Estado nutricional de escolares do semi-árido do nordeste brasileiro

SILVA, João B. da et al. Estado Nutricional de Escolares do Semi-Árido do Nordeste Brasileiro. Revista de Salud Pública, v. 11, n. 1, p. 62-71, 2009.

Estado nutricional e efeito da vitamina A na resposta imune frente à infecção por Leishmania Infantum

Nutritional status is an important determinant to the response against Leishmania infection, although few studies have characterized the molecular basis for the association found between malnutrition and the disease. Vitamin A supplementation has long been used in developing countries to prevent mortality by diarrheal and respiratory diseases, but there are no studies on the role of vitamin A in Leishmania infection, although we and others have found vitamin A deficiency in visceral Leishmaniasis (VL). Regulatory T cells are induced in vitro by vitamin A metabolites and are considered important cells implicated T CD4+ cell suppression in human VL. This work aimed to examine the correlation of nutritional status and the effect of vitamin A in the response against Leishmania infantum infection. A total of 179 children were studied: 31 had active VL, 33 VL history, 44 were DTH+ and 71 were DTH- and had negative antibody to Leishmania (DTH-/Ac-). Peripheral blood monuclear cells were isolated in a subgroup of 10 active VL and 16 DTH-/Ac- children and cultivated for 20h under 5 different conditions: 1) Medium, 2) Soluble promastigote L. infantum antigens (SLA), 3) All-trans retinoic acid (ATRA), 4) SLA + ATRA and 5) Concanavalin A. T CD4+CD25highFoxp3+, T CD4+CD25-Foxp3- and CD14+ monocytes were stained and studied by flow cytometry for IL-10, TGF-β and IL-17 production. Nutritional status was compromised in VL children, which presented lower BMI/Age and retinol concentrations when compared to healthy controls. We found a negative correlation between nutritional status (measured by BMI/Age and serum retinol) and anti-Leishmania antibodies and acute phase proteins. There was no correlation between nutritional status and parasite load. ATRA presented a dual effect in Treg cells and monocytes: In healthy children (DTH-/Ac-), it induced a regulatory response, increasing IL-10 and TGF-β production; in VL children it modulated the immune response, preventing increased IL-10 production after SLA stimulation. Furthermore, we found a positive correlation between BMI/Age and IL-17 production and negative correlation between serum retinol and IL-10 and TGF-β production in T CD4+CD25highFoxp3+ cells after SLA stimulus. Our results show a potential dual role of vitamin A in the immune system: improvement of regulatory profile during homeostasis and down modulation of IL-10 in Treg cells and monocytes during symptomatic VL. Therefore, the use of vitamin A concomitant to VL therapy might improve recovery from disease status in Leishmania infantum infection

Efeito sacietogênico de um novo inibidor de tripsina da paçoca do amendoim com aumento plasmático de colecistocinina (cck)

Obesity is increasing, reaching epidemic levels in many regions of the world. Studies have shown that consumption of peanuts influences on weight control and this influence may be due to the action of trypsin inhibitors sacietogênica that condition increased plasma colescistocinina (CCK). Moreover, the peanut has other health benefits, and these assignments are guaranteed to increase their production and consumption of several of its products, including the paçoca peanut. The aim of this study was to identify the presence of a trypsin inhibitor in paçoca peanut and evaluate its effect on food intake, weight gain and histomorphological changes in swiss mice (n = 8) and Wistar rats (n = 6). Experimental diets were prepared based on the AIN-93G and supplemented with tack or peanut trypsin inhibitor partially purified paçoca peanut (AHTI). After each treatment, the animals were anesthetized and euthanized, their bloods were collected by cardiac puncture for the determination of CCK and other biochemical parameters (glucose, triglycerides, total cholesterol, high density lipoprotein, low density lipoprotein, glutamic-pyruvic transaminase, glutamic oxaloacetic transaminase and albumin) and their pancreas removed for histologic and morphometric analysis. The supplementation with paçoca peanut and the AHTI showed a decrease of body weight gain and food intake in both mice and rats, due to the satiety, since the animals showed no evidence of impairment of nutritional status conditioned by consumption the AHTI. There were also observed biochemical or morphological important when compared with controls. However, AHTI led to increased secretion of CCK, a peptide sacietogênico. Thus, these results indicate that AHTI present in paçoca peanut, is able to enhance the secretion of plasma CCK and thereby reduce the weight gain associated with lower food intake of experimenta animals

Interação competitiva do zinco e ferro após administração oral e venosa de zinco em crianças eutróficas

The aim of this study was to assess the acute and chronic effects of zinc in serum iron profile of children aged 6-9 years in relation to nutritional status and dietary intake. The study participants were 11 children regardless of sex, aged 6-9 years. They were selected from three public schools of the city of Natal, Brazil. Body mass index was used to assess nutritional status. In order to determine the patterns of childhood growth and ideal weight we used the standards of the World Health Organization. The dietary intake assessment was based on information from a three-day prospective food survey. The variables were energy intake, protein, lipids, carbohydrates, fiber, calcium, iron and zinc. All children underwent an intravenous administration of zinc (IVAZn) before and after oral administration of zinc (OAZn) (5 mg Zn / day) for three months. We measured serum iron, hematocrit, hemoglobin and total protein, before and after the use of oral zinc. The analysis of hematocrit, hemoglobin and total protein was performed using standard methods of clinical laboratory. Zinc levels and serum iron were measured by atomic absorption spectrophotometry. The project was evaluated and approved by the Ethics in Research Committee of Federal University of Rio Grande do Norte. Results: All children had normal weight. The consumption of energy, fat, fiber, calcium and iron were below recommended levels. However, the levels of protein and carbohydrates were high. Protein and zinc increased significantly after OAZn. Carbohydrate and protein were elevated in the blood. After OAZn, both protein and zinc increased, being statistically significant. Conclusion: The potential inhibitory effect of physiological or pharmacological doses of zinc on the profile of serum iron was observed in children with healthy weight and aged between 6 and 9 years. This negative effect of zinc did not affect the levels of hematocrit or hemoglobin, and therefore did not cause anemia. This was a multidisciplinary study, involving researchers from medicine, nutrition and pharmacy. This met the requirements of multidisciplinarity of the Post Graduate Program in Health Sciences of Federal University of Rio Grande do Norte.

Associação entre fatores nutricionais e a resposta frente à infecção por Leishmania chagasi

Leishmania chagasi infection presents a wide spectrum of clinical outcomes, ranging from asymptomatic self resolving infection to disease, visceral leishmaniasis (VL). The exact mechanisms that lead the evolution of infection to disease are not understood. It is believed that malnutrition is a risk factor associated with VL development, although there are few human studies in the area. We aimed to assess the nutritional factors associated with the response to L. chagasi infection in Rio Grande do Norte. The study was conducted from December 2006 to January 2008. 149 children were assessed: 20 active VL cases, 33 children with VL history, 40 DTH+ asymptomatic children and 56 DTH-. Nutritional status was assessed using z scores for Weight/Age, Weight/Height, Height/Age, Body Mass Index (BMI), and mid-upper arm circumference/height (MUAC/height). Vitamin A status was determined by serum retinol concentrations and the modified-relative-dose-esponse test (MRDR). Breastfeeding time and birth weight were also evaluated. VL children presented compromised nutritional status when compared to the other groups using BMI and MUAC/age, with means -1,53 ± 1,10 and -1,48 ± 1,28 z scores, respectively (ANOVA, p < 0,05). VL children also showed lower vitamin A levels: 43% presented serum retinol < 20 µg/dL and 15% MRDR > 0,060. Birth weight was inverserly associated with the risk to belong the VL group (β = -0,00; OR = 0,84; 95% CI 0,73 - 0,99; p = 0,047), whereas more breastfeeding time was directly associated with the risk to belong to the DTH+ group (β = 0,02; OD = 1,16; 95% CI 1,01 - 1,33; p = 0,036). The nutritional variables evaluated were associated with the response to the L. chagasi infection, with malnutrition and compromised vitamin A status as markers of children who present with VL. Higher birth weight was associated with protection to disease, and higher breastfeeding time was associated with increased likelihood of an asymptomatic infection. The results show that modifiable nutritional aspects in the study population are associated with the response to the L. chagasi infection

Marcadores nutricionais e inflamatórios e sua associação com a morbimortalidade em hemodiálise

Background: Malnutrition, inflammation and comorbidities are frequent in patients with chronic renal failure in hemodialysis (HD), contributing for morbidity and mortality. Aims: To evaluate the correlation between anthropometric, laboratory parameters, bioelectrical impedance (BIA) and inflammatory markers with the morbidity and mortality of patients in HD, as well as the impact of its alterations throughout 12 months. Methods: 143 patients of a dialysis facility in Northeast Brazil were evaluated throughout 18 months. Patients with more than 3 months on dialysis, older than 18 years, without amputation of hands and feet, were included in the study. We performed a clinical (subjective global assessment - SGA), anthropometric (BMI, percent of ideal weight, MAC, MAMC, MAMA, percent of fat mass and TSF), laboratory (albumin, creatinine, lymphocyte count as nutritional markers and CRP, IL-6 and TNF- as inflammatory markers) evaluation and BIA (reactance, phase angle and percent of body cell mass) at the beginning of study and after 3, 6 and 12 months of follow-up. The association between study variables and deaths and hospitalizations in 6 and 12 months was investigated. The variable with significance < 10% in the univariate analysis had been enclosed in a multivariate logistic regression analysis. We also investigated the risk of mortality and hospitalization associated with differences in measurements of the variables at baseline and six months later. Results: Patients were aged 52.2 ± 16.6 years on the average, 58% were male, and mean dialysis vintage was 5.27 ± 5.12 years. The prevalence of malnutrition varied from 7.7-63.6%, according to the nutritional marker. The variables associated with morbidity and mortality in 6 and 12 months had been creatinine ≤ 9.45 mg/dl, phase angle ≤ 4.57 degrees, BMI ≤ 23 kg/m2, age ≤ 64.9 years, reactance ≤ 51.7 ohms; Charlson´s index ≥ 4 and socioeconomic status ≤ 7. During six months of follow up, decrease in albumin was associated with significantly higher mortality risk. Conclusions: This study detected that the best predictors of morbidity and mortality between nutritional and inflammatory markers are phase angle, reactance, creatinine and BMI and that changes in albumin values over six 107 months provide additional prognostic information. The authors believe that parameters of BIA may detect early changes in nutritional status and emphasize that longitudinal studies with larger number of patients are necessary to confirm these data and to recommend BIA as a routine nutritional evaluation in HD patients

Alterações no metabolismo de zinco relacionadas ao envelhecimento

Although many studies point to alterations in the organic concentrations of zinc in elderly patients, the mechanisms by which aging might cause changes in the metabolism of this nutrient remain unclear. Thus, we assessed the changes in plasma zinc, Zinc Binding Capacity to Plasma Protein (ZnBCPP) and Saturation Index (SI), comparing elderly individuals and young adults. The zinc analyses were performed by atomic absorption spectrophotometry. A statistically significant difference (p < 0.001) was found between the two groups, in relation to plasma zinc and SI, but the ZnBCPP did not differ between the younger and older subjects. In agreement with this result, it was shown in the young group that 76% (R2 = 0.760) of the ZnBCPP variations are explained by the variations in plasma zinc and SI. In the elderly group this measure decreased to 30.5% (R2 = 0.305). We conclude, therefore, that aging may be a factor associated to changes in control mechanisms and in zinc homeostasis, and could even alter ZnBCPP response patterns and other zinc-related indicators of nutritional status.

Estado nutricional antropométrico, perfil lipídico e consumo alimentar como fatores de risco para doença cardiovascular em adolescentes

The dyslipidemia and excess weight in adolescents, when combined, suggest a progression of risk factors for cardiovascular disease (CVD). Besides these, the dietary habits and lifestyle have also been considered unsuitable impacting the development of chronic diseases. The study objectives were: (1) estimate the prevalence of lipid profile and correlate with body mass index (BMI), waist circumference (WC) and waist / height ratio (WHR) in adolescents, considering the maturation sexual, (2) know the sources of variance in the diet and the number of days needed to estimate the usual diet of adolescents and (3) describe the dietary patterns and lifestyle of adolescents, family history of CVD and age correlates them with the patterns of risk for CVD, adjusted for sexual maturation. A cross-sectional study was performed with 432 adolescents, aged 10-19 years from public schools of the Natal city, Brazil. The dyslipidemias were evaluated considering the lipid profile, the index of I Castelli (TC / HDL) and II (LDL / HDL) and non-HDL cholesterol. Anthropometric indicators were BMI, WC and WHR. The intake of energy, nutrients including fiber, fatty acids and cholesterol was estimated from two 24-hour recalls (24HR). The variables of lipid profile, anthropometric and clinical data were used in the models of Pearson correlation and linear regression, considering the sexual maturation. The variance ratio of the diet was calculated from the component-person variance, determined by analysis of variance (ANOVA). The definition of the number of days to estimate the usual intake of each nutrient was obtained by taking the hypothetical correlation (r) ≥ 0.9, between nutrient intake and the true observed. We used the principal component analysis as a method of extracting factors that 129 accounted for the dependent variables and known cardiovascular risk obtained from the lipid profile, the index for Castelli I and II, non-HDL cholesterol, BMI, and WC the WHR. Dietary patterns and lifestyle were obtained from the independent variables, based on nutrients consumed and physical activity weekly. In the study of principal component analysis (PCA) was investigated associations between the patterns of cardiovascular risk factors in dietary patterns and lifestyle, age and positive family history of CVD, through bivariate and multiple logistic regression adjusted for sexual maturation. The low HDL-C dyslipidemia was most prevalent (50.5%) for adolescents. Significant correlations were observed between hypercholesterolemia and positive family history of CVD (r = 0.19, p <0.01) and hypertriglyceridemia with BMI (r = 0.30, p <0.01), with the CC (r = 0.32, p <0.01) and WHR (r = 0.33, p <0.01). The linear model constructed with sexual maturation, age and BMI explained about 1 to 10.4% of the variation in the lipid profile. The sources of variance between individuals were greater for all nutrients in both sexes. The reasons for variances were  1 for all nutrients were higher in females. The results suggest that to assess the diet of adolescents with greater precision, 2 days would be enough to R24h consumption of energy, carbohydrates, fiber, saturated and monounsaturated fatty acids. In contrast, 3 days would be recommended for protein, lipid, polyunsaturated fatty acids and cholesterol. Two cardiovascular risk factors as have been extracted in the ACP, referring to the dependent variables: the standard lipid profile (HDL-C and non-HDL cholesterol) and "standard anthropometric index (BMI, WC, WHR) with a power explaining 75% of the variance of the original data. The factors are representative of two independent variables led to dietary patterns, "pattern 130 western diet" and "pattern protein diet", and one on the lifestyle, "pattern energy balance". Together, these patterns provide an explanation power of 67%. Made adjustment for sexual maturation in males remained significant variables: the associations between puberty and be pattern anthropometric indicator (OR = 3.32, CI 1.34 to 8.17%), and between family history of CVD and the pattern lipid profile (OR = 2.62, CI 1.20 to 5.72%). In females adolescents, associations were identified between age after the first stage of puberty with anthropometric pattern (OR = 3.59, CI 1.58 to 8.17%) and lipid profile (OR = 0.33, CI 0.15 to 0.75%). Conclusions: The low HDL-C was the most prevalent dyslipidemia independent of sex and nutritional status of adolescents. Hypercholesterolemia was influenced by family history of CVD and sexual maturation, in turn, hypertriglyceridemia was closely associated with anthropometric indicators. The variance between the diets was greater for all nutrients. This fact reflected in a variance ratio less than 1 and consequently in a lower number of days requerid to estimate the usual diet of adolescents considering gender. The two dietary patterns were extracted and the pattern considered unhealthy lifestyle as healthy. The associations were found between the patterns of CVD risk with age and family history of CVD in the studied adolescents

Intervenção dietoterápica em portadores de lipodistrofia generalizada congênita do Rio Grande do Norte

Congenital generalized lipodystrophy is a rare genetic disease with autosomal recessive inheritance characterized by the generalized absence of subcutaneous adipose tissue and insulin resistance. The aim of our study was to determine the profile of patients with congenital generalized lipodystrophy (Berardinelli-Seip syndrome) through their clinical history, eating habits, and socioeconomic and cultural aspects; assess food consumption and nutritional status of the study group; propose and evaluate a diet therapy model associated to oral supplementation with zinc to help in the control and prevention of metabolic complications associated to the pathology. Initial assessment of food consumption indicated a voracious appetite in all the patients studied. The introduction of zinc reduced appetite, contributing to patient adherence to the food plan proposed. It was also observed that the proposed diet contributed mainly to glycidic control, specifically with respect to HbA1c. The nutritional status of the patients investigated was adequate in terms of body mass index (BMI), arm muscle circumference (AMC), arm muscle area AMA, but triceps skinfold (TSF) indicated serious malnutrition. Our study is unique in the literature and provides important information to the field of nutrition and to individuals with this pathology. Furthermore, it contemplates the interdisciplinary and multidisciplinary requirements of the Postgraduate Program in Health Sciences of the Federal University of Rio Grande do Norte (UFRN), Natal, Brazil

Impacto da variabilidade de peso no controle matebólico de pacientes transplantados cardíacos

Heart transplantation (HT) represents one of the greatest advances in medicine over the last decades. It is indicated for patients with severe heart disease unresponsive to clinical treatment and conventional surgery, poor short-term prognosis and a 1- year mortality rate over 40%. HT has improved survival worldwide (80% in the first year, 70% in five years and 60% in ten years). However, the procedure has been associated with weight change and increased risk of secondary conditions such as diabetes, hypertension, dyslipidemia and obesity due to immunosuppressive therapy following transplantation. The objective of this study was to determine the impact of weight change on the metabolic stability of HT patients. The study was retrospective with data collected from the records of 82 adult patients (83% male; average age 45.06±12.04 years) submitted to HT between October 1997 and December 2005 at a transplantation service in Ceará (Brazil). The selected outcome variables (biopathological profile, weight and body mass index―BMI) were related to biochemical and metabolic change. The results were expressed in terms of frequency, measures of central tendency, Student s t test and Pearson s correlation coefficients. The analysis showed that following HT the average global BMI increased from 23.77±3.68kg/m2 to 25.48±3.92kg/m2 in the first year and to 28.38±4.97kg/m2 in the fifth. Overweight/obese patients (BMI ≥ 25 kg/m2) had higher average levels of glucose, total cholesterol, low-density lipoprotein and triglycerides than patients with eutrophy/malnutrition (BMI < 25 kg/m2). In conclusion, overweight/obese patients were likely to present higher average levels of glucose, triglycerides, total cholesterol and fractions than patients with eutrophy/malnutrition, indicating a direct and significant relation between nutritional status and weight change in the metabolic profile of HT patients

Avaliação do estado nutricional relativo ao selênio e da expressão gênica de selenoproteínas em pacientes com aterosclerose tratados com estatinas

The aim of this study was to determine the effects of the use of rosuvastatin in patients with atherosclerosis, in relation to blood parameters of selenium and selenoproteins, and also observe possible changes in gene expression of selenoproteins in these patients. The sample consisted of 27 adult and elderly patients with a clinical diagnosis of coronary artery disease undergoing angioplasty, treated at Natal Hospital Center hospital, Natal, RN. Patients were treated with rosuvastatin 10 mg/day during four months. Anthropometric variables such as body mass index (BMI) and Waist circumference (WC) were measured before and after treatment, as well as lipid profile, blood glucose and liver enzymes (AST and ALT). The diet of the patients was also analyzed using 24-hour diet recall. We analyzed the concentrations of selenium in plasma and erythrocytes, and also the activity of Glutathione Peroxidase and gene expression by Real Time PCR of selenoproteins GPx1, SelP1 and SelN1. Patients had mean age of 61.0 ± 9.4 years, 59.3% were men and 40.7% were women. After four months of treatment there was significant reduction of CA and, according to BMI, most were overweight. The intake of macronutrients, cholesterol, polyunsaturated fatty acids, monounsaturated and saturated was adequate, but the energy and fiber intake was below the recommendations. Regarding the selenium intake was observed a high prevalence of inadequacy. As expected, after treatment with rosuvastatin, a significant reduction in total cholesterol, LDL and glucose, which was not observed for HDL. Selenium concentrations in plasma and erythrocytes showed no changes, keeping within the established cutoffs. We observed a significant increase in GPx enzyme activity and mRNA expression of GPX1 and SEPN1, but not for gene SEPP1. Thus, it was found that treatment with rosuvastatin did not reduce the expression of selenoproteins. More studies are needed to clarify the effects of rosuvastatin on gene expression of selenoproteins in patients with atherosclerosis

Produção pesqueira artesanal: diagnóstico ergonômico e bases para um planejamento nutricional situado e a promoção da saúde dos jangadeiros

The traditional fishing with rafts is characterized by unpredictability, high stakes and inadequate work conditions. The extensive working hours, physical wear, inadequate nutrition, unsanitary conditions, lack of salvage equipment and instruments suitable working, added by the presence of changes in the nutritional status of fisherman, that contribute to the picture of insecurity in high seas, injuries and health. This study aimed to analyze the activity of the fisherman s from Ponta Negra, Natal / RN, and check the conditions of supply of these fishermen and their implications on health and development of their work. To this finality, was used a methodology based on the ergonomic work analysis employing techniques such as observational and interactional conversational action, listening to the answers, observation protocols, photographic and video records. The script conversational dynamic action was developed from literature searches about the artisanal fisheries, culture and food habits of this population, and analyzes the overall situation of focus and two reference situations. To collect data on the usual diet of fisherman as well as quantitative and qualitative analysis that was used for data analysis and 24h recall the Food Frequency Questionnaire (FFQ). The impact of this power to the health of fisherman was evaluated performing a nutritional assessment. The results revealed that the fishermen carry out their activities with poor working conditions, health and nutrition. Feeding practices of these fishermen undertake development work, making it even more stressful, as well contributing to the emergence of Chronic Noncommunicable Diseases. The management of the activity, as well as the current structure of the vessel, also contributes to the adoption of inappropriate feeding practices during the shipment of catch. The results of this indicate the need for adequate interventions in order to assist in recovery and / or maintenance of health of fisherman minimizing reflections of nutritional disorders for the development activity by improving the quality of life in this population

Prevalência e fatores associados ao risco e a desnutrição em idosos institucionalizados

One of the most important problems in the elderly is a nutritional deficiency. Several physiological changes and the use of multiple drugs interfere with appetite, food intake and absorption of nutrients, which can lead to the risk and malnutrition in the elderly, especially among institutionalized. The present study aimed to evaluate the prevalence of malnutrition and risk for malnutrition and its associated factors in institutionalized elderly. The same can be characterized by the type individual, observational and cross-sectional. Obtaining the sample was through the records of individuals of long-stay institutions for the elderly in the city of Natal, RN. The elderly were evaluated through the Mini Nutritional Assessment (MNA) and triceps skinfold (TSF) and each senior or caregiver answered a questionnaire about information like type and dietary restrictions, accessibility to food, use of alcohol and tobacco, practice physical activity and appetite. Variables such as age, gender, education, marital status, time that the elderly living in the institution, the reason for the institutionalization and comorbidities were taken from the records of each senior. The frequency of food consumption of various food groups was assessed from the questionnaire frequency of feeding study Health, Wellbeing and Aging (HWA). Data were presented as means and standard deviations, absolute and relative frequencies. To analyze the frequency of consumption, there was a factor analysis with extraction of factors from the principal components analysis with varimax rotation. A bivariate analysis was performed using the chi-square and the magnitude of the effect observed by prevalence ratio (95% CI). The Poisson regression assessed the net effect of independent variables on the two outcomes, considering a significance level of 5%. We studied twelve Homes for the Aged totaling 381 seniors eligible for the study. The prevalence of risk of malnutrition was 46.1% (45.9 to 46.2) and malnutrition was 31.4% (31.2 to 31.5). The risk of malnutrition was significantly associated with the presence of urinary incontinence (RP = 1.444, 1.113 to 1.874) was associated with malnutrition and lack of appetite (RP = 1.757, 1.246 to 2.476), the fact that the individuals do not have access to food outside the institution (RP = 0.565, 0.337 to 0.946), low water consumption (RP = 1.646, 1.101 to 2.459) and dementia (PR = 1.537, 1.072 to 2.204). The high prevalence of malnutrition and risk of malnutrition in the study suggests that we should pay attention to information related to eating habits and the presence of comorbidities, as these can influence the nutritional status of this population

Prevalência da síndrome metabólica e seus componentes nos estágios pubertários de escolares do sexo feminino norte-rio-grandenses

The diagnosis of nutritional status is extremely re levant in clinical practice and population assessment, due to the association betwe en body fat and metabolic alterations. The aim of this study is to analyze th e prevalence of metabolic syndrome (MS) and its components in the pubertal stages of f emale students in Rio Grande do Norte state, Brazil, in accordance with Internation al Diabetes Federation criteria. This is a cross-sectional study with 449 students aged betw een 8 and 19 years, stratified into pubertal stages systematized by Marshal and Tanner (1969), as follows: 27.6% prepubertal, 44.3% pubertal and 28.1% postpubertal, with mean ages of 9.4±1.27, 12.4±2.23 and 15.1±1.88 years, respectively. Preval ences were analyzed using distribution of frequencies and their respective 95 % confidence intervals, while the chi- square test and odds ratio were applied to analyze the associations between variables. The general prevalence of MS was 3.3% (CI: 2% - 5%) , without occurrences in the prepubertal stage, observing that it emerges from t he pubertal stage onwards with a prevalence of 2.5% (CI 95% 0.1% - 5%), 1% (CI 95% 0.4% - 2.3%) of cases with overweight and 1.5% (CI 95% -0.1% - 3.2%) with obes e individuals, while in the postpubertal stage the prevalence is 7.9% (CI 95% 3 .2% - 12.6%), 0.8% (CI 95% -0.8% - 2.3%) normal weight cases, 4% (CI 95% 0.6% - 7.4% ) overweight and 3.1% (CI 0.1% - 6.2%) obese individuals. There was an association (p<0.02) between pubertal stages and MS ( x 2 =5.2), with an OR of 3.3 (CI: 1.2 - 5), showing tha t postpubertal adolescents are more prone to SM than pubertals, while the OR i n obese individuals was 2.1 (CI: 2– 2.2) compared to the overweight. Body mass index (B MI) ( x 2 = 29.4; p<0.001) and age range ( x 2 = 13.1; p<0.001) showed a significant linear assoc iation with MS. Of the adolescents with MS, those aged ten years or younge r exhibited higher %G. The most prevalent components in all the stages were altered waist circumference (27.2% [CI 23% - 31%]) and low HDL cholesterol (39.6% [CI 35% – 44%]), which, coupled with hypertension, displayed significant differences in the postpubertal stage in relation to the other stages. The results show that MS emerges from the pubertal stage onwards in proportion to excess childhood body fat, a fact tha t calls for prevention strategies using an educational approach, reducing the large demand on the National Health System. Keywords: Metabolic syndrome, pubertal stages, risk factors.

A influência da perda de peso no perfil inflamatório de mulheres com síndrome dos ovários policísticos

The polycystic ovary syndrome (PCOS) is considered the most common endocrine disorder in reproductive age women, with a prevalence ranging from 15 to 20%. In addition to hormonal and reproductive changes, it is common in PCOS the presence of risk factors for developing cardiovascular disease (CVD) and diabetes mellitus, insulin resistance (IR), visceral obesity, chronic low-grade inflammation and dyslipidemia. Due to the high frequency of obesity associated with PCOS, weight loss is considered as the first-line treatment for the syndrome by improving metabolic and normalizes serum androgens, restoring reproductive function of these patients. Objectives: To evaluate the inflammatory markers and IR in women with PCOS and healthy ovulatory with different nutritional status and how these parameters are displayed after weight loss through caloric restriction in with Down syndrome. Methods: Tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6) and C-reactive protein (CRP) were assessed in serum samples from 40 women of childbearing age. The volunteers were divided into four groups: Group I (not eutrophic with PCOS, n = 12); Group II (not eutrophic without PCOS, n = 10), Group III (eutrophic with PCOS, n = 08) and Group IV (eutrophic without PCOS, n = 10). The categorization of groups was performed by body mass index (BMI), according to the World Health Organization (WHO) does not eutrophic, overweight and obesity (BMI> 25 kg / m²) and normal weight (BMI <24.9 kg / m²). IR was determined by HOMA-IR index. In the second phase of the study a controlled dietary intervention was performed and inflammatory parameters were evaluated in 21 overweight and obese women with PCOS, before and after weight loss. All patients received a low-calorie diet with reduction of 500 kcal / day of regular consumption with standard concentrations of macronutrients. Results: Phase 1: PCOS patients showed increased levels of CRP (p <0.01) and HOMAIR (p <0.01). When divided by BMI, both not eutrophic group with PCOS (I) as eutrophic with PCOS (III) showed increased levels of CRP (I = 2.35 ± 0,55mg / L and 2.63 ± III = 0,65mg / L; p <0.01) and HOMA-IR (I = 2.16 ± 2.54 and III = 1.07 ± 0.55; p <0.01). There were no differences in TNF-α and IL-6 between groups. Step 2: After the weight loss of 5% of the initial weight was reduced in all of the components of serum assessed inflammatory profile, PCR (154.75 ± 19:33) vs (78.06 ± 8.9) TNF α (10.89 ± 5.09) vs (6:39 ± 1:41) and IL6 (154.75 ± 19:33) vs (78.06 ± 08.09) (p <0:00) in association with improvement some hormonal parameters evaluated. Conclusion: PCOS contributed to the development of chronic inflammation and changes in glucose metabolism by increasing CRP, insulin and HOMA-IR, independent of nutritional status. The weight loss, caloric restriction has improved the inflammatory condition and hormonal status of the evaluated patients.