Riesgo cardiovascular, dislipemias e indicación de estatinas en una población de obesos mórbidos

Introducción: La obesidad se relaciona con un riesgo cardiovascular (RCV) elevado. Esto nos obliga a tomar conductas terapéuticas y prevencionistas. El objetivo de este trabajo es evaluar el riesgo cardiovascular en una población de obesos mórbidos y valorar la correcta indicación de estatinas. Metodología: Estudio transversal, descriptivo, observacional, con la población obesos mórbidos del Programa de Obesidad y Cirugía Bariátrica (POCB) del Hospital Maciel, desde noviembre del 2014 a marzo del 2020. El RCV se valoró con la calculadora de la organización panamericana de la salud. La indicación de estatinas se consideró según RCV o diagnóstico de dislipemia. Resultados: Se analizaron 478 pacientes, el 84.3% fueron mujeres, la mediana para la edad fue de 44 años, y para el IMC 50 kg/m2. Se calculó un RCV bajo para el 57% de los pacientes; y alto o muy alto para un 37%. La prevalencia de las dislipemias fue 84,3%, a predominio de hipercolesterolemia (33,7%) y dislipemia aterogénica (19,5%). El 60.6% (290) de los pacientes presenta indicación de tratamiento con estatinas, solo el 38.9%. (113) las recibe. El 38.1% (43) alcanzan los objetivos terapéuticos. Conclusiones : La obesidad presenta múltiples comorbilidades que aumentan el RCV, aun así se encuentra subestimada por las calculadoras de riesgo. Queda en evidencia un infratratamiento farmacológico de estos pacientes, no logrando los objetivos terapéuticos propuestos.

Introduction: Obesity is related to a high cardiovascular risk (CVR). This forces us to take therapeutic and preventive behaviors. The objective of this work is to evaluate cardiovascular risk in a morbidly obese population and assess the correct indication of statins. Methodology: Cross-sectional, descriptive, observational study, with the morbidly obese population of the Obesity and Bariatric Surgery Program (POCB) of the Maciel Hospital, from November 2014 to March 2020. CVR was assessed with the calculator of the Pan-American health organization. The indication for statins was considered according to CVR or diagnosis of dyslipidemia. Results: 478 patients were analyzed, 84.3% were women, the median age was 44 years, and the BMI was 50 kg/m2. A low CVR was calculated for 57% of patients; and high or very high for 37%. The prevalence of dyslipidemia was 84.3%, with a predominance of hypercholesterolemia (33.7%) and atherogenic dyslipidemia (19.5%). 60.6% (290) of patients have an indication for treatment with statins, only 38.9%. (113) receives them. 38.1% (43) achieved therapeutic objectives. Conclusions: Obesity presents multiple comorbidities that increase CVR, yet it is underestimated by risk calculators. Pharmacological undertreatment of these patients is evident, not achieving the proposed therapeutic objectives.

Introdução : A obesidade está relacionada a um alto risco cardiovascular (RCV). Isso nos obriga a adotar comportamentos terapêuticos e preventivos. O objetivo deste trabalho é avaliar o risco cardiovascular em uma população com obesidade mórbida e avaliar a correta indicação de estatinas. Metodologia: Estudo transversal, descritivo, observacional, com a população com obesidade mórbida do Programa de Obesidade e Cirurgia Bariátrica (POCB) do Hospital Maciel, no período de novembro de 2014 a março de 2020. O RCV foi avaliado com a calculadora da organização pan-americana de saúde. A indicação de estatinas foi considerada de acordo com RCV ou diagnóstico de dislipidemia. Resultados: Foram analisados ​​478 pacientes, 84,3% eram mulheres, a mediana de idade foi de 44 anos e o IMC foi de 50 kg/m2. Um RCV baixo foi calculado para 57% dos pacientes; e alto ou muito alto para 37%. A prevalência de dislipidemia foi de 84,3%, com predomínio de hipercolesterolemia (33,7%) e dislipidemia aterogênica (19,5%). 60,6% (290) dos pacientes têm indicação de tratamento com estatinas, apenas 38,9%. (113) os recebe. 38,1% (43) alcançaram objetivos terapêuticos. Conclusões: A obesidade apresenta múltiplas comorbidades que aumentam o RCV, mas é subestimada pelas calculadoras de risco. É evidente o subtratamento farmacológico destes pacientes, não atingindo os objetivos terapêuticos propostos.

Risk factors for lower renal compensation after nephrectomy: an analysis of living kidney donors in an Amazonian cohort / Fatores de risco para menor compensação renal pós-nefrectomia: análise de doadores de rim vivo em uma coorte amazônica

Abstract Introduction: Living donor kidney transplantation is considered the ideal renal replacement therapy because it has a lower complication rate and allows an efficient response to the high demand for grafts in the healthcare system. Careful selection and adequate monitoring of donors is a key element in transplantation. Individuals at greater risk of developing kidney dysfunction after nephrectomy must be identified. Objective: To identify risk factors associated with a renal compensation rate (CR) below 70% 12 months after nephrectomy. Methods: This observational retrospective longitudinal study included living kidney donors followed up at the Lower Amazon Regional Hospital between 2016 and 2022. Data related to sociodemographic variables, comorbid conditions and kidney function parameters were collected. Results: The study enrolled 32 patients. Fourteen (43.75%) had a CR < 70% 12 months after kidney donation. Logistic regression found obesity (Odds Ratio [95%CI]: 10.6 [1.7-65.2]), albuminuria (Odds Ratio [95%CI]: 2.41 [1.2-4.84]) and proteinuria (Odds Ratio [95%CI]: 1.14 [1.03-1.25]) as risk factors. Glomerular filtration rate was a protective factor (Odds Ratio [95% CI]: 0.92 [0.85-0.99]). Conclusion: Obesity, albuminuria and proteinuria adversely affected short-term renal compensation rate. Further studies are needed to uncover the prognostic implications tied to these risk factors. Our findings also supported the need for careful individualized assessment of potential donors and closer monitoring of individuals at higher risk.

Resumo Introdução: O transplante de rim de doador vivo é considerado a terapia renal substitutiva ideal por oferecer menor taxa de complicações e possibilitar uma resposta eficiente à grande demanda por enxertos no sistema de saúde. A seleção criteriosa e o acompanhamento adequado dos doadores constituem um pilar fundamental dessa modalidade terapêutica, sendo essencial a identificação dos indivíduos em maior risco de disfunção renal pós-nefrectomia. Objetivo: Identificar fatores de risco para uma Taxa de Compensação (TC) da função renal inferior a 70% 12 meses após a nefrectomia. Métodos: Estudo observacional, retrospectivo e longitudinal conduzido com doadores de rim vivo acompanhados no Hospital Regional do Baixo Amazonas entre 2016 e 2022. Foram coletados dados correspondentes a variáveis sociodemográficas, comorbidades e parâmetros de função renal. Resultados: Foram incluídos 32 pacientes na amostra final. Destes, 14 (43,75%) obtiveram TC < 70% 12 meses após a doação. A regressão logística identificou a obesidade (Odds Ratio [IC95%]: 10.6 [1.7-65.2]), albuminúria (Odds Ratio [IC95%]: 2.41 [1.2-4.84]) e proteinúria (Odds Ratio [IC95%]: 1.14 [1.03-1.25]) como fatores de risco. A taxa de filtração glomerular atuou como fator de proteção (Odds Ratio [IC95%]: 0.92 [0.85-0.99]). Conclusão: Obesidade, albuminúria e proteinúria demonstraram impacto negativo na taxa de compensação renal em curto prazo, o que reitera a necessidade de estudos acerca das implicações prognósticas desses fatores. Além disso, reforça-se a necessidade de avaliação cuidadosa e individualizada dos possíveis doadores, com acompanhamento rigoroso, especialmente para indivíduos de maior risco.

Direct costs for outpatient excess body weight treatment in Brazilian children and adolescents attending a public children's hospital

Abstract Objective: To estimate the direct costs of treating excess body weight in children and adolescents attending a public children's hospital. Methods: This study analyzed the costs of the disease within the Brazilian Unified Health System (SUS) for 2,221 patients with excess body weight using a microcosting approach. The costs included operational expenses, consultations, and laboratory and imaging tests obtained from medical records for the period from 2009 to 2019. Healthcare expenses were obtained from the Table of Procedures, Medications, Orthoses/Prostheses, and Special Materials of SUS and from the hospital's finance department. Results: Medical consultations accounted for 50.6% (R$703,503.00) of the total cost (R $1,388,449.40) of treatment over the period investigated. The cost of treating excess body weight was 11.8 times higher for children aged 5-18 years compared to children aged 2-5 years over the same period. Additionally, the cost of treating obesity was approximately 4.0 and 6.3 times higher than the cost of treating overweight children aged 2-5 and 5-18 years, respectively. Conclusion: The average annual cost of treating excess body weight was R$138,845.00. Weight status and age influenced the cost of treating this disease, with higher costs being observed for individuals with obesity and children over 5 years of age. Additionally, the important deficit in reimbursement by SUS and the small number of other health professionals highlight the need for restructuring this treatment model to ensure its effectiveness, including a substantial increase in government investment.

Experimental Model Exposed to Bisphenol and Submitted to a High-Fat Diet and Related Morphologic Testicular Parameters Alterations Analysis

ABSTRACT Purpose To evaluate the morphological and stereological parameters of the testicles in mice exposed to bisphenol S and/or high-fat diet-induced obesity. Material and Methods Forty adult male C57BL/6 mice were fed a standard diet (SC) or high-fat diet (HF) for a total of 12 weeks. The sample was randomly divided into 4 experimental groups with 10 mices as follows: a) SC - animals fed a standard diet; b) SC-B - animals fed a standard diet and administration of BPS (25 μg/kg of body mass/day) in drinking water; c) HF: animals fed a high-fat diet; d) HF-B - animals fed a high-fat diet and administration of BPS (25 μg/Kg of body mass/day) in drinking water. BPS administration lasted 12 weeks, following exposure to the SC and HF diets. BPS was diluted in absolute ethanol (0.1%) and added to drinking water (concentration of 25 μg/kg body weight/day). The animals were euthanized, and the testes were processed and stained with hematoxylin and eosin (H&E) for morphometric and stereological parameters, including density of seminiferous tubules per area, length density and total length of seminiferous tubules, height of the tunica albuginea and the diameter of the seminiferous tubules. The images were captured with an Olympus BX51 microscope and Olympus DP70 camera. The stereological analysis was done with the Image Pro and Image J programs. Means were statistically compared using ANOVA and the Holm-Sidak post-test (p<0.05). Results The seminiferous tubule density per area reduced in all groups when compared with SC samples (p<0.001): HF (40%), SC-B 3(2%), and HF-B (36%). Length density was reduced significantly (p<0.001) in all groups when compared with SC group: HF (40%), SC-B (32%), and HF-B (36%). The seminiferous tubule total length was reduced (p<0.001) when compared to f HF (28%) and SC-B (26%) groups. The tubule diameter increased significantly (p<0.001) only when we compared the SC group with SC (54%) an SC-B (25%) groups and the tunica thickness increased significantly only in HF group (117%) when compared with SC-B (20%) and HF-B 31%. Conclusion Animals exposed to bisphenol S and/or high-fat diet-induced obesity presented important structural alterations in testicular morphology.

Organização, gestão e cuidado nutricional de pessoas com sobrepeso e obesidade na Atenção Primária à Saúde / Organization, management and nutritional care of overweight and obesity people in Primary Health Care

Objetivo: Avaliar a organização, gestão e o cuidado nutricional ofertado às pessoas com sobrepeso e obesidade na Atenção Primária à Saúde (APS). Métodos: Trata-se de um estudo transversal realizado com 54 profissionais da Atenção Primária à Saúde da cidade de Goiânia-GO. Os dados foram obtidos por meio do questionário eletrônico semiestruturado e autoaplicável. Resultados: Os profissionais participantes eram enfermeiros 88,9%, e com mais de cinco anos na função atual 79,6%. Ao analisar a infraestrutura e mobiliário, apenas 11,1% relataram cadeiras e bancos adequados, 33,3% acessibilidade física. O mapeamento do território foi referido por 51,8% dos profissionais. As principais estratégias para organização do cuidado e tratamento foram: central de regulação 79,6%, referência e contrarreferência 77,8%. Conclusão: Os resultados deste estudo refletem que a APS em Goiânia-GO, está em processo de implantação da gestão e cuidado nutricional que atendam às políticas públicas previstas para a prevenção e manejo do sobrepeso e obesidade.

Objective: To evaluate the organization, management, and nutritional care offered to overweight and obese individuals in primary healthcare (PHC) centers. Methods: A cross-sectional study was conducted with 54 professionals from PHC in the city of Goiânia-GO. Data were obtained using a semi-structured, self-administered electronic questionnaire. Results: The participating professionals were predominantly nurses (88.9%) with more than five years in their current position (79.6%). Regarding office infrastructure, including seating, only 11.1% reported adequate chairs and benches, while 33.3% reported adequate physical accessibility. Territory mapping was reported by 51.8% of professionals. The main strategies for organizing care and treatment were central regulation (79.6%), and referrals and counter-referrals (77.6%). Conclusion: The results of this study reflect that PHC in Goiânia-GO is in the process of implementing management services and nutritional care that meet the public policy standards envisaged for the prevention and management of overweight conditions and obesity.

Association between the environment for physical activity in public schools and childhood obesity: a view in the light of complex systems / Associação entre ambiente para atividade física em escolas públicas e obesidade infantil: um olhar à luz de sistemas complexos

Abstract This article aims to analyse the relationship between physical activity (PA) environment at schools, sex, age, and obesity in children, using a network approach. This is a cross-sectional study, with 1,200 children (8.1±1.0 years old) from eight public schools in the same municipality. Weight and height measurements were assessed to calculate the Body Mass Index (BMI) and classified as healthier weight or overweight. To assess the PA environment at school, a interview with the school´s manager was conducted. The association between the PA environment at school and obesity was tested using a Network Analysis performed on the Jasp software. Positive associations between BMI and Physical Education classes (0.847), physical education teacher (0.349), break duration (0.564), and indoor sports court (0.662) were observed. Negative associations were seen with sex (-0.212) age (-0.387), extracurricular PA (-0.492), and playground (-0.557). Additionally, the centrality indicators highlighted extracurricular PA (1.789) as the variables with the highest betweenness values, and BMI with the highest closeness (2.239) and strength (1.230) values. Extracurricular PA and the presence of playgrounds in school´s environment are associated with healthier weight in low-income children.

Resumo O objetivo deste artigo é analisar a relação entre ambiente de atividade física (AF) nas escolas, sexo, idade e obesidade em crianças, usando uma abordagem de rede. Trata-se de um estudo transversal com 1.200 crianças (8,1±1,0 anos) de oito escolas públicas do mesmo município. Peso e estatura foram avaliadas para cálculo do Índice de Massa Corporal (IMC) e classificadas como peso saudável ou sobrepeso. Para avaliar o ambiente de AF na escola, foi aplicado um questionário por meio de entrevista com o gestor da escola. A associação entre o ambiente de AF na escola e a obesidade foi testada por meio Análise de Redes realizada no software Jasp. Foram observadas associações positivas entre o IMC e as aulas de Educação Física (0,847), professor de educação física (0,349), duração do intervalo (0,564) e quadra poliesportiva (0,662). Associações negativas foram observadas com sexo (-0,212), idade (-0,387), AF extracurricular (-0,492) e playground (-0,557). Adicionalmente, os indicadores de centralidade destacaram a AF extracurricular (1,789) como a variável com o maior valor de intermediação, e o IMC com o maior valor de proximidade (2,239) e força (1,230). A AF extracurricular e a presença de playgrounds no ambiente escolar estão associadas a um peso mais saudável em crianças de baixa renda.

Fasting glucose: a cardiometabolic indicator for subclinical atherosclerosis on excess weight adolescents

Abstract Objective: To build a model based on cardiometabolic indicators that allow the identification of overweight adolescents at higher risk of subclinical atherosclerotic disease (SAD). Methods: Cross-sectional study involving 161 adolescents with a body mass index ≥ + 1 z-Score, aged 10 to 19 years. Carotid intima-media complex thickness (IMT) was evaluated using ultrasound to assess subclinical atherosclerotic disease. Cardiometabolic indicators evaluated included nutritional status, central adiposity, blood pressure, lipidic profile, glycemic profile, as well as age and sex. Data was presented using measures of central tendency and dispersion, as well as absolute and relative frequency. The relationship between IMT measurement (outcome variable) and other variables (independent variables) was assessed using Pearson or Spearman correlation, followed by multiple regression modeling with Gamma distribution to analyze predictors of IMT. Statistical analysis was performed using SPSS and R software, considering a significance level of 5 %. Results: It was observed that 23.7 % had Carotid thickening, and the prevalence of abnormal fasting glucose was the lowest. Age and fasting glucose were identified as predictors of IMT increase, with IMT decreasing with age by approximately 1 % per year and increasing with glucose by around 0.24 % per mg/dL. Conclusion: The adolescent at higher risk is younger with higher fasting glycemia levels.

Asociación del índice de masa corporal con la insatisfacción corporal en escolares / Association of body mass index with body dissatisfaction in schoolchildren

Introducción: La malnutrición por exceso causa sobrepeso y obesidad, siendo un problema de salud pública, que se ha presentado en los primeros años de vida. Investigaciones realizadas han informado la existencia de insatisfacción corporal relacionada con el peso, debido a los estándares de belleza establecidos en la sociedad. Objetivo: asociar el índice de masa corporal con la insatisfacción corporal y percepción de la imagen corporal de los escolares. Materiales y métodos: estudio transversal con 610 escolares. El estado nutricional se clasificó según el puntaje z del IMC. Para determinar la insatisfacción corporal y la percepción de la imagen corporal, se aplicó una escala de imagen corporal infantil de siete fotografías, con un valor del 1 al 7 de acuerdo con el tamaño creciente, y el rango final del IMC. Se calculó la diferencia entre la figura que los participantes consideraron ideal y la forma corporal percibida. Resultados: el 47,3% presentaron sobrepeso y obesidad. La insatisfacción corporal fue mayor en las niñas con sobrepeso y obesidad (p = 0,013). El IMC correlacionó con la insatisfacción corporal (rho(608) = 0,480; p < 0,001) y la percepción de la imagen corporal (rho(608) = 0,433; p < 0,001). Conclusiones: El IMC se relacionó positivamente con la insatisfacción corporal y la percepción de la imagen corporal; esto podría elevar el riesgo de presentar trastornos alimentarios, contribuir al mantenimiento del exceso de peso corporal, al no percibirse con exceso de peso, es menos probable que realicen acciones para controlarlo(AU)

Introduction: Excessive malnutrition causes overweight and obesity, being a public health problem, which has occurred in the first years of life. Research has reported the existence of body dissatisfaction related to weight, due to beauty standards established in society. Objective: to associate the BMI with body dissatisfaction and body image perception of schoolchildren. Materials and methods: cross-sectional study of 610 schoolchildren. Nutritional status was classified according to the BMI z score. To determine body dissatisfaction and body image perception, a child body image scale of seven photographs was applied, with a value of 1 to 7 according to the increasing size, and the final range of the BMI. The difference between the figure that participants considered ideal, and the perceived body shape was calculated. Results: 47.3% were overweight and obese. Body dissatisfaction was higher in overweight and obese girls (p = 0.013). BMI correlated with body dissatisfaction (rho(608) = 0.480; p < 0.001) and body image perception (rho(608) = 0.433; p < 0.001). Conclusions: BMI was positively related to body dissatisfaction and body image perception; this could increase the risk of developing eating disorders, contribute to the maintenance of excess body weight, as it is not perceived with excess weight, are less likely to take actions to control it(AU)

Promoción de la salud y obesidad infantil en el cotidiano de los escolares y familias / Health promotion and child obesity in the daily life of school children and families / Promoção da saúde e obesidade infantil no cotidiano de escolares e famílias

ResumenObjetivos: comprender el cotidiano de familiar de niños y niñas de enseñanza prebásica y básica en una escuela del sector Barranco Amarillo, región de Magallanes y Antártica Chilena; conocer la experiencia de cuidados relacionados con la prevención de la obesidad infantil y la promoción de la salud de sus familias. Método: estudio cualitativo, descriptivo-exploratorio, basado en la sociología comprensiva y del cotidiano de Michel Maffesoli, con la participación de doce familias. Resultados: las familias tienen conocimientos sobre una buena salud, tratando de comer de forma sana, pero les resulta difícil aplicarlos porque no encuentran una rutina apropiada, por el mayor costo de los alimentos saludables, el sedentarismo y la preferencia por comidas rápidas, entre otros. Conclusión: es preciso instaurar estrategias de intervención en la prevención de la obesidad infantil, teniendo como foco la promoción de la salud para una vida digna y saludable.

AbstractObjectives: to understand the daily life of families of boys and girls in pre-school and basic education in a school in the Barranco Amarillo sector, Magallanes and Chilean Antarctic Region; to know the experience of care related to the prevention of childhood obesity and the promotion of the health of their families. Method: qualitative, descriptive-exploratory study, based on the Comprehensive and Daily Sociology of Michel Maffesoli, with the participation of twelve families. Results: families have knowledge about good health, trying to eat healthy, but it is difficult for them to apply them because they do not find an appropriate routine, due to the higher cost of healthy foods, sedentary lifestyle, and the preference for fast foods, among others. Conclusion: it is necessary to establish intervention strategies in the prevention of childhood obesity, focusing on health promotion, for a dignified and healthy life

ResumoObjetivos: compreender o cotidiano das famílias de meninos e meninas na educação pré-escolar e básica em uma escola do setor Barranco Amarillo, Magalhães e Região Antártica Chilena; conhecer a experiência de cuidados relacionados à prevenção da obesidade infantil e à promoção da saúde de seus familiares. Método: estudo qualitativo, descritivo-exploratório, baseado na Sociologia Compreensiva e Cotidiana de Michel Maffesoli, com a participação de 12 famílias. Resultados: as famílias têm conhecimento sobre a boa saúde, procurando se alimentar de forma saudável, mas têm dificuldade em aplicá-los por não encontrarem uma rotina adequada devido ao maior custo dos alimentos saudáveis, sedentarismo e preferência por fast foods, entre outros. Conclusão:é necessário estabelecer estratégias de intervenção na prevenção da obesidade infantil, com foco na promoção da saúde para uma vida digna e saudável.

Effect of Swimming at Low Temperature on Uncoupling Protein Gene Expression in Skeletal Muscle of Wistar Rats / Efecto de la Natación a Baja Temperatura sobre la Expresión del Gen de la Proteína de Desacoplamiento en el Músculo Esquelético de Ratas Wistar

SUMMARY: As the economy develops and living standards improve, overweight and obesity are increasingly prevalent. Currently, weight-loss medications are primarily administered orally or intravenously, which can result in poor targeting, low bioavailability, frequent administration, and high toxicity and side effects. The study aimed to address these challenges by preparing polylactic acid- polyethylene glycol staple fibers that carry the browning drug pioglitazone hydrochloride using electrostatic spinning and freeze-cutting techniques. Animal experiments were conducted to test the effectiveness of these fibers. Additionally, the study investigated the expression of uncoupling protein genes in rats exposed to different water temperatures by measuring changes in serum urea nitrogen and mRNA expression levels of skeletal muscle uncoupling protein genes. The physiological and genetic effects of low-temperature swimming exercise on changes in energy metabolism in rats were also analyzed at both the individual and molecular levels. The results revealed that serum urea nitrogen remained more stable in hypothermic swimming rats compared to rats in the swimming group. Furthermore, the study observed an induced up-regulation of uncoupling proteins in the skeletal muscle of Wistar rats in response to external temperature stimulation, and the expression of mRNA for skeletal muscle uncoupling proteins significantly increased as the temperature decreased. And the prepared short nanofibers also had a significant promotive effect on uncoupling protein gene, COX7A1, while suppressing the expression of lipogenic gene.

A medida que la economía se desarrolla y los niveles de vida mejoran, el sobrepeso y la obesidad son cada vez más frecuentes. Actualmente, los medicamentos para bajar de peso se administran principalmente por vía oral o intravenosa, lo que puede resultar en una mala focalización, baja biodisponibilidad, administración frecuente y alta toxicidad y efectos secundarios. El estudio tuvo como objetivo abordar estos desafíos mediante la preparación de fibras cortadas de ácido poliláctico y polietilenglicol que transportan el fármaco pardo clorhidrato de pioglitazona mediante técnicas de hilado electrostático y liofilización. Se realizaron experimentos con animales para probar la eficacia de estas fibras. Además, el estudio investigó la expresión de genes de proteínas desacopladoras en ratas expuestas a diferentes temperaturas del agua midiendo los cambios en el nitrógeno ureico sérico y los niveles de expresión de ARNm de genes de proteínas desacopladoras del músculo esquelético. También se analizaron los efectos fisiológicos y genéticos del ejercicio de natación a baja temperatura sobre los cambios en el metabolismo energético en ratas, tanto a nivel individual como molecular. Los resultados revelaron que el nitrógeno ureico sérico permaneció más estable en ratas nadadoras hipotérmicas en comparación con las ratas del grupo de natación. Además, el estudio observó una regulación positiva inducida de las proteínas desacopladoras en el músculo esquelético de ratas Wistar en respuesta a la estimulación de la temperatura externa, y la expresión de ARNm para las proteínas desacopladoras del músculo esquelético aumentó significativamente a medida que disminuía la temperatura. Además, las nanofibras cortas preparadas también tuvieron un efecto promotor significativo sobre el gen de la proteína de desacoplamiento, COX7A1, al tiempo que suprimieron la expresión del gen lipogénico.

Caracterización del infarto agudo de miocardio con elevación del segmento st en pacientes atendidos en un centro de referencia. Periodo 2021-2023

Introducción: el riesgo de aparición del infarto agudo de miocardio está relacionada con varias comorbilidades, muchas de las cuales son prevenibles y tratables. El infarto agudo de miocardio tiene un impacto relevante en términos de mortalidad y número de hospitalizaciones. Objetivos: determinar las características clínica-epidemiológicas del infarto agudo de miocardio con elevación del segmento ST en pacientes atendidos en el Centro Médico Nacional-Hospital Nacional, durante el periodo 2021-2023. Metodología: el diseño del estudio fue observacional, descriptivo de corte transversal, sobre las características clínica-epidemiológicas del infarto agudo de miocardio con elevación del segmento ST en pacientes mayores de edad atendidos en el Centro Médico Nacional-Hospital Nacional, durante el periodo 2021-2023. Resultados: se analizaron 102 expedientes de pacientes con diagnóstico de infarto agudo de miocardio con elevación del segmento ST con una media de 64 ± 12 años; el 68 % (n = 69) correspondió al sexo masculino, con una edad promedio de 62 años, y en relación a las mujeres el promedio fue de 64 años. El motivo de consulta principal fue el dolor precordial y la cara miocárdica más afectada de acuerdo con el electrocardiograma inicial fue la cara anteroseptal. La mortalidad intrahospitalaria fue del 16 %, el 68 % correspondió a varones. La comorbilidad más frecuente fue la hipertensión arterial. Conclusión: La hipertensión arterial es la patología más prevalente. Asimismo, son habituales la obesidad, el tabaquismo y la diabetes mellitus. Las comorbilidades están en relación directa con la edad y prevalecen en mayores de 60 años. El infarto agudo de miocardio con elevación del segmento ST es más frecuente en el sexo masculino.

Introduction: the risk of acute myocardial infarction is related to several comorbidities, many of which are preventable and treatable. Acute myocardial infarction has a relevant impact in terms of mortality and number of hospitalizations. Objectives: the design of the study was observational, descriptive, cross-sectional, on the clinical characteristics of ST-segment elevation myocardial infarction, in adult patients treated at the Centro Médico Nacional-Hospital Nacional, during the period 2021-2023. Methodology: the design of the study was observational, descriptive, cross-sectional, on the clinical-epidemiological characteristics of acute myocardial infarction with ST segment elevation in adult patients treated at the National Medical Center-National Hospital, during the period 2021-2023. Results: 102 records of patients with a diagnosis of ST-segment elevation myocardial infarction with a mean age of 64 ± 12 years were analyzed; 68 % (n = 69) were male, with an average age of 62 years, and in relation to women the average was 64 years. The main reason for consultation was precordial pain and the most affected myocardial aspect according to the initial electrocardiogram was the anteroseptal aspect. In-hospital mortality was 16 %, 68 % of which were men. The most frequent comorbidity was arterial hypertension. Conclusion: high blood pressure is the most prevalent pathology. Likewise, obesity, smoking and diabetes mellitus are common. Comorbidities are directly related to age and prevail in those over 60 years of age. ST-segment elevation myocardial infarction is more common in males.

Resultados cardiometabólicos de largo plazo tras cirugía bariátrica: control de comorbilidades, pérdida y reganancia de peso a los 5 años de seguimiento / Long-term cardiometabolic results after bariatric surgery: Control of comorbidities, weight loss and regain at 5 years of follow-up

Introducción. La cirugía bariátrica y metabólica (CBM) es efectiva en lograr pérdida de peso a corto plazo. Sin embargo, existe evidencia limitada en desenlaces clínicos y metabólicos a largo plazo. Métodos. Estudio longitudinal retrospectivo con pacientes llevados a baipás gástrico en Y de Roux (BGYR) o gastrectomía en manga (MG) por laparoscopia en Bogotá, D.C., Colombia, entre 2013 y 2021. El cambio de peso, control de comorbilidades y resultados metabólicos se recopilaron al inicio del estudio, 3, 6 y 12 meses después de cirugía, y anualmente hasta el quinto año. Las tasas de control de comorbilidades se evaluaron mediante la prueba Kaplan-Meier. Se utilizó un modelo de riesgos proporcionales de Cox para evaluar el efecto de covariables en la reganancia de peso. Resultados. De 1092 pacientes con CBM (71,4 % MG y 28,6 % BGYR), 67 % eran mujeres, con mediana de edad 48 años e índice de masa corporal de 35,5 Kg/m2. Después de cinco años de seguimiento, la tasa de control en diabetes mellitus fue 65,5 %, en hipertensión 56,6 % y en dislipidemia 43,6 %. La tasa de reganancia de peso fue 28 %, sin diferencias entre MG vs BGYR (p=0,482). El tiempo promedio hasta peso nadir fue 14 meses. La edad al momento de CBM fue el mejor predictor independiente de reganancia (HR=1,02, IC95% 1,01-1,04), pero con efecto clínico modesto. Conclusión. La CBM es segura y muestra beneficios a largo plazo en la pérdida de peso y control de comorbilidades en población colombiana.

Introduction. Bariatric and metabolic surgery (BMS) has shown its efficacy in achieving short-term weight loss. However, there is limited evidence regarding long-term clinical and metabolic outcomes. Methods. Retrospective longitudinal study with patients who underwent laparoscopic Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) interventions in Bogotá, Colombia, between 2013 and 2021. Weight change, comorbidity control, and metabolic outcomes were collected at the onset, 3-, 6-, and 12-month post-surgery, and annually up to the fifth year. Comorbidity control rates were assessed using the Kaplan-Meier test. A Cox proportional hazards model was used to evaluate the effect of covariates on weight regain. Results. Of 1092 patients with BMS (71.4% SG and 28.6% RYGB), 67% were women, with a median age of 48 years, BMI 35.5 kg/m2. After five years of follow-up, the control rate in diabetes mellitus was 65.5%, in hypertension 56.6%, and dyslipidemia 43.6%. The weight regain rate was 28% with no differences between SG vs RYGB (p=0.482). The mean time to nadir weight was 14 months. Age at the time of BMS was the best independent predictor of weight regain (HR=1.02, 95%CI: 1.01-1.04), but with a modest clinical effect. Conclusion. BMS is safe and shows long-term benefits in weight loss and control of comorbidities in Colombian population.

Impacto de la pandemia por SARS-CoV-2 en el índice de masa corporal de niños asistidos en la Ciudad Autónoma de Buenos Aires / Impact of the SARS-CoV-2 pandemic on the body mass index of children seen in the City of Buenos Aires

Introducción. El sobrepeso y la obesidad infantil constituyen un problema de salud pública. El inicio de la pandemia por COVID-19 pudo haber favorecido esta patología. El puntaje Z del índice de masa corporal (Z-IMC) es un indicador aceptado para su diagnóstico y seguimiento. Objetivo. Evaluar si la prevalencia de sobrepeso y obesidad, y el Z-IMC en niños de 2 a 5 años aumentó durante la pandemia. Población y métodos. Estudio de cohorte retrospectiva. Se incluyeron pacientes asistidos en efectores públicos de salud del Gobierno de la Ciudad Autónoma de Buenos Aires (GCABA), de 2 a 5 años de edad, con registro de peso y talla en dos consultas, antes y después de haber comenzado el aislamiento social preventivo y obligatorio (ASPO). Se registró estado nutricional (Z-IMC) y variación del Z-IMC entre ambas consultas. Resultados. Se evaluaron 3866 sujetos, edad promedio 3,4 ± 0,8 años; el 48,1 % fueron mujeres. El intervalo promedio entre consultas fue 14,3 ± 2,5 meses. La prevalencia de sobrepeso/obesidad aumentó del 12,6 % (IC95% 11,6-13,6) al 20,9 % (IC95% 19,6-22-2); p <0,001, al igual que el Z-IMC (0,4 ± 1,1 vs. 0,8 ± 1,3; p <0,001). Conclusión. La prevalencia de sobrepeso y obesidad, y el Z-IMC en niños de 2 a 5 años aumentó significativamente durante la pandemia.

Introduction. Childhood overweight and obesity are a public health problem. The onset of the COVID-19 pandemic may have contributed to this condition. The body mass index (BMI) Z-score has been accepted as an indicator for overweight and obesity diagnosis and follow-up. Objective. To assess whether the prevalence of overweight and obesity and the BMI Z-score in children aged 2 to 5 years increased during the pandemic. Population and methods. Retrospective, cohort study. Patients included were those seen at public health care facilities in the City of Buenos Aires (CABA), who were aged 2 to 5 years, had weight and height values recorded at 2 different visits, before and after the establishment of the preventive and mandatory social isolation policy. Patients' nutritional status (BMI Z-score) and the variation in this indicator between both visits were recorded. Results. A total of 3866 subjects were assessed; their average age was 3.4 ± 0.8 years; 48.1% were girls. The average interval between both visits was 14.3 ± 2.5 months. The prevalence of overweight/ obesity increased from 12.6% (95% CI: 11.6­13.6) to 20.9% (95% CI: 19.6­22.2), p < 0.001, and so did the BMI Z-score (0.4 ± 1.1 versus 0.8 ± 1.3, p < 0.001). Conclusion. The prevalence of overweight and obesity and the BMI Z-score in children aged 2 to 5 years increased significantly during the pandemic.

Hepcidin and inflammation associated with iron deficiency in childhood obesity - A systematic review

Abstract Objectives: This paper aims to review data on the association of obesity and iron deficiency in children and adolescents, exposing the possible involvement of hepcidin and interleukin-6 (IL-6), obesity's inflammation biomarkers. Data source: Articles from PUBMED and WEB OF SCIENCE database with no chronological limit were reviewed to write this systematic review. Keywords such as children, obesity, iron deficiency, and hepcidin were used. After deleting duplicated and review articles, 91 were screened, and 39 were selected as eligible. Sixteen articles were included because they involved serum hepcidin levels in obese children and adolescents as outcomes. Summary of findings: Finally, those 16 articles were organized in two tables: one includes therapeutic interventions, and the other does not. As hepcidin was discovered in 2000, the first articles that presented serum hepcidin's quantification in obese children and adolescents, homeostasis iron markers, and their possible association with obesity's inflammatory environment began to be published in 2008. Conclusions: Obesity's chronic inflammation state leads to the production of IL-6, which acts as a signaling molecule for hepcidin synthesis, resulting in iron deficiency, which is common in obese children and adolescents who respond inadequately to iron supplementation. On the other hand, that population responds adequately to therapeutic intervention programs that lead to weight loss, guaranteeing iron homeostasis improvement. Therefore, perhaps it is time to discuss serum hepcidin level quantification as part of evaluating children and adolescents with iron deficiency, which could guide clinical choices that might lead to better therapeutic outcomes.

What causes obesity in children and adolescents?

Abstract Objective To present the different aspects that may be involved in the genesis and maintenance of obesity in children and adolescents. Data source Narrative review of articles published in the PubMed, Scielo, Lilacs, Scopus and Google Scholar databases, using the search terms: overweight, obesity, pre-conception, prenatal, infants, schoolchildren, children, and adolescents. The search was conducted in studies written in Portuguese, English and Spanish, including narrative, integrative or systematic reviews, meta-analyses, cross-sectional, case-control and cohort studies, published between 2003 and 2023. Data synthesis A total of 598 studies were initially screened and 60 of them, which showed the main biopsychosocial aspects related to greater risks of excessive adiposity in the pediatric age, were included in the review. The data were presented taking into account the incidence of risk factors and their consequences in six periods: pre-conception, pre-natal, infant, preschool, school age, and adolescence. Conclusions The causal factors described in the scientific literature that have been shown to be related to obesity in childhood and adolescence are presented.

Anthropometric Characteristics, Body Composition and Nutritional Status of Younger Primary School Children in Montenegro: National Study / Características Antropométricas, Composición Corporal y Estado Nutricional de los Niños más Pequeños de la Escuela Primaria en Montenegro. Estudio Nacional

SUMMARY: This article has two aims: (a) first aim was to determine what is the most applicable and the simplest alternative for recommended BMI categories for underweight, overweight and obesity related to IOTF references, from the practical standpoint; (b) second aim was to determine the prevalence of the nutritional status in Montenegro on this representative sample of school children aged 9-13 years and compare them with peers from relevant and similar studies from both the local region and globally. A total sample of 1478 healthy children from Montenegro participated in this study divided into two sub-samples of 732 girls and 746 boys. According to the IOTF body mass index (BMI) reference values were used through ROC curve analysis to evaluate potential alternatives for estimation of the nutritional status of this sample of children. Only WHtR did not show significant age-related differences in the case of both genders. Considering the nutritional status of children from this study it has been found that boys have a considerably higher prevalence of being overweight (22.7 % vs. 16.4 %) and obese (7.5 % vs. 3.3 %) compared to girls. On the other hand, girls were more prevalent to be underweight (10.5 % vs. 7.5 %). WHtR seems like the best alternative for the estimation of obesity and being overweight due to simplicity and the equipment needed.

Este artículo tiene dos objetivos: (a) el primero fue determinar cuál es la alternativa más aplicable y más sencilla para las categorías de IMC recomendadas para bajo peso, sobrepeso y obesidad relacionadas con las referencias de la IOTF, desde el punto de vista práctico; (b) el segundo objetivo fue determinar la prevalencia del estado nutricional en Montenegro en esta muestra representativa de escolares de 9 a 13 años y compararlos con pares de estudios relevantes y similares tanto de la región local como a nivel mundial. En el estudio participaron 1478 niños sanos de Montenegro divididos en dos submuestras de 732 niñas y 746 niños. De acuerdo con el índice de masa corporal (IMC) de la IOTF, se utilizaron valores de referencia mediante análisis de curvas ROC para evaluar posibles alternativas para la estimación del estado nutricional de esta muestra en niños. Sólo el ICT no mostró diferencias significativas relacionadas con la edad en el caso de ambos sexos. Teniendo en consideración el estado nutricional de los niños, se determinó que los éstos tenían una prevalencia considerablemente mayor de sobrepeso (22,7 % frente a 16,4 %) y obesidad (7,5 % frente a 3,3 %) en comparación con las niñas. Por otro lado, las niñas tenían más prevalencia de bajo peso (10,5 % frente a 7,5 %). El WHtR parece la mejor alternativa para la estimación de la obesidad y el sobrepeso por su sencillez y equipamiento necesario.

Standing-Long-Jump Test Application in Identifying Female Adolescents at Risk of Sarcopenic Obesity / Aplicación de la Prueba de Salto de Longitud de Pie para Identificar a Adolescentes con Riesgo de Obesidad Sarcopénica

SUMMARY: The identification of children and adolescents who are at risk of sarcopenic obesity development often requires specialized equipment and expensive test procedures. Therefore, the establishment of cheaper and faster methods would be greatly useful, especially if they could be applied in the field. The study's objective was to establish if identification of female adolescents who suffer the risk of developing sarcopenic obesity can be obtained through the standing-long-jump test application. To achieve the research objectives, various anthropometric and body composition measurements were performed and lower limb explosive strength was assessed using the standing long jump fitness test. The research was conducted on a sample of 535 female respondents randomly selected from 9 elementary schools in the Skopje region of the Republic of North Macedonia. The respondents were divided into quintiles according to BMI z-scores, and the arithmetic means and SD about muscle-to-fat ratio were calculated for each quintile. The cutoff was determined based on the mean and standard deviation of the muscle-to-fat ratio for the 3rd quintile of BMI and the percentage of respondents with sarcopenic obesity was examined. The optimal cut-off value of the long jump fitness test results for predicting sarcopenic obesity in an adolescent girl showed that the area under the ROC curve was 0.781 (95 % CI 0.743-0.815). The standing-long-jump test values, on grounds of odds ratio (OR 95 % CI) about the girls at risk of sarcopenic obesity development, which was identified on muscle-to-fat ratio base, were 8.76 (4.39 - 17.54, p 0.001). It can be used to predict sarcopenic obesity presence in female adolescents, which can be vital in case of health intervention.

La identificación de niños y adolescentes que corren riesgo de desarrollar obesidad sarcopénica a menudo requiere equipos especializados y procedimientos de pruebas costosos. Por lo tanto, el establecimiento de métodos más baratos y rápidos sería de gran utilidad, especialmente si pudieran aplicarse en el campo. El objetivo del estudio fue establecer si la identificación de mujeres adolescentes que sufren riesgo de desarrollar obesidad sarcopénica se puede obtener mediante la aplicación de la prueba de salto de longitud de pie. Para lograr los objetivos de la investigación, se realizaron diversas mediciones antropométricas y de composición corporal y se evaluó la fuerza explosiva de los miembros inferiores mediante la prueba de aptitud de salto de longitud de pie. La investigación se realizó con una muestra de 535 mujeres encuestadas seleccionadas al azar de 9 escuelas primarias de la región de Skopje, en la República de Macedonia del Norte. Los encuestados se dividieron en quintiles según las puntuaciones z del IMC, y se calcularon las medias aritméticas y la DE sobre la relación músculo-grasa para cada quintil. El límite se determinó en función de la media y la desviación estándar de la relación músculo-grasa para el tercer quintil del IMC y se examinó el porcentaje de encuestados con obesidad sarcopénica. El valor de corte óptimo de los resultados de la prueba de condición física de salto de longitud para predecir la obesidad sarcopénica en una adolescente mostró que el área bajo la curva ROC fue 0,781 (IC del 95 %: 0,743-0,815). Los valores de la prueba de salto de longitud de pie, sobre la base del odds ratio (OR IC del 95 %) sobre las niñas en riesgo de desarrollar obesidad sarcopénica, que se identificó sobre la base del ratio músculo-grasa, fueron 8,76 (4,39 - 17,54, p. 0,001). Puede utilizarse para predecir la presencia de obesidad sarcopénica en adolescentes, lo que puede ser vital en caso de intervención sanitaria.

O papel da escola e da Educação Física no controle do sobrepeso e obesidade juvenil na perspectiva de professores atuantes no ensino superior / The role of schools and Physical Education in the control of overweight and juvenile obesity from the perspective of teachers working in higher education / El papel de las escuelas y la Educación Física en el control del sobrepeso y la obesidad juvenil desde la perspectiva de docentes que trabajan en la educación superior

O presente artigo apresenta os resultados de uma pes-quisa quantitativa com viés exploratório descritivo, cujo objetivo foi analisar a percepção de 22 professores de Educação Física (18 homens e 04 mulheres), atuantes no magistério superior, sobre o papel da escola e da Educação Física no controle do sobrepeso e obesidade juvenil. Foi utilizada versão adaptada do Perceptions of Youth Obesity and Physical Education Questionnaire. A análise dos dados deu-se a partir das seguintes categorias: percepção da obe-sidade juvenil, papel da escola e papel da Educação Física permi-tiu inferir que os professores percebema escola como um espaço potencial para a promoção de ações, como a oferta de disciplinas curriculares voltadas ao controle do peso corporal. Contudo, tanto a escola, quanto o professor e sua práxis nas aulas de Educação Física não devem restringir as intervenções de forma circunscrita ao tratamento e controle da obesidade juvenil.

This article presents the results of a quantitative re-search with a descriptive exploratory bias, whose objective was to analyze the perception of 22 Physical Education teachers (18 men and 04 women), working in higher education, about the role of school and Physical Education in controlling overweight and juveni-le obesity. An adapted version of the Perceptions of Youth Obesity and Physical Education Questionnaire was used. The analysis of the data from the categories called perception of youth obesity, role of the school and role of Physical Education allowed inferring that teachers perceive the school as a potential space for the pro-motion of actions, such as the offer of curricular disciplines aimed at controlling the body weight. However, both the school and the teacher and their practice in Physical Education classes should not limit interventions to the treatment and control of juvenile obesity.

Este artículo presenta los resultados de una investiga-ción cuantitativa con sesgo exploratorio descriptivo, cuyo objetivo fue analizar la percepción de 22 profesores de Educación Física (18 hombres y 04 mujeres), que actúan en la enseñanza superior, sobre el papel de la escuela y la Educación Física en el control so-brepeso y obesidad juvenil. Se utilizó una versión adaptada del Cuestionario de Percepciones de Obesidad Juvenil y Educación Física. El análisis de los datos de las categorías denominadas per-cepción de la obesidad juvenil, rol de la escuela y rol de la Educación Física permitió inferir que los docentes perciben la escuela como un espacio potencial para la promoción de acciones, como la ofer-ta de disciplinas curriculares dirigidas al control el peso corporal. Sin embargo, tanto la escuela como el docente y su práctica en las clases de Educación Física no deben limitar las intervenciones al tratamiento y control de la obesidad juvenil.

Estigmatización por peso en estudiantes universitarios chilenos

Antecedentes: El aumento de la obesidad ha llevado a una mayor estigmatización, con impactos en la salud psicológica y social de las víctimas. La estigmatización por peso puede expresarse en las creencias respecto al control de la obesidad. Escasos estudios han explorado el rol de la victimización por peso corporal y las creencias hacia otras personas con obesidad. Objetivo: Analizar la asociación entre la victimización por peso corporal y características de estudiantes universitarios, en relación con las creencias hacia personas con obesidad. Métodos: Estudio transversal con 281 estudiantes de Santiago, Chile. Los participantes completaron un cuestionario online con la escala Beliefs about Obese Persons Scale (BAOP), preguntas sobre discriminación por su peso corporal, y características personales. La escala BAOP fue validada mediante entrevistas cognitivas (N=8) y análisis de consistencia interna (α-Cronbach=0,814). Los resultados se analizaron con las pruebas U Mann-Whitney, Kruskal-Wallis y Chi-cuadrado. Resultados: La mayoría de los estudiantes creían que la obesidad es controlable por las personas que la padecen, pero aquellos que reportaron victimización por peso en lugares como el hogar y la universidad presentaron menores creencias sobre la controlabilidad de la obesidad (p<0,05). No se reportaron diferencias en las creencias hacia personas con obesidad según características personales, exceptuando entre los hombres de distinta cohorte de estudios. Conclusión: Este estudio indica que las víctimas de estigmatización de peso tienden a presentar menores creencias respecto a la controlabilidad de la obesidad. Futuras intervenciones debiesen incorporar estrategias para reducir los sesgos de peso entre estudiantes universitarios en formación.

Background: The rise in obesity prevalence has led to increased weight stigmatization, impacting the psychological and social health of those affected. Weight stigma can manifest in beliefs regarding individuals' control over their obesity. Few studies have explored the role of weight-based victimization and beliefs towards individuals with obesity. Objective: To analyze the association between weight-based victimization and university students' characteristics, with beliefs toward individuals with obesity. Methods: Cross-sectional study involving 281 students in Santiago, Chile. Participants completed an online questionnaire including the Beliefs about Obese Persons Scale (BAOP), questions about weight-based discrimination, and personal characteristics. The BAOP scale was validated through cognitive interviews (N=8) and internal consistency analysis (α-Cronbach=0,814). Results were analyzed using U Mann-Whitney, Kruskal-Wallis, and Chi-square tests. Results: Most students believed that obesity is controllable by those affected, but those who reported weight-based victimization in places such as home and university exhibited lower beliefs about the controllability of obesity (p<0,05). No differences in beliefs towards individuals with obesity were reported based on personal characteristics, except among male students in different study cohorts. Conclusion: This study identifies that victims of weight bias tend to exhibit lower beliefs regarding the controllability of obesity. Future interventions should incorporate strategies to reduce weight biases among university students in training.