Association between psoriasis and thyroid function: results from the Brazilian Longitudinal Study of Adults Health (ELSA-Brasil)

ABSTRACT Objective: To determine the relationship between psoriasis, thyroid-stimulating hormone (TSH), free thyroxine (FT4), free triodothyronine (FT3), thyroid peroxidase antibodies (TPOAb), and subclinical thyroid dysfunctions in middle-aged and older adults. Materials and methods: Cross-sectional analyses included a self-reported medical diagnosis of psoriasis and thyroid function from the 3rd visit (2017-2019) of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). TSH, FT4, and FT3 levels were analyzed as continuous variables and quintiles, and TPOAb positivity and subclinical hypothyroidism as a yes/no variable. Logistic regression models were built as crude and adjusted by main confounders (age, sex, education level, race/ethnicity, and smoking). Results: From 9,649 participants (52.3% women; 59.2 ± 8.7 years old), the prevalence of psoriasis was 2.8% (n = 270). TSH, FT4, TPOAb positivity, and subclinical hypothyroidism were not associated with psoriasis in the main analyses. In the stratified analysis, our findings showed positive associations of the lowest (OR = 2.01; 95% CI 1.05-3.84; p = 0.036) and the highest (OR = 2.13; 95% CI 1.12-4.05; p = 0.022) quintiles of FT4 and a protective association of TPOAb positivity (OR = 0.43; 95% CI 0.19-0.98; p = 0.046) with prevalent psoriasis in women. In the logistic regression for FT3, participants in the 1st quintile showed a statistically significant association with psoriasis for the whole sample (OR = 1.66; 95% CI 1.11-2.46; p = 0.013) and for men (OR = 2.25; 95% CI 1.25-4.04; p = 0.007) in the sex-stratified analysis. Conclusions: The present study showed that the association of FT4 levels with psoriasis are different according to sex, with a possible U-shaped curve in women but not in men. Although there were some associations of FT3 with psoriasis, they may be a consequence of non-thyroidal illness syndrome. Further prospective data may clarify the association of thyroid function and psoriasis.

Does physical activity moderate the association between device-measured sedentary time patterns and depressive symptoms in adults?

Objectives: To investigate the association between sedentary time (ST) patterns and depressive symptoms, and whether moderate-to-vigorous physical activity (MVPA) can moderate this association. Methods: This cross-sectional study included a representative sample of 243 adults (mean age 41.8±16.7 years, 56.4% women) from a city in Southeast Brazil. Depressive symptoms were estimated through the Hospital Anxiety and Depression Scale (HADS). ST patterns (i.e., number of breaks, mean length of sedentary bouts, and number of long sedentary bouts), total ST, and MVPA were assessed using accelerometers. Results: Poisson regression models revealed associations of total ST (β = 0.063; 95%CI 0.011 to 0.116) and number of long bouts (0.108; 0.047 to 0.171) with depressive symptoms among men. MVPA moderated the associations of breaks and longer bouts of ST with depressive symptoms, with an increase of one break/hour, the increase of one long bout, and a decrease of 1 minute in mean bout length being associated with a reduction of 0.211 and increases of 0.081 and 0.166, respectively, in the number of depressive symptoms among men with physical inactivity (breaks = -0.211; -0.360 to -0.063; mean bout length = 0.081; 0.003 to 0.158; number of long bouts = 0.166; 0.090 to 0.242). Conclusions: Interventions that encourage breaking up ST should be helpful to reduce depressive symptoms among people with physical inactivity. Clinical trial registration: ClinicalTrials.gov (NCT03986879).

Chronic inflammatory diseases, subclinical atherosclerosis, and cardiovascular diseases: Design, objectives, and baseline characteristics of a prospective case-cohort study ‒ ELSA-Brasil

Abstract Objectives This analysis describes the protocol of a study with a case-cohort to design to prospectively evaluate the incidence of subclinical atherosclerosis and Cardiovascular Disease (CVD) in Chronic Inflammatory Disease (CID) participants compared to non-diseased ones. Methods A high-risk group for CID was defined based on data collected in all visits on self-reported medical diagnosis, use of medicines, and levels of high-sensitivity C-Reactive Protein >10 mg/L. The comparison group is the Aleatory Cohort Sample (ACS): a group with 10% of participants selected at baseline who represent the entire cohort. In both groups, specific biomarkers for DIC, markers of subclinical atherosclerosis, and CVD morbimortality will be tested using weighted Cox. Results The high-risk group (n = 2,949; aged 53.6 ± 9.2; 65.5% women) and the ACS (n=1543; 52.2±8.8; 54.1% women) were identified. Beyond being older and mostly women, participants in the high-risk group present low average income (29.1% vs. 24.8%, p < 0.0001), higher BMI (Kg/m2) (28.1 vs. 26.9, p < 0.0001), higher waist circumference (cm) (93.3 vs. 91, p < 0.0001), higher frequencies of hypertension (40.2% vs. 34.5%, p < 0.0001), diabetes (20.7% vs. 17%, p = 0.003) depression (5.8% vs. 3.9%, p = 0.007) and higher levels of GlycA a new inflammatory marker (p < 0.0001) compared to the ACS. Conclusions The high-risk group selected mostly women, older, lower-income/education, higher BMI, waist circumference, and of hypertension, diabetes, depression, and higher levels of GlycA when compared to the ACS. The strategy chosen to define the high-risk group seems adequate given that multiple sociodemographic and clinical characteristics are compatible with CID.

Is physical activity associated with resting heart rate in boys and girls? A representative study controlled for confounders / A atividade física está associada à frequência cardíaca de repouso em meninos e meninas? Estudo representativo controlado para fatores de confusão

Abstract Objective: Investigate the relationship between different domains of physical activity and resting heart rate (RHR) in boys and girls. Method: The sample included 1011 adolescents, aged between 10 and 17 years. RHR was measured by a heart rate monitor and physical activity was assessed in total and in three different domains (school, occupational, and sports practice) by a questionnaire. Anthropometry was directly obtained for body mass index and central fat. Ethnicity, sedentary behavior, and smoking habits were self-reported and used to adjust the analysis, through hierarchical linear regression. Results: Total physical activity was associated with low RHR in boys (β = −0.52; 95% CI: −0.92, −0.12) and girls (β = −0.67; 95% CI: −1.07, −0.28). Although sporting physical activities were associated with low RHR in both boys (β = −0.58; 95% CI: −1.05, −0.11) and girls (β = −0.87; 95% CI: −1.34, −0.39), occupational physical activity was related to low RHR only in boys (β = −1.56; 95% CI: −2.99, −0.14). Conclusion: The practice of physical activity in the sport practice domain and total physical activity were related to low RHR in both sexes, while occupational physical activities were associated with RHR only in boys.

Resumo Objetivo Investigar a relação entre diferentes domínios de atividade física e frequência cardíaca de repouso (FCRep) em meninos e meninas. Método A amostra incluiu 1.011 adolescentes, entre 10 e 17 anos. A FCRep foi medida por um monitor de frequência cardíaca e a atividade física foi avaliada no total e em três diferentes domínios (escolar, ocupacional e prática esportiva) através de um questionário. A antropometria foi obtida diretamente para o índice de massa corporal e gordura central. Etnia, comportamento sedentário e tabagismo foram autorrelatados e usados para ajustar a análise, através da regressão linear hierárquica. Resultados A atividade física total foi associada à baixa FCRep nos meninos (β = −0,52; IC95% −0,92; −0,12) e meninas (β = −0,67; IC95% −1,07; −0,28). Embora as atividades físicas esportivas estivessem associadas à baixa FCRep em ambos, meninos (β = −0,58; IC95% −1,05, −0,11) e meninas (β = −0,87; IC95% −1,34, −0,39), a atividade física ocupacional estava relacionada à baixa FCRep apenas em meninos (β = −1,56; IC95% −2,99; −0,14). Conclusão A prática de atividade física no domínio da prática esportiva e a atividade física total foram relacionadas à baixa FCRep em ambos os sexos, enquanto as atividades físicas ocupacionais foram associadas à FCRep apenas em meninos.

Physical activity of parents and of their children: a systematic review of Brazilian sample studies - Report Card Brazil / Atividade física de pais e filhos: uma revisão sistemática de estudos com amostras brasileiras - Report Card Brazil

Abstract The aim of this study was systematically review the researches in regard the association of PA of parents and the PA of their children. A literature search was performed in five databases (Medline, Embase, Cinahl, Lilacs and SciELO) using combined terms about youth, PA and social support, with restriction to publications with Brazilian sample and to English and Portuguese language. Thirteen studies were included in this review and was observed a positive association of parental PA and the PA of their children for the majority of the studies (n=11). Only two studies did not observed significant association between PA of parents and their children and, otherwise, it was not observed negative associations in the review. It was observed different associations according to the gender of both parents and children. This findings support the importance for the practice of PA by parents as encouragement for the practice of PA by their children among Brazilians. The strategies to promote the increase in practice of physical activity of children and adolescents of both genders may consider the social support as an important factor, especially in relation to the practice of PA of their parents.

Resumo O objetivo do presente estudo foi revisar sistematicamente estudos que analisaram a associação da prática de atividade física de pais e filhos. Foi realizada uma busca sistemática em cinco bases de dados (Medline, Embase, Cinahl, Lilacs e SciELO), por meio da combinação de termos sobre crianças e adolescentes, atividade física e suporte social, sendo restrita a estudos contendo amostras brasileiras e escritos em Inglês e/ou Português. Foram incluídos treze estudos na presente revisão e foi observada associação positiva da prática de atividade física de pais e filhos na maioria dos estudos (n=11). Somente dois estudos não observaram associação significativa da atividade física de pais e filhos, contudo não foram observadas associações negativas. Foram observadas diferentes associações de acordo com o gênero tanto dos pais quanto dos filhos. Estes achados ressaltam a importância da prática de atividade física dos pais como incentivo à prática de atividade física dos filhos em amostras brasileiras. Estratégias de promoção da prática de atividade física em crianças e adolescentes de ambos os sexos devem considerar o suporte social como um fator importante, especialmente a respeito da prática de atividade física dos pais.

Obesidade abdominal: prevalência, fatores sociodemográficos e de estilo de vida associados em adolescentes / Abdominal obesity: prevalence, sociodemographic and lifestyle-associated factors in adolescents

INTRODUCTION: Among human development stages, adolescence comprises the period in which intense somatic and behavioural changes occur¹. In this period of life, the presence of detrimental health habits can be consolidated until and into adulthood, and can be a precursor for higher risk of mortality and chronic diseases. OBJECTIVE: The aim of this study was to determine the prevalence of abdominal obesity and its associated factors among adolescents, independent of confounders. METHODS: A sample of 14-17-year-old individuals (n = 1.231), who were students from Londrina/PR - Brazil public schools, was studied. A questionnaire about physical activity, sedentary behaviour and socioeconomic conditions was applied. Anthropometry was composed of body weight (kg), height (m), body mass index (BMI = kg/m²) and waist circumference (cm). The association of abdominal obesity and independent variables was assessed using the chi-square test and the magnitude of associations was verified using Binary Logistic Regression in an unadjusted model and adjusted for confounders (gender, age, socioeconomic status, physical activity and sedentary behaviour). The confidence interval and statistical significance were set at 95% and 5%, respectively, using SPSS v15.0. RESULTS: The abdominal obesity prevalence was 17.5% (CI = 15.4%-19.6%), and was higher in boys than in girls. Adolescents with abdominal obesity had higher values of body weight, height, body mass index and sedentary behaviour compared to eutrophic individuals. Being male increased the risk of abdominal obesity by 36% in adolescents. This risk was two times higher in those with high levels of sedentary behaviour. CONCLUSION: Abdominal obesity was significantly associated with gender and high levels of sedentary behaviour, regardless of confounding factors. Lifestyle habits are important modifiable risk factors that can effectively contribute to the reduction of obesity from an early age.

OBJETIVO: Verificar a prevalência de obesidade abdominal e fatores associados em adolescentes brasileiros, independentemente de fatores de confusão. MÉTODO: Amostra composta por adolescentes de 14 a 17 anos (n = 1.231), alunos de escolas públicas de Londrina/PR-Brasil. Um questionário sobre o nível de atividade física, comportamento sedentário e condições socioeconômicas foi aplicado. A antropometria foi composta por peso corporal (kg), estatura (m), índice de massa corporal (IMC = kg/m²) e circunferência de cintura (cm). A associação entre obesidade abdominal e as variáveis independentes foi verificada pelo teste qui-quadrado e a magnitude das associações verificada por Regressão Logística Binária no modelo não-ajustado e ajustado por confundidores (sexo, idade, nível socioeconômico, atividade física e comportamento sedentário). O intervalo de confiança e a significância estatística foram fixados em 95% e 5%, respectivamente, por meio da utilização do programa estatístico SPSS v15.0. RESULTADOS: A prevalência de obesidade abdominal foi de 17,5% (IC = 15,4%-19,6%) em adolescentes brasileiros, sendo maior em meninos do que em meninas. Indivíduos com obesidade abdominal apresentaram maiores valores de peso corporal, estatura, índice de massa corporal e comportamento sedentário do que indivíduos eutróficos. Ser do sexo masculino elevou em 50% o risco de adolescentes apresentarem obesidade abdominal. Esse risco foi duas vezes maior nos que tiveram elevado comportamento sedentário. CONCLUSÃO: Obesidade abdominal foi associada significativamente ao sexo e ao elevado comportamento sedentário, independentemente de fatores de confusão. Hábitos de vida são importantes fatores de risco modificáveis que podem contribuir efetivamente na redução da obesidade desde idades precoces.