Navegando por Palavras-chave "Dislipidemias"

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    Adherence to statin treatment and associated factors in female users from the Unified Health System (SUS)
    (Universidade de São Paulo, Escola de Enfermagem, 2014-06-01) Bonfim, Mariana Rotta; Hansen, Arina; Turi, Bruna Camilo; Zanini, Gabriel De Souza; Oliveira, Acary Souza Bulle [UNIFESP]; Amaral, Sandra Lia do; Monteiro, Henrique Luiz; Universidade Estadual Paulista (UNESP); Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP); Universidade Estadual de Campinas (UNICAMP)
    Objective: To identify the adherence rate of a statin treatment and possible related factors in female users from the Unified Health System. Method: Seventy-one women were evaluated (64.2 ± 11.0 years) regarding the socio-economic level, comorbidities, current medications, level of physical activity, self-report of muscular pain, adherence to the medical prescription, body composition and biochemical profile. The data were analyzed as frequencies, Chi-Squared test, and Mann Whitney test (p<0.05). Results: 15.5% of women did not adhere to the medical prescription for the statin treatment, whose had less comorbidities (p=0.01), consumed less quantities of medications (p=0.00), and tended to be younger (p=0.06). Those patients also presented higher values of lipid profile (CT: p=0.01; LDL-c: p=0.02). Musculoskeletal complains were not associated to the adherence rate to the medication. Conclusion: The associated factors to adherence of dyslipidemic women to statin medical prescription were age, quantity of comorbidities and quantity of current medication.

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    Alterações no perfil lipídico durante o primeiro ano após o transplante renal: Fatores de risco e a influência do regime imunossupressor
    (Universidade Federal de São Paulo (UNIFESP), 2010-07-28) Spinelli, Glaucio Amaral [UNIFESP]; Pestana, Jose Osmar Medina [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Aim: Dyslipidemia is a recognized risk factor associated with cardiovascular events after kidney transplantation, Cyclosporine (CSA), tacrolimus (TAC), mycophenolate (MMF), sirolimus (SRL), everolimus (EVR) and prednisone have differential effects on the development of dyslipidemia, This study analyzed the incidence, time-course, severity and risk factors associated with dyslipidemia during the first year after kidney transplantation, Methods: In a cohort of 474 kidney transplant recipients [CSA/SRL (n=137), CSA/MMF (n=58), CSA/EVR (n=47), SRL/MMF (n=32), TAC/SRL (n=86), TAC/MMF (n=114)] we evaluated the influence of demographics, clinical ouCOLomes and statin use on lipid profile changes [total cholesterol (TC), triglycerides (TG), HDL-C, LDL-C, non-HDL-C, COL/HDL-C, LDL-C/HDL-C, TG/HDL-C] during the first year after transplantation, Results: Lipid profile was within recommended ranges in 28% of patients pretransplant and in 10% at one year, with 27% of them receiving statins, LDL-C could not be measured due to high TG concentrations in 20% of patients, At one year, LDL-C < 100 mg/dl was observed in 31,8% of patients, Within this group around 35% of patients still showed lipid fractions or ratios outside recommended target concentrations, Age, gender, time on dialysis, new onset diabetes mellitus, use of CSA or SRL/EVR and dose of prednisone were independent risk factors associated with dyslipidemia at one year, Conclusion: One year after transplant dyslipidemia is almost universal, Modifiable risk factors include the type and dose of immunosuppressive drugs, he variable changes in all lipid fractions and ratios may limit proper therapeutic interventions.
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    Avaliação da adequação do perfil lipídico em pacientes hipertensos
    (Universidade Federal de São Paulo (UNIFESP), 2011-02-22) Ribeiro, Hércules Ferreira [UNIFESP]; Batista, Marcelo Costa [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    A hipertensão arterial e a dislipidemia são fatores de risco cardiovascular potencialmente modificáveis, cuja presença concomitante aumenta o risco de novos eventos. Foi estudada uma população de portadores de hipertensão arterial sob acompanhamento ambulatorial em relação à adequação do perfil lipídico, de acordo com as recomendações do NCEP-ATP III. Fatores associados à adequação do LDL-C foram determinados, tanto na população total quanto no grupo de diabéticos. Dos 1202 pacientes estudados, os 886 (73,8% sexo feminino, idade 59,9±11,1 anos, 59% brancos) que apresentavam perfil lipídico completo e dados para estratificação de risco cardiovascular foram incluídos na análise. Da população estudada, 544 (61,4%) tinham LDL-C dentro do alvo recomendado, 663 (74,8%) apresentavam diagnóstico de dislipidemia e 285 (32,2%) estavam em uso de hipolipemiantes. Os indivíduos com LDL-C inadequado apresentavam maior idade (61,3±10,3 vs 58,9±11,6 anos; p<0,001), maior pressão arterial (PA) sistólica (140,7±22,0 vs 137,7±21,1 mmHg; p=0,04), maior prevalência de diabetes (56,1% vs 28,7%; p<0,001), bem como de doença cardiovascular (DCV) (27,8% vs 7,7%; p<0,001). Estes pacientes utilizavam mais frequentemente três ou mais antihipertensivos (42,7% vs 32,7%; p=0,003) e menos comumente apresentavam a PA dentro do alvo terapêutico (27,2% vs 35,8%; p=0,007). Observou-se uma associação positiva entre o risco cardiovascular e o percentual de inadequação do LDL-C. Pacientes com LDL-C inadequado apresentavam maior prevalência de síndrome metabólica (54,1% vs 41%; p<0,001) e o aumento do número de componentes da síndrome se associou a um pior controle do LDL-C. Em um modelo de regressão logística binária incluindo a inadequação do LDL-C como variável dependente, a idade, diabetes e doença cardiovascular se associaram de maneira independente com a inadequação do LDL-C. Adicionalmente, mesmo após a correção para variáveis demográficas e clínicas, a inadequação do LDL-C se associou de maneira independente com a doença cardiovascular tanto na população total quanto nos diabéticos. O controle da dislipidemia em hipertensos permanece inadequado, está relacionado ao mau controle da hipertensão e os resultados são ainda mais proeminentes em indivíduos com DCV.
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    Avaliação da relação entre o polimorfismo C677T no gene para MTHFR e a concentração plasmática de homocisteína na doença arterial coronariana
    (Sociedade Brasileira de Endocrinologia e Metabologia, 2006-12-01) Muniz, Maria Tereza C.; Siqueira, Erika R.f.; Fonseca, Rosana A.; D'Almeida, Vânia [UNIFESP]; Hotta, Júlia K.; Santos, José E. dos; Cavalcanti, Maria do Socorro de Mendonça; Sampaio, Cláudio A.m.; Universidade Federal de São Paulo (UNIFESP); Universidade de Pernambuco ICB Departamento de Ciências Fisiológicas; Universidade de São Paulo (USP)
    OBJECTIVE: The aim of this study is to determine the prevalence of C677T methylenetetrahydrofolate reductase (MTHFR) polymorphism and correlate it with plasma homocysteine levels in coronary artery disease (CAD). METHODS: Ninety-three patients with documented CAD from Hospital Universitário Oswaldo Cruz (Recife, PE, Brazil) and 108 healthy controls were evaluated. Homocysteine and folate levels were determined by HPLC and chemoluminescence, respectively, and lipid profile was considered. Genotyping was done by RFLP/PCR. RESULTS: The groups were homogeneous for the C677T polymorphisms. The homocysteine level in cases (11.7 µmol/L) was statistically different from that observed in controls (8.84 µmol/L, p< 0.05). It was also observed that 72% of the patients had homocysteine values above12 µmol/L while the control group presented only 32% in this range. There was no relationship between homozigosity for the C677T polymorphism and the homocysteine level (p= 0.634). We noticed statistical differences between folate levels from patients and controls (6.22 and 7.69 ng/dL, p< 0.05, respectively). However, there was no correlation between homocysteine and folate concentrations in the entire group (r= -0.202). Comparing cases and controls, the odds ratio (OR) when homocysteine is high and folate is low was OR= 11.9; CI 95%= 4.16-34.42, p< 0.01. CONCLUSION: A lack of correlation between C677T mutation and homocysteine level suggests that environmental factors and others genetic factors seem to exert more influence on homocysteine level in this population.
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    Avaliação do perfil lipídico, fatores de risco cardíaco e síndrome metabólica de pessoas vivendo com HIV/AIDS
    (Universidade Federal de São Paulo (UNIFESP), 2007) Silva, Érika Ferrari Rafael da [UNIFESP]; Lewi, David Salomao [UNIFESP]
    Objetivo: Avaliar o perfil lipidico, fatores de risco para doenca cardiovascular atraves da Escala de risco de Framingham, medidas antropometricas e sindrome metabolica de pessoas vivendo com HIV/Aids em uso ou nao de anti-retrovirais em acompanhamento nas unidades ambulatoriais da Universidade Federal da São Paulo e da Secretaria Municipal de Saúde São Paulo. Metodos: Durante 18 meses foram selecionados 319 pacientes em acompanhamento ambulatorial em uso ou nao de terapia anti-retroviral. Resultados: No grupo que utiliza anti-retrovirais foram incluidos 243 pacientes e 76 no grupo virgem de tratamento. A media de idade e de 39,7 anos e 60,9 por cento dos pacientes sao do sexo masculino. Os principais fatores de risco encontrados nesta populacao sao: 26,8 por cento de tabagismo, 19,2 por cento de hipertensao arterial, 4,0 por cento de diabetes mellitus, 40,2 por cento de historia familiar de aterosclerose e 17,7 por cento de sedentarismo. Em relacao ao perfil lipidico, as medias de colesterol total (205 x 108 mg/dL), HDL-c (51 x 43 mg/dL) e triglicerides (219 x 164 mg/dL) foram maiores no grupo que utiliza anti-retrovirais. A sindrome metabolica esteve presente em 14,4 por cento dos pacientes que utilizam anti¬retrovirais. A maior parte dos pacientes apresentava-se eutrofico de acordo com o indice de massa corporea. Conclusoes: Observamos que a media dos niveis de colesterol total, HDL-c, VLDL e triglicerides foi significativamente maior no grupo que faz uso de anti-retrovirais. Nao foi encontrada diferenca significante entre grupos mesmo com as alteracoes metabolicas proporcionadas pelo uso de anti-retrovirais quanto ao aumento no risco de desenvolvimento de DCV. A analise das medidas antropometricas evidenciou uma populacao eutrofica, com uma baixa frequencia de desnutridos e tendo a obesidade o principal disturbio observado. A analise do consumo alimentar nao mostrou diferencas significantes entre os grupos. O uso de anti-retrovirais nao aumentou a presenca da sindrome metabolica, pois a presenca desta foi semelhante entre os grupos. Todos os esquemas ARV proporcionaram alteracoes nos niveis de lipides quando comparados aos pacientes sem uso de TARV, porem as alteracoes nos niveis de lipides nao foram estatisticamente diferentes entre os diversos grupos de T ARV avaliados, nao sendo possivel descrever qual o pior ou melhor esquema em relacao ao perfil lipidico
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    Avaliação do perfil lipídico, sdLDL e da apolipoproteína A-I: relação com enzimas associadas ao rico cardiovascular em pacientes com hipogamaglobulinemia
    (Universidade Federal de São Paulo (UNIFESP), 2013) Vieira, Daniele Gonçalves [UNIFESP]; Sarni, Roseli Oselka Saccardo [UNIFESP]; Carvalho, Beatriz Tavares Costa [UNIFESP]; Silva, Rosangela da [UNIFESP]; http://lattes.cnpq.br/1072990929102111; http://lattes.cnpq.br/3066513306945328; http://lattes.cnpq.br/1760819469047929; http://lattes.cnpq.br/2508710984493194; Universidade Federal de São Paulo (UNIFESP)
    Introdução: A ImunodefiCiência Comum Variavel (ICV) e a Agamaglobulinemia Ligada ao X (XLA) sao imunodefiCiências primarias (IDP´s) classificadas como defiCiências de anticorpos resultando em hipogamaglobulinemia. Em semelhanca com outras doencas cronicas, as IDPÆs podem cursar com disturbios inflamatorios, endocrinos e com a exacerbacao do estresse oxidativo. Com a melhoria nos protocolos de atendimento clinico houve impacto positivo na sobrevida destes pacientes, surgindo assim preocupacao com o risco para o desenvolvimento de outras doencas cronicas, como as cardiovasculares. Objetivos: Avaliar o perfil lipidico e a concentracao serica da apolipoproteina A-I (apo A-I) e da particula pequena e densa do LDL-c (sdLDL), e relaciona-las com biomarcadores associados ao risco de doenca cardiovascular dos pacientes com ICV e XLA. Casuistica e Metodos: Foram avaliados, por meio de estudo transversal e controlado, 24 pacientes atendidos no Departamento de Pediatria da UNIFESP e 12 controles saudaveis pareados por idade e sexo com os pacientes. Foram realizadas a avaliacao antropometrica e dosagens sericas de colesterol total (CT) e as fracoes HDL-c e LDL-c, com analise da apo A-I e quantificacao de sdLDL, triglicerideos (TG), proteina C reativa (CRP), fator de necrose tumoral alfa (TNF-alfa) e as enzimas relacionadas ao risco cardiovascular mieloperoxidase (MPO), proteina de transferencia de ester de colesterol (CETP) e a lecitina colesterol aciltransferase (LCAT). Resultados: As concentracoes da CRP (p=0,008) e TNF-alfa (p<0,001) foram significativamente mais elevadas, enquanto o HDL-c (p=0,025) e a apo A-1 (p=0,013) foram significantemente mais baixas nos pacientes comparativamente aos controles. No grupo de pacientes foi observada correlacao negativa e significante entre o HDL-c e o TNF-alfa (r=-0,406; p=0,049) e os TG (r=-0,641; p=0,001). Verificou-se diferenca estatisticamente significante para a idade (p= 0,024), indice de massa corporal (p=<0,001), circunferencia abdominal (p=0,001), TG (p=0,020), MPO (p=0,036) e TNF-alfa (p=0,045) quando se comparou entre os pacientes a presenca ou nao de dislipidemia para HDL-c. Conclusao: Os pacientes com IDPÆs demonstraram risco cardiovascular elevado caracterizado pela elevacao de marcadores inflamatorios em associacao com enzimas que participam da oxidacao de lipoproteinas. A identificacao precoce dessas alteracoes permite o estabelecimento de medidas de prevencao e tratamento visando a reducao do risco cardiovascular nesses pacientes
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    Comparação De Diferentes Protocolos Na Estratificação Do Risco Cardiovascular E Indicação Do Uso De Estatina Em Pacientes Portadores De Hipertensão Arterial
    (Universidade Federal de São Paulo (UNIFESP), 2018-05-25) Oliveira, Vinicius De [UNIFESP]; Batista, Marcelo Costa [UNIFESP]
    Objective: To Evaluate The Difference In Indication Of The Use Of Statin In Patients Submitted To Different Protocols Of Stratification Of Cardiovascular Risk For The Treatment Of Dyslipidemia. Methods: A Total Of 641 Patient Charts Were Reviewed Regularly In The Osvaldo Ramos Foundation Hypertension Outpatient Clinic, Who Were Without The Use Of Statin. These Patients Were Submitted To The Application Of Different Guidelines To Classify The Cardiovascular Risk. The Framingham And Pooled Cohort Equation Scores Were Used. After These Patients Were Submitted To Different Protocols For Calculating Cardiovascular Risk, The Criteria Were Applied According To Each National Cholesterol Education Program's Adult Treatment Panel Iii And American College Of Cardiology/American Heart Association 2013 Protocol For The Start Of The Use Of Statins. Results: Of The 641 Patients Analyzed (56.9 ± 9.7 Years, 66.1% Female, 30.7% Diabetic, 31% Black, 11.2% Smoker, 44.1% With Metabolic Syndrome, 10 (33%) Were Identified As Having
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    Concentrações de vitaminas C e E em pacientes com ataxia telangiectasia: relação com biomarcadores associados a aterosclerose e ao estresse oxidativo.
    (Universidade Federal de São Paulo (UNIFESP), 2013) Andrade, Itana Gomes Alves [UNIFESP]; Sarni, Roseli Oselka Saccardo [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Introdução: A ataxia telangiectasia (AT) e uma doenca neurodegenerativa, que cursa com imunodefiCiência em graus variaveis, disfuncao mitocondrial e exacerbacao do estresse oxidativo. Objetivo: avaliar o estado nutricional, perfil lipidico, peroxidacao lipidica e as concentracoes plasmaticas de vitaminas C e E e relaciona-las com biomarcadores associados ao risco de aterosclerose de pacientes com AT e controles. Metodos: Estudo transversal controlado envolvendo 13 pacientes e 22 controles saudaveis, pareados por genero e idade. Foram avaliados: estado nutricional, consumo alimentar, perfil lipidico e suas relacoes, concentracoes plasmaticas de vitaminas C e E, malondialdeido (MDA) e proteina C reativa ultrassensivel (PCRus). Resultados: A media de idade do grupo AT foi 14,6 anos; 4/13 (30,8%) eram desnutridos e 3/13 (23,1%) apresentavam baixa estatura para idade. Os pacientes apresentaram maior comprometimento de massa magra comparativamente aos controles. As concentracoes de triglicerides, colesterol total e de LDL-c foram significantemente mais elevadas nos pacientes e as de HDL-c, mais baixas. As relacoes associadas ao risco de aterosclerose (CT/HDL-c, LDL-c/HDL-c e Log TG/HDL-c) e o colesterol nao HDL (NHDL-c) foram significantemente superiores no grupo de pacientes em comparacao aos controles. Nao houve diferenca para as concentracoes de malondialdeido, proteina C reativa e de vitaminas C e E entre os dois grupos. As relacoes vitamina E/lipideos totais e vitamina E/triglicerides mostraram valores mais baixos no grupo de pacientes; correlacao significante e inversa entre estas relacoes e NHDL-c, CT/HDL-c, LDL-c/HDL-c e Log TG/HDL-c foi observada no grupo de pacientes. A alanina aminotransferase (ALT) correlacionou-se de forma direta e significante com NHDL-c, CT/HDL-c e LDL-c/HDL-c, no grupo de pacientes. A inGestão dietetica de energia, macronutrientes e de vitaminas C e E nao diferiu entre os grupos. Conclusao: O elevado risco aterosclerotico de pacientes com AT aliado ao comprometimento da defesa antioxidante e do estado nutricional pode complicar a evolucao da doenca e enfatiza a importancia da atencao multiprofissional com monitoramento de biomarcadores e orientacao nutricional apropriada
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    Dislipidemia em adolescentes com lúpus eritematoso sistêmico: relação com atividade da doença e concentrações de homocisteína e cisteína
    (Universidade Federal de São Paulo (UNIFESP), 2011) Abad, Thais Tobaruela Ortiz [UNIFESP]; Hilário, Maria Odete Esteves [UNIFESP]
    Introdução: O lupus eritematoso sistemico (LES) juvenil e uma doenca inflamatoria cronica, que acomete individuos ate 18 anos de idade. Pacientes adultos apresentam risco elevado de aterosclerose prematura e a incidencia de infarto do miocardio em mulheres lupicas e 50 vezes maior que mulheres sem doenca. Alem de fatores classicos associados ao risco cardiovascular, como a dislipidemia, outros como a elevacao nas concentracoes de homocisteina (Hcy) e cisteina (Cys), tambem estao envolvidos.Objetivo: Avaliar a presenca de dislipidemia e as concentracoes plasmaticas de Hcy e Cys de adolescentes com LES juvenil em comparacao com controles saudaveis. Nos pacientes com LES juvenil relacionar a presenca de dislipidemia e as concentracoes de Hcy e Cys com: atividade da doenca, proteina C reativa, indice de massa corporal, circunferencia abdominal, estadiamento puberal, consumo alimentar, uso de corticosteroides e outros medicamentos e concentracoes de acido folico e vitamina B12.Metodos: Estudo transversal e controlado com 26 adolescentes de sexo feminino com LES juvenil e 26 controles saudaveis. Foram avaliados: atividade da doenca (SLEDAI), medicamentos utilizados, indice de massa corporal e de estatura para a idade (escore z), consumo alimentar (recordatorio de 24 horas). Foram realizados tambem os seguintes exames: proteinuria, perfil lipidico, homocisteina, cisteina, acido folico, vitamina B12 e proteina C reativa.Resultados: A mediana do SLEDAI foi 4,0 (0,0-31,0). 42,3% dos pacientes faziam uso de corticosteroides, com mediana de dose maxima utilizada de 1,4 mg/kg/dia (0,2-2,0). Dislipidemia foi observada em 46,2% dos pacientes e em 19,2% dos controles, sem diferenca estatistica, sendo a hipertrigliceridemia a alteracao mais frequente. As concentracoes de cisteina foram superiores (p=0,027) e as de HDL-c inferiores (p=0,006) no grupo com LES juvenil comparativamente aos controles. Houve associacao significante entre dislipidemia e maior atividade da doenca (SLEDAI) (p=0,031), menor inGestão de energia (p=0,019), concentracoes mais elevadas de homocisteina (p=0,002) e baixas de acido folico (p=0,016) e vitamina B12 (p=0,004). As concentracoes de homocisteina e cisteina correlacionaram-se entre si (r=0,412, p=0,037) e houve correlacao significante entre as concentracoes de homocisteina e colesterol total (r=0,630; p=0,001), LDL-c (r=0,704; p=0,000) e proteina C reativa (r=0,412; p=0,037) e entre as concentracoes de cisteina e triglicerides (r=0,446; p=0,022), colesterol total (r=0,512; p=0,007) e LDL-c (r=0,403; p=0,041).Conclusao: Encontramos presenca de fatores de risco cardiovascular em adolescentes com LES juvenil. A identificacao precoce dessas alteracoes permite o desenvolvimento de estrategias de intervencao com possivel impacto na reducao do risco para doenca cardiovascular que e muito prevalente nestes pacientes
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    Distúrbios no perfil lipídico são altamente prevalentes em população nipo-brasileira
    (Sociedade Brasileira de Endocrinologia e Metabologia, 2008-02-01) Siqueira, Antonela F. A. [UNIFESP]; Harima, Helena A. [UNIFESP]; Osiro, Katsumi [UNIFESP]; Hirai, Amélia Toyomi [UNIFESP]; Gimeno, Suely Godoy Agostinho [UNIFESP]; Ferreira, Sandra Roberta Gouvea [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP); Japanese-Brazilian Diabetes Study Group
    High prevalence of diabetes has been previously reported in Japanese-Brazilians. In an attempt to better estimate the cardiometabolic risk, this study evaluated lipid disorders in 1,330 Japanese-Brazilians (46% men) aged >30 years. Hypercholesterolemia was defined as serum cholesterol > 240 mg/dL, hypertriglyceridemia as values > 150 mg/dL and low-HDL-C as values <40 mg/dL and <50 mg/dl for men and women respectively. The prevalence of dyslipidemias was compared by the chi-square test between gender and glycemic category. Mean and Standard Deviation of lipids and lipoproteins were compared by the Student t-Test between gender. Hypertriglyceridemia was detected in 66.0% [95% CI: 63.5-68.5] of the population, being more common in men and increasing with deterioration of glucose metabolism. Mean level of triglycerides was 235.7±196.3 mg/dL. The prevalence of hypercholesterolemia was 24.4% [95% CI: 22.1- 26.7]. Low HDL-C was observed in 17.5% [95% CI: 14.5-20.5] of men and 43.0% [95% CI: 39.4- 46.6] of women but total / HDL-cholesterol ratio was lower in women (4.23 ± 0.68 vs. 4.40 ± 0.73, p<0.001). In Japanese-Brazilians, hypertriglyceridemia is the commonest dyslipidemia, in agreement with the high prevalence of diabetes. Men showed a worse lipid profile than women; it was suggested that the Western diet and living habits could be deteriorating their health.
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    Efeito do exercício de força sobre a adiposidade periférica e visceral, perfil lipídico, glicídico e hormonal em adolescentes obesos
    (Universidade Federal de São Paulo (UNIFESP), 2006-12-31) Stella, Sérgio Garcia [UNIFESP]; Mello, Marco Tulio de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Objective: Verify the possible changes promote by strength exercise to visceral and periferic adipose tissue, lipidic profile, glucose and hormonal aswers, after twelvy weeks of intervention, in obese adolescents Methods: was select 126 adolescents, both genders, aged between 14and 19 years, and body mass index (BMI) 95 th, distributed in four groups: control (no exercise), leasure activity, aerobic exercise and strength exercise. They performed physical exercise for 12 weeks, 3 sessions each week, with 1hour of duration. Training intensity was not controlled in the leasure activity group, aerobic group training was at intensity corresponding to ventilatory threeshold – I, strength exercise was performed at 70% of 1 Maximun Repetition. Total body fat, subcutaneous fat and lean body mass was assessed by whole-body dual-energy X-ray absormetry scan (DEXA), visceral adipose tissue assessed by ultrassonography. Lipidic profile was measured by calorimetry and hormonals assays by radioimmunoassay. Results: Relation to body composition, after treatment, strength training promoted significant decreased in the BMI, body mass, visceral and subcutaneous fat in boys. Aerobic training promoted same changes in boys and girls. There was lean body mass preservation in both genders in all groups. Aerobic training decreased total cholesterol and LDL – c in both genders. The leasure physical activity reduced the blood levels of glucose and insulin, ass well in HOMA, only in girls. Conclusions: Strength training was the more effective to promote changes in body composition in boys. However to total cholesterol and LDL – c aerobic training is better in both genders.
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    Estado nutricional e alteracoes metabolicas em pre-puberes expostos ao HIV e nao infectados
    (Universidade Federal de São Paulo (UNIFESP), 2011) Claudio, Cristiane Chiantelli [UNIFESP]
    Objetivo: avaliar o estado nutricional e presenca de alteracoes metabolicas em criancas pre-puberes expostas ao HIV e nao infectadas, com enfase nos fatores de risco para o desenvolvimento de dislipidemia. Metodos: Estudo transversal com 76 criancas divididas em grupos: criancas expostas ao HIV e nao infectadas (n= 31) e criancas nao expostas (n=45). Utilizou-se escore z de indice de massa corporea (zIMC) e de estatura/idade (zE/I). Averiguou-se consumo alimentar, composicao corporal e alteracoes metabolicas por analise bioquimica (perfil lipidico, glicidico, funcao hepatica, parametros hematologicos e PCR). Para analise estatistica realizou-se o teste de Shapiro-Wilk, teste Qui-quadrado ou Exato de Fisher para as variaveis qualitativas, teste t-Student ou Mann Whitney para as variaveis quantitativas, e teste de Spearman para avaliar correlacoes. Considerou-se nivel de significancia de 5% (p<0,05). Resultados: Os grupos foram semelhantes quanto ao zIMC, zE/I e estado nutricional. O grupo exposto ao HIV apresentou maior prevalencia de dislipidemia (38,7%, p=0, 010), valores alterados de colesterol total (CT) (19,4%, p=0, 016) e inadequados de LDL-c (40%, p=0, 011) e CT (41,9%, p=0,038), quando comparado ao grupo controle. O consumo alimentar diferiu apenas quanto ao licopeno, sendo menor porcentagem de inadequacao no grupo exposto ao HIV (p<0,05), verificando-se neste grupo correlacao entre o colesterol total e LDL-c com a vitamina A e β-caroteno. Conclusao: Apesar da similaridade do estado nutricional e do consumo alimentar em ambos os grupos, nossos dados demonstram maior prevalencia de dislipidemia e valores limitrofes de LDL-c em criancas expostas
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    Estado nutricional relativo ao selênio em pacientes com imunodeficiências primárias: associação com estresse oxidativo e risco de aterosclerose
    (Universidade Federal de São Paulo (UNIFESP), 2019-12-13) Andrade, Itana Gomes Alves [UNIFESP]; Sarni, Roseli Oselka Saccardo [UNIFESP]; Costa-Carvalho, Beatriz Tavares [UNIFESP]; Aranda, Carolina Sanchez [UNIFESP]; http://lattes.cnpq.br/1072990929102111; http://lattes.cnpq.br/5724846317829655; http://lattes.cnpq.br/1760819469047929; http://lattes.cnpq.br/8706501435944868; Universidade Federal de São Paulo (UNIFESP)
    Introduction: Ataxia Telangiectasia (AT) and Common Variable Immunodeficiency (ICV) are Inborn Immunity Errors (EII) that can be associated with endocrine changes, oxidative stress and inflammation. Studies suggest that selenium (Se) is a trace element related to protection, against the damage caused by oxidative stress; thus, it is postulated that adequate consumption reduces the risk of some chronic diseases. Objectives: To describe the concentrations of Se and glutathione peroxidase (GPx) in patients with TA and ICV and relate them to markers of the lipid profile, comparing them to the control group. Casuistry and methods: Cross-sectional controlled study, involving 54 patients, of both sexes, 22 with TA and 32 with ICV. Patients were matched for sex and age, with healthy individuals. The following were evaluated: nutritional status, food consumption, serum selenium, glutathione peroxidase (activity), biomarkers of lipid metabolism (lipid profile, apolipoproteins AI and B [Apo AI and Apo B] and oxidized LDL [LDLox]), inflammation (protein C ultrasensitive reactive [CRP] and adiponectin) and lipid peroxidation (malondialdehyde). Results: The median age in the TA group was 12.2 years, with a predominance of males; in the ICV the female gender predominated, with a mean age of 36.8 years. TA patients showed greater impairment of lean mass and lower abdominal circumference when compared to their controls. A more atherogenic lipoprotein profile was observed in the TA group, with higher concentrations of total cholesterol, non-HDL cholesterol, LDLox, ApoB, Apo B / Apo A-I ratio and LDL / HDL; while a lower value was observed in the Apo A-I / HDL ratio. ICV patients had lower serum concentrations of Se and GPx activity. On the other hand, in these same patients, the LDLox, CRP and non-HDL-c cholesterol values ​​were higher when compared to their controls. Dietary intake of energy, macronutrients, vitamins C and selenium were similar among patients and their respective controls, except in patients with TA, who had lower consumption of calories, carbohydrates, proteins, monounsaturated fats, trans and Se its controls Conclusion: the study showed a higher risk for CVD in patients with EII, such as ICV and TA. The presence of low selenium in ICVs and less GPx activity in TA points to the importance of assessing the nutritional status related to selenium in these patients. Patients with TA seem to have a potential risk for CVD due to impaired nutritional status, impaired liver function, dyslipidemia and inflammation.
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    Evolution of the biochemical profile of children treated or undergoing treatment for moderate or severe stunting: consequences of metabolic programming?
    (Sociedade Brasileira de Pediatria, 2014-07-01) Alves, Jullyana Flávia da Rocha; Britto, Revilane Parente de Alencar; Ferreira, Haroldo da Silva; Sawaya, Ana Lydia [UNIFESP]; Florêncio, Telma Maria de Menezes Toledo [UNIFESP]; Universidade Federal de Alagoas School of Nutrition; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVE:to evaluate changes in the biochemical profile of children treated or being treated for moderate or severe stunting in a nutrition recovery and education center.METHODS:this was a retrospective longitudinal study of 263 children treated at this center between August of 2008 to August of 2011, aged 1 to 6 years, diagnosed with moderate (z-score of height-for-age [HAZ] < -2) or severe stunting (HAZ < -3). Data were collected on socioeconomic conditions, dietary habits, and biochemical changes, as well as height according to age.RESULTS:the nutritional intervention showed an increase in HAZ of children with moderate (0.51 ± 0.4, p = 0.001) and severe (0.91 ± 0.7, p = 0.001) stunting during the monitoring. Increased levels of insulin-like growth factor 1 (IGF-1) (initial: 71.7 ng/dL; final: 90.4 ng/dL; p = 0.01) were also observed, as well as a reduction in triglycerides (TG) in both severely (initial: 91.8 mg/dL; final: 79.1 mg/dL; p = 0.01) and in moderately malnourished children (initial: 109.2 mg/dL; final 88.7 mg/dL; p = 0.01), and a significant increase in high-density lipoprotein cholesterol HDL-C only in the third year of intervention (initial: 31.4 mg/dL; final: 42.2 mg/dL). The values of total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) levels remained high throughout the treatment (initial: 165.1 mg/dL; final: 163.5 mg/dL and initial: 109.0 mg/dL; final: 107.3 mg/dL, respectively).CONCLUSION:the nutritional treatment for children with short stature was effective in reducing stunting and improving TG and HDL-C after three years of intervention. However, the levels of LDL-C and TC remained high even in treated children. It is therefore speculated that these changes may result from metabolic programming due to malnutrition.
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    Habitos Alimentares, indices antropometricos e de adiposidade e associacao com perfil lipidico de pre-escolares
    (Universidade Federal de São Paulo (UNIFESP), 2012) Ferreira, Sofia Emanuelle de Castro [UNIFESP]
    Objetivos: Identificar o perfil lipidico de pre-escolares e verificar associacao com praticas alimentares e parametros antropometricos e de adiposidade. Metodos: Estudo transversal aninhado em uma coorte de nascidos entre os anos de 2004 e 2005 na cidade de Diamantina/MG. Foram coletados dados sobre condicao socioeconomica, estilo de vida, medidas antropometricas e de adiposidade, dieteticas e perfil lipidico dos pre-escolares. Foram considerados alterados os valores de Colesterol Total (CT) ≥170mg/dL, colesterol de lipoproteina de baixa densidade (LDL-c) ≥110mg/dL, colesterol da lipoproteina de alta densidade (HDL-c) <40 mg/dL e triglicerideos (TG) >100mg/dL. A amostra consistiu de 227 preescolares aos cinco anos de idade, avaliados no periodo entre julho de 2009 a julho de 2010. Utilizou-se a regressao de Poisson para o estudo dos fatores associados a dislipidemia. Na primeira etapa foram testados modelos univariados, sendo as variaveis com valor p < 0,2 incluidas como possiveis confundidoras das variaveis de interesse. As variaveis que permaneceram associadas, valor p < 0,05, constituiram o modelo final. Resultados: A dislipidemia ocorreu em 63% dos pre-escolares e foi mais frequente em meninas. Identificou-se valores elevados de CT, LDL-c e TGL em 45,37%, 48,02% e 11,01% respectivamente. O HDL-c apresentou-se alterado em 20,26% das criancas. A prevalencia de excesso de peso foi de 17,62% de acordo com o IMC, e nao apresentou associacao positiva com dislipidemias. Em relacao a pratica alimentar, criancas que consomem quantidades elevadas de colesterol (RP=1,6; IC95%=1,24u 2,04) e lipidios (RP=1,24; IC95%=1,01u1,60) apresentaram maior risco de desenvolverem dislipidemia. O sexo feminino apresentou-se como fator de risco para dislipidemia (RP= 1,24; IC95%=1,03- 1,50). As demais variaveis nao apresentaram associacoes estatisticamente significantes. Conclusao: Os resultados deste estudo alertam para as altas prevalencias de dislipidemias ja na infancia e demonstram associacao dos habitos alimentares e sexo com o perfil lipidico alterado. Ha necessidade premente da modificacao do estilo de vida a partir da mais tenra idade para se evitar consequencias futuras
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    A ingestão de ácidos graxos trans, durante a gestação e lactação, modifica os mecanismos intracelulares envolvidos com a resposta inflamatória, na prole com 21 dias de vida
    (Universidade Federal de São Paulo (UNIFESP), 2010-11-24) Oliveira, Juliana Lopez de [UNIFESP]; Nascimento, Claudia Maria da Penha Oller do [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Although lipids transfer through placenta is very limited, modification in dietary fatty acids can lead to implications in fetal and postnatal development. Trans fatty acid intake during gestation and lactation have been reported to promote dyslipidemia and increase in pro- inflammatory adipokines in offspring. The aim of this study was to evaluate whether the alterations on proinflammatory cytokines and dyslipidemia observed previously in 21-d-old offspring of rats fed a diet containing hydrogenated vegetable fat during gestation and lactation were related to alterations in TLR-4, TRAF-6 and adipo- R1 receptor in white adipose tissue and muscle. On the first day of gestation, rats were randomly divided into two groups: (C) received a control diet, and (TFA) received a diet enriched with hydrogenated vegetable fat, rich in trans fatty acids. The diets were maintained throughout gestation and lactation. Each mother was given eight male pups. On the 21st day of life the offspring were killed. Blood, soleus and extensor digital longus (EDL) muscles, and retroperitoneal (RET) white adipose tissue were collected. 21-d-old of TFA rats had higher serum triacylglycerols, cholesterol, and insulin. The Adipo R1 protein expression was lower in RET and higher in EDL of TFA group than C. TLR-4 protein content in all studied tissues were similar between groups, the same was verified in TRAF-6 protein expression in soleus and EDL. However, TRAF- 6 protein expression in RET was higher in TFA than C. These results demonstrated that maternal ingestion of hydrogenated vegetable fat rich in TFAs during gestation and lactation decrease in Adipo R1 protein expression and increase in TRAF-6 protein expression in retroperitoneal adipose tissue, but not in skeletal muscle, which could contributed for hyperinsulinemia and dyslipidemia observed in their 21-d-old offspring.
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    Metabolismo lipídico em pacientes com artrite idiopática juvenil dos subtipos poliarticular e sistêmico
    (Universidade Federal de São Paulo (UNIFESP), 2018-03-01) Rodrigues, Wellington Douglas Rocha [UNIFESP]; Terreri, Maria Teresa De Sande E Lemos Ramos Ascensao [UNIFESP]; http://lattes.cnpq.br/2661280959330284; Universidade Federal de São Paulo (UNIFESP)
    Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in the pediatric population. Mortality due to disease activity and secondary infectious complications has decreased, however, this group of patients coexists chronically with the disease and presents, to a greater extent, early negative outcomes such as osteoporosis and late as cardiovascular diseases. Objective: To describe the biomarkers of lipid metabolism related to the cardiovascular risk of children and adolescents with JIA and to relate them to variables of the disease, lipid and glucose profile, nutritional status and food consumption. Methods: Cross-sectional study with 62 patients with JIA. The following were evaluated: disease activity and medications used, body mass index, height for age (z score), skin folds (bicipital, tricipital, subscapular and suprailiac), food consumption (24 hour recall), lipid profile (Total Cholesterol, low density lipoprotein - LDL, high density lipoprotein - HDL and triglycerides - TG and non-HDL), C-reactive protein, erythrocyte sedimentation rate (ESR), apolipoproteins AI and B Paraoxonase (PON). Statistical analysis: Exact Fischer, Chi-square, Mann-Whitney and Spearman correlation tests, p <0.05. Results: The mean duration of the disease was 5 years (± 3.4) and the active disease was observed in 33.9% of the patients. The prevalence of dyslipidemia in general was 62.9% when the lipid profile (CT, LDL-c, HDL-c, non-HDL-c and TG) and 82.3% were evaluated, including apolipoproteins (Apo AI and Apo B) altered. HDL-c and Apo A-I were the most frequent lipid profile changes. The low concentrations of Apo A-I were statistically more frequent in systemic JIA compared to polyarticular. Patients using biological agents showed better adequacy of Apo A-I concentrations. There was no significant correlation between us-CRP and variables related to lipid metabolism. However, HSV showed a negative correlation with Apo A-I levels (r = -0.25, p = 0.047). Conclusion: We conclude that dyslipidemia and alteration of lipid biomarkers are common in patients with JIA. The systemic form and the elevated HSV were associated with lower concentrations of Apo A-I suggesting the participation of the inflammatory process. In addition, the use of biological agents may be a protective factor for dyslipidemia.
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    Obesidade e fatores de risco para doenças cardiovasculares em adolescentes de escolas públicas
    (Universidade Federal de São Paulo (UNIFESP), 2008) Cobayashi, Fernanda [UNIFESP]; Taddei, Jose Augusto de Aguiar Carrazedo [UNIFESP]
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    PCSK9 and its clinical importance with the new therapeutic targets against dyslipidemia
    (Instituto Israelita de Ensino e Pesquisa Albert Einstein, 2012-12-01) Ferreira, Carlos Eduardo dos Santos [UNIFESP]; Fonseca, Francisco Antonio Helfenstein [UNIFESP]; Mangueira, Cristóvão Luis Pitangueiras; Hospital Israelita Albert Einstein; Universidade Federal de São Paulo (UNIFESP)
    This is a remarkable progress; since the finding of statins, there was no new way of reducing, significantly, cholesterol and LDL fraction. It is also clear that this decrease, by statins, is related to future cardiovascular lesions, being useful in its primary and secondary prophylaxis. The authors presented studies on research to promote the falling of blood cholesterol by means of antibodies, which inhibit the pro-protein PCSK9, as well as agents that act performing the RNA interference. We had two advantages immediately: for patients with myopathy associated with statins, and the fact of being injected every 15 days, that may contribute to better treatment adherence.
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    Perda auditiva neurossensorail subita idiopatica
    (Universidade Federal de São Paulo (UNIFESP), 2007) Nagaoka, Jayson [UNIFESP]