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. 2023 Jul 17;120(7):e20220728.
doi: 10.36660/abc.20220728. eCollection 2023.

Association between Arterial Hypertension and Laboratory Markers, Body Composition, Obstructive Sleep Apnea and Autonomic Parameters in Obese Patients

[Article in English, Portuguese]
Clarcson Plácido Conceição Santos  1 , Laura Souza Lagares  1 , Sarah Rafaela Mascarenhas Santos  1 , Mariana Sousa de Pina Silva  1 , Rodrigo Colares de Macedo  1 , Luiz Alberto Bastos de Almeida  2 , Eric Simas Bomfim  1
Affiliations

Association between Arterial Hypertension and Laboratory Markers, Body Composition, Obstructive Sleep Apnea and Autonomic Parameters in Obese Patients

[Article in English, Portuguese]
Clarcson Plácido Conceição Santos et al. Arq Bras Cardiol. .

Abstract
in English, Portuguese

Background: Systemic arterial hypertension (SAH) is a multifactorial disease, highly prevalent and associated with health risks.

Objective: The purpose of this study was to investigate the association between SAH and laboratory, anthropometric, heart rate variability (HRV), and obstructive sleep apnea markers and, secondarily, to analyze the sensitivity and specificity of the variables that are independent factors in the association.

Methods: Cross-sectional study with 95 obese patients treated at an obesity referral clinic in Salvador, BA, Brazil. SAH data were obtained from electronic medical records. The sample was stratified in the Normotensive Group (NG) and the Hypertensive Group (HG), and laboratory markers, body composition, polysomnography, and HRV were measured to evaluate the association of SAH with the predictor variables. For the analysis, p<0.05 was adopted.

Results: The average age of the NG was 36.3 ± 10.1 and HG 40.4 ± 10.6 years; 73.7% were women in the NG and 57.9% in HG; 82.4% in HG had insulin resistance. In the multivarious logistics regression model with adjustments in age, sex, height, and oxyhemoglobin saturation, SAH was inversely associated with fasting plasma glucose mg/dL (odds ratio [OR] = 0.96; 95% confidence interval [CI] = 0.92-0.99) and visceral fat area (VFA) cm2(OR = 0.98; 95% CI = 0.97-0.99). The area under the VFA curve was 0.728; CI 95% (0.620-0.836); fasting plasma glucose 0.693;CI 95% (0.582-0.804).

Conclusions: Lower VFA and fasting plasma glucose concentrations were inversely associated with SAH. In addition, fasting plasma glucose and VFA showed a high sensitivity for SAH screening.

Fundamento: A hipertensão arterial sistêmica (HAS) é uma doença multifatorial, altamente prevalente e associada a riscos à saúde.

Objetivo: O objetivo deste estudo foi investigar a associação entre HAS e marcadores laboratoriais, antropométricos, de variabilidade da frequência cardíaca (VFC) e de apneia obstrutiva do sono e, em segundo plano, analisar a sensibilidade e especificidade das variáveis que são fatores independentes na associação.

Métodos: Estudo transversal com 95 pacientes obesos atendidos em um ambulatório de referência em obesidade em Salvador, BA, Brasil. Os dados da HAS foram obtidos dos prontuários eletrônicos. A amostra foi estratificada em Grupo Normotenso (GN) e Grupo Hipertenso (GH), sendo medidos marcadores laboratoriais, composição corporal, polissonografia e VFC para avaliar a associação da HAS com as variáveis preditoras. Para as análises, adotou-se p<0,05.

Resultados: A média da idade do GN foi de 36,3 ± 10,1 e GH 40,4 ± 10,6 anos, 73,7% eram mulheres no GN e 57,9% no GH; 82,4% no GH apresentavam resistência à insulina. No modelo de regressão logística multivariado com ajustes para idade, sexo, altura e saturação de oxi-hemoglobina, a HAS foi inversamente associada à glicose plasmática em jejum mg/dL (odds ratio [OR] = 0,96; intervalo de confiança de 95% [IC] = 0,92-0,99) e área de gordura visceral (AGV) cm2 (OR = 0,98; IC 95% = 0,97-0,99). A área sob a curva AGV foi de 0,728; IC 95% (0,620-0,836) e glicemia de jejum 0,693; IC 95% (0,582-0,804).

Conclusão: Menores concentrações de AGV e glicemia de jejum foram inversamente associadas à HAS. Além disso, tanto a glicemia de jejum quanto o AGV mostraram alta sensibilidade para triagem de HAS.

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Conflict of interest statement

Potencial conflito de interesse

Não há conflito com o presente artigo.

Figures

Figura Central
Figura Central. : Associação entre Hipertensão Arterial Sistêmica com Marcadores Laboratoriais, Composição Corporal, Apneia Obstrutiva do Sono e Variabilidade da Frequência Cardíaca em Adultos Obesos
Figura 1
Figura 1. – Curva ROC para área de gordura visceral como triagem para HAS. Área soba curva (AUC) = 0,728; IC 95% (0,620 – 0,836). Ponto de corte para HAS: > 220,3 cm2.
Figura 2
Figura 2. – Curva ROC para triagem de glicemia de jejum para HAS. Área sob a curva (AUC) = 0,693; IC 95% (0,582 – 0,804). Ponto de corte para HAS: > 95 mg/dl.
Central Illustration
Central Illustration. : Association between Arterial Hypertension and Laboratory Markers, Body Composition, Obstructive Sleep Apnea and Autonomic Parameters in Obese Patients
Figure 1
Figure 1. – ROC curve for the visceral fat area as screening for SAH. Area under the curve = 0.728; IC 95% (0.620 – 0.836). Visceral fat area cut-off point for SAH: > 220.3 cm2.
Figure 2
Figure 2. – ROC curve for fasting blood glucose screening for SAH. Area under the curve = 0.693; CI 95% (0.582 – 0.804). Fasting blood glucose cut-off point for SAH: > 95 mg/dl.
See this image and copyright information in PMC

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