Prevalence of metabolic syndrome and its components in Brazilian adolescents: a systematic review and meta-analysis / Prevalência da síndrome metabólica e seus componentes em adolescentes brasileiros: uma revisão sistemática e metanálise

Abstract Objective: To determine the prevalence of metabolic syndrome (MS) and its components among Brazilian adolescents. Data source: Databases, such as LILACS, MEDLINE, and SciELO, were searched for original cross-sectional studies published between 2010 and 2021. The inclusion criteria were determined based on the mnemonic CoCoPop — Condition, Context, and Population: studies determining the prevalence of MS and its components (condition) in the general population of Brazilian adolescents, female and male (population), enrolled in public or private schools in rural or urban areas (context). Reviews, editorials, and articles that did not directly relate to the prevalence of MS or that included non-adolescent age groups or groups with specific health conditions (obesity/overweight and others) were excluded. Data synthesis: A total of 15 studies, including 43,227 adolescents, were identified. MS prevalence (95% confidence interval [95%CI]) was 2.9% (2.65-3.18) and 2.4% (1.90-2.90) (p<0.001) in males and females, respectively, by using the International Diabetes Federation (IDF) criteria. There was a significant difference in MS prevalence among Brazilian regions (Q=24.7; p<0.001). The lowest MS prevalence (95%CI) was determined for North Region of Brazil, 1.8% (1.52-2.13), and the highest for Northeast Region of Brazil, 2.9% (2.62-3.23). Regarding MS components, a higher prevalence (95%CI) was found for low high-density lipoprotein (HDL), 22.1% (12.49-36.17), followed by abdominal obesity, 11.0% (8.05-14.94), and arterial hypertension, 10.3% (7.84-13.48). Conclusions: This study allowed the determination of the prevalence of MS and the MS components in Brazilian adolescents, highlighting relevant aspects to be addressed on public health management.

RESUMO Objetivo: Determinar a prevalência da síndrome metabólica (SM) e seus componentes em adolescentes brasileiros. Fontes de dados: Realizaram-se buscas nas bases de dados Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs), Medical Literature Analysis and Retrieval System Online (Medline) e Scientific Electronic Library Online (SciELO) por estudos transversais originais publicados entre 2010 e 2021. Os critérios de inclusão foram determinados pelo Mnemônico CoCoPop — Condição, Contexto e População: estudos que determinam a prevalência de SM e seus componentes (condição) na população geral de adolescentes brasileiros, feminino e masculino (população), matriculados em escolas públicas ou privadas em áreas rurais ou urbanas (contexto). Revisões, editoriais, artigos não relacionados com a prevalência de SM ou que incluíssem grupos etários não adolescentes ou com condições de saúde específicas (obesidade/sobrepeso e outros) foram excluídos. Síntese dos dados: Quinze estudos, com 43.227 adolescentes, foram identificados. A prevalência de SM (intervalo de confiança — IC95%) no sexo masculino foi de 2,9% (2,65-3,18) e no feminino foi de 2,4% (1,90-2,90) (p<0,001), pelos critérios da Federação Internacional de Diabetes (IDF). Houve diferença significativa na prevalência de SM entre regiões brasileiras (Q=24,7; p<0,001). A menor prevalência de SM (IC95%) foi encontrada em região Norte, com 1,8% (1,52-2,13), e a maior na região Nordeste, com 2,9% (2,62-3,23). Em relação aos componentes da SM, maior prevalência (IC95%) foi encontrada para lipoproteína de baixa densidade (HDL) baixa (22,1%, 12,49-36,17), seguida de obesidade abdominal (11,0%, 8,05-14,94) e hipertensão arterial (10,3%, 7,84-13,48). Conclusões: Este estudo permitiu determinar a prevalência da SM e seus componentes em adolescentes brasileiros, destacando aspectos relevantes a serem abordados na gestão da saúde pública.

Prevalence of metabolic syndrome and its components in Brazilian adolescents: a systematic review and meta-analysis.

OBJECTIVE: To determine the prevalence of metabolic syndrome (MS) and its components among Brazilian adolescents. DATA SOURCE: Databases, such as LILACS, MEDLINE, and SciELO, were searched for original cross-sectional studies published between 2010 and 2021. The inclusion criteria were determined based on the mnemonic CoCoPop - Condition, Context, and Population: studies determining the prevalence of MS and its components (condition) in the general population of Brazilian adolescents, female and male (population), enrolled in public or private schools in rural or urban areas (context). Reviews, editorials, and articles that did not directly relate to the prevalence of MS or that included non-adolescent age groups or groups with specific health conditions (obesity/overweight and others) were excluded. DATA SYNTHESIS: A total of 15 studies, including 43,227 adolescents, were identified. MS prevalence (95% confidence interval [95%CI]) was 2.9% (2.65-3.18) and 2.4% (1.90-2.90) (p<0.001) in males and females, respectively, by using the International Diabetes Federation (IDF) criteria. There was a significant difference in MS prevalence among Brazilian regions (Q=24.7; p<0.001). The lowest MS prevalence (95%CI) was determined for North Region of Brazil, 1.8% (1.52-2.13), and the highest for Northeast Region of Brazil, 2.9% (2.62-3.23). Regarding MS components, a higher prevalence (95%CI) was found for low high-density lipoprotein (HDL), 22.1% (12.49-36.17), followed by abdominal obesity, 11.0% (8.05-14.94), and arterial hypertension, 10.3% (7.84-13.48). CONCLUSIONS: This study allowed the determination of the prevalence of MS and the MS components in Brazilian adolescents, highlighting relevant aspects to be addressed on public health management.

The in vivo and in vitro roles of Trypanosoma cruzi Rad51 in the repair of DNA double strand breaks and oxidative lesions.

In Trypanosoma cruzi, the etiologic agent of Chagas disease, Rad51 (TcRad51) is a central enzyme for homologous recombination. Here we describe the different roles of TcRad51 in DNA repair. Epimastigotes of T. cruzi overexpressing TcRAD51 presented abundant TcRad51-labeled foci before gamma irradiation treatment, and a faster growth recovery when compared to single-knockout epimastigotes for RAD51. Overexpression of RAD51 also promoted increased resistance against hydrogen peroxide treatment, while the single-knockout epimastigotes for RAD51 exhibited increased sensitivity to this oxidant agent, which indicates a role for this gene in the repair of DNA oxidative lesions. In contrast, TcRad51 was not involved in the repair of crosslink lesions promoted by UV light and cisplatin treatment. Also, RAD51 single-knockout epimastigotes showed a similar growth rate to that exhibited by wild-type ones after treatment with hydroxyurea, but an increased sensitivity to methyl methane sulfonate. Besides its role in epimastigotes, TcRad51 is also important during mammalian infection, as shown by increased detection of T. cruzi cells overexpressing RAD51, and decreased detection of single-knockout cells for RAD51, in both fibroblasts and macrophages infected with amastigotes. Besides that, RAD51-overexpressing parasites infecting mice also presented increased infectivity and higher resistance against benznidazole. We thus show that TcRad51 is involved in the repair of DNA double strands breaks and oxidative lesions in two different T. cruzi developmental stages, possibly playing an important role in the infectivity of this parasite.