Genetically determined variations of selenoprotein P are associated with antioxidant, muscular, and lipid biomarkers in response to Brazil nut consumption by patients using statins.

Several single nucleotide polymorphisms (SNPs) could indirectly, as well directly, influence metabolic parameters related to health effects in response to selenium (Se) supplementation. This study aimed to investigate whether the selenoprotein SNPs were associated with the response of Se status biomarkers to the Brazil nut consumption in patients using statins and if the variation in Se homoeostasis could affect antioxidant protection, lipid profile, muscle homoeostasis and selenoproteins mRNA. The study was performed in the Ribeirão Preto Medical School University Hospital. Thirty-two patients using statins received one unit of Brazil nut daily for 3 months. Body composition, blood Se concentrations, erythrocyte glutathione peroxidase (GPX) activity, total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), triacylglycerol (TAG), creatine kinase (CK) activity and gene expression of GPX1 and selenoprotein P (SELENOP) were evaluated before and after Brazil nut consumption. The volunteers were genotyped for SNP in GPX1 (rs1050450) and SELENOP (rs3877899 and rs7579). SNPs in selenoproteins were not associated with plasma and erythrocyte Se, but SNPs in SELENOP influenced the response of erythrocyte GPX activity and CK activity, TAG and LDL after Brazil nut consumption. Also, Brazil nut consumption increased GPX1 mRNA expression only in subjects with rs1050450 CC genotype. SELENOP mRNA expression was significantly lower in subjects with rs7579 GG genotype before and after the intervention. Thus, SNP in SELENOP could be associated with interindividual differences in Se homeostasis after Brazil nut consumption, emphasising the involvement of genetic variability in response to Se consumption towards health maintenance and disease prevention.

Intersection between Obesity, Dietary Selenium, and Statin Therapy in Brazil.

Obesity is among the most alarming health concerns, impacting public health and causing a socioeconomic challenge, especially in developing countries like Brazil, where approximately one quart of the population presents obesity. As an established risk factor for numerous comorbidities with a multifactorial etiology, obesity is a consequence of energy-dense overfeeding, however with significant undernourishment, leading to excessive adipose tissue accumulation and dysfunction, dyslipidemia, and micronutrient deficiencies. About 60% of patients with obesity take statins, a cholesterol-lowering medication, to curb dyslipidemia, with ~10% of these patients presenting various myopathies as side effects. Statins act upon the rate-limiting enzyme of cholesterol biosynthesis in the liver, which is a pathway providing intermediates to the synthesis of selenoproteins, i.e., enzymes containing the micronutrient selenium. Statins have been postulated to negatively impact selenoprotein synthesis, particularly in conditions of selenium deficiency, and potentially implicated in the myopathies occurring as side effects of statins. The Brazilian population is prone to selenium deficiency, hence could be considered more susceptible to statin side effects. This review examines the specific consequences to the Brazilian population of the harmful intersection between obesity development and concomitant micronutrient deficiencies, particularly selenium, combined with statin treatment in the context of nutrition in Brazil.

Lipodystrophy diagnosis in people living with HIV/AIDS: prediction and validation of sex-specific anthropometric models.

BACKGROUND: Body composition alterations, or lipodystrophy, can lead to serious health problems in people living with HIV/AIDS (PLWHA). The objectives of this study are to predict and validate sex-specific anthropometric predictive models for the diagnosis of lipodystrophy in PLWHA. METHODS: A cross-sectional design was employed to recruit 106 PLWHA (men = 65 and women = 41) in Brazil during 2013-2014. They were evaluated using dual-energy X-ray absorptiometry, and 19 regions of body perimeters and 6 skinfold thicknesses were taken. Sex-specific predictive models for lipodystrophy diagnosis were developed through stepwise linear regression analysis. Cross-validations using predicted residual error sum of squares was performed to validate each predictive model. RESULTS: Results support the use of anthropometry for the diagnosis of lipodystrophy in men and women living with HIV/AIDS. A high power of determination with a small degree of error was observed for lipodystrophy diagnosis for men in model six (r2 = 0.77, SEE = 0.14, r2PRESS = 0.73, SEE PRESS = 0.15), that included ratio of skinfold thickness of subscapular to medial calf, skinfold thickness of thigh, body circumference of waist, formal education years, time of diagnosis to HIV months, and type of combined antiretroviral therapy (cART) (with protease inhibitor "WI/PI = 1" or without protease inhibitor "WO/PI = 0"); and model five for women (r2 = 0.78, SEE = 0.11, r2PRESS = 0.71, SEE PRESS = 0.12), that included skinfold thickness of thigh, skinfold thickness of subscapular, time of exposure to cART months, body circumference of chest, and race (Asian) ("Yes" for Asian race = 1; "No" = 0). CONCLUSIONS: The proposed anthropometric models advance the field of public health by facilitating early diagnosis and better management of lipodystrophy, a serious adverse health effect experienced by PLWHA.

Anthropometric measures of central adiposity are highly concordant with predictors of cardiovascular disease risk in HIV patients.

Background: Body fat redistribution and metabolic abnormalities found in HIV patients receiving highly active antiretroviral therapy (HAART) contribute to an atherogenic profile, increasing cardiovascular disease risk. Objective: We aimed to evaluate adiposity measures/indexes and propose cutoffs associated with predictors of cardiovascular disease risk in HIV patients on HAART. Design: To evaluate cardiovascular disease risk in this cross-sectional study, we conducted electrocardiogram exams and stress electrocardiography, measured the ankle brachial index and blood pressure arterial hypertension, conducted lipid biochemical tests, and measured blood glucose. We measured circumferences [waist (WC), hip, thigh, calf, neck, trunk] and skinfold thicknesses (biceps, triceps, subscapular, suprailiac), conducted bioelectrical impedance analysis (BIA), and calculated indexes [body mass index, waist-to-hip ratio, waist-to-thigh ratio, waist-to-calf ratio, waist-to-height ratio (WHtR), trunk-to-arm ratio, body mass index corrected for body fat mass, Body Adiposity Index, conicity index, body shape index, fat mass (percentage), and phase angle]. For evaluating the performance of all adiposity measures/indexes, we used receiver operating characteristic (ROC) curves. Results: Measures of central adiposity WC and WHtR showed the best performances-WC area under the curve (AUC) for men: 0.83 (95% CI: 0.78, 0.89; P < 0.05); WC AUC for women: 0.86 (95% CI: 0.81, 0.91; P < 0.05); WHtR AUC for men: 0.83 (95% CI: 0.78, 0.88; P < 0.05); and WHtR AUC for women: 0.85 (95% CI: 0.80, 0.91; P < 0.05). All adiposity measures/indexes presented different cutoffs from those proposed for the HIV seronegative population. The cutoffs for WC were 87.75 cm (sensitivity: 82.2%; specificity: 75.5%) for men and 90.5 cm (sensitivity: 84.0%; specificity: 73.0%) for women. Conclusions: The measures/indexes of central adiposity presented excellent associations with predictors of cardiovascular disease risk, and the use of the cutoffs proposed in the present study aims to contribute to the early identification of increasing risk of cardiovascular diseases, enabling interventions. This trial was registered at the Brazilian clinical trials registry Registro brasileiro de ensaios clínicos (Rebec) as RBR-9rcxbq.

Doubly Labeled Water Method and Accelerometer for the Measurement of Energy Expenditure in Human Immunodeficiency Virus-Infected Patients.

BACKGROUND: Several studies have reported increased resting energy expenditure (REE) in human immunodeficiency virus (HIV)-infected patients with HIV-associated lipodystrophy syndrome (HALS). However, limited data exist on the total energy expenditure (TEE). This study was aimed at evaluating the REE and TEE of HIV-infected patients with and without HALS by using the doubly labeled water (DLW) technique and the activity monitor based on accelerometry system (AM), and comparing the results obtained using both methods. METHODS: Evaluated total of 45 HIV+ men undergoing antiretroviral therapy, including 18 LIPO- (without lipodystrophy) and 27 LIPO+ (with lipodystrophy) individuals were evaluated. Habitual physical activity patterns were measured by using the ActivPAL™ AM system, REE by indirect calorimetry, and TEE by DLW and AM. RESULTS: No significant differences were found between LIPO- and LIPO+ in REE (1,433 ± 196 vs. 1,510 ± 203 kcal), TEE-DLW (2,691 ± 856 vs. 2,618 ± 415 kcal) and TEE-AM (2,560 ± 458 vs. 2,594 ± 456 kcal), respectively. RQ was a predictor of REE in LIPO+. TEE estimated by the AM had a moderate correlation with DLW, but there was a wide variance in the intra-subject results. CONCLUSIONS: TEE is not increased in HIV-infected patients with HALS. AM should be used with caution for TEE evaluation during clinical practice.

Impact of Strength Training on Bone Mineral Density in Patients Infected With HIV Exhibiting Lipodystrophy.

This study aimed to evaluate the impact of strength training on bone mineral density (BMD) in individuals harboring HIV exhibiting lipodystrophy. The study included 20 subjects (16 men) aged 50.60 ± 6.40 years with reduced BMD, presenting positive serology for HIV, using highly active antiretroviral therapy, and performing no regular practice of physical exercise before being enrolled in the study. Bone mineral density levels were evaluated by dual-energy x-ray absorptiometry in the lumbar spine, femoral neck, and 1/3 radius, before and after 36 sessions (12 weeks) of strength training. Compared with pre-exercise period, the results showed increased BMD in lumbar spine (3.28%; p = 0.012), femoral neck (8.45%; p = 0.044), and 1/3 radius (5.41%; p = 0.035). This is the first study evaluating the impact of strength training in patients living with HIV and exhibiting lipodystrophy, showing an increased BMD in all the regions measured (lumbar spine, femoral neck, and 1/3 radius). This study showed the beneficial impact of the strength training on BMD increase in patients living with HIV as an effective and available approach to improve bone health.

Quality of life in short bowel syndrome: in a single center / Qualidade de vida na síndrome do intestino curto: em um único centro

Model of the study: This is an exploratory and descriptive study which was executed in sector of Nutrology nursing at University Hospital, Faculty of Medicine of Ribeirão Preto, University of São Paulo (HCFMRPUSP). Objective: The aim of this research was to evaluate the perception of quality of life of individuals with short bowel syndrome (SBS) with the help of the Quality of Life Core - 30 Questionnaire (QLQ - C30). Methods: The instrument used was the EORTC- QLQ-C30 (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire/ Quality of Life Core - 30 Questionnaire) version 3.0 in Portuguese. The study was conducted on six patients with SBS. Results: The applicability of the questionnaire was adequate and the mean score obtained for this sample (70.7) was considered to be satisfactory. Conclusions: The most affected domains were: Emotional Function and Symptoms: pain, insomnia, fatigue, and diarrhea. The application of the QLQ - C30 permitted us to evaluate the perception of the patient regarding his condition and quality of life, important aspects that should be considered by the team

Modelo do estudo: Estudo de corte transversal do tipo descritivo e exploratório realizado na enfermaria da Unidade Metabólica do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidadede São Paulo (HCFMRP-USP). Objetivos do estudo: Avaliar a aplicabilidade do Quality of Life Core- 30 Questionnaire (QLQ - C30), não específico para Síndrome do intestino curto (SIC) em portadores da síndrome. Metodologia: Para a coleta de dados foi utilizado como instrumento o questionário EORTCQLQ-C30 (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire/Quality of Life Core - 30 Questionnaire) versão 3.0 em português. O estudo foi realizado com 6 pacientes com SIC. Resultados: A aplicabilidade deste questionário foi adequada; o escore médio obtido nesta amostra foi considerado satisfatório (escore médio = 70,7). Conclusões: Os domínios mais afetados foram: Função Emocional e sintomas: dor, insônia, fadiga e diarréia. A aplicação do questionário QLQ -C30 possibilitou avaliar a percepção dos pacientes quanto a sua condição de saúde e qualidade devida, revelando pontos importantes que devem ser considerados pela equipe.

Perfil do estado de saúde de mulheres climatéricas / Health status profile of climacteric women

Modelo do estudo: Estudo retrospectivo com análise de dados de prontuário. Objetivo: O presente estudo teve por objetivo verificar a freqüência de obesidade, diabetes mellitus, hipertensão arterial e dislipidemia em um grupo de mulheres climatéricas. Metodologia: Estudo das primeiras pacientes atendidas no Ambulatório do Climatério (ACLI) do Departamento de Ginecologia e Obstetrícia da Faculdade de Medicina de Ribeirão Preto -USP, no período de1983 a 2007. De fevereiro a abril de 2008 foram coletados dados de peso, estatura, Índice de Massa Corporal (IMC), grupo biológico, diagnóstico de hipertensão, diabetes e dislipidemia. Resultados: De 1983 a 2007, 400 pacientes tiveram seguimento no Ambulatório (ACLI), e 272 apresentavam seus prontuários com os dados do presente estudo devidamente registrados. Dessas 272pacientes, foram selecionadas 628 consultas, sendo que, portanto, em média, cada mulher teve trêsretornos. Estas mulheres tinham idade mínima de 29 e máxima de 80 anos, com IMC mediano acimade 25 kg/m2. O diagnóstico de diabetes, hipertensão e dislipidemia foi detectado em, respectivamente:32%, 68% e 54% dos casos.Conclusão: Mulheres climatéricas atendidas em um hospital de nível de atendimento terciário apresentaram um aumento do IMC e da prevalência de doenças crônicas não transmissíveis com o passar dotempo, o que faz urgir um olhar mais atento dos profissionais de saúde a esse grupo populacional.

Study design: Retrospective analysis of medical records.Purpose: This study aimed to determine the prevalence of obesity, diabetes mellitus, hypertension anddyslipidemia in a group of climacteric women.Methods: Study of the first patients treated at the Menopause Clinic (ACLI), Department of Obstetrics andGynecology, School of Medicine of Ribeirão Preto (USP), from 1983 to 2007. Data on weight, height, BMI,biological group, diagnosis of hypertension, diabetes and dyslipidemia was collected from February/2008 until April/2008. Results: From 1983 until 2007, 400 patients were followed up, and 272 had their records registered. Of these 272 patients, 628 were selected queries, and therefore, on average, each woman had three returns. Women over the age of 29 and maximum of 80 years and median BMI above 25kg/m². The prevalence of diabetes, hypertension and dyslipidemia was respectively 32%, 68% and 54%. The prevalence of NCDs and BMI was higher for the later groups. Conclusion: Climacteric women treated at a hospital level care center showed a worsening of the BMI and the prevalence of noncommunicable chronic diseases over time, which is urging a closer look at health professionals in this population group.

Clinical and metabolic profile of HIV-positive patients with lipodistrophy / Perfil clínico e metabólico de pacientes soropositivos para HIV portadores de lipodistrofia

Objective: To evaluate the clinical and metabolic profile of HIV-seropositive patients on HAART with a diagnosis of associated lipodystrophy. Methods: We analyzed data computed in a protocol attached to the records of patients treated at the University Hospital of the Medical School of Ribeirão Preto. Results: 69.7% of the participants were male. Mean ± standard deviation body mass index was 24.7 ± 3.6 kg/m2and 26.7 ± 5.98 kg/m2, and average weight 72.78 ± 12.7 kg and 65.94 ± 15.4 kg for males and females, respectively. The percentage of lean mass was greater in men (p = 0.0008) and body fat was greater in women (p = 0.0006)...

Objetivo: Avaliar o perfil clínico e metabólico dos pacientes soropositivo para HIV, em uso de terapia antiretroviral fortemente ativa (Highly Active Antiretroviral Therapy - HAART) e com diagnóstico de lipodistrofia associada. Métodos: A pesquisa foi realizada a partir da análise de dados computados em um protocolo anexado ao prontuário de pacientes atendidos na Unidade Especial de Tratamento para Doenças Infecciosas (UETDI), no Ambulatório de Dislipidemia (ADIS) do Hospital das Clínicas da Faculdade deMedicina de Ribeirão Preto (HC-FMRP). Resultados: 69,7% dos participantes eram do sexo masculino. As médias (DP) de IMC foram 24,7 ± 3.6 Kg/m2 e 26,7 ± 5.98 Kg/m2 e média de peso 72,78 ±12.7 Kg e 65,94 ± 15.4 Kg para o sexo masculino e feminino, respectivamente. A porcentagem de massa magra foi maior nos homens (p=0,0008) e de gordura corporal, maior no sexo oposto (p=0,0006)...