OBJETIVO: A obesidade, especialmente de distribuição abdominal, associa-se a fatores de risco cardiovasculares como a dislipidemia, a hipertensão arterial (HA) e o diabetes mellitus (DM). A importância desses fatores em nipo-brasileiros foi previamente demonstrada, apesar de a obesidade não ser característica marcante dos migrantes japoneses. Realizou-se estudo com o objetivo de avaliar a prevalência de excesso de peso e a adiposidade central (AC) em nipo-brasileiros e suas relações com distúrbios metabólicos. MÉTODOS: A amostra incluiu 530 nipo-brasileiros (40-79 anos) de primeira e segunda gerações, submetidos a medidas antropométricas de pressão arterial, perfil lipídico e teste oral de tolerância à glicose. A prevalência (por ponto e intervalo de confiança) de excesso de peso foi calculada pelo valor de corte >26,4 kg/m². O diagnóstico de AC foi baseado na razão entre as circunferências da cintura e do quadril (RCQ), sendo que valores > ou = 0,85 e > ou = 0,95, para mulheres e homens, respectivamente, firmavam esse diagnóstico. RESULTADOS: A prevalência de excesso de peso foi de 22,4% (IC95%-- 20,6-28,1), e a de AC, de 67,0% (IC95% -- 63,1-70,9). Além de maiores prevalências de DM, HA e dislipidemia, estratificando-se pelo índice de massa corporal (IMC) e RCQ, indivíduos com excesso de peso e adiposidade central apresentaram pior perfil metabólico: a pressão arterial foi significantemente maior naqueles com excesso de peso, sem e com AC; indivíduos com AC apresentaram maiores índices de glicemia, triglicerídeos, colesterol total e LDL e menor HDL quando comparados aos sem excesso de peso e sem AC; a insulinemia de jejum foi significantemente maior em indivíduos com excesso de peso (sem e com AC) do que naqueles sem excesso de peso e sem AC. CONCLUSÃO: A comparação de subgrupos com e sem adiposidade central foi compatível com a hipótese de que a deposição abdominal de gordura representa fator de risco para doenças interligadas pela resistência à insulina, inclusive em população de origem oriental. A alta prevalência de síndrome metabólica nos migrantes japoneses pode ser decorrente da deposição visceral de gordura, implicada na gênese da resistência à insulina.
Although the number of diabetic subjects was similar between the criteria, those identified as being at risk for diabetes were quite distinct. Fewer subjects were classified as having IFG by ADA criteria than as having IGT by WHO criteria. Abnormal glucose tolerance based on WHO criteria seems to identify a worse cardiovascular profile than abnormal tolerance based on ADA criteria. Follow-up studies are necessary to know the prognostic significance of IFG to predict subsequent diabetes.
SUMMARY A study of the prevalence of hypertension was undertaken among workers in 10 subsectors of the economy in Sao Paulo, a major urban-industrial area of Brazil. Included in the study were 5500 subjects 15-65 years of age, employed in 57 randomly selected firms. Hypertension rates (DBP ^ 90 mm Hg) were higher among males up to 44 years of age. There was a decreasing gradient from mild to moderate and severe forms in all groups. Severity tended to increase with age in all groups. Black males showed higher rates than whites (29.2% vs 16.7%, p < 0.05), the excess being partially accounted for by moderate and severe forms (40% vs 20%). Subjects who overworked showed a trend toward higher hypertension rates. Higher rates in four subsectors (metallurgy, finance, transport, and journalism), aside from the distribution of known risk factors and job selection, may reflect a variety of work-related stressors. 1 " 4 In most developed countries hypertension and associated diseases have been acknowledged as major public health concerns. In underdeveloped countries, however, the issue is much less clear. For a long time, health and disease patterns in underdeveloped countries have been considered to be altogether different from those prevailing in developed societies. Evidence has accumulated in recent years, however, that shows at least in some areas of the so-called "third world" a mixed pattern of disease characterized by disorders considered more prevalent among urban industrial populations than in "traditional" societies.'The transition from traditional to industrial societies is a complex process involving profound social and economic changes that, in turn influence health and disease patterns of the members of society. In urban industrial societies, entry into the job market, qualitative aspects of work (time pressured, hierarchically controlled, competitive) as well as the quantity of work, have been argued to be critical events regarding hypertension. 6 The objectives of the present study were to: 1) estimate the prevalence of hypertension among workers in selected economic activities of a highly urbanized area of the third world, the Metropolitan area of Sao Paulo; 2) provide descriptive data on the epidemiology of hypertension in that population; and 3) set up baseline data for testing hypotheses relating to work-related factors associated with hypertension. MethodologySubjects from 10 subsectors of the economy were studied. In the secondary sector (industry), the following subsectors were selected: textile, metallurgy, housing, and automobile construction. In the tertiary sector (trade and services) the selected subsectors were the following: trade (wholesale, retail), insurance, loans and finance, transportation, advertising and journalism, teaching, liberal arts professionals.In Brazil, a federal law, known as the "Law of the Two Thirds," makes it mandatory for each firm to report annually to the Ministry of Labour the number
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