RESUMEN
Inadequate nutrient intake can lead to worse outcomes in patients with heart failure (HF). This prospective cohort study aimed to assess the prevalence of inadequate micronutrient intake and their association with prognosis in 121 adult and elderly outpatients with HF. Habitual micronutrient intake was evaluated using 24-h dietary recalls (minimum 2 and maximum 6). Participants were grouped into moderate (n = 67) and high (n = 54) micronutrient deficiency groups, according to the individual assessment of each micronutrient intake. Patients' sociodemographic, clinical, and anthropometric data and clinical outcomes (hospitalization and mortality) within 24 months were collected. Overall and event-free survival rates were calculated using Kaplan-Meier estimates, and curves were compared using the log-rank test. The death risk rate (hazard ratio (HR)) was calculated using Cox's univariate model. The rate of inadequate intake was 100% for vitamins B1 and D and above 80% for vitamins B2, B9, and E, calcium, magnesium, and copper. No differences in overall survival and event-free survival were observed between groups of HF outpatients with moderate and high micronutrient deficiencies (HR = 0.94 (CI = 0.36-2.48), p = 0.91, and HR = 1.63 (CI = 0.68-3.92), p = 0.26, respectively), as well as when the inadequacy of each micronutrient intake was evaluated alone (all p > 0.05). In conclusion, a high prevalence of inadequate micronutrient intake was observed in outpatients with HF. Inadequate micronutrient intake was not associated with hospitalization and mortality in this group of patients.
Asunto(s)
Insuficiencia Cardíaca , Pacientes Ambulatorios , Adulto , Anciano , Ingestión de Alimentos , Insuficiencia Cardíaca/complicaciones , Humanos , Micronutrientes , Pronóstico , Estudios ProspectivosRESUMEN
Introdução: Fatores cardiometabólicos característicos da síndrome metabólica (SM) influenciam no metabolismo do zinco, de forma isolada ou conjuntamente. Objetivo: Comparar as concentrações de zinco no plasma e na dieta entre os três de grupos de indivíduos com SM, distribuídos conforme número de componentes da SM. Métodos: Estudo transversal incluindo 88 indivíduos com SM, diagnosticados segundo NCEP-ATP III. Definiu-se os grupos, considerando três (n=36), quatro (n=40) e cinco componentes da SM (n=12). O zinco da dieta foi avaliado por dois recordatórios de 24h. Verificou-se a pressão arterial, perímetro da cintura e glicemia de jejum, colesterol da lipoproteína de alta densidade e triglicerídeos. O zinco no plasma foi avaliado por espectrofotometria de absorção atômica. As comparações entre os grupos foram realizadas por meio do teste ANOVA, seguido do teste Tukey. Resultados e discussão: A idade média foi de 50(11) anos, predominando o sexo feminino (72%). Observou-se no grupo com três componentes, dez diferentes fenótipos, destacando- se a combinação: hipertensão arterial ou pressão arterial elevada, diabetes mellitus ou glicemia de jejum elevada e perímetro da cintura aumentado (11,4%). Não foram verificadas diferenças significativas do zinco no plasma entre os grupos com três, quatro e cinco componentes, apresentando médias de 92,62(18,26) μg/dL; 86,24(17,88) μg/dL; 86,94(17,12) μg/dL, respectivamente (p>0,05). Constataramse percentuais de inadequação de ingestão de zinco de 75%, 73,6% e 66,6% nos grupos com três, quatro e cinco componentes, respectivamente. Conclusão: Indivíduos com SM, independentemente do número de componentes, apresentam médias de zinco no plasma dentro da normalidade e baixa ingestão de zinco na dieta
Introduction: Cardiometabolic risk factors characteristic of the metabolic syndrome (MS) influence zinc metabolism, either alone or in combination. Objective: This study aims to compare plasma zinc and zinc intake among the three groups of individuals with MS, distributed according to the number of components of SM. Methods: Cross-sectional study including 88 individuals with MS, diagnosed according to NCEP-ATP III. The groups were defined, considering three (n = 36), four (n = 40) and five components of MS (n = 12). Zinc intake was evaluated by two 24-hour recall. Blood pressure, waist circumference and fasting glycemia, high density lipoprotein cholesterol and triglycerides were measured. Analysis of plasma zinc was performed by atomic absorption spectrophotometry. We used ANOVA, followed by the Tukey test, for comparisons between the groups. Results and discussion: The mean age was 5011 years, predominantly female (72%). We found ten different phenotypes based on the three components of MS, with emphasis on the phenotype: arterial hypertension or high blood pressure, diabetes mellitus or fasting blood glucose and increased waist circumference (11.4%). There were no significant differences in plasma zinc between the groups with three, four and five components, presenting a mean of 92.62 (18.26) μg / dL; 86.24 (17.88) μg / dL; 86.94 (17.12) μg / dL, respectively (p> 0.05). The percentages of zinc intake inadequacy were 75%, 73.6% and 66.6% in the groups with three, four and five components, respectively. Conclusion: Individuals with MS, regardless of the number of components, present mean plasma zinc within normal range and low dietary zinc intake
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