Serum Uric Acid Levels as an Indicator for Metabolically Unhealthy Obesity in Children and Adolescents.

BACKGROUND: Metabolically healthy obesity (MHO) refers to those individuals who do not show cardiometabolic abnormalities. Our aim was to identify potential clinical and metabolic indicators that may help to distinguish between metabolically healthy and unhealthy individuals amongst overweight and obese children and adolescents. METHODS: The study involved 246 overweight/obese and 212 normal-weight individuals enrolled in the LIFE Child study, aged between 6 and 18 years. Overweight/obese individuals without cardiovascular risk factors (fasting serum lipids, blood pressure, and glucose) were classified as MHO. Individuals meeting 1 or more criteria of cardiovascular risk factors were classified as metabolically unhealthy obesity (MUO). RESULTS: Among the 246 overweight/obese individuals, 173 (70%) were MHO and 73 (30%) were MUO. The MHO individuals were younger, more likely to be male, and had lower BMI SDS. In the logistic regression models, uric acid (UA) SDS (OR 1.61, 95% CI 1.1-2.6, p = 0.004), waist circumference SDS (OR 2.50, 95% CI 1.2-6.4, p = 0.017), and C-peptide (OR 4.05, 95% CI 3.5-91, p = 0.003) were significant indicators of MUO. CONCLUSION: Our results suggest that nearly one-third of overweight/obese children are already identified as MUO. Serum levels of UA can be used as an indicator of unhealthy obesity in youth, where lower levels of UA indicate a lower risk and higher levels suggest a higher risk of MUO. We note that the relevance of identifying potential indicators remains the first most important step in future clinical research.

Peregrinação (Via Crucis) até o diagnóstico da hanseníase / Peregrination (Via Crucis) to a diagnosis of leprosy / Peregrinación (Via Crucis) hasta el diagnóstico de la lepra

O objetivo do estudo foi identificar as dificuldades relatadas por usuários em tratamento para hanseníase, na busca por diagnóstico e tratamento, relacionadas com a peregrinação do indivíduo com suspeita de hanseníase até o diagnóstico definitivo. Estudo descritivo, com abordagem qualitativa. As informações foram obtidas por meio de entrevistas com 16 usuários com hanseníase nos meses de dezembro de 2009 e janeiro de 2010, na Policlínica Lessa de Andrade em Recife. Os dados foram submetidos à análise de conteúdo de Bardin. Foram delineados três eixos temáticos: Peregrinação até o diagnóstico correto da hanseníase; Atuação do profissional de saúde; Consequência da peregrinação. Conclui-se que diagnósticos incorretos e tardios demonstram o despreparo dos profissionais de saúde em todos os níveis de complexidade para a suspeição e diagnóstico da hanseníase, exigindo a educação continuada, principalmente para os trabalhadores da atenção básica.

The aim of this qualitative, descriptive study was to identify the difficulties associated with the peregrinations of persons with suspected leprosy in their efforts to obtain diagnosis and treatment, until receiving a definitive diagnosis, as reported by healthcare users being treated for leprosy. Data was obtained between December 2009 and January 2010, through interviews of 16 patients with leprosy at the Lessa de Andrade Clinic in Recife, and analyzed according to Bardin’sIndex. Three themes were outlined: peregrination until correct diagnosis of leprosy; role of health professionals; and outcome of the peregrination. It was concluded that incorrect and delayed diagnoses attest to the lack of preparedness, among health professionals at all levels of complexity, to suspect and diagnose leprosy. This points to a need for continuing professional development, especially for primary health care workers.

El objetivo del estudio fue identificar las dificultades reportadas por usuarios en tratamiento de la lepra, en la búsqueda del diagnóstico y tratamiento, relacionados con la peregrinación de la persona con sospecha de lepra hasta el diagnóstico definitivo. Es un estudio descriptivo, con enfoque cualitativo. Las informaciones se obtuvieron a través de entrevistas con 16 usuarios con lepra, en diciembre de 2009 y enero de 2010, en la Clínica Lessa de Andrade, Recife. Los datos fueron sometidos a análisis de contenido de Bardin. Se eligieron tres ejes temáticos: Peregrinación hasta la obtención el correcto diagnóstico de lepra; Desempeño de los profesionales de la salud; Consecuencias de la peregrinación. Se concluye que diagnósticos equivocados y tardíos demuestran la falta de preparo de los profesionales de salud en todos los niveles de complejidad para sospecha y diagnóstico de lepra, lo que exige la educación continua, en especial para los trabajadores de atención primaria.