Estudo dos fatores de risco nutricionais, cl?nicos, bioqu?micos e comportamentais para as doen?as cardiovasculares na popula??o do ensino fundamental de Ouro Preto, Minas Gerais, Brasil, 2006.

As doen?as cardiovasculares (DCV) representam a principal causa de morbidade e mortalidade. Os fatores de risco cardiovasculares, tais como, hipertens?o arterial, a obesidade, a dislipidemia, o sedentarismo e o diabetes mellitus iniciam-se j? na inf?ncia. O objetivo principal do projeto foi identificar precocemente os riscos cardiovasculares na popula??o estudada e estabelecer pontos de corte de medidas antropom?tricas que auxiliem a triagem nutricional. Estudo epidemiol?gico transversal de base populacional escolar foi realizado com indiv?duos de 6 a 14 anos de idade. Uma amostra de 850 estudantes foi selecionada por processo aleat?rio simples estratificado pela propor??o de escolares de acordo com o sexo, idade e n?mero de alunos em cada escola. As seguintes vari?veis foram inclu?das: demogr?ficas (sexo, idade), bioqu?micas (colesterol total, HDL-c, LDL-c, triglic?rides, glicose), cl?nica (press?o arterial), antropom?tricas (IMC, circunfer?ncia de cintura, percentual de gordura corporal pelas dobras cut?neas e pela imped?ncia bioel?trica bipolar e tetrapolar), est?gio puberal, peso ao nascer, atividade f?sica, comportamento sedent?rio, socioecon?mica (renda familiar) e hist?ria familiar (IMC e press?o arterial). A amostra foi composta de 47,6% meninos e 52,4% meninas. Observamos que 8,2% e 6,7% dos estudantes eram sobrepeso e obesos, respectivamente. Na avalia??o bioqu?mica, foi observado que 23,7% dos alunos apresentam n?veis lim?trofes de colesterol, e 36,9% aumentados. 18,6% apresentaram n?veis baixos de HDL, enquanto 24% apresentam n?veis lim?trofes e 5,8% n?veis aumentados de LDL. Em rela??o aos triglic?rides, 7,5% dos alunos apresentaram n?veis elevados, sendo que 83% est?o normais. N?o foi observada altera??o nos n?veis de glicose de jejum. Observamos que 1,2% dos alunos eram pr?-hipertensos, 1,2% eram hipertensos n?vel 1 e 1,5% hipertensos n?vel 2. Na an?lise da curva ROC, verificamos que a imped?ncia bioel?rica bipolar assim como o IMC s?o m?todos de escolha para a triagem de adiposidade na popula??o analisada e que a escolha dos m?todos deve ser de acordo com o est?dio de matura??o sexual. Observamos uma associa??o de risco entre obesidade e IMC dos pais e entre as vari?veis bioqu?micas. Em rela??o a press?o arterial, observamos uma associa??o de risco com o IMC e o peso ao nascer. Observamos que 44,4% dos escolares estavam expostos a 2-3 fatores de risco e 8,2% a 4-6 fatores de risco cardiovasculares. Conclu?mos que a popula??o analisada apresenta fatores de risco precoces, tais como excesso de peso, hipercolesterolemia, hipertens?o arterial, sedentarismo, al?m de uma associa??o entre eles. Os pontos de corte estabelecidos podem auxiliar na detec??o de adiposidade e dos riscos futuros para as doen?as cardiovasculares.Cardiovascular diseases (CVD) are the main cause of morbidity and mortality. Cardiovascular risk factors, such as, arterial hypertension, obesity, dyslipidemia, sedentary life stile and diabetes mellitus already begin in childhood. This study aims to identify risk factors for cardiovascular disorders in schoolchildren living in Ouro Preto City and to establish cutoff for anthropometrics measures for nutricional screening. A cross-sectional study was carried out in a population-based sampling of schoolchildren (6?14 years old). A sample of 850 students was randomly selected and stratified by the proportion of them according age and gender in each schools of the city. The following variables were included: demographic (sex, age), biochemical [levels of total cholesterol, high density lipoprotein-cholesterol (HDL-c), low density lipoprotein-cholesterol (LDL-c), triglyceride, glucose], clinical (arterial blood pressure), anthropometric [body mass index (BMI), waist circumference, body fat estimated for skinfold thickness and bipolar and tetrapolar bioelectrical impedance], pubertal stage, birth weight, physical activity, sedentary behavior, socioeconomic status (family income) and family history (BMI and arterial blood pressure). Total sample was composed of 47.6% boys and 52.4% girls. We observed that 8.2% and 6.7% schoolchildren were overweight and obese, respectively. In biochemical evaluation, was observed that 23.7% of schoolchildren present borderline levels of cholesterol, and 36.9% increased. 18.6% presented low levels of HDL, while 24% present borderline and 5.8% increased levels of LDL. In relation to triglycerides, 7.5% presented high levels, and 83% are normal. Alteration was not observed in fasting glucose. The prevalence of prehypertension was 1.2% and hypertension level 1 and 2 were 1.2% and 1.5%, respectively. In the curve ROC analysis, verified that BIA-FF as BMI are the methods for obesity screening in population. The method choice for body fat screening must be done according to sexual maturity. We observed obesity risk was greater in subjects presenting high triglyceride and low HDL-c levels, and those whose parents were obese, whilst the risk of hypertension was high in obese subjects and those who presented low birth weight. It was observed that 44.4% of the schoolchildren were exposed to 2 or 3 CVD risk factors and 8.2% were exposed to 4 or 6 factors. We concluded that population presents precocious risk factors, such as overweight, hypercholesterolemia, arterial hypertension, sedentary, besides an association among them. The cut-off established can to help in the adiposity detection in order to reduce the probability of the development of CVD in adult life