Método indirecto para la verificación del intervalo de referencia del perfil lipídico / Indirect method for the verification of the lipid profile reference range

Introducción: La dislipidemia es uno de los problemas más frecuentes en los niños y adolescentes y su estudio es importante debido a su fuerte correlación con la enfermedad cardiovascular aterosclerótica en adultos. Muchos países desarrollaron valores de referencia nacionales investigando los lípidos séricos utilizando datos basados en la población nacional propia. Nuestro objetivo fue verificar el intervalo de referencia del perfil lipídico calculando las curvas de percentiles a través del método indirecto en nuestra población pediátrica. Materiales y métodos: Se analizaron los resultados de nuestra base de datos utilizando el método indirecto. Luego de aplicar filtros y criterios de exclusión se calcularon los percentiles 25, 50, 75, 95 y 99 para colesterol total (CT), colesterol HDL (C-HDL), colesterol no HDL (C-no-HDL), triglicéridos (TG) y colesterol LDL (C-LDL) y para el C-HDL además se calculó el percentil 10. El valor de referencia para el cambio (RCV) se utilizó para determinar si existía diferencia clínicamente significativa entre los valores de percentiles obtenidos y los utilizados en el consenso de la SAP. Resultados: No se evidenció diferencia clínicamente significativa contra los valores propuesto por la SAP, excepto para los TG para las edades 1,5,7 años en el percentil 95 y para la edad de 8 años en el percentil 75 y 95; para el C-HDL en el percentil 10 para las edades 1,16 y 17 años. Discusión: Se obtuvieron los percentiles de los lípidos y se compararon con los valores de referencia utilizados por el consenso en el que están basados las guías (AU)

Introduction: Dyslipidemia is one of the most common problems in children and adolescents and its study is important because of its strong correlation with atherosclerotic cardiovascular disease in adulthood. Many countries have developed national reference values investigating serum lipids using data based on their own national population. Our aim was to verify the lipid profile reference range by calculating percentile curves through the indirect method in our pediatric population. Materials and methods: The results of our database were analyzed using the indirect method. After applying filters and exclusion criteria, the 25th, 50th, 75th, 95th, and 99th percentiles were calculated for total cholesterol (TC), HDL cholesterol (HDL-C), non-HDL cholesterol (non-HDL-C), triglycerides (TG), and LDL cholesterol (LDL-C); for HDL-C, the 10th percentile was also calculated. The reference change values (RCV) were used to determine whether there was a clinically significant difference between the percentile values obtained and those used in the consensus of the Argentine Association of Pediatrics (SAP). Results: There was no clinically significant difference with the values proposed by the SAP, except for TG for ages 1, 5, and 7 years at the 95th percentile and for age 8 years at the 75th and 95th percentile; and for HDL-C at the 10th percentile for ages 1, 16, and 17 years. Discussion: Lipid percentiles were obtained and compared with the reference values used by the consensus on which the guidelines are based (AU)

Chinese expert consensus on integrated lipid management in HIV/AIDS / 中华内科杂志

Human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) are one of the global public health issues concerning health of human beings. Dyslipidemia is one of the major risk factors for cardiovascular events, while elevation of plasma cholesterol levels is associated with the onset of over 50% coronary heart disease. The incidence risks of cardiovascular diseases are higher in HIV/AIDS patients than those in normal populations. In addition to conventional risk factors, viral duplication and suboptimal treatments increase risks of atherosclerotic coronary vascular disease (ASCVD) in HIV/AIDS patients. Thus, a deep knowledge of lipid metabolism and dysregulation profiles, an efficient control of conventional ASCVD risk factors, as well as strengthened measures to lipid management, are of significance to improve long-term prognosis and life quality for HIV/AIDS patients. However, up to date, there is no particular consensus on lipid management for HIV/ADIS populations under long-term antiretroviral therapies (ART). Hereby, based on current status quo of ART in China and frontier achievements of fundamental researches and clinical trials, we invited domestic experts in fields of infectious diseases and cardiovascular diseases to compose this expert consensus on the integrated management of lipid in HIV/AIDS patients in China.

Prevalencia de hipotiroidismo subclínico y biomarcadores de riesgo cardiovascular en pacientes del Hospital General de Riobamba / Prevalence of subclinical hypothyroidism and biomarkers of cardiovascular risk in patients of the General Hospital of Riobamba

El Hipotiroidismo subclínico (HSC) es definido bioquímicamente por una elevación en la concentración sérica de la hormona TSH con niveles normales de T4 libre. El objetivo de este estudio fue determinar la prevalencia de HSC en los pacientes que asistieron a la consulta de medicina interna del Hospital General IESS de Riobamba. Así como, analizar la correlación entre los parámetros hormonales y ciertos marcadores bioquímicos asociados con el incremento de riesgo cardiovascular. Se realizó una investigación de tipo descriptiva, observacional, con un diseño no experimental de corte transversal, que abarcó el periodo comprendido desde enero de 2019 hasta septiembre de 2021. 245 pacientes fueron diagnosticados con HSC, lo cual representó el 10.58 % del universo poblacional estudiado, 61.2% eran del sexo femenino, mientras que el 38.8% del sexo masculino. El mayor número de casos (59.61 %) se observó en el grupo etario mayor de 65 años, distribuidos de la siguiente manera: (22.86% hombres y 36.75% mujeres), también se encontró que el HSC está asociado con un perfil lipídico aterogénico, caracterizado por un incremento en la concentración de colesterol total y LDL los cuales se correlacionaron positivamente con las concentraciones de TSH.

Subclinical hypothyroidism (SH) is biochemically defined by an elevation in the serum concentration of TSH hormone with normal levels of free T4. The aim of this study was to determine the prevalence of SH in patients attending the internal medicine clinic of the General Hospital IESS of Riobamba. Also, to analyze the correlation between hormonal parameters and certain biochemical markers associated with increased cardiovascular risk. A descriptive, observational, non-experimental cross-sectional design was performed, covering the period from January 2019 to September 2021. 245 patients were diagnosed with SH, which represented 10.58 % of the population universe studied, 61.2% were female, while 38.8% were male. The highest number of cases (59.61 %) was observed in the age group over 65 years, distributed as follows: (22.86% men and 36.75% women), it was also found that SH is associated with an atherogenic lipid profile, characterized by an increase in the concentration of total cholesterol and LDL which correlated positively with TSH concentrations.

Polymorphisms of the Vitamin D Receptor Gene and Sex-Differential Associations with Lipid Profiles in Chinese Han Adults / 生物医学与环境科学（英文）

OBJECTIVE@#To explore the association of single nucleotide polymorphisms (SNPs) of the vitamin D receptor gene ( VDR) with circulating lipids considering gender differences.@*METHODS@#Of the Han Chinese adults recruited from a health examination center for inclusion in the study, the circulating lipids, 25-hydroxyvitamin D (25OHD), and other parameters were measured. The VDR SNPs of Cdx2 (rs11568820), Fok1 (rs2228570), Apa1 (rs7975232), and Taq1 (rs731236) were genotyped with a qPCR test using blood DNA samples, and their associations with lipids were analyzed using logistic regression.@*RESULTS@#In the female participants ( n = 236 with dyslipidemia and 888 without dyslipidemia), multiple genotype models of Fok1 indicated a positive correlation of B (not A) alleles with LDLC level ( P < 0.05). In the male participants ( n = 299 with dyslipidemia and 564 without dyslipidemia), the recessive model of Cdx2 and the additive and recessive models of Fok1 differed ( P < 0.05) between the HDLC-classified subgroups, respectively, and Fok1 BB and Cdx2 TT presented interactions with 25OHD in the negative associations with HDLC ( P < 0.05).@*CONCLUSION@#In the Chinese Han adults included in the study, the Fok1 B-allele of VDR was associated with higher LDLC in females, and the Fok1 B-allele and the Cdx2 T-allele of VDR were associated with lower HDLC in males. The interaction of VD and Fok1 BB or Cdx2 TT in males synergistically decreased HDLC levels.

Synthesis and In Vivo Hypolipidemic Effect of Some N-(Benzoylphenyl)-Carboxamide Derivatives in Triton WR-1339-Induced Hyperlipidemic Rats

A series of N-(benzoylphenyl)-carboxamide derivatives (2a, 2b, 3a, 3b, 4a, 4b, 5a, 5b, 6a and 6b) was prepared with good yields by reacting the corresponding carbonyl chlorides with aminobenzophenones at room temperature. This was followed by evaluating the hypotriglyceridemic and hypocholesterolemic effects of 3b, 5a and 5b. Triton WR-1339 (300 mg/kg) was intraperitoneally administered to overnight-fasted rats to induce hyperlipidemia. Rats were divided into six groups: control, hyperlipidemic, hyperlipidemic plus compounds 3b, 5a and 5b and hyperlipidemic plus bezafibrate. Results showed that after 18 h of treatment at a dose of 15 mg/kg body weight of each of the test compounds, the elevated plasma levels of triglycerides (TG) and total cholesterol (TC) were significantly lowered by compounds 5b and 3b (p < 0.001) and by 5a (p < 0.0001), compared to the hyperlipidemic control group. Compounds 3b and 5a significantly increased levels of high-density lipoprotein cholesterol (HDL-C) by 58 and 71%, respectively. In addition, compounds 3b and 5a caused significant reduction (p < 0.0001) of low-density lipoprotein cholesterol (LDL-C) levels compared to the control group. These results suggest a promising potential for compounds 3b, 5a and 5b as lipid-lowering agents, which may contribute to reducing the risk of atherosclerosis and cardiovascular disease

Marein regulates insulin resistance in diabetic nephropathy mice by inducing autophagy / Marein regula la resistencia a la insulina en ratones con nefropatía diabética induciendo la autofagia

SUMMARY: Marein is the main active substance of Coreopsis tinctoria nutt. It not only has anti-oxidation and anti-tumor effects, but also can lower blood lipid, prevent high blood glucose, improve insulin resistance, inhibit gluconeogenesis and promote glycogen synthesis. However, the exact mechanism of its action is still unclear. Here, we explored the effect and mechanism of Marein on insulin resistance. The mice were divided into db/m, db/db, metformin+db/db, and marein+db/db groups. The body weight and kidney weight were recorded. Serum biochemical and renal function tests were measured after 8 weeks of continuous administration. Kidney tissues were subjected to HE staining, PAS staining, and Masson staining. The effect of marein on PI3K/Akt signal and autophagy pathway was detected by Western blot. After 8 weeks of Marein intervention, the body weight and kidney weight of mice did not change significantly, but the fasting blood glucose and blood lipid levels were significantly reduced than db/db group. Marein significantly improved the insulin resistance index, increased serum adiponectin and improved glucose and lipid metabolism disorders of db/db mice. Moreover, marein improved the basement membrane thickness of glomeruli and tubules, improved glomerular sclerosis and tubular fibrosis, as well as renal insufficiency, thereby protecting kidney function and delaying the pathological damage. Furthermore, marein increased the expression of PI3K and the phosphorylation of Akt/Akt (Ser473), and promoted the expression of LC3II/I, Beclin1 and ATG5. Additionally, it promoted the expression of FGFR1 in the kidney of db/db mice, and promoted the increase of serum FGF21 and FGF23. Marein has a protective effect on the kidneys of diabetic mice. It protects diabetic nephropathy by regulating the IRS1/PI3K/Akt signaling pathway to improve insulin resistance. Therefore, marein may be an insulin sensitizer.

RESUMEN: Marein es la principal sustancia activa de Coreopsis tinctoria nutt. No solo tiene efectos antioxidantes y antitumorales, sino que también puede reducir los lípidos en sangre, prevenir la glucemia alta, mejorar la resistencia a la insulina, inhibir la gluconeogénesis y promover la síntesis de glucógeno. Sin embargo, el mecanismo exacto de su acción aún no está claro. Se analizó el efecto y el mecanismo de Marein sobre la resistencia a la insulina. Los ratones se dividieron en grupos db / m, db / db, metformina + db / db y mareína + db / db. Se registró el peso corporal y el peso de los riñones. Se midieron las pruebas de función renal y bioquímica sérica después de 8 semanas de administración continua. Los tejidos renales se sometieron a tinción HE, tinción PAS y tinción Masson. El efecto de la mareína sobre la señal de PI3K / Akt y la vía de autofagia se detectó mediante Western blot. Al término de 8 semanas de tratamiento con mareína, el peso corporal y el peso de los riñones de los ratones no cambiaron significativamente, pero los niveles de glucosa en sangre y lípidos en sangre en ayunas se redujeron significativamente en relación a los del grupo db / db. Marein mejoró significativamente el índice de resistencia a la insulina, aumentó la adiponectina sérica y mejoró los trastornos del metabolismo de la glucosa y los lípidos de los ratones db / db. Además, la mareína mejoró el grosor de la membrana basal de los glomérulos y túbulos, mejoró la esclerosis glomerular y la fibrosis tubular, así como la insuficiencia renal, protegiendo la función renal y retrasando el daño patológico. Además, la mareína aumentó la expresión de PI3K y la fosforilación de Akt / Akt (Ser473), y promovió la expresión de LC3II / I, Beclin1 y ATG5. Además, promovió la expresión de FGFR1 en el riñón de ratones db / db y el aumento de FGF21 y FGF23 en suero. Marein tiene un efecto protector sobre los riñones de ratones diabéticos. Protege la nefropatía diabética regulando la vía de señalización IRS1 / PI3K / Akt para mejorar la resistencia a la insulina. Por tanto, la mareína puede ser un sensibilizador a la insulina.

Improvement of cardiovascular function health level by regular sports / Melhoria do nível de saúde da função cardiovascular por meio de esportes regulares / Mejora del nivel de salud de la función cardiovascular mediante deportes regulares

ABSTRACT Introduction Regular physical activity helps improve cardiovascular and cerebrovascular skills. How to evaluate the nervous tension of the cardiovascular and cerebrovascular vessels through sports is a hot topic. Objective The paper discusses the influence of regular participation in sports on people's cardiovascular function and blood-related indicators. Methods We select 30 healthy older adults who regularly participate in sports, record their ECG changes, blood pressure, heart rate and other related cardiovascular function indicators, and analyze the blood function of the elderly. Detection of blood cell count (RBC), red blood cell volume (MCV) and hemoglobin (Hb), serum creatinine (Cr), blood glucose (BGS), triglycerides (TG), cholesterol (TC), low-density lipoprotein (LDL) and high-Density lipoprotein (HDL) is measured. Results Older adults who persist in exercise for a long time have better indicators than those who do not exercise. Conclusions Appropriate aerobic exercise can reduce the stiffness of blood vessels in the elderly. Exercise can help the elderly increase heart rate variability and improve the heart's autonomic nerve function's blood indicators, and body mass. Level of evidence II; Therapeutic studies - investigation of treatment results.

RESUMO Introdução A atividade física regular ajuda a melhorar as habilidades cardiovasculares e cerebrovasculares. Como avaliar a tensão nervosa dos vasos cardiovasculares e cerebrovasculares por meio de esportes é um assunto quente. Objetivo o artigo discute a influência da participação regular em esportes sobre a função cardiovascular das pessoas e indicadores relacionados ao sangue. Métodos Selecionamos 30 idosos saudáveis que participam regularmente de esportes, registramos suas alterações no ECG, pressão arterial, frequência cardíaca e outros indicadores relacionados à função cardiovascular e analisamos a função sanguínea dos idosos. Detecção de contagem de células sanguíneas (RBC), volume de glóbulos vermelhos (MCV) e hemoglobina (Hb), creatinina sérica (Cr), glicose no sangue (BGS), triglicerídeos (TG), colesterol (TC), lipoproteína de baixa densidade (LDL ) e a lipoproteína de alta densidade (HDL) é medida. Resultados Idosos que persistem por muito tempo nos exercícios têm melhores indicadores do que aqueles que não praticam. Conclusão O exercício aeróbio adequado pode reduzir a rigidez dos vasos sanguíneos em idosos. O exercício pode ajudar os idosos a aumentar a variabilidade da frequência cardíaca e melhorar os indicadores sanguíneos da função nervosa autonômica do coração e a massa corporal. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción La actividad física regular ayuda a mejorar las habilidades cardiovasculares y cerebrovasculares. Cómo evaluar la tensión nerviosa de los vasos cardiovasculares y cerebrovasculares a través del deporte es un tema candente. Objetivo El artículo analiza la influencia de la participación regular en deportes sobre la función cardiovascular de las personas y los indicadores relacionados con la sangre. Métodos Seleccionamos a 30 adultos mayores sanos que participan regularmente en deportes, registramos sus cambios en el ECG, presión arterial, frecuencia cardíaca y otros indicadores relacionados con la función cardiovascular, y analizamos la función sanguínea de los ancianos. Detección del recuento de glóbulos rojos (RBC), volumen de glóbulos rojos (MCV) y hemoglobina (Hb), creatinina sérica (Cr), glucosa en sangre (BGS), triglicéridos (TG), colesterol (TC), lipoproteínas de baja densidad (LDL) ) y se mide la lipoproteína de alta densidad (HDL). Resultados Los adultos mayores que persisten en el ejercicio durante mucho tiempo tienen mejores indicadores que los que no lo hacen. Conclusión El ejercicio aeróbico adecuado puede reducir la rigidez de los vasos sanguíneos en los ancianos. El ejercicio puede ayudar a los ancianos a aumentar la variabilidad de la frecuencia cardíaca y mejorar los indicadores sanguíneos y la masa corporal de la función nerviosa autónoma del corazón. Nivel de evidencia II; Estudios terapéuticos: investigación de los resultados del tratamiento.

Conocimiento de los médicos generales sobre complicaciones obstétricas asociadas a riesgo cardiovascular subsecuente / General practitioners’ knowledge about pregnancy complications associated with long-term cardiovascular risk

Resumen Introducción: La enfermedad cardiovascular (ECV) constituye la principal causa de mortalidad en mujeres; la preeclampsia (PE) y la diabetes mellitus gestacional (DMG) están asociadas a incremento en el riesgo de ECV. Objetivo: Evaluar el conocimiento de los médicos generales (MG) sobre complicaciones obstétricas asociadas a ECV. Métodos: Se envió a los MG un cuestionario electrónico anónimo basado en casos, diseñado para evaluar el entendimiento de la influencia de la historia obstétrica en el riesgo cardiovascular a largo plazo y el conocimiento general sobre riesgo de ECV. Resultados: La tasa de respuesta fue de 35 % (161/465). Los participantes reconocieron que la PE y la DMG son factores de riesgo para ECV (98 y 83 %, respectivamente) y reportaron las siguientes estrategias de tamizaje de ECV en mujeres con historial de PE y DMG: monitoreo de presión arterial (PE 100 %, DMG 46 %), cálculo de índice de masa corporal (PE 68 %, DMG 57 %), evaluación del perfil de lípidos (PE 71 %, DMG 57 %), hemoglobina glucosilada (PE 26 %, DMG 92 %) y glucosa en ayuno (PE 28 %, DMG 91 %). Conclusión: Las estrategias de tamizaje para identificar ECV en mujeres con antecedentes de PE y DMG reportadas por los MG fueron variables.

Abstract Introduction: Cardiovascular disease (CVD) is the leading cause of mortality in women; preeclampsia (PE) and gestational diabetes mellitus (GDM) are associated with an increased risk of CVD. Objective: To evaluate general practitioners (GP) knowledge about complicated pregnancies and their association with CVD. Methods: An anonymous case-based electronic questionnaire designed to assess the level of understanding on the influence of a history of pregnancy complications on long-term cardiovascular risk and general knowledge about CVD risk was sent to GPs. Results: The response rate was 35 % (161/465). The participants recognized that PE and GDM are risk factors for CVD (98 and 83 %, respectively), and reported the following CVD screening strategies in women with a history of PE and GDM: blood pressure monitoring (PE 100 %, GDM 46 %), body mass index calculation (PE 68 %, GDM 57 %), lipid profile evaluation (PE 71 %, GDM 57 %), glycated hemoglobin (PE 26 %, GDM 92 %), and fasting glucose (PE 28 %, GDM 91 %). Conclusion: GP-reported screening strategies to identify CVD in women with a history of PE and GDM were variable.

Associations of plasma lipids, lipoproteins, and cardiovascular outcomes with climatic variations in a large Brazilian population of Campinas, São Paulo state: an eight-year study

In this eight-year retrospective study, we evaluated the associations between climatic variations and the biological rhythms in plasma lipids and lipoproteins in a large population of Campinas, São Paulo state, Brazil, as well as temporal changes of outcomes of cardiovascular hospitalizations. Climatic variables were obtained at the Center for Meteorological and Climatic Research Applied to Agriculture (University of Campinas - Unicamp, Brazil). The plasma lipid databases surveyed were from 27,543 individuals who had their lipid profiles assessed at the state university referral hospital in Campinas (Unicamp). The frequency of hospitalizations was obtained from the Brazilian Public Health database (DATASUS). Temporal statistical analyses were performed using the methods Cosinor or Friedman (ARIMA) and the temporal series were compared by cross-correlation functions. In normolipidemic cases (n=11,892), significantly different rhythmicity was observed in low-density lipoprotein (LDL)- and high-density lipoprotein (HDL)-cholesterol (C) both higher in winter and lower in summer. Dyslipidemia (n=15,651) increased the number and amplitude of lipid rhythms: LDL-C and HDL-C were higher in winter and lower in summer, and the opposite occurred with triglycerides. The number of hospitalizations showed maximum and minimum frequencies in winter and in summer, respectively. A coincident rhythmicity was observed of lower temperature and humidity rates with higher plasma LDL-C, and their temporal series were inversely cross-correlated. This study shows for the first time that variations of temperature, humidity, and daylight length were strongly associated with LDL-C and HDL-C seasonality, but moderately to lowly associated with rhythmicity of atherosclerotic outcomes. It also indicates unfavorable cardiovascular-related changes during wintertime.

Correlation between estimated plasma remnant-like particle cholesterol and vegetable fat intake in Uku town, Japan

BACKGROUND@#Remnant-like particle cholesterol (RLP-C) is highly atherogenic, which is associated with atherosclerosis. However, RLP-C has not been routinely measured in the clinical practice. We estimated RLP-C levels using conventional lipid profiles and examined the association between estimated RLP-C and related factors including nutrient intake.@*METHODS@#This study was performed in Uku town, Nagasaki prefecture, Japan in 2019. A total of 225 subjects were enrolled and directly measured RLP-C levels. Estimated RLP-C levels were defined as the following formula [total cholesterol - (LDL-cholesterol) - (HDL-cholesterol)]. Multivariate analyses were used to assess the relationship between estimated RLP-C and atherogenic factors. We calculated cut-off values on dichotomized RLP-C (< 7.5 mg/dL vs. ≥ 7.5 mg/dL) by receiver operating characteristic (ROC) curve.@*RESULTS@#The mean values of directly measured RLP-C levels and estimated RLP-C were 4.0 mg/dL and 16.4 mg/dL, respectively. In the multiple stepwise linear regression analysis, directly measured and estimated RLP-C levels were independently and commonly associated with apolipoprotein E, triglycerides, and vegetable fat intake (inversely). Using ROC curves, we found the cut-off value of estimated RLP-C was 22.0 mg/dL.@*CONCLUSION@#We demonstrated that the estimated RLP-C levels using conventional lipid profiles may substitute for directly measured RLP-C and these levels were independently and inversely associated with vegetable fat intake in the community-dwelling Japanese population.

Associação entre o consumo de alimentos ultraprocessados e parâmetros lipídicos em adolescentes / Association between ultra-processed food consumption and lipid parameters among adolescents

Resumo O objetivo do estudo foi analisar a associação entre o consumo de alimentos ultraprocessados (AUP) e parâmetros lipídicos. Estudo transversal realizado com adolescentes de ensino médio. O consumo alimentar foi analisado por meio de recordatório alimentar de 24h, sendo os AUP identificados de acordo com a NOVA classificação de alimentos. Os níveis de colesterol total, HDL-c e triglicérides, foram determinados por colorimetria enzimática e a fração de LDL-c estimada por fórmula. Utilizou-se o teste t de Student ou Mann-Whitney para comparação de médias e regressão linear para realizar associações entre as variáveis. Os resultados mostram que o consumo de AUP foi mais frequente nas adolescentes do sexo feminino, entre a faixa etária 17 a 19 anos, com renda familiar superior a dois salários mínimos e de escolas particulares. Nota-se que os indivíduos no maior tercil de consumo de AUP apresentaram maior ingestão energética, de carboidratos e de sódio, com menor ingestão de proteínas e de fibras. Observou-se, ainda, que o maior consumo de AUP foi associado negativamente aos níveis de HDL-c e positivamente aos níveis de triglicerídeos e dislipidemia. Portanto, os AUP estão associados a uma piora no perfil nutricional da dieta e alterações negativas nos parâmetros lipídicos de jovens.

Abstract The scope of this study was to analyze the association between ultra-processed food (UPF) consumption and lipid parameters. It was a cross-sectional study performed with high school adolescents. Food consumption was analyzed by means of a 24-hour food recall form, where UPF were identified in line with the NOVA system of food classification. The total cholesterol levels, HDL-c and triglycerides were determined by enzymatic colorimetry and the LDL-c fraction estimated by formula. The Student's t-test or Mann-Whitney was used to compare averages, and linear regression to make associations among the variables. The results show that UPF consumption was more frequent in female adolescents between 17 and 19 years of age, with a family income above two minimum wages and from private schools. It was observed that individuals in the upper third of UPF consumption had a higher energetic, carbohydrate and sodium intake, with a lower intake of proteins and fibers. Moreover, it was found that a higher UPF intake was negatively associated with HDL-c levels and positively associated with triglyceride levels and dyslipidemia. Therefore, UPF is associated with a worsening of the nutritional profile of the diet and contributes to negative changes in the lipid parameters of young individuals.

Dyslipidemia prevalence, awareness, treatment and control in Mexico: results of the Ensanut 2012 / Prevalencia de dislipidemias, diagnóstico previo, tratamiento y control: resultados de la Ensanut 2012

Abstract: Objective: To describe in a national sample 1) the prevalence, awareness, treatment and control of dyslipidemias 2) the prevalence of dyslipidemias through previous national surveys. Materials and methods: We analyzed data of the National Health and Nutrition Survey 2012, a representative cross-sectional study. Serum samples of 9 566 adults ≥20 years old with fasting ≥8 hours were analyzed for lipid fractions. Age-adjusted prevalences were calculated, by sociodemographic variables. Prevalence of awareness, treatment and control was estimated. A description of the dyslipidemia prevalence reported in previous surveys is reported. Results: Hypoalphalipoproteinemia and elevated LDL-C are the most prevalent dyslipidemias in Mexican adults. One in four adults had hypercholesterolemia at the moment of the interview without previous diagnosis. Awareness, treatment and control of dyslipidemia were 12.6, 3.7 and 3.1%, respectively. Conclusions: Dyslipidemias are the most prevalent risk factor for cardiovascular diseases in Mexico. Public policies to increase awareness, access to therapy and sustained control are urgently needed.

Resumen: Objetivo: Describir en una muestra nacional 1) la prevalencia de dislipidemias, su diagnóstico previo, tratamiento y control, y 2) la prevalencia de dislipidemias en las encuestas previas. Material y métodos: Se analizaron datos de la Encuesta Nacional de Salud y Nutrición 2012 con representatividad nacional. Se analizaron fracciones de lípidos séricos de 9 566 adultos ≥20 años con ayuno ≥8 horas. Se estimaron las prevalencias de dislipidemias, diagnóstico previo (DP), tratamiento y control, ajustadas por edad. Se presenta un análisis comparativo de las prevalencias de dislipidemias reportadas previamente. Resultados: Las dislipidemias más prevalentes en adultos mexicanos fueron hipoalfalipoproteinemia y LDL-C elevado. Uno de cada cuatro adultos tenía hipercolesterolemia al momento de la entrevista, sin DP. El DP, tratamiento y control de dislipidemias fue de 12.6, 3.7 y 3.1%, respectivamente. Conclusiones: Las dislipidemias son el factor de riesgo para enfermedades cardiovasculares más prevalente en adultos mexicanos. Se necesitan políticas públicas para incrementar el diagnóstico, acceso a terapia y control.

Consumo de bebidas açucaradas em pacientes com doença aterosclerótica manifesta / Consumption of sugar-sweetened beverages in patients with established atherosclerosis disease

Resumo O presente estudo investigou a associação entre o consumo de bebidas açucaradas e variáveis antropométricas e bioquímicas em análise transversal, realizado com dados secundários referentes à primeira consulta do ensaio clínico randomizado Dieta Cardioprotetora Brasileira (2013-2014). Foram coletados peso, altura, circunferência da cintura, perfil lipídico e glicemia de jejum e dados de um recordatório alimentar de 24 horas. Diferenças entre o consumo e não consumo de bebidas açucaradas foram avaliadas pelo teste T de student. Para analisar a associação entre o consumo de bebidas açucaradas e fatores bioquímicos e antropométricos foi utilizado o teste qui quadrado. A amostra foi de 2.172 indivíduos, sendo a maioria homens (58,5%), idosos (63,6%), do nível econômico C (57,3%), com ensino fundamental (45,8%) e com excesso de peso (62,7%). Houve associação significativa entre o consumo de bebidas açucaradas e maior valores de índice de massa corporal (p=0,029), circunferência da cintura (p=0,004) e triglicerídeos (p=0,023). Esses resultados reforçam a necessidade de intervenção nutricional quanto ao consumo de bebidas açucaradas como parte do tratamento dietético desta população.

Abstract This study investigated the association between consumption of sugar-sweetened beverages and anthropometric and biochemical variables in a cross-sectional study conducted with secondary data from the first visit of the randomized clinical trial of the Brazilian Cardioprotective Nutritional Program (BALANCE Program) (2013-2014). Weight, height, waist circumference, lipid profile and fasting glycemia and a 24-hour diet recall were collected. Differences between consumption and non-consumption of sugar-sweetened beverages were evaluated by Student's t-test. The Chi-square test was employed to analyze the association between consumption and non-consumption of sugar-sweetened beverages and biochemical and anthropometric factors. The sample consisted of 2,172 individuals, mostly men (58.5%), elderly (63.6%), C-rated economic class (57.3%), and overweight (62.7%). A statistically significant difference was found between the consumption of sugar-sweetened beverages and higher BMI values (p=0.029), waist circumference (p=0.004) and triglycerides (p=0.023). These results emphasize the need for nutritional intervention regarding the consumption of sugar-sweetened beverages as part of the dietary treatment of this population.

Evaluation of Lipid Profiles of Children and Youth from Basic Health Units in Campinas, SP, Brazil: A Cross-Sectional Laboratory Study / Avaliação de Perfis Lipídicos Infanto-Juvenis Solicitados nas Unidades Básicas de Saúde em Campinas/SP, Brasil: Um Estudo Laboratorial Transversal

Abstract Background: Among dyslipidemias, hypercholesterolemia is considered the main risk factor for cardiovascular diseases in adults. In childhood and adolescence, elevated total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) are positively associated with atherosclerosis markers, however, systematic screening for dyslipidemias in these groups is a controversial topic. Objective: To characterize the frequencies, types and severity of dyslipidemias in children and adolescents attended at the Basic Health Units managed by SUS in Campinas/SP. Methods: After an agreement with the Municipal Health Department of Campinas, consecutive results of serum lipid profiles (n = 312,650) of individuals of both sexes (n = 62,530) aged between 1 day old and 19 years were obtained, from 2008 to 2015. Age groups and dyslipidemias were classified according to recommendations in the literature. The statistical significance level adopted was the probability value (p) of 0.05 or less. Results: The observed frequencies of increased TC, triglycerides (TG), LDL-C and non-HDL-C (NHDL-C) were 33%, 40%, 29% and 13% respectively, and of reduced high-density lipoprotein cholesterol (HDL-C) the frequency was 39%. The frequencies, in general, were greater in females and in the southwest and south regions of the city, whose populations are more vulnerable from the socioeconomic point of view; on the other hand, in children and adolescents, the frequencies of TG and HDL-C prevailed, respectively. Conclusions: The high frequency and regionalization of dyslipidemias in children and adolescents indicate the need for specific actions in the handling and treatment of such diseases by the public health system of Campinas.

Resumo Fundamento: Dentre as dislipidemias, a hipercolesterolemia é considerada o principal fator de risco para doenças cardiovasculares em adultos. Na infância e adolescência, a elevação de colesterol total (CT) e colesterol da lipoproteína de baixa densidade (LDL-C) associam-se positivamente a marcadores de aterosclerose, entretanto, a triagem sistemática para dislipidemias nestes grupos é um tema controverso. Objetivos: Caracterizar as frequências, tipos e gravidade de dislipidemias em crianças e adolescentes atendidos nas Unidades Básicas de Saúde (UBS) mantidas pelo SUS em Campinas/SP. Métodos: A partir do convênio com a Secretaria Municipal de Saúde de Campinas foram obtidos resultados consecutivos de perfis lipídicos séricos (n = 312.650) de indivíduos de ambos os sexos (n = 62.530), com idade entre 1 dia e 19 anos, entre 2008 e 2015. Grupos etários e dislipidemias foram classificados conforme recomendações da literatura. O nível de significância estatístico considerado significativo foi de p < 0,05. Resultados: As frequências observadas de CT, triglicérides (TG), LDL-C e não HDL-C (NHDL-C) aumentados foram, respectivamente 33%, 40%, 29% e 13% e de redução do colesterol da lipoproteína de alta densidade (HDL-C) 39%, no total, sendo maiores no sexo feminino e nas regiões sudoeste e sul da cidade, mais vulneráveis do ponto de vista socioeconômico; já em infantes a de TG, e nos adolescentes a de HDL-C prevaleceram. Conclusões: A alta frequência e a regionalização das dislipidemias em crianças e adolescentes apontam para a necessidade de ações específicas no manuseio e tratamento destas no âmbito do sistema público de saúde em Campinas.

Associações entre consumo de produtos lácteos, proteína C-reativa e perfil lipídico em adultos: resultados do ELSA-Brasil / Associations between consumption of dairy products, C-reactive protein, and lipid profile in adults: results of the ELSA-Brasil study / Asociaciones entre consumo de productos lácteos, proteína C-reativa y perfil lipídico en adultos: resultados del ELSA-Brasil

Anormalidades lipídicas e inflamação sistêmica subclínica estão associadas ao processo de aterosclerose, sendo utilizadas como marcadores de risco cardiovascular. Estudos sugerem um possível efeito benéfico dos produtos lácteos na saúde cardiovascular, mas os resultados em marcadores lipídicos e inflamatórios ainda são controversos. O objetivo deste trabalho foi avaliar a associação entre o consumo de produtos lácteos e seus diferentes subgrupos e proteína C-reativa (PCR), LDL-colesterol (LDL-C) e razão triglicerídeo/HDL-colesterol (TG/HDL-C) nos participantes do Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil) (n = 9.372). O consumo de lácteos foi avaliado por meio de questionário de frequência alimentar validado e apresentado em porções/dia. O consumo total de lácteos foi descrito em quatro categorias (≤ 1 porção/dia a > 4 porções/dia). As associações foram estimadas por meio do odds ratios (OR), utilizando-se o grupo de menor consumo (≤ 1 porção/dia) como referência. Os menores valores de OR para TG/HDL-C no modelo multivariado (0,70; IC95%: 0,55-0,90 em homens; e 0,55; IC95%: 0,43-0,70 em mulheres) foram encontrados no grupo com consumo > 4 porções/dia de lácteos totais. Esses resultados foram apoiados pelas associações inversas encontradas entre diferentes subgrupos de lácteos e a razão TG/HDL-C. Não foi encontrada associação entre consumo de produtos lácteos e seus subgrupos e valores de LDL-C e de PCR. Os resultados sugerem um possível efeito benéfico dos lácteos no perfil lipídico, porém são necessárias evidências de estudos longitudinais e de intervenção que elucidem os mecanismos de efeito dos diferentes tipos de lácteos.

Lipid abnormalities and subclinical systemic inflammation are associated with atherosclerosis and are used as markers of cardiovascular risk. Studies have suggested a possible beneficial effect of dairy products on cardiovascular health, but the results in lipid and inflammatory markers are still controversial. This study aimed to assess the association between consumption of dairy products and their different subgroups and C-reactive protein (CRP), LDL-cholesterol (LDL-C), and triglyceride/HDL-cholesterol ratio (TG/HDL-C) in participants in the Longitudinal Study of Adult Health (ELSA-Brasil) (n = 9,372). Consumption of dairy products was assessed via a validated food frequency questionnaire and expressed as servings/day. Total consumption of dairy products was described in four categories (≤ 1 serving/day to > 4 servings/day). The associations were estimated via odds ratios (OR), using the group with the lowest consumption (≤ 1 serving/day) as the reference. The lowest ORs for TG/HDL-C in the multivariate model (0.70; 95%CI: 0.55-0.90 in men; and 0.55; 95%CI: 0.43-0.70 in women) were found in the group that consumed > 4 servings day of dairy products. These results were supported by the inverse associations between different subgroups of dairy products and the TG/HDL-C ratio. No association was found between consumption of dairy products and their subgroups and LDL-C and CRP. The results suggest a possible beneficial effect of dairy products on lipid profile, but longitudinal and intervention studies are needed to elucidate the effect mechanisms of different types of dairy products.

Las anormalidades lipídicas e inflamación sistémica subclínica están asociadas con el proceso de arteriosclerosis, siendo utilizadas como marcadores de riesgo cardiovascular. Los estudios sugieren un posible efecto benéfico de los productos lácteos en la salud cardiovascular, pero los resultados en marcadores lipídicos e inflamatorios todavía son controvertidos. El objetivo de este estudio fue evaluar la asociación entre el consumo de productos lácteos y sus diferentes subgrupos y proteína C-reativa (PCR), LDL-colesterol (LDL-C) y razón triglicéridos/HDL-colesterol (TG/HDL-C) en los participantes del Estudio Longitudinal de Salud del Adulto (ELSA-Brasil) (n = 9.372). El consumo de lácteos fue evaluado mediante un cuestionario de frecuencia alimentaria validado, y presentado en porciones/día. El consumo total de lácteos se describió en cuatro categorías (≤ 1 porción/día a > 4 porciones/día). Las asociaciones fueron estimadas mediante odds ratios (OR), utilizando el grupo de menor consumo (≤ 1 porción/día) como referencia. Los menores valores de OR para TG/HDL-C en el modelo multivariado (0,70; IC95%: 0,55-0,90 en hombres; y 0,55; IC95%: 0,43-0,70 en mujeres) se encontraron en el grupo con consumo > 4 porciones/día de lácteos totales. Estos resultados se apoyaron en las asociaciones inversas encontradas entre diferentes subgrupos de lácteos y la razón TG/HDL-C. No se encontró asociación entre consumo de productos lácteos y sus subgrupos y valores de LDL-C y de PCR. Los resultados sugieren un posible efecto benéfico de los lácteos en el perfil lipídico, pese a que se necesitan evidencias de estudios longitudinales y de intervención que eluciden los mecanismos de efecto de los diferentes tipos de lácteos.

The APOB rs693 polymorphism impacts the lipid profile of Brazilian older adults

The apolipoprotein B (APOB) gene contains several polymorphic sites described as risk modifiers for cardiovascular events. The objective of this study was to verify the association of the classic APOB Xba I polymorphism (rs693) with atherosclerotic risk factors in a segment of the Brazilian elderly population considering their usual dietary intake. Clinical and biochemical characteristics as well as total caloric and fat intake data were determined from 644 elderly individuals. Polymorphism analysis was performed by conventional polymerase chain reaction followed by enzyme restriction. Statistical analyses compared measures and proportions according to different APOB genotypic combinations. Statistically significant association was found between Xba I polymorphism and serum LDL, total cholesterol, and total lipid levels, with important elevations among T homozygotes compared to the other genotypes. There was homogeneity in all other parameters analyzed (including intake pattern), with a tendency for reduced levels of circulating apolipoprotein B among TT individuals. Our results pointed out that genetic variation in APOB affected the lipemic profile of elderly individuals in a context not biased by diet, generating a pattern suggestive of secretory disorder of lipoprotein particles, with possible implication in atherosclerotic risk.

The beneficial effects of a water-based aerobic exercise session on the blood lipids of women with dyslipidemia are independent of their training status

OBJECTIVES: To evaluate the acute effects of a session of water-based aerobic exercise on the blood lipid levels of women with dyslipidemia and to compare these results according to their training status. METHOD: Fourteen premenopausal women with dyslipidemia, aged 40-50 years, participated in two water-based aerobic exercise sessions, the first when they were generally sedentary and the second after they were trained with a water-based aerobic training program for 12 weeks. Both experimental sessions were performed using the same protocol, lasted 45 min, and incorporated an interval method, alternating 3 min at a rating of perceived exertion (RPE) of 13 and 2 min at an RPE of 9. Total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and lipoprotein lipase enzyme (LPL) were obtained through venous blood collection before and immediately after each session. A generalized estimating equation method and Bonferroni tests were conducted (with time and training status as factors) for statistical analyses. RESULTS: At enrollment, the mean age of the participants was 46.57 years (95% confidence interval [CI] 44.81−48.34). The statistical analyses showed a significant time effect for all variables (TC: p=0.008; TG: p=0.012; HDL: p<0.001; LPL: p<0.001) except for LDL (p=0.307). However, the training status effect was not significant for any variable (TC: p=0.527; TG: p=0.899; HDL: p=0.938; LDL: p=0.522; LPL: p=0.737). These results indicate that the TC and TG levels reduced and the HDL and LPL concentrations increased from pre- to post-session in similar magnitudes in both sedentary and trained women. CONCLUSIONS: A single water-based aerobic exercise session is sufficient and effective to beneficially modify the lipid profile of women with dyslipidemia, regardless of their training status.

Effect of sleeve gastrectomy on lipid parameters and cardiometabolic risk in young women / Efeito da gastrectomia vertical nos parâmetros lipídicos e risco cardiometabólico em mulheres jovens

ABSTRACT Objective: to analyze the effect of vertical gastrectomy on lipid profile and cardiometabolic risk in young women, preoperatively and 6 months after the operation. Methods: retrospective study, encompassing medical record reviews of women's charts, preoperatively and in six months after the operation. Data collection was performed in the second half of 2015, using a review protocol with questions on the clinical-laboratory profile, anthropometric and laboratory classification of dyslipidemias. Descriptive and inferential analysis were used to treat the variables, using measures of variance, association and linear regression. Results: we analyzed medical records of 114 women undergoing vertical gastrectomy, with a mean age of 33.82±10.92, and with complete high school education. There was a significant reduction of anthropometric data, as well as serum lipid values, six months after the surgical procedure. The coefficients of determination and the results of linear regression, showed that the reduction in serum triglyceride values and increase in high-density lipoprotein have a direct impact on the reduction of the cardiometabolic risk. Regarding the laboratory classification of dyslipidemias, it was observed that the majority presented a significant reduction at the six-month follow-up. Mixed hyperlipidemia showed no significant reduction. The categorized cardiometabolic risk showed a significant reduction in women at risk before vertical gastrectomy. Conclusion: at the six-month follow-up, vertical gastrectomy was effective in reducing the serum lipid profile and the cardiometabolic risk of young women when compared to the preoperative data. There was also a different improvement in the laboratory classification of dyslipidemias at the six-month follow-up after the surgical procedure.

RESUMO Objetivo: analisar o efeito da gastrectomia vertical no perfil lipídico e risco cardiometabólico em mulheres jovens, no pré-operatório e com seis meses de seguimento. Métodos: estudo retrospectivo, realizado a partir de consultas a prontuários de mulheres, no pré-operatório e com seis meses de seguimento. A coleta de dados foi realizada no segundo semestre de 2015, utilizando-se roteiro com questões sobre o perfil clínico-laboratorial, antropométrico e da classificação laboratorial das dislipidemias. Para tratamento das variáveis, foi utilizada análise descritiva e inferencial, por meio de medidas de variância, associação e regressão linear. Resultados: foram analisados prontuários de 114 mulheres submetidas a gastrectomia vertical, com idade média de 33,82±10,92 e ensino médio completo. Houve redução significativa da antropometria, como também dos valores séricos dos lipídios após seis meses de seguimento do procedimento cirúrgico. Os coeficientes de determinação, resultados da regressão linear, mostraram que a redução dos valores séricos dos triglicerídeos e o aumento da lipoproteína de alta densidade têm explicação direta na redução do risco cardiometabólico. Quanto à classificação laboratorial das dislipidemias, observou-se que a maioria apresentou redução significativa, no seguimento de seis meses. A hiperlipidemia mista não teve redução significativa. O risco cardiometabólico, categorizado, teve redução significativa em mulheres que apresentavam risco antes da gastrectomia vertical. Conclusão: no seguimento de seis meses, houve eficácia da gastrectomia vertical na redução dos valores séricos do perfil lipídico e do risco cardiometabólico de mulheres jovens, em relação ao período pré-operatório. A classificação laboratorial das dislipidemias também teve redução dos parâmetros, no seguimento de seis meses após o procedimento cirúrgico.

Effects of curcumin on cardiovascular risk factors in obese and overweight adolescent girls: a randomized clinical trial

ABSTRACT BACKGROUND: Obese adolescents are at higher risk of development of cardiovascular risk factors and obesity in later life. Dietary intake of antioxidants, particularly curcumin, as an active ingredient of turmeric extract, may have noticeable effects on obesity and its important complications such as cardiovascular risk factors. Therefore, the aim of this study was to assess the effects of curcumin supplementation on cardiovascular risk factors among overweight and obese female adolescents. DESIGN AND SETTING: Randomized placebo-controlled clinical trial; Pediatric Cardiovascular Research Center, Isfahan, Iran. METHODS: 60 adolescent girls (aged 13-18 years) were randomly assigned to receive either placebo or intervention. The adolescents were asked to consume one 500 mg tablet per day, containing either standardized 95% turmeric extract or placebo, and to undergo a weight maintenance or a mild weight loss diet for 10 weeks. Anthropometric and biochemical indices were assessed at the baseline and the end of the intervention. RESULTS: Curcumin supplementation had beneficial effects on body mass index (P = 0.019), waist circumference (P = 0.008), hip circumference (P = 0.030), high-density lipoprotein levels (P = 0.042) and triglyceride/high-density lipoprotein ratio (P = 0.021). However, in univariate analysis of covariance, no significant differences were found between the intervention and placebo groups after 10 weeks of supplementation (P > 0.05). CONCLUSIONS: Prescription of curcumin supplementation along with use of a slight weight loss diet might have beneficial effects on some cardiovascular risk factors among overweight and obese female adolescents. Larger clinical trials with higher curcumin doses and longer duration are needed to confirm the results from the current study. CLINICAL TRIAL REGISTRATION: IRCT20171107037302N1

Relação entre composição corporal e dislipidemias em crianças e adolescentes / Relationship between body composition and dyslipidemia in children and adolescentes

Resumo Verificou-se a relação entre diferentes índices antropométricos e os lipídios plasmáticos. Os dados foram coletados de 2014 a 2016 em 854 escolares (6-18 anos). Foram aferidas a circunferência da cintura (CC), o percentual de gordura corporal (%G) por bioimpedância, o índice de massa corporal (IMC) e relação da cintura/estatura (RCE). Em sangue coletado em jejum mediu-se o colesterol total (CT), HDLc, e triglicerídeos e calculou-se o colesterol não HDL (Não HDLc). Os dados são apresentados por média ± desvio padrão, porcentagens. A comparação de médias foi feita pelo teste t ou ANOVA seguida de teste de Tukey. A associação entre variáveis foi testada por regressão linear. O estudo foi aprovado pelo Comitê de Ética da Universidade Federal do Espírito Santo. Meninos obesos tinham CT, Não HDLc e LDLc mais elevados do que os eutróficos. Em meninas este achado foi apenas para o Não HDLc. Crianças com o %G e RCE inadequados apresentaram LDLc e Não HDLc maiores (p < 0,001), os quais associaram-se positivamente (p < 0,001) com as frações lipídicas (CT e Não HDLc). O excesso de gordura corporal elevou em 21% a probabilidade de ocorrência de colesterol acima da referência (170 mg/dL). O excesso de gordura corporal associou-se com o perfil lipídico aterogênico (maior Não HDLc), principalmente em meninos.

Abstract We studied the relationship between different anthropometric indexes and plasma lipids. Data were collected from 2014 to 2016 in 854 schoolchildren (6-18 years). Waist circumference (WC), body fat percentage (BFP) by bioimpedance, body mass index (BMI), and waist-to-height ratio (WHtR) were measured. Total cholesterol (TC), HDLc, and triglycerides were measured in fasting blood samples and Non-HDL cholesterol (Non-HDLc) was calculated. Data are presented as mean ± standard deviation, with percentages. Means were compared using the t test or ANOVA followed by Tukey's test. The association between variables was tested by linear regression. The study was approved by the Research Ethics Committee of the Universidade Federal do Espírito Santo. Obese boys had higher TC, non-HDLc, and LDLc than eutrophic boys (p < 0.05). In girls this difference was found only for non-HDLc (p < 0.05). Children with inappropriate BFP and WHtR presented higher LDLc and non-HDLc concentrations (p < 0.001), which showed positive association (p<0.001) with lipid fractions (TC and non-HDLc). Excess body fat increased the probability of cholesterol above the reference value (170 mg/dL) by 21%. Excess body fat was associated with an atherogenic lipid profile (higher non-HDLc), especially in boys.