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- ItemSomente MetadadadosCardiovascular and metabolic risk markers are related to parasympathetic indices in pre-pubertal adolescents(Cambridge Univ Press, 2016) Cayres, Suziane U.; Vanderlei, Luiz Carlos M.; Silva, Danilo R. P.; Lima, Manoel Carlos S.; Barbosa, Mauricio F. [UNIFESP]; Fernandes, Romulo A.Objective To analyse the relationship between different heart rate variability indices, resting heart rate, and cardiovascular markers in adolescents. Methods A cross-sectional study was carried out with information from an ongoing cohort study. The sample was composed of 99 adolescents who complied with the following inclusion criteria: aged between 11 and 14 years; enrolled in a school unit of elementary education; absence of any known diseases; no drug consumption; and a formal consent signed by the parents or legal guardians. Weight, height, heart rate variability, lipid profile, inflammatory markers, blood pressure, resting heart rate, intima-media thickness, blood flow, and trunk fatness were measured. Partial correlation and linear regression (expressed by and 95% confidence intervals [95%CI]) analyses were used to analyse the relationships between the variables. Results In the linear regression analysis, even after adjustments for sex, age, trunk fatness, and somatic maturation, parasympathetic activity presented significant correlations with maximum carotid artery blood flow (=-0.111 [95%CI=-0.216; -0.007]), systolic blood pressure (=-0.319 [95%CI=-0.638; -0.001]), and resting heat rate (=-0.005 [95%CI=-0.009; -0.002]). Conclusion Parasympathetic activity at rest is inversely related to maximum and minimum blood flow, triacylglycerol levels, and systolic blood pressure. These findings suggest that heart rate variability has the potential to discriminate pre-pubertal adolescents at increased risk.
- ItemSomente MetadadadosCardiovascular and metabolic risk markers are related to parasympathetic indices in pre-pubertal adolescents(Cambridge Univ Press, 2016) Cayres, Suziane U.; Vanderlei, Luiz Carlos M.; Silva, Danilo R. P.; Lima, Manoel Carlos S.; Barbosa, Mauricio F. [UNIFESP]; Fernandes, Romulo A.Objective To analyse the relationship between different heart rate variability indices, resting heart rate, and cardiovascular markers in adolescents. Methods A cross-sectional study was carried out with information from an ongoing cohort study. The sample was composed of 99 adolescents who complied with the following inclusion criteria: aged between 11 and 14 years; enrolled in a school unit of elementary education; absence of any known diseases; no drug consumption; and a formal consent signed by the parents or legal guardians. Weight, height, heart rate variability, lipid profile, inflammatory markers, blood pressure, resting heart rate, intima-media thickness, blood flow, and trunk fatness were measured. Partial correlation and linear regression (expressed by and 95% confidence intervals [95%CI]) analyses were used to analyse the relationships between the variables. Results In the linear regression analysis, even after adjustments for sex, age, trunk fatness, and somatic maturation, parasympathetic activity presented significant correlations with maximum carotid artery blood flow (=-0.111 [95%CI=-0.216; -0.007]), systolic blood pressure (=-0.319 [95%CI=-0.638; -0.001]), and resting heat rate (=-0.005 [95%CI=-0.009; -0.002]). Conclusion Parasympathetic activity at rest is inversely related to maximum and minimum blood flow, triacylglycerol levels, and systolic blood pressure. These findings suggest that heart rate variability has the potential to discriminate pre-pubertal adolescents at increased risk.
- ItemSomente MetadadadosConsequences of subchronic and chronic exposure to intermittent hypoxia and sleep deprivation on cardiovascular risk factors in rats(Elsevier B.V., 2007-06-15) Perry, Juliana Cini [UNIFESP]; D'Almeida, Vânia [UNIFESP]; Souza, Fernanda G.; Schoorlemmer, Gerhardus Hermanus Maria [UNIFESP]; Colombari, Eduardo [UNIFESP]; Tufik, Sergio [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Since studies suggest that both hypoxia and sleep fragmentation are related to cardiovascular alterations induced by obstructive sleep apnea, the present study was designed to evaluate the effects of hypoxia, sleep deprivation, and their combination on biochemical blood parameters in rats. in subchrome experiments (4 days), rats were exposed to intermittent hypoxia (IH) during the light period (2 min room air-2 min 10% O-2 for 12 h/day) and/or paradoxical sleep deprivation (PSD, 24 h/day). Consequences of chronic intermittent hypoxia (CIH) exposure were examined after 21 consecutive days of hypoxia protocol from 10:00 to 16:00 followed by a sleep restriction (SR) period of 18 h (16:00-10:00). Rats were randomly assigned to seven treatment groups: (1) control (2) IH (3) PSD (4) IH-PSD (5) SR (6) CIH and (7) CIH-SR. PSD reduced triglycerides and very low-density lipoprotein (VLDL) cholesterol concentrations and increased total cholesterol and high-density lipoprotein (HDL) cholesterol. IH did not alter any of these parameters. the combination of IH-PSD did not modify the values of total cholesterol and HDL compared to control group. in the chronic experiment, the animals exposed to CIH displayed a reduction of Vitamin B-6 and an increase of triglycerides and VLDL. Our findings show a duration-dependent effect of hypoxia on triglycerides. Rats in the SR and CIH-SR groups showed a diminished concentration of triglycerides and VLDL. SR rats showed a reduction in the concentration of homocysteine but the animals in the CIH-SR treatment condition did not display any alterations in this parameter. in this latter group, an augmentation of cysteine concentration was observed. These results suggest that sleep deprivation and hypoxia modify biochemical blood parameters in distinct ways. (C) 2006 Elsevier B.V. All rights reserved.
- ItemSomente MetadadadosDeterminação dos valores de corte da circunferência abdominal, índice de massa corpórea e do homa-ir associado a um conjunto de fatores de risco cardiovascular em adolescentes com tolerância à glicose normal(Universidade Federal de São Paulo (UNIFESP), 2013-05-29) Rocco, Eloa Roberta [UNIFESP]; Dib, Sergio Atala Dib [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objective: The aim of this study was to establish the best cutoff values of waist circumference (WC), body mass index (BMI) and HOMA-IR (HR) to identify a cluster (≥ 3) of cardiovascular risk factors (CVRF) in normal glucose-tolerant (NGT) Brazilian children and adolescents. Subjects and methods: Cross-sectional study of 319 individuals (aged 10-19 y) from a southern Brazilian city. Gender-specific receiver-operating characteristics (ROC) curves were constructed to assess cutoffs values of BMI (kg/m2), WC (cm) and HR. Results: The areas under the ROC curves to detect a cluster of CVRF were 0.92, 0.93 and 0.68 (females), and 0.93, 0.93 and 0.89 (males), for WC, BMI and HR, respectively. The cutoff values were 83.0 and 80.5 cm (WC), 22.7 and 20.4 kg/m2 (BMI), and 1.65 and 1.95 (HR), for females and males, respectively, to detect the cluster of CVRF. Conclusion: These values of BMI, WC and HR detected a high proportion of NGT Brazilian children and adolescents with a cluster of CVRF.
- ItemAcesso aberto (Open Access)Impact of self-reported fasting duration on lipid profile variability, cardiovascular risk stratification and metabolic syndrome diagnosis(Sbem-Soc Brasil Endocrinologia & Metabologia, 2018) Janovsky, Carolina Castro Porto Silva [UNIFESP]; Laurinavicius, Antonio; Cesena, Fernando; Valente, Viviane; Ferreira, Carlos Eduardo; Mangueira, Cristovao; Conceicao, Raquel; Santos, Raul D.; Bittencourt, Marcio SommerObjective: We sought to investigate the impact of self-reported fasting duration times on the lipid profile results and its impact on the cardiovascular risk stratification and metabolic syndrome diagnosis. Subjects and methods: We analyzed data from all consecutive individuals evaluated in a comprehensive health examination at the Hospital Israelite Albert Einstein from January to December 2015. We divided these patients in three groups, according to the fasting duration recalled (< 8h, 8-12h and > 12h). We calculated the global cardiovascular risk and diagnosed metabolic syndrome according to the current criteria and estimated their change according to fasting duration. Results: A total of 12,196 (42.3 +/- 9.2 years-old, 30.2% females) patients were evaluated. The distribution of cardiovascular risk was not different among groups defined by fasting duration in both men and women (p = 0.547 for women and p = 0.329 for men). Similarly, the prevalence of metabolic syndrome was not influenced by the fasting duration (p = 0.431 for women and p = 0.166 for men). Conclusion: Self-reported fasting duration had no significant impact on the lipid profile results, including triglyceride levels. Consequently, no changes on the cardiovascular risk stratification using the Framingham risk score nor changes on the prevalence of metabolic syndrome were noted.
- ItemSomente MetadadadosLipid profile in women over 35 years old using triphasic combined oral contraceptives(Elsevier B.V., 2004-05-01) Aldrighi, J. M.; Petta, C. A.; Bahamondes, L.; Caetano, M. E.; Martinez, TRL; De Lima, G. R.; Universidade de São Paulo (USP); Universidade Estadual de Campinas (UNICAMP); Universidade Federal de São Paulo (UNIFESP)Twenty-nine women aged 35 years old or more, using triphasic combined oral contraceptive (COC) were evaluated during six cycles for the following parameters: total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and its subfraction HDL2, triglycerides, apoproteins A and B, Castelli risk index I and II (cholesterol/HDL-C and LDL-C/HDL-C) and apoprotein ratio (apoprotein B/apoprotein A). the same laboratory measurements were done in a control group of 49 non-COC-user women. the results showed that there were no differences on most of the studied parameters between user and nonuser women. There was a significant reduction of HDL-C and LHD2-C, although within the normal range. in addition, it was observed a significant increment of triglycerides and apoprotein B at 6 months of follow-up only in user group (p < 0.05), although within the normal range. It is concluded that the use of levonorgestrel triphasic COC appeared to have no additional adverse impact when used by women aged over 35 years. Further studies are needed to obtain conclusive data. (C) 2004 Elsevier Inc. All rights reserved.
- ItemSomente MetadadadosMetabolic syndrome among prepubertal Brazilian schoolchildren(Sage Publications Ltd, 2008-11-01) Strufaldi, Maria Wany Louzada [UNIFESP]; Silva, Edina Mariko Koga da [UNIFESP]; Puccini, Rosana Fiorini [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)This was a two-stage cross-sectional study that assessed metabolic syndrome and associated factors among prepubertal schoolchildren. in the first stage, nutritional status, blood pressure, personal (low birth weight) and family antecedents for cardiovascular disease (CVD) were collected. in the second stage, schoolchildren with at least one of these criteria participated: obesity, personal or family history. Metabolic syndrome (MS) was defined by ATP III and WHO definitions. Among 929 (6-10 year old) schoolchildren, 27.7% presented with over-weight/obesity, 12.2% hypertension, and personal (9.4%) and family (35.3%) antecedents. 205 children finished the second stage. the frequencies of MS-ATP and MS-WHO were 9.3% and 1.9%. Among the obese, MS was present in 25.8% (ATP) and 5.2% (WHO). Children with normal weight presented: low HDL (23.6%), hyperglycaemia (3.6%), HOMA-IR (0.9%) and MS-ATP (0.9%). in conclusion, overweight/obesity was associated with metabolic syndrome in schoolchildren. It was found that children with normal weight with personal and/or family antecedents presented with HOMA-IR and MS-ATR.
- ItemAcesso aberto (Open Access)Obstructive Sleep Apnea A Cardiometabolic Risk in Obesity and the Metabolic Syndrome(Elsevier B.V., 2013-08-13) Drager, Luciano Ferreira; Togeiro, Sonia Maria [UNIFESP]; Polotsky, Vsevolod Y.; Lorenzi-Filho, Geraldo; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP); Johns Hopkins UnivObstructive sleep apnea (OSA) is an underdiagnosed condition characterized by recurrent episodes of obstruction of the upper airway leading to sleep fragmentation and intermittent hypoxia during sleep. Obesity predisposes to OSA, and the prevalence of OSA is increasing worldwide because of the ongoing epidemic of obesity. Recent evidence has shown that surrogate markers of cardiovascular risk, including sympathetic activation, systemic inflammation, and endothelial dysfunction, are significantly increased in obese patients with OSA versus those without OSA, suggesting that OSA is not simply an epiphenomenon of obesity. Moreover, findings from animal models and patients with OSA show that intermittent hypoxia exacerbates the metabolic dysfunction of obesity, augmenting insulin resistance and nonalcoholic fatty liver disease. in patients with the metabolic syndrome, the prevalence of moderate to severe OSA is very high (similar to 60%). in this population, OSA is independently associated with increased glucose and triglyceride levels as well as markers of inflammation, arterial stiffness, and atherosclerosis. A recent randomized, controlled, crossover study showed that effective treatment of OSA with continuous positive airway pressure for 3 months significantly reduced several components of the metabolic syndrome, including blood pressure, triglyceride levels, and visceral fat. Finally, several cohort studies have consistently shown that OSA is associated with increased cardiovascular mortality, independent of obesity. Taken together, these results support the concept that OSA exacerbates the cardiometabolic risk attributed to obesity and the metabolic syndrome. Recognition and treatment of OSA may decrease the cardiovascular risk in obese patients. (C) 2013 by the American College of Cardiology Foundation
- ItemSomente MetadadadosSleep disturbances, oxidative stress and cardiovascular risk parameters in postmenopausal women complaining of insomnia(Taylor & Francis Ltd, 2006-08-01) Campos, H. Hachul de; Brandao, L. C.; D'Almeida, V.; Grego, B. H. C.; Bittencourt, L. R.; Tufik, S.; Baracat, E. C.; Universidade Federal de São Paulo (UNIFESP)Objective the aim of this work was to investigate cardiovascular risk factors and oxidative stress parameters as well as sleep disturbances in polysomnography recordings of 38 postmenopausal women with insomnia.Methods Polysomnography recordings were performed on subjects for sleep analysis. Oxidative stress parameters were analyzed by measuring blood concentration of catalase, superoxide dismutase (SOD), thiobarbituric acid reactive substances (TBARS) and glutathione. for cardiovascular risk factors, we measured plasma levels of homocysteine, folic acid and vitamin B6.Results Findings of polysomnography recordings revealed: 68% experienced decreased sleep efficiency, 50% had apnea, 7.8% had periodic leg movements and 2.6% had bruxism (involuntary gnashing and grinding of the teeth during sleep). Our results showed that the majority of our subjects presented normal concentrations of the parameters studied according to standards reached in our laboratory. the only notable exception was TBARS. in this case, only 21% displayed normal values. We also found inverse correlations between SOD activity and both age and time of menopause.Conclusions Although all women complained of insomnia, 50% of them demonstrated apnea during polysomnography recordings. of the parameters measuring oxidative stress, only TBARS levels were increased in our sample. Some clinical data, such as time of onset of menopause, may be associated with the oxidative stress status of these women, probably due to the lack of estrogen and to sleep disturbances, such as apnea.