Non-traditional cardiometabolic risk factors within the spectrum of the metabolic syndrome in the ELSA - São Paulo

Abstract

This project is included in the Longitudinal Study on Adult Health - ELSA. Among employees from public universities, epidemiological, clinical and molecular aspects of chronic diseases, such as cardiovascular disease and type 2 diabetes mellitus - which are the leading causes of morbidity and mortality worldwide - will be investigated. The ELSA assess associations between classical cardiovascular risk factors and will describe the temporal trends of those fators and determinants of the outcomes. However, several non-traditional risk factors, recently postulated, were not included in the major project. Among these factors, concentrations of circulating adipocytokines, inflammatory, endothelial and thrombotic markers, are elevated in individuals with increased adiposity and metabolic syndrome. The present study will describe the cardiometabolic profile of participants of the ELSA based on non-traditional cardiovascular risk factors and evaluate their associations with type 2 diabetes or components of the metabolic syndrome (central obesity, systemic hypertension, dyslipidemias, glucose intolerance). For this cross-sectional study, a sample of 1000 participants of both sexes, aged 35-55 years, without prevoius cardiovascular disease or diabetes was estimated. All subjects with prediabtic conditions will be included and the double of those with normal glucose tolerance. Variables of main interest will be: adiponectin and leptin; inflammatory markers IL-6, TNF-alpha, MCP-1, amyloid A and TGF-B1); fibrinogen; endothelial markers ADMA and E-selectin); apolipoprotein A1 and apolipoprotein B; ferritin and albumin. Subjects will be stratified according to the presence of metabolic syndrome or glucose metabolism disturbance. Independent associations with those dependent variables will be tested by logistic regression analysis; ROC curve will be used. Our results at baseline will be relevant for further analysis of the outcomes which are being assessed in the main study ELSA. Our additional findings should bring important data for the development of preventive programs for these chronic diseases and for the establishment of public policies, potentially able to slow the course of epidemics in the country. (AU)