Cardiometabolic evaluation of small for gestational age children: protective effect of breast milk / Evaluación cardiometabólica de niños pequeños para su edad gestacional: efecto protector de la leche materna

INTRODUCTION: human growth is the result of an interaction between genetic, hormonal, nutritional, and environmental factors. It is not yet fully understood what is predominant and decisive in determining an individual's weight and height. OBJECTIVE: the aim of this study was to evaluate the cardiometabolic profile of exclusively breastfed children born small for gestational age (SGA). METHODS: this is a prospective cohort study of children born at term who were classified as SGA, and as appropiate for gestational age (AGA), who were followed up to pre-school age. Anthropometric measures and body composition parameters were obtained. Breastfeeding duration was calculated in days, and achievement of catch up of weight was considered an increase in Z-score ≥ 0.67. The cardiometabolic profile was evaluated in the first month of life and repeated at pre-school age. At pre-school age, fasting blood glucose, insulin, HOMA-IR, and blood pressure were measured. RESULTS: twenty SGA and 12 AGA children were studied. The mean duration of exclusive breastfeeding (EBF) was 180 days in both groups. Of SGA children, 85 % had recovery anthropometric parameters for age within the first six months, with a speed of weight gain significantly higher than the that of AGAs (p < 0.001). SGAs continued to be thinner and smaller than AGAs at pre-school age. There was no diagnosis of overweight or obesity in the studied sample, and no differences were foun between groups in laboratory tests. CONCLUSION: these findings suggest that EBF may confer protection until pre-school age in children born SGA, who are considered at higher risk for chronic non-communicable diseases

INTRODUCCIÓN: el crecimiento humano es el resultado de la interacción de factores genéticos, hormonales, nutricionales y ambientales. Todavía no se comprende completamente lo que es predominante y decisivo para determinar el peso y la altura del individuo. OBJETIVO: el objetivo de este estudio fue evaluar el perfil cardiometabólico de niños alimentados con lactancia materna exclusivamente y que nacieron pequeños para la edad gestacional (PEG). MÉTODOS: este es un estudio de cohortes prospectivo con niños nacidos a término, unos clasificados como PEG y otros como apropiados para la edad gestacional (AEG). Se hizo un seguimiento de estos niños hasta la edad preescolar. Se realizaron medidas antropométricas y de la composición corporal. La duración de la lactancia materna se calculó en días y el éxito en la recuperación del peso se consideró como un aumento de la puntuación Z ≥ 0,67. El perfil cardiometabólico se evaluó en el primer mes de vida y se repitió en la edad preescolar. En la edad preescolar se midieron la glucosa en sangre en ayunas, la insulina, el HOMA-IR y la presión arterial. RESULTADOS: el grupo del estudio estaba formado por veinte niños PEG y doce niños AEG. La duración media de la lactancia materna exclusiva (LME) fue de 180 días en ambos grupos. De los niños PEG, el 85 % tenían parámetros antropométricos de recuperación para la edad en los primeros seis meses, siendo la velocidad del aumento de peso significativamente mayor que en los AEG (p < 0,001). Aun así, los niños PEG continuaron siendo más delgados y pequeños que los AEG en la edad preescolar. No hubo diagnóstico de sobrepeso u obesidad en la muestra estudiada, y no hay diferencia entre los grupos relativos a las pruebas de laboratorio. CONCLUSIÓN: estos hallazgos sugieren que la LME puede conferir protección hasta la edad preescolar en los niños nacidos PEG, que se consideran en mayor riesgo de contraer enfermedades crónicas no transmisibles

Cardiometabolic evaluation of small for gestational age children: protective effect of breast milk.

INTRODUCTION: Introduction: human growth is the result of an interaction between genetic, hormonal, nutritional, and environmental factors. It is not yet fully understood what is predominant and decisive in determining an individual's weight and height. Objective: the aim of this study was to evaluate the cardiometabolic profile of exclusively breastfed children born small for gestational age (SGA). Methods: this is a prospective cohort study of children born at term who were classified as SGA, and as appropiate for gestational age (AGA), who were followed up to pre-school age. Anthropometric measures and body composition parameters were obtained. Breastfeeding duration was calculated in days, and achievement of catch up of weight was considered an increase in Z-score ≥ 0.67. The cardiometabolic profile was evaluated in the first month of life and repeated at pre-school age. At pre-school age, fasting blood glucose, insulin, HOMA-IR, and blood pressure were measured. Results: twenty SGA and 12 AGA children were studied. The mean duration of exclusive breastfeeding (EBF) was 180 days in both groups. Of SGA children, 85 % had recovery anthropometric parameters for age within the first six months, with a speed of weight gain significantly higher than the that of AGAs (p < 0.001). SGAs continued to be thinner and smaller than AGAs at pre-school age. There was no diagnosis of overweight or obesity in the studied sample, and no differences were foun between groups in laboratory tests. Conclusion: these findings suggest that EBF may confer protection until pre-school age in children born SGA, who are considered at higher risk for chronic non-communicable diseases.

INTRODUCCIÓN: Introducción: el crecimiento humano es el resultado de la interacción de factores genéticos, hormonales, nutricionales y ambientales. Todavía no se comprende completamente lo que es predominante y decisivo para determinar el peso y la altura del individuo. Objetivo: el objetivo de este estudio fue evaluar el perfil cardiometabólico de niños alimentados con lactancia materna exclusivamente y que nacieron pequeños para la edad gestacional (PEG). Métodos: este es un estudio de cohortes prospectivo con niños nacidos a término, unos clasificados como PEG y otros como apropiados para la edad gestacional (AEG). Se hizo un seguimiento de estos niños hasta la edad preescolar. Se realizaron medidas antropométricas y de la composición corporal. La duración de la lactancia materna se calculó en días y el éxito en la recuperación del peso se consideró como un aumento de la puntuación Z ≥ 0,67. El perfil cardiometabólico se evaluó en el primer mes de vida y se repitió en la edad preescolar. En la edad preescolar se midieron la glucosa en sangre en ayunas, la insulina, el HOMA-IR y la presión arterial. Resultados: el grupo del estudio estaba formado por veinte niños PEG y doce niños AEG. La duración media de la lactancia materna exclusiva (LME) fue de 180 días en ambos grupos. De los niños PEG, el 85 % tenían parámetros antropométricos de recuperación para la edad en los primeros seis meses, siendo la velocidad del aumento de peso significativamente mayor que en los AEG (p < 0,001). Aun así, los niños PEG continuaron siendo más delgados y pequeños que los AEG en la edad preescolar. No hubo diagnóstico de sobrepeso u obesidad en la muestra estudiada, y no hay diferencia entre los grupos relativos a las pruebas de laboratorio. Conclusión: estos hallazgos sugieren que la LME puede conferir protección hasta la edad preescolar en los niños nacidos PEG, que se consideran en mayor riesgo de contraer enfermedades crónicas no transmisibles.

Tempo de trânsito intestinal de indivíduos portadores de síndrome metabólica pela escala de bristol / Intestinal transit time of individuals with metabolic syndrome by the bristol scale

Introdução: a síndrome Metabólica (SM) é um transtorno de origem multifatorial que envolve a elevação da circunferência da cintura, da glicemia, da pressão arterial e dos triglicerídeos e redução do HDL-colesterol. Na etiopatogenia deste transtorno, diversos fatores genéticos e ambientais estão envolvidos, dentre eles, a alteração da microbiota intestinal pode ser um dos agentes causais deste distúrbio. Devido aos elevados custos para analisar este ecossistema, e à sua impossibilidade na prática clínica, ferramentas podem ser utilizadas com a intenção de monitorar o funcionamento intestinal, a exemplo da Escala de Bristol. Metodologia: foram avaliados indivíduos adultos e idosos com Síndrome Metabólica atendidos entre fevereiro de 2015 e maio de 2017. A síndrome metabólica foi definida de acordo com o preconizado pela Federação Internacional de Diabetes. Foi realizada anamnese com informações a respeito da consistência das fezes e coleta de medidas clínicas e antropométricas. Foi realizada análise estatística descritiva. Resultados: foram incluídos neste estudo 186 pacientes, com predominância do sexo feminino (83,9%) e indivíduos adultos (55,1%). Dentre os critérios da SM, o mais presente foi a pressão arterial elevada (95,1%), e a maior parte dos indivíduos apresentaram ritmo intestinal normal pela Escala de Bristol (54,8%). Em relação à idade entre os grupos, o que apresentou ritmo lento, teve maior média de idade (69 anos) em relação aos grupos com ritmo normal e ritmo rápido (57 e 54 anos, respectivamente). Por sua vez, indivíduos com ritmo intestinal rápido, apresentaram maiores médias de índice de massa corporal. Conclusão: indivíduos com Síndrome Metabólica parecem possuir tempo de trânsito intestinal adequado segundo a Escala de Bristol.

Introduction: metabolic syndrome (MS) is a multifactorial disorder that involves elevation of waist circumference, blood glucose, blood pressure and triglycerides, and reduction of HDL-cholesterol. In the etiopathogenesis of this disorder, intestinal health plays an important role, especially in the composition of the microbiota. Due to the high costs to analyze this ecosystem, and the impossibility in clinical practice, other tools can be used with the intention of monitoring the state of health of the microbiota such as the Bristol Scale. Metodology: adult and elderly individuals attended at the Núcleo de Pesquisa e Extensão em Genômica Nutricional e Disfunções Metabólicas of Universidade do Estado da Bahia between February 2015 and May 2017 were evaluated. Anamnesis was performed with information about the consistency of feces and Collection of clinical and anthropometric measurements. The metabolic syndrome was defined according to the International Diabetes Federation. Data were analyzed descriptively. Results: a total of 186 patients were analyzed during the study period, with a predominance of females (83.9%) and adults (55.1%). Among the criteria of MS, the most present was high blood pressure (95.1%), and most of the individuals presented normal bowel rhythm by the Bristol Scale (54.8%). In relation to the age between the groups, which presented a slow rhythm, the mean age (69 years) was higher in relation to the groups with normal rhythm and fast rhythm (57 and 54 years, respectively). In turn, individuals with fast bowel rhythm presented higher mean body mass index. Conclusion: individuals with Metabolic Syndrome seem to have intestinal transit time according to the Bristol Scale.

Associação entre níveis séricos de vitamina D e componentes da síndrome metabólica em pacientes atendidos no centro de estudos e atendimento dietoterápico da Universidade do Estado da Bahia / Association between serum levels of vitamin D and components of the metabolic syndrome in patients attended at the Center for Studies and Diet Therapy at the State University of Bahia

Introdução: a síndrome metabólica é um conjunto de disfunções que ocorre no metabolismo. Por sua vez, as disfunções endocrinometabólicas, incluindo componentes da síndrome, tais como obesidade, diabetes mellitus, elevação da pressão arterial e dislipidemias, têm sido associadas a baixos níveis séricos de vitamina D. A Hipovitaminose D tem atingido altas prevalências em diferentes populações mundiais, sobretudo em portadores desta síndrome. Metodologia: estudo observacional analítico, descritivo, de corte transversal. Os pacientes foram diagnosticados com síndrome metabólica a partir das recomendações da IDF, 2006. A coleta de dados foi realizada no período de agosto de 2015 a julho de 2016 e para determinação da concentração sérica de 25-hidroxivitamina D foi utilizado o método de quimioluminescência. Resultados: a hipovitaminose D foi observada em 77,6% dos pacientes. Dentre os componentes da SM a hipertensão arterial foi o mais prevalente. A análise de dados evidenciou correlação inversamente proporcional entre os níveis séricos de 25(OH)D, com as medidas de circunferência da cintura (r= ­ 0,245; pvalor= 0,013), com níveis séricos de triglicerídeos (r= ­ 1,54; pvalor= 0,030) e também com valores de Índice de Massa Corporal (r= ­ 0,225; pvalor= 0,023). Conclusão: neste estudo foi observado alta prevalência de hipovitaminose D e evidenciada correlação inversa entre os níveis séricos de vitamina D e as medidas de Circunferência da Cintura, de níveis séricos de triglicerídeos e valores de IMC.

Introduction: metabolic syndrome is a condition in which the individual manifests a set of metabolic dysfunctions. Endocrine-metabolic dysfunctions, including components of the syndrome, such as diabetes mellitus, elevated blood pressure and dyslipidemias, have been associated with low serum levels of vitamin D. Hypovitaminosis D has reached high prevalence in different world populations, Patients with this syndrome. Metodology: descriptive, cross-sectional observational study. Patients were diagnosed with metabolic syndrome from the recommendations of the IDF, 2006. Data collection was performed from August 2015 to July 2016 and for determination of the serum concentration of 25-hydroxyvitamin D was used the chemiluminescence method. Results: hypovitaminosis D was observed in 77.6% of the patients. Among the components of MS, arterial hypertension was the most prevalent. Data analysis showed an inversely proportional correlation between 25 (OH) D serum levels and waist circumference (r = ­ 0.245; pvalor = 0.013), with serum triglyceride levels (r = ­ 1.54; pvalor = 0.030) and also with values of Body Mass Index (r = ­ 0.225, pvalor = 0.023). Conclusion: in this study, a high prevalence of D-hypovitaminosis was observed and an inverse correlation was found between serum vitamin D levels and Waist Circumference, serum triglyceride levels and BMI values.

Detection of metabolic disorders in high-risk patients: a pilot study in Salvador, Bahia

The purpose of this pilot-study was to evaluate the applicability of a screening protocol for the detection of inborn errors of metabolism (IEM) in high-risk patients. The protocol was applied in 65 patients referred to the Medical Genetics Laboratory of the University Hospital Professor Edgard Santos due to the suspicion of an IEM. Eight of these patients (12.3 percent) displayed an abnormal result in the screening protocol. These patients, along with 22 who displayed normal results in the screening protocol but who presented clinical symptoms or signs suggestive of an IEM not detectable by the tests applied, were selected for a further diagnostic investigation. In 5 of these 30 patients (7.7 percent of the total sample) it was possible to establish the diagnosis of an specific IEM. The results indicate that the designed screening protocol was sucessfully applied, allowing the detection of affected patients in a frequency comparable to that observed in larger studies performed elsewhere. The continuation of this study and the enlargement of the sample will help to delineate the profile of IEM in northeast of Brazil and will allow the identification of a significative number of patients and families. who could benefit from the therapeutic and preventive measures available for these diseases.