Cardioprotective effect of the quercetin on cardiovascular remodeling and atherosclerosis in rodents fed a high-fat diet: A systematic review.

Cardiovascular diseases (CVD) are the leading cause of death globally, estimated at 17.9 million premature deaths. Several risk factors contribute to the development of CVD, including unhealthy diet rich in saturated fat. Quercetin (Q) is a important natural flavonoid with cardioprotective effect. However, it is crucial to understand and clarify which dosages and intervention times quercetin promotes better cardioprotective effects when exposed to a High-Fat Diet (HFD). We aim was to carry out a review to identify and compare experimental studies that investigated the quercetin effect on cardiac parameters in rodents fed a HFD. This literature search was performed through the specialized databases PubMed, Embase, Web of Science and Lilacs in May 2022. The following information was collected and assessed: Species of animals, dietary fat content, intervention protocol (quercetin), and main results of alterations associated with cardiac change. A total of 116 articles were selected from the database and 30 articles were included in this study. The administration form of quercetin was used in the diet supplemented in 73.4% (n = 22) of the studies. The dosage ranged between 10 and 100 mg/kg, 0.01%-0.36%, and 4-8 g/kg diet. The treatment time ranged between 14 and 63 days in 48.4% studies and most of the selected studies observed changes in the: Serum concentrations of lipids (60%, n = 18) mainly decrease in TC and TG, left ventricle (LV) (16.13%, n = 5) includes attenuation of the cardiac hypertrophy; inhibition of atherosclerotic progression (32%, n = 10) with decrease in lesions and plaque formation; improvement in the expression of gene and protein associated with cardiac functionality and oxidative stress (51.6%; n = 16). Quercetin supplementation at different concentrations/doses promotes important cardioprotective effects in experimental models exposed to a HFD. The supplemented diet was shown to be the better administration option. The methodological variation presented in the articles selected in this review proves that the most appropriate intervention protocol, as well as the most effective route of administration, promotes these effects.

Modulation of hypothalamic AMPK and hypothalamic neuropeptides in the control of eating behavior: A systematic review.

Eating behavior is regulated by central and peripheral signals, which interact to modulate the response to nutrient intake. Central control is mediated by the hypothalamus through neuropeptides that activate the orexigenic and anorexigenic pathways. Energy homeostasis depends on the efficiency of these regulatory mechanisms. This neuroendocrine regulation of hunger and appetite can be modulated by nutritional sensors such as adenosine monophosphate-activated protein kinase (AMPK). Thus, this systematic review discusses the literature on correlations between AMPK and hypothalamic neuropeptides regarding control of eating behavior. Lilacs, PubMed/Medline, ScienceDirect, and Web of Science were searched for articles published from 2009 to 2021 containing combinations of the following descriptors: "eating behavior," "hypothalamus," "neuropeptide," and "AMPK." Of the 1330 articles found initially, 27 were selected after application of the inclusion and exclusion criteria. Of the selected articles, 15 reported decreased AMPK activity, due to interventions using angiotensin II infusion, fructose, glucose, cholecystokinin, leptin, or lipopolysaccharide (LPS) injection; dietary control through a low-protein diet or a high-fat diet (60 % fat); induction of hyperthyroidism; or injection of AMPK inhibitors. Seven studies showed a decrease in neuropeptide Y (NPY) through CV4 AICAR administration; fructose, glucose, leptin, or angiotensin II injections; or infusion of LPS from Escherichia coli and liver kinase B1 (LKB1) overexpression. Eleven studies reported a decrease in food consumption due to a decrease in AMPK activity and/or hypothalamic neuropeptides such as NPY. The results indicate that there is a relationship between AMPK and the control of eating behavior: a decrease in AMPK activity due to a dietary or non-dietary stimulus is associated with a consequent decrease in food intake. Furthermore, AMPK activity can be modulated by glucose, thyroid hormones, estradiol, leptin, and ghrelin.

Potential therapeutic effects of green tea on obese lipid profile - a systematic review.

Background: Green tea, obtained from the plant Camellis sinensis, is one of the oldest drinks in the world and contains numerous bioactive compounds. Studies have demonstrated the efficacy of green tea in preventing obesity and cardiovascular diseases that may be related to the reduction of lipid levels. Aim: This study aimed to evidence, through a systematic review, the therapeutic potential of green tea on the lipid profile in preclinical studies in obese animals and clinical studies in obese individuals. Methods: This systematic review follows the recommendations of the preferred report items for systematic reviews and meta-analyses. The electronic databases, PubMed (Medline), Science Direct, Scopus, and Web of Science were consulted. Articles from January 2009 to December 2019 were selected. Results: This search resulted in twenty-nine articles were included cirtically reviewed. In experimental studies, green tea administration has been shown to reduce total cholesterol, triglycerides and low-density lipoprotein cholesterol in animals exposed to obesity-inducing diet. In humans' studies green tea was not shown to be effective for obese lipid control. Because supplementation with green tea extract reduced total cholesterol, triglycerides, low-density lipoprotein for three months at a specific dose. Conclusion: Therefore, green tea appears to act as a protective agent for dyslipidemia in obesity-induced animals. In human studies, green tea has not been shown to be effective in controlling obese lipids.

Perinatal and post-weaning exposure to an obesogenic diet promotes greater expression of nuclear factor-κB and tumor necrosis factor-α in white adipose tissue and hypothalamus of adult rats.

Aim: To analyze the effects of exposure to a high-fat diet during the perinatal period and after weaning on white adipose tissue accumulation and gene expression of TNF- α and NF- κB.Method: Wistar female rats were fed with high-fat (H) or control (C) diet during pregnancy and lactation. The offspring were allocated into four groups: Control Control (CC), offspring of mothers GC, fed a control diet after weaning; Control High-fat (CH), offspring of mothers GC, fed a hight-fat diet after weaning; High-fat Control (HC), offspring of mothers GH, fed with control diet after weaning; and High-fat High-fat (HH), offspring of mothers GH, fed a H diet after weaning.Results: HH and HC groups showed increased body weight compared to CC group and increases in caloric intake, larger amount of white adipose tissue and adipocyte size compared to CC and CH groups. The HH and CH groups showed higher NF-kB expression in white adipose tissue compared to the CC and HC groups, and the HH group also showed higher TNF- α expression. In the hypothalamus, the HH and HC groups exhibited higher TNF- α expression compared to the CC and CH groups.Conclusion: Perinatal and post-weaning exposure to the high-fat diet increases the amount of white adipose tissue, adipocyte size, and expression of the inflammatory genes TNF-α and NF-kB.

Sarcopenia and Mortality in Patients With Chronic Non-dialytic Renal Disease: Systematic Review and Meta-Analysis.

OBJECTIVE: To analyze the results of prospective studies on the presence of sarcopenia and its association with cardiovascular events and mortality in patients with non-dialysis-dependent chronic renal disease. METHODS: This study used the PRISMA protocol for systematic review. The systematic review and meta-analysis protocol was recorded in the prospective record of systematic reviews by PROSPERO International: CRD42019120391. DATA SOURCES: MEDLINE via PubMed, Embase, Cochrane Library, CINAHL, Scopus, Web of Science and LILACS from December 2018 to April 20, 2019, with the survey results updated in January 2021. DATA ANALYSIS: Random effect models were calculated to compare the results due to high heterogeneity identified. RESULTS: The survey identified 951 studies. Of these, 392 were removed by duplicates and 559 references were selected for analysis. In the stage of evaluating titles and abstracts, 555 articles were excluded because they did not include inclusion criteria related to the population and study design, leaving 4 articles that were included in the systematic review and meta-analysis. A meta-analysis identified that the presence of sarcopenia increased the risk of mortality by 143%. CONCLUSION(S): The meta-analysis identified the influence of sarcopenia on mortality in non-dialysis-dependent chronic renal disease.

Sarcopenic obesity in community-dwelling older women, determined by different diagnostic methods / Obesidad sarcopénica en mujeres mayores que viven en la comunidad, determinada por diferentes métodos de diagnóstico

Background: sarcopenic obesity (SO) decreases functional capacity, favors loss of autonomy, and is associated with increased mortality in the elderly. The prevalence of sarcopenic obesity differs according to the chosen diagnostic method and/or the population studied. Objective: to identify sarcopenic obesity in community-dwelling elderly women using different diagnostic methods. Methods: this is a cross-sectional study involving 138 elderly women enrolled in an Open University of the Third Age. Sarcopenia was defined according to three criteria: a skeletal muscle index (SMI) = 6.42 kg/m²; reduced muscle strength, defined by handgrip strength (HS) < 20 kg/f; and reduced physical performance, determined by a usual gait speed (GS) < 0.8 m/s. Obesity was diagnosed when body mass index (BMI)  > 28 kg/m², waist circumference (WC)  > 88 cm, total body fat percentage (TBF%) determined by bioelectric impedance analysis (BIA) = 38%, and value for triceps skinfold (TS) = 85th percentile. Sarcopenic obesity is the coexistence of sarcopenia and obesity. Results: the prevalence of sarcopenia and severe sarcopenia was 14.5% and 3.6%, respectively. The highest prevalence of obesity was found using WC (69.6%) and TBF% (52.9%) (p < 0.001). The highest prevalence of sarcopenic obesity was found using TBF% (9.4%) and WC (6.5%) (p < 0.001). Sarcopenic obesity according to BMI was only 0.7%. Conclusion: the prevalence of sarcopenic obesity was high and depended on the diagnostic criteria applied. The association of TBF% with the diagnosis of sarcopenia was the method that identified the highest prevalence of sarcopenic obesity

Antecedentes: la obesidad sarcopénica (SO) disminuye la capacidad funcional, favorece la pérdida de autonomía y se asocia a mayor mortalidad en los ancianos. La prevalencia de la obesidad sarcopénica difiere según el método de diagnóstico elegido y/o la población estudiada. Objetivo: identificar la obesidad sarcopénica en mujeres ancianas que viven en la comunidad utilizando diferentes métodos de diagnóstico. Métodos: este es un estudio transversal en el que participaron 138 mujeres ancianas inscritas en una Universidad Abierta de la Tercera Edad. La sarcopenia se definió de acuerdo con tres criterios: un índice de músculo esquelético (SMI) = 6.42 kg/m²; fuerza muscular reducida, definida por una fuerza de empuñadura (HS) < 20 kg/f, y rendimiento físico reducido, determinado por una velocidad de marcha habitual (GS) < 0,8 m/s. La obesidad se diagnosticó si: índice de masa corporal (IMC)  > 28 kg/m², perímetro de la cintura (WC)  > 88 cm, porcentaje de grasa corporal total (TBF%) determinado por análisis de impedancia bioeléctrica (BIA) = 38%, y valor de pliegue cutáneo del tríceps (TS) = percentil 85. La obesidad sarcopénica es la coexistencia de sarcopenia y obesidad. Resultados: la prevalencia de la sarcopenia y la sarcopenia severa fue del 14,5% y 3,6%, respectivamente. La mayor prevalencia de obesidad se encontró mediante el WC (69,6%) y el porcentaje de TBF (52,9%) (p < 0,001). La prevalencia más alta de obesidad sarcopénica se encontró utilizando el % de TBF (9,4%) y el WC (6,5%) (p < 0,001). La obesidad sarcopénica según el IMC fue solo del 0,7%. Conclusión: la prevalencia de la obesidad sarcopénica fue alta y dependió de los criterios diagnósticos aplicados. La asociación del TBF% con el diagnóstico de sarcopenia fue el método que identificó la prevalencia más alta de obesidad sarcopénica

Sarcopenic obesity in community-dwelling older women, determined by different diagnostic methods.

INTRODUCTION: Background: sarcopenic obesity (SO) decreases functional capacity, favors loss of autonomy, and is associated with increased mortality in the elderly. The prevalence of sarcopenic obesity differs according to the chosen diagnostic method and/or the population studied. Objective: to identify sarcopenic obesity in community-dwelling elderly women using different diagnostic methods. Methods: this is a cross-sectional study involving 138 elderly women enrolled in an Open University of the Third Age. Sarcopenia was defined according to three criteria: a skeletal muscle index (SMI) ≤ 6.42 kg/m²; reduced muscle strength, defined by handgrip strength (HS) < 20 kg/f; and reduced physical performance, determined by a usual gait speed (GS) < 0.8 m/s. Obesity was diagnosed when body mass index (BMI) > 28 kg/m², waist circumference (WC) > 88 cm, total body fat percentage (TBF%) determined by bioelectric impedance analysis (BIA) ≥ 38%, and value for triceps skinfold (TS) ≥ 85th percentile. Sarcopenic obesity is the coexistence of sarcopenia and obesity. Results: the prevalence of sarcopenia and severe sarcopenia was 14.5% and 3.6%, respectively. The highest prevalence of obesity was found using WC (69.6%) and TBF% (52.9%) (p < 0.001). The highest prevalence of sarcopenic obesity was found using TBF% (9.4%) and WC (6.5%) (p < 0.001). Sarcopenic obesity according to BMI was only 0.7%. Conclusion: the prevalence of sarcopenic obesity was high and depended on the diagnostic criteria applied. The association of TBF% with the diagnosis of sarcopenia was the method that identified the highest prevalence of sarcopenic obesity.

INTRODUCCIÓN: Antecedentes: la obesidad sarcopénica (SO) disminuye la capacidad funcional, favorece la pérdida de autonomía y se asocia a mayor mortalidad en los ancianos. La prevalencia de la obesidad sarcopénica difiere según el método de diagnóstico elegido y/o la población estudiada. Objetivo: identificar la obesidad sarcopénica en mujeres ancianas que viven en la comunidad utilizando diferentes métodos de diagnóstico. Métodos: este es un estudio transversal en el que participaron 138 mujeres ancianas inscritas en una Universidad Abierta de la Tercera Edad. La sarcopenia se definió de acuerdo con tres criterios: un índice de músculo esquelético (SMI) ≤ 6.42 kg/m²; fuerza muscular reducida, definida por una fuerza de empuñadura (HS) < 20 kg/f, y rendimiento físico reducido, determinado por una velocidad de marcha habitual (GS) < 0,8 m/s. La obesidad se diagnosticó si: índice de masa corporal (IMC) > 28 kg/m², perímetro de la cintura (WC) > 88 cm, porcentaje de grasa corporal total (TBF%) determinado por análisis de impedancia bioeléctrica (BIA) ≥ 38%, y valor de pliegue cutáneo del tríceps (TS) ≥ percentil 85. La obesidad sarcopénica es la coexistencia de sarcopenia y obesidad. Resultados: la prevalencia de la sarcopenia y la sarcopenia severa fue del 14,5% y 3,6%, respectivamente. La mayor prevalencia de obesidad se encontró mediante el WC (69,6%) y el porcentaje de TBF (52,9%) (p < 0,001). La prevalencia más alta de obesidad sarcopénica se encontró utilizando el % de TBF (9,4%) y el WC (6,5%) (p < 0,001). La obesidad sarcopénica según el IMC fue solo del 0,7%. Conclusión: la prevalencia de la obesidad sarcopénica fue alta y dependió de los criterios diagnósticos aplicados. La asociación del TBF% con el diagnóstico de sarcopenia fue el método que identificó la prevalencia más alta de obesidad sarcopénica.

Reduction of relative handgrip strength and cardiometabolic risk in individuals with HIV/AIDS.

INTRODUCTION: Low handgrip strength (HS) is associated with cardiometabolic alterations that have affected people with HIV/AIDS. METHODS: This was a cross-sectional study performed in adults receiving antiretroviral treatment. HS was evaluated using a dynamometer and divided by body weight to obtain the relative strength. The association between relative HS and overweight, increased waist circumference (WC), high body fat percentage, glycemia, and lipid ratios were assessed using logistic regression. RESULTS: Low relative HS was identified in 35% of participants and associated with increased WC (odds ratio = 9.7; 95% confidence interval = 2.8-33.0). CONCLUSIONS: The prevalence of low HS was high and associated with increased WC.

Reduction of relative handgrip strength and cardiometabolic risk in individuals with HIV/AIDS

Abstract INTRODUCTION: Low handgrip strength (HS) is associated with cardiometabolic alterations that have affected people with HIV/AIDS. METHODS: This was a cross-sectional study performed in adults receiving antiretroviral treatment. HS was evaluated using a dynamometer and divided by body weight to obtain the relative strength. The association between relative HS and overweight, increased waist circumference (WC), high body fat percentage, glycemia, and lipid ratios were assessed using logistic regression. RESULTS: Low relative HS was identified in 35% of participants and associated with increased WC (odds ratio = 9.7; 95% confidence interval = 2.8-33.0). CONCLUSIONS: The prevalence of low HS was high and associated with increased WC.

Associação Entre Força Muscular Relativa e Risco Cardiometabólico em Pacientes Hipertensos / Association between Relative Muscular Strength and Cardiometabolic Risk in Hypertensive Patients

Introdução: A força muscular tem sido considerada bom preditor de risco para doenças cardiovasculares. Objetivo: Avaliar a associação entre força muscular relativa com fatores de risco cardiometabólicos em pacientes hipertensos. Métodos: Estudo transversal realizado com 115 pacientes hipertensos atendidos em um hospital universitário. Foram coletadas variáveis antropométricas e bioquímicas (glicemia de jejum, colesterol total e frações e triglicerídeos). Foram calculados os indicadores razão cintura/altura e Índice de massa corporal. A força muscular relativa foi avaliada a partir da força de preensão palmar, medida pelo dinamômetro, e dividida pelo peso corporal. A correlação de Pearson e o modelo de regressão linear foram utilizados para estimar a relação entre as variáveis de risco e a força muscular relativa. Foram adotados um nível de significância de 5% e intervalo de confiança de 95%. Resultados: A maioria da população (82,6%) foi do sexo feminino, 64,3% adultos, 56,5% sedentários e 93,0% com excesso de peso. Foram observadas correlações inversas significantes entre a força muscular relativa com a razão cintura/ altura e Índice de massa corporal (p=0,000). O modelo de regressão mostrou que o aumento na razão cintura/altura contribuiu significativamente para a redução da força de preensão palmar relativa (p=0,023), assim como ser do sexo feminino (p=0,000). Conclusão: O presente estudo identificou associação entre a força de preensão palmar relativa e variáveis de risco cardiometabólico

Introduction: Muscle strength has been considered a good predictor of risk for cardiovascular diseases. Objective: To evaluate the association between relative muscular strength and cardiometabolic risk factors in hypertensive patients. Methods: A cross-sectional study was carried out with 115 hypertensive patients attended at a university hospital. Anthropometric and biochemical variables (fasting glycemia, total cholesterol and fractions and triglycerides) were collected. The Waist / height ratio and body mass index were calculated. Relative muscle strength was assessed from the palmar grip strength, measured by the dynamometer, and divided by body weight. Pearson's correlation was used and the linear regression model to estimate the relationship between risk variables and relative muscle strength. A significance level of 5% and a 95% confidence interval were adopted. Results: The majority of the population (82.6%) were female, 64.3% were adults, 56.5% were sedentary and 93.0% were overweight. Significant inverse correlations were observed between relative muscle strength with waist / height ratio and body mass index (p=0.000). The regression model showed that the increase in waist / height ratio contributed significantly to the reduction of relative muscle strength (p = 0.023), as well as being female (p = 0.000). Conclusion: The present study identified an association between relative muscle strength and cardiometabolic risk variables

No disponible

Factors associated with sarcopenia in institutionalized elderly.

INTRODUCTION: The sarcopenia is a negative aspect for the health of the elderly, increased the risk for disease and mortality. Additionally can contributes greatly to functional reducing capacity and quality of life. OBJECTIVE: To identify the prevalence and factors associated with sarcopenia in institutionalized elderly. METHODS: This is a cross-sectional study, conducted with 216 elderly people, aged ≥ 60 years, of both sexes, residents in long-term care facilities in Salvador-Bahia, Brazil. To identify sarcopenia was used the skeletal muscle Index. Covariates were considered: gender, age, time of institutionalization, type of institution, body mass index and functional capacity. The Association between sarcopenia and covariates was evaluated using the Poisson regression model with robust variance. RESULTS: The prevalence of sarcopenia in the elderly was 72.2% and this condition was associated with male sex (PR = 1,33; CI 95% = 1,081,65), thinness (PR = 1,29; CI 95% = 1,16-1,43) and obesity (PR = 0,37; CI 95% = 0,23-0,61). CONCLUSION: The prevalence of sarcopenia was high among the elderly living in long-term institutions, especially among men. Elderly with thinness showed greater impairment of muscle reserves, while the state of obesity was protective.

Factors associated with sarcopenia in institutionalized elderly / Factores asociados con la presencia de sarcopenia en ancianos institucionalizados

Introduction: The sarcopenia is a negative aspect for the health of the elderly, increased the risk for disease and mortality. Additionally can contributes greatly to functional reducing capacity and quality of life. Objective: To identify the prevalence and factors associated with sarcopenia in institutionalized elderly. Methods: This is a cross-sectional study, conducted with 216 elderly people, aged ≥ 60 years, of both sexes, residents in long-term care facilities in Salvador-Bahia, Brazil. To identify sarcopenia was used the skeletal muscle Index. Covariates were considered: gender, age, time of institutionalization, type of institution, body mass index and functional capacity. The Association between sarcopenia and covariates was evaluated using the Poisson regression model with robust variance. Results: The prevalence of sarcopenia in the elderly was 72.2% and this condition was associated with male sex (PR = 1,33; CI 95% = 1,08- 1,65), thinness (PR = 1,29; CI 95% = 1,16-1,43) and obesity (PR = 0,37; CI 95% = 0,23-0,61). Conclusion: The prevalence of sarcopenia was high among the elderly living in long-term institutions, especially among men. Elderly with thinness showed greater impairment of muscle reserves, while the state of obesity was protective (AU)

Introducción: la sarcopenia es un aspecto negativo para la salud de las personas mayores, aumenta el riesgo de enfermedad y mortalidad. Además puede contribuir en gran medida a la reducción de la capacidad funcional y calidad de vida. Objetivo: identificar la prevalencia y los factores asociados con la sarcopenia en los ancianos institucionalizados. Métodos: se trata de un estudio transversal, realizado con 216 personas de edad avanzada (≥ 60 años), de ambos sexos, residentes en centros de atención a largo plazo en Salvador-Bahia, Brasil. Para identifi car la sarcopenia se utilizó el índice musculoesquelético. Se consideraron covariables: género, edad, tiempo de institucionalización, tipo de institución, índice de masa corporal y la capacidad funcional. La asociación entre la sarcopenia y covariables se evaluó utilizando el modelo de regresión de Poisson con varianza robusta. Resultados: la prevalencia de la sarcopenia en los ancianos fue de 72,2% y esta condición se asocia con el sexo masculino (RP = 1,33; IC del 95% = 1,08-1,65), la delgadez (RP = 1,29; IC del 95 % = 1,16-1,43) y la obesidad (RP = 0,37; IC del 95% = 0,23-0,61). Conclusión: la prevalencia de la sarcopenia fue alta entre los ancianos que viven en instituciones de larga duración, especialmente entre los hombres. Los ancianos con delgadez mostraron un mayor deterioro en las reservas musculares, mientras que los obesos mostraban una mayor protección muscular (AU)

Association between sarcopenic obesity and cardiovascular risk: where are we?

INTRODUCTION: The main changes in the body composition refer to the increase of adipose tissue and/or the decrease of muscular mass, and these changes have effect in many clinical outcomes. Sarcopenic obesity (SO) consists of the presence of excessive adipose tissue and deficit of muscular mass simultaneously. People with SO may have synergistic effect due to obesity and sarcopenia, with increases cardiovascular risk more than obesity itself. OBJECTIVE: To describe the findings in the literature about the association between SO and risk factors and/or cardiometabolic disease (CMD) or cardiovascular disease (CVD). METHODS: An electronic search was done on the following databases: MEDLINE, Scopus, SciELO, LILACS and Web of Science, using the matching expressions and Boolean operators: "obesity sarcopenic" OR "sarcopenic obesity", in the titles of the studies, AND "cardiometabolic disease" OR "cardiovascular disease" OR "metabolic syndrome" OR "insulin resistance", in the abstract. RESULTS: Most of studies are cross-sectional and present many different diagnosis criteria for SO. It was possible to verify the association of the SO and the risk factors and/or CMD or CVD. CONCLUSION: SO is associated with risk factors and/or CMD or CVD. The lack of a consensus about this definition jeopardizes the effective clinical practice and the research about the subject.

Association between sarcopenic obesity and cardiovascular risk: where are we? / Asociación entre obesidad sarcopénica y riesgo cardiovascular: ¿dónde estamos?

Introduction: The main changes in the body composition refer to the increase of adipose tissue and/or the decrease of muscular mass, and these changes have effect in many clinical outcomes. Sarcopenic obesity (SO) consists of the presence of excessive adipose tissue and deficit of muscular mass simultaneously. People with SO may have synergistic effect due to obesity and sarcopenia, with increases cardiovascular risk more than obesity itself. Objective: To describe the findings in the literature about the association between SO and risk factors and/or cardiometabolic disease (CMD) or cardiovascular disease (CVD). Methods: An electronic search was done on the following databases: MEDLINE, Scopus, SciELO, LILACS and Web of Science, using the matching expressions and Boolean operators: «obesity sarcopenic» OR «sarcopenic obesity», in the titles of the studies, AND «cardiometabolic disease» OR «cardiovascular disease» OR «metabolic syndrome» OR «insulin resistance», in the abstract. Results: Most of studies are cross-sectional and present many different diagnosis criteria for SO. It was possible to verify the association of the SO and the risk factors and/or CMD or CVD. Conclusion: SO is associated with risk factors and/or CMD or CVD. The lack of a consensus about this definition jeopardizes the effective clinical practice and the research about the subject (AU)

Introducción: los principales cambios en la composición del cuerpo refi eren el incremento de tejido adiposo y/o la disminución de masa muscular, y estos cambios tienen efecto en varios resultados clínicos. La obesidad sarcopénica (OS) consiste en la presencia simultánea del exceso de tejido adiposo y el déficit de masa muscular. Las personas con OS pueden tener un efecto sinérgico debido a la obesidad y la sarcopenia, lo que incrementa el riesgo de enfermedad cardiovascular, más que la obesidad en sí. Objetivo: describir los hallazgos en la literatura científica sobre la asociación de la SO y los factores de riesgo y/o ECM (enfermedad cardiometabólica) o enfermedad cardiovascular (ECV). Métodos: se realizó una búsqueda electrónica en las siguientes bases de datos: MEDLINE, Scopus, SciELO, LILACS y Web of Science, usando las expresiones coincidentes y los operadores booleanos: «obesidad sarcopénica» o «sarcopénica obesidad», en los títulos de los estudios, y «enfermedad cardiometabólica» o «enfermedad cardiovascular» o «síndrome metabólico» o «resistencia a la insulina», en el abstract. Resultados: la mayoría de los estudios son de corte transversales y presentan diferentes criterios de diagnóstico para la OS. Fue posible verificar la asociación de la OS y los factores de riesgo y/o ECM o ECV. Conclusión: la OS está asociada con los factores de riesgo y/o ECM o ECV. La falta de un consenso sobre esta definición pone en peligro la efectividad de la práctica clínica y la investigación sobre el tema (AU)

MATERNAL AND POST-WEANING EXPOSURE TO A HIGH FAT DIET PROMOTES VISCERAL OBESITY AND HEPATIC STEATOSIS IN ADULT RATS.

AIM: considering the frequent consumption of fat-rich diets by women of reproductive age, the aim of the present study was to investigate the effects of maternal consumption of a high-fat diet during the perinatal and/ or post-weaning period on the liver parameters and lipid metabolism of young rats. METHODS: Wistar female rats were fed a high-fat (H) or control (C) diet during pregnancy and lactation. The offspring were allocated to four groups: Control Control (CC, n = 11), offspring fed a control diet after weaning; Control High-fat (CH, n = 10), offspring fed a high-fat diet after weaning; High-fat High-fat (HH, n = 10), offspring of mothers H fed a high-fat diet after weaning; and High-fat Control (HC, n = 9), offspring of mothers H fed with control diet after weaning. RESULTS AND DISCUSSION: the food intake did not differ among the groups, however, the relative weight of the adipose tissue was higher in animals from the HC, HH and CH groups (p ≤ 0.005). Liver steatosis was found in the CH and HH animals, which also exhibited hypercholesterolemia (p ≤ 0.05). The levels of the liver enzymes alanine aminotransferase (ALT) and gamma-glutamyl transpeptidase (GGT) were higher in the HH group, and the LDL level was higher in the CH group compared to the CC. The consumption of an obesogenic diet during critical periods of development may contribute to the occurrence of visceral obesity, liver steatosis and hypercholesterolemia in adult rats, even in the absence of changes in dietary intake.

Objetivo: teniendo en cuenta el consumo frecuente de dietas ricas en grasas por las mujeres en edad reproductiva, el objetivo del presente estudio fue investigar los efectos del consumo materno de una dieta alta en grasas durante el periodo perinatal y/o post-destete en el higado y el metabolismo de los lipidos en ratas jovenes. Métodos: ratas hembra Wistar fueron alimentadas durante el embarazo y la lactancia con un alto contenido de grasa (H) o de control (C). La descendencia se asigno a cuatro grupos: Control (CC, n = 11), descendencia alimentada con una dieta de control despues del destete; Control de dieta alta en grasa (CH, n = 10), crias alimentadas con una dieta alta en grasas despues del destete; Alta en grasas de alta en grasa (HH, n = 10), hijos de madres H alimentados con una dieta alta en grasas despues del destete; y Control de alta en grasa (HC, n = 9), hijos de madres H alimentados con dieta de control tras el destete. Resultados y discusión: la ingesta de alimentos no difirio entre los grupos; sin embargo, el peso relativo del tejido adiposo fue mayor en los animales de los grupos HC, HH y CH (p ≤ 0,005). La esteatosis hepatica se encontro en los CH y HH, que tambien presentaban hipercolesterolemia (p ≤ 0,05). Los niveles de las enzimas hepaticas alanina aminotransferasa (ALT) y gamma-glutamil transpeptidasa (GGT) fueron mayores en el grupo de HH, y el nivel de LDL fue mayor en el grupo CH en comparacion con el CC. El consumo de la dieta propicio la obesidad durante los periodos criticos del desarrollo y puede contribuir a la aparicion de obesidad visceral, esteatosis hepatica e hipercolesterolemia en ratas adultas, incluso en ausencia de cambios en la ingesta dietetica.

Maternal and post-weaning exposure to a high fat diet promotes visceral obesity and hepatic steatosis in adult rats / La exposición en el periodo perinatal y el postdestete a una dieta alta en grasas promueve la obesidad visceral y la esteatosis hepática en ratas adultas

Aim: considering the frequent consumption of fatrich diets by women of reproductive age, the aim of the present study was to investigate the effects of maternal consumption of a high-fat diet during the perinatal and/ or post-weaning period on the liver parameters and lipid metabolism of young rats. Methods: Wistar female rats were fed a high-fat (H) or control (C) diet during pregnancy and lactation. The offspring were allocated to four groups: Control Control (CC, n = 11), offspring fed a control diet after weaning; Control High-fat (CH, n = 10), offspring fed a high-fat diet after weaning; High-fat High-fat (HH, n = 10), offspring of mothers H fed a high-fat diet after weaning; and High-fat Control (HC, n = 9), offspring of mothers H fed with control diet after weaning. Results and discussion: the food intake did not differ among the groups, however, the relative weight of the adipose tissue was higher in animals from the HC, HH and CH groups (p ≤ 0.005). Liver steatosis was found in the CH and HH animals, which also exhibited hypercholesterolemia (p ≤ 0.05). The levels of the liver enzymes alanine aminotransferase (ALT) and gamma-glutamyl transpeptidase (GGT) were higher in the HH group, and the LDL level was higher in the CH group compared to the CC. The consumption of an obesogenic diet during critical periods of development may contribute to the occurrence of visceral obesity, liver steatosis and hypercholesterolemia in adult rats, even in the absence of changes in dietary intake (AU)

Objetivo: teniendo en cuenta el consumo frecuente de dietas ricas en grasas por las mujeres en edad reproductiva, el objetivo del presente estudio fue investigar los efectos del consumo materno de una dieta alta en grasas durante el período perinatal y/o post-destete en el hígado y el metabolismo de los lípidos en ratas jóvenes. Métodos: ratas hembra Wistar fueron alimentadas durante el embarazo y la lactancia con un alto contenido de grasa (H) o de control (C). La descendencia se asignó a cuatro grupos: Control (CC, n = 11), descendencia alimentada con una dieta de control después del destete; Control de dieta alta en grasa (CH, n = 10), crías alimentadas con una dieta alta en grasas después del destete; Alta en grasas de alta en grasa (HH, n = 10), hijos de madres H alimentados con una dieta alta en grasas después del destete; y Control de alta en grasa (HC, n = 9), hijos de madres H alimentados con dieta de control tras el destete. Resultados y discusión: la ingesta de alimentos no difirió entre los grupos; sin embargo, el peso relativo del tejido adiposo fue mayor en los animales de los grupos HC, HH y CH (p ≤ 0,005). La esteatosis hepática se encontró en los CH y HH, que también presentaban hipercolesterolemia (p ≤ 0,05). Los niveles de las enzimas hepáticas alanina aminotransferasa (ALT) y gamma-glutamil transpeptidasa (GGT) fueron mayores en el grupo de HH, y el nivel de LDL fue mayor en el grupo CH en comparación con el CC. El consumo de la dieta propició la obesidad durante los períodos críticos del desarrollo y puede contribuir a la aparición de obesidad visceral, esteatosis hepática e hipercolesterolemia en ratas adultas, incluso en ausencia de cambios en la ingesta dietética (AU)

Inflammatory, nutritional and clinical parameters of individuals with chronic kidney disease undergoing conservative treatment / Inflamación, estado clínico y nutricional de pacientes renales crónicos en tratamiento conservador

Introduction: due to the relevance of inflammation in individuals with chronic kidney disease (CKD), inflammation should be taken into account in the interpretation of the clinical-nutritional status. Objective: assess the association between inflammation, nutritional and clinical parameters in patients with CKD. Materials and methods: 92 patients with CKD. C-reactive protein (CRP) was used as an inflammation marker. Assessed nutritional parameters were anthropometry and biochemical exams. Evaluated clinical parameters were comorbidities, CKD characteristics, lipid profile, lipid-lowering agents, urea, creatinine and total leukocytes. Comparisons between two groups (with or without inflammation) were performed using Student’s t-test or chi-square test. Results: 15 (16.3%) patients had CRP above greater than or equal to 10mg/L and were considered with inflammation. In the group with inflammation, 05 (33%) had hypoalbuminemia as compared with 05 (6.5%) in the group without inflammation (p = 0.002). Lipid values were lower in the group with inflammation, with mean total cholesterol 171 (± 41.2) mg/dL and mean LDL-C 95 (± 31.2) mg/dL as compared with the group without inflammation, which had and a mean total cholesterol 198 (± 46) mg/dL and mean LDL-C 124 (± 40.1) mg/dL, p = 0,038 and p = 0.011, respectively. No other statistically significant differences between groups were found. Conclusion: inflammation was associated with changes in the total cholesterol and LDL levels and with an increased incidence of hypoalbuminemia. We suggest that serum albumin levels should only be used to assess nutritional status in the absence of inflammation and CRP levels ought to be considered in nutritional status interpretation in patients with CKD (AU)

Introducción: la inflamación es un problema frecuente en pacientes con enfermedad renal crónica (ERC) y se debe relacionar con el estado clínico y nutricional de estos. Objetivo: evaluar si existe una asociación entre la inflamación y los parámetros clínicos y nutricionales en los pacientes con ERC. Material y métodos: fueron evaluados 92 pacientes con ERC. Se utilizo la proteína C reactiva (PCR) como marcador de la inflamación. Los parámetros nutricionales evaluados fueron antropometría y exámenes bioquímicos. Los parámetros clínicos evaluados fueron comorbilidades, características de la ERC, perfil lipidico, hipolipemiantes, urea, creatinina y leucocitos totales. Para analizar las diferencias entre los grupos (con o sin inflamación) se utilizo el test t de Student o el test de Chi-cuadrado. Resultados: 15 pacientes (16,3%) presentaban PCR más o igual a 10,0 mg/dL y tenían inflamación. De estos, 05 (33%) tuvieron hipoalbuminemia, en comparacion con 05 (6,5%) en el grupo sin inflamación (p = 0,002). Los valores de lípidos fueron inferiores en el grupo con inflamación, con colesterol total medio de 171 mg/dL (} 41,2) e LDL-C medio de 95 mg / dL (} 31,2) en comparación con aquellos sin inflamación con medias de 198 mg / dL (} 46) y 124 mg/dL (} 40,1), respectivamente. No se encontraron otras diferencias significativas entre los grupos. Conclusión: la inflamación se ha asociado con modificaciones en el colesterol total, LDL e hipoalbuminemia. Se concluye que la albumina sérica solo se debe utilizar para evaluar el estado nutricional en ausencia de inflamación. El nivel de PCR es un marcador sensible de la inflamación y debe ser empleado en la interpretación del estado nutricional en pacientes con ERC (AU)

INFLAMMATORY, NUTRITIONAL AND CLINICAL PARAMETERS OF INDIVIDUALS WITH CHRONIC KIDNEY DISEASE UNDERGOING CONSERVATIVE TREATMENT.

INTRODUCTION: due to the relevance of inflammation in individuals with chronic kidney disease (CKD), inflammation should be taken into account in the interpretation of the clinical-nutritional status. OBJECTIVE: assess the association between inflammation, nutritional and clinical parameters in patients with CKD. MATERIALS AND METHODS: 92 patients with CKD. C-reactive protein (CRP) was used as an inflammation marker. Assessed nutritional parameters were anthropometry and biochemical exams. Evaluated clinical parameters were comorbidities, CKD characteristics, lipid profile, lipid-lowering agents, urea, creatinine and total leukocytes. Comparisons between two groups (with or without inflammation) were performed using Student's t-test or chi-square test. RESULTS: 15 (16.3%) patients had CRP above ≥ 10mg/L and were considered with inflammation. In the group with inflammation, 05 (33%) had hypoalbuminemia as compared with 05 (6.5%) in the group without inflammation (p = 0.002). Lipid values were lower in the group with inflammation, with mean total cholesterol 171 (± 41.2) mg/dL and mean LDL-C 95 (± 31.2) mg/dL as compared with the group without inflammation, which had and a mean total cholesterol 198 (± 46) mg/dL and mean LDL-C 124 (± 40.1) mg/dL, p = 0,038 and p = 0.011, respectively. No other statistically significant differences between groups were found. CONCLUSION: inflammation was associated with changes in the total cholesterol and LDL levels and with an increased incidence of hypoalbuminemia. We suggest that serum albumin levels should only be used to assess nutritional status in the absence of inflammation and CRP levels ought to be considered in nutritional status interpretation in patients with CKD.

Introducción: la inflamacion es un problema frecuente en pacientes con enfermedad renal cronica (ERC) y se debe relacionar con el estado clinico y nutricional de estos. Objetivo: evaluar si existe una asociacion entre la inflamacion y los parametros clinicos y nutricionales en los pacientes con ERC. Material y métodos: fueron evaluados 92 pacientes con ERC. Se utilizo la proteina C reactiva (PCR) como marcador de la inflamacion. Los parametros nutricionales evaluados fueron antropometria y examenes bioquimicos. Los parametros clinicos evaluados fueron comorbilidades, caracteristicas de la ERC, perfil lipidico, hipolipemiantes, urea, creatinina y leucocitos totales. Para analizar las diferencias entre los grupos (con o sin inflamacion) se utilizo el test t de Student o el test de Chi-cuadrado. Resultados: 15 pacientes (16,3%) presentaban PCR ≥ 10,0 mg/dL y tenian inflamacion. De estos, 05 (33%) tuvieron hipoalbuminemia, en comparacion con 05 (6,5%) en el grupo sin inflamacion (p = 0,002). Los valores de lipidos fueron inferiores en el grupo con inflamacion, con colesterol total medio de 171 mg/dL (} 41,2) e LDL-C medio de 95 mg / dL (} 31,2) en comparacion con aquellos sin inflamacion con medias de 198 mg / dL (} 46) y 124 mg/dL (} 40,1), respectivamente. No se encontraron otras diferencias significativas entre los grupos. Conclusión: la inflamacion se ha asociado con modificaciones en el colesterol total, LDL e hipoalbuminemia. Se concluye que la albumina serica solo se debe utilizar para evaluar el estado nutricional en ausencia de inflamacion. El nivel de PCR es un marcador sensible de la inflamacion y debe ser empleado en la interpretacion del estado nutricional en pacientes con ERC.

Nutritional assessment in surgical oncology patients: a comparative analysis between methods / Valoración nutricional en pacientes oncológicos quirúrgicos: un análisis comparativo entre métodos

Background and aims: The malnutrition found in oncology patients is the main responsible for the increase in morbimortality and worsening of their quality of life. Currently, the assessment of malnutrition is performed by subjective and objective methods, or the combination of them. Although these methods are routinely applied and their association is very common in clinical practice, there are few studies on the agreement between them. Thereby, this study aims to compare different methods for nutritional status assessment in surgical oncology patients. Methods: 173 oncology patients, admitted for surgery, were submitted to an anthropometric evaluation and answered a SGA, PG-SGA and NRS-2002. Kappa test was used to evaluated the level of concordance between the methods. Results: Poor concordance were observed between BMI and NRS-2002 (K=0,286), SGA (K=0,372) and PGSGA (K=0,173). Among the subjective methods, the best results were found for SGA and PG-SGA (K=0,690), and the lowest between NRS-2002 and both others (SGA: K=0,345; PG-SGA: K=0,322). Conclusions: The poor concordance found between objective and subjective methods reinforces the importance of associating indicators in the nutritional assessment of this population Despite of the poor concordance found between the nutritional status assessment methods investigated in this study, patients who had greater depletion of body stores were also diagnosed with a higher degree of malnutrition by subjective methods (AU)

Introducción y objetivos: La desnutrición en el paciente oncológico es responsable por el aumento de la morbilidady la mortalidady produce una disminución de su calidad de vida. En la actualidad, la identificación de la desnutrición se lleva a cabo por medio de métodos subjetivos y objetivos o por la unión de ambos. A pesar de la asociación de estos métodos como examen de rutina en la práctica clínica, son muy pocos los trabajos que evalúan la concordancia entre ellos. De ese modo, el objetivo de este estudio fue comparar diferentes métodos para evaluar el estado nutricional de los pacientes oncológicos quirúrgicos. Métodos: Se analizaron 173 pacientes oncológicos, ingresados para cirugía, se sometieron a una evaluación antropométrica y respondieron a SGA, PG-SGA y NRS- 2002. Se utilizó el test Kappa para evaluar el nível de concordancia entre los métodos. Resultados: Baja concordancia entre el IMC con el NRS-2002 (K=0,286), ASG(K=0,372) y ASG-PPP (K=0,173) fue identificado. Entre los métodos subjetivos, los resultados fueron mejores com ASG y ASG-PPP (K=0,690) y menor entre el NRS-2002 y los otros (ASG: K=0,345; ASG-PPP: K=0,322). Conclusión: Los resultados demostraron baja concordancia entre los métodos objetivos y subjetivos, lo que refuerza La importancia de la asociación de los indicadores en la evaluación nutricional de esta población. Aunque se ha encontrado baja concordancia entre los métodos de evaluación nutricional empleados en este estudio, los pacientes que presentaron una mayor reducción de las reservas corporales, fueron diagnosticados com un mayor rado de mal nutrición por los métodos subjetivos (AU)

Hypertriglyceridemic waist phenotype: association with metabolic disorders and visceral fat in adults.

OBJECTIVE: To evaluate the association of Hypertriglyceridemic waist with metabolic disorders and visceral fat in adults. METHODS: Cross-sectional study with 191 individuals of both sexes. Subjects were grouped according to Waist Circumference (WC) ratings (Men: > 90 cm; Women: > 80 cm) and triglycerides (TG) (> 150 mg/dl) in Group 1 (HTW Phenotype): elevated WC and TG; Group 2 (absence of HTW Phenotype): elevated WC and normal TG or normal WC and elevated TG or normal WC and TG. Metabolic alternations, visceral adipose tissue (VAT) and visceral/subcutaneous fat index (VF/SF) measured by computed tomography were evaluated as cardiovascu - lar risk factors between the groups. RESULTS: Individuals with HTW phenotype, 82% had three or more cardiovascular risk factors. The association between cardiovascular risk factors with HTW phenotype revealed that among men 73.7% had hypercholesterolemia, 94.9% elevated non-HDLc and 78.9% excess of VAT area (p = 0.001). Among women, 65% had elevated Sistolic Blood Plessure, 80% hypercholesterolemia and 90% elevated non-HDLc (p < 0.02). CONCLUSION: The HTW phenotype associated with the metabolic alternations and VAT excess. Individuals with HTW had higher number of cardiovascular risk factors. The Hypertriglyceridemic waist can be used in clinical practice for investigating cardiovascular risk and visceral adipose tissue in individuals.

OBJETIVO: Evaluar la relación entre Cintura Hipertrigliceridémica (CHT) con cambios metabólicos y grasa visceral en adultos. MÉTODOS: Estudio transversal con 191 personas de ambos sexos. Los participantes fueron agrupados según clasificación de Circunferencia de Cintura (CC) (Hombres: > 90 cm; Mujeres: > 80 cm) y triglicéridos séricos (TG) (>150 mg/dl) en el Grupo 1 (Fenotipo CHT): Elevación en CC y TG; Grupo 2 (ausencia del Fenotipo CHT): Aumento en CC y TG normal, o CC normal y TG elevado o CC y TG normales. Cambios metabólicos, área del tejido adiposo visceral (TAV) y índice de grasa visceral/subcutáneo (GV/GS), medidas por tomografía computadorizada, fueron evaluados como factores de riesgo cardiovascular entre los grupos. RESULTADOS: De los participantes con el Fenotipo CHT, 82% presentaban tres o más factores de riesgo cardiovascular. La relación entre los factores de riesgo cardiovascular y el Fenotipo CHT demostró que entre los hombres 73,7% presentaban hipercolesterolemia, 94,9% no- HDLc elevado y 78,9% exceso de área TAV (p = 0,001). Entre las mujeres, 65% presentaban presión arterial sistólica alta, 80% hipercolesterolemia y 90% no-HDLc elevado (p < 0,02). CONCLUSIÓN: El Fenotipo CHT se relacionó con cambios metabólicos y exceso de TAV. Personas con CHT presentaron más factores de riesgo cardiovascular. La Cintura Hipertrigliceridémica puede ser utilizada en la práctica clínica para investigar el riesgo cardiovascular y el depósito del tejido adiposo visceral en las personas.