Estado menopáusico e síndrome metabólica em mulheres no climatério atendidas em um ambulatório no sul do Brasil

AUTOR(ES)
FONTE

IBICT - Instituto Brasileiro de Informação em Ciência e Tecnologia

DATA DE PUBLICAÇÃO

2012

RESUMO

Metabolic syndrome (MetS) is a complex disorder represented by a cluster of cardiovascular risk factors. Menopausal transition may be a key factor in the increase of prevalence of MetS.A cross-sectional study was conducted with 551 women from 40 to 65 years treated at a clinic in southern Brazil. Hysterectomized women and women who were submitted to hormone replacement therapy were excluded from the study. The review article aimed to evaluate, through a systematic review, the prevalence of MetS and its components in the menopausal transition. Based on the studies analyzed, the MetS prevalence increases when comparing pre- and post menopausal periods, regardless of the population and study design. The highest evidences were found in a population-based, cross-sectional study when compared to crosssectional studies performed at a clinic. Regarding to the components, the change was more significant for WC and BP measurements. It is suggested that these components may be those which have more influence on the prevalence of MetS. The original article I aimed to understand the relationship between menopausal status and the presence of Metabolic Syndrome in women from 40 to 65 years, as well as to describe the distribution of each component of Metabolic Syndrome according to menopausal status.. The prevalence of Metabolic Syndrome in the sample was 56.1% (CI95% 51.9 to 60.2), being more common among older women (56 to 65 years), with low education, menarche <11 years old, with three or more pregnancies and in the postmenopausal period. Regarding the analysis of isolated components in the sample, the most prevalent altered components were: hypertension (84.8%; CI95%: 81.7 to 87.8), waist circumference (66.4%; CI95%: 62.5 to 70.4) and HDL cholesterol (51.7%; CI95%: 47.5 to 55.9). In multivariate analysis, there was an increase of prevalence ratios when comparing perimenopause and post-menopause with pre-menopause; however, the confidence intervals include the unit. The original article II aimed to verify the association of LAP index with socioeconomic, demographic, reproductive and quality of life characteristics, to investigate its relation with menopausal status, as well as to assess the LAP as a tracker of diabetes mellitus and metabolic syndrome. Metabolic syndrome was assessed according to NCEP-ATPIII¿s (National Cholesterol Education Program s Adult Treatment Panel III) criteria. Women with fasting glucose above 100 mg/dl / presence of Diabetes Mellitus were also evaluated separately. LAP mean was 61.31 cm.mmol/L (CI95% 59.9 to 64.7). Ages from 56 to 65 years, three or more pregnancies and being former smoker was positively associated with increased LAP, even after adjustment in the multivariate models. The prevalence of high LAP (¿34.5 cm.mmol/L) was 71.3% (IC95%: 67.6 to 75.1). Women with high LAP had 4.6 times more likely to develop MetS (IC95% 3.2 to 6.6) and 2.4 times more likely to have high glucose or presence of DM (IC95% 1.6 to 7.4) compared with women with LAP <34.5 cm.mmol/L. Data from the present study demonstrate that, in addition to blood pressure and waist circumference, the change in blood glucose and serum triglycerides play an important role in increasing Metabolic Syndrome during climacteric. It was also possible to notice that LAP can be a new alternative to predict cardiometabolic risk, since besides the waist circumference measurement, it includes triglyceride measurement, which in women appears to represent an increased risk for cardiovascular mortality, regardless of other lipid fractions.

ASSUNTO(S)

síndrome x metabólica climatério menopausa saúde da mulher

ACESSO AO ARTIGO

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