Made available in DSpace on 2014-12-17T14:13:37Z (GMT). No. of bitstreams: 1
SeverinaCVCL_TESE.pdf: 1816207 bytes, checksum: 5755d36ea1a1726759b308b22d1cfcdb (MD5)
Previous issue date: 2011-02-28 / The dyslipidemia and excess weight in adolescents, when combined, suggest a progression of risk factors for cardiovascular disease (CVD). Besides these, the dietary habits and lifestyle have also been considered unsuitable impacting the development of chronic diseases. The study objectives were: (1) estimate the prevalence of lipid profile and correlate with body mass index (BMI), waist circumference (WC) and waist / height ratio (WHR) in adolescents, considering the maturation sexual, (2) know the sources of variance in the diet and the number of days needed to estimate the usual diet of adolescents and (3) describe the dietary patterns and lifestyle of adolescents, family history of CVD and age correlates them with the patterns of risk for CVD, adjusted for sexual maturation. A cross-sectional study was performed with 432 adolescents, aged 10-19 years from public schools of the Natal city, Brazil. The dyslipidemias were evaluated considering the lipid profile, the index of I Castelli (TC / HDL) and II (LDL / HDL) and non-HDL cholesterol. Anthropometric indicators were BMI, WC and WHR. The intake of energy, nutrients including fiber, fatty acids and cholesterol was estimated from two 24-hour recalls (24HR). The variables of lipid profile, anthropometric and clinical data were used in the models of Pearson correlation and linear regression, considering the sexual maturation. The variance ratio of the diet was calculated from the component-person variance, determined by analysis of variance (ANOVA). The definition of the number of days to estimate the usual intake of each nutrient was obtained by taking the hypothetical correlation (r) ≥ 0.9, between nutrient intake and the true observed. We used the principal component analysis as a method of extracting factors that
129
accounted for the dependent variables and known cardiovascular risk obtained from the lipid profile, the index for Castelli I and II, non-HDL cholesterol, BMI, and WC the WHR. Dietary patterns and lifestyle were obtained from the independent variables, based on nutrients consumed and physical activity weekly. In the study of principal component analysis (PCA) was investigated associations between the patterns of cardiovascular risk factors in dietary patterns and lifestyle, age and positive family history of CVD, through bivariate and multiple logistic regression adjusted for sexual maturation. The low HDL-C dyslipidemia was most prevalent (50.5%) for adolescents. Significant correlations were observed between hypercholesterolemia and positive family history of CVD (r = 0.19, p <0.01) and hypertriglyceridemia with BMI (r = 0.30, p <0.01), with the CC (r = 0.32, p <0.01) and WHR (r = 0.33, p <0.01). The linear model constructed with sexual maturation, age and BMI explained about 1 to 10.4% of the variation in the lipid profile. The sources of variance between individuals were greater for all nutrients in both sexes. The reasons for variances were  1 for all nutrients were higher in females. The results suggest that to assess the diet of adolescents with greater precision, 2 days would be enough to R24h consumption of energy, carbohydrates, fiber, saturated and monounsaturated fatty acids. In contrast, 3 days would be recommended for protein, lipid, polyunsaturated fatty acids and cholesterol. Two cardiovascular risk factors as have been extracted in the ACP, referring to the dependent variables: the standard lipid profile (HDL-C and non-HDL cholesterol) and "standard anthropometric index (BMI, WC, WHR) with a power explaining 75% of the variance of the original data. The factors are representative of two independent variables led to dietary patterns, "pattern
130
western diet" and "pattern protein diet", and one on the lifestyle, "pattern energy balance". Together, these patterns provide an explanation power of 67%. Made adjustment for sexual maturation in males remained significant variables: the associations between puberty and be pattern anthropometric indicator (OR = 3.32, CI 1.34 to 8.17%), and between family history of CVD and the pattern lipid profile (OR = 2.62, CI 1.20 to 5.72%). In females adolescents, associations were identified between age after the first stage of puberty with anthropometric pattern (OR = 3.59, CI 1.58 to 8.17%) and lipid profile (OR = 0.33, CI 0.15 to 0.75%).
Conclusions: The low HDL-C was the most prevalent dyslipidemia independent of sex and nutritional status of adolescents. Hypercholesterolemia was influenced by family history of CVD and sexual maturation, in turn, hypertriglyceridemia was closely associated with anthropometric indicators. The variance between the diets was greater for all nutrients. This fact reflected in a variance ratio less than 1 and consequently in a lower number of days requerid to estimate the usual diet of adolescents considering gender. The two dietary patterns were extracted and the pattern considered unhealthy lifestyle as healthy. The associations were found between the patterns of CVD risk with age and family history of CVD in the studied adolescents / As dislipidemias e o excesso de peso corporal em adolescentes, quando associados, sugerem uma progress?o dos fatores de risco modific?veis para as doen?as cardiovasculares (DCV). Al?m destes, os h?bitos alimentares e de estilo de vida inadequados, tamb?m t?m sido considerados impactantes no desenvolvimento de doen?as cr?nicas. Os objetivos do estudo foram: (1) estimar a preval?ncia das altera??es do perfil lip?dico e correlacionar com o ?ndice de massa corporal (IMC), a circunfer?ncia da cintura (CC) e a raz?o cintura/altura (RCA) em adolescentes, considerando a matura??o sexual; (2) conhecer as fontes de vari?ncia da dieta e o n?mero de dias necess?rios para estimar a dieta habitual dos adolescentes e (3) descrever os padr?es diet?ticos e de estilo de vida dos adolescentes, a hist?ria familiar positiva de DCV e a idade e correlacion?-los com os padr?es de risco para DCV, ajustados pela matura??o sexual.
Foi conduzido um estudo transversal com 432 adolescentes de escolas p?blicas municipais da cidade do Natal, RN, Brasil, com idade entre 10-19 anos. As dislipidemias foram avaliadas considerando o perfil lip?dico, o ?ndice de Castelli I (CT/HDL) e II (LDL/HDL) e o colesterol n?o-HDL. Os indicadores antropom?tricos inclu?dos foram o IMC, a CC e a RCA. A ingest?o de energia, dos macronutrientes inclusive a fibra, dos ?cidos graxos e do colesterol foi estimada a partir de dois recordat?rios de 24h (R24h). As vari?veis do perfil lip?dico, antropom?tricas e cl?nicas foram usadas nos modelos de correla??o de Pearson e de regress?o linear multivariada, considerando a matura??o sexual. A raz?o de vari?ncia da dieta foi calculada entre o componente da vari?ncia intrapessoal e interpessoal, determinada pela an?lise de vari?ncia (ANOVA). A
xv
defini??o do n?mero de dias para a estimativa da ingest?o habitual de cada nutriente foi obtida considerando a correla??o hipot?tica de (r) ≥ 0,9, entre a ingest?o de nutrientes verdadeira e a observada. Utilizou-se a an?lise de componentes principais (ACP) como m?todo de extra??o dos fatores que representaram as vari?veis dependentes denominadas de risco cardiovascular e obtido a partir do perfil lip?dico, do ?ndice de Castelli I e II, do colesterol n?o-HDL, do IMC, da CC e da RCA. Os padr?es diet?ticos e do estilo de vida foram obtidos a partir das vari?veis independentes, com base nos nutrientes consumidos e na atividade f?sica semanal. No estudo da ACP foram investigadas as associa??es entre os padr?es de risco cardiovascular com os padr?es diet?ticos e do estilo de vida, idade e com a hist?ria familiar positiva de DCV, por meio da an?lise bivariada e regress?o log?stica m?ltipla ajustada pela matura??o sexual.
O baixo HDL-c foi a dislipidemia mais prevalente (50,5%) nos adolescentes. Foram verificadas correla??es significativas entre a hipercolesterolemia e a hist?ria familiar positiva de DCV (r=0,19, p<0,01); e a hipertrigliceridemia com o IMC (r=0,30, p<0,01), com a CC (r=0,32, p<0,01) e com a RCQ (r=0,33, p<0,01). O modelo linear constru?do com a matura??o sexual, idade e IMC explicaram cerca de 1 10,4% da varia??o dos valores do perfil lip?dico.
As fontes de vari?ncia interpessoal foram maiores para todos os nutrientes, em ambos os sexos. As raz?es de vari?ncias foram  1 para todos os nutrientes sendo mais elevadas no sexo feminino. Os resultados sugerem que para avaliar a dieta destes adolescentes, 2 dias de R24h seriam suficientes para consumo de energia, carboidratos, fibra, ?cidos graxos saturados e monoinsaturados. Diferentemente, 3 dias seria o recomendado para a prote?na,
xvi
lip?deos, os ?cidos graxos poliinsaturados e o colesterol. Dois fatores denominados de risco cardiovascular foram extra?dos na ACP, referentes ?s vari?veis dependentes: o padr?o perfil lip?dico (HDL-C e colesterol n?o-HDL) e o padr?o indicador antropom?trico (IMC, CC, RCA), com um poder de explica??o de 75% da vari?ncia dos dados originais. Os fatores representativos das vari?veis independentes originaram dois padr?es diet?ticos, padr?o dieta ocidental e padr?o dieta prot?ica ; e um relativo ao estilo de vida, padr?o equil?brio energ?tico . Em conjunto, estes padr?es fornecem um poder de explica??o de 67%. Feito o ajuste pela matura??o sexual, permaneceram significativas no sexo masculino as seguintes vari?veis: as associa??es entre ser p?bere e o padr?o indicador antropom?trico (OR=3,32, IC% 1,34-8,17); e entre a hist?ria familiar de DCV e o padr?o perfil lip?dico (OR=2,62, IC% 1,20-5,72). No sexo feminino, identificaram-se associa??es entre a idade ap?s a primeira fase da puberdade com os padr?es indicadores antropom?tricos (OR=3,59, IC% 1,58-8,17) e do perfil lip?dico (OR=0,33, IC% 0,15-0,75).
Conclus?es: O baixo HDL-c foi a mais prevalente dislipidemia independente do sexo e do estado nutricional dos adolescentes. A hipercolesterolemia teve influ?ncia da hist?ria familiar positiva de DCV e da matura??o sexual; por sua vez, a hipertrigliceridemia foi fortemente associada aos indicadores antropom?tricos. A vari?ncia interpessoal da dieta foi a maior para todos os nutrientes. Tal fato repercutiu em uma raz?o de vari?ncia menor que 1 e consequentemente em um menor n?mero de dias necess?rios para se estimar a dieta habitual dos adolescentes, considerando o sexo. Os dois padr?es diet?ticos extra?dos foram considerados n?o saud?veis e o padr?o estilo de vida como saud?vel. As associa??es encontradas foram entre os padr?es de
xvii
risco para DCV com a idade e a hist?ria familiar positiva de DCV nos adolescentes estudados
| Identifer | oai:union.ndltd.org:IBICT/oai:repositorio.ufrn.br:123456789/13215 |
| Date | 28 February 2011 |
| Creators | Lima, Severina Carla Vieira Cunha |
| Contributors | CPF:17547644449, http://lattes.cnpq.br/1863589790139155, Maranh?o, T?cia Maria de Oliveira, CPF:13049127449, http://lattes.cnpq.br/7869140767244263, Maranhao, H?lcio de Sousa, CPF:44435762404, http://lattes.cnpq.br/3263555213414154, Guerra, Ricardo Oliveira, CPF:39643069400, http://lattes.cnpq.br/4265185619165890, Cerqueira, M?nica Maria Os?rio de, CPF:25518909420, http://lattes.cnpq.br/9671375461391765, Marchioni, Dirce Maria Lobo, CPF:12656646847, http://lattes.cnpq.br/9059164202721558, Schwarzschild, L?cia de F?tima Campos Pedrosa |
| Publisher | Universidade Federal do Rio Grande do Norte, Programa de P?s-Gradua??o em Ci?ncias da Sa?de, UFRN, BR, Ci?ncias da Sa?de |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/doctoralThesis |
| Format | application/pdf |
| Source | reponame:Repositório Institucional da UFRN, instname:Universidade Federal do Rio Grande do Norte, instacron:UFRN |
| Rights | info:eu-repo/semantics/openAccess |
Page generated in 0.0026 seconds