Cézane Priscila Reuter

Uma análise entre índices pressóricos, obesidade e capacidade cardiorrespiratória em escolares

FUNDAMENTO: Durante a infância e adolescencia, o sedentarismo, o excesso de peso e a alimentacao inadequada sao fatores de risco para doencas cronicas, sobretudo obesidade, hipertensao arterial sistemica e diabete melito. A intervencao precoce pode prevenir o desenvolvimento dessas complicacoes. OBJETIVO: Verificar a presenca de fatores de risco cardiovasculares (obesidade e hipertensao arterial) e suas possiveis interacoes com a capacidade cardiorrespiratoria. Metodos: Estudo transversal composto de amostra estratificada por conglomerados, de 1.666 escolares, com idades entre 7 e 17 anos, 873 (52,4%) do sexo masculino e 793 (47,6%) do sexo feminino. Avaliaram-se as pressoes arteriais sistolica (PAS) e diastolica (PAD), indice de massa corporal (IMC), percentual de gordura (%G) e capacidade cardiorrespiratoria. Ainda, PAS e PAD foram correlacionadas com circunferencia da cintura (CC), relacao cintura-quadril (RCQ), somatorio de dobras cutâneas (ΣDC) e capacidade cardiorrespiratoria. RESULTADOS: A avaliacao do IMC dos escolares evidenciou 26,7% de sobrepeso ou obesidade e 35,9% com o percentual de gordura acima de moderadamente alto. Com relacao aos niveis pressoricos, encontraram-se 13,9% e 12,1% de escolares limitrofes e hipertensos, para PAS e PAD, respectivamente. Houve associacao entre hipertensao, obesidade e capacidade cardiorrespiratoria. Observou-se correlacao significativa em relacao a PAS e PAD, para todas as variaveis analisadas, apresentando, ainda, uma relacao fraca a moderada com as variaveis idade, peso, estatura, IMC e circunferencia da cintura. CONCLUSAO: A presenca da hipertensao arterial associada a obesidade e seu reflexo na capacidade cardiorrespiratoria reforcam a importância de se propor, ja na infância, um estilo de vida mais ativo e saudavel.

Relationship between anthropometric measures and cardiovascular risk factors in children and adolescents.

Background Obesity has been identified as an important risk factor in the development of cardiovascular diseases; however, other factors, combined or not with obesity, can influence cardiovascular risk and should be considered in cardiovascular risk stratification in pediatrics. Objective To analyze the association between anthropometry measures and cardiovascular risk factors, to investigate the determinants to changes in blood pressure (BP), and to propose a prediction equation to waist circumference (WC) in children and adolescents. Methods We evaluated 1,950 children and adolescents, aged 7 to 18 years. Visceral fat was assessed by WC and waist hip relationship, BP and body mass index (BMI). In a randomly selected subsample of these volunteers (n = 578), total cholesterol, glucose and triglycerides levels were evaluated. Results WC was positively correlated with BMI (r = 0.85; p < 0.001) and BP (SBP r = 0.45 and DBP = 0.37; p < 0.001). Glycaemia and triglycerides showed a weak correlation with WC (r = 0.110; p = 0.008 e r = 0.201; p < 0.001, respectively). Total cholesterol did not correlate with any of the variables. Age, BMI and WC were significant predictors on the regression models for BP (p < 0.001). We propose a WC prediction equation for children and adolescents: boys: y = 17.243 + 0.316 (height in cm); girls: y = 25.197 + 0.256 (height in cm). Conclusion WC is associated with cardiovascular risk factors and presents itself as a risk factor predictor of hypertension in children and adolescents. The WC prediction equation proposed by us should be tested in future studies.

Obesidade e hipertensão arterial em escolares de Santa Cruz do Sul - RS, Brasil

Resumo Objetivo Verificar a prevalencia de obesidade e hipertensao arterial em escolares de Santa Cruz do Sul – RS, Brasil, nos periodos de 2005 e 2008. Metodo Estudo com duas medidas transversais consecutivas, composto de amostra estratificada por conglomerados, totalizando 414 escolares, com idades entre 7 e 17 anos, 215 (51,9%) do sexo masculino, e 199 (48,1%) do sexo feminino. Foi avaliada a obesidade atraves do indice de massa corporea (IMC) e percentual de gordura (%G). A hipertensao foi ponderada pelos valores de pressoes arteriais, tanto sistolica (PAS) quanto diastolica (PAD). Resultados A avaliacao do IMC evidenciou 18,6% e 22,3% de excesso de peso nos meninos (2005 e 2008, respectivamente), enquanto nas meninas estes indices foram de 22,6% e 14,6%. Em relacao a obesidade, a prevalencia foi de 4,7% em ambos os anos para os meninos, e reducao de 12,6% para 9,0% nas meninas, quando comparados os dois anos. Quando analisada a diferenca entre as avaliacoes, houve significância na classificacao do IMC (pxa0=xa00,022) e %G (pxa0=xa00,017) somente no sexo feminino. Alteracoes estatisticamente significativas para a alteracao da PAS foram encontradas somente no sexo masculino (pxa0 Conclusao Os niveis de excesso de peso, obesidade e percentual de gordura em meninas, bem como o aumento dos niveis tensionais de pressao arterial sistolica em meninos, evidenciam a necessidade de intervencao precoce atraves de campanhas de saude publica mais eficazes.

Prevalence of obesity and cardiovascular risk among children and adolescents in the municipality of Santa Cruz do Sul, Rio Grande do Sul

CONTEXT AND OBJECTIVEnStudies have demonstrated that metabolic complications from child obesity, although silent, increase the risk of development of cardiovascular diseases in adulthood. The present paper sought to describe the prevalence of overweight/obesity and analyze the possible relationship between obesity and other cardiovascular risk factors among children and adolescents.nnnDESIGN AND SETTINGnCross-sectional study, conducted in a university.nnnMETHODSnThe study included 564 children and adolescents, aged 8 to 17 years. Body mass index and waist circumference were used to evaluate obesity. Other cardiovascular risk factors were evaluated, like systolic and diastolic blood pressure, glycemia, triglycerides and total cholesterol. Descriptive analysis was used for sample characterization, the chi-square test for categorical variables and Pearsons linear correlation for evaluating the relationship between obesity indicators and other cardiovascular risk factors.nnnRESULTSnHigh prevalence of overweight/obesity was found among the schoolchildren (25.3% among the boys and 25.6% among the girls), along with abdominal obesity (19.0%). The overweight/obese schoolchildren presented higher percentages for the pressure and biochemical indicators, compared with underweight and normal-weight schoolchildren. Body mass index and waist circumference showed a weak correlation with the variables of age and systolic and diastolic blood pressure (P < 0.001), but there was no correlation between these obesity indices and biochemical variables.nnnCONCLUSIONnThe high prevalence of overweight/obesity and its relationship with other cardiovascular risk factors demonstrate that it is necessary to develop intervention and prevention strategies from childhood onwards, in order to avoid development of chronic-degenerative diseases in adulthood.

Dyslipidemia is Associated with Unfit and Overweight-Obese Children and Adolescents.

Background Both poor aerobic fitness and obesity, separately, are associated with abnormal lipid profiles. Objective To identify possible relationships of dyslipidemia with cardiorespiratory fitness and obesity, evaluated together, in children and adolescents. Methods This cross-sectional study included 1,243 children and adolescents (563 males and 680 females) between 7 and 17 years of age from 19 schools. Obesity was assessed using body mass index (BMI) measurements, and cardiorespiratory fitness was determined via a 9-minute run/walk test. To analyze the lipid profile of each subject, the following markers were used: total cholesterol, cholesterol fractions (high-density lipoprotein and low-density lipoprotein) and triglycerides. Data were analyzed using SPSS v. 20.0, via prevalence ratio (PR), using the Poisson regression. Results Dyslipidemia is more prevalent among unfit/overweight-obese children and adolescents compared with fit/underweight-normal weight boys (PR: 1.25; p = 0.007) and girls (PR: 1.30, p = 0.001). Conclusions The prevalence of dyslipidemia is directly related to both obesity and lower levels of cardiorespiratory fitness.

Prevalência de anti-HCV em uma população privada de liberdade

A alta prevalencia da sorologia reagente para o HCV observada entre os internos causa particular preocupacao, uma vez que e bem maior em relacao a populacao em geral. Portanto, e necessaria a realizacao de campanhas de abordagens especificas para mais informacoes sobre doencas infecciosas em ambientes prisionais, alem de um adequado tratamento para evitar a disseminacao viral.

Low-grade inflammation markers in children and adolescents: Influence of anthropometric characteristics and CRP and IL6 polymorphisms.

Overweight and obesity are associated with chronic and subclinical inflammation due to an imbalance of inflammatory mediators. However, the association with gene polymorphism has been rarely studied in children. The aim of this study was to determine if serum concentrations of C-reactive protein (CRP) and interleukin-6 (IL-6) are related to the IL6 rs1800795, IL6 rs2069845 and CRP rs1205 polymorphisms (SNPs) according to body mass index (BMI) in a sample of children and adolescents. A cross-sectional study in 470 students between 7 and 17yearsof age of anthropometric characteristics, high sensitivity-CRP (Hs-CRP) and IL-6 levels and three SNPs genotyped. The prevalence ratio of hs-CRP>3mg/L in obese individuals was 4.15 (CI 2.43-7.06; p=0.01), and it was 1.91 (CI 1.03-3.55; p=0.03) in overweight individuals and 1.74 (CI 1.05-2.88 p=0.03) in females. Individuals with waist circumference (WC) and body fat percentage (BF%) alterations showed elevated levels of hs-CRP (p=4.3×10-5 and p=5.3×10-6). The combination of any two anthropometric measurement increases CRP levels, especially combinations with obesity body mass index (BMI): BMI+WC and BMI+BF%. Among the overweight/obesity group, T allele carriers of CRP rs1205 showed lower levels of hs-CRP (0.5, IQR=0.3-1.8mg/L) than CC homozygotes (1.5, IQR=0.4-3.4mg/L, p=0.018). Additionally, considering subjects with two or three anthropometric alterations for CRP rs1205: rs1205 T allele carriers had lower levels of hs-CRP (0.7, IQR=0.3-2.7mg/L) than CC homozygotes (1.2, IQR=0.5-3.5mg/L, p=0.02). In conclusion, carriers of the rs1205/T allele with higher BMIs had lower levels of hs-CRP. Schoolchildren who were overweight/obese had higher levels of CRP and IL-6, whereas individuals with WC and BF% alterations had higher levels of CRP.

Association of IL-6 and CRP gene polymorphisms with obesity and metabolic disorders in children and adolescents

Activation of adipose tissue inflammation is associated with obesity caused by lipid accumulation in adipocytes. Through this activation, proinflammatory cytokines, such as Interleukin-6 (IL-6) and C-reactive protein (CRP) seem to influence metabolic disorders. The present study evaluated whether polymorphisms in the CRP (rs1205) and IL-6 (rs1800795, rs2069845) genes are associated with the development of metabolic disorders in children and adolescents. A cross-sectional study was performed, consisting of 470 students from the municipality of Santa Cruz do Sul, Brazil, aged 7-17 years. Body mass index (BMI) was classified according to overweight and obesity. Genotyping was performed by real-time Polymerase Chain Reaction (PCR). Anthropometric characteristics, biochemical markers, immunological markers and blood pressure were assessed. Descriptive statistics, chi-square and logistic regression were used for the analyses. No association was detected between the rs1800795 polymorphism and the assessed variables. Individuals with the risk genotype in the rs1205 gene were associated with the risk of developing hypercholesterolemia (OR 2.79; CI 1.40, 5.57; p = 0.003). Carriers of the risk genotype in the rs2069845 gene are associated with the risk of developing obesity (OR 3.07; CI 1.08, 8.72; p = 0.03). The polymorphism rs2069845 was associated with obesity and rs1205 was associated with the risk of developing hypercholesterolemia in Brazilian schoolchildren.

Differences in body posture, strength and flexibility in schoolchildren with overweight and obesity: A quasi-experimental study

BACKGROUNDnBody posture and its components have been widely discussed, given the high prevalence of musculoskeletal disorders in children and adolescents. Among children and adolescents with overweight and obesity issues, these changes can be pronounced.nnnOBJECTIVESnThis study sought to investigate whether a global exercise routine could result in positive changes in the angles and distances measured in postural assessments and in the number of abdominal and flexibility exercise repetitions performed by children and adolescents with overweight or obesity.nnnMETHODSnA quasi-experimental design including an experimental group (EG) and a control group (CG) was used. The primary outcome variables included ratings of body posture (using SAPO software) and measures of abdominal muscle strength (number of sit-ups) and flexibility. The EG received an interdisciplinary intervention the included 48 sessions of global postural exercises performed three times a week.nnnRESULTSnOf the 46 schoolchildren evaluated (EG, n = 23 and CG, n = 23), significant changes were observed in the EG from pre-to post-test in the thoracic angle (p = 0.001) and abdominal muscle strength (p = 0.016) for boys and in the thoracic angle (p = 0.010), abdominal muscle strength (p = 0.003) and flexibility (p = 0.010) for girls.nnnCONCLUSIONSnOverall, the exercise program led to changes in the angle and distance measurements obtained in postural evaluations and contributed to increases in the number of repetitions of abdominal and flexibility exercises, indicating improvements in the EG groups body posture and health indicators.

FTO polymorphism, cardiorespiratory fitness, and obesity in Brazilian youth.

The aim of the present study was to evaluate the relationship between the rs9939609 fat mass and obesity‐associated (FTO) polymorphism and cardiorespiratory fitness (CRF) with overweight/obesity outcomes in youth.