Avaliação da correlação entre o índice aterogênico plasmático e o risco cardiovascular em adolescentes de Lagarto, Sergipe, Brasil

Abstract

Atherosclerosis is a clinical disease that plays a central role in cardiovascular diseases (CVD) whose pathogenesis starts in childhood and adolescence. Visceral obesity is a predisposing factor for atherosclerosis by causing insulin resistance (IR), dyslipidemias, increased blood pressure and an oxidative and inflammatory environment. Together, those risk predictors are called cardiometabolic risk (CMR). The CMR can be estimated by the atherogenic index of plasma (AIP) which is calculated by the log10TG / HDL. This work determined the AIP of 448 students (12-17 years) of public schools of Lagarto-SE and correlated it with cardiovascular risk (CVR) predictors. The total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides (TG), and the prevalence of Castelli I index, Castelli II index, non-HDL ratio and TG / HDL ratio were also determined. The results were classified as normal, limit and altered, and IAP median was determined for each category. Anthropometric, sociodemographic, economic, lifestyle and family history of CVD variables were determined and correlated with the median AIP for each category. The differences between IAP medians among those variables and their own medians were determined by Kruskal-Wallis and Mann-Whitney tests (p <0.05). ROC curves were constructed and used to verify the detection of CVR by AIP in the studied population. Most of the students were female (73.00%) and from social class C (58.48%), 65.18% of them were brown and lived in urban areas (66.07%). Moreover, 42,19% lived in a house with more than 4 people, were used to consume alcoholic beverages (27.68%), were sedentary (61.61%) and had a positive family history for CVD (57.14%). Girls presented higher values for the waist-to-height ratio (RCA), total cholesterol and HDL when compared to boys who, on the other hand, had higher waist-hip ratio (WHR), Castelli I and II indexes and IAP. The prevalence of dyslipidemia was: high total cholesterol (6.3%), LDL (5.3%), TG (8.7%), non-HDL cholesterol (7.8%), Castelli I index (36.2%) and Castelli II index (31.0%). HDL reduction was found in 27.7% of the participants. Ultra-Sensitive C-Reactive Protein (US-CRP) indicating CMR were observed in 35.7%. The prevalence of anthropometric alterations was: overweight (10.0%); obesity (5.4%); RCA (7.6%); WHR (15.4%); abdominal circumference (CA) (14.1%); index of conicity (47.8%). The highest AIP indexes were associated with sedentary lifestyle, borderline or elevated TG, reduced HDL, high non-HDL cholesterol, altered Castelli I and II indexes, US-CRP, overweight and obesity, and change in WHR, RCA and CA. The ROC curves showed good sensitivity (SENS) for the IAP for the detection of CMR when the adolescents also showed alterations in the index of Castelli I (SENS 0,792), non-HDL CHC (SENS 0,746), HDL (SENS 0,736) and TG (SENS 0,979). These results point to a positive correlation of the AIP with most of the CVR predictors in adolescents, wich suggests that it can be used as a reliable CMR marker in adolescentes with dyslipidemias and anthropometric changes indicative of obesity and sedentary lifestyle.