Abstract Background The angiotensin-converting enzyme (ACE) insertion/deletion (I/D) polymorphism (rs4340) is associated with the pathogenesis of heart failure (HF). This polymorphism may contribute to a greater propensity for severe HF and excess weight. Objective To evaluate adiposity, cardiac function, and their association with ACE I/D polymorphism in HF patients. Methods Cross-sectional study with ambulatory individuals ≥18 years diagnosed with HF. Genetic analysis was performed using polymerase chain reaction followed by agarose gel electrophoresis. Left ventricular ejection fraction (LVEF) was determined by echocardiography. Nutritional status was assessed using body mass index, while adiposity was analyzed using bioelectrical impedance analysis (BIA), waist circumference, waist-to-hip ratio, and waist-to-height ratio. The adopted significance level was 5% (p < 0.05). Results Seventy-one individuals were included, with a mean age of 55.8 ± 13.0 years, predominantly male (66.2%), with functional class I and II (90.9%), and a median LVEF of 30% (24-40). The prevalence of overweight was 38%, class I obesity was 23.9%, and class II and III obesity was 12.7%, with 50.7% exhibiting excess adiposity as assessed by BIA. A total of 88 D alleles and 54 I alleles of the ACE gene were identified. Regarding ACE genotypes, 38.1% were DD, 47.8% were ID, and 14.1% were II. In the multivariate analysis, the D allele (DD + ID genotypes versus II) was associated with LVEF (PR 0.995; 95% CI 0.991–1.000; p = 0.048) and with the etiology of HF (dilated cardiomyopathy: PR 1.283; 95% CI 1.039–1.583; p = 0.021). No independent association was found with adiposity. Conclusion The presence of the D allele of the ACE polymorphism is associated with LVEF and HF etiology. Despite overweight being prevalent in the sample, no independent associations were found.

Resumo Fundamento O polimorfismo de Inserção/Deleção (I/D) da enzima conversora de angiotensina (ECA) (rs4340) está associado à patogênese da insuficiência cardíaca (IC). Esse polimorfismo pode contribuir para uma maior propensão à IC grave e ao excesso de peso. Objetivo Avaliar a adiposidade, a função cardíaca e sua associação com o polimorfismo I/D da ECA em pacientes com IC. Métodos Estudo transversal com indivíduos ambulatoriais com idade ≥18 anos diagnosticados com IC. A análise genética foi realizada por reação em cadeia da polimerase seguida de eletroforese em gel de agarose. A fração de ejeção do ventrículo esquerdo (FEVE) foi determinada por ecocardiografia. O estado nutricional foi avaliado pelo índice de massa corporal, enquanto a adiposidade foi avaliada pela análise de Bioimpedância elétrica (BIA), circunferência da cintura, razão cintura-quadril e razão cintura-estatura. O nível de significância adotado foi de 5% (p < 0,05). Resultados Setenta e um indivíduos foram incluídos, com média de idade de 55,8 ± 13,0 anos, predominantemente do sexo masculino (66,2%), com classe funcional I e II (90,9%) e FEVE mediana de 30% (24-40). A prevalência de sobrepeso foi de 38%, obesidade classe I foi de 23,9% e obesidade classe II e III foi de 12,7%, com 50,7% apresentando excesso de adiposidade conforme avaliado pela BIA. Um total de 88 alelos D e 54 alelos I do gene da ECA foram identificados. Em relação aos genótipos da ECA, 38,1% eram DD, 47,8% eram ID e 14,1% eram II. Na análise multivariada, o alelo D (genótipos DD+ID versus II) foi associado à FEVE (RP de 0,995; IC de 95% 0,991–1,000; p = 0,048) e à etiologia da IC (cardiomiopatia dilatada: RP 1,283; IC de 95% 1,039–1,583; p = 0,021). Nenhuma associação independente foi encontrada com a adiposidade. Conclusão A presença do alelo D do polimorfismo da ECA está associada à FEVE e à etiologia da IC. Apesar da prevalência do sobrepeso na amostra, não foram encontradas associações independentes.

Abstract Background Acute coronary syndrome (ACS) is one of the leading causes of mortality worldwide. Knowing the predisposing factors is essential for preventing it. Objectives To describe the etiological and epidemiological characteristics of the population with ACS admitted to an emergency room in the State of São Paulo. Methods The prospective cohort study, based on electronic medical records from a public cardiology institute located in the state of São Paulo, Brazil, describes 5,580 patients hospitalized with ACS between August 2018 and October 2022. The main epidemiological characteristics, the association between confirmed ACS and risk scores, and adverse events during hospitalization and in the 30-day follow-up after hospital discharge were evaluated. The significance level was set at 5%. Results The main factors associated with ACS were hypertension (80.38%), obesity or overweight (72.47%), and previous coronary artery disease (CAD) (59.11%). In the GRACE score, 65.10% were considered low risk, while 81.34% in the TIMI and 71.16% in the HEART were identified as moderate risk. Catheterization represented 84.93% of the diagnostic methods. Clinical treatment was the strategy adopted in 46.47% of the cases. In the 30-day evolution, 3.10% presented major bleeding, 7.86% infarction/reinfarction, 5.55% stroke, and 2.53% evolved to death. Conclusion The results of the largest Brazilian ACS registry to date highlight the impact of potentially modifiable risk factors on the occurrence of ischemic events in the local population. The findings may contribute to the development of public policies aimed at preventing and controlling the burden of ischemic disease in the country.

Resumo Fundamentos A síndrome coronariana aguda (SCA) é uma das principais causas de mortalidade no mundo. Conhecer os fatores predisponentes é essencial para a prevenção desta. Objetivos Descrever as características etiológicas e epidemiológicas da população com SCA admitida em um pronto-socorro do Estado de São Paulo. Métodos A coorte prospectiva realizada com base nos registros de prontuário eletrônico de um instituto cardiológico público localizado no Estado de São Paulo descreve 5.580 pacientes internados com SCA entre agosto de 2018 e outubro de 2022. Avaliou-se as principais características epidemiológicas, a associação entre confirmação de SCA e escores de risco, eventos adversos durante o internamento e no seguimento de 30 dias após a alta hospitalar. O nível de significância foi de 5%. Resultados Os principais fatores associados a SCA foram hipertensão (80,38%), obesidade ou sobrepeso (72,47%) e doença arterial coronariana prévia (59,11%). No escore Grace, 65,10% foram considerados de baixo risco, enquanto 81,34% no TIMI e 71,16% no HEART foram identificados como risco moderado. O cateterismo representou 84,93% dos métodos diagnósticos. O tratamento clínico foi a estratégia adotada em 46,47% dos casos. Na evolução em 30 dias, 3,10% apresentaram sangramento maior, 7,86% infarto/reinfarto, 5,55% acidente vascular encefálico e 2,53% evoluíram para óbito. Conclusão Os resultados do maior registro de SCA brasileiro até o momento evidenciam o impacto dos fatores de risco potencialmente modificáveis na ocorrência de eventos isquêmicos na população local. Os achados podem contribuir para o desenvolvimento de políticas públicas visando a prevenção e controle da carga da doença isquêmica no país.

RESUMO Objetivo: Investigar a presença de doença hepática gordurosa associada à disfunção metabólica (MAFLD) e anormalidades da vesícula biliar em uma amostra de pessoas com síndrome de Down no Brasil. Métodos: Trata-se de um estudo retrospectivo, utilizando prontuários médicos, envolvendo pacientes com síndrome de Down, diagnosticados por cariótipo, com idade superior a 5 anos, que realizaram ultrassonografia abdominal e foram acompanhados pelo mesmo profissional em um consultório em Curitiba, Brasil. Os dados abrangeram o período de janeiro de 1995 a setembro de 2023; todos os casos sem uso de álcool ou medicamentos hepatotóxicos. Resultados: Foram avaliados 124 pacientes, sendo 64 (51,6%) do sexo feminino. As idades variaram entre 5 e 30 anos (média de 13,2±5,7 anos). O índice de massa corporal variou de 14,08 a 44,98 kg/m2, sendo que 27 (21,7%) pacientes estavam com sobrepeso e 42 (33,8%) com obesidade. A frequência de concentrações aumentadas de colesterol total e triglicerídeos foi significativamente maior em crianças. Não foram observadas diferenças de idade ou sexo nas concentrações de colesterol de lipoproteína de baixa e alta densidades. Os níveis de aspartato transferase (AST) e alanina transferase (ALT) estavam normais e não apresentaram diferenças em relação ao sexo ou idade. Quatro pacientes (3,2%) tiveram diagnóstico de MAFLD. A prevalência de cálculo biliar variou amplamente em termos de número e tamanho dos cálculos entre os pacientes, afetando 11 (8,9%) deles, sem diferença significativa em idade ou sexo. Conclusões: MAFLD foi encontrada em 3,2% dos indivíduos, enquanto cálculo biliar foi identificado em 8,9% dos casos estudados. Além disso, notamos uma presença significativa de fatores de risco associados à MAFLD, com dislipidemia sendo o fator predominante.

ABSTRACT Objective: To investigate the presence of metabolic dysfunction-associated fatty liver disease (MAFLD) and gallbladder abnormalities in a sample of people with Down syndrome in Brazil. Methods: This is a retrospective study using medical charts involving Down syndrome patients, diagnosed by karyotype, aged over 5 years, who underwent abdominal ultrasound and were monitored by the same professional in a clinic in Curitiba, Brazil. Data spanned January 1995 to September 2023; all cases with no use of alcohol or hepatotoxic medications. Results: A total of 124 patients were evaluated, 64 (51.6%) being females. Ages varied between 5 and 30 years (average of 13.2±5.7 years). Body mass index ranged from 14.08 to 44.98 kg/m2, with 27 (21.7%) patients being overweight and 42 (33.8%) obese. The frequency of increased total cholesterol and triglyceride concentrations was significantly higher in children. No age or sex differences were seen in low- and high-density lipoprotein cholesterol. Alanine transferase (ALT) and aspartate transferase (AST) levels were within normal ranges and showed no differences concerning sex or age. Four patients (3.2%) had diagnosis of MAFLD. The prevalence of gallstone varied widely in terms of the number and size of stones among patients, affecting 11 (8.9%) of them, with no significant difference in age or sex. Conclusions: MAFLD was found in 3.2% of the individuals, while gallstone disease was identified in 8.9% of the cases studied. Moreover, we noted a significant presence of risk factors associated with MAFLD, with dyslipidemia being the predominant factor.

Resumo Objetivou-se identificar os padrões alimentares e sua associação com características socioeconômicas, demográficas, de estilo de vida e excesso de peso em adultos da Região Metropolitana do Recife, em 2015/16 e 2019. Estudo transversal com indivíduos de ambos os sexos, com idades entre 20 e 59 anos. Os padrões alimentares (PA) foram identificados por meio da análise de componentes principais (ACP). A regressão logística binária foi utilizada para estimar as razões de chances bruta e ajustada e intervalos de confiança 95% (IC95%). Foram identificados três PA: Duplo, Ultraprocessado (UP) e Tradicional. Observou-se que o PA Duplo explicou a maior variância em 2015/16 (15,4%), enquanto em 2019 foi o PA UP (15,1%). Em 2015/16, o PA Duplo associou-se à idade ≥41 anos, maior escolaridade e segurança alimentar (SA); já em 2019, associou-se a maior escolaridade, SA e excesso de peso. O PA UP relacionou-se às faixas etárias de 20-29 anos e 30-40 anos em 2015/16, sem associações em 2019. O PA Tradicional associou-se à prática de atividade física em 2015/16 e, em 2019, a residir com ≥5 pessoas no domicílio, menor escolaridade e excesso de peso. Os padrões alimentares em 2019 mostraram uma maior associação com os determinantes sociais, indicando maior influência desses fatores na alimentação.

Resumen El objetivo fue identificar patrones alimentarios y su asociación con características socioeconómicas, demográficas, de estilo de vida y de sobrepeso en adultos de la Región Metropolitana de Recife, en 2015/16 y 2019. Estudio transversal con individuos de ambos sexos, con edades entre 20 y 59 años. años. Los patrones dietéticos (PD) se identificaron mediante análisis de componentes principales (ACP). Se utilizó regresión logística binaria para estimar los odds ratios crudos y ajustados y los intervalos de confianza del 95% (IC95%). Se identificaron tres PDs: Doble, Ultraprocesado (UP) y Tradicional. Se observó que el Doble PD explicó la mayor variación en 2015/16 (15,4%), mientras que en 2019 fue el PD UP (15,1%). En 2015/16, el Doble PD se asoció con edad ≥41 años, educación superior y seguridad alimentaria (SA); en 2019, se asoció con estudios superiores, SA y sobrepeso. El PD UP se relacionó con los grupos etarios de 20-29 años y 30-40 años en 2015/16, sin asociaciones en 2019. El PD Tradicional se asoció con la práctica de actividad física en 2015/16 y, en 2019, con la vida con ≥5 personas en el hogar, menor nivel educativo y sobrepeso. Los patrones dietéticos en 2019 mostraron una mayor asociación con los determinantes sociales, lo que indica una mayor influencia de estos factores en la dieta.

Abstract The aim of this study was to identify dietary patterns (DP) and their association with socioeconomic, demographic, lifestyle, and overweight characteristics in adults from the Metropolitan Region of Recife (MRR) in 2015/16 and 2019. A cross-sectional study was conducted with individuals of both sexes, aged 20 to 59 years. DPs were identified using Principal Component Analysis (PCA). Binary logistic regression was used to estimate crude and adjusted odds ratios and 95% confidence intervals (95%CI). Three DPs were identified: Dual, Ultra-processed (UP), and Traditional. The Dual DP explained the highest variance in 2015/16 (15.4%), while in 2019, it was the UP DP (15.1%). In 2015/16, the Dual DP was related to the age groups of 20-29 years and 30-40 years, with no associations in 2019. The Traditional DP was associated with physical activity in 2015/16 and, in 2019, with living with ≥5 people in the household, lower education, and overweight. The dietary patterns in 2019 showed a stronger association with social determinants, indicating a greater influence of these factors on eating habits.

Resumo Objetivou-se avaliar a Linha de Cuidado à pessoa com sobrepeso e obesidade em municípios paraibanos. Estudo de caso de abordagem qualitativa, englobando quatro municípios-sede de macrorregiões de saúde. Realizaram-se entrevistas semiestruturadas com 19 participantes, envolvendo gestores, gerentes e profissionais de saúde vinculados à atenção primária e/ou serviços especializados, de novembro de 2020 a abril de 2021. Análise de conteúdo temática foi utilizada para analisar o material obtido. Elaboraram-se três categorias temáticas: “Linha de Cuidado à pessoa com sobrepeso e obesidade: sobre conceitos e abordagens”; “Da gestão à assistência: entraves e dificuldades identificadas na Linha de Cuidado”; “Perspectivas para a Linha de Cuidado à pessoa com sobrepeso e obesidade”. Os resultados revelam que, embora os participantes apontem preceitos teórico-conceituais, preconizados para o adequado funcionamento da Linha de Cuidado, sua operacionalização se apresenta incipiente e fragmentada. Identificaram-se problemas ligados à infraestrutura, falta de equipamentos essenciais, dificuldade na realização exames complementares e inexistência de protocolos regionais e de política institucional entre os serviços. Conclui-se que as barreiras relacionadas à oferta de cuidado no âmbito da Linha de Cuidado à pessoa com sobrepeso e obesidade reforçam a necessidade de revisão do processo de trabalho e maior qualificação das equipes de saúde.

Abstract This study aimed to evaluate the Care Line for overweight and obese people in municipalities in Paraíba. This is a qualitative case study, encompassing four municipalities that are headquarters of health macro-regions. Semi-structured interviews were conducted with 19 participants, involving managers, administrators and health professionals linked to primary care and/or specialized services, from November 2020 to April 2021. Thematic content analysis was used to analyze the material obtained. Three thematic categories were developed: “Care Line for overweight and obese people: on concepts and approaches”; “From management to assistance: obstacles and difficulties identified in the Care Line”; “Perspectives for the Care Line for overweight and obese people”. The results reveal that, although the participants point out theoretical-conceptual precepts, recommended for the adequate functioning of the Care Line, its operationalization is incipient and fragmented. Problems related to infrastructure, lack of essential equipment, difficulty in performing additional tests and lack of regional protocols and institutional policies between services were identified. It is concluded that the barriers related to the provision of care within the scope of the Care Line for people with overweight and obesity reinforce the need to review the work process and improve the qualification of health teams.

Resumen Objetivo: La imagen corporal es un factor predictivo de la salud psicológica, física y social. Por lo tanto, puede ser un indicador para detectar problemas de salud, para utilizar en el contexto de la educación superior. El objetivo de este estudio fue evaluar la satisfacción con la imagen corporal en estudiantes de enseñanza superior y determinar si la insatisfacción con la imagen corporal está relacionada con los comportamientos de estilo de vida y la satisfacción con la vida. Metodología: En este estudio participaron 166 estudiantes portugueses de enseñanza superior. La imagen corporal se evaluó mediante la escala Figure Rating Scale. Las elecciones activas durante la vida cotidiana se evaluaron mediante el Active Choice Index. El cuestionario también incluía preguntas sobre el comportamiento durante el sueño y el consumo de tabaco y alcohol. La satisfacción con la vida se evaluó mediante una escala de cinco ítems previamente adaptada a la población portuguesa. Resultados: Predominaron los chicos insatisfechos por delgadez (26.10%), mientras que la mayoría de las chicas revelaron estar insatisfechas por sobrepeso (55.70%). Los resultados indican diferencias estadísticamente significativas entre chicos y chicas en cuanto a las categorías de imagen corporal (p<0.001). Sin embargo, al analizar los comportamientos por separado en función del sexo, no se observaron diferencias. Las conductas activas, así como las demás conductas de salud analizadas (horas de sueño semanales y consumo de alcohol y tabaco) no difirieron entre los distintos niveles de satisfacción con la imagen corporal (p>0.05). Conclusiones: La mayoría de los estudiantes están insatisfechos con su imagen corporal, siendo mayoritaria la insatisfacción de las chicas por sobrepeso. Los estilos de vida y la satisfacción vital no difieren entre los alumnos satisfechos y los insatisfechos con su imagen corporal.

Abstract Objective: Body image is a predictor of physical, psychological, and social health. Therefore, it can be an indicator for detecting health problems, to be used in the context of higher education. The aim of this study was to assess body image satisfaction in higher education students and to determine whether body image dissatisfaction is related to lifestyle behaviours and life satisfaction. Methodology: This study included 166 Portuguese higher education students. Body image was assessed using the Figure Rating Scale. Active choices during everyday life were assessed using the Active Choice Index. The questionnaire also included questions about sleep behaviour and tobacco and alcohol consumption. Satisfaction with Life was assessed using a five-item scale previously adapted for the Portuguese population. Results: There was a predominance of boys dissatisfied with thinness (26.10%), while the majority of girls revealed that they were dissatisfied due to being overweight (55.70%). The results indicate statistically significant differences between boys and girls in terms of body image categories (p<0.001). However, when we analysed the behaviours separately according to gender, there were no differences. Active behaviours, as well as the other health behaviours analysed (hours of sleep per week and alcohol and tobacco consumption) did not differ between the different levels of body image satisfaction (p>0.05). Conclusion: Most of the students are dissatisfied with their body image, with the majority of girls showing dissatisfaction due to being overweight. Lifestyles and life satisfaction do not differ between students who are satisfied and those who are dissatisfied with their body image.

RESUMEN Introducción: Existe un importante aumento de niños y adolescentes con sobrepeso y obesidad, los cuales son considerados como los principales factores de riesgo para desarrollar la hipertensión arterial Objetivo: Determinar la frecuencia y factores de riesgo asociados a la hipertensión arterial sistémica en una población de 10 a 18 años de un Centro Educativo del Departamento Central en el año 2023. Materiales y Métodos: El presente trabajo se basó en un diseño observacional, analítico y de corte transversal. Por medio de un muestreo no probabilístico a conveniencia, de una población N=1230 estudiantes matriculados en los turnos mañana y tarde de la institución tomada como población de estudio, n=446 cumplan con criterios de inclusión. Resultados: La mediana de a edad fue 14 años con P25 12 y p75 15. El 62% fue del sexo femenino. En cuanto al estado nutricional de la población de estudio el 46.4 eran normo pesos, 37.7% tenían sobrepeso y el 15.9% obesidad. La mediana de la presión arterial de toda la población sistólica fue 116 P25-75 (67-78), y la diastólica 73 P25-75 (67-78). Se obtuvo que el 10% de los pacientes presentaban HTA. En cuanto a la asociación entre el estado nutricional en los grupos con y sin HTA, en el primer grupo el 95.7% eran obesos frente al 6.8% en el grupo de sin HTA p=0.0001. Conclusión: La frecuencia de hipertensión arterial encontrada en este estudio fue de 10%, con predominio del sexo femenino y edad mediana de 14 años. El 15.9 % eran obesos y la hipertensión arterial estuvo asociada a esa condición nutricional.

ABSTRACT Introduction: There is a significant increase in overweight and obese children and adolescents, these conditions are risk factors for developing arterial hypertension. Objective: To determine the frequency and risk factors associated with systemic arterial hypertension in a population aged 10 to 18 years of an Educational Center in the Central Department in 2023. Materials and Methods: The study design was observational, analytical and cross-sectional. Using non-probabilistic convenience sampling, from a population N=1230 students, we enrolled subjects from the morning and afternoon shifts of the institution. 446 met the inclusion criteria. Results: The median age was 14 years with P25 12 and p75 15. 62% were female. Regarding the nutritional status of the study population, 46.4 were of normal weight, 37.7% were overweight and 15.9% obese. The median blood pressure of the entire population was a systolic of 116 P25-75 (67-78), and a diastolic of 73 P25-75 (67-78). It was found that 10% of the patients had hypertension. Regarding the association between nutritional status in the groups with and without hypertension, in the first group, 95.7% were obese versus 6.8% in the group without hypertension, p=0.0001. Conclusion: The frequency of arterial hypertension found in this study was 10%, with a predominance of the female sex and a median age of 14 years. 15.9% were obese and high blood pressure was associated with this nutritional condition.

RESUMEN Introducción: el índice de masa corporal y el perímetro abdominal son medidas antropométricas que podrían ser concordantes en la población peruana para el cribado de sobrepeso u obesidad. Objetivo: analizar la correlación y concordancia entre las pruebas de índice de masa corporal y perímetro abdominal para la detección de sobrepeso u obesidad en adultos peruanos. Metodología: estudio observacional, analítico y transversal basado en datos de la encuesta nacional demográfica de salud familiar. La población fue de 28960 adultos. Las variables fueron: índice de masa corporal y perímetro abdominal. Se utilizó la prueba V de Cramer, t de student, correlación de Spearman y kappa de Cohen. Resultados: hubo una asociación fuerte entre índice de masa corporal y perímetro abdominal en mujeres (V=0,701), moderada en hombres (V=0,632). En la prueba kappa de Cohen, ambas variables concordaron sustancialmente en mujeres (kappa=0,677) y moderadamente en hombres (kappa=0,580). Mediante el Odds Ratio, las mujeres con índice de masa corporal elevado tuvieron una probabilidad 97,22 veces mayor de perímetro abdominal elevado, mientras que en hombres con índice de masa corporal elevado fue 110,76 veces mayor. La correlación de Spearman fue muy alta y positiva en ambos sexos Conclusiones: el perímetro abdominal y el índice de masa corporal están asociados y correlacionados significativamente en adultos peruanos, presentaron una concordancia sustancial en mujeres y moderada en hombres. Se sugiere priorizar el uso del perímetro abdominal, debido a que distingue sobrepeso u obesidad según sexo, optimizándolo mediante la determinación de un punto de corte ajustado a la población peruana.

ABSTRACT Introduction: body mass index and abdominal perimeter are anthropometric measurements that could be concordant in the Peruvian population for screening for overweight or obesity. Objective: to analyze the correlation and agreement between body mass index and abdominal circumference tests for the detection of overweight or obesity in Peruvian adults. Methodology: observational, analytical and cross-sectional study based on data from the national demographic family health survey. The population was 28,960 adults. The variables were: body mass index and abdominal perimeter. Cramer's V test, student's t, Spearman's correlation and Cohen's kappa were used. Results: there was a strong association between body mass index and abdominal perimeter in women (V=0.701), moderate in men (V=0.632). In Cohen's kappa test, both variables agreed substantially in women (kappa=0.677) and moderately in men (kappa=0.580). Using the Odds Ratio, women with a high body mass index had a 97.22 times greater probability of having a high abdominal circumference, while in men with a high body mass index it was 110.76 times greater. The Spearman correlation was very high and positive in both sexes. Conclusions: abdominal circumference and body mass index are significantly associated and correlated in Peruvian adults; they presented substantial agreement in women and moderate agreement in men. It is suggested to prioritize the use of the abdominal perimeter, because it distinguishes overweight or obesity according to sex, optimizing it by determining a cut-off point adjusted to the Peruvian population.

RESUMEN Introducción: La diabetes mellitus tipo 2 (DM2) es un problema de salud pública creciente, frecuentemente asociada con sobrepeso y obesidad. El índice de masa corporal (IMC) y la hemoglobina glicosilada (HbA1c) son indicadores clave en el manejo de la DM2. Objetivo: Correlacionar el IMC y la HbA1c en pacientes con DM2 atendidos en el Hospital Distrital de Capiatá, Paraguay, en diciembre de 2022. Materiales y métodos: Estudio correlacional con datos secundarios de 38 pacientes DM2. Se recolectaron datos demográficos, clínicos, antropométricos y bioquímicos. Se utilizó la correlación de Pearson para determinar la correlación entre IMC y HbA1c, con un nivel de significancia de p<0,05. El protocolo de investigación fue aprobado por el Comité de Ética en Investigaciones de la FCQ-UNA (CEI913/2022). Resultados: El 65,8% fueron mujeres, con edad promedio de 55,8±5,2 años. El 86,8% presentó exceso de peso. La glucemia en ayunas promedio fue 245,0±57,0mg/dL y la HbA1c 8,8±3,4%. Se observó una tendencia al aumento de los niveles de HbA1c con el incremento del IMC. Los pacientes con peso normal presentaron una HbA1c promedio de 6,8±1,5% (buen control), mientras que aquellos con sobrepeso y obesidad mostraron valores de 8,6±2,7% (mal control) y 11,2±3,0% (control crítico), respectivamente. Estas diferencias resultaron estadísticamente significativas (p<0,01). Se observó una correlación fuerte y significativa entre IMC y HbA1c (r=0,681, p<0,01). Conclusión: Existe una correlación directamente proporcional entre el IMC y el control glucémico en pacientes con DM2. Estos hallazgos resaltan la importancia del control del peso en el manejo de la DM2.

ABSTRACT Introduction: Type 2 diabetes mellitus (T2DM) is a growing public health problem, frequently associated with overweight and obesity. Body mass index (BMI) and glycated hemoglobin (HbA1c) are key indicators in the management of T2DM. Objective: To correlate BMI and HbA1c in patients with DM2 treated at the Capiatá District Hospital, Paraguay, in December 2022. Materials and methods: Correlational study with secondary data from 38 DM2 patients. Demographic, clinical, anthropometric and biochemical data were collected. Pearson's correlation was used to determine the correlation between BMI and HbA1c, with a significance level of p<0.05. The research protocol was approved by the Research Ethics Committee of the FCQ-UNA (CEI913/2022). Results: 65.8% were women, with an average age of 55.8±5.2 years. 86.8% were overweight. The average fasting blood glucose was 245.0±57.0mg/dL and the HbA1c was 8.8±3.4%. A tendency to increase HbA1c levels with increasing BMI was observed. Patients with normal weight had an average HbA1c of 6.8±1.5% (good control), while those with overweight and obesity showed values of 8.6±2.7% (poor control) and 11.2± 3.0% (critical control), respectively. These differences were statistically significant (p<0.01). A strong and significant correlation was observed between BMI and HbA1c (r=0.681, p<0.01). Conclusion: There is a directly proportional correlation between BMI and glycemic control in patients with DM2. These findings highlight the importance of weight control in the management of T2DM.

Resumen La transición nutricional genera gran impacto en la salud de las personas, especialmente en los países más pobres. La globalización, la industrialización y otros factores socioambientales han cambiado las dietas y los patrones alimentarios, lo que ha conllevado a un aumento en las enfermedades crónicas y de malnutrición en poblaciones vulnerables como las comunidades indígenas, afectando principalmente a los niños. El objetivo de esta investigación es analizar la alimentación actual y su impacto en el estado nutricional de los niños menores de cinco años pertenecientes a las comunidades Embera Katio del resguardo indígena Gito Dokabú. Se evaluó el estado nutricional de estos menores utilizando los índices antropométricos de peso para la talla según los estándares de la Organización Mundial de la Salud [OMS] (2006). Se indagó, a través de entrevistas semiestructuradas realizadas a los padres de los menores, sobre la frecuencia de consumo de los diferentes grupos de alimentos según las Guías Alimentarias colombianas. La investigación contó con la aprobación del Comité de Ética de la Universidad de Caldas y el consentimiento de los padres. Como resultado, se observó una baja prevalencia de desnutrición (1,74%) pero un alto riesgo de sobrepeso (21%). Se destaca el alto consumo de alimentos del grupo 1 (arroz, plátano y maíz) y la baja ingesta de alimentos del grupo 2 (frutas y verduras). La introducción de alimentos exógenos y el cambio en las preferencias hacia alimentos menos saludables son factores que afectan la alimentación de las comunidades indígenas del resguardo Gito Dokabú. Rev Arg Antrop Biol 26(2), 087, 2024. https://doi.org/10.24215/18536387e087

Abstract The nutritional transition has a significant impact on people's health, especially in the poorest countries. Globalization, industrialization, and other socio-environmental factors have changed diets and eating patterns, leading to an increase in chronic diseases and malnutrition in vulnerable populations, such as indigenous communities, with children being the most affected. The objective of this research is to analyze the current diet and its impact on the nutritional status of children under five years of age belonging to the Embera Katío communities of the Gito Dokabú indigenous reservation. The nutritional status of these children was evaluated using anthropometric indices of weight for height according to the standards of the World Health Organization [WHO] (2006). The frequency of consumption of the different food groups determined by Colombian Dietary Guidelines was investigated through semi-structured interviews with the parents of the minors. The research had the approval of the Ethics Committee of the University of Caldas and the consent of the parents. As a result, a low prevalence of malnutrition (1.74%) but a high risk of being overweight (21%) was observed. A high consumption of foods from group 1 (rice, plantain, and corn) and the low intake of foods from group 2 (fruits and vegetables) is observed. The introduction of exogenous foods and the change in preferences towards less healthy foods are factors that affect the diet of the indigenous communities of the Gito Dokabú reservation. Rev Arg Antrop Biol 26(2), 087, 2024. https://doi.org/10.24215/18536387e087

RESUMEN Introducción: En reportes anteriores de nuestro grupo de trabajo se demostró que la población originaria de Quilmes (Tucumán) presenta un alto índice de sobrepeso y obesidad y un régimen alimentario occidentalizado. Para evaluar si estas características son compartidas por otras comunidades originarias de los Valles calchaquíes se llevó a cabo el Programa SONQO-CALCHAQUÍ III (Edición 2023). Objetivo: Evaluar variables cardiovasculares en tres comunidades originarias de los Valles Calchaquíes y sus posibles diferencias. Material y métodos: Estudio descriptivo transversal en las comunidades de Cachi, Colalao del Valle y Fuerte Quemado. Se realizaron cuestionarios, electrocardiograma, ecocardiograma, determinaciones antropométricas, y pruebas de resistencia y fuerza muscular. Resultados: Se incluyeron 819 pobladores (Cachi: 292; Colalao del Valle: 251; Fuerte Quemado:276). La edad promedio fue 52,9±0,6 años. Alta proporción de pacientes no controlaba el estado de sus factores de riesgo cardiovascular. El 39,5% tenía sobrepeso y 28,1% obesidad. El 38,9% presentaba un perímetro de cintura normal. Un 9,5% presentaba placa aterosclerótica carotídea y 39,1% tenía la fuerza prensil disminuida. Según la escala de Edmonton la población se encontraba en rango no frágil. El Minimental test indicó deterioro cognitivo leve a moderado. En Colalao del Valle se detectó un mejor estado de salud, pero en Fuerte Quemado se evidenció una mejor calidad de sueño y autoestima. Conclusiones: No se observó una población homogénea, teniendo cada comunidad características diferenciadas. En general el estado físico es aceptable pero con un alto índice de sobrepeso y obesidad, independientemente de la comunidad donde viven, indicando una occidentalización de los hábitos alimenticios. Sin embargo existen factores locales con un rol protector cardiovascular que deben ser estudiados más a fondo en esta población.

ABSTRACT Background: Previous reports of our work group demonstrated that the native population of Quilmes (Tucumán) has a high rate of overweight and obesity and a Western pattern diet. The 2023 SONQO-CALCHAQUÍ III program was designed to evaluate whether these characteristics are shared by other native communities in the Calchaqui Valleys. Objective: The aim of this study was to evaluate the cardiovascular variables in three native communities of the Calchaqui Valleys and their possible differences. Methods: We conducted a cross-sectional study in the communities of Cachi, Colalao del Valle and Fuerte Quemado. The participants answered questionnaires and were evaluated with electrocardiogram, anthropometric determinations and endurance and muscular strength testing. Results: A total of 819 inhabitants were included (Cachi: 292; Colalao del Valle: 251; Fuerte Quemado: 276). Mean age was 52.9 ± 0.6 years. A high proportion of patients had not checked their cardiovascular risk factors; 39.5% were overweight, 28.1% were obese, 38.9% had normal waist circumference; 9.5% presented carotid atherosclerotic plaques and 39.1% had reduced hand grip strength. The Edmonton Scale revealed that the population was non-frail. The Mini-Mental test indicated mild to moderate cognitive impairment. Colalao del Valle had the best health status but residents of Fuerte Quemado had better sleep quality and self-esteem. Conclusions: The population is not homogeneous, and each community has its own characteristics. In general, physical fitness is acceptable, but the rate of overweight and obesity is high, regardless of the community in which they live, indicating a Western diet pattern. There are, however, local factors with a protective role in cardiovascular disease that should be further investigated in this population.

Resumen Objetivo: Analizar en forma multifactorial la diabetes mellitus (DM) con el consumo de las bebidas gaseosas azucaradas (BGA) y de las variables estado nutricional, sexo, predisposición genética, edad y etnia, para determinar la relación de las BGA y la DM en la comunidad Mazahua Otomí (MO). Diseño Metodológico: El estudio fue cuantitativo. Se diseñó, validó y aplicó una encuesta estructurada sobre variables sociales y nutricionales. Se elaboró un modelo logístico para encontrar la relación de DM con las variables: consumo de BGA, sexo, predisposición genética, edad, índice de masa corporal y etnia. Resultados: En la comunidad MO que se investigó un padre de familia promedio tiene un ingreso mensual por debajo de la línea de pobreza extrema y no existe control de la enfermedad de estudio: 68% tiene obesidad o sobrepeso y el consumo de BGA es entre medio y alto en 90% de la población. En forma multifactorial, hay probabilidad de manifestar la DM en función de las variables antes señaladas; mientras que, a excepción de estado nutricional y la edad, las demás son las más significativas. En gustos y preferencias, 52% opta por la marca de BGA Coca-Cola. Limitaciones de la investigación: Los resultados encontrados deberán complementarse con estudios de caso en comunidades con características similares y una muestra poblacional probabilística más amplia. Hallazgos: En la comunidad MO existe una relación entre el consumo de BGA y la DM y no hay control de la enfermedad. Este trabajo aporta al diseño de políticas públicas de prevención del daño a la salud por el consumo excesivo de BGA y su relación con la DM. De igual manera aquellas políticas públicas que rescaten y fomenten las buenas prácticas nutritivas entre las comunidades de los pueblos originarios.

Abstract Purpose: To analyze diabetes mellitus (DM) in a multifactorial manner with the consumption of sugar-sweetened beverages (SSB) and variables like nutritional status, sex, genetic predisposition, age and ethnicity; in order to determine the relationship between BGA and DM in the Mazahua Otomí (MO) community. Methodological design: This quantitative survey on social and nutritional variables was designed, validated and applied. A logistic model was developed to find the relationship of DM in relation to the variables: SSB consumption, sex, genetic predisposition, age, body mass index and ethnicity. Results: The Mazahua otomi community has a monthly family income below the extreme poverty line; they do not have disease control: 68% are obese or overweight and SSB consumption is medium to high in 90% of the population. In a multifactorial manner and according to the model, there is a probability of manifesting DM depending on the variables mentioned above; while, with the exception of nutritional status and age, the others are the most significant. In taste and preferences, 52% opt for the Coca-Cola SSB brand. Research limitations: The results found should be complemented in other case studies in communities with similar characteristics and a broader probabilistic population sample. Finding: In the MO community there is a relationship between BGA consumption and DM and there is no control of the disease. This work contributes to the design of public policies to prevent health damage because of excessive consumption of SSB and its relationship with DM; likewise, those policies that rescue and promote good nutritional practices of the communities of indigenous peoples.

Resumo Introdução: A doença renal crônica (DRC) e a síndrome metabólica (SM) são reconhecidas como problemas de saúde pública relacionados ao excesso de peso e a fatores cardiometabólicos. O objetivo deste estudo foi desenvolver um modelo para prever a SM em pessoas com DRC. Métodos: Este foi um estudo transversal prospectivo de pacientes de um centro de referência em São Luís, MA, Brasil. A amostra incluiu voluntários adultos classificados de acordo com a presença de DRC leve ou grave. Para o rastreamento da SM, o algoritmo de classificação k-nearest neighbors (KNN) foi utilizado com os seguintes dados: sexo, tabagismo, circunferência do pescoço e relação cintura-quadril. Os resultados foram considerados significativos com p < 0,05. Resultados: Foram avaliados 196 pacientes adultos com média de idade de 44,73 anos, 71,9% do sexo feminino, 69,4% com sobrepeso e 12,24% com DRC. Desses últimos, 45,8% apresentaram SM, a maioria tinha até 3 componentes metabólicos alterados, e o grupo com DRC apresentou significância estatística em: circunferência da cintura, pressão arterial sistólica, pressão arterial diastólica e glicemia de jejum. O algoritmo KNN comprovou ser um bom preditor para a triagem de SM com acurácia e sensibilidade de 79% e especificidade de 80% (área sob a curva ROC – AUC = 0,79). Conclusão: O algoritmo KNN pode ser usado como um método de triagem de baixo custo para avaliar a presença de SM em pessoas com DRC. Introdução (DRC (SM cardiometabólicos Métodos Luís MA Brasil grave knearest k nearest (KNN dados tabagismo cinturaquadril. cinturaquadril cintura quadril. quadril cintura-quadril 005 0 05 0,05 Resultados 19 4473 44 73 44,7 anos 719 71 9 71,9 feminino 694 69 4 69,4 1224 12 24 12,24 últimos 458 45 8 45,8 alterados sistólica jejum 79 80 área 0,79. 079 0,79 . 0,79) Conclusão 00 0,0 1 447 7 44, 71, 6 69, 122 2 12,2 45, 07 0,7 0, 12,

Abstract Introduction: Chronic kidney disease (CKD) and metabolic syndrome (MS) are recognized as public health problems which are related to overweight and cardiometabolic factors. The aim of this study was to develop a model to predict MS in people with CKD. Methods: This was a prospective cross-sectional study of patients from a reference center in São Luís, MA, Brazil. The sample included adult volunteers classified according to the presence of mild or severe CKD. For MS tracking, the k-nearest neighbors (KNN) classifier algorithm was used with the following inputs: gender, smoking, neck circumference, and waist-to-hip ratio. Results were considered significant at p < 0.05. Results: A total of 196 adult patients were evaluated with a mean age of 44.73 years, 71.9% female, 69.4% overweight, and 12.24% with CKD. Of the latter, 45.8% had MS, the majority had up to 3 altered metabolic components, and the group with CKD showed statistical significance in: waist circumference, systolic blood pressure, diastolic blood pressure, and fasting blood glucose. The KNN algorithm proved to be a good predictor for MS screening with 79% accuracy and sensitivity and 80% specificity (area under the ROC curve – AUC = 0.79). Conclusion: The KNN algorithm can be used as a low-cost screening method to evaluate the presence of MS in people with CKD. Introduction (CKD (MS factors Methods crosssectional cross sectional Luís MA Brazil tracking knearest k nearest (KNN inputs gender smoking circumference waisttohip hip ratio 005 0 05 0.05 19 4473 44 73 44.7 years 719 71 9 71.9 female 694 69 4 69.4 1224 12 24 12.24 latter 458 45 8 45.8 components pressure glucose 79 80 area 0.79. 079 0.79 . 0.79) Conclusion lowcost low cost 00 0.0 1 447 7 44. 71. 6 69. 122 2 12.2 45. 07 0.7 0. 12.

Abstract Introduction: Pre-eclampsia complicates 2-4% of pregnancies. Metformin is a promising therapeutic candidate as would reduce the secretion of soluble fms-like tyrosine kinase 1 and soluble endoglin from endothelial cells and primary villous trophoblasts. Objective: The objective of the study was to determine the effects and safety of metformin for preventing pre-eclampsia. Materials and methods: A systematic review was carried out with Cochrane methodology, performing an electronic search for randomized clinical trials in pregnant women, which compared the use of metformin with placebo or no intervention, and reported incidence of pre-eclampsia within their results. Review manager software was used for the statistical analysis. Results: Five studies were included with results for 1977 participants. A 56% reduction in the risk of pre-eclampsia in pregnant women who received metformin was found, compared to placebo or no intervention (RR 0.44; 95% confidence interval 0.21-0.90; random effects analysis; I2 = 71%; Tau2 = 0.46; low-quality evidence). No significant differences were found for the secondary outcomes. Conclusions: The use of metformin in overweight or obese pregnant women, beginning before 20 weeks of gestation, could reduce the risk of pre-eclampsia by 56%; however, the beneficial effect could be non-significant, due to heterogeneity and low quality of current evidence.

Resumen Introducción: La preeclampsia complica del 2 al 4% de los embarazos. La metformina es un candidato terapéutico prometedor, al reducir la secreción de tirosina-quinasa-1 soluble similar a fms (sFlt-1) y endoglina soluble (sEng) de las células endoteliales y los trofoblastos vellosos primarios. Objetivo: Se propone determinar los efectos y la seguridad de la metformina para prevenir la preeclampsia a través de una revisión sistemática con metodología Cochrane. Materiales y métodos: Se realizó búsqueda electrónica de ensayos clínicos aleatorizados en mujeres embarazadas, que compararon el uso de metformina con placebo o ninguna intervención, y reportaron dentro de sus resultados incidencia de preeclampsia. Resultados: Se incluyeron cinco estudios con resultados de 1977 participantes. Se encontró una reducción del 56% en el riesgo de preeclampsia en embarazadas que recibieron metformina, en comparación con placebo o ninguna intervención (RR 0,44; IC 95% 0,21-0,90; I2 = 71%; baja calidad evidencia). No hubo diferencias significativas para los resultados secundarios. Conclusiones: El uso de metformina en mujeres embarazadas con sobrepeso u obesidad, iniciado antes de las 20 semanas de gestación, podría reducir el riesgo de preeclampsia en un 56%. Sin embargo, el efecto beneficioso podría no ser significativo, dada la heterogeneidad y baja calidad de la evidencia actual.

Abstract Objective: To determine the level of adherence to the Mediterranean Diet (ADM) among schoolchildren in Lorca, Murcia, and its relationship with factors associated with overweight and obesity. Methods: Adherence to the ADM was assessed in a sample of 367 primary school students using the Kidmed test, recording data on sex, age, and school for each participant. Results: The sample included 205 boys and 162 girls, all students from various schools in Lorca. A total of 57.4% showed high adherence to the ADM, with no significant differences by sex or age group. A positive association was found between not snacking, not consuming sugary soft drinks, drinking water, and having the grandmother cook at home with better adherence to the ADM. Conclusion: Although most schoolchildren showed high adherence to the ADM, their eating habits still need improvement, underscoring the importance of ongoing health promotion and prevention in school and family settings.

Resumen Objetivo: Determinar el grado de adherencia a la Dieta Mediterránea (ADM) de los escolares de Lorca, Murcia, y su relación con factores asociados al sobrepeso y la obesidad. Métodos: Se evaluó la adherencia a la ADM en una muestra de 367 escolares de primaria mediante el test Kidmed, registrando datos de sexo, edad y colegio de cada participante. Resultados: La muestra incluyó a 205 niños y 162 niñas, todos estudiantes de distintos colegios de Lorca. El 57,4 % presentó una alta adherencia a la ADM, sin diferencias significativas por sexo ni edad. Se observó una asociación positiva entre no picotear, no consumir refrescos azucarados, beber agua, y que la abuela cocinara en casa, con una mejor adherencia a la ADM. Conclusión: Aunque la mayoría de los escolares presentaban una alta adherencia a la ADM, sus hábitos alimentarios aún son mejorables, lo que destaca la necesidad de continuar promoviendo y previniendo la salud desde el entorno escolar y familiar.