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

Insatisfação corporal de escolares e sua relação com o estado nutricional real

This paper aims to identify the prevalence of body dissatisfaction among schoolchildren and relate it to their real nutritional status. The evaluation included 1578 schoolchildren in the municipality of Santa Cruz do Sul-RS, through the measures of weight and height, for the calculation of the body mass index (BMI) and questionnaire to evaluate the satisfaction with the body weight. The results show that body dissatisfaction was significantly higher among the girls, among the adolescents and among the higher economic classes. Most schoolchildren showed a body perception consistent with the actual nutritional status, however, some worrying results were found that point out a distortion between body perception and actual nutritional status, as the percentage of eutrophic girls who would like to decrease weight, and overweight school children who said they were satisfied with their weight or who would like to increase it.Este estudo objetiva identificar a prevalência da insatisfação corporal entre os escolares e relacioná-la com o seu real estado nutricional. Foram avaliados 1578 escolares do município de Santa Cruz do Sul-RS, através das medidas de peso e altura, para o cálculo do índice de massa corporal (IMC) e questionário para avaliar a satisfação com o peso corporal. Os resultados demonstram que a insatisfação corporal foi significativamente maior entre as meninas, os adolescentes e os níveis socioeconômicos mais altos. Os escolares, em sua maioria, mostraram uma percepção corporal condizente com o estado nutricional real, porém, alguns resultados preocupantes foram encontrados que apontam uma distorção entre a percepção corporal e o estado nutricional real, como o percentual de meninas eutróficas que gostariam de diminuir de peso, e escolares com excesso de peso que declararam estarem satisfeitos com seu peso ou ainda, que gostariam de aumentá-lo.Este estudio tiene como objetivo identificar la prevalencia de la insatisfacción corporal entre los estudiantes y relacionarlo con su estado nutricional real. Evaluaron en 1578 escolares de la ciudad de Santa Cruz do Sul-RS, a través de las medidas de peso y altura, para el cálculo del índice de masa corporal (IMC) y el cuestionario para evaluar la satisfacción con el peso corporal. Los resultados muestran que la insatisfacción corporal fue significativamente mayor entre las niñas, los adolescentes y entre los más altos niveles socioeconómicos. Los escolares, en su mayoría, mostraron una percepción corporal acorde con el estado nutricional real, sin embargo, algunos resultados preocupantes fueron encontrados que apunta una distorsión entre la percepción corporal y el estado nutricional real, como el porcentaje de niñas eutróficas que les gustaría disminuir peso, y escolares con sobrepeso que declararon estar satisfechos con su peso o aún, que les gustaría aumentarlo

Perfil do estilo de vida de atletas amadores de Futebol 7 de um clube social de Santa Cruz do Sul-RS

The present study aimed to describe the lifestyle of club’s members enrolled as athletes of a soccer championship in Santa Cruz do Sul (RS). A total of 113 subjects, aged between 18 and 46 years, answered, using questionnaires, questions about the following subjects: nutrition, exercise, preventive behavior, relationship and stress management. The results showed that the partner’s profile is characterized by seeking, through the sports’ practice, moments of relaxation and leisure among friends, that provides them to feel active in their social environment, although they sometimes don’t care about healthy food, alcohol consumption and preventive behaviors related to health way of life.O presente estudo teve como objetivo descrever o perfil do estilo de vida dos sócios inscritos como atletas em um campeonato de Futebol 7 de um clube de Santa Cruz do Sul (RS). Participaram do estudo 113 sujeitos, entre 18 e 46 anos, que, através de questionário, responderam questões sobre os seguintes temas: nutrição, atividade física, comportamento preventivo, relacionamento e controle de estresse. Os resultados demonstraram que o perfil do sócio é caracterizado por buscar, através da prática esportiva, momentos de descontração e lazer entre amigos, de forma que se sinta ativo em seu meio social, embora peque em aspectos alimentares, alcoólicos e comportamentos preventivos relacionados à saúde.

Presença de obesidade em escolares: estudo comparativo entre a zona urbana e rural de Santa Cruz do Sul-RS

This cross-sectional study aimed to verify if there is a difference in the presence of obesity in schoolchildren from the urban and rural areas of Santa Cruz do Sul-RS. The study was composed of 2373 children and adolescents, schoolchildren from public schools, urban and rural areas, aged between six and 17 years. The Body Mass Index (BMI) was used as an indicator of school obesity, being calculated from the measures of weight and height, classified according to the percentile curves of the World Health Organization and analyzed in SPSS v. 23.0 (IBM, Armonk, USA). The prevalence of overweight /obesity is more prevalent in the urban area, only in males (RP: 1.08, p = 0.003), among the regions, was more prevalent in the north of the city (RP: 1.14, p <0.001), and among girls, the prevalence of overweight / obesity was lower in the central region (PR: 0.94, p = 0.043) and west (PR: 0.92, p = 0.025), not associated with the zona or place of residence.O presente estudo transversal teve como objetivo verificar diferença na presença de obesidade em escolares da zona urbana e rural de Santa Cruz do Sul-RS. A pesquisa foi composta por 2373 crianças e adolescentes, escolares da rede pública, da zona urbana e rural, com idade entre seis e 17 anos. O Índice de Massa Corporal (IMC) foi utilizado para avaliar a presença de obesidade do escolar. Os dados foram analisados pela regressão de Poisson, sendo descritos em razão de prevalência (RP). A prevalência de sobrepeso/obesidade é mais predominante na zona urbana, apenas no sexo masculino (RP: 1,08; p=0,003); entre as regiões, foi mais prevalente no norte do município (RP: 1,14; p<0,001). Entre as meninas, a prevalência de sobrepeso/obesidade foi inferior na região centro (RP: 0,94; p=0,043) e oeste (RP: 0,92; p=0,025), não estando associada com a zona ou local de moradia. Conclui-se que a prevalência de sobrepeso/obesidade é superior na zona urbana, para o sexo masculino. Em relação às regiões, o sobrepeso/obesidade foi mais predominante no norte do município. ABSTRACT Presence of obesity in schoolchildren: a comparative study between the urban and rural areas of Santa Cruz do Sul-RSThis cross-sectional study aimed to verify if there is a difference in the presence of obesity in schoolchildren from the urban and rural areas of Santa Cruz do Sul-RS. The study was composed of 2373 children and adolescents, schoolchildren from public schools, urban and rural areas, aged between six and 17 years. The Body Mass Index (BMI) was used as an indicator of school obesity, being calculated from the measures of weight and height, classified according to the percentile curves of the World Health Organization and analyzed in SPSS v. 23.0 (IBM, Armonk, USA). The prevalence of overweight /obesity is more prevalent in the urban area, only in males (RP: 1.08, p = 0.003), among the regions, was more prevalent in the north of the city (RP: 1.14, p <0.001), and among girls, the prevalence of overweight / obesity was lower in the central region (PR: 0.94, p = 0.043) and west (PR: 0.92, p = 0.025), not associated with the zona or place of residence

Tracking of cardiometabolic risk in a Brazilian schoolchildren cohort: A 3-year longitudinal study

Background: Clustering of cardiometabolic risk factors is a sign of detrimental health. Tracking is a term used to describe a variable longitudinal stability across time. High tracking provides the chance to determine which cardiometabolic risk factors should be the target of early treatment and prevention efforts. The present study aims to analyze the tracking of cardiometabolic risk factors and clustered cardiometabolic risk score in children across a 3-year time span, and to verify the odds of staying at risk (measured by the clustered score) from baseline to follow-up. Methods: Longitudinal study that included 354 (155 boys) children, aged 7-12 years at baseline. A clustered score was calculated by summing the systolic blood pressure, waist circumference, triglycerides, glucose, and the TC/HDL-C ratio Z-scores divided by five. A second clustered score was calculated including cardiorespiratory fitness (CRF). Results: CRF and anthropometric parameters presented high tracking (r≥0.662), whereas the cardiometabolic parameters exhibited low-to-moderate tracking (0.100≤r≤0.571). The clustered scores' tracking was moderate (r≥0.508; r≥0.588 [CRF]). Participants in the higher risk groups at baseline presented 3.81 (95% CI: 2.40; 6.05) and 4.64 (95% CI: 2.85; 7.56), including CRF, times higher chance of remaining at risk three years later. Moreover, participants in the worst profile regarding CRF or anthropometrics at baseline presented at least 4.00 times higher chance of being at risk three years later. Conclusions: Participants with worst CRF and adiposity had an increased risk of presenting higher clustered risk after three years

Association of IL-6 and CRP gene polymorphisms with obesity and metabolic disorders in children and adolescents

Activation of adipose tissue inflammation is associated with obesity caused by lipid accumulation in adipocytes. Through this activation, proinflammatory cytokines, such as Interleukin-6 (IL-6) and C-reactive protein (CRP) seem to influence metabolic disorders. The present study evaluated whether polymorphisms in the CRP (rs1205) and IL-6 (rs1800795, rs2069845) genes are associated with the development of metabolic disorders in children and adolescents. A cross-sectional study was performed, consisting of 470 students from the municipality of Santa Cruz do Sul, Brazil, aged 7-17 years. Body mass index (BMI) was classified according to overweight and obesity. Genotyping was performed by real-time Polymerase Chain Reaction(PCR). Anthropometric characteristics, biochemical markers, immunological markers and blood pressure were assessed. Descriptive statistics, chi-square and logistic regression were used for the analyses. No association was detected between the rs1800795 polymorphism and the assessed variables. Individuals with the risk genotype in the rs1205 gene were associated with the risk of developing hypercholesterolemia (OR 2.79; CI 1.40, 5.57; p = 0.003). Carriers of the risk genotype in the rs2069845 gene are associated with the risk of developing obesity (OR 3.07; CI 1.08, 8.72; p = 0.03). The polymorphism rs2069845 was associated with obesity and rs1205 was associated with the risk of developing hypercholesterolemia in Brazilian schoolchildren

Hyperuricemia is associated with low cardiorespiratory fitness levels and excess weight in schoolchildren

Objective: To evaluate the possible association between hyperuricemia and cardiorespiratory fitness levels/nutritional profile, grouped into a single variable, in schoolchildren. Method: Cross‐sectional study of 2335 students from Elementary schools, aged 7–17 years of both genders, stratified by conglomerates of a municipality in Southern Brazil. Body mass index (BMI) was calculated and cardiorespiratory fitness (CRF) was assessed by the 6‐minute run/walk test. The BMI and CRF were grouped into a single variable, considering: (1) low and normal weight/fit; (2) low and normal weight/unfit; (3) overweight‐obesity/fit; (4) overweight‐obesity/unfit. The Poisson regression (prevalence ratio, PR) was used for the association between hyperuricemia and BMI/CRF ratio with 95% confidence intervals and differences were considered significant when p < 0.05. Results: There is an association, although subtle, between the presence of hyperuricemia with low levels of CRF and the presence of excess weight, when grouped into a single variable. Boys and girls with this condition have higher prevalence of hyperuricemia (PR: 1.07; p = 0.007 for boys; PR: 1.10; p < 0.001 for girls). Conclusion: Together, excess weight and low levels of cardiorespiratory fitness are associated with the presence of hyperuricemia in schoolchildren

Genotypic carriers of the obesity-associated FTO polymorphism exhibit different cardiometabolic profiles after an intervention

ABSTRACT Background: Children and adolescents with at-risk genotypes (AA/AT) of the rs9939609 polymorphism in FTO, a fat mass and obesity-associated gene, may exhibit different cardiometabolic profile responses than subjects with the TT genotype after an interdisciplinary intervention. Methods: The sample consisted of 36 school children from southern Brazil. We used DNA quantitation and real-time polymerase chain reaction (PCR) for polymorphism genotyping. We measured anthropometric parameters (body mass index (BMI), waist circumference, hip circumference, waist-hip ratio, body fat percentage and skinfold sum), biochemical parameters (glucose, lipid profile, ultra-sensitive C-reactive protein, uric acid, alanine aminotransferase, aspartate aminotransferase, insulin and adiponectin) and blood pressure. The 4-month intervention consisted of physical education classes, nutritional counseling, and postural and oral health counseling. Results: We observed no significant differences among the groups (AA, AT and TT) after the intervention. However, we observed improvements in three parameters (waist circumference, hip circumference and C-reactive protein) in the AT/AA genotype group and in two parameters (hip circumference and uric acid) in the TT genotype group. Conclusions: After an intervention program, carriers of at-risk genotypes for obesity (AA/AT) do not exhibit differences in biochemical parameters, blood pressure and anthropometric parameters compared with carriers of the TT genotype

Overweight and Obesity in Schoolchildren: Hierarchical Analysis of Associated Demographic, Behavioral, and Biological Factors

Studies focused on the mechanisms involved in the development of obesity in children and adolescents have reported associations between this condition and birth weight, sedentary lifestyle, and hereditary conditions. However, few studies have simultaneously evaluated these factors. This cross-sectional study aims to identify demographic, behavioral, and biological factors associated with overweight/obesity in children and adolescents. 381 schoolchildren aged seven to 17 years were included in the study to evaluate the associations between overweight/obesity and biological factors (including family history of obesity, birth weight, and the fat mass and obesity-associated (FTO) rs9939609 polymorphism), demographic variables (including gender and age), and behavioral variables (including physical activity and/or sports participation). The results of this study showed that there was a lower prevalence of obesity in schoolchildren aged 11–17 years (PR: 0.89; p=0.004). Obesity was more prevalent in children whose father (PR: 1.24; p<0.001) and maternal grandmother (PR: 1.16; p=0.019) were obese. Higher prevalence rates of obesity were also identified in schoolchildren who were overweight at birth (PR: 1.18; p=0.002) and carriers of the obesity risk genotype (PR: 1.13; p=0.016). Biological factors, such as family history of obesity, overweight at birth, and the presence of the fat mass and obesity-associated rs9939609 polymorphism were associated with the prevalence of obesity in children and adolescents