Made available in DSpace on 2015-04-14T13:54:02Z (GMT). No. of bitstreams: 1
448864.pdf: 1967442 bytes, checksum: b1b3bc5be32c8fa705556a09dc483351 (MD5)
Previous issue date: 2013-03-11 / Introduction : Anthropometry is a simple and effective method to identify excess body fat and, therefore, individuals with higher risk for cardiovascular disease (CVD), in addition to being one of the diagnostic criteria for metabolic syndrome (MetS). During the course of aging, body composition changes occur, however, for most anthropometric measurements, no specific cut-off points have been determined for this age group, which are fundamental for prevention and management of CVD risk factors, especially in basic attention. Objective : to determine optimal cut-off points for anthropometric measurements [body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR) and waist-to-hip ratio (WHR)] for MetS and CVD in elderly served by the family health strategy. Methods : descriptive and analytical cross-sectional study, which evaluated 518 elderly, from 30 Family Health Strategy units from Porto Alegre, participants of the Epidemiological and Clinical Study of Elderly Served by the participants of seniors served by the Family Health Strategy of Porto Alegre (EMISUS). In anthropometric assessment were obtained the BMI, WC (obtained at the midpoint between the last rib and iliac crest), WHtR and WHR. For the diagnosis of MetS, we used the revised NCEP-ATPIII. To determine the risk of cardiovascular disease, we used the Framingham risk score. The cut-off points of anthropometric measurements were obtained from the construction of the ROC curves using the software SPSS (for analyses, individuals classified as intermediate and high risk were grouped together). Results : most of the sample was composed of 326 women (62.9%). The average age was 68.25?6.7 years (60-100 years). It was possible to establish the diagnosis for MetS in 469 individuals, being classified as suffering from MetS 334 individuals (71,2%). It was possible to determine the risk of CVD on 362 individuals, of who 186 were classified as low risk (51.4%), 144 as intermediate risk (39.8%) and 32 as high risk (8.8%). Considering MetS, the cut-off points with discriminatory power relevance were BMI≥26.8kg/m? for the total sample, ≥25.2kg/m? for men and ≥27.8kg/m? for women. For WC, the values were ≥93.7cm for the general population, ≥94.8cm for men and ≥91.7cm for women. For WHtR, found values of ≥0.59 for the total population, ≥0.57 for men and ≥0.61 for women. In relation to the WHR, the values were ≥0.95 to total population, ≥0.99 for men and ≥0.93 for women. To determine the risk of CVD, the most significant values were BMI ≥27.8kg/m? for the general population, WC ≥93.7cm for men, WHtR ≥0.57 for men and WHR ≥ 0.96 for the total population. Conclusion : for discrimination of SM, the areas under the curve of anthropometric parameters were representative, both in the total sample as between the genders. As for the discrimination of CVD risk intermediate/high, areas below the curve of BMI and WHR were representative only in the total sample, and of WC and WHtR only in men. / Introdu??o : a antropometria ? um m?todo simples e eficaz de identificar excesso de gordura corporal e, assim, indiv?duos com maior risco cardiovascular (RCV), al?m de ser um dos crit?rios diagn?sticos de s?ndrome metab?lica (SM). Ao longo do envelhecimento, ocorrem altera??es de composi??o corporal, contudo, para a maioria dos par?metros antropom?tricos, ainda n?o foram estabelecidos pontos de corte espec?ficos para esta faixa et?ria, os quais s?o fundamentais para preven??o e manejo dos fatores de RCV, especialmente na aten??o b?sica. Objetivo : determinar pontos de corte de par?metros antropom?tricos [?ndice de massa corporal (IMC), circunfer?ncia da cintura (CC), rela??o cintura/altura (RCA) e rela??o cintura/quadril (RCQ)] para SM e RCV em idosos atendidos pela Estrat?gia Sa?de da Fam?lia. M?todos : estudo transversal, descritivo e anal?tico, no qual foram avaliados 518 idosos, provenientes de 30 Estrat?gias Sa?de da Fam?lia de Porto Alegre, participantes do Estudo Epidemiol?gico e Cl?nico dos Idosos Atendidos pela Estrat?gia Sa?de da Fam?lia do Munic?pio de Porto Alegre (EMISUS). Na avalia??o antropom?trica, foram obtidos o IMC, CC (obtida no ponto m?dio entre a ?ltima costela e a crista il?aca), RCA e RCQ. Para o diagn?stico de SM, foi utilizado o crit?rio NCEP-ATPIII revisado. Para determina??o do risco cardiovascular, utilizou-se o Escore de Risco de Framingham. Os valores de ponto de corte dos par?metros antropom?tricos foram obtidos a partir da constru??o de curvas ROC pelo programa SPSS (para as an?lises, os indiv?duos classificados como risco intermedi?rio e alto foram agrupados). Resultados : A maioria da amostra foi composta por 326 mulheres (62,9%). A m?dia da idade foi 68,25?6,7 anos (60-100 anos). Foi poss?vel estabelecer o diagn?stico de SM em 469 indiv?duos, sendo classificados como portadores de SM 334 indiv?duos (71,2%). Foi poss?vel determinar o RCV em 362 indiv?duos, dos quais 186 foram classificados como risco baixo (51,4%), 144 risco intermedi?rio (39,8%) e 32 risco alto (8,8%). Considerando a SM, os pontos de corte com poder discriminante relevante foram IMC≥26,8kg/m? para a amostra total, ≥25,2kg/m? para homens e ≥27,8kg/m? para mulheres. Para CC, os valores foram ≥93,7cm para a popula??o geral, ≥94,8cm para homens e ≥91,7cm para mulheres. Para RCA, encontramos valores de ≥0,59 para a popula??o total, ≥0,57 para homens e ≥0,61 para mulheres. Em rela??o a RCQ, os valores foram ≥0,95 para popula??o total, ≥0,99 para homens e ≥0,93 para mulheres. Para determinar o RCV, os valores mais significantes foram IMC ≥27,8kg/m? para a popula??o geral, CC ≥93,7cm para homens, RCA ≥0,57 para homens e RCQ ≥0,96 para a popula??o total. Conclus?o : para discrimina??o de SM, as ?reas abaixo da curva dos par?metros antropom?tricos se mostraram representativas, tanto na amostra total quanto entre os sexos. J? para a discrimina??o de RCV intermedi?rio/alto, as ?reas abaixo da curva do IMC e da RCQ se mostraram representativas somente na amostra total e da CC e da RCA, somente no sexo masculino.
| Identifer | oai:union.ndltd.org:IBICT/oai:tede2.pucrs.br:tede/2704 |
| Date | 11 March 2013 |
| Creators | Rosemberg, Laura Schlatter |
| Contributors | Schwanke, Carla Helena Augustin |
| Publisher | Pontif?cia Universidade Cat?lica do Rio Grande do Sul, Programa de P?s-Gradua??o em Gerontologia Biom?dica, PUCRS, BR, Instituto de Geriatria e Gerontologia |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| Format | application/pdf |
| Source | reponame:Biblioteca Digital de Teses e Dissertações da PUC_RS, instname:Pontifícia Universidade Católica do Rio Grande do Sul, instacron:PUC_RS |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 4438661476953179033, 500, 600, 2296420844541114010 |
Page generated in 0.0058 seconds