Clayton Franco Moraes

Association between the -174 G/C promoter polymorphism of the interleukin-6 gene and cardiovascular disease risk factors in Brazilian older women

In worldwide studies, interleukin-6 (IL-6) is implicated in age-related disturbances. The aim of the present report was to determine the possible association of IL-6 -174 C/G promoter polymorphism with the cytokine profile as well as with the presence of selected cardiovascular risk features. This was a cross-sectional study on Brazilian women aged 60 years or older. A sample of 193 subjects was investigated for impaired glucose regulation, diabetes, hypertension, and dyslipidemia. Genotyping was done by direct sequencing of PCR products. IL-6 and C-reactive protein were quantified by high-sensitivity assays. General linear regression models or the Student t-test were used to compare continuous variables among genotypes, followed by adjustments for confounding variables. The chi-square test was used to compare categorical variables. The genotypes were consistent with Hardy-Weinberg equilibrium proportions. In a recessive model, mean waist-to-hip ratio, serum glycated hemoglobin and serum glucose were markedly lower in C homozygotes (P = 0.001, 0.028, and 0.047, respectively). In a dominant hypothesis, G homozygotes displayed a trend towards higher levels of circulating IL-6 (P = 0.092). Non-parametric analysis revealed that impaired fasting glucose and hypertension were findings approximately 2-fold more frequent among G homozygous subjects (P = 0.042 and 0.043, respectively). Taken together, our results show that the IL-6 -174 G-allele is implicated in a greater cardiovascular risk. To our knowledge, this is the first investigation of IL-6 promoter variants and age-related disturbances in the Brazilian elderly population.

Acute exercise performed close to the anaerobic threshold improves cognitive performance in elderly females

The objective of the present study was to compare the effect of acute exercise performed at different intensities in relation to the anaerobic threshold (AT) on abilities requiring control of executive functions or alertness in physically active elderly females. Forty-eight physically active elderly females (63.8 +/- 4.6 years old) were assigned to one of four groups by drawing lots: control group without exercise or trial groups with exercise performed at 60, 90, or 110% of AT (watts) and submitted to 5 cognitive tests before and after exercise. Following cognitive pretesting, an incremental cycle ergometer test was conducted to determine AT using a fixed blood lactate concentration of 3.5 mmol/L as cutoff. Acute exercise executed at 90% of AT resulted in significant (P < 0.05, ANOVA) improvement in the performance of executive functions when compared to control in 3 of 5 tests (verbal fluency, Tower of Hanoi test (number of movements), and Trail Making test B). Exercising at 60% of AT did not improve results of any tests for executive functions, whereas exercise executed at 110% of AT only improved the performance in one of these tests (verbal fluency) compared to control. Women from all trial groups exhibited a remarkable reduction in the Simple Response Time (alertness) test (P = 0.001). Thus, physical exercise performed close to AT is more effective to improve cognitive processing of older women even if conducted acutely, and using a customized exercise prescription based on the anaerobic threshold should optimize the beneficial effects.

Long-Term Resistance Training Is Associated with Reduced Circulating Levels of IL-6, IFN-Gamma and TNF-Alpha in Elderly Women

Objective: The increase in inflammatory activity associated with aging is a characteristic of chronic disease processes that accounts for most of the mortality in the elderly. Resistance training (RT) has been shown to promote metabolic and functional benefits in this population. The objective of this study was to investigate the association between long-term RT and circulating levels of the proinflammatory mediators IL-6, TNF-α and IFN-γ in elderly women. Methods: This cross-sectional study included 54 older outpatients divided into a group that underwent RT (n = 28) for an average of 8.6 ± 0.3 months and a sedentary group (n = 26). Measurements were taken only at the end of the intervention, and cytokine values were log-transformed. Dietary intake was controlled as a confounding factor. Results: The RT group presented reduced levels of log10IFN-γ (approx. 45%; p = 0.003), log10IL-6 (approx. 30%; p = 0.002) and log10TNF-α (approx. 22%; p = 0.036). Total caloric intake and systolic arterial blood pressure were significantly lower in the RT group (p = 0.001 and p = 0.022, respectively). Pearson’s product moment correlation test revealed a negative association between the fat-free mass (FFM) index and log-transformed IL-6 levels (p = 0.03; n = 54) and a trend towards significance for the correlation between the FFM index and log10IFN-γ (p = 0.05; n = 54). Conclusion: Long-term, moderate-intensity RT in elderly women is associated with lower circulating levels of cytokines that are potentially implicated in disorders associated with physical inactivity and aging.

A common polymorphism in the renin angiotensin system is associated with differential outcome of antihypertensive pharmacotherapy prescribed to Brazilian older women

BACKGROUND Since variations on the renin angiotensin (RA) system tend to exert effects on blood pressure, we investigated the association of the common ACE and AT1R polymorphisms with response to a multivariate pharmacotherapy. METHODS This prospective study involved 169 hypertensive, community-dwelling older women. Genotypes were obtained by length analysis or direct sequencing of PCR products. Blood pressure-lowering pharmacotherapy was conducted according to current Brazilian Guidelines on Hypertension. RESULTS Genotype frequencies were in agreement to the Hardy-Weinberg equilibrium. Interventions were found to represent actual hypertension-management practices in Brazil, and accounted for a significant reduction in both systolic (P<0.001) and diastolic (P<0.001) blood pressure. Concerning the effect of polymorphisms, no influence of the ACE and AT1R genotypes were found on the magnitude of the treatment-induced blood pressure reduction (P>0.05). Nonetheless, the clinical result varied according to the ACE alleles since mean systolic pressure was roughly 10 mm Hg higher in insertion (I) homozygotes than in the deletion (D) counterparts either in baseline (P=0.001) and endpoint (P=0.010). CONCLUSION The outcome of the antihypertensive pharmacotherapy advocated by national guidelines was significantly influenced by the ACE I/D polymorphism but not by the AT1R 1166 A/C polymorphism among postmenopausal women.

Amerindian Genetic Ancestry Protects against Alzheimer's Disease

Background: Alzheimer’s disease (AD) is the most common form of dementia worldwide, and bears remarkable evidence for a differential prevalence among continental populations. In this scenario, estimating ancestry proportions in recently admixed populations is a strategy that can help increasing knowledge about the genetic structure of this complex trait. Aim/Methods: Our purpose was to assess mean ancestry estimates for the three main parental contributors to the Brazilian contingent (European, African and Amerindian) using a panel of 12 ancestry informative markers. Outpatients with the late-onset form of AD (n = 120) were compared for ancestry levels with non-cognitively impaired subjects (n = 412) in the Midwest Brazil, controlling for classic clinical, social and anthropometric risk factors. Results: Our findings show a 3-fold greater genetic Amerindian content among control subjects compared to AD patients (p < 0.001). Conclusion: Our results suggest that the allelic architecture of Native Americans can confer protection against the onset of the disease.

Lessons from genome-wide association studies findings in Alzheimer's disease.

Alzheimers disease (AD) is the most common neurodegenerative disorder with a complex genetic background. Recent genome‐wide association studies (GWAS) have placed important new contributors into the genetic framework of early‐ and late‐onset forms of this dementia. Besides confirming the major role of classic allelic variants (e.g. apolipoprotein E) in the development of AD, GWAS have thus far implicated over 20 single nucleotide polymorphisms in AD. In this review, we summarize the findings of 16 AD‐based GWAS performed to date whose public registries are available at the National Human Genome Research Institute, with an emphasis on understanding whether the polymorphic markers under consideration support functional implications to the pathophysiological role of the major genetic risk factors unraveled by GWAS.

Implication of the G145C polymorphism (rs713598) of the TAS2r38 gene on food consumption by Brazilian older women

To evaluate the capacity to perceive bitter taste in a sample of the elderly population of the Brazilian Federal District, and to investigate its association with the consumption profile of distinct food groups. A total of 255 female outpatients aged 60 years or older took part in this cross-sectional study. The following data were determined for all the volunteers: alimentary frequency by clinical dieticians; genotyping of the G145C polymorphism in the TAS2r38 gene; cognitive status; sensorial (visual and hearing) acuity and drugs related to ageusia or dysgeusia. Sensitivity to bitter taste was assessed using phenylthiocarbamide (PTC) in a subset. Non-parametric tests confirmed the remarkable effect of the C allele in determining sensitivity to PTC (p<0.001). C allele carriers displayed diminished consumption of type B vegetables as well as of some vegetables generally recognized as bitter: arugula (p=0.044) and chard (p=0.006). No associations were observed for the remaining food classes. The present findings suggest that the G145C genetic variation in the TAS2r38 gene modestly influenced food consumption habits of Brazilian older women. Nonetheless, the results do not rule out possible effects of past experiences on choices of elderly individuals.

Association of serum lipid components and obesity with genetic ancestry in an admixed population of elderly women

The prevalence of metabolic disorders varies among ethnic populations and these disorders represent a critical health care issue for elderly women. This study investigated the correlation between genetic ancestry and body composition, metabolic traits and clinical status in a sample of elderly women. Clinical, nutritional and anthropometric data were collected from 176 volunteers. Genetic ancestry was estimated using 23 ancestry-informative markers. Pearsons correlation test was used to examine the relationship between continuous variables and an independent samples t-test was used to compare the means of continuous traits within categorical variables. Overall ancestry was a combination of European (57.49%), Native American (25.78%) and African (16.73%). Significant correlations were found for European ancestry with body mass index (r = 0.165; p = 0.037) and obesity (mean difference (MD) = 5.3%; p = 0.042). African ancestry showed a significant correlation with LDL (r = 0.159, p = 0.035), VLDL (r = −0.185; p = 0.014), hypertriglyceridemia (MD = 6.4%; p = 0.003) and hyperlipidemia (MD = 4.8%; p = 0.026). Amerindian ancestry showed a significant correlation with triglyceride levels (r = 0.150; p = 0.047) and hypertriglyceridemia (MD = 4.5%; p = 0.039). These findings suggest that genetic admixture may influence the etiology of lipid metabolism-related diseases and obesity in elderly women.

Prediction of metabolic syndrome in children through anthropometric indicators

FUNDAMENTO: Debido a la necesidad de medir las variables antropometricas, bioquimicas y hemodinamicas para el diagnostico del sindrome metabolico, se percibe la dificultad de la evaluacion de grandes poblaciones, principalmente en ninos, provocada por el dificil acceso y por el caracter invasivo. Es urgente la necesidad de desarrollar formas diagnosticas de facil aplicacion, buena precision y bajo costo, con la finalidad de predecir el sindrome metabolico ya en las edades iniciales. OBJETIVO: Verificar la prevalencia del sindrome metabolico en ninos y probar los indicadores antropometricos con capacidad predictiva. METODOS: Estudio transversal realizado con 109 ninos, de 7 a 11 anos. Se utilizo el criterio National Cholesterol Education Program para el diagnostico del sindrome metabolico, adaptado a la edad. Como posibles predictores, fueron probados: indice de masa corporal (IMC), circunferencia de la cintura (CC), relacion cintura/cadera (RCC), indice de conicidad (indice C) y el porcentual de grasa corporal. RESULTADOS: La prevalencia del sindrome metabolico fue de 13,3% y 36% para ninos y ninas, respectivamente. Los principales indicadores antropometricos fueron: IMC = 0,81 (0,69 - 0,94), CC = 0,79 (0,64 - 0,94), grasa corporal = 0,79 (0,66 - 0,92) y RCC = 0,37 (0,21 - 0,54). CONCLUSION: Fueron considerados factores predictores del sindrome metabolico la CC superior a 78 cm, la grasa corporal superior a 41% y el IMC superior a 24,5 kg/m2. El indice C y la RCC no fueron considerados predictores.BACKGROUND Because of the need to measure anthropometric, biochemical and hemodynamic variables for the diagnosis of metabolic syndrome, we realize how difficult it is to analyze large populations, especially children, due to the poor accessibility and the invasive character. There is an urgent need to develop easy-to-use, accurate and low-cost diagnostic tools in order to predict metabolic syndrome at early ages. OBJECTIVE To verify the prevalence of metabolic syndrome in children and to test predictive anthropometric indicators. METHODS Cross-sectional study conducted among 109 children aged 7 to 11 years. The age-adjusted National Cholesterol Education Program definition was used for the diagnosis of metabolic syndrome. The following parameters were tested as possible predictors: body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), conicity index (C index), and body fat percentage. RESULTS The prevalence of metabolic syndrome was 13.3% and 36% for boys and girls, respectively. The main anthropometric indicators were: BMI = 0.81 (0.69 - 0.94), WC = 0.79 (0.64 - 0.94), body fat = 0.79 (0.66 - 0.92) and WHR = 0.37 (0.21 - 0.54). CONCLUSION WC higher than 78 cm, body fat higher than 41%, and BMI higher than 24.5 kg/m² were considered predictors of metabolic syndrome. The C index and WHR were not considered predictors.

Predição da síndrome metabólica em crianças por indicadores antropométricos

FUNDAMENTO: Debido a la necesidad de medir las variables antropometricas, bioquimicas y hemodinamicas para el diagnostico del sindrome metabolico, se percibe la dificultad de la evaluacion de grandes poblaciones, principalmente en ninos, provocada por el dificil acceso y por el caracter invasivo. Es urgente la necesidad de desarrollar formas diagnosticas de facil aplicacion, buena precision y bajo costo, con la finalidad de predecir el sindrome metabolico ya en las edades iniciales. OBJETIVO: Verificar la prevalencia del sindrome metabolico en ninos y probar los indicadores antropometricos con capacidad predictiva. METODOS: Estudio transversal realizado con 109 ninos, de 7 a 11 anos. Se utilizo el criterio National Cholesterol Education Program para el diagnostico del sindrome metabolico, adaptado a la edad. Como posibles predictores, fueron probados: indice de masa corporal (IMC), circunferencia de la cintura (CC), relacion cintura/cadera (RCC), indice de conicidad (indice C) y el porcentual de grasa corporal. RESULTADOS: La prevalencia del sindrome metabolico fue de 13,3% y 36% para ninos y ninas, respectivamente. Los principales indicadores antropometricos fueron: IMC = 0,81 (0,69 - 0,94), CC = 0,79 (0,64 - 0,94), grasa corporal = 0,79 (0,66 - 0,92) y RCC = 0,37 (0,21 - 0,54). CONCLUSION: Fueron considerados factores predictores del sindrome metabolico la CC superior a 78 cm, la grasa corporal superior a 41% y el IMC superior a 24,5 kg/m2. El indice C y la RCC no fueron considerados predictores.BACKGROUND Because of the need to measure anthropometric, biochemical and hemodynamic variables for the diagnosis of metabolic syndrome, we realize how difficult it is to analyze large populations, especially children, due to the poor accessibility and the invasive character. There is an urgent need to develop easy-to-use, accurate and low-cost diagnostic tools in order to predict metabolic syndrome at early ages. OBJECTIVE To verify the prevalence of metabolic syndrome in children and to test predictive anthropometric indicators. METHODS Cross-sectional study conducted among 109 children aged 7 to 11 years. The age-adjusted National Cholesterol Education Program definition was used for the diagnosis of metabolic syndrome. The following parameters were tested as possible predictors: body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), conicity index (C index), and body fat percentage. RESULTS The prevalence of metabolic syndrome was 13.3% and 36% for boys and girls, respectively. The main anthropometric indicators were: BMI = 0.81 (0.69 - 0.94), WC = 0.79 (0.64 - 0.94), body fat = 0.79 (0.66 - 0.92) and WHR = 0.37 (0.21 - 0.54). CONCLUSION WC higher than 78 cm, body fat higher than 41%, and BMI higher than 24.5 kg/m² were considered predictors of metabolic syndrome. The C index and WHR were not considered predictors.