Carla Helena Augustin Schwanke

Associations among Metabolic Syndrome, Ischemia, Inflammatory, Oxidatives, and Lipids Biomarkers

CONTEXT Metabolic syndrome (MS) is described as a cluster of cardiometabolic risk factors. Studies suggest that ischemia-modified albumin (IMA) is a biomarker of cardiovascular diseases. IMA levels could be associated with cardiometabolic risks and represent a possible indication of microvascular dysfunction in MS patients. OBJECTIVE To confirm this possible association, we evaluated the association between IMA levels and MS. DESIGN We performed a case-control study (32 healthy individuals and 74 subjects with MS) to evaluate the association between MS, IMA, and other biomarkers [high-sensitivity C-reactive protein (hs-CRP), oxidized low-density lipoprotein (OxLDL), oxidized low-density lipoprotein autoantibodies (anti-OxLDL), IL-6, lipid profile, and glucose]. RESULTS The MS group showed higher levels of IMA (0.618 +/- 0.1355) as well as higher levels of hs-CRP, OxLDL, anti-OxLDL, and IL-6 than did control subjects (IMA = 0.338 +/- 0.0486) (P < 0.01). Multivariate analysis showed that IMA and MS association was independent of sex, age, diabetes mellitus 2, and hypercholesterolemia. CONCLUSION We found an association between IMA and MS. Additional studies including prospective genetic variation approaches need to be performed to help elucidate this association between IMA and MS and its potential clinical role.

Effect of green tea (Camellia sinensis) consumption on the components of metabolic syndrome in elderly

ObjectiveTo evaluate the effect of the consumption of green tea on components of MS in the elderly.DesignIntervention study.SettingThe sample was selected from the Geriatric Service of Hospital São Lucas of Pontifical Catholic University of Rio Grande do Sul.Participants45 elderly with MS were enrolled and allocated into two groups: green tea group (GTG, n = 24), who drank green tea and control group (CG, n= 21) without intervention.InterventionThe GTG received sachets of 1.0 g of green tea, and should drink three cups per day for 60 days and the CG was instructed not to make changes in their lifestyle.MeasurementsThe diagnostic criteria for MS used were the International Diabetes Federation. The lipidic and glycemie profile, and anthropometric measurements were evaluated before and after intervention.ResultsThere was a statistically significant weight loss only in GTG [71.5±12.6 kg to 70.3±12.6 kg (p<0.001)]. A statistically significant decrease in BMI [−0.5±0.4 kg/m2 in GTG and −0.2±0.6 kg/m2 in CG (P=0.032)] and waist circumference [−2.2±2.0 cm in GTG and − 0.3±1.8 cm in CG (P=0.002)] were observed. The intake of green tea did not change the biochemical parameters.ConclusionThe consumption of green tea was effective in inducing weight loss, reducing BMI and waist circumference in the elderly with MS.

Association between interleukin-1 beta polymorphism (+3953) and obesity.

It now appears that obesity is associated with a low-grade inflammation of white adipose tissue resulting from chronic activation of the innate immune system as interleukin-1 beta (IL-1). Previous investigations have described a positive association between IL-1 beta +3953 (C>T) gene polymorphism (rs 1143634) and obesity, suggesting functional effects on fat mass, fat metabolism and body mass. However, it is necessary to determine if these results occur in other populations and if they are influenced by sex and age. Therefore, we performed a case-control study using 880 Caucasian subjects (59.7+/-11.9 years old) from the Brazilian Aging Research Program (non-overweight=283, overweight=334, obese=263) previously investigated in genetic studies, in whom we analyzed the IL-1 beta +3953C/T polymorphism. We observed higher T allele (CT/TT) frequency in non-overweight than overweight and obese groups. The odds ratio showed 1.340 (95% CI: 1.119-1.605) times more chance of the obese group being CC carriers compared to non-overweight group independent of sex and age. This study corroborates the idea that the IL-1 system is linked to the development of obesity.

Preditores cardiovasculares da mortalidade em idosos longevos

This article investigates the association between cardiovascular risk factors and cardiovascular morbidity and mortality in the oldest old. In 1996, 91% of the population ³ 80 years of age from Veranopolis, Rio Grande do Sul State, Brazil, were evaluated to detect cardiovascular risk factors and morbidity. The sample was followed up for three years, with the assessment of deaths. The analysis was done using univariate statistics and multivariate logistic regression analysis. There were 41 deaths (21%): 20 men and 21 women. Deaths were distributed by year as follow: 03 (7.3%) in the first year, 08 (19.5%) in the second, and 30 (73.2%) in the third. There was a significant and independent association between death and the following variables: diastolic blood pressure (DBP), total cholesterol (TC), LDL-C, ApoA-I, prior stroke (CVA), right bundle branch block (RBBB), and left ventricular hypertrophy (LVH) by ECG. Survivors presented higher levels of DBP, TC, LDL-C, ApoA-I, CVA, RBBB and LVH. According to the multivariate analysis, the variables were independent risk factors for mortality. Cardiovascular risk factors appear to have a distinct impact on the oldest old.

A evolução do índice de envelhecimento no Brasil, nas suas regiões e unidades federativas no período de 1970 a 2010

Introduction: The aging index (AI) assesses the process of the broadening of the elderly portion of the total population in relation to the relative variation in the young age group, where it is determined by the ratio of the elderly population to the young population. This indicator allows the observation of the evolution of the aging rhythm of the population, comparing geographic areas and social groups, and can thus help in the formulation, management and evaluation of public policies in the areas of health and social welfare. Palavras-chave: Envelhecimento da populacao. Envelhecimento Demografico. Indices. Censo Demografico. Transicao demografica. Brasil.

Egg consumption and coronary atherosclerotic burden

OBJECTIVE To verify the association between egg consumption and coronary atherosclerotic burden. DESIGN Observational study. SETTING Cardiac catheterization laboratory. PARTICIPANTS Adult patients referred for coronary angiography. MEASUREMENTS Socio-demographic data (age, education level, and occupation), cardiovascular risk factors (smoking, systemic hypertension, dyslipidemia, diabetes, and family history of coronary artery disease), and egg-eating habits were assessed using a research questionnaire. Egg consumption was divided into three categories: less than one egg a week; one egg a week; and more than one egg a week. Coronary atherosclerotic burden was assessed by a blinded interventional cardiologist using the Friesinger Score (FS) obtained from the coronary angiography. This score varies from 0 to 15 and evaluated each of the three main coronary arteries separately. For this analysis, the FS was divided into three categories: 0-4, 5-9, and 10-15. RESULTS The study sample was composed of 382 adult patients; 241 patients (63.3%) were male. The average age was 60.3 ± 10.8 years (range 23-89 years). The egg-eating category was inversely associated with dyslipidemia (p < 0.05) but not with the other cardiovascular risk factors. A significant association was found between egg consumption and FS (p < 0.05), showing that patients who ate more than one egg a week had a lower coronary atherosclerotic burden. By multivariate analysis, the atherosclerotic burden was independently associated with sex, age, hypertension and egg consumption. CONCLUSION In this observational study of patients undergoing coronary angiography, the consumption of more than one egg per week was associated with a lower coronary atherosclerotic burden.

Envelhecimento e longevidade no Rio Grande do Sul: um perfil histórico, étnico e de morbi-mortalidade dos idosos

Rio Grande do Sul states population has great ethnic and cultural diversity. However, knowledge on the genetic profile of this population concerning chronic non-communicable diseases (NCDs) and the pattern of inheritance related to ethnic origin is poor. Ethnicity and genetic background, associated with the Brazilian sanitary reform and Brazilian lifestyle, contributed a lot to the increase in average life expectancy at birth, and longevity of that population. Thus, the population of Rio Grande do Sul presents an accelerated aging process, with a distinct pattern of morbidity and mortality for the elderly (aged 60 years or more). The increased longevity of this population increased not only the incidence and prevalence, but also the mortality from NCDs such as cardiovascular diseases and cancer. Therefore, public health policies must address ethnic, cultural and biological characteristics to promote aging with quality of life. In this context this paper aims to contribute to the discussion about the aging process in Rio Grande do Sul state, Brazil.

Association between self-reported oral health, tooth loss and atherosclerotic burden

Previous studies have suggested that oral diseases may influence the development of atherosclerosis. The aim of this study was to test the hypothesis that poor self-reported oral health (SROH) and tooth loss are positively associated with coronary atherosclerotic burden (CAB). 382 consecutive subjects undergoing coronary angiography were included. Socio-demographic characteristics, cardiovascular risk factors and oral health status were collected using a standardized questionnaire, including data on SROH and use of dental prosthesis. Number of teeth and anthropometric measures were collected through clinical examinations. CAB at coronary angiography was quantified using the Friesinger score (FS). Prevalence ratios (PR) were calculated with Poisson regression analyses. Mean age was 60.3 ± 10.8 years, with 63.2% males. In the bivariate analysis, there was a significant association (p < 0.05) between CAB and age (> 60y) (PR = 1.01, 95%CI = 1.02-1.16), male gender (PR = 1.11, 95%CI = 1.03-1.19), smoking (PR = 1.08, 95%CI = 1.01- 1.16), hypertension (PR = 1.12, 95%CI = 1.03-1.22), diabetes (PR = 1.17, 95%CI = 1.05-1.21), poor SROH (PR = 1.22, 95%CI = 1.02-1.46) and tooth loss (< 20 teeth present) (PR = 1.10, 95%CI = 1.02-1.19). The use of dental prosthesis was not associated with CAB. The multivariate models, adjusted for age, gender, smoking, hypertension, diabetes and dyslipidemia showed that poor SROH (p = 0.03) and tooth loss (p = 0.02) were independently associated with CAB, confirming the study hypothesis.

Hematological parameters and prevalence of anemia among free-living elderly in south Brazil

Objective The aims of this study were to analyze the hematological parameters, the prevalence of anemia and the association between anemia and socioeconomic conditions in an elderly community-based population. Methods A population-based study was performed as part of the Multidimensional Study of the Elderly in Porto Alegre, Brazil (EMIPOA). An initial total of 1058 community residents aged 60 years and older were interviewed. Of these, 392 agreed to have a physical evaluation and a blood sample was taken from each. The hematological parameters analyzed in the blood samples included the hemoglobin concentration, mean cell volume (MCV), mean corpuscular hemoglobin concentration (MCHC) and red cell distribution width (RDW). The association between the variables and the diagnosis of anemia was assessed using the chi-squared test and a multiple logistic regression model. Results The overall prevalence of anemia was 12.8%. Anemia was present in 13.7% of women and in 10.4% of men. Normocytic normochromic anemia without anisocytosis was the most common type of anemia (46%). The assessment of erythrocyte morphology showed significant differences between anemic and non-anemic individuals (microcytosis = 12% vs. 1.5%, hypochromia = 40% vs. 8.8%, and anisocytosis = 26% vs. 7%). In the analysis of socioeconomic conditions, significant differences were found in respect to age and race. Conclusion The prevalence of anemia increases with age and is associated with race, microcytosis, hypochromia and anisocytosis. Anemia is not a condition that should be associated only with the aging process, as it may be due to pathological conditions that occur most frequently in this age group. As a result, a diagnosis of anemia warrants adequate clinical attention.

Associação de diferentes medidas e índices antropométricos com a carga aterosclerótica coronariana

BACKGROUND The association between anthropometric parameters and atherosclerotic burden is not well established and few studies have addressed this issue. OBJECTIVE To evaluate the association of different anthropometric parameters with the coronary atherosclerotic burden. METHODS Adult patients undergoing coronary angiography were enrolled in the study. Sociodemographic characteristics and cardiovascular risk factors were collected through a standardized questionnaire. Weight, height, waist circumference (WC), abdominal circumference (AbC), hip circumference (HC) and neck circumference (NC) were measured and body mass index (BMI), waist-hip ratio (WHR), abdominal circumference-hip ratio (AbCHR) and waist-height ratio (WHtR) were calculated. The atherosclerotic burden at the coronary angiography was measured through Friesinger score (FS). Significant atherosclerosis was considered when FS ≥ 5. RESULTS The sample consisted of 337 patients, of whom 213 were men (63.2%). The mean age was 60.1 ± 10 years. Only WHR (r = 0.159 and p = 0.003) showed a significant linear correlation with the coronary atherosclerotic burden as measured by FS. When the sample was stratified by gender, we found a significant correlation between womens AbCHR (r = 0.238 and p = 0.008) and WHR (r = 0.198 and p = 0.028) with FS. Men showed no correlation between anthropometric parameters and FS. After adjusting for gender, age, hypertension, smoking and DM, no anthropometric parameter was associated with coronary atherosclerotic burden as measured by FS in the total sample or when separated by gender. CONCLUSION No anthropometric parameter was an independent risk factor for coronary atherosclerotic burden.