Síndrome Metabólica e a associação de fatores de risco cardiovascular em profissionais de Enfermagem da atenção especializada de Manaus

Abstract

Introduction: Metabolic Syndrome (MS) represents a group of cardiovascular risk factors that include abdominal obesity, combined with high blood pressure, fasting blood glucose and triglycerides, and lowering HDL-Cholesterol level. Brazil has varied prevalence in addition to attributing worsening in the quality of life of individuals and being associated with illness due to cardiovascular disease. Objective: To estimate the prevalence of metabolic syndrome and its association with cardiovascular risk factors in nursing professionals working in two specialized care units. Methods: Cross-sectional study with 394 nursing professionals from two specialized care units in Manaus, Amazonas. The data collection period was performed from January to March 2020 in the first unit and in the second unit from January to September 2020. The criteria of the National Cholesterol Education Program's Adult Treatment Panel III (NCEP-ATP III) for the diagnosis of metabolic syndrome were adopted, as presented in the I Brazilian Guideline for diagnosis and treatment of metabolic syndrome (2005). The participants were characterized in relation to socioeconomic variables related to work, lifestyle (with variables on alcohol consumption, smoking, physical activity, sleep quality, in addition to eating habits during the shift), self-assessment of health status, family history. Anthropometric parameters measured the circumferences: neck, waist, abdominal, height. The ratio of hip waist, taint index and body mass index was calculated. From bioimpedance, the percentage of body fat and visceral fat was evaluated. The measurements of blood pressure levels met the recommendations of the VII Brazilian Guidelines on Hypertension, the digital automatic arm-of-arm device was used, validated and calibrated. Three pressure measurements were performed with the adoption of the mean value of the last two measurements. Serum lipid and blood glucose levels were performed by laboratory analysis in the laboratories of the respective health units involved in the study. Participants were recommended to perform caloric fasting before blood collection of at least 8 hours and a maximum of 12 hours. This study also had five subprojects linked to the Scientific Initiation Program (PIBIC 2019/2020) of the Federal University of Amazonas (UFAM), a pilot study was also conducted with 15 nursing professionals from an emergency care unit in Manaus that allowed the evaluation of the average time of data collection for each participant and mainly to verify the understanding of the professionals to the questions contained in the data collection instrument. Data analyses were performed in the R Development Core Team (2009) program. Categorical variables were presented in tables containing absolute (n) and relative (%), and continuous variables on average and standard deviation. The continuous variables were compared by the Student's T-test and the categorical variables with Pearson's Chi-square test, the p≤0.05 value was adopted. The associations of the variables with metabolic syndrome were estimated by odds ratio (OR) obtained by logistic regression with bivariate variance, with respective 95% confidence intervals. The research was approved by the Research Ethics Committee of the Federal University of Amazonas, with the number of Opinion NO 3,739,664. All the prerogatives of Resolution of the National Health Council nº 466/2012 were respected. Results: Of the 394 professionals, there were two losses due to the non-retest of HDL-Cholesterol serum analysis, so the prevalence of metabolic syndrome in the 392 nursing professionals was 20.1%. Among the five components of MS, established by NCEP-ATP III, it was evidenced that increased triglyceride levels were prevalent in all professionals, followed by the high prevalence of low HDL-Cholesterol (92.4%), increased abdominal circumference (75.9%), changes in blood pressure levels (45.6%) and change in serum blood glucose levels (26.6%). Among the variables associated with metabolic syndrome, we highlight: age [OR=1.06 (95% CI 1.03-1.09); p<0.001]; number of children [OR=1.27 (95% CI 1.06-1.53); p=0.012]; to be a nursing assistant [OR=3.40 (95% CI 1.28-9.18); p=0.014]; being a smoker [OR=3.42 (95% CI 1.18-9.52); p=0.019];neck circumference increased [OR=2.63 (95% CI 1.50-4.82); p=0.001];increased waist ratio [OR=3.38 (95% CI 2.04 -5.66); p<0.001];increased taper index [OR=2.98 (95% CI 1.78-5.14); p<0.001];overweight [OR=6.68 (95% CI 2.31-28.37); p=0.002]; obesity grade II [OR=12.31 (95% CI 3.62-56.98); p<0.001]; high visceral fat [OR=3.01 (95% CI 1.76-5.14); p<0.001]; pre-hypertension [OR=2.31 (95% CI 1.12-4.59); p=0.020]; hypertension [OR=3.24 (95% CI 1.74-6.00); p<0.001];pre-diabetes [OR=1.96 (95% CI 1.03 -3.60); p=0.035]; diabetes [OR=11.88 (95% CI 4.74-32.62) p<0.001]; increased total cholesterol [OR=2.51 (95% CI 1.48-4.38); p=0.001];self-reported personal history of cardiovascular disease [OR=2.74 (95% CI 1.65-4.59); p<0.001]; diabetes [OR=3.32 (95% CI 1.47-7.33); p=0.003]; dyslipidemia [OR=3.07 (95% CI 1.78-5.28); p<0.001];hypertension[OR=2.47 (95% CI 1.34-4.47); p=0.003]. Conclusion: The prevalence of metabolic syndrome was high. This is the first study that evaluated metabolic syndrome and the association of cardiovascular risk factors in nursing professionals working in a specialized care unit in Manaus, Amazonas.