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J. pediatr. (Rio J.) ; 98(1): 53-59, Jan.-Feb. 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1360559


Abstract Objective: To investigate the association between oral contraceptive use and cardiovascular risks, including metabolic syndrome and their components in Brazilian adolescents. Method: This study used data from the Study of Cardiovascular Risks in Adolescents (Estudo de Riscos Cardiovasculares em Adolescentes - ERICA), a nationwide, cross-sectional, school-based study with individuals aged 12-17 years. Sociodemographic variables and OC use were assessed by a self-administered questionnaire. International Diabetes Federation criteria were used to define metabolic syndrome. Descriptive statistics were reported as prevalence and their respective confidence interval of 95% of oral contraceptives according to variables. Logistic regression was performed. Crude and adjusted odds ratios were calculated. Results: This subsample was composed of 22,682 female adolescents, of which 12.65% reported using oral contraceptives and their use was associated with hypertension and hypertriglyceridemia. These associations remained statistically significant after adjusting for age, school region, race, and tobacco use with an increase of 2.68 (1.66 - 4.32) and 3.45 (2.56 - 4.65) times, respectively. Conclusion: The present study was the first to examine the association between the use of oral contraceptives and cardiovascular risk factors among the largest number of female Brazilian adolescents. This method was significantly associated with hypertension, hypertriglyceridemia. Teenagers using oral contraceptives should be monitored for side effects, including blood pressure measurements and advised to avoid smoking.

An. bras. dermatol ; 97(1): 28-36, Jan.-Feb. 2022. tab, graf
Article in English | LILACS | ID: biblio-1360088


Abstract Background: Vitiligo is an acquired and progressive mucocutaneous disease resulting from the loss of active epidermal melanocytes. Metabolic syndrome (MetS) affects about 25% of the world's population and is linked to inflammatory skin diseases including vitiligo. Fatty AcidBinding Protein 4 (FABP4) is an intracellular lipid chaperone. FABP4 is closely associated with MetS. Objectives: To evaluate the serum level of FABP4 in vitiligo patients and its relation to MetS in the investigated cases. Methods: This case control study was conducted on 45 patients having non segmental vitiligo and 45 matched controls. Their lipid profile, blood glucose and serum FABP4 levels were measured. Results: There were significant elevations in FABP4 (p < 0.001), cholesterol (p < 0.001), triglycerides (p = 0.005), and glucose (fasting [p = 0.001] and 2 hours post prandial [p < 0.001]) levels in patients in comparison with controls. MetS was significantly more prevalent among vitiligo patients (p < 0.001) and associated with high FABP4 serum levels (p = 0.037). In vitiligo patients, there were significant positive correlations between FABP4 serum levels and triglycerides (p = 0.047), cholesterol (p = 0.001) and LDL (p = 0.001) levels and negative correlation regarding HDL level (p = 0.009). FABP4 level was a significantly good diagnostic test for early detection of vitiligo (p < 0.001). Study limitations: The small number of studied subjects. Conclusions: FABP4 may play an active role in the disease process of vitiligo that could be mediated through associated dyslipidemia and hyperglycemia. FABP4 may be a marker of vitiligo helping in its early diagnosis, but it does not appear to be useful for determining vitiligo severity, activity or associated MetS.

Humans , Metabolic Syndrome , Fatty Acid-Binding Proteins/blood , Triglycerides , Vitiligo , Case-Control Studies
Rev. Assoc. Med. Bras. (1992) ; 68(2): 250-255, Feb. 2022. tab, graf
Article in English | LILACS | ID: biblio-1365337


SUMMARY OBJECTIVE: The metabolic syndrome involves both metabolic and cardiovascular risk factors and is associated with cardiovascular mortality. Epicardial fat tissue plays a crucial role in deleterious effects of metabolic syndrome on the heart, including myocardial fibrosis. The fragmented QRS reflects heterogeneous depolarization of the myocardium and occurs as a result of fibrosis. Thus, we aimed to investigate whether there is an association between fragmented QRS and epicardial fat tissue in patients with metabolic syndrome. METHODS: This study enrolled 140 metabolic syndrome patients, of whom 35 patients with fragmented QRS (+) and 105 patients with fragmented QRS (−). The two groups were compared with respect to clinical, laboratory, electrocardiographic, and echocardiographic indexes. RESULTS: Fragmented QRS (+) patients had higher waist circumference, red cell distribution width, creatinine, left ventricular end-systolic diameter, left atrium diameter, septal a velocity, QRS duration, and epicardial fat tissue compared with fragmented QRS (−) patients. Waist circumference, red cell distribution width, QRS duration, left ventricular end-systolic diameter, left atrium diameter, septal a velocity, and epicardial fat tissue were significantly associated with the presence of fragmented QRS. The QRS duration and epicardial fat tissue were independently associated with the presence of fragmented QRS on surface electrocardiographic in metabolic syndrome patients. CONCLUSIONS: Epicardial fat tissue and QRS duration were independently associated with the presence of fragmented QRS. Basic echocardiographic and electrocardiographic parameters might be used for the risk stratification in metabolic syndrome patients.

Humans , Metabolic Syndrome/complications , Echocardiography , Adipose Tissue/diagnostic imaging , Electrocardiography/methods , Waist Circumference
Arq. bras. cardiol ; 118(1): 33-40, jan. 2022. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1360114


Resumo Fundamento A ação do peptídeo natriurético atrial (ANP) na natriurese, diurese e vasodilatação, resistência à insulina, fígado, rim e tecido adiposo pode contribuir para o desenvolvimento metabólico e cardiovascular saudável. Embora o nível circulante de ANP seja reduzido em pacientes com obesidade, sua resposta à perda de peso ainda é pouco explorada em populações pediátricas. Objetivo Avaliar os efeitos das variações do ANP em resposta à intervenção interdisciplinar para perda de peso na Síndrome Metabólica (SMet) e nos riscos cardiometabólicos em adolescentes com obesidade. Métodos 73 adolescentes com obesidade participaram de uma terapia interdisciplinar para perda de peso de 20 semanas, incluindo uma abordagem clínica, nutricional, psicológica e de exercícios físicos. A composição corporal, análises bioquímicas e pressão sanguínea foram avaliadas. A SMet foi classificada de acordo com a Federação Internacional de Diabetes (IDF) (2007). Após o tratamento, os voluntários foram divididos de acordo com os níveis de plasma do ANP aumento (n=31) ou ANP redução (n=19). Resultados Ambos os grupos apresentaram redução significativa de peso corporal, índice de massa corporal (IMC) e circunferências de cintura, pescoço e quadril (CC, CP e CQ, respectivamente), e aumento da massa livre de gordura (MLG). É interessante observar que houve uma redução significativa na gordura corporal, na razão de TG/HDL-c e na prevalência de SMet (de 23% para 6%) somente no grupo com ANP aumento. Conclusão Este estudo sugere que o aumento nos níveis séricos de ANP após a terapia para perda de peso pode estar associado a melhorias nos riscos cardiometabólicos e na prevalência reduzida de SMet em adolescentes com obesidade.

Abstract Background The action of atrial natriuretic peptide (ANP) on natriuresis, diuresis and vasodilatation, insulin resistance, liver, kidney, and adipose tissue may contribute to the healthy metabolic and cardiovascular development. Even though the circulating level of ANP is reduced in patients with obesity, its response to weight loss remains poorly explored in pediatric populations. Objective To evaluate the effects of ANP variations in response to interdisciplinary weight loss intervention on metabolic syndrome (MetS) and cardiometabolic risks in adolescents with obesity. Methods 73 adolescents with obesity attended a 20-week clinical interdisciplinary weight loss therapy including clinical, nutritional, psychological and exercise training approach. Body composition, biochemical analyses and blood pressure were evaluated. MetS was classified according to the International Diabetes Federation (IDF) (2007). After the treatment, volunteers were divided according to Increasing (n=31) or Decreasing (n=19) ANP plasma levels. Results Both groups present significant reduction of body weight, Body Mass Index (BMI), waist, neck and hip circumferences (WC, NC and HC, respectively) and increasing fat-free mass (FFM). Interestingly, a significant reduction in body fat, TG/HDL-c ratio and MetS prevalence (from 23% to 6%) was observed in the Increased ANP group only. Conclusion This study suggests that an increase in ANP serum levels after weight loss therapy could be associated with improvements in cardiometabolic risks and the reduced prevalence of MetS in adolescents with obesity.

Humans , Child , Adolescent , Cardiovascular Diseases/etiology , Cardiovascular Diseases/prevention & control , Metabolic Syndrome/epidemiology , Pediatric Obesity/therapy , Body Composition , Weight Loss/physiology , Body Mass Index , Atrial Natriuretic Factor/metabolism
Ciênc. Saúde Colet ; 27(2): 783-792, Fev. 2022. tab
Article in English | LILACS | ID: biblio-1356082


Abstract Our aim was to analyze the joint association of parental characteristics and offspring obesity indicators with metabolic risk in adolescents. A cross-sectional study was carried out with 972 adolescents and their parents. We observed that overweight adolescents who have a normal weight mother show lower metabolic risk in comparison with their counterparts with overweight mothers. In conclusion, mother's weight status moderates the relationship between offspring' obesity indicators and metabolic risk in adolescents.

Resumo Nosso objetivo foi analisar a associação combinada entre características dos pais e indicadores de adiposidade dos filhos com o risco metabólico em adolescentes. Foi realizado estudo transversal com 972 adolescentes e seus pais. Observamos que adolescentes com sobrepeso que possuem mãe com peso normal apresentaram menor risco metabólico em comparação com seus pares com mães que apresentam sobrepeso. Concluímos que o status de peso da mãe modera a relação entre indicadores de obesidade e risco metabólico dos adolescentes.

Humans , Female , Adolescent , Overweight/epidemiology , Obesity/epidemiology , Parents , Exercise , Body Mass Index , Cross-Sectional Studies , Risk Factors
Rev. bras. cineantropom. desempenho hum ; 24: e83146, 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1360839


Abstract As obesity has reached epidemic proportions and given the current recognition of central adiposity as an important cardiometabolic risk factor, several researchers have focused on developing and validating predictive indexes and equations to evaluate Visceral Adipose Tissue (VAT). This study evaluates the applicability of the Visceral Adiposity Index (VAI) for predicting cardiometabolic risk in individuals treated in a hospital In the northeast region of Brazil. The VAT was evaluated by computed tomography (CT) and the VAI was calculated through specific equations for each gender. The sample involved adult and elderly patients of both genders followed up in a cardiology outpatient clinic. The following cardiometabolic parameters were collected: fasting glycemia, glycated hemoglobin, lipid profile, C-reactive protein (CRP) and uric acid. The simple linear regression was used to evaluate the explanatory power of the VAI in relation to the volume of VAT determined by CT. The predictive capacity of VAI in relation to the volume of VAT determined by CT was 25.8% (p=0.004) for males and 19.9% (p<0.001) for females. VAI correlated strongly with the triglyceride (TG) (p<0.001) and TG/high-density lipoprotein (HDL) ratio (p<0.001) and inversely correlated with HDL (p<0.001). Moreover, VAI showed low correlation with the following variables: abdominal circumference, total cholesterol, low density lipoprotein, fasting glycemia, and glycated hemoglobin (p<0.05). VAI was associated with variables considered as cardiometabolic risk factors, but exhibited a low predictive capacity regarding the volume of VAT determined by CT. Thus, caution is recommended in its use in Brazilian individuals.

Resumo Em razão de a obesidade ter alcançado proporções epidêmicas e dado ao atual reconhecimento da adiposidade central como um importante fator de risco cardiometabólico, diversos pesquisadores têm se dedicado em desenvolver e validar índices e equações preditivas para avaliar o Tecido Adiposo Visceral (TAV). Este estudo avaliou a aplicabilidade do Índice de Adiposidade Visceral (IAV) como preditor de risco cardiometabólico em indivíduos atendidos em um hospital no nordeste brasileiro. O TAV foi avaliado por tomografia computadorizada (TC) e o IAV foi calculado através de equações específicas para cada sexo. A amostra envolveu pacientes adultos e idosos de ambos os sexos acompanhados no ambulatório de cardiologia. Os seguintes parâmetros cardiometabólicos foram coletados: glicemia de jejum, hemoglobina glicada, perfil lipídico, proteína C-reativa e ácido úrico. Regressão linear simples foi empregada para avaliar o poder explicativo do IAV em relação ao volume de TAV determinado por TC. A capacidade preditiva do IAV em relação ao volume de TAV determinado pela TC foi de 25,8% (p=0,004) para o sexo masculino e 19,9% (p<0,001) para o sexo feminino. O IAV se correlacionou fortemente com as variáveis TG (r=0,916, p< 0,001) e TG/HDL (r=0,952, p<0,001) e inversamente com o HDL (r=-0,441, p<0,001), além disso, apresentou baixa correlação com as variáveis: circunferência abdominal, colesterol total, lipoproteína de baixa densidade, glicemia de jejum e hemoglobina glicada (p<0,05). O IAV associou-se com variáveis consideradas fatores de risco cardiometabólico, porém exibiu baixa capacidade preditiva em relação ao volume de TAV determinado pela TC, sendo recomendada cautela em sua utilização em indivíduos brasileiros.

Acta Paul. Enferm. (Online) ; 35: eAPE02982, 2022. tab, graf
Article in Portuguese | LILACS, BDENF | ID: biblio-1364227


Resumo Objetivo Avaliar a efetividade de um programa educativo de promoção à saúde na melhora dos domínios da qualidade de vida e no conhecimento da síndrome metabólica. Métodos Ensaio clínico não-randomizado incluindo 61 adultos com síndrome metabólica (49±7,6 anos). Os participantes foram intencionalmente alocados em dois grupos: intervenção (n=31) e controle (n=30). O desfecho primário foi a mudança do conhecimento sobre síndrome metabólica e seus fatores de risco, e o secundário, a melhora da qualidade de vida (SF-36) avaliados em dois momentos, na condição basal e ao final da intervenção (seis meses). Foram utilizados os testes U de Mann Whitney e Wilcoxon, adotando-se nível de significância de 5%. Resultados O programa educativo melhorou o domínio de dor corporal da qualidade de vida no grupo intervenção (p=0,01), embora sem diferença estatística entre os grupos. O conhecimento sobre hipertensão e diabetes (p=0,02), síndrome metabólica (p<0,001) e conhecimento geral (p<0,001) apresentaram aumento significativo no grupo intervenção aos seis meses, o que não ocorreu no grupo controle. Conclusão O programa educativo pode ser uma estratégia efetiva para melhorar a qualidade de vida com destaque para o domínio de dor corporal e aumentar o conhecimento da síndrome metabólica em adultos com a síndrome.

Resumen Objetivo Evaluar la efectividad de un programa educativo de promoción de la salud en la mejora de los dominios de calidad de vida y en los conocimientos del síndrome metabólico. Métodos Ensayo clínico no aleatorizado, que incluyó 61 adultos con síndrome metabólico (49±7,6 años). Los participantes fueron intencionalmente separados en dos grupos: experimental (n=31) y de control (n=30). El criterio principal de valoración fue el cambio de conocimientos sobre síndrome metabólico y sus factores de riesgo, y el secundario, la mejora de la calidad de vida (SF-36), evaluados en dos momentos: en condición basal y al final de la intervención (seis meses). Se utilizaron las pruebas U de Mann-Whitney y de Wilcoxon y se adoptó un nivel de significación de 5 %. Resultados El programa educativo mejoró el dominio de dolor corporal de la calidad de vida en el grupo experimental (p=0,01), aunque no hubo diferencia estadística entre los grupos. Los conocimientos sobre hipertensión y diabetes (p=0,02), síndrome metabólico (p<0,001) y conocimientos generales (p<0,001) presentaron aumento significativo en el grupo experimental a los seis meses, lo que no ocurrió en el grupo de control. Conclusión El programa educativo puede ser una estrategia efectiva para mejorar la calidad de vida, con énfasis en el dominio de dolor corporal, y aumentar los conocimientos sobre el síndrome metabólico en adultos con el síndrome. Registro de Ensaio Clínico Brasileiro (REBEC): RBR-43K52N

Abstract Objective To assess the effectiveness of an educational health promotion program in improving quality of life and knowledge domains of metabolic syndrome. Methods This is a non-randomized clinical trial including 61 adults with metabolic syndrome (49±7.6 years). Participants were intentionally divided into two groups: intervention (n=31) and control (n=30). The primary outcome was the change in knowledge about metabolic syndrome and its risk factors, and the secondary, the improvement in quality of life (SF-36) assessed in two moments, at baseline and at the end of intervention (six months). Mann Whitney and Wilcoxon U tests were used, adopting a significance level of 5%. Results The educational program improved the body ache domain of quality of life in the intervention group (p=0.01), although with no statistical difference between the groups. Knowledge about hypertension and diabetes (p=0.02), metabolic syndrome (p<0.001) and general knowledge (p<0.001) showed a significant increase in the intervention group at six months, which did not occur in the control group. Conclusion The educational program can be an effective strategy to improve quality of life, highlighting the domain of body ache and increasing knowledge of metabolic syndrome in adults with the syndrome.

Humans , Male , Female , Adolescent , Adult , Middle Aged , Quality of Life , Patient Education as Topic/methods , Knowledge , Metabolic Syndrome/prevention & control , Risk Factors
Rev. Univ. Ind. Santander, Salud ; 53: e320, dic. 2021. tab, graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1365450


Resumen Introducción: Es importante identificar los polimorfismos de interés clínico en patologías complejas como el Síndrome Metabólico. Por esto, las metodologías para su evaluación deben estar diseñadas y validadas correctamente, esto permite optimizar recursos y tiempo en la genotipificación y detección correcta de los alelos presentes en los individuos. Objetivo: Diseñar y validar una PCR múltiple, seguida de detección por minisecuenciación, para la genotipificación de ocho polimorfismos de nucleótido simple ubicados en el gen del Receptor Beta 3-Adrenérgico (rs4994 y rs4998), gen de la Apolipoproteina A5 (rs3135506 y rs2075291), gen de la Adiponectina (rs1501299 y rs2241766) y gen del Receptor Activador de la Proliferación de los Peroxisomas tipo gamma (rs1801282 y rs1800571), asociados con el síndrome metabólico. Materiales y métodos: Se diseñaron 24 cebadores para la amplificación y detección de ocho polimorfismos de nucleótido sencillo ubicados en cuatro genes candidatos a estar asociados con el síndrome metabólico, usando el software Primer3®. Dieciséis fueron diseñados para amplificar los polimorfismos y ocho para detectarlos por minisecuenciación. Las estructuras secundarias entre los cebadores se verificaron con el software Autodimer. Los polimorfismos se amplificaron simultáneamente y los fragmentos amplificados se acoplaron a las sondas diseñadas para detectar por minisecuenciación el alelo presente, por medio de bases marcadas con fluorocromos. Finalmente, los alelos fueron detectados por electroforesis capilar en un analizador genético ABI 310 y se interpretaron con el software GeneMapper®. La validación del multiplex se realizó genotipando 20 muestras de individuos, cada uno de ellos autorizó este procedimiento por medio del consentimiento informado. Resultados: Se obtuvieron los perfiles genéticos de los 20 controles genotipados, a partir de la amplificación múltiple, seguida de minisecuenciación, diseñada y validada para detectar los ocho polimorfismos. Conclusión: Se diseñó y validó un ensayo para la detección simultánea de los polimorfismos, ubicados en cuatro genes asociados con el Síndrome metabólico. Los cuales pueden ser empleados como referencia para futuros estudios poblacionales.

Abstract Introduction: It is important to identify the polymorphisms of clinical interest in complex pathologies such as Metabolic Syndrome. Therefore, the methodologies for its evaluation must be designed and validated correctly, this permits optimization of resources and time in genotyping and correct detection of the alleles present in individuals. Objective: To design and validate a multiplex PCR, followed by detection by minisequencing, for the genotyping of eight single nucleotide polymorphisms located in the Beta 3-Adrenergic Receptor gene (rs4994 and rs4998), Apolipoprotein A5 gene (rs3135506 and rs2075291), Adiponectin gene (rs1501299 and rs2241766) and gamma-type Peroxisome Proliferation Activating Receptor gene (rs1801282 and rs1800571), associated with metabolic syndrome. Materials and methods: Twenty-four primers were designed for the amplification and detection of eight single nucleotide polymorphisms located in four candidate genes to be associated with the metabolic syndrome, using the Primer3® software. Sixteen were designed to amplify the polymorphisms and eight to detect them by minisequencing. The secondary structures between the primers were verified with Autodimer software. The polymorphisms were simultaneously amplified, and the amplified fragments were coupled to probes designed to minisequence the present allele using fluorochrome-labeled bases. Finally, the alleles were detected by capillary electrophoresis using an ABI 310 genetic analyzer and analyzed with the GeneMapper® software. The validation of the multiplex was performed by genotyping 20 individual samples, each of them authorized this procedure through informed consent. Results: The genetic profiles of the 20 genotyped controls were obtained, from multiple amplification, followed by minisequencing, designed and validated to detect the eight polymorphisms. Conclusion: An essay was designed and validated for the simultaneous detection of polymorphisms, located in four genes associated with metabolic syndrome, and can used as a reference for future population studies.

Rev. Méd. Inst. Mex. Seguro Soc ; 59(6): 490-499, 01-dic-2021. tab, grap
Article in Spanish | LILACS | ID: biblio-1355275


Introducción: en México existe escasa información respecto al vínculo entre el síndrome metabólico (MetS), el nivel socioeconómico (NSE) y la calidad de vida (CdV) de la población. Objetivo: evaluar la asociación entre sujetos que tienen alto riesgo de desarrollar MetS con NSE y CdV. Métodos: se invitó a participar a pacientes de la UMF-2 del IMSS y del Centro Urbano-SSA Clínica-1. Se recolectaron medidas antropométricas y se aplicaron los cuestionarios AMAI, SF12 y ESF-I para NSE, CdV y MetS, respectivamente. La asociación se determinó calculando rho de Spearman. El riesgo se evaluó mediante regresión logística (razon de momios e intervalo de confianza del 95%). Resultados: la diferencia entre NSE (193  53 frente a 124  50) y CdV (86.3  14.8 frente a 56.0  25.4) fue significativa entre los grupos de bajo y alto riesgo, respectivamente (p < 0.001). Hubo una fuerte correlación negativa entre las puntuaciones de la ESF-I y NSE (rho = -0.623, p < 0.001) así como con la CdV (rho = -0.719, p < 0.001). El riesgo de MetS aumentó al disminuir el NSE (C+: OR = 6.4, IC95%: 3.2 - 13.0; D: OR = 66.1, IC95%: 23.2 - 188.3), mientras que el aumento de la CdV lo atenuó (OR = 0.93, IC95%: 0.91 - 0.94). Interesantemente, la CdV mitigó el efecto del NSE (C+: OR = 4.5, IC95%: 2.1 - 9.6; D: OR = 11.9, IC95%: 3.8 - 37.6). Conclusión: Una menor CdV y NSE aumentan el riesgo de MetS en la región centro de México; sin embargo, el aumento en la CdV podría disminuir el efecto que tiene el NSE en el desarrollo de MetS.

Background: In Mexico there is little information regarding the link between metabolic syndrome (MetS), socioeconomic status (SES) and quality of life (QoL) Objective: To assess the association between subjects who are at high risk of developing MetS with SES and QoL. Methods: Patients attending UMF-2 IMSS or Centro Urbano-SSA Clínica-1 were asked to participate. Anthropometric measures were collected, the AMAI, SF12, and ESF-I questionnaire where apply for SES, QoL, and MetS, respectively. Association were determined by calculating Spearman's rho and the risk (odds ratio and 95% confidence-interval) was assessed using logistic regression. Results: The difference of SES (193  53 vs. 124  50) and QoL (86.3  14.8 vs. 56.025.4) questionnaires were significantly between low-risk and high-risk groups, respectively (p < 0.001). There was a negative correlation between ESF-I and SES (rho = -0.623, p < 0.001) as well as the QoL (rho = -0.719, p < 0.001). MetS risk was augmented by decreasing SES (C+: OR = 6.4, 95%IC: 3.2-13.0; D: OR = 66.1, 95%IC: 23.2-188.3), whereas increasing QoL attenuated it (OR = 0.93, 95%CI: 0.91-0.94). However, QoL mitigated the effect of SES (C+: OR = 4.5, 95%IC: 2.1-9.6; D: OR = 11.9, 95%IC: 3.8-37.6).

Humans , Male , Female , Quality of Life , Risk Groups , Public Health , Metabolic Syndrome , Association , Logistic Models , Mexico
Arch. latinoam. nutr ; 71(4): 300-309, dic. 2021. tab, graf
Article in Spanish | LILACS, LIVECS | ID: biblio-1355226


La administración crónica de cafeína evita la alteración de la glucosa postprandial en ratas. El aumento en el consumo de la cafeína alrededor del mundo no es discutible, es así como su investigación se ha vuelto extensa en sus diferentes campos. Objetivo. Analizar los efectos de la administración crónica de cafeína en ratas alimentadas con dieta de cafetería, a través de evaluar índices de consumo, antropométricos y bioquímicos. Materiales y métodos. La dieta de cafetería es un modelo dietético equivalente a las características de la dieta occidental típica que origina síndrome metabólico en humanos. En esta investigación se realizó la administración crónica vía intraperitoneal de cafeína por ocho semanas a ratas adultas macho Wistar alimentadas con dieta de cafetería. Dada la poca evidencia acerca de los efectos biológicos y comportamentales de la administración crónica de dicha sustancia frente a un modelo de dieta de cafetería se evaluaron parámetros de consumo, antropométricos y bioquímicos. Resultados. La dieta de cafetería ocasionó anomalías asociadas al síndrome metabólico; no obstante, la administración de cafeína en las ratas alimentadas con esa dieta resultó ser un factor protector en la glucosa postprandial, más no en la alteración de la tolerancia a la glucosa o perfil lipídico. Conclusiones. La cafeína permitió proteger los niveles de glucosa postprandial al término del experimento y un descenso en el peso corporal y consumo de alimento solo en la primera semana. Sin embargo, no se observaron mejoras significativas en el perfil de lípidos, adiposidad, tolerancia a la glucosa y glucosa plasmática(AU)

Chronic caffeine administration prevents postprandial glucose disturbance in rats. The increase in caffeine consumption is not debatable, this is how his research has become extensive in his different fields. Objective. To analyze the effects of chronic administration of caffeine in rats fed a cafeteria diet, by evaluating consumption, anthropometric and biochemical indices. Previous studies refer to administering caffeine in diets high in carbohydrates and / or in fat that induce obesity or symptoms of metabolic syndrome. Material and methods. The cafeteria diet is a dietary model equivalent to the characteristics of the typical western diet that causes metabolic syndrome in humans. In this research, chronic intraperitoneal administration of caffeine was performed for 8 weeks to adult male Wistar rats fed a cafeteria diet. Given the little evidence about the biological and behavioral effects of the chronic administration of this substance against a cafeteria diet model, consumption, anthropometric and biochemical parameters were evaluated. Results. After eight weeks it was found that the cafeteria diet given to the controls caused abnormalities associated with the metabolic syndrome; regarding the administration of caffeine in the rats fed this diet, the treatment turned out to be a protective factor in postprandial glucose, but not in the alteration of glucose tolerance or lipid profile. Conclusions. Caffeine allowed to protect postprandial glucose levels at the end of the experiment and a decrease in body weight and food consumption only in the first week. However, no significant improvements were seen in lipid profile, adiposity, glucose tolerance, and plasma glucose(AU)

Animals , Rats , Body Weight , Caffeine/metabolism , Insulin Resistance , Postprandial Period , Reference Parameters , Glucose/analysis , Central Nervous System Stimulants , Adenosine , Rats, Wistar , Metabolic Syndrome , Diabetes Mellitus, Type 2 , Eating , Receptors, Leptin , Obesity
Rev. Ciênc. Méd. Biol. (Impr.) ; 20(3): 441-446, dez 20, 2021. fig, tab
Article in Portuguese | LILACS | ID: biblio-1354290


Introdução: a duração do sono tem sido associada à síndrome metabólica e o principal mediador entre tais fatores parece ser a dieta, pois a ingestão de quilocalorias e macronutrientes pode variar conforme as horas dormidas. Objetivo: avaliar se existe associação entre duração do sono e o consumo de energia e de macronutrientes em indivíduos com síndrome metabólica. Metodologia: trata-se de um estudo retrospectivo, transversal, com dados secundários de prontuários de pacientes adultos, atendidos entre os anos de 013-2020. A duração do sono foi categorizada em: curta para ≤6 horas por noite; adequada para 7-8 horas por noite; e longa para ≥9 horas por noite; já os dados dietéticos foram obtidos por meio da aplicação e cálculo de recordatórios alimentares de 24 horas. Após ajustes para idade e sexo, as variáveis foram avaliadas por meio do teste Qui-Quadrado, sendo considerados significativos valores de p< 0,05. Resultados: das 375 pessoas avaliadas, quase metade relatou uma curta duração de sono; entretanto, não foram encontradas associações estatisticamente significativas entre a duração do sono e o consumo calórico (p=0,957), de carboidratos (p=0,975), proteínas (p=0,865) e lipídios (p=0,382). Discussão: a maior prevalência encontrada de curta duração do sono pode estar associada a algumas características sociodemográficas da população estudada, como o sexo feminino, o sedentarismo, o aumento da idade, a baixa renda e a ocupação ativa no mercado de trabalho. Conclusão: indivíduos com síndrome metabólica parecem ter menor tempo de sono, contudo, a associação do sono com o consumo alimentar ainda requer maiores investigações.

Introduction: Sleep duration has been associated with metabolic syndrome and the main mediator between these factors seems to be diet, as the ingestion of kilocalories and macronutrients can vary according to the hours of sleep. Objective: to assess whether there is an association between sleep duration and energy and macronutrient intake in individuals with metabolic syndrome. Methods: this is a retrospective, cross-sectional study, with secondary data from medical records of adult patients, treated between the years 2013- 2020. Sleep duration was categorized into: short for ≤6 hours per night; suitable for 7-8 hours per night; and long for ≥9 hours per night; dietary data were obtained through the application and calculation of 24-hour dietary recalls. After adjustments for age and sex, the variables were evaluated using the Chi-Square test, with values p<0.05 being considered significant. Results: of the 375 people surveyed, nearly half reported a short sleep duration; however, no statistically significant associations were found between sleep duration and caloric intake (p=0.957), carbohydrates (p=0.975), proteins (p=0.865) and lipids (p=0.382). Discussion: the higher prevalence of short sleep duration found may be associated with some sociodemographic characteristics of the studied population, such as female gender, sedentary lifestyle, increasing age, low income and active occupation in the labor market. Conclusion: Individuals with metabolic syndrome seem to have less sleep time; however, the association of sleep with food consumption still requires further investigation.

Humans , Male , Female , Adult , Middle Aged , Sleep , Energy Intake , Nutrients , Metabolic Syndrome , Cross-Sectional Studies , Retrospective Studies
Rev Bras Hipertens ; 28(4): 261-268, 20211210.
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1367449


As Doenças Cardiovasculares (DCV) são alterações nos vasos sanguíneos decorrentes, principalmente, da aterosclerose, e representam 28% dos óbitos anuais no Brasil. Em 2013, a prevalência de DCV era de 4,2% na população adulta e 11,4% nos idosos. A Síndrome Metabólica (SM), cuja prevalência é estimada entre 25 e 30%, é um dos principais fatores de risco para a instalação das DCV, assim como a Rigidez Arterial (RA), determinada pela Velocidade de Onda de Pulso (VOP) alterada. O Sistema Sphygmocor é utilizado para mensuração da VOP através da razão entre enrijecimento arterial, elasticidade e complacência vascular, considerando valores normais aqueles abaixo de 10m/s. A VOP foi o método de escolha, junto a medidas antropométricas e exames laboratoriais, para avaliar a prevalência de SM e RA numa amostra populacional de Salvador, Bahia. O teste T de Student foi utilizado para comparar as variáveis e o teste Qui Quadrado, para comparar as proporções das variáveis qualitativas. O cálculo das prevalências foi realizado com o número de indivíduos com RA ou SM no numerador e o número total da amostra no denominador, com resultado multiplicado por 102 . O estudo foi aprovado pelo Comitê de Ética em Pesquisa através do parecer número 1.827.621 de 21 de novembro de 2016. A amostra de 162 participantes demonstrou prevalência de 25,93% de Síndrome Metabólica e 26,57% de Rigidez Arterial, expondo a importância de maior atenção à prevenção das DCV na atenção primária à Saúde.

Cardiovascular Diseases (CVD) are modifications in blood vessels resulting mainly from atherosclerosis and represent 28% of annual deaths in Brazil. In 2013, the prevalence of CVD was 4.2% in the adult population and 11.4% in the elderly. Metabolic Syndrome (MS), whose prevalence is estimated between 25 and 30%, is one of the main risk factors for the settlement of CVD, as well as Arterial Stiffness (AS), determined by altered Pulse Wave Velocity (PWV). The Sphygmocor System is used to measure PWV through the ratio between arterial stiffening, elasticity, and vascular complacency, considering normal valor those below 10m/s. PWV was the method of choice, with anthropometric measurements and laboratory tests, to evaluate the prevalence of MS and AS in a population sample from Salvador, Bahia. The Student's T test was used to compare the variables and the Chi Square test to compare the proportions of the qualitative variables. The calculation of prevalence was made with the number of individuals with AS or MS in the numerator and the total number of sample in the denominator, with the result multiplied by 102. The study was approved by the Research Ethics Committee through opinion number 1,827,621 of November 21, 2016. The sample of 162 participants showed a prevalence of 25.93% of Metabolic Syndrome and 26.57% of Arterial Stiffness, exposing the importance of greater attention to the prevention of CVD in primary health care.

Arq. bras. cardiol ; 117(4): 737-747, Oct. 2021. tab, graf
Article in Portuguese | LILACS | ID: biblio-1345234


Resumo Fundamento A síndrome metabólica é caracterizada por um conjunto de comorbidades. Durante a síndrome, observam-se alterações estruturais no sistema cardiovascular, especialmente o remodelamento vascular. Uma das causas predisponentes para essas alterações é a inflamação crônica oriunda de mudanças na estrutura e composição do tecido adiposo perivascular. Atorvastatina é eficaz no tratamento das dislipidemias. No entanto, seus efeitos pleiotrópicos não são totalmente compreendidos. Supõe-se que, durante a síndrome metabólica, ocorre remodelamento vascular e que o tratamento com atorvastatina pode ser capaz de atenuar tal condição. Objetivos Avaliar os efeitos do tratamento com atorvastatina sobre o remodelamento vascular em modelo experimental de síndrome metabólica. Métodos Camundongos Swiss receberam dieta controle ou dieta hiperglicídica por 18 semanas. Após 14 semanas de dieta, os camundongos foram tratados com veículo ou atorvastatina (20mg/kg) durante 4 semanas. Foram avaliados o perfil nutricional e metabólico por testes bioquímicos; análise estrutural da artéria aorta por histologia e dosagem de citocinas por ensaio imunoenzimático. O nível de significância aceitável para os resultados foi p <0,05. Resultados A dieta hiperglicídica promoveu o desenvolvimento de síndrome metabólica. Tal fato culminou no remodelamento hipertrófico do músculo liso vascular e tecido adiposo perivascular. Além disso, houve aumentos das citocinas TNF-α e IL-6 circulantes e no tecido adiposo perivascular. O tratamento com atorvastatina reduziu significativamente os danos metabólicos, o remodelamento vascular e os níveis de citocinas. Conclusão Atorvastatina ameniza danos metabólicos associados à síndrome metabólica induzida por dieta hiperglicídica, além de atenuar o remodelamento vascular, sendo esses efeitos associados à redução de citocinas pró-inflamatórias.

Abstract Background Metabolic syndrome is characterized by an array of comorbidities. During this syndrome, structural changes are observed in the cardiovascular system, especially vascular remodeling. One of the predisposing causes for these changes is chronic inflammation resulting from changes in the structure and composition of perivascular adipose tissue. Atorvastatin is effective in the treatment of dyslipidemias. However, its pleiotropic effects have not been completely understood. We hypothesize that metabolic syndrome may lead to vascular remodeling and that atorvastatin therapy may be able to attenuate this condition. Objectives To assess the effects of atorvastatin therapy on vascular remodeling in an experimental model of metabolic syndrome. Methods Swiss mice received a control diet or a hyperglicemic diet for 18 weeks. After 14 weeks of diet, mice were treated with vehicle or atorvastatin (20mg/kg) during for 4 weeks. Nutritional and metabolic profiles were assessed by biochemical tests; moreover, a histological assessment of aorta structure was conducted, and cytokine levels were determined by the immunoenzyme assay. The acceptable level of significance for the results was set at p<0.05. Results Hyperglicemic diet promoted the development of metabolic syndrome. It indeed culminated in hypertrophic remodeling of vascular smooth muscle and perivascular adipose tissue. Furthermore, there were increases in the levels of circulating TNF-α and IL-6 and in the perivascular adipose tissue. Atorvastatin therapy significantly reduced metabolic damages, vascular remodeling, and cytokine levels. Conclusion Atorvastatin attenuate metabolic damages associated with metabolic syndrome induced by hyperglycemic diet, in addition to attenuating vascular remodeling; both effects are associated with reduced levels of pro-inflammatory cytokines.

Animals , Mice , Metabolic Syndrome/drug therapy , Adipose Tissue , Cytokines , Vascular Remodeling , Atorvastatin/pharmacology
Medisan ; 25(5)2021.
Article in Spanish | LILACS, CUMED | ID: biblio-1346550


Introducción: La COVID-19 es una infección del tracto respiratorio causada por el SARS-CoV-2, que aparece en pacientes con elevado factores de riesgo como el síndrome metabólico. Objetivo: Actualizar los conocimientos sobre la evolución y el pronóstico de pacientes con síndrome metabólico infectados por el nuevo coronavirus. Desarrollo: Las fuentes secundarias y terciarias consultadas explican la relación directa entre los factores de riesgo del síndrome metabólico y las formas graves de la COVID-19, de manera que la evolución clínica y el pronóstico de estos pacientes es muy desfavorable, a pesar de que los protocolos terapéuticos de actuación hoy día se consideran complejos y contextualizados. Conclusiones: La desfavorable evolución clínica de los pacientes con síndrome metabólico infectados por la COVID-19 enmascara su pronóstico, por lo que las estrategias terapéuticas actuales para la atención a estos enfermos no han podido detener el curso progresivo de la enfermedad infecciosa identificada en la comorbilidad metabólica, lo que dificulta la prevención de complicaciones.

Introduction: The COVID-19 is an infection of the respiratory tract caused by the SARS-CoV-2 that appears in patients with high risk factors as the metabolic syndrome. Objective: To update the knowledge on the clinical course and prognosis of patients with metabolic syndrome infected by the new coronavirus. Development: The secondary and tetiary sources consulted explain the direct relationship between the risk factors of the metabolic syndrome and the serious forms of the COVID-19, so that the clinical course and prognosis of these patients is very unfavorable, although the performance therapeutic protocols nowadays are considered complex and contextualized. Conclusions: The unfavorable clinical course of the patients with metabolic syndrome infected by the COVID-19 hides its prognosis, reason why the current therapeutic strategies for the care to these sick persons have not been able to stop the progressive course of the infectious disease identified in the metabolic comorbidity, that makes difficult the prevention of complications.

Risk Factors , Metabolic Syndrome , COVID-19 , Clinical Evolution , Immune System
Rev. medica electron ; 43(5): 1395-1408, 2021. graf
Article in Spanish | LILACS | ID: biblio-1352119


RESUMEN El síndrome metabólico comprende un conjunto de factores de riesgo cardiovascular asociado a resistencia a la insulina, que propicia la aparición de enfermedad cardiovascular y de diabetes mellitus tipo 2. Su etiología se atribuye a la combinación de factores genéticos y ambientales, asociados al estilo de vida, que favorecen un estado proinflamatorio y protrombótico que empeora el cuadro clínico de los pacientes con covid-19. El objetivo de la revisión consistió en analizar el estado actual del conocimiento científico en las investigaciones sobre la interrelación entre los desórdenes del metabolismo glucídico y el síndrome metabólico, asociados a la condición proinflamatoria exacerbada en pacientes de covid-19. Se hicieron búsquedas en las bases de datos PubMed, SciELO, ClinicalKey y LILACS. Al proceso proinflamatorio generado por malos hábitos alimentarios, la sobrealimentación calórica de alto índice glicémico, y estilos de vida sedentarios, se atribuye un papel relevante en la patogénesis del síndrome metabólico, así como en sus posibles complicaciones en pacientes de covid-19 con comorbilidades asociadas. Es posible reducir la condición inflamatoria del síndrome metabólico mediante modificaciones en el estilo de vida y hábitos alimentarios, que prevengan la obesidad y sus efectos en la resistencia a la insulina, lo cual propicia reducir la gravedad asociada a los procesos inflamatorios inherentes (AU).

ABSTRACT Metabolic syndrome includes a set of cardiovascular risk factors associated with resistance to insulin, favoring the appearance of cardiovascular disease and diabetes mellitus type 2. Its etiology is attributed to the combination of genetic and environmental factors, associated to lifestyle, and favoring a proinflammatory and prothrombotic status that worsens the clinical characteristics of the patients with COVID-19. The objective of the review was to analyze the current state of the scientific knowledge in research on the interrelationship between glucide metabolism disorders and metabolic syndrome, associated with the exacerbated proinflammatory condition in COVID-19 patients. Searches were conducted in PubMed, SciELO, CinicalKey, and LILACS databases. A relevant role in the metabolic syndrome pathogenesis is attributed to the inflammatory process generated by poor eating habits, high caloric overfeeding, and to sedentary lifestyle, and also to possible complications with associated comorbidities in COVID-19 patients. It is possible to reduce the metabolic syndrome inflammatory condition through life style and alimentary habits changes that prevent obesity and its effects on insulin resistance and propitiate the reduction of the disease severity associated with the inherent inflammatory processes (AU).

Humans , Male , Female , Coronavirus Infections/complications , Metabolic Syndrome/diagnosis , Patients , Insulin Resistance , Metabolic Syndrome/therapy , Inflammation/complications , Obesity
Horiz. meÌüd. ; 21(4): e1378, oct.-dic. 2021. tab, graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1356239


RESUMEN Objetivo: Determinar la prevalencia de obesidad metabólicamente sana en estudiantes de la carrera de Medicina de la Universidad Nacional de Trujillo. Materiales y métodos: Investigación observacional descriptiva de corte transversal, que incluyó a 37 estudiantes de Medicina obesos. Para clasificar a los participantes como personas con obesidad metabólicamente sana (EObMS) u obesidad metabólicamente enferma (EObME), se evaluó circunferencia de la cintura (CC), presión arterial sistólica (PAS), diastólica (PAD), trigliceridemia (TG), colesterol-HDL sérico (C-HDL) y glucemia. Resultados: La prevalencia de obesidad en estudiantes de Medicina fue de 9,14 %. Según la clasificación del ATP III, el 78,38 % de la muestra presentó obesidad metabólicamente sana. Se encontró una diferencia significativa en el colesterol HDL en hombres, presión arterial sistólica y diastólica entre los grupos con obesidad metabólicamente sana y obesidad metabólicamente enferma. De acuerdo con la clasificación de Wildman modificada, la prevalencia de obesidad metabólicamente sana fue de 64,86 %, con diferencias significativas en el colesterol HDL en el grupo de los hombres y de las mujeres; y también en triglicéridos, presión arterial sistólica y diastólica entre los grupos con obesidad metabólicamente sana y obesidad metabólicamente enferma. Conclusiones: La prevalencia de obesidad metabólicamente sana en estudiantes de Medicina de la Universidad Nacional de Trujillo es elevada.

ABSTRACT Objective: To determine the prevalence of metabolically healthy obesity in medical students from the Universidad Nacional de Trujillo. Materials and methods: An observational descriptive cross-sectional research which included 37 medical students with obesity. Waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), triglycerides (TG), serum HDL cholesterol (HDL-C) and glycemia were evaluated to classify the participants as having metabolically healthy obesity (MHO) or metabolically unhealthy obesity (MUO). Results: The prevalence of obesity in the medical students was 9.14 %. According to the Adult Treatment Panel III (ATP III),78.38 % of the sample had MHO. Significant differences in HDL-C were found among the male students, and in SBP and DBP among the students with MHO and MUO. According to the Wildman modified classification, the prevalence of MHO was 64.86 %, with significant differences in HDL-C among the male and female students, and in TG, SBP and DBP among the students with MHO and MUO. Conclusions: The prevalence of MHO in medical students from the Universidad Nacional de Trujillo is high.

Pediátr Panamá ; 50(2): 11-21, 1 October 2021.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1343237


Introducción: La obesidad afecta a niño y adultos, y se asocia con la aparición de enfermedades crónicas no trasmisibles, pero que se pueden presentar, incluso en edades tempranas de la vida. Métodos: Estudio retrospectivo, analítico de pacientes egresados del Hospital del Niño Dr. José Renán Esquivel y Hospital José Domingo de Obaldía, con diagnóstico de sobrepeso, obesidad; fueron estudiados 185 pacientes entre las edades de 2 a 15 años durante el periodo comprendido del 1 enero 2015 al 31 de diciembre del 2019. Resultados: Se encontró una frecuencia, en 5 años, de 4.6 pacientes con sobrepeso y obesidad, por cada mil egresos hospitalarios. El 96% presentó obesidad y 4% sobrepeso. En individuos mayores de 10 años, 36.8% cumplían criterios de síndrome metabólico. Se encontró en las variables numéricas: IMC: 31.3Kg/m2, Insulina: 25.8uUI/ml, glucosa: 110.6mg/dl, HOMA: 6.1, dentro de este grupo se encontraron diferencias estadísticamente significativas en la presión arterial sistólica / diastólica (p= 0.0002 / 0.0014), ALT (p=0.05), triglicéridos (p=0.0001), HDL (p= 0.0001). De los pacientes con síndrome metabólico 80% presentaban obesidad severa. En las variables categóricas se encontraron anormales: ALT 72.4%, colesterol 22.9%, triglicéridos 68.6% (OR=6, IC=2.4-14.97), LDL 28.6%, HDL 71.4% (OR:8.65, IC= 3.31-22.56), insulina 66.6%, glucosa 52.9% (OR= 7.87, IC= 2.78-22.27) y resistencia a insulina en 81.4%. El grupo de edad de prepúberes no está exento de presentar resistencia a la insulina. Conclusiones: En este estudio se encontró que las complicaciones metabólicas más significativas fueron hipertrigliceridemia, HDLc bajo e hipertensión arterial. La frecuencia encontrada está muy por debajo de lo reportado en la literatura. Es urgente el desarrollo de estrategias adecuadas de fomento de la salud, para promover cambios en los hábitos alimentarios y en la actividad física desde la edad infantil, con el objeto de formar conductas que permanezcan en el tiempo, como medidas preventivas de la obesidad y de sus complicaciones.

Introduction: Obesity affects children and adults, and is associated with the appearance of chronic diseases that are not communicable, but that can occur, even at an early age in life. Methods: Retrospective, analytical study of patients discharged from Hospital del Niño Dr. José Renán Esquivel and Hospital José Domingo de Obaldia, diagnosed with overweight, obesity; 185 patients between the ages of 2 to 15 years were studied during the period from January 1, 2015 to December 31, 2019. Results: A frequency, in 5 years, of 4.6 overweight and obese patients was found for every thousand hospital discharges. 96% presented obesity and 4% overweight. In individuals older than 10 years, 36.8% met criteria for metabolic syndrome. It was found in the numerical variables: BMI: 31.3Kg /m2, Insulin: 25.8µU /ml, glucose: 110.6mg / dl, HOMA: 6.1, within this group statistically significant differences were found in systolic / diastolic blood pressure (p = 0.0002 / 0.0014), ALT (p = 0.05), triglycerides (p = 0.0001), HDL (p = 0.0001). Of the patients with metabolic syndrome, 80% had severe obesity. In the categorical variables, abnormal: ALT 72.4%, cholesterol 22.9%, triglycerides 68.6% (OR = 6, CI = 2.4-14.97), LDL 28.6%, HDL 71.4% (OR: 8.65, CI = 3.31-22.56), insulin 66.6%, glucose 52.9% (OR = 7.87, CI = 2.78-22.27) and insulin resistance in 81.4%. The prepuberal age group is not exempt from insulin resistance. Conclusions: In this study it was found that the most significant metabolic complications were hypertriglyceridemia, low HDLc and arterial hypertension. The frequency found is well below that reported in the literature. The development of adequate health promotion strategies is urgent, to promote changes in eating habits and physical activity from childhood, to form behaviors that remain over time, as preventive measures for obesity and its complications.