Simultaneous prediction of hyperglycemia and dyslipidemia in school children in Santa Catarina State, Brazil based on waist circumference measurement.

OBJECTIVES: Waist circumference (WC) is highly associated with metabolic risk factor clusters (RFC) for chronic non-communicable diseases (NCDs). In this study, we evaluated the use of WC measurements to detect hyperglycemia and dyslipidemia in children and adolescents using the WC cutoff points reported in the Bogalusa Heart study and the New Zealand study. DESIGN AND METHODS: Students (n=1011; aged 6 to 14years) were enrolled in a cross-sectional study. Anthropometric indices, fasting glucose, and lipid profiles were measured. The associations between WC measures and serum parameters were investigated by logistic regression models, and the clinical accuracy of the studied parameters was assessed using receiver operating characteristic (ROC) curve analysis. RESULTS: The prevalence of increased WC was 30.2% using the New Zealand cutoff points and 13.7% using the Bogalusa cutoff values. In general, children with increased WC exhibited higher concentrations of total cholesterol, triglycerides, LDL-cholesterol, and non-HDL-cholesterol and lower levels of HDL-cholesterol. The areas under the ROC curves (AUC) of the WC measurements were 0.770 (95% CI: 0.744-0.797) and 0.600 (95% CI: 0.569-0.631) using, respectively, the New Zealand and Bogalusa cutoff points for WC, indicating the prediction of simultaneous hyperglycemia, increased levels of non-HDL-cholesterol, and reduced HDL-cholesterol for students with increased WC. There was a significant difference between AUC values (P=0.001). Furthermore, the sensitivity of using WC for detecting RFC in students was 2.0 to 2.5-fold higher with the New Zealand study cutoff values for WC than with those from the Bogalusa study. Logistic regression analysis revealed that increased WC was associated with simultaneous hyperglycemia and dyslipidemia after controlling for differences in sex and age (P<0.01 for all). CONCLUSIONS: Children and adolescents exhibited a high prevalence of increased WC associated with other RFCs for NCDs. Increased WC may be used to screen and identify students with elevated clusters of metabolic risk factors for NCDs.

Application of a modified precipitation method for the measurement of small dense LDL-cholesterol (sd-LDL-C) in a population in southern Brazil.

BACKGROUND: In the study reported herein, we used the precipitation method employing heparin-Mg(2+), with slight modifications to avoid lipemia interference, to measure small dense-low density lipoprotein-cholesterol (sd-LDL-C) in Brazilian subjects with a high risk of developing cardiovascular diseases. METHODS: Lipemic samples were diluted with various solvents prior to precipitation with heparin-Mg(2+). Validation assays were performed with ultracentrifugation (n=100) and the reproducibility of sd-LDL-C measured in diluted serum (n=50). The applicability of this modification was evaluated by measuring sd-LDL-C in 434 southern Brazilian normolipidemic, dyslipidemic and type 2 diabetes mellitus (T2DM) individuals. RESULTS: Lipemic serum diluted with 100 mmol/L phosphate buffer pH 8.5 was effective for the quantification of sd-LDL-C, which was correlated with non-diluted serum (r=0.961; p<0.0001) and with ultracentrifugation (r=0.705; p<0.0001). Ultracentrifugation sd-LDL-C was 0.08 mmol/L (CI 95%: -0.42-0.58 mmol/L) higher than the precipitation method (p>0.05). Subjects with dyslipidemias and T2DM had, respectively, 2.3 and 2.6-fold higher sd-LDL-C concentrations than normolipidemic individuals (p<0.05). The incidence of normolipidemic subjects with a high concentration of sd-LDL-C was only 2.2%. The sd-LDL-C was found to be enhanced by 8.3% every 10 years and young normolipidemic men had 24% higher sd-LDL-C than young women (p<0.05). Lipid-lowering therapy reduced sd-LDL-C by 26% (p<0.001). CONCLUSIONS: In this paper we described a simple and inexpensive approach to improving the measurement of sd-LDL-C in high-triglycerides serum. Furthermore, we showed that southern Brazil dyslipidemic and T2DM individuals have increased sd-LDL-C concentrations.

Mate tea (Ilex paraguariensis) improves glycemic and lipid profiles of type 2 diabetes and pre-diabetes individuals: a pilot study.

OBJECTIVES: Yerba mate (Ilex paraguariensis) infusions have been shown to reduce plasma glucose in animals and serum lipids in humans. The aim of this study was to evaluate the effects of roasted mate tea consumption, with or without dietary counseling, on the glycemic and lipid profiles of individuals with type 2 diabetes mellitus (T2DM) or pre-diabetes. METHODS: Twenty-nine T2DM and 29 pre-diabetes subjects were divided into 3 groups: mate tea, dietary intervention, and mate tea and dietary intervention. Individuals drank 330 mL of roasted mate tea 3 times a day and/or received nutritional counseling over 60 days. Blood samples were collected and food intake was assessed at baseline and after 20, 40, and 60 days of treatments. RESULTS: Mate tea consumption decreased significantly the levels of fasting glucose (25.0 mg/dL), glycated hemoglobin A(1c) (HbA(1c)) (0.85%), and low-density lipoprotein cholesterol (LDL-c) (13.5 mg/dL) of T2DM subjects (p < 0.05); however, it did not change the intake of total energy, protein, carbohydrate, cholesterol, and fiber. In pre-diabetes individuals, mate tea consumption combined with nutritional counseling diminished significantly the levels of LDL-c (11 mg/dL), non-high-density lipoprotein cholesterol (HDL-c) (21.5 mg/dL), and triglycerides (53.0 mg/dL) (p < 0.05). Individuals of this group decreased significantly their consumption of total fat (14%), cholesterol (28%), and saturated (23.8%) and monounsaturated (28.0%) fatty acids, and increased their fiber intake by 35% (p < 0.05). CONCLUSIONS: Mate tea consumption improved the glycemic control and lipid profile of T2DM subjects, and mate tea consumption combined with nutritional intervention was highly effective in decreasing serum lipid parameters of pre-diabetes individuals, which may reduce their risk of developing coronary disease.