 1) Estimation of metabolic syndrome and obesity prevalence according to age and sex. 2) Assessment of metabolic risk linked to obesity. 3) Correlation of obesity with MS parameters in adolescents of Posadas, capital city of Misiones province. Subjects: the population studied was a representative sampling of 532 students recruited during the year of 2005 (NC=95 %), aged from 11 to 20 years old (mean=15 years)- 60 % of them were women. MS was defined following the Adult Treatment Panel III criteria and age-modified according to Cook. Participation in the trial was optional and written consent was obtained from parents or tutors. Authorization model was based on Helsinki(24). Methods: weight, height and waist perimeter (WP) data were recorded under WHO standards. Blood pressure was evaluated regarding American Health Organization recommendations(20). Cole et al. tables(23) were used to classify subjects as normal, overweighed and obese depending on their BMI. Own reference data were registered for WP in 2861 further students in the same schools previously chosen, with the calculation of the 90th percentile in normal teen-agers for age and sex. Blood samples with 12-hours of fasting were collected and glucose, triglyceride and HDL-cholesterol were measured by enzymatic colorimetric methods, with internal control from a pool serum prepared at the laboratory, and an external control provided by the Argentine Biochemical Foundation. Statistical analysis was performed with SPSS 11.S program, and chi square or Mann Whitney Statistical tests when needed, with a significance level >/= 95 % (p<0.05); for risk calculation Odds Ratio (OR) 95 % of confidence interval. Results: 4,5 % showed MS (table 1). They were male subjects aged from 15 to 20 years old with obesity and overweight. 44.7 % had at least one of MS compounds (Table 1). Triglyceride was the most frequent raised analyte, followed by HDL diminished, high blood pressure and high waist perimeter (Table 2). 11.7 % showed overweight and 3,4 were obese (Tables 2 and 3), No significant difference was found for age and sex. Risk for MS increased related to obesity grade (OR overweight= 39.71, CI 10,93-144,18), (OR obese = 119,73 CI 27,6-519,41). BMI correlated significantly to all MS parameters (Table 4). Conclusions: About 1400 students from Posadas should have MS, with its high risk for DBT 2 and /or CVD. School and Community programs to change nutritional habits and increase physical activity should be necessary to face this concerning situation.