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Abstract Objective: To build a model based on cardiometabolic indicators that allow the identification of overweight adolescents at higher risk of subclinical atherosclerotic disease (SAD). Methods: Cross-sectional study involving 161 adolescents with a body mass index ≥ + 1 z-Score, aged 10 to 19 years. Carotid intima-media complex thickness (IMT) was evaluated using ultrasound to assess subclinical atherosclerotic disease. Cardiometabolic indicators evaluated included nutritional status, central adiposity, blood pressure, lipidic profile, glycemic profile, as well as age and sex. Data was presented using measures of central tendency and dispersion, as well as absolute and relative frequency. The relationship between IMT measurement (outcome variable) and other variables (independent variables) was assessed using Pearson or Spearman correlation, followed by multiple regression modeling with Gamma distribution to analyze predictors of IMT. Statistical analysis was performed using SPSS and R software, considering a significance level of 5 %. Results: It was observed that 23.7 % had Carotid thickening, and the prevalence of abnormal fasting glucose was the lowest. Age and fasting glucose were identified as predictors of IMT increase, with IMT decreasing with age by approximately 1 % per year and increasing with glucose by around 0.24 % per mg/dL. Conclusion: The adolescent at higher risk is younger with higher fasting glycemia levels.
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Introducción: Existe escaso conocimiento sobre la asociación entre marcadores cardiometabólicos en preescolares con características nutricionales y sociodemográficos familiares. Objetivo: Determinar la asociación entre marcadores cardiometabólicos de preescolares y sus padres con las características nutricionales y sociodemográficas familiares. Materiales y Métodos: Estudio de corte transversal, de asociación y correlación entre variables Padre-Hijo/a de carácter multicéntrico, en el cual participaron 140 sujetos (70 preescolares y su respectivo padre o madre). Las variables fueron estado nutricional, composición corporal, fuerza prensil y presión arterial de padres/madres y sus hijos/as preescolares y variables sociodemográficas de las familias. Resultados: Existió diferencia significativa al 5% respecto de la obesidad de los padres con la de los hijos/as, se presentó correlación positiva (0,397) entre las variables "porcentaje de grasa" padres e hijos/as. En relación al "nivel de escolaridad de la madre" hubo diferencia significativa con el "porcentaje de grasa" de los hijos/as (p<0,011). Existió similarmente diferencia significativa (p=0,033) entre la variable "tener hermanos" respecto a la variable "porcentaje de grasa" de los hijos/as. Finalmente se presentó asociación entre "usa Tablet" (dispositivo audiovisual) y "presión arterial" de los hijos/as (p=0,030). La variable "usa Tablet" se asoció significativamente con la "fuerza prensil" de los hijos/as (p=0,044). Conclusiones: Padres obesos con alto porcentaje de grasa tienen hijos/as preescolares con bajo perfil cardiometabólico; las variables nivel educacional inferior de la madre y tener hermanos se asociaron a un mayor porcentaje de grasa en los hijos/as, conjuntamente el uso de Tablet en preescolares mostró mayores niveles de presión arterial y menor fuerza prensil(AU)
Introduction: Little is known about the association between cardiometabolic markers in preschoolers with family nutritional and socio- demographic characteristics. Objective: To determine the association between cardiometabolic markers in preschoolers and their parents with family nutritional and sociodemographic characteristics. Materials and methods: cross-sectional study of association and correlation between parent-child variables, multicenter, 140 subjects participated (70 preschoolers and their respective parents). The variables were nutritional status, body composition, prehensile strength and blood pressure of parents and their preschool children and sociodemographic variables of the families. Results: There was a significant difference at 5% between parents' obesity and children's obesity, with a positive correlation (0.397) between the variable "percentage of fat" parents/children. In relation to the "mother's level of schooling" there was a significant difference with the "percentage of fat" of the children (p<0.011). Similarly, there was a significant difference (p=0.033) between the variable "Having siblings" with respect to the variable "percentage of fat" of the children. Finally, there was an association between "Tablet use" (audiovisual device) and "blood pressure" of the children (p=0.030). The variable "Tablet use" was significantly associated with the "prehensile strength" of the children (p=0.044). Conclusions: Obese parents with a high percentage of fat have preschool children with a low cardiometabolic profile; the variables lower educational level of the mother and having siblings were associated with a higher percentage of fatness in children; together, the use of Tablet in preschoolers showed higher levels of blood pressure and lower prehensile strength(AU)
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Humanos , Masculino , Femenino , Preescolar , Enfermedades Cardiovasculares , Diabetes Mellitus , Obesidad Infantil , Hipertensión , Factores Socioeconómicos , Estado Nutricional , Ingestión de Alimentos , Nutrición del Adolescente , Conducta AlimentariaRESUMEN
INTRODUCCIÓN: La niñez y adolescencia son las etapas de la vida donde generalmente se instauran hábitos alimentarios que se relacionan con el desarrollo defactores de riesgo cardiovascular. OBJETIVO: Clasificar el riesgo cardiovascular en adolescentes escolarizados de Villavicencio (Colombia) y a su vez, estimar la asociación que tiene con la frecuencia de consumo de diferentes tipos de alimentos. METODOLOGÍA: Se trata de un estudio transversal analítico, desarrollado en 1.504 adolescentes escolarizados entre 13 a 17 años de Villavicencio, el riesgo cardiovascular fue evaluado de acuerdo al modelo propuesto por Rodríguez-Soriano y Sanjurjo, la frecuencia de alimentos se evaluó por medio de una encuesta estructurada para tal fin. Para estimar la relación entre el riesgo cardiovascular y la frecuencia de alimentos, se usaron modelos regresión binomial. RESULTADOS: La edad media de los participantes fue de 14,9 ± 0,07 años; el 61,9% eran mujeres, 80,6% provenían de colegios ubicados en la zona urbana. De acuerdo con la clasificación del riesgo cardiovascular, se encontró que el 34,5% de los adolescentes tenía riesgo cardiovascular alto, mientras que 25,4% tenían un riesgo intermedio. Los hombres, y los que consumían más de dos bebidas azucaradas al día eran aquellos que presentaron mayores cifras de alto riesgo cardiovascular (48,6% y 36,9% respectivamente). Los modelos de regresión mostraron que el consumo de más de una bebida azucaradas al día (RP 1,27 IC 95% 1,04-1,55) estaba asociado con niveles altos de riesgo cardiovascular en adolescentes. CONCLUSIÓN: Se identificó una alta proporción de adolescentes con riesgo medio y alto; adicionalmente, el consumo de bebidas azucaradas mostró su asociación con el riesgo cardiovascular.
BACKGROUND: Childhood and adolescence are the life stages where eating habits related to the development of cardiovascular risk factors are usually established. OBJECTIVE: To classify cardiovascular risk in school adolescents from Villavicencio (Colombia) and, additionally, to estimate its association with food intake frequency according to food kind. METHODOLOGY: This is an analytical cross-sectional study developed in 1,504 adolescents of 13 to 17 years of age schooling in Villavicencio. We evaluated the cardiovascular risk according to the model proposed by Rodríguez-Soriano and Sanjurjo, and the food intake frequency with a structured survey. We used a binomial regression model to estimate the relationship between cardiovascular risk and food intake frequency. RESULTS: The mean age of the participants was 14.9 ± 0,07 years; 61.9% were women, and 80.6% came from schools located in urban areas. According to the cardiovascular risk classification, 34.5% of adolescents had a high cardiovascular risk, while 25.4% had intermediate risk. Men and those who consume more than two sugary drinks per day are those who presented a higher percentage of high cardiovascular risk (48.6% and 36.9%, respectively). Regression models showed that consumption of more than one sugary drink per day was associated with high levels of cardiovascular risk in adolescents (OR 1.27 95%CI 1.04-1.55). CONCLUSION: A high proportion of adolescents have medium and high cardiovascular risk; additionally, the consumption ofsugary drinks showed its association with cardiovascular risk.
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Humanos , Masculino , Femenino , Adolescente , Enfermedades Cardiovasculares/etiología , Enfermedades Cardiovasculares/epidemiología , Conducta Alimentaria , Factores de Riesgo de Enfermedad Cardiaca , Factores Socioeconómicos , Estudios Transversales , Factores de Riesgo , Colombia/epidemiología , Medición de RiesgoRESUMEN
Abstract Objective Premature ovarian insufficiency (POI) is characterized by early hypoestrogenism. An increased risk of cardiovascular (CV) disease is a long-term consequence of POI. A challenge of hormone therapy (HT) is to reduce the CV risk. Methods Cross-sectional study with lipid profile analysis (total cholesterol, LDL-C, HDL-C, VLDL-C and triglycerides), blood glucose levels and arterial blood pressure of women with POI using HT, compared with age and BMI-matched women with normal ovarian function (controls). Results The mean age and BMI of 102 POI patients using HT and 102 controls were 37.2 ± 6.0 and 37.3 ± 5.9 years, respectively; 27.0 ± 5.2 and 27.1 ± 5.4 kg/m2. There wasn't difference between groups in arterial systolic and diastolic blood pressure, blood glucose levels, total cholesterol, LDL-C, VLDL-C and triglycerides. HDL-C levels were significantly higher in the POI group (56.3 ± 14.6 and 52 ± 13.9mg/dL; p = 0.03). Arterial hypertension was the most prevalent chronic disease (12% in the POI group, 19% in the control group, p = ns), followed by dyslipidemia (6 and 5%, in POI and control women). Conclusion Women with POI using HT have blood pressure levels, lipid and glycemic profile and prevalence of hypertension and dyslipidemia similar to women of the same age and BMI with preserved gonadal function, in addition to better HDL levels.
Resumo Objetivo A insuficiência ovariana prematura (IOP) é caracterizada pelo hipoestrogenismo precoce. Risco aumentado de doença cardiovascular (CV) é uma consequência a longo prazo da IOP e um desafio da terapia hormonal (TH) é reduzir o risco CV. Métodos Estudo transversal com análise do perfil lipídico (colesterol total, LDL-C, HDL-C, VLDL-C e triglicerídeos), glicemia e pressão arterial de mulheres com IOP em uso de TH, em comparação a mulheres com função ovariana normal (controles) pareadas por idade e IMC. Resultados A média de idade e IMC de 102 pacientes com IOP em uso de TH e 102 controles foi de 37,2 ± 6,0 e 37,3 ± 5,9 anos, respectivamente; 27,0 ± 5,2 e 27,1 ± 5,4 kg/m2. Não houve diferença entre os grupos na pressão arterial sistólica e diastólica, glicemia, colesterol total, LDL-C, VLDL-C e triglicerídeos. Os níveis de HDL-C foram significativamente maiores no grupo IOP (56,3 ± 14,6 e 52 ± 13,9mg/dL; p = 0,03). A hipertensão arterial foi a doença crônica mais prevalente (12% no grupo POI, 19% no grupo controle, p = ns), seguida da dislipidemia (6 e 5%, no grupo POI e controle). Conclusão Mulheres com IOP em uso de TH apresentam níveis pressóricos, perfil lipídico e glicêmico e prevalência de hipertensão e dislipidemia semelhantes às mulheres da mesma idade e IMC com função gonadal preservada, além de melhores níveis de HDL.
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Humanos , Femenino , Enfermedades Cardiovasculares , Insuficiencia Ovárica Primaria , Terapia de Reemplazo de Hormonas , Factores de Riesgo CardiometabólicoRESUMEN
INTRODUCTION: Excess body weight and its comorbidities represent a major public health issue. Interventions based on diet and exercise have not only been shown to promote weight loss, but also improve overall health, including cardiovascular health. OBJECTIVE: This study aimed to evaluate the effects of a 12-week hypocaloric low-carbohydrate (CHO) diet coupled with high-intensity functional training (HIFT) on the cardiometabolic risk of overweight adults. METHODS: This is a randomized controlled trial. A total of 31 overweight adults participated in this study, divided into two groups based on the dietary intervention: reduced-CHO (R-CHO, ≤130 g/day; n=15) and adequate-CHO (A-CHO, >130 g/day; n=16). The cardiometabolic risk was assessed using lipidaemic, insulinemia, and glycaemic parameters. A two-way ANOVA with Bonferroni post hoc test was utilized to evaluate the effects of the intervention. A p-value < 0.05 was considered statistically significant. RESULTS: Participants from both groups displayed decreased low-density lipoprotein, very-low-density lipoprotein, total cholesterol, and triacylglycerol concentrations, as well as the number of risk factors for the metabolic disease after 12 weeks. The high-density lipoprotein (HDL) cholesterol concentration of both groups increased after 12 weeks, however, the result of the intragroup analysis revealed that a significant increase was only observed in the participants from the A-CHO group. CONCLUSION: Reduced or adequate CHO intake was both found to be effective in reducing cardiometabolic risk. However, improvements in HDL and final cardiometabolic classification risk indicated that CHO adequacy in the diet might be a better strategy associated with caloric restriction and HIFT.
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Humanos , Masculino , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Adulto Joven , Ejercicio Físico , Restricción Calórica , Sobrepeso , Dieta Baja en Carbohidratos , Factores de Riesgo Cardiometabólico , UniversidadesRESUMEN
ABSTRACT Objective: There is no consensus as to the best criterion for the evaluation of metabolic syndrome (MS), impairing the estimation of its prevalence. This study aims to compare MS estimates using three recommended definitions for adolescents based on a cross-sectional study nested in the Consortium of Brazilian Birth Cohorts in São Luís, Maranhão. Subjects and methods: A total of 2,515 adolescents aged between 18 and 19 years were evaluated. The criteria of International Diabetes Federation (IDF) and National Cholesterol Education Program Panel III (NCEP-ATP) modified by Cook and cols. (2003) and De Ferranti and cols. (2004) defined SM. To compare the estimates of MS prevalence, the chi-square, Fisher's exact and Cohen's Kappa index tests were used. Results: Among the 2,064 participants evaluated in the final sample. The prevalence of MS ranged from 4.2% (95% CI: 3.3-5.1) to 10.2% (95% CI: 8.8-11.4). When comparing the estimates of MS prevalence in the total sample and by sex, a statistically significant difference was observed. The agreement between the criteria ranged from 0.42 (CI 95%: 0.35-0.49) to 0.55 (CI 95%: 0.48-0.62) in the total sample, 0.33 (CI 95%: 0.24-0.42) to 0.59 (95%CI: 0.47-0.71) among boys and 0.39 (95% CI: 0.26-0.52) to 0.54 (95% CI: 0.44-0.64) among girls. Conclusion: Different criteria provide different estimates for the prevalence of MS in adolescents, reflecting the importance of establishing a consensus.
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Abstract: This study aimed to assess the association of birth conditions, nutritional status, and childhood growth with cardiometabolic risk factors at 30 years of age. We also evaluated whether body mass index (BMI) at 30 years mediated the association of weight gain in childhood with cardiometabolic risk factors. This is a prospective cohort study that included all live births in 1982 in hospitals in the city of Pelotas, Rio Grande do Sul State, Brazil, whose families lived in the urban area. Mothers were interviewed at birth, and participants were followed at different ages. For our analyses, we used data on weight and height collected at birth, 2 and 4 years and cardiovascular risk factors at 30 years. Multiple linear regressions were performed to obtain adjusted coefficients and G-formula for mediation analysis. Relative weight gain in childhood, despite the age, was positively related to mean arterial pressure, whereas relative weight gain in late childhood was positively associated with carotid intima-media thickness, pulse wave velocity, triglycerides, non-HDL cholesterol, plasma glucose, and C-reactive protein. BMI in adulthood captured the total effect of relative weight gain in the period between 2 and 4 years on carotid intima-media thickness, triglycerides, non-HDL cholesterol, and C-reactive protein. Our findings reinforce the evidence that rapid relative weight gain after 2 years of age may have long-term consequences on the risk of metabolic and cardiovascular disorders.
Resumo: O objetivo deste estudo foi avaliar a associação das condições de nascimento, do estado nutricional e do crescimento infantil com fatores de risco cardiometabólicos aos 30 anos de idade. Também foi verificado se o índice de massa corporal (IMC) aos 30 anos mediava a associação entre o ganho de peso na infância e fatores de risco cardiometabólicos. Trata-se de um estudo de coorte prospectivo que incluiu todos os nascidos vivos em 1982 em hospitais da cidade de Pelotas, Rio Grande do Sul, Brasil, residentes da área urbana. As mães foram entrevistadas no parto e os participantes foram acompanhados em diferentes idades. Para as análises, foram utilizados os dados de peso e altura coletados no nascimento e aos 2 e 4 anos de idade e fatores de risco cardiovascular aos 30 anos. Regressões lineares múltiplas foram realizadas para a obtenção de coeficientes ajustados e G-fórmula para a análise de mediação. O ganho de peso relativo na infância, apesar da idade, está positivamente associado à pressão arterial média, enquanto o ganho de peso relativo tardio na infância está positivamente associado à espessura médio-intimal da artéria carótida, à velocidade da onda de pulso, aos triglicerídeos, ao colesterol não-HDL, à glicose plasmática e à proteína C reativa. O IMC na idade adulta capturou o efeito total do ganho de peso relativo entre 2 e 4 anos sobre a espessura médio-intimal da carótida, os triglicerídeos, o colesterol não-HDL e a proteína C reativa. Estes achados reforçam a evidência de que o rápido ganho de peso relativo após os 2 anos de idade pode ter consequências a longo prazo sobre o risco de distúrbios metabólicos e cardiovasculares.
Resumen: El objetivo de este estudio fue evaluar la asociación de las condiciones de nacimiento, estado nutricional y crecimiento infantil con factores de riesgo cardiometabólico a los 30 años de edad. También se verificó si el índice de masa corporal (IMC) a los 30 años mediaba la asociación entre el aumento de peso infantil y los factores de riesgo cardiometabólicos. Se trata de un estudio de cohorte prospectivo que incluyó todos los nacidos vivos en 1982 en hospitales de la ciudad de Pelotas, estado de Río Grande del Sur, Brasil, residentes del área urbana. Las madres fueron entrevistadas en el momento del parto y los participantes fueron seguidos a diferentes edades. Para los análisis, utilizamos los datos de peso y altura recopilados al nacer y a los 2 y 4 años de edad y los factores de riesgo cardiovascular a los 30 años. Se realizaron regresiones lineales múltiples para obtener coeficientes ajustados y la G-fórmula para el análisis de mediación. El aumento de peso relativo en la infancia, a pesar de la edad, se asocia positivamente con la presión arterial media, mientras que el aumento de peso relativo en la infancia tardía se asocia positivamente con el espesor de la íntima-media de la arteria carotídea, la velocidad de la onda del pulso, los triglicéridos, el colesterol no HDL, la glucosa plasmática y la proteína C reactiva. El IMC en adultos capturó el efecto completo del aumento de peso relativo a los 2 y 4 años sobre el espesor de la íntima-media carotídea, los triglicéridos, el colesterol no HDL y la proteína C reactiva. Estos hallazgos refuerzan la evidencia de que el rápido aumento de peso relativo después de los 2 años puede tener consecuencias a largo plazo sobre el riesgo de trastornos metabólicos y cardiovasculares.
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Resumo Fundamento O comportamento sedentário tem sido associado a diversos fatores de risco cardiometabólicos durante a infância. No entanto, pouco se sabe sobre o impacto do comportamento sedentário na saúde e nos hábitos alimentares de crianças e adolescentes fisicamente ativos. Objetivo Avaliar a associação entre comportamento sedentário e fatores de risco cardiometabólicos e hábitos alimentares em crianças e adolescentes fisicamente ativos. Métodos Esse estudo transversal avaliou 516 crianças e adolescentes (10 a 18 anos; ambos os sexos) fisicamente ativos integrados no projeto social "Estação Conhecimento-Vale". O comportamento sedentário foi determinado de maneira indireta (questionário), utilizando como ponto de corte o tempo sentado ≥ 3 h/dia. Foram estatisticamente significantes as análises com p-valor < 0,05. Resultados O comportamento sedentário não foi associado ao excesso de peso (odds ratio = 0,72 [intervalo de confiança (IC) de 95%: 0,325-1,389]), hipertrigliceridemia ( odds ratio = 0,63 [IC95%: 0,306-1,297]), HDL colesterol baixo ( odds ratio = 0,57 [IC95%: 0,323-1,019]) e HDL não colesterol alto ( odds ratio = 0,63 [IC95%: 0,283-1,389]). Contudo, crianças e adolescentes que adotavam comportamento sedentário apresentaram maior chance de consumir regularmente alimentos em frente à televisão ( odds ratio =1,96 [IC95%: 1,114-3,456]) e de consumir pelo menos um alimento ultraprocessado por dia ( odds ratio =2,42 [IC95%: 1,381-4,241]). Além disso, apresentaram menor chance de consumir frutas regularmente (OR=0,52 [IC95%: 0,278-0,967]). Conclusão Não houve associação entre comportamento sedentário e fatores de risco cardiometabólicos em crianças e adolescentes fisicamente ativos. Contudo, o comportamento sedentário foi associado a hábitos alimentares inadequados. Dessa forma, podemos sugerir que a prática regular de atividade física pode atenuar os efeitos deletérios do comportamento sedentário nos parâmetros cardiometabólicos de crianças e adolescentes.
Abstract Background Sedentary behavior has been associated with several cardiometabolic risk factors during childhood. However, little is known about the impact of sedentary behavior on the health and eating habits of physically active children and adolescents. Objective To evaluate the association between sedentary behavior and cardiometabolic risk factors and eating habits in physically active children and adolescents. Methods This cross-sectional study was conducted, including 516 physically active children and adolescents (10 to 18 years old; both sexes) enrolled in the social project "Estação Conhecimento-Vale" were evaluated. Biochemical and lifestyle variables (questionnaire) were collected. Sedentary behavior was determined indirectly (questionnaire), by using sitting time ≥ 3 hours per day as a cutoff point. A p-value < 0.05 was considered statistically significant for all tests. Results Sedentary behavior was not associated with overweight/obesity (odds ratio = 0.72 [95% confidence interval (CI): 0.325-1.389]), hypertriglyceridemia (odds ratio = 0.63 [95% CI: 0.306-1.297]), low HDL cholesterol (odds ratio = 0.57 [95% CI: 0.323-1.019]), or high non-HDL cholesterol (odds ratio = 0.63 [95% CI: 0.283-1.389]). However, children and adolescents with sedentary behavior were more likely to regularly consume food in front of the television (odds ratio = 1.96 [95% CI: 1.114-3.456]) and to consume at least one ultra-processed food per day (odds ratio = 2.42 [95% CI: 1.381-4.241]). In addition, they were less likely to consume fruit regularly (odds ratio = 0.52 [95% CI: 0.278-0.967]). Conclusion There was no association between sedentary behavior and cardiometabolic risk factors in physically active children and adolescents. However, sedentary behavior was associated with inadequate eating habits. Thus, we may suggest that the regular engagement in physical activity may attenuate the deleterious effects of sedentary behavior on the cardiometabolic parameters of children and adolescents.
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Introducción: En la aparición de las enfermedades crónicas durante las edades pediátricas y la adolescencia, la restricción del crecimiento intrauterino se considera un factor clave. Objetivo: Determinar la relación entre la restricción del crecimiento intrauterino y las enfermedades no trasmisibles durante las edades pediátricas. Métodos: Se realizó una revisión narrativa con búsqueda bibliográfica en Pubmed, SciELO, LILACS y Google académico en los últimos cinco años sobre el tema que se trata. Se examinaron artículos originales, de revisión y capítulos de libros. Se utilizaron las palabras clave: retardo del crecimiento fetal, factores de riesgo cardiometabólicoy atención integrada a las enfermedades prevalentes de la infancia. Se descartaron aquellos artículos no pertinentes o que tuvieran deficiencias metodológicas notables. Análisis y síntesis de la información: Se expusieron las definiciones de pequeño para la edad gestacional y restricción del crecimiento intrauterino, se mostró la clasificación más actualizada, se mencionaron las enfermedades que aparecen en la infancia en estos recién nacidos de riesgo y se señalaron sus mecanismos. Conclusiones: El antecedente de restricción del crecimiento intrauterino se relaciona con alteraciones del crecimiento pondoestatural, del neurodesarrollo; el síndrome metabólico; las afecciones cardiovasculares; las enfermedades endocrinas, hepáticas, respiratorias, del sistema inmunológico y renales, los trastornos auditivos y de la visión. Estas afecciones se presentan en etapas tempranas de la vida como la infancia y la adolescencia(AU)
Introduction: In the occurrence of chronic diseases during pediatric ages and adolescence, intrauterine growth restriction is considered a key factor. Objective: To determine the relationship between intrauterine growth restriction and noncommunicable diseases during pediatric ages. Methods: A narrative review was performed with a literature search in Pubmed, SciELO, LILACS and Google Scholar in the last five years on the topic under discussion. Original articles, review articles and book chapters were examined. The keywords used were: fetal growth retardation, cardiometabolic risk factors, integrated care for prevalent childhood diseases. Articles that were not relevant or had notable methodological deficiencies were discarded. Analysis and synthesis of the information: The definitions of small for gestational age and intrauterine growth restriction were exposed, the most updated classification was shown, the diseases that appear during infancy in these at-risk newborns were mentioned and their mechanisms were pointed out. Conclusions: The history of intrauterine growth restriction is related to alterations of pondoestatural growth, neurodevelopment, metabolic syndrome, cardiovascular conditions, endocrine, hepatic, respiratory, immune system, renal, hearing and vision disorders. These conditions surface in early stages of life such as infancy and adolescence(AU)
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Humanos , Lactante , Preescolar , Niño , Adolescente , Factores de Riesgo , Síndrome Metabólico/etiología , Retardo del Crecimiento Fetal , Enfermedades no Transmisibles , Productos y Servicios de InformaciónRESUMEN
Introdução: a hipertensão arterial sistêmica (HAS) está associada a fatores de risco metabólicos e pode ser definida como uma doença crônica multifatorial, com valores persistentes de pressão arterial sistólica (PAS) e (ou) pressão arterial diastólica (PAD) maiores ou iguais a 140 mmHg x 90 mmHg, respectivamente. A HAS é um dos fatores que compõem a síndrome metabólica (SM) juntamente com a hiperglicemia, dislipidemia e (ou) obesidade central. Modificações no estilo de vida, como a alimentação e perda de peso, demonstraram melhorar os parâmetros cardiometabólicos nos pacientes com HAS e SM. Objetivo: verificar o efeito de uma dieta hipocalórica na antropometria, na pressão arterial e em outros cofatores da síndrome metabólica. Metodologia: trata-se de um ensaio clínico não randomizado, retrospectivo, com dados secundários, em que o mesmo grupo foi de "intervenção" e "comparador", e cujos dados foram coletados antes (baseline) e após a intervenção. A pesquisa foi realizada com 84 pacientes, adultos, com síndrome metabólica, de ambos os sexos. Os pacientes seguiram dieta com restrição calórica de 200 a 500kcal/dia, com cálculo energético em torno de 20kcal/kg de peso, valor energético total não inferior a 1200kcal, durante um período de dois meses. Foi utilizada estatística descritiva e o teste t pareado ou Wilcoxon-Sign-Rank intragrupo para analisar as variações ao longo do tempo (p < 0,05). Resultado:houve uma redução na antropometria (índice de massa corporal, circunferência da cintura, circunferência do braço e circunferência do quadril), PAS e PAD, glicemia de jejum e triglicerídeos com p< 0,05 dos pacientes após a intervenção, mas não houve melhora no HDL (p > 0,05). Conclusão: a dieta hipocalórica reduziu as medidas antropométricas, a pressão arterial e os demais cofatores da SM nos pacientes avaliados após o acompanhamento de dois meses.
Introduction: systemic arterial hypertension (SAH) is associated with metabolic risk factors and can be defined as a multifactorial chronic disease, with persistent values of systolic blood pressure (SBP) and (or) diastolic blood pressure (DBP) greater than or equal to 140 mmHg x 90 mmHg, respectively. SAH is one of the factors that make up the metabolic syndrome (MS) along with hyperglycemia, dyslipidemia and (or) central obesity. Lifestyle modifications, such as diet and weight loss, have been shown to improve cardiometabolic parameters in patients with SAH and MS. Objective: to verify the effect of a hypocaloric diet on anthropometry, blood pressure and other cofactors of the metabolic syndrome. Methodology: this is a non-randomized, retrospective clinical trial, with secondary data, in which the same group was "intervention" and "comparator", and whose data were collected before (baseline) and after the intervention. Research was carried out with 84 patients, adults, with metabolic syndrome, of both sexes. Patients followed a calorie-restricted diet of 200 to 500kcal/day, with energy calculation around 20kcal/kg of weight, total energy value not less than 1200kcal, during a period of two months. Descriptive statistics and the paired t test or intragroup Wilcoxon-Sign-Rank were used to analyze variations over time (p < 0.05). Result: there was a reduction in anthropometry (body mass index, waist circumference, arm circumference and hip circumference), SBP and DBP, fasting glucose and triglycerides with p<0.05 of patients after the intervention, but there was no improvement in HDL (p > 0.05). Conclusion: the hypocaloric diet reduced anthropometric measurements, blood pressure and other MS cofactors in the patients evaluated after a two-month follow-up.
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Humanos , Masculino , Femenino , Adulto , Anciano , Enfermedades Cardiovasculares , Antropometría , Síndrome Metabólico , Restricción Calórica , Factores de Riesgo Cardiometabólico , Hiperglucemia , Hipertensión , ObesidadRESUMEN
Abstract Introduction: Patients with chronic kidney disease (CKD) are known to have increased cardiovascular risk but there are few data on the risk of pediatric kidney transplant recipients. We aimed to assess the impact of pre- and post-transplant overweight on allograft function and to characterize the evolution of several cardiovascular risk variables over time and their impact. Methods: A retrospective analysis of the records of 23 children/adolescents followed at a tertiary center after kidney transplant was conducted. Data on anthropometry and cardiometabolic variables were analyzed before transplant, six and 12 months after the transplant, and at the last follow-up visit. The impact of the variables on allograft function (glomerular filtration rate (GFR)) was estimated by creatinine-based revised Schwartz formula (Cr-eGFR) and was evaluated using nonparametric tests. Results: The 23 patients included in the study had a median age of 6.3 (4.4-10.1) years. Both systolic and diastolic BP z-score values significantly decreased between BMI groups [1.2 (-0.2 - 2.3) vs. 0.3 (-0.4 - 0.6), p=0.027 and 0.8 (-0.4 - 1.3) vs. 0.1 (-0.6 - 0.7), p=0.028, pre-transplant and at the final evaluation, respectively]. During follow-up, GFR values decreased (Cr-GFR: 68.9 (57.7-76.8) vs. 58.6 (48.9-72.9), p=0.033 at 6-months and at the end, respectively). Significant negative correlations between triglycerides and cystatin C-based eGFR (ρ=-0.47, p=0.028) and Cr-Cys-eGFR (ρ=-0.45, p=0.043) at the end of the study were found. Conclusion: Our study showed a high number of overweight children undergoing kidney transplant. A negative correlation between triglycerides and GFR was found, which highlights the importance of managing nutritional status and regular blood lipids evaluation after kidney transplant.
Resumo Introdução: Sabe-se que pacientes com doença renal crônica (DRC) têm maior risco cardiovascular, mas há poucos dados sobre risco de receptores de transplante renal pediátrico. Visamos avaliar o impacto do sobrepeso pré/pós-transplante na função do aloenxerto e caracterizar a evolução de diversas variáveis de risco cardiovascular com o tempo e seus impactos. Métodos: Realizou-se análise retrospectiva dos registros de 23 crianças/adolescentes acompanhados em um centro terciário após transplante renal. Foram analisados dados sobre antropometria e variáveis cardiometabólicas antes do transplante, seis e 12 meses após transplante, e na última consulta de acompanhamento. O impacto das variáveis na função do aloenxerto (taxa de filtração glomerular (TFG)) foi estimado pela fórmula de Schwartz revisada e baseada na creatinina (TFGe-Cr), e avaliado usando testes não paramétricos. Resultados: Os 23 pacientes incluídos no estudo tinham idade média de 6,3 (4,4-10,1) anos. Valores do escore Z das pressões arteriaissistólica e diastólica diminuíram significativamente entre grupos de índice de massa corporal [1,2 (-0,2 - 2,3) vs. 0,3 (-0,4 - 0,6), p=0,027 e 0,8 (-0,4 - 1,3) vs. 0,1 (-0,6 - 0,7), p=0,028, pré-transplante e na avaliação final, respectivamente]. Durante acompanhamento, valores da TFG diminuíram [TFG-Cr: 68,9 (57,7-76,8) vs. 58,6 (48,9-72,9), p=0,033 aos 6 meses e ao final, respectivamente]. Encontramos correlações negativas significativas entre triglicerídeos, TFGe baseada na cistatina C (ρ=-0,47, p=0,028) e TFGe-Cr-Cis (ρ=-0,45, p=0,043) ao final do estudo. Conclusão: Nosso estudo mostrou alto número de crianças com sobrepeso submetidas a transplante renal. Verificou-se correlação negativa entre triglicerídeos e TFG, destacando a importância de controlar o estado nutricional e da avaliação regular dos lipídios sanguíneos após transplante renal.
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Presentación: En el presente artículo exponemos nuestra valoración crítica de un estudio observacional publicado en la revista International Journal of Environmental Research and Public Health el año 2022. Conclusiones del estudio: Se identificó una asociación inversa entre vivir a mayor altura y el nivel de riesgo cardiometabólico en la población adulta peruana. Sin embargo, la prevalencia de riesgo cardiometabólico en las diferentes categorías altitudinales evaluadas se mantiene por encima del 82% (80.9 - 84.6), lo que representa una gran proporción de la población en riesgo en cada altitud. Comentario crítico: El estudio es relevante por el uso de la relación cintura-talla, considerado como un indicador antropométrico con gran precisión para estimar el riesgo cardiometabólico, ser un estudio de bajo riesgo de sesgo y tener representatividad nacional. Por otro lado, es importante porque la relación cintura-talla es económica y fácil de usar, además de ser superior al IMC, ideal para aplicarlo en Perú. Además la conclusión general del estudio es válida, sin embargo, la falta de evaluación de la temporalidad por la misma característica del estudio (tipo transversal) y el sesgo residual que tiene al no evaluar algunas variables, hace necesario que se realicen estudios longitudinales para poder apoyar los resultados del estudio.La presente revisión crítica encuentra validez interna de los resultados del estudio, pero al momento no serían aplicables para generalizarse en toda la población por el sesgo residual.
Presentation: This article presents our critical appraisal of an observational study published in the International Journal of Environmental Research and Public Health in 2022. Conclusions of the Study: An inverse association was identified between living at higher altitudes and the level of cardiometabolic risk in the Peruvian adult population. However, the prevalence of cardiometabolic risk in the different altitude categories evaluated remains above 82% (80.9 - 84.6), which represents a large proportion of the population at risk at every altitude. Critical comment: The study is relevant because of the use of the waist-height ratio, considered an anthropometric indicator with greater precision for estimating cardiometabolic risk, being a study with a low risk of bias, and having national representativity. In addition, it is important because the waist-height ratio is inexpensive and easy to use. It is also superior to BMI and ideal for application in Peru. In addition, the general conclusion of the study is valid; however, the lack of evaluation of temporality due to the same characteristic of the study (cross-sectional study) and the residual bias that it has by not evaluating some variables, makes it necessary to carry out a longitudinal study to be able to support the results of the study. The present critical review finds internal validity in the results of the study, but at the moment they would not be applicable to generalize to the entire population due to the residual bias.
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RESUMEN Introducción: Actualmente se ha observado que la hipovitaminosis D y la obesidad pueden influir en el desarrollo de enfermedad cardiovascular en el futuro. Objetivo: Identificar la asociación entre deficiencia de vitamina D y factores de riesgo cardiometabólicos en los pacientes pediátricos del noroeste de México. Materiales y métodos : se incluyeron niños de 6 a 15 años, se les midieron variables somatométricas, niveles séricos de colesterol total, C-HDL, C-LDL, triglicéridos, glucosa, insulina, vitamina D e índice HOMA-IR. Se identificó la asociación de factores de riesgo cardiometabólicos y la deficiencia de vitamina D, mediante la prueba de Chi cuadrado. Resultados: De los 114 pacientes evaluados, se detectó eutrofia en 42.1%, sobrepeso en 12.3%, obesidad en 41.2% y desnutrición en 4.4%. La prevalencia de deficiencia en vitamina D, insuficiencia y suficiencia fueron 18.4%, 27.2% y 54.4% respectivamente. La deficiencia de vitamina D mostró mayor predominio en pacientes con obesidad (27 %). La hipertrigliceridemia se asoció estadísticamente con deficiencia de vitamina D (p 0.041). Se observaron correlaciones inversas entre niveles de vitamina D con HOMA (r=-0.191; p=0.41), score Z IMC (r=-0.210; p=0.025) e insulina (r=-0.227; p=0.015). Conclusiones: La deficiencia de vitamina D se asocia en niños con un IMC elevado y resistencia a la insulina, lo cual puede acelerar el desarrollo de síndrome metabólico, diabetes mellitus tipo 2 y enfermedad cardiovascular.
ABSTRACT Introduction: It has currently been observed that hypovitaminosis D and obesity can influence the future development of cardiovascular disease. Objective: To identify the association between vitamin D deficiency and cardiometabolic risk factors in pediatric patients from northwestern Mexico. Materials and methods: Children aged 6 to 15 years were included, somatometric variables, serum levels of total cholesterol, HDL-C, LDL-C, triglycerides, glucose, insulin, vitamin D and HOMA-IR index were measured. The association of cardiometabolic risk factors and vitamin D deficiency was identified using the Chi square test. Results: Of the 114 patients evaluated, normal body-mass index was detected in 42.1%, 12.3% were overweight, 41.2% were obese and 4.4% were malnourished. The prevalence of vitamin D deficiency, insufficiency and sufficiency were 18.4%, 27.2% and 54.4% respectively. Vitamin D deficiency was more prevalent in obese patients (27%). Hypertriglyceridemia was statistically associated with vitamin D deficiency (p = 0.041). Inverse correlations were observed between vitamin D levels with HOMA (r = -0.191; p = 0.41), BMI Z score (r = -0.210; p = 0.025) and insulin (r = -0.227; p = 0.015). Conclusions: Vitamin D deficiency is associated with a higher BMI and insulin resistance in children, which can accelerate the development of metabolic syndrome, type 2 diabetes mellitus and cardiovascular disease.
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RESUMEN Fundamento las enfermedades no transmisibles han estado entre las primeras causas de morbi-mortalidad en el mundo y en Cuba desde hace más de 20 años. Entre ellas se destacan: la obesidad, la hipertensión arterial y la diabetes mellitus. Estas patologías aparecen desde la infancia y su prevención debe comenzar desde edades tempranas. Objetivo: determinar la obesidad, estratificar el riesgo cardiometabólico y promover estilos de vida saludable en escolares de Santa Clara. Métodos se realizó una investigación epidemiológica, descriptiva con diseño transversal a 959 escolares entre 8 y 12 años de Santa Clara y entre los años 2012 al 2020. Se desarrollaron programas computacionales, que permitieron estudiar la obesidad y calcular los índices de masa corporal, de cintura-cadera y de cintura-talla. Se incluyeron variables como: edad, sexo, color de la piel, peso, talla, circunferencia de la cintura, circunferencia de la cadera, tensión arterial, antecedentes patológicos personales y familiares, complementarios de laboratorio clínico, electrocardiogramas y ecocardiogramas. Se emplearon tablas de contingencia con doble entrada, para registrar la frecuencia de aparición de los valores de dos variables simultáneamente. Se aplicaron pruebas no paramétricas, como el Chi Cuadrado para independencia de factores y prueba de hipótesis de diferencia de proporción para grupos independientes. Resultados se detectaron un 17,94 % de escolares con sobrepeso y 15,95 % con obesidad. Fueron obesos moderados 4,48 % y 9,18 % severos. Aumentaron las medias de colesterol, triglicéridos y ácido úrico con el grado de obesidad. Se desarrollaron estimaciones de riesgo cardiometabólico en formatos Androide y WEB. Conclusiones existen altos porcentajes de obesos y sobrepesos. El índice cintura-cadera fue el mejor predictor de riesgo cardiometabólico en la investigación realizada en Santa Clara. Se requiere una mayor intervención clínica y educativa, que garantice la adopción de estilos de vida más saludable.
ABSTRACT Background: noncommunicable diseases have been among the leading causes of morbidity and mortality in the world and in Cuba for more than 20 years. These include: obesity, high blood pressure and diabetes mellitus. These pathologies appear from childhood and their prevention must begin from an early age. Objectives: to determine obesity, stratify cardiometabolic risk and promote healthy lifestyles in schoolchildren from Santa Clara. Methods: an epidemiological, descriptive investigation with a cross-sectional design was carried out on 959 schoolchildren between 8 and 12 years of age in Santa Clara and between 2012 and 2020. Computer programs were developed, which allowed studying obesity and calculating body mass indexes, waist -hip and waist-height. Variables were included such as: age, sex, skin color, weight, height, waist circumference, hip circumference, blood pressure, personal and family pathological history, clinical laboratory tests, electrocardiograms and echocardiograms. Double-entry contingency tables were used to record the frequency of appearance of the values of two variables simultaneously. Non-parametric tests were applied, such as Chi Square for factor independence and proportion difference hypothesis test for independent groups. Results: 17.94 % of schoolchildren were overweight and 15.95 % obese. 4.48 % were moderately obese and 9.18 % were severely obese. The means of cholesterol, triglycerides and uric acid increased with the degree of obesity. Cardiometabolic risk estimates were developed in Android and WEB formats. Conclusions: there are high percentages of obese and overweight. The waist-hip ratio was the best predictor of cardiometabolic risk in the study conducted in Santa Clara. Greater clinical and educational intervention is required, which guarantees the adoption of healthier lifestyles.
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INT RODUCTIO N: Th e eld erly h ypert en si ve pa ti ent s of ten h aveincreased prevalence of cardiometabolic risk factors and their attendantco-morbidities. The aim of this study was to determine the prevalenceof cardiometabolic risk factors and blood pressure control among elderlyhypertensive patients, and to determine the influence of modifiablecardiometabolic risk factors on the control of hypertension amongelderly hypertensive patients.SUBJECTS AND METHODS: A case-control comparative and hospital-based study involving a total of 190 consenting elderly (>65 years),hypertensive patients (subjects) (n=100) and normotensive controls(n=90) was carried out over a period of ten months. Using interviewer-administered questionnaire, biodata and information regarding theirlifestyle was obtained. Standard protocols were used to measure bloodpressure, weight, height, waist circumference, fasting plasma glucoseand fasting lipid profile of the subjects. Body mass index was derivedfrom weight and height.RESULTS: The mean age of the subjects was 71.5 ± 6.3 years and thecontrols was 72.3 ± 7.2 years. Forty-eight percent (48%) and 47.8% ofthe subjects and controls were females (p = 0.651). The level of controlof hyperten sion was poor in over two-thirds (68%) of the elderlyhypertensive patients. The prevalence of modifiable cardiometabolicrisk factors burden was higher in the hypertensive subjects when comparedwith the controls. Prevalence of Dyslipidaemia was 76% in the subjectsand 51% in the controls (p = 0.004). Prevalence of Diabetes Mellituswas 40% among the subjects and 17.8% in the controls (p = 0.0001);prevalence of Obesity was 24% in the subjects and 4.4% in the controls(p=<0.001); prevalence of excess alcohol intake was 49% in the subjectsand 14.4% in the controls (p=<0.001). Prevalence of sedentary lifestyle was high in both the subjects (53%) and controls (50%), p=0.679.Poor blood pressure control was predicted by dyslipidaemia and centralobesity.CONCLUSION: The level of control of hypertension was poor amongthe elderly and modifiable cardiometabolic risk factors were relativelyprevalent. Central obesity and dyslipidaemia were predictive of poorcontrol of hypertension. Addressing these factors may therefore improveblood pressure control
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Humanos , Presión Arterial , Factores de Riesgo Cardiometabólico , Presión Sanguínea , Anciano , MorbilidadRESUMEN
RESUMEN Introducción: La enfermedad renal crónica afecta alrededor de la décima parte de la población mundial y los métodos analíticos que más se utilizan para su diagnóstico tienen una baja sensibilidad y precisión. Objetivo: Determinar las concentraciones de cistatina C para la evaluación del filtrado glomerular en fases predialíticas de la enfermedad renal crónica. Métodos: Se realizó un estudio descriptivo, transversal. El universo de estudio estuvo conformado por 102 pacientes con enfermedad renal crónica en estadios del uno al cuatroque se atendieron en consulta externa del servicio de Nefrología.La muestra fueron 81 pacientes que no presentaron factores modificadores del filtrado glomerular, creatinina y cistatina C relacionados con la enfermedad renal crónica. Resultados: Predominaron los pacientes mayores de 61 años. La cistatina C se elevó en más pacientes que la creatinina. La cistatina C se elevó por igual en ambos sexos y la creatinina más en hombres. La media de los resultados se alejó más de la media del valor de referencia en la cistatina C y la creatinina no presentó valores normales en pacientes con insuficiencia renal crónica. Las ecuaciones que utilizan la cistatina C fueron mejor predictoras de daño renal. Conclusiones: La cistatina C fue mejor predictora de daño renal.
ABSTRACT Introduction: The renal chronic disease affects around a tenth part of the worldwide population and the most used analytical methods for its diagnosis have a low sensibility and precision. Objective: To determine cystatin C's concentrations for evaluation of glomerular masking in pre-dialytic phases of the renal chronic disease. Methods: A descriptive, cross-sectional study was carried out.The study universe was made up of 102 patients with chronic kidney disease in stages from one to four who were treated in an outpatient department of the Nephrology service. The samplewas 81 patients who did not present the modifier factors of glomerular masking, creatinine and cystatin C related with the renal chronic disease. Results: The patients older than 61 years predominated. The cystatin C augmented in more patients than the creatinine. The cystatin C augmented equally in both sexes and the creatinine more in men. The average of the results moved away over the average of the value of reference in the cystatin C and the creatinine did not present normal values in patients with renal chronic insufficiency. The equations that they use cystatin C were better forecaster of damage renal. Conclusions: The cystatin C was the best predictor of renal damage.
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RESUMEN Introducción: La retinopatía diabética es la complicación microvascular más común de la diabetes mellitus. Niveles elevados de glucosa en sangre inducen cambios estructurales, fisiológicos y hormonales que afectan a los capilares de la retina. La retinopatía inicia su desarrollo al menos siete años antes del diagnóstico de diabetes mellitus tipo 2. Objetivo: Describir el comportamiento dela retinopatía diabética en pacientes atendidos en la consulta de Retina del Hospital Universitario Manuel Ascunce Domenech de la provincia Camagüey. Métodos: Se realizó un estudio descriptivo, longitudinal en pacientes con el diagnóstico de retinopatía diabética. La población la conformaron 330 pacientes que acudieron a la consulta, en el periodo de enero a noviembre 2019 y que cumplieron con los criterios de selección. Se diseñó un formulario de recolección de datos y se estudiaron variables independientes: edad, sexo, factores de riesgo, tiempo de evolución de la enfermedad y como variable dependiente la severidad de la retinopatía. Resultados: El comportamiento de los grupos de edades entre 41 y 60 años, fue más frecuente, seguido de pacientes entre 20 y 40 año que padecieron de retinopatía diabética proliferativas. El mal control glucémico fue el factor de riesgo más frecuente, seguido de la hipertensión arterial. Entre 17 y 21 años de enfermedad, se encontraron la mayor cantidad de pacientes, seguido de los pacientes de 22 a 27 años de enfermedad. Conclusiones: Predominó en el estudio la edad entre 41 y 60 años. Todos los pacientes presentaron más de un factor de riesgo. El mal control glucémico y la hipertensión arterial fueron los factores de riesgo más frecuente en el estudio. El tiempo de evolución de la enfermedad predominó entre 17 y 21 años. Existió relación entre edad del paciente, factores de riesgo y tiempo de evolución de la enfermedad con la severidad de la retinopatía diabética, donde predominó la retinopatía diabética proliferativa.
ABSTRACT Introduction: Diabetic retinopathy isthemostcommonmicrovascularcomplication of diabetes mellitus. Elevatedlevels of glucose in theblood induce structural, physiological and hormonal changesthataffectthecapillaries of the retina. Retinopathy beginsitsdevelopment at leastsevenyearsbeforethe diagnosis of type 2 diabetes mellitus. Objective: To describe thebehavior of diabetic retinopathy in patientstreated at the Retina clinic of the Manuel Ascunce Domenech University Hospital in Camagüey province. Methods: Adescriptive, longitudinal study in patientswiththe diagnosis of diabetic retinopathy wascarriedout. 330 patientsthatattendedtheretinalconsultation in theperiodfromJanuarytoNovember, 2019 and thattheyfulfilledtheselectioncriteria, conformedthepopulation. A collectingfill-outform of data wasdesigned and independent variables: Age, sex, risk factors, time of evolution of disease and likedependent variable theseverity of retinopathy, werestudied. Results: Thebehavior of theagegroupsbetween 41 and 60 years, was more frequent, followedbypatientsbetween 20 and 40 yearthattheysufferedfromproliferative diabetic retinopathy. Thebadglycemic control wasthemostfrequent risk factor, followedbyhighbloodpressure. Thegreatestquantity of patientshadbetween 17 and 21 years of disease, followedbythosepatientsbetween 22 and 27 years of disease. Conclusions: Theagebetween 41 and 60 yearsprevailed in thestudy. Allpatientshad more thanone risk factor. Poor glycemic control and arterial hypertensionwerethemostfrequent risk factors in thestudy. Thedisease'sevolution time between 17 and 21 years of illnesspredominated. Therewas a relationshipbetweenthepatient'sage, risk factors and time of evolution of thediseasewiththeseverity of diabetic retinopathy, whereproliferative diabetic retinopathy predominated.
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RESUMO Objetivo: verificar os efeitos do autocuidado apoiado sobre o perfil pressórico e cardiometabólico de hipertensos. Método: ensaio clínico randomizado desenvolvido com 78 hipertensos acompanhados pela Estratégia Saúde da Família do município de Cajazeiras - PB - Brasil. A intervenção consistiu na aplicação de consultas de enfermagem baseadas no autocuidado apoiado. O grupo controle seguiu com o acompanhamento habitual da equipe de saúde. Para a coleta de dados foi utilizado um questionário sociodemográfico e clínico, análise de sangue, verificação da pressão arterial e das medidas antropométricas. Resultados: houve redução do peso, da circunferência abdominal, da relação cintura/quadril e do Índice de Massa Corporal no grupo intervenção, com melhora significativa da pressão arterial. Nenhuma melhora significativa foi visualizada no grupo controle. Conclusão: o autocuidado apoiado mostrou efeitos positivos sobre o perfil pressórico e cardiometabólico dos participantes, minimizando fatores de risco e configurando uma metodologia com potencial promissor quando aplicada pelo enfermeiro. REBEC - RBR-5m5qg8.
ABSTRACT Objective: to verify the effects of supported self-care on the blood pressure and cardiometabolic profile of hypertensive individuals. Method: randomized clinical trial developed with 78 hypertensive patients monitored by the Family Health Strategy in the municipality of Cajazeiras - PB - Brazil. The intervention consisted of nursing consultations based on supported self-care. The control group followed up with the usual monitoring by the health team. For data collection, a sociodemographic and clinical questionnaire, blood tests, blood pressure and anthropometric measurements were used. Results: There was a reduction in weight, abdominal circumference, waist-to-hip ratio, and Body Mass Index in the intervention group, with significant improvement in blood pressure. No significant improvement was seen in the control group. Conclusion: supported self-care showed positive effects on the participants' blood pressure and cardiometabolic profile, minimizing risk factors and configuring a methodology with promising potential when applied by nurses. REBEC - RBR-5m5qg8
RESUMEN Objetivo: verificar los efectos del autocuidado apoyado en la presión arterial y el perfil cardiometabólico de los pacientes hipertensos. Material y método: ensayo clínico aleatorio desarrollado con 78 pacientes hipertensos controlados por la Estrategia de Salud de la Familia en el municipio de Cajazeiras - PB - Brasil. La intervención consistió en la aplicación de consultas de enfermería basadas en el autocuidado apoyado. El grupo de control siguió con el control habitual del equipo sanitario. Para la recogida de datos se utilizó un cuestionario sociodemográfico y clínico, análisis de sangre, presión arterial y mediciones antropométricas. Resultados: hubo una reducción del peso, la circunferencia abdominal, la relación cintura/cadera y el índice de masa corporal en el grupo de intervención, con una mejora significativa de la presión arterial. No se observó ninguna mejora significativa en el grupo de control. Conclusión: el autocuidado apoyado mostró efectos positivos sobre la presión arterial y el perfil cardiometabólico de los participantes, minimizando los factores de riesgo y configurando una metodología con un potencial prometedor cuando es aplicada por las enfermeras. REBEC - RBR-5m5qg8.
Asunto(s)
Factores de Riesgo , HipertensiónRESUMEN
Objetivo: A síndrome dos ovários policísticos (SOP) é uma alteração endócrina comum em mulheres que estão em fase reprodutiva. Essa patologia pode estar relacionada a fatores de risco para o desenvolvimento de complicações cardiometabólicas, o que a torna um tema relevante para discussão, visto sua grande prevalência na população feminina. Trata-se de uma revisão integrativa da literatura com o objetivo de identificar os fatores de risco associados à SOP e verificar se há maior risco cardiovascular para as mulheres com essa síndrome. Fonte de dados: Foi realizada uma busca nas bases de dados Biblioteca Virtual de Saúde, National Library of Medicine, Scientific Eletronic Library Online e EbscoHost, com os seguintes descritores: "Síndrome do ovário policístico e riscos cardiovasculares"; "Mulheres, policístico e riscos cardiovasculares"; "Ovário policístico e riscos" e "Mulheres, ovários policísticos"; "Polycystic ovary and risks"; "Polycystic ovary syndrome and cardiovascular risk" e "Polycystic ovaries and cardiovascular". Seleção de estudos: Foram encontrados 21 artigos, dos quais 15 atenderam aos critérios de inclusão previamente estabelecidos. Foram incluídos os artigos originais e as publicações entre o período de 2014 e 2021 que relacionavam diretamente a síndrome aos riscos cardiovasculares, síndromes metabólicas e alterações lipídicas. Coleta de dados: A estratégia de seleção dos artigos foi realizada mediante busca nas bases de dados selecionadas, leitura dos títulos de todos os artigos encontrados e exclusão daqueles que não abordavam o assunto, leitura crítica dos resumos dos artigos e leitura na íntegra dos artigos selecionados nas etapas anteriores. Síntese de dados: Todos os autores afirmam que a síndrome é um distúrbio ovulatório e metabólico, uma vez que a resistência à insulina e a consequente hiperinsulinemia compensatória podem ser exacerbadas pela coexistência da obesidade, presente em muitas mulheres com SOP. Além disso, foram identificados os fatores de risco tradicionais para o desenvolvimento de doenças cardiovasculares, e 93,33% dos artigos analisados demonstraram que, entre as mulheres com a síndrome, alguns fatores de risco para o desenvolvimento de tais doenças parecem apresentar uma chance maior de estarem presentes. Conclusão: Ao final dessa revisão, foi possível responder à pergunta clínica proposta, pois todos os artigos pesquisados concluíram e trouxeram estudos comprovando que mulheres com a SOP possuem maiores chances de desenvolver algum problema cardiovascular precoce, devido a fatores como o hiperandrogenismo e o aumento da gordura visceral e da resistência insulínica.(AU)
Objective: Polycystic ovary syndrome is an endocrine disorder, common in women who are in the reproductive phase. This pathology may be related to risk factors for the development of cardiometabolic complications, which makes it a relevant topic for discussion, given its high prevalence in the female population. This is an integrative literature review with the aim of identifying the risk factors associated with polycystic ovary syndrome and verifying whether there is a higher cardiovascular risk for women with this syndrome. Data source: A search was performed in the Virtual Health Library databases; National Library of Medicine; Scientific Electronic Library Online and EbscoHost, with the following descriptors: "Polycystic ovary syndrome and cardiovascular risks"; "Women, polycystic and cardiovascular risks"; "Polycystic ovaries and risks" and "Women, polycystic ovaries"; "Polycystic ovary and risks"; "Polycystic ovary syndrome and cardiovascular risk" and "Polycystic ovaries and cardiovascular". Study selection: Twenty-one articles were found, of which 15 met the previously established inclusion criteria. Original articles and publications between the period 2014 and 2021 that directly related the syndrome to cardiovascular risks, metabolic syndromes and lipid disorders were included. Data collect: The article selection strategy was performed by searching the selected databases; reading the titles of all articles found and excluding those that did not address the subject; critical reading of the abstracts of the articles and full reading of the articles selected in the previous steps. Data synthesis: All authors state that the Syndrome is an ovulatory and metabolic disorder, since insulin resistance and consequent compensatory hyperinsulinemia can be exacerbated by the coexistence of obesity, present in many women with polycystic ovary syndrome. In addition, traditional risk factors for the development of cardiovascular diseases were identified, with 93.33% of the articles analyzed showing that, among women with the syndrome, some risk factors for the development of such diseases seem to have a chance greater than being present. Conclusion: At the end of this review, it was possible to answer the proposed clinical question, as all the researched articles concluded and brought studies proving that women with polycystic ovary syndrome are more likely to develop an early cardiovascular problem, due to factors such as hyperandrogenism, the increase in visceral fat and insulin resistance.(AU)
Asunto(s)
Humanos , Femenino , Síndrome del Ovario Poliquístico/complicaciones , Factores de Riesgo de Enfermedad Cardiaca , Factores de Riesgo Cardiometabólico , Bases de Datos Bibliográficas , Hiperandrogenismo/complicaciones , Síndrome Metabólico/patologíaRESUMEN
SUMMARY OBJECTIVE: This study aimed to describe the prevalence of acanthosis nigricans and high blood pressure in children and adolescents from low-income families, and to verify the association of elevated blood pressure with nutritional status and the presence of acanthosis nigricans. METHODS: This is a cross-sectional and controlled study with 232 children and adolescents from an institution for low-income families. Pubertal stage, body mass index Z-score, waist-to-height circumference ratio (increased waist-to-height circumference ratio >0.5), the presence of acanthosis nigricans, and blood pressure were assessed. RESULTS: The prevalence of excess weight and the change in waist-to-height circumference ratio was 37.9%. Acanthosis nigricans and increased blood pressure occurred in 20.3 and 34.8%, respectively. The prevalence of acanthosis nigricans and hypertension was higher in individuals with excess weight (p<0.001; p<0.001) and with an increased waist-to-height circumference ratio (p=0.009; p<0.001). Logistic regression showed a significant and independent association of body mass index Z-score (OR 2.35; 95%CI 1.52-3.65; p<0.001) and the presence of acanthosis nigricans (OR 2.43; 95%CI 1.12-5.23; p=0.023) with elevated blood pressure. CONCLUSION: Acanthosis nigricans and elevated blood pressure occurred in one-fifth and one-third of the individuals in an institution for children from low-income families. Overweight and the presence of acanthosis nigricans increased the risk of high blood pressure more than twofold.