IJCS | Volume 33, Nº3, May / June 2020

246 The individuals with high VAT levels tend to have insulin resistance, hyperglycemia, hypertriglyceridemia, increased lowdensity lipoprotein (LDL) serum levels and reduced high density lipoprotein (HDL-C) concentration. 8 HDL-C reduction in viscerally obese patients represents themain factor responsible for increased total cholesterol/ HDL-C ratio, and this relationship is a strong risk predictor for cardiovascular disease. 5,6,9 According to Piepoli et al., 10 age is the main cardiovascular risk factor and most individuals aged 65 years are already considered at high risk. Thus, it is of major relevance to determine the associations of metabolic RF with advanced age, especially among the population in the northeast of Brazil, where there are no studies in this context, due to its negative influence on functional capacity, as well as to the costs incurred to the Brazilian Unified Health System (SUS) for its treatment. 11-14 The objective of this study is to determine the association between central obesity and biochemical markers of cardiometabolic risk in elderly patients treated at a geriatric outpatient clinic in the city of Lagarto-SE. Materials and Methods This is a cross-sectional, primary data collection study, composed by a sample selected by convenience of 159 elderly individuals (aged ≥ 60 years), of both sexes, treated at a geriatric outpatient clinic in the city of Lagarto-SE. The inclusion criteria used in the research were: patients aged ≥ 60 years, registered at the reference outpatient service and who accepted to participate voluntarily. The exclusion criteria were: patients with abdominal injury or tumors, hepatomegaly and/or splenomegaly, ascites and those who had undergone abdominal surgery recently which could compromise the verification of abdominal fat measures. The data were collected using a standardized questionnaire, applied by duly trained individuals, following standardizedprocedures for data collection, such as quality controlmeasures and consistency of information. The selected covariables were: sex (male and female), age in complete years, self-referred skin color (black; non-black), education (uneducated/Incomplete middle school, complete middle school/Incomplete high school, complete high school or more), occupation (receiving assistance/Organic Law of Social Assistance - LOAS), retired, living on income or pension). Central adiposity (the accumulation of adipose tissue in the abdominal region) was considered an independent variable, determined by waist circumference (WC) measurement, using an inelastic anthropometric tape (Cescorf, Brazil), in accordance with the measurement techniques proposed by Lohman et al., 15 and classified according to the International Diabetes Federation (IDF) criteria 16 for South American individuals, when WC ≥ 80 cm and ≥ 90 cm for women and men, respectively. Total cholesterol (TC), LDL-C, HDL-C, Non HDL-C, Triglycerides (TG), Glucose and Castelli’s I and II risk indexes were considered dependent variables, obtained upon request and/or through analysis of data contained in the geriatric medical record, over a period of less than one month fromdata collection. To perform the classification, the criteria established by the V Brazilian Guidelines on Dyslipidemia and Atherosclerosis Prevention 17 and by the Brazilian Diabetes Society Guidelines 18 were used: TC < 200 mg/dL; LDL-C < 160 mg/dL; HDL-C > 40 mg/ dl in men and > 50 mg/dl in women; non-HDL-C < 130 mg/dL, TG < 150 mg/dL and Glucose < 100 mg/dL. Castelli risk index-I (CRI-I) is calculated as TC/HDLc and Castelli risk index-II (CRI-II), as LDLc/HDLc. TC/HDL-C ratio > 4.7 and LDL-C/HDL-C ratio > 3.1 indicate high metabolic risk. Statistical Analysis Statistical software SPSS (version 20.0) was used for statistical analysis. The categorical variables were expressed as percentages and the continuous variables, as mean and standard deviation or median and interquartile interval, according to the distribution pattern. The normality of continuous variables distribution was evaluated using the Kolmogorov-Smirnov test. For parametric and nonparametric variables, the unpaired student’s t-test and the Mann-Whitney test were used, respectively, for independent samples. All analyses were performed with the statistical significance level of 5% (p < 0.05). Pearson’s chi-square test was used to assess the association between central obesity and biochemical markers of cardiometabolic risk. Those with p < 0.20 were included in the bivariate logistic regression analysis, adopting a CI of 95%. Ethical aspects This studywas approved by the Committee of Ethics in Research of the Federal University of Sergipe, under the protocol number 559.936, complying with the Resolution Oliveira et al. Cardiometabolic risk in elderly Int J Cardiovasc Sci. 2020; 33(3):245-251 Original Article