Frequency and factors associated with sarcopenia prediction in adult and elderly patients hospitalized for COVID-19.

Patients with COVID-19 may develop symptoms that interfere with food intake. Systemic inflammatory response associated with physical inactivity and/or immobilization during hospital stay can induce weight and muscle loss leading to sarcopenia and worsening the clinical condition of these patients. The present study identifies the frequency and factors associated with sarcopenia prediction in adult and elderly patients hospitalized for COVID-19. It is a cohort-nested cross-sectional study on adult and elderly patients admitted to wards and intensive care units (ICUs) of 8 hospitals in a northeastern Brazilian state. The study was conducted from June 2020 to June 2021. Sociodemographic, economic, lifestyle, and current and past clinical history variables were collected. Sarcopenia prediction was determined by the Strength, Assistance in walking, Rise from a chair, Climb stairs, and Falls (SARC-F) questionnaire compiled in the Remote-Malnutrition APP (R-MAPP). Patients were diagnosed with sarcopenia when the final score ≥ 4 points. The study included 214 patients with a mean age of 61.76 ± 16.91 years, of which 52.3 % were female and 57.5 % elderly. Sarcopenia prevailed in 40.7 % of the sample. Univariate analysis showed greater probability of sarcopenia in elderly individuals, nonpractitioners of physical activities, hypertensive patients, diabetic patients, and those hospitalized in the ICU. In the multivariate model, the type of hospital admission remained associated with sarcopenia prediction, where patients admitted to the ICU were 1.43 (95 % CI: 1.04; 1.97) more likely to have sarcopenia than those undergoing clinical treatment. Sarcopenia prediction was not associated with patient outcome (discharge, transfer, or death) (p = 0.332). The study highlighted an important percentage of sarcopenia prediction in patients with COVID-19, especially those admitted to the ICU. Additional investigations should be carried out to better understand and develop early diagnostic strategies to assist in the management of sarcopenic patients with COVID-19.

Prevalência de fatores de risco para doenças cardiovasculares em diabéticas / Prevalence of risk factors for cardiovascular disease in diabetic women

Introdução: A principal causa de morbimortalidade em indivíduos diabéticos são as doenças ateroscleróticas cardiovasculares, bem como também são as maiores contribuintes pelos custos diretos e indiretos de diabetes. Objetivo: O presente estudo avaliou em análise descritiva transversal a prevalência de fatores de risco para doenças cardiovasculares em 131 diabéticas com idade ³ 20 anos acompanhadas no ambulatório de Nutrição/Diabetes de hospital universitário em Recife-Pernambuco. Sujeitos e Métodos: Foram avaliadas as variáveis renda, escolaridade, tabagismo, etilismo, atividade física, Índice de Massa Corporal, Circunferência da Cintura, história clínica pessoal/ familiar e consumo de alimentos de risco e cardioprotetores. Resultados: Os fatores de risco para doenças cardiovasculares mais prevalentes foram circunferência da cintura muito elevada (86,9%) e sedentarismo (83,2%). A prevalência de história clínica pessoal (79,4%) e familiar (74,0%) de hipertensão, excesso de peso (77,5%), baixa renda (75,6%) e baixa escolaridade (67,1%) também foram relevantes. Verificou-se que tabagismo (2,3%), etilismo (0,8%) e o consumo de alimentos de risco cardiovascular não representaram de fatores de risco para doenças cardiovasculares. Dentre os alimentos de risco cardiovascular mais consumidos destacaram-se margarina e leite integral (10,8%) e, dentre os cardioprotetores, o tomate (64,9%) e feijão (62,6%). Conclusão: Devido à prevalência elevada dos fatores de risco para doenças cardiovasculares nas diabéticas, ressaltasse a importância do desenvolvimento de ações que visem garantir seu controle metabólico, no intuito de prevenir ou colaborar no tratamento de doenças cardiovasculares (AU)

Introduction: The main cause of morbidity and mortality in diabetic patients are cardiovascular atherosclerotic diseases, and are also the biggest contributors for direct and indirect costs of diabetes. Objective: This study evaluated cross descriptive analysis the prevalence of risk factors for cardiovascular disease in 131 diabetic women aged ³ 20 years old accompanied on Ambulatory of Nutrition/Diabetes in a teaching hospital in Recife - Pernambuco. Subjects and Methods: We evaluated the variables income, education, smoking, alcohol consumption, physical activity, body mass index, waist circumference, personal/family clinical history and consumption of risk foods and cardioprotective foods. Results: The most prevalent risk factors for cardiovascular disease were very high waist circumference (86.9%) and physical inactivity (83.2%). The prevalence of personal (79.4%) and family (74.0%) clinical history of hypertension, overweight (77,5%), low income (75.6%) and low school level (67.1%) were also relevant. It was found that smoking (2.3%), alcohol (0.8%) and consumption of cardiovascular risk food didn`t constitutes risk factors for cardiovascular disease. Conclusion: Among cardiovascular risk food more consumed, the highlights were margarine and whole milk (10.8%) and among cardioprotective food, the highlights were tomato (64,9%) and bean (62,6%). Due to high prevalence of risk factors for cardiovascular disease in diabetic women, we emphasize the importance of the development of actions aimed at achieving metabolic control in order to prevent or collaborate in the treatment of cardiovascular disease (AU)

Perfil nutricional e fatores associados em mulheres com diabetes gestacional / Nutritional profile and associated factors in women with gestational diabetes

Introdução: A avaliação do estado nutricional tem como objetivo analisar as medidas corporais de um indivíduo ou de uma população, com o propósito de criar uma conduta de intervenção. Objetivos: avaliar estado nutricional de portadoras de diabetes mellitus gestacional (DMG), associando com variáveis demográficas, socioeconômicas, obstétricas e clínicas. Métodos: a coleta foi realizada através de entrevistas com gestantes em ambulatório de pré-natal. Resultados: 50 mulheres, com idade de 32,8 ± 5,6 anos, no 2º (26%) e 3º terceiro trimestre (74%). A maioria eram não brancas, casadas/união estável, escolaridade superior a 9 anos, sem atividades remuneradas, renda familiar < 2 salários mínimos, multigestas e multíparas. O IMC gestacional revelou 88% de excesso de peso. Evidenciou-se TOTG elevado aos 120’ nas gestantes que realizavam tratamento para o DMG. IMC gestacional adequado associou-se positivamente com a pressão arterial diastólica e, entre os fatores de risco para o DMG, idade ≥ 25 anos teve uma frequência de 88%. Discussão: Dados da literatura com esse tipo de pacientes revelam que mulheres com DMG iniciam seu tratamento com dieta e mudanças no estilo de vida; porém, quando essas medidas falham em atingir um controle glicêmico adequado ou na presença de crescimento fetal excessivo à ultrassonografia, a insulinoterapia deve ser considerada. Conclusão: Foi detectado excesso de peso antes e durante a gestação, não sendo associado com fatores de risco para a incidência de DMG (AU)

Objective: The aim of the present study was to assess the nutritional status of women with gestational diabetes mellitus (GDM) and determine associations with demographic, socioeconomic, obstetric and clinical variables. Methods: Data collection was carried out through interviews with pregnant women in prenatal follow up. Results: The sample was made up of 50 women (mean age: 32.8 ± 5.6 years) in the second (26%) and third (74%) trimesters. Most participants were non Caucasian, married or in a stable relationship, had more than nine years of schooling, had no paid activities, had a household income of less than two times the minimum salary, had previous pregnancies and had given birth before. The gestational body mass index (BMI) revealed that 88% of the sample had excess weight. Oral glucose tolerance at 120 min was high among the women in treatment for GDM. Adequate gestational BMI was associated with diastolic blood pressure. Age ≥ 25 was a risk factor for GDM. Conclusion: While excess weight before and during pregnancy was detected in the present sample, this variable was not a risk factor for the occurrence of GDM (AU)