Examining the mediating role of muscle quantity in adolescents: associations with adiposity, cardiorespiratory fitness, muscular fitness, and cardiometabolic risk factors.

The aim of this study was to evaluate the mediation role of muscle quantity in the relationship between physical fitness and cardiometabolic risk factors (CMRF) in adolescents. This cross-sectional study conducted with 120 adolescents of both sexes, aged between 10 and 17 years. Body mass, height, fat mass (FM), lean mass, blood pressure, high-density lipoprotein, low-density lipoprotein, triglycerides, glucose, insulin, cardiorespiratory fitness (CRF) and 1 repetition maximum strength (1-RM) with evaluation of the leg press 45° (RM-leg), bench press (RM-bench) and arm curl (RM-arm). Body mass index z-score, appendicular skeletal muscle mass, appendicular skeletal muscle mass index, lean mass index (LMI), muscle-to-fat ratio (MFR), age at peak height velocity, and CMRF z-score were calculated. The direct relation between FM and CMRF was mediated by the LMI (26%) and inverse relation between CRF and CMRF was mediated by the LMI (26%). For girls, the direct relation between FM and CMRF was mediated by the LMI (32%); the inverse relation between CRF, RM-leg, RM-arm and CMRF was mediated by the LMI (32%, 33%, and 32%, respective). For boys, the indirect effect was not significant, indicating that LMI is not a mediator in the relation between FM, CRF, 1-RM with CMRF. The direct relation between RM-leg and CMRF was mediated by the MRF (16%). This finding evidenced the importance of promoting a healthy lifestyle to improve physical fitness levels and the quantity of muscle mass in adolescents.

Comparison of the dietary intake amongst women in the late postoperative period after Roux-en-Y gastric bypass with the bariatric food pyramidof dietary intake with reference values among women in late postoperative of y-en-roux gastric bypass.

INTRODUCTION: Introduction: the Roux-en-Y gastric bypass (RYGB) is considered to be an efficient treatment of obesity. There is an improvement in the dietary intake in the immediate postoperative period, but after the first year there is a tendency to return to the old pre-surgery habits. The objective of the present study was to compare the dietary intake of women in the late postoperative period after RYGB with the recommendations of the specific bariatric food pyramid. Methodology: the whole population of patients submitted to RYGB being accompanied by two out-patients departments of the Complexo Hospital de Clínicas of Universidade Federal do Paraná in the period from March to September 2017 were considered, selecting only those who conformed to the inclusion criteria. The analyses carried out were: the hospital records, anthropometric evaluation, basal metabolic rate by indirect calorimetry, food consumption and questionnaires concerning physical activity, food intolerance and the dumping syndrome. The food consumption was separated into food groups in order to compare with the specific pyramid. Descriptive analyses were used to characterize the sample. Results: it can be seen that the percent of macronutrients in relation to the total energy value (TEV) was within the values established by the recommended dietary allowances (RDA), although with respect to fiber, 68% of the participants showed a consumption below the adequate intake (AI). Inadequacy was observed for practically all the components when comparing the number of portions per food group of the bariatric pyramid, with the exception of the protein group. Conclusion: after RYGB, the dietary consumption was compromised in quantity and quality. In addition, in the late postoperative period, women tended to choose high calorie dense foods poor in fiber, a fact that is aggravated by the presence of food intolerances.

INTRODUCCIÓN: Introducción: el bypass gástrico en Y de Roux (BGYR) es considerado un tratamiento eficaz de la obesidad. Normalmente, se percibe una mejoría en la ingesta dietética en el postoperatorio inmediato, pero después del primer año hay una tendencia a volver a los viejos hábitos preoperatorios. El objetivo del presente estudio fue comparar la ingesta dietética de las mujeres en el postoperatorio tardío después del BGYR con las recomendaciones de la pirámide nutricional bariátrica. Material y métodos: se consideró a toda la población de pacientes sometidos a BGYR, además de dos ambulatorios del Complexo Hospital de Clínicas de la Universidade Federal de Paraná en el periodo de marzo a septiembre de 2017, seleccionando solo a aquellos que cumplían con los criterios de inclusión. Los análisis realizados fueron: registros hospitalarios, evaluación antropométrica, tasa metabólica basal por calorimetría indirecta, consumo de alimentos y cuestionarios sobre actividad física, intolerancia alimentaria y síndrome de dumping. El consumo de alimentos se dividió en grupos de alimentos para compararlos con la pirámide específica. Se utilizaron análisis descriptivos para caracterizar la muestra. Resultados: podemos observar que el porcentaje de macronutrientes en relación con el valor energético total (VET) estuvo dentro de los valores recomendados por las ingestas diarias recomendadas (IDR), aunque con respecto a la fibra, el 68% de los participantes mostró un consumo inferior a la ingesta adecuada (AI, por sus siglas en inglés). Se observó una insuficiencia en prácticamente todos los componentes al comparar el número de porciones por grupo de alimentos de la pirámide bariátrica, con la excepción del grupo de proteínas. Conclusión: después del BGYR, el consumo dietético se vio comprometido en cantidad y calidad. Además, en el postoperatorio tardío, las mujeres tendían a elegir alimentos ricos en calorías y pobres en fibra, un hecho que se agrava por la presencia de intolerancias alimentarias.

12-Week aerobic exercise and nutritional program minimized the presence of the 64Arg allele on insulin resistance.

BACKGROUND: The objective of the study was to investigate the response of 64Arg allele carriers of the ADRB3 gene (Trp64Arg polymorphism) in the anthropometric, cardiorespiratory and metabolic variables in overweight adolescents after a 12-week aerobic exercise and nutritional program. METHODS: A total of 92 overweight adolescents, 10-16 years old and of both genders, participated. Body composition, waist circumference (WC), pubertal stage status, blood pressure, glucose, insulin and lipid profile and direct maximal oxygen uptake were assessed at baseline and after 12 weeks of a training program. The homeostasis metabolic assessments [homeostasis model assessment of insulin resistance (HOMA-IR)] and quantitative insulin sensitivity check index (QUICKI) were determined and the Trp64Arg polymorphism of the ADRB3 gene was investigated by Taqman single nucleotide polymorphism (SNP) genotyping assays. Exercise sessions consisted of 100-min aerobic exercise and 20-min stretching, 3 times a week, totalizing 36 sessions. Multivariate analysis of variance (MANOVA), analysis of covariance (ANCOVA) and effect size were used for variables, with p<0.05 considered significant. RESULTS: In baseline, HOMA-IR was higher in carriers of the 64Arg allele and decreased more after 12 weeks than in non-carriers (p=0.01). The anthropometric, physical fitness and metabolic profiles had similar responses after training in carriers and non-carriers. CONCLUSIONS: Overweight adolescents present changes in body composition and physical fitness, independent of Trp64Arg genotypes. However, a 12-week aerobic exercise and nutritional program promoted greater reductions in insulin resistance in carriers of the 64Arg allele.

Good weight loss responders and poor weight loss responders after Roux-en-Y gastric bypass: clinical and nutritional profiles.

BACKGROUND: Bariatric surgery is one of the main treatments for severity obesity, but weight regain after surgery is an important issue. OBJECTIVES: To compare the clinical and nutritional profiles of good and poor weight loss responders in the late postoperative period after bariatric surgery. METHODS: A cross-sectional study with patients undergoing Roux-en-Y gastric bypass in a University Hospital. Patients were divided into good weight loss responders (GWLR) and poor weight loss responders (PWLR) defined as ≥ 50% or < 50% excess weight loss (EWL), respectively, at least 2 years post-surgery. RESULTS: The sample included 204 individuals (87.7% women; mean age 50.15 ± 11.1 years; mean time after surgery 67.38 ± 30.76 months). Two years post-surgery, 71.1% were considered GWLR and 28.9% PWLR (mean EWL 72.33% ± 13.86%, and 35.06% ± 12.10%, respectively; p = 0.000). Weight regain was < 10% for 36.3% of patients, 10.1-20% for 36.3%, and > 20% for 21.3%, compared with the lowest post-surgery weight. Among PWLR, 49.0% regained > 20% of the lowest post-surgery weight. GWLR lost most weight at all time points analyzed (p < 0.05). GWLR presented improvement or remission of diabetes, dyslipidemia and hypertension more frequently compared to PWLR (p < 0.05). Eating patterns was similar between GWLR and PWLR (p > 0.05, study's power 100%). Quality of life improved in 79.5% of the total study sample, with greater improvements in the GWLR (p < 0.05). CONCLUSIONS: Greater weight loss correlated with improved remission in comorbidities and better quality of life.

One year of GH replacement therapy with a fixed low-dose regimen improves body composition, bone mineral density and lipid profile of GH-deficient adults.

OBJECTIVE: We have studied the effects on body composition and metabolism of a fixed low dose of growth hormone (GH), 0.6 IU (0.2 mg)/day, administered for 12 months to GH-deficient (GHD) adults. DESIGN AND METHODS: Prospective open-label study, using 18 GHD patients (11 women, 7 men; aged 21-58 years). All investigations were performed at baseline and after 12 months. Body composition was determined by dual energy X-ray absorptiometry. RESULTS: Total body fat decreased (-1.74+/-2.87%) and lean body mass (LBM) increased (1.27+/-2.08 kg) after therapy (P < 0.05). Changes in truncal fat did not reach statistical significance, but a decrease varying from 0.72 to 2.78kg (1 to 8.7%) was observed in 13 (72%) patients. Bone mineral density (BMD) increased at lumbar spine, total femur and femoral neck (P < 0.05). Levels of total and low-density lipoprotein (LDL)-cholesterol were lower after therapy (P < 0.05), and their changes were directly associated with values at baseline. Insulin levels increased and the insulin resistance index worsened at 12 months (P < 0.05). Median IGF-I s.d. score was -4.30 (range, -11.03 to -0.11) at baseline and -1.73 (range, -9.80 to 2.26) at 12 months. Normal age-adjusted IGF-I levels were obtained with therapy in 5 of 11 patients who had low IGF-I levels at baseline. Changes in IGF-I levels were not correlated with any biological end point, except changes in LBM (r = 0.53, P = 0.02). Side effects were mild and disappeared spontaneously. CONCLUSIONS: One-year of a fixed low-dose GH regimen in GHD adults resulted in a significant reduction in body fat, total cholesterol and LDL-cholesterol, and a significant increase in LBM and BMD at lumbar spine and femur, regardless of normalization of IGF-I levels. This regimen led to an elevation of insulin levels and a worsening of the insulin resistance index.

Peak oxygen uptake responses to training in obese adolescents: a multilevel allometric framework to partition the influence of body size and maturity status.

The influence of body size and maturation on the responses in peak oxygen uptake (VO2) to a 12-week aerobic training and nutritional intervention in obese boys (n = 30; 10-16 years) was examined using multilevel allometric regressions. Anthropometry, sexual maturity status, peak VO2, and body composition were measured pre- and postintervention. Significant decrements for body mass, body mass index z-score, and waist circumference and increments for stature, fat-free mass, and peak oxygen uptake were observed after intervention. Partitioning body size on peak VO2, the responses of the individuals to training were positive (11.8% to 12.7% for body mass; 7.6% to 8.1% for fat-free mass). Body mass and fat-free mass were found as significant explanatory variables, with an additional positive effect for chronological. The allometric coefficients (k') in the initial models were k' = 0.883 and k' = 1.058 for body mass and fat-free mass, respectively. The coefficients decreased when age was considered (k' = 0.530 for body mass; k' = 0.860 for fat-free mass). Including maturity indicator in the models was not significant, thus the influence of variability in sexual maturity status in responses to exercise-based intervention in peak VO2 may be mediated by the changes in body dimensions.

Age and menarcheal status do not influence metabolic response to aerobic training in overweight girls.

BACKGROUND: Multidisciplinary intervention is an alternative for the treatment of children and adolescent obese. However, the influence of age and menarcheal status in the pattern of metabolic response of obese girls has not been investigated. The following study examined the effects of a 12-week multidisciplinary intervention on metabolic health in overweight girls and the contribution of age and menarcheal status on the resulting changes. METHODS: Eighty-eight overweight girls (10 - 16 years) were considered initially for this study and randomly assigned (intervention group: n = 58; control group: n = 30). Forty-six girls completed the intervention program and 16 girls completed the follow-up for the control group. The 12-week intervention included aerobic exercises (three times per week) and nutritional intervention. Anthropometrical measures (body mass, body mass index and waist circumference), menarcheal status and metabolic profiles including glucose, insulin, triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were assessed in the beginning and after of intervention. Additionally, were calculated homeostatic model assessment-insulin resistance (HOMA-IR) and quantitative insulin sensitivity check index (QUICKI). RESULTS: After 12-week, girls decreased significantly the body mass (76.6 ± 14.7 to 75.7 ± 14.6 kg) body mass index (30.1 ± 4.0 to 29.4 ± 4.0 kg/m2) and waist circumference (98.9 ± 10.9 to 96.5 ± 11.4 cm). There were differences in HDL-C (43.1 ± 8.2 to 50.3 ± 9.4 mg/dl), TG (120.9 ± 64.3 to 93.3 ± 47.9 mg/dl) and insulin (16.9 ± 7.6 to 15.6 ± 9.8 mg/dl). Relative contribution of age was significant only for within-subject variability in waist circumference. CONCLUSIONS: The multidisciplinary based on aerobic training intervention used in this study produced substantial benefits on metabolic health indicators in overweight girls. The changes observed were not related to inter-individual variability in age and maturity status.

Good weight loss responders and poor weight loss responders after Roux-en-Y gastric bypass: clinical and nutritional profiles / Buenos y malos respondedores después de bypass gástrico en Y de Roux: perfiles clínicos y nutricionales

Background: Bariatric surgery is one of the main treatments for severity obesity, but weight regain after surgery is an important issue. Objectives: To compare the clinical and nutritional profiles of good and poor weight loss responders in the late postoperative period after bariatric surgery. Methods: A cross-sectional study with patients undergoing Roux-en-Y gastric bypass in a University Hospital. Patients were divided into good weight loss responders (GWLR) and poor weight loss responders (PWLR) defined as ≥ 50% or < 50% excess weight loss (EWL), respectively, at least 2 years post-surgery. Results: The sample included 204 individuals (87.7% women; mean age 50.15 ± 11.1 years; mean time after surgery 67.38 ± 30.76 months). Two years post-surgery, 71.1% were considered GWLR and 28.9% PWLR (mean EWL 72.33% ± 13.86%, and 35.06% ± 12.10%, respectively; p = 0.000). Weight regain was < 10% for 36.3% of patients, 10.1-20% for 36.3%, and > 20% for 21.3%, compared with the lowest post-surgery weight. Among PWLR, 49.0% regained > 20% of the lowest post-surgery weight. GWLR lost most weight at all time points analyzed (p < 0.05). GWLR presented improvement or remission of diabetes, dyslipidemia and hypertension more frequently compared to PWLR (p < 0.05). Eating patterns was similar between GWLR and PWLR (p > 0.05, study’s power 100%). Quality of life improved in 79.5% of the total study sample, with greater improvements in the GWLR (p < 0.05). Conclusions: Greater weight loss correlated with improved remission in comorbidities and better quality of life (AU)

Introducción: la cirugía bariátrica es uno de los principales tratamientos para la obesidad, pero la recuperación de peso después de la cirugía es una cuestión importante. Objetivo: comparar los perfiles clínicos y nutricionales de los buenos y malos respondedores en postoperatorio (PO) tardío de la cirugía bariátrica. Método: estudio transversal con pacientes sometidos a bypass gástrico en Y de Roux en un hospital universitario. La muestra se divide en buenos respondedores (BR) y respuesta deficiente (MR), teniendo en cuenta el porcentaje de pérdida de exceso de peso (PEP) del 50,0%, después de al menos 2 años de PO. Resultados: un total de 204 personas (87,7% mujeres, con una edad media de 50,15 ± 11,1 años y 67,38 ± 30,76 meses después de la operación). Después de 2 años de la operación, el 71,1% se consideraron BR y el 28,9% MR (PEP promedio 72,33 ± 13,86% y 35,06 ± 12,10%, respectivamente) (p < 0,05). La recuperación de peso fue < 10% para el 36,3% de los pacientes, 10,1 a 20% a 36,3% y > 20% a 21,3% en comparación con el menor peso después de la cirugía. Entre MR, el 49,0% recuperó más del 20% del peso más bajo después de la cirugía. El BR perdió la mayor parte de sobrepeso en los diferentes tiempos analizados PO (p < 0,05). El BR mostró mejoría o remisión de la diabetes mellitus, dislipidemia e hipertensión con más frecuencia, en comparación con los MR (p < 0,05). El patrón de dieta fue similar entre la BR y MR (p > 0,05; 100% de la potencia del estudio). La calidad de vida mejoró en el 79,5% del total del grupo, con la mejor evolución en los BR (p < 0,05). Conclusión: la pérdida de peso mayor se correlaciona con la mejora de la remisión de comorbilidades y una mejor calidad de vida (AU)

[Efficacy, safety and compliance of long-term growth hormone (GH) replacement therapy in adults with GH deficiency]. / Eficácia, segurança e aderência ao tratamento de longo prazo com hormônio de crescimento (GH) em adultos com deficiência de GH.

AIM: To study efficacy, safety and compliance of GH therapy for 4 years in 18 GH deficient (GHD) adults [12 women; mean age 50.5 yrs (25-66 yrs)]. METHODS: Clinical, biochemical and body composition (DXA) measurements were performed before and every year after GH therapy. Ecocardiography was performed at baseline and after 4 years. Dose of GH was 0.2 mg/day during the first year with subsequent titration to attain normal IGF-1 levels. RESULTS: There was a significant reduction of total body fat (mean 2.8 kg), truncal fat (mean 1.9 kg) and an increase of lean body mass (mean 0.8 kg) and bone mineral density (BMD) on lumbar spine and femur, particularly in sites with T-score<-1,0 at baseline. Insulin levels and HOMA index worsened in the first year, but at the end no changes were noted on glucose, insulin, HOMA index and glycosylated hemoglobin. Two patients with altered glucose tolerance at baseline developed type 2 diabetes during follow-up. Total and LDL-cholesterol were significantly lower after therapy, with changes directly associated with baseline values. Cardiac parameters did not change. Side effects were mild and disappeared spontaneously. Tumor recurrence was not observed. Low compliance (estimated by low IGF-1 levels) was observed in 4 (22%), 2 (11%) and 6 (33%) patients at the end of second, third and fourth year, respectively. CONCLUSIONS: Four years of GH therapy in GHD adults had a positive impact on body composition, BMD and lipid profile, with no effects on insulin sensitivity and heart. Glucose tolerance should be monitored carefully during long-term GH therapy.

Eficácia, segurança e aderência ao tratamento de longo prazo com hormônio de crescimento (GH) em adultos com deficiência de GH / Efficacy, safety and compliance of long-term growth hormone (GH) replacement therapy in adults with GH deficiency

OBJETIVO: Avaliar a eficácia, a segurança e a aderência de quatro anos de tratamento com GH em 18 adultos [12 mulheres, 6 homens, com idade média de 50,5 anos (25-66 anos)] com deficiência grave de GH (DGH). MÉTODOS: Avaliações clínica, laboratorial e de composição corporal (DXA) realizadas antes e anualmente após o início do GH, e ecocardiografia realizada antes e após quatro anos de tratamento. Dose de 0,2 mg GH/dia mantida fixa no primeiro ano, com posteriores ajustes para normalizar IGF-1. RESULTADOS: Redução significativa da gordura corporal total (média 2,8 kg) e da gordura truncal (média 1,9 kg), associadas com aumento da massa magra (média 0,8 kg) e aumento da densidade mineral óssea (DMO) em coluna lombar e fêmur, particularmente nos sítios com T-escore menor que 1,0 na avaliação basal. Houve piora dos níveis de insulina e HOMA no primeiro ano de terapia, mas ao final do quarto ano os valores de glicose, insulina, HOMA e hemoglobina glicosilada não eram diferentes dos basais. Desenvolveram diabetes tipo 2 no seguimento dois pacientes com intolerância à glicose pré-tratamento. O colesterol total e o LDL colesterol reduziram significativamente, e as mudanças foram proporcionais aos valores basais. Os parâmetros ecocardiográficos não se alteraram. Os efeitos colaterais foram leves e bem tolerados. Não foi observada recorrência tumoral. Baixa adesão ao tratamento (estimada por níveis baixos de IGF-1) ocorreu em quatro (22 por cento), dois (11 por cento) e seis (30 por cento) pacientes ao final do segundo, terceiro e quarto ano, respectivamente. CONCLUSÕES: Quatro anos de tratamento com GH em adultos com DGH teve impacto positivo sobre a composição corporal, a DMO e o perfil lipídico, e nenhum efeito sobre sensibilidade insulínica e o coração. A intolerância à glicose deve ser cuidadosamente monitorada no tratamento de longo prazo.

AIM: To study efficacy, safety and compliance of GH therapy for 4 years in 18 GH deficient (GHD) adults [12 women; mean age 50.5 yrs (25-66 yrs)]. METHODS: Clinical, biochemical and body composition (DXA) measurements were performed before and every year after GH therapy. Ecocardiography was performed at baseline and after 4 years. Dose of GH was 0.2 mg/day during the first year with subsequent titration to attain normal IGF-1 levels. RESULTS: There was a significant reduction of total body fat (mean 2.8 kg), truncal fat (mean 1.9 kg) and an increase of lean body mass (mean 0.8 kg) and bone mineral density (BMD) on lumbar spine and femur, particularly in sites with T-score < -1,0 at baseline. Insulin levels and HOMA index worsened in the first year, but at the end no changes were noted on glucose, insulin, HOMA index and glycosylated hemoglobin. Two patients with altered glucose tolerance at baseline developed type 2 diabetes during follow-up. Total and LDL-cholesterol were significantly lower after therapy, with changes directly associated with baseline values. Cardiac parameters did not change. Side effects were mild and disappeared spontaneously. Tumor recurrence was not observed. Low compliance (estimated by low IGF-1 levels) was observed in 4 (22 percent), 2 (11 percent) and 6 (33 percent) patients at the end of second, third and fourth year, respectively. CONCLUSIONS: Four years of GH therapy in GHD adults had a positive impact on body composition, BMD and lipid profile, with no effects on insulin sensitivity and heart. Glucose tolerance should be monitored carefully during long-term GH therapy.

Controle neuroendócrino do peso corporal: implicaçöes na gênese da obesidade / Neuroendocrine control of food intake: implications in the genesis of obesity

O peso corporal é regulado por uma interaçäo complexa entre hormônios e neuropeptídeos, sob o controle principal de núcleos hipotalâmicos. Mutaçöes nos genes de hormônios e neuropeptídeos, de seus receptores ou de elementos regulatórios, têm sido descritas na espécie humana, mas säo tidas como raras, näo explicando as formas mais comuns de obesidade. No entanto, o estudo destas mutaçöes tem propiciado um grande avanço nos conhecimentos sobre a base genética e a fisiopatologia da obesidade, possibilitando o estudo e abrindo perspectivas para o desenvolvimento de novas modalidades terapêuticas. Recentemente, demonstrou-se que mutaçöes no receptor 4 da melanocortina podiam ser encontradas em até 5 por cento dos casos de obesidade severa, representando até o presente momento a forma mais prevalente de obesidade monogênica na espécie humana. Nesta revisäo, säo discutidas as diversas mutaçöes descritas nos seres humanos de elementos da rede neuroendócrina de controle do peso corporal, bem como as implicaçöes dos mesmos na gênese da obesidade

O uso da ultra-sonografia na avaliaçäo da distribuiçäo de gordura abdominal / Ultrasound use in abdominal fat distribution evaluation

A quantificação da adiposidade visceral é de suma importância, pois a gordura visceral é a grande responsável pelas complicações metabólicas da população obesa. O método de escolha para tal quantificação é a Tomografia Computadorizada. No entanto, este exame tem alto custo, é pouco prático e submete os indivíduos aos riscos da irradiação. A medida de cintura, a relação cintura-quadril e o diâmetro sagital são métodos que determinam indiretamente a gordura visceral. A ultra-sonografia tem sido proposta como uma técnica não invasiva para a avaliação de gordura intra-abdominal. No presente estudo foram determinadas, através da ultra-sonografia, as espessuras subcutâneas e intra-abdominais em 29 mulheres obesas em pré-menopausa. Estes valores foram comparados com os parâmetros antropométricos e com as áreas subcutâneas e viscerais medidas pela tomografia computadorizada. A espessura intra-abdominal foi a variável que obteve maior coeficiente de correlação com as áreas adiposas viscerais. Para a equação preditiva de área visceral, além da espessura intra-abdominal, foram incluídas as variáveis espessura subcutânea e medida de cintura. A espessura intra-abdominal mostrou correlação significativa com os níveis tensionais e com os valores de triglicerídeos. A correlação entre a ultra-sonografia e a tomografia computadorizada foi maior no grupo onde as áreas viscerais eram maiores. A ultra-sonografia é um método útil para a determinação do tecido adiposo visceral.

Deficiência de GH em adultos: resultados do estudo multicêntrico brasileiro / GH deficiency in adults: results of the Brazilian multicenter study

Avaliamos 70 pacientes com deficiência de GH, 39 mulheres e 31 homens, com idades entre 18 e 69 anos (média de 38,3±13,5), provenientes de 3 centros no Brasil. A dose de reposiçäo variou entre os centros, bem como a resposta do IGF-1, que mostrou maior aumento nos centros com maior dose de GH. Reposiçäo de GH levou a um aumento significativo nos níveis de IGF-1 e HDL colesterol, bem como da densidade mineral óssea (DMO), e a uma reduçäo significativa nos níveis de colesterol total e LDL colesterol, semelhante nos 3 centros. Encontramos aumento mais significativo de HDL colesterol nas mulheres e aumento mais acentuado da DMO nos pacientes do sexo masculino. Concluimos que reposiçäo de GH leva à melhora do perfil lipídico e da DMO, e que doses menores apresentam o mesmo benefício, provavelmente com menor incidência de efeitos colaterais