Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI <18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For schoolaged children and adolescents, we report thinness (BMI <2 SD below the median of the WHO growth reference) and obesity (BMI >2 SD above the median). Findings From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesit

Global variation in diabetes diagnosis and prevalence based on fasting glucose and hemoglobin A1c

Fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) are both used to diagnose diabetes, but these measurements can identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening, had elevated FPG, HbA1c or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardized proportion of diabetes that was previously undiagnosed and detected in survey screening ranged from 30% in the high-income western region to 66% in south Asia. Among those with screen-detected diabetes with either test, the age-standardized proportion who had elevated levels of both FPG and HbA1c was 29-39% across regions; the remainder had discordant elevation of FPG or HbA1c. In most low- and middle-income regions, isolated elevated HbA1c was more common than isolated elevated FPG. In these regions, the use of FPG alone may delay diabetes diagnosis and underestimate diabetes prevalence. Our prediction equations help allocate finite resources for measuring HbA1c to reduce the global shortfall in diabetes diagnosis and surveillance

Global variations in diabetes mellitus based on fasting glucose and haemogloblin A1c

Fasting plasma glucose (FPG) and haemoglobin A1c (HbA1c) are both used to diagnose diabetes, but may identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening had elevated FPG, HbA1c, or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardised proportion of diabetes that was previously undiagnosed, and detected in survey screening, ranged from 30% in the high-income western region to 66% in south Asia. Among those with screen-detected diabetes with either test, the agestandardised proportion who had elevated levels of both FPG and HbA1c was 29-39% across regions; the remainder had discordant elevation of FPG or HbA1c. In most low- and middle-income regions, isolated elevated HbA1c more common than isolated elevated FPG. In these regions, the use of FPG alone may delay diabetes diagnosis and underestimate diabetes prevalence. Our prediction equations help allocate finite resources for measuring HbA1c to reduce the global gap in diabetes diagnosis and surveillance.peer-reviewe

Different laser’s doses in neural treatment neural after experimental axonotmese of sciatic nerve in rats under hind limb unloading

A irradiação com o laser é muito empregada para tratar uma variedade de condições patológicas do sistema músculo-esquelético, inclusive dos nervos periféricos. O objetivo desse trabalho foi avaliar por análises clínicas e morfométricas, a reparação neural e muscular após a compressão do nervo ciático de ratos submetidos à imobilização por suspensão e tratados ou não com diferentes doses de laser terapêutico. Foram utilizados 48 ratos machos, com idade de 60 dias, da raça Wistar, distribuídos em três grupos de 16 animais, sendo um utilizado como controle (GA) e outros dois que receberam diferentes doses do laser (GB com dose de 4 J/cm² e GC com dose de 6 J/cm²). Após a compressão do nervo ciático os animais foram submetidos à hipocinesia dos membros pélvicos e ao tratamento com Laser de GaAlAs três vezes por semana, durante 14 ou 28 dias. O índice funcional do ciático (IFC) foi avaliado nos períodos pré-operatório, aos 14 e aos 28 dias apresentando melhora para ambos os grupos, porém com destaque para o GA aos 28 dias. Os resultados da morfometria demonstraram que a recuperação do nervo foi melhor para os grupos tratados, principalmente aos 14 dias. Já os músculos não foram afetados pela laserterapia. A conclusão aponta para os benéficos da laserterapia sobre a recuperação morfológica do nervo ciático principalmente nos primeiros 14 dias após a lesão por axonotmese. Além de que a laserterapia, per si, não é capaz de influenciar a recuperação e a funcionalidade dos músculos acometidos.Laser irradiation is frequently used as treatment for many pathologies of skeletal muscle, including peripheral nerves lesion. Therefore, the aim of this research was to evaluate by clinical and morfometric analysis the effects of laser therapy on neural and muscle repair after crushing of sciatic nerve and hind limb unloading. 48 Wistar male rats machos, with 60 days old, were divided in three groups with 16 animals each, and they were performed as one control group (GA) and two irradiated groups (GB with 4 J/cm² dose; GC with 6 J/cm² dose). After the sciatic nerve was crushed animals were maintained under hind limb suspension and received laser (GaAlAs) irradiation three times per week, during 14 or 28 days. The sciatic functional index (SFI) were measured before surgery, at 14 and 28 days, recovery was observed in all groups especially to GA at 28 days. Morfometric analysis of the nerve showed that the nerve recovery was better to the treated groups, specially at 14 days. The muscle morfometric analysis weren’t effected by laser therapy. Taken together the results allowed to conclude that laser therapy promotes morphological recover of the nerve, specially until 14 days. Yet laser isn’t able to influence the muscle recovery and function.Fundação de Amparo a Pesquisa do Estado de Minas Gerai

Propriedades mecânicas de aloenxertos meniscais de coelhos após preservação em glicerina e reidratação em NaCl 0,9%

Foram avaliadas as propriedades mecânicas, força, deformação e tensão ao limite elástico, tensão ao ponto de ruptura e índice de rigidez, de meniscos frescos e meniscos transplantados por 70 dias em joelhos de coelhos, após preservação em glicerina. O primeiro grupo (tratado) foi formado por seis meniscos mediais do joelho esquerdo, coletados de animais oriundos de criação comercial. Esses meniscos foram armazenados em glicerina 98% por um período de 45-60 dias; em seguida, foram reidratados em solução salina a 0,5% de enrofloxacina, por 12 horas, e implantados em joelhos de outros seis coelhos, submetidos à meniscectomia. Após 70 dias da cirurgia, foi realizada a eutanásia dos animais e retirada dos aloenxertos para avaliação mecânica. O segundo grupo (controle) foi composto por seis meniscos mediais, retirados dos joelhos contralaterais (direito) dos mesmos animais. Para a amostra estudada, não houve diferença estatisticamente significante entre os grupos controle e tratado para nenhuma das variáveis analisadas, demonstrando que a reidratação de aloenxertos meniscais, após preservação em glicerina, mantém as características mecânicas desses, após 70 dias de implantação, semelhantes às de meniscos frescos.We evaluated the mechanical properties, strength, strain and stress to the elastic limit, the rupture stress point and stiffness index of fresh menisci and menisci transplanted for 70 days in the knees of rabbits after preservation in glycerin. The first group (treated) was formed by six medial menisci of the left knee, collected from these animals for commercial breeding. These menisci were stored in 98% glycerin for a period of 30-60 days, and then rehydrated in a solution in 0.5% saline enrofloxacin for 12 hours, and implanted in the knees of another six rabbits underwent meniscectomy . After 70 days of surgery was performed the euthanasia of animals and removal of allografts for mechanical evaluation. The second group (control) consisted of six medial menisci, removed from the contralateral knees (right) of the same animals. For the sample studied, had no statistically significant difference between control and treated groups for any of the variables analyzed, showing that the rehydration of meniscal allografts after preservation in glycerin keeps the mechanical characteristics of these, after 70 days of implantation, similar to the meniscus fresh

Profiling Humoral Immune Response Against Pre-Erythrocytic and Erythrocytic Antigens of Malaria Parasites Among Neotropical Primates in the Brazilian Atlantic Forest.

Human malaria due to zoonotic transmission has been recorded in the Atlantic Forest, an extra-Amazonian area in Brazil, which are a challenge for malaria control. Naturally acquired humoral immune response against pre-erythrocytic and erythrocytic antigens of Neotropical primates (NP) was evaluated here to improve the knowledge about the exposure of those animals to the malaria transmission and support the identification of the potential reservoirs of the disease in the Atlantic Forest. Blood samples of 154 monkeys from three areas of the Atlantic Forest were used to identify IgG antibodies against peptides of the repeat region of the major pre-erythrocytic antigen, the circumsporozoite protein (CSP), of Plasmodium vivax (PvCSP), Plasmodium brasilianum/Plasmodium malariae (Pb/PmCSP), and Plasmodium falciparum (PfCSP) by ELISA. Antibodies against erythrocytic recombinant antigens of P. vivax, Apical membrane antigen 1 (PvAMA-1), Erythrocyte binding protein 2 (PvEBP-2) and domain II of Duffy binding protein (PvDBPII) were also evaluated. Parameters, such as age, sex, PCR positivity, and captivity, potentially associated with humoral immune response were analyzed. Eighty-five percent of NP had antibodies against at least one CSP peptide, and 76% against at least one P. vivax erythrocytic antigen. A high percentage of adults compared to non-adults were seropositive and showed increased antibody levels. Neotropical primates with PCR positive for P. simium had a significantly higher frequency of positivity rate for immune response against PvEBP-2, PvDBPII and also higher antibody levels against PvDBPII, compared to PCR negative NPs for this species. Monkeys with PCR positive for P. brasilianum/P. malariae showed higher frequency of seropositivity and antibody levels against Pb/PmCSP. Levels of antibodies against Pb/PmCSP, PvEBP-2 and PvDBPII were higher in free-living than in captive monkeys from the same area. All Platyrrhine families showed antibodies against CSP peptides, however not all showed IgG against erythrocytic antigens. These findings showed a high prevalence of naturally acquired antibodies against CSP repeats in all studied areas, suggesting an intense exposure to infected-mosquitoes bites of NP from all families. However, mainly monkeys of Atelidae family showed antibodies against P. vivax erythrocytic antigens, suggesting blood infection, which might serve as potential reservoirs of malaria in the Atlantic Forest

IgM antibody responses against Plasmodium antigens in neotropical primates in the Brazilian Atlantic Forest

IntroductionZoonotic transmission is a challenge for the control and elimination of malaria. It has been recorded in the Atlantic Forest, outside the Amazon which is the endemic region in Brazil. However, only very few studies have assessed the antibody response, especially of IgM antibodies, in Neotropical primates (NP). Therefore, in order to contribute to a better understanding of the immune response in different hosts and facilitate the identification of potential reservoirs, in this study, naturally acquired IgM antibody responses against Plasmodium antigens were evaluated, for the first time, in NP from the Atlantic Forest.MethodsThe study was carried out using 154 NP samples from three different areas of the Atlantic Forest. IgM antibodies against peptides of the circumsporozoite protein (CSP) from different Plasmodium species and different erythrocytic stage antigens were detected by ELISA.ResultsFifty-nine percent of NP had IgM antibodies against at least one CSP peptide and 87% against at least one Plasmodium vivax erythrocytic stage antigen. Levels of antibodies against PvAMA-1 were the highest compared to the other antigens. All families of NP showed IgM antibodies against CSP peptides, and, most strikingly, against erythrocytic stage antigens. Generalized linear models demonstrated that IgM positivity against PvCSP and PvAMA-1 was associated with PCR-detectable blood-stage malaria infection and the host being free-living. Interestingly, animals with IgM against both PvCSP and PvAMA-1 were 4.7 times more likely to be PCR positive than animals that did not have IgM for these two antigens simultaneously.DiscussionIgM antibodies against different Plasmodium spp. antigens are present in NP from the Atlantic Forest. High seroprevalence and antibody levels against blood-stage antigens were observed, which had a significant association with molecular evidence of infection. IgM antibodies against CSP and AMA-1 may be used as a potential marker for the identification of NP infected with Plasmodium, which are reservoirs of malaria in the Brazilian Atlantic Forest

DataSheet_1_IgM antibody responses against Plasmodium antigens in neotropical primates in the Brazilian Atlantic Forest.docx

IntroductionZoonotic transmission is a challenge for the control and elimination of malaria. It has been recorded in the Atlantic Forest, outside the Amazon which is the endemic region in Brazil. However, only very few studies have assessed the antibody response, especially of IgM antibodies, in Neotropical primates (NP). Therefore, in order to contribute to a better understanding of the immune response in different hosts and facilitate the identification of potential reservoirs, in this study, naturally acquired IgM antibody responses against Plasmodium antigens were evaluated, for the first time, in NP from the Atlantic Forest.MethodsThe study was carried out using 154 NP samples from three different areas of the Atlantic Forest. IgM antibodies against peptides of the circumsporozoite protein (CSP) from different Plasmodium species and different erythrocytic stage antigens were detected by ELISA.ResultsFifty-nine percent of NP had IgM antibodies against at least one CSP peptide and 87% against at least one Plasmodium vivax erythrocytic stage antigen. Levels of antibodies against PvAMA-1 were the highest compared to the other antigens. All families of NP showed IgM antibodies against CSP peptides, and, most strikingly, against erythrocytic stage antigens. Generalized linear models demonstrated that IgM positivity against PvCSP and PvAMA-1 was associated with PCR-detectable blood-stage malaria infection and the host being free-living. Interestingly, animals with IgM against both PvCSP and PvAMA-1 were 4.7 times more likely to be PCR positive than animals that did not have IgM for these two antigens simultaneously.DiscussionIgM antibodies against different Plasmodium spp. antigens are present in NP from the Atlantic Forest. High seroprevalence and antibody levels against blood-stage antigens were observed, which had a significant association with molecular evidence of infection. IgM antibodies against CSP and AMA-1 may be used as a potential marker for the identification of NP infected with Plasmodium, which are reservoirs of malaria in the Brazilian Atlantic Forest.</p

Núcleos de Ensino da Unesp: artigos 2008

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq