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1.
Pesqui. vet. bras ; 40(1): 39-45, Jan. 2020. tab, graf
Article in English | LILACS (Americas), VETINDEX | ID: biblio-1091655

ABSTRACT

Insulin deregulation (ID) is a central player in the pathophysiology of equine metabolic syndrome (EMS), which is associated with generalized and/or regional obesity. The objective of this experiment was to characterize the alterations in the hormonal profile in horses exposed to a hypercaloric diet. A total of nine Mangalarga Marchador adult horses with initial body condition score (BCS) of 2.9±1/9 (mean±SD) were submitted to a high calorie grain-rich diet for 5 months. The data was collected before the start of the experiment and every 15 days until the end of the experiment and glucose and insulin concentrations were measured in the plasma. Proxies G:I, RISQI, HOMA-IR and MIRG were calculated. The low-dose oral glucose tolerance test (OGTT) was performed and the total area under the glucose (GTA) and insulin (ITA) curves at three different timepoints (before inducing obesity, after 90 days and after 150 days) was used. Analysis of variance of the results was performed considering the time effects and the means were compared with repeated measures by the Tukey's test (P≤0.05). The ID was observed during the first 90 days of the experiment and was characterized as a decompensated ID, showing an increase of basal glucose and insulin plasma levels, changes in all proxies and a significant increase in GTA (P<0.001) and ITA (P<0.05). However, a clear compensation of the ID was evident after 150 days of experiment, which was supported by data from the insulin secretory response of ß cells of the pancreas that showed an increase in insulin plasma levels, after fasting or exposure to gastric glucose, with a concomitant decrease in fasting glucose and fructosamine levels, and a decrease of GTA and marked increase of ITA (P<0.0001) in the dynamic test. These findings confirm the occurrence of hyperinsulinemia associated with insulin deregulation in Mangalarga Marchador horses exposed to hypercaloric diets.(AU)


A desregulação insulínica (DI) é o ponto central dos mecanismos fisiopatológicos da síndrome metabólica equina (SME), que é associada à obesidade generalizada e/ou regional. O objetivo deste experimento foi caracterizar as alterações no perfil hormonal em equinos submetidos à dieta hipercalórica. Foram utilizados nove equinos Mangalarga Marchador adultos com escore corporal (EC) médio (±DP) inicial de 2,9±1 (escala de 1-9) submetidos à dieta hipercalórica atingindo um EC de 8,3±1 após cinco meses. Os dados foram coletados antes do início do experimento e com o intervalo de 15 dias até o final do experimento, os valores plasmáticos foram obtidos para mensuração das concentrações de glicose e insulina. Foram calculados os proxies G:I, RISQI, HOMA-IR e o MIRG. Foi realizado o teste de baixa dose de glicose oral (TBDGO) utilizando a área total sob a curva de glicose (ATG) e insulina (ATI) em três momentos, antes da indução a obesidade, após 90 e 150 dias. Os resultados foram submetidos à análise de variância considerando-se os efeitos de tempo e as médias comparadas com medidas repetidas pelo teste de Tukey, com o valor P≤0,05. A DI foi observada nos primeiros 90 dias de experimento, se caracterizando como um quadro de DI descompensada, apresentando um aumento dos níveis plasmáticos basais de glicose e insulina, pelas alterações em todos os proxies e com um aumento significativo da ATG (P<0,001) e ATI (P<0,05). Contudo, ficou evidente uma compensação do quadro de DI após 150 dias de experimento, sendo demonstrado pelos dados da resposta secretória insulínica das células ß do pâncreas, que se manifestaram pelo aumento dos níveis plasmáticos de insulina pós-jejum ou exposição à glicose gástrica com concomitante redução nos níveis de glicose e frutosamina pós-jejum e pela redução da ATG e pela marcada elevação de ATI (P<0,0001) no teste dinâmico. Tais achados comprovam a ocorrência de hiperinsulinemia associada à desregulação insulínica em equinos Mangalarga Marchador expostos a dietas à dieta hipercalórica.(AU)


Subject(s)
Animals , Insulin Resistance , Metabolic Syndrome/etiology , Metabolic Syndrome/veterinary , Diet/veterinary , Horses/metabolism , Hyperinsulinism/etiology , Hyperinsulinism/veterinary , Obesity/etiology , Weight Gain , Obesity/veterinary
2.
J. pediatr. (Rio J.) ; 95(3): 342-349, May-June 2019. tab
Article in English | LILACS (Americas) | ID: biblio-1012613

ABSTRACT

Abstract Objective: To associate intra-abdominal fat thickness measured by ultrasonography to the factors related to metabolic syndrome and to determine cutoff points of intra-abdominal fat measurement associated with a greater chance of metabolic syndrome in adolescents. Methods: This was a cross-sectional study, with 423 adolescents from public schools. Intra-abdominal fat was measured by ultrasonography. Anthropometric data were collected, and biochemical analyses were performed. Results: Intra-abdominal fat was measured by ultrasonography, showing a statistically significant association with the diagnosis of metabolic syndrome (p = 0.037), body mass index (p < 0.001), elevated triglyceride levels (p = 0.012), decreased plasma HDL levels (p = 0.034), and increased systemic blood pressure values (p = 0.023). Cutoff values of intra-abdominal fat thickness measurements were calculated by ultrasound to estimate the individuals most likely to develop metabolic syndrome. In the logistic regression models, the cutoff values that showed the highest association with metabolic syndrome in males were 4.50, 5.35, 5.46, 6.24, and 6.50 cm for the ages of 14, 15, 16, 17, and 18/19 years, respectively. In the female gender, the cutoff values defined for the same age groups were 4.46, 4.55, 4.45, 4.90, and 6.46 cm. In an overall analysis using the ROC curve, without gender and age stratification, the cut-off of 3.67 cm showed good sensitivity, but low specificity. Conclusion: Ultrasonography is a useful method to estimate intra-abdominal adipose tissue in adolescents, which is associated with the main factors related to obesity and metabolic syndrome.


Resumo Objetivo: Relacionar a espessura da gordura intra-abdominal medida pela ultrassonografia aos fatores ligados à síndrome metabólica. Determinar pontos de corte da medida da gordura intra-abdominal associados a uma maior chance de síndrome metabólica em adolescentes. Métodos: Estudo seccional, com 423 adolescentes de escolas públicas. A gordura intra-abdominal foi medida pela ultrassonografia. Foram coletados dados antropométricos e feitas análises bioquímicas. Resultados: As medidas da gordura intra-abdominal por ultrassonografia apresentaram associação estatisticamente significativa com o diagnóstico de síndrome metabólica (p = 0,037), índice de massa corporal (p < 0,001), níveis elevados de triglicerídeos (p = 0,012), redução dos níveis plasmáticos de HDL (p = 0,034) e aumento da pressão arterial sistêmica (p = 0,023). Calcularam-se pontos de corte da medida da espessura da gordura intra-abdominal por ultrassom, para estimar os indivíduos com mais chance para o desenvolvimento de síndrome metabólica. Em modelos de regressão logística, os pontos de corte que apresentaram maior associação com a síndrome metabólica no sexo masculino foram de 4,50, 5,35, 5,46, 6,24 e 6,50 cm para as idades de 14, 15, 16, 17 e 18/19 anos, respectivamente. No sexo feminino, os pontos de corte definidos para as mesmas faixas etárias foram de 4,46, 4,55, 4,45, 4,90 e 6,46 cm. Em análise global por meio da curva ROC, sem estratificações por sexo e idade, o ponto de corte de 3,67 cm teve boa sensibilidade, porém apresentou baixa especificidade. Conclusão: A ultrassonografia é um método útil para a estimativa do tecido adiposo intra-abdominal em adolescentes, está associada com os principais fatores relacionados à obesidade e à síndrome metabólica.


Subject(s)
Humans , Male , Female , Adolescent , Young Adult , Metabolic Syndrome/etiology , Intra-Abdominal Fat/diagnostic imaging , Obesity/diagnostic imaging , Body Mass Index , Anthropometry , Adipose Tissue , Cross-Sectional Studies , Risk Factors , ROC Curve , Ultrasonography , Sensitivity and Specificity , Metabolic Syndrome/diagnosis , Obesity/complications
3.
Rev. medica electron ; 41(3): 628-640, mayo.-jun. 2019. tab
Article in Spanish | LILACS (Americas) | ID: biblio-1094072

ABSTRACT

RESUMEN Introducción: la prevalencia del síndrome metabólico, a nivel mundial, es muy elevada y continúa en aumento vertiginosamente en los últimos años. Por lo que se puede considerar una pandemia de la época contemporánea, se estima que el 25 % de la población adulta la padece. Objetivo: determinar la prevalencia del síndrome metabólico e identificar otras formas clínicas de enfermedad vascular ateroesclerótica, en gerontes hospitalizados en Servicios de Geriatría del Hospital Provincial Clínico Quirúrgico Docente "Celia Sánchez Manduley", Manzanillo, Granma; en el período comprendido entre junio 2015 a junio 2016. Materiales y métodos: se realizó estudio observacional, descriptivo, de corte transversal. Se incluyeron los 120 senescentes que ingresaron en los Servicios de Geriatría. Resultados: se estableció el diagnóstico de síndrome metabólico en 105 individuos de 120 sujetos estudiados. El grupo de 70-79 años de edad y el sexo masculino fueron los más afectados por la endocrinopatía. Las otras formas clínicas de enfermedad vascular ateroesclerótica que se identificaron en los senescentes estudiados, fueron: cardiopatía isquémica, enfermedad cerebrovascular y cardiopatía hipertensiva. Conclusiones: existe una alta prevalencia del síndrome metabólico en los adultos mayores estudiados.


ABSTRACT Introduction: the prevalence of the metabolic syndrome is very high around the world and is still vertiginously increasing in the last years. Therefore, it can be considered a pandemic of the current times. It is thought that 25 % of the adult population suffers it. Objective: to determine the prevalence of the metabolic syndrome and to identify other clinical forms of the atherosclerotic vascular disease in elder people who entered the Service of Geriatrics of the Provincial Teaching Clinical Surgical Hospital "Celia Sanchez Manduley", of Manzanillo, Granma, in the period from June 2015 to June 2016. Materials and methods: a cross-sectional, observational, descriptive study was carried out with the inclusion of the 120 elder people who the Service of Geriatrics. Results: 105 individuals of 129 studied were diagnosed with metabolic syndrome. The 79-79 age group and male sex were the most affected by endocrinopathy. Other clinical forms of the arteriosclerotic vascular disease identified in the studied elder people were ischemic heart disease, cerebrovascular disease and hypertensive heart disease. Conclusions: there is a high prevalence of the metabolic syndrome among the studied elder people.


Subject(s)
Humans , Aged , Aging , Cerebrovascular Disorders/diagnosis , Risk Factors , Myocardial Ischemia/diagnosis , Metabolic Syndrome/diagnosis , Metabolic Syndrome/etiology , Metabolic Syndrome/prevention & control , Metabolic Syndrome/therapy , Metabolic Syndrome/epidemiology , Diabetes Mellitus, Type 2/diagnosis , Geriatrics , Epidemiology, Descriptive , Cross-Sectional Studies , Hospital Care , Obesity, Abdominal/diagnosis , Early Medical Intervention , Observational Study , Hypertension/diagnosis
4.
Rev. gaúch. enferm ; 40: e20180379, 2019. tab
Article in Portuguese | LILACS (Americas) | ID: biblio-1004079

ABSTRACT

Resumo OBJETIVOS Verificar a associação entre os fatores sociodemográficos e comportamentais com a síndrome metabólica em pessoas vivendo com HIV. MÉTODOS Estudo transversal, realizado em ambulatórios especializados no município de Ribeirão Preto - SP, entre outubro de 2014 a outubro de 2016. Para avaliação da síndrome metabólica utilizou-se os critérios do National Cholesterol Education Program Adult Treatment Panel III e da International Diabetes Federation. Foram realizadas entrevistas individuais e utilizou-se o teste qui-quadrado e exato de Fisher. RESULTADOS Foram avaliados 340 pacientes, 28,5% (n=97) com SM pelo critério do National Cholesterol Education Program Adult Treatment Panel III, e 39,4% (n=134) pela International Diabetes Federation. Houve associação entre a síndrome metabólica e as variáveis sexo (ATP: p<0,001; IDF: p=0,002), idade (ATP: p<0,001; IDF: p<0,001), escolaridade (ATP: p=0,003; IDF: p=0,003), estado civil (ATP: p=0,003; IDF: p=0,022), situação de trabalho (ATP: p=0,003; IDF: p=0,024), orientação sexual (ATP: p=0,003; IDF: p=0,015), hábitos de fumar (ATP: p=0,037; IDF: p=0,033) e atividades de lazer (ATP: p=0,010; IDF: p=0,006). CONCLUSÕES Existem associações significativas entre a síndrome metabólica, fatores sociodemográficos e comportamentais em pessoas vivendo com HIV.


Resumen OBJETIVO Verificar la asociación entre factores sociodemográficos y comportamentales con el síndrome metabólico en personas que viven con VIH/SIDA. MÉTODOS Estudio transversal, realizado en ambulatorios especializados en la ciudad de Ribeirão Preto-SP, entre octubre de 2014 y octubre de 2016. Para la evaluación de la SM se utilizaron los criterios del National Cholesterol Education Program Adult Treatment III y de la International Diabetes Federation. Se realizaron entrevistas individuales y se utilizó el test Qui-cuadrado y exacto de Fisher. RESULTADOS Se evaluaron 340 pacientes, 28,5% (n = 97) con SM por el criterio del National Cholesterol Education Program Adult Treatment III, y el 39,4% (n = 134) por el IDF. En el presente estudio se evaluó la relación entre el síndrome metabólico y las variables sexo (ATP: p<0,001, IDF: p=0,002), edad (ATP: p<0,001; IDF: p<0,001), escolaridad (ATP: p=0,003; IDF: p=0,003), estado civil (ATP: p=0.003, IDF: p=0.022), situación de trabajo (ATP: p=0,003, IDF: p=0,024), los hábitos de fumar (ATP: p=0,037, IDF: p=0,033) y actividades de ocio (ATP: p=0,010; IDF: p=0,006). CONCLUSIONES Existen asociaciones significativas entre el síndrome metabólico, factores sociodemográficos y comportamentales en personas que viven con VIH/SIDA.


Abstract OBJECTIVE To analyze the association between sociodemographic and behavioral factors with the metabolic syndrome in people living with HIV. METHODS A cross-sectional study was carried out in specialized outpatient clinics in Ribeirão Preto - SP city, between October 2014 and October 2016. The criteria of the National Cholesterol Education Program Adult Treatment Panel III and the International Diabetes Federation were used for the evaluation of metabolic syndrome. Individual interviews were conducted and the Chi-square and Fisher's exact test was used. RESULTS 340 patients were evaluated, 28.5% (n=97) with metabolic syndrome by the National Cholesterol Education Program Adult Treatment Panel III criterion, and 39.4% (n=134) by the International Diabetes Federation. There was an association between MS and the variables gender (ATP: p<0.001, p=0.002), age (ATP: p<0.001, IDF: p<0.001), schooling (ATP: p=0.003, IDF: p=0.003), marital status (ATP: p=0.003, IDF: p=0.022), work status (ATP: p=0.003; IDF: p=0.024), smoking (ATP: p=0.037, IDF: p=0.033) and leisure activities (ATP: p=0.010, IDF: p=0.006). CONCLUSIONS There are significant associations between the metabolic syndrome, sociodemographic and behavioral factors in people living with HIV.


Subject(s)
Humans , Male , Female , Adult , Aged , Young Adult , HIV Infections/complications , Metabolic Syndrome/etiology , Smoking/epidemiology , Chi-Square Distribution , HIV Infections/drug therapy , Sex Factors , Cross-Sectional Studies , Age Factors , Marital Status , Metabolic Syndrome/diagnosis , Educational Status , Employment/statistics & numerical data , Leisure Activities , Middle Aged
5.
Cad. Saúde Pública (Online) ; 34(9): e00105317, 2018. tab, graf
Article in English | LILACS (Americas) | ID: biblio-952462

ABSTRACT

The goals of this study were to develop reference values for waist circumference (WC) in Brazilian children between 6-10 years old and to evaluate the WC performance in predicting cardiovascular risk factors and metabolic syndrome (MetS) in children. This is a population-based epidemiological cross-sectional study, in which 1,397 children participated, with a 6-10 years old probability sampling and from public and private schools in the city of Uberaba, Minas Gerais State, Brazil. WC was measured at the waist narrowest point (WC1) and at the umbilicus level (WC2). Blood samples and blood pressure were collected to determine the MetS diagnosis. There was a significant effect of age (p = 0.001), anatomical point (WC1 vs. WC2, p = 0.001) and sex-anatomical point interaction (p = 0.016) for WC. Smoothed sex- and age-specific 5th, 10th, 25th, 50th, 75th, 90th and 95th percentile curves of WC1 and WC2 were designed by the LMS method. WC was accurate to predict MetS, for all ages [area under the ROC curve (AUC) > 0.79 and p < 0.05], regardless of sex. This study presented percentile curves for WC at two anatomical points in a representative sample of Brazilian children. Furthermore, WC was shown to be a strong predictor of cardiovascular risk factors and MetS in children.


O estudo teve como objetivos desenvolver valores de referência para perímetro de cintura (PC) em crianças brasileiras entre 6 e 10 anos de idade e avaliar o desempenho da PC na predição de fatores de risco cardiovasculares e de síndrome metabólica (SM) em crianças. O estudo epidemiológico transversal de base populacional incluiu 1.397 crianças entre 6 e 10 anos de idade, através de amostragem probabilística em escolas públicas e privadas em Uberaba, Minas Gerais, Brasil. A PC era medida no ponto mais estreito da cintura (PC1) e ao nível do umbigo (PC2). Foram coletadas amostras de sangue e medidas de pressão arterial para determinar o diagnóstico de SM. Os seguintes fatores mostram associação significativa com PC: idade (p = 0,001), ponto anatômico (PC1 vs. PC2, p = 0,001) e interação sexo/ponto anatômico (p = 0,016). O método LMS foi utilizado para desenhar as curvas suavizadas específicas para sexo e idade, dos percentis 5, 10, 25, 50, 75, 90 e 95. A PC mostrou-se acurada para a predição de SM, para todas as idades [área sob a curva ROC (AUC) > 0,79 e p < 0,05], independente de sexo. Conclusão: o estudo apresentou curvas de percentis de PC em dois pontos anatómicos em uma amostra representativa de crianças brasileiras. Além disso, a PC mostrou ser forte preditor de fatores de risco cardiovasculares e SM em crianças.


Los objetivos de este estudio fueron desarrollar valores de referencia para la circunferencia de cintura (WC por sus siglas en inglés), en niños brasileños entre 6-10 años de edad, y evaluar los resultados de WC para predecir factores de riesgo cardiovasculares y síndrome metabólico (MetS) en niños. Se trata de un estudio epidemiológico transversal, basado en población, en el que participaron 1.397 niños, de 6 a 10 años de edad con muestreo probabilístico, procedentes de escuelas públicas y privadas en la ciudad de Uberaba, Minas Gerais, Brasil. WC fue medido en el punto de cintura más estrecho (WC1) y al nivel del ombligo (WC2). Las muestras de sangre y presión arterial se recogieron para determinar el diagnóstico de MetS. Había un significativo efecto de la edad (p = 0.001), punto anatómico (WC1 vs. WC2, p = 0.001) y punto de interacción sexo-anatómico (p = 0.016) para el WC. Sexo uniforme y edad específica 5º, 10º, 25º, 50º, 75º, 90º y 95º curvas de percentil de WC1 y WC2 fueron diseñados mediante el método LMS. WC fue exacto para predecir MetS en todas las edades [área bajo la curva ROC (AUC) > 0.79 y p < 0.05], independientemente del sexo. Conclusión: este estudio presentó un percentil de curvas para WC en dos puntos anatómicos en una muestra representativa de niños brasileños. Asimismo, la WC se mostró como un fuerte predictor de factores de riesgo cardiovasculares y MetS en niños.


Subject(s)
Humans , Male , Female , Child , Cardiovascular Diseases/diagnosis , Risk Assessment/methods , Metabolic Syndrome/diagnosis , Waist Circumference/physiology , Reference Standards , Reference Values , Brazil/epidemiology , Cardiovascular Diseases/etiology , Cardiovascular Diseases/epidemiology , Body Mass Index , Sex Factors , Cross-Sectional Studies , Reproducibility of Results , Risk Factors , Analysis of Variance , Sensitivity and Specificity , Age Factors , Metabolic Syndrome/etiology , Metabolic Syndrome/epidemiology , Early Diagnosis , Pediatric Obesity/complications , Pediatric Obesity/epidemiology
6.
Cad. Saúde Pública (Online) ; 34(4): e00067617, 2018. tab
Article in Portuguese | LILACS (Americas) | ID: biblio-889945

ABSTRACT

O objetivo deste estudo foi estimar a prevalência do fenótipo cintura hipertrigliceridêmica (FCH) em participantes do Estudo Longitudinal da Saúde do Adulto (ELSA-Brasil), identificar fatores de risco associados e comparar com outros indicadores de risco cardiovascular e metabólico. Trata-se de um estudo transversal com dados da linha de base de uma coorte de servidores públicos. O FCH é definido pela presença simultânea de circunferência da cintura (CC) aumentada (≥ 80cm para mulheres, ≥ 90cm para homens de acordo com a Federação Internacional de Diabetes - IDF; e ≥ 88cm para mulheres, ≥ 102cm para homens de acordo com o Programa Nacional de Educação sobre o Colesterol dos Estados Unidos - NCEP) e hipertrigliceridemia. A associação entre as variáveis independentes e FCH foi testada por meio de modelos de regressão logística multivariada. O FCH foi comparado também com outros indicadores de risco cardiovascular e metabólico por meio de testes de correlação, índice kappa, sensibilidade e especificidade. Após exclusões, foram analisados 12.811 participantes. A prevalência do FCH variou de 24,7% (IDF) a 13,3% (NCEP). FCH foi associado a ter idade mais avançada, ao consumo excessivo de álcool, ser ex-fumante, apresentar HDL baixo, não-HDL alto e PCR aumentado, independente do sexo ou critério de definição. FCH associou-se a indicadores de risco cardiovascular, especialmente à síndrome metabólica. A elevada prevalência de FCH e sua associação com indicadores de risco cardiovascular, especialmente com a síndrome metabólica, apoia sua utilização como ferramenta de triagem de risco cardiometabólico na prática clínica.


This study's objectives were to estimate the prevalence of hypertriglyceridemic waist (HTW) phenotype in participants in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), identify associated risk factors, and compare with other cardiovascular and metabolic risk indicators. This was a cross-sectional study with baseline data from a cohort of public employees. HTW is defined as the simultaneous presence of increased waist circumference (WC) (≥ 80cm for women, ≥ 90cm for men according to the International Diabetes Federation - IDF; and ≥ 88cm for women, ≥ 102cm for men according to the U.S. National Cholesterol Education Program - NCEP) and hypertriglyceridemia. Associations between independent variables and HTW were tested with multivariate logistic regression models. HTW was also compared to other cardiovascular and metabolic risk indicators by means of correlation tests, kappa index, sensitivity, and specificity. After exclusions, 12,811 participants were analyzed. Prevalence of HTW ranged from 24.7% (IDF) to 13.3% (NCEP). HTW was associated with age, excessive alcohol consumption, former smoking, low HDL, non-high HDL, and increased C-reactive protein, independently of gender or the criterion used to define HTW. HTW was associated with cardiovascular risk indicators, especially metabolic syndrome. The high prevalence of HTW and its association with cardiovascular risk indicators, especially metabolic syndrome, supports its use as a cardiometabolic risk screening tool in clinical practice.


El objetivo de este estudio fue estimar la prevalencia del fenotipo cintura hipertrigliceridémica (FCH), en participantes del Estudio Longitudinal de la Salud del Adulto (ELSA-Brasil), identificar factores de riesgo asociados, y compararlo con otros indicadores de riesgo cardiovascular y metabólico. Se trata de un estudio transversal con datos de la línea de referencia de una cohorte de empleados públicos. El FCH se define por la presencia simultánea de circunferencia de la cintura (CC) aumentada (≥ 80cm para mujeres, ≥ 90cm para hombres de acuerdo con la Federación Internacional de Diabetes - IDF; y ≥ 88cm para mujeres, ≥ 102cm para hombres de acuerdo con el Programa National de Educación sobre el colesterol de los EE.UU. - NCEP) e hipertrigliceridemia. La asociación entre las variables independientes y FCH fue probada mediante modelos de regresión logística multivariada. El FCH se comparó también con otros indicadores de riesgo cardiovascular y metabólico, mediante pruebas de correlación, índice kappa, sensibilidad y especificidad. Tras las exclusiones, se analizaron a 12.811 participantes. La prevalencia del FCH varió de un 24,7% (IDF) a un 13,3% (NCEP). El FCH se asoció a tener una edad más avanzada, al consumo excesivo de alcohol, ser ex-fumador, presentar HDL bajo, no-HDL alto y PCR aumentado, independiente del sexo o criterio de definición. FCH se asoció a indicadores de riesgo cardiovascular, especialmente al síndrome metabólico. La elevada prevalencia de FHC y su asociación con indicadores de riesgo cardiovascular, especialmente con el síndrome metabólico, apoya su utilización como herramienta de clasificación de riesgo cardiometabólico en la práctica clínica.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Cardiovascular Diseases/etiology , Metabolic Syndrome/etiology , Waist Circumference , Hypertriglyceridemic Waist/complications , Phenotype , Socioeconomic Factors , Cross-Sectional Studies , Risk Factors , Longitudinal Studies , Obesity, Abdominal/complications
8.
Actual. osteol ; 13(3): 214-222, Sept - DIc. 2017. graf, tab
Article in Spanish | LILACS (Americas) | ID: biblio-1117383

ABSTRACT

Los bajos niveles de 25-hidroxivitamina D (25OHD) se han vinculado con el desarrollo de enfermedad cardiovascular, diabetes mellitus tipo 2, obesidad, dislipidemia e hipertensión arterial, todos componentes del síndrome metabólico (SM). Además, se ha reportado una asociación inversa entre 25OHD y el SM, resistencia a la insulina, deterioro de la función celular ß e intolerancia a la glucosa. El objetivo de este trabajo fue evaluar los niveles de 25OHD en pacientes diabéticos tipo 2 con y sin SM. Se llevó a cabo un estudio observacional de corte transversal. Se evaluaron 108 pacientes diabéticos tipo 2 (grupo DM2) y 89 pacientes sin DM2 (GC) con y sin SM, en los cuales se determinó la concentración de 25OHD total. Se calculó el cociente de probabilidad (OR) e intervalo de confianza del 95% (IC95) para la deficiencia de 25OHD (<20 ng/ml). Resultados: el grupo DM2 presentó niveles menores de 25OHD (19,8 ng/ml vs. 25,0 ng/ml) y mayor proporción de pacientes con deficiencia de 25OHD respecto del GC (50,9% vs. 28,1%, OR 2,7, IC95%: 1,5-4,8). No se halló una correlación entre 25OHD y HbA1c. Se halló asociación significativa entre deficiencia de 25OHD y presencia de diabetes, obesidad y SM. Sin embargo, en el análisis multivariado solo la presencia del SM presentó asociación negativa significativa con la deficiencia de 25OHD (OR=4,04, IC95% 1,48-11,68). En conclusión, nuestros datos demuestran una elevada prevalencia de hipovitaminosis D en pacientes con diabetes mellitus tipo 2 a expensas, principalmente, del elevado porcentaje de pacientes que padecen SM. El SM incrementa cuatro veces el riesgo de deficiencia de vitamina D independientemente de la presencia de diabetes mellitus tipo 2. (AU)


Low levels of 25-hydroxyvitamin D (25OHD) have been linked to cardiovascular disease, type 2 diabetes mellitus, obesity, dyslipidemia and hypertension, all components of the metabolic syndrome. An inverse association has been observed between 25OHD and metabolic syndrome, insulin resistance, impaired ß-cell function and glucose intolerance. The aim of this study was to evaluate the 25OHD levels in type 2 diabetic patients with and without metabolic syndrome. An observational cross-sectional study was carried out. We included 108 type 2 diabetic patients (DM2 group) and 89 patients without DM2 (CG) with and without metabolic syndrome, in which the total 25OHD levels were measured. The odds ratio (OR) and 95% confidence interval (95%CI) for 25OHD deficiency (<20 ng/ml) were estimated. Results: The DM2 group had lower 25OHD levels (19.8 ng/ml vs 25.0 ng/ml) and higher proportion of patients with a 25OHD deficiency compared to the CG (50.9% vs 28.1%, OR 2.7, 95%CI: 1.5-4.8). No correlation was found between 25OHD and HbA1c. A significant association was found between 25OHD deficiency and the presence of diabetes, obesity, and the presence of metabolic syndrome. However, in the multivariate analysis only the presence of metabolic syndrome had a significant negative association with the 25OHD deficiency (OR=4.04, 95%CI 1.48-11.68). In conclusion, we found a high prevalence of hypovitaminosis D in DM2 and the metabolic syndrome increases the risk of 25OHD deficiency by four times. (AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Vitamin D Deficiency/blood , Metabolic Syndrome/complications , Diabetes Mellitus, Type 2/complications , Hydroxycholecalciferols/deficiency , Avitaminosis/diagnosis , Vitamin D/physiology , Insulin Resistance , Body Mass Index , Calcium/metabolism , Prevalence , Cross-Sectional Studies , Multivariate Analysis , Metabolic Syndrome/diagnosis , Metabolic Syndrome/etiology , Metabolic Syndrome/blood , Diabetes Mellitus, Type 2/diagnosis , Diabetes Mellitus, Type 2/blood , Overweight/complications , Hydroxycholecalciferols/blood , Obesity/complications
9.
Rev. psiquiatr. Urug ; 81(2): 101-105, dic. 2017. ilus, tab
Article in Spanish | LILACS (Americas) | ID: biblio-973356

ABSTRACT

La clozapina ha demostrado ser el antipsicóticomás efectivo para la esquizofrenia resistente, perotambién está vinculada con un mayor riesgo de producir alteraciones metabólicas en los pacientes. Se realizó un estudio prospectivo de pacientes de la Policlínica del Hospital Vilardebó donde se correlacionaron las siguientes variables: dosis diaria de clozapina, concentración plasmática de clozapina y su principal metabolito norclozapinaa predosis, cociente metabólico clozapina/norclozapina, sexo, edad, estatus fumador, duración del tratamiento con clozapina, marca comercialde clozapina utilizada, comedicación con ácido valproico, comedicación con antipsicóticos, comedicación con litio y consumo de café enrelación con el síndrome metabólico (definido porla Asociación Latinoamericana de Diabetes). Laúnica covariable significativa como dependiente del síndrome metabólico fue la concentración plasmática en valle de clozapina. El modelo que se encontró para dicha explicación es el siguiente: P(SM)=Exp(-1.69+0.00358*CZP)/((1+Exp(-1.69+0.00358*CZP)). A mayores concentraciones de clozapina el riesgo de síndrome metabólico aumenta. Esto puede tener implicancias en la clínica, ya que a pacientes con altas concentraciones de clozapina se deberían buscar estrategias para disminuir el impacto metabólico que pueda existir.


Clozapine has proven to be the most effective antipsychotic for resistant schizophrenia, but it is also linked to an increased risk of producing metabolic alterations in patients. A prospective study of patients from the Vilardebó Hospital Polyclinic where the following variables were correlated: daily dose of clozapine, plasma concentration of clozapine and its main metabolite norclozapinaa predose, metabolic ratio clozapine / norclozapine, sex, age, smoking status, duration of the treatment with clozapine, trademark of clozapine used, comedication with valproic acid, comedication with antipsychotics, comedication with lithium and consumption of coffee related to the metabolic syndrome (defined by the Latin American Diabetes Association). The only significant covariate as dependent on the metabolic syndrome was the plasma concentration in clozapine. The model found for this explanation is as follows: P (SM) = Exp (-1.69 + 0.00358 * CZP) / ((1 + Exp (-1.69 + 0.00358 * CZP)) At higher concentrations of clozapine the risk of Metabolic syndrome increases This may have clinical implications, since patients with high concentrations of clozapine should seek strategies to reduce the metabolic impact that may exist.


Subject(s)
Male , Female , Humans , Metabolic Syndrome/etiology , Clozapine/adverse effects , Prospective Studies , Longitudinal Studies , Schizophrenia , Clozapine/analysis
10.
J. pediatr. (Rio J.) ; 93(5): 490-496, Sept.-Oct. 2017. tab, graf
Article in English | LILACS (Americas) | ID: biblio-894062

ABSTRACT

Abstract Objectives: To draw skinfold (SF) reference curves (subscapular, suprailiac, biceps, triceps) and to determine SF cutoff points for predicting the risk of metabolic syndrome (MetS) in children aged 6-10 years old. Methods: This was a cross-sectional study with a random sample of 1480 children aged 6-10 years old, 52.2% females, from public and private schools located in the urban and rural areas of the municipality of Uberaba (MG). Anthropometry, blood pressure, and fasting blood samples were taken at school, following specific protocols. The LMS method was used to draw the reference curves and ROC curve analysis to determine the accuracy and cutoff points for the evaluated skinfolds. Results: The four SF evaluated (subscapular, suprailiac, biceps, and triceps) and their sum (∑4SF) were accurate in predicting MetS for both girls and boys. Additionally, cutoffs have been proposed and percentile curves (p5, p10, p25, p50, p75, p90, and p95) were outlined for the four SF and ∑4SF, for both genders. Conclusion: SF measurements were accurate in predicting metabolic syndrome in children aged 6-10 years old. Age- and gender-specific smoothed percentiles curves of SF provide a reference for the detection of risk for MetS in children.


Resumo Objetivos: Desenhar curvas de referência de quatro dobras cutâneas (subescapular, suprailíaca, bíceps, tríceps) e determinar pontos de corte para predizer o risco de SM em crianças de seis a 10 anos. Métodos: Estudo epidemiológico de base populacional, corte transversal, com amostra probabilística, estratificada por segmento de ensino, com 1.480 crianças de seis a 10 anos idade, 52,2% do sexo feminino, oriundas de escolas públicas e privadas nas zonas urbana e rural do município de Uberaba (MG). Antropometria (dobras cutâneas), pressão arterial e as coletas de sangue em jejum foram feitas em espaço reservado na escola, seguiram protocolos específicos. O método LMS foi usado para desenhar as curvas de referência e análise de curva ROC para determinar a acurácia e os pontos de corte para as dobras cutâneas avaliadas. Resultados: As quatro DC avaliadas (subescapular, suprailíaca, bíceps e tríceps) e o seu somatório (∑4DC) foram acurados na predição da SM para meninas e meninos. Adicionalmente, pontos de corte foram propostos e curvas percentílicas (p5, p10, p25, p50, p75, p90 e p95) foram delineadas para as quatro DC e o ∑4DC, para ambos os sexos. Conclusão: Medidas de DC foram acuradas em predizer SM em escolares de seis a 10 anos. As curvas percentílicas de DC desenhadas por idade e sexo fornecem referência na detecção do risco de SM em crianças.


Subject(s)
Humans , Male , Female , Child , Skinfold Thickness , Metabolic Syndrome/diagnosis , Reference Values , Cross-Sectional Studies , Predictive Value of Tests , Risk Factors , Metabolic Syndrome/etiology
11.
J. pediatr. (Rio J.) ; 93(5): 525-531, Sept.-Oct. 2017. tab
Article in English | LILACS (Americas) | ID: biblio-894057

ABSTRACT

Abstract Objective: To analyze the performance of three different diagnostic criteria of overweight and obesity (WHO, IOTF and Conde and Monteiro) using body mass index (BMI) as predictors of metabolic syndrome (MetS) in a representative sample of adolescents. Methods: A sample of 1035 adolescents aged 12-20 years (565 girls and 470 boys) was used in the study. BMI was calculated through the quotient of weight (kg)/height squared (m)2, and MetS was defined according to the criteria of the International Diabetes Federation. Sensitivity, specificity, and overall accuracy (area under the curve) were estimated using the receiver operating characteristic (ROC) curves method and used to describe the predictive performance. Results: The three diagnostic criteria showed higher absolute values of sensitivity and specificity for predicting MetS in boys and older adolescents. The highest sensitivity to identify MetS was found using the IOTF criterion (60-85%), while specificity values ≥ 90% were found for the three criteria. The Conde and Monteiro diagnostic criterion pointed to a significantly lower overall accuracy (0.52-0.64) than that of the WHO (0.70-0.84) and IOTF (0.75-0.89) diagnostic criterion. Conclusions: Overweight and obesity using BMI showed a moderate association with MetS, regardless of the diagnostic criteria used. However, the IOTF criterion showed better predictive capacity for the presence of MetS than the WHO and the Conde and Monteiro criteria.


Resumo Objetivo: Analisar o desempenho de três diferentes critérios diagnósticos de sobrepeso e obesidade (WHO, IOTF e Conde & Monteiro) a partir do índice de massa corporal (IMC) como preditores da síndrome metabólica (SMet) em amostra representativa de adolescentes. Métodos: A amostra foi constituída por 1.035 adolescentes (565 moças e 470 rapazes) entre 12 e 20 anos. O IMC foi calculado mediante quociente entre peso (kg)/altura (m)2 e SMet foi definida através dos critérios da International Diabetes Federation. Desempenho preditivo foi descrito a partir das estimativas de sensibilidade, especificidade e acurácia global (área sob a curva) com o método de curvas Receiver Operating Characteristic. Resultados: Os três critérios diagnósticos apresentaram maiores valores absolutos de sensibilidade e especificidade para predição da SMet nos rapazes e nos adolescentes com mais idade. Maior sensibilidade para identificar SMet foi observada com o critério IOTF (60% a 85%), enquanto especificidade ≥ 90% foi observada mediante o uso dos três critérios diagnósticos. O critério diagnóstico Conde & Monteiro apontou acurácia global (0,52 a 0,64) significativamente menor do que os critérios diagnósticos WHO (0,70 a 0,84) e IOTF (0,75 a 0,89). Conclusões: Sobrepeso e obesidade a partir do IMC mostraram uma moderada associação com SMet, independentemente do critério diagnóstico empregado. Contudo, o critério IOTF demonstrou melhor capacidade preditiva para presença de SMet do que os critérios WHO e Conde & Monteiro.


Subject(s)
Humans , Male , Female , Child , Adolescent , Body Mass Index , Metabolic Syndrome/etiology , Overweight/complications , Overweight/diagnosis , Cross-Sectional Studies , Predictive Value of Tests , ROC Curve , Sensitivity and Specificity , Obesity/complications , Obesity/diagnosis
12.
Arch. argent. pediatr ; 115(4): 323-330, ago. 2017. tab, Ilus
Article in English, Spanish | LILACS (Americas), BINACIS | ID: biblio-887342

ABSTRACT

Objetivo. Evaluar la asociación entre síndrome metabólico (SM) y carga glicémica (CG) de la ingesta alimentaria en niños y adolescentes obesos atendidos en consulta endocrinológica de un hospital de referencia pediátrica en Lima, Perú. Población y método. Estudio transversal en niños y adolescentes obesos (índice de masa corporal ≥ percentil 95) de 10 a 15 años. Se clasificó como SM según los criterios de la International Diabetes Federation. Se aplicó un recordatorio de 24 horas y se calculó la CG total y por comida. Se evaluó la asociación entre los terciles de CG (comparación con el inferior) y SM usando razones de prevalencia ajustadas (RPa) por variables demográficas, antecedentes familiares, de actividad física y consumo total de carbohidratos en modelos de regresión de Poisson con varianza robusta. Resultados. De 273 niños y adolescentes obesos, 52,4% fueron varones y 94,9% fueron físicamente inactivos. La mediana de CG fue de 213 (164,8287,4) y la de ingesta calórica diaria fue 2275 (1851-3024) kcal, dada principalmente por carbohidratos (62%). La prevalencia de SM fue de 22,3%; los componentes con mayor prevalencia fueron la obesidad abdominal (81,7%) y los valores de lipoproteínas de alta densidad (HDL, del inglés high density lipoprotein) bajos (63,7%). Por último, se encontró una asociación entre el consumo elevado de CG y el riesgo de presentar SM (RPa 4,5; IC 95%: 1,3-15,3). Conclusiones. Existe una asociación entre el alto consumo de CG y la presencia de SM en niños y adolescentes con obesidad.


Objective. To study the association between the metabolic syndrome (MS) and the glycemic load (GL) of food intake among obese children and adolescents seen in consultation by the endocrinology team in a pediatric referral hospital in Lima, Peru. Population and Method. Cross-sectional study among obese children and adolescents (body mass index ≥ 95 percentile), 10-15 years old. The MS was classified according to criteria of the International Diabetes Federation. A 24 hour reminder was used, and the overall and per meal GL was calculated. The association between the GL tertiles (comparison with the lower tertile) and the MS was assessed using prevalence ratios adjusted by demographic outcome measures, family history, physical activity and total carbohydrate consumption in Poisson regression models with a robust variance. Results. Out of 273 obese children and adolescents, 52.4% were male and 94.9% did not engage in any physical activity. Glycemic load median value was 213 (164.8-287.4) and the daily calorie intake value was 2275 (1851-3024) kcal, consisting mainly of carbohydrates (62%). MS prevalence was 22.3%; the most prevalent components were abdominal obesity (81.7%) and low values of high density lipoprotein (HDL) (63.7%). Lastly, an association was observed between a high consumption of GL and the risk of developing MS (aRP 4.5; 95% CI: 1.3-15.3). Conclusions. There is an association between a high consumption of GL and the presence of MS among obese children and adolescents.


Subject(s)
Humans , Male , Female , Child , Adolescent , Metabolic Syndrome/etiology , Diet , Pediatric Obesity/complications , Glycemic Load , Prevalence , Cross-Sectional Studies , Metabolic Syndrome/epidemiology
13.
Clinics ; 72(1): 36-43, Jan. 2017. tab
Article in English | LILACS (Americas) | ID: biblio-840037

ABSTRACT

OBJECTIVE: This study analyzed the frequency of cardiometabolic risk markers and metabolic syndrome occurrence in overweight and obese children and adolescents. METHODS: The participants included 161 overweight (n=65) and obese (n=96) individuals aged between 5 and 19 years. Clinical markers were assessed (body mass index, body fat percentage, waist circumference, acanthosis, systolic and diastolic blood pressures, laboratory parameters [glucose, insulin, cholesterol (total and fractions) and triglyceride levels and homeostasis model assessment of insulin resistance (HOMA-IR) index] and leptin and adiponectin levels). The frequency of changes, odds ratios and correlations among markers were determined. Metabolic syndrome was assessed according to International Diabetes Federation criteria. RESULTS: A high frequency of acanthosis (51.6%); increased waist circumference (45.4%), systolic blood pressure / diastolic blood pressure (8.1% / 9.3%), glucose (10%), insulin (36.9%) and HOMA-IR (44.3%) values; and reduced high-density lipoprotein levels (47.2%) were observed. Leptin levels were increased in 95% of obese and in 66% of overweight subjects. Adiponectin was decreased in 29.5% of obese and in 34% of overweight subjects. An odd ratio analysis revealed a greater probability of increased waist circumference (9.0), systolic blood pressure (4.1), triglyceride (2.3) and insulin (2.9) levels and HOMA-IR (3.0) in the obese group than in the overweight group. The clinical and laboratory parameters and leptin levels exhibited significant correlations, whereas adiponectin was negatively correlated with systolic blood pressure. The occurrence rate of metabolic syndrome was 13.6%. CONCLUSIONS: The high frequency of changes in clinical, laboratory and adipokine markers indicates the need for early interventions aimed at preventing cardiometabolic complications in adulthood.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Young Adult , Biomarkers/blood , Metabolic Syndrome/blood , Obesity/blood , Adiponectin/blood , Blood Glucose/analysis , Blood Pressure/physiology , Body Mass Index , Cholesterol/blood , Insulin/blood , Leptin/blood , Metabolic Syndrome/etiology , Obesity/complications , Overweight/blood , Overweight/complications , Predictive Value of Tests , Prospective Studies , Triglycerides/blood , Waist Circumference
14.
J. pediatr. (Rio J.) ; 92(4): 388-393, July-Aug. 2016. tab
Article in English | LILACS (Americas) | ID: lil-792580

ABSTRACT

Abstract Objective Verify the association between metabolic risk profile in students with different levels of cardiorespiratory fitness and body mass index, as well as the nutritional status of their parents. Methods A cross-sectional study comprising 1.254 schoolchildren aged between seven and 17 years. The metabolic risk profile was calculated by summing the standardized values of high density lipoproteins and low density lipoproteins, triglycerides, glucose and systolic blood pressure. The parents’ nutritional status was evaluated by self-reported weight and height data, for body mass index calculating. The body mass index of schoolchildren was classified as underweight/normal weight and overweight/obesity. The cardiorespiratory fitness was assessed by 9-minute running/walk test, being categorized as fit (good levels) and unfit (low levels). Data were analyzed using prevalence ratio values (PR). Results The data indicates a higher occurrence of developing metabolic risk in schoolchildren whose mother is obese (PR: 1.50; 95% CI: 1.01, 2.23), and even higher for those whose father and mother are obese (PR: 2, 79, 95% CI: 1.41; 5.51). Students who have low levels of cardiorespiratory fitness and overweight/obesity have higher occurrence of presenting metabolic risk profile (PR: 5.25; 95% CI: 3.31; 8.16). Conclusion the occurrence of developing metabolic risk in schoolchildren increase when they have low levels of cardiorespiratory fitness and overweight/obesity, and the presence of parental obesity.


Resumo Objetivo Verificar se há associação entre o perfil de risco metabólico em escolares com diferentes níveis de aptidão cardiorrespiratória e índice de massa corporal, bem como com o perfil nutricional de seus pais. Métodos Estudo transversal constituído por 1.254 escolares com idade entre sete e 17 anos. O perfil de risco metabólico foi calculado por meio da soma dos valores estandardizados de lipoproteína de alta densidade e lipoproteína de baixa densidade, triglicerídeos, glicose e pressão arterial sistólica. O perfil nutricional dos pais foi avaliado pelos dados autorreferidos de peso e estatura, calculando-se posteriormente o índice de massa corporal. O índice de massa corporal do escolar foi classificado em baixo peso/peso normal e sobrepeso/obesidade. A aptidão cardiorrespiratória foi avaliada através do teste de corrida/caminhada de 9 minutos, sendo categorizada em apto (bons níveis) e inapto (baixos níveis). Os dados foram analisados através dos valores de razão de prevalência (RP). Resultados Os dados apontam maior ocorrência de desenvolvimento de risco metabólico em escolares que apresentam mãe com obesidade (RP: 1,50; IC 95%: 1,01; 2,23) e, maior ainda, em escolares que possuem pai e mãe obesos (RP: 2,79; IC 95%: 1,41; 5,51). Escolares que apresentam baixos níveis de aptidão cardiorrespiratória e sobrepeso/obesidade possuem maior ocorrência de perfil metabólico de risco (RP: 5,25; IC 95%: 3,31; 8,16). Conclusões a ocorrência de desenvolvimento de risco metabólico em escolares aumentam quando estes apresentam baixos níveis de aptidão cardiorrespiratória e sobrepeso/obesidade, assim como na presença de obesidade dos pais.


Subject(s)
Humans , Male , Female , Child , Adolescent , Nutritional Status/physiology , Metabolic Syndrome/etiology , Cardiorespiratory Fitness/physiology , Obesity/complications , Parents , Rural Population , Triglycerides/blood , Urban Population , Blood Glucose/analysis , Blood Pressure/physiology , Brazil , Body Mass Index , Sex Factors , Cross-Sectional Studies , Risk Factors , Risk Assessment , Metabolic Syndrome/physiopathology , Exercise Test , Lipoproteins, HDL/blood , Lipoproteins, LDL/blood , Obesity/physiopathology
15.
Rev. cuba. med. mil ; 45(2): 195-205, abr.-jun. 2016.
Article in Spanish | LILACS (Americas) | ID: biblio-960530

ABSTRACT

Introducción: se realiza una revisión sobre la relación del cáncer de mama con el síndrome metabólico y la posible utilidad del Metformín® en el tratamiento de esta enfermedad. Objetivo: establecer un marco teórico para futuras investigaciones en este terreno. Métodos: el cáncer de mama constituye una de las enfermedades neoplásicas con mayor incidencia en Cuba y el mundo. Dentro de los factores de riesgo para la misma se señala con mucha fuerza al síndrome metabólico. El Metformín® es una droga de probada utilidad en el manejo del síndrome metabólico y la diabetes mellitus. Actualmente, los metanálisis de estudios retrospectivos sobre el uso del Metformín®, como monoterapia o combinado con otros fármacos en pacientes diabéticas con cáncer de mama, son equívocos y muestran un aumento o ninguna diferencia en la sobrevida. Conclusiones: la mayoría de los estudios no son conclusivos y se recomienda más confirmación(AU)


Introduction: A review is made on the relation between breast cancer and the metabolic syndrome and the possible usefulness of Metformin® in this disease treatment. Objective: Establish a theoretical framework for future research in this field. Methods: breast cancer is one of the neoplastic diseases with the highest incidence in Cuba and worldwide. Among its risk factors, the metabolic syndrome stands out significantly. Metformin® is a drug of proven utility in the management of metabolic syndrome and diabetes mellitus. Currently, meta-analyzes of retrospective studies on the use of Metformin® as sole therapy or combined with other drugs in diabetic patients with breast cancer are misleading and show increase or no difference in survival. Conclusions: Most studies are not conclusive and more confirmation is recommended(AU)


Subject(s)
Humans , Female , Breast Neoplasms/epidemiology , Review Literature as Topic , Metabolic Syndrome/etiology , Metformin/therapeutic use
16.
Article in English | WPRIM (Western Pacific) | ID: wprim-225242

ABSTRACT

OBJECTIVES: We investigated the associations of sarcopenia-defined both in terms of muscle mass and muscle strength-and sarcopenic obesity with metabolic syndrome. METHODS: Secondary data pertaining to 309 subjects (85 men and 224 women) were collected from participants in exercise programs at a health center in a suburban area. Muscle mass was measured using bioelectrical impedance analysis, and muscle strength was measured via handgrip strength. Sarcopenia based on muscle mass alone was defined as a weight-adjusted skeletal muscle mass index more than two standard deviations below the mean of a sex-specific young reference group (class II sarcopenia). Two cut-off values for low handgrip strength were used: the first criteria were <26 kg for men and <18 kg for women, and the second criteria were the lowest quintile of handgrip strength among the study subjects. Sarcopenic obesity was defined as the combination of class II sarcopenia and being in the two highest quintiles of total body fat percentage among the subjects. The associations of sarcopenia and sarcopenic obesity with metabolic syndrome were evaluated using logistic regression models. RESULTS: The age-adjusted risk ratios (RRs) of metabolic syndrome being compared in people with or without sarcopenia defined in terms of muscle mass were 1.25 (95% confidence interval [CI], 1.06 to 1.47, p=0.008) in men and 1.12 (95% CI, 1.06 to 1.19, p<0.001) in women, which were found to be statistically significant relationships. The RRs of metabolic syndrome being compared in people with or without sarcopenic obesity were 1.31 in men (95% CI, 1.10 to 1.56, p=0.003) and 1.17 in women (95% CI, 1.10 to 1.25, p<0.001), which were likewise found to be statistically significant relationships. CONCLUSIONS: The associations of sarcopenia defined in terms of muscle mass and sarcopenic obesity with metabolic syndrome were statistically significant in both men and women. Therefore, sarcopenia and sarcopenic obesity must be considered as part of the community-based management of non-communicable diseases.


Subject(s)
Adolescent , Adult , Aged , Electric Impedance , Exercise , Female , Hand Strength , Humans , Male , Metabolic Syndrome/etiology , Middle Aged , Muscle Strength/physiology , Muscle, Skeletal/physiology , Obesity/complications , Odds Ratio , Sarcopenia/complications , Young Adult
17.
An. venez. nutr ; 28(2): 132-144, dic. 2015. tab
Article in Spanish | LILACS (Americas), LIVECS | ID: lil-798250

ABSTRACT

La incidencia de la obesidad, los desórdenes asociados al síndrome metabólico y la diabetes tipo 2 han aumentado en la última década. Estas afecciones pueden estar influenciadas por factores genéticos, ambientales y por vías que conectan el metabolismo con el sistema inmunológico. De esta manera, se observa un metabolismo energético anormal y la inflamación crónica de bajo nivel del tejido adiposo. La incidencia de estos trastornos puede devenir de la susceptibilidad genética y cambios en el estilo de vida de cada individuo. Adicional a esto, se ha sugerido la influencia de la microbiota intestinal en la prevalencia de dichas afecciones. Datos reciente indican que la población de microorganismos residentes en el intestino, puede influir sobre la absorción de nutrientes y el almacenamiento de energía. Todo lo anterior contribuye a un balance energético positivo, consistente en un aumento del aporte energético de la dieta. Se ha relacionado su influencia en los mecanismos de inflamación y respuesta inmune asociados a dicha patología. Se hace necesario conocer con mayor certeza el papel que juega la microbiota intestinal en la aparición de la diabetes en el huésped. En esta revisión se recopilan los resultados recientes obtenidos en estudios recientes que muestran las contribuciones de la microbiota intestinal a la diabetes. Se hace necesario conocer con mayor certeza el papel que juega la microbiota intestinal en la aparición de la diabetes(AU)


The incidence of obesity, disorders associated with metabolic syndrome and type 2 diabetes have increased in the last decade. These conditions can be influenced by genetic, environmental factors and pathways linking metabolism to the immune system. Thus, an abnormal energy metabolism and a low level chronic inflammation of the adipose tissue is observed. The incidence of these disorders can become genetic susceptibility and changes in the lifestyle of each individual. In addition to this, it has been suggested the influence of intestinal microbiota in the prevalence of such conditions. Recent data indicate that the population of microorganisms living in the intestine, can influence nutrient absorption and energy storage. All this contributes to a positive energy balance consisting in increased energy from the diet. It has been implicated in the mechanisms influence of inflammation and immune response associated with such pathology. In-depth knowledge of the role of intestinal microbiota in the onset of diabetes in the host is required. In this review recent results obtained in studies focusing on the contributions of gut microbiota to diabetes are collected(AU)


Subject(s)
Humans , Male , Female , Dietary Carbohydrates , Dietary Fats , Metabolic Syndrome/etiology , Diabetes Mellitus, Type 2/etiology , Gastrointestinal Microbiome , Obesity , Food , Public Health , Intestinal Absorption , Metabolic Diseases
18.
Arq. bras. cardiol ; 105(6): 560-565, Dec. 2015. tab, graf
Article in Portuguese | LILACS (Americas) | ID: lil-769536

ABSTRACT

Abstract Background: Truck driver sleepiness is a primary cause of vehicle accidents. Several causes are associated with sleepiness in truck drivers. Obesity and metabolic syndrome (MetS) are associated with sleep disorders and with primary risk factors for cardiovascular diseases (CVD). We analyzed the relationship between these conditions and prevalence of sleepiness in truck drivers. Methods: We analyzed the major risk factors for CVD, anthropometric data and sleep disorders in 2228 male truck drivers from 148 road stops made by the Federal Highway Police from 2006 to 2011. Alcohol consumption, illicit drugs and overtime working hours were also analyzed. Sleepiness was assessed using the Epworth Sleepiness Scale. Results: Mean age was 43.1 ± 10.8 years. From 2006 to 2011, an increase in neck (p = 0.011) and abdominal circumference (p < 0.001), total cholesterol (p < 0.001), triglyceride plasma levels (p = 0.014), and sleepiness was observed (p < 0.001). In addition, a reduction in hypertension (39.6% to 25.9%, p < 0.001), alcohol consumption (32% to 23%, p = 0.033) and overtime hours (52.2% to 42.8%, p < 0.001) was found. Linear regression analysis showed that sleepiness correlated closely with body mass index (β = 0.19, Raj2 = 0.659, p = 0.031), abdominal circumference (β = 0.24, Raj2 = 0.826, p = 0.021), hypertension (β = -0.62, Raj2 = 0.901, p = 0.002), and triglycerides (β = 0.34, Raj2 = 0.936, p = 0.022). Linear multiple regression indicated that hypertension (p = 0.008) and abdominal circumference (p = 0.025) are independent variables for sleepiness. Conclusions: Increased prevalence of sleepiness was associated with major components of the MetS.


Resumo Fundamento: A sonolência de motoristas de caminhão, que pode resultar de diferentes causas, é a principal causa de acidentes com veículos. Obesidade e síndrome metabólica (SMet) estão associadas a distúrbios do sono e fatores de risco primários para doença cardiovascular (DCV). Este estudo verificou a relação entre essas condições e a prevalência de sonolência em motoristas de caminhão. Métodos: Este estudo analisou os principais fatores de risco para DCV, dados antropométricos e distúrbios do sono em 2.228 motoristas de caminhão do sexo masculino a partir de informação coletada de 148 paradas efetuadas em rodovias pela Polícia Rodoviária Federal entre 2006 e 2011. Consumo de álcool e de drogas ilícitas e excesso de horas trabalhadas também foram analisados. Sonolência foi avaliada com a Escala de Sonolência de Epworth. Resultados: A idade média foi de 43,1 ± 10,8 anos. De 2006 a 2011, observou-se aumento de: circunferências cervical (p = 0,011) e abdominal (p < 0,001); colesterol total (p < 0,001); níveis séricos de triglicerídeos (p = 0,014); sonolência (p < 0,001). Além disso, houve redução de hipertensão (de 39,6% para 25,9%, p < 0,001), consumo de álcool (de 32% para 23%, p = 0,033) e excesso de horas trabalhadas (de 52,2% para 42,8%, p < 0,001). A análise de regressão linear mostrou correlação íntima de sonolência com índice de massa corporal (β = 0,19, Raj2 = 0,659, p = 0,031), circunferência abdominal (β = 0,24, Raj2 = 0,826, p = 0,021), hipertensão (β = -0,62, Raj2 = 0,901, p = 0,002) e triglicerídeos (β = 0,34, Raj2 = 0,936, p = 0,022). Regressão linear múltipla indicou que hipertensão (p = 0,008) e circunferência abdominal (p = 0,025) são variáveis independentes para sonolência. Conclusões: Elevada prevalência de sonolência foi associada com os principais componentes da SMet.


Subject(s)
Adult , Humans , Male , Middle Aged , Automobile Driving/statistics & numerical data , Cardiovascular Diseases/etiology , Disorders of Excessive Somnolence/etiology , Metabolic Syndrome/etiology , Anthropometry , Accidents, Traffic/statistics & numerical data , Alcohol Drinking/epidemiology , Brazil/epidemiology , Cross-Sectional Studies , Cardiovascular Diseases/epidemiology , Cholesterol/blood , Disorders of Excessive Somnolence/epidemiology , Metabolic Syndrome/epidemiology , Obesity/complications , Obesity/epidemiology , Occupational Diseases/epidemiology , Occupational Diseases/etiology , Risk Factors , Sedentary Behavior , Substance-Related Disorders/complications , Substance-Related Disorders/epidemiology , Time Factors , Triglycerides/blood , Work Schedule Tolerance , Workload
19.
Arch. latinoam. nutr ; 65(3): 152-157, sep. 2015. ilus, graf
Article in Spanish | LILACS (Americas) | ID: lil-780111

ABSTRACT

La presencia de componentes cardiometabólicos condiciona un aumento del riesgo en la aparición de síndrome metabólico y las patologías asociadas. La insulinoresistencia, es probablemente, el mecanismo subyacente a las complicaciones derivadas de este síndrome, donde la acumulación adiposa abdominal se presenta como característica frecuente. El objetivo de este estudio fue determinar la capacidad predictiva de los índices antropométricos estimadores de distribución adiposa central versus el índice de masa corporal en la detección de síndrome metabólico en adultos chilenos. Se realizó un estudio de tipo descriptivo de corte transversal con 229 adultos, cuyos datos fueron obtenidos a través de una fuente de datos secundaria. Estos fueron analizados a través de correlación de Pearson y curva operador receptor estableciendo área bajo la curva. Los resultados mostraron una prevalencia de 58,3% de síndrome metabólico según NCEP-ATP III, donde los índices antropométricos como el índice cintura estatura (0,746), circunferencia de cintura (0,735) e índice de masa corporal (0,722) no presentaron diferencias significativas en la detección de síndrome metabólico. Se estableció mayor correlación de los factores cardiometabólicos con el índice cintura estatura y circunferencia cintura.


The presence of cardiometabolic components conditions the risk increase in the appearance of the metabolic syndrome and the associated pathologies. The insulin resistance is probably the subjacent mechanism to the complications derived from this syndrome, where the abdominal adipose accumulation is a common and frequent characteristic. The purpose of this study was to determine the predictive capability of the anthropometric estimating central adipose distribution indexes against the body mass index in the detection of the metabolic syndrome in Chilean adults. A descriptive crosssectional study was conducted on 229 adults, information obtained through a secondary database. There were analyzed through a Pearson correlation and receiver operating curves determining the area under the curve. The results showed the predominance of 58.3 % of the metabolic syndrome prevailed according to NCEP-ATP III, where the anthropometric indexes such as waist height index (0.746), waist circumference (0.735) and body mass index (0.722) did not show significant differences in the detection of the metabolic syndrome components. It did show a higher correlation of these cardio-metabolic factors with the waist height index and waist circumference.


Subject(s)
Adult , Female , Humans , Male , Middle Aged , Anthropometry , Cardiovascular Diseases/complications , Metabolic Syndrome/diagnosis , Metabolic Syndrome/etiology , Obesity, Abdominal/complications , Body Mass Index , Chile/epidemiology , Epidemiologic Methods , Metabolic Syndrome/epidemiology , Waist Circumference , Waist-Hip Ratio
20.
Clinics ; 70(9): 601-605, Sept. 2015. tab
Article in English | LILACS (Americas) | ID: lil-759294

ABSTRACT

OBJECTIVE:In this study, we aimed to compare the cardiovascular risk factors that might be associated with inflammation, atherosclerosis and metabolic syndrome between hemodialysis and peritoneal dialysis patients.METHODS:Fifty hemodialysis and 50 peritoneal dialysis patients who had been receiving dialysis therapy for at least one year were included in the study. Venous blood samples were taken after 12 hours of fasting, and serum glucose, triglyceride, low-density lipoprotein (LDL)-cholesterol, high-density lipoprotein (HDL)-cholesterol, C-reactive protein, fibrinogen and homocysteine levels were measured. The presence of atherosclerotic plaques in the carotid artery was evaluated by carotid Doppler ultrasound. These data were analyzed by Student’s t test, the chi-square test and the Mann-Whitney U test, as appropriate.RESULTS:No difference was found between the hemodialysis (n=50) and peritoneal dialysis (n=50) patient groups regarding mean age, gender distribution, body mass index or dialysis duration (p=0.269, 0.683, 0.426, and 0.052, respectively). LDL-cholesterol, fibrinogen and homocysteine levels were significantly higher in peritoneal dialysis patients (p=0.006, 0.001, and 0.002, respectively). In patients with diabetes mellitus (n=17) who were undergoing renal replacement therapy, LDL-cholesterol and fibrinogen levels were significantly higher than in patients without diabetes mellitus who were undergoing renal replacement therapy (p=0.001 and 0.004, respectively).CONCLUSION:In our study, cardiovascular risk factors (especially LDL-cholesterol) were more frequent in peritoneal dialysis patients than in hemodialysis patients.


Subject(s)
Adult , Female , Humans , Male , Middle Aged , Atherosclerosis/etiology , Inflammation/complications , Metabolic Syndrome/etiology , Peritoneal Dialysis/adverse effects , Body Mass Index , Blood Glucose/analysis , C-Reactive Protein/analysis , Cardiovascular Diseases/etiology , Cholesterol, HDL/blood , Cholesterol, LDL/blood , Diabetes Mellitus/blood , Fibrinogen/analysis , Homocysteine/blood , Risk Factors , Renal Dialysis/adverse effects , Triglycerides/blood
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