Risco cardiometabólico em adolescentes : associação com diferentes padrões de sono, estado nutricional e tempo de televisão.

Abstract

Introduction: The increase in the presence of cardiometabolic risk observed in Brazilian adolescents draws public health attention due to its relationship with cardiometabolic diseases. In this sense, it is important to investigate associated factors, such as changes in lifestyle, especially in adolescents with inadequate hours of sleep, long TV screen and an increase in cases of obesity. Objective: To verify the association between cardiometabolic risk in adolescents with different patterns of sleep duration, nutritional status and TV time. Article 1: Objective: To verify the association between sleep duration and TV time with cardiometabolic risk and the moderating role of age, gender and skin color/ethnicity in this relationship among adolescents. Method: Cross-sectional study with 1411 adolescents (800 girls) aged 10 to 17 years. TV time, sleep duration, age, gender and skin color/ethnicity were obtained by self reported questionnaire. Cardiometabolic risk was composed by sum of standardized Z-score of HDL-c cholesterol, triglycerides, glycemia, systolic blood pressure, waist circumference and cardiorespiratory fitness. Generalized linear regression models were used. Results: There was an association between TV time and cardiometabolic risk (β: 0.002; 95% CI: 0.001; 0.003). Short (β: 0.422; 95% CI: 0.012; 0.833) and long sleep duration (β: 0.906; 95% CI: 0.098; 1.715) are positively associated with cardiometabolic risk. It was also found that age moderated the relationship between TV time and cardiometabolic risk (β: -0.009; 95% CI: -0.0017; -0.0001), suggesting that this relationship was stronger at ages 11 and 13 years (β: 0.0039; 95% CI: 0.0015; 0.0063) compared to 13 to 15 years (β: 0.0021; 95% CI: 0.0005; 0.0036). No association was found in older adolescents (β: 0.0002; 95% CI: - 0.0020; 0.0023). Conclusion: Strategies to improve sleep patterns and reduce TV time are important and must consider the adolescent's age to reduce cardiometabolic risk. Article 2: Objective: To verify if the combination of sleep duration, television (TV) time and body mass index (BMI) is associated with cardiometabolic risk and to assess the moderating role of age in this relationship in adolescents. Methods: Cross-sectional study with 1411 adolescents (611 male), aged 10 to 17 years. Sleep duration, TV time and BMI were assessed and grouped. Cardiometabolic risk was assessed by calculating the continuous metabolic risk score. Generalized linear models were used to test the moderation. Results: Cardiometabolic risk values are higher when individuals have adequate sleep/short TV time/obese (β= 3,838; IC 95%= 3,344; 4,332), adequate sleep/ prolonged TV time/obese (β= 4.096; 95% CI= 3.612; 4.579), inadequate sleep/short TV time/obese (β= 3,998; IC 95%= 3,379; 4,617) and inadequate sleep/prolonged TV time/obese (β = 4.304; 95% CI = 3.645; 4.963). Age moderated the relationship between sleep duration/TV time/BMI and cardiometabolic risk. This association was stronger in younger adolescents. In addition, individuals with obesity, regardless of sleep duration and TV time, present higher cardiometabolic risk values. Conclusion: The main factor associated with adolescents' cardiometabolic risk is obesity, regardless of sleep duration or poor sedentary behavior. In addition, it is suggested that this risk is even higher in younger adolescents. Considerations: Sleep time, TV time and the combination of sleep duration, TV time and BMI are associated with CR, in which it was found that short and long sleep time and high TV time are more harmful for cardiometabolic health of adolescents than individuals who comply with sleep and TV time recommendations. However, in the combination of sleep duration, TV time and BMI, obesity was more harmful to the development of cardiometabolic risk, regardless of sleep duration and TV time.