Proposição de instrumentos de avaliação e critérios para triagem de fatores de risco cardiometabólico em adultos com excesso de peso

Abstract

People who are overweight or obese have more risk factors for developing cardiometabolic diseases. However, these factors present different degrees of cardiovascular risk depending on the metabolic profile. Considering the limitations and scarcity of specific assessment instruments and criteria in this context, the objectives of the present study are: 1) to develop and cross-validate two equations to estimate Fat Free Mass by bioimpedance analysis: one for the group of people with overweight or obesity (GSO) and another, for the group of people with obesity only (GO). 2) determine cut-off points for indices with anthropometric and biochemical parameters (IABP) for screening cardiometabolic risk factors (CMR) for the same population; 2) For objective 1, 305 people (134 women) were divided into two groups: development (n=206) and cross-validation (n=99); and for objective 2, the sample consisted of 330 subjects (192 women). For the study, DXA was used as a standard body composition technique, the tetrapolar monofrequency Bioelectrical Impedance Analysis (BIA) as equipment for using the equations, and the Visceral Adiposity Index (VAI), the Cardiometabolic Index (ICM) and the Triglycerides-Glucose Index (ITG) as IABP. To develop and validate the equations, the Paired t-test, multiple regression and Bland-Altman plot were used. To determine cutoff points, the ROC curve was plotted based on sensitivity and specificity, in addition to identifying the area under the AUC curve. Diagnostic agreement was calculated using Kappa analysis. The equation for GSO presented a correlation coefficient of agreement (CCC)=0.971; r2=0.94; standard error of estimate (SPE)=2.69kg; limits of agreement (LOA)=-4.4 to 4.3; and 2) and the equation for GO presented CCC=0.965; r2=0.93; EPE=2.27kg; LOA=-5.5 to 4.7. Women had the following cutoff points: IAV>4.11 (AUC=0.894), ITG>3.64 (AUC=0.858) and ICM>1.02 (AUC=0.912) and men: IAV>2.75 (AUC = 0.918), ITG>3.8 (AUC=0.888) and ICM>1.66 (AUC=0.923). When comparing the new models and the standard technique, there was no difference in the FFM value (p>0.05). The two derived equations are valid options for estimating the FFM of people with the characteristics of the studied sample, just as all IABP showed good results for screening RCM factors.