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1.
Hipertens. riesgo vasc ; 37(3): 115-124, jul.-sept. 2020. tab, graf, ilus
Artigo em Espanhol | IBECS | ID: ibc-193520

RESUMO

INTRODUCCIÓN Y OBJETIVO: La obesidad y el síndrome metabólico (SM) continúan siendo un problema a nivel socioeconómico, causando elevada morbilidad y mortalidad en la población adulta, por lo que se debería realizar una prevención de factores de riesgo desde temprana edad. En la actualidad no existe un consenso del momento oportuno para iniciar la intervención y tratamiento con respecto al SM. El objetivo del estudio es describir el fenotipo para predecir diagnóstico temprano de SM en escolares. MATERIALES Y MÉTODOS: Estudio observacional, prospectivo, transversal y analítico en escolares de seis a 15 años, aplicado en Guayaquil. Se realizó valoración antropométrica y encuesta escrita, tras firma del consentimiento informado. Se utilizó para los cálculos de asociación la plataforma de inteligencia artificial (IA) Watson de IBM y su software Modeler Flow. RESULTADOS: Se examinó una población de 1.025 estudiantes entre seis y 15 años (media de 12 años para varones y 13 años para mujeres), de los cuales 62,3% fueron hombres y 37,7% mujeres. El 23,9% de la población presentó sobrepeso y 14% obesidad. Se observó una mayor tendencia a la alteración del peso en varones que en mujeres (51,37% vs. 47,79%), y menor perímetro de cintura en varones (85 cm vs. 87 cm, respectivamente). Los varones tuvieron mayor nivel de presión arterial sistólica (PAS), encontrándose dentro del percentil 90 (PAS media de 123 mmHg) un 61,2%, en comparación con un 38,8% de las mujeres, con una p < 0,001. El sedentarismo es similar en ambos grupos, con una media de 4,79 horas frente a la pantalla y/o videojuegos. Se demostró correlación estadísticamente significativa entre la presión arterial y el índice cintura /talla (I c/t) en el percentil 90 y percentil 95 (X2 9,075, p < 0,028, y X2 23,54, p < 0,000, respectivamente), así como relación entre el P95 de la presión arterial y el sexo (X2 11,57, p < 0,001). El sistema Modeler Flow, nos demostró que, si se observa un I c/t > 0,46, peso > 56,1 kg, talla > 1,61 m, y sedentarismo puro mayor a tres horas de tiempo frente a la pantalla, hay una probabilidad de presentar SM de 82,4%. El modelado matemático del árbol de decisiones (basado en inteligencia artificial) tiene una precisión predictiva del 90% (desviación de error de 0,009). La importancia de los predictores de SM, van de un 97,57% a un 100%. CONCLUSIONES: Se observó en escolares de seis a 15 años, una prevalencia del 33,9% de SM, con puntos de corte patológicos de: I c/t ≥ 0,46, peso ≥ 56,1 kg, sedentarismo puro mayor a tres horas frente a la pantalla/videojuegos, y PAS dentro del P90 (> 123 mmHg). Con estos cuatro indicadores, podemos predecir una probabilidad de diagnóstico temprano de SM de 97% al 100%


INTRODUCTION AND OBJECTIVES: Obesity and metabolic syndrome (MS) continue to be a problem at a socioeconomic level, causing high morbidity and mortality in the adult population. Prevention of risk factors should be carried out from an early age. Currently, there is no consensus on the opportune moment to start an intervention or treatment, regarding metabolic syndrome. The objective of the study is to describe the phenotype to predict early diagnosis of metabolic syndrome in schoolchildren. MATERIAL AND METHODS: Observational, prospective, cross-sectional and analytical study in schoolchildren from 6 to 15 years old, conducted in Guayaquil. Anthropometric measurements and a survey were performed, obtaining signing informed consent. The IBM Watson artificial intelligence (AI) platform with its software Modeler Flow, were used for the analysis. RESULTS: A population of 1025 students between 6 and 15 years old (mean of 12 years for men and 13 years for women) was examined, of whom 62.3% were men and 37.7% women. 23.9% of the population was overweight and 14% obese. A greater tendency to weight alteration was observed in men than in women (51.37% vs 47.79%), and a lower waist circumference in men (85 cm vs 87 cm, respectively). Males had a higher level of systolic blood pressure (SBP), being within the 90th percentile (mean SBP of 123 mmHg) 61.2%, compared to 38.8% of women, with a p < 0.001. Sedentary lifestyle is similar in both groups, with an average of 4.79 hours in front of the screen and/or video games. A statistically significant correlation was demonstrated between SBP and the waist/height ratio (WHtR) in the 90th percentile and 95th percentile (X2 9.075, p < 0.028, and X2 23,54, p < 0,000 respectively), as well as a relationship between 95th percentile and sex (X2 11.57, p < 0.001). The Modeler Flow software showed us that if WHtR, > 0.46, weight > 56.1 kg and height > 1.61 m, the probability of presenting metabolic syndrome, was of 82.4%. The statistic of this study has a predictive accuracy of 90% (error deviation of 0.009). The importance in the predictors of metabolic syndrome, range from 97.57% to 100%. CONCLUSIONS: A prevalence of 33.9% of metabolic syndrome was observed in schoolchildren from 6 to 15 years old, with pathological cut-off points of: WHtR > 0.46, weight > 56.1 kg, pure sedentary lifestyle > 3 hours in front of the screen/playing video games, and SBP within the 90th percentile (> 123 mmHg). With these four indicators, we can predict a probability of early diagnosis of metabolic syndrome of 97% to 100%


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Diagnóstico Precoce , Síndrome Metabólica/diagnóstico , Fenótipo , Pressão Sanguínea , Estudos Prospectivos , Estudos Transversais , Antropometria , Inteligência Artificial , Estudantes/estatística & dados numéricos , Relação Cintura-Quadril
2.
Medicine (Baltimore) ; 99(35): e21722, 2020 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-32871891

RESUMO

BACKGROUND: In recent years, the role of vitamin D (VD) as a protective factor in cardiovascular disease has been recognized. Thus, there is a need to study the effect of vitamin D supplementation in the control of different cardiovascular risk factors and metabolic syndrome, especially in young populations where few studies have been conducted. METHODS: Pilot study of a randomized, parallel two-arm, triple-blind clinical controlled trial in 150 adolescents and young adults in the city of Bucaramanga-Colombia. The intervention group will receive 1000 IU of VD and the control group 200 IU of VD daily for 15 weeks. The main outcomes are: serum calcifediol levels (25(OH) D), body mass index and lipid profile; secondary outcomes are complementary to the previous ones (skin folds, waist-hip ratio). Other variables will be analyzed such as assessment of dietary intake, physical activity, sun exposure, cigarette and tobacco consumption and compliance with VD supplementation. DISCUSSION: This study is innovative since there is little evidence from clinical trials in adolescents and young adults; similar studies are not known in our context. The results of this study may facilitate the recommendation of oral vitamin D supplementation in the population of interest. In addition, it is a low-cost and easy-to-apply intervention that could contribute to the formulation and implementation of health policies. TRIAL REGISTRATION: NCT04377386.


Assuntos
Índice de Massa Corporal , Calcifediol/sangue , Lipídeos/sangue , Vitamina D/administração & dosagem , Vitaminas/administração & dosagem , Administração Oral , Adolescente , Colômbia , Suplementos Nutricionais , Método Duplo-Cego , Humanos , Projetos Piloto , Ensaios Clínicos Controlados Aleatórios como Assunto , Pregas Cutâneas , Relação Cintura-Quadril , Adulto Jovem
3.
BMJ ; 370: m3324, 2020 09 23.
Artigo em Inglês | MEDLINE | ID: mdl-32967840

RESUMO

OBJECTIVE: To quantify the association of indices of central obesity, including waist circumference, hip circumference, thigh circumference, waist-to-hip ratio, waist-to-height ratio, waist-to-thigh ratio, body adiposity index, and A body shape index, with the risk of all cause mortality in the general population, and to clarify the shape of the dose-response relations. DESIGN: Systematic review and meta-analysis. DATA SOURCES: PubMed and Scopus from inception to July 2019, and the reference lists of all related articles and reviews. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Prospective cohort studies reporting the risk estimates of all cause mortality across at least three categories of indices of central fatness. Studies that reported continuous estimation of the associations were also included. DATA SYNTHESIS: A random effects dose-response meta-analysis was conducted to assess linear trend estimations. A one stage linear mixed effects meta-analysis was used for estimating dose-response curves. RESULTS: Of 98 745 studies screened, 1950 full texts were fully reviewed for eligibility. The final analyses consisted of 72 prospective cohort studies with 2 528 297 participants. The summary hazard ratios were as follows: waist circumference (10 cm, 3.94 inch increase): 1.11 (95% confidence interval 1.08 to 1.13, I2=88%, n=50); hip circumference (10 cm, 3.94 inch increase): 0.90 (0.81 to 0.99, I2=95%, n=9); thigh circumference (5 cm, 1.97 inch increase): 0.82 (0.75 to 0.89, I2=54%, n=3); waist-to-hip ratio (0.1 unit increase): 1.20 (1.15 to 1.25, I2=90%, n=31); waist-to-height ratio (0.1 unit increase): 1.24 (1.12 to 1.36, I2=94%, n=11); waist-to-thigh ratio (0.1 unit increase): 1.21 (1.03 to 1.39, I2=97%, n=2); body adiposity index (10% increase): 1.17 (1.00 to 1.33, I2=75%, n=4); and A body shape index (0.005 unit increase): 1.15 (1.10 to 1.20, I2=87%, n=9). Positive associations persisted after accounting for body mass index. A nearly J shaped association was found between waist circumference and waist-to-height ratio and the risk of all cause mortality in men and women. A positive monotonic association was observed for waist-to-hip ratio and A body shape index. The association was U shaped for body adiposity index. CONCLUSIONS: Indices of central fatness including waist circumference, waist-to-hip ratio, waist-to-height ratio, waist-to-thigh ratio, body adiposity index, and A body shape index, independent of overall adiposity, were positively and significantly associated with a higher all cause mortality risk. Larger hip circumference and thigh circumference were associated with a lower risk. The results suggest that measures of central adiposity could be used with body mass index as a supplementary approach to determine the risk of premature death.


Assuntos
Obesidade Abdominal/mortalidade , Índice de Massa Corporal , Humanos , Obesidade Abdominal/diagnóstico , Circunferência da Cintura , Relação Cintura-Quadril
4.
Zhonghua Yi Xue Za Zhi ; 100(27): 2102-2108, 2020 Jul 21.
Artigo em Chinês | MEDLINE | ID: mdl-32689750

RESUMO

Objective: To investigate the relationship between different waist-hip ratios and sleep-disordered breathing (SDB) in patients with acute coronary syndrome (ACS) and its effect on patients' long-term prognosis. Methods: A total of 725 patients who were diagnosed with ACS in the emergency ward of Beijing An Zhen Hospital from June 2015 to May 2017 were included, and all the patients were monitored for sleep and breathing. Patients were divided into four groups according to their waist-hip ratios. The differences of SDB-related indicators among the four groups were compared, and the correlation between different waist-hip ratios and SDB was analyzed using multiple logistic regression. COX regression analysis and Kaplan-Meier curve were used to compare the prognostic differences among the four groups. Results: As the waist-hip ratio increased, the apnea hypopnea index (AHI) (P=0.004) and the proportion of sleep apnea hypopnea syndrome (OSAHS) increased (39.3% vs 46.0% vs 53.2% vs 60.0%, P=0.004). Meanwhile, the number of hypoventilation increased, and the mean and minimum arterial oxygen saturation (SaO(2)) decreased (all P<0.001). Logistic regression analysis showed that high waist-hip ratio was significantly related with OSAHS (OR=2.579, 95%CI 1.521-4.373, P<0.001). The survival curves showed the highest incidence of major cardio-cerebral vascular events (MACCE) occurred in the high waist-hip ratio group (Log Rank P=0.036). COX regression analysis showed that high waist-hip ratio was an independent risk factor for MACCE in ACS patients (HR=2.855, 95%CI 1.375-5.929, P=0.005). Conclusions: In ACS patients, central obesity is related with SDB. Patients with high waist-hip ratio have a poor prognosis. Elevated waist-hip ratio and SDB jointly impact the prognosis of ACS patients.


Assuntos
Síndrome Coronariana Aguda , Síndromes da Apneia do Sono , Apneia Obstrutiva do Sono , Humanos , Prognóstico , Fatores de Risco , Relação Cintura-Quadril
5.
J Assoc Physicians India ; 68(4): 14-17, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32610839

RESUMO

Background and Purpose: Framingham 10 year risk score traditionally used to diagnose future risk. There is need to find simple and powerful marker for future risks of coronary artery disease. Framingham 10 year risk score take many variables together. Recently, abnormal glucose metabolism is a major determinant of CHD. Although the relationship between cardiovascular disease (CHD) and glycaemia is believed to represent a continuum without a threshold effect, as it is a more stable, accurate parameter of glucose homeostasis. Therefore, the aim of the current study was to establish association between high normal HbA1c and Framingham 10 year risk score for coronary artery diseases in non-diabetics. Methods: A total 100 patients of coronary artery disease, aged 18-80 years were enrolled. Complete physical and systemic examination including vitals was performed. Framingham's 10 year risk score, Height, Weight, Hip Circumference, Waist Circumference, and Waist-Hip Ratio and BMI are calculated. Investigated for HbA1c, HsCRP and other routine investigations needed to diagnose coronary artery disease. Chi square test was applied to detect association between HsCRP and High HbA1c and Correlation Coefficient(r) was calculated to study linear relationship. Results: The Chi square Test significant meaning that higher value of HsCRP associated with high level of HbA1c (p=0.04). The Correlation Coefficient(r) is -0.02 so there were no linear relationship between HbA1c and Framingham risk score. In our study average Framingham risk score was 9.72 while average age of patient was 53.7 years. There were linear relationship between patient's age and Framingham 10 year risk score (r= 0.60). Conclusions: Coronary artery disease patients had high prevalence of High HsCRP. there was significant association between glycosylated haemoglobin and High HsCRP (P=0.04). We find association between high normal HbA1c and Framingham risk score in non-diabetic patient. But, There is no any linear correlation between high normal HbA1c and Framingham 10 risk score (r=0.02). We find out that Framingham 10 year risk score has linear relationship with patient's age and sex. It implies that coronary artery disease calculated by using Framingham 10 year risk score increases with increase in age. But Glycosylated Haemoglobin predicts coronary artery disease risk independence of patient's age. It predicts low risk in young female patients compare to young male patient in our study. Glycosylated haemoglobin is independent of age and sex of patient. So Glycosylated haemoglobin is good marker for coronary artery disease.


Assuntos
Doença da Artéria Coronariana , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Glicemia , Feminino , Hemoglobina A Glicada , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Relação Cintura-Quadril , Adulto Jovem
6.
Nutr. hosp ; 37(3): 514-523, mayo-jun. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-193859

RESUMO

INTRODUCCIÓN: se evidencia un aumento cada vez mayor de la preocupación debido a valores alarmantes en condición física y composición corporal, que sitúan a los escolares en unos parámetros de riesgo en lo relativo a la salud física. Numerosas investigaciones relacionan la actividad física con la mejora en la condición física y la composición corporal. OBJETIVO: analizar los efectos de un programa de ejercicio interválico de intensidad moderada-vigorosa sobre indicadores de condición física (fuerza isométrica manual en ambas manos, fuerza explosiva del tren inferior, velocidad-agilidad y capacidad aeróbica) y de composición corporal (índice de masa corporal, % de grasa corporal, perímetro de cintura e índice cintura/altura), referentes todos ellos para la salud en escolares de 11 y 12 años. MÉTODOS: se desarrolla una intervención en la que participó un grupo experimental y otro control con 28 escolares cada uno de ellos. Transcurrió a lo largo de 7 semanas, con sesiones de 30 minutos totales antes del inicio de la actividad académica, 3 días por semana. Se realizaron diferentes juegos interválicos, con una intensidad moderada-vigorosa (70-80 % de la frecuencia cardíaca máxima). El registro en condición física y composición corporal se realizó a través de la batería ALPHA. RESULTADOS: mejoras significativas en fuerza isométrica con ambas manos y una reducción significativa del perímetro de cintura e índice cintura/altura. CONCLUSIÓN: los resultados muestran mejoras significativas en indicadores de condición física y composición corporal; sin embargo, se precisa de una intervención de mayor duración para conocer si las otras mejoras logradas en los indicadores analizados consiguen ser significativas con el transcurso del tiempo


INTRODUCTION: there is growing evidence of concern for values in terms of physical condition and body composition that place school children being at risk in physical health. Numerous investigations relate physical activity with improvement in physical condition and body composition. OBJECTIVE: to analyze the effects of a sub-maximal intensity interval exercise program on physical condition (upper body isometric strength in both hands, lower body explosive strength, velocity-agility and cardiorespiratory fitness) and body composition (body mass index, % of body fat, waist circumference and waist/height index), all of them related to health, in schoolchildren of 11 and 12 years. METHODS: an intervention was developed in which an experimental group participated and another control group with 28 schoolchildren each. The study developped over 8 weeks, with sessions of total 30 minutes before the start of the academic activity 3 days per week. Different intervallic games were made with motor, cognitive and coordination challenges; with a moderate-vigorous intensity (70 %-80 % of maximum heart rate). The registration in physical condition and body composition was made through the ALPHA Battery. RESULTS: significant improvements in isometric strength in both hands and a reduction in waist circumference and waist/height were found. CONCLUSIONS: the results show significant improvements in indicators of fitness and fatness, however, it requires a long-term intervention to know if the other improvements achieved in the analyzed indicators are significant over time


Assuntos
Humanos , Masculino , Criança , Composição Corporal/fisiologia , Valor Nutritivo , Treinamento Intervalado de Alta Intensidade/métodos , Atividade Motora/fisiologia , Índice de Massa Corporal , Relação Cintura-Quadril/métodos
7.
Nat Commun ; 11(1): 2797, 2020 06 03.
Artigo em Inglês | MEDLINE | ID: mdl-32493999

RESUMO

Fat distribution is an independent cardiometabolic risk factor. However, its molecular and cellular underpinnings remain obscure. Here we demonstrate that two independent GWAS signals at RSPO3, which are associated with increased body mass index-adjusted waist-to-hip ratio, act to specifically increase RSPO3 expression in subcutaneous adipocytes. These variants are also associated with reduced lower-body fat, enlarged gluteal adipocytes and insulin resistance. Based on human cellular studies RSPO3 may limit gluteofemoral adipose tissue (AT) expansion by suppressing adipogenesis and increasing gluteal adipocyte susceptibility to apoptosis. RSPO3 may also promote upper-body fat distribution by stimulating abdominal adipose progenitor (AP) proliferation. The distinct biological responses elicited by RSPO3 in abdominal versus gluteal APs in vitro are associated with differential changes in WNT signalling. Zebrafish carrying a nonsense rspo3 mutation display altered fat distribution. Our study identifies RSPO3 as an important determinant of peripheral AT storage capacity.


Assuntos
Adipócitos/citologia , Adipócitos/metabolismo , Distribuição da Gordura Corporal , Peptídeos e Proteínas de Sinalização Intracelular/metabolismo , Trombospondinas/metabolismo , Proteínas de Peixe-Zebra/metabolismo , Adipócitos/efeitos dos fármacos , Tecido Adiposo/metabolismo , Adiposidade/genética , Adulto , Alelos , Animais , Biomarcadores/metabolismo , Diferenciação Celular/efeitos dos fármacos , Linhagem Celular , Tamanho Celular/efeitos dos fármacos , Doxiciclina/farmacologia , Feminino , Regulação da Expressão Gênica/efeitos dos fármacos , Glucose/metabolismo , Humanos , Peptídeos e Proteínas de Sinalização Intracelular/genética , Masculino , Pessoa de Meia-Idade , Mutação/genética , Polimorfismo de Nucleotídeo Único/genética , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Caracteres Sexuais , Células-Tronco/metabolismo , Trombospondinas/genética , Relação Cintura-Quadril , Via de Sinalização Wnt/efeitos dos fármacos , Peixe-Zebra/genética , Proteínas de Peixe-Zebra/genética
8.
Ann Epidemiol ; 46: 20-23, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32532369

RESUMO

PURPOSE: This study investigates the predictive effects of body mass index (BMI) and waist circumference (WC) for all-cause mortality in old age over 27 years of follow-up. METHODS: Participants were from the Berlin Aging Study (n = 444, M ± SD = 84.55 ± 8.38 years). Reported significance values for hazard ratios were adjusted for age, sex, socioeconomic status, smokers, depressive illness, functional status, cholesterol, and objectively assessed physical diseases. RESULTS: BMI emerged as a significant predictor of all-cause mortality after adjustment. WC was not a significant predictor of mortality either within the unadjusted model or when fully adjusted, including BMI. After the introduction of WC alongside all covariates, the effect for BMI remained significant. A significant quadratic effect for BMI and mortality within the fully adjusted model also emerged. CONCLUSIONS: Our results suggest that lower BMI in the oldest old is associated with increased mortality hazards, and risks were particularly elevated for people who are underweight. This study found no evidence that higher BMI in old age is associated with increased mortality hazards relative to normal weight ranges.


Assuntos
Envelhecimento/fisiologia , Índice de Massa Corporal , Circunferência da Cintura/fisiologia , Idoso , Idoso de 80 Anos ou mais , Causas de Morte , Feminino , Seguimentos , Alemanha/epidemiologia , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Mortalidade , Obesidade/mortalidade , Relação Cintura-Quadril
9.
Pol Merkur Lekarski ; 48(285): 152, 2020 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-32564037

RESUMO

Overweight or obesity is diagnosed in approximately 60-80% of polycystic ovary syndrome (PCOS) patients. Since obesity exacerbates the hormonal and clinical features of PCOS, and women suffering from PCOS have a high risk of obesity, we suggest that hormonal imbalance resulting in certain body features can be linked to the pathogenesis of PCOS. AIM: The aim of the study was to define the features of the reproductive hormone metabolism in women with infertility due to PCOS depending on the constitutional body types. MATERIALS AND METHODS: The present study involved 100 women aged 25-39 years with infertility due to PCOS (experimental group) and 30 women of the same age with infertility due to tubal-peritoneal causes (control group). Infertility due to PCOS was diagnosed according to the Rotterdam criteria. Waist-hip ratio (WHR) was used to characterize the distribution of adipose tissue in overweight and obese patients. Hormone levels in blood serum were determined by ELISA using the «Diagnostic Systems Laboratories, Inc.¼ test systems (USA). RESULTS: We found hormonal imbalance in women with infertility caused by PCOS: increased levels of anti-Müllerian and luteinizing hormones, estradiol and testosterone, and decreased FSH levels. Body fat distribution conformed to the gluteofemoral (gynoid) type in 6.00% of the women and abdominal (android) type in 52.00%. Analysis of the relationship between the concentration of reproductive hormones and waist-hip ratio showed a weak inverse relationship between WHR with FSH levels, as well as a direct correlation with the levels of testosterone. CONCLUSIONS: In women with infertility caused by PCOS and android type of obesity, all these changes are significant compared to the women with normal body weight. Thus, obesity exacerbates the hormonal imbalance in women with infertility caused by PCOS.


Assuntos
Hormônio Foliculoestimulante , Infertilidade , Hormônio Luteinizante , Síndrome do Ovário Policístico , Somatotipos , Adulto , Índice de Massa Corporal , Feminino , Hormônio Foliculoestimulante/sangue , Humanos , Hormônio Luteinizante/sangue , Síndrome do Ovário Policístico/sangue , Testosterona , Relação Cintura-Quadril
10.
Vasc Med ; 25(4): 309-318, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32484395

RESUMO

Arterial stiffness (AS) and obesity are recognized as important risk factors of cardiovascular disease (CVD). The purpose of this study was to investigate the relationship between AS and obesity. AS was defined as high augmentation index (AIx) and low elasticity (C1, large artery elasticity; C2, small artery elasticity) in participants enrolled in the Multi-Ethnic Study of Atherosclerosis at baseline. We compared AIx, C1, and C2 by body mass index (BMI) (< 25, 25-29.9, 30-39.9, ⩾ 40 kg/m2) and waist-hip ratio (WHR) (< 0.85, 0.85-0.99, ⩾ 1). The obesity-AS association was tested across 10-year age intervals. Among 6177 participants (62 ± 10 years old, 52% female), a significant inverse relationship was observed between obesity and AS. After adjustments for CVD risk factors, participants with a BMI > 40 kg/m2 had 5.4% lower AIx (mean difference [Δ] = -0.82%; 95% CI: -1.10, -0.53), 15.4% higher C1 (Δ = 1.66 mL/mmHg ×10; 95% CI: 1.00, 2.33), and 40.2% higher C2 (Δ = 1.49 mL/mmHg ×100; 95% CI: 1.15, 1.83) compared to those with a BMI < 25 kg/m2 (all p for trend < 0.001). Participants with a WHR ⩾ 1 had 5.6% higher C1 (∆ = 0.92 mL/mmHg ×10; 95% CI: 0.47, 1.37) compared to those with a WHR < 0.85. The WHR had a significant interaction with age on AIx and C2, but not with BMI; the inverse relationships of the WHR with AIx and C2 were observed only in participants < 55 years between the normal (WHR < 0.85) and the overweight (0.85 ⩽ WHR < 0.99) groups. Different associations of WHR and BMI with arterial stiffness among older adults should be further investigated.


Assuntos
Adiposidade , Doenças Cardiovasculares/fisiopatologia , Obesidade/fisiopatologia , Rigidez Vascular , Adiposidade/etnologia , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/etnologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/diagnóstico , Obesidade/etnologia , Prognóstico , Fatores de Risco , Fatores de Tempo , Estados Unidos/epidemiologia , Relação Cintura-Quadril
11.
Endocrinol. diabetes nutr. (Ed. impr.) ; 67(5): 333-341, mayo 2020. tab
Artigo em Inglês | IBECS | ID: ibc-191309

RESUMO

BACKGROUND: It is estimated that 37% of Mexican adults have undiagnosed diabetes, and are therefore at high risk of developing the severe and devastating complications associated to it. In recent years, a variety of screening tools based on the characteristics of the adult Mexican population have been proposed in order to reduce the negative effects of the disease. OBJECTIVES: To assess the performance of screening models to diagnose diabetes in the Mexican adult population and to propose a screening model based on HbA1c measurements. MATERIALS AND METHODS: Data from the 2016 Halfway National Health and Nutrition Survey (NHNS) were used to assess the screening models and to develop and validate the proposed 2016 NHNS model, built using a multivariate logistic regression model. Explanatory variables included in the 2016 NHNS 2016 model were selected through a stepwise backward procedure, using sensitivity and specificity as performance indicators. RESULTS: Of the screening models assessed, only the model based on the 2006 NHNS survey showed a performance consistent with previous reports. The proposed 2016 NHNS model included age, waist circumference, and systolic blood pressure as explanatory variables and showed a sensitivity of 0.72 and a specificity of 0.80 in the validation data set. CONCLUSIONS: Age, waist circumference, and systolic blood pressure are variables of special importance for early detection of undiagnosed diabetes in Mexican adults. Based on the consistent performance of the 2006 NHNS model in different data sets, its use as a screening tool for adults with undiagnosed diabetes in Mexico is recommended


ANTECEDENTES: Se estima que el 37% de adultos mexicanos que padecen diabetes no han sido diagnosticados, teniendo un alto riesgo de desarrollar las graves y devastadores complicaciones asociadas. En los últimos años, con el objetivo de reducir los efectos negativos de la enfermedad, se han propuesto herramientas de detección basadas en las características de la población adulta mexicana. OBJETIVOS: Evaluar el funcionamiento de los modelos de detección de diabetes no diagnosticada en la población adulta mexicana y proponer un modelo de detección basado en mediciones de HbA1c. MATERIAL Y MÉTODOS: Se utilizaron datos de la Encuesta Nacional de Salud y Nutrición (NHNS) de Medio Camino 2016 para evaluar los modelos de detección y para desarrollar y validar el modelo NHNS 2016, construido usando un modelo de regresión logística multivariada. Las variables incluidas en el modelo NHNS 2016 se seleccionaron mediante un procedimiento de pasos hacia atrás, utilizando la sensibilidad y la especificidad como indicadores de funcionamiento. RESULTADOS: De los modelos de detección evaluados, únicamente el modelo basado en la encuesta NHNS 2006 mostró un funcionamiento consistente con lo reportado anteriormente. Las variables seleccionadas para el modelo propuesto (NHNS 2016) fueron edad, circunferencia de cintura y presión sistólica como variables explicativas, mostrando una sensibilidad de 0,72 y una especificidad de 0,80 en el conjunto de datos de validación. CONCLUSIONES: Edad, circunferencia de cintura y presión sistólica son variables de relevancia especial para la detección temprana de diabetes no diagnosticada en adultos mexicanos. Dada la consistencia en el funcionamiento mostrado por el modelo NHNS 2006 en diferentes conjuntos de datos, se recomienda su uso como herramienta de detección de adultos con diabetes no diagnosticada en México


Assuntos
Humanos , Masculino , Feminino , Adulto , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/prevenção & controle , Programas de Rastreamento , Diabetes Mellitus/diagnóstico , México/epidemiologia , Inquéritos Nutricionais , Relação Cintura-Quadril/métodos , Pressão Sanguínea , Sensibilidade e Especificidade , Circunferência Abdominal
12.
Cancer Causes Control ; 31(7): 651-662, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32358695

RESUMO

PURPOSE: General and central adiposity are associated with the risk of developing prostate cancer (PCa), but the role of these exposures on PCa survival among men of African ancestry are less studied. This study aimed to investigate the association of anthropometry at diagnosis with all-cause and PCa-specific mortality and evaluate whether androgen deprivation therapy (ADT) modulated this risk. METHODS: Associations between body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) at diagnosis and mortality were examined in 242 men with newly diagnosed PCa enrolled between 2005 and 2007 and re-evaluated 10.9 years later. Multi-variable Cox proportional hazard models were used to examine associations of body size variables (using standard WHO cut-points and as continuous variables) with mortality, adjusted for sociodemographic characteristics, Gleason score, smoking, diabetes, primary treatment, and ADT therapy. RESULTS: A total of 139 deaths (all-cause mortality 6.98/100 person-years) occurred (PCa-specific deaths, 56; other causes, 66; causes unknown, 17). In multi-variable analysis BMI, WC and WHR categories at diagnosis were not associated with all-cause mortality even after adjusting for ADT. While WHR (but not BMI or WC) when included as a continuous variable predicted lower PCa-specific mortality (multi-variable adjusted WHR per 0.1 difference: HR, 0.50; 95%CI 0.28, 0.93), the effect disappeared with ADT covariance and excluding deaths within the first 2 years. CONCLUSION: Our study suggests that central adiposity as measured by WHR may improve long-term survival among men of African ancestry. Metabolic studies to understand the mechanism for this association are needed.


Assuntos
Adiposidade/etnologia , Grupo com Ancestrais do Continente Africano/estatística & dados numéricos , Neoplasias da Próstata/etnologia , Neoplasias da Próstata/mortalidade , Adulto , Idoso , Antagonistas de Androgênios/administração & dosagem , Índice de Massa Corporal , Estudos de Casos e Controles , Seguimentos , Humanos , Jamaica/epidemiologia , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Modelos de Riscos Proporcionais , Neoplasias da Próstata/tratamento farmacológico , Circunferência da Cintura , Relação Cintura-Quadril/estatística & dados numéricos
13.
Obesity (Silver Spring) ; 28(7): 1263-1269, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32427420

RESUMO

OBJECTIVE: This study aimed to investigate cross-sectional and longitudinal associations between fat mass (i.e., body mass index [BMI], waist circumference [WC], and waist to hip ratio [WTHR]) and hippocampal volumes. METHODS: UK Biobank participants (N = 20,395) aged 40 to 70 years (mean follow-up = 7.66 years), were included and categorized into one of four groups, which represented their baseline fat mass status and trajectory of change by follow-up assessment: normal weight to overweight/obesity, overweight/obesity to normal weight (ON), normal weight stable (NS), or overweight/obesity stable (OS). Regression models used NS (WC < 80 cm in women and < 94 cm in men; WTHR < 0.85 in women and < 0.90 in men; BMI < 25 kg/m2 in women and men) as the reference group. Hippocampal volumes were automatically segmented using the FMRIB Software Library. RESULTS: Compared with NS, OS (BMI: B = -62.23 [SE = 16.76]; WC: B = -145.56 [SE = 16.97]; WTHR: B = -101.26 [SE = 19.54]) and ON (BMI: B = -61.1 [SE = 30.3]; WC: B = -93.77 [SE = 24.96]; WTHR: B = -69.92 [SE = 26.22]) had significantly lower hippocampal volumes. CONCLUSIONS: The detrimental effects of overweight/obesity may extend beyond the duration of overweight/obesity itself.


Assuntos
Tecido Adiposo/patologia , Adiposidade/fisiologia , Hipocampo/patologia , Tecido Adiposo/metabolismo , Adulto , Idoso , Índice de Massa Corporal , Estudos Transversais , Feminino , Humanos , Peso Corporal Ideal/fisiologia , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Obesidade/metabolismo , Obesidade/patologia , Tamanho do Órgão/fisiologia , Sobrepeso/epidemiologia , Sobrepeso/metabolismo , Sobrepeso/patologia , Reino Unido/epidemiologia , Circunferência da Cintura , Relação Cintura-Quadril
14.
Nutr Metab Cardiovasc Dis ; 30(7): 1179-1187, 2020 06 25.
Artigo em Inglês | MEDLINE | ID: mdl-32451274

RESUMO

BACKGROUND AND AIMS: Previous data show contradicting results regarding relevance of obesity on outcome in peripheral arterial disease (PAD). Thus, this study aims to evaluate the predictive power of obesity as measured by established and novel obesity indices (waist circumference WC, waist-hip ratio WHR, body-mass index BMI, body adiposity index BAI, visceral adiposity index VAI, weight-adjusted waist index WWI) in a PAD cohort. METHODS AND RESULTS: In 367 patients with diagnosed PAD anthropometric parameters were assessed at study inclusion in an observational study. Mortality data was retrieved from the central death registry after five years. Outcome analyses were performed by multivariable Cox-regression models. 57 PAD patients (15.5%) died during the follow-up, of those 36 were categorized as cardiovascular origin. Patients from the all-cause mortality group were older, more often diabetics with a worse glucose control and had worse renal function. Obesity indices were not significantly different between the event and control group. None of the evaluated risk factors predicted cardiovascular or all-cause death after multivariable adjustment for age, gender, LDL-C, serum creatinine, systolic blood pressure, CRP, smoking habits, diabetes status and previous history of peripheral revascularisation (all-cause WC 1.007 (0.983-1.031), WHR 1.772 (0.106-29.595), BMI 1.006 (0.939-1.078), BAI 1.002 (0.945-1.063), VAI 1.019 (0.895-1.161), WWI 1.085 (0.831-1.416); cv-death WC 1.007 (0.978-1.036), WHR 0.382 (0.006-25.338), BMI 1.004 (0.918-1.098), BAI 1.034 (0.959-1.116), VAI 1.036 (0.885-1.213), WWI 1.061 (0.782-1.441)). CONCLUSION: Obesity as risk marker estimated by indices both for general and visceral adiposity, does not predict mortality in a secondary prevention cohort of PAD patients.


Assuntos
Antropometria , Obesidade/diagnóstico , Doença Arterial Periférica/mortalidade , Adiposidade , Adulto , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Causas de Morte , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/mortalidade , Obesidade/fisiopatologia , Doença Arterial Periférica/diagnóstico , Doença Arterial Periférica/fisiopatologia , Doença Arterial Periférica/terapia , Valor Preditivo dos Testes , Prognóstico , Sistema de Registros , Medição de Risco , Fatores de Risco , Fatores de Tempo , Circunferência da Cintura , Relação Cintura-Quadril
15.
Nat Genet ; 52(6): 634-639, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32424355

RESUMO

With very large sample sizes, biobanks provide an exciting opportunity to identify genetic components of complex traits. To analyze rare variants, region-based multiple-variant aggregate tests are commonly used to increase power for association tests. However, because of the substantial computational cost, existing region-based tests cannot analyze hundreds of thousands of samples while accounting for confounders such as population stratification and sample relatedness. Here we propose a scalable generalized mixed-model region-based association test, SAIGE-GENE, that is applicable to exome-wide and genome-wide region-based analysis for hundreds of thousands of samples and can account for unbalanced case-control ratios for binary traits. Through extensive simulation studies and analysis of the HUNT study with 69,716 Norwegian samples and the UK Biobank data with 408,910 White British samples, we show that SAIGE-GENE can efficiently analyze large-sample data (N > 400,000) with type I error rates well controlled.


Assuntos
Bancos de Espécimes Biológicos/estatística & dados numéricos , Estudos de Casos e Controles , Exoma , Modelos Lineares , Marcadores Genéticos , Humanos , Lipoproteínas HDL/genética , Modelos Genéticos , Herança Multifatorial , Noruega , Reino Unido , Relação Cintura-Quadril
16.
Nutr. hosp ; 37(2): 299-305, mar.-abr. 2020. tab
Artigo em Inglês | IBECS | ID: ibc-190594

RESUMO

OBJECTIVE: to identify cytokines and to associate them with several indexes of total and central adiposity in young female undergraduate students. METHODS: 58 young female sophomore students, aged 18 to 25 years, from a Brazilian public university were evaluated. Both anthropometric measures (weight, height, waist circumference and hip circumference) and body composition were assessed through DXA, and the values of android, gynoid and truncal fat mass were obtained. Cytokines (IL-8, IL-1beta, IL-6, IL-10 e TNF-a) were analyzed, and Body Mass Index (BMI), Body Adiposity Index (BAI), Visceral Adiposity Index (VAI), Conicity Index (CCI), Waist-Hip Index (WHR), Waist-to-Height Ratio (WHtR), Fat Mass Distribution Index 1 (FMI1) and Fat Mass Distribution Index 2 (FMI2) were calculated. Eventually, a linear regression was carried out to determine the regression coefficient and confidence interval (CI), having the predictor variables (cytokines) adjusted according to age and family history of obesity. The statistical significance of a = 5 % was applied. RESULTS: a correlation between adiposity indexes and cytokines (CCI, WHR and IL-12; CCI, WHR, FMI1, FMI2 and TNF-a) was identified. When it comes to the regression models, cytokines increase was related to CCI, WHR, FMI1 and FMI2 increase. CONCLUSION: pro-inflammatory cytokines were associated with an increase in adipose indexes. Therefore, these indexes became a feasible strategy for clinical practice in order to identify propensity to inflammatory disorders


OBJETIVO: identificar citoquinas y asociarlas con los distintos índices de adiposidad total y central en estudiantes universitarias jóvenes. MÉTODOS: se evaluaron 58 jóvenes estudiantes, de 18 a 25 años de edad, de segundo curso de carrera de una universidad pública brasileña. Se analizaron mediante densitometría (DEXA) tanto las medidas antropométricas (peso, talla, perímetro de la cintura y perímetro de la cadera) como la composición corporal, obteniéndose los valores de masa grasa androide, ginoide y troncal. Se analizaron las citoquinas (IL-8, IL-1beta, IL-6, IL-10 y TNF-a) y se calcularon el índice de masa corporal (IMC), el índice de adiposidad corporal (IAC), el índice de adiposidad visceral (IAV), el índice de conicidad (CCI), el índice cintura-cadera (WHR), la ratio cintura-talla (WHtR), el índice de distribución de la masa grasa 1 (FMI1) y el índice de distribución de la masa grasa 2 (FMI2). Finalmente se realizó una regresión lineal para determinar el coeficiente de regresión y el intervalo de confianza (IC), ajustando las variables predictivas (citoquinas) a la edad y los antecedentes familiares de obesidad. Se aplicó una significación estadística de a = 5 %. RESULTADOS: se detectó una correlación entre índices adiposos y citoquinas (CCI, WHR e IL-12; CCI, WHR, FMI1, FMI2 and TNF-a). Conforme a los modelos de regresión, el aumento de las citoquinas se relacionó con el aumento de CCI, WHR, FMI1 y FMI2. CONCLUSIÓN: las citoquinas proinflamatorias se asociaron al aumento de los índices adiposos. Por tanto, los índices se convierten en una estrategia factible para detectar la propensión hacia los trastornos inflamatorios en la práctica clínica


Assuntos
Humanos , Feminino , Adulto Jovem , Adulto , Citocinas/análise , Tecido Adiposo/fisiologia , Estudantes/estatística & dados numéricos , Citocinas/metabolismo , Antropometria , Densitometria , Relação Cintura-Quadril , Valor Nutritivo , Índice de Massa Corporal
17.
Medicine (Baltimore) ; 99(17): e19950, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32332676

RESUMO

Neck circumference (NC) is an attractive method for determining overweight and obesity in school age children because it is inexpensive and culturally acceptable. However, this technique has not been assessed for its accuracy in school children from countries of the Gulf Cooperation Council, which have high prevalence of overweight and obesity.The aim of this preliminary study was to investigate the correlation between the body mass index (BMI), NC, and waist-hip ratio and demographic characteristics among 10- to 18-year-old adolescent school children in Bahrain.BMI was calculated using Center of Disease Control and Prevention Children's BMI Tool for Schools. Data was collected for a total of n = 397 adolescents from 4 different private schools with an average age of 12.91 years; 57.7% were male and 42.3% female.In this sample of adolescents, 50.1% were either overweight (21.4%) or obese (28.7%). BMI was significantly associated with waist-hip ratio (P < .01), gender (P < .05), and age (P < .01). Multiple linear regressions revealed that NC was significantly associated with age (P < .001) and less so with gender (P = .071) and BMI was significantly associated with NC (P < .01), gender (P < .01), and age (P < .05). Analysis of the receiver operating characteristic for males and females combined showed fair sensitivity and specificity (Area under the curve (AUC) = 0.707; 95% CI: 0.656, 0.758).NC is weakly correlated with BMI, and only a fair instrument for identifying overweight/obesity based on receiver operating characteristic curve analysis. Therefore, NC could only be used as an adjunct screening tool for weight status in this sample.


Assuntos
Índice de Massa Corporal , Pescoço , Obesidade Pediátrica/classificação , Relação Cintura-Quadril , Adolescente , Barein/epidemiologia , Criança , Estudos de Coortes , Estudos Transversais , Feminino , Humanos , Modelos Lineares , Masculino , Obesidade Pediátrica/epidemiologia , Prevalência
18.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(3): 326-330, 2020 Mar 10.
Artigo em Chinês | MEDLINE | ID: mdl-32294829

RESUMO

Objective: To analyze the relationship of body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) with diabetes mellitus in community residents aged ≥15 years in Pudong new district of Shanghai, and provide evidence for the prevention and treatment of diabetes mellitus. Methods: Using multi-stage stratified cluster sampling method, a total of 7 194 community residents aged ≥15 years were surveyed by using questionnaire, physical examination and laboratory tests in 2016. The relationship of BMI, waist circumference and waist-hip ratio with diabetes mellitus was analyzed by χ(2) test, single factor linear correlation and logistic regression analyses. Results: In 2016, the crude prevalence rate of diabetes mellitus in Pudong was 27.37%, which was 12.75% after standardization. The prevalence rate of diabetes mellitus was slightly higher in men than in women and was increased with age. The levels of FPG, 2 h plasma glucose and HbA1c were positively correlated with BMI, WC and WHR. After adjusting the confounding factors, multiple logistic regression analysis showed that obesity (OR=1.351, P<0.01), excessive waist circumference (OR=1.255, P<0.01) and high WHR (OR=1.291, P<0.01) were risk factors for diabetes mellitus. Conclusions: The increase of obesity, WC and WHR will increase the risk for diabetes mellitus. It is important to maintain healthy weight, especially the control of WC and WHR, reduce the accumulation of abdominal fat to reduce the risk for diabetes mellitus.


Assuntos
Índice de Massa Corporal , Diabetes Mellitus/epidemiologia , Circunferência da Cintura , Relação Cintura-Quadril , Adolescente , Adulto , China/epidemiologia , Feminino , Humanos , Masculino , Fatores de Risco
19.
BMC Public Health ; 20(1): 452, 2020 Apr 06.
Artigo em Inglês | MEDLINE | ID: mdl-32252701

RESUMO

BACKGROUND: Body composition is a crucial factor associated with the incidence of type 2 diabetes mellitus. However, no study on this relationship has been performed in the Chinese population. This study aimed to investigate the relationship between body composition indicators and risk of type 2 diabetes mellitus among Chinese adults undergoing medical examination. METHODS: Between January 2018 and July 2018, a retrospective cross-sectional study was performed on 3367 (2307 male and 1060 female) participants aged ≥18 years undergoing medical examination in Zhengzhou. Logistic regression analysis was performed to explore the relationship between body composition indicators and risk of type 2 diabetes mellitus. A receiver operating characteristic curve was used to calculate cutoff points and the predictive power of each indicator. RESULTS: Among the 3367 participants, 12.53% were diagnosed with type 2 diabetes mellitus. Multivariate logistic analysis indicated that male participants (odds ratio [OR] = 1.68, 95% confidence interval [CI]: 1.29-2.19), older participants (OR = 1.05, 95% CI: 1.04-1.06), participants with a waist-to-hip ratio above the reference value (OR = 1.56, 95% CI: 1.18-2.07), participants with body fat percentage above the reference value (OR = 1.62, 95% CI: 1.01-2.68), and participant with a large visceral fat area (OR = 1.01, 95% CI: 1.01-1.02) had a high risk of type 2 diabetes mellitus. Waist-to-hip ratio, body fat percentage, and visceral fat area were the best indicators of type 2 diabetes mellitus (P < 0.001) with cutoff values of 0.90, 25.02%, and 92.00 cm2, respectively. CONCLUSION: This study suggests a predictive relationship between type 2 diabetes mellitus and body composition indicators of waist-to-hip ratio, body fat percentage, and visceral fat area, which are valuable for screening diabetes and providing effective health education and behavioral intervention for high-risk populations.


Assuntos
Tecido Adiposo , Composição Corporal , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/etiologia , Relação Cintura-Quadril , Adolescente , Adulto , Idoso , Índice de Massa Corporal , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Incidência , Gordura Intra-Abdominal , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Curva ROC , Valores de Referência , Estudos Retrospectivos , Fatores de Risco , Adulto Jovem
20.
PLoS One ; 15(3): e0229576, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32134933

RESUMO

BACKGROUND: Cardiovascular disease (CVD) is the leading cause of death in women worldwide. The cardiovascular risk profile deteriorates after women enter menopause. By definition, women diagnosed with premature ovarian insufficiency (POI) experience menopause before 40 years of age, which may render these women even more susceptible to develop CVD later in life. However, prospective long-term follow up data of well phenotyped women with POI are scarce. In the current study we compare the CVD profile and risk of middle aged women previously diagnosed with POI, to a population based reference group matched for age and BMI. METHODS AND FINDINGS: We compared 123 women (age 49.0 (± 4.3) years) and diagnosed with POI 8.1 (IQR: 6.8-9.6) years earlier, with 123 population controls (age 49.4 (± 3.9) years). All women underwent an extensive standardized cardiovascular screening. We assessed CVD risk factors including waist circumference, BMI, blood pressure, lipid profile, pulse wave velocity (PWV), and the prevalence of diabetes mellitus, metabolic syndrome (MetS) and carotid intima media thickness (cIMT), in both women with POI and controls. We calculated the 10-year CVD Framingham Risk Score (FRS) and the American Heart Association's suggested cardiovascular health score (CHS). Waist circumference (90.0 (IQR: 83.0-98.0) versus 80.7 (IQR: 75.1-86.8), p < 0.01), waist-to-hip ratio (0.90 (IQR: 0.85-0.93) versus 0.79 (IQR: 0.75-0.83), p < 0.01), systolic blood pressure (124 (IQR 112-135) versus 120 (IQR109-131), p < 0.04) and diastolic blood pressure (81 (IQR: 76-89) versus 78 (IQR: 71-86), p < 0.01), prevalence of hypertension (45 (37%) versus 21 (17%), p < 0.01) and MetS (19 (16%) versus 4 (3%), p < 0.01) were all significantly increased in women with POI compared to healthy controls. Other risk factors, however, such as lipids, glucose levels and prevalence of diabetes were similar comparing women with POI versus controls. The arterial stiffness assessed by PWV was also similar in both populations (8.1 (IQR: 7.1-9.4) versus 7.9 (IQR: 7.1-8.4), p = 0.21). In addition, cIMT was lower in women with POI compared to controls (550 µm (500-615) versus 684 µm (618-737), p < 0.01). The calculated 10-year CVD risk was 5.9% (IQR: 3.7-10.6) versus 6.0% (IQR: 3.9-9.0) (p = 0.31) and current CHS was 6.1 (1.9) versus 6.5 (1.6) (p = 0.07), respectively in POI versus controls. CONCLUSIONS: Middle age women with POI presented with more unfavorable cardiovascular risk factors (increased waist circumference and a higher prevalence of hypertension and MetS) compared to age and BMI matched population controls. In contrast, the current study reveals a lower cIMT and similar 10-year cardiovascular disease risk and cardiovascular health score. In summary, neither signs of premature atherosclerosis nor a worse cardiovascular disease risk or health score were observed among middle age women with POI compared to population controls. Longer-term follow-up studies of women of more advanced age are warranted to establish whether women with POI are truly at increased risk of developing CVD events later in life. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02616510.


Assuntos
Doenças Cardiovasculares/fisiopatologia , Sistema Cardiovascular/fisiopatologia , Insuficiência Ovariana Primária/fisiopatologia , Aterosclerose/sangue , Aterosclerose/metabolismo , Aterosclerose/fisiopatologia , Pressão Sanguínea/fisiologia , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/metabolismo , Sistema Cardiovascular/metabolismo , Estudos de Casos e Controles , Diabetes Mellitus/fisiopatologia , Feminino , Glucose/metabolismo , Humanos , Hipertensão/sangue , Hipertensão/metabolismo , Hipertensão/fisiopatologia , Lipídeos/sangue , Menopausa/sangue , Menopausa/metabolismo , Menopausa/fisiologia , Menopausa Precoce/sangue , Menopausa Precoce/metabolismo , Menopausa Precoce/fisiologia , Pessoa de Meia-Idade , Insuficiência Ovariana Primária/sangue , Insuficiência Ovariana Primária/metabolismo , Estudos Prospectivos , Análise de Onda de Pulso/métodos , Fatores de Risco , Rigidez Vascular/fisiologia , Circunferência da Cintura/fisiologia , Relação Cintura-Quadril/métodos
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