Persistência da síndrome metabólica em crianças e adolescentes com excesso de peso: Fatores associados e relação com o risco cardiovascular pelo escore Pathobiological Determinants of Atherosclerosis in Youth

Abstract

Introduction: Cardiovascular diseases (CVD) belong to the group of chronic noncommunicable diseases (NCDs) and many of these are related to obesity, especially the metabolic syndrome (MS), which can be present already in the early stages of life. It is essential to the study of cardiometabolic risk factors, as well as cardiovascular risk stratification rated by PDAY risk scores, which can improve the prediction of overall cardiovascular disease risk, with the aim of reducing harmful effects on the later stages of life. Objective: To check the persistence of metabolic syndrome in children and adolescents overweight, associated factors and their relationship with cardiovascular risk scoring pathobiological Determinants of Atherosclerosis in Youth (PDAY). Methods: Cross- sectional study of repeated measurements carried out in two stages: the first, related to entry into the study (2009/2010), and the second, held after 24 months (2011/2012). The study was developed in the Childhood Obesity Center (IOC), involving 133 children and adolescents between two and 18 years are overweight. A form which addressed socioeconomic and demographic issues, held the anthropometric and blood collection required to study procedures was applied. For the diagnosis of MS, the NCEP / ATPIII adapted to age group were used and its prevalence was evaluated at two points (baseline and 24 months), classifying it into negative (absent in the colon), intermittent (on a present points) and persistent (present in the colon). The second point was also evaluated glycosylated hemoglobin HbA1c and lifestyle (smoking, physical activity and sedentary lifestyle) for construction of PDAY score. For all analyzes, we used the SPSS (version 22.0), adopting the significance level of 5%. Descriptive analysis was performed, applied the chi-square test to verify the association of the variables with sex and the persistence of metabolic syndrome; and the McNemar test to check the behavior of the characteristics evaluated in both parts of the study. Although logistic regression analysis was performed using the persistence of the syndrome as the dependent variable and also the PDAY risk score. The project was approved by the Research Ethics Committee of UEPB (CAAE No. 0040.0.133.000-08). Results: Of the 133 children and adolescents evaluated, the majority (60.9%) were female, not white (67.7%), teenagers (59.4 and 66.9% in the colon study respectively), the public schools (56.4%) wit h an income above the minimum wage (86.5%) and with eight or fewer years of maternal education (55.6%). Physical inactivity was recorded in 83.5% of the sample, and the majority (52.6%) practiced 150 minutes or more of physical activity per week; there were no smokers record. MS was classified as negative (19.5%), intermittent (42.1%) and persistent (38.3%). It was identified important effect of obesity, low HDL cholesterol, high non-HDL cholesterol on the persistence of SM frame. In assessing cardiovascular risk by PDAY score, it was found that 79.7% had intermediate / high risk. Conclusion: In general, it is possible to say that the situation of children and adolescents of the study is worrying, both for the persistence of metabolic syndrome and the remarkable change of PDAY score, which results from the sum of cardiovascular risk factors in early stages the life cycle. Given the above, early initiated preventive measures help in a lower risk of developing chronic diseases in adulthood, and may thus improve the survival and quality of life of this segment of the population.