Mortality, sarcopenic obesity, and sarcopenia: Frailty in Brazilian Older People Study - FIBRA - RJ

ABSTRACT OBJECTIVE To investigate the risk of mortality associated with sarcopenic obesity (SO), obesity (OB), and sarcopenia in elderlies. METHODS We analyzed longitudinal data from 270 participants > 65 years of age of Phase III of the Study on Frailty in Brazilian Older People (FIBRA-RJ-2012). Socioeconomic, demographic, lifestyle, morbidity, and functional data were collected by home based interviews. DXA and body composition assessment was conducted in a laboratory. In women, OB was diagnosed when body fat percentage ≥ 38% and sarcopenia by an Appendicular Lean Mass Index (ALMI) < 6.00 kg/m2 and muscle strength < 16 Kgf. In men, OB was diagnosed when body fat percentage ≥ 27%, and sarcopenia was diagnosed with ALMI < 7.00 kg/m2 and muscle strength < 27 Kgf. SO was assessed by combining variables used to diagnose obesity and sarcopenia. The probabilistic linkage method was used to obtain deaths in the 2012-January 2017 period from the Brazilian Mortality Registry. Cox regression models were tested, and crude and adjusted hazard ratio calculations were conducted. RESULTS After adjusting for sex, age, race/skin color, walking as an exercise, and hypertension, individuals with sarcopenia were 5.7 times more likely to die (95%CI: 1.17-27.99) than others without sarcopenia and obesity. CONCLUSION A high risk of death was observed in individuals with sarcopenia. These results show the need for preventive strategies of early detection and treatment in order to increase survival employing multimodal interventions.

Effect of early determinants on adolescent fat-free mass: RPS cohort of São Luís - MA

ABSTRACT OBJECTIVE: To analyze the effects of early determinants on adolescent fat-free mass. METHODS: A cohort study with 579 adolescents evaluated at birth and adolescence in a birth cohort in São Luís, Maranhão. In the proposed model, estimated by structural equation modeling, socioeconomic status (SES) at birth, maternal age, pregestational body mass index (BMI), gestational smoking, gestational weight gain, type of delivery, gestational age, sex of the newborn, length and weight at birth, adolescent socioeconomic status, "neither study/nor work" generation, adolescent physical activity level and alcohol consumption were tested as early determinants of adolescent fat-free mass (FFM). RESULTS: A higher pregestational BMI resulted in higher FFM in adolescence (Standardized Coefficient, SC = 0.152; p < 0.001). Being female implied a lower FFM in adolescence (SC = −0.633; p < 0.001). The negative effect of gender on FFM was direct (SC = −0.523; p < 0.001), but there was an indirect negative effect via physical activity level (SC = −0.085; p < 0.001). Women were less active (p < 0.001). An increase of 0.5 kg (1 Standard Deviation, SD) in birth weight led to a gain of 0.25 kg/m2 (0.106 SD) in adolescent FFM index (p = 0.034). Not studying or working had a negative effect on the adolescent's FFM (SC = −0.106; p = 0.015). Elevation of 1 SD in the adolescent's physical activity level represented an increase of 0.5 kg/m2 (0.207 SD) in FFM index (p < 0.001). CONCLUSIONS: The early determinants with the greatest effects on adolescent FFM are gender, adolescent physical activity level, pregestational BMI, birth weight and belonging to the "neither-nor" generation.

Associação entre periodontite crônica severa e reatividade microvascular cutânea de pacientes hipertensos / Association between severe chronic periodontitis and cutaneous microvascular reactivity in hypertensive patients

No presente trabalho, foram realizados exames em 49 pacientes para avaliar a possível associação da periodontite crônica grave na reatividade microvascular cutânea em pacientes hipertensos. Secundariamente, avaliou-se a relação da adiposidade corporal com a doença periodontal. Para avaliação periodontal os exames utilizados foram índices de placa e sangramento à sondagem, profundidade de bolsa à sondagem e nível de inserção clínica. A reatividade microvascular cutânea foi analisada por meio do Laser Speckle Contrast Imaging (LSCI), que é uma técnica não invasiva, enquanto a adiposidade corporal foi examinada através da Bioimpedância elétrica (BIA). Os resultados mostraram que não houve diferença na reatividade microvascular cutânea em pacientes com periodontite crônica grave em comparação com os periodontalmente saudáveis, assim como também não houve diferenças entre hipertensos e normotensos. Quanto a adiposidade corporal, a periodontite não influenciou os resultados, porém pacientes hipertensos demonstraram maiores índices de massa gorda em relação aos demais. Assim, a periodontite crônica severa não influenciou na reatividade microvascular cutânea em pacientes hipertensos e pessoas hipertensas apresentaram maior adiposidade corporal. Foi considerado p<0,05

In the present study, 49 patients were evaluated in order to evaluate a possible association between severe chronic periodontitis on cutaneous microvascular reactivity in hypertensive patients. Secondarily, the relationship between body adiposity and periodontal disease was evaluated. For periodontal evaluation the exams included were plaque index and bleeding on probing, probing pocket depth and clinical attachment loss. Cutaneous microvascular reactivity was analyzed by means of the Laser Speckle Contrast Imaging (LSCI), a noninvasive technique, while body fatness was examined through Electric Bioimpedance (BIA). The results showed that there was no difference in cutaneous microvascular reactivity in patients with severe chronic periodontitis when compared to periodontally healthy patients, nor were there differences between hypertensive and normotensive individuals. As for body adiposity, a periodontitis did not influence the results, but hypertensive patients showed higher fat mass indexes as compared to non-hypertensive patients. Thus, severe chronic periodontitis did not influence cutaneous microvascular reactivity and hypertensive individuals had greater body adiposity. Be considered p<0,05