Estudo sobre composição corporal, metabolismo e proteína de ligação do retinol em indivíduos infectados pelo vírus da imunodeficiência humana (HIV) de São Paulo, Brasil / Study of body composition and metabolism and retinol binding protein in human immunodeficiency virus subjects from São Paulo, Brazil

Objetivo: Avaliar a composição corporal, metabolismo e proteína de ligação do retinol (RBP) e RBP-4 e valores de retinol em indivíduos infectados pelo HIV. Métodos: Homens com idades entre os 19 e60 anos foram divididos em dois grupos: infectados pelo HIV (HIV+, n = 20) e não infectados pelo HIV(n = 20). Todos os indivíduos foram submetidos à absorciometria de raios-X de dupla energia (DXA) para avaliar a composição corporal e foram coletadas as amostras de sangue para medidas de retinol, RBP,RBP-4, glicose, triglicérides (TG) e lipoproteína de alta densidade (HDL). Resultados: O grupo HIV+ apresentou menor massa gorda em perna (18,5 ± 7%) e relação ao grupo controle (26,1 ± 6,7 %). Foram observados valores mais baixos de HDL no grupo HIV+ (29 ± 5 mg / dL) e níveis mais elevados de TG (282 ± 176) do que o controle(respectivamente 33 ± 3mg/dL, 144 ± 43 mg / dl). A proporção de TG para HDL, considerada como parâmetro para avaliar resistência insulínica foi maior no grupo HIV+ (10 ± 9) do que no grupo Controle (4 ± 1). Nenhum resultado significativofoi encontrado para diferenças entre grupos quanto aretinol, RBP e RBP-4. Conclusão: Indivíduos infectados pelo HIV apresentaram alterações metabólicas e de composição corporal, confirmando presença de síndrome da lipodistrofia, mas não houve diferença para o retinol, RBP e RBP-4, em comparação ao grupo controle (AU)

Objective: To evaluate body composition, metabolism and RBP, RBP4 and retinol values in HIV-patients. Methods: Males aged between 19 and 60 were divided into two groups: infected by HIV (HIV +, n = 20) and not infected by HIV (n = 20). All subjects were submitted to X-ray absorptiometry (DXA) to assess body composition and blood samples were collected to measured retinol, RBP, RBP-4, glucose, triglycerides (TG) and high-density lipoprotein (HDL). Results: The HIV + group showed significant lower fat mass on leg (18,5 ± 7%) than control (respectively 26 ± 6,7 %). It was observed lower levels of HDL in HIV+ group (29 ± 5 mg/dL), and higher levels of TG (282 ± 176) than in control group (respectively 33 ±3mg/dL, 144 ± 43 mg / dl). The ratio of TG to HDL, considered as insulin resistance parameter was higher in HIV+ group (10 ± 9) than control (4 ± 1). Neither statistical significant result was found for retinol, RBP and RBP-4. Conclusion: HIV patients had metabolic and body composition changes, confirming lipodystrophy syndrome, but there was no difference for retinol, RBP and RBP-4 compared to control group (AU)

Drinking patterns and alcohol use disorders in São Paulo, Brazil: the role of neighborhood social deprivation and socioeconomic status.

BACKGROUND: Research conducted in high-income countries has investigated influences of socioeconomic inequalities on drinking outcomes such as alcohol use disorders (AUD), however, associations between area-level neighborhood social deprivation (NSD) and individual socioeconomic status with these outcomes have not been explored in Brazil. Thus, we investigated the role of these factors on drink-related outcomes in a Brazilian population, attending to male-female variations. METHODS: A multi-stage area probability sample of adult household residents in the São Paulo Metropolitan Area was assessed using the WHO Composite International Diagnostic Interview (WMH-CIDI) (n = 5,037). Estimation focused on prevalence and correlates of past-year alcohol disturbances [heavy drinking of lower frequency (HDLF), heavy drinking of higher frequency (HDHF), abuse, dependence, and DMS-5 AUD] among regular users (RU); odds ratio (OR) were obtained. RESULTS: Higher NSD, measured as an area-level variable with individual level variables held constant, showed an excess odds for most alcohol disturbances analyzed. Prevalence estimates for HDLF and HDHF among RU were 9% and 20%, respectively, with excess odds in higher NSD areas; schooling (inverse association) and low income were associated with male HDLF. The only individual-level association with female HDLF involved employment status. Prevalence estimates for abuse, dependence, and DSM-5 AUD among RU were 8%, 4%, and 8%, respectively, with excess odds of: dependence in higher NSD areas for males; abuse and AUD for females. Among RU, AUD was associated with unemployment, and low education with dependence and AUD. CONCLUSIONS: Regular alcohol users with alcohol-related disturbances are more likely to be found where area-level neighborhood characteristics reflect social disadvantage. Although we cannot draw inferences about causal influence, the associations are strong enough to warrant future longitudinal alcohol studies to explore causal mechanisms related to the heterogeneous patterns of association and male-female variations observed herein. Hopefully, these findings may help guide future directions for public health.

Which equation should be used to measure energy expenditure in HIV-infected patients? / Qual equação utilizar para avaliar gasto energético de portadores do HIV?

OBJECTIVE: In view of the practical need to use equations for the evaluation of energy expenditure in HIV-infected patients, the objective of the present study was to determine the concordance between the energy expenditure values obtained by indirect calorimetry as the gold standard and those obtained by predictive equations elaborated from data for the healthy population: Harris-Benedict, Schofield and Cunningham, and by equations elaborated from data for HIV-infected patients: Melchior (1991-1993). METHODS: The study was conducted at the Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto on 32 HIV-infected men under treatment with highly active antiretroviral therapy. Resting energy expenditure was measured by indirect calorimetry and estimated on the basis of measurement of O2 consumption and CO2 production. RESULTS: Statistical analysis revealed weak concordance for the Harris-Benedict (0.38) and Cunningham (0.34) equations and satisfactory concordance for the Schofield equation (0.47). Only the two Melchior equations (1991 and 1993) showed strong concordance with the values obtained by indirect calorimetry (0.63 and 0.66, respectively) and could be used in practice. CONCLUSION: The best equations seem to be population-specific, such as the Melchior equations elaborated for HIV-infected patients.

OBJETIVO: Frente à necessidade prática da utilização de equações para avaliar gasto energético em portadores do HIV, o presente estudo avaliou a concordância dos valores de gasto energético obtidos pelo padrão ouro de calorimetria indireta com equações preditivas desenvolvidas a partir de população saudável: Harris-Benedict, Schofield e Cunningham e equações desenvolvidas a partir de portadores do HIV: Melchior (1991 a 1993). MÉTODOS: O estudo foi realizado no Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, com 32 homens portadores do HIV em terapia antirretroviral de alta potência. O gasto energético de repouso foi medido por calometria indireta e estimado a partir de medida de consumo de O2 e produção de CO2. RESULTADOS: De acordo com análise estatística, a concordância foi fraca para equações de Harris-Benedict (0,38) e Cunningham (0,34) e satisfatória para Schofield (0,47). Apenas as duas equações de Melchior apresentaram forte concordância com valores obtidos por calometria indireta (respectivamente 0,63 e 0,66) e poderiam ser utilizadas na prática. CONCLUSÃO:: As melhores equações parecem ser população específica, como as de Melchior, desenvolvidas para portadores do HIV.