Avaliação da adiposidade abdominal e sua associação com as complicações crônicas cardiometabólicas em jovens adultos com excesso de peso

Abstract

Introduction: Overweight and obesity are a major public health problem, causing high financial and social costs, being relevant risk factors for the development of chronic noncommunicable diseases. Obesity, particularly abdominal, promotes changes in adipose tissue such as hypertrophy and dysfunctions in the secretory profile of adipocytes, responsible for the development of subclinical inflammation, and the appearance of chronic cardiometabolic complications. Objective: Evaluation of abdominal adiposity and its association with chronic cardiometabolic complications observed in young adults with excess weight. Methods: Cross-sectional epidemiological study, including overweight boys and girls, aged 16 to 30 years attending an outpatient clinic for obesity and hypertension. We analyzed the subcutaneous and visceral fat, hepatic and intima-media thickness (IMT) through ultrasound (US), anthropometric indicators body mass index (BMI), neck circumference (NC), waist circumference (WC), waist-hip ratio (WHR) and waist-to-height ratio (WHtR), laboratory tests, blood pressure measurement and risk of obstructive sleep apnea syndrome through the adjusted neck circumference (ANC). Insulin and fasting glycemia were used to calculate HOMA-IR and to evaluate insulin resistance (IR). We evaluated the association and correlation between visceral and subcutaneous abdominal adiposity with chronic cardiometabolic complications and anthropometric indicators with IR. Results: The anterior and posterior visceral adiposity had a significant association with BMI, current weight, systolic blood pressure, diastolic blood pressure, PPA, fat-free mass, insulin, HOMA-IR, left and right EIM, and hepatic steatosis. It was observed that the thickness of posterior visceral adiposity better identifies individuals with increased cardiometabolic risk. Subcutaneous abdominal adiposity was associated only with BMI, current weight, total body fat and hepatic steatosis. NC and WC, WHR and WHtR indices had a significant association with IR measured by HOMA-IR, and PP presented a better correlation when compared with other measures. Conclusion: Among the anthropometric indicators used, NC was the best predictor of IR. The thickness of adzominal visceral adiposity better identified individuals with cardiometabolic risk.