Determinantes da pressão arterial em diabéticos tipo 2 com alta ocorrência de controle glicêmico inadequado

Study design: Association studyObjective: To analyze the association between different biological/behavioral risk factors and bloodpressure in a sample of type 2 diabetes mellitus patients with poor glycemic control. Methods: A sampleof 121 type 2 diabetic patients was selected in the Public Healthcare System in a middle size Braziliancity. Blood pressure was measured using an aneroid device, previously calibrated. Six determinants ofblood pressure were taken into count: age, hypoglycemic agents, general obesity, abdominal obesity,eating behaviors and physical activity level. Results: The type 2 diabetic patients presented mean age of60.1±8.9 years-old and, at least, one risk factor. Eating behaviors (ORadj= 0.31 [0.12-0.75]) and sportspractice (ORadj= 0.12 [0.02-0.75]) constituted protective factors associated with lower systolic blood pressure. On the other hand, age was positively associated with high systolic blood pressure (ORadj= 3.81[1.39-10.38]). Patients with 5-6 risk factors, presented higher values of systolic and (F= 3.857; p= 0.011[post hoc with p= 0.039]), diastolic blood pressure (F= 4.158; p= 0.008 [post hoc with p= 0.036]) andincreased occurrence of hypertension (p= 0.010). Conclusion: Our findings indicate that, behavioralvariables were important determinants of blood pressure in type 2 diabetic patients with poor glycemiccontrol and clustering of behavioral and biological risk factors increase the hypertension occurrence.Modelo do estudo: Estudo de associaçãoObjetivo: Analisar a associação entre diferentes fatores de risco biológicos/comportamentais e pressãoarterial in uma amostra de diabéticos do tipo 2 com pobre controle glicêmico. Métodos: Uma amostra de121 diabéticos tipo 2 foi selecionada no sistema público de uma cidade brasileira de porte médio.Pressão arterial foi aferida usando um aparelho aneroide previamente calibrado. Seis determinantes dapressão arterial foram considerados: idade, hipoglicemiantes, obesidade geral, obesidade central, hábitos alimentares e atividade física. Resultados: Os diabéticos apresentaram média de idade de 60,1±8,9anos e ao menos um fator de risco. Hábitos alimentares (ORadj= 0.31 [0.12-0.75]) e prática esportiva(ORadj= 0.12 [0.02-0.75]) constituíram fatores de proteção associados a menor pressão arterial. Poroutro lado, idade foi positivamente associada com alta pressão arterial sistólica (ORadj= 3.81 [1.39-10.38]).Pacientes com 5-6 fatores de risco apresentaram maiores valores sistólicos (F= 3,857; p= 0,011 [post hoccom p= 0,039]) e diastólicos (F= 4,158; p= 0,008 [post hoc com p= 0,036]) e maior ocorrência de hipertensão (p= 0,001). Conclusão: Nossos achados indicam que variáveis comportamentais foram importantesdeterminantes de pressão arterial em pacientes com pobre controle glicêmico e a agregação de fatorescomportamentais e biológicos aumentaram a ocorrência de hipertensão

Analysis of cardiac autonomic modulation in obese and eutrophic children

INTRODUCTION: Obesity causes alterations in cardiac autonomic function. However, there are scarce and conflicting data on this function with regard to heart rate variability in obese children. OBJECTIVE: To compare the autonomic function of obese and eutrophic children by analyzing heart rate variability. METHODS: One hundred twenty-one children (57 male and 64 female) aged 8 to 12 years were distributed into two groups based on nutritional status [obese (n = 56) and eutrophic (ideal weight range; n = 65) according to the body mass index reference for gender and age]. For the analysis of heart rate variability, heart rates were recorded beat by beat as the children rested in the dorsal (prone) position for 20 minutes. Heart rate variability analysis was carried out using linear approaches in the domains of frequency and time. Either Student's t-test or the Mann-Whitney U-test was applied to compare variables between groups. Statistical significance was set at 5%. RESULTS: The SDNN, RMSSD, pNN50, SD1, SD2, LF and HF indices in milliseconds squared were lower among the obese children when compared to the eutrophic group. There were no alterations in the SD1/SD2 ratio, LF/HF ratio, LF index or HF index in normalized units. There was a significant difference between groups in the RR interval (R-to-R EKG interval). CONCLUSION: The obese children exhibited modifications in heart rate variability, characterized by a reduction in both sympathetic and parasympathetic activity. These findings stress the need for the early holistic care of obese children to avoid future complications

Fatores de risco associados ao excesso de peso entre adolescentes da Região Oeste Paulista

The objective of this study was to analyze the association between being overweight and family risk factors in adolescents from Western Sao Paulo state. This cross-sectional study involved 1779 adolescents of both genders and with ages ranging between 11 and 17 years. The participants' body mass index was calculated, and the family risk factors were analyzed through a questionnaire. Excessive weight was associated with the male gender (CR=1.55 [1.22-1.97]), studying in a private school (CR=2.14 [1.56-2.94]) and mother's higher education (CR=0.52 [0.33-0.83]). There is a need to implement initiatives to fight obesity in the school environment and reach the whole family structure, taking gender-related specificities into consideration.Analizar la asociación entre exceso de peso y diferentes factores de riesgo familiares en adolescentes de la región oeste del estado de São Paulo. Estudio transversal con 1779 adolescentes de ambos sexos, y edad comprendida entre 11 y 17 años. Se calculó el índice de masa corporal; los factores de riesgo familiares fueron analizados por medio de cuestionario. El exceso de peso fue asociado con: sexo masculino (RC=1,55 [1,22-1,97]), estudiar en escuela particular (RC=2,14 [1,56-2,94]), y mayor escolaridad materna (RC=0,52 [0,33-0,83]). Iniciativas de combate a la obesidad deben ser instauradas en el medio escolar y alcanzar a toda la estructura familiar, así como llevar en consideración particularidades provenientes del sexo.Analisar a associação entre excesso de peso e diferentes fatores de risco familiares em adolescentes da região oeste do estado de São Paulo. Estudo transversal com 1779 adolescentes de ambos os sexos, e idade compreendida entre 11 e 17 anos. Calculou-se o índice de massa corporal e os fatores de risco familiares foram analisados por meio de questionário. O excesso de peso foi associado com o sexo masculino (RC=1,55 [1,22-1,97]), estudar em escola particular (RC=2,14 [1,56-2,94]) e maior escolaridade materna (RC=0,52 [0,33-0,83]). Iniciativas de combate à obesidade devem ser instauradas em meio escolar e atingir toda a estrutura familiar, bem como levar em consideração particularidades decorrentes do sexo

The Mediating Role of Physical Inactivity on the Relationship between Inflammation and Artery Thickness in Prepubertal Adolescents

Objective: To analyze the relationship between inflammatory markers and the lipid profile, blood flow, and artery structure in prepubertal adolescents stratified according to sports practice.Study design The sample was composed of 120 adolescents (57 boys and 63 girls) with a mean age of 11.7 +/- 0.7 years (ranging from 11 to 13 years). Intima-media thickness (IMT) and blood flow were measured with ultrasonography. The lipid profile and high-sensitivity C-reactive protein were measured after the subjects had fasted for 12 hours overnight. Trunk fatness was measured by dual-energy x-ray absorptiometry. Organized sports participation was analyzed as a categorical variable. Biological maturation was determined via the age at peak height velocity. Results: In the adjusted model, high-sensitivity C-reactive protein was significantly related to high-density lipoprotein-cholesterol (beta = -5.797 [-11.500 to -0.093]), femoral IMT (beta = 0.062 [0.008-0.116]), and the sum of femoral and carotid IMT (beta = 1.107 [0.223-1.919]), but only in the group without sports participation. Slopes of the crude linear regression were greater in the group without sports participation for femoral IMT (t = 2.621; P = .009) and the sum of femoral and carotid IMT (t = 2.876; P = .004) when compared with the group with sports participation. Conclusion: Independent of body fatness and biological maturation, inflammatory status was related to artery IMT and dyslipidemia in prepubertal adolescents, modulated by sport participation.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq

Body composition analysis of athletes from the elite of Brazilian soccer players Análise da composição corporal de atletas da elite do futebol brasileiro

ABSTRACT This study analyzed the body composition and bone mineral density of elite Brazilian soccer players and compared its differences according to the player position. Eighty-two soccer players competing at Brazilian first division were split according to their field positions: Goalkeepers (GK, n= 10), Backfielders (BF, n= 10), Lateral-midfielders (LM, n= 15), Central-midfielders (CM, n= 25), Forwards (FW, n= 22), and a Control Group (CG, n= 72) of university students. To estimate fat free mass (FFM), fat mass (FM), percentage of body fat (%FM), fat free mass of legs (FFM-Legs) and bone mineral density (BMD), a DEXA was selected. The positions LM (10.5 ± 5.2), CM (9.7 ± 4.0) and FW (9.9 ± 4.4) had lower values of FM and %FM than the GK (17.3 ± 6.0) and the control group (15.0 ± 5.3). Compared to the other positions, FFM was higher in the GK (68.2 ± 10.9) and BF (64.6 ± 6.8) (p< 0.05). All the soccer players were different from the CG (p< 0.05). Soccer players have an FFM, FFM-Legs and BMD significantly higher and FM and %FM lower than the control group. Keywords: athletes, muscle mass, bone density, DXA RESUMO Este estudo analisou a composição corporal e densidade mineral óssea de atletas da elite do futebol brasileiro e comparar as diferenças entre as posições de jogo. Oitenta e dois jogadores de futebol da primeira divisão do Brasil foram divididos de acordo com a posição de jogo. Goleiros (GL, n= 10), Defensores (DF, n= 10), Laterais (LT, n= 15), Centrais (CT, n= 25), Atacantes (AT, n= 22) e um grupo controle (CG, n= 72). Para estimar a massa livre de gordura (MLG), massa gorda (MG), percentual de massa gorda (%MG), massa livre de gordura de pernas (MLG-Pernas) e densidade mineral óssea (DMO), foi usado o DEXA. A posição LT (10.5 ± 5.2), CT (9.7 ± 4.0) e AT (9.9 ± 4.4) apresentaram menores valores de MG e %MG que os GL (17.3 ± 6.0) e GC (15.0 ± 5.3). Comparado a outras posições, a MLG foi maior nos GL (68.2 ± 10.9) e DF (64.6 ± 6.8) (p< 0.05). Todos os jogadores apresentaram diferenças significativas em relação ao grupo controle (p< 0.05). Em suma, conclui-se que atletas da elite do futebol brasileiro apresentaram significativamente maior MLG, MLG-Pernas, DMO e menor MG e %MG que o grupo controle. Palavras-chave: atletas, massa muscular; densidade mineral óssea Manuscrip

Estado nutricional de adolescentes segundo o índice de massa corporal

In the last decades, the obesity prevalence has increased in worldwide, and is necessary to be followed. The aim of the presented study was to analyze the efficiency of Brazilian body mass index cutoffs in the nutritional status indication. A sample of 1384 subjects was evaluated, with age ranging from 10 to 17 years old. Were assessed the body weight, stature (body mass index), and the triceps skinfold. For the male gender, the sensibility’s scores were 43.8% (overweight/obesity) and 5.6% (malnutrition). For the female gender, the sensibility’s scores were 31.4% (overweight/obesity) and 5.7% (malnutrition). The specificity’s scores were 72.5% (overweight/obesity) and 99.1% (malnutrition) for the male gender, and equal to 84.2% (overweight/obesity) and 96.1% (malnutrition) for the female gender. The analyzed body mass index cutoffs are more specific than sensitive in the nutritional status identification.A prevalência da obesidade tem crescido de forma alarmante nas últimas décadas, crescimento este que precisa ser acompanhado de perto. O objetivo do estudo foi analisar a eficiência de valores críticos de índice de massa corporal específicos para a população brasileira na indicação do estado nutricional. Foram avaliados 1384 indivíduos, com idade entre 10 e 17 anos. Aferiu-se o peso corporal, a estatura (índice de massa corporal) e a dobra cutânea tricipital. Para o sexo masculino, foram observados valores de sensibilidade iguais a 43.8% (sobrepeso/obesidade) e 5.6% (desnutrição). Para o sexo feminino, os valores de sensibilidade foram iguais a 31.4% (sobrepeso/obesidade) e 5.7% (desnutrição). Os valores de especificidade foram iguais a 72.5% (sobrepeso/obesidade) e 99.1% (desnutrição) para o sexo masculino, e iguais a 84.2% (sobrepeso/obesidade) e 96.1% (desnutrição) para o feminino. Os valores críticos de Índice de Massa Corporal analisados são mais específicos do que sensíveis na indicação do estado nutricional