Parâmetros antropométricos e sua associação com função endotelial e parâmetros de rigidez arterial de indivíduos saudáveis eutróficos e com sobrepeso

Abstract

Vascular endothelial dysfunction and arterial stiffness caused by several risk factors, such as excess body weight, may directly contribute to the occurrence of cardiovascular events. Among the methods that can be used to evaluate body adiposity is anthropometry. It is noteworthy that it is not yet clear which anthropometric measurements and indices best correlate with endothelial function and arterial stiffness. The present study aims to investigate the association between anthropometric parameters, endothelial function and arterial stiffness in normal-weight and overweight adult individuals. A cross-sectional study was conducted with individuals of both sexes, with body mass index (BMI) between 18.5 kg / m² and <30 kg / m², aged between 25 and 59 years and with low to intermediate cardiovascular risk. Data collection took place between February and July 2019 at the Heart Institute of Santa Maria / RS. Sociodemographic data (gender, age, marital status, profession, self-reported race and education) were collected through a structured questionnaire. The anthropometric variables evaluated were: body weight, height, waist circumference (WC), neck (NC), hip circumference (HC) and sagittal abdominal diameter (SAD). After these evaluations, BMI, waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) were calculated. Laboratory tests included lipid profile and nitric oxide dosage. Endothelial function was measured using the flow-mediated dilatation technique (FMD) by ultrasound and arterial stiffness (pulse wave velocity –PWV and augmentation index - AIx@75) using the oscillometric method. Thirty-six individuals were evaluated, 18 eutrophic and 18 overweight, with a mean age of 37.5 ± 10.2 years, mostly with low cardiovascular risk (86.1%), female (80.6%), single (52.8%), employees with a formal contract (44.4%) and with more than twelve years of schooling (88.9%). All anthropometric parameters were significantly higher in overweight individuals when compared to normal weight subjects, except for the waist-hip ratio (p=0.200). Regarding the laboratory tests evaluated, only LDL was higher in the overweight group (P=0.047). There was no statistical difference between the groups regarding PWV (P=0.070), AIx@75 (P=0.845) and % FDM (P=0.348). PWV showed a moderate correlation with WC (r=0.584, P=0.000), WHR (r=0.513, P=0.001) and WHtR (r =0.590, P=0.000), and low with NC (r=0.372, P=0.013) and SAD (r = 0.356, P = 0.033). Moreover, no anthropometric parameter correlated with Alx @ 75 and %FMD in the total sample. When analyzed by groups, we found that in normal-weight subjects, body weight (r =-0.622, P=0.006), WC (r=-0.630, P=0.005) and SAD (r=-0.488, P=0.040) were inversely associated with AIx@75, and weight (r=-0.488, P=0.045) inversely with %FMD. In overweight individuals, there was a positive, moderate correlation of WC (r=0.533, P=0.022), WHR (r=0.593, P=0.009) and WHtR (r=0.470, P=0.049) with PWV. Thus, this study confirms the importance of using simple anthropometric measurements in clinical practice, as another tool to identify individuals at cardiovascular risk.