Cardiac sympathetic drive is increased in cafeteria diet-fed rats independent of impairment in peripheral baroreflex and chemoreflex functions.

BACKGROUND AND AIMS: Consumption of a high caloric diet induces autonomic imbalance, which can lead to cardiovascular disease. Impaired arterial baroreflex control is suggested to play an important role in cardiovascular autonomic imbalance, often seen in obesity. We previously demonstrated that cafeteria diets increase the sympathetic drive to white and brown adipose tissue. METHODS AND RESULTS: After feeding a cafeteria diet to rats for 26 days, we evaluated: (i)heart rate (HR) and arterial pressure (AP); (ii)baroreflex and chemoreflex function; and (iii) autonomic modulation of the heart and vessels, measured through pulse interval (PI) and systolic arterial pressure (SAP) variability analyses and following administration of autonomic blockers. The cafeteria diet increased body fat mass and serum insulin, leptin, triacylglycerol and cholesterol levels. Baseline HR (15%) was also increased, accompanied by increased power in the low frequency band (60%) and in the low frequency/high frequency ratio (104%) in the PI spectra. Nonlinear analysis revealed an increased occurrence of 0V (39%) and decreased occurrence of 2UV (18%) patterns. Following administration of autonomic blockers, we observed an increase in cardiac sympathetic tone (425%) in cafeteria diet-fed rats. The cafeteria diet had no effect on AP, SAP variability, baroreflex and chemoreflex control. CONCLUSION: Our findings suggest that consumption of a cafeteria diet increases sympathetic drive to the heart but not to the blood vessels, independent of impairment in baroreflex and chemoreflex functions. Other mechanisms may be involved in the increased cardiac sympathetic drive, and compensatory vascular mechanisms may prevent the development of hypertension in this model of obesity.

Frequency of metabolic syndrome in children and adolescents from public schools of Divinópolis, Minas Gerais, Brazil, according to three international diagnostic criteria / Frequência de síndrome metabólica em crianças e adolescentes de escolas públicas de Divinópolis, Minas Gerais, Brasil, conforme três critérios diagnósticos internacionais

AIMS: To assess the frequency of metabolic syndrome in children and adolescents according to three international diagnostic criteria determining the level of agreement between these different criteria. METHODS: Waist circumference, blood pressure, blood glucose, high-density lipoprotein cholesterol, and serum triglycerides were evaluated in students from public schools of different regions of Divinópolis, MG, Brazil. Children and adolescents aged between 10 and 17 years were selected. Criteria adapted from the World Health Organization (WHO), National Cholesterol Education Program ­ Adult Treatment Panel III (NCEP/ATPIII), and International Diabetes Federation (IDF) were used for the diagnosis of metabolic syndrome. The kappa coefficient was used to evaluate the level of agreement among the three criteria. RESULTS: The study evaluated 202 students (86 boys and 116 girls). The frequency of metabolic syndrome was 1.16% for boys and none of the girls presented with metabolic syndrome, according to WHO criteria. According to the NCEP/ATPIII and IDF criteria, metabolic syndrome was not detected in the studied sample. Low blood levels of high-density lipoprotein cholesterol was the most frequent metabolic alteration in all teenagers according to the NCEP/ATPIII and IDF criteria, while body mass index was the most frequent one according to WHO criteria. The level of agreement for one altered parameter was poor when comparing WHO and NCEP/ATP/III, moderate when comparing WHO and IDF and high when comparing the NCEP/ATP/III and IDF criteria. CONCLUSIONS: Significant differences between the frequencies of individual metabolic syndrome parameters were found in the studied sample of children and adolescents, depending on the criteria used. According to WHO criteria, metabolic syndrome was found at a low frequency and only in boys, while the NCEP/ATPIII and IDF criteria did not diagnose metabolic syndrome. The present findings suggest the need to reach a consensus on the cut-off points for risk factors and a single diagnostic definition of metabolic syndrome in children and adolescents.

Esquizofrenia e o uso de álcool e outras drogas: perfil epidemiológico / Schizophrenia and the use of alcohol and other drugs: epidemiological profile

Este estudo teve como objetivo caracterizar o perfil sociodemográfico e clínico de pacientes esquizofrênicos e dependentes de álcool e outras drogas usuários de um Centro de Atenção Psicossocial III do Centro-Oeste de Minas Gerais, Brasil, no período julho de 1997 a julho de 2013. Configura-se como estudo epidemiológico descritivo, observacional e retrospectivo. A amostra foi composta por 1.618 pacientes e os principais resultados encontrados foram: prevalência do sexo masculino (60,4%) e da faixa etária de 21 a 30 anos (48,2%), abuso mais expressivo de álcool (35,6%) e de canabinóides (29,5%) e diagnóstico mais frequente de esquizofrenia paranoide (41,7%). Compreender os fatores associados a coexistência dessas duas patologias pode fornecer subsídios para a criação de estratégias intervencionistas que visem melhorar o prognóstico desses pacientes.