ABC | Volume 112, Nº2, February 2019

Original Article Vizentin et al Prevalence of dyslipidemia in adolescents Arq Bras Cardiol. 2019; 112(2):147-151 Table 2 – Mean and standard deviation of anthropometric characteristics and lipid profile according to nutritional status Variable Nutritional status according to BMI p value Eutrophy (n = 52) Overweight (n = 60) Obesity (n = 127) Mean SD Mean SD Mean SD Weight (kg) 52.3 ± 10.5 66.9 11.7 ± 90.3 19.0 < 0.01* Height (cm) 162.0 ± 0.1 162.1 0.1 ± 163.3 0.1 0.62 BMI (kg/m²) 19.7 ± 2.3 25.3 2.1 ± 33.7 5.9 < 0.01* WC (cm) 77.3 ± 10.1 82.6 9.8 ± 96.5 14.9 < 0.01* TC (mg/dl) 158.6 ± 34.8 159.1 35.6 ± 161.6 33.4 0.82 LDL-c (mg/dl) 87.2 ± 26.2 94.8 29.1 ± 96.3 30.1 0.16 HDL-c (mg/dl) 53.9 ± 16.2 48.2 12.6 ± 44.7 12.9 < 0.01* TG (mg/dl) 87.3 ± 45.1 88.5 46.2 ± 109.6 58.3 0.01* Statistical test: ANOVA (One Way) and Post Hoc test; *Statistically significant difference (p < 0.05); BMI: body mass index; WC: waist circumference; TC: total cholesterol; LDL-c: low density lipoprotein; HDL-c : high density lipoprotein; TG: triglycerides. nutritional status. The nutritional status classification revealed that 53.1% of the adolescents were obese, 25.1% overweight, and 21.8% eutrophic. The eutrophic adolescents had mean values of HDL-c significantly higher than the obese ones. Regarding triglycerides, the obese adolescents had values that were significantly higher than the eutrophic ones. The most prevalent changes were low HDL-c (50.6%), hypercholesterolemia (35.1%), and hypertriglyceridemia (18.4%). Regarding the prevalence of lipid profile changes, according to gender, it was observed that the girls showed higher prevalence of change, but with no statistically significant difference. The prevalence of lipid profile changes in girls and boys were respectively 64.3% and 35.7% (p = 0.07) for high TC, 73.1% and 26.9% (p = 0.07) in the LDL-c, 50.4% and 49.6% (p = 0.05) in HDL, and 59.1% and 40.6% (p = 0.07) in TG. Table 3 presents the prevalence of changes in lipid profile according to the nutritional status by BMI. The prevalence of low HDL-c was significantly higher (p = 0.01) in obese patients. In this study, a negative correlation was observed between BMI and HDL-c (r = -0.23, p < 0.01) and a positive correlation between BMI (r = 0.25, p < 0.01) andWC (r = 0.20, p = 0.03) with TG. In the bivariate andmultivariate linear regression analysis the negative association of BMI with HDL-c was maintained, as well as the positive association of BMI and WC with TG even after adjustment for gender and skin color (Table 4). Discussion This study presented higher mean values of the lipid profile than others in the literature. 19-21 HDL-c, a lipoprotein that acts as a protective factor against cardiovascular diseases, was the component with the highest change prevalence found among adolescents, as well as in the study by Ribas and da Silva, 2009. 22 Another population-based study with more than 30,000 participants also found similar results. 19 This fact is extremely worrying, because dyslipidemia alone and mainly accompanied by other factors, either environmental or genetic, can condition the development of atherosclerosis and, consequently, increase the risk of cardiovascular events. It is fundamental to always consider the prevention and treatment of dyslipidemias, from childhood to adolescence, to reduce the risks of cardiovascular diseases. 11,13 The lipid profile may vary during adolescence, and the female gender usually has higher levels, a fact that may be justified by the menarche. 23 Although no significant difference between the lipid profile means within the genders was observed, it is possible to notice that the girls had higher values for all parameters, and this is commonly observed in the literature. 19,22,24 In the study by Garcez MR et al., 20 it was observed that overweight adolescents had higher mean values for TC, LDL-c and TG, as well as low HDL-c, as in this study. 20 Similarly, Oliveira et al. 24 found such results when they assessed the lipid profile according to the nutritional status. 24 The main changes that are usually associated with obesity in this age group, and which have been observed as the standard are changes in HDL-c and TG. 25,26 This study demonstrated an association between HDL-c/TG and WC/BMI, showing the relationship with adiposity. This same association was seen in other studies, such as in the one by Pavão et al., 21 when they evaluated adolescents in a municipality of the state of Paraná and observed a predisposition to dyslipidemia when abdominal obesity, seen through WC, was present. Another study in the city of Recife showed that adolescents with overweight or abdominal obesity had higher values of TG and lower levels of HDL-c. 25 This study had as a limitation a convenience sample, which does not allow the generalization of results. Conclusions The present study demonstrated a high prevalence of dyslipidemia among adolescents seen at NESA outpatient clinic, mainly low HDL-c in obese adolescents. Considering the significant association between low levels of HDL-c and TG increased with adiposity, the control of these factors should receive attention, with the investigation and early diagnosis of the lipid change being important, especially if it is associated with another cardiovascular risk such as obesity, to develop effective intervention strategies. In addition, data presented 149