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1.
Arch. latinoam. nutr ; 72(1): 23-30, mar. 2022. tab, graf
Article in Spanish | LILACS, LIVECS | ID: biblio-1368353

ABSTRACT

La obesidad se define por un exceso de masa grasa, sin embargo, hay otros indicadores antropométricos que pueden ser útiles para el diagnóstico de sobrepeso u obesidad; Objetivo. Determinar la exactitud diagnóstica del índice de masa corporal (IMC), circunferencia de la cintura (CC) e índice de forma corporal (ABSI) para el diagnóstico de sobrepeso u obesidad en una población adulta del Ecuador. Materiales y métodos. Se desarrolló un estudio observacional de corte transversal en el que participaron 253 sujetos con edades entre 20 y 60 años. Se midió peso, estatura, circunferencia de la cintura y porcentaje de grasa corporal (PGC). Se correlacionó el PGC con IMC, CC y ABSI y se estableció la sensibilidad y especificidad de estos indicadores para el diagnóstico de sobrepeso u obesidad con curvas ROC. Resultados. El PGC fue menor en hombres que en mujeres (30,9 vs 41,87), ABSI y CC fue mayor en hombres que en mujeres (0,079 vs 0,075) y (99,76 vs 91,25) respectivamente. Se encontró una correlación positiva fuerte (≥0,75) entre el PGC e IMC y CC. En la curva ROC, el área bajo la curva más alta se observa para el IMC (0,949), mientras que el área más baja se observa para ABSI (0,395). Conclusión. El IMC es el indicador con mayor precisión diagnóstica de sobrepeso u obesidad. ABSI no sería un indicador útil en el diagnóstico de sobrepeso u obesidad(AU)


Obesity is defined by an excess of fat mass, however, there are other anthropometric indicators that can be useful for the diagnosis of overweight or obesity; Objetive. To determine the diagnostic accuracy of the body mass index (BMI), waist circumference (WC) and body shape index (ABSI) for the diagnosis of overweight or obesity in an adult population of Ecuador. Materials and methods. An observational cross-sectional study was carried out in which 253 subjects aged between 20 and 60 years participated. Weight, height, waist circumference and percentage body fat (PBF) were measured. The PBF was correlated with BMI, WC and ABSI and the sensitivity and specificity of these indicators were established for the diagnosis of overweight or obesity with ROC curves. Results. The PBF was lower in men than in women (30.09 vs 41.87), ABSI and CC were higher in men than in women (0.079 vs 0.075) and (99.76 vs 91.25) respectively. A strong positive correlation (≥0.75) was found between % body fat and BMI and WC. On the ROC curve, the area under the highest curve is observed for BMI (0.949), while the lowest area is observed for ABSI (0.395). Conclusion. The BMI is the indicator with the highest diagnostic precision of overweight or obesity. ABSI would not be a useful indicator in the diagnosis of overweight or obesity(AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Body Mass Index , Adipose Tissue , Overweight , Body Fat Distribution , Obesity , Anthropometry , Cross-Sectional Studies , Diagnosis , Ecuador , Waist Circumference
2.
Rev. Assoc. Med. Bras. (1992) ; 68(2): 250-255, Feb. 2022. tab, graf
Article in English | LILACS | ID: biblio-1365337

ABSTRACT

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


Subject(s)
Humans , Metabolic Syndrome/complications , Echocardiography , Adipose Tissue/diagnostic imaging , Electrocardiography/methods , Waist Circumference
3.
Article in English | LILACS | ID: biblio-1368554

ABSTRACT

ABSTRACT: Objective: to assess the relationship between anthropometric indicators and laboratorial markers of cardiovascular risk in overweight/obese children and adolescents, in order to verify whether any anthropometric indicator has a better potential for use in screening cardiovascular risk in the population. Method: retrospective cross-sectional study enrolling 237 individuals aged 7 to 18 years. Body mass index (BMI), waist circumference (WC), waist circumference/height index (WC/H), glucose, HOMA-IR, total cholesterol (TC), LDL, HDL, triglycerides and TC/HDL and LDL/HDL indexes were obtained. Associations between anthropometric and laboratory markers were tested in contingency tables using the chi-square test. Correlations were tested by Spearman's correlation. Results: higher WC (Freedman cutoffs) was associated with lower levels of HDL and higher score in the TC/HDL and LDL/HDL indexes, but, using +2 z-scores as the cutoff, there were associations with low HDL and higher HOMA-IR. WC/H indicator (0.5 cutoff) was not associated with any of the outcomes, but, using +2 z-scores, an association was found with HOMA-IR. Z-scores of WC, WC/H and BMI showed positive correlation with HOMA-IR, TC/HDL and HOMA-IR, respectively. Negative correlations were found between WC and WC/H z-scores with HDL. WC and WC/H z-score were related to changes in HDL and HOMA-IR. Conclusions: there seems to be an advantage in using WC alone as a possible predictor of dyslipidemia and insulin resistance in children and adolescents. It is not possible to state that WC, WC/H or BMI measurements differ in their abilities to identify Brazilian children and adolescents with risk factors for cardiovascular diseases. (AU)


RESUMO:Objetivo: avaliar a relação entre indicadores antropométricos e marcadores laboratoriais de risco cardiovascular em crianças e adolescentes com sobrepeso / obesidade, a fim de verificar se algum indicador antropométrico tem melhor potencial para uso no rastreamento de risco cardiovascular na população. Método: estudo transversal retrospectivo com 237 indivíduos com idades entre 7 e 18 anos. Índice de massa corporal (IMC), circunferência da cintura (CC), índice de circunferência da cintura / altura (CC / H), glicose, HOMA-IR, colesterol total (CT), LDL, HDL, triglicerídeos e índices CT/HDL e LDL/HDL foram obtidos. As associações entre marcadores antropométricos e laboratoriais foram testadas em tabelas de contingência por meio do teste do qui-quadrado. As correlações foram testadas pela correlação de Spearman. Resultados: CC mais elevado (pontos de corte de Freedman) foi associado a níveis mais baixos de HDL e maior pontuação nos índices TC/HDL e LDL/HDL, mas, usando +2 escores z como ponto de corte, houve associações com HDL baixo e HOMA-IR mais alto. O indicador CC/H (0,5 ponto de corte) não foi associado a nenhum dos desfechos, mas, usando +2 escores z, foi encontrada associação com o HOMA-IR. Os escores Z de CC, CC/E e IMC mostraram correlação positiva com HOMA-IR, TC/HDL e HOMA-IR, respectivamente. Correlações negativas foram encontradas entre CC e escores z de CC/H com HDL. CC e escore z de CC/H foram relacionados a mudanças em HDL e HOMA-IR. Conclusões: parece haver vantagem em usar a CC isoladamente como possível preditor de dislipidemia e resistência à insulina em crianças e adolescentes. Não é possível afirmar que as medidas de CC, CC/E ou IMC diferem na capacidade de identificar crianças e adolescentes brasileiros com fatores de risco para doenças cardiovasculares. (AU)


Subject(s)
Humans , Male , Female , Child , Adolescent , Body Weights and Measures , Insulin Resistance , Cardiovascular Diseases , Cross-Sectional Studies , Waist Circumference , Obesity, Abdominal , Heart Disease Risk Factors
4.
Ciênc. Saúde Colet ; 27(2): 737-746, Fev. 2022. tab
Article in Portuguese | LILACS | ID: biblio-1356072

ABSTRACT

Resumo Objetivou-se analisar a associação entre consumo de bebidas alcoólicas e adiposidade abdominal em adultos. Estudo transversal realizado com dados da linha de base do ELSA-Brasil (2008-2010). A amostra foi constituída por 15.065 servidores públicos de seis instituições de ensino e pesquisa (35 a 74 anos, ambos os sexos). Para identificar adiposidade central por meio das medidas de circunferência da cintura (CC) e relação cintura/quadril (RCQ), utilizou-se os pontos de corte preconizados pela Organização Mundial da Saúde. Para as análises estatísticas foi utilizado o teste qui-quadrado e modelos de regressão de Poisson ajustados por variáveis potencialmente confundidoras. Cerca de 40% da amostra apresentava CC e RCQ elevadas. A probabilidade de apresentar CC elevada foi 5% e 3% maior no grupo mais exposto de consumo de cerveja em homens e mulheres quando comparado ao grupo de referência [RP = 1,05 (IC 95% 1,02-1,08) e RP = 1,03 (IC 95% 1,00-1,07)]. Também foi encontrada maior probabilidade de apresentar RCQ elevada entre os maiores consumidores de cerveja [RP = 1,03 (IC 95% 1,00-1,07) em homens e RP=1,10 (IC 95% 1,04-1,15) em mulheres]. Maior número de doses/semana de bebida alcoólica aumentou a probabilidade de ocorrência de CC e RCQ elevadas, sendo mais importante a contribuição da cerveja.


Abstract The objective was to analyze the association between alcohol consumption and abdominal adiposity in adults. Cross-sectional study conducted at baseline data from ELSA-Brasil (2008- 2010). The sample consisted of 15,065 civil servants from six education and research institutions (35 to 74 years old, both sexes). To identify central adiposity by measuring waist circumference (WC) and waist-to-hip ratio (WHR), the cutoff points recommended by the World Health Organization were used. Poisson regression models adjusted for potentially confounding variables were tested. About 40% of the sample had elevated WC and WHR. The probability of having elevated WC was 5% and 3% higher in the most exposed group of beer consumption in men and women when compared to the reference group [PR= 1.05 (95% CI 1.02-1.08) and P R= 1.03 (95% CI 1.00-1.07)]. A higher probability of having a high WHR was also found among the highest beer consumers [PR = 1.03 (95% CI 1.00-1.07) in men and PR = 1.10 (95% CI 1.04-1.15) in women]. A greater number of doses/week of alcoholic drink increased the probability of occurrence of high WC and WHR, with the beer contribution being more important.


Subject(s)
Humans , Male , Female , Adult , Aged , Alcoholic Beverages , Obesity, Abdominal/epidemiology , Body Mass Index , Cross-Sectional Studies , Risk Factors , Waist-Hip Ratio , Waist Circumference , Middle Aged
5.
Arq. bras. cardiol ; 117(4): 701-712, Oct. 2021. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1345245

ABSTRACT

Resumo Fundamento: Indicadores antropométricos são utilizados na prática clínica e em estudos epidemiológicos para rastreamento de fatores de risco à saúde. Objetivo: Avaliar o poder discriminatório individual do Índice de Adiposidade Corporal (IAC), do Índice de Massa Corporal (IMC), da Circunferência da Cintura (CC) e da Razão Cintura-Quadril (RCQ) para identificar risco coronariano e investigar se a combinação de indicadores antropométricos de obesidade geral e central melhora a capacidade preditiva em adultos. Métodos: Avaliou-se 15 092 participantes (54,4% mulheres) com idades entre 35-74 anos na linha de base do ELSA-Brasil. Indivíduos em risco coronariano foram identificados pelo Escore de Risco de Framingham, e divididos em risco muito alto (RMA20%) e risco alto (RA10%). Medidas de acurácia diagnóstica e áreas sob curvas ROC (AUC) foram analisadas. Associações foram testadas por regressão de poisson com variância robusta, conforme sexo e idade. Foi adotada significância estatística de 5%. Resultados: A RCQ apresentou melhor poder discriminatório para RMA20% em todos os grupos, com maior capacidade preditiva nas mulheres (AUC: 0,802; IC95%: 0,748-0,856 vs 0,657; IC95%: 0,630-0,683 nas faixas etárias 35-59 anos e AUC: 0,668; IC95%: 0,621-0,715 vs 0,611; IC95%: 0,587-0,635 nas faixas etárias 60-74 anos). As combinações IAC+RCQ e IMC+RCQ apresentaram melhor poder preditivo em homens e mulheres, respectivamente. Combinações entre indicadores de obesidade geral e central estiveram mais fortemente associadas com RMA20% e RCA10% em todos os estratos. Conclusões: Indicadores combinados tiveram melhor capacidade preditiva do que um indicador isoladamente, sendo IAC+RCQ e IMC+RCQ melhores estimadores de risco coronariano em homens e mulheres, respectivamente. RCQ teve melhor desempenho individual.


Abstract Background: Anthropometric indicators have been used in clinical practice and epidemiological studies for screening of health risk factors. Objectives: To evaluate the individual discriminatory power of body adiposity index (BAI), body mass index (BMI), waist circumference (WC) and waist-hip-ratio (WHR) to identify individuals at risk for coronary heart disease and to evaluate whether combinations of anthropometric indicators of overall obesity with indicators of central obesity improve predictive ability in adults. Methods: A total of 15,092 participants (54.4% women) aged 35-74years were assessed at baseline of the ELSA-Brasil study. Individuals at risk for coronary heart disease were identified using the Framingham risk score and divided into very-high risk (VHR 20%) and high risk (HR10%). Measures of diagnostic accuracy and area under the ROC curves (AUC) were analyzed. Associations were tested using Poisson regression analysis with robust variance, according to age and sex. Statistical significance was set at 5%. Results: WHR showed the highest discriminatory power for VHR20% in all groups, with higher predictive ability in women (AUC: 0.802; 95%CI: 0.748-0.856 vs 0.657; 95%CI: 0.630-0.683 in the age range of 35-59 years, and AUC: 0.668; 95%CI: 0.621-0.715 vs 0.611; 95%CI: 0.587-0.635 in the age range of 60-74 years). BAI + WHR and BMI + WHR had the highest predictive power in men and women, respectively. Combinations of indicators of overall obesity with indicators of central obesity were more strongly associated with VHR20% and HR10% in all subgroups. Conclusion: Combined indicators had greater predictive ability than indicators taken individually. BAI+ WHR and BMI + WHR were the best estimators of coronary risk in men and women, respectively, and WHR had the best individual performance.


Subject(s)
Humans , Male , Female , Adult , Obesity, Abdominal/complications , Obesity, Abdominal/epidemiology , Body Mass Index , Risk Factors , Waist-Hip Ratio , Waist Circumference , Middle Aged , Obesity/complications , Obesity/epidemiology
7.
Arq. bras. cardiol ; 116(5): 950-956, nov. 2021. tab
Article in Portuguese | LILACS | ID: biblio-1248890

ABSTRACT

Resumo Fundamento: Evidências apontam variáveis antropométricas e de condicionamento físico como fatores associados à pressão arterial infantil. Analisá-los em apenas um contexto é um meio relevante de identificar o peso que cada um deles pode apresentar no desenvolvimento da hipertensão arterial. Objetivo: Identificar as possíveis associações de medidas antropométricas, da composição corporal, da atividade física moderada-vigorosa (AFMV) e da aptidão cardiorrespiratória (ApC) com a pressão arterial em crianças. Métodos: Estudo correlacional com abordagem quantitativa. Duzentos e quinze (215) estudantes com idades de 6 a 12 anos de uma escola pública de Porto Alegre, selecionados por critério de conveniência. A pressão arterial foi aferida através de um esfigmomanômetro digital. Para o tratamento dos dados, os valores de pressão arterial sistólica e diastólica foram padronizados (escore Z) e somados. As variáveis testadas como preditoras foram: AFMV; Percentual de gordura (%G); Índice de massa corporal (IMC); Razão cintura/estatura (RCE); Maturação somática; ApC. Após a verificação dos parâmetros de normalidade, as associações brutas e ajustadas (para sexo, idade e maturação somática) foram testadas através de equações de regressão linear. Para as análises, foi considerado p < 0,05. Resultados: Três diferentes modelos indicaram os melhores conjuntos de fatores associados à pressão arterial padronizada: O Modelo 1 (R2 = 0,21) se constituiu das variáveis RCE (β = 9,702) e AFMV (β = - 0,021); O Modelo 2 (R2 = 0,19) foi composto pelas variáveis IMC (β = 0,156) e AFMV (β = - 0,021); O Modelo 3 (R2 = 0,18) incluiu as variáveis %G (β = 0,063) e ApC (β = - 0,004). Conclusões: A pressão arterial de crianças é predita pelas variáveis corporais %G, IMC e RCE. Além disso, está associada negativamente à AFMV e a ApC.


Abstract Background: Evidence points to anthropometric and fitness variables as associated factors with children's blood pressure. Analysing these factors in a single context is a relevant possibility of identifying the weight that each factor can present for the development of arterial hypertension. Objective: Identify the possible associations between anthropometric measurements, body composition, moderate-vigorous physical activity (MVPA) and cardiorespiratory fitness (CRF) with blood pressure in children. Methods: Correlational study with a quantitative approach. Sample: 215 schoolchildren aged 6-12 years selected by convenience criteria of a public school in Porto Alegre, Brazil. Blood pressure was measured with a digital sphygmomanometer. For data treatment, the values of systolic and diastolic blood pressure were standardized (Z score) and added. The variables tested as predictors were: MVPA; body fat percentage (BF%); Body Mass Index (BMI); waist-height ratio (WHTR); maturity-offset and CRF. After checking the normality parameters, the crude and adjusted associations (for sex, age and maturity-offset) were tested with linear regression equations. For the analyses, p <0.05 was considered. Results: Three different models indicated the best sets of factors associated with standardized blood pressure. Model 1 (R2 = 0.21) consisted of the variables WHTR (β = 9.702) and MVPA (β = −0.021). Model 2 (R2 = 0.19) was composed of the variables BMI (β = 0.156) and MVPA (β = −0.021). Model 3 (R2 = 0.18) included the variables BF% (β = 0.063) and CRF (β = −0.004). Conclusion: Blood pressure in children is predicted by the body variables BF%, BMI and WHTR, in addition, it is negatively associated with MVPA and CRF.


Subject(s)
Humans , Child , Cardiorespiratory Fitness , Blood Pressure , Body Composition , Brazil , Exercise , Body Mass Index , Physical Fitness , Cross-Sectional Studies , Waist Circumference
8.
Arq. bras. cardiol ; 116(5): 879-886, nov. 2021. tab
Article in English, Portuguese | LILACS | ID: biblio-1248888

ABSTRACT

Resumo Fundamento: O índice de massa corporal (IMC) é o índice mais usado para categorizar uma pessoa como obesa ou não-obesa, e está sujeito a limitações importantes. Objetivo: Avaliar o efeito direto do IMC nos desfechos cardiovasculares em participantes sem obesidade central. Métodos: Esta análise incluiu 14.983 homens e mulheres com idades entre 45-75 anos do Estudo de Risco de Aterosclerose em Comunidades (ARIC). O IMC foi medido como obesidade geral e a circunferência da cintura (CC), a relação cintura-quadril (RCQ) e circunferência do quadril como obesidade central. A estimativa de máxima verossimilhança direcionada (TMLE, no acrônimo em inglês) foi usada para estimar os efeitos totais (TEs) e os efeitos diretos controlados (CDEs). A proporção de ET que seria eliminada se todos os participantes fossem não obesos em relação à obesidade central foi calculada usando o índice de proporção eliminada (PE). P<0,05 foi considerado estatisticamente significativo. As análises foram realizadas no pacote TMLE R. Resultados: O risco de desfechos cardiovasculares atribuídos ao IMC foi significativamente revertido com a eliminação da obesidade na RCQ (p <0,001). A proporção eliminada dos efeitos do IMC foi mais tangível para participantes não obesos em relação à CC (PE = 127%; IC95% (126,128)) e RCQ (PE = 97%; IC95% (96,98)) para doença arterial coronariana (DAC), e RCQ (PE = 92%; IC95% (91,94)) para acidente vascular cerebral, respectivamente. Com relação ao sexo, a proporção eliminada dos efeitos do IMC foi mais tangível para participantes não obesos em relação a RCQ (PE = 428%; IC95% (408.439)) para DAC em homens e CC (PE = 99%; IC95% (89,111)) para acidente vascular cerebral em mulheres, respectivamente. Conclusão: Esses resultados indicam diferentes efeitos potenciais da eliminação da obesidade central na associação entre IMC e desfechos cardiovasculares em homens e mulheres. (Arq Bras Cardiol. 2021; 116(5):879-886)


Background: Body mass index (BMI) is the most commonly used index to categorize a person as obese or non-obese, which is subject to important limitations. Objective: To evaluate the direct effect of BMI on cardiovascular outcomes among participants without central obesity. Methods: This analysis included 14,983 males and females aged 45-75 years from the Atherosclerosis Risk in Communities Study (ARIC). BMI was measured as general obesity, and waist circumference (WC), waist-to-hip ratio (WHR) and hip circumference as central obesity. Targeted maximum likelihood estimation (TMLE) was used to estimate the total effects (TEs) and the controlled direct effects (CDEs). The proportion of TE that would be eliminated if all participants were non-obese regarding central obesity was computed using the proportion eliminated (PE) index. P <0.05 was considered statistically significant. Analyses were performed in the TMLE R package. Results: The risk of cardiovascular outcomes attributed to BMI was significantly reversed by eliminating WHR obesity (p<0.001). The proportion eliminated of BMI effects was more tangible for non-obese participants regarding WC (PE=127%; 95%CI (126,128)) and WHR (PE=97%; 95%CI (96,98)) for coronary heart disease (CHD), and WHR (PE=92%; 95%CI (91,94)) for stroke, respectively. With respect to sex, the proportion eliminated of BMI effects was more tangible for non-obese participants regarding WHR (PE=428%; 95%CI (408,439)) for CHD in males, and WC (PE=99%; 95%CI (89,111)) for stroke in females, respectively. Conclusion: These results indicate different potential effects of eliminating central obesity on the association between BMI and cardiovascular outcomes for males and females. (Arq Bras Cardiol. 2021; 116(5):879-886)


Subject(s)
Humans , Male , Female , Aged , Obesity, Abdominal/complications , Body Mass Index , Likelihood Functions , Risk Factors , Waist-Hip Ratio , Waist Circumference , Middle Aged , Obesity/complications
9.
Arq. bras. cardiol ; 117(4): 648-654, Oct. 2021. tab
Article in Portuguese | LILACS | ID: biblio-1345225

ABSTRACT

Resumo Fundamento O interesse pela hipertensão em crianças e adolescentes aumentou desde a atualização do sistema de classificação da pressão arterial para comparar com o sistema de classificação dos adultos, alterando a terminologia de "normal alta" para "pré-hipertensão". Objetivo O objetivo deste estudo foi analisar a associação da modulação autonômica cardíaca com os níveis pressóricos dos adolescentes. Métodos 203 adolescentes foram agrupados de acordo com a pressão arterial sistólica (PAS) e a pressão arterial diastólica (PAD). Um grupo foi caracterizado como pré-hipertensão, e o outro como normotenso. Foram coletadas características antropométricas, cardiovasculares e de qualidade do sono. Inicialmente, os dados foram submetidos ao teste de normalidade Kolmogorov-Smirnov . As variáveis quantitativas contínuas foram analisadas por meio do teste T de Student não pareado. Para análise das variáveis categóricas, foi utilizado o teste qui-quadrado. Um modelo de regressão logística foi realizado. O nível de significância estabelecido foi p<0,05. Os dados foram expressos como média ± desvio padrão e intervalo de confiança. O software R foi utilizado para análise dos dados. O tamanho do efeito foi calculado com a fórmula de Cohen. Resultados O grupo pré-hipertensão apresentou aumento da entropia de Shannon e diminuição da variância total. Além disso, no modelo de regressão logística, os adolescentes deste grupo tiveram 1,03 mais chances de ter a entropia de Shannon afetada quando a PAS foi ajustada ao gênero, maturação sexual, tempo escolar, idade, circunferência da cintura e qualidade do sono. Conclusão Nossos dados mostram que a modulação autonômica pode desempenhar um papel importante no desenvolvimento da pressão arterial elevada em adolescentes ao controlar fatores como tempo escolar e qualidade do sono.


Abstract Background The interest regarding hypertension among children and adolescents has increased since the blood pressure rating system was updated to be compared with the adult rating system, changing the terminology from "normal high" to "prehypertension". Objective This study aimed to analyze the association between cardiac autonomic modulation and pressure levels of adolescents. Methods 203 adolescents were grouped according to systolic blood pressure (SBP) and diastolic blood pressure (DBP). One group was characterized as prehypertension, and the other as normotensive. Anthropometric, cardiovascular and sleep quality characteristics were collected. Initially, the data were submitted to the Kolmogorov-Smirnov normality test. Continuous quantitative variables were analyzed using the unpaired Student t-test. For the analysis of categorical variables, a chi-square test was used. A logistic regression model was performed. The level of significance was set at p<0.05. The data were expressed as mean ± standard deviation and confidence interval. The R software was used for data analysis. The effect size was calculated using the Cohen's formula. Results The prehypertension group showed an increase in Shannon entropy and a decrease in total variance. Also, in the logistic regression model, adolescents in this group were 1.03 times more likely to have Shannon entropy's affected when SBP was adjusted for gender, sexual maturation, school time, age, waist circumference, and sleep quality. Conclusion Our data show that autonomic modulation may play an important role in the development of elevated blood pressure in adolescents, when controlling for other factors, such as school time and sleep quality.


Subject(s)
Humans , Child , Adolescent , Prehypertension , Hypertension , Blood Pressure , Cross-Sectional Studies , Risk Factors , Waist Circumference
10.
Arch. latinoam. nutr ; 71(3): 178-188, sept. 2021. tab
Article in Spanish | LILACS, LIVECS | ID: biblio-1353191

ABSTRACT

Los problemas relacionados con los trastornos metabólicos se han incrementado en la actualidad en población joven. Promover un estilo de vida saludable en estudiantes universitarios puede ayudar a prevenir diabetes, enfermedades cardiovasculares y diferentes tipos de cáncer. Objetivo. Calcular el Índice de Masa Corporal (IMC) de universitarios para identificar la prevalencia de obesidad e hipertensión como factores de riesgo metabólico. Materiales y método. Se utilizó muestreo probabilístico aleatorio simple (n= 282, edad 19,1 ± 1,8, 54,6% mujeres, 48,5% hombres). Se realizaron mediciones de peso y estatura para calcular el IMC, circunferencia de cintura y presión arterial. Resultados. Los resultados promedio para mujeres y hombres respectivamente fueron: IMC 24,0 ±5,5 y 25,2 ±5,2 kg/m2 (p= 0,25); cintura 76,25 ± 11,87 y 82,32 ± 15,85 cm (p= 0,001), indicando un riesgo bajo en 73,1% de mujeres y 82,5% de hombres; y presión arterial 127,73/86,03 y 142,3/94,2 mmHg (p= 0,001). La probabilidad de tener hipertensión arterial fue mayor al tener una relación cintura/estatura (RCE) alterada en mujeres y hombres (OR=3,037; IC95% 1,385-6,657 y OR=3,664; IC95% 1,249-2,179, respectivamente). Conclusiones. La población universitaria presenta factores de riesgo que pueden derivar en enfermedades crónicas no transmisibles en un futuro próximo, por lo cual es necesario modificar sus estilos de vida. La RCE es un buen predictor de riesgo de hipertensión en esta población(AU)


The problems related to metabolic disorders have now increased in the young population. Promoting a healthy lifestyle in college students can help prevent diabetes, cardiovascular disease, and different types of cancer. Objective. To calculate the Body Mass Index (BMI) in college students to identify the prevalence of obesity and hypertension as metabolic risk factors. Materials and methods. Simple random probability sampling was used (n = 282, age 19,1 ± 1,8, 54,6% women, 48,5% men). BMI was calculated with weight and height, waist circumference, and blood pressure. Results. The average results for women and men respectively were: BMI 24,0 ± 5,5 and 25,2 ± 5,2 kg/m2 (p = 0,25); waist 76,25 ± 11,87 and 82,32 ± 15,85 cm (p = 0,001), indicating a low risk in 73,1% of women and 82,5% of men; and blood pressure 127,73 / 86,03 and 142,3 / 94,2 mm Hg (p = 0,001). The probability of having arterial hypertension was higher when there was an altered waist / height ratio (WHR) in women and men (OR = 3,037; 95% CI 1,385-6,657 and OR = 3,664; 95% CI 1,249-2,179, respectively). Conclusions. The university population presents risk factors that could lead to chronic diseases. It is necessary to modify their lifestyles to prevent future diseases. WHR is a good predictor of hypertension risk in this population(AU)


Subject(s)
Humans , Male , Female , Adolescent , Adult , Body Mass Index , Chronic Disease , Waist Circumference , Atrial Pressure , Waist-Height Ratio , Noncommunicable Diseases , Students , Universities , Risk Factors , Pediatric Obesity , Life Style
11.
Arq. bras. cardiol ; 117(2): 352-362, ago. 2021. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1339164

ABSTRACT

Resumo Fundamento: Interrupções no tempo despendido em comportamento sedentário (breaks) têm sido associadas a melhores níveis de indicadores cardiometabólicos na população adulta. No entanto, em adolescentes, os achados sobre essa associação ainda são conflitantes. Objetivos: Analisar a associação do número de breaks por dia em comportamento sedentário com marcadores cardiometabólicos e avaliar se ela é moderada pelo estado nutricional e o tempo excessivo em comportamento sedentário em adolescentes. Métodos: Estudo transversal com 537 adolescentes (52,3% do sexo feminino), de 10 a 14 anos de idade, de escolas públicas de João Pessoa (PB). O número diário de breaks em comportamento sedentário (>100 counts/minutos) foi mensurado por meio de acelerômetros (Actigraph GT3X+). Os marcadores cardiometabólicos analisados foram: pressão arterial sistólica e diastólica (mmHg), glicose de jejum, colesterol total, triglicerídeos, HDL-c, LDL-c (todos em mg/dL) e índice de massa corporal (IMC) (kg/m2). Utilizou-se a regressão linear para analisar a associação do número de breaks com marcadores cardiometabólicos e avaliar se ela é moderada pelo estado nutricional e o tempo excessivo em comportamento sedentário. O nível de significância de p<0,05 foi adotado para todas as análises. Resultados: O número de breaks por dia se associou negativamente ao IMC (ß = −0,069; IC95%: −0,102; −0,035), mas não aos demais marcadores cardiometabólicos, e essa associação não foi moderada pelo estado nutricional dos adolescentes (p=0,221) e nem pelo tempo excessivo em comportamento sedentário (p=0,176). Conclusão: A inclusão de breaks no tempo em comportamento sedentário parece contribuir para valores mais baixos do IMC em adolescentes.


Abstract Background: The interruption of the time spent in sedentary behavior (breaks) has been associated with better levels of cardiometabolic indicators in the adult population, but in adolescents, further investigations are still needed to confirm these findings. Objectives: To analyze the association of the number of breaks per day in sedentary behaviors with cardiometabolic markers and whether it was moderated by nutritional status and excessive time on sedentary behavior in adolescents. Methods: This is a cross-sectional study of 537 adolescents (52.3% girls), aged between 10 and 14 years, enrolled in public schools in the city of João Pessoa, Paraíba state, Brazil. The number of daily breaks (>100 counts/minutes) in sedentary time was measured by Actigraph GT3X+ accelerometers. The following cardiometabolic markers were analyzed: systolic and diastolic blood pressure (mmHg), fasting blood glucose levels, total cholesterol, triglycerides, HDL-c, LDL-c (all in mg/dL) and body mass index (BMI) (kg/m2). Linear regression was used to analyze the association between the number of breaks and cardiometabolic markers and whether this association was moderated by nutritional status and excessive time in sedentary behavior. The significance level of p<0.05 was adopted for all analyses. Results: The number of daily breaks was negatively associated with BMI (boys - ß = −0.083; 95%CI: −0.132; −0.034 and girls - ß = −0.115; 95%CI: −0.169; −0.061), but not with the remaining cardiometabolic markers. The number of breaks per day was negatively associated with BMI (ß = −0.069; 95% CI: −0.102; −0.035), but not with the other cardiometabolic markers and this association was not moderated by the adolescents' nutritional status (p=0.221), or by excessive time in sedentary behavior (p=0.176). Conclusions: Including breaks in sedentary time seems to contribute to lower BMI values in adolescents.


Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Cardiovascular Diseases/etiology , Sedentary Behavior , Blood Pressure , Biomarkers , Body Mass Index , Cross-Sectional Studies , Risk Factors , Waist Circumference
12.
Arq. bras. cardiol ; 117(1): 74-81, July. 2021. tab, graf
Article in Portuguese | LILACS | ID: biblio-1285232

ABSTRACT

Resumo Fundamento A frequência cardíaca em repouso (FCR) pode ser uma ferramenta útil de triagem para o risco cardiovascular. Porém, os pontos de corte para FCR nunca foram descritos em populações jovens. Objetivo Estabelecer os pontos de corte para FCR em adolescentes brasileiros e analisar se há associação entre pontos de corte e fatores de risco cardiovascular. Métodos A amostra foi composta por 6.794 adolescentes (de 10 a 19 anos). A pressão arterial e a FCR foram avaliadas por dispositivo oscilométrico. Também foram avaliados o índice de massa corporal e a circunferência da cintura. Foi adotada a curva ROC para analisar a sensibilidade e especificidade, e as associações de FCR elevada com os fatores de risco cardiovascular foram analisadas por regressão logística binária. Foi considerado estatisticamente significante um valor de p < 0,05 para todas as análises. Resultados Os valores médios da FCR eram mais altos entre os participantes de 10 a 14 anos do naqueles de 15 a 19 anos, em meninos (p < 0,001) e meninas (< 0,001). Os pontos de corte de FCR propostos para detecção de fatores de risco cardiovascular foram significativos para meninos de 10 a 14 (> 92 bpm) e de 15 a 19 anos (> 82 bpm) e para meninas de 15 a 19 anos (> 82 bpm) (p < 0,05 para todos), enquanto nenhum ponto de corte foi identificado para as meninas de 10 a 14 anos (p > 0,05). Os pontos de corte propostos para a FCR foram associados com obesidade abdominal, sobrepeso e pressão arterial elevada em meninos e meninas. Os pontos de corte da FCR foram associados ao conjunto de fatores de risco cardiovascular em adolescentes de 15 a 19 anos. Conclusões Os pontes de corte propostos para a FCR foram associados com os fatores de risco cardiovascular em adolescentes.


Abstract Background Resting heart rate (RHR) may be a useful screening tool for cardiovascular risk. However, RHR cutoff points, an interesting clinical approach, have never been described in young populations. Objective To establish RHR cutoff points in Brazilian adolescents and to analyze whether cutoff points are associated with cardiovascular risk factors. Methods The sample was composed of 6,794 adolescents (10 to 19 years old). Blood pressure and RHR were assessed by oscillometric device. Body mass index and waist circumference were also assessed. Receiver operating characteristic curve was adopted to analyze the sensitivity and specificity, and associations of high RHR with cardiovascular risk factors were analyzed by binary logistic regression. A p value < 0.05 was considered statistically significant for all the analyses. Results Mean RHR values were higher among participants ages 10 to 14 years than 15 to 19 years, for boys (p < 0.001) and girls (< 0.001). The proposed RHR cutoff points for cardiovascular risk factors detection were significant for boys ages 10 to 14 (> 92 bpm) and 15 to 19 years (> 82 bpm), as well as for girls ages 15 to 19 years (> 82 bpm) (p < 0.05 for all), whereas no cutoff point was identified for girls ages 10 to 14 years (p > 0.05). Proposed RHR cutoff points were associated with abdominal obesity, overweight, and high blood pressure in boys in girls. RHR cutoff points were associated with the cluster of cardiovascular risk factors in adolescents ages 15 to 19 years. Conclusion The proposed RHR cutoff points were associated with cardiovascular risk factors in adolescents.


Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Young Adult , Cardiovascular Diseases/diagnosis , Body Mass Index , Cross-Sectional Studies , Risk Factors , Waist Circumference , Heart Rate
13.
Arch. latinoam. nutr ; 71(2): 85-93, jun. 2021. tab
Article in Spanish | LILACS, LIVECS | ID: biblio-1290813

ABSTRACT

Tradicionalmente se han utilizado algunos índices antropométricos para el diagnóstico de exceso de peso en niños y adolescentes que han mostrado algunas desventajas por lo que se han postulado otros indicadores. En ese sentido, se plantea estimar el nivel de asociación entre indicadores antropométricos y la presencia de dislipidemia en adolescentes y adultos jóvenes. Se realizó una investigación observacional, descriptiva y de corte transversal en 123 adolescentes (68,2% mujeres, edad promedio 14,5 años) y 122 adultos jóvenes (70,5% mujeres, edad promedio 21 años) de la ciudad de Caracas. Se calcularon Índices de Masa Corporal (IMC), Índice Cintura­Talla (ICT), Índice de Masa Corporal Abdominal (IMCA) e Índice de Masa Tri-Ponderal (IMT). Se obtuvo una muestra de sangre por punción venosa, en ayuno de 12 a 14 horas, a partir de la cual se cuantificó Colesterol Total, Lipoproteína de alta densidad y Triglicéridos. Se calculó la concentración de Lipoproteína de baja densidad por la fórmula de Friedewald, así como el índice LDL-C/HDL-C y el índice LogTg/HDL. Para el análisis e interpretación de los datos se utilizó estadística descriptiva univariante y multivariante. Los resultados revelaron que los índices antropométricos IMCA e IMT no mostraron mejor desempeño en predecir dislipidemia que los indicadores IMC, Circunferencia de Cintura (CC) e ICT en adolescentes y adultos jóvenes. Los indicadores antropométricos de adiposidad abdominal, CC e ICT, tendieron a presentar mayores OR, ABC, sensibilidad y especificidad independientemente del grupo de estudio. En general, la capacidad de los indicadores antropométricos evaluados en predecir la presencia de dislipidemia en adultos jóvenes fue adecuada, situación que no se presentó en los adolescentes(AU)


Traditionally, some anthropometric indices have been used for the diagnosis of excess weight in children and adolescents, which have shown some disadvantages for which other indicators have been postulated. In this sense, it is proposed to estimate the level of association between anthropometric indicators and the presence of dyslipidemia in adolescents and young adults. An observational, descriptive cross-sectional investigation was carried out in 123 adolescents (68,2% women, media age 14,5 years) and 122 young adults (70,5% women, media age 21 years) from the city of Caracas. Body Mass Indices (BMI), Waist-Height Ratio (WHR), Abdominal Body Mass Index (BMAI) and Tri-Ponderal Mass Index (TMI) were calculated. A blood sample was obtained by venipuncture, fasting for 12 to 14 hours, from which Total Cholesterol, High Density Lipoprotein and Triglycerides were quantified. The low-density lipoprotein concentration was calculated by the FriedEwald formula, as well as the LDL-C / HDL-C index and the LogTg / HDL index. Univariate and multivariate descriptive statistics were used for the analysis and interpretation of the data. The results revealed that the BMI and TMI anthropometric indices did not show better performance in predicting dyslipidemia than the BMI, Waist Circumference (WC) and WHR indicators in adolescents and young adults. The anthropometric indicators of abdominal adiposity, WC and WHR, tended to present higher OR, AUC, sensitivity and specificity regardless of the study group. In general, the capacity of the anthropometric indicators evaluated to predict the presence of dyslipidemia in young adults was adequate, a situation that did not occur in adolescents(AU)


Subject(s)
Humans , Animals , Male , Adolescent , Adult , Dyslipidemias/physiopathology , Waist Circumference , Waist-Height Ratio , Body Mass Index , Anthropometry , Obesity, Abdominal , Pediatric Obesity
14.
Rev. Ciênc. Méd. Biol. (Impr.) ; 20(1): 112-119, maio 5, 2021. tab
Article in Portuguese | LILACS | ID: biblio-1355029

ABSTRACT

Introdução: alguns indicadores antropométricos se caracterizam por serem facilmente aplicados e amplamente utilizados para a avaliação da obesidade e distribuição da gordura corporal, constituindo um dos primeiros passos para identificar risco inicial à saúde. Objetivo: avaliar e identificar a frequência de obesidade geral e abdominal por meio de indicadores antropométricos e verificar a presença de comorbidades em indivíduos que participaram das reuniões educativas e atividades do NASF do Município de Candói, Paraná. Metodologia: trata-se de um estudo quantitativo e transversal, com aplicação de questionário para conhecer as comorbidades e caracterizar a amostra por meio da aferição de peso, estatura e circunferência da cintura (CC), além da determinação do índice de massa corporal (IMC) e relação cintura-estatura (RCE). Nas análises de associação, utilizou-se o teste de qui-quadrado seguido do cálculo das razões de chance (RC). Resultados: a maior parte da amostra foi classificada como sobrepeso/obesidade (69,2%), com base no IMC, e apresentou elevados índices de obesidade abdominal pela CC e RCE. Os valores de CC aumentados foram observados em 83,01% dos pacientes. Em relação a RCE, o valor adequado foi verificado em apenas 14,5% dos participantes. As associações entre os índices antropométricos e as demais variáveis mostraram diferenças estatisticamente significativas em relação à idade dos participantes, revelando maior frequência de RCE aumentada em pacientes com 60 anos ou mais (RC = 8,53, p = 0,01). Dentre as comorbidades, o destaque foi a presença da hipertensão arterial sistêmica. Conclusão: além das elevadas frequências de obesidade geral, obesidade abdominal e da presença de comorbidades, como a hipertensão arterial sistêmica, a RCE foi o índice antropométrico capaz de sugerir risco cardiometabólico aumentado em idosos. Neste sentido, este estudo mostra a capacidade de caracterizar os usuários do sistema público de saúde com potencial para o desenvolvimento de doença cardiovascular através do uso de ferramentas antropométricas de baixo custo, e assim, poder dar suporte para ações corretivas a nível de políticas públicas municipais.


Introduction: some anthropometric indicators are characterized by being easily applied and widely used to assess obesity and body fat distribution, constituting one of the first steps to identify initial health risk. Objective: to assess and identify the frequency of general and abdominal obesity using anthropometric indicators and to verify the presence of comorbidities in individuals who participated in the NASF educational meetings and activities in the city of Candói, Paraná. Methodology: this is a quantitative and cross-sectional study, with the application of a questionnaire to find out about comorbidities and to characterize the sample by measuring weight, height and waist circumference (WC), in addition to determining the body mass index (BMI) and waist-height ratio (RCE). In the association analyzes, the chi-square test was used followed by the calculation of the odds ratios (CR). Results: most of the sample was classified as overweight/obesity (69.2%), based on BMI, and showed high rates of abdominal obesity by WC and WHR. The increased WC values were observed in 83.01% of the patients. Regarding CER, the adequate value was verified in only 14.5% of the participants. The associations between the anthropometric indices and the other variables showed statistically significant differences in relation to the age of the participants, revealing a higher frequency of increased CER in patients aged 60 years or older (RC = 8.53, p = 0.01). Among the comorbidities, the highlight was the presence of systemic arterial hypertension. Conclusion: in addition to the high frequencies of general obesity, abdominal obesity and the presence of comorbidities, such as systemic arterial hypertension, the CER was the anthropometric index capable of suggesting increased cardiometabolic risk in the elderly. In this sense, this study shows the ability to characterize users of the public health system with the potential for the development of cardiovascular disease through the use of low-cost anthropometric tools, and thus be able to support corrective actions at the level of municipal public policies. .


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Body Mass Index , Comorbidity , Anthropometry , Waist Circumference , Obesity , Body Height , Demography , Evaluation Studies as Topic
15.
Rev. Assoc. Med. Bras. (1992) ; 67(4): 549-554, Apr. 2021. tab, graf
Article in English | LILACS | ID: biblio-1340640

ABSTRACT

SUMMARY OBJECTIVE: Non-alcoholic fatty liver disease, which is characterized by lipid being deposited into hepatocytes, affects nearly one in three adults globally. Inflammatory markers were suggested to be related with hepatic steatosis. Uric acid to HDL cholesterol ratio is proposed as a novel inflammatory and metabolic marker. We aimed to compare Uric acid to HDL cholesterol ratio levels of patients with Non-alcoholic fatty liver disease to those of healthy controls and find out potential correlations between Uric acid to HDL cholesterol ratio and other inflammatory and metabolic markers of Non-alcoholic fatty liver disease. METHODS: Patients with a diagnosis of Non-alcoholic fatty liver disease who were on clinical follow-up in our institution were enrolled in the study as the Non-alcoholic fatty liver disease group, while healthy volunteers were enrolled as the control group. The Uric acid to HDL cholesterol ratio of the groups was compared and potential correlations were studied between Uric acid to HDL cholesterol ratio and fasting blood glucose, transaminases, serum lipids (triglyceride, LDL-cholesterol), weight, and body mass index. RESULTS: The Uric acid to HDL cholesterol ratio of the Non-alcoholic fatty liver disease (13±5%) group was significantly higher compared to the Uric acid to HDL cholesterol ratio of the control (10±4%) group (p<0.001). Uric acid to HDL cholesterol ratio was significantly and positively correlated with fasting blood glucose, transaminases, triglyceride, body weight, waist circumference, hip circumference, and body mass index. A ROC analysis revealed that a Uric acid to HDL cholesterol ratio level greater than 9.6% has 73% sensitivity and 51% specificity in determining Non-alcoholic fatty liver disease. CONCLUSION: Due to the inexpensive and easy-to-assess nature of Uric acid to HDL cholesterol ratio, we suggest that elevated Uric acid to HDL cholesterol ratio levels be considered a useful tool in diagnosing hepatic steatosis.


Subject(s)
Humans , Adult , Uric Acid , Non-alcoholic Fatty Liver Disease , Triglycerides , Body Mass Index , Waist Circumference , Cholesterol, HDL
16.
Rev. Assoc. Med. Bras. (1992) ; 67(4): 566-570, Apr. 2021. tab, graf
Article in English | LILACS | ID: biblio-1340633

ABSTRACT

SUMMARY OBJECTIVE: To evaluate whether there is an association between the body mass index z-score and waist-to-height ratio of children and adolescents. METHODS: This was a cross-sectional study conducted in a school in Santo André, SP, between June and August 2019. Body mass index was measured for all participants, adopting the z-score cutoff of +2 recommended by the World Health Organization. The waist-to-height ratio was determined in children over two years of age and considered abnormal when ≥0.5. The qualitative variables are presented as absolute numbers and percentages. To compare qualitative data, we used the χ2 test or Fisher's exact test. Pearson's test was applied to assess the correlation between BMI and waist-to-height ratio. The level of significance adopted was 5%. RESULTS: The body mass index was calculated for 518 children and the waist-to-height ratio for 473 children. Regarding body mass index, 60.6% of the participants had normal weight, 3.1% were underweight, and 36.3% were overweight. overweight (24.7%) and obesity (22.7%) were more prevalent in adolescents. The waist-to-height ratio was abnormal in 50.5% of the sample. There was an increasing association between body mass index and waist-to-height ratio with age, according to the Pearson correlation coefficients for the age groups <5 years (r=0.459; p<0.001), 5 to 10 years (r=0.687; p<0.001) and >10 years (r=0.805; p<0.001). CONCLUSION: There was a significant correlation between body mass index and waist-to-height ratio. This association was higher in adolescents. The waist-to-height ratio is easy to apply and may be useful as a predictor of cardiometabolic risk.


Subject(s)
Humans , Child, Preschool , Child , Adolescent , Overweight/epidemiology , Obesity , Thinness , Body Height , Body Mass Index , Cross-Sectional Studies , Risk Factors , Waist Circumference
17.
Rev. cuba. endocrinol ; 32(1): e217, 2021. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1289382

ABSTRACT

Introducción: El diagnóstico clínico del hipercortisolismo endógeno puede ser complejo si las manifestaciones clínicas no son patognomónicas. Es importante conocer cuáles son las distintivas en nuestros pacientes, que permitan diagnosticar la enfermedad de forma precoz. Objetivo: Determinar sensibilidad, especificidad y valor predictivo positivo de las manifestaciones clínicas para diagnosticar el hipercortisolismo endógeno. Métodos: Estudio descriptivo transversal. Grupo I: 65 pacientes con hipercortisolismo endógeno y grupo II (comparación): 75 con sospecha clínica de hipercortisolismo endógeno a los que se les descartó la enfermedad. Se estudiaron pacientes con diagnóstico de hipercortisolismo endógeno (2004-2017), atendidos en el Instituto de Endocrinología. Se determinaron los valores de sensibilidad, especificidad y valor predictivo positivo para el diagnóstico de hipercortisolismo endógeno de cada síntoma y signo por separado, así como para las combinaciones de tres manifestaciones clínicas; además se realizó una regresión logística binaria para identificar las combinaciones de sintomatologías que mejor predicen la presencia de hipercortisolismo endógeno. Se consideró diferencia estadística significativa con p ≤ 0,05. Resultados: La mayoría de los síntomas presentó una sensibilidad inferior al 45 por ciento. La circunferencia de la cintura fue el único signo que mostró alta sensibilidad (76,9 por ciento), baja especificidad (28,6 por ciento) con valor predictivo positivo de 42,0 por ciento. Cuando se presentan dos o tres de estos signos: rubicundez, cara de "luna llena" e hirsutismo la posibilidad de tener hipercortisolismo endógeno es 75,4 por ciento, con valor predictivo positivo de 71 por ciento y, cuando no están presentes la probabilidad de no tenerlo es de 77,5 por ciento. Conclusiones: La combinación de sensibilidad, especificidad y valor predictivo positivo de los síntomas y signos de forma aislada no predice el diagnóstico de la enfermedad; sin embargo, la presencia de dos o tres de los síntomas y/o signos tiene una elevada sensibilidad y valor predictivo positivo para el diagnóstico del hipercortisolismo endógeno. Las combinaciones que mejor predicen la posibilidad de tener un hipercortisolismo endógeno son: piel fina, edema y acné; cara de "luna llena", hirsutismo y rubicundez, así como "giba de búfalo", hematomas y estrías(AU)


ABSTRACT Introduction: The clinical diagnosis of endogenous hypercortisolism can be complex if clinical manifestations are not pathognomonic. It is important to know what are distinctive in our patients, which allows to diagnose the disease early. Objective: To determine the sensitivity, specificity and positive predictive value of clinical manifestations for diagnosis. of endogenous hypercortisolism. Methods: Descriptive and cross-sectional study. Group I was made up of 65 patients with endogenous hypercortisolism; group II (comparison) was made up of 75 patients with clinical suspicion of endogenous hypercortisolism, finally ruled out. We studied patients diagnosed of endogenous hypercortisolism from 2004 to 2017, treated at the Endocrinology Institute. Sensitivity, specificity and positive predictive values were determined for the diagnosis of endogenous hypercortisolism for each symptom and sign separately, as well as for the combinations of three clinical manifestations; in addition, binary logistic regression was performed to identify the combinations of symptoms that best predict the presence of endogenous hypercortisolism. A statistically significant difference was considered with p ≤ 0.05. Results: Most of the symptoms presented a sensitivity lower than 45 percent. Waist circumference was the only sign that showed high sensitivity (76.9 percent), low specificity (28.6 percent), and positive predictive value of 42.0 percent. When two or three of these signs (redness, "full-moon" face, and hirsutism) are present, the possibility of having endogenous hypercortisolism is 75.4 percent, with positive predictive value of 71 percent; and, when they are not present, the probability of not having it is 77,5 percent. Conclusions: The combination of sensitivity, specificity and positive predictive value of the symptoms and signs in isolation does not predict the diagnosis of the disease; however, the presence of two or three of the symptoms and/or signs has a high sensitivity and positive predictive value for the diagnosis of endogenous hypercortisolism. The combinations that best predict the possibility of having an endogenous hypercortisolism are thin skin, edema and acne; "full-moon" face, hirsutism and redness; as well as "buffalo hump," bruises and stretch marks(AU)


Subject(s)
Humans , Clinical Diagnosis , Predictive Value of Tests , Sensitivity and Specificity , Cushing Syndrome/diagnosis , Epidemiology, Descriptive , Cross-Sectional Studies , Waist Circumference
18.
Arq. ciências saúde UNIPAR ; 25(1): 31-36, jan-abr. 2021.
Article in Portuguese | LILACS | ID: biblio-1151403

ABSTRACT

A aptidão física se relaciona com marcadores de saúde na infância. O objetivo do presente estudo é mensurar os níveis de aptidão física de escolares, de 10 anos, de acordo com as classificações da base de dados do Projeto Esporte Brasil, 2016 e comparar os resultados das avaliações entre os escolares da rede pública e privada. Participaram desse estudo cento e vinte e seis escolares das cidades de Leme e Pirassununga. Foram determinados o Índice de Massa Corporal e Razão Cintura-Estatura dos indivíduos, que também foram avaliados quanto à aptidão cardiorrespiratória, flexibilidade, resistência muscular abdominal, potência de membros superiores, potência de membros inferiores, agilidade e velocidade. Concluímos que os estudantes da rede pública de ensino apresentaram nível de aptidão física superior em detrimento aos estudantes da rede particular e que os estudantes do sexo masculino da rede privada obtiveram resultados considerados abaixo dos níveis saudáveis para a faixa etária.


Physical fitness is related to health markers in childhood. The aim of this study is to measure the physical fitness levels of 10-year-old schoolchildren according to the classifications in the 2016 Projeto Esporte Brasil database and to compare the results among public and private schoolchildren. One hundred and twenty-six schoolchildren from the cities of Leme and Pirassununga took part in this study. The Body Mass Index and Waist-to-Height Ratio of the individuals were determined. The children were also evaluated for cardiorespiratory fitness, flexibility, abdominal muscle resistance, upper limb power, lower limb power, agility, and speed. It could be concluded that students from the public school system presented a higher level of physical fitness when compared to those from the private system, and that male students from the private school system presented results which were considered below the healthy levels for that age group.


Subject(s)
Humans , Male , Female , Child , Schools , Students , Physical Fitness , Physical Education and Training , Body Height , Body Mass Index , Child Health , Range of Motion, Articular , Abdominal Muscles , Waist Circumference , Pediatric Obesity , Cardiorespiratory Fitness
19.
Rev. bras. med. esporte ; 27(1): 49-54, Jan.-Mar. 2021. tab, graf
Article in English | LILACS | ID: biblio-1156108

ABSTRACT

ABSTRACT Introduction It has been suggested that visceral adipose tissue (VAT) is associated with several non-communicable chronic diseases, but measuring it is difficult. Thus, anthropometry could be used because is easily applied in clinical practice. Objectives The present study aimed to develop and validate VAT estimation equations (Eq) in military men. Methods The sample consisted of 409 (mean age, 36.5 ± 6.7 years) military men in the Brazilian Army (BA) divided into an equation group (EG) ( n = 270; mean age, 37.0 ± 6.3 years) and a validation group (VG) ( n =139; mean age, 36.0 ± 7.2 years). Anthropometric, hemodynamic and DXA body composition evaluations ( GE iLunar ) were performed. The Student's t test, Pearson's correlation, and stepwise general linear regression were applied. Bland-Altman graphics were used to assess the concordance between VAT by Eq and by DXA. The level of significance was 95% ( p < 0.05). Results Age, waist circumference (WC), hip circumference and body mass index presented the main significant positive correlations with the VAT-DXA. Four Eq were created Eq1 ( r 2 = 0.793), Eq2 ( r 2 = 0.810), Eq3 ( r 2 = 0.817), and Eq 4 ( r 2 = 0.823) ( p < 0.05). No differences were observed between VAT by DXA and VAT by Eq ( p = 0.982, p = 0.970, p = 0.495 and p = 0.698). Bland-Altman analysis also presented good concordance as the bias was close to zero and was not statistically significant. Conclusion Eq2 (age*13.0 + WC*60.0 - 4975,.5) was more suitable because it is easier to apply, has a higher predictive power (81.0%), less bias (1.86) and validation yielded average VAT values close to those found in DXA. It may still be considered a valuable tool for other extensive epidemiological studies in military men in the BA and can be used in adult men. Evidence Level I: Development of diagnostic criteria on consecutive patients (with universally applied reference ''gold'' standard).


RESUMO Introdução A literatura científica tem sugerido que o tecido adiposo visceral (TAV) está associado a doenças crônicas não transmissíveis, mas é difícil fazer sua mensuração. Assim, a antropometria pode ser empregada por ser de fácil aplicação na prática clínica. Objetivos Este estudo teve como objetivo desenvolver e validar equações de estimativa (Eq) do TAV em militares. Métodos A amostra consistiu em 409 (média de idade 36,5 ± 6,7 anos) militares do Exército Brasileiro (EB) divididos em Grupo equação (GE) (n = 270; média de idade 37,0 ± 6,3 anos) e Grupo validação (GV) (n = 139; média de idade 36,0 ± 7,2 anos). Foram realizadas avaliações antropométricas, hemodinâmicas e de composição corporal por DXA (GE iLunar). O teste t de Student, a correlação de Pearson e a regressão linear geral Stepwise foram aplicados. Os gráficos de Bland-Altman foram usados para avaliar a concordância entre os resultados de TAV pela Eq e por DXA. O nível de significância adotado foi de 95% (p <0,05). Resultados Idade, circunferência da cintura (CC), circunferência do quadril e o índice de massa corporal apresentaram as principais correlações positivas e significativas com TAV-DXA. Foram criadas quatro equações: Eq1 (r2 = 0,793), Eq2 (r2 = 0,810), Eq3 (r2 = 0,817) e Eq 4 (r2 = 0,823), p < 0,05. Não foram observadas diferenças entre o TAV por DXA pelas Eq (p = 0,982, p = 0,970, p = 0,495 e p = 0,698). A análise de Bland-Altman também apresentou boa concordância, porque o viés foi próximo de zero e não estatisticamente significativo. Conclusões A Eq2 (idade*13,0 + CC*60,0 - 4975,5) foi mais adequada, porque é mais fácil de aplicar, tem maior poder preditivo (81,0%), menor viés (1,86) e a validação forneceu valores médios de TAV próximos aos encontrados no DXA. Além disso, pode ser considerada uma ferramenta valiosa para outros estudos epidemiológicos extensos em militares do EB e pode ser usada em homens adultos. Nível de Evidência I; Teste de critérios diagnósticos desenvolvidos anteriormente em pacientes consecutivos (com padrão de referência "ouro" aplicado).


RESUMEN Introducción La literatura científica ha sugerido que el tejido adiposo visceral (TAV) está asociado a enfermedades crónicas no transmisibles, pero es difícil hacer su medición. Así, la antropometría puede ser empleada por ser de fácil aplicación en la práctica clínica. Objetivos Este estudio tuvo como objetivo desarrollar y validar ecuaciones de estimativa (Ec) del TAV en militares. Métodos La muestra consistió en 409 (promedio de edad 36,5 ± 6,7 años) militares del Ejército Brasileño (EB) divididos en Grupo de ecuación (GE) (n = 270; promedio de edad 37,0 ± 6,3 años) y Grupo validación (GV) (n = 139; promedio de edad 36,0 ± 7,2 años). Fueron realizados análisis antropométricos, hemodinámicos y de composición corporal por DXA (GE iLunar). Fueron aplicados el teste t de Student, la correlación de Pearson y la regresión linear general Stepwise. Los gráficos de Bland-Altman fueron usados para evaluar la concordancia entre los resultados de TAV por la Ec y por DXA. El nivel de significancia fue de 95% (p <0,05). Resultados Edad, circunferencia de cintura (CC), circunferencia de la cadera y el índice de masa corporal presentaron las principales correlaciones positivas y significativas con TAV-DXA. Fueron creadas cuatro ecuaciones: Ec1 (r2 = 0,793), Ec2 (r2 = 0,810), Ec3 (r2 = 0,817) y Ec4 (r2 = 0,823), p <0,05. No fueron observadas diferencias entre el TAV por DXA por las Ec (p = 0,982, p = 0,970, p = 0,495 y p = 0,698). El análisis de Bland-Altman también presentó buena concordancia, porque el sesgo fue próximo de cero y no estadísticamente significativo. Conclusiones La Ec2 (edad*13,0 + CC*60,0 - 4975.5) fue más adecuada, porque que es más fácil de aplicar, tiene mayor poder predictivo (81,0%), menor sesgo (1,86) y la validación suministró valores promedio de TAV próximos a los encontrados en el DXA. Además, puede ser considerada una herramienta valiosa para otros estudios epidemiológicos extensos en militares del EB y puede ser usada en hombres adultos. Nivel de Evidencia I: Test de criterios diagnósticos desarrollados anteriormente en pacientes consecutivos (con patrón de referencia "oro" aplicado).


Subject(s)
Humans , Male , Adult , Intra-Abdominal Fat/diagnostic imaging , Military Personnel , Models, Biological , Absorptiometry, Photon , Body Mass Index , Cross-Sectional Studies , Waist Circumference
20.
Braz. j. biol ; 81(2): 246-250, 2021. tab
Article in English | MEDLINE, LILACS, VETINDEX | ID: biblio-1153363

ABSTRACT

Aim: This study aimed to verify the correlation between murine measurements and retroperitoneal adipose tissue in rats exposed to the high-fat diet. Material and methods: Wistar male adult rats, descendants of mothers who consumed a high-fat diet during pregnancy and lactation and fed the same diet after weaning were used. At 60 days of life, body weight, longitudinal axis and waist circumference (WC) were measured. The Body Mass Index (BMI) and the Lee Index were calculated for a posterior analysis of the correlation with the amount of retroperitoneal adipose tissue dissected on the same day. For analysis of the data, the Pearson correlation test was used, considering statistical significance for p<0.05. Results: Body weight had a weak correlation (r= 0.31; p= 0.38) with retroperitoneal adipose tissue. While the longitudinal correlated moderately and negative (r= -0.40; p= 0.25). Abdominal circumference (r= 0.62; p= 0.05), body mass index (r= 0.61; p= 0.03) and Lee (r= 0.69; p= 0.03) correlated moderately and positively with adipose tissue. Conclusion: Among the measured murine measurements, weight and longitudinal axis were not good indicators to represent accumulation of retroperitoneal adipose tissue in rats. However, Lee's index seems to be the best murine marker to diagnose the accumulation of retroperitoneal fat. BMI, CA and Lee index were murine parameters with higher correlation.


Objetivo: Este estudo teve como objetivo verificar a correlação entre medidas murinométricas e tecido adiposo retroperitoneal em ratos expostos à dieta hiperlipídica. Material e métodos: Foram utilizados ratos Wistar machos adultos, descendentes de mães que consumiram dieta hiperlipídica durante a gestação e lactação e alimentados com a mesma dieta após o desmame. Aos 60 dias de vida, foram medidos o peso corporal, o eixo longitudinal e a circunferência da cintura (CC). O Índice de Massa Corporal (IMC) e o Índice de Lee foram calculados para posterior análise da correlação com a quantidade de tecido adiposo retroperitoneal dissecado no mesmo dia. Para análise dos dados, utilizou se o teste de correlação de Pearson, considerando significância estatística para p<0.05. Resultados: O peso corporal apresentou uma correlação fraca (r= 0,31; p= 0,38) com o tecido adiposo retroperitoneal. Enquanto o longitudinal correlacionou moderadamente e negativo (r= -0,40; p= 0,25). A circunferência abdominal (r = 0,62; p = 0,05), índice de massa corporal (r= 0,61; p= 0,03) e Lee (r= 0,69; p= 0,03) correlacionaram-se moderada e positivamente com o tecido adiposo. Conclusão: Entre as medidas murinométricas, o peso e o eixo longitudinal não foram bons indicadores para representar o acúmulo de tecido adiposo retroperitoneal em ratos. No entanto, o índice de Lee parece ser o melhor indicador murinométrico para diagnosticar o acúmulo de gordura retroperitoneal. O IMC, índice de Lee e CA foram parâmetros murinométricos com maior correlação.


Subject(s)
Animals , Male , Rats , Intra-Abdominal Fat/anatomy & histology , Diet, High-Fat/veterinary , Body Mass Index , Rats, Wistar/anatomy & histology , Reference Parameters , Waist Circumference
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