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.

Serum uric acid in children and adolescents / Valores de referência do ácido úrico em crianças e adolescentes

ABSTRACT Introduction: Uric acid (UrA) is a product of purine catabolism, and hyperuricemia (hUrA) is associated with risk factors for cardiometabolic diseases. Objective: To evaluate the concentration of UrA in children and adolescents. Methods: Cross-sectional study with 623 eutrophic students (5 to 15 years old, aged 9.9 ± 2.7 years, 52% girls). Blood was collected (fasting 12-14 h) for analysis of laboratory parameters, and blood pressure and anthropometric measures were verified. UrA was stratified according to sex and age ranges (5 to < 10, ≥ 10 to < 13 and ≥ 13 to 15 years, male; and 5 to < 9, ≥ 9 to < 12 and ≥ 12 to 15 years, female), and the percentiles 2.5 (2.5th) and 97.5 (97.5th) were calculated. Results: The mean UrA was 3.7 ± 1.03 mg/dl (boys) and 3.58 ± 0.91 mg/dl (girls) (p = 0.0113). Considering the age ranges, the mean UrA was increasing and higher for boys (p = 0.0024, for the 3rd age range). For girls, the UrA increased progressively and significantly in the age ranges (p ≤ 0.005). According to the 97.5th, there was statistical difference only in the third range between sexes (p = 0.002). For comparisons between age ranges, UrA 97.5th also increased for boys and girls (p ≤ 0.05). According to the 97.5th, 26 students presented hUrA. Conclusion: According to the results, stratification by age ranges and sex, in addition to the 97.5th as concentration threshold, was important for evaluation of serum levels of UrA in children and adolescents.

RESUMO Introdução: O ácido úrico (AUr) é um produto do catabolismo das purinas, e a hiperuricemia (hAUr) associa-se a fatores de risco para doenças cardiometabólicas. Objetivo: Avaliar a concentração de AUr em crianças e adolescentes. Métodos: Estudo transversal com 623 estudantes eutróficos (5 a 15 anos de idade; 9,9 ± 2,7 anos; 52% meninas). Foi coletado sangue (jejum 12-14 h) para análise de parâmetros laboratoriais e foram aferidas pressão arterial e medidas antropométricas. AUr foi estratificado segundo sexo e faixas etárias (5 a < 10, ≥ 10 a < 13 e ≥ 13 a 15 anos, masculino; 5 a < 9, ≥ 9 a < 12 e ≥ 12 a 15 anos, feminino) e foram calculados os percentis 2,5 (2,5th) e 97,5 (97,5th). Resultados: A média de AUr foi de 3,7 ± 1,03 mg/dl (meninos) e 3,58 ± 0,91 mg/dl (meninas) (p = 0,0113). Considerando as faixas etárias, a média de AUr foi crescente e superior nos meninos (p = 0,0024, para terceira faixa). Nas meninas, o AUr aumentou progressiva e significativamente nas faixas etárias (p ≤ 0,005). Segundo o 97,5th, houve diferença estatística somente na terceira faixa entre os sexos (p = 0,002). Nas comparações entre faixas etárias, o 97,5th do AUr também aumentou para meninos e meninas (p ≤ 0,05). Segundo o 97,5th, 26 estudantes apresentaram hAUR. Conclusão: A estratificação por faixas etárias e sexo, além do 97,5th como limiar de concentração, foi importante para avaliação da concentração sérica do AUr em crianças e adolescentes.

Metabolic Syndrome and Importance of Associated Variables in Children and Adolescents in Guabiruba - SC, Brazil / Síndrome Metabólica e Importância das Variáveis Associadas em Crianças e Adolescentes de Guabiruba - SC, Brasil

The risk factors that characterize metabolic syndrome (MetS) may be present in childhood and adolescence, increasing the risk of cardiovascular disease in adulthood.

Os fatores de risco que caracterizam a síndrome metabólica (SM) podem estar presentes na infância e adolescência, agravando o risco para as doenças cardiovasculares na idade adulta.

Metabolic Syndrome and Importance of Associated Variables in Children and Adolescents in Guabiruba - SC, Brazil.

BACKGROUND: The risk factors that characterize metabolic syndrome (MetS) may be present in childhood and adolescence, increasing the risk of cardiovascular disease in adulthood. OBJECTIVE: Evaluate the prevalence of MetS and the importance of its associated variables, including insulin resistance (IR), in children and adolescents in the city of Guabiruba-SC, Brazil. METHODS: Cross-sectional study with 1011 students (6-14 years, 52.4% girls, 58.5% children). Blood samples were collected for measurement of biochemical parameters by routine laboratory methods. IR was estimated by the HOMA-IR index, and weight, height, waist circumference and blood pressure were determined. Multivariate logistic regression models were used to examine the associations between risk variables and MetS. RESULTS: The prevalence of MetS, IR, overweight and obesity in the cohort were 14%, 8.5%, 21% and 13%, respectively. Among students with MetS, 27% had IR, 33% were overweight, 45.5% were obese and 22% were eutrophic. IR was more common in overweight (48%) and obese (41%) students when compared with eutrophic individuals (11%; p = 0.034). The variables with greatest influence on the development of MetS were obesity (OR = 32.7), overweight (OR = 6.1), IR (OR = 4.4; p ≤ 0.0001 for all) and age (OR = 1.15; p = 0.014). CONCLUSION: There was a high prevalence of MetS in children and adolescents evaluated in this study. Students who were obese, overweight or insulin resistant had higher chances of developing the syndrome.

Multiplicidade de fatores de risco cardiovascular em crianças e adolescentes DE Guabiruba-SC, Brasil / Multiple cardiovascular risk factors in children and adolescents from Guabiruba-SC, Brazil

A prevenção das doenças cardiovasculares consiste na identificação precoce dos fatores de risco envolvidos. Assim, o objetivo deste estudo foi verificar a prevalência de fatores de risco para doenças cardiovasculares em crianças e adolescentes no município de Guabiruba-SC, Brasil. Participaram deste estudo transversal 1011 crianças e adolescentes (6-14 anos; 52,4% meninas), sem desordens diagnosticadas. Amostras de sangue (jejum de 12-14 h) foram coletadas para avaliações laboratoriais e foram aferidos os índices antropométricos e a pressão arterial. De acordo com os resultados, foi observada alta prevalência de dislipidemias (26-77% dependendo do parâmetro lipídico), hiperglicemia (11,6%), resistência à insulina (8,4%), pressão arterial elevada (4,5%), inflamação subclínica (27,2%), sobrepeso (17,6%), obesidade (6,5%), obesidade abdominal (30,2%) e gordura corporal elevada (31,1%). Conclui-se que a população infanto-juvenil avaliada possui risco elevado para as doenças cardiovasculares e medidas de prevenção e tratamento deverão ser implantadas.

Prevention of cardiovascular diseases (CVDs) consists in the early detection of the risk factors involved. Therefore, the aim of this study was to verify the prevalence of risk factors for CVDs in children and adolescents from Guabiruba-SC, Brazil. Participated in this sectional study 1,011 children and adolescents (aged 6-14 years, 52.4% females), without diagnosed clinical disorders. Fasting blood samples were collected for biochemical measurements and the anthropometric indices and blood pressure were measured. Based on the results, it was observed a high prevalence of risk factors for dyslipidemias (26-77% depending on the lipid parameter), hyperglycemia (11.6%), insulin resistance (8.4%), high blood pressure (4.5%), subclinical inflammation (27.2%), overweight (17.6%), obesity (6.5%), abdominal obesity (30.2%), and elevated body fat (31.1%). In summary, the studied children and adolescents had high risk for CVDs and preventive and treatment programs should be established.

Jogos recreativos melhoram os fatores de risco cardiovascular em crianças e adolescentes com dislipidemia e obesidade abdominal: Um estudo piloto / Recreational games improve cardiovascular risk factors in children and adolescents with dyslipidemia and abdominal obesity: A pilot study

O objetivo do presente estudo piloto foi verificar se a prática de jogos recreativos e cooperativos promove modificação dos fatores de risco cardiometabólicos em crianças e adolescentes. Vinte e seis estudantes (15 meninos), com idade entre oito e 12 anos, portadores de dislipidemias e/ou obesidade abdominal participaram desse estudo. As atividades recreativas e de lazer foram realizadas 2 h/dia, três vezes por semana, durante 3,5 meses, e foram supervisionadas por profissional de Educação Física. No início e no final do estudo, amostras de sangue foram coletadas (jejum 12-14 h) para as análises bioquímicas. Além disto, foram realizadas medidas antropométricas por métodos padronizados. De acordo com os resultados, houve melhoras significativas na concentração de HDL-colesterol (+3,7%), triglicérides (-25,4%), índice de Castelli I (-7,1%), ácido úrico (-15,4%), circunferência da cintura (-5,4%) e relação circunferência da cintura/altura (-4,3%). Pode-se concluir que a prática de jogos recreativos e cooperativos promoveu melhoras cardiometabólicas, particularmente nos parâmetros lipídicos e na obesidade central, nas crianças e adolescentes com dislipidemias e/ou obesidade abdominal que participaram desse estudo. Sugere-se, assim, que a atividade física na criança e no adolescente, visando à prevenção dos fatores de risco para as doenças cardiovasculares, não requer a adoção de treinamento intensivo de exercícios físicos que exijam a capacidade máxima do praticante.

The aim of this pilot study was to verify whether the practice of recreational and cooperative games promotes the reduction of cardiometabolic risk factors in children and adolescents. Twenty-six students (15 boys), aged 8-12 y, with dyslipidemia and/or abdominal obesity, participated of this study. Recreational and leisure activities were performed 2 h daily, 3 times a week, during 3.5 months, and they were supervised by physical educator. At the beginning and end of the study, blood samples (12-14 h fast) were withdrawn for the measurement of biochemical parameters. Furthermore, anthropometric measures were assessed using standard procedures. According to results, there were significant improvements in the levels of HDL-cholesterol (+3.7%), triglycerides (-25.4%), Castelli I index (-7.1%), uric acid (-15.4%), waist circumference (-5.4%) and waist circumference/height ratio (-4.3%). We may conclude that the practice of recreational and cooperative games promoted cardiometabolic improvements in the children and adolescents with dyslipidemias and/or abdominal obesity who participated of this study. It is suggested, therefore, that physical activity in children and adolescents aiming the prevention of risk factors for cardiovascular diseases, does not require the adoption of intensive training exercise with the maximum capacity of the practitioner.

Simultaneous prediction of hyperglycemia and dyslipidemia in school children in Santa Catarina State, Brazil based on waist circumference measurement.

OBJECTIVES: Waist circumference (WC) is highly associated with metabolic risk factor clusters (RFC) for chronic non-communicable diseases (NCDs). In this study, we evaluated the use of WC measurements to detect hyperglycemia and dyslipidemia in children and adolescents using the WC cutoff points reported in the Bogalusa Heart study and the New Zealand study. DESIGN AND METHODS: Students (n=1011; aged 6 to 14years) were enrolled in a cross-sectional study. Anthropometric indices, fasting glucose, and lipid profiles were measured. The associations between WC measures and serum parameters were investigated by logistic regression models, and the clinical accuracy of the studied parameters was assessed using receiver operating characteristic (ROC) curve analysis. RESULTS: The prevalence of increased WC was 30.2% using the New Zealand cutoff points and 13.7% using the Bogalusa cutoff values. In general, children with increased WC exhibited higher concentrations of total cholesterol, triglycerides, LDL-cholesterol, and non-HDL-cholesterol and lower levels of HDL-cholesterol. The areas under the ROC curves (AUC) of the WC measurements were 0.770 (95% CI: 0.744-0.797) and 0.600 (95% CI: 0.569-0.631) using, respectively, the New Zealand and Bogalusa cutoff points for WC, indicating the prediction of simultaneous hyperglycemia, increased levels of non-HDL-cholesterol, and reduced HDL-cholesterol for students with increased WC. There was a significant difference between AUC values (P=0.001). Furthermore, the sensitivity of using WC for detecting RFC in students was 2.0 to 2.5-fold higher with the New Zealand study cutoff values for WC than with those from the Bogalusa study. Logistic regression analysis revealed that increased WC was associated with simultaneous hyperglycemia and dyslipidemia after controlling for differences in sex and age (P<0.01 for all). CONCLUSIONS: Children and adolescents exhibited a high prevalence of increased WC associated with other RFCs for NCDs. Increased WC may be used to screen and identify students with elevated clusters of metabolic risk factors for NCDs.

Variabilidade interensaios de dislipidemias em pacientes hipertensos / Inter-assays variability of dislipidemias in hypertensive patients

INTRODUÇÃO E OBJETIVOS: Ensaios de diferentes procedências para avaliação das dislipidemia podem resultar em variações significativas nos resultados obtidos e consequente conduta inadequada pelo clínico. O estudo objetivou comparar resultados laboratoriais de colesterol total (CT), triglicérides (TG), colesterol da lipoproteína de alta densidade (HDL-C), colesterol da lipoproteína de baixa densidade (LDL-C), apolipoproteína A-1 (Apo A-1), apolipoproteína B (Apo B) e lipoproteína (a) (Lp[a]) e índices lipídicos (não-HDL-C, CT/HDL-C, LDL-C/HDL-C, TG/HDL-C e Apo B/HDL-C) de pacientes hipertensos e/ou diabéticos diagnosticados. MÉTODOS: Foram utilizados conjuntos reativos, e os respectivos analisadores Gold Analisa, Dia Sys (CCX - Abbott), Dade Behring (Nefelômetro BN 100) e Roche (COBAS Integra 400), para verificar a reprodutibilidade dos resultados obtidos. Participaram 99 pacientes (36 do sexo masculino e 63 do feminino). Comparando os resultados, verificamos que: todas as médias obtidas dos constituintes lipídicos apresentaram diferença significativa; número semelhante de pacientes apresentou níveis séricos elevados de CT, TG, Lp(a) e Apo A-1. O HDL-C, o LDL-C e a Apo B apresentaram discordância, assim como os índices de CT/LDL-C, LDL-C/HDL-C e TG/HDL-C. Para não-HDL-C e ApoB/HDL, houve semelhança no número de pacientes com valores não recomendados. Em consequência da diferença, em relação ao LDL-C, a decisão da conduta terapêutica poderá ser inadequada, enquanto o não-HDL-C, além de evidenciar partículas aterogênicas, apresentou número de hipertensos com valores séricos não referendados semelhantes, independente da metodologia e do equipamento utilizado. CONCLUSÃO: No grupo de hipertensos analisados, o não-HDL-C se caracterizou um importante fator de correção interensaios de parâmetros lipídicos. E sua associação à relação Apo B/HDL-C pode ser um fator adicional em relação às condutas hipolipemiantes a serem adotadas.

INTRODUCTION AND OBJECTIVES: Different assays to evaluate dyslipidemia may show significant variations in the obtained results and a consequent inappropriate clinical approach may be adopted. This study aimed to compare the results of total cholesterol (CT), triglycerides (TG), HDL-C, Apo A1, Apo B, lipoprotein (a) and lipidic indexes (not-HDL-C, CT/HDL-C, LDL-C/HDL-C, TG/HDL-C and Apo B/HDL-C) of hypertensive and/or diabetic patients. METHODS: The following reactive kits and respective analyzers were applied to verify the reproducibility of results: Gold Analisa, DiaSys (CCX-ABBOTT), Dade Behring (Nephelometer BN 100) and Roche (COBAS Integra 400). Ninety nine patients (36 male and 63 female gender) were investigated. Comparing the results, we observed that all mean numbers of lipid constituents showed a significant difference. A similar number of patients had high CT, TG, Lp (a) and Apo A-1 serum levels. There was also disagreement in HDL-C, LDL-C, ApoB, CT/LDL-C, LDL-C/HDL-C and TG/HDL-C indexes. For not-HDL-C and ApoB/HDL, there was similarity in the number of patients with not recommended values. As a consequence of this difference, the choice of therapeutic approach may be inappropriate as to LDL-C levels, whereas Not-HDL-C not only showed atherogenic particles but also a number of hypertensive patients with similar not recommended serum values, regardless of the methodology and the equipment used. CONCLUSION: In the analyzed group of hypertensive patients, not-HDL-C was an important inter assay correction factor of lipidic parameters. The association with Apo B/HDL-C relation may be an additional factor as to the choice of hypolipemiant treatments.

Presença de hiper-homocisteinemia em pacientes portadores de três fatores de risco para doença cardiovascular: hipertensão, tabagismo e histórico familiar / The presence of homocysteinemia in patients carrying three risk factors for cardiovascular diseases: hypertension, smoking habit and family history

A hiper-homocisteinemia é um fator de risco independente para desenvolvimento de doença cardiovascular e na presença de outros fatores de risco (FR) poderá acarretar em risco adicional para o surgimento do evento. Foram realizadas dosagens séricas de homocisteína e creatinina em 146 pacientes (51 homens e 95 mulheres) cadastrados no programa HIPERDIA/MS sendo todos portadores de três FR associados: hipertensão, tabagismo e histórico familiar para doença cardiovascular. A média geral foi de 14,48 µmol/L ± 5,98 (15,38 µmol/L ± 6,77 e 13,99 µmol/L ± 5,48, homens e mulheres respectivamente). A hiper-homocisteinemia esteve presente em 34,90% (39,20% e 32,60%, homens e mulheres respectivamente), de acordo com o intervalo de referência entre 5 - 15 µmol/L. Entretanto, segundo recomendações da DACH-LIGA Homocysteine, valores entre 12 - 30 µmol/L são considerados como moderada hiper-homocisteinemia. O estudo revelou que 60,30% (70,60% e 54,70%, homens e mulheres respectivamente) estavam acima de 12 µmol/L. Na avaliação do estudo, a dosagem de homocisteína sérica deve ser realizada em pacientes cadastrados no programa HIPERDIA/MS, pois além de hipertensos e/ou diabéticos, a presença de hiper-homocisteinemia pode ser um risco adicional para o desenvolvimento de doença cardiovascular.

Hiper-homocysteinemia is an independent risk factor in the development of cardiovascular diseases and in the presence of other risk factors (RF) may bring about an additional risk for the occurrence of the event. Serum dosages of homocysteine and creatinine in 146 patients (51 men and 95 women), registered at the HIPERDIA/MS Program, all presenting three associated RF's; hypertension, smoking habit and family history for cardiovascular diseases. The general average has been 14.48 µmol/L ± 5,98 (15,38 µmol/L ±6,77 and 13,99 µmol/L ± 5,48, for men and women respectively). Hiper-homocysteinemia had been present in 34.90% (39.20% and 32.60%, men and women, respectively), according to the reference interval between 5 - 15 µmol/L. Although, according to Homocysteine DACH-LIGA recommendations, values between 12 - 30 µmol/L are considered being a moderate hiper-homocysteinemia. The study has revealed that 60.30% (70.60% and 54.70%, men and women, respectively) had been above 12 µmol/L. In the evaluation of the study, the serum dosage of homocysteine has to be performed in patients registered at the HIPERDIA/MS Program for, besides being hypertense and/or diabetic, the presence of hiper-homocisteinemia may be an additional risk for the development of cardiovascular disease.

Prevalência de síndrome metábólica e estratificação de risco para DAC em pacientes hipertensos-tabagistas / Metabolic syndrome prevalence and risk stratification for coronary artery disease in hypertension-tobacco patients

A síndrome metabólica (SM) é caracterizada por um conjunto de fatores de risco (FR), que, por si só, contribuem para a gênese de doenças cardiovasculares (DCV), enquanto o escore de risco de Framingham (ERF) permite o cálculo do risco absoluto deeventos coronarianos acontecerem em 10 anos. Seguindo os critérios estabelecidos pela National Cholesterol Education Program (NCEP – ATP III), foram verificados a prevalência de SM e o risco absoluto em 146 pacientes hipertensos-tabagistas com histórico familiar para DCV, na cidade de Brusque/SC. Em 59,6% foi caracterizada a síndrome. Em 24,7% havia a associação de três critérios,com quatro, 28,1% e em 6,8% todos os critérios. Pelo ERF, 37,7% apresentaram risco >20%, 38,4% entre 10 – 20% e 23,9% inferior a 10%. Nos pacientes com risco >20%, 81,8% apresentaram colesterol total >200 mg/dl, 56,4% com triglicérides >150 mg/dl e 54,5% HDL-c diminuído. O elenco de FR que poderão acometer o indivíduo com SM, além do alto risco calculado pelo ERF para desenvolverDAC, principalmente em hipertensos-tabagistas com histórico familiar para DCV, faz do diagnóstico da síndrome e a identificação precoce dos fatores de fundamental importância para estratificar o risco global do paciente, bem como introduzir terapias visando ocontrole do maior número possível de distúrbios presente

[Study of the prevalence and multiplicity of cardiovascular risk factors in hypertensive individuals from the city of Brusque, SC, Brazil]. / Estudo de prevalência e multiplicidade de fatores de risco cardiovascular em hipertensos do Município de Brusque, SC.

OBJECTIVE: To investigate the prevalence and multiplicity of additional risk factors (RF) in a population sample of hypertensive smokers, diagnosed and enrolled at the Hiperdia Program of the Ministry of Health, in the city of Brusque, SC, Brazil. METHODS: Determination of the anthropometrical parameters and laboratory variables recognized as cardiovascular risk factors. RESULTS: Elevated prevalence of RF in addition to systemic arterial hypertension (SAH) and smoking, configuring the multiplicity that concurs with a marked elevation of the risk of cardiovascular events in this population sample. CONCLUSION: In hypertensive populations, the prevention, identification and RF control measures must be implemented; computerized programs such as the Hiperdia/MS can help in patients follow-up, allowing a more stringent multidisciplinary approach, especially regarding the analysis of the attainment of treatment goals and the subsequent decrease of cardiovascular risk.

Estudo de prevalência e multiplicidade de fatores de risco cardiovascular em hipertensos do Município de Brusque, SC / Study of the prevalence and multiplicity of cardiovascular risk factors in hypertensive individuals from the city of Brusque, SC, Brazil

OBJETIVO: Investigar a prevalência e a multiplicidade de fatores de risco (FR) adicionais em uma amostra populacional de indivíduos hipertensos e tabagistas, diagnosticados e inscritos no Programa Hipertensos e Diabéticos do MS (HIPERDIA/Ministério da Saúde), no Município de Brusque, SC, Brasil. MÉTODOS: Determinação de parâmetros antropométricos e variáveis laboratoriais reconhecidas como fatores de risco cardiovascular. RESULTADO: Elevada prevalência de FR adicionais à hipertensão arterial (HAS) e ao tabagismo, configurando a multiplicidade que concorre com uma elevação acentuada do risco de eventos cardiovasculares nessa amostra populacional. CONCLUSÃO: Em populações de hipertensos, medidas de prevenção, identificação e controle de FR devem ser implementadas e programas informatizados, como o Hiperdia/MS, podem auxiliar no seguimento dos pacientes, possibilitando uma abordagem multidisciplinar mais criteriosa, sobretudo na análise do alcance das metas de tratamento e conseqüente redução de risco cardiovascular.

Presença de hiper-homocisteinemia em pacientes portadores de três fatores de risco para doença cardiovascular: hipertensão, tabagismo e histórico familiar / The presence of homocysteinemia in patients carrying three risk factors for cardiovascular diseases: hypertension, smoking habit and family history

A hiper-homocisteinemia é um fator de risco independente para desenvolvimento de doença cardiovascular e na presença de outros fatores de risco (FR) poderá acarretar em risco adicional para o surgimento do evento. Foram realizadas dosagens séricas de homocisteína e creatinina em 146 pacientes (51 homens e 95 mulheres) cadastrados no programa HIPERDIA/MS sendo todos portadores de três FR associados: hipertensão, tabagismo e histórico familiar para doença cardiovascular. A média geral foi de 14,48 μmol/L ± 5,98 (15,38 μmol/L ± 6,77 e 13,99 μmol/L ± 5,48, homens e mulheres respectivamente). A hiper-homocisteinemia esteve presente em 34,90 por cento (39,20).

Seroprevalence of HbsAg, Anti-HBc and anti-HCV in Southern Brazil, 1999-2001.

The prevalence of infection by the hepatitis B (HBV) and C (HCV) viruses varies among geographical regions. We evaluated 263,795 blood donor samples collected from 1999-2001 in various cities in the state of Santa Catarina to determine the prevalence of HbsAg, anti-HBc and anti-HCV markers. The markers were analyzed by immunoenzymatic tests, as determined by the Ministry of Health, and the data were obtained from blood banks and from ANVISA (the Brazilian National Agency for Sanitary Vigilance). There was a significant reduction in the mean frequency of HbsAg and anti-HBc during the study period, from 0.98% to 0.64% and from 8.83% to 5.35%, respectively, though they varied considerably among the different regions. There was also a decrease in the mean frequency of anti-HCV, although it was not significant, decreasing from 0.38% to 0.34%. Even with this reduction, the frequency of these markers was still high compared with that found in other countries, indicating high rates of infection by hepatitis B and C viruses. This emphasizes the urgency of vaccination programs against HBV, especially in some regions of Santa Catarina state, in order to reduce the prevalence of this infection and consequently reduce the risk of transmission through sexual relations or from the donation of blood and/or hemocomponents.

Seroprevalence of HbsAg, anti-HBc and anti-HCV in Southern Brazil, 1999-2001

The prevalence of infection by the hepatitis B (HBV) and C (HCV) viruses varies among geographical regions. We evaluated 263,795 blood donor samples collected from 1999-2001 in various cities in the state of Santa Catarina to determine the prevalence of HbsAg, anti-HBc and anti-HCV markers. The markers were analyzed by immunoenzymatic tests, as determined by the Ministry of Health, and the data were obtained from blood banks and from ANVISA (the Brazilian National Agency for Sanitary Vigilance). There was a significant reduction in the mean frequency of HbsAg and anti-HBc during the study period, from 0.98 percent to 0.64 percent and from 8.83 percent to 5.35 percent, respectively, though they varied considerably among the different regions. There was also a decrease in the mean frequency of anti-HCV, although it was not significant, decreasing from 0.38 percent to 0.34 percent. Even with this reduction, the frequency of these markers was still high compared with that found in other countries, indicating high rates of infection by hepatitis B and C viruses. This emphasizes the urgency of vaccination programs against HBV, especially in some regions of Santa Catarina state, in order to reduce the prevalence of this infection and consequently reduce the risk of transmission through sexual relations or from the donation of blood and/or hemocomponents