Navegando por Palavras-chave "Índice De Massa Corporal"

Agora exibindo 1 - 2 de 2
  • Nenhuma Miniatura disponível
    Item
    Somente Metadadados
    Duração do aleitamento materno e seu impacto sobre a variação da massa corporal materna durante o primeiro ano de vida de crianças pertencentes a uma coorte de nascimentos
    (Universidade Federal de São Paulo (UNIFESP), 2021) Marinho, Patricia De Menezes [UNIFESP]; Taddei, Jose Augusto De Aguiar Carrazedo [UNIFESP]; Universidade Federal de São Paulo
    Introduction: Despite the efforts and actions to promote breastfeeding (BF), in Brazil, the estimates on its duration (exclusive and total) remains below the recommended by the World Health Organization, with gaps regarding regional, economic, social, cultural and behavioral determinants of early interruption. Furthermore, although the benefits of breastfeeding in women’s health are widely recognized, its role in post-pregnancy weight control and/or loss is not consensual in the literature, indicating the need for more studies to better understand this complex interaction. Objectives: this dissertation, consisting of two scientific papers aimed to analyze the BF duration and determinants and its impact on the variation of maternal body mass during the first year of life of children belonging to a cohort of live births in Rio Largo, Alagoas. Methods: we used data from the birth cohort “Child Health, Feeding, Nutrition and Development – HFND: a cohort study”, carried out in Rio Largo, AL., composed of children born between February and August 2017 in the only maternity in the city. Socio-demographic, economic, anthropometric and food consumption information, from mother and child, were collected at birth (up to 24 hours post-childbirth), at 3, 6 and 12 months of the child. The considered dependent variables were: (paper 1) duration of EBF and BF, analyzed by Kaplan-Meier survival curves and the risk factors for early weaning through Cox proportional hazards model and; (paper 2) maternal body mass index variation twelve months post-childbirth, the effect of BF duration (≤60/>60days) on this variation was analyzed by linear mixed-effect models. Results: the low duration of EBF and BF was evidenced, with an average of 30 (15-60) and 330 (91-365) days, respectively. The low maternal schooling (HR:1.40 [95%IC:1.04-1.87]) and cesarean section births (HR:1.41 [95%IC:1.04-1.90]) were the risk factors for early EBF weaning, while the use of pacifier (HR:2.37 [95%IC:1.62-3.48]) and child consumption, before the third month, of meals with added salt and sugar (HR:1.63 [95%IC:1.12-2.38]) composed the factors for early BF interruption. Furthermore, in the second study, the results indicate that, in the baseline, the difference between BMI measures, according to BF duration, was 1.37 kg/m² (p=0.146). Breastfeeding for a longer time had a more pronounced effect on lowering BMI at three months. Throughout the analyzed period, the BMI of women who breastfed for more than 60 days went from 26.54 kg/m² (95%IC: 25.78-27.29) to 24.49 kg/m² (95%IC: 23.73-25.25). Conclusions: BF duration was below the international recommendations, identifying risk factor sensible to change with intervention strategies in the different health attention levels. Additionally, it was observed that BF for longer was significantly associated with reduction in maternal BMI twelve months after childbirth, which reinforces the importance of this practice for mother-child health, specially in contexts of high social vulnerability.
  • Nenhuma Miniatura disponível
    Item
    Somente Metadadados
    Interação do ácido úrico e da massa corporal como moderadores da pressão arterial em crianças e adolescentes após transplante renal
    (Universidade Federal de São Paulo (UNIFESP), 2021) Seibert, Helena [UNIFESP]; Nogueira, Paulo Cesar Koch [UNIFESP]; Universidade Federal de São Paulo
    The association between elevated serum uric acid concentration and hypertension in adults in children and adolescents is controversial in the literature. Hyperuricemia has already been identified as a risk factor for chronic kidney disease (CKD). It is often found in these patients and is considered an important cardiovascular risk factor. Currently there is a discussion if hyperuricemia acts as a marker or as an independent risk factor for CKD. In a previous study, we evaluated post-pubertal, obese and eutrophic adolescents without chronic kidney disease and the results showed that a high serum uric acid concentration was associated with higher values of systolic blood pressure in obese children. These data led us to formulate the hypothesis that uric acid concentration may modulate the effect of increased body mass on blood pressure in pediatric patients. However, our previous study was cross-sectional and therefore did not allow us to correctly assess this hypothesis. Kidney transplantation seemed an interesting condition to test our hypothesis due to the frequency of rapid gain in body mass that characterizes the first months of follow-up of children undergoing this treatment. Objectives: To test whether the serum concentration of uric acid increases the hypertensive effect of body mass gain in pediatric kidney transplant recipients, as well as to verify the impact of post-transplant changes in uric acid levels on the estimated glomerular filtration rate. Patients and methods: An observational and longitudinal study of children and adolescents who received kidney transplants was performed, with analysis of clinical, anthropometric and laboratory data at the following times: pre-transplant and 1, 3, and 6 months after kidney transplantation. The sample consisted of children and adolescents treated and transplanted at Hospital do Rim, from March 2017 to May 2019. During the study period data was collected on the following parameters: weight, height, blood pressure, drug prescriptions, serum uric acid and creatinine levels. We developed repeated measures models to test the study hypotheses, using the “generalized estimating equations” (GEE) method for the outcomes of hypertension and the evolution of eGFR. Results: 103 transplant patients were included and regarding the occurrence of hypertension, the significant associations at the end of the analysis were kidney and urinary tract malformation as the etiology of chronic kidney disese (Odds Ratio: 0.45, 95% CI: 0.24-0.84, p = 0.01) and age (Odds Ratio: 0.84, 95% CI: 0.77 - 0.92 p = 0.00). In the analysis of the glomerular filtration rate, we observed an inverse relationship with uric acid (β= -11.14, IC95%: -1.79- -5.50), p<0.01). Conclusion: Although we observed a high prevalence of hypertension, elevated weigh gain and high uric acid, we found no association between the three variables. Nevertheless, the metabolic situation of children after kidney transplantation deserves attention, as the period is characterized by significant gain in body mass, high frequency of hyperuricemia and hypertension.