Quando suspeitar de Síndrome Metabólica no Exame Físico e qual a relevância para a Saúde Ocupacional?

Introduction / background / objective In a western world marked by a high prevalence of metabolic changes related to metabolic syndrome (obesity, cardiovascular diseases, type 2 diabetes mellitus, high blood pressure, dyslipidemia), it is essential to know where to look and recognize early signs. In companies, it is common to find workers with various risk factors that characterize metabolic syndrome since the environment and work organization can have an influence (such as inappropriate food choices in cafeteria or vending machines, work organization and stress, or shift work and its impact on circadian rhythm). Its consequences will cause more illnesses, more work accidents and bigger losses for companies. Therefore, in occupational health services, there is another way to invest in the development of health and well-being, in addition to the direct prevention of occupational diseases and accidents at work, by analyzing the worker from a global point of view throughout his life, and acting in synergy with Primary Health Care. The main objective of this work is to elaborate a review of the cutaneous manifestations that can provide clues during the physical exam, having as main focus the metabolic syndrome. Methodology It is a Scoping Review, carried out in the EBSCO databases (CINAHL, MEDLINE, Nursing & Allied Health Collection: Comprehensive, Cochrane Database, MedicLatina), PUBMED and RCAAP, in the period of June 2020. The keywords used were: “Skin manifestations”, “Signs on the skin”, “Insulin resistance”, “Metabolic syndrome”. Results Several signs suggestive of metabolic syndrome or insulin resistance were found, namely acanthosis nigricans, acrochordons/skin tags, xanthelasmas, eruptive xanthomas, diagonal earlobe crease/ Frank’s sign, some inflammatory skin manifestations (acne, hidradenitis suppurativa) and autoimmune (psoriasis, vitiligo). Conclusions It is essential to encourage lifestyle changes that address Metabolic Syndrome. Empowering or reminding professionals of non-invasive assessment techniques for signals recognition, can contribute to helping the team to detect metabolic manifestations early, simply by looking at the skin of those they care for. This approach can be an asset in occupational health services, which are at the forefront of monitoring adults, and whose disease course can be controlled or even reversed with early diagnosis and intervention. In fact, analyzing the worker in his entire definition of health (adding Preventive Medicine / Nursing to Curative) and working in synergy with Primary Health Care, will end up influencing the productivity of companies (by avoiding sick leave due to illness, or even reducing work accidents).