Abstract Introduction: currently, there is no consensus regarding accurate and low-cost methods for diagnosing lipodystrophy in people living with HIV/AIDS (PLWHA). The aim of this study was to propose anthropometric cutoff points for the diagnosis of lipodystrophy among PLWHA. Methods: we included 106 PLWHA (men = 65, women = 41) who are under antiretroviral therapy and have been clinically classified into either a “lipodystrophy” or “non-lipodystrophy” group. Anthropometric measurements included 19 regions of body perimeters and 6 skinfold thickness measures. The Youden index was used to establish anthropometric cutoff points for the diagnosis of lipodystrophy, using the mean values of the anthropometric data (referred to as “original”) along with the “Z index” (ZI) values, which were adjusted by the “Phantom Strategy.” The cutoff points were proposed when “original” anthropometric measurements and ZI values had a statistical significance of p < 0.01 and an area under the curve (AUC) higher than 70%. The size effect was assessed to verify the influence of lipodystrophy on each anthropometric measure. Results: our data analysis proposes sex-specific cutoff points for the diagnosis of lipodystrophy in PLWHA – 17 points using the “original” anthropometric measurements, and 20 using the ZI values (average effect size between 1.0 and 1.1, and AUC = 76.7% and 78%). Conclusions: our study proposes accurate cutoff points for the diagnosis of lipodystrophy using “original” anthropometric measurements and ZI values adjusted by the “Phantom Strategy.” Our findings support the use of anthropometric measurements as a simplified method for diagnosing lipodystrophy and monitoring body composition alterations in people living with HIV/AIDS.

Resumen Introducción: no existe consenso con respecto a métodos precisos y de bajo coste para diagnosticar la lipodistrofia en personas que viven con VIH/SIDA (PVVS). El objetivo de este estudio es proponer puntos de corte antropométricos para el diagnóstico de lipodistrofia entre las PVVS. Métodos: se incluyeron 106 PVVS (hombres = 65, mujeres = 41) en tratamiento antirretroviral que se clasificaron clínicamente en dos grupos de “lipodistrofia” o “no lipodistrofia”. Las mediciones antropométricas incluyeron 19 regiones de parámetros corporales y 6 medidas de pliegues cutáneos. El índice de Youden se utilizó para establecer puntos de corte antropométricos para el diagnóstico de lipodistrofia utilizando la media de los datos antropométricos (denominados “originales”) junto con los valores del “índice Z” (IZ), que fueron ajustados por la “estrategia Phantom”. Los puntos de corte se propusieron cuando las mediciones antropométricas “originales” y los valores de IZ fueron estadísticamente significativos con un valor p < 0,01 y un área bajo la curva (AUC) superior al 70%. Se evaluó el tamaño del efecto para verificar la influencia de la lipodistrofia en cada medida antropométrica. Resultados: se propusieron puntos de corte específicos según el sexo para el diagnóstico de lipodistrofia en PVVS: 17 puntos usando las medidas antropométricas “originales” y 20 usando los valores de IZ (tamaño del efecto promedio entre 1.0 y 1.1, y AUC = 76.7% y 78%). Conclusiones: se propusieron puntos de corte antropométricos para el diagnóstico de lipodistrofia. Las mediciones antropométricas son un método simplificado para diagnosticar y monitorear los cambios de composición corporal en las PVVS.

Abstract Hepatitis B is a major public health problem worldwide and associated with significant mortality. To prevent or delay the deleterious effects of chronic infection by the hepatitis B virus, patients should be carefully followed, and antiviral therapy indicated according to specific recommendations. Currently, available drugs inhibit viral replication and slow or stop the progression of inflammation and fibrosis of the liver. However, the drugs for oral use in the treatment of hepatitis B, jointly referred to as nucleoside/nucleotide analogs, are indicated for prolonged use and have potential side effects. The reduction in bone mineral density was associated with the use of tenofovir, already evaluated in patients infected with HIV because the drug is also part of the therapeutic arsenal for this viral infection. There are few studies on the effects of tenofovir in patients with mono hepatitis B. Therefore, this literature review proposes to examine how hepatitis B acts in the body and the mechanisms by which antiretroviral drugs (especially tenofovir) can affect bone metabolism.

Abstract Introduction: adequate iodine intake during pregnancy is essential for the synthesis of thyroid hormones, which are important for the physiological functions of the mother and appropriate maturation of the central nervous system of the fetus. Objective: the objective of the present study was to determine the levels of urinary iodine excretion and thyroid function, antioxidants and oxidative stress markers in pregnant women. Methods: the study was conducted on 191 pregnant women and 62 non-pregnant women who were evaluated regarding nutritional status. Analyses of urinary iodine, of oxidative stress markers and thyroid function were performed, revealing iodine insufficiency in 81 pregnant women. Results: there was no change in the thyroid stimulating hormone concentration in 89% of the pregnant women. Antithyroperoxidase antibody values were higher in the control group compared to the pregnant women's group (64.5% and 12.6%, respectively) and antithyroglobulin antibody values were also higher in the control group (11.6%). Assessment of oxidative stress revealed higher levels of advanced oxidation protein products, of total antioxidant capacity and of superoxide dismutase antioxidants in pregnant women. Classification of ioduria with respect to oxidative stress markers revealed lower α-tocopherol levels for the pregnant women with iodine insufficiency. Conclusion: on this basis, the results suggest that iodine insufficiency did not induce changes in thyroid stimulating hormone levels or antibodies and those pregnant women with adequate urinary iodine excretion had a better profile of the α-tocopherol antioxidant, indicating that iodine may play a significant role in antioxidant capacity during gestation.

Resumen Introducción: la ingesta adecuada de yodo durante el embarazo es esencial para la síntesis de las hormonas tiroideas, que son importantes para las funciones fisiológicas de la madre y la maduración apropiada del sistema nervioso central del feto. Objetivo: el objetivo del presente estudio fue determinar los niveles de excreción de yodo urinario y función tiroidea, antioxidantes y marcadores de estrés oxidativo en mujeres embarazadas. Métodos: el estudio se realizó en 191 mujeres embarazadas y 62 mujeres no embarazadas que fueron evaluadas con respecto al estado nutricional. Se realizaron análisis de yodo urinario, marcadores de estrés oxidativo y función tiroidea, que revelaron insuficiencia de yodo en 81 embarazadas. Resultados: no hubo cambios en la concentración de hormona estimulante tiroidea en el 89% de las mujeres embarazadas. Los valores de anticuerpos antitiroperoxidasa fueron mayores en el grupo control en comparación con el grupo de mujeres embarazadas (64,5% y 12,6%, respectivamente) y los de anticuerpos antitiroglobulina fueron también mayores en el grupo control (11,6%). La evaluación del estrés oxidativo reveló niveles más altos de productos avanzados de proteína de oxidación, de capacidad antioxidante total y de antioxidantes de superóxido dismutasa en mujeres embarazadas. La clasificación de la yoduria con respecto a marcadores de estrés oxidativo reveló menores niveles de α-tocopherol para las mujeres embarazadas con insuficiencia de yodo. Conclusión: sobre esta base, los resultados sugieren que la insuficiencia de yodo no indujo cambios en los niveles de hormona estimulante de la tiroides o anticuerpos y las mujeres embarazadas con excreción urinaria adecuada de yodo tuvieron un mejor perfil del antioxidante α-tocopherol, lo que indica que el yodo puede desempeñar un papel significativo en la capacidad antioxidante durante la gestación.

RESUMO: Introdução: A síndrome da lipodistrofia do HIV é caracterizada por alterações no metabolismo e na composição corporal, que aumentam o risco cardiovascular de pessoas vivendo com HIV/AIDS (PVHA) em uso da terapia antirretroviral de alta potência (TARV). Objetivo: Avaliar a prevalência de lipodistrofia e de alterações do metabolismo de lipídios e glicose em PVHA em uso da TARV. Métodos: Para avaliação antropométrica foram aferidos peso, estatura e circunferência abdominal (CA). Para avaliação da lipodistrofia foi realizado o exame físico (subjetivo) e o exame (objetivo) de absortometria com raios X de dupla energia (DEXA) por meio da razão de massa gorda (RMG). Foram também realizados exames de lipidograma e glicemia de jejum e utilizados os critérios sugeridos pelo The National Cholesterol Education Program III para classificação de alterações metabólicas. Resultados: A amostra final consistiu em 262 pacientes com idade média de 44,3 ± 10,2 anos. A lipodistrofia, de acordo com o exame físico, esteve presente em 47,7% (IC95% 41,7 - 53,8) dos pacientes, enquanto pela RMG (DEXA) sua prevalência foi de 40,8% (IC95% 33,1 - 48,5). A maioria (53,0%; IC95% 47,0 - 59,1) dos pacientes apresentou aumento de adiposidade abdominal segundo a CA. As alterações metabólicas mais presentes foram o HDL reduzido (67,6%; IC95% 61,9 - 73,2) e a hipertrigliceridemia (55,7%; IC95% 49,7 - 61,7). Conclusões: A alta prevalência de lipodistrofia e alterações do metabolismo de lipídios e glicose evidenciam a importância da intervenção precoce nesse grupo de pacientes para prevenir complicações cardiovasculares.

ABSTRACT: Introduction: The HIV lipodystrophy syndrome is characterized by changes in metabolism, and body composition that increase cardiovascular risk of people living with HIV/AIDS (PLWHA) using highly active antiretroviral therapy (HAART). Objective: To assess the prevalence of lipodystrophy and changes in lipid and glucose metabolism in PLWHA in use of HAART. Methods: For the anthropometric evaluation we measured weight, height and abdominal circumference (AC). For the lipodystrophy evaluation we conducted physical examination (subjective) and the (objective) examination of absorptiometry with X-ray dual energy (DEXA) by fat mass ratio (FMR). We also conducted lipid profile tests and fasting glucose and used the criteria suggested by The National Cholesterol Education Program III for metabolic disorders classification. Results: The final sample consisted of 262 patients with a mean age of 44.3 ± 10.2 years. Lipodystrophy, according to the physical examination, was present in 47.7% (95%CI 41.7 - 53.8) of patients, while the prevalence using FMR (DEXA) was 40.8% (95%CI 33.1 - 48.5). Most (53.0%; 95%CI 47.0 - 59.1) of the patients showed increased abdominal adiposity according to AC. The most prevalent metabolic alterations were reduced HDL (67.6%; 95%CI 61.9 - 73.2) and hypertriglyceridemia (55.7%; 95%CI 49.7 - 61.7). Conclusion: The high prevalence of lipodystrophy and changes in lipid and glucose metabolism show the importance of early intervention in this group of patients to prevent cardiovascular complications.

RESUMO: Introdução: A síndrome da lipodistrofia do HIV é caracterizada por alterações no metabolismo e na composição corporal, que aumentam o risco cardiovascular de pessoas vivendo com HIV/AIDS (PVHA) em uso da terapia antirretroviral de alta potência (TARV). Objetivo: Avaliar a prevalência de lipodistrofia e de alterações do metabolismo de lipídios e glicose em PVHA em uso da TARV. Métodos: Para avaliação antropométrica foram aferidos peso, estatura e circunferência abdominal (CA). Para avaliação da lipodistrofia foi realizado o exame físico (subjetivo) e o exame (objetivo) de absortometria com raios X de dupla energia (DEXA) por meio da razão de massa gorda (RMG). Foram também realizados exames de lipidograma e glicemia de jejum e utilizados os critérios sugeridos pelo The National Cholesterol Education Program III para classificação de alterações metabólicas. Resultados: A amostra final consistiu em 262 pacientes com idade média de 44,3 ± 10,2 anos. A lipodistrofia, de acordo com o exame físico, esteve presente em 47,7% (IC95% 41,7 - 53,8) dos pacientes, enquanto pela RMG (DEXA) sua prevalência foi de 40,8% (IC95% 33,1 - 48,5). A maioria (53,0%; IC95% 47,0 - 59,1) dos pacientes apresentou aumento de adiposidade abdominal segundo a CA. As alterações metabólicas mais presentes foram o HDL reduzido (67,6%; IC95% 61,9 - 73,2) e a hipertrigliceridemia (55,7%; IC95% 49,7 - 61,7). Conclusões: A alta prevalência de lipodistrofia e alterações do metabolismo de lipídios e glicose evidenciam a importância da intervenção precoce nesse grupo de pacientes para prevenir complicações cardiovasculares.

ABSTRACT: Introduction: The HIV lipodystrophy syndrome is characterized by changes in metabolism, and body composition that increase cardiovascular risk of people living with HIV/AIDS (PLWHA) using highly active antiretroviral therapy (HAART). Objective: To assess the prevalence of lipodystrophy and changes in lipid and glucose metabolism in PLWHA in use of HAART. Methods: For the anthropometric evaluation we measured weight, height and abdominal circumference (AC). For the lipodystrophy evaluation we conducted physical examination (subjective) and the (objective) examination of absorptiometry with X-ray dual energy (DEXA) by fat mass ratio (FMR). We also conducted lipid profile tests and fasting glucose and used the criteria suggested by The National Cholesterol Education Program III for metabolic disorders classification. Results: The final sample consisted of 262 patients with a mean age of 44.3 ± 10.2 years. Lipodystrophy, according to the physical examination, was present in 47.7% (95%CI 41.7 - 53.8) of patients, while the prevalence using FMR (DEXA) was 40.8% (95%CI 33.1 - 48.5). Most (53.0%; 95%CI 47.0 - 59.1) of the patients showed increased abdominal adiposity according to AC. The most prevalent metabolic alterations were reduced HDL (67.6%; 95%CI 61.9 - 73.2) and hypertriglyceridemia (55.7%; 95%CI 49.7 - 61.7). Conclusion: The high prevalence of lipodystrophy and changes in lipid and glucose metabolism show the importance of early intervention in this group of patients to prevent cardiovascular complications.

ABSTRACT Introduction: Assessment of the quantity and distribution of body fat in people living with HIV/AIDS is of great importance in clinical practice, due to the association of body fat changes with clinical conditions. The aim of this systematic review was to answer the central question: Can anthropometry accurately measure the body fat in people living with HIV/AIDS? Material and Methods: Systematic review carried out using four databases: Medline, LILACS, Scopus and BDTD. Results: Of the 581 studies found, 11 met the eligibility criteria. To assess the validate of anthropometry, only two studies employed regress analysis to development of predictive body fat equations in people living with HIV/AIDS and nine studies employed correlation analysis. This coefficient only measures the strength of the relation between two variables, and there is not concordance between them and therefore, these studies did not accurately evaluate whether or not the anthropometric information showed good concordance with the gold standard. The other two studies developed five equations to evaluate the total fat and limbs (arm, leg and trunk) in people living with HIV/AIDS using antiretrovirals and showed R2 between 0.50 and 0.83. Conclusions: Further research needs to be conducted to answer the central question of this review, as the small number of articles that applied the correct statistical test and the absence of research on people living with HIV/AIDS without the use of antiretrovirals.

RESUMEN Introducción: La evaluación de la cantidad y distribución de la grasa corporal en personas que viven con el VIH/SIDA es de gran importancia en la práctica clínica, debido a la asociación de los cambios de grasa corporal con condiciones clínicas. El objetivo de esta revisión es responder a la pregunta central: ¿Puede la antropometría medir con precisión la grasa corporal en las personas que viven con el VIH/SIDA? Material y Métodos: Revisión sistemática llevada a cabo por medio de cuatro bases de datos: Medline, LILACS, Scopus y BDTD. Resultados: De los 581 estudios encontrados, 11 cumplieron con los criterios de elegibilidad. Para evaluar la validación de la antropometría, sólo dos estudios emplearon análisis de regresión para el desarrollo de las ecuaciones de predicción de grasa corporal en las personas que viven con el VIH/SIDA y nueve estudios emplearon análisis de correlación. Este coeficiente sólo mide la fuerza de la relación entre dos variables, y no hay concordancia entre ellos y, por lo tanto, estos estudios no evaluaron con precisión si la información antropométrica mostró buena concordancia con el estándar de oro. Los otros dos estudios desarrollaron cinco ecuaciones para evaluar la grasa total y en las extremidades (brazos, piernas y tronco) en personas que viven con el VIH/SIDA y usan antirretrovirales y mostraron R2 entre 0,50 y 0,83. Conclusiones: Más investigación debe llevarse a cabo para responder a la pregunta central de esta revisión, dado el pequeño número de artículos en que se aplicó la prueba estadística correcta y la ausencia de investigaciones sobre personas que viven con el VIH/SIDA que no usan antirretrovirales.

Objetivo Avaliar o estresse oxidativo, perfil antioxidante e de micronutrientes em pacientes portadores de hanseníase multibacilar e paucibacilar antes do tratamento poliquimioterápico. Métodos Analisaram-se 52 amostras de soro de pacientes portadores de hanseníase - 38 multibacilares e 14 paucibacilares -, usuários do ambulatório de dermatologia de um hospital público universitário, além de 30 amostras controles. Quantificaram-se marcador de peroxidação lipídica malondialdeído pelo método de substâncias reativas ao ácido tiobarbitúrico, antioxidante glutationa reduzida pelo método baseado na quantificação de tiol solúvel em ácido, antioxidante vitamina E por cromatografia líquida de alta eficiência, minerais selênio, zinco, cobre, magnésio por espectrometria de massa com fonte plasma acoplado, e sorologia do anticorpo glicolipídio fenólico I pelo método Enzyme-Linked Immunosorbent Assay. Foi utilizado teste não paramétrico de Mann-Whitney para comparar as variáveis quantificadas neste estudo entre os diferentes grupos, e correlação de Pearson para verificar associação dessas variáveis com o anticorpo. O critério de significância adotado foi de p<0,05. Resultados Houve diferença significativa para o malondialdeído (p<0,001) e vitamina E (p<0,001) no grupo controle comparado aos grupos com hanseníase, multibacilar e paucibacilar. No entanto, essas mesmas variáveis não diferiram entre os grupos multibacilar e paucibacilar (p=0,495 e p=0,920 respectivamente). A glutationa reduzida foi superior no grupo controle em relação ao grupo com hanseníase (p=0,012) e multibacilar (p=0,001), no entanto não diferiu do grupo paucibacilar (p=0,920). Quando comparada com os multibacilares e paucibacilares, a glutationa reduzida também não diferiu (p=0,063). Quanto aos minerais, todos se apresentaram dentro da normalidade, exceto o magnésio, cujos níveis foram deficientes em todos os pacientes do estudo. Não foi possível observar correlação do anticorpo glicolipídio fenólico I com as demais variáveis. Conclusão Os pacientes paucibacilares parecem possuir maior defesa antioxidante de glutationa reduzida, semelhante à de indivíduos saudáveis. Baixos níveis de vitamina E nos pacientes com hanseníase são sugestivos dos benefícios de suplementação. As alterações metabólicas observadas não evidenciaram relação com a sorologia do glicolipídio fenólico I.

Objective To determine the oxidative stress and the antioxidant and micronutrient profile of patients with multibacillary and paucibacillary leprosy before polychemotherapeutic treatment. Methods Thirty control samples and fifty-two serum samples from leprosy patients who attended the dermatology outpatient clinic of a public university hospital were analyzed; 38 of them had multibacillary and 14 paucibacillarty. Malondialdehyde, a marker of lipid peroxidation, was determined using the thiobarbituric acid reacting substances assay; the antioxidant reduced glutathione was determined using a method based on the quantification of acid-soluble thiol; the antioxidant vitamin E was determined using High-Performance Liquid Chromatography; the minerals selenium, zinc, copper and magnesium were determined using coupled-mass spectrometry, and the serum phenol I glycolipid antibody was determined using Enzyme-Linked Immunosorbent Assay. The nonparametric Mann-Whitney test was used to compare the variables quantified in the present study between the different groups, and Pearson's correlation analysis was used to verify the association between these variables and the antibody. The significance level was set at p<0.05. Results There was a significant difference in the content of malondialdehyde (p<0.001) and vitamin E (p<0.001) between the groups with multibacillary and paucibacillary leprosy (p=0.495 and p=0.920, respectively) and the control groups. Reduced glutathione levels were higher in the control group compared with those of the group with leprosy (p=0.012) and multibacillary leprosy (p=0.001), but did it not differ from that of the paucibacillary group (p=0.920). Reduced glutathione levels did not differ between the multibacillary and paucibacillary groups (p=0.063) either. All minerals were within normal limits, except for magnesium; magnesium deficiency was detected in all groups studied. No correlation was observed between the anti-phenolic glycolipid I antibody and the remaining variables. Conclusion Paucibacillary patients seem to have more pronounced reduced glutathione antioxidant defense, similar to that of healthy individuals. The low vitamin E levels of leprosy patients suggest the benefits of supplementation. The metabolic changes observed did not demonstrate an association with anti-phenolic glycolipid I serology.

Objetivo : O consumo de quantidade adequada de iodo durante a gestação é de fundamental importância para o desenvolvimento neurológico do feto. O objetivo deste estudo foi avaliar o estado nutricional iódico em gestantes do estado de São Paulo, Brasil.Material e métodos : Analisamos a concentração urinária de iodo (UIC) em 191 gestantes e em 58 mulheres não gestantes de mesma faixa etária. Foram utilizados os critérios da OMS para definir suficiência iódica (mediana de UIC: 150-249 µg/L entre as gestantes e 100-199 µg/L para as não gestantes).Resultados : A mediana de UIC das gestantes estudadas esteve abaixo da recomendada (mediana = 137,7 μg/L; 95% IC = 132,9 – 155,9) enquanto a das mulheres não grávidas se mostrou na faixa adequada (mediana = 190 μg/L; 95% IC = 159,3 – 200,1). Entre as gestantes, 57% apresentaram UIC < 150 μg/L.Conclusões : Apesar de uma maior amostragem ser necessária para a confirmação desses achados, os resultados levantam preocupação quanto à suficiência iódica nas mulheres grávidas no Brasil, principalmente diante das novas determinações governamentais brasileiras quanto à redução das concentrações de iodo no sal de cozinha para 15-45 mg/kg. Arq Bras Endocrinol Metab. 2014;58(3):282-7

Objective : The intake of adequate amounts of iodine during pregnancy is essential for the neurological development of the fetus. The aim of this study was to assess iodine nutrition status in pregnant women from the state of São Paulo, Brazil.Material and methods : We analyzed urinary iodine concentration (UIC) in 191 pregnant and 58 non-pregnant women matched by age. We used the World Health Organization criteria to define sufficient iodine supply (median UIC: 150-249 µg/L among pregnant women, and 100-199 µg/L for non-pregnant women).Results : Median UIC of the pregnant women studied was lower than the recommended value (median = 137.7 µg/L, 95% CI = 132.9 – 155.9), while non-pregnant women had UIC levels within the appropriate range (median = 190 μg/L; 95% IC = 159.3-200.1). UIC was below 150 µg/L in 57% of the pregnant women.Conclusions : Although a larger sample is needed to consolidate these findings, these results raise concerns about the adequacy of the iodine supply of pregnant women in Brazil, especially considering the new determinations of the Brazilian government, which have recently reduced the concentrations of iodine in table salt to 15-45 mg/kg of salt. Arq Bras Endocrinol Metab. 2014;58(3):282-7

Introduction: HIV-seropositive patients have shown changes in body composition such as lipoatrophy in certain regions of the body and lipohypertrophy in others, representing characteristics of lipodystrophy syndrome. It is important to monitor the quantity of fat per body segment using practical and low-cost methods in order to optimize the treatment of this group. Objectives: To correlate the body composition per body segment obtained by anthropometric measurements and by segmental bioelectrical impedance with DXA in HIV-seropositive patients on antiretroviral treatment Methods: We measured circumferences (arm, waist, hip, thigh and calf) and skinfolds (biceps, triceps, subscapular, suprailiac) and performed segmental bioelectrical impedance (BIA) analysis and DXA. The Pearson test was used to determine correlations and the St. Laurent test was used to assess concordance between variables. Results: We evaluated 26 patients, 35% of whom were overweight. The triceps skinfold (TSF), waist circumference (WC) and thigh circumference (TC) were significantly correlated with the measurement obtained by the gold standard (p<0.01). There was no concordance between the values obtained by segmental BIA and by DXA. Conclusions: Anthropometric measurements such as TSF, WC and TC are importantfor the monitoring of changes in body composition among HIV-seropositive patients on antiretroviral treatment. Segmental BIA did not prove to be appropriate for the assessment of body composition in HIV-seropositive patients.

Introducción: Se ha descrito cambios en la composición corporal de pacientes infectados por VIH, tales como la lipoatrofia en ciertas regiones del cuerpo y lipohipertrofia en otros, en representación de las características del síndrome de lipodistrofia. Es importante controlar la cantidad de grasa corporal por segmento utilizando métodos prácticos y de bajo costo con el fin de optimizar el tratamiento de este grupo. Objetivos: correlacionar la composición corporal por segmento corporal obtenidos por las mediciones antropométricas y por impedancia bioeléctrica com DXA segmentaria en pacientes seropositivos al VIH en tratamiento antir-retroviral. Métodos: Se midieron las circunferencias de brazo, cintura, cadera, muslo y pantorrilla y los pliegues cutáneos: bíceps, tríceps, subescapular, suprailíaco) y se realizaron impedancia bioeléctrica segmentaria (BIA) el análisis y DXA. La prueba de Pearson se utilizó para determinar las correlaciones y la prueba de San Lorenzo se utilizó para evaluar la concordancia entre las variables. Resultados: Se evaluaron 26 pacientes, 35% de los cuales tenían sobrepeso. El pliegue del tríceps (PT), circunferencia de la cintura (CC) y la circunferencia del muslo (CM) se correlacionaron significativamente con la medida obtenida por el patrón de oro (p <0.01). No hubo concordancia entre los valores obtenidos por BIA y DXA segmentaria. Conclusiones: Las mediciones antropométricas como PT, CC y CM son importantes para el seguimiento de los cambios en la composición corporal de los pacientes infectados por VIH que reciben tratamiento antirretroviral. La BIA segmental no demostró ser adecuado para la evaluación de la composición corporal en pacientes infectados por VIH.

OBJETIVO E MÉTODOS: Estudos prévios apontaram Ribeirão Preto, São Paulo, como área de carência limítrofe de iodo e, posteriormente, de iodação excessiva. Reavaliando seu estado iódico em 2007-2008, foram analisados 300 escolares entre 8 e 10 anos de idade, procedentes de três escolas de diferentes níveis socioeconômicos e realizadas dosagens de iodo urinário e da concentração de iodo no sal doméstico e ultrassonografia tireoidiana. RESULTADOS E CONCLUSÃO: A iodúria foi superior na escola com maior nível socioeconômico, comparada às outras, e a diferença foi significante aos 8 e 10 anos para os meninos (p < 0,0001 e p = 0,0106, respectivamente) e aos 8 e 9 anos para as meninas (p = 0,0024 e p = 0,0154, respectivamente). As concentrações medianas de iodo em amostras de sal doméstico variaram entre 26,6 e 27,8 mg iodo/kg e não foram diferentes nas escolas estudadas. À ultrassonografia, 15,6% das tireoides examinadas apresentaram-se hipoecoicas, sugerindo que elas possam apresentar mudanças em sua arquitetura sem ainda alterar seus volumes.

OBJECTIVE AND METHODS: Previous studies have pointed out that Ribeirão Preto, São Paulo, is an area of borderline iodine deficiency, later becoming a region of excessive iodination. In a reevaluation of the iodine status of the city in 2007-2008, 300 schoolchildren aged 8 to 10 years were evaluated, from 3 schools of 3 different socioeconomic levels who were submitted to the determination of iodine concentration in urine samples and in kitchen salt and thyroid ultrasound. RESULTS AND CONCLUSION: Among boys and girls ioduria was higher in the school of highest socioeconomic level compared to the others, with a significant difference in the ages 8 and 10 years for boys with ranges : p < 0,0001 and p = 0,0106, respectively; and in the ages 8 and 9 years for girls with ranges: p = 0,0024 and p = 0,0154, respectively. Median iodine concentrations in samples of kitchen salt ranged from 26.6 to 27.8 mg iodine/kg and did not differ between the schools studied. Ultrasound evaluation revealed that 15,6% of thyroids examined were hypoechoic, suggesting that these glands may present changes in the architecture not reflected yet in their volume.

The objective of the present study was to evaluate the urinary excretion of iodine and relate it to the amount present in salt for human consumption. The study involved 145 children from two schools: a rural one and an urban one. We performed anthropometric measurements and collected a urine sample and a kitchen salt sample from each child. In the rural school, 3.38% of children had iodine deficiency. However, most of the values of urinary iodine were above 300 μg/L (62.03%) and 59.49% of the kitchen salt samples contained 20 to 60 mg iodine per kilo of salt. In the urban school, 3.03% of the children had urinary iodine excretion of less than 100 μg/L and 90.91% of the children had urinary iodine values exceeding 300 μg/L. Of this total, 84.85% of the kitchen salt samples contained 20 to 60 mg iodine per kilo of salt. Iodine deficiency is controlled in this population, with the current reality showing a high prevalence of excess urinary iodine.

O presente trabalho tem como objetivo avaliar a excreção urinária de iodo e relacionar com a sua quantidade presente no sal de consumo humano. Participaram do estudo 145 crianças de duas escolas: uma de zona rural e outra de urbana. Foram realizadas avaliação antropométrica e coleta de amostra de urina e do sal de cozinha cada uma das crianças voluntárias. Na escola rural, 3,8% das crianças apresentaram deficiência de iodo. Entretanto, a maioria dos valores de iodúria ficou acima de 300μg/L (62,03%) com 59,49% das amostras do sal de cozinha entre 20 e 60mg de iodo por quilo de sal. Para a escola urbana, 3,03% das crianças apresentaram iodúria inferior à 100μg/L, sendo que, 90,91% das crianças apresentaram valores de iodúria superior a 300μg/L. Desse total, 84,85% das amostras do sal de cozinha encontrava-se entre 20 e 60mg de iodo por quilo de sal. A deficiência de iodo na população estudada está controlada, destacando-se agora uma nova realidade de alta prevalência de excesso de iodo urinário.

O objetivo deste trabalho foi avaliar a distribuição de gordura corporal, visceral e não visceral, em pacientes internados, medida por meio da antropometria. Foram avaliados 157 pacientes internados, distribuídos em dois grupos: Grupo I (95 pacientes portadores de doenças crônicas) e Grupo II (62 pacientes portadores de hepatopatias, pneumopatias, nefropatias, neoplasias, úlceras, gastrites, e doenças hematológicas), denominados PTodos. Em cada paciente, foram obtidas as seguintes medidas antropométricas: peso, altura, prega cutânea tricipital e circunferências (cintura e quadril). Os maiores valores dos parâmetros relação cintura/quadril e índice de gordura do braço foram encontrados no Grupo I e estes valores foram significativamente superiores quando comparados ao Grupo II. Os resultados demonstraram que, no grupo de pacientes estudados, houve uma distribuição de gordura corporal diferenciada entre pacientes Grupo I e Grupo II. Estas relações confirmam que os pacientes portadores de doenças crônicas (Grupo I) apresentam valores de relação cintura/quadril e índice de gordura do braço que são discriminatórios em relação aos dos pacientes portadores de hepatopatias, pneumopatias, nefropatias, neoplasias, úlceras, gastrites e doenças hematológicas (Grupo II).

The objective of this work was to evaluate the distribution of corporal, visceral and not visceral fat, in hospitalized patients, measured by means of the anthropometry. The study evaluated 157 hospitalized patients, distributed in two groups: Group I (95 patients with chronic-degenerative diseases) and Group II (62 patients with liver, lung and kidney diseases, neoplasms, ulcers, gastritis, and hematologic diseases). The following anthropometric measurements were obtained from each patient: weight, height, triceps skinfold thickness and circumferences (waist and hip). The largest values of the parameters waist to hip relationship and arm fat index were found in the Group I and these values were significantly superior when compared to the Group II. The results demonstrated that, in the group of patients studied, there was a differentiated distribution of body fat between patients Group I and Group II. These relationships confirm that the patients with chronic-degenerative diseases (Group I) present values of waist to hip relationship and arm fat index that are differentiating in relation to the patients with liver, lung and kidney diseases, neoplasms, ulcers, gastritis and hematologic diseases (Group II).