remeReme: Revista Mineira de EnfermagemReme : Rev. Min. Enferm.1415-27622316-9389Escola de Enfermagem da Universidade Federal de Minas Gerais-UFMGBelo Horizonte, MG, BrazilS1415-27622008000300016S1415-2762(08)01200316Revisão TeóricaSíndrome metabólica: uma revisão dos critérios de diagnósticoSíndrome metabólico: una revisión de los criterios de diagnósticoMetabolic syndrome: a review on diagnostic criteriaFreitasEulilian Dias deFernandesAmanda CarlaMendesLarissa LouresPimentaAdriano MarçalVelásquez-MeléndezGustavoUniversidade Federal de Minas GeraisEscola de Enfermagem Departamento de Enfermagem Materno-Infantil e Saúde Públicaguveme@ufmg.br0920081234034113009200818022008This work is licensed under a Creative Commons Attribution 4.0 International License.Texto completo somente em PDF (PT)

INTRODUÇÃO: A síndrome metabólica (SM) é caracterizada pelo agrupamento de anormalidades fisiopatológicas, tais como a obesidade, a dislipidemia, a resistência à insulina (RI), a hiperinsulinemia a intolerância à glicose e a hipertensão arterial (HA), e está fortemente relacionada às doenças cardiovasculares. OBJETIVOS: Descrever os aspectos históricos do reconhecimento da SM e comparar as diferentes definições existentes. METODOLOGIA: Foi realizado um levantamento bibliográfico nas bases de dados Medline, Lilacs e Scielo, durante o mês de junho de 2008. Os descritores utilizados, concomitantemente, foram: síndrome x metabólica/metabolic syndrome x; história/history; diagóstico/diagnosis, epidemiologia/epidemiology; de acordo com o MeSH e DECs. Referências bibliográficas também foram analisadas. Foram selecionados 49 artigos dada a clareza na descrição dos objetivos e das variáveis de confusão, validade externa e validade interna e boa potência estatística. RESULTADOS: Existem atualmente 6 definições para a SM propostas por diferentes organizações internacionais de saúde: World Health Organization, National Cholesterol Education Program, European Group for the Study of Insulin Resistance, American Association of Clinical Endocrinologists/American College of Endocrinollogy, International Diabetes Federation. Todas elas usam componentes e pontos de corte específicos para o diagnóstico da SM. Contudo, a dislipidemia, HA, obesidade, medidas de glicemia e de RI são incluídos, se não em todas, na maioria das definições. Apesar disso, a concordância entre essas definições são quase sempre baixas, produzindo prevalências e fatores de risco diferentes para a SM, mesmo quando a população de base era a mesma. CONCLUSÃO: É necessário estabelecer um critério consensual para a SM.

INTRODUCCIÓN: El síndrome metabólico (SM) se caracteriza por la agrupación de anormalidades fisiopatológicas, que incluyen la obesidad, la dislipidemia, la resistencia a la insulina (RI), la hiperinsulinemia, la intolerancia a la glucosa y la hipertensión arterial (HA) y está muy vinculada a las enfermedades cardiovasculares. OBJETIVOS: Describir los aspectos históricos del reconocimiento del SM y comparar las distintas definiciones existentes. METODOLOGÍA: Se realizó un estudio bibliográfico en las bases de datos MEDLINE, LILACS y SCIELO, durante el mes de junio de 2008. Los descriptores utilizados conjuntamente fueron los siguientes: síndrome x metabólico/metabolic syndrome x; historia/history; diagóstico/diagnosis, epidemiologia/epidemiology; de acuerdo con el MeSH y el DeCS. También fueron analizadas las referencias. Fueron seleccionados 49 artículos por la claridad en la descripción de los objetivos y las variables de confusión, validez externa y validez interna, la buena potencia estadística. RESULTADOS: Actualmente hay seis definiciones para el SM propuestas por diferentes organizaciones internacionales de salud: World Health Organization, National Cholesterol Education Program, European Group for the Study of Insulin Resistance, American Association of Clinical Endocrinologists/American College of Endocrinollogy, International Diabetes Federation. Todas usan componentes y puntos de corte específicos para el diagnóstico del SM. Sin embargo, la dislipidemia, HA, obesidad, medidas de glucemia y de la RI están incluidas en la mayoría de las definiciones. A pesar de ello, la concordancia entre esas definiciones son casi siempre bajas, resultando en prevalencias y factores de riesgo diferentes para el SM, incluso cuando la población de base es la misma. CONCLUSIÓN: Se precisa establecer un criterio consensual para el SM.

INTRODUCTION: Metabolic syndrome (MS) is characterized by a group of metabolic abnormalities that include obesity, dyslipidemia, insulin resistance, glucose intolerance and hypertension, and is associated with cardiovascular diseases. OBJECTIVES: To describe the historical aspects of MS recognition and compare the various definitions proposed for this syndrome. METHODOLOGY: A survey on bibliographic databases Medline, Lilacs and Scielo was conducted in June, 2008. Used descriptors were: metabolic syndrome x, history, diagnosis, and epidemiology; according to the MeSH and DECs. Bibliographic references were also analyzed. Forty nine articles were selected once the authors clearly described the goals and the confusion variables; they had external validity, internal validity, and good statistical power. RESULTS: Six MS definitions were proposed by international health organizations:World Health Organization, National Cholesterol Education Program, European Group for the Study of Insulin Resistance, American Association of Clinical Endocrinologists/American College of Endocrinology, and International Diabetes Federation. All organizations used specific components and cut-off points for MS diagnosis. However, dyslipidemia, hypertension, obesity, measures of glycaemia and insulin resistance were included in most of the settings. One the other hand, concordance among these definitions was weak, producing different prevalence rates and risk factors for MS in the same population. CONCLUSION: It is necessary to establish a consensual definition for MS.

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