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Resumo Fundamento: O índice de massa corporal (IMC) é o índice mais usado para categorizar uma pessoa como obesa ou não-obesa, e está sujeito a limitações importantes. Objetivo: Avaliar o efeito direto do IMC nos desfechos cardiovasculares em participantes sem obesidade central. Métodos: Esta análise incluiu 14.983 homens e mulheres com idades entre 45-75 anos do Estudo de Risco de Aterosclerose em Comunidades (ARIC). O IMC foi medido como obesidade geral e a circunferência da cintura (CC), a relação cintura-quadril (RCQ) e circunferência do quadril como obesidade central. A estimativa de máxima verossimilhança direcionada (TMLE, no acrônimo em inglês) foi usada para estimar os efeitos totais (TEs) e os efeitos diretos controlados (CDEs). A proporção de ET que seria eliminada se todos os participantes fossem não obesos em relação à obesidade central foi calculada usando o índice de proporção eliminada (PE). P<0,05 foi considerado estatisticamente significativo. As análises foram realizadas no pacote TMLE R. Resultados: O risco de desfechos cardiovasculares atribuídos ao IMC foi significativamente revertido com a eliminação da obesidade na RCQ (p <0,001). A proporção eliminada dos efeitos do IMC foi mais tangível para participantes não obesos em relação à CC (PE = 127%; IC95% (126,128)) e RCQ (PE = 97%; IC95% (96,98)) para doença arterial coronariana (DAC), e RCQ (PE = 92%; IC95% (91,94)) para acidente vascular cerebral, respectivamente. Com relação ao sexo, a proporção eliminada dos efeitos do IMC foi mais tangível para participantes não obesos em relação a RCQ (PE = 428%; IC95% (408.439)) para DAC em homens e CC (PE = 99%; IC95% (89,111)) para acidente vascular cerebral em mulheres, respectivamente. Conclusão: Esses resultados indicam diferentes efeitos potenciais da eliminação da obesidade central na associação entre IMC e desfechos cardiovasculares em homens e mulheres. (Arq Bras Cardiol. 2021; 116(5):879-886)
Background: Body mass index (BMI) is the most commonly used index to categorize a person as obese or non-obese, which is subject to important limitations. Objective: To evaluate the direct effect of BMI on cardiovascular outcomes among participants without central obesity. Methods: This analysis included 14,983 males and females aged 45-75 years from the Atherosclerosis Risk in Communities Study (ARIC). BMI was measured as general obesity, and waist circumference (WC), waist-to-hip ratio (WHR) and hip circumference as central obesity. Targeted maximum likelihood estimation (TMLE) was used to estimate the total effects (TEs) and the controlled direct effects (CDEs). The proportion of TE that would be eliminated if all participants were non-obese regarding central obesity was computed using the proportion eliminated (PE) index. P <0.05 was considered statistically significant. Analyses were performed in the TMLE R package. Results: The risk of cardiovascular outcomes attributed to BMI was significantly reversed by eliminating WHR obesity (p<0.001). The proportion eliminated of BMI effects was more tangible for non-obese participants regarding WC (PE=127%; 95%CI (126,128)) and WHR (PE=97%; 95%CI (96,98)) for coronary heart disease (CHD), and WHR (PE=92%; 95%CI (91,94)) for stroke, respectively. With respect to sex, the proportion eliminated of BMI effects was more tangible for non-obese participants regarding WHR (PE=428%; 95%CI (408,439)) for CHD in males, and WC (PE=99%; 95%CI (89,111)) for stroke in females, respectively. Conclusion: These results indicate different potential effects of eliminating central obesity on the association between BMI and cardiovascular outcomes for males and females. (Arq Bras Cardiol. 2021; 116(5):879-886)
Subject(s)
Humans , Male , Female , Aged , Obesity, Abdominal/complications , Body Mass Index , Likelihood Functions , Risk Factors , Waist-Hip Ratio , Waist Circumference , Middle Aged , Obesity/complicationsABSTRACT
Objective: To evaluate the success rate of the Nationalnewborn screening program in maintenance of intelligent quotient(IQ) of children with congenital hypothyroidism in Iran.Design: Retrospective cohort study.Methods: The IQ scores, in three subsets of verbal, non verbal(Performance) and full scale IQ, of 240 children diagnosed withTransient congenital hypothyroidism (TCH) and Permanentcongenital hypothyroidism (PCH), from 5 provinces in 5 differentgeographical areas of Iran, were measured at the age of 6 yearsusing revised Wechsler pre school and primary scale ofintelligence and compared with 240 healthy children. We usedindependent sample t test and two-way ANOVA for data analysis. Results: Mean of verbal, performance, and full scale IQ scoreswere lower in the CH cases (permanent and transient) than thecontrol group. Most of the IQ differences in two studied groupsrelated to the PCH cases (P=0.005). Mean difference of IQsbetween children in the two groups in Yazd province (center ofIran) was higher than other provinces, and they also hadsignificantly lower IQ than their control (healthy) children(P=0.001). No treated child had IQ<70.Conclusion: Although mean IQs of CH children was lower thantheir controls, IQ of all treated CH cases were close to the healthychildren
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Background: Obesity is a major public health issue and the prevalence has increased in both the industrialized and developing world. Fruit and vegetable intake has been proposed to protec against Obesity. The purpose of this paper was to assess knowledge and perceptions of obesity prevention and consumption of fruits and vegetables among high school girl students in Shahr-ekord. Methods: This descriptive- cross-sectional survey was done on 308 high school girl students, aged 13-14 years, who were selected, based on a simple random selection method from eight schools. Data collected using a Food Frequency Questionnaire (FFQ) and researcher-made Questionnaire were based on Health Belief Model. Finally, data collected were analyzed by SPSS16. Results: The findings showed the mean score of knowledge was 39.14±20.40, perceived susceptibility: 31.65±16.40, perceived severity: 36.31±20.02, perceived benefit: 42.69±19.55 and perceived barriers was 40.50±18.59. There was a statistically significant and direct relationship between knowledge and perceived susceptibility and perceived benefit. The number of consumed units per day for fruits was 1.42 and the number of consumed serving per day for vegetables was 1.46. Also there was a statistically significant and indirect relationship between BMI of students with fruit and vegetables intake. Conclusions: The low level of appropriate practice of fruit and vegetable consumption by students in the study area needs to be improved by health workers and teachers via the mass media, health talks and one-on-one health education of students.
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Cancer is becoming an increasingly important cause of premature mortality in developing countries as their populations expand and their lifestyle becomes westernized. The aim of this study was to determine the frequency distribution of various neoplasms among Iranian inpatients, their demographic status and length of stay involved in hospitals during 2000-2002. Records of 17447 inpatients who were hospitalized with malignant tumors in Iranian public hospitals during 2000-2002 were studied. The neoplasms had been coded and classified according to International Classification of Diseases, 10th Revision (ICD-10). The frequency distribution of cancer patients was evaluated by age, sex, place of residence and the length of stay at hospital. There were 9470 male patients (54.3%) and 7977 females (45.7%). The mean +/- sd age was 51.2+/-20.6 with a median of 55 years. The average for females (49.4+/-19.2 yrs) was significantly lower than that for males (52.8+/-21.7 yrs) (p<0.001). The five most common cancer sites were the digestive organs (27.6%) followed by lymphoid and haematopoitic tissues (21.4%), breast (10.2%), respiratory and intrathoracic organs (8.8%) and skin (6%). These accounted for 74% of all malignancies. Some 31% of women's cancers were found in breast or genital organs compared to only 7.6% for males. The male/female ratio was 1.19 with the highest being 2.85 for respiratory organs and the lowest being 0.04 for breast. Mean age of male patients with cancer of the digestive organs, respiratory and intrathoracic organs and skin was significantly lower than that of females (p<0.001). The median length of stay of patients in hospitals each time they were admitted was 6 days. Of the cancer patients, 77.7% lived in urban areas which include only 64.5% of the population. Rural patients with skin cancer accounted for 32.1%. In conclusion, the results of this study carry important implications for future health planning strategies and provide a baseline for further studies on the evaluation of malignancies in Iran.