Perfil antropométrico e metabólico de adolescentes nascidos prematuros em município do Oeste do Paraná

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Abstract

RESUMO Objetivo Relacionar o grau de prematuridade e adequação de peso ao nascer ao perfil lipídico, glicêmico, pressórico e antropométrico de adolescentes nascidos prematuros. Métodos Estudo transversal. Amostra com 50 adolescentes nascidos prematuros – idade gestacional menor que 37 semanas – classificados com base na idade gestacional e peso ao nascer: Adequado para Idade Gestacional (AIG), Pequeno para Idade Gestacional (PIG) e Grande para Idade Gestacional (GIG). Avaliaram-se medidas antropométricas; Pressão Arterial (PA); glicose, Colesterol Total (CT), Triglicerídeos (TG), coletados por punção digital. Análise por estatística descritiva, teste de associação exato de Fisher e análise de variância (ANOVA), considerando 5% de significância. Resultados 8% apresentaram Síndrome Metabólica (SM). 70% foram classificados como AIG, 30% apresentaram excesso de peso. 6% nasceu prematuro extremo e muito prematuro (14%). O grau de prematuridade associou-se significativamente a PA (p=0,027) e mostrou tendência à associação com o TG (p=0,05). Conclusão e implicações para a prática Os níveis pressóricos são influenciados pelo grau de prematuridade; foi evidenciado tendência a TG aumentados. Prematuros têm maior vulnerabilidade para desenvolver SM, alterações pressóricas e possíveis alterações na homeostase glicêmica devido à alteração de TG, indicando a necessidade de seguimento na infância e adolescência atentando ao seu maior risco para doenças cardiovasculares.

Translated abstract

RESUMEN Objetivo Relacionar el grado de prematuridad y la adecuación del peso al nacer con los lípidos, la glucemia, la Presión Arterial (PA) y el perfil antropométrico de adolescentes nacidos prematuros. Métodos Estudio transversal. Muestra con 50 adolescentes prematuros - edad gestacional menor de 37 semanas - clasificados según la edad gestacional y peso al nacer. Se evaluaron medidas antropométricas; PA; glucosa, Colesterol Total (CT), Triglicéridos (TG), recolectados por punción digital. Análisis estadístico descriptivo, prueba de asociación exacta de Fisher y análisis de varianza (ANOVA), considerando 5% de significancia. Resultados El 8% tenía Síndrome Metabólico (SM), el 70% fue clasificado como adecuado a la edad gestacional, el 30% tenía sobrepeso. Hubo asociación significativa entre la PA y el grado de prematuridad (p = 0.027); y tendencia a asociación entre grado de prematuridad y TG (p = 0.05). Conclusión y implicaciones para la práctica los niveles de PA están influenciados por el grado de prematuridad; se evidenció tendencia al aumento de TG. Los prematuros presentan mayor vulnerabilidad para el desarrollo de SM, cambios en la PA y posibles cambios en la homeostasis glucémica debido a alteración de TG, indicando necesidad de seguimiento en la infancia y adolescencia, considerando su mayor riesgo de enfermedad cardiovascular.

Translated abstract

ABSTRACT Objective To relate to the degree of prematurity and weight adequacy at birth with a lipid, glycemic, pressure, and anthropometric profile of adolescents born prematurely. Methods A cross-sectional study. Sample of 50 premature adolescents – gestational age less than 37 weeks – classified as follows regarding gestational age and birth weight: Adequate for Gestational Age (AGA), Small for Gestational Age (SGA), and Large for Gestational Age (LGA). Anthropometric measurements were evaluated: Blood Pressure (BP), glucose, Total Cholesterol (TC), Triglycerides (TG), collected by digital puncture. Analysis by descriptive statistics, Fisher's exact association test, and analysis of variance (ANOVA) considering a 5% significance level. Results 8% presented Metabolic Syndrome (MS), 70% were classified as AGA, 30% were overweight, 6% were born extremely preterm, and 14% very preterm. It showed a significant association between BP and the degree of prematurity (p=0.027) and a tendency for associating prematurity and TG (p=0.05). Conclusion and implications for practice: Pressure levels were influenced by the degree of prematurity; a tendency to increased TG was evidenced. Premature babies are more vulnerable to developing MS, pressure changes in adolescence, and possible changes in glycemic homeostasis due to TG alteration, indicating the need for follow-up in childhood and adolescence considering their higher risk for cardiovascular disease.

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Cardiometabolic Risk Factors in Young Adults Who Were Born Preterm

Marika Sipola-Leppänen, Marja Vääräsmäki, Marjaana Tikanmäki … (2015)

Adults who were born preterm with a very low birth weight have higher blood pressure and impaired glucose regulation later in life compared with those born at term. We investigated cardiometabolic risk factors in young adults who were born at any degree of prematurity in the Preterm Birth and Early Life Programming of Adult Health and Disease (ESTER) Study, a population-based cohort study of individuals born in 1985–1989 in Northern Finland. In 2009–2011, 3 groups underwent clinical examination: 134 participants born at less than 34 gestational weeks (early preterm), 242 born at 34–36 weeks (late preterm), and 344 born at 37 weeks or later (controls). Compared with controls, adults who were born preterm had higher body fat percentages (after adjustment for sex, age, and cohort (1985–1986 or 1987–1989), for those born early preterm, difference = 6.2%, 95% confidence interval (CI): 0.4, 13.2; for those born late preterm, difference = 8.0%, 95% CI: 2.4, 13.8), waist circumferences, blood pressure (for those born early preterm, difference = 3.0 mm Hg, 95% CI: 0.9, 5.1; for those born late preterm, difference = 1.7, 95% CI: −0.1, 3.4), plasma uric acid levels (for those born early preterm, difference = 20.1%, 95% CI: 7.9, 32.3; for those born late preterm, difference = 20.2%, 95% CI: 10.7, 30.5), alanine aminotransferase levels, and aspartate transaminase levels. They were also more likely to have metabolic syndrome (for those born early preterm, odds ratio = 3.7, 95% CI: 1.6, 8.2; for those born late preterm, odds ratio = 2.5, 95% CI: 1.2, 5.3). Elevated levels of conventional and emerging risk factors suggest a higher risk of cardiometabolic disease later in life. These risk factors are also present in the large group of adults born late preterm.