Influência da menopausa, idade, etnia e do sexo sobre as lipoproteínas e suas subfrações nas três fases da vida (adolescentes, adultos e idosos) / Influence of menopause, age, ethnicity and sex on lipoproteins and their subfractions in the three stages of life (adolescents, adults and the elderly)

Introdução: A prevalência de doenças cardiovasculares tem crescido em todo o mundo. Além da hipercolesterolemia, fatores como o envelhecimento, menopausa, diferenças no metabolismo do colesterol entre homens e mulheres e entre etnias, provavelmente contribuem para as prevalências dessas doenças. Objetivo: Avaliar a influência da menopausa, da idade (adolescentes, adultos e idosos), do sexo e da etnia sobre as subfrações lipoproteicas aterogênicas. Métodos: Trata-se de um estudo transversal, de base populacional e amostra probabilística de residentes da cidade de São Paulo. Foram utilizados dados de participantes "ISA-CAPITAL 2015" que tiveram coleta de dados bioquímicos. Foram realizadas análises de partículas de LDL e HDL respectivamente, em 827 amostras. O tamanho das partículas de LDL e HDL foi determinado pelo sistema Lipoprint® System (Quantimetrix Corporation. Todos os testes estatísticos foram realizados com o auxílio do programa SPSS 16. Foi considerado significativo p<0,05. Resultados: As análises com adolescentes mostraram que as meninas apesar de possuírem maior IMC, CC e concentração de TG, apresentaram melhor perfil de subfrações de LDL (LDL grande% 17,8; LDL pequena% 1,7) do que os meninos (LDL grande% 13,5; LDL pequena% 3,4) p<0,001 e p=0,002, respectivamente. Entre os indivíduos adultos, foi identificado um perfil mais aterogênico entre homens, com maior percentual de LDL pequena, quando comparados às mulheres (4,9% vs 2,7%; p<0,001, respectivamente). Com relação à população idosa, os resultados demonstraram que apesar do avanço da idade, as idosas quando comparadas aos idosos possuíam maior concentração LDL grande (32,5mg/dL vs 28,5mg/dL; p=0,007 respectivamente). As mulheres idosas tiveram uma piora das subfrações lipoproteicas se comparadas com as mulheres adultas (razão de LDL mg/dL=12,3 mulheres adultas vs 10,7 mulheres idosas; p=0,002) se aproximando ao perfil mais aterogênico encontrado entre os homens (razão de LDLmg/dL=9,9 homens adultos vs 9,0 homens idosos; p=0,027). Entretanto, quando pareadas por homens de mesma idade, as mulheres idosas, ainda assim, demonstraram um perfil menos aterogênico do que os homens idosos (razão de LDL mg/dL=10,7 mulheres idosas vs 9,0 homens idosos; p=0,001). Ao analisar a presença de menopausa, foi identificado que as mulheres no período pós menopausa tiveram piora do perfil lipídico clássico com aumento do IMC (p=0,025), CC (p<0,001), glicose (p<0,001), PAS (p<0,001), PAD (p=0,005) e TG (p<0,001), assim como tiveram piora do perfil lipoproteico com diminuição de LDL grande% quando comparadas com as mulheres no período pré menopausa (17,6% vs 14,6%; p=0,001). Quanto à etnia, foi identificado que os indivíduos brancos apresentaram valores maiores para IMC (p=0,005), CC (p=0,001), glicose (p=0,015) e TG (p=0,010). Após ajustes para etnia, idade e IMC, houve associação positiva com HDL grande (=0,122; R2=0,013; p=0,001), demonstrando maior aterogenicidade entre os indivíduos brancos. Conclusão: Em todas as faixas etárias o sexo feminino apresentou perfil menos aterogênico quando comparado ao masculino. A presença de menopausa e da etnia branca demonstrou um perfil lipídico clássico e lipoproteico mais aterogênico.

Introduction: The prevalence of cardiovascular diseases has increased throughout the world. In addition to hypercholesterolemia, factors such as aging, menopause, differences in cholesterol metabolism between men and women and between ethnicities probably contribute to the prevalence of these diseases. Objective: To evaluate the influence of menopause, age (adolescents, adults and elderly), sex and ethnicity on atherogenic lipoprotein subfractions. Methods: This is a cross-sectional, population-based study with a probabilistic sample of residents of the city of São Paulo. Data from "ISA-CAPITAL 2015" participants who had biochemical data collected were used. LDL and HDL particle analyzes were carried out respectively in 827 samples. The size of LDL and HDL particles was determined using the Lipoprint® System (Quantimetrix Corporation. All statistical tests were performed with the aid of the SPSS 16 program. Was considered significant p<0.05. Results: Analyzes with adolescents showed that girls, despite having higher BMI, WC and TG concentration, presented a better profile of LDL subfractions (LDL large% 17.8; LDL small% 1.7) than boys (LDL large% 13.5; LDL small% 3.4) p<0.001 and p=0.002, respectively. Among adult individuals, a more atherogenic profile was identified among men, with a higher percentage of LDL small, when compared to women (4.9% vs 2.7%; p<0.001, respectively). Regarding the elderly population, the results demonstrated that despite advancing age, elderly women, when compared to elderly men, had a higher large LDL concentration (32.5mg/dL vs 28.5mg/dL; p=0.007 respectively). Elderly women had a worsening of lipoprotein subfractions compared to adult women (LDL ratio mg/dL=12.3 adult women vs 10.7 elderly women; p=0.002) approaching the more atherogenic profile found among men (LDLmg/dL ratio=9.9 adult men vs 9.0 elderly men; p=0.027). However, when paired with men of the same age, elderly women still demonstrated a less atherogenic profile than elderly men (LDL ratio mg/dL=10.7 elderly women vs 9.0 elderly men; p=0.001). When analyzing the presence of menopause, it was identified that women in the postmenopausal period had a worsening of the classic lipid profile with an increase in BMI (p=0.025), WC (p<0.001), glucose (p<0.001), SBP (p< 0.001), DBP (p=0.005) and TG (p<0.001), as well as a worsening of the lipoprotein profile with a reduction in LDL large when compared to women in the premenopausal period (17.6% vs 14.6%; p=0.001). Regarding ethnicity, it was identified that white individuals presented higher values for BMI (p=0.005), WC (p=0.001), glucose (p=0.015) and TG (p=0.010). After adjustments for ethnicity, age and BMI, there was a positive association with HDL large (=0.122; R2=0.013; p=0.001), demonstrating greater atherogenicity among white individuals. Conclusion: In all age groups, females presented a less atherogenic profile when compared to males. The presence of menopause and white ethnicity demonstrated a more atherogenic classic lipid and lipoprotein profile.

Relação entre indicadores de risco à saúde e componentes do somatótipo consoante atividade física em crianças / Relación entre indicadores de riesgo para la salud y componentes del somatótipo según la actividad física en niños / Relationship between health risk indicators and somatotype components according to physical activity in children

Este estudo analisou a relação entre indicadores de risco à saúde e as componentes do somatótipo consoante os níveis de atividade física em crianças. Trata-se de uma pesquisa epidemiológica de base escolar, composta por 168 crianças (6 a 11 anos) de ambos os sexos. Informações demográficas foram obtidas. Avaliações antropométricas (estatura; massa corporal; pregas de adiposidade subcutânea; perímetros do braço contraído, cintura, quadril e panturrilha), pressão arterial sistólica e diastólica, e atividade física (ativo; inativo) foram mensuradas. O somatótipo, razão cintura-quadril e razão cintura-estatura foram calculados. Análise de comparação, correlação e regressão linear múltipla foram realizadas, considerando intervalo de confiança de 95%. Meninos apresentaram maior número de passos, razão cintura-quadril e cintura-estatura. Crianças ativas eram mais velhas, possuíam maior perímetro de cintura, quadril e pressão arterial sistólica. No grupo fisicamente ativo, o sexo esteve associado diretamente ao perímetro de cintura e razão cintura-estatura, enquanto a idade associou-se com a perímetro de quadril e pressão arterial diastólica. Nas crianças inativas, todas as variáveis preditoras (exceto para a variável sexo em relação ao perímetro de quadril) mostraram-se significativas para o perímetro da cintura e quadril, explicando, conjuntamente, ~83% e 85% da expressão destas variáveis, respectivamente. A relação entre indicadores de risco à saúde e as componentes do somatótipo foi maior em crianças inativas. Independentemente do nível de atividade física, a endomorfia mostrou relação significativa com os componentes de saúde, com maior efeito no grupo inativo, tendo em vista a associação com a composição corporal dos sujeitos.

Este estudio analizó la relación entre indicadores de riesgo para la salud y los componentes del somatótipo según los niveles de actividad física en niños. Se trata de una investigación epidemiológica, compuesta por 168 niños (6 a 11 años) de ambos sexos. Fueron mensuradas: evaluaciones antropométricas (estatura; masa corporal; pliegues de adiposidad subcutánea; perímetros del brazo contraído, cintura, cuadril y pantorrilla), presión arterial sistólica y diastólica, y actividad física (activo/inactivo); el somatótipo, a través del cálculo de: razón cintura-cuadril y razón cintura-estatura. Se realizó el análisis de comparación, correlación y regresión lineal múltiple, considerando intervalo de confianza del 95%. Los niños presentaron mayor número de pasos, razón cintura-cuadril y cintura-estatura. Los niños activos eran mayores, tenían mayor perímetro de cintura, cuadril y presión arterial sistólica. En el grupo físicamente activo, el sexo estuvo asociado directamente al perímetro de cintura y razón cintura-estatura, mientras que la edad se asoció con el perímetro de cuadril y presión arterial diastólica. En los niños inactivos, todas las variables predictoras (excepto para la variable sexo con relación al perímetro de cuadril) se mostraron significativas para el perímetro de la cintura y cuadril, explicando, conjuntamente, ~83% y 85% de la expresión de estas variables, respectivamente. La relación entre indicadores de riesgo para la salud y los componentes del somatotipo fue mayor en niños inactivos. Independientemente del nivel de actividad física, la endomorfia mostró una relación significativa con los componentes de salud, con mayor efecto en el grupo inactivo, con vistas a la asociación con la composición corporal de los sujetos.

This study analysed the relationship between health risk indicators and somatotype components according to physical activity levels in children. This epidemiological and school-based research comprised 168 children of both sexes (56% boys), aged between 6 to 11 years. Demographic information (sex, age) was obtained. Anthropometric information (body height; body mass; contracted arm, waist, hip, and calf circumferences), body composition (subcutaneous adiposity and somatotype), systolic and diastolic blood pressure, and physical activity level (active; inactive) were measured. The waist-hip ratio and waist-to-height ratio were computed. Comparison, correlation, and multiple linear regression analysis were performed, considering 95% of the confidence interval. Boys presented higher values for physical activity, waist-hip, and waist-to-height ratio. Active children were older, had a larger waist and hip circumference, and higher systolic blood pressure. Among the active group, sex was associated with waist circumference and waist-to-height ratio, while age was associated with hip circumference and diastolic blood pressure. Among inactive children, all predictors (except for sex for hip circumference) were significantly associated with waist and hip circumferences, explaining ≅83% and 85% of the expression of these variables, respectively. The relationship between health risk indicators and somatotype components was higher among inactive children. Regardless of the physical activity level, the endomorphic component shows a significant relationship with health components, with a higher effect among the inactive group, considering the body composition association.

Cardiovascular Risk Factors in Premature Ovarian Insufficiency using Hormonal Therapy / Fatores de risco cardiovascular na insuficiência ovariana prematura em uso de terapia hormonal

Abstract Objective Premature ovarian insufficiency (POI) is characterized by early hypoestrogenism. An increased risk of cardiovascular (CV) disease is a long-term consequence of POI. A challenge of hormone therapy (HT) is to reduce the CV risk. Methods Cross-sectional study with lipid profile analysis (total cholesterol, LDL-C, HDL-C, VLDL-C and triglycerides), blood glucose levels and arterial blood pressure of women with POI using HT, compared with age and BMI-matched women with normal ovarian function (controls). Results The mean age and BMI of 102 POI patients using HT and 102 controls were 37.2 ± 6.0 and 37.3 ± 5.9 years, respectively; 27.0 ± 5.2 and 27.1 ± 5.4 kg/m2. There wasn't difference between groups in arterial systolic and diastolic blood pressure, blood glucose levels, total cholesterol, LDL-C, VLDL-C and triglycerides. HDL-C levels were significantly higher in the POI group (56.3 ± 14.6 and 52 ± 13.9mg/dL; p = 0.03). Arterial hypertension was the most prevalent chronic disease (12% in the POI group, 19% in the control group, p = ns), followed by dyslipidemia (6 and 5%, in POI and control women). Conclusion Women with POI using HT have blood pressure levels, lipid and glycemic profile and prevalence of hypertension and dyslipidemia similar to women of the same age and BMI with preserved gonadal function, in addition to better HDL levels.

Resumo Objetivo A insuficiência ovariana prematura (IOP) é caracterizada pelo hipoestrogenismo precoce. Risco aumentado de doença cardiovascular (CV) é uma consequência a longo prazo da IOP e um desafio da terapia hormonal (TH) é reduzir o risco CV. Métodos Estudo transversal com análise do perfil lipídico (colesterol total, LDL-C, HDL-C, VLDL-C e triglicerídeos), glicemia e pressão arterial de mulheres com IOP em uso de TH, em comparação a mulheres com função ovariana normal (controles) pareadas por idade e IMC. Resultados A média de idade e IMC de 102 pacientes com IOP em uso de TH e 102 controles foi de 37,2 ± 6,0 e 37,3 ± 5,9 anos, respectivamente; 27,0 ± 5,2 e 27,1 ± 5,4 kg/m2. Não houve diferença entre os grupos na pressão arterial sistólica e diastólica, glicemia, colesterol total, LDL-C, VLDL-C e triglicerídeos. Os níveis de HDL-C foram significativamente maiores no grupo IOP (56,3 ± 14,6 e 52 ± 13,9mg/dL; p = 0,03). A hipertensão arterial foi a doença crônica mais prevalente (12% no grupo POI, 19% no grupo controle, p = ns), seguida da dislipidemia (6 e 5%, no grupo POI e controle). Conclusão Mulheres com IOP em uso de TH apresentam níveis pressóricos, perfil lipídico e glicêmico e prevalência de hipertensão e dislipidemia semelhantes às mulheres da mesma idade e IMC com função gonadal preservada, além de melhores níveis de HDL.

High-intensity functional training with an adequate and carbohydrate restricted hypocaloric diet promotes weight loss and cardiometabolic improvements

INTRODUCTION: Excess body weight and its comorbidities represent a major public health issue. Interventions based on diet and exercise have not only been shown to promote weight loss, but also improve overall health, including cardiovascular health. OBJECTIVE: This study aimed to evaluate the effects of a 12-week hypocaloric low-carbohydrate (CHO) diet coupled with high-intensity functional training (HIFT) on the cardiometabolic risk of overweight adults. METHODS: This is a randomized controlled trial. A total of 31 overweight adults participated in this study, divided into two groups based on the dietary intervention: reduced-CHO (R-CHO, ≤130 g/day; n=15) and adequate-CHO (A-CHO, >130 g/day; n=16). The cardiometabolic risk was assessed using lipidaemic, insulinemia, and glycaemic parameters. A two-way ANOVA with Bonferroni post hoc test was utilized to evaluate the effects of the intervention. A p-value < 0.05 was considered statistically significant. RESULTS: Participants from both groups displayed decreased low-density lipoprotein, very-low-density lipoprotein, total cholesterol, and triacylglycerol concentrations, as well as the number of risk factors for the metabolic disease after 12 weeks. The high-density lipoprotein (HDL) cholesterol concentration of both groups increased after 12 weeks, however, the result of the intragroup analysis revealed that a significant increase was only observed in the participants from the A-CHO group. CONCLUSION: Reduced or adequate CHO intake was both found to be effective in reducing cardiometabolic risk. However, improvements in HDL and final cardiometabolic classification risk indicated that CHO adequacy in the diet might be a better strategy associated with caloric restriction and HIFT.

Accuracy and capability of tri-ponderal mass index in assessing cardio-metabolic risk factors in Chinese children and adolescents aged 3 to 17 years, compared with body mass index / 中华医学杂志(英文版)

BACKGROUND@#Tri-ponderal mass index (TMI) has been reported to be a more accurate estimate of body fat than body mass index (BMI). This study aims to compare the effectiveness of TMI and BMI in identifying hypertension, dyslipidemia, impaired fasting glucose (IFG), abdominal obesity, and clustered cardio-metabolic risk factors (CMRFs) in 3- to 17-year-old children.@*METHODS@#A total of 1587 children aged 3 to 17 years were included. Logistic regression was used to evaluate correlations between BMI and TMI. Area under the curves (AUCs) were used to compare discriminative capability among indicators. BMI was converted to BMI- z scores, and accuracy was compared by false-positive rate, false-negative rate, and total misclassification rate.@*RESULTS@#Among children aged 3 to 17 years, the mean TMI was 13.57 ± 2.50 kg/m 3 for boys and 13.3 ± 2.33 kg/m 3 for girls. Odds ratios (ORs) of TMI for hypertension, dyslipidemia, abdominal obesity, and clustered CMRFs ranged from 1.13 to 3.15, higher than BMI, whose ORs ranged from 1.08 to 2.98. AUCs showed similar ability of TMI (AUC: 0.83) and BMI (AUC: 0.85) in identifying clustered CMRFs. For abdominal obesity and hypertension, the AUC of TMI was 0.92 and 0.64, respectively, which was significantly better than that of BMI, 0.85 and 0.61. AUCs of TMI for dyslipidemia and IFG were 0.58 and 0.49. When 85th and 95th of TMI were set as thresholds, total misclassification rates of TMI for clustered CMRFs ranged from 6.5% to 16.4%, which was not significantly different from that of BMI- z scores standardized according to World Health Organization criteria.@*CONCLUSIONS@#TMI was found to have equal or even better effectiveness in comparison with BMI in identifying hypertension, abdominal obesity, and clustered CMRFs TMI was more stable than BMI in 3- to 17-year-old children, while it failed to identify dyslipidemia and IFG. It is worth considering the use of TMI for screening CMRFs in children and adolescents.

El Estimador de Sensibilidad Insulínica de Punto Único (SPISE) supera a marcadores antropométricos de uso rutinario en la pesquisa de riesgo cardiometabólico asociado a obesidad: un estudio en adolescentes de la Región Metropolitana / The single Point Insulin Sensitivity Estimator (SPISE) outperforms routine anthropometric markers in the screening of obesity-related cardiometabolic risk: a study in adolescents from the Metropolitan Region

El Estimador de Sensibilidad a la Insulina de Punto Único (SPISE) es un biomarcador de sensibilidad a la insulina comparable al Índice de Matsuda. Se estima utilizando el IMC y los niveles de triglicéridos y HDL. El objetivo de este estudio fue comparar el rendimiento diagnóstico de SPISE con el de otros marcadores antropométricos de uso rutinario, como el IMC y la relación cintura | talla, en la pesquisa de insulinoresistencia (IR) y Síndrome Metabólico (MetS) en una muestra de 901 adolescentes de 11 a 16 años. En todos ellos se midió peso, talla, cintura, presión arterial, perfil lipídico, insulina y glicemia. La IR se diagnosticó con el HOMA-IR y el MetS con el criterio de Cook. Un zIMC ≥2.0 DE, un índice cintura/ talla ≥0.54 y un SPISE ≤ 5.4 fueron los puntos de corte utilizados para evaluar el rendimiento de estos marcadores en el diagnóstico de IR y MetS. No hubo diferencias por sexo en la prevalencia de obesidad, IR y MetS. Tanto en hombre como en mujeres, SPISE mostro una mejor capacidad para predecir el MetS (AUC: 0.95 y 0.89, respectivamente) e IR (AUC: 0.83 y 0.79, respectivamente) comparado con el rendimiento diagnóstico de la relación cintura | talla y el IMC-z. De igual manera, el SPISE mostro una mayor sensibilidad para identificar a los portadores de MetS e IR (96% y 75% en varones y 81% y 67% en mujeres, respectivamente). SPISE mostró una mejor capacidad para identificar el riesgo cardiometabólico asociado a la malnutrición por exceso al compararlo con otros indicadores de uso frecuente en clínica. Un índice de SPISE ≤5.4 fue un mejor predictor de MetS e IR que un IMC ≥2.0 DE y una relación cintura | talla ≥0.54.

The Single Point Insulin Sensitivity Estimator (SPISE) is a biomarker of insulin sensitivity comparable to the Matsuda Index. It is estimated using data on BMI, TG, and HDL. We aim to compare the diagnostic performance of SPISE with other routinely used anthropometric markers, such as BMI and waist-to-height ratio, in diagnosing insulin resistance (IR) and Metabolic Syndrome (MetS) in adolescents from 11 to 16 years. Weight, height, waist, blood pressure, lipid profile, insulin, and glycemia were measured. IR was diagnosed with the HOMA-IR and the MetS with the Cook criteria. A BMIz ≥2.0 SD, a waist-to-height ratio ≥0.54, and a SPISE ≤ 5.4 were the cut-off points used for diagnosing IR and MetS. There were no sex differences in the prevalence of obesity, IR, and MetS. In both males and females, SPISE showed a better ability to predict MetS (AUC: 0.95 and 0.89, respectively) and IR (AUC: 0.83 and 0.79, respectively) compared to the waist-to-height ratio and BMI-z. Similarly, SPISE showed greater sensitivity to identify adolescents with MetS and IR (96% and 75% in men and 81% and 67% in women, respectively) than the waist-to-height ratio and BMI-z. SPISE performed better in identifying obesity-related cardiometabolic risk than other frequently used clinical indicators. A SPISE index ≤5.4 was a better predictor of MetS and RI than a BMI ≥2.0 SD and a waist-to-height ratio ≥0.54.

Efeito da dieta hipocalórica na pressão arterial e demais cofatores da síndrome metabólica / Effect of hypocaloric diet on blood pressure and other cofactors of metabolic syndrome

Introdução: a hipertensão arterial sistêmica (HAS) está associada a fatores de risco metabólicos e pode ser definida como uma doença crônica multifatorial, com valores persistentes de pressão arterial sistólica (PAS) e (ou) pressão arterial diastólica (PAD) maiores ou iguais a 140 mmHg x 90 mmHg, respectivamente. A HAS é um dos fatores que compõem a síndrome metabólica (SM) juntamente com a hiperglicemia, dislipidemia e (ou) obesidade central. Modificações no estilo de vida, como a alimentação e perda de peso, demonstraram melhorar os parâmetros cardiometabólicos nos pacientes com HAS e SM. Objetivo: verificar o efeito de uma dieta hipocalórica na antropometria, na pressão arterial e em outros cofatores da síndrome metabólica. Metodologia: trata-se de um ensaio clínico não randomizado, retrospectivo, com dados secundários, em que o mesmo grupo foi de "intervenção" e "comparador", e cujos dados foram coletados antes (baseline) e após a intervenção. A pesquisa foi realizada com 84 pacientes, adultos, com síndrome metabólica, de ambos os sexos. Os pacientes seguiram dieta com restrição calórica de 200 a 500kcal/dia, com cálculo energético em torno de 20kcal/kg de peso, valor energético total não inferior a 1200kcal, durante um período de dois meses. Foi utilizada estatística descritiva e o teste t pareado ou Wilcoxon-Sign-Rank intragrupo para analisar as variações ao longo do tempo (p < 0,05). Resultado:houve uma redução na antropometria (índice de massa corporal, circunferência da cintura, circunferência do braço e circunferência do quadril), PAS e PAD, glicemia de jejum e triglicerídeos com p< 0,05 dos pacientes após a intervenção, mas não houve melhora no HDL (p > 0,05). Conclusão: a dieta hipocalórica reduziu as medidas antropométricas, a pressão arterial e os demais cofatores da SM nos pacientes avaliados após o acompanhamento de dois meses.

Introduction: systemic arterial hypertension (SAH) is associated with metabolic risk factors and can be defined as a multifactorial chronic disease, with persistent values of systolic blood pressure (SBP) and (or) diastolic blood pressure (DBP) greater than or equal to 140 mmHg x 90 mmHg, respectively. SAH is one of the factors that make up the metabolic syndrome (MS) along with hyperglycemia, dyslipidemia and (or) central obesity. Lifestyle modifications, such as diet and weight loss, have been shown to improve cardiometabolic parameters in patients with SAH and MS. Objective: to verify the effect of a hypocaloric diet on anthropometry, blood pressure and other cofactors of the metabolic syndrome. Methodology: this is a non-randomized, retrospective clinical trial, with secondary data, in which the same group was "intervention" and "comparator", and whose data were collected before (baseline) and after the intervention. Research was carried out with 84 patients, adults, with metabolic syndrome, of both sexes. Patients followed a calorie-restricted diet of 200 to 500kcal/day, with energy calculation around 20kcal/kg of weight, total energy value not less than 1200kcal, during a period of two months. Descriptive statistics and the paired t test or intragroup Wilcoxon-Sign-Rank were used to analyze variations over time (p < 0.05). Result: there was a reduction in anthropometry (body mass index, waist circumference, arm circumference and hip circumference), SBP and DBP, fasting glucose and triglycerides with p<0.05 of patients after the intervention, but there was no improvement in HDL (p > 0.05). Conclusion: the hypocaloric diet reduced anthropometric measurements, blood pressure and other MS cofactors in the patients evaluated after a two-month follow-up.

Riesgo cardiometabólico en pacientes con hipertensión arterial esencial no complicada / Cardiometabolic risk in patients with uncomplicated essential arterial hypertension

Introducción: La evaluación del riesgo cardiometabólico en pacientes con hipertensión arterial esencial es vital y constituye un reto diagnóstico. Objetivo: Evaluar el comportamiento del riesgo cardiometabólico en pacientes con hipertensión arterial esencial no complicada. Métodos: Se realizó una investigación descriptiva y transversal en 100 pacientes hipertensos sin lesión en órgano diana a los que se les realizó historia clínica, glucemia, hemoglobina glicosilada, lipidograma y ácido úrico. Se correlacionaron con el índice de masa corporal, el tiempo de evolución de la hipertensión arterial y el riesgo cardiovascular global. Resultados: De los pacientes, el 56 por ciento fueron hombres, el 31 por ciento fumadores, con sobrepeso y obesidad el 83 por ciento, el 86 por ciento eran sedentarios, 71 por ciento no llevaban dieta saludable y 53 por ciento tenían más de 5 años de hipertensos. En los obesos se encuentra una relación significativa con la circunferencia abdominal (110,9 ± 8,9, p=0,000), los triglicéridos (1,8 ± 0,9, p=0,000) y al ácido úrico (374 ± 100,7, p=0,001). La edad (62,9 ± 7,8, p=0,000), la presión arterial sistólica (151,6 ± 15,6, p=0,021), la disminución del HDL (0,9 ± 0,3, p=0,000) y el ácido úrico (349, 3 ± 115,3, p=0,015) se relacionaron significativamente con el riesgo cardiovascular alto. Conclusiones: Los resultados demostraron el valor de parámetros clínicos como la edad, la circunferencia abdominal, el índice de masa corporal y la presión arterial sistólica, así como de parámetros metabólicos como los triglicéridos, el HDL y el ácido úrico en la evaluación del riesgo cardiometabólico y su relación con el riesgo cardiovascular en pacientes hipertensos(AU)

Introduction: Cardiometabolic risk assessment in patients with essential arterial hypertension is vital and a diagnostic challenge. Objective: To evaluate the behavior of cardiometabolic risk in patients with uncomplicated essential hypertension. Methods: A descriptive, cross-sectional study was carried out in 100 hypertensive patients without target organ damage who underwent clinical history, glycemia, glycosylated hemoglobin, lipidogram and uric acid. They were correlated with body mass index, time of evolution of arterial hypertension and global cardiovascular risk. Results: Of the patients, 56percent were men, 31percent were smokers, 83percent were overweight and obese, 86percent were sedentary, 71percent did not have a healthy diet and 53pwercent had been hypertensive for more than 5 years. In the obese, a significant relationship was found with abdominal circumference (110.9 ± 8.9, p=0.000), triglycerides (1.8 ± 0.9, p=0.000) and uric acid (374 ± 100.7, p=0.001). Age (62.9 ± 7.8, p=0.000), systolic blood pressure (151.6±15.6, p=0.021), lower HDL (0.9±0.3, p=0.000) and uric acid (349, 3 ± 115.3, p=0.015) were significantly related to high cardiovascular risk. Conclusions: The results demonstrated the value of clinical parameters such as age, abdominal circumference, body mass index and systolic blood pressure, as well as metabolic parameters such as triglycerides, HDL and uric acid in the evaluation of cardiometabolic risk and its relationship with cardiovascular risk in hypertensive patients(AU)

Overview of Cardiovascular Disease Risk Factors in Adults in São Paulo, Brazil: Prevalence and Associated Factors in 2008 and 2015

Abstract Background Cardiovascular diseases (CVDs) are the main cause of morbidity and mortality in Brazil. Objective To provide population-based data on prevalence and factors associated with CVD risk factors. Methods Individuals aged ≥20 years from two editions of the cross-sectional Health Survey of São Paulo focusing on Nutrition (ISA-Nutrition), performed in Sao Paulo city in 2008 (n=590) and 2015 (n=610), were evaluated for: obesity, central obesity, waist/height ratio, high blood pressure (HBP), dyslipidemia, diabetes, and number of CVD risk factors ≥3. Prevalence was estimated according to complex survey procedures. Factors associated with cardiovascular risk factors were assessed using logistic regression, with statistical significance of p<0.05. Results Obesity and older age were associated with higher odds of all cardiovascular risk factors investigated, except for dyslipidemia. HBP was positively associated with being Black/Brown and negatively associated with being physicaly active in leisure time. Women were more likely to have increased adiposity indicators and three or more cardiovascular risk factors than men. Those with higher education had lower chances of having diabetes, HBP and dyslipidemia, and those with higher income had higher chances of having three or more risk factors. Former smokers had higher odds of diabetes, obesity, and high waist/height ratio, and smokers had higher odds of high non-HDL cholesterol levels. From 2008 to 2015, there was an increase (p<0.001) in the prevalence of diabetes (6.9% to 17.3%), HBP (31.9% to 41.8%), dyslipidemia (51.3% to 67.6%), and number of CVD risk factors ≥3 (18.9% to 34.1%). Conclusion This study shows increasing prevalence of CVD risk factors in adult population in Sao Paulo and may support the definition of target groups and priority actions on CVD prevention and treatment.

Asociación entre la termografía por infrarrojo y parámetros antropométricos de riesgo cardiometabólico en hombres / Association between infrared thermography, anthropometry and cardiovascular risk parameters in men

RESUMEN: Los parámetros antropométricos para la estimación de la composición corporal son variables comúnmente utilizadas en la identificación de factores de riesgo cardiovascular (FRCV). En este sentido la termografía por infrarrojo (TI) podría ser utilizada como una herramienta que aporte información relevante en la evaluación de los FRCV mediante la estimación de la temperatura superficial en la piel y su relación con medidas antropométricas asociadas a estos factores. El objetivo de este estudio fue determinar la relación de la temperatura superficial de hombres adultos con variables antropométricas asociadas a FRCV. Participaron 64 hombres sanos de 26,4 ± 7,8 años, 76,1 ± 13,3 kg de masa corporal, 171,3 ± 7,2 cm de estatura y 25,9 ± 3,7 kg/m2 de índice de masa corporal (IMC). Se realizaron evaluaciones antropométricas de 6 pliegues cutáneos (tricipital, subescapular, supra-espinal, abdominal, muslo medio y pantorrilla), circunferencia de cintura y cadera, además de mediciones de la temperatura superficial mediante TI en las zonas de medición. Se encontraron relaciones significativas negativas entre la temperatura superficial y las mediciones de los pliegues cutáneos a nivel subescapular, supra-espinal, muslo y pantorrilla (p < 0,01; r = -0,39 a -0,55). La temperatura promedio de la TI de los 6-pliegues, y todas las TI individuales de los pliegues presentaron correlaciones negativas significativas con el IMC, perímetro de cintura, índice cintura cadera, índice cintura estatura y la sumatoria de 6 pliegues cutáneos (p < 0,05; r = -0,35 a -0,65). Se puede concluir que existe una relación entre la temperatura superficial de la piel y algunos parámetros antropométricos de la composición corporal que muestran estar asociados a FRCV, pudiendo ser la TI una herramienta útil para complementar la evaluación de estos parámetros.

SUMMARY: Anthropometric parameters for the estimation of body composition are variables commonly used in the identification of cardiovascular risk factors (CVRFs). In this regard, infrared thermography (IT) could be used as a tool that provides relevant information in the CVRFs assessment by estimating skin surface temperature and its relationship with the anthropometric measures associated with these factors. The aim of this study was to determine the relationship of skin surface temperature in adult men with anthropometric variables associated with CVRFs. The study gathered sixty-four healthy men aged 26.4 ± 7.8 years, 76.1 ± 13.3 kg body mass, 171.3 ± 7.2 cm height and 25.9 ± 3.7 kg/m2 body mass index (BMI). Anthropometric assessments of 6 skinfolds (tricipital, subscapular, suprascapular, supraspinal, abdominal, mid-thigh, and calf), waist and hip circumference were conducted, as well as IT surface temperature measurements at the measurement areas. Significant negative relationships were found between surface temperature and skinfold measurements at the subscapular, supraspinal, thigh and calf levels (p < 0.01; r = -0.39 to -0.55). The average IT temperature of the 6- folds and all individual folds IT had significant negative correlations with BMI, waist circumference, waist hip ratio, waist height ratio, and the sum of 6 skinfolds (p < 0.05; r = -0.35 to -0.65). There is a relationship between skin surface temperature and some body composition anthropometric parameters that indicate and association with CVRFs, therefore, IT may be a useful tool to complement the assessment of these parameters.

Lifestyle Intervention in Reducing Cardiometabolic Risk Factors in Students with Dyslipidemia and Abdominal Obesity: A Randomized Study

Abstract Background The long incubation periods of cardiovascular diseases offer opportunities for controlling risk factors. In addition, preventive interventions in childhood are more likely to succeed because lifestyle habits become ingrained as they are repeated. Objective To investigate the effects of recreational physical activities, in combination or not with a qualitative nutritional counseling, in cardiometabolic risk factors of students with dyslipidemia and abdominal obesity. Methods Students (8-14 years old) were randomly divided into three groups (n=23 each): i ) Control; ii ) PANC, students undergoing Physical Activity and Nutritional Counseling, and iii ) PA, students submitted to Physical Activity, only. Blood samples (12-h fasting) were collected for biochemical analysis and anthropometric markers were also assessed. Two-Way RM-ANOVA and Holm-Sidak's test, and Friedman ANOVA on Ranks and Dunn's test were applied. P ≤ 0.05 was considered significant. Effect sizes were evaluated by Hedges' g and Cliff's δ for normal and non-Gaussian data, respectively. Results Compared to the control group and to baseline values, both interventions caused significant average reductions in total cholesterol (11%; p <0.001), LDL-c (19%; p=0.002), and non-HDL-c (19%; p=0.003). Furthermore, students in the PANC group also experienced a significant decrease in body fat compared to baseline (p=0.005) and to control (5.2%; g=0.541). Conclusions The proposed strategies were effective to reduce cardiometabolic risk factors in children and adolescents. The low cost of these interventions allows the implementation of health care programs in schools to improve the students' quality of life.

Department of Internal Medicine, Faculty of Clinical Medicine, College of Health Sciences, Ebonyi State University

INT RODUCTIO N: Th e eld erly h ypert en si ve pa ti ent s of ten h aveincreased prevalence of cardiometabolic risk factors and their attendantco-morbidities. The aim of this study was to determine the prevalenceof cardiometabolic risk factors and blood pressure control among elderlyhypertensive patients, and to determine the influence of modifiablecardiometabolic risk factors on the control of hypertension amongelderly hypertensive patients.SUBJECTS AND METHODS: A case-control comparative and hospital-based study involving a total of 190 consenting elderly (>65 years),hypertensive patients (subjects) (n=100) and normotensive controls(n=90) was carried out over a period of ten months. Using interviewer-administered questionnaire, biodata and information regarding theirlifestyle was obtained. Standard protocols were used to measure bloodpressure, weight, height, waist circumference, fasting plasma glucoseand fasting lipid profile of the subjects. Body mass index was derivedfrom weight and height.RESULTS: The mean age of the subjects was 71.5 ± 6.3 years and thecontrols was 72.3 ± 7.2 years. Forty-eight percent (48%) and 47.8% ofthe subjects and controls were females (p = 0.651). The level of controlof hyperten sion was poor in over two-thirds (68%) of the elderlyhypertensive patients. The prevalence of modifiable cardiometabolicrisk factors burden was higher in the hypertensive subjects when comparedwith the controls. Prevalence of Dyslipidaemia was 76% in the subjectsand 51% in the controls (p = 0.004). Prevalence of Diabetes Mellituswas 40% among the subjects and 17.8% in the controls (p = 0.0001);prevalence of Obesity was 24% in the subjects and 4.4% in the controls(p=<0.001); prevalence of excess alcohol intake was 49% in the subjectsand 14.4% in the controls (p=<0.001). Prevalence of sedentary lifestyle was high in both the subjects (53%) and controls (50%), p=0.679.Poor blood pressure control was predicted by dyslipidaemia and centralobesity.CONCLUSION: The level of control of hypertension was poor amongthe elderly and modifiable cardiometabolic risk factors were relativelyprevalent. Central obesity and dyslipidaemia were predictive of poorcontrol of hypertension. Addressing these factors may therefore improveblood pressure control

Aumento do risco cardiovascular em mulheres com síndrome do ovário policístico / Increased cardiovascular risk in women with polycystic ovary syndrome

Objetivo: A síndrome dos ovários policísticos (SOP) é uma alteração endócrina comum em mulheres que estão em fase reprodutiva. Essa patologia pode estar relacionada a fatores de risco para o desenvolvimento de complicações cardiometabólicas, o que a torna um tema relevante para discussão, visto sua grande prevalência na população feminina. Trata-se de uma revisão integrativa da literatura com o objetivo de identificar os fatores de risco associados à SOP e verificar se há maior risco cardiovascular para as mulheres com essa síndrome. Fonte de dados: Foi realizada uma busca nas bases de dados Biblioteca Virtual de Saúde, National Library of Medicine, Scientific Eletronic Library Online e EbscoHost, com os seguintes descritores: "Síndrome do ovário policístico e riscos cardiovasculares"; "Mulheres, policístico e riscos cardiovasculares"; "Ovário policístico e riscos" e "Mulheres, ovários policísticos"; "Polycystic ovary and risks"; "Polycystic ovary syndrome and cardiovascular risk" e "Polycystic ovaries and cardiovascular". Seleção de estudos: Foram encontrados 21 artigos, dos quais 15 atenderam aos critérios de inclusão previamente estabelecidos. Foram incluídos os artigos originais e as publicações entre o período de 2014 e 2021 que relacionavam diretamente a síndrome aos riscos cardiovasculares, síndromes metabólicas e alterações lipídicas. Coleta de dados: A estratégia de seleção dos artigos foi realizada mediante busca nas bases de dados selecionadas, leitura dos títulos de todos os artigos encontrados e exclusão daqueles que não abordavam o assunto, leitura crítica dos resumos dos artigos e leitura na íntegra dos artigos selecionados nas etapas anteriores. Síntese de dados: Todos os autores afirmam que a síndrome é um distúrbio ovulatório e metabólico, uma vez que a resistência à insulina e a consequente hiperinsulinemia compensatória podem ser exacerbadas pela coexistência da obesidade, presente em muitas mulheres com SOP. Além disso, foram identificados os fatores de risco tradicionais para o desenvolvimento de doenças cardiovasculares, e 93,33% dos artigos analisados demonstraram que, entre as mulheres com a síndrome, alguns fatores de risco para o desenvolvimento de tais doenças parecem apresentar uma chance maior de estarem presentes. Conclusão: Ao final dessa revisão, foi possível responder à pergunta clínica proposta, pois todos os artigos pesquisados concluíram e trouxeram estudos comprovando que mulheres com a SOP possuem maiores chances de desenvolver algum problema cardiovascular precoce, devido a fatores como o hiperandrogenismo e o aumento da gordura visceral e da resistência insulínica.(AU)

Objective: Polycystic ovary syndrome is an endocrine disorder, common in women who are in the reproductive phase. This pathology may be related to risk factors for the development of cardiometabolic complications, which makes it a relevant topic for discussion, given its high prevalence in the female population. This is an integrative literature review with the aim of identifying the risk factors associated with polycystic ovary syndrome and verifying whether there is a higher cardiovascular risk for women with this syndrome. Data source: A search was performed in the Virtual Health Library databases; National Library of Medicine; Scientific Electronic Library Online and EbscoHost, with the following descriptors: "Polycystic ovary syndrome and cardiovascular risks"; "Women, polycystic and cardiovascular risks"; "Polycystic ovaries and risks" and "Women, polycystic ovaries"; "Polycystic ovary and risks"; "Polycystic ovary syndrome and cardiovascular risk" and "Polycystic ovaries and cardiovascular". Study selection: Twenty-one articles were found, of which 15 met the previously established inclusion criteria. Original articles and publications between the period 2014 and 2021 that directly related the syndrome to cardiovascular risks, metabolic syndromes and lipid disorders were included. Data collect: The article selection strategy was performed by searching the selected databases; reading the titles of all articles found and excluding those that did not address the subject; critical reading of the abstracts of the articles and full reading of the articles selected in the previous steps. Data synthesis: All authors state that the Syndrome is an ovulatory and metabolic disorder, since insulin resistance and consequent compensatory hyperinsulinemia can be exacerbated by the coexistence of obesity, present in many women with polycystic ovary syndrome. In addition, traditional risk factors for the development of cardiovascular diseases were identified, with 93.33% of the articles analyzed showing that, among women with the syndrome, some risk factors for the development of such diseases seem to have a chance greater than being present. Conclusion: At the end of this review, it was possible to answer the proposed clinical question, as all the researched articles concluded and brought studies proving that women with polycystic ovary syndrome are more likely to develop an early cardiovascular problem, due to factors such as hyperandrogenism, the increase in visceral fat and insulin resistance.(AU)

Dietary patterns and cardiometabolic risk factors of a federal public institution staff in the northern region of Brazil / Padrões alimentares e fatores de risco cardiometabólicos em funcionários de uma instituição pública federal na região norte do Brasil

ABSTRACT Objective To identify dietary patterns in an adult population and assess those patterns association with cardiometabolic risk factors. Methods Cross-sectional study conducted with 130 workers of a university in Tocantins, Brazil, aged 20-59 years. Dietary patterns were identified by principal component analysis based on a food frequency questionnaire. Body mass index, waist circumference, blood pressure, fasting glycemia, triacylglycerols, low-density lipoprotein and high-density lipoprotein cholesterol were measured. Multinomial logistic regression was used to assess the association between dietary patterns and cardiometabolic risk factors. Results Three dietary patterns were identified that together explained 78.74% of total variance: healthy, western and fit dietary patterns. In the adjusted model, greater adherence to the healthy pattern was associated with lower fasting glucose values (OR: 0.89; 95%IC: 0.82-0.97; p=0.009) and with higher concentrations of low-density lipoprotein cholesterol (OR: 1.02; 95%IC: 1.00-1.04; p=0.024); the western dietary pattern was associated with higher fasting glucose values (OR: 1.06; 95%IC: 1.00-1.13; p=0.05) and the fit pattern was associated with lower concentrations of low-density lipoprotein cholesterol (OR: 0.98; 95%IC: 0.97-0.99; p=0.048). Conclusion Food was an important risk and protective factor for cardiometabolic changes.

RESUMO Objetivo Identificar padrões alimentares em uma população adulta e avaliar a associação com fatores de risco cardiometabólico. Métodos Estudo transversal realizado com 130 funcionários entre 20 e 59 anos de uma universidade do Tocantins, Brasil. Os padrões alimentares foram identificados por análise de componentes principais com base em um questionário de frequência alimentar. Foram mensurados índice de massa corporal, perímetro da cintura, pressão arterial, glicemia de jejum, triglicerídeos, lipoproteínas de baixa densidade e lipoproteínas de alta densidade. As associações dos padrões com os fatores de risco cardiometabólico foram determinadas por regressão logística multinomial. Resultados Três padrões foram identificados que explicaram 78.74% da variância total: saudável, ocidental e fit. No modelo ajustado, a maior adesão ao padrão saudável foi associada com menores valores de glicemia de jejum (OR: 0.89; 95% IC: 0.82-0.97; p=0.009) e com maiores concentrações de lipoproteína de baixa densidade colesterol (OR: 1.02; 95% IC: 1.00-1.04; p=0.024); o padrão ocidental foi associado com maiores valores de glicemia de jejum (OR: 1.06; 95% IC: 1.00-1.13; p=0.05) e o padrão fit foi associado com menores concentrações de lipoproteína de baixa densidade colesterol (OR: 0.98; 95% IC: 0.97-0.99; p=0.048). Conclusão A alimentação constituiu um importante fator de risco e de proteção para alterações cardiometabólicas.

Intervenciones para prevenir el síndrome metabólico en adolescentes / Interventions to Prevent Metabolic Syndrome in Adolescents

Introducción: El sobrepeso y la obesidad son actualmente problemas de salud pública de alto impacto a nivel mundial, que predisponen al ser humano a adquirir enfermedades crónicas no transmisibles como el síndrome metabólico, afecta a los adolescentes, un grupo etario vulnerable. Objetivo: Analizar la evidencia científica acerca de las intervenciones para prevenir el síndrome metabólico en adolescentes. Métodos: Revisión sistemática de artículos publicados entre 2010 y 2019, se realizó la búsqueda en bases de datos SciELO, BVS, PUBMED. Luego de aplicar los criterios de inclusión y exclusión se seleccionaron 11 artículos. Se utilizó el diagrama de flujo Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA). Conclusiones: En los 11 artículos analizados, se han encontrado diversos enfoques de intervención, que fueron desarrollados, principalmente, en aspectos educativos, nutricionales y actividades físicas. Los estudios en los que se abordaron más estrategias de prevención del síndrome metabólico en los adolescentes, aunado a un enfoque familiar e incorporando a docentes y un equipo multidisciplinario, presentaron cambios más significativos en las características antropométricas y parámetros bioquímicos relacionados a los factores de riesgo cardiometabólicos(AU)

Introduction: Overweight and obesity are currently high-impact public health problems worldwide, predisposing humans to acquire chronic non-communicable diseases such as metabolic syndrome, affecting adolescents, a vulnerable age group. Objective: To analyze the scientific evidence about interventions to prevent metabolic syndrome in adolescents. Methods: A systematic review was conducted of articles published between 2010 and 2019; a search was carried out in SciELO, BVS, PUBMED databases. After applying the inclusion and exclusion criteria, 11 articles were selected. The Preferred Reporting Items for Systematic Review and Meta-Analyzes (PRISMA) flow chart was used. Conclusions: In the 11 articles analyzed, various intervention approaches have been found, which were developed mainly in educational, nutritional and physical activities aspects. The studies in which more strategies for the prevention of metabolic syndrome in adolescents were addressed, together with a family approach and incorporating teachers and a multidisciplinary team, showed more significant changes in anthropometric characteristics and biochemical parameters related to cardiometabolic risk factors(AU)

Cardiometabolic risk profile in relation to the practice of healthy habits in a sample of Spanish workers

Insulin resistance is a pathological entity that can lead to alterations in lipid metabolism and can increase cardiovascular risk. Objective. The aim of this study was to assess the influence of different sociodemographic variables such as age, sex and social class and healthy habits such as smoking, physical activity and adherence to the Mediterranean diet on the cardiometabolic profile of Spanish workers. Material and methods. A descriptive, cross-sectional study was carried out in 1457 Spanish workers in an attempt to evaluate the effect of healthy habits (physical exercise determined with the IPAQ questionnaire, Mediterranean diet and tobacco consumption) and sociodemographic variables (age, sex and social class) on the values of different insulin resistance scales. Results. The progressive increase in the level of physical activity and high adherence to the Mediterranean diet achieved an improvement in the mean values and in the prevalence of elevated values in all the insulin resistance scales analyzed in this study. Age over 50 years and belonging to the least favored social classes (social classes II-III) were the variables that increased the risk of presenting insulin resistance. Male sex also increased the risk of presenting insulin resistance. Conclusions. The different healthy habits such as vigorous physical exercise and high adherence to the Mediterranean diet improve the values of the different scales that assess insulin resistance(AU)

La resistencia a la insulina es una entidad patológica que puede provocar alteraciones en el metabolismo de los lípidos y puede aumentar el riesgo cardiovascular. Objetivo. En este trabajo se pretende valorar la influencia de diferentes variables sociodemográficas como la edad, el sexo y la clase social y hábitos saludables como el consumo de tabaco, la actividad física y la adherencia a la dieta mediterránea en el perfil cardiometabólico de trabajadores españoles. Material y métodos. Se realizó un estudio descriptivo y transversal en 1457 trabajadores españoles intentando evaluar el efecto de los hábitos saludables (ejercicio físico determinado con el cuestionario IPAQ, dieta mediterránea y consumo de tabaco) y las variables sociodemográficas (edad, sexo y clase social) sobre los valores de diferentes escalas de resistencia a la insulina. Resultados. El aumento progresivo del nivel de actividad física y la alta adherencia a la dieta mediterránea consiguieron una mejoría en los valores medios y en la prevalencia de los valores elevados en todas las escalas de resistencia a la insulina analizadas en este estudio. La edad por encima de los 50 años y la pertenencia a las clases sociales menos favorecidas (clases sociales II-III) fueron las variables que aumentaron el riesgo de presentar resistencia a la insulina. El sexo masculino también incrementó el riesgo de presentar resistencia a la insulina. Conclusiones. Los diferentes hábitos saludables como el ejercicio físico vigoroso y la alta adherencia a la dieta mediterránea mejoran los valores de las diferentes escalas que valoran resistencia a la insulina(AU)

Risco cardiometabólico em pacientes sobrepesados e obesos: um estudo comparativo entre os sexos / Cardiometabolic risk in overweight and obese patients: a comparative study between the sexes / Riesgo cardiometabólico en pacientes con sobrepeso y obesidad: un estudio comparativo entre sexos

Objetivos: Analisar a diferença do risco cardiometabólico entre homens e mulheres com excesso de peso corporal. Método: Estudo descritivo transversal realizado com adultos, de ambos os sexos, com idade entre 18 e 50 anos, com excesso de peso e com circunferência da cintura alterada, de acordo com os critérios da Organização Mundial da Saúde (2015). Resultados: A idade média entre as mulheres foi de 37,82 anos e entre os homens, de 31,56 anos. Em relação ao peso, a média entre as mulheres foi menor que dos homens. Em relação à medida de circunferência de quadril, a média das mulheres foi de 123,16 cm e dos homens de 114,94 cm. Os resultados médios dos exames laboratoriais foram maiores entre os homens com 212,77, enquanto o "colesterol bom" (HDL) entre as mulheres foi de 50,58. Conclusão: O risco cardiometabólico apresentado pelo sexo feminino. (AU)

Objective: To analyze the difference in cardiometabolic risk between men and women with excess body weight. Methods: Descriptive cross-sectional study carried out with adults, of both sexes, aged between 18 and 50 years, with excess weight and with altered waist circumference, according to the criteria of the World Health Organization. Results: The average age among women was 37,82 years and among men, 31,56 years. Regarding weight, the average among women was lower than that of men. Regarding the measure of hip circumference, the average for women was 123,16 cm and for men, 114,94 cm. Conclusion: The cardiometabolic risk presented by women was lower than the risk presented by men. The variables that showed the most evident significance between gender differences were: age, weight, height, hip circumference, triglycerides, cholesterol. (AU)

Objetivo: Analizar la diferencia de riesgo cardiometabólico entre hombres y mujeres con exceso de peso corporal. Métodos: Estudio descriptivo transversal realizado con adultos, de ambos sexos, de entre 18 y 50 años, con sobrepeso y con alteración de la circunferencia de la cintura, según los criterios de la Organización Mundial de la Salud. Resultados: La edad media de las mujeres fue de 37,82 años y de los hombres de 31,56 años. En cuanto al peso, el promedio entre las mujeres fue menor que el de los hombres. En cuanto a la medida de la circunferencia de la cadera, la media para las mujeres fue de 123,16 cm y para los hombres, de 114,94 cm. Conclusión: El riesgo cardiometabólico presentado por las mujeres fue menor que el riesgo presentado por los hombres. Las variables que mostraron mayor significación entre las diferencias de género fueron: edad, peso, talla, perímetro de la cadera, triglicéridos, colesterol. (AU)

Análise de componentes principais dos fatores de risco em adolescentes com excesso de peso antes e após um programa de intervenção / Analysis of principal components of risk factors in overweight adolescents before and after an intervention program

O objetivo do estudo é verificar o agrupamento dos fatores de risco cardiometabólicos e as possíveis mudanças deste, após um programa de intervenção interdisciplinar realizado com adolescentes com sobrepeso/obesidade. Os sujeitos foram alocados em dois grupos: grupo intervenção e grupo controle. O grupo intervenção participou de um programa com a duração de seis meses, com sessões três vezes por semana, que incluiu sessões com exercícios físicos, orientações nutricionais e psicológicas. Foram realizadas avaliações antropométricas, pressão arterial, aptidão cardiorrespiratória e coleta sanguínea para avaliação da glicose e perfil lipídico, antes e após o período de intervenção. Análise de componentes principais foi realizada para verificar o agrupamento dos fatores de risco nos períodos pré e pós-intervenção. A análise fatorial agrupou os componentes em três fatores no momento pré-intervenção, no grupo intervenção, que representou 83,88% da variância total do modelo. Já, no grupo controle, no período pré e pós-intervenção, e na avaliação pós-intervenção do grupo intervenção, os componentes foram agrupados em dois fatores centrais, que explicam, respectivamente, 68,38%, 71,23%, 75,19% da variância total do modelo. O grupo intervenção apresentou mudanças no agrupamento das variáveis nos resultados pós-intervenção, em comparação com o pré-teste. Nenhum componente central, que inter-relacionasse todos os demais fatores, nas quatro análises realizadas, foi encontrado. Entretanto, as variáveis antropométricas aparecem como os componentes de maior carga fatorial, agrupadas no fator 1, em todas as análises realizadas, fator que explica a maior variância total em torno das variáveis iniciais. (AU)

The objective of the study is to verify the grouping of cardiometabolic risk factors and their possible changes after an interdisciplinary intervention program performed with overweight/obese adolescents. The subjects were allocated in two groups: the intervention group and the control group. The intervention group participated in a program lasting six months, with sessions three times a week, which included sessions with physical exercises, nutritional and psychological orientations. Anthropometric evaluations, blood pressure, cardiorespiratory fitness, and blood collection were performed for evaluation of glucose and lipid profile before and after the intervention period. Main component analysis was performed to verify the grouping of risk factors in the pre-and post-intervention periods. The factorial analysis grouped the components into three factors at the pre-intervention time, in the intervention group, which represented 83.88% of the total variance of the model. In the control group, in the pre-and post-intervention period, and in the post-intervention evaluation of the intervention group, the components were grouped into two central factors, which explain, respectively, 68.38%, 71.23%, 75, 19% of the total variance of the model. The intervention group presented changes in the grouping of the variables in the post-intervention results, compared to the pre-test. No central component, which interrelated all the other factors, was found in the four analyzes. However, the anthropometric variables appear as the components of higher factor load, grouped in factor 1, in all the analyzes performed, a factor that explains the largest total variance around the initial variables. (AU)

Metabolic Syndrome and Risk of Cardiovascular Diseases in Female Breast Cancer Survivors

Abstract Background The implementation of intensive therapy protocols increases the probability of adverse events in patients with breast cancer (BC). Components of metabolic syndrome (MS) are among these events. Objective To verify the prevalence of MS and cardiovascular disease (CVD) risk in female BC survivors. Materials and Methods This is a descriptive, observational, cross-sectional study. Our sample comprised 60 women without BC (G1) and 60 women who had survived BC (G2). We collected sociodemographic, anthropometric, tumor, and clinical data. After variable analysis, the participants received positive or negative MS diagnoses and a 10-year CVD risk stratification. The significance level adopted for the analyses was 5% ( p < 0.05) and the confidence interval (CI) was 95%. For comparing categorical data, we used the chi-squared, Fisher's exact, or G tests; for comparing continuous data, we used the parametric Student's t-test and the non-parametric Mann-Whitney test. Results Both groups presented overweight and an increased waist-to-hip ratio. Weight, body mass index, abdominal circumference, hip circumference, and low-density cholesterol were variables that presented statistically significant differences between groups. MS was diagnosed in 32% of women in G1 and 45% of those in G2. Regarding the 10-year risk for CVD, most women were in the low-risk stratum: the mean total risk of CVD occurrences was 7.48% in G1 and 7.70% in G2. Conclusion We observed a higher prevalence of MS among women who survived BC, possibly due to overweight, as well as a low 10-year risk for CVD after cancer treatment. Although we did not observe a statistically significant difference, we suggest the adoption of a healthy lifestyle and rigorous control of cardiometabolic risk factors.