Luciane Bresciani Salaroli

Prevalência de síndrome metabólica em estudo de base populacional, Vitória, ES - Brasil

Metabolic Syndrome (MS) is a complex disorder including several factors predisposing to development of cardiovascular diseases and diabetes. Despite the importance of MS for the health system, the epidemiological characteristics of this condition in the Brazilian population are still scarce. The prevalence of MS as a function of gender, age and socioeconomic level was determined in a population-based study in Vitória, ES, Brazil, by using the NCEP-ATPIII diagnosis criteria. Socioeconomic, biochemical, anthropometric, and hemodynamic data were obtained in 1,663 individuals from a random sample of Vitória population (25-64 y). The estimated prevalence of MS was 29,8% (CI95 = 28-32%). No significant sex-related differences were observed. Prevalence increased from the youngest (26-34 y) to the oldest (55-64 y) group (15.8% and 48.3%, respectively). A progressive increase of MS frequency was observed in women from the higher to the lowest socioeconomic level. The most frequent trait of MS in males was high blood pressure, followed by hypertriglyceridemia, low HDL-c levels, hyperglycemia, and central obesity. In females, hypertension was also the most frequent factor, followed by low HDL-c levels, abdominal obesity, hypertriglyceridemia and hyperglycemia. Our data show that prevalence of MS is high in the studied population, even in the youngest group. Moreover, high blood pressure gives a significant contribution to the diagnosis of this syndrome in both sexes. The precocious control of risk factors is necessary to reduce the impact of cardiovascular morbidity and mortality.

Gender Distribution of Serum Uric Acid and Cardiovascular Risk Factors: Population Based Study

FUNDAMENTO: Nao ha dados relativos a epidemiologia da hiperuricemia em estudos brasileiros de base populacional. OBJETIVO: Investigar a distribuicao de acido urico serico e sua relacao com variaveis demograficas e cardiovasculares. METODOS: Estudamos 1.346 individuos. A hiperuricemia foi definida como > 6,8 e > 5,4 mg/dL para homens e mulheres, respectivamente. A sindrome metabolica (SM) foi definida utilizando-se os criterios NCEP ATP III. RESULTADOS: A prevalencia de hiperuricemia foi de 13,2%. A associacao de acido urico serico (AUS) com fatores de risco cardiovasculares foi especifica para o genero: em mulheres, maiores niveis de AUS estiveram associados com IMC elevado, mesmo apos ajustes da pressao arterial sistolica para idade (PAS). Em homens, a relacao do AUS com o colesterol HDL esteve mediada pelo IMC, enquanto em mulheres, o AUS mostrou-se semelhante e dependente do IMC, independentemente dos niveis glicose e presenca de hipertensao. Nos homens, os triglicerideos, a circunferencia abdominal (CA) e a PAS explicaram 11%, 4% e 1% da variabilidade do AUS, respectivamente. Nas mulheres, a circunferencia abdominal e os triglicerideos explicaram 9% e 1% da variabilidade de AUS, respectivamente. Em comparacao com o primeiro quartil, homens e mulheres no quarto quartil apresentavam 3,29 e 4,18 vezes mais de aumento de risco de SM, respectivamente. As mulheres apresentaram uma prevalencia quase tres vezes maior de diabetes melito. Homens normotensos com MS apresentaram maiores niveis de AUS, independente do IMC. CONCLUSAO: Nossos resultados parecem justificar a necessidade de uma avaliacao baseada no genero em relacao a associacao do AUS com fatores de risco cardiovasculares, que se mostraram mais acentuados em mulheres. A SM esteve positivamente associada com AUS elevado, independentemente do genero. A obesidade abdominal e a hipertrigliceridemia foram os principais fatores associados com a hiperuricemia mesmo em individuos normotensos, o que pode adicionar maior risco para a hipertensao.BACKGROUND There is no data concerning the epidemiology of hyperuricemia in Brazilian population-based studies. OBJECTIVE To investigate the distribution of serum uric acid and its relationship with demographics and cardiovascular variables. METHODS We studied 1,346 individuals. Hyperuricemia was defined as ≥ 6.8 and ≥ 5.4 mg/dL for men and women, respectively. Metabolic syndrome (MS) was defined with NCEP ATP III criteria. RESULTS The prevalence of hyperuricemia was 13.2%. The association of serum uric acid (SUA) with cardiovascular risk factors was gender-specific: in women, higher SUA was associated with increasing BMI, even after adjustments for age-systolic blood pressure (SBP). In men, the relationship of SUA with HDLc was mediated by BMI, whereas in women, SUA was similar and dependent on BMI, regardless of glucose levels and presence of hypertension. In men, triglycerides, waist circumference (WC) and SBP explained 11%, 4% and 1% of SUA variability, respectively. In women, WC and triglycerides explained 9% and 1% of SUA variability, respectively. Compared to the first quartile, men and women in the fourth quartile had a 3.29 fold and 4.18 fold increase of MS risk, respectively. Women had almost three fold higher prevalence of diabetes mellitus. Normotensive men with MS presented higher SUA, regardless of BMI. CONCLUSION Our results seem to justify the need for gender-based evaluation regarding the association of SUA with cardiovascular risk factors, which was more pronounced in women. MS was positively associated with increasing SUA, regardless of gender. Abdominal obesity and hypertriglyceridemia were the main factors associated with hyperuricemia even in normotensive individuals, which may add a higher risk for hypertension.

Distribuição por gênero de ácido úrico sérico e fatores de risco cardiovascular: estudo populacional

FUNDAMENTO: Nao ha dados relativos a epidemiologia da hiperuricemia em estudos brasileiros de base populacional. OBJETIVO: Investigar a distribuicao de acido urico serico e sua relacao com variaveis demograficas e cardiovasculares. METODOS: Estudamos 1.346 individuos. A hiperuricemia foi definida como > 6,8 e > 5,4 mg/dL para homens e mulheres, respectivamente. A sindrome metabolica (SM) foi definida utilizando-se os criterios NCEP ATP III. RESULTADOS: A prevalencia de hiperuricemia foi de 13,2%. A associacao de acido urico serico (AUS) com fatores de risco cardiovasculares foi especifica para o genero: em mulheres, maiores niveis de AUS estiveram associados com IMC elevado, mesmo apos ajustes da pressao arterial sistolica para idade (PAS). Em homens, a relacao do AUS com o colesterol HDL esteve mediada pelo IMC, enquanto em mulheres, o AUS mostrou-se semelhante e dependente do IMC, independentemente dos niveis glicose e presenca de hipertensao. Nos homens, os triglicerideos, a circunferencia abdominal (CA) e a PAS explicaram 11%, 4% e 1% da variabilidade do AUS, respectivamente. Nas mulheres, a circunferencia abdominal e os triglicerideos explicaram 9% e 1% da variabilidade de AUS, respectivamente. Em comparacao com o primeiro quartil, homens e mulheres no quarto quartil apresentavam 3,29 e 4,18 vezes mais de aumento de risco de SM, respectivamente. As mulheres apresentaram uma prevalencia quase tres vezes maior de diabetes melito. Homens normotensos com MS apresentaram maiores niveis de AUS, independente do IMC. CONCLUSAO: Nossos resultados parecem justificar a necessidade de uma avaliacao baseada no genero em relacao a associacao do AUS com fatores de risco cardiovasculares, que se mostraram mais acentuados em mulheres. A SM esteve positivamente associada com AUS elevado, independentemente do genero. A obesidade abdominal e a hipertrigliceridemia foram os principais fatores associados com a hiperuricemia mesmo em individuos normotensos, o que pode adicionar maior risco para a hipertensao.BACKGROUND There is no data concerning the epidemiology of hyperuricemia in Brazilian population-based studies. OBJECTIVE To investigate the distribution of serum uric acid and its relationship with demographics and cardiovascular variables. METHODS We studied 1,346 individuals. Hyperuricemia was defined as ≥ 6.8 and ≥ 5.4 mg/dL for men and women, respectively. Metabolic syndrome (MS) was defined with NCEP ATP III criteria. RESULTS The prevalence of hyperuricemia was 13.2%. The association of serum uric acid (SUA) with cardiovascular risk factors was gender-specific: in women, higher SUA was associated with increasing BMI, even after adjustments for age-systolic blood pressure (SBP). In men, the relationship of SUA with HDLc was mediated by BMI, whereas in women, SUA was similar and dependent on BMI, regardless of glucose levels and presence of hypertension. In men, triglycerides, waist circumference (WC) and SBP explained 11%, 4% and 1% of SUA variability, respectively. In women, WC and triglycerides explained 9% and 1% of SUA variability, respectively. Compared to the first quartile, men and women in the fourth quartile had a 3.29 fold and 4.18 fold increase of MS risk, respectively. Women had almost three fold higher prevalence of diabetes mellitus. Normotensive men with MS presented higher SUA, regardless of BMI. CONCLUSION Our results seem to justify the need for gender-based evaluation regarding the association of SUA with cardiovascular risk factors, which was more pronounced in women. MS was positively associated with increasing SUA, regardless of gender. Abdominal obesity and hypertriglyceridemia were the main factors associated with hyperuricemia even in normotensive individuals, which may add a higher risk for hypertension.

Prevalence of metabolic syndrome and related factors in bank employees according to different defining criteria, Vitória/ES, Brazil

OBJECTIVE: To determine the prevalence of metabolic syndrome and related factors in bank employees in the city of Vitoria/ES, Brazil. METHODS: This was a cross-sectional study that included 521 working men and women ≥20 years of age. Sociodemographic, lifestyle, anthropometric, biochemical, and hemodynamic characteristics were collected. Metabolic syndrome was diagnosed using the criteria of the National Cholesterol Education Program-ATPIII and the International Diabetes Federation. A logistic regression model was used to calculate the crude and adjusted OR of the variables, and the statistical level of significance was set at 5.0%. RESULTS: We identified 86 (17.2%) and 113 (22.6%) subjects with metabolic syndrome according to the criteria of the National Cholesterol Education Program-ATPIII and the International Diabetes Federation, respectively. The risk of developing metabolic syndrome was higher in individuals with a high school education (OR 2.6 [CI95%, 1.1-6.1]). In overweight and obese subjects, the risks were also higher (OR 12.6 [CI95%, 4.8-33.2, p = 0.000] and OR 43.7% [CI95%, 16.1-118.9, p = 0.000], respectively). CONCLUSION: A large number of bank employees have metabolic syndrome, which can be associated with an increased risk of developing cardiovascular disease. Individuals who had college degrees had a higher prevalence of metabolic syndrome; this finding can be explained by the high rates of overweight and obesity found in subjects with college and graduate school educations.

Autoavaliação do estado de saúde e fatores associados: um estudo em trabalhadores bancários

O objetivo deste trabalho foi verificar como trabalhadores bancarios avaliam seu estado de saude e os principais fatores associados a esse indicador nessa populacao. Trata-se de um estudo transversal com 525 funcionarios de uma rede bancaria do Estado do Espirito Santo, Brasil. A magnitude das associacoes foi avaliada atraves de regressao logistica hierarquizada em niveis. Verificou-se que 17% (n = 87) dos bancarios autoavaliaram seu estado de saude como regular ou ruim. Estiveram associados a pior autoavaliacao de saude o reduzido nivel socioeconomico (OR = 1,80; IC95%: 1,06-3,05), o estilo de vida sedentario (OR = 2,64; IC95%: 1,42-4,89), o excesso de peso (OR = 3,18; IC95%: 1,79-5,65), o baixo apoio social (OR = 3,71; IC95%: 2,10-6,58) e a presenca de doencas cronicas (OR = 5,49; IC95%: 2,46-12,27). Concluiu-se que, comparado com outras localidades, houve um expressivo numero de bancarios que autoavaliaram seu estado de saude como regular ou ruim, e que a presenca de doencas cronicas apresentou-se como o fator de maior impacto sobre a forma como o individuo avalia sua propria saude.The aim of this study was to determine how bank employees assess their health status and risk factors associated with this indicator in this population. This is a cross-sectional study involving 525 workers of a banking system in the State of Espírito Santo, Brazil. The magnitude of the associations was assessed using logistic regression hierquizada in levels. It was found that 17% (n = 87) of bank self-rated their health status as fair or poor. Were associated with worse self-assessed health of the low socioeconomic level (OR = 1.80; 95%CI: 1.06-3.05), the sedentary lifestyle (OR = 2.64; 95%CI: 1.42-4.89), the excess weight (OR = 3.18; 95%CI: 1.79-5.65), low social support (OR = 3.71; 95%CI: 2.10-6.58), and the presence of chronic diseases (OR = 5,49; 95%CI: 2.46-12.27). It is concluded that, compared with other locations, there was a significant number of banking that self-rated their health status as fair or poor, and that the presence of chronic diseases was presented as the factor with the greatest impact on how the individual evaluates their own health.

Distribución por género del ácido úrico sérico y factores de riesgo cardiovascular: estudio poblacional

FUNDAMENTO: Nao ha dados relativos a epidemiologia da hiperuricemia em estudos brasileiros de base populacional. OBJETIVO: Investigar a distribuicao de acido urico serico e sua relacao com variaveis demograficas e cardiovasculares. METODOS: Estudamos 1.346 individuos. A hiperuricemia foi definida como > 6,8 e > 5,4 mg/dL para homens e mulheres, respectivamente. A sindrome metabolica (SM) foi definida utilizando-se os criterios NCEP ATP III. RESULTADOS: A prevalencia de hiperuricemia foi de 13,2%. A associacao de acido urico serico (AUS) com fatores de risco cardiovasculares foi especifica para o genero: em mulheres, maiores niveis de AUS estiveram associados com IMC elevado, mesmo apos ajustes da pressao arterial sistolica para idade (PAS). Em homens, a relacao do AUS com o colesterol HDL esteve mediada pelo IMC, enquanto em mulheres, o AUS mostrou-se semelhante e dependente do IMC, independentemente dos niveis glicose e presenca de hipertensao. Nos homens, os triglicerideos, a circunferencia abdominal (CA) e a PAS explicaram 11%, 4% e 1% da variabilidade do AUS, respectivamente. Nas mulheres, a circunferencia abdominal e os triglicerideos explicaram 9% e 1% da variabilidade de AUS, respectivamente. Em comparacao com o primeiro quartil, homens e mulheres no quarto quartil apresentavam 3,29 e 4,18 vezes mais de aumento de risco de SM, respectivamente. As mulheres apresentaram uma prevalencia quase tres vezes maior de diabetes melito. Homens normotensos com MS apresentaram maiores niveis de AUS, independente do IMC. CONCLUSAO: Nossos resultados parecem justificar a necessidade de uma avaliacao baseada no genero em relacao a associacao do AUS com fatores de risco cardiovasculares, que se mostraram mais acentuados em mulheres. A SM esteve positivamente associada com AUS elevado, independentemente do genero. A obesidade abdominal e a hipertrigliceridemia foram os principais fatores associados com a hiperuricemia mesmo em individuos normotensos, o que pode adicionar maior risco para a hipertensao.BACKGROUND There is no data concerning the epidemiology of hyperuricemia in Brazilian population-based studies. OBJECTIVE To investigate the distribution of serum uric acid and its relationship with demographics and cardiovascular variables. METHODS We studied 1,346 individuals. Hyperuricemia was defined as ≥ 6.8 and ≥ 5.4 mg/dL for men and women, respectively. Metabolic syndrome (MS) was defined with NCEP ATP III criteria. RESULTS The prevalence of hyperuricemia was 13.2%. The association of serum uric acid (SUA) with cardiovascular risk factors was gender-specific: in women, higher SUA was associated with increasing BMI, even after adjustments for age-systolic blood pressure (SBP). In men, the relationship of SUA with HDLc was mediated by BMI, whereas in women, SUA was similar and dependent on BMI, regardless of glucose levels and presence of hypertension. In men, triglycerides, waist circumference (WC) and SBP explained 11%, 4% and 1% of SUA variability, respectively. In women, WC and triglycerides explained 9% and 1% of SUA variability, respectively. Compared to the first quartile, men and women in the fourth quartile had a 3.29 fold and 4.18 fold increase of MS risk, respectively. Women had almost three fold higher prevalence of diabetes mellitus. Normotensive men with MS presented higher SUA, regardless of BMI. CONCLUSION Our results seem to justify the need for gender-based evaluation regarding the association of SUA with cardiovascular risk factors, which was more pronounced in women. MS was positively associated with increasing SUA, regardless of gender. Abdominal obesity and hypertriglyceridemia were the main factors associated with hyperuricemia even in normotensive individuals, which may add a higher risk for hypertension.

Insulin resistance and associated factors: a cross-sectional study of bank employees

OBJECTIVE: Insulin resistance is characterized by the failure of target cells to respond to normal levels of circulating insulin, and this condition is related to cardiovascular disease. This study sought to evaluate the prevalence of insulin resistance and its association with markers of metabolic abnormalities and metabolic syndrome in bank employees. METHODS: A cross-sectional study was performed on 498 working men and women aged ≥20 years old. The Homeostasis Model Assessment (HOMA-IR) was used to determine the presence of insulin resistance based on cut-off values of ≤2.71 for normal insulin levels and >2.71 for insulin resistance, as established for the adult Brazilian population. RESULTS: It was observed that the 52 (10.4%) overweight individuals with insulin resistance were 4.97 times (95%CI 1.31-18.83) more likely to have high HOMA-IR values than the normal-weight participants; among those who were obese, the likelihood increased to 17.87 (95%CI 4.36-73.21). Individuals with large waist circumferences were 3.27 times (95%CI 1.03-10.38) more likely to develop insulin resistance than those who were within normal parameters. The HOMA-IR values differed between subjects with and without metabolic syndrome, with values of 2.83±2.5 and 1.10±0.81 (p=0.001), respectively. The levels of insulin, ultrasensitive C-reactive protein and uric acid were also associated with insulin resistance. CONCLUSION: The prevalence of insulin resistance among bank employees is high, and insulin resistance is associated with and serves as a marker of metabolic syndrome. Cardiovascular disease and metabolic syndrome-associated metabolic abnormalities were observed, and insulin resistance may be a risk factor in this group of professionals.

Metabolic syndrome and C-reactive protein in bank employees.

Background The ultrasensitive C-reactive protein (us-CRP) is used for the diagnosis of cardiovascular disease, but it is not well described as a marker for the diagnosis of metabolic syndrome (MS). Methods An observational and transversal study of bank employees evaluated anthropometric, hemodynamic, and biochemical data. CRP values were determined using commercial kits from Roche Diagnostics Ltd, and MS criteria were analyzed according to National Cholesterol Education Program’s – Adult Treatment Panel III (NCEP/ATP III). Results A total of 88 individuals had MS, and 77.3% (n=68) of these showed alterations of us-CRP (P=0.0001, confidence interval [CI] 0.11–0.34). Individuals with MS had higher mean values of us-CRP in global measures (P=0.0001) and stratified by sex (P=0.004) than individuals without the syndrome. This marker exhibited significant differences with varying criteria for MS, such as waist circumference (P=0.0001), triglycerides (P=0.002), and diastolic blood pressure (P=0.007), and the highest levels of us-CRP were found in individuals with more MS criteria. Conclusion us-CRP was strongly associated with the presence of MS and MS criteria in this group of workers. us-CRP is a useful and effective marker for identifying the development of MS and may be used as a reference in routine care.

Self-assessment of health status and associated factors: a study in bank workers

O objetivo deste trabalho foi verificar como trabalhadores bancarios avaliam seu estado de saude e os principais fatores associados a esse indicador nessa populacao. Trata-se de um estudo transversal com 525 funcionarios de uma rede bancaria do Estado do Espirito Santo, Brasil. A magnitude das associacoes foi avaliada atraves de regressao logistica hierarquizada em niveis. Verificou-se que 17% (n = 87) dos bancarios autoavaliaram seu estado de saude como regular ou ruim. Estiveram associados a pior autoavaliacao de saude o reduzido nivel socioeconomico (OR = 1,80; IC95%: 1,06-3,05), o estilo de vida sedentario (OR = 2,64; IC95%: 1,42-4,89), o excesso de peso (OR = 3,18; IC95%: 1,79-5,65), o baixo apoio social (OR = 3,71; IC95%: 2,10-6,58) e a presenca de doencas cronicas (OR = 5,49; IC95%: 2,46-12,27). Concluiu-se que, comparado com outras localidades, houve um expressivo numero de bancarios que autoavaliaram seu estado de saude como regular ou ruim, e que a presenca de doencas cronicas apresentou-se como o fator de maior impacto sobre a forma como o individuo avalia sua propria saude.The aim of this study was to determine how bank employees assess their health status and risk factors associated with this indicator in this population. This is a cross-sectional study involving 525 workers of a banking system in the State of Espírito Santo, Brazil. The magnitude of the associations was assessed using logistic regression hierquizada in levels. It was found that 17% (n = 87) of bank self-rated their health status as fair or poor. Were associated with worse self-assessed health of the low socioeconomic level (OR = 1.80; 95%CI: 1.06-3.05), the sedentary lifestyle (OR = 2.64; 95%CI: 1.42-4.89), the excess weight (OR = 3.18; 95%CI: 1.79-5.65), low social support (OR = 3.71; 95%CI: 2.10-6.58), and the presence of chronic diseases (OR = 5,49; 95%CI: 2.46-12.27). It is concluded that, compared with other locations, there was a significant number of banking that self-rated their health status as fair or poor, and that the presence of chronic diseases was presented as the factor with the greatest impact on how the individual evaluates their own health.

Autoevaluación del estado de salud y factores asociados: un estudio en empleados del banco

O objetivo deste trabalho foi verificar como trabalhadores bancarios avaliam seu estado de saude e os principais fatores associados a esse indicador nessa populacao. Trata-se de um estudo transversal com 525 funcionarios de uma rede bancaria do Estado do Espirito Santo, Brasil. A magnitude das associacoes foi avaliada atraves de regressao logistica hierarquizada em niveis. Verificou-se que 17% (n = 87) dos bancarios autoavaliaram seu estado de saude como regular ou ruim. Estiveram associados a pior autoavaliacao de saude o reduzido nivel socioeconomico (OR = 1,80; IC95%: 1,06-3,05), o estilo de vida sedentario (OR = 2,64; IC95%: 1,42-4,89), o excesso de peso (OR = 3,18; IC95%: 1,79-5,65), o baixo apoio social (OR = 3,71; IC95%: 2,10-6,58) e a presenca de doencas cronicas (OR = 5,49; IC95%: 2,46-12,27). Concluiu-se que, comparado com outras localidades, houve um expressivo numero de bancarios que autoavaliaram seu estado de saude como regular ou ruim, e que a presenca de doencas cronicas apresentou-se como o fator de maior impacto sobre a forma como o individuo avalia sua propria saude.The aim of this study was to determine how bank employees assess their health status and risk factors associated with this indicator in this population. This is a cross-sectional study involving 525 workers of a banking system in the State of Espírito Santo, Brazil. The magnitude of the associations was assessed using logistic regression hierquizada in levels. It was found that 17% (n = 87) of bank self-rated their health status as fair or poor. Were associated with worse self-assessed health of the low socioeconomic level (OR = 1.80; 95%CI: 1.06-3.05), the sedentary lifestyle (OR = 2.64; 95%CI: 1.42-4.89), the excess weight (OR = 3.18; 95%CI: 1.79-5.65), low social support (OR = 3.71; 95%CI: 2.10-6.58), and the presence of chronic diseases (OR = 5,49; 95%CI: 2.46-12.27). It is concluded that, compared with other locations, there was a significant number of banking that self-rated their health status as fair or poor, and that the presence of chronic diseases was presented as the factor with the greatest impact on how the individual evaluates their own health.