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OBJECTIVE: The objective of this study was to evaluate the relationship between quality of life, perceived stress, anxiety, and depression in medical students and the university teaching method: traditional method versus active methodology. METHODS: Four questionnaires were administered to volunteer students (n=361) enrolled in two institutions that employ active (Universidade Tiradentes) or traditional (Faculdade de Medicina do ABC) teaching methodology: socioeconomic level; brief quality of life (World Health Organization Quality of Life-Bref); perceived stress scale (PSS10); and depression and anxiety scale (hospital anxiety and depression scale). RESULTS: Of the students who responded to the questionnaires (226 UNIT and 135 FMABC), 70% were female and 67% were White. The majority did not use medication for depression (90%), anxiety (81%), and stress management (91%). Regarding anxiety, it was found: absence in the traditional method and moderate anxiety in the active methodology (26% UNIT×13% FMABC) (p<0.001). Regarding quality of life, it was found to be better quality of life in the environment domain at FMABC (78.12%) versus 71.88% at the UNIT (p<0.001). There was no difference between the institutions in relation to depression and perceived stress, and in quality of lifethere was only a difference in the environmental domain (p<0.001). In relation to gender, stress was higher in females (93.7%) than males (79.6%) with p<0.001. CONCLUSION: Differences were recorded between the groups regarding anxiety, with a predominance in UNIT students (active methodology), and no differences were recorded in relation to depression, perceived stress, and quality of life in all domains, except for the environment domain, which was higher in the traditional methodology, although about one-third of participants used medication for anxiety/depression.
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Ansiedad , Depresión , Salud Mental , Calidad de Vida , Estrés Psicológico , Estudiantes de Medicina , Humanos , Femenino , Masculino , Estudiantes de Medicina/psicología , Encuestas y Cuestionarios , Estrés Psicológico/psicología , Adulto Joven , Adulto , Brasil , Factores Socioeconómicos , Estudios Transversales , EnseñanzaRESUMEN
Abstract Objectives To review and discuss the role of an elimination diet in food-allergic children, emphasizing nutritional aspects for a better practical approach. Sources Non-systematic review of the literature. Findings Under an elimination diet, food-allergic patients may suffer from growth impairment or obesity and compromised quality of life. Disease phenotype, age, type, number of foods excluded, comorbidities, eating difficulties, economic status, and food availability must be considered for an appropriate diet prescription. Diet quality encompasses diversity and degree of food processing, which may alter immune regulation. Conclusions A friendly food elimination diet prescription depends on a multidisciplinary approach beyond macro and micronutrients.
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OBJECTIVE: The aim of this study was to analyze the prescription of packed red blood cells performed by emergency physicians for adults with sickle cell anemia. METHODS: Transfusions performed in adults with sickle cell anemia treated at an emergency service in São Bernardo do Campo, São Paulo Brazil, between January 2018 and January 2022 were evaluated. For data comparison, the chi-square2 test was used. The significance level adopted was 5%. RESULTS: A total of 114 transfusions were performed. The mean age was 41.8±16.4 years, and pretransfusion hemoglobin was 6.1±1.23 g/dL. Regarding the indication, the adequacy of transfusions performed in symptomatic individuals was significantly higher compared to asymptomatic individuals (100% vs. 3.9%, p<0.001). Symptomatic individuals received excessive volumes of packed red blood cells less frequently than asymptomatic individuals (17.5% vs. 56.9%, p<0.001). The filtered subtype, indicated for sickle cell anemia, was prescribed in only a quarter of the patients. However, non-indicated subtypes were frequently prescribed. CONCLUSION: This study found low adequacy in the indication and calculation of the transfusion volume of packed red blood cells in asymptomatic individuals. Few patients received filtered red blood cells, resulting in increased risks of transfusion reactions. On the contrary, non-indicated subtypes were prescribed in a quarter of transfusions, which resulted in higher costs and delay in receiving packed red blood cells.
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Anemia de Células Falciformes , Adulto , Humanos , Persona de Mediana Edad , Brasil , Anemia de Células Falciformes/terapia , Transfusión Sanguínea , Hospitales , EritrocitosRESUMEN
This study aimed to describe the dietary intake of ultra-processed foods (UPF) by children and adolescents with food allergy (FA) and to verify a possible association between the UPF intake with clinical characteristics and nutritional status in this group. This cross-sectional study included 110 children and adolescents with single or multiple FA IgE and non-IgE mediated. We evaluated food intake using the NOVA classification through the three 24-h recalls. The average contribution of UPF to total energy intake (calories) ranges from 21% in the first quartile to 43% in the last quartile (mean UPF intake 33.9 ± 14.9%). After binary logistic regression, an association was verified between dietary intake of UPF (>4th quartile) as a percentage of total energy intake and having multiple food allergies (OR 4.102; 95% CI - 1.331 to 12.643; p = .014). We concluded that children and adolescents with FA consumed a higher amount of UPF.
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Ingestión de Energía , Hipersensibilidad a los Alimentos , Alimentos Procesados , Adolescente , Niño , Preescolar , Femenino , Humanos , Masculino , Estudios Transversales , Dieta , Inmunoglobulina E/sangre , Estado NutricionalRESUMEN
BACKGROUND: Atopic dermatitis (AD) is a relapsing, chronic cutaneous inflammatory disease with onset, in general, in early childhood. Chronic skin inflammation is associated with overproduction of reactive oxygen species (ROS) such as superoxide and hydrogen peroxide. Oxidative stress, an imbalance between the production of free radicals and antioxidant defense, results in tissue inflammation due to the upregulation of genes that encode inflammatory cytokines. This condition plays an important role in the pathogenesis of AD. OBJECTIVE: To compare the antioxidant defense in children and adolescents with AD with that of healthy individuals and to verify the association of antioxidant defense with disease severity and nutritional status. METHODS: Cross-sectional study that evaluated 48 children and adolescents with AD and 25 controls for nutritional assessment (body mass index z score [BMIZ] and height for age z score [HAZ]) and levels of vitamins A, C, E, and D, zinc (Zn), copper (Cu), antioxidant enzymes (superoxide dismutase [SOD], catalase [CAT], glutathione peroxidase [GPx]), high-sensitivity C-reactive protein (CRP) and interleukin 33 (IL-33). RESULTS: There was no significant difference in the comparison between AD and control groups for serum levels of vitamins (A, D, C, and E), copper, and antioxidant enzymes. Serum zinc levels were higher in the AD group (ß = 24.20; 95% CI 13.95-34.91; P < 0.001) even after adjusting the BMIZ, HAZ, gender, IL-33, and CRP. Children and adolescents with moderate or severe AD compared to mild AD (SCORAD - 36.7±17.4 vs 11.8 ± 3.9; P < 0.001) had lower values of the vitamin E/total lipid ratio (3.68 [0.29;12.63] vs 5.92 [3.27;17.37]; P = 0.013). CONCLUSION: Children and adolescents with AD had higher concentrations OF elevated levels of zinc compared to controls, a fact not observed for other biomarkers of antioxidant defense. AD in moderate or severe forms presented lower concentrations of vitamin E, a potent antioxidant fat soluble.
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Antioxidantes , Dermatitis Atópica , Preescolar , Niño , Adolescente , Humanos , Dermatitis Atópica/epidemiología , Interleucina-33 , Cobre , Estudios Transversales , Vitaminas , Vitamina E , Vitamina A , Inflamación , Gravedad del Paciente , Vitamina K , ZincRESUMEN
OBJECTIVES: To review and discuss the role of an elimination diet in food-allergic children, emphasizing nutritional aspects for a better practical approach. SOURCES: Non-systematic review of the literature. FINDINGS: Under an elimination diet, food-allergic patients may suffer from growth impairment or obesity and compromised quality of life. Disease phenotype, age, type, number of foods excluded, comorbidities, eating difficulties, economic status, and food availability must be considered for an appropriate diet prescription. Diet quality encompasses diversity and degree of food processing, which may alter immune regulation. CONCLUSIONS: A friendly food elimination diet prescription depends on a multidisciplinary approach beyond macro and micronutrients.
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Hipersensibilidad a los Alimentos , Calidad de Vida , Niño , Humanos , Hipersensibilidad a los Alimentos/prevención & control , Dieta , Alimentos , Dieta de Eliminación , AlérgenosRESUMEN
SUMMARY OBJECTIVE: The aim of this study was to analyze the prescription of packed red blood cells performed by emergency physicians for adults with sickle cell anemia. METHODS: Transfusions performed in adults with sickle cell anemia treated at an emergency service in São Bernardo do Campo, São Paulo Brazil, between January 2018 and January 2022 were evaluated. For data comparison, the chi-square2 test was used. The significance level adopted was 5%. RESULTS: A total of 114 transfusions were performed. The mean age was 41.8±16.4 years, and pretransfusion hemoglobin was 6.1±1.23 g/dL. Regarding the indication, the adequacy of transfusions performed in symptomatic individuals was significantly higher compared to asymptomatic individuals (100% vs. 3.9%, p<0.001). Symptomatic individuals received excessive volumes of packed red blood cells less frequently than asymptomatic individuals (17.5% vs. 56.9%, p<0.001). The filtered subtype, indicated for sickle cell anemia, was prescribed in only a quarter of the patients. However, non-indicated subtypes were frequently prescribed. CONCLUSION: This study found low adequacy in the indication and calculation of the transfusion volume of packed red blood cells in asymptomatic individuals. Few patients received filtered red blood cells, resulting in increased risks of transfusion reactions. On the contrary, non-indicated subtypes were prescribed in a quarter of transfusions, which resulted in higher costs and delay in receiving packed red blood cells.
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SUMMARY OBJECTIVE: The objective of this study was to evaluate the relationship between quality of life, perceived stress, anxiety, and depression in medical students and the university teaching method: traditional method versus active methodology. METHODS: Four questionnaires were administered to volunteer students (n=361) enrolled in two institutions that employ active (Universidade Tiradentes) or traditional (Faculdade de Medicina do ABC) teaching methodology: socioeconomic level; brief quality of life (World Health Organization Quality of Life-Bref); perceived stress scale (PSS10); and depression and anxiety scale (hospital anxiety and depression scale). RESULTS: Of the students who responded to the questionnaires (226 UNIT and 135 FMABC), 70% were female and 67% were White. The majority did not use medication for depression (90%), anxiety (81%), and stress management (91%). Regarding anxiety, it was found: absence in the traditional method and moderate anxiety in the active methodology (26% UNIT×13% FMABC) (p<0.001). Regarding quality of life, it was found to be better quality of life in the environment domain at FMABC (78.12%) versus 71.88% at the UNIT (p<0.001). There was no difference between the institutions in relation to depression and perceived stress, and in quality of lifethere was only a difference in the environmental domain (p<0.001). In relation to gender, stress was higher in females (93.7%) than males (79.6%) with p<0.001. CONCLUSION: Differences were recorded between the groups regarding anxiety, with a predominance in UNIT students (active methodology), and no differences were recorded in relation to depression, perceived stress, and quality of life in all domains, except for the environment domain, which was higher in the traditional methodology, although about one-third of participants used medication for anxiety/depression.
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OBJECTIVE: The aim of this study was to evaluate the influence of serum 25-hydroxyvitamin D [25(OH)D] levels at birth in postnatal growth at discharge and 12 mo of corrected age in preterm infants. METHODS: This prospective cohort included 63 preterm newborns born before 34 gestational weeks evaluated from birth until 12 mo of corrected age. The serum 25(OH)D levels in umbilical cord blood and from their mothers were evaluated at delivery. RESULTS: The mean 25(OH)D levels in preterm newborns were higher than maternal levels (24.8 ± 13.3 ng/mL versus 21 ± 10.2 ng/mL, P < 0.001) and showed a moderate correlation between (r = 0.548; P < 0.001). Considering the body mass index Z-score at 12 mo, 3 (10%), 25 (83%), and 2 (7%) of the preterm infants were thin, had normal body mass index, and were overweight, respectively. The 25(OH)D levels in the umbilical cord did not influence the anthropometric indicators at hospital discharge and 12 mo of corrected age. We observed improvement in all anthropometric indicators assessed over the months, and there was no difference between preterm infants with 25(OH)D levels >20 ng/mL and <20 ng/mL in the umbilical cord. CONCLUSIONS: The results of this study suggested that the 25(OH)D serum levels in the umbilical cord did not influence postnatal growth from birth to the first year of life in preterm infants. There was a direct association between maternal and umbilical cord serum 25(OH)D levels.
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Recien Nacido Prematuro , Deficiencia de Vitamina D , Lactante , Femenino , Humanos , Recién Nacido , Estudios Prospectivos , Vitamina D , Vitaminas , Sangre Fetal , Cordón UmbilicalRESUMEN
OBJECTIVE: To compare serum amyloid A concentrations between overweight and eutrophic children and adolescents and to relate it to lipid profiles, glucose tolerance, and carotid intima-media thickness. METHODS: One hundred children and adolescents (mean age: 10.8±3.16 years) were included and divided into two groups: overweight and non-overweight. The following were evaluated: Z-score body mass index, carotid intima-media thickness, lipid metabolism biomarkers (lipid profile and apolipoproteins A1 and B), inflammatory biomarkers (ultra-sensitive C-reactive protein and serum amyloid A), and glucose homeostasis model assessment of insulin resistance. RESULTS: The groups were homogeneous in age, sex, and pubertal stage. Higher levels of triglycerides, apolipoprotein B, homeostasis model assessment of insulin resistance, ultrasensitive C-reactive protein, serum amyloid A, and carotid intima-media thickness were observed in the overweight group. In the multivariate analysis, age (OR=1.73; 95%CI: 1.16-2.60, p=0.007), Z-score body mass index (OR=3.76; 95%CI: 1.64-8.59, p=0.002), apolipoprotein-B (OR=1.1; 95%CI: 1.01-1.2, p=0.030), and carotid intima-media thickness (OR=5.00; 95%CI: 1.38-18.04, p=0.014) were independently associated with serum amyloid A levels above the fourth quartile of the studied sample (>9.4mg/dL). CONCLUSION: Overweight children and adolescents had higher serum amyloid A concentrations than eutrophic children. There was an independent association between higher concentrations of serum amyloid A and Z-score, body mass index, apolipoprotein B, and carotid intima-media thickness, indicating the importance of this inflammatory biomarker in identifying the early risk of atherosclerosis.
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Grosor Intima-Media Carotídeo , Resistencia a la Insulina , Humanos , Adolescente , Niño , Proteína C-Reactiva , Proteína Amiloide A Sérica , Glucosa , SobrepesoRESUMEN
BACKGROUND: Ataxia-telangiectasia (A-T) is a DNA repair disorder characterized by changes in several organs and systems. Advances in clinical protocols have resulted in increased survival of A-T patients, however disease progression is evident, mainly through metabolic and liver changes. OBJECTIVE: To identify the frequency of significant hepatic fibrosis in A-T patients and to verify the association with metabolic alterations and degree of ataxia. METHODS: This is a cross-sectional study that included 25 A-T patients aged 5 to 31 years. Anthropometric data, liver, inflammatory, lipid metabolism and glucose biomarkers (oral glucose tolerance test with insulin curve-OGTT) were collected. The Cooperative Ataxia Rating Scale was applied to assess the degree of ataxia. The following were calculated: Homeostasis Model Assessment-Insulin Resistance, Homeostasis Model Assessment-Adiponectin (HOMA-AD), Matsuda index, aspartate aminotransferase (AST): platelet ratio index, nonalcoholic fatty liver disease fibrosis score and BARD score. Liver ultrasonography and transient liver elastography by FibroScan® were performed. RESULTS: Significant hepatic fibrosis was observed in 5/25 (20%). Patients in the group with significant hepatic fibrosis were older (p < 0.001), had lower platelet count values (p = 0.027), serum albumin (p = 0.019), HDL-c (p = 0.013) and Matsuda index (p = 0.044); and high values of LDL-c (p = 0.049), AST (p = 0.001), alanine aminotransferase (p = 0.002), gamma-glutamyl transferase (p = 0.001), ferritin (p = 0.001), 120-min glycemia by OGTT (p = 0.049), HOMA-AD (p = 0.016) and degree of ataxia (p = 0.009). CONCLUSIONS: A non-invasive diagnosis of significant hepatic fibrosis was observed in 20% of A-T patients associated with changes in liver enzymes, ferritin, increased HOMA-AD, and the severity of ataxia in comparison with patients without hepatic fibrosis.
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Ataxia Telangiectasia , Resistencia a la Insulina , Enfermedad del Hígado Graso no Alcohólico , Humanos , Estudios Transversales , Cirrosis Hepática , HígadoRESUMEN
BACKGROUND: Individuals undergoing bariatric surgery often have inadequate protein intake, which can cause loss of lean body mass, low level of physical activity and sarcopenia. The whey protein supplement is the most suitable in this situation, however there is a low adherence to long-term use due to the palatability and monotony of the recipes. The aim this study was to analyze the acceptability of recipes containing whey-based protein supplements in individuals undergoing bariatric and metabolic surgery. METHODS: An on-demand sampling was performed, through a prospective, experimental study, with individuals undergoing bariatric surgery, treated by a multidisciplinary team, in a clinic located in São Paulo, Brazil. The study excluded: individuals with possible changes in taste during the sensory testing period. The study was divided into selection of recipes containing whey proteins, recruitment of tasters, sensory and chemical analysis of the recipes. RESULTS: The sample consisted of 40 tasters, adults, and elderly, who underwent bariatric and metabolic surgery, with a median of eight years of surgery, who had previously consumed a supplement. These individuals were subjected to sensory analysis of six recipes with fresh and minimally processed foods, plus protein supplement. All recipes had food acceptance above 78% and the chemical analysis of the recipes showed an average of 13 g of protein per serving. CONCLUSION: There was favorable acceptance of recipes with whey proteins, which places them as good dietary alternatives for the prevention of sarcopenia and weight relapse in individuals undergoing bariatric and metabolic surgery.
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Cirugía Bariátrica , Obesidad Mórbida , Sarcopenia , Adulto , Humanos , Anciano , Proteína de Suero de Leche , Estudios Prospectivos , Brasil , Obesidad Mórbida/cirugíaAsunto(s)
Lactancia Materna , Autoeficacia , Femenino , Adolescente , Humanos , Periodo Posparto , MadresRESUMEN
OBJECTIVE: The aim of this study was to describe homocysteine concentrations in overweight and obese children and adolescents and relate them to blood pressure levels, renal function, and insulin resistance. METHODS: This is a cross-sectional and observational study with 64 overweight children and adolescents (mean age: 11.6±3.5 years) in outpatient follow-up. The following parameters were evaluated: body mass index z-score, waist-to-height circumference ratio, pubertal stage, blood pressure, serum homocysteine, glycemia, insulin, lipid profile, renal function, high-sensitivity C-reactive protein, microalbuminuria, and creatinuria. Statistical analysis: analysis of variance and logistic regression (dependent variable: homocysteine) (p<0.05). RESULTS: The mean body mass index z-score was 2.9±1.1. The mean homocysteine concentrations were 8.6±2.2 µmol/L (10th and 90th percentiles: 6.6 and 11.2 µmol/L, respectively), with no difference when compared with children with severe obesity and obesity/overweight (p=0.431). High values of waist-to-height ratio (93.8%), systolic blood pressure (18.8%), diastolic blood pressure (12.5%), glycemia (4.7%), low-density lipoprotein cholesterol (31.1%), triglycerides (35.9%), non-high-density lipoprotein cholesterol (34.4%), and microalbuminuria (21.9%) were obtained. The mean glomerular filtration rate was 122.9±24.6 mL/min/1.73 m². Homocysteine concentrations were not associated with any of the studied variables (R²=0.095). CONCLUSION: Homocysteine concentrations in overweight children and adolescents (mean 8.6±2.2 µmol/L) were not associated with body mass index z-score, blood pressure, renal function, and insulin resistance.
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Homocisteína , Resistencia a la Insulina , Sobrepeso , Obesidad Infantil , Adolescente , Niño , Humanos , Presión Sanguínea/fisiología , Índice de Masa Corporal , Estudios Transversales , Sobrepeso/complicaciones , Obesidad Infantil/complicaciones , Factores de Riesgo , Homocisteína/sangreRESUMEN
OBJECTIVE: The aim of this study was to evaluate serum 25(OH)D concentrations in the homebound elderly people and relate them to level of dementia, nutritional risk, and route of dietary administration. METHODS: This is a cross-sectional study involving 207 bedridden elderly people assisted by the Home Care Service in the city of Santo André - SP, from June to December 2016. The following factors were evaluated: dietary intake of vitamin D, arm circumference, triceps skin fold thickness, calf circumference, nutritional risk by Mini-Nutritional Assessment, level of dementia by the adapted Clinical Dementia Rating questionnaire, and laboratory tests such as serum concentrations of 25(OH)D, ultrasensitive C-reactive protein, alkaline phosphatase, serum calcium, and parathormone. RESULTS: The mean age of the elderly people was 81.6 (9.2) years. Deficiency of 25(OH)D was observed in 76.3% of the elderly people. There was an inverse correlation between serum concentrations of 25(OH)D: parathormone (r=-0.418, p<0.001) and alkaline phosphatase (r=-0.188, p=0.006) and a direct correlation with serum calcium (r=-0.158, p=0.022). Logistic regression showed that vitamin D deficiency was directly and independently associated with oral feeding (odds ratio 7.71; 95%CI 2.91-20.40). CONCLUSION: Bedridden households showed high prevalence of vitamin D deficiency without association with nutritional risk and level of dementia. Oral diet was associated with vitamin D deficiency, possibly due to low consumption of source foods.
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Demencia , Deficiencia de Vitamina D , Anciano , Anciano de 80 o más Años , Humanos , Fosfatasa Alcalina , Calcio , Estudios Transversales , Demencia/complicaciones , Hormona Paratiroidea , Vitamina D/sangre , Deficiencia de Vitamina D/complicaciones , Personas EncamadasRESUMEN
SUMMARY OBJECTIVE: The aim of this study was to describe homocysteine concentrations in overweight and obese children and adolescents and relate them to blood pressure levels, renal function, and insulin resistance. METHODS: This is a cross-sectional and observational study with 64 overweight children and adolescents (mean age: 11.6±3.5 years) in outpatient follow-up. The following parameters were evaluated: body mass index z-score, waist-to-height circumference ratio, pubertal stage, blood pressure, serum homocysteine, glycemia, insulin, lipid profile, renal function, high-sensitivity C-reactive protein, microalbuminuria, and creatinuria. Statistical analysis: analysis of variance and logistic regression (dependent variable: homocysteine) (p<0.05). RESULTS: The mean body mass index z-score was 2.9±1.1. The mean homocysteine concentrations were 8.6±2.2 μmol/L (10th and 90th percentiles: 6.6 and 11.2 μmol/L, respectively), with no difference when compared with children with severe obesity and obesity/overweight (p=0.431). High values of waist-to-height ratio (93.8%), systolic blood pressure (18.8%), diastolic blood pressure (12.5%), glycemia (4.7%), low-density lipoprotein cholesterol (31.1%), triglycerides (35.9%), non-high-density lipoprotein cholesterol (34.4%), and microalbuminuria (21.9%) were obtained. The mean glomerular filtration rate was 122.9±24.6 mL/min/1.73 m². Homocysteine concentrations were not associated with any of the studied variables (R²=0.095). CONCLUSION: Homocysteine concentrations in overweight children and adolescents (mean 8.6±2.2 μmol/L) were not associated with body mass index z-score, blood pressure, renal function, and insulin resistance.
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SUMMARY OBJECTIVE: The aim of this study was to evaluate serum 25(OH)D concentrations in the homebound elderly people and relate them to level of dementia, nutritional risk, and route of dietary administration. METHODS: This is a cross-sectional study involving 207 bedridden elderly people assisted by the Home Care Service in the city of Santo André - SP, from June to December 2016. The following factors were evaluated: dietary intake of vitamin D, arm circumference, triceps skin fold thickness, calf circumference, nutritional risk by Mini-Nutritional Assessment, level of dementia by the adapted Clinical Dementia Rating questionnaire, and laboratory tests such as serum concentrations of 25(OH)D, ultrasensitive C-reactive protein, alkaline phosphatase, serum calcium, and parathormone. RESULTS: The mean age of the elderly people was 81.6 (9.2) years. Deficiency of 25(OH)D was observed in 76.3% of the elderly people. There was an inverse correlation between serum concentrations of 25(OH)D: parathormone (r=-0.418, p<0.001) and alkaline phosphatase (r=-0.188, p=0.006) and a direct correlation with serum calcium (r=-0.158, p=0.022). Logistic regression showed that vitamin D deficiency was directly and independently associated with oral feeding (odds ratio 7.71; 95%CI 2.91-20.40). CONCLUSION: Bedridden households showed high prevalence of vitamin D deficiency without association with nutritional risk and level of dementia. Oral diet was associated with vitamin D deficiency, possibly due to low consumption of source foods.
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Zinc is an important nutrient involved in cell division, physical growth, and immune system function. Most studies evaluating the nutritional status related to zinc and prematurity were conducted with hospitalized preterm infants. These studies show controversial results regarding the prevalence of deficiency, clinical implications, and the effect of zinc supplementation on mortality, infectious diseases, and growth in these groups. This study aimed to compare serum and erythrocyte zinc levels in a group of preterm and full-term infants after 9 months of age, and related the zinc levels to dietary intake and anthropometric indicators in both groups. This cross-sectional study compared 43 preterm infants (24 to 33 weeks) aged 9-24 months to 47 full-term healthy infants. Outcome measures: anthropometric indicators and dietary intake. Blood sample for serum and erythrocyte zinc levels (ICP-MS, Inductively Coupled Plasma Mass Spectrometry). There was no difference between the groups regarding the mean of serum and erythrocyte zinc. Variables associated with higher serum zinc levels were breastfeeding at evaluation (ß = 20.11 µg/dL, 95% CI 9.62-30.60, p < 0.001) and the later introduction of solid foods (ß = 6.6 µg/dL, 95% CI 5.3-11.4, p < 0.001). Breastfeeding was also associated with higher erythrocyte zinc levels. The zinc levels were adequate in both groups, there was no association with anthropometric indicators or dietary intake and were slightly influenced by breastfeeding and time of solid food introduction.
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Lactancia Materna , Recien Nacido Prematuro , Femenino , Humanos , Recién Nacido , Lactante , Estudios Transversales , Fenómenos Fisiológicos Nutricionales del Lactante , Zinc , EritrocitosRESUMEN
ABSTRACT Objective To compare serum amyloid A concentrations between overweight and eutrophic children and adolescents and to relate it to lipid profiles, glucose tolerance, and carotid intima-media thickness. Methods One hundred children and adolescents (mean age: 10.8±3.16 years) were included and divided into two groups: overweight and non-overweight. The following were evaluated: Z-score body mass index, carotid intima-media thickness, lipid metabolism biomarkers (lipid profile and apolipoproteins A1 and B), inflammatory biomarkers (ultra-sensitive C-reactive protein and serum amyloid A), and glucose homeostasis model assessment of insulin resistance. Results The groups were homogeneous in age, sex, and pubertal stage. Higher levels of triglycerides, apolipoprotein B, homeostasis model assessment of insulin resistance, ultrasensitive C-reactive protein, serum amyloid A, and carotid intima-media thickness were observed in the overweight group. In the multivariate analysis, age (OR=1.73; 95%CI: 1.16-2.60, p=0.007), Z-score body mass index (OR=3.76; 95%CI: 1.64-8.59, p=0.002), apolipoprotein-B (OR=1.1; 95%CI: 1.01-1.2, p=0.030), and carotid intima-media thickness (OR=5.00; 95%CI: 1.38-18.04, p=0.014) were independently associated with serum amyloid A levels above the fourth quartile of the studied sample (>9.4mg/dL). Conclusion Overweight children and adolescents had higher serum amyloid A concentrations than eutrophic children. There was an independent association between higher concentrations of serum amyloid A and Z-score, body mass index, apolipoprotein B, and carotid intima-media thickness, indicating the importance of this inflammatory biomarker in identifying the early risk of atherosclerosis.