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Perfil Lipídico, Prevalência de Obesidade e Hábitos Alimentares de uma População de Adolescentes
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Advisor(s)
Abstract(s)
RESUMO
Introdução: A aterosclerose tem
início na infância e progride durante a
adolescência. Nas últimas décadas verifica-se uma tendência para o aumento da
adiposidade corporal e distúrbios metabólicos
associados. A sua prevenção, detecção
e correcção precoces podem reduzir
a incidência de doença cardiovascular na
idade adulta. As recomendações actuais
para o rastreio de dislipidémia apontam
para um rastreio selectivo baseado na
identificação de vários factores de risco.
Objectivo: Conhecer o perfil lipídico,
a prevalência de sobrepeso e obesidade,
a história familiar de doença cardiovascular
e os hábitos alimentares entre
88 adolescentes, observados durante
exame global de saúde dos 11-13 anos,
no Centro de Saúde da Sr.ª da Hora - Matosinhos.
Material e Métodos: O IMC foi avaliado
e classificado segundo as curvas de
crescimento do CDC- Centres of disease
control- National Centrer for Health Statistics
dos Estados Unidos. A classificação
do perfil lipídico baseou-se nos critérios
do National Cholesterol Education
Program (NCEP) para o Colesterol Total
e Colesterol LDL e do Lipid Research Clinics
Prevalence Study (LRC) para os triglicerideos
e colesterol HDL. Os hábitos
alimentares foram avaliados através da
aplicação de um inquérito de frequência
alimentar. A análise estatística dos dados
foi efectuada através do teste do Fisher,
tendo sido considerados significativos valores
de p<0,05.
Resultados: A prevalência global de
obesidade e sobrepeso foi de 11% e 23%,
respectivamente, tendo sido encontrada
uma prevalência maior no sexo feminino.
Verificaram-se alterações do perfil lipidico
em 26% dos adolescentes e valores border-
line em 16%. Não foram encontradas
diferenças, com significado estatístico,
entre a existência de obesidade ou de
hiperLDLcolesterolémia e as frequências
alimentares. A prevalência de história parental
positiva para dislipidemia nos adolescentes,
com alterações do perfil lipidico
(26%), foi igual à prevalência global.
Comentário: A elevada prevalência
de obesidade e dislipidemia encontrada
nesta população, constitui um dado particularmente
preocupante, uma vez que a
prevalência de obesidade na adolescência
é fortemente preditiva de obesidade
e factores de risco cardiovasculares associados
na idade adulta, realçando-se
a necessidade de instituição precoce
de medidas preventivas e de hábitos de
vida saudáveis. Em relação aos hábitos
alimentares destacam-se uma baixa ingestão
de legumes e peixe e um elevado
consumo diário de produtos de pastelaria/
confeitaria e refrigerantes e sumos,
constando-se globalmente, uma dieta
que se afasta da dieta mediterrânica, que
nos caracterizava no passado.
Em relação à história familiar dos
adolescentes com dislipidemia, os dados
obtidos estão de acordo com resultados
de estudos anteriores que concluem que
os critérios de rastreio de dislipidémia,
baseados na história parental não oferecem
vantagem em relação ao rastreio
aleatório na identifi cação de jovens com
hipercolesterolémia, o que parece pôr em
causa a estratégia baseada no risco recomendada
pelo NCEP e AAP. Assim, o rastreio
de dislipidémia deve ser fortemente
considerado em todos os adolescentes.
ABSTRACT Introduction: Atherosclerosis begins in childhood and progresses through adolescence and adulthood. In the last decades there has been a trend for increase of adiposity and prevalence of cardiovascular disease with associated metabolic disturbances. Prevention, early detection with treatment of these risk factors can prevent the latter development of cardiovascular disease. There are specific recommendations for selective screening involving the identification of various cardiovascular risk factors. Objective: This study was conducted to evaluate lipid profile, prevalence of overweight and obesity, family history of cardiovascular risk factors and dietary habits among 88 adolescents observed during a global health visit, in Srª da Hora Health Centre-Matosinhos. Methods and Procedures: Body Mass Index (BMI) classification was based on CDC Growth Charts- Centres of disease control- National Centre for Health Statistics dos EUA. Total cholesterol and Low-density lipoproteins cholesterol (LDL-C) classification was based on National Cholesterol Education Program (NCEP) criteria. Triglycerides and Hight-density lipoproteins cholesterol (HDL-C) classification was based on Lipid Research Clinics Prevalence Study. The dietary habits were evaluated by a frequency questionnaire. Statistical analisys included Fisher test. The value of significance was considered for p<0,05. Results: Global prevalence of obesity and overweight was 11% and 23% respectively, with greater prevalence of female gender. Lipid profile was abnormal in 26% adolescents and 16% presented borderline values. There were no differences on the frequency of ingestion of the foods inquired. The prevalence of a positive family history of abnormal lipid profile was the same among patients with hyperlipidemia and total population. Discussion: The high prevalence of overweight, obesity and abnormal lipid profile in this population is particular worrisome since adolescent obesity strongly predicts obesity in adulthood and associated cardiovascular risk factors, enhancing the needs for prevention. In the dietary habits we found a low ingestion of vegetables and fish and high ingestion of bakery and sweet foods and beverages, a diet that is globally different from the Mediterranean diet that used to characterize us. The results obtained are concordant with previous studies concluding that criteria for screening based on parental history seem to offer no advantage over random screening in the identification of young people with abnormal lipid profile therefore not supporting the risk based strategy recommended by NCEP and American Academy of Pediatrics. Lipid profile screening should be considered among all adolescents.
ABSTRACT Introduction: Atherosclerosis begins in childhood and progresses through adolescence and adulthood. In the last decades there has been a trend for increase of adiposity and prevalence of cardiovascular disease with associated metabolic disturbances. Prevention, early detection with treatment of these risk factors can prevent the latter development of cardiovascular disease. There are specific recommendations for selective screening involving the identification of various cardiovascular risk factors. Objective: This study was conducted to evaluate lipid profile, prevalence of overweight and obesity, family history of cardiovascular risk factors and dietary habits among 88 adolescents observed during a global health visit, in Srª da Hora Health Centre-Matosinhos. Methods and Procedures: Body Mass Index (BMI) classification was based on CDC Growth Charts- Centres of disease control- National Centre for Health Statistics dos EUA. Total cholesterol and Low-density lipoproteins cholesterol (LDL-C) classification was based on National Cholesterol Education Program (NCEP) criteria. Triglycerides and Hight-density lipoproteins cholesterol (HDL-C) classification was based on Lipid Research Clinics Prevalence Study. The dietary habits were evaluated by a frequency questionnaire. Statistical analisys included Fisher test. The value of significance was considered for p<0,05. Results: Global prevalence of obesity and overweight was 11% and 23% respectively, with greater prevalence of female gender. Lipid profile was abnormal in 26% adolescents and 16% presented borderline values. There were no differences on the frequency of ingestion of the foods inquired. The prevalence of a positive family history of abnormal lipid profile was the same among patients with hyperlipidemia and total population. Discussion: The high prevalence of overweight, obesity and abnormal lipid profile in this population is particular worrisome since adolescent obesity strongly predicts obesity in adulthood and associated cardiovascular risk factors, enhancing the needs for prevention. In the dietary habits we found a low ingestion of vegetables and fish and high ingestion of bakery and sweet foods and beverages, a diet that is globally different from the Mediterranean diet that used to characterize us. The results obtained are concordant with previous studies concluding that criteria for screening based on parental history seem to offer no advantage over random screening in the identification of young people with abnormal lipid profile therefore not supporting the risk based strategy recommended by NCEP and American Academy of Pediatrics. Lipid profile screening should be considered among all adolescents.
Description
Keywords
Adolescentes perfil lipidico obesidade doença cardiovascular Adolescents lipid profile obesity cardiovascular disease
Citation
Nascer e Crescer 2006; 15(2): 65-70