Associa??o entre leuc?citos, prote?na C reativa e componentes da s?ndrome metab?lica em adolescentes.

A obesidade, um grave problema de sa?de p?blica, em todo o mundo, vem atingindo as variadas faixas et?rias, inclusive a pedi?trica. O dist?rbio ? associado a um conjunto de doen?as, tais como hipertens?o arterial, dislipidemia aterog?nica e diabetes mellitus do tipo 2, que comp?em a S?ndrome Metab?lica (SM). A presen?a de SM na idade pedi?trica, em decorr?ncia dos m?ltiplos fatores de risco cardiovascular que a comp?em, est? associada a um maior risco de manifesta??es prematuras no adulto. Recentemente v?rios estudos t?m apresentado evid?ncias de que al?m do estresse metab?lico (caracterizado por anormalidades no metabolismo de lip?dios e de glicose), o estresse inflamat?rio constitui importante mecanismo patog?nico da SM. No entanto poucos estudos t?m explorado esta rela??o em adolescentes. Em vista disso, este estudo foi desenvolvido com o objetivo de avaliar a preval?ncia dos componentes da SM e sua associa??o com a prote?na C reativa (PCR) e leuc?citos em adolescentes de 11 a 15 anos de idade, matriculados em escolas privadas e p?blicas do munic?pio de Alegre, Esp?rito Santo. Dos volunt?rios do estudo foram obtidos os seguintes dados: idade, sexo, peso, altura (para c?lculo do ?ndice de massa corporal, circunfer?ncia da cintura, percentual de gordura corporal), hemograma completo (s?rie branca e s?rie vermelha), lipidograma, glicemia de jejum, insulinemia, PCR e press?o arterial. Para caracterizar a SM foram utilizados os pontos de corte e os fatores de risco preconizados pela I Diretriz de Preven??o da Aterosclerose na Inf?ncia e Adolesc?ncia da Sociedade Brasileira de Cardiologia. A amostra foi composta por 524 adolescentes, sendo 247 do g?nero masculino e 277 do g?nero feminino. A idade m?dia foi 13 anos. O excesso de peso estava presente em 29,6% dos adolescentes e 25,7% apresentavam circunfer?ncia da cintura aumentada. Na avalia??o bioqu?mica, 27,2% dos adolescentes apresentavam-se com hipercolesterolemia, 21,8% com hipertrigliceridemia, 49,5% com concentra??es diminu?das de colesterol HDL, 18,7% com colesterol LDL elevado, 14,2% com hiperglicemia, 15,1% com hiperinsulinemia e 12,0% dos adolescentes com concentra??es de PCR consideradas de alto risco. Adolescentes com maiores concentra??es de triacilglicer?is, circunfer?ncia da cintura e percentual de gordura corporal apresentaram maiores m?dias para as popula??es de leuc?citos e linf?citos. A presen?a da SM foi verificada em 16%, a resist?ncia ? insulina em 12,9% e mais de 49% dos adolescentes apresentaram pelo menos 2 componentes da SM. A hipertens?o foi observada em 6,5%. Foi encontrada uma associa??o positiva significativa entre concentra??es de PCR e press?o arterial sist?lica, glicose e colesterol HDL, independentemente da idade, da composi??o corporal e do IMC. A ?nica vari?vel associada significativamente aos leuc?citos foi o percentual de gordura corporal. Conclui-se que a popula??o estudada apresenta alta preval?ncia de fatores de risco cl?ssicos para as doen?as cardiovasculares, para o diabetes do tipo 2 e para a S?ndrome Metab?lica.Obesity, a serious public health problem, widely found around the world, has been affecting various age groups, including children. The disorder is associated with a set of diseases such as hypertension, atherogenic dyslipidemia, and diabetes mellitus type 2, comprising the Metabolic Syndrome (MS). The presence of MS in the pediatric age, as a result of multiple cardiovascular risk factors that comprise it, is associated with an increased risk of premature manifestations in adults. Recently, several studies have presented evidence that in addition to metabolic stress (characterized by abnormalities in lipid and glucose metabolism), the inflammatory stress is an important pathogenic mechanism of MS. However few studies have explored this relationship in adolescents. This study was developed to evaluate the prevalence of MS components and their association with C-reactive protein (CRP) and leukocytes in adolescents from 11 to 15 years old, enrolled in private and public schools in the municipality of Alegre, Esp?rito Santo. From the volunteers were obtained the following data: age, sex, weight, height (to calculate body mass index), waist circumference, body fat percentage, complete blood count, lipid profile, fasting glucose, insulin, CRP and blood pressure. No specific criterion was used to characterize the MS, but the cutoffs and the risk factors recommended by the I Guidelines for the Prevention of Atherosclerosis in Children and Adolescents of the Brazilian Society of Cardiology. The sample consisted of 524 adolescents, 247 males and 277 females. The mean age was 13 years. Overweight was present in 29.6% of adolescents and 25.7% had increased waist circumference. In biochemical analyzes, we found 27,2% adolescents with hypercholesterolemia, 21,8% with hypertriglyceridemia, 49,5% with decreased serum concentrations of HDL cholesterol, 18,7% with elevated LDL cholesterol, 14,2% with hyperglycemia, 15,1% with hyperinsulinemia and 12.0% of adolescents with CRP concentrations considered as high risk. Adolescents with higher concentrations of triglycerides, waist circumference and percentage body fat had higher average values for leukocytes. MS was observed in 16%, insulin resistance in 12.9% and over 49% of adolescents had at least two components of MS. The hypertension was observed at 6.5%. A positively and significant association between CRP and systolic blood pressure, glucose and HDL cholesterol, independent of age, body composition and BMI was observed. Only body fat percentage was significantly associated with leukocytes. We conclude that the studied population has a high prevalence of classic risk factors for cardiovascular disease, for type 2 diabetes and the metabolic syndrome