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1.
Univ. salud ; 21(2): 127-131, mayo-ago. 2019.
Artigo em Espanhol | LILACS, COLNAL | ID: biblio-1004850

RESUMO

Resumen Introducción: El índice de masa corporal (IMC) se asocia inversamente a la frecuencia de exacerbaciones en pacientes con enfermedad pulmonar obstructiva crónica (EPOC); sin embargo, esta puede variar según el contexto. Objetivo: Cuantificar la asociación entre el IMC y la frecuencia de exacerbaciones en pacientes en Santa Marta, Colombia. Materiales y métodos: Estudio transversal de adultos con EPOC. Se calculó el IMC y la frecuencia de exacerbaciones se estimó a partir de la clasificación GOLD de estado global. Resultados: Participaron 292 pacientes entre 49 y 95 años; 61,6% eran hombres. Los IMC se observaron entre 12,8 y 40,2 (media=24,2; DE=4,5) distribuidos en 21 pacientes (7,2%) con desnutrición; 153 (52,4%), saludables; y 118 (40,4%), sobrepeso-obesidad. Un total de 146 pacientes (53,4%) se clasificaron GOLD A o B (exacerbaciones no frecuentes); y 136 pacientes (46,6%), GOLD C o D (exacerbaciones frecuentes). El 85,7% de los pacientes con desnutrición presentaron exacerbaciones frecuentes comparado con 51,6% en pacientes con peso saludable y 33,1% en pacientes con sobrepeso-obesidad (OR=0,18; IC95% 0,05-0,66 para peso saludable y OR=0,08; IC95% 0,02-0,29 para sobrepeso-obesidad frente a desnutrición). Conclusiones: El IMC presenta una relación inversa con la frecuencia de exacerbaciones en pacientes con EPOC de Santa Marta, Colombia.


Abstract Introduction: Body mass index (BMI) is inversely related to the exacerbation frequency in patients with chronic obstructive pulmonary disease (COPD). However, this relationship may vary depending on the context. Objective: To quantify the association of BMI with exacerbation frequency in patients from Santa Marta-Colombia. Materials and methods: A cross-sectional study of adults with COPD. We calculated the BMIs, and the exacerbation frequencies were estimated using the Global initiative for Chronic Obstructive Lung Disease (GOLD) classification. Results: 292 patients aged between 49-95 years were included. From those, 180 (61.6%) were male, 153 (52.4%) were healthy, 21 (7.2%) showed malnutrition, and 118 (40.4%) were overweight/obese patients. The observed IMCs were between 12.8 and 40.2 (median=24.2; SD=4.5). Whereas 156 patients (53,4%) were classified as GOLD A or B (infrequent exacerbations), 136 of them (46.6%) were GOLD C of D (frequent exacerbations). 85,7% of the patients with malnutrition showed frequent exacerbations, compared to both patients with healthy weight (51,6%) and overweight/obese patients (33.1%) (OR=0.18; CI95% 0.05-0.66 for healthy weight and OR=0.08; CI95% 0.02-0.29 for overweight/obesity, both compared to patients with malnutrition). Conclusions: BMI is inversely correlated with exacerbation frequency in patients with COPD from Santa Marta-Colombia.


Assuntos
Doença Pulmonar Obstrutiva Crônica , Qualidade de Vida , Índice de Massa Corporal , Estudos Transversais
2.
Int. j. cardiovasc. sci. (Impr.) ; 32(4): 355-361, July-Aug. 2019. tab
Artigo em Inglês | LILACS | ID: biblio-1012343

RESUMO

Depression and hypertension are highly prevalent among elderly people. Although the relationship between these conditions is well recognized, however, the factors that may influence such association are not clearly understood. Objective: To analyze the association between depression and hypertension in community-dwelling elders. Methods: Two-hundred and thirty-one community-dwelling elders provided information regarding the following variables: sex, age, ethnicity, smoking habit, physical activity level (PA), body mass index (BMI) and diabetes mellitus (DM). These variables can potentially influence depression and hypertension, as well as its relationship. Screening for depression was made using the Geriatric Depression Scale (GDS). The presence of hypertension was defined based on self-reported data and/or the use of antihypertensive drugs. The logistic regression technique was applied, using hypertension as the dependent variable and depressive state as a predictive variable. Logistic regression was applied with and without adjustment for the potential intervening variables. Results: The prevalence of depressive state and hypertension in the studied population was 14% and 59%, respectively. The association between depression and hypertension without adjustments was not significant (odds ratio [OR] = 2.28, 95% confidence interval [95%CI] = 0.98 - 5.32; p = 0.06). However, after adjusting for PA, BMI and DM, the strength of association between depression and hypertension significantly increased (OR = 3.08, 95%CI = 1.12 - 8.46; p = 0.03). Conclusion: The association between depression and hypertension in the elderly is directly influenced by PA, BMI and DM. This finding may guide strategies to increase the adherence to a healthier lifestyle


Assuntos
Humanos , Masculino , Feminino , Idoso , Composição Corporal , Depressão , Diabetes Mellitus , Vida Independente , Hipertensão , Atividade Motora , Idoso , Envelhecimento , Fumar , Índice de Massa Corporal , Prevalência , Análise Estatística , Obesidade
3.
Int. j. cardiovasc. sci. (Impr.) ; 32(4): 368-373, July-Aug. 2019. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1012344

RESUMO

Cardiopulmonary exercise testing is widely used in the evaluation of patients with left ventricular dysfunction, and some of these patients have an implantable cardioverter-defibrillator (ICD). However, this test presents specific challenges because of the susceptibility to ventricular arrhythmias during maximal levels of exercise. Objective: To evaluate the safety of cardiopulmonary exercise testing in patients with ICD. Methods: The study included patients with ICD who underwent cardiopulmonary exercise testing between 2007 and 2015. The tests were completed once the electronic devices were programmed. The maximum allowed heart rate reached during exercise was 10 beats below the first therapy zone programmed. Results: The study included 69 patients with mean age 53.7 ± 10.8 years, including 68% men. Exercise time was 8.7±2.3 minutes, with peak oxygen consumption of 13.3 ± 4.3 ml.kg-1.min-1. Peak heart rate was 62.9 ± 13.4% of the maximum rate predicted, with all patients taking specific medication. Ventricular arrhythmia was observed in 29% of the patients, and paired ventricular extrasystoles, ventricular bigeminism or non-sustained ventricular tachycardia were observed in only 14.5% of the patients. There was no sustained ventricular arrhythmia resulting in ICD therapy or other complications, such as inappropriate therapies. The frequency of severe events was 0%, 95% CI (0 - 5.2%). Conclusion: In the sample of patients evaluated, the cardiopulmonary exercise testing was shown to be safe during its performance in a hospital setting, following the safety standards


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Estudos Retrospectivos , Desfibriladores Implantáveis , Teste de Esforço/métodos , Consumo de Oxigênio , Arritmias Cardíacas , Doenças Cardiovasculares , Índice de Massa Corporal , Morte Súbita Cardíaca , Eletrocardiografia/métodos , Frequência Cardíaca
4.
Int. j. cardiovasc. sci. (Impr.) ; 32(4): 362-367, July-Aug. 2019. graf, tab
Artigo em Inglês | LILACS | ID: biblio-1012350

RESUMO

Maximal oxygen uptake is a powerful prognostic indicator and a reliable measure of physical conditioning. It can be measured directly by cardiopulmonary exercise testing (CPET) or indirectly by formulas derived from conventional protocols. Objective: We compared the VO2 max obtained by formula using exercise testing with Bruce protocol (BP) with the VO2 max obtained by CPET on the treadmill. Methods: We selected 41 healthy, non-obese, physically inactive young volunteers, aged between 21 and 50 years, residents of Florianópolis, Brazil. Results: Twenty-one women (52%) with mean age of 35.62 ± 8.83 years, and 20 males, with mean age of 32.5 ± 7.18 years participated in the study. Statistically significant differences were found for VO2 max between the two methods (BP - 42.31 ± 5.21 ml/kg.min vs. CPET - 30.46 ± 5.50 ml/kg.min., p < 0.0001). The Bruce formula overestimated the result by 34.1% (BP - 45.95 ± 3.94 ml/kg.min vs. CPX - 34.27 ± 4.20 ml/kg.min, p < 0.0001) for men, and by 44.8% (BP - 38.84 ± 3.72 ml/kg.min vs. CPX - 26.83 ± 3.90, p < 0.0001) for women. A moderate correlation was observed between the methods (r = 0.65). When classifying the results according to the table of aerobic capacity of the American Heart Association, the agreement was null (kappa = 0.0034; Pearson chi2 = 0.001). Conclusion: VO2 estimated by BP is not capable of demonstrating the true aerobic capacity in these individuals, while CPET is an important tool for early detection of diminished functional capacity in sedentary young men and women


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Consumo de Oxigênio , Adolescente , Teste de Esforço/métodos , Doenças Cardiovasculares , Índice de Massa Corporal , Fatores Sexuais , Protocolos Clínicos , Aptidão Física , Fatores de Risco , Comportamento Sedentário
5.
J Appl Oral Sci ; 27: e20180365, 2019 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-31365708

RESUMO

OBJECTIVES: Visfatin is an adipokine that plays an important role in immune functions as a growth factor, enzyme, and pro-inflammatory mediator. We aimed to determine the levels of visfatin, interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) in gingival crevicular fluid (GCF) in both obese/non-obese patients, with/without generalized chronic periodontitis (GCP). METHODOLOGY: Patients were categorized as obese (O) (n=31) or non-obese (nO) (n=19). Groups were divided into four subgroups according to periodontal conditions: (1) periodontally healthy without obesity (nO-Ctrl); (2) GCP without obesity (nO-CP); (3) periodontally healthy with obesity (O-Ctrl); and (4) GCP with obesity (O-CP). Demographic variables, anthropometric and laboratory data were recorded. Periodontal parameters were measured at baseline and 3rd months after either non-surgical periodontal treatment or calorie -restricted diet therapy. At the same time, GCF samples were taken from patients to analyze TNF-alpha, IL-6,and visfatin levels. RESULTS: Periodontal parameters were significantly higher in the O group than in the nO group (P<0.05). IL-6 levels were higher in the O group than in the nO group (P<0.001). The visfatin levels of the obese patients were reduceddecreased following the treatments (P<0.05). Cholesterol levels were higher in the O group than in the nO groups (P<0.05). IL-6 levels were higher in O-CP and O-Ctrl groups than in the nO-Ctrl group (P<0.05). Compared to the other groups, visfatin levels were significantly higher in the O-CP group but decreased following treatment (P<0.05). CONCLUSIONS: Our findings suggest that visfatin and IL-6 levels in GCF are associated with the pathogenesis of obesity and periodontitis. Within the limits of this study, we considered that there might be an association between the lipid profile and periodontitis on systemically healthy individuals.


Assuntos
Citocinas/análise , Líquido do Sulco Gengival/química , Interleucina-6/análise , Nicotinamida Fosforribosiltransferase/análise , Obesidade/metabolismo , Periodontite/metabolismo , Fator de Necrose Tumoral alfa/análise , Adulto , Idoso , Biomarcadores/análise , Índice de Massa Corporal , Estudos de Casos e Controles , Citocinas/fisiologia , Feminino , Humanos , Interleucina-6/fisiologia , Masculino , Pessoa de Meia-Idade , Nicotinamida Fosforribosiltransferase/fisiologia , Índice Periodontal , Periodontite/diagnóstico por imagem , Radiografia Panorâmica , Valores de Referência , Estatísticas não Paramétricas , Fator de Necrose Tumoral alfa/fisiologia
6.
Pan Afr Med J ; 33: 30, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31384345

RESUMO

Introduction: In Ghana, there is no data regarding physical activity habits and lipid profiles of students. Therefore, the aim of this study was to investigate the relationship between physical activities, Body Mass Index (BMI) and lipid profile of students in Ghana. Methods: Cluster and systematic sampling techniques were employed to recruit 120 students, aged 18 years and above. This cross-sectional study was carried out among students from the University of Ghana. Biochemical analysis was conducted analysing total cholesterol (TC), high density lipoprotein (HDL), low density lipoprotein (LDL) and triglycerides (TG) in serum samples. Anthropometry measurements were also taken and BMI calculated. The physical activities, undertaken over a 7-day period, by the students were assessed using the International Physical Activity Questionnaire (IPAQ). Results: 31.7% and 21.7% of the students were overweight and obese respectively. 61.5% of the obese students were engaged in high level physical activity as compared to 45.5% and 36.8% of the normal and overweight students, respectively. Normal weight students and overweight students showed significant differences in means of TC; [(4.56 ± 0.930 mmol/L) and (5.06 ± 0.93 mmol/L), respectively] and also between normal weight group (4.54 ± 0.93 mmol/L) and the obese students (5.24 ± 1.18 mmol/L). Significant correlations were also observed between TG, TC and BMI; and TC and TG, HDL and a strong correlation between LDL and TC (r=0.967). Conclusion: Strong correlations between BMI, physical activity and lipid profile indices among students in Ghana. Comprehensive efforts should be applied to reduce the incidence of CVDs among students.


Assuntos
Índice de Massa Corporal , Exercício/fisiologia , Lipídeos/sangue , Estudantes/estatística & dados numéricos , Adolescente , Adulto , Peso Corporal/fisiologia , Doenças Cardiovasculares/prevenção & controle , Análise por Conglomerados , Estudos Transversais , Feminino , Gana , Humanos , Masculino , Obesidade/epidemiologia , Sobrepeso/epidemiologia , Universidades , Adulto Jovem
7.
Adv Exp Med Biol ; 1121: 41-55, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31392651

RESUMO

AIM: The 14 years' Prevention Education Program PEP was started 1994 among first graders, their siblings and parents living in the half million city Nuremberg (Germany). The aim of prospective family-based observational study was early detection and lifestyle intervention of traditional cardiovascular risk factors. SUBJECTS AND METHODS: Out of 3370 families 24,927 adults and 23,740 children participated in the PEP Family Heart study. Anthropometric parameters including blood pressure and fasting lipids were measured. Because these variables change specifically because of natural growth and development in 3-18 years old children we had to calculate age-and gender-specific growth curves using the LMS method. Non-overweight (normal weight) is defined as BMI < 85th percentile (pctl), overweight as BMI 85th to <95th percentile, obesity as BMI ≥ 95th percentile and severe obesity as ≥ 120% of the 95th pctl. Prehypertension is categorized as the ≥90th to <95th pctl or ≥120/80 mm Hg and hypertension as ≥95th pctl on ≥3 occasions. MAIN RESULTS: 1. Cardiovascular risk (CVD) factor screening in school children predicted CVD risk in parents. 2. The growths curves for auscultatory systolic (SBP) and diastolic (DBP) blood pressure of non-overweight 8713 boys and 8138 girls nearly identical with the percentile curves of all 11,328 boys and 10,723 girls. 3. The shapes of the 10 lipid percentile curves between the 3rd and 97th pctl differ considerably by age and gender. 4. The wais-to-height ratio (WHtR) percentiles as a measure for abdominal adiposity vary substantially by age and gender 5. Among overweight and obese ≥85th pctl the percentile curves of body fat increase steeply until age 10 years and then decrease slowly in boys whereas the BF% percentile curves in girls increase continuously until age 18 years 6. The prevalence of hypertension increased strongly in severe obesity at the 99th pctl, more steeply beyond 120% of the 95th pctl to 59.1% in boys and 56% in girls. 7. The association between hypertension and normal weight, overweight and obesity increased in boys from 0,5, via 2,7 to 4,3 and in girls from 0,4 via 2,1 to 5,9. 8. Between 2000 and 2007 mean blood pressure decreased from 138.3 ± 18.5 mm Hg to 124.0 ± 13.8 mm Hg in fathers and from 119.1 ± 2.8 mm Hg to 110.4 ± 11.2 mm Hg in mothers. 9. After 1 year weighed dietary protocols demonstrate in 166 fathers a decrease of all six nutrional components like daily energy consumption from 2423 to 2307 Kcal, from 98 g to 91 g fat, from 260 g to 252 g carbohydrates, from 88 g to 84 g protein, cholesterol from 362 mg to 339 mg and alcohol from 19 g to 17 g per day and in 237 mothers from 1915 Kcal to 1830 Kcal, from 79 g to 73 g total fat, from 216 g to 212 g carbohydrates, from 66 g to 64 g protein, from 299 g to 244 mg cholesterol. 10. Sustained intensive individual and family-based lifestyle counseling in daily life in terms of healthy diet, less sedentary behavior and more leisure time physical activity slightly improved the CVD risk factor profiles in parents and their children already after 1 year.


Assuntos
Doenças Cardiovasculares , Dieta , Estilo de Vida , Adolescente , Adulto , Pressão Sanguínea , Índice de Massa Corporal , Doenças Cardiovasculares/prevenção & controle , Criança , Pré-Escolar , Exercício , Família , Feminino , Alemanha , Humanos , Masculino , Estudos Prospectivos , Fatores de Risco
8.
West Afr J Med ; 36(2): 129-132, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31385598

RESUMO

BACKGROUND: Acne vulgaris is a common skin disease of adolescents. One risk factor for the development of acne is a high body mass indices. Children with high body mass index are said to be more likely to have increased Insulin-like growth factor-1, which has been implicated in acne pathogenesis. The aim of this study was to correlate body mass index with the presence and severity of facial acne vulgaris in adolescent school children. METHODS: This was a cross-sectional study in four co-educational secondary schools in Ibadan, Nigeria. One thousand and seventy nine students aged 9-20 years were physically assessed for facial acne vulgaris and their heights (m2) and weights (kg) were measured for body mass index (kg/m2) estimation. The severity of acne was assessed using the comprehensive acne severity scale. Data was analyzed using the SPSS 16. RESULTS: The prevalence of facial acne vulgaris was 53.2%. The age of the students ranged from 9-20 years. The mean body mass index (BMI) for the students with acne was 19.9±3.3kg/m2 and 18.3 ± 3.11 kg/m2 for students without acne, P<0.0001. The prevalence of acne was 81.7% among adolescents with a BMI >25Kg/m2, 61.1% in those with a BMI of 18.5-24.99 kg/m2 and 42.0% among adolescents with a BMI of <18.5 Kg/m2, P<0.001 but BMI was not significantly associated with severity of acne (p=0.830). CONCLUSION: Adolescents with a high body mass index are more likely to have facial acne vulgaris but severity of acne is independent of body mass index.


Assuntos
Acne Vulgar/diagnóstico , Índice de Massa Corporal , Acne Vulgar/epidemiologia , Adolescente , Estudos Transversais , Feminino , Humanos , Masculino , Nigéria/epidemiologia , Prevalência , Índice de Gravidade de Doença , Fatores Sexuais
9.
An Bras Dermatol ; 94(3): 279-286, 2019 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-31365655

RESUMO

BACKGROUND: Exposure to UVR provides benefits related to vitamin D synthesis, but also causes harms, since UVB is considered a complete carcinogen. There is no definition of the level of sun exposure and the proportion of exposed body required for proper synthesis of vitamin D in the skin without causing it damage. OBJECTIVES: This study aims to analyze the sun exposure index, vitamin D levels and clinical changes in the skin caused by constant sun exposure in the fishermen population. METHODS: It is a cross-sectional, observational and analytical study. The sample consisted of fishermen and was calculated in 174 individuals. The questionnaire was applied, the dermatological examination was carried out and the examinations of calcidiol, parathyroid hormone, calcium and phosphorus were requested. Data were expressed as percentages. The comparative analysis was done through the Chi-square test, and the correlations were established through the Pearson's linear coefficient. Results: We observed that there was vitamin D deficiency in a small part of the cases (11.46%), and the frequency of diagnosis of skin cancer was 2.7% of the cases surveyed. STUDY LIMITATIONS: The difficulty in categorizing the sun exposure index. CONCLUSION: The fact that fishermen expose themselves to the sun chronically and have been exposed to the sun for more than 15 years, between 21 and 28 hours a week, and without photoprotection, were indicative factors for protection against vitamin D deficiency. Chronic exposure to sun and high vitamin levels D may be indicative of protection of this population against skin cancer.


Assuntos
Neoplasias Cutâneas/epidemiologia , Neoplasias Cutâneas/etiologia , Luz Solar , Raios Ultravioleta , Deficiência de Vitamina D/epidemiologia , Deficiência de Vitamina D/reabilitação , Vitamina D/biossíntese , Adulto , Índice de Massa Corporal , Brasil/epidemiologia , Estudos Transversais , Dieta , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estado Nutricional , Inquéritos e Questionários , Vitamina D/sangue
10.
An Bras Dermatol ; 94(3): 298-303, 2019 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-31365658

RESUMO

BACKGROUND: Hidradenitis suppurativa is a complex and infrequent autoinflammatory disease that impacts on quality of life. Its pathogenesis is not fully understood, which limits the development of curative treatments. OBJECTIVES: To evaluate clinical and quality of life aspects of hidradenitis suppurativa patients from a social group on the Internet. METHODS: A cross-sectional, Internet-based survey study among participants in a discussion group (Facebook) of individuals with hidradenitis suppurativa. Patients were asked to answer a questionnaire about clinical-demographic aspects and quality of life (DLQI-BRA). RESULTS: A total of 390 individuals agreed to participate in the study, 82% of them female, median age (p25-p75), of 31 (25-37) years old, disease onset at 15 (13-23) years, family member affected in 20% of cases, overweight (BMI 29 [25-33]) kg/m2 and severe impact on quality of life (DLQI 20 [13-25]). Regarding Hurley's classification, the participants provided information that enabled classification into: I (19%), II (52%) and III (29%). More severe cases were associated with males (OR = 1.69), higher weight (BMI: OR = 1.03) non-white color (OR = 1.43) and higher frequency of other autoinflammatory diseases (OR = 1.37). STUDY LIMITATIONS: Voluntary adherence survey with self-completion of the questionnaire by 390 from about 1600 group members. CONCLUSIONS: Hidradenitis suppurativa patients who participated in a social network group had onset of the disease after puberty, with a predominance in females and overweight people, with great impact on the quality of life.


Assuntos
Pesquisa Participativa Baseada na Comunidade/métodos , Hidradenite Supurativa/psicologia , Qualidade de Vida , Mídias Sociais , Adulto , Idoso , Índice de Massa Corporal , Comorbidade , Estudos Transversais , Feminino , Hidradenite Supurativa/terapia , Humanos , Internet , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Fatores Sexuais , Inquéritos e Questionários
11.
Medicine (Baltimore) ; 98(32): e16825, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31393416

RESUMO

Observational studies have reported that childhood obesity is positively associated with risks of type 2 diabetes (T2D) and coronary artery disease (CAD) in adults; however, whether this association is causal is still unclear. In the present study, we conducted the 2-sample Mendelian randomization (MR) studies to investigate whether childhood obesity is causally associated with T2D and CAD in adults.Seven single-nucleotide polymorphisms (SNPs) that significantly associated with childhood obesity were used as instrumental variables. The 2-sample MR analyses were performed with the summary-level data of large-sample genome-wide association studies to evaluate the causal effects of childhood obesity on adult T2D and CAD and the levels of cardiometabolic traits.The 2-sample MR analyses suggested that each 1-unit increase in the log-odds of having childhood obesity was causally associated with an increased risk of adult T2D (odds ratio [OR] = 1.16, 95% confidential interval [CI] = 1.06-1.28; P = 1.0 × 10) and CAD (OR = 1.07, 95% CI = 1.02-1.12; P = 4.0 × 10) based on the inverse-variance weighted method. The MR analyses also suggested that childhood obesity was positively associated with the levels of adult body mass index, waist circumference, hip circumference, waist and hip ratio, log-transformed fasting glucose, log-transformed homeostatic model assessment (HOMA) of insulin resistance (%), and triglycerides. The childhood obesity was negatively associated with the adult high-density lipoprotein cholesterol level; however, there was no evidence of a causal association between childhood obesity and the levels of fasting glucose, 2-hour glucose, HbA1c (%), log-transformed HOMA of ß-cell function (%), low-density lipoprotein cholesterol, or total cholesterol in adults.In conclusion, a genetic predisposition to childhood obesity was associated with an increased risk of adult T2D and CAD, providing causal relations between childhood obesity and the risks of T2D and CAD in adults; however, the results need to be validated with larger-scale intervention studies.


Assuntos
Doença da Artéria Coronariana/epidemiologia , Diabetes Mellitus Tipo 2/epidemiologia , Obesidade Pediátrica/epidemiologia , Obesidade Pediátrica/genética , Glicemia , Índice de Massa Corporal , Pesos e Medidas Corporais , Feminino , Predisposição Genética para Doença , Estudo de Associação Genômica Ampla , Humanos , Resistência à Insulina , Lipídeos/sangue , Masculino , Polimorfismo de Nucleotídeo Único , Fatores de Risco
13.
Medicine (Baltimore) ; 98(33): e16871, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31415425

RESUMO

Predicting long-term outcomes after sepsis is important when caring for patients with this condition. The purpose of the present study was to develop models predicting long-term mortality of patients with sepsis, including septic shock.Retrospective data from 446 patients with sepsis (60.8% men; median age, 71 years) treated at a single university-affiliated tertiary care hospital over 3 years were reviewed. Binary logistic regression was used to identify factors predicting mortality at 180 and 365 days after arrival at the emergency department. Long-term prognosis scores for the 180- and 365-day models were calculated by assigning points to variables according to their ß coefficients.The 180- and 365-day mortality rates were 40.6% and 47.8%, respectively. Multivariate analysis identified the following factors for inclusion in the 180- and 365-day models: age ≥65 years, body mass index ≤18.5 kg/m, hemato-oncologic diseases as comorbidities, and ventilator care. Patients with scores of 0 to ≥3 had 180-day survival rates of 83.8%, 70.8%, 42.3%, and 25.0%, respectively, and 365-day survival rates of 72.1%, 64.6%, 36.2%, and 15.9%, respectively (all differences P < .001; log-rank test). The areas under the receiver operating characteristic curves of the 180- and 365-day models were 0.713 (95% confidence interval [CI] 0.668-0.756, P < .001) and 0.697 (95% CI 0.650-0.740, P < .001), respectively.These long-term prognosis models based on baseline patient characteristics and treatments are useful for predicting the 6- and 12-month mortality rates of patients with sepsis.


Assuntos
Unidades de Terapia Intensiva/estatística & dados numéricos , Tempo de Internação/estatística & dados numéricos , Choque Séptico/mortalidade , Análise de Sobrevida , APACHE , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Comorbidade , Serviço Hospitalar de Emergência/estatística & dados numéricos , Feminino , Mortalidade Hospitalar , Humanos , Masculino , Pessoa de Meia-Idade , Respiração Artificial/efeitos adversos , Adulto Jovem
14.
Stud Health Technol Inform ; 266: 30-36, 2019 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-31397298

RESUMO

INTRODUCTION: A great number of weight loss interventions have been delivered through digital solutions. Analysis of the effectiveness in terms of weight loss is fundamental to understand the real potential of digital technologies as tools for delivery of weight loss interventions. For this, we need accurate and reliable anthropometric data. For reasons of convenience, self-reported weight and height often replace actual measurements in these interventions. This might lead to misclassification of BMI status during selection of participants and to bias in the assessment of the outcomes. Therefore, it is fundamental to have validation studies of self-reported web-based data. OBJECTIVES: We aimed to validate online self-reported height, weight and BMI in a POEmaS trial subsample. METHODS: We included 12.5% of the POEmaS' population (n=159). Anthropometric data reported on the web-platform were compared to measured data by paired T-tests. Agreement was assessed by Bland-Altman plots. Multinomial regression was used to investigate factors associated with self-reported weight validity. RESULTS: There was no significant difference between reported and measured weight (0.4 kg, SD 1.7; p=0.13) and BMI (0.03 kg/m2, SD 0.87; p=0.06). Reported height was on average 0.4 cm (SD 1.2) higher than the measured ones (p<0.001). For all anthropometric data, >=95% of the cases were within the limits of agreement. Higher measured BMI was the only factor associated with low accuracy of weight report. Each unit increase in BMI increased the odds that the reported weight was lower than the one measured (OR 1.13; 95%CI 1.01-1.26). DISCUSSION: Self-reported weight and BMI change showed good agreement with measured ones. Since these are the primary outcomes of the POEmaS trial, the findings of the validation study suggest that the outcomes' accuracy is high and that it does not vary across gender, age, study group. These findings are relevant to digital health researchers and assessors and suggest that digital health interventions for weight loss might rely on self-reported assessment of outcomes. This might be particularly useful when other modes of assessment, such as anthropometry and e-scales, are not feasible or not available. However, we acknowledge that these results might not be applicable to low educated populations.


Assuntos
Estatura , Perda de Peso , Índice de Massa Corporal , Peso Corporal , Humanos , Internet , Autorrelato
15.
Arch Endocrinol Metab ; 63(4): 427-437, 2019 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-31365625

RESUMO

OBJECTIVE: Chronic kidney disease (CKD) risk is inconsistent in the normal-weight, overweight, and obese individuals due to the heterogeneity of metabolic status. This meta-analysis aimed to examine the combined effects of body mass index (BMI) and metabolic status on CKD risk. MATERIALS AND METHODS: The MEDLINE, EMBASE, and Web of Knowledge databases were systematically searched up to March 2019 to identify all eligible studies investigating the CKD risk (defined as GFR < 60 mL/min per 1.73 m2 and/or microalbuminuria or proteinuria) associated with the body size phenotypes which are known as metabolically unhealthy normal-weight (MUNW), metabolically healthy overweight (MHOW), metabolically unhealthy overweight, metabolically healthy obese (MHO) and metabolically unhealthy obese (MUHO). The classification of subjects in included studies as metabolically unhealthy was based on the presence of three components of metabolic syndrome. BMI categorization was based on the criteria of included studies. The risk estimates and 95% confidence intervals (CIs) were extracted and pooled using random effects analysis. RESULTS: A total of 9 prospective cohort studies with 128773 participants and 4797 incident cases were included in the meta-analysis. Compared with healthy normal-weight individuals as reference, MUNW and MHO subjects showed an increased risk for CKD events with a pooled RR of 1.58 (95% CI = 1.28-1.96) in MUNW and 1.55 (95% CI = 1.34-1.79) in MHO persons. Also, MHOW was at increased risk for CKD (RR = 1.34, 95% CI = 1.20-1.51). MUHO individuals were at the highest risk for the development of CKD (RR = 2.13, 95% CI = 1.66-2.72). CONCLUSIONS: Individuals with metabolic abnormality, although at normal-weight, have an increased risk for CKD. Healthy overweight and obese individuals had higher risk; refuting the notion that metabolically healthy overweight and obese phenotypes are benign conditions.


Assuntos
Peso Corporal/genética , Síndrome Metabólica/genética , Fenótipo , Insuficiência Renal Crônica/genética , Índice de Massa Corporal , Humanos , Síndrome Metabólica/metabolismo , Estudos Observacionais como Assunto , Insuficiência Renal Crônica/metabolismo , Risco
16.
Arch Endocrinol Metab ; 63(4): 402-410, 2019 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-31365628

RESUMO

OBJECTIVE: The increased prevalence of obesity and associated comorbidities, such as cardiovascular and metabolic diseases, has gained attention worldwide, and the renin-angiotensin system (RAS) has been pointed out as a possible link. Thus, the present study aimed to verify the possible association between angiotensinogen (AGT) or angiotensin-converting enzyme (ACE) polymorphisms with overweight and obesity in adults. SUBJECTS AND METHODS: The present investigation was a population-based cross-sectional study including 1,567 individuals from an urban area in Brazil. Anthropometric, clinical and biochemical parameters were evaluated, and all individuals were genotyped for the ACE I/D and AGT M/T polymorphisms. RESULTS: The prevalence of overweight was higher among men, whereas obesity was more prevalent among women. However, the frequency of ACE or AGT polymorphisms was similar among body mass index (BMI) categories. In addition, the mean age-adjusted BMI averages did not change significantly for ACE or AGT polymorphisms, regardless of sex or BMI category. The age-adjusted BMI average for the combination of ACE and AGT genotypes evidenced no significant differences regardless of sex or BMI categories. Results were similar when BMI was replaced by waist circumference (WC). CONCLUSIONS: We were not able to find any associations between BMI and WC (overweight/obesity) and ACE and AGT polymorphisms, indicating that the RAS system might not be involved in overweight and obesity, at least based on genetic backgrounds. However, further studies must measure RAS components to elucidate this question.


Assuntos
Obesidade/genética , Sobrepeso/genética , Polimorfismo Genético/genética , Sistema Renina-Angiotensina/genética , Adulto , Distribuição por Idade , Angiotensinogênio/genética , Pressão Sanguínea , Índice de Massa Corporal , Brasil , Estudos Transversais , Feminino , Frequência do Gene/genética , Humanos , Masculino , Pessoa de Meia-Idade , Peptidil Dipeptidase A/genética , Distribuição por Sexo , Circunferência da Cintura
17.
Arch Endocrinol Metab ; 63(4): 411-416, 2019 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-31365629

RESUMO

OBJECTIVE: The prevalence of overweight and obesity is gradually increasing in both developed and developing countries. Obesity, for instance, can present multifactorial causes that interact with each other. Among the important factors, parental obesity plays a prominent role in the onset of obesity during childhood and teenage years through genetics and ambient aspects. This study aims to verify the possible existence of an association between overweight/obesity of schoolchildren and cardiovascular risk (CVR) factors for their parents. SUBJETCS AND METHODS: For this purpose, a cross-sectional study was conducted with a sample of 1,243 children and adolescents, aged between 7 and 17. Out of the total number of participants, 563 (45.3%) were boys who were selected across 19 schools in the urban and rural areas of Santa Cruz do Sul, Rio Grande do Sul (Brazil). The overweight/obesity status of the schoolchildren was evaluated through their body mass index (BMI). Additionally, a self-reference questionnaire was employed to measure their parents' CVR. RESULTS: The results of this study revealed that students with overweight/obesity have a higher probability of having a father with hypertension (OR = 1.49; p = 0.038) and obesity (OR = 2.36; p = 0.002) and a mother with obesity (OR = 1.72; p = 0.016). CONCLUSION: To conclude, this study confirms a relationship between overweight/obesity of schoolchildren with CVR for their parents.


Assuntos
Doenças Cardiovasculares/epidemiologia , Sobrepeso/epidemiologia , Pais , Obesidade Pediátrica/epidemiologia , Adolescente , Índice de Massa Corporal , Criança , Estudos Transversais , Feminino , Humanos , Hipertensão , Masculino , Prevalência , Fatores de Risco , Inquéritos e Questionários
20.
Rev Fac Cien Med Univ Nac Cordoba ; 76(3): 135-141, 2019 08 29.
Artigo em Espanhol | MEDLINE | ID: mdl-31465179

RESUMO

Introduction: The relationship of the metabolic syndrome (MS) and its components with the reduced glomerular filtration rate and proteinuria is not yet widely elucidated. The aim of the study was to associate the estimated glomerular filtration rate (eGFR) and proteinuria to MS and its individual components in adults with cardiometabolic risk factors, who attended a public health center in the municipality of San Diego, Carabobo State, Venezuela. Methods: Descriptive and cross-sectional study (n=176 individuals). Weight, height, waist circumference, body fat percentage and blood pressure were measured; serum glucose, creatinine, urea, ureic nitrogen, total cholesterol, low (LDLc) and high (HDLc) density lipoprotein cholesterol, triglycerides and glycosylated hemoglobin A1C in whole blood were determined; the presence of proteinuria was determined in partial urine. The eGFR was estimated by equations and the body mass index (BMI) was calculated. Results: The frequency of MS was significantly higher among patients with CKD (eGFR < 60 mL/min/m2), mildly reduced eGFR (60-89 mL/min/m2), hyperfiltration or proteinuria. The risks of mildly reduced eGFR and protenuria were significantly associated with elevated fasting blood glucose, low HDLc and MS, with and without adjustment for sex, age and BMI. When adjusted for the diabetic condition, only the risk of proteinuria remained associated with MS and elevated blood pressure. The risk of hyperfiltration was not associated with MS. Conclusion: The reduction in estimated glomerular function and proteinuria were associated with MS and its individual components. Other studies that confirm the results are required.


Assuntos
Doenças Cardiovasculares/etiologia , Taxa de Filtração Glomerular , Síndrome Metabólica/complicações , Índice de Massa Corporal , Doenças Cardiovasculares/sangue , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Estudos Transversais , Feminino , Humanos , Masculino , Síndrome Metabólica/sangue , Pessoa de Meia-Idade , Atenção Primária à Saúde , Fatores de Risco , Triglicerídeos/sangue , Venezuela , Circunferência da Cintura
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