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1.
Adv Exp Med Biol ; 1232: 331-337, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31893428

RESUMO

Obesity, a risk factor of coronary artery disease, is known to cause peripheral microcirculatory disturbances. This study evaluated the relationship between the degree of obesity and peripheral microcirculatory disturbances, using peripheral near infrared spectroscopy (NIRS) with a vascular occlusion test (VOT). We compared correlations between the NIRS parameter changes induced by VOT and body mass index (BMI) in patients with and without statin therapy. A NIRS probe was set on the right thenar eminence, brachial artery blood flow was blocked for 3 min, and then released. Although total hemoglobin (ΔcHb), deoxyhemoglobin (ΔHHb) and tissue oxygenation index (ΔTOI) were not correlated with BMI, a significant negative correlation was found between oxyhemoglobin (ΔO2Hb) and BMI in the overall study population (r = -0.255, p-value 0.02). In addition, a significant negative correlation was found between ΔO2Hb and BMI in patients without statin therapy (r = -0.353, p-value 0.02) but not in patients with statin therapy (r = -0.181, p-value 0.27). These findings suggest that ΔO2Hb may be a useful indicator to assess peripheral microcirculation.


Assuntos
Índice de Massa Corporal , Doença da Artéria Coronariana , Espectroscopia de Luz Próxima ao Infravermelho , Idoso , Feminino , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Masculino , Microcirculação/fisiologia , Oxigênio , Consumo de Oxigênio , Oxiemoglobinas/metabolismo , Fatores de Risco , Espectroscopia de Luz Próxima ao Infravermelho/normas
2.
Adv Exp Med Biol ; 1232: 355-360, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31893431

RESUMO

Epicardial adipose tissue (EAT) is associated with visceral fat and various cardiac disorders, such as atrial fibrillation and adverse cardiovascular events. Therefore, it is important to develop a simple and non-invasive inspection method to assess EAT, to prevent unfavorable cardiac events. This study assessed correlations between near-infrared spectroscopy (NIRS) changes induced by a vascular occlusion test (VOT) and EAT volume measured by cardiac computed tomography (CCT) in patients with suspected coronary artery disease. We also assessed correlations between body mass index (BMI) and EAT volume in the same population. In addition, these correlations were compared in patients treated with statin therapy and in those without statin therapy. A NIRS probe was set on the right thenar eminence, and brachial artery blood flow was blocked for 3 min before being released. A negative correlation was found between oxyhemoglobin (ΔO2Hb) and EAT volume in the overall study population (r = -0.236, p = 0.03). Interestingly, although a strong correlation was observed in patients without statin therapy (r = -0.488, p < 0.001), this correlation was not observed in patients with statin therapy (r = 0.157, p = 0.34). These findings suggest that NIRS measurements with VOT may be a useful method to identify patients with high EAT volume and high cardiovascular risks.


Assuntos
Doença da Artéria Coronariana , Espectroscopia de Luz Próxima ao Infravermelho , Tecido Adiposo/metabolismo , Idoso , Índice de Massa Corporal , Angiografia por Tomografia Computadorizada , Doença da Artéria Coronariana/diagnóstico , Feminino , Humanos , Masculino , Oxiemoglobinas/metabolismo , Fatores de Risco
3.
Bone Joint J ; 102-B(1): 108-116, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31888356

RESUMO

AIMS: Limited evidence is available on mid-term outcomes of robotic-arm assisted (RA) partial knee arthroplasty (PKA). Therefore, the purpose of this study was to evaluate mid-term survivorship, modes of failure, and patient-reported outcomes of RA PKA. METHODS: A retrospective review of patients who underwent RA PKA between June 2007 and August 2016 was performed. Patients received a fixed-bearing medial or lateral unicompartmental knee arthroplasty (UKA), patellofemoral arthroplasty (PFA), or bicompartmental knee arthroplasty (BiKA; PFA plus medial UKA). All patients completed a questionnaire regarding revision surgery, reoperations, and level of satisfaction. Knee Injury and Osteoarthritis Outcome Scores (KOOS) were assessed using the KOOS for Joint Replacement Junior survey. RESULTS: Mean follow-up was 4.7 years (2.0 to 10.8). Five-year survivorship of medial UKA (n = 802), lateral UKA (n = 171), and PFA/BiKA (n = 35/10) was 97.8%, 97.7%, and 93.3%, respectively. Component loosening and progression of osteoarthritis (OA) were the most common reasons for revision. Mean KOOS scores after medial UKA, lateral UKA, and PFA/BiKA were 84.3 (SD 15.9), 85.6 (SD 14.3), and 78.2 (SD 14.2), respectively. The vast majority of the patients reported high satisfaction levels after RA PKA. Subgroup analyses suggested tibial component design, body mass index (BMI), and age affects RA PKA outcomes. Five-year survivorship was 98.4% (95% confidence interval (CI) 97.2 to 99.5) for onlay medial UKA (n = 742) and 99.1% (95% CI 97.9 to 100) for onlay medial UKA in patients with a BMI < 30 kg/m2 (n = 479). CONCLUSION: This large single-surgeon study showed high mid-term survivorship, satisfaction levels, and functional outcomes in RA UKA using metal-backed tibial onlay components. In addition, favourable results were reported in RA PFA and BiKA. Cite this article: Bone Joint J 2020;102-B(1):108-116.


Assuntos
Artroplastia do Joelho/estatística & dados numéricos , Prótese do Joelho/estatística & dados numéricos , Procedimentos Cirúrgicos Robóticos/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Artroplastia do Joelho/métodos , Índice de Massa Corporal , Feminino , Seguimentos , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Osteoartrite do Joelho/cirurgia , Medidas de Resultados Relatados pelo Paciente , Falha de Prótese , Reoperação/estatística & dados numéricos , Estudos Retrospectivos
4.
BMJ ; 368: l6669, 2020 01 08.
Artigo em Inglês | MEDLINE | ID: mdl-31915124

RESUMO

OBJECTIVE: To examine how a healthy lifestyle is related to life expectancy that is free from major chronic diseases. DESIGN: Prospective cohort study. SETTING AND PARTICIPANTS: The Nurses' Health Study (1980-2014; n=73 196) and the Health Professionals Follow-Up Study (1986-2014; n=38 366). MAIN EXPOSURES: Five low risk lifestyle factors: never smoking, body mass index 18.5-24.9, moderate to vigorous physical activity (≥30 minutes/day), moderate alcohol intake (women: 5-15 g/day; men 5-30 g/day), and a higher diet quality score (upper 40%). MAIN OUTCOME: Life expectancy free of diabetes, cardiovascular diseases, and cancer. RESULTS: The life expectancy free of diabetes, cardiovascular diseases, and cancer at age 50 was 23.7 years (95% confidence interval 22.6 to 24.7) for women who adopted no low risk lifestyle factors, in contrast to 34.4 years (33.1 to 35.5) for women who adopted four or five low risk factors. At age 50, the life expectancy free of any of these chronic diseases was 23.5 (22.3 to 24.7) years among men who adopted no low risk lifestyle factors and 31.1 (29.5 to 32.5) years in men who adopted four or five low risk lifestyle factors. For current male smokers who smoked heavily (≥15 cigarettes/day) or obese men and women (body mass index ≥30), their disease-free life expectancies accounted for the lowest proportion (≤75%) of total life expectancy at age 50. CONCLUSION: Adherence to a healthy lifestyle at mid-life is associated with a longer life expectancy free of major chronic diseases.


Assuntos
Doenças Cardiovasculares , Diabetes Mellitus Tipo 2 , Estilo de Vida Saudável/fisiologia , Expectativa de Vida , Neoplasias , Comportamento de Redução do Risco , Adulto , Consumo de Bebidas Alcoólicas , Índice de Massa Corporal , Doenças Cardiovasculares/prevenção & controle , Doenças Cardiovasculares/psicologia , Diabetes Mellitus Tipo 2/prevenção & controle , Diabetes Mellitus Tipo 2/psicologia , Exercício , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/prevenção & controle , Neoplasias/psicologia , Pesquisa em Enfermagem , Estudos Prospectivos , Fumar
5.
Angiology ; 71(1): 77-82, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31018673

RESUMO

Nonalcoholic fatty liver disease (NAFLD) is a hepatic manifestation of the metabolic syndrome and is associated with cardiovascular disease (CVD). The NAFLD Fibrosis Score (NFS) is an index used for the detection of liver fibrosis. We investigated the relationship between NFS and complexity of coronary artery disease (CAD). In this cross-sectional study, 109 patients with CAD and 50 patients without CAD were enrolled. Demographic data, laboratory parameters, epicardial fat thickness (EFT), NFS, and Synergy between percutaneous coronary intervention with Taxus and cardiac surgery (SYNTAX) score were recorded. Waist circumference, fasting glucose, low-density lipoprotein cholesterol (LDL-C), EFT, and NFS were significantly higher in the CAD group (P < .05). High-density lipoprotein cholesterol (HDL-C) and ejection fraction were significantly lower in the CAD group (P < .05). The SYNTAX score was positively correlated with fasting glucose, LDL-C, EFT, and NFS and negatively correlated with HDL-C (P < .05). The NFS was positively correlated with EFT (P = .019). Multivariate linear regression analysis revealed that NFS (P = .012), EFT (P < .001), and LDL-C (P = .001) were independently associated with the SYNTAX score. In conclusion, NFS, as a marker of NAFLD, could identify patients at higher risk of CVD.


Assuntos
Tecido Adiposo/diagnóstico por imagem , Adiposidade , Angiografia Coronária , Doença da Artéria Coronariana/diagnóstico por imagem , Ecocardiografia , Cirrose Hepática/diagnóstico , Testes de Função Hepática , Hepatopatia Gordurosa não Alcoólica/diagnóstico , Pericárdio/diagnóstico por imagem , Tecido Adiposo/fisiopatologia , Idoso , Biomarcadores/sangue , Índice de Massa Corporal , Doença da Artéria Coronariana/fisiopatologia , Estudos Transversais , Feminino , Humanos , Cirrose Hepática/sangue , Masculino , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/sangue , Pericárdio/fisiopatologia , Valor Preditivo dos Testes , Prognóstico , Medição de Risco , Fatores de Risco , Índice de Gravidade de Doença
6.
Eur J Endocrinol ; 182(1): G1-G32, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31855556

RESUMO

Obesity is an emerging condition, with a prevalence of ~20%. Although the simple measurement of BMI is likely a simplistic approach to obesity, BMI is easily calculated, and there are currently no data showing that more sophisticated methods are more useful to guide the endocrine work-up in obesity. An increased BMI leads to a number of hormonal changes. Additionally, concomitant hormonal diseases can be present in obesity and have to be properly diagnosed - which in turn might be more difficult due to alterations caused by body fatness itself. The present European Society of Endocrinology Clinical Guideline on the Endocrine Work-up in Obesity acknowledges the increased prevalence of many endocrine conditions in obesity. It is recommended to test all patients with obesity for thyroid function, given the high prevalence of hypothyroidism in obesity. For hypercortisolism, male hypogonadism and female gonadal dysfunction, hormonal testing is only recommended if case of clinical suspicion of an underlying endocrine disorder. The guideline underlines that weight loss in obesity should be emphasized as key to restoration of hormonal imbalances and that treatment and that the effect of treating endocrine disorders on weight loss is only modest.


Assuntos
Índice de Massa Corporal , Hipotireoidismo/diagnóstico , Obesidade/diagnóstico , Comorbidade , Endocrinologia , Humanos , Hipotireoidismo/epidemiologia , Obesidade/epidemiologia , Prevalência , Testes de Função Tireóidea
7.
BJOG ; 127(1): 39-45, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31444892

RESUMO

OBJECTIVE: To explore the relation between famine exposure in early life and subsequent pregnancy loss, including stillbirth, and spontaneous abortion in adulthood. DESIGN: A population-based, partly ecological study. SETTING AND POPULATION: Individual data of 58 601 females born around the time of the Great Chinese Famine in 1959-1961. METHODS: Associations between the famine exposure in early life and pregnancy loss (stillbirth and spontaneous abortion) in adulthood were analysed using negative binomial regression, with the non-exposure group as reference, adjusting for region, highest education, monthly income, alcohol consumption, tobacco use, body mass index in 25-year-olds and metabolic equivalent. Further analyses were stratified by rural versus urban region. MAIN OUTCOME MEASURES: Continuous variables of times of stillbirths and spontaneous abortions were used according to the individual self-reported reproductive history. RESULTS: No association was found between famine exposure and spontaneous abortion. In contrast, females experiencing the famine during their prenatal period (incidence rate ratio = 1.15, 95% CI 1.00-1.33) or infant period (incidence rate ratio = 1.27, 95% CI 1.12-1.44) were more likely to report stillbirth in later adult life. Such an association appeared stronger in women living in rural regions. CONCLUSIONS: Early life exposure of famine was associated with an increased risk of stillbirth but not spontaneous abortion in adulthood. The strength of such an association appeared stronger in rural areas. Given the high potential for unmeasured confounding, these associations must be interpreted with caution. Regarding the potential implication that undernutrition in the fetal period is related to reproductive outcome in adulthood, fetal nutritional supply may play an important role in human reproduction. TWEETABLE ABSTRACT: Exposure to famine in early life was associated with increased pregnancy loss in adulthood.


Assuntos
Aborto Espontâneo/epidemiologia , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Natimorto/epidemiologia , Adulto , Idoso , Índice de Massa Corporal , China/epidemiologia , Feminino , Humanos , Estilo de Vida , Pessoa de Meia-Idade , Gravidez , Saúde da População Rural
8.
BJOG ; 127(1): 47-56, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31512355

RESUMO

OBJECTIVE: To describe the epidemiology of rheumatic heart disease (RHD) in pregnancy in Australia and New Zealand (A&NZ). DESIGN: Prospective population-based study. SETTING: Hospital-based maternity units throughout A&NZ. POPULATION: Pregnant women with RHD with a birth outcome of ≥20 weeks of gestation between January 2013 and December 2014. METHODS: We identified eligible women using the Australasian Maternity Outcomes Surveillance System (AMOSS). De-identified antenatal, perinatal and postnatal data were collected and analysed. MAIN OUTCOME MEASURES: Prevalence of RHD in pregnancy. Perinatal morbidity and mortality. RESULTS: There were 311 pregnancies associated with women with RHD (4.3/10 000 women giving birth, 95% CI 3.9-4.8). In Australia, 78% were Aboriginal or Torres Strait Islander (60.4/10 000, 95% CI 50.7-70.0), while in New Zealand 90% were Maori or Pasifika (27.2/10 000, 95% CI 22.0-32.3). One woman (0.3%) died and one in ten was admitted to coronary or intensive care units postpartum. There were 314 births with seven stillbirths (22.3/1000 births) and two neonatal deaths (6.5/1000 births). Sixty-six (21%) live-born babies were preterm and one in three was admitted to neonatal intensive care or special care units. CONCLUSION: Rheumatic heart disease in pregnancy persists in disadvantaged First Nations populations in A&NZ. It is associated with significant cardiac and perinatal morbidity. Preconception planning and counselling and RHD screening in at-risk pregnant women are essential for good maternal and baby outcomes. TWEETABLE ABSTRACT: Rheumatic heart disease in pregnancy persists in First Nations people in Australia and New Zealand and is associated with major cardiac and perinatal morbidity.


Assuntos
Complicações Cardiovasculares na Gravidez/etnologia , Cardiopatia Reumática/etnologia , Adulto , Índice de Massa Corporal , Feminino , Humanos , Renda , Nova Zelândia/epidemiologia , Nova Zelândia/etnologia , Northern Territory/epidemiologia , Northern Territory/etnologia , Grupo com Ancestrais Oceânicos/etnologia , Paridade , Gravidez , Prevalência , Estudos Prospectivos , Adulto Jovem
9.
Kardiologiia ; 59(11S): 44-52, 2019 Sep 12.
Artigo em Russo | MEDLINE | ID: mdl-31884940

RESUMO

AIM:  To study influence of hypertension, overweight, hypertriglyceridemia and their combinations for all-cause and cardiovascular mortality risk formation. Methods. The prevalence of hypertension, overweight and hypertriglyceridemia was studied (1988-1991) by 27-year prospective cohort study of unorganized population of Tomsk (1546 persons - 916 female and 630 male). The predictive value of these risk factors for all-cause and cardiovascular mortality risk formation were researched in 2015. Hypertension was diagnosed in persons with blood pressure greater or equal to 140/90 mm Hg, overweight was diagnosed in people with body mass index 25 kg/m2, hypertriglyceridemia was diagnosed in individuals having high blood level of triglycerides (greater or equal to 1.7).  Results.  Influence of hypertension for all-cause (relative risk (RR) 2.2) and cardiovascular mortality (RR 3.38) risk formation was detected. A hypertension related elevation of mortality risk was observed both among women and men and in all age groups with the exception of men 40-59 years (the results for cardiovascular mortality in these persons was statistically insignificant). We established that hypertension had the independent significant contribution for mortality risk formation. It is shown that RR of all-cause mortality 1.25 times (cardiovascular mortality 1.8 times) more in overweight persons. Increase of relative mortality risk was detected in overweight women, especially in women 20-39 years old. Hypertriglyceridemia increases relative risk of all-cause mortality 1.46 times, relative risk of cardiovascular mortality 2.15 times, especially in individuals 40-59 years old. It was revealed that hypertriglyceridemia is significant risk factor for all-cause mortality formation only in women. Combination of hypertension and overweight increases the risk of all-cause mortality 2.23 times and the risk of cardiovascular mortality  4.0 times, combination of hypertension and hypertriglyceridemia - 2.83 and 5.06 times,  combination of overweight and hypertriglyceridemia - 1.73 and 2.99 times, respectively. We detected the additional risk of hypertriglyceridemia in individuals with overweight for all-cause (RR 1.53) and cardiovascular (RR 2.18) mortality risk formation compared with overweight persons with normal level of triglycerides and also the additional risk of hypertriglyceridemia (RR 1.51 and 2.04, respectively) in individuals with hypertension compared with normotensive persons (p<0,05). The additional risk of overweight in individuals with hypertension for all-cause mortality was found only in women (RR 3.23). Conclusion. The independent significant impact of hypertension for all-cause and cardiovascular mortality risk formation was revealed by the results of 27-year prospective study. Combination of hypertension and hypertriglyceridemia increases the risk of all-cause mortality 2.8 times and the risk of cardiovascular mortality 5.1 times, combination of hypertension and overweight - 2.2 and 4 times, combination of overweight and hypertriglyceridemia - 1.7 and 3 times, respectively. We detected the additional risk of hypertriglyceridemia for all-cause mortality in overweight people (RR 1.5) and in individuals with hypertension (RR 1.5). Also, the additional risk of hypertriglyceridemia for cardiovascular mortality risk formation in overweight people (RR 2.2) and in persons with hypertension (RR 2.0) was found.


Assuntos
Hipertensão , Hipertrigliceridemia , Sobrepeso , Adulto , Índice de Massa Corporal , Doenças Cardiovasculares , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco , Adulto Jovem
10.
Wei Sheng Yan Jiu ; 48(6): 888-944, 2019 Nov.
Artigo em Chinês | MEDLINE | ID: mdl-31875810

RESUMO

OBJECTIVE: To analyze the weight recognition and control among women aged 15-49 in China. METHODS: Data was from the China National Nutrition and Health Surveillance 2010-2013. Stratified multistage cluster sampling method was used. The data of 35 664(16 914 urban women and 18 750 rural women) 15-49 years old women of childbearing age was used. The basic information was collected by questionnaires. Physical measurement indexes such as height and weight were collected. RESULTS: Among overweight and obese women of childbearing age, only 34. 9%(95%CI 34. 2%-35. 6%) of them correctly judged themselves overweight or obese, and 61. 4%(95% CI 60. 6%-62. 1%) of them thought they were normal weight; 10. 8%(95%CI10. 3%-11. 2%) of the normal-weight women thought they were overweight; while 3. 0%(95% CI 2. 6%-3. 4%) of the low-weight women thought they were overweight. Only17. 1%(95% CI 16. 4%-17. 8%) of overweight and obese women of childbearing age take weight control measures. In addition, 3. 6%(95% CI 3. 1%-4. 1%) of low-weight women of childbearing age and 9. 7%(95% CI 9. 3%-10. 1%) of normal-weight women took weight control measures, respectively. The proportion of women aged 15-24 taking weight control measures was higher than that of women aged 25-34 and 35-49, 14. 8%(95% CI 13. 3%-16. 4%), 12. 2%(95% CI 11. 1%-13. 2%) and 10. 0%(95% CI9. 3%-10. 1%), respectively. The proportion of women aged 15-24 taking weight control measures was the highest among normal weight women and overweight and obese women, 13. 9%(95% CI 13. 1%-14. 7%) and 26. 9%(95% CI 26. 4%-27. 4%), respectively. CONCLUSION: At present, there were more women of childbearing age in China who could not correctly assess their own body weight, leading to the inability to take correct weight control measures.


Assuntos
Cognição , Sobrepeso , Adolescente , Adulto , Índice de Massa Corporal , Peso Corporal , China , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Prevalência , Adulto Jovem
11.
Wei Sheng Yan Jiu ; 48(6): 892-897, 2019 Nov.
Artigo em Chinês | MEDLINE | ID: mdl-31875811

RESUMO

OBJECTIVE: To analyze the height, weight and BMI of children and adolescents aged 6-17 in different sex, age and area in Henan Province from 2010 to2013. METHODS: Based on the monitoring of nutrition and health status of Chinese residents conducted in 9 urban and rural monitoring points in Henan Province from October 2010 to December 2013, 3221 aged 6-17 children and adolescents were selected by multi-stage stratification and population proportional random sampling method, including 1660 male students and 1561 female students; 420 in large cities, 628 in small and medium-sized cities, 1460 in rural areas, and 713 in poor rural areas. Family members basic information questionnaires were used to collect basic information, measured height, weight to obtain data, after weighted to analyze the height, weight, body mass index(BMI), stunting, wasting, overweight and obesity. RESULTS: In 2010-2013, the development of children and adolescents aged 6-17 in Henan Province were in line with the general principles. The height and weight development of urban students were generally better than those of rural students. The difference between urban and rural areas had been narrowed in BMI. The overall malnutrition rate in the province was 6. 89%. A total of 89 children and adolescents had stunting with a stunting rate of 2. 76%. In addition to stunting, there were 59 moderate-serve wasting(1. 83%) and 74 mild wasting(2. 30%). The malnutrition of rural students was more serious than that of cities. The overweight and obesity rates of children and adolescents in big cities, small and mediumsized cities, ordinary rural areas and poor rural areas were 10. 0%, 9. 69%, 5. 47%, 4. 56%, and 9. 02%, 9. 34%, 3. 40% and 4. 10%, respectively. The overweight and obese were more serious in urban than rural areas. Especially the obesity was epidemic in low-age primary school students. CONCLUSION: In view of the double burden coexists in stunting, wasting, overweight and obesity of children and adolescents in Henan Province, and meanwhile, the feature that malnutrition in rural students more serious, overweight and obese in urban students more critical, scientific and effective preventive measures should be carried out in time to ensure the healthy growth of children and adolescents, especially more attention on lower grade children in primary school.


Assuntos
Estado Nutricional , Sobrepeso , Adolescente , Índice de Massa Corporal , Criança , Cidades , Feminino , Humanos , Masculino , Prevalência , População Rural , População Urbana
12.
RECIIS (Online) ; 13(4): 854-862, out.-dez. 2019. ilus, tab
Artigo em Português | LILACS | ID: biblio-1047588

RESUMO

A avaliação do estado nutricional dos idosos possibilita uma intervenção adequada, a fim de evitar ou minimizar agravos à saúde que comprometam a capacidade funcional dessas pessoas. Nessa perspectiva, o trabalho apresentado neste artigo teve como objetivo verificar o estado nutricional e hábitos alimentares da população idosa do estado do Piauí. Foram utilizados dados de acesso público disponíveis no SISVAN Web referentes à avaliação nutricional realizada nos anos de 2014 a 2018. Observou-se aumento da prevalência de sobrepeso naquela população e uma diminuição do número de pessoas com baixo peso. Quando avaliados por sexo, as mulheres apresentaram maiores percentuais de excesso de peso em todos aqueles anos. O perfil do consumo alimentar mostrou que a maioria dos idosos consome alimentos in natura como frutas, verduras e feijão, e que, entre os que participaram da amostra, poucos fizeram uso de alimentos ultraprocessados. Por fim, cabe ressaltar a importância da avaliação do quadro de saúde da população como forma de subsídio para o planejamento de ações de saúde, dessa forma alocando melhor os recursos e possibilitando uma atuação eficaz dos que trabalham na área da saúde.


The evaluation of the nutritional status of the elderly allows the appropriate nutritional intervention avoiding or minimizing health problems that cause damage on their functional capacity. From this perspective, the study presented in this article aimed to verify the nutritional status and eating habits of the elderly population of the state of Piauí, Brazil. We used public access data available in the SISVAN Web regarding the nutritional evaluation carried out from 2014 to 2018. The data revealed an increase in the prevalence of overweight in that population and a reduction of the number of elderly with low weight. When evaluated by sex, women presented higher percentages of overweight in all those years. The food consumption profile showed that the majority of the eldery population consumes fresh foods such as fruits, vegetables and beans and only a few of participants of the sample consumed ultra-processed foods. Finally, the importance of the evaluation of the health of the population as a form of incentive to plan health actions is highlighted, so that the resources can be more competently allocated and the health care workers can act efficiently and effectively.


La evaluación del estado nutricional de las personas mayores permite una intervención nutricional adecuada evitando o minimizando los problemas de salud que comprometen su capacidad funcional. Desde esta perspectiva, el estudio presentado en este artículo tuvo como objetivo verificar el estado nutricional y los hábitos alimenticios de la población anciana del estado de Piauí, Brasil. Utilizamos los datos de acceso público disponibles en el SISVAN Web con respecto a la evaluación nutricional realizada desde los años 2014 hasta 2018. Se observó un aumento en la prevalencia del sobrepeso en laquella población y una disminución en el número de personas que tenían bajo peso. Cuando fueron evaluados por sexo, las mujeres presentaron porcentajes más altos de sobrepeso en todos aquellos años. El perfil del consumo de alimentos mostró que la mayoría de los ancianos consumía alimentos frescos como frutas, verduras y frijol, y pocos participantes de la muestra habían consumido alimentos ultraprocesados. Por fin, debe ser destacada la importancia de la evaluación de la salud de la población como una forma de incentivo para la planificación de acciones de salud, asignando así mejores recursos y posibilitando una actuación de los trabajadores de la salud eficiente y eficaz.


Assuntos
Humanos , Vigilância Nutricional , Envelhecimento , Saúde Pública , Fatores de Risco , Sistemas de Informação em Saúde , Qualidade de Vida , Idoso , Consumo de Alimentos , Índice de Massa Corporal , Estado Nutricional , Estudos Retrospectivos , Desnutrição , Sobrepeso , Obesidade
13.
Medicine (Baltimore) ; 98(50): e18213, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31852078

RESUMO

We aimed to investigate the association between excess body mass index (BMI) and papillary thyroid cancer (PTC) in an operative population, and the impact of higher BMI on clinicopathological aggressiveness of PTC.Charts of 10,844 consecutive patients with thyroid nodules undergoing partial or total thyroidectomy between 1993 and 2015 were reviewed. Patients diagnosed with PTC were stratified in 4 groups: BMI < 18.5 (underweight), 18.5 ≤ BMI < 24 (normal-weight), 24 ≤ BMI < 28 (overweight) and BMI ≥ 28(obese). The impacts of high BMI on prevalence and clinicopathological parameters of PTC were retrospectively analyzed in both univariate and multivariate binary logistic regression analysis.For every 5-unit increase in body mass, the odds of risk-adjusted malignance increased by 36.6%. The individuals who were obese and overweight were associated with high risk of thyroid cancer [odds ratio (OR)= 1.982, P < .001; OR= 1.377, P < .001; respectively] compared to normal weight patients, and this positive association was found in both genders. Obesity was independent predictors for tumors larger than 1 cm (OR = 1.562, P < .001) and multifocality (OR = 1.616, P < .001). However, there was no difference in cervical lymph node (LN) metastasis among BMI groups. Crude analysis showed BMI was associated with advanced tumor-node-metastasis (TNM) stage (relative risk, approximately 1.23 per 5 BMI units, P < .001), but this association disappeared after adjusting for confounding factors.Obesity was significantly associated with the risk of PTC in a large, operative population. Higher BMI was significantly associated with larger tumor size and multifocal tumor.


Assuntos
Índice de Massa Corporal , Obesidade/complicações , Câncer Papilífero da Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/diagnóstico , Tireoidectomia/métodos , Estudos de Casos e Controles , China/epidemiologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Estudos Retrospectivos , Câncer Papilífero da Tireoide/etiologia , Câncer Papilífero da Tireoide/cirurgia , Neoplasias da Glândula Tireoide/etiologia , Neoplasias da Glândula Tireoide/cirurgia
14.
N Engl J Med ; 381(25): 2440-2450, 2019 12 19.
Artigo em Inglês | MEDLINE | ID: mdl-31851800

RESUMO

BACKGROUND: Although the national obesity epidemic has been well documented, less is known about obesity at the U.S. state level. Current estimates are based on body measures reported by persons themselves that underestimate the prevalence of obesity, especially severe obesity. METHODS: We developed methods to correct for self-reporting bias and to estimate state-specific and demographic subgroup-specific trends and projections of the prevalence of categories of body-mass index (BMI). BMI data reported by 6,264,226 adults (18 years of age or older) who participated in the Behavioral Risk Factor Surveillance System Survey (1993-1994 and 1999-2016) were obtained and corrected for quantile-specific self-reporting bias with the use of measured data from 57,131 adults who participated in the National Health and Nutrition Examination Survey. We fitted multinomial regressions for each state and subgroup to estimate the prevalence of four BMI categories from 1990 through 2030: underweight or normal weight (BMI [the weight in kilograms divided by the square of the height in meters], <25), overweight (25 to <30), moderate obesity (30 to <35), and severe obesity (≥35). We evaluated the accuracy of our approach using data from 1990 through 2010 to predict 2016 outcomes. RESULTS: The findings from our approach suggest with high predictive accuracy that by 2030 nearly 1 in 2 adults will have obesity (48.9%; 95% confidence interval [CI], 47.7 to 50.1), and the prevalence will be higher than 50% in 29 states and not below 35% in any state. Nearly 1 in 4 adults is projected to have severe obesity by 2030 (24.2%; 95% CI, 22.9 to 25.5), and the prevalence will be higher than 25% in 25 states. We predict that, nationally, severe obesity is likely to become the most common BMI category among women (27.6%; 95% CI, 26.1 to 29.2), non-Hispanic black adults (31.7%; 95% CI, 29.9 to 33.4), and low-income adults (31.7%; 95% CI, 30.2 to 33.2). CONCLUSIONS: Our analysis indicates that the prevalence of adult obesity and severe obesity will continue to increase nationwide, with large disparities across states and demographic subgroups. (Funded by the JPB Foundation.).


Assuntos
Obesidade Mórbida/epidemiologia , Obesidade/epidemiologia , Adulto , Índice de Massa Corporal , Feminino , Previsões , Humanos , Renda , Masculino , Obesidade/etnologia , Obesidade Mórbida/etnologia , Prevalência , Autorrelato , Distribuição por Sexo , Estados Unidos/epidemiologia
15.
Medicine (Baltimore) ; 98(50): e18265, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31852096

RESUMO

The purpose of this study was to investigate the association between triglyceride glucose (TyG) index and abnormal liver function both in urban and rural Chinese adult populations. The 5824 urban (Nanjing) and 20,269 rural (Hefei) Chinese adults, from random selected households provided clinical history, glucose, lipids, anthropometric, and blood pressure measurements. Liver functions were assessed using Alanine Aminotransferase (ALT). Linear regression was applied to examine the dose-response relationship between TyG index and ALT. Logistic regression was used to estimate the association between TyG index and abnormal liver and function. Cubic spline models were applied to investigate the dose-response association between TyG index and abnormal liver function. C-statistics was used to compare the discriminable capacity over triglyceride, glucose and TyG index. Linear dose-response relationship was identified between TyG index and ALT as 1.222 IU increase by 1 unit increase of TyG index (1.242 for urban population and 1.210 for rural population). The 6.0% of urban and 11.0% of rural Chinese adults were observed to have abnormal liver function. The linear association between TyG index and abnormal liver function was revealed as 2.044 (1.930 to 2.165) of odds ratio by in unit increase of TyG index (2.334 for urban population and 1.990 for rural population). Higher C-statistics was found for TyG index compared with fasting glucose and triglyceride both in Chinese urban and rural populations. This study suggested in both urban and rural Chinese adult populations, TyG index is associated with abnormal liver function. TyG index is a potential indicator to identify high-risk individuals with metabolic disorders, for example impaired liver function in Chinese population, especially in Chinese urban population.


Assuntos
Alanina Transaminase/sangue , Glicemia/metabolismo , Hepatopatias/sangue , Vigilância da População , População Rural , Triglicerídeos/sangue , População Urbana , Adulto , Biomarcadores/sangue , Índice de Massa Corporal , China/epidemiologia , Estudos Transversais , Feminino , Seguimentos , Humanos , Incidência , Hepatopatias/epidemiologia , Testes de Função Hepática , Masculino , Pessoa de Meia-Idade , Morbidade/tendências , Fatores de Risco , Adulto Jovem
16.
Zhonghua Fu Chan Ke Za Zhi ; 54(12): 833-839, 2019 Dec 25.
Artigo em Chinês | MEDLINE | ID: mdl-31874473

RESUMO

Objective: To examine the association of pre-pregnancy obesity, excessive gestational weight gain (GWG) and gestational diabetes mellitus (GDM) with the risk of large for gestational age (LGA), and assess the dynamic changes in population attributable risk percent (PAR%) for having these exposures. Methods: A retrospective cohort study was conducted to collect data on pregnant women who received regular health care and delivered in Beijing Obstetrics and Gynecology Hospital from January to December in 2011, 2014 and 2017, respectively. Information including baseline characteristics, metabolic indicators during pregnancy, pregnancy complications, and pregnancy outcomes were collected. Multivariate logistic regression model was constructed to assess their association with LGA delivery. Adjusted relative risk and prevalence of these factors were used to calculate PAR%and evaluate the comprehensive risk. Results: (1)The number of participants were 11 132, 13 167 and 4 973 in 2011, 2014 and 2017, respectively. Corresponding prevalence of LGA were 15.19% (1 691/11 132), 14.98% (1 973/13 167) and 16.21% (806/4 973). No significant change in the prevalence of LGA was observed across all years investigated (all P>0.05). (2)According to results from multivariate logistic regression model, advanced maternal age, multiparity, pre-pregnancy overweight or obesity, GWG,GDM and serum triglyceride level≥1.7 mmol/L in the first trimester were associated with high risk of LGA (all P<0.05). Among these factors, pre-pregnancy overweight or obesity, excessive GWG and multiparity were common risk factors of LGA. GDM was not associated with risk of LGA in 2017 database. (3) Dynamic change of PAR% in these years were notable. PAR% of GWG for LGA decreased (32.6%, 27.2% and 22.2% in 2011, 2014 and 2017, respectively), while PAR% of pre-pregnancy overweight or obesity showed an upward trend (4.2%, 3.3% and 8.4%). In addition, PAR% of multiparity increased as well (3.5%, 6.3% and 15.9%). (4) Further analysis showed that excessive GWG in the first and second trimesters contributed the most (20.2% and 19.0% in 2014 and 2017). Conclusions: Excessive GWG, pre-pregnancy overweight or obesity and multiparity are the important risk factors what contribute to LGA. PAR% of excessive GWG for LGA decrease in recent years. However, GWG in the first and second trimesters is a critical factor of LGA. Appropriate weight management in pre-pregnancy, the first or second trimester is the key point to reduce the risk of LGA.


Assuntos
Diabetes Gestacional/epidemiologia , Macrossomia Fetal/epidemiologia , Obesidade/complicações , Peso ao Nascer , Índice de Massa Corporal , China/epidemiologia , Feminino , Macrossomia Fetal/etiologia , Idade Gestacional , Humanos , Obesidade/epidemiologia , Sobrepeso/complicações , Sobrepeso/epidemiologia , Gravidez , Complicações na Gravidez/epidemiologia , Estudos Retrospectivos , Ganho de Peso
17.
J Opioid Manag ; 15(5): 367-374, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31849028

RESUMO

OBJECTIVE: This study describes changes in weight and cardiovascular risk factors over time among individuals enrolled in methadone maintenance treatment for opioid use disorder. Demographic and clinical predictors of weight gain were also evaluated. DESIGN: This study was a retrospective chart review evaluating data over a period of 3 years. SETTING: Medical records of individuals enrolled in an academic research outpatient methadone maintenance treatment program were reviewed. PATIENTS: Seventy-four individuals who were admitted and retained in methadone maintenance treatment for at least 3 consecutive years were included. OUTCOME MEASURES: Annual weight was assessed by calculating body mass index (BMI). Changes over time in cardiovascular risk factors of hypertension, diabetes, and hypercholesterolemia were also assessed. RESULTS: The percentage of patients categorized as overweight, obese, or morbidly obese BMI increased from 42 percent (n = 31) at admission to 76 percent (n = 56), 82 percent (n = 61), and 88 percent (n = 65) at 1, 2, and 3 years post-admission, respectively. Hypertension, diabetes, and hypercholesterolemia also tended to increase following admission. BMI increases tended to be greater for those with a higher dose of methadone, as well as for females and Black/African American individuals. No other predictors of weight gain were identified. CONCLUSIONS: These data indicate that methadone maintenance treatment is associated with clinically meaningful weight gain and increases in cardiovascular risk factors. Given the importance of methadone maintenance for treatment of opioid use disorder, future research should examine additional predictors and potential mechanisms of weight gain among methadone patients and develop tailored interventions including nutritional knowledge and lifestyle recommendations.


Assuntos
Índice de Massa Corporal , Doenças Cardiovasculares , Metadona/efeitos adversos , Obesidade Mórbida , Analgésicos Opioides , Doenças Cardiovasculares/induzido quimicamente , Feminino , Humanos , Masculino , Obesidade Mórbida/induzido quimicamente , Estudos Retrospectivos , Fatores de Risco
18.
Medicine (Baltimore) ; 98(51): e18315, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31860982

RESUMO

The incidence of breast cancer among Japanese women is substantially increasing. This study evaluated the effects of reproductive and lifestyle factors with respect to breast cancer overall and separately among pre- and postmenopausal women using data from the Three-Prefecture Cohort Study of Japan.A total of 33,410 women aged 40 to 79 years completed a self-administered questionnaire, which included items about menstrual and reproductive history and other lifestyle factors. The follow-up period was from 1984 to 1992 in Miyagi and 1985 to 2000 in Aichi Prefectures. We used Cox proportional hazards regression models to estimate hazards ratios (HRs) and 95% confidence intervals (CIs) after adjusting for confounding factors.After 9.8 mean years of follow-up, 287 cases of breast cancer were recorded. In the overall analysis, later menarche (≥16 years) and parity were significantly associated with a decreased risk of breast cancer, with HRs of 0.69 (95% CI 0.48-0.99) and 0.72 (95% CI 0.52-0.99), respectively. Further, there was a significant decline in the risk of breast cancer with increasing number of birth among parous women (P for trend = .010). On the contrary, a family history of breast cancer in the mother was significantly associated with an increased risk of breast cancer (HR 3.22, 95% CI 1.52-6.84). Analyses based on menopausal status at baseline indicated that height (≥160 cm) and weight (≥65 kg) were significantly associated with an increased risk of postmenopausal breast cancer, with HRs of 1.34 (95% CI 0.72-2.50) and 3.13 (95% CI 1.75-5.60), respectively. Risk associated with BMI significantly differs by menopausal status.Our findings suggest the important role of reproductive factors in the development of breast cancer in Japanese women; however, body mass index (BMI) may have different effects on breast cancer in Japanese women compared with western women.


Assuntos
Neoplasias da Mama/etiologia , Adulto , Idoso , Índice de Massa Corporal , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/genética , Estudos de Coortes , Feminino , Humanos , Japão/epidemiologia , Estilo de Vida , Anamnese , Menarca , Pessoa de Meia-Idade , Paridade , Fatores de Risco , Inquéritos e Questionários
19.
Medicine (Baltimore) ; 98(52): e18421, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31876717

RESUMO

The objective of our research was to confirm the prediction role of Grobman model for vaginal birth after cesarean (VBAC) in Chinese pregnant women. In this research, 535 pregnant who had once cesarean delivery and the least once subsequent try to a vaginal labor in Jiaxing of China were involved. The Grobman background factors and five new factors were included. Overall, in total of 456 women had successful VBAC, the success percent was 85.2%. The new background variable "maternal height" was considered as an additional predictor for VBAC. The Grobman model's area under the curve (AUC) was 0.811 (95% CI = 0.751-0.870) and the AUC of this modified model combined 2 new factors was 0.834 (95% CI = 0.781-0.886). Nevertheless, there has no markedly difference between these 2 models of the AUC. In conclusion, the Grobman model was suitable for Chinese pregnant. However, further improvements were needed to make a new predictive model of VBAC success rate for Chinese pregnant women through analyzing the clinical data of vaginal trial delivery after cesarean section.


Assuntos
Nascimento Vaginal Após Cesárea/estatística & dados numéricos , Adulto , Fatores Etários , Índice de Massa Corporal , Cesárea/estatística & dados numéricos , China/epidemiologia , Feminino , Idade Gestacional , Humanos , Modelos Logísticos , Modelos Estatísticos , Gravidez , Curva ROC , Reprodutibilidade dos Testes , Estudos Retrospectivos
20.
Nan Fang Yi Ke Da Xue Xue Bao ; 39(11): 1293-1297, 2019 Nov 30.
Artigo em Chinês | MEDLINE | ID: mdl-31852647

RESUMO

OBJECTIVE: To investigate the predictive value of body mass index (BMI) combined with waist circumference (WC) for new-onset nonalcoholic fatty liver disease (NAFLD) in patients with type 2 diabetes mellitus (T2DM). METHODS: This community-based prospective cohort study was conducted among 3501 T2DM patients without NAFLD recruited from the staff of Kailuan Company, who underwent routine physical examination in the year 2006 and 2007, and a total of 2920 subjects were included in the final analysis. According to the baseline BMI and WC, the subjects were divided into group A (with normal BMI and WC), group B (with normal BMI but elevated WC), group C (with elevated BMI but a normal WC) and group D (with elevated BMI and WC). The subjects in the 4 groups were followed for the occurrence of NAFLD by reviewing their reports of physical examinations during the periods of 2008-2009, 2010-2011, 2012-2013, 2014-2015 and 2016-2017. The cumulative incidence of NAFLD was compared across the 4 groups and Cox regression analysis was used to test the correlation of BMI and WC with new onset of NAFLD. RESULTS: The cumulative incidence of NAFLD increased progressively in the 4 groups (50%, 66%, 68% and 77%, respectively). Cox regression analysis showed that compared with group A, groups B, C and D had increased risks of NAFLD after adjusting for age, gender and other risk factors, with HR values of 1.62, 1.98 and 2.47, respectively. CONCLUSIONS: Elevated BMI and WC are both independent risk factors for NAFLD in type 2 diabetic patients, and the combination of BMI and WC has a greater predictive value for NAFLD than either of them alone.


Assuntos
Diabetes Mellitus Tipo 2 , Hepatopatia Gordurosa não Alcoólica , Índice de Massa Corporal , Diabetes Mellitus Tipo 2/complicações , Humanos , Hepatopatia Gordurosa não Alcoólica/complicações , Obesidade , Estudos Prospectivos , Fatores de Risco , Circunferência da Cintura
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