The global diet quality score as an indicator of adequate nutrient intake and dietary quality - a nation-wide representative study.

BACKGROUND: The Global Diet Quality Score (GDQS) was developed to be a simple, timely and cost-effective tool to track, simultaneously, nutritional deficiency and non-communicable disease risks from diet in diverse settings. The objective was to investigate the performance of GDQS as an indicator of adequate nutrient intake and dietary quality in a national-representative sample of the Brazilian population. METHODS: Nationally-representative data from 44,744 men and non-pregnant and non-lactating women aging ≥ 10 years, from the Brazilian National Dietary Survey were used. Dietary data were collected through two 24-h recalls (24HR). The GDQS was calculated and compared to a proxy indicator of nutrient adequate intake (the Minimum Dietary Diversity for Women-MDD-W) and to an indicator of high-risk diet for non-communicable diseases (caloric contribution from ultra-processed foods-UPF). To estimate the odds for overall nutrient inadequacy across MDD-W and GDQS quintiles, a multiple logistic regression was applied, and the two metrics' performances were compared using Wald's post-test. RESULTS: The mean GDQS for Brazilians was 14.5 (0-49 possible range), and only 1% of the population had a low-risk diet (GDQS ≥ 23). The GDQS mean was higher in women, elderly individuals and in higher-income households. An inverse correlation was found between the GDQS and UPF (rho (95% CI) = -0.20(-0.21;-0.19)). The odds for nutrient inadequacy were lower as quintiles of GDQS and MDD-W were higher (p-trend < 0.001), and MDD-W had a slightly better performance than GDQS (p-diff < 0.001). Having a low-risk GDQS (≥ 23) lowered the odds for nutrient inadequacy by 74% (95% CI:63%-81%). CONCLUSION: The GDQS is a good indicator of overall nutrient adequacy, and correlates well with UPF in a nationally representative sample of Brazil. Future studies must investigate the relationship between the GDQS and clinical endpoints, strengthening the recommendation to use this metric to surveillance dietary risks.

Intra- and inter-rater reliability of muscle and fat thickness measurements obtained using portable ultrasonography in older adults.

BACKGROUND & AIMS: Ultrasonography (US) is a promising tool for assessing body composition, offering accuracy and accessibility. However, technician skills and equipment characteristics can impact measurement reliability. We aimed to evaluate the intra- and inter-rater reliability of two evaluators using A-mode Portable Ultrasound to measure muscle and fat thickness in Brazilian older adults. METHODS: Quantitative cross-sectional study carried out with 150 community-dwelling older adults of Campinas-SP-Brazil, recruited in a retirement preparation program and a geriatric outpatient care unit. Scans of nine anatomical points were performed using the portable ultrasound in A-mode (BodyMetrix Pro System BX2000; Livermore, CA), with 6 scans per location and 3 measurements taken by each evaluator. After the selection and analysis of the generated images, muscle and fat thickness were measured. Reliability estimates between measures of the same evaluator (intra-rater) and between evaluators (inter-rater) were assessed using intraclass correlation coefficients (ICC), and differences within and between technicians were assessed using one-way ANOVA. Analyses were carried out for the overall sample and stratified by sex and by nutritional status. RESULTS: Excellent ICC values (>0.90) were found for subcutaneous fat thickness in intra- and inter-rater reliability analyses. The lowest ICC values were observed for deep abdominal fat thickness measured by evaluator 1 (ICC = 0.90) and evaluator 2 (ICC = 0.87), as well as in the inter-rater analysis (ICC = 0.85). Muscle thickness measurements had satisfactory ICC values for triceps, biceps, anterior thigh, and calf, ranging from moderate to good (ICC 0.50-0.90). CONCLUSION: A portable A-mode ultrasound demonstrates excellent reliability among both intra- and inter-raters for assessing fat thickness but only moderate for muscle thickness in older adults. Hence, this could prompt inquiries regarding the sole reliance on this tool for quantifying muscle mass and examining sarcopenia in older adults. To our knowledge, this study represents the first assessment of reliability for a portable A-mode ultrasound device conducted with older adults.

The Use of Herbal Medicines Among Cancer Patients.

Background and objective The use of herbal medicines has been increasing among cancer patients, as a way to control cancer and treatment-related symptoms; however, many patients are reluctant to disclose this use to their medical practitioners. The fact that oncological treatments have a narrow therapeutic margin, associated with the lack of control and clinical evidence concerning these supplements, makes medication-herbal interactions a reality. These interactions could lead to increased toxicity or a decreased effectiveness of oncological treatment. In light of this, we aimed to assess the prevalence of herbal medicine use in a patient population at a Portuguese central hospital: Centro Hospitalar Lisboa Ocidental. Materials and methods Patients with breast, prostate, or colorectal cancer diagnoses between August 2022 and July 2023 and undergoing oncological treatment were included. Data were collected through a survey during their first appointment, as well as by consulting the patients' clinical files. An interaction evaluation was carried out to assess potential medication-herbal interactions. Finally, a statistical analysis was performed to identify predictive factors for the use of herbal medicines. Results Among the 65 patients included in the study, 52% were females, and the median age of the cohort was 65 years. Breast cancer was the most prevalent diagnosis and the majority of the patients were undergoing palliative treatment. We found that 46% of patients used herbal medicines regularly: to strengthen the immune system, detoxification of the body, and treat insomnia and constipation. A medication-herbal interaction was found in 37% of the cases, the most frequent being doxorubicin-vitamin C, through an antioxidant mechanism. The univariable analysis failed to show any predictive factors associated with the use of herbal medicines. Conclusions This study sheds light on herbal medicine use among cancer patients and the reality of medication-herbal interactions. There is an urgent need for further research and evidence-based medical protocols regarding herbal medicine use, especially in complex cases such as cancer patients, to provide better and safer care.

Gut bacterial markers involved in association of dietary inflammatory index with visceral adiposity.

OBJECTIVE: To deepen the understanding of the influence of diet on weight gain and metabolic disturbances, we examined associations between diet-related inflammation and body composition and fecal bacteria abundances in participants of the Nutritionists' Health Study. METHODS: Early-life, dietary and clinical data were obtained from 114 women aged ≤45 years. A validated food frequency questionnaire was used to calculate the energy-adjusted dietary inflammatory index (E-DII). Participants' data were compared by E-DII quartiles using ANOVA or Kruskal-Wallis. Associations of DXA-determined body composition with the E-DII were tested by multiple linear regression using DAG-oriented adjustments. Fecal microbiota was analyzed targeting the V4 region of the 16S rRNA gene. Spearman correlation coefficients were used to test linear associations; differential abundance of genera across the E-DII quartiles was assessed by pair-wise comparisons. RESULTS: E-DII score was associated with total fat (b=1.80, p<0.001), FMI (b=0.08, p<0.001) and visceral fat (b=1.19, p=0.02), independently of maternal BMI, birth type and breastfeeding. E-DII score was directly correlated to HOMA-IR (r=0.30; p=0.004), C-reactive protein (r=0.29; p=0.003) and to the abundance of Actinomyces, and inversely correlated to the abundance of Eubacterium.xylanophilum.group. Actinomyces were significantly more abundant in the highest (most proinflammatory) E-DII quartile. CONCLUSIONS: Association of E-DII with markers of insulin resistance, inflammation, body adiposity and certain gut bacteria are consistent with beneficial effects of anti-inflammatory diet on body composition and metabolic profile. Bacterial markers, such as Actinomyces, could be involved in the association between the dietary inflammation with visceral adiposity. Studies designed to explore how a pro-inflammatory diet affects both central fat deposition and gut microbiota are needed.

Bone Resorption in Apical Periodontitis Enhanced by Cigarette Smoke Inhalation: Histometric, Immunohistochemical, and Microtomographic Analysis in Rats.

INTRODUCTION: This study evaluated the effects of cigarette smoke inhalation (CSI) on apical periodontitis (AP) induced in rats by histometric, immunohistochemical, and microtomographic analysis. METHODS: A total of 32 male Wistar rats were divided into 4 experimental groups (n = 8): control, CSI, AP, and CSI + AP. Rats in the CSI and CSI + AP groups inhaled cigarette smoke by remaining inside a smoking chamber for 8 minutes 3 times a day for 50 days. After 20 days of smoke inhalation, rats in the AP and CSI + AP groups had the pulp of their first right lower molar exposed to induce AP. Blood was collected on day 50 to evaluate nicotine and serum cotinine levels. The animals' mandibles were removed for histologic processing to evaluate bone resorption by histometric, immunohistochemical (receptor activator of nuclear factor kappa B ligand/osteoprotegerin), and microtomographic analysis. The Student t test was applied. RESULTS: Histometric analysis showed a larger area of bone resorption (P < .05) and microtomographic analysis found greater resorption volume (P < .001) for the CSI + AP group compared with the AP group. The CSI + AP group presented a high RANKL immunostaining pattern compared with the AP group (P < .001). CONCLUSIONS: CSI increased bone resorption caused by AP.

The threshold value for identifying insulin resistance (HOMA-IR) in an admixed adolescent population: A hyperglycemic clamp validated study

ABSTRACT Objectives: To validate the homeostasis model assessment (HOMA) of insulin resistance (IR) as a surrogate to the hyperglycemic clamp to measure IR in both pubertal and postpubertal adolescents, and determine the HOMA-IR cutoff values for detecting IR in both pubertal stages. Subjects and methods: The study sample comprised 80 adolescents of both sexes (aged 10-18 years; 37 pubertal), in which IR was assessed with the HOMA-IR and the hyperglycemic clamp. Results: In the multivariable linear regression analysis, adjusted for sex, age, and waist circumference, the HOMA-IR was independently and negatively associated with the clamp-derived insulin sensitivity index in both pubertal (unstandardized coefficient - B = −0.087, 95% confidence interval [CI] = −0.135 to −0.040) and postpubertal (B = −0.101, 95% CI, −0.145 to −0.058) adolescents. Bland-Altman plots showed agreement between the predicted insulin sensitivity index and measured clamp-derived insulin sensitivity index in both pubertal stages (mean = −0.00 for pubertal and postpubertal); all P > 0.05. The HOMA-IR showed a good discriminatory power for detecting IR with an area under the receiver operator characteristic curve of 0.870 (95% CI, 0.718-0.957) in pubertal and 0.861 (95% CI, 0.721-0.947) in postpubertal adolescents; all P < 0.001. The optimal cutoff values of the HOMA-IR for detecting IR were > 3.22 (sensitivity, 85.7; 95% CI, 57.2-98.2; specificity, 82.6; 95% CI, 61.2-95.0) for pubertal and > 2.91 (sensitivity, 63.6; 95% CI, 30.8-89.1, specificity, 93.7; 95%CI, 79.2-99.2) for postpubertal adolescents. Conclusion: The threshold value of the HOMA-IR for identifying insulin resistance was > 3.22 for pubertal and > 2.91 for postpubertal adolescents.

Parental body mass index and maternal gestational weight gain associations with offspring body composition in young women from the Nutritionists' Health Study

ABSTRACT Objective: Intrauterine environment can induce fetal metabolic programming that predisposes to adiposity-related chronic diseases in its lifespan. We examined the associations of parental nutritional status and gestational weight gain with offspring body composition in early adulthood. Materials and methods: This is cross-sectional analysis of female participants of the NutriHS who were submitted to questionnaires, clinical examinations and body composition assessed by DXA. Association of pre-conception parental BMI and maternal gestational weight gain (exposures) with body composition measurements (outcomes) were analyzed using multiple linear models adjusted for Directed Acyclic Graphs-based covariables (maternal and paternal educational level, maternal age, and tobacco, alcohol and/or drugs use). The sample included 124 women (median 28 (24-31) years) with a mean BMI of 25.4 ± 4.7 kg/m2. Results: No association between previous paternal BMI and offspring's body composition was detected. In the fully adjusted linear regression model, maternal BMI was associated with offspring's total lean mass (β = 0.66, p = 0.001), appendicular skeletal muscle mass index (ASMI) (β = 0.11, p = 0.003) and fat mass index (FMI) (β = 0.03, p = 0.039). Gestational weight gain was associated with increased offspring's BMI (OR 1.12 [95% CI 1.02-1.20], p = 0.01). The linear regression model adjusted for maternal age and maternal and paternal education levels showed associations of gestational weight gain with offspring's ASMI (β = 0.42, p = 0.046), FMI (β = 0.22, p = 0.005) and android-to-gynoid fat ratio (β = 0.09, p = 0.035). Conclusion: Our findings suggest that preconception maternal BMI could influence lean mass and general adiposity of young adult female offspring and that gestational weight gain could be useful for predicting centrally distributed adiposity.

Accuracy of Root ZXII, E-PEX and FIND apex locators in teeth with vital pulp: an in vivo study

Abstract: This research evaluated, in vivo, the accuracy of three electronic apex locators - EALs (Root ZXII, E-PEX and FIND) in teeth with vital pulp submitted to biopulpectomy, preserving the periodontal stump. For this study, 90 single-rooted teeth with extraction indication were selected. After positive pulpal cold sensitivity test, pulp chamber access was performed. The cervical and middle thirds of root canals were instrumented with Reciproc R25, and the K#15 file was used as a standard instrument to determine working length, forming 2 groups: Constriction (insertion of the instrument until the apical constriction limit) and Foramen (insertion of the instrument until the foramen and then repositioning at constriction, without removing the file from the canal). The hand file was stabilized with a light-cured flow resin. After extraction, the samples were analyzed through microCT SkyScan 1272, with CTAN software, which evaluated the proximity between the tip of the file to the apical constriction, providing data for comparative analysis using Kruskal-Wallis and Dunn tests (p<0.05). There was a statistically significant difference in the abilities of the EALs to detect the apical constriction after reaching the foramen with Root ZX II showing higher accuracy (89%). However, there was no difference in the accuracy of the three EALs in detecting the apical constriction without reaching the foramen. Based on the present results, we conclude that EALs may show accurate measures in detecting apical constriction and foramen, even without damaging the periodontal stump in biopulpectomy.

Estado nutricional, qualidade de vida e hábitos de vida em mulheres com síndrome do intestino irritável: um estudo caso-controle / Nutritional status, quality of life and life habits of women with irritable bowel syndrome: a case-control study

ABSTRACT BACKGROUND: Irritable bowel syndrome is a functional and chronic gastrointestinal disorder that may cause abdominal pain and altered bowel habits, affecting the nutritional status and quality of life of its carriers. Its prevalence is high, affecting about 10% to 15% of the general population in developed countries, being more prevalent in women than in men in the proportion 2:1. OBJECTIVE: The aim of our study was to compare the profile of body adiposity, life habits, and the quality of life of women with irritable bowel syndrome with a healthy control group. METHODS: Case-control study on 70 women, 34 with irritable bowel syndrome and 36 healthy. We applied the "Irritable Bowel Syndrome Quality of Life Questionnaire"to assess quality of life. Body adiposity was assessed from body mass index, waist circumference, and waist-to-hip ratio. We investigated the self-reporting of gastrointestinal symptoms with food deemed as problematic for carriers of irritable bowel syndrome and the presence of typical comorbidities. Assessment of life habits included: practice of physical activities, alcoholism, smoking, daytime sleepiness, and exclusion of foods from the feeding routine. For statistical analysis we used the IBM SPSS program, with a significance level at 5%. RESULTS: There was higher volume of central and general adiposity in the case group compared with the control group (P<0.05). Cases presented a higher chance of developing IBS-related comorbidities (P<0.05). About of 80% of patients with irritable bowel syndrome have excluded some food from the diet (P<0.01) and the total amount of troublesome foods varied from 7 to 21 (P<0.01). The case group featured worse quality of life compared with the control (P<0.05). CONCLUSION: Compared to the control group, women with irritable bowel syndrome showed greater body adiposity, higher frequency of comorbidities, greater restriction on the consumption of problematic foods and worse quality of life.

RESUMO CONTEXTO: A síndrome do intestino irritável é uma desordem gastrointestinal crônica e funcional que pode causar dor abdominal e alteração do hábito intestinal, afetando o estado nutricional e a qualidade de vida. Sua prevalência é alta, acomete cerca de 10% a 15% da população geral em países desenvolvidos, sendo mais prevalente em mulheres do que em homens na proporção 2:1. OBJETIVO: O objetivo deste estudo foi comparar o perfil de adiposidade corporal, os hábitos de vida e a qualidade de vida de indivíduos portadores da síndrome do intestino irritável com um grupo controle saudável. MÉTODOS: Estudo caso-controle com 70 mulheres, 34 com a síndrome do intestino irritável e 36 saudáveis. Foi aplicado o Irritable Bowel Syndrome Quality of Life Questionnaire para avaliação da qualidade de vida. A adiposidade corporal foi avaliada a partir do índice de massa corporal, circunferência da cintura e relação cintura-quadril. Foi investigado o auto-relato de sintomas gastrointestinais de alimentos considerados problemáticos para portadores da síndrome do intestino irritável e a presença de comorbidades típicas. A análise do estilo de vida incluiu a prática de atividade física, alcoolismo, tabagismo, sonolência diurna e exclusão de alimentos. Para análise estatística foi utilizado o programa IBM SPSS, com o nível de significância de 5%. RESULTADOS: Houve maior acúmulo de adiposidade central e periférica no grupo caso em comparação ao grupo controle (P<0,05). Os casos apresentaram maior chance de desenvolver comorbidades associadas à síndrome do intestino irritável (P<0,05). Cerca de 80% dos pacientes com a síndrome do intestino irritável excluíram algum alimento da dieta (P<0,01) e o total de alimentos problemáticos pode variar de 7 a 21 alimentos (P<0,01). Grupo caso apresentou pior qualidade de vida para o escore geral e para todos os domínios avaliados (P<0,05). CONCLUSÃO: Em comparação aos controles, as mulheres portadoras da síndrome do intestino irritável apresentaram maior adiposidade corporal, maior frequência de comorbidades, maior restrição ao consumo de alimentos considerados problemáticos e pior qualidade de vida.

Prevalence of hepatic steatosis among children and adolescents with cystic fibrosis and its association with nutritional status / Prevalência de esteatose hepática em crianças e adolescentes com fibrose cística e associação com o estado nutricional

ABSTRACT Objective: To determine the prevalence of hepatic steatosis (HS) in children and adolescents with cystic fibrosis (CF) and associate it with nutritional status. Methods: Cross-sectional study with children and adolescents with CF diagnosis. Weight and height were used to calculate the body mass index (BMI) and subsequent classification of the nutritional status. The midarm circumference (MAC), triceps skinfold thickness (TSF) and midarm muscle circumference (MAMC) were used to evaluate body composition. Abdominal ultrasonography was performed for diagnosis of HS. The statistical tests used were Student's t test, Mann-Whitney test and chi-square test with significance level of 5%. Results: 50 patients with CF were evaluated, 18 (36%) were diagnosed with HS (Group A) and 32 (64%) without HS (Group B). The mean age of Group A was 13,2±4,9 years old and Group B 11,7±4,9; for BMI, the value for Group A was 18,0±4,1 and Group B was 15,7±3,8; the TSF of Group A was 8,4±3,5 mm and Group B was 7,0±2,5 mm. For these variables, there was no significant difference between the groups. The mean of MAC and MAMC differed significantly between the groups, being higher in the HS group, with p values of 0,047 and 0,043. Conclusions: The frequency of HS in patients with CF is high and it is not related to malnutrition, according to the parameters of BMI, TSF and MAMC. The values of MAC and MAMC indicated a greater reserve of muscle mass in patients with HS.

RESUMO Objetivo: Determinar a prevalência de esteatose hepática (EH) em crianças e adolescentes com fibrose cística (FC) e associá-la com o estado nutricional. Métodos: Estudo transversal com crianças e adolescentes com diagnóstico de FC. Foram aferidos o peso e a altura para o cálculo do índice de massa corpórea (IMC) e classificação do estado nutricional. A circunferência do braço (CB), a dobra cutânea tricipital (DCT) e a circunferência muscular do braço (CMB) foram empregadas para avaliação da composição corporal. A ultrassonografia abdominal foi realizada para o diagnóstico de EH. Os testes estatísticos empregados foram o teste t de Student, o teste de Mann-Whitney e o teste do qui-quadrado, com nível de significância de 5%. Resultados: Dos 50 pacientes avaliados, 18 (36%) apresentaram EH (Grupo A) e 32 (64%) não (Grupo B). Para as médias de idade (Grupo A: 13,3±5,0 anos; e Grupo B: 11,7±5,0 anos), IMC (Grupo A: 18,0±4,1; e Grupo B: 15,7±3,8) e DCT (Grupo A: 8,4±3,5 mm; e Grupo B: 7,0±2,5 mm), não houve diferença significativa entre os grupos. A média da CB e da CMB diferiram significativamente entre os grupos, sendo mais elevada no grupo com EH, com valores p respectivos de 0,047 e 0,043. Conclusões: É alta a frequência de EH em pacientes com FC e ela não está relacionada com a desnutrição, segundo os parâmetros de IMC, DCT e CMB. Os valores de CB e CMB indicaram maior reserva de massa muscular nos pacientes com EH.

Cleaning effectiveness of a nickel-titanium ultrasonic tip in ultrasonically activated irrigation: a SEM study

Abstract In endodontic treatment, regardless of the instrumentation technique, the presence of a smear layer covering contaminated dentin walls is always a concern. Thus, irrigation plays an essential role in reducing bacterial load. To enhance irrigation effectiveness, different ultrasonic activation methods and the use of different tips have been studied. This study assessed the cleaning capacity of the novel NiTi ultrasonic tip for smear layer removal using ultrasonically activated irrigation (UAI) with passive or continuous ultrasonic irrigation (PUI or CUI, respectively), compared with conventional irrigation. Forty-five single-rooted human mandibular premolars were decoronated to a standardized length of 16 mm. Instrumentation was performed using the Genius system up to size 50.04 and irrigated with 3% NaOCl. The specimens were divided into three groups (n = 15) according to the final irrigation activation technique: conventional irrigation (CI), as control group; PUI; and CUI, following the manufacturer's protocol. The samples were longitudinally cleaved and analyzed under a scanning electron microscope for smear layer removal according to a cleanliness score for the cervical, middle, and apical thirds. Data were evaluated by means of the Kruskal-Wallis and Tukey's tests, with a 5% level of significance. UAI enhanced cleaning compared to conventional irrigation, mainly at the apical third. CUI showed the best results, with statistically significant lower scores than PUI and CI (p < 0.05). Final irrigant activation with the NiTi tip showed better cleaning capacity than conventional irrigation. In addition, CUI resulted in better smear layer removal than PUI.

Avaliação da influência do tabagismo no desenvolvimento da periodontite apical em ratos wistar / Evaluation of smoking influence on the development of apical periodontitis in wistar rats

A infecção endodôntica ocorre a após contaminação do tecido pulpar levando à uma colonização bacteriana dos canais radiculares resultando em uma resposta inflamatória dos tecidos periapicais e formação de uma lesão periapical, a periodontite apical (PA). O tabagismo, por sua vez, tem impactos prejudiciais à saúde oral e sistêmica sendo considerado um importante fator de risco para as doenças periodontais. Este trabalho tem por finalidade investigar a influência do tabagismo no desenvolvimento da periodontite apical em ratos. Trinta e dois ratos machos Wistar foram divididos em 4 grupos experimentais (n=8): Controle (sem periodontite apical induzida e sem inalação da fumaça do cigarro); FU (com inalação a fumaça do cigarro); PA (com periodontite apical induzida); FU+PA (com inalação a fumaça do cigarro e periodontite apical induzida). Para a inalar a fumaça do cigarro, grupo de cinco animais permaneceram em uma câmara de tabagismo inalando a fumaça de 10 cigarros por 8 minutos, três vezes ao dia, durante 50 dias. Decorridos 20 dias de inalação de fumaça do cigarro, foi realizada a cirurgia para indução da periodontite apical nos animais do grupo PA e FU+PA, no primeiro molar inferior direto, o qual permaneceu aberto na cavidade bucal por 30 dias. Nesses 30 dias subsequentes da indução da PA, os animais do grupo FU+PA e FU continuaram com a inalação a fumaça do cigarro. No 50º dia, os animais foram eutanasiados e coletados amostras de tecido hematológico para avalição dos níveis séricos de nicotina, cotinina, fosfatase alcalina, cálcio, fósforo, série vermelha e série branca. As hemimandibula removidas foram escaneadas em microtomógrafo para avaliar o volume da destruição óssea e processadas histologicamente para avaliação do perfil inflamatório e expressão das citocinas IL-6, IL-1ß, TNF-α e dos marcadores do metabolismo ósseo RANKL e OPG. Os dados foram tabulados e aplicados os testes estatísticos de Mann-Whitney para os dados não paramétricos e teste t para os dados paramétricos, a um nível de significância de P< 0.05. Com relação a análise histológica o grupo FU+PA apresentou infiltrado inflamatório mais intenso em relação aos demais grupos (P< 0,05). As citocinas pró-inflamatórias IL-6, IL-1ß, TNF-α apresentaram alto padrão de imunomarcação para o grupo FU+PA (P< 0,05). A análise histométrica mostrou maior área de reabsorção óssea no grupo FU+PA, assim como na análise microtomográfica (P< 0,05). As citocinas RANKL esteve mais expressa no grupo FU+PA (P< 0,05) e OPG teve maior expressão no grupo PA (P< 0,05). Na análise hematológica houve um aumento na concentração de hemácias, hemoglobina e leucócitos para o FU+PA (P< 0,05). Os níveis séricos de cálcio foram menores no FU+PA (P> 0,05), a fosfatase alcalina e o cálcio se manteve constante em todos os grupos experimentais (P> 0,05). A concentração sérica de nicotina e cotinina no grupo FU e FU+PA foram compatíveis com fumante humano(AU)

Endodontic infection occurs mainly after pulp tissue contamination by a carious process, leading to bacterial colonization of root canal system and inflammatory response of periapical tissues, followed by formation of apical periodontitis (AP). It is widely known that smoking has harmful impacts on oral and systemic health and is considered a risk factor for periodontal diseases. The objective of this research was to investigate the influence of smoking on the development of AP in rats. Thirty-two male Wistar rats were divided into 4 experimental groups (n = 8): C - Control (no induced AP and no cigarette smoke inhalation); CSI (cigarette smoke inhalation); AP (induced apical periodontitis); CSI + AP (cigarette smoke inhalation and induced apical periodontitis). To inhale cigarette smoke, group with five animals remained in a smoking chamber inhaling smoke from 10 cigarettes for 8 minutes, three times daily, for 50 days. After 20 days of cigarette smoke inhalation, pulp chamber access was performed to induce apical periodontitis in the first mandibular right molar, which remained with pulp chamber exposed to oral cavity for 30 days in animals in the AP and CSI + AP group. During these 30 days after the AP induction, animals in the CSI + AP and CSI group continued to inhale cigarette smoke. On the 50th day, animals were euthanized and blood sample collected to assess serum levels of nicotine, cotinine, alkaline phosphatase, calcium, phosphorus, red series and white series. The hemimandibles were removed and scanned in microtomograph to assess bone volume and histologically processed to assess inflammatory profile and expression of cytokines IL-6, IL-1ß, TNF-α and bone metabolism markers RANKL and OPG. Data were tabulated and statistically analyzed using Mann-Whitney tests for nonparametric data and analysis of variation test for parametric data, with a significance level of P< 0.05. Regarding histological analysis, CSI+AP group showed more intense inflammatory infiltrate compared to other groups (P < 0.05). Histometric analysis showed a larger area of bone resorption in the CSI + AP group, also observed in the microtomographic analysis (P< 0.05). Group CSI+AP had elevated pro-inflammatory cytokines IL-6, IL-1ß, TNF-α expression (P< 0.05). The RANKL cytokines were also more expressed in the CSI+AP group (P< 0.05), while OPG was more expressed in the AP group (P< 0.05). The hematological analysis revealed an increase in the concentration of red blood cells, hemoglobin, and leukocytes for CSI+AP (P< 0.05). Serum calcium levels were lower in CSI+AP (P> 0.05), and alkaline phosphatase and calcium remained constant in all experimental groups (P> 0.05). The serum concentrations of nicotine and cotinine in the CSI and CSI+AP group were compatible with human smokers(AU)

Effect of biliopancreatic diversion on sleep quality and daytime sleepiness in patients with obesity and type 2 diabetes

ABSTRACT Objective: The poor quality of sleep and the deprivation thereof have been associated with disruption of metabolic homeostasis, favoring the development of obesity and type 2 diabetes (T2DM). We aimed to evaluate the influence of biliopancreatic diversion (BPD) surgery on sleep quality and excessive daytime sleepiness of obese patients with T2DM, comparing them with two control groups consisting of obese and normal weight individuals, both normal glucose tolerant. Subjects and methods: Forty-two women were divided into three groups: LeanControl (n = 11), ObeseControl (n = 13), and ObeseT2DM (n = 18). The LeanC and ObeseC groups underwent all tests and evaluations once. The ObeseT2DM underwent BPD and were reassessed after 12 months. Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) were applied before and 12 months after BPD. Results: Before surgery, there was less daytime sleepiness in LeanC group (p = 0.013) compared with ObeseC and T2DMObese groups. The two obese groups did not differ regarding daytime sleepiness, demonstrating that the presence of T2DM had no influence on daytime sleepiness. After surgery, the daytime sleepiness (p = 0.002) and the sleep quality (p = 0.033) improved. The score for daytime sleepiness of operated T2DMObese group became similar to LeanC and lower than ObeseC (p = 0.047). Conclusion: BPD surgery has positively influenced daytime sleepiness and sleep quality of obese patients with T2DM, leading to normalization of daytime sleepiness 12 months after surgery. These results reinforce previously identified associations between sleep, obesity and T2DM in view of the importance of sleep in metabolic homeostasis, quality of life and health.

Calcium hydroxide associated with a new vehicle: Psidium cattleianum leaf extracts. Tissue response evaluation

Abstract The aim of this study was to evaluate edemogenic activity and subcutaneous inflammatory reaction induced by Psidium cattleianum leaf extracts associated with Ca(OH)2. Thirty male Wistar rats, split equally into three groups [aqueous extract + Ca(OH)2; ethanolic extract + Ca(OH)2; and propylene glycol + Ca(OH)2], were assessed every 3 h or 6 h (five animals in each period). Under general anesthesia, 0.2 mL of 1% Evans blue per 100 g of body weight was injected into the penile vein and each combination to be evaluated was subcutaneously injected into the dorsal region 30 min thereafter. Edemogenic activity was analyzed by spectrophotometry (λ=630 nm). For inflammatory reaction analysis, 50 rats received four polyethylene tubes (three experimental groups) and an empty tube (control group). The assessments were made at 7, 15, 30, 60, and 90 days, followed by hematoxylin-eosin staining and by the assignment of scores for evaluation of tissue response intensity. Ethanolic extract + Ca(OH)2 yielded the largest edemogenic activity at 3 h. Intergroup differences at 6 h were not significant. The histological analysis showed progressive repair over time (p<0.05) and aqueous and ethanolic extracts produced similar responses to those of the control and Ca(OH)2 + propylene glycol groups. Psidium cattleianum leaf extracts used as Ca(OH)2 vehicles evoked similar tissue response when compared to Ca(OH)2 associated with propylene glycol.

Mixing failures of endodontic sealers: an in vivo biocompatibility study / Falhas durante espatulação de cimentos endodônticos: um estudo de biocompatibilidade in vivo

Objectives: Evaluate, in vivo, the influence of mixing failures on endodontic sealers. Material and Methods: To alveolus analysis, 80 rats were divided into Sealapex® and AH Plus® groups. Within each group, the sealer was subjected to either partial (incomplete homogenization­ simulating handling failures) or total mixing (complete homogenization) over two periods of 7 and 30 days (n = 20). The maxillary incisor was extracted and a polyethylene tube containing the sealer was inserted. To quantify edema, 40 male rats were divided into four groups (n = 10). The animals received 2% Evans Blue intravenously, and either AH Plus® or Sealapex® was injected subcutaneously. The rats were euthanized after 3 or 6 hours and analyzed in a spectrophotometer (630 ƞm). To analyze the subcutaneous tissue, 20 rats received polyethylene tube implants with the sealers in the dorsal area (n=10), then euthanized after either 7 or 30 days, and inflammation was evaluated according to an inflammatory cells score. Results: In the alveolar 7-day group, control group presented an inflammation score 1, while all other groups presented a score 2, except AH plus® total mix group (3). After 30 days, all groups presented a score 1. The edemogenic test showed less edema in Sealapex® groups (p < 0.5). In subcutaneous 7-day period, all groups presented score 2. In 30 days, all groups revealed score 1, except AH Plus® partial mix group (2). Conclusion: Regarding mixing of the sealers, there were no significant differences among the groups (AU)

Objetivo: Avaliar, in vivo, a influência das falhas de espatulação de cimentos endodônticos. Material e Métodos: Para análise alveolar, 80 ratos foram divididos nos grupos Sealapex® e AH Plus®. Em cada grupo, o cimento foi espatulado de forma parcial (homogeneização incompleta, simulando falhas) ou total (homogeneização completa) em dois períodos de 7 e 30 dias (n=20). O incisivo superior foi extraído e um tubo de polietileno contendo o cimento foi inserido. Para quantificar edema, 40 ratos foram divididos em quatro grupos (n = 10). Os animais receberam Azul de Evans 2% intravenoso, e AH Plus® ou Sealapex® injetados no tecido subcutâneo. Após 3 ou 6 horas foram eutanasiados e analisados em espectrofotômetro (630 ƞm). Para analisar a resposta subcutânea, 20 ratos receberam implantes de tubo de polietileno com os cimentos na região dorsal (n = 10), eutanasiados após 7 ou 30 dias, e a inflamação foi avaliada de acordo com um escore de células inflamatórias. Resultados: Na análise alveolar em 7 dias, o grupo controle apresentou escore 1 de inflamação, enquanto que todos os outros grupos apresentaram 2, com exceção do AH plus® espatulação total (3). Após 30 dias, todos os grupos apresentaram escore 1. O teste edemogênico mostrou menor edema nos grupos Sealapex® (p < 0,5). No período subcutâneo de 7 dias, todos os grupos apresentaram escore 2. Em 30 dias, todos os grupos revelaram escore 1, exceto AH Plus® espatulação parcial (2). Conclusão: Não houve diferença estatística significante entre os cimentos quanto à espatulação. (AU)

Serum levels of retinol binding protein 4 in women with different levels of adiposity and glucose tolerance / Níveis séricos da proteína carreadora do retinol 4 em mulheres com diferentes níveis de adiposidade e tolerância à glicose

Objective Retinol-binding protein 4 (RBP4) is an adipokine responsible for vitamin A (retinol) transportation. Studies associated RBP4 increased levels with severity of type 2 diabetes mellitus (T2DM) and insulin resistance (IR). The study aimed to quantify RBP4 serum standards in women with a wide range of body mass index (BMI) and glucose tolerance level. Subjects and methods: Cross-sectional study was performed with 139 women divided into three groups: Group 1 (lean-control, n = 45) and Group 2 (obese, n = 53) with normal glucose tolerance and group 3 (obese with T2DM, n = 41), called G1, G2 and G3. Were assessed clinical, biochemical, anthropometric and body composition parameters. Results According to data analysis, we obtained in G1 higher RBP4 levels (104.8 ± 76.8 ng/mL) when compared to G2 (87.9 ± 38 ng/mL) and G3 (72.2 ± 15.6 ng/mL) levels. Also, were found: in G1 positive correlations of RBP4 with BMI (r = 0.253), glycated hemoglobin (r = 0.378) and fasting insulin (r = 0.336); in G2 with glycated hemoglobin (r = 0.489); in G3 with glycated hemoglobin (r = 0.330), fasting glucose (r = 0.463), HOMA-IR (r = 0.481). Conclusions Although RBP4 have shown lower levels in diabetic and obese, a strong correlation with HOMA-IR index highlights that, in our study, there is growing IR when there is an increasing in RBP4 levels. .

Objetivo A proteína carreadora do retinol 4 (RBP4) é uma adipocina responsável pelo transporte de vitamina A (retinol). Estudos associam os níveis aumentados de RBP4 com a gravidade do diabetes melito tipo 2 (DM2) e resistência à insulina (RI). O objetivo deste estudo foi investigar como esses níveis se comportam em mulheres com ampla variação do índice de massa corporal (IMC) e tolerância à glicose. Sujeitos e métodos: Estudo transversal realizado com 139 mulheres, divididas em três grupos: Grupo 1 (controles-magras; n = 45) e Grupo 2 (obesas; n = 53), com tolerância normal à glicose; Grupo 3 (obesas DM2; n = 41), denominados G1, G2 e G3. Foram avaliados parâmetros clínicos, bioquímicos, antropométricos e composição corporal. Resultados De acordo com a análise dos dados, obtivemos em G1 maiores níveis de RBP4 (104,8 ± 76,8 ng/mL) em comparação ao G2 (87,9 ± 38 ng/mL) e G3 (72,2 ± 15,6 ng/mL). Também foram encontradas correlações positivas entre RBP4 e IMC (r = 0,253), hemoglobina glicada (r = 0,378) e insulinemia de jejum (r = 0,336); em G2 com hemoglobina glicada (r = 0,489); G3 com hemoglobina glicada (r = 0,330), insulinemia de jejum (r = 0,463) e HOMA-IR (r = 0,481). Conclusões Embora a RBP4 tenha apresentado níveis menores em pacientes diabéticas e obesas, a forte correlação com o índice HOMA-IR deixa claro que, em nosso estudo, há crescente RI quando os níveis dessa proteína também são crescentes. .

Metabolic syndrome and insulin resistance in obese adolescents / Sindrome metabolico y resistencia a la insulina en adolescentes obesos / Sindrome metabolica e resistencia a insulina em adolescentes obesos

Objective: To verify the prevalence of metabolic syndrome and insulin resistance in obese adolescents and its relationship with different body composition indicators. Methods: A cross-sectional study comprising 79 adolescents aged ten to 18 years old. The assessed body composition indicators were: body mass index (BMI), body fat percentage, abdominal circumference, and subcutaneous fat. The metabolic syndrome was diagnosed according to the criteria proposed by Cook et al. The insulin resistance was determined by the Homeostasis Model Assessment for Insulin Resistance (HOMA-IR) index for values above 3.16. The analysis of ROC curves was used to assess the BMI and the abdominal circumference, aiming to identify the subjects with metabolic syndrome and insulin resistance. The cutoff point corresponded to the percentage above the reference value used to diagnose obesity. Results: The metabolic syndrome was diagnosed in 45.5% of the patients and insulin resistance, in 29.1%. Insulin resistance showed association with HDL-cholesterol (p=0.032) and with metabolic syndrome (p=0.006). All body composition indicators were correlated with insulin resistance (p<0.01). In relation to the cutoff point evaluation, the values of 23.5 and 36.3% above the BMI reference point allowed the identification of insulin resistance and metabolic syndrome. The best cutoff point for abdominal circumference to identify insulin resistance was 40%. Conclusions: All body composition indicators, HDL-cholesterol and metabolic syndrome showed correlation with insulin resistance. The BMI was the most effective anthropometric indicator to identify insulin resistance. .

Objetivo: Verificar la prevalencia del síndrome metabólico y de la resistencia a la insulina en adolescentes obesos y su relación con distintos indicadores de composición corporal. Métodos: Estudio transversal con 79 adolescentes de 10 a 18 años. Los indicadores de composición corporal fueron: índice de masa corporal (IMC), porcentaje de grasa corporal, circunferencia abdominal y grasa subcutánea. El síndrome metabólico fue diagnosticado conforme a los criterios de Cook et al. La resistencia a la insulina fue determinada por el índice de Homeostasis Model Assessment for Insulin Resistence (HOMA-IR) para valores superiores a 3,16. Se utilizó el análisis de curvas ROC para evaluar el IMC y la circunferencia abdominal, identificándose los individuos con resistencia a la insulina y síndrome metabólico. El punto de corte correspondió al porcentaje superior al valor de referencia para el diagnóstico de obesidad. Resultados: El síndrome metabólico fue diagnosticado en 45,5% de los pacientes y la resistencia a la insulina, en 29,1%. La resistencia a la insulina presentó asociación con el HDL-colesterol (p=0,032) y con el síndrome metabólico (p=0,006). Todos los indicadores de composición corporal evaluados presentaron correlación con la resistencia a la insulina (p<0,01). En la evaluación de los puntos de corte, los valores de 23,5 y 36,3% por encima del valor de referencia del IMC permitieron identificar la resistencia a la insulina y el síndrome metabólico. El mejor punto de corte de la circunferencia abdominal para identificar la resistencia a la insulina fue de 40%. Conclusiones: Todos los indicadores de composición corporal, el HDL-colesterol y el síndrome metabólico presentaron correlación con la resistencia a la insulina. El IMC se mostró el indicador ...

Objetivo: Verificar a prevalência da síndrome metabólica e da resistência à insulina em adolescentes obesos e sua relação com diferentes indicadores de composição corporal. Métodos: Estudo transversal com 79 adolescentes de dez a 18 anos. Os indicadores de composição corporal foram: índice de massa corpórea (IMC), porcentagem de gordura corporal, circunferência abdominal e gordura subcutânea. A síndrome metabólica foi diagnosticada segundo os critérios de Cook et al. A resistência à insulina foi determinada pelo índice de Homeostasis Model Assessment for Insulin Resistance (HOMA-IR) para valores acima de 3,16. Utilizou-se a análise de curvas ROC para avaliar o IMC e a circunferência abdominal, identificando-se os indivíduos com resistência à insulina e síndrome metabólica. O ponto de corte correspondeu ao percentual acima do valor de referência para o diagnóstico de obesidade. Resultados: A síndrome metabólica foi diagnosticada em 45,5% dos pacientes e a resistência à insulina, em 29,1%. A resistência à insulina apresentou associação com o HDL-colesterol (p=0,032) e com a síndrome metabólica (p=0,006). Todos os indicadores de composição corporal avaliados apresentaram correlação com a resistência à insulina (p<0,01). Na avaliação dos pontos de corte, os valores de 23,5 e 36,3% acima do valor de referência do IMC permitiram identificar a resistência à insulina e a síndrome metabólica. O melhor ponto de corte da circunferência abdominal para identificar a resistência à insulina foi de 40%. Conclusões: Todos os indicadores de composição corporal, o HDL-colesterol e a síndrome metabólica apresentaram correlação ...

Biochemical, anthropometric and body composition indicators as predictors of hepatic steatosis in obese adolescents / Indicadores bioquímicos, antropométricos y de composición corporal como predictores de la esteatosis hepática en adolescentes obesos / Indicadores bioquímicos, antropométricos e de composição corporal como preditores da esteatose hepática em adolescentes obesos

To describe the prevalence of hepatic steatosis and to assess the performance of biochemical, anthropometric and body composition indicators for hepatic steatosis in obese teenagers. METHODS: Cross-sectional study including 79 adolecents aged from ten to 18 years old. Hepatic steatosis was diagnosed by abdominal ultrasound in case of moderate or intense hepatorenal contrast and/or a difference in the histogram ≥7 on the right kidney cortex. The insulin resistance was determined by the Homeostasis Model Assessment-Insulin Resistance (HOMA-IR) index for values >3.16. Anthropometric and body composition indicators consisted of body mass index, body fat percentage, abdominal circumference and subcutaneous fat. Fasting glycemia and insulin, lipid profile and hepatic enzymes, such as aspartate aminotransferase, alanine aminotransferase, gamma-glutamyltransferase and alkaline phosphatase, were also evaluated. In order to assess the performance of these indicators in the diagnosis of hepatic steatosis in teenagers, a ROC curve analysis was applied. RESULTS: Hepatic steatosis was found in 20% of the patients and insulin resistance, in 29%. Gamma-glutamyltransferase and HOMA-IR were good indicators for predicting hepatic steatosis, with a cutoff of 1.06 times above the reference value for gamma-glutamyltransferase and 3.28 times for the HOMA-IR. The anthropometric indicators, the body fat percentage, the lipid profile, the glycemia and the aspartate aminotransferase did not present significant associations. CONCLUSIONS: Patients with high gamma-glutamyltransferase level and/or HOMA-IR should be submitted to abdominal ultrasound examination due to the increased chance of having hepatic steatosis...

Describir la prevalencia de la esteatosis hepática y evaluar el desempeño de indicadores bioquímicos, antropométricos y de composición corporal para identificar la enfermedad en adolescentes obesos. MÉTODOS: Estudio transversal con 79 adolescentes de 10 a 18 años. Se diagnosticó la esteatosis hepática por ultrasonido abdominal en caso de contraste hepatorrenal moderado o intenso y/o diferencia en el histograma ≥7 con relación al córtex del riñón derecho. Se determinó la resistencia a la insulina por el índice Homeostasis Model Assessment-Insulin Resistence (HOMA-IR) para valores >3,16. Los indicadores antropométricos y de composición corporal fueron índice de masa corporal, porcentaje de grasa corporal, circunferencia abdominal y grasa subcutánea. Se dosificaron glucemia e insulina en ayuno, perfil lipídico y las encimas hepáticas aspartato aminotransferasa, alanina aminotransferasa, gama-glutamiltransferasa y fosfatasa alcalina. Se analizaron curvas ROC para evaluar el desempeño de los indicadores en identificar adolescentes con esteatosis hepática. RESULTADOS: La esteatosis hepática estuvo presente en el 20% de los pacientes y la resistencia a la insulina, en el 29%. La gama-glutamiltransferasa y el HOMA-IR se mostraron buenos indicadores para predecir la esteatosis hepática, con punto de corte de 1,06 veces por encima del valor de referencia para la gama-glutamiltransferasa y de 3,28 para el HOMA-IR. Los indicadores antropométricos, el porcentaje de grasa corporal, el perfil lipídico, la glucemia y la aspartato aminotransferasa no presentaron diferencias significantes. CONCLUSIONES: Pacientes con elevación de gama-glutamiltransferasa y/o HOMA-IR deben ser sometidos al examen de ultrasonido abdominal con gran probabilidad de obtenerse como resultado la esteatosis...

Descrever a prevalência da esteatose hepática e avaliar o desempenho de indicadores bioquímicos, antropométricos e de composição corporal para identificar a doença em adolescentes obesos. MÉTODOS: Estudo transversal com 79 adolescentes de dez a 18 anos. Diagnosticou-se a esteatose hepática por ultrassom abdominal em caso de contraste hepatorrenal moderado ou intenso e/ou diferença no histograma ≥7 em relação ao córtex do rim direito. Determinou-se a resistência à insulina pelo índice Homeostasis Model Assessment-Insulin Resistance (HOMA-IR) para valores >3,16. Os indicadores antropométricos e de composição corporal foram: índice de massa corpórea, porcentagem de gordura corporal, circunferência abdominal e gordura subcutânea. Dosaram-se glicemia e insulina de jejum, perfil lipídico e enzimas hepáticas aspartato aminotransferase, alanina aminotransferase, gama-glutamiltransferase e fosfatase alcalina. Aplicou-se a curva ROC para avaliar o desempenho dos indicadores para identificar adolescentes com esteatose hepática. RESULTADOS: A esteatose hepática esteve presente em 20% dos pacientes e a resistência à insulina, em 29%. A gama-glutamiltransferase e o HOMA-IR mostraram-se bons indicadores para predizer a esteatose hepática, com ponto de corte de 1,06 vezes acima do valor de referência para a gama-glutamiltransferase e de 3,28 para o HOMA-IR. Os indicadores antropométricos, a porcentagem de gordura corporal, o perfil lipídico, a glicemia e a aspartato aminotransferase não apresentaram diferenças significantes. CONCLUSÕES: Pacientes com elevação de gama-glutamiltransferase e/ou HOMA-IR devem ser submetidos ao exame de ultrassom abdominal, havendo grande probabilidade de se obter como resultado a esteatose hepática...

Neck circumference as a new anthropometric indicator for prediction of insulin resistance and components of metabolic syndrome in adolescents: Brazilian Metabolic Syndrome Study / Circunferencia del cuello como un nuevo indicador antropométrico para predicción de resistencia a la insulina y componentes del síndrome metabólico en adolescentes: Brazilian Metabolic Syndrome Study - BRAMS / Circunferência do pescoço como um novo indicador antropométrico para predição de resistência à insulina e componentes da síndrome metabólica em adolescentes: Brazilian Metabolic Syndrome Study

To evaluate the correlation between neck circumference and insulin resistance and components of metabolic syndrome in adolescents with different adiposity levels and pubertal stages, as well as to determine the usefulness of neck circumference to predict insulin resistance in adolescents. METHODS: Cross-sectional study with 388 adolescents of both genders from ten to 19 years old. The adolescents underwent anthropometric and body composition assessment, including neck and waist circumferences, and biochemical evaluation. The pubertal stage was obtained by self-assessment, and the blood pressure, by auscultation. Insulin resistance was evaluated by the Homeostasis Model Assessment-Insulin Resistance. The correlation between two variables was evaluated by partial correlation coefficient adjusted for the percentage of body fat and pubertal stage. The performance of neck circumference to identify insulin resistance was tested by Receiver Operating Characteristic Curve. RESULTS: After the adjustment for percentage body fat and pubertal stage, neck circumference correlated with waist circumference, blood pressure, triglycerides and markers of insulin resistance in both genders. CONCLUSIONS: The results showed that the neck circumference is a useful tool for the detection of insulin resistance and changes in the indicators of metabolic syndrome in adolescents. The easiness of application and low cost of this measure may allow its use in Public Health services...

Evaluar la correlación de la circunferencia del cuello con resistencia a la insulina y con los componentes del síndrome metabólico en adolescentes con distintos niveles de adiposidad y estadios puberales, así como determinar la utilidad de la circunferencia del cuello como un parámetro en la predicción de resistencia a la insulina en adolescentes. MÉTODOS: Estudio transversal en el que se evaluó a 388 adolescentes de ambos sexos, de los 10 a los 19 años. Los adolescentes fueron sometidos a evaluación antropométrica y de composición corporal, incluyendo circunferencias del cuello y de la cintura, y la evaluación bioquímica. El estadio puberal se obtuvo mediante autoevaluación y la presión arterial, por el método de ausculta. Se evaluó la resistencia a la insulina por el Homeostasis Model Assessment-Insulin Resistence. La correlación entre dos variables fue evaluada con el coeficiente de corrrelación parcial ajustado para el porcentaje de grasa corporal y el estadio puberal. El desempeño de la circunferencia del cuello para identificar resistencia a la insulina fue evaluado por la Receiver Operating Characteristic Curve y se consideró p<0,05. RESULTADOS: Después del ajuste para el porcentaje de grasa corporal y estadio puberal, la circunferencia del cuello se correlacionó con la circunferencia de la cintura, presión arterial, triglicéridos y marcadores de resistencia a la insulina en ambos sexos. CONCLUSIONES: Los resultados demostraron que la circunferencia del cuello es una herramienta útil para detectar la resistencia a la insulina y la alteración en los indicadores de síndrome metabólico en adolescentes. La facilidad de aplicación y el bajo costo pueden hacer su uso viable en servicios de Salud Pública...

Avaliar a correlação da circunferência do pescoço com resistência à insulina e com os componentes da síndrome metabólica em adolescentes com diferentes níveis de adiposidade e estadios puberais, bem como determinar a utilidade da circunferência do pescoço como um parâmetro na predição de resistência à insulina em adolescentes. MÉTODOS: Estudo transversal no qual se avaliaram 388 adolescentes de ambos os sexos, de dez a 19 anos. Os adolescentes foram submetidos à avaliação antropométrica e de composição corporal, incluindo circunferências do pescoço e da cintura, e a avaliação bioquímica. O estadio puberal foi obtido por meio de autoavaliação e a pressão arterial, pelo método auscultatório. Analisou-se a resistência à insulina pelo Homeostasis Model Assessment-Insulin Resistance. A correlação entre duas variáveis foi verificada com o coeficiente de correlação parcial ajustado para o percentual de gordura corporal e o estadio puberal. O desempenho da circunferência do pescoço para identificar resistência à insulina foi testado pela Receiver Operating Characteristic Curve. RESULTADOS: Após ajuste para o percentual de gordura corporal e estadio puberal, a circunferência do pescoço correlacionou-se com circunferência da cintura, pressão arterial, triglicérides e marcadores de resistência à insulina em ambos os sexos. CONCLUSÕES: Os resultados demonstraram que a circunferência do pescoço é uma ferramenta útil para detectar a resistência à insulina e a alteração nos indicadores de síndrome metabólica em adolescentes. A facilidade de aplicação e o baixo custo podem viabilizar sua utilização...