Fatores prÃ-aterotrombÃticos associados à SÃndrome MetabÃlica X na populaÃÃo de Pernambuco â Nordeste â Brasil

AUTOR(ES)
DATA DE PUBLICAÇÃO

2009

RESUMO

Metabolic Syndrome X (MSX) is a cluster of at least three metabolic disorders, among which insulin resistance/compensatory hyperinsulinemia, hyperglycemia, obesity and/or abdominal obesity, hypertension, characteristic dyslipidemia with hypertriglyceridemia and/or reduction of levels of cholesterol in high-density lipoprotein (HDL-c), and other pro-atherothrombotic risk factors, such as hyperuricemia and high levels of plasma fibrinogen. It is believed that when these risk factors are related to a single individual, there is a potentiation of atherosclerotic cardiovascular risk (ASCVR), for example, Castelli I and II indexes and the values of reason apolipoproteinB/apolipoproteinA- I. In Pernambuco, northeastern of Brazil, is still unknown prevalence of MSX and its relationship with further pro-atherothrombotic factors and its influence on atherosclerotic cardiovascular disease (ASCVDs). Thus, this study had, as main aim, the investigation of this relationship. In the first aspect, it was investigated a combination of MSX and proatherothrombotic factors with smoking in 1,078 young women (20 to 29 years), since it has estimated a causal relationship between the habit of smoking, and approximately 250 million deaths in coming years. The overall prevalence of smoking was 12.3%. The young smokers had higher body mass and waist / hip indexes, increased insulin resistance (accessed by Homeostasis Model Assessment and triglycerides/HDL-c ratio), higher rates of ASCVR, higher blood pressure levels of fibrinogen and of uric acid; and lower HDL-c and quantitative insulin sensitive check index. The cluster of disorders of MSX was more prevalent in smokers than in young nonsmokers, and smoking had an odds ratio of 4.49 and 9.31 to SMX in women aging 20-24 and 25-29 years respectively. There was also a new assessment of lipid profile of a female population (n=508), from State of Pernambuco, Brazil, according to the IIIrd and IVth Brazilian Guidelines for Dyslipidemia, highlighting the changes. The lipid profile "Isolated Decrease in HDL-cholesterol Levels" showed up about 4 times more frequent, while the number of women normolipidemic reduced by half. This change was also assessed in 212 men. In these, there was a considerable increase of hypertriglyceridemia. It was also investigated the degree of influence of major disturbances of MSX in ASCVDs carriers (n = 252, both sexes), compared to 250 control subjects. Obesity/Abdominal obesity, triglycerides, and VLD-c were major contributors for ASCVDs. It was also investigated the relationship of genetic factors (polymorphism of apolipoprotein E) with MSX (n=160 elderly). The e4 allele showed an association with the lipid profile characteristic of MSX (hypertriglyceridemia, high VLDL-c and triglycerides/HDL-c). Therefore, this study demonstrates the strong relationship between "Pro-Atherothrombotic Factors/MSX/ASCVDs", and it emphasizes the need for epidemiological studies to identify the characteristics of each population, because of peculiarities related to biological and not biological factors of ASCVR.

ASSUNTO(S)

bioquÃmica sÃndrome metabÃlica x pro-atherothrombotic factors fatores prÃ- aterotrombÃticos atherosclerotic cardiovascular diseases doenÃas cardiovasculares aterosclerÃticas ciencias biologicas metabolic syndrome x

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