Perfil nutricional e metabólico de adultos do povo Kawaiwete (Kaiabi) da aldeia Kwarujá, Parque Indígena do Xingu, Brasil
Data
2017-04-28
Autores
Haquim, Vanessa Moreira 
Orientadores
Franco, Maria do Carmo Pinho
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Introdução: As doenças metabólicas têm sido uma das principais causas de morbimortalidade em países desenvolvidos e em desenvolvimento. No entanto, ainda são escassos os estudos que avaliam a ocorrência de doenças como diabetes tipo II, hipertensão, dislipidemias e outras desordens metabólicas associadas à obesidade no campo da saúde indígena. O número crescente do surgimento dessas doenças torna-se motivo de preocupação na medida em que eles indicam uma nova realidade entre os povos indígenas. Objetivo: Avaliar o perfil nutricional e metabólico de adultos indígenas do povo Kawaiwete que habitam a aldeia Kwarujá do Parque Indígena do Xingu no ano de 2013. Métodos: Trata-se de um estudo do tipo transversal, de base populacional, realizado a partir de dados secundários disponibilizados pelo Distrito Sanitário Especial Indígena Xingu (Mato Grosso - Brasil), e de banco de dados obtido por meio de fichas médicas e relatórios técnicos disponibilizados pelo Projeto Xingu, programa de extensão da Universidade Federal de São Paulo. Foram avaliados 62 indígenas (33 mulheres e 29 homens) maiores de 19 anos da etnia Kawaiwete no ano de 2013. Para o estudo atual foram analisadas as frequências de estado nutricional, composição corporal (por meio do aparelho de impedância bioelétrica modelo tetrapolar) e fatores de risco cardiometabólicos. A síndrome metabólica foi determinada pela presença de pelo menos três dos seguintes componentes: obesidade central, níveis pressóricos elevados, hipertrigliceridemia, baixo HDL-colesterol e intolerância à glicose. Para a análise estatística, utilizou-se o programa SPSS® (versão 22). Resultados: Do total dos 62 indígenas avaliados identificou-se em 25,8% a presença de síndrome metabólica. Em relação ao perfil nutricional e de fatores de risco cardiometabólicos, 35,5% apresentaramsobrepeso, 4,8% obesidade, 24,2% níveis pressóricos elevados, 25,8% pré-diabetes, 29,0% LDL-c elevado, 67,7% HDL-c reduzido e 17,7% hipertrigliceridemia. Em comparação aos homens, as mulheres apresentaram pior perfil cardiometabólico no que se refere à presença de obesidade central (31,0% vs.81,8%, p=<0,001), tolerância à glicose diminuída (4,8% vs.17,7%, p=0,031), LDL-colesterol elevado (13,8% vs. 42,4%, p=0,013) e à média do percentual de massa adiposa (16,5±6,1 vs. 26,7±6,3, p=<0,001). Apesar de não haver diferença estatisticamente significativa, as mulheres apresentaram 33,3% de síndrome metabólica, enquanto os homens apresentaram 17,2%. Os resultados mostraram que todos os indígenas que possuíam a síndrome apresentaram obesidade central, porém nem todos tinham IMC elevado, portanto, a medida da circunferência abdominal se apresentou um melhor parâmetro do que o índice de massa corporal (IMC) para identificar o perfil de risco cardiometabólico nessa população. Observou-se que, entre os indígenas, o IMC, a circunferência abdominal e o percentual de massa adiposa também se associaram de forma direta com a presença síndrome metabólica, enquanto que o percentual de massa muscular de forma indireta. Na análise de regressão múltipla, essas variáveis persistiram correlacionadas de forma independente de sexo e idade com a síndrome metabólica. Conclusão: O presente estudo possibilitou a identificação de uma população que se encontra com um risco cardiometabólico elevado, sendo o sexo feminino o grupo mais comprometido. Esforços devem ser empreendidos no sentido de compreender melhor os determinantes dessa situação de saúde e de controlar os fatores de risco para esta população.
Introduction: Metabolic diseases have been a major cause of morbidity and mortality in developed and developing countries. However, there are still few studies that evaluate the occurrence of diseases such as type II diabetes, hypertension, dyslipidemias and other metabolic disorders associated with obesity in the field of indigenous health. The increasing number of these diseases becomes a source of concern as they indicate a new reality among indigenous peoples. Objective: To evaluate the nutritional and metabolic profile of indigenous adults of the Kawaiwete people living in the Kwarujá village of the Xingu Indigenous Park in the year 2013. Methods: This is a cross-sectional, population-based study based on secondary data provided by the Xingu Indigenous Special Sanitary District (Mato Grosso, Brazil), and a database obtained through medical records and technical reports made available by the Xingu Project, an extension program of the Federal University of São Paulo. A total of 62 indigenous women (33 women and 29 men) over the age of 19 years of the Kawaiwete ethnic group were evaluated in the year of 2013. The present study analyzed the frequencies of nutritional status, body composition (using the four-phase model bioelectrical impedance device) and cardiometabolic risk factors. The metabolic syndrome was determined by the presence of at least three of the following components: central obesity, high blood pressure levels, hypertriglyceridemia, low HDL-cholesterol, and glucose intolerance. For the statistical analysis, the SPSS® program (version 22) was used. Results: Of the total of 62 natives evaluated, it was identified that 25.8% had presence of metabolic syndrome. In relation to the nutritional profile and cardiometabolic risk factors, 35.5% presented overweight, 4.8% obesity, 24.2% high blood pressure levels, 25.8% pre-diabetes, 29.0% high LDL-c, 67.7% reduced HDL-c and 17.7% hypertriglyceridemia. Compared to men, women had a worse cardiometabolic profile in relation to the presence of central obesity (31.0% vs 81.8%, p <0.001), decreased glucose tolerance (4.8% vs 17.7%, p <0.01), high LDL-cholesterol (13.8% vs. 42.4%, p 0.013) and the mean percentage of adipose mass (16.5±6.1vs.26.7±6.3, p < 0.001). Although there was no statistically significant difference, women presented 33.3% of metabolic syndrome, while men presented 17.2%. It was identified that all the natives that had the syndrome presented central obesity, but not all had a high BMI, therefore, the measurement of the abdominal circumference presented a better parameter than the body mass index (BMI) to identify the cardiometabolic risk profile in this population. It was observed that, among the natives, the BMI, abdominal circumference and percentage of adipose mass were also directly associated with the metabolic syndrome presence, while the percentage of muscle mass was indirect. In the multiple regression analysis, these variables persisted correlated independently of gender and age with the metabolic syndrome. Conclusion: The present study made it possible to identify a population that has a high cardiometabolic risk, the female being the most compromised group. Efforts should be made to better understand the determinants of this health situation and to control the risk factors for this population.
Introduction: Metabolic diseases have been a major cause of morbidity and mortality in developed and developing countries. However, there are still few studies that evaluate the occurrence of diseases such as type II diabetes, hypertension, dyslipidemias and other metabolic disorders associated with obesity in the field of indigenous health. The increasing number of these diseases becomes a source of concern as they indicate a new reality among indigenous peoples. Objective: To evaluate the nutritional and metabolic profile of indigenous adults of the Kawaiwete people living in the Kwarujá village of the Xingu Indigenous Park in the year 2013. Methods: This is a cross-sectional, population-based study based on secondary data provided by the Xingu Indigenous Special Sanitary District (Mato Grosso, Brazil), and a database obtained through medical records and technical reports made available by the Xingu Project, an extension program of the Federal University of São Paulo. A total of 62 indigenous women (33 women and 29 men) over the age of 19 years of the Kawaiwete ethnic group were evaluated in the year of 2013. The present study analyzed the frequencies of nutritional status, body composition (using the four-phase model bioelectrical impedance device) and cardiometabolic risk factors. The metabolic syndrome was determined by the presence of at least three of the following components: central obesity, high blood pressure levels, hypertriglyceridemia, low HDL-cholesterol, and glucose intolerance. For the statistical analysis, the SPSS® program (version 22) was used. Results: Of the total of 62 natives evaluated, it was identified that 25.8% had presence of metabolic syndrome. In relation to the nutritional profile and cardiometabolic risk factors, 35.5% presented overweight, 4.8% obesity, 24.2% high blood pressure levels, 25.8% pre-diabetes, 29.0% high LDL-c, 67.7% reduced HDL-c and 17.7% hypertriglyceridemia. Compared to men, women had a worse cardiometabolic profile in relation to the presence of central obesity (31.0% vs 81.8%, p <0.001), decreased glucose tolerance (4.8% vs 17.7%, p <0.01), high LDL-cholesterol (13.8% vs. 42.4%, p 0.013) and the mean percentage of adipose mass (16.5±6.1vs.26.7±6.3, p < 0.001). Although there was no statistically significant difference, women presented 33.3% of metabolic syndrome, while men presented 17.2%. It was identified that all the natives that had the syndrome presented central obesity, but not all had a high BMI, therefore, the measurement of the abdominal circumference presented a better parameter than the body mass index (BMI) to identify the cardiometabolic risk profile in this population. It was observed that, among the natives, the BMI, abdominal circumference and percentage of adipose mass were also directly associated with the metabolic syndrome presence, while the percentage of muscle mass was indirect. In the multiple regression analysis, these variables persisted correlated independently of gender and age with the metabolic syndrome. Conclusion: The present study made it possible to identify a population that has a high cardiometabolic risk, the female being the most compromised group. Efforts should be made to better understand the determinants of this health situation and to control the risk factors for this population.
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Citação
HAQUIM, Vanessa Moreira. Perfil nutricional e metabólico de adultos do povo Kawaiwete (Kaiabi) da aldeia Kwarujá, Parque Indígena do Xingu, Brasil. São Paulo, 2017. [114] p. Dissertação (Mestrado em Medicina translacional) - Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, 2017.