Generation and External Validation of a Histologic Transformation Risk Model for Patients with Follicular Lymphoma.

Follicular lymphoma (FL) is the most frequent indolent lymphoma. Some patients (10%-15%) experience histologic transformation (HT) to a more aggressive lymphoma, usually diffuse large B-cell lymphoma (DLBCL). This study aimed to validate and improve a genetic risk model to predict HT at diagnosis.We collected mutational data from diagnosis biopsies of 64 FL patients. We combined them with the data from a previously published cohort (total n = 104; 62 from nontransformed and 42 from patients who did transform to DLBCL). This combined cohort was used to develop a nomogram to estimate the risk of HT. Prognostic mutated genes and clinical variables were assessed using Cox regression analysis to generate a risk model. The model was internally validated by bootstrapping and externally validated in an independent cohort. Its performance was evaluated using a concordance index and a calibration curve. The clinicogenetic nomogram included the mutational status of 3 genes (HIST1HE1, KMT2D, and TNFSR14) and high-risk Follicular Lymphoma International Prognostic Index and predicted HT with a concordance index of 0.746. Patients were classified as being at low or high risk of transformation. The probability HT function at 24 months was 0.90 in the low-risk group vs 0.51 in the high-risk group and, at 60 months, 0.71 vs 0.15, respectively. In the external validation cohort, the probability HT function in the low-risk group was 0.86 vs 0.54 in the high-risk group at 24 months, and 0.71 vs 0.32 at 60 months. The concordance index in the external cohort was 0.552. In conclusion, we propose a clinicogenetic risk model to predict FL HT to DLBLC, combining genetic alterations in HIST1H1E, KMT2D, and TNFRSF14 genes and clinical features (Follicular Lymphoma International Prognostic Index) at diagnosis. This model could improve the management of FL patients and allow treatment strategies that would prevent or delay transformation.

Serum Zinc Concentrations by Inflammation Status, Time of Day, and Fasting Status for Estimating Zinc Deficiency in 6-59-Mo-Old Children: Results from the Brazilian National Survey on Child Nutrition (ENANI-2019).

BACKGROUND: Serum zinc concentration (SZC) is considered the best biomarker of zinc status in population-level evaluations. However, zinc deficiency (ZD) estimations can be biased if they do not consider blood collection timing, inflammation, and fasting status. OBJECTIVES: The objectives of this study were to determine SZC without and with adjustment for inflammation, according to blood collection timing and fasting status, estimate ZD prevalence, and evaluate the associated factors with ZD in a representative sample of Brazilian children aged <5 y. METHODS: Population-based study with 7597 children aged 6-59 mo surveyed by the Brazilian National Survey on Child Nutrition. SZC was adjusted for inflammation using the Biomarkers Reflecting Inflammation and Nutritional Determinants of Anemia regression correction approach, with high-sensitive C-reactive protein, assessed according to blood collection timing (morning/afternoon) and fasting status (<8 and ≥8 h). SZC <65 µg/dL (morning collection) or SZC <57 µg/dL (afternoon collection) were classified as ZD. The analysis between associated factors and ZD used the adjusted prevalence ratio (PR). RESULTS: After adjusting for inflammation, SZC was higher in all percentiles and varied according to collection timing and fasting status. Children who had blood collected in the morning without fasting or in the afternoon had lower SZC than those assessed in the morning with fasting. The differences in adjusted SZC according to the timing of collection and fasting status were greater in the higher percentiles of the distribution, with the greatest absolute difference observed when comparing the 95th percentile of morning fasting compared with nonfasting (20.3 µg/dL). The prevalence of ZD estimated without and with adjusting SZC for inflammation was 17.8% and 13.8%, respectively. The occurrence of diarrhea, fever, or respiratory symptoms in the 15 d before blood collection was associated with a higher prevalence of ZD (PR: 1.42; 95% confidence interval: 1.04, 1.94). CONCLUSIONS: Adjusting SZC for inflammation and considering fasting status is important to avoid overestimating the prevalence of ZD.

Effects of selenium supplementation on glycaemic control markers in healthy rodents: a systematic review and meta-analysis.

Overexposure to Se is detrimental to glucose metabolism, mainly because of its pro-oxidant effects and the overexpression of selenoproteins. This systematic review evaluated the effects of Se supplementation on glycaemic control in healthy rodents. The methodology followed the PRISMA. We searched the databases for articles published up to May 2022. The risk of bias and the methodological quality were assessed using the SYRCLE and CAMARADES. The results are presented as meta-analytic estimates of the overall standardised mean difference (SMD) and 95 % CI. Of the 2359 records retrieved, thirteen studies were included, of which eleven used sodium selenite and two used zero-valent Se nanoparticles as supplement. Nine studies were included in the meta-analysis. Generally, the risk of bias was high, and 23·1 % of the studies were of high quality. Supplementation with sodium selenite significantly increased fasting blood glucose (SMD = 2·57 (95 % CI (1·07, 4·07)), I2 = 93·5 % (P = 0·001). Subgroup analyses showed effect size was larger for interventions lasting between 21 and 28 d (SMD = 25·74 (95 % CI (2·29, 9·18)), I2 = 96·1 % (P = 0·001)) and for a dose of 864·7 µg/kg/d of sodium selenite (SMD = 10·26 (95 % CI (2·42, 18·11), I2 = 97·1 % (P = 0·010)). However, it did not affect glutathione peroxidase activity (SMD = 0·60 (95 % CI (-0·71, 1·91)), I2 = 83·2 % (P = 0·37)). The current analysis demonstrated the adverse effects of sodium selenite supplementation on glycaemic control in healthy rodents.

Motivations for weight loss in adolescents with overweight and obesity: a systematic review.

BACKGROUND: Adolescents with overweight and obesity report various motivations for weight loss other than the desire for better health. However, there is little evidence regarding the main motivations for weight loss in adolescents. The present systematic review aimed to identify the motivations for weight loss in adolescents with overweight and obesity. METHODS: A systematic search for original articles published up to December 2016 was carried out in the PubMed, Scopus, LILACS, and ADOLEC databases. The terms used in the search were: motivation, motive, reason, "weight loss," "lose weight," and adolescent. RESULTS: Six studies (all cross-sectional) met the selection criteria and were included in the review. The instruments used to assess the participants' motivations for weight loss were interviews and questionnaires with open questions. Seventeen motivations for weight loss were identified, the main ones being better health, esthetic/cosmetic reasons, improvements in self-esteem, and avoidance of provocation/bullying. CONCLUSIONS: The results of the present review show the need for validated instruments to assess the motivations for weight loss in adolescents with overweight and obesity. Moreover, the high frequency of motivations for weight loss related to appearance and social acceptance evidences the need for multidisciplinary weight loss interventions that consider not only the biological factors, but also the psychological and social aspects.

Food cravings among Brazilian population.

This study aimed to develop and validate a Brazilian version of the Food Craving Inventory (FCI-Br), adapted to the cultural-gastronomic context of Brazil, and to explore this behavior among adult Brazilians. The Study 1 population consisted of 453 adults from all regions of Brazil. Participants responded to a preliminary form of the instrument online. Exploratory factor analysis revealed an FCI-Br presenting 23 items and three factors: High Fat, Sweet Food and Traditional Meal. The FCI-Br overall reliability was considered adequate (α = 0.82), as were each of the sub-scales. The food items receiving higher average scores from the application of the instrument were chocolate (3.14 ± 1.28; women) and bread (2.94 ± 1.44, men). A significant association was observed between the specific-craving for Sweet Food and female respondents. Most participants reported experiencing more frequent episodes of food craving when alone (68.0%; n = 391) and during the afternoon (32.2%; n = 127) or evening (43.8%; n = 173) hours. Application of the FCI-Br in a population of 649 university students (Study 2) demonstrated a good adjustment of the model developed according to the Confirmatory factor analysis (χ2/gl = 2.82, CFI = 0.94; TLI = 0.93; RMSEA = 0.06). The current findings indicate that the FCI-Br has adequate psychometric properties to measure craving behavior with respect to specific food groups in the resident population of Brazil. The results of this study also shed light on the importance of considering the cultural diversity of a population when investigating eating behaviors.

The Brazilian version of the three-factor eating questionnaire-R21: psychometric evaluation and scoring pattern.

PURPOSE: This study aimed to evaluate the psychometric properties and scoring pattern of the Brazilian version of the three-factor eating questionnaire-r21 (TFEQ-R21). METHODS: Data were collected from 410 undergraduate students. Confirmatory factor analysis was conducted to examine the factor structure of the TFEQ-R21. Convergent and discriminant validity also was assessed. Cluster analysis was performed to investigate scoring patterns. RESULTS: In assessing the quality setting, the model was considered satisfactory (χ 2/gl = 2.24, CFI = 0.97, TLI = 0.96, RMSEA = 0.05). The instrument was also considered appropriate in relation to the discriminant and convergent validity. There was a positive correlation between body mass index and the dimensions of cognitive restraint (r s  = 0.449, p < 0.001) and emotional eating (r s  = 0.112, p = 0.023). Using cluster analysis three respondent profiles were identified. The profile "A" was associated with appropriate weight, the "B" was characterized by high scores in cognitive restraint dimension, and the cluster "C" focused individuals who had higher scores on the uncontrolled eating and emotional eating dimensions. CONCLUSIONS: The Brazilian version of TFEQ-R21 has adequate psychometric properties, and the identified response profiles offer a promising prospect for its use in clinical practice, in weight loss interventions.

Brazilian version of food cravings questionnaires: Psychometric properties and sex differences.

The Food Cravings Questionnaires, State (FCQ-State) and Trait (FCQ-Trait), are commonly used to assess food-craving behavior. This study aimed to develop and validate the Brazilian version of these questionnaires, and to explore potential gender differences in the trait version scores. Data were collected from (n = 611) undergraduate students. Confirmatory factor analysis was conducted to examine the questionnaires structure, and construct validity was assessed. The FCQ-State-Br and FCQ-Trait-Br presented good psychometric properties, adequate model fit, and internal consistency, in general and by gender. A conservation of original structure of the Food Cravings Questionnaires was verified in the Brazilian versions. A good performance in the evaluations concerning the discriminant and convergent validity seem to corroborate these structures. Overweight individuals showed an increase in food-craving behavior. In females, this increase occurred in the guilt dimension, whereas in males, the increase was in the lack of control dimension. In addition, female dieters presented higher scores on the guilt dimension compared with female non-dieters. FCQ-State-Br and FCQ-Trait-Br constitute valid instruments for measuring food-craving behavior in the Brazilian population. Moreover, these findings suggest that food cravings may be an important aspect to be considered in clinical management of overweight individuals, and may require a sex-specific approach.

Assessing the impact of arsenic, lead, mercury, and cadmium exposure on glycemic and lipid profile markers: A systematic review and meta-analysis protocol.

The toxicity of metals presents a significant threat to human health due to the metabolic changes they induce. Thus, it is crucial to understand the impact of exposure to toxic elements on glycemic and lipid profiles. To this end, we developed a systematic review protocol registered in PROSPERO (CRD42023393681), following PRISMA-P guidelines. This review aims to assess environmental exposure to arsenic, cadmium, mercury, and lead in individuals aged over ten years and elucidate their association with glycemic markers such as fasting plasma glucose, glycated hemoglobin, as well as lipid parameters including total cholesterol, triglycerides, high-density lipoprotein, and low-density lipoprotein cholesterol. Articles published in the MEDLINE (PubMed), EMBASE, Web of Science, LILACS, and Google Scholar databases until March 2024 will be included without language restrictions. The modified Newcastle-Ottawa scale will be employed to assess the quality of the included studies, and the results will be presented through narrative synthesis. If adequate data are available, a meta-analysis will be conducted. This review can help understand the metabolic responses to exposure to toxic elements and the associated health risks.

Glycemic Changes Related to Arsenic Exposure: An Overview of Animal and Human Studies.

BACKGROUND: Arsenic (As) is a risk factor associated with glycemic alterations. However, the mechanisms of action and metabolic aspects associated with changes in glycemic profiles have not yet been completely elucidated. Therefore, in this review, we aimed to investigate the metabolic aspects of As and its mechanism of action associated with glycemic changes. METHODS: We searched the PubMed (MEDLINE) and Google Scholar databases for relevant articles published in English. A combination of free text and medical subject heading keywords and search terms was used to construct search equations. The search yielded 466 articles; however, only 50 were included in the review. RESULTS: We observed that the relationship between As exposure and glycemic alterations in humans may be associated with sex, smoking status, body mass index, age, occupation, and genetic factors. The main mechanisms of action associated with changes induced by exposure to As in the glycemic profile identified in animals are increased oxidative stress, reduced expression of glucose transporter type 4, induction of inflammatory factor expression and dysfunction of pancreatic ß cells. CONCLUSIONS: Therefore, As exposure may be associated with glycemic alterations according to inter-individual differences.