Navegando por Autor "Schmidt, Maria Inês"

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Early-life nutritional status and metabolic syndrome : gender-specific associations from a cross-sectional analysis of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).
(2018) Briskiewicz, Bruna Lucas; Barreto, Sandhi Maria; Amaral, Joana Ferreira do; Diniz, Maria de Fátima Haueisen Sander; Molina, Maria del Carmen Bisi; Matos, Sheila Maria Alvim de; Cardoso, Leticia de Oliveira; Velásquez Meléndez, Jorge Gustavo; Schmidt, Maria Inês; Gonçalves, Luana Giatti
Objective: In the present study we investigated gender-specific associations of low birth weight (LBW) and shorter relative leg length with metabolic syndrome (MetS) after adjusting for sociodemographic characteristics and health-related behaviours. We also investigated whether these associations are independent of age at menarche and BMI at 20 years old. Design: Cross-sectional analysis. Subjects: Baseline data from 12 602 participants (35–74 years) of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), 2008–2010. Setting: MetS was defined according to the revised National Cholesterol Education Program Adult Treatment Panel III guidelines. LBW (<2·5 kg) and age- and sex-standardized relative leg length (high, medium and low) were the explanatory variables studied. The strength of the associations between the explanatory variables and MetS was estimated by Poisson regression with robust variance. Results: MetS prevalence was 34·2 %; it was more prevalent in men (36·8 %) than in women (32·2 %). In multivariate analysis, LBW was associated (prevalence ratio; 95 % CI) with MetS only in women (1·28; 1·24, 1·45). Shorter leg length was associated with MetS in both men (1·21; 1·09, 1·35 and 1·46; 1·29, 1·65 for low and medium lengths, respectively) and women (1·12; 1·00, 1·25 and 1·40; 1·22, 1·59 for low and medium lengths, respectively). Additional adjustments for age at menarche and BMI at 20 years old did not change the associations. Conclusions: Poor nutritional status as estimated by LBW and lower leg length in childhood was associated with a higher prevalence of MetS, although LBW was a significant factor only among women.
Education plays a greater role than age in cognitive test performance among participants of the brazilian longitudinal study of adult health (ELSA - Brasil).
(2015) Passos, Valéria Maria de Azeredo; Gonçalves, Luana Giatti; Benseñor, Isabela Judith Martins; Tiemeier, Henning; Ikram, Mohammed Arfan; Figueiredo, Roberta Carvalho de; Chor, Dóra; Schmidt, Maria Inês; Barreto, Sandhi Maria
Background: Brazil has gone through fast demographic, epidemiologic and nutritional transitions and, despite recent improvements in wealth distribution, continues to present a high level of social and economic inequality. The ELSA–Brasil, a cohort study, aimed at investigating cardiovascular diseases and diabetes, offers a great opportunity to assess cognitive decline in this aging population through time-sequential analyses drawn from the same battery of tests over time. The purpose of this study is to analyze the influence of sex, age and education on cognitive tests performance of the participants at baseline. Methods: Analyses pertain to 14,594 participants with aged 35 to 74 years, who were functionally independent and had no history of stroke or use of neuroleptics, anticonvulsants, cholinesterase inhibitors or antiparkinsonian agents. Mean age was 52.0 ± 9.0 years and 54.2 % of participants were women. Cognitive tests included the word memory tests (retention, recall and recognition), verbal fluency tests (VFT, animals and letter F) and Trail Making Test B. Multivariable linear regression analysis was used to determine the influence of sociodemographic characteristics on the distribution of the final score of each test. Results: Women had significant and slightly higher scores than men in all memory tests and VFT, but took more time to perform Trail B. Reduced performance in all tests was seen with an increase age and, more importantly, with decrease level of education. The word list and VFT scores decreased at about one word for every 10 years of age; whereas higher-educated participants scored four words more on the word list test, and six or seven more correct words on VFT, when compared to lower-educated participants. Additionally, the oldest and less educated participants showed significant lower response rates in all tests. Conclusions: The higher influence of education than age in this Brazilian population reinforce the need for caution in analyzing and diagnosing cognitive impairments based on traditional cognitive tests and the importance of searching for education-free cognitive tests, especially in low and middle-income countries.
Gender differences in cumulative life-course socioeconomic position and social mobility in relation to new onset diabetes in adultsdthe Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).
(2016) Camelo, Lidyane do Valle; Giatti, Luana; Duncan, Bruce Bartholow; Chor, Dóra; Griep, Rosane Härter; Schmidt, Maria Inês; Barreto, Sandhi Maria
Purpose: We investigated gender-specific associations of cumulative socioeconomic position across life course and social mobility with new onset diabetes mellitus (NODM) in over 12,000 civil servants in Brazil. Methods: We used data from ELSA-Brasil baseline (2008e2010). The accumulation of risk was assessed using an education-based score and an occupation-based score. Educational and occupational social mobility were also evaluated. Results: In minimally adjusted models, NODM increased with increasing exposure to life-course social disadvantages, especially in men. This gender difference was pronounced when cumulative processes were evaluated by education-based scores (high vs. low cumulative social disadvantage, odds ratio [OR] ¼ 4.7; 95% confidence interval [CI]: 2.6e8.5 in men and OR ¼ 2.0; 95% CI: 1.1e3.6 in women). After including proximal diabetes risk factors possibly acting as mediators, these associations remained high only in men (high vs. low cumulative social disadvantage, OR ¼ 4.4; 95% CI: 2.4e8.1). Social mobility was associated with NODM in men. Compared to the high-stable trajectory, downward had greater associations than upward mobility. In women, when considering metabolic syndromeerelated variables, changes in social hierarchy did not seem to have an influence on their risk of diabetes. Conclusions: Accumulation of risk and social mobility were associated with NODM with gender-specific patterns, suggesting differences in mechanisms connecting life-course socioeconomic position and diabetes in men and women.
Inconsistency of association between coffee consumption and cognitive function in adults and elderly in a cross - sectional study (ELSA–Brasil).
(2015) Araújo, Larissa Fortunato; Gonçalves, Luana Giatti; Reis, Rodrigo Citton Padilha dos; Goulart, Alessandra Carvalho; Schmidt, Maria Inês; Duncan, Bruce Bartholow; Ikram, Mohammed Arfan; Barreto, Sandhi Maria
Background: Coffee is one of the most consumed beverages worldwide and the effect on cognition appears to be task specific and vary by age. Method: In cohort of 14,563 public service workers (35–74 years old) we assessed coffee consumption habits and examined cognitive function using standardized neuropsychological test battery. By linear regression and generalize linear regression with logarithmic link and gamma distribution we investigated the relation of coffee consumption (never/almost never, ¤1 cup/day, 2–3 cups/day, ¥3 cups/day) in the last 12 months to performance on specific domains of cognition for adults and elderly separately. Results: Among elderly, after adjustments, coffee consumption was associated only with an increase in the mean words remembered on learning, recall, and word recognition tests when comparing the 2–3 cups/day to never/almost never category (arithmetic mean ratio (AMR): 1.03; 95% Confidence Interval (CI): 1.00 to 1.07), and to an increase in the mean words pronounced in semantic verbal fluency test when comparing the ¥3 cups/day to never/almost never category (difference of the mean: 1.23; 95% CI: 0.16 to 2.29). However, coffee consumption was not associated with any cognitive function tests in adults and also was not associated with the phonemic verbal fluency test and trail-making test B in elderly. Conclusions: Results suggest that coffee consumption might be slightly beneficial to memory in elderly but lacks a dose response relationship. Longitudinal analyses are needed to investigate possible, even if subtle, positive effects of coffee drinking on specific cognitive domains in elderly.
A pandemia da COVID-19 no Brasil : a série de projeções do Institute for Health Metrics and Evaluation e a evolução observada, maio a agosto de 2020.
(2021) Stein, Caroline; Cousin, Ewerton; Machado, Ísis Eloah; Mendes, Mariana Santos Felisbino; Passos, Valéria Maria de Azeredo; Sousa, Tatiane Moraes de; Schmidt, Maria Inês; Gallagher, John; Naghavi, Mohsen; Duncan, Bruce Bartholow
Objetivo: Descrever as projeções do Institute for Health Metrics and Evaluation (IHME) para a COVID-19 no Brasil e seus estados, apresentar sua acurácia e discutir suas implicações. Métodos: As previsões do IHME de maio a agosto de 2020, para o Brasil e alguns estados, foram comparadas ao número de mortes cumulativas observadas. Resultados: A projeção prevê 182.809 mortes causadas pela pandemia até 1o de dezembro de 2020 no Brasil. O aumento no uso de máscara poderia poupar ~17 mil óbitos. O erro médio no número acumulado de óbitos em duas, quatro e seis semanas das projeções foi de 13%, 18% e 22% respectivamente. Conclusão: Projeções de curto e médio prazo dispõem dados importantes e acurácia suficiente para informar os gestores de saúde, autoridades eleitas e sociedade geral. Após trajeto difícil até agosto, a pandemia, conforme as projeções, terá declínio sustentado, embora demorado, causando em média 400 óbitos/dia no início de dezembro.
Prevalência de diabetes mellitus determinada pela hemoglobina glicada na população adulta brasileira, Pesquisa Nacional de Saúde.
(2019) Malta, Deborah Carvalho; Duncan, Bruce Bartholow; Schmidt, Maria Inês; Machado, Ísis Eloah; Silva, Alanna Gomes da; Bernal, Regina Tomie Ivata; Pereira, Cimar Azeredo; Damacena, Giseli Nogueira; Stopa, Sheila Rizzato; Rosenfeld, Luiz Gastão Mange; Szwarcwald, Célia Landmann
Objetivo: Analisar as prevalências de diabetes mellitus segundo diferentes critérios diagnósticos, na população adulta brasileira, segundo os resultados laboratoriais da Pesquisa Nacional de Saúde. Métodos: Análise dos dados laboratoriais da Pesquisa Nacional de Saúde, coletados entre os anos de 2014 e 2015. Foram calculadas as prevalências de diabetes conforme diferentes critérios diagnósticos. Foram calculadas as prevalências de diabetes segundo o critério de hemoglobina glicosilada ≥ 6,5% ou em uso de medicamentos, empregando regressão de Poisson para o cálculo da razão de prevalência (RP) bruta e ajustada e intervalo de confiança de 95% (IC95%). Resultados: A prevalência de diabetes segundo diferentes critérios pode variar 6,6 a 9,4%; e a hiperglicemia intermediária, ou pré-diabetes, de 6,8 a 16,9%. Usando-se o critério laboratorial ou uso de medicamentos, a prevalência de diabetes foi de 8,4%. A RP ajustada para sexo, idade, escolaridade e região foi menor no sexo masculino (RP = 0,75; IC95% 0,63 – 0,89); aumentou com a idade: 30 a 34 anos (RP = 2,32; IC95% 1,33 – 4,07), 40 a 59 anos (RP = 8,1; IC95% 4,86 – 13,46), 60 anos ou mais (RP = 12,6; IC95% 7,1 – 21,0); e a escolaridade elevada foi protetora (RP = 0,8; IC95% 0,6 – 0,9). Maior RP foi encontrada na Região Centro-Oeste (RP = 1,3; IC95% 1,04 – 1,7) e naqueles com sobrepeso (RP = 1,8; IC95% 1,4 – 2,1) e obesidade (RP = 3,3; IC95% 2,6 – 4,1). Conclusão: A prevalência de diabetes foi maior no sexo feminino, naqueles com idade maior que 30 anos, em população com baixa escolaridade, com excesso de peso e obesidade. Os critérios laboratoriais são mais fidedignos para o conhecimento da situação real do diabetes no país.
The burden of non-communicable diseases attributable to high BMI in Brazil, 1990– 2017 : findings from the Global Burden of Disease Study.
(2020) Mendes, Mariana Santos Felisbino; Cousin, Ewerton; Malta, Deborah Carvalho; Machado, Ísis Eloah; Ribeiro, Antônio Luiz Pinho; Duncan, Bruce Bartholow; Schmidt, Maria Inês; Silva, Diego Augusto Santos; Glenn, Scott; Afshin, Ashkan; Velásquez Meléndez, Jorge Gustavo
Background: The prevalence and burden of disease resulting from obesity have increased worldwide. In Brazil, more than half of the population is now overweight. However, the impact of this growing risk factor on disease burden remains inexact. Using the 2017 Global Burden of Disease (GBD) results, this study sought to estimate mortality and disability-adjusted life years (DALYs) lost to non-communicable diseases caused by high body mass index (BMI) in both sexes and across age categories. This study also aimed to describe the prevalence of overweight and obesity throughout the states of Brazil. Methods: Age-standardized prevalence of overweight and obesity were estimated between 1990 and 2017. A comparative risk assessment was applied to estimate DALYs and deaths for non-communicable diseases and for all causes linked to high BMI. Results: The prevalence of overweight and obesity increased during the period of analysis. Overall, age- standardized prevalence of obesity in Brazil was higher in females (29.8%) than in males (24.6%) in 2017; however, since 1990, males have presented greater rise in obesity (244.1%) than females (165.7%). Increases in prevalence burden were greatest in states from the North and Northeast regions of Brazil. Overall, burden due to high BMI also increased from 1990 to 2017. In 2017, high BMI was responsible for 12.3% (8.8–16.1%) of all deaths and 8.4% (6.3– 10.7%) of total DALYs lost to non-communicable diseases, up from 7.2% (4.1–10.8%), and 4.6% (2.4-6.0%) in 1990, respectively. Change due to risk exposure is the leading contributor to the growth of BMI burden in Brazil. In 2017, high BMI was responsible for 165,954 deaths and 5,095,125 DALYs. Cardiovascular disease and diabetes have proven to be the most prevalent causes of deaths, along with DALYs caused by high BMI, regardless of sex or state. Conclusions: This study demonstrates increasing age-standardized prevalence of obesity in all Brazilian states. High BMI plays an important role in disease burdens in terms of cardiovascular diseases, diabetes, and all causes of mortality. Assessing levels and trends in exposures to high BMI and the resulting disease burden highlights the current priority for primary prevention and public health action initiatives focused on obesity.
Trends in mortality due to non- communicable diseases in the Brazilian adult population : national and subnational estimates and projections for 2030.
(2020) Malta, Deborah Carvalho; Duncan, Bruce Bartholow; Schmidt, Maria Inês; Teixeira, Renato; Ribeiro, Antônio Luiz Pinho; Mendes, Mariana Santos Felisbino; Machado, Ísis Eloah; Velásquez Meléndez, Jorge Gustavo; Brant, Luisa Campos Caldeira; Silva, Diego Augusto Santos; Passos, Valéria Maria de Azeredo; Nascimento, Bruno Ramos; Cousin, Ewerton; Glenn, Scott; Naghavi, Mohsen
Background: Monitoring and reducing premature mortality due to non-communicable diseases (NCDs) is a global priority of Agenda 2030. This study aimed to describe the mortality trends and disability-adjusted life years (DALYs) lost due to NCDs between 1990 and 2017 for Brazil and to project those for 2030 as well as the risk factors (RFs) attributed deaths according to estimates of the Global Burden of Disease Study. Methods: We analyzed cardiovascular diseases, chronic respiratory diseases, neoplasms, and diabetes, and compared the mortality rates in 1990 and 2017 for all of Brazil and states. The study used the definition of premature mortality (30–69 years) that is used by the World Health Organization. The number of deaths, mortality rates, DALYs, and years of life lost (YLL) were used to compare 1990 and 2017. We analyzed the YLL for NCDs attributable to RFs. Results: There was a reduction of 35.3% from 509.1 deaths/100,000 inhabitants (1990) to 329.6 deaths/100,000 inhabitants due to NCDs in 2017. The DALY rate decreased by 33.6%, and the YLL rate decreased by 36.0%. There were reductions in NCDs rates in all 27 states. The main RFs related to premature deaths by NCDs in 2017 among women were high body mass index (BMI), dietary risks, high systolic blood pressure, and among men, dietary risks, high systolic blood pressure, tobacco, and high BMI. Trends in mortality rates due to NCDs declined during the study period; however, after 2015, the curve reversed, and rates fluctuated and tended to increase. Conclusion: Our findings highlighted a decline in premature mortality rates from NCDs nationwide and in all states. There was a greater reduction in deaths from cardiovascular diseases, followed by respiratory diseases, and we observed a minor reduction for those from diabetes and neoplasms. The observed fluctuations in mortality rates over the last 3 years indicate that if no further action is taken, we may not achieve the NCD Sustainable Development Goals. These findings draw attention to the consequences of austerity measures in a socially unequal setting with great regional disparities in which the majority of the population is dependent on state social policies.