Dislipidemia em escolares jujeños com excesso de peso avaliado pelo programa de saúde escolar
DOI:
https://doi.org/10.31053/1853.0605.v76.n3.23817Palavras-chave:
dislipidemia, crianças, obesidade, excesso de pesoResumo
RESUMO
Introdução: Excesso de peso (EP) e alterações no metabolismo lipídico são fatores de risco para doenças cardiovasculares em adultos e crianças. Neste estudo, a prevalência de dislipidemia em escolares de Jujuy com EP é analisada.
População e métodos: Estudo descritivo, transversal, com 891 escolares entre 10 e 14 anos de idade (367 mulheres, 524 homens) da província de Jujuy (noroeste da Argentina). As prevalências de dislipidemia foram calculadas para o sobrepeso (SP) e obesidade (OB), determinadas de acordo com os pontos de corte da Força Tarefa Internacional para Obesidade. As prevalências de alterações lipídicas foram analisadas e sete perfis dislipidêmicos foram estabelecidos. As comparações e associações entre variáveis foram analisadas com o teste Qui quadrado. Odds ratios brutos e ajustados foram estimados a partir de uma regressão logística.
Resultados: Independentemente do sexo e estado nutricional de 13,7%, 21,8% e 16,5% dos alunos tinham colesterol total, triglicérides e colesterol LDL elevado, respectivamente, e 20,3% de colesterol HDL baixo. Valores significativamente mais elevados de colesterol HDL em SP e triglicérides em OB foram observados. Houve uma associação significativa entre OB e triglicérides elevados. Crianças em idade escolar com OB apresentam 54% mais chances de apresentar pelo menos um distúrbio lipídico.
Conclusão: A EP, e especialmente a OB, constitui um importante fator de risco para o desenvolvimento de dislipidemia em escolares de Jujuy.
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Referências
Wang Y, Lobstein T. Worldwide trends in childhood overweight and obesity. Inter J Pediat Obesity. 2006; 1: 11–25.
Peña M, Bacallao J??. La obesidad en la pobreza: un nuevo reto para la salud pública. OPS. 2000. Disponible en: http://www.who.int/iris/handle/10665/170604.
Kovalskys I, Bay L, Rausch Herscovici C, et al. Prevalencia de obesidad en una población de 10 a 19 años en la consulta pediátrica. Arch Argent Pediatr. 2003; 101(6):1-7.
Linetzkya B, Morello P, Virgolinia M, et al. Resultados de la Primera Encuesta Nacional de Salud Escolar. Argentina. Arch Argent Pediatr. 2011; 109(2):111-116.
Bejarano IF, Dipierri J, Alfaro E, et al. Evolución de la prevalencia de sobrepeso, obesidad y desnutrición en escolares de San Salvador de Jujuy. Arch Argent Pediatr. 2005;103(2):101-109.
Meyer E, Carrillo R, Román E, et al. Prevalencia de sobrepeso y obesidad en escolares jujeños de diferente nivel altitudinal según las referencias IOTF, CDC y OMS. Arch argent pediatr, 2013; 111(6), 0-0.
Pedrozo WR, Bonneau G, Castillo Rascón MS, et al. Valores de referencia y prevalencia de las alteraciones del perfil lipídico en adolescentes. Arch argent Pediatr. 2010;108(2):107-115.
Cook S, Kavey RE. Dyslipidemia and pediatric obesity. Pediatr Clin North Am. 2011;58(6):1363-73.
Daniels SR. Complications of obesity in children and adolescents. International Journal of Obesity. 2009; 33:60-65
Sociedad Argentina de Pediatría (SAP). Comite de Nutricion.
Consensus on management of dyslipidemia in pediatrics. Arch argent pediatr. 2015;113:177-187.
Lim H, Xue H, Wang Y. Association between obesity and metabolic co-morbidities among children and adolescents in South Korea based on national data. BMC Public Health. 2014;14:279.
Weiss R, Dziura J, Burgert TS, et al. Obesity and the metabolic syndrome in children and adolescents. New England journal of medicine. 2004; 350(23): 2362-2374.
Jessup A, Harrell JS. The metabolic syndrome: look for it in children and adolescents, too!. Clinical diabetes. 2005; 23(1): 26-32.
Casavalle PL, Lifshitz F, Romano LS, Pet al. Prevalence of dyslipidemia and metabolic syndrome risk factor in overweight and obese children. Pediatr Endocrinol Rev. 2014;12(2):213-23.
INDEC. Censo Nacional de Población, Hogares y Viviendas 2001.
INDEC. Censo Nacional de Población, Hogares y Viviendas 2010. Disponible en: http://www.indec.gov.ar/censos_provinciales.asp?id_tema_1=2&id_tema_2=41&id_tema_3=135&p=38&d=000&t=3&s=1&c=2010.
Cole TJ, Bellizi MC, Flegal KM. Establishing a standard definition for child overweight and obesity worlwide international survey. BMJ. 2000;320:1240-3.
National Cholesterol Education Program (NCEP): highlights of the report of the Expert Panel on Blood Cholesterol Levels in Children and Adolescents. Pediatrics. 1992;89:495-501.
Reich JD, Miller S, Brogdon B, et al. American Heart Association guidelines for primary prevention of atherosclerotic cardiovascular disease beginning in childhood. Circulation 2003;107:1562-6. co-published in J Pediatr 2003;142:368-72.
Lee J, Lauer RM, Clarke WR. Lipoproteins in the progeny of young men with coronary artery disease: children with increased risk. Pediatrics. 1986;78(2):330-337.
Kwiterovich Jr PO. Recognition and management of dyslipidemia in children and adolescents. The Journal of Clinical Endocrinology & Metabolism. 2008;93(11):4200-4209.
Hirschler V, Gonzalez C, Molinari C. Prevalence and Distribution of Lipid Concentrations among Argentina's School Children. Childhood Obesity. 2011;7(4): 298-305.
Dathan-Stumpf A, Vogel M, Hiemisch A, et al. Pediatric reference data of serum lipids and prevalence of dyslipidemia: Results from a population-based cohort in Germany. Clinical biochemistry. 2016:49(10-11), 740-749.
Margolis KL, Greenspan LC, Trower NK, et al. Lipid screening in children and adolescents in community practice: 2007 to 2010. Circ Cardiovasc Qual Outcomes. 2014;7(5):718-726.
Hirschler V, Gonzalez C, Maccallini G, et al. Comparison Between HDL-C Levels in Argentine Indigenous Children Living at High Altitudes and U.S. Children. Diabetes Technol Ther 2016;18(4):233-9.
US Department of Health and Human Services. Vol II: The Prevalence Study Nutrient Intake. The Lipid Research Clinics Population Studies Data Book. 1980. NIH Pub. No. 80-1527: Bethesda, MD: NIH.
Lee JM, Gebremariam A, Card-Higginson P, et al. Poor performance of body mass index as a marker for hypercholesterolemia in children and adolescents. Arch Pediatr Adolesc Med. 2009;163(8):716-23.
Lozano P, Henrikson NB, Morrison CC, et al. Lipid screening in childhood and adolescence for detection of multifactorial dyslipidemia: evidence report and systematic review for the US Preventive Services Task Force. JAMA. doi:10.1001/jama.2016.6423.
Wang Y, Lobstein T. Worldwide trends in childhood overweight and obesity. Inter J Pediat Obesity. 2006; 1: 11–25. Peña M, Bacallao J??. La obesidad en la pobreza: un nuevo reto para la salud pública. OPS. 2000. Disponible en: http://www.who.int/iris/handle/10665/170604. Kovalskys I, Bay L, Rausch Herscovici C, et al. Prevalencia de obesidad en una población de 10 a 19 años en la consulta pediátrica. Arch Argent Pediatr. 2003; 101(6):1-7. Linetzkya B, Morello P, Virgolinia M, et al. Resultados de la Primera Encuesta Nacional de Salud Escolar. Argentina. Arch Argent Pediatr. 2011; 109(2):111-116. Bejarano IF, Dipierri J, Alfaro E, et al. Evolución de la prevalencia de sobrepeso, obesidad y desnutrición en escolares de San Salvador de Jujuy. Arch Argent Pediatr. 2005;103(2):101-109. Meyer E, Carrillo R, Román E, et al. Prevalencia de sobrepeso y obesidad en escolares jujeños de diferente nivel altitudinal según las referencias IOTF, CDC y OMS. Arch argent pediatr, 2013; 111(6), 0-0. Pedrozo WR, Bonneau G, Castillo Rascón MS, et al. Valores de referencia y prevalencia de las alteraciones del perfil lipídico en adolescentes. Arch argent Pediatr. 2010;108(2):107-115. Cook S, Kavey RE. Dyslipidemia and pediatric obesity. Pediatr Clin North Am. 2011;58(6):1363-73. Daniels SR. Complications of obesity in children and adolescents. International Journal of Obesity. 2009; 33:60-65 Sociedad Argentina de Pediatría (SAP). Comite de Nutricion. Consensus on management of dyslipidemia in pediatrics. Arch argent pediatr. 2015;113:177-187. Lim H, Xue H, Wang Y. Association between obesity and metabolic co-morbidities among children and adolescents in South Korea based on national data. BMC Public Health. 2014;14:279. Weiss R, Dziura J, Burgert TS, et al. Obesity and the metabolic syndrome in children and adolescents. New England journal of medicine. 2004; 350(23): 2362-2374. Jessup A, Harrell JS. The metabolic syndrome: look for it in children and adolescents, too!. Clinical diabetes. 2005; 23(1): 26-32. Casavalle PL, Lifshitz F, Romano LS, Pet al. Prevalence of dyslipidemia and metabolic syndrome risk factor in overweight and obese children. Pediatr Endocrinol Rev. 2014;12(2):213-23. INDEC. Censo Nacional de Población, Hogares y Viviendas 2001. INDEC. Censo Nacional de Población, Hogares y Viviendas 2010. Disponible en: http://www.indec.gov.ar/censos_provinciales.asp?id_tema_1=2&id_tema_2=41&id_tema_3=135&p=38&d=000&t=3&s=1&c=2010. Cole TJ, Bellizi MC, Flegal KM. Establishing a standard definition for child overweight and obesity worlwide international survey. BMJ. 2000;320:1240-3. National Cholesterol Education Program (NCEP): highlights of the report of the Expert Panel on Blood Cholesterol Levels in Children and Adolescents. Pediatrics. 1992;89:495-501. Reich JD, Miller S, Brogdon B, et al. American Heart Association guidelines for primary prevention of atherosclerotic cardiovascular disease beginning in childhood. Circulation 2003;107:1562-6. co-published in J Pediatr 2003;142:368-72. Lee J, Lauer RM, Clarke WR. Lipoproteins in the progeny of young men with coronary artery disease: children with increased risk. Pediatrics. 1986;78(2):330-337. Kwiterovich Jr PO. Recognition and management of dyslipidemia in children and adolescents. The Journal of Clinical Endocrinology & Metabolism. 2008;93(11):4200-4209. Hirschler V, Gonzalez C, Molinari C. Prevalence and Distribution of Lipid Concentrations among Argentina's School Children. Childhood Obesity. 2011;7(4): 298-305. Dathan-Stumpf A, Vogel M, Hiemisch A, et al. Pediatric reference data of serum lipids and prevalence of dyslipidemia: Results from a population-based cohort in Germany. Clinical biochemistry. 2016:49(10-11), 740-749. Margolis KL, Greenspan LC, Trower NK, et al. Lipid screening in children and adolescents in community practice: 2007 to 2010. Circ Cardiovasc Qual Outcomes. 2014;7(5):718-726. Hirschler V, Gonzalez C, Maccallini G, et al. Comparison Between HDL-C Levels in Argentine Indigenous Children Living at High Altitudes and U.S. Children. Diabetes Technol Ther 2016;18(4):233-9. US Department of Health and Human Services. Vol II: The Prevalence Study Nutrient Intake. The Lipid Research Clinics Population Studies Data Book. 1980. NIH Pub. No. 80-1527: Bethesda, MD: NIH. Lee JM, Gebremariam A, Card-Higginson P, et al. Poor performance of body mass index as a marker for hypercholesterolemia in children and adolescents. Arch Pediatr Adolesc Med. 2009;163(8):716-23. Lozano P, Henrikson NB, Morrison CC, et al. Lipid screening in childhood and adolescence for detection of multifactorial dyslipidemia: evidence report and systematic review for the US Preventive Services Task Force. JAMA. doi:10.1001/jama.2016.6423.
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