Índices lipídicos em pessoas idosas assistidas na atenção primária à saúde : associação com indicadores demográficos, do estilo de vida, inflamatórios e cardiometabólicos

Abstract

Aging is a major risk factor to metabolic decline. The identification of early metabolic changes presents the possibility of disease prevention and improvement of quality of life. Therefore, new indices based on blood lipids were proposed to identify insulin resistance (IR) and metabolic syndrome (MS): the lipid indices. These indexes are composed of biochemical variables, which were associated with anthropometric parameters, including: the Visceral Adiposity index (VAI), the Lipid Accumulation Product (LAP), ratio between plasma levels of triglycerides (TG) and HDL-c cholesterol (TG/HDL-c), Triglycerides and Glucose index (TyG) and the product of TyG with specific anthropometric parameters [body mass index (TyG-BMI); waist circumference (TyG-CC), waist-to-height ratio (TyG-RCA); and waist-hip ratio (TyG-WHR)]. These indices are considered more accessible to clinical practice. Data from a cross-sectional study was obtained from the previous project “Epidemiological and Clinical Study of Elderly People Attended by the Family Health Strategy (ESF) of the Municipality of Porto Alegre, Rio Grande do Sul (EMI-SUS)”. For this, 463 elderly subjects were included, and the thesis is organized in two original articles. In the first article entitled “LIPID INDICES ASSOCIATED WITH DEMOGRAPHIC, LIFESTYLE, CLINICAL AND INFLAMMATORY INDICATORS IN ELDERLY PEOPLE: A CROSS-SECTIONAL STUDY”, we investigated the association of lipid indices with demographic, lifestyle, clinical and inflammatory characteristics in elderly people assisted in primary health care. The investigated variables included: sex, age group, insulin resistance (IR), consumption of alcoholic beverages, active smoking, physical activity, consumption of fruit-vegetables, interleukin-6 (IL-6), high-sensitivity C-reactive protein (hs-CRP) and the lipid indices (LAP, VAI, TG/HDL-c, TyG and four TyG-derived indices (TyG-BMI, TyG-CC, TyG-RCA and TyG-RCQ). The studied population consisted of 62.9% of women, with mean age of 68.09±6.63 years (ranging from 60 to 100 years). The TyG-BMI and TyG-RCA indices had the highest medians for most of studied variables. All lipid indices were significantly higher in individuals with IR and obesity. We also found relationships between TyG, TyG-BMI, TyG-RCQ and TyG-RCA indices and hs-CRP. No relationships were observed for the alcohol consumption, physical activity, and IL-6 with the studied lipid indices. In the second article entitled “LIPID INDICES AS SURROGATE MARKERS FOR METABOLIC SYNDROME AMONG OLDER ADULTS ASSISTED AT PRIMARY HEALTH CARE”, we sought to investigate the diagnostic performance of lipid indices in the diagnosis of MS in elderly subjects assisted in primary health care. Demographic, clinical and laboratory parameters, and lipid indices were employed. It has been shown that all eight lipid indices investigated presented accuracy above 75%, demonstrating a good performance in the diagnosis of MS. It is noteworthy that the TyG-CC, TyG-RCA and LAP indices showed excellent performance with accuracy above 80%.