Método indirecto para la verificación del intervalo de referencia del perfil lipídico / Indirect method for the verification of the lipid profile reference range

Introducción: La dislipidemia es uno de los problemas más frecuentes en los niños y adolescentes y su estudio es importante debido a su fuerte correlación con la enfermedad cardiovascular aterosclerótica en adultos. Muchos países desarrollaron valores de referencia nacionales investigando los lípidos séricos utilizando datos basados en la población nacional propia. Nuestro objetivo fue verificar el intervalo de referencia del perfil lipídico calculando las curvas de percentiles a través del método indirecto en nuestra población pediátrica. Materiales y métodos: Se analizaron los resultados de nuestra base de datos utilizando el método indirecto. Luego de aplicar filtros y criterios de exclusión se calcularon los percentiles 25, 50, 75, 95 y 99 para colesterol total (CT), colesterol HDL (C-HDL), colesterol no HDL (C-no-HDL), triglicéridos (TG) y colesterol LDL (C-LDL) y para el C-HDL además se calculó el percentil 10. El valor de referencia para el cambio (RCV) se utilizó para determinar si existía diferencia clínicamente significativa entre los valores de percentiles obtenidos y los utilizados en el consenso de la SAP. Resultados: No se evidenció diferencia clínicamente significativa contra los valores propuesto por la SAP, excepto para los TG para las edades 1,5,7 años en el percentil 95 y para la edad de 8 años en el percentil 75 y 95; para el C-HDL en el percentil 10 para las edades 1,16 y 17 años. Discusión: Se obtuvieron los percentiles de los lípidos y se compararon con los valores de referencia utilizados por el consenso en el que están basados las guías (AU)

Introduction: Dyslipidemia is one of the most common problems in children and adolescents and its study is important because of its strong correlation with atherosclerotic cardiovascular disease in adulthood. Many countries have developed national reference values investigating serum lipids using data based on their own national population. Our aim was to verify the lipid profile reference range by calculating percentile curves through the indirect method in our pediatric population. Materials and methods: The results of our database were analyzed using the indirect method. After applying filters and exclusion criteria, the 25th, 50th, 75th, 95th, and 99th percentiles were calculated for total cholesterol (TC), HDL cholesterol (HDL-C), non-HDL cholesterol (non-HDL-C), triglycerides (TG), and LDL cholesterol (LDL-C); for HDL-C, the 10th percentile was also calculated. The reference change values (RCV) were used to determine whether there was a clinically significant difference between the percentile values obtained and those used in the consensus of the Argentine Association of Pediatrics (SAP). Results: There was no clinically significant difference with the values proposed by the SAP, except for TG for ages 1, 5, and 7 years at the 95th percentile and for age 8 years at the 75th and 95th percentile; and for HDL-C at the 10th percentile for ages 1, 16, and 17 years. Discussion: Lipid percentiles were obtained and compared with the reference values used by the consensus on which the guidelines are based (AU)

Vitamin d levels and lipid profile in patients undergoing bariatric surgery / Níveis de vitamina d e perfil lipídico em pacientes submetidos à cirurgia bariátrica

ABSTRACT BACKGROUND: Vitamin, mineral, and metabolic deficiencies occur in the postoperative period of bariatric surgery, in the short and long term, and are worrisome intercurrences. AIMS: To evaluate the association of serum vitamin D levels with the lipid profile in obese patients undergoing bariatric surgery. METHODS: Case series of patients assisted from 2010 to 2018, in a private hospital of medium and high complexity, who underwent bariatric surgery using sleeve gastrectomy or Roux-en-Y gastric bypass techniques, monitored by the same surgeon. Sociodemographic, clinical, laboratory, and anthropometric data were collected preoperatively and at 6, 12, and 24 months after surgery. RESULTS: A total of 156 individuals, mostly female (75.6%) were monitored. The most frequent comorbidities were hepatic steatosis (76.3%) and hypertension (48.27). Regarding preoperative vitamin D levels, only 18.9% of the population had a satisfactory level (≥30 ng/mL). There was a reduction in weight and an improvement in the lipid profile after surgery. Significant correlations were observed between the lipid profile and vitamin D concentration only in the sample submitted to the Roux-en-Y gastric bypass technique: negative correlation between total cholesterol and vitamin D two years after surgery; positive correlation between triglycerides and vitamin D one year after surgery; and negative correlation between high-density lipoprotein and vitamin D two years post-surgery. CONCLUSIONS: It is essential to routinely monitor vitamin D levels and lipid profile pre- and postoperatively in order to avoid damage associated with this vitamin deficiency.

RESUMO RACIONAL: Deficiências vitamínicas, minerais e metabólicas ocorrem no pós-operatório de cirurgia bariátrica, a curto e longo prazo, sendo intercorrências preocupantes. OBJETIVOS: Avaliar a associação dos níveis séricos de vitamina D com o perfil lipídico, em pacientes obesos submetidos à cirurgia bariátrica. MÉTODOS: Série de casos de pacientes atendidos de 2010 até 2018, em hospital privado de média e alta complexidade, submetidos à cirurgia bariátrica pelas técnicas da gastrectomia vertical e derivação gástrica em Y de Roux, acompanhados pelo mesmo cirurgião. Foram coletados dados sociodemográficos, clínicos, dados laboratoriais e antropométricos no pré-operatório, 6 meses, 12 meses e 24 meses após cirurgia. RESULTADOS: Foram acompanhados 156 indivíduos, maioria sexo feminino (75,6%), comorbidades mais frequentes foram esteatose hepática (76,3%) e hipertensão (48,27). Em relação aos níveis de vitamina D pré-operatórios, apenas 18,9% da população apresentaram níveis satisfatórios (=30 ng/mL). Observou-se redução do peso e melhora do perfil lipídico pós-cirúrgico. Sobre as correlações entre o perfil lipídico e concentração de vitamina D foram observadas correlações significativas apenas na amostra que passou pela técnica cirúrgica derivação gástrica em Y de Roux: correlação negativa entre o colesterol total e vitamina D após 2 anos de cirurgia; correlação positiva entre triglicerídeo e vitamina D 1 ano pós-operatório; e correlação negativa entre HDL e vitamina D 2 anos pós-operatório. CONCLUSÕES: é essencial acompanhar os níveis de vitamina D e perfil lipídico no pré e pós-operatório de forma rotineira a fim de evitar danos relacionados a deficiência dessa vitamina.

The effect of kefir consumption on the lipid profile for individuals with normal and dyslipidemic properties: a randomized controlled trial / O efeito do consumo de kefir no perfil lipídico em indivíduos com propriedades normais e dislipidêmicas: um ensaio clínico randomizado

ABSTRACT Objective This research was conducted as a prospective, self-controlled, eight-week clinical trial to investigate the effect of kefir consumption on the lipid profile of individuals with normal and dyslipidemic properties. Methods Kefir microorganisms given to volunteer subjects were determined using classical microbial count methods and qReal-Time Polymerase Chain Reaction. The study was carried out with 23 volunteer hospital health personnel between the ages of 20 and 55 who met the research criteria and did not have any health problems. The volunteers regularly consumed kefir on an empty stomach for four weeks. In the last stage, the eight-week study was completed by making blood and anthropometric measurements of the subjects, who continued to be studied without kefir consumption for four more weeks. Results Considering the changes in the serum lipid profiles of 13 individuals with dyslipidemic symptoms during the 4-week period they consumed kefir, Total Cholesterol values decreased by 9.15% compared to initial values, LDL-Cholesterol values decreased by 10.64%, HDL-Cholesterol values decreased by 6.9%, and triglyceride values decreased by 2.46%. The changes in the serum lipid profiles of 13 individuals with dyslipidemic findings at the end of an eight-week study were a 5.71% decrease in total cholesterol values (p<0.018) considered statistically significant, as well as a 5.31% decrease in LDL-Cholesterol values (p<0.021); the HDL-Cholesterol results were found to be significant with an 8.58% decrease in the values (p<0.035) and insignificant with a 17.21% increase in the triglyceride values (p<0.926). We concluded that regular kefir consumption was effective in both women and men in lowering total cholesterol and LDL-Cholesterol from blood lipid profiles, especially in individuals with dyslipidemic symptoms, while this effect was not observed in normal individuals. Conclusion Kefir can positively affect the total cholesterol and LDL-Cholesterol blood parameters of dyslipidemic individuals with high serum lipid values.

RESUMO Objetivo Esta pesquisa foi conduzida como um ensaio clínico prospectivo e autocontrolado de oito semanas para investigar o efeito do consumo de kefir no perfil lipídico de indivíduos com propriedades normais e dislipidêmicas. Métodos Microrganismos kefir dados a voluntários foram determinados usando métodos clássicos de contagem microbiana e de reação em cadeia da polimerase em tempo real. O estudo foi conduzido em 23 profissionais de saúde de hospitais voluntários, com idades entre 20 e 55 anos, que atendiam aos critérios da pesquisa e não apresentavam problemas de saúde. Os voluntários consumiram kefir com o estômago vazio regularmente durante quatro semanas. No último estágio, o estudo de oito semanas foi concluído com medidas de sangue e antropométricas dos indivíduos, que continuaram a ser avaliados sem consumo de kefir por mais quatro semanas. Resultados Considerando as mudanças nos perfis lipídicos séricos de 13 indivíduos com sintomas dislipidêmicos durante o período de quatro semanas em que consumiram kefir, os valores de colesterol total diminuíram em 9,15% em comparação com os valores iniciais; os valores de LDL-Colesterol diminuíram em 10,64%, os valores de HDL-Colesterol diminuíram em 6,9% e os valores de triglicerídeos diminuíram em 2,46%. Ao final de um estudo de oito semanas, o resultado foi considerado estatisticamente significativo, com queda de 5,71% nos valores de colesterol total (p<0,018); de 5,31% nos valores de Colesterol-LDL (p<0,021) e de 8,58% nos valores de HDL-Colesterol (p <0,035), e insignificantes com aumento de 17,21% nos valores de triglicerídeos (p<0,926). Como resultado do estudo, concluiu-se que o consumo regular de kefir foi eficaz em mulheres e homens na redução do colesterol total e do LDL-Colesterol dos perfis de lipídios no sangue, especialmente em indivíduos com sintomas dislipidêmicos, enquanto esse efeito não foi observado em indivíduos normais. Conclusão O kefir pode afetar positivamente os parâmetros sanguíneos do colesterol total e do LDL-Colesterol de indivíduos dislipidêmicos com altos valores de lipídios séricos.

Correlation of serum lipids levels of Alzheimer's disease patients with sex, age and apolipoprotein E gene polymorphism / 中华预防医学杂志

Objective: To explore the correlation of serum lipids levels of Alzheimer's disease (AD) patients with sex, age and apolipoprotein E (Apo E) gene polymorphism. Methods: The retrospective study method was used, and 407 AD patients (142 males and 265 females, aged 52-91 years) were selected from Beijing Tiantan Hospital from January 2015 to August 2021 as the research target, and 894 healthy persons (339 males and 555 females, aged 52-94 years) who did body examination were selected as the control group. The AD patients were divided into four age groups according to the age interval of 10 years, including 85 aged 50-59 years, 163 aged 60-69 years, 119 aged 70-79 years, and 40 aged more than 80 years. The serum lipids levels were detected by biochemical analyzer, including triglycerides (TG), cholesterol (CHO), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), apolipoproteinA1(Apo A1) and apolipoprotein B (Apo B). ApoE gene polymorphism were detected by PCR fluorescent probe method. Mann-Whitney U test and Kruskal-Wallis H test were used to compare the serum lipids levels in each group. Results: The levels of serum CHO and LDL-C were 3.30(1.41,4.82) mmol/L and 1.76(1.39,2.78) mmol/L in AD patients, and 4.84(4.24, 5.56) mmol/L and 2.91(2.36, 3.57) mmol/L in control group, and the levels of serum CHO and LDL-C of AD patients were significantly lower than control group (Z=-15.172,Z=-14.583 , P<0.001, P<0.001). The levels of serum HDL-C and Apo B were 1.84(1.30, 3.88) mmol/L and 1.17(0.85, 1.57) g/L in AD patients, and 1.39(1.18, 1.64) mmol/L and 0.93(0.81, 1.09) g/L in control group, and the levels of serum HDL-C and Apo-B of AD patients were significantly higher than control group (Z=-12.249 , Z=-9.706 , P<0.001, P<0.001). There was no significant difference in TG and Apo A1 between 2 groups (Z=-1.577 , Z=-0.408 , P=0.115, P=0.683). The levels of TG, CHO, LDL-C in female AD patients were significantly higher than male patients (Z=-2.737 , Z=-3.963 , Z=-4.417, P=0.006, P<0.001, P<0.001). There were significant differences in TG, CHO, HDL-C, LDL-C, Apo A1 and Apo B among AD patients of all age groups (Z=11.263 , Z=10.060 , Z=40.246 , Z=10.451 , Z=24.315 , Z=19.922 , P=0.010 , P=0.018 , P<0.001 , P=0.015 , P<0.001 , P<0.001). The serum CHO and LDL-C levels were positively correlated with age (rs=0.160, rs=0.174, P=0.001, P<0.001), and HDL-C, Apo A1 and Apo B levels were negatively correlated with age (rs=-0.312, rs=-0.272, rs=-0.146, P<0.001, P<0.001, P=0.003), and there was no correlation between TG level and age in AD patients (rs=0.086, P=0.082). There were 3 cases (3.33%) of E2, 43 cases of E3 (47.78%) and 44 cases of E4 (48.89%) in AD patients, and 22 cases (12.72%) of E2, 117 cases of E3 (67.63%) and 34 cases of E4 (19.65%) in control group. There was significant difference in Apo E genotype distribution between AD patients and control group (χ²=26.381 , P<0.001). Apo E4 was the most common genotype in AD patients, and the proportion was 48.89%. Except for Apo A1(Z=7.821 , P=0.020), there was no significant difference in TG, CHO, HDL-C, LDL-C and Apo B levels among all patients with different genotypes (Z=3.732 , Z=1.677 , Z=1.455 , Z=1.619 , Z=2.202 , P=0.155, P=0.432, P=0.483, P=0.445, P=0.333). Conclusion: The levels of CHO and LDL-C decreased while the levels of HDL-C and Apo B increased in AD patients. The dyslipidemia in AD patients might be correlated with age, but not sex and Apo E genotypes.

Variáveis clínicas consideradas fatores de risco para a síndrome metabólica: um estudo transversal / Variables clínicas consideradas factores de riesgo para síndrome metabólico: un estudio transversal / Clinical variables considered risk factors for the metabolic syndrome: a cross-sectional study

RESUMO Objetivo Identificar os principais fatores de risco para a síndrome metabólica e sua relação com a percepção da qualidade de vida em colônias pesqueiras brasileiras. Métodos Incluímos 77 participantes com idade > 18 anos. Síndrome metabólica e qualidade de vida foram os principais desfechos do estudo. Consideramos nível de significância < 0,05 e todos os procedimentos foram aprovados pelo comitê de ética. Resultados A maioria dos participantes é do sexo masculino, solteiros, classe econômica D-E, carga horária trabalhada de 6 a 8 horas, tempo de serviço de 1 a 5 anos e dedicados exclusivamente à pesca. Conclusão: Perímetro abdominal e pressão arterial foram os critérios mais frequentes e de maior contribuição para a síndrome metabólica. Apesar de a qualidade de vida apresentar maior escore para o domínio relações sociais, neste estudo, o domínio físico foi o único associado a outra observação, na qual observamos correlação significativa com a pressão arterial sistólica.

RESUMEN Objetivo Identificar los principales factores de riesgo del síndrome metabólico y su relación con la percepción de la calidad de vida en las colonias pesqueras brasileñas. Métodos se incluyeron 77 participantes mayores de 18 años. El síndrome metabólico y la calidad de vida fueron los principales resultados del estudio. Se consideró un nivel de significancia <0.05 y todos los procedimientos fueron aprobados por el comité de ética. Resultados La mayoría de los participantes son hombres, solteros, clase económica D-E, jornada laboral de 6 a 8 horas, antigüedad de 1 a 5 años y dedicados exclusivamente a la pesca. Conclusión La circunferencia de la cintura y la presión arterial fueron los criterios más frecuentes y la mayor contribución al síndrome metabólico. Aunque la calidad de vida tuvo una puntuación más alta para el dominio de relaciones sociales, en este estudio, el dominio físico fue el único asociado con otra observación, en la que observamos una correlación significativa con la presión arterial sistólica.

ABSTRACT Objective To identify the main risk factors for metabolic syndrome and its relationship with the perception of quality of life in Brazilian fishing colonies. Methods We included 77 participants aged > 18 years. Metabolic syndrome and quality of life were the main study outcomes. We considered a significance level < 0.05 and all procedures were approved by the ethics committee. Results Most participants are male, single, economic class D-E, working hours of 6 to 8 hours, length of service from 1 to 5 years, and dedicated exclusively to fishing. Conclusion Abdominal perimeter and blood pressures were the most frequent criteria and the greatest contribution to metabolic syndrome. Although quality of life had a higher score for the social relationship domain, in this study, the physical domain was the only one associated with another observation, in which we observed a significant correlation with systolic blood pressure.

Optimal Cutoff of the TG/HDL-c ratio for Cardiovascular Risk in Hypertensive and Diabetic Patients Monitored by Primary Health Care in a city in Minas Gerais

Abstract Background The analysis of the atherogenic potential of the lipid profile for biomarkers, such as the TG/HDL-c ratio, predicts cardiovascular risk better than isolated lipids. Objective To identify the TG/HDL-c cutoff points for multiple risks (hypertension, Diabetes Mellitus, obesity) and to evaluate the association between sociodemographic, clinical, laboratory, anthropometric, and life habit variables and the TG/HDL-c ratio in hypertensive and/or diabetic individuals in the context of Primary Health Care. Methods This was a cross-sectional study with 833 hypertensive and/or diabetic patients, conducted between August 2017 and April 2018. The cutoff point of the TG/HDL-c were obtained by the ROC curve. Cardiovascular risk was discriminated by TG/HDL-c, categorized by the cutoff and evaluated in relation to multiple risks. The magnitude of the association between TG/HDL-c and independent variables was estimated by logistic regression. The significance level of p<0.05 was adopted for all tests. Results The cutoff values of TG/HDL-c (3.26 for men and 2.72 for women) were more sensitive and less specific than those in the literature. Women (OR=1.90 and 95% CI 1.13-3.20) and men (OR=4.58 and 95% CI 1.78-11.76) with multiple risks, and white men, alcohol users, with a history of stroke, had a higher chance of altered GT/HDL-c. Increases in glycosylated hemoglobin, glycemia, and phosphorus in women, and cholesterol, glycemia, and microalbuminuria in men increased the chances of altered TG/HDL-c. Being a former smoker and black reduced the chance of altered TG/HDL-c in women. Conclusions TG/HDL-c proved to be a good indicator for habitual use in Primary Care.

Incremento de la proteína C reactiva ultrasensible en pacientes con hipotiroidismo subclínico y su posible relación con el desarrollo de daño cardiovascular / Increase in high sensitivity C-reactive protein in patients with subclinical hypothyroidism and its possible relationship to the development of cardiovascular damages

INTRODUCCIÓN: El hipotiroidismo subclínico (HSC) se define bioquímicamente por una elevación en la concentración sérica de la hormona estimulante de la tiroides (TSH), con niveles normales de tiroxina libre (T4L). La asociación entre el HSC y el daño cardiovascular ha sido un tema controversial. OBJETIVO: determinar la asociación entre el HSC y el desarrollo de la enfermedad cardiovascular mediante la cuantificación de la proteína C reactiva ultrasensible PCR-us y la determinación de lípidos circulantes asociados a la enfermedad cardiovascular y la ateroesclerosis. MÉTODOS: Estudio descriptivo, correlacional de corte transversal realizado en el Hospital IESS de Riobamba, Ecuador en el periodo comprendido desde enero a diciembre de 2019. Se estudiaron 70 individuos (40 pacientes con HSC y 30 controles) con edades entre 18 y 75 años. Se realizaron las historias clínicas y el examen físico a cada paciente y la toma de las muestras sanguíneas para determinar la concentración sérica de los siguientes parámetros bioquímicos y hormonales: colesterol total, triglicéridos, HDL colesterol y LDL colesterol, TSH, T4L y PCR-us. RESULTADOS: Se encontró un incremento significativo en la concentración de colesterol total (p<0.0001), LDL colesterol (p<0.01) y PCR-us (p<0.0001) en los pacientes con HSC vs los controles. Se observó una correlación positiva (p<0.0001; r=0.9148) entre la TSH y la PCR-us en los pacientes con HSC. CONCLUSIÓN: los pacientes con HSC experimentan una elevación en los niveles séricos de PCR-us la cual está correlacionada con un incremento en la concentración sérica de TSH. Estos parámetros asociados a un aumento del colesterol total y de la LDL colesterol sugieren un estado inflamatorio de bajo grado que podría estar asociado con el desarrollo de aterosclerosis y daño cardiovascular.

INTRODUCTION: Subclinical hypothyroidism (SH) is defined biochemically by an elevation in serum thyroid stimulating hormone (TSH) concentration, with normal levels of free thyroxine (T4L). The association between SH and cardiovascular damage has been a controversial issue. OBJECTIVE: to determine the association between SH and the development of cardiovascular disease through the quantification of the high sensitivity C-reactive protein (hs-PCR) and the determination of circulating lipids associated to cardiovascular disease and atherosclerosis. METHODS: Observational, correlational cross-sectional study with patients captured in the internal medicine office as well as those attending screening activities at the IESS Hospital in Riobamba- Ecuador, in the period from January to December 2019. Seventy individuals (40 patients with SH and 30 controls) between the ages of 18 and 75 years were studied. Each patient's medical history and physical examination were performed, and blood samples were taken to determine the serum concentration of the following biochemical and hormonal parameters: total cholesterol, triglycerides, HDL cholesterol and LDL cholesterol, TSH, T4L and hs-PCR. RESULTS: A significant increase in the concentration of total cholesterol (p<0.0001), LDL cholesterol (p<0.01) and hs-PCR (p<0.0001) was found in patients with SH vs. controls. A positive correlation (p<0.0001; r=0.9148) was observed between TSH and hs-PCR in patients with SH. CONCLUSION: patients with SH experience an elevation in serum hs-PCR levels which is correlated with an increase in serum TSH concentration. These parameters associated with an increase in total cholesterol and LDL cholesterol suggest a low-grade inflammatory state that may be associated with the development of atherosclerosis and cardiovascular damage.

Relación de la actividad física medida objetivamente con dislipidemias y factores de riesgo cardiovascular en escolares de la Región de La Araucanía / Relationship of objectively measured physical activity with dyslipidemias and cardiovascular risk factors in schoolchildren from Región de La Araucanía cases

INTRODUCCIÓN: Las dislipidemias favorecen la formación precoz de placas ateroscleróticas, aumentando el riesgo de enfermedades cardiovasculares (ECVs). La Actividad Física (AF) es un factor protector de ECVs, por lo que el objetivo de este trabajo fue evaluar la asociación entre AF medida objetivamente y dislipidemias en población pediátrica. METODOLOGÍA: La AF fue evaluada en 159 niños (9-13 años) de la Región de La Araucanía a través de acelerometría (ActiGraph GT3X+). Por este medio se estimó el porcentaje de AF moderada a vigorosa (AFMV) y el de conducta sedentaria (CS). Sujetos con ≥60 min de AFMV se consideraron físicamente activos según recomendación de la Organización Mundial de la Salud (OMS). Individuos con %CS>75° percentil fueron considerados sedentarios. El perfil lipídico fue determinado usando métodos convencionales. Fueron calculados índices de aterogenicidad TG/cHDL e índice de aterogenicidad del plasma (IAP). RESULTADOS: 37,1% presentó dislipidemia, 8% hipercolesterolemia, 19,5% hipertrigliceridemia, 6,3% cLDL elevado y 25,2% cHDL disminuido. Solo un 9,4% fueron considerados físicamente activos de acuerdo a la recomendación de la OMS. En los sujetos físicamente activos no hubo caso de dislipidemias (p= 0,032) y tampoco bajos niveles de cHDL (p= 0,013). El %AFMV estaba reducido en sujetos con cHDL bajo y se correlacionó positivamente con HDL-c (r= 0,157, p=0,048). Además, el %AFMV se correlacionó con menores valores de TG/cHDL (r= -0,193, p=0,015) e IAP (r= -0,214, p=0,006). Si bien el comportamiento sedentario no estuvo asociado con riesgo de dislipidemias, el %CS se correlacionó positivamente con niveles de glucosa (r= 0,159, p=0,044) y HOMA-IR (r= 0,178, p=0,037) y negativamente con Quicki (r= -0,160, p=0,044). CONCLUSIONES: Los hallazgos sugieren que la AF se correlaciona a menor frecuencia de dislipidemias y la práctica de AFMV aumentaría los valores de HDL-c y reduciría los índices aterogénicos, por lo que promoverla puede significar disminuir el riesgo de ECVs en nuestra población. Además, la CS se relaciona con un aumento en valores de glucosa e índices de resistencia insulínica en escolares de la Región de La Araucanía.

Dyslipidemias cause early formation of atherosclerotic plaque, increasing the risk of cardiovascular diseases (CVD). Physical Activity (PA) is a protective factor against CVDs. The aim of this study is to evaluate the association between objectively measured PA with dyslipidemias in a pediatric population. METHOD: The PA was evaluated in 159 children (9-13 years old) from Región de La Araucanía using accelerometry (ActiGraph GT3X +). The percentage of moderate to vigorous PA (MVPA) and sedentary behavior (SB) were estimated. Subjects with ≥60 min of MVPA were considered physically active according to the recommendation of the World Health Organization (WHO). Individuals with %SB >75th percentile were sedentary. The lipid profile was determined using conventional methods. TG/HDL-C ratio and atherogenic index of plasma (AIP) were calculated. RESULTS: 37.1% presented dyslipidemia, 8% hypercholesterolemia, 19.5% hypertriglyceridemia, 6.3% elevated LDL-C and 25.2% decreased HDL-C. Only 9.4% were physically active according to the WHO recommendation. In physically active subjects where no cases of dyslipidemias (p =0.032) and no low HDL-C (p = 0.013). The %MVPA was reduced in subjects with low HDL-C and positively correlated with HDL-c (r = 0.157, p = 0.048). In addition, %MVPA was correlated with lower TG / HDL-C values (r = -0.193, p = 0.015) and AIP (r = -0.214, p = 0.006). SB was not associated with risk of dyslipidemia, % SB was positively correlated with glucose levels (r = 0.159, p = 0.044) and HOMA-IR (r = 0.178, p = 0.037) and negatively with Quicki (r = -0.160, p = 0.044). CONCLUSIONS: Our results suggested that PA is it correlates to a lower frequency of dyslipidemia and the practice of MVPA would increase HDL-c values and reduce atherogenic index, promoting it may been reducing the risk of CVDs in our population. In addition, the SB is related to an increase in glucose values and insulin resistance index in schoolchildren in Región de La Araucanía.

Associations of plasma lipids, lipoproteins, and cardiovascular outcomes with climatic variations in a large Brazilian population of Campinas, São Paulo state: an eight-year study

In this eight-year retrospective study, we evaluated the associations between climatic variations and the biological rhythms in plasma lipids and lipoproteins in a large population of Campinas, São Paulo state, Brazil, as well as temporal changes of outcomes of cardiovascular hospitalizations. Climatic variables were obtained at the Center for Meteorological and Climatic Research Applied to Agriculture (University of Campinas - Unicamp, Brazil). The plasma lipid databases surveyed were from 27,543 individuals who had their lipid profiles assessed at the state university referral hospital in Campinas (Unicamp). The frequency of hospitalizations was obtained from the Brazilian Public Health database (DATASUS). Temporal statistical analyses were performed using the methods Cosinor or Friedman (ARIMA) and the temporal series were compared by cross-correlation functions. In normolipidemic cases (n=11,892), significantly different rhythmicity was observed in low-density lipoprotein (LDL)- and high-density lipoprotein (HDL)-cholesterol (C) both higher in winter and lower in summer. Dyslipidemia (n=15,651) increased the number and amplitude of lipid rhythms: LDL-C and HDL-C were higher in winter and lower in summer, and the opposite occurred with triglycerides. The number of hospitalizations showed maximum and minimum frequencies in winter and in summer, respectively. A coincident rhythmicity was observed of lower temperature and humidity rates with higher plasma LDL-C, and their temporal series were inversely cross-correlated. This study shows for the first time that variations of temperature, humidity, and daylight length were strongly associated with LDL-C and HDL-C seasonality, but moderately to lowly associated with rhythmicity of atherosclerotic outcomes. It also indicates unfavorable cardiovascular-related changes during wintertime.

Análisis clínico-epidemiológico de las subfracciones HDL2 y HDL3 en adultos de la ciudad de Maracaibo, Venezuela / Clinical-epidemiological analysis of HDL2 and HDL3 subfractions in adults from Maracaibo city, Venezuela

RESUMEN Objetivo: Realizar un análisis clínico-epidemiológico de las subfracciones de colesterol unido a lipoproteinas de alta densidad (HDL-C, por sus siglas en inglés) en adultos de la ciudad de Maracaibo, Venezuela. Materiales y métodos: Se realizó un estudio descriptivo y transversal de la base de datos del Estudio de Prevalencia de Síndrome Metabólico de Maracaibo, que incluyó 359 individuos de ambos sexos, mayores de 18 años, a quienes se les determinó la concentración sérica de HDL3 y HDL2, así como el índice HDL2/HDL3; evaluando sus niveles según características sociodemográficas, clínicas y bioquímicas. Resultados: La edad promedio de la población era 39,4 ± 15,2 años, y 51,5% era de sexo femenino. Solo se observaron diferencias en los niveles de HDL-C en aquellos sujetos con HDL-C bajas. Las mujeres con hipertriacilgliceridemia mostraron concentraciones séricas de HDL3 y HDL2 significativamente menores con respecto a aquellas con triacilglicéridos normales (p=0,033); asimismo, se encontró una concentración menor de HDL3 y relación HDL2/HDL3 en aquellas con proteína C reactiva ultrasensible (PCR-us) elevada (p<0,001). En hombres, se evidenció una concentración significativamente menor de HDL2 en aquellos con algún grado de hipertensión arterial (p=0,031), insulinorresistencia (p=0,050) y síndrome metabólico (p=0,003); mientras que aquellos con PCR-us elevada mostraron una menor concentración de HDL3 (p=0,011). Conclusión: Las subfracciones de HDL-C muestran un comportamiento clínico epidemiológico variable en adultos de la población de Maracaibo, con promedios más bajos en los hombres, diferencias en los niveles únicamente en aquellos con HDL-C bajas, y sin predominio de alguna subclase según las características sociodemográficas, clínicas y bioquímicas.

ABSTRACT Objective: To carry out a clinical-epidemiological analysis of high-density lipoprotein cholesterol subfractions (HDL-C) in adults from Maracaibo, Venezuela. Materials and methods: A descriptive and cross-sectional study of the database from the Metbolic Syndrome Prevalence in Maracaibo Study was carried out. HDL3 and HDL2 serum concentration, as well as the HDL2/HDL3 ratio, were determined in 359 individuals of both sexes, over 18 years of age. Values obtained were evaluated according to sociodemographic, clinical and biochemical characteristics. Results: Mean population age was 39.4 ± 15.2 years, and 51.5% were female. Differences in HDL-C subfraction levels were only observed in those subjects with low HDL-C levels. Women with hypertriglyceridemia showed significantly lower serum HDL3 and HDL2 concentrations than those with normal triglycerides (p=0.033), as well as a lower HDL3 level and HDL2 / HDL3 ratio in those with higher levels of ultra-sensitive C-reactive protein (us-CRP) (p<0.001). A significantly lower concentration of HDL2 was observed in men with some degree of hypertension (p=0.031), insulin resistance (p=0.050) and metabolic syndrome (p=0.003); while those with elevated us-CRP showed a lower concentration of HDL3 (p=0.011). Conclusion: HDL-C subfractions show varying clinical-epidemiological behavior in adults from Maracaibo. Lower serum levels are observed in men, differences only in those with low HDL-C; and no predominance of any subclass was observed according to sociodemographic, clinical and biochemical characteristics.

Association between Central Obesity and Biochemical Markers of Cardiometabolic Risk in Elderly Attended in Geriatric Ambulatory - Lagarto/SE

Abstract Backgroud: Central obesity, especially visceral adipose tissue (VAT), represents a health risk due to its endocrine and metabolic capacity, contributing to the development of the atherogenic profile and strongly associating with cardiovascular morbimortality. Objective: To identify the association between central obesity and biochemical markers of cardiometabolic risk in elderly patients treated at a geriatric outpatient clinic in Lagarto-SE. Method: This is a cross-sectional study of 159 elderly people of both sexes. Central adiposity was considered an independent variable, identified by measuring the Waist Circumference (WC). Total Cholesterol (TC), LDL-c, HDL-c, non-HDL-c, triglycerides, glycemia and Castelli I and II indices were considered dependent variables. Pearson's chi-square test was used to evaluate the association between central obesity and biochemical markers of cardiometabolic risk. Those with p < 0.20 were used in the bivariate regression analysis, adopting a 95% confidence interval. Results: Mean age was 70.9 ± 7.5 years. Central obesity was present in 43.2% of males and 56.8% of females (p = 0.002). There was statistically significant association between HDL-c, HDL-C and Castelli I Index and central obesity. Individuals with central obesity are 2.48 and 3.13 times more likely to develop changes in HDL-C and Castelli I index, respectively. Conclusion: There is an association between central obesity and biochemical markers of cardiometabolic risk in the elderly.

Síndrome metabólica em adolescentes: comparação entre três diferentes critérios diagnósticos / Metabolic syndrome in adolescents: comparison between three different diagnostic criteria

Objetivo: verificar a diferença na proporção de adolescentes com síndrome metabólica, identificada por três diferentes critérios diagnósticos. Metodologia: estudo descritivo e transversal, realizado com 716 adolescentes de 10 a 19 anos, de escolas municipais e estaduais da cidade de Picos, Piauí. Para a coleta de dados utilizou-se um instrumento para verificação de dados socioeconômicos, antropométricos, bioquímicos e da pressão arterial. A síndrome metabólica foi definida por três critérios diagnósticos diferentes: International Diabetes Federation (IDF), Cook e Ferranti. Para a análise da diferença entre as médias utilizouse o teste t, e o coeficiente Kappa para a concordância entre os critérios. Resultados: A síndrome foi observada em 3,1, 8,5 e 1,4 % dos adolescentes, de acordo com as definições de Cook, Ferranti, e da International Diabetes Federation, respectivamente. Na verificação dos critérios em pares a concordância entre: IDF e Cook foi 98,3% (Kappa = 0,618; p = 0,000); IDF e Ferranti foi 91,4% (Kappa = 0,228; p = 0,000); Cook e Ferranti foi 92,9% (Kappa = 0,425; p = 0,000). Conclusão: Foi possível observar considerável diferença entre os critérios para o diagnóstico, sugerindo pouca prevalência da síndrome por falta de consenso dos critérios diagnósticos em adolescentes.

Objective: To verify the difference in the proportion of adolescents with metabolic syndrome, identified by three different diagnostic criteria. Methodology: Descriptive and cross-sectional study conducted with 716 adolescents aged 10 to 19 years old from state and municipal schools in the city of Picos, Piauí. For data collection, an instrument was used to verify socioeconomic, anthropometric, biochemical and blood pressure data. Metabolic syndrome was defined by three different diagnostic criteria: International Diabetes Federation (IDF), Cook and Ferranti. For the analysis of the difference between the averages we used the ttest and the Kappa coefficient for agreement between the criteria. Results: The syndrome was observed in 3.1, 8.5 and 1.4% of adolescents, according to the definitions of Cook, Ferranti, and the International Diabetes Federation, respectively. In the paired criteria verification the agreement between IDF and Cook was 98.3% (Kappa = 0.618; p=0.000); IDF and Ferranti was 91.4% (Kappa = 0.228; p=0.000); Cook and Ferranti was 92.9% (Kappa = 0.425; p=0.000). Conclusion: It was possible to observe considerable difference between the criteria for the diagnosis of the syndrome, suggesting low prevalence of the syndrome due to lack of consensus on diagnostic criteria in adolescents.

Prevalência do fenótipo cintura hipertrigliceridêmica e fatores associados: estudo transversal em bancários da região metropolitana de Vitória, ES, Brasil / Prevalence of hypertriglyceridemic waist phenotype and associated factors: cross-sectional study of bank workers in the metropolitan region of Vitória, ES, Brazil

Objetivo: Este artigo investiga a prevalência de cintura hipertrigliceridêmica em bancários e sua associação com fatores socioeconômicos, laborais, comportamentais, antropométricos e de condições de saúde. Método: trata-se de um estudo transversal com 525 bancários. Para avaliação do fenótipo cintura hipertrigliceridêmica foi considerada a associação de circunferência da cintura e hipertrigliceridemia. Resultados: A investigação resultou em uma prevalência de fenótipo de 19,4%, sendo maior em homens, pessoas em idades avançadas, que vivem maritalmente e que trabalham na agência há mais de cinco anos. O fenótipo também se associou ao excesso de peso, HDL-c (high density lipoprotein) baixo, hiperlipidemia mista, elevada relação triglicerídeos/HDL-c e hipertensão arterial. Ter mais de 50 anos e estar acima do peso aumentava as chances de os bancários apresentarem o fenótipo. Ser do sexo feminino e ter níveis adequados de HDL-c mostraram-se fatores de proteção contra o fenótipo. Conclusão: A prevalência de cintura hipertrigliceridêmica entre bancários é alta e associa-se principalmente ao excesso de peso e perfil lipídico desfavorável desta população. (AU)

Objective: This paper investigates the prevalence of hypertriglyceridemic waist in bank workers and its association with socioeconomic, labor, behavioral, anthropometric and health condition factors. Method: This is a cross-sectional study based on information from 525 bank workers. To investigate the hypertriglyceridemic waist phenotype, it was necessary to consider the association between waist circumference and high levels of serum triglycerides. Results: The investigation resulted in a phenotype prevalence of 19.4%, being higher in men, elderly, married and working in the bank for more than five years. The phenotype was also associated with overweight, low HDL-c (high-density lipoprotein), mixed hyperlipidemia, high triglyceride/HDL-c ratio and arterial hypertension. Being over 50 years of age and being overweight increased the chances of the bankers presenting the phenotype. Being female and having adequate levels of HDL-c were shown to be protective factors against the phenotype. Conclusion: The prevalence of hypertriglyceridemic waist is high and is associated mainly with the excess weight and unfavorable lipid profile of this population. (AU)

Associações entre consumo de produtos lácteos, proteína C-reativa e perfil lipídico em adultos: resultados do ELSA-Brasil / Associations between consumption of dairy products, C-reactive protein, and lipid profile in adults: results of the ELSA-Brasil study / Asociaciones entre consumo de productos lácteos, proteína C-reativa y perfil lipídico en adultos: resultados del ELSA-Brasil

Anormalidades lipídicas e inflamação sistêmica subclínica estão associadas ao processo de aterosclerose, sendo utilizadas como marcadores de risco cardiovascular. Estudos sugerem um possível efeito benéfico dos produtos lácteos na saúde cardiovascular, mas os resultados em marcadores lipídicos e inflamatórios ainda são controversos. O objetivo deste trabalho foi avaliar a associação entre o consumo de produtos lácteos e seus diferentes subgrupos e proteína C-reativa (PCR), LDL-colesterol (LDL-C) e razão triglicerídeo/HDL-colesterol (TG/HDL-C) nos participantes do Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil) (n = 9.372). O consumo de lácteos foi avaliado por meio de questionário de frequência alimentar validado e apresentado em porções/dia. O consumo total de lácteos foi descrito em quatro categorias (≤ 1 porção/dia a > 4 porções/dia). As associações foram estimadas por meio do odds ratios (OR), utilizando-se o grupo de menor consumo (≤ 1 porção/dia) como referência. Os menores valores de OR para TG/HDL-C no modelo multivariado (0,70; IC95%: 0,55-0,90 em homens; e 0,55; IC95%: 0,43-0,70 em mulheres) foram encontrados no grupo com consumo > 4 porções/dia de lácteos totais. Esses resultados foram apoiados pelas associações inversas encontradas entre diferentes subgrupos de lácteos e a razão TG/HDL-C. Não foi encontrada associação entre consumo de produtos lácteos e seus subgrupos e valores de LDL-C e de PCR. Os resultados sugerem um possível efeito benéfico dos lácteos no perfil lipídico, porém são necessárias evidências de estudos longitudinais e de intervenção que elucidem os mecanismos de efeito dos diferentes tipos de lácteos.

Lipid abnormalities and subclinical systemic inflammation are associated with atherosclerosis and are used as markers of cardiovascular risk. Studies have suggested a possible beneficial effect of dairy products on cardiovascular health, but the results in lipid and inflammatory markers are still controversial. This study aimed to assess the association between consumption of dairy products and their different subgroups and C-reactive protein (CRP), LDL-cholesterol (LDL-C), and triglyceride/HDL-cholesterol ratio (TG/HDL-C) in participants in the Longitudinal Study of Adult Health (ELSA-Brasil) (n = 9,372). Consumption of dairy products was assessed via a validated food frequency questionnaire and expressed as servings/day. Total consumption of dairy products was described in four categories (≤ 1 serving/day to > 4 servings/day). The associations were estimated via odds ratios (OR), using the group with the lowest consumption (≤ 1 serving/day) as the reference. The lowest ORs for TG/HDL-C in the multivariate model (0.70; 95%CI: 0.55-0.90 in men; and 0.55; 95%CI: 0.43-0.70 in women) were found in the group that consumed > 4 servings day of dairy products. These results were supported by the inverse associations between different subgroups of dairy products and the TG/HDL-C ratio. No association was found between consumption of dairy products and their subgroups and LDL-C and CRP. The results suggest a possible beneficial effect of dairy products on lipid profile, but longitudinal and intervention studies are needed to elucidate the effect mechanisms of different types of dairy products.

Las anormalidades lipídicas e inflamación sistémica subclínica están asociadas con el proceso de arteriosclerosis, siendo utilizadas como marcadores de riesgo cardiovascular. Los estudios sugieren un posible efecto benéfico de los productos lácteos en la salud cardiovascular, pero los resultados en marcadores lipídicos e inflamatorios todavía son controvertidos. El objetivo de este estudio fue evaluar la asociación entre el consumo de productos lácteos y sus diferentes subgrupos y proteína C-reativa (PCR), LDL-colesterol (LDL-C) y razón triglicéridos/HDL-colesterol (TG/HDL-C) en los participantes del Estudio Longitudinal de Salud del Adulto (ELSA-Brasil) (n = 9.372). El consumo de lácteos fue evaluado mediante un cuestionario de frecuencia alimentaria validado, y presentado en porciones/día. El consumo total de lácteos se describió en cuatro categorías (≤ 1 porción/día a > 4 porciones/día). Las asociaciones fueron estimadas mediante odds ratios (OR), utilizando el grupo de menor consumo (≤ 1 porción/día) como referencia. Los menores valores de OR para TG/HDL-C en el modelo multivariado (0,70; IC95%: 0,55-0,90 en hombres; y 0,55; IC95%: 0,43-0,70 en mujeres) se encontraron en el grupo con consumo > 4 porciones/día de lácteos totales. Estos resultados se apoyaron en las asociaciones inversas encontradas entre diferentes subgrupos de lácteos y la razón TG/HDL-C. No se encontró asociación entre consumo de productos lácteos y sus subgrupos y valores de LDL-C y de PCR. Los resultados sugieren un posible efecto benéfico de los lácteos en el perfil lipídico, pese a que se necesitan evidencias de estudios longitudinales y de intervención que eluciden los mecanismos de efecto de los diferentes tipos de lácteos.

Relations between serum magnesium and calcium levels and body composition and metabolic parameters in women with fibromyalgia

Abstract Objective: Correlate serum magnesium (Mg) and Calcium (Ca) levels with body composition and metabolic parameters in women with fibromyalgia (FM). Patients and methods: Cross-sectional study compared with a control group paired by age and body mass index (BMI) of adult women diagnosed with fibromyalgia. All participants went through assessment of their body composition through dual-energy X-ray absorptiometry (DXA) and had blood samples collected for dosing of Mg, Ca, C-reactive Protein (CRP), lipidogram and glycemia. Results: 53 women with FM (average age 48.1 ±8.2 years, average BMI 26.6 ±4.5 kg/m2) and 50 control women (average age 47.1 ±9.9 years, average BMI 25.6 ± 3.6 kg/m2) participated in the study. Serum levels turned out to have inverse correlation with CRP in the FM group (r = −0.29, p = 0.03) and with BMI and glycemia in the control group (r = 0.31; p = 0.02 and r = 0.48; p = 0.0004 respectively). Serum levels of calcium correlated with triglycerides (r = 0.29; p = 0.03) in the FM group and with glycemia in the control group (r = 0.64; p = 0.0001). Conclusions: In patients with FM, magnesemia turned out to have inverse correlation with CRP and calcemia had positive association with triglycerides.(AU)

The beneficial effects of a water-based aerobic exercise session on the blood lipids of women with dyslipidemia are independent of their training status

OBJECTIVES: To evaluate the acute effects of a session of water-based aerobic exercise on the blood lipid levels of women with dyslipidemia and to compare these results according to their training status. METHOD: Fourteen premenopausal women with dyslipidemia, aged 40-50 years, participated in two water-based aerobic exercise sessions, the first when they were generally sedentary and the second after they were trained with a water-based aerobic training program for 12 weeks. Both experimental sessions were performed using the same protocol, lasted 45 min, and incorporated an interval method, alternating 3 min at a rating of perceived exertion (RPE) of 13 and 2 min at an RPE of 9. Total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and lipoprotein lipase enzyme (LPL) were obtained through venous blood collection before and immediately after each session. A generalized estimating equation method and Bonferroni tests were conducted (with time and training status as factors) for statistical analyses. RESULTS: At enrollment, the mean age of the participants was 46.57 years (95% confidence interval [CI] 44.81−48.34). The statistical analyses showed a significant time effect for all variables (TC: p=0.008; TG: p=0.012; HDL: p<0.001; LPL: p<0.001) except for LDL (p=0.307). However, the training status effect was not significant for any variable (TC: p=0.527; TG: p=0.899; HDL: p=0.938; LDL: p=0.522; LPL: p=0.737). These results indicate that the TC and TG levels reduced and the HDL and LPL concentrations increased from pre- to post-session in similar magnitudes in both sedentary and trained women. CONCLUSIONS: A single water-based aerobic exercise session is sufficient and effective to beneficially modify the lipid profile of women with dyslipidemia, regardless of their training status.

Tri-ponderal mass index is useful for screening children and adolescents with insulin resistance / O índice de massa tri-ponderal é útil na triagem de crianças e adolescentes com resistência à insulina

ABSTRACT Objective: To investigate whether tri-ponderal mass index and body mass index Z scores are equivalent for screening children and adolescents with insulin resistance. Methods: Cross-sectional study with 296 children and adolescents enrolled at public schools of Vitória, Espírito Santo, Brazil, aged eight to 14 years. The tri-ponderal mass index was calculated as the ratio between weight and height cubed. The body mass index was calculated as the ratio between weight and height squared. Insulin resistance was defined with the homeostatic model assessment (HOMA-IR). Results: The HOMA-IR was higher in the 4th quartile of body mass index Z scores and tri-ponderal mass index compared to 1st and 2nd quartiles for both girls and boys. The areas under the age-adjusted receiver operating characteristic curves were similar between the indices for girls (body mass index Z scores=0.756; tri-ponderal mass index=0.763) and boys (body mass index Z scores=0.831; tri-ponderal mass index=0.843). In addition, according to the simple linear regression analyses estimations, both body mass index Z scores and tri-ponderal mass index explained a significant fraction of the homeostatic model assessment variability for girls (body mass index Z scores: R2=0.269; tri-ponderal mass index: R2=0.289; p<0.001) and boys (body mass index Z scores: R2=0.175; tri-ponderal mass index: R2=0.210; p<0.001). Conclusions: The tri-ponderal mass index and body mass index Z scores were similar to discriminate children and adolescents with insulin resistance. It is noteworthy that the use of tri-ponderal mass index is clearly advantageous, because it can be calculated with no concerns on adjustments for the age, a fact that makes it very applicable in the clinical practice.

RESUMO Objetivo: Investigar se o índice de massa tri-ponderal e os escores-z do índice de massa corporal são equivalentes na triagem de crianças e adolescentes com resistência à insulina. Métodos: Estudo transversal com 296 crianças e adolescentes matriculados em escolas públicas de Vitória, Espírito Santo, Brasil, com idades entre oito e 14 anos. O índice de massa tri-ponderal foi calculado como a razão entre o peso e a altura ao cubo. O índice de massa corporal foi calculado como a razão entre o peso e a altura ao quadrado. A resistência à insulina foi definida pelo modelo de avaliação da homeostase para resistência à insulina (HOMA-IR). Resultados: O HOMA-IR foi maior no 4º quartil dos escores-z do índice de massa corporal e do índice de massa tri-ponderal, em relação ao 1º e 2º quartis em ambos os sexos. As áreas sob as curvas receiver operating characteristic ajustadas por idade foram semelhantes em meninas (escores-z do índice de massa corporal=0,756; índice de massa tri-ponderal=0,763) e meninos (escores-z do índice de massa corporal=0,831; índice de massa tri-ponderal=0,843). Além disso, de acordo com as estimativas das análises de regressão linear simples, os escores-z do índice de massa corporal e o índice de massa tri-ponderal explicaram uma fração significativa da variabilidade do modelo de avaliação da homeostase para meninas (escores-z do índice de massa corporal: R2=0,269; índice de massa tri-ponderal: R2=0,289; p<0,001) e meninos (escores-z do índice de massa corporal: R2=0,175; índice de massa tri-ponderal: R2=0,210; p<0,001). Conclusões: O índice de massa tri-ponderal e os escores-z do índice de massa corporal foram semelhantes na triagem de crianças e adolescentes com resistência à insulina. É importante ressaltar que o uso do índice de massa tri-ponderal é claramente vantajoso, pois pode ser calculado sem ajustes por idade, fato que o torna muito aplicável à prática clínica.

Association between metabolic syndrome and euthyroid nodular goiter: a case-control study / Asociación entre el síndrome metabólico y el bocio nodular eutiroideo: un estudio de casos y controles

Abstract Background: Metabolic syndrome is a cluster of metabolic abnormalities and abdominal obesity; its pathophysiologic basis, insulin resistance, has been shown to act as agent in thyroid cell proliferation. Few studies analyze the relationship between metabolic syndrome and thyroid nodular disease, with a substantial knowledge gap. Objective: Determine the association between metabolic syndrome and nodular thyroid disease in a region with adequate iodine intake. Methods: Case-control study. A total of 182 patients referred to radiology to undergo thyroid ultrasonography due to suspicion of thyroid disease. Cases had at least one thyroid nodule greater than 3 mm (n= 91). Controls did not have evidence of thyroid nodules (n= 91). Results: Bivariate analysis showed a significant association between metabolic syndrome and the presence of thyroid nodule (OR 2.56, 95% CI: 1.41-4.66, p <0.05). Low levels of HDL (OR 2.81, 95% CI: 1.54-5.12, p <0.05) and impaired fasting glucose (OR 2.05, 95%CI 1.10 to 3.78, p <0.05) were significantly associated with the presence of thyroid nodule, independent of the presence of metabolic syndrome. Multivariate analysis maintained the association between metabolic syndrome and thyroid nodule with an OR of 2.96 (95%CI 1.47 to 5.95, p <0.05); similarly, the associations of low levels of HDL (OR 2.77, 95%CI 1.44 to 5.3, p <0.05) and impaired fasting glucose (OR 2.23, 95%CI 1.14 to 4.34, p<0.05) with thyroid nodule remained significant. Conclusion: The thyroid nodular disease is associated with increased risk of metabolic syndrome, specifically decreased HDL and impaired fasting glucose levels were the factors that increased association was found.

Resumen Antecedentes: el síndrome metabólico es un conjunto de anormalidades metabólicas y obesidad abdominal; Se ha demostrado que su base fisiopatológica, la resistencia a la insulina, actúa como agente en la proliferación de las células tiroideas. Pocos estudios analizan la relación entre el síndrome metabólico y la enfermedad nodular tiroidea, con una brecha de conocimiento sustancial. Objetivo: determinar la asociación entre el síndrome metabólico y la enfermedad tiroidea nodular en una región con una ingesta adecuada de yodo. Métodos: estudio de casos y controles. Un total de 182 pacientes remitidos a radiología para someterse a una ecografía tiroidea debido a la sospecha de enfermedad tiroidea. Los casos tenían al menos un nódulo tiroideo mayor de 3 mm (n = 91). Los controles no tenían evidencia de nódulos tiroideos (n = 91). Resultados: El análisis bivariado mostró una asociación significativa entre el síndrome metabólico y la presencia de nódulo tiroideo (OR 2.56, IC 95%: 1.41-4.66, p <0.05). Los niveles bajos de HDL (OR 2.81, IC 95%: 1.54-5.12, p <0.05) y glucosa en ayunas alterada (OR 2.05, IC 95% 1.10 a 3.78, p <0.05) se asociaron significativamente con la presencia de nódulo tiroideo, independiente de la presencia de síndrome metabólico. El análisis multivariado mantuvo la asociación entre el síndrome metabólico y el nódulo tiroideo con un OR de 2.96 (IC 95% 1.47 a 5.95, p <0.05); de manera similar, las asociaciones de niveles bajos de HDL (OR 2.77, IC 95% 1.44 a 5.3, p <0.05) y glucosa en ayunas alterada (OR 2.23, IC 95% 1.14 a 4.34, p <0.05) con nódulo tiroideo permanecieron significativas. Conclusión: la enfermedad nodular tiroidea se asocia con un mayor riesgo de síndrome metabólico, específicamente la disminución de HDL y los niveles de glucosa en ayunas alterados fueron los factores que aumentaron la asociación.

The effects of physical activity during childhood, adolescence, and adulthood on cardiovascular risk factors among adults

SUMMARY OBJECTIVES: To analyze the association between physical activity during life and cardiovascular risk factors among adults. DESIGN: The sample was composed of 101 adults (59 men) between 30 and 50 years old, who were recruited from different gyms and from a University in Brasil. Participants were divided according to their engagement in sports in early life (self-reported) and current physical activity (pedometer) (sports participation during childhood/adolescence and currently active [n=26], sports participation during childhood/adolescence and currently inactive [n=26], and control [n=49]). Cardiovascular risk factors were measured, such as body fat (through DXA), HDL-C, triglycerides, HOMA index, systolic blood pressure, diastolic blood pressure, and C-reactive protein. We adopted the covariates of chronological age, sex, alcohol consumption, tobacco, and body mass index. General estimating equations were used, with p<0.05. RESULTS: After the adjustments of the final model, individuals engaged in sports during childhood and adolescence and inactive during adulthood presented lower body fat, when compared to participants persistently inactive (p<0.001). Participants persistently active presented lower body fat (p<0.001) and lower c-reactive protein (p=0.010) when compared to the control group. CONCLUSION: Early sports participation was associated with reduced body fat, and being physically active throughout life was associated with reduced body fat and C-reactive protein.

RESUMO OBJETIVO: Analisar a associação entre atividade física durante a vida e fatores de risco cardiovasculares entre adultos. DESIGN: A amostra foi composta por 101 adultos (59 homens) entre 30 e 50 anos, os quais foram recrutados em diferentes academias de ginástica e uma universidade brasileira. Os participantes foram divididos de acordo com o engajamento prévio (autorrelatado) e atual de atividade física (mensurada por pedômetro) (participação esportiva durante a infância/adolescência e prática atual [n=26], participação esportiva durante a infância/adolescência e ausência de prática atual [n=26] e controle [n=49]). Como fatores de risco cardiovasculares foram mensurados gordura corporal (por meio de DXA), HDL, triglicérides, índice Homa, pressão arterial sistólica e diastólica, além da proteína c-reativa. Foram adotadas como covariáveis: idade cronológica, sexo, consumo de álcool e índice de massa corporal. Equações gerais de estimativa foram utilizadas adotando p<0,05. RESULTADOS: Após os ajustes no modelo final, indivíduos engajados em esporte durante a infância e adolescência e inativos durante a idade adulta apresentaram menor gordura corporal quando comparados com participantes persistentemente inativos (p<0,001). Participantes persistentemente ativos apresentaram menor gordura corporal (p<0,001) e proteína c-reativa (p=0,010) quando comparados ao grupo controle. CONCLUSÃO: Prática esportiva prévia (durante infância e adolescência) foi associada com redução da gordura corporal e ser fisicamente ativo ao longo da vida foi associado à redução da gordura corporal e proteína c-reativa.