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Association between waist circumference values and hypertension, heart disease and diabetes, reported by the elderly - SABE Survey: Health, Wellness and Ageing, 2000 e 2006

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Author(s):
Luiza Antoniazzi Gomes de Gouveia
Total Authors: 1
Document type: Master's Dissertation
Press: São Paulo.
Institution: Universidade de São Paulo (USP). Faculdade de Saúde Pública (FSP/CIR)
Defense date:
Examining board members:
Maria de Fatima Nunes Marucci; Wolney Lisbôa Conde; Luciana Silva Ferreira
Advisor: Maria de Fatima Nunes Marucci
Abstract

Background: The positive association between waist circumference (WC) and hypertension (H), diabetes mellitus (DM) and heart disease (HD) is well established and evaluated from critic values that showed this association in adults, however, this relationship must be investigated in the elderly due to physiological changes in this population group. Objective: To analyze the association between WC values, measured in 2000, and H, DM and HD, reported in 2006, and identify WC values, with better discriminatory capacity of the risk for developing these diseases, in elderly residents in the municipality of São Paulo. Methods: This was a longitudinal study using data from the SABE Survey: Health, Wellness and Aging, held in São Paulo, in 2000 and 2006. The study population was comprised of elderly individuals who did not report H, DM and HD in 2000, and who had WC value. The study variables were WC (continuous variable), body mass index (<28 kg/m and 28 kg/m 2 ), sex, age group (60 to 74 and 75), and ethnicity (caucasian and others), information of 2000, and H, DM and HD, reported in 2006. To verify the association, the Rao & Scott test for complex sample was used (p <0.05), and multiple logistic regression. The area under the ROC (Receiver Operating Caracteristics) curve (AUC) was used to estimate the performance of WC values in correctly discriminating elderly, according to the reference or not of diseases associated with WC. WC critical values were identified by the highest positive likelihood ratio, and negative likelihood ratio equal to zero. To assess the discriminatory capacity of WC values identified in this study and the WC values commonly used (WC 80 ou 88 cm, for women, e WC 94 ou 102 cm, for men) was made the comparison of AUC and confidence intervals of 95 per cent . All calculations carried out by using Stata version 10.0. Results: Four hundred five elderly people were analyzed, of which 26.9 per cent reported H, 4.1 per cent DM and 10.0 per cent HD. The WC value in 2000, was a risk factor for DM reference, in 2006, regardless of sex, age group, ethnicity and body mass index (OR 1.10, 95 per cent CI 1.05-1.16, p=0.000, p model=0.000). The AUC showed satisfactory performance of WC critical values, in discriminating the DM reference to women and men of 60-74 years. The WC critical values identified were 87 cm, for women, and 99 cm, for men, which showed better performance according to the AUC value compared to the WC values commonly used. Conclusion: The WC critical values identified in this study, for individuals of 60-74 years, showed better discriminatory ability of reference of DM, in period of 6 years, compared to the WC values commonly used (AU)

FAPESP's process: 11/04888-0 - Association between waist circumference values and hypertension, diabetes and heart disease, reported by the elderly - SABE Survey: Health, Wellness and Ageing, 2000 e 2006.
Grantee:Luiza Antoniazzi Gomes de Gouveia
Support Opportunities: Scholarships in Brazil - Master