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1.
Nutr. hosp ; 36(5): 1087-1094, sept.-oct. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-184631

RESUMO

Objetivos: analizar la prevalencia de salud metabólica en pacientes obesos de Mallorca. Métodos: los participantes se clasificaron en obesos sanos metabólicamente (OSM) y obesos no sanos metabólicamente (ONSM) en función de si presentaban o no síndrome metabólico (SMet), definido según los criterios del NCEP ATP III. Se evaluaron hábitos alimentarios, tóxicos y estilo de vida, tiempo de evolución de la obesidad, antecedentes de lactancia materna, obesidad en la infancia y familiares de obesidad y diabetes mellitus, así como glucosa, colesterol total, colesterol-HDL y triglicéridos plasmáticos en 457 pacientes obesos residentes en Mallorca. Resultados: la prevalencia de OSM fue del 49,2% y la de ONSM fue del 50,8%. El fenotipo de OSM disminuyó con la edad. Todos los pacientes presentaron hábitos inadecuados. Ambos grupos presentaron similar consumo de frutas, ensaladas y verduras, hábito tabáquico y práctica de actividad física. El 37,4% de los sujetos consumía bebidas azucaradas y el 52,9% consumía alcohol, más en ONSM (4,3%) que en OSM (0,4%). Los sujetos ONSM presentaron mayores valores de índice de masa corporal (IMC), circunferencia abdominal, porcentaje de grasa e índice de grasa visceral (IGV) y variables metabólicas estudiadas que los OSM. Conclusiones: más de la mitad de la población obesa analizada presentó complicaciones metabólicas, aunque toda la población obesa mostró similares hábitos alimentarios y de estilo de vida inadecuados. El incremento de edad, el bajo nivel educativo, los años de evolución de la obesidad y la localización visceral de la grasa se asocian a un estado metabólico no saludable. Deberían aunarse criterios para definir y tipificar el estado metabólico de los sujetos obesos


Aims: to assess the prevalence of metabolic health in Mallorca obese patients. Methods: participants were classified in metabolically healthy obese (MHO) and metabolically non-healthy obese (MNHO). Food, toxic and lifestyle habits, time of obesity evolution, breastfeeding, obesity in childhood and family history of obesity and diabetes mellitus, as well as glycemia, total cholesterol, HDL-cholesterol and triglyceridemia were evaluated in 457 obese patients. Results: prevalence of MHO was 49.2% and that of MNHO was 50.8%. MHO phenotype decreased with age. All patients showed inadequate habits. Consumption of fruits, salads and vegetables, tobacco and physical activity were similar between both groups; 37.4% of patients consumed sugary sweet drinks, and 52.9% consumed alcohol, higher in MNHO (4.3%) than in MHO (0.4%). MNHO showed higher values of BMI, abdominal circumference, fat percentage and visceral fatty index, as well as all metabolically studied outcomes. Conclusions: more than half of assessed obese population showed metabolic complications, but all obese population showed similar inadequate food and lifestyle habits. Increase of age, low educational level, years of obesity evolution, and visceral localization of fat are associated with a metabolically non-healthy status. Criteria to define and typify the metabolic state of obese subjects should be unified


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/complicações , Espanha/epidemiologia , Obesidade/classificação , Comportamento Alimentar , Atividade Motora , Índice de Massa Corporal , Estilo de Vida , Inquéritos Nutricionais , Antropometria , Estudos Transversais
2.
Diabetes Metab Syndr ; 13(4): 2419-2424, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31405653

RESUMO

AIMS: To investigate the association of obesity phenotypes with non-obese components of metabolic syndrome (MetS) by considering the presence of general adiposity and central obesity. METHODS: We analyzed the data of population-based cross-sectional study of 981 adults' individuals who were community dwelling in urban population of Babol, the north of Iran. The demographic characteristics and anthropometric measures and hypertension were collected with standard method by trained nurses. The fasting blood sugar, CHL, TG, HDL-C and LDL-C were measured by enzymatic method. The presence of cardiometabolic risk factors were analyzed according to the combination of obesity phenotypes either overweight/obese or central obese. The logistic regression model was used to calculate the adjusted odds ratio (OR) of obesity phenotypes in compared with normal weight not central obese in association of presence of metabolic abnormality. RESULTS: The 394 (40.6%) individuals were both overweight/obese and central obese and 295 (30.1%) persons were "normal weight not central obese" and the minority 28(2.9%) were normal weight but central obese and the remainder 260 (26.5%) were "overweight/obese not central obese". Overweight/obese not central obese increased significantly the odds of presence of ≥2 non-obese components of metabolic abnormality by 2.17 times (95%CI OR: 1.51, 3.13) but the OR was elevated for the joint phenotypes of overweight/obese and central obese (OR = 4.16 (95%CI: 2.85, 6.06) as compare with normal weight not central obese. CONCLUSIONS: Overweight/obese alone increased the risk of cardiometabolic abnormality but being overweight/obese and central obese a further elevated the risk compared with "normal weight not central obese".


Assuntos
Adiposidade , Hipertensão/fisiopatologia , Síndrome Metabólica/epidemiologia , Obesidade/classificação , Obesidade/fisiopatologia , Sobrepeso/fisiopatologia , Adulto , Biomarcadores/análise , Índice de Massa Corporal , Estudos Transversais , Feminino , Seguimentos , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Fenótipo , Prognóstico
3.
Diabetes Metab Syndr ; 13(1): 62-67, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30641777

RESUMO

Insulin resistance (IR) is the corner stone of metabolic obesity. This cross-sectional analytical study was aimed to find out the frequency of IR in non-diabetic adult individuals of different obesity phenotypes that would help to implement preventive measures to avoid the cardiometabolic catastrophes. METHODS: Total 955 nondiabetic adult individuals were selected and categorized into six metabolic phenotypes by metabolic syndrome criteria in each BMI group (18.5-24.9-normal weight, 25-29.9-overweight, ≥30-obese). From them, metabolically obese normal weight, metabolically obese overweight, metabolically healthy obese and metabolically unhealthy obese were selected as Obesity phenotypes (N = 616). RESULTS: The frequency of IR was found to be very high (60.2%) in total nondiabetic adult obese individuals (N = 616). Highest frequency of IR was found in MUO phenotype (76.3%), lowest frequency of IR was found in MONW phenotype (37.1%) and frequency of IR in MOOW and MHO phenotypes found to be identical but significantly (p < 0.0001) less than MUO and significantly (p < 0.0001) more than MONW phenotype. Among the obesity phenotypes, females were more insulin resistant than males (67.5% vs 48.1% respectively, p < 0.05). Frequency of IR found significantly (p < 0.05) more in female than male in all obesity phenotypes except in MUO phenotype where males found to show significantly (p < 0.05) higher frequency than females. Frequency of IR was significantly higher in younger (20-39 yrs) age group than 40-60 yrs age group (63.2% vs 53.5% respectively, p < 0.05). CONCLUSION: IR is alarmingly high (60.2%) in nondiabetic adult obese individuals. Among different obesity phenotypes, it is highest (76.3%) in MUO and lowest (37.1%) in MONW.


Assuntos
Resistência à Insulina , Síndrome Metabólica/etiologia , Obesidade/complicações , Adulto , Bangladesh/epidemiologia , Biomarcadores/análise , Índice de Massa Corporal , Estudos Transversais , Feminino , Seguimentos , Humanos , Masculino , Síndrome Metabólica/epidemiologia , Pessoa de Meia-Idade , Obesidade/classificação , Fenótipo , Prognóstico , Adulto Jovem
4.
Obes Surg ; 29(1): 191-196, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30238216

RESUMO

BACKGROUND: The aim of the study was to assess the long-term outcome in terms of weight loss and remission of comorbidities among the patients who had undergone LSG in an Indian setting. METHODS: This is a retrospective observational study of patients (BMI > 30 kg/m2) who underwent LSG having a minimum 6 months of follow-up data. Based on preoperative BMI, patients were grouped as class 1, 30 < BMI < 35 kg/m2; class 2, 35 < BMI < 40 kg/m2; and class 3, BMI > 40 kg/m2. Data on BMI and %EWL between three classes and among genders at different follow-up points for 7 years were compared. RESULT: Study included 95 patients (mean age of 33.7 ± 11 years), and the preoperative mean BMI was 40.2 ± 5.1 kg/m2. At one year of surgery, 85.5% patients achieved > 50%EWL. The highest mean %EWL was found in class 1 (66.19%), followed by class 2 (56.73%) and class 3 (46.59%) at the sixth month follow-up. At the seventh year, %EWLs were 85.11% (class 1), 76.69% (class 2), and 62.98% (class 3) and the mean BMIs were 25.13 ± 3.09 kg/m2 (class 1), 26.86 ± 2.12 kg/m2 (class 2), and 31.07 ± 3.39 kg/m2 (class 3) and were significantly different (p < 0.05). At the last follow-up, though, the males showed slight weight regain; however, there were no statistical differences between the genders (p = 0.065). CONCLUSION: Outcome from LSG was better in patients with BMI < 40 kg/m2 compared to the patients with BMI > 40 kg/m2. Remission of obesity-related comorbidities was observed with LSG in all groups and gender did not influence the outcome significantly.


Assuntos
Gastrectomia , Obesidade/epidemiologia , Obesidade/cirurgia , Adulto , Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Índice de Massa Corporal , Comorbidade , Feminino , Seguimentos , Gastrectomia/efeitos adversos , Gastrectomia/estatística & dados numéricos , Humanos , Índia/epidemiologia , Laparoscopia/efeitos adversos , Laparoscopia/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Obesidade/classificação , Obesidade/etnologia , Obesidade Mórbida/classificação , Obesidade Mórbida/epidemiologia , Obesidade Mórbida/cirurgia , Estudos Retrospectivos , Resultado do Tratamento , Perda de Peso , Adulto Jovem
5.
Clin Obes ; 9(1): e12287, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30458581

RESUMO

Health behaviour change is a cornerstone in the management of obesity, and data on health behaviours, intentions and barriers to change would be useful to inform the development of interventions. The aim of this study was to describe these variables in individuals with obesity, and to compare obesity classes. The study obtained data from the Canadian Community Health Survey 2011-2012 including 5614 adults with body mass index (BMI) ≥30 kg m-2 . The majority of participants reported eating four or more fruits and vegetables daily (65.3% [95% confidence interval {CI}: 64.1-66.6]), being a regular drinker (59.6% [95% CI: 58.4-61.0]) and inactive (58.0% [95% CI: 56.7-59.3]). About 84% of participants answered they should do and/or intend to do something in the next year to improve their health, with increasing exercise being the most reported choice (69.2% [95% CI: 67.1-71.5]). Among the 58.0% (95% CI: 55.9-60.2) of participants facing barriers to change, the lack of willpower was the most reported (37.0% [95% CI: 34.2-39.7]). No difference between classes for intention to change and barriers were found. Comorbidities were the most important factor explaining several health behaviours and barriers to change. The vast majority of participants, regardless of the severity of obesity, know they should do and also want to do something to improve their health, but faced a lack of willpower. Thus, the most important thing to consider during an obesity intervention is the lack of motivation to modify health behaviours and beyond BMI, the presence of comorbidities.


Assuntos
Terapia Comportamental/estatística & dados numéricos , Comportamentos Relacionados com a Saúde , Obesidade/psicologia , Obesidade/terapia , Adolescente , Adulto , Idoso , Consumo de Bebidas Alcoólicas/epidemiologia , Índice de Massa Corporal , Canadá , Comorbidade , Dieta , Exercício , Feminino , Frutas , Inquéritos Epidemiológicos , Humanos , Intenção , Masculino , Pessoa de Meia-Idade , Motivação , Obesidade/classificação , Verduras
6.
Semergen ; 45(2): 101-108, 2019 Mar.
Artigo em Espanhol | MEDLINE | ID: mdl-30268360

RESUMO

INTRODUCTION: Overweight and obesity have the features of a worldwide epidemic, making it a public health problem. The traditional classification with the body mass index is a good start, but after the evidence of the biochemical activities of adipose tissue, its measurement is a necessity. There are multiple formulas for this purpose, but with little possibility of applying it in Primary Care. The following formulas are proposed for its use in this setting; Men=(body mass index [BMI/Abdominal Circumference [AC]*10)+BMI. Women=([BMI/AC]*10)+BMI+10. MATERIAL AND METHODS: A descriptive, prospective study was conducted, including 505 women and 489 men aged between 30 and 90 years. Weight, height, and abdominal circumference were measured, and the body mass index, percentage of fat using the CUN BAE (Clínica Universidad de Navarra - Body Adiposity Estimator) and proposed formulas were calculated. RESULTS: Comparative calculations were made between CUN BAE and formulas. No significant differences were observed in the descriptive values (Women χ2=1.1; P=.89. Men χ2=0.8; P=.93. The confidence interval and standard error p=1. The numerical correlation shows r=0.94; p=0.0001; R2=0.89. The relative error of the mean in men was 5.48% and -0.43% in women. The comparison of medians demonstrated Wilcoxon=0.8333. The study of sensitivity and specificity for cut-off points shows a ROC curve AUC=0.986; P=<.0001. CONCLUSIONS: The lack of significant differences between the results of both formulas, makes it possible to be proposed for the calculation of the fat percentage in body weight in Primary Care Clinics.


Assuntos
Tecido Adiposo , Índice de Massa Corporal , Circunferência da Cintura , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/classificação , Obesidade/diagnóstico , Sobrepeso/classificação , Sobrepeso/diagnóstico , Estudos Prospectivos
7.
Aging Clin Exp Res ; 31(7): 977-984, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30293107

RESUMO

INTRODUCTION: Mobility disability affects nearly 15% of people aged 65 or over worldwide. Excess weight or obesity (OB), along with an accentuated loss of muscle strength (dynapenia), is recognized to be one of the most common risk factors for mobility impairment among the elderly. OBJECTIVE: To investigate the effect of a 12-week mixed power training (MPT high-velocity resistance training mixed with functional exercises) on physical function in obese older men exhibiting different severities of dynapenia. METHODS: Community-dwelling older men (69 ± 6 years) were assigned to the study if they were considered obese (OB, fat mass ≥ 25% body weight, BW) and to one of the two groups according to severity of dynapenia [(handgrip strength-HS)/BW]: type 1(OB-DY1) or type 2(OB-DY2), < 1 or 2SD from a young reference group. Participants followed a 12-week MPT, three times/week, 75 min/session. Main outcomes included the performance on the 4-m and 6-min walking tests, Timed Up and Go, stair and balance tests. RESULTS AND DISCUSSION: At baseline, OB-DY1 performed better than OB-DY2 in all functional tests (p < 0.05). Following the intervention, medium-to-large training effect size (ES) were observed for fat (ES = 0.21) and lean (ES = 0.32, p < 0.001) masses, functional performance (ES 0.11-0.54, p < 0.05), HS (ES = 0.10, p < 0.05) and lower limb muscle strength (ES = 0.67, p < 0.001) and power (ES = 0.60, p < 0.05). Training-by-group interaction showed that OB-DY1 lost more FM (ES = 0.11, p = 0.03) and OB-DY2 improved more HS (ES = 0.19, p = 0.006) than their counterparts. CONCLUSIONS: Seniors with obesity and severe dynapenia have poorer physical function than those in the early stage of dynapenia. Both seem to benefit from a high-velocity resistance training mixed with functional exercises, although by slightly different pathways.


Assuntos
Obesidade/terapia , Treinamento de Resistência/métodos , Sarcopenia/terapia , Idoso , Idoso de 80 Anos ou mais , Força da Mão/fisiologia , Humanos , Masculino , Debilidade Muscular/complicações , Obesidade/classificação , Obesidade/complicações , Fatores de Risco , Sarcopenia/classificação , Sarcopenia/complicações , Índice de Gravidade de Doença
8.
São Paulo; s.n; s.n; 2019. 102 p. graf, tab.
Tese em Português | LILACS | ID: biblio-1048637

RESUMO

A obesidade é um dos principais fatores etiológicos do desenvolvimento da resistência à insulina, e ambos são responsáveis, em parte, pelo aumento do estresse oxidativo e diabete mellitus tipo 2. Vários estudos têm mostrado os benefícios de uma dieta rica em vegetais e frutas, devido à ação dos compostos bioativos sobre os parâmetros clínicos e estresse oxidativo. O objetivo deste estudo foi verificar os efeitos dos sucos de laranja, obtido das variedades Pera e Moro, sobre os marcadores bioquímicos e de estresse oxidativo, em indivíduos com resistência à insulina, classificados através do índice HOMA-IR. Os voluntários foram suplementados durante 15 dias com os sucos de laranja em um ensaio crossover, com washout de 40 dias. Nos dias 0 e 16 de cada ensaio, foram registrados parâmetros antropométricos e de consumo alimentar, e coletadas amostras de sangue e urina pra análises bioquímicas e de estresse oxidativo. A composição de flavonoides entre as variedades de suco foi similar, diferindo no conteúdo de ácido ascórbico e antocianinas do suco de laranja Moro. Não foram observadas mudanças nos parâmetros de estresse oxidativo após a administração dos sucos de laranja, com exceção do 8-OHdG urinário, um marcador de dano oxidativo ao DNA que apresentou-se reduzido após ambas as intervenções. Dados clínicos não foram significativamente modificados, entretanto, observou-se grande variabilidade interindividual nos valores de pressão arterial e lipídios séricos. A partir desta premissa, foi realizada a análise lipidômica do plasma com amostras do ensaio com o suco de laranja cv. Pera e observaram-se reduções significativas nos triglicérides, principalmente aqueles compostos de ácidos graxos saturados ou monoinsaturados, ou contendo ao menos uma cadeia de ácido linoleico, além do aumento de espécies de acilcarnitinas de cadeia longa. O consumo de ambos os sucos de laranja parece exercer um efeito protetor contra o dano oxidativo ao DNA, provavelmente por ação não-enzimática. A análise lipidômica do plasma sugere que o suco de laranja cv. Pera pode modular o metabolismo de lipídios, relacionados à lipogênese de novo e beta-oxidação


Obesity is one of the main etiological factors of insulin resistance development, and both are responsible, in part, for the increase on oxidative stress and Diabetes mellitus type 2 development. Several studies have showed the benefits of a diet rich in vegetables and fruits, due to the action of bioactive compounds on biochemical and oxidative stress parameters. The aim of this study was to study the effects of orange juices obtained by varieties Pera and Moro on oxidative stress and clinical biomarkers, in obese subjects with insulin resistance, classified through the HOMA-IR index. The volunteers consumed both orange juices for 15 days with in a crossover design, with 40-day washout period. On days 0 and 16 of each trial, anthropometric and food consumption parameters were registered, and blood and urine samples were collected to analyze biochemical parameters and oxidative stress biomarkers. The flavonoids content of both juices was similar, but only orange juice from Moro variety contained anthocyanins and higher ascorbic acid content. No changes in oxidative stress markers were found after juice administration, except for urinary 8-OHdG, an oxidative DNA damage marker, which was reduced after both interventions. Clinical data were not significantly modified, but a high interindividual difference was observed in blood pressure and serum lipids. From this point of view, plasma lipidomic analysis was performed with samples of clinical trial with orange juice cv. Pera and showed significant decrease in triglycerides, mainly those with saturated or monounsaturated fatty acids, or containing at least one linoleic acid (related with inflammatory processes), besides the increase of long chain acylcarnitines. The intake of both orange juices appears to have a protective effect against DNA damage, probably by non-enzymatic action. Plasma lipidomic analysis suggests that Pera orange juice can modulate lipid metabolism related to de novo lipogenesis and fatty acid beta-oxidation


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Resistência à Insulina , Estresse Oxidativo , Citrus sinensis/efeitos adversos , Sucos de Frutas e Vegetais/efeitos adversos , Obesidade/classificação
9.
São Paulo; s.n; s.n; 2019. 110 p. graf, tab.
Tese em Inglês | LILACS | ID: biblio-1023378

RESUMO

Metabolic Syndrome (MetS) is a combination of diseases interrelated and associated with increased mortality and risk of cardiovascular events. Among the elucidated molecular mechanisms of MetS, there are several genes regulated by miRNAs - small non-coding RNAs. A large number of transcriptomic studies in public databases integrated with new analysis methods can generate new insights. Therefore, this study aimed to identify circulating miRNAs and their target genes in MetS using a Systems Biology approach. For this, we used GEO-NCBI to download and analyse 26 microarray transcriptome studies of MetS and obesity. After preprocessing, the data underwent differential expression (LIMMA method), gene co-expression (CEMiTool), and enrichment (GSEA, Reactome) analyses. We retrieved a gene expression signature for subcutaneous adipose tissue (SAT) for obese individuals that included 291 consistent differentially expressed genes (DEG). This signature had a positive normalized enrichment score (NES) for adaptive immune system activation responses, and negative NES for metabolic pathways. The consensus co-expression network of SAT revealed 3 communities (CM) of densely interconnected genes. These CMs had a high number of up regulated genes and a consistent positive NES among the studies. The co-expressed genes of these 3 CMs were related to neutrophil degranulation, infiltration of immune system cells, and inflammatory processes. Also, a small brazillian cohort (6 individuals with MetS and 6 controls) underwent a seric miRNA profiling using PCR array. From the 222 miRNAs detected in serum, the differential expression analysis identified 4 upregulated miRNAs (miR-30c-5p, miR-421, miR-542-5p and miR-574) in MetS patients (p<0.01). The integrative miRNAs-mRNAs analysis revealed that the circulating upregulated miRNAs had 12 targets in the SAT, 3 targets in the liver; and no targets in the muscle and blood. Many of these target genes are known modulators of proinflammatory pathways. In conclusion, the use of Systems Biology in the analysis of gene networks and circulating miRNAs identified some potential molecular and pathophysiological mechanisms of the Metabolic Syndrome. The circulating miRNAs identified in this study are potential biomarkers and/or therapeutic targets. However, further studies are needed to validate these miRNAs and their target mRNA


A Síndrome Metabólica (MetS) é um conjunto de doenças inter-relacionadas e associadas ao aumento de mortalidade e risco de eventos cardiovasculares. Entre os mecanismos moleculares elucidados da MetS, existem muitos genes regulados por miRNAs - RNAs pequenos não codificadores. O grande número de estudos transcriptômicos em banco dados públicos integrado a novos métodos de análise podem gerar novas descobertas. Deste modo, o objetivo deste estudo foi identificar miRNAs circulantes e genes alvos na MetS usando a abordagem de Biologia de Sistemas. Para isso, GEO-NCBI foi usado para obter e analisar 26 estudos de transcriptoma por microarray de MetS e obesidade. Após o pré-processamento, realizamos análises de expressão diferencial (método LIMMA), co-expressão gênica (CEMiTool), e enriquecimento (GSEA, Reactome). Identificamos uma assinatura de expressão gênica do tecido adiposo subcutâneo (SAT) de indivíduos obesos, composta por 291 genes consistentemente diferencialmente expressos (DEG). Essa assinatura teve um escore de enriquecimento normalizado (NES) positivo para ativação de respostas do sistema imune adaptativo, e NES negativo para vias de metabolismo. A rede consenso de co-expressão do SAT revelou 3 comunidades (CM) de genes densamente interconectadas. Essas CMs continham muitos genes regulados positivamente e com consistência de NES positivo entre os estudos. Os genes co-expressos dessas 3 comunidades pertenciam a vias de a degranulação de neutrófilos, infiltração de células do sistema imune e processos inflamatórios. Além disso, uma pequena coorte brasileira (6 indivíduos com MetS e 6 controles) foi submetida à dosagem sérica de miRNAs por PCR array. Dos 222 miRNAs detectados no soro, a análise de expressão diferencial identificou 4 miRNAs regulados positivamente (miR-30c-5p, miR-421, miR-542-5p e miR-574) nos pacientes com MetS (p<0.01). A análise integrativa miRNAs-mRNAs revelou que osmiRNAs circulantes superexpressos tinham 12 alvos no SAT, 3 alvos no fígado; e nenhum alvo no músculo e no sangue. Muitos desses alvos são moduladores de vias ró-inflamatórias. Em conclusão, a utilização da Biologia de Sistemas na análise de redes gênicas e miRNAs circulantes identificou alguns potenciais mecanismos moleculares e fisiopatológicos da Síndrome Metabólica. Os miRNAs circulantes identificados neste trabalho são potenciais biomarcadores e/ou alvos terapêuticos. Entretanto, mais estudos são necessários para validar esses miRNAs e seus mRNAs alvos


Assuntos
Síndrome Metabólica/diagnóstico , MicroRNAs/análise , Biologia de Sistemas/instrumentação , RNA Mensageiro/análise , Redes Reguladoras de Genes , Obesidade/classificação
10.
Pregnancy Hypertens ; 14: 205-212, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30527113

RESUMO

OBJECTIVE: To investigate the association between early-pregnancy weight gain and risk of preeclampsia to inform pregnancy weight gain recommendations. STUDY DESIGN: We performed a case-cohort study using a hospital database including 80,812 singleton deliveries from Magee-Womens Hospital, Pittsburgh, Pennsylvania (1998-2011). In each of 6 prepregnancy body mass index (BMI) groups, we abstracted serial antenatal weight measurements from the records of up to 339 preeclampsia cases and 1254 randomly selected pregnancies. Early gestational weight gain (16-19 weeks' gestation) was standardized for gestational duration using BMI-specific z-score charts. Multivariable log-binomial regression was used to assess the association between weight gain z-score and risk of preeclampsia. We determined the impact of preeclampsia misclassification using probabilistic bias analysis. MAIN OUTCOME MEASURE: Risk of preeclampsia. RESULTS: For normal weight women, there was a steady increase in preeclampsia risk with increasing early gestational weight gain z-score. For example, compared with a weight gain of 1.2 kg (z-score = -1 SD), a 7.2-kg weight gain (z-score = +1 SD) at 16 weeks was associated with 1.3 (0.50, 2.2) excess preeclampsia cases per 100 deliveries. Weight loss at 16-19 weeks among grade 2 or 3 obese women was associated with a reduced risk of preeclampsia. Associations were null among overweight and grade 1 obese women. The bias analysis supported the validity of the conventional analysis. CONCLUSIONS: Early-pregnancy weight gain may be associated with preeclampsia in some BMI groups. Future revisions of pregnancy weight gain recommendations should account for preeclampsia risks from this and additional studies.


Assuntos
Ganho de Peso na Gestação , Obesidade/complicações , Pré-Eclâmpsia/etiologia , Adulto , Índice de Massa Corporal , Estudos de Casos e Controles , Feminino , Humanos , Obesidade/classificação , Gravidez , Estudos Retrospectivos , Fatores de Risco , Adulto Jovem
11.
AMA J Ethics ; 20(12): E1195-1200, 2018 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-30585584

RESUMO

Addressing the question of how medicine should engage with people who consider their clinical disease condition to be importantly constitutive of their identity, this article focuses on one group-advocates for the fat acceptance (FA) or body positivity movement in American society. Drawing on philosophical analysis, I try to show that FA and physician communities represent different traditions within the larger culture and that whether obesity should be considered a disease is a culture battle. I argue that diseases (medical) and illnesses (cultural) are 2 different designations of clinical symptoms and that both disease and illness designations can change over time or be uncertain.


Assuntos
Doença Crônica/classificação , Características Culturais , Doença/classificação , Obesidade/classificação , Obesidade/psicologia , Terminologia como Assunto , Humanos , Estados Unidos
13.
Int J Cardiol ; 272: 185-188, 2018 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-30172477

RESUMO

BACKGROUND: The frontal QRS-T angle, defined as the absolute value of the difference between QRS axis and T-wave axis on 12­lead electrocardiogram (ECG), is the difference in orientation between ventricular depolarization and repolarization. We tested the hypothesis that QRS-T angle is affected by obesity. METHODS: A total of 177 patients undergoing both ECG and echocardiography within one month were recruited from outpatient clinic. Using the World Health Organization (WHO) classification of body mass index (BMI), the patients were classified into the four groups: underweight (<18.5 kg/m2, n = 25), normal weight (18.5-24.9 kg/m2, n = 79), overweight (25-29.9 kg/m2, n = 38) and obese (≥30 kg/m2, n = 35). RESULTS: Obese patients were significantly younger than those in other groups. As for echocardiographic variables, left ventricular internal dimension and left ventricular mass (LVM) increased with increased WHO classification of BMI. QRS axis and T-wave axis decreased with increased WHO classification of BMI, whereas QRS-T angle increased. Multivariate linear regression analysis showed that BMI (ß = 0.23, p = 0.01) and LVM (ß = 0.19, p = 0.046) were independent determinants of QRS-T angle. CONCLUSIONS: Our results suggest that BMI is an independent determinant of QRS-T angle.


Assuntos
Índice de Massa Corporal , Eletrocardiografia/classificação , Obesidade/classificação , Obesidade/fisiopatologia , Organização Mundial da Saúde , Idoso , Idoso de 80 Anos ou mais , Ecocardiografia/classificação , Ecocardiografia/métodos , Eletrocardiografia/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/diagnóstico por imagem
15.
Enferm Clin ; 28 Suppl 1: 310-315, 2018.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-30115355

RESUMO

OBJECTIVE: Hypertriglyceridemia is an independent risk factor for cardiovascular diseases. This study aimed to determine the prevalence and association of triglyceride level and lifestyle factors among Malay obese class I and II adults. METHOD: This is a cross-sectional study of 65 Malay obese class I and class II adults aged 20-62 years (21 male, 44 female) from sub-urban areas of Malaysia. Overnight fasting venous blood samples were obtained to determine the triglyceride level (mmol/L). Subjects were classified into either normal or elevated triglyceride level groups based on the triglyceride level (normal < 1.6 mmol/L, elevated > 1.7 mmol/L). Unhealthy lifestyle behaviors, defined as smoking status, hours per day spent on sitting passively and sitting with active motion, and the amount of saturated fat, mono-unsaturated and polyunsaturated fat from dietary intake, were measured from 24-h dietary intake and physical activity recall. We compare the variables of unhealthy lifestyle behaviors between subjects with normal and elevated triglyceride level using independent samples t-test. RESULTS: Among 65 obese class I and II adults, 16 subjects (24.6%) were found to have elevated triglyceride levels (mean ± standard deviation of body mass index 31.89 ± 3.29 kg/m2). There are significant differences between subjects having normal and elevated triglyceride level with gender, marital status, the number of children, smoking status, weight and monounsaturated fat intake (all P-values < .05). CONCLUSIONS: The findings of this study highlighted elevated triglyceride level in obese adults might be influenced by unhealthy lifestyle behaviors. We suggest that lifestyle modification intervention is appropriate to prevent cardiovascular disease among Malay obese class I and II adults.


Assuntos
Hipertrigliceridemia/complicações , Hipertrigliceridemia/epidemiologia , Estilo de Vida , Obesidade/sangue , Obesidade/complicações , Triglicerídeos/sangue , Adulto , Estudos Transversais , Gorduras na Dieta/administração & dosagem , Feminino , Humanos , Hipertrigliceridemia/sangue , Malásia/epidemiologia , Masculino , Obesidade/classificação , Prevalência , Fatores de Risco , Comportamento Sedentário
16.
Sci Rep ; 8(1): 10980, 2018 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-30030479

RESUMO

High whole-body fat percentage is independently associated with increased mortality. We aimed to identify a simple anthropometric linear equation that is more accurate than the body mass index (BMI) to estimate whole-body fat percentage among adult individuals. National Health and Nutrition Examination Survey (NHANES) 1999-2004 data (n = 12,581) were used for model development and NHANES 2005-2006 data (n = 3,456) were used for model validation. From the 365 anthropometric indices generated, the final selected equation was as follows: 64 - (20 × height/waist circumference) + (12 × sex), named as the relative fat mass (RFM); sex = 0 for men and 1 for women. In the validation dataset, compared with BMI, RFM better predicted whole-body fat percentage, measured by dual energy X-ray absorptiometry (DXA), among women and men. RFM showed better accuracy than the BMI and had fewer false negative cases of body fat-defined obesity among women and men. RFM reduced total obesity misclassification among all women and all men and, overall, among Mexican-Americans, European-Americans and African-Americans. In the population studied, the suggested RFM was more accurate than BMI to estimate whole-body fat percentage among women and men and improved body fat-defined obesity misclassification among American adult individuals of Mexican, European or African ethnicity.


Assuntos
Tecido Adiposo , Antropometria/métodos , Obesidade/classificação , Absorciometria de Fóton , Adulto , Índice de Massa Corporal , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Obesidade/etnologia , Fatores Sexuais , Estados Unidos , Adulto Jovem
17.
Ann Epidemiol ; 28(8): 510-514, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-29936049

RESUMO

PURPOSE: Exposure misclassification, selection bias, and confounding are important biases in epidemiologic studies, yet only confounding is routinely addressed quantitatively. We describe how to combine two previously described methods and adjust for multiple biases using logistic regression. METHODS: Weights were created from selection probabilities and predictive values for exposure classification and applied to multivariable logistic regression models in a case-control study of prepregnancy obesity (body mass index ≥30 vs. <30 kg/m2) and cleft lip with or without cleft palate (CL/P) using data from the National Birth Defects Prevention Study (2523 cases, 10,605 controls). RESULTS: Adjusting for confounding by race/ethnicity, prepregnancy obesity, and CL/P were weakly associated (odds ratio [OR]: 1.10; 95% confidence interval: 0.98, 1.23). After weighting the data to account for exposure misclassification, missing exposure data, selection bias, and confounding, multiple bias-adjusted ORs ranged from 0.94 to 1.03 in nonprobabilistic bias analyses and median multiple bias-adjusted ORs ranged from 0.93 to 1.02 in probabilistic analyses. CONCLUSIONS: This approach, adjusting for multiple biases using a logistic regression model, suggested that the observed association between obesity and CL/P could be due to the presence of bias.


Assuntos
Índice de Massa Corporal , Peso Corporal , Fenda Labial/etiologia , Fissura Palatina/etiologia , Obesidade/classificação , Complicações na Gravidez/classificação , Adolescente , Adulto , Viés , Estudos de Casos e Controles , Feminino , Humanos , Modelos Logísticos , Pessoa de Meia-Idade , Obesidade/complicações , Vigilância da População , Gravidez , Resultado da Gravidez , Análise de Regressão , Medição de Risco , Adulto Jovem
18.
Arq Bras Cir Dig ; 31(1): e1362, 2018 Jun 21.
Artigo em Inglês, Português | MEDLINE | ID: mdl-29947696

RESUMO

BACKGROUND: Body mass index (BMI) has some limitations for nutritional diagnosis since it does not represent an accurate measure of body fat and it is unable to identify predominant fat distribution. AIM: To develop a BMI based on the ratio of trunk mass and height. METHODS: Fifty-seven patients in preoperative evaluation to bariatric surgery were evaluated. The preoperative anthropometric evaluation assessed weight, height and BMI. The body composition was evaluated by bioimpedance, obtaining the trunk fat free mass and fat mass, and trunk height. Trunk BMI (tBMI) was calculated by the sum of the measurements of the trunk fat free mass (tFFM) and trunk fat mass (tFM) in kg, divided by the trunk height squared (m2)). The calculation of the trunk fat BMI (tfBMI) was calculated by tFM, in kg, divided by the trunk height squared (m2)). For the correction and adjustment of the tBMI and tfBMI, it was calculated the relation between trunk extension and height, multiplying by the obtained indexes. RESULTS: The mean data was: weight 125.3±19.5 kg, height 1.63±0.1 m, BMI was 47±5 kg/m2) and trunk height was 0.52±0,1 m, tFFM was 29.05±4,8 kg, tFM was 27.2±3.7 kg, trunk mass index was 66.6±10.3 kg/m², and trunk fat was 32.3±5.8 kg/m². In 93% of the patients there was an increase in obesity class using the tBMI. In patients with grade III obesity the tBMI reclassified to super obesity in 72% of patients and to super-super obesity in 24% of the patients. CONCLUSION: The trunk BMI is simple and allows a new reference for the evaluation of the body mass distribution, and therefore a new reclassification of the obesity class, evidencing the severity of obesity in a more objectively way.


Assuntos
Índice de Massa Corporal , Adolescente , Adulto , Composição Corporal , Estatura , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/classificação , Tórax , Adulto Jovem
20.
Int J Obes (Lond) ; 42(10): 1804-1811, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-29795457

RESUMO

BACKGROUND/OBJECTIVES: Obesity has been declared a disease by the American and Canadian Medical Associations. Although these declarations sparked much debate as to the impact of framing obesity as a disease on weight bias, strong empirical research is needed to examine this impact. The current study examined the impact of framing obesity a disease on weight bias, focusing on moderating and mediating processes. SUBJECTS/METHODS: A sample of 309 participants living in the United States or Canada was recruited from Crowdflower. Participants completed measures of demographics, ideology, general attitudes, and previous contact quality and quantity with people living with obesity. Participants then read one of three articles as part of an experimental manipulation framing obesity as a disease, obesity not as a disease, and a control article unrelated to obesity. Post-manipulation included measures of affect, disgust, empathy, blame, and weight bias. RESULTS: Orthogonal contrasts were used to compare the obesity-disease condition to the obesity-not-disease condition and control condition. The manipulation had a direct effect on affect (emotions), such that affect toward individuals with obesity was more positive in the obesity-disease condition than the obesity-not-disease and control condition combined. Exploration of moderating effects revealed that both the belief in a just world and weight satisfaction moderated the relationship between the obesity-disease manipulation and blame for obesity. Two models of indirect effects on weight bias were also examined, which demonstrated that the obesity-disease manipulation predicted less weight bias through more positive affect (model 1) as well as less weight bias through decreased blame among individuals high in belief in a just world (model 2). CONCLUSIONS: This study further highlights the complex effects of declaring obesity a disease, uncovering a new direction for future research into the role of affect as well as indirect effects of characterising obesity a disease on weight bias.


Assuntos
Obesidade/classificação , Preconceito/estatística & dados numéricos , Percepção Social , Terminologia como Assunto , Adulto , Canadá , Asco , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Obesidade/psicologia , Preconceito/psicologia , Teoria Psicológica , Autoimagem , Estereotipagem , Inquéritos e Questionários , Estados Unidos
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