Ankle-brachial index and peripheral arterial disease: An evaluation including a type 2 diabetes mellitus drug-naïve patients cohort.

BACKGROUND: Peripheral arterial disease in patients with type 2 diabetes mellitus is an important risk factor for vascular events. Recommendations about whether ankle-brachial index should be performed differ depending on the source; therefore, it is necessary to re-evaluate the most important risk factors associated with peripheral arterial disease and whether it is useful to perform ankle-brachial index in newly diagnosed and drug-naïve patients with diabetes, independent of age or peripheral arterial disease symptoms. METHODS: A total of 711 subjects were divided into groups: group 1, 600 type 2 diabetes mellitus patients, symptomatic or not for peripheral arterial disease; group 2, 61 type 2 diabetes mellitus patients newly diagnosed and drug naïve; and group 3, 50 subjects without diabetes. Ankle-brachial index, medical records and physical examination were performed in all patients, accessing cardiovascular risk factors. RESULTS: Analysing group 1 asymptomatic patient to peripheral arterial disease, we found abnormal ankle-brachial index in 49% (77/156) ⩾50 years and 42% (16/38) <50 years (p = not significant). Considering drug-naïve patients, a peripheral arterial disease prevalence of 39% (24/61) was found; among these, 48% (13/27) were <50 years and 32% (11/34) were ⩾50 years (p = not significant). A forward stepwise regression model was developed, with type 2 diabetes mellitus duration (r2 = 0.12) and sedentary lifestyle (r2 = 0.14) found as independent variable predictors of severity of peripheral arterial disease, related to ankle-brachial index. CONCLUSION: We suggest that, in type 2 diabetes mellitus, ankle-brachial index should be measured at diagnosis. In addition, sedentary lifestyle was strongly associated with presence and severity of peripheral arterial disease.

Consumo alimentar de lactentes de dois estratos socioecônomicos / Dietary intake of infants from two different socioeconomic groups

Objetivo: verificar o consumo alimentar de lactentes de dois estratos socioeconômicos (ESE). Método: estudo transversal, comparativo, realizado através de entrevista com os responsáveis dos 79 lactentes atendidos em unidade básica de saúde e consultórios particulares em Belém-Pará, no período de junho de 2005 a setembro de 2006. Resultados: quanto à mediana de frequência de ingestão diária de alimentos para as crianças do ESE baixo (ESEB): 2 - óleos e gorduras; 1 - especiarias; 2 - sal; 0 - fórmula infantil; para as crianças do ESE alto (ESES): 2 - leguminosas; 3 - frutas. Em relação à idade média em meses de introdução de alimentos obteve-se para o ESEA: 4,6 - frutas; 5,7 - arroz; 5,9 - tubérculos e raízes; 5,8 - hortaliças. Conclusões: o consumo alimentar dos lactentes consistiu de componentes de todos os grupos da pirâmide. Quanto à frequência de ingestão, encontrou-se: 1) maior consumo de frutas e leguminosas pelos lactentes do ESEA; 2) consumo duas vezes maior ao dia de óleos e gorduras, especiarias e sal por algumas crianças do ESEB; 3) consumo exclusivo de FI pelas crianças do ESEA. Verificou-se ingestão precoce de alguns alimentos pelas crianças do ESEA.

Objective: this study aims to check the food intake of infants from two different socioeconomic stratum (SES). Methods: cross-sectional study, observational, comparative, conducted through interviews with officials from 79 infants treated at a primary health and prvate offices in Belém - Pará from june 2005 to september 2006. Results: it was found as the median frequency of daily food intake for children of low SES (LSES): 2 - oils and fats; 1 - spices; 2 - salt; 0 - infant formula; for children of high SES (HSES): 2 - leguminous; 3 - fruits. Regarding the average age in months of the introduction of foods it was observed for the HSES: 4.6 - fruits; 5.7 - rice; 5.9 - tubers and roots; 5.8 - greenery. Conclusions: thus, the food intake of infantis consisted of components from all sections of the pyramid. With regard to frequency of intake, it was found higher intakes of fruits and vegetables by infantis of the HSES; some children of LSES had intakes twice higher a day of fats and oils, spices and salt; and exclusive consumption of IF by children of the HSES. There was an early intake of food by children of the HSES.