Asociación del ángulo de fase con parámetros de evaluación del estado nutricional en pacientes en hemodiálisis / Association of the phase angle with nutritional status assessment parameters in hemodialysis patients

RESUMEN La desnutrición energético-proteica es altamente prevalente en pacientes en tratamiento con diálisis, siendo un importante marcador de riesgo para morbimortalidad. Entre los diversos parámetros disponibles para evaluación de la condición nutricional, la medida del Ángulo de Fase (AF) se ha señalado como marcador útil para evaluar a pacientes en hemodiálisis (HD). Objetivo: Evaluar la asociación del AF con parámetros de evaluación del estado nutricional en pacientes en HD. Métodos: Se realizó un estudio transversal entre febrero y julio de 2016 en dos unidades de hemodiálisis, de Recife, Nordeste brasileño. Resultados: Se evaluó a 101 pacientes, con edades de 51,7±16,8 años e IMC de 24,3±4,5 kg/m². El promedio del AF fue 5,6±1,7° y se correlacionó inversamente con la edad (r= −0,222; p= 0,024) y con el % grasa (r= −0,219; p= 0,026) y directamente con la altura (r= 0,286; p= 0,003), con el índice de masa muscular esquelética (r= 0,269; p= 0,006), con la fuerza de agarre palmar (r= 0,627;p <0,001), velocidad de marcha (r= 0,263; p= 0,008), masa libre de grasa (r= 0,303; p= 0,002) y creatininemia (r= 0,278; p= 0,004). Conclusiones: El AF presentó asociación con algunos parámetros de evaluación nutricional, que puede ser una medida útil adicional para reflejar la condición nutricional y evaluar la sarcopenia en pacientes en HD.

ABSTRACT Energy-protein malnutrition is highly prevalent in dialysis patients, being an important marker of risk for morbidity and mortality. Among the various parameters available for assessing nutritional status, the phase angle (PA) measurement has been indicated as a useful marker for evaluating patients on hemodialysis (HD). Objective: To evaluate the association of PA with parameters of nutritional status in patients on HD. Methods: We performed a cross-sectional, observational study from February to July, 2016, in two hemodialysis units, in the city of Recife, Northeastern Brazil. Results: A total of 101 patients were evaluated, with a mean age of 51.7±16.8 years and mean BMI of 24.3±4.5kg/m². The mean PA was 5.6±1.7°. PA was inversely correlated with age (r= −0.222; p= 0.024), fat% (r= −0.219; p= 0.026) and positively with height (r= 0.267; p= 0.003), velocity speed (r= 0.267; p= 0.003), skeletal muscle mass index (r= 0.269; p= 0.006), fat free mass (r= 0.303; p= 0.002) and serum creatinine (r= 0.278; p= 0.004). Conclusions: PA was associated with some parameters of nutritional status. Thus, it may be an additional useful measure to reflect nutritional status and to evaluate sarcopenia in patients on HD.

Central adiposity among elderly women in a gerontology-geriatric unit / Adiposidade central em idosas de uma unidade geronto-geriátrica

Abstract Objective: To evaluate central adiposity in elderly women in a gerontology-geriatric care unit of the Universidade Federal de Pernambuco (the Federal University of Pernambuco). Method: A cross-sectional study involving a sample of 182 elderly women, aged from 60 to 89 years, who received care from January to July 2011, was performed. The variables analyzed were the socio-economic and demographic conditions, lifestyle, waist circumference (WC) and body mass index (BMI) of the women, as well as the occurrence of hypertension, diabetes mellitus and high total cholesterol levels. Yates' chi-squared test and Fisher's exact test were applied. A significance rate of 5% was adopted for the rejection of the null hypothesis. Results: Of the elderly women surveyed 82.4% had a WC signifying a large waist size, 57.2% were over-weight, 78.3% presented hypercholesterolemia, 63.2% had hypertension and 23.6% had diabetes. 61.5% were aged between 60 and 69 years old; 56% received up to two minimum salaries; 63.5% had less than eight years of schooling, 74.7% stated that they did not smoke, 87.9% did not drink alcohol; and 51.4 had sedentary habits. An association was observed between BMI and central adiposity (CA) (p=0.000). CA tended to be present around 1.2 times more frequently in elderly women with excess weight than among those who were not overweight. Conclusion: The high frequency of central adiposity and overweight indicates the susceptibility of this population to these factors. While no association with cardiovascular risk factors was observed, there is a clear need for monitoring by a multidisciplinary team, so as to identify and treat this debilitating condition, thereby contributing to the quality of life of this population. AU

Resumo Objetivo: Avaliar a adiposidade central em idosas assistidas em uma unidade geronto-geriátrica da Universidade Federal de Pernambuco. Método: O estudo teve delineamento transversal envolvendo uma amostra de 182 idosas com faixa etária entre 60 a 89 anos, atendidas no período janeiro-julho de 2011. As variáveis analisadas foram: circunferência abdominal (CA), índice de massa corporal, estilo de vida, presença de Hipertensão Arterial Sistêmica (HAS), diabetes mellitus, colesterol total, condições socioeconômicas e demográficas. Aplicou-se o teste qui-quadrado e o teste exato de Fisher. Adotou-se o nível de significância de 5% para rejeição da hipótese de nulidade. Resultado: Das idosas avaliadas, 82,4% indicaram CA muito elevada, 57,2% apresentavam excesso de peso, 78,3% encontravam-se com hipercolesterolemia, 63,2% com HAS e 23,6% eram diabéticas, 61,5% encontravam-se entre 60 a 69 anos, 56% recebiam até 2 salários mínimos, 63,5% estudaram menos de 8 anos, 74,7% relataram não ser tabagista, 87,9% eram abstêmios e 51,4% sedentárias. Observou-se associação entre o Índice de Massa Corporal e AC (p=0,000). A AC tende apresentar cerca de 1,2 vezes no excesso de peso quando comparados com idosos sem AC. Conclusão: A elevada frequência de adiposidade central e o excesso de peso apontam a suscetibilidade dessa população, ainda que nenhuma associação com os fatores de risco cardiovascular tenha sido observada, impõe-se a necessidade de acompanhamento por equipe multidisciplinar para a identificação e tratamento desse agravo, contribuindo para a qualidade de vida dessa população. AU