ABSTRACT Objective: Herein, we compared ambulatory blood pressure (ABP) between young adults with congenital adrenal hyperplasia (CAH) due to 21-hydroxylase enzyme (21OHase) deficiency and a control group. Additionally, we analyzed correlations between the glucocorticoid dose and androgen levels and ABP parameters. Subjects and methods: This case-control study included 18 patients (6 males and 12 females) and 19 controls (8 males and 11 females) matched by age (18-31 years). ABP monitoring was used to estimate blood pressure (BP) over a 24-h period. Results: No difference was noted between patients and controls in terms of systolic BP (males, 115.5 ± 5.6 vs. 117.0 ± 9.3, P = 0.733; and females, 106.4 ± 7.9 vs. 108.4 ± 7.6, P = 0.556, respectively) and diastolic BP during 24 h (males, 62.8 ± 7.5 vs. 66.2 ± 5.6, P = 0.349; and females, 62.7 ± 4.9 vs. 62.3 ± 4.9, P = 0.818, respectively). Systolic and diastolic BP and pulse pressure during daytime and nocturnal periods were similar between patients and controls. Furthermore, no differences were detected in the percentage of load and impaired nocturnal dipping of systolic and diastolic BP between patients and controls during the 24-h period. Additionally, the glucocorticoid dose (varying between r = −0.24 to 0.13, P > 0.05) and androgens levels (varying between r = 0.01 to 0.14, P > 0.05) were not associated with ABP parameters. Conclusion: No signs of an elevated risk for hypertension were observed based on ABP monitoring in young adults with CAH attributed to 21OHase deficiency undergoing glucocorticoid replacement therapy. Objective Herein (ABP (CAH 21hydroxylase hydroxylase 21 OHase (21OHase group Additionally parameters methods casecontrol case 1 6 ( females 8 1831 31 (18-3 years. years . years) (BP 24h period Results males, (males 1155 115 5 115. 56 5. vs 1170 117 0 117. 93 9 3 9.3 0.733 0733 733 1064 106 4 106. 79 7 7. 1084 108 108. 76 7.6 0556 556 0.556 respectively 2 628 62 62. 75 662 66 66. 0.349 0349 349 627 49 4. 623 0818 818 0.818 respectively. Furthermore varying 024 −0.2 013 13 0.13 0.05 005 05 001 01 0.0 014 14 0.14 Conclusion therapy 183 (18- 9. 0.73 073 73 10 055 55 0.55 0.34 034 34 081 81 0.81 02 −0. 0.1 00 0. (18 0.7 07 0.5 0.3 03 08 0.8 −0 (1 −

Abstract BACKGROUND: Because normal male sexual differentiation is more complex than normal female sexual differentiation, there are more cases of disorders of sex development (DSDs) with 46,XY karyotype that have unclear etiology. However, Leydig and Sertoli cell markers are rarely used in distinguishing such individuals. OBJECTIVES: To evaluate the function of Leydig and Sertoli cells in individuals with genital ambiguity, 46,XY karyotype, palpable gonads and normal testosterone secretion. STUDY DESIGN AND SETTING: Case-control study with 77 patients, including eight with partial androgen insensitivity syndrome, eight with 5α-reductase deficiency type 2 (5ARD2) and 19 with idiopathic 46,XY DSD, and 42 healthy controls, from the Interdisciplinary Study Group for Sex Determination and Differentiation (GIEDDS), at the State University of Campinas (UNICAMP), Campinas, Brazil. METHODS: Baseline levels of gonadotropins, anti-Müllerian hormone (AMH), inhibin B, insulin-like 3 (INSL3), testosterone and dihydrotestosterone in cases, and AMH, inhibin B, and INSL3 levels in controls, were assessed. RESULTS: There was no significant difference in age between cases and controls (P = 0.595). AMH and inhibin B levels were significantly lower in cases than in controls (P = 0.031 and P < 0.001, respectively). INSL3 levels were significantly higher in cases than in controls (P = 0.003). Inhibin B levels were lower in 5ARD2 patients (P = 0.045) and idiopathic patients (P = 0.001), in separate comparisons with the controls. CONCLUSION: According to our findings, we can speculate that inhibin B levels may be used to differentiate among DSD cases.

RESUMO Objetivo Verificar a influência dos esportes de combate sobre a massa óssea. Métodos Foi realizada revisão sistemática da literatura de acordo com o método PRISMA, com buscas nas bases de dados Pubmed, Bireme, Embase e Web of Science, referente ao período de 1900 a 2015, com os descritores “martial arts”, “fight”, “combat”, “karate”, “kung fu”, “tae kwon do”, “judo”, “aikido”, “bone”, “bone mass”, “bone health”, “bone tissue”, “bone density”, “bone mineral contents”. A busca e a recuperação dos artigos foram realizadas por meio eletrônico e manual, executadas por dois revisores independentes. Resultados Foram identificados 79 artigos, dos quais, 25 eram duplicados, restando 54 artigos para leitura e avaliação dos títulos; posteriormente, foram excluídos os que tratavam de doenças como lesões ortopédicas e/ou ósseas, maxilofaciais, cirurgias, fraturas, mulheres osteopênicas e osteoporóticas, prevenção de quedas e aptidão física, restando 15 artigos. Dos estudos selecionados e encontrados na íntegra, todos foram publicados entre 2002 e 2015. Apenas um era estudo de caso controle, dois eram estudos longitudinais, dois estudos randomizados e 10 estudos transversais. Verificou-se um total de 1.368 crianças, adolescentes, adultos e idosos envolvidos em esportes de combate e avaliação óssea por imagem. Fatores como ingestão calórica, de cálcio e/ou vitamina D, intensidade e volume do exercício, aspectos hormonais como marcadores ósseos e características da menopausa não são conclusivos com relação à massa óssea e requerem um número maior de estudos. Conclusão A prática de esportes de combate evidencia melhora significativa na massa óssea em todas as idades . Nível de Evidência III, Estudos terapêuticos – Investigação dos resultados do tratamento.

ABSTRACT Objective To determine the influence of combat sports on bone mass. Methods A systematic review was performed according to the PRISMA method, with searches in the Pubmed, Bireme, Embase and Web of Science databases covering the period 1900 to 2015, using the keywords “martial arts”, “fight”, “combat”, “karate”, “kung fu”, “tae kwon do”, “judo”, “aikido”, “bone mass”, “bone health”, “bone tissue”, “bone density”, and “bone mineral contents”. The articles were searched for and retrieved electronically and manually, by two independent reviewers. Results Seventy-nine articles were identified, of which 25 were duplicates, leaving 54 for reading and evaluation of the titles; next, articles about diseases such as bone and/or orthopedic injuries, maxillofacial, surgeries, fractures, osteoporosis and osteopenia in women, prevention of falls, and physical fitness were excluded, leaving 15 articles. Of the articles selected and retrieved in full, all were published between 2002 and 2015. One article was a case control study; two were longitudinal studies, two were randomized studies; and 10 were cross-sectional studies. A total of 1368 children, adolescents, adults and elderly subjects were involved in combat sports and had bone evaluation by imaging. Factors such as calorie intake, calcium and/or vitamin D, intensity and volume of the exercise, hormonal aspects as bone markers, and characteristics of menopause are not conclusive in relation to bone mass, and further studies are needed. Conclusion The practice of combat sports shows a significant improvement in bone mass at all ages. Level of Evidence III, Therapeutic study – Investigation of treatment results.

RESUMEN Objective To determine the influence of combat sports on bone mass. Methods A systematic review was performed according to the PRISMA method, with searches in the Pubmed, Bireme, Embase and Web of Science databases covering the period 1900 to 2015, using the keywords “martial arts”, “fight”, “combat”, “karate”, “kung fu”, “tae kwon do”, “judo”, “aikido”, “bone mass”, “bone health”, “bone tissue”, “bone density”, and “bone mineral contents”. The articles were searched for and retrieved electronically and manually, by two independent reviewers. Results Seventy-nine articles were identified, of which 25 were duplicates, leaving 54 for reading and evaluation of the titles; next, articles about diseases such as bone and/or orthopedic injuries, maxillofacial, surgeries, fractures, osteoporosis and osteopenia in women, prevention of falls, and physical fitness were excluded, leaving 15 articles. Of the articles selected and retrieved in full, all were published between 2002 and 2015. One article was a case control study; two were longitudinal studies, two were randomized studies; and 10 were cross-sectional studies. A total of 1368 children, adolescents, adults and elderly subjects were involved in combat sports and had bone evaluation by imaging. Factors such as calorie intake, calcium and/or vitamin D, intensity and volume of the exercise, hormonal aspects as bone markers, and characteristics of menopause are not conclusive in relation to bone mass, and further studies are needed. Conclusion The practice of combat sports shows a significant improvement in bone mass at all ages. Level of Evidence III, Therapeutic study – Investigation of treatment results.

RESUMO Objetivo: Verificar a influência da prática de atividade física e/ou esportes na geometria óssea de crianças e adolescentes saudáveis. Fonte de dados: Foi realizada uma revisão sistemática, utilizando como referência o método Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Foram utilizadas as bases de buscas PubMed, Biblioteca Regional de Medicina/Literatura Latino-Americana e do Caribe em Ciências da Saúde (BIREME/LILACS) e Scientific Electronic Library Online (SciELO), para levantamento de artigos publicados de 2006 a 2016, e os seguintes descritores: “Bone geometry” AND (Sport* OR Exercise* OR “Physical Activity”). Síntese dos dados: Após a seleção, foram incluídos 21 artigos. A maioria dos estudos demonstrou que a prática de atividade física e/ou esportes foi benéfica do ponto de vista da geometria e densidade mineral óssea; apenas dois estudos apresentaram valores dos parâmetros ósseos dos indivíduos controles melhores do que os praticantes de natação. As atividades físicas e esportes encontrados foram: ginástica artística (n=7), ginástica rítmica (n=2), tênis (n=1), futebol (n=3), capoeira (n=1), natação (n=4), ciclismo (n=1), atividades com saltos (n=2), estudos relacionando atividade física com pico de torque isocinético (n=1), atividade física em geral, tempo presente ou passado, mensurado por questionário (n=4) e aulas adicionais de educação física (n=2). Conclusões: Dentre os esportes e atividades físicas encontradas, a ginástica, o futebol e a prática de atividade física mais intensa avaliada por questionário resultaram em geometria óssea melhor em comparação à não prática de atividade física, enquanto que a natação e exercícios de saltos não influenciaram a geometria óssea. Portanto, atividades esportivas com sobrecarga corporal, avaliadas como mais intensas e mais frequentes, exercem efeito benéfico sobre a geometria óssea.

ABSTRACT Objective: To perform a systematic review on the practice of physical activity and/or sports in health and its influence on bone geometry of healthy children and adolescents. Data source: The method used as reference was the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Databases searched for articles published from 2006 to 2016, with “Bone geometry” AND (Sport* OR Exercise* OR “Physical Activity”) as descriptors, were PubMed, BIREME/LILACS and SciELO. Data syntheses: After the selection, 21 articles were included. Most studies stated that practice of physical activity and/or sports was beneficial for bone geometry and bone mineral density. Only two studies presented values of bone parameters for control individuals better than those of swimmers. Physical activities and sports studied were: gymnastics (n=7), rhythmic gymnastics (n=2), tennis (n=1), soccer (n=3), capoeira (n=1), swimming (n=4), cycling (n=0), jumping activities (n=2), studies relating physical activity with isokinetic peak torque (n=1), physical activity measured by questionnaire (n=4), and additional physical education classes (n=2). Conclusions: Among the sports and physical activities found, gymnastics, soccer, and more intense physical activity assessed by questionnaires were mentioned along with better results in bone geometry compared to the absence of physical activity, whereas swimming and jumping exercises did not influence it. Therefore, sports activities with weight bearing and those practiced more frequently and intensively are beneficial for bone geometry.

Resumo Otimizar o ganho da massa óssea durante a infância e adolescência pode auxiliar na prevenção de doenças ósseas em idades mais avançadas. Objetivou-se verificar a densidade mineral óssea (DMO) e conteúdo mineral ósseo (CMO) em adolescentes do sexo feminino. Foi realizado um estudo transversal com 68 meninas adolescentes (12 a 17 anos), divididas em dois grupos: jogadoras de handebol (HG: n=29) e grupo controle (CG: n=39). DMO e CMO de corpo inteiro (TB), corpo total menos cabeça (TBLH), coluna lombar (L1-L4), colo do fêmur (FN) e triângulo de Ward’s (WT) e respectivos escore Z foram medidos usando a absorciometria por dupla emissão de raios-x (DXA). Também foi avaliada a maturidade sexual, menarca, PVC e ingestão de cálcio e vitamina D. As jogadoras de handebol mostraram valores de CMO, DMO e respectivos escores Z do corpo inteiro, TBLH, fêmur, quadril e coluna lombar significativamente maiores quando comparados ao grupo controle. Quando ajustados para a massa isenta de gordura o grupo HG apresentou valores maiores para o CMO do fêmur e DMO do fêmur e TBLH; e nos valores de escore Z de todos os sítios ósseos, exceto o quadril, quando comparadas ao CG. Concluímos que as jogadoras de handebol têm valores de massa óssea significativamente maiores comparadas ao grupo de meninas da mesma idade.

Abstract Optimizing bone mass gain during childhood and adolescence may help prevent bone diseases in advanced ages. The aim of this study was to verify the bone mineral density (BMD) and bone mineral content (BMC) in female adolescent’s handball players. This is a cross-sectional study where 68 female adolescents (12–17 years) were allocated into two groups: handball players (n = 29) (HG) and control group (n = 39) (CG). BMC and BMD from total body (TB), total body less head (TBLH), lumbar spine (L1–L4), femoral neck (FN), Ward’s triangle (WT) and respectively Z-scores were measured using dual-energy X-ray absorptiometry (DXA). Sexual maturity, menarche, PHV, time of sun exposure, physical activity level and Calcium and vitamin D intake were assessed. The HG showed significantly higher BMC, BMD as well Z-scores values (p≤0.05) of total body, TBLH, femoral neck, hip and lumbar spine than the CG. When the values were adjusted for lean soft tissue (LST) the HG showed significantly higher BMC of femoral neck (p≤0.05), as well as BMD of TBLH and femoral neck (p≤0.05) and Z-score values all bone sites except hip, than the CG. We conclude that handball players have significantly higher bone mass values compared to group of girls of the same age.

RESUMO Objetivo: Avaliar a massa óssea pela ultrassonografia quantitativa de falanges em jovens praticantes de karatê em relação a um grupo controle. Métodos: Amostra constituída por 162 praticantes de karatê (52 meninas) e 326 controles escolares (110 meninas) saudáveis, de 6 a 16 anos de idade, do oeste do Paraná. Foram avaliados peso, estatura, índice de massa corporal (IMC), Amplitude Dependent Speed of Sound (AD-SoS) e Bone Time Transmission (BTT), e os valores de IMC, AD-SoS e BTT transformados em escore Z. Aplicaram-se testes de Mann-Whitney, qui-quadrado ou Exato de Fisher e regressão linear múltipla, sendo significante p≤0,05. Resultados: Para ambos os sexos, os praticantes de karatê apresentaram valores superiores do escore Z do BTT comparados aos controles. Quanto à AD-SoS, as meninas do grupo de controle apresentaram valor absoluto e de escore Z superiores aos apresentados pelas praticantes de karatê do mesmo sexo. Ao avaliar a frequência relativa e absoluta de acordo com o escore Z do BTT em ambos os grupos, os meninos praticantes de karatê apresentaram maior frequência de massa óssea adequada. Nas meninas praticantes de karatê, a idade apresentou poder de explicação de 42% na variação da AD-SoS e o peso de 45% na variação do BTT. Nos meninos praticantes de karatê, a idade apresentou poder de explicação de 26% na variação da AD-SoS e a estatura 36% na variação do BTT. Conclusões: Nesse grupo de crianças e adolescentes, independentemente do sexo, os praticantes de karatê apresentaram maior massa óssea em relação ao grupo controle, sendo o BTT mais sensível para essa avaliação.

ABSTRACT Objective: To evaluate bone mass by quantitative ultrasound of the phalanges in young karate practitioners compared to a control group. Methods: Sample composed of 162 karate practitioners (52 females) and 326 healthy controls (110 females) aged 6 to 16 years old, in Western Paraná (Southern Brazil). Weight, height, BMI, amplitude-dependent speed of sound (AD-SoS) and bone transmission time (BTT) were evaluated. BMI, AD-SoS and BTT values were converted to Z scores. Mann-Whitney, chi-square or Fisher Exact tests and multiple linear regression were applied, with significance level set at p≤0.05. Results: Both genders showed higher values of BTT as Z scores when compared to control group. Females from the control group had higher AD-SoS values (m/s and Z score) compared to female karate practitioners. When relative and absolute frequencies were assessed according to BTT Z score in both groups, male karate practitioners’ bone mass was shown to be adequate more frequently. In female practitioners, age and weight were independent predictors of AD-SoS (R2=0.42) and BTT (R2=0.45), respectively. Among male karate practitioners, age was related to 26% of AD-SoS variances and height was responsible for 36% of BTT variances. Conclusions: Children and adolescents who practice karate were shown to have more bone mass in comparison to the control group, regardless of gender. BTT was more sensitive for this evaluation.

Abstract Aim: To ascertain the effects of an after-school intervention on physical activity levels and cardiovascular risk factors in adolescents from Campinas, Brazil. Methods: This was an intervention study with 71 adolescents that was carried out in two schools, randomly assigned to a control group (CG:n=45) or an intervention group (IG:n=26). We performed evaluations of body composition, sexual maturation, blood pressure, level of physical activity, sedentary time (ST), and eating habits, as well as biochemical variables by a portable analyzer. The IG participated in two weekly sessions of physical activities and controlled physical exercises for 14 weeks. The sessions lasted 60’, and were divided into warm-up (5-10’), main part (40-50’), and recovery (5-10’). Results: 30.8% of the IG and 24.4% of the CG were classified as overweight/obese. Additionally, the IG showed significantly lower ST (total: p=0.037; daily: p=0.009) after the intervention, as well as in the post-period (total ST: p=0.043; daily ST: p=0.007). The IG showed a reduction in glycemia (p=0.025). Conclusion: The intervention program generated positive changes in glycemia levels and ST. These results suggest that interventions involving physical exercise should be promoted in the school environment, as physical activity is an important component of a healthy lifestyle.

Introduction: Adolescents with Down syndrome (DS) show high rate of overweight and tend to accumulate high amount of fat compared to the same people without the syndrome. Objective: To estimate the cutoff point of the Body Mass Index (BMI) for the diagnosis of obesity in adolescents with DS according to different references for BMI in relation to the percentage of body fat (%BF) measured by dual-energy X-ray absorptiometry (DXA). Methods: The sample was composed of 34 adolescents with DS (aged: 10 to 17 years old). BMI was evaluated according to the references of the International Obesity Task Force (IOTF), the World Health Organization (WHO) for the general population, and Myrelid et al. and Styles et al. for people with DS. The %BF was assessed by whole body DXA and classified according to National Health And Nutrition Examination Survey (NHANES, 2011). Results: The boys were significantly taller than the girls and this %BF higher than boys. All references who have used BMI to assess obesity was positively associated with %BF measured by DXA in the diagnosis of obesity. Using the ROC curve in relation to %BF by DXA, all references showed high sensitivity, but the z-score of BMI by WHO showed better specificity, with the value of the accuracy of 0.82 for the cutoff point above 2.14. Conclusions: All the references used for the diagnosis of obesity were associated with %BF measured by DXA, and the cutoff point of z-scores above 2.14 by WHO showed better specificity.

Introducción: adolescentes con síndrome de Down (SD) muestran alta tasa de sobrepeso y tienden a acumular gran cantidad de grasa en comparación con los adolescentes sin el síndrome. Objetivo: estimar el punto de corte del índice de masa corporal (IMC) para el diagnóstico de obesidad en adolescentes con SD de acuerdo con las diferentes referencias para el IMC en relación con el porcentaje de grasa corporal (%GC) obtenido por el absorciometría con rayos X de doble energía (DXA). Métodos: la muestra se compone de 34 adolescentes con SD (10 a 17 años). El IMC se evaluó de acuerdo con las referencias de la International Obesity Task Force (IOTF), Organización Mundial de la Salud (OMS) para la población general, y Myrelid et al. y Estyles et al. para personas con SD. El %GC fue evaluado por DXA y clasificado según NHANES (2011). Resultados: los niños fueron significativamente más altos que las niñas, y estas con mayor %GC que los niños. Todas las referencias que han utilizado el IMC se asociaron positivamente con el %GC medido por DXA en el diagnóstico de la obesidad. Utilizando la curva ROC en relación con %GC por DXA todas las referencias mostraron alta sensibilidad, pero el score-z del IMC por la OMS mostró mejor especificidad, con el valor de exactitud de 0,82 para el punto de corte por encima de 2,14. Conclusiones: todas las referencias utilizadas para el diagnóstico de obesidad se asociaron con el %GC medido por DXA, y el punto de corte del score-z por encima de 2,14 por la OMS mostró mejor especificidad.

Resumo O objetivo do estudo foi realizar uma revisão sistemática sobre os programas de intervenção, com ações de atividades físicas e/ou educação nutricional, na redução de fatores de risco à saúde (sobrepeso/obesidade e alterações no perfil metabólico), em adolescentes escolares brasileiros. Foi realizada busca nas bases de dados eletrônicas Medline (PubMed), Lilacs, Embase, Scielo e Banco de Teses da Capes. Identificaram-se 1.568 estudos e 21 textos completos foram analisados, dos quais, cinco foram incluídos na revisão. A maioria dos estudos envolveu a prática de atividades físicas combinada à educação nutricional em diferentes regiões do país e todas as intervenções mostraram efeitos positivos na redução de fatores de risco à saúde. Conclui-se que todos os estudos nesta revisão demonstraram alterações positivas após as intervenções, mesmo que não significativas estatisticamente, reforçando a importância de programas de intervenção para a promoção de uma vida mais saudável e para reduzir os fatores de risco à saúde, em adolescentes.

Abstract The aim of this study was to systematically review studies on intervention programs involving physical activity promotion and/or nutritional education to reduce health-related risk factors (overweight/obesity and metabolic profilealterations) in Brazilian adolescent students. A search was performed in the following electronic databases: Medline (PubMed), Lilacs, Embase, Scielo and Capes Thesis Database. A total of 1,568 studies were identified, of which 21 full papers were analyzed and 5 were included in the systematic review. The majority of the studies involved physical activity practice combined with nutritional education in Brazilian adolescent students and all interventions showed positive effect on reducing health-related risk factors among Brazilian adolescents.It was concluded that all studies included in this review showed positive alterations in health-related risk factors after interventions, reinforcing the importance of intervention programs to promote a healthier lifestyle and reduce health-related risk factors in adolescents.

OBJETIVO: Verificar as modificações da composição corporal de escolares pós-púberes após a prática da atividade física programada durante um ano letivo. MÉTODO: Amostra composta de 386 alunos, divididos em dois grupos: estudo 195 e controle 191, entre 15 e 17 anos. O grupo estudo (GE) foi submetido a atividade física programada e o grupo controle (GC) a aulas convencionais de educação física. A composição corporal foi avaliada pelo índice de massa corporal (IMC), percentual de gordura (%G) e massa gorda (MG) e magra (MM). RESULTADOS: Foi possível observar um efeito positivo do programa de atividade física sobre a composição corporal no GE (p < 0,001) do grupo e da interação tempo x grupo em todas as variáveis analisadas em ambos os sexos. Foram observados reduções na %G (média das diferenças = -5,58%) e no perímetro da cintura (-2,33 cm) e aumento da MM (+2,05 kg) no GE em ambos os sexos. O contrário foi observado no GC. CONCLUSÃO: A prática de atividade física programada promove redução significativa de gordura corporal em escolares pós-púberes.

OBJECTIVE: To assess body composition modifications in post-pubertal schoolchildren after practice of a physical activity program during one school year. METHODS: The sample consisted of 386 students aged between 15 and 17 years and divided into two groups: the study group (SG) comprised 195 students and the control group (CG), 191. The SG was submitted to a physical activity program and the CG attended conventional physical education classes. Body composition was assessed using body mass index (BMI), percentage of body fat (%BF), fat mass (FM), and lean mass (LM). RESULTS: A positive effect of the physical activity program on body composition in the SG (p < 0.001) was observed, as well as on the interaction time x group in all the variables analyzed in both genders. A reduction in %BF (mean of differences = -5.58%) and waist circumference (-2.33 cm), as well as an increase in LM (+2.05 kg) were observed in the SG for both genders, whereas the opposite was observed in the CG. CONCLUSION: The practice of programmed physical activity promotes significant reduction of body fat in post-pubertal schoolchildren.

Objetivo:Analisar quais os principais fatores que influenciam na massa óssea de crianças e adolescentes avaliada pelo ultrassom quantitativo (QUS) de falanges.Fonte de dados:Foi realizada revisão sistemática da literatura, de acordo com o método Prisma, com buscas nas bases de dados do Pubmed/Medline, Bireme e Scielo, referente ao período de 2001 a 2012, nos idiomas inglês e português, utilizando os descritores children, adolescent, ultrassonography finger phalanges, quantitative ultrasound of phalanges, phalangeal quantitative ultrasound.Síntese dos dados:Foram incluídos 21 artigos. As meninas apresentaram no QUS valores de Amplitude Dependent Speed of Sound (AD-SoS) superiores aos meninos durante o desenvolvimento puberal. Os valores dos parâmetros do QUS de falanges aumentaram com o incremento do estádio maturacional, assim como ocorre com o Dual-energy X-ray Absorptiometry (DXA). Variáveis antropométricas, como idade, peso, estatura, índice de massa corporal (IMC) e massa magra, demonstraram correlações positivas com os valores do QUS de falanges. A atividade física também demonstrou estar positivamente relacionada ao aumento da massa óssea. Fatores como etnia, genética, ingestão calórica e perfil socioeconômico ainda não mostraram relação conclusiva e necessitam um número maior de estudos.Conclusões:O QUS de falanges é um método indicado para avaliar a progressiva aquisição da massa óssea durante o crescimento e a maturação dos indivíduos em fase escolar, por acompanhar as alterações que ocorrem com o aumento da idade e do estádio puberal. Observouse influência positiva, principalmente das variáveis de sexo, maturação, estatura, peso e IMC, sendo seus dados semelhantes quando comparados ao método padrão-ouro, o DXA.

Objective:To analyze the main factors that influence bone mass in children and teenagers assessed by quantitative ultrasound (QUS) of the phalanges.Data source:A systematic literature review was performed according to the PRISMA method with searches in databases Pubmed/Medline, SciELO and Bireme for the period 2001-2012, in English and Portuguese languages, using the keywords: children, teenagers, adolescent, ultrasound finger phalanges, quantitative ultrasound of phalanges, phalangeal quantitative ultrasound.Data synthesis:21 articles were included. Girls had, in QUS, Amplitude Dependent Speed of Sound (AD-SoS) values higher than boys during pubertal development. The values of the parameters of QUS of the phalanges and dual-energy X-ray Absorptiometry (DXA) increased with the increase of the maturational stage. Anthropometric variables such as age, weight, height, body mass index (BMI), lean mass showed positive correlations with the values of QUS of the phalanges. Physical activity has also been shown to be positively associated with increased bone mass. Factors such as ethnicity, genetics, caloric intake and socioeconomic profile have not yet shown a conclusive relationship and need a larger number of studies.Conclusions:QUS of the phalanges is a method used to evaluate the progressive acquisition of bone mass during growth and maturation of individuals in school phase, by monitoring changes that occur with increasing age and pubertal stage. There were mainly positive influences variables of sex, maturity, height, weight and BMI, with similar data when compared to the gold standard method, the DXA.

A aptidão aeróbia é considerada um dos mais importantes componentes da aptidão física relacionada à saúde. O objetivo deste estudo foi analisar a influência da idade, das variáveis de crescimento, composição corporal, maturação sexual e do nível econômico (NE) sobre aptidão aeróbia em escolares do sexo feminino de escolas públicas da cidade de Cascavel, PR, Brasil. Estudo epidemiológico transversal realizado com 1.317 escolares de oito a 17 anos de idade no ano de 2006. Foram coletadas as variáveis de massa corporal, estatura, dobras cutâneas do tríceps e panturrilha medial e calculado o percentual de gordura corporal (%GC). A maturação sexual foi autoavaliada por meio da prancha de desenvolvimento de mamas (M1 a M5). O NE foi obtido por um questionário proposto pela Associação Brasileira das Empresas de Pesquisa. O teste de vai-vem de 20 metros foi utilizado para mensurar a aptidão aeróbia. Foram aplicados a Anova two-way, teste post hoc de Tukey, as correlações de Pearson e Spearman e a análise de regressão linear múltipla, com nível de confiança de 95%. Três variáveis (idade, %GC e NE) apresentaram interação (p<0,05) na predição do VO2pico rel (R²=0,73) e todas as variáveis independentes (massa corporal, idade, estatura, %G, NE e maturação sexual) foram significativas para predizer o VO2pico abs (R²=0,88). Conclui-se que a idade cronológica e a maturação sexual foram as variáveis que melhor predizem positivamente os valores de VO2pico abs e negativamente os de VO2pico rel.

Aerobic fitness is an important health-related fitness component. The objective of this study was to analyze the influence of age, growth, body composition, sexual maturation and socioeconomic status on the aerobic fitness of female school children attending public schools in Cascavel, Paraná, Brazil. A cross-sectional epidemiological study was conducted in 2006 on 1,317 school children aged 8 to 17 years. Body mass, height and triceps and medial calf skinfold thickness were measured and relative body fat (%BF) was calculated. Sexual maturation was self-assessed using a breast development scale (M1 to M5). The questionnaire proposed by the Brazilian Association of Research Companies was used to assess socioeconomic status. Aerobic fitness was estimated by the 20-m shuttle run test. The results were analyzed using two-way ANOVA, Tukey post hoc test, Spearman and Pearson correlation coefficients, and multiple linear regression with 95% confidence intervals. Three variables (age, %BF and socioeconomic status) showed an interaction (p<0.05) in the prediction of VO2peak rel (R²=0.73). All independent variables (body mass, height, age, %BF, socioeconomic status, and sexual maturation) were significant predictors (p<0.05) of VO2pico abs (R²=0.88). In conclusion, chronological age and sexual maturation were the best predictors of VO2peak abs (positive) and VO2peak rel (negative).

OBJETIVO: Verificar a prevalência e os fatores associados ao excesso de peso em estudantes adolescentes em Rio Branco, Acre, Brasil. MÉTODOS: Estudo transversal com 741 adolescentes de escolas particulares de Rio Branco, Acre. Foram mensuradas as seguintes variáveis: sexo, idade, classe socioeconômica, escolaridade dos pais, número de moradores no domicílio, número de irmãos, atividade física, tempo de TV e de computador. A regressão logística binária foi utilizada para verficar as possíveis relações entre excesso de peso corporal e algus fatores associados. RESULTADOS: A prevalência geral de excesso de peso foi de 26,9% (30,0% nos meninos e 24,2% nas meninas): apenas o sexo (masculino, OR=1,34), a classe socioeconômica (média alta, OR=2,06 e alta, OR=2,36) e a atividade física (insuficientemente ativo, OR=2,75) apresentaram maior risco para desenvolver excesso de peso. CONCLUSÃO: Os estudantes adolescentes do sexo masculino, de classe socioeconômica elevada e que praticam pouca atividade física foram os que apresentaram maior risco de excesso de peso nessa região do Brasil.

OBJECTIVE: This study verified the prevalence of excess weight and associated factors in adolescents from private schools in Rio Branco, Acre, Brazil. METHODS: This cross-sectional study included 741 adolescents from private schools in Rio Branco, Acre. The following data were collected: sex, age, socioeconomic status, parents' education level, number of people in the household, number of siblings, level of physical activity, and number of hours spent daily watching television and using a computer. Logistic regression was used to investigate possible relationships between excess weight and associated factors. RESULTS: The general prevalence of excess weight was 26.9% (30.0% for males and 24.2% for females). Inactive (OR=2.75) males (OR=1.34) from the upper middle class (OR=2.06) or upper class (OR=2.36) were at highest risk of excess weight. CONCLUSION: Inactive male adolescents belonging to the upper middle and upper classes are at high risk of excess weight in this region of Brazil.

OBJETIVO: Avaliar associação entre ultrassonografia quantitativa de falanges da mão (QUS) e a densitometria por absorção de raio-X de dupla energia (DXA) e desses com os históricos alimentar e de fraturas. SUJEITOS E MÉTODOS: Após dois anos de acompanhamento de 270 escolares, 10 com massa óssea por QUS abaixo de -2 DP foram incluídos no estudo e avaliados com DXA. RESULTADOS: A massa óssea por DXA de L1-L4 variou de -2,8 a -1,1 DP e de corpo inteiro -2,9 e -1,2. Três estudantes apresentaram fraturas. Baixa ingestão de cálcio foi observada nos 10 casos, de fósforo em 6 e de vitamina D em 8. Não houve diferença entre os casos com massa abaixo de -2 DP nos três métodos de avaliação. Não foi observada associação entre as fraturas e o histórico alimentar, nem com os valores de massa óssea. CONCLUSÃO: Neste pequeno grupo de adolescentes houve associação entre QUS e DXA, porém sem associação entre essas avaliações e as fraturas e a ingestão de cálcio, fósforo e vitamina D.

OBJECTIVE: To evaluate the association between quantitative ultrasonography at hand phalanges (QUS) and dual energy X-ray absorptiometry (DXA), and between these methods with food intake and history of bone fractures. SUBJECTS AND METHODS:After two years of follow up of 270 schoolchildren, 10 of them, who showed bone mass below - 2 SD in QUS, were included in the present study. Laboratory results and DXA data were analyzed. RESULTS: Bone mass evaluated by DXA at L1-L4 ranged from -2.8 to -1.1 SDS, and whole body bone mass, from -2.9 to -1.2 SDS. Three children had history of non-pathological bone fractures. Dietary assessment showed low intake of calcium in 10 cases, of phosphorus in 6, and of vitamin D in 8 cases. There were no differences among the cases of bone mass below-2 SD in any of the three used methods. There was no association between history of bone fractures and food intake, and between these evaluations and bone mass. CONCLUSION: In this small group of schoolchildren there was an association between the methods QUS and DXA. However, there was no association between bone mass and the history of bone fractures, or calcium, phosphorus and vitamin D intake.