Prevalence of the metabolic syndrome using two proposed definitions in a Japanese-Brazilians community

Metabolic Syndrome (MetS) is associated with increased risk of morbi-mortality, thus the characterization of the population magnitude of this syndrome is critical for allocating health care. However, prevalence estimates of MetS in the same population could differ depending on the definition used. Therefore, we compared the prevalence of the MetS using definitions proposed by: National Cholesterol Education Panel Revised (NCEP) and International Diabetes Federation (IDF) 2009 in a Japanese-Brazilians community (131 individuals, age 57 ± 16 years, 1st and 2nd generation). All individuals went through a clinical and laboratorial evaluation for assessment of weigh, height, waist circumference, blood pressure, triglycerides, HDL-cholesterol and fasting plasma glucose. The prevalence of MetS was 26.7% (n = 35) and 37.4% (n = 49) under the NCEP and IDF definitions, respectively. Despite higher blood pressure measurements, waist circumference and serum triglyceride levels and lower HDL cholesterol levels (p < 0.01), individuals identified with MetS did not show increased blood glucose levels. IDF definition classified 14 individuals (10.7%) with MetS that were not classified under the NCEP and 35 individuals were identified with MetS by both criteria. We observed, in this group, more severe lipid disorders, compared to individuals identified only under the IDF definition, and the BMI and waist circumference (p = 0.01; p = 0.006, respectively) were lower. In conclusion, the IDF revised criteria, probably because of the ethnic specific values of waist circumference, was able to identify a larger number of individuals with MetS. However, our data suggesting that additional studies are necessary to define best MetS diagnostic criteria in this population.We are grateful to patients participating in this study and to Sebastiao L. Brandao Filho for technical assistance.This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sector

Epidemiology of multimorbidity within the Brazilian adult general population:Evidence from the 2013 National Health Survey (PNS 2013)

Middle-income countries are facing a growing challenge of adequate health care provision for people with multimorbidity. The objectives of this study were to explore the distribution of multimorbidity and to identify patterns of multimorbidity in the Brazilian general adult population. Data from 60202 adults, aged ≥18 years that completed the individual questionnaire of the National Health Survey 2013 (Portuguese: "Pesquisa Nacional de Saúde"-"PNS") was used. We defined multimorbidity as the presence of two or more chronic conditions, including self-reported diagnoses and responses to the 9-item Patient Health Questionnaire for depression. Multivariate Poisson regression analyses were used to explore relationship between multimorbidity and demographic factors. Exploratory tetrachoric factor analysis was performed to identify multimorbidity patterns. 24.2% (95% CI 23.5-24.9) of the study population were multimorbid, with prevalence rate ratios being significantly higher in women, older people and those with lowest educational level. Multimorbidity occurred earlier in women than in men, with half of the women and men aged 55-59 years and 65-69 years, respectively, were multimorbid. The absolute number of people with multimorbidity was approximately 2.5-fold higher in people younger than 65 years than older counterparts (9920 vs 3945). Prevalence rate ratios of any mental health disorder significantly increased with the number of physical conditions. 46.7% of the persons were assigned to at least one of three identified patterns of multimorbidity, including: "cardio-metabolic", "musculoskeletal-mental" and "respiratory" disorders. Multimorbidity in Brazil is as common as in more affluent countries. Women in Brazil develop diseases at younger ages than men. Our findings can inform a national action plan to prevent multimorbidity, reduce its burden and align health-care services more closely with patients' needs

Diabetes como causa básica ou associada de morte no Estado de São Paulo, Brazil, 1992

INTRODUÇÃO: As estatísticas de mortalidade, em geral, baseiam-se na análise das causas básicas de óbito. No caso do diabetes, sua importância é sempre subestimada, pois os diabéticos geralmente morrem devido às complicações crônicas da doença, sendo estas que figuram como a causa básica do óbito. Para atenuar esse problema, deveriam ser analisadas todas as causas mencionadas no atestado de óbito. Como contribuição ao problema foi analisada a freqüência das menções do diabetes nas declarações de óbito e as principais causas associadas. METODOLOGIA: Os coeficientes específicos e a mortalidade proporcional por diabetes, como causa básica ou associada, foram calculados com base nas informações extraídas dos atestados de óbito, através do sistema ACME (Automated Classification of Medical Entities), para o Estado de São Paulo, em1992. RESULTADOS E CONCLUSÕES: De um total de 202.141 óbitos, o diabetes foi mencionado em 13.786 (6,8%), sendo a causa básica em 5.305 (2,6%). A proporção foi maior para mulheres do que para homens (10,1 vs 4,6% como causa mencionada e 6,1 vs 2,9% como causa básica). Entre os óbitos com menção de diabetes no atestado, as principais causas básicas foram: diabetes (38,5%), doenças cardiovasculares (37,2%), doenças respiratórias (8,5%) e neoplasias (4,8%). Quando o diabetes foi a causa básica, as principais causas associadas foram: doenças cardiovasculares (42,2%), respiratórias (10,7%) e geniturinárias (10,1%) . Nos casos onde o diabetes figura como causa associada, as principais causas básicas foram as doenças cardiovasculares (60,5%), respiratórias (13,8%) e neoplásicas (7,9%). Apesar das limitações dos dados obtidos dos atestados de óbito, observou-se que o diabetes representa uma importante causa de morte, traduzindo um problema de saúde de grande magnitude. Também, a análise pelas causas múltiplas de morte fornece um perfil da morbidade associada ao diabetes por ocasião do óbito, salientando a importância das doenças cardiovasculares

Evaluation of body adiposity index (BAI) to estimate percent body fat in an indigenous population

Background & aims: the aim of this study was to evaluate the usefulness of Body Adiposity Index (BAI) as a predictor of body fat in Xavante Indians and to investigate which anthropometric measures of adiposity best correlate with body fat in this population.Methods: We evaluated 974 individuals (476 male), aged 423 +/- 19.5 years. Percentage of body fat (%BF) determined by bioimpedance analysis (BIA) was used as the reference measure of adiposity. Bland-Altman analysis was used to assess the agreement between the two methods: BAI and BIA. Associations between anthropometric measures of adiposity were investigated by Pearson correlation analysis.Results: BAI overestimates %BF (mean difference: 4.10%), mainly at lower levels of adiposity. Significant correlations were found between %BF and all measurements, being the strongest correlation with BAI. However, stratified analyses according to gender showed that among men waist circumference has the strongest correlation (r = 0.73, p <0.001) and among women BAI (r = 0.71, p < 0.001), BMI (r = 0.69, p < 0.001) and waist circumference (r = 0.70, p < 0.001) performed similarly.Conclusion: BAI can be a useful tool to predict %BF in Xavante Indians, although it has some limitations. However, it is not a better predictor of adiposity than waist circumference in men or BMI and waist circumference in women. (C) 2013 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Universidade Federal de São Paulo, Discipline Endocrinol, Escola Paulista Med, BR-04039001 São Paulo, BrazilUniv São Paulo, Fac Med Ribeirao Preto, Dept Med Social, BR-14049 Ribeirao Preto, BrazilUniversidade Federal de São Paulo, Discipline Endocrinol, Escola Paulista Med, BR-04039001 São Paulo, BrazilFAPESP: 2010/05634-0CNPq: 573856/2008-7Web of Scienc

Macrovascular disease in a Japanese-Brazilian population of high prevalence of metabolic syndrome: Associations with classical and non-classical risk factors

Background: the Japanese-Brazilian Diabetes Study detected high prevalence of metabolic syndrome (MS) in a population of Japanese ancestry living in Brazil. We describe the prevalence of macrovascular disease (MVD) and its association with classical and non-classical cardiovascular risk factors in this population.Methods: An overall of 1163 individuals were studied; diagnosis of MVD was based on a score obtained from medical history, ankle-brachial pressure index and electrocardiogram, defining three groups: no MVD, possible MVD and definite MVD.Results: Prevalence of MVD was 14.3% (possible MVD: 11.2%; definite MVD: 3.1%). Individuals with MS had higher rates of MVD (16.9% versus 11.2%; p < 0.05). Comparing to no MVD, age, 2 It plasma glucose, anti-LDL(+) and anti-LDL(-) levels, and urinary albumin-to-creatinine ratio were higher in both categories with MVD; waist-to-hip ratio, fasting plasma glucose, HbAlc, total-to-HDL cholesterol ratio and triglycerides were higher in that with definite MVD; systolic blood pressure and homocysteine were higher in that with possible MVD. Using logistic regression, systolic blood pressure, smoking habit and anti-LDL(+) were independently associated with MVD.Conclusion: MVD is highly prevalent in Japanese-Brazilians and its association with MS was confirmed. A novel marker of lipoprotein modifications-anti-LDL(+) antibody-could be useful in identifying individuals at higher risk. (c) 2006 Elsevier Ireland Ltd. All rights reserved.Universidade Federal de São Paulo, Dept Internal Med, Div Endocrinol, BR-05508 São Paulo, BrazilUniv São Paulo, Ribeirao Preto Med Sch, Dept Social & Prevent Med, BR-05508 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Prevent Med, São Paulo, BrazilUniv São Paulo, Dept Clin & Toxicol Anal, BR-05508 São Paulo, BrazilUniv São Paulo, Sch Publ Hlth, Dept Nutr, BR-05508 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Surg, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Internal Med, Div Endocrinol, BR-05508 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Prevent Med, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Surg, São Paulo, BrazilWeb of Scienc

Prevalence of the metabolic syndrome using two proposed definitions in a Japanese-Brazilians community

Abstract Metabolic Syndrome (MetS) is associated with increased risk of morbi-mortality, thus the characterization of the population magnitude of this syndrome is critical for allocating health care. However, prevalence estimates of MetS in the same population could differ depending on the definition used. Therefore, we compared the prevalence of the MetS using definitions proposed by: National Cholesterol Education Panel Revised (NCEP) and International Diabetes Federation (IDF) 2009 in a Japanese-Brazilians community (131 individuals, age 57 ± 16 years, 1st and 2nd generation). All individuals went through a clinical and laboratorial evaluation for assessment of weigh, height, waist circumference, blood pressure, triglycerides, HDL-cholesterol and fasting plasma glucose. The prevalence of MetS was 26.7% (n = 35) and 37.4% (n = 49) under the NCEP and IDF definitions, respectively. Despite higher blood pressure measurements, waist circumference and serum triglyceride levels and lower HDL cholesterol levels (p < 0.01), individuals identified with MetS did not show increased blood glucose levels. IDF definition classified 14 individuals (10.7%) with MetS that were not classified under the NCEP and 35 individuals were identified with MetS by both criteria. We observed, in this group, more severe lipid disorders, compared to individuals identified only under the IDF definition, and the BMI and waist circumference (p = 0.01; p = 0.006, respectively) were lower. In conclusion, the IDF revised criteria, probably because of the ethnic specific values of waist circumference, was able to identify a larger number of individuals with MetS. However, our data suggesting that additional studies are necessary to define best MetS diagnostic criteria in this population.</p