Prevalência e fatores associados à síndrome metabólica em Agentes Comunitários de Saúde

Abstract

Metabolic syndrome is defined as the common set of cardiovascular risk factors, characterized by abdominal obesity, hypertension, hyperglycemia and atherogenic dyslipidemia, and is strongly associated with increased risk of diabetes and cardiovascular morbidity and mortality. It can be influenced by social determinants of health, such as work. Community Health Workers stand out, an important population subgroup, which has particularities in their daily work that can impact their health. The first scientific article aimed to identify and synthesize the scientific evidence on the prevalence and factors associated with the metabolic syndrome in primary health care professionals. A scoping review was conducted in accordance with the methodological guidelines of the Joanna Briggs Institute for scoping review and reported based on the PRISMA-ScR checklist. The searched databases were PubMed, Web of Science, Scopus, ScienceDirect, Embase and LILACS. The search strategy was formulated using Population, Concept and Context elements, using the descriptors “Health Personnel”, “Metabolic Syndrome” and “Primary Health Care”, applying the Boolean operators “AND” and “OR”. Quantitative and/or qualitative primary studies, in English, Spanish and Portuguese, with no time limit, were included. In the scope review, 6 articles were included, the prevalence of the Metabolic Syndrome ranged from 13.8% to 62%. The most prevalent component was altered HDL-c (n = 5) and nursing professionals were surveyed in most studies (n = 5). Schooling (n = 5), professional category (n = 4), age (n = 4), physical activity (n = 2), being a smoker (n = 2) and professional exhaustion (n = 2) were associated with metabolic syndrome. The scope review showed that the problem is prevalent and the theme little explored in primary care health professionals by national and international literature, thus reflecting a knowledge gap to be studied. The second study aimed to estimate the prevalence of metabolic syndrome and its associated factors in community health workers in a city in the north of Minas Gerais, Brazil. This is a cross-sectional and analytical study, involving 673 community health workers. Sociodemographic, lifestyle, work, anthropometric, hemodynamic, biochemical and emotional data were collected. The dependent variable Metabolic Syndrome was defined according to the revised National Cholesterol Education Program Adult Treatment Panel III criteria. Descriptive and multiple Poisson regression analyzes were performed with robust variance, considering a significance level of 5% (p<0,05) for the final model. The prevalence of metabolic syndrome was 20,8% and the co-occurrence of components occurred mostly with the presence of three components (13,4%). Among the components of the Metabolic Syndrome, the most prevalent in the total sample was altered blood pressure (41,8%) and the least prevalent was glycemic alteration (12,0%). Metabolic syndrome was associated with age group ≥ 40 years (PR=1,62; 95%CI 1,22-2,14), lower education (elementary and/or high school) (PR=1,45; 95%CI 1,08-1,96), overweight/obesity (PR=4,78; 95%CI 2,76-8,29), low-density lipoprotein ≥130 mg/dl (PR=2,18; 95%CI 1,64-2,90) and C-reactive protein >5,0 mg/L (PR=1,68; 95%CI 1,28-2,20). There was a high prevalence of metabolic syndrome. There is a need to develop actions aimed at promoting changes in lifestyle, especially with regard to weight reduction, as well as the treatment of risk factors. Five technical products were developed: two scientific events, “CHW Day” and the “II Community Health Workers Week: Caring for Who Cares”; a Pitch (orientation video) entitled “Do you know what Metabolic Syndrome is?”; a physical activity level calculator, and finally, a technical report on the health and work of Community Health Workers in the north of Minas Gerais during the COVID-19 pandemic.