Body adiposity markers and insulin resistance in patients with type 1 diabetes

ABSTRACT Objectives: Body composition changes are associated with adverse effects such as increased insulin resistance (IR) in individuals with diabetes mellitus. This study aims to evaluate the association between different body adiposity markers and IR in adults with type 1 diabetes (T1D). Subjects and methods: The cross-sectional study included outpatient adults with T1D from a university public hospital in southern Brazil. The body adiposity markers studied were waist circumference (WC), waist-height ratio (WHtR), body mass index (BMI), conicity index (CI), lipid accumulation product (LAP) and body adiposity index (BAI). IR was calculated using an Estimated Glucose Disposal Rate (EGDR) equation (analyzed in tertiles), considering an inverse relation between EGDR and IR. Poisson regression models were used to estimate the odds ratio (OR) and 95% CIs of association of adiposity markers with IR. Results: A total of 128 patients were enrolled (51% women), with a median EGDR of 7.2 (4.4-8.7) mg.kg−1.min−1. EGDR was negatively correlated with WC (r = −0.36, p < 0.01), WHtR (r = −0.39, p < 0.01), CI (r = −0.44, p < 0.01), LAP (r = −0.41, p < 0.01) and BMI (r = −0.24, p < 0.01). After regression analyses, WC (OR = 2.07; CIs: 1.12-3.337; p = 0.003), WHtR (OR = 2.77; CIs: 1.59-4.79; p < 0.001), CI (OR = 2.59; CIs: 1.43-4.66; p = 0.002), LAP (OR = 2.27; CIs: 1.25-4.11; p = 0.007) and BMI (OR = 1.78; CIs: 1.09-2.91; p = 0.019) remained associated with IR. Conclusions: The authors suggest using the studied adiposity markers as a routine since they were shown to be suitable parameters in association with IR.

Maternal visceral adiposity and fetal biometry in women with obesity and diabetes

SUMMARY OBJECTIVE: The aim of this study was to compare the correlation of maternal visceral adiposity with sonographic variables related to fetal biometry in the second trimester of pregnancy in mothers who were previously obese versus nonobese and gestational diabetic versus nondiabetic. METHODS: This cross-sectional study included 583 pregnant women who received prenatal care between October 2011 and September 2013 at the Instituto de Medicina Integral Prof. Fernando Figueira, northeast of Brazil. Maternal visceral adiposity was measured by ultrasound examination at the same time as fetal biometry. Gestational age was 14.9±3.2 weeks. The correlation between maternal visceral adiposity and fetal biometric variables was evaluated using Pearson's correlation coefficient. Among the groups, the correlation coefficients were compared using Fisher's Z-test. This test was also used to evaluate the null hypothesis of correlation coefficients between pairs of variables. RESULTS: Maternal visceral adiposity positively correlated with fetal abdominal circumference, estimated fetal weight, head circumference, femur length, and biparietal diameter in pregnant women with obesity, nonobesity, gestational diabetes, and nondiabetes, but the correlation coefficients were statistically similar among the groups. CONCLUSION: Maternal visceral adiposity positively correlated with fetal biometry in the second trimester of pregnancy in the same manner in pregnant women previously obese and nonobese, as well as in pregnant women with gestational diabetes and nondiabetes.

Injerto de grasa autóloga con lipofiltración en surco nasolabial

Introducción: La profundización de los surcos nasolabiales es uno de los signos más tempranos del envejecimiento natural del ser humano y puede ser atenuado con el empleo de materiales de relleno, entre ellos el injerto de grasa autóloga. Objetivo: Describir los resultados de la infiltración de grasa autóloga en el surco nasolabial para el rejuvenecimiento facial. Métodos: Se realizó un estudio observacional, descriptivo, de corte longitudinal y prospectivo, para describir la infiltración de grasa autóloga en el surco nasolabial para el rejuvenecimiento facial en 40 pacientes. Los pacientes se siguieron durante seis meses de forma trimestral (un mes, tres meses y seis meses) y se evaluaron las variables: tiempo de recuperación, aparición de complicaciones, grado de satisfacción de los pacientes y resultados estéticos. Resultados: La edad media fue de 47 años, con predominio del sexo femenino. El 92 % de los pacientes se recuperó en menos de 10 días, con la aparición de seis complicaciones. La disminución del defecto posterior al procedimiento fue significativa respecto al momento inicial; sin embargo, con el tiempo (tres a seis meses) el defecto en el surco nasolabial reapareció en algunos pacientes. El grado de satisfacción de los pacientes vario entre un 95 % (un mes) a un 90 % a los seis meses y los resultados estéticos catalogados como buenos disminuyeron de un 90 % (un mes) a un 65 % (seis meses). Conclusiones: Se demostró que el injerto de grasa autóloga en el surco nasolabial es un procedimiento con resultados estéticos buenos, sin embargo, este disminuye en los meses posteriores, lo que puede estar relacionado con la reabsorción del injerto graso.

Introduction: The deepening of the nasolabial folds is one of the earliest signs of natural aging in humans and can be mitigated with the use of filler materials, including autologous fat grafting. Objective: To describe the results of autologous fat infiltration in the nasolabial fold for facial rejuvenation. Methods: An observational, descriptive, longitudinal and prospective study to describe the infiltration of autologous fat in the nasolabial fold for facial rejuvenation was carried out in 40 patients. The patients were followed up for 6 months: one month (1M), three months (3M) and six months (6M) and the evaluated variables were: recovery time, appearance of complications, degree of patient satisfaction and aesthetic results. Results: The average age was 47 years, with a female prevalence. 92% of patients recovered in less than 10 days, with the only appearance of six complications. The decrease in the defect after the procedure was significant compared to the initial moment; however, over time (3-6M) the defect in the nasolabial fold reappeared in some patients. The degree of patient satisfaction varied between 95% (1M) to 90% at 6M and the aesthetic results classified as good decreased from 90% (1M) to 65% (6M). Conclusions: It was shown that autologous fat grafting in the nasolabial fold is a procedure with good aesthetic results, however it decreases in subsequent months, which may be related to the reabsorption of the fat graft.

The effect of abdominal visceral fat area on perioperative complications and pancreatic fistula in primary gastric carcinoma patients after laparoscopic assisted radical gastrectomy / 中华普通外科杂志

Objective:To study the effect of visceral fat area (VFA) on postoperative complications and pancreatic fistula in patients undergoing laparoscopic assisted radical gastrectomy for gastric careinoma.Methods:Clnical data of 214 primary gastric cancer patients undergoing laparoscopic assisted radical gastrectomy between Jan 2017 and Jan 2022 at the Department of General Surgery, Shouguang People's Hospital were retrospectively reviewed.Results:There were 85 patients in high VFA group and 129 patients in the low VFA group. The body mass index (25.1±3.4) kg/m 2 and visceral fat area (143.4±41.1) cm 2 in the high VFA group were higher than those in the low VFA group (21.2±2.9) kg/m 2 and visceral fat area (58.7±31.9) cm 2. The operative time was (228.3±53.1) min vs. (206.3±62.9) min ( t=5.538, P=0.017). The intraoperative blood loss was (264.6±173.6) ml vs. (213.9±156.2) ml ( t=3.373, P=0.035). The postoperative hospital stay was (12.5±4.0) d vs. (10.3±3.7) d ( t=7.781, P=0.013). Twenty-three cases developed postoperative complications in the high VFA group vs. 20 cases in the low VFA group ( χ2=4.261, P=0.039). Patients in the high VFA group had an incidence of clinically relevant pancreatic fistula of 10.6% vs. 3.1% in patients in the low VFA group ( χ2=5.034, P=0.038). Univariate and multivariate analysis of clinically relevant pancreatic fistulas in patients with different VFA groups showed that men ≥134.6 cm 2 and women ≥91.1 cm 2 with VFA and operative time ≥250 min were independent risk factors for the occurence of clinically relevant pancreatic fistulas after laparoscopic assisted radical gastrectomy. Conclusions:VFA increases the difficulty of laparoscopic-assisted radical gastrectomy, resulting in increased postoperative complications. VFA and operation time are independent risk factors for clinically relevant pancreatic fistula after radical gastrectomy for gastric cancer.

Volume de Gordura Epicárdica está Associada com Disfunção Endotelial, mas Não com Calcificação Coronariana: Do ELSA-Brasil / Epicardial Fat Volume Is Associated with Endothelial Dysfunction, but not with Coronary Calcification: From the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

Resumo Fundamento O aumento no volume de gordura epicárdica (VGE) está relacionado com doença arterial coronariana (DAC), independentemente de gordura visceral ou subcutânea. O mecanismo dessa associação não é claro. O escore de cálcio coronariano (CC) e a disfunção endotelial estão relacionados com eventos coronarianos, mas não está bem esclarecido se o VGE está relacionado com esses marcadores. Objetivos Avaliar a associação entre VGE medido por método automatizado, fatores de risco cardiovasculares, escore de CC, e função endotelial. Métodos: Em 470 participantes do Estudo Longitudinal de Saúde do Adulto LSA-Brasil com medidas de VGE, escore de CC e função endotelial, realizamos modelos multivariados para avaliar a relação entre fatore de risco cardiovascular e VGE (variável resposta), e entre VGE (variável explicativa), e função endotelial ou escore de CC. Valor de p<0,05 bilateral foi considerado estatisticamente significativo. Resultados A idade média foi 55 ± 8 anos, e 52,3% dos pacientes eram homens. O VGE médio foi 111mL (86-144), e a prevalência de escore de CC igual a zero foi 55%. Nas análises multivariadas, um VGE mais alto relacionou-se com sexo feminino, idade mais avançada, circunferência da cintura, e triglicerídeos (p<0,001 para todos). Um VGE mais alto foi associado com pior função endotelial: em comparação ao primeiro quartil, os valores de odds ratio para a amplitude de pulso basal foram (q2=1,22; IC95% 1,07-1,40; q3=1,50, IC95% 1,30-1,74; q4=1,50, IC95% 1,28-1,79) e para a razão de tonometria arterial periférica foram (q2=0,87; IC95% 0,81-0,95; q3=0,86, IC95% 0,79-0,94; q4=0,80, IC95% 0,73-0,89), mas não com escore de CC maior que zero. Conclusão Um VGE mais alto associou-se com comprometimento da função endotelial, mas não com escore de CC. Os resultados sugerem que o VGE esteja relacionado ao desenvolvimento de DAC por uma via diferente da via do CC, possivelmente pela piora da disfunção endotelial e doença microvascular.

Abstract Background The increase in epicardial fat volume (EFV) is related to coronary artery disease (CAD), independent of visceral or subcutaneous fat. The mechanism underlying this association is unclear. Coronary artery calcium (CAC) score and endothelial dysfunction are related to coronary events, but whether EFV is related to these markers needs further clarification. Objectives To evaluate the association between automatically measured EFV, cardiovascular risk factors, CAC, and endothelial function. Methods In 470 participants from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) with measures of EFV, CAC score and endothelial function, we performed multivariable models to evaluate the relation between cardiovascular risk factors and EFV (response variable), and between EFV (explanatory variable) and endothelial function variables or CAC score. Two-sided p <0.05 was considered statistically significant. Results Mean age was 55 ± 8 years, 52.3% of patients were men. Mean EFV was 111mL (IQ 86-144), and the prevalence of CAC score=0 was 55%. In the multivariable analyses, increased EFV was related to female sex, older age, waist circumference, and triglycerides (p<0.001 for all). Higher EFV was associated with worse endothelial function: as compared with the first quartile, the odds ratio for basal pulse amplitude were (q2=1.22, 95%CI 1.07-1.40; q3=1.50, 95%CI 1.30-1.74; q4=1.50, 95%CI 1.28-1.79) and for peripheral arterial tonometry ratio were (q2=0.87, 95%CI 0.81-0.95; q3=0.86, 95%CI 0.79-0.94; q4=0.80, 95%CI 0.73-0.89), but not with CAC score>0. Conclusion Higher EFV was associated with impaired endothelial function, but not with CAC. The results suggest that EFV is related to the development of CAD through a pathway different from the CAC pathway, possibly through aggravation of endothelial dysfunction and microvascular disease.

Adiposidad abdominal y resistencia a la insulina al finalizar el primer trimestre de la gestación / Abdominal Adiposity and Insulin Resistance at the End of the First Trimester of Gestation

Introducción: La adiposidad central como factor desencadenante de resistencia a la insulina precoz constituye una amenaza potencial de riesgo metabólico y cardiovascular en el embarazo. Objetivo: Determinar la capacidad discriminante de las grasas abdominales sobre la resistencia a la insulina, diagnosticada por el índice triglicéridos/glucosa-IMC al finalizar el primer trimestre del embarazo. Métodos: Se realizó un estudio observacional analítico de 526 gestantes con embarazo simple y edad gestacional entre 12 y 13 semanas, entre los años 2016 y 2020. Se estudió el test de triglicéridos/glucosa-IMC y las grasas abdominales por ultrasonido. Se utilizaron las curvas ROC (Receiver operating characteristic Curve) para discriminar la resistencia a la insulina al finalizar el primer trimestre de la gestación, cuando aumentan las grasas abdominales. Resultados: La grasa subcutánea fue la que presentó mayor área bajo la curva en la discriminación de la resistencia a la insulina, con un nivel de sensibilidad y especificidad aceptable. Conclusiones: La grasa subcutánea, aunque con bajo valor discriminativo, puede considerarse como augurio de resistencia a la insulina y de diabetes gestacional. Se requiere profundizar en el estudio de las grasas abdominales dado el conocimiento de su impacto en los desórdenes metabólicos en el curso avanzado de la gestación(AU)

Introduction: Central adiposity as a triggering factor for early insulin resistance is a potential threat of metabolic and cardiovascular risk in pregnancy. Objective: To determine the discriminating capacity of abdominal fat over insulin resistance, diagnosed by the triglyceride/glucose-BMI index at the end of the first trimester of pregnancy. Methods: An analytical and observational study was carried out with 526 pregnant women of singleton pregnancy and gestational age between twelve and thirteen weeks, between 2016 and 2020. The triglyceride/glucose-BMI test was studied, together with abdominal fats by ultrasound. ROC (receiver operating characteristic) curves were used to discriminate insulin resistance at the end of the first trimester of gestation, when abdominal fats increase. Results: Subcutaneous fat presented the highest area under the curve in the discrimination of insulin resistance, with an acceptable level of sensitivity and specificity. Conclusions: Subcutaneous fat, although with low discriminative value, can be considered as a harbinger of insulin resistance and gestational diabetes. Further study of abdominal fat is required, given the knowledge of its impact on metabolic disorders in late gestation(AU)

Effectiveness and protocols of pelvic floor muscle exercise for the treatment of urinary incontinence in older people / 体力科学

Urinary incontinence (UI) among older people is a common problem. Several treatments are available for older people with UI including surgery, drug therapies, and behavioral interventions. Recently, much attention has been placed on the behavioral treatments for UI, including pelvic floor muscle (PFM) exercise, weight loss exercise, and thermal therapy, as they have few risks, no side effects, and are effective. These therapies are often recommended as first line treatments for older people with UI. PFM exercise programs often incorporate alternations of fast contractions that are usually held for about two to three seconds interspersed with relaxation intervals of four to five seconds, and sustained contractions, where participants hold the contraction for about eight to ten seconds followed by a relaxation interval of ten to twelve seconds between the contractions. While exercise periods vary between 3 to 24 weeks, 8 to 12 weeks seems to be the most effective length for PFM exercise. The effectiveness of PFM exercise for the improvement of UI has been validated by many studies, with improvement rates ranging widely from 17 to 84%. Also, research has shown that UI is associated with obesity. Increases in body weight cause increases in abdominal wall weight, which in turn increases intra-abdominal pressure and intra-vesicular pressure. Therefore, abdominal fat reduction from exercise may decrease intra-abdominal pressure, perhaps causing improvements in urethral sphincter contraction and, hence, decreasing UI risk. Evidence reveals that PFM exercise and fitness training targeted at reducing modifiable risk factors are effective strategies for treating UI in older people, regardless of UI type.

Metabolizable energy levels in diets with a fixed nutrient: calorie ratio for free-range broilers / Níveis de energia metabolizável com manutenção da relação nutriente: caloria em dietas para frangos de corte tipo caipira

The present study proposes to examine the effect of dietary levels of metabolizable energy, under a fixed nutrient:calorie ratio, on the production performance; body fat and protein deposition; and carcass characteristics of free-range broilers from 1 to 84 days of age. Nine hundred unsexed chicks were allocated to six treatments in a completely randomized design with six replicates of 25 birds each. Treatments consisted of diets with varying levels of metabolizable energy (2700, 2800, 2900, 3000, 3100 and 3200 Kcal ME/kg of diet) and a fixed proportion of nutrients relative to the energy level according to the nutritional requirements for each rearing phase. Body weight, weight gain, feed intake, feed conversion, production viability, metabolizable energy intake, protein intake, lysine intake, body fat deposition, body protein deposition and carcass characteristics were evaluated. Data were subjected to analysis of variance and, later, to regression analysis. Increasing levels of metabolizable energy, coupled with a fixed nutrient:calorie ratio, reduced feed intake, increased body weight and weight gain, improved feed conversion and did not affect carcass characteristics. In conclusion, adjusting the nutrient supply according to the dietary energy level improves production performance by improving feed conversion, ensuring adequate nutrient intake and preserving fat and protein deposition in the carcass when the metabolizable energy level is raised up to 3200 Kcal/kg in all rearing stages.(AU)

O objetivo do presente estudo foi avaliar os níveis de energia metabolizável, sob uma relação nutriente:caloria fixa, no desempenho produtivo; deposição de gordura e proteína corporal e características de carcaça de frangos de corte tipo caipiras. Foram utilizados novecentos pintainhos não sexados, distribuidos em seis tratamentos em delineamento inteiramente casualizado com seis repetições de 25 aves cada. Os tratamentos consistiram em dietas com diferentes níveis de energia metabolizável (2700, 2800, 2900, 3000, 3100 e 3200 Kcal EM / kg de dieta) e uma proporção fixa de nutrientes em relação ao nível de energia de acordo com as necessidades nutricionais de cada fase de criação. Foram avaliados o peso corporal, ganho de peso, consumo de ração, conversão alimentar, viabilidade criatória, consumo de energia metabolizável, consumo de proteína, consumo de lisina, deposição de gordura corporal, deposição de proteína corporal e características de carcaça. Os dados foram submetidos à análise de variância e posteriormente à análise de regressão. O aumento dos níveis de energia metabolizável juntamente com a manutenção da relação nutriente:caloria reduziu o consumo de ração, aumentou o peso corporal e o ganho de peso, melhorou a conversão alimentar e não afetou as características da carcaça. Em conclusão, o ajuste da oferta de nutrientes de acordo com o nível de energia da dieta melhora o desempenho da produção, melhorando a conversão alimentar, garantindo a ingestão adequada de nutrientes e preservando a deposição de gordura e proteína na carcaça quando o nível de energia metabolizável é elevado até 3200 Kcal/kg em todas as fases de criação.(AU)

Aerobic exercise attenuates the effects of ovariectomy and sedentarism on body composition and food intake in female rats / Exercício aeróbico atenua os efeitos da ovariectomia e do sedentarismo na composição corporal e no consumo alimentar em ratas

ABSTRACT Objective To evaluate the impact of low to moderate aerobic exercise and ovariectomy on body composition and food consumption in female rats. Methods Forty adult Wistar female rats (age: 23 weeks; body weight: 275.2±3.6g; mean±SEM) were divided into 4 groups (n=10): laparotomy-sedentary; laparotomy-exercised; ovariectomy-sedentary; and ovariectomy-exercised. The exercised groups were submitted to a treadmill running program (16m/min; 30min/day, 5 days/week), for 8 weeks. Body weight and food consumption were monitored during the experiment. Visceral fat and carcass water, protein, ash, fat and carbohydrate fractions were analyzed. Two-way ANOVA plus the Tukey's post hoc test was used for comparisons and p<0.05 was considered significant. Results The ovariectomized (ovariectomy-sedentary+ovariectomy-exercised) and sedentary (laparotomy-sedentary+ovariectomy-sedentary) animals showed higher (p<0.05) weight gain, food consumption, food efficiency ratio and weight gain/body weight ratio than laparotomy animals (laparotomy-sedentary+laparotomy-exercised) and exercised (exercised laparotomy+exercised ovariectomy), respectively. The ovariectomized and sedentary animals showed higher (p<0.05) carcass weight, fat percentage and visceral fat than laparotomy and exercised rats, respectively. Conclusion Ovariectomy and physical inactivity increase obesogenic indicators, whereas regular aerobic exercise of low to moderate intensity attenuates these unfavorable effects in female rats.

RESUMO Objetivo Avaliar o impacto do exercício aeróbico de intensidade baixa a moderada e da ovariectomia na composição corporal e no consumo alimentar em ratas. Métodos Quarenta ratas Wistar adultas (idade: 23 semanas; peso corporal: 275, 2±3, 6g; média±EPM) foram divididas em 4 grupos (n=10): laparotomia-sedentária, laparotomia-exercitada, ovariectomia-sedentária e ovariectomia-exercitada. Os grupos laparotomia-exercitada e ovariectomia-exercitada foram submetidos a um programa de corrida em esteira (16m/mim; 30min/dia, 5 dias/semana) durante 8 semanas. Foram monitorados o peso corporal e o consumo alimentar das ratas durante o experimento. Analisaram-se as frações de água, proteínas, cinzas, gordura e carboidrato da carcaça, bem como a gordura visceral. Empregou-se ANOVA Two-Way, seguida do teste post hoc de Tukey para as análises estatísticas. Adotou-se o nível de significância de p<0,05. Resultados As ratas ovariectomizadas (ovariectomia-sedentária+ovariectomia-exercitada) e sedentárias (laparotomia-sedentária+ ovariectomia-sedentária) exibiram maior (p<0,05) ganho de peso, consumo alimentar, coeficiente de eficácia alimentar e taxa de ganho de peso/peso corporal do que as ratas laparotomizadas (laparotomia-sedentária+laparotomia-exercitada) e exercitadas (laparotomia-exercitada+ovariectomia-exercitada), respectivamente. A carcaça das ratas ovariectomizadas e sedentárias apresentaram maior (p<0,05) peso, percentual de gordura e gordura visceral do que as ratas laparotomizadas e exercitadas, respectivamente. Conclusão A ovariectomia e o sedentarismo elevam indicadores obesogênicos, enquanto que o exercício aeróbico regular de intensidade baixa a moderada atenua esses efeitos desfavoráveis em ratas.

Quality of life and its relationship with different anthropometric indicators in adults with obesity / Qualidade de vida e sua relação com diferentes indicadores antropométricos em adultos com obesidade

Abtract Introduction: Obesity compromises the quality of life. However, few studies have investigated the influence of different anthropometric indicators on the quality of life of this population. Objective: We aimed to correlate the physical and mental components of quality of life and verify its association with different anthropometric indicators in adults with obesity. Methods: A cross-sectional study was conducted in adults with obesity [body mass index (BMI) ≥ 30 kg/m²]. The quality of life was investigated using the SF-36 questionnaire, with scores ranging from 0 (worst-case scenario) to 100 (best scenario for the outcome). The anthropometric indicators used were BMI, waist circumference, waist/height ratio (WHR), and lean and fat body mass. For analysis, Spearman's correlation and crude and adjusted linear regression for sociodemographic variables were used. Results: A total of 75 subjects (nfemales = 47; µage= 34.8 ± 7.1 years) were included, and their means of the physical and mental components were 64.5 ± 15.9 and 50.8 ± 21.3 points, respectively. The social functioning domain presented a strong positive correlation (r = 0.760) with the mental health domain, and eight moderate correlations (0.400 ≤ r ≥ 0.699) were found between the different domains of the questionnaire. The functional capacity domain and the physical component presented a moderate negative correlation with the WHR (r = -0.402 and r = -0.407, respectively). After adjustment, the WHR was inversely associated with the physical component (β = -1.197; p = 0.002). Conclusion: In adults with obesity, important correlations were observed between the physical and mental components of quality of life, and the waist/height ratio was the only anthropometric indicator correlated and associated with the physical component of the outcome.

Resumo Introdução: A obesidade compromete a qualidade de vida física e mental em função do excesso de peso corporal. Entretanto poucos estudos se propuseram a compreender a influência dos diferentes indicadores antropométricos na qualidade de vida dessa população. Objetivo: Correlacionar os componentes físico e mental da qualidade de vida e verificar a sua associação com diferentes indicadores antropométricos em adultos com obesidade. Métodos: Realizou-se um estudo transversal com adultos com obesidade (índice de massa corporal [IMC] ≥ 30kg/m²). A qualidade de vida foi investigada pelo questionário SF-36, com amplitude de escores de zero (pior cenário) a 100 (melhor cenário para o desfecho). Os indicadores antropométricos foram: IMC, perímetro de cintura, razão cintura/estatura (RCE), massa corporal magra e gorda. Na estatística, empregou-se correlação de Spearman e regressão linear bruta e ajustada para variáveis sociodemográficas. Resultados: Nos 75 sujeitos (nmulheres = 47; µidade = 34,8 ± 7,1 anos), o componente físico apresentou média de 64,5 ± 15,9 pontos e mental de 50,8 ± 21,3 pontos. O domínio de aspecto social apresentou forte correlação positiva (r = 0,760) com o domínio da saúde mental e foram encontradas oito correlações moderadas (0,400 ≤ r ≥ 0,699) entre os distintos domínios do questionário. O domínio capacidade funcional e o componente físico apresentaram moderada correlação negativa com a RCE (r = -0,402 e r = -0,407, respectivamente). Na análise ajustada, a RCE apresentou uma associação inversa com o componente físico (β = -1,197; p = 0,002). Conclusão: Em adultos com obesidade, observou-se importantes correlações entre os componentes físico e mental da qualidade de vida e a razão cintura/estatura foi o único indicador antropométrico correlacionado e associado ao componente físico do desfecho.

Quantitative computed tomography-derived abdominal visceral adipose tissue and cardiometabolic risk in a large-scale population / 中华健康管理学杂志

Objective:To investigate the relationship between abdominal visceral adipose tissue (VAT) and cardiometabolic risk (CMR) through quantitative computed tomography (QCT).Methods:The present study included 76226 participants. Abdominal fat areas were measured using the QCT Pro Model 4 system. Cardiometabolic indices were collected, including systolic and diastolic blood pressures, fasting plasma glucose, total cholesterol, triglyceride, and low-density and high-density lipoprotein cholesterols CMR score was the sum of abnormal blood pressure, fasting glucose, triglyceride, and high-density lipoprotein cholesterol. Restricted cubic spline and ordered logistic regression models were applied.Results:The mean age was 50±13 years and the percentage of men was 58.8%. The level of VAT area was higher in men than in women (191.7±77.1 cm 2 vs 116.4±56.2 cm 2, P<0.0001 for all). After adjustment for age, the cardiometabolic indices except high-density lipoprotein cholesterol increased with increasing VAT area. When VAT area was 300 cm 2, age-adjusted odds ratios and 95% confidence intervals of a CMR score ≥ 1 were 14.61 (13.31, 16.04) for men and 5.46 (4.06, 7.36) for women, and the age-adjusted probability of a CMR score ≥ 3 was 31.7% for men and 31.3% for women. Conclusions:QCT-derived VAT is closely related to CMR. The findings suggest that measurement of visceral fat is recommended for the management of abdominal obesity in subjects who agree to undergo lung cancer screening via low-dose CT without additional radiation exposure.

Effect of increased visceral fat on the perioperative period of laparoscopic-assisted distal gastric cancer radical resection / 国际外科学杂志

Objective:To explore the effect of excessive visceral fat area (VFA) on the intraoperative risk and postoperative outcome of laparoscopic-assisted distal gastric cancer surgery (LADG).Methods:A retrospective selection of 82 patients who underwent LADG at the Department of General Surgery, Beijing Friendship Hospital, Capital Medical University from June 2017 to March 2018 was selected. The patients were divided into two groups according to the VFA value calculated by preoperative CT: high VFA group ( n=31) and the low VFA group ( n=51). Patients in the high-VFA group had VFA≥100 cm 2, and those in the low-VFA group had VFA<100 cm 2. The differences in operation time, blood loss, number of lymph node dissections, and postoperative complications (including intestinal obstruction, anastomotic fistula, pancreatic fistula, and abdominal infection) were statistically compared between the two groups. Measurement data were expressed as mean±standard deviation ( Mean± SD), comparison between groups was by t-test; comparison of count data between groups was by Chi-square test. The factors related to pancreatic fistula were tested by one-way variance test, and the factors with differences were entered into the multivariate Logistic regression analysis as independent variables. Results:In terms of surgical bleeding ( P=0.061), lymph node dissection ( P=0.089), postoperative anastomotic leakage ( P=0.210), intestinal obstruction ( P=0.275) and abdominal infection ( P=0.130), the comparison between the two groups showed no significant statistical difference ( P>0.05), but compared with the low VFA group, the operation time of the high VFA group was prolonged [(258±91)min vs (230±82)min, P=0.018], and the onset of pancreatic fistula rate was significantly higher (11/31 vs 3/51, P=0.001), and there was statistical significance between the two groups ( P<0.05). The results of univariate analysis showed that gender and VFA were risk factors for pancreatic fistula; the results of multivariate analysis showed that VFA was a predictor of pancreatic fistula. Conclusion:Excessive VFA prolongs LADG operation time and is more valuable in predicting the occurrence of postoperative pancreatic fistula.

Research progress on fat aging and the occurrence and development of metabolic syndrome / 中华老年医学杂志

Obesity has become a major public health problem that threatens human health.Abdominal obesity, especially the increase in visceral adipose tissue(VAT), can in some cases lead to insulin resistance and other metabolism-related diseases such as diabetes, cardiovascular disease, thrombosis, and pro-inflammatory metabolic abnormalities.Metabolic syndrome is a group of clinical syndromes characterized by the co-occurrence of various metabolic diseases, including insulin resistance and inflammatory response.In a large extent, the occurrence and development of the metabolic syndrome are related to fat aging and visceral obesity related.Visceral obesity is an independent risk factor for cardiovascular events, and can be changed, so by setting realistic goals, by insisting on reasonable exercise and diet control can achieve control of visceral fat, prevention and control of the metabolic syndrome.This review reviews the concept and pathophysiology of metabolic syndrome and the relationship between visceral obesity and metabolic syndrome.

Effect of Shenqi Maiwei Dihuangtang Combined with Acarbose on Blood Glucose Level，Body Mass Index and Abdominal Fat Thickness in Patients with Impaired Glucose Tolerance / 中国实验方剂学杂志

Objective:To explore the effect of Shenqi Maiwei Dihuangtang （SQMWDH） combined with acarbose on the level of 2-hour oral glucose tolerance test （2 h OGTT），body mass index （BMI）， and abdominal fat thickness in patients with impaired glucose tolerance （IGT）. Method:A total of 130 patients with IGT admitted to the First People's Hospital of Shuangliu District from February 2017 to January 2019 were divided into a control group and a treatment group by a random number table. All patients received conventional treatment， such as diet regulation and exercise. The patients in the control group received additional oral administration of acarbose，while those in the treatment group were treated with SQMWDH based on the control group. Fasting blood glucose （FBG），2 h OGTT， and glycated hemoglobin A1c（HbA1c）levels were measured by the blood glucose meter. Abdominal fat thickness was measured by ultrasound tomography，and serum total cholesterol （TC），triglyceride （TG），adiponectin， and leptin levels in fasting venous blood were measured. Result:After treatment，the total response rate of the treatment group was higher than that of the control group （95.00% vs. 81.67%， <italic>χ</italic>²=5.175，<italic>P</italic><0.05）. Before treatment，there was no significant difference in FBG，2 h OGTT，HbA1c， BMI，waist circumference，abdominal fat thickness，TC，TG，adiponectin， and leptin of IGT patients between the two groups. After treatment，the levels of FBG，2 h OGTT，HbA1c， BMI，waist circumference，abdominal fat thickness，TC，TG，and leptin of IGT patients were lower than those before treatment in both groups （<italic>P</italic><0.05）， and the treatment group was inferior to the control group（<italic>P</italic><0.05，<italic>P</italic><0.01）. The level of adiponectin after treatment was higher than that before treatment in both groups （<italic>P</italic><0.05），and the treatment group was superior to the control group （<italic>P</italic><0.05）. Conclusion:SQMWDH combined with acarbose is effective in treating IGT patients by effectively reducing 2 h OGTT and abdominal fat thickness to alleviate obesity and improve the constitution of patients.

Outras tendências na abdominoplastia: novo desenho e importância da lipomidiabdominoplastia na cirurgia do contorno corporal / Other trends in abdominoplasty: new design and importance of lipomid- abdominoplasty in body contour surgery

Introdução: Durante os últimos anos, os princípios cirúrgicos da abdominoplastia permaneceram inalterados. Portanto, muitos resultados observados apresentam desalinhamento, cicatrizes transversais altas e retas do abdome, levando ao posicionamento final da cicatriz umbilical a ser muito próximo da cicatriz transversal, o que dá a impressão de abdome curto. Propomos que a abdominoplastia modifique a concepção básica de sua marcação, pois acreditamos que é importante posicionar a cicatriz transversal mais baixa na região medial e púbica, e mais alta nas extremidades laterais, permitindo, no nível dos flancos, a rotação dos retalhos lombares no sentido anterior em direção inferomedial. Métodos: Foram analisados de forma retrospectiva 146 pacientes portadores de deformidades abdominais e os submetemos a lipomidiabdominoplastia, marcando com forte concavidade superior e orientando os lados da cicatriz em direção à linha transversa inferior do abdômen, 4cm equidistantes da raiz da coxa. Também associamos a lipoaspiração como um tratamento complementar ao contorno corporal. Resultados: Consideramos que os parâmetros da midiabdominoplastia são aplicáveis na maioria dos casos, obtendo resultados igualmente satisfatórios, tanto nos pacientes com flacidez e lipodistrofia abdominal supraumbilical, quanto nos pacientes com abdome em avental com importante flacidez e diástase dos retos abdominais. Conclusão: É importante determinar a área da deformidade abdominal e sua classificação, para estabelecer as estratégias do tratamento e associação de procedimentos complementares. Uma marcação mais baixa, respeitando as áreas de tratamento, permitirá uma melhor cicatriz estética e um contorno corporal harmônico, além de uma adequada colocação dos elementos: cicatriz umbilical, púbis e extremidades laterais da cicatriz abdominal transversa.

Introduction: During the last few years, the surgical principles of abdominoplasty have remained unchanged. Therefore, many patients undergoing this technique have misalignment and high and straight transverse scars of the abdomen, with the final position of the umbilical scar being very close to the transverse scar, making the abdomen seem short. We propose modifying the basic concept of marking in abdominoplasty, because we believe it is important to position the transverse scar lower in the medial and pubic region and higher at the lateral ends, allowing anterior lumbar flap rotation in an inferomedial direction. Methods: We retrospectively analyzed 146 patients with abdominal defects and subjected them to lipo-mid-abdominoplasty, marking with strong upper concavity and guiding the sides of the scar towards the lower transverse line of the abdomen, 4 cm equidistant from the root of the thigh. We also define liposuction as a complementary treatment to body contouring. Results: We consider that midabdominoplasty parameters are applicable in most cases, obtaining satisfactory results both in patients with flatness and supraumbilical abdominal lipodystrophy and patients with an "apron" abdomen with considerable flaccidity and diastasis of the abdominal rectus. Conclusion: It is important to determine the area of the abdominal defect and its classification to establish treatment strategies and association with complementary procedures. A lower marking with respect to the treatment areas will allow a more aesthetic scar and a harmonic body contour as well as an adequate placement of the umbilical scar, pubis, and lateral ends of the transverse abdominal scar.

Visceral fat, physical fitness and biochemical markers of brazilian military personnel / Gordura visceral, aptidão física e marcadores bioquímicos de militares brasileiros / Grasa visceral, aptitud física y marcadores bioquímicos de militares brasileños

ABSTRACT Introduction: Adipocyte volume (fat accumulation) in different parts of the body may play different roles in the metabolism and in the appearance of cardiovascular risk factors. Most studies indicate that the regional distribution of body fat seems to be more important than excess adiposity per se. High levels of physical activity are associated with lower total and visceral body fat levels. Military physical training is of paramount importance for the health and performance of soldiers in the Brazilian Army. In this context, physical evaluation will provide data on the main physical benefits involved in military tasks. Objective: Verify the relationship between visceral fat (VF), physical performance and biochemical markers of soldiers in the Brazilian Army. Methods: The sample consisted of 41 (38.9 ± 2.2 years) Brazilian male military personnel. VF was obtained with a Dual Energy X-Ray Absorptiometry densitometry device. The biochemical analysis included fasting glycemia, triglycerides (TG) and HDL-C levels. Physical performance was evaluated through two tests (12-min run and pull-ups). The Shapiro-Wilk test confirmed the normality of the variables. Pearson's correlation test was then applied, with a p-value of <0.05. Results: Significant negative correlations of VF were found with the results of both physical tests (Pull-ups r = −0.59; 12-min r = −0.61). The only biochemical variable that had a significant positive correlation with VF was TG (r = 0.44). Conclusion: The results of this study showed a significant negative association between VF and physical tests. A significant positive association between VF and TG was also found. Level of Evidence I; Diagnostic studies - Investigation of a diagnostic test.

RESUMO Introdução: O acúmulo de adipócitos em diferentes regiões do corpo pode desempenhar diferentes papéis no metabolismo e no aparecimento de fatores de risco cardiovascular. A maioria dos estudos aponta que a distribuição regional da gordura corporal parece ser mais importante do que o excesso de adiposidade per se. Altos níveis de atividade física estão associados a níveis mais baixos de gordura corporal total e visceral. O treinamento físico militar é de fundamental importância para a saúde e desempenho dos militares do Exército Brasileiro, neste sentido a avaliação física fornecerá dados referentes aos principais benefícios físicos envolvidos nas tarefas militares. Objetivo: Verificar a relação entre a gordura visceral (GV), o desempenho físico e os marcadores bioquímicos de militares do Exército Brasileiro. Método: A amostra foi composta por 41(38,9± 2,2 anos) militares brasileiros, do sexo masculino. A GV foi obtida através de um aparelho de densitometria "Dual Energy X-Ray Absorptiometry". A análise bioquímica incluiu as dosagens em jejum da glicemia, de triglicerídeos (TG) e HDL-C. O desempenho físico foi avaliado por meio de dois testes (corrida de 12 min e flexão de braços na barra fixa). O teste de Shapiro-Wilk confirmou a normalidade das variáveis. Na sequência foi aplicado o teste de correlação de Pearson, com valor de p < 0,05. Resultados: Foram encontradas correlações negativas e significativas da GV, com o resultado dos dois testes físicos (Barra r = - 0,59; Teste de 12 min r = - 0,61). A única variável bioquímica que apresentou correlação positiva significativa com a GV foi TG (r = 0,44). Conclusão: Os resultados do presente estudo mostraram haver associação negativa significativa entre a GV e os testes físicos. Além disso, encontrou-se uma associação positiva significativa entre a GV e os TG. Nível de Evidência I; Estudos diagnósticos-Investigação de um exame para diagnóstico.

RESUMEN Introducción: La acumulación de adipocitos en diferentes regiones del cuerpo puede desempeñar papeles diferentes en el metabolismo y la aparición de factores de riesgo cardiovascular. La mayoría de los estudios indica que la distribución regional de la grasa corporal parece ser más importante que el exceso de adiposidad per se. Altos niveles de actividad física están asociados a niveles más bajos de grasa corporal total y visceral. El entrenamiento físico militar es de fundamental importancia para la salud y el desempeño de los militares del Ejército Brasileño, en este sentido la evaluación física proporcionará datos referentes a los principales beneficios físicos involucrados en las tareas militares. Objetivo: Verificar la relación entre la grasa visceral (GV), el desempeño físico y los marcadores bioquímicos de militares del Ejército Brasileño. Método: La muestra fue compuesta por 41 (38,9 ± 2,2 años) militares brasileños, del sexo masculino. La GV fue obtenida a través de un aparato de densitometría "Dual Energy X-Ray Absorptiometry". El análisis bioquímico incluyó las dosificaciones en ayuno de glucemia, de triglicéridos (TG) y del HDL-C. El desempeño físico fue evaluado por medio de dos tests (carrera de 12 minutos y flexión de brazos en la barra fija). El test de Shapiro-Wilk confirmó la normalidad de las variables. A continuación, fue aplicado el test de correlación de Pearson con valor de p <0,05. Resultados: Se encontraron correlaciones negativas y significativas de la GV, con el resultado de los dos tests físicos (Barra r = - 0,59; 12 min r = - 0,61). La única variable bioquímica que presentó una correlación positiva significativa con la GV fue TG (r = 0,44). Conclusión: Los resultados del presente estudio mostraron que hay una asociación negativa significativa entre la GV y los tests físicos. Además, se encontró una asociación positiva significativa entre GV y los TG. Nivel de evidencia I; Estudios diagnósticos-Investigación de un examen para diagnóstico.

Visceral-to-Subcutaneous Abdominal Fat Ratio Is Associated with Nonalcoholic Fatty Liver Disease and Liver Fibrosis

BACKGROUND: We evaluated the association of visceral-to-subcutaneous fat ratio (VSR) with nonalcoholic fatty liver disease (NAFLD) and advanced fibrosis degree based on noninvasive serum fibrosis markers in the general population with NAFLD.METHODS: This is a cross-sectional study, in 7,465 Korean adults who underwent health screening examinations. NAFLD was defined as fatty liver detected on ultrasonography, and visceral and subcutaneous abdominal fat was measured using computed tomography. We predicted fibrosis based on the fibrosis-4 (FIB-4) score and aspartate aminotransferase-to-platelet ratio index (APRI) and categorized the risk for advanced fibrosis as low, indeterminate, or high.RESULTS: The multivariable-adjusted prevalence ratios for indeterminate to high risk of advanced fibrosis based on FIB-4, determined by comparing the second, third, and fourth quartiles with the first quartile of VSR, were 3.38 (95% confidence interval [CI], 0.64 to 17.97), 9.41 (95% CI, 1.97 to 45.01), and 19.34 (95% CI, 4.06 to 92.18), respectively. The multivariable-adjusted prevalence ratios for intermediate to high degree of fibrosis according to APRI also increased across VSR quartiles (5.04 [95% CI, 2.65 to 9.59], 7.51 [95% CI, 3.91 to 14.42], and 19.55 [95% CI, 9.97 to 38.34], respectively). High VSR was more strongly associated with the prevalence of NAFLD in nonobese subjects than in obese subjects, and the associations between VSR and intermediate to high probability of advanced fibrosis in NAFLD were stronger in obese subjects than in nonobese subjects.CONCLUSION: High VSR values predicted increased NAFLD risk and advanced fibrosis risk with NAFLD, and the predictive value of VSR for indeterminate to high risk of advanced fibrosis was higher in obese subjects than in nonobese subjects.

Valor de corte del índice cintura/cadera como predictor independiente de disglucemias / Cutoff value of the waist-hip ratio as an independent predictor of dysglycemia

RESUMEN Introducción: En Cuba, no existe consenso acerca de qué valor del índice cintura/cadera debe ser considerado de riesgo para identificar disglucemias. Objetivos: Determinar el punto de corte del índice cintura/cadera como predictor de disglucemias para ambos sexos, en personas con sospecha de padecer diabetes mellitus. Métodos: Estudio descriptivo transversal con 975 personas, de ellas 523 mujeres y 452 hombres. La muestra no fue obtenida de población general y no fue aleatoria. A los sujetos se les realizó interrogatorio, examen físico y estudios complementarios. Se determinaron distribuciones de frecuencia de las variables cualitativas y cuantitativas. Se utilizó para el procesamiento estadístico el coeficiente de correlación de Pearson, análisis de regresión logística y el análisis de curvas Receiver Operator Characteristic. Se empleó la prueba Chi Cuadrado para evaluar la significación estadística. Resultados: En ambos sexos observamos una correlación directamente proporcional y significativa entre el índice cintura/cadera y las diferentes variables estudiadas, entre ellas: glucemia en ayunas y a las 2h, insulinemia en ayunas, triglicéridos, ácido úrico y el índice de resistencia a la insulina (HOMA-IR). El colesterol se comportó de la misma forma en los hombres, pero en las mujeres se verificó una correlación débil y no significativa. El punto de corte óptimo del índice cintura/cadera, como predictor independiente de disglucemias, fue de 0,85 en las mujeres y 0,93 en los hombres. El índice cintura/cadera presentó un buen poder predictivo para identificar a sujetos con y sin disglucemias para ambos sexos y superior al de la edad. Conclusiones: El punto de corte óptimo del índice cintura/cadera, como predictor independiente de disglucemias, es de 0,85 en las mujeres y 0,93 en los hombres. Su poder predictor de disglucemias fue bueno(AU)

ABSTRACT Introduction: In Cuba, there is no consensus about what value of the waist-hip ratio must be considered as a risk to identify dysglycemia. Objectives: To determine the cut-off point of the waist-hip ratio as a predictor of dysglycemias for both sexes, in people suspected of suffering from diabetes mellitus. Methods: Descriptive cross-sectional study with 975 people, including 523 women and 452 men. The sample was not obtained from general population and it was not random. The subjects underwent interrogation, physical examination and complementary studies. There were identified frequency distributions of qualitative and quantitative variables. It was used for the statistical processing the Pearson's correlation coefficient, logistic regression analysis and the curves analysis called Receiver Operator Characteristic. It was used the chi-square test to assess the statistical significance. Results: In both sexes, it was observed a directly proportional and significant correlation between the waist-hip ratio and the different variables studied, including: fasting and after 2 hours glycemia, fasting insulinemia, triglycerides, uric acid and the insulin resistance index (HOMA-IR). Cholesterol behaved the same way in men, but in women there was a weak and not significant correlation. The optimal cut-point of the waist-hip ratio, as an independent predictor of dysglycemia, was 0.85 in women and 0.93 in men. The waist-hip ratio presented a good predictive power to identify subjects with and without dysglycemia for both sexes and it was higher than that of the age. Conclusions: The optimal cut-point of the waist-hip ratio, as an independent predictor of dysglycemia, was 0.85 in women and 0.93 in men. Its power as predictor of dysglycemia was good(AU)

Comparison of different criteria in the prevalence of metabolic syndrome in students from paranavaí, paraná / Comparação de diferentes critérios na prevalência de síndrome metabólica em escolares de paranavaí, paraná

ABSTRACT Objective: To investigate the difference in the proportion of students with metabolic syndrome, diagnosed according to different criteria. Methods: The sample consisted of 241 students (136 boys and 105 girls) aged 10 to 14 years, from public and private schools in Paranavaí, Paraná. We used three distinct diagnostic criteria for metabolic syndrome, considering the presence of at least three of the following risk factors: increased waist circumference, hypertension, fasting hyperglycemia, low HDL-C, and elevated triglycerides. Results: The prevalence of metabolic syndrome found was 1.7% (confidence interval of 95% - 95%CI 0-3.3) for the IDF criterion; 3.3% (95%CI 1.0-5.6) for Cook; and 17.4% (95%CI 12.6-22.3) for Ferranti. Analyzing the criteria in pairs, the agreement between IDF and Cook was 97.5% (k=0.95); between IDF and Ferranti, 83.4% (k=0.67); and between Cook and Ferranti, 85.9% (k=0.72). Onlyone student (0.4%) was diagnosed with metabolic syndrome solely by the IDF criterion, while 34 (14.1%) were diagnosed exclusively by Ferranti. The comparison of the three criteria showed that Ferranti presented the highest proportion of metabolic syndrome (p<0.001), and Cook had a greater proportion than IDF (p<0.001). Conclusions: We found a significant difference in the proportion of metabolic syndrome in the three criteria. The choice of which criterion to use can compromise not only the percentage of metabolic syndrome prevalence but also interfere in strategies of intervention and prevention in children and adolescents with and without metabolic syndrome, respectively.

RESUMO Objetivo: Investigar a diferença na proporção de escolares com síndrome metabólica diagnosticada segundo diferentes critérios. Métodos: Duzentos e quarenta e um escolares (136 meninos e 105meninas), com idade entre dez e 14 anos, das redes pública e privada de Paranavaí, Paraná. Foram utilizados três diferentes critérios para o diagnóstico da síndrome metabólica, considerando a presença de, ao menos, três dos seguintes fatores de risco: circunferência de cintura aumentada, hipertensão arterial, hiperglicemia em jejum, baixo nível de HDL-C e triglicerídeos elevado. Resultados: A prevalência de síndrome metabólica encontrada foi de 1,7% (intervalo de confiança de 95% - IC95% 0-3,3), para o critério de IDF; 3,3% (IC95% 1,0-5,6) em Cook; e 17,4% (IC95% 12,6-22,3) em Ferranti. Na verificação dos critérios em pares, a concordância entre IDF e Cook foi de 97,5% (k=0,95); entre IDF e Ferranti, 83,4% (k=0,67); e entre Cook e Ferranti, 85,9% (k=0,72). Em apenas um aluno (0,4%) a síndrome metabólica foi diagnosticada exclusivamente pelo critério de IDF, e em 34 alunos (14,1%), pelo critério de Ferranti. A comparação entre os três critérios mostrou que o de Ferranti apresentou maior proporção de síndrome metabólica que os demais (p<0,001), e o de Cook maior proporção em relação ao da IDF (p<0,001). Conclusões: Houve diferença significante na proporção de síndrome metabólica nos três critérios. A escolha do critério a ser utilizado pode comprometer não apenas o percentual de prevalência de síndrome metabólica, mas também atrapalhar as estratégias de prevenção e intervenção em crianças e adolescentes com e sem síndrome metabólica, respectivamente.

Lipoaspiração de definição abdominal / Abdominal etching

Introdução: A lipoaspiração de definição abdominal consiste na criação de sulcos em locais específicos do abdome através da retirada de gordura em toda sua espessura, incluindo a camada superficial, permitindo um maior detalhamento da musculatura. O objetivo deste estudo foi avaliar os resultados da técnica de lipoaspiração na definição abdominal. Métodos: Foram avaliadas 80 pacientes do sexo feminino no período de 2017 a 2018. O grau de definição e as complicações relacionadas ao procedimento foram avaliadas pelo autor. Todas as pacientes responderam um questionário padrão sobre grau de definição abdominal, satisfação, naturalidade do resultado, aumento da atividade física e melhora da alimentação. Resultados: A média de idade das pacientes foi de 38,97 anos e a média de índice de massa corporal, 24,01. Gestação prévia foi observada em 75% dos casos, cirurgia abdominal pregressa em 25% e tabagismo em 2,5%. Cirurgias simultâneas foram realizadas em 90%. Em relação ao tipo de cirurgia realizada, ocorreu a seguinte distribuição: 40% lipoaspiração isolada, 36,25% lipoabdominoplastia, 12,5% minilipoabdominoplastia, 10% lipoaspiração pós-abdominoplastia e 1,25% lipoabdominoplastia reversa. Grau 2 de definição abdominal foi observado em 86,25% e complicações ocorreram em 8 pacientes. O índice de satisfação foi de 91,7% e o resultado foi classificado como natural por 97,5% das pacientes. Conclusão: A lipoaspiração de definição abdominal promoveu um alto índice de satisfação e naturalidade à região abdominal. Esse resultado pode ser atingido através da técnica de lipoaspiração convencional, sem nenhum dispositivo tecnológico adicional. Contudo, são necessários novos estudos para avaliação dos resultados em longo prazo.

Introduction: Abdominal etching involves improvement of the appearance of the abdominal musculature by removing fat from several skin layers, including the superficial layer. This study evaluated the aesthetic results of abdominal etching using liposuction. Methods: The aesthetic results and surgical complications of female patients were evaluated between 2017 and 2018. All study patients answered a standard questionnaire about the extent of improvement in body image, overall satisfaction level, naturalness of the result, and changes in exercise and dietary habits. Results: The mean patient age was 38.97 years, while the mean body mass index was 24.01. In our sample, 75% of the subjects had previous pregnancies, 25% had previous abdominal surgeries, and 2.5% had a history of smoking. Simultaneous surgeries were performed in 90% of cases. The following surgery types were performed: liposuction alone (40.00%), liposuction + abdominoplasty (36.25%), miniabdominoplasty (12.50%), abdominoplasty + liposuction (10.00%), and reverse abdominoplasty (1.25%). Moderate aesthetic improvement was observed in 86.25% of the patients, and surgical complications occurred in eight patients. The satisfaction rate was 91.7%, and the result was classified as natural by 97.5% of the patients. Conclusion: Abdominal etching promoted high patient satisfaction and achieved a natural appearance of the abdomen. This surgical outcome was achieved using conventional liposuction without the need for additional techniques. However, further studies are needed to evaluate long-term outcomes.