Mapping of Scientific Production on Metabolic Syndrome Related to Anthropometric Aspects: a Systematic Review revIew

Metabolic syndrome (MS) can be defined as a set of risk factors such as central obesity, dyslipidemia, insulin resistance and increased blood pressure. In this context, anthropometric measures can relate to some of these factors and neck circumference an alternative and innovative approach. This study aims to map the scientific production of the last three years on metabolic syndrome related to anthropometric aspects. A systematic review was conducted in SciELO databases, PubMed and MEDLINE using as descriptors in DeCS (MeSH) Health Sciences: “syndrome x metabolic”, “neck” and “anthropometry” with publications of the last three years. 517 references were found and only 14 met the established criteria. Over 70% of production is in a foreign language and most authors agree that neck circumference is significantly associated with metabolic syndrome and which is a useful tool in the identification of metabolic syndrome. It highlights the importance of further development of studies on this issue that can guide strategic actions especially at the primary care level in the prevention of risk factors associated with MS. Mapping of Scientific Production on Metabolic Syndrome Related to Anthropometric Aspects: a Systematic Review


Introduction
Metabolic syndrome can be understood as a set of risk factors for development of diabetes and cardiovascular diseases.This syndrome is characterized by a set of factors to be highlight: central obesity, dyslipidemia, insulin resistance and increased blood pressure (Vieira, 2014).Within this context, anthropometric measures may be related to some of these factors, especially obesity.Some measures such as, body mass index (BMI), waist circumference (WC) and neck circumference (NC) can be used.WC has been used in determining the metabolic syndrome, but as an alternative, studies have suggested the use of (NC) as a simpler and practical anthropometric indicator.Increased (NC) associated with cardiometabolic risk serving for identification and prevention of diseases (Silva 2014).
The occurrence of metabolic disorders has emerged at a time earlier in the population and becoming the main cause of morbidity and mortality in many countries.Because of its magnitude the development of diagnostic markers for MS with easy application, good accuracy and low cost are noticeably relevant.In this sense would allow for greater prediction in diseases and as well as a better understanding of the population and healthcare sectors (Ribeiro-Silva, 2014).
In addition, the measure of the neck circumference is an alternative and innovative approach to the determination of body fat.Along with other factors it can determine its positive association with the occurrence of MS.Hypertension Syndrome is the component that is most prevalent for both men and women occurring in over 80% of cases (Vieira, 2014).
As stated, the most varied studies are especially relevant in clinical and epidemiological contexts being important in its correlation with the prediction and prevention of diseases in this case the MS Reasoning that the syndrome involves a number of factors mentioned above and that these factors are shown to be associated with its development could result in type II diabetes mellitus and cardiovascular disease which are extremely harmful to the individual.
Given the above, this study aims to map the scientific production of the last three years on metabolic syndrome related to anthropometric aspects.This will enable an overview of studies produced according to some established criteria and to deduce possible generalizations about the features found.

Method
To achieve the objectives of this study it was opted for a systematic review and quantitative approach, allowing a critical review and synthesis of evidence that it is possible to deduce some generalizations from a set of previously selected studies by inclusion and exclusion criteria on research in data base.
This study carried a few steps to the review as: selection of guiding questions to be analyzed, establishing the inclusion/exclusion criteria previously listed to select the sample, the characteristics analysis texts and data from the initial reading of titles and abstracts and then by reading the studies in their entirety, interpretation of the results based on their characteristics and criteria for analysis and presentation of the review.
We conducted the search for descriptors in electronic databases Scielo, PubMed, MEDLINE, using as descriptors in Decs -Health Sciences: "syndrome x metabolic", "neck" and "anthropometry" and their corresponding English "metabolic syndrome x", "neck" and "anthropometry" in the database requiring that such results are obtained by adding up in all the databases 517 studies.It was established from January publications 2012 to December 2014, due to a greater chance of finding studies on the subject in recent years to consider that in previous year's anthropometric relationship, mainly considered the neck circumference proved to be scarce, with the review taking place in December 2014.
The Boolean operator choice was originally AND, but for the database SciELO where no result was obtained it was used OR operator.In the same way the results obtained with the descriptors and the AND operator in the MEDLINE database was insufficient opting for removing the descriptor "anthropometry" with no prejudice to the collection of studies that were inherent to the theme and objective proposed by the study, which were significantly selected according to pre-established studies criteria.
At first there was a preliminary analysis with the following inclusion criteria to be available free of charge, published in the midst of 2012-2014 and considering the subject matter inherent in the theme.Exclusion criteria were articles that addressed other types of syndrome and not correlating to any anthropometric aspect.The inclusion criteria was applied leaving 115 studies.The exclusion of repeated studies was performed excluding 11 studies and leaving 104 articles.
After reading the titles and abstracts to identify the exclusion criteria highlighted above have resulted in 14 studies supporting the review in question.The selected studies were analyzed on its distribution according to the temporal analysis, health areas which belonged to (public health I or II), languages, periodicals (databases which belonged), national and international productions, researchers, outcomes and types of study.
These characteristics allowed us to know some of delineations as it has and in what areas and directions of the studies are being given to the subject.Figure 1 summarizes the methodological procedures adopted in the research.

Results and Discussion
We found 517 references cited in databases and after application of the inclusion/exclusion criteria we selected 14 studies that make up this review.Some features of the work are summarized in the table below according to the analysis criteria that was established.
Regarding the temporal distribution of the studies, they subdivided uniformly in the cut-off time established that can portray certain uniformity of publications and various studies on the subject inherent.Studies of the last year are the ones that show the anthropometric relation to the development of pathologies.The most studied health concerns are associated with that primary care.This phenomenon can produced significance in the metabolic syndrome represented by obesity, high blood pressure, abnormal blood glucose and cholesterol levels these very factors related to primary care with respect to care and initial information.
Still in this context, more than 70% of production is in a language other than Brazilian Portuguese.Despite the Brazilian scientific production growth be increasing in recent years, one can say that in some cases is not yet ideologically relevant within the world stage when compared with other pa- rameters.This fact attests to the need for performing further studies and, in this case referring to the anthropometric aspects of metabolic syndrome.The analyzed data in general contain relatively few studies on the subject.Most authors agree that neck circumference is significantly associated to metabolic syndrome and which constitutes a useful tool in the identification of metabolic syndrome.Many diseases are associated with certain types of anthropometric standards in certain anatomical regions constituting an effective correlation with clinical practice.This measure is a simple and practical indicator and is unaffected by other variables and can bring you, for example, consistent results on the excess subcutaneous fat in the upper body (Silva 2014).
Connected therewith, it was evident that older people, especially women, have a higher risk of developing cardiovascular disease and lower strength in the muscles compared to other people without metabolic syndrome.It highlights the importance of knowing and recognizing the syndrome in various contexts and its importance related to clinical practice (Farias, 2013).
Most studies that have been addressed are a cross-sectional that can answer which frequencies and exposure to a risk factor or event that might occur.The other study also prevalent as their achievement it is the descriptive research that aims to describe facts and features present in certain reality without interfering.
The researchers originate from different professions but one notices the great interest that medicine plays in clinical studies.This may generate a biased view of the production and acquisition of knowledge by certain category.It also contributes to this fact the low expression carried by the nursing class mainly in the field, proving once again the need to seeking and conducting studies on the subject.

Conclusion
Metabolic syndrome is characterized by a cluster of risk factors for development of diabetes type II and cardiovascular diseases generally associated with insulin resistance.Therefore, their identification by traditional methods as alternative in the case of anthropometric measurement of the circumference of the neck are associated with other measures become major point to recognize the syndrome it becomes extremely important.
Despite the growth of publications anthropometric primarily related to previously mentioned, still shows up scarce especially regarding national publications.Although the research findings can be generalized in several locations the need to study and interest in the subject at the local level is very important to support strategic actions in various contexts.
It is highlighted the importance of further development of studies on this issue that could guide strategic actions especially at the primary care level in the prevention of risk factors related to MS.As in most cases results in metabolic diseases such as diabetes and cardiovascular disease also these complications and diseases could be reduced in incidence bringing great benefits to patients.Where Doctors exchange clinical experiences, review their cases and share clinical knowledge.You can also access lots of medical publications for free.Join Now! http://medicalia.org/

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Figure 1 :
Figure 1: Flowchart of studies to search.

Table 1 .
Studies distribution according to the criteria.