Masticatory function according to body mass index: part I: kinematic analysis using different food textures / Función masticatoria según índice de masa corporal: parte I: análisis cinemático utilizando diferentes texturas de alimentos

Introduction: Chewing is a learned orofacial function, important in the nutrition process of most mammals. It has been described that it can vary according to the characteristics of the individuals and the characteristics of the food. The aim of this study was to compare the kinematic characteristics of mastication in subjects with different body mass index (BMI), including foods of different hardness in the analysis. Material and Methods: A cross-sectional observational study was conducted. The mastication of 3.7 g of peanut (soft food) and 3.7 g of carrot (hard food) was compared among three study groups formed according to BMI: normal weight (BMI 18.5-24.9), overweight (BMI 25-29.9) and obese (BMI ≥30); each with 7 participants. The kinematics of the masticatory movement were assessed with a 3D Electromagnetic Articulograph, the characteristics analyzed were number of masticatory cycles, masticatory frequency, speed and area of the cycles. Results: No significant differences were noted among the study groups for the number of masticatory cycles, frequency or speed in the two foods studied. It was observed that when chewing carrot, the horizontal area of the masticatory cycles was significantly larger in the obese than in the overweight group. However, when chewing peanuts, this parameter did not present significant differences among the different groups. A comparison of the characteristics of mastication of the two foods revealed that the carrot chewing presented a significantly greater masticatory frequency and speed than the peanut chewing. Conclusion: This study demonstrated that food hardness influences the kinematic characteristics of mastication more than BMI, noting that hard foods are masticated faster and more frequently than soft foods and that masticatory frequency tends to increase with BMI.

Introduction: Chewing is a learned orofacial function, important in the nutrition process of most mammals. It has been described that it can vary according to the characteristics of the individuals and the characteristics of the food. The aim of this study was to compare the kinematic cha-racteristics of mastication in subjects with different body mass index (BMI), including foods of different hardness in the analysis. Material and Methods: A cross-sectional observational study was con- ducted. The mastication of 3.7 g of peanut (soft food) and 3.7 g of carrot (hard food) was compared among three study groups formed according to BMI: normal weight (BMI 18.5-24.9), overweight (BMI 25-29.9) and obese (BMI ?30); each with 7 participants. The kinematics of the masticatory movement were assessed with a 3D Electromagnetic Articulograph, the characteristics analyzed were number of masticatory cycles, masticatory frequency, speed and area of the cycles. Results: No significant differences were noted among the study groups for the number of masticatory cycles, frequency or speed in the two foods studied. It was observed that when chewing carrot, the horizontal area of the masticatory cycles was significantly larger in the obese than in the overweight group. However, when chewing peanuts, this parameter did not present significant differences among the different groups. A comparison of the characteristics of mastication of the two foods revealed that the carrot chewing presented a significantly greater masticatory frequency and speed than the peanut chewing. Conclusion: This study demonstrated that food hardness influences the kinematic characteristics of mastication more than BMI, noting that hard foods are masticated faster and more frequently than soft foods and that masticatory frequency tends to increase with BMI.

Food consumption, anthropometry and body composition of patients diagnosed with Parkinson's disease / Consumo alimentar, antropometria e composição corporal de pacientes diagnosticados com doença de Parkinson

ABSTRACT Objective The aim of the present study was to evaluate the consumption of risk and protective foods for chronic noncommunicable diseases and to investigate associations with anthropometric parameters and body composition in individuals with Parkinson's disease. Methods A case-series study was conducted with 79 adult and elderly patients of both genders in outpatient care. Food intake was evaluated using a food frequency questionnaire for the identification of foods with greater daily consumption, stratified by gender. The consumption frequency of each food was converted into scores of two food groups characteristics: risk and protection. The conceptual model took into account sociodemographic, behavioral and anthropometric variables as well as body composition. Results A total of 72.1% of the participants in the sample had excess weight based on the body mass index and 43.5% had excess body fat. The consumption of protective foods was greater among individuals with a higher body mass index and with a greater rate of body fat. Conclusion The data indicate a situation of reverse causality and reveal the complexity of the relationship among food intake, body fat and chronic noncommunicable diseases.

RESUMO Objetivo Este estudo visou avaliar o consumo de alimentos de risco e proteção para as doenças crônicas não transmissíveis e sua associação com parâmetros antropométricos e de composição corporal em pacientes com doença de Parkinson. Métodos Estudo do tipo série de casos, com 79 pacientes adultos e idosos, de ambos os sexos, atendidos ambulatorialmente. O consumo alimentar desses pacientes foi avaliado por um questionário de frequência alimentar, sendo identificados inicialmente os alimentos com maior frequência de consumo diário por sexo e, em seguida, a frequência de consumo de cada alimento foi convertida em escores, sendo constituídos dois grupos de alimentos: risco e proteção. O modelo conceitual considerou variáveis sociodemográficas, comportamentais, antropométricas e de composição corporal. Resultados Ao todo, 72,1% dos pacientes apresentaram excesso de peso segundo o índice de massa corporal e 43,5% apresentaram excesso de gordura corporal. O consumo de alimentos protetores foi maior nos pacientes com maior índice de massa corporal e maior percentual de gordura corporal. Conclusão Os dados apontam para uma condição de causalidade reversa e revelam a complexidade envolvida na relação entre consumo alimentar, gordura corporal e doenças crônicas não transmissíveis.

Alteraciones de la función pulmonar medida por espirometría y oscilometría de impulso en niños asmáticos con sobrepeso y obesidad / Alterations in lung function as measured by spirometry and impulse oscillometry in asthmatic children with overweight and obesity

INTRODUCCIÓN: El incremento del índice de masa corporal afecta la función pulmonar en el asma. Objetivo: determinar si existen diferencias entre asmáticos con estado nutricional normal, sobrepeso y obesidad en cuanto a alteraciones de la oscilometría de impulso (IOS) y espirometría. MÉTODO: Estudio realizado en niños y adolescentes con asma persistente. Se practicó sucesivamente IOS y Espirometría pre y post- broncodilatador según criterios ATS/ERS/SER. Los pacientes se clasificaron en: eutróficos (AE), con sobrepeso (ASP) y obesos (AO). Se compararon promedios de valores basales y con respuesta broncodilatadora (RB) en espirometría e IOS, con análisis de varianzas ANOVA y test de Tukey post hoc. Se consideró un poder de 80% y error α de 5%. RESULTADOS: Se analizaron 559 pacientes, promedio de edad 9,2 años, 50,9% varones. AE 52,4%, ASP 31,3% y AO 16,3%. Se encontraron diferencias significativas entre AO vs AE (X5, AX, D5-20, VEF1/CVF, FEF25-75/CVF, RB VEF1), y entre ASP vs AE (AX, D5-20, VEF1/CVF). También se encontraron diferencias significativas en varones, no encontradas en las mujeres (X5, D5-20, VEF1/CVF, RB CVF, RB VEF1). CONCLUSIONES: Los niños asmáticos con sobrepeso y obesidad, tienen un mayor compromiso de los índices de función pulmonar medida por espirometría e IOS que los asmáticos con estado nutricional normal. Existen diferencias de género en las alteraciones espirometría e IOS.

INTRODUCTION: Increased body mass index asthma affects lung function in asthma. Objective: to determine if asthmatics with overweight or obesity have alterations in Impulse oscillometry (IOS) and spirometry compared to eutrophic METHOD: Study carried out in children and adolescents with persistent asthma. IOS-Spirometry pre and post bronchodilator were performed successively according to ATS/ERS/SER criteria. The patients were classified as: eutrophic (AE), overweight (ASP) and obese (OA). Baseline and bronchodilator response (BR) averages were compared in spirometry and IOS with ANOVA and Tukey's post hoc analysis of variance. A power of 80% and α error of 5% were considered. RESULTS: 559 patients were analyzed, mean age 9.2 years, 50.9% male. AE 52.4%, ASP 31.3% and OA 16.3%. Significant differences were found between OA vs AE (X5, AX, D5-20, FEV1/FVC, FEF25-75 / FVC, RB FEV1), and between ASP vs AE (AX, D5-20, FEV1/FVC). Significant differences were also found in men, not women (X5, D5-20, FEV1/FVC, BR FVC, BR FEV1). CONCLUSIONS: Asthmatic children with overweight and obesity have a greater compromise of pulmonary function parameters measured by spirometry and IOS than asthmatics with normal nutritional status. There are gender differences in spirometry and IOS alterations.

Evaluation of nutritional risk factors in hematopoietic stem cell transplantation-eligible patients / Avaliação dos fatores de riscos nutricionais em pacientes pré-transplante de célula-tronco hematopoiética

ABSTRACT Objective To evaluate the nutritional risk factors in patients eligible for hematopoietic stem cell transplantation. Methods A cross-sectional, descriptive study conducted with patients recruited from an hematology outpatient clinic. Study variables included demographic and clinical data, patient-generated global subjective assessment findings, anthropometric indicators, food intake and oxidative stress levels. The level of significance was set at 5% (p<0.05). Results The sample comprised 72 patients, mean age of 48.93 years (14.5%). Multiple myeloma was the most prevalent condition (51.4%) in this sample. Most patients (55.6%) were overweight according to body mass index and at risk of cardiovascular disease according to waist circumference, conicity index and percentage of body fat. Sarcopenia was associated with risk of cardiovascular disease, hip-to-waist ratio (p=0.021), muscle strength depletion (p<0.001), food intake (p=0.023), reduced functional capacity (p=0.048), self-reported well-nourished status; p=0.044) and inadequate vitamin B6 (p=0.022) and manganese (p=0.026) intake. Elevated oxidative stress, detected in 33.3% of patients in this sample, was not associated with sarcopenia. Conclusion Most patients in this sample were overweight and sarcopenic. Lean mass depletion was associated with risk of cardiovascular disease, reduced muscle strength, food intake changes, reduced functional capacity, self-reported well-nourished status and inadequate intake of vitamin B6 and manganese, but not with oxidative stress.

RESUMO Objetivo Avaliar os fatores de riscos nutricionais em pacientes pré-transplante de célula-tronco hematopoiética. Métodos Estudo transversal, descritivo, realizado com pacientes de um ambulatório de hematologia. As variáveis estudadas foram demográficas, dados clínicos, avaliação subjetiva global produzida pelo próprio paciente, indicadores antropométricos, ingestão alimentar e estresse oxidativo. Os dados foram considerados estatisticamente significativos quando p<0,05. Resultados A amostra do estudo foi constituída por 72 pacientes, com média de idade de 48,93 (14,5%) anos e com mieloma múltiplo (51,4%) como a patologia mais prevalente. Conforme índice de massa corporal, 55,6% dos pacientes encontravam-se com excesso de peso. De acordo com a circunferência da cintura, índice de conicidade e percentual de gordura corporal, houve prevalência de risco para doença cardiovascular. A sarcopenia foi associada ao risco de doença cardiovascular pela relação cintura/quadril (p=0,021), depleção da força muscular (p<0,001), além da ingestão alimentar (p=0,023), da capacidade funcional reduzida (p=0,048) e do diagnóstico de "bem nutrido" (p=0,044), conforme a avaliação subjetiva global, e com consumo inadequado de vitamina B6 (p=0,022) e de manganês (p=0,026). Dentre os avaliados, 33,3% apresentaram estresse oxidativo elevado sem associação com sarcopenia. Conclusão Pacientes do pré-transplante se apresentam, em sua maioria, com excesso de peso, mas com sarcopenia, estando essa ausência de massa magra associada a risco de doença cardiovascular, depleção da força muscular, alteração da ingestão alimentar, redução da capacidade funcional, classificação de "bem nutrido", segundo a avaliação subjetiva global e consumo inadequado de vitamina B6 e manganês, não estando associada a estresse oxidativo.

Nutritional intervention may improve migraine severity: a pilot study / Intervenção nutricional melhora a gravidade da migrânea: estudo piloto

ABSTRACT Although some studies have investigated the role of nutritional intervention on migraine, they had focused on triggers or on weight change and, to the best of our knowledge, none studied diet quality. Objective To investigate whether nutritional intervention focused on improving diet quality and healthy weight can promote improvement in clinical parameters of women with migraine. Methods Non-controlled and non-randomized intervention study conducted for 90 days. Women received an individualized diet meal plan and nutritional orientation according to their nutritional diagnosis. Anthropometric, clinical and nutritional data were measured once a month. Diet energy content and macronutrients were evaluated using 24-hour dietary recall. Diet quality was assessed through the Brazilian Healthy Eating Index-Revised (BHEI-R). The Migraine Disability Assessment and Headache Impact Test version 6 were used to assess the severity of migraine, and the Beck Depression Inventory evaluated depressive symptoms. Results Fifty-two women aged 44.0 ± 13.0 years were enrolled. Anthropometric characteristics, energy, macronutrients and fiber intake did not change after intervention. However, the BHEI-R scores improved after 60 and 90 days of intervention. Concurrent to this, the Beck Depression Inventory scores and Headache Impact Test scores decreased after 60 and 90 days, respectively. The change in the BHEI-R score was negatively correlated with the migraine severity as assessed by the Headache Impact Test at the end of the intervention. Conclusions We concluded that the management of diet quality may be a good strategy for improving migraine severity, regardless of the nutritional status and weight change.

RESUMO Estudos investigaram o papel da intervenção nutricional, focada no consumo de alimentos "gatilhos" ou na alteração de peso, na melhora da migrânea. Porém, mudanças na qualidade da dieta ainda não foram abordadas. Objetivo Investigar se intervenção nutricional focada na qualidade da dieta e peso saudável pode melhorar parâmetros clínicos em mulheres com migrânea. Métodos Estudo de intervenção, não controlado e não randomizado. As mulheres receberam plano alimentar individualizado e orientações nutricionais, conforme o diagnóstico nutricional. Dados antropométricos, clínicos e alimentares foram medidos uma vez por mês durante três meses. Recordatório alimentar de 24 horas forneceu informações sobre o consumo alimentar. Qualidade da dieta foi avaliada pelo Índice Brasileiro de Alimentação Saudável (IQD-R). Os questionários Migraine Disability Test (MIDAS) e Headache Impact Test, versão 6 (HIT-6) avaliaram a incapacidade gerada pela enxaqueca e o Inventário de Depressão de Beck (BDI) investigou sintomas depressivos. Resultados Cinquenta e duas mulheres com 44,0 ± 13,0 anos participaram da amostra. Características antropométricas e consumo de energia, macronutrientes e fibras não se alteraram depois da intervenção. No entanto, os escores do IQD-R melhoraram após 60 e 90 dias de intervenção. Os escores do BDI e do HIT-6 diminuíram após 60 e 90 dias, respectivamente. A mudança no escore do IQD-R correlacionou de maneira negativa com a gravidade da enxaqueca avaliada pelo HIT-6 ao final da intervenção. Conclusões O manejo da qualidade da dieta pode ser estratégia para melhorar a gravidade da migrânea, independente do estado nutricional e da mudança de peso dos pacientes.

Waist-to-height ratio is as reliable as biochemical markers to discriminate pediatric insulin resistance / A razão cintura/estatura é tão confiável quanto marcadores bioquímicos para discriminar resistência à insulina

Abstract Objective: Given the importance of incorporating simple and low-cost tools into the pediatric clinical setting to provide screening for insulin resistance, the present study sought to investigate whether waist-to-height ratio is comparable to biochemical markers for the discrimination of insulin resistance in children and adolescents. Methods: This cross-sectional study involved students from nine public schools. In total, 296 children and adolescents of both sexes, aged 8 -14 years, composed the sample. Waist-to-height ratio, triglycerides/glucose index, and triglycerides-to-HDL-C ratio were determined according to standard protocols. Insulin resistance was defined as homeostatic model assessment for insulin resistance with cut-off point ≥ 3.16. Results: Age, body mass index, frequency of overweight, waist circumference, waist-to-height ratio, insulin, glucose, homeostatic model assessment for insulin resistance, triglycerides, triglycerides/glucose index, and triglycerides-to-HDL-C were higher among insulin resistant boys and girls. Moderate correlation of all indicators (waist-to-height ratio, triglycerides/glucose index, and triglycerides-to-HDL-C ratio) with homeostatic model assessment for insulin resistance was observed for both sexes. The areas under the receiver operational characteristic curves ware similar between waist-to-height ratio and biochemical markers. Conclusion: The indicators provided similar discriminatory power for insulin resistance. However, taking into account the cost-benefit ratio, we suggest that waist-to-height ratio may be a useful tool to provide screening for insulin resistance in pediatric populations.

Resumo Objetivo: Considerando a importância de incorporar ferramentas simples e de baixo custo no cenário clínico-pediátrico para a triagem de resistência à insulina, o presente estudo buscou investigar se a razão cintura/estatura é comparável a marcadores bioquímicos na discriminação de resistência à insulina em crianças e adolescentes. Métodos: Este estudo transversal envolveu estudantes de nove escolas públicas. No total, 296 crianças e adolescentes, de ambos os sexos, com idades entre 8 e 14 anos, compuseram a amostra. A razão cintura/estatura, o índice triglicerídeos/glicose e a razão triglicerídeos/HDL-C foram determinados de acordo com protocolos padrão. A resistência à insulina foi definida por meio do modelo de avaliação homeostática para resistência insulínica, com ponto de corte ≥ 3.16. Resultados: Idade, índice de massa corporal, frequência de excesso de peso, circunferência da cintura, razão cintura/estatura, insulina, glicemia, modelo de avaliação homeostática para resistência insulínica, triglicerídeos, índice triglicerídeos/glicose e razão triglicerídeos/HDL-C foram maiores entre meninos e meninas com resistência à insulina. Também foram observadas, em ambos os sexos, correlações moderadas de todos os indicadores (razão cintura/estatura, índice triglicerídeos/glicose e razão triglicerídeos/HDL-C) com o modelo de avaliação homeostática para resistência à insulina. As áreas sob as curvas ROC foram semelhantes entre a razão cintura/estatura e os marcadores bioquímicos. Conclusão: Os indicadores forneceram poder discriminatório similar para a resistência à insulina. No entanto, levando em conta o custo-benefício, sugerimos que a razão cintura/estatura pode ser uma ferramenta útil para a triagem de resistência à insulina em populações pediátricas.

The ability of waist-to-height ratio to identify health risk / Habilidade da razão cintura-estatura na identificação de risco à saúde

ABSTRACT OBJECTIVE To evaluate the performance of the ratio between the waist circumference and the height in the identification of health risk compared with the correlation matrix between the anthropometric parameters body mass index and waist circumference. METHODS A population-based study presenting a transversal cut in a representative sample of the Brazilian adult and older population. The combination of the body mass index with the waist circumference resulted in health risk categories, and the cutoff points of the ratio between the waist circumference and the height as anthropometric indicator were used for classification of low and increased risk. Poisson regression was used to verify the association of systemic arterial hypertension with the health risk categories. RESULTS The results showed 26% of adult men, 10.4% of adult women and more than 30% of the older adults of both genders classified as without risk by the combination matrix between body mass index and waist circumference presented a ratio between the waist circumference and height that showed increased risk. All risk categories continued to be associated with hypertension after control for confounding factors, being almost two times higher for adults with moderate and high risk according to both methods. When the waist-to-height ratio was used as a risk indicator, the prevalence of hypertension ratios for the older adults was 1.37 (95%CI 1.16-1.63) and 1.35 (95%CI 1.12-1.62) for men and women, respectively, being these values close to the combination matrix body mass index and waist circumference. CONCLUSIONS The waist-to-height ratio identified more individuals at early health risk than the combination matrix between the body mass index and the waist circumference and showed comparable ability to identify health risk, regardless of gender and age, regarding the prevalence ratios for systemic arterial hypertension.

RESUMO OBJETIVO Avaliar o desempenho da razão entre a circunferência da cintura e a estatura na identificação de risco à saúde comparada à matriz de associação entre os parâmetros antropométricos índice de massa corporal e circunferência da cintura. MÉTODOS Estudo de base populacional apresentando um corte transversal em uma amostra representativa da população adulta e idosa brasileira. A combinação do índice de massa corporal com a circunferência da cintura deu origem às categorias de risco à saúde, assim como os pontos de corte da razão entre a circunferência da cintura e a estatura como indicador antropométrico foram utilizados para a classificação de baixo risco e risco aumentado. A regressão de Poisson foi utilizada para verificar a associação da hipertensão arterial sistêmica com as categorias de risco à saúde. RESULTADOS Os resultados apontaram que 26% dos homens adultos, 10,4% das mulheres adultas e mais de 30% dos idosos de ambos os sexos classificados como sem risco pela matriz de combinação índice de massa corporal e circunferência da cintura apresentaram razão entre a circunferência da cintura e a estatura indicativa de risco aumentado. Todas as categorias de risco continuaram apresentando associação com a hipertensão após controle para os fatores de confusão, permanecendo próximas de duas vezes maiores para os indivíduos adultos com risco moderado e elevado segundo ambos os métodos. Já os idosos apresentaram razões de prevalência de hipertensão de 1,37 (IC95% 1,16-1,63) e de 1,35 (IC95% 1,12-1,62), para homens e mulheres, respectivamente, quando utilizada a razão entre a circunferência da cintura e a estatura como indicador de risco, estando estes valores próximos à matriz de combinação índice de massa corporal e circunferência da cintura. CONCLUSÕES A razão entre a circunferência da cintura e a estatura identificou mais indivíduos em risco precoce à saúde do que a matriz de combinação entre o índice de massa corporal e a circunferência da cintura e apresentou habilidades comparáveis na identificação de risco à saúde, independentemente do sexo e da faixa etária, no que tange às razões de prevalência para hipertensão arterial sistêmica.

Anthropometric status of individuals with COPD in the city of São Paulo, Brazil, over time - analysis of a population-based study / Análise evolutiva antropométrica em indivíduos com DPOC na cidade de São Paulo - estudo de base populacional

ABSTRACT Objective: To evaluate the anthropometric data obtained for residents of the city of São Paulo, Brazil, in a study of Latin America conducted in two phases (baseline, in 2003, and follow-up, in 2012). Methods: This was an analysis of data obtained for São Paulo residents in a two-phase population-based study evaluating the prevalence of COPD and its relationship with certain risk factors among individuals ≥ 40 years of age. The anthropometric data included values for weight, height, body mass index (BMI), and waist circumference. In the follow-up phase of that study, the same variables were evaluated in the same population sample as that of the baseline phase. Results: Of the 1,000 São Paulo residents enrolled in the baseline phase of that study, 587 participated in the follow-up phase, and 80 (13.6%) of those 587 subjects had COPD. Comparing the baseline and follow-up phases, we found increases in all anthropometric measures in both groups (COPD and non-COPD), although the differences were significant only in the non-COPD group. The subjects with mild COPD showed increases in weight and BMI (Δweight = 1.6 ± 5.7 and ΔBMI = 0.7 ± 2.2), whereas those with moderate or severe COPD showed reductions (Δweight = −1.7 ± 8.1 and ΔBMI = −0.4 ± 3.0), as did those with severe or very severe COPD (Δweight = −0.5 ± 5.4 and ΔBMI = −0.8 ± 3.3). Conclusions: Between the two phases of the study, the subjects with mild COPD showed increases in weight and BMI, whereas those with a more severe form of the disease showed reductions.

RESUMO Objetivo: Avaliar a evolução dos dados antropométricos obtidos em uma pesquisa latino-americana realizada em duas fases (basal, em 2003, e seguimento, em 2012) na cidade de São Paulo. Métodos: Estudo de base populacional que avaliou indivíduos com idade ≥ 40 anos com o objetivo de definir a prevalência da DPOC e sua relação com alguns fatores de risco. A avaliação antropométrica incluiu medições de peso, altura, índice de massa corpórea (IMC) e circunferência abdominal. Foram avaliadas as mesmas variáveis na mesma população na fase de seguimento. Resultados: Dos 1.000 indivíduos incluídos inicialmente, 587 participaram da fase de seguimento; desses, 80 (13,6%) tinham DPOC. Entre a avaliação inicial e a de seguimento ambos os grupos (DPOC e não DPOC) apresentaram aumentos nas medidas antropométricas, mas esses somente foram significativos no grupo não DPOC. Os indivíduos com DPOC leve tiveram aumentos de peso e IMC (Δpeso = 1,6 ± 5,7 kg e ΔIMC = 0,7 ± 2,2 kg/m2) enquanto aqueles com doença moderada ou grave tiveram reduções dessas medidas (DPOC moderada: Δpeso = −1,7 ± 8,1 kg e ΔIMC = −0,4 ± 3,0 kg/m2; e DPOC grave ou muito grave (Δpeso = −0,5 ± 5,4 kg e ΔIMC = −0,8 ± 3,3 kg/m2). Conclusões: Entre as duas fases da pesquisa, os pacientes com DPOC leve tiveram aumento de peso e IMC, enquanto aqueles com doença mais grave apresentaram perda ponderal e redução do IMC.

Prevalência e fatores associados da obesidade na população brasileira: estudo com dados aferidos da Pesquisa Nacional de Saúde, 2013 / Prevalence of obesity and associated factors in the Brazilian population: a study of data from the 2013 National Health Survey

RESUMO: Introdução: A prevalência de obesidade está aumentando em um ritmo alarmante em muitos países. Uma alimentação não saudável e o sedentarismo são os principais fatores de risco para a obesidade. O objetivo deste artigo foi estudar a prevalência e identificar fatores associados à obesidade na população adulta brasileira com base nos dados coletados na Pesquisa Nacional de Saúde, 2013. Método: Amostra de 59.402 indivíduos adultos, excluindo-se as mulheres grávidas. O índice de massa corporal foi calculado por meio das aferições de peso e estatura. A obesidade foi definida por índice de massa corporal ≥ 30 kg/m2. Utilizaram-se modelos de regressão logística para identificar os fatores associados à obesidade. Resultados: As prevalências de obesidade foram de 16,8% para homens e 24,4% para mulheres. Idade avançada (a partir dos 50 anos), nível de instrução baixo (sem instrução ou ensino fundamental incompleto), raça/cor preta e viver com companheiro foram fatores de risco à obesidade. A atividade física no lazer e o hábito de assistir mais de 4 horas de televisão por dia mostraram associações significativas para ambos os sexos. Quanto à morbidade referida, em pessoas obesas, as chances de ter o diagnóstico de hipertensão, diabetes ou de alguma doença crônica não transmissível foram maiores. Homens e mulheres obesos tiveram a pressão arterial sistólica significativamente aumentada. Conclusão: Os achados enfatizam a importância de políticas públicas para a prevenção da obesidade e para a promoção de hábitos saudáveis na sociedade brasileira.

ABSTRACT: Introduction: The prevalence of obesity is increasing at an alarming rate in many countries. Unhealthy eating and sedentary lifestyle are the main risk factors for obesity. The objective of this study was to determine the prevalence of obesity and identify the associated factors in the Brazilian adult population on the basis of data collected in the 2013 National Health Survey. Method: We analyzed the data from a sample of 59,402 adult subjects, excluding pregnant women. Body mass index (BMI) was calculated by means of weight and height measurements. Obesity was defined as BMI ≥30 kg/m2. Logistic regression models were used to identify the factors associated with obesity. Results: The prevalence of obesity was 16.8% for men and 24.4% for women. Advanced age (over 50 years), low education level (no schooling or incomplete elementary school), African Brazilian and living with partner were risk factors for obesity. Leisure time physical activity and the habit of watching more than 4 hours of television per day showed significant effects for both sexes. Regarding the referred morbidity, in obese people, the chances of having a diagnosis of hypertension, diabetes, or some non-communicable chronic disease were higher. Obese men and women had significantly increased systolic blood pressure. Conclusion: Our findings emphasize the importance of public policies for the prevention of obesity and for the promotion of healthy habits in Brazilian society.

Modulación de marcadores de inflamación y estrés oxidativo en pacientes con diabetes tipo 1 y sobrepeso que participan en un programa de cambio de estilo de vida / Modulation of Inflammatory and oxidative stress markers in overweight type 1 Diabetes patients participating in a lifestyle change program

Introduction: Reduction in the expression of inflammatory markers and oxidative stress associated with exercise will protect against cardiovascular complications in Diabetes Mellitus (DM). Aim: The aim of this study was evaluated cardiovascular fitness (VO2 Max), interleukin-6 (IL-6), monocyte chemo-attractant protein 1 (MCP-1) and serum lipid peroxidation (TBARS) in overweight patients with Type-1 diabetes (T1DM) participating in a lifestyle-change program. Results: 20 T1DM overweight patients (43.3 ± 13.8 years), with BMI= 29.6 ± 3.5 kg/m2 , initial HbA1c 7.9 ± 0.91% and treated with multiple insulin injections, were included in this work. The lifestyle-change program consisted of: a) walking 10,000 steps/day, b) sequence of exercises of 24 minutes, 3-5 times/week, c) ¨healthy-plate¨ (and counting carbohydrates, and d) prandial insulin as blood-glucose levels. VO2 max, HbA1c, TBARS, IL6, MCP-1 were determined before starting the lifestyle-change program. Six months of adherence later, participants showed an average number of steps of 8242 ± 1834, a significant increase in VO2 max, (33.4 ±1.3 vs 36.2 ±1.5 ml.Kg-1.min-1 p= 0.008), a significant decrease in serum MCP-1 (314 ±42 vs 235 ±43 MFI p= 0.02), and less TBARS (3.01 ±0.44 vs 2.12 ±0.22 µmol/mL p= 0.015). IL-6 and HbA1c showed no significant decrease. Conclusion: Our results showed that a 6-month systemized and simple exercise plan improves cardiorespiratory fitness (VO2 max), and reduces both circulating oxidative stress and inflammation markers in overweight patients with T1DM.

Introducción: La reducción en la expresión de marcadores inflamatorios y de estrés oxidativo asociado con el ejercicio podría proteger contra las complicaciones cardiovasculares de la diabetes mellitus (DM). Objetivo: El objetivo de este estudio fue evaluar en pacientes con DM tipo1 (DMT1) y sobrepeso, la capacidad cardiorespiratoria (VO2 Max), la expresión sérica de marcadores inflamatorios (IL-6 y MCP-1) y la peroxidación lipídica sérica (TBARS), luego de participar por 6 meses de un programa de cambios de estilo de vida. Resultados: Veinte pacientes adultos (43.3 ± 13.8 años), de ambos sexos, con un Índice de Masa Corporal de 29.6 ± 3.5 kg/m2 , HbA1c inicial de 7,9% ± 0,91, en tratamiento con inyecciones múltiples de insulina participaron del estudio. Se indicó: 1) caminar 10.000 pasos/día, 2) realizar en domicilio una secuencia de ejercicios de 20 minutos, 3-5 veces/semana, 3) plato saludable (consumo de 1 fruta antes de las 3 comidas principales), 4) Insulina prandial según glucemia y conteo de carbohidratos. Se registraron parámetros antropométricos, presión arterial, se determinó VO2 max, y se midieron los niveles séricos de HbA1c, IL6, MCP-1 y TBARs. Luego de seis meses, los participantes alcanzaron un número promedio de pasos de 8242 ± 1834 y mostraron un aumento significativo en VO2 max, (33.4 ±1.3 vs 36.2 ±1.5 ml.Kg-1.min-1 p= 0.008). Además, se encontró una disminución significativa de MCP-1 (314 ±42 vs 235 ±43 MFI p=0.02) y TBARs (3.01 ±0.44 vs 2.12 ±0.22 µmol/mL p= 0.015) en comparación con el día 0. No se observaron modificaciones en los niveles de IL-6 y HbA1c. Conclusión: Nuestros resultados demuestran que el ejercicio, implementado como un plan accesible y acompañado, es adecuado para reducir los riesgos de inflamación y estado pro-oxidativo en pacientes con DM tipo1.

Timing of permanent tooth emergence is associated with overweight/obesity in children from the amazon region

Abstract The aim of this study was to evaluate the association between timing of permanent tooth emergence with overweight and obesity in children from Brazilian Amazon region. The studied population consisted of 192 children, 09 to 12 year-old, from public schools at Manaus, Amazonas-Brazil. Clinical examination was performed and the tooth emergence was evaluated according to the number of permanent erupted teeth. Body mass index z-score was calculated. For the statistical analysis 'Overweight/obese' group was compared with 'Normal weight' group in a case to control ratio 1:2. The t-test based on age was used for means comparison between the groups. A linear regression analysis using age and gender as co-variants was used. The established alpha was 5%. One hundred twenty-seven children were classified as normal weight and 65 were classified as overweight/obese (49 were overweight and 16 were obese). Overweight/obesity condition was associated with the gender, in which boys had a higher chance to present higher weight conditions (OR=1.84; CI 95% 1.06-3.37; p=0.04). The mean number of permanent teeth was higher in the overweight/obesity group (p<0.001). Linear regression analysis demonstrated that nutritional status, gender and age were strongly associated with number of permanent erupted teeth (p<0.05). In conclusion, our study demonstrated that timing of permanent tooth emergence is associated with overweigh/obesity in children from Manaus, Brazil.

Resumo O objetivo deste estudo foi avaliar se a erupção dentária está associada com sobrepeso/obesidade em crianças da região Amazônica brasileira. A população estudada foi composta por 192 crianças, de 9 a 12 anos, de escolas públicas de Manaus, Amazonas-Brasil. O exame clínico foi realizado e a erupção dentária foi avaliada de acordo com o número de dentes permanentes irrompidos. O índice de massa corporal escore-z foi calculado. Para a análise estatística, comparou-se o grupo "sobrepeso / obesidade" com o grupo "peso normal" em uma proporção de controle 1: 2. O teste t baseado na idade foi utilizado para comparação das médias entre os grupos. Uma análise de regressão linear usando idade e sexo como co-variáveis foi utilizada. O alfa estabelecido foi de 5%. Cento e vinte e sete crianças foram classificadas com peso normal e 65 foram classificados com sobrepeso / obesidade (49 com sobrepeso e 16 com obesidade). A condição de sobrepeso / obesidade associou-se ao gênero, no qual os meninos tiveram maior chance de apresentar condições de maior peso (OR = 1,84; IC 95% 1,06-3,37; p = 0,04). O número médio de dentes permanentes irrompidos foi maior no grupo sobrepeso / obesidade (p <0,001). A análise de regressão linear demonstrou que o estado nutricional, sexo e idade foram fortemente associados ao número de dentes permanentes irrompidos (p <0,05). Concluindo, nosso estudo demonstrou que o momento da erupção dos dentes permanentes é associado com sobrepeso / obesidade em crianças de Manaus, Brasil.

Factores de riesgo asociados a bajo nivel de actividad física y exceso de peso corporal en estudiantes universitarios / Levels of physical activity and excess body weight in university students

Background: University students are considered a vulnerable group due to their adoption of unhealthy diets and lifestyles. Aim: To determine the main risk factors associated with low level of physical activity and excess body weight in university students. Material and Methods: This cross-sectional study included 358 university students from Talca, (53% female). Sociodemographic, academic, health, lifestyle, nutritional status, physical activity and sedentary behavior variables were analyzed by logistic regression. Results: Men were more likely to present excess body weight than women (Odds ratio (OR): 2.16 [95% CI: 1.17-4.01], p = 0.01). Similarly, those with low level of physical activity (OR: 2.13 [95% CI: 1.10-414], p = 0.03), musculoskeletal injuries (OR: 2.43 [95% CI: 1.09-6.34], p = 0.05) and smokers (OR: 2.09 [95% CI: 1.05-4.14], p = 0.04) were more likely to have excess body weight. Individuals with excess body weight (OR: 2.94 [95% CI: 1.31-6.61], p < 0.01), high sedentary behaviors (OR: 2.01 [95% CI: 1.04-4.55], p = 0.04), those who spent more than 7 hours per week studying (OR: 2.11 [95% CI: 1.06-4.66], p = 0.04), and those with presence of musculoskeletal injuries (OR: 1.49 [95% CI: 1.06- 3.66], p = 0.04) were more likely to be physically inactive. In addition, men were 73% less likely to have low physical activity levels compared to women (OR: 0.27 [95% CI: 0.11-0.56], p < 0.01). Conclusions: University students have several modifiable risk factors associated with low levels of physical activity and excess weight. Healthy lifestyles promotion should modify these risk behaviors.

Impulse oscillometry and obesity in children / Oscilometria de impulso e obesidade em crianças

Abstract Objective: To compare impulse oscillometry system parameters of normal-weight children with overweight and obese children. Method: All participants were submitted to the evaluation of lung function (spirometry and impulse oscillometry) following the American Thoracic Society standards. The evaluation of respiratory mechanics was performed using the Jaeger™ MasterScreen™ Impulse Oscillometry System (Erich Jaeger, Germany), three tests were recorded, with acquisition for at least 20 seconds. Results: The study included 81 children (30 in the control group, 21 in the overweight group, and 30 the in obesity group), matched for age and sex. Regarding spirometry data, obesity group showed higher numerical values in relation to the control group; however, there were no significant differences among the three groups. For impulse oscillometry parameters, there was a difference between control group and obesity group for respiratory impedance (p = 0.036), resistance at 5 hertz (p = 0.026), resonant frequency (p = 0.029), and reactance area (p = 0.014). For the parameters expressed in percentage of predicted, there were differences in resistance at 5 hertz, resonant frequency, and reactance area between control group and obesity group. Conclusions: Obese children showed increased oscillometry parameters values representative of airway obstruction, compared to normal-weight children. Changes in some oscillometry parameters can already be observed in overweight school-aged children.

Resumo Objetivo: Comparar parâmetros do Sistema de Oscilometria de Impulso de crianças com peso normal com crianças com sobrepeso e obesas. Método: Todos os participantes foram submetidos à avaliação de mecanismos respiratórios utilizando o Sistema de Oscilometria de Impulso Jaeger™ (MasterScreen™ IOS, Erich Jaeger, Alemanha) seguindo as normas da Sociedade Torácica Americana. Todos os participantes foram submetidos a testes de espirometria e oscilometria (três testes foram registrados, com coleta de dados por pelo menos 20 segundos). Resultados: O estudo incluiu 81 crianças (30 no grupo de controle, 21 no grupo sobrepeso e 30 no grupo obesidade), pareadas por idade e sexo. No que diz respeito a dados de espirometria, o grupo obesidade mostrou valores numéricos mais elevados; contudo, não houve diferenças significativas entre os três grupos. No que diz respeito a parâmetros do Sistema de Oscilometria de Impulso, houve diferença entre o grupo de controle e o grupo obesidade em Z5 (p = 0,036), resistência 5 hertz (p = 0,026), frequência de ressonância (p = 0,029) e área de reatância (p = 0,014). Nos parâmetros expressos em percentual previsto, houve diferenças em resistência 5 hertz, frequência de ressonância e área de reatância entre o grupo de controle e grupo obesidade. Conclusões: Crianças obesas mostraram parâmetros de oscilometria aumentados representativos de obstrução das vias aéreas em comparação a crianças com peso normal. As alterações em alguns parâmetros oscilométricos já podem ser observadas em crianças com sobrepeso em idade escolar.

Correlation of body mass index Z-scores with glucose and lipid profiles among overweight and obese children and adolescents / Correlação dos escores-z de IMC com os perfis glicêmico e lipídico entre crianças e adolescentes com sobrepeso e obesidade

Abstract Objective To evaluate the prevalence of abnormalities in plasma lipid and glucose profiles among overweight and obese children and adolescents, and to assess the presence of a correlation between body mass index Z-scores and indicators of comorbidities related to both profiles. Methods This was a multicenter cross-sectional study conducted at two outpatient clinics. The study included all 417 comers for the first visit from 2008 to 2012, aged between 7 and 18 years, with BMI above the Z-score +1. Anthropometry and blood sampling were obtained. The prevalence of dyslipidemias, hyperglycemia, and insulin resistance were evaluated, together with the correlations of these variables with the increase of Z-BMI. Results Dyslipidemia was observed in 43.4% of the boys and 66.1% of the girls, with no difference between genders. High glucose levels were detected in 6.2% of the individuals. Insulin resistance was present in 32.3% and 41.7% of the cases, with no statistical significance between boys and girls. Correlations between the Z-BMI were noted for triglycerides in the entire group and among girls; for HDL-c, only among girls; for glucose, a correlation was observed for the entire group, but not when stratified by gender. The indicators of insulin resistance were all correlated with Z-BMI, even when corrected for age. Conclusions Overweight and obesity give origin to a high prevalence of dyslipidemia and insulin resistance. BMI Z-scores showed a weak positive correlation with glucose and triglyceride, and negative with HDL-c. In turn, the strongest positive correlation was found with insulin resistance indicators.

Resumo Objetivo Avaliar a prevalência de anormalidades nos perfis lipídico e glicêmico entre crianças e adolescentes com sobrepeso e obesidade e também verificar se existe correlação entre os escores-z de índice de massa corporal (z-IMC) e indicadores de comorbidades ligados a esses perfis. Métodos Estudo de corte transversal multicêntrico, incluiu 417 pacientes entre 7 e 18 anos e IMC acima do escore-z > + 1 que fizeram a consulta de caso novo entre 2008 e 2012. Antropometria e coleta de sangue foram realizadas. As prevalências de dislipidemia, hiperglicemia e resistência insulínica foram avaliadas, juntamente com as correlações entre essas variáveis e o z-IMC. Resultados Dislipidemia foi encontrada em 43,4% dos meninos e 66,1% das meninas, sem diferença entre os sexos. Hiperglicemia foi encontrada em 6,2% dos indivíduos. Resistência insulínica esteve presente entre 32,3 e 41,7% dos casos, sem diferença estatística entre os sexos. Foi observada correlação com z-IMC para triglicerídeos quando considerado o grupo todo e entre as meninas; e para HDL-c apenas entre as meninas. A glicemia apresentou correlação quando considerado o grupo todo, mas não quando separados por sexo. Os indicadores de resistência insulínica estiveram todos correlacionados com IMC, mesmo quando se executou correção para a idade. Conclusões Sobrepeso e obesidade levam a prevalências elevadas de dislipidemia e resistência insulínica. Os escores-z de IMC mostraram discreta correlação positiva com glicose e triglicerídeos e negativa com HDL-c. Por outro lado, correlação positiva mais forte foi observada com os indicadores de resistência insulínica.

Metabolic syndrome components are associated with oxidative stress in overweight and obese patients

ABSTRACT Objective: The aim of this study is to evaluate the influence of the body mass index (BMI) and the metabolic syndrome (MetS) parameters on oxidative and nitrosative stress in overweight and obese subjects. Subjects and methods: Individuals were divided into three groups: the control group (G1, n = 131) with a BMI between 20 and 24.9 kg/m2, the overweight group (G2, n = 120) with a BMI between 25 and 29.9 kg/m2 and the obese group (G3, n = 79) with a BMI ≥ 30 kg/m2. Results: G3 presented higher advanced oxidation protein products (AOPPs) in relation to G1 and G2 (p = 0.001 and p = 0.011, respectively) whereas G2 and G3 had lower levels of nitric oxide (NO) (p = 0.009 and p = 0.048, respectively) compared to G1. Adjusted for the presence of MetS to evaluate its influence, the levels of AOPPs did not differ between the groups, whereas NO remained significantly lower. Data adjusted by the BMI showed that subjects with higher triacylglycerol levels had higher AOPPs (p = 0.001) and decreased total radical-trapping antioxidant parameter/uric Acid (p = 0.036). Subjects with lower high-density lipoprotein (HDL) levels and patients with higher blood pressure showed increased AOPPs (p = 0.001 and p = 0.034, respectively) and lower NO levels (p = 0.017 and p = 0.043, respectively). Subjects who presented insulin resistance had higher AOPPs (p = 0.024). Conclusions: Nitrosative stress was related to BMI, and protein oxidation and nitrosative stress were related to metabolic changes and hypertension. MetS components were essential participants in oxidative and nitrosative stress in overweight and obese subjects.

Weight reduction for a better visual outcome in idiopathic intracranial hypertension / Redução de peso para a melhora do resultado visual na hipertensão intracraniana idiopática

ABSTRACT Purpose: To evaluate the correlation between weight reduction and visual outcome in overweight patients with idiopathic intracranial hypertension. Methods: Thirty-nine newly diagnosed, overweight (body mass index >25 kg/m2) patients with idiopathic intracranial hypertension were studied retrospectively. All patients underwent medical treatment with acetazolamide, and a weight reduction program was also offered. Patients were grouped according to their compliance with this weight reduction program into the diet-success (Group 1) and diet-failure groups (Group 2). Body mass index, papilledema, visual acuity, and perimetric mean deviation were compared at the end of the 6-month study period. Results: Groups 1 and 2 did not differ regarding the baseline mean body mass index (32.63 ± 5.61, 32.35 ± 5.06 kg/m2), visual acuity (0.080 ± 0.13, 0.130 ± 0.24 logMAR), perimetric mean deviation (-9.978 ± 0.68, -12.86 ± 8.91), or papilledema grade (2.94 ± 0.22, 2.90 ± 0.30), respectively (p>0.05). During the 6 months' follow-up, Group 1 patients, who complied with both medical and diet therapy, improved significantly in all parameters, including body mass index (p<0.001), visual acuity (p=0.001), perimetric mean deviation (p=0.016), and papilledema grade (p<0.001). Conversely, Group 2 patients, who only underwent medical therapy, improved only in papilledema grade (p<0.001). However, coincident development of optic disc pallor was observed in three patients. Further, they also had significant loss in visual acuity (p=0.047) during the study period. Conclusion: Weight reduction combined with medical treatment is associated with significantly better improvement in visual acuity, visual field, and papilledema in idiopathic intracranial hypertension patients. Compliance with an efficient diet program should be encouraged in overweight patients with idiopathic intracranial hypertension.

RESUMO Objetivo: Avaliar a correlação entre a redução de peso e o resultado visual em pacientes com hipertensão intracraniana idiopática e sobrepeso. Métodos: Trinta e nove pacientes, recém-diagnosticados com hipertensão intracraniana idiopática e sobrepeso (índice de massa corporal >25 kg/m2), foram estudados retrospectivamente. Todos os pacientes foram submetidos a tratamento médico com acetazolamida e receberam um programa para redução de peso. Os pacientes foram classificados de acordo com o cumprimento do programa de redução de peso em: sucesso da dieta (Grupo 1) e falha da dieta (Grupo 2). Os índices de massa corporal, a papiledema, a acuidade visual e desvios médios perimétricos foram comparados no final de 6 meses. Resultados: Os grupos não apresentaram diferenças em relação às médias da linha de base de índice de massa corporal (32,63 ± 5,61/32,35 ± 5,06 kg/m2), acuidade visual (0,080 ± 0,13/0,130 ± 0,24 logMAR), desvios médios perimétricos (-9,978 ± 0,68/-12,86 ± 8,91) e níveis de papiledema (2,94 ± 0,22/2,90 ± 0,30) (p>0,05). Durante o período de acompanhamento de 6 meses, os pacientes do grupo 1, que obedeceram as terapias médicas e dietéticas, melhoraram significativamente em todos os parâmetros, incluindo o índice de massa corporal (p<0,001), a acuidade visual (p=0,001), o desvio médio perimétrico (p=0,016) e o nível de papiledema (p<0,001). Por outro lado, os pacientes do grupo 2, que receberam apenas terapia médica, apresentaram melhoras somente no nível de papiledema (p<0,001). No entanto, observou-se o desenvolvimento coincidente de palidez de disco óptico em três pacientes. Além disso, esses pacientes também apresentaram perda significativa de acuidade visual (p=0,047) durante o período de estudo. Conclusão: A redução de peso combinada ao tratamento médico está associada à melhora significativa das acuidades visuais, dos campos visuais e de papiledema em pacientes com hipertensão intracraniana idiopática. O cumprimento de programas de dietas eficientes deve ser encorajado em pacientes obesos com hipertensão intracraniana idiopática.

Overweight in youth and sleep quality: is there a link?

ABSTRACT Objective Overweight seems to be related to a higher prevalence of sleep disturbances. Decreased sleep duration and altered sleep quality are risk factors for obesity. Our aim was to compare the sleep pattern of overweight children with that of a matched control group and assess the relationship between sleep quality and obesity. Materials and methods Retrospective cohort study comparing 41 overweight children with a normal-weight control group, both submitted to polysomnography. The samples were matched for age, sex, and apnea-hypopnea index. Body mass index (BMI) z-scores were calculated using World Health Organization (WHO) growth charts. Insulin resistance in the study group was determined using the homeostatic model assessment for insulin resistance (HOMA-IR). Sleep patterns were compared. The statistical analysis was performed using SPSS® version 21. Results The mean age (± standard deviation) of the population was 10 ± 3.4 years (min. 5 years; max. 17 years). Fifty-six percent of the participants in both groups were girls. N3% was lower in the study group (18.95 ± 6.18%) compared with the control group (21.61 ± 7.39%; t (40) = 2.156, p = 0.037). We found a correlation in the study group between HOMA-IR and N3% (Rs = -0.434, p = 0.008). Conclusion The present study suggests a link between overweight/obesity and altered sleep quality due to compromised non-rapid eye movement sleep, an indirect marker of sleep quality. There was also a link between slow-wave sleep duration and insulin resistance. We must find a strategy to provide adequate slow-wave sleep duration to reduce the obesity epidemic at young ages. Further research is needed.

Serum levels of leptin and adiponectin and clinical parameters in women with fibromyalgia and overweight/obesity

ABSTRACT Objectives The objectives of this study were to evaluate the serum levels of adipokines in women with fibromyalgia with and without overweight/obesity, and to correlate the adipokines levels with clinical parameters associated with fibromyalgia and adipose tissue mass (body fat). Subjects and methods The study included 100 women divided into four groups: (a) fibromyalgia and overweight/obesity; (b) fibromyalgia and normal weight; (c) controls and overweight/obesity; and (d) controls and normal weight. Patients and controls were evaluated for clinical, anthropometric, and fibromyalgia-related parameters. Assessments included serum levels of leptin, adiponectin, monocyte chemoattractant protein-1 (MCP-1), and C-reactive protein (CRP). Levels of adipokines were further adjusted for fat mass. Results Fibromyalgia patients with overweight/obesity or normal weight had no differences in clinical parameters. Unadjusted leptin levels were lower in fibromyalgia patients than controls, a finding that was more remarkable in fibromyalgia patients with overweight/obesity. Leptin levels had no correlation with clinical parameters of fibromyalgia or inflammation markers (MCP-1 and CRP), and adiponectin levels showed no difference between groups. Conclusions No correlation was observed between adjusted leptin levels and clinical parameters of fibromyalgia. Patients with fibromyalgia and overweight/obesity presented lower levels of leptin than controls with overweight/obesity.

Growth velocity and weight gain in prepubertal asthmatic children / Velocidade de crescimento e ganho de peso em crianças pré-púberes asmáticas

Summary Objective: To evaluate the stature growth rate (GR) and the weight gain of prepubertal asthmatic children. Method: A retrospective cohort study evaluating medical records of 85 children diagnosed with asthma, aged less than 9 years, of both sexes, with at least one year of follow-up in the allergy outpatient clinic. The data on the disease, weights and heights were collected through a standardized questionnaire on two occasions, with an interval of one year. The curves proposed by Tanner were applied for the analysis of the GR, and the Z-score of the GR (ZGR) was calculated. Results: Excess weight (risk for overweight, overweight and obesity) was observed in 31.8% (27/85) of the patients, but there was no association with the severity of asthma. Low GR (ZGR < -2) was found in 13.9% (11/79) of patients, most frequently among children with moderate/severe persistent asthma compared to persistent mild and intermittent forms (7/11 - 63.6% vs. 21/68 - 30.2%, respectively, p=0.047). Use of steroids (dose, type and time of use) was not associated with GR. Conclusion: GR was most affected in children with moderate/severe asthma.

Resumo Objetivo: Avaliar a velocidade de crescimento estatural e o ganho de peso de crianças asmáticas pré-púberes. Método: Estudo de coorte retrospectiva que avaliou 85 prontuários de crianças com diagnóstico de asma, menores de 9 anos, de ambos os sexos, com no mínimo um ano de acompanhamento no ambulatório de alergia. Os dados relativos à doença, aos pesos e às alturas foram coletados por meio de questionário padronizado em dois momentos com intervalo de um ano. Para análise da velocidade de crescimento (VC), foram empregadas as curvas propostas por Tanner e realizado o cálculo do escore Z da VC (ZVC). Resultados: O excesso de peso (risco para sobrepeso, sobrepeso e obesidade) foi observado em 31,8% (27/85) dos pacientes, mas sem associação com a gravidade da asma. Velocidade de crescimento baixa (ZVC < -2) foi encontrada em 13,9% (11/79) dos pacientes, com maior frequência entre as crianças com asma persistente moderada/grave em relação às formas persistente leve e intermitente (7/11 - 63,6% vs. 21/68 - 30,2%, respectivamente; p=0,047). O uso de corticosteroides (dose, tipo e tempo de uso) não mostrou associação com a VC. Conclusão: Foi constatado um maior comprometimento da VC em crianças com asma moderada/grave.