Relationship between the FTO genotype and early chronic kidney disease in type 2 diabetes : the mediating role of central obesity, hypertension, and high albuminuria

Introduction: Single nucleotide polymorphisms (SNP) in the fat mass and obesity-associated (FTO) gene have been associated with type 2 diabetes (T2D) and its complications. The aim of the present research was to investigate which and how (directly or indirectly) clinical and metabolic variables mediate the association between fat mass and the FTO gene and early chronic kidney disease (CKD) in individuals with T2D. Methods: This cross-sectional study was conducted in a sample of 236 participants with T2D (53.4% women, mean age 60 ± 10 years). DNA samples were genotyped for the rs7204609 polymorphism (C/T) in the FTO gene. Clinical, anthropometric, and metabolic data were collected. Path analysis was used to evaluate the associations. Results: Of the sample, 78 individuals with T2D had CKD (33%). Presence of the risk allele (C) was higher among participants with CKD (21.8 vs. 10.8%; p = 0.023). This polymorphism was positively associated with higher waist circumference, which in turn was associated with higher glycated hemoglobin and higher blood pressure. A higher blood-pressure level was associated with higher urinary albumin excretion (UAE) and as expected, higher UAE was associated with CKD. Path analysis showed an indirect relationship between the FTO gene and early CKD, mediated by waist circumference, blood-pressure levels, and UAE. Conclusions: These findings suggest that the C allele may contribute to genetic susceptibility to CKD in individuals with T2D through the presence of central obesity, hypertension, and high albuminuria

Job Strain and Casual Blood Pressure Distribution: Looking beyond the Adjusted Mean and Taking Gender, Age, and Use of Antihypertensives into Account. Results from ELSA-Brasil

Submitted by Sandra Infurna ([email protected]) on 2017-07-13T11:38:54Z No. of bitstreams: 1 rosane3_griep_etal_IOC_2017.pdf: 1983850 bytes, checksum: 3757ec211428802f5ff69628c5895842 (MD5)Approved for entry into archive by Sandra Infurna ([email protected]) on 2017-07-13T12:13:38Z (GMT) No. of bitstreams: 1 rosane3_griep_etal_IOC_2017.pdf: 1983850 bytes, checksum: 3757ec211428802f5ff69628c5895842 (MD5)Made available in DSpace on 2017-07-13T12:13:38Z (GMT). No. of bitstreams: 1 rosane3_griep_etal_IOC_2017.pdf: 1983850 bytes, checksum: 3757ec211428802f5ff69628c5895842 (MD5) Previous issue date: 2017Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sérgio Arouca. Rio de Janeiro, RJ. BrasilFundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sérgio Arouca. Rio de Janeiro, RJ. BrasilFundação Oswaldo Cruz. Programa de Computação Científica. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sérgio Arouca. Rio de Janeiro, RJ. BrasilUniversidade Federal do Espírito Santo. Departamento de Ciências Fisiológicas. Vitória, ES, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Educação em Ambiente e Saúde. Rio de Janeiro, RJ. Brasil.Methodological issues are pointed to as the main sources of inconsistencies in studies about the association between job strain and blood pressure (BP)/hypertension. Our aim was to analyze the relationship between job strain and the whole BP distribution, as well as potential differences by gender, age, and use of antihypertensives. Additionally, we addressed issues relating to the operationalization of the exposure and outcome variables that influence the study of their inter-relations. We evaluated the baseline date of 12,038 participants enrolled in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) (2008-2010), a multicenter cohort study of 35-74-year-old civil servants. Job strain was assessed by the Demand-Control-Support Questionnaire. The distribution of casual BP by categories of job strain was compared by a combination of exploratory techniques. Participants were classified into three subgroups (normotensives, medicated hypertensives, and unmedicated hypertensives), and analyses were stratified by gender and age. The relationship between job strain and casual BP varied along the whole outcome distribution. Hypertensive participants had greater differences in casual BP by job strain category, especially medicated hypertensives. Differences in casual BP were also greater for systolic than for diastolic BP and for older participants. No differences were encountered by gender. The exclusion of participants susceptible to misclassification for the exposure and outcome variables increased the differences observed between the categories of low and high job strain. In conclusion, the relationship between job strain and casual BP varied along the whole outcome distribution and by use of antihypertensive drugs, age, and BP parameter evaluated. Misclassification for exposure and outcome variables should be considered in analyses of this topic

Factors associated with overweight: are the conclusions influenced by choice of the regression method?

Submitted by Sandra Infurna ([email protected]) on 2016-12-13T11:19:33Z No. of bitstreams: 1 rosane_griep_etal_IOC_2016.pdf: 638520 bytes, checksum: d78da175901f86574b7d533290fc776f (MD5)Approved for entry into archive by Sandra Infurna ([email protected]) on 2016-12-13T11:29:34Z (GMT) No. of bitstreams: 1 rosane_griep_etal_IOC_2016.pdf: 638520 bytes, checksum: d78da175901f86574b7d533290fc776f (MD5)Made available in DSpace on 2016-12-13T11:29:34Z (GMT). No. of bitstreams: 1 rosane_griep_etal_IOC_2016.pdf: 638520 bytes, checksum: d78da175901f86574b7d533290fc776f (MD5) Previous issue date: 2016Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sérgio Arouca. Rio de Janeiro, RJ. BrasilFundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sérgio Arouca. Rio de Janeiro, RJ. BrasilFundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sérgio Arouca. Rio de Janeiro, RJ. BrasilFundação Oswaldo Cruz. Presidência. Programa de Computação Científica. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Presidência. Programa de Computação Científica. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ. Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ. Brasil.Background: Different analytical techniques have been used to study the determinants of overweight. However, certain commonly used techniques may be limited by the continuous nature and skewed distribution of body mass index (BMI) data. In this article, different regression models are compared to identify the best approach for analysing predictors of BMI. Methods: Data collected on 2270 nurses at 18 public hospitals in Rio de Janeiro, RJ (2010–2011) were analysed (80.6 % of the respondents). The explanatory variables considered were age, marital status, race/colour, mother’s schooling, domestic overload, years worked at night, Consumption of fried food, physical inactivity, self-rated health and BMI at age 20 years. In addition to gamma regression, regarded as the reference method for selecting the set of explanatory variables described here, other modelling strategies – including linear, quantile (for the 0.25, 0.50 and 0.75 quantiles), binary and multinomial logistic regression – were compared in terms of final results and measures of fit. Results: The variables age, marital status, race/colour, domestic overload, self-rated health, physical inactivity and BMI at age 20 years were significantly associated with BMI, independently of the method used. In the same way, consumption of fried food was significant in all the models, but a dose–response pattern was identified only in the gamma and normal models and the quantile model for the 0.75 quantile. Years worked at night was also associated with BMI in these three models only. The variable mother’s schooling returned significant results only for the category 12 or more years of schooling, except for overweight in the multinomial model and for the 0.50 quantile in the quantile model, in which the two categories were not significant. The results of the quantile regression showed that, generally, the effects of the variables investigated were greater in the upper quantiles of the BMI distribution. Of the models using BMI in its continuous form, the gamma model showed best fit, followed by the quantile models (0.25 and 0.5 quantiles). Conclusions: The different strategies used produced similar results for the factors associated with BMI, but differed in the magnitude of the associations and goodness of fit. We recommend using the different approaches in combination, because they furnish complementary information on the problem studied

Dietary intake as a predictor for all-cause mortality in hemodialysis subjects (NUGE-HD study).

This study aimed to identify the factors capable of mortality prediction in patients on hemodialysis, using a prospective cohort with three years of follow-up. We hypothesized that lack of clinical-metabolic control, impairment of nutritional status, and inadequate food consumption are risk factors for mortality in this population. This is a longitudinal study on a non-probabilistic sample of 85 adults and elderly patients undergoing hemodialysis, aged ≥ 18 years (66.0% male, 61.6±13.7 years). Data on anthropometric, biomarkers, body composition and food intake were obtained. Predictors of mortality were evaluated using Cox regression analysis. During the three years follow-up, 16 patients (18.8%) died. We observed that age (HR = 1.319, CI 95% = 1.131-1.538), calcium-phosphorus product (HR = 1.114, CI 95% = 1.031-1.205), ferritin (HR = 1.001, CI 95% = 1.001-1.002), nitric oxide (HR = 1.082, CI 95% = 1.006-1.164), and vitamin C intake (HR = 1.005, CI 95% = 1.001-1.009) were positively associated with mortality. Serum iron (HR = 0.717, CI 95% = 0.567-0.907), triceps skinfold thickness (HR = 0.704, CI 95% = 0.519-0.954), lean mass (HR = 0.863, CI 95% = 0.787-0.945), and the ratio of dietary monounsaturated/polyunsaturated fat (HR = 0.022, CI 95% = 0.001-0.549) were independent negative predictors of mortality. Our results suggest that dietary intake is also a predictor of mortality in patients on hemodialysis, besides nutritional status, body composition, oxidative stress, inflammation, and bone metabolism, indicating the importance of evaluation of these factors altogether for better prognosis

Factors associated with bone mineral density in adults: a cross-sectional population-based study

Objective: This study aimed to analyze the association between lumbar spine, femoral neck, total hip bone mineral density (biophysical bone health assessment parameter), and sociodemographic, anthropometric, behavioral, and health condition factors in Brazilian adults. Method: This is a cross-sectional, population-based study performed with individuals of both genders, aged between 20 and 59 (n=701). The dependent variables were evaluated by Dual Energy X-ray Absorptiometry. The independent variables were evaluated through a questionnaire, anthropometric evaluation and blood collection. The association between bone mineral density and the independent variables was evaluated by linear regression analysis. All analyses were stratified by gender. Results: Men presented higher bone mineral density than women. Bone mineral density was inversely associated with age range and directly associated with nutritional status in both genders and in the three bone sites analyzed. In addition, 25 Hydroxyvitamin D deficient status among men and contraceptive use among women were associated with lower bone mineral density, and a significant association was only found with lumbar spine bone mineral density in women. Conclusion: The factors associated with bone health among men were age, skin color, nutritional status, and vitamin D status. For women, the associated factors with bone health were age, skin color, nutritional status and contraceptive use.Objetivo: Este estudo tem como objetivo analisar a associação entre coluna lombar, colo femoral, densidade mineral óssea total do quadril (parâmetro biofísico de avaliação da saúde óssea) e fatores sociodemográficos, antropométricos, comportamentais e de condição de saúde nos adultos brasileiros. Método: Este é um estudo transversal, baseado em população, realizado com indivíduos de ambos os gêneros, com idades entre 20 e 59 anos (n=701). As variáveis dependentes foram avaliadas por Absorciometria com Raios-X de Dupla Energia. As variáveis independentes foram avaliadas por meio de um questionário, avaliação antropométrica e coleta de sangue. A associação entre densidade mineral óssea e variáveis independentes foi avaliada por análise de regressão linear. Todas as análises foram estratificadas por gênero. Resultados: Os homens apresentaram densidade mineral óssea mais alta do que as mulheres. A densidade mineral óssea foi inversamente associada à faixa etária e diretamente associada ao estado nutricional em ambos os gêneros e nos três locais ósseos analisados. Além disso, o estado de deficiência de 25-Hidroxivitamina D entre os homens e o uso de contraceptivos entre as mulheres foram associados a uma densidade mineral óssea mais baixa, e uma associação significativa só foi encontrada com a densidade mineral óssea da coluna lombar nas mulheres. Conclusão: Os fatores associados à saúde óssea entre os homens foram idade, cor da pele, estado nutricional e estado da vitamina D. Para as mulheres, os fatores associados à saúde óssea foram idade, cor da pele, estado nutricional e uso de contraceptivos.Objetivo: Este estudio tiene como fin analizar la asociación entre columna lumbar, cuello femoral, densidad mineral ósea total de la cadera (parámetro biofísico de evaluación de la salud ósea) y factores sociodemográficos, antropométricos, comportamentales y de condición de salud en los adultos brasileños. Método: Este es un estudio transversal, basado en población, llevado a cabo con individuos de ambos géneros, con edades entre 20 y 59 años (n=701). Las variables dependientes fueron evaluadas por Absorciometría con Rayos X de Doble Energía. Las variables independientes fueron evaluadas mediante un cuestionario, evaluación antropométrica y recolección de sangre. La asociación entre densidad mineral ósea y variables independientes fue valorado por análisis de regresión lineal. Todos los análisis fueron estratificados por género. Resultados: Los varones presentaron densidad mineral ósea más alta que las mujeres. La densidad mineral ósea estuvo inversamente asociada con el rango de edad y directamente asociada con el estado nutritivo en ambos géneros y en los tres sitios óseos analizados. Además, el estado de deficiencia de 25-Hidroxivitamina D entre los hombres y el uso de contraceptivos entre las mujeres estuvieron asociados con una densidad mineral ósea más baja, y una asociación significativa solo fue encontrada con la densidad mineral ósea de la columna lumbar en las mujeres. Conclusión: Los factores asociados con la salud ósea entre los varones fueron edad, color de la piel, estado nutritivo y estado de la vitamina D. Para las mujeres, los factores asociados con la salud ósea fueron edad, color de la piel, estado nutritivo y uso de contraceptivos

Using Google Trends Data to Study Public Interest in Breast Cancer Screening in Brazil: Why Not a Pink February?

Submitted by Sandra Infurna ([email protected]) on 2018-03-08T13:16:46Z No. of bitstreams: 1 valeria_trajano_etal_IOC_2017.pdf: 798165 bytes, checksum: 52d97a53ebfb26228f269c2a0da829bf (MD5)Approved for entry into archive by Sandra Infurna ([email protected]) on 2018-03-08T13:28:35Z (GMT) No. of bitstreams: 1 valeria_trajano_etal_IOC_2017.pdf: 798165 bytes, checksum: 52d97a53ebfb26228f269c2a0da829bf (MD5)Made available in DSpace on 2018-03-08T13:28:35Z (GMT). No. of bitstreams: 1 valeria_trajano_etal_IOC_2017.pdf: 798165 bytes, checksum: 52d97a53ebfb26228f269c2a0da829bf (MD5) Previous issue date: 2017Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Inovações em Terapias, Ensino e Bioprodutos. Rio de Janeiro, RJ. Brasil / Instituto Nacional de Câncer. Coordenação de Pesquisa. Rio de Janeiro, RJ, Brasil.Universidade Federal de São João del-Rei. Departamento de Ciência da Computação. São João del-Rei, MG, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Inovações em Terapias, Ensino e Bioprodutos. Rio de Janeiro, RJ. Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Inovações em Terapias, Ensino e Bioprodutos. Rio de Janeiro, RJ. Brasil / Universidade do Estado do Rio de Janeiro. Departamento de Línguas Germânicas. Instituto de Letras. Setor de Literatura Inglesa. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Inovações em Terapias, Ensino e Bioprodutos. Rio de Janeiro, RJ. Brasil.Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Rio de Janeiro, RJ. Brasil.One of the major challenges of the Brazilian Ministry of Health is to foster interest in breast cancer screening (BCS), especially among women at high risk. Strategies have been developed to promote the early identification of breast cancer mainly by Pink October campaigns. The massive number of queries conducted through Google creates traffic data that can be analyzed to show unrevealed interest cycles and their seasonalities

Association between perceived racial discrimination and hypertension: findings from the ELSA-Brasil study

“Pardos” and blacks in Brazil and blacks in the USA are at greater risk of developing arterial hypertension than whites, and the causes of this inequality are still little understood. Psychosocial and contextual factors, including racial discrimination, are indicated as conditions associated with this inequality. The aim of this study was to identify the association between perceived racial discrimination and hypertension. The study evaluated 14,012 workers from the ELSA-Brazil baseline population. Perceived discrimination was measured by the Lifetime Major Events Scale, adapted to Portuguese. Classification by race/color followed the categories proposed by Brazilian Institute of Geography and Statistics (IBGE). Hypertension was defined by standard criteria. The association between the compound variable - race/racial discrimination - and hypertension was estimated by Poisson regression with robust variance and stratified by the categories of body mass index (BMI) and sex. Choosing white women as the reference group, in the BMI 25kg/m2 and men in any BMI category, no effect of racial discrimination was identified. Despite the differences in point estimates of prevalence of hypertension between “pardo” women who reported and those who did not report discrimination, our results are insufficient to assert that an association exists between racial discrimination and hypertension

A associação entre discriminação racial percebida e hipertensão: achados do estudo ELSA-Brasil

“Pardos” and blacks in Brazil and blacks in the USA are at greater risk of developing arterial hypertension than whites, and the causes of this inequality are still little understood. Psychosocial and contextual factors, including racial discrimination, are indicated as conditions associated with this inequality. The aim of this study was to identify the association between perceived racial discrimination and hypertension. The study evaluated 14,012 workers from the ELSA-Brazil baseline population. Perceived discrimination was measured by the Lifetime Major Events Scale, adapted to Portuguese. Classification by race/color followed the categories proposed by Brazilian Institute of Geography and Statistics (IBGE). Hypertension was defined by standard criteria. The association between the compound variable - race/racial discrimination - and hypertension was estimated by Poisson regression with robust variance and stratified by the categories of body mass index (BMI) and sex. Choosing white women as the reference group, in the BMI 25kg/m2 and men in any BMI category, no effect of racial discrimination was identified. Despite the differences in point estimates of prevalence of hypertension between “pardo” women who reported and those who did not report discrimination, our results are insufficient to assert that an association exists between racial discrimination and hypertension.CNPq - Conselho Nacional de Desenvolvimento Científico e TecnológicoCAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível SuperiorPretos e pardos no Brasil e negros nos Estados Unidos têm risco aumentado de desenvolver hipertensão arterial, quando comparados com brancos, mas as causas dessa desigualdade ainda são pouco compreendidas. Fatores psicossociais e contextuais, inclusive discriminação racial, têm sido apontados como condições associadas a essa desigualdade. O estudo teve como objetivo identificar a associação entre discriminação racial percebida e hipertensão. O estudo avaliou 14.012 participantes da linha de base do estudo ELSA-Brasil. A discriminação foi medida com a Lifetime Major Events Scale, adaptada para português. A classificação de raça/cor seguiu as categorias propostas pelo Instituto Brasileiro de Geografia e Estatística (IBGE). Hipertensão arterial foi definida de acordo com as diretrizes atuais. A associação entre a variável composta - raça/discriminação racial - e hipertensão foi estimada através de regressão de Poisson com variância robusta, e estratificada pelas categorias de índice de massa corporal (IMC) e gênero. Tendo como categoria de referência as mulheres brancas, no estrato de IMC 25kg/m2 e homens em qualquer categoria de IMC, não foi identificado nenhum efeito de discriminação racial. Apesar das diferenças nas estimativas pontuais da prevalência de hipertensão entre mulheres pardas que relataram (vs. não relataram) discriminação racial, nossos resultados são insuficientes para afirmar que existe uma associação entre discriminação racial percebida e hipertensão.Los “mestizos” y negros in Brasil y los negros en los EE.UU. tienen un riesgo mayor de desarrollar hipertensión que los blancos, y las causas de esta inequidad se han estudiado poco. Factores psicosociales y contextuales, incluyendo la discriminación racial, han sido identificados como las condiciones asociadas a esta inequidad. El objetivo de este estudio fue identificar la asociación entre la discriminación racial percibida y la hipertensión. El estudio evaluó a 14.012 trabajadores procedentes de la base de referencia poblacional del ELSA-Brasil. La discriminación percibida se midió mediante la Lifetime Major Events Scale, adaptada al portugués. La clasificación por raza/color siguió las categorías propuestas por el Instituto Brasileño de Geografía y Estadística. La hipertensión fue definida por criterios estándar. La asociación entre la variable compuesta -raza/discriminación racial- e hipertensión se estimó por regresión de Poisson con varianza robusta y estratificada por las categorías: índice de masa corporal (IMC) y sexo. Se eligieron mujeres blancas como grupo de referencia, en el IMC 25kg/m2 y hombres en cualquier categoría IMC, no se identificaron efectos de discriminación racial. A pesar de las diferencias en las estimaciones puntuales sobre la prevalencia de la hipertensión entre las mujeres “mestizas”, que informaron y no informaron discriminación racial, nuestros resultados son insuficientes para afirmar que existe una asociación entre la discriminación racial e hipertensión.MENDES, P. M. Universidade Federal do Par