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      Índices de obesidade central e fatores de risco cardiovascular na síndrome dos ovários policísticos Translated title: Central obesity index and cardiovascular risk factors in polycystic ovary syndrome Translated title: Índices de obesidad central y factores de riesgo cardiovascular en el síndrome de ovarios poliquísticos

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          Abstract

          FUNDAMENTO: A obesidade abdominal apresenta elevada prevalência em mulheres com síndrome dos ovários policísticos (SOP) e está associada a um aumento do risco cardiovascular. OBJETIVO: Verificar a acurácia da circunferência da cintura (CC), da relação cintura-quadril (RCQ), da relação cintura-estatura (RCEST) e do índice de conicidade (índice C), no que se refere à detecção de fatores de risco cardiovascular (FRCV) em mulheres com SOP. MÉTODOS: Por meio de estudo transversal, foram alocadas 102 mulheres (26,5 ± 5 anos) com diagnóstico de SOP, de acordo com o consenso de Rotterdam. O colesterol total (CT), os triglicerídeos (TG), o LDL-colesterol (LDL-C), o HDL-colesterol (HDL-C), a glicemia de jejum, a glicemia após teste oral de tolerância à glicose (TOTG) e a pressão arterial (PA) foram avaliados em todas as pacientes, além das variáveis antropométricas. RESULTADOS: A relação cintura-estatura foi o marcador que apresentou correlações positivas significativas com o maior número de FRCV (PA, TG e glicemia após TOTG), destacando-se ainda a correlação negativa com HDL-C. Todos os marcadores antropométricos avaliados se correlacionaram positivamente com PA, enquanto CC e RCQ apresentaram correlação positiva também com TG. No tocante à acurácia para detecção de FRCV, os indicadores antropométricos considerados apresentaram taxas de sensibilidade superiores a 60%, com destaque para a RCEST, que apresentou sensibilidade superior a 70%. CONCLUSÃO: A RCEST demonstrou ser o indicador antropométrico com a melhor acurácia para a predição de FRCV. Nesse sentido, propõe-se a inclusão desse parâmetro de fácil mensuração na avaliação clínica para o rastreamento de mulheres com SOP e FRCV.

          Translated abstract

          BACKGROUND: Women with polycystic ovary syndrome (PCOS) present a high prevalence of abdominal obesity, which is associated with an increased cardiovascular risk. OBJECTIVE: To verify the accuracy of the waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR) and the conicity index (CI) in the detection of cardiovascular risk factors (CVRF) in women with PCOS. METHODS: The present transversal study allocated 102 women (26.5 ± 5 years) with a diagnosis of PCOS, according to the Rotterdam criteria. Total cholesterol (TC), triglycerides (TG), LDL-cholesterol (LDL-C), HDL-cholesterol (HDL-C), fasting glucose, glucose after the oral glucose tolerance test (OGTT) and blood pressure (BP) were evaluated in all patients, in addition to the anthropometric variables. RESULTS: The WHtR was the marker that presented significant positive correlations with the highest number of CVRF (BP, TG and post-OGTT glucose), whereas there was a negative correlation with HDL-C. All the evaluated anthropometric markers were positively correlated with BP, whereas WC and WHR also presented a positive correlation with TG. Regarding the accuracy for the detection of CVRF, the anthropometric markers presented a sensibility > 60%, especially the WHtR, which had a sensibility > 70%. CONCLUSION: The WHtR showed to be the most accurate anthropometric indicator for the prediction of CVRF. In this sense, we propose the inclusion of this easily-measured parameter in the clinical assessment for the screening of women with PCOS and CVRF.

          Translated abstract

          FUNDAMENTO: La obesidad abdominal presenta elevada prevalencia en mujeres con Síndrome de Ovarios Poliquísticos (SOP) y está asociada a un aumento del riesgo cardiovascular. OBJETIVO: Verificar la precisión de la circunferencia de la cintura (CC), de la relación cintura-cadera (RCC), de la relación cintura-estatura (RCEst) y del índice de conicidad (índice C), en los que se refiere a la detección de factores de riesgo cardiovascular (FRCV) en mujeres con SOP. MÉTODOS: Por medio de estudio transversal, fueron seleccionadas 102 mujeres (26,5 ± 5 años) con diagnóstico de SOP, de acuerdo con el consenso de Rotterdam. El colesterol total (CT), los triglicéridos (TG), el LDL-colesterol (LDL-c), el HDL-colesterol (HDL-C), la glucemia en ayunas, la glicemia después del test oral de tolerancia a la glucosa (TOTG) y la presión arterial (PA) fueron evaluadas en todas las pacientes, además de las variables antropométricas. RESULTADOS: La relación cintura-estatura fue el marcador que presentó correlaciones positivas significativas con el mayor número de FRCV (PA, TG y glucemia después del TOTG), destacándose además la correlación negativa con HDL-C. Todos los marcadores antropométricos evaluados se correlacionaron positivamente con la PA, mientras que CC y RCC presentaron correlación positiva también con TG. En lo tocante a la precisión para detección de FRCV, los indicadores antropométricos considerados presentaron índices de sensibilidad superiores al 60%, destacándose la RCEst, que presentó sensibilidad superior al 70%. CONCLUSIÓN: La RCEst demostró ser el indicador antropométrico con la mayor precisión para la predicción de FRCV. En este sentido, se propone la inclusión de ese parámetro de fácil medición en la evaluación clínica para el rastreo de mujeres con SOP y FRCV.

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          Most cited references 36

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          A simple model-based index of abdominal adiposity.

           R Valdez (1990)
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            The superiority of waist-to-height ratio as an anthropometric index to evaluate clustering of coronary risk factors among non-obese men and women.

            Overtly obesity is relatively rare among the Japanese despite the high prevalence of metabolic disorders, which suggests the need to develop simple and effective methods for assessing metabolic risks among the non-obese individuals as part of public health education. We compared body mass index (BMI), waist circumference, and waist-to-height ratio (W/Ht) as indices for evaluation of clustering of coronary risk factors (hypertension, hyperglycemia, hypertriglyceridemia, hypercholesterolemia, and low HDL cholesterol) in 4,668 men and 1,853 women with BMI /=2 and >/=3 coronary risk factors were highest for a waist-to-height ratio >/=0.5 in both genders. Waist-to-height ratio is more sensitive than BMI or waist circumference alone to evaluate clustering of coronary risk factors among non-obese men and women.
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              Visceral fat is associated with cardiovascular risk in women with polycystic ovary syndrome.

              Women with polycystic ovary syndrome (PCOS) have been reported to have subclinical cardiovascular disease (CVD) and increased abdominal fat. The aim of this study was to evaluate the relationship between visceral fat (VF) and early markers of CVD in PCOS women. Two hundred overweight PCOS women [(mean +/- SD) age 24.6 +/- 3.2 years, body mass index (BMI) 28.5 +/- 2.8 kg/m2] and 100 healthy age- and BMI-matched volunteer controls entered this cross-sectional study. In all subjects, the amount of VF was measured by ultrasonography. Anthropometric measurements [BMI and waist circumference (WC)], complete hormonal and metabolic pattern, carotid intima-media thickness (IMT), brachial arterial flow-mediated dilation (FMD) and inflammatory biomarkers [C-reactive protein (CRP), fibrinogen, white blood cells count and plasminogen activated inhibitor-1] were also obtained from all subjects. A stepwise linear regression model was used in PCOS patients to verify if IMT or FMD as dependent variables are affected by other independent variables. VF amount was significantly (P < 0.001) higher in PCOS subjects than in healthy controls [31.4 +/- 7.3 versus 28.0 +/- 6.1 (mean+/-SD) mm, respectively] and directly related to insulin resistance: HOMA (r = 0.918, P < 0.001) and AUC(INS) (r = 0.879, P < 0.001), and to WC (r = 0.658; P < 0.001). In PCOS, the two linear regression analyses showed that IMT is positively affected by VF and CRP, whereas FMD is positively affected by IMT and negatively by VF and CRP. VF amount is associated with subclinical CVD in PCOS patients.
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                Author and article information

                Affiliations
                [1 ] Universidade Federal do Rio Grande do Norte Brazil
                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                abc
                Arquivos Brasileiros de Cardiologia
                Arq. Bras. Cardiol.
                Sociedade Brasileira de Cardiologia - SBC (São Paulo )
                1678-4170
                May 2010
                : 94
                : 5
                : 633-638
                S0066-782X2010000500010

                http://creativecommons.org/licenses/by/4.0/

                Product
                Product Information: SciELO Brazil
                Categories
                CARDIAC & CARDIOVASCULAR SYSTEMS

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