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1.
Medicine (Baltimore) ; 98(38): e17274, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31568007

RESUMO

BACKGROUND: Weight status and autism spectrum disorder (ASD) are rising public health concerns. An increasing number of reports indicate that individuals with ASD may have unhealthy weight status, but the evidence is mixed. To understand the weight status in individuals with ASD and provide strategies for prevention and intervention, we describe the protocol for a systematic review and meta-analysis aimed at assessing the prevalence of obesity, overweight, and underweight in ASD. METHODS: A broad range of key bibliographic databases including MEDLINE (PubMed), Embase, Cochrane, and ISI Web of Science will be searched to identify studies reporting the prevalence of obesity, overweight, and underweight in patients with ASD. Retrieved records will be independently screened by 2 authors and relevant estimates will be extracted from studies reporting data on obesity, overweight, and underweight prevalence among individuals with ASD. The assessment of study quality will be conducted primarily using the Newcastle-Ottawa scale and checklist proposed by the Joanna Briggs Institute. Prevalence estimates of obesity and overweight will be separately pooled using random-effects model. The pooled estimates will be summarized and presented by regional groupings. Subgroup analysis will be conducted for variables (such as study setting, participants' age, and geographical region) across studies, depending on data availability. Between-study heterogeneity will be assessed using the I statistic and explored through subgroup analyses. This systematic review and meta-analysis will be reported following the preferred reporting items for systematic reviews and meta-analyses checklist and the meta-analysis of observational studies in epidemiology statements guidelines for meta-analysis and systematic reviews of observational studies. RESULTS: In this study, we will outline details of the aims and methods on the meta-analysis of weight status of individuals with ASD. CONCLUSION: The results of this study will summarize the current data of weight status of individuals with ASD. REGISTRATION: PROSPERO-National Institute of Health Research (NIHR) Prospective Register of Systematic Reviews (CRD42019130790).


Assuntos
Transtorno do Espectro Autista/complicações , Peso Corporal , Criança , Humanos , Obesidade/complicações , Obesidade/psicologia , Sobrepeso/complicações , Sobrepeso/psicologia , Obesidade Pediátrica/complicações , Obesidade Pediátrica/psicologia , Magreza/complicações , Magreza/psicologia
2.
Rev Saude Publica ; 53: 66, 2019.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31553376

RESUMO

OBJECTIVE: To evaluate the performance of the ratio between the waist circumference and the height in the identification of health risk compared with the correlation matrix between the anthropometric parameters body mass index and waist circumference. METHODS: A population-based study presenting a transversal cut in a representative sample of the Brazilian adult and older population. The combination of the body mass index with the waist circumference resulted in health risk categories, and the cutoff points of the ratio between the waist circumference and the height as anthropometric indicator were used for classification of low and increased risk. Poisson regression was used to verify the association of systemic arterial hypertension with the health risk categories. RESULTS: The results showed 26% of adult men, 10.4% of adult women and more than 30% of the older adults of both genders classified as without risk by the combination matrix between body mass index and waist circumference presented a ratio between the waist circumference and height that showed increased risk. All risk categories continued to be associated with hypertension after control for confounding factors, being almost two times higher for adults with moderate and high risk according to both methods. When the waist-to-height ratio was used as a risk indicator, the prevalence of hypertension ratios for the older adults was 1.37 (95%CI 1.16-1.63) and 1.35 (95%CI 1.12-1.62) for men and women, respectively, being these values close to the combination matrix body mass index and waist circumference. CONCLUSIONS: The waist-to-height ratio identified more individuals at early health risk than the combination matrix between the body mass index and the waist circumference and showed comparable ability to identify health risk, regardless of gender and age, regarding the prevalence ratios for systemic arterial hypertension.


Assuntos
Sobrepeso/complicações , Medição de Risco/métodos , Razão Cintura-Estatura , Adulto , Distribuição por Idade , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Brasil/epidemiologia , Estudos Transversais , Feminino , Humanos , Hipertensão/epidemiologia , Hipertensão/etiologia , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Sobrepeso/fisiopatologia , Distribuição de Poisson , Valores de Referência , Fatores de Risco , Distribuição por Sexo , Fatores Sexuais , Circunferência da Cintura , Adulto Jovem
3.
Rev Fac Cien Med Univ Nac Cordoba ; 76(3): 159-163, 2019 08 29.
Artigo em Espanhol | MEDLINE | ID: mdl-31465183

RESUMO

Background: Excess weight (EW) and alterations in lipid metabolism constitute risk factors for cardiovascular disease in adults and children. Prevalence of dyslipidemia in schoolchildren from Jujuy with EW is analyzed in this study. Methods: Cross-sectional descriptive study of 891 schoolchildren 10-14 years old (367 girls; 524 boys) from the province of Jujuy (Northwestern Argentina). Prevalence of dyslipidemia for Overweight (OW) and Obesity (OB) were calculated, according to the International Obesity Task Force cut-off points. Prevalence of lipid alterations were analyzed and 7 dyslipidemic profiles were established. Comparisons and associations between variables were analyzed by Chi-square test. Crude and adjusted odds ratio were estimated from a logistic regressions. Results: Regardless of sex and nutritional status, 13.7%, 21.8%, and 16.5% of schoolchildren showed high values of total cholesterol, triglycerides, and LDL cholesterol, respectively, and 20.3% had low HDL cholesterol. Significantly higher values of HDL cholesterol were found in OW, and of triglycerides in OB. A significant association was recorded between OB and high triglycerides. Schoolchildren with OB have a 54% more chances of showing at least one lipid alteration. Conclusion: EW, and especially OB, constitutes an important risk factor in the development of dyslipidemia in schoolchildren from Jujuy.


Assuntos
Dislipidemias/sangue , Dislipidemias/etiologia , Sobrepeso/complicações , Adolescente , Argentina/epidemiologia , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/etiologia , Criança , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Estudos Transversais , Dislipidemias/epidemiologia , Feminino , Humanos , Masculino , Obesidade/complicações , Sobrepeso/epidemiologia , Prevalência , Instituições Acadêmicas , Triglicerídeos/sangue
4.
Artigo em Chinês | MEDLINE | ID: mdl-31327197

RESUMO

Objective:To investigate the overweight and obesity effects on pulmonary function in OSA patients.Method:Randomly selected 90 cases OSA patients who were treated January 2017 to December 2017. On the basis of BMI were divided into three groups, the normal OSA group(A,30 cases), overweight OSA group(B,30 cases) and obesity OSA group(C,30 cases). Comparative analysis between groups of age, AHI, lowest arterial saturation oxygen(LSaO2), the longest apnea time(LAD) and pulmonary function indicators include: a second volume(FEV1),forced vital capacity(FVC), FEV1/FVC,the chase volume(MVV), per minute resting ventilation(MV), peak expiratory flow velocity(PEF),tidal volume(VT), the residual gas volume(RV), functional residual capacity(FRC) and expiratory reserve volume volume(ERV), total lung volume(TLC) vital capacity(VC), deep inspiratory capacity(IC), RV/TLC. Result:Compared group C with B and A, B and A, AHI increased significantly(P<0.01); compared group C with B and A, LSaO2 significantly reduced(P<0.01); compared group C with A, LAD is prolonged(P<0.05).Compared group C with A, MVV, MV, TLC and IC increased significantly(P<0.05), FRC, ERV significantly reduced(P<0.05); compared C with B, MVV, MV and TLC increased significantly(P<0.05). Compared group B with A,MVV,MV,MEF75,ERV and IC increased significantly(P<0.05); AHI and VT,RV,TLC and FRC has significant positive correlation(P<0.05), and VT, MVV and FEV1/FVC has significant negative correlation(P<0.05);LAD with BMI,VC,FVC,FEV1,MEF50,PEF and MVV is a significant positive correlation(P<0.05).FEV1/FVC, IC is the independence of overweight and obesity OSA severe impact factor. Conclusion:With the increasing of BMI, not only increase the severity of OSA, and further damage to the pulmonary function; the OSA severity of overweight and obesity are closely associated with multiple pulmonary function index; FEV1% FVC, IC for overweight and obesity independent factor influencing the severity of OSA. Pulmonary function can be used as overweight and obesity auxiliary to assess the severity of OSA patients.


Assuntos
Pulmão/fisiopatologia , Obesidade/complicações , Sobrepeso/complicações , Apneia Obstrutiva do Sono/fisiopatologia , Estudos de Casos e Controles , Humanos , Testes de Função Respiratória , Apneia Obstrutiva do Sono/complicações , Capacidade Vital
5.
Rev Saude Publica ; 53: 52, 2019 Jul 01.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31269091

RESUMO

OBJECTIVE: To investigate the relationship between the dietary patterns of pregnant women with maternal excessive body weight and gestational diabetes mellitus. METHODS: A cross-sectional study conducted with a convenience sample of 785 adult pregnant women attended by the Unified Health System of Ribeirão Preto, state of São Paulo, between 2011 and 2012. Two 24-hour dietary recalls, corrected by the multiple source method, were employed . For the classification of the body mass index and the diagnosis of gestational diabetes mellitus, the criteria by Atalah and the World Health Organization were used, respectively. Dietary patterns were obtained by principal component analysis using the Varimax rotation method. The relationship between adherence to patterns, overweight and obesity was analyzed by multinomial logistic regression models and the relationship with gestational diabetes mellitus by adjusted unconditional logistic regression models. RESULTS: We identified four dietary patterns: "traditional Brazilian"; "snacks"; "coffee" and "healthy". Women with a higher adherence to the "Healthy" (OR = 0.52; 95%CI 0.33-0.83) and "Brazilian Traditional" patterns (OR = 0.61; 95%CI 0.38-0.96) presented a lower chance of obesity, when compared to women with lower adherence, regardless of confounding factors. After adjustment for maternal excessive body weight, there was no association between dietary patterns and gestational diabetes mellitus. CONCLUSIONS: Among the pregnant women, greater adherence to "traditional Brazilian" and "healthy" patterns was inversely associated with obesity, but no relationship was identified with gestational diabetes mellitus after adjusting for excessive body weight. Prospective studies are recommended to investigate the relationship between dietary patterns, overweight and gestational diabetes mellitus, reducing the chance of reverse causality.


Assuntos
Diabetes Gestacional/etiologia , Dieta/efeitos adversos , Obesidade/complicações , Sobrepeso/complicações , Adulto , Índice de Massa Corporal , Brasil , Métodos Epidemiológicos , Comportamento Alimentar , Feminino , Humanos , Fenômenos Fisiológicos da Nutrição Materna , Gravidez , Ganho de Peso , Adulto Jovem
6.
Braz Oral Res ; 33: e056, 2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-31271568

RESUMO

The aim of this study was to assess the association between weight status and ΔDMFS among 12-year-old schoolchildren from South Brazil. A total of 801 12-year-old schoolchildren were followed-up for 2.5 ± 0.3 years. Data collection included questionnaire, recording of anthropometric measures (height and weight), and caries examination. The outcome was the difference between DMFS (number of decayed, missing or filled surfaces) at follow-up and baseline (ΔDMFS). Weight status, based on body mass index-for-age Z-scores, was considered the main predictor variable. Negative binomial regression models were used to model the association, and rate ratios and their 95% confidence intervals were estimated. A multivariable fractional polynomial model was used to further explore the relationship between obesity and dental caries. DMFS increased by 0.86 (95%CI = 0.65-1.07), 0.91 (95%CI = 0.59-1.23), and 0.42 (95%CI = 0.03-0.80) for normal weight, overweight, and obese schoolchildren, respectively. Obese adolescents had significantly lower ΔDMFS than normal weight ones (p < 0.05). No significant association between categories of weight status and ΔDMFS was found (overweight, IRR=0.92, 95%CI = 0.69-1.21, p = 0.54; obese IRR = 0.75, 95%CI = 0.51-1.12, p = 0.16). However, the multivariable fractional polynomial model showed an inverted U shaped relationship with a decreasing ΔDMFS with increasing BMI (p < 0.05). This population-based longitudinal study showed an inverse association between obesity and ΔDMFS over a 2.5-year period among South Brazilian adolescents.


Assuntos
Cárie Dentária/epidemiologia , Cárie Dentária/etiologia , Obesidade/complicações , Obesidade/epidemiologia , Índice de Massa Corporal , Brasil/epidemiologia , Criança , Índice CPO , Métodos Epidemiológicos , Feminino , Humanos , Masculino , Sobrepeso/complicações , Sobrepeso/epidemiologia , Fatores Socioeconômicos
7.
Einstein (Sao Paulo) ; 17(3): eAO4782, 2019 Jun 27.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31271610

RESUMO

OBJECTIVE: To determine the prevalence of risky sexual behavior and its association with overweight and obesity among adolescent students. METHODS: This is a cross-sectional study, conducted in public schools with adolescents aged 12 to 17 years. We used the questionnaire Youth Risk Behavior Survey. The body mass index percentiles were calculated by means of table from the Center for Control and Prevention of Diseases. Possible associations were assessed using the χ2 test and binary logistic regression model. The odds ratio and 95%CI were calculated. RESULTS: We evaluated 1,169 students, and 33.9% reported having had sexual intercourse. Of those, 33% did not use a condom during their last intercourse, and 32.7% had had four or more sexual partners thus far. Regarding nutritional status, 15.3% were overweight or obese. In relation to the non-use of condoms, we observed only an association with the number of lifetime sexual partners (OR: 0.50; 95%CI: 0.28-0.88). The number of lifetime sexual partners was associated with males (OR: 9.17; 95%CI: 4.16-20.22), sexual debut age at 13 years or less (OR: 2.51; 95%CI: 1.23-5.13) and drinking alcohol or using drugs before the last intercourse (OR: 6.16; 95%CI: 2.14-17.73). CONCLUSION: Risky sexual behavior rates were high and no association was found between risky sexual behaviors and overweight and obesity.


Assuntos
Comportamento do Adolescente/psicologia , Obesidade/psicologia , Sobrepeso/psicologia , Comportamento Sexual/psicologia , Comportamento Sexual/estatística & dados numéricos , Adolescente , Índice de Massa Corporal , Criança , Estudos Transversais , Humanos , Obesidade/complicações , Sobrepeso/complicações , Assunção de Riscos , Fatores Sexuais , Parceiros Sexuais
8.
Rev Med Chil ; 147(3): 289-295, 2019 Mar.
Artigo em Espanhol | MEDLINE | ID: mdl-31344165

RESUMO

BACKGROUND: The evaluation of physical fitness is important to determine workloads and to assess the effectiveness of exercise interventions in obese people. AIM: To determine the maximum aerobic power output (MAPO) in overweight and obese individuals and to establish reference parameters for the Chilean population. MATERIAL AND METHODS: One hundred five men and 218 women performed a cycle ergometer test up to 85% of their maximum heart rate. MAPO was determined by linear extrapolation of the theoretical maximum heart rate. RESULTS: Among men, MAPO values were 234.9 ± 48.4 w for body mass index (BMI) values between 30 and 34.9 kg/m2, 235.1 ± 69.7 w for BMI between 35 and 39.9 kg/m2, 270.2 ± 86.5 w for BMI over 40 kg/m2. MAPO relative values were 2.27 ± 0.5, 2.16 ± 0.6 and 1.96 ± 0.8 w/kg, respectively. Among women, MAPO was 172.6 ± 36.1 w for a BMI < 30 kg/m2, 169.2 ± 39.4 w for BMI between 30 and 34.9 kg/m2, 179.5 ± 48.8 w f179.5 ± 48.8 w for BMI between 35 and 39.9 kg/m2 and 202.3 ± 57.3 w for BMI of 40 kg/m2 or over. The relative values were 2.33 ± 0.5; 2.02 ± 0.5; 1.91 ± 0.5 and 1.81 ± 0.5 w / kg (p < 0.05). CONCLUSIONS: MAPO estimation with a cycle ergometer test is well tolerated in overweight and obese individuals. MAPO decreased along with BMI increments in women. No association between BMI and MAPO in men was observed.


Assuntos
Obesidade/complicações , Sobrepeso/complicações , Consumo de Oxigênio , Adulto , Índice de Massa Corporal , Chile , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Aptidão Física , Testes de Função Respiratória , Estudos Retrospectivos , Adulto Jovem
9.
Rev Lat Am Enfermagem ; 27: e3161, 2019 Jul 18.
Artigo em Português, Inglês, Espanhol | MEDLINE | ID: mdl-31340346

RESUMO

OBJECTIVE: to detect the risk of development of type 2 diabetes in nurses and its relationship with metabolic alterations. METHOD: cross-sectional study, with 155 nurses. The variables investigated were: sociodemographic, body mass index, waist circumference, waist-hip index, lipid profile, basal glycemia and oral glucose tolerance curve. The Finnish Diabetes Risk Score was used to collect data. RESULTS: 155 nurses were included, with an average age of 44 years and 85% were overweight or obese. 52% had a family history of diabetes and 21% had occasional hyperglycemia. With respect to the risk, 59% were identified with moderate and very high risk for type 2 diabetes. Glucose, insulin, glycosylated hemoglobin A1c and insulin resistance increased in parallel to the increased risk for type 2 diabetes, although lipids did not increase. 27% of the sample had impaired fasting glycemia. 15% had glucose intolerance and 5% had type 2 diabetes. CONCLUSION: there was a high detection rate of people at risk for type 2 diabetes (59%) and the high and very high risk score was associated with high levels of glycosylated hemoglobin A1c, glucose, insulin and insulin resistance, but not with lipids.


Assuntos
Diabetes Mellitus Tipo 2/etiologia , Obesidade/complicações , Sobrepeso/complicações , Adulto , Índice de Massa Corporal , Estudos Transversais , Diabetes Mellitus Tipo 2/prevenção & controle , Feminino , Humanos , Hiperglicemia , Resistência à Insulina , México , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros , Estado Pré-Diabético/complicações , Estado Pré-Diabético/prevenção & controle , Fatores de Risco , Fatores Socioeconômicos , Inquéritos e Questionários
10.
Int Braz J Urol ; 45(4): 790-797, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31184451

RESUMO

OBJECTIVE: The purpose of this study was to determine whether the presence of obesity was related with symptoms of nocturnal enuresis (NE) and the efficacy of behavioral intervention in the treatment of NE. MATERIALS AND METHODS: The patients diagnosed with primary monosymptomatic nocturnal enuresis (PMNE) were studied retrospectively. NE severity was classifi ed as mild, moderate, and severe according to the frequency of enuresis. The children were divided into three groups, namely normal weight (5th-84th percentile), overweight (85th-94th percentile), and obesity (≥95th percentile), according to their Body Mass Index (BMI) percentage. The relationship between obesity level and enuresis severity was analyzed. After three months of behavioral therapy, the effi cacy of treatment among normal, overweight, and obese groups were evaluated. Moreover, the predictive risk factors for treatment failure were investigated. RESULTS: The rates of severe enuresis in patients with normal weight, overweight, and obesity were 63.9%, 77.5%, and 78.6%, respectively. Obese children depicted higher odds of having severe enuresis compared with normal-weight children (OR: 1.571; 95% confi dence interval [CI]: 1.196-2.065; P=0.001). The odds of presenting with severe enuresis were 1.99 times higher in children who are obese or overweight compared to children with normal weight (OR: 1.994; 95% CI: 1.349-2.946; P=0.001). The complete response of the normal group was higher than those of the overweight and obese groups (26.8% vs. 14.0%, P=0.010; 26.8% vs. 0.0%, P=0.000). Overweight children showed higher complete response than obese ones (14.0% vs. 0.0%, P=0.009). Logistic regression analysis revealed that obesity level and enuresis frequency were significantly related to the treatment failure of behavioral intervention. CONCLUSIONS: Obesity is associated with severe enuresis and low effi cacy of behavioral therapy in children with nocturnal enuresis.


Assuntos
Terapia Comportamental/métodos , Enurese Noturna/etiologia , Enurese Noturna/terapia , Obesidade Pediátrica/complicações , Adolescente , Índice de Massa Corporal , Criança , Pré-Escolar , Feminino , Humanos , Modelos Logísticos , Masculino , Sobrepeso/complicações , Valores de Referência , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença , Fatores Sexuais , Falha de Tratamento
11.
Bull Cancer ; 106(7-8): 635-646, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31227175

RESUMO

In the past decades, obesity and overweight prevalence has been rising worldwide, in both men and women. In France, the prevalence of overweight in adults was 49% in 2015 (54% among men and 44% among women), including 17% of obese adults. According to the last evaluation performed by IARC in 2017, overweight and obesity are established risk factors for 13 cancer sites with risk estimates per 5kg/m2 varying largely depending on the cancer site. In 2015 in France, 5.4% of cancer cases could be attributed to excess weight, corresponding to 18,600 cases, including 3400 colon cancers, 2600 kidney cancers, 4500 breast cancers and 2500 endometrial cancers. Obesity is also related to worse prognosis for some cancers, in particular breast and colon cancers. Obesity in children and adolescents, also rising in many countries, has also been associated to an increase in adult cancer risk. A major cause of obesity is a disequilibrium in energy balance favoured by a diet rich in processed food, red meat, trans and saturated fatty acids, sweetened foods and beverages and poor in fruits and vegetables, legumes and whole grains. Main national and international recommendations to reduce the prevalence of obesity are to have a balanced diet and regular physical activity.


Assuntos
Neoplasias/epidemiologia , Sobrepeso/epidemiologia , Adulto , Criança , Cocarcinogênese , Comorbidade , Dieta/efeitos adversos , Metabolismo Energético , Exercício , Feminino , Saúde Global , Hormônios Esteroides Gonadais/fisiologia , Guias como Assunto , Humanos , Inflamação , Insulina/fisiologia , Fator de Crescimento Insulin-Like I/fisiologia , Masculino , Neoplasias/etiologia , Neoplasias/prevenção & controle , Especificidade de Órgãos , Sobrepeso/complicações , Sobrepeso/fisiopatologia , Prevalência , Fatores de Risco , Organização Mundial da Saúde
12.
Rev. Bras. Saúde Mater. Infant. (Online) ; 19(2): 275-283, Apr.-June 2019. tab
Artigo em Inglês | LILACS | ID: biblio-1013141

RESUMO

Abstract Objectives: to investigate the relationship between the Diet Quality Index Adapted for Pregnant Women (IQDAG) and excess maternal body weight. Methods: a cross-sectional study was conducted with 754 adult pregnant women, in Ribeirão Preto, São Paulo, between 2011 and 2012. The criteria proposed by Atalah were used to classify the body mass index (BMI). Adjusted multinomial logistic regression models were employed to investigate the relationship between the IQDAG and being overweight and obese, estimating the odds ratio (OR) and the 95% confidence interval (CI95%). Results: the mean (SD) age of women was 28 (5) years, 33.4% were overweight and 25.6% obese. The pregnant women with higher scores in the IQDAG were less likely to be overweight [OR= 0.56 (CI95% = 0.37-0.85)] or obese [0.43 (0.26-0.71)]; those with higher scores in the "Fiber" [0.51 (0.33; 0.78)] and "Iron" [0.62 (0.40-0.96)] components were less likely to be overweight. However, women with higher scores in the percentage of energy from ultra-processed foods were more likely to be overweight [1.72 (1.10-2.94)] or obese [5.24 (2.80-9.80)], when compared to women with lower scores. Conclusions: poorer quality maternal diets were observed among the women who were overweight and obese during pregnancy.


Resumo Objetivos: investigar a relação entre o Índice de Qualidade da Dieta Adaptado para Gestantes (IQDAG) e o excesso de peso materno. Métodos: estudo transversal conduzido entre 754 gestantes adultas em Ribeirão Preto, SP, entre 2011 e 2012. Os critérios propostos por Atalah foram empregados para a classificação do índice de massa corporal (IMC). Modelos de regressão logística multinomial ajustados foram utilizados para investigar a relação da pontuação do IQDAG com o sobrepeso e obesidade, estimando-se o odds ratio (OR) e seu intervalo de confiança de 95% (IC95%). Resultados: a média (DP) de idade das mulheres foi de 28 (5) anos, 33,4% e 25,6% eram portadoras de sobrepeso e obesidade, respectivamente. As gestantes com maior pontuação do IQDAG apresentaram menor chance de sobrepeso [OR= 0,56 (IC95%= 0,37-0,85)] e obesidade [0,43 (0,26-0,71)]; as com maior pontuação para os componentes "Fibras" [0,51 (0,33-0,78)] e "Ferro" [0,62 (0,40-0,96)] apresentaram menor chance de sobrepeso. Em contrapartida, mulheres com maior pontuação para o percentual do valor energético proveniente dos alimentos ultraprocessados apresentaram maior chance de sobrepeso [1,72 (1,10-2,94)] e obesidade [5,24 (2,80-9,80)], quando comparadas com as mulheres com menor pontuação. Conclusões: pior qualidade da dieta materna foi observada entre as mulheres portadoras de sobrepeso e obesidade no período gestacional.


Assuntos
Humanos , Feminino , Gravidez , Inquéritos Nutricionais , Sobrepeso/complicações , Nutrição Materna , Brasil , Índice de Massa Corporal , Saúde Materno-Infantil , Alimentos Industrializados , Obesidade/complicações
13.
Clin Biochem ; 69: 15-20, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31129183

RESUMO

OBJECTIVE: Despite the current guidelines for the management of type 2 diabetes mellitus (T2DM), patients still struggle with the hyperglycemia consequences. Imbalance in zinc homeostasis, in particular, renders diabetic patients more susceptible to the damages of oxidative stress. This study aimed to evaluate the effects of zinc supplementation on the superoxide dismutase gene expression and enzyme activity in overweight individuals with T2DM. Additionally, biochemical parameters, such as fasting blood glucose (FBG), insulin, glycated hemoglobin (HbA1c), homeostasis model of assessment-insulin resistance (HOMA-IR), serum levels of zinc and lipid profile, were assessed. METHODS: In this randomized, double-blind, placebo-controlled trial, 70 overweight (BMI > 25) T2DM patients were selected based on the inclusion criteria. They were divided into two groups for supplementation of daily 50 mg zinc gluconate or placebo for 8 weeks. Blood samples were collected from all the individuals in the zinc group and controls for analysis. RESULTS: The results showed that, in comparison with the control group, zinc supplementation increased both gene expression and enzyme activity of SOD (p < 0.01) as well as the levels of insulin (p = 0.02) among the patients in the zinc group. Moreover, there was a meaningful reduction in the levels of FBG, HbA1c and HOMA-IR value (p < 0.001), triglycerides and total cholesterol (p < 0.05) after the zinc treatment. CONCLUSIONS: Taken together, the current study suggests that daily supplementation with 50 mg zinc gluconate could be a useful approach for the management of overweight T2DM. CLINICAL TRIAL REGISTRATION: IRCT2015083102.


Assuntos
Diabetes Mellitus Tipo 2/metabolismo , Sobrepeso/complicações , Superóxido Dismutase/genética , Superóxido Dismutase/metabolismo , Zinco/administração & dosagem , Adulto , Idoso , Biomarcadores/sangue , Glicemia/análise , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/enzimologia , Diabetes Mellitus Tipo 2/genética , Método Duplo-Cego , Feminino , Humanos , Lipídeos/sangue , Masculino , Pessoa de Meia-Idade , Placebos , RNA Mensageiro/metabolismo
14.
Medicine (Baltimore) ; 98(21): e15782, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31124971

RESUMO

This study aims to investigate urban-rural differences in characteristics and risk factors of ischemic stroke in northern China.The present cross-sectional study was based on the High-risk Population Screening and Intervention Project for Stroke. The cluster sampling method was used to select urban and rural screening sites in northern China. By collecting information and screening the data, patients with ischemic stroke were obtained and a control group with similar gender, age, and regional distribution was selected among the nonischemic stroke patients. Then, the demographic and risk factors of patients with ischemic stroke were described and analyzed.The prevalence of ischemic stroke in northern China was 2.88%, with a greater prevalence in rural areas than in urban areas (3.32% vs 2.43%), and a greater prevalence in males than in females (3.06% vs 2.73%). Furthermore, rural stroke patients were younger than urban stroke patients. Hypertension, family history of stroke, and smoking were the top 3 independent risk factors for ischemic stroke. Overweight/obesity and low education were associated with increased ischemic stroke in urban areas, while low education was associated with less ischemic stroke in rural areas. In addition, the prevalence of alcoholism, dyslipidemia, diabetes, and obvious overweight/obesity was greater in urban areas, while high-salt diet and low education and income were more prevalent in rural regions. Moreover, the smoking index was higher in rural areas than in urban areas.The characteristics and risk factors of ischemic stroke differ between rural and urban areas, which could be used to design specific preventative measures.


Assuntos
Programas de Rastreamento/estatística & dados numéricos , População Rural/estatística & dados numéricos , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/etiologia , População Urbana/estatística & dados numéricos , Adulto , China/epidemiologia , Análise por Conglomerados , Estudos Transversais , Diabetes Mellitus/epidemiologia , Dislipidemias/complicações , Dislipidemias/epidemiologia , Escolaridade , Feminino , Humanos , Hipertensão/complicações , Hipertensão/epidemiologia , Renda/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Sobrepeso/complicações , Sobrepeso/epidemiologia , Prevalência , Fatores de Risco , Fatores Sexuais , Fumar/efeitos adversos , Fumar/epidemiologia
15.
Wiad Lek ; 72(3): 350-356, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31050979

RESUMO

OBJECTIVE: Introduction: In recent years, NAFLD is considered as the key of the so-called metabolic inflammation, in which the intestinal microbiota plays an important role. The aim: To determine the effect of small intestine bacterial overgrowth on the liver structural and functional parameters in children with obesity and overweight. PATIENTS AND METHODS: Materials and methods: The object of the study was 89 children with obesity/overweight. Depending on the presence of SIBO based on the results of the hydrogen breath test with glucose, the patients were divided into 2 groups: first (I) consisted of 31 children with SIBO, the second (II) included 58 children without SIBO. All the patients under study performed a general blood analysis and a biochemical blood test, immuno-enzyme test method with insulin level determination HOMA index calculation. For diagnostics of the liver steatosis, transient elastography with the CAP (controlled attenuation parameter) function was carried out using FibroScan® 502 touch (Echosens, Paris, France). RESULTS: Results: According to fibroscan data, the presence of SIBO in obese children can lead to raise of CAP level; liver steatosis was diagnosed in 22 patients (70.9%) of the 1st group and 24 patients (41.4%) of the 2 group (p<0,05). We found significant differences in the the ratio of neutrophils and lymphocytes (NLR) (p <0.05). The average glucose level and HOMA index were significantly higher in SIBO group (p<0,05). The analysis of risk factors of SIBO showed that metabolic syndrome and NAFLD as the risk factors for SIBO development (p<0,05). CONCLUSION: Conclusions: SIBO has an effect on the structural and functional characteristics of the liver resulting in higher insulin and glucose level, higher NLR level and greater prevalence of NAFLD.


Assuntos
Infecções Bacterianas , Hepatopatia Gordurosa não Alcoólica , Infecções Bacterianas/complicações , Testes Respiratórios , Criança , Humanos , Intestino Delgado/microbiologia , Obesidade , Sobrepeso/complicações
16.
Fertil Steril ; 111(6): 1054-1064, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31036339

RESUMO

Parental excess weight and especially pregestational maternal obesity and excessive weight gain during pregnancy have been related to an increased risk of metabolic (obesity, type 2 diabetes, cardiovascular disease, metabolic syndrome) and nonmetabolic (cancer, osteoporosis, asthma, neurologic alterations) diseases in the offspring, probably mediated by epigenetic mechanisms of fetal programming. Maternal underweight is less common in developed societies, but the discrepancy between a poor nutritional environment in utero and a normal or excessive postnatal food supply with rapid growth catch-up appears to be the main candidate mechanism of the development of chronic diseases during the offspring's adulthood. The role of the postnatal environment in both scenarios (parental overweight or underweight) also seems to influence the offspring's health. Lifestyle interventions before and during pregnancy in both parents, but especially in the mother, as well as in children after birth, are advisable to counteract the many undesirable chronic conditions described.


Assuntos
Saúde da Criança , Filho de Pais Incapacitados , Saúde Materna , Sobrepeso/complicações , Magreza/complicações , Adolescente , Comportamento do Adolescente , Desenvolvimento do Adolescente , Fatores Etários , Criança , Comportamento Infantil , Desenvolvimento Infantil , Pré-Escolar , Suscetibilidade a Doenças , Feminino , Ganho de Peso na Gestação , Nível de Saúde , Humanos , Lactente , Recém-Nascido , Masculino , Sobrepeso/diagnóstico , Sobrepeso/fisiopatologia , Gravidez , Resultado da Gravidez , Medição de Risco , Fatores de Risco , Magreza/diagnóstico , Magreza/fisiopatologia
17.
Acta Diabetol ; 56(9): 1073-1082, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31062097

RESUMO

AIMS: Offspring of mothers suffering from obesity and/or gestational diabetes mellitus (GDM) were reported to be at risk of higher birth weight (BW), later obesity and diabetes. We hypothesize that infant anthropometry changes related to maternal pathological status are due to dysregulated infant metabolism. METHODS: First, we inspected differences in BMI z-scores (z-BMI) between three infant groups: born to normal weight (NW; n = 49), overweight/obese (OV/OB; n = 40) and GDM mothers (n = 27) at birth and 1 year. Then, we inspected associations between cord blood metabolites and 1-year Δ z-BMI in the three infant groups at birth and 1 year. RESULTS: No statistically significant difference was detected in z-BMI between the study groups at birth; however, GDM was associated with heavier infants at 1 year. Regarding the associations between the metabolites and z-BMI, phospholipids, especially those containing polyunsaturated fatty acids, were the species most impacted by the maternal metabolic status, since numerous phosphatidylcholines-PUFA were positively associated with z-BMI in NW but negatively in OV/OB and GDM groups at birth. Conversely, the sum of lysophosphatidylcholines was only positively associated with z-BMI in NW at birth but of no relation in the other two groups. At 1 year, most of the associations seen at birth were reversed in NW and lost in OV/OB and GDM groups. In the NW group, PC-PUFA were found to be negatively associated with Δ z-BMI at 1 year in addition to some medium-chain acylcarnitines, tricarboxylic acid metabolites, Asp and Asn-to-Asp ratio. In OV/OB and GDM groups, the non-esterified fatty acid (NEFA26:0) and His correlated with Δ z-BMI at 1 year in negative and positive directions, respectively. CONCLUSIONS: GDM was associated with overweight in offspring at 1 year, independent of the BW with lack of evidence on existing correlation of this finding with metabolic alterations detected in cord blood metabolome. Associations were found between cord blood metabolites and infant anthropometry at birth and were influenced by maternal OB and GDM. However, an extension of the findings monitored at birth among the three groups was not detected longitudinally showing a lack of predictive power of cord blood metabolome for later development at least 1 year.


Assuntos
Crianças Adultas , Filho de Pais Incapacitados , Diabetes Gestacional , Sangue Fetal/metabolismo , Metaboloma , Obesidade , Efeitos Tardios da Exposição Pré-Natal/metabolismo , Adulto , Crianças Adultas/estatística & dados numéricos , Peso ao Nascer/fisiologia , Índice de Massa Corporal , Estudos de Casos e Controles , Filho de Pais Incapacitados/estatística & dados numéricos , Efeito de Coortes , Diabetes Gestacional/sangue , Diabetes Gestacional/metabolismo , Características da Família , Ácidos Graxos não Esterificados/análise , Ácidos Graxos não Esterificados/sangue , Feminino , Sangue Fetal/química , Humanos , Lactente , Recém-Nascido , Masculino , Metabolômica/instrumentação , Metabolômica/métodos , Pessoa de Meia-Idade , Obesidade/sangue , Obesidade/complicações , Obesidade/diagnóstico , Sobrepeso/complicações , Gravidez , Efeitos Tardios da Exposição Pré-Natal/sangue , Efeitos Tardios da Exposição Pré-Natal/diagnóstico
18.
Int Heart J ; 60(3): 624-630, 2019 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-31105141

RESUMO

The aim of this study was to evaluate the association of the body mass index (BMI) categories with the risk of sudden cardiac death (SCD) in a systematic review and meta-analysis.We systematically searched the PubMed, Embase, and Cochrane Library databases up to February 2018 for all studies reporting an association between BMI and risk of SCD. Relative risks (RRs) and 95% confidence intervals (CIs) were extracted and pooled using a random effects model.A total of 10 studies involving 1,381,445 participants were included in the meta-analysis. Overall, compared with the risk level in normal-weight controls, being underweight was not associated with increased risk of SCD (RR = 1.20, 95% CI, 0.95-1.51; P = 0.13). In contrast, both being overweight (RR = 1.21, 95% CI, 1.08-1.35; P = 0.0008) and obesity (RR = 1.52, 95% CI, 1.31-1.77; P < 0.00001) were associated with increased risk of SCD. The association between the BMI categories and risk of SCD was stable in the sensitivity analysis in which individual studies were serially excluded.The findings from this meta-analysis indicate that excess weight is associated with an increased risk of SCD. Further research is required to explore the underlying mechanisms.


Assuntos
Morte Súbita Cardíaca/etiologia , Obesidade/complicações , Sobrepeso/epidemiologia , Índice de Massa Corporal , Causas de Morte , Feminino , Humanos , Masculino , Obesidade/epidemiologia , Sobrepeso/complicações , Medição de Risco
19.
Medicine (Baltimore) ; 98(19): e15602, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31083250

RESUMO

The apnea test is an essential examination for the determination of brain death; however, hypotension, hypoxemia, and other complications during the apnea test can affect the stability of brain-dead patients, as well as organ function for recipients. Therefore, it is necessary to establish standard guidelines for apnea testing.The modified apnea test (MAT) comprises delivery of 100% oxygen through the endotracheal tube connected to manual resuscitator (Ambu bag) with the positive end-expiratory pressure (PEEP) valve after disconnection of the mechanical ventilator for maintenance of PEEP. Forty-nine instances of the conventional apnea test (CAT) were performed in 25 brain-dead patients; 77 instances of the MAT were performed in 39 brain-dead patients.The mean duration of the apnea test was 3.5 ±â€Š1.4 minutes in the CAT group and 3.0 ±â€Š1.2 minutes in the MAT group. There were no significant changes in PaCO2, PaO2, or pH between the CAT and MAT groups (P = .341, .593, and .503, respectively). In overweight patients (body mass index ≥ 23 kg/m), MAT prevented dramatic reductions in PaO2 and SaO2 (P < .05 for both). In the patients who had hypoxic brain injury due to hanging, differences in PaO2 and SaO2 in the MAT group were significantly smaller than in the CAT group (P < .05).Although MAT, which was invented to maintain PEEP, was not efficient for all brain-dead patients, it could be helpful in selected patient groups, such as overweight patients or those who had hypoxic injury due to hanging. And clinicians should consider short-term apnea test to avoid unnecessarily prolonged hypoxemia.


Assuntos
Apneia/diagnóstico , Gasometria/métodos , Morte Encefálica/diagnóstico , Respiração com Pressão Positiva/métodos , Apneia/complicações , Feminino , Humanos , Hipóxia Encefálica/complicações , Masculino , Pessoa de Meia-Idade , Sobrepeso/complicações
20.
Medicine (Baltimore) ; 98(15): e14994, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30985644

RESUMO

OBJECTIVE: The impact of aldosterone blockade using eplerenone on hypertensives with obesity has not been clarified. We compared the efficacy and safety between eplerenone and trichlormethiazide in hypertensives with overweight or obesity. METHODS: A prospective, randomized, open-labeled, blinded-endpoint design, multicenter trial enrolled 204 hypertension-treated outpatients with obesity [body mass index (BMI) ≥25 kg/m] evaluated by ambulatory blood pressure (BP) measurement. Patients were randomly assigned to receive 50 mg of eplerenone (n = 102) or 1 mg of trichlormethiazide (n = 102), each of which were administered once every morning. Primary efficacy endpoints were systolic and diastolic BPs and biomarkers of glucose metabolism after 6 months of treatment. RESULTS: At baseline, BPs were comparable between the two groups. Systolic/diastolic blood pressure (SBP/DBP) were reduced from 153.9 ±â€Š12.6/84.6 ±â€Š11.8 to 129.8 ±â€Š14.2/73.7 ±â€Š12.2 mm Hg by eplerenone therapy and from 152.2 ±â€Š12.5/85.2 ±â€Š10.9 to 133.8 ±â€Š12.6/76.1 ±â€Š8.6 mm Hg by trichlormethiazide therapy (all; P < .001). The efficacy of SBP reduction after adjustment for age, sex, and BMI was significantly greater in the eplerenone group than the trichlormethiazide (P = .034), although the efficacy of DBP reduction was marginally significant (P = .072). Especially, the efficacy of BP reduction was more effective for aged over 65 years than less than 65 years. However, biomarkers of glucose metabolism were not significantly different between these 2 groups. CONCLUSION: The eplerenone therapy was more effective in BP lowering in hypertensives with overweight or obesity than the trichlormethiazide therapy, especially in the elderly.


Assuntos
Anti-Hipertensivos/uso terapêutico , Pressão Sanguínea/efeitos dos fármacos , Eplerenona/uso terapêutico , Hipertensão/tratamento farmacológico , Hipoglicemiantes/uso terapêutico , Sobrepeso/tratamento farmacológico , Idoso , Feminino , Glucose/metabolismo , Humanos , Hipertensão/complicações , Hipertensão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Sobrepeso/complicações , Sobrepeso/fisiopatologia , Resultado do Tratamento , Triclormetiazida/uso terapêutico
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