A Retrospective Study about the Differences in Cardiometabolic Risk Indicators and Level of Physical Activity in Bariatric Surgery Patients from Private vs. Public Units.

Background: Obesity is a pathology with a growing incidence in developing countries. Objective: To evaluate the evolution of cardiometabolic, anthropometrics, and physical activity parameters in individuals undergoing bariatric surgery (BS) in the public healthcare system (PUS) and private healthcare system (PHS). Methods: A longitudinal, observational, and retrospective study was conducted with 111 bariatric patients on two different health systems, with 60 patients from the PUS and 51 from the PHS. Cardiometabolic risk (CR) was analyzed by the assessment of obesity-related comorbidities (AORC) on admission and 3, 6, and 12 months after BS, and the International Physical Activity Questionnaire (IPAQ) was surveyed before and 12 months after BS. In addition, cardiometabolic risk was also assessed by biochemical (fasting glucose and complete lipidogram) and anthropometric (weight, weight loss, waist circumference, and waist-to-height ratio) parameters. Results: On admission, the parameters of severe obesity, systemic arterial hypertension (SAH), Diabetes mellitus (DM), and waiting time to BS were higher in the PUS. Additionally, in the PUS, AORC was reduced only in the SAH parameter. However, in the post-surgery moment, AORC reduced, and there was no difference between the two groups after BS. Regarding physical activity, the IPAQ showed a higher level of activity in the PHS before and one year after BS. Conclusion: At the PUS, BS is performed in patients with a higher degree of comorbidities, but BS improved the reduction of the CR at a similar level to those observed in the PHS.

Pontos de corte da circunferência do pescoço para identificação de excesso de peso em adultos: um estudo trasnversal / Cut-off points of neck circumference for identification of overweight in adults: transversal study

Introdução: A circunferência do pescoço pode ser uma medida possível para a identificação do excesso de peso em adultos na prática clínica. Objetivo: Determinar os pontos de corte da circunferência do pescoço correspondentes aos níveis de excesso de peso classificados pelo Índice de Massa Corporal (IMC). Métodos: Estudo transversal, com pacientes adultos, ambos os sexos, atendidos no ambulatório de nutrição do Hospital Universitário de Sergipe. Medidas antropométricas de circunferência abdominal, circunferência do pescoço, peso corporal e estatura foram aferidas, as duas últimas utilizadas para o cálculo do IMC. Os dados foram analisados usando o teste de Mann-Whitney e a correlação entre as variáveis numéricas pelo teste de Spearman. A curva ROC (Receiver Operating Characteristic) foi utilizada para avaliar a capacidade preditiva da circunferência do pescoço, bem como, a determinação dos pontos de corte de sobrepeso ou obesidade (alfa=5%). Resultados: Foram avaliados 323 indivíduos, com média de idade de 40,9 (10,8) anos, maioria (81%) mulheres. Para o sexo masculino e feminino, respectivamente, a circunferência do pescoço mostrou forte correlação com o peso corporal (r = 0,859; p<0,001 e r = 0,757; p<0,001), o IMC (r = 0,827; p<0,001 e r = 0,760; p<0,001) e circunferência abdominal (r = 0,834; p<0,001 e r = 0,765; p<0,001). Os pontos de corte da circunferência do pescoço, que melhor rastrearam adultos com sobrepeso, foi 37,9 cm para homens e 34,7 cm para mulheres, e, para obesidade 40 cm para homens e 36,5 cm para mulheres. Conclusão: A Circunferência do pescoço mostrou-se uma ferramenta de rastreio simples para identificar o excesso de peso em adultos, com pontos de corte de 37,9 cm para homens e 34,7 cm para mulheres para identificar o sobrepeso, e, 40 cm para homens e 36,5 cm para mulheres para obesidade

Introduction: Circumference of the neck may be a possible measure for the identification of overweight in adults in clinical practice The objective was determined the cut-off points of neck circumference corresponding to excess weight levels classified by Body Mass Index (BMI). Method: Cross-sectional study, with adults patients, of both genders, attended in nutrition clinic of Sergipe University Hospital. Were collected waist circumference, neck circumference, body weight, height, the latter two used for the determination of BMI. Data were analyzed using the Mann-Whitney test and the correlation between the numerical variables by the Spearman test. The Receiver Operating Characteristic (ROC) curve was used to evaluate the predictive capacity of the neck circumference, as well as, the determination of the cut-off points of overweight or obesity (alfa = 5%). Results: A total of 323 subjects were evaluted, with a mean age of 40.9 (10.8) years, most (81%) women. For the male and female, respectivamente, neck circumference showed a strong correlation with body weight (r = 0.859, p <0.001 and r = 0.757, p <0.001), BMI (r = 0.827, p <0.001 and r = 0.760; p <0.001) and abdominal circumference (r = 0.834, p <0.001 and r = 0.765, p <0.001). Neck circumference cutaways, which best track overweight adults, were 37,9 cm for men and 34,7 cm for women, and for obesity 40 cm for men and 36,5cm for women. Conclusion: The neck circumference showed to be a simple screening tool to identify overweight in adults, with cutoff points of 37,9 cm for men and 34,7 cm for women to identify overweight, and 40 cm for men and 36,5 cm for women for obesity

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Fatores associados à presença da cintura hipertrigliceridêmica em mulheres hipertensas e com excesso de peso / Factors associated with hypertriglyceridemic waist in hypertensive female with overweight

Introdução: A cintura hipertrigliceridêmica é um preditor indireto do risco caridiometabólico. Objetivo: Analisar os fatores associados à presença da cintura hipertrigliceridêmica em mulheres hipertensas e com excesso de peso. Métodos: Trata-se de estudo transversal que incluiu mulheres hipertensas e com excesso de peso, com idades acima de 18 anos. Os pontos de cortes adotados para diagnóstico de cintura hipertrigliceridêmica seguiram os critérios do National Cholesterol Evaluation Program for Adult Treatment Panel III para o sexo feminino: circunferência da cintura ≥88 cm e triglicerídeos ≥ 150 mg/dL. Foram estimadas as razões de prevalência e seus respectivos intervalos de confiança de 95%. Para identificação dos fatores associados à cintura hipertrigliceridêmica foi utilizado o modelo de regressão logística e adotado um nível de significância de 5%. Resultados: A presença da cintura hipertrigliceridêmica foi mais frequente entre as mulheres que fumavam (RP: 1,74; p = 0,003) e naquelas que apresentaram um escore de Framingham mais elevado (p < 0,001). Essas mulheres também apresentaram idade (p = 0,001) e parâmetros bioquímicos mais elevados, como glicemia (p = 0,001) e colesterol total (p = 0,007) e HDL mais baixo (p < 0,001). Após análise de regressão multivariada, as variáveis resultantes no modelo final foram: glicemia (p = 0,0242), colesterol total (p = 0,0004), HDL (p = 0,0007), idade (p = 0,0324) e hábito de fumar (p = 0,0218). Conclusões: Os fatores associados significativamente à presença da cintura hipertrigliceridêmica na amostra estudada foram: hiperglicemia de jejum, hipercolesterolemia e baixos níveis séricos de HDL

Introdution: Hypertriglyceridemic waist is an indirect predictor of caridiometabolic risk. Objective: To analyze the factors associated to the presence of hypertriglyceridemic waist in hypertensive woman with overweight. Methods: A transversal study that included hypertensive and overweight female, with ages above 18 years old. The limiting points for the hypertriglyceridemic waist diagnose followed the criteria established by the National Cholesterol Evaluation Program for Adult Treatment Panel III, for females: waist circumference of ≥ 88 cm and triglycerides ≥ 150 mg/dL. The prevalence reasons were estimated and their respective confidence intervals were of 95%. To identify the factors associated to hypertriglyceridemic waist were used as a logistic regression model adopting a significance level of 5%. Results: The presence of hypertriglyceridemic waist was frequently seen in woman that smoked (PR: 1.74; p = 0.003) and for woman with higher Framingham scores (p < 0.001). These woman also presented age (p = 0.001) and biochemical parameters more elevated, such as glycemia (p = 0.001) and total cholesterol (p = 0.007) and lower high density lipoproteins (HDL) (p < 0.001). After multivariate regression analysis, the variables resulting from the final model were glycemia (p = 0.0242), total cholesterol (p = 0.0004), HDL (p = 0.0007), age (p =0.0324) and smoking habits (p = 0.0218). Conclusions: The factors associated significantly to the presence of hypertriglyceridemic waist in the samples studied were: fasting hyperglycemia, hypercholesterolemia and low serum levels of HDL

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