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The Peri-renal Fat as a Diagnostic Criterion for Metabolic Syndrome : New Evidences. FEDERAL UNIVERSITY OF UBERLANDIA. Leonardo S. R. Borges; Luis H. P. Resende; Angélica L. D. Diniz; Nilson Penha-Silva; Elmiro S. Resende . Introduction.
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The Peri-renal Fat as a DiagnosticCriterion for MetabolicSyndrome: New Evidences FEDERAL UNIVERSITY OF UBERLANDIA Leonardo S. R. Borges; Luis H. P. Resende; Angélica L. D. Diniz; Nilson Penha-Silva; Elmiro S. Resende.
Introduction Metabolicsyndrome (MS) isdefined as a set of pro-atherogenicand pro-thromboticriskfactorsthatmany times culminate in prematuredeathcausedbyatheroscleroticdiseaseand its ischemicevents.
Diagnosis of Metabolic Syndrome • Circumferencewaist > 94 cm for menand > 80 cm for women; • Triglycerideshigherthan 150 mg / dL; • HDL cholesterollowerthan 40 mg/dL for menandlowerthan 50 mg/dL for women; • SBP higherthan 130 mmHg, DBP higherthan 85 mmHg; • Fasting glucose higherthan 100 mg / dLordiabetes mellitus undertreatment. Diagnosticscriteria include thecircumferencewaistandtwo more itemsmentionedabove. IV BrazilianGuidelines...(2007).
Fundamentals The peri-renal fat (PRF) is related to hypertension, but its determination by ultrasound and its relationship with the diagnosis of metabolic syndrome (MS) are still not well established.
Objective Quantify the PRF by ultrasonography and to correlate the measures with the presence or lack of MS.
Methodology • Cross-sectional study with patients who attended the medical service of our University Clinical Hospital. • The selection and inclusion of volunteers took place from February to October 2011.
Material and Methods We included 48 volunteers of both sexes, selected by the clinical history and physical examination These volunteers underwent some laboratory tests and abdomen ultrasound.
Material and Methods We used the following exclusion criteria: Patients who were taking medications that could interfere in the hemodynamic and metabolic profile. Patients who did not know which medication they were taking. Those who ingested more than 15g a day of ethanol.
The PRF thickness was measured from the inner side of the transverse abdominal muscle to the posterior surface of the right kidney.
Results The study population characteristics Table 1. Distribution of volunteers by gender and diagnosis of metabolic syndrome.
Results The presence of three risk factors for MS was associated with the PRF thicknesses of 0.56 cm for males and 0.46 cm for females. These cut-off points were used as a criteria for diagnosis of MS in the researched population.
Results For a MS prevalence of 58.3% (M) and 37.5% (F) the sensitivity of our cut-off was 64.3% (M) and 66.7% (F), with confidence intervals (CI) from 35.1-87.2 (M) and 29.9-92.5 (F) The specificity was 80.0 % (M) and 73.3% (F) with CI from 44.4-97.5 (M) and 44.9-92.2 (F).
Results The positive predictive value was 81.8% (M) and 60.0% (F), and the negative predictive value was 61.5% (M ) and 78.6% (F); The odds ratio were 58 (M) and 38 (F); The area under the ROC curve was 0.76 (M) and 0.82 (F).
Conclusion The results demonstrated that there is a strong link between the values of PRF measured by abdominal ultrasound and the presence of MS which may indicate a new criterion to be considered in its diagnosis.
