EMED - Escola de Medicina
URI permanente desta comunidadehttp://www.hml.repositorio.ufop.br/handle/123456789/3649
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Item 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 GustavoBackground: 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.Item Diagnostic accuracy of the Berlin questionnaire and the NoSAS score in detecting risk for obstructive sleep apnea in rotating shift workers.(2021) Menezes Júnior, Luiz Antônio Alves de; Fajardo, Virgínia Capistrano; Nascimento Neto, Raimundo Marques do; Freitas, Silvia Nascimento de; Oliveira, Fernando Luiz Pereira de; Pimenta, Fausto Aloísio Pedrosa; Coelho, George Luiz Lins Machado; Meireles, Adriana LúciaBackground Data on the validity of tools for sleep apnea risk detection in rotating shift workers are limited. The aim was to evaluate the Berlin questionnaire (BQ) and the Neck, Obesity, Snoring, Age, Sex (NoSAS) score for the detection of obstructive sleep apnea risk in shift workers. Methods This cross-sectional study included male rotating shift workers, drivers of heavy of-road machinery in an iron ore extraction company. Polysomnography was the gold standard for evaluation. Obstructive sleep apnea (OSA) was defned as an apnea–hypopnea index (AHI) of≥5 events/h. The Shapiro–Wilk test verifed the data distribution and comparative analysis was conducted using the chi-square analyses and U Mann–Whitney with Bonferroni correction. Receiver operating characteristic curve analysis, sensitivity, specifcity, positive and negative predictive values, positive and negative likelihood ratios, and accuracy were used for evaluate BQ and NoSAS with OSA diagnosis by polysomnograph. Results Among 119 male shift workers, ages 24 to 57 years, polysomnography showed that 84% had obstructive sleep apnea (AHI≥5), and 46% had moderate to severe sleep apnea (AHI≥15). For AHI≥5, the NoSAS score had higher sensitivity and specifcity than the BQ. For AHI≥15 and AHI≥30, the NoSAS score had a sensitivity higher than 70% while BQ was 60% and 58%, respectively. The accuracy of the NoSAS score was higher for all OSA criteria than that of BQ. Conclusion In rotating shift workers, drivers of heavy of-road machinery, the NoSAS score showed higher accuracy in identifying patients at risk for sleep apnea than the BQ.Item Rotating shift workers with vitamin D defciency have a higher risk of obstructive sleep apnea.(2022) Menezes Júnior, Luiz Antônio Alves de; Fajardo, Virgínia Capistrano; Freitas, Silvia Nascimento de; Coelho, George Luiz Lins Machado; Oliveira, Fernando Luiz Pereira de; Nascimento Neto, Raimundo Marques do; Meireles, Adriana LúciaObjectives The study aimed to evaluate the association between obstructive sleep apnea (OSA) and vitamin D defciency (VDD) in shift workers. Methods This cross-sectional study included male rotating shift workers in an iron ore extraction company. Participants were classified as VDD when 25(OH)D < 20 ng/mL for a healthy population and 25(OH)D < 30 ng/ mL for groups at risk for VDD. Risk of developing OSA was classified by Berlin questionnaire (BQ) and NoSAS score. Data were compared using chi-square analysis with Cramer’s V as effect size, and Bonferroni correction. Multivariate logistic regression analysis was performed to investigate whether or not VDD was associated with OSA risk assessment. Results Among 1423 male workers, mostly younger, aged 30 to 39 years (53%), worked shifts for more than 5 years (76%). The prevalence of high risk of OSA by BQ was 16%, and 33% by NoSAS score. Additionally, 29% had VDD. In multivariate analysis, controlled for confounding factors, workers with VDD had a 52% increased chance of OSA by BQ (OR 1.52; CI95% 1.06–2.18) and a 64% increased chance of OSA by NoSAS score (OR 1.64; CI95% 1.09–2.48). After subgroup analyses, similar results were not observed in workers aged 20–29 and 30–39 years. Conclusion Rotating shift workers with vitamin D defciency are more likely to have obstructive sleep apnea, assessed by the Berlin questionnaire and NoSAS score.Item Hypertension is associated with a variant in the RARRES2 gene in populations of Ouro Preto, Minas Gerais, Brazil : a cross-sectional study.(2021) Batista, Aline Priscila; Barbosa, Keila Furbino; Azevedo, Rafael Júnior de; Vianna, Valeska Natiely; Queiroz, Erica Maria de; Marinho, Carolina Coimbra; Coelho, George Luiz Lins MachadoBackground: Arterial hypertension (AH) is implicated in vascular health and contributes significantly to cardiovascular morbidity and mortality. In addition to the contribution of usual risk factors for AH, elucidating the influence of genetic factors is a promising area of investigation. Therefore, we evaluated the association between AH and cardiovascular risk factors (CVRFs) and genetic polymorphisms in communities in Southeast Brazil. Methods: A total of 515 adults aged 18-91 years, who were cross-sectionally assessed between 2015-2016, were included. Demographic, clinical, behavioral, anthropometric characteristics, and laboratory parameters and 12 single nucleotide polymorphisms in seven candidate genes involved in cardiovascular risk (RARRES2, AGT, NOS3, GNB3, APOE, APOB, APOC3, LDLR, and PPARG) were evaluated, with AH as the outcome. Sex, age, and laboratory parameters were considered the main confounding factors. Results: There was a significant association between age >60 years (odds ratio [OR] =6.74), alcohol dependence (OR=3.84), smoking (OR=1.74), overweight (OR=1.74), high plasma triglyceride (TG) levels (OR=1.98) and low high-density lipoprotein (HDL-c) (OR=6.22), diabetes (OR=3.68), and insulin resistance (OR=2.40) and AH. A significant association was observed between rs4721 in RARRES2 and AH. The T allele in homozygosis was a potent chance modifier for AH. The highest chance gradients for AH were characterized by the presence of the TT genotype and DMT2 (OR=9.70), high TG (OR=6.26), low HDL-c (OR=8.20), and age more than 60 years (OR=9.96). Conclusion: The interaction of the T allele of the rs4721 polymorphism in RARRES2 with CVRFs may predispose carriers to a higher cardiovascular risk.Item Body fat indicators for cardiometabolic risk screening among shift workers.(2020) Diniz, Amanda Popolino; Alves, Márcia Elivane; Fajardo, Virgínia Capistrano; Freitas, Silvia Nascimento de; Batista, Guilherme Augusto Sousa; Athadeu, Bruno Francia Maia; Coelho, George Luiz Lins Machado; Oliveira, Fernando Luiz Pereira de; Pimenta, Fausto Aloísio Pedrosa; Nascimento Neto, Raimundo Marques doBackground: In view of the costly methods currently available for the assessment of body adiposity, anthropometric obesity indicators have proven effective in predicting cardiovascular risk. Objective: To investigate the discriminatory power of body fat indicators for cardiovascular risk screening among shift workers. Methods: Cross-sectional study with male employees of an iron ore extraction company. The predictive power of body fat indicators relative to cardiovascular risk was analyzed based on the Framingham risk score and metabolic syndrome by means of receiver operating characteristic curves, sensitivity, specificity, positive and negative predictive values, area under the receiver operating characteristic curve and Youden’s index. Results: The prevalence of cardiovascular risk was 14.2% in the metabolic syndrome risk model. According to the Framingham score, 95.0%, 4.1% and 0.9% of the participants exhibited low, moderate and high risk, respectively. All the analyzed body fat indicators exhibited satisfactory discriminatory power for the tested cardiovascular risk models. Conclusion: Waist-height ratio exhibited the highest ability to predict cardiometabolic risk in both risk models.Item Adiposity indicators as a screening method for polysomnography in shift workers.(2019) Diniz, Amanda Popolino; Fajardo, Virgínia Capistrano; Freitas, Silvia Nascimento de; Oliveira, Fernando Luiz Pereira de; Nascimento Neto, Raimundo Marques do; Pimenta, Fausto Aloísio Pedrosa; Coelho, George Luiz Lins MachadoObjective: to verify the discriminatory power of adiposity indicators in the prediction of obstructive sleep apnoea (OSA) in shift workers. Methods: a crosssectional study carried out in an iron ore extraction company, in Minas Gerais, Brazil. Anthropometric data were collected and polysomnography (PSG) was performed in 118 male shift workers who owned at least one overall risk factor for cardiovascular disease. Results: the OSA prevalence in the sample was 84.7%. Among the adiposity indicators used to predict OSA (≥ 5 events/hour), body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), and total body fat (TBF) showed sensitivity values higher than 70%. Visceral fat (VF), neck circumference (NC), and neck-to-height ratio (NHtR) were the most effective in correctly identifying workers without OSA (specificity values higher than 70%). The areas under the receiver operating characteristic (ROC) curves for WC and NHtR were greater than 0.7, which indicated the test was effective in discriminating individuals with OSA. Conclusions: alterations in abdomen and neck adiposity indicators have a significant relationship with the presence of OSA and showed effectiveness as a screening method for PSG. WC and NHtR are considered good indicators for OSA prediction.Item A comparative study of methods for diagnosis of obesity in an urban mixed-race population in Minas Gerais, Brazil.(2007) Freitas, Silvia Nascimento de; Caiaffa, Waleska Teixeira; César, Cibele Comini; Cândido, Ana Paula Carlos; Faria, Valéria Andrade; Nascimento Neto, Raimundo Marques do; Coelho, George Luiz Lins MachadoObesity is defined as an excess of total body fat and may be assessed by different methods. The objective of the present study was to establish the discriminatory power of anthropometric data in determining obesity.Item Anthropometric measurements and obesity diagnosis in schoolchildren.(2011) Cândido, Ana Paula Carlos; Freitas, Silvia Nascimento de; Coelho, George Luiz Lins MachadoTo evaluate whether anthropometric methods such as arm muscle area, armfat area, Rohrer index, conicity index, and waist-to-height ratio and the commonly usedbody mass index method are suitable for obesity screening in a multiethnic paediatric pop-ulation.Item Ability of body mass index to predict abnormal waist circumference : receiving operating characteristics analysis.(2013) Lauria, Márcio Weissheimer; Moreira, Lívia Maria Pinheiro; Coelho, George Luiz Lins Machado; Nascimento Neto, Raimundo Marques do; Soares, Maria Marta Sarquis; Ramos, Adauto VersianiBody mass index (BMI) and waist circumference (WC) are the most used anthropometric measures to identify obesity. While BMI is considered to be a simple and accurate estimate of general adiposity, WC is an alternative surrogate measure of visceral obesity. However, WC is subject to significant inter-examiner variation. The aim of the present study was to correlate BMI and WC measures in a group of Brazilian adults to determine the most accurate BMI values for predicting abnormal WC.Item Study of the clinical and histopathological repercussions of the “omental band” in dogs’ stomach.(2015) Siqueira, Sávio Lana; Silva, Adriana Torres da; Bráulio, Cléber Stockler Ribeiro; Jalles, Marina Paranhos; Mendes, Guilherme Matos Serretti; Carmo, Pedro Sérgio Cascimiro Nicolau do; Camargos, Maria Luiza LopesPURPOSE: To evaluate the efficacy of the “omental band” as a bariatric surgical technique. METHODS: A sample of 35 dogs was studied. The Test Group was composed by 20 dogs. Of these, six were observed by 10 days, six were observed by 20 days and eight were observed by 30 days of post-operatory. The Control Group was composed by 15 dogs. Of these, five were observed by 10 days, five were observed by 20 days and five were observed by 30 days of post-operatory. The weight loose was the variable utilized to the evaluation of the efficacy of the surgical technique described in this study, once all of the dogs were weighted in precision balance before the surgical act and at the end of the post-operatory observation period. RESULTS: At the end of the study it was observed that the weight loose of the dogs submitted to the “omental band’s” surgical technique was meaningfully higher in comparison with the dogs of the Control Group at the end of the post-operatory observation period. CONCLUSION: The surgical technique of the “omental band” showed effective in dogs, once has proposed a meaningfully weight loose.