Excess weight in adolescents and associated factors: data from the ERICA study

Abstract Objective: To estimate the prevalence of excessive weight and to identify associations with socioeconomic, demographic, biological, and lifestyle factors in adolescents. Methods: It is a cross-sectional school-based study, with a stratified and complex sample. The evaluated individuals were adolescents (2404), aged 12-17 years old, participating in the Study of Cardiovascular Risk Factors in Adolescents (ERICA). Demographic, socioeconomic, biological, anthropometric, and lifestyle variables were assessed. Poisson regression was used to verify the association between excess weight and independent variables. Results: The prevalence of excessive weight was 26.3% in the study population, being 16.3% for overweight and 10% for obesity. In the multivariate analysis (hierarchical model), were associated with excessive weight: private education network, a higher number of televisions in the residence, eating habits related to the breakfast consumption, snacks purchase in the canteen, snacks in front to screens consumption and consumption of carbohydrates and lipids, in addition to age group (12-14 years) and sexual maturation (post-pubertal). Conclusions: The prevalence of excessive weight among the school adolescents studied is high, with a value higher than the national average and the results of previous studies with adolescents. Its distribution is associated with different factors, which are socioeconomic, demographic, biological, and related to lifestyle, reinforcing the complexity of this condition, which deserves a broad coping approach, involving not only individual efforts but social and public ones as well.

Síndrome metabólica em idosos de um aglomerado urbano subnormal: prevalência e fatores associados / Metabolic syndrome in older adults living in a subnormal urban cluster: Prevalence and associated factors

Resumo Introdução A síndrome metabólica (SM) é o agrupamento de fatores de risco associados à adiposidade central e à resistência à insulina. Objetivo O objetivo desta pesquisa foi analisar a prevalência da SM e os fatores associados em idosos de uma comunidade do município de Recife, Pernambuco. Método Estudo transversal com 166 idosos de ambos os sexos com idade igual ou superior a 60 anos, residentes na Comunidade dos Coelhos, no município de Recife. Para o diagnóstico da SM, foi utilizado o critério do NCEP-ATPIII. A análise dos dados foi efetuada com a utilização do programa estatístico SPSS para Windows, versão 13.1. Na comparação entre proporções, foram utilizados o teste de qui-quadrado de Pearson e o teste exato de Fischer. A razão de prevalência foi utilizada como medida de efeito considerando a SM como variável dependente. Resultados A prevalência de SM encontrada foi de 38,3%. Os fatores associados à SM após ajustes foram: a idade, na faixa etária 60-69 anos (44,4%, p = 0,047), o sexo feminino (43,1%, p = 0,056) e o excesso de peso (57,3%, p < 0,001). Conclusão A SM apresentou uma alta prevalência na população idosa avaliada, sendo associada às características demográficas e ao estado nutricional.

Abstract Background Metabolic syndrome (MS) is a clustering of risk factors associated with central adiposity and insulin resistance. Objective This study aimed to analyze the prevalence of MS and associated factors in older adults living in a subnormal urban cluster located in the city of Recife, state of Pernambuco, Brazil. Method A cross-sectional study was carried out with 166 older adults of both sexes aged ≥60 years residing in the Coelhos Community in Recife. MS was diagnosed through the NCEP/ATP III criteria. Data analysis was performed using the SPSS 13.1 statistical software. The Pearson's chi-squared test and the Fisher's exact test were used to compare the proportions. Prevalence ratio was used as an effect measure considering MS as dependent variable. Results Prevalence of MS was 38.3%. The factors associated with MS after adjustments were being 60-69 years old (44.4%, p=0.047), female (43.1%, p=0.056), and overweight (57.3%, p<0.001). Conclusion High prevalence of MS was observed in the older population evaluated, being associated with demographic characteristics and nutritional status. The group of older adults assessed should be provided with nutritional education and motivation to the practice of physical activities.

Identification of cutoff points for homeostatic model assessment for insulin resistance index in adolescents: systematic review / Identificação dos pontos de corte do índice homeostatic model assessment for insulin resistance em adolescentes: revisão sistemática

Objective: To identify cutoff points of the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) index established for adolescents and discuss their applicability for the diagnosis of insulin resistance in Brazilian adolescents. Data source: A systematic review was performed in the PubMed, Lilacs and SciELO databases, using the following descriptors: "adolescents", "insulin resistance" and "Receiver Operating Characteristics Curve". Original articles carried out with adolescents published between 2005 and 2015 in Portuguese, English or Spanish languages, which included the statistical analysis using Receiver Operating Characteristics Curve to determine the index cutoff (HOMA-IR) were included. Data synthesis: A total of 184 articles were identified and after the study phases were applied, seven articles were selected for the review. All selected studies established their cutoffs using a Receiver Operating Characteristics Curve, with the lowest observed cutoff of 1.65 for girls and 1.95 for boys and the highest of 3.82 for girls and 5.22 for boys. Of the studies analyzed, one proposed external validity, recommending the use of the HOMA-IR cutoff>2.5 for both genders. Conclusions: The HOMA-IR index constitutes a reliable method for the detection of insulin resistance in adolescents, as long as it uses cutoffs that are more adequate for the reality of the study population, allowing early diagnosis of insulin resistance and enabling multidisciplinary interventions aiming at health promotion of this population.

Objetivo: Identificar os pontos de corte do índice Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) estabelecidos para adolescentes e discutir a sua aplicabilidade para o diagnóstico da resistência à insulina em adolescentes brasileiros. Fontes de dados: Revisão sistemática feita nas bases de dados PubMed, LILACS e SciELO com os descritores "Adolescentes", "Resistência à insulina" e "Curva ROC". Foram incluídos artigos originais, publicados entre 2005 e 2015, conduzidos com adolescentes, no idioma português, inglês ou espanhol e incluindo análise estatística com uso da curva ROC para determinação dos pontos de corte do índice (HOMA-IR). Síntese dos dados: Foram identificados 184 artigos e, após a aplicação das etapas do procedimento, foram selecionados sete para compor a revisão. Todos os estudos selecionados estabeleceram seus pontos de corte com a curva ROC. O menor ponto de corte observado foi de 1,65 para meninas e 1,95 para meninos e o maior de 3,82 para meninas e 5,22 para meninos. Dos estudos analisados, um propôs validade externa, recomendando o uso do ponto de corte do HOMA-IR >2,5 para ambos os sexos. Conclusões: O índice HOMA-IR constitui-se em método confiável para detenção da resistência insulínica em adolescentes, desde que usados os pontos de corte que mais se adequem à realidade da população em estudo, o que permite um diagnóstico precoce da resistência à insulina e possibilita intervenções multiprofissionais para a promoção da saúde dessa população.