Perfil da metilação do DNA do binômio mãe-filho no contexto da obesidade materna, adiposidade fetal e neonatal / DNA methylation profile of the mother-child binomial in maternal obesity, fetal and neonatal adiposity

Introdução: Um mecanismo epigenético pelo qual os efeitos adversos do ambiente intra-uterino são transferidos aos descendentes é a metilação do DNA. Objetivo: Avaliar a relação entre obesidade materna, ganho de peso gestacional (GPG) e alteração da metilação do DNA sobre o desenvolvimento fetal e neonatal. Metodologia: Subpopulação de gestantes do estudo epidemiológico prospectivo "Coorte Araraquara" foram acompanhadas durante os três trimestres da gestação, parto e no pós-parto. Para avaliar o impacto do GPG na metilação do DNA e desenvolvimento fetal e neonatal, as gestantes foram alocadas em 2 grupos: ganho de peso gestacional adequado (n=45) e ganho de peso gestacional excessivo (n=30). Para avaliar o impacto da obesidade materna na metilação do DNA e desenvolvimento fetal e neonatal, as gestantes foram alocadas em 2 grupos: A. IMC pré-gestacional adequado (n=25) e B. IMC pré-gestacional sobrepeso/obesidade (n=39 gestantes). A biometria e composição corporal fetal foram avaliadas por ultrassom Siemens ACUSON X300TM (Siemens®, Mountain View, CA, USA) e a composição corporal do neonato por pletismografia, com o PEA POD (Cosmed®, Concord, CA, USA). A dieta materna ao final da gestação foi investigada por recordatórios de 24 horas e analisada no software Nutrition Data System for Research (NDSR, Minnesota, USA). O DNA dos sangues materno e cordão umbilical, da vilosidade e decídua placentárias foram extraídos utilizando proteinase K pelo método santing-out. As regiões hipo e hipermetiladas foram analisados pela técnica de Digestão Enzimática Sensível à Metilação associada à PCR quantitativa (qPCR) e a expressão gênica por qPCR. Para análise da influência do GPG o DNA do sangue materno de gestantes com GPG adequado (N=8) versus com GPG excessivo (N=8), foi hibridizado na plataforma Illumina com o Human Methylation 850K Bead Chip (Illumina, CA, USA). Para análise estatística aplicou-se o Teste t, Qui-quadrado (X2), ANOVA de medidas repetidas e modelos de regressão linear múltiplo e o nível de significância adotado foi de p≤0,05. Resultados: O excessivo ganho de peso gestacional (EGPG) alterou os triglicerídeos (TGs) e colesterol total (CT) maternos, o diâmetro occipito-frontal (DOF) do feto, a circunferência da cabeça, perímetro torácico, peso e a massa gorda neonatais. A análise de metilação global do DNA materno identificou 46 posições diferencialmente metiladas e 11 regiões diferencialmente metiladas (DMRs). Nove fenótipos humanos foram enriquecidos para essas 11 DMRs localizadas em 13 genes (EMILIN1, HOXA5, CPT1B, CLDN9, ZFP57, BRCA1, POU5F1, ANKRD33, HLA-B, RANBP17, ZMYND11, DIP2C, TMEM232), destacando-se os termos resistência à insulina e hiperglicemia. O DNAm materno foi associado com parâmetros de composição corporal, como: tecido total da coxa e do braço fetais e gordura subcutânea da coxa e do braço fetais, bem como ao percentual de massa gorda e massa gorda neonatais. A metilação do DNA materno também foi associada com os TGs e a insulina de jejum maternos, com circunferência abdominal e circunferência da cabeça fetais (CC) e CC neonatal. As DMRs estudadas foram enriquecidas em 142 processos biológicos, 21 funções moleculares e 17 componentes celulares. Três módulos gênicos diferencialmente metilados foram identificados. Por outro lado, o IMC pré-gestacional sopreso/obesidade alterou os percentis do diâmetro biparietal (DBF), o DOF, a CC, a espessura da gordura subcutânea do abdômen (ETSA), tecido total do braço, massa muscular do braço e gordura subcutânea do braço fetais e a CC do neonato. O gene H19DMR foi significativamente menos metilado no sangue materno do grupo com sobrepeso/obesidade em comparação ao grupo com IMC pré-gestacional adequado, para o sangue do cordão umbilical e tecidos placentários, não houve diferença de metilação entre os grupos, bem como não houve diferença de expressão gênica dos genes H19 e IGF2 nos tecidos placentários entre os grupos. Houve associações entre metilação de H19DMR no sangue do cordão umbilical com os percentis do DBP, com a ETSA e a CC neonatais; na decídua com o DOF, a CC e comprimento fetais; no vilo com o DOF, a CC e a ETSA fetais e com a CC neonatal. A expressão do gene H19 na decídua também foi associada ao DBP e ao percentil do comprimento do fêmur fetais; no vilo com o DOF e gordura subcutânea do braço fetais. A expressão do gene IGF2 na decídua foi associada com o DBP fetal e no vilo com o DOF fetal. Conclusão: A metilação do DNA foi alterada pelo ganho de peso gestacional e obesidade maternos e se associou com a adiposidade e crescimento fetais. O excessivo GPG alterou o metiloma materno e está envolvido com um fenótipo de risco para o desenvolvimento de doenças crônicas e metabólicas, a exemplo da diabetes.

Introduction: An epigenetic mechanism by which the adverse effects of the intrauterine environment are transferred to offspring is DNA methylation. Objective: Evaluate the relationship between maternal obesity, gestational weight gain and DNA methylation alteration on fetal and neonatal development. Methodology: Subpopulation of pregnant women from the prospective epidemiological study "Cohorte Araraquara" were followed during the three trimesters of pregnancy, delivery and postpartum and were allocated into 2 groups: A. adequate weight (N=25) and B. overweight/obesity (N=39 pregnant women). Fetal biometry and adiposity were evaluated by ultrasound and the neonate's body composition by plethysmography, with the PEA POD (Cosmed®, Concord, CA, USA). Maternal diet in the end of pregnancy was investigated using 24-hour recalls and analyzed using the Nutrition Data System for Research software (NDSR, Minnesota, USA). DNA maternal and umbilical cord blood, and placental villus and decidua were extracted using proteinase K by the santing-out method. The hypo and hypermethylated regions were analyzed by the Methylation Sensitive Enzymatic Digestion technique associated with quantitative PCR (qPCR) and gene expression by qPCR. To analyze the influence of gestational weight gain (GWG), maternal blood DNA from pregnant women with adequate AGWG (N=8) versus excessive EGWG (N=8) was hybridized on the Human Methylation 850K Bead Chip (Illumina, CA). For statistical analysis, the t test, chi-square (X2) test, repeated measures ANOVA and multiple linear regression models were applied, and the significance level adopted was p≤0.05. Results: The pre-gestational weight, pre-gestational BMI and BMI during pregnancy were higher in group B. In this same group, higher values of fasting insulin, us-CRP and lipid consumption were found in relation to group A. subcutaneous abdominal fat thickness (SCFT) and subcutaneous fat of the fetal arm was also higher in group B compared to group A. Regarding the body composition of neonates, the amount of fat mass was higher in group B. The H19DMR gene was less methylated in maternal blood from group B. No statistical difference was found in the values of IGF2 and H19 gene expression between the groups. There were associations between methylation of the H19DMR gene in umbilical cord blood with fetal biparietal diameter (BPD) and SCFT and neonatal head circumference (HC); in the decidua with occipito frontal diameter (OFD), fetal length and HC; in the villi with DOF, HC and SCFT and neonatal HC. Excessive gestational weight gain altered 46 CpG sites, 11 differentially methylated regions (DMRs) located in 13 genes, namely: EMILIN1, HOXA5, CPT1B, CLDN9, ZFP57, BRCA1, POU5F1, ANKRD33, HLA-B, RANBP17, ZMYND11, DIP2C, TMEM232. These DMRs were enriched in 142 biological processes, 21 molecular functions, 17 cellular components and 9 human phenotypes. In addition, 3 differentially methylated gene modules were identified to the phenotype of interest. Conclusion: DNA methylation was altered by maternal nutritional status and was associated with fetal adiposity and growth. Excessive GPG altered maternal methylome and was associated with the phenotype of metabolic diseases such as diabetes mellitus.

Visceral Adiposity Index and Prognostic Nutritional Index in Predicting Atrial Fibrillation after On-Pump Coronary Artery Bypass Operations: a Prospective Study

Abstract Introduction: Rhythm problems are the most observed complications following coronary artery bypass grafting (CABG), the most common being postoperative atrial fibrillation (PoAF), with an incidence reaching 50% of the patients. In this study, we aimed to investigate the predictive importance of prognostic nutritional index (PNI) and visceral adiposity index (VAI) in predicting PoAF, which occurs after CABG accompanied by cardiopulmonary bypass. Methods: Patients who underwent isolated CABG with cardiopulmonary bypass between June 15 and October 15, 2019, were prospectively included in the study. Patients who did not develop in-hospital PoAF were identified as Group 1, and those who did constituted Group 2. Results: PoAF developed in 55 (27.6%) patients (Group 2). The mean age of the 144 patients included in Group 1 and 55 patients in Group 2 were 56.9±8.7 and 64.3±10.2 years, respectively (P<0.001). In multivariate analysis Model 1, age (odds ratio [OR]: 1.084, confidence interval [CI]: 1.010-1.176, P=0.009), chronic obstructive pulmonary disease (OR: 0.798, CI: 0.664-0.928, P=0.048), and PNI (OR: 1.052, CI: 1.015-1.379, P=0.011) were determined as independent predictors for PoAF. In Model 2, age (OR: 1.078, CI: 1.008-1.194, P=0.012), lymphocyte counts (OR: 0.412, CI: 0.374-0.778, P=0.032), and VAI (OR: 1.516, CI: 1.314-2.154, P<0.001) were determined as independent predictors for PoAF. Conclusion: In this study, we determined that low PNI, a simply calculable and cheap parameter, along with high VAI were risk factors for PoAF.

Lipoprotein(a) levels in children and adolescents: Ouro Preto Study

Abstract Background Lipoprotein (a) is a cardiovascular risk factor in adult. Studies have shown the presence of this emergent risk factor in school children, which may contribute to the development of atherosclerosis in adulthood. Objective To evaluate the association between lipoprotein (a) and cardiovascular risk factors in school children. Methods Lipoprotein (a) levels were measured in 320 school children (6-14 years) selected from a population survey carried out in Ouro Preto (southeast of Brazil). Demographic (sex and age), biochemical (total cholesterol, high-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol, triglycerides, and glucose), anthropometric (body mass index, waist circumference, body fat percentage), clinical (arterial blood pressure, pubertal stage and birth weight) and economic (family income) parameters, as well as family history (obese and/or hypertensive parents) were analyzed. Non-parametric analysis was used to evaluate lipoprotein (a) levels in each subgroup. Variables with p≤0.20 in the univariate analysis were included in binary regression logistic model. Differences with p < 0.05 were considered significant. Results Lipoprotein (a) levels were associated with total cholesterol (p=0.04), body fat (p=0.009), and mother´s systolic (p=0.02) and diastolic blood pressure (p=0.04). In a logistic regression analysis, children with high lipoprotein (a) levels and body fat, and children born from hypertensive mothers were, respectively, at 3.2(p=0.01) and 1.4 (p=0.03) times higher risk than other children. In clustering these factors, elevated lipoprotein (a) was 2.6 times more likely to be seen in school children with high body fat and born hypertensive mothers. Conclusions Lipoprotein (a) was correlated with cardiovascular risk factors in children and adolescents. Persistence of these risk factors in childhood suggests a contribution of elevated lipoprotein (a) to future cardiovascular disease. (Int J Cardiovasc Sci. 2020; [online].ahead print, PP.0-0)

Efeitos do fortalecimento muscular do tríceps sural na função da bomba venosa na insuficiência venosa crônica / Effects of strengthening the surae triceps muscle on venous pump function in chronic venous insufficiency

Resumo Contexto A insuficiência venosa crônica (IVC) é uma doença comum, uma disfunção da bomba muscular da panturrilha que repercute na hemodinâmica das estruturas. Objetivos Analisar os efeitos dos exercícios de fortalecimento muscular da panturrilha na hemodinâmica venosa em pacientes com IVC. Métodos O estudo contou com a participação de 13 pacientes e 25 membros inferiores com IVC, classificados entre C1 e C5 da classificação Clínica, Etiologia, Anatomia e Fisiopatologia (CEAP), oriundos do ambulatório de cirurgia vascular do Hospital Universitário Regional dos Campos Gerais. As variáveis analisadas foram dinamometria isométrica, goniometria, perimetria, adipometria no início, primeiro mês, segundo mês e final da aplicação do protocolo de exercícios. Resultados Os valores da dorsiflexão e da plantiflexão aumentaram 5º (p < 0,001). Na adipometria notou-se uma redução de 5 mm (p < 0,001). Quando separados em grupos pela CEAP, na C2 houve aumento de 5º na dorsiflexão (p = 0,02) e na plantiflexão (p < 0,001); na C3 houve aumento de 5º na dorsiflexão (p = 0,003) e redução de 1 mm na adipometria (p < 0,004); na C1 houve aumento da perimetria de 1,2 cm (p = 0,04). Conclusões A aplicação de protocolos de exercícios deveria ser considerada como uma forma de tratamento para IVC, pois impacta positivamente em fatores de risco e nas funções que estão deterioradas pela patologia.

Abstract Background Chronic venous insufficiency (CVI) is a common disease that causes calf muscle pump dysfunction and has repercussions for the hemodynamics of the structures involved. Objectives To analyze the effects on venous hemodynamics of exercises to strengthen the calf muscles in patients with CVI. Methods The study analyzed 25 lower limbs with CVI, classified from C1 to C5 according to the Clinical, Etiology, Anatomy, and Pathophysiology (CEAP) classification, in 13 patients recruited from a Lymphedema and Angiodysplasia Clinic at the Hospital Universitário Regional dos Campos Gerais (Brazil). The variables analyzed were collected by isometric dynamometry, goniometry, leg circumference measurement, and adipometry at baseline, after 1 month and 2 months and at the end of the exercise protocol. Results Dorsiflexion and plantar flexion measurements increased by 5º (p < 0.001). Adipometry detected a reduction in 5 mm (p < 0.001). When grouped by CEAP class, C2 exhibited 5º increases in dorsiflexion (p = 0.02) and plantar flexion (p < 0.001); C3 exhibited a 5ºincrease in dorsiflexion (p = 0.003) and a 1mm reduction in adipometry (p < 0.004); and C1 exhibited a 1.2cm increase in leg circumference (p = 0.04). Conclusions Administration of exercise protocols should be considered as a treatment option for CVI, since it has a positive impact on risk factors and on the functions that are impaired by this pathology.

Estudo da Reatividade Microvascular em Pacientes Hipertensos com Adiposidade Corporal Elevada / Microvascular Reactivity in Hypertensive Patients with High Body Adiposity

Resumo Fundamento: Diversos índices antropométricos têm sido propostos para determinar a associação entre excesso de peso e fatores de risco cardiovascular. Objetivo: Avaliar a relação entre adiposidade corporal e reatividade microvascular em pacientes hipertensos sob terapia anti-hipertensiva. Métodos: Pacientes hipertensos tratados de 40 a 70 anos foram submetidos à avaliação de índices antropométricos: conicidade (IC), adiposidade corporal (IAC), adiposidade visceral (IAV) e relação cintura-estatura (RCE). Os participantes foram divididos pelos tercis de percentual de gordura (%G) obtido pela bioimpedância elétrica (BIA) e submetidos a teste de reatividade microvascular (laser speckle contrast image), medida da velocidade da onda de pulso (VOP). O valor de p < 0,05 foi considerado estatisticamente significativo. Resultados: A variação da área sob a curva (ASC) da perfusão cutânea foi inferior no tercil superior (97 ± 57% vs. 67 ± 36%; p = 0,027). O %G apresentou correlação significativa com RCE (r = 0,77; p < 0,001), IAV (r = 0,41; p = 0,018), IC (r = 0,60; p < 0,001) e IAC (r = 0,65; p < 0,001) nos homens e somente com RCE (r = 0,55; p < 0,001) e IAC (r = 0,60; p < 0,001) nas mulheres. Na regressão linear, a ASC mostrou associação independente com o %G (β =-3,15; p = 0,04) nas mulheres e com a glicemia (β = -1,15; p = 0,02) nos homens. Não houve diferença nas medidas de VOP. Conclusão: Os índices antropométricos de obesidade foram mais associados ao %G nos homens. A maior adiposidade corporal foi relacionada com menor reatividade microvascular, o que foi mais evidente nas mulheres. Não houve diferença na rigidez arterial, o que pode ter sido influenciado pelo tratamento anti-hipertensivo.

Abstract Background: Several anthropometric indexes have been proposed to determine the association between overweight and cardiovascular risk factors. Objective: To evaluate the relationship between body adiposity and microvascular reactivity in hypertensive patients under antihypertensive therapy. Methods: Treated hypertensive patients aged 40 to 70 were submitted to evaluation of anthropometric indexes: conicity (CI), body adiposity (BAI), visceral adiposity (VAI) and waist-to-height ratio (WHtR). Participants were divided by the terciles of fat percentage (%F) obtained by bioelectrical impedance. The patients underwent microvascular reactivity test (Laser Speckle Contrast Image) and pulse wave velocity (PWV) measurement. The p value <0.05 was considered statistically significant. Results: The variation of the area under the curve (AUC) of the skin perfusion was lower in the upper tercile (97±57% vs. 67±36%; p=0.027). %F showed significant correlation with WHtR (r=0.77; p<0.001), VAI (r=0.41; p=0.018), CI (r=0.60; p<0.001), BAI (r=0.65; p<0.001) in men and only with WHtR (r=0.55; p<0.001) and BAI (r=0.60; p<0.001) in women. In linear regression, AUC was independently associated with %F (β=−3.15; p=0.04) in women and with blood glucose (β=−1.15; p=0.02) in men. There was no difference in PWV measurements. Conclusion: Anthropometric indices were more associated with %F in men. Higher body adiposity was associated with lower microvascular reactivity, which was more evident in women. There was no difference in arterial stiffness, which may have been influenced by antihypertensive treatment.

Serum ferritin levels among schoolchildren and its correlation with lipid profile and adiposity

To determine the association between serum ferritin levels, lipid profile and adiposity in school-age children. Methods: A cross-sectional study was conducted on obese and non-obese children. Weight, height, waist circumference and blood pressure were measured for all participants. Lipid profile, serum ferritin and glucose were determined and analysed through absorbance. The Spearman correlation was performed for the quantitative variables and a regression analysis was used to determine the interaction between variables. Eighty-nine children were included, with a median age of 9.0 years. Results: When comparing serum ferritin levels in normal weight group, vs. the overweight and obesity group, values were significantly higher in the latter. Serum ferritin correlated positively with BMI (Rho .282, p <0.01), waist circumference (Rho .372, p < 0.01), diastolic blood pressure (Rho .244, p < 0.05), body fat percentage (Rho .375, p < 0.001), insulin (Rho .254, p <.05) and sex (Rho .224, p <.05); and negatively with high-density lipoprotein cholesterol (Rho. -221, p< 0.05). When analysing the significant variables in a multivariate regression model, sex, body mass index, waist circumference, and body fat percentage remained statistically significant (p <0.01). Conclusion: We observed associations between serum ferritin and obesity in Mexican school aged children(AU)

Determinar la asociación entre los niveles de ferritina sérica, el perfil de lípidos y la adiposidad en niños en edad escolar. Metodología: Se realizó un estudio transversal en niños obesos y no obesos. Se midieron el peso, la altura, la circunferencia de cintura y la presión arterial en todos los participantes. El perfil lipídico, la ferritina sérica y la glucosa se determinaron y analizaron mediante absorbancia. Se realizó correlación de Spearman para las variables cuantitativas y se utilizó un análisis de regresión para determinar la interacción entre las variables. Se incluyeron ochenta y nueve niños, con una edad media de 9,0 años. Resultados: Al comparar los niveles de ferritina sérica en el grupo de peso normal, frente al grupo de sobrepeso y obesidad, los valores fueron significativamente más altos en este último. La ferritina sérica se correlacionó positivamente con el IMC (Rho 0,282, p <0,01), la circunferencia de cintura (Rho 0,372, p <0,01), la presión arterial diastólica (Rho 0,244, p <0,05), el porcentaje de grasa corporal (Rho 0,375, p < 0,001), insulina (Rho 0,254, p <0,05) y sexo (Rho 0,224, p < 0,05); y negativamente con colesterol de lipoproteínas de alta densidad (Rho -0,221, p <0,05). Al analizar las variables significativas en un modelo de regresión multivariante, el sexo, el índice de masa corporal, la circunferencia de cintura y el porcentaje de grasa corporal se mantuvieron estadísticamente significativos (p <0,01). Conclusión: Observamos asociaciones entre la ferritina sérica y la obesidad en niños mexicanos en edad escolar(AU)

Elevated leptin levels in healthy climacteric women from Northeastern Brazil: an effect of age or adiposity?

ABSTRACT Objective Climacterium is associated with elevated leptin levels and increased risk of cardiovascular disorders. Conflicting data diverge on whether high leptin levels in climacterium reflect increasing adipose mass or, at least partially, age-related hormonal changes. This study addresses this issue in women from a Brazilian state with a low human development index. Subjects and methods A case-control study was conducted, enrolling 136 women from the state of Maranhão, 52 (38.2%) climacteric and 84 (61.8%) non-climacteric. Biometric, biochemical, hormonal and immunological parameters were analyzed. Results Climacteric women showed a moderately increased waist/hip ratio (0.894 versus 0.834, p < 0.05), sustained body mass index (27.46 versus 28.68, p > 0.05) increased leptin levels (9.59 versus 7.13, p < 0.05) and no evidence of metabolic syndrome. No other parameters were altered. The climacteric cohort didn't show significant body fat gains but displayed a typical age-related redistribution of adipose tissue. Even so, leptin levels were significantly elevated compared with non-climacteric women. Conclusions Altogether, these data support the hypothesis that leptin is elevated, at least partially, as a function of age and climacterium and is not necessarily correlated with metabolic dysfunction and systemic inflammation. Further studies are needed to evaluate the impact of higher leptin levels on postmenopausal women. Arch Endocrinol Metab. 2020;64(3):276-81

Porcentaje de grasa corporal en adolescentes asociado con conductas alimentarias de riesgo, hogar y sexo / Body fat percentage in adolescent among eating risk behaviors, home and sex

Resumen: Objetivo: Determinar la asociación de las conductas alimentarias de riesgo (CAR) y el hogar con el porcentaje de grasa corporal (PGC) en los adolescentes, modificado por sexo. Material y métodos: Se analizó la información de una cohorte de 2 388 adolescentes de Morelos, México, de 2004 a 2007. Se realizaron técnicas descriptivas y modelos de regresión lineal múltiple de efectos mixtos. Resultados: El cambio del PGC es -1.4 puntos porcentuales (EE 0.22), en hombres -3.1 (EE 0.35) y en mujeres 0.2 (EE 0.21). El cambio del PGC en relación con CAR y el hogar es diferente por sexo. El modelo múltiple muestra que realizar dieta se asocia con el incremento del PGC (1.25 IC95% 0.68-1.83) en mujeres y en hombres (1.74 IC95% 0.60-2.88). En relación con la familia, las mujeres muestran una relación positiva con el incremento del PGC de acuerdo con que sientan o no que su familia no las quiere a veces o nunca (valor p de tendencia <0.001); los hombres muestran en la variable de "Satisfecho de la ayuda que recibe se su familia" una asociación marginal. Conclusiones: Realizar dieta sin supervisión se asocia con el incremento en el PGC, lo que da un efecto contrario a lo deseado; esto se asocia con relaciones familiares y es diferente entre sexo.

Abstract: Objective: To determine the association of risky eating behaviors and the home with the percentage of body fat in adolescents, modified by gender. Materials and methods: We analyzed the information of a cohort of 2 388 adolescents from Morelos in Mexico, from 2004 to 2007. Descriptive techniques and multiple linear regression models of mixed effects were performed. Results: The change in body fat percentage (PGC) is -1.4 percentage points, in men -3.1, in women 0.2. The change of the PGC in relation to CAR's and the household is different by sex. The multiple model shows that diet is associated with an increase in PGC (1.25 IC95% 0.68-1.83) in women, in men of 1.74 (95% CI 0.60-2.88). In relation with the family, women show a positive relationship with the increase in the percentage of body fat according to whether they feel that their family does not love them sometimes or never (value p of trend <0.001), men show in the variable "Satisfied with the help your family receives", a marginal association. Conclusions: Performing a diet without supervision is associated with an increase in the PGC, giving an effect contrary to what is desired. This is associated with family relationships, and is different between sex.

Effect of early determinants on adolescent fat-free mass: RPS cohort of São Luís - MA

ABSTRACT OBJECTIVE: To analyze the effects of early determinants on adolescent fat-free mass. METHODS: A cohort study with 579 adolescents evaluated at birth and adolescence in a birth cohort in São Luís, Maranhão. In the proposed model, estimated by structural equation modeling, socioeconomic status (SES) at birth, maternal age, pregestational body mass index (BMI), gestational smoking, gestational weight gain, type of delivery, gestational age, sex of the newborn, length and weight at birth, adolescent socioeconomic status, "neither study/nor work" generation, adolescent physical activity level and alcohol consumption were tested as early determinants of adolescent fat-free mass (FFM). RESULTS: A higher pregestational BMI resulted in higher FFM in adolescence (Standardized Coefficient, SC = 0.152; p < 0.001). Being female implied a lower FFM in adolescence (SC = −0.633; p < 0.001). The negative effect of gender on FFM was direct (SC = −0.523; p < 0.001), but there was an indirect negative effect via physical activity level (SC = −0.085; p < 0.001). Women were less active (p < 0.001). An increase of 0.5 kg (1 Standard Deviation, SD) in birth weight led to a gain of 0.25 kg/m2 (0.106 SD) in adolescent FFM index (p = 0.034). Not studying or working had a negative effect on the adolescent's FFM (SC = −0.106; p = 0.015). Elevation of 1 SD in the adolescent's physical activity level represented an increase of 0.5 kg/m2 (0.207 SD) in FFM index (p < 0.001). CONCLUSIONS: The early determinants with the greatest effects on adolescent FFM are gender, adolescent physical activity level, pregestational BMI, birth weight and belonging to the "neither-nor" generation.

Normative values for anthropometric, adiposity, and handgrip strength in Costa Rican adults aged 60 to 110 years old / Valores normativos de antropometría, adiposidad y fuerza de prensión manual en adultos Costarricenses entre 60 y 100 años de edad

Abstract Objective: The purpose of the study was to develop normative data for anthropometric, adiposity and upper body strength in Costa Rican adults 60 to 110 years old. Method: A representative sample of Costa Rican male and female older adults (n= 2 711) were assessed for body weight and height, knee height, waist, hip and arm circumferences, adiposity, and upper-body strength. The 10th, 25th, 50th, 75th, and 90th percentiles were selected as the normative reference points for each 10-year age groups (60-69, 70-79, 80-89, 90-99, and ≥100). Results: Men and women experience age-related increased adiposity and reductions in upper body strength; however, men increased their upper-body strength at older ages. Conclusion: The normative values allow health professionals to monitor anthropometric, adiposity, and upper-body strength in older adults, and to design comprehensive fitness interventions that promote a healthy lifestyle in the population.

Resumen Objetivo: El propósito del estudio fue desarrollar datos normativos para antropometría, adiposidad y fuerza de la parte superior del cuerpo en adultos costarricenses de 60 a 110 años de edad. Método: Se evaluó una muestra representativa de adultos mayores costarricenses varones y mujeres (n = 2 711) para determinar el peso y la talla corporal, la altura de la rodilla, la cintura, las circunferencias de la cadera y el brazo, la adiposidad y la fuerza de la parte superior del cuerpo. Los percentiles 10, 25, 50, 75 y 90 se seleccionaron como puntos de referencia normativos para cada grupo de edad de 10 años (60-69, 70-79, 80-89, 90-99 y ≥100). Resultados: Los hombres y las mujeres experimentan una mayor adiposidad relacionada con la edad y reducciones en la fuerza de la parte superior del cuerpo; sin embargo, los hombres aumentaron la fuerza de la parte superior del cuerpo a edades más avanzadas. Conclusión: Los valores normativos permiten a los profesionales de la salud monitorear antropometría, adiposidad y fuerza de la parte superior del cuerpo en adultos mayores, y diseñar intervenciones integrales de acondicionamiento físico que promuevan un estilo de vida saludable en la población.

Sleep pattern, obesity and healthcare expenditures in Brazilian adults / Padrões do sono, obesidade e despesas em saúde com brasileiros adultos

Abstract The aim of this study was to analyze the relationship between sleep pattern and healthcare expenditures in adults, as well as to identify whether physical activity, biochemical markers and obesity affect this relationship. The sample was composed of 168 adults aged ≥ 50 years attended by two Basic Healthcare Units in Presidente Prudente, SP, Brazil. Health expenditure, sleep pattern, anthropometry, adiposity index, physical activity, metabolic and cardiovascular variables were assessed. Statistical analyses were performed using Kruskal-Wallis, Mann-Whitney and Spearman tests. Sleep disorders were positively correlated to higher costs with medicines and negatively correlated to costs with laboratory tests, even after adjusts by confounders. In addition, healthcare costs were also correlated to physical activity score, blood pressure, obesity and metabolic variables. Severe sleep disorders and high percentage of body fat were associated with increased use of medications. Sleep pattern is correlated to primary care healthcare costs, obesity and physical activity level.

Resumo O objetivo deste estudo foi analisar a relação entre padrão de sono e despesas de saúde em adultos, bem como identificar se atividade física, marcadores bioquímicos e obesidade afetam esse relacionamento. A amostra foi composta por 168 adultos com idade ≥ 50 anos atendidos por duas unidades básicas de saúde em Presidente Prudente, SP, Brasil. Foram avaliadas as despesas de saúde, padrões do sono, antropometria, atividade física, variáveis metabólicas e cardiovasculares. Foram utilizados Kruskal-Wallis, Mann-Whitney e Spearman. Os distúrbios do sono foram correlacionados positivamente com os custos mais elevados com medicamentos e negativamente com os custos com testes laboratoriais, mesmo após ajuste por fatores de confusão. Além disso, os custos de saúde também foram correlacionados ao escore de atividade física, pressão arterial, obesidade e variáveis metabólicas. Distúrbios graves do sono e alta porcentagem de gordura corporal foram associados ao aumento do uso de medicamentos. O padrão de sono está correlacionado com os custos de cuidados de saúde primários, obesidade e atividade física.

¿Existe asociación entre asma y adiposidad en la población adulta chilena? / Association between adiposity and asthma

Background: In people with asthma, adiposity is associated with more symptoms and less control of the disease whereas on those without asthma adiposity is associated with a higher risk of developing the disease. Aim: To investigate the association between asthma and adiposity markers in Chilean adults. Material and Methods: Data from 5,499 adults older than 15-years-old from the Chilean National Health Survey 20162017 were analyzed. Quintiles of body-mass index (BMI) and waist circumference (WC) were used as a proxy of adiposity. The association between asthma and quintiles of BMI and WC was determined by logistic regression. Results: A higher BMI and WC was associated with a higher odds for asthma. This trend remained significant even after adjusting the models for socio-demographic factors, physical activity and smoking (Odds Ratio [OR] BMI: 1.13 [95% confidence intervals (CI): 1.04; 1.22], p < 0.01 and OR WC: 1.15 [95% IC: 1.06; 1.25], p < 0.01). Conclusions: A higher BMI and WC were positively associated with asthma.

Relación entre adiposidad corporal y presión arterial en niños y adolescentes con enfermedades reumáticas / Relationship between body adiposity and blood pressure in children and adolescents with rheumatic diseases

Introducción: las enfermedades reumáticas son un grupo de afecciones que se caracterizan por la presencia, generalmente, de dolor, inflamación, deformidad, discapacidad funcional y disminución de la percepción de calidad de vida relacionada con la salud. Las complicaciones cardiovasculares son frecuentes en el curso de estas enfermedades; los trastornos nutricionales pueden ser causa o consecuencia de estas complicaciones. Objetivo: determinar la relación existente entre adiposidad corporal y presión arterial en niños y adolescentes con enfermedades reumáticas. Metodos: estudio descriptivo, de corte transversal en 45 pacientes con enfermedades reumáticas diagnosticadas según los criterios del American College of Reumathology. Se utilizó la técnica de bioimpedancia para determinar el porcentaje de grasa corporal e índice de correlación de Pearson para determinar relación entre variable. Resultados: promedio de edad de 12,26 ± 8,74 años, predominio de pacientes femeninas (68,69 por ciento) y entre 15 y 18 años de edad (42,22 por ciento). La enfermedad reumática más representada fue la artritis idiopática juvenil (46,67 por ciento). Predominaron los pacientes con aumento del porcentaje de grasa, donde el sobrepeso (44,44 por ciento) y la obesidad (20,0 por ciento) fueron los más representados. El 20,0 por ciento de los pacientes incluidos en la investigación presentaron alteraciones de la presión arterial con predominio en pacientes obesos (33,33 por ciento) y con sobrepeso (20,0 por ciento). Conclusiones: Mantener un adecuado control de la adiposidad corporal disminuye considerablemente la posibilidad de aparición de trastornos de la presión arterial. La bioimpedancia eléctrica es un método de fácil aplicación y de comprobada efectividad para determinar el porcentaje de grasa(AU)

Introduction: rheumatic diseases are a group of conditions that are characterized by the presence, usually, of pain, inflammation, deformity, functional disability and decreased perception of quality of life related to health. Cardiovascular complications are frequent in the course of these diseases; Nutritional disorders may be the cause or consequence of these complications. Objective: to determine the relationship between body adiposity and blood pressure in children and adolescents with rheumatic diseases. Methodology: descriptive, cross-sectional study in 45 patients with rheumatic diseases diagnosed according to the criteria of the American College of Reumathology. The bioimpedance technique was used to determine the percentage of body fat and Pearson's correlation index to determine the relationship between variables. Results: average age of 12.26 ± 8.74 years, predominance of female patients (68.69 percent) and between 15 and 18 years of age (42.22 percent). The most represented rheumatic disease was juvenile idiopathic arthritis (46.67 percent). Patients with increased fat percentage predominated, where overweight (44.44 percent) and obesity (20.0 percent) were the most represented. 20.0 percent of the patients included in the investigation presented alterations in blood pressure, predominantly in obese patients (33.33 percent) and overweight (20.0 percent). Conclusions: Maintaining adequate control of body adiposity considerably reduces the possibility of the appearance of blood pressure disorders. The electric bioimpedance is a method of easy application and proven effectiveness to determine the percentage of fat(AU)

Increased ApoB/ApoA1 ratio is associated with excess weight, body adiposity, and altered lipid profile in children / A razão ApoB/ApoA1 aumentada está associada ao excesso de peso, de adiposidade corporal e ao perfil lipídico alterado em crianças

Abstract Objective: To investigate ApoB/ApoA1 ratio and its association with cardiovascular risk factors in children. Methods: Cross-sectional study with 258 children aged 8 and 9 years old, enrolled in all urban schools in the city of Viçosa-MG. Anthropometric and body composition assessment, as well as biochemical profile of the children was performed. Socioeconomic variables and sedentary lifestyle were evaluated through a semi-structured questionnaire. Results: Many children had excess weight (35.2%), abdominal adiposity (10.5%), and body fat (15.6%), as well as increased ApoB/ApoA1 ratio (14.7%), total cholesterol (51.8%), and triglycerides (19.8%). Children with excess weight and total and central fat had a higher prevalence of having a higher ApoB/ApoA1 ratio, as well as those with atherogenic lipid profile (increased LDL-c and triglycerides and low HDL-c). A direct association was found between the number of cardiovascular risk factors and the ApoB/ApoA1 ratio (p = 0.001), regardless of age and income. Conclusion: The increased ApoB/ApoA1 ratio was associated with excess weight, body adiposity (total and central), and altered lipid profile in children. Children with a higher number of cardiovascular risk factors had higher ApoB/ApoA1 ratio, in both genders.

Resumo Objetivo: Investigar a razão ApoB/ApoA1 e sua relação com fatores de risco cardiovascular em crianças. Métodos: Estudo transversal com 258 crianças de 8 e 9 anos, matriculadas em todas as escolas urbanas de Viçosa-MG. Foi feita avaliação antropométrica, da composição corporal e bioquímica das crianças. As variáveis socioeconômicas e o sedentarismo foram avaliados por questionário semiestruturado. Resultados: Muitas crianças apresentaram excesso de peso (35,2%), de adiposidade abdominal (10,5%) e de gordura corporal (15,6%), bem como a razão ApoB/ApoA1 (14,7%), colesterol-total (51,8%) e triglicerídeos (19,8%) aumentados. Crianças com excesso de peso e de gordura total e central apresentaram maiores prevalências de maior razão ApoB/ApoA1, bem como as com perfil lipídico aterogênico (LDL-c e triglicerídeos aumentados e baixo HDL-c). Foi encontrada associação direta entre o número de fatores de risco cardiovascular e a razão ApoB/ApoA1 (p = 0,001), independente da idade e renda. Conclusão: A razão ApoB/ApoA1 aumentada esteve associada ao excesso de peso, de adiposidade corporal (total e central) e ao perfil lipídico alterado nas crianças. As crianças com maior número de fatores de risco cardiovascular apresentaram maior razão ApoB/ApoA1, em ambos os sexos.

Association of breastfeeding, maternal anthropometry and body composition in women at 30 years of age / Associação entre aleitamento materno, antropometria e composição corporal em mulheres de 30 anos de idade / Asociación entre lactancia materna, antropometría y composición corporal en mujeres con 30 años de edad

This study aimed at assessing the association of breastfeeding with maternal body mass index (BMI), waist circumference, fat mass index, fat free mass index, android/gynoid fat ratio and bone mineral density. In 1982, the maternity hospitals in Pelotas, Rio Grande do Sul State, Brazil, were daily visited and all live births were identified and examined. These subjects underwent follow-up for several times. At 30 years of age, the participants were interviewed and examined. Parous women provided information on parity and duration of breastfeeding. Multiple linear regression was used in the multivariate analysis, controlling for genomic ancestry, family income, schooling and smoking at 2004-2005. After controlling for confounding factors, breastfeeding was inversely associated with BMI and fat mass index, whereas breastfeeding per live birth was negatively associated with BMI, waist circumference and fat mass index. Women who had had a child in the last 5 years and had breastfed, showed lower BMI (β = -2.12, 95%CI: -4.2; -0.1), waist circumference (β = -4.46, 95%CI: -8.3; -0.6) and fat mass index (β = -1.79, 95%CI: -3.3; -0.3), whereas no association was observed among those whose last childbirth was > 5 years, but the p-value for the tests of interaction were > 0.05. Our findings suggest that breastfeeding is associated with lower BMI and other adiposity measures, mostly in the first years after delivery. Besides that, it has no negative impact on bone mineral density.

Este estudo teve por objetivo avaliar a associação entre aleitamento materno e índice de massa corporal (IMC), circunferência da cintura, índice de massa gorda, índice de massa magra, razão de gordura andróide/ginóide e densidade mineral óssea maternos. Em 1982, as maternidades de Pelotas, Rio Grande do Sul, Brasil, foram visitadas diariamente e todos os nascidos vivos foram identificados e examinados. Essas pessoas foram seguidas em diversos momentos. Aos 30 anos de idade, as participantes foram entrevistadas e examinadas. As que haviam dado à luz forneceram informação sobre paridade e duração do aleitamento materno. Usamos regressão múltipla linear na análise multivariada, controlando por ancestralidade genômica, renda familiar, escolaridade e tabagismo em 2004-2005. Após controlar por fatores de confundimento, o aleitamento materno estava inversamente associado ao IMC e índice de massa gorda, enquanto o aleitamento materno por nascido vivo estava negativamente associado ao IMC, circunferência da cintura e índice de massa gorda. Mulheres que haviam dado à luz nos últimos 5 anos e que haviam amamentado apresentaram IMC (β = -2,12, IC95%: -4,2; -0,1), circunferência da cintura (β = -4,46, IC95%: -8,3; -0,6) e índice de massa gorda (β = -1,79, IC95%: -3,3; -0,3) mais baixos. Nenhuma associação foi observada entre aquelas cujo último parto havia sido > 5 anos, mas o valor de p dos testes de interação foi > 0,05. Nossos resultados sugerem que o aleitamento materno está associado a valores mais baixos de IMC e de outras medidas de adiposidade, especialmente nos primeiros anos após o parto. Adicionalmente, o aleitamento não tem impacto negativo sobre a densidade mineral óssea.

El objetivo de este estudio fue evaluar la asociación entre lactancia materna, índice de masa corporal (IMC), perímetro de cintura, índice de grasa corporal, índice de masa libre de grasa, proporción de grasa en hombres/mujeres y densidad mineral ósea. En 1982, se visitaron diariamente hospitales maternales en Pelotas, Rio Grande do Sul, Brasil, y se identificaron y examinaron todos los nacimientos vivos. A estos últimos se les realizó un seguimiento en varias ocasiones. Se entrevistó y examinó a madres con 30 años de edad. Las mujeres con hijos proporcionaron información en paridad y duración de la lactancia. Se usó una regresión múltiple lineal en el análisis multivariado, controlando la ascendencia genómica, los ingresos por hogar, la escolaridad y ser fumador en 2004-2005. Tras controlar los factores de confusión, la lactancia estuvo inversamente asociada con el IMC y el índice de grasa corporal, mientras que la lactancia en nacimientos vivos estuvo negativamente asociada con el IMC, el perímetro de cintura y el índice de masa corporal. Las mujeres que tuvieron un niño en los últimos 5 años, y habían amamantado alguna vez, tuvieron un menor IMC (β = -2,12, IC95%: -4,2; -0,1), perímetro de cintura (β = -4,46, IC95%: -8,3; -0,6) e índice de grasa corporal (β = -1,79, C95%: -3,3; -0,3), mientras que no se observó ninguna asociación entre quienes tuvieron el último parto en > 5 años, pero el valor de p para las pruebas de interacción fue > 0,05. Nuestros resultados plantean que la lactancia materna está asociada con el IMC y otras medidas de adiposidad, la mayor parte durante los primeros años tras el parto. Asimismo, no tuvo impacto negativo en la densidad mineral ósea.

Associação entre adiposidade, índice de massa corporal, força de preensão palmar e velocidade de marcha em idosos comunitários / Association between adiposity, body mass index, grip strength and walking speed in community-dwelling elderly

Esta pesquisa objetivou avaliar a relação entre índice de massa corporal e adiposidade com força de preensão palmar e velocidade de marcha em idosos. É um estudo transversal aninhado em um estudo de intervenção com idosos comunitários assistidos por Unidades Básicas de Saúde no Município de Diamantina/MG. Foram avaliados dados socioeconômicos, antropométricos, de adiposidade, clínicos, bioquímicos, de força de preensão palmar e de velocidade de marcha. Testes de correlação de Pearson ou Spearman e regressão linear foram utilizados na análise dos dados. Foram estudados 49 idosos, com idade média de 77,21 ± 6,24 anos e predomínio de mulheres (69,29%). Valores elevados de adiposidade e índice de massa corporal ocorreram respectivamente em 69,39% e 34,69% dos idosos. A análise de regressão, estratificada por gênero e ajustada por variáveis de controle, indica que os índices de massa corporal e adiposidade não se associaram à força de preensão palmar e à velocidade de marcha dos idosos. No entanto, na análise considerando a amostra geral, a adiposidade influenciou negativamente na força de preensão palmar (para cada aumento de 1% na adiposidade, há uma redução de 0,226 kg no valor desta variável). Em relação à velocidade de marcha, a cada aumento de um ano de vida há uma redução de 0,014 m/s no valor desta variável, e o aumento de cada kg na força causa um aumento de 0,0193 m/s na velocidade de marcha. Pode-se concluir que a adiposidade e a idade influenciaram negativamente na força de preensão palmar dos idosos avaliados, e maior força influenciou positivamente na velocidade de marcha. (AU)

The objective of this research is to evaluate the relationship between body mass index and adiposity with handgrip strength and gait speed in the elderly. It is a cross-sectional study nested in an intervention study with community-based elderly people assisted by Basic Health Units in the municipality of Diamantina/MG. Socioeconomic, anthropometric, adiposity, clinical, biochemical, handgrip strength and gait velocity data were evaluated. Pearson or Spearman correlation tests and linear regression were used in data analysis. We studied 49 elderly people, with mean age of 77.21 ± 6.24 years and predominance of women (69.29%). High values of adiposity and body mass index occurred respectively in 69.39% and 34.69% of the elderly. The results of the regression analysis, stratified by gender and adjusted for control variables, indicate that body mass index and adiposity were not associated with handgrip strength and gait speed of elderly. However, in the analysis considering the general sample, adiposity negatively influenced handgrip strength (for each increase of 1% in adiposity, there is a reduction of 0.226 kg in the value of this variable). Regarding the gait speed, for every full year of life, there is a reduction of 0.014 m/s in the value of this variable, and, for each kg increased in force, there is an increase of 0.0193 m/s in gait speed. It can be concluded that adiposity and age negatively influenced the handgrip strength of the evaluated elderly, and greater strength influenced positively in gait speed. (AU)

Asociación entre el polimorfismo rs9939609 del gen FTO y marcadores de adiposidad en población adulta chilena / Association between FTO (ns9939609) genotype and adiposity markers in Chilean adults

Background: Numerous studies have identified the role of Fat-mass-associated-gene (FTO) in the development of obesity. Aim: To investigate the association of FTO gene with adiposity markers in Chilean adults. Material and Methods: 409 participants were included in this cross-sectional study. The association between FTO (rs9939609) genotype and adiposity markers was determined using linear regression analyses. Adiposity markers included were: body weight, body mass index, fat mass, waist circumference, hip circumference and waist/hip ratio. Results: A fully adjusted model showed a significant association between FTO genotype and body weight (2.16 kg per each extra copy of the risk allele [95% confidence intervals (CI): 0.45 to 3.87], p = 0.014), body mass index (0.61 kg.m-2 [95% CI: 0.12 to 1.20], p = 0.050) and fat mass (1.14% [95% CI: 0.39 to 1.89], p = 0.010). The greater magnitude of association was found between the FTO gene and fat mass when the outcomes were standardized to z-score. Conclusions: This study confirms an association between the FTO gene and adiposity markers in Chilean adults, which is independent of major confounding factors.

Sociodemographic and behavioral characteristics of obese students with sleep problems in Southern Brazil / Características sociodemográfi cas e comportamentais de escolares com obesidade e problemas de sono no Sul do Brasil

ABSTRACT Objective This study estimated the combined prevalence of insufficient number of hours of sleep per day and excess body adiposity among young students. The sociodemographic and behavioral characteristics associated with this concurrent health conditions were investigated. Methods This is a cross-sectional school-based study of 975 participants aged 11-14 years in Florianópolis, Santa Catarina state, Brazil. Body adiposity was assessed based on tricipital and subscapular skinfold measurements and classified according to Lohman. The total number of hours of sleep per day was reported by the students' parents/guardians, and it was classified as follows: as <8 hours per day and ≥8 hours per day. Data on sociodemographic characteristics, food consumption, and physical activity were collected using a self-administered questionnaire. The chi-square test and multinomial logistic regression with a 5% significance level were used to evaluate the association between the variables. Results The combined prevalence of insufficient number of hours of sleep per day and excess body adiposity was 25.1% (CI95%:20.7-29.9). The sociodemographic and behavioral factors predictive of these conditions were as follows: 13-14 year age group and household monthly income in the intermediate tertile. Conclusion The concurrent presence of insufficient sleep and excess body adiposity was found in a little more than a quarter of the students investigated. The population subgroups belonging to the 13-14 year age group and intermediate tertile of income were more likely to have concurrent insufficient number of hours of sleep per day and excess body adiposity.

RESUMO Objetivos Este trabalho estimou a prevalência conjunta de horas insuficientes de sono/dia e excesso de adiposidade corporal em escolares, bem como verificou as características sociodemográficas e comportamentais correlatas. Métodos Trata-se de estudo transversal de base escolar, realizado com 975 participantes de 11 a 14 anos de idade, em Florianópolis (SC). A adiposidade corporal foi avaliada por mensuração das dobras cutâneas tricipital e subescapular, sendo classificada segundo Lohman. O total de horas de sono/dia foi relatado pelos pais/respon-sáveis dos escolares, e posteriormente classificado em <8 horas por dia e ≥8 horas por dia. Os dados de condições sociodemográficas, consumo alimentar e atividade física foram levantados por questionário autopreenchível. Utilizou-se o teste Qui-quadrado e a regressão logística multinomial, com nível de significância de 5% para avaliação das associações. Resultados A prevalência conjunta de horas insuficientes de sono/dia e excesso de adiposidade corporal foi de 25,1% (IC95%:20,7-29,9). Os fatores sociodemográficos e comportamentais preditores a essa condição foram faixa etária de 13 a 14 anos e renda mensal no tercil intermediário. Conclusão O estudo concluiu que pouco mais de um quarto dos estudantes apresentou, concomitantemente, horas insuficientes de sono/dia e excesso de adiposidade corporal. Os subgrupos populacionais pertencentes à faixa etária entre 13 e 14 anos e ao tercil intermediário de renda foram mais propícios a apresentar simultaneamente horas insuficientes de sono/dia e excesso de adiposidade corporal.

Predictive capacity of indicators of adiposity in the metabolic syndrome in elderly individuals / Capacidade preditiva de indicadores de adiposidade sobre a síndrome metabólica em idosos

ABSTRACT Objective To evaluate the predictive ability of adiposity indicators as MetS predictors in elderly individuals. Methods Cross-sectional study enrolled in the Estratégia Saúde da Família (Family Health Strategy). Anthropometric measurements were measured. Body Mass Index, Waist-Hip Ratio, Waist-Height Ratio, Conicity Index and Body Adiposity Index were calculated. Blood was collected and resting blood pressure was measured. MetS was classified according to the harmonizing criteria. The predictive ability of anthropometric variables was evaluated using Receiver Operating Characteristic curves. Results Regarding male individuals, our research indicates that the BMI, Waist-Height Ratio and Waist Hip Ratio are better predictors and they are equivalent to each other. As for female individuals, results show that the Body Mass Index and Waist-Height Ratio are better predictors and equivalent to each other. Conclusion Waist-Height Ratio and Body Mass Index are good MetS predictors for elderly individuals, especially among men. More research in this area is important. Comitê de Ética em Pesquisa com Seres Humanos da Universidade Federal de Viçosa. (Viçosa University Ethics Committee in Research with Human Beings) (nº 039/2011).

RESUMO Objetivo Este estudo objetivou avaliar a capacidade preditiva dos indicadores de adiposidade como preditores da Síndrome Metabólica em idosos. Métodos Trata-se de estudo transversal com idosos inscritos na Estratégia Saúde da Família. Foram aferidas medidas antropométricas e calculados o Índice de Massa Corporal, a Relação Cintura-Quadril, a Relação Cintura-Estatura, o Índice de Conicidade e o Índice de Adiposidade Corporal. Foi coletada amostra sanguínea e aferida a pressão arterial de repouso. A Síndrome Metabólica foi classificada de acordo com os Critérios Harmonizados. A capacidade preditiva das variáveis antropométricas foi avaliada por meio das curvas Receiver Operating Characteristic. Resultados Para o sexo masculino, o Índice de Massa Corporal, a Relação Cintura-Estatura e a Relação Cintura-Quadril são melhores preditores e equivalentes entre si. Já para o sexo feminino, os dois primeiros são melhores preditores e equivalentes entre si. Conclusão Concluiu-se que o Índice de Massa Corporal e a Relação Cintura-Estatura são bons preditores da Síndrome Metabólica em indivíduos idosos, especialmente entre homens. Mais investigações nesse âmbito se fazem importantes. Comitê de Ética em Pesquisa com Seres Humanos da Universidade Federal de Viçosa. (nº 039/2011).

Associação das concentrações séricas de zinco com hipercolesterolemia e resistência à insulina em crianças brasileiras / Association between serum zinc level and hypercholesterolemia and insulin resistance in Brazilian children / Asociación de las concentraciones séricas de zinc con la hipercolesterolemia y resistencia a la insulina en niños brasileñas

O objetivo foi avaliar a associação entre a concentração sérica de zinco e os fatores cardiometabólicos em crianças pré-púberes brasileiras. Trata-se de um estudo transversal com amostra representativa de escolares na faixa etária de 8 e 9 anos, matriculados em escolas urbanas públicas e privadas em Viçosa, Minas Gerais, Brasil. A composição corporal foi avaliada pela técnica de absortometria de raios-x de dupla energia. Foram avaliadas as concentrações séricas de glicose, insulina, colesterol total, lipoproteínas de alta e de baixa densidade de colesterol, triglicerídeos, apolipoproteínas A (Apo A) e B, ácido úrico, leptina, homocisteína, proteína C reativa-ultrassensível e zinco sérico. A pressão arterial foi aferida por equipamento de insuflação automática. A deficiência de zinco foi observada em 1,3% das crianças. As meninas apresentaram o pior perfil cardiometabólico, com maiores prevalências de valores aumentados para gordura androide, triglicerídeos, resistência à insulina, leptina, zinco e Apo A. No 1º terço de concentração sérica de zinco, a prevalência de resistência à insulina foi 96% maior (RP = 1,96; IC95%: 1,04-3,66) e a de hipercolesterolemia foi 23% menor (RP = 0,77; IC95%: 0,61-0,96) em relação à categoria de referência (2º e 3º terços de concentração sérica de zinco agrupado). Apesar da baixa prevalência da deficiência de zinco, a resistência à insulina foi mais prevalente entre crianças localizadas no menor terço da concentração sérica de zinco. Torna-se importante a prevenção das alterações cardiometabólicas na infância, principalmente da resistência à insulina, com ênfase na avaliação sérica do zinco.

The objective of the study was to assess the association between serum zinc level and cardiometabolic factors in prepubertal Brazilian children. This was a cross-sectional study in a representative sample of schoolchildren 8 to 9 years of age in public and private urban schools in Viçosa, Minas Gerais State, Brazil. Body composition was assessed with dual-energy x-ray absorptiometry. The study measured serum glucose, insulin, total cholesterol, high and low density lipoprotein cholesterol, triglycerides, apolipoproteins A (Apo A) and B, uric acid, leptin, homocysteine, ultrasenstive C-reactive protein, and serum zinc. Arterial pressure was measured with automatic inflation equipment. Zinc deficiency was observed in 1.3% of the children. Girls showed the worst cardiometabolic profile, with higher prevalence of increased android fat, triglycerides, insulin resistance, leptin, zinc, and Apo A. In the first tertile of serum zinc concentration, prevalence of insulin resistance was 96% higher (PR = 1.96; 95%CI: 1.04-3.66) and hypercholesterolemia was 23% lower (PR = 0.77; 95%CI: 0.61-0.96) than in the reference category (grouped 2nd and 3rd tertiles of serum zinc concentration). Despite the low prevalence of zinc deficiency, insulin resistance was more prevalent in children in the lowest third of serum zinc concentration. It is important to prevent cardiometabolic alterations in childhood, especially insulin resistance, with an emphasis on serum zinc level.

El objetivo fue evaluar la asociación entre la concentración sérica de zinc y los factores cardiometabólicos en niñas pre-púberes brasileñas. Se trata de un estudio transversal con una muestra representativa de escolares en la franja de edad de 8 y 9 años, matriculadas en escuelas urbanas públicas y privadas en Viçosa, Minas Gerais, Brasil. La composición corporal se evaluó por la técnica de absorciometría de rayos-x de doble energía. Se evaluaron las concentraciones séricas de glucosa, insulina, colesterol total, lipoproteínas de alta y de baja densidad de colesterol, triglicéridos, apolipoproteínas A (Apo A) y B, ácido úrico, leptina, homocisteína, proteína C reactiva-ultrasensible y zinc sérico. La presión arterial se midió mediante un equipo de insuflación automática. La deficiencia de zinc se observó en un 1,3% de los niños. Las niñas presentaron el peor perfil cardiometabólico, con mayores prevalencias de valores aumentados para la obesidad androide, triglicéridos, resistencia a la insulina, leptina, zinc y Apo A. En el primer tercio de concentración sérica de zinc, la prevalencia de resistencia a la insulina fue un 96% mayor (RP = 1,96; IC95%: 1,04-3,66) y la de hipercolesterolemia fue un 23% menor (RP = 0,77; IC95%: 0,61-0,96), en relación con la categoría de referencia (2º y 3º tercios de concentración sérica de zinc agrupado). A pesar de la baja prevalencia de la deficiencia de zinc, la resistencia a la insulina fue más prevalente entre niñas localizadas en el menor tercio de la concentración sérica de zinc. Es importante la prevención de las alteraciones cardiometabólicas durante la infancia, principalmente de la resistencia a la insulina, con énfasis en la evaluación sérica del zinc.