Irregularidade do ciclo menstrual no Menacme como marcador para fatores de risco cardiovasculares na p��s-menopausa

A associa����o entre fatores de risco cardiovascular (FRCV) na p��smenopausa e o antecedente de irregularidade menstrual no menacme foi avaliado em estudo caso-controle envolvendo 414 mulheres na p��smenopausa com idade de 60,4 �� 5,5 anos e IMC de 25,3 �� 4,7 kg/m2. As vari��veis consideradas foram: caracteriza����o do ciclo menstrual entre 20 e 35 anos (independente) e relato atual sobre ocorr��ncia de hipertens��o arterial, dislipidemia, diabetes mellitus e doen��a arterial coronariana (dependentes). Utilizou-se o teste qui-quadrado e modelos de regress��o log��stica, ajustados para outras vari��veis implicadas no risco para doenças CV, com n��vel de signific��ncia 5%. Observou-se que mulheres que relataram irregularidade menstrual pr��via estiveram associadas com risco aumentado para ocorr��ncia de algum FRCV [odds ratio ajustado (OR)= 2,14; IC-95%= 1,02���4,48], quando comparadas ��quelas com ciclos regulares. An��lise estratificada demonstrou as seguintes associa����es significativas com o antecedente de irregularidade menstrual: hipertens��o arterial (OR= 2,4; 95% IC= 1,39���5,41), hipercolesterolemia (OR= 2,32; 95% IC= 1,17���4,59), hipertrigliceridemia (OR= 2,09; 95% IC= 1,10���4,33) e angioplastia coronariana (OR= 6,82; 95% IC= 1,44���32,18). Os dados sugerem que o antecedente de irregularidade menstrual, indicativo da ocorr��ncia da s��ndrome dos ov��rios polic��sticos na idade reprodutiva, pode estar relacionado com aumento do risco para doenças CV na p��s-menopausa __________________________________________________ABSTRACT Menstrual Cycle Irregularity as a Marker of Cardiovascular Risk Factors at Postmenopausal Years.To evaluate the association between cardiovascular risk factors (CVRF)during postmenopausal years and previous menstrual irregularity during reproductive years, we performed a case-control study in 414 postmenopausal women (mean age 60.4 �� 5.5 years; BMI 25.3 �� 4.7 kg/m2). The variables assessed were: menstrual cycle characteristics at age 20���35y (independent) and records of arterial hypertension, dyslipidemia, diabetes mellitus, and coronary heart disease (dependent). Statistical analysis used the chi-square test and logistic regression, adjusting for potential confounders for cardiovascular risk, with significance set at 5%. Women reporting previous menstrual irregularity were associated with increased risk for some CVRF [adjusted odds ratio (OR) 2.14; CI-95%= 1.02���4.48], when compared with those reporting regular menstrual cycles. Stratified analysis demonstrated significant associations of previous menstrual irregularity with: arterial hypertension [OR= 2.74; CI-95%= 1.39���5.41), hypercholesterolemia (OR= 2.32; CI-95%= 1.17���4.59), hypertriglyceridemia (OR= 2.09; CI-95%=1.10���4.33), and coronary angioplasty (OR= 6.82; CI-95%= 1.44���32.18). These data suggest that a prior history of menstrual irregularity, as indicative of polycystic ovary syndrome, may be related to increased risk for CVD during postmenopausal years

��ndices de obesidade central e fatores de risco cardiovascular na s��ndrome dos ov��rios polic��sticos

Fundamento: A obesidade abdominal apresenta elevada preval��ncia em mulheres com s��ndrome dos ov��rios polic��sticos (SOP) e est�� associada a um aumento do risco cardiovascular. Objetivo: Verificar a acur��cia da circunfer��ncia da cintura (CC), da rela����o cintura-quadril (RCQ), da rela����o cinturaestatura (RCEST) e do ��ndice de conicidade (��ndice C), no que se refere �� detec����o de fatores de risco cardiovascular (FRCV) em mulheres com SOP. M��todos: Por meio de estudo transversal, foram alocadas 102 mulheres (26,5 �� 5 anos) com diagn��stico de SOP, de acordo com o consenso de Rotterdam. O colesterol total (CT), os triglicer��deos (TG), o LDL-colesterol (LDL-C), o HDLcolesterol (HDL-C), a glicemia de jejum, a glicemia ap��s teste oral de toler��ncia �� glicose (TOTG) e a press��o arterial (PA) foram avaliados em todas as pacientes, al��m das vari��veis antropom��tricas. Resultados: A rela����o cintura-estatura foi o marcador que apresentou correla����es positivas significativas com o maior n��mero de FRCV (PA, TG e glicemia ap��s TOTG), destacando-se ainda a correla����o negativa com HDL-C. Todos os marcadores antropom��tricos avaliados se correlacionaram positivamente com PA, enquanto CC e RCQ apresentaram correla����o positiva tamb��m com TG. No tocante �� acur��cia para detec����o de FRCV, os indicadores antropom��tricos considerados apresentaram taxas de sensibilidade superiores a 60%, com destaque para a RCEST, que apresentou sensibilidade superior a 70%. Conclus��o: A RCEST demonstrou ser o indicador antropom��trico com a melhor acur��cia para a predi����o de FRCV. Nesse sentido, prop��e-se a inclus��o desse par��metro de f��cil mensura����o na avalia����o cl��nica para o rastreamento de mulheres com SOP e FRCV----------------------ABSTRACT Background: Women with polycystic ovary syndrome (PCOS) present a high prevalence of abdominal obesity, which is associated with an increased cardiovascular risk. Objective: To verify the accuracy of the waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR) and the conicity index (CI) in the detection of cardiovascular risk factors (CVRF) in women with PCOS. Methods: The present transversal study allocated 102 women (26.5 �� 5 years) with a diagnosis of PCOS, according to the Rotterdam criteria. Total cholesterol (TC), triglycerides (TG), LDL-cholesterol (LDL-C), HDL-cholesterol (HDL-C), fasting glucose, glucose after the oral glucose tolerance test (OGTT) and blood pressure (BP) were evaluated in all patients, in addition to the anthropometric variables. Results: The WHtR was the marker that presented significant positive correlations with the highest number of CVRF (BP, TG and post-OGTT glucose), whereas there was a negative correlation with HDL-C. All the evaluated anthropometric markers were positively correlated with BP, whereas WC and WHR also presented a positive correlation with TG. Regarding the accuracy for the detection of CVRF, the anthropometric markers presented a sensibility > 60%, especially the WHtR, which had a sensibility > 70%. Conclusion: The WHtR showed to be the most accurate anthropometric indicator for the prediction of CVRF. In this sense, we propose the inclusion of this easily-measured parameter in the clinical assessment for the screening of women with PCOS and CVRF