Prevalência do fenótipo cintura hipertrigliceridêmica e fatores associados em agentes comunitários de saúde

Abstract

Growing evidence suggests that the combination of altered waist circumference and triglycerides would detect the presence of the atherogenic metabolic triad in individuals and, consequently, could be used as a cardiovascular risk variable. In this way, the hypertriglyceridemic waist phenotype can make the cardiovascular risk assessment of community health agents a practical, viable, lower-cost approach, especially in primary care in the country's health services. The study aimed to estimate the prevalence of the hypertriglyceridemic waist phenotype in community health workers and identify associated factors. This is a cross-sectional, quantitative, and analytical study carried out with community health agents working in the 135 units of the Family Health Strategy in the municipality of Montes Claros-MG, between August and October 2018. The evaluation of the hypertriglyceridemic waist phenotype was considered from the measurements of the participants' waist circumference and triglycerides. Lifestyle was assessed using the “Fantastic Lifestyle” questionnaires and the International Physical Activity Questionnaire. Sociodemographic variables of training and occupation, self-assessment of health, and consumption of alcoholic beverages were evaluated using structured and specific questionnaires. The chi-square test was used to verify the association between the hypertriglyceridemic waist phenotype and sociodemographic, occupational, lifestyle, and health conditions variables. The variables that presented a descriptive level (p-value) up to 0.25 were selected for the multiple analysis. In the multiple analysis, the Poisson Regression Model was used, with robust variance, in which the backward method was used to adjust the model. Crude and adjusted prevalence ratios (PR) were estimated, with a 95% confidence interval, for the variables that remained in the multiple models. The model's goodness of fit was evaluated using the Deviance test, at a level of 0.05. A total of 675 community health workers participated in the study, predominantly female, aged over 36 years, who studied up to elementary school, marital status with a partner, family income of up to two minimum wages, time in the profession less than or equal to six years, a weekly workload of 40 hours, with a contracted or CLT employment relationship, without another job and accompanying up to one hundred and twenty families. The prevalence of the hypertriglyceridemic waist phenotype was 25.3%. In the multiple analysis, there was an association between the phenotype and the variables: male sex (PR= 1.53 95%CI -1.14 – 2.06), age over 36 years (PR= 2.80 95%CI 1, 88 – 4.15), soda consumption greater than or equal to 5 days/week (PR=1.54 95%CI 1.02 – 2.33), alcohol consumption (PR=1.48 95%CI 1.14 – 1.92), regular/needs improvement (PR=1.71 95%CI 1.08 – 2.72) and poor/very poor health self assessment (PR=1.71 95%CI 1.14 – 2 .56). It was found that about a quarter of the population studied had the phenotype. Sociodemographic characteristics, lifestyle, and health conditions were associated with the outcome variable.