Palavras-chave
risco cardiovascular
risco coronariano
saúde
militares
Como Citar
Resumo
Introdução: A obesidade pode ser considerada como um fator limitador do desempenho profissional, com destaque para a carreira militar, a qual tem na higidez e na manutenção da aptidão física requisitos essenciais para o desempenho em suas tarefas.
Objetivo: Comparar a prevalência de risco elevado de doença coronariana (REDC), estimada por pontos de corte específicos a partir dos indicadores antropométricos: Índice de Massa Corporal (IMC), Índice de Conicidade (Índice C), circunferência de cintura (CC), Índice Indicativo da Gordura Corporal (IGC) e razão cintura-estatura (RCEst) em militares do Exército Brasileiro (EB).
Métodos: Estudo transversal, com amostra aleatória populacional, composta por 49.414 militares do sexo masculino, categorizados por faixa etária. A prevalência de REDC foi estimada por cada indicador antropométrico. As diferenças entre as médias foram examinadas pela análise de variância de Kruskal-Wallis (H) com análise post hoc do teste de Mann-Whitney (U). Para todas as análises o nível de confiança adotado foi de 95%.
Resultados: Houve prevalência elevada de REDC segundo todos os indicadores antropométricos examinados, em todas as faixas etárias, exceto na de até 20 anos de idade, sendo que se observou aumento na prevalência conforme aumentava a faixa etária, sendo que todas as faixas acima de 30 anos exibiam prevalência igual ou superior a 50%.
Conclusão: A prevalência elevada na população de estudo indica que há necessidade de intervenção em saúde no âmbito do EB incentivar mudanças em hábitos saudáveis como nutrição e nível de atividade física promovendo a saúde e a medicina preventiva. Os resultados foram discutidos.
Referências
Pi-Sunyer FX. The Obesity Epidemic: Pathophysiology and Consequences of Obesity. Obesity Research. 2002;10(S12): 97S-104S. https://doi.org/10.1038/oby.2002.202.
Jayedi A, Soltani S, Zargar MS, Khan TA, Shab-Bidar S. Central fatness and risk of all cause mortality: systematic review and dose-response meta-analysis of 72 prospective cohort studies. BMJ (Clinical research ed.). 2020;370: m3324. https://doi.org/10.1136/bmj.m3324.
World Health Organization. Obesity. Obesity. https://www.who.int/news-room/facts-in-pictures/detail/6-facts-on-obesity [Accessed 5th October 2023].
IBGE. Tabela 8168: Pessoas de 18 anos ou mais de idade com excesso de peso ou obesidade, por sexo e grupo de idade. SIDRA. https://sidra.ibge.gov.br/tabela/8168 [Accessed 5th October 2023].
Warburton DER, Bredin SSD. Health benefits of physical activity: a systematic review of current systematic reviews. Current Opinion in Cardiology. 2017;32(5): 541–556. https://doi.org/10.1097/HCO.0000000000000437.
Warburton DER, Bredin SSD. Health Benefits of Physical Activity: A Strengths-Based Approach. Journal of Clinical Medicine. 2019;8(12): 2044. https://doi.org/10.3390/jcm8122044.
Warburton DER, Nicol CW, Bredin SSD. Health benefits of physical activity: the evidence. CMAJ : Canadian Medical Association Journal. 2006;174(6): 801–809. https://doi.org/10.1503/cmaj.051351.
Peake J, Gargett S, Waller M, McLaughlin R, Cosgrove T, Wittert G, et al. The health and cost implications of high body mass index in Australian defence force personnel. BMC Public Health. 2012;12: 451. https://doi.org/10.1186/1471-2458-12-451.
Taanila H, Suni J, Pihlajamäki H, Mattila VM, Ohrankämmen O, Vuorinen P, et al. Aetiology and risk factors of musculoskeletal disorders in physically active conscripts: a follow-up study in the Finnish Defence Forces. BMC Musculoskeletal Disorders. 2010;11: 146. https://doi.org/10.1186/1471-2474-11-146.
Cunha RSP da, Waissmann W. O estabelecimento de pontos de corte no Índice de Conicidade, como proposta de um indicador antropométrico simples, para avaliação da obesidade e estimativa do risco coronariano elevado no Exército Brasileiro. [Thesis] 2011. https://www.arca.fiocruz.br/handle/icict/24769 [Accessed 5th October 2023].
Martinez EC, Anjos LA dos. Fatores de risco de doenças ateroscleróticas coronarianas em militares da ativa do exército brasileiro com idade superior a 40 anos. 2004; https://www.arca.fiocruz.br/handle/icict/5438
Keys A, Fidanza F, Karvonen MJ, Kimura N, Taylor HL. Indices of relative weight and obesity. Journal of Chronic Diseases. 1972;25(6): 329–343. https://doi.org/10.1016/0021-9681(72)90027-6.
Welin L, Svärdsudd K, Wilhelmsen L, Larsson B, Tibblin G. Analysis of risk factors for stroke in a cohort of men born in 1913. The New England Journal of Medicine. 1987;317(9): 521–526. https://doi.org/10.1056/NEJM198708273170901.
Jones PR, Hunt MJ, Brown TP, Norgan NG. Waist-hip circumference ratio and its relation to age and overweight in British men. Human Nutrition. Clinical Nutrition. 1986;40(3): 239–247.
Salem M, Waissmann W. Desenvolvimento e validação de equações e índices para a determinação da gordura corporal relativa, em militares brasileiros, a partir de medidas antropométricas. [Thesis] 2008. https://www.arca.fiocruz.br/handle/icict/4549 [Accessed 6th October 2023].
Rêgo RC de A, Baptista MT, Salem M. EQUAÇÕES NACIONAIS PARA A ESTIMATIVA DA GORDURA CORPORAL DE MILITARES DO EXÉRCITO BRASILEIRO. Revista de Educação Física / Journal of Physical Education. 2008;77(140). https://doi.org/10.37310/ref.v77i140.326.
Valdez R, Seidell JC, Ahn YI, Weiss KM. A new index of abdominal adiposity as an indicator of risk for cardiovascular disease. A cross-population study. International Journal of Obesity and Related Metabolic Disorders: Journal of the International Association for the Study of Obesity. 1993;17(2): 77–82.
Kim SH, Choi H, Won CW, Kim BS. Optimal Cutoff Points of Anthropometric Parameters to Identify High Coronary Heart Disease Risk in Korean Adults. Journal of Korean Medical Science. 2016;31(1): 61–66. https://doi.org/10.3346/jkms.2016.31.1.61.
Anderson KM, Wilson PW, Odell PM, Kannel WB. An updated coronary risk profile. A statement for health professionals. Circulation. 1991;83(1): 356–362. https://doi.org/10.1161/01.cir.83.1.356.
Rodgers JL, Jones J, Bolleddu SI, Vanthenapalli S, Rodgers LE, Shah K, et al. Cardiovascular Risks Associated with Gender and Aging. Journal of Cardiovascular Development and Disease. 2019;6(2): 19. https://doi.org/10.3390/jcdd6020019.
Liu J, Tse LA, Liu Z, Rangarajan S, Hu B, Yin L, et al. Predictive Values of Anthropometric Measurements for Cardiometabolic Risk Factors and Cardiovascular Diseases Among 44 048 Chinese. Journal of the American Heart Association. 2019;8(16): e010870. https://doi.org/10.1161/JAHA.118.010870.
Held C, Hadziosmanovic N, Aylward PE, Hagström E, Hochman JS, Stewart RAH, et al. Body Mass Index and Association With Cardiovascular Outcomes in Patients With Stable Coronary Heart Disease – A STABILITY Substudy. Journal of the American Heart Association. 2022;11(3): e023667. https://doi.org/10.1161/JAHA.121.023667.
Gilani N, Kazemnejad A, Zayeri F, Hadaegh F, Azizi F, Khalili D. Anthropometric Indices as Predictors of Coronary Heart Disease Risk: Joint Modeling of Longitudinal Measurements and Time to Event. Iranian Journal of Public Health. 2017;46(11): 1546–1554.
Hozhabrnia A, Jambarsang S, Namayandeh SM. Cut-off values of obesity indices to predict coronary heart disease incidence by time-dependent receiver operating characteristic curve analysis in 10-year follow-up in study of Yazd Healthy Heart Cohort, Iran. ARYA atherosclerosis. 2022;18(3): 1–10. https://doi.org/10.48305/arya.2022.24262.
Jonnalagadda SS, Skinner R, Moore L. Overweight athlete: fact or fiction? Current Sports Medicine Reports. 2004;3(4): 198–205. https://doi.org/10.1249/00149619-200408000-00005.
Turocy PS, DePalma BF, Horswill CA, Laquale KM, Martin TJ, Perry AC, et al. National Athletic Trainers’ Association Position Statement: Safe Weight Loss and Maintenance Practices in Sport and Exercise. Journal of Athletic Training. 2011;46(3): 322–336.
Haun DR, Pitanga FJG, Lessa I. Razão cintura/estatura comparado a outros indicadores antropométricos de obesidade como preditor de risco coronariano elevado. Revista da Associação Médica Brasileira. 2009;55: 705–711. https://doi.org/10.1590/S0104-42302009000600015.
Siavash M, Sadeghi M, Salarifar F, Amini M, Shojaee-Moradie F. Comparison of body mass index and waist/height ratio in predicting definite coronary artery disease. Annals of Nutrition & Metabolism. 2008;53(3–4): 162–166. https://doi.org/10.1159/000172977.
Sabah KMN, Chowdhury AW, Khan HLR, Hasan AH, Haque S, Ali S, et al. Body mass index and waist/height ratio for prediction of severity of coronary artery disease. BMC Research Notes. 2014;7(1): 246. https://doi.org/10.1186/1756-0500-7-246.
Patil VC, Parale GP, Kulkarni PM, Patil HV. Relation of anthropometric variables to coronary artery disease risk factors. Indian Journal of Endocrinology and Metabolism. 2011;15(1): 31–37. https://doi.org/10.4103/2230-8210.77582.
Hsieh SD, Yoshinaga H, Muto T. Waist-to-height ratio, a simple and practical index for assessing central fat distribution and metabolic risk in Japanese men and women. International Journal of Obesity and Related Metabolic Disorders: Journal of the International Association for the Study of Obesity. 2003;27(5): 610–616. https://doi.org/10.1038/sj.ijo.0802259.
Rao G, Powell-Wiley TM, Ancheta I, Hairston K, Kirley K, Lear SA, et al. Identification of Obesity and Cardiovascular Risk in Ethnically and Racially Diverse Populations. Circulation. 2015;132(5): 457–472. https://doi.org/10.1161/CIR.0000000000000223.
Brindle P, Emberson J, Lampe F, Walker M, Whincup P, Fahey T, et al. Predictive accuracy of the Framingham coronary risk score in British men: prospective cohort study. BMJ (Clinical research ed.). 2003;327(7426): 1267. https://doi.org/10.1136/bmj.327.7426.1267.
Kjaergaard AD, Teumer A, Witte DR, Stanzick KJ, Winkler TW, Burgess S, et al. Obesity and Kidney Function: A Two-Sample Mendelian Randomization Study. Clinical Chemistry. 2022;68(3): 461–472. https://doi.org/10.1093/clinchem/hvab249.
Rao VN, Fudim M, Mentz RJ, Michos ED, Felker GM. Regional adiposity and heart failure with preserved ejection fraction. European Journal of Heart Failure. 2020;22(9): 1540–1550. https://doi.org/10.1002/ejhf.1956.
Arslan AA, Helzlsouer KJ, Kooperberg C, Shu XO, Steplowski E, Bueno-de-Mesquita HB, et al. Anthropometric measures, body mass index, and pancreatic cancer: a pooled analysis from the Pancreatic Cancer Cohort Consortium (PanScan). Archives of Internal Medicine. 2010;170(9): 791–802. https://doi.org/10.1001/archinternmed.2010.63.
Vedire Y, Kalvapudi S, Yendamuri S. Obesity and lung cancer-a narrative review. Journal of Thoracic Disease. 2023;15(5): 2806–2823. https://doi.org/10.21037/jtd-22-1835.
Brinton LA, Cook MB, McCormack V, Johnson KC, Olsson H, Casagrande JT, et al. Anthropometric and hormonal risk factors for male breast cancer: male breast cancer pooling project results. Journal of the National Cancer Institute. 2014;106(3): djt465. https://doi.org/10.1093/jnci/djt465.
Grassi G, Biffi A, Seravalle G, Trevano FQ, Dell’Oro R, Corrao G, et al. Sympathetic Neural Overdrive in the Obese and Overweight State. Hypertension (Dallas, Tex.: 1979). 2019;74(2): 349–358. https://doi.org/10.1161/Hypertensionaha.119.12885.
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