Associação entre proteína C reativa ultrassensível e fatores de risco cardiovascular em adolescentes

• Autor(a) principal: Giannini, Denise Tavares
• Data de Publicação: 2015
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da UERJ
• Texto Completo: http://www.bdtd.uerj.br/handle/1/8596
• topic: Metabolic syndrome; Adolescents; Cardiovascular risk factors; High-sensitivity C-reactive protein; Obesity; Síndrome metabólica; Adolescente; Fatores de risco cardiovascular; Proteína C reativa ultrassensível; Obesidade; Obesidade na adolescência; Síndrome Metabólica; Proteína C; Doenças cardiovasculares; CNPQ::CIENCIAS DA SAUDE::SAUDE COLETIVA::EPIDEMIOLOGIA

Adolescent obesity is a major public health issue associated with cardiovascular risk factors, including abdominal obesity, insulin resistance, dyslipidemia and hypertension. The low-intensity chronic inflammation state typical of obesity can be an important pathophysiological link between increased adiposity and cardiovascular disease. This study aimed to verify the behavior of high-sensitivity C-reactive protein and its association with cardiovascular risk factors in adolescents. To achieve this objective two manuscripts were written, using data from ERICA (Study of Cardiovascular Risk in Adolescents). The analysis was adjusted for the sampling, using statistical routines for complex sample. In the first article, we have evaluated the association between anthropometric indicators and high-sensitivity C-reactive protein. 778 adolescents from Porto Alegre city were evaluated, and it was observed that high-sensitivity C-reactive protein showed a greater association with waist-to-height ratio [RP: 3.93 (95%CI 1.3-11.57); p<0.001] followed by index body mass [RP: 1.06 (95%CI 1.04-1.09); p<0.001], whereas there was no significant association with waist circumference (p=0.465) and conicity index (p=0.244). The purpose of the second article was to evaluate the association between high-sensitivity C-reactive protein with metabolic syndrome and their components in adolescents. The study has been evaluated 3,723 adolescents, being 864 from Porto Alegre, 1216 from Brasilia and 1643 from Rio de Janeiro. The median of high-sensitivity C-reactive protein was significantly higher in Porto Alegre (0.35 mg/L; IQR: 0.12 to 1.33), followed by Rio de Janeiro (0.23 mg / L; IQR: 0.12-1.12) and Brasilia (0.16 mg / L; IQR: 0.12-0.83). The median high-sensitivity C-reactive protein was 4.9 times higher in those with metabolic syndrome (0.93 mg/L; IQR: 0.51-2.52) than without metabolic syndrome (0.19 mg/L; IQR: 0.12-0.81). The association between high-sensitivity C-reactive protein and metabolic syndrome was significant, even after adjustment by insulin, sex, age, pubertal stage and skin color. The waist-to-height ratio has showed the anthropometric index more appropriate to evaluate inflammation and consequently cardiovascular risk, and high-sensitivity C-reactive protein is associated with metabolic syndrome. Therefore, inflammation may be an early event on the development of metabolic disorders in adolescents, suggesting that this marker can be an important cardio metabolic predictor in adolescents.