Expression levels of ACE and ACE2 in the placenta and white adipose tissue of lean and obese pregnant women.

BACKGROUND: This study evaluated the expression of ACE and ACE2 in the placenta and white adipose tissue in lean and obese women, and correlated their levels with anthropometric, clinical, and laboratory parameters, and tissue count of inflammatory cells. METHODS: A cross-sectional analytical study was performed with 49 pregnant women and their respective newborns. Samples of placenta and adipose tissue were used for measuring mRNA expression for ACE and ACE2 through qRT-PCR. Inflammatory cell counting was performed through conventional microscopy. RESULTS: An increase in ACE expression and a decrease in ACE2 were observed in the placenta and adipose tissue of women with obesity. ACE2 levels showed a negative correlation with pre-pregnancy BMI and total cholesterol. CONCLUSION: Maternal obesity can modulate the expression of RAS components in the placenta and white adipose tissue, with ACE2 correlated with pre-pregnancy BMI and total cholesterol.

Oral supplementation with resveratrol improves hormonal profile and increases expression of genes associated with thermogenesis in oophorectomy mice.

Menopause causes important bodily and metabolic changes, which favor the increased occurrence of cardiovascular diseases, obesity, diabetes, and osteoporosis. Resveratrol exerts proven effects on body metabolism, improving glucose and lipid homeostasis and reducing inflammation and oxidative stress in various organs and tissues. Accordingly, this study evaluates the effects of resveratrol supplementation on the expression of markers associated with thermogenesis in brown adipose tissue, and on the body, metabolic and hormonal parameters of female mice submitted to bilateral oophorectomy. Eighteen female mice were randomized into three groups: G1: control (CONTROL), G2: oophorectomy (OOF), and G3: oophorectomy + resveratrol (OOF + RSV); the animals were kept under treatment for twelve weeks, being fed a standard diet and treated with resveratrol via gavage. Body, biochemical, hormonal, and histological parameters were measured; in addition to the expression of markers associated with thermogenesis in brown adipose tissue. The results showed that animals supplemented with resveratrol showed reduced body weight and visceral adiposity, in addition to glucose, total cholesterol, and triglyceride levels; decreased serum FSH levels and increased estrogen levels were observed compared to the OOF group and mRNA expression of PRDM16, UCP1, and SIRT3 in brown adipose tissue. The findings of this study suggest the important role of resveratrol in terms of improving body, metabolic, and hormonal parameters, as well as modulating markers associated with thermogenesis in brown adipose tissue of female mice submitted to oophorectomy.

Salt Intake in Adults with Diabetes and Hypertension: The Longitudinal Study of Adult Health-Brasil Study.

Background and Objective: Hypertension and type-2 diabetes are strong risk factors for cardiovascular diseases, and their management requires lifestyle changes, including a shift in dietary habits. The consumption of salt has increased in the last decades in some countries, but its association with type-2 diabetes remains unknown. Thus, we aimed to estimate the amount of salt intake among adults with and without diabetes and to assess whether concomitant hypertension and diabetes are associated with higher salt intake. Methods: Data from 11,982 adults 35-74 years of age enrolled in the baseline of the Longitudinal Study of Adult Health-Brasil study (2008-2010) were studied. A clinical and anthropometric evaluation was performed, and their daily salt intake was estimated by the overnight 12-hr urine sodium excretion. Results: Salt intake (gram per day) was higher in participants with diabetes as compared with those without diabetes, regardless of sex (men: 14.2 ± 6.4 vs. 12.4 ± 5.6, P < 0.05; women: 10.5 ± 4.8 vs. 9.1 ± 4.1, P < 0.05). However, salt intake is high in participants with fasting glucose ≥126 mg/dL or HbA1c ≥6.5%, but not in participants with blood glucose 2 hr after the glucose tolerance test ≥200 mg/dL. When hypertension and diabetes coexisted, salt consumption was higher than among people without these conditions. The prevalence of hypertension increased with increasing salt intake in women with diabetes, but not in men with this condition. Conclusions: Our findings highlight the high consumption of salt in individuals with diabetes and/or hypertension, and the need for effective strategies to reduce salt consumption in these groups of increased risk for major cardiovascular events, especially in women.

Association Between Triglycerides, High-Density Lipoprotein Cholesterol, and Their Ratio With the Pulse Wave Velocity in Adults From the ELSA-Brasil Study.

Atherogenic dyslipidemia is a risk factor for cardiovascular diseases. The present study aimed to evaluate the association between triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and the triglycerides to high-density lipoprotein (TG/HDL-C) ratio with carotid-femoral pulse wave velocity (cf-PWV), a marker of vascular stiffness. Anthropometric, biochemical, and clinical data from 13,732 adults were used to assess this association. Individuals within the third TG/HDL-C tertile presented worse anthropometric, biochemical, and clinical profiles as compared with the participants in the lower TG/HDL-C tertile. There was a linear association between TG, HDL-C, and TG/HDL-C ratio and cf-PWV in both men and women (stronger in women). After adjustment for confounders, lower levels of HDL-C were associated with increased cf-PWV in men (9.63 ± .02 m/s) and women (8.90 ± .03 m/s). However, TG was not significantly associated with cf-PWV after adjustment, regardless of sex. An increased TG/HDL-C ratio is associated with higher cf-PWV only in women (9.01 ± .03 m/s), but after adjustment for HDL-C levels, the association was non-significant (8.99 ± .03 m/s). These results highlight the stronger association of HDL-C with arterial stiffness, and that the association of TG/HDL-C with cf-PWV is dependent on HDL-C.

The association between salt intake and blood pressure is mediated by body mass index but modified by hypertension: The ELSA-Brasil study.

High salt intake has been linked to both obesity and high blood pressure (BP). Part of the variability of BP attributed to salt intake might be BMI-mediated. To investigate whether hypertension would be an effect modifier in the complex network including salt intake, obesity, and BP, we tested the hypothesis that salt intake has direct and BMI-mediated effects on systolic (SBP) and diastolic blood pressure (DBP). Data from 9,028 participants (aged 34-75 years, 53.6% women) were analyzed. A validated formula was used to estimate daily salt intake from the sodium excretion (12 h urine collection). A path model adjusted for covariates was designed in which salt intake has both a direct and a BMI-mediated effect on BP. In normotensives, standardized beta coefficients showed significant direct (Men: 0.058 and 0.052, Women: 0.072 and 0,061, P < 0.05) and BMI-mediated (Men: 0.040 and 0.065, Women: 0.038 and 0.067, P < 0.05) effect of salt intake on the SBP and DBP, respectively. However, in hypertensive individuals, neither the direct (Men: 0.006 and 0.056, Women: 0.048 and 0.017) nor the indirect effect (Men: -0.044 and 0.014, Women: 0.011 and 0.050) of salt intake on the SBP and DBP were significant. These data suggest that cardiovascular risk stratification should consider the complex interaction between salt intake and weight gain, and their effects on BP of normotensive and hypertensive individuals.

Reference values for the tri-ponderal mass index and its association with cardiovascular risk factors in Brazilian adolescents aged 12 to 17 years.

OBJECTIVES: The aims of this study was to determine the cutoff values for tri-ponderal mass index (TMI) and investigate the association between overweight/obesity as classified by TMI and cardiometabolic risk factors in Brazilian adolescents aged 12 to 17 y. METHODS: This was a cross-sectional study comprising 37 815 adolescents (40 % boys; 12-17 y) enrolled in the Study of Cardiovascular Risks in Adolescents. TMI was calculated as weight divided by cubed height (kg/m3). Overweight (TMI-for-age ≥85th percentile to <95th percentile) and obesity (TMI-for-age ≥95th percentile) were determined for both sexes. Poisson regression model analyses were used to test associations. RESULTS: TMI was stable across the age span (12-17 y) in both sexes. Boys and girls classified by TMI as obese had higher prevalence ratios (PR) for hypertension (PR, 4.98; 95% confidence interval [CI], 3.26-7.61 for boys; PR, 6.88; 95% CI, 3.70-12.78 for girls), insulin resistance (PR, 19.72; 95% CI, 13.56-28.69 for boys; PR, 10.04; 95% CI, 7.47-13.50 for girls), hypercholesterolemia (PR,5.05; 95% CI, 3.68-6.94 for boys; PR, 1.44; 95% CI, 1.00-2.11 for girls), and hypertriacylglycerolemia (PR,7.36; 95% CI, 5.16-10.50 for boys; PR, 3.37; 95% CI, 2.52-4.51 for girls) when compared with normal weight counterparts. CONCLUSIONS: Obesity, as classified by TMI, was strongly associated with several cardiovascular risk factors. Our data showed that TMI was stable across the age span. Therefore, a fixed cutoff value to determine weight status in Brazilian adolescents seems appropriate.

Development and Evaluation of a Low-cost Dairy Food Supplement with Mauritia Flexuosa (Buriti) to Combat Malnutrition: Translational Study in Mice and Institutionalized Elderly Woman.

AIMS: The present study aimed to develop and evaluate a new dairy by-product nutritional supplement with Buriti fruit to improve malnutrition in mice and elderly woman. BACKGROUND: Malnutrition is a prevalent problem in the elderly; therefore, oral dietary supplementation is an important strategy to reduce this health problem incidence. OBJECTIVE: The present study evaluated the effects of a low-cost food supplement, made from byproducts of the dairy and fruit industry in the Brazilian Cerrado (Buriti), on the nutritional status and on the recovery of the metabolic profile of malnourished animals and elderly women. METHODS: In the pre-clinical phase, Swiss mice were divided into six groups and subjected to malnutrition and renutrition. The clinical phase was carried out with 25 elderly women residing in a long-term institution, aged ≥ 65 years and with malnutrition or risk of malnutrition. RESULTS: The main results showed improvements in anthropometric parameters and an increase in serum albumin levels, in addition to lipid profile improvement in the preclinical phase and an increase in the red blood cells and hemoglobin in the clinical phase. CONCLUSION: The supplement based on Buriti was able to reverse malnutrition promoting improvements in anthropometric and biochemical parameters.

Exposure to pesticides or agroecological practices: suicidal ideation among peasant farmers in Brazil's semi-arid region. / Exposição a agrotóxicos ou práticas agroecológicas: ideação suicida entre camponeses do semiárido no Brasil.

Health risks faced by peasant farmers may vary depending on the type of agriculture they practice. This study examined the association between suicide ideation and exposure to pesticides by comparing two groups of peasant farmers of both sexes living in the semi-arid region of the north of Minas Gerais, Brazil: exposed to pesticides and adopting agroecological practices without the use of pesticides. Group participants were selected using convenience sampling and data was collected using a previously validated questionnaire administered through face-to-face interviews. Bivariate analysis was performed, followed by logistic regression. A total of 547 peasant farmers were interviewed (311 in the group exposed to pesticides and 236 in the group adopting agroecological practices). Respondents from the group exposed to pesticides were more likely to report suicidal ideation (OR=2.30; 95%CI 1.16-4.56), harmful alcohol consumption (OR=2.30; 95%CI 1.18-4.48), and lifetime acute pesticide poisoning (OR=8.58; 95%CI 2.98-24.72). The findings suggest that agricultural practices that lead to chronic pesticide exposure are associated with a greater likelihood of suicide ideation, regardless of previous episodes of acute pesticide poisoning or harmful alcohol consumption.

Diferentes práticas agrícolas estão associadas a diferentes riscos para a saúde de camponeses. Objetivou-se analisar a associação entre ideação suicida e exposição a agrotóxicos, comparando camponeses vivendo sob exposição ambiental a agrotóxicos em relação a camponeses envolvidos com práticas agroecológicas, sem o uso de agrotóxicos, no semiárido norte mineiro. As famílias avaliadas foram amostradas, por conveniência, a partir da prática agrícola a qual estavam vinculadas, e os dados coletados por meio de entrevistas com instrumento previamente validado. Foram realizadas análises bivariadas seguidas de regressão logística. Foram entrevistados 547 camponeses, de ambos os sexos, sendo 311 sob exposição a agrotóxicos. Os camponeses expostos a agrotóxicos, em relação a camponeses envolvidos com práticas agroecológicas, tiveram maiores chances para ideação suicida (OR=2,30; IC95% 1,16-4,56), consumo problemático de álcool (OR=2,30; IC95% 1,18-4,48) e episódios prévios de intoxicação aguda por agrotóxicos (OR=8,58; IC95% 2,98-24,72).Conclui-se que as práticas agrícolas que implicam em exposição crônica a agrotóxicos se associam a maiores chances de ideação suicida, independentemente de episódios prévios de intoxicação aguda por agrotóxicos ou do uso problemático do álcool.

Exposição a agrotóxicos ou práticas agroecológicas: ideação suicida entre camponeses do semiárido no Brasil / Exposure to pesticides or agroecological practices: suicidal ideation among peasant farmers in Brazil's semi-arid region

Resumo Diferentes práticas agrícolas estão associadas a diferentes riscos para a saúde de camponeses. Objetivou-se analisar a associação entre ideação suicida e exposição a agrotóxicos, comparando camponeses vivendo sob exposição ambiental a agrotóxicos em relação a camponeses envolvidos com práticas agroecológicas, sem o uso de agrotóxicos, no semiárido norte mineiro. As famílias avaliadas foram amostradas, por conveniência, a partir da prática agrícola a qual estavam vinculadas, e os dados coletados por meio de entrevistas com instrumento previamente validado. Foram realizadas análises bivariadas seguidas de regressão logística. Foram entrevistados 547 camponeses, de ambos os sexos, sendo 311 sob exposição a agrotóxicos. Os camponeses expostos a agrotóxicos, em relação a camponeses envolvidos com práticas agroecológicas, tiveram maiores chances para ideação suicida (OR=2,30; IC95% 1,16-4,56), consumo problemático de álcool (OR=2,30; IC95% 1,18-4,48) e episódios prévios de intoxicação aguda por agrotóxicos (OR=8,58; IC95% 2,98-24,72).Conclui-se que as práticas agrícolas que implicam em exposição crônica a agrotóxicos se associam a maiores chances de ideação suicida, independentemente de episódios prévios de intoxicação aguda por agrotóxicos ou do uso problemático do álcool.

Abstract Health risks faced by peasant farmers may vary depending on the type of agriculture they practice. This study examined the association between suicide ideation and exposure to pesticides by comparing two groups of peasant farmers of both sexes living in the semi-arid region of the north of Minas Gerais, Brazil: exposed to pesticides and adopting agroecological practices without the use of pesticides. Group participants were selected using convenience sampling and data was collected using a previously validated questionnaire administered through face-to-face interviews. Bivariate analysis was performed, followed by logistic regression. A total of 547 peasant farmers were interviewed (311 in the group exposed to pesticides and 236 in the group adopting agroecological practices). Respondents from the group exposed to pesticides were more likely to report suicidal ideation (OR=2.30; 95%CI 1.16-4.56), harmful alcohol consumption (OR=2.30; 95%CI 1.18-4.48), and lifetime acute pesticide poisoning (OR=8.58; 95%CI 2.98-24.72). The findings suggest that agricultural practices that lead to chronic pesticide exposure are associated with a greater likelihood of suicide ideation, regardless of previous episodes of acute pesticide poisoning or harmful alcohol consumption.

Reference values for the triglyceride to high-density lipoprotein ratio and its association with cardiometabolic diseases in a mixed adult population: The ELSA-Brasil study.

BACKGROUND: Among several lipid ratios available, the triglyceride/HDL-cholesterol (TG/HDL-C) may detect individuals at risk of cardiometabolic diseases. However, its reference values for different ethnicities are not well established. OBJECTIVE: To define sex- and ethnicity-specific reference values for TG/HDL-C ratio in a large sample of healthy multiethnic adults and test its association with cardiometabolic conditions. METHODS: An apparently healthy sample (n = 2,472), aged 35-74, free of major cardiovascular risk factors, was used to generate the reference values for the TG/HDL-C. Exclusion criteria were diabetes, elevated blood pressure, obesity, hypercholesterolemia, severe hypertriglyceridemia, and smoking history. Cut-offs based on the reference values were tested in the whole ELSA Brasil study (n = 13,245), stratified by sex and ethnicity, to identify cardiometabolic conditions. RESULTS: TG/HDL-C ratio was higher in men than women, and did not change significantly with age, regardless of sex and ethnicity. Also, black individuals showed lower levels of TG/HDL-C as compared to other ethnic groups. ROC curve showed that the cut-off based on the 75th percentile displayed better sensitivities and specificities for men and women, regardless of ethnicity. Also, the sex- and ethnicity-specific cut-offs based on the 75th percentile were significantly associated with all tested cardiometabolic conditions (hypertension, diabetes, obesity, metabolic syndrome, and insulin resistance). Also, we observed that the use of a single sex-specific cut-off (men: 2.6; women: 1.7) could be used for the different ethnicities with good reliability. CONCLUSION: The defined TG/HDL-C cut-offs (men: 2.6; women: 1.7) are reliable and showed good clinical applicability to detect cardiometabolic conditions in a multiethnic population.

High fructose intake and the route towards cardiometabolic diseases.

It is known that dietary habits have a strong influence on body metabolism. In the last decades, the dietary habits have changed worldwide, and the consumption of fructose, especially in sugar-sweetened beverages, increased significantly. In this perspective, the present review aimed to summarize the effects of fructose on different cardiometabolic conditions. Clinical, experimental, and epidemiological studies evidenced that fructose can exert several deleterious effects when its consumption is above the recommended amounts. The increased fructose consumption decreases satiety, favoring a positive energy balance, increases adipogenesis, leading to visceral fat accumulation, induces ectopic fat accumulation, especially in the skeletal muscle and liver, leading to insulin resistance, inflammation, and lipid metabolism impairment, increases arterial blood pressure and causes vascular damage. Therefore, increased fructose consumption is linked to the development of alarming cardiometabolic conditions, such as obesity, insulin resistance, type 2 diabetes, non-alcoholic fatty liver disease, and cardiovascular diseases, through several different mechanisms. Further clinical and experimental studies are still necessary to elucidate additional signaling pathways and mechanisms by which fructose is involved in all the mentioned cardiometabolic disorders. Also, the reported findings raise the need for the creation of public health policies aimed to prevent diet-associated cardiometabolic disorders, thus improving the population quality of life.

Local tissue electrical parameters predict oral mucositis in HNSCC patients: A diagnostic accuracy double-blind, randomized controlled trial.

Oral Mucositis (OM) is a common adverse effect of head and neck squamous cell carcinoma (HNSCC) treatment. The purpose of this study was to investigate the significance of early changes in tissue electrical parameters (TEPs) in predicting the development of OM in HNSCC patients receiving radiation therapy (RT). The current study combined two study designs. The first was a case-control study. The control group comprised of RT patients who did not receive head and neck RT, and patients with HNSCC who received RT comprised the case group. In the second part of the study, the case group was included in a parallel cohort. A total of 320 patients were assessed for eligibility, and 135 patients were enrolled. Double blinding was performed, and neither the patients nor the care providers knew the measured parameters. The primary outcome was the detection of between-group changes in local TEPs over the follow-up period. The secondary outcome was the appearance of OM grades II, III, or IV and the predictive value of local TEPs in determining the incidence of OM after RT. The variables, impedance module, resistance, reactance, phase angle, and capacitance, were analyzed by the receiver operator curves (ROC). The case and control groups did not differ in demographic and clinical characteristics. Radiation therapy increased the local impedance module, resistance, reactance, and phase angle and reduced the local tissue capacitance in both groups. Evaluation of TEPs in the first week of RT correlated with the development of OM lesions during cancer therapy. ROC analysis showed that local impedance module and resistance presented higher specificity than did other parameters in predicting OM. In conclusion, local tissue electrical parameters measured at the first RT week can be useful tools to predict oral mucositis.

QT Interval Dispersion Behavior in Patients With and Without Obstructive Coronary Artery Disease Undergoing Exercise Test

Abstract Background: Stress test is used to detect coronary artery disease (CAD). The QTc interval dispersion (dQTc) is an electrocardiographic index of ventricular repolarization heterogeneity. Some researchers have linked transient myocardial ischemia induced by physical exertion with increased heterogeneity of ventricular repolarization measured by dQTc. Objectives: To study the patterns of dQT in patients with and without chronic obstructive CAD and to define a reliable cutoff point for dQT that could become a diagnostic criterion for myocardial ischemia. Methods: We retrospectively analyzed the electrocardiogram in resting and in exercise of 63 patients submitted to exercise test and cardiac catheterization. We divided the patients into three groups: true negative (VN), true positive (VP) and false positive (FP). VN: patients with coronary lesion lower than 70% and exercise test without myocardial ischemia; VP: individuals with stenosis greater than 70% in coronary arteries and a test suggestive of myocardial ischemia; FP: people with stenosis lower than 70% in the coronary arteries and stress test with ischemia criteria. Values of p < 0.05 were considered statistically significant. Results: Resting dQTc was not different among the three groups. However, for the dispersion of the QTc interval in exercise was, respectively, 47 ± 17 ms, 72 ± 42 ms, and 61 ± 31 ms for VN, VP and FP (p = 0.003). Conclusions: Obstructive chronic coronary disease patients have an increase in dQTc during exercise. Measurement of dQTc may be helpful in the diagnosis of myocardial ischemia in the stress test.

Polymorphisms of the renin-angiotensin system are not associated with overweight and obesity in a general adult population.

OBJECTIVE: The increased prevalence of obesity and associated comorbidities, such as cardiovascular and metabolic diseases, has gained attention worldwide, and the renin-angiotensin system (RAS) has been pointed out as a possible link. Thus, the present study aimed to verify the possible association between angiotensinogen (AGT) or angiotensin-converting enzyme (ACE) polymorphisms with overweight and obesity in adults. SUBJECTS AND METHODS: The present investigation was a population-based cross-sectional study including 1,567 individuals from an urban area in Brazil. Anthropometric, clinical and biochemical parameters were evaluated, and all individuals were genotyped for the ACE I/D and AGT M/T polymorphisms. RESULTS: The prevalence of overweight was higher among men, whereas obesity was more prevalent among women. However, the frequency of ACE or AGT polymorphisms was similar among body mass index (BMI) categories. In addition, the mean age-adjusted BMI averages did not change significantly for ACE or AGT polymorphisms, regardless of sex or BMI category. The age-adjusted BMI average for the combination of ACE and AGT genotypes evidenced no significant differences regardless of sex or BMI categories. Results were similar when BMI was replaced by waist circumference (WC). CONCLUSIONS: We were not able to find any associations between BMI and WC (overweight/obesity) and ACE and AGT polymorphisms, indicating that the RAS system might not be involved in overweight and obesity, at least based on genetic backgrounds. However, further studies must measure RAS components to elucidate this question.

Polymorphisms of the renin-angiotensin system are not associated with overweight and obesity in a general adult population

ABSTRACT Objective The increased prevalence of obesity and associated comorbidities, such as cardiovascular and metabolic diseases, has gained attention worldwide, and the renin-angiotensin system (RAS) has been pointed out as a possible link. Thus, the present study aimed to verify the possible association between angiotensinogen (AGT) or angiotensin-converting enzyme (ACE) polymorphisms with overweight and obesity in adults. Subjects and methods The present investigation was a population-based cross-sectional study including 1,567 individuals from an urban area in Brazil. Anthropometric, clinical and biochemical parameters were evaluated, and all individuals were genotyped for the ACE I/D and AGT M/T polymorphisms. Results The prevalence of overweight was higher among men, whereas obesity was more prevalent among women. However, the frequency of ACE or AGT polymorphisms was similar among body mass index (BMI) categories. In addition, the mean age-adjusted BMI averages did not change significantly for ACE or AGT polymorphisms, regardless of sex or BMI category. The age-adjusted BMI average for the combination of ACE and AGT genotypes evidenced no significant differences regardless of sex or BMI categories. Results were similar when BMI was replaced by waist circumference (WC). Conclusions We were not able to find any associations between BMI and WC (overweight/obesity) and ACE and AGT polymorphisms, indicating that the RAS system might not be involved in overweight and obesity, at least based on genetic backgrounds. However, further studies must measure RAS components to elucidate this question.

Distúrbio de movimento por conta de estado hiperosmolar não cetótico em idosa: relato de caso / Movement disorder caused by hyperosmolar hyperglycemic state in an older adult: a case report

O diabetes e suas complicações constituem as principais causas de mortalidade precoce na maioria dos países. O envelhecimento da população e a crescente prevalência da obesidade e do sedentarismo, além dos processos de urbanização, são considerados os principais fatores responsáveis pelo aumento da incidência e da prevalência do diabetes mellitus (DM) em todo o mundo. Este relato de caso objetiva descrever a presença de distúrbio do movimento em idoso por conta do estado hiperosmolar não cetótico. A combinação de hemicoreia-hemibalismo, hiperglicemia não cetótica e envolvimento dos gânglios da base em exames de imagem é considerada uma síndrome única. Os distúrbios do movimento em estado hiperosmolar não cetótico apresentam resposta terapêutica satisfatória com o uso de neurolépticos e controle glicêmico adequado. A escassez de trabalhos publicados proporciona subdiagnósticos clínico e laboratorial, interferindo no prognóstico e no acompanhamento dos pacientes.

Diabetes mellitus (DM) and its complications constitute the leading causes of early mortality in most countries. Population aging and the growing prevalence of obesity and sedentary lifestyles, in addition to spreading urbanization, are considered the main drivers of the increasing incidence and prevalence of DM worldwide. This case report describes the acute onset of movement disorder in an older woman secondary to hyperosmolar hyperglycemic state (HHS). The combination of hemichorea­hemiballismus, HHS, and evidence of basal ganglia involvement on neuroimaging is considered a unique syndrome. Movement disorders secondary to HHS respond satisfactorily to administration of neuroleptic agents and proper glycemic control. The lack of published studies on this pathologic entity may lead to clinical and laboratory underdiagnosis, with negative impacts on patient prognosis and follow-up.

Prevalence of cardiovascular risk factors in the population of Vitória according to data from VIGITEL and the National Health Interview Survey of 2013. / Prevalência de fatores de risco cardiovascular na população de Vitória segundo dados do VIGITEL e da Pesquisa Nacional de Saúde de 2013.

OBJECTIVE: To compare the prevalence of cardiovascular risk factors in the adult population of Vitória, Espírito Santo, Brazil, in two surveys conducted by telephone interview (VIGITEL) or by clinic and laboratory exams during the National Health Interview Survey (NHIS). METHOD: Data were collected from adults (≥ 18 years). In VIGITEL, 1,996 subjects (males = 38%) were interviewed. In NHIS, home visit followed by clinical and laboratory tests was made with 318 individuals (males = 48%) selected in 20 census tracts of the city. The prevalence of risk factors was adjusted to the estimated population of the city in 2013. Data are shown as prevalence and 95% confidence interval (95%CI). RESULTS: Similar values of prevalence were found in VIGITEL and NHIS, respectively, for smoking (8.2%; 95%CI 6.7-9.7% vs 10.0; 95%CI 6.4 - 13.6%) and hypertension (24.8%; 95%CI 22.6 - 27.0% vs 27.2%; 95%CI 21.8 - 32.5%). Statistical differences between surveys (p < 0.01) were found for diabetes (6.7%; 95%CI 5.6 - 7.9% vs 10.7%; 95%CI 7.1 - 14.5%), obesity (16.8%; 95%CI 14.1 - 18.1% vs 25.7%; 95%CI 20.4 - 30.9%) and high cholesterol (≥ 200mg/dL) (20.6%; 95%CI 18.6- 22.6% vs 42.3%; 95%CI 36.9 - 47.7%). The prevalence of diabetes was also higher (p < 0.01) in NHIS (6.7 vs 10.7%). CONCLUSION: Prevalence of smoking and hypertension, but not obesity, was adequately detected in VIGITEL, because there might have been information bias related to body weight during telephone interviews. Datashow the necessity to improve the diagnosis of dyslipidemias in primary care services, as the control of this risk factor is of utmost importance to prevent cardiovascular diseases.

OBJETIVO: Comparar a prevalência de fatores de risco cardiovascular na população de Vitória (ES) em pesquisa autorreferida por contato telefônico (VIGITEL) ou por exames clínicos e laboratoriais realizados na Pesquisa Nacional de Saúde (PNS). MÉTODO: Os inquéritos foram realizados na população adulta de Vitória (≥18anos). No VIGITEL foram entrevistados 1996 indivíduos (homens = 38%). Na PNS foi feita visita domiciliar seguida de exames clínicos e laboratoriais em 318 indivíduos (homens = 48%) selecionados em 20setores censitários da cidade. Nos dois inquéritos, as prevalências foram ajustadas para a estrutura populacional estimada para o ano de 2013. Os dados são fornecidos como porcentagens e intervalo de confiança de 95% (IC95%). RESULTADOS: Foram encontradas prevalências similares no VIGITEL e na PNS, respectivamente, para tabagismo (8,2%; IC95% 6,7 - 9,7% versus 10,0; IC95% 6,4 - 13,6%) e hipertensão (24,8%; IC95% 22,6- 27,0% versus 27,2%; IC95% 21,8 - 32,5%). Houve diferença estatística (p < 0,01) entre o VIGITEL e a PNS, respectivamente, para as prevalências de obesidade (16,8%; IC95% 14,1 - 18,1% versus 25,7%; IC95% 20,4- 30,9%) e colesterol elevado (≥ 200mg/dL) no sangue (20,6%; IC95% 18,6 - 22,6% versus 42,3%; IC95% 36,9- 47,7%). A prevalência de diabetes também foi maior (p < 0,05) na PNS (6,7 versus 10,7%). CONCLUSÃO: A prevalência populacional de hipertensão e tabagismo foi estimada adequadamente no VIGITEL. Isso não ocorreu com a obesidade por provável viés de informação do peso corporal no VIGITEL. Os dados mostram a necessidade de melhorar a cobertura diagnóstica das dislipidemias em vista da importância do controle desse fator de risco na prevenção primária das doenças cardiovasculares.

Prevalência de fatores de risco cardiovascular na população de Vitória segundo dados do VIGITEL e da Pesquisa Nacional de Saúde de 2013 / Prevalence of cardiovascular risk factors in the population of Vitória according to data from VIGITEL and the National Health Interview Survey of 2013

RESUMO: Objetivo: Comparar a prevalência de fatores de risco cardiovascular na população de Vitória (ES) em pesquisa autorreferida por contato telefônico (VIGITEL) ou por exames clínicos e laboratoriais realizados na Pesquisa Nacional de Saúde (PNS). Método: Os inquéritos foram realizados na população adulta de Vitória (≥18anos). No VIGITEL foram entrevistados 1996 indivíduos (homens = 38%). Na PNS foi feita visita domiciliar seguida de exames clínicos e laboratoriais em 318 indivíduos (homens = 48%) selecionados em 20setores censitários da cidade. Nos dois inquéritos, as prevalências foram ajustadas para a estrutura populacional estimada para o ano de 2013. Os dados são fornecidos como porcentagens e intervalo de confiança de 95% (IC95%). Resultados: Foram encontradas prevalências similares no VIGITEL e na PNS, respectivamente, para tabagismo (8,2%; IC95% 6,7 - 9,7% versus 10,0; IC95% 6,4 - 13,6%) e hipertensão (24,8%; IC95% 22,6- 27,0% versus 27,2%; IC95% 21,8 - 32,5%). Houve diferença estatística (p < 0,01) entre o VIGITEL e a PNS, respectivamente, para as prevalências de obesidade (16,8%; IC95% 14,1 - 18,1% versus 25,7%; IC95% 20,4- 30,9%) e colesterol elevado (≥ 200mg/dL) no sangue (20,6%; IC95% 18,6 - 22,6% versus 42,3%; IC95% 36,9- 47,7%). A prevalência de diabetes também foi maior (p < 0,05) na PNS (6,7 versus 10,7%). Conclusão: A prevalência populacional de hipertensão e tabagismo foi estimada adequadamente no VIGITEL. Isso não ocorreu com a obesidade por provável viés de informação do peso corporal no VIGITEL. Os dados mostram a necessidade de melhorar a cobertura diagnóstica das dislipidemias em vista da importância do controle desse fator de risco na prevenção primária das doenças cardiovasculares.

ABSTRACT: Objective: To compare the prevalence of cardiovascular risk factors in the adult population of Vitória, Espírito Santo, Brazil, in two surveys conducted by telephone interview (VIGITEL) or by clinic and laboratory exams during the National Health Interview Survey (NHIS). Method: Data were collected from adults (≥ 18 years). In VIGITEL, 1,996 subjects (males = 38%) were interviewed. In NHIS, home visit followed by clinical and laboratory tests was made with 318 individuals (males = 48%) selected in 20 census tracts of the city. The prevalence of risk factors was adjusted to the estimated population of the city in 2013. Data are shown as prevalence and 95% confidence interval (95%CI). Results: Similar values of prevalence were found in VIGITEL and NHIS, respectively, for smoking (8.2%; 95%CI 6.7-9.7% vs 10.0; 95%CI 6.4 - 13.6%) and hypertension (24.8%; 95%CI 22.6 - 27.0% vs 27.2%; 95%CI 21.8 - 32.5%). Statistical differences between surveys (p < 0.01) were found for diabetes (6.7%; 95%CI 5.6 - 7.9% vs 10.7%; 95%CI 7.1 - 14.5%), obesity (16.8%; 95%CI 14.1 - 18.1% vs 25.7%; 95%CI 20.4 - 30.9%) and high cholesterol (≥ 200mg/dL) (20.6%; 95%CI 18.6- 22.6% vs 42.3%; 95%CI 36.9 - 47.7%). The prevalence of diabetes was also higher (p < 0.01) in NHIS (6.7 vs 10.7%). Conclusion: Prevalence of smoking and hypertension, but not obesity, was adequately detected in VIGITEL, because there might have been information bias related to body weight during telephone interviews. Datashow the necessity to improve the diagnosis of dyslipidemias in primary care services, as the control of this risk factor is of utmost importance to prevent cardiovascular diseases.

Lipid disorders among Black Africans non-users of lipid-lowering medication.

OBJECTIVE: Angola is a sub-Saharan African country where the population has scarce access to lipidlowering medication. We sought to determine the frequency of lipid disorders among Angolan nonusers of lipid-lowering medication. MATERIAL AND METHODS: A cross-sectional descriptive study was carried out in a sample of 604 workers from the public sector. Blood pressure and anthropometric data were measured along with biochemical parameters including total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C). LDL-C to HDL-C ratio (LDL-C/HDL-C) was obtained from LDL-C and HDL-C levels. RESULTS: High frequencies of elevated blood pressure (44.8%), metabolic syndrome (20.2%), increased TC (39.2%) and increased LDL-C (19.3%) were found. Low HDL-C was more frequent in women (62.4% vs. 36.1%, p < 0.001). Isolated hypercholesterolemia was more frequent in men (9.6% vs. 2.5%, p < 0.001). Among men TC, TG, LDL-C and LDL-C/HDL-C ratio were higher and HDL-C was lower in obese than in low-weight and normal-weight participants. Among women TC, TG, LDL-C and LDL-C/HDL-C ratio were higher in obese than in normal-weight participants. Significant linear trend of increasing TC and LDL-C levels as age increased was detected for both genders (p for trend < 0.05). CONCLUSION: The results of our study showed a high frequency of lipid disorders in Angolan non-users of lipid-lowering medication.