Associação da obesidade metabolicamente saudável e metabolicamente não saudável com aspectos bioquímicos, estilo de vida e aptidão cardiorrespiratória : um estudo com escolares de Santa Cruz do Sul - RS.

Abstract

Introduction: Obesity is associated with metabolic alterations, mainly related to the metabolic syndrome. However, a subset of obese individuals presents a normal metabolic profile, being called Metabolically Healthy Obesity (MHO). Objective: to compare biochemical parameters, lifestyle aspects related to physical activity and cardiorespiratory fitness among metabolically healthy obese and metabolically unhealthy obese students. Two articles were developed. Article 1: Objective: to verify the relation of renal and hepatic markers in adolescents with MHO and MUO. Method: sample composed of 274 adolescents aged 12 to 17 years. For the calculation of the body mass index, the BMI curves were used, for age and sex. For metabolic syndrome waist ircumference, systolic blood pressure and lipid profile were evaluated. As a renal marker, microalbuminuria and alanine aminotransferase and aspartate aminotransferase were used for hepatic markers. For the classification of adolescents with MHO, the classification of overweight / obesity and the presence of up to one risk factor for metabolic syndrome was considered. The descriptive analyzes were done in frequency and percentage. For association between renal and hepatic markers with MUO / MHO phenotypes, Poisson regression was applied. Data were expressed as prevalence ratio and confidence intervals (CI) to 95%. The Mann-Whitney U test was applied to compare the median values between MHO and MUO students. Significant differences were considered for p <0.05. Results: altered microalbuminuria was shown to be a protective factor for the MUO group (p <0.009). For the other metabolic variables, there were no significant associations to the MUO group. In the MUO 5 group, higher values of AST (18.00 mg / dL versus 16.00 mg / dL, p = 0.024) and ALT (16.00 mg / dL versus 15.00 mg / dL, p = 0.001) were found. Conclusion: altered liver markers were directly related to the development of MUO but altered levels of microalbuminuria demonstrated a lower risk of MUO. Article 2: Objective: to establish the relationship of metabolically healthy and unhealthy obesity with physical activity and cardiorespiratory fitness in adolescents. Method: sample of 274 adolescents, aged between 12 and 17 years. The classification of body mass index values was considered overweight and obese, according to age and sex. Waist circumference, blood pressure and lipid profile were evaluated. For cardiopulmonary fitness, the 6-minute run / walk test was used. The lifestyle was evaluated according to a self-referenced questionnaire by the students. For the presence of MHO, the presence of overweight / obesity and up to one risk factor for metabolic syndrome and two or more factors for MUO were used. Frequency and percentage were used to describe the variables. The Poisson regression test was adjusted for sex and maturational stage and Mann Whitney U for comparison of mean values between MHO and MUO students. Results: low levels of CPPA (p <0.004) and adolescents who did not walk or pedal as a means of transport (p <0.032) were shown to be a risk factor for the MUO group, and these associations were significant. Adolescents classified in the APCR in a health risk zone were more frequent in the MUO group (87.9%), never / sometimes walking or pedaling as a means of transportation also showed a greater association with the MUO group (59.6%). Conclusion: dolescents with MUO demonstrate a more sedentary lifestyle with less physical activity and low cardiorespiratory fitness. Considerations: a representative study when dealing with a population with an age group that lacks studies that contribute to the investigation of biochemical changes and lifestyle for the presented metabolic condition.