A pilot observational study to identify reference values for the 6-minute walk test in Brazilian people with hypertension / Um estudo observacional piloto para identificar valores de referência para o teste de caminhada de 6 minutos em hipertensos brasileiros

Abstract Introduction Systemic arterial hypertension (SAH) is responsible for 9.5 million deaths in the global popu-lation. Lifestyle factors, including physical inactivity, are important modifiable risk factors in the development of SAH. Thus, physical exercise has been shown to be effective to control SAH and before the prescription, the six-minute walk test (6-MWT) has been commonly used to assess the physical capacity. Objective To propose reference values for the 6-MWT test in Brazilian people with SAH. Methods A cross-sectional observational study was conducted with 302 hypertensive subjects (62.61 + 10.93 years) admitted to a cardiac rehabilitation program. Participants were divided into different age quartiles and submitted to 6-MWT. The walking distance data was compared between the quartiles and adjusted by mul-tiple linear regression analysis. Results The hypertensive subjects walked 388.07 + 115.03 m during the 6-MWT. No significant difference between the genders was found. However, when the age quartiles were compared, for the 46-59 age group, the women walked less than the men. Intra-group comparisons showed that the distance walked in the 6-MWT decreased with the increase in age, in both men and women. Conclusion The present study provides reference values for the 6-MWT, both for Brazilian men and women of different age groups. This data may be an important parameter for future clinical studies, prevention strategies, and clinical intervention.

Resumo Introdução A hipertensão arterial sistêmica (HAS) é respon-sável por 9,5 milhões de mortes na população mundial. Con-dições do estilo de vida, incluindo a inatividade física, são importantes fatores de risco modificáveis no desenvolvimento da HAS. Desse modo, o exercício físico tem se mostrado eficaz no controle da HAS e, antes da prescrição, o teste de caminhada de seis minutos (TC6) tem sido comumente utilizado para ava-liar a capacidade física. Objetivo Propor valores de referência para o teste de TC6 em brasileiros com HAS. Métodos Realizou-se um estudo observacional transversal com 302 hipertensos (62,61 + 10,93 anos) admitidos em um programa de reabilitação cardíaca. Os participantes foram divididos em diferentes quartis de idade e submetidos ao TC6. Os dados de distância percorrida foram comparados entre os quartis e ajustados por análise de regressão linear múltipla. Resultados Os hipertensos caminharam 388,07 + 115,03 m durante o TC6. Não encontrou-se diferença significativa entre os gêneros. No entanto, quando comparados os quartis de idade, para a faixa etária de 46 a 59 anos, as mulheres caminharam menos do que os homens. As comparações intragrupo mostraram que a distância percorrida no TC6 diminuiu com o aumento da idade, tanto em homens quanto em mulheres. Conclusão O presente estudo fornece valores de referência para o TC6, tanto para homens quanto para mulheres brasileiras de diferentes faixas etárias. Esses dados podem ser um parâmetro importante para futuros estudos clínicos, estratégias de prevenção e intervenção clínica.

Anxiety and depression symptoms in university students from public institutions of higher education in Brazil during the covid-19 pandemic: a multicenter study

This is a multicenter, cross-sectional study carried out with students regularly enrolled in undergraduate courses at eight Brazilian IFES. Data collection was conducted between October 2021 and February 2022 using an online self-completed questionnaire, which addressed sociodemographic and academic characteristics, lifestyle habits, and health conditions. Symptoms of anxiety and depression were assessed using the Depression, Anxiety, and Stress Scale-21 (DASS-21). Variables were analyzed descriptively using frequency distribution and Pearson's chi-square test. To estimate the prevalence of symptoms of anxiety and depression, the proportion and 95% confidence interval (95%CI) were used. The level of adopted statistical significance was 5%.

Triglyceride-glucose index is associated with poor sleep quality in apparently healthy subjects: A cross-sectional study

ABSTRACT Objectives: We aimed to evaluate the association between the triglyceride glucose index (TyG index) and sleep quality and to establish a cut-off value for the TyG index based on the prevalence of subjects with insulin resistance (IR). Materials and methods: This cross-sectional study involved Brazilian health professionals (20-59 years). A total of 138 subjects answered the Pittsburgh Sleep Quality questionnaire to evaluate sleep quality. They were categorized into two groups: good sleep quality (global score ≤ 5 points) and poor sleep quality (global score ≥ 6 points). Also, we classified the subjects as having a high (>8.08 or >4.38) or low TyG index (≤8.08 or ≤4.38). Results: The majority of the subjects (70%) with high TyG index values (>8.08 or >4.38) reported poor sleep quality (p ≤ 0.001). Those with poor sleep quality had a 1.44-fold higher prevalence of IR (TyG index >8.08 or >4.38) compared to those with good sleep quality, regardless of sex, total cholesterol, LDL/HDL ratio, insulin, complement C3, CRP, and adiponectin (p ≤ 0.001). Conclusion: Our data showed a positive and significant association between the TyG index and poor sleep quality. Thus, these findings support the association between poor sleep quality and IR.

Efeito da reabilitação cardíaca sobre o limiar nociceptivo aumentado de indivíduos hipertensos / Effect of cardiac rehabilitation on the nociceptive threshold increased of hypertensive subjects

Objetivos: Indivíduos hipertensos apresentam um limiar nociceptivo aumentado, o que pode contribuir para uma redução da percepção da dor. Assim, o objetivo deste estudo foi avaliar o efeito de um programa de reabilitação cardíaca (PRC) sobre limiar nociceptivo aumentados de indivíduos hipertensos. Métodos: Quarenta e um participantes foram divididos em dois grupos: grupo normotenso e grupo hipertenso. Nos dois grupos, foram avaliados a massa corporal, índice de massa corporal (IMC), circunferência abdominal, pressão arterial sistólica e diastólica, frequência cardíaca, limiar nociceptivo e a capacidade funcional pelo teste de caminhada de seis minutos (TC6). O PRC foi composto de exercícios aeróbicos em esteira com duração de 30 minutos, 3 vezes por semana, durante 7 semanas. Resultados: Após o PRC, houve uma significativa redução (p < 0,001) no limiar mecânico nociceptivo e um aumento na distância percorrida durante o TC6 (p < 0,001) no grupo composto por indivíduos hipertensos. Conclusão: Os resultados do presente estudo sugeriram que o exercício aeróbico é uma modalidade importante para normalizar o limiar nociceptivo e melhorar a capacidade funcional de indivíduos hipertensos.

Evaluation of respiratory and peripheral muscle training in individuals undergoing myocardial revascularization.

OBJECTIVES: To investigate the effect of peripheral muscle strength training (PMT) and respiratory muscle strength training (RMT) muscle strength training associated with conventional physical therapy on the respiratory muscle strength, functional capacity, and quality of life in the immediate postoperative period of patients undergoing coronary artery bypass graft (CABG). METHODS: This was a randomized controlled trial. Eighty-three patients undergoing CABG were divided into two groups: Intervention group, patients that received PMT and RMT associated with conventional physical therapy, one session a day for 5 days; control group, patients that received conventional physical therapy, one session a day for 5 days. All patients had respiratory muscle strength, peripheral muscle strength, functional capacity, and quality of life evaluated by manovacuometry, dynamometry, 6-min walking test, and 36-item Short-Form Health Survey Questionnaire, respectively, before and 5 days after CABG. RESULTS: Both groups showed a significantly reduced respiratory muscle strength after CABG; however, in the intervention group, the inspiratory muscle strength reduction was lower (confidence interval [CI] 95%: 2.29 [1.9; 27.54]). The quality of live domains for pain (CI 95%: 3.08 [5.21; 24.97]) and vitality perception (CI 95%: 2.51 [2.12; 19.53]) worsened in the control and improved in the intervention group (pain: CI 95%: 1.19 [-3.38; 13.09]; vitality CI 95%: 0.07 [-6.55; 7.04]). Both groups showed reduced functional capacity and expiratory muscle strength after CABG. CONCLUSION: Conventional physical therapy combined with PMT and RMT may reduce inspiratory muscle strength loss and improve pain and vitality perception in the immediate postoperative period after CABG.

Perfil antropométrico, dietético e pressão arterial de adultos onívoros e vegetarianos / Anthropometric, dietary and blood pressure profile of omnivorous and vegetarian adults

INTRODUÇÃO: Estudos demonstram que dietas vegetarianas restritivas ou desequilibradas podem determinar deficiências nutricionais, porém se bem equilibradas podem prevenir possíveis deficiências, bem como algumas doenças crônicas. OBJETIVOS: Analisar o perfil antropométrico, dietético e pressão arterial de onívoros e vegetarianos. MÉTODOS: Estudo transversal, em que foram realizados atendimentos individuais, sendo aplicado questionário semiestruturado. Foram aferidos peso, estatura, perímetro da cintura (PC) e perímetro do quadril. A partir das medidas antropométricas foram calculados índices antropométricos: índice de massa corporal (IMC), relação cintura/quadril (RCQ) e relação cintura/estatura (RCE). Composição corporal foi avaliada por meio de equação pelo método de quatro pregas. Consumo alimentar foi avaliado por meio do recordatório de 24 horas. RESULTADOS: Participaram 123 adultos, com idade de 25,7±7,7 anos, sendo a maioria (74%) mulheres. Do total de participantes, 54,5% eram onívoros e 45,5% vegetarianos. A média do IMC foi 23,0±3,4 kg/m², do PC 75,3±9,6 cm, da RCE 0,46±0,05 e da RCQ 0,77±0,07, sem diferenças entre os grupos (p > 0,05), com exceção da RCQ, que foi maior entre os vegetarianos (0,78±0,08) em relação aos onívoros (0,75±0,05) (p < 0,05). Quanto ao estado nutricional, 72,4% encontravam-se eutróficos e 22% com excesso de peso. Quanto às complicações metabólicas associadas à obesidade, 19,5% apresentaram risco elevado de desenvolver doenças crônicas não transmissíveis (DCNT) segundo a RCE, 13% segundo o PC e, 1,6% segundo à RCQ. A média da pressão arterial (PA) sistólica foi 114,0±15,2 mmHg e da PA diastólica foi 76,9±10,7 mmHg. Quanto a avaliação dietética, os vegetarianos apresentaram consumo significativamente maior de carboidratos, vitamina C e fibras, e um consumo menor de proteínas, vitamina B12 e zinco (p < 0,05). CONCLUSÕES: O perfil antropométrico mostrou resultados positivos, sendo que a maioria se encontrava eutrófico(a), com PC, RCE e RCQ indicando baixo risco ao desenvolvimento de DCNT. Em relação ao perfil dietético, deve-se dar especial atenção ao consumo de proteínas, vitamina B12 e zinco

INTRODUCTION: Studies show that restrictive or unbalanced vegetarian diets can determine nutritional deficiencies, but if well balanced they can prevent possible deficiencies, as well as some chronic diseases. OBJECTIVE: To analyze the anthropometric, dietary and blood pressure profile of omnivorous and vegetarians. METHODS: Cross-sectional study, in which individual consultations were performed, using a semi-structured questionnaire. Weight, height, waist circumference (WC) and hip circumference were measured. From anthropometric measurements, anthropometric indices were calculated: body mass index (BMI), waist/hip ratio (WHR) and waist/height ratio (WHtR). Body composition was assessed using the four-skinfold method. Food consumption was assessed using the 24-hour recall. RESULTS: The study included 123 adults, with a mean age of 25.7±7.7 years, and the majority (74%) were females. Of the total participants, 54.5% were omnivorous and 45.5% were vegetarian. The mean BMI was 23.0±3.4 kg/m², the WC 75.3±9.6 cm, the WHtR 0.46 ± 0.05 and the WHR 0.77±0.07, with no differences between groups (p > 0.05), with the exception of WHR, which was higher among vegetarians (0.78±0.08) compared to omnivorous (0.75±0.05) (p < 0.05) Regarding nutrition status, 72.4% were eutrophic and 22% were overweight. As for metabolic complications associated with obesity, 19.5% were at high risk of developing chronic non-communicable diseases (NCDs) according to the WHtR, 13% according to the WC and 1.6% according to the WHR. The mean systolic blood pressure (BP) was 114.0±15.2 mmHg and the diastolic BP was 76.9±10.7 mmHg. As for dietary assessment, vegetarians had a significantly higher consumption of carbohydrates, vitamin C and fiber, and a lower consumption of proteins, vitamin B12 and zinc (p < 0.05). CONCLUSIONS: The anthropometric profile showed positive results, with the majority being eutrophic(a), with WC, WHtR and WHR indicating low risk for the development of NCDs. Regarding the dietary profile, special attention should be paid to the consumption of proteins, vitamin B12 and zinc

Higher Waist Circumference Is Related to Lower Plasma Polyunsaturated Fatty Acids in Healthy Participants: Metabolic Implications.

OBJECTIVE: We evaluated whether the relationship between waist circumference (WC) and cardiometabolic risk is related to usual diet and plasma fatty acid composition. METHODS: This cross-sectional study included 226 health professionals from 20 to 59 years old. Anthropometric features, oxidative stress, inflammatory markers, and plasma fatty acid profile were assessed. Dietary intake was evaluated with a semi-quantitative food frequency questionnaire, the quality of dietary habits by Healthy Eating Index, and insulin resistance by homeostasis model assessment-insulin resistance and triglyceride-glucose index. RESULTS: Higher WC was associated with lower concentrations of high-density lipoprotein cholesterol (p = 0.000) and adiponectin (p = 0.000) and higher uric acid levels (p = 0.011). Plasma polyunsaturated fatty acid (PUFA) levels were negatively associated with weight (p = 0.046), systolic blood pressure (p = 0.035), fasting glucose (p = 0.000), triglyceride-glucose index (p = 0.023), and IL-1ß (p = 0.037). Individuals with elevated WC consumed more calories (p = 0.002), niacin (p = 0.002), and pyridoxine (p = 0.017), but less calcium (p = 0.001), phosphorus (p = 0.016), and vitamin B2 (p = 0.011). In addition, individuals with higher WC denoted lower PUFA concentrations (p = 0.036). CONCLUSION: The results suggest that participants with higher WC have lower plasma PUFA concentrations and higher levels of saturated fatty acids. This could be related to metabolic and inflammatory changes that could trigger increased risk of metabolic syndrome and cardiovascular disease.

Prevalence of metabolic syndrome and pre-metabolic syndrome in health professionals: LATINMETS Brazil study.

BACKGROUND: The metabolic syndrome (MS) is characterized by several cardiovascular risk factors and is associated with an increased incidence of diabetes, cardiovascular events and mortality. The prevalence of MS is increasing in epidemic proportions worldwide. The present study aimed to investigate the prevalence of MS and its components in health professionals in the municipality of Viçosa, Brazil. METHODS: Cross-sectional observational study in the frame of the LATIN America METabolic Syndrome (LATINMETS) multicenter study. The study sample consisted of 226 healthcare personnel (20-59 years). Weight, height, waist circumference and hip circumference were determined. The following anthropometric indices were calculated: body mass index (BMI), waist/hip ratio, waist/height ratio, body adiposity index (BAI) and conicity index. Body composition was assessed by tetrapolar bioelectrical impedance. The lipid profile, fasting glucose, insulin, uric acid, high-sensitive C-reactive protein (hs-CRP) and complement C3 were measured in fasting conditions. Insulin resistance was assessed by the Homeostasis Model Assessment Index of Insulin Resistance (HOMA-IR). RESULTS: Of the 226 healthcare individuals included in the study, 74.3% were female, 77.0% graduated and 23.0% students of the last two years of courses in health area, with a median age of 27 years. The overall prevalence of MS was 4.5%, and increased with age (20 to 29 years: 1.3%; 30 to 39 years: 5.6%; ≥ 40 years: 26.3%) (P < 0.01). The presence of pre-MS and MS was associated with several measures of adiposity, total cholesterol/HDL-c and LDL-c/HDL-c ratios and serum complement C3 concentrations. CONCLUSIONS: The LATINMETS Brazil study reported an association between MS prevalence and age, especially in those over 40 years. The presence of MS is associated with an increased prevalence of several cardiovascular risk factors.

Relationship between waist circumference and sagittal abdominal diameter measured at different anatomical sites and inflammatory biomarkers in apparently health men / Relación entre la circunferencia de la cintura y el diámetro abdominal sagital medido en diferentes sitios anatómicos y biomarcadores del estado inflamatorio en hombres adultos sanos

Introduction: Visceral fat accumulation is associated with several changes, such as, increased production of inflammatory biomarkers, especially, C-reactive protein (CRP) and fibrinogen. Anthropometric measurements for central adiposity evaluation, such as, waist circumference (WC) and sagittal abdominal diameter (SAD) have been highlighted. However, there is no consensus on the best anatomical site for measurement. Objective: To evaluate the reliability of different measurements of WC and SAD and verify their capacity to discriminate changes in inflammatory biomarkers. Method: 130 men (20-59 years) were assessed, having measurements of weight, height, WC and SAD. It was considered as the cutoff point for high-sensitivity CRP (hs-CRP) values ≥ 0.12 mg/dL and for fibrinogen the 50th percentile of the evaluated sample. Results: All measurements presented an intraclass correlation coefficient between 0.998 and 0.999. WC measured at the umbilical level (AUC=0.693±0.049) and the smallest circumference between the thorax and the hips (AUC=0.607±0.050) had greater ability to discriminate changes in concentrations of hs-CRP and fibrinogen, respectively. SAD (umbilical level) showed the better ability to detect changes in concentrations of hs-CRP (AUC=0.698± 0.049) and fibrinogen (AUC=0.625±0.049), according to the ROC analysis (p<0.05). Conclusion: WC (smallest circumference between the thorax and the hips) and SAD (umbilical level) are the anatomic sites of measurement for use in predicting the inflammatory risk in apparently health men (AU)

Introducción: La acumulación de grasa visceral se asocia con varios cambios, tales como, aumento de la producción de los biomarcadores inflamatorios, en especial, la proteína C-reactiva (PCR) y fibrinógeno. Las medidas antropométricas para la evaluación de la adiposidad central, como la circunferencia de la cintura (CC) y el diámetro abdominal sagital (DAS) se han destacado. Sin embargo, no hay consenso sobre el mejor sitio anatómico para la medición. Objetivos: Evaluar la fiabilidad de diferentes mediciones de CC y DAS y verificar su capacidad para discriminar los cambios en biomarcadores inflamatorios. Métodos: Se evaluaron 130 hombres (20-59 años). Se midió peso, estatura, circunferencia de la cintura (CC) y diámetro abdominal sagital (DAS). Se consideró como punto de corte para los valores de PCR ultrasensible (PCR-us) ≥ 0,12 mg/dL y para el fibrinógeno se utilizó el percentil 50 de la muestra evaluada. Resultados: Todas las mediciones presentaron un coeficiente de correlación intraclase entre 0.998 y 0.999. CC medida a nivel umbilical (AUC=0,693±0,049) y la circunferencia más pequeña entre el tórax y las caderas (AUC=0,607±0,050) tuvieron una mayor capacidad para discriminar los cambios en las concentraciones de PCRus y fibrinógeno, respectivamente. DAS (nivel umbilical) mostró la mejor capacidad para detectar cambios en las concentraciones de PCR-us (AUC=0,698±0,049) y fibrinógeno (AUC=0,625±0,049), de acuerdo con el análisis ROC (p<0,05). Conclusiones: CC (circunferencia más pequeña entre el tórax y las caderas) y DAS (nivel umbilical) son los sitios anatómicos de elección para su uso en la predicción del riesgo inflamatorio en hombres adultos sanos (AU)

Serum uric acid can predict higher C-reactive protein levels in apparently healthy men / Ácido úrico sérico puede predecir mayores niveles de proteína c-reactiva en hombres adultos sanos

Introduction: Epidemiological studies have shown an association between coronary heart disease and emerging cardiovascular risk factors, such as, levels of fibrinogen and high-sensitivity C-reactive protein (hs-CRP). Objectives: To verify the ability of biochemical indicators in discriminating changes in the levels of hs-CRP and fibrinogen, in apparently healthy adult men. Methods: Were evaluated 130 apparently healthy men (20-59 years), having measurement of weight and height. Biochemical measurements (lipid profile, fasting glucose, uric acid, hs-CRP and fibrinogen) were performed. Body mass index, total cholesterol/HDL-c and LDL-c/HDL-c ratios were calculated. It was considered as the cutoff point for hs-CRP values ≥ 0.12 mg/dL and for fibrinogen the 50th percentile of the evaluated sample. Results: The uric acid showed the best correlation (r = 0.325) and the higher area under the ROC curve (0.704 ± 0.054), showing greater ability to discriminate higher levels of hs-CRP (p < 0.01). The total cholesterol/HDL-c ratio (r = 0.222) and the LDL-c/HDL-c ratio (r = 0.235) showed the best correlations and the higher areas under the ROC curves (0.624 ± 0.049 and 0.624 ± 0.049) in identify higher levels of fibrinogen (p < 0.05). Conclusion: The uric acid and the total choles - terol/HDL-c and the LDL-c/HDL-c ratios showed greater ability to identify changes in the levels of hs-CRP and fibrinogen, respectively. It was suggested the use of biochemical markers in the clinical practice, in order to establish preventive action for cardiovascular disease in apparently healthy adult men (AU)

Introducción: Los estudios epidemiológicos han demostrado una asociación entre la enfermedad coronaria y nuevos factores de riesgo cardiovascular, como, los niveles de proteína C-reactiva ultrasensible (PCR-us) y fibrinógeno. Objetivos: Evaluar la capacidad de los indicadores bioquímicos en discriminar cambios en los niveles de PCRus y fibrinógeno, en hombres adultos sanos. Métodos: Se evaluaron 130 hombres (20-59 años). Se midió peso y talla. Se realizó mediciones bioquímicas (perfil lipídico, glucosa en ayunas, ácido úrico, PCR-us y fibrinógeno). Se calculó el índice de masa corporal, la relación colesterol total/HDL-c y la relación LDL-c/HDL-c. Se consideró como punto de corte para los valores de PCR-us ≥ 0,12 mg/dL y para el fibrinógeno se utilizó el percentil 50 de la muestra evaluada. Resultados: El ácido úrico mostró la mejor correlación (r = 0,325) y el área más alta bajo la curva ROC (0,704 ± 0,054), mostrando una mayor capacidad predictiva para detectar niveles más altos de PCR-us (p < 0,01). La relación colesterol total/HDL-c (r = 0,222) y la relación LDLc/HDL-c (r = 0,235) mostraron una mejor correlación y el área más alta bajo la curva ROC (0,624 ± 0,049 y 0,624 ± 0,049) en la identificación de niveles más altos de fibrinógeno (p < 0,05). Conclusiones: El ácido úrico y la relación colesterol total/HDL-c y la relación LDL-c/HDL-c mostraron una mayor capacidad predictiva para detectar cambios en los niveles de PCR-us y fibrinógeno, respectivamente. Se sugirió el uso de marcadores bioquímicos en la práctica clínica, a fin de establecer medidas preventivas para la enfermedad cardiovascular en hombres adultos sanos (AU)

Predictive ability of the anthropometric and body composition indicatorsfor detecting changes in inflammatory biomarkers / Capacidad predictiva de los indicadores antropométricos y de composición corporal para detectar cambios en los biomarcadores del estado inflamatorio

Introduction: Obesity has been considered a chronic subclinical inflammation. High sensitivity C-reactive protein (hs-CRP) and fibrinogen are increasingly associated with cardiovascular risk. Objectives: To evaluate the ability of anthropometric and body composition indicators in discriminating higher levels of hs-CRP and fibrinogen. Methods: 130 men (20-59 years) were assessed, having measurement of weight, height, waist circumference (WC), hip and thigh circumferences, sagittal abdominal diameter (SAD), coronal diameter (CD) and body composition. Conicity index, waist/height ratio, body mass index, waist/hip ratio, waist/thigh ratio and sagittal index were calculated. It was considered as the cutoff point for hs-CRP values ≥ 0.12 mg/dL and for fibrinogen the 50th percentile of the evaluated sample. Results: Sagittal index (r = 0.280), waist/thigh ratio (r = 0.233) and waist/height ratio (r = 0.233) showed the best correlation with hs-CRP (p < 0.01). Conicity index (r = 0.305) and waist/height ratio (r = 0.279) showed the best correlation with fibrinogen (p < 0.01). In ROC analysis, the SAD (0.698 ± 0.049) and the conicity index (0.658 ± 0.048) had greater ability to discriminate cardiovascular risk through higher levels of hs-CRP and fibrinogen, respectively (p < 0.01). The cutoff points of 30 cm, 89.9 cm and 20.5 cm were the ones that reached largest sum between sensitivity and specificity values for the CD, WC and SAD, respectively. Conclusions: The SAD and the conicity index demonstrated a greater ability to detect higher levels of hs-CRP and fibrinogen, respectively, in apparently healthy adult men (AU)

Introducción: La obesidad ha sido considerada como una inflamación crónica subclínica. La proteína C-reactiva ultrasensible (PCR-us) y el fibrinógeno se han asociado cada vez más con el riesgo cardiovascular. Objetivos: Evaluar la capacidad, de los indicadores antropométricos y de composición corporal, en discriminar mayores niveles séricos de PCR-us y fibrinógeno. Métodos: Se evaluaron 130 hombres (20-59 años). Se midió peso, estatura, circunferencia de la cintura, de la cadera y del muslo, diámetro abdominal sagital (DAS), diámetro coronal (DC) y composición corporal. Se calculó el índice de conicidad, la relación cintura/estatura, el índice de masa corporal, la relación cintura/cadera, la relación cintura/muslo y el índice sagital. Se consideró como punto de corte para los valores de PCR-us ≥ 0,12 mg/dl y para el fibrinógeno se utilizó el percentil 50 de la muestra evaluada. Resultados: El índice sagital (r = 0,280), la relación cintura/muslo (r = 0,233) y la relación cintura/estatura (r = 0,233) mostraron una mejor correlación con la PCR-us (p < 0,01). El índice de conicidad (r = 0,305) y la relación cintura/estatura (r = 0,279) mostraron una mejor correlación con el fibrinógeno (p < 0,01). En el análisis ROC, el DAS (0,698 ± 0,049) y el índice de conicidad (0,658 ± 0,048) mostraron una mayor capacidad predictiva de riesgo cardiovascular determinado a través de mayores niveles de PCR-us y fibrinógeno, respectivamente (p < 0,01). Los puntos de corte de 30 cm, 89,9 cm y 20,5 fueron los que alcanzaron mayor sumatorio entre los valores de sensibilidad y especificidad para el DC, circunferencia de la cintura y DAS, respectivamente. Conclusiones: En hombres adultos sanos, el DAS y el índice de conicidad mostraron una mayor capacidad predictiva para detectar niveles más altos de PCR-us y fibrinógeno respectivamente.

Índice de massa corporal e circunferência abdominal: associação com fatores de risco cardiovascular / Body mass index and waist circumference: association with cardiovascular risk factors

OBJETIVO: Determinar a associação entre índice de massa corporal (IMC) e circunferência abdominal (CA) com fatores de risco para doenças cardiovasculares. MÉTODOS: Estudou-se 231 servidores da Universidade Federal de Viçosa, sendo 54,1 por cento do sexo masculino (21-76 anos). Analisou-se glicemia de jejum, colesterol total e frações, triglicérides, pressão arterial, IMC, CA, relação cintura-quadril e percentual de gordura corporal. Informações sobre tabagismo, ingestão de bebidas alcoólicas e atividade física também foram obtidas. RESULTADOS: As freqüências de sobrepeso/obesidade foram bastante elevadas, principalmente em mulheres. A obesidade abdominal foi observada em 74 por cento das mulheres e 46,1 por cento dos homens. Os homens apresentaram valores médios e medianos de colesterol total, HDL, triglicérides, IMC e percentual de gordura corporal maiores do que as mulheres (p<0,05). O sedentarismo apresentou-se como fator de risco para obesidade e o tabagismo e o consumo de bebidas alcoólicas foram mais freqüentes entre homens e entre eutróficos. A maioria das correlações entre índices antropométricos e fatores de risco foram significativas, entretanto apresentaram-se fracas. A CA foi o indicador antropométrico que se correlacionou mais fortemente e com maior número de variáveis. Observou-se que com o aumento do IMC e da gordura abdominal houve elevação principalmente da glicemia, dos triglicérides, da pressão arterial e redução do HDL. A freqüência de síndrome metabólica foi maior no grupo sobrepeso/obesidade e em homens. CONCLUSÃO: Neste estudo, a freqüência de fatores de risco cardiovascular aumentou com aumento do IMC e CA.

OBJECTIVE: To evaluate the association between cardiovascular risk factors and the anthropometric values - body mass index (BMI) and waist circumference (WC). METHODS: It was studied 231 employees of Federal University of Viçosa, Brazil, 54,1 percent of them were men (21-76 years old). Glycemia, total cholesterol, LDL, HDL, triglycerides, blood pressure, BMI, WC, waist-to-hip ratio and body fatness were measured. It was also investigated smoking, alcohol consumption and physical activity. RESULTS: The prevalence of overweight/obesity in this population was high mainly in women. The abdominal obesity was observed in 74 percent of the women and 46,1 percent of the men. The average of BMI, body fatness, total cholesterol, HDL and triglycerides were significantly higher in men than in women. (p < 0,05). The sedentary lifestyle was a risk factor for obesity. Smoking and alcohol consumption were more common among men and normal weight volunteers. Most of the correlations between anthropometric indices and risk factors for cardiovascular diseases were significant, but weak and the WC was the index that had the strongest correlation and that associated with the largest number of variables. It was observed that with an increase of the BMI and the abdominal fat, there was also an increase of the glycemia, triglycerides and blood pressure and a decrease of HDL. The metabolic syndrome was more common among men and overweight and obese volunteers. CONCLUSION: In this study, the frequency of cardiovascular risk factors increased along with BMI and WC.

Perfil clínico e antropométrico de pacientes portadores de hipertensão arterial sistêmica atendidos em um programa de atenção cardiovascular em Minas Gerais, Brasil / Clinical, and anthropometric profile of patients suffering from systemic arterial hypertension assisted by the cardiovascular attention program in Minas Gerais, Brazil

Objetivos: Caracterizar o perfil clínico e antropométrico de indivíduos hipertensos e verificar a associação entre o estado nutricional e a hipertensão arterial sistêmica (HA). Metodologia: foram realizadas avaliações clínicas, bioquímicas (perfil lipídico e glicemia) e antropométricas (peso, estatura, circunferência da cintura e do quadril) em hipertensos atendidos pelo Programa de Atenção à Saúde Cardiovascular da Universidade Federal de Viçosa —MG. Resultados: Foram avaliados 74 indivíduos com distribuição eqüitativa por sexo. A maioria estava na faixa etária dos 40-59 anos; 80,6% das mulheres e 78,4% dos homens apresentavam antecedentes familiares com HA. Em ambos os sexos, foram encontradas elevadas proporções de excesso de peso e de inadequações da circunferência da cintura e da relação cintura-quadril (p<0,05). Os hipertensos com excesso de peso apresentaram mais altas medianas das pressões arteriais sistólica (p<0,05) e diastólica (p<0,01). Não houve diferença estatística significativa no uso de medicamentos anti-hipertensivos segundo o índice de massa corpórea (IMC). Os hipertensos com excesso de peso e com inadequação da circunferência da cintura apresentaram níveis glicêmicos mais altos (p<0,05) e para o perfil lipídico não houve diferença estatisticamente significativa. Conclusões: os fatores de risco identificados nesses pacientes, passíveis de intervenção por meio de modificações no estilo de vida, demonstram a importância da orientação nutricional como forma de diminuir os riscos de morbimortalidade e de melhorar a qualidade de vida desses indivíduos.

Body mass index and waist circumference: association with cardiovascular risk factors.

OBJECTIVE: To evaluate the association between cardiovascular risk factors and the anthropometric values--body mass index (BMI) and waist circumference (WC). METHODS: It was studied 231 employees of Federal University of Viçosa, Brazil, 54.1% of them were men (21-76 years old). Glycemia, total cholesterol, LDL, HDL, triglycerides, blood pressure, BMI, WC, waist-to-hip ratio and body fatness were measured. It was also investigated smoking, alcohol consumption and physical activity. RESULTS: The prevalence of overweight/obesity in this population was high mainly in women. The abdominal obesity was observed in 74% of the women and 46.1% of the men. The average of BMI, body fatness, total cholesterol, HDL and triglycerides were significantly higher in men than in women. (p < 0,05). The sedentary lifestyle was a risk factor for obesity. Smoking and alcohol consumption were more common among men and normal weight volunteers. Most of the correlations between anthropometric indices and risk factors for cardiovascular diseases were significant, but weak and the WC was the index that had the strongest correlation and that associated with the largest number of variables. It was observed that with an increase of the BMI and the abdominal fat, there was also an increase of the glycemia, triglycerides and blood pressure and a decrease of HDL. The metabolic syndrome was more common among men and overweight and obese volunteers. CONCLUSION: In this study, the frequency of cardiovascular risk factors increased along with BMI and WC.

Perfil de saúde de idosas, praticantes de atividade física, cadastradas no Programa Municipal da Terceira Idade do município de Viçosa – MG / Elderly women health profile, who practices exercises regularly, registered in the Third Age Municipal Program in Viçosa - Minas Gerais State

Objetivo: Estudar o perfil de saúde de um grupo de idosas do Programa Municipal da Terceira Idade (PMTI) do município de Viçosa/ MG, praticantes de atividade física. Desenho do estudo: Estudo transversal, no qual se aplicou um questionário semi-estruturado a 53 mulheres idosas do grupo, analisando idade, morbidades informadas; realização de atividades diárias e de lazer; utilização de serviços de saúde. A avaliação antropométrica foi feita com peso e estatura para o cálculo do índice de Massa Corporal. Resultados: A faixa etária das idosas estudadas variava entre 60 a 80 anos (mediana: 68). Com relação à capacidade funcional e sociabilidade, 13.2% moravam sozinhas, 100% freqüentavam igreja, teatro ou cinema, 94,3% faziam compras, 73,6% faziam viagens de longa duração, 93% visitavam parentes e amigos, 56,6% participam de atividades de grupo e 82,5% preparavam seu próprio alimento. Todos os indivíduos do grupo praticavam atividades físicas regulares. Entre as enfermidades auto-informadas, a mais prevalente foi a hipertensão, seguida do colesterol sérico elevado e depressão. Diabetes e obesidade também foram relatadas com freqüência. Observou-se que 88.7% relataram pelo menos uma doença crônica. Avaliando o estado nutricional como fator de risco para algumas das doenças auto-referidas, não se observou relação deste com diabetes (OR: 0.56: 0.10-2.93: p=0,40) e hipertensão (OR: 3,18: 0.78-13, 48, p=0.06). Conclusão: No grupo estudado, embora a presença das enfermidades crônicas comuns dessa faixa etária tenha sido observada, a capacidade funcional parece preservada, o que pode estar relacionado à prática de atividade.

Objectives: To study the health profile of a group of elderly women, who practice exercises regularly and are part of the Third Age Municipal Program in Viçosa - Minas Gerais State. Study Design: Transversal study, in which a semi-structured questionnaire was applied to 53 elderly women, analyzing: age, informed disease, practice of regular and spare time physical activities and health care service utilization. Body mass index (- weight/[height]2) was evaluated. Results: the age range studied was: 60 to 20 years (average, 68). Regarding functional capability as well as sociability: 13.2% live alone, 100% often go to church, cinema or theater, 94.3% go shopping, 73.6% travel, 93.0% go out to visit friends and relatives, 56,6% participate in group activities and 82.5% prepare their own meals. All individuals practice exercises in regular basis. Among the informed diseases, the most common were hypertension, hypercholesterolemia, and depression. Diabetes and obesity were also reported. In addition, 88.7% of the studied group have already had at least one chronic disease. No correlation was found between nutritional status and the informed diseases, including diabetes and hypertension. Conclusion: In the studied group, the functional capability remains preserved, what can be explained by the regular exercise practice in spite of the occurrence of chronic disease related to aging.