Risco metabólico em adolescentes : enzimas hepáticas, ácida árico, hemoglobina e os fatores sociodemográficos associados.

Abstract

Introduction: The presence of Metabolic Risk (MR) and short-term and long-term complications are of concern to adolescents and adults. MR through the cMetS (Continuous Metabolic Risk Score) is a composite of interrelated metabolic factors associated with increased cardiovascular disease, type 2 diabetes, chronic metabolic disorders and all-cause mortality. Overall objective: To investigate whether the presence of MR in schoolchildren is associated with liver enzymes, uric acid, hemoglobin (Hb) and sociodemographic indicators. Two articles were developed. Article I: Objective: To verify the association of MR with liver enzymes, uric acid and Hb in schoolchildren. Materials and methods: A total of 1,713 Brazilian adolescents between 10 and 17 years old were evaluated. MR was calculated by cMetS, using the sum of the Z score of the following parameters: waist circumference (WC), systolic blood pressure (SBP), glucose, high density lipoprotein (HDL-c), triglycerides (TG) and cardiorespiratory fitness (CRF). For alanine aminotranferase (ALT) and aspartate aminotransferase (AST), 30 U / L and 37 U / L respectively were considered, and the AST/ALT ratio less than 1 suggested the presence of NAFLD. Values above 5.5 mg/dL were considered hyperuricemia. Hb was divided into quartiles, being considered elevated when values> p75.Results: Adolescents with the presence of MR showed higher levels of uric acid (4.76 versus 4.22 mg / Dl; p <0.001), ALT (19.05 versus 16.69 U / L; p = 0.021) and Hb (13.48 versus 13.20 g / dL; p = 0.006). A positive relationship of cMetS with uric acid (β: 0.25 SD; p <0.001), ALT (β: 0.10 SD; p <0.001) and AST (β: 0.05 SD; p = 0.042) was observed in adolescents. High concentrations of ALT (OR: 2.64; 95% CI: 1.63-4.27), AST (OR: 2.53; 95% CI: 1.24-5.18) and uric acid (OR: 2.50; 95% CI: 1.74-3.59) were associated with MR. Uric acid was the best predictor of MR (sensitivity: 55.79%, specificity: 61.35% and AUC: 0.616). Conclusion: MR was associated with ALT, AST, Hb and uric acid in adolescents. The findings are potentially important, allowing the use of cMetS in the identification of these altered risk factors in adolescents. Article II: Objective: to verify association between the presence of MR with sociodemographic indicators such as sex, age, skin color, housing region and socioeconomic level) in dolescents. Method: A cross sectional study with a sample of 1,152 schoolchildren between 10 and 17 years of age, both sexes. MR was calculated by cMetS. The data were later classified in presence or absence of MR. The results were expressed as prevalence (PR) and confidence interval (CI) to 95%. Results: The resence of MR was demonstrated in 8.7% of adolescents. The skin color is not less supported by the MR (PR: 0.96, 95% CI: 0.93-0.99). Adolescents living in urban areas had a higher prevalence of low HDL-c (PR: 0.95; CI 95%: 0.94-0.97), high glucose (PR: 0.96; CI 95%: 0.95-0.98), and SBP was higher in those adolescents living in rural areas (PR: 1.11, CI 95%: 1.05-1.17). In girls, there was a higher prevalence of altered TG (PR: 1.06; CI 95%: 1.02-1.10) and low APCR (PR: 1.20; CI 95%: 1.16-1.24). Conclusions: MR in adolescents was higher in those with white skin and lower in rural residents. Final Considerations: a study of importance for clinical and metabolic investigations, since there is little research involving the use of cMetS in the Brazilian infantojuvenil population, making possible an early follow-up of the risk factors in adolescents.