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1.
Int. j. cardiovasc. sci. (Impr.) ; 33(4): 340-347, July-Aug. 2020. tab
Artigo em Inglês | LILACS | ID: biblio-1134388

RESUMO

Abstract Background: Among anthropometric measures for assessing adiposity-related risk, waist circumference (WC) is simple and fast to perform. Cut-off values for WC proposed by the International Diabetes Federation (IDF), and the Adult Treatment Panel III of the National Cholesterol Education Program (NCEP-ATP III) are categorized by gender and are not age-specific. Objective: To analyze the association between WC and cardiometabolic risk factors in adult women. Methods: A total of 164 healthy adult women were grouped by WC according to IDF and NCEP-ATP III cutoff values. Continuous variables were described as mean ± standard deviation or median (interquartile range). The Shapiro-Wilk test was used to assess the normality of data. Variables were analyzed by unpaired Student's t-test, Mann-Whitney U and Kruskal-Wallis tests. The correlation of WC categories with systolic (SBP) and diastolic (DBP) blood pressure, fasting blood glucose, high-density lipoprotein cholesterol (HDL-c), and triglycerides were examined by Spearman's rho correlation coefficient and linear regression analysis. A p value < 0.05 was considered statistically significant. Results: Increased WC showed a significant correlation with SBP, DBP, glucose, HDL-c, and triglycerides. In bivariate linear regression, approximately 63.0 % of the variability of SBP (≥ 130 mmHg) among the age group 20-40 years was predicted by increased WC according to both criteria. Conclusion: A WC above 80 cm in women aged 20-40 years strongly predicted variability in SBP, calling attention to the importance of measuring WC for the monitoring and prevention of cardiovascular and metabolic diseases in women in this age group.


Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Circunferência da Cintura , Fatores de Risco de Doenças Cardíacas , Doenças Cardiovasculares/prevenção & controle , Antropometria/instrumentação , Estudos Transversais , Adiposidade , Pressão Arterial , HDL-Colesterol/efeitos adversos
2.
Rev. cuba. pediatr ; 90(2): 306-312, abr.-jun. 2018. tab
Artigo em Espanhol | LILACS | ID: biblio-901490

RESUMO

Introducción: una alimentación muy selectiva y poco variada durante la primera infancia, puede modificar seriamente los índices de riesgo cardiovascular, ante lo cual, la detección de la alteración lipídica es de suma importancia para promover e implementar el cambio de hábitos. Caso clínico: se presenta una niña de 6 años con una dieta a base de alimentos industriales, a quien se le realizó un perfil lipídico, por considerar que la alimentación tan limitada que consumía era un factor de riesgo aterogénico. Esto permitió diagnosticar una marcada disminución del HDL-colesterol, hipertrigliceridemia y franca alteración de los índices de riesgo. Discusión: existe una relación directa entre la hipertrigliceridemia y el consumo de azúcares simples, presentes en las golosinas, postres o gaseosas. Además, las grasas saturadas e industriales (trans) son responsables de la disminución del colesterol HDL. Llamó la atención la contundencia que ejerció la alteración del laboratorio, sobre el accionar de los padres. Luego de 6 meses de poner en práctica las indicaciones, los valores y los índices de riesgo se normalizaron. Conclusiones: se destaca la importancia de realizar un perfil lipídico en niños mayores de 2 años cuando se detecta el consumo de una dieta aterogénica, dado que el descenso de colesterol HDL tiene relación directa con la alimentación y el estilo de vida. Un valor inferior a 45 mg/dL es un factor de riesgo que puede ser modificado(AU)


Introduction: a very selective and little varied diet during early childhood can seriously modify the cardiovascular risk indexes, and because of that the detection of lipid alteration is very important to promote and implement the change of habits. Clinical case: a 6-year-old girl was presented with a diet based on industrial foods. A lipid profile was made considering that the very limited diet she consumed was an atherogenic risk factor. This allowed diagnosing a marked decrease in HDL-cholesterol, hypertriglyceridemia and real alteration in the risk indexes. Discussion: there is a direct relation among hypertriglyceridemia and the consumption of simple sugars, which are present in sweets, desserts or sodas. In addition, saturated and industrial (trans) fats are responsible for lowering HDL cholesterol. It was significant the impact of the alteration in the laboratory results in the actions taken by the parents. After 6 months of putting the indications into practice, the values and risk indexes were normalized. Conclusions: it is highlighted the importance of performing a lipid profile in children older than 2 years when the consumption of an atherogenic diet is detected, since the decrease in HDL cholesterol is directly related to diet and lifestyle. A value below 45 mg/dL is a risk factor that can be modified(AU)


Assuntos
Humanos , Feminino , Criança , Dislipidemias/prevenção & controle , Açúcares da Dieta/efeitos adversos , Doenças Cardiovasculares/complicações , Impactos da Poluição na Saúde/prevenção & controle , HDL-Colesterol/efeitos adversos
3.
Int J Biol Markers ; 30(2): e200-7, 2015 May 26.
Artigo em Inglês | MEDLINE | ID: mdl-25953090

RESUMO

PURPOSE: This study aimed to evaluate the associations between metabolic syndrome (MS) and its components at initial diagnosis and outcomes of breast cancer including triple-negative breast cancer (TNBC) and non-TNBC. METHODS: A cohort of 1,391 patients was reviewed between January 2004 and July 2008 (including 394 TNBC and 855 non-TNBC cases). MS and its components including body mass index (BMI), serum high-density lipoprotein (HDL) and triglycerides (TG) and their relationships with clinical outcomes were analyzed and then compared between groups. RESULTS: The incidences of MS and its components including BMI, the levels of HDL and TG were not differently distributed between the 2 groups (all p's >0.05). However, more TNBC than non-TNBC patients presented with hypertension and elevated serum glucose (20.3% vs. 14.9% and 16.0% vs. 10.8%, p = 0.018 and p = 0.012, respectively). TNBC patients had poorer 5-year relapse-free survival (RFS) than non-TNBC patients (72.8% vs. 84.2%, p<0.0001). Only in the TNBC group, patients with low high-density lipoprotein (HDL) demonstrated worse RFS and overall survival (OS; p<0.0001). Multivariate analysis identified that low HDL was an independent worse prognostic factor for both RFS (hazard ratio [HR] = 3.266, 95% confidence interval [95%CI], 2.087-5.112, p<0.0001) and OS (HR = 3.071, 95%CI, 1.732-5.445, p<0.0001) in TNBC patients. CONCLUSIONS: Decreased level of HDL may predict worse outcomes both in terms of RFS and OS for TNBC patients but not for non-TNBC patients. Further investigations are warranted to detect the underlying mechanisms.


Assuntos
HDL-Colesterol/efeitos adversos , HDL-Colesterol/sangue , Síndrome Metabólica/sangue , Neoplasias de Mama Triplo Negativas/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Humanos , Pessoa de Meia-Idade , Resultado do Tratamento , Adulto Jovem
4.
Ann Pharmacother ; 45(11): 1346-55, 2011 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-22028418

RESUMO

BACKGROUND: Depression is associated with poor glycemic control, increased number of microvascular and macrovascular complications, functional impairment, mortality, and 4.5 times higher total health care costs in patients with diabetes. Shared medical appointments (SMAs) may be an effective method to attain national guideline recommendations for glycemic control in diabetes for patients with depression through peer support, counseling, problem solving, and improved access to care. OBJECTIVE: To test the efficacy as assessed by attainment of a hemoglobin A(1c) (A1C) <7% of pharmacist-led group SMA visits, Veterans Affairs Multidisciplinary Education in Diabetes and Intervention for Cardiac Risk Reduction in Depression (VA-MEDIC-D), in patients with type 2 diabetes mellitus. METHODS: This was a randomized controlled trial of VA-MEDIC-D added to standard care versus standard care alone in depressed patients with diabetes with A1C >6.5%. VA-MEDIC-D consisted of 4 once-weekly, 2-hour sessions followed by 5 monthly 90-minute group sessions. Each SMA session consisted of multidisciplinary education and pharmacist-led behavioral and pharmacologic interventions for diabetes, lipids, smoking, and blood pressure. No pharmacologic interventions for depression were provided. The change in the proportion of participants who achieved an A1C <7% at 6 months was compared. RESULTS: Compared to standard care (n = 44), a lower proportion of patients in VA-MEDIC-D (n = 44) had systolic blood pressure (SBP) <130 mm Hg at baseline, but were similar in other cardiovascular risk factors and psychiatric comorbidity. The change in the proportion of participants achieving an A1C <7% was greater in the VA-MEDIC-D arm than in the standard care arm (29.6% vs 11.9%), with odds ratio 3.6 (95% CI 1.1 to 12.3). VA-MEDIC-D participants also achieved significant reductions in SBP, low-density lipoprotein cholesterol, and non-high-density lipoprotein (HDL) cholesterol from baseline, whereas significant reductions were attained only in non-HDL cholesterol with standard care. There was no significant change in depressive symptoms for either arm. CONCLUSIONS: Pharmacist-led group SMA visits are efficacious in attainment of glycemic control in patients with diabetes and depression without change in depression symptoms.


Assuntos
Depressão/etiologia , Depressão/terapia , Diabetes Mellitus Tipo 2/psicologia , Diabetes Mellitus Tipo 2/terapia , Serviços Hospitalares Compartilhados/métodos , Farmacêuticos , Administração da Prática Médica/organização & administração , Agendamento de Consultas , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/prevenção & controle , HDL-Colesterol/efeitos adversos , LDL-Colesterol/efeitos adversos , Comorbidade , Depressão/tratamento farmacológico , Diabetes Mellitus Tipo 2/tratamento farmacológico , Gerenciamento Clínico , Emergências , Feminino , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Assistência ao Paciente/métodos , Atenção Primária à Saúde/métodos , Fatores de Risco
5.
Rev. chil. nutr ; 37(4): 446-454, dic. 2010. tab
Artigo em Espanhol | LILACS | ID: lil-583000

RESUMO

Restrictions of sleep predispose to experience, in the long-term, excess malnutrition and non-transmissible chronic diseases. The objective of this research has to study the influence of working shifts on nutritional status lipid profile and fasting blood glucose (FBG). Study of a series of cases considered a total of47 recruited workers from which 31 of them had a rotating shift (day and night) and 16 a steady shift (day). The nutritional assessment involved: BMI (Body Mass index), waist and hip circumference, tricipital, bicipital, sub scapular and supra iliac skin folds. Sleep hours were studied with a weekly record, food intake was studied by means of 24-hours dietary recall. It was determined: total cholesterol, c-HDL, c-LDL, blood triglycerides and fasting blood glucose (FBG). The sample was composed by 87 percent women and 13 percent men, average age of 38,7years [19,0] v/s 44,7[25¿2] (p=0,420) in rotating and steady shifts respectively. The rotating shift did not show any significant differences compared to the steady shift in terms of anthropometric parameters except for sub scapular skin fold that was significantly higher (p=0,032) in relation to the macronutrients intake. Lipid profile and glycerin did not show important differences (p=>0,05). The prevalence of the nutritional status was: rotating shift 35,4 percent normal, 45,1 percent overweight and 19,5 percent obese. On the other hand, the steady shift showed: 43,7 percent normal and 56¿ percent overweight. Seniority only in the rotating shift showed a positive correlation of BMI (r=0,436 p<0,005) body fat (r=0,454 p<0,005) total cholesterol (r= 0,¿94 p<0,005) LDL (r=0,484 p<0,005) and glycerin (r=0,405 p<0,005). We concluded that workers of the rotating and steady shift did not show significant differences among variables studied except for the sub scapular skin fold that was significantly higher in the rotating shift, that can be associated to predominantly central fat distribution.


Restricciones del sueño predisponen a padecer, a largo plazo, malnutrición por exceso y enfermedades crónicas no transmisibles. El objetivo fue estudiar la influencia del turno laboral sobre estado nutricional, perfil lipídico y glicemia en ayuno. Estudio exploratorio del tipo de serie de casos, 47 reclutados; 31 turnos rotativos (día y noche), y 16 turno permanente (día). La evaluación nutricional se efectuó mediante el IMC, la circunferencia cintura-cadera y los pliegues tricipital, bícipital, subescapular y suprailiaco. Se estudió las horas sueño mediante un registro semanal, la ingesta dietética por encuesta de recordatorio de 24 horas. Se determinó el colesterol total, c-HDL, c-LDL, triglicéri-dos séricos y glicemia. La muestra estuvo representada en un 87 por ciento mujeres y 13 por ciento por hombres, cuya mediana de edad fue de 38,7 años [19,0] y 44,7[25,2] (p=0,420) en turno rotativo y permanente, respectivamente. El turno rotativo no mostró diferencias significativas respecto al turno permanente en los parámetros antropométricos a excepción, del pliegue subescapular que fue significativamente superior (p=0,032), respecto a ingesta de macronutrientes, perfil lipídico y glicemia tampoco mostró diferencias significativas (p=> 0,05). La prevalencia del estado nutricional en el turno rotativo fue en 35,4 por ciento normal, en 45,1 por ciento sobrepeso y en 19,5 por ciento obesidad, y turno permanente: 43,7 por ciento normal y 56,3 por ciento sobrepeso. La antigüedad laboral sólo en el turno rotativo se correlacionó positivamente con IMC (r=0,436 p<0,005), grasa corporal (r=0,454 p<0,005), el colesterol total (r= 0,394 p<0,005) el LDL (r=0,484 p<0,005) y la glicemia (r=0,405 p<0,005). En conclusión, los funcionarios del turno rotativo y permanente no mostraron diferencias significativas entre las variables estudiadas, a excepción del pliegue subescapular que fue significativamente mayor en el turno rotativo, lo que podría asociarse a la distribución de la...


Assuntos
Humanos , Masculino , Feminino , Administração de Recursos Humanos em Hospitais/estatística & dados numéricos , Recursos Humanos de Enfermagem/estatística & dados numéricos , Recursos Humanos em Hospital/estatística & dados numéricos , Socorristas/estatística & dados numéricos , Transtornos do Sono do Ritmo Circadiano/metabolismo , /efeitos adversos , /efeitos adversos , HDL-Colesterol/efeitos adversos , Sistema Hipotálamo-Hipofisário , LDL-Colesterol/efeitos adversos , Estado Nutricional
7.
Drugs Exp Clin Res ; 25(2-3): 125-31, 1999.
Artigo em Inglês | MEDLINE | ID: mdl-10370875

RESUMO

Epidemiological studies have demonstrated an inverse correlation between moderate wine and alcohol consumption and morbidity and mortality from coronary heart disease (CHD). This protective effect has been associated with an increase in the plasma level of high density lipoprotein (HDL)-cholesterol, as it is well known that plasma HDL is inversely correlated with CHD. In addition, it has become evident that blood platelets contribute to the rate of development of atherosclerosis and CHD through several mechanisms. Recent studies have shown HDL-cholesterol levels can explain only 50% of the protective effect of alcoholic beverages. The other 50% may be partly related to decreased platelet activity. The antiplatelet activity of wine is explained not only by ethanol but also by the polyphenolic components with which red wines are richly endowed. Several studies carried out in humans and animals have shown that wine phenolics could exert their effects by reducing prostanoid synthesis from arachidonate. In addition, it has been suggested that wine phenolics could reduce platelet activity mediated by nitric oxide. Moreover, wine phenolics increase vitamin E levels while decreasing the oxidation of platelets submitted to oxidative stress. However, a rebound phenomenon of hyperaggregability is observed after acute alcohol consumption but not after wine consumption. This protection afforded by wine has been duplicated in animals with grape phenolics added to alcohol. This rebound phenomenon could explain ischemic strokes or sudden deaths known to occur after episodes of drunkenness. It appears that wine and wine phenolics in particular could significantly inhibit platelet aggregation and that this could explain, at least in part, the protective effect of red wine against atherosclerosis and coronary heart disease.


Assuntos
Arteriosclerose/prevenção & controle , HDL-Colesterol/efeitos adversos , Flavonoides , Fenóis/farmacologia , Inibidores da Agregação Plaquetária/farmacologia , Polímeros/farmacologia , Trombose/prevenção & controle , Animais , Doença das Coronárias/prevenção & controle , Humanos , Estresse Oxidativo/efeitos dos fármacos , Polifenóis , Prostaglandinas/biossíntese
8.
Antioxid. calid. vida ; 6(23): 6-14, mayo 1999. ilus
Artigo em Espanhol | LILACS | ID: lil-241863

Assuntos
Humanos , Hipolipemiantes/uso terapêutico , Arteriosclerose/fisiopatologia , LDL-Colesterol/efeitos dos fármacos , Doença das Coronárias/tratamento farmacológico , Vasos Coronários/efeitos dos fármacos , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Triglicerídeos/efeitos adversos , Anticolesterolemiantes/farmacologia , Anticolesterolemiantes/uso terapêutico , Hipolipemiantes/farmacologia , Angioplastia Coronária com Balão/efeitos adversos , Antioxidantes , Apolipoproteínas A/efeitos adversos , Apolipoproteínas B/efeitos adversos , Arteriosclerose/tratamento farmacológico , Aterosclerose/tratamento farmacológico , Aterosclerose/fisiopatologia , Transtornos Cerebrovasculares/epidemiologia , Transtornos Cerebrovasculares/mortalidade , HDL-Colesterol/efeitos adversos , LDL-Colesterol/sangue , Resina de Colestiramina/uso terapêutico , Clofibrato/farmacologia , Clofibrato/uso terapêutico , Doença das Coronárias/fisiopatologia , Doença das Coronárias/prevenção & controle , Vasos Coronários/patologia , Método Duplo-Cego , Genfibrozila/farmacologia , Genfibrozila/uso terapêutico , Estudos Longitudinais , Lovastatina/uso terapêutico , Metanálise , Microcorpos/efeitos dos fármacos , Infarto do Miocárdio/fisiopatologia , Pravastatina/uso terapêutico , Probucol/efeitos adversos , Probucol/uso terapêutico , Estudos Prospectivos , Risco , Fatores de Risco , Sinvastatina/uso terapêutico , Resultado do Tratamento , Triglicerídeos/sangue
9.
Rev. Soc. obstet. ginecol. B.Aires ; 75(922): 259-74, nov. 1996. tab
Artigo em Espanhol | LILACS | ID: lil-205031

RESUMO

Se investigaron los resultados de estrogenoterapia transdermal sostenida, durante un año y medio, en una población homogeneizada. No solo la edad, ausencia de patología asociada, talla, peso, antigüedad en la menopausia, sino fundamentalmente el programa dietético y de ejercitación física, en el grupo tratado THR, 35 casos y el grupo control PHD, 56 casos, fuesen semejantes. Se enfatizó la motivación para el cumplimiento en 18 meses del programa higiénico dietético. Con respecto a las lipoproteínas del colesterol, el análisis de varianza anidado evidenció una curva descendente significativamente más pronunciada, en el grupo THR, que la pendiente descendente del grupo PHD. Interacción p < 1 por ciento. En lo que atañe al HDL colesterol, la franca curva ascendente del grupo tratado difiere muy significativamente, de la curva muy levemente descendente, del grupo control. Interacción p < 1 por ciento. En la sintomatología se observó un impacto favorable general. Se realizó test no paramétrico de Wilcoxon y Wilcox comparando las observaciones con la basal y para comparar la THR el test U de Mann-Withney, que demostró diferencias significativas en orden decrecientes, para ostealgias, desinterés sexual, depresión y tuforadas


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , HDL-Colesterol/efeitos adversos , LDL-Colesterol/efeitos adversos , Climatério/efeitos dos fármacos , Estradiol/uso terapêutico , Menopausa/efeitos dos fármacos , Estudos Prospectivos , Terapia de Reposição de Estrogênios/estatística & dados numéricos , Administração Cutânea , Climatério/psicologia , Depressão/tratamento farmacológico , Osteoporose Pós-Menopausa/tratamento farmacológico , Osteoporose Pós-Menopausa/reabilitação , Fatores de Risco , Comportamento Sexual/efeitos dos fármacos
10.
Arteriosclerosis ; 8(6): 737-41, 1988.
Artigo em Inglês | MEDLINE | ID: mdl-3196218

RESUMO

In 12 years of follow-up for 2748 Framingham Heart Study participants ages 50 to 79, low levels of high density lipoprotein cholesterol (HDL-C) were associated with increased mortality. For men, the relative risk of death in the first HDL-C quintile (less than 35 mg/dl) as compared to the top quintile (greater than 54 mg/dl) was 1.9 for all causes, and 3.6 and 4.1 for death due to cardiovascular and coronary heart disease (CHD), respectively, after adjustment for standard cardiovascular risk factors. In women, corresponding relative risks, comparing the bottom HDL-C quintile (less than 45 mg/dl) to the top quintile (greater than 69 mg/dl), were 1.5, 1.6, and 3.1. With HDL-C considered as a continuous variable, and after adjustment for standard cardiovascular risk factors, highly significant associations were seen with HDL-C and CHD death in both men and women. In addition, a significant HDL-C effect on total mortality and death due to cardiovascular disease was seen in men. In none of the continuous variable analyses was HDL-C associated with cancer death. We conclude that HDL-C is a potent predictor of CHD death in both sexes and has less consistent associations with other types of death.


Assuntos
HDL-Colesterol/efeitos adversos , Mortalidade , Idoso , Estatura , Peso Corporal , Doenças Cardiovasculares/mortalidade , Doenças Cardiovasculares/fisiopatologia , Doença das Coronárias/mortalidade , Doença das Coronárias/fisiopatologia , Feminino , Seguimentos , Humanos , Masculino , Massachusetts , Pessoa de Meia-Idade , Neoplasias/mortalidade , Neoplasias/fisiopatologia , Estudos Prospectivos , Fatores de Risco , Fatores Sexuais , Fumar
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