RESUMO
OBJETIVO: Verificar o impacto da obesidade sobre os componentes da síndrome metabólica e sobre os níveis de adipocitoquinas em crianças pré-púberes. MÉTODOS: Estudo transversal comparando 30 crianças obesas, 31 com sobrepeso e 33 eutróficas, oriundas do ambulatório de pediatria geral de um hospital universitário, quanto às médias de glicose, lipídios séricos, insulina, HOMA-IR (homeostasis model assessment-insulin resistance), relação glicose/insulina, adiponectina e leptina. Compararam-se as frequências de acantose nigricans e das alterações de cintura, pressão arterial, glicose, lipídios séricos e insulina. Avaliou-se a correlação entre escore z de índice de massa corporal (IMC) e adipocitoquinas. RESULTADOS: Houve diferença nas médias dos obesos, quanto a HDL-colesterol e adiponectina, e nas dos eutróficos, quanto a insulina, HOMA-IR, relação glicose/insulina e leptina (p < 0,001). O mesmo ocorreu em relação às frequências dos obesos quanto a acantose nigricans e alteração de cintura e HDL-colesterol (p < 0,005). O escore z de IMC se correlacionou positivamente com leptina (p < 0,001) e negativamente com adiponectina (p = 0,001). Na regressão linear múltipla, esta correlação se manteve apenas para leptina; o HDL-colesterol se correlacionou com adiponectina (p = 0,007) e o HOMA-IR com ambas (p < 0,05). CONCLUSÃO: Os achados comprovam a influência da obesidade sobre os componentes da síndrome metabólica e sobre os níveis de adipocitoquinas já nas crianças pré-púberes e apontam para a importância destas na gênese da doença cardiovascular.
OBJECTIVE: To verify the impact of obesity on metabolic syndrome components and adipokine levels in prepubertal children. METHODS: This cross-sectional study compared 30 obese, 31 overweight and 33 eutrophic children attending a university hospital-based outpatient pediatric clinic. Parameters assessed included glucose, serum lipids, insulin, homeostasis model assessment-insulin resistance (HOMA-IR), glucose/insulin relation, adiponectin, and leptin. We compared the frequency of acanthosis nigricans and changes in waist, blood pressure, glucose, serum lipids, and insulin. The correlation between body mass index (BMI) z score and adipokines was evaluated. RESULTS: Among obese children, there was a difference in the mean values of HDL cholesterol and adiponectin, whereas among the eutrophic children, there was a difference in the mean values of insulin, HOMA-IR, glucose/insulin relation, and leptin (p < 0.001). A difference was also observed regarding the frequency of acanthosis nigricans and alteration in waist and HDL cholesterol (p < 0.005) in the obese group. The BMI z score showed a positive correlation with leptin (p < 0.001) and a negative correlation with adiponectin (p = 0.001). In multiple linear regression, this correlation was maintained only for leptin; HDL-cholesterol correlated with adiponectin (p = 0.007) and HOMA-IR correlated with both variables (p < 0.05). CONCLUSION: These findings provide evidence of the influence of obesity on metabolic syndrome components and on adipokine levels in prepubertal children, indicating that these components may contribute to the beginning of cardiovascular diseases.
Assuntos
Criança , Feminino , Humanos , Masculino , Adipocinas/sangue , Síndrome Metabólica/sangue , Obesidade/sangue , Acantose Nigricans/sangue , Acantose Nigricans/epidemiologia , Índice de Massa Corporal , Biomarcadores/sangue , Brasil/epidemiologia , HDL-Colesterol/sangue , Métodos Epidemiológicos , Homeostase/fisiologia , Insulina/sangue , Sobrepeso/sangue , Circunferência da Cintura/fisiologiaRESUMO
OBJECTIVES: To verify the impact of obesity on metabolic syndrome components and adipokine levels in prepubertal children. METHODS: This cross-sectional study compared 30 obese, 31 overweight and 33 eutrophic children attending a university hospital-based outpatient pediatric clinic. Parameters assessed included glucose, serum lipids, insulin, homeostasis model assessment-insulin resistance (HOMA-IR), glucose/insulin relation, adiponectin, and leptin. We compared the frequency of acanthosis nigricans and changes in waist, blood pressure, glucose, serum lipids, and insulin. The correlation between body mass index (BMI) z score and adipokines was evaluated. RESULTS: Among obese children, there was a difference in the mean values of HDL cholesterol and adiponectin, whereas among the eutrophic children, there was a difference in the mean values of insulin, HOMA-IR, glucose/insulin relation, and leptin (p < 0.001). A difference was also observed regarding the frequency of acanthosis nigricans and alteration in waist and HDL cholesterol (p < 0.005) in the obese group. The BMI z score showed a positive correlation with leptin (p < 0.001) and a negative correlation with adiponectin (p = 0.001). In multiple linear regression, this correlation was maintained only for leptin; HDL-cholesterol correlated with adiponectin (p = 0.007) and HOMA-IR correlated with both variables (p < 0.05). CONCLUSIONS: These findings provide evidence of the influence of obesity on metabolic syndrome components and on adipokine levels in prepubertal children, indicating that these components may contribute to the beginning of cardiovascular diseases.
Assuntos
Adipocinas/sangue , Síndrome Metabólica/sangue , Obesidade/sangue , Acantose Nigricans/sangue , Acantose Nigricans/epidemiologia , Biomarcadores/sangue , Índice de Massa Corporal , Brasil/epidemiologia , Criança , HDL-Colesterol/sangue , Métodos Epidemiológicos , Feminino , Homeostase/fisiologia , Humanos , Insulina/sangue , Masculino , Sobrepeso/sangue , Circunferência da Cintura/fisiologiaRESUMO
OBJECTIVE: To determine the influence of non-nutritive sucking and oral stimulation programs on breastfeeding rates at discharge, at 3 and at 6 months of corrected age in preterm infants with very low birth weight. METHODS: Preterm infants were randomized into experimental and control groups. Ninety-eight preterm infants were randomized and 96 remained in the study until reaching the corrected age of 6 months. The experimental group received sensory-motor-oral stimulation and non-nutritive sucking, while infants in the control group received a sham stimulation program. Both were administered from reaching enteral feeding (100 kcal/kg/day) until the beginning of oral feeding. RESULTS: Fifty-nine infants (61.5%) were breastfeeding at the time of hospital discharge, 31 (36.9%) at 3 months, and only 18 (20.5%) at 6 months of corrected age. At discharge, 46.9% of the control group and 76.5% of the experimental group were breastfeeding. There were statistically significant differences between rates of breastfeeding at discharge (47 vs. 76%), 3 months (18 vs. 47%) and 6 months after discharge (10 vs. 27%). The experimental group showed significantly higher rates of breastfeeding (p < 0.05). CONCLUSION: Non-nutritive sucking, associated with oral stimulation programs, can contribute to the improvement of breastfeeding rates among preterm infants with very low birth weight.
Assuntos
Aleitamento Materno/estatística & dados numéricos , Recém-Nascido de muito Baixo Peso/fisiologia , Estimulação Física/métodos , Comportamento de Sucção/fisiologia , Estudos de Casos e Controles , Feminino , Humanos , Lactente , Recém-Nascido , Recém-Nascido Prematuro , Masculino , Fatores SocioeconômicosRESUMO
OBJETIVO: Determinar a influência da sucção não-nutritiva e da estimulação oral nas taxas de amamentação na alta hospitalar, aos 3 meses e 6 meses de idade corrigida em recém-nascidos pré-termo de muito baixo peso ao nascer. MÉTODOS: Foram randomizados 98 recém-nascidos pré-termo de muito baixo peso ao nascer, e 96 permaneceram no estudo até o 6º mês de idade corrigida. Os recém-nascidos foram randomizados em grupo experimental e grupo controle. O grupo experimental recebeu um programa de estimulação (sucção não-nutritiva associado à estimulação sensório-motora-oral), e o grupo controle, um procedimento simulado a partir do momento em que atingiam alimentação plena até a alimentação oral completa. RESULTADOS: Observou-se que 59 (61,5 por cento) recém-nascidos estavam em amamentação na alta, 31 (32,6 por cento) aos 3 meses e apenas 18 (18,75 por cento) aos 6 meses de idade corrigida. Na alta, 47 por cento dos recém-nascidos do grupo controle e 76 por cento do grupo estimulado estavam em amamentação. Aos 3 meses, 18 por cento do grupo controle e 47 por cento do grupo estimulado continuavam em amamentação, e aos 6 meses, 10 por cento do grupo controle e 27 por cento do grupo estimulado. Houve diferença estatística nos três períodos estudados, favorecendo o grupo estimulado (p < 0,05). CONCLUSÃO: O presente estudo demonstra que a sucção não-nutritiva, associada à estimulação oral, pode contribuir para a melhoria das taxas de amamentação em pré-termos de muito baixo peso ao nascer.
OBJECTIVE: To determine the influence of non-nutritive sucking and oral stimulation programs on breastfeeding rates at discharge, at 3 and at 6 months of corrected age in preterm infants with very low birth weight. METHODS: Preterm infants were randomized into experimental and control groups. Ninety-eight preterm infants were randomized and 96 remained in the study until reaching the corrected age of 6 months. The experimental group received sensory-motor-oral stimulation and non-nutritive sucking, while infants in the control group received a sham stimulation program. Both were administered from reaching enteral feeding (100 kcal/kg/day) until the beginning of oral feeding. RESULTS: Fifty-nine infants (61.5 percent) were breastfeeding at the time of hospital discharge, 31 (36.9 percent) at 3 months, and only 18 (20.5 percent) at 6 months of corrected age. At discharge, 46.9 percent of the control group and 76.5 percent of the experimental group were breastfeeding. There were statistically significant differences between rates of breastfeeding at discharge (47 vs. 76 percent), 3 months (18 vs. 47 percent) and 6 months after discharge (10 vs. 27 percent). The experimental group showed significantly higher rates of breastfeeding (p < 0.05). CONCLUSION: Non-nutritive sucking, associated with oral stimulation programs, can contribute to the improvement of breastfeeding rates among preterm infants with very low birth weight.