Atividade física, comportamento sedentário, síndrome metabólica e mortalidade: estudo longitudinal com pacientes do Sistema Único de Saúde
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Data
2019-08-02
Autores
Lemes, Ítalo Ribeiro
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
O tema central desta tese é a associação e relação entre atividade física (AF) e comportamento sedentário com doenças crônicas não transmissíveis (DCNT), como a síndrome metabólica (SM), e mortalidade por todas as causas. Devido a sua elevada prevalência mundial, a SM é considerada problema de saúde pública. A prática de AF tem impacto positivo sobre as DCNT e mortalidade precoce. O conjunto de evidências acerca da associação entre AF e comportamento sedentário com desfechos em saúde é robusto. Entretanto, a maior parte desses estudos são oriundos de países de alta renda. Considerando que a maior parte da população brasileira é atendida exclusivamente pelo Sistema Único de Saúde (SUS), esta tese é pioneira em apresentar estudos abordando a associação desses dois comportamentos com DCNT e mortalidade por todas as causas em adultos pacientes do SUS. Para isso, seis estudos originais foram desenvolvidos: i) O primeiro estudo abordou a associação entre comportamento sedentário e diabetes mellitus tipo 2; ii) O segundo, investigou se há associação entre comportamento sedentário e presença de SM; iii) O terceiro,verificou se há associação entre AF e presença de SM, e se a presença da SM afeta a trajetória de AF ao longo do tempo; iv) O estudo quatro abordou a associação entre alterações nos níveis de AF em diferentes domínios e presença de SM após oito anos de acompanhamento; v) o estudo cinco verificou se há relação entre comportamento sedentário e mortalidade por todas as causas em adultos hipertensos; e, vi) o sexto investigou a relação entre nível de AF em diferentes domínios e mortalidade por todas as causas após oito anos. O conjunto de estudos originais desenvolvidos nesta tese indicaram que: i) o comportamento sedentário está associado à presença de diabetes; ii) houve associação significante entre comportamento sedentário e presença de SM; iii) houve redução significante dos níveis de AF ao longo do tempo, e a presença de SM afetou esta trajetória significativamente; iv) os participantes com maior redução no nível de AF total apresentaram maiores chances de SM após oito anos de acompanhamento; v) maior tempo de tela está associado ao risco aumentado de mortalidade em adultos hipertensos; e vi) o nível de AF total está inversamente associado ao risco de mortalidade por todas as causas.
This thesis investigates the association of physical activity (PA) and sedentary behavior with non-communicable diseases, such as metabolic syndrome (MetS), and all-cause mortality. MetS is a major public health problem due to its high prevalence worlwide. Physical activity has positive effects on MetS risk factors and mortality. There is strong evidence regarding the association of PA, sedentary behavior and health outcomes, however, most of the data comes from high-income countries. Considering the high proportion of the Brazilian population attended exclusively by the National Health System (SUS), this thesis aims to investigate the association of PA and sedentary behavior with non-communicable diseases and all-cause mortality in this specific population. Six original studies were developed to investigate these associations: i) The first study addresses the association of sedentary behavior and type 2 diabetes mellitus; ii) The second study investigates the association between sedentary behavior and MetS; iii) The third study addresses the association of PA and MetS, and whether the presence of MetS affect the PA trend over time; iv) The fourth study investigates the association between changes in PA levels in different domains and presence of MetS after eight years of follow-up; v) The fifth study investigates the association between sedentary behavior and all-cause mortality in hypertensive patients after six years of follow-up; vi) The sixth study addresses the association of different domains of PA with all-cause mortality after eight years of follow-up. The results of this thesis conclude that i) sedentary behavior is associated with type 2 diabetes mellitus; ii) TV viewing is associated with the presence of MetS; iii) there was a significant reduction in PA levels over time, and MetS affected this phenomenon significantly; iv) participants with greater reductions in total PA level were more likely to have MetS after eight years of follow-up; v) sedentary behavior was associated with increased risk of all-cause mortality in hypertensive patients; and vi) total PA level was inversely associated with all-cause mortality.
This thesis investigates the association of physical activity (PA) and sedentary behavior with non-communicable diseases, such as metabolic syndrome (MetS), and all-cause mortality. MetS is a major public health problem due to its high prevalence worlwide. Physical activity has positive effects on MetS risk factors and mortality. There is strong evidence regarding the association of PA, sedentary behavior and health outcomes, however, most of the data comes from high-income countries. Considering the high proportion of the Brazilian population attended exclusively by the National Health System (SUS), this thesis aims to investigate the association of PA and sedentary behavior with non-communicable diseases and all-cause mortality in this specific population. Six original studies were developed to investigate these associations: i) The first study addresses the association of sedentary behavior and type 2 diabetes mellitus; ii) The second study investigates the association between sedentary behavior and MetS; iii) The third study addresses the association of PA and MetS, and whether the presence of MetS affect the PA trend over time; iv) The fourth study investigates the association between changes in PA levels in different domains and presence of MetS after eight years of follow-up; v) The fifth study investigates the association between sedentary behavior and all-cause mortality in hypertensive patients after six years of follow-up; vi) The sixth study addresses the association of different domains of PA with all-cause mortality after eight years of follow-up. The results of this thesis conclude that i) sedentary behavior is associated with type 2 diabetes mellitus; ii) TV viewing is associated with the presence of MetS; iii) there was a significant reduction in PA levels over time, and MetS affected this phenomenon significantly; iv) participants with greater reductions in total PA level were more likely to have MetS after eight years of follow-up; v) sedentary behavior was associated with increased risk of all-cause mortality in hypertensive patients; and vi) total PA level was inversely associated with all-cause mortality.
Descrição
Palavras-chave
Exercício, Estilo de vida sedentário, Doenças crônicas, Mortalidade