Estado pró-trombólico e fatores de risco cardiometabólicos em crianças e adolescentes com sobrepeso ou obesidade

Abstract

OBJECTIVE: To determine serum levels of fibrinogen and measurement of the carotid intima-media layer in overweight or obese children and adolescents, and their relationship with cardiometabolic risk factors.

METHODS: Cross-sectional study involving overweight or obese children and adolescents. Anthropometry, blood pressure measurements and laboratory tests were performed in 138 individuals and carotid doppler to measure the intima-media layer of the common carotid artery in 32 adolescents. The association of fibrinogen with high cardiometabolic risk factors was verified by the chi-square test (Fisher, when n <5). The averages of the cardiometabolic risk factors were compared between quartiles of fibrinogen through variance analysis and its relationship assessed by Pearson correlation. The measures of carotid intima-media layer were divided into percentiles and compared with the mean values of cardiometabolic risk factors by analysis of variance. All analysis were performed with SPSS version 17.0 program, considering the significance level of 5%. RESULTS: Serum levels of fibrinogen were elevated in 28.3% (39/138), being more frequent among children (43.3%) than among adolescents (24.1%). Among the cardiometabolic risk factors, low levels of high density lipoprotein was the most prevalent (89.7%), and 52.8% had four or more cardiometabolic risk factors. We observed a significant elevation of mean density lipoprotein, total cholesterol and C reactive protein ultrasensitive according to increasing quartiles of fibrinogen. In about one third (11/32) of the study population, measurement of intima-media layer of the carotid artery was above the 75th percentile or for age was considered abnormal. CONCLUSIONS: Elevated levels of fibrinogen and increased intima-media thickness of the carotid may be present in children and adolescents with overweight and obesity.