Prevalence of metabolic syndrome in Brazilian adults in the last 10 years: a systematic review and meta-analysis.

BACKGROUND: A cluster of interconnected cardiometabolic risk factors characterizes metabolic Syndrome (MS). The prevalence of MS is increasing worldwide, but there is not a meta-analysis of this prevalence in the Brazilian population. We aimed to determine the prevalence of metabolic syndrome among adult general population in Brazil through a meta­analysis study. METHODS: Original research studies were searched at PubMed, Scopus, Web of Science, and SciELO databases, from 2011 to 2021. We used the Joanna Briggs Institute tool to assess the quality of included studies. The random effect model was used to estimate the pooled prevalence of MS. Subgroup and meta-regression analysis were conducted for explored heterogeneity and used the Funnel Plot and Egger's test to assess publication bias. The study was performed based on the criteria of Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). RESULTS: The search in electronic databases identified 1598 records. From this total, 26 studies were eligible to be included in the final analysis. The overall pooled prevalence among the general population of Brazil was 33% with high heterogeneity observed. By gender, the prevalences were 26% in males and 38% in females. By criteria that was used to define MS, the prevalence were 31% in NCEP ATP III, 25% in JIS, 37% in IDF/NHLBI/AHA/WHF/IAS/IASO and 33% in IDF criteria. The prevalence in different habitat was 34% in urban, 15% in rural, 28% in quilombola and 37% in indigenous. In different regions was 37% in the South, 30% in Southeast, 38% in North, 31% in Northeast and 39% in Midwest. The pooled prevalence of MS with age was < 45 years: 43% and ≥ 45 years: 42% and the prevalence based on year of study implementation was 31% in 2015-2019, 35% in 2010-2014 and 28% in 2005-2009. There were no statistically significant differences between subgroups. Most of the studies showed high quality assessment criteria's except adequate sample size criteria and many studies participants were not sampled in an appropriate way. CONCLUSIONS: Our review indicates a high prevalence of MS in the healthy Brazilian adult population, when compared to others countries and with a world estimate.

Cartografando controvérsias na implantação da estratégia e-sus atenção básica a Saúde em Minas Gerais / Cartografía de las controversias en la implementación de la estrategia para la Atención Primaria de Salud en Minas Gerais / Mapping controversies in the implementation of the strategy for Primary Health Care in Minas Gerais

O estudo teve o objetivo de cartografar controvérsias relacionadas à rede de atores na implantação de uma estratégia de informatização da Atenção Básica a Saúde, em Minas Gerais, Brasil. Trata-se de um estudo de abordagem qualitativa fundamentado na Teoria Ator-Rede. Como referencial metodológico utilizou-se a Cartografia de Controvérsias. Entrevistamos 16 porta-vozes (profissionais de saúde, gestores e técnicos de informática) envolvidos com a implantação da estratégia em um município da região oeste de Minas Gerais. Realizamos observação participante e coleta de 43 documentos ao seguir os porta-vozes durante o processo de implantação no período de Janeiro de 2018 a Abril de 2019. Mapeamos como controvérsia central a decisão em utilizar ou não o sistema próprio municipal em detrimento de outra tecnologia. Outros desdobramentos emergiram: controvérsias éticas; controvérsias diante do processo de integração das informações entre o sistema próprio municipal e os sistemas de software governamentais; controvérsias nas unidades básicas durante a implantação da estratégia de informatização relacionadas às fragilidades estruturais e sobrecarga de trabalho dos profissionais. Ainda constatamos traduções relacionadas ao ato de não planejar e não decidir a partir dos dados armazenados nos sistemas, além de incertezas sobre a responsabilização em alimentar os sistemas de software. Conclui-se que há uma controvérsia central (a decisão em implantar a tecnologia) envolvendo uma rede de atores humanos e não-humanos mobilizando decisões, conflitos e acordos, bem como há desdobramentos (outras controvérsias) que acabam por influenciar a informatização(AU)

El estudio tuvo como objetivo mapear controversias relacionadas con la red de actores en la implementación de una estrategia de informatización para la Atención Primaria de Salud, en Minas Gerais, Brasil. Se trata de un estudio cualitativo basado en la Teoría Actor-Red. Como marco metodológico se utilizó la cartografía de controversias. Fueron entrevistados 16 voceros (profesionales de la salud, gerentes y técnicos en computación) involucrados en la implementación de la estrategia en un municipio de la región occidental de Minas Gerais. Se recolectaron 43 documentos durante el proceso de implementación de enero del año 2018 hasta abril de 2019. Como controversia central se mapeó la decisión de usar o no el propio sistema municipal a expensas de otras tecnologías. Surgieron las siguientes controversias: éticas; sobre el proceso de integración de información entre el propio sistema municipal y los sistemas de software del gobierno; y en las unidades básicas durante la implementación de la estrategia de informatización relacionada con las debilidades estructurales y la sobrecarga de trabajo de los profesionales. Aún encontramos traducciones relacionadas con el acto de no planificar y no decidir a partir de los datos almacenados en los sistemas, además de incertidumbres sobre la responsabilidad de alimentar los sistemas de software. Se concluye que existe una controversia central (la decisión de implantar la tecnología) que involucra a una red de actores humanos y no humanos que movilizan decisiones, conflictos y acuerdos, así como también hay desarrollos (otras controversias) que terminan por influir en la informatización(AU)

The study aimed to map controversies related to the network of actors in the implementation of a computerization strategy for Primary Health Care, in Minas Gerais, Brazil. It was a qualitative study based on the Actor-Network Theory. As a methodological framework, Controversy Cartography was used. We interviewed 16 spokespersons (health professionals, managers and computer technicians) involved with the implementation of the strategy in a municipality in the Western region of Minas Gerais. We conducted participant observation and collected 43 documents when following the spokespersons during the implementation process from January 2018 to April 2019. We map as a central controversy the decision to use or not the municipal system itself at the expense of other technology. Other developments have emerged: ethical controversies; controversies regarding the process of integrating information between the municipal system itself and government software systems; controversies in basic units during the implementation of the computerization strategy related to structural weaknesses and work overload of professionals. We still found translations related to the act of not planning and not deciding from the data stored in the systems, in addition to uncertainties about the responsibility to feed the software systems. It is concluded that there is a central controversy (the decision to implant the technology) involving a network of human and non-human actors mobilizing decisions, conflicts and agreements, as well as there are developments (other controversies) that end up influencing computerization(AU)

Antioxidant potential of Buriti (Mauritia flexuosa) pulp flour in diabetic rats

Buriti pulp flour (BPF) contains significant levels of antioxidants. This study evaluated the effect of BPF on biomarkers of oxidative damage in the liver, heart, and pancreas of diabetic rats. The chemical composition, antioxidant capacity, and polyphenol content of BPF were determined. Thirty-six female Fisher rats were divided into four groups: control (C); control + BPF (CB); diabetic (D); diabetic + BPF (DB). Diabetes was induced by treatment with streptozotocin. Thirty days after the induction of diabetes, glucose, total cholesterol and triacylglycerides serum levels, aminotransferase and paraoxonase activities were evaluated. Oxidative damage to lipids and proteins was assessed through thiobarbituric acid reactive substances (TBARS) and protein carbonyl analyses, respectively. Histopathological analyses were also performed. BPF contained high concentrations of phenolic compounds, lipids, and fibers, and exhibited a high capacity to neutralize the 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical. Diabetes was evidenced by equivalent high levels of glucose in plasma from rats in the D and DB groups. Diabetic rats in both groups also presented the same increased activity of aminotransferases. Protein carbonyl levels were increased in liver, heart, and pancreas in the D compared with C group. Although treatment with BPF did not result in any histopathological alterations, it reduced significantly the levels of TBARS in the heart and protein carbonyls in the liver and heart. No effect on blood glucose and tissue histology was observed following treatment with BPF. However, BPF diminished oxidative damage in liver and heart, indicating a possible antioxidant potential in vivo, in addition to in vitro(AU)

La harina de pulpa buriti (BPF) contiene niveles significativos de antioxidantes. Este estudio evaluó el efecto del BPF en biomarcadores de daño oxidativo en el hígado, el corazón y el páncreas de ratas diabéticas. Se determino la composición química, la capacidad antioxidante y el contenido de polifenoles del BPF. Treinta y seis ratas Fisher fueron divididas en cuatro grupos: Control (C); Control + BPF (CB); Diabético (D); Diabético + BPF (DB). La diabetes fue inducida por tratamiento con estreptozotocina. Treinta dias después de la inducción de la diabetes, se evaluaron los niveles séricos de glucosa, colesterol total y triacilglicéridos, y las actividades de aminotransferasa y paraoxonasa. El daño oxidativo a lípidos y proteínas se evaluó a través de sustancias reactivas al ácido tiobarbitúrico (TBARS) y análisis de proteínas carboniladas respectivamente. También se realizaron análisis histopatológicos. El BPF contenía altas concentraciones de compuestos fenólicos, lípidos y fibras, y exhibía una alta capacidad para neutralizar el radical 2,2-difenil-1-picrilhidracil (DPPH). La diabetes se evidenció por altos niveles de glucosa en plasma de ratas en los grupos D y DB. Las ratas diabéticas en ambos grupos también presentaron la misma actividad aumentada de las aminotransferasas. Los niveles de proteínas carboniladas se incrementaron en el hígado, el corazón y el páncreas en el grupo D en comparación con el C. Aunque el tratamiento con BPF no dio lugar a alteraciones histopatológicas, redujo significativamente los niveles de TBARS en el corazón y las proteínas carboniladas en el hígado y el corazón. No se observo ningún efecto sobre la glucosa en la sangre y la histología de tejidos después del tratamiento con BPF. Sin embargo, el BPF disminuyó el daño oxidativo en el hígado y el corazón, lo que indica un posible potencial antioxidante in vivo, además de in vitro(AU)