Assessment of cardiometabolic risk and associated factors in elderly diabetic people
DOI:
https://doi.org/10.59171/nutrivisa-2023v10e10981Keywords:
aged, diabetes mellitus type 2, visceral adiposity indices; adiposity, adiposity, cardiometabolic risk.Abstract
To evaluate cardiometabolic risk based on visceral fat indices and associated factors in elderly people with diabetes. Cross-sectional study with an analytical approach, carried out in primary health care. Cardiometabolic risk was estimated from two visceral adiposity indices, the product of lipid accumulation and the visceral adiposity index. Associations were made between cardiometabolic risk and sociodemographic, laboratory and lifestyle variables using the Chi-square test or Fisher's exact test and multivariate analysis using the Poisson model adjusted with robust variance. 202 elderly people with diabetes were evaluated, with a mean age of 67.9 ± 6.7 years. Visceral adiposity indices were related to variables compatible with cardiometabolic risk. Female sex, changes in fasting blood glucose, neck circumference, waist-to-hip ratio and total cholesterol were associated with the visceral adiposity index. While in the lipid accumulation product, the association occurred with an increase in the percentage of fat assessed by body mass index, neck circumference, changes in total cholesterol, fasting blood glucose, glycated hemoglobin and a reduction in HDL. Access to studies was the only sociodemographic variable that was related to the product of lipid accumulation in this population. The lack of association between the studied indices and clinical variables, inflammatory parameters or blood pressure levels suggests that their use as a method of assessing and monitoring cardiometabolic risk should be carried out with caution.
References
ALBERTI, K.G.M.M.; ZIMMET, P.; SHAW, J. Metabolic syndrome--a new world-wide definition. A Consensus Statement from the International Diabetes Federation. Diabetic Medicine: A Journal of the British Diabetic Association, v.23, n.5, p.469–480, 2006. Doi: https://doi.org/10.1111/j.1464-5491.2006.01858.x
AMATO, M.C.; GIORDANO, C.; GALIA, M.; CRISCIMANNA, A.; VITABILE, S.; MIDIRI, M.; GALLUZZO, A.; ALKAMESY STUDY GROUP. Visceral Adiposity Index: a reliable indicator of visceral fat function associated with cardiometabolic risk. Diabetes Care, v. 33, n. 4, p.920-922, abr. 2010. Doi: https://doi.org/10.2337/dc09-1825
AMATO, M.C.; GIORDANO, C.; PITRONE, M.; GALLUZZO, A. Cut-off points of the visceral adiposity index (VAI) identifying a visceral adipose dysfunction associated with cardiometabolic risk in a Caucasian Sicilian population. Lipids in Health and Disease, v.10, p.183, 2011. Doi: https://doi.org/10.1186/1476-511X-10-183
AMATO, M.C.; GIORDANO, C. Visceral adiposity index: an indicator of adipose tissue dysfunction. International Journal of Endocrinology, 2014. Doi: https://doi.org/10.1155/2014/730827
AMERICAN DIABETES ASSOCIATION. STANDARDS OF MEDICAL CARE IN DIABETES—2017 ABRIDGED FOR PRIMARY CARE PROVIDERS | CLINICAL DIABETES, 2017. Disponível em: https://diabetesjournals.org/clinical/article/35/1/5/35446/Standards-of-Medical-Care-in-Diabetes-2017.
AMERICAN DIABETES ASSOCIATION (ADA). STANDARDS OF MEDICAL CARE IN DIABETES—2019 ABRIDGED FOR PRIMARY CARE PROVIDERS | CLINICAL DIABETES, 2019. Disponível em: https://diabetesjournals.org/clinical/article/37/1/11/32671/Standards-of-Medical-Care-in-Diabetes-2019.
BARBOSA, P.S.; SANTOS, R.P.; MENDONÇA, J.L.S.; ROCHA, V.S. Circunferência do pescoço e sua associação com parâmetros antropométricos de adiposidade corporal em adultos. Braspen J, p.315-320, 2017.
BOSSAN, Francine Moreira; ANJOS, Luiz Antonio dos; VASCONCELLOS, Mauricio Teixeira Leite de; WAHRLICH, Vivian. Nutritional status of the adult population in Niterói, Rio de Janeiro, Brazil: the Nutrition, Physical Activity, and Health Survey. Cadernos de Saúde Pública, v.23, p.1867-1876, 2007. Doi: https://doi.org/10.1590/S0102-311X2007000800013
BOZORGMANESH, M.; HADAEGH, F.; AZIZI, F. Predictive performances of lipid accumulation product vs. adiposity measures for cardiovascular diseases and all-cause mortality, 8.6-year follow-up: Tehran lipid and glucose study. Lipids in Health and Disease, v.9, p.100, 2010. Doi: https://doi.org/10.1186/1476-511X-9-100.
CAMELO, L.V.; FIGUEIREDO, R.C.; OLIVEIRA-CAMPOS, M.; GIATTI, L.; BARRETO, S.M. Comportamentos saudáveis e escolaridade no Brasil: tendência temporal de 2008 a 2013. Ciência & Saúde Coletiva, v.21, n.4, p.1011-1021, 2016. Doi: https://doi.org/10.1590/1413-81232015214.09742015
CARTOLANO, F.D.C.; PAPPIANI, C.; FREITAS, M.C.P.; FIGUEIREDO NETO, A.M.; CARIOCA, A.A.F.; DAMASCENO, N.R.T. Is Lipid Accumulation Product Associated with an Atherogenic Lipoprotein Profile in Brazilian Subjects? Arquivos Brasileiros de Cardiologia, v.110, p.339-347,2018. Doi: https://doi.org/10.5935/abc.20180054
CHEN, C.; XU, Y.; GUO, Z.; YANG, J.; WU, M.; HU, X. The application of visceral adiposity index in identifying type 2 diabetes risks based on a prospective cohort in China. Lipids in Health and Disease, v.13, p.108, 2014. Doi: https://doi.org/10.1186/1476-511X-13-108
CHENG, Y.L.; WANG, Y.J.; LAN, K.H.; HUO, T.I.; HUANG, Y.H.; SU, C.W.; HSIEH, W.Y.; HOU, M.C.; LIN, H.C.; LEE, F.Y.; WU, J.C.; LEE, S.D. Fatty Liver Index and Lipid Accumulation Product Can Predict Metabolic Syndrome in Subjects without Fatty Liver Disease. Gastroenterology Research and Practice, v. 2017, p.9279836, 2017. Doi: https://doi.org/10.1155/2017/9279836
CHUMLEA, W.C.; ROCHE, A.F.; STEINBAUGH, M.L. Estimating stature from knee height for persons 60 to 90 years of age. Journal of the American Geriatrics Society, v.33, n.2, p.116-120, 1985. Doi: https://doi.org/10.1111/j.1532-5415.1985.tb02276.x
CRITÉRIO BRASIL - ABEP. [s. d.]. Disponível em: https://www.abep.org/criterio-brasil. Acesso em: 14 jun. 2023.
DAI, D.; CHANG, Y.; CHEN, Y.; CHEN, S.; YU, S.; GUO, X.; SUN, Y. Visceral Adiposity Index and Lipid Accumulation Product Index: Two Alternate Body Indices to Identify Chronic Kidney Disease among the Rural Population in Northeast China. International Journal of Environmental Research and Public Health, v.13, n.12, p.1231, 2016. https://doi.org/10.3390/ijerph13121231.
GAO, X.; WANG, G.; WANG, A.; XU, T.; TONG, W.; ZHANG, Y. Comparison of lipid accumulation product with body mass index as an indicator of hypertension risk among Mongolians in China. Obesity Research & Clinical Practice, v.7, n.4, p.e308-314, 2013. Doi: https://doi.org/10.1016/j.orcp.2012.02.002
GERALDA-FERREIRA, F.; SEGHETO, W.; GUIMARÃES-DA-SILVA, D.C.; FELICIANO- PEREIRA, P.; ZARBATO-LONGO, G. Visceral adiposity index associated with behavioral and inflammatory parameters in adults: a population based study. Nutricion Hospitalaria, v.35, n.2, p.326-331, 2018. Doi: https://doi.org/10.20960/nh.1325
JABŁONOWSKA-LIETZ, B.; WRZOSEK, M.; WŁODARCZYK, M.; NOWICKA, G. New indexes of body fat distribution, visceral adiposity index, body adiposity index, waist-to-height ratio, and metabolic disturbances in the obese. Kardiologia Polska, v.75, n.11, p.1185-1191, 2017. https://doi.org/10.5603/KP.a2017.0149
KAHN, H.S. The “lipid accumulation product” performs better than the body mass index for recognizing cardiovascular risk: a population-based comparison. BMC cardiovascular disorders, v.5, p.26, 2005. Doi: https://doi.org/10.1186/1471-2261-5-26
KAHN, H.S. The lipid accumulation product is better than BMI for identifying diabetes: a population-based comparison. Diabetes Care, v.29, n.1, p.151-153, 2006. Doi: https://doi.org/10.2337/diacare.29.1.151
KAVARIC, N.; KLISIC, A.; NINIC, A. Are visceral adiposity index and lipid accumulation product reliable indices for metabolic disturbances in patients with type 2 diabetes mellitus? Journal of Clinical Laboratory Analysis, v.32, n.3, p.e22283, 2018. Doi: https://doi.org/10.1002/jcla.22283.
KLISIC, A.; KOTUR-STEVULJEVIC, J.; KAVARIC, N.; MATIC, M. Relationship between Cystatin C, Retinol-binding Protein 4 and Framingham Risk Score in Healthy Postmenopausal Women. Archives of Iranian Medicine, v.19, n.12, p.845-851, 2016. .
LEE, C.G.; CARR, M.C.; MURDOCH, S. J.; MITCHELL, E.; WOODS, N.F.; WENER, Mark H.; CHANDLER, W.L.; BOYKO, E.J.; BRUNZELL, J.D. Adipokines, inflammation, and visceral adiposity across the menopausal transition: a prospective study. The Journal of Clinical Endocrinology and Metabolism, v.94, n.4, p.1104-1110, 2009. Doi: https://doi.org/10.1210/jc.2008-0701
MARCADENTI, A.; FUCHS, F.D.; MOREIRA, L.B.; GUS, M.; FUCHS, S.C. Adiposity phenotypes are associated with type-2 diabetes: LAP index, body adiposity index, and neck circumference. Atherosclerosis, v.266, p.145-150, 2017. Doi: https://doi.org/10.1016/j.atherosclerosis.2017.09.022
MARTIN, S.S.; BLAHA, M.J.; ELSHAZLY, M.B.; TOTH, P.P.; KWITEROVICH, P.O.; BLUMENTHAL, R.S.; JONES, S.R. Comparison of a novel method vs the Friedewald equation for estimating low-density lipoprotein cholesterol levels from the standard lipid profile. JAMA, v.310, n.19, p.2061-2068, 2013. Doi: https://doi.org/10.1001/jama.2013.280532
MIRMIRAN, P.; BAHADORAN, Z.; AZIZI, F. Lipid accumulation product is associated with insulin resistance, lipid peroxidation, and systemic inflammation in type 2 diabetic patients. Endocrinology and Metabolism (Seoul, Korea), v.29, n.4, p.443-449, 2014. Doi: https://doi.org/10.3803/EnM.2014.29.4.443
NUSRIANTO, R.; AYUNDINI, G.; KRISTANTI, M.; ASTRELLA, C.; AMALINA, N.; MUHADI, null; RIYADINA, W.; TAHAPARY, D.L.; SOEWONDO, P. Visceral adiposity index and lipid accumulation product as a predictor of type 2 diabetes mellitus: The Bogor cohort study of non-communicable diseases risk factors. Diabetes Research and Clinical Practice, v.155, p.107798, 2019. Doi: https://doi.org/10.1016/j.diabres.2019.107798
OLIVEIRA, R.E.P.; FOSS-FREITAS, M.C.; MONTENEGRO JÚNIOR, R.M.; VENCIO, S.(orgs}). Diretrizes da Sociedade Brasileira de Diabetes 2017-2018. São Paulo: Clannad, 2017. Disponível em: https://edisciplinas.usp.br/pluginfile.php/4925460/mod_resource/content/1/diretrizes-sbd-2017-2018.pdf
PAN AMERICAN HEALTH ORGANIZATION (PAHO). Encuesta multicéntrica salud bienestar y envejecimiento (SABE) en América Latina: informe preliminar. 2001. Disponível em: https://iris.paho.org/handle/10665.2/45890. Acesso em: 14 jun. 2023.
PIEPOLI, M.F.; HOES, A.W.; BROTONS, C.; HOBBS, R.F.D.; CORRA, U. Task Force for the 2016 guidelines on cardiovascular disease prevention in clinical practice. Main messages for primary care from the 2016 European Guidelines on cardiovascular disease prevention in clinical practice. The European Journal of General Practice, v.24, n.1, p.51–56, 2018. Doi: https://doi.org/10.1080/13814788.2017.1398320
PITANGA, F.J.G.; LESSA, I. Razão cintura-estatura como discriminador do risco coronariano de adultos. Revista da Associação Médica Brasileira, v.52, p.157-161, 2006. Doi: https://doi.org/10.1590/S0104-42302006000300016
PREIS, S.R.; MASSARO, J.M.; HOFFMANN, U.; D’AGOSTINO, R.B.; LEVY, D.; ROBINS, S.J.; MEIGS, J.B.; VASAN, R.S.; O’DONNELL, C.J.; FOX, C.S. Neck circumference as a novel measure of cardiometabolic risk: the Framingham Heart study. The Journal of Clinical Endocrinology and Metabolism, v.95, n.8, p.3701-3710, 2010. Doi: https://doi.org/10.1210/jc.2009-1779
SCHWARTZ, S.S.; EPSTEIN, S.; CORKEY, B.E.; GRANT, S.F.A.; GAVIN, J.R.; AGUILAR, R.B. The Time Is Right for a New Classification System for Diabetes: Rationale and Implications of the β-Cell-Centric Classification Schema. Diabetes Care, v.39, n.2, p.179-186, 2016. Doi: https://doi.org/10.2337/dc15-1585
SELVAN, C.; DUTTA, D.; THUKRAL, A.; NARGIS, T.; KUMAR, M.; MUKHOPADHYAY, S.; CHOWDHURY, S. Neck height ratio is an important predictor of metabolic syndrome among Asian Indians. Indian Journal of Endocrinology and Metabolism, v.20, n.6, p.831-837, 2016. Doi: https://doi.org/10.4103/2230-8210.192927.
VIEIRA, J.N.; BRAZ, M.A.D.; GOMES, F.O.; SILVA, P.R.; SANTOS, O.T.M.; ROCHA, I.M.G.; SOUSA, I.M.; FAYH, A.P.T. Cardiovascular risk assessment using the lipid accumulation product index among primary healthcare users: a cross-sectional study. São Paulo Medical Journal, v.137, p.126-131, 2019. Doi: https://doi.org/10.1590/1516-3180.2018.0293240119.
VIGITEL BRASIL 2014 - VIGILÂNCIA DE FATORES DE RISCO E PROTEÇÃO PARA DOENÇAS CRÔNICAS POR INQUÉRITO TELEFÔNICO — MINISTÉRIO DA SAÚDE. [s. d.]. Disponível em: https://www.gov.br/saude/pt-br/centrais-de-conteudo/publicacoes/svsa/vigitel/vigitel_2014.pdf/view. Acesso em: 14 jun. 2023.
YANG, G.R.; YUAN, S.Y.; FU, H.J.; WAN, G.; ZHU, L.X.; BU, X.L.; ZHANG, J.D.; DU, X.P.; LI, Y.L.; JI, Y.; GU, X.N.; LI, Y.; BEIJING COMMUNITY DIABETES STUDY GROUP. Neck circumference positively related with central obesity, overweight, and metabolic syndrome in Chinese subjects with type 2 diabetes: Beijing Community Diabetes Study 4. Diabetes Care, v.33, n.11, p.2465-2467, 2010. Doi: https://doi.org/10.2337/dc10-0798.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Fernanda Mirela Amaral Gomes, Ilma Kruze Grande de Arruda, Ana Paula de Oliveira Marques, Márcia Carrera Campos Leal, Luciana Caroline Paulino do Nascimento, Belvania Ramos Ventura da Silva Cavalcanti, Anna Karla de Oliveira Tito Borba
This work is licensed under a Creative Commons Attribution 4.0 International License.
