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.

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.

PREVALENCE OF INSULIN RESISTANCE AND ASSOCIATION WITH METABOLIC RISK FACTORS AND FOOD CONSUMPTION IN ADOLESCENTS - RECIFE/BRAZIL.

OBJECTIVE: To identify the prevalence of insulin resistance in adolescents and its associations with metabolic factors and food intake. METHODS: Cross-sectional study conducted with a stratified, complex, school-based sample. The subjects were adolescents (n=1,081) who participated in the Study of Cardiovascular Risk in Adolescents in the city of Recife (Pernambuco, Brazil). We analyzed demographic, socioeconomic, behavioral, anthropometric, biochemical, and dietary variables. Insulin resistance was defined as HOMA-IR>75th percentile. A Poisson multivariate regression model with robust variance adjustment was used, and variables with p≤0.05 in the final model were considered statistically associated with insulin resistance. RESULTS: Median age was 14 years (interquartile range: 13-16 years), and 25.3% of the sample showed insulin resistance. The variables associated with insulin resistance in the final model were age, body mass index-for-age (BMI/A), biochemical markers (triglycerides and high-density lipoprotein cholesterol) and saturated fat intake, with insulin resistance being more prevalent in individuals whose consumption of this type of fat was below the median of the sample distribution. CONCLUSIONS: Insulin resistance was prevalent in the adolescents analyzed and was significantly associated with metabolic variables and saturated fat intake.

Prevalence of insulin resistance and association with metabolic risk factors and food consumption in adolescents - recife/brazil / Prevalência de resistência à insulina e associação com fatores de risco metabólicos e consumo alimentar de adolescentes - recife/brasil

ABSTRACT Objective: To identify the prevalence of insulin resistance in adolescents and its associations with metabolic factors and food intake. Methods: Cross-sectional study conducted with a stratified, complex, school-based sample. The subjects were adolescents (n=1,081) who participated in the Study of Cardiovascular Risk in Adolescents in the city of Recife (Pernambuco, Brazil). We analyzed demographic, socioeconomic, behavioral, anthropometric, biochemical, and dietary variables. Insulin resistance was defined as HOMA-IR>75th percentile. A Poisson multivariate regression model with robust variance adjustment was used, and variables with p≤0.05 in the final model were considered statistically associated with insulin resistance. Results: Median age was 14 years (interquartile range: 13-16 years), and 25.3% of the sample showed insulin resistance. The variables associated with insulin resistance in the final model were age, body mass index-for-age (BMI/A), biochemical markers (triglycerides and high-density lipoprotein cholesterol) and saturated fat intake, with insulin resistance being more prevalent in individuals whose consumption of this type of fat was below the median of the sample distribution. Conclusions: Insulin resistance was prevalent in the adolescents analyzed and was significantly associated with metabolic variables and saturated fat intake.

RESUMO Objetivo: Identificar a prevalência de resistência à insulina em adolescentes e verificar sua associação com variáveis metabólicas e com o consumo alimentar. Métodos: Estudo transversal, de base escolar, com amostra do tipo estratificada e complexa. Os indivíduos analisados foram adolescentes (n=1.081) participantes do Estudo de Riscos Cardiovasculares em Adolescentes (ERICA) na cidade de Recife (Pernambuco, Brasil). Foram coletadas variáveis demográficas, socioeconômicas, comportamentais, antropométricas, bioquímicas e do consumo alimentar. A resistência à insulina foi definida como HOMA-IR>percentil 75. Análises de regressão de Poisson com ajuste robusto da variância foram empregadas, sendo identificadas associações estatisticamente significativas quando p≤0,05. Resultados: A idade mediana foi de 14 anos (intervalo interquartílico=13-16) e a resistência à insulina foi evidenciada em 25,3% da amostra. As variáveis que se associaram significativamente com a resistência à insulina no modelo final foram a faixa etária, o índice de massa corpórea por idade (IMC/I), marcadores bioquímicos (triglicerídeos e HDL-colesterol) e o consumo alimentar de gordura saturada, observando-se maior prevalência da resistência à insulina naqueles indivíduos que apresentaram a ingestão deste tipo de gordura abaixo da mediana da própria distribuição. Conclusões: A resistência à insulina foi prevalente nos adolescentes avaliados e se associou significativamente com variáveis metabólicas e com o consumo alimentar de gordura do tipo saturada.

Prevalence of Systemic Arterial Hypertension and Associated Factors Among Adults from the Semi-Arid Region of Pernambuco, Brazil / Prevalência e Fatores Associados à Hipertensão Arterial Sistêmica em Adultos do Sertão de Pernambuco, Brasil

Abstract Background: Systemic arterial hypertension is a substantial public health problem responsible for millions of deaths per year worldwide. However, little is known about the epidemiology of this disease in areas distant from large urban centers in Brazil. Such information is necessary to plan health promotion strategies. Objective: To estimate the prevalence of hypertension and determine its associated factors in adults residing in the semi-arid region of the state of Pernambuco, Northeastern Brazil. Method: This is a cross-sectional study conducted with a random sample of male and female adults. Individuals with systolic blood pressure ≥ 140 mm/Hg and/or diastolic blood pressure ≥ 90 mm/Hg and those who reported being under treatment with antihypertensive drugs were considered hypertensive. We collected data on demographic, socioeconomic, behavioral, and anthropometric characteristics, as well as health and nutrition. The statistical analysis used Pearson's chi-square test, the chi-square test for trend, and multivariate Poisson regression analysis. A p-value < 0.05 in the final model was considered indicative of statistical significance. Results: The sample consisted of 416 individuals, and the prevalence of hypertension was 27.4% (95%CI 23.2 - 32.0). In the final model, the independent predictors of hypertension were age of 40 years or older (p = 0.000), low economic class (p = 0.007), smoking (p = 0.023), overweight determined by the body mass index (p = 0.003), and reduced glucose tolerance/diabetes mellitus (p = 0.012). Conclusion: The prevalence of hypertension was high and related to important risk factors. Thus, prevention and control strategies are recommended.

Resumo Fundamento: A hipertensão arterial sistêmica (HAS) constitui grande problema de saúde pública, responsável por milhões de mortes por ano no mundo. Apesar disso e frente à necessidade de informações para o delineamento de estratégias de promoção da saúde, pouco se conhece sobre a epidemiologia da doença em regiões distantes dos grandes centros urbanos brasileiros. Objetivo: Estimar a prevalência e verificar os aspectos associados à HAS em adultos do sertão de Pernambuco, Brasil. Métodos: Estudo de delineamento transversal, com uma amostra aleatória de adultos de ambos os sexos. Foram considerados hipertensos aqueles que apresentaram pressão arterial sistólica ≥ 140 mmHg e/ou diastólica ≥ 90 mmHg, além daqueles que relataram estar em tratamento com anti-hipertensivos. Informações demográficas, socioeconômicas, comportamentais, antropométricas e de saúde e nutrição foram coletadas. Foram aplicados os testes do 2 de Pearson, c2 para tendência e a regressão multivariada de Poisson. No modelo final, foi considerada significância estatística quando p < 0,05. Resultados: A amostra foi composta por 416 indivíduos e a prevalência de HAS foi de 27,4% (IC95% 23,2 - 32,0). No modelo final, foram identificados como preditores independentes da HAS a faixa etária a partir dos 40 anos (p = 0,000), classe econômica baixa (p = 0,007), tabagismo (p = 0,023), excesso de peso pelo índice de massa corporal (p = 0,003) e adultos com tolerância à glicose diminuída/diabetes mellitus (p = 0,012). Conclusão: A prevalência de HAS é elevada e se relaciona com fatores de risco importantes, logo, são recomendáveis ações de prevenção e controle.

Prevalence of Systemic Arterial Hypertension and Associated Factors Among Adults from the Semi-Arid Region of Pernambuco, Brazil.

BACKGROUND: Systemic arterial hypertension is a substantial public health problem responsible for millions of deaths per year worldwide. However, little is known about the epidemiology of this disease in areas distant from large urban centers in Brazil. Such information is necessary to plan health promotion strategies. OBJECTIVE: To estimate the prevalence of hypertension and determine its associated factors in adults residing in the semi-arid region of the state of Pernambuco, Northeastern Brazil. METHOD: This is a cross-sectional study conducted with a random sample of male and female adults. Individuals with systolic blood pressure ≥ 140 mm/Hg and/or diastolic blood pressure ≥ 90 mm/Hg and those who reported being under treatment with antihypertensive drugs were considered hypertensive. We collected data on demographic, socioeconomic, behavioral, and anthropometric characteristics, as well as health and nutrition. The statistical analysis used Pearson's chi-square test, the chi-square test for trend, and multivariate Poisson regression analysis. A p-value < 0.05 in the final model was considered indicative of statistical significance. RESULTS: The sample consisted of 416 individuals, and the prevalence of hypertension was 27.4% (95%CI 23.2 - 32.0). In the final model, the independent predictors of hypertension were age of 40 years or older (p = 0.000), low economic class (p = 0.007), smoking (p = 0.023), overweight determined by the body mass index (p = 0.003), and reduced glucose tolerance/diabetes mellitus (p = 0.012). CONCLUSION: The prevalence of hypertension was high and related to important risk factors. Thus, prevention and control strategies are recommended.

Estado nutricional e capacidade funcional de idosos oncológicos hospitalizados / Nutritional status and functional capacity of hospitalized oncological elderly

OBJETIVO: Avaliar o estado nutricional e a capacidade funcional de idosos oncológicos internados em um hospital universitário de Recife, Pernambuco. MÉTODOS: Estudo transversal, desenvolvido com indivíduos com câncer, do sexo masculino e feminino, com idade ≥ 60 anos. Para a identificação do estado nutricional, foi realizada aplicação da mini avaliação nutricional, seguida da avaliação antropométrica e aferição da força de preensão manual e por fim foi avaliada a capacidade funcional. As análises estatísticas foram realizadas pelo Statistical Package for Social Sciences 21.0. O nível de significância adotado foi de 5% (p ≤ 0,05). RESULTADOS: Participaram 51 idosos sendo a maioria do sexo masculino e tendo o câncer do sistema reprodutor como o mais prevalente. A desnutrição e o risco de desnutrição pela mini avaliação nutricional estiveram presentes em 7,8% e 33,4%, respectivamente. A maioria dos idosos não apresentavam desnutrição pela avaliação antropométrica. A força da mão tanto dos homens quanto das mulheres foi considerada adequada em sua maioria e foi observada uma correlação muito fraca entre a força de preensão manual com a idade de ambos os sexos. Dos idosos, 70,6% foram classificados como dependentes funcionais. O desempenho funcional se associou positivamente com a mini avaliação nutricional, o índice de massa corporal e a circunferência da panturrilha. CONCLUSÃO: Os achados demonstraram alta prevalência do risco nutricional e uma considerável desnutrição por meio da mini avaliação nutricional. Quanto à capacidade funcional, grande parte dos idosos apresentou dependência funcional, ressaltando a necessidade de se avaliar e monitorar o estado nutricional, bem como a capacidade funcional de geriátricos oncológicos hospitalizados

OBJECTIVE: To assess the nutritional status and functional capacity of elderly oncology admitted to a university hospital in Recife, Pernambuco. METHODS: Cross-sectional study developed with individuals with cancer, male and female, aged ≥ 60 years. For the identification of the nutritional status, the mini nutritional assessment was applied, followed by the anthropometric evaluation and manual grip strength, and finally the functional capacity was evaluated. Statistical analyzes were performed by the Statistical Package for Social Sciences 21.0. The level of significance was 5% (p ≤ 0.05). RESULTS: Fifty-one elderly people participated in the research, in which the majority were male, had cancer of the reproductive system. Malnutrition and the risk of malnutrition by the mini nutritional assessment were present in 7.8% and 33.4%, respectively. Most of the elderly did not present malnutrition due to anthropometric evaluation. The hand strength of both men and women was considered to be adequate for the most part, and a very weak correlation was observed between manual grip strength and the age of both sexes. Among the elderly, 70.6% were classified as functional dependents. The functional performance was positively associated with the mini nutritional assessment, the body mass index and the calf circumference. CONCLUSION: The findings showed a high prevalence of nutritional risk and considerable malnutrition through mini nutritional assessment. Regarding functional capacity, most of the elderly had functional dependence in at least one basic daily life activity. Emphasizing the need to evaluate and monitor the nutritional status as well as the functional capacity of hospitalized geriatric oncologists

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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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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.