Association between Arterial Hypertension and Laboratory Markers, Body Composition, Obstructive Sleep Apnea and Autonomic Parameters in Obese Patients. / Associação entre Hipertensão Arterial Sistêmica com Marcadores Laboratoriais, Composição Corporal, Apneia Obstrutiva do Sono e Variabilidade da Frequência Cardíaca em Adultos Obesos.

BACKGROUND: Systemic arterial hypertension (SAH) is a multifactorial disease, highly prevalent and associated with health risks. OBJECTIVE: The purpose of this study was to investigate the association between SAH and laboratory, anthropometric, heart rate variability (HRV), and obstructive sleep apnea markers and, secondarily, to analyze the sensitivity and specificity of the variables that are independent factors in the association. METHODS: Cross-sectional study with 95 obese patients treated at an obesity referral clinic in Salvador, BA, Brazil. SAH data were obtained from electronic medical records. The sample was stratified in the Normotensive Group (NG) and the Hypertensive Group (HG), and laboratory markers, body composition, polysomnography, and HRV were measured to evaluate the association of SAH with the predictor variables. For the analysis, p<0.05 was adopted. RESULTS: The average age of the NG was 36.3 ± 10.1 and HG 40.4 ± 10.6 years; 73.7% were women in the NG and 57.9% in HG; 82.4% in HG had insulin resistance. In the multivarious logistics regression model with adjustments in age, sex, height, and oxyhemoglobin saturation, SAH was inversely associated with fasting plasma glucose mg/dL (odds ratio [OR] = 0.96; 95% confidence interval [CI] = 0.92-0.99) and visceral fat area (VFA) cm2(OR = 0.98; 95% CI = 0.97-0.99). The area under the VFA curve was 0.728; CI 95% (0.620-0.836); fasting plasma glucose 0.693;CI 95% (0.582-0.804). CONCLUSIONS: Lower VFA and fasting plasma glucose concentrations were inversely associated with SAH. In addition, fasting plasma glucose and VFA showed a high sensitivity for SAH screening.

FUNDAMENTO: A hipertensão arterial sistêmica (HAS) é uma doença multifatorial, altamente prevalente e associada a riscos à saúde. OBJETIVO: O objetivo deste estudo foi investigar a associação entre HAS e marcadores laboratoriais, antropométricos, de variabilidade da frequência cardíaca (VFC) e de apneia obstrutiva do sono e, em segundo plano, analisar a sensibilidade e especificidade das variáveis que são fatores independentes na associação. MÉTODOS: Estudo transversal com 95 pacientes obesos atendidos em um ambulatório de referência em obesidade em Salvador, BA, Brasil. Os dados da HAS foram obtidos dos prontuários eletrônicos. A amostra foi estratificada em Grupo Normotenso (GN) e Grupo Hipertenso (GH), sendo medidos marcadores laboratoriais, composição corporal, polissonografia e VFC para avaliar a associação da HAS com as variáveis preditoras. Para as análises, adotou-se p<0,05. RESULTADOS: A média da idade do GN foi de 36,3 ± 10,1 e GH 40,4 ± 10,6 anos, 73,7% eram mulheres no GN e 57,9% no GH; 82,4% no GH apresentavam resistência à insulina. No modelo de regressão logística multivariado com ajustes para idade, sexo, altura e saturação de oxi-hemoglobina, a HAS foi inversamente associada à glicose plasmática em jejum mg/dL (odds ratio [OR] = 0,96; intervalo de confiança de 95% [IC] = 0,92-0,99) e área de gordura visceral (AGV) cm2 (OR = 0,98; IC 95% = 0,97-0,99). A área sob a curva AGV foi de 0,728; IC 95% (0,620-0,836) e glicemia de jejum 0,693; IC 95% (0,582-0,804). CONCLUSÃO: Menores concentrações de AGV e glicemia de jejum foram inversamente associadas à HAS. Além disso, tanto a glicemia de jejum quanto o AGV mostraram alta sensibilidade para triagem de HAS.

Molecular aspects of COVID-19 and its relationship with obesity and physical activity: a narrative review

Abstract BACKGROUND: Severe acute respiratory syndrome coronavirus 2 has several mechanisms of action related to inflammatory responses, especially in individuals diagnosed with obesity. This hyperinflammatory clinical profile resulting from the association between obesity and coronavirus disease 2019 (COVID-19) may be attenuated by regular physical activity. OBJECTIVE: The aim of this study was to review the evidence on the consequences of physical inactivity and physical activity on COVID-19 in patients with obesity. DESIGN AND SETTING: Narrative review at the Bahiana School of Medicine and Public Health in Salvador, Brazil. METHODS: We searched evidence on the association of COVID-19 with physical activity and obesity using the following keywords: "covid-19," "physical activity," and "obesity". The databases used were MEDLINE (PubMed), ScienceDirect, and Virtual Health Library. Studies published from 2019 to 2021 and available in Portuguese, English, and Spanish were included. The final search was conducted on September 26, 2021. RESULTS: We identified 661 studies in the database, among which 71 were considered for inclusion in the narrative review of the molecular aspects of COVID-19 and its relationship with physical activity and obesity. CONCLUSION: This literature review enabled the perception of the relationship between the molecular mechanisms of COVID-19 and obesity. Regular physical activity had various benefits for the inflammatory condition of the studied population, highlighting moderate-intensity.

Molecular aspects of COVID-19 and its relationship with obesity and physical activity: a narrative review.

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 has several mechanisms of action related to inflammatory responses, especially in individuals diagnosed with obesity. This hyperinflammatory clinical profile resulting from the association between obesity and coronavirus disease 2019 (COVID-19) may be attenuated by regular physical activity. OBJECTIVE: The aim of this study was to review the evidence on the consequences of physical inactivity and physical activity on COVID-19 in patients with obesity. DESIGN AND SETTING: Narrative review at the Bahiana School of Medicine and Public Health in Salvador, Brazil. METHODS: We searched evidence on the association of COVID-19 with physical activity and obesity using the following keywords: "covid-19," "physical activity," and "obesity". The databases used were MEDLINE (PubMed), ScienceDirect, and Virtual Health Library. Studies published from 2019 to 2021 and available in Portuguese, English, and Spanish were included. The final search was conducted on September 26, 2021. RESULTS: We identified 661 studies in the database, among which 71 were considered for inclusion in the narrative review of the molecular aspects of COVID-19 and its relationship with physical activity and obesity. CONCLUSION: This literature review enabled the perception of the relationship between the molecular mechanisms of COVID-19 and obesity. Regular physical activity had various benefits for the inflammatory condition of the studied population, highlighting moderate-intensity.

Associação entre Hipertensão Arterial Sistêmica com Marcadores Laboratoriais, Composição Corporal, Apneia Obstrutiva do Sono e Variabilidade da Frequência Cardíaca em Adultos Obesos / Association between Arterial Hypertension and Laboratory Markers, Body Composition, Obstructive Sleep Apnea and Autonomic Parameters in Obese Patients

Resumo Fundamento A hipertensão arterial sistêmica (HAS) é uma doença multifatorial, altamente prevalente e associada a riscos à saúde. Objetivo O objetivo deste estudo foi investigar a associação entre HAS e marcadores laboratoriais, antropométricos, de variabilidade da frequência cardíaca (VFC) e de apneia obstrutiva do sono e, em segundo plano, analisar a sensibilidade e especificidade das variáveis que são fatores independentes na associação. Métodos Estudo transversal com 95 pacientes obesos atendidos em um ambulatório de referência em obesidade em Salvador, BA, Brasil. Os dados da HAS foram obtidos dos prontuários eletrônicos. A amostra foi estratificada em Grupo Normotenso (GN) e Grupo Hipertenso (GH), sendo medidos marcadores laboratoriais, composição corporal, polissonografia e VFC para avaliar a associação da HAS com as variáveis preditoras. Para as análises, adotou-se p<0,05. Resultados A média da idade do GN foi de 36,3 ± 10,1 e GH 40,4 ± 10,6 anos, 73,7% eram mulheres no GN e 57,9% no GH; 82,4% no GH apresentavam resistência à insulina. No modelo de regressão logística multivariado com ajustes para idade, sexo, altura e saturação de oxi-hemoglobina, a HAS foi inversamente associada à glicose plasmática em jejum mg/dL (odds ratio [OR] = 0,96; intervalo de confiança de 95% [IC] = 0,92-0,99) e área de gordura visceral (AGV) cm2 (OR = 0,98; IC 95% = 0,97-0,99). A área sob a curva AGV foi de 0,728; IC 95% (0,620-0,836) e glicemia de jejum 0,693; IC 95% (0,582-0,804). Conclusão Menores concentrações de AGV e glicemia de jejum foram inversamente associadas à HAS. Além disso, tanto a glicemia de jejum quanto o AGV mostraram alta sensibilidade para triagem de HAS.

Abstract Background Systemic arterial hypertension (SAH) is a multifactorial disease, highly prevalent and associated with health risks. Objective The purpose of this study was to investigate the association between SAH and laboratory, anthropometric, heart rate variability (HRV), and obstructive sleep apnea markers and, secondarily, to analyze the sensitivity and specificity of the variables that are independent factors in the association. Methods Cross-sectional study with 95 obese patients treated at an obesity referral clinic in Salvador, BA, Brazil. SAH data were obtained from electronic medical records. The sample was stratified in the Normotensive Group (NG) and the Hypertensive Group (HG), and laboratory markers, body composition, polysomnography, and HRV were measured to evaluate the association of SAH with the predictor variables. For the analysis, p<0.05 was adopted. Results The average age of the NG was 36.3 ± 10.1 and HG 40.4 ± 10.6 years; 73.7% were women in the NG and 57.9% in HG; 82.4% in HG had insulin resistance. In the multivarious logistics regression model with adjustments in age, sex, height, and oxyhemoglobin saturation, SAH was inversely associated with fasting plasma glucose mg/dL (odds ratio [OR] = 0.96; 95% confidence interval [CI] = 0.92-0.99) and visceral fat area (VFA) cm2(OR = 0.98; 95% CI = 0.97-0.99). The area under the VFA curve was 0.728; CI 95% (0.620-0.836); fasting plasma glucose 0.693;CI 95% (0.582-0.804). Conclusions Lower VFA and fasting plasma glucose concentrations were inversely associated with SAH. In addition, fasting plasma glucose and VFA showed a high sensitivity for SAH screening.

Anthropometric Measures for the Prognosis of Obstructive Sleep Apnea in Obese.

OBJECTIVE: The objective of this study was to identify, among the different anthropometric indicators, the one that shows higher discriminatory power for the prognosis of Obstructive Sleep Apnea Syndrome (OSAS). DESIGN: Observational cross-sectional study PARTICIPANTS: Obese individuals elective to bariatric surgery METHODS: A study based on data of 758 patients aged ≥ 21 years old, of both sexes, in the pre-operatory stage of the surgical procedure of gastric bypass. Obstructive sleep apnea and obstructive sleep hypopnea were evaluated and classified through the apnea-hypopnea index, which was obtained through the examination of polysomnography. Variables were divided into two groups: individuals with and without OSAS. As predictors, measures of body mass index (BMI), neck circumference (NC), and waist circumference (WC) were used. RESULTS: The area under the ROC curve was used to check the sensitivity and specificity. All evaluated anthropometric indicators showed statistical significance. WC: area of 0.62 (CI 95%: 0.58 - 0.67), NC: area of 0,68 (CI 95%: 0.64 - 0.72) and BMI: area of 0.58 (CI 95%: 0.54 - 0.63). CONCLUSION: The investigated anthropometric indicators performed as good predictors of OSAS. However, NC seems to be the best anthropometric indicator for the prognosis of OSAS in obese individuals when compared to BMI and WC.

Effect of sodium bicarbonate supplementation on two different performance indicators in sports: a systematic review with meta-analysis.

PURPOSE: Sodium bicarbonate shows ergogenic potential in physical exercise and sports activities, although there is no strong evidence which performance markers show the greatest benefit from this supplement. This study evaluated the effects of sodium bicarbonate supplementation on time trial performance and time to exhaustion in athletes and sports practitioners. METHODS: A systematic review was conducted using three databases, including 17 clinical trials. Among these clinical trials, 11 were considered eligible for the meta-analysis according to the criteria for the assessment of methodological quality using the PEDro Scale. Time to exhaustion was assessed in six studies, while time trial performance was evaluated in five studies. RESULTS: A significant beneficial effect of supplementation on time to exhaustion was found in a random effects model (1.48; 95% confidence interval [CI], 0.49 to 2.48). There was no significant effect of supplementation on time trial performance in a fixed effects model (slope = -0.75; 95% CI, -2.04 to 0.55) relative to a placebo group. CONCLUSION: Sodium bicarbonate has the potential to improve sports performance in general, especially in terms of time to exhaustion.

Prevalência e Fatores Associados à Inatividade Física no Tempo Livre em Adultos na Cidade de Lauro de Freitas-Bahia-Brasil / Prevalence and Factors Associated to Physical Inactivity During Leisure Time among Adults from Lauro de Freitas, Bahia, Brazil

Objetivo: Identificar a prevalência e os fatores sóciodemográficos associados à inatividade física no tempo livre em adultos na cidade de Lauro de Freitas-Bahia-Brasil. Materiais e Métodos: O desenho foi transversal; para cálculo da amostra considerou o tamanho da população de 138.240 habitantes, prevalência da atividade física de 50%, nível de confiança de 95% de precisão e erro assumido para a prevalência esperada de 5%. Amostra foi constituída de 522 indivíduos com idade e" 18 anos, sendo 220 do sexo masculino e 302 do sexo feminino. O instrumento utilizado foi o International Physical Activity Questionnaire (IPAQ), versão longa além de um Questionário de Identificação para a coleta de informações pessoais. Inicialmente, calculou-se a prevalência da inatividade física no tempo livre, em seguida calculou-se a razão de prevalência por fatores sóciodemográficos. Resultado: Observou-se que a prevalência da inatividade física no tempo livre foi de 82,5%, sendo maior nas mulheres com 87% em relação aos homens 76,3%. As pessoas com idade <60 anos, solteiras, com menor nível de escolaridade e classe social D apresentaram-se mais inativas. Conclusão: O estudo mostra alta prevalência de inatividade física no tempo livre em adultos na cidade de Lauro de Freitas, assim como, identifica que pessoas com idade menor que 60 anos, solteiras, com baixos niveis de escolaridade e classe social, apresentam associação com a inatividades física no tempo livre. Sugere-se a implantação de programas de incentivo à prática de atividades físicas aos subgrupos populacionais mais afetados, colaborando desta forma com a saúde pública de Lauro de Freitas. (AU)

Objective: To identify the prevalence and factors associated with physical inactivity during leisure time among adults from Lauro de Freitas, Bahia, Brazil. Material and Methods: This was a cross-sectional study considering a sample population of 138,240 inhabitants, 50% prevalence of physical activity, 95% confidence level, and a 5% error for the expected prevalence. The sample consisted of 522 adults e" 18 years of age, including 220 males and 302 females. The long version of the International Physical Activity Questionnaire (IPAQ) as well as an identification questionnaire to collect personal information were used for data collection. Initially, we calculated the prevalence of physical inactivity during leisure time and then the prevalence ratio for sociodemographic variables. Results: the prevalence of physical inactivity during leisure time was 82.5%, being higher in women (87%) as compared to men (76.3%). Individuals aged < 60 years, single, with low education level and those belonging to social class D, were found to be more inactive. Conclusion: This study shows a high prevalence of physical inactivity during leisure time among adults from Lauro de Freitas city. It was further identified that individuals under the age of 60, single, with low levels of schooling and low-income social class, are associated with physical inactivity during leisure time. It is suggested the implementation of programs to encourage the practice of physical activities to these specific groups, thus collaborating with the community public health in Lauro de Freitas. (AU)

Atividade física como discriminador da ausência de hipertensão arterial em homens adultos / Physical activity as discriminator of the absence of hypertension in adult men / Actividad física como discriminador de la ausencia de hipertensión arterial en hombres adultos

Introdução: Diversos estudos epidemiológicos demonstram que a atividade física reduz a pressão arterial, porém a quantidade necessária para que estes benefícios sejam alcançados permanece especulativa. Objetivo: Analisar a quantidade (duração e intensidade) de atividade física em seus diferentes domínios (trabalho, deslocamento, atividade doméstica e tempo livre) como discriminador da ausência de hipertensão arterial em adultos do sexo masculino. Métodos: Estudo transversal realizado na cidade de Lauro de Freitas, Bahia, Brasil com amostra constituída por 220 indivíduos do sexo masculino com idade superior a 18 anos. Foram construídas diversas curvas Receiver Operating Characteristic (ROC) e comparadas às áreas sobre as mesmas entre a quantidade de atividade física em seus diferentes domínios e a ausência de hipertensão arterial. Verificou-se também a sensibilidade e especificidade para a quantidade de atividade física necessária para prevenção de hipertensão arterial. Foi utilizado o intervalo de confiança a 95%. Resultados: Entre os diferentes domínios de atividade física analisados encontrou-se maior significância estatística nas áreas sob a curva ROC para a atividade física no trabalho e no tempo livre. A caminhada não foi boa discriminadora para a ausência de hipertensão arterial em nenhum dos domínios analisados. Observou-se também que 180 min/semana de atividade física moderada, acumulada nos diferentes domínios foi o melhor ponto de corte para discriminar a ausência de hipertensão arterial. Conclusão: A prática da atividade física, principalmente de intensidade moderada, com duração de pelo menos 180 min/semana deve ser sugerida para indivíduos ...

Introduction: Several epidemiological studies show that physical activity reduces blood pressure but the amount needed to bring these benefits remains speculative. Objective: To analyze the amount (duration and intensity) of physical activity in its different domains (work, commuting, household activity and leisure time) as discriminator of the absence of hypertension in adult males. Methods: Cross-sectional study conducted in the city of Lauro de Freitas, Bahia, Brazil with sample of 220 males aged over 18 years. Several Receiver Operating Characteristic (ROC) curves were constructed which were compared to the areas between the amount of physical activity in their various domains and the absence of hypertension. For the amount of physical activity needed to prevent hypertension, sensitivity and specificity were also checked. The confidence interval of 95% was used. Results: Among the different domains of physical activity analyzed we found a greater statistical significance in the areas under the ROC curve for physical activity at work and leisure time. Hiking was not a good discriminator for the absence of hypertension in any of the domains analyzed. It was also observed that 180 minutes/week of moderate physical activity accumulated in the different domains was the best cutoff point for discriminating the absence of hypertension. Conclusion: The practice of physical activity, especially moderate intensity, lasting at least 180 minutes/week should be suggested for males to contribute to the prevention of hypertension. .

Introducción: Diversos estudios epidemiológicos demuestran que la actividad física reduce la presión arterial, aunque la cantidad necesaria para que estos beneficios sean alcanzados permanece especulativa. Objetivo: Analizar la cantidad (duración e intensidad) de actividad física en sus diferentes dominios (trabajo, desplazamiento, actividad doméstica y tiempo libre) como discriminador de la ausencia de hipertensión arterial en adultos del sexo masculino. Métodos: Estudio transversal realizado en la ciudad de Lauro de Freitas, Estado de Bahia, Brasil, con muestra constituida por 220 individuos del sexo masculino con edad superior a 18 años. Fueron construidas diversas curvas Receiver Operating Characteristic (ROC) y comparadas a las áreas sobre las mismas entre la cantidad de actividad física en sus diferentes dominios y la ausencia de hipertensión arterial. Se verificó también la sensibilidad y especificidad para la cantidad de actividad física necesaria para prevención de hipertensión arterial. Fue utilizado el intervalo de confianza a 95%. Resultados: Entre los diferentes dominios de actividad física analizados se encontró mayor significado estadístico en las áreas bajo la curva ROC para la actividad física en el trabajo y en el tiempo libre. La caminata no fue buena discriminadora para la ausencia de hipertensión arterial en ninguno de los dominios analizados. Se observó también que 180 min/semana de actividad física moderada, acumulada en los diferentes dominios fue el mejor punto de corte para discriminar la ausencia de hipertensión arterial. Conclusión: La práctica de la actividad física, principalmente de intensidad moderada, con duración de por los menos 180 min/semana debe ser sugerida para individuos del sexo masculino buscando contribuir para la prevención ...

Gasto calórico dos diferentes domínios de atividade física como preditor da ausência de diabetes em adultos / Caloric expenditure of different domains of physical activity as predictors of the absence of diabetes in adults

INTRODUÇÃO: A atividade física apresenta efeito protetor contra doenças crônicas e fatores de risco cardiovascular; no entanto, o gasto calórico necessário para promover a prevenção do diabetes permanece especulativo. OBJETIVO: Analisar o gasto calórico dos diferentes domínios da atividade física (trabalho, deslocamento, atividade doméstica, tempo livre e atividade física total) como preditores da ausência de diabetes em adultos de ambos os sexos. MÉTODOS: Estudo transversal realizado na cidade de Lauro de Freitas, Bahia, Brasil (2007-2008) com amostra constituída por 522 indivíduos maiores de 18 anos, sendo 302 do sexo feminino e 220 do sexo masculino. Foram construídas curvas Receiver Operating Characteristic (ROC) e comparadas as áreas sob as mesmas, além de verificar-se a sensibilidade e especificidade para identificar os melhores pontos de corte entre os diferentes domínios da atividade física e a ausência de diabetes. Foi utilizado o intervalo de confiança a 95%. RESULTADOS: Entre os diferentes domínios de atividade física analisados encontrou-se significância estatística nas áreas sob a curva ROC para o tempo livre, deslocamento e para atividade física total. Observou-se também que o gasto calórico na atividade física total de 830kcal/semana quando analisados apenas os homens, e 1,774kcal/semana quando analisados homens e mulheres conjuntamente, foram os melhores pontos de corte para predizer a ausência de diabetes. CONCLUSÃO: A prática da atividade física deve ser sugerida em níveis adequados para indivíduos de ambos os sexos visando contribuir para a prevenção do diabetes.

BACKGROUND: Physical activity had a protective effect against chronic diseases and cardiovascular risk factors; however, the caloric expenditure necessary to promote diabetes prevention remains speculative. OBJECTIVE: To analyze the caloric expenditure of different domains of physical activity (work, commuting, household, leisure time and total physical activity) as predictors of the absence of diabetes in adults of both sexes. METHODS: This was a cross-sectional study in the town of Lauro de Freitas, Bahia, Brazil (2007 - 2008) with a sample of 522 individuals over 18 years of age; 302 female and 220 male. Receiver Operating Characteristic Curves (ROC) were constructed and the areas below them were compared. Additionally, the sensitivity and specificity to identify the best cutoff points among the different domains of physical activity and the absence of diabetes were verified. Confidence interval at 95% was used. RESULTS: Among the different domains of physical activity analysed, statistical significance was only found in the areas under the ROC curve for leisure time, commuting and total physical activity. Additionally, it was observed that the caloric expenditure in total physical activity ranging from 830 kcal/week and 1.774 kcal/week were the best cutoff points for predicting the absence of diabetes. CONCLUSION: Physical activity should be suggested at appropriate levels for individuals of both sexes to contribute to diabetes prevention.