Profile of obese patients with metabolic syndrome eligible for bariatric surgery at a private clinic in Porto Alegre, Rio Grande do Sul, Brazil
DOI:
https://doi.org/10.15448/1980-6108.2016.3.22898Keywords:
obesity, health profile, metabolic syndrome X, drug utilization, bariatric surgery.Abstract
Aims: To describe the sociodemographic and biochemical profiles, presence of comorbidities, lifestyles, and drug utilization of obese patients with metabolic syndrome eligible for bariatric surgery.
Methods: This retrospective cross-sectional study included metabolic syndrome patients with class I, II, and III obesity treated at a specialized clinic in Porto Alegre, Rio Grande do Sul, Brazil, who were candidates for bariatric surgery. The patients were seen between January 2007 and March 2014 and the data for the study were collected from medical records. The following variables were investigated: age, sex, education, marital status, comorbidities, biochemical markers, drug utilization, smoking history, history of childhood overweight, and sleep quality. Patients were classified as class I obesity (BMI = 30 to 34.9), class II obesity (BMI = 35 to 39.9), and class III, or severe, obesity (BMI≥40). The diagnosis of metabolic syndrome was established according to the International Diabetes Federation.
Results: A total of 198 subjects (83.8% of whom were women and 68.7% were married) with a mean age of 40.5±11.1 years (range of 21-69 years) were evaluated. Most of the patients (37.4%) were 30 to 39 years old. With regard to health, 77.3% of the patients had hypertension, 75.8% had dyslipidemia, and 75.3% had gastritis, and it should be noted that 67.2% of the patients were on antihypertensive medications and 42.9% on psychiatric drugs. A median of 0.81 (0.70-0.97mg/dL) was obtained for C-reactive protein levels. One hundred and thirteen patients (57%) reported having had excessive weight in childhood. Poor sleep quality was mentioned by 61 (31%) of individuals.
Conclusions: Most individuals with class I, II, and III obesity and metabolic syndrome who sought care at the bariatric surgery clinic were young, adult, and married women with a college degree or higher education presenting with several comorbidities in addition to excess weight and inflammatory conditions. Other common findings included sleep disorders, excessive weight in childhood, and use of more than one type of medication.
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References
World Health Organization. Health topics. Obesity [Internet]. Copenhagen: WHO; 2015 [updated 2015 Dec 16; cited 2015 Dec 28]. Available from: http://www.who.int/topics/obesity/en/
Neff KJ, Olbers T, le Roux CW. Bariatric surgery: the challenges with candidate selection, individualizing treatment and clinical outcomes. BMC Med. 2013 Jan 10;11:8. http://dx.doi.org/10.1186/1741-7015-11-8
Alberti KG, Zimmet P, Shaw J; IDF Epidemiology Task Force Consensus Group. The metabolic syndrome--a new worldwide definition. Lancet. 2005 Sep 24-30;366(9491):1059-62. http://dx.doi.org/10.1016/S0140-6736(05)67402-8
International Diabetes Federation. Consensus worldwide definition of the metabolic syndrome [Internet]. Brussels: IDF; 2015 [updated 2015 Dec 17; cited 2015 Dec 22]. Available from: http://www.idf.org/metabolic-syndrome
Finelli C, Padula MC, Martelli G, Tarantino G. Could the improvement of obesity-related co-morbidities depend on modified gut hormones secretion? World J Gastroenterol. 2014 Nov 28;20(44):16649-64. http://dx.doi.org/10.3748/wjg.v20.i44.16649
Reis CEG, Vasconcelos IAL, Barros JFN. Políticas públicas de nutrição para controle da obesidade infantil. Rev Paul Pediatr. 2011;29(4):625-33.
Kelles SMB, Diniz MFHS, Machado CJ, Barreto SM. The profile of patients undergoing bariatric surgery in the Brazilian Unified National Health System: a systematic review. Cad Saude Publica. 2015 Aug;31(8):1587-601. http://dx.doi.org/10.1590/0102-311X00022714
Garrow JS, Webster J. Quetelet's index (W/H2) as a measure of fatness. Int J Obes. 1985;9(2):147-53.
World Health Organization. Collaborating Centre for Drug Statistic Methodology, Norwegian Institute of Public Health. The Anathomical Therapeutic Chemical Classification System [Internet]. Oslo: WHO; 2015 [updated 2015 Dec 16; cited 2015 Dec 28]. Available from: http://www.whocc.no/atcddd/
Oliveira APF, Malheiros CA, Santos AS, Jesus SR, Manuel J. Perfil de pacientes submetidos à cirurgia bariátrica atendidos em um hospital universitário do município de São Paulo. Saúde Colet. 2009;35(6):275-9.
Diniz MFHS, Passos VMA, Barreto SM, Diniz MTC, Linares DB, Mendes LN. Perfil de pacientes obesos classe III do sistema público de saúde submetidos à gastroplastia em "Y de ROUX", no Hospital das Clínicas da UFMG: altas co-morbidades e mortalidade hospitalar. Rev Med Minas Gerais. 2008;18(3):183-90.
Oliveira MS, Lima EFA, Leite FMC, Primo CC. Perfil do paciente obeso submetido à cirurgia bariátrica. Cogitare Enferm. 2013;18(1):90-4. http://dx.doi.org/10.5380/ce.v18i1.31312
Cavalcante RC. Análise comportamental de obesos mórbidos e de pacientes submetidos à cirurgia bariátrica [dissertação]. [Recife]: Universidade Federal de Pernambuco; 2009. 110 p.
Garciacaballero M, Reyes-Ortiz A, Martínez-Moreno JM, Toval-Mata JA. Glycemic and lipid metabolic disorders in diabetic and non-diabetic patients bmi < 35 or > 35 before gastric bypass. Nutr Hosp. 2014 May 1;29(5):1095-102.
Lam DW, LeRoith D. Metabolic Syndrome [Internet]. Bethesda; 2015 [updated 2015 May 19; cited 2015 Nov 28]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK278936/
Oh S, Oh S. Epidemiological and genome-wide association study of gastritis or gastric ulcer in korean populations. Genomics Inform. 2014 Sep;12(3):127-33. http://dx.doi.org/10.5808/GI.2014.12.3.127
Wree A, Kahraman A, Gerken G, Canbay, A. Obesity affects the liver – the link between adipocytes and hepatocytes. Digestion. 2011;83(1-2):124-33. http://dx.doi.org/10.1159/000318741
Gerhard GS, Benotti P, Wood GC, Chu X, Argyropoulos G, Petrick A, Strodel WE, Gabrielsen JD, Ibele A, Still CD, Kingsley C, DiStefano J. Identification of novel clinical factors associated with hepatic fat accumulation in extreme obesity. J Obes. 2014;2014:368210. http://dx.doi.org/10.1155/2014/368210
Costa AJRB, Pinto SL. Transtorno da compulsão alimentar periódica e qualidade de vida de pacientes candidatos a cirurgia bariátrica. Arq Bras Cir Dig. 2015;28(Supl.1):52-5. http://dx.doi.org/10.1590/S0102-6720201500S100015
Bandeira VAC, Oliveira KR. Potenciais interações entre medicamentos usados na síndrome metabólica. Sci Med. 2014;24(2):156-64. http://dx.doi.org/10.15448/1980-6108.2014.2.16330
Sotolongo OG, Gámez AA, Sierra YH. Influencia del síndrome metabólico sobre la evolución de pacientes. Rev Cuba Med Mil. 2014;43(4).
Junqueira ASM, Romêo Filho LJM, Junqueira CLC. Avaliação do grau de inflamação vascular em pacientes com síndrome metabólica. Arq Bras Cardiol. 2009;93(3):360-6. http://dx.doi.org/10.1590/S0066-782X2009001000008
Kim NH, Lee SK, Eun CR, Seo JA, Kim SG, Choi KM, Baik SH, Choi DS, Yun CH, Kim NH, Shin C. Short sleep duration combined with obstructive sleep apnea is associated with visceral obesity in Korean adults. Sleep. 2013 May 1;36(5):723-9. http://dx.doi.org/10.5665/sleep.2636
Organización Mundial de La Salud. Obesidad y sobrepeso. Nota Descriptiva nº311 [Internet]. Copenhagen: OMS; 2015 [updated 2015 Jan; cited 2015 Nov 28]. Available from: http://www.who.int/mediacentre/factsheets/fs311/es/
Hruby A, Hu FB. The epidemiology of obesity: a big picture. Pharmacoeconomics. 2015 Jul;33(7):673-89. http://dx.doi.org/10.1007/s40273-014-0243-x
Kaur J. A Comprehensive review on metabolic syndrome. Cardiol Res Pract. 2014;2014:943162. http://dx.doi.org/10.1155/2014/943162
Araújo TF, Guimarães DF, Gomes ET, Melo Luz JC, Spini VBMG. Síndrome metabólica - fatores de risco e aspectos fisiopatológicos. RBM Rev Bras Med. 2011;68(7-8):233-7.
