?ndices lip?dicos em pessoas idosas assistidas na aten??o prim?ria ? sa?de : associa??o com indicadores demogr?ficos, do estilo de vida, inflamat?rios e cardiometab?licos

Autor: Couto, Analie Nunes
Přispěvatelé: Schwanke, Carla Helena Augustin, Bauer, Mois?s Evandro
Jazyk: portugalština
Rok vydání: 2022
Předmět:
Zdroj: Biblioteca Digital de Teses e Dissertações da PUC_RS
Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS)
instacron:PUC_RS
Popis: O envelhecimento ? um fator de risco para o decl?nio metab?lico, e a identifica??o de altera??es metab?licas apresenta a possibilidade de preven??o de doen?as e melhoria da qualidade de vida. Desta maneira, novos ?ndices relacionados aos lip?deos sangu?neos foram propostos para a identifica??o da resist?ncia ? insulina (RI) e da s?ndrome metab?lica (SM). Estes foram denominados ?ndices lip?dicos. Os ?ndices s?o compostos por vari?veis bioqu?micas, podendo ser associadas com par?metros antropom?tricos. Entre eles est?o o Visceral Adiposity index (VAI), o Lipid Accumulation Product (LAP), rela??o entre os n?veis plasm?ticos de triglicer?deos (TG) e o colesterol HDL-c (TG/HDL-c), Triglycerides and Glucose index (TyG) e o produto do TyG com par?metros antropom?tricos [?ndice de massa corporal (TyG-IMC); circunfer?ncia da cintura (TyG-CC), rela??o cintura-altura (TyG-RCA); e rela??o cintura-quadril (TyG-RCQ)]. Estes ?ndices s?o considerados mais acess?veis ? pr?tica cl?nica. Neste contexto, para esta tese com delineamento transversal, foram utilizados dados do projeto guarda-chuva ?Estudo Epidemiol?gico e Cl?nico dos Idosos Atendidos pela Estrat?gia Sa?de da Fam?lia (ESF) do Munic?pio de Porto Alegre, Rio Grande do Sul (EMI-SUS)?. Foram inclu?das 463 pessoas idosas. Desta maneira, a presente tese apresenta dois artigos originais. No primeiro artigo, intitulado ASSOCIA??O DE ?NDICES LIP?DICOS COM INDICADORES DEMOGR?FICOS, DO ESTILO DE VIDA, CL?NICOS E INFLAMAT?RIOS EM PESSOAS IDOSAS: UM ESTUDO TRANSVERSAL, buscou-se verificar a associa??o dos ?ndices lip?dicos com caracter?sticas demogr?ficas, estilo de vida, cl?nicas e inflamat?rias, em pessoas idosas atendidas na aten??o prim?ria ? sa?de. As vari?veis investigadas foram: sexo, faixa et?ria, resist?ncia ? insulina, consumo de bebida alco?lica, tabagismo , n?vel de atividade f?sica, consumo di?rio de frutas e verduras, Interleucina 6 (IL-6), Prote?na C-reativa ultra-sens?vel (PCR-us) e os ?ndices lip?dicos: LAP, VAI, TG/HDL-c, TyG e quatro ?ndices derivados de TyG (TyG-IMC, TyG-CC, TyG-RCA e TyG-RCQ). Como resultados, 62,9% da amostra era composta por mulheres. A m?dia de idade foi 68,09?6,63 anos (variando de 60 a 100 anos). Os ?ndices TyG-IMC e o TyG-RCA foram os que apresentaram medianas mais elevadas para o maior n?mero de vari?veis analisadas. Os valores de todos os ?ndices lip?dicos foram significativamente maiores nos indiv?duos com RI e obesidade. Foram encontradas associa??es dos ?ndices TyG, TyG-IMC, TyG-RCQ e TyG-RCA com a PCR-us. J? em rela??o ao consumo de bebida alco?lica, ao n?vel de atividade f?sica e de IL-6, n?o se observou associa??o com os ?ndices lip?dicos. O segundo artigo, LIPID INDICES AS SURROGATE MARKERS FOR METABOLIC SYNDROME AMONG OLDER ADULTS ASSISTED AT PRIMARY HEALTH CARE, investigou o desempenho diagn?stico dos ?ndices lip?dicos no diagn?stico da SM em pessoas idosas atendidas na aten??o prim?ria ? sa?de. Foram utilizados par?metros demogr?ficos, cl?nicos e laboratoriais e ?ndices lip?dicos. Como resultado, observou-se que todos os oito ?ndices lip?dicos investigados apresentaram acur?cia acima de 75%, demostrando um bom desempenho no diagn?stico de SM. Destaca-se que os ?ndices TyG-CC, TyG-RCA e LAP apresentaram um desempenho excelente com acur?cia acima de 80%. 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%. Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES
Databáze: OpenAIRE
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