Anemia, marcadores inflamatórios e perfil alimentar em lactentes - MG
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Data
2024-04-04
Autores
Lourenção, Luiz Felipe de Paiva [UNIFESP]
Orientadores
Sarni, Roseli Oselka Saccardo [UNIFESP]
Tipo
Tese de doutorado
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Introdução: A anemia configura-se como um grande problema de saúde pública, chegando a atingir, globalmente, até 40% das crianças menores de 5 anos. No Brasil, a anemia resultante da deficiência de ferro é comum no público pediátrico, onde o acompanhamento das rotinas de saúde e alimentação na infância são cruciais para a formação das práticas alimentares saudáveis e adequadas, a fim de evitar distúrbios alimentares diversos, como as anemias carenciais. O consumo excessivo de alimentos ultraprocessados pode desencadear o aumento do excesso de peso na população infantil e exercer influência direta na inflamação. Objetivo: Avaliar o estado nutricional e as condições neonatais dos lactentes, e descrever a frequência e caracterizar o perfil de anemia de crianças até 3 anos de idade, assistidos pela Rede Pública de Ensino de um município sul-mineiro, verificando possíveis associações com as práticas alimentares, condição nutricional e marcadores inflamatórios. Métodos: Trata-se de um estudo transversal, realizado em 3 (três) Centros de Educação Infantil em um município do sul de Minas Gerais. Participaram do presente estudo, 112 crianças, na faixa etária de 6 meses a 3 anos de idade. A coleta de dados consistiu em 4 etapas, sendo: Dados socioeconômicos, histórico de nascimento e condições clínicas; Avaliação do estado nutricional; Marcadores do consumo alimentar; e Avaliação dos marcadores bioquímicos. Foi realizada a avaliação do estado nutricional relativo ao ferro e a avaliação do perfil de inflamação pelos marcadores bioquímicos. Os dados foram digitados e consolidados em planilha do Excel® e as análise foram realizadas no pacote estatístico SPSS 29.0, sendo que as variáveis categóricas e binárias foram comparadas pelo teste do Qui-quadrado, com nível de significância de p < 0,05. Resultados: A média de idade foi de foi de 28,1±7,9 meses e 50 (44,6%) eram do sexo feminino. Em relação as características socioeconômicas 25 (22,9%), 60 (53,6%) e 59 (52,6%) das famílias recebiam o Programa de Transferência de Renda “Auxílio Brasil”, tinham classificação ABEP > B2 e foram classificados em algum grau de insegurança alimentar, respectivamente. Quanto aos indicadores antropométricos observou-se elevado percentual de excesso de peso e comprometimento estatural, 39 (36,1%) e 27 (25,0%), respectivamente nas crianças avaliadas. Anemia e ferropenia foram detectadas em 47 (42,0%) e 89 (79,5%) das crianças, respectivamente. A PCRus associou-se de forma direta com os valores de RDW, ferritina e Receptor solúvel da transferrina, e de forma inversa com os níveis de hemoglobina, ferro sérico e Índice de saturação de transferrina. A Alfa-1 Glicoproteína Ácida associou-se de forma inversa com todos os marcadores bioquímicos relativos ao ferro. Conclusões: O presente estudo evidenciou anemia e ferropenia em 47% e 79% das crianças avaliadas, respectivamente. Houve associação direta e significante entre as concentrações de hemoglobina e o escore Z de estatura por idade, mesmo após ajuste para os valores de PCRus. As práticas alimentares avaliadas não se associaram com a presença de anemia. RDW e o Receptor solúvel da transferrina mostraram o melhor poder discriminatório entre os grupos com e sem anemia.
Introduction: Anemia is a major public health problem, affecting up to 40% of children under 5 years of age globally. In Brazil, anemia resulting from iron deficiency is common in the pediatric population, where monitoring health and nutrition routines in childhood are crucial for the formation of healthy and appropriate eating practices, in order to avoid various eating disorders, such as deficiency anemia. Excessive consumption of ultra-processed foods can trigger an increase in excess weight in children and have a direct influence on inflammation. Objective: To evaluate the nutritional status and neonatal conditions of infants, and describe the frequency and characterize the profile of anemia in children up to 3 years of age, assisted by the Public Education Network of a municipality in the south of Minas Gerais, verifying possible associations with the practices food, nutritional status and inflammatory markers. Methods: This is a cross-sectional study, carried out in 3 (three) Early Childhood Education Centers in a municipality in the south of Minas Gerais. A total of 112 children, aged 6 months to 3 years, participated in the present study. Data collection consisted of 4 stages, namely: Socioeconomic data, birth history and clinical conditions; Assessment of nutritional status; Food consumption markers; and Assessment of biochemical markers. The nutritional status regarding iron and the inflammation profile were evaluated using biochemical markers. The data were entered and consolidated into an Excel® spreadsheet and the analyzes were carried out using the SPSS 29.0 statistical package, with categorical and binary variables compared using the Chi-square test, with a significance level of p < 0.05. Results: The average age was 28.1±7.9 months and 50 (44.6%) were female. Regarding socioeconomic characteristics, 25 (22.9%), 60 (53.6%) and 59 (52.6%) of the families received the “Auxílio Brasil” Income Transfer Program, had an ABEP classification > B2 and were classified some degree of food insecurity, respectively. Regarding anthropometric indicators, a high percentage of overweight and impaired height was observed, 39 (36.1%) and 27 (25.0%), respectively in the children evaluated. Anemia and iron deficiency were detected in 47 (42.0%) and 89 (79.5%) of the children, respectively. hsCRP was directly associated with the values of RDW, ferritin and soluble transferrin receptor, and inversely with the levels of hemoglobin, serum iron and transferrin saturation index. Alpha-1 Acid Glycoprotein was inversely associated with all biochemical markers related to iron. Conclusions: The present study showed anemia and iron deficiency in 47% and 79% of the children evaluated, respectively. There was a direct and significant association between hemoglobin concentrations and height-for-age Z score, even after adjustment for hsCRP values. The eating practices evaluated were not associated with the presence of anemia. RDW and soluble transferrin receptor showed the best discriminatory power between groups with and without anemia.
Introduction: Anemia is a major public health problem, affecting up to 40% of children under 5 years of age globally. In Brazil, anemia resulting from iron deficiency is common in the pediatric population, where monitoring health and nutrition routines in childhood are crucial for the formation of healthy and appropriate eating practices, in order to avoid various eating disorders, such as deficiency anemia. Excessive consumption of ultra-processed foods can trigger an increase in excess weight in children and have a direct influence on inflammation. Objective: To evaluate the nutritional status and neonatal conditions of infants, and describe the frequency and characterize the profile of anemia in children up to 3 years of age, assisted by the Public Education Network of a municipality in the south of Minas Gerais, verifying possible associations with the practices food, nutritional status and inflammatory markers. Methods: This is a cross-sectional study, carried out in 3 (three) Early Childhood Education Centers in a municipality in the south of Minas Gerais. A total of 112 children, aged 6 months to 3 years, participated in the present study. Data collection consisted of 4 stages, namely: Socioeconomic data, birth history and clinical conditions; Assessment of nutritional status; Food consumption markers; and Assessment of biochemical markers. The nutritional status regarding iron and the inflammation profile were evaluated using biochemical markers. The data were entered and consolidated into an Excel® spreadsheet and the analyzes were carried out using the SPSS 29.0 statistical package, with categorical and binary variables compared using the Chi-square test, with a significance level of p < 0.05. Results: The average age was 28.1±7.9 months and 50 (44.6%) were female. Regarding socioeconomic characteristics, 25 (22.9%), 60 (53.6%) and 59 (52.6%) of the families received the “Auxílio Brasil” Income Transfer Program, had an ABEP classification > B2 and were classified some degree of food insecurity, respectively. Regarding anthropometric indicators, a high percentage of overweight and impaired height was observed, 39 (36.1%) and 27 (25.0%), respectively in the children evaluated. Anemia and iron deficiency were detected in 47 (42.0%) and 89 (79.5%) of the children, respectively. hsCRP was directly associated with the values of RDW, ferritin and soluble transferrin receptor, and inversely with the levels of hemoglobin, serum iron and transferrin saturation index. Alpha-1 Acid Glycoprotein was inversely associated with all biochemical markers related to iron. Conclusions: The present study showed anemia and iron deficiency in 47% and 79% of the children evaluated, respectively. There was a direct and significant association between hemoglobin concentrations and height-for-age Z score, even after adjustment for hsCRP values. The eating practices evaluated were not associated with the presence of anemia. RDW and soluble transferrin receptor showed the best discriminatory power between groups with and without anemia.
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Citação
LOURENÇÃO, Luiz Felipe de Paiva. Anemia, marcadores inflamatórios e perfil alimentar em lactentes - MG. 2024. 134 f. Tese (Doutorado em Pediatria e Ciências Aplicadas à Pediatria) - Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP). São Paulo, 2024.