Reference values for the triglyceride to high-density lipoprotein ratio and its association with cardiometabolic diseases in a mixed adult population: The ELSA-Brasil study.

BACKGROUND: Among several lipid ratios available, the triglyceride/HDL-cholesterol (TG/HDL-C) may detect individuals at risk of cardiometabolic diseases. However, its reference values for different ethnicities are not well established. OBJECTIVE: To define sex- and ethnicity-specific reference values for TG/HDL-C ratio in a large sample of healthy multiethnic adults and test its association with cardiometabolic conditions. METHODS: An apparently healthy sample (n = 2,472), aged 35-74, free of major cardiovascular risk factors, was used to generate the reference values for the TG/HDL-C. Exclusion criteria were diabetes, elevated blood pressure, obesity, hypercholesterolemia, severe hypertriglyceridemia, and smoking history. Cut-offs based on the reference values were tested in the whole ELSA Brasil study (n = 13,245), stratified by sex and ethnicity, to identify cardiometabolic conditions. RESULTS: TG/HDL-C ratio was higher in men than women, and did not change significantly with age, regardless of sex and ethnicity. Also, black individuals showed lower levels of TG/HDL-C as compared to other ethnic groups. ROC curve showed that the cut-off based on the 75th percentile displayed better sensitivities and specificities for men and women, regardless of ethnicity. Also, the sex- and ethnicity-specific cut-offs based on the 75th percentile were significantly associated with all tested cardiometabolic conditions (hypertension, diabetes, obesity, metabolic syndrome, and insulin resistance). Also, we observed that the use of a single sex-specific cut-off (men: 2.6; women: 1.7) could be used for the different ethnicities with good reliability. CONCLUSION: The defined TG/HDL-C cut-offs (men: 2.6; women: 1.7) are reliable and showed good clinical applicability to detect cardiometabolic conditions in a multiethnic population.

Methods of cognitive function investigation in the Longitudinal Study on Adult Health (ELSA-Brasil).

CONTEXT AND OBJECTIVE: Many uncertainties concerning risk factors and evolution of cognitive disorders remain. We describe the methods and preliminary results from the investigation of the cognitive function in the Longitudinal Study on Adult Health (ELSA-Brasil). DESIGN AND SETTING: Multicenter cohort study on public employees at six public teaching and research institutions. METHODS: The participants were interviewed and examined to obtain a broad range of social, clinical and environmental characteristics. The following standardized tools were used to assess memory, language and visuospatial and executive functions: words or figure memory test; semantic (animals) and phonemic (letter F) verbal fluency tests; and trail test B. RESULTS: 15,101 out of 15,105 participants took the cognitive tests: 54% were women; the mean age was 51 years; and 52% had a university degree. 14,965 participants (99%) did the word test and 136 (1%) did the figure test due to low schooling level. The scores from the semantic verbal fluency tests (mean = 18.42 ± 5.29; median = 18 words) were greater than the scores from the phonemic verbal fluency tests (mean = 12.46 ± 4.5; median = 12 words). The median time taken to perform the trail test was 1.6 minutes. CONCLUSION: The large cohort size, of young age, and the extensive amount of clinical and epidemiological data available will make it possible to investigate the prognostic value of biological, behavioral, environmental, occupational and psychosocial variables over the short and medium terms in relation to cognitive decline, among adults and elderly people.

Methods of cognitive function investigation in the Longitudinal Study on Adult Health (ELSA-Brasil) / Métodos de investigação da função cognitiva no Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil)

CONTEXT AND OBJECTIVE: Many uncertainties concerning risk factors and evolution of cognitive disorders remain. We describe the methods and preliminary results from the investigation of the cognitive function in the Longitudinal Study on Adult Health (ELSA-Brasil). DESIGN AND SETTING: Multicenter cohort study on public employees at six public teaching and research institutions. METHODS: The participants were interviewed and examined to obtain a broad range of social, clinical and environmental characteristics. The following standardized tools were used to assess memory, language and visuospatial and executive functions: words or figure memory test; semantic (animals) and phonemic (letter F) verbal fluency tests; and trail test B. RESULTS: 15,101 out of 15,105 participants took the cognitive tests: 54% were women; the mean age was 51 years; and 52% had a university degree. 14,965 participants (99%) did the word test and 136 (1%) did the figure test due to low schooling level. The scores from the semantic verbal fluency tests (mean = 18.42 ± 5.29; median = 18 words) were greater than the scores from the phonemic verbal fluency tests (mean = 12.46 ± 4.5; median = 12 words). The median time taken to perform the trail test was 1.6 minutes. CONCLUSION: The large cohort size, of young age, and the extensive amount of clinical and epidemiological data available will make it possible to investigate the prognostic value of biological, behavioral, environmental, occupational and psychosocial variables over the short and medium terms in relation to cognitive decline, among adults and elderly people. .

CONTEXTO E OBJETIVO: Ainda persistem muitas incertezas relativas a fatores de risco e evolução das desordens cognitivas. Descrevemos métodos e resultados preliminares da investigação da cognição no ELSA-Brasil, Estudo Longitudinal de Saúde do Adulto. TIPO DE ESTUDO E LOCAL: Estudo de coorte, multicêntrico, com servidores públicos de seis instituições públicas de ensino e pesquisa. MfÉTODOS: Participantes foram entrevistados e examinados, para obtenção de amplo espectro de variáveis sociais, clínicas e ambientais. Foram utilizados instrumentos padronizados de avaliação da memória, linguagem e funções executiva e visual espacial: teste de memória de palavras ou de figuras, de fluência verbal semântica (animais) e fonêmica (letra F) e teste de trilhas B. RESULTADOS: 15,101 de 15,105 participantes fizeram os testes cognitivos; 54% eram mulheres, a média da idade foi de 51 anos e 52% tinham grau universitário. 14.965 participantes (99%) fizeram o teste de palavras e 136 (1%) o teste de figuras, dado o menor grau de instrução. Os escores dos testes de fluência verbal semântica (média = 18.42 ± 5.29, mediana = 18 palavras) foram maiores que os escores dos testes de fluência verbal fonêmica (média = 12.46 ± 4.5, mediana = 12 palavras). O tempo mediano para execução do teste de trilhas foi de 1,6 minutos. CONCLUSÃO: O grande tamanho da coorte, de idade jovem, e a extensa quantidade de dados clínicos e epidemiológicos disponíveis permitirão a investigação do prognóstico de variáveis de natureza biológica, comportamental, ambiental, ocupacional e psicossociais, em curto e médio prazo, sobre o declínio cognitivo em adultos e idosos. .