Non-HDL cholesterol is a good predictor of the risk of increased arterial stiffness in postmenopausal women in an urban Brazilian population

OBJECTIVES: Increased arterial stiffness is an important determinant of the risk of cardiovascular disease. Lipid profile impairment, especially hypercholesterolemia, is associated with stiffer blood vessels. Thus, the aim of this study was to determine which of the five circulating lipid components (high-density lipoprotein cholesterol (HDL-C), non-high-density lipoprotein cholesterol (non-HDL-C), low-density lipoprotein cholesterol (LDL), total cholesterol (TC) and triglycerides) is the best predictor of increased arterial stiffness in an urban Brazilian population. METHODS: A random sample of 1,662 individuals from the general population of Vitoria, Brazil (25-64 years), was selected, and lipid components were measured using standard methods. Pulse wave velocity was measured using a non-invasive automatic device, and increased arterial stiffness was defined as a pulse wave velocity ≥10 m/s. RESULTS: In men, only total cholesterol (OR=1.59; CI=1.02 to 2.48, p=0.04) was associated with the risk of increased arterial stiffness. In women, HDL-C (OR=1.99; CI=1.18 to 3.35, p=0.01) and non-HDL-C (OR=1.61; CI=1.01 to 2.56, p=0.04) were good predictors of the risk of increased arterial stiffness. However, these associations were only found in postmenopausal women (OR=2.06; CI=1.00 to 4.26, p=0.05 for HDL-C and OR=1.83; CI=1.01 to 3.33, p=0.04 for non-HDL-C). CONCLUSION: Our findings indicate that both HDL-C and non-HDL-C are good predictors of the risk of increased arterial stiffness in postmenopausal women in an urban Brazilian population and may be useful tools for assessing the risk of arterial stiffness.

Atualização dos critérios diagnósticos para Diabetes Mellitus utilizando a A1C / Update of diagnosis criteria for Diabetes Mellitus using the A1C

O Diabetes Mellitus (DM) não diagnosticado e não controlado promove complicações orgânicas graves. Diante disso, cresce o interesse acerca de métodos eficazes na identificação do diabetes instalado e dos indivíduos pré-diabéticos. A hemoglobina glicada (A1C), cuja dosagem através do exame de sangue já é utilizada no controle da doença, tornou-se alvo de pesquisas e ações que convergem no sentido de reconhecê-la também como método de valor diagnóstico do DM tipo 2. Nos últimos anos, diversas entidades têm demonstrado sua validade no diagnóstico do DM, embora ainda pairem dúvidas sobre seu uso como o principal método e no rastreio do pré-diabetes. Assim, elucidar o posicionamento das principais entidades que consideram o assunto é objetivo deste trabalho de revisão, assim como o são os aspectos bioquímicos da A1C, suas vantagens, limitações e recomendações de uso.