Utilização de medidas antropométricas para a avaliação do acúmulo de gordura visceral The use of anthropometric measures to assess visceral fat accumulation

A obesidade visceral tem sido associada ao desenvolvimento de doenças cardiovasculares e a alguns tipos de câncer. Nesse sentido, é crescente o interesse na avaliação da adiposidade intra-abdominal, de forma a se analisarem o risco de doenças e alterações metabólicas, como intolerância à glicose, hiperinsulinemia, diabetes mellitus tipo 2, dislipidemias e hipertensão arterial. Técnicas de imagem, como a tomografia computadorizada e a ressonância magnética, permitem a mensuração acurada e precisa da gordura visceral..Contudo, ambas são dispendiosas e inaplicáveis na prática clínica de rotina e nos estudos epidemiológicos..Parâmetros antro-pométricos surgem como uma opção para a avaliação da gordura visceral nessas situações, por serem inócuos, de fácil aplicação e de baixo custo. À luz dessas questões, este trabalho objetivou analisar criticamente estudos que avaliaram a pertinência em empregar parâmetros antropométricos como indicadores da gordura visceral. Realizou-se um levantamento bibliográfico, no qual foram consultados periódicos nacionais e internacionais disponíveis nas seguintes bases científicas: Portal de periódicos da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, Scientific Electronic Library Online, Science Direct e Pubmed, abrangendo publicações entre os anos de 1947 e 2007. Procurou-se dar ênfase aos parâmetros antropométricos, como o índice de massa corporal, a circunferência da cintura, a relação cintura-quadril e o diâmetro abdominal sagital.<br>Visceral obesity has been associated with the development of cardiovascular diseases and some types of cancer. Therefore, there is an increasing interest in quantifying intra-abdominal adiposity in order to assess the risk of metabolic disorders, such as glucose intolerance, hyperinsulinemia, type 2 diabetes, dyslipidemia and hypertension. Imaging techniques such as computed tomography and magnetic resonance provide an accurate and precise measurement of visceral fat. However, both are costly and inapplicable in routine clinical practice and epidemiological studies. Anthropometric parameters are an option for visceral fat assessment in these situations, since they are innocuous, easy to use and inexpensive. In this context, this work aimed to critically analyze studies that assessed anthropometric parameters as indicators of visceral fat. A bibliographic review of domestic and international articles found in the databases Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, Scientific Electronic Library Online, Science Direct and Pubmed, published from 1947 to 2007 was done. Emphasis was given to anthropometric parameters, such as body mass index, waist circumference, waist-to-hip ratio and sagittal abdominal diameter

Fibrosis and carcinoid syndrome: from causation to future therapy

Carcinoid tumors are part of a heterogeneous group of gastrointestinal and pancreatic endocrine tumors that are characterized by their capacity to produce and secrete hormones, 5-hydroxytryptamine, tachykinins and other mediators. These substances are thought to be responsible for the collection of symptoms, which include diarrhea, flushing and wheezing, that is known as carcinoid syndrome. Fibrosis that occurs either local to or distant from the primary tumor is one of the hallmarks of carcinoid tumors that originate from the midgut. The fibrotic process can occur in the mesentery as a desmoplastic response and may lead to obstruction of the small bowel, but it can also occur in the lungs, skin or retroperitoneum. Importantly, up to one-third of patients develop cardiac valvulopathy. One or more products that are secreted by the tumor and enter into the circulation are likely to have a role in this process. This Review discusses the incidence and prevalence of fibrosis in carcinoid syndrome and explores evidence to date for causative agents, in particular the roles of 5-hydroxytryptamine and elements of the downstream signaling pathway. Improved understanding of the etiology of carcinoid-tumor-related fibrosis may lead to better treatments for this condition than those we currently have.