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Previous issue date: 2013-12-13 === O diagn?stico do estado nutricional ? de grande relev?ncia na pr?tica cl?nica e na avalia??o de popula??es devido ? associa??o da gordura corporal com altera??es metab?licas. O objetivo deste estudo ? analisar a preval?ncia da s?ndrome metab?lica (SM) e seus componentes nos est?gios pubert?rios de escolares norte-rio-grandenses de acordo com os crit?rios da International Diabetes Federation. Estudo transversal com 449 escolares do sexo feminino na faixa et?ria dos 8 aos 19 anos, estratificadas nos est?gios pubert?rios sistematizado por Marshal e Tanner (1969), sendo 27,6% pr?-p?bere, 44,3% p?bere e 28,1% p?s-p?bere, com idade m?dia de 9,4?1,27, 12,4?2,23 e 15,1?1,88 respectivamente. As preval?ncias foram analisadas por meio da distribui??o de frequ?ncias com seus respectivos intervalos de confian?a de 95%, o teste do Qui-quadrado e a raz?o de chance foram utilizados para analisar as associa??es entre as vari?veis. A preval?ncia geral de SM foi 3,3% (IC: 2% - 5%), sem ocorr?ncias no est?gio pr?-p?bere, observando-se que ela surge a partir do est?gio p?bere com preval?ncia de 2,5% (IC 95% 0,1% - 5%), sendo 1% (IC 95% 0,4% - 2,3%) dos casos com sobrepeso e 1,5% (IC 95% -0,1% - 3,2%) de obesos, enquanto no est?gio p?s-p?bere a preval?ncia ? de 7,9% (IC 95% 3,2% - 12,6%), sendo 0,8% (IC 95% -0,8% - 2,3%) dos casos com peso normal, 4% (IC 95% 0,6% - 7,4%) com sobrepeso e 3,1% (IC 0,1% - 6,2%) s?o obesos. Observa-se associa??o (p<0,02) dos est?gios pubert?rios com a SM (x2=5,2), com uma RC de 3,3 (IC: 1,2 - 5) mostrando adolescentes p?s-p?beres mais propensas a SM em rela??o as p?beres, j? nas obesas a RC ? de 2,1 (IC: 2-2,2) comparadas as sobrepeso. O IMC (x2 = 29,4; p<0,001) e faixas et?rias (x2 = 13,1; p<0,001) mostram associa??o linear significantes com a SM. Das adolescentes com SM aquelas com idade menor de dez anos apresentam maiores %G. Os componentes mais prevalentes em todos os est?gios foram a altera??o da circunfer?ncia da cintura (27,2% [IC 23% - 31%]) e o colesterol HDL baixo (39,6% [IC 35% - 44%]), que junto com a hipertens?o apresentaram diferen?as significantes no est?gio p?s-p?bere em rela??o aos demais est?gios. Os resultados mostram que a SM surge a partir do est?gio p?bere proporcional ao excesso de gordura corporal a partir da inf?ncia, fato que demanda estrat?gias de preven??o por meio de uma abordagem educacional, minimizando a grande demanda no Sistema ?nico de Sa?de. === The diagnosis of nutritional status is extremely re
levant in clinical practice and
population assessment, due to the association betwe
en body fat and metabolic
alterations. The aim of this study is to analyze th
e prevalence of metabolic syndrome
(MS) and its components in the pubertal stages of f
emale students in Rio Grande do
Norte state, Brazil, in accordance with Internation
al Diabetes Federation criteria.
This is
a cross-sectional study with 449 students aged betw
een 8 and 19 years, stratified into
pubertal stages systematized by Marshal and Tanner
(1969), as follows: 27.6%
prepubertal, 44.3% pubertal and 28.1% postpubertal,
with mean ages of 9.4?1.27,
12.4?2.23 and 15.1?1.88 years, respectively. Preval
ences were analyzed using
distribution of frequencies and their respective 95
% confidence intervals, while the chi-
square test and odds ratio were applied to analyze
the associations between variables.
The general prevalence of MS was 3.3% (CI: 2% - 5%)
, without occurrences in the
prepubertal stage, observing that it emerges from t
he pubertal stage onwards with a
prevalence of 2.5% (CI 95% 0.1% - 5%), 1% (CI 95%
0.4% - 2.3%) of cases with
overweight and 1.5% (CI 95% -0.1% - 3.2%) with obes
e individuals, while in the
postpubertal stage the prevalence is 7.9% (CI 95% 3
.2% - 12.6%), 0.8% (CI 95% -0.8%
- 2.3%) normal weight cases, 4% (CI 95% 0.6% - 7.4%
) overweight and 3.1% (CI 0.1%
- 6.2%) obese individuals. There was an association
(p<0.02) between pubertal stages
and MS (
x
2
=5.2), with an OR of 3.3 (CI: 1.2 - 5), showing tha
t postpubertal adolescents
are more prone to SM than pubertals, while the OR i
n obese individuals was 2.1 (CI: 2?
2.2) compared to the overweight. Body mass index (B
MI) (
x
2
= 29.4; p<0.001) and age
range (
x
2
= 13.1; p<0.001) showed a significant linear assoc
iation with MS. Of the
adolescents with MS, those aged ten years or younge
r exhibited higher %G. The most
prevalent components in all the stages were altered
waist circumference (27.2% [CI
23% - 31%]) and low HDL cholesterol (39.6% [CI 35%
? 44%]), which, coupled with
hypertension, displayed significant differences in
the postpubertal stage in relation to
the other stages. The results show that MS emerges
from the pubertal stage onwards in
proportion to excess childhood body fat, a fact tha
t calls for prevention strategies using
an educational approach, reducing the large demand
on the National Health System.
Keywords:
Metabolic syndrome, pubertal stages, risk factors.
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