Índice de masa corporal de adolescentes: comparación entre distintas referencias

OBJECTIVE: To compare the performance of the references (National Health and Nutrition Examination Survey I, National Center for Health Statistics/2000, International Obesity Task Force and Pesquisa Nacional sobre Saúde e Nutrição) to assess the nutritional status of children and adolescents with the new reference of body mass index values proposed by the World Health Organization in 2007. METHODS: Cross-sectional study that enrolled a non-probabilistic sample of 5,122 children and adolescents of low socioeconomic status. In the matrix study, sample size was calculated in order to identify the association between blood pressure changes and stunting in different nutritional status. This interim report relates to the comparison among different references for assessment of nutritional status. Cochran's Q, McNemar, chisquare and Kappa statistics were used to compare the proportion of underweight and overweight by different references and the agreement among them. RESULTS: The five references used in this study showed differences between them. Both for boys as for girls, the estimated prevalence of underweight by the Brazilian reference is much smaller than with the other references. For overweight girls, a higher prevalence was detected by the Pesquisa Nacional sobre Saúde e Nutrição reference, followed by the World Health Organization/2007. There was an excellent agreement (k>0.75) between the references regarding overweight, but the agreement among them regarding underweight was weak (k0.75) entre la mayoría de las clasificaciones para exceso de peso analizadas. Sin embargo, la concordancia entre las clasificaciones para bajo peso se presentódébil (k0,75) entre a maioria das classificações para excesso de peso analisadas. Porém, a concordância entre as classificações para baixo peso apresentou-se fraca (k<0,40). CONCLUSÕES: A nova referência da Organização Mundial da Saúde é adequada para classificar os distúrbios nutricionais nos adolescentes brasileiros.Universidade Federal de São Paulo (UNIFESP)UNIFESPSciEL

Dyslipidaemia and Undernutrition in Children from Impoverished Areas of Maceió, State of Alagoas, Brazil

Chronic undernutrition causes reduced growth and endocrine adaptations in order to maintain basic life processes. In the present study, the biochemical profiles of chronically undernourished children were determined in order to test the hypothesis that chronic undernutrition also causes changes in lipid profile in pre-school children. The study population comprised 80 children aged between 12 and 71 months, including 60 with moderate undernutrition [height-for-age Z (HAZ) scores ≤ −2 and > −3] and 20 with severe undernutrition (HAZ scores ≤ −3). Socioeconomic, demographic and environmental data were obtained by application of a questionnaire, and anthropometric measurements and information relating to sex, age and feeding habits were collected by a trained nutritionist. Blood samples were analysed for haemoglobin, vitamin A, insulin-like growth factor 1 (IGF-1) and serum lipids, while cortisol was assayed in the saliva. Faecal samples were submitted to parasitological investigation. Analysis of variance and χ2 methods were employed in order to select the variables that participated in the multivariate logistic regression analysis. The study population was socioeconomically homogeneous, while the lack of a treated water supply was clearly associated with the degree of malnutrition. Most children were parasitised and anaemia was significantly more prevalent among the severely undernourished. Levels of IGF-1 decreased significantly with increasing severity of undernutrition. Lipid analysis revealed that almost all of the children had dyslipidemia, while low levels of high-density lipoprotein were associated with the degree of undernutrition. It is concluded that chronic malnutrition causes endocrine changes that give rise to alterations in the metabolic profile of pre-school children

Outcome of Patients With Small Vessel Vasculitis After Renal Transplantation: National Database Analysis

Background. Small vessel vasculitis commonly affects the kidney and can progress to end-stage renal disease. The goal of this study is to compare outcomes of patients who received a renal transplant as a result of small vessel vasculitis (group A) with those who received kidney transplants because of other causes (group B). Methods. This is a retrospective analysis of United Network for Organ Sharing registry data for adult primary kidney transplants from January 2000 to December 2014. Group A patients (N = 2196) were compared with a group B (N = 6588); groups were case matched for age, race, sex, donor type, and year of transplant in a 1:3 ratio. Results. Renal and patient survivals were better in the group A (P \u3c 0.001). New-onset diabetes after transplant developed in 8.3% of the group A and 11.3% of group B (P \u3c 0.001). Seventeen (0.8%) patients in group A developed recurrent disease. Of these, 7 patients had graft failure, 3 of which were due to disease recurrence. Group A patients had significantly higher risk of developing posttransplant solid organ malignancies (11.3% vs 9.3%, P = 0.006) and lymphoproliferative disorder (1.3% vs 0.8%, P = 0.026). Independent predictors of graft failure and patient mortality were recipients\u27 morbid obesity, diabetes, age, and dialysis duration (hazard ratio of 1.7, 1.4, 1.1/10 years, and 1.1/year for graft failure, and 1.7, 1.7, 1.6/10 years and 1.1/year for patient mortality, respectively). Conclusions. Renal transplantation in patients with has favorable long-term graft and patient outcomes with a low disease recurrence rate. However, they may have a higher risk of developing posttransplant malignancies

Long-Lasting Effects of Undernutrition

Undernutrition is one of the most important public health problems, affecting more than 900 million individuals around the World. It is responsible for the highest mortality rate in children and has long-lasting physiologic effects, including an increased susceptibility to fat accumulation mostly in the central region of the body, lower fat oxidation, lower resting and postprandial energy expenditure, insulin resistance in adulthood, hypertension, dyslipidaemia and a reduced capacity for manual work, among other impairments. Marked changes in the function of the autonomic nervous system have been described in undernourished experimental animals. Some of these effects seem to be epigenetic, passing on to the next generation. Undernutrition in children has been linked to poor mental development and school achievement as well as behavioural abnormalities. However, there is still a debate in the literature regarding whether some of these effects are permanent or reversible. Stunted children who had experienced catch-up growth had verbal vocabulary and quantitative test scores that did not differ from children who were not stunted. Children treated before 6 years of age in day-hospitals and who recovered in weight and height have normal body compositions, bone mineral densities and insulin production and sensitivity

Museums and cradles of diversity are geographically coincident for narrowly distributed Neotropical snakes

Factors driving the spatial configuration of centres of endemism have long been a topic of broad interest and debate. Due to different eco-evolutionary processes, these highly biodiverse areas may harbour different amounts of ancient and recently diverged organisms (paleo- and neo-endemism, respectively). Patterns of endemism still need to be measured at distinct phylogenetic levels for most clades and, consequently, little is known about the distribution, the age and the causes of such patterns. Here we tested for the presence of centres with high phylogenetic endemism (PE) in the highly diverse Neotropical snakes, testing the age of these patterns (paleo- or neo-endemism), and the presence of PE centres with distinct phylogenetic composition. We then tested whether PE is predicted by topography, by climate (seasonality, stability, buffering and relictualness), or biome size. We found that most areas of high PE for Neotropical snakes present a combination of both ancient and recently diverged diversity, which is distributed mostly in the Caribbean region, Central America, the Andes, the Atlantic Forest and on scattered highlands in central Brazil. Turnover of lineages is higher across Central America, resulting in more phylogenetically distinct PE centres compared to South America, which presents a more phylogenetically uniform snake fauna. Finally, we found that elevational range (topographic roughness) is the main predictor of PE, especially for paleo-endemism, whereas low paleo-endemism levels coincide with areas of high climatic seasonality. Our study highlights the importance of mountain systems to both ancient and recent narrowly distributed diversity. Mountains are both museums and cradles of snake diversity in the Neotropics, which has important implications for conservation in this region.Fil: Azevedo, Josué Anderson Rêgo. University Goteborg; Suecia. Gothenburg Global Biodiversity Centre; SueciaFil: Guedes, Thaís B.. University Goteborg; Suecia. Gothenburg Global Biodiversity Centre; Suecia. Universidade Estadual do Maranhão. Centro de Estudos Superiores de Caxias. Programa de Pós-graduação em Biodiversidade, Ambiente e Saúde; PortugalFil: Nogueira, Cristiano de Campos. Universidade de Sao Paulo; BrasilFil: Passos, Paulo. Universidade Federal do Rio de Janeiro; BrasilFil: Sawaya, Ricardo. Universidad Federal do Abc; BrasilFil: Prudente, Ana. Museu Paraense Emílio Goeldi; BrasilFil: Barbo, Fausto Erritto. Governo do Estado de Sao Paulo. Secretaria da Saude. Instituto Butantan; BrasilFil: Strüssmann, Christine. Universidade Federal do Mato Grosso do Sul; BrasilFil: Franco, Francisco L.. Governo do Estado de Sao Paulo. Secretaria da Saude. Instituto Butantan; BrasilFil: Arzamendia, Vanesa. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Santa Fe. Instituto Nacional de Limnología. Universidad Nacional del Litoral. Instituto Nacional de Limnología; ArgentinaFil: Giraudo, Alejandro Raul. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Santa Fe. Instituto Nacional de Limnología. Universidad Nacional del Litoral. Instituto Nacional de Limnología; ArgentinaFil: Argolo, Antonio. Universidade Estadual de Santa Cruz; BrasilFil: Jansen, Martin. Senckenberg Research Institute and Nature Museum; AlemaniaFil: Zaher, Hussam. Universidade de Sao Paulo; BrasilFil: Tonini, Joao Filipe Riva. Centre National de la Recherche Scientifique; Francia. Muséum National d'Histoire Naturelle; Francia. Sorbonne University; Francia. Harvard University; Estados UnidosFil: Faurby, Søren. University Goteborg; SueciaFil: Antonelli, Alexandre. University Goteborg; Sueci

Short stature, abdominal obesity, insulin resistance and alterations in lipid profile in very low-income women living in Maceio, north-eastern Brazil

Objective To test the hypothesis that short stature is associated with abdominal obesity, insulin resistance and lipid profile changes.Methods Anthropometric data were collected from 237 women (18-60 years old), residents of a shantytown in Maceio. Biochemical profiles of 60 individuals drawn from this population were determined.Results Total and low-density lipoprotein (LDL) cholesterol levels and insulin resistance rose with increasing waist:hip circumference ratio, particularly in women. Short, overweight individuals exhibited larger biochemical alterations than overweight individuals of average stature.Conclusion Short stature, when associated with overweight, is a risk factor for increased insulin resistance and alterations in lipid profile.Univ Fed Alagoas, Dept Nutr, Maceio, AL, BrazilUniversidade Federal de São Paulo, Dept Physiol, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Physiol, São Paulo, BrazilWeb of Scienc

Why are nutritionally stunted children at increased risk of obesity? Studies of metabolic rate and fat oxidation in shantytown children from Sao Paulo, Brazil

Background: Previous research suggested that nutritionally stunted children may have increased risk of obesity, but little is known about potential underlying mechanisms.Objective: We sought to test the hypothesis that stunted children have a low metabolic rare and impaired fat oxidation relative to nonstunted children.Design: The subjects were 58 prepubertal boys and girls aged 8-11 y from the shantytowns of Sao Paulo, Brazil. Twenty-eight were stunted (height-for-age z score -1.5). Parents of children in the 2 groups had equivalent height and body mass index values. Pasting and postprandial energy expenditure, respiratory quotient (RQ), and substrate oxidation were measured with indirect calorimetry in a 3-d resident study in which all food was provided and body composition was measured with dual-energy X-ray absorptiometry.Results: Stunted children had normal resting energy expenditure relative to body composition compared with control children (4559 +/- 90 and 4755 +/- 86 kJ/d, respectively; P = 0.14) and had normal postprandial thermogenesis (2.4 +/- 0.3% and 2.0 +/- 0.3% of meal load, respectively; P = 0.42). However, fasting RQ was significantly higher in the stunted group (0.92 +/- 0.009 compared with 0.89 +/- 0.007, P = 0.04) and consequently, fasting fat oxidation was significantly lower (25 +/- 2% compared with 34 +/- 2% of energy expenditure; P < 0.01).Conclusions: Childhood nutritional stunting is associated with impaired fat oxidation, a factor that predicted obesity in other at risk populations. This finding may help explain recent increases in body fatness and the prevalence of obesity among stunted adults and adolescents in developing countries.Univ Fed Sao Paulo, Escola Paulista Med, BR-04023900 Sao Paulo, BrazilTufts Univ, USDA, Jean Mayer Human Nutr Res Ctr Aging, Boston, MA 02111 USAUniv Fed Sao Paulo, Escola Paulista Med, BR-04023900 Sao Paulo, BrazilWeb of Scienc