Abdominal obesity and reduction of glomerular filtration

SUMMARY The objective was to evaluate the association between nutritional status and the glomerular filtration rate (GFR) in remaining quilombolas. Cross-sectional study carried out on 32 remaining quilombola communities in the municipality of Alcântara-MA. The nutritional indicators (IN) used were: body mass index (BMI); Waist circumference (WC); Waist-to-hip ratio (WHR); Waist-to-height ratio (WHtR); conicity index (CI) and estimated visceral adipose tissue (VAT). GFR was estimated from the CKD-EPI creatinine-cystatin C formula. The Shapiro Wilk test was used to evaluate the normality of the quantitative variables. In order to compare the second IN sex, the chi-square test was applied. The Anova or Kruskal-Wallis tests were used to verify the association between IN and GFR. Of the 1,526 remaining quilombolas studied, 89.5% were black or brown, 51.2% were women, 88.6% belonged to economic classes D and E and 61.2% were farmers or fishermen. Clinical investigation revealed 29.2% of hypertensive patients, 8.5% of diabetics and 3.1% with reduced GFR. The BMI revealed 45.6% of the remaining quilombolas with excess weight. When compared to men, women presented a higher prevalence of overweight by BMI (56.6% vs 33.8%, p <0.001) and abdominal obesity CC (52.3% vs 4.3%), WHR (76,5% vs 5.8%), WHtR (82.3% vs 48.9%) and VAT (27.1% vs 14.5%) (p <0.001). Comparing the means of IN according to the GFR, it was observed that the higher the mean value of the IN lower the GFR (p <0.05). The GFR reduced with increasing mean values of nutritional indicators of abdominal obesity, regardless of sex.

RESUMO O objetivo foi avaliar a associação entre o estado nutricional e a taxa de filtração glomerular (TFG) em remanescentes quilombolas. Estudo transversal, realizado em 32 comunidades remanescentes de quilombolas, no município de Alcântara - MA. Os indicadores nutricionais (IN) utilizados foram: índice de massa corporal (IMC); circunferência da cintura (CC); relação cintura-quadril (RCQ); relação cintura-estatura (RCEst); índice de conicidade (Índice C) e tecido adiposo visceral estimado (TAVe). A TFG foi estimada a partir da fórmula do CKD-EPI creatinina-cistatina C. O teste Shapiro Wilk foi utilizado para avaliar a normalidade das variáveis quantitativas. Para comparar os IN segundo sexo foi aplicado o teste qui-quadrado. Os testes Anova ou Kruskal-Wallis foram usados para verificar a associação entre os IN e a TFG. Dos 1.526 remanescentes quilombolas estudados, 89,5% eram da cor preta ou parda, 51,2% eram mulheres, 88,6% pertenciam às classes econômicas D e E e 61,2% eram lavradores ou pescadores. A investigação clínica revelou 29,2% de hipertensos, 8,5% de diabéticos e 3,1% com TFG reduzida. O IMC revelou 45,6% dos remanescentes quilombolas com excesso de peso. Quando comparadas aos homens, as mulheres apresentaram maior prevalência de excesso de peso pelo IMC (56,6% vs. 33,8%; p <0,001) e obesidade abdominal CC (52,3% vs. 4,3%), RCQ (76,5% vs. 5,8%), RCEst (82,3% vs. 48,9%) e TAVe (27,1% vs. 14,5%) (p<0,001). Comparando as médias dos IN segundo a TFG observou-se que, quanto maior o valor médio dos IN, menor a TFG (p<0,05). A TFG foi reduzida com o aumento dos valores médios dos indicadores nutricionais de obesidade abdominal, independentemente do sexo.

Predictors of subclinical atherosclerosis evaluated by carotid intima-media thickness in asymptomatic young women with type 1 diabetes mellitus

ABSTRACT Objective This study aimed to evaluate the occurrence and clinical predictors of subclinical atherosclerosis in asymptomatic, young adult women with type 1 DM. Subjects and methods The study included 45 women with type 1 diabetes mellitus (DM) (aged 36 ± 9 years) who underwent carotid Doppler ultrasound evaluation to determine the carotid artery intima-media thickness (CIMT) and to assess the occurrence of carotid artery plaques. Insulin sensitivity was assessed by estimated glucose disposal rate (eGDR), and metabolic syndrome (MS) was defined by the World Health Organization criteria. Results The cohort had a mean age of 36 ± 9 years, diabetes duration of 18.1 ± 9.5 years, and body mass index (BMI) of 24.6 ± 2.4 kg/m2. MS was present in 44.4% of the participants. The CIMT was 0.25 ± 0.28 mm, and the prevalence of carotid artery plaques was 13%. CIMT correlated positively with hypertension (p = 0.04) and waist-to-hip ratio (r = 0.37, p = 0.012). The presence of carotid artery plaques correlated positively with age (p = 0.018) and hypertension (p = 0.017). eGDR correlated negatively with CIMT (r = -0.39, p = 0.009) and carotid plaques (p = 0.04). Albuminuria showed a correlation trend with CIMT (p = 0.06). Patients with carotid artery plaques were older, had a higher prevalence of hypertension, and lower eGDR. No correlation was found between CIMT and carotid plaques with diabetes duration, MS, BMI, cholesterol profile, glycated hemoglobin, high-sensitivity C-reactive protein, or fibrinogen. Conclusion Insulin resistance, central obesity, hypertension, and older age were predictors of subclinical atherosclerosis in asymptomatic, young adult women with type 1 DM.

O paradigma da biologia de sistemas aplicado às doenças cardiovasculares / The Paradigm of Systems Biology Applied to Cardiovascular Diseases

O método osleriano, baseado na análise individual dos componentes funcionais de um organismo, vem apresentandosinais de esgotamento na tentativa de explicar a fisiopatologia de síndromes complexas como o câncer e as doençascardiovasculares. Por essa razão, vem sendo substituído progressivamente por um novo paradigma: a metodologia dossistemas biológicos. Esse novo modelo busca integrar conhecimentos de diferentes e modernas áreas de pesquisa como as ciências ômicas e a bioinformática, com o objetivo de desenvolver redes biológicas capazes de auxiliar no melhor entendimento dessas síndromes complexas. O objetivo dessa revisão é apresentar ao cardiologista clínico e ao investigador cardiovascular uma nova ferramenta denominada biologia de sistemas e a forma com que ela integra os dados provenientes das ciências ômicas, além de sua contribuição na nova abordagem das doenças cardiovasculares. Foirealizada pesquisa na base de dados Medline, dos principais artigos, até o presente momento, referentes ao cruzamento das palavras-chave em português e em inglês: “biologia de sistemas”, “insuficiência cardíaca”, “síndrome metabólica” e“arritmias cardíacas”; “systems biology”, “heart failure”, “metabolic syndrome” and “cardiac arrhythmias”. Concluiu-se que a biologia de sistemas deverá ser mais empregada para o melhor entendimento de doenças cardiovasculares complexas, como síndrome metabólica, aterosclerose, hipertensão arterial, insuficiência cardíaca e arritmias cardíacas. Cardiologistas, investigadores cardiovasculares, outros profissionais da saúde e pesquisadores da área básica de diferentes campos do conhecimento estarão mais integrados, buscando identificar modelos de redes aplicados à saúde e à doença, aquilo que hoje se denomina medicina em rede.

Based on individual analyses of the functional components of an organism, the oslerian method shows signs of depletion when attempting to explain the pathophysiology of complex syndromes such as cancer and cardiovascular diseases. This is why it isgradually being supplanted by a new paradigm: the methodology of biological systems. This new model strives to integrate knowledge in different modern research areas with the omics sciences and bioinformatics, in order to develop biological networks leading to abetter understanding of these complex syndromes. The purpose of this review is to introduce clinical cardiologists and cardiovascular researchers a new tool called systems biology, showing how it integrates data from the omics sciences and its contribution to a new approach to cardiovascular disease. To date, a search of the Medline database has been conducted with the following key words inPortuguese and English: “biologia de sistemas”, “insuficiência cardíaca”, “síndrome metabólica” e “arritmias cardíacas”; “systemsbiology”, “heart failure”, “metabolic syndrome” and “cardiac arrhythmias”. This led to the conclusion that systems biology must be used to an increasing extent for a better understanding of complex cardiovascular diseases such as metabolic syndrome, atherosclerosis, hypertension, heart failure and cardiac arrhythmias. Cardiologists, cardiovascular researchers, other healthcare practitioners and basic researchers in other fields of knowledge will build up closer links in a quest to identify health and disease network models that are now called network medicine.

Prevalencia de obesidad abdominal en una población rural del estado portuguesa / Prevalence of abdominal obesity in a rural population of the portuguese state

La obesidad afecta a más de mil millones de personas en el mundo según la Organización Mundial de la Salud (OMS). El exceso de peso condiciona la aparición de otras enfermedades crónicas no transmisibles. Venezuela es el país con mayor prevalencia de obesidad en Suramérica por lo que su prevención es una exigencia inmediata. Se realizó un estudio descriptivo, transversal, durante el año 2014, utilizando una muestra no probabilística. Se estudiaron 264 adultos residenciados en San Nicolás o en sus caseríos aledaños del Estado Portuguesa. Se aplicó un instrumento que incluía: datos de identificación, antecedentes familiares, antecedentes personales, hábitos psicobiológicos, circunferencia abdominal, tensión arterial e índice de masa corporal (IMC). 23% de los hombres y 63% de las mujeres presentaron un perímetro abdominal que confiere alto riesgo según la OMS. La población que presentó mayor frecuencia de obesidad abdominal fueron las mujeres entre 30 y 49 años con 46,5% (n=60), seguidas por el grupo de mujeres entre 18 y 29 años con una frecuencia de 21,9% (n=28). La población menos afectada fueron los hombres mayores de 70 años. Al relacionar IMC y obesidad abdominal se determinó que el grupo con mayor frecuencia de obesidad abdominal eran las mujeres con sobrepeso, seguidas por las mujeres con obesidad grado I. La obesidad abdominal afecta una quinta parte de los hombres y tres quintas partes de las mujeres de la población rural venezolana estudiada.Las mujeres en edad productiva fueron el grupo más afectado(AU)

Obesity affects more than one billion people in the world becoming one of the major health problems nowadays according to the World Health Organization (WHO). Obesity is associated with the occurrence of other chronic non transmissible diseases. According to WHO statistics, Venezuela is the country with more obesity prevalence in South America; for that reason prevention health plans are an immediate requirement. A descriptive, crosssectional study was conducted during 2014 using a nonrandom sample selected from the population of San Nicolas and its surrounding villages. 264 people were included. An instrument of data collection was applied that included: identification data, family and personal history, psychobiological habits, , waist circumference, blood pressure and body mass index.. Of the sample, 33.33% (n88) were men. Twenty three percent of men and 63% of women had a waist circumference in high risk according to the WHO. The the group of women between 30 and 49 years with 46.5% (n60) followed for women between 18 and 29 years with 21.9% (n28). higher abdominal obesity and the group of men over 70 years with 0.8% (n2).was less affected In relation to BMI and abdominal obesity it was determined that the group with higher frequency of abdominal obesity was overweight women with a percentage of 37.5% (n48); followed by women presenting with Grade I obesity a percentage of 16.2% (n31)(AU)

Does Abdominal Obesity Accelerate the Effect of Hypertriglyceridemia on Impaired Fasting Glucose?

PURPOSE: This study sought to determine whether abdominal obesity is a risk factor for impaired fasting glucose (IFG) and hypertriglyceridemia and to verify whether moderate effect of abdominal obesity on the relationship between IFG and hypertriglyceridemia in Korea. MATERIALS AND METHODS: Data from the Korean National Health and Nutrition Examination Survey was used for the analysis. The study population included 5,938 subjects aged 20 year old drawn from non-diabetic participants in a health examination survey. The subjects were classified according to the presence of abdominal obesity based on waist circumference, IFG based on their fasting blood glucose level, and hypertriglyceridemia on their fasting triglyceride. RESULTS: The multivariate-adjusted odds ratios for the occurrence of hypertriglyceridemia were 2.91 in the abdominal obesity group as compared with the nonobesity group and 1.31 in subjects with IFG compared with the normoglycemia controls. Abdominal obesity was found to be positively moderated in the interaction between waist circumference and fasting blood sugar. CONCLUSION: The moderate effect between abdominal obesity and IFG contributes to the development of hypertriglyceridemia in Korea.