Keila Fernandes Dourado

Excessive weight – muscle depletion paradox and cardiovascular risk factors in outpatients with inflammatory bowel disease

BACKGROUND Evidence suggests a nutritional transition process in patients with inflammatory bowel disease. Obesity, which was once an uncommon occurrence in such patients, has grown in this population at the same prevalence rate as that found in the general population, bringing with it an increased risk of cardiovascular disease. Objective The aim of the present study was to determine the nutritional status and occurrence of cardiovascular risk factors in patients with inflammatory bowel disease. METHODS A case-series cross-sectional study was conducted involving male and female adult outpatients with inflammatory bowel disease. Data were collected on demographic, socioeconomic, clinical and anthropometric variables as well as the following cardiovascular risk factors: sedentary lifestyle, excess weight, abdominal obesity, medications in use, comorbidities, alcohol intake and smoking habits. The significance level for all statistical tests was set to 5% (P< 0.05). RESULTS The sample comprised 80 patients with inflammatory bowel disease, 56 of whom (70.0%) had ulcerative colitis and 24 of whom (30.0%) had Crohns disease. Mean age was 40.3±11 years and the female genre accounted for 66.2% of the sample. High frequencies of excess weight (48.8%) and abdominal obesity (52.5%) were identified based on the body mass index and waist circumference, respectively, in both groups, especially among those with ulcerative colitis. Muscle depletion was found in 52.5% of the sample based on arm muscle circumference, with greater depletion among patients with Crohns disease (P=0.008). The most frequent risk factors for cardiovascular disease were a sedentary lifestyle (83.8%), abdominal obesity (52.5%) and excess weight (48.8%). CONCLUSION The results of the complete anthropometric evaluation draw ones attention to a nutritional paradox, with high frequencies of both - muscle depletion, as well as excess weight and abdominal obesity.

Relação entre o estado nutricional e as complicações imediatas em pacientes submetidos a cirurgias colorretais

INTRODUCAO: intervencoes cirurgicas colorretais estao sujeitas a diversas complicacoes e varios fatores, como o estado nutricional, contribuem substancialmente para essa problematica. OBJETIVO: avaliar a relacao do estado nutricional, determinado por diferentes ferramentas, com o surgimento de complicacoes pos-operatorias imediatas, bem como a analise de parâmetros sociais, estilo de vida, consumo alimentar e tempo de reintroducao a dieta. METODOS: estudo de serie de casos, conduzido na enfermaria de cirurgia proctologica do Hospital Barao de Lucena, Recife, Pernambuco, com individuos de ambos os sexos diagnosticados com câncer colorretal e que foram submetidos a procedimento cirurgico envolvendo pelo menos uma anastomose. Foram avaliadas as condicoes sociais, demograficas, clinicas, o estilo de vida, o consumo alimentar, o estado nutricional e as complicacoes imediatas pos-cirurgicas. RESULTADOS: dos 31 pacientes estudados, houve uma maior prevalencia do sexo feminino (74,2%), media de idade de 61,9 ±12,4 anos e 54,8% apresentaram o reto como localizacao primaria do câncer. A maioria eram procedentes do interior do estado, aposentados, baixa escolaridade e apresentaram demasiada ingestao de carnes vermelhas, embutidos e gorduras e um menor consumo de frutas e verduras e eram sedentarios. Quanto ao estado nutricional, foi encontrado um risco nutricional de 58,1%, IMC medio de 25,7 ±6,8 kg/m² e 54,8% apresentaram perda ponderal significativa. Alem disso, 38,7% apresentaram alguma das complicacoes imediatas, sendo as mais frequentes o ileo paralitico e a distensao abdominal. Houve retardo no inicio da realimentacao e nao houve associacao entre o estado nutricional e as complicacoes imediatas. CONCLUSAO: o surgimento do câncer colorretal esta bem relacionado com os habitos alimentares e o estilo de vida. Pacientes com essa neoplasia apresentam uma acentuada perda ponderal, entretanto, nesse estudo, nao houve associacao entre o estado nutricional e a incidencia de complicacoes pos-operatorias.