Fernanda de Carvalho Vidigal

Índice de massa corporal e circunferência abdominal: associação com fatores de risco cardiovascular

OBJECTIVE To evaluate the association between cardiovascular risk factors and the anthropometric values--body mass index (BMI) and waist circumference (WC). METHODS It was studied 231 employees of Federal University of Viçosa, Brazil, 54.1% of them were men (21-76 years old). Glycemia, total cholesterol, LDL, HDL, triglycerides, blood pressure, BMI, WC, waist-to-hip ratio and body fatness were measured. It was also investigated smoking, alcohol consumption and physical activity. RESULTS The prevalence of overweight/obesity in this population was high mainly in women. The abdominal obesity was observed in 74% of the women and 46.1% of the men. The average of BMI, body fatness, total cholesterol, HDL and triglycerides were significantly higher in men than in women. (p < 0,05). The sedentary lifestyle was a risk factor for obesity. Smoking and alcohol consumption were more common among men and normal weight volunteers. Most of the correlations between anthropometric indices and risk factors for cardiovascular diseases were significant, but weak and the WC was the index that had the strongest correlation and that associated with the largest number of variables. It was observed that with an increase of the BMI and the abdominal fat, there was also an increase of the glycemia, triglycerides and blood pressure and a decrease of HDL. The metabolic syndrome was more common among men and overweight and obese volunteers. CONCLUSION In this study, the frequency of cardiovascular risk factors increased along with BMI and WC.

Predictive ability of the anthropometric and body composition indicators for detecting changes in inflammatory biomarkers

INTRODUCTION Obesity has been considered a chronic subclinical inflammation. High sensitivity C-reactive protein (hs-CRP) and fibrinogen are increasingly associated with cardiovascular risk. OBJECTIVES To evaluate the ability of anthropometric and body composition indicators in discriminating higher levels of hs-CRP and fibrinogen. METHODS 130 men (20-59 years) were assessed, having measurement of weight, height, waist circumference (WC), hip and thigh circumferences, sagittal abdominal diameter (SAD), coronal diameter (CD) and body composition. Conicity index, waist/height ratio, body mass index, waist/hip ratio, waist/thigh ratio and sagittal index were calculated. It was considered as the cutoff point for hs-CRP values ≥ 0.12 mg/dL and for fibrinogen the 50th percentile of the evaluated sample. RESULTS Sagittal index (r = 0.280), waist/thigh ratio (r = 0.233) and waist/height ratio (r = 0.233) showed the best correlation with hs-CRP (p < 0.01). Conicity index (r = 0.305) and waist/height ratio (r = 0.279) showed the best correlation with fibrinogen (p < 0.01). In ROC analysis, the SAD (0.698 ± 0.049) and the conicity index (0.658 ± 0.048) had greater ability to discriminate cardiovascular risk through higher levels of hs-CRP and fibrinogen, respectively (p < 0.01). The cutoff points of 30 cm, 89.9 cm and 20.5 cm were the ones that reached largest sum between sensitivity and specificity values for the CD, WC and SAD, respectively. CONCLUSIONS The SAD and the conicity index demonstrated a greater ability to detect higher levels of hs-CRP and fibrinogen, respectively, in apparently healthy adult men.

Serum uric acid can predict higher C-reactive protein levels in apparently healthy men

INTRODUCTION Epidemiological studies have shown an association between coronary heart disease and emerging cardiovascular risk factors, such as, levels of fibrinogen and high-sensitivity C-reactive protein (hs-CRP). OBJECTIVES To verify the ability of biochemical indicators in discriminating changes in the levels of hs-CRP and fibrinogen, in apparently healthy adult men. METHODS Were evaluated 130 apparently healthy men (20-59 years), having measurement of weight and height. Biochemical measurements (lipid profile, fasting glucose, uric acid, hs-CRP and fibrinogen) were performed. Body mass index, total cholesterol/HDL-c and LDL-c/HDL-c ratios were calculated. It was considered as the cutoff point for hs-CRP values ≥ 0.12 mg/dL and for fibrinogen the 50th percentile of the evaluated sample. RESULTS The uric acid showed the best correlation (r = 0.325) and the higher area under the ROC curve (0.704 ± 0.054), showing greater ability to discriminate higher levels of hs-CRP (p < 0.01). The total cholesterol/HDL-c ratio (r = 0.222) and the LDL-c/HDL-c ratio (r = 0.235) showed the best correlations and the higher areas under the ROC curves (0.624 ± 0.049 and 0.624 ± 0.049) in identify higher levels of fibrinogen (p < 0.05). CONCLUSION The uric acid and the total cholesterol/HDL-c and the LDL-c/HDL-c ratios showed greater ability to identify changes in the levels of hs-CRP and fibrinogen, respectively. It was suggested the use of biochemical markers in the clinical practice, in order to establish preventive action for cardiovascular disease in apparently healthy adult men.

Social Components of the Obesity Epidemic

Obesity represents an important public health concern and has negative health and social consequences. Epidemiological and observational studies have contributed to highlighting the multifactorial and complex etiology of obesity. Among the social components of the obesity epidemic the following appear to be the most relevant: assortative mating, parental age, socio-economical status and educational level, body dissatisfaction, sleep conditions, sedentary environments by build neighborhood, energy saving devices, work occupation and alcohol consumption. The assortative mating and parental traits (age, education level) have shown an important influence on the weight of children. In turn, sleep deprivation may reduce the energy expenditure and increase food intake, which can explain a relation with obesity. Body dissatisfaction in childhood and adolescence seems to increase the risk of obesity in adulthood. The low physical activity and spent sedentary time can be associated with unfavorably built environment, including low walk ability, unsafe playgrounds and pedestrian pathways. Moreover, the obesity per se, over time, may reduce physical activity level and social ability as well as influence in assortative mating, and subsequent intergenerational obesity condition. All findings together demonstrated that social components of obesity are as complex as itself. In summary, more studies concerning social, cultural and environment traits are needed in order to assess the effect of excessive adiposity in its own occurrence and chronicity. In addition, it is urgent to include obesity prevention as a relevant topic on the public health agenda in developing countries.

Ácido úrico sérico puede predecir mayores niveles de proteína c-reactiva en hombres adultos sanos

INTRODUCTION Epidemiological studies have shown an association between coronary heart disease and emerging cardiovascular risk factors, such as, levels of fibrinogen and high-sensitivity C-reactive protein (hs-CRP). OBJECTIVES To verify the ability of biochemical indicators in discriminating changes in the levels of hs-CRP and fibrinogen, in apparently healthy adult men. METHODS Were evaluated 130 apparently healthy men (20-59 years), having measurement of weight and height. Biochemical measurements (lipid profile, fasting glucose, uric acid, hs-CRP and fibrinogen) were performed. Body mass index, total cholesterol/HDL-c and LDL-c/HDL-c ratios were calculated. It was considered as the cutoff point for hs-CRP values ≥ 0.12 mg/dL and for fibrinogen the 50th percentile of the evaluated sample. RESULTS The uric acid showed the best correlation (r = 0.325) and the higher area under the ROC curve (0.704 ± 0.054), showing greater ability to discriminate higher levels of hs-CRP (p < 0.01). The total cholesterol/HDL-c ratio (r = 0.222) and the LDL-c/HDL-c ratio (r = 0.235) showed the best correlations and the higher areas under the ROC curves (0.624 ± 0.049 and 0.624 ± 0.049) in identify higher levels of fibrinogen (p < 0.05). CONCLUSION The uric acid and the total cholesterol/HDL-c and the LDL-c/HDL-c ratios showed greater ability to identify changes in the levels of hs-CRP and fibrinogen, respectively. It was suggested the use of biochemical markers in the clinical practice, in order to establish preventive action for cardiovascular disease in apparently healthy adult men.

Relationship between waist circumference and sagittal abdominal diameter measured at different anatomical sites and inflammatory biomarkers in apparently health men

INTRODUCTION Visceral fat accumulation is associated with several changes, such as, increased production of inflammatory biomarkers, especially, C-reactive protein (CRP) and fibrinogen. Anthropometric measurements for central adiposity evaluation, such as, waist circumference (WC) and sagittal abdominal diameter (SAD) have been highlighted. However, there is no consensus on the best anatomical site for measurement. OBJECTIVE To evaluate the reliability of different measurements of WC and SAD and verify their capacity to discriminate changes in inflammatory biomarkers. METHOD 130 men (20-59 years) were assessed, having measurements of weight, height, WC and SAD. It was considered as the cutoff point for high-sensitivity CRP (hs-CRP) values ≥ 0.12 mg/dL and for fibrinogen the 50th percentile of the evaluated sample. RESULTS All measurements presented an intraclass correlation coefficient between 0.998 and 0.999. WC measured at the umbilical level (AUC=0.693 ± 0.049) and the smallest circumference between the thorax and the hips (AUC=0.607 ± 0.050) had greater ability to discriminate changes in concentrations of hs-CRP and fibrinogen, respectively. SAD (umbilical level) showed the better ability to detect changes in concentrations of hs-CRP (AUC=0.698 ± 0.049) and fibrinogen (AUC=0.625 ± 0.049), according to the ROC analysis (p<0.05). CONCLUSION WC (smallest circumference between the thorax and the hips) and SAD (umbilical level) are the anatomic sites of measurement for use in predicting the inflammatory risk in apparently health men.