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1.
Front Nutr ; 11: 1168715, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38633601

RESUMO

Background: Dietary composition can modify gene expression, favoring the development of chronic diseases via epigenetic mechanisms. Objective: Our study aimed to investigate the relationship between dietary patterns and NR3C1 gene methylation in users of the Brazilian Public Unified Health System (SUS). Methods: We recruited 250 adult volunteers and evaluated their socioeconomic status, psychosocial characteristics, lifestyle, and anthropometrics. Peripheral blood was collected and evaluated for cortisol levels, glycemia, lipid profile, and insulin resistance; methylation of CpGs 40-47 of the 1F region of the NR3C1 gene was also measured. Factors associated with degree of methylation were evaluated using generalized linear models (p < 0.05). Lifestyle variables and health variables were included as confounding factors. Results: The findings of our cross-sectional study indicated an association between NR3C1 DNA methylation and intake of processed foods. We also observed relevant associations of average NR3C1 DNA across the segment analyzed, methylation in component 1 (40-43), and methylation in component 2 (44-47) with a pattern of consumption of industrialized products in relation to BMI, serum cortisol levels, and lipid profile. These results may indicate a relationship between methylation and metabolic changes related to the stress response. Conclusion: These findings suggest an association of methylation and metabolic alterations with stress response. In addition, the present study highlights the significant role of diet quality as a stress-inducing factor that influences NR3C1 methylation. This relationship is further linked to changes in psychosocial factors, lifestyle choices, and cardiometabolic variables, including glucose levels, insulin resistance, and hyperlipidemia.

2.
Artigo em Inglês, Português | LILACS-Express | LILACS | ID: biblio-1436696

RESUMO

Introduction: Psychiatric disorders have become a global problem that leads millions of people to use psychotropic medications, especially benzodiazepines. The effects of these substances are widely known regarding tolerance and chemical dependence, however, from epigenetics perspective, there are still little known.Objective: To evaluate the association between psychotropic drug use, NR3C1 gene methylation and its relation with symptoms suggestive of depression in adult individuals assisted in the public health system.Methods: 385 adult volunteers (20-59 years) users of the Brazilian Unified Health System were recruited to evaluate socioeconomic, health, lifestyle conditions in a cross sectional study. BDI-II evaluated symptoms suggestive of depression and pyrosequencing evaluated NR3C1 DNA methylation. Bivariate and multivariate Poisson regression model with robust variance (p < 0.05) evaluated the association between psychotropic drug use and NR3C1 gene methylation.Results: Specific depressive symptoms such as irritability, insomnia and fatigability were associated with psychotropic drug use. Symptoms of past failure, indecision and loss of appetite were associated with hypermethylation patterns in CpGs 40 to 47 of NR3C1 gene. Moreover, psychotropic drug use is associated with 50% reduction in NR3C1 gene methylation, through model adjusted with socioeconomic, health and lifestyle confounding variables.Conclusions: Psychotropic drug use and depressive symptoms was associated with changes in NR3C1 DNA methylation. In this context, epigenetic modification resulting from psychotropic drug use and depressive symptoms could be considered, mainly in population studies with epigenetic evaluation, where these factors may be influencing the findings of future studies.


Introdução: os distúrbios psiquiátricos tornaram-se um problema global que leva milhões de pessoas ao uso de medicamentos psicotrópicos. Os efeitos dessas substâncias são amplamente conhecidos quanto à tolerância e dependência química, porém, do ponto de vista epigenético, ainda são pouco conhecidos.Objetivos: avaliar a associação entre o uso de drogas psicotrópicas, metilação do gene NR3C1 e sua relação com sintomas sugestivos de depressão em indivíduos entre 20 a 59 anos usuários da rede pública de saúde.Método: 385 voluntários de 20-59 anos, usuários do Sistema Único de Saúde brasileiro foram recrutados para avaliação das condições socioeconômicas, de saúde e de estilo de vida em estudo transversal. O BDI-II avaliou sintomas sugestivos de depressão e o pirosequenciamento avaliou a metilação do DNA de NR3C1. Modelo de regressão de Poisson bivariado e multivariado com variância robusta (p < 0,05) avaliou a associação entre o uso de drogas psicotrópicas e metilação do gene NR3C1.Resultados: sintomas depressivos específicos como irritabilidade, insônia e fadiga foram associados ao uso de medicamentos psicotrópicos. Sintomas de fracasso passado, indecisão e perda de apetite foram associados a padrões de hipermetilação nos CpGs 40 a 47 do gene NR3C1. Além disso, o uso de psicofármacos está associado à redução de 50% na metilação do gene NR3C1, por meio de modelo ajustado com variáveis de confusão socioeconômicas, de saúde e estilo de vida.Conclusão: o uso de drogas psicotrópicas e sintomas específicos depressivos foram associados a alterações na metilação do DNA de NR3C1.

3.
J Psychiatr Res ; 159: 240-248, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-36753898

RESUMO

This study aimed to investigate BDNF gene methylation in individuals with depression based on tobacco use. Therefore, 384 adults from southeastern Brazil were recruited to assess depression, socioeconomic status, lifestyle, and methylation by pyrosequencing exon IV promoter region of the BDNF gene. The Generalized Linear Model (GzLM) was used to check the effect of depression, tobacco, and the interaction between depression and tobacco use in methylation levels. In addition, the Kruskal-Wallis test, followed by Dunn's post hoc test, was used to compare methylation levels. Interaction between depression and tobacco use was significant at levels of BDNF methylation in the CpG 5 (p = 0.045), 8 (p = 0.016), 9 (p = 0.042), 10 (p = 0.026) and mean 5-11 (p < 0.001). Dunn's post hoc test showed that individuals with depression and tobacco use compared to those with or without depression who did not use tobacco had lower levels of BDNF methylation in CpG 5, 6, 7, 8, 9, 11, and mean 5-11. Therefore, we suggest that tobacco use appears to interfere with BDNF gene methylation in depressed individuals.


Assuntos
Fator Neurotrófico Derivado do Encéfalo , Metilação de DNA , Adulto , Humanos , Fator Neurotrófico Derivado do Encéfalo/genética , Depressão/genética , Éxons , Uso de Tabaco
4.
Artigo em Inglês, Português | LILACS-Express | LILACS | ID: biblio-1436142

RESUMO

ntroduction: state of Food and Nutritional Security (FNS) is one that should guarantee the right of permanent access to quality food and in sufficient quantity without prejudicing access to other basic rights. In Brazil, rural family farming establishments represent 84.4% of total agricultural establishments and contribute to more than 70% of all food consumed by Brazilians. In this context, the production of the coffee commodity stands out. However, despite being food producers, they do not earn a good income. Slow economic activity can lead to loss of wages and income, illness, as well as food insecurity (FNiS). In addition, the molecular effects of FNiS are poorly studied, especially epigenetic.Objective: the objective of the present study is to analyze the association between Brain-Derived Neurotrophic Factor (BDNF) DNA methylation and socio demographic, lifestyle, and epigenetic factors, among coffee farmers in the Caparaó zone, in Espirito Santo, Southeast Brazil.Methods: the study was carried out in 22 randomly selected coffee producing communities in Zona Caparaó, an area that produces coffee of recognized quality. A total of 570 coffee farming households, 18 to 60 years of age, were included in the study by answering a questionnaire about socioeconomic characteristics, land use and ownership, behavior, health, and working conditions. FNiS evaluation was carried out using the Brazilian Food Insecurity Scale. BDNF exon I methylation was examined by methylation-specific PCR. Body mass index and biochemical analyses were performed. Logistic regression models were used to verify factors associated with FNiS (p<0.05). Data were analyzed using the Stata® statistical software package version 14.Results: the FNiS prevalence found was 23.68%. In multivariable logistic regression, the occurrence of FNiS was associated with hypermethylation of exon I of the BDNF promoter exon I [ORa = 5.03 (95% (1.98, 12.82)] when compared to the unmethylated gene. Moreover, FNiS was associated with excessive workload [ORa = 3.36 (1.23, 9.22)], possession of less land (hectares) [ORa = 0.77 (0.67, 0.90)] and greater number symptoms and / or illnesses in real life [ORa = 1.12 (1.04.1.20)].Conclusion: there is a high prevalence of Food Insecurity in the studied region. This phenomenon was associated with epigenetic factors (BDNF methylation), excessive workload, small land ownership and a greater number of diseases / symptoms. Food insecurity is a psychosocial stressor that can lead to epigenetic changes in the BDNF gene, responsible for regulating cognitive functions, neuronal survival and involved in the genesis of psychiatric diseases.


Introdução: o Estado de Segurança Alimentar e Nutricional (SAN) é aquele que deve garantir o direito de acesso permanente à alimentação de qualidade e em quantidade suficiente sem prejudicar o acesso a outros direitos básicos. No Brasil, os estabelecimentos de agricultura familiar rural representam 84,4% do total de estabelecimentos agropecuários e contribuem com mais de 70% de todos os alimentos consumidos pelos brasileiros. Nesse contexto, destaca-se a produção da commodity café. No entanto, apesar de serem produtores de alimentos, não auferem bons rendimentos. A lenta atividade econômica pode levar à perda de salários e renda, doenças e insegurança alimentar (INSAN). Além disso, os efeitos moleculares da INSAN são pouco estudados, sobretudo epigenéticos.Objetivos: o objetivo do presente estudo é analisar a associação entre a metilação do promotor do BDNF e a INSAN e a associação da INSAN com fatores sociodemográficos, de estilo de vida e epigenéticos, em cafeicultores da zona do Caparaó, no Espírito Santo, Sudeste do Brasil.Método: o estudo foi realizado em 22 comunidades cafeeiras selecionadas aleatoriamente na Zona do Caparaó, área que produz café de reconhecida qualidade. Um total de 570 famílias de cafeicultores, entre 18 a 60 anos, foram incluídos no estudo e responderam a um questionário sobre características socioeconômicas, uso e posse da terra, hábitos de vida, saúde e condições de trabalho. A avaliação da INSAN foi realizada por meio da Escala Brasileira de Insegurança Alimentar. A metilação do éxon I do BDNF foi examinada por PCR específica para metilação. Índice de massa corporal e análises bioquímicas foram realizadas. Modelos de regressão logística foram utilizados para verificar os fatores associados à INSAN (p<0,05). Os dados foram analisados usando o software estatístico Stata® versão 14.Resultados: a prevalência de INSAN encontrada foi de 23,68%. Na regressão logística multivariada, a ocorrência de INSAN foi associada a hipermetilação do éxon I do promotor do gene BDNF [ORa = 5,03 (95% (1,98, 12,82)] quando comparado ao gene não metilado. Além disso, a INSAN foi associada a carga de trabalho excessiva [ORa = 3,36 (1,23, 9,22)], posse de menos hectares de terra [ORa = 0,77 (0,67, 0,90)] e maior número de sintomas e/ou doenças da vida real [ORa = 1,12 (1.04.1.20)].Conclusão: o estudo mostrou uma alta prevalência de Insegurança Alimentar na região analisada. Esse fenômeno foi associado a fatores epigenéticos (metilação do gene BDNF), carga horária excessiva, pequena propriedade de terra e maior número de doenças/sintomas. A INSAN pode ser um estressor capaz de promover alterações epigenéticas no gene BDNF, importante gene regulador da cognição, crescimento e sobrevivência neuronal e envolvido com doenças psiquiátricas.

5.
Life Sci ; 309: 120940, 2022 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-36108769

RESUMO

AIMS: the present study aimed to investigate how glucose and insulin levels may be associated with changes in NR3C1 gene methylation levels in adults. MAIN METHODS: 375 volunteers users of the Brazilian Public Unified Health System (SUS) were recruited to assess socioeconomic status, lifestyle, anthropometric data, blood glucose and serum cortisol levels, insulin resistance, and NR3C1 gene methylation assessment. Factors associated with glucose levels and insulin resistance were investigated using multivariate analysis GLzM at 5% significance (p<0.05). KEY FINDINGS: our results verified that glucose levels and insulin resistance were directly related to NR3C1 gene methylation and age, while not being overweight and obese and no tobacco consumption were indirectly related to glucose levels and insulin resistance. SIGNIFICANCE: habits and lifestyle may influence NR3C1 gene regulation, revealing the complexity of environmental impacts on NR3C1 methylation. Furthermore, associated risk factors must be taken into account in epigenetic studies as they directly interfere with blood glucose levels and insulin resistance.


Assuntos
Resistência à Insulina , Insulinas , Adulto , Humanos , Metilação de DNA , Hidrocortisona , Receptores de Glucocorticoides/metabolismo , Resistência à Insulina/genética , Glicemia , Éxons , Estilo de Vida , Insulinas/genética
6.
Ann Med Surg (Lond) ; 65: 102303, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34094525

RESUMO

INTRODUCTION: Immune cells contribute with mediators in the protein expression profile of the tumor microenvironment. Levels of plasminogen activator inhibitor-1 (PAI-1) are elevated in non-malignant inflammatory conditions; however, the association between PAI-1 expression and inflammation remains uncertain in oral squamous cell carcinoma (OSCC). This study aimed to investigate PAI-1 expression in mononuclear inflammatory cell infiltrate in OSCC and its role as a prognostic marker. METHODS: Samples were collected from patients with OSCC, treated surgically, and followed for 24 months after the procedure. Thirty-nine tumoral tissue were analyzed using immunohistochemistry. Correlation between protein expression, clinicopathological parameters, and the prognosis was investigated. RESULTS: Positive PAI-1 expression in mononuclear inflammatory cell infiltrate was significantly associated with lymph node status (p = 0.009) and with the cytoplasmic expression of vascular endothelial growth factor A (VEGFA) (p = 0.028). Multivariate analysis revealed weak PAI-1 expression as an independent marker for lymph node metastases, with approximately 8-fold increased risk compared to strong expression (OR = 8.60; CI = 1.54-48.08; p = 0.014). CONCLUSION: Our results suggest that the strong PAI-1 expression in intratumoral inflammatory infiltrate is an indicator of a better prognosis for patients diagnosed with oral squamous cell carcinoma.

7.
Stress ; 24(6): 814-821, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-33977868

RESUMO

The aim of this study was to investigate socioeconomic stressors predictive of depressive symptoms and possible epigenetic changes in the glucocorticoid receptor - NR3C1-1F - an encoding gene involved in depressive symptoms. A total of 321 adult volunteers from southeastern Brazil were recruited to evaluate depressive symptoms, socio-demographic and economic factors, including food and nutritional security (FNS) or insecurity (FNiS) status, and NR3C1-1F region methylation by pyrosequencing. Depressive symptom determinants were investigated using a Poisson regression model with robust variance. Mann-Whitney tests and structural mediation equation models were used to evaluate the relationship between NR3C1 DNA methylation, FNiS, and depressive symptoms. Multivariate Poisson regression with robust variance adjusted for sex and FNiS and NR3C1-1F region methylation predicted risk factors for depressive symptoms. Mediation analysis revealed that NR3C1-1F region methylation mediated the relationship between FNiS exposure and depressive symptoms as an outcome, and depressive volunteers and FNiS individuals exhibited a significant increase in NR3C1 methylation when compared to healthy individuals and FNS volunteers, respectively. Therefore, we suggest that stress caused by FNiS may lead to depressive symptoms and that NR3C1-1F DNA methylation can act as a mediator of both FNiS and depressive symptoms.


Assuntos
Depressão , Insegurança Alimentar , Estresse Psicológico , Adulto , Metilação de DNA , Depressão/genética , Epigênese Genética , Humanos , Regiões Promotoras Genéticas , Receptores de Glucocorticoides/genética , Receptores de Glucocorticoides/metabolismo , Estresse Psicológico/genética
8.
Sci Rep ; 11(1): 6768, 2021 03 24.
Artigo em Inglês | MEDLINE | ID: mdl-33762648

RESUMO

The NR3C1 glucocorticoid receptor (GR) gene is a component of the stress response system, which can be regulated by epigenetic mechanisms. NR3C1 methylation has been associated with trauma and mental issues, including depression, post-traumatic stress, anxiety, and personality disorders. Previous studies have reported that stressful events are involved in NR3C1 gene methylation, suggesting that its regulation under environmental effects is complex. The present study aimed to analyze associations involving stressors such as socioeconomic status, health conditions, and lifestyle in relation to NR3C1 methylation in adults. This study included 386 individual users of the Brazilian Public Unified Health System (SUS), and evaluated socioeconomic and health conditions, body mass index, cortisol levels, and lifestyle. Data were correlated with NR3C1 methylation, determined using DNA pyrosequencing. The results showed that alcohol consumption, overweight, and high cortisol levels were related to NR3C1 demethylation, while depression was related to its methylation. Habits, lifestyle, and health status may influence NR3C1 gene regulation via methylation, revealing the complexity of environmental impacts on NR3C1 methylation.


Assuntos
Consumo de Bebidas Alcoólicas/genética , Cortisona/sangue , Metilação de DNA , Depressão/genética , Sobrepeso/genética , Receptores de Glucocorticoides/genética , Adulto , Biomarcadores , Ilhas de CpG , Estudos Transversais , Depressão/metabolismo , Suscetibilidade a Doenças , Feminino , Estudos de Associação Genética , Humanos , Masculino , Pessoa de Meia-Idade , Sobrepeso/metabolismo , Receptores de Glucocorticoides/metabolismo , Fatores Socioeconômicos , Adulto Jovem
9.
Sci Rep ; 10(1): 10382, 2020 06 25.
Artigo em Inglês | MEDLINE | ID: mdl-32587307

RESUMO

Oral cancer squamous cell carcinoma (OCSCC) mainly affects individuals aged between 50 and 70 years who consume tobacco and alcohol. Tobacco smoke contains hundreds of known toxic and carcinogenic molecules, and a few studies have sought to verify the relationship of such trace elements as risk or prognostic factors for head and neck cancer. We obtained 78 samples of tumor tissues from patients with OCSCC, and performed a qualitative elemental characterization using the micro X-Ray Fluorescence technique based on synchrotron radiation. We found the presence of magnesium, phosphorus, sulfur, chlorine, potassium, calcium, chromium, manganese, iron, zinc, cobalt, nickel, copper, arsenic and bromine in OCSCC samples. Magnesium, chlorine, chromium, manganese, nickel, arsenic and bromine are associated with smoking. We observed a significant association between relapse and chlorine and chromium. The presence of chlorine in the samples was an independent protective factor against relapse (OR = 0.105, CI = 0.01-0.63) and for best disease-free survival (HR = 0.194, CI = 0.04-0.87). Reporting for the first time in oral cancer, these results suggest a key relationship between smoking and the presence of certain elements. In addition, chlorine proved to be important in the context of patient prognosis and survival.


Assuntos
Carcinoma de Células Escamosas/mortalidade , Elementos Químicos , Neoplasias Bucais/mortalidade , Recidiva Local de Neoplasia/mortalidade , Fumar/efeitos adversos , Carcinoma de Células Escamosas/etiologia , Carcinoma de Células Escamosas/metabolismo , Carcinoma de Células Escamosas/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/etiologia , Neoplasias Bucais/metabolismo , Neoplasias Bucais/patologia , Recidiva Local de Neoplasia/etiologia , Recidiva Local de Neoplasia/metabolismo , Recidiva Local de Neoplasia/patologia , Prognóstico , Taxa de Sobrevida
10.
Community Ment Health J ; 56(7): 1292-1297, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32451795

RESUMO

This study aimed to investigate the risk factors for depressive symptoms among rural residents in Brazil. A representative sample of two hundred eighty-eight volunteers aged from 18 to 65 years was included and determining factors for high BDI-II score were investigated through a multivariate logistic model. Sadness, loss of pleasure, crying, worthlessness and loss of interest in sex are more likely to be observed in females, and risk factors to this high depression score among rural residents were shown to be: female gender, tobacco use, pesticide application, poor self-perceived health and presence of chronic disease. These data contribute to the knowledge of factors determining depressive symptoms among rural residents and may help to expand health policies to improve quality of rural life on these communities and others with similar characteristics.


Assuntos
Depressão , População Rural , Brasil/epidemiologia , Depressão/epidemiologia , Feminino , Humanos , Fatores de Risco , Uso de Tabaco
11.
J Psychiatr Res ; 121: 24-30, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31731185

RESUMO

OBJECTIVE: The aim of this study was to verify determinant factors for depression and analyze the relationship between possible changes in HPA axis and depression, in this case NR3C1 DNA methylation and serum cortisol levels. METHODS: 349 adult volunteers were recruited to evaluate depression, socio-demographic, economic and lifestyle factors, serum cortisol levels and NR3C1 DNA methylation by pyrosequencing. Depression determinant factors were investigated using a Poisson regression model with robust variance (p < 0.05). RESULTS: Poisson regression with robust variance adjusted by gender, tobacco use, self-perceived stress, leisure activity, suicidal ideation, low cortisol levels and NR3C1 DNA methylation was performed and predicted risk factors for depression. Furthermore, depressive volunteers showed a significant increase in NR3C1 DNA methylation when compared to healthy volunteers. CONCLUSIONS: This findings provide a basis for understanding the role of HPA axis in depression, especially its regulation by NR3C1 DNA methylation. Furthermore, it emphasizes the stressful lifestyle risk factors (female, tobacco uso, self perceived stress, leisure activities absence and suicidal ideation) that can contribute to future research and the search for public health policies to improve quality of live, mental and general health.


Assuntos
Metilação de DNA , Depressão/metabolismo , Epigênese Genética , Hidrocortisona/sangue , Sistema Hipotálamo-Hipofisário/metabolismo , Estilo de Vida , Receptores de Glucocorticoides/metabolismo , Estresse Psicológico/metabolismo , Ideação Suicida , Adulto , Brasil/epidemiologia , Depressão/sangue , Depressão/epidemiologia , Feminino , Humanos , Atividades de Lazer , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Fatores Sexuais , Fumar/epidemiologia , Fumar/metabolismo , Estresse Psicológico/epidemiologia , Adulto Jovem
12.
PLoS One ; 13(7): e0197699, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30063700

RESUMO

OBJECTIVE: To assess the association between indicators of psychosocial stress and central adiposity in adult users of the Unified Health System (SUS) from Southeast of Brazil. METHODS: This cross-sectional study was conducted with 384 adults (20 to 59 years old) from the city of Alegre, Southeastern Brazil. The simple random sample represented the population using the public health system of the municipality. The prevalence of obesity was based on the Body Mass Index, and central adiposity (dependent variable) was measured by waist circumference in centimeters. The independent variables were the following indicators of psychosocial stress: food and nutrition insecurity (yes/no), serum cortisol (µg/dL), symptoms suggestive of depression using the Beck Depression Inventory-II ≥ 17 (yes/no), and altered blood pressure ≥ 130/85 mmHg (yes/no). Univariate linear regression was performed between central adiposity and each stress indicator, and later the models were adjusted for socioeconomic, health, and lifestyle variables. All analyses were made separately by rural and urban location. RESULTS: The prevalence of weight excess, by the classification of the Body Mass Index ≥ 25.0 kg/m2, was 68.3% and, by waist circumference, 71.5% of individuals presented an increased risk for metabolic complications related to central adiposity. Mean waist circumference scores for the rural and urban population were 89.3 ± 12.7 cm and 92.9 ± 14.7 cm, respectively (p = 0.012). Indicators of stress that were associated with central adiposity were: cortisol in the rural population (ß = -0.60; 95% CI = -1.09;-0.11) and altered blood pressure in the urban population (ß = 6.66; 95% CI = 2.14;11.18). This occurred both in the raw analysis and in the models adjusted for confounding factors. CONCLUSION: Central adiposity was inversely associated with cortisol in the rural population and directly associated with higher arterial blood pressure in the urban population, suggesting a local influence on how individuals react to stress.


Assuntos
Depressão/epidemiologia , Abastecimento de Alimentos/estatística & dados numéricos , Hipertensão/epidemiologia , Obesidade Abdominal/epidemiologia , Estresse Psicológico/epidemiologia , Adulto , Idoso , Índice de Massa Corporal , Brasil/epidemiologia , Estudos Transversais , Depressão/sangue , Depressão/fisiopatologia , Feminino , Humanos , Hidrocortisona/sangue , Hipertensão/sangue , Hipertensão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Obesidade Abdominal/sangue , Obesidade Abdominal/fisiopatologia , Prevalência , Saúde Pública/estatística & dados numéricos , Fatores de Risco , População Rural , Estresse Psicológico/sangue , Estresse Psicológico/fisiopatologia , População Urbana , Circunferência da Cintura
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