Fatores associados a diabetes mellitus, síndrome metabólica e redução da taxa de filtração glomerular entre idosos: estudo epidemiológico molecular

Abstract

In recent decades, the aging population has resulted in increased morbidity and mortality from chronic noncommunicable diseases (NCD) such as diabetes mellitus (DM), metabolic syndrome (MS) and chronic kidney disease (CKD). Sociodemographic, behavioral and genetic factors interact in the development of these NCD, particularly in the elderly. The objective this research was to assess factors associated with DM, MS and CKD in the elderly population. This is a cross-sectional study with 327 elderly individuals (≥ 60 years) living in the urban area Ibiaí, MG. The questionnaires investigated sociodemographic factors, health behaviors, diet and health. We collect: anthropometric data; measurement of blood pressure (BP); blood collection for evaluation of cholesterol, triglycerides (TG), glucose and creatinina, and exfoliation of oral mucosa for genetic evaluation of polymorphic variant I/D angiotensin converting enzyme (ACE). We have identified the prevalence of DM (fasting blood glucose ≥ 126 mg/dL and/or use of hypoglycemic drugs), MS (based on four criteria) and altered glomerular filtration rate (GFR) (<60 ml / min / 1.73m2), suggestive of CKD. Descriptive statistics, univariate and multiple, for logistic regression, were performed using SPSS 18.0 program. DM was prevalent in 16.5% of the elderly and it was associated with smoking (p = 0.013), undesirable TGL (p = 0.002) and overweight (p = 0.001). MS was prevalent in 48.5 to 62.2%, depending on the criteria used, and it was associated with female sex (p = 0.024), the undesirable total cholesterol (p = 0.006) and overweight (p = 0.000). The variables that were significantly more prevalent in women than men were increased waist circumference (p = 0.000) and low HDL (p = 0.000). CKD was present in 126 elderly (38.9%), and of these, 78 (24.1%) had normal plasma creatinine. The reduction in GFR was associated with the females (p = 0.042), older age (p = 0.000) and low intake of fruits (p = 0.023). It conclusion, there is a high prevalence of MS and CKD in the elderly, especially in women. Women have more metabolic alterations of men. The DM, MS and DRC were associated with factors that can be modified by healthy habits like proper nutrition and physical activity. The DM also was associated with smoking. The I/D polymorphism of ACE was not associated with any of the diseases studied.