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Catálogo Taxonômico da Fauna do Brasil: Setting the baseline knowledge on the animal diversity in Brazil
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Boeger, Walter A.
; Valim, Michel P.
; Zaher, Hussam
; Rafael, José A.
; Forzza, Rafaela C.
; Percequillo, Alexandre R.
; Serejo, Cristiana S.
; Garraffoni, André R.S.
; Santos, Adalberto J.
Slipinski, Adam
Linzmeier, Adelita M.
Calor, Adolfo R.
Garda, Adrian A.
Kury, Adriano B.
Fernandes, Agatha C.S.
Agudo-Padrón, Aisur I.
Akama, Alberto
Silva Neto, Alberto M. da
Burbano, Alejandro L.
Menezes, Aleksandra
Pereira-Colavite, Alessandre
Anichtchenko, Alexander
Lees, Alexander C.
Bezerra, Alexandra M.R.
Domahovski, Alexandre C.
Pimenta, Alexandre D.
Aleixo, Alexandre L.P.
Marceniuk, Alexandre P.
Paula, Alexandre S. de
Somavilla, Alexandre
Specht, Alexandre
Camargo, Alexssandro
Newton, Alfred F.
Silva, Aline A.S. da
Santos, Aline B. dos
Tassi, Aline D.
Aragão, Allan C.
Santos, Allan P.M.
Migotto, Alvaro E.
Mendes, Amanda C.
Cunha, Amanda
Chagas Júnior, Amazonas
Sousa, Ana A.T. de
Pavan, Ana C.
Almeida, Ana C.S.
Peronti, Ana L.B.G.
Henriques-Oliveira, Ana L.
Prudente, Ana L.
Tourinho, Ana L.
Pes, Ana M.O.
Carmignotto, Ana P.
Wengrat, Ana P.G. da Silva
Dornellas, Ana P.S.
Molin, Anamaria Dal
Puker, Anderson
Morandini, André C.
Ferreira, André da S.
Martins, André L.
Esteves, André M.
Fernandes, André S.
Roza, André S.
Köhler, Andreas
Paladini, Andressa
Andrade, Andrey J. de
Pinto, Ângelo P.
Salles, Anna C. de A.
Gondim, Anne I.
Amaral, Antonia C.Z.
Rondón, Antonio A.A.
Brescovit, Antonio
Lofego, Antônio C.
Marques, Antonio C.
Macedo, Antonio
Andriolo, Artur
Henriques, Augusto L.
Ferreira Júnior, Augusto L.
Lima, Aurino F. de
Barros, Ávyla R. de A.
Brito, Ayrton do R.
Romera, Bárbara L.V.
Vasconcelos, Beatriz M.C. de
Frable, Benjamin W.
Santos, Bernardo F.
Ferraz, Bernardo R.
Rosa, Brunno B.
Sampaio, Brunno H.L.
Bellini, Bruno C.
Clarkson, Bruno
Oliveira, Bruno G. de
Corrêa, Caio C.D.
Martins, Caleb C.
Castro-Guedes, Camila F. de
Souto, Camilla
Bicho, Carla de L.
Cunha, Carlo M.
Barboza, Carlos A. de M.
Lucena, Carlos A.S. de
Barreto, Carlos
Santana, Carlos D.C.M. de
Agne, Carlos E.Q.
Mielke, Carlos G.C.
Caetano, Carlos H.S.
Flechtmann, Carlos H.W.
Lamas, Carlos J.E.
Rocha, Carlos
Mascarenhas, Carolina S.
Margaría, Cecilia B.
Waichert, Cecilia
Digiani, Celina
Haddad, Célio F.B.
Azevedo, Celso O.
Benetti, Cesar J.
Santos, Charles M.D. dos
Bartlett, Charles R.
Bonvicino, Cibele
Ribeiro-Costa, Cibele S.
Santos, Cinthya S.G.
Justino, Cíntia E.L.
Canedo, Clarissa
Bonecker, Claudia C.
Santos, Cláudia P.
Carvalho, Claudio J.B. de
Gonçalves, Clayton C.
Galvão, Cleber
Costa, Cleide
Oliveira, Cléo D.C. de
Schwertner, Cristiano F.
Andrade, Cristiano L.
Pereira, Cristiano M.
Sampaio, Cristiano
Dias, Cristina de O.
Lucena, Daercio A. de A.
Manfio, Daiara
Amorim, Dalton de S.
Queiroz, Dalva L. de
Queiroz, Dalva L. de
Colpani, Daniara
Abbate, Daniel
Aquino, Daniel A.
Burckhardt, Daniel
Cavallari, Daniel C.
Prado, Daniel de C. Schelesky
Praciano, Daniel L.
Basílio, Daniel S.
Bená, Daniela de C.
Toledo, Daniela G.P. de
Takiya, Daniela M.
Fernandes, Daniell R.R.
Ament, Danilo C.
Cordeiro, Danilo P.
Silva, Darliane E.
Pollock, Darren A.
Muniz, David B.
Gibson, David I.
Nogueira, David S.
Marques, Dayse W.A.
Lucatelli, Débora
Garcia, Deivys M.A.
Baêta, Délio
Ferreira, Denise N.M.
Rueda-Ramírez, Diana
Fachin, Diego A.
Souza, Diego de S.
Rodrigues, Diego F.
Pádua, Diego G. de
Barbosa, Diego N.
Dolibaina, Diego R.
Amaral, Diogo C.
Chandler, Donald S.
Maccagnan, Douglas H.B.
Caron, Edilson
Carvalho, Edrielly
Adriano, Edson A.
Abreu Júnior, Edson F. de
Pereira, Edson H.L.
Viegas, Eduarda F.G.
Carneiro, Eduardo
Colley, Eduardo
Eizirik, Eduardo
Santos, Eduardo F. dos
Shimbori, Eduardo M.
Suárez-Morales, Eduardo
Arruda, Eliane P. de
Chiquito, Elisandra A.
Lima, Élison F.B.
Castro, Elizeu B. de
Orlandin, Elton
Nascimento, Elynton A. do
Razzolini, Emanuel
Gama, Emanuel R.R.
Araujo, Enilma M. de
Nishiyama, Eric Y.
Spiessberger, Erich L.
Santos, Érika C.L. dos
Contreras, Eugenia F.
Galati, Eunice A.B.
Oliveira Junior, Evaldo C. de
Gallardo, Fabiana
Hernandes, Fabio A.
Lansac-Tôha, Fábio A.
Pitombo, Fabio B.
Dario, Fabio Di
Santos, Fábio L. dos
Mauro, Fabio
Nascimento, Fabio O. do
Olmos, Fabio
Amaral, Fabio R.
Schunck, Fabio
Godoi, Fábio S. P. de
Machado, Fabrizio M.
Barbo, Fausto E.
Agrain, Federico A.
Ribeiro, Felipe B.
Moreira, Felipe F.F.
Barbosa, Felipe F.
Silva, Fenanda S.
Cavalcanti, Fernanda F.
Straube, Fernando C.
Carbayo, Fernando
Carvalho Filho, Fernando
Zanella, Fernando C.V.
Jacinavicius, Fernando de C.
Farache, Fernando H.A.
Leivas, Fernando
Dias, Fernando M.S.
Mantellato, Fernando
Vaz-de-Mello, Fernando Z.
Gudin, Filipe M.
Albuquerque, Flávio
Molina, Flavio B.
Passos, Flávio D.
Shockley, Floyd W.
Pinheiro, Francielly F.
Mello, Francisco de A.G. de
Nascimento, Francisco E. de L.
Franco, Francisco L.
Oliveira, Francisco L. de
Melo, Francisco T. de V.
Quijano, Freddy R.B.
Salles, Frederico F.
Biffi, Gabriel
Queiroz, Gabriel C.
Bizarro, Gabriel L.
Hrycyna, Gabriela
Leviski, Gabriela
Powell, Gareth S.
Santos, Geane B. dos
Morse, Geoffrey E.
Brown, George
Mattox, George M.T.
Zimbrão, Geraldo
Carvalho, Gervásio S.
Miranda, Gil F.G.
Moraes, Gilberto J. de
Lourido, Gilcélia M.
Neves, Gilmar P.
Moreira, Gilson R.P.
Montingelli, Giovanna G.
Maurício, Giovanni N.
Marconato, Gláucia
Lopez, Guilherme E.L.
Silva, Guilherme L. da
Muricy, Guilherme
Brito, Guilherme R.R.
Garbino, Guilherme S.T.
Flores, Gustavo E.
Graciolli, Gustavo
Libardi, Gustavo S.
Proctor, Heather C.
Gil-Santana, Helcio R.
Varella, Henrique R.
Escalona, Hermes E.
Schmitz, Hermes J.
Rodrigues, Higor D.D.
Galvão Filho, Hilton de C.
Quintino, Hingrid Y.S.
Pinto, Hudson A.
Rainho, Hugo L.
Miyahira, Igor C.
Gonçalves, Igor de S.
Martins, Inês X.
Cardoso, Irene A.
Oliveira, Ismael B. de
Franz, Ismael
Fernandes, Itanna O.
Golfetti, Ivan F.
S. Campos-Filho, Ivanklin
Oliveira, Ivo de S.
Delabie, Jacques H.C.
Oliveira, Jader de
Prando, Jadila S.
Patton, James L.
Bitencourt, Jamille de A.
Silva, Janaina M.
Santos, Jandir C.
Arruda, Janine O.
Valderrama, Jefferson S.
Dalapicolla, Jeronymo
Oliveira, Jéssica P.
Hájek, Jiri
Morselli, João P.
Narita, João P.
Martin, João P.I.
Grazia, Jocélia
McHugh, Joe
Cherem, Jorge J.
Farias Júnior, José A.S.
Fernandes, Jose A.M.
Pacheco, José F.
Birindelli, José L.O.
Rezende, José M.
Avendaño, Jose M.
Duarte, José M. Barbanti
Ribeiro, José R. Inácio
Mermudes, José R.M.
Pujol-Luz, José R.
Santos, Josenilson R. dos
Câmara, Josenir T.
Teixeira, Joyce A.
Prado, Joyce R. do
Botero, Juan P.
Almeida, Julia C.
Kohler, Julia
Gonçalves, Julia P.
Beneti, Julia S.
Donahue, Julian P.
Alvim, Juliana
Almeida, Juliana C.
Segadilha, Juliana L.
Wingert, Juliana M.
Barbosa, Julianna F.
Ferrer, Juliano
Santos, Juliano F. dos
Kuabara, Kamila M.D.
Nascimento, Karine B.
Schoeninger, Karine
Campião, Karla M.
Soares, Karla
Zilch, Kássia
Barão, Kim R.
Teixeira, Larissa
Sousa, Laura D. do N.M. de
Dumas, Leandro L.
Vieira, Leandro M.
Azevedo, Leonardo H.G.
Carvalho, Leonardo S.
Souza, Leonardo S. de
Rocha, Leonardo S.G.
Bernardi, Leopoldo F.O.
Vieira, Letícia M.
Johann, Liana
Salvatierra, Lidianne
Oliveira, Livia de M.
Loureiro, Lourdes M.A. El-moor
Barreto, Luana B.
Barros, Luana M.
Lecci, Lucas
Camargos, Lucas M. de
Lima, Lucas R.C.
Almeida, Lucia M.
Martins, Luciana R.
Marinoni, Luciane
Moura, Luciano de A.
Lima, Luciano
Naka, Luciano N.
Miranda, Lucília S.
Salik, Lucy M.
Bezerra, Luis E.A.
Silveira, Luis F.
Campos, Luiz A.
Castro, Luiz A.S. de
Pinho, Luiz C.
Silveira, Luiz F.L.
Iniesta, Luiz F.M.
Tencatt, Luiz F.C.
Simone, Luiz R.L.
Malabarba, Luiz R.
Cruz, Luiza S. da
Sekerka, Lukas
Barros, Lurdiana D.
Santos, Luziany Q.
Skoracki, Maciej
Correia, Maira A.
Uchoa, Manoel A.
Andrade, Manuella F.G.
Hermes, Marcel G.
Miranda, Marcel S.
Araújo, Marcel S. de
Monné, Marcela L.
Labruna, Marcelo B.
Santis, Marcelo D. de
Duarte, Marcelo
Knoff, Marcelo
Nogueira, Marcelo
Britto, Marcelo R. de
Melo, Marcelo R.S. de
Carvalho, Marcelo R. de
Tavares, Marcelo T.
Kitahara, Marcelo V.
Justo, Marcia C.N.
Botelho, Marcia J.C.
Couri, Márcia S.
Borges-Martins, Márcio
Felix, Márcio
Oliveira, Marcio L. de
Bologna, Marco A.
Gottschalk, Marco S.
Tavares, Marcos D.S.
Lhano, Marcos G.
Bevilaqua, Marcus
Santos, Marcus T.T.
Domingues, Marcus V.
Sallum, Maria A.M.
Digiani, María C.
Santarém, Maria C.A.
Nascimento, Maria C. do
Becerril, María de los A.M.
Santos, Maria E.A. dos
Passos, Maria I. da S. dos
Felippe-Bauer, Maria L.
Cherman, Mariana A.
Terossi, Mariana
Bartz, Marie L.C.
Barbosa, Marina F. de C.
Loeb, Marina V.
Cohn-Haft, Mario
Cupello, Mario
Martins, Marlúcia B.
Christofersen, Martin L.
Bento, Matheus
Rocha, Matheus dos S.
Martins, Maurício L.
Segura, Melissa O.
Cardenas, Melissa Q.
Duarte, Mércia E.
Ivie, Michael A.
Mincarone, Michael M.
Borges, Michela
Monné, Miguel A.
Casagrande, Mirna M.
Fernandez, Monica A.
Piovesan, Mônica
Menezes, Naércio A.
Benaim, Natalia P.
Reategui, Natália S.
Pedro, Natan C.
Pecly, Nathalia H.
Ferreira Júnior, Nelson
Silva Júnior, Nelson J. da
Perioto, Nelson W.
Hamada, Neusa
Degallier, Nicolas
Chao, Ning L.
Ferla, Noeli J.
Mielke, Olaf H.H.
Evangelista, Olivia
Shibatta, Oscar A.
Oliveira, Otto M.P.
Albornoz, Pablo C.L.
Dellapé, Pablo M.
Gonçalves, Pablo R.
Shimabukuro, Paloma H.F.
Grossi, Paschoal
Rodrigues, Patrícia E. da S.
Lima, Patricia O.V.
Velazco, Paul
Santos, Paula B. dos
Araújo, Paula B.
Silva, Paula K.R.
Riccardi, Paula R.
Garcia, Paulo C. de A.
Passos, Paulo G.H.
Corgosinho, Paulo H.C.
Lucinda, Paulo
Costa, Paulo M.S.
Alves, Paulo P.
Roth, Paulo R. de O.
Coelho, Paulo R.S.
Duarte, Paulo R.M.
Carvalho, Pedro F. de
Gnaspini, Pedro
Souza-Dias, Pedro G.B.
Linardi, Pedro M.
Bartholomay, Pedro R.
Demite, Peterson R.
Bulirsch, Petr
Boll, Piter K.
Pereira, Rachel M.M.
Silva, Rafael A.P.F.
Moura, Rafael B. de
Boldrini, Rafael
Silva, Rafaela A. da
Falaschi, Rafaela L.
Cordeiro, Ralf T.S.
Mello, Ramon J.C.L.
Singer, Randal A.
Querino, Ranyse B.
Heleodoro, Raphael A.
Castilho, Raphael de C.
Constantino, Reginaldo
Guedes, Reinaldo C.
Carrenho, Renan
Gomes, Renata S.
Gregorin, Renato
Machado, Renato J.P.
Bérnils, Renato S.
Capellari, Renato S.
Silva, Ricardo B.
Kawada, Ricardo
Dias, Ricardo M.
Siewert, Ricardo
Brugnera, Ricaro
Leschen, Richard A.B.
Constantin, Robert
Robbins, Robert
Pinto, Roberta R.
Reis, Roberto E. dos
Ramos, Robson T. da C.
Cavichioli, Rodney R.
Barros, Rodolfo C. de
Caires, Rodrigo A.
Salvador, Rodrigo B.
Marques, Rodrigo C.
Araújo, Rodrigo C.
Araujo, Rodrigo de O.
Dios, Rodrigo de V.P.
Johnsson, Rodrigo
Feitosa, Rodrigo M.
Hutchings, Roger W.
Lara, Rogéria I.R.
Rossi, Rogério V.
Gerstmeier, Roland
Ochoa, Ronald
Hutchings, Rosa S.G.
Ale-Rocha, Rosaly
Rocha, Rosana M. da
Tidon, Rosana
Brito, Rosangela
Pellens, Roseli
Santos, Sabrina R. dos
Santos, Sandra D. dos
Paiva, Sandra V.
Santos, Sandro
Oliveira, Sarah S. de
Costa, Sávio C.
Gardner, Scott L.
Leal, Sebastián A. Muñoz
Aloquio, Sergio
Bonecker, Sergio L.C.
Bueno, Sergio L. de S.
Almeida, Sérgio M. de
Stampar, Sérgio N.
Andena, Sérgio R.
Posso, Sergio R.
Lima, Sheila P.
Gadelha, Sian de S.
Thiengo, Silvana C.
Cohen, Simone C.
Brandão, Simone N.
Rosa, Simone P.
Ribeiro, Síria L.B.
Letana, Sócrates D.
Santos, Sonia B. dos
Andrade, Sonia C.S.
Dávila, Stephane
Vaz, Stéphanie
Peck, Stewart B.
Christo, Susete W.
Cunha, Suzan B.Z.
Gomes, Suzete R.
Duarte, Tácio
Madeira-Ott, Taís
Marques, Taísa
Roell, Talita
Lima, Tarcilla C. de
Sepulveda, Tatiana A.
Maria, Tatiana F.
Ruschel, Tatiana P.
Rodrigues, Thaiana
Marinho, Thais A.
Almeida, Thaís M. de
Miranda, Thaís P.
Freitas, Thales R.O.
Pereira, Thalles P.L.
Zacca, Thamara
Pacheco, Thaynara L.
Martins, Thiago F.
Alvarenga, Thiago M.
Carvalho, Thiago R. de
Polizei, Thiago T.S.
McElrath, Thomas C.
Henry, Thomas
Pikart, Tiago G.
Porto, Tiago J.
Krolow, Tiago K.
Carvalho, Tiago P.
Lotufo, Tito M. da C.
Caramaschi, Ulisses
Pinheiro, Ulisses dos S.
Pardiñas, Ulyses F.J.
Maia, Valéria C.
Tavares, Valeria
Costa, Valmir A.
Amaral, Vanessa S. do
Silva, Vera C.
Wolff, Vera R. dos S.
Slobodian, Verônica
Silva, Vinícius B. da
Espíndola, Vinicius C.
Costa-Silva, Vinicius da
Bertaco, Vinicius de A.
Padula, Vinícius
Ferreira, Vinicius S.
Silva, Vitor C.P. da
Piacentini, Vítor de Q.
Sandoval-Gómez, Vivian E.
Trevine, Vivian
Sousa, Viviane R.
Sant’Anna, Vivianne B. de
Mathis, Wayne N.
Souza, Wesley de O.
Colombo, Wesley D.
Tomaszewska, Wioletta
Wosiacki, Wolmar B.
Ovando, Ximena M.C.
Leite, Yuri L.R.








ABSTRACT The limited temporal completeness and taxonomic accuracy of species lists, made available in a traditional manner in scientific publications, has always represented a problem. These lists are invariably limited to a few taxonomic groups and do not represent up-to-date knowledge of all species and classifications. In this context, the Brazilian megadiverse fauna is no exception, and the Catálogo Taxonômico da Fauna do Brasil (CTFB) (http://fauna.jbrj.gov.br/), made public in 2015, represents a database on biodiversity anchored on a list of valid and expertly recognized scientific names of animals in Brazil. The CTFB is updated in near real time by a team of more than 800 specialists. By January 1, 2024, the CTFB compiled 133,691 nominal species, with 125,138 that were considered valid. Most of the valid species were arthropods (82.3%, with more than 102,000 species) and chordates (7.69%, with over 11,000 species). These taxa were followed by a cluster composed of Mollusca (3,567 species), Platyhelminthes (2,292 species), Annelida (1,833 species), and Nematoda (1,447 species). All remaining groups had less than 1,000 species reported in Brazil, with Cnidaria (831 species), Porifera (628 species), Rotifera (606 species), and Bryozoa (520 species) representing those with more than 500 species. Analysis of the CTFB database can facilitate and direct efforts towards the discovery of new species in Brazil, but it is also fundamental in providing the best available list of valid nominal species to users, including those in science, health, conservation efforts, and any initiative involving animals. The importance of the CTFB is evidenced by the elevated number of citations in the scientific literature in diverse areas of biology, law, anthropology, education, forensic science, and veterinary science, among others.
2.
The impact of diabetes and subclinical hypothyroidism association with coronary artery calcium: results from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)
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Spilack, Aída de Melo
; Goulart, Alessandra C.
; Janovsky, Carolina C. P. S.
; Almeida-Pittito, Bianca de
; Lotufo, Paulo A.
; Bittencourt, Márcio Sommer
; Generoso, Giuliano
; Santos, Itamar de Souza
; Bensenor, Isabela M.
.









ABSTRACT Objective: We aimed to analyze the association of diabetes and subclinical hypothyroidism with subclinical atherosclerosis measured by coronary artery calcium (CAC) in the baseline of the ELSA-Brasil study. Materials and methods: CAC was measured using a 64-detector computed tomographic scanner. The association of CAC > 0 was presented as an odds ratio (OR) and 95% confidence intervals (95%CI) in logistic models and as β (95%CI) in linear models after multivariable adjustment for confounders. Results: We analyzed 3,809 participants (mean-age (SD) 50.5 (8.8); 51.7% women). In the main analysis, we did not find an association of diabetes and subclinical hypothyroidism with CAC. However, in stratified analysis according to age strata, we found no significative interaction terms, an important heterogeneity between the groups, with the younger age strata showing an association of the group with both diseases and CAC > 0 (OR 7.16; 95%CI, 1.14; 44.89) with a wide but significative 95%CI, suggesting that the smaller number of participants in the younger group may influence the results. Our findings also showed an association of CAC > 0 and log (CAC+1) with diabetes in logistic (OR, 1.31; 95%CI, 1.05-1.63) and linear models (β, 0.24, 0.16, 0.40), respectively. Diabetes was independently associated with CAC > 0 in linear models. Discussion: In conclusion, our results showed a great heterogeneity in stratified analysis based on age in the younger age strata. Although we found no significant interaction factors, the smaller sample size for the analysis may influence the negative findings.
3.
Negative life events and depression by gender in the Brazilian Longitudinal Study of Adult Health (ELSA-Brazil)
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Silva, Simone V.
; Santos, Itamar S.
; Lima, Danielle B.
; Goulart, Alessandra C.
; Varella, Ana C.
; Lotufo, Paulo A.
Brunoni, Andre R.
Bensenor, Isabela M.





Abstract Objective Gender differences may interfere with the association between Negative Life Events (NLEs) and prevalent/incident depression. This study evaluated the effect of gender in this association using data from the ELSA-Brazil cohort. Methods The authors analyzed 15,088 participants (mean age, 52.1 (9.1), 54.4 % women). NLEs (robbery, hospitalization, death of a close relative, financial hardship, and rupture of a love relationship) were accessed at baseline. Depression was assessed at baseline and follow-ups. The authors built logistic (Odds Ratio [OR], 95 % Confidence Interval [95 % CI]) and Poisson regression models (Relative Risk [RR], [95 % CI]) to evaluate this association. Results Women reported more NLEs compared to men. The authors found associations between NLEs and prevalent depression: for men, hospitalization (OR = 1.83; 95 % CI 1.16‒2.91), financial hardship (OR = 2.42; 95 % CI 1.69‒3.49), rupture of a love relationship (OR = 2.54; 95 % CI 1.50‒4.29), and any NLE (OR = 2.30; 95 % CI 1.59‒3.35); and for women, robbery (OR = 1.81; 95 % CI 1.31‒2.49), hospitalization (OR = 1.46; 95 % CI 1.11‒1.92), financial hardship (OR = 1.76; 95 % CI 1.43‒2.17), rupture of a love relationship (OR = 1.66; 95 % CI 1.20‒2.32), and any NLE (OR = 1.65; 95 % CI 1.34‒2.04). For incident depression only financial hardship (RR = 2.09; 95 % CI 1.55‒2.83) was associated with depression in men, while, for women, robbery (RR = 1.54; 95 % CI 1.16‒2.04); hospitalization (RR = 1.36; 95 % CI 1.07‒1.74), financial hardship (RR = 1.37; 95 % CI 1.14‒1.65), and any NLE (RR = 1.25; 95 % CI 1.04‒1.49) were associated with incident depression. No association was found between the death of a close relative and prevalent/incident depression. Conclusion NLEs were associated with depression in men and women, with a higher impact in the latter.
4.
O Risco de Doença Cardiovascular Segundo o Escore Não Laboratorial da OMS em uma População Brasileira Selecionada: Percentis da Distribuição e Concordância com o Escore Laboratorial
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Cesena, Fernando Yue
; Generoso, Giuliano
; Santos, Itamar de S.
; Pereira, Alexandre C.
Bittencourt, Marcio S.
Santos, Raul D.
Lotufo, Paulo A.
Benseñor, Isabela M.



5.
The association of diabetes, subclinical hypothyroidism and carotid intima-media thickness: results from the Brazilian Longitudinal Study of Adult Health (ELSA-Brazil) diabetes intimamedia intima media thickness ELSABrazil ELSA Brazil (ELSA-Brazil
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Spilack, Aída de Melo
; Goulart, Alessandra C.
; Almeida-Pititto, Bianca de
; Janovsky, Carolina Castro Porto Silva
; Lotufo, Paulo A.
; Santos, Itamar de Souza
; Benseñor, Isabela M.
.







Abstract Introduction: The association of diabetes with subclinical thyroid diseases may increase the risk of cardiovascular diseases. We analyzed the association of subclinical hypothyroidism, diabetes, and both diseases with carotid Intima-Media Thickness (cIMT) as a surrogate maker for early cardiovascular disease in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Methods: Cross-sectional analysis with data from the 3rd visit (2017‒2019). Linear regression models were used to evaluate the association of subclinical hypothyroidism, diabetes and of both diseases with a cIMT presented as Beta (95% Confidence Interval – 95% CI) without adjustment, with adjustment for sociodemographic variables (Model 1) and multivariable adjustment (Model 1 more cardiovascular risk factors). We also used logistic regression models to analyze the Odds Ratio (OR) and 95% CI for the association of both diseases using cIMT > P75%. Results: After the exclusion of patients with previous cardiovascular disease, 5,077 participants with no diseases, 1578 with diabetes, 662 with subclinical hypothyroidism, and 234 with both diseases were included in the analysis. Linear regression models showed an association of cIMT with only diabetes (β = 0.019; 95% CI 0.012 to 0.027; p < 0.0001) and subclinical hypothyroidism more diabetes (β = 0.03; 95% CI 0.010‒0.047, p < 0.0001). The logistic regression model reported an association between diabetes and CIMT higher than P75% (OR = 1.49, 95% CI 1.30‒1.71). No interaction between diabetes and subclinical hypothyroidism was detected using cIMT respectively as a continuous (p = 0.29) or as a categorical variable (p = 0.92). Discussion: Diabetes was associated with higher cIMT values. However, no additive effect of subclinical hypothyroidism associated with diabetes over cIMT was detected. Introduction IntimaMedia Intima Media (cIMT ELSABrasil. ELSABrasil ELSA Brasil . (ELSA-Brasil) Methods Crosssectional Cross sectional rd 2017‒2019. 20172019 2017‒2019 2017 2019 (2017‒2019) 95 (95 Model factors. factors factors) OR P75 P Results 5077 5 077 5,07 157 66 23 β 0.019 0019 0 019 0012 012 0.01 0.027 0027 027 0.0001 00001 0001 0.03 003 03 00100047 010 047 0.010‒0.047 0.0001. 149 49 1.49 1.30‒1.71. 130171 1.30‒1.71 30 71 1.30‒1.71) 0.29 029 29 0.92. 092 0.92 92 0.92) Discussion values However (ELSA-Brasil 2017201 2017‒201 201 (2017‒2019 9 (9 P7 507 07 5,0 15 6 2 001 01 0.0 0.02 002 02 0.000 0000 000 00 0010004 04 0.010‒0.04 14 4 1.4 13017 1.30‒1.7 3 7 0.2 09 0.9 201720 2017‒20 20 (2017‒201 ( 50 5, 0. 0.00 001000 0.010‒0.0 1. 1301 1.30‒1. 20172 2017‒2 (2017‒20 00100 0.010‒0. 130 1.30‒1 2017‒ (2017‒2 0010 0.010‒0 13 1.30‒ (2017‒ 0.010‒ 1.30 (2017 0.010 1.3 (201 (20 (2
6.
Prognóstico Relacionado à Terapia de Reperfusão Pós-Síndrome Coronariana Aguda na Atenção Secundária: Análise de Sobrevida em Longo Prazo na Estratégia ERICO PósSíndrome Pós Síndrome Secundária
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Bruno, Tatiana C.
; Bittencourt, Márcio S.
; Quidim, Alessandra V. L.
Santos, Itamar S.
Lotufo, Paulo A.
Benseñor, Isabela M.
Goulart, Alessandra C.


Resumo Fundamento A relação entre terapia de reperfusão após a síndrome coronariana aguda (SCA) e mortalidade na atenção secundária não é bem conhecida. Objetivos Avaliar o impacto de três estratégias terapêuticas: (1) terapia medicamentosa exclusiva, (2) Angioplastia Transluminal percutânea coronaria (ATPC) e (3) revascularização do miocárdio (RM) na sobrevida em longo prazo de participantes da Estratégia de Registro de Insuficiência Coronariana Aguda (ERICO). Métodos Análises de sobrevida para mortalidade por todas as causas, mortalidade por doença cardiovascular (DCV) e mortalidade por doença arterial coronariana (DAC) foram realizadas de acordo com três estratégias terapêuticas (tratamento clínico exclusivo, ATPC ou RM). Modelos de regressão de Cox foram usados para estimar o hazard ratio (HR) com intervalo de confiança de 95% (IC95%) de 180 dias a quatro anos de acompanhamento após a SCA. Os modelos são apresentados como modelo sem ajuste ou ajustado quanto à idade, sexo e DAC prévia, tipo de SCA, tabagismo, hipertensão, dislipidemia, fração de ejeção do ventrículo esquerdo e de acordo com o número de artérias coronárias principais obstruídas (≥50%). Resultados Entre os 800 participantes, as piores taxas de sobrevida (mortalidade por todas as causas e DCV) foram detectadas entre os indivíduos que se submeteram a RM. Houve correlação entre RM e DAC [HR: 2,19 (IC95% 1,05-4,55)], mas o risco perdeu significância no modelo multivariado. A ATPC foi associada a uma menor probabilidade de eventos fatais durante os quatro anos de acompanhamento: mortalidade por todas as causas [HR, análise multivariada: 0,42 (IC95% 0,26-0,70)], por DCV [HR: 0,39 (95% CI: 0,20-0,73)] e DAC [HR, análise multivariada: 0,24 (IC95% 0,09-0,63)] em comparação aos submetidos ao tratamento clínico exclusivo. Conclusão No ERICO, a ATPC após a SCA foi associada a um melhor prognóstico, principalmente sobrevida por DAC. (SCA conhecida 1 (1 exclusiva 2 (2 (ATPC 3 (3 (RM ERICO. ERICO . (ERICO) (DCV (DAC exclusivo RM) HR (HR 95 IC95% IC95 IC 18 idade prévia tabagismo hipertensão dislipidemia ≥50%. 50 ≥50% (≥50%) 80 [HR 219 19 2,1 (IC95 1,054,55, 105455 1,05 4,55 , 05 4 55 1,05-4,55)] multivariado HR, multivariada 042 0 42 0,4 0,260,70, 026070 0,26 0,70 26 70 0,26-0,70)] 039 39 0,3 (95 CI 0,200,73 020073 0,20 0,73 20 73 0,20-0,73) 024 24 0,2 0,090,63 009063 0,09 0,63 09 63 0,09-0,63) prognóstico ( (ERICO 9 IC9 5 ≥50 (≥50% 8 21 2, (IC9 054 1,054,55 10545 105 1,0 455 4,5 1,05-4,55) 04 0, 260 0,260,70 02607 026 070 0,7 7 0,26-0,70) 03 (9 200 0,200,7 02007 020 073 0,20-0,73 02 090 0,090,6 00906 009 0,0 063 0,6 6 0,09-0,63 ≥5 (≥50 (IC 1,054,5 1054 10 1, 45 4, 1,05-4,55 0,260,7 0260 07 0,26-0,70 0,200, 0200 0,20-0,7 0,090, 0090 00 06 0,09-0,6 ≥ (≥5 1,054, 1,05-4,5 0,260, 0,26-0,7 0,200 0,20-0, 0,090 0,09-0, (≥ 1,054 1,05-4, 0,260 0,26-0, 0,20-0 0,09-0 1,05-4 0,26-0 0,20- 0,09- 1,05- 0,26-
Abstract Background Relationship between reperfusion therapy post-acute coronary syndrome (ACS) and mortality in secondary care is not well-known. Objectives To evaluate the impact of three therapeutic strategies: (1) exclusive medical therapy, (2) percutaneous coronary intervention (PCI) and (3) coronary artery bypass grafting (CABG) on long-term survival of participants in the Strategy of Registry of Acute Coronary Syndrome (ERICO) study. Methods Survival analyses for all-cause, cardiovascular (CVD) and coronary artery disease (CAD) mortality were performed according to three therapeutic strategies (exclusive medical therapy, PCI or CABG). Cox regression models were used to estimate the hazard ratio (HR) with respective 95% confidence interval (95%CI) from 180 days to four years of follow-up after ACS. Models are presented as crude, age-sex adjusted and further adjusted for previous CAD, ACS subtype, smoking, hypertension, dyslipidemia, left ventricular ejection fraction and according to the number of obstructed (≥ 50%) major coronary arteries. Results Among 800 participants, the lowest crude survival rates were detected among individuals who underwent CABG (all-cause and CVD). CABG was correlated to CAD (HR: 2.19 [95% CI: 1.05-4.55]). However, this risk lost significance in the full model. PCI was associated to lower probability of fatal events during four-year follow-up: all-cause [multivariate HR: 0.42 (95% CI: 0.26-0.70)], CVD [HR: 0.39 (95% CI: 0.20-0.73)] and CAD [multivariate HR: 0.24 (95% CI: 0.09-0.63)] compared to those submitted to exclusive medical therapy. Conclusion In the ERICO study, PCI after ACS was associated to better prognosis, particularly CAD survival. postacute post acute (ACS wellknown. wellknown well known. known well-known 1 (1 2 (2 (PCI 3 (3 (CABG longterm long term (ERICO study allcause, allcause all cause, cause (CVD (CAD CABG. . CABG) HR (HR 95 95%CI 95CI CI (95%CI 18 followup follow up agesex age sex subtype smoking hypertension dyslipidemia ≥ ( 50% 50 arteries 80 CVD. CVD) 219 19 2.1 [95 1.054.55. 105455 1.05 4.55 05 4 55 1.05-4.55]) However model fouryear year multivariate 042 0 42 0.4 (95 0.260.70, 026070 0.26 0.70 , 26 70 0.26-0.70)] [HR 039 39 0.3 0.200.73 020073 0.20 0.73 20 73 0.20-0.73) 024 24 0.2 0.090.63 009063 0.09 0.63 09 63 0.09-0.63) prognosis 9 5 8 21 2. [9 054 1.054.55 10545 105 1.0 455 4.5 1.05-4.55] 04 0. (9 260 0.260.70 02607 026 070 0.7 7 0.26-0.70) 03 200 0.200.7 02007 020 073 0.20-0.73 02 090 0.090.6 00906 009 0.0 063 0.6 6 0.09-0.63 [ 1.054.5 1054 10 1. 45 4. 1.05-4.55 0.260.7 0260 07 0.26-0.70 0.200. 0200 0.20-0.7 0.090. 0090 00 06 0.09-0.6 1.054. 1.05-4.5 0.260. 0.26-0.7 0.200 0.20-0. 0.090 0.09-0. 1.054 1.05-4. 0.260 0.26-0. 0.20-0 0.09-0 1.05-4 0.26-0 0.20- 0.09- 1.05- 0.26-
7.
Association between psoriasis and thyroid function: results from the Brazilian Longitudinal Study of Adults Health (ELSA-Brasil) function ELSABrasil ELSA Brasil (ELSA-Brasil
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Meneghini, Vandrize
; Tebar, William R.
; Santos, Itamar Souza
; Janovsky, Carolina Castro Porto Silva
; Almeida-Pititto, Bianca de
; Lotufo, Paulo A.
; Goulart, Alessandra C.
; Bensenor, Isabela M.
.








ABSTRACT Objective: To determine the relationship between psoriasis, thyroid-stimulating hormone (TSH), free thyroxine (FT4), free triodothyronine (FT3), thyroid peroxidase antibodies (TPOAb), and subclinical thyroid dysfunctions in middle-aged and older adults. Materials and methods: Cross-sectional analyses included a self-reported medical diagnosis of psoriasis and thyroid function from the 3rd visit (2017-2019) of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). TSH, FT4, and FT3 levels were analyzed as continuous variables and quintiles, and TPOAb positivity and subclinical hypothyroidism as a yes/no variable. Logistic regression models were built as crude and adjusted by main confounders (age, sex, education level, race/ethnicity, and smoking). Results: From 9,649 participants (52.3% women; 59.2 ± 8.7 years old), the prevalence of psoriasis was 2.8% (n = 270). TSH, FT4, TPOAb positivity, and subclinical hypothyroidism were not associated with psoriasis in the main analyses. In the stratified analysis, our findings showed positive associations of the lowest (OR = 2.01; 95% CI 1.05-3.84; p = 0.036) and the highest (OR = 2.13; 95% CI 1.12-4.05; p = 0.022) quintiles of FT4 and a protective association of TPOAb positivity (OR = 0.43; 95% CI 0.19-0.98; p = 0.046) with prevalent psoriasis in women. In the logistic regression for FT3, participants in the 1st quintile showed a statistically significant association with psoriasis for the whole sample (OR = 1.66; 95% CI 1.11-2.46; p = 0.013) and for men (OR = 2.25; 95% CI 1.25-4.04; p = 0.007) in the sex-stratified analysis. Conclusions: The present study showed that the association of FT4 levels with psoriasis are different according to sex, with a possible U-shaped curve in women but not in men. Although there were some associations of FT3 with psoriasis, they may be a consequence of non-thyroidal illness syndrome. Further prospective data may clarify the association of thyroid function and psoriasis. Objective thyroidstimulating stimulating TSH , (TSH) FT (FT4) (FT3) TPOAb, (TPOAb) middleaged middle aged adults methods Crosssectional Cross sectional selfreported self reported rd 20172019 2017 2019 (2017-2019 ELSABrasil. ELSABrasil ELSA Brasil . (ELSA-Brasil) yesno yes no variable age, age (age sex level raceethnicity race ethnicity race/ethnicity smoking. smoking smoking) Results 9649 9 649 9,64 52.3% 523 52 3 (52.3 592 59 2 59. 87 8 7 8. old, old old) 28 2.8 n 270. 270 270) analysis OR 2.01 201 01 95 1.053.84 105384 1.05 3.84 1 05 84 1.05-3.84 0.036 0036 0 036 2.13 213 13 1.124.05 112405 1.12 4.05 12 4 1.12-4.05 0.022 0022 022 0.43 043 43 0.190.98 019098 0.19 0.98 19 98 0.19-0.98 0.046 0046 046 st 1.66 166 66 1.112.46 111246 1.11 2.46 11 46 1.11-2.46 0.013 0013 013 2.25 225 25 1.254.04 125404 1.25 4.04 04 1.25-4.04 0.007 0007 007 sexstratified Conclusions Ushaped U shaped nonthyroidal non thyroidal syndrome (TSH (FT4 (FT3 (TPOAb 2017201 (2017-201 (ELSA-Brasil 964 64 9,6 52.3 5 (52. 2. 27 2.0 20 053 1.053.8 10538 105 1.0 384 3.8 1.05-3.8 0.03 003 03 2.1 21 124 1.124.0 11240 112 1.1 405 4.0 1.12-4.0 0.02 002 02 0.4 190 0.190.9 01909 019 0.1 098 0.9 0.19-0.9 0.04 004 1.6 16 6 1.112.4 11124 111 246 2.4 1.11-2.4 0.01 001 2.2 22 254 1.254.0 12540 125 1.2 404 1.25-4.0 0.00 000 00 (FT 201720 (2017-20 96 9, 52. (52 1.053. 1053 10 1. 38 3. 1.05-3. 0.0 1.124. 1124 40 4. 1.12-4. 0. 0.190. 0190 09 0.19-0. 1.112. 1112 24 1.11-2. 1.254. 1254 1.25-4. 20172 (2017-2 (5 1.053 1.05-3 1.124 1.12-4 0.190 0.19-0 1.112 1.11-2 1.254 1.25-4 (2017- ( 1.05- 1.12- 0.19- 1.11- 1.25- (2017 (201 (20 (2
8.
Saúde Cardiovascular e Fibrilação ou Flutter Atrial: Um Estudo Transversal do ELSA-Brasil
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Santos, Itamar S.
; Lotufo, Paulo A.
; Goulart, Alessandra C.
; Brant, Luisa C. C.
; Pinto Filho, Marcelo M
Pereira, Alexandre C.
Barreto, Sandhi M.
Ribeiro, Antonio L. P.
Thomas, G Neil
Lip, Gregory Y. H.
Bensenor, Isabela M.
Arasalingam, Ajini
Beane, Abi
Bensenor, Isabela M
Brocklehurst, Peter
Cheng, Kar Keung
El-Bouri, Wahbi
Feng, Mei
Goulart, Alessandra C
Greenfield, Sheila
Guo, Yutao
Guruparan, Mahesan
Gusso, Gustavo
Gooden, Tiffany E
Haniffa, Rashan
Humphreys, Lindsey
Jolly, Kate
Jowett, Sue
Kumarendran, Balachandran
Lancashire, Emma
Lane, Deirdre A
Li, Xuewen
Lip (Co-PI), Gregory Y.H.
Li, Yan-guang
Lobban, Trudie
Lotufo, Paulo A
Manseki-Holland, Semira
Moore, David J
Nirantharakumar, Krishnarajah
Olmos, Rodrigo D
Paschoal, Elisabete
Pirasanth, Paskaran
Powsiga, Uruthirakumar
Romagnolli, Carla
Santos, Itamar S
Shantsila, Alena
Sheron, Vethanayagam Antony
Shribavan, Kanesamoorthy
Szmigin, Isabelle
Subaschandren, Kumaran
Surenthirakumaran, Rajendra
Tai, Meihui
Neil Thomas (Co-PI), G
Varella, Ana C
Wang, Hao
Wang, Jingya
Zhang, Hui
Zhong, Jiaoyue




Resumo Fundamento A associação entre o status de saúde cardiovascular ideal ( ideal cardiovascular health ( ICVH) e diagnóstico de fibrilação ou flutter atrial (FFA) foi menos estudado em comparação a outras doenças cardiovasculares. Objetivos Analisar a associação entre o diagnóstico de FFA e métricas e escores de ICVH no Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil). Métodos Este estudo analisou dados de 13141 participantes com dados completos. Os traçados eletrocardiográficos foram codificados de acordo com o Sistema de Minnesota, em um centro de leitura centralizado. As métricas do ICVH (dieta, atividade física, índice de massa corporal, tabagismo, glicemia de jeju, e colesterol total) e escores do ICVH foram calculados conforme proposto pela American Heart Association . Modelos de regressão logística bruta e ajustada foram construídos para analisar associações de métricas e escores do ICVH com diagnóstico de FFA. O nível de significância foi estabelecido em 0,05. Resultados A idade mediana da amostra foi de 55 anos, e 54,4% eram mulheres. Nos modelos ajustados, os escores de ICVH não apresentaram associação significativa com diagnóstico de FFA prevalente [odds ratio (OR):0,96; intervalo de confiança de 95% (IC95%):0,80-1,16; p=0,70). Perfis de pressão arterial ideal (OR:0,33; IC95%:0,1-0,74; p=0,007) e colesterol total ideal (OR:1,88; IC95%:1,19-2,98; p=0,007) foram significativamente associados com o diagnóstico de FFA. Conclusões Não foram identificadas associações significativas entre escores de ICVH global e diagnóstico de FFA após ajuste multivariado em nossas análises, devido, ao menos em parte, às associações antagônicas da FFA com métricas de pressão arterial e de colesterol total do ICVH. Nossos resultados sugerem que estimar a prevenção da FFA por meio de escore de ICVH global pode não ser adequado, e as métricas do ICVH devem ser consideradas separadamente.
Abstract Background The association between ideal cardiovascular health (ICVH) status and atrial fibrillation or flutter (AFF) diagnosis has been less studied compared to other cardiovascular diseases. Objective To analyze the association between AFF diagnosis and ICVH metrics and scores in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Methods This study analyzed data from 13,141 participants with complete data. Electrocardiographic tracings were coded according to the Minnesota Coding System, in a centralized reading center. ICVH metrics (diet, physical activity, body mass index, smoking, blood pressure, fasting plasma glucose, and total cholesterol) and scores were calculated as proposed by the American Heart Association. Crude and adjusted binary logistic regression models were built to analyze the association of ICVH metrics and scores with AFF diagnosis. Significance level was set at 0.05. Results The sample had a median age of 55 years and 54.4% were women. In adjusted models, ICVH scores were not significantly associated with prevalent AFF diagnosis (odds ratio [OR]:0.96; 95% confidence interval [95% CI]:0.80-1.16; p=0.70). Ideal blood pressure (OR:0.33; 95% CI:0.15–0.74; p=0.007) and total cholesterol (OR:1.88; 95% CI:1.19–2.98; p=0.007) profiles were significantly associated with AFF diagnosis. Conclusions No significant associations were identified between global ICVH scores and AFF diagnosis after multivariable adjustment in our analyses, at least partially due to the antagonistic associations of AFF with blood pressure and total cholesterol ICVH metrics. Our results suggest that estimating the prevention of AFF burden using global ICVH scores may not be adequate, and ICVH metrics should be considered in separate.
9.
Saúde Cardiovascular e Fibrilação ou Flutter Atrial: Um Estudo Transversal do ELSA-Brasil
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Santos, Itamar S.
; Lotufo, Paulo A.
; Goulart, Alessandra C.
; Brant, Luisa C. C.
; Pinto Filho, Marcelo M
Pereira, Alexandre C.
Barreto, Sandhi M.
Ribeiro, Antonio L. P.
Thomas, G Neil
Lip, Gregory Y. H.
Bensenor, Isabela M.
Arasalingam, Ajini
Beane, Abi
Bensenor, Isabela M
Brocklehurst, Peter
Cheng, Kar Keung
El-Bouri, Wahbi
Feng, Mei
Goulart, Alessandra C
Greenfield, Sheila
Guo, Yutao
Guruparan, Mahesan
Gusso, Gustavo
Gooden, Tiffany E
Haniffa, Rashan
Humphreys, Lindsey
Jolly, Kate
Jowett, Sue
Kumarendran, Balachandran
Lancashire, Emma
Lane, Deirdre A
Li, Xuewen
Lip (Co-PI), Gregory Y.H.
Li, Yan-guang
Lobban, Trudie
Lotufo, Paulo A
Manseki-Holland, Semira
Moore, David J
Nirantharakumar, Krishnarajah
Olmos, Rodrigo D
Paschoal, Elisabete
Pirasanth, Paskaran
Powsiga, Uruthirakumar
Romagnolli, Carla
Santos, Itamar S
Shantsila, Alena
Sheron, Vethanayagam Antony
Shribavan, Kanesamoorthy
Szmigin, Isabelle
Subaschandren, Kumaran
Surenthirakumaran, Rajendra
Tai, Meihui
Neil Thomas (Co-PI), G
Varella, Ana C
Wang, Hao
Wang, Jingya
Zhang, Hui
Zhong, Jiaoyue




Resumo Fundamento A associação entre o status de saúde cardiovascular ideal ( ideal cardiovascular health ( ICVH) e diagnóstico de fibrilação ou flutter atrial (FFA) foi menos estudado em comparação a outras doenças cardiovasculares. Objetivos Analisar a associação entre o diagnóstico de FFA e métricas e escores de ICVH no Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil). Métodos Este estudo analisou dados de 13141 participantes com dados completos. Os traçados eletrocardiográficos foram codificados de acordo com o Sistema de Minnesota, em um centro de leitura centralizado. As métricas do ICVH (dieta, atividade física, índice de massa corporal, tabagismo, glicemia de jeju, e colesterol total) e escores do ICVH foram calculados conforme proposto pela American Heart Association . Modelos de regressão logística bruta e ajustada foram construídos para analisar associações de métricas e escores do ICVH com diagnóstico de FFA. O nível de significância foi estabelecido em 0,05. Resultados A idade mediana da amostra foi de 55 anos, e 54,4% eram mulheres. Nos modelos ajustados, os escores de ICVH não apresentaram associação significativa com diagnóstico de FFA prevalente [odds ratio (OR):0,96; intervalo de confiança de 95% (IC95%):0,80-1,16; p=0,70). Perfis de pressão arterial ideal (OR:0,33; IC95%:0,1-0,74; p=0,007) e colesterol total ideal (OR:1,88; IC95%:1,19-2,98; p=0,007) foram significativamente associados com o diagnóstico de FFA. Conclusões Não foram identificadas associações significativas entre escores de ICVH global e diagnóstico de FFA após ajuste multivariado em nossas análises, devido, ao menos em parte, às associações antagônicas da FFA com métricas de pressão arterial e de colesterol total do ICVH. Nossos resultados sugerem que estimar a prevenção da FFA por meio de escore de ICVH global pode não ser adequado, e as métricas do ICVH devem ser consideradas separadamente.
Abstract Background The association between ideal cardiovascular health (ICVH) status and atrial fibrillation or flutter (AFF) diagnosis has been less studied compared to other cardiovascular diseases. Objective To analyze the association between AFF diagnosis and ICVH metrics and scores in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Methods This study analyzed data from 13,141 participants with complete data. Electrocardiographic tracings were coded according to the Minnesota Coding System, in a centralized reading center. ICVH metrics (diet, physical activity, body mass index, smoking, blood pressure, fasting plasma glucose, and total cholesterol) and scores were calculated as proposed by the American Heart Association. Crude and adjusted binary logistic regression models were built to analyze the association of ICVH metrics and scores with AFF diagnosis. Significance level was set at 0.05. Results The sample had a median age of 55 years and 54.4% were women. In adjusted models, ICVH scores were not significantly associated with prevalent AFF diagnosis (odds ratio [OR]:0.96; 95% confidence interval [95% CI]:0.80-1.16; p=0.70). Ideal blood pressure (OR:0.33; 95% CI:0.15–0.74; p=0.007) and total cholesterol (OR:1.88; 95% CI:1.19–2.98; p=0.007) profiles were significantly associated with AFF diagnosis. Conclusions No significant associations were identified between global ICVH scores and AFF diagnosis after multivariable adjustment in our analyses, at least partially due to the antagonistic associations of AFF with blood pressure and total cholesterol ICVH metrics. Our results suggest that estimating the prevention of AFF burden using global ICVH scores may not be adequate, and ICVH metrics should be considered in separate.
10.
Chronic inflammatory diseases, subclinical atherosclerosis, and cardiovascular diseases: Design, objectives, and baseline characteristics of a prospective case-cohort study ‒ ELSA-Brasil
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Bensenor, Isabela M.
; Goulart, Alessandra C.
; Pereira, Alexandre C.
; Brunoni, André R.
; Alencar, Airlane
; Santos, Raul D.
; Bittencourt, Márcio S.
; Telles, Rosa W.
; Machado, Luciana Andrade Carneiro
; Barreto, Sandhi Maria
; de Almeida-Pititto, Bianca
; Janovsky, Carolina Porto Silva
; Sgarbi, José Augusto
; Tebar, William R.
; Meneghini, Vandrize
; Barbosa Junior, Fernando
; Ribeiro, Ana Cristina de Medeiros
; Pasoto, Sandra Gofinet
; Pereira, Rosa Maria R.
; Bonfá, Eloísa
; Sipahi, Aytan M.
; Santos, Itamar de S.
; Lotufo, Paulo A.
.























Abstract Objectives This analysis describes the protocol of a study with a case-cohort to design to prospectively evaluate the incidence of subclinical atherosclerosis and Cardiovascular Disease (CVD) in Chronic Inflammatory Disease (CID) participants compared to non-diseased ones. Methods A high-risk group for CID was defined based on data collected in all visits on self-reported medical diagnosis, use of medicines, and levels of high-sensitivity C-Reactive Protein >10 mg/L. The comparison group is the Aleatory Cohort Sample (ACS): a group with 10% of participants selected at baseline who represent the entire cohort. In both groups, specific biomarkers for DIC, markers of subclinical atherosclerosis, and CVD morbimortality will be tested using weighted Cox. Results The high-risk group (n = 2,949; aged 53.6 ± 9.2; 65.5% women) and the ACS (n=1543; 52.2±8.8; 54.1% women) were identified. Beyond being older and mostly women, participants in the high-risk group present low average income (29.1% vs. 24.8%, p < 0.0001), higher BMI (Kg/m2) (28.1 vs. 26.9, p < 0.0001), higher waist circumference (cm) (93.3 vs. 91, p < 0.0001), higher frequencies of hypertension (40.2% vs. 34.5%, p < 0.0001), diabetes (20.7% vs. 17%, p = 0.003) depression (5.8% vs. 3.9%, p = 0.007) and higher levels of GlycA a new inflammatory marker (p < 0.0001) compared to the ACS. Conclusions The high-risk group selected mostly women, older, lower-income/education, higher BMI, waist circumference, and of hypertension, diabetes, depression, and higher levels of GlycA when compared to the ACS. The strategy chosen to define the high-risk group seems adequate given that multiple sociodemographic and clinical characteristics are compatible with CID.
11.
ELSA-Brasil: a 4-year incidence of hearing loss in adults with and without hypertension
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Padilha, Fernanda Yasmin Odila Maestri Miguel
; Oenning, Nágila Soares Xavier
; Santos, Itamar de Souza
; Rabelo, Camila Maia
; Moreira, Renata Rodrigues
; Bensenor, Isabela M.
; Lotufo, Paulo A.
; Samelli, Alessandra Giannella
.








ABSTRACT OBJECTIVE To compare the incidence of hearing loss among adults stratified by the occurrence of hypertension, and to investigate the association between hypertension and hearing loss. METHODS Longitudinal observational study, part of the Estudo Longitudinal da Saúde do Adulto (ELSA-Brasil, Longitudinal Study on Adult’s Health). Data from the first and second waves were analyzed, including information from audiological assessment and general health of the subjects. As outcome, we considered the presence of hearing loss (hearing thresholds above 25 dBHL at frequencies from 500 Hz to 8 kHz) and, as exposure variable, hypertension (report of medical diagnosis of hypertension; and/or use of drugs to treat hypertension; and/or pressure systolic blood pressure ≥ 140 mmHg; or diastolic blood pressure ≥ 90 mmHg). As covariables for adjustment were considered: sex, age, education, race / ethnicity, income, smoking, diabetes, and occupational exposure to noise. Poisson regression analysis was conducted, estimating the crude and adjusted relative risks, with 95% confidence intervals, in order to assess the factors associated with hearing loss. RESULTS In crude analyses, the incidence of hearing loss was higher for subjects with hypertension (9.7% versus 5.4%). The crude relative risks for hearing loss was almost double (1.93; 95%CI: 1.10–3.39) for subjects with hypertension in the right ear. In the adjusted analyses, the relative risks was not significant for the hypertension variable (1.42; 95%CI: 0.75–2.67). Being 60 years or older (RR: 5.41; 95%CI: 2.79–10.50) showed a statistically significant association with hearing loss, indicating that older adults have higher relative risks for hearing loss. CONCLUSION In the adjusted analyses controlled for multiple risk factors there was no association between hypertension and hearing loss. The dichotomous variable age (being 60 years or older), on the other hand, has shown a significant association with hearing loss.
12.
ELSA-Brasil: a 4-year incidence of hearing loss in adults with and without hypertension
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Padilha, Fernanda Yasmin Odila Maestri Miguel
; Oenning, Nágila Soares Xavier
; Santos, Itamar de Souza
; Rabelo, Camila Maia
; Moreira, Renata Rodrigues
; Bensenor, Isabela M.
; Lotufo, Paulo A.
; Samelli, Alessandra Giannella
.








ABSTRACT OBJECTIVE To compare the incidence of hearing loss among adults stratified by the occurrence of hypertension, and to investigate the association between hypertension and hearing loss. METHODS Longitudinal observational study, part of the Estudo Longitudinal da Saúde do Adulto (ELSA-Brasil, Longitudinal Study on Adult’s Health). Data from the first and second waves were analyzed, including information from audiological assessment and general health of the subjects. As outcome, we considered the presence of hearing loss (hearing thresholds above 25 dBHL at frequencies from 500 Hz to 8 kHz) and, as exposure variable, hypertension (report of medical diagnosis of hypertension; and/or use of drugs to treat hypertension; and/or pressure systolic blood pressure ≥ 140 mmHg; or diastolic blood pressure ≥ 90 mmHg). As covariables for adjustment were considered: sex, age, education, race / ethnicity, income, smoking, diabetes, and occupational exposure to noise. Poisson regression analysis was conducted, estimating the crude and adjusted relative risks, with 95% confidence intervals, in order to assess the factors associated with hearing loss. RESULTS In crude analyses, the incidence of hearing loss was higher for subjects with hypertension (9.7% versus 5.4%). The crude relative risks for hearing loss was almost double (1.93; 95%CI: 1.10–3.39) for subjects with hypertension in the right ear. In the adjusted analyses, the relative risks was not significant for the hypertension variable (1.42; 95%CI: 0.75–2.67). Being 60 years or older (RR: 5.41; 95%CI: 2.79–10.50) showed a statistically significant association with hearing loss, indicating that older adults have higher relative risks for hearing loss. CONCLUSION In the adjusted analyses controlled for multiple risk factors there was no association between hypertension and hearing loss. The dichotomous variable age (being 60 years or older), on the other hand, has shown a significant association with hearing loss.
13.
Incidence of TPOAb over a 4-year follow-up period: results from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)
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Benseñor, Isabela M.
; Janovsky, Carolina Castro Porto Silva
; Goulart, Alessandra C.
; Santos, Itamar de Souza
; Diniz, Maria de Fátima Haueisen Sander
; Almeida-Pititto, Bianca de
; Sgarbi, José Augusto
; Lotufo, Paulo A.
.








ABSTRACT Objective: Although some previous data have suggested a high iodine intake in Brazil, the prevalence of antithyroperoxidase antibodies (TPOAb) in the country is compatible with rates from countries with adequate iodine intake. This observation emphasizes the importance of knowing the incidence of TPOAb in Brazil. Materials and methods: This prospective analysis included euthyroid participants with negative TPOAb at baseline and a thyroid function assessment at a 4-year follow-up. TPOAb was measured by electrochemiluminescence and considered positive when titers were ≥34 IU/mL. TSH and free T4 (FT4) levels were determined by a third-generation immunoenzymatic assay. The incidence of TPOAb is expressed in percentage per year or as a cumulative incidence within the 4-year follow-up period. Results: Of 8,922 euthyroid participants (mean age 51.1 years; 50.9% women) with a negative TPOAb test at baseline, 130 presented incident TPOAb at the 4-year follow-up, yielding an annual incidence of TPOAb of 0.38%/year (95% confidence interval [95% CI], 0.37-0.39%/year) and a cumulative incidence over 4 years of 1.46% (95% CI, 1.21-1.71%). In men, the annual incidence was 0.32% (95% CI, 0.31-0.33%), and the cumulative incidence over 4 years was 1.23% (95% CI, 0.90-1.56%). In women, the annual incidence was 0.43%/year (95% CI, 0.42-0.44%/year) and the cumulative incidence over 4 years was 1.67% (95% CI, 1.30-2.04%). The only factor associated with incident TPOAb was the occurrence of thyroid diseases at follow-up. No differences in TPOAb incidence were detected across ELSA-Brasil research centers. Conclusion: Based on the results of this study, the incidence of TPOAb per year and at a 4-year follow-up period are compatible with those of a country with adequate iodine intake.
https://doi.org/10.20945/2359-3997000000422
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14.
Diagnóstico de Fibrilação Atrial na Comunidade Utilizando Eletrocardiograma e Autorrelato: Análise Transversal do ELSA-Brasil
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Santos, Itamar S.
; Lotufo, Paulo A.
; Brant, Luisa
; Pinto Filho, Marcelo M.
; Pereira, Alexandre da Costa
Barreto, Sandhi Maria
Ribeiro, Antonio L.
Thomas, G Neil
Lip, Gregory Y. H.
Bensenor, Isabela M.




Resumo Fundamento: A fibrilação ou flutter atrial (FFA) é a arritmia cardíaca sustentada mais comum. Existem poucos dados sobre a epidemiologia da FFA na América do Sul. Objetivo: O presente estudo procurou descrever a epidemiologia clínica da FFA e o uso de anticoagulantes na avaliação da linha de base do Estudo Longitudinal da Saúde do Adulto (ELSA-Brasil). Métodos: Foram analisados dados de 13.260 participantes do ELSA-Brasil. A FFA foi definida pelo eletrocardiograma ou por autorrelato. Modelos de regressão logística foram construídos para analisar fatores associados à FFA. Este estudo também analisou se idade e sexo estavam associados ao uso de anticoagulantes para evitar acidente vascular cerebral. O nível de significância foi de 5%. Resultados: A idade mediana foi de 51 anos, e 7.213 (54,4%) participantes eram mulheres. A FFA foi detectada em 333 (2,5%) participantes. O aumento da idade (razão de chances [RC]:1,05; intervalo de confiança de 95% [IC95%]: 1,04-1,07), hipertensão (RC:1,44; IC95%:1,14-1,81) coronariopatia (RC: 5,11; IC95%:3,85–6,79), insuficiência cardíaca (RC:7,37; IC95%:5,00–10,87) e febre reumática (RC:3,38; IC95%:2,28–5,02) foram associadas à FFA. Dos 185 participantes com FFA e pontuação no CHA2DS2-VASc≥2, apenas 20 (10,8%) usavam anticoagulantes (50,0% entre aqueles com FFA no eletrocardiograma de linha de base). O uso de anticoagulantes nesse grupo foi associado a maior idade (1,8% vs 17,7% naqueles com idade ≤ 54 e ≥ 65 anos, respectivamente; p=0,013). Observou-se uma tendência ao menor uso de anticoagulantes em mulheres (7,1% vs. 16,4% em mulheres e homens, respectivamente; p=0,055). Conclusões: No recrutamento do ELSA-Brasil, 2,5% dos participantes tinham FFA. O baixo uso de anticoagulantes era comum, o que representa um desafio para os cuidados de saúde nesse cenário.
Abstract Background: Atrial fibrillation or flutter (AFF) is the most common sustained cardiac arrhythmia. Limited data can be found on AFF epidemiology in South America. Objective: The present study sought to describe the clinical epidemiology of AFF and the use of stroke prevention medication in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) baseline assessment. Methods: This study analyzed data from 13,260 ELSA-Brasil participants. AFF was defined according to ECG recording or by self-report. Logistic regression models were built to analyze factors associated with AFF. This study also analyzed if age and sex were associated with anticoagulant use for stroke prevention. Significance level was set at 5%. Results: Median age was 51 years and 7,213 (54.4%) participants were women. AFF was present in 333 (2.5%) participants. Increasing age (odds ratio [OR]:1.05; 95% confidence interval [95%CI]: 1.04–1.07), hypertension (OR:1.44; 95%CI: 1.14–1.81), coronary heart disease (OR: 5.11; 95%CI: 3.85–6.79), heart failure (OR:7.37; 95%CI: 5.00–10.87), and rheumatic fever (OR:3.38; 95%CI: 2.28–5.02) were associated with AFF. From 185 participants with AFF and a CHA2DS2-VASc score ≥2, only 20 (10.8%) used anticoagulants (50.0% among those with AFF in the baseline ECG). Stroke prevention in this group was associated with a higher age (1.8% vs 17.7% in those aged ≤ 54 and ≥ 65 years, respectively; p=0.013). A trend towards a reduced anticoagulant use was observed in women (7.1% vs. 16.4% in women and men, respectively; p=0.055). Conclusions: At the ELSA-Brasil baseline, 2.5% of the participants had AFF. The lack of stroke prevention was common, which is an especially challenging point for healthcare in this setting.
https://doi.org/10.36660/abc.20190873
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15.
Incidence of thyroid diseases: Results from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)
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Benseñor, Isabela M.
; Sgarbi, José Augusto
; Janovsky, Carolina Castro Porto Silva
; Pittito, Bianca Almeida
; Diniz, Maria de Fátima Haueisen Sander
; Almeida, Maria da Conceição Chagas de
; Alvim, Sheila Maria
; Barreto, Sandhi M.
; Giatti, Luana
; Duncan, Bruce B.
; Schmidt, Maria Inês
; Fonseca, Maria de Jesus M.
; Griep, Rosane H.
; Molina, Maria del Carmen B.
; Mill, José Geraldo
; Santos, Itamar de Souza
; Goulart, Alessandra C.
; Lotufo, Paulo A.
.


















ABSTRACT Objective: To evaluate incidence of subclinical and overt hyperthyroidism and hypothyroidism. Subjects and methods: The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) is a prospective cohort study of 15,105 civil servants, examined at baseline and over a 4-year follow-up. This analysis included 9,705 participants with normal thyroid function at baseline, follow-up information about thyroid function and with no report of using drugs that may interfere in the thyroid function. Thyroid function was defined by TSH/FT4 levels or routine use of thyroid hormones/anti-thyroid medications. Annual and cumulative (over 4-year) incidence rates were presented as percentages (95% Confidence Intervals). Results: The incidence of all overt and subclinical thyroid disease was 6.7% (1.73%/year): 0.19% for overt hyperthyroidism (0.048%/year), 0.54% for subclinical hyperthyroidism (0.14%/year), 1.98% for overt hypothyroidism (0.51%/year), and 3.99% for subclinical hypothyroidism (1.03%/year). The incidence of all thyroid diseases was higher in women, when compared to men, with a low women:men ratio (1.36). For Blacks the highest incidence was for overt hyperthyroidism, while for Whites, the highest incidence was for overt hypothyroidism. However, the highest incidence of overt hyperthyroidism was detected in Asian descendants. The presence of antithyroperoxidase antibodies at baseline was associated with higher incidence of overt thyroid diseases. Conclusion: These results showed a high incidence of hypothyroidism, which is compatible with a country with a more-than-adequate iodine intake. The low women:men ratio of the incidence of thyroid dysfunction highlights the importance of the diagnosis of thyroid diseases among men in Brazil.
https://doi.org/10.20945/2359-3997000000348
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