Abstract Background The long incubation periods of cardiovascular diseases offer opportunities for controlling risk factors. In addition, preventive interventions in childhood are more likely to succeed because lifestyle habits become ingrained as they are repeated. Objective To investigate the effects of recreational physical activities, in combination or not with a qualitative nutritional counseling, in cardiometabolic risk factors of students with dyslipidemia and abdominal obesity. Methods Students (8-14 years old) were randomly divided into three groups (n=23 each): i ) Control; ii ) PANC, students undergoing Physical Activity and Nutritional Counseling, and iii ) PA, students submitted to Physical Activity, only. Blood samples (12-h fasting) were collected for biochemical analysis and anthropometric markers were also assessed. Two-Way RM-ANOVA and Holm-Sidak’s test, and Friedman ANOVA on Ranks and Dunn’s test were applied. P ≤ 0.05 was considered significant. Effect sizes were evaluated by Hedges’ g and Cliff’s δ for normal and non-Gaussian data, respectively. Results Compared to the control group and to baseline values, both interventions caused significant average reductions in total cholesterol (11%; p <0.001), LDL-c (19%; p=0.002), and non-HDL-c (19%; p=0.003). Furthermore, students in the PANC group also experienced a significant decrease in body fat compared to baseline (p=0.005) and to control (5.2%; g=0.541). Conclusions The proposed strategies were effective to reduce cardiometabolic risk factors in children and adolescents. The low cost of these interventions allows the implementation of health care programs in schools to improve the students’ quality of life.

RESUMO Introdução: O ácido úrico (AUr) é um produto do catabolismo das purinas, e a hiperuricemia (hAUr) associa-se a fatores de risco para doenças cardiometabólicas. Objetivo: Avaliar a concentração de AUr em crianças e adolescentes. Métodos: Estudo transversal com 623 estudantes eutróficos (5 a 15 anos de idade; 9,9 ± 2,7 anos; 52% meninas). Foi coletado sangue (jejum 12-14 h) para análise de parâmetros laboratoriais e foram aferidas pressão arterial e medidas antropométricas. AUr foi estratificado segundo sexo e faixas etárias (5 a < 10, ≥ 10 a < 13 e ≥ 13 a 15 anos, masculino; 5 a < 9, ≥ 9 a < 12 e ≥ 12 a 15 anos, feminino) e foram calculados os percentis 2,5 (2,5th) e 97,5 (97,5th). Resultados: A média de AUr foi de 3,7 ± 1,03 mg/dl (meninos) e 3,58 ± 0,91 mg/dl (meninas) (p = 0,0113). Considerando as faixas etárias, a média de AUr foi crescente e superior nos meninos (p = 0,0024, para terceira faixa). Nas meninas, o AUr aumentou progressiva e significativamente nas faixas etárias (p ≤ 0,005). Segundo o 97,5th, houve diferença estatística somente na terceira faixa entre os sexos (p = 0,002). Nas comparações entre faixas etárias, o 97,5th do AUr também aumentou para meninos e meninas (p ≤ 0,05). Segundo o 97,5th, 26 estudantes apresentaram hAUR. Conclusão: A estratificação por faixas etárias e sexo, além do 97,5th como limiar de concentração, foi importante para avaliação da concentração sérica do AUr em crianças e adolescentes.

ABSTRACT Introduction: Uric acid (UrA) is a product of purine catabolism, and hyperuricemia (hUrA) is associated with risk factors for cardiometabolic diseases. Objective: To evaluate the concentration of UrA in children and adolescents. Methods: Cross-sectional study with 623 eutrophic students (5 to 15 years old, aged 9.9 ± 2.7 years, 52% girls). Blood was collected (fasting 12-14 h) for analysis of laboratory parameters, and blood pressure and anthropometric measures were verified. UrA was stratified according to sex and age ranges (5 to < 10, ≥ 10 to < 13 and ≥ 13 to 15 years, male; and 5 to < 9, ≥ 9 to < 12 and ≥ 12 to 15 years, female), and the percentiles 2.5 (2.5th) and 97.5 (97.5th) were calculated. Results: The mean UrA was 3.7 ± 1.03 mg/dl (boys) and 3.58 ± 0.91 mg/dl (girls) (p = 0.0113). Considering the age ranges, the mean UrA was increasing and higher for boys (p = 0.0024, for the 3rd age range). For girls, the UrA increased progressively and significantly in the age ranges (p ≤ 0.005). According to the 97.5th, there was statistical difference only in the third range between sexes (p = 0.002). For comparisons between age ranges, UrA 97.5th also increased for boys and girls (p ≤ 0.05). According to the 97.5th, 26 students presented hUrA. Conclusion: According to the results, stratification by age ranges and sex, in addition to the 97.5th as concentration threshold, was important for evaluation of serum levels of UrA in children and adolescents.

Fundamento:Os fatores de risco que caracterizam a síndrome metabólica (SM) podem estar presentes na infância e adolescência, agravando o risco para as doenças cardiovasculares na idade adulta.Objetivo:Verificar a prevalência de SM e a importância de suas variáveis associadas, incluindo resistência à insulina (RI), em crianças e adolescentes do município de Guabiruba-SC, Brasil.Métodos:Estudo transversal realizado com 1011 estudantes (6–14 anos; 52,4% meninas; 58,5% crianças). Amostras de sangue foram coletadas para as medidas de parâmetros bioquímicos por métodos laboratoriais de rotina. A RI foi estabelecida pelo índice HOMA-IR e foram aferidos o peso, a altura, a circunferência da cintura e a pressão arterial. Modelos de regressão logística multivariada foram usados para examinar associações entre as variáveis de risco e a SM.Resultados:Na população avaliada, as prevalências de SM, RI, sobrepeso e obesidade foram de 14%, 8,5%, 21% e 13%, respectivamente. Dentre os estudantes com SM, 27% tinham RI, 33% apresentavam sobrepeso, 45,5% eram obesos e 22% eutróficos. A RI foi mais frequente nos estudantes com sobrepeso (48%) e obesos (41%) em comparação aos indivíduos eutróficos (11%; p = 0,034). As variáveis com maior influência para o desenvolvimento da SM foram a obesidade (OR = 32,7), o sobrepeso (OR= 6,1), a RI (OR = 4,4; p ≤ 0,0001 para todos) e a idade (OR = 1,15; p = 0,014).Conclusão:Foi observada elevada prevalência de SM nas crianças e adolescentes avaliados. Estudantes obesos, com sobrepeso ou resistentes à insulina tiveram maiores chances de desenvolver a síndrome.

Background:The risk factors that characterize metabolic syndrome (MetS) may be present in childhood and adolescence, increasing the risk of cardiovascular disease in adulthood.Objective:Evaluate the prevalence of MetS and the importance of its associated variables, including insulin resistance (IR), in children and adolescents in the city of Guabiruba-SC, Brazil.Methods:Cross-sectional study with 1011 students (6–14 years, 52.4% girls, 58.5% children). Blood samples were collected for measurement of biochemical parameters by routine laboratory methods. IR was estimated by the HOMA-IR index, and weight, height, waist circumference and blood pressure were determined. Multivariate logistic regression models were used to examine the associations between risk variables and MetS.Results:The prevalence of MetS, IR, overweight and obesity in the cohort were 14%, 8.5%, 21% and 13%, respectively. Among students with MetS, 27% had IR, 33% were overweight, 45.5% were obese and 22% were eutrophic. IR was more common in overweight (48%) and obese (41%) students when compared with eutrophic individuals (11%; p = 0.034). The variables with greatest influence on the development of MetS were obesity (OR = 32.7), overweight (OR = 6.1), IR (OR = 4.4; p ≤ 0.0001 for all) and age (OR = 1.15; p = 0.014).Conclusion:There was a high prevalence of MetS in children and adolescents evaluated in this study. Students who were obese, overweight or insulin resistant had higher chances of developing the syndrome.

INTRODUÇÃO E OBJETIVOS: Ensaios de diferentes procedências para avaliação das dislipidemia podem resultar em variações significativas nos resultados obtidos e consequente conduta inadequada pelo clínico. O estudo objetivou comparar resultados laboratoriais de colesterol total (CT), triglicérides (TG), colesterol da lipoproteína de alta densidade (HDL-C), colesterol da lipoproteína de baixa densidade (LDL-C), apolipoproteína A-1 (Apo A-1), apolipoproteína B (Apo B) e lipoproteína (a) (Lp[a]) e índices lipídicos (não-HDL-C, CT/HDL-C, LDL-C/HDL-C, TG/HDL-C e Apo B/HDL-C) de pacientes hipertensos e/ou diabéticos diagnosticados. MÉTODOS: Foram utilizados conjuntos reativos, e os respectivos analisadores Gold Analisa, Dia Sys (CCX - Abbott), Dade Behring (Nefelômetro BN 100) e Roche (COBAS Integra 400), para verificar a reprodutibilidade dos resultados obtidos. Participaram 99 pacientes (36 do sexo masculino e 63 do feminino). Comparando os resultados, verificamos que: todas as médias obtidas dos constituintes lipídicos apresentaram diferença significativa; número semelhante de pacientes apresentou níveis séricos elevados de CT, TG, Lp(a) e Apo A-1. O HDL-C, o LDL-C e a Apo B apresentaram discordância, assim como os índices de CT/LDL-C, LDL-C/HDL-C e TG/HDL-C. Para não-HDL-C e ApoB/HDL, houve semelhança no número de pacientes com valores não recomendados. Em consequência da diferença, em relação ao LDL-C, a decisão da conduta terapêutica poderá ser inadequada, enquanto o não-HDL-C, além de evidenciar partículas aterogênicas, apresentou número de hipertensos com valores séricos não referendados semelhantes, independente da metodologia e do equipamento utilizado. CONCLUSÃO: No grupo de hipertensos analisados, o não-HDL-C se caracterizou um importante fator de correção interensaios de parâmetros lipídicos. E sua associação à relação Apo B/HDL-C pode ser um fator adicional em relação às condutas hipolipemiantes a serem adotadas.

INTRODUCTION AND OBJECTIVES: Different assays to evaluate dyslipidemia may show significant variations in the obtained results and a consequent inappropriate clinical approach may be adopted. This study aimed to compare the results of total cholesterol (CT), triglycerides (TG), HDL-C, Apo A1, Apo B, lipoprotein (a) and lipidic indexes (not-HDL-C, CT/HDL-C, LDL-C/HDL-C, TG/HDL-C and Apo B/HDL-C) of hypertensive and/or diabetic patients. METHODS: The following reactive kits and respective analyzers were applied to verify the reproducibility of results: Gold Analisa, DiaSys (CCX-ABBOTT), Dade Behring (Nephelometer BN 100) and Roche (COBAS Integra 400). Ninety nine patients (36 male and 63 female gender) were investigated. Comparing the results, we observed that all mean numbers of lipid constituents showed a significant difference. A similar number of patients had high CT, TG, Lp (a) and Apo A-1 serum levels. There was also disagreement in HDL-C, LDL-C, ApoB, CT/LDL-C, LDL-C/HDL-C and TG/HDL-C indexes. For not-HDL-C and ApoB/HDL, there was similarity in the number of patients with not recommended values. As a consequence of this difference, the choice of therapeutic approach may be inappropriate as to LDL-C levels, whereas Not-HDL-C not only showed atherogenic particles but also a number of hypertensive patients with similar not recommended serum values, regardless of the methodology and the equipment used. CONCLUSION: In the analyzed group of hypertensive patients, not-HDL-C was an important inter assay correction factor of lipidic parameters. The association with Apo B/HDL-C relation may be an additional factor as to the choice of hypolipemiant treatments.

A hiper-homocisteinemia é um fator de risco independente para desenvolvimento de doença cardiovascular e na presença de outros fatores de risco (FR) poderá acarretar em risco adicional para o surgimento do evento. Foram realizadas dosagens séricas de homocisteína e creatinina em 146 pacientes (51 homens e 95 mulheres) cadastrados no programa HIPERDIA/MS sendo todos portadores de três FR associados: hipertensão, tabagismo e histórico familiar para doença cardiovascular. A média geral foi de 14,48 µmol/L ± 5,98 (15,38 µmol/L ± 6,77 e 13,99 µmol/L ± 5,48, homens e mulheres respectivamente). A hiper-homocisteinemia esteve presente em 34,90% (39,20% e 32,60%, homens e mulheres respectivamente), de acordo com o intervalo de referência entre 5 - 15 µmol/L. Entretanto, segundo recomendações da DACH-LIGA Homocysteine, valores entre 12 - 30 µmol/L são considerados como moderada hiper-homocisteinemia. O estudo revelou que 60,30% (70,60% e 54,70%, homens e mulheres respectivamente) estavam acima de 12 µmol/L. Na avaliação do estudo, a dosagem de homocisteína sérica deve ser realizada em pacientes cadastrados no programa HIPERDIA/MS, pois além de hipertensos e/ou diabéticos, a presença de hiper-homocisteinemia pode ser um risco adicional para o desenvolvimento de doença cardiovascular.

Hiper-homocysteinemia is an independent risk factor in the development of cardiovascular diseases and in the presence of other risk factors (RF) may bring about an additional risk for the occurrence of the event. Serum dosages of homocysteine and creatinine in 146 patients (51 men and 95 women), registered at the HIPERDIA/MS Program, all presenting three associated RF's; hypertension, smoking habit and family history for cardiovascular diseases. The general average has been 14.48 µmol/L ± 5,98 (15,38 µmol/L ±6,77 and 13,99 µmol/L ± 5,48, for men and women respectively). Hiper-homocysteinemia had been present in 34.90% (39.20% and 32.60%, men and women, respectively), according to the reference interval between 5 - 15 µmol/L. Although, according to Homocysteine DACH-LIGA recommendations, values between 12 - 30 µmol/L are considered being a moderate hiper-homocysteinemia. The study has revealed that 60.30% (70.60% and 54.70%, men and women, respectively) had been above 12 µmol/L. In the evaluation of the study, the serum dosage of homocysteine has to be performed in patients registered at the HIPERDIA/MS Program for, besides being hypertense and/or diabetic, the presence of hiper-homocisteinemia may be an additional risk for the development of cardiovascular disease.

OBJETIVO: Investigar a prevalência e a multiplicidade de fatores de risco (FR) adicionais em uma amostra populacional de indivíduos hipertensos e tabagistas, diagnosticados e inscritos no Programa Hipertensos e Diabéticos do MS (HIPERDIA/Ministério da Saúde), no Município de Brusque, SC, Brasil. MÉTODOS: Determinação de parâmetros antropométricos e variáveis laboratoriais reconhecidas como fatores de risco cardiovascular. RESULTADO: Elevada prevalência de FR adicionais à hipertensão arterial (HAS) e ao tabagismo, configurando a multiplicidade que concorre com uma elevação acentuada do risco de eventos cardiovasculares nessa amostra populacional. CONCLUSÃO: Em populações de hipertensos, medidas de prevenção, identificação e controle de FR devem ser implementadas e programas informatizados, como o Hiperdia/MS, podem auxiliar no seguimento dos pacientes, possibilitando uma abordagem multidisciplinar mais criteriosa, sobretudo na análise do alcance das metas de tratamento e conseqüente redução de risco cardiovascular.

OBJECTIVE: To investigate the prevalence and multiplicity of additional risk factors (RF) in a population sample of hypertensive smokers, diagnosed and enrolled at the Hiperdia Program of the Ministry of Health, in the city of Brusque, SC, Brazil. METHODS: Determination of the anthropometrical parameters and laboratory variables recognized as cardiovascular risk factors. RESULTS: Elevated prevalence of RF in addition to systemic arterial hypertension (SAH) and smoking, configuring the multiplicity that concurs with a marked elevation of the risk of cardiovascular events in this population sample. CONCLUSION: In hypertensive populations, the prevention, identification and RF control measures must be implemented; computerized programs such as the Hiperdia/MS can help in patients’ follow-up, allowing a more stringent multidisciplinary approach, especially regarding the analysis of the attainment of treatment goals and the subsequent decrease of cardiovascular risk.

The prevalence of infection by the hepatitis B (HBV) and C (HCV) viruses varies among geographical regions. We evaluated 263,795 blood donor samples collected from 1999-2001 in various cities in the state of Santa Catarina to determine the prevalence of HbsAg, anti-HBc and anti-HCV markers. The markers were analyzed by immunoenzymatic tests, as determined by the Ministry of Health, and the data were obtained from blood banks and from ANVISA (the Brazilian National Agency for Sanitary Vigilance). There was a significant reduction in the mean frequency of HbsAg and anti-HBc during the study period, from 0.98% to 0.64% and from 8.83% to 5.35%, respectively, though they varied considerably among the different regions. There was also a decrease in the mean frequency of anti-HCV, although it was not significant, decreasing from 0.38% to 0.34%. Even with this reduction, the frequency of these markers was still high compared with that found in other countries, indicating high rates of infection by hepatitis B and C viruses. This emphasizes the urgency of vaccination programs against HBV, especially in some regions of Santa Catarina state, in order to reduce the prevalence of this infection and consequently reduce the risk of transmission through sexual relations or from the donation of blood and/or hemocomponents.