Desempenho de indicadores antropométricos na predição de síndrome metabólica em idosos assistidos na atenção básica

Abstract

Performance of anthropometric indicators in the prediction of metabolic syndrome in elderly people attended basic care. 2018. 118f. Dissertation (Master in Biomedical Gerontology) - Escola de Medicina da Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, 2018.

Introduction: Metabolic syndrome (MetS) is frequent among the elderly and is associated with negative outcomes such as cardiovascular morbidity, cancer and mortality. Studies have demonstrated the performance of anthropometric indicators in the prediction of metabolic syndrome, however, studies involving the elderly population in general and Brazilian in particular are insipient. Objectives: To describe the frequency of MetS and its components in elderly patients assisted in basic care and to determine the performance of anthropometric indicators in the prediction of metabolic syndrome. Methods: This is a cross-sectional study with 479 elderly people who were evaluated in the Epidemiological and Clinical Study of the Elderly Attended by the Family Health Strategy of the Municipality of Porto Alegre (EMI-SUS). For the diagnosis of MetS, the revised NCEP-ATPIII criterion was used. The variables under investigation were: MetS and its components (central obesity, decreased HDL-c and triglycerides, high blood pressure and glucose); (age, sex and age) and five anthropometric indicators (neck circumference, sagittal abdominal diameter (SAD), SAD/height ratio, sagittal index and conicity index]. The predictive power and cut-off points of the anthropometric indicators were determined using Receiver Operating Characteristic (ROC) curves. The anthropometric indicators that presented area under the curve (auROC)> 0.70 were considered as adequate performance. Results: The majority of the sample was female (63.5%) and had MetS (60.5%). The most frequent MetS was high blood pressure (69.5%) and the least frequent was decreased HDL cholesterol (34.9%). In the total sample, the anthropometric indicators that demonstrated adequate performance were SAD/height (cutoff point: 0.14, auROC: 0.810, 95% CI: 0.771-0.850), SAD (cut-off point: 24.65 cm, 0.777, 95% CI: 0.734-0.820) and conicity index (cut-off point: 1.57, aROC: 0.706, 95% CI: 0.660-0.753). In females, anthropometric indicators with adequate performance were the SAD (cut-off point: 23.34 cm, auROC: 0.820, 95% CI: 0.766-0.875), SAD/height (cutoff point: 0.13, auROC: 0.810 , 95% CI: 0.755-0.865), neck circumference (cutoff point: 34.09 cm, auROC: 0.782, 95% CI: 0.727-0.838), and conicity index (cutoff point: 1.56, auROC: 0.727; 95% CI: 0.666-0.788). In males, the indicators with adequate performance were SAD/height (cutoff point: 0.14, auROC: 0.768, 95% CI: 0.695-0.841), SAD (cutoff point: 25.04 cm, auROC: 0.760; %: 0.685-0.835), and conicity index (cutoff point: 1.61, auROC: 0.724, 95% CI: 0.649-0.799). Conclusions: The elderly attending the Family Health Strategy had a high frequency of metabolic syndrome (60.5%). It was observed that, of the five anthropometric indicators investigated, three (SAD/height, SAD, and conicity index) performed well in the total sample, four (SAD, SAD/height, neck circumference and conicity index) in women and three in men (SAD/height, SAD and conicity index). That is, SAD, SAD/height and conicity index were adequate in all three segments.