Transição de obesidade metabolicamente saudável para obesidade não saudável em adultos do ELSA Brasil : uma análise longitudinal
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Data
2024-07-23
Autores
Mendes, Fernanda Duarte
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Universidade Federal do Espírito Santo
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This is a longitudinal study with baseline data (2008/10) and wave 3 (2017/19) from the Longitudinal Study of Adult Health (ELSA-Brasil). The objective is to describe the trajectory of metabolic status in individuals with obesity and the factors associated with the transition to an unhealthy status. Metabolic status was determined using blood pressure, fasting glucose and/or hemoglobin A1c, triglycerides, and HDL cholesterol. Individuals should not have a prior diagnosis of any alterations in these parameters or be taking medication to control them. If any parameter is altered, it is considered metabolically unhealthy obesity (ObMNS); otherwise, it is classified as metabolically healthy obesity (ObMS). Dietary intake was classified according to the degree of food processing, based on the NOVA classification. Physical activity was measured using the International Physical Activity Questionnaire (IPAQ). Sociodemographic variables were collected through a standardized questionnaire, with interviews conducted at each ELSA-Brasil center. For statistical analyses, the Student's t-test and/or Mann-Whitney test were used for continuous variables, and the chi-square or Fisher's exact test for categorical variables. SPSS software version 21.0 was used, with a significance level of 5%. Among the 190 ObMS participants included at baseline, 75.8% transitioned to ObMNS status after an average follow-up of 7.7 years. Alcohol use was considered a risk factor for the transition of metabolic status [RR: 1.359 (95% CI: 1.005 - 1.838)]. Additionally, each 1 cm increase in waist circumference (WC) contributed to a 1% increase in the risk of transitioning from healthy to unhealthy metabolic status [RR: 1.011 (95% CI: 1.004 - 1.018)]. It can be concluded that metabolic health is transient, as most participants transitioned from ObMS to ObMNS. Alcohol consumption was associated with a higher risk of metabolic status deterioration. Furthermore, the accumulation of visceral fat appears to influence the risk of changes in metabolic status. Therefore, it is emphasized that classifying individuals with obesity is important to identify metabolic status and the presence of risk factors for losing a healthy status
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Obesidade