Marco Fabio Mastroeni

Perfil demográfico de idosos da cidade de Joinville, Santa Catarina: estudo de base domiciliar

OBJETIVO: Identificar o perfil demografico dos idosos residentes na area urbana de Joinville-SC. METODOLOGIA: Utilizando-se amostragem por conglomerados em multiplos estagios nos setores censitarios urbanos de Joinville, 660 idosos foram entrevistados em suas casas por meio de questionarios. A analise estatistica para variaveis categoricas consistiu em testes de associacao segundo o sexo, utilizando-se o Teste do Qui-Quadrado. Em todas as analises foi considerado o nivel de significância p<0,05. RESULTADOS: A media de idade dos idosos foi de 69,8 anos, sendo a maioria (57,6%) mulheres. Grande parte (62,0%) dos idosos vivia com o conjuge, e 33,0% eram viuvos (as); o grupo etario predominante foi o de 60-69 anos (54,8%); o grupo etnico com maior representatividade foi o de cor branca (89,5%); a maioria (84,5%) era natural de Santa Catarina, sendo o Rio Grande do Sul o Estado que apresentou maior representatividade de imigrantes (3,9%). Em relacao a escolaridade, 72,9% nao completaram o ensino fundamental, 9,2% eram analfabetos e apenas 5,3% ingressaram no ensino medio. A maior parte (45,6%) dos idosos recebia ate dois salarios minimos, e 50,3% das mulheres eram dependentes financeiramente. Em relacao ao IMC, 32,8% apresentaram valores medios acima do adequado. CONCLUSAO: O perfil demografico do grupo estudado mostrou caracteristicas similares a de outros estudos realizados com idosos no pais. Por se tratar de um grupo etario em rapido crescimento no mundo, as caracteristicas demograficas sao imprescindiveis para o estabelecimento de politicas publicas de saude que visem controlar o estado de saude da populacao.

Antropometria de idosos residentes no município de Joinville-SC, Brasil

OBJECTIVE: To provide anthropometric data of elderly people living in the urban area of Joinville, SC. Methodology: Two hundred and eighteen elderly people, aged 60 years or more, of both sexes, not institutionalized and residents in the urban area of Joinville city-SC were analyzed, in the year of 2002. The elderly were gathered according to sex and age group (60-69 years, 70-79 years and 80 and more). The anthropometric variables are presented under the average form, deviation-pattern and percentile (P5, P10, P25, P50, P75, P90 and P95). RESULTS: From 218 elderly, 130 (59.6%) were women and 88 (40.4%) men. Although the mean values of most investigated variables were proposing a tendency to reduce with the age increase, there was no statistically significant difference in the mean values among the age groups for both sex (p>0.05). When compared by sex, the body mass index, hip circumference and skinfolds mean values of women were significantly higher from the men. These, however, presented the waist circumference mean value significantly higher from the women (p <0.05). CONCLUSION: Most of the studies accomplished with elderly people in other countries have been investigated this category considering people with 65 years old or more, what makes difficult the comparison with the Brazilian data. In addition to other studies with elderly people in Brazil, the data obtained in this study can contribute for the construction of an anthropometric pattern of the Brazilian elderly population, inexistent in the country so far.

Influence of altered maternal lipid profile on the lipid profile of the newborn

OBJECTIVE To evaluate whether there is an association between altered maternal lipid profile and the lipid profile of the newborn in a maternity hospital. SUBJECTS AND METHOD Cross-sectional study with 435 parturients and their respective newborns. Blood samples from the newborns were collected during delivery by venipuncture of the umbilical cord close to the placenta. Blood samples from the parturients were collected in the pre-delivery room or right after delivery. The concentrations of total cholesterol, triglycerides and HDL-c were determined by an enzymatic colorimetric method and LDL-c was calculated by the Friedewald formula. RESULTS There was no significant difference in mean concentrations of total cholesterol, LDL-c, HDL-c and triglycerides in neonates according to altered or non-altered maternal total cholesterol, LDL-c, HDL-c and triglycerides. CONCLUSIONS Change in maternal lipid profile is not significantly associated with the mean concentrations of total cholesterol, LDL-c, HDL-c and triglycerides in newborns.

The Association of Serum 25-Hydroxyvitamin D Concentrations and Elevated Glycated Hemoglobin Values: A Longitudinal Study of Non-Diabetic Participants of a Preventive Health Program

The prevalence of Type 2 Diabetes (T2D) is sharply on the rise, both in Canada and worldwide. As addressing its root causes, i.e., promotion of healthy lifestyles and weight management, has been largely unsuccessful, new clues for primary prevention seem essential to curbing the increasing public health burden of T2D. In the present study, we examined whether improvements in vitamin D status, i.e., serum 25-hydroxyvitamin D [25(OH)D] concentrations, are paralleled by a reduction in the risk for reaching adverse glycated hemoglobin (HbA1c) levels in a community sample of non-diabetic volunteers participating in a preventive health program that encourages the use of vitamin D. Repeated observations on 6565 participants revealed that serum 25(OH)D concentrations increased from 90.8 to 121.3 nmol/L, HbA1c values decreased from 5.6% to 5.5%, and the prevalence of having HbA1c values ≥ 5.8% decreased from 29.5% to 17.4% while in the program. Compared to participants who did not increase their 25(OH)D concentrations during follow-up, those who increased their 25(OH)D concentrations with 50 nmol/L or more were 0.74 times as likely to achieve elevated HbA1c values at follow-up (p = 0.03). These findings suggest that public health initiatives that promote vitamin D status along with healthy lifestyles in the population at large may alleviate the future public health burden associated with T2D.

The Effect of Serum 25-Hydroxyvitamin D on Elevated Homocysteine Concentrations in Participants of a Preventive Health Program

Both lower serum 25-hydroxyvitamin D [25(OH)D] and elevated homocysteine concentrations are potential risk factors for cardiovascular disease (CVD). A recent analysis of the National Health and Nutrition Examination Survey reported an inverse association of serum 25(OH)D with homocysteine, however, the longitudinal relationship has yet to be investigated. We hypothesized and examined whether a temporal increase in 25(OH)D concentrations is paralleled by a reduction in the risk for elevated homocysteine. We analyzed data of 4475 participants with repeated assessments of serum 25(OH)D and homocysteine concentrations who enrolled in a preventive health program that encourages vitamin D supplementation and monitors serum 25(OH)D and homocysteine concentrations. We defined elevated homocysteine as concentrations greater than 13 micromoles per liter. Logistic regression was applied to assess the association of temporal changes in serum 25(OH)D with the risk of elevated homocysteine. We observed an inverse gradient whereby greater increases in 25(OH)D concentrations were associated with a lower prevalence of elevated homocysteine. Relative to those without temporal increases in 25(OH)D, participants who showed improvements in their serum 25(OH)D concentrations of “<25”, “25–50”, “50–75”, and “≥75” nanomoles per liter at follow up were 0.92 (95% confidence interval: 0.62–1.37), 0.52 (0.33–0.80), 0.34 (0.20–0.58), and 0.32 (0.19–0.54) times as likely to have elevated homocysteine, respectively. These observations suggest that temporal improvements in vitamin D status reduce serum homocysteine concentrations, and therefore may potentially contribute to the primary prevention of CVD.

Cardiometabolic Risk Markers of Normal Weight and Excess Body Weight in Brazilian Adolescents

Excess body weight leads to a variety of metabolic changes and increases the risk for cardiovascular diseases (CVD) in adulthood. The objective of this study was to investigate the presence of risk markers for CVD among Brazilian adolescents of normal weight and with excess body weight. The markers included blood pressure, C-reactive protein, homocysteine, tumor necrosis factor alpha, fibrinogen, fasting insulin and glucose, homeostasis model assessment of insulin resistance (HOMA-IR), leptin, total cholesterol, low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c), and triglycerides. We calculated odds ratios (OR) using logistic regression and adjusted for potential confounders such as age, sex, physical activity, and socioeconomic background. Compared with normal weight subjects, overweight/obese adolescents were more likely to have higher systolic blood pressure (OR = 3.49, p < 0.001), fasting insulin (OR = 8.03, p < 0.001), HOMA-IR (OR = 8.03, p < 0.001), leptin (OR = 5.55, p < 0.001), and LDL-c (OR = 5.50, p < 0.001) and lower serum HDL-c concentrations (OR = 2.76, p = 0.004). After adjustment for confounders, the estimates did not change substantially, except for leptin for which the risk associated with overweight increased to 11.09 (95% CI: 4.05-30.35). In conclusion, excess body weight in adolescents exhibits strong associations with several markers that are established as causes of CVD in adults. This observation stresses the importance of primary prevention and of maintaining a healthy body weight throughout adolescence to reduce the global burden of CVD.

Neck circumference as a complementary measure to identify excess body weight in children aged 13-24 months

Objectives:to analyze the accuracy of neck circumference (NC) as a measure for assessing excess body weight in children aged 13-24 months of life, according to gender.Methods:this is a cross-sectional study comparing the neck circumferences in relation to body mass index (BMI) and other anthropometric measures. The best cut-off point for identifying excess body weight was determined using the Receiver Operating Characteristics curve (ROC curve), according to gender and age groups 13-15 months, 16-19 months and 20-24 months.Results:NC waspositively correlated (p<0.001) with body weight and BMI in both genders, and length in girls (p<0.001). Positive correlations were found between NC and BMI in the three age groups (13-15, 16-19 and 20-24 months) in both boys and girls. The NC cut-off points for boys were 23.6, 23.9 and 24.0 cm, and 23.4, 23.5 and 23.6 cm for girls, for the 1315, 16-19 and 20-24 age groups respectively.Conclusions:NC can be used to screen for excess body weight in children aged 13-24 months. However, further studies with a larger sample will be required in order to complement these results.

Lactobionic Acid Produced by Zymomonas mobilis: Alternative to Prepare Targeted Nanoparticles

The bacterium Zymomonas mobilis has the ability to produce several organic acids from mixtures of fructose and different aldoses as an alternative to glucose. One of these organic acids, lactobionic acid, is produced from the oxidation of lactose and is produced in equimolar amounts with sorbitol, a product of fructose reduction. Sorbitol is widely used in the food and pharmaceutical industry, while lactobionic acid has important applications in medicine and cosmetics. It has been reported in the literature that lactobionic acid has the potential for drug vectorization, particularly for anti-tumor drugs. The objective of this work is to show that lactobionic acid produced by Zymomonas mobilis can be used for targeted delivery of chemotherapeutic agents. Using analytical techniques such as HPLC, NMR and polarimetry, we showed that lactobionic acid produced in Zymomonas mobilis is of high purity (100%) when compared to the 97% pure lactobionic acid salt from Sigma®, which was used as a reference. In addition, the lactobionic acid made from Zymomonas was free of any contaminants or racemic isomers and had an open chain, suggesting its suitability for targeted delivery of nanoparticle drugs.

Smoking during Pregnancy and Plasma Concentrations of beta-Carotene and alpha-Tocopherol in the Immediate Postpartum Period in Brazilian Women

This study investigated the relationship between plasma concentrations of beta-carotene and the alpha-tocopherol/lipid ratio, and smoking in 233 postpartum women, from July to November 2002, in the city of Joinville, Brazil. Thirty-seven percent (37%) of the women included in this study had low concentrations of alpha-tocopherol (< 11.63 micromol/L) and 61% of the women presented low concentrations of beta-carotene (< 0.39 micromol/L). Multivariate regression analysis investigated the relationship between smoking and the concentration of the vitamins, adjusting by confounding variables. The final regression model showed inverse associations between beta-carotene concentrations and smoking (p = 0.036), and beta-carotene concentrations and triglyceride levels (p = 0.021). There was an association between the plasma alpha-tocopherol/lipid ratio and per capita income (p = 0.003), but no association with smoking. We advise further studies to evaluate the impact of smoking and oxidative stress on the concentrations of these vitamins.

Breast-feeding duration for the prevention of excess body weight of mother–child pairs concurrently: a 2-year cohort study

OBJECTIVE To examine the association between breast-feeding duration and the risk of excess body weight (children >85th percentile, mothers BMI≥25·0 kg/m2) concurrently in mother-child pairs two years after delivery. DESIGN Prospective cohort study in Joinville, Brazil. Multivariable logistic regression was used to examine the independent relationship between breast-feeding duration and risk of excess body weight. SETTING Brazilian public maternity hospital. SUBJECTS Three hundred and five mother-child pairs. RESULTS At 2-year follow-up, 23·6 % of mother-child pairs had excess body weight. Children breast-fed for <2 months were more likely to have excess body weight than children breast-fed for ≥6 months (OR=2·4; 95 % CI 1·1, 5·1). Breast-feeding for <2 months was also associated with a greater likelihood of maternal excess body weight compared with those who breast-fed for ≥6 months (OR=2·9; 95 % CI 1·1, 8·1). There was a progressive increase in the likelihood of mother-child pairs having excess body weight as breast-feeding duration decreased. In addition to breast-feeding duration, other independent determinants of excess body weight were pre-pregnancy weight, gestational weight gain and number of pregnancies in mothers, and birth weight in children. CONCLUSIONS Breast-feeding for a longer duration has a parallel protective effect on the risk of excess body weight in mother-child pairs two years after birth. Since members of the same family could be influenced by the same risk factors, continued promotion and support of breast-feeding may help to attenuate the rising prevalence of overweight in mother-child pairs.