ABSTRACT Objective: There is no consensus as to the best criterion for the evaluation of metabolic syndrome (MS), impairing the estimation of its prevalence. This study aims to compare MS estimates using three recommended definitions for adolescents based on a cross-sectional study nested in the Consortium of Brazilian Birth Cohorts in São Luís, Maranhão. Subjects and methods: A total of 2,515 adolescents aged between 18 and 19 years were evaluated. The criteria of International Diabetes Federation (IDF) and National Cholesterol Education Program Panel III (NCEP-ATP) modified by Cook and cols. (2003) and De Ferranti and cols. (2004) defined SM. To compare the estimates of MS prevalence, the chi-square, Fisher’s exact and Cohen’s Kappa index tests were used. Results: Among the 2,064 participants evaluated in the final sample. The prevalence of MS ranged from 4.2% (95% CI: 3.3-5.1) to 10.2% (95% CI: 8.8-11.4). When comparing the estimates of MS prevalence in the total sample and by sex, a statistically significant difference was observed. The agreement between the criteria ranged from 0.42 (CI 95%: 0.35-0.49) to 0.55 (CI 95%: 0.48-0.62) in the total sample, 0.33 (CI 95%: 0.24-0.42) to 0.59 (95%CI: 0.47-0.71) among boys and 0.39 (95% CI: 0.26-0.52) to 0.54 (95% CI: 0.44-0.64) among girls. Conclusion: Different criteria provide different estimates for the prevalence of MS in adolescents, reflecting the importance of establishing a consensus.

ABSTRACT Objective: Cardiovascular diseases represent the main cause of death in chronic kidney disease (CKD). We aimed to evaluate the prevalence and association of the hypertriglyceridemia-waist phenotype (HWP) and visceral adiposity index (VAI) with cardiometabolic risk factors (CR) in patients with CKD on hemodialysis (HD). Materials and methods: The study is based on a cross-sectional design with 265 HD patients in two cities in northeastern Brazil. The VAI was calculated considering the variables body mass index (BMI), waist circumference (WC), triglycerides (TG) and high density lipoprotein cholesterol (HDL-c). HWP was defined as the concomitant elevation of WC and TG. The Poisson Regression Model with robust variance estimation was adjusted considering a hierarchical approach for explanatory variables. Prevalence ratios (PR) were also estimated. The level of significance adopted was 5%. Results: In our study HWP and VAI prevalence’s were 29.82% and 58.49%, respectively. In the final model, there was an association between VAI and female gender (PR = 1.46; p < 0.0001) and high body fat (% BF) (PR = 1.33; p < 0.0019). HWP was associated with females (PR = 1.80; p = 0.002), alcohol consumption (PR = 1.58; p = 0.033), obesity (PR = 1.89; p = 0.0001), high %BF (PR = 1.76; p = 0.012) and reduced HDL-c (PR = 1.48; p = 0.035). Conclusion: The HWP stood out as the association with more CR factors, representing a promising method for tracking cardiometabolic risk in HD patients, mainly female.

Abstract Introduction: body fat reflects important clinical impacts among hemodialysis patients; thus, simple and safe methods are required for a careful evaluation of this body compartment. Objectives: to evaluate the concordance of estimates of total body fat percentage (%BF), calculated using bioelectrical impedance analysis (BIA) and sum of four skinfolds (SSKD) measures, with those obtained using dual-energy X-ray absorptiometry (DEXA) in patients with chronic kidney disease (CKD) receiving hemodialysis. Methods: a cross-sectional study was conducted in 317 patients undergoing hemodialysis. The %BF was evaluated using BIA, SSKD measurement, and DEXA, and stratified by sex and tertiles. The Wilcoxon test for paired samples was used to compare the %BF obtained using the different methods, and Lin's concordance correlation coefficient (CCC-L) to evaluate concordance. Results: the average %BF estimated using DEXA was 29.3 ± 9.3 %, with significant differences among the three methods (p < 0.05). SSKD measurement presented a higher CCC-L concordance with DEXA, regardless of sex. After stratification of the sample in tertiles, BIA presented a higher CCC-L concordance with DEXA among the patients with CKD with a %BF above 34.4 % (third tertile). Conversely, SSKD measurement presented better concordance with DEXA for those with a %BF equal to or less than 34.4 %. Conclusions: in terms of the estimates of the %BF, SSKD measurement displayed a better concordance with DEXA.

Resumen Introducción: la grasa corporal refleja importantes impactos clinicos entre los pacientes en hemodialisis; por lo tanto, se requieren metodos simples y seguros para una evaluacion cuidadosa de este compartimiento del cuerpo. Objetivos: evaluar la concordancia de las estimaciones del porcentaje de grasa corporal total (%GC), calculadas mediante el analisis de impedancia bioelectrica (BIA) y la suma de las medidas de cuatro pliegues cutaneos (CPC), con las obtenidas mediante absorciometria dual energetica de rayos X (DEXA) en pacientes con enfermedad renal cronica (ERC) que reciben hemodialisis. Métodos: se realizo un estudio transversal en 317 pacientes en hemodialisis. La %GC se evaluo mediante BIA, medicion de CPC y DEXA, y se estratifico por sexos y terciles. Se utilizo la prueba de Wilcoxon para muestras pareadas para comparar los %GC obtenidos con los diferentes metodos, y el coeficiente de correlacion de concordancia de Lin (CCC-L) para evaluar la concordancia. Resultados: el %GC promedio estimado usando DEXA fue del 29,3 ± 9,3 %, con diferencias significativas entre los tres metodos (p < 0,05). La medicion de los CPC presento una mayor concordancia de CCC-L con DEXA, independientemente del sexo. Tras la estratificacion de la muestra en terciles, la BIA presento una mayor concordancia de CCC-L con DEXA entre los pacientes con ERC con un %GC superior al 34,4 % (tercer tercil). Por el contrario, la medicion de los CPC presento una mejor concordancia con la DEXA para aquellos con un %GC igual o inferior al 34,4 %. Conclusión: en terminos de las estimaciones del %GC, la medicion de los CPC mostro una mejor concordancia con la DEXA.