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Resumo O presente artigo apresenta uma ampla avaliação sobre o destacamento de pessoal chinês para operações de paz ao longo das últimas três décadas (1990-2019). Para tanto, um conjunto de dados original foi construído a partir de dados coletados do Departamento de Operações de Paz da ONU (DPO). Os seguintes quatro indicadores foram analisados: (i) contribuição total de pessoal por ano; (ii) contribuição de pessoal por missão; (iii) contribuição de pessoal em relação ao contingente total da missão; e (iv) contribuição de pessoal em uma determinada missão em relação ao total destacado pela China naquele ano. De modo geral, as missões da ONU na Libéria (UNMIL) e no Sudão do Sul (UNMISS) foram os principais destinos das forças chinesas de manutenção de paz no século XXI, enquanto o Camboja (UNTAC) foi, de longe, o único lugar onde a China se envolveu profundamente durante a década de 1990. Além de exibir dados descritivos, o artigo também analisa brevemente o envolvimento chinês nessas operações.

Abstract This article presents a broad assessment of Chinese personnel deployments to peacekeeping operations (PKOs) for the past three decades (1990-2019). To this end, an original dataset was built with data collected from the UN Department of Peace Operations. The following four indicators were considered in the analysis: (i) total personnel contribution per year; (ii) personnel contribution per mission; (iii) personnel contribution in relation to the mission’s total contingent; and (iv) personnel in a given mission in relation to the total personnel dispatched by China that year. Generally speaking, UN missions in Liberia (UNMIL) and South Sudan (UNMISS) have been the main destinations of Chinese peacekeepers in the 21st Century, while Cambodia (UNTAC) was by far the only place where China got deeply involved during the 1990s. In addition to displaying descriptive data, the paper also briefly analyses Chinese engagement in these operations.

https://doi.org/10.1590/s0102-8529.2019430200008 156 downloads

Establishment of reference interval for thyroid-stimulating hormone using electrochemiluminescence assay in a healthy adult population from Fortaleza, Brazil
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Gurgel, Maria Helane C

; Ponte, Clarisse M. M.

; Fontes, Rosita

; Rocha, Ítalo V.

; Batista, Lívia A. A.

; Sousa, Tamara C. S.

; Montenegro Junior, Renan M.

Archives of Endocrinology and Metabolism

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aug 2020, Volume 64 N. 4 Pages 362 - 368

Abstract: En | Text: En | PDF: En

ABSTRACT Objective This study aimed to determine the thyroid-stimulating hormone (TSH) reference interval (RI) and to assess the influence of the use of thyroid ultrasonography (TUS) on reference individual selection from a healthy adult population in Fortaleza, Brazil. Subjects and methods This cross-sectional study recruited patients (N = 272; age = 18-50 years) with normal thyroid function (NTF) and placed them in three groups according to their test results: NTF (n = 272; all participants), TUS (n = 170; participants who underwent thyroid US), RI (n = 124; reference individuals with normal TSH levels). TSH, FT4, TT3, TgAb, and TPOAb concentrations were determined by electrochemiluminescence assay. TUS was performed using a 7-12 MHz multifrequency linear transducer by two radiologists. The 2.5th and 97.5th percentiles of the distribution curve corresponded to lower and upper TSH RI levels, respectively. Results The mean TSH level was 1.74 ± 0.96 mIU/L, and TSH range was 0.56-4.45 mIU/L. There was no difference in the TSH concentrations between men and women nor between the groups. TUS did not appear to be an essential tool for the reference group selection. Conclusion The upper limit of TSH was comparable to the reference interval provided by the assay manufacturer (4.45 vs. 4.20 mIU/L) but the lower limit was not (0.56 vs. 0.27 mIU/L). This finding may have a clinical impact since these values may lead to the misdiagnosis of euthyroid patients with subclinical hyperthyroidism.

https://doi.org/10.20945/2359-3997000000264 565 downloads

Type B insulin resistance syndrome: a systematic review
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Martins, Luizianne Mariano

; Fernandes, Virgínia Oliveira

; Carvalho, Manuela Montenegro Dias de

; Gadelha, Daniel Duarte

; Queiroz, Paulo Cruz de

; Montenegro Junior, Renan Magalhães

Archives of Endocrinology and Metabolism

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aug 2020, Volume 64 N. 4 Pages 337 - 348

Abstract: En | Text: En | PDF: En

ABSTRACT A literature review on the clinical, laboratory, and treatment features of type B insulin resistance syndrome (TBIRS). Data from PubMed, the Virtual Health Library and Cochrane database were selected and analyzed using the REDCap application and R statistical program. From 182 papers, 65 were selected, which assessed 119 clinical cases, 76.5% in females and 42.9% in African-Americans, with an average age of 44 years. A common feature of TBIRS is co-occurrence of autoimmune diseases, such as systemic lupus erythematosus (most frequently reported). Hyperglycemia of difficult control was the mostly reported condition. Tests for anti-insulin receptor antibodies were positive in 44.2% of the cases. Disease management comprised fractional diet, insulin therapy (maximum dose given was 57 600 IU/day), plasmapheresis and immunosuppression with several classes of drugs, mainly glucocorticoids. Remission occurred in 69.7% of cases, in 30.3% of these spontaneously. The mortality rate was 15.38%. There was an inverse relationship between anti-insulin antibodies and remission (p = 0.033); and a positive correlation between combined immunosuppressive therapy and remission (p = 0.002). Relapse occurred in 7.6% of the cases. This rare syndrome has difficult-to-control diabetes, even with high doses of insulin, and it is usually associated with autoimmune diseases. Therapeutic advances using immunomodulatory therapy have led to significant improvements in the rate of remission.

https://doi.org/10.20945/2359-3997000000257 1728 downloads

Aggressive papillary thyroid carcinoma in a child with type 2 congenital generalized lipodystrophy
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Lima, Grayce Ellen da Cruz Paiva

; Fernandes, Virgínia Oliveira

; Montenegro, Ana Paula Dias Rangel

; Carvalho, Annelise Barreto de

; Karbage, Lia Beatriz de Azevedo Sousa

; Aguiar, Lindenberg Barbosa

; Macedo, Mário Sérgio Rocha

; Ferreira, Luis Alberto Albano

; Montenegro Júnior, Renan Magalhães

Archives of Endocrinology and Metabolism

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jan 2019, Volume 63 N. 1 Pages 79 - 83

Abstract: En | Text: En | PDF: En

SUMMARY Thyroid carcinoma (TC) is rare in children, particularly in those aged < 10 years. Several studies have demonstrated a correlation between neoplasms and hyperinsulinemia and insulin resistance, which are often associated with a higher risk for and/or aggressiveness of the neoplasm. Congenital generalized lipodystrophy (CGL) with autosomal recessive inheritance is a rare disease and is characterized by the lack of adipose tissue, severe insulin resistance, and early metabolic disturbances. Here, we reported a rare case of a type 2 CGL in a girl who presented with a papillary TC (PTC) at the age of 7 years. She had no family history of TC or previous exposure to ionizing radiation. She had a generalized lack of subcutaneous fat, including the palmar and plantar regions, muscle hypertrophy, intense acanthosis nigricans, hepatomegaly, hypertriglyceridemia, severe insulin resistance, and hypoleptinemia. A genetic analysis revealed a mutation in the BSCL2 gene (p.Thr109Asnfs* 5). Ultrasound revealed a hypoechoic solid nodule measuring 1.8 × 1.0 × 1.0 cm, and fine needle aspiration biopsy suggested malignancy. Total thyroidectomy was performed, and a histopathological examination confirmed PTC with vascular invasion and parathyroid lymph node metastasis (pT3N1Mx stage). This is the first report to describe a case of differentiated TC in a child with CGL. Severe insulin resistance that is generally observed in patients with CGL early in life, especially in those with type 2 CGL, may be associated with this uncommon presentation of aggressive PTC during childhood.

https://doi.org/10.20945/2359-3997000000096 1086 downloads

Herbicide Selectivity In Eucalyptus Influenced By Spraying Nozzles
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Silva, Luiz Eduardo

; Montenegro, Caio

; Moura, Renato Baboza

; Acchile, Saymon

; Vitorino, Hermeson Santos

; Endres, Lauricio

; Souza, Renan Cantalice de

Floresta e Ambiente

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2019, Volume 26 N. 2 elocation e20170651

Abstract: En | Text: En | PDF: En

ABSTRACT The objective of this study was to verify the influence of spraying nozzles on the selectivity of herbicides in eucalyptus seedlings. XR 110.02 and TTI 110.02 spraying nozzles were used for the application of the herbicides: control treatment; oxyfluorfen (150 g ha–1) and saflufenacil (98 g ha–1). The experimental arrangement was a 2 × 3 factorial one (two spraying nozzles × 3 herbicides), using a randomized complete block design with four replications. The application was performed 15 days after transplanting the seedlings. Plant height (PH), stem diameter (SD), number of leaves (NL), total dry matter (DM), leaf area (LA), visual phytotoxicity (P), quantum efficiency of photosystem II - Fv/Fm, electron transport rate (ETR) and SPAD (S) index were evaluated. The XR 110.02 and TTI 110.02 nozzles did not change the selectivity of oxyfluorfen and saflufenacil.

https://doi.org/10.1590/2179-8087.065117 453 downloads

China’s World: What Does China Want?
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Montenegro, Renan Holanda

Contexto Internacional

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dec 2018, Volume 40 N. 3 Pages 617 - 620

Abstract: En | Text: En | PDF: En

https://doi.org/10.1590/s0102-8529.2018400300010 1951 downloads

Insulin autoimmune syndrome in an occidental woman: a case report and literature review
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Reis, Mariella Zaiden Rezende

; Fernandes, Virgínia Oliveira

; Fontenele, Eveline Gadelha Pereira

; Sales, Ana Paula Abreu Martins

; Montenegro Junior, Renan Magalhães

; Quidute, Ana Rosa Pinto

Archives of Endocrinology and Metabolism

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oct 2018, Volume 62 N. 5 Pages 566 - 570

Abstract: En | Text: En | PDF: En

SUMMARY Insulin autoimmune syndrome (IAS, Hirata's disease) is a rare hypoglycemic disorder characterized by spontaneous hypoglycemia associated with extremely high circulating insulin levels and positive anti-insulin antibody results. Thus far, most cases have been reported in Asian countries, notably Japan, with few cases reported in western countries. As a possible cause, it is associated with the use of drugs containing sulfhydryl radicals, such as captopril. This report refers to a 63-year-old female Brazilian patient with a history of postprandial hypoglycemia. After extensive investigation and exclusion of other causes, her hyperinsulinemic hypoglycemia was considered to have likely been induced by captopril. Most cases of IAS are self-limiting. However, dietary management, corticosteroids, plasmapheresis, and rituximab have already been used to treat patients with IAS. In our case, after discontinuation of captopril, an initial decrease in insulin autoantibody levels was observed followed by improvement in episodes of hypoglycemia. Although it is a rare disease, IAS should be considered in the differential diagnosis of endogenous hyperinsulinemic hypoglycemia. Patients with suspected IAS must be screened for autoimmunity-related drugs for insulin. Initial clinical suspicion of IAS can avoid unnecessary costs associated with imaging examinations and/or invasive surgical procedures.

https://doi.org/10.20945/2359-3997000000078 1926 downloads

Controversial issues in the management of hyperprolactinemia and prolactinomas – An overview by the Neuroendocrinology Department of the Brazilian Society of Endocrinology and Metabolism
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Vilar, Lucio

; Abucham, Julio

; Albuquerque, José Luciano

; Araujo, Luiz Antônio

; Azevedo, Monalisa F.

; Boguszewski, Cesar Luiz

; Casulari, Luiz Augusto

; Cunha Neto, Malebranche B. C.

; Czepielewski, Mauro A.

; Duarte, Felipe H. G.

; Faria, Manuel dos S.

; Gadelha, Monica R.

; Garmes, Heraldo M.

; Glezer, Andrea

; Gurgel, Maria Helane

; Jallad, Raquel S.

; Martins, Manoel

; Miranda, Paulo A. C.

; Montenegro, Renan M.

; Musolino, Nina R. C.

; Naves, Luciana A.

; Ribeiro-Oliveira Júnior, Antônio

; Silva, Cíntia M. S.

; Viecceli, Camila

; Bronstein, Marcello D.

Archives of Endocrinology and Metabolism

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mar 2018, Volume 62 N. 2 Pages 236 - 263

Abstract: En | Text: En | PDF: En

ABSTRACT Prolactinomas are the most common pituitary adenomas (approximately 40% of cases), and they represent an important cause of hypogonadism and infertility in both sexes. The magnitude of prolactin (PRL) elevation can be useful in determining the etiology of hyperprolactinemia. Indeed, PRL levels > 250 ng/mL are highly suggestive of the presence of a prolactinoma. In contrast, most patients with stalk dysfunction, drug-induced hyperprolactinemia or systemic diseases present with PRL levels < 100 ng/mL. However, exceptions to these rules are not rare. On the other hand, among patients with macroprolactinomas (MACs), artificially low PRL levels may result from the so-called “hook effect”. Patients harboring cystic MACs may also present with a mild PRL elevation. The screening for macroprolactin is mostly indicated for asymptomatic patients and those with apparent idiopathic hyperprolactinemia. Dopamine agonists (DAs) are the treatment of choice for prolactinomas, particularly cabergoline, which is more effective and better tolerated than bromocriptine. After 2 years of successful treatment, DA withdrawal should be considered in all cases of microprolactinomas and in selected cases of MACs. In this publication, the goal of the Neuroendocrinology Department of the Brazilian Society of Endocrinology and Metabolism (SBEM) is to provide a review of the diagnosis and treatment of hyperprolactinemia and prolactinomas, emphasizing controversial issues regarding these topics. This review is based on data published in the literature and the authors' experience.

https://doi.org/10.20945/2359-3997000000032 36158 downloads

10.

Associação entre polifarmácia e adesão ao tratamento farmacológico em pacientes com diabetes
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Penaforte, Kiarelle Lourenço

; Araújo, Samila Torquato

; Fernandes, Virginia Oliveira

; Barbosa, Islene Victor

; Cestari, Virna Ribeiro Feitosa

; Montenegro Júnior, Renan Magalhães

Rev Rene

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oct 2017, Volume 18 N. 5 Pages 631 - 638

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

Objective: to evaluate the occurrence of polypharmacy and its association with the adherence to the pharmacological treatment in patients with diabetes mellitus type 2. Methods: cross-sectional study conducted with 235 patients with diabetes mellitus type 2 through interview about the demographic and clinical data, drug therapy prescribed and adherence to treatment. To analyze the data, we used Student t-tests and Chi-square, with significance level p<0.05. Results: polypharmacy was evidenced in 88.4% of cases with a predominance of moderate level. An average of 7.5 pills per person among the 19 types of prescribed drugs were used. Adherence to prescribed therapy was reported by 88.2% of patients evaluated and there was no association with polypharmacy (p=0.266). Conclusion: it was verified that polypharmacy is a condition of high prevalence and is not associated with worse adherence to therapy.

Objetivo: avaliar a ocorrência da polifarmácia e sua associação com a adesão ao tratatamento farmacológico em pacientes com diabetes mellitus tipo 2. Métodos: estudo transversal realizado com 235 portadores de diabetes mellitus tipo 2 por meio de entrevista sobre os dados sociodemográficos e clínicos, a terapêutica medicamentosa prescrita e a adesão ao tratamento. Para análise dos dados foram utilizados os testes t de Student e qui-quadrado, com nível de significância p<0,05. Resultados: a polifarmácia foi evidenciada em 88,4% dos casos com predomínio da moderada. Foram utilizados, em média, 7,5 comprimidos por pessoa dentre os 19 tipos de fármacos prescritos. A adesão à terapêutica prescrita foi relatada por 88,2% dos pacientes avaliados e não houve associação com a polifarmácia (p=0,266). Conclusão: foi verificado que a polifarmácia é uma condição de elevada prevalência e não está associada a pior adesão à terapêutica.

https://doi.org/10.15253/2175-6783.2017000500010 2 downloads

11.

Leaders or Loners? How Do the BRICS Countries and their Regions Vote in the UN General Assembly
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Montenegro, Renan Holanda

; Mesquita, Rafael

Brazilian Political Science Review

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2017, Volume 11 N. 2 elocation e0005

Abstract: En | Text: En | PDF: En

The so-called emerging powers, including the BRICS nations (Brazil, Russia, India, China and South Africa), typically present themselves as natural leaders of their regions. Although physical size confers them the status of regional powers, their role as leaders depends on the consensual acceptance of their would-be followers. Can it be affirmed then that the countries under the influence of the BRICS show convergent positions? Can the five BRICS be considered de facto leaders of their regions? This article sets out to answer these questions by analysing the behaviour of the BRICS and their regional partners in the United Nations General Assembly (UNGA). The research design replicates the data from Voeten (2013) in order to compare the average affinity between each of the BRICS countries and their regions in the votes of the UNGA from 1992 to 2014. The data indicate a high level of regional cohesion for Brazil, China and South Africa when compared to Russia and India. The findings corroborate the literature in relation to Brazil and South Africa but conflict with what has been produced on the regional leadership of Russia, India and China.

https://doi.org/10.1590/1981-3821201700020005 4409 downloads

12.

Challenges for conducting blood collection and biochemical analysis in a large multicenter school-based study with adolescents: lessons from ERICA in Brazil
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Cureau, Felipe Vogt

; Bloch, Katia Vergetti

; Henz, Aline

; Schaan, Camila W.

; Klein, Carlos Henrique

; Oliveira, Cecília Lacroix de

; Giannini, Denise Tavares

; Leon, Elisa Brosina de

; Abreu, Gabriela de Azevedo

; Telo, Gabriela Heiden

; Dias, Glauber Monteiro

; Carvalho, Kênia Mara Baiocchi de

; Barufaldi, Laura Augusta

; Kuschnir, Maria Cristina Caetano

; Szklo, Moyses

; Montenegro Jr., Renan

; Silva, Thiago Luiz Nogueira da

; Ekelund, Ulf

; Schaan, Beatriz D.

Cadernos de Saúde Pública

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2017, Volume 33 N. 4 elocation e00122816

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

Resumo: O Estudo de Riscos de Cardiovasculares em Adolescentes (ERICA) é um estudo pioneiro que tem como objetivo avaliar a prevalência de fatores de risco cardiovascular, incluindo componentes da síndrome metabólica, entre adolescentes brasileiros. Este artigo tem como objetivo descrever os aspectos metodológicos relacionados com a coleta de sangue, assim como informar os resultados da preparação, transporte, armazenamento e exames no ERICA. Os exames foram realizados em um único laboratório e as amostras de sangue foram coletadas de forma padronizada. A logística envolveu o transporte aéreo das amostra até o laboratório de referência, com a temperatura controlada desde a coleta do sangue. O soro foi armazenado em biorrepositores locais em quatro centros e se serão utilizados em análises futuras. Durante o estudo foram realizados 284.247 exames e a taxa de participação foi de 56,2%, representando 40.732 adolescentes. Do total, 92,6% das amostras chegaram ao laboratório de referência mantendo a temperatura entre 0-10°C. Não foram identificadas alterações clínicas significativas nos resultados devido a mudanças de temperatura. O controle de qualidade externo registrou resultados satisfatórios em 98,7% das avaliações. Foram criados quatro biorrepositores com amostras de 7.785 adolescentes. Assim, podemos considerar que a logística adotada no ERICA foi bastante exitosa e sua descrição, tal como as dificuldades experimentadas no Brasil, podem informar e facilitar o planejamento de futuros estudos, especialmente nos países em desenvolvimento.

Abstract: The Study of Cardiovascular Risk in Adolescents (ERICA) is a pioneering study that aimed to assess the prevalence of cardiovascular risk factors, including metabolic syndrome components in Brazilian adolescents. This study aims to describe the methodological aspects related to blood collection as well as to report pertaining results of the preparation, transport, storage, and exams in ERICA. Exams in ERICA were performed in a single laboratory and blood samples were collected in schools in a standardized manner. Logistics involved air transportation of samples to the reference laboratory with controlled temperature since sample collection. The serum was stored in local biorepositories in four centers to be used in future analyses. During the study, 284,247 exams were performed and rate of participation in exams was 56.2%, thus involving 40,732 adolescents. From the total, 92.6% of the samples reached the reference laboratory maintaining the temperature between 0-10°C. No clinical significant changes in results due to temperature changes were identified. External quality control recorded satisfactory results in 98.7% of the evaluations. Four biorepositories with samples of 7,785 adolescents were created. Thus, we can consider that the logistics adopted in ERICA was fairly successful and description of this as well as the difficulties experienced in Brazil can inform and facilitate the planning of future studies, especially in developing countries.

Resumen: El Estudio de Riesgos Cardiovasculares en Adolescentes (ERICA) es un estudio pionero que tiene como objetivo evaluar la prevalencia de factores de riesgo cardiovascular, incluyendo componentes del síndrome metabólico en adolescentes brasileños. Este estudio tiene como objetivo describir los aspectos metodológicos relacionados con la recolección de sangre, así como informar sobre los resultados de la preparación, transporte, almacenamiento y exámenes en el ERICA. Los exámenes en ERICA se realizaron en un solo laboratorio y se recogieron muestras de sangre en las escuelas de manera estandarizada. La logística involucró el transporte aéreo de muestras al laboratorio de referencia con temperatura controlada desde la recolección de muestras. El suero fue almacenado en biorepositories locales en cuatro centros que se utilizarán en análises futuros. Durante el estudio se realizaron 284.247 exámenes y la tasa de participación fue de 56,2%, lo que involucró a 40.732 adolescentes. Del total, el 92,6% de las muestras alcanzaron el laboratorio de referencia manteniendo la temperatura entre 0-10°C. No se identificaron cambios clínicos significativos en los resultados debido a cambios de temperatura. El control de calidad externo registró resultados satisfactorios en el 98,7% de las evaluaciones. Se crearon cuatro biorrepositores con muestras de 7.785 adolescentes. Así, podemos considerar que la logística adoptada en el ERICA fue bastante exitosa y su descripción así como las dificultades experimentadas en Brasil pueden informar y facilitar la planificación de futuros estudios, especialmente en los países en desarrollo.

https://doi.org/10.1590/0102-311x00122816 365 downloads

13.

Challenges for conducting blood collection and biochemical analysis in a large multicenter school-based study with adolescents: lessons from ERICA in Brazil
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Cureau, Felipe Vogt

; Bloch, Katia Vergetti

; Henz, Aline

; Schaan, Camila W.

; Klein, Carlos Henrique

; Oliveira, Cecília Lacroix de

; Giannini, Denise Tavares

; Leon, Elisa Brosina de

; Abreu, Gabriela de Azevedo

; Telo, Gabriela Heiden

; Dias, Glauber Monteiro

; Carvalho, Kênia Mara Baiocchi de

; Barufaldi, Laura Augusta

; Kuschnir, Maria Cristina Caetano

; Szklo, Moyses

; Montenegro Jr., Renan

; Silva, Thiago Luiz Nogueira da

; Ekelund, Ulf

; Schaan, Beatriz D.

Cadernos de Saúde Pública

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2017, Volume 33 N. 4 elocation e00122816

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

https://doi.org/10.1590/0102-311x00122816 2977 downloads

14.

ERICA: prevalence of metabolic syndrome in Brazilian adolescents
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Kuschnir, Maria Cristina C

; Bloch, Katia Vergetti

; Szklo, Moyses

; Klein, Carlos Henrique

; Barufaldi, Laura Augusta

; Abreu, Gabriela de Azevedo

; Schaan, Beatriz

; Veiga, Gloria Valeria da

; Silva, Thiago Luiz Nogueira da

; Vasconcellos, Maurício T L de

; Moraes, Ana Júlia Pantoja de

; Oliveira, Ana Mayra Andrade de

; Tavares, Bruno Mendes

; Oliveira, Cecília Lacroix de

; Cunha, Cristiane de Freitas

; Giannini, Denise Tavares

; Belfort, Dilson Rodrigues

; Santos, Eduardo Lima

; Leon, Elisa Brosina de

; Oliveira, Elizabete Regina Araújo

; Fujimori, Elizabeth

; Borges, Ana Luíza

; Magliano, Erika da Silva

; Vasconcelos, Francisco de Assis Guedes

; Azevedo, George Dantas

; Brunken, Gisela Soares

; Guimarães, Isabel Cristina Britto

; Faria Neto, José Rocha

; Oliveira, Juliana Souza

; Carvalho, Kenia Mara B de

; Gonçalves, Luis Gonzaga de Oliveira

; Monteiro, Maria Inês

; Santos, Marize M

; Muniz, Pascoal Torres

; Jardim, Paulo César B Veiga

; Ferreira, Pedro Antônio Muniz

; Montenegro Jr, Renan Magalhães

; Gurgel, Ricardo Queiroz

; Vianna, Rodrigo Pinheiro

; Vasconcelos, Sandra Mary

; Martins, Stella Maris Seixas

; Goldberg, Tamara Beres Lederer

Revista de Saúde Pública

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2016, Volume 50 Suppl. 1 elocation 11s

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO OBJETIVO Determinar a prevalência de síndrome metabólica e de seus componentes em adolescentes brasileiros. MÉTODOS Foram avaliados 37.504 adolescentes, participantes do Estudo de Riscos Cardiovasculares em Adolescentes (ERICA), estudo transversal de âmbito nacional e de base escolar. Os adolescentes, de 12 a 17 anos de idade, residiam em municípios com mais de 100 mil habitantes. A amostra foi estratificada e conglomerada em escolas e turmas. Os critérios da International Diabetes Federation foram utilizados para definir síndrome metabólica. Prevalências de síndrome metabólica foram estimadas segundo sexo, faixa etária, tipo de escola e estado nutricional. RESULTADOS Dos 37.504 adolescentes, 50,2% eram do sexo feminino; 54,3% tinham de 15 a 17 anos e 73,3% estudavam em escolas públicas. A prevalência nacional de síndrome metabólica foi 2,6% (IC95% 2,3-2,9), discretamente maior no sexo masculino e naqueles de 15 a 17 anos na maioria das macrorregiões. A prevalência foi a maior nos residentes na macrorregião Sul, nas adolescentes mais jovens e nos adolescentes mais velhos. A prevalência foi maior nas escolas públicas (2,8% [IC95% 2,4-3,2]) que nas escolas privadas (1,9% [IC95% 1,4-2,4]) e nos adolescentes obesos em comparação aos não obesos. As combinações de componentes mais frequentes, respondendo por 3/4 das combinações, foram: circunferência de cintura elevada, HDL-colesterol baixo e pressão arterial elevada, seguida de circunferência da cintura elevada, lipoproteína de alta densidade (HDL-c) baixo e triglicerídeos elevados, e wpor circunferência da cintura elevada, HDL baixa e triacilgliceróis e pressão arterial elevados. A HDL baixa foi o segundo componente mais frequente, mas a maior prevalência de síndrome metabólica (26,8%) foi observada na presença de triglicerídeos elevado. CONCLUSÕES O ERICA é o primeiro estudo nacional a apresentar prevalências de síndrome metabólica e descrever a participação dos seus componentes. Apesar de a prevalência da síndrome metabólica ter sido baixa, as altas prevalências de alguns componentes e de participação de outros na composição da síndrome torna importante o diagnóstico precoce de tais alterações, mesmo que não agrupadas na síndrome metabólica.

ABSTRACT OBJECTIVE To determine the prevalence of metabolic syndrome and its components in Brazilian adolescents. METHODS We evaluated 37,504 adolescents who were participants in the Study of Cardiovascular Risks in Adolescents (ERICA), a cross-sectional, school-based, national study. The adolescents, aged from 12 to 17 years, lived in cities with populations greater than 100,000 inhabitants. The sample was stratified and clustered into schools and classes. The criteria set out by the International Diabetes Federation were used to define metabolic syndrome. Prevalences of metabolic syndrome were estimated according to sex, age group, school type and nutritional status. RESULTS Of the 37,504 adolescents who were evaluated: 50.2% were female; 54.3% were aged from 15 to 17 years, and 73.3% were from public schools. The prevalence of metabolic syndrome was 2.6% (95%CI 2.3-2.9), slightly higher in males and in those aged from 15 to 17 years in most macro-regions. The prevalence was the highest in residents from the South macro-region, in the younger female adolescents and in the older male adolescents. The prevalence was higher in public schools (2.8% [95%CI 2.4-3.2]), when compared with private schools (1.9% [95%CI 1.4-2.4]) and higher in obese adolescents when compared with nonobese ones. The most common combinations of components, referring to 3/4 of combinations, were: enlarged waist circumference (WC), low HDL-cholesterol (HDL-c) and high blood pressure; followed by enlarged WC, low HDL-c and high triglycerides; and enlarged WC, low HDL-c, high triglycerides and blood pressure. Low HDL was the second most frequent component, but the highest prevalence of metabolic syndrome (26.8%) was observed in the presence of high triglycerides. CONCLUSIONS ERICA is the first Brazilian nation-wide study to present the prevalence of metabolic syndrome and describe the role of its components. Despite the prevalence of Metabolic Syndrome being low, the high prevalences of some components and participation of others in the syndrome composition shows the importance of early diagnosis of this changes, even if not grouped within the metabolic syndrome.

https://doi.org/10.1590/s01518-8787.2016050006701 1789 downloads

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ERICA: prevalences of hypertension and obesity in Brazilian adolescents
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Bloch, Katia Vergetti

; Klein, Carlos Henrique

; Szklo, Moyses

; Kuschnir, Maria Cristina C

; Abreu, Gabriela de Azevedo

; Barufaldi, Laura Augusta

; Veiga, Gloria Valeria da

; Schaan, Beatriz

; Silva, Thiago Luiz Nogueira da

; Moraes, Ana Julia Pantoja

; Oliveira, Ana Mayra Andrade de

; Tavares, Bruno Mendes

; Magliano, Erika da Silva

; Oliveira, Cecília Lacroix de

; Cunha, Cristiane de Freitas

; Giannini, Denise Tavares

; Belfort, Dilson Rodrigues

; Santos, Eduardo Lima

; Leon, Elisa Brosina de

; Oliveira, Elizabete Regina Araújo

; Fujimori, Elizabeth

; Borges, Ana Luíza

; Vasconcelos, Francisco de Assis Guedes

; Azevedo, George Dantas

; Brunken, Gisela Soares

; Guimarães, Isabel Cristina Britto

; Faria Neto, José Rocha

; Oliveira, Juliana Souza

; Carvalho, Kenia Mara B. de

; Gonçalves, Luis Gonzaga de Oliveira

; Monteiro, Maria Inês

; Santos, Marize M.

; Jardim, Paulo César B. Veiga

; Ferreira, Pedro Antônio Muniz

; Montenegro Jr., Renan Magalhães

; Gurgel, Ricardo Queiroz

; Vianna, Rodrigo Pinheiro

; Vasconcelos, Sandra Mary

; Goldberg, Tamara Beres Lederer

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2016, Volume 50 Suppl. 1 elocation 9s

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO OBJETIVO Estimar as prevalências de hipertensão arterial e obesidade e a fração atribuível populacional de hipertensão arterial devida à obesidade em adolescentes brasileiros. MÉTODOS Foram avaliados dados dos participantes do Estudo de Riscos Cardiovasculares em Adolescentes, estudo seccional l nacional de base escolar. A amostra foi dividida em 32 estratos geográficos e conglomerados de escolas e turmas, com representatividade nacional, macrorregional e de capitais. Obesidade foi classificada pelo índice de massa corporal segundo idade e sexo. Considerou-se hipertensão arterial a média da pressão arterial sistólica ou diastólica maior ou igual ao percentil 95 da curva de referência. Foram estimadas prevalências e intervalos de confiança de 95% (IC95%) de hipertensão arterial e de obesidade, nacionais e nas macrorregiões do País, por sexo e grupo etário, assim como as frações de hipertensão atribuíveis à obesidade na população. RESULTADOS Foram avaliados 73.399 estudantes, 55,4% do sexo feminino, com média de idade 14,7 anos (DP = 1,6). A prevalência de hipertensão arterial foi 9,6% (IC95% 9,0-10,3); sendo as mais baixas observadas nas regiões Norte, 8,4% (IC95% 7,7-9,2) e Nordeste, 8,4% (IC95% 7,6-9,2) e a mais alta na região Sul, 12,5% (IC95% 11,0-14,2). A prevalência de obesidade foi 8,4% (IC95% 7,9-8,9), mais baixa na região Norte e mais alta na Sul. As prevalências de hipertensão arterial e obesidade foram maiores no sexo masculino. Adolescentes com obesidade tiveram prevalência de hipertensão arterial mais elevada, 28,4% (IC95% 25,5-31,2), do que aqueles com sobrepeso, 15,4% (IC95% 13,8-17,0), ou eutróficos, 6,3% (IC95% 5,6-7,0). A fração de hipertensão arterial atribuível à obesidade foi de 17,8%. CONCLUSÕES O ERICA foi o primeiro estudo brasileiro com representatividade nacional a estimar a prevalência de hipertensão arterial aferida em adolescentes. A fração da prevalência de hipertensão arterial atribuível à obesidade mostrou que cerca de 1/5 dos hipertensos poderiam não ser hipertensos se não fossem obesos.

ABSTRACT OBJECTIVE To estimate the prevalence of arterial hypertension and obesity and the population attributable fraction of hypertension that is due to obesity in Brazilian adolescents. METHODS Data from participants in the Brazilian Study of Cardiovascular Risks in Adolescents (ERICA), which was the first national school-based, cross-section study performed in Brazil were evaluated. The sample was divided into 32 geographical strata and clusters from 32 schools and classes, with regional and national representation. Obesity was classified using the body mass index according to age and sex. Arterial hypertension was defined when the average systolic or diastolic blood pressure was greater than or equal to the 95th percentile of the reference curve. Prevalences and 95% confidence intervals (95%CI) of arterial hypertension and obesity, both on a national basis and in the macro-regions of Brazil, were estimated by sex and age group, as were the fractions of hypertension attributable to obesity in the population. RESULTS We evaluated 73,399 students, 55.4% female, with an average age of 14.7 years (SD = 1.6). The prevalence of hypertension was 9.6% (95%CI 9.0-10.3); with the lowest being in the North, 8.4% (95%CI 7.7-9.2) and Northeast regions, 8.4% (95%CI 7.6-9.2), and the highest being in the South, 12.5% (95%CI 11.0-14.2). The prevalence of obesity was 8.4% (95%CI 7.9-8.9), which was lower in the North region and higher in the South region. The prevalences of arterial hypertension and obesity were higher in males. Obese adolescents presented a higher prevalence of hypertension, 28.4% (95%CI 25.5-31.2), than overweight adolescents, 15.4% (95%CI 17.0-13.8), or eutrophic adolescents, 6.3% (95%CI 5.6-7.0). The fraction of hypertension attributable to obesity was 17.8%. CONCLUSIONS ERICA was the first nationally representative Brazilian study providing prevalence estimates of hypertension in adolescents. Regional and sex differences were observed. The study indicates that the control of obesity would lower the prevalence of hypertension among Brazilian adolescents by 1/5.

https://doi.org/10.1590/s01518-8787.2016050006685 1511 downloads

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