Influence of liver transplantation in the nutritional profile of severe cirrhotic patients

OBJECTIVE: The aim of this study was to analyze the influence of liver transplantation in food intake and nutritional status of severe cirrhotic patients. METHODS: The sample consisted of 23 patients who underwent liver transplantation. Three 24-hour dietary recall were applied and anthropometric measurements were collected before and three months after transplantation. The consumption of macronutrients and fat soluble vitamins were also evaluated. The anthropometric data evaluated were body mass index, abdominal circumference, percentage of adequacy of arm circumference, triceps skinfold thickness and arm muscle circumference. Related mean comparison tests, comparison of changes in the proportions of categorical variables and correlation of quantitative variables were used in the statistical analysis. Data were considered to be significant when p < 0.05. RESULTS: Most patients were female and aged between 40 and 65 years. The average consumption of calories, proteins, lipids, cholesterol and monounsaturated fatty acids was significantly higher after liver transplantation (p < 0.05). The average of anthropometric parameters did not differ significantly between the evaluated times. There was no significant change in nutrient intake or anthropometric classification after transplantation. Most patients were classified as malnourished or overweight after transplantation, according to some anthropometric parameters. CONCLUSION: Food consumption changed after transplantation. There was no change in the nutritional status from pre- to post-transplant but, in general, most patients had altered nutritional status in both evaluation moments.

Associação entre dislipidemia e excesso de peso de crianças e adolescentesatendidos em uma unidade de saúde / Association between dyslipidemia and excess weight in children and adolescents attended in a health care center / Asociación entre dislipidemia y sobrepeso en niños y adolescentes atendidos en un centro de salud

A dislipidemia e o excesso de peso em crianças e adolescentes ocasionam sérios problemas com alto risco para as doenças cardiovasculares. Este artigo tem como objetivo avaliar a associação entre dislipidemia e grau de excesso de peso em crianças e adolescentes. Trata-se de um estudo transversal com abordagem quantitativa. Foram avaliadas 62 crianças e adolescentes de 7 a 19 anos, com excesso de peso, atendidos em um centro de saúde localizado em Fortaleza, Ceará. O grau de excesso de peso foi determinado pelo índice de massa corporal, admitindo-se duas categorias mediante os pontos de corte para idade e sexo: sobrepeso (maior ou igual percentil 85 e menor que 95) e obesidade (maior ou igual percentil 95). Foram realizadas dosagens séricas de colesterol total, LDL-colesterol, HDLcolesterol e triglicerídeos. Os valores foram interpretados como normais ou alterados, segundo os critérios da Sociedade Brasileira de Cardiologia. A distribuição do grupo quanto ao grau de excesso de peso foi similar, havendo mais crianças obesas do que adolescentes (p igual 0,044). A prevalência de dislipidemia foi alta (66,1por cento), sendo detectados, em todas as frações lipídicas, menores percentuais de obesos com valores desejáveis, embora com significância estatística apenas para triglicerídeos. Conclui-se que houve associação entre a trigliceridemia e grau de excesso de peso, evidenciando que, na faixa etária pesquisada, o sobrepeso já acarreta um perfil lipídico de risco.

Dyslipidemia and excess weight in children and adolescents cause serious problems with a high risk for cardiovascular disease. The purpose of this study was to evaluate the degree of association between dyslipidemia and excessive weight among children and teenagers. This was a cross-sectional study with a quantitative approach. Sixty-two patients, with ages from 7 to 19 yearsold, all with excessive weight, seen at a health care center in the Brazilian city of Fortaleza, Ceara, were evaluated. The degree of excessive weight was determined by the body mass index, and two categories were admitted by cut-off points for age and sex: overweight (greater than or equal percentil 85 and less than 95) and obesity (greater than or equal percentil 95). Serum dosages of total cholesterol, LDL-cholesterol, HDL-cholesterol and triglycerides were taken. The values obtained were interpreted as ônormalõ or ôaltered,õ according to criteria of the Brazilian Society of Cardiology. The distribution of the group according to the degree of weight excess was similar, but there were more obese children than adolescents (p equal 0.044). The prevalence of dyslipidemia was high (66.1percent), but in all lipid fractions there were fewer percentages of obesity with desirable values in comparison with the individuals who were overweight, although the statistical significance was only for triglycerides. It was concluded that there was an association between dyslipidemia and the degree of excess weight among the studied group, indicating that, in this age range, excessive weight already causes a lipid-risk profile.

La dislipidemia y sobrepeso en niños y adolescentes causan problemas graves con alto riesgo de enfermedades cardiovasculares. El objetivo de este estudio fue evaluar la asociación entre dislipidemia y el grado de exceso de peso en niños y adolescentes. Se trata de un estudio transversal con un enfoque cuantitativo. Fueron evaluadas 62 niños y adolescentes de 7 a 19 años de edad, con exceso de peso, atendidos en un centro de atención de la salud en la ciudad de Fortaleza, Ceará. El grado de exceso de peso fue determinado por el índice de masa corporal, y dos categorías fueron admitidos mediante los puntos de corte para edad y sexo: sobrepeso (mayor o igual percentil 85 y menos que 95) y obesidad (percentil mayor o igual 95). Fueron tomadas dosificaciones séricas de colesterol total, LDL-colesterol, HDL-colesterol y triglicéridos. Los valores obtenidos fueron interpretados como normales o alterados, de acuerdo con los criterios de la Sociedad Brasileña de Cardiología. La distribución de los grupos según el grado de exceso de peso fue similar, habiendo más niños obesos de que adolescentes (p igual 0,044). La prevalencia de la dislipidemia fue elevada (66,1por ciento), y fue detectada en todas las fracciones de lípido menor porcentaje de pacientes obesos con valores deseables, aunque con significancia estadística sólo para los triglicéridos. Se concluye que hubo asociación entre la dislipidemia y el grado de exceso de peso entre el grupo estudiado, lo que indica que, en este rango de edad, el sobrepeso ya causa un perfil de lípido de riesgo.