Efeito da dieta hipocalórica na pressão arterial e demais cofatores da síndrome metabólica / Effect of hypocaloric diet on blood pressure and other cofactors of metabolic syndrome

Introdução: a hipertensão arterial sistêmica (HAS) está associada a fatores de risco metabólicos e pode ser definida como uma doença crônica multifatorial, com valores persistentes de pressão arterial sistólica (PAS) e (ou) pressão arterial diastólica (PAD) maiores ou iguais a 140 mmHg x 90 mmHg, respectivamente. A HAS é um dos fatores que compõem a síndrome metabólica (SM) juntamente com a hiperglicemia, dislipidemia e (ou) obesidade central. Modificações no estilo de vida, como a alimentação e perda de peso, demonstraram melhorar os parâmetros cardiometabólicos nos pacientes com HAS e SM. Objetivo: verificar o efeito de uma dieta hipocalórica na antropometria, na pressão arterial e em outros cofatores da síndrome metabólica. Metodologia: trata-se de um ensaio clínico não randomizado, retrospectivo, com dados secundários, em que o mesmo grupo foi de "intervenção" e "comparador", e cujos dados foram coletados antes (baseline) e após a intervenção. A pesquisa foi realizada com 84 pacientes, adultos, com síndrome metabólica, de ambos os sexos. Os pacientes seguiram dieta com restrição calórica de 200 a 500kcal/dia, com cálculo energético em torno de 20kcal/kg de peso, valor energético total não inferior a 1200kcal, durante um período de dois meses. Foi utilizada estatística descritiva e o teste t pareado ou Wilcoxon-Sign-Rank intragrupo para analisar as variações ao longo do tempo (p < 0,05). Resultado:houve uma redução na antropometria (índice de massa corporal, circunferência da cintura, circunferência do braço e circunferência do quadril), PAS e PAD, glicemia de jejum e triglicerídeos com p< 0,05 dos pacientes após a intervenção, mas não houve melhora no HDL (p > 0,05). Conclusão: a dieta hipocalórica reduziu as medidas antropométricas, a pressão arterial e os demais cofatores da SM nos pacientes avaliados após o acompanhamento de dois meses.

Introduction: systemic arterial hypertension (SAH) is associated with metabolic risk factors and can be defined as a multifactorial chronic disease, with persistent values of systolic blood pressure (SBP) and (or) diastolic blood pressure (DBP) greater than or equal to 140 mmHg x 90 mmHg, respectively. SAH is one of the factors that make up the metabolic syndrome (MS) along with hyperglycemia, dyslipidemia and (or) central obesity. Lifestyle modifications, such as diet and weight loss, have been shown to improve cardiometabolic parameters in patients with SAH and MS. Objective: to verify the effect of a hypocaloric diet on anthropometry, blood pressure and other cofactors of the metabolic syndrome. Methodology: this is a non-randomized, retrospective clinical trial, with secondary data, in which the same group was "intervention" and "comparator", and whose data were collected before (baseline) and after the intervention. Research was carried out with 84 patients, adults, with metabolic syndrome, of both sexes. Patients followed a calorie-restricted diet of 200 to 500kcal/day, with energy calculation around 20kcal/kg of weight, total energy value not less than 1200kcal, during a period of two months. Descriptive statistics and the paired t test or intragroup Wilcoxon-Sign-Rank were used to analyze variations over time (p < 0.05). Result: there was a reduction in anthropometry (body mass index, waist circumference, arm circumference and hip circumference), SBP and DBP, fasting glucose and triglycerides with p<0.05 of patients after the intervention, but there was no improvement in HDL (p > 0.05). Conclusion: the hypocaloric diet reduced anthropometric measurements, blood pressure and other MS cofactors in the patients evaluated after a two-month follow-up.

Overview of Cardiovascular Disease Risk Factors in Adults in São Paulo, Brazil: Prevalence and Associated Factors in 2008 and 2015

Abstract Background Cardiovascular diseases (CVDs) are the main cause of morbidity and mortality in Brazil. Objective To provide population-based data on prevalence and factors associated with CVD risk factors. Methods Individuals aged ≥20 years from two editions of the cross-sectional Health Survey of São Paulo focusing on Nutrition (ISA-Nutrition), performed in Sao Paulo city in 2008 (n=590) and 2015 (n=610), were evaluated for: obesity, central obesity, waist/height ratio, high blood pressure (HBP), dyslipidemia, diabetes, and number of CVD risk factors ≥3. Prevalence was estimated according to complex survey procedures. Factors associated with cardiovascular risk factors were assessed using logistic regression, with statistical significance of p<0.05. Results Obesity and older age were associated with higher odds of all cardiovascular risk factors investigated, except for dyslipidemia. HBP was positively associated with being Black/Brown and negatively associated with being physicaly active in leisure time. Women were more likely to have increased adiposity indicators and three or more cardiovascular risk factors than men. Those with higher education had lower chances of having diabetes, HBP and dyslipidemia, and those with higher income had higher chances of having three or more risk factors. Former smokers had higher odds of diabetes, obesity, and high waist/height ratio, and smokers had higher odds of high non-HDL cholesterol levels. From 2008 to 2015, there was an increase (p<0.001) in the prevalence of diabetes (6.9% to 17.3%), HBP (31.9% to 41.8%), dyslipidemia (51.3% to 67.6%), and number of CVD risk factors ≥3 (18.9% to 34.1%). Conclusion This study shows increasing prevalence of CVD risk factors in adult population in Sao Paulo and may support the definition of target groups and priority actions on CVD prevention and treatment.

Asociación entre la termografía por infrarrojo y parámetros antropométricos de riesgo cardiometabólico en hombres / Association between infrared thermography, anthropometry and cardiovascular risk parameters in men

RESUMEN: Los parámetros antropométricos para la estimación de la composición corporal son variables comúnmente utilizadas en la identificación de factores de riesgo cardiovascular (FRCV). En este sentido la termografía por infrarrojo (TI) podría ser utilizada como una herramienta que aporte información relevante en la evaluación de los FRCV mediante la estimación de la temperatura superficial en la piel y su relación con medidas antropométricas asociadas a estos factores. El objetivo de este estudio fue determinar la relación de la temperatura superficial de hombres adultos con variables antropométricas asociadas a FRCV. Participaron 64 hombres sanos de 26,4 ± 7,8 años, 76,1 ± 13,3 kg de masa corporal, 171,3 ± 7,2 cm de estatura y 25,9 ± 3,7 kg/m2 de índice de masa corporal (IMC). Se realizaron evaluaciones antropométricas de 6 pliegues cutáneos (tricipital, subescapular, supra-espinal, abdominal, muslo medio y pantorrilla), circunferencia de cintura y cadera, además de mediciones de la temperatura superficial mediante TI en las zonas de medición. Se encontraron relaciones significativas negativas entre la temperatura superficial y las mediciones de los pliegues cutáneos a nivel subescapular, supra-espinal, muslo y pantorrilla (p < 0,01; r = -0,39 a -0,55). La temperatura promedio de la TI de los 6-pliegues, y todas las TI individuales de los pliegues presentaron correlaciones negativas significativas con el IMC, perímetro de cintura, índice cintura cadera, índice cintura estatura y la sumatoria de 6 pliegues cutáneos (p < 0,05; r = -0,35 a -0,65). Se puede concluir que existe una relación entre la temperatura superficial de la piel y algunos parámetros antropométricos de la composición corporal que muestran estar asociados a FRCV, pudiendo ser la TI una herramienta útil para complementar la evaluación de estos parámetros.

SUMMARY: Anthropometric parameters for the estimation of body composition are variables commonly used in the identification of cardiovascular risk factors (CVRFs). In this regard, infrared thermography (IT) could be used as a tool that provides relevant information in the CVRFs assessment by estimating skin surface temperature and its relationship with the anthropometric measures associated with these factors. The aim of this study was to determine the relationship of skin surface temperature in adult men with anthropometric variables associated with CVRFs. The study gathered sixty-four healthy men aged 26.4 ± 7.8 years, 76.1 ± 13.3 kg body mass, 171.3 ± 7.2 cm height and 25.9 ± 3.7 kg/m2 body mass index (BMI). Anthropometric assessments of 6 skinfolds (tricipital, subscapular, suprascapular, supraspinal, abdominal, mid-thigh, and calf), waist and hip circumference were conducted, as well as IT surface temperature measurements at the measurement areas. Significant negative relationships were found between surface temperature and skinfold measurements at the subscapular, supraspinal, thigh and calf levels (p < 0.01; r = -0.39 to -0.55). The average IT temperature of the 6- folds and all individual folds IT had significant negative correlations with BMI, waist circumference, waist hip ratio, waist height ratio, and the sum of 6 skinfolds (p < 0.05; r = -0.35 to -0.65). There is a relationship between skin surface temperature and some body composition anthropometric parameters that indicate and association with CVRFs, therefore, IT may be a useful tool to complement the assessment of these parameters.

Lifestyle Intervention in Reducing Cardiometabolic Risk Factors in Students with Dyslipidemia and Abdominal Obesity: A Randomized Study

Abstract Background The long incubation periods of cardiovascular diseases offer opportunities for controlling risk factors. In addition, preventive interventions in childhood are more likely to succeed because lifestyle habits become ingrained as they are repeated. Objective To investigate the effects of recreational physical activities, in combination or not with a qualitative nutritional counseling, in cardiometabolic risk factors of students with dyslipidemia and abdominal obesity. Methods Students (8-14 years old) were randomly divided into three groups (n=23 each): i ) Control; ii ) PANC, students undergoing Physical Activity and Nutritional Counseling, and iii ) PA, students submitted to Physical Activity, only. Blood samples (12-h fasting) were collected for biochemical analysis and anthropometric markers were also assessed. Two-Way RM-ANOVA and Holm-Sidak's test, and Friedman ANOVA on Ranks and Dunn's test were applied. P ≤ 0.05 was considered significant. Effect sizes were evaluated by Hedges' g and Cliff's δ for normal and non-Gaussian data, respectively. Results Compared to the control group and to baseline values, both interventions caused significant average reductions in total cholesterol (11%; p <0.001), LDL-c (19%; p=0.002), and non-HDL-c (19%; p=0.003). Furthermore, students in the PANC group also experienced a significant decrease in body fat compared to baseline (p=0.005) and to control (5.2%; g=0.541). Conclusions The proposed strategies were effective to reduce cardiometabolic risk factors in children and adolescents. The low cost of these interventions allows the implementation of health care programs in schools to improve the students' quality of life.

Aumento do risco cardiovascular em mulheres com síndrome do ovário policístico / Increased cardiovascular risk in women with polycystic ovary syndrome

Objetivo: A síndrome dos ovários policísticos (SOP) é uma alteração endócrina comum em mulheres que estão em fase reprodutiva. Essa patologia pode estar relacionada a fatores de risco para o desenvolvimento de complicações cardiometabólicas, o que a torna um tema relevante para discussão, visto sua grande prevalência na população feminina. Trata-se de uma revisão integrativa da literatura com o objetivo de identificar os fatores de risco associados à SOP e verificar se há maior risco cardiovascular para as mulheres com essa síndrome. Fonte de dados: Foi realizada uma busca nas bases de dados Biblioteca Virtual de Saúde, National Library of Medicine, Scientific Eletronic Library Online e EbscoHost, com os seguintes descritores: "Síndrome do ovário policístico e riscos cardiovasculares"; "Mulheres, policístico e riscos cardiovasculares"; "Ovário policístico e riscos" e "Mulheres, ovários policísticos"; "Polycystic ovary and risks"; "Polycystic ovary syndrome and cardiovascular risk" e "Polycystic ovaries and cardiovascular". Seleção de estudos: Foram encontrados 21 artigos, dos quais 15 atenderam aos critérios de inclusão previamente estabelecidos. Foram incluídos os artigos originais e as publicações entre o período de 2014 e 2021 que relacionavam diretamente a síndrome aos riscos cardiovasculares, síndromes metabólicas e alterações lipídicas. Coleta de dados: A estratégia de seleção dos artigos foi realizada mediante busca nas bases de dados selecionadas, leitura dos títulos de todos os artigos encontrados e exclusão daqueles que não abordavam o assunto, leitura crítica dos resumos dos artigos e leitura na íntegra dos artigos selecionados nas etapas anteriores. Síntese de dados: Todos os autores afirmam que a síndrome é um distúrbio ovulatório e metabólico, uma vez que a resistência à insulina e a consequente hiperinsulinemia compensatória podem ser exacerbadas pela coexistência da obesidade, presente em muitas mulheres com SOP. Além disso, foram identificados os fatores de risco tradicionais para o desenvolvimento de doenças cardiovasculares, e 93,33% dos artigos analisados demonstraram que, entre as mulheres com a síndrome, alguns fatores de risco para o desenvolvimento de tais doenças parecem apresentar uma chance maior de estarem presentes. Conclusão: Ao final dessa revisão, foi possível responder à pergunta clínica proposta, pois todos os artigos pesquisados concluíram e trouxeram estudos comprovando que mulheres com a SOP possuem maiores chances de desenvolver algum problema cardiovascular precoce, devido a fatores como o hiperandrogenismo e o aumento da gordura visceral e da resistência insulínica.(AU)

Objective: Polycystic ovary syndrome is an endocrine disorder, common in women who are in the reproductive phase. This pathology may be related to risk factors for the development of cardiometabolic complications, which makes it a relevant topic for discussion, given its high prevalence in the female population. This is an integrative literature review with the aim of identifying the risk factors associated with polycystic ovary syndrome and verifying whether there is a higher cardiovascular risk for women with this syndrome. Data source: A search was performed in the Virtual Health Library databases; National Library of Medicine; Scientific Electronic Library Online and EbscoHost, with the following descriptors: "Polycystic ovary syndrome and cardiovascular risks"; "Women, polycystic and cardiovascular risks"; "Polycystic ovaries and risks" and "Women, polycystic ovaries"; "Polycystic ovary and risks"; "Polycystic ovary syndrome and cardiovascular risk" and "Polycystic ovaries and cardiovascular". Study selection: Twenty-one articles were found, of which 15 met the previously established inclusion criteria. Original articles and publications between the period 2014 and 2021 that directly related the syndrome to cardiovascular risks, metabolic syndromes and lipid disorders were included. Data collect: The article selection strategy was performed by searching the selected databases; reading the titles of all articles found and excluding those that did not address the subject; critical reading of the abstracts of the articles and full reading of the articles selected in the previous steps. Data synthesis: All authors state that the Syndrome is an ovulatory and metabolic disorder, since insulin resistance and consequent compensatory hyperinsulinemia can be exacerbated by the coexistence of obesity, present in many women with polycystic ovary syndrome. In addition, traditional risk factors for the development of cardiovascular diseases were identified, with 93.33% of the articles analyzed showing that, among women with the syndrome, some risk factors for the development of such diseases seem to have a chance greater than being present. Conclusion: At the end of this review, it was possible to answer the proposed clinical question, as all the researched articles concluded and brought studies proving that women with polycystic ovary syndrome are more likely to develop an early cardiovascular problem, due to factors such as hyperandrogenism, the increase in visceral fat and insulin resistance.(AU)

Dietary patterns and cardiometabolic risk factors of a federal public institution staff in the northern region of Brazil / Padrões alimentares e fatores de risco cardiometabólicos em funcionários de uma instituição pública federal na região norte do Brasil

ABSTRACT Objective To identify dietary patterns in an adult population and assess those patterns association with cardiometabolic risk factors. Methods Cross-sectional study conducted with 130 workers of a university in Tocantins, Brazil, aged 20-59 years. Dietary patterns were identified by principal component analysis based on a food frequency questionnaire. Body mass index, waist circumference, blood pressure, fasting glycemia, triacylglycerols, low-density lipoprotein and high-density lipoprotein cholesterol were measured. Multinomial logistic regression was used to assess the association between dietary patterns and cardiometabolic risk factors. Results Three dietary patterns were identified that together explained 78.74% of total variance: healthy, western and fit dietary patterns. In the adjusted model, greater adherence to the healthy pattern was associated with lower fasting glucose values (OR: 0.89; 95%IC: 0.82-0.97; p=0.009) and with higher concentrations of low-density lipoprotein cholesterol (OR: 1.02; 95%IC: 1.00-1.04; p=0.024); the western dietary pattern was associated with higher fasting glucose values (OR: 1.06; 95%IC: 1.00-1.13; p=0.05) and the fit pattern was associated with lower concentrations of low-density lipoprotein cholesterol (OR: 0.98; 95%IC: 0.97-0.99; p=0.048). Conclusion Food was an important risk and protective factor for cardiometabolic changes.

RESUMO Objetivo Identificar padrões alimentares em uma população adulta e avaliar a associação com fatores de risco cardiometabólico. Métodos Estudo transversal realizado com 130 funcionários entre 20 e 59 anos de uma universidade do Tocantins, Brasil. Os padrões alimentares foram identificados por análise de componentes principais com base em um questionário de frequência alimentar. Foram mensurados índice de massa corporal, perímetro da cintura, pressão arterial, glicemia de jejum, triglicerídeos, lipoproteínas de baixa densidade e lipoproteínas de alta densidade. As associações dos padrões com os fatores de risco cardiometabólico foram determinadas por regressão logística multinomial. Resultados Três padrões foram identificados que explicaram 78.74% da variância total: saudável, ocidental e fit. No modelo ajustado, a maior adesão ao padrão saudável foi associada com menores valores de glicemia de jejum (OR: 0.89; 95% IC: 0.82-0.97; p=0.009) e com maiores concentrações de lipoproteína de baixa densidade colesterol (OR: 1.02; 95% IC: 1.00-1.04; p=0.024); o padrão ocidental foi associado com maiores valores de glicemia de jejum (OR: 1.06; 95% IC: 1.00-1.13; p=0.05) e o padrão fit foi associado com menores concentrações de lipoproteína de baixa densidade colesterol (OR: 0.98; 95% IC: 0.97-0.99; p=0.048). Conclusão A alimentação constituiu um importante fator de risco e de proteção para alterações cardiometabólicas.

Department of Internal Medicine, Faculty of Clinical Medicine, College of Health Sciences, Ebonyi State University

INT RODUCTIO N: Th e eld erly h ypert en si ve pa ti ent s of ten h aveincreased prevalence of cardiometabolic risk factors and their attendantco-morbidities. The aim of this study was to determine the prevalenceof cardiometabolic risk factors and blood pressure control among elderlyhypertensive patients, and to determine the influence of modifiablecardiometabolic risk factors on the control of hypertension amongelderly hypertensive patients.SUBJECTS AND METHODS: A case-control comparative and hospital-based study involving a total of 190 consenting elderly (>65 years),hypertensive patients (subjects) (n=100) and normotensive controls(n=90) was carried out over a period of ten months. Using interviewer-administered questionnaire, biodata and information regarding theirlifestyle was obtained. Standard protocols were used to measure bloodpressure, weight, height, waist circumference, fasting plasma glucoseand fasting lipid profile of the subjects. Body mass index was derivedfrom weight and height.RESULTS: The mean age of the subjects was 71.5 ± 6.3 years and thecontrols was 72.3 ± 7.2 years. Forty-eight percent (48%) and 47.8% ofthe subjects and controls were females (p = 0.651). The level of controlof hyperten sion was poor in over two-thirds (68%) of the elderlyhypertensive patients. The prevalence of modifiable cardiometabolicrisk factors burden was higher in the hypertensive subjects when comparedwith the controls. Prevalence of Dyslipidaemia was 76% in the subjectsand 51% in the controls (p = 0.004). Prevalence of Diabetes Mellituswas 40% among the subjects and 17.8% in the controls (p = 0.0001);prevalence of Obesity was 24% in the subjects and 4.4% in the controls(p=<0.001); prevalence of excess alcohol intake was 49% in the subjectsand 14.4% in the controls (p=<0.001). Prevalence of sedentary lifestyle was high in both the subjects (53%) and controls (50%), p=0.679.Poor blood pressure control was predicted by dyslipidaemia and centralobesity.CONCLUSION: The level of control of hypertension was poor amongthe elderly and modifiable cardiometabolic risk factors were relativelyprevalent. Central obesity and dyslipidaemia were predictive of poorcontrol of hypertension. Addressing these factors may therefore improveblood pressure control

Intervenciones para prevenir el síndrome metabólico en adolescentes / Interventions to Prevent Metabolic Syndrome in Adolescents

Introducción: El sobrepeso y la obesidad son actualmente problemas de salud pública de alto impacto a nivel mundial, que predisponen al ser humano a adquirir enfermedades crónicas no transmisibles como el síndrome metabólico, afecta a los adolescentes, un grupo etario vulnerable. Objetivo: Analizar la evidencia científica acerca de las intervenciones para prevenir el síndrome metabólico en adolescentes. Métodos: Revisión sistemática de artículos publicados entre 2010 y 2019, se realizó la búsqueda en bases de datos SciELO, BVS, PUBMED. Luego de aplicar los criterios de inclusión y exclusión se seleccionaron 11 artículos. Se utilizó el diagrama de flujo Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA). Conclusiones: En los 11 artículos analizados, se han encontrado diversos enfoques de intervención, que fueron desarrollados, principalmente, en aspectos educativos, nutricionales y actividades físicas. Los estudios en los que se abordaron más estrategias de prevención del síndrome metabólico en los adolescentes, aunado a un enfoque familiar e incorporando a docentes y un equipo multidisciplinario, presentaron cambios más significativos en las características antropométricas y parámetros bioquímicos relacionados a los factores de riesgo cardiometabólicos(AU)

Introduction: Overweight and obesity are currently high-impact public health problems worldwide, predisposing humans to acquire chronic non-communicable diseases such as metabolic syndrome, affecting adolescents, a vulnerable age group. Objective: To analyze the scientific evidence about interventions to prevent metabolic syndrome in adolescents. Methods: A systematic review was conducted of articles published between 2010 and 2019; a search was carried out in SciELO, BVS, PUBMED databases. After applying the inclusion and exclusion criteria, 11 articles were selected. The Preferred Reporting Items for Systematic Review and Meta-Analyzes (PRISMA) flow chart was used. Conclusions: In the 11 articles analyzed, various intervention approaches have been found, which were developed mainly in educational, nutritional and physical activities aspects. The studies in which more strategies for the prevention of metabolic syndrome in adolescents were addressed, together with a family approach and incorporating teachers and a multidisciplinary team, showed more significant changes in anthropometric characteristics and biochemical parameters related to cardiometabolic risk factors(AU)

Risco cardiometabólico em pacientes sobrepesados e obesos: um estudo comparativo entre os sexos / Cardiometabolic risk in overweight and obese patients: a comparative study between the sexes / Riesgo cardiometabólico en pacientes con sobrepeso y obesidad: un estudio comparativo entre sexos

Objetivos: Analisar a diferença do risco cardiometabólico entre homens e mulheres com excesso de peso corporal. Método: Estudo descritivo transversal realizado com adultos, de ambos os sexos, com idade entre 18 e 50 anos, com excesso de peso e com circunferência da cintura alterada, de acordo com os critérios da Organização Mundial da Saúde (2015). Resultados: A idade média entre as mulheres foi de 37,82 anos e entre os homens, de 31,56 anos. Em relação ao peso, a média entre as mulheres foi menor que dos homens. Em relação à medida de circunferência de quadril, a média das mulheres foi de 123,16 cm e dos homens de 114,94 cm. Os resultados médios dos exames laboratoriais foram maiores entre os homens com 212,77, enquanto o "colesterol bom" (HDL) entre as mulheres foi de 50,58. Conclusão: O risco cardiometabólico apresentado pelo sexo feminino. (AU)

Objective: To analyze the difference in cardiometabolic risk between men and women with excess body weight. Methods: Descriptive cross-sectional study carried out with adults, of both sexes, aged between 18 and 50 years, with excess weight and with altered waist circumference, according to the criteria of the World Health Organization. Results: The average age among women was 37,82 years and among men, 31,56 years. Regarding weight, the average among women was lower than that of men. Regarding the measure of hip circumference, the average for women was 123,16 cm and for men, 114,94 cm. Conclusion: The cardiometabolic risk presented by women was lower than the risk presented by men. The variables that showed the most evident significance between gender differences were: age, weight, height, hip circumference, triglycerides, cholesterol. (AU)

Objetivo: Analizar la diferencia de riesgo cardiometabólico entre hombres y mujeres con exceso de peso corporal. Métodos: Estudio descriptivo transversal realizado con adultos, de ambos sexos, de entre 18 y 50 años, con sobrepeso y con alteración de la circunferencia de la cintura, según los criterios de la Organización Mundial de la Salud. Resultados: La edad media de las mujeres fue de 37,82 años y de los hombres de 31,56 años. En cuanto al peso, el promedio entre las mujeres fue menor que el de los hombres. En cuanto a la medida de la circunferencia de la cadera, la media para las mujeres fue de 123,16 cm y para los hombres, de 114,94 cm. Conclusión: El riesgo cardiometabólico presentado por las mujeres fue menor que el riesgo presentado por los hombres. Las variables que mostraron mayor significación entre las diferencias de género fueron: edad, peso, talla, perímetro de la cadera, triglicéridos, colesterol. (AU)

Análise de componentes principais dos fatores de risco em adolescentes com excesso de peso antes e após um programa de intervenção / Analysis of principal components of risk factors in overweight adolescents before and after an intervention program

O objetivo do estudo é verificar o agrupamento dos fatores de risco cardiometabólicos e as possíveis mudanças deste, após um programa de intervenção interdisciplinar realizado com adolescentes com sobrepeso/obesidade. Os sujeitos foram alocados em dois grupos: grupo intervenção e grupo controle. O grupo intervenção participou de um programa com a duração de seis meses, com sessões três vezes por semana, que incluiu sessões com exercícios físicos, orientações nutricionais e psicológicas. Foram realizadas avaliações antropométricas, pressão arterial, aptidão cardiorrespiratória e coleta sanguínea para avaliação da glicose e perfil lipídico, antes e após o período de intervenção. Análise de componentes principais foi realizada para verificar o agrupamento dos fatores de risco nos períodos pré e pós-intervenção. A análise fatorial agrupou os componentes em três fatores no momento pré-intervenção, no grupo intervenção, que representou 83,88% da variância total do modelo. Já, no grupo controle, no período pré e pós-intervenção, e na avaliação pós-intervenção do grupo intervenção, os componentes foram agrupados em dois fatores centrais, que explicam, respectivamente, 68,38%, 71,23%, 75,19% da variância total do modelo. O grupo intervenção apresentou mudanças no agrupamento das variáveis nos resultados pós-intervenção, em comparação com o pré-teste. Nenhum componente central, que inter-relacionasse todos os demais fatores, nas quatro análises realizadas, foi encontrado. Entretanto, as variáveis antropométricas aparecem como os componentes de maior carga fatorial, agrupadas no fator 1, em todas as análises realizadas, fator que explica a maior variância total em torno das variáveis iniciais. (AU)

The objective of the study is to verify the grouping of cardiometabolic risk factors and their possible changes after an interdisciplinary intervention program performed with overweight/obese adolescents. The subjects were allocated in two groups: the intervention group and the control group. The intervention group participated in a program lasting six months, with sessions three times a week, which included sessions with physical exercises, nutritional and psychological orientations. Anthropometric evaluations, blood pressure, cardiorespiratory fitness, and blood collection were performed for evaluation of glucose and lipid profile before and after the intervention period. Main component analysis was performed to verify the grouping of risk factors in the pre-and post-intervention periods. The factorial analysis grouped the components into three factors at the pre-intervention time, in the intervention group, which represented 83.88% of the total variance of the model. In the control group, in the pre-and post-intervention period, and in the post-intervention evaluation of the intervention group, the components were grouped into two central factors, which explain, respectively, 68.38%, 71.23%, 75, 19% of the total variance of the model. The intervention group presented changes in the grouping of the variables in the post-intervention results, compared to the pre-test. No central component, which interrelated all the other factors, was found in the four analyzes. However, the anthropometric variables appear as the components of higher factor load, grouped in factor 1, in all the analyzes performed, a factor that explains the largest total variance around the initial variables. (AU)

Cardiometabolic risk profile in relation to the practice of healthy habits in a sample of Spanish workers

Insulin resistance is a pathological entity that can lead to alterations in lipid metabolism and can increase cardiovascular risk. Objective. The aim of this study was to assess the influence of different sociodemographic variables such as age, sex and social class and healthy habits such as smoking, physical activity and adherence to the Mediterranean diet on the cardiometabolic profile of Spanish workers. Material and methods. A descriptive, cross-sectional study was carried out in 1457 Spanish workers in an attempt to evaluate the effect of healthy habits (physical exercise determined with the IPAQ questionnaire, Mediterranean diet and tobacco consumption) and sociodemographic variables (age, sex and social class) on the values of different insulin resistance scales. Results. The progressive increase in the level of physical activity and high adherence to the Mediterranean diet achieved an improvement in the mean values and in the prevalence of elevated values in all the insulin resistance scales analyzed in this study. Age over 50 years and belonging to the least favored social classes (social classes II-III) were the variables that increased the risk of presenting insulin resistance. Male sex also increased the risk of presenting insulin resistance. Conclusions. The different healthy habits such as vigorous physical exercise and high adherence to the Mediterranean diet improve the values of the different scales that assess insulin resistance(AU)

La resistencia a la insulina es una entidad patológica que puede provocar alteraciones en el metabolismo de los lípidos y puede aumentar el riesgo cardiovascular. Objetivo. En este trabajo se pretende valorar la influencia de diferentes variables sociodemográficas como la edad, el sexo y la clase social y hábitos saludables como el consumo de tabaco, la actividad física y la adherencia a la dieta mediterránea en el perfil cardiometabólico de trabajadores españoles. Material y métodos. Se realizó un estudio descriptivo y transversal en 1457 trabajadores españoles intentando evaluar el efecto de los hábitos saludables (ejercicio físico determinado con el cuestionario IPAQ, dieta mediterránea y consumo de tabaco) y las variables sociodemográficas (edad, sexo y clase social) sobre los valores de diferentes escalas de resistencia a la insulina. Resultados. El aumento progresivo del nivel de actividad física y la alta adherencia a la dieta mediterránea consiguieron una mejoría en los valores medios y en la prevalencia de los valores elevados en todas las escalas de resistencia a la insulina analizadas en este estudio. La edad por encima de los 50 años y la pertenencia a las clases sociales menos favorecidas (clases sociales II-III) fueron las variables que aumentaron el riesgo de presentar resistencia a la insulina. El sexo masculino también incrementó el riesgo de presentar resistencia a la insulina. Conclusiones. Los diferentes hábitos saludables como el ejercicio físico vigoroso y la alta adherencia a la dieta mediterránea mejoran los valores de las diferentes escalas que valoran resistencia a la insulina(AU)

Metabolic Syndrome and Risk of Cardiovascular Diseases in Female Breast Cancer Survivors

Abstract Background The implementation of intensive therapy protocols increases the probability of adverse events in patients with breast cancer (BC). Components of metabolic syndrome (MS) are among these events. Objective To verify the prevalence of MS and cardiovascular disease (CVD) risk in female BC survivors. Materials and Methods This is a descriptive, observational, cross-sectional study. Our sample comprised 60 women without BC (G1) and 60 women who had survived BC (G2). We collected sociodemographic, anthropometric, tumor, and clinical data. After variable analysis, the participants received positive or negative MS diagnoses and a 10-year CVD risk stratification. The significance level adopted for the analyses was 5% ( p < 0.05) and the confidence interval (CI) was 95%. For comparing categorical data, we used the chi-squared, Fisher's exact, or G tests; for comparing continuous data, we used the parametric Student's t-test and the non-parametric Mann-Whitney test. Results Both groups presented overweight and an increased waist-to-hip ratio. Weight, body mass index, abdominal circumference, hip circumference, and low-density cholesterol were variables that presented statistically significant differences between groups. MS was diagnosed in 32% of women in G1 and 45% of those in G2. Regarding the 10-year risk for CVD, most women were in the low-risk stratum: the mean total risk of CVD occurrences was 7.48% in G1 and 7.70% in G2. Conclusion We observed a higher prevalence of MS among women who survived BC, possibly due to overweight, as well as a low 10-year risk for CVD after cancer treatment. Although we did not observe a statistically significant difference, we suggest the adoption of a healthy lifestyle and rigorous control of cardiometabolic risk factors.

Agrupamentos de fatores de risco cardiometabólicos e sua associação com aterosclerose e inflamação crônica em adultos e idosos em florianópolis, Sul do Brasil / Clusters of cardiometabolic risk factors and their association with atherosclerosis and chronic inflammation among adults and elderly in florianópolis, Southern Brazil

Resumo Fundamento O aumento significativo de doenças cardiovasculares em países em desenvolvimento alerta sobre seu impacto em populações carentes. Objetivo Identificar a relação de agrupamentos de componentes da síndrome metabólica (SM) com aterosclerose e inflamação crônica em adultos e idosos. Métodos Análise transversal usando dados de dois estudos populacionais de tipo coorte realizados em Florianópolis, sul do Brasil (EpiFloripa Adult Cohort Study, n = 862, 39,9±11,5 anos; EpiFloripa Aging Cohort Study, n = 1197, 69,7±7,1 anos). Pressão arterial (PA), circunferência da cintura (CC), e níveis plasmáticos de lipídio e glicose foram analisados como fatores individuais ou como agrupamentos de componentes da SM (como número de componentes presentes em um indivíduo ou como combinações). Os desfechos incluíram espessura intima-media carotídea (EIMC), placas ateroscleróticas, e níveis de proteína C reativa (CRP). Regressão linear múltipla e regressão logística, ajustadas quanto aos fatores de confusão, foram usadas para análise. O nível de significância adotado foi de 5%. Resultados Indivíduos com PA e CC elevadas, dislipidemia e hiperglicemia (61,5%) apresentaram maiores valores de EIMC e PCR que aqueles que não apresentaram componentes de SM. CC elevada foi um determinante comum de inflamação sistêmica, ao passo que a coexistência de PA elevada e CC elevada (agrupamentos de dois ou três fatores) associou-se com maior EIMC (β entre +3,2 e +6,1 x 10-2 mm; p < 0,05) e PCR (EXPβ entre 2,18 e 2,77; p < 0,05). Conclusão A coexistência de PA e CC elevadas associou-se com maiores valores de EIMC e níveis de PCR. A obesidade central, isolada ou em combinação com outros fatores de risco, teve efeito sobre a inflamação sistêmica.

Abstract Background The significant increase in cardiovascular diseases in developing countries alerts about their impact on underprivileged populations. Objective To identify the relationship of clusters of metabolic syndrome (MS) components with atherosclerosis and chronic inflammation among adults and elderly. Methods Cross-sectional analysis using data from two population-based cohort studies in Florianópolis, Southern Brazil (EpiFloripa Adult Cohort Study, n = 862, 39.9±11.5 years; EpiFloripa Aging Cohort Study, n = 1197, 69.7±7.1 years). Blood pressure (BP), waist circumference (WC), and lipid and glucose levels were analyzed as individual factors or as clusters (either as the number of components present in an individual or as combinations of components). Outcomes included carotid intima-media thickness (IMT), atherosclerotic plaques, and C-reactive protein (CRP) levels. Multiple linear and logistic regression analyses adjusted for confounding factors were used. The statistical significance adopted was 5%. Results Individuals with high BP, elevated WC, dyslipidemia and hyperglycemia (6.1% of the sample) showed higher IMT and CRP than those negatives for all MetS components. Elevated WC was a common determinant of systemic inflammation, while the coexistence of high BP and elevated WC (clusters of two or three factors) was associated with higher IMT (β between +3.2 and +6.1 x 10-2 mm; p value < 0.05) and CRP (EXPβ between 2.18 and 2.77; p value < 0.05). Conclusion The coexistence of high BP and elevated WC was associated with increased IMT and CRP levels, but central obesity affected systemic inflammation either alone or in combination with other risk factors.

Maternal overweight and its relation with child's anthropometric indices / Excesso de peso materno e sua relação com os índices antropométricos infantis

Abstract Objectives: to investigate the relation between maternal overweight and child's anthropometric indices, identifying the interaction with the child's age. Methods: a cross-sectional study with mothers and their children under 2 years old. The mothers' body mass index (BMI), waist-to-hip ratio and waist-to-height ratio was calculated. In children, we calculated height/age (H/A), body mass index/age (BMI/A), weight/height (W/H) and weight/age (W/A) indices. The means of the anthropometric indices of children with excess weight and maternal cardiometabolic risk were compared. Mothers and children's anthropometric indices were correlated. Linear regression models were proposed. We investigated the child's age interaction with anthropometric variables of the dyad. Results: the means of BMI/A and W/H were higher in children of overweight mothers and the means of BMI/A, W/H and W/A were higher when mothers had increased risk for cardiometabolic diseases. There was an association of maternal weight and height with the W/A index; maternal BMI with W/H; maternal height with H/A; maternal weight, BMI and waist circumference with BMI/A. The children's age did not interact with the assessed parameters. Conclusion: children under 2 years of age, whose mothers are overweight, tend to show changes in weight, regardless of age.

Resumo Objetivos: investigar a relação do excesso de peso materno com índices antropométricosinfantis, identificando a interação da idade da criança. Métodos: estudo transversal com mães e seus filhos menores de 2 anos. Calculou-se o índice de massa corporal (IMC), relação cintura quadril e relação cintura estaturadas mães. Nas crianças, calculou-se os índices estatura/idade (E/I), índice de massa corporal/idade (IMC/I), peso/estatura (P/E) e peso/idade (P/I). Comparou-se as médias dos índices antropométricos das crianças com excesso de peso e risco cardiometabólico materno. Correlacionou-se índices antropométricos infantis e maternos. Modelos de regressão linear foram propostos. Foi investigada interação da idade da criança com variáveis antropométricas da díade. Resultados: as médias do IMC/I e P/E foram maiores em filhos de mães com excesso de peso e as médias do IMC/I, P/E e P/I foram maiores quando mães apresentaram risco aumentado para doenças cardiometabólicas. Verificou-se associação do peso e estatura materna com o índice P/I; do IMC materno com P/E; da estatura materna com E/I; do peso, IMC e perímetro da cintura materna com IMC/I. A idade das crianças não interagiu com os parâmetros avaliados. Conclusão: crianças menores de 2 anos, cujas mães têm excesso de peso, tendem a apresentar alteração no peso, independente da idade.

Anthropometry, dietetic habits and sleepiness in Ecuadorian adults

The reduction of hours of sleep affects the physical and mental health of people. Having unhealthy sleep habits are associated with a greater occurrence of daytime sleepiness, which in turn has been related to poorer nutritional status. The objective of this study was to relate food intake, anthropometric measurements, and daytime sleepiness in Ecuadorian adults. Non-experimental, cross-sectional study, the sample included 400 men and women between 18 and 65 years of age, who attended an outpatient consultation of general medicine, family medicine, and traumatology services of a public hospital in Quito-Ecuador. Anthropometric and body composition measurements were measured using tetrapolar bio-impedance, following the recommendations of the International Society for the Advancement of Anthropometry (ISAK). Caloric intake was measured using a 24-hour recall and for daytime sleepiness (DS) the Epworth questionnaire was used. Statistical analyzes were performed using R. From the sample 56.5% presented DS, which affected women more frequently compared to men (p < 0.05). Differences were found between body measurements and dietary intake between groups of people with and without DS. Caloric intake, waist circumference, percentage of fat mass were higher in people with DS (p < 0.05), while muscle mass was higher in subjects without DS (p <0.05). No differences were found concerning visceral fat. We conclude that SD is related to less healthy values in terms of dietary intake and anthropometric measures(AU)

La reducción de las horas de sueño afecta la salud física y mental de las personas. Tener hábitos de sueño poco saludables se asocia a una mayor ocurrencia de somnolencia diurna, lo que a su vez se ha relacionado con un peor Estado Nutricional. El objetivo de este estudio fue relacionar la ingesta de alimentos, las medidas antropométricas y la somnolencia diurna en adultos ecuatorianos. Estudio no experimental, transversal n=400 hombres y mujeres entre 18 y 65 años, que acudieron a consulta externa de los servicios de medicina general, medicina familiar y traumatología de un hospital público de Quito, Ecuador tomado como referencia. Se tomaron medidas antropométricas siguiendo las recomendaciones de la Sociedad Internacional para el Avance de la Antropometría (ISAK) y de composición corporal a través de la bioimpedancia tetrapolar. La ingesta calórica se midió mediante un recordatorio de 24 horas y para somnolencia diurna (SD)se utilizó el cuestionario de Epworth. Los análisis estadísticos se realizaron utilizando el software R. 56,5% de la muestra presenta SD, que afectó con mayor frecuencia a las mujeres en comparación con los hombres (p <0,05). Se encontraron diferencias entre las medidas corporales y la ingesta dietética entre grupos de personas con SD y sin ella. La ingesta calórica, la circunferencia de la cintura, el porcentaje de masa grasa fue mayor en personas con SD (p <0.05), mientras que la masa muscular fue mayor en sujetos sin SD (p <0.05). No se encontraron diferencias en relación con la grasa visceral. Concluimos que SD está relacionada con valores menos saludables en cuanto a ingesta dietética y medidas antropométricas(AU)

Efeitos de diferentes métodos de treinamento na melhora dos indicadores cardiometabólicos em corredores recreacionais: uma revisão sistemática / Effects of different training methods in improving cardiometabolic indicators in recreational runners: a systematic review

: O exercício físico, em especial a corrida de rua tem sido recomendada para prevenção e tratamento de doenças crônicas não transmissíveis. O objetivo desta revisão sistemática foi verificar os efeitos de diferentes métodos de treinamento sobre os indicadores cardiometabólicos de corredores recreacionais. As bases de dados eletrônicas utilizadas na presente pesquisa foram: PUBMED, SCIENCE DIRECT, LILACS e COCHRANE LIBRARY, usando os descritores agrupados segundo o método PICO; População ("adults" OR "young adult" OR "middle aged") AND Intervenção ("endurance training" OR "aerobic training" OR "running") OR Comparação ("recreational runners" OR "jogging") AND Outcome/Desfecho ("cardiovascular risk factors" OR "cardiometabolic risk factors" OR "metabolic syndrome"). Na seleção os artigos foram excluídos por título, resumo e texto. Obteve-se um total de 813 artigos encontrados, no qual nove (9) preencheram os critérios de inclusão e baixo risco de viés de acordo com a Escala Testex. Foram encontrados três métodos de treinamento: Combinado (Contínuo +Intervalado); Contínuo e Intervalado. Considerando a somatória das amostras dos nove estudos, um total de 604 indivíduos (466 homens e 138 mulheres) participaram dos ensaios. Os diferentes métodos de treinamentos resultaram na redução dos níveis de triglicerídeos, insulina e glicose e na redução do colesterol total e LDL, e consequentemente o aumento do HDL. Na composição corporal houve diminuição significativa do peso e da gordura corporal, do IMC, na medida da circunferência da cintura, e no aumento da capacidade aeróbia (VO2). Concluiu-se que os treinamentos combinado, contínuo e intervalado podem ser aplicados para melhora dos indicadores cardiometabólicos, cada um dentro da sua especificidade de frequência, volume e intensidade.(AU)

Physical exercise, especially running, has been recommended for the prevention and treatment of chronic non-communicable diseases. The objective of this systematic review was to verify the effects of different training methods on the cardiometabolic indicators of recreational runners. The electronic databases used in the present research were: PUBMED, SCIENCE DIRECT, LILACS and COCHRANE LIBRARY, using the descriptors grouped according to the PICO method; Population ("adults" OR "young adult" OR "middle aged") AND Intervention ("endurance training" OR "aerobic training" OR "running") OR Comparison ("recreational runners" OR "jogging") AND Outcome / Outcome ("Cardiovascular risk factors" OR "cardiometabolic risk factors" OR "metabolic syndrome"). In the selection, articles were excluded by title, abstract and text. A total of 813 articles were obtained, in which nine (9) met the inclusion criteria and low risk of bias according to the Testex Scale. Three training methods were found: Combined (Continuous + Interval); Continuous and Interval. Considering the sum of the samples from the nine studies, a total of 604 individuals (466 men and 138 women) participated in the trials. The different training methods resulted in a reduction in the levels of triglycerides, insulin and glucose and in the reduction of total cholesterol and LDL, and consequently an increase in HDL. In body composition, there was a significant decrease in weight and body fat, in BMI, as measured by waist circumference, and in increased aerobic capacity (VO2). It is concluded that combined, continuous and interval training can be applied to improve cardiometabolic indicators, each within its specific frequency, volume and intensity.(AU)

Índice cintura-talla e índice de masa corporal como predictores de riesgo cardiometabólico en niños y adolescentes / Waist size index and body mass index as predictors of cardiometabolic risk in children and adolescents

Objetivo: comparar la utilidad del índice cintura-talla y el índice de masa corporal para detectar factores de riesgo cardiometabólicos en niños de 5-18 años, atendidos en la consulta externa del Hospital Infantil Regional Universitario Doctor Arturo Grullón en el período octubre-diciembre del año 2016. Método: se realizó un estudio observacional, comparativo, de corte transversal y fuente primaria, con una muestra de 118 pacientes. Se midieron las variables sociodemográficas (edad y sexo), antropométricas (peso, talla, IMC, ICT, PC, TA), y laboratorios (glicemia, ALT, colesterol, triglicéridos, HDL, LDL). Para el análisis cuantitativo se calculó el promedio y la desviación estándar, para el análisis cualitativo se utilizó la prueba estadística chi-cuadrado. Resultados: tanto el ICT como el IMC detectan de manera similar las alteraciones de la presión arterial sistólica (ICT=15.9 %, IMC=15 %), diastólica (ICT=20.4 %, IMC= 21.8 %), obesidad (ICT=69.5 %, IMC=73.7 %), HDL (ICT=6.8 %, IMC=5.6 %). En relación a la evaluación de la obesidad ambos índices arrojaron resultados afines, 69.5 % para ICT y 73.7 % el IMC. En la valoración de los niveles altos de ALT se obtuvieron resultados similares, presentando el ICT un 8.1 % y el IMC un 8.9 %. Conclusión: se demostró que tanto el ICT como el IMC son buenos predictores de factores de riesgos cardiometabólicos.

Objective: To compare the utility of the WSI and BMI in detecting cardiometabolic risks on children between 5-18 years, during external consult in Hospital Infantil Regional Universitario Dr. Arturo Grullón in the period of October-December 2016. Methods: A cross-sectional, primary source, observational design study was conducted with a sample of 118 patients. The variables measured for this study included sociodemographic (age and sex), anthropometric (weight, height, BMI, ICT, PC), and laboratories (glycemia, ALT, cholesterol, triglycerides, HDL, LDL). The quantitative analysis was carried out by calculating the average and the standard deviation. As for the qualitative analysis, the statistical test χ² was used. Results: Both the WSI and the BMI proved to be effective in detecting changes in Systolic (WSI = 15.9%, BMI = 18.4%) and Diastolic Blood Pressure (WSI = 20.4%, BMI = 18.6%), obesity (WSI = 69.5%, BMI = 73.7%), HDL (WSI = 29.3%, BMI = 29.9%). Regarding the detection of obesity, both rates showed similar results, 69.5% for ICT, and 73.7% for BMI. Comparable results were obtained in the assessment of high levels of ALT, with the ICT at 8.1% and the BMI at 8.9%. Conclusions: WSI and BMI are both useful to detect cardiometabolic risk factors.