Arrifano Gabriela P, Alvarez-Leite Jacqueline I, Macchi Barbarella M, Campos Núbia F S S, Augusto-Oliveira Marcus, Santos-Sacramento Letícia, Lopes-Araújo Amanda, Souza-Monteiro José Rogério, Alburquerque-Santos Raquel, do Nascimento José Luiz M, Santos Sidney, Ribeiro-Dos-Santos Ândrea, Oriá Reinaldo B, Crespo-Lopez Maria Elena
Laboratório de Farmacologia Molecular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075-110, Brazil.
Laboratório de Aterosclerose e Bioquímica Nutricional, Departamento de Bioquímica e Imunologia, Universidade Federal de Minas Gerais, Belo Horizonte 30161-970, Brazil.
J Clin Med. 2021 Aug 17;10(16):3630. doi: 10.3390/jcm10163630.
The metabolic syndrome (MetS) epidemic is a global challenge. Although developing countries (including Brazil, India, and South Africa) present a higher proportion of deaths by cardiovascular diseases than developed countries, most of our knowledge is from these developed countries. Amazonian riverine populations (ARP), as well as other vulnerable populations of the Southern Hemisphere, share low-income and traditional practices, among other features. This large cross-sectional study of ARP ( = 818) shows high prevalence of hypertension (51%) and obesity (23%). MetS was diagnosed in 38% of participants (especially in women and 60-69 years-old individuals) without the influence of ancestry. Only 7-8% of adults had no cardio-metabolic abnormalities related to MetS. Atherogenic dyslipidemia (low HDL-cholesterol) was generally observed, including in individuals without MetS. Still, slight differences were detected between settings with a clear predominance of hypertension in Tucuruí. Hypotheses on possible genetic influence and factors (nutrition transition and environmental pollutants -mercury) are proposed for future studies. Moreover, a roadmap to MetS progression based on the most prevalent components is provided for the development of tailored interventions in the Amazon (initially, individuals would present low HDL-cholesterol levels, later progressing to increased blood pressure characterizing hypertension, and ultimately reaching MetS with obesity). Our alarming results support the need to improve our knowledge on these vulnerable populations.
代谢综合征（MetS）的流行是一项全球性挑战。尽管发展中国家（包括巴西、印度和南非）心血管疾病导致的死亡比例高于发达国家，但我们的大部分认知都来自这些发达国家。亚马逊河流域居民（ARP）以及南半球的其他弱势群体都有低收入和传统生活方式等特点。这项针对818名ARP的大型横断面研究显示，高血压患病率很高（51%），肥胖率为23%。38%的参与者被诊断患有代谢综合征（尤其是女性和60至69岁的个体），且不受祖先的影响。只有7%至8%的成年人没有与代谢综合征相关的心血管代谢异常。普遍观察到致动脉粥样硬化性血脂异常（低高密度脂蛋白胆固醇），包括在没有代谢综合征的个体中。不过，在图库里伊明显以高血压为主的地区之间仍检测到细微差异。针对未来研究提出了关于可能的遗传影响和因素（营养转变和环境污染物——汞）的假设。此外，还提供了基于最常见成分的代谢综合征进展路线图，以制定针对亚马逊地区的个性化干预措施（最初，个体的高密度脂蛋白胆固醇水平较低，随后血压升高表现出高血压，最终因肥胖达到代谢综合征）。我们令人担忧的结果支持有必要增进我们对这些弱势群体的了解。
