Obesidade dinapênica e sarcopênica e risco cardiovascular em trabalhadores de uma unidade de saúde terciária: um estudo transversal
Obesidade dinapênica e sarcopênica e risco cardiovascular em trabalhadores de uma unidade de saúde terciária: um estudo transversal
Data
2024
Autores
Carvalho, Mariana de Oliveira
Journal Title
Journal ISSN
Volume Title
Publisher
Instituto Nacional de Cardiologia
Resumo
Introdução: A obesidade sarcopênica (OS) tem prevalência estimada em 11% no Brasil, com projeções de afetar 100-200 milhões globalmente em 35 anos. A obesidade dinapênica (OD), tem prevalência de 11% em pessoas com 60 anos ou mais no Brasil. As duas condições parecem estar relacionadas a um perfil metabólico disfuncional e maior risco cardiovascular. Objetivos: Avaliar associação de obesidade, dinapenia, obesidade dinapênica e obesidade sarcopênica com risco cardiovascular. Descrever o perfil antropométrico e bioquímico, a prevalência dessas condições e associar o risco cardiovascular aos perfis de obesidade. Métodos: Este foi um estudo transversal que analisou os dados antropométricos de 199 trabalhadores de uma unidade de saúde terciária entre novembro de 2018 e março de 2020. Os participantes foram estratificados nos perfis mioantropométricos: obeso, dinapênico, sarcopênico, não obeso / não dinapênicos (NO / ND), não obeso / dinapênicos (NO / D), obeso / não dinapênicos (O / ND) e obeso dinapênicos (OD). Considerando variáveis de antropometria e força muscular, associado a dados bioquímicos, foi avaliada associação dos perfis com risco cardiovascular por meio de: Índice Aterogênico (IA), Índice Aterogênico do Plasma (IAP), Cintura Hipertrigliceridêmica (CH), Índice de Forma Corporal (ABSI), Dislipidemia Aterogênica (DA), Índices de Castelli I e II, e Escore de Framingham (EF). Resultados: A média de idade dos voluntários foi de 45,1 anos. 40,7% dos voluntários eram homens e 59,3% eram mulheres. A mediana de força de preensão palmar foi de 40KgF nos homens e 23KgF nas mulheres. A prevalência de obesos foi de 37%, de dinapênicos 46,7 % considerando a mediana de força da amostra de 45,7% pelos pontos de corte de Shülussel et al. A prevalência de OD foi de 16,5% e 17%. O grupo com OD obteve HDL significativamente menor em relação a todos os demais e apresentavam maior IA e Índices de Castelli I e Castelli II em relação a todos os demais. Pelo Escore de Framingham, os OD possuíam maior risco cardiovascular em relação ao O / ND, e estes possuíam maior risco em relação aos NO / D. Quanto à variável IAP, o grupo O / ND apresentou 4,6 vezes mais chances de pontuar um IAP maior em relação aos NO / ND, enquanto os OD apresentaram 8.9 vezes mais chances de apresentar IAP de maior pontuação em relação aos NO / ND. O grupo OD apresentou ainda 15,2 vezes mais chances de apresentar IAP classificado como risco cardiovascular
aumentado em relação aos NO / ND. Conclusões: Os resultados deste estudo sugerem que a obesidade, dinapenia e obesidade dinapênica estão associadas positivamente ao risco cardiovascular na amostra estudada. A presença de obesidade parece ter sido mais determinante para o maior risco cardiovascular do que a dinapenia isolada, porém a OD apresentou predição de risco cardiovascular maior em relação aos indivíduos com apenas uma das duas comorbidades.
Palavras-chave: Obesidade, Sarcopenia, Dinapenia, Obesidade Dinapênica, Obesidade sarcopênica, Risco cardiovascular
ABSTRACT Introduction: Sarcopenic obesity (SO) has an estimated prevalence of 11% in Brazil, with projections indicating it could affect 100-200 million individuals globally within 35 years. Dynapenic obesity (DO) has a prevalence of 11% among individuals aged 60 and over in Brazil. Both conditions appear to be linked to a dysfunctional metabolic profile and an increased cardiovascular risk. Objectives: To evaluate the association of obesity, dynapenia, dynapenic obesity, and sarcopenic obesity with cardiovascular risk. To describe the anthropometric and biochemical profiles, the prevalence of these conditions, and to associate cardiovascular risk with obesity profiles. Methods: This was a cross-sectional study that analyzed the anthropometric data of 199 workers from a tertiary health unit between November 2018 and March 2020. Participants were stratified into myoanthropometric profiles: obese, dynapenic, sarcopenic, non-obese/non-dynapenic (NO/ND), non-obese/dynapenic (NO/D), obese/non-dynapenic (O/ND), and dynapenic obese (DO). Considering anthropometry and muscle strength variables, along with biochemical data, the association of profiles with cardiovascular risk was assessed through: Atherogenic Index (AI), Plasma Atherogenic Index (PAI), Hypertriglyceridemic Waist (HW), Body Shape Index (ABSI), Atherogenic Dyslipidemia (AD), Castelli’s Index I and II, and Framingham Score (FS). Results: The average age of the volunteers was 45.1 years. 40.7% of the volunteers were male and 59.3% were female. The median grip strength was 40KgF for men and 23KgF for women. The prevalence of obesity was 37%, and dynapenia was 46.7%, considering the sample's median strength of 45.7% by the cut-off points of Shülussel et al. The prevalence of DO was 16.5% and 17%. The DO group had significantly lower HDL compared to all others and had higher AI and Castelli’s Index I and II compared to all others. According to the Framingham Score, the DO group had a higher cardiovascular risk compared to the O/ND, and these had a higher risk compared to the NO/D. Regarding the PAI variable, the O/ND group was 4.6 times more likely to score a higher PAI compared to the NO/ND, while the DO group was 8.9 times more likely to present a higher scoring PAI compared to the NO/ND. The DO group also had 15.2 times more chances of presenting a PAI classified as increased cardiovascular risk compared to the NO/ND. Conclusions: The results of this study suggest that obesity, dynapenia, and dynapenic obesity are positively associated with cardiovascular risk in the studied sample. The presence of obesity seems to have been more determinant for the higher cardiovascular risk than dynapenia alone, however, DO presented a higher cardiovascular risk prediction compared to individuals with only one of the two comorbidities. Keywords: Obesity, Sarcopenia, Dynapenia, Dynapenic Obesity, Sarcopenic Obesity, Cardiovascular Risk.
ABSTRACT Introduction: Sarcopenic obesity (SO) has an estimated prevalence of 11% in Brazil, with projections indicating it could affect 100-200 million individuals globally within 35 years. Dynapenic obesity (DO) has a prevalence of 11% among individuals aged 60 and over in Brazil. Both conditions appear to be linked to a dysfunctional metabolic profile and an increased cardiovascular risk. Objectives: To evaluate the association of obesity, dynapenia, dynapenic obesity, and sarcopenic obesity with cardiovascular risk. To describe the anthropometric and biochemical profiles, the prevalence of these conditions, and to associate cardiovascular risk with obesity profiles. Methods: This was a cross-sectional study that analyzed the anthropometric data of 199 workers from a tertiary health unit between November 2018 and March 2020. Participants were stratified into myoanthropometric profiles: obese, dynapenic, sarcopenic, non-obese/non-dynapenic (NO/ND), non-obese/dynapenic (NO/D), obese/non-dynapenic (O/ND), and dynapenic obese (DO). Considering anthropometry and muscle strength variables, along with biochemical data, the association of profiles with cardiovascular risk was assessed through: Atherogenic Index (AI), Plasma Atherogenic Index (PAI), Hypertriglyceridemic Waist (HW), Body Shape Index (ABSI), Atherogenic Dyslipidemia (AD), Castelli’s Index I and II, and Framingham Score (FS). Results: The average age of the volunteers was 45.1 years. 40.7% of the volunteers were male and 59.3% were female. The median grip strength was 40KgF for men and 23KgF for women. The prevalence of obesity was 37%, and dynapenia was 46.7%, considering the sample's median strength of 45.7% by the cut-off points of Shülussel et al. The prevalence of DO was 16.5% and 17%. The DO group had significantly lower HDL compared to all others and had higher AI and Castelli’s Index I and II compared to all others. According to the Framingham Score, the DO group had a higher cardiovascular risk compared to the O/ND, and these had a higher risk compared to the NO/D. Regarding the PAI variable, the O/ND group was 4.6 times more likely to score a higher PAI compared to the NO/ND, while the DO group was 8.9 times more likely to present a higher scoring PAI compared to the NO/ND. The DO group also had 15.2 times more chances of presenting a PAI classified as increased cardiovascular risk compared to the NO/ND. Conclusions: The results of this study suggest that obesity, dynapenia, and dynapenic obesity are positively associated with cardiovascular risk in the studied sample. The presence of obesity seems to have been more determinant for the higher cardiovascular risk than dynapenia alone, however, DO presented a higher cardiovascular risk prediction compared to individuals with only one of the two comorbidities. Keywords: Obesity, Sarcopenia, Dynapenia, Dynapenic Obesity, Sarcopenic Obesity, Cardiovascular Risk.
Description
Palavras-chave
Obesidade, Sarcopenia, Dinapenia, Obesidade Dinapênica, Obesidade sarcopênica, Risco cardiovascular, Obesity, Sarcopenia, Dynapenia, Dynapenic Obesity, Sarcopenic Obesity, Cardiovascular Risk
Citação
Carvalho MC. Obesidade dinapênica e sarcopênica e risco cardiovascular em trabalhadores de uma unidade de saúde terciária: um estudo transversal. Rio de Janeiro. dissertação [Mestrado Profiossional em Ciências Cardiovasculares] Instituto Nacional de Cardiologia - INC; 2024.