Higher atherogenic risk in schoolchildren is associated with MTMR9 rs2293855 gene polymorphism and genetic score.

Childhood dyslipidaemia is associated with the occurrence of cardiovascular diseases in adulthood, so evaluating whether an individual has a genetic predisposition to this pathology is of great importance for early action of prevention and treatment. This study aimed to evaluate the association between the FTO (rs9939609), MC4R (rs17782313) and MTMR9 (rs2293855) polymorphisms, the obesity-related genetic risk score and atherogenic risk in Brazilian children. This is a cross-sectional study conducted in 544 children aged 4-9 years in the city of Viçosa, Minas Gerais state, Brazil. The single nucleotide polymorphisms rs9939609, rs17782313 and rs2293855, were identified by the system TaqMan SNP genotyping and the obesity-related genetic risk score was determined. The lipid profile (serum total cholesterol [TC], high density lipoprotein [HDL] cholesterol, low density lipoprotein [LDL] cholesterol, triglycerides) was analysed and the atherogenic indices (Castelli I and II indices), atherogenic coefficient (AC), lipoprotein combined index (LCI) and plasma atherogenic index (PAI) were calculated. A semi-structured questionnaire was applied, obtaining data on the sociodemographic, economic and lifestyle characteristics of the children. Weight and height measurements were performed in all children, and body composition was evaluated by Dual-Energy X-ray Absorptiometry (DXA). 55.5% of the sample had dyslipidaemia, while 28.5% of the sample had at least one polymorphism and 2.2% had three polymorphisms. Children with the AG/AA genotypes in the rs2293855 polymorphism had lower HDL cholesterol levels and higher TC/HDL cholesterol, LDL/HDL cholesterol ratios and AC. Those with one or more polymorphisms (rs9939609, rs17782313 and rs2293855) in the genetic risk score had lower HDL cholesterol levels and higher TC/HDL cholesterol ratios, AC, LCI and PAI. In conclusion, the risk allele of the rs2293855 polymorphism and a higher obesity-related genetic risk score were positively associated with higher atherogenic risk in Brazilian children.

Association between rapid weight gain and overweight in children aged 0 to 5 years in Latin America / Associação entre ganho rápido de peso e excesso de peso em crianças de 0 a 5 anos de idade na América Latina

Abstract Objectives: to assess the prevalence of rapid weight gain (RWG) in children born with normal weight and its association with overweight (OW) in four Latin America countries. Methods: cross-sectional study in children aged 0 to 5 from the Pesquisa Nacional de Demografia e Saúde da Criança e da Mulher in Brazil and the Encuesta Nacional de Demografía y Salud in Bolivia, Colombia and Peru,using a birth weight ≥2,500g. The outcome variable was OW, the exposure was RWG and breastfeeding (BF) was the adjustment variable. Prevalence, odds ratio and 95% confidence intervalwere estimated using multivariate logistic regression model. Results: there was a greater prevalence of RWG and BF at less than 6 months in Brazil, and a greater prevalence of OW in Brazil and Bolivia. The chances of OW when RWG was present and adjusted for BF were 6.1 times (CI95% = 3.8-9.7) in Brazil, 4.4 times (CI95% = 3.6-5.3) in Bolivia, 6.7 times (CI95% = 5.5-8.2) in Colombia, and 12.2 times in Peru (CI95% = 9.4-15.7) with a p < 0.001 for all countries. Conclusions: RWG in children with normal birth weight was associated with a greater chance of being OW in the four observed Latin America countries.

Resumo Objetivos: avaliar a prevalência do ganho rápido de peso (GRP) em crianças nascidas com peso normal e sua associação com o excesso de peso (EP) em quatro países da América Latina. Métodos: estudo transversal de inquéritos populacionais com crianças de 0 a 5 anos da Pesquisa Nacional de Demografia e Saúde da Criança e da Mulher no Brasil e da Encuesta Nacional de Demografía y Salud da Bolívia, Colômbia e Peru, selecionadas pelo peso ao nascer ≥2.500 gramas. A variável desfecho foi o EP; de exposição o GRP; e de ajuste a amamentação. Foram estimadas as prevalências, odds ratio e intervalo de confiança de 95% por regressão logística multivariada. Resultados: observou-se maior prevalência de GRP e tempo de amamentação menor do que 6 meses no Brasil e maior prevalência de EP no Brasil e Bolívia. As chances de EP quando GRP presente e ajustado por amamentação foram de 6,1 vezes (IC95% = 3,8-9,7) no Brasil; 4,4 vezes (IC95% = 3,6-5,3) na Bolívia; 6,7 vezes (IC95% = 5,5-8,2) na Colômbia; 12,2 vezes no Peru (IC95% = 9,4-15,7) e p<0,001 nos quatro países. Conclusões: o GRP em crianças nascidas com peso normal foi associado a maior chance de EP infantil nos quatro países da América Latina.

Determinantes do ganho rápido de peso e a sua influência no estado nutricional infantil / Determinants of rapid weight gain and its influence on child nutritional status

A ocorrência do ganho rápido de peso infantil (GRP) pode estar associado a desfechos de peso ao longo do ciclo de vida. Os fatores de risco para o GRP incluem preditores maternos, gestacionais, infantis e contextuais e reforça-se a importância de avaliar também a hipótese sobre a possível associação com polimorfismos genéticos. Objetivo: Testar a associação entre ganho rápido de peso na infância, polimorfismos genéticos e estado nutricional de crianças. Metodologia (Manuscrito 1): Estudo transversal com bases de dados de inquéritos populacionais em crianças com peso ao nascer adequado no Brasil, Bolívia, Colômbia e Peru para estimar a associação entre GRP e excesso de peso em crianças de 0 a 5 anos. Foram estimadas as prevalências, odds ratio e IC95% por regressão logística multivariada. Metodologia (Manuscrito 2): Estudo de coorte com crianças do PROLAC no município de Viçosa, Minas Gerais, do nascimento aos seis meses. Foi obtido material biológico por swab bucal para análises genéticas de polimorfismos dos genes FTO, MC4R e APOA5. Considerouse GRP quando a diferença (subtração) de escore-z de peso para idade (P/I) era >+0,67 entre duas avaliações. Na análise exploratória das curvas da taxa de incidência acumulada de GRP utilizou-se o estimador de Kaplan-Meier (failure), bem como o teste Log-Rank para realizar as comparações entre os grupos de interesse. Para estimar a razão de riscos utilizou-se o modelo semi-paramétrico de Cox e para verificar a qualidade do ajuste do modelo proposto foram utilizados os resíduos generalizados de Cox-Snell. Metodologia (Manuscrito 3): Estudo de coorte com 267 crianças. As crianças tinham que ter ao menos 3 avaliações antropométricas, ou seja, ao nascer, entre o nascimento e seis meses de vida e entre 4 e 7 anos de idade, e foram divididas em grupo de acordo com a presença ou ausência do GRP, diagnosticado se a diferença de escore-z de P/I peso para idade foi > +0,67 entre duas avaliações. Para analisar a trajetória da média de IMC infantil foi utilizada a função Longitudinal Analyses Data Plots, para comparação entre as médias de IMC dos grupos em cada tempo foi aplicado uma ANOVA de dois fatores e para as comparações múltiplas foi utilizado o teste Bonferroni. Resultados (Manuscrito 1): As chances de excesso de peso em crianças com GRP, ajustado por amamentação, foram de 6,1 vezes, 4,4 vezes, 6,7 vezes e 12,2 vezes quando comparado às crianças sem GRP no Brasil, Bolívia, Colômbia e Peru, respectivamente. Resultados 13 (Manuscrito 2): A porcentagem de crianças com GRP foi 31,84% ao longo do estudo e a taxa de incidência foi estimada em 2,31 casos/1000 pessoas-dia. Apresentaram maior risco de GRP as crianças que nasceram com peso <3000g e cujas mães que apresentaram sobrepeso ou obesidade pré-gestacional. Resultados (Manuscrito 3): As crianças com GRP apresentaram significativamente maiores níveis da média de IMC ao longo da trajetória. Conclusões: Não foi possível demostrar associação entre os polimorfismos genéticos e GRP pelo menos na infância, porém o peso ao nascer inadequado e o alto peso pré-gestacional materno se associaram significativamente ao GRP. O GRP foi associado a um maior risco de desfechos de peso aferidos por meio de índices de massa corporal. Dado o impacto do GRP na trajetória da média de IMC ao longo da infância e no excesso de peso infantil, faz-se importante os cuidados desde o pré-natal, pós-parto e puericultura nos primeiros anos de vida da criança.

The occurrence of rapid infant weight gain (RWG) may be associated with weight outcomes throughout the life cycle. Risk factors for RWG include maternal, gestational, infant and contextual predictors and the importance of also evaluating the hypothesis about the possible association with genetic polymorphisms is reinforced. Objective To test the association between RWG, genetic polymorphisms and children's nutritional status Methodology (Manuscript 1): Cross-sectional study with databases of population surveys in children with adequate birth weight in Brazil, Bolivia, Colombia and Peru to estimate the association between RWG and excess weight in children aged 0 to 5 years. Prevalence, odds ratio and 95%CI were estimated by multivariate logistic regression. Methodology (Manuscript 2): Cohort study with children from birth to six months of PROLAC in the municipality of Viçosa, Minas Gerais. Biological material was obtained by oral swab for genetic analysis of FTO, MC4R and APOA5 gene polymorphisms. RWG was considered when the difference of weight-for-age (W/A) z-score was >+0.67 between two evaluations. In the exploratory analysis of the curves of the cumulative incidence rate of RWG, the Kaplan-Meier estimator (failure) was used, as well as the Log-Rank test to make comparisons between the groups of interest. The hazard ratio was estimated using the Cox semi-parametric model. Methodology (Manuscript 3): Cohort study with 267 children. Children had to have at least 3 anthropometric assessments, that is, at birth, between birth and six months of life and between 4 and 7 years of age, and were divided into groups according to the presence or absence of RWG, diagnosed if the difference in weight-for-age (W/A) z-score was > +0.67 between two evaluations. The Longitudinal Analyzes Data Plots function was used to analyze the trajectory of the child's BMI mean, to compare the child's BMI mean of the groups at each time point a two-way ANOVA was applied and the Bonferroni test was used for multiple comparisons. Results (Manuscript 1): The odds of overweight in children with RWG, adjusted for breastfeeding, were 6.1 times, 4.4 times, 6.7 times, and 12.2 times in Brazil, Bolivia, Colombia and Peru, respectively, when compared to children without RWG. Results (Manuscript 2): The percentage of children with RWG was 31.84% throughout the study and the incidence rate was estimated at 2.31 cases/1000 person-days. Children who were born weighing <3000g and 15 whose mothers were overweight or obese pre-pregnancy presented a higher risk of RWG. Results (Manuscript 3): Children with GRP had significantly higher mean BMI levels along the trajectory. Conclusions: It was not possible to demonstrate an association between genetic polymorphisms and GRP, at least in childhood, but inadequate birth weight and high maternal pre-pregnancy weight were significantly associated with RWG. RWG was associated with a higher risk of weight outcomes measured using body mass index. Given the impact of RWG on the trajectory of child's BMI mean throughout childhood and on childhood excess weight, care from prenatal, postpartum and childcare in the first years of a child's life is important.

Alteration of inflammatory adipokines after four months of smoking abstinence in multidisciplinary intervention program.

BACKGROUND: many endocrine-metabolic changes are involved in smoking. OBJECTIVES: to evaluate serum concentrations of inflammatory adipokines in smokers at baseline and after four months of treatment for smoking cessation. METHODS: the serum concentrations of inflammatory cytokines were evaluated in smokers and abstinent. Nutritional assessment was based on measurements of body weight, height, and waist circumference (WC), to calculate body mass index (BMI), body adiposity index (BAI) and waist-to-height ratio (WHtR). Biochemical parameters were analyzed: total cholesterol, LDL-c, HDL-c, triglycerides, glucose, cortisol and insulin. The serum levels of leptin, adiponectin and ghrelin were determined by enzyme-linked immunosorbent assay (ELISA). The leptin/adiponectin ratio (L/A) was calculated. RESULTS: a total of 29 subjects were included in this study (22 women and seven men). The mean age of participants was 50.7 ± 10.47 years. The medium values of WHtR and BAI were above of the proposed cutoff point, indicating abdominal obesity. The biochemical parameters did not present statistically significant differences when comparing the initial and final values. At the end of treatment, the abstinent had higher levels of adiponectin when compared to those who remained smoker (p = 0.024). There was an increase in leptin levels and L/A, and a reduction in adiponectin levels after the treatment in abstinent and smokers (p < 0.05). CONCLUSION: this study has demonstrated that smoking cessation improves adiponectin levels when compared with smokers. Leptin and L/A levels increased throughout the treatment in both groups. The increased values of leptin and L/A in abstinent participants may indicate risk of metabolic events associated with smoking history that should be investigated.

Alteration of inflammatory adipokines after four months of smoking abstinence in multidisciplinary intervention program / Cambio en las adipocinas inflamatorias tras cuatro meses de abstinencia de fumar en un programa de intervención multimodal

Background: many endocrine-metabolic changes are involved in smoking. Objectives: to evaluate serum concentrations of inflammatory adipokines in smokers at baseline and after four months of treatment for smoking cessation. Methods: the serum concentrations of inflammatory cytokines were evaluated in smokers and abstinent. Nutritional assessment was based on measurements of body weight, height, and waist circumference (WC), to calculate body mass index (BMI), body adiposity index (BAI) and waist-to-height ratio (WHtR). Biochemical parameters were analyzed: total cholesterol, LDL-c, HDL-c, triglycerides, glucose, cortisol and insulin. The serum levels of leptin, adiponectin and ghrelin were determined by enzyme-linked immunosorbent assay (ELISA). The leptin/adiponectin ratio (L/A) was calculated. Results: a total of 29 subjects were included in this study (22 women and seven men). The mean age of participants was 50.7 ± 10.47 years. The medium values of WHtR and BAI were above of the proposed cutoff point, indicating abdominal obesity. The biochemical parameters did not present statistically significant differences when comparing the initial and final values. At the end of treatment, the abstinent had higher levels of adiponectin when compared to those who remained smoker (p = 0.024). There was an increase in leptin levels and L/A, and a reduction in adiponectin levels after the treatment in abstinent and smokers (p < 0.05). Conclusion: this study has demonstrated that smoking cessation improves adiponectin levels when compared with smokers. Leptin and L/A levels increased throughout the treatment in both groups. The increased values of leptin and L/A in abstinent participants may indicate risk of metabolic events associated with smoking history that should be investigated

Introducción: en el tabaquismo están involucrados un gran número de cambios endocrino-metabólicos. Objetivos: evaluar las concentraciones séricas de adipocinas inflamatorias en fumadores al inicio y después de cuatro meses de tratamiento para dejar de fumar. Métodos: se evaluaron las concentraciones séricas de citocinas inflamatorias en fumadores y no fumadores. La evaluación nutricional se basó en las mediciones del peso corporal y la altura, para calcular el índice de masa corporal (IMC), la circunferencia de la cintura (CC), el índice de adiposidad corporal (IAC) y la relación cintura/estatura (RCE). Se analizaron los parámetros bioquímicos: colesterol total, LDL-c, HDL-c, triglicéridos, glucosa, cortisol e insulina. Los niveles séricos de leptina, adiponectina y grelina se determinaron mediante ensayo de inmunoabsorción enzimática (ELISA). Se calculó la relación leptina/adiponectina (L/A). Resultados: se incluyeron un total de 29 personas (22 mujeres y siete hombres). La edad media de los participantes fue de 50,7 ± 10,47 años. Los valores medios de CC e IAC se mostraron por encima del punto de corte propuesto, indicando obesidad abdominal. Los parámetros bioquímicos no presentaron diferencias estadísticamente significativas al comparar los valores iniciales y finales. Al final del tratamiento, los abstinentes tenían niveles más altos de adiponectina cuando se comparaban con los de aquellos que seguían fumando (p = 0,024). Hubo un aumento en los niveles de leptina y L/A y reducción de los niveles de adiponectina después del tratamiento en abstinentes y fumadores (p < 0,05). Conclusiones: este estudio ha demostrado que el abandono del hábito de fumar mejora los niveles de adiponectina en comparación con los fumadores. Los niveles de leptina y L/A aumentaron a lo largo del tratamiento en ambos grupos. Los valores aumentados de leptina y L/A en abstinentes pueden indicar riesgo de eventos metabólicos asociados al historial de tabaquismo que deben ser investigados

Tendência temporal das comorbidades referidas sobrepeso-diabetes e obesidade-diabetes na população adulta brasileira, 2006 a 2014 / Temporal trend of the referred comorbidities overweight-diabetes and obesity-diabetes in the Brazilian adult population, from 2006 to 2014

Introdução: As prevalências do excesso de peso e diabetes melito tem aumentado globalmente e constituem um problema de saúde pública. 0 ganho de peso excessivo e considerado com fator de risco para o acometimento do diabetes melito e, neste contexto, o acometimento dessas morbidades de forma simultânea pode, provavelmente, agravar e acelerar a morbimortalidade e reduzir a qualidade de vida dos indivíduos acometidos. Objetivo: Verificar as tendências temporais das prevalências de sobrepeso, obesidade e diabetes, bem como das categorias de IMC-diabetes: sobrepeso-diabético e obeso-diabético. Métodos Trata-se de um estudo de tendência de série temporal realizado nas 26 capitais dos estados brasileiros e Distrito Federal, utilizando dados do Sistema de Vigilância de Fatores de Risco e de Proteção para Doenças Crônicas por Inquérito Telefônico (Vigitel) nos anos de 2006 a 2014, desenvolvido com adultos (?:18 anos). Foram utilizados dados das características sociodemográficas (idade, sexo, escolaridade e estado civil), regiões brasileiras, capitais e furam criadas as categorias de IMC-diabetes (utilizando IMC em categorias e presença ou ausência de diabetes). Empregou-se a técnica de regressão linear simples para verificar a ocorrencia de tendência linear das prevalências de sobrepeso, obesidade e diabetes, das categorias de IMC-diabetes, hem corm das categorias sobrepeso-diabético e obeso-diabético estrati:ficados pelas varáveis sociodemográficas, regiões e capitais brasileiras.Resultados: As prevalências de sobrepeso, obesidade, diabetes e das categorias sobrepeso- diabético e obeso-diabetico apresentaram tendência significativa de aumento. Algumas variáveis sociodemográficas, principalmente nas faixas etárias de 18 a 24 anos e 25 a 34 anos, apresentaram estabilização das prevalências de sobrepeso-diabético e obeso-diabético. Destaca-se que as capitais Maceió, Belo Horizonte, São Paulo, Vitória e Porto Alegre apresentaram prevalências...

Introduction: The prevalence of excess weight and diabetes mellitus have increased globally and are a public heahh problem. Excessive weight gain is considered a risk factor for the onset of diabetes mellitus and in this context, the involvement of these simuhaneously morbidities can aggravate and accelerate morbidity and mortality and reduce the quality of lifu of affected individuals. Objective: To determine the temporal trends of prevalence of overweight, obesity and diabetes, as well as the categories of BMI-diabetes, overweight-diabetes and obesity-diabetes. Methods: This is a time series trend study conducted in 26 Brazilian state capitals and the Federal District, using data from the Risk Factor Surveillance System and Protection forChronic Diseases by Telephone Survey (Vigitel) in 2006-2014, developed with adults (~18 years). Socioderrographic datas were used (age, sex, education and marital status), Brazilian regions and capitals. Tbe categories of BMI-diabetes (using BMI categories and presence or absence of diabetes) were created. Sirrple linear regression technique was errployed to verify the occurrence of linear trend of the prevalence of overweight, obesity and diabetes, as well as the categories of BMI-diabetes, and categories overweight-diabetic and obese-diabetics tratified by socioderrographic variables, regions and brazilians capital Results: The prevalence of overweight, obesity, diabetes and the categories of BMI-diabetesobese-diabetic and overweight-diabetic showed a significant upward trend. Some socioderrographic variables, especially in the age groups 18 to 24 and 25 to 34 years, showed stabilization of prevalence of overweight-diabetic and obese-diabetic. It is noteworthy that the capitals Maceió, Belo Horizonte, Sao Paulo, Vitória and Porto Alegre had significantly increased prevalence of both overweight-diabetic, as obese-diabetic. Conclusion: This study highlights the originality of monitoring the prevalence...

Hormonal, metabolic and nutritional alterations in smokers: emergency for smoking abstinence / Alterações metabólicas, hormonais e nutricionais de fumantes: urgência para a abstinência tabágica

OBJECTIVE: To evaluate the biochemical and nutritional status of smokers in treatment for smoking cessation and its association with anthropometric parameters. METHODS: This is a cross-sectional study with convenience sample. Adult smokers were assessed at the start of treatment in the Interdisciplinary Center for Tobacco Research and Intervention of the University Hospital of the Federal University of Juiz de Fora (CIPIT/HU-UFJF). We evaluated the body mass index (BMI), conicity index (CI); waist circumference (WC), percentage of body fat (%BF), fasting glycemia, cortisol, insulin, total cholesterol (TC), LDL-c, HDL-c, triglycerides (TG) and metabolic syndrome (MS). RESULTS: Most participants (52.2%) had MS and high cardiovascular risk. The fasting glycemia was abnormal in 30.4%. There was a significant positive correlation between BMI and WC (r = 0.90; p = 0.0001), %BF (r = 0.79; p = 0.0001), CI (r = 0.65; p = 0.0001), glycemia (r = 0.42; p = 0.04) and TG (r = 0.47; p = 0.002). The CI presented positive correction with insulin (r = 0.60; p = 0.001), glycemia (r = 0.55; p = 0.007), TG (r = 0.54; p = 0.008) and %BF (r = 0.43; p = 0.004). Patients with longer duration of smoking had a higher risk of developing MS (OR = 9.6, p = 0.016). CONCLUSION: The smokers evaluated had increased risk for developing MS, especially those with longer duration of smoking, requiring urgent smoking cessation.

OBJETIVO: Avaliar o perfil bioquímico e nutricional de fumantes em tratamento para a cessação tabágica e sua associação com parâmetros antropométricos. MÉTODOS: Trata-se de um estudo transversal com amostra de conveniência. Adultos fumantes foram avaliados no início do tratamento no Centro Interdisciplinar de Pesquisa e Intervenção em Tabagismo do Hospital Universitário da Universidade Federal de Juiz de Fora (CIPIT/HU-UFJF). Foram avaliados o índice de massa corporal (IMC), índice de conicidade (IC), circunferência da cintura (CC), percentual de gordura corporal (%GC), glicemia de jejum, cortisol, insulina, colesterol total (TC), colesterol LDL-c, HDL-c, triglicéridos (TG) e síndrome metabólica (SM). RESULTADOS: A maioria dos participantes possuía SM e alto risco cardiovascular. A glicemia de jejum estava alterada em 30,4%. Houve correlação positiva significativa entre IMC e CC (r = 0,90; p = 0,0001), %GC (r = 0,79; p = 0,0001), IC (r = 0,65; p = 0,0001), glicemia (r = 0,42; p = 0,04) e TG (r = 0,47; p = 0,002). O IC também apresentou correlação positiva com insulina (r = 0,6; p = 0,001), glicemia (r = 0,55; p = 0,007), TG (r = 0,54; p = 0,008) e %GC (r = 0,43; p = 0,004). Pacientes com maior tempo de tabagismo tiveram maior risco de desenvolver SM (O = 9,6; p = 0,016). CONCLUSÃO: Os fumantes avaliados tiveram maior risco de desenvolver SM, especialmente aqueles que fumavam por mais tempo, requerendo urgência para a cessação tabágica.