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1.
Medicine (Baltimore) ; 100(24): e26291, 2021 Jun 18.
Artigo em Inglês | MEDLINE | ID: mdl-34128864

RESUMO

ABSTRACT: Ultrasonography is the ideal tool for assessing hip morphology in infants younger than 6-month-old. This study assessed the interobserver agreement and clinical disparities of the 2 most widely used ultrasound (US) methods, the Graf method, and femoral head coverage (FHC) measurement.A prospective observational study (STROBE compliant) of 2024 newborns was conducted between January 2017 and December 2018. Hip US was conducted on all newborns with abnormal Barlow and Ortolani maneuvers as well as on 50 randomly selected normal newborns. The physical examination and US were performed by a senior pediatric orthopedic surgeon with musculoskeletal sonography certification. Three observers with different levels of experience interpreted the images by using the Graf method and FHC. We analyzed the intraclass correlation coefficient, Cohen kappa, and the disparity between the clinical findings of the 2 methods.A total of 198 newborns (9.8%) presented with clinical instability, including 193 subluxatable hips in 168 patients (84.8%) and 45 dislocatable/dislocated hips in 30 patients (15.2%). The mean age at US examination was 11.69 days (range: 0-18 days). The intraclass correlation coefficient was .71 (95% CI: 0.55-0.83) for FHC, 0.63 (95% CI: 0.38-0.78) for the alpha angle, and 0.47 (95% CI: 0.16-0.69) for beta angle. The Cohen kappa coefficients of Graf type were 0.19 (95% CI: 0.03-0.35), 0.39 (95% CI: 0.20-0.58), and 0.17 (95% CI: 0.02-0.32) between observers 1 and 2, observers 1 and 3, and observers 2 and 3, respectively. Based on the Graf method, 14% of the stable hips had abnormal USs; by contrast, 19.2% of the subluxatable hips and 17.8% of the dislocatable/dislocated hips had normal Graf morphologies. In USs interpreted using FHC, 16% of stable hips demonstrated abnormal coverage, whereas 13.5% of subluxatable hips and 4.4% of dislocatable/dislocated hips had normal FHC.Incidence of clinically detectable hip instability was 9.8% among newborns in our series. Both alpha angle and FHC ratio revealed substantial interobserver agreement while beta angle achieved moderate agreement. FHC ratio possesses higher sensitivity and similar specificity compared with the Graf method when screening unstable hips.Level II, development of diagnostic criteria on basis of consecutive patients.


Assuntos
Antropometria/métodos , Displasia do Desenvolvimento do Quadril/diagnóstico , Triagem Neonatal/métodos , Exame Físico/estatística & dados numéricos , Ultrassonografia/estatística & dados numéricos , Feminino , Cabeça do Fêmur/diagnóstico por imagem , Quadril/diagnóstico por imagem , Humanos , Recém-Nascido , Instabilidade Articular/diagnóstico , Masculino , Variações Dependentes do Observador , Exame Físico/métodos , Estudos Prospectivos , Sensibilidade e Especificidade , Ultrassonografia/métodos
2.
Clin Interv Aging ; 16: 1095-1104, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34163153

RESUMO

Purpose: Mid-upper arm circumference (MUAC) is a simple, noninvasive anthropometric indicator. This study evaluated the applicability of MUAC as an alternative screening instrument to appendicular skeletal muscle mass index (ASMI) for detecting sarcopenia, and determined the optimal MUAC cutoff values. Patients and Methods: A total of 4509 subjects ≥50 years of age from the West China Health and Aging Trend study were included in the present study. ASM was measured by bioelectrical impedance analysis. MUAC, calf circumference (CC), and grip strength were evaluated and the Short Physical Performance Battery and 3-m timed up-and-go test were administered. Low muscle mass was diagnosed based on Asian Working Group for Sarcopenia 2019 (AWGS2019) and updated European Working Group on Sarcopenia in Older People 2 (EWGSOP2) criteria. Results: ASMI was positively correlated with MUAC in both men (r=0.726, P<0.001) and women (r=0.698, P<0.001). The area under the receiver operating characteristic curve (AUC) for MUAC as an indicator of low muscle mass in men and women was 0.86 (95% confidence interval [CI]: 0.85-0.88) and 0.85 (95% CI: 0.84-0.86), respectively, according to AWGS2019 criteria; and 0.86 (95% CI: 0.85-0.88) and 0.86 (95% CI: 0.85-0.88), respectively, according to EWGSOP2 criteria. Optimal MUAC cutoff values for predicting low muscle mass were ≤28.6 cm for men and ≤27.5 cm for women. There was no significant difference between the AUCs of MUAC and CC in men according to the 2 reference standards (P=0.809), whereas the AUC of CC was superior to that of MUAC in women according to AWGS2019 (P<0.001) and EWGSOP2 (P=0.008) criteria. Conclusion: MUAC is strongly correlated with ASMI among community-dwelling middle-aged and older adults in China. MUAC can be used as a simple screening instrument to ASMI for diagnosing sarcopenia, especially in men.


Assuntos
Antropometria/métodos , Braço/fisiologia , Músculo Esquelético/fisiologia , Sarcopenia/diagnóstico , Idoso , Envelhecimento/fisiologia , Área Sob a Curva , Pesos e Medidas Corporais , China , Estudos Transversais , Feminino , Humanos , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Curva ROC
3.
J Sports Med Phys Fitness ; 61(6): 818-828, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34110120

RESUMO

BACKGROUND: Anthropometric and demographic properties may affect balance, but there is no consensus on this subject; so, there is a need for studies that explore it. This study aimed to assess the relationship between balance and anthropometric as well as demographic properties; and to determine the effect of anthropometric and demographic properties on balance in healthy adults. METHODS: Sixty healthy adults were included in this study. The ages of the participants were questioned; height, body weight, Body Mass Index, head circumference, upper extremity, lower extremity, and foot length were evaluated, and shoe numbers were recorded. Balance assessments were performed with the Balance Master System device. RESULTS: The mean age of the participants was 23.50±1.97 years. The balance developed with age (P<0.05), while there was a negative correlation between height and balance (P<0.05). Weight gain affected balance negatively (P<0.05). The increase in head circumference, extremity, and foot length was associated with a deterioration in balance (P<0.05). CONCLUSIONS: The results of the current study were showed that anthropometric and demographic properties affect balance. The increase in some of the anthropometric and demographic properties including height, weight, head circumference, extremity, and foot length harms the balance. During balance assessments, anthropometric and demographic characteristics should be considered as a factor that affects balance.


Assuntos
Antropometria/métodos , Equilíbrio Postural/fisiologia , Adulto , Estatura/fisiologia , Índice de Massa Corporal , Peso Corporal/fisiologia , Extremidades/fisiologia , Feminino , Humanos , Masculino , Adulto Jovem
4.
Clin Nutr ESPEN ; 43: 377-382, 2021 06.
Artigo em Inglês | MEDLINE | ID: covidwho-1163554

RESUMO

BACKGROUND AND AIM: We conducted the present study to investigate the nutritional status of critically ill COVID-19 patients and validate the GLIM criteria with respect to the SGA. METHODS: In this prospective cohort study, 109 ICU patients were assessed for malnutrition based on GLIM and SGA criteria. The relation between nutrition assessment tools and duration of hospitalization and mortality were also evaluated. The sensitivity and specificity of GLIM criteria concerning the detection of malnutrition was assessed based on the area under the curve. RESULTS: Malnutrition, according to the SGA and GLIM criteria, was found in 68 (62.4%) and 66 (61.5%) of our subjects. There was an optimal agreement between the GLIM criteria and the SGA criteria regarding malnutrition diagnosis (K = 0.85, P < 0.001). The area under curve for the GLIM was stratified based on the SGA results and was 0.927 (95% CI: 0.868-0.985) with a sensitivity and specificity of 92% and 93%, respectively. CONCLUSION: Malnutrition is frequently observed in critically ill COVID-19 patients. GLIM criteria is a valid tool and has a strong association with mortality and longer duration of ICU stay.


Assuntos
COVID-19 , Estado Terminal , Desnutrição/diagnóstico , Avaliação Nutricional , Estado Nutricional , Adulto , Idoso , Antropometria/métodos , Área Sob a Curva , Índice de Massa Corporal , COVID-19/complicações , Feminino , Saúde Global , Humanos , Liderança , Masculino , Desnutrição/complicações , Pessoa de Meia-Idade , Atrofia Muscular , Estudos Prospectivos , Reprodutibilidade dos Testes , SARS-CoV-2 , Sensibilidade e Especificidade , Perda de Peso
5.
Clin Nutr ESPEN ; 43: 377-382, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34024543

RESUMO

BACKGROUND AND AIM: We conducted the present study to investigate the nutritional status of critically ill COVID-19 patients and validate the GLIM criteria with respect to the SGA. METHODS: In this prospective cohort study, 109 ICU patients were assessed for malnutrition based on GLIM and SGA criteria. The relation between nutrition assessment tools and duration of hospitalization and mortality were also evaluated. The sensitivity and specificity of GLIM criteria concerning the detection of malnutrition was assessed based on the area under the curve. RESULTS: Malnutrition, according to the SGA and GLIM criteria, was found in 68 (62.4%) and 66 (61.5%) of our subjects. There was an optimal agreement between the GLIM criteria and the SGA criteria regarding malnutrition diagnosis (K = 0.85, P < 0.001). The area under curve for the GLIM was stratified based on the SGA results and was 0.927 (95% CI: 0.868-0.985) with a sensitivity and specificity of 92% and 93%, respectively. CONCLUSION: Malnutrition is frequently observed in critically ill COVID-19 patients. GLIM criteria is a valid tool and has a strong association with mortality and longer duration of ICU stay.


Assuntos
COVID-19 , Estado Terminal , Desnutrição/diagnóstico , Avaliação Nutricional , Estado Nutricional , Adulto , Idoso , Antropometria/métodos , Área Sob a Curva , Índice de Massa Corporal , COVID-19/complicações , Feminino , Saúde Global , Humanos , Liderança , Masculino , Desnutrição/complicações , Pessoa de Meia-Idade , Atrofia Muscular , Estudos Prospectivos , Reprodutibilidade dos Testes , SARS-CoV-2 , Sensibilidade e Especificidade , Perda de Peso
6.
Am J Med Sci ; 361(6): 751-758, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33892918

RESUMO

INTRODUCTION: Some studies indicate an association between coronary artery disease (CAD) and osteoporosis. This case-control study examined the association between body composition and bone mineral content (BMC) and density (BMD) among patients with CAD. MATERIALS AND METHODS: A group of men (n = 73) with established CAD and age and sex matched controls (n=65) were included in the study. Data collected included socio-demographic information, disease related data (from cases), anthropometric measurements, serum vitamin D, calcium and phosphorous and body composition analysis using DEXA. Two groups were compared using independent sample t-test, Mann Whitney U-test or Chi square test. Pearson correlation and regression models were used to test the associations between body compartments. RESULTS: Among cases, the mean disease duration was 29 (range 5-192) months and 15% had triple vessel disease. Patients had higher mean total body fat mass (TBFM) (18869.7 vs 16733.0) g, p = 0.018), truncal fat mass (TRFM) (9259.1 vs 7992.5 g, p = 0.009) and fat percentage (28.6 vs 25.9%, p = 0.001) compared to controls. Median serum vitamin D level was significantly lower among patients (20.0 ng/mL) compared to controls (27.1 ng/mL) (p = 0.003). In both groups, TBFM and total body lean mass (TBLM) both showed significant positive correlations with total body BMD/BMC and regional BMDs. Of the two, TBLM emerged the best predictor of TBBMC/TBBMD. These associations were greater among patients than controls. CONCLUSIONS: TBLM appears to be the strongest predictor of TBBMD and TBBMC in patients and controls. The strength of associations was greater among patients compared to controls even after adjusting for possible confounders .


Assuntos
Tecido Adiposo/fisiopatologia , Composição Corporal/fisiologia , Densidade Óssea/fisiologia , Doença da Artéria Coronariana/diagnóstico , Doença da Artéria Coronariana/fisiopatologia , Antropometria/métodos , Estudos de Casos e Controles , Doença da Artéria Coronariana/sangue , Estudos Transversais , Humanos , Masculino , Pessoa de Meia-Idade , Osteoporose/sangue , Osteoporose/diagnóstico , Osteoporose/fisiopatologia
7.
Nutrients ; 13(3)2021 Mar 19.
Artigo em Inglês | MEDLINE | ID: mdl-33808883

RESUMO

Prediabetes is closely related to excess body weight and adipose distribution. For this reason, we aimed to assess and compare the diagnostic usefulness of ten anthropometric adiposity indices to predict prediabetes. Cross-sectional study with 8188 overweight subjects free of type 2 diabetes from the ILERVAS project (NCT03228459). Prediabetes was diagnosed by levels of glycated hemoglobin (HbA1c). Total body adiposity indices [BMI, Clínica Universidad de Navarra-Body Adiposity Estimator (CUN-BAE) and Deurenberg's formula] and abdominal adiposity (waist and neck circumferences, conicity index, waist to height ratio, Bonora's equation, A body shape index, and body roundness index) were calculated. The area under the receiver-operating characteristic (ROC) curve, the best cutoff and the prevalence of prediabetes around this value were calculated for every anthropometric index. All anthropometric indices other than the A body adiposity were higher in men and women with prediabetes compared with controls (p < 0.001 for all). In addition, a slightly positive correlation was found between indices and HbA1c in both sexes (r ≤ 0.182 and p ≤ 0.026 for all). None of the measures achieved acceptable levels of discrimination in ROC analysis (area under the ROC ≤ 0.63 for all). Assessing BMI, the prevalence of prediabetes among men increased from 20.4% to 36.2% around the cutoff of 28.2 kg/m2, with similar data among women (from 29.3 to 44.8% with a cutoff of 28.6 kg/m2). No lonely obesity index appears to be the perfect biomarker to use in clinical practice to detect individuals with prediabetes.


Assuntos
Antropometria/métodos , Estado Pré-Diabético/diagnóstico , Adiposidade , Biomarcadores , Peso Corporal , Estudos de Coortes , Estudos Transversais , Diabetes Mellitus Tipo 2 , Feminino , Hemoglobina A Glicada , Humanos , Masculino , Obesidade , Obesidade Abdominal , Sobrepeso , Curva ROC
8.
Isr Med Assoc J ; 23(4): 233-238, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33899356

RESUMO

BACKGROUND: Evaluation of children's anthropometrics poses challenges due to age-related changes. The main focus is on height and weight. However, since weight is height-dependent, body mass index (BMI) is the best surrogate measurement of adiposity. Israel has not developed national growth tables; therefore, researchers and clinicians utilize either World Health Organization (WHO) or U.S. Centers for Disease Control and Prevention (CDC) tables as benchmarks. OBJECTIVES: To evaluate the anthropometrics of Israeli children benchmarked by CDC and WHO tables. METHODS: A retrospective review was conducted of the 1987-2003 birth cohort (age 4-18 years) from Clalit Health Services databases. Anthropometrics were retrieved twice: at study entry and one year later. We evaluated them as separate cohorts. Gender-specific age-matched median height and BMI were compared with CDC and WHO height and BMI tables. RESULTS: he study consisted of 15,650, mean age at study entry 9.5 years (range 4-18). Gender-specific median heights of the Israeli children were similar to CDC and WHO values at younger ages, but were slightly shorter than the age-matched CDC and WHO toward the age of final height in both cohorts. However, gender-specific median BMI was considerably and statistically significant higher compared to CDC and WHO values consistently along the entire age range in both cohorts. CONCLUSIONS: Israeli children were slightly shorter toward the age of final height, compared to WHO and CDC. However, BMI in Israeli children was significantly higher compared to the CDC and WHO consistently along the age range, which raises an alarm regarding obesity patterns.


Assuntos
Antropometria/métodos , Estatura , Índice de Massa Corporal , Obesidade , Pediatria , Adolescente , Fatores Etários , Criança , Desenvolvimento Infantil , Estudos de Coortes , Feminino , Humanos , Israel/epidemiologia , Masculino , Obesidade/diagnóstico , Obesidade/epidemiologia , Obesidade/prevenção & controle , Pediatria/métodos , Pediatria/normas , Padrões de Referência , Fatores Sexuais , Organização Mundial da Saúde
9.
Top Spinal Cord Inj Rehabil ; 27(1): 11-22, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33814880

RESUMO

Background: Obesity is at epidemic proportions in the population with spinal cord injury (SCI), and adipose tissue (AT) is the mediator of the metabolic syndrome. Obesity, however, has been poorly appreciated in SCI because of the lack of sensitivity that body mass index (BMI) conveys for obesity risk in SCI without measuring AT. Objectives: The specific objectives were to compare measures of body composition assessment for body fat with the criterion standard 4-compartment (4C) model in persons with SCI, to develop a regression equation that can be utilized in the clinical setting to estimate fat mass (FM), and to determine cardiometabolic risk using surrogates of obesity in a current model of metabolic syndrome. Methods: Seventy-two individuals with chronic (>1 year) motor complete (AIS A and B) C5-L2 SCI were recruited over 3 years. Subjects underwent assessment with 4C using hydrostatic (underwater) weighing (UWW), dual-energy x-ray absorptiometry (DXA), and total body water (TBW) assessment to determine percent body fat (%BF); fasting glucose and lipid profiles, and resting blood pressure were also obtained. BMI, DXA, bioelectrical impedance analyses (BIA), BodPod, circumferences, diameters, lengths, and nine-site skinfold (SF) were assessed and validated against 4C. A multiple linear regression model was used to fit %BF (dependent variable) using anthropometric and demographic data that had the greatest correlations with variables, followed by a combined forward/backward stepwise regression with Akaike information criterion (AIC) to identify the variables most predictive of the 4C %BF. To allow for a more practical model for use in the clinical setting, we further reduced the AIC model with minimal loss of predictability. Surrogate markers of obesity were employed with metabolic biomarkers of metabolic syndrome to determine prevalence in persons with SCI. Results: Subject characteristics included age 44.4 ± 11.3 years, time since injury (TSI) 14.4 ± 11.0 years, BMI 27.3 ± 5.9 kg/m2; 59 were men and 13 were women. Sitting waist circumference (WCSit ) was 95.5 ± 13.1 cm, supine waist circumference (WCSup) was 93.4 ± 12.7 cm, and abdominal skinfold (ABDSF) was 53.1 ± 19.6 mm. Findings showed 4C %BF 42.4 ± 8.6%, UWW %BF 37.3 ± 9.7%, DXA %BF 39.1 ± 9.4%, BodPod %BF 33.7 ± 11.4%, nine-site SF %BF 37.8 ± 9.3%, and BIA %BF 27.6 ± 8.6%. A regression equation using age, sex, weight, and ABDSF provided R2 correlation of 0.57 with 4C %BF (p < .0001). Metabolic syndrome was identified in 59.4% of the sample. Conclusion: Body composition techniques to determine body fat are labor intensive and expensive for persons with SCI, and the regression equation developed against the criterion standard 4C model may allow clinicians to quickly estimate %BF and more accurately demonstrate obesity-induced cardiometabolic syndrome in this population.


Assuntos
Tecido Adiposo/metabolismo , Antropometria/métodos , Fatores de Risco Cardiometabólico , Obesidade/metabolismo , Traumatismos da Medula Espinal/complicações , Adulto , Idoso , Composição Corporal , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
10.
Top Spinal Cord Inj Rehabil ; 27(1): 23-35, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33814881

RESUMO

Over two-thirds of persons with spinal cord injury (SCI) experience neurogenic obesity-induced cardiometabolic syndrome (CMS) and other chronic comorbidities. Obesity is likely to impede social and recreational activities, impact quality of life, and impose additional socioeconomic burdens on persons with SCI. Advances in imaging technology facilitate the mapping of adiposity and its association with the cardiometabolic profile after SCI. Central adiposity or central obesity is characterized by increased waist (WC) and abdominal circumferences (AC) as well as visceral adipose tissue (VAT). A number of studies, while relying on expensive imaging techniques, have reported direct associations of both central obesity and VAT in imposing significant health risks after SCI. The mechanistic role of central obesity on cardiometabolic heath in persons with SCI has yet to be identified, despite the knowledge that it has been designated as an independent risk factor for cardiometabolic dysfunction and premature mortality in other clinical populations. In persons with SCI, the distribution of adipose tissue has been suggested to be a function of sex, level of injury, and age. To date, there is no SCI-specific WC or AC cutoff value to provide anthropometric prediction of VAT and diagnostic capability of persons at risk for central obesity, CMS, and cardiovascular disease after SCI. The purpose of the current review is to summarize the factors contributing to visceral adiposity in persons with SCI and to develop an SCI-specific anthropometric prediction equation for this population. Furthermore, a proposed WC cutoff will be discussed as a surrogate index for central obesity, CMS, and cardiovascular disorders after SCI.


Assuntos
Antropometria/métodos , Fatores de Risco Cardiometabólico , Gordura Intra-Abdominal/diagnóstico por imagem , Gordura Intra-Abdominal/metabolismo , Obesidade/diagnóstico por imagem , Obesidade/metabolismo , Traumatismos da Medula Espinal/complicações , Fatores Etários , Humanos , Valor Preditivo dos Testes , Fatores Sexuais
11.
Nutr. hosp ; 38(2): 245-251, mar.-abr. 2021. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-201866

RESUMO

INTRODUCCIÓN: en niños y niñas, la aplicación de intervenciones terapéuticas, lo que incluye la administración de medicamentos, se basa en el peso corporal. OBJETIVO: validar las ecuaciones propuestas por "Advanced Pediatric Life Support - APLS" en 2011 (APLS 1) y 2001 (APLS 2) para estimar el peso de las niñas y niños ecuatorianos, considerando la diversidad étnica y los grupos de edad. MÉTODOS: estudio transversal que incluyó 21.735 niñas y niños pertenecientes a tres grupos étnicos -mestizo, indígena y otro (blancos, negros y mulatos)- con edades comprendidas entre 0 y 12 años y que habían participado en el estudio ENSANUT-ECU. Se calcularon las diferencias, la correlación de Spearman, los gráficos de Bland-Altman y el porcentaje error (PE). Los datos se procesaron y analizaron usando R. RESULTADOS: la APLS 1 tiende a sobrestimar el peso mientras que la APLS 2 lo subestima. El sesgo del peso estimado fue mayor para la ecuación clásica. Los grupos étnicos indígena y otro presentaron las diferencias más altas con respecto al peso medido. Las diferencias de peso estimado con respecto al medido aumentaron progresivamente con la edad. Con la APLS 1, el porcentaje de individuos con un PE > 10 % fue mayor que con la APLS 2. CONCLUSIONES: la APLS no estima con exactitud el peso en la población pediátrica ecuatoriana. La diferencia entre el peso estimado y el peso medido es sensible a las diferencias étnicas y de edad


INTRODUCTION: in children the use of therapeutic interventions, which includes the administration of medications, is based on body weight. OBJECTIVE: to validate the equations proposed by "Advanced Pediatric Life Support - APLS" in 2011 (APLS 1) and 2001 (APLS 2) to estimate weight in Ecuadorian girls and boys, considering their ethnic diversity and age groups. METHODS: a cross-sectional study which included 21,735 girls and boys belonging to three ethnic groups: mestizo, indigenous, and other (white, black, and mulatto), with ages between 0 and 12 years, who participated in the ENSANUT-ECU study. Differences, Spearman's correlation, Bland-Altman graphs, and percentage error (PE) were calculated. Data were processed and analyzed using R. RESULTS: APLS 1 tends to overestimate weight whereas APLS 2 underestimates it. The estimated weight bias was greater for the classical equation. The indigenous and "other" ethnic groups presented the highest differences with respect to measured weight. The differences between estimated weight and measured weight increased progressively with age. With APLS 1, the percentage of individuals with a PE > 10 % was greater than with APLS 2. CONCLUSIONS: APLS does not accurately estimate weight in the Ecuadorian pediatric population. The difference between estimated weight and measured weight is sensitive to ethnic and age differences


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Peso Corporal/fisiologia , Antropometria/instrumentação , Pediatria/normas , Antropometria/métodos , Estudos Transversais , Amostragem por Conglomerados , Peso Corporal/etnologia
12.
Biomed Res Int ; 2021: 6696357, 2021.
Artigo em Inglês | MEDLINE | ID: covidwho-1140377

RESUMO

Background: Sedentary lifestyle and work from home schedules due to the ongoing COVID-19 pandemic in 2020 have caused a significant rise in obesity across adults. With limited visits to the doctors during this period to avoid possible infections, there is currently no way to measure or track obesity. Methods: We reviewed the literature on relationships between obesity and facial features, in white, black, hispanic-latino, and Korean populations and validated them against a cohort of Indian participants (n = 106). The body mass index (BMI) and waist-to-hip ratio (WHR) were obtained using anthropometric measurements, and body fat mass (BFM), percentage body fat (PBF), and visceral fat area (VFA) were measured using body composition analysis. Facial pictures were also collected and processed to characterize facial geometry. Regression analysis was conducted to determine correlations between body fat parameters and facial model parameters. Results: Lower facial geometry was highly correlated with BMI (R 2 = 0.77) followed by PBF (R 2 = 0.72), VFA (R 2 = 0.65), WHR (R 2 = 0.60), BFM (R 2 = 0.59), and weight (R 2 = 0.54). Conclusions: The ability to predict obesity using facial images through mobile application or telemedicine can help with early diagnosis and timely medical intervention for people with obesity during the pandemic.


Assuntos
Antropometria/métodos , Reconhecimento Facial Automatizado/métodos , COVID-19/epidemiologia , Obesidade/diagnóstico , Adulto , Composição Corporal , Índice de Massa Corporal , Peso Corporal , Reconhecimento Facial/fisiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Obesidade/metabolismo , Pandemias , Valor Preditivo dos Testes , Prognóstico , Fatores de Risco , SARS-CoV-2/isolamento & purificação , Circunferência da Cintura , Relação Cintura-Quadril
13.
JAMA Netw Open ; 4(3): e213238, 2021 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-33764424

RESUMO

Importance: Higher caffeine consumption during pregnancy has been associated with lower birth weight. However, associations of caffeine consumption, based on both plasma concentrations of caffeine and its metabolites, and self-reported caffeinated beverage intake, with multiple measures of neonatal anthropometry, have yet to be examined. Objective: To evaluate the association between maternal caffeine intake and neonatal anthropometry, testing effect modification by fast or slow caffeine metabolism genotype. Design, Setting, and Participants: A longitudinal cohort study, the National Institute of Child Health and Human Development Fetal Growth Studies-Singletons, enrolled 2055 nonsmoking women at low risk for fetal growth abnormalities with complete information on caffeine consumption from 12 US clinical sites between 2009 and 2013. Secondary analysis was completed in 2020. Exposures: Caffeine was evaluated by both plasma concentrations of caffeine and paraxanthine and self-reported caffeinated beverage consumption measured/reported at 10-13 weeks gestation. Caffeine metabolism defined as fast or slow using genotype information from the single nucleotide variant rs762551 (CYP1A2*1F). Main Outcomes and Measures: Neonatal anthropometric measures, including birth weight, length, and head, abdominal, arm, and thigh circumferences, skin fold and fat mass measures. The ß coefficients represent the change in neonatal anthropometric measure per SD change in exposure. Results: A total of 2055 participants had a mean (SD) age of 28.3 (5.5) years, mean (SD) body mass index of 23.6 (3.0), and 580 (28.2%) were Hispanic, 562 (27.4%) were White, 518 (25.2%) were Black, and 395 (19.2%) were Asian/Pacific Islander. Delivery occurred at a mean (SD) of 39.2 (1.7) gestational weeks. Compared with the first quartile of plasma caffeine level (≤28 ng/mL), neonates of women in the fourth quartile (>659 ng/mL) had lower birth weight (ß = -84.3 g; 95% CI, -145.9 to -22.6 g; P = .04 for trend), length (ß = -0.44 cm; 95% CI, -0.78 to -0.12 cm; P = .04 for trend), and head (ß = -0.28 cm; 95% CI, -0.47 to -0.09 cm; P < .001 for trend), arm (ß = -0.25 cm; 95% CI, -0.41 to -0.09 cm: P = .02 for trend), and thigh (ß = -0.29 cm; 95% CI, -0.58 to -0.04 cm; P = .07 for trend) circumference. Similar reductions were observed for paraxanthine quartiles, and for continuous measures of caffeine and paraxanthine concentrations. Compared with women who reported drinking no caffeinated beverages, women who consumed approximately 50 mg per day (~ 1/2 cup of coffee) had neonates with lower birth weight (ß = -66 g; 95% CI, -121 to -10 g), smaller arm (ß = -0.17 cm; 95% CI, -0.31 to -0.02 cm) and thigh (ß = -0.32 cm; 95% CI, -0.55 to -0.09 cm) circumference, and smaller anterior flank skin fold (ß = -0.24 mm; 95% CI, -0.47 to -0.01 mm). Results did not differ by fast or slow caffeine metabolism genotype. Conclusions and Relevance: In this cohort study, small reductions in neonatal anthropometric measurements with increasing caffeine consumption were observed. Findings suggest that caffeine consumption during pregnancy, even at levels much lower than the recommended 200 mg per day of caffeine, are associated with decreased fetal growth.


Assuntos
Antropometria/métodos , Peso ao Nascer/fisiologia , Cafeína/farmacocinética , Desenvolvimento Fetal/efeitos dos fármacos , Exposição Materna/efeitos adversos , Adulto , Biomarcadores/sangue , Feminino , Seguimentos , Idade Gestacional , Humanos , Recém-Nascido , Masculino , Gravidez , Estudos Retrospectivos , Teofilina/sangue
14.
Am J Clin Nutr ; 113(6): 1679-1687, 2021 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-33742191

RESUMO

BACKGROUND: Calf circumference (CC) is used in geriatric studies as a simple and practical skeletal muscle (SM) marker for diagnosing low SM and sarcopenia. Currently applied CC cutoff points were developed in samples including older participants; values representative of the full adult lifespan are lacking. OBJECTIVES: We aimed to develop CC cutoff points and to identify relevant confounding factors from the large and diverse NHANES 1999-2006 population sample. METHODS: Demographic, anthropometric, and imaging data (DXA, appendicular lean mass) from the adult (age ≥18 y) NHANES sample were partitioned into subgroups according to sex, age, ethnicity, and race. Adults aged 18-39 y and BMI (in kg/m2) 18.5-24.9 were set as a reference population; CC cutoff points were derived at 1 and 2 SDs below the mean. RESULTS: The sample included 17,789 participants, 51.3% males and 48.7% females, with respective ages (mean ± SD) of 43.3 ± 16.1 y and 45.5 ± 16.9 y. CC was strongly correlated with appendicular lean mass, r = 0.84 and 0.86 for males and females (both P < 0.001), respectively. Significant differences in mean CC were present across sex, ethnic, self-reported race, and BMI groups. Adjusting CC for adiposity using BMI revealed a decrease in CC beginning after the second decade in males and third decade in females. Rounded CC cutoff values for moderately and severely low CC were 34 cm and 32 cm (males), and 33 cm and 31 cm (females), respectively. Our findings support the use of BMI-adjusted CC values for participants outside the normal-weight BMI range (18-24.9). CONCLUSIONS: This study defined CC values in a diverse population sample along with a BMI-adjustment approach that helps to remove the confounding effects of adiposity and thereby improves CC as a useful clinical estimate of SM mass.


Assuntos
Antropometria/métodos , Composição Corporal , Perna (Membro)/anatomia & histologia , Estado Nutricional , Sarcopenia/diagnóstico , Adulto , Índice de Massa Corporal , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/fisiologia , Inquéritos Nutricionais
15.
Clin Nutr ESPEN ; 42: 233-238, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33745585

RESUMO

BACKGROUND: Paediatric Crohn's disease (CD) has been associated with undernutrition. Accurate and accessible measures of body composition would provide data to personalise nutritional therapy. We assessed feasibility of MRI-derived measures of psoas cross-sectional area (PCSA) in paediatric CD and correlated with anthropometric and bioelectrical impedance spectroscopy (BIS) measures. METHODS: MRI small bowel/pelvis images of patients with CD, aged <18 years, were retrieved. Patients with concurrent anthropometric and BIS measurements were eligible for inclusion. The PCSA at L3 was calculated by two assessors and combined. To assess reproducibility of measures we calculated the coefficient of variation (CoV). Age, height-Z-scores, weight-Z-scores and BIS measures were correlated with PCSA. Using normal paediatric data from CT-scans we derived psoas area Z-scores for our cohort. RESULTS: 10 patients were included. Mean age at MRI scan was 14.6 years (11.7-16.3). PCSA was calculated for all MRI scans. There was high reproducibility between measurers, mean CoV 0.099. There was a significant positive correlation between PCSA and BIA-derived fat free mass, Pearson correlation coefficient (PCC) 0.831, p = 0.003. Correlation coefficients for PCSA and Height-for-age Z-score, weight-for-age -Z-score and age were PCC 0.343- p = 0.33, PCC = 0.222- p = 0.54, and PCC 0.6034- p = 0.065, respectively. The mean PCSA Z-score was -1.81, with 70% of the patients having a Z-score < -2.0. CONCLUSIONS: These data demonstrate the feasibility of deriving measures of body composition from routine MRI imagine. There was significant positive correlation between PCSA and BIS-derived lean mass. Further studies are required to confirm applicability of normal ranges prior to routine clinical implementation.


Assuntos
Doença de Crohn/diagnóstico por imagem , Espectroscopia Dielétrica/métodos , Impedância Elétrica , Imageamento por Ressonância Magnética/métodos , Músculos Psoas/diagnóstico por imagem , Adolescente , Antropometria/métodos , Composição Corporal , Peso Corporal , Criança , Feminino , Humanos , Masculino , Avaliação Nutricional , Pelve , Reprodutibilidade dos Testes
16.
Biomed Res Int ; 2021: 6696357, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33778081

RESUMO

Background: Sedentary lifestyle and work from home schedules due to the ongoing COVID-19 pandemic in 2020 have caused a significant rise in obesity across adults. With limited visits to the doctors during this period to avoid possible infections, there is currently no way to measure or track obesity. Methods: We reviewed the literature on relationships between obesity and facial features, in white, black, hispanic-latino, and Korean populations and validated them against a cohort of Indian participants (n = 106). The body mass index (BMI) and waist-to-hip ratio (WHR) were obtained using anthropometric measurements, and body fat mass (BFM), percentage body fat (PBF), and visceral fat area (VFA) were measured using body composition analysis. Facial pictures were also collected and processed to characterize facial geometry. Regression analysis was conducted to determine correlations between body fat parameters and facial model parameters. Results: Lower facial geometry was highly correlated with BMI (R 2 = 0.77) followed by PBF (R 2 = 0.72), VFA (R 2 = 0.65), WHR (R 2 = 0.60), BFM (R 2 = 0.59), and weight (R 2 = 0.54). Conclusions: The ability to predict obesity using facial images through mobile application or telemedicine can help with early diagnosis and timely medical intervention for people with obesity during the pandemic.


Assuntos
Antropometria/métodos , Reconhecimento Facial Automatizado/métodos , COVID-19/epidemiologia , Obesidade/diagnóstico , Adulto , Composição Corporal , Índice de Massa Corporal , Peso Corporal , Reconhecimento Facial/fisiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Obesidade/metabolismo , Pandemias , Valor Preditivo dos Testes , Prognóstico , Fatores de Risco , SARS-CoV-2/isolamento & purificação , Circunferência da Cintura , Relação Cintura-Quadril
17.
Medicine (Baltimore) ; 100(5): e24061, 2021 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-33592858

RESUMO

ABSTRACT: Irisin, a novel myokine, is believed to be the crucial factor in converting white adipose tissue to beige adipose tissue. For this paper, we studied the relationship among irisin and components of metabolic syndrome (MetS), and insulin secretion and resistance in schoolchildren of Taiwan.Subjects receiving routine annual health examination at elementary school were enrolled. Demographic data, anthropometry, MetS components, irisin, and insulin secretion and resistance were collected. Subjects were divided into normal, overweight, and obese groups for evaluation of irisin in obesity. Finally, the relationship between irisin and MetS was analyzed.There were 376 children (179 boys and 197 girls), aged 10.3 ±â€Š1.5 years, were enrolled. In boys, irisin levels were not associated with body mass index percentile, body fat, blood pressure, lipid profiles, insulin secretion or resistance. After adjusting for age, the irisin level in boys was negatively related to fasting plasma glucose (FPG) (r = -0.21, P = .006). In girls, after adjusting for age, the irisin levels were positively related only to FPG (r = 1.49, P = .038). In both genders, irisin levels were similar among normal, overweight, and obese groups, and between subjects with and without MetS.The irisin levels were not associated with MetS in either boys or girls. In girls, circulating irisin levels have a nonsignificant declining trend in overweight and obese girls. However, irisin levels were negatively related to FPG in boys and positively related to FPG in girls. The contrary relationship between irisin and FPG in boys and girls needs further exploration.


Assuntos
Tecido Adiposo/metabolismo , Fibronectinas , Secreção de Insulina/fisiologia , Insulina , Síndrome Metabólica , Sobrepeso , Antropometria/métodos , Determinação da Pressão Arterial/métodos , Índice de Massa Corporal , Criança , Estudos Transversais , Feminino , Fibronectinas/sangue , Fibronectinas/metabolismo , Humanos , Insulina/sangue , Insulina/metabolismo , Resistência à Insulina/fisiologia , Masculino , Síndrome Metabólica/sangue , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/epidemiologia , Obesidade/diagnóstico , Obesidade/epidemiologia , Obesidade/metabolismo , Sobrepeso/diagnóstico , Sobrepeso/epidemiologia , Sobrepeso/metabolismo , Serviços de Saúde Escolar/estatística & dados numéricos , Taiwan/epidemiologia
18.
Diabetes Res Clin Pract ; 173: 108687, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33571601

RESUMO

AIMS: To compare body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) as determinants of type 2 diabetes (T2DM) and determine optimal cut-offs in a sub-Saharan African population. METHODS: Data from the RODAM study including Ghanaians aged 25-70 living in rural Ghana, urban Ghana and Europe were used. Logistic regression was used to assess associations between BMI, WC, WHR and T2DM status, by sex and site. Area under the curve (AUC) were constructed to discriminate between indices and establish performance and cut-off values. RESULTS: WHR had the strongest association with T2DM in men and women across sites, except for rural men. The highest adjusted odds ratio (aOR) and AUC were in rural women for WHR (aOR = 2.09, 95%CI = 1.47-2.99; AUC = 0.71). Among migrants, WHR had higher AUCs compared with BMI (p < 0.01) and WC (p < 0.05). Cut-offs for BMI and WC in men were lower compared with the WHO reference across sites (WC: 85.4-93.7 vs 102 cm, BMI: 23.1-28.2 vs 30.0 kg/m2). CONCLUSIONS: WHR outperformed BMI and WC as anthropometric indices in relation to T2DM among Ghanaian migrants. The lower BMI and WC cut-offs for T2DM than WHO established standards, highlights the need for African specific cut-offs to avoid missing high risk populations.


Assuntos
Antropometria/métodos , Índice de Massa Corporal , Diabetes Mellitus Tipo 2/epidemiologia , Circunferência da Cintura/fisiologia , Relação Cintura-Quadril/métodos , Adulto , Idoso , Estudos Transversais , Feminino , Gana , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Migrantes
19.
Enferm. clín. (Ed. impr.) ; 31(1): 45-50, ene.-feb. 2021. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-202290

RESUMO

OBJETIVOS: Desarrollar y validar una herramienta de estimación del peso en emergencias pediátricas. MÉTODO: Estudio realizado en 2 etapas. Utilizando datos antropométricos informatizados de los servicios de pediatría de atención primaria de Bilbao (País Vasco, España) se elaboraron modelos de regresión lineal para estimar el peso en función de la estatura. Posteriormente, estos modelos fueron aplicados de forma prospectiva a una muestra consecutiva de pacientes pediátricos atendidos en urgencias de 2 hospitales terciarios. Se compararon los pesos estimados con los reales, calculando el coeficiente de correlación intraclase (CCI), media de la diferencia y proporción de mediciones con un error del peso estimado inferior al 10 y 20% con respecto al valor real. RESULTADOS: A partir de los datos antropométricos de 15.522 menores se desarrollaron 2 fórmulas predictivas del peso («fórmulas de Bilbao»). Las formulas fueron validadas sobre una muestra de 780 pacientes pediátricos, y estimaron valores del peso con un alto grado de correlación intraclase con respecto al peso real (CCI=0,93; p < 0,001) y una media de la diferencia de 0,63 (DE: 4,3). La proporción de error de la estimación del peso con respecto al valor real fue inferior al 10 en el 62,2% (IC 95%: 58,7-65,6) de las mediciones e inferior al 20% en el 93,1% (IC 95%: 91,1-94,8), unos resultados notablemente mejores que los que hubiesen obtenido otras fórmulas clásicas. CONCLUSIONES: Las «fórmulas de Bilbao» pueden suponer una herramienta válida en la estimación del peso en pacientes pediátricos en urgencias y predicen el peso con mayor precisión que otras fórmulas de uso más habitual basadas en la edad


OBJECTIVE: To develop and validate a weight estimation tool applicable in paediatric emergency care. METHODS: Using anthropometric data from a computerized database of the primary health care paediatric services, Bilbao (Basque Country, Spain), linear regression models were developed with the objective of estimating weight from height. Subsequently, these models were prospectively validated using a consecutive sample of children attended in the emergency department of two tertiary hospitals. Estimated weights were compared with actual weights, calculating the intraclass correlation coefficient (ICC), mean difference and percentages of estimations falling within 10% and 20% of the actual weight. RESULTS: Using anthropometric data from 15522 children two weight predictive formulas were developed (Bilbao Formulas). The formulas were validated on a sample of 780 children and estimated weight values with a high degree of intraclass correlation with the real weight (ICC=.93, P<.001) and a mean difference of .63 (SD: 4.3). The percentages of estimations falling within 10% and 20% of the actual weight of the child was 62.2% (95% CI: 58.7-65.6) and 93.1% (95% CI: 91.1-94.8), respectively. Weight estimations were more accurate using Bilbao Formulas than other classical formulas. CONCLUSIONS: Bilbao Formulas would be a valid tool for estimating weight in children in the emergency department and predict weight more accurately than other more commonly used age-based formulas


Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Peso Corporal , Peso-Estatura , Antropometria/métodos , Cálculos da Dosagem de Medicamento , Serviço Hospitalar de Emergência/estatística & dados numéricos , Tratamento de Emergência/métodos , Enfermagem Pediátrica/métodos , Medicina de Emergência Pediátrica/métodos
20.
Heart Vessels ; 36(8): 1184-1189, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33512598

RESUMO

This study aimed to clarify the effects of the interruption of cardiac rehabilitation (CR) and refraining from going outside due to the COVID-19 pandemic on hemodynamic response and rating of perceived exertion (RPE) during exercise including differences by age in phase 2 CR outpatients. Among 76 outpatients participating in consecutive phase 2 CR in both periods from March to April and June to July 2020, which were before and after CR interruption, respectively, at Sanda City Hospital were enrolled. The inclusion criterion was outpatients whose CR was interrupted due to COVID-19. We compared the data of hemodynamic response and RPE during exercise on the last day before interruption and the first day after interruption when aerobic exercise was performed at the same exercise intensity in the < 75 years group and ≥ 75 years group. Fifty-three patients were enrolled in the final analysis. Post-CR interruption, peak heart rate increased significantly (p = 0.009) in the < 75 years group, whereas in the ≥ 75 years group, weight and body mass index decreased significantly (p = 0.009, 0.011, respectively) and Borg scale scores for both dyspnea and lower extremities fatigue worsened significantly (both, p < 0.001). CR interruption and refraining from going outside due to the COVID-19 pandemic affected the hemodynamic response, RPE during exercise and body weight in phase 2 CR outpatients. In particular, patients aged ≥ 75 years appeared to be placed at an increased risk of frailty.


Assuntos
COVID-19 , Reabilitação Cardíaca , Doenças Cardiovasculares , Fragilidade , Hemodinâmica , Esforço Físico , Idoso , Antropometria/métodos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Reabilitação Cardíaca/métodos , Reabilitação Cardíaca/estatística & dados numéricos , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/fisiopatologia , Controle de Doenças Transmissíveis/métodos , Dispneia/diagnóstico , Dispneia/etiologia , Exercício Físico/fisiologia , Teste de Esforço/métodos , Teste de Esforço/estatística & dados numéricos , Feminino , Fragilidade/etiologia , Fragilidade/fisiopatologia , Fragilidade/prevenção & controle , Humanos , Japão/epidemiologia , Masculino , SARS-CoV-2
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