Prevalence of metabolic components in university students1

OBJECTIVE: to identify the frequency of components of Metabolic Syndrome (MetS) among university students. METHOD: descriptive study with 550 students, from various courses run by a public university. The socioeconomic data, lifestyle, and components of MetS were filled out using a questionnaire. Blood sample collection was undertaken in the university itself by a contracted clinical analysis laboratory. RESULTS: 66.2% were female, with a mean age of 22.6±4.41; 71.7% were sedentary; 1.8% stated that they smoke; and 48.5% were classified as at medium risk for alcoholism. 5.8% had raised abdominal circumference and 20.4% had excess weight; 1.3% and 18.9% had raised fasting blood glucose levels and triglycerides, respectively; 64.5% had low HDL cholesterol and 8.7% had blood pressure levels compatible with borderline high blood pressure. Thus, of the sample, 64.4% had at least one component for MetS; 11.6% had two, and 3.5% had three or more. CONCLUSION: a significant proportion of the population already has the components for metabolic syndrome, and this profile reinforces the importance of early diagnosis so as to reduce the risk of developing chronic comorbidities.


Introduction
In Brazil, the frequency of Metabolic Syndrome (MetS) is unknown in various regions, and little studied in differing populations. This is because it arises from globalization, an inherent indicator of modification to society's lifestyle.
Its development in an individual depends on the complex interaction between genetic predisposition and factors linked to lifestyle, such as dietary standards, sedentarism and obesity (1) .
The physical pathology of MetS has various origins, but sedentarism and obesity, associated with dietary standards and heredity factors, are strong interactions for its development. One of the most frequently-used definitions of MetS is that proposed by the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (2) and is based on the presence of three or more cardiovascular risk factors in an individual: abdominal obesity, intolerance to glucose, dyslipidemia (a rise in the levels of triglycerides in the plasma and reduction of the levels of High Density Lipoprotein -HDL-c) and increase in systemic arterial hypertension (SAH) (3) .
MetS is responsible for approximately 7% of deaths worldwide, regardless of the cause, and for 17% of those related to cardiovascular diseases (CVD). It increases the risk of CVD by 34% and 16% for men and women, respectively. Taking each component of MetS as a base, the most morbid are raised blood pressure (33%) and low HDL cholesterol (25%) (4) .
For young adults, such as, for example, university students, the international literature has evidenced investigations undertaken at the University of Kansas, the University of Carabobo (Venezuela) and the University of Stellenbosch (South Africa), which found significant prevalences of MetS. According to the researchers, it is possible that this is owed to the changes in the lives of individuals on entering university, which can lead to the adoption of inappropriate eating habits which favor the appearance of risk factors for chronic noncommunicable diseases (5)(6) .
Brazil -and many other countries, worldwidepresented a concerning situation regarding the chronic diseases, not only because of the high levels of morbidity and mortality, but mainly because these are strongly affecting the younger age ranges (7) . It is essential that practical methods for identifying this initially-silent syndrome should be outlined. Thus, the researcherss aimed to identify the frequency of the components of metabolic syndrome among university students.

Methods
This descriptive study was undertaken with 550 students of a public higher education teaching institution located in the municipality of Picos in the Brazilian state of Piauí (PI), the sample being calculated with the use of the formula for a finite population.
The inclusion criteria were: to be at least 18 years old, to accept to participate in the study, to be enrolled at, and to regularly attend, the University and to have participated in all the stages of the study (interview and collection of samples).  In relation to lifestyle, those students who did not practice light or moderate activity for a minimum of 30 minutes daily at least five days per week, or 20 minutes a day of vigorous activity on three or more days per week, were classified as sedentary. The following are considered light or moderate activities: walking, walking on a treadmill, lifting weights, hydrogymnastics, gymnastics in general, swimming, martial arts, cycling and volleyball. Vigorous activities were running, running on a treadmill, aerobic gymnastics, football, basketball, and tennis (8) .
In relation to smoking, the students were classified in four categories: daily smokers, occasional smokers, ex-smokers, and non-smokers. Those who smoked at Silva ARV, Sousa LSN, Rocha TS, Cortez RMA, Macêdo LGN, Almeida PC. least one cigarette per day at least one month prior to filling out the questionnaire were considered to be daily smokers; occasional smokers were those who did not smoke daily; ex-smokers were those who, after having been smokers, had ceased smoking at least one month previously; and those who had never smoked, or who had been smoking for less than one month, were considered non-smokers (9) .
In relation to drinking alcohol, the Alcohol Use Disorders Identification Test (AUDIT) was used, a test of 10 questions developed by the WHO as a tracking instrument specifically for identifying people with harmful consumption of alcohol, as well as those who have already developed dependence (10) .

Results
The sample consisted of 550 university students, of whom 66.2% were female, with a mean age of 22.6±4.41, of whom 85.1% were in the age range between 18 and 25 years old. 51.6% stated that they were of mixed race.
In relation to economic class, 51.8% were denominated between the classes C1 and C2, with a mean income of R$1,629.00. In relation to lifestyle, 71.7% were sedentary.
91.8% stated that they had never smoked or had been smoking for less than one month, and 48.5% were classified in zone II, of medium risk.       (12) .

Excess weight is emphasized when one investigates
MetS. One study with university students from São Paulo identified a prevalence of 28.6% and 55.6% of overweight and 22.4% and 5.5% obesity, respectively, in women and men. It also evidenced that there was  (13) . In the present study, on the other hand, the highest alterations were perceived in the male sex, in relation to AC, triglycerides and AP.
One study aiming to investigate the prevalence of metabolic syndrome in young adults and the influence of birth conditions and nutritional status in adolescence found a prevalence of MetS of 13% of those assessed.
The birth conditions did not present a relationship with the determination of the syndrome. Those diagnosed with MetS presented -in adolescence -higher values for weight (11 kg; p =<0.001), waist circumference (8 cm; p < 0.001) and body mass index (2.5 kg/m 2 ; p= 0.002) (14) . between the sexes, as well as with the rise in the body mass index (15) . the adolescents with excess weight were considered, the prevalence was 35.5%, (16) a data far higher than those found in this and in other studies with university students (11,13) .
One study aiming to describe the prevalence of  No statistical difference was found between the sexes in the following variables: triglycerides, HDL-c and arterial pressure (18) . In the present investigation, in relation to sex, there was a difference between the means related to abdominal circumference, to the triglycerides, and to systolic and diastolic pressure (p<0.05).
One descriptive study undertaken with females aged between 12 and 18 years old, from a college in  (20) .

Conclusion
Although the data analyzed belonged to a specific group -in this case, university students -the results demonstrate the high prevalence of excess weight, of sedentarism, and of alterations in these individuals' lipid profile, as the majority of the study subjects presented