Abstract This systematic review examined the effects of paternal exposure to a high-fat diet on the likelihood of offspring developing health consequences, including metabolic conditions. While the connection between a mother’s diet and offspring health has been well established, our understanding of whether offspring health is affected by a father’s diet remains limited. This systematic review was performed according to the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) recommendations. The PubMed, Scopus, and Embase electronic databases were searched using combinations of the MESH terms: obesogenic diet, high-fat diet, cafeteria diet, paternal diet, parental diet, programming, paternal effects, and paternal programming. Sixteen studies were selected after assessing articles for eligibility criteria. The main outcomes concerning offspring health related to metabolic disorders. The offspring of fathers exposed to a high-fat diet displayed elevated gene expression and serum levels of leptin, decreased gene expression and serum levels of adiponectin, insulin resistance, glucose intolerance, hyperglycemia, hyperinsulinemia, changes in the transcriptome of pancreatic islet tissues, increased triglycerides, and increased expression of lipogenic genes. The available evidence suggests that paternal exposure to a high-fat diet may induce harmful effects on the health of offspring.

RESUMO Objetivo: Descrever a frequência de tabagismo ativo entre pacientes com asma e indivíduos sem asma, usando questionários padronizados e dosagem da cotinina urinária. Métodos: Estudo transversal realizado em Salvador (BA), com 1.341 indivíduos, sendo 498 com asma grave, 417 com asma leve/moderada e 426 sem asma. O tabagismo foi identificado por meio de autorrelato utilizando questionários e por mensuração da cotinina urinária. Para a comparação das variáveis estudadas, utilizaram-se os testes do qui-quadrado e de Kruskal-Wallis. Resultados: Dos 55 participantes (4,1%) que se declararam tabagistas atuais, 5, 17 e 33 eram dos grupos asma grave, asma leve/moderada e sem asma, respectivamente. Desses 55, 32 (58,2%) eram tabagistas diários e 23 (41,8%) eram tabagistas ocasionais. Observaram-se níveis elevados de cotinina urinária entre não fumantes autodeclarados e tabagistas pregressos, especialmente no grupo asma grave, o que sugere omissão do hábito atual de fumar. A carga tabágica entre os fumantes e a proporção de ex-tabagistas foram maiores no grupo asma grave do que no grupo asma leve/moderada. Conclusões: O tabagismo pregresso esteve associado à asma grave. Tabagismo atual também foi observado em alguns pacientes com asma grave e detectou-se omissão em alguns casos. A investigação de tabagismo deve ser meticulosa em pacientes com asma grave e a entrevista desses deve ser complementada por uma avaliação objetiva.

ABSTRACT Objective: To determine the frequency of active smoking among patients with asthma and individuals without asthma by self-report and urinary cotinine measurement. Methods: This was a cross-sectional study conducted in the city of Salvador, Brazil, and involving 1,341 individuals: 498 patients with severe asthma, 417 patients with mild-to-moderate asthma, and 426 individuals without asthma. Smoking status was determined by self-report (with the use of standardized questionnaires) and urinary cotinine measurement. The study variables were compared with the chi-square test and the Kruskal-Wallis test. Results: Of the sample as a whole, 55 (4.1%) reported being current smokers. Of those, 5 had severe asthma, 17 had mild-to-moderate asthma, and 33 had no asthma diagnosis. Of the 55 smokers, 32 (58.2%) were daily smokers and 23 (41.8%) were occasional smokers. Urinary cotinine levels were found to be high in self-reported nonsmokers and former smokers, especially among severe asthma patients, a finding that suggests patient nondisclosure of smoking status. Among smokers, a longer smoking history was found in patients with severe asthma when compared with those with mild-to-moderate asthma. In addition, the proportion of former smokers was higher among patients with severe asthma than among those with mild-to-moderate asthma. Conclusions: Former smoking is associated with severe asthma. Current smoking is observed in patients with severe asthma, and patient nondisclosure of smoking status occurs in some cases. Patients with severe asthma should be thoroughly screened for smoking, and findings should be complemented by objective testing.

Resumo Diversas mudanças ocorrem no metabolismo lipídico durante a gestação em função das alterações hormonais e metabólicas, que são essenciais para satisfazer a demanda nutricional ocasionada pelo desenvolvimento da unidade feto-placentária. O período da gestação apresenta dois momentos distintos que iniciam com acúmulo de gordura principalmente no tecido adiposo materno, e a fase tardia, caracterizada por catabolismo acelerado, com aumento de ácidos graxos na circulação causando hiperlipidemia, principalmente a aquela caracterizada como hipertrigliceridemia. A hiperlipidemia materna pode estar associada ao desenvolvimento de complicações materno-fetais (parto prematuro, pré-eclâmpsia, complicações vasculares) e de doenças cardiovasculares, a longo prazo. O risco pode estar relacionado não apenas ao teor de colesterol contido nas frações lipoprotéicas, mas também ao número e a funcionalidade das partículas lipoproteicas. Esta revisão aborda as principais mudanças que ocorrem no metabolismo lipoproteico durante a gravidez, e que estão associadas ao desenvolvimento de dislipidemias, fenótipo aterogênico e complicações maternofetais.

Abstract Several changes occur in lipid metabolism during gestation due to hormonal and metabolic changes, which are essential to satisfy the nutritional demands of the maternal-fetal unit development. The gestation shows two distinct periods that begin with fat accumulation, mainly in maternal adipose tissue, and the late phase, characterized by accelerated catabolism, with the increase of fatty acids in the circulation that causes hyperlipidemia, especially the one characterized as hypertriglyceridemia. Maternal hyperlipidemia may be associated with the development of maternal-fetal complications (preterm birth, preeclampsia, vascular complications) and the development of long-term cardiovascular disease. The cardiovascular risk may not only be related to lipoproteins cholesterol content, but also to the number and functionality of circulating lipoprotein particles. This review reports themajor changes that occur in lipoprotein metabolismduring pregnancy and that are associated with the development of dyslipidemias, lipoprotein atherogenic phenotype, and maternal-fetal unit complications.

RESUMO Entre as doenças cardiovasculares (DCV), o infarto agudo do miocárdio (IAM) atualmente é considerado a causa mais comum de morte e incapacidade em todo o mundo. Vários testes laboratoriais vêm sendo desenvolvidos para a detecção de lesões cardíacas, entre eles, as troponinas, consideradas marcador (biomarcador sugestivo) padrão-ouro de lesão miocárdica. A alta especificidade da troponina para a necrose dos cardiomiócitos está relacionada com a sequência peptídica única presente na troponina do músculo cardíaco. Em função disso, estudos estão voltados para o desenvolvimento de conjuntos diagnósticos de alta sensibilidade para a determinação das troponinas I (hs-cTnI). Esses conjuntos diagnósticos surgem com o objetivo de detectar concentrações séricas cada vez menores desses biomarcadores a partir da detecção de fragmentos peptídicos que são liberados após modificações bioquímicas estruturais. O presente artigo discorre sobre as diferenças de imunorreatividade dos fragmentos de troponina no desenvolvimento de nossos testes para a determinação da cTnI, a exemplo dos testes de alta sensibilidade, que surgem com a proposta de garantir maior eficiência no diagnóstico associado do IAM.

ABSTRACT Among the cardiovascular diseases (CVD), acute myocardial infarction (AMI) is currently considered the most common cause of death and disability worldwide. Several laboratory tests have been developed for the detection of cardiac injury, including troponins that are considered the gold standard marker (surrogate biomarker) of myocardial injury. The high specificity of troponin for cardiomyocyte necrosis is related to a single unique peptide sequence present in troponin at the cardiac muscle. As a result, studies are currently focused on the development of troponin (hs-cTnI) determination tests with high diagnostic sensitivity value. These diagnostic tests aim to detect increasingly lower serum concentrations of cTnI biomarkers, from the detection of peptide fragments that are released after structural biochemical changes. This article discusses the differences between troponin fragments immunoreactivity to the development of cTnI determination tests, such as the high-sensitivity tests, which arise with the proposal of guaranteeing greater efficiency in the AMI associated diagnosis.

Abstract Background: Sepsis is an illness with a high morbidity for which no effective treatment exists. Its treatment has a high cost because it usually requires an intensive care unit and expensive antibiotics. The present study focus in the production of reactive oxygen species in the early stages of sepsis. This study aimed at investigating the production of reactive oxygen specie during the inflammatory response in patients with sepsis. Methods: Reactive oxygen specie production and insoluble myeloperoxidase obtained from fresh whole blood were measured by photon counting chemiluminescence in the blood of 18 septic patients and 12 healthy individuals. Modified red blood cells were evaluated by staining of blood smears. The production of reactive oxygen species by macrophages and polymorphonuclear leukocytes put into contact with modified red blood cells were also assessed by photon counting chemiluminescence. Results: The appearance of oxidatively modified erythrocytes, which is an evidence of oxidative stress, was supported by the detection of reactive oxygen species and insoluble myeloperoxidase in the whole blood of all septic patients. Peroxynitrite was the main reactive oxygen species found in the whole blood. Oxidatively modified erythrocytes activated phagocytic cells in vitro, leading to the considerable production of free radicals. Conclusion: It was found that sepsis led to a high oxidative stress and to extensive modification of erythrocytes. It is proposed that a positive feedback mechanism, involving the activation of circulating leukocytes by these modified erythrocytes would maintain the pro-oxidative state even after the disappearance of bacteria.

RESUMO: O estudo objetivou verificar a ação do óleo essencial de Lippia alba (EOLA) na resposta de estresse para o transporte de tilápia-do-Nilo Oreochromis niloticus . Os peixes foram transportados por 8h sob três tratamentos (triplicata): controle, 10 e 20µL L-1 EOLA. Níveis plasmáticos de glicose foram significativamente menores em peixes expostos a 20µL L-1 de EOLA, em relação com o grupo controle e os peixes expostos a 10µL L-1 de EOLA, mas, cortisol, lactato e paraoxonase plasmáticos foram similares. Amônia não-ionizada e taxa de ventilação demonstraram redução significativa nos tratamentos com EOLA. Conclui-se que o uso de 20µL L-1 de EOLA é indicado para o transporte de tilápia-do-Nilo.

ABSTRACT: This study aimed to examine the action of the essential oil of Lippia alba (EOLA) in the stress response for transport of Nile tilapia Oreochromis niloticus . The fish were transported into three treatments (in triplicate): control, 10 and 20 µL L-1 EOLA, with loading density of 15 fish/plastic bags for 8h. Plasma glucose levels were significantly decreased in fish exposed to 20µL L-1 EOLA in comparison with the control group and fish exposed to 10µL L-1 EOLA, but the plasma cortisol, lactate and paraoxonase levels were similar. Un-ionized ammonia and ventilatory rate demonstrated a significant reduction in the treatments with the use of EOLA. In conclusion the use of 20µL L-1 EOLA is indicated for Nile tilapia transport.

Aim: considering the frequent consumption of fatrich diets by women of reproductive age, the aim of the present study was to investigate the effects of maternal consumption of a high-fat diet during the perinatal and/ or post-weaning period on the liver parameters and lipid metabolism of young rats. Methods: Wistar female rats were fed a high-fat (H) or control (C) diet during pregnancy and lactation. The offspring were allocated to four groups: Control Control (CC, n = 11), offspring fed a control diet after weaning; Control High-fat (CH, n = 10), offspring fed a high-fat diet after weaning; High-fat High-fat (HH, n = 10), offspring of mothers H fed a high-fat diet after weaning; and High-fat Control (HC, n = 9), offspring of mothers H fed with control diet after weaning. Results and discussion: the food intake did not differ among the groups, however, the relative weight of the adipose tissue was higher in animals from the HC, HH and CH groups (p ≤ 0.005). Liver steatosis was found in the CH and HH animals, which also exhibited hypercholesterolemia (p ≤ 0.05). The levels of the liver enzymes alanine aminotransferase (ALT) and gamma-glutamyl transpeptidase (GGT) were higher in the HH group, and the LDL level was higher in the CH group compared to the CC. The consumption of an obesogenic diet during critical periods of development may contribute to the occurrence of visceral obesity, liver steatosis and hypercholesterolemia in adult rats, even in the absence of changes in dietary intake.

Objetivo: teniendo en cuenta el consumo frecuente de dietas ricas en grasas por las mujeres en edad reproductiva, el objetivo del presente estudio fue investigar los efectos del consumo materno de una dieta alta en grasas durante el periodo perinatal y/o post-destete en el hígado y el metabolismo de los lipidos en ratas jóvenes. Métodos: ratas hembra Wistar fueron alimentadas durante el embarazo y la lactancia con un alto contenido de grasa (H) o de control (C). La descendencia se asignó a cuatro grupos: Control (CC, n = 11), descendencia alimentada con una dieta de control después del destete; Control de dieta alta en grasa (CH, n = 10), crias alimentadas con una dieta alta en grasas después del destete; Alta en grasas de alta en grasa (HH, n = 10), hijos de madres H alimentados con una dieta alta en grasas después del destete; y Control de alta en grasa (HC, n = 9), hijos de madres H alimentados con dieta de control tras el destete. Resultados y discusión: la ingesta de alimentos no difirio entre los grupos; sin embargo, el peso relativo del tejido adiposo fue mayor en los animales de los grupos HC, HH y CH (p ≤ 0,005). La esteatosis hepatica se encontro en los CH y HH, que tambien presentaban hipercolesterolemia (p ≤ 0,05). Los niveles de las enzimas hepaticas alanina aminotransferasa (ALT) y gamma-glutamil transpeptidasa (GGT) fueron mayores en el grupo de HH, y el nivel de LDL fue mayor en el grupo CH en comparación con el CC. El consumo de la dieta propicio la obesidad durante los periodos criticos del desarrollo y puede contribuir a la aparición de obesidad visceral, esteatosis hepatica e hipercolesterolemia en ratas adultas, incluso en ausencia de cambios en la ingesta dietética.

Aim: to evaluate the effects of a protocol promoting adequate and healthy eating on adolescent health parameters. Methods: this controlled intervention study was conducted for 9 months, with the participation of adolescents enrolled in two schools (intervention/control) located in a poor neighbourhood in the city of Salvador (Bahia), Brazil. For the intervention school, activities promoting adequate and healthy eating were designed based on the Food Guide for the Brazilian Population (Guia Alimentar para a População Brasileira). Students underwent biochemical, sexual maturation and anthropometric tests at baseline and at the end of the 9-month period. In addition, students answered a questionnaire on food consumption, physical activity and sedentary behaviour. Information on the socioeconomic status of their family was also obtained. Generalized Estimating Equation (GEE) analysis was chosen to evaluate the associations of interest. Results: students under intervention presented decreases of 7.64 mg/dL in mean total cholesterol (TC) (p = 0.009) and 7.77 mg/dL in mean low-density lipoprotein cholesterol (LDLc) (p = 0.003) and increases of 18% in legume consumption (odds ratio [OR] = 1.18; 95% confidence interval [CI] 1.03-1.37) and 17% in vegetable consumption (OR = 1.17; 95%CI 1.01-1.35) compared with students who did not undergo intervention. No differences were observed in the anthropometric parameters analysed. Conclusion: the results showed a positive effect of activities promoting adequate and healthy eating on reducing TC and LDLc and on increasing the consumption of vegetables and legumes, evidencing that the intervention model was able to prevent and/or treat cardiovascular risk factors in adolescents.

Objetivo: evaluar las repercusiones de un protocolo de promoción de una alimentación adecuada y saludable en los parámetros de salud de adolescentes. Métodos: se trata de un estudio de intervención, controlado, con una duración de nueve meses, en el cual participaron estudiantes, con una edad entre 10 y 17 años, matriculados en dos escuelas (intervención/ control) situadas en un barrio pobre del municipio de Salvador (Bahia), Brasil. Fueron previstas para la escuela bajo intervención acciones de promoción de una alimentación adecuada y saludable, con base en el Guia Alimentar para a População Brasileira (Guía Alimentaria para la Población Brasileña). Con el propósito de evaluar el efecto de tales acciones, todos los alumnos fueron sometidos a los exámenes bioquímicos, de maduración y antropométricos al principio y al final de los nueve meses. Además, contestaron a un cuestionario sobre consumo alimentario, actividad física y comportamiento sedentario. También se consiguió información sobre las condiciones socioeconómicas de la familia. La opción fue el análisis de Ecuaciones de Estimaciones Generalizadas (GEE) para evaluar las asociaciones de interés. Resultados: se verificó que los estudiantes bajo intervención presentaron una disminución de 7,64 mg/dL en la media del colesterol total (p = 0,009), de 7,77 mg/dL en la media del LDLc (p = 0,003), un incremento del 18% en el consumo de legumbres (OR = 1,18; 95%IC 1,03-1,37) y del 17% en el consumo de verduras (OR = 1,17; 95%IC 1,01-1,35), comparados con aquellos que no fueron sometidos a la intervención. No hubo diferencias en los parámetros antropométricos estudiados. Conclusión: los resultados apuntaron un efecto positivo de las acciones de promoción de la alimentación adecuada y saludable en la reducción del colesterol total, LDL-c, en el aumento del consumo de vegetales y legumbres, evidenciando una vez más que el modelo de intervención fue capaz de prever y/o tratar factores de riesgo cardiovascular en los adolescentes.

Objective Diabetes mellitus is the main cause of Charcot neuroarthropathy and is clinically classified as follows: Charcot foot, acute Charcot foot (ACF) when there is inflammation, and inactive Charcot foot when inflammatory signs are absent. The aim of this study was to identify the risk factors for ACF in patients with type 2 diabetes mellitus.Materials and methods A matched case-control study was conducted to assess the factors associated with acute Charcot foot from February 2000 until September 2012. Four controls for each case were selected 47 cases of ACF and 188 controls without ACF were included. Cases and controls were matched by year of initialization of treatment. Conditional logistic regression was used to estimate matched odds ratios (ORs) and 95% confidence intervals (95% CIs).Results In multivariate analysis, patients having less than 55 years of age (adjusted OR = 4.10, 95% CI = 1.69 – 9.94), literate education age (adjusted OR = 3.73, 95% CI = 1.40 – 9.92), living alone (adjusted OR = 5.84, 95% CI = 1.49 – 22.86), previous ulceration (adjusted OR = 4.84, 95% CI = 1.62 – 14.51) were at increased risk of ACF. However, peripheral arterial disease (adjusted OR = 0.16, 95% CI = 0.05 – 0.52) of 6.25 (1.92 – 20.0) was a protective factor.Discussion The results suggest that PCA in type 2 diabetes primarily affects patients under 55 who live alone, are literate, and have a prior history of ulcers, and that peripheral arterial disease is a protective factor. Arch Endocrinol Metab. 2015;59(3):226-30

OBJETIVO: Este estudo objetivou identificar a soroprevalência da doença celíaca em adolescentes de escolas públicas da cidade de Salvador, Bahia. MÉTODO: Trata-se de um estudo transversal com amostra probabilística de 1.213 adolescentes de 11 a 17 anos, de ambos os sexos. O índice de massa corporal foi utilizado para o diagnóstico do estado nutricional, adotando-se os percentis segundo idade e sexo, propostos pela World Health Organization. O anticorpo anti-transglutaminase humana da classe imunoglobulina A (anti-tTG-IgA) foi adotado como teste sorológico para triagem da doença celíaca e foi determinado pela técnica do ensaio imunoabsorvente ligado à enzima (ELISA). Foi realizada análise descritiva, utilizando-se a proporção e a média (desvio padrão). RESULTADOS: O sexo feminino predominou entre os adolescentes, e a maioria encontrava-se com adequado estado nutricional. O anticorpo anti-tTG-IgA foi positivo em 6/1.213 (0,49%) adolescentes. CONCLUSÃO: A soroprevalência de doença celíaca entre os adolescentes estudados foi 0,49%. Novas investigações são necessárias para confirmar a prevalência de doença celíaca nessa faixa etária.

OBJECTIVE: This study aimed to identify the seroprevalence of celiac disease in adolescents from public schools in the city of Salvador, Bahia. METHODS: This was a cross-sectional study with probabilistic sample of 1,213 adolescents, aged 11 to 17 years old, of both genders. The body mass index was used to determine the participants' nutritional status based on the percentiles for age and gender recommended by the World Health Organization. Measurement of the anti-human transglutaminase immunoglobulin A (anti-tTG-IgA) antibody was established as the specific screening test for celiac disease, which involved an enzyme-linked immunosorbent assay (ELISA). Descriptive analysis was performed using proportions and means (standard deviation). RESULTS: The female gender prevailed in the sample, and most of the participants had normal weights. The anti-tTG-IgA antibody was positive in 6/1,213 (0.49%) adolescents. CONCLUSION: The seroprevalence of celiac disease was 0.49% in the investigated adolescents. Further studies are necessary to establish the prevalence of celiac disease in this age range.

OBJETIVO: Este estudo objetivou identificar a soroprevalência da doença celíaca em adolescentes de escolas públicas da cidade de Salvador, Bahia. MÉTODO: Trata-se de um estudo transversal com amostra probabilística de 1.213 adolescentes de 11 a 17 anos, de ambos os sexos. O índice de massa corporal foi utilizado para o diagnóstico do estado nutricional, adotando-se os percentis segundo idade e sexo, propostos pela World Health Organization. O anticorpo anti-transglutaminase humana da classe imunoglobulina A (anti-tTG-IgA) foi adotado como teste sorológico para triagem da doença celíaca e foi determinado pela técnica do ensaio imunoabsorvente ligado à enzima (ELISA). Foi realizada análise descritiva, utilizando-se a proporção e a média (desvio padrão). RESULTADOS: O sexo feminino predominou entre os adolescentes, e a maioria encontrava-se com adequado estado nutricional. O anticorpo anti-tTG-IgA foi positivo em 6/1.213 (0,49%) adolescentes. CONCLUSÃO: A soroprevalência de doença celíaca entre os adolescentes estudados foi 0,49%. Novas investigações são necessárias para confirmar a prevalência de doença celíaca nessa faixa etária.

OBJECTIVE: This study aimed to identify the seroprevalence of celiac disease in adolescents from public schools in the city of Salvador, Bahia. METHODS: This was a cross-sectional study with probabilistic sample of 1,213 adolescents, aged 11 to 17 years old, of both genders. The body mass index was used to determine the participants' nutritional status based on the percentiles for age and gender recommended by the World Health Organization. Measurement of the anti-human transglutaminase immunoglobulin A (anti-tTG-IgA) antibody was established as the specific screening test for celiac disease, which involved an enzyme-linked immunosorbent assay (ELISA). Descriptive analysis was performed using proportions and means (standard deviation). RESULTS: The female gender prevailed in the sample, and most of the participants had normal weights. The anti-tTG-IgA antibody was positive in 6/1,213 (0.49%) adolescents. CONCLUSION: The seroprevalence of celiac disease was 0.49% in the investigated adolescents. Further studies are necessary to establish the prevalence of celiac disease in this age range.

Objetivos: avaliar a capacidade dos indicadores antropométricos e pontos de corte na predição da síndrome metabólica (SM) em crianças e adolescentes. Métodos: estudo transversal, envolvendo amostra probabilística de 879 crianças e adolescentes de ambos os sexos. Dados metabólicos, antropométricos e sociodemográficos foram coletados. Para diagnóstico da SM, foi utilizada a definição modificada do National Cholesterol Education Program's Adult Treatment Panel III (NCEP-ATP III). A capacidade dos indicadores antropométricos na predição do SM foi avaliada por meio da curva Receiver Operating Characteristic (ROC). Resultados: a prevalência de SM foi de 6,6%. Na predição da SM, a área sob a curva ROC foi de 0,79 (0,72; 0,85) para índice de massa corporal (IMC), de 0,79 (0,73; 0,85) para circunferência da cintura (CC) e de 0,83 (0,78; 0,89) para circunferência da cintura corrigida pela estatura (RCE). O ponto de corte identificado para RCE na predição da SM foi de 0,448 (ambos os gêneros). Conclusões: todos os indicadores antropométricos utilizados, com pequena superioridade da RCE, foram bons preditores da SM. O ponto de corte identificado para RCE na predição da SM aproxima-se daquele proposto por alguns autores como universal. Sugere-se o uso deste índice dado a sua simples operacionalidade em estudos clínicos e epidemiológicos como preditor da SM.

Objectives: to assess the capacity of anthropometric indicators to predict metabolic syndrome in children and adolescents and to establish cut-off points. Methods: a cross-sectional study was carried out with a probabilistic sample of 879 children and adolescents of both sexes. Metabolic, anthropometric and socio-demographic data were gathered. Diagnosis of metabolic syndrome was carried out using the modified definition of the National Cholesterol Education Program 's Adult Treatment Panel III (NCEP-ATPIII). The capacity of anthropometric indicators to predict metabolic syndrome was assessed using the Receiver Operating Characteristic (ROC) curve. Results: the prevalence of metabolic syndrome was 6.6%. For prediction of metabolic syndrome, the area under the ROC curve was 0. 79 (0. 72; 0.85) for body mass index, 0. 79 (0.73; 0.85) for waist circumference and 0.83 (0.78; 0.89) for waist circumference corrected for height. The cut-off point identified for waist circumference corrected for height for prediction of metabolic syndrome was 0.448 (for both sexes). Conclusions: all anthropometric indicators used were good predictors of metabolic syndrome, with slightly better results for waist circumference corrected for height. The cut-off point identified for waist circumference corrected for height for prediction of metabolic syndrome was similar to the standard proposed by other authors. It is suggested that this indicator be used in clinical and epidemiological studies as a predictor of metabolic syndrome, since it is simple to measure.

INTRODUÇÃO: Complicações da aterosclerose agregam as principais causas de morte no mundo por problemas cardiovasculares relativos a distúrbio da condição mecânica e fisiológica que promove espessamento e endurecimento nas artérias. OBJETIVO: Avaliar as concentrações plasmáticas de biomarcadores do metabolismo lipídico e os resultados de doppler de carótidas, relacionando-os com a doença aterogênica de carótidas. MÉTODOS: Foram acompanhados 66 pacientes, com a média de idade entre 57,5 ± 15,5 anos, (20 a 77), sendo 63% mulheres. Utilizaram-se biomarcadores séricos e imagens (doppler) para avaliar a associação com a doença aterogênica carotídea (DCA). RESULTADOS E DISCUSSÃO: A DCA foi mais prevalente no gênero feminino (33% vs. 15%) entre as idades de 56-65 anos, risco relativo (RR) 1,56 nas mulheres (p < 0,002; Fisher, Katz). Em relação ao colesterol da lipoproteína de alta densidade (HDL-C) e à classificação da estenose de carótidas, North American Symptomatic Carotid Endarterectomy Trial (NASCET), observamos que 76% dos indivíduos apresentavam HDL-C na faixa protetora, sendo 31 grau I (normal); 81% possuíam lipoproteína de alta densidade (HDL) sérica > 40 mg/dl em comparação com 19% que tinham concentração de HDL-C ≥ 40 mg/dl. A prevalência de HDL-C > 40 mg/dl nos graus II, III e IV foi significativa. Não houve diferença de HDL-C entre os grupos (p = 0,4910, teste t não pareado). Não foi observada diferença entre as atividades de paraoxonase (PON1) quando estratificada para HDL-C > e < que 40 mg/dl (p > 0,05). CONCLUSÃO: O gênero feminino teve maior prevalência de DCA entre 56-65 anos, RR 1,56 vezes maior. Esse achado revela a importância de atenção nesse gênero e nessa faixa etária, uma vez que a ausência de proteção hormonal agrava o risco de DCA, podendo influenciar na atividade antioxidante da HDL por atuar diretamente na PON1. A razão triglirecídeos (TG)/HDL-C aponta para risco cardiovascular e deficiências no transporte reverso do colesterol.

INTRODUCTION: Atherosclerosis and correlated cardiovascular problems, whose mechanical and physiological disorders cause thickening and hardening of blood vessels, are among the main causes of death worldwide. OBJECTIVE: To assess plasma concentrations of biomarkers from the lipid metabolism and carotid doppler sonography results by correlating them with atherogenic carotid disease. METHODS: the study comprised 66 patients aged 57.5 ± 15.5 years (20-77), from which 63% were female. Serum markers and doppler sonography images were used to evaluate the association with atherogenic carotid disease (ACD). RESULTS: There was a higher prevalence of ACD among females (33% vs. 15%), age range 56-65, showing a relative risk (RR) of 1.56 among females (p < 0.002; Fisher, Katz). Concerning high density lipoprotein cholesterol (HDL-C) and carotid stenosis classification, North American Symptomatic Carotid Endarterectomy Trial (NASCET), 76% of patients showed HDL-C within the protection range, from which 31 individuals presented level I (normal). 81% of them showed HDL-C > 40 mg/dl and 19% had HDL-C ≥ 40 mg/dl. The prevalence of HDL-C > 40 mg/dl at levels II, III and IV was considerable. There was no difference in HDL-C among the groups (p = 0.4910; unpaired t test). Furthermore, there was no difference in paraoxonase (PON1) activity when stratified to HDL-C > and < 40 mg/dl (p > 0.05). CONCLUSION: The female group displayed higher ACD prevalence at 56-65 age range, with RR of 1.56 times higher. These findings substantiate the importance of analyzing this group and age range carefully, inasmuch as the absence of hormonal protection may increase ACD risk and ultimately influence HDL antioxidant activity due to its direct action on PON1. Triglycerides (TG)/HDL-C ratio indicates cardiovascular risk and impaired reverse cholesterol transport.

INTRODUÇÃO: O diabetes mellitus (DM) é considerado um problema importante de saúde pública; possui prevalência elevada e nos últimos anos observa-se aumento progressivo na sua incidência. OBJETIVO: verificar possíveis variações na concentração de hemoglobina (Hb) glicada (HbA1c) na presença de Hbs S e C e avaliar o impacto da redução da HbA1c na avaliação clínica e no monitoramento do paciente diabético. MATERIAL E MÉTODOS: Foram incluídos no estudo, 150 indivíduos diabéticos oriundos da cidade de Salvador, Bahia, de ambos os gêneros, com idade média de 56 anos. Foram determinadas a glicemia de jejum e a HbA1c por metodologia de oxidase-peroxidase e cromatografia líquida de alta eficiência (CLAE), respectivamente. RESULTADOS: Foram observadas variações na concentração da HbA1c em função da presença de variantes de Hb, como 7,85%, AA; 7,30%, AS e 7,15%, AC. DISCUSSÃO E CONCLUSÃO: A metodologia analítica a ser utilizada para determinação de HbA1c deve ser escolhida com base nas características gerais da população atendida e nas comorbidades associadas, pois a presença de Hbs S e C ocasiona reduções significativas de glicação. Essa redução pode levar a interpretações clínicas inadequadas relativas ao controle glicêmico dos pacientes.

INTRODUCTION: Diabetes mellitus (DM) is considered an important public health problem. It is highly prevalent and its incidence has progressively increased in recent years. OBJECTIVE: To verify possible variations of glycated hemoglobin (HbA1c) concentration in the presence of Hb S and Hb C and to evaluate the impact of HbA1c reduction on clinical evaluation and monitoring of diabetic patients. MATERIAL AND METHODS: This study comprised 150 diabetic individuals from Salvador city, Bahia, from both genders and average age of 56 years old. Fast blood glucose and HbA1c were determined by oxidase-peroxidase and high-performance liquid chromatography (HPLC) methods, respectively. RESULTS: There were variations in the concentration of HbA1c in the presence of hemoglobin variants such as AA (7.85%), AS (7.30%), and AC (7.15%). DISCUSSION AND CONCLUSION: The analytical method used to determine HbA1c needs to be chosen according to the general population characteristics and associated comorbidities, since the presence of hemoglobin S and C causes significant reductions in hemoglobin glycation, which may lead to clinical misinterpretation of patients' glycemic control.

INTRODUÇÃO: Índices calculados a partir de medidas laboratoriais e a determinação de marcadores plasmáticos são frequentemente utilizados para a avaliação do risco cardiovascular. OBJETIVO: Utilizar a razão triglicérides/colesterol da lipoproteína de alta densidade (HDL-C), estimativa de tamanho de partículas de lipoproteína de baixa densidade (LDL) e os níveis da proteína C reativa de alta sensibilidade (PCR-as) para a avaliação clínica e laboratorial do risco cardiovascular de pacientes com doença arterial coronariana (DAC). MATERIAL E MÉTODOS: Foram selecionados 60 pacientes por conveniência, 36 do sexo feminino (F) (65 ± 9 anos) e 24 do sexo masculino (M) (55 ± 10 anos) com diagnóstico de cardiopatia isquêmica estável, atendidos no Hospital Ana Neri, em Salvador, Bahia. A investigação foi realizada no Laboratório de Bioquímica Clínica da Faculdade de Farmácia da Universidade Federal da Bahia (UFBA). Amostras de sangue foram coletadas após 12 horas de jejum para determinação da PCR-as, do perfil lipídico e do cálculo de indicadores de risco. As determinações foram realizadas no equipamento Syncron LX®20 Beckman Coulter, USA. Foram considerados significativos os resultados da análise inferencial para p < 5%. A análise dos dados foi realizada no software GraphPad Prism®, versão 4.03. RESULTADOS: A análise dos dados mostrou correlação positiva entre a PCR-as e a razão triglicérides/HDL-C apenas para o sexo feminino (r = 0,4; p = 0,0442), n = 36. A análise dos demais parâmetros não mostrou significância. CONCLUSÃO: A razão triglicérides/HDL-C e a PCR-as podem ser utilizadas como indicadores do aumento do risco cardiovascular em mulheres com DAC.

INTRODUCTION: Calculated indexes from laboratory measurements and the determination of plasma markers are commonly used in cardiovascular risk assessment. OBJECTIVE: To use triglycerides/high-density lipoprotein cholesterol (HDL-C) ratio, estimate of low-density lipoprotein (LDL) particle size and high sensitive C-reactive protein (hs-CRP) levels to the clinical and laboratorial assessment of coronary risk among patients with coronary disease. MATERIAL AND METHODS: Sixty patients were chosen accordingly, 36 female (F) (65 ± 9 years of age) and 24 male (M) (55 ± 10 years of age) diagnosed with stable ischemic cardiopathy at Ana Neri Hospital, Salvador, Bahia, Brazil. The investigation was carried out at the Clinical Biochemistry Laboratory of the College of Pharmacy at Federal University of Bahia (UFBA). Blood samples were collected after a 12-hour fast to determine hs-CRP, lipid profile and risk indicators. All data were assessed through Syncron LX®20 Beckman Coulter. The inferential analysis results were considered significant when p < 5%. Data analysis was carried out with GraphPad Prism® (4.03 version) software. RESULTS: Data analysis showed a positive correlation between hs-CRP and triglycerides/HDL-C ratio only among women (r = 0.4; p = 0.0442), n = 36. The analysis of other parameters did not show any significance. CONCLUSION: The triglycerides/HDL-C ratio and hs-CRP may be used as indicators of increase in cardiovascular risk among women with coronary artery disease (CAD).