Cardiovascular diseases have emerged as the leading cause of death in Brazil and in the world, representing a third of the deaths and the main spending on health care. Between 2000-2010, the number of deaths from cardiovascular disease in one hundred thousand inhabitants increased by 28% in the North, with dyslipidemia and metabolic syndrome among the main risk factors. These values become more worrying as it may be underestimated because of consequential underreported the geographical isolation of the region, which is characteristic of northern Brazil. Dyslipidemias correspond to changes in the plasma lipid profile, and represents a criterion for the diagnosis of metabolic syndrome. Metabolic syndrome can be defined as a set of metabolic changes such as hyperglycemia, dyslipidemia, hypertension and obesity. Recently, animal studies and clinical models have shown increased risk of atherosclerotic disease and hypertension with exposure to mercury. In the Tapajós River region, several studies have shown human exposure in riverine populations that consume fish contaminated with methylmercury. Also, recent data from our group show that the riverine communities of Tucuruí have high levels of mercury. The aim of this observational cohort study was to analyze the possible lipid abnormalities and the presence of metabolic syndrome in riverside communities in the Amazon region: Boa Vista do Tapajós, Barreiras, Pimental, Brasilia Legal, Fordlândia and Pedra Branca (Tapajós), Vila Cametá and community Ouro Verde (Tucuruí) with mercury exposure history. For this, the calculations were carried out in body mass index (by weight and height), blood pressure measurements, analysis of glycemic control (fasting blood glucose) and lipid, by plasma levels of triglycerides, total cholesterol, HDL and the calculations LDL, VLDL and HDL cholesterol did not the lipid. After application of the inclusion and exclusion criteria, a total of 337 adults of both sexes (220 of the Tapajos and 117 Tucuruí) were analyzed. High average levels of obesity and high frequency of individuals who had dyslipidemia were detected, especially in Tucuruí, where the frequencies were even higher than in the Tapajos. Also, high percentages of individuals were identified with metabolic syndrome (14% to 35% depending on the definition adopted). The criteria adopted by the NCEP have proved the most sensitive for the identification of metabolic syndrome (MS) in these populations. The main factor that contributes to the detection of the presence of MS was the low HDL level, present in 32% of individuals with MS. In Tapajós, the second and third most common factors were the high levels of triglycerides and glucose, however in Tucuruí was altered blood pressure and high triglycerides levels. In conclusion, our study provides, epidemiological data on the prevalence of dyslipidemia, overweight and obesity, high blood pressure and metabolic syndrome in adults bordering the Amazon. Adding to this, the epidemiological assessment of the lipid profile is an important tool for the promotion of health measures to prevent and reduce cardiovascular risk factors.
|
