Decreased plasma iron levels in women with hyperglycemia are associated with inflammatory status and involve increased HbA1c, osmotic stability, and volume variability of red blood cells.

BACKGROUND AND AIMS: Iron deficiency tendency in individuals with hyperglycemia influences the HbA1c levels' ability to estimate the stationary blood glucose levels. This study investigated the associations of iron status indicators and HbA1c levels with anthropometric, inflammatory, regulatory, metabolic, and hematologic variables in women with hyperglycemia to most widely characterize this iron deficiency tendency. METHODS: A total of 143 volunteers (68 with normoglycemia and 75 with hyperglycemia) participated in this cross-sectional study. Mann-Whitney test was used to compare groups, and the search for associations between pairs of variables used the Spearman correlation method. RESULTS: In women with hyperglycemia, decreased plasma iron level is associated directly with increased HbA1c (p < 0.001), and these changes are both related to C-reactive protein elevation (p = 0.02 and p < 0.05, respectively) and involve decreased mean hemoglobin concentration (p < 0.01 and p < 0.01), which in turn, involves enhanced osmotic stability (dX) (p < 0.05) and volume variability (RDW) (p < 0.0001) of erythrocytes, as well as decreased indirect bilirubin/total bilirubin ratio (p = 0.04). This indirect bilirubin/total bilirubin decrease, which expresses decreased hemoglobin catabolism, does not seem to be solely a process associated with diminished intracellular concentrations of this protein (p = 0.04) since it is associated with CRP elevation (p = 0.03) and reduced LDL cholesterol (p < 0.0001). CONCLUSIONS: In women with hyperglycemia, decreased plasma iron levels were associated with inflammatory status and involved increased HbA1c, osmotic stability, and volume variability of red blood cells.

Negative effects of the COVID-19 pandemic on physical activity and binge eating disorder in Brazilian women: a cross-sectional study / Efeitos negativos da pandemia de COVID-19 na atividade física e no transtorno da compulsão alimentar periódica em mulheres brasileiras: um estudo transversal / Efectos negativos de la pandemia de COVID-19 sobre la actividad física y el trastorno por atracón en mujeres brasileñas: un estudio transversal

ABSTRACT This study aimed to identify changes in physical activity, sitting time, and binge eating disorder in Brazilian women during the COVID-19 pandemic. A cross-sectional and retrospective study was conducted online on 150 Brazilian women adults. The prevalence of binge eating and physically inactive women increased during the COVID-19 pandemic (p = < 0.001 and p = 0.01, respectively). Binge eating was associated with insufficient physical activity before (p = 0.01) and during the pandemic (p = 0.05). The physical activity time and sitting time showed no differences after adjustment for possible confounders (p > 0.05). In conclusion, the pandemic affected Brazilian women's lifestyle and eating behavior.

RESUMO Este estudo teve como objetivo identificar mudanças na atividade física, tempo sentado e transtorno da compulsão alimentar periódica em mulheres brasileiras durante a pandemia de COVID-19. Foi realizado um estudo transversal e retrospectivo por meio de um formulário on-line em 150 mulheres adultas brasileiras. A prevalência de compulsão alimentar e de mulheres fisicamente inativas aumentou durante a pandemia de COVID-19 (p = < 0,001 e p = 0,01, respectivamente). A compulsão alimentar foi associada à atividade física insuficiente antes (p = 0,01) e durante a pandemia (p = 0,05). O tempo de atividade física e o tempo sentado não apresentaram diferenças após ajuste para possíveis fatores de confusão (p > 0,05). Em conclusão, a pandemia afetou o estilo de vida e o comportamento alimentar das mulheres brasileiras.

RESUMEN El objetivo del estudio fue identificar cambios los cambios en la actividad física, el tiempo sentado y el trastorno por atracón en mujeres brasileñas durante la pandemia de COVID-19. Es un estudio transversal y retrospectivo que evaluó, a través de un formulario en línea en 150 mujeres brasileñas adultas. La prevalencia de atracones y de mujeres físicamente inactivas aumentó durante la pandemia de COVID-19 (p = < 0,001 y p = 0,01, respectivamente). Los atracones se asociaron con actividad física insuficiente antes (p = 0,01) y durante la pandemia (p = 0,05). El tiempo de actividad física y el tiempo sentado no difirieron después del ajuste por posibles factores de confusión (p > 0,05). En conclusión, la pandemia afectó el estilo de vida y el comportamiento alimentario de las mujeres brasileñas.

Effects of social distancing caused by the COVID-19 pandemic on physical activity level, sitting time, and binge eating: a comparison between overweight/obese and normal-weight adults.

Purpose: To compare changes in physical activity level (PAL), sitting time (ST), and binge eating disorder (BED) in overweight/obese adults vs. those normal weight during social distancing caused by the COVID-19 pandemic. Methods: A cross-sectional and retrospective study was carried out with adults of both sexes, aged 18-60 years, which assessed, through an online form, the PAL, ST, and BED pre (PSD) and during social distancing (DSD) caused by the COVID-19 pandemic. The PAL and ST were assessed by the short version of the International Physical Activity Questionnaire and the assessment of BED by the Binge Eating Scale. Results: 323 responses were included in the analysis (194 normal weight and 129 overweight/obese). There was a decrease in PAL and an increase in the prevalence of BED in both groups; nevertheless, the overweight/obese group had a 62% chance of presenting lower PALs than normal-weight individuals (OR = 1.62; 95% CI 1.03-2.55) and showed a lower total weekly physical activity time during the pandemic (adjusted p = 0.05). In addition, overweight individuals were more likely to binge eat before (OR = 4.21; 95% CI 2.10-8.45) and during the pandemic (OR = 4.24; 95% CI 2.54-7.06) and showed a higher prevalence during social distancing. Conclusion: The social distancing caused by the COVID-19 pandemic changed exercise behaviors and increased the prevalence of binge eating in the general population. However, overweight/obese participants engaged in less total weekly physical activity and showed a higher prevalence of binge eating before and during social distancing. Level of evidence: Level III; analytical observational cohort study.

Does Obesity Aggravate Climacteric Symptoms in Postmenopausal Women?

OBJECTIVE: To determine if there is a correlation between body mass index (BMI) and climacteric symptoms in postmenopausal women. METHODS: The study sample was composed of 109 postmenopausal women with a mean age of 57 ± 8 years, mean body mass index (BMI) of 30 ± 6 kg/m2, and 8 ± 8 years after menopause. For the assessment of the climacteric symptoms, the Blatt-Kupperman Index (BKI), the Menopause Rating Scale (MRS), and the Cervantes Scale (CS) were used. Data analysis was performed through the Chi-squared test, analysis of variance (ANOVA) with the Bonferroni post hoc test, and multiple linear regression. The level of significance adopted was of p < 0.05. The statistical analyses were performed using the Statistical Package for the Social Sciences (IBM SPSS Statistics for Windows, IBM Corp., Armonk, NY, United States) software, version 26.0. RESULTS: The multiple linear regression showed a positive association (p < 0.01) between BMI values and menopause symptoms when adjusted for age and time after menopause in the 3 questionnaires used (BKI: B = 0.432; CS: B = 304; and MRS: B = 302). Regarding symptom scores, the obese women had higher mean scores (p < 0.05) when compared to eutrophic women (BKI = 28 ± 10 and 20 ± 10; and MRS = 20 ± 10 and 13 ± 7, respectively). In the Chi-squared analysis, 28% of obese women had severe symptoms and 46% had moderate symptoms, while only 1% and 46% of eutrophic women had these same symptoms. CONCLUSION: There is an association between BMI and climacteric symptoms, and overweight or obese women have more intense and moderate symptoms than eutrophic women.

OBJETIVO: Verificar se há correlação entre o índice de massa corporal e os sintomas do climatério em mulheres na pós-menopausa. MéTODOS: Participaram do estudo 109 mulheres na pós-menopausa, com idade média de 57 ± 8 anos, índice de massa corporal (IMC) médio de 30 ± 6 kg/m2 e 8 ± 8 anos após a menopausa. Para a avaliação dos sintomas climatéricos, foram utilizados os questionários específicos para essa população: Índice de Kupperman-Blatt (IKB), Menopause Rating Scale (MRS), e Escala de Cervantes (EC). A análise dos dados foi realizada por meio do teste do chi-quadrado, análise de variância (analysis of variance, ANOVA, em inglês) com o teste post hoc de Bonferroni e regressão linear múltipla. O nível de significância adotado foi p < 0,05. Todas as análises estatísticas foram realizadas no programa Statistical Package for the Social Sciences (IBM SPSS Statistics for Windows, IBM Corp., Armonk, NY, Estados Unidos), versão 26.0. RESULTADOS: A regressão linear múltipla mostrou associação positiva (p < 0,01) entre os valores do IMC e os sintomas do climatério quando ajustados pela idade e pelo tempo após a menopausa nos 3 questionários utilizados (IKB: B = 0,432; CE: B = 304; e MRS: B = 302). Quanto às pontuações dos sintomas, as mulheres com obesidade apresentaram médias maiores (p < 0,05) quando comparadas às mulheres eutróficas (IKB = 28 ± 10 e 20 ± 10; e MRS = 20 ± 10 e 13 ± 7). Na análise pelo chi-quadrado 28% das mulheres obesas apresentaram sintomas graves, e 46%, moderados, ao passo que apenas 1% e 46% das eutrópicas apresentavam esses mesmos sintomas. CONCLUSãO: Há uma associação entre IMC e sintomas climatéricos, e mulheres com sobrepeso ou obesidade apresentam sintomas mais intensos e moderados do que mulheres eutróficas.

Does Obesity Aggravate Climacteric Symptoms in Postmenopausal Women? / A obesidade agrava os sintomas climatéricos em mulheres na pós-menopausa?

Abstract Objective To determine if there is a correlation between body mass index (BMI) and climacteric symptoms in postmenopausal women. Methods The study sample was composed of 109 postmenopausal women with a mean age of 57 ± 8 years, mean body mass index (BMI) of 30 ± 6 kg/m2, and 8 ± 8 years after menopause. For the assessment of the climacteric symptoms, the Blatt-Kupperman Index (BKI), the Menopause Rating Scale (MRS), and the Cervantes Scale (CS) were used. Data analysis was performed through the Chi-squared test, analysis of variance (ANOVA) with the Bonferroni post hoc test, and multiple linear regression. The level of significance adopted was of p < 0.05. The statistical analyses were performed using the Statistical Package for the Social Sciences (IBM SPSS Statistics for Windows, IBM Corp., Armonk, NY, United States) software, version 26.0. Results The multiple linear regression showed a positive association (p<0.01) between BMI values and menopause symptoms when adjusted for age and time after menopause in the 3 questionnaires used (BKI: B = 0.432; CS: B = 304; and MRS: B = 302). Regarding symptom scores, the obese women had higher mean scores (p<0.05) when compared to eutrophic women (BKI = 28 ± 10 and 20 ± 10; and MRS = 20 ± 10 and 13±7, respectively). In the Chi-squared analysis, 28% of obese women had severe symptoms and 46% had moderate symptoms, while only 1% and 46% of eutrophic women had these same symptoms. Conclusion There is an association between BMI and climacteric symptoms, and overweight or obese women have more intense and moderate symptoms than eutrophic women.

Resumo Objetivo Verificar se há correlação entre o índice de massa corporal e os sintomas do climatério em mulheres na pós-menopausa. Métodos Participaram do estudo 109 mulheres na pós-menopausa, com idade média de 57± 8 anos, índice de massa corporal (IMC) médio de 30± 6kg/m2 e 8± 8 anos após a menopausa. Para a avaliação dos sintomas climatéricos, foram utilizados os questionários específicos para essa população: Índice de Kupperman-Blatt (IKB), Menopause Rating Scale (MRS), e Escala de Cervantes (EC). A análise dos dados foi realizada por meio do teste do chi-quadrado, análise de variância (analysis of variance, ANOVA, em inglês) com o teste post hoc de Bonferroni e regressão linear múltipla. O nível de significância adotado foi p<0,05. Todas as análises estatísticas foram realizadas no programa Statistical Package for the Social Sciences (IBM SPSS Statistics for Windows, IBM Corp., Armonk, NY, Estados Unidos), versão 26.0. Resultados A regressão linear múltipla mostrou associação positiva (p < 0,01) entre os valores do IMC e os sintomas do climatério quando ajustados pela idade e pelo tempo após a menopausa nos 3 questionários utilizados (IKB: B = 0,432; CE: B = 304; e MRS: B = 302). Quanto às pontuações dos sintomas, as mulheres com obesidade apresentaram médias maiores (p < 0,05) quando comparadas às mulheres eutróficas (IKB = 28 ± 10 e 20 ± 10; e MRS = 20± 10 e 13 ±7). Na análise pelo chi-quadrado 28% das mulheres obesas apresentaram sintomas graves, e 46%, moderados, ao passo que apenas 1% e 46% das eutrópicas apresentavam esses mesmos sintomas. Conclusão Há uma associação entre IMC e sintomas climatéricos, e mulheres com sobrepeso ou obesidade apresentam sintomas mais intensos e moderados do que mulheres eutróficas.

Efeito do tratamento multidisciplinar em adolescentes obesos: um estudo de follow up / Effect of a multidisciplinary treatment in obese adolescents: a follow up study

Introdução: O tratamento multidisciplinar é um método de controle da obesidade, porém, poucos estudos relatam os efeitos após cessar este tipo de intervenção. Objetivo: Acompanhar adolescentes um e dois anos após a cessação do tratamento multidisciplinar por meio de reavaliações física, metabólica e antropométrica, aplicação de questionários e entrevista semiestruturada para diagnosticar as causas da evasão e alteração do estilo de vida. Resultados: As variáveis físicas, e antropométricas dos adolescentes que concluíram o tratamento se mantiveram por dois anos após a cessação do tratamento. As principais causas de evasão foram necessidade de inserção no mercado de trabalho e ingresso no ensino técnico ou superior. Conclusão: O tratamento multidisciplinar provavelmente causou prevenção de ganho de massa corporal e aumento do IMC e os indivíduos que completaram o tratamento tiveram maiores chances de alterar o estilo de vida.

Introduction: The multidisciplinary treatment is an obesity control method, however, few studies have reported the effects after ceasing this intervention type. Objective: To monitor teenagers one and two years after multidisciplinary treatment through physical, metabolic and anthropometric revaluations, questionnaires and semi-structured interviews to diagnose the causes of evasion and change of lifestyle. Results: The physical and anthropometric variables of adolescents who completed treatment were maintained for two years after cessation of treatment. The main evasion causes were necessity of a employment and technical education and university admission. Conclusion: The multidisciplinary treatment probably caused body weight and BMI gain prevention and individuals who completed treatment had higher chances to change the lifestyle.

Interdisciplinary therapy changes superoxide dismutase activity and adiponectin in obese adolescents: a randomised controlled trial.

The objective of this study is to evaluate the effect of interdisciplinary therapy in the parameters of the oxidative stress and the anti-inflammatory responses of obese adolescents. We selected 57 participants, who were randomly divided into 2 groups: interdisciplinary therapy group and a control group. After 6 months of intervention, 17 participants of the interdisciplinary therapy group and 8 of the control group returned for re-evaluation. The interdisciplinary therapy group participated in a treatment with 4 weekly sessions of exercise, a weekly group therapy session and a weekly nutritional education session. Blood parameters of oxidative stress and anti-inflammatory response were evaluated. The results demonstrated that there were significant increases in the interdisciplinary therapy group for superoxide dismutase activity (6.56 ± 3.22 to 11.40 ± 7.49) and ferric-reducing antioxidant potential concentration (532.91 ± 106.48 to 573.25 ± 112.57), although adiponectin levels did not reduce (40.9 ± 29.34 to 49.05 ± 41.22). A significant decrease in nitrite levels was also found (14.23 ± 8.48 to 11.45 ± 6.05). In the control group, significant reduction was found in adiponectin (31.56 ± 18.88 to 18.01 ± 11.66). This study suggests that interdisciplinary therapy for 6 months was effective in improving the anti-inflammatory responses and the antioxidant defences in obese adolescents.

Associação da ingestão de macronutrientes com o padrão de sono de adolescentes obesos / Associations of macronutrients intake with sleep pattern among obese adolescents

Introdução: A obesidade tornou-se uma preocupação mundial. Estudos mostraram relação negativa entre a duração do sono e o Índice de Massa Corporal (IMC), adicionalmente, pesquisas revelam que a privação do sono está relacionada com a inadequação alimentar. Objetivos: Avaliar e relacionar a qualidade do sono, ingestão alimentar e percentual de gordura de adolescentes obesos. Métodos: A amostra foi composta por 41 adolescentes obesos. Foi realizada avaliação da composição corporal, ingestão alimentar por recordatório e análise do sono por questionários. Resultados: Foi observada alta prevalência de dietas hiperlipídicas (60,98%), além de má qualidade do sono (82,93%) e sonolência (56,10%). Além disso,a sonolência apresentou correlação positiva com massa corporal (r=0,327), com IMC (r=0,363) e ingestão hiperproteíca (r=0,343). A má qualidade do sono apresentou correlação com a massa corporal (r=0,336). Conclusão: Os sujeitos apresentaram importantes alterações no padrão de sono, possivelmente associada à ingestão exacerbada de nutrientes e a adiposidade.

Introduction: Obesity has become a global concern. Studies show negative relationship between sleep duration and body mass index (BMI), additionally, research shows that sleep deprivation is related to inadequate diet. Objectives: To analyze the quality of sleep, food intake and body fat percentage of obese adolescents. Methods: The sample consisted of 41 obese adolescents. The assessment of body composition has been carried out by food intake recall, sleep analysis questionnaires. Results: We found a high prevalence of high fat diet (60.98%), and poor sleep quality (82.93%) and somnolence (56.10%). In addition, sleepiness was positively correlated with body weight (r = 0.327), BMI (r = 0.363) and the high protein intake (r = 0.343). The poor sleep quality correlated with body mass (r = 0.336). Conclusion: The subjects showed significant changes in sleep patterns, possibly associated with exacerbated nutrient intake and adiposity.

Esteatose hepática não alcoólica: relação com a síndrome metabólica e os fatores de risco cardiovascular em adolescentes obesos / Esteatosis hepática no alcohólica: relación con el síndrome metabólico y los factores de riesgo cardiovascular em adolescentes obesos / Nonalcoholic hepatic steatosis: association with metabolic syndrome and cardiovascular risk factors in obese adolescents

Avaliar a associação entre esteatose hepática não alcoólica (EHNA), síndrome metabólica (SM) e fatores de risco cardiovascular (FRCs) em adolescentes obesos. Métodos: Estudo observacional do tipo transversal com abordagem quantitativa, realizado de junho a agosto de 2011. Os voluntários foram aleatoriamente selecionados e encaminhados para avaliação clínica no setor de endocrinologia e cardiologia do hospital de clínicas da Universidade Federal de Uberlândia. Participaram 34 adolescentes de 14 a 19 anos, acima do percentil 95 da curva de crescimento. A EHNA foi analisada por ultrassonografia. A SM e os FRCs foram identificados pelos critérios da International Diabetes Federation. Resultados: A amostra foi composta de 14 indivíduos do sexo masculino e 20 do sexo feminino, com idade (16,8±1,6) e índice de massa corporal (IMC) (35,7±3,9). A ocorrência de EHNA e SM foi de 76,5% (n=26) e 50% (n=17), respectivamente. O sexo masculino apresentou maior ocorrência de EHNA (78,6%, n=11), SM (64,3%, n=09) e associação de EHNA com SM (50%, n=07). Em relação aos FRCs 100% (n=34), 61,8% (n=21) e 52,9% (n=18) dos adolescentes apresentaram valores aumentados da circunferência da cintura (CC), da lowdensity- lipoprotein cholesterol (LDL-C) e pressão arterial sistólica (PAS), respectivamente, e 52,9% (n=18) apresentaram baixos valores de high-density lipoprotein cholesterol (HDL-C). Houve correlações entre SM e triglicerídeos, PAS e diastólica e HDL-C, e entre EHNA, IMC e CC. Conclusão: Observou-se uma alta ocorrência de EHNA, SM e FRCs em adolescentes obesos. Uma forte correlação foi observada entre EHNA e SM, e entre FRCs com EHNA e SM...

To evaluate the association between nonalcoholic hepatic steatosis (NAHS),metabolic syndrome (MS) and cardiovascular risk factors (CRF) in obese adolescents.Methods: Cross-sectional observational study with a quantitative approach, carried out from June to August 2011. The volunteers were randomly selected and referred to clinical evaluation in the endocrinology and cardiology units at the clinics hospital of the Federal University of Uberlândia, being included 34 adolescents of 14-19 years above the 95th percentile of the growth curve. NAHS was assessed by ultrasonography. The MS and CRF were diagnosed by the International Diabetes Federation criteria. Results: The sample consisted of 14 male and 20 female patients aged 16.8 ± 1.6 and body mass index (BMI) of 35.7 ± 3.9. The occurrence of NAHS and MS was 76.5% and 50%, respectively. Males had a higher incidence of NAHS (78.6%), SM (64.3%) and association of NAHS with MS (50%). Regarding the CRF, 100% (n=34), 61.8% (n=21) and 52.9% (n=18) of the adolescents had elevated values of waist circumference (WC), low-density lipoprotein cholesterol (LDL-C) and systolic blood pressure (SBP), respectively, and 52.9% (n=18) showed low levels of high-density lipoprotein cholesterol (HDL-C). There were correlations between MS and triglycerides; systolic and diastolic blood pressure and HDL-C; and between NAHS and BMI and WC. Conclusion: A high occurrence of NAHS, SM and CRF was observed in obese adolescents. A strong correlation was observed between MS and NAHS, and between FRC and NAHS and SM...

Evaluar la asociación entre la esteatosis hepática no alcohólica (EHNA), síndrome metabólico (SM) y factores de riesgo cardiovascular (FRCs) en adolescentes obesos. Métodos: Estudio observacional del tipo trasversal com abordaje cuantitativo realizado entre junio y agosto de 2011. Los voluntarios fueron seleccionados al azar y encaminados para evaluación clínica en el sector de endocrinología y cardiología delhospital de la Universidad Federal de Uberlandia. Participaron 34 adolescentes entre 14 y 19 años que estaban por encima Del percentil 95 de la curva de crecimiento. La EHNA fue analizada con la ultrasonografía. La SM y los FRCs fueron identificados a través de criterios de la International Diabetes Federtion. Resultados: La muestra fue constituida de 14 individuos del sexo masculino y 20 del sexo femenino con media de edad de 16,8±1,6años y media del índice de masa corporal (IMC) de 35,7±3,9. La ocurrencia de EHNA y SM fue del 76,5% (n=26) y 50% (n=17), respectivamente. El sexo masculino presentó mayor ocurrencia de EHNA (78,6%, n=11), SM (64,3%, n=09) y asociación de EHNA y SM (50%, n=07). Respecto a los FRCs, el 100% (n=34), 61,8% (n=21) y el 52,9% (n=18) de los adolescentes presentaron valores mayores de la circunferencia de cintura (CC), de la low-densitylipoprotein cholesterol (LDL-C) y tensión arterial sistólica (TAS), respectivamente, y el 52,9% (n=18) presentó bajos niveles de high-density lipoprotein cholesterol (HDL-C). Hubieron correlaciones entre SM y triglicérides, TAS y diastólica y HDL-C, y entre EHNA, IMC y CC. Conclusión: Se observó una elevada ocurrencia de EHNA, SM y FRCs en adolescentes obesos. Uma fuerte correlación fue observada entre EHNA y SM, y entre FRCs y EHNA y SM...

Reduction in the leptin concentration as a predictor of improvement in lung function in obese adolescents.

OBJECTIVE: To assess the effects of weight loss on adipokines, asthma-related symptoms, exercise-induced bronchospasm (EIB) and lung function, and to evaluate the role of leptin and adiponectin levels on lung function after treatment in obese adolescents. METHODS: 84 postpubertal obese adolescents were enrolled and distributed in quartiles according to weight loss (low (<2.5 kg), low to moderate (>2.5 and <8 kg), moderate (<8 and <14 kg) and massive (<14 kg)). Body composition was measured by plethysmography, and visceral and subcutaneous fat were detected by ultrasound. Serum levels of adiponectin and leptin were analyzed. Lung function, asthma and EIB were evaluated according to the American Thoracic Society criteria. Patients were submitted to 1 year of interdisciplinary intervention consisting of physiotherapy, medical, nutritional, exercise, and psychological therapy. RESULTS: After treatment the moderate and massive weight loss promoted an increase in adiponectin and adiponectin/leptin (A/L) ratio as well as a decrease in leptin levels and a reduction in EIB frequency and asthma-related symptoms. Furthermore, the reduction in leptin levels was a predictor factor to improvement in lung function. CONCLUSION: Interdisciplinary therapy was able to decrease EIB and asthma-related symptoms and to improve pro/anti-inflammatory adipokines. Additionally, the leptin concentration was a predictor factor to explain changes in lung function.

Adaptação cultural e validação do Questionário KINDL no Brasil para adolescentes entre 12 e 16 anos / Cultural adaptation and validation of the KINDL questionnaire in Brazil for adolescents between 12 and 16 years of age

OBJETIVO: Obter uma versão em português do questionário Kiddo-KINDL que seja semântica e culturalmente equivalente à versão original. MÉTODOS: Para a adaptação, utilizou-se a metodologia de tradução direta e inversa. O questionário foi aplicado nas salas de aula em três escolas de Uberlândia, MG, em 378 crianças/adolescentes com idade entre 12 e 16 anos completos, dentre os quais 16% foram selecionados aleatoriamente para fazer o reteste. Na análise estatística foram avaliados os dados perdidos, efeito piso e teto, consistência interna do item e confiabilidade da consistência interna das escalas. RESULTADOS: A porcentagem de dados perdidos nas escalas foi baixa, variando de 1,6% a 2,57%, indicando uma boa aceitabilidade do questionário. As taxas de efeito piso e teto encontradas sugerem a possibilidade de o instrumento ser sensível para detectar diferenças na qualidade de vida relacionada à saúde entre as crianças/adolescentes situadas nos extremos. A confiabilidade do Kiddo-KINDL mostrou-se adequada em geral, exceto na escala bem-estar físico. CONCLUSÃO: O Kiddo-KINDL é um instrumento confiável para ser utilizado em crianças e adolescentes no Brasil, fornecendo dados importantes de natureza multidimensional.

OBJECTIVE: Obtain a Portuguese version of the Kiddo-KINDL questionnaire that is semantic and culturally equivalent to the original version. METHODS: For the adaptation, the methodology of direct and inverse translation was used. The questionnaire was applied to groups from three schools in Uberlândia, MG - Brazil, and comprised of 378 children and adolescents aged between 12 and 16. 16% of the students were randomly selected to repeat the test. In the statistical analysis, the following aspects were appraised and analyzed such as: lost data, floor and ceiling effect, internal consistence of the item and reliability of the internal consistence of the scales. RESULTS: The percentage of lost data in the scales was low varying between 1.6% to 2.57%, which indicates good acceptability of the questionnaire. The rates of floor and ceiling effect were lower than 12% suggesting that the instrument is sensitive to detect differences in quality of life related to the health of the children and adolescents ranked within the extreme ends. The Kiddo-KINDL as a whole has shown high reliability (Alpha Cronbach = 0.79). CONCLUSION: The Kiddo-KINDL is a reliable tool to be used with children and adolescents in Brazil, and has provided important data of multidimensional nature.

Efeitos da adaptação às próteses auditivas na qualidade de vida, no equilíbrio e no medo de queda em idosos com perda neurossensorial / Effects of hearing aids in the balance, quality of life and fear to fall in elderly people with sensorineural hearing loss

Introdução: O processo de envelhecimento provoca modificações estruturais e funcionais à saude, comprometendo o controle postural e processamento central. Estudos têm abordado a necessidade de identificar os fatores de risco prejudiciais à saúde auditiva e segurança em idosos acometidos por déficits auditivos e com alterações de equilíbrio. Objetivo: Avaliar o efeito da prótese auditiva na qualidade de vida, no equilíbrio e no medo de queda em idosos com perda auditiva bilateral. Método: Estudo clínico e experimental realizado com 56 idosos com perda auditiva neurossensorial, submetidos ao uso da prótese auditiva de amplificação sonora individual (AASI). Os idosos responderam aos questionários de qualidade de vida Short Form Health Survery (SF-36), Falls Efficacy Scale- Internacional (FES-I) e o teste de Berg Balance Scale (BBS). Após 4 meses, os idosos que adaptaram ao uso da AASI foram reavaliados. Resultados: Houve 50% de adaptação dos idosos ao AASI. Foi observado que o sexo masculino teve maior dificuldade em adaptar ao aparelho auditivo e que as variáveis idade, grau de perda, presença de zumbido e vertigem não interferiram na adaptação à prótese auditiva. Houve melhora da qualidade de vida nos domínios Estado da Saúde Geral (EGS) e Capacidade Funcional (CF) e do zumbido, assim como o aumento da auto-confiança após adaptação da prótese auditiva. Conclusão: O uso de prótese auditiva propiciou a melhora dos domínios da qualidade de vida, o que refletiu em uma melhor auto-confiança e consequentemente a longo prazo na redução do medo de queda em idosos com perda auditiva neurossensorial...

Introduction: The aging process provokes structural modifications and functional to it greets, compromising the postural control and central processing. Studies have boarded the necessity to identify to the harmful factors of risk to aged the auditory health and security in stricken aged by auditory deficits and with alterations of balance. Objective: To evaluate the effect of auditory prosthesis in the quality of life, the balance and the fear of fall in aged with bilateral auditory loss. Method: Carried through clinical and experimental study with 56 aged ones with sensorineural auditory loss, submitted to the use of auditory prosthesis of individual sonorous amplification (AASI). The aged ones had answered to the questionnaires of quality of life Short Form Health Survey (SF-36), Falls Efficacy International Scale- (FES-I) and the test of Berg Balance Scale (BBS). After 4 months, the aged ones that they adapted to the use of the AASI had been reevaluated. Results: It had 50% of adaptation of the aged ones to the AASI. It was observed that the masculine sex had greater difficulty in adapting to the auditory device and that the variable age, degree of loss, presence of humming and vertigo had not intervened with the adaptation to auditory prosthesis. It had improvement of the quality of life in the dominance of the State General Health (EGS) and Functional Capacity (CF) and of the humming, as well as the increase of the auto-confidence after adaptation of auditory prosthesis. Conclusion: The use of auditory prosthesis provided the improvement of the domains of the quality of life, what it reflected consequently in one better auto-confidence and in the long run in the reduction of the fear of fall in aged with sensorineural auditory loss...

Food restriction and refeeding induces changes in lipid pathways and fat deposition in the adipose and hepatic tissues in rats with diet-induced obesity.

The aim of this study was to determine the effects of successive cycles of a moderately restrictive diet and refeeding with a high-fat diet on the metabolism of the adipose and hepatic tissues of obese rats. Rats were assigned to the following groups: a chow diet; a high-fat diet; a moderate caloric restriction; or a moderate caloric restriction plus refeeding. Some animals in each group were given [1-(14)C]triolein intragastrically, while others received an intraperitoneal injection of 3 mCi (3)H(2)O. All animals were killed by decapitation. The retroperitoneal, visceral epididymal and omental white adipose tissues, brown adipose tissue, liver and blood were immediately removed. The lipid uptake from the diet, in vivo rate of lipogenesis, percentage of fat, lipid profile and leptin concentration were analysed. The high-fat diet promoted an increase in fatty liver (P ≤ 0.05), adiposity mass (P ≤ 0.05) and the plasma concentration of leptin (P ≤ 0.05) and a decreased lipid uptake in white adipose tissue depots (P ≤ 0.05) in relation to the chow diet. The moderate caloric restriction did not reverse the changes promoted by the high-fat diet but induced a small decrease in adiposity, which was reversed after refeeding, and the animals maintained a dyslipidaemic profile and high fat deposition in the liver. We can conclude that the high-fat diet and subsequent moderate caloric restriction plus refeeding increased the risks of developing visceral obesity, dyslipidaemia and non-alcoholic fatty liver disease, which suggests that this type of experimental protocol can be used to study mechanisms related to the metabolic syndrome.

Interdisciplinary therapy improves biomarkers profile and lung function in asthmatic obese adolescents.

BACKGROUND: The simultaneous rise in the prevalence of asthma and obesity in the world, have demonstrated the importance of the development of treatment strategies. The purpose of this study was to evaluate the short- and long-term results of interdisciplinary therapy on inflammatory biomarkers and lung function in asthmatics obese adolescents. METHODS: Seventy-six post-pubertal obese adolescents were recruited, including 50 non-asthmatics [body mass index (BMI), 36 ± 5 kg/m(2) ) and 26 asthmatics (BMI, 39 ± 4 kg/m(2) ). Body composition was measured by plethysmography, and visceral fat was analyzed by ultrasound. Serum levels of adiponectin, leptin, and C-reactive protein (CRP) were analyzed. Asthma and lung function were evaluated according to the American Thoracic Society criteria. Patients were submitted to 1-year weight loss interdisciplinary intervention consisting of medical, nutritional, exercise, and psychological therapy. RESULTS: After interdisciplinary intervention, the lung function and pro/anti-inflammatory adipokines improved significantly in both groups. Most importantly, there was an increase in adiponectin [4 (1.86-12.9) to 5.1 (2.48-16)], a reduction in CRP [2,073 (385-9,174) to 1,538 (205-7,083)] and leptin concentrations [59 (29-69) to 33 (9-49)] in the asthmatics patients. Furthermore, it was observed a reduction in asthma severity after treatment. In addition, Δ adiponectin was an independent factor to improve lung function after therapy in both groups. CONCLUSIONS: Interdisciplinary therapy resulted in beneficial changes in inflammatory biomarkers profile and lung function in asthmatic and non-asthmatic obese adolescents. Additionally, for the first time we showed that change in adiponectin level was an independent predictor to improve lung function in Brazilian obese adolescents.

Cultural adaptation and validation of the KINDL questionnaire in Brazil for adolescents between 12 and 16 years of age.

OBJECTIVE: Obtain a Portuguese version of the Kiddo-KINDL questionnaire that is semantic and culturally equivalent to the original version. METHODS: For the adaptation, the methodology of direct and inverse translation was used. The questionnaire was applied to groups from three schools in Uberlândia, MG - Brazil, and comprised of 378 children and adolescents aged between 12 and 16. 16% of the students were randomly selected to repeat the test. In the statistical analysis, the following aspects were appraised and analyzed such as: lost data, floor and ceiling effect, internal consistence of the item and reliability of the internal consistence of the scales. RESULTS: The percentage of lost data in the scales was low varying between 1.6% to 2.57%, which indicates good acceptability of the questionnaire. The rates of floor and ceiling effect were lower than 12% suggesting that the instrument is sensitive to detect differences in quality of life related to the health of the children and adolescents ranked within the extreme ends. The Kiddo-KINDL as a whole has shown high reliability (Alpha Cronbach = 0.79). CONCLUSION: The Kiddo-KINDL is a reliable tool to be used with children and adolescents in Brazil, and has provided important data of multidimensional nature.

The role of pro-inflammatory and anti-inflammatory adipokines on exercise-induced bronchospasm in obese adolescents undergoing treatment.

BACKGROUND: Recent studies have demonstrated a greater prevalence in exercise-induced bronchospasm (EIB) in obese adolescents. However, the role of pro-/anti-inflammatory adipokines and the repercussions of obesity treatment on EIB need to be explored further. Therefore, the objective of this study was to evaluate the role of pro-/anti-inflammatory adipokines on EIB in obese adolescents evaluated after long-term interdisciplinary therapy. METHODS: Thirty-five post-pubertal obese adolescents, including 20 non-EIB (body mass index [BMI] 36 ± 5 kg/m(2)) and 15 EIB (BMI 36 ± 5 kg/m(2)), were enrolled in this study. Body composition was measured by plethysmography, using the BOD POD body composition system, and visceral fat was analyzed by ultrasound. Serum levels of adiponectin and leptin were analyzed. EIB and lung function were evaluated according to the American Thoracic Society criteria. Patients were recruited to a 1-year interdisciplinary intervention of weight loss, consisting of medical, nutritional, exercise, and psychological components. RESULTS: Anthropometrics and lung function variables improved significantly after the therapy in both groups. Furthermore we observed a reduction in EIB occurrence in obese adolescents after treatment. There was an increase in adiponectin levels and a reduction in leptin levels after the therapy. In addition, a low FEV(1) value was a risk factor associated with EIB occurrence at baseline, and was correlated after treatment with changes in anthropometric and maximal O(2) consumption values as well as the adipokines profile. CONCLUSIONS: In the present study it was demonstrated that 1 year of interdisciplinary therapy decreased EIB frequency in obese adolescents, paralleled by an increase in lung function and improvement in pro-/anti-inflammatory adipokines.

Effects of hearing aids in the balance, quality of life and fear to fall in elderly people with sensorineural hearing loss.

INTRODUCTION: The aging process provokes structural modifications and functional to it greets, compromising the postural control and central processing. Studies have boarded the necessity to identify to the harmful factors of risk to aged the auditory health and security in stricken aged by auditory deficits and with alterations of balance. OBJECTIVE: To evaluate the effect of auditory prosthesis in the quality of life, the balance and the fear of fall in aged with bilateral auditory loss. METHOD: Carried through clinical and experimental study with 56 aged ones with sensorineural auditory loss, submitted to the use of auditory prosthesis of individual sonorous amplification (AASI). The aged ones had answered to the questionnaires of quality of life Short Form Health Survey (SF-36), Falls Efficacy International Scale- (FES-I) and the test of Berg Balance Scale (BBS). After 4 months, the aged ones that they adapted to the use of the AASI had been reevaluated. RESULTS: It had 50% of adaptation of the aged ones to the AASI. It was observed that the masculine sex had greater difficulty in adapting to the auditory device and that the variable age, degree of loss, presence of humming and vertigo had not intervened with the adaptation to auditory prosthesis. It had improvement of the quality of life in the dominance of the State General Health (EGS) and Functional Capacity (CF) and of the humming, as well as the increase of the auto-confidence after adaptation of auditory prosthesis. CONCLUSION: The use of auditory prosthesis provided the improvement of the domains of the quality of life, what it reflected consequently in one better auto-confidence and in the long run in the reduction of the fear of fall in aged with sensorineural auditory loss.

Avaliação do broncoespasmo induzido pelo exercício avaliado pelo Peak Flow Meter em adolescentes obesos / Evaluation of exercise-induced bronchospasm assessed by Peak Flow Meter in obese adolescents

INTRODUÇÃO: Crianças e adolescentes com excesso de peso apresentam maior prevalência de broncoespasmo induzido pelo exercício (BIE), quando comparados a eutróficos. A espirometria e o peak flow meter são importantes métodos avaliativos da função pulmonar. Porém, a aplicabilidade do medidor do pico de fluxo expiratório (peak flow meter) na detecção do BIE em crianças e adolescentes com excesso de peso não é conhecida, o que justifica o desenvolvimento desta pesquisa. OBJETIVOS: Avaliar e comparar o desencadeamento de broncoespasmo induzido pelo exercício (BIE) em crianças e adolescentes não asmáticos com excesso de peso, avaliados pela espirometria e pelo peak flow meter (PFE). CASUÍSTICA E MÉTODOS: Participaram do estudo 39 voluntários acima do percentil 85º (OB) e 30 eutróficos (EU), de oito a 15 anos. A avaliação da função pulmonar pré e pós-teste de broncoprovocação foi realizada pela espirometria e peak flow meter, de acordo com o protocolo de Del Río-Navarro et al., (2000). O BIE foi considerado positivo quando o voluntário apresentou uma redução > 10 por cento do VEF1 basal ou redução > 20 por cento do PFE PFM e/ou PFE E. RESULTADOS: Na detecção do BIE, a prevalência do grupo obeso foi de 26 por cento avaliado pelo peak flow meter (PFEPFM) e 23 por cento pelo VEF1. O tempo do BIE ocorreu nos primeiros 15 minutos pós-exercício em ambos os parâmetros: (PFE PFM) e VEF1. CONCLUSÃO: Os voluntários obesos apresentaram tempo e prevalências similares de BIE, quando avaliados por ambos os métodos de avaliação pulmonar. O fácil manejo e o baixo custo facilitam a maior acessibilidade para a população geral do peak flow meter, o que demonstra sua importância como parte integrante de um programa educacional no diagnóstico inicial do BIE em vias aéreas de grande calibre.

INTRODUCTION: Children and adolescents who are overweight have a higher prevalence of exercise-induced bronchospasm (EIB), as compared to eutrophics. Spirometry and peak flow meter are important evaluation methods of lung function. However, the applicability of the peak expiratory flow (peak flow meter) in the detection of EIB in children and adolescents who are overweight is not known, hence the development of this research. OBJECTIVES: To evaluate and compare the onset of exercise-induced bronchospasm (EIB) in children and adolescents non-asthmatic who are overweight, evaluated by spirometry and the peak flow meter (PEF). METHODS: The study included 39 volunteers above the 85th percentile (OB) and 30 normal weight (EU), with the age of 8 to 15 years. The evaluation of lung function before and after bronchial provocation test was performed by spirometry and peak flow meter, according to the protocol of Del Río-Navarro et al, (2000). The EIB was considered positive when the volunteer showed a reduction > 10 percent of baseline FEV1 or > 20 percent reduction in PEF PFM and / or PEFE. RESULTS: The detection of the BIE, the prevalence of obese group was 26 percent measured by peak flow meter (PEF PFM) and 23 percent for FEV1. The time of the BIE occurred with the first 15 minutes post-exercise in both parameters: (PFE PFM) and FEV1. CONCLUSION: The obese volunteers presented similar time and prevalence of EIB, when evaluated by both methods of pulmonary assessment. The easy handling and low cost from this method created greater accessibility for the general population from the peak flow meter, which shows its importance as part of an educational program in the initial diagnosis of EIB in large airway caliber.

Avaliação antropométrica e do ângulo quadricipital na osteoartrite de joelho em mulheres obesas / Anthropometric and Q angle assessment in obese women with knee osteoarthritis

A osteoartrite (OA) é uma doença articular degenerativa, caracterizada porprocesso inflamatório, dor e deformidades; um de seus fatores preditivos é a obesidade. O objetivo deste estudo foi verificar possíveis correlações entre medidas antropométricas, o ângulo quadricipital (Q) e a osteoartrite de joelho. A amostra foi composta por 50 voluntárias obesas (30 com OA de joelho e 20 sem OA), com idade entre 40 e 60 anos. Foram mensurados, além do IMC (índice de massacorporal), circunferência abdominal (CA), perímetros de cintura e quadril para cálculo da relação cintura-quadril e o ângulo Q; a osteoartrite foi diagnosticada clinicamente e por meio de radiografia da articulação do joelho. Foram encontradas correlações positivas fracas entre IMC e ângulo Q e entre tempo de obesidade e grau de degeneração articular. A CA apresentou correlação positiva fraca com o grau de degeneração articular e o de gravidade da OA. O cálculo da razão de chance (OR) indica que as voluntárias com IMC>34 kg/m2 e CA>110 cm tiveram 3,7 e 7 vezes, respectivamente, mais chance de apresentarem OA. A obesidade central, seu grau e duração possivelmente contribuem para a incidência da OA de joelhos em mulheres obesas. A circunferência abdominal foi a medida que melhor se correlacionou com a presença e grau de OA em obesas, o que aponta para a relevância de sua mensuração na avaliação clínica.

Osteoarthritis (OA) is a degenerative joint disease characterized by inflammatory process, pain, and deformity; one of its main predictive factors isobesity. The aim of this study was to search for possible correlations between anthropometric measures, the Q angle and knee osteoarthritis. A sample of 50 obese women (30 with knee osteoarthritis and 20 with no joint disease), aged between 40 to 60 years, were assessed as to BMI (body mass index), abdominal circumference (AC), waist and hip perimeters (so as to calculate waist-hip ratio), and the Q angle; osteoarthritis was diagnosed by clinical exam and knee joint radiography. Results showed a positive, poor correlation between BMI and Q angle, as well as between time of obesity onset and degree of joint degeneration. AC was found to positively, though weakly, correlate with the degree of joint degeneration and of OA severity. Adjusted odds ratio for OA showed that women with BMI>34kg/m2 and AC>110 cm were respectively 3.7 and 7 times more likely to develop OA. The degree and duration of central obesity possibly contribute to incidence of knee OA in obese women. Abdominal circumference was the measure that most correlated with the degree of joint degeneration and of OA severity, which suggests it should be used in clinical evaluation.

Altura percentual do centro de gravidade e número de quedas em idosos ativos e sedentários / Center of gravity height and number of falls in active and sedentary older adults

No envelhecimento, verifica-se modificações no metabolismo energético, resultando em aumento da gordura corporal, diminuição da massa muscular e da estatura o que pode levar às alterações no posicionamento do Centro de Gravidade (CG) e consequentes quedas. Os objetivos do presente estudo foram: identificar a altura percentual do CG e o número de quedas (NQ) sofridas pelos idosos nos últimos 12 meses, compará-los entre o grupo de idosos ativos e sedentários e correlacioná-los com as variáveis antropométricas (massa corporal, estatura e IMC). A amostra foi composta por 102 idosos de ambos os sexos, com idade entre 60 e 84 anos, entre eles, 64 ativos e 38 sedentários. Foram avaliados dadosantropométricos, NQ, nível de atividade física dos idosos sedentários e altura percentual do CG. Foram realizados cálculos de média e desvio padrão e as correlações entre as variáveis foram verificadas através da aplicação do Coeficiente de Correlação de Pearson. Identificou-se que a altura percentual do CG dos idosos ativos encontra-se a 57,54% ± 2,57%e dos idosos sedentários a 57,47% ± 1,94% de sua altura, não foram observadas correlações significativas da altura percentual do CG com nenhuma das variáveis antropométricas e com NQ nos idosos de ambos os grupos. Pode-se concluir que os idosos apresentam valor do CG acima do considerado fisiológico (55%), não houve associação significativa entre a altura percentual do CG, as variáveis antropométricas e o NQ.

Older adults present changes in energy metabolism that result in an increase of body fat and a decrease of muscle mass and height, leading to alterations in the position of the center of gravity (CG) and consequent falls. The objective of the present study was to compare the percent CG height and the number of falls (NF) over the last 12 months between active and sedentary older adults and to correlate them with anthropometric variables (body weight, height and BMI). The sample consisted of 102 men and women ranging in age from 60 to 84 years,including 64 active and 38 sedentary subjects. Anthropometric variables, NF, level of physical activity of sedentary subjects, and percent CG height were evaluated and the mean and standard deviation were calculated. Correlations between variables were estimated using Pearson?scorrelation coefficient. The percent CG height was 57.54 ± 2.57% in active subjects and 57.47 ± 1.94% in sedentary subjects. No significant correlations were observed between percent CG height and anthropometric variables or NF in either group. In conclusion, older adults present a CG above the physiological value (55%). No significant association was observed between percent CG height, anthropometric variables and NF.