16 research outputs found

    Body composition and somatotype in persons with Down Syndrome

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    Orientador: José Irineu GorlaDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Educação FísicaResumo: O objetivo do presente estudo foi avaliar a composição corporal e o somatotipo de pessoas com idade entre 6 e 19 anos de idade de ambos os sexos com síndrome de Down, institucionalizados do município de Campinas - SP. Inicialmente, foi realizada uma revisão de literatura sobre a composição corporal de crianças e adolescentes com síndrome de Down. Os capítulos subseqüentes foram constituídos através da análise da prevalência de obesidade, topografia da gordura subcutânea e perfil somatotipológico, por meio da realização de treze medidas antropométricas, incluindo peso, estatura, diâmetros biepicondilar do fêmur e úmero, perímetros da perna medial e braço, dobras cutâneas tricipital, bicipital, subescapular, supra-ilíaca, abdominal, coxa e perna. Para determinação do percentual de gordura foram utilizadas as equações de Slaughter, Lohman e Boileau et al. (1988). Em relação à técnica do somatotipo, recorreu-se ao método de Heath e Carter (1967). O tratamento estatístico dos dados foi realizado através do pacote computadorizado R Commander 1.6-3 (Rcmdr) no software R plus, versão 2.12.1. Os dados foram submetidos ao teste de normalidade e utilizada estatística descritiva (mediana e percentis 25 e 75), teste de Mann-Whitney e teste t para amostras independentes para comparação entre grupos etários, adotando-se como nível de significância (p _ 0,05). A concordância entre os valores de gordura e o componente de endomorfia, e os valores de massa magra e o componente de mesomorfia foram analisados através do teste de correlação momentoproduto de Pearson e Spearman para dados paramétricos e não paramétricos, respectivamente. De acordo com a revisão de literatura, meninos e meninas apresentaram quadros elevados de obesidade na maioria dos estudos. Em relação ao aspecto genético, a análise do gene RE Xbal foi fundamental para a compreensão dos genótipos envolvidos com o sobrepeso. Além disso, os aspectos ambientais indicaram baixos níveis no consumo de calorias e práticas de atividades físicas em crianças e adolescentes com síndrome de Down comparados aos indivíduos sem a síndrome. Por fim, através da observação das variáveis fisiológicas, verificou-se a ocorrência de alterações no hormônio leptina e insulina, micronutriente zinco, colesterol, triglicérides e taxa metabólica basal. Com base nessas descobertas, foi possível concluir que os aspectos genéticos, ambientais e fisiológicos exerceram influências relativamente negativas sobre a composição corporal nos indivíduos com síndrome de Down. Em relação aos dados obtidos no presente estudo, a maioria dos indivíduos apresentou excesso de gordura, sendo encontrados valores superiores no sexo feminino em relação ao masculino, verificadas tanto na análise do percentual de gordura quanto nos valores somatotipológicos. Quanto à topografia da gordura subcutânea, a maioria apresentou maior concentração de gordura na coxa e menor depósito na região do bíceps. Diante dessas informações, considera-se que a avaliação da composição corporal e do somatotipo são recursos importantes para subsidiar pesquisadores e profissionais que atuam diretamente na melhora da qualidade de vida de crianças e adolescentes com síndrome de DownAbstract: The aim of this study was to evaluate the body composition and somatotype of persons of both sexes aged between 6 and 19 years old with Down syndrome, institutionalized in the city of Campinas - SP. Initially, we performed a review of the literature regarding body composition of children and adolescents with Down syndrome. Subsequent chapters were established by analyzing the prevalence of obesity and measure and profile of subcutaneous fat somatotype, by performing thirteen anthropometric measurements including weight, height, biepicondylar diameter of femur and humerus, medial perimeters of the leg and arm folds, triceps, biceps, subscapular, suprailiac, abdomen, thigh and leg. To measure the fat percentage, the equations of Slaughter, Boileau and Lohman et al. (1988) were used. The method of Heath and Carter (1967) was used in relation to the somatotype technique. The statistical treatment of data was performed using the computer package R Commander 1.6-3 (Rcmdr) in the software R, version 2.12.1. Data was tested for normality and used descriptive statistics (median and percentiles 25 and 75), Mann-Whitney and t test for independent samples to compare age groups, adopting the significance level (p _ 0,05). The relationship between the values of fat and endomorphic component, and the values of lean body mass and mesomorphy component were analyzed using the correlation test of Pearson product-moment and Spearman for parametric and nonparametric data, respectively. According to the literature review, boys and girls showed high incidence of obesity in most studies. Regarding the genetic aspect, the analysis of gene RE Xbal was essential to the understanding of the genotypes related to being overweight. In addition, environmental aspects indicated low levels of calorie intake and physical activity in children and adolescents with Down syndrome compared to individuals without the syndrome. Finally, by examining physiological variables, changes occurred in the levels of leptin, insulin, micronutrient zinc, cholesterol, triglycerides and basal metabolic rate. Grounded by these findings, it is possible to conclude that genetics, physiology and the environment exerted relatively negative influences on the body composition of individuals with Down syndrome. Regarding the data obtained in this study, most individuals had excess fat, with higher values seen in both the analysis of the percentage of fat and the somatotype values in females compared to males. In the measure of subcutaneous fat, the majority presented a higher concentration of fat in the thigh and lower deposits in the area of the biceps. With this information known, it is considered that the value of body composition and somatotype are important resources to support researchers and professionals who work directly towards improving the quality of life of children and adolescents with Down syndromeMestradoAtividade Fisica AdaptadaMestre em Educação Físic

    Reference growth charts for children and adolescents with Down syndrome aged 0 to 20 years

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    Orientador: Gil Guerra JúniorTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências MédicasResumo: Estrutura da tese: No presente estudo optou-se pelo "Modelo Escandinavo", o qual é chamado de "Modelo Alternativo" no Programa de Pós-Graduação em Saúde da Criança e do Adolescente da Faculdade de Ciências Médicas da Universidade Estadual de Campinas. A tese foi composta por introdução, objetivos, metodologia, resultados (três artigos na íntegra), discussão geral e conclusão. Introdução: A tese apresenta uma introdução geral sobre a síndrome de Down (SD), fatores de risco relacionados ao crescimento e peso corporal, e curvas de crescimento na referida população. Objetivos: O estudo teve como objetivos (1) desenvolver curvas de peso, estatura, perímetro cefálico e Índice de Massa Corporal (IMC) para a população brasileira com SD na faixa etária entre 0 e 20 anos e (2) comparar os dados de crescimento com as referências estabelecidas na literatura. Metodologia: A amostra foi constituída de 938 indivíduos com SD na faixa etária entre 0 e 20 anos (53,7%, masculino), recrutados de um estudo retrospectivo e prospectivo entre 2012 e 2015 na Universidade Estadual de Campinas e 50 centros para pessoas com SD no estado de São Paulo. Para a construção das curvas, foram utilizadas 10.516 medidas de peso, estatura, e perímetro cefálico. Modelos Aditivos Generalizados para Posição, Escala e Forma foram utilizados para a construção das curvas, utilizando-se do software R (versão 3.2.2). O método LMS foi utilizado para modelar as curvas e gráficos worm plots foram examinados para o diagnóstico da modelagem. Escores Z médios foram calculados para comparar os dados de crescimento do presente estudo com as referências estabelecidas pela Organização Mundial da Saúde (G1), Centro para o controle de Doenças dos Estados Unidos (G2), e população com SD de outros estudos (G3). Resultados: Curvas de peso-para-idade, estatura-para-idade, perímetro cefálico-para-idade, e IMC-para-idade foram desenvolvidas para indivíduos com SD de ambos os sexos na faixa etária entre 0 e 20 anos. Quando comparados à população sem SD, brasileiros com SD apresentaram menor estatura (todas as idades), menor perímetro cefálico (0-24 meses), menor peso corporal (0-15 meses) e maior IMC (3-18 anos). Os dados também mostraram diferenças em crescimento entre as crianças e adolescentes do presente estudo e a população com SD estabelecida na literatura. Variações entre escores z médios foram: escores z estatura (G1: -1,1 a -3,2 cm; G3: -1,7 a +1,3 cm); escores z peso (G1: -0,8 a -1,4 Kg; G3: -0,8 a +1,0 kg); escores z perímetro cefálico (G1: -1,0 a -1,9 cm; G3: -1,0 a +1,2 cm); escores z IMC (G2: -0,2 a +1,3 kg/m²). Conclusão: Indivíduos com SD apresentaram diferentes padrões de crescimento quando comparados à população com e sem SD de outros estudos. Curvas de peso, estatura, perímetro cefálico e IMC para idade e sexo devem guiar pais e profissionais da saúde no monitoramento do crescimento da população brasileira com SDAbstract: Thesis structure: In this study we choose the "Scandinavian Model", which is called "Alternative Model" in the Graduate Program in Child and Adolescent Health of the School of Medical Sciences at the University of Campinas. The thesis consisted of introduction, objectives, methods, results (three full-text articles), overall discussion, and conclusions. Introduction: The thesis presents a brief introduction about Down syndrome (DS), growth risk factors, and growth charts for children and adolescents with DS. Objectives: The objectives of this study were (1) to develop growth charts for weight, height, head circumference, and body mass index (BMI) for Brazilian individuals with DS aged 0 to 20 years, and (2) to compare the growth data with previous studies. Methods: The sample consisted of 938 individuals with DS aged 0 to 20 years (53,7% boys). Mixed retrospective and prospective study was performed at University of Campinas and 50 specialized centers for people with DS in São Paulo State between 2012 and 2015. Weight, height, and head circumference charts were developed from 10,516 data points. The LMS method was used to construct the curves using generalized additive models for location, scale, and shape in R software (version 3.2.2). Goodness of fit was checked using worm plots. Mean Z-scores were calculated to compare the growth data with the Child Growth Standards by the World Health Organization (G1), Centers for Disease Control and Prevention (G2), and individuals with DS of other studies (G3). Results: Weight-for-age, height-for-age, head circumference-for-age, BMI-for-age charts were developed for boys and girls with DS from birth to 20 years of age. The Brazilians individuals with DS had lower height (in all ages), lower head circumference (0-24 months), lower body weight (0-15 months), and higher BMI (3-18 years) when compared to individuals without DS. This study also found differences in growth compared to youth with DS of other studies. The mean z-scores were: mean height z-scores (G1: -1.1 to -3.2 cm; G3: -1.7 to +1.3 cm); mean weight z-scores (G1: -0.8 to -1.4 Kg; G3: -0.8 to +1.0 kg); mean head circumference z-scores (G1: -1.0 to -1.9 cm; G3: -1.0 to +1.2 cm); mean BMI z-scores (G2: -0.2 to +1.3 kg/m²). Conclusion: Brazilian individuals with DS had different growth patterns when compared to individuals with and without DS of previous studies. Growth charts for weight, height, head circumference, and BMI should guide health professionals and parents in the evaluation and management of the growth of Brazilian children and adolescents with DSDoutoradoSaude da Criança e do AdolescenteDoutor em Ciências01P-1732/2016, 99999.003546/2015-02CAPE

    Body mass index reference charts for individuals with Down syndrome aged 2–18 years

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    AbstractObjectiveTo develop Brazilian growth charts for body mass index (BMI-for-age) for individuals with Down syndrome (DS). The secondary objective was to compare the BMI-for-age with the Centers for Disease Control and Prevention standards (CDC).MethodsA retrospective and cross-sectional growth study of 706 youth with DS (56.7% males) was performed in 51 centers in São Paulo state, Brazil. Weight and height were used to calculate the BMI (kg/m2). The LMS method was applied to construct the growth charts. Z-scores were based on the CDC 2000 growth standards.ResultsThe BMI-for-age reference charts showed excellent goodness of fit statistics for boys and girls with DS aged 2–18 years. At 2 years of age, the mean BMI Z-scores of boys and girls with DS were lower compared to those of the CDC (Z-score=−0.2). In contrast, children with DS aged 3–18 years had higher mean Z-scores for BMI-for-age when compared to those of the CDC (Z-scores=+0.2 to +1.3).ConclusionsThe BMI of Brazilian youth with DS differs from those references established by CDC. These are the first Brazilian BMI-for-age charts for individuals with DS and will hopefully guide clinicians and parents in the evaluation and management of the nutritional status in children and adolescents with DS in Brazil

    Gráfico De Referência Do Índice De Massa Corporal Para Os Indivíduos Com Síndrome De Down Entre 2 E 18 Anos De Idade

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    To develop Brazilian growth charts for body mass index (BMI-for-age) for individuals with Down syndrome (DS). The secondary objective was to compare the BMI-for-age with the Centers for Disease Control and Prevention standards (CDC). Methods: A retrospective and cross-sectional growth study of 706 youth with DS (56.7% males) was performed in 51 centers in São Paulo state, Brazil. Weight and height were used to calculate the BMI (kg/m2). The LMS method was applied to construct the growth charts. Z-scores were based on the CDC 2000 growth standards. Results: The BMI-for-age reference charts showed excellent goodness of fit statistics for boys and girls with DS aged 2-18 years. At 2 years of age, the mean BMI Z-scores of boys and girls with DS were lower compared to those of the CDC (Z-score = −0.2). In contrast, children with DS aged 3-18 years had higher mean Z-scores for BMI-for-age when compared to those of the CDC (Z-scores = +0.2 to +1.3). Conclusions: The BMI of Brazilian youth with DS differs from those references established by CDC. These are the first Brazilian BMI-for-age charts for individuals with DS and will hopefully guide clinicians and parents in the evaluation and management of the nutritional status in children and adolescents with DS in Brazil.931949

    PREVALENCE OF OBESITY AND THE BODY FAT TOPOGRAPHY IN CHILDREN AND TEENAGERS WITH DOWN SYNDROME

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    Objective: To evaluate the prevalence of obesity and the body fat topography in children andadolescents from both sexes aged 6 to 19 years old with Down syndrome, residents in the city ofCampinas, São Paulo. Methods: There were nine anthropometric measurements taken, includingweight, height, and tricipital, bicipital, subscapular, suprailiac, abdominal, thigh, and calf skin folds.The fat percentage was determined by employing the prediction equations from Slaughter et al.Statistical analysis was performed using the computer package R Commander 1.6-3, with thedescriptive statistics (median and 25th and 75th percentiles), the Mann-Whitney test, and the t-testfor comparison between age groups, at the 5% (p d” 0.05) level. Results: Most subjects hadexcess body fat, with the higher values being found among the females. The obesity was not aprominent characteristic among the boys, unlike the other age groups who had manifestations ofelevated obesity. Regarding the body fat topography, most showed higher concentration of fat in thethigh, and smaller deposits in the biceps region. In the transition from childhood to adolescence, itwas verifiable that boys and young men differ in the amounts of adipose tissue. However, no significantdifferences were observed among the girls, and the young women. Conclusion: The assessment ofthe prevalence of obesity and subcutaneous fat topography are important resources to supportresearchers, and practitioners who work directly on improving the quality of life of children andadolescents with Down syndrome.Objetivo: Avaliar a prevalência de obesidade e topografia da gordura corporal em crianças eadolescentes com idade entre 6 e 19 anos de idade de ambos os sexos com síndrome de Down nomunicípio de Campinas, São Paulo. Método: Foram realizadas nove medidas antropométricas,incluindo peso, estatura, dobras cutâneas tricipital, bicipital, subescapular, supra-ilíaca, abdominal,coxa e perna. Para determinação do percentual de gordura foram utilizadas as equações de prediçãode Slaughter et al. O tratamento estatístico foi realizado através do pacote computadorizado RCommander 1.6-3, sendo utilizada estatística descritiva (mediana e percentis 25 e 75), teste deMann-Whitney e teste t para comparação entre grupos etários, ao nível de 5% (p d” 0,05).Resultados: A maioria dos indivíduos apresentou excesso de gordura corporal, sendo encontradosvalores superiores no sexo feminino. A obesidade entre os meninos não foi uma característicaproeminente, diferentemente dos demais grupos etários que apresentaram quadros elevados deobesidade. Quanto à topografia da gordura, a maioria apresentou maior concentração de gordura nacoxa e menor depósito na região do bíceps. Na transição entre a infância e a adolescência, foipossível verificar que meninos e rapazes diferem quanto às quantidades de tecido adiposo. Comrelação às meninas e moças, não foram observadas diferenças significativas. Conclusão: A avaliaçãoda prevalência de obesidade e topografia da gordura subcutânea são recursos importantes parasubsidiar pesquisadores e profissionais que atuam diretamente na melhora da qualidade de vida decrianças e adolescentes com síndrome de Down

    Growth Curves For Girls With Turner Syndrome.

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    The objective of this study was to review the growth curves for Turner syndrome, evaluate the methodological and statistical quality, and suggest potential growth curves for clinical practice guidelines. The search was carried out in the databases Medline and Embase. Of 1006 references identified, 15 were included. Studies constructed curves for weight, height, weight/height, body mass index, head circumference, height velocity, leg length, and sitting height. The sample ranged between 47 and 1,565 (total = 6,273) girls aged 0 to 24 y, born between 1950 and 2006. The number of measures ranged from 580 to 9,011 (total = 28,915). Most studies showed strengths such as sample size, exclusion of the use of growth hormone and androgen, and analysis of confounding variables. However, the growth curves were restricted to height, lack of information about selection bias, limited distributional properties, and smoothing aspects. In conclusion, we observe the need to construct an international growth reference for girls with Turner syndrome, in order to provide support for clinical practice guidelines.201468797

    Growth charts for Brazilian children with Down syndrome: Birth to 20 years of age

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    Background: The growth of youth with Down syndrome (DS) differs from that of youth without DS, and growth charts specific to DS have been developed. However, little is known about the growth of Brazilian youth with DS. The objective of this study was to construct growth charts for Brazilian youth with DS and compare the growth data with the Child Growth Standards of the World Health Organization (WHO) and charts for children with DS from other studies. Methods: Mixed longitudinal and cross-sectional data were collected at University of Campinas, 48 specialized centers for people with intellectual disabilities, and two foundations for people with DS between 2012 and 2015. A total of 10,516 growth measurements from birth to 20 years of age were available from 938 youth with DS (53.7% boys) born between 1980 and 2013. The Lambda Mu Sigma method was applied to construct the curves using generalized additive models for location, scale, and shape. Results: Length/height-for-age, weight-for-age, and head circumference-for-age percentile curves were generated for Brazilian boys and girls from birth to 20 years of age. Differences in growth of Brazilian youth ranged from −0.8 to −3.2 z-scores compared to WHO standards, and −1.9 to +1.3 compared to children with DS in other studies. Conclusions: These specific growth charts may guide clinicians and families in monitoring the growth of Brazilian children and adolescents with DS

    Accelerometer cut points for adults with down syndrome

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    Past research has indicated that the relationship between energy expenditure and accelerometer output is different between adults with and without Down syndrome (DS). This suggests a need for DS-specific cut points for determining levels of sedentary behavior and physical activity from accelerometer output for adults with DS. To develop accelerometer output cut points for sedentary behavior and moderate and vigorous intensity physical activity for adults with DS. Sixteen adults with DS (10 men & 6 women; age 31 ± 15 years) performed 12 tasks each lasting 6 min: sitting; playing app on tablet; drawing; folding clothes; sweeping; fitness circuit; moving a box; basketball; standing; and walking at the preferred speed and at 0.8 and 1.4 m.s-1. We measured the rate of oxygen uptake with portable indirect calorimetry (K4b2, Cosmed) and expressed it in Metabolic Equivalents (METs). Output from a triaxial accelerometer (wGT3X-BT, Actigraph) worn on the non-dominant hip was determined as Vector Magnitude. Receiver Operating Characteristic (ROC) curves were used to identify Vector Magnitude cut points for sedentary behavior and moderate (3.0 - 5.99 METs) and vigorous (≥6 METs) intensity physical activity. Overall performance of classification models was assessed with the area under the ROC curve. Optimal cut points maximizing sensitivity and specificity were selected based on Youden’s index. Area under the ROC curve was high for all models: (a) sedentary behavior (0.96; 95% CI: 0.93 - 0.98); (b) moderate intensity physical activity (0.92; 95% CI: 0.88 - 0.96); and (c) vigorous intensity physical activity (0.92; 95% CI: 0.85 - 0.99). The optimal Vector Magnitude cut points were: (a) sedentary behavior ≤236 counts·min-1 (sensitivity 0.98; specificity 0.90; Youden’s index 0.88); (b) moderate-intensity physical activity ≤2167 counts·min-1 (sensitivity 0.99; specificity 0.82; Youden’s index 0.81); and (c) vigorous-intensity physical activity ≥4200 counts·min-1 (sensitivity 1.00; specificity 0.84; Youden’s index 0.84). This study offers the first DS-specific accelerometer output cut-points for classifying sedentary behavior and intensity of physical activity in adults with DS. Overall classification accuracy was excellent527

    Body mass index reference charts for individuals with Down syndrome aged 2-18 years,

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    Abstract: Objective: To develop Brazilian growth charts for body mass index (BMI-for-age) for individuals with Down syndrome (DS). The secondary objective was to compare the BMI-for-age with the Centers for Disease Control and Prevention standards (CDC). Methods: A retrospective and cross-sectional growth study of 706 youth with DS (56.7% males) was performed in 51 centers in São Paulo state, Brazil. Weight and height were used to calculate the BMI (kg/m2). The LMS method was applied to construct the growth charts. Z-scores were based on the CDC 2000 growth standards. Results: The BMI-for-age reference charts showed excellent goodness of fit statistics for boys and girls with DS aged 2-18 years. At 2 years of age, the mean BMI Z-scores of boys and girls with DS were lower compared to those of the CDC (Z-score = −0.2). In contrast, children with DS aged 3-18 years had higher mean Z-scores for BMI-for-age when compared to those of the CDC (Z-scores = +0.2 to +1.3). Conclusions: The BMI of Brazilian youth with DS differs from those references established by CDC. These are the first Brazilian BMI-for-age charts for individuals with DS and will hopefully guide clinicians and parents in the evaluation and management of the nutritional status in children and adolescents with DS in Brazil
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