Analysis of criteria for metabolic syndrome in a population-based study of Japanese-Brazilians

Objective: Criteria for metabolic syndrome (MS) differ particularly regarding the definition of central obesity and consequently, there could be differences in the assessment of cardiovascular risk. We estimated the prevalence of metabolic syndrome, compared the agreement of the World Health Organization (WHO) criteria with the standard and a modified National Cholesterol Education Program (NCEP) criterion and investigated whether additional factors were associated with the diagnosis of the syndrome in a Japanese descendant population.Methods: In this cross-sectional, population-based survey, 1166 Japanese-Brazilians (533 men, 633 women) aged 57.4 +/- 12.4 years with mean body mass index (BMI) and waist of 25.2 +/- 4.0 kg/m(2) and 84.5 +/- 10.6 cm, respectively, were included. McNemar and kappa statistics were used to assess the concordance between WHO criteria with the standard and a modified NCEP criteria (waist of 90 and 80 cm, for men and women, respectively). in logistic regression analysis, a number of metabolic variables and albumin-to-creatinine ratio were included to test independent associations with metabolic syndrome defined by the modified NCEP criteria.Results: According to WHO, 55.4% (95% Cl 52.5-58.2%) of the subjects had MS and to NCEP 47.4% (95% Cl 44.6-50.0%). WHO criterion detected 48.3% of central obese subjects while NCEP only 14.0%. Kappa statistics showed a good strength of agreement (k = 0.67, p < 0.01) between WHO and NCEP standard definitions of MS. Using the modified NCEP criterion for Asians, more subjects with metabolic syndrome were identified (58%) and agreement with WHO was improved (k = 0.72, p < 0.001). However, similar Framingham risk scores were attributed to the subsets of subjects classified by any of the three criteria. Areas under the receiver operating characteristic curves, obtained for the modified waist values to diagnose metabolic syndrome according to WHO, were > 0.80 and corresponded, respectively, to sensitivity and specificity of 63 and 83% for men and 77 and 72% for women. In final logistic regression model, age, male sex, BMI and homeostasis model assessment-insulin resistance but not with albumin-to-creatinine ratio (ACR) were independently associated with the syndrome.Conclusions: High prevalence of MS, independent of the criterion considered, was found in this Japanese-Brazilian population. The replacement of waist cutoff by those proposed by WHO for Asians lead to this diagnosis in a higher number of subjects with elevated cardiovascular risk. Our data did not support that ACR should be included in the classical definition of MS in Japanese descendants as previously suggested by WHO.

Subtropical Cyclones over the Southwestern South Atlantic: Climatological Aspects and Case Study

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Um estudo de caso de eventos atmosféricos severos no estado de São Paulo no ano de 2005

Nos últimos anos, têm se notado a grande preocupação com relação às condições climáticas do planeta e suas implicações. As discussões sobre as mudanças climáticas têm se tornado cada vez mais relevantes à medida que as adversidades climáticas têm implicações diretas na sociedade. Neste contexto, o objetivo deste trabalho foi identificar e avaliar episódios atmosféricos severos ocorridos no Estado de São Paulo no ano de 2005, elaborando posteriormente o estudo de caso do tornado ocorrido na cidade de Indaiatuba (SP). No levantamento sobre o evento atmosférico levou-se em conta a condição atmosférica que o originaram, além dos impactos ambientais e sócio-econômicos do fenômeno na sua região de abrangência. Para isso foram realizados levantamentos bibliográficos mais completos possíveis sobre o assunto, utilizando revistas credenciadas em âmbito nacional ou internacional. Logo após esta etapa foram coletados os dados de estações meteorológicas e dados atmosféricos como vento, temperatura, pressão disponibilizados pelo (NCEP) National Centers for Environmental Prediction. Estes dados atmosféricos disponibilizados pelo (NCEP) foram avaliados e analisados para a caracterização do episódio atmosférico e o cruzamento de informações por meio dos (SIGs) Sistema de Informação Geográfica, referentes à dinâmica atmosférica e topografia. A interpretação de todos os dados gerados relacionados e suas implicações no contexto ambiental e sócio-econômico está organizada em forma de uma síntese na redação final.

Influência da composição corporal e da síndrome metabólica sobre a relação da aptidão cardiorrespiratória com o estresse inflamatório

Physical activity is associated with lower cardiovascular disease risk factors, being cardiorespiratory fitness a major component of physical activity health related. Body fatness and sarcopenia are related to sedentary lifestyle leading to proinflammatory stress and lower cadiorespiratory capacity. This study aimed correlates C-reactive protein with cardiorespiratory fitness, analyzing the influences of anthropometrics variables and metabolic syndrome (MS) presence. the cross-sectional retrospective study included baseline data of 194 adults (62 male and 132 female), 53,74 ± 8,77 years, clinically and ethically selected for a lifestyle modification program. Total cholesterol (TC) and cholesterol lipoprotein fractions, triglycerides (TG) and glucose was dosed by dry chemistry (Vitros® system, Johnson & Johnson). Blood leukocytes was quantified by automatic cell counter (Coulter ABX®, Horiba). LDL-cholesterol was obtained by Friedwald formula. Serum ultrasensitive C-reactive protein (US-CRP) was accessed by the immunochemoluminescence method (Immulite 2000®, DPC Medlab). Weight, height, body mass index (BMI) and waist circumference (WC) were measured. Muscular mass and fat mass were obtained by bioelectrical impedance analysis (impedancemeter Quantum BIA-101Q®, Clinton Township). Arterial blood pressure was checked by auscultatory method and cardiorespiratory fitness was determined by ergoespirometric test (Balke protocol). The metabolic syndrome was diagnosed according NCEP – ATP III (2001), following recommendations of American Diabetes Association (2004). Pearson’s correlation crude and adjusted for confounders variables with p<0,05. The prevalence of MS was 30.4%. Crude correlation shows hsCRP was correlated inverse and significantly with VO2max (r= -0.21; p=-0.003) ...(Complete abstract click electronic access below)

Prevalence of dyslipidemia in adolescents: comparison between definitions

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

BRAZILIAN OFFSHORE WAVE CLIMATE BASED ON NWW3 REANALYSIS

This paper provides a description of the wave climate off the Brazilian coast based on an eleven-year time series (Jan/1997-Dec/2007) obtained from the NWW3 operational model hindcast reanalysis. Information about wave climate in Brazilian waters is very scarce and mainly based on occasional short-term observations, the present analysis being the first covering such temporal and spatial scales. To define the wave climate, six sectors were defined and analyzed along the Brazilian shelf-break: South (W1), Southeast (W2), Central (W3), East (W4), Northeast (W5) and North (W6). W1, W2 and W3 wave regimes are determined by the South Atlantic High (SAH) and the passage of synoptic cold fronts; W4, W5 and W6 are controlled by the Intertropical Convergence Zone (ITCZ) and its meridional oscillation. The most energetic waves are from the S, generated by the strong winds associated to the passage of cold fronts, which mainly affect the southern region. Wave power presents a decrease in energy levels from south to north, with its annual variation showing that the winter months are the most energetic in W1 to W4, while in W5 and W6 the most energetic conditions occur during the austral summer. The information presented here provides boundary conditions for studies related to coastal processes, fundamental for a better understanding of the Brazilian coastal zone.

Representation of the Weddell Sea deep water masses in the ocean component of the NCAR-CCSM model

We examine Weddell Sea deep water mass distributions with respect to the results from three different model runs using the oceanic component of the National Center for Atmospheric Research Community Climate System Model (NCAR-CCSM). One run is inter-annually forced by corrected NCAR/NCEP fluxes, while the other two are forced with the annual cycle obtained from the same climatology. One of the latter runs includes an interactive sea-ice model. Optimum Multiparameter analysis is applied to separate the deep water masses in the Greenwich Meridian section (into the Weddell Sea only) to measure the degree of realism obtained in the simulations. First, we describe the distribution of the simulated deep water masses using observed water type indices. Since the observed indices do not provide an acceptable representation of the Weddell Sea deep water masses as expected, they are specifically adjusted for each simulation. Differences among the water masses` representations in the three simulations are quantified through their root-mean-square differences. Results point out the need for better representation (and inclusion) of ice-related processes in order to improve the oceanic characteristics and variability of dense Southern Ocean water masses in the outputs of the NCAR-CCSM model, and probably in other ocean and climate models.

Influence of salinity on the interannual heat storage trends in the Atlantic estimated from altimeters and Pilot Research Moored Array in the Tropical Atlantic data

Changes in the oceanic heat storage (HS) can reveal important evidences of climate variability related to ocean heat fluxes. Specifically, long-term variations in HS are a powerful indicator of climate change as HS represents the balance between the net surface energy flux and the poleward heat transported by the ocean currents. HS is estimated from sea surface height anomaly measured from the altimeters TOPEX/Poseidon and Jason 1 from 1993 to 2006. To characterize and validate the altimeter-based HS in the Atlantic, we used the data from the Pilot Research Moored Array in the Tropical Atlantic (PIRATA) array. Correlations and rms differences are used as statistical figures of merit to compare the HS estimates. The correlations range from 0.50 to 0.87 in the buoys located at the equator and at the southern part of the array. In that region the rms differences range between 0.40 and 0.51 x 10(9) Jm(-2). These results are encouraging and indicate that the altimeter has the precision necessary to capture the interannual trends in HS in the Atlantic. Albeit relatively small, salinity changes can also have an effect on the sea surface height anomaly. To account for this effect, NCEP/GODAS reanalysis data are used to estimate the haline contraction. To understand which dynamical processes are involved in the HS variability, the total signal is decomposed into nonpropagating basin-scale and seasonal (HS(l)) planetary waves, mesoscale eddies, and small-scale residual components. In general, HS(l) is the dominant signal in the tropical region. Results show a warming trend of HS(l) in the past 13 years almost all over the Atlantic basin with the most prominent slopes found at high latitudes. Positive interannual trends are found in the halosteric component at high latitudes of the South Atlantic and near the Labrador Sea. This could be an indication that the salinity anomaly increased in the upper layers during this period. The dynamics of the South Atlantic subtropical gyre could also be subject to low-frequency changes caused by a trend in the halosteric component on each side of the South Atlantic Current.

Prevalência e fatores associados à síndrome metabólica em usuários de unidades básicas de saúde em São Paulo - SP

OBJETIVO: Determinar a relação da síndrome metabólica (SM) com o nível socioeconômico, hábitos comportamentais, condições de saúde, antecedentes familiares de morbidades e áreas de residência. MÉTODOS: Trata-se de um estudo de corte transversal. A amostra aleatória foi constituída por usuários de duas Unidades Básicas de Saúde da cidade de São Paulo - Jardim Comercial (UBS1) e Jardim Germânia (UBS2) -, totalizando 452. Para o diagnóstico de SM utilizou-se o critério do Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (NCEP-ATP III). Na avaliação antropométrica foram aferidas medidas de peso, estatura, circunferências abdominal e do quadril. Foi utilizado questionário geral para obtenção de dados sociodemográficos, socioeconómicos, antecedentes familiares e pessoais de morbidades, hábitos comportamentais como tabagismo, etilismo e nível de atividade física. Foi estabelecida associação entre as variáveis explicativas de interesse e SM, empregando-se a regressão logística multivariada. RESULTADOS: Na UBS1, o percentual de SM foi de 56,1% e na UBS2, de 34,0%. Houve associação direta e significativa entre SM e idade, sexo feminino, cor, tabagismo, etilismo, nível de atividade física, estresse e antecedentes familiares de doença cardíaca e de diabetes mellitus. A escolaridade apresentou associação inversa: morar no bairro de menor nível socioeconómico aumentou a chance de SM. CONCLUSÃO: Os resultados sugerem que as morbidades que compõem a SM são um grave problema de saúde pública nessa população.

THE ASSOCIATION BETWEEN CHILDHOOD ADVERSITY AND COMPONENTS OF METABOLIC SYNDROME IN ADULTS WITH MOOD DISORDERS: RESULTS FROM THE INTERNATIONAL MOOD DISORDERS COLLABORATIVE PROJECT

Objective: We sought to determine whether a reported history of childhood adversity is associated with components of the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP-III)-defined metabolic syndrome in adults with mood disorders. Method: This was a cross-sectional analysis of adult outpatients (N = 373; n = 230 female, n = 143 male; mean age [SD] = 42.86 [14.43]) from the International Mood Disorders Collaborative Project (University of Toronto and Cleveland Clinic) with DSM-IV-defined major depressive disorder and bipolar I/II disorder. Childhood adversity was measured with the Klein Trauma & Abuse-Neglect self-report scale. The groups with and without childhood adversity were compared to determine possible differences in the rates of metabolic syndrome and its components. Logistic and linear regressions adjusted for age, sex, education, employment status, and smoking were used to evaluate the association between childhood adversity and components of metabolic syndrome. Results: For the full sample, 83 subjects (22.25%) met criteria for metabolic syndrome. Individuals reporting a history of any childhood adversity had higher systolic and diastolic blood pressure (systolic: p = 0.040; diastolic: p = 0.038). Among subjects with a history of sexual abuse, a significant proportion met criteria for obesity (45.28% vs. 32.88%; p = 0.010); a trend toward overweight was found for subjects with a history of physical abuse (76.32% vs. 63.33%; p = 0.074), although this relationship did not remain significant after adjusting for potential confounders. There was no statistically significant difference in the overall rate of dyslipidemia and/or metabolic syndrome between subjects with and without childhood adversity. Conclusion: The results herein provide preliminary evidence suggesting that childhood adversity is associated with metabolic syndrome components in individuals with mood disorders. Int'l. J. Psychiatry in Medicine 2012;43:165-177)

Prevalence of the metabolic syndrome using two proposed definitions in a Japanese-Brazilians community

Metabolic Syndrome (MetS) is associated with increased risk of morbi-mortality, thus the characterization of the population magnitude of this syndrome is critical for allocating health care. However, prevalence estimates of MetS in the same population could differ depending on the definition used. Therefore, we compared the prevalence of the MetS using definitions proposed by: National Cholesterol Education Panel Revised (NCEP) and International Diabetes Federation (IDF) 2009 in a Japanese-Brazilians community (131 individuals, age 57 ± 16 years, 1st and 2nd generation). All individuals went through a clinical and laboratorial evaluation for assessment of weigh, height, waist circumference, blood pressure, triglycerides, HDL-cholesterol and fasting plasma glucose. The prevalence of MetS was 26.7% (n = 35) and 37.4% (n = 49) under the NCEP and IDF definitions, respectively. Despite higher blood pressure measurements, waist circumference and serum triglyceride levels and lower HDL cholesterol levels (p < 0.01), individuals identified with MetS did not show increased blood glucose levels. IDF definition classified 14 individuals (10.7%) with MetS that were not classified under the NCEP and 35 individuals were identified with MetS by both criteria. We observed, in this group, more severe lipid disorders, compared to individuals identified only under the IDF definition, and the BMI and waist circumference (p = 0.01; p = 0.006, respectively) were lower. In conclusion, the IDF revised criteria, probably because of the ethnic specific values of waist circumference, was able to identify a larger number of individuals with MetS. However, our data suggesting that additional studies are necessary to define best MetS diagnostic criteria in this population.

Componentes da síndrome metabólica na hipertensão arterial

Este estudo teve como objetivo identificar e comparar a prevalência da síndrome metabólica entre hipertensos e normotensos. Os aspectos adotados para a definição de síndrome metabólica foram os definidos pelo National Cholesterol Education Program/Adults Treatment Painel (NCEP-ATP III). Os dados referentes aos perfis clínicos e bioquímicos foram processados no programa SPSS para cálculo de frequências absolutas e porcentagens. Utilizou-se o teste t de Student para comparações das médias, sendo as diferenças consideradas estatisticamente significantes para p<0,05. A amostra foi composta por 93 participantes normotensos e 168 hipertensos. Identificou-se a presença de síndrome metabólica em 60,7% dos hipertensos e 18,3% dos normotensos. Os portadores de hipertensão arterial apresentam diferença significante nos valores de pressão arterial (p<0,001), circunferência abdominal (p<0,001), glicemia (p<0,05) e triglicérides plasmáticos (p<0,05). A frequência dos riscos cardiometabólicos associados à síndrome metabólica é maior na presença de doença hipertensiva.

Efeito do detalhamento dos ventos na modelagem de agitação marítima no oeste do Atlântico Sul

Neste trabalho foram feitas simulações numéricas de ondas de gravidade da superfície do mar, utilizando o modelo WAVEWATCH-III versão 1.18 sobre o Atlântico, com a finalidade de avaliar a importância do detalhamento dos ventos para diferentes estados de mar. O domínio escolhido foi delimitado pelos paralelos 18ºS e 45ºS, e pelos meridianos 035ºW e 070ºW, de modo que o centro do domínio ficasse sobre o litoral do RS. Para cada evento, foram inseridos ventos oriundos do modelo de mesoescala RAMS (grade de 0,34º x 0,284º e saída temporal a cada hora) e oriundos do modelo global do NCEP (grade de 2,5º x 2,5º e saída temporal a cada 6 horas), no intuito de verificar a influência das escalas na geração de ondas de superfície do mar. Notou-se que nos eventos extremos, as simulações superestimaram as alturas das ondas. Foi verificado também, que as integrações, alimentadas por dados da Reanálise do NCEP, foram as mais discrepantes dos valores observados in situ, se comparados com os valores resultantes da simulação com os ventos oriundos do modelo RAMS. O comportamento mais preciso dos casos RAMS evidenciou a importância dos fenômenos de mesoescala para a geração dos trens de ondas; ou seja, das ondas que se propagam em grupo. Na ocorrência de calmaria, as ondas foram subestimadas, sendo então levantadas duas linhas de ação: a primeira de ampliar o domínio escolhido, pois esse padrão parece estar associado a ondulações geradas em uma região ainda mais remota e a segunda, iniciar o WW3 com um campo de onda mais realístico.

Análise climatológica da precipitação e do transporte de umidade na região da ZCAS através da nova geração de reanálises

O conhecimento do desempenho das reanálises e dos erros associados a elas apresenta um papel fundamental na compreensão dos processos físicos que ocorrem na atmosfera. Este trabalho tem por objetivo documentar as principais características da precipitação associada à Zona de Convergência do Atlântico Sul (ZCAS), baseado em seis conjuntos de reanálises atmosféricas (MERRA, ERA-Interim, ERA-40, NCEP 1, NCEP 2 e NCEP CFSR) e cinco conjuntos de produtos observados de precipitação (SALDAS, CPC, CMAP, GPCP e GLDAS). Através destes dados também foi analisado o transporte de umidade sobre a região da ZCAS, para os anos de 1979 a 2007. Em resumo, este trabalho evidencia o avanço das novas reanálises na tentativa de representar de forma mais adequada a variável precipitação acumulada. Os diagramas de Taylor mostram que os produtos de precipitação estão bem correlacionados com o ponto de referência (CPC), com coeficientes entre 0,6 e 0,9. Somente a reanálise do NCEP CFSR possui correlações próximas as dos produtos de precipitação. Os conjuntos mais antigos de reanálises apresentam correlações menores, abaixo de 0,6. O Oceano Atlântico é a fonte principal do fluxo de umidade para a direção da ZCAS, que diminui na direção do continente. Na Região SE do Brasil, a topografia tem um papel importante para a convergência de umidade. Já na parte noroeste da ZCAS, este fator deve estar associado a processos termodinâmicos.

Wind-driven cross-equatorial flow in the Indian ocean

Máster en Oceanografía