Relationship between abdominal and neck fat with sleep disorders in obese patients / Relação entre gordura abdominal e do pescoço com distúrbios do sono em pacientes obesas

Abstract Introduction Obesity is one of the main public health problem worldwide and it has a negative short- and long-term relationship with women's health. Assessment of this disorder is essential, as is a body composition assessed by dual-energy X-ray absorptiometry (DXA) with the new region of interest as the neck. Objective To verify the association between abdominal and neck fat with sleep quality in obese women. Methods The sample, obtained from a Biomedical Engineering and Health Program database, was characterized by being obese female aged between 20 and 65 years. The tests performed were anthropometric assessment, sleep quality questionnaire, physical activity level, nutritional assessment, and body composition by dual-energy X-ray absorptiometry (DXA). For statistical analysis, the Shapiro-Wilk test, t test for independent samples, Kendall's Tau, linear and multiple regression and ROC curve were used. Results The sample consisted of 15 individuals with a mean age of 45 ± 11.10 years, neck circumference of 41.50 ± 2.61 and abdominal circumference of 128.20 ± 11.62. We found no correlation between the regions of interest and the sleep quality questionnaire. Regression analysis shows non-significant statistical values for abdominal fat. The statistical test proved that the new region of interest in abdominal fat is closer to better sensitivity and has a greater relationship with sleep quality. Conclusion there was no statistically significant correlation between the regions of interest and the sleep quality questionnaire. However, the abdominal fat region of interest was the point that presented the best association with sleep quality assessed by the Pittsburgh questionnaire.

Resumo Introdução A obesidade é um dos principais problemas de saúde pública em todo o mundo e tem uma relação negativa de curto e longo prazo com a saúde da mulher. A avaliação desse distúrbio é essencial, assim como a composição corporal avaliada por absorciometria de raios X de dupla energia (DXA), com a nova região de interesse como o pescoço. Objetivo Verificar a associação da gordura abdominal e cervical com a qualidade de sono em mulheres obesas. Métodos A amostra, obtida de um banco de dados do Programa de Engenharia Biomédica e Saúde, caracterizou-se por mulheres obesas com idade entre 20 e 65 anos. Os testes realizados foram avaliação antropométrica, questionário de qualidade do sono, nível de atividade física, avaliação nutricional e composição corporal por dual-energy X-ray absorptiometry (DXA). Para análise estatística, foram utilizados o teste de Shapiro-Wilk, teste t para amostras independentes, Tau de Kendall, regressão linear e múltipla, e curva ROC. Resultados A amostra foi composta por 15 indivíduos com idade média de 45 ± 11,10 anos, circunferência do pescoço de 41,50 ± 2,61 e circunferência abdominal de 128,20 ± 11,62. Não encontrou-se correlação entre as regiões de interesse e o questionário de qualidade do sono. A análise de regressão mostrou valores estatísticos não significativos para a gordura abdominal. O teste estatístico comprovou que a nova região de interesse na gordura abdominal está mais próxima de melhor sensibilidade e tem maior relação com a qualidade do sono. Conclusão Não houve correlação estatisticamente significativa entre as regiões de interesse e o questionário de qualidade do sono. A região de gordura abdominal de interesse, no entanto, foi o ponto que apresentou melhor associação com a qualidade do sono avaliada pelo questionário de Pittsburgh.

Lean mass and strength profile of women submitted to bariatric surgery: comparison of the EWGSOP2 and FNIH classification for sarcopenia - ASBS program phase II.

Aim: To assess the effect of bariatric surgery on the lean mass of women after one year of the procedure, comparing its outcomes upon the classification from both the Foundation of the National Institutes of Health (FNIH) and the European Working Group on Sarcopenia in the Elderly People (EWGSOP). Material and methods: Twenty-eight obese women aged 40.5 ± 9.8 yrs who underwent Roux-en-Y gastric bypass (RYGB) were included. 27 of them were reassessed after 6 months of surgery, and 16 completed the one-year follow-up. Pre-sarcopenia condition was assessed through a handgrip strength test and body composition by dual-energy X-ray absorptiometry (DXA). Total body mass, body mass index, and lean mass (LM) were collected prior to, 6 and 12 months after RYGB surgery. Results: All subjects reassessed after 12 months were diagnosed with pre-sarcopenia according to the FNIH classification criteria, while according to the EWGSOP2 Consensus they presented normal values. LM represented 14% of the influence on handgrip strength (p = .049) after 6 months of surgery; however, its influence on strength after 12 months increased to 30% (p = .028). Conclusion: The FNIH classification is the most effective criteria since it uses LM content as the first test, considering that strength capacity needs more time to be affected by the surgical procedure. On the other hand, the EWGSOP2 classification should not be applied to determine the loss of LM in younger populations regardless of what may have caused such changes.

Relationship between postural changes, osteoarthritis and bone mineral density in postmenopausal women.

OBJECTIVES: To assess the relationship between postural changes, osteoarthritis (OA) and bone mineral density (BMD) in postmenopausal women. METHODS: A total of 127 Brazilian women, aged 45 years or older, were included in this retrospective study. Subjects were divided in two groups: study group with postural changes (SG) and control group without postural changes (CG). Possible postural changes considered were scoliosis, kyphosis and lordosis. All women underwent BMD assessment and OA was identified at the region of the hip and lumbar spine by dual energy X-ray absorptiometry (DXA) analysis. RESULTS: SG was older (66.0 ± 7.3 years) than the CG (61.0 ± 8.6 years). In the entire sample we found thirteen women with OA and low BMD. Overall, the lumbar spine area was more affected by OA than the hip. The value of BMD T-score accounted for up to 77% of the changes observed in the SG group. CONCLUSION: Postural changes identified in women are directly related to aging and associated with bone loss and joint degeneration. Postural changes may be the primary sign of frailty as a result of body adaptation to pain related to musculoskeletal diseases.

Effects of anthropometric parameters on bone mineral density in women: from perimenopause to old age.

AIM: To analyze the influence of body components on bone mineral density (BMD) in women from perimenopause to old age. MATERIAL AND METHODS: A total of 117 women were allocated into three groups according to the reproductive stage (STRAW): perimenopausal (PEM, N = 28, mean age 44.8 ± 3.6), early postmenopausal (EPM, N = 36, mean age 51.4 ± 2.8) and late postmenopausal (LPM, N = 53; mean age 64.0 ± 1.7). Total body mass, body mass index (BMI), lean mass (LM), fat mass (FM), fat percentage (FP) and BMD at the lumbar spine (lBMD) and femoral neck (fBMD) were assessed. RESULTS: BMI, FM, LM and BMD values decreased from PEM to LPM. The total effect of FM on fBMD and lBMD was of 42% and 8% for PEM, 28% and 33% for EMP and 9% and 1% for LPM respectively. Additionally, the total effect of LM on fBMD and lBMD was 48% and 3% for PEM, 54% and 53% for EMP and 9% and 11% for LPM women respectively. CONCLUSION: BMI, LM, and FM decreased with aging. All these components had great influence on both fBMD and lBMD in EMP women. Conversely, in PEM these parameters only had influence on femoral BMD, but not on lumbar spine. These data suggests that LM is the most important component in BMD for women older than 50 years old, particularly in the hip.