Inflammatory cytokines and chemokines in obese adolescents with antibody against to adenovirus 36.

Obesity in adolescents has reached epidemic proportions and is associated with the inflammatory response and viral infections. The aim of this study was to understand the profile of inflammatory cytokines and chemokines associated with the inflammatory response and metabolic syndrome (MetS) in obese adolescents with positive serology for adenovirus 36 (ADV36). Thirty-six overweight, 36 obese, and 25 severe obesity adolescents aged 10 to 16 years were included in the study. The following variables were analyzed: sex, age, body mass index (BMI), blood pressure, total cholesterol and fractions, triglycerides, glucose, serum cytokine concentrations, and ADV36 antibodies. Cytokines and chemokines were quantified by cytometry and ADV36 serology was determined by enzyme-linked immunosorbent assay (ELISA). The results showed higher levels of the cytokines interleukin-1beta (IL-1ß), IL-6, IL-10 and of the chemokine interferon-gamma-inducible protein 10 (IP-10) in severe obesity adolescents compared to the obese and overweight groups, as well as in the group with MetS compared to the group without this syndrome. The frequency of ADV36-positive individuals did not differ between groups. The findings revealed differences in BMI between the obese and severe obesity groups versus the overweight group in the presence of positivity for ADV36, suggesting an association with weight gain and possibly MetS installation.

Níveis séricos de vitamina D3 em mulheres com diabetes mellitus tipo 2 / Serum levels of vitamin D3 in women with type 2 diabetes mellitus

Objetivo ­ Verificar os níveis de vitamina D3 e correlacioná-los com os níveis de glicemia de jejum e de hemoglobina glicada em pacientes com diabetes mellitus tipo 2 em tratamento medicamentoso por hipoglicemiantes orais ou insulina. Métodos ­ Trata-se de um estudo transversal, retrospectivo, realizado em consultório particular com prontuários de pacientes do sexo feminino com diabetes mellitus tipo 2 em uso de hipoglicemiantes, onde avaliou-se a correlação entre vitamina D3 e glicemia de jejum e hemoglobina glicada, sendo excluídas pacientes gestantes, lactantes, portadores de doença renal e hepática. Pontos de coorte da vitamina D3: deficiência/insuficiência ≤ 30 ng/mL; suficiência ≥ 30 ng/mL. Critérios diagnósticos para diabetes: níveis de glicemia de jejum ≥ 126mg/dL; hemoglobina glicada ≥ 6,5%. Resultados ­ Os portadores de diabetes mellitus tipo 2 apresentaram níveis insuficientes de vitamina D3 em 87% de casos. Conclusões ­ Não houve correlações lineares significativas entre vitamina D3 e glicemia de jejum e nem entre vitamina D3 e hemoglobina glicada em portadores de diabetes mellitus tipo 2 no presente estudo. Níveis baixos de vitamina D3 sugere suplementação de vitamina D3 em doses elevadas.

Objective ­ To verify the levels of vitamin D3 and correlate them with the levels of fasting glucose and glycated hemoglobin in patients with type 2 diabetes mellitus in drug treatment, by oral hypoglycemic agents or insulin. Methods ­ It was a cross-sectional, retrospective research, held in private practice with charts of female patients diagnosed with type 2 diabetes mellitus in hypoglycemic, which were evaluated the correlation between vitamin D3 and fasting glucose and glycated hemoglobin. Were excluded pregnant patients, lactating, people suffering from kidney and liver diseases. Clinical categories of vitamin D3: deficiency/insufficiency ≤ 30 ng/mL; sufficiency ≥ 30 ng/mL. The diagnostic criteria for diabetes: levels of fasting glucose ≥ 126mg/dL; glycated hemoglobin ≥ 6.5 %. Results ­ Patients with type 2 diabetes mellitus had insufficient levels of vitamin D3 in 87 % of cases. Conclusions ­ There were not significant linear correlations between vitamin D3 and fasting glucose or between glycated hemoglobin and vitamin D3 in patients with type 2 diabetes mellitus in this research. Low levels of vitamin D3 suggests vitamin D3 supplementation in high doses.

Excess body fat negatively affects bone mass in adolescents.

OBJECTIVE: The aim of this study was to investigate the effects of excess body fat on bone mass in overweight, obese, and extremely obese adolescents. METHODS: This study included 377 adolescents of both sexes, ages 10 to 19 y. Weight, height, body mass index (BMI), bone age, bone mineral content (BMC), and bone mineral density (BMD) were obtained by dual-energy x-ray absorptiometry. The results were adjusted for chronological age and bone age. Comparisons according to nutritional classification were performed by analysis of variance, followed by Tukey test. Linear regression models were used to explain the variation in BMD and BMC in the L1-L4 lumbar spinal region, proximal femur, and whole body in relation to BMI, lean mass, fat mass (FM), and body fat percentage (BF%), considering P < 0.05. RESULTS: For all nutritional groups, average bone age was higher than chronological age. In both sexes, weight and BMI values increased from eutrophic to extremely obese groups, except for BMD and BMC, which did not differ among male adolescents, and were smaller in extremely obese than in obese female adolescents (P < 0.01). Significant differences were observed for FM and BF% values among all nutritional groups (P < 0.01). Positive, moderate to strong correlations were detected between BMD and BMC for BMI, lean mass, and FM. A negative and moderate correlation was found between BMC and BF%, and between BMD and BF% at all bone sites analyzed in males and between BF% and spine and femur BMD, in females. CONCLUSION: The results reveal a negative effect of BF% on bone mass in males and indicate that the higher the BF% among overweight adolescents, the lower the BMD and BMC values.

Metabolic syndrome reduces bone mineral density in overweight adolescents.

Growing concern has focused on the occurrence of metabolic syndrome (MetS) and its effects on bone mass. There is little information available in the literature concerning the relationship between MetS and BMD in adolescents. The aim of this study was to evaluate the effects of MetS and its components on bone mineral density (BMD) in overweight adolescent boys and girls. This cross-sectional study assessed 271 overweight adolescents with or without MetS (age 10 to 16years). Anthropometric and biochemical tests were performed. Lumbar spine, proximal femur and total and subtotal body BMD values were obtained by bone densitometry with dual-energy X-ray absorptiometry. MetS was observed in 14% of the adolescents. Overweight adolescents of both genders who were positive for MetS presented with significant decreases in BMD (g/cm(2)/kg bodyweight) at all sites evaluated (p<0.01). Female adolescents with large waist circumference, low HDLc, hypertriglyceridemia and high blood pressure showed significant reductions in BMD at all sites evaluated (p<0.01) and, with the exception of increased triglycerides (which had no effect on BMD, p>0.05), the same pattern was observed in male adolescents. Linear regression analyses revealed that waist circumference was negatively correlated with BMD in both genders and that triglycerides were negatively correlated with BMD only in female adolescents. Our results suggest that overweight adolescents with MetS have lower BMD than adolescents without MetS. Among all MetS components measured, increased waist circumference had the strongest relationship with reductions in BMD.

Does excess weight interfere with bone mass accumulation during adolescence?

Obesity and osteoporosis are important global health problems characterized by increasing prevalence with high impact on morbidity and mortality. The objective of this review was to determine whether excess weight during adolescence interferes with bone mass accumulation. If bone mineral gain can be optimized during puberty, adults are less likely to suffer from the devastating complications of osteoporosis. The increased fracture risk in obese children has also been attributed to a lower bone mass for weight compared to non-obese children. Thus, adiposity present in this age group may not result in the protection of bone mass, in contrast to what has been observed in adults. However, studies involving adolescents have reported both protective and detrimental effects of obesity on bone. The results and mechanisms of these interactions are controversial and have not been fully elucidated, a fact highlighting the extreme relevance of this topic and the need to monitor intervening and interactive variables.

Densidade mineral óssea de adolescentes sobrepesos, obesos e superobesos: o impacto do excesso de gordura corporal sobre a massa óssea / Bone mineral density of overweight adolescents, obese and super obese: the impact of excess body fat mass on bone

A obesidade e a osteoporose são duas morbidades que afetam a população geral, consideradas graves problemas de saúde pública. Sabe-se que, o excesso de peso se instala em idades cada vez mais precoces e que, com o ganho em sobrevida, o envelhecimento populacional resulta em aumento da prevalência da osteopenia/osteoporose e das fraturas delas resultantes. Investigar o impacto do excesso de gordura corporal sobre a aquisição da massa óssea de adolescentes de ambos os sexos, de 10 a 19 anos, considerados sobrepesos, obesos e superobesos. Adolescentes de 10 a 19 anos, matriculados na condição de casos novos no Ambulatório de Medicina do Adolescente da Faculdade de Medicina de Botucatu – UNESP, foram avaliados clínica e nutricionalmente, obtendo-se peso, estatura e Índice de Massa Corpórea (IMC). Aqueles que apresentavam IMC ≥85o e <95o percentil das curvas do Centers for Disease Control and Prevention (CDC, 2000) foram considerados sobrepesos, os que se localizavam igual ou acima do 95opercentil, obesos e os com IMC superior ao 99o percentil, superobesos. Realizou-se inquérito alimentar através do recordatório alimentar de 3 dias e obtida a Idade Óssea pelo Método de Greulich & Pyle (1959). Aqueles considerados sobrepesos, obesos e superobesos realizaram avaliação do Conteúdo Mineral Ósseo (CMO g) e da Densidade Mineral Óssea (DMO g/cm2) por densitometria óssea por atenuação de Raio X de dupla energia (DXA) obtida em Coluna Lombar (L1-L4), Fêmur Proximal, Corpo Subtotal e Corpo Total. Todos os procedimentos foram realizados estando os adolescentes e seus responsáveis cientes e de acordo, tendo assinado o Termo de Consentimento Livre e Esclarecido. Os dados foram analisados segundo ajuste para idade cronológica e óssea, apresentados em médias, medianas, desvios padrão, quartis e limites mínimo e máximo para cada variável...

Obesity and Osteoporosis are two morbities that affect general population, being considered a great public health issue. It is known that overweight is installed in much more precocious ages and with a longer life expectation, population aging has resulted in the prevalence of osteoporosis and resulting fractures. Investigate the impact of body fatness over the acquisition of bone mass in adolescents of both gender, from 10 to 19 years old, considered to be either overweight, obese and extremely obese. Adolescents from 10 to 19 years old signed up as new cases at the Teen’s Medical Clinic of Botucatu Medical School - UNESP, were evaluated clinically and nutritionally as far as weight, height and body mass index (BMI). Those who had shown BMI ≥85th and <95th percentile for their age group according to Centers for Disease Control and Prevention criteria (CDC, 2000) were considered overweight, those who were evaluated on equal or above 95th percentiles, were considered obese, and those who had their BMI superior than 99th percentiles, were considered extremely obese. It was performed a dietary survey through a three day food recall and obtained the bone age through the application of the Greulich & Pyle Method (1959). Those considered overweight, obese and extremely obese performed evaluation about the Bone Mineral Content (BMC g) and Bone Mineral Density (BMD g/cm2) evaluations through Dual Energy Xray Absorptiometry (DXA), obtained in Lumbar Spine (L1-L4), Proximal Femur, Body Subtotal and Body Total. All the procedures were done according to parental and patient approval and agreement by signing a Free Consent Form and have it clarified. Collected data was analyzed according to chronological and bone age adjustments presented in mean, median, quartiles, standard deviation and minimum and maximum limits for each variable...

Consumo alimentar, ingestão de cálcio e antropometria de adolescentes de escola municipal e particular do município de Santos, SP / Dietary intake, calcium intake and anthropometry of adolescents of public and private school of Santos, SP

Objetivo: Investigar o consumo alimentar,a ingestão de cálcio e sua relação com o estado nutricional. Método: Estudo transversal com50 adolescentes de escola particular e municipal de Santos, SP. Realizou-se avaliação antropométrica (peso, estatura e circunferência de cintura),do consumo alimentar (Recordatório 24 horas) e do estadiamento puberal (Planilhas de Tanner).Resultados: Dentre os participantes, 52% eram do sexo masculino, com média de idade de 14,10 (0,66) anos, e 56% eram púberes. Na escola particular, verificou-se maior média de altura e não houve diferença significativa dos demais parâmetrosantropométricos. Identificou-se 28% debaixo peso, 12% de sobrepeso e 2% de obesidade. Quanto ao consumo alimentar, verificou-se média de ingestão de energia de 2025,22 (816,50) kcal/ dia, 57,38 (9,56)% de carboidratos, 15,55 (5,48)% de proteínas e 27,79 (7,76)% de lipídios, com diferenças significativas entre as escolas. Na escola municipal, houve maior prevalência de consumoinsuficiente de carboidratos, em contraposição a maior frequência de consumo de lipídios (p<0,05).A ingestão média de cálcio foi baixa em ambas as escolas, sendo significativamente inferior na escolamunicipal (522,94 ± 299,00 mg vs. 792,00 ± 483,40 mg na escola particular, p=0,002). Observou-serelação positiva da ingestão de cálcio com o peso corporal (r=0,279; p=0,049). Conclusões: Os achados apontam elevada ocorrência de desviosnutricionais, inadequações alimentares, insuficiente ingestão de cálcio e relação da ingestão deste nutriente com o peso corporal, denotando a necessidadede intervenções que envolvam promoção de hábitos saudáveis neste estágio de vida.

Objective: To investigate the food consumption, the calcium ingestion and its relationship with the nutritional state. Methods: Cross-sectional studywith 50 adolescents from private and public school of Santos, SP, had been evaluated. Anthropometric assessment (weight, height and circumference of waist), of food intake (24-hour dietary recall) and pubertal stage (Tanner stages) was performed. Results: Fromthe participants, 52% were male, with mean age of 14.10 (0.66) year-old and 56% were pubescent. In the private school the height average was bigger, and there was no significant difference in other anthropometric parameters. It was identified 28% of low weight, 12% of overweight and 2% of obesity. As forfood consumption, the mean energy intake of adolescents was 2025.22 (816.50) kcal/day, and 57.38(9.56)% carbohydrates, 15.55 (5.48)% protein and 27.79 (7.76)% of lipids, with significant differencesbetween schools. At municipal school there was higher prevalence of inadequate consumption of carbohydrates as opposed to higher frequency of consumption of fatamong (p<0.05). The average intake of calcium was low in both schools and was significantly lower in themunicipal school (522.94 ± 299.00 mg vs. 792.00 ± 483.40 mg in the private school, p=0.002). There waspositive relationship of calcium intake with body weight (r=0.279, p=0.049). Conclusions: The findings suggest a high occurrence of deviations nutritional,dietary inadequacies, inadequate calcium intake and the relationship of nutrient intake with body weight,indicating the need intervention involving promotion of healthy ways of life in this stage of life.

Avaliação dos sintomas climatéricos na mulher em menopausa e pós-menopausa em uso de proteína isolada de soja / Evaluation of the climateric symptoms in postmenopausal women after menopause and use of isolated soy protein

Objetivo - Avaliar a eficácia da suplementação de proteína isolada de soja sobre os sintomas climatéricos. Métodos - Foi conduzido estudo quase-experimental, prospectivo, longitudinal e quantitativo com 30 mulheres no período da menopausa e pós-menopausa pré-selecionadas em um Centro Municipal de Terceira Idade, da cidade de Birigui/SP, entre a faixa etária de 40 e 65 anos. As mulheres ingeriram, 30 g/dia de proteína isolada de soja (equivalente a 57 mg de isoflavonas), fracionada 3 vezes ao dia, durante 4 semanas. Foram avaliadas por meio do Índice Menopausal de Kupperman (IMK) e questionadas quanto ao aparecimento de efeitos colaterais. Para análise estatística, utilizou-se médias, desvios-padrão, porcentagens e o test t de Student. Resultados - Os sintomas avaliados pelo Índice Menopausal de Kupperman (IMK) apresentaram melhora significativa: no momento inicial 11,10% das mulheres apresentavam sintomas acentuados, 74,10% moderados e14,80% sintomas leves. Ao final 93,30% das avaliadas apresentavam os sintomas leves e 3,70% a ausência destes. Houve redução significativa dos valores medianos da somatória do IMK (26,41 x 7,93). Os efeitos colaterais relatados não foram relevantes. Conclusão - A proteína isolada de soja se mostrou uma terapêutica eficaz para o alívio dos sintomas climatéricos, apresentando-se uma alternativa para mulheres nesta fase. A baixa ocorrência de efeitos colaterais resultou em uma maior aceitação pela continuidade do tratamento por parte das integrantes do estudo.

Objective - To evaluate the effects of supplementation with isolated soy protein on the climacterics symptoms. Methods - An almost-experimental study was lead, prospective, longitudinal and quantitative with 30 women during menopause and post menopause pre-selected in a Municipal Center of Third Age, of the city of Birigui/SP, with age in the 40 to 65 years old. Women ingested 30 g/day of isolated soy protein (equivalent to 57 mg of isoflavones), divided into 3 times daily for 4 weeks. Were assessed using the Kupperman Menopausal Index and questioned about the appearance of side effects. For statistics analysis, it was used average, standard deviation, percentages and Student's t test. Results - Symptoms assessed by the Kupperman Menopausal Index (KMI), a significant improvement: as baseline, 11.10% of women had symptoms accented 74.10% moderate and 14.80% mild symptoms. At the end of 93.30% of those assessed had mild symptoms and 3.70% in their absence. There was a significant reduction in median values of the sum of KMI (26.41 x 7.93). Reported side effects were not relevant. Conclusion - The isoflavone isolated soy protein showed a solid therapy to relief to climacteric symptoms, introducing an alternative to women in this phase. The low occurrence of side effects resulted in greater acceptance and continued treatment by the study subjects.