Does a Gluten-free Diet Improve Metabolic Syndrome Parameters? A Systematic Review

Abstract To review scientific evidence on the effects of a gluten-free diet on body composition and improvement of clinical and biochemical parameters of metabolic syndrome. The Preferred Reporting Items for Systematic Reviews and Meta-Analyzes - PRISMA guidelines were followed. A literature search was performed in the PubMed, ScienceDirect, Trip Database, Bireme and Scielo databases, without language restriction, until March 2021. The terms "gluten-free diet", "obesity", "metabolic syndrome", and "weight loss", and Boolean operators (AND/OR) were used. The clinical hypothesis was structured according to the acronym PICOT. Randomized clinical trials with adult and elderly humans without a diagnosis of celiac disease, consuming a gluten-free diet, evaluating associations of the effects of this diet on weight loss and metabolic syndrome components were considered eligible. To assess the risk of bias, the RoB2 was used. A total of 3,198 articles were identified and, after the screening and evaluation of pre-defined eligibility criteria, four studies were included in the qualitative analysis. Weight loss was not associated with a gluten-free diet. However, individuals under a gluten-free diet had lower mean waist circumference, fat percentage (-2.3%) and serum triglyceride levels. The impact of a gluten-free diet on metabolic syndrome parameters is still controversial. In individuals without gluten sensitivity or celiac disease, the consumption of a gluten-free diet appears to provide no nutritional benefit.

Frequency and factors associated with sarcopenia prediction in adult and elderly patients hospitalized for COVID-19.

Patients with COVID-19 may develop symptoms that interfere with food intake. Systemic inflammatory response associated with physical inactivity and/or immobilization during hospital stay can induce weight and muscle loss leading to sarcopenia and worsening the clinical condition of these patients. The present study identifies the frequency and factors associated with sarcopenia prediction in adult and elderly patients hospitalized for COVID-19. It is a cohort-nested cross-sectional study on adult and elderly patients admitted to wards and intensive care units (ICUs) of 8 hospitals in a northeastern Brazilian state. The study was conducted from June 2020 to June 2021. Sociodemographic, economic, lifestyle, and current and past clinical history variables were collected. Sarcopenia prediction was determined by the Strength, Assistance in walking, Rise from a chair, Climb stairs, and Falls (SARC-F) questionnaire compiled in the Remote-Malnutrition APP (R-MAPP). Patients were diagnosed with sarcopenia when the final score ≥ 4 points. The study included 214 patients with a mean age of 61.76 ± 16.91 years, of which 52.3 % were female and 57.5 % elderly. Sarcopenia prevailed in 40.7 % of the sample. Univariate analysis showed greater probability of sarcopenia in elderly individuals, nonpractitioners of physical activities, hypertensive patients, diabetic patients, and those hospitalized in the ICU. In the multivariate model, the type of hospital admission remained associated with sarcopenia prediction, where patients admitted to the ICU were 1.43 (95 % CI: 1.04; 1.97) more likely to have sarcopenia than those undergoing clinical treatment. Sarcopenia prediction was not associated with patient outcome (discharge, transfer, or death) (p = 0.332). The study highlighted an important percentage of sarcopenia prediction in patients with COVID-19, especially those admitted to the ICU. Additional investigations should be carried out to better understand and develop early diagnostic strategies to assist in the management of sarcopenic patients with COVID-19.

Association between being underweight and excess body weight before SARS coronavirus type 2 infection and clinical outcomes of coronavirus disease 2019: Multicenter study.

OBJECTIVES: The present study aimed to identify associations between extremes in body weight status (underweight and excess body weight) before a COVID-19 diagnosis and clinical outcomes in patients infected with SARS coronavirus type 2. METHODS: A multicenter cohort study was conducted in eight different states in northeastern Brazil. Demographic, clinical (previous diagnosis of comorbidities), and anthropometric (self-reported weight and height) data about individuals who tested positive for COVID-19 were collected. Outcomes included hospitalization, mechanical ventilation, and death. Multivariable logistic regression models, adjusted based on age, sex and previous comorbidities, were used to assess the effects of extremes in body weight status on clinical outcomes. RESULTS: A total of 1308 individuals were assessed (33.6% were elderly individuals). The univariable analyses showed that only hospitalization was more often observed among underweight (3.2% versus 1.2%) and overweight (68.1% versus 63.3%) individuals. In turn, cardiovascular diseases were more often observed in all clinical outcomes (hospitalization: 19.7% versus 4.8%; mechanical ventilation: 19.9% versus 13.5%; death: 21.8% versus 14.1%). Based on the multivariable analysis, body weight status was not associated with risk of hospitalization (underweight: odds ratio [OR]: 1.10; 95% confidence interval [CI] 95%, 0.50-2.41 and excess body weight: OR: 0.81; 95 CI, 0.57-1.14), mechanical ventilation (underweight: OR: 0.92; 95% CI, 0.52-1.62 and excess weight: OR: 0.90; 95% CI, 0.67-1.19), and death (underweight: OR: 0.61; 95% CI, 0.31-1.20 and excess body weight: OR 0.88; 95% CI, 0.63-1.23). CONCLUSIONS: Being underweight and excess body weight were not independently associated with clinical outcomes in patients with COVID-19 in the herein analyzed cohort. This finding indicates that the association between these variables may be confounded by both age and comorbidities.

ENERGY AND NUTRIENT INTAKE IN OSTOMY PATIENTS AND CORRELATIONS WITH ANTHROPOMETRIC VARIABLES: RESULTS FROM A REFERENCE HOSPITAL IN THE STATE OF PERNAMBUCO, BRAZIL.

BACKGROUND: Studies that assess the food intake and nutritional status of ostomy patients are scarce in the literature. However, such individuals have symptoms in the postoperative period that determine changes in the intake of calories and nutrients as well as anthropometric variables. OBJECTIVE: Estimate the energy and nutrient intake of ostomy patients and determine correlations with anthropometric variables. METHODS: A cross-sectional study was conducted with ostomy individuals in outpatient follow-up at a reference hospital for postoperative ostomy surgery in the city of Recife, Brazil. Demographic, socioeconomic, clinical, anthropometric, and dietary data were collected through interviews and from patient charts. Statistical analyses were performed with the aid of the Statistical Package for the Social Sciences, version 13.0 for Windows, with the level of significance set at 5% (P≤0.05). RESULTS: The sample was composed of 100 individuals (54% males) with a mean age of 55.1±15.4 years. Colostomy patients predominated (82%) and had a greater frequency of excess weight compared to ileostomy patients (86.36% versus 13.64%). Median intake was below the Estimated Average Requirements, especially for vitamins A, C, and E. Significant inverse correlations were found between carbohydrate intake and both arm circumference and triceps skinfold (P=0.0302 for each) and a positive correlation was found between protein intake and arm muscle circumference (P=0.0158) in male patients. CONCLUSION: The present study found significant correlations between macronutrient intake and anthropometric variables indicative of reserves of lean and adipose mass. Moreover, intake was below the recommended values according to sex and age group, especially with regards to vitamins.

Ingestão de energia e nutrientes em pacientes ostomizados e sua correlação com variáveis antropométricos: resultados de um hospital de referência em Pernambuco, Brasil / Energy and nutrient intake in ostomy patients and correlations with anthropometric variables: results from a reference hospital in the state of pernambuco, brazil

ABSTRACT BACKGROUND: Studies that assess the food intake and nutritional status of ostomy patients are scarce in the literature. However, such individuals have symptoms in the postoperative period that determine changes in the intake of calories and nutrients as well as anthropometric variables. OBJECTIVE: Estimate the energy and nutrient intake of ostomy patients and determine correlations with anthropometric variables. METHODS: A cross-sectional study was conducted with ostomy individuals in outpatient follow-up at a reference hospital for postoperative ostomy surgery in the city of Recife, Brazil. Demographic, socioeconomic, clinical, anthropometric, and dietary data were collected through interviews and from patient charts. Statistical analyses were performed with the aid of the Statistical Package for the Social Sciences, version 13.0 for Windows, with the level of significance set at 5% (P≤0.05). RESULTS: The sample was composed of 100 individuals (54% males) with a mean age of 55.1±15.4 years. Colostomy patients predominated (82%) and had a greater frequency of excess weight compared to ileostomy patients (86.36% versus 13.64%). Median intake was below the Estimated Average Requirements, especially for vitamins A, C, and E. Significant inverse correlations were found between carbohydrate intake and both arm circumference and triceps skinfold (P=0.0302 for each) and a positive correlation was found between protein intake and arm muscle circumference (P=0.0158) in male patients. CONCLUSION: The present study found significant correlations between macronutrient intake and anthropometric variables indicative of reserves of lean and adipose mass. Moreover, intake was below the recommended values according to sex and age group, especially with regards to vitamins.

RESUMO CONTEXTO: Estudos que avaliam o consumo alimentar e o estado nutricional de pacientes ostomizados são escassos na literatura, entretanto, sabe-se que tais indivíduos cursam com sintomatologia que determinam modificações na ingestão calórica e de nutrientes, bem como nos parâmetros antropométricos durante o pós-operatório. OBJETIVO: Estimar a ingestão de energia e nutrientes em pacientes ostomizados e verificar sua relação com variáveis antropométricas. MÉTODOS: Estudo transversal, realizado com grupo de indivíduos ostomizados em acompanhamento ambulatorial em um hospital de referência para pós-operatório de ostomias em Recife - Pernambuco. Foram obtidos dados demográficos, socioeconômicos, clínicos, antropométricos e dietéticos por meio de entrevistas e coleta direta nos prontuários. As análises estatísticas foram realizadas no software Statistical Package for the Social Sciences versão 13.0 para Windows, adotando-se o valor de 5% para verificação de significância estatística (P≤0,05). RESULTADOS: A amostra foi composta por 100 indivíduos, sendo 54% do sexo masculino, com média de idade de 55,1±15,4 anos. O grupo foi caracterizado por um predomínio de pacientes colostomizados (82%; n=82), os quais apresentaram maiores frequências de excesso de peso, quando comparados àqueles com ileostomia (86,36% vs 13,64%). Foram identificadas medianas de ingestão abaixo dos valores recomendados pelos requisitos médios estimados principalmente para as vitaminas A, C e E. Houve correlação inversa significante entre o consumo de carboidratos com a circunferência do braço e a prega cutânea tricipital (P=0,0302), e correlação positiva entre o consumo de proteínas e a circunferência muscular do braço (P=0,0158) nos pacientes do sexo masculino. CONCLUSÃO: O presente estudo encontrou relação significante entre o consumo de macronutrientes e variáveis antropométricas indicativas de reservas de massa magra e adiposa. A ingestão, principalmente de vitaminas, foi abaixo dos valores preconizados segundo o sexo e a faixa etária.

OVERWEIGHT AND ASSOCIATED FACTORS IN CHILDREN AND ADOLESCENTS WITH PHENYLKETONURIA: A SYSTEMATIC REVIEW.

OBJECTIVE: To verify the occurrence of overweight in children and adolescents with phenylketonuria and to identify possible causal factors. DATA SOURCES: A systematic review was performed in the SciELO, PubMed and VHL databases using the descriptors "Phenylketonurias", "Overweight", "Child" and "Adolescent". Original articles conducted with children and adolescents, published between 2008 and 2018 in Portuguese, English or Spanish languages were included. DATA SYNTHESIS: A total of 16 articles were identified and, after screening procedures, 6 studies were selected for the review. Overweight in children and adolescents with phenylketonuria was a frequent occurence in the studies included in this review, ranging from 7.8 to 32.6%. The female sex was the most affected by the nutritional disorder. Furthermore, a high caloric intake combined with a lack of stimuli to practice physical activities were main factors associated with the excessive weight in the population of interest. CONCLUSIONS: Excess weight can be considered a common outcome in children and adolescents with phenylketonuria. It is mainly caused by inadequate food consumption and sedentary lifestyle. The importance of early identification of nutritional disturbances in children and adolescents with phenylketonuria should be emphasized, in order to prevent associated chronic diseases and to promote health by encouraging continued healthy eating habits and the regular practice of physical exercises.

Overweight and associated factors in children and adolescents with phenylketonuria: a systematic review / Excesso de peso e fatores associados em crianças e adolescentes com fenilcetonúria: uma revisão sistemática

ABSTRACT Objective: To verify the occurrence of overweight in children and adolescents with phenylketonuria and to identify possible causal factors. Data sources: A systematic review was performed in the SciELO, PubMed and VHL databases using the descriptors "Phenylketonurias", "Overweight", "Child" and "Adolescent". Original articles conducted with children and adolescents, published between 2008 and 2018 in Portuguese, English or Spanish languages were included. Data synthesis: A total of 16 articles were identified and, after screening procedures, 6 studies were selected for the review. Overweight in children and adolescents with phenylketonuria was a frequent occurence in the studies included in this review, ranging from 7.8 to 32.6%. The female sex was the most affected by the nutritional disorder. Furthermore, a high caloric intake combined with a lack of stimuli to practice physical activities were main factors associated with the excessive weight in the population of interest. Conclusions: Excess weight can be considered a common outcome in children and adolescents with phenylketonuria. It is mainly caused by inadequate food consumption and sedentary lifestyle. The importance of early identification of nutritional disturbances in children and adolescents with phenylketonuria should be emphasized, in order to prevent associated chronic diseases and to promote health by encouraging continued healthy eating habits and the regular practice of physical exercises.

RESUMO Objetivo: Verificar a ocorrência de excesso de peso em crianças e adolescentes com fenilcetonúria e identificar possíveis fatores causais. Fontes de dados: Revisão sistemática realizada nas bases de dados Scientific Eletronic Library Online (SciELO), Publisher Medline (PubMed) e Biblioteca Virtual em Saúde (BVS) com os descritores "Phenylketonurias", "Overweight", "Child" e "Adolescent". Foram incluídos artigos originais sobre crianças e adolescentes, publicados entre 2008 e 2018 nos idiomas português, inglês ou espanhol. Síntese dos dados: Foram identificados 16 artigos e, após aplicação dos procedimentos de seleção, 6 estudos foram selecionados para compor a revisão. O excesso de peso em crianças e adolescentes com fenilcetonúria foi evento frequente nos estudos incluídos na presente revisão, variando de 7,8 a 32,6%. Aponta-se o sexo feminino como o grupo mais acometido pelo distúrbio nutricional. O principal fator associado ao excesso de peso na população de interesse na população de interesse foi o consumo calórico elevado aliado à falta de estímulos para a prática de atividades físicas. Conclusões: O excesso de peso pode ser considerado um desfecho comum em crianças e adolescentes com fenilcetonúria, sendo ocasionado principalmente pelo consumo alimentar inadequado e pelo sedentarismo. Salienta-se a importância da identificação precoce de agravos nutricionais em crianças e adolescentes fenilcetonúricos, a fim de prevenir doenças crônicas associadas e promover a saúde, com incentivo à manutenção de hábitos alimentares saudáveis e à prática regular de exercícios físicos.

Malnutrition associated with inflammation in the chronic renal patient on hemodialysis

SUMMARY INTRODUCTION Malnutrition-Inflammation-Atherosclerosis Syndrome is very frequent in patients with chronic kidney disease on haemodialysis. In these patients, the inflammation associated with malnutrition is observed by the Malnutrition-Inflammation Score. OBJECTIVE To analyse the relationship between malnutrition-inflammation-atherosclerosis syndrome and anthropometric and biochemical parameters of patients on haemodialysis. METHODS A cross - sectional study was performed at the Haemodialysis Clinic of the Barão de Lucena Hospital, Recife, Brazil, between July and August 2016, with patients cared at the clinic for at least six months. Patients with amputees, hospitalized, visually impaired, HIV positive, with catheters in the neck, ascites and/or oedema, and those who were unable to provide information at the time of the interview were excluded. The patients were submitted to anthropometric evaluation for the classification of the nutritional status by waist circumference, neck circumference, body mass index, waist-to-hip ratio and waist-to-height ratio. Nutritional status related to inflammation was measured by the Malnutrition-Inflammation Score and nutritional status assessment using biochemical indicators that used urea, creatinine and albumin. RESULTS Twenty-seven individuals of both genders, adults and elderly, aged 51.3 ± 13.3 years old participated in the study. The anthropometric evaluation showed that most of the population presented cardiovascular risk. The biochemical evaluation reported low frequencies of malnutrition. Malnutrition-Inflammation-Atherosclerosis syndrome was evidenced in 3.7% of the patients. The Malnutrition-Inflammation Score had a moderate negative correlation with body mass index, waist circumference, neck circumference, waist-to-height ratio and creatinine. CONCLUSION The correlation seen among the parameters suggests that most of the parameters evaluated can be used as an indirect indicator of malnutrition-inflammation-atherosclerosis syndrome.

RESUMO INTRODUÇÃO A síndrome Desnutrição-Inflamação-Aterosclerose é frequente nos pacientes com doença renal crônica em hemodiálise, acarretando perda de proteínas corporais e produção de citocinas pró-inflamatórias. OBJETIVO Verificar, entre os indicadores nutricionais estudados, aqueles que melhor se correlacionam com a síndrome Desnutrição-Inflamação-Aterosclerose em pacientes submetidos à hemodiálise. MÉTODOS O estudo foi transversal, realizado na Clínica de Hemodiálise do Hospital Barão de Lucena, no Recife (PE), entre julho e agosto de 2016, com pacientes atendidos há pelo menos seis meses. Foram excluídos pacientes amputados, internados, com deficiência visual, cateter no pescoço, HIV positivo, ascite e/ou edema e aqueles incapazes de prestar informações no momento da entrevista. Os pacientes foram submetidos à avaliação antropométrica para a classificação do estado nutricional pela circunferência da cintura, perímetro do pescoço, índice de massa corporal, relação cintura-quadril e relação cintura-estatura. O estado nutricional relacionado à inflamação foi mensurado pelo escore Desnutrição-Inflamação e a avaliação do estado nutricional pelos indicadores bioquímicos: ureia, creatinina e albumina. RESULTADOS Participaram do estudo 27 indivíduos de ambos os sexos, adultos e idosos, com idade de 51,3 ± 13,3 anos. A avaliação antropométrica mostrou que a maior parte da população apresentava risco cardiovascular. A avaliação bioquímica relatou baixas frequências de desnutrição. Foi evidenciada síndrome Desnutrição-Inflamação-Aterosclerose em 3,7% dos pacientes. O escore Desnutrição-Inflamação apresentou correlação moderada negativa com o índice de massa corporal, circunferência da cintura, perímetro do pescoço, relação cintura-estatura e creatinina. CONCLUSÃO A correlação observada entre os parâmetros sugere que a maioria dos parâmetros avaliados pode ser utilizada como indicador indireto da síndrome Desnutrição-Inflamação-Aterosclerose.

Malnutrition associated with inflammation in the chronic renal patient on hemodialysis.

INTRODUCTION: Malnutrition-Inflammation-Atherosclerosis Syndrome is very frequent in patients with chronic kidney disease on haemodialysis. In these patients, the inflammation associated with malnutrition is observed by the Malnutrition-Inflammation Score. OBJECTIVE: To analyse the relationship between malnutrition-inflammation-atherosclerosis syndrome and anthropometric and biochemical parameters of patients on haemodialysis. METHODS: A cross - sectional study was performed at the Haemodialysis Clinic of the Barão de Lucena Hospital, Recife, Brazil, between July and August 2016, with patients cared at the clinic for at least six months. Patients with amputees, hospitalized, visually impaired, HIV positive, with catheters in the neck, ascites and/or oedema, and those who were unable to provide information at the time of the interview were excluded. The patients were submitted to anthropometric evaluation for the classification of the nutritional status by waist circumference, neck circumference, body mass index, waist-to-hip ratio and waist-to-height ratio. Nutritional status related to inflammation was measured by the Malnutrition-Inflammation Score and nutritional status assessment using biochemical indicators that used urea, creatinine and albumin. RESULTS: Twenty-seven individuals of both genders, adults and elderly, aged 51.3 ± 13.3 years old participated in the study. The anthropometric evaluation showed that most of the population presented cardiovascular risk. The biochemical evaluation reported low frequencies of malnutrition. Malnutrition-Inflammation-Atherosclerosis syndrome was evidenced in 3.7% of the patients. The Malnutrition-Inflammation Score had a moderate negative correlation with body mass index, waist circumference, neck circumference, waist-to-height ratio and creatinine. CONCLUSION: The correlation seen among the parameters suggests that most of the parameters evaluated can be used as an indirect indicator of malnutrition-inflammation-atherosclerosis syndrome.

Circunferência do pescoço como indicador de risco cardiovascular em pacientes renais crônicos em hemodiálise / Neck circumference as indicator of cardiovascular risk in patients in dialysis for chronic kidney disease

Introdução: Portadores de doença renal crônica (DRC) são frequentemente acometidos por doenças cardiovasculares (DCV). Nesse contexto, a circunferência do pescoço (CP) surge como parâmetro promissor para avaliação do risco cardiovascular (RCV) na DRC. Objetivo: Avaliar a CP como um parâmetro indicativo de RCV em pacientes renais crônicos em hemodiálise (HD), relacionando-a com variáveis antropométricas e bioquímicas associadas aos desfechos cardiometabólicos. Métodos: Estudo transversal, com pacientes adultos e idosos, de ambos os sexos, portadores de DRC em HD, cadastrados no Setor de Nefrologia do Hospital Barão de Lucena, Recife - PE. Foram obtidas variáveis demográficas, socioeconômicas, clínicas e comportamentais, além de parâmetros antropométricos e bioquímicos relacionados aos eventos cardiometabólicos. A CP identificou o RCV elevado quando ≥37cm para homens e ≥34cm para mulheres. As análises estatísticas foram conduzidas no programa Statistical Package for the Social Sciences (SPSS) versão 13.0, sendo confirmada significância estatística quando p<0,05. Resultados: A amostra foi composta por 40 indivíduos, com idade média de 54,4±14,7 anos e 72,5% (n=29) do sexo masculino. A CP evidenciou 55,0% (n=22) de pacientes com alto RCV, estando associada significativamente com o sexo masculino e com as classes econômicas B e C. Foram constatadas correlações positivas entre a CP e demais parâmetros antropométricos (índice de massa corporal, circunferência da cintura, razão cintura/estatura e razão cintura/quadril) e correlação negativa entre a CP e o HDL-Colesterol. Conclusão: A CP mostrou-se como bom método para identificação do RCV em pacientes renais crônicos em HD, correlacionando-se com variáveis antropométricas e bioquímicas associadas aos desfechos cardiometabólicos

Introduction: Individuals with chronic kidney disease are often affected by cardiovascular disease. Neck circumference (NC) is a promising variable for the evaluation of cardiovascular risk in these patients. Objective: Evaluate NC as an indicator of cardiovascular risk in patients with chronic kidney disease undergoing dialysis, relating this measure to anthropometric and biochemical variables associated with cardiometabolic outcomes. Methods: A cross-sectional study was conducted with adult patients with chronic kidney disease undergoing dialysis at the Nephrology Center of the Barão de Lucena Hospital in Recife, Brazil. Demographic, socioeconomic, clinical and behavioral characteristics were recorded, along with anthropometric and biochemical variables related to cardiometabolic events. High cardiovascular risk was identified when NC was ≥37cm in men and ≥34cm in women. Statistical analysis involved the SPSS 13.0 program, with a p-value<0.05 indicative of statistical significance. Results: Forty individuals participated (72.5% males; mean age: 54.4 ± 14.7). NC identified 55.0% (n=22) of the patients with high cardiovascular risk and was associated with the male sex as well as economic classes B and C. Positive correlations were found between NC and other anthropometric variables (body mass index, waist circumference, waist/height ratio and waist/hip ratio) and a negative correlation was found between NC and HDL cholesterol. Conclusion: NC proved to be a good method for identifying cardiovascular risk in patients undergoing dialysis for chronic kidney disease and was correlated with anthropometric and biochemical variables associated with cardiometabolic outcomes

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Qualidade da dieta e fatores relacionados ao desenvolvimento de Diabetes mellitus gestacional em gestantes de alto risco de um hospital público do Nordeste brasileiro / Quality of diet and factors related to the development of gestational diabetes mellitus in high-risk pregnant women in a public hospital in Northeastern Brazil

Introdução: a qualidade da dieta de gestantes está associada a complicações na gestação, dentre as quais o Diabetes mellitus Gestacional. Conhecer o padrão alimentar dessa população, por métodos que avaliem a qualidade global da dieta é importante, pois permite o ajuste da ingestão alimentar, pode evitar distúrbios associados para mãe e filho e contribuir na definição de estratégias de intervenção. Objetivo: avaliar a qualidade da dieta de gestantes de alto risco, inclusive com Diabetes mellitus Gestacional, e a presença de fatores relacionados ao desenvolvimento da patologia. Metodologia: estudo transversal, conduzido em um hospital do Nordeste. Foram coletadas variáveis clínicas, socioeconômicas, demográficas, de estilo de vida, antropométricas e dietéticas. A qualidade da dieta foi avaliada pelo HEIP-B. Resultados: o Diabetes mellitus Gestacional foi a patologia mais comum na gestação (n = 31; 70,4%), seguida pela hipertensão (n = 27; 61,4%). As frequências de excesso de peso materno pré e gestacional foram expressivas, sobretudo nas grávidas com Diabetes mellitus Gestacional (93,6% e 96,7%, respectivamente). Nenhuma paciente consumia dieta de má qualidade e a proporção de dieta de boa qualidade e precisando de melhorias foi similar. Mas observou-se que a maioria das grávidas diabéticas consomem dieta de boa qualidade (p = 0,046). Discussão: os percentuais de hipertensão e excesso de peso podem ter levado ao desenvolvimento de Diabetes mellitus Gestacional pelas gestantes, pois são fatores de risco para a doença. A qualidade da dieta acompanha a preocupante tendência mostrada por outros estudos. O maior consumo de dieta de boa qualidade por gestantes diabéticas é animador, tendo em vista a importância da dieta no tratamento da patologia. Conclusão: gestantes diabéticas parecem se preocupar com a alimentação e, em sua maioria, consomem dieta de boa qualidade. Mas o HEIP-B mostrou alto percentual de gestantes adeptas de dietas precisando de melhorias e que não seguem plano alimentar orientado. Não apenas a qualidade da dieta, mas também as expressivas freqüências de hipertensão e excesso de peso são preocupantes e falam a favor da alta prevalência de Diabetes mellitus Gestacional observada. Estes resultados reforçam a necessidade de melhoria na qualidade da alimentação desse público, fazendo-se necessário incentivar práticas alimentares saudáveis, além do acompanhamento pré-natal para o diagnóstico das patologias e sua intervenção precoce (AU)

Introduction: the quality of the diet of pregnant women is associated with complications during pregnancy, such as Gestational Diabetes Mellitus. Knowing the dietary pattern of this population, by methods that evaluate the overall quality of the diet is important, since it allows the adjustment of food intake, can avoid associated disorders for mother and child and contribute to the definition of intervention strategies. Objective: to evaluate the quality of the diet of high-risk pregnant women, including Gestational Diabetes Mellitus, and the presence of factors related to the development of the pathology. Methodology: a cross-sectional study conducted at a hospital in the Northeast. Clinical, socioeconomic, demographic, lifestyle, anthropometric and dietary variables were collected. The quality of the diet was evaluated by HEIP-B. Results: Gestational Diabetes mellitus was the most common pathology in pregnancy (n = 31, 70.4%), followed by hypertension (n = 27, 61.4%). The frequencies of pre and gestational maternal overweight were significant, especially in pregnant women with Gestational Diabetes mellitus (93.6% and 96.7%, respectively). No patient consumed poor diet and the proportion of good quality diet and needing improvement was similar. But it was observed that the majority of diabetic pregnant women consume a good quality diet (p = 0.046). Discussion: Percentages of hypertension and overweight may have led to the development of Gestational Diabetes Mellitus by pregnant women, as they are risk factors for the disease. The quality of the diet accompanies the worrying trend shown by other studies. The higher consumption of good quality diet by pregnant diabetics is encouraging, considering the importance of diet in the treatment of pathology. Conclusion: Diabetic pregnant women seem to worry about eating and, for the most part, consume good quality diet. But HEIP-B showed a high percentage of pregnant women who were diets in need of improvement and did not follow a food oriented plan. Not only the quality of the diet, but also the expressive frequencies of hypertension and overweight are worrisome and speak in favor of the high prevalence of observed Gestational Diabetes Mellitus. These results reinforce the need to improve the quality of food for this public, making it necessary to encourage healthy eating practices, as well as prenatal care to diagnose pathologies and their early intervention (AU)

Comparação entre diferentes métodos de triagem nutricional em pacientes oncológicos ambulatoriais / Comparison between different nutritional screnning tools in cancer outpatients

Introdução: A caquexia é uma condição que ocorre frequentemente nos pacientes oncológicos, sendo de suma importância avaliar o estado e o risco nutricional desses indivíduos. Existem diversas triagens nutricionais que identificam esse risco, dentre elas: Malnutrition Universal Screening Tool (MST) Nutritional Risk Screening 2002 (NRS 2002), Mini Avaliação Nutricional Simplificada (MAN-SF), NutriScore e Avaliação Subjetiva Global Produzida Pelo Paciente (ASG-PPP), sendo essa última padrão ouro para pacientes oncológicos. Objetivo: Comparar diferentes métodos de triagem nutricional em pacientes oncológicos atendidos ambulatorialmente em um hospital público do Recife-PE. Metodologia: Estudo transversal com pacientes portadores de câncer, adultos e idosos, de ambos os sexos. Foram obtidos dados demográficos, socioeconômicos, do estilo de vida, clínicos e antropométricos. Foi realizada a associação entre 5 protocolos de triagem nutricional, sendo adotado o nível de significância de 5%. Resultados: A amostra compreendeu 65 pacientes, a maioria do sexo feminino (n=51; 78,5%). O tipo de neoplasia mais observada foi o câncer de mama (52,3%), seguido por tumores localizados no trato gastrointestinal (23,1%) e no sistema reprodutor (21,6%). A quimioterapia foi o tratamento antineoplásico mais utilizado (84,6%). No que diz respeito aos dados nutricionais, a maior parcela da amostra apresentou-se sem risco nutricional. As triagens NRS 2002 e a NutriScore demonstraram associação estatisticamente significante com a ASG-PPP (p<0,05). Discussão: Assim como no presente estudo, o câncer de mama é a neoplasia mais frequente no sexo feminino. Nos estudos de Gomes e Maio e de Khoshnevis et al. a quimioterapia foi o tratamento mais utilizado também. De acordo com a pesquisa de Bozetti et al. a maioria dos pacientes não apresentava risco nutricional, enquanto que Shaw identificou mais pacientes com risco. Quanto a associação entre as triagens nutricionais, a NRS 2002 e a NutriScore foram as únicas que apresentaram associação com a ASG-PPP provavelmente por conterem questões relativas ao catabolismo da doença. Conclusão: As triagens nutricionais aplicadas no presente estudo identificaram maior proporção de pacientes sem risco nutricional. A NutriScore e a NRS 2002 apresentaram associação estatisticamente significante com a ASG-PPP, podendo ser recomendadas como alternativas mais práticas e rápidas à ASG-PPP (AU)

Introduction: Cachexia is a condition that often occurs in oncology patients and it is imperative to assess the nutritional status and risk of these diseases. There are several nutritional screenings that identify this risk, among them: the Malnutrition Universal Screening Tool (MST) Nutritional Risk Screening 2002 (NRS 2002), Mini Simplified Nutrition Assessment (MAN-SF), NutriScore and Patient Produced Subjective Global Assessment, which is the gold standard for cancer patients. Objective: To compare different methods of nutritional risk screening in oncology outpatients attended in a public hospital in Recife-PE. Methodology: Cross-sectional study with patients with cancer, adults and elderly, of both sexes. It was obtained demographic, socioeconomic, lifestyle, clinical and anthropometric data. The association between 5 nutritional screening protocols was performed and the significance level of 5% was adopted. Results: The sample comprised 65 patients, most of whom were female (n=51, 78.5%). The most observed neoplasia was breast cancer (52.3%), followed by tumors located in the gastrointestinal tract (23.1%) and the reproductive system (21.6%). Chemotherapy was the most used antineoplastic treatment (84.6%). Concerning nutritional data, the largest portion of the sample was presented without nutritional risk. The NRS 2002 and NutriScore showed a statistically significant association with ASG-PPP (p<0.05). Discussion: As in the present study, breast cancer is the most frequent neoplasm in females. In the studies by Gomes and Maio and Khoshnevis et al. Chemotherapy was the most commonly used treatment as well. According to the research of Bozetti et al. The majority of patients did not present nutritional risk, while Shaw identified more patients at risk. As for the association between nutritional screenings, NRS 2002 and NutriScore were the only ones that were associated with ASG-PPP probably because they contained questions regarding the catabolism of the disease. Conclusion: The nutritional screening applied in the present study identified a higher proportion of patients without nutritional risk. NutriScore and NRS 2002 showed a statistically significant association with ASG-PPP and could be used (AU)

Associação do músculo adutor do polegar com parâmetros de avaliação nutricional em pacientes renais crônicos em hemodiálise / Association of the adductor pollicis muscle thickness with nutritional assessment parameters in patients in dialysis for chronic kidney disease

Com o objetivo de verificar a espessura do músculo adutor do polegar e sua associação com parâmetros de avaliação nutricional em pacientes renais crônicos em hemodiálise, conduziu-se a presente investigação de caráter transversal realizada com 40 pacientes com idade média de 54,4±14,5 anos submetidos à hemodiálise no Hospital Barão de Lucena, Recife-PE. A espessura do músculo adutor do polegar identificou 35,0% (n=14) de pacientes em risco nutricional/desnutrição e revelou associação com o índice de massa corporal e com a prega cutânea tricipital (p<0,05). A espessura do músculo adutor do polegar se mostrou como um método simples e viável na execução da avaliação nutricional de pacientes renais crônicos em hemodiálise.

In order to verify the adductor pollicis muscle thickness and its association with nutritional assessment parameters in patients in dialysis for chronic kidney disease, this cross-sectional research was conducted. The sample comprised 40 patients undergoing hemodialysis in Barão de Lucena Hospital/Recife-PE. The adductor pollicis muscle thickness identified 35.0% (n=14) of patients at nutritional risk/malnutrition and it was associated with body mass index and the triceps skin fold (p <0.05). The adductor pollicis muscle thickness was as a simple and feasible method for the nutritional assessment of patients in dialysis for chronic kidney disease.

Perfil epidemiológico e laboratorial de pacientes com diferentes formas clínicas da doença de Crohn: série de casos de um Hospital Regional do Nordeste do Brasil / Epidemiological and laboratory profile of outpatients with different clinical forms of crohn's disease: case series from a regional Hospital at Northeast of Brazil

Com o objetivo de caracterizar o perfil epidemiológico e laboratorial de pacientes com doença de Crohn (DC), conduziu-se a presente série de casos, englobando 26 indivíduos atendidos no Hospital das Clínicas da Universidade Federal de Pernambuco. Coletaram-se dados epidemiológicos, clínicos e bioquímicos, incluindo a relação Proteína C-Reativa (PCR) /Albumina. A amostra apresentou idade de 41,3±13,2 anos e 100,0% estava em remissão da DC. A relação PCR/Albumina foi elevada em 76,9% dos participantes, principalmente naqueles com menor tempo da DC e com alta Velocidade de Hemossedimentação (p≤0,05). Os indivíduos desta casuística revelaram características típicas da DC e valores elevados da relação PCR/Albumina.

In order to characterize the epidemiological and laboratory profile of patients with Crohn's disease (CD), this case-series was conducted, involving 26 patients treated at Hospital das Clinicas, Federal University of Pernambuco. Epidemiological, clinical and biochemical data were collected, including the C-Reactive Protein (CRP)/Albumin ratio. The sample had mean age of 41.3 ± 13.2 years and 100.0% were in remission of CD. CRP/Albumin ratio was elevated in 76.9% of the patients, especially in those with shorter duration of CD and higher values of erythrocyte sedimentation rate (p≤0.05). The patients of this study showed typical characteristics of CD and high CRP/Albumin ratio.

Excessive weight--muscle depletion paradox and cardiovascular risk factors in outpatients with inflammatory bowel disease.

BACKGROUND: Evidence suggests a nutritional transition process in patients with inflammatory bowel disease. Obesity, which was once an uncommon occurrence in such patients, has grown in this population at the same prevalence rate as that found in the general population, bringing with it an increased risk of cardiovascular disease. Objective The aim of the present study was to determine the nutritional status and occurrence of cardiovascular risk factors in patients with inflammatory bowel disease. METHODS: A case-series cross-sectional study was conducted involving male and female adult outpatients with inflammatory bowel disease. Data were collected on demographic, socioeconomic, clinical and anthropometric variables as well as the following cardiovascular risk factors: sedentary lifestyle, excess weight, abdominal obesity, medications in use, comorbidities, alcohol intake and smoking habits. The significance level for all statistical tests was set to 5% (P< 0.05). RESULTS: The sample comprised 80 patients with inflammatory bowel disease, 56 of whom (70.0%) had ulcerative colitis and 24 of whom (30.0%) had Crohn's disease. Mean age was 40.3±11 years and the female genre accounted for 66.2% of the sample. High frequencies of excess weight (48.8%) and abdominal obesity (52.5%) were identified based on the body mass index and waist circumference, respectively, in both groups, especially among those with ulcerative colitis. Muscle depletion was found in 52.5% of the sample based on arm muscle circumference, with greater depletion among patients with Crohn's disease (P=0.008). The most frequent risk factors for cardiovascular disease were a sedentary lifestyle (83.8%), abdominal obesity (52.5%) and excess weight (48.8%). CONCLUSION: The results of the complete anthropometric evaluation draw one's attention to a nutritional paradox, with high frequencies of both - muscle depletion, as well as excess weight and abdominal obesity.

Excessive weigh – muscle depletion paradx and cardiovascular risk factoors in outpatients with inflammatory bowel disease / Paradoxo excesso de peso – depleção muscular e fatores de risco cardiovascular em pacientes ambulatoriais com doenças inflamatórias intestinais

Background Evidence suggests a nutritional transition process in patients with inflammatory bowel disease. Obesity, which was once an uncommon occurrence in such patients, has grown in this population at the same prevalence rate as that found in the general population, bringing with it an increased risk of cardiovascular disease. Objective The aim of the present study was to determine the nutritional status and occurrence of cardiovascular risk factors in patients with inflammatory bowel disease. Methods A case-series cross-sectional study was conducted involving male and female adult outpatients with inflammatory bowel disease. Data were collected on demographic, socioeconomic, clinical and anthropometric variables as well as the following cardiovascular risk factors: sedentary lifestyle, excess weight, abdominal obesity, medications in use, comorbidities, alcohol intake and smoking habits. The significance level for all statistical tests was set to 5% (P< 0.05). Results The sample comprised 80 patients with inflammatory bowel disease, 56 of whom (70.0%) had ulcerative colitis and 24 of whom (30.0%) had Crohn's disease. Mean age was 40.3±11 years and the female genre accounted for 66.2% of the sample. High frequencies of excess weight (48.8%) and abdominal obesity (52.5%) were identified based on the body mass index and waist circumference, respectively, in both groups, especially among those with ulcerative colitis. Muscle depletion was found in 52.5% of the sample based on arm muscle circumference, with greater depletion among patients with Crohn’s disease (P=0.008). The most frequent risk factors for cardiovascular disease were a sedentary lifestyle (83.8%), abdominal obesity (52.5%) and excess weight (48.8%). Conclusion The results of the complete anthropometric evaluation draw one’s attention to a nutritional paradox, with high frequencies of both - muscle depletion, as well as excess weight and abdominal obesity. .

Contexto Evidências sugerem um processo de transição nutricional nos pacientes com doenças inflamatórias intestinais. A obesidade, que era um distúrbio incomum nas doenças inflamatórias intestinais, cresce em paralelo com a prevalência da obesidade em toda a população, podendo aumentar o risco de doenças cardiovasculares nesta população. Objetivo Avaliar o estado nutricional e a ocorrência de fatores de risco cardiovascular em pacientes com doenças inflamatórias intestinais. Métodos Métodos – Estudo transversal, série de casos, realizado em pacientes ambulatoriais com doenças inflamatórias intestinais, adultos e de ambos os sexos. Foram obtidas variáveis demográficas, socioeconômicas, clínicas, antropométricas e os fatores de risco cardiovascular: sedentarismo, excesso de peso, obesidade abdominal, medicamentos, comorbidades, alcoolismo e tabagismo. O nível de significância foi de 5,0%. Resultados A amostra foi constituída por 80 pacientes com doenças inflamatórias intestinais, 56 (70,0%) com etocolite ulcerativa inespecífica e 24 (30,0%) com doença de Crohn, sendo a idade média 40,3±11 anos e 66,2% do sexo feminino. Elevadas frequências de excesso de peso (48,8%) e obesidade abdominal (52,5%) foram identificadas, segundo o índice de massa corporal e a circunferência da cintura, respectivamente, em ambos os grupos, e de forma mais importante na retocolite ulcerativa inespecífica. A depleção de massa muscular ocorreu em 52,5% dos pacientes segundo a circunferência muscular do braço, sendo mais depletados aqueles com (P=0,008). Dentre os fatores de risco para doenças cardiovasculares, os mais frequentes foram o sedentarismo (83,8%), o perímetro abdominal elevado (52,5%) e o excesso de peso (48,8%). Conclusão A avaliação antropométrica completa mostrou elevada frequência de déficit proteico somático ao mesmo tempo em que se encontraram elevadas frequências de excesso de peso e obesidade abdominal. .

Síndrome Metabólica e outros fatores de risco para doença cardiovasculares em população de obesos / Metabolic Syndrome and other risk factors for cardiovascular disease in an obese population

Fundamentos: A síndrome metabólica (SM) se caracteriza pela perda da homeostase corporal. Está relacionada principalmente com a obesidade abdominal, que se associa às alterações no perfil lipídico, ao aumento da pressão arterial e à hiperinsulinemia, fatores esses que aumentam o risco de diabetes mellitus (DM) tipo 2, doenças cardiovasculares e resistência à insulina. A adesão ao exercício físico e a um plano alimentar saudável é fundamental no tratamento da SM.Objetivo: Verificar a prevalência da síndrome metabólica (SM) e outros fatores de risco para doenças cardiovasculares (DCV) em obesos.Métodos: Estudo transversal incluindo 293 pacientes obesos, acompanhados no ambulatório de nutrição. A SM foi definida segundo o NCEP-ATP III.Resultados: Dos indivíduos avaliados (44 homens e 249 mulheres), 67,7 % apresentaram SM, sem diferença entre os sexos, e mais frequente nos idosos. As comorbidades mais prevalentes foram: dislipidemias (69,1 %), hipertensão arterial sistêmica (49,0 %) e diabetes mellitus ou intolerância à glicose (36,3 %). Aqueles com SM apresentaram maior frequência de outros indicadores para DCV (relação TG/HDL; razão cintura/estatura; LDL e CT).Conclusão: Verificou-se elevada prevalência de SM associada a várias comorbidades e outros indicadores para DCV.

Background: Metabolic syndrome (MS) is characterized by the loss of body homeostasis related mainly to abdominal obesity that is associated with lipid profile alterations, increased blood pressure and hyperinsulinemia, which are factors stepping up the risk of type 2 diabetes mellitus (DM2), cardiovascular disease and insulin resistance. Adherence to exercise and a healthy eating plan are vital for treating this syndrome.Objective: To ascertain the prevalence of metabolic syndrome (MS) and other risk factors for cardiovascular diseases (CVD) in obese patients. Methods: Cross-sectional study of 293 obese patients monitored at a nutrition outpatient clinic. MS was defined on the basis of the NCEP-ATP III.Results: Among the 44 men and 249 women evaluated, 67.7% had MS, with no significant difference between genders, but more frequent among the elderly. The most prevalent comorbidities were dyslipidemia (69.1%), systemic hypertension (49.0%) and diabetes mellitus or glucose intolerance (36.3%). Patients with MS presented higher rates for other CVD indicators (TG/HDL ratio, waist/height ratio, LDL and TC).Conclusion: The prevalence of MS was high, associated with several other comorbidities and CVD indicators.

Relationship between nutritional status and immediate complications in patients undergoing colorectal surgery / Relação entre o estado nutricional e as complicações imediatas em pacientes submetidos a cirurgias colorretais

INTRODUCTION: several complications may occur during colorectal surgical procedures and factors, such as nutritional status, substantially contribute to this problem. OBJECTIVE: evaluate the relationship between nutritional status (determined by different tools) and the emergence of early postoperative complications, as well as analyze social parameters, lifestyle, food intake, and time to diet reintroduction. METHODS: case series study conducted in the surgical proctologic ward of the Hospital Barão de Lucena, Recife, Pernambuco, with individuals of both sexes diagnosed with colorectal cancer who underwent a surgical procedure involving at least one anastomosis. Social, demographic and clinical data, life style, dietary intake, nutritional status, and the immediate postsurgical complications were evaluated. RESULTS: among the 31 patients studied, there was a higher prevalence of females (74.2%), mean age of 61.9 ± 12.4 years old, and the rectum was the primary site of cancer in 54.8%. Most patients came from the countryside, were retirees, had lower education, consumed too much red meat, processed meats, and fats, with low consumption of fruits and vegetables, and were sedentary. Regarding nutritional status, nutritional risk was found in 58.1%, mean BMI of 25.7 ± 6.8 kg/m², and 54.8% had significant weight loss. Additionally, 38.7% had some of the immediate complications, particularly paralytic ileus and abdominal distension. There was a delay in the onset of renourishment, and there was no association between nutritional status and immediate complications. CONCLUSION: colorectal cancer is closely related to eating habits and lifestyle. Patients with this malignancy have a marked weight loss; however, in this study, we found no association between nutritional status and the incidence of postoperative complications. (AU)

INTRODUÇÃO: intervenções cirúrgicas colorretais estão sujeitas a diversas complicações e vários fatores, como o estado nutricional, contribuem substancialmente para essa problemática. OBJETIVO: avaliar a relação do estado nutricional, determinado por diferentes ferramentas, com o surgimento de complicações pós-operatórias imediatas, bem como a análise de parâmetros sociais, estilo de vida, consumo alimentar e tempo de reintrodução à dieta. MÉTODOS: estudo de série de casos, conduzido na enfermaria de cirurgia proctológica do Hospital Barão de Lucena, Recife, Pernambuco, com indivíduos de ambos os sexos diagnosticados com câncer colorretal e que foram submetidos a procedimento cirúrgico envolvendo pelo menos uma anastomose. Foram avaliadas as condições sociais, demográficas, clínicas, o estilo de vida, o consumo alimentar, o estado nutricional e as complicações imediatas pós-cirúrgicas. RESULTADOS: dos 31 pacientes estudados, houve uma maior prevalência do sexo feminino (74,2%), média de idade de 61,9 ±12,4 anos e 54,8% apresentaram o reto como localização primária do câncer. A maioria eram procedentes do interior do estado, aposentados, baixa escolaridade e apresentaram demasiada ingestão de carnes vermelhas, embutidos e gorduras e um menor consumo de frutas e verduras e eram sedentários. Quanto ao estado nutricional, foi encontrado um risco nutricional de 58,1%, IMC médio de 25,7 ±6,8 kg/m² e 54,8% apresentaram perda ponderal significativa. Além disso, 38,7% apresentaram alguma das complicações imediatas, sendo as mais frequentes o íleo paralítico e a distensão abdominal. Houve retardo no início da realimentação e não houve associação entre o estado nutricional e as complicações imediatas. CONCLUSÃO: o surgimento do câncer colorretal está bem relacionado com os hábitos alimentares e o estilo de vida. Pacientes com essa neoplasia apresentam uma acentuada perda ponderal, entretanto, nesse estudo, não houve associação entre o estado nutricional e a incidência de complicações pós-operatórias. (AU)

Razão triglicerídeo/HDL-C como indicador de risco cardiovascular em alcoolistas crônicos / Triglyceride/HDL-C ratio as a cardiovascular risk indicator in chronic alcoholic patients

Fundamentos: O consumo de grande quantidade de bebidas alcoólicas associa-se a alterações no sistemacardiovascular. A utilização da razão triglicerídeo/HDL-C (TG/HDL-C) apresenta-se como forte marcadoraterogênico. Objetivos: Estabelecer o perfil lipídico e razão TG/HDL-C de alcoolistas crônicos e comparar comindivíduos não alcoolistas. Métodos: Estudo de caso-controle compreendendo 50 indivíduos alcoolistas crônicos e 50 indivíduos não alcoolistas do mesmo sexo correspondente e idadessemelhantes. Foram analisadas variáveis referentes às condições socioeconômicas e de estilo de vida,antropometria e perfil lipídico de ambos os grupos, além da pressão arterial do grupo de alcoolistas. Com os resultados de triglicerídeo e HDL-C foi possível o cálculo da razão TG/HDL-C. Resultados: Com relação aos dados socioeconômicos e de estilo de vida não houve diferenças em relação à prática de atividade física e comorbidades. Quanto àantropometria, o grupo alcoolista apresentou valores menores de IMC, circunferência da cintura e razãocintura/estatura. Sobre o perfil lipídico e razão TG/HDL-C não houve diferença entre os grupos, apenas em relação ao HDL-C. A razão TG/HDL-C apresentouassociação com o IMC e razão cintura/estatura no grupo dos alcoolistas crônicos e com o IMC, circunferência da cintura, razão cintura/estatura e índice de conicidade no grupo dos não alcoolistas.Conclusão: O grupo de alcoolistas crônicos estudado apresentou melhor perfil bioquímico e razão TG/HDL-Cem comparação ao grupo de não alcoolistas.

Razão TG/HDL-c e 3 indicadores antropométricos preditores de risco para doença cardiovascular / TG/HDL-c ratio and anthropometric indicators as cardiovascular disease risk predictors

Fundamentos: A prevenção de doenças cardiovascularesé prioridade na saúde pública, principalmente naquelesindivíduos de alto risco. Portanto a utilização depreditores do desenvolvimento de doença arterialcoronariana (DAC), como a razão triglicerídeos/HDLcolesterol(TG/HDL-c) e indicadores antropométricos dedistribuição de gordura corporal central, são importantesna prática clínica.Objetivo: Verificar se o excesso de peso e a obesidadecentral, por meio de indicadores antropométricos,exercem influência nos valores médios da razãoTG/HDL-c.Métodos: Estudo caso-controle, com 27 pacientes adultose idosos, portadores de DAC, de ambos os sexos, comidade mínima de 20 anos, internados na enfermaria decardiologia da instituição durante o período de abril aagosto 2009. Para cada paciente foram selecionados doisindivíduos saudáveis de mesmo sexo e idade semelhante,totalizando 54 indivíduos do grupo-controle.Resultados: A média de idade foi de 50,2±6,0 anos, 68,8do sexo masculino. Dentre os casos 70,4 apresentavamexcesso de peso e 55,6 apresentavam uma razãoTG/HDL-c elevada. Quanto aos controles 77,4apresentavam excesso de peso [IC95: 63,79-87-72] e30,2 tinham uma razão TG/HDL-c elevada. Aprevalência de risco cardiovascular, quanto aosindicadores antropométricos, foi mais elevada pela razãocintura-estatura (RCEst): 96,3 e 86,8 para os casos econtroles, respectivamente. Todos os indicadoresantropométricos foram capazes de discriminar diferenças nos valores médios da razão TG/HDL-c,porém a RCEst apresentou poder mais satisfatório paradiscriminar uma razão TG/HDL-c elevada.Conclusão: Sugere-se o uso dos indicadores RCEst, CCe IMC como instrumentos para detectar possíveisalterações na razão TG/HDL-c.