Exposição a dieta hiperlipídica no período perinatal e pós desmame aumenta risco cardiometabólico e altera histomorfometria aórtica em ratos jovens / Exposure to high-fat diet in the perinatal and post-weaning period increases cardiometabolic risk and alters aortic histomorphometry in young rats

Introdução: estudos sugerem forte associação da exposição perinatal e pós-natal a dietas ricas em gordura e complicações cardiovasculares. Objetivo: avaliar os efeitos da exposição a dieta hiperlipídica no período perinatal e pós desmame sobre indicadores de risco cardiometabólico e alterações histomorfometrica na aorta em ratos. Metodologia: Ratas Wistar foram separadas em grupos de acordo com a dieta durante a gestação e lactação: dieta controle (n=3) e dieta hiperlipídica (n=3). No 21º dia de vida filhotes machos foram divididos em subgrupos (n=6): CC: formado por ratos expostos a dieta controle durante toda a vida; CH: formado por ratos cuja a mãe consumiu dieta controle e após o desmame os filhotes consumiram dieta hiperlipídica; HH: formado por filhotes expostos a dieta hiperlipídica durante toda a vida e HC: formado por ratos cuja a mãe consumiu dieta hiperlipídica e após o desmame os filhotes consumiram dieta controle. No 60º dia de vida, IMC, índices aterogênicos, proteína C reativa e histomorfometria da aorta dos descendentes foram avaliados. Resultados: o grupo HC apresentou maior IMC em comparação aos grupos HH e CH (p= 0,0004). A razão colesterol total / HDL-colesterol foi maior para o grupo CH comparado ao CC e HC (p = 0,016). Coeficiente aterogênico (p = 0,003), espessura da aorta (p = 0,003) e quantidade de lamelas elásticas (p = 0,0002) foram maiores nos grupos CH e HH em comparação a CC e HC. Conclusão: exposição a dieta hiperlipídica nos períodos perinatal e pós desmame aumentou o risco cardiometabólico e alterou a histomorfometria aórtica de ratos.

Background: studies suggest a strong association of perinatal and postnatal exposure to high-fat diets and cardiovascular complications. Objective: to evaluate the effects of exposure to a high-fat diet in the perinatal and post-weaning period on indicators of cardiometabolic risk and aorta histomorphometric changes in the rats. Methodology: Wistar rats were separated into groups according to the diet during pregnancy and lactation: control diet (n=3) and high fat diet (n=3). On the 21st day of life, male pups were divided into subgroups (n=6): CC: formed by rats exposed to a control diet for all life; CH: formed by rats whose mother consumed a control diet and after weaning the pups consumed a high-fat diet; HH: formed by pups exposed to a high-fat diet for all life and HC: formed by rats whose mother consumed a high-fat diet and after weaning the pups consumed a control diet. On the 60th day of life, BMI, atherogenic indices, C-reactive protein and histomorphometry of the aorta of the offspring were evaluated. Results: the HC group showed higher BMI compared to the HH and CH groups (p=0.0004). The total cholesterol / HDL-cholesterol ratio was higher for the CH group compared to CC and HC (p = 0.016). Atherogenic coefficient (p= 0,003), aortic thickness (p = 0.003) and amount of elastic lamellae (p = 0.0002) were higher in CH and HH groups compared to CC and HC. Conclusion: exposure to a high-fat diet in the perinatal and post-weaning periods increased cardiometabolic risk and altered aortic histomorphometry in rats.

Modulation of hypothalamic AMPK and hypothalamic neuropeptides in the control of eating behavior: A systematic review.

Eating behavior is regulated by central and peripheral signals, which interact to modulate the response to nutrient intake. Central control is mediated by the hypothalamus through neuropeptides that activate the orexigenic and anorexigenic pathways. Energy homeostasis depends on the efficiency of these regulatory mechanisms. This neuroendocrine regulation of hunger and appetite can be modulated by nutritional sensors such as adenosine monophosphate-activated protein kinase (AMPK). Thus, this systematic review discusses the literature on correlations between AMPK and hypothalamic neuropeptides regarding control of eating behavior. Lilacs, PubMed/Medline, ScienceDirect, and Web of Science were searched for articles published from 2009 to 2021 containing combinations of the following descriptors: "eating behavior," "hypothalamus," "neuropeptide," and "AMPK." Of the 1330 articles found initially, 27 were selected after application of the inclusion and exclusion criteria. Of the selected articles, 15 reported decreased AMPK activity, due to interventions using angiotensin II infusion, fructose, glucose, cholecystokinin, leptin, or lipopolysaccharide (LPS) injection; dietary control through a low-protein diet or a high-fat diet (60 % fat); induction of hyperthyroidism; or injection of AMPK inhibitors. Seven studies showed a decrease in neuropeptide Y (NPY) through CV4 AICAR administration; fructose, glucose, leptin, or angiotensin II injections; or infusion of LPS from Escherichia coli and liver kinase B1 (LKB1) overexpression. Eleven studies reported a decrease in food consumption due to a decrease in AMPK activity and/or hypothalamic neuropeptides such as NPY. The results indicate that there is a relationship between AMPK and the control of eating behavior: a decrease in AMPK activity due to a dietary or non-dietary stimulus is associated with a consequent decrease in food intake. Furthermore, AMPK activity can be modulated by glucose, thyroid hormones, estradiol, leptin, and ghrelin.

Serotonergic mechanisms associated with experimental models of hypoxia: A systematic review.

PURPOSE: The aim of this systematic review was to explore and discuss the literature concerning the effects of hypoxia or anoxia during the perinatal period on the serotoninergic network in rodents, through mechanisms that lead to changes in serotonergic neurons, levels, segments of central nervous system affected, 5-HT transporter, and 5-HT receptor. METHODS: Literature searches were performed in Embase, Medline (PubMed), Web of Science, and SCOPUS, from April to July 2021, with a total of 1045 published studies found. Using a predefined protocol, as registered on the CAMARADES website, 10 articles were included in this review. The PRISMA statement was used for reporting this systematic review. The internal validity was assessed using the SYRCLE's risk of bias tool. RESULTS: Our main findings show that hypoxia in the first days of postnatal life led to a disturbance in the serotonergic system with reduced in 5-HT fibers, reduced brain levels of 5-HT and 5-HIAA, reduced SERT protein expression, and reduced receptor 5-HT7 . Putative mechanisms involving damage in the serotoninergic system include retrograde cell death resulting from primary damage mainly in forebrain areas, which impairs remote areas including serotonergic raphe nuclei. Other probable mechanisms associated with the serotoninergic network damage may be triggered by excitotoxic lesion and neuroinflammation. CONCLUSION: Hypoxia at the beginning of an animal's life leads to modification of the serotonergic components associated with putative mechanisms that include cell damage and neuroinflammation.

Paternal High-Fat Diet Exposure Induces Adverse Effects on Offspring Health: a Systematic Review of Animal Studies

Abstract This systematic review examined the effects of paternal exposure to a high-fat diet on the likelihood of offspring developing health consequences, including metabolic conditions. While the connection between a mother's diet and offspring health has been well established, our understanding of whether offspring health is affected by a father's diet remains limited. This systematic review was performed according to the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) recommendations. The PubMed, Scopus, and Embase electronic databases were searched using combinations of the MESH terms: obesogenic diet, high-fat diet, cafeteria diet, paternal diet, parental diet, programming, paternal effects, and paternal programming. Sixteen studies were selected after assessing articles for eligibility criteria. The main outcomes concerning offspring health related to metabolic disorders. The offspring of fathers exposed to a high-fat diet displayed elevated gene expression and serum levels of leptin, decreased gene expression and serum levels of adiponectin, insulin resistance, glucose intolerance, hyperglycemia, hyperinsulinemia, changes in the transcriptome of pancreatic islet tissues, increased triglycerides, and increased expression of lipogenic genes. The available evidence suggests that paternal exposure to a high-fat diet may induce harmful effects on the health of offspring.

L-tryptophan administration and increase in cerebral serotonin levels: Systematic review.

The amino acid tryptophan (2-Amino-3-(lH-indol-3-yl)-propanoic acid; Trp) is a precursor of the neurotransmitter serotonin (5-hydroxytryptamine; 5-HT) that performs various brain functions. The administration of Trp is used in experimental studies to manipulate the serotonergic system, however the dose of Trp required to raise brain 5-HT levels is controversial. The aim of this study was to systemically review the effect of the administration of different doses of Trp on cerebral 5-HT levels. Two independent authors conducted a systematic review in the electronic databases. Twenty-five studies were included in the present review. Trp was administered orally, intraperitoneally or subcutaneous in adult animals. The brain 5-HT levels elevated after Trp administration in different intensities, dependent of the brain region evaluated and the time of administration. Further studies are needed to assess the dose-response of Trp administration to brain 5-HT levels.

Razão TG/HDL-c, indicadores antropométricos e bioquímicos de risco cardiovascular no renal crônico em tratamento conservador / TG/HDL-c reason, anthropometrics and biochemical indicators of cardiovascular risk in chronic renal in conservative treatment

Introdução: As doenças cardiovasculares (DCV) representam no Brasil a principal causa de morbimortalidade e sua prevalência cresce em todo o mundo. O paciente com doença renal crônica apresenta alto risco de desenvolvimento da doença e este risco eleva-se na presença de dislipidemia. Triglicérides (TG) elevado e lipoproteína de alta densidade (HDL-c) reduzida são preditores independentes de eventos cardiometabólicos. O excesso de tecido adiposo também está envolvida com risco de DCV. Portanto a utilização de preditores do desenvolvimento de DCV, como a razão triglicerídeos/HDL colesterol (TG/HDL-c) e indicadores antropométricos de avaliação de gordura corporal são importantes na prática clínica. Objetivo: Avaliar a associação entre a razão TG/HDL e indicadores antropométricos de risco cardiovascular em pacientes renais crônicos em tratamento conservador. Métodos: Estudo transversal, envolvendo 90 pacientes clinicamente estáveis atendidos ambulatorialmente. A razão TG/HDL-c foi definida de acordo com equação preestabelecida, sendo considerado risco para DCV valores >2,5 para mulheres e >3,5 para homens. Os parâmetros antropométricos utilizados foram o índice de massa corporal (IMC) e a circunferência da cintura (CC). Dados sociais, de estilo de vida, clínicos e bioquímicos também foram coletados. Na comparação entre os dois grupos (razão TG/HDL-c elevado e razão TG/HDL adequado) foi utilizado o teste t de Student para os dados paramétricos e de Mann-Whitney para os dados não paramétricos. As proporções foram comparadas pelo teste do quiquadrado. Os ajustes entre Razão TG/HDL, IMC e CC foram realizadas através da análise de regressão logística. Resultados: Da amostra avaliada, 50 pacientes (55,6%) apresentaram razão TG/HDL elevada. Pacientes com IMC e CC alterada apresentavam maior risco de DCV, avaliado através da razão TG/HDL-c. Houve diferença estatisticamente significante entre os indicadores antropométricos utilizados, IMC e CC, e razão TG/HDL-c quando estratificado em elevado e adequado. Entretanto, na análise ajustada, não foi observada associação entre o IMC ou a CC e a razão TG/HDL. Conclusão: Os resultados demonstram que após ajustes com possíveis variáveis de confusão não houve associação entre os valores da razão TG / HDL-C e indicadores antropométricos de adiposidade, IMC e CC. Os resultados deste estudo levam a questionar a real influência do excesso de peso e da obesidade central na razão TG/HDL-c (AU)

Introduction: Cardiovascular diseases (CVD) are a major cause of morbidity and mortality, and its prevalence is growing worldwide. Patients with chronic kidney disease (CKD) are at high risk of group, especially those with dyslipidemia. Triglycerides (TG) and high-density lipoprotein (HDL-c) are independent predictors of cardiovascular events. Excessive adipose tissue also increases the cardiovascular risk. Therefore, CVD predictors, such as the Triglycerides / HDL cholesterol (TG / HDL-c) ratio and the anthropometric measurements for assessing body fat are important in clinical practice. Objective: To evaluate the association between TG / HDL ratio, anthropometric measurements and the cardiovascular risk in CKD patients on dialysis. Methods: A cross-sectional study involving 90 clinically stable outpatients. The TG / HDL-c ratio was defined according to a predetermined equation, considering high CVD risk values greater than 2.5 for women and greater than 3.5 for men. The anthropometric parameters used were the body mass index (BMI) and the waist circumference (WC). Social data, lifestyle, clinical and biochemical data were also collected. Results: Fifty patients (55.6%) had a high TG / HDL ratio. Patients with abnormal BMI and WC were at a higher cardiovascular risk, as measured by the TG / HDL-c ratio. There was a statistically significant difference between the anthropometric measurements (BMI and the WC), and the TG / HDL-c ratio in the stratified analysis. However, in the adjusted analysis no association between the BMI or the WC and the TG/HDL ratio was observed. Conclusion: There was no association between the TG / HDL-C ratio and the adiposity measurements (BMI and WC) in the adjusted analysis. The results of this study question the real influence of overweight and central obesity in the TG / HDL-c ratio (AU)

Ângulo de fase e marcadores tradicionais do estado nutricional em pacientes renais crônicos antes e após a hemodiálise / Phase angle and traditional markers of nutritional status in patients with chronic renal failure before and after hemodialysis

Introdução: Na prática clínica são muitos os métodos utilizados na avaliação de pacientes em hemodiálise, a maioria com limitações. O ângulo de fase, uma variável da bioimpedância elétrica, vem se destacando como importante indicador prognóstico, mas sua relação com marcadores nutricionais é controversa. Objetivo: Avaliar a existência de correlação e concordância entre o ângulo de fase padronizado e marcadores tradicionais do estado nutricional em pacientes renais crônicos, antes e após o tratamento dialítico. Métodos: Estudo transversal com 57 pacientes em hemodiálise, de ambos os sexos, em uma unidade de tratamento dialítico, Salvador, Bahia, Brasil. Os participantes foram avaliados por antropometria, bioimpedância e dinamometria, antes e após a hemodiálise. Foram realizadas análises descritivas, teste T de Student, correlação de Pearson e concordância a partir do coeficiente Kappa. Resultados: Não houve diferença significante no período pré e pós-diálise para as variáveis: circunferência muscular do braço, força do aperto de mão e percentual de massa celular corporal. No período pré-diálise, a correlação foi positiva e fraca entre o ângulo de fase padronizado e o índice de massa corporal, a circunferência muscular do braço, a força do aperto de mão e o percentual de massa celular corporal. No período pós-diálise o percentual de massa celular corporal foi a única variável que não teve correlação estatisticamente significante. A análise de concordância entre o ângulo de fase padronizado e demais parâmetros, no período pré-diálise, mostrou concordâncias pobres ou fracas. No período pós-diálise houve discordância com a percentual de massa celular corporal e concordância moderada com a força do aperto de mão. Conclusão: O ângulo de fase padronizado apresentou correlações fracas com os indicadores antropométricos e moderada concordância com a força do aperto de mão (AU)

Introducion: In clinical practice there are many methods used to assess patients on hemodialysis, most with limitations. The phase angle, a variable of the electric bioimpedance, has been excelling as an important prognostic indicator, but its relation to nutritional markers is controversial. Objective: To evaluate the existence of correlations and concordances between the standard phase angle and traditional markers of nutritional status in patients with chronic renal failure, prior to and following dialysis treatment. Methods: A transversal study with fifty-seven hemodialysis patients, of both sexes, in a dialysis treatment unit, in Salvador, Bahia (Brazil). The participants were evaluated for anthropometry, bioimpedance, and dynamometry, before and after hemodialysis. We performed a descriptive analysis, Student’s t test, Pearson correlation and agreement from the kappa coefficient. Results: There was no significant difference between the pre- and post-dialysis period for the following variables: muscular circumference of the arm, handgrip force, and percentage of cellular body mass. In the pre-dialysis period, the correlation was positive and weak between the standard phase angle and the body mass index, the muscular circumference of the arm, handgrip force, and cellular body mass. In the post-dialysis period the percentage of cellular body mass was the only variable that had no statistically significant correlation. The analysis of concordance between the standard phase angle and other parameters, in the pre-dialysis period, showed poor or weak concordances. In the post-dialysis period there were discordances for the percentage of cellular body mass and moderate concordance for handgrip force. Conclusion: The standard phase angle presented weak correlations with the anthropométric indicators and moderate concordance for handgrip force (AU)

Correction: Factors Associated with Anemia in the Institutionalized Elderly.

[This corrects the article DOI: 10.1371/journal.pone.0162240.].

Factors Associated with Anemia in the Institutionalized Elderly.

As a common problem in long-term care facilities (LTCFs), anemia affects 25-63% of the elderly. The aim of the present study was to describe the prevalence and characteristics of anemia and its associated factors in the institutionalized elderly. The cross-sectional study was carried out with three hundred thirteen individuals aged ≥ 60 years, of both genders, living in long-term care facilities for the elderly in Salvador, Bahia, Brazil. Poisson regression (PR) with robust variance estimates was used to assess the factors related to anemia. The prevalence of anemia was 38%. Mild anemia was predominant in both genders (male: 26.8%; female: 21.1%), as normocytic and normochromic anemia, with no anisocytosis (69.75%). Anemia was associated with thinness (PR: 1.68; 95% CI: 1.04-2.72) and with moderate (PR: 1.98; 95% CI: 1.07-3.63) and total (PR: 2.61; 95% CI: 1.34-5.07) dependence in the final model. Severe dependence exhibited borderline significance (PR: 1.94; 95% CI: 1.00-3.77). The prevalence of anemia was high in the institutionalized elderly in both genders, with characteristics suggesting chronic diseases as the causal factor, and the frequency of occurrence was higher in thinness elderly with moderate to total dependence.

Cintura Hipertrigliceridêmica em Pacientes Hipertensos / Hypertriglyceridemic Waist in Hypertensive Patients

Fundamentos: O uso de diferentes critérios para a determinação da cintura hipertrigliceridêmica (CHT) pode resultar em interpretações imprecisas, podendo comprometer o diagnóstico de pacientes com risco de desenvolver doenças cardiovasculares. Objetivo: Avaliar a concordância no diagnóstico da CHT utilizando diferentes pontos de corte para classificação da circunferência da cintura, em pacientes hipertensos. Métodos: Trata-se de um estudo transversal realizado com 120 pacientes, de 30 a 74 anos de idade, de ambos os sexos em atendimento ambulatorial. Realizou-se avaliação antropométrica (peso, altura e circunferência da cintura) e dos níveis séricos de triglicérides. A CHT foi definida pela presença simultânea da circunferência da cintura aumentada e hipertrigliceridemia. A concordância entre os diagnósticos de cintura hipertrigliceridêmica foi avaliada pelo índice Kappa. Resultados: A prevalência da CHT foi maior em adultos, para ambos os sexos pelos critérios do International Diabetes Federation (IDF) e Organização Mundial de Saúde (OMS) (28%), já pelo National Cholesterol Education Program - Adult Treatment Panel III (NCEP-ATP III) foram identificados 22,7% de indivíduos. Identificou-se uma concordância quase perfeita (0,864) entre o diagnóstico da CHT pelos pontos de corte da IDF versus NCEP-ATP III, OMS versus NCEP-ATP III. Entre o IDF e OMS a concordância foi perfeita. Conclusão: A utilização dos pontos de corte da circunferência da cintura propostos pelo IDF e OMS, para caracterizar indivíduos com cintura hipertrigliceridêmica foi melhor do que a do NCEP-ATP III

Background: The adoption of different criteria to determine the occurrence of the hypertriglyceridemic waist (HTW) can result in inaccurate interpretations, compromising the diagnosis of patients at risk of developing cardiovascular diseases. Objective: To evaluate the diagnostic agreement of HTW using different cut-off points for waist circumference in hypertensive patients. Methods: Cross-sectional study including 120 patients of both sexes, aged 30 to 74 years and receiving care on an outpatient basis. We assessed the participants' anthropometric data (weight, height, and waist circumference) and determined their serum triglycerides levels. The diagnosis of HTW was defined by concurrent increased waist circumference and hypertriglyceridemia. The agreement among the diagnoses of HTW was assessed with the kappa index. Results: In adults of both sexes, the HTW had a higher prevalence (28%) when determined by the criteria defined by the International Diabetes Federation (IDF) and the World Health Organization (WHO) than by those defined by the National Cholesterol Education Program - Adult Treatment Panel III (NCEP-ATP III, 22.7%). We identified an almost perfect agreement (0.864) between the diagnosis of HTW determined by the cut-off points of the IDF versus NCEP-ATP III and by the WHO versus NCEP-ATP III. The correlation was perfect between the diagnoses established by the IDF and WHO. Conclusion: The cut-off points for waist circumference proposed by the IDF and WHO was better than those by the NCEP-ATP III to characterize individuals with HTW

Perfil metabólico, antropométrico e lipodistrofia em pessoas vivendo com HIV/AIDS em uso de terapia antirretroviral / Metabolic profile, anthropometric and lipodystrophy in people living with HIV/AIDS in antiretroviral therapy

Introdução: A morbidade e mortalidade associadas à infecção pelo HIV tem se modificado nas últimas décadas devido à evolução da terapia antirretroviral de alta potência (TARV). Contudo, os efeitos adversos ainda têm sido relatados com a realização desse tratamento. O objetivo deste estudo foi avaliar o perfil metabólico, antropométrico e a presença de lipodistrofia em pessoas vivendo com HIV/AIDS em uso de terapia antirretroviral, segundo sexo. Métodos: Corresponde a um estudo transversal realizado em um centro de referência em HIV/aids, na cidade de Salvador-Bahia-Brasil. O perfil metabólico foi analisado através da dosagem de glicemia de jejum e do perfil lipídico. O estado antropométrico pelo Índice de Massa Corpórea, circunferência da cintura e razão cintura/quadril. Além disso, a lipodistrofia foi diagnosticada pela técnica de auto relato do paciente somada a confirmação pelo profissional de saúde. Foram realizadas análises descritivas e Teste Qui-quadrado. Resultados: A amostra foi composta por 80 pacientes, sendo 45 (56,3%) do sexo feminino, com média de idade 43,19, DP 7,46 anos. A maioria das mulheres apresentou obesidade central e baixos índices de lipoproteína de alta densidade. Identificou-se que 75% (60) dos indivíduos avaliados apresentavam lipodistrofia. Entre os pacientes com lipodistrofia 53,3% (32) apresentaram hipercolesterolemia (p=0,009). Discussão: Apesar dos avanços científicos, a terapia antirretroviral ainda está associada a alterações do perfil lipídico, de parâmetros antropométricos e a presença de lipodistrofia. Conclusão: Em pessoas vivendo com HIV/AIDS em uso de terapia antirretroviral foram encontradas alterações metabólicas, caracterizadas por hipertrigliceridemia e baixos níveis de HDL, obesidade central e a lipodistrofia com diferenças entre homens e mulheres (AU)

Introduction: The morbidity and mortality associated with HIV infection has changed in the last decades due to the evolution of antiretroviral therapy high (HAART). However, adverse effects have yet been reported with such processing. The aim of this study was to evaluate the metabolic profile, anthropometric and presence of lipodystrophy, in people living with HIV / AIDS in antiretroviral therapy, according to gender. Methods: Corresponds to a cross-sectional study in a referral center for HIV/AIDS in the city of Salvador, Bahia, Brazil. The metabolic profile was analyzed by measurement of fasting glucose and lipid profile, anthropometric status by body mass index and waist circumference and and waist / hip ratio. The lipodystrophy was diagnosed by the technique of self-report of the patient added to confirmation health professionals. Descriptive analyzes and chi - square test were performed. Results: The sample consisted of 80 patients, 45 (56.3 %) females, mean age 43.19 SD 7.46 years. In the study, the majority of women had central obesity and low levels of high density lipoprotein. Was identified that 75% (60) of the subjects evaluated had lipodystrophy. Among patients with lipodystrophy 53.3% (n = 32) had hypercholesterolemia (p = 0.009).Discussion: Despite advances in antiretroviral therapy is still associated with changes in lipid profile, anthropometric parameters and the presence of lipodystrophy. Conclusion: In people living with HIV / AIDS on antiretroviral therapy, metabolic abnormalities were found, characterized by hypertriglyceridemia and low HDL levels, central obesity and lipodystrophy with differences between men and women (AU)

Hypertriglyceridemic waist phenotype: association with metabolic disorders and visceral fat in adults / Fenotipo cintura hipertrigliceridémica: relación entre cambios metabólicos y grasa visceral en adultos

Objective: To evaluate the association of Hypertriglyceridemic waist with metabolic disorders and visceral fat in adults. Methods: Cross-sectional study with 191 individuals of both sexes. Subjects were grouped according to Waist Circumference (WC) ratings (Men: > 90 cm; Women: > 80 cm) and triglycerides (TG) (> 150 mg/dl) in Group 1 (HTW Phenotype): elevated WC and TG; Group 2 (absence of HTW Phenotype): elevated WC and normal TG or normal WC and elevated TG or normal WC and TG. Metabolic alternations, visceral adipose tissue (VAT) and visceral/subcutaneous fat index (VF/SF) measured by computed tomography were evaluated as cardiovascular risk factors between the groups. Results: Individuals with HTW phenotype, 82% had three or more cardiovascular risk factors. The association between cardiovascular risk factors with HTW phenotype revealed that among men 73.7% had hypercholesterolemia, 94.9% elevated non-HDLc and 78.9% excess of VAT area (p = 0.001). Among women, 65% had elevated Sistolic Blood Plessure, 80% hypercholesterolemia and 90% elevated non-HDLc (p < 0.02). Conclusion: The HTW phenotype associated with the metabolic alternations and VAT excess. Individuals with HTW had higher number of cardiovascular risk factors. The Hypertriglyceridemic waist can be used in clinical practice for investigating cardiovascular risk and visceral adipose tissue in individuals (AU)

Objetivo: Evaluar la relación entre Cintura Hipertrigliceridémica (CHT) con cambios metabólicos y grasa visceral en adultos. Métodos: Estudio transversal con 191 personas de ambos sexos. Los participantes fueron agrupados según clasificación de Circunferencia de Cintura (CC) (Hombres: > 90 cm; Mujeres: > 80 cm) y triglicéridos séricos (TG) (>150 mg/dl) en el Grupo 1 (Fenotipo CHT): Elevación en CC y TG; Grupo 2 (ausencia del Fenotipo CHT): Aumento en CC y TG normal, o CC normal y TG elevado o CC y TG normales. Cambios metabólicos, área del tejido adiposo visceral (TAV) y índice de grasa visceral/subcutáneo (GV/GS), medidas por tomografía computadorizada, fueron evaluados como factores de riesgo cardiovascular entre los grupos. Resultados: De los participantes con el Fenotipo CHT, 82% presentaban tres o más factores de riesgo cardiovascular. La relación entre los factores de riesgo cardiovascular y el Fenotipo CHT demostró que entre los hombres 73,7% presentaban hipercolesterolemia, 94,9% noHDLc elevado y 78,9% exceso de área TAV (p = 0,001). Entre las mujeres, 65% presentaban presión arterial sistólica alta, 80% hipercolesterolemia y 90% no-HDLc elevado (p < 0,02). Conclusión: El Fenotipo CHT se relacionó con cambios metabólicos y exceso de TAV. Personas con CHT presentaron más factores de riesgo cardiovascular. La Cintura Hipertrigliceridémica puede ser utilizada en la práctica clínica para investigar el riesgo cardiovascular y el depósito del tejido adiposo visceral en las personas (AU)

[Nutritional status and food intake of continuous peritoneal dialysis patients with and without secondary hyperparathyroidism]. / Estado nutricional e ingestão alimentar de pacientes em diálise peritoneal contínua com e sem hiperparatireoidismo secundário.

INTRODUCTION: Secondary hyperparathyroidism (SHPT) is a common and early complication in chronic kidney disease (CKD) patients. Studies have suggested that high levels of parathyroid hormone (PTH) may have deleterious effects on the nutritional status of patients with CKD. Thus, the aim of this study was to compare the nutritional status of CKD patients in continuous peritoneal dialysis (CPD) with and without SHPT. OBJECTIVE: The aim of this study was to compare the nutritional status of CKD patients in continuous peritoneal dialysis (CPD) with and without SHPT. METHODS: 74 patients were evaluated, including adults and seniors, divided into two groups according to PTH levels. In group 1 (n = 18) levels of PTH higher than 300 pg/mL and in group 2 less than or equal to 300 pg/mL. The nutritional status of patients was assessed by anthropometry, biochemical and subjective global assessment (SGA). Food intake was measured by food record for 3 days. We also collected clinical data, such as calcium and serum phosphorus, and the presence of inflammation was assessed by measuring C-reactive protein ultra-sensitive (CRP US). RESULTS: The average age of the population studied was 54.97 ± 17.06 years, with predominance of adult patients (58.1%) and females (56.8%). The time of CPD expressed in median was 17 months (7.75-33). Through ASG, it was shown a prevalence of 36.5% of the population undernourished. In the analysis of difference between the groups in relation to anthropometry, biochemical indicators and ASG as well as food intake, there were no differences between the groups. CONCLUSION: There were no differences in nutritional status and dietary intake between patients with and without SHPT.

Estado nutricional e ingestão alimentar de pacientes em diálise peritoneal contínua com e sem hiperparatireoidismo secundário / Nutritional status and food intake of continuous peritoneal dialysis patients with and without secondary hyperparathyroidism

INTRODUÇÃO: O hiperparatireoidismo secundário (HPT2) é uma complicação comum e precoce em pacientes com doença renal crônica (DRC). Estudos têm sugerido que os altos níveis de paratormônio (PTH) podem exercer efeitos deletérios no estado nutricional de pacientes com DRC. Assim, o objetivo deste estudo foi comparar o estado nutricional de pacientes com DRC em diálise peritoneal contínua (DPC) com e sem HPT2. OBJETIVO: O objetivo deste estudo é comparar o estado nutricional de pacientes com DRC em diálise peritoneal contínua (DPC) com e sem HPTS. MÉTODOS: Foram avaliados 74 pacientes, entre adultos e idosos, divididos em dois grupos, de acordo com os níveis de PTH. No grupo 1 (n = 18) os níveis de PTH eram maiores do que 300 pg/mL e, no grupo 2, menores ou iguais a 300 pg/mL. O estado nutricional dos pacientes foi avaliado através da antropometria, exames bioquímicos e avaliação subjetiva global (ASG). O consumo alimentar foi avaliado através do registro alimentar de 3 dias. Foram coletados também dados clínicos, como cálcio e fósforo séricos, e a presença de inflamação foi avaliada através da dosagem de proteína C reativa ultrassensível (PCR US). RESULTADOS: A média de idade da população estudada foi de 54,97 ± 17,06 anos, com predominância de pacientes adultos (58,1%) e do sexo feminino (56,8%). O tempo de DPC expresso em mediana foi de 17 meses (7,75-33). Através da ASG, demonstrou-se prevalência de 36,5% de desnutridos na população. Na análise de diferença entre os grupos, em relação à antropometria, indicadores bioquímicos e ASG, bem como ingestão alimentar, não foram evidenciadas diferenças entre os grupos estudados. CONCLUSÃO: Não houve diferenças no estado nutricional e na ingestão alimentar entre os pacientes com e sem HPT2.

INTRODUCTION: Secondary hyperparathyroidism (SHPT) is a common and early complication in chronic kidney disease (CKD) patients. Studies have suggested that high levels of parathyroid hormone (PTH) may have deleterious effects on the nutritional status of patients with CKD. Thus, the aim of this study was to compare the nutritional status of CKD patients in continuous peritoneal dialysis (CPD) with and without SHPT. OBJECTIVE: The aim of this study was to compare the nutritional status of CKD patients in continuous peritoneal dialysis (CPD) with and without SHPT. METHODS: 74 patients were evaluated, including adults and seniors, divided into two groups according to PTH levels. In group 1 (n = 18) levels of PTH higher than 300 pg/mL and in group 2 less than or equal to 300 pg/mL. The nutritional status of patients was assessed by anthropometry, biochemical and subjective global assessment (SGA). Food intake was measured by food record for 3 days. We also collected clinical data, such as calcium and serum phosphorus, and the presence of inflammation was assessed by measuring C-reactive protein ultra-sensitive (CRP US). RESULTS: The average age of the population studied was 54.97 ± 17.06 years, with predominance of adult patients (58.1%) and females (56.8%). The time of CPD expressed in median was 17 months (7.75-33). Through ASG, it was shown a prevalence of 36.5% of the population undernourished. In the analysis of difference between the groups in relation to anthropometry, biochemical indicators and ASG as well as food intake, there were no differences between the groups. CONCLUSION: There were no differences in nutritional status and dietary intake between patients with and without SHPT.

Methods of predicting visceral fat in Brazilian adults and older adults: a comparison between anthropometry and computerized tomography.

Visceral adipose tissue (VAT) is linked with the metabolic consequences of obesity, being necessary the use alternative methods of predicting this type of fat, like anthropometry. The objective of this study was assess the performance of anthropometry in predicting visceral fat measured with computerized tomography in adults and older adults. Study transversal with 197 individuals underwent computerized tomography (CT) and anthropometry. The variables analized were: visceral adipose tissue area by CT, Sagittal Abdominal Diameter (SAD), Waist Circumference (WC) and Waist-Hip Ratio (WHR). A descriptive analysis, Pearson correlation and ROC curve were carried out. We observed Correlations higher than 0.7 (p = 0.000) between the SAD, WC and the VAT area were found in adult men and older men and in adult women. WHR displayed the least correlations. The most sensitive and specific SAD cut-off points were equal for all the men (Adults: 20.2 cm/Older adults: 20.2 cm) but different for the women (Adults: 21.0 cm; sens.: 83.3; spec.: 79.1/Older adults: 19.9 cm; sens.: 81.0; spec.:79.3). The WC cutoff points that identified a VAT area = 130 cm2 were 90.2 cm and 92.2 cm for men (adult men--sens.: 86.7; spec.: 86.1--and older men-sens.: 79.3; spec.: 77.8 -respectively), while for women the recorded values were 92.3 cm (adult women--sens.: 83.3; spec: 81.4) and 88.2 cm (older women--sens.:76.2; spec.: 69.0). This study showed that WC and SAD achieved the best performance in the identification of visceral fat considered at risk for the development of cardiometabolic diseases in adults and older adults.

Imaging assessment of visceral adipose tissue area and its correlations with metabolic alterations.

BACKGROUND: Androgenic obesity is associated with a higher risk of metabolic disorders, thus favoring the occurrence of cardiovascular diseases and other morbidities. OBJECTIVE: To verify the influence of the visceral adipose tissue (VAT) area, measured by computed tomography (CT), on the metabolic alterations in adult and elderly individuals. METHODS: CT results and lipoprotein levels, total cholesterol and fractions, triglycerides, glycemia and uric acid levels, were obtained from 194 individuals stratified by sex, age group and body mass and analyzed using the tests of correlation and means. RESULTS: The elderly individuals presented higher VAT area, glycemia, uric acid and total cholesterol levels. The most important correlations were observed between VAT area, triglycerides (TG) and VLDL-c (r > 0.5; p < 0.01), in both age groups. The mean VAT area was always higher when TG and glycemia levels were altered, in both age groups. CONCLUSION: Most tests showed a strong correlation with VAT area, which was considered as risk for metabolic alterations. In elderly individuals, the risk VAT area seems to be higher than that of adult individuals.

Avaliação por imagem da área de gordura visceral e suas correlações com alterações metabólicas / Imaging assessment of visceral adipose tissue area and its correlations with metabolic alterations / Evaluación por imagen del área de grasa visceral y sus correlaciones con alteraciones metabólicas

FUNDAMENTO: A obesidade androgênica está associada a um risco maior de distúrbios metabólicos, favorecendo assim a ocorrência de doenças cardiovasculares e outras morbidades. OBJETIVO: Verificar a influência da área de tecido adiposo visceral (ATAV), medida pela tomografia computadorizada, sobre alterações metabólicas em adultos e idosos. MÉTODOS: Tomografias computadorizadas e valores de lipoproteínas: o colesterol total e frações, os triglicérides, a glicemia e o ácido úrico foram obtidos de 194 indivíduos estratificados por sexo, grupo etário e massa corporal, e analisados utilizando os testes de correlação e de média. RESULTADOS: Os idosos apresentaram maiores valores da ATAV, glicemia, ácido úrico e colesterol total. As maiores correlações foram encontradas entre a ATAV, os triglicérides e o VLDL-c (r > 0,5; p < 0,01), em ambos os grupos etários. A média da área de tecido adiposo visceral mostrou-se sempre mais elevada quando os valores de triglicérides e de glicemia estavam alterados, em ambos os grupos etários. CONCLUSÃO: A maioria dos exames apresentou forte correlação com a ATAV considerada de risco para alterações metabólicas. Em idosos, a área de tecido adiposo visceral de risco parece ser superior a de adultos.

BACKGROUND: Androgenic obesity is associated with a higher risk of metabolic disorders, thus favoring the occurrence of cardiovascular diseases and other morbidities. OBJECTIVE: To verify the influence of the visceral adipose tissue (VAT) area, measured by computed tomography (CT), on the metabolic alterations in adult and elderly individuals. METHODS: CT results and lipoprotein levels, total cholesterol and fractions, triglycerides, glycemia and uric acid levels, were obtained from 194 individuals stratified by sex, age group and body mass and analyzed using the tests of correlation and means. RESULTS: The elderly individuals presented higher VAT area, glycemia, uric acid and total cholesterol levels. The most important correlations were observed between VAT area, triglycerides (TG) and VLDL-c (r > 0.5; p < 0.01), in both age groups. The mean VAT area was always higher when TG and glycemia levels were altered, in both age groups. CONCLUSION: Most tests showed a strong correlation with VAT area, which was considered as risk for metabolic alterations. In elderly individuals, the risk VAT area seems to be higher than that of adult individuals.

FUNDAMENTO: La obesidad androgénica está asociada a un riesgo mayor de disturbios metabólicos, favoreciendo así la ocurrencia de enfermedades cardiovasculares y otras morbilidades. OBJETIVOS: Verificar la influencia del área de tejido adiposo visceral (ATAV), medida por la tomografía computarizada, sobre alteraciones metabólicas en adultos y adultos mayores. MÉTODOS: Tomografías computarizadas y valores de lipoproteínas: el colesterol total y fracciones, los triglicéridos, la glucemia y el ácido úrico se obtuvieron de 194 individuos estratificados por sexo, grupo de edad y masa corporal, y se analizaron utilizando las pruebas de correlación y de promedio. RESULTADOS: Los adultos mayores presentaron mayores valores de la ATAV, glucemia, ácido úrico y colesterol total. Las mayores correlaciones se encontraron entre la ATAV, los triglicéridos y el VLDL-c (r > 0,5; p < 0,01), en ambos grupos de edad. La media del área de tejido adiposo visceral se evidenció siempre más elevada cuando los valores de triglicéridos y de glucemia estaban alterados, en ambos grupos de edad. CONCLUSIÓN: La mayoría de los exámenes presentó fuerte correlación con la ATAV considerada de riesgo para alteraciones metabólicas. En adultos mayores, el área de tejido adiposo visceral de riesgo parece ser superior a la de adultos.

Desnutrição, inflamação e outros fatores de risco para doença cardiovascular em pacientes sob diálise peritoneal / Malnutrition, inflammation and other risk factors for cardiovascular diseases in patients undergoing peritoneal dialysis

OBJETIVO: Identificar a ocorrência de desnutrição, inflamação e outros fatores de risco para doença cardiovascular em pacientes sob diálise peritoneal. MÉTODOS: Estudo transversal, envolvendo 61 pacientes em duas unidades de diálise em Salvador (BA). O estado nutricional foi avaliado por meio da Avaliação Subjetiva Global. Realizou-se a dosagem de proteína C reativa ultrassensível para determinar inflamação. Foram estudados fatores de risco tradicionais para doença cardiovascular, como gênero, idade, etilismo, tabagismo, sedentarismo, hipertensão, diabetes, dislipidemia e hábitos alimentares e fatores não tradicionais, como alterações no metabolismo de cálcio, fósforo e anemia. RESULTADOS: Nessa população, 36,0 por cento dos pacientes encontravam-se desnutridos e 49,2 por cento com processo inflamatório. Desnutrição e inflamação foram evidenciadas em 21,3 por cento dos pacientes. O grupo de pacientes desnutridos apresentou níveis maiores de proteína C reativa ultrassensível do que o de pacientes com bom estado nutricional (p=0,04). A elevada ocorrência dos outros fatores risco para doença cardiovascular também foi observada na população. CONCLUSÃO: A desnutrição ainda é frequente nos pacientes sob diálise peritoneal, assim como a inflamação. Pacientes desnutridos apresentam maiores níveis séricos de proteína C reativa ultrassensível do que aqueles com bom estado nutricional. Observa-se que muitos dos fatores de risco evidenciados na população estudada são passíveis de terapêutica.

OBJECTIVE: This study aimed to identify the occurrence of malnutrition, inflammation and other risk factors for cardiovascular diseases in patients undergoing peritoneal dialysis. METHODS: This is a crosssectional study comprising 61 patients from two dialysis units in Salvador (Bahia, Brazil). Nutritional status was determined by the global subjective assessment and inflammation by the ultra sensitive creactive protein levels. Traditional risk factors for cardiovascular diseases, such as gender, age, consumption of alcoholic beverages, smoking, inactivity, hypertension, diabetes, dyslipidemia and food habits, as well as nontraditional factors such as disturbed calcium and phosphorus metabolism and anemia, were investigated. RESULTS: Malnutrition was found in 36.0 percent of the patients in the population under study whereas inflammation was present in 49.2 percent of them. Patients with both malnutrition and inflammation were shown to comprise 21.3 percent of the sample. Ultra sensitive creactive protein levels were found to be higher (p=0.04) in malnourished patients than in those with good nutritional status. High rates of other risk factors for cardiovascular disease were also observed in this population. CONCLUSION: Malnutrition and inflammation are still common among patients undergoing peritoneal dialysis. Ultra sensitive creactive protein levels were found to be higher among malnourished patients than in well-nourished patients. Many of the risk factors found in the studied population are treatable.

Action of selective serotonin reuptake inhibitor on aggressive behavior in adult rat submitted to the neonatal malnutrition

The effect of the malnutrition during suckling on the aggressiveness was investigated in adult rats treated or not with citalopram, a selective serotonin reuptake inhibitor (SSRI). The animals were divided into two groups according to the diet used: nourished groupó the rats received the control diet with 23 per cent protein during the life; and malnourished groupó the rats had its mothers submitted to diet with 7.8 per cent protein during suckling. At 120 days of age, each group was sub-divided according to the treatment: acute ó consisting a single i.p. injection of saline solution or 20-mg/Kg citalopram; chronic ó consisting the single injections (1 per day during 14 days) of saline or 20 mg/Kg citalopram. The acute or chronic treatment with SSRI reduces aggressive response in nourished rats, but not in malnourished ones. Thus, the malnutrition during the critical period of brain development seems to induce durable alterations in the function of the serotoninergic neurotransmission