Variation of modulation and expression of biomarkers associated with inflammation in bariatric surgery patients: A systematic review and meta-analysis.

BACKGROUND: Bariatric surgery is an effective intervention that causes a series of metabolic changes related to inflammatory processes; however, the variation of biomarkers related to these processes is not entirely understood. Our objective was to investigate the variation of modulation and expression of biomarkers associated with inflammation in patients who underwent bariatric surgery. METHODS: We searched the MEDLINE (via PubMed), EMBASE (via Elsevier), Cochrane Central Register of Controlled Trials, Latin American and Caribbean Literature on Health Sciences (via virtual health library), Cumulative Index to Nursing and Allied Health Literature (via EBSCO), Web of Science core collection, and Scopus (via Elsevier) databases, and the gray literature was examined from inception to January 2022. Three pairs of reviewers performed data screening, extraction, and quality assessment independently. Meta-analysis with random effects models was used for general, subgroup, and sensitivity analyses. The I2 statistic was used to assess heterogeneity between studies. RESULTS: In total, 96 articles were included in this systematic review; of these, 87 studies met the criteria for the meta-analysis, involving 3,533 participants. Five biomarkers were included in the meta-analysis (tumor necrosis factor alpha; interleukin 6; leptin; interleukin 1 beta, and lipopolysaccharides). Only leptin showed a significant decrease in the first month after surgery (mean difference -20.71; [95% confidence interval: -28.10 to -13.32, P < .0001; I2 = 66.7%), with moderate heterogeneity. The 12 months after surgery showed a significant decrease in tumor necrosis factor alpha (mean difference -0.89; [95% confidence interval: -1.37 to -0.42], P = .0002; I2 = 94.7%), interleukin 6 (mean difference -1.62; [95% confidence interval: -1.95 to -1.29], P < .0001; I2 = 94.9%), leptin (mean difference -28.63; [95% confidence interval: -34.02 to -23.25], P < .0001; I2 = 92.7%), and interleukin 1 beta (mean difference -2.46; [95% confidence interval: -4.23 to -0.68], P = .006; I2 = 98.3%), all with high heterogeneity. The type of surgery did not show significant differences for the biomarkers at the first month and 12 months, and the results have not changed with high-quality studies. In the 12-month measurement, variations in tumor necrosis factor alpha and leptin were associated with body mass index. CONCLUSION: The findings of this meta-analysis suggest that Roux-en-Y gastric bypass and sleeve gastrectomy bariatric surgeries are associated with a significant reduction in leptin at 1 month after bariatric surgical intervention and tumor necrosis factor alpha, leptin, and interleukin 1 beta after 12 months.

Phase angle of bioimpedance as a marker of inflammation in cardiovascular diseases: A systematic review.

OBJECTIVE: The aim of this systematic review was to investigate whether phase angle (PhA) of bioelectrical impedance is associated with inflammatory markers in cardiovascular diseases (CVDs). METHODS: A search was performed in the following databases: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), Latin American Caribbean Health Sciences Literature (LILACS), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science and Scopus; and in the gray literature up to January 2022. Studies with individuals with CVDs were included, to evaluate the association between PhA and the inflammatory markers interleukin (IL)-6, IL-10, IL-18, IL-1ß, IL-33, tumor necrosis factor (TNF)-α, C-reactive protein (CRP), toll-like receptor (TLR) 2, TLR 4, nuclear factor κB, pathogen-associated molecular pattern molecules, lipopolysaccharides, interferon-γ-inducing factor, and JAK STAT. RESULTS: We identified 755 articles and, after an eligibility analysis, 5 studies were included. The inflammatory markers investigated in the studies were CRP, TNF-α, and IL-33. In patients with CVDs, PhA was negatively associated with CRP and TNF-α in 80% and 100% of the studies, respectively. CONCLUSIONS: The present results suggested that PhA is inversely associated with inflammatory markers in individuals with CVDs, and its clinical use is encouraged for better therapeutic planning.

Phase angle of bioimpedance at 50 kHz is associated with cardiovascular diseases: systematic review and meta-analysis.

The phase angle of bioimpedance is an important prognostic tool in clinical practice. The aim of this study was to investigate the association between phase angle and cardiovascular diseases. Electronic searches were carried out on MEDLINE, EMBASE, Cochrane, SCIELO, LILACS, CINAHL, Scopus, and the Web of Science. The PECO was "P" adults over 18 years of age, "E" the presence of cardiovascular disease, "C" absence of cardiovascular disease, and "O" phase angle values. The phase-angle means difference (MD) was analyzed separately by sex. Subgroup metanalysis with age, body mass index, and heart failure disease and meta-regressions were analyzed with random-effects models. Sensitivity analysis was performed considering only studies with high quality. The heterogeneity among studies was assessed using the Q-Cochran test and I² statistics. Four-hundred-thirty-nine articles were identified, and 22 studies were included in this systematic review, totaling 10.010 participants. Eight studies met the criteria for the meta-analysis, involving 2164 participants. The phase angle (PA) was measured at 50 kHz frequency in all studies. Individuals with cardiovascular disease had a smaller PA compared to the control group, for both males (MD -0.70; 95% CI -1.01 to -0.39) and females (MD -0.76; 95% CI -1.39 to -0.13). In the sensitivity analysis, in men, the quality of studies (P < 0.01), and in women, heart failure (P < 0.01) was significantly different between groups.The values of the phase angle were lower in individuals with cardiovascular disease than in control subjects. This result reinforces the importance of this tool in clinical practice, highlighting its potential to assess health status. Registration: The systematic review protocol was registered in the PROSPERO database as CRD42020164178.

Performance of Anthropometric Indicators in the Prediction of Metabolic Syndrome in the Elderly.

Introduction: Studies have demonstrated the relevance of anthropometric indicators in the prediction of metabolic syndrome (MetS). However, researches involving older people are still scarce. Therefore, the objective was to describe the frequency of MetS and to determine the performance of anthropometric indicators as predictors of MetS in the total sample, in men and women. Methods: Cross-sectional study involving 479 elderly individuals attended in primary health care. The revised National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATPIII) guidelines were used for the MetS diagnosis. The anthropometric indicators evaluated were neck circumference, sagittal abdominal diameter (SAD), SAD/height, sagittal index, and conicity index (C-Index). The predictive performance of the MetS anthropometric indicators was determined using a receiver operating characteristic (ROC) curve. A cutoff point >0.700 was used to evaluate diagnostic performance. Results: The frequency of MetS was 60.5%. The anthropometric indicators demonstrating adequate performance were in total sample: SAD/height (auROC = 0.810), SAD (auROC = 0.777), and C-Index (auROC = 0.706); in women: SAD (auROC = 0.820), SAD/height (auROC = 0.810), neck circumference (auROC = 0.782), and C-Index (auROC = 0.727); in men: SAD/height (auROC = 0.768), SAD (auROC = 0.760), and C-Index (auROC = 0.724). Conclusions: A high frequency of MetS was observed. Of the five anthropometric indicators investigated, three presented good performance in the total sample (SAD, SAD/height, and C-Index), four in women (SAD, SAD/height, neck circumference, and C-Index), and three in men (SAD, SAD/height, and C-Index). The anthropometric indicators, SAD, SAD/height, and C-Index, proved to perform adequately in all the three segments investigated.

Comparação seriada da miniavaliação nutricional em idosos institucionalizados / Serial comparison of the nutritional small evaluation in institutionalized elderly

Os idosos representam o segmento da população que mais cresce no mundo, e, no Brasil, o envelhecimento populacional está ocorrendo de forma rápida e progressiva. Apesar de ser um processo natural, o envelhecimento submete o organismo a diversas alterações, podendo repercutir diretamente no estado nutricional do idoso. Com base no exposto, este estudo tem como objetivo comparar o estado nutricional utilizando a Miniavaliação nutricional de idosos moradores em uma instituição de longa permanência, em uma cidade no interior do RS, no período de 2013 a 2014. Trata-se de um estudo quantitativo com análise de dados retrospectivos, extraídos dos prontuários de idosos institucionalizados de 2013 e 2014, utilizando a Miniavaliação Nutricional (MAN) como instrumento da pesquisa. A população de estudo foi constituída por 36 idosos, totalizando um percentual de 66,7% do sexo feminino. O diagnóstico obtido por meio da Miniavaliação nutricional observou que a maioria dos idosos institucionalizados apresentou risco nutricional em 2013 (61,1%), bem como em 2014 (58,3%). Já em relação à desnutrição o percentual aumentou de 16,7% para 25% no ano de 2013 para 2014. Em suma, por ser um grupo nutricionalmente vulnerável, principalmente por se tratar de idosos institucionalizados, as avaliações seriadas se revestem de importância no sentido de propor intervenção para os casos com alterações nutricionais.

Old people represent the part of the population that increases more in the world, and, in Brazil, the population's aging happens in a progressive and fast way. In spite of being a natural process, aging submits the human body to many changes and it can influence directly on the elderly's nutritional status. Based on the above, this study aims to compare the nutritional status using the elderly's nutritional minivaluation in a long stay institution, in a town from Rio Grande do Sul, between 2013 and 2014. This is a quantitative study with retrospective data analysis, analyzing information from 2013 and 2014, extracted from the institutionalized elderly's records using Miniavaliação Nutrition (MNA) as a research instrument. The population of the research was formed by 36 old people, totaling a percentile of 66,7% of women. The diagnosis got from the nutritional minivaluation observed that most institutionalized elderly showed nutritional risk in 2013 (61,1%) as well as in 2014 (58,3%). In relation to innutrition, in 2013 the percentage was 16,7% and in 2014 it increased to 25%. In short, for being a group vulnerable nutricionalty, mainly for taking care of institutionalized seniors, the seriate evaluations are covered of importance in the sense of proposing intervention for the cases with alterations nutricionals