A inadequação do índice de massa corporal como marcador de obesidade e prevalência de doenças em idosas

• Ano de defesa: 2013
• Autor(a) principal: Silva, Giselma Alcantara da
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de Alagoas; Brasil; Programa de Pós-Graduação em Nutrição; UFAL
• Palavras-chave em Português: Estado nutricional; Índice de massa corporal – Ponto de corte; Idosas – Obesidade; Idosas – Pós-operatório de cirurgia vascular; Nutritional status; Body mass index - Point cut; Elderly - Obesity; Elderly - Post-operative vascular surgery; CNPQ::CIENCIAS DA SAUDE::NUTRICAO
• Link de acesso: http://www.repositorio.ufal.br/handle/riufal/4905

Objectives: Besides discussing the associations between body mass index (BMI) and the results of postoperative vascular surgery infarction in middle-aged adults and seniors (the two populations most affected by cardiovascular diseases), this study investigated the adequacy of BMI as a marker of obesity in elderly women. To this end, this paper presents itself divided into two parts, the first represented by a review article (Art. 1) and second (Art.2) for a result. Methodology of Art 1: to carry out the review article, we carried out a systematic review using the following databases: PubMed, Science Direct and Scielo. During the review were retrieved articles written in Portuguese and / or English, published in the last ten years (2002 - 2012). In the vast majority of studies, BMI, expressed as the ratio between body mass and the square of height (kg/m²) was stratified into six categories: underweight (BMI ≤ 18.5 kg/m²), normal weight (BMI = 18.6 to 24.9 kg/m²), overweight (BMI = 25-29.9 kg/m²), I obesity (BMI = 30 to 34.9 kg/m²), II obesity (BMI = 35-39, 9 kg/m²) and III obesity (BMI ≥ 40 kg/m²). Methodology of Art 2: relationships and matching two cutoff points (CP) of BMI used to assess the nutritional status of elderly referenced in literature: WHO (≥ 30kg/m²) and Lipschitz (> 27 kg/m²) and body fat percentage (BF%), were investigated in a sample of 449 elderly. To calculate the% F, was used a regression equation for the specific population. To determine the adequacy of the two PC BMI, used for the classification and diagnosis of obesity, we used the ROC curve (Receiver Operating Characteristic Curve), considering a confidence interval of 95%. Results Section 1: Of the 24 articles selected for review, 18 (75%) showed positive associations between overweight and / or obesity and increased survival after cardiac surgery, supporting the existence of the obesity paradox. Article 2 Results: The sensitivity and specificity values of BMI cutoffs, using as criteria the F% verified by specific equation, were respectively 33.17% and 100% for the PC proposed by WHO ( BMI ≥ 30 kg/m²) and 55% and 90% for the PC proposed by Lipschitz (BMI> 27 kg/m²). Completion of Art 1: evidence raised during the review suggest a possible reverse effect of overweight and / or obesity in post-surgical patients with heart disease. Conclusion of Section 2: the results of this study showed low sensitivities for both cutoffs investigated: WHO and Lipischitz. However, the cutoff found in the search: ≥ 23kg/m² with high sensitivity (92%) and good specificity (67%).