Metabolically unhealthy and overweight phenotypes are associated with increased levels of inflammatory cytokines: a population-based study.

OBJECTIVE: The aim of this study was to determine the association between cytokine levels in metabolic phenotypes. Our hypothesis was that an unhealthy metabolic profile is associated to higher levels of proinflammatory cytokines. METHODS: The study sample was composed of 743 Brazilian adults classified in four phenotypes: metabolically healthy normal weight (MHNW), metabolically unhealthy normal weight (MUNW), metabolically healthy overweight (MHOW), and metabolically unhealthy overweight (MUOW). Sociodemographic, anthropometric, clinical, and biochemical parameters were collected. Six different cytokines were analyzed from blood samples using the CBA Human Inflammatory cytokines kit and the values divided in quartiles for analysis. Logistic regression models were constructed to assess the association between metabolic phenotypes and cytokines concentrations, adjusted for potential confounders and P < 0.05 was used. RESULTS: The MUOW phenotype showed a higher risk for increased levels of all cytokines analyzed compared with the reference group (MHNW). CONCLUSIONS: These results indicated that excess weight and altered metabolic profile are related to inflammation, especially when both conditions are associated, possibly linked to visceral adiposity. Therefore, the categorization of metabolic phenotypes in populations is an important factor for prevention of chronic diseases, as inflammation is associated with cardiovascular risk and obesity is not the only influencing factor.

BODY ADIPOSITY INDEX AND ASSOCIATED FACTORS IN ADULTS: METHOD AND LOGISTICS OF A POPULATION-BASED STUDY.

INTRODUCTION: obesity is a public health problem that has increased considerably. Several techniques have been developed and used to measure the amount of body fat, or a combination of excess fat with some comorbidities. The Body Adiposity Index is a new method proposed to determine body fat and its validation is still limited. Methods and logistics of a population-based study reported in the literature are few, mainly multidiciplinas team. OBJECTIVE: the objective was to report the proceedings of a population-based study, the denouement is the index of adiposity in adults. DESIGN: the design of this study was cross-sectional, with a sample of 1085 adults aged 20-59 years living in the city of Viçosa, MG. A questionnaire was applied at home with sociodemographic, behavioral issues, health and level of physical activity. Then anthropometric and biochemical data were collected. The training for data collection involved the calibration of evaluators, being the correlation between the measurements checked by the intraclass correlation test and was adopted as the acceptable value of 0.60. RESULTS: it is noted that, with the exception of assessors 1, the triceps and subscapular skin folds, and the evaluator 4, in the pectoral skinfolds and suprailiac, all other measures reached acceptable cutoff point for agreement among evaluators. CONCLUSIONS: multidisciplinary research is important to understand the various factors that may be operating in health and disease process tool. Methodological and logistical aspects described in this study should be followed, which will lead to a steady decrease in research biases.

Introducción: la obesidad es un problema de salud pública que ha aumentado considerablemente. Se han desarrollado distintas técnicas para medir la cantidad de grasa corporal, o una combinación de exceso de grasa con ciertas comorbilidades. El Índice de Adiposidad Corporal es un nuevo método propuesto para determinar la grasa corporal y su validación es aún limitada. Solo hay algunos métodos y logísticas de estudios poblacionales recogidos en la bibliografía, la mayoría de equipos multidisciplinares. Objetivo: el objetivo consistió en informar de los procedimientos de un estudio poblacional, para concluir en el índice de adiposidad en adultos. Diseño: el diseño de este estudio fue transversal, con una muestra de 1.085 adultos con edades entre 20 y 59 años, que vivían en la ciudad de Viçosa, MG. Se aplicó un cuestionario para completar en casa, con aspectos sociodemográficos, conductuales, de salud y del nivel de actividad física. Después se recopilaron los valores antropométricos y bioquímicos. La formación para la recogida de datos incluyó el calibrado de los evaluadores, estableciéndose la correlación entre las mediciones a partir de una comprobación mediante una prueba de correlación intraclase, siendo 0,60 el valor definido como aceptable. Resultados: se observa que, a excepción del evaluador 1, para los pliegues cutáneos subescapulares, y del evaluador 4, para los pliegues cutáneos pectorales y suprailiacos, el resto de mediciones alcanzaron un nivel aceptable de acuerdo entre los evaluadores. Conclusiones: la investigación multidisciplinar es importante para comprender los distintos factores que podrían intervenir en la herramienta de evaluación de salud y enfermedad. Se deberían seguir los aspectos metodológicos y logísticos descritos en este estudio, los cuales llevan a una reducción continua de los sesgos de la investigación.

HYPERTRIGLYCERIDEMIC WAIST PHENOTYPE AND CARDIOMETABOLIC ALTERATIONS IN BRAZILIAN ADULTS.

AIMS: the present study aims to evaluate the prevalence of cardiometabolic changes according to the hypertriglyceridemic waist (HW) phenotype in Brazilian adults. METHODS: it is a population based transversal study with 976 adults (n = 533 women) 20-59 years old. Phenotype was defined by triglycerides concentration (TGL) ≥ 150 mg/dl and waist circumference (WC) ≥80 cm in females and ≥ 90 cm in males. All the analyses were adjusted according to the study design and pondered by gender, age and schooling. A descriptive analysis was performed through averages and ratios; their respective confidence intervals were herein presented (CI 95%). The prevalence of cardiometabolic changes due to the presence of HW and to gender was calculated and compared by means of Pearson's chi-square test. Statistic significance level was 0.05. The probability of coronary event risk was estimated in 10 years and calculated from Framinghan score, using Kernel density graph. RESULTS: no difference in phenotype prevalence between genders was observed. Higher averages in all the cardiometabolic risk factors analyzed and higher probability of evolving to a cardiovascular event in 10 years were observed in individuals with the HW phenotype. Lower HDL values were only verified in this group. CONCLUSION: the HW phenotype is an important cardiovascular risk sign and allows the premature identification of individuals with higher risk, so that its use in clinical practice must be encouraged, mainly because it is a simple low cost asset.

Objetivos: evaluar la prevalencia de alteraciones cardiometabolicas segun el fenotipo cintura hipertrigliceridemica (CH) en adultos brasilenos. Métodos: estudio transversal, de base poblacional, con 976 (n = 533 mujeres) individuos de 20 a 59 anos. El CH fue definido por un aumento en las concentraciones de trigliceridos y en la circunferencia de la cintura (CC). Todos los analisis fueron ajustados por el efecto del diseno del estudio y ponderados por genero, edad y escolaridad. Fue realizado un análisis descriptivo de promedio y presentados sus respectivos intervalos de confianza (IC 95%). La prevalencia de las alteraciones cardiometabolicas segun la presencia o no del fenotipo CH y segun el sexo fue calculada y comparada a traves del test chi-cuadrado de Pearson. El nivel de significancia estadistica adoptado fue de 0,05. Se estimo la probabilidad de riesgo de evento coronario en 10 anos, a partir del score de Framinghan a traves del grafico de densidad de Kernel. Resultados: la prevalencia del fenotipo CH en la muestra fue de 17,32% (IC 95% 13,54-21,89), no se observo diferencia entre sexos. Se observaron mayores promedios para todos los factores de riesgo cardiometabolico analizados en aquellos con CH. Solo Se verificaron menores valores medianos para el HDL en este grupo. Los individuos con CH presentaban mayor probabilidad de evolucionar hacia un evento cardiovascular en 10 anos que aquellos sin el fenotipo. Conclusión: el fenotipo CH constituye un importante marcador precoz del riesgo cardiovascular. Su utilizacion en la practica clinica debe ser incentivada, ya que se trata de una herramienta sencilla y de bajo coste.