Obesidade abdominal e a morbimortalidade por doenças crônicas entre nipo-brasileiros: um estudo de coorte

• Autor(a) principal: Bevilacqua, Marselle Rodrigues [UNIFESP]
• Data de Publicação: 2010
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• dARK ID: ark:/48912/001300000hzzh
• Texto Completo: http://repositorio.unifesp.br/handle/11600/9877
• topic: Antropometria; Migrantes japoneses; Mortalidade; Obesidade abdominal; Doenças crônicas; Anthropometry; Abdominal obesity; Mortality; Chronic disease; Japanese migrants

Objective: To describe mortality (all causes and cardiovascular diseases) and incidences of diabetes and hypertension among Japanese-Brazilians according to the presence of abdominal obesity defined from different anthropometric measures. Methods: In this cohort study, we used in the mortality study data from 1567 Japanese-Brazilians (n = 727 in the diabetes incidence study and n = 655 in the hypertension incidence study) aged 30 years and both genders. The subjects were followed for 14 years and we collected at baseline socio-demographic, lifestyle, metabolic and anthropometric data. We defined as dependent variables (outcomes) the status at the end of the study (alive versus death from all causes or live versus death from cardiovascular diseases) and the occurrence of new cases of diabetes or hypertension (yes versus no). The presence of abdominal obesity at baseline according to each of the three anthropometric measures (waist circumference, waist-to-hip ratio and waist-to-height ratio) was the independent variable of principal interest. We estimated mortality rates and incidence of diabetes and hypertension, by point and by 95% confidence intervals. In multivariable analysis we used the Poisson model to obtain the adjusted mortality or incidence rate ratios and the presence of abdominal obesity. The ROC curve was used to identify anthropometric variables cutoff points with the best capacity to predict the interest outcomes, for each gender separately. Results: The overall mortality was 10.68/1,000 person-years and the diabetes and hypertension incidences were, respectively, 20.28/1,000 person-years and 49.81/1,000 person-years. It was noted at the beginning of the study, high prevalence of abdominal obesity (values between 38.5% and 74.4%). In analysis with multiple regression models, it was found that the presence of abdominal obesity by waist-to-hip ratio was associated with mortality. In addition, male gender, age 60 years and have hypertension were independent risk factors for mortality and work placement was a risk factor for developing diabetes. The cutoff points identified for waist circumference, waist-to-hip ratio and waist-to- height ratio, as indicative of the presence of abdominal obesity, especially among men, were lower than those proposed in the literature Conclusions: The prevalence of abdominal obesity was high among Japanese- Brazilians and waist-to-hip ratio was an independent risk factor for mortality. It is necessary to reevaluate the cutoff points proposed in the literature, particularly among men, considering the differences in body composition of different ethnic groups.