ABSTRACT Objective: To evaluate the association between HbA1c levels measured in the third trimester and the risk for large for gestational age (LGA) in neonates of mothers affected by gestational diabetes mellitus (GDM). Secondarily, we aimed to identify an ideal cut-off for increased risk of LGA amongst pregnant women with GDM. Materials and methods: Observational retrospective review of singleton pregnant women with GDM evaluated in a diabetes and pregnancy clinic of a tertiary and academic hospital. From January/2011 to December/2017, 1,085 pregnant women underwent evaluation due to GDM, of which 665 had an HbA1c test in the third trimester. A logistic regression model was performed to evaluate predictors of LGA. A receiver-operating-characteristic (ROC) curve was used to evaluate the predictive ability of third trimester HbA1c for LGA identification. Results: A total of 1,085 singleton pregnant women were evaluated during the study period, with a mean age of 32.9 ± 5.3 years. In the multivariate analysis, OGTT at 0 minutes (OR: 1.040; CI 95% 1.006-1.076, p = 0.022) and third trimester HbA1c (OR: 4.680; CI 95% 1.210-18.107, p = 0.025) were associated with LGA newborns. Using a ROC curve to evaluate the predictive ability of third trimester HbA1c for LGA identification, the optimal HbA1c cut-off point was 5.4% where the sensitivity was 77.4% and the specificity was 71.7% (AUC 0.782; p < 0.001). Conclusions: Few studies in the Mediterranean population have evaluated the role of HbA1c in predicting neonatal complications in women with GDM. A third trimester HbA1c > 5.4% was found to have good sensitivity and specificity for identifying the risk of LGA.

Abstract Objective: To explore triceps skinfold (TSF) compressibility and its associated factors among hospitalized patients. Methods: A cross-sectional study was conducted among hospitalized adult patients. Evolution of tissue compressibility during two seconds was registered and 120 TSF values were obtained using a digital calliper. Compressibility was determined according to the difference between the initial value and the final value (TSF difference) and according to time (τ). Multivariable linear regression models were performed in order to identify factors associated with TSF compressibility. Results: One hundred and six patients (30.2% aged ≥ 65 years) composed the study sample. Compressibility based on TSF difference was independently associated with TSF thickness (regression coefficient, 95% confidence interval [CI] = 0.38, 0.01-0.05, p = 0.002) and nutritional risk (regression coefficient, 95% CI = 0.23, 0.12-1.23, p = 0.018), but time of compressibility (τ) was not significantly associated with any of the studied variables. Conclusions: Among a sample of hospitalized patients, undernutrition risk and higher TSF thickness were factors independently associated with higher compressibility assessed by the difference between the initial and fi nal TSF value. Time of compressibility (τ) was not affected by any of the studied factors.

Resumen Objetivo: explorar la compresibilidad del pliegue cutáneo del tríceps (PCT) y sus factores asociados entre los pacientes hospitalizados. Métodos: se realizó un estudio transversal en pacientes adultos hospitalizados. Se registró la evolución de la compresibilidad del tejido durante dos segundos y se obtuvieron 120 valores del PCT utilizando un calibrador digital. La compresibilidad se determinó según la diferencia entre el valor inicial y el valor final (diferencia PCT) y según el tiempo (τ). Se realizaron modelos de regresión lineal múltiple con el fin de identificar los factores asociados con la compresibilidad del PCT. Resultados: ciento seis pacientes (30,2% ≥ 65 años) compusieron la muestra del estudio. La compresibilidad basada en la diferencia de PCT se asoció independientemente con el espesor del PCT (coeficiente de regresión, intervalo de confianza 95% [IC] = 0,38, 0,01-0,05, p = 0,002) y el riesgo nutricional (coeficiente de regresión, IC del 95% = 0,23, 0,12-1,23, p = 0,018), pero el tiempo de compresibilidad (τ) no se asoció significativamente con ninguna de las variables estudiadas. Conclusiones: entre una muestra de pacientes hospitalizados, el riesgo de desnutrición y el mayor espesor del PCT fueron factores asociados independientemente con una mayor compresibilidad evaluada por la diferencia entre el valor inicial y final del PCT. El tiempo de compresibilidad (τ) no se vio afectado por ninguno de los factores estudiados.ciated with higher compressibility assessed by the difference between the initial and final TSF value. Time of compressibility (τ) was not affected by any of the studied factors.

As doenças cardiovasculares são a principal causa de morte, por doenças não transmissíveis, matando mais que os tumores e as doenças respiratórias crónicas. Tratando-se de uma doença tão relevante, que em Portugal é responsável por 37% das mortes anuais, existe um conjunto de medidas criadas para intervir sobre os principais factores de risco: a tensão arterial elevada, a obesidade, a hiperglicemia e a hiperlipidemia. Algumas destas medidas focam-se na mudança do estilo de vida, nomeadamente na alteração de certos hábitos alimentares como o consumo de carne, especialmente, de carne vermelha. Este alimento é considerado uma fonte de ácidos gordos saturados e colesterol, componentes que intervêm na aterogénese, uma doença que contribui para as doenças cardiovasculares. No entanto, o perfil de saturação dos ácidos gordos da carne vermelha varia de acordo com um conjunto de factores extrínsecos e intrínsecos ao animal que a originou. A análise da literatura mais recente revela duas conclusões opostas: uma meta-análise conclui que não há associação entre o consumo de carne vermelha e a mortalidade por doenças cardiovasculares, enquanto que dois estudos coorte prospectivos concluem que existe uma associação positiva. Quanto à relação entre os ácidos gordos e o risco de doenças cardiovasculares há estudos que afirmam não existir uma associação entre o consumo de ácidos gordos saturados e as doenças cardiovasculares. Os ácidos gordos monoinsaturados também não estão associados com as doenças cardiovasculares, estando apenas os ácidos gordos polinsaturados associados à redução do risco de doenças cardiovasculares.

Cardiovascular diseases are the leading cause of death for non-communicable diseases, killing more than tumors and chronic respiratory diseases. Having such impact, and being responsible for 37% of Portuguese deaths annually, there are a set of measures designed to intervene on the main risk factors: high blood pressure, obesity, hyperglycemia and hyperlipidemia. Some of these measures focus on changing lifestyle, particularly in changing food habits and consumption of meat, especially red meat. This food is considered a source of saturated fatty acids and cholesterol, components involved in atherogenesis, a disease which contribute to cardiovascular diseases. However, the saturation profile of red meat’s fatty acids changes according to a set of extrinsic and intrinsic factors related to the animal. The analysis of recent literature reveals two opposite conclusions: a meta-analysis concludes that there is no association between red meat consumption and mortality from cardiovascular diseases, while two prospective cohorts conclude that there is a positive association. As for the relationship between fatty acids and cardiovascular diseases risk, there are studies concluding that there is no association between the consumption of source of saturated fatty acids and cardiovascular diseases. Also monounsaturated fatty acids are not associated with cardiovascular disease being polyunsaturated fatty acids the ones associated with the reduction of such risk.