Cláudia Porto Sabino Pinho

Excesso de peso em adultos do Estado de Pernambuco, Brasil: magnitude e fatores associados

In order to evaluate the prevalence of overweight and associated factors in Pernambuco State, Brazil, a cross-sectional population-based study was conducted in 2006, including 1,580 adults 25 to 59 years of age. Overweight was defined as body mass index > 25kg/m2. The conceptual model included demographic, socioeconomic, reproductive, and behavioral variables. Prevalence of overweight was 51.1% (95%CI: 48.6-53.6) and was statistically associated with age over 40 years (PR = 1.27; 95%CI: 1.10-1.46), female gender (PR = 1.29; 95%CI: 1.16-1.43), former smoking (PR = 1.42; 95%CI: 1.20-1.69), higher income (PR = 1.49; 95%CI: 1.30-1.71), and history of early pregnancy (< 18 years) (PR = 1.25; 95%CI: 1.11-1.66). There was no association with alcohol consumption, level of physical activity, or specific foods. The high prevalence of overweight is consistent with epidemic levels of this problem elsewhere in world, and the association with several factors supports its multifactor etiology.

ÚLCERA POR PRESIÓN: INCIDENCIA Y FACTORES DEMOGRÁFICOS, CLÍNICOS Y NUTRICIONALES ASOCIADOS EN PACIENTES DE UNA UNIDAD DE CUIDADOS INTENSIVOS

UNLABELLED Pressure ulcer (PU) is a lesion in the skin and/or underlying tissue, usually over bony prominences caused by pressure and / or shear associated. Although preventable, is still very prevalent, and pointed out that multiple factors are involved in its etiology. OBJECTIVE to identify the incidence of pressure ulcers, clinical and nutritional factors associated in patients admitted to the Intensive Care Unity (ICU) of a university hospital. METHODS a prospective, observational study, with patients admitted to an ICU from June to November 2014. The UP was determined by inspection body three times a week during the morning bath, based on the characteristics established by the National Pressure Ulcer Advisory Panel, 2014. We collected demographic, clinical, biochemical and nutritional. The Braden Scale was used to verify individuals at risk of PU development. RESULTS the sample consisted of 51 patients with a mean age of 57.7 (± 16.4) years. There was an incidence of UP 52.9%, and the factors associated with its development were: use of vasoactive drugs (p = 0.029), length of hospital stay > 10 days (p ≤ 0.001) and absence of anemia (p = 0.011). CONCLUSION the high incidence of UP highlights the vulnerability of patients in intensive care. Although characterized by being a multifactorial condition only the use of vasoactive drugs, length of hospital stay and the absence of anemia were associated with the appearance of refs. Nutritional and clinical factors often related to trauma were not associated with their development.

Prevalência e fatores associados à obesidade abdominal em indivíduos na faixa etária de 25 a 59 anos do Estado de Pernambuco, Brasil

In order to estimate the prevalence of abdominal obesity and associated factors in Pernambuco State, Brazil, a cross-sectional population-based study was conducted in 2006, including 1,580 adults 25 to 59 years of age. Abdominal obesity was defined as waist circumference (WC) ≥ 80 cm in women and ≥ 94 cm in men. The conceptual model included demographic, socioeconomic, reproductive, and behavioral variables. Prevalence of abdominal obesity was 27.1% (95%CI: 23.8-30.7) in males and 69.9% (95%CI: 66.8-72.8) in females (p < 0.001). Multivariate analysis showed higher prevalence in men 50 years or older in the metropolitan area and those with higher income, former smokers, and drinkers. Among women, obesity was more prevalent above 30 years of age, in former smokers, and in women with first pregnancy before age 18. Central adiposity is clearly a multifactor condition in the State of Pernambuco, and the determinants of obesity differ between the sexes.Com o objetivo de estimar a prevalencia de obesidade abdominal e avaliar os fatores associados em adultos do Estado de Pernambuco, Brasil, foi realizado, em 2006, um estudo transversal, de base populacional, envolvendo 1.580 individuos na faixa etaria de 25-59 anos. A obesidade abdominal foi determinada pela circunferencia da cintura ≥ 80cm para mulheres e ≥ 94cm para homens. O modelo conceitual considerou variaveis socioeconomicas, demograficas, reprodutivas e comportamentais. A prevalencia de obesidade abdominal foi de 27,1% (IC95%: 23,8-30,7) no sexo masculino e 69,9% (IC95%: 66,8-72,8) no feminino (p < 0,001). A analise ajustada revelou maior prevalencia em homens a partir de 50 anos, da regiao metropolitana, de maior renda, ex-fumantes e consumidores de bebidas alcoolicas. Entre as mulheres, foi mais prevalente a partir de 30 anos, em ex-fumantes e naquelas com a primeira gestacao antes de 18 anos. Fica evidente a gravidade e a multifatorialidade do problema da adiposidade central no Estado de Pernambuco, alem de ser possivel destacar que os determinantes da obesidade sao diferentes entre os sexos.

Consumo de alimentos protetores e preditores do risco cardiovascular em adultos do estado de Pernambuco

Artigo elaborado a partir da dissertacao de CPS PINHO, intitulada “Excesso de peso e distribuicao corporal de gordura:magnitude e fatores associados em adultos do Estado de Pernambuco”. Universidade Federal de Pernambuco; 2011. Apoio:Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq), (Processos No 505540/2004-5 e 501989/2005-4).

Prevalence of abdominal obesity and associated factors among individuals 25 to 59 years of age in Pernambuco State, Brazil

In order to estimate the prevalence of abdominal obesity and associated factors in Pernambuco State, Brazil, a cross-sectional population-based study was conducted in 2006, including 1,580 adults 25 to 59 years of age. Abdominal obesity was defined as waist circumference (WC) ≥ 80 cm in women and ≥ 94 cm in men. The conceptual model included demographic, socioeconomic, reproductive, and behavioral variables. Prevalence of abdominal obesity was 27.1% (95%CI: 23.8-30.7) in males and 69.9% (95%CI: 66.8-72.8) in females (p < 0.001). Multivariate analysis showed higher prevalence in men 50 years or older in the metropolitan area and those with higher income, former smokers, and drinkers. Among women, obesity was more prevalent above 30 years of age, in former smokers, and in women with first pregnancy before age 18. Central adiposity is clearly a multifactor condition in the State of Pernambuco, and the determinants of obesity differ between the sexes.Com o objetivo de estimar a prevalencia de obesidade abdominal e avaliar os fatores associados em adultos do Estado de Pernambuco, Brasil, foi realizado, em 2006, um estudo transversal, de base populacional, envolvendo 1.580 individuos na faixa etaria de 25-59 anos. A obesidade abdominal foi determinada pela circunferencia da cintura ≥ 80cm para mulheres e ≥ 94cm para homens. O modelo conceitual considerou variaveis socioeconomicas, demograficas, reprodutivas e comportamentais. A prevalencia de obesidade abdominal foi de 27,1% (IC95%: 23,8-30,7) no sexo masculino e 69,9% (IC95%: 66,8-72,8) no feminino (p < 0,001). A analise ajustada revelou maior prevalencia em homens a partir de 50 anos, da regiao metropolitana, de maior renda, ex-fumantes e consumidores de bebidas alcoolicas. Entre as mulheres, foi mais prevalente a partir de 30 anos, em ex-fumantes e naquelas com a primeira gestacao antes de 18 anos. Fica evidente a gravidade e a multifatorialidade do problema da adiposidade central no Estado de Pernambuco, alem de ser possivel destacar que os determinantes da obesidade sao diferentes entre os sexos.

Phase Angle as a Sarcopenia Marker in Hospitalized Elderly Patients

BACKGROUND Phase angle (PhA) has been proposed as a parameter to predict clinical outcomes and mortality for various diseases. Several studies have considered it an important nutrition assessment tool. However, the usefulness of this parameter as a sarcopenia marker has not yet been evaluated. This study was developed to evaluate the performance of PhA as a sarcopenia marker in hospitalized elderly patients. MATERIALS AND METHODS This was a cross-sectional study involving elderly patients admitted to a hospital in northeastern Brazil. The PhA was obtained from resistance and reactance measurements by bioelectrical impedance. Sarcopenia was defined as a decrease in muscle mass associated with a reduced muscle strength or physical performance. RESULTS The sample consisted of 148 patients with a mean age of 71.6 (±7.6) years and a 62.8% prevalence of sarcopenia. The average PhA was 5.9 ± 2.0°, similar for men and women (5.9 ± 2.3 vs 5.9 ± 1.8; P = .946). In men, sarcopenic patients had a lower average PhA (5.6 ± 2.3°) when compared with patients without this condition (6.8 ± 1.9°; P = .024). When comparing the value of PhA regarding the degree of sarcopenia, it was found that patients from both sexes with severe sarcopenia had lower averages. The PhA had a low predictive capacity in relation to the diagnostic components of sarcopenia (physical performance, muscle mass, and strength). CONCLUSION PhA was an inaccurate marker to identify sarcopenia and presented low predictive capacity to explain muscle mass, muscle strength, and functional capacity, components involved in the diagnosis of sarcopenia.

Cachexia in hospitalized patients with heart failure

AIMS to evaluate cachexia prevalence in hospitalized heart failure (HF) patients by comparing two methods for diagnosing cachexia and alterations in each component involved in its diagnosis. METHOD a cross-sectional study, involving patients diagnosed with HF and admitted between April and August 2015 to a public hospital in the Brazilian Northeast. Cardiac cachexia was defined using the Cachexia Consensus criteria (Washington, DC), which defines cachexia as ≥ 5% unintentional weight loss in the previous 12 months or a body mass index (BMI) ≤ 20.0 kg/m², in combination with at least two of the following criteria: fatigue, anorexia, low hand grip strength, low muscle strength, and biological alterations (hemoglobin < 12 g/dl, albumin < 3.2 g/dl, and PCR ≥ 5 mg/dl), and for comparative purposes a diagnostic criterion which considers weight loss ≥ 6% in at least six months as a cachexia diagnosis. RESULTS one hundred and fifty-six individuals were evaluated, with an average age of 59.1 (± 15.3). Cachexia prevalence was 37.2% and associated with a low BMI (p < 0.001), low muscle mass (p < 0.001), reduced ejection fraction (p = 0.005), hypoalbuminemia (p = 0.040), and anemia (p = 0.002). Among the diagnostic components, the greatest alterations were observed in relation to fatigue (88.2%), anorexia (72.1%) and weight loss (61.7%). CONCLUSIONS the high prevalence of diagnosed cachexia indicates that this condition is common and is associated with poor nutritional state and clinical condition.

Predictive models for estimating visceral fat: The contribution from anthropometric parameters

Background Excessive adipose visceral tissue (AVT) represents an independent risk factor for cardiometabolic alterations. The search continues for a highly valid marker for estimating visceral adiposity that is a simple and low cost tool able to screen individuals who are highly at risk of being viscerally obese. The aim of this study was to develop a predictive model for estimating AVT volume using anthropometric parameters. Objective Excessive adipose visceral tissue (AVT) represents an independent risk factor for cardiometabolic alterations. The search continues for a highly valid marker for estimating visceral adiposity that is a simple and low cost tool able to screen individuals who are highly at risk of being viscerally obese. The aim of this study was to develop a predictive model for estimating AVT volume using anthropometric parameters. Methods A cross-sectional study involving overweight individuals whose AVT was evaluated (using computed tomography–CT), along with the following anthropometric parameters: body mass index (BMI), abdominal circumference (AC), waist-to-hip ratio (WHpR), waist-to-height ratio (WHtR), sagittal diameter (SD), conicity index (CI), neck circumference (NC), neck-to-thigh ratio (NTR), waist-to-thigh ratio (WTR), and body adiposity index (BAI). Results 109 individuals with an average age of 50.3±12.2 were evaluated. The predictive equation developed to estimate AVT in men was AVT = -1647.75 +2.43(AC) +594.74(WHpR) +883.40(CI) (R2 adjusted: 64.1%). For women, the model chosen was: AVT = -634.73 +1.49(Age) +8.34(SD) + 291.51(CI) + 6.92(NC) (R2 adjusted: 40.4%). The predictive ability of the equations developed in relation to AVT volume determined by CT was 66.9% and 46.2% for males and females, respectively (p<0.001). Conclusions A quick and precise AVT estimate, especially for men, can be obtained using only AC, WHpR, and CI for men, and age, SD, CI, and NC for women. These equations can be used as a clinical and epidemiological tool for overweight individuals.

Prevalencia y factores asociados a la obesidad abdominal en individuos en una franja de edad de 25 a 59 años del estado de Pernambuco, Brasil

In order to estimate the prevalence of abdominal obesity and associated factors in Pernambuco State, Brazil, a cross-sectional population-based study was conducted in 2006, including 1,580 adults 25 to 59 years of age. Abdominal obesity was defined as waist circumference (WC) ≥ 80 cm in women and ≥ 94 cm in men. The conceptual model included demographic, socioeconomic, reproductive, and behavioral variables. Prevalence of abdominal obesity was 27.1% (95%CI: 23.8-30.7) in males and 69.9% (95%CI: 66.8-72.8) in females (p < 0.001). Multivariate analysis showed higher prevalence in men 50 years or older in the metropolitan area and those with higher income, former smokers, and drinkers. Among women, obesity was more prevalent above 30 years of age, in former smokers, and in women with first pregnancy before age 18. Central adiposity is clearly a multifactor condition in the State of Pernambuco, and the determinants of obesity differ between the sexes.Com o objetivo de estimar a prevalencia de obesidade abdominal e avaliar os fatores associados em adultos do Estado de Pernambuco, Brasil, foi realizado, em 2006, um estudo transversal, de base populacional, envolvendo 1.580 individuos na faixa etaria de 25-59 anos. A obesidade abdominal foi determinada pela circunferencia da cintura ≥ 80cm para mulheres e ≥ 94cm para homens. O modelo conceitual considerou variaveis socioeconomicas, demograficas, reprodutivas e comportamentais. A prevalencia de obesidade abdominal foi de 27,1% (IC95%: 23,8-30,7) no sexo masculino e 69,9% (IC95%: 66,8-72,8) no feminino (p < 0,001). A analise ajustada revelou maior prevalencia em homens a partir de 50 anos, da regiao metropolitana, de maior renda, ex-fumantes e consumidores de bebidas alcoolicas. Entre as mulheres, foi mais prevalente a partir de 30 anos, em ex-fumantes e naquelas com a primeira gestacao antes de 18 anos. Fica evidente a gravidade e a multifatorialidade do problema da adiposidade central no Estado de Pernambuco, alem de ser possivel destacar que os determinantes da obesidade sao diferentes entre os sexos.