Metabolic syndrome and dietary components are associated with coronary artery disease risk score in free-living adults: a cross-sectional study

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Associação das concentrações plasmáticas de proteína C-reativa com fatores de risco e componentes da síndrome metabólica e comorbidades

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Efeito da participação e do desligamento de programa de mudança no estilo de vida sobre o nível de atividade e aptidão física, percepção de saúde e presença de síndrome metabólica em adultos da comunidade de Botucatu - SP

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Risco de Farmingham e evento cardiovascular em mulheres com síndrome dos ovários policísticos

Pós-graduação em Ginecologia, Obstetrícia e Mastologia - FMB

Impact of Glucocorticoid Receptor Gene Polymorphisms on the Metabolic Profile of Adult Patients with the Classical Form of 21-Hydroxylase Deficiency

Background: CAH patients have an increased risk of cardiovascular disease, and it remains unknown if lifelong glucocorticoid (GC) treatment is a contributing factor. In the general population, glucocorticoid receptor gene (NR3C1) polymorphisms are associated with an adverse metabolic profile. Our aim was to analyze the association between the NR3C1 polymorphisms and the metabolic profile of CAH patients. Methodology: Sixty-eight adult patients (34SV/34SW) with a mean age of 28.4 +/- 9 years received dexamethasone (mean 0.27 +/- 0.11 mg/day) to obtain normal androgen levels. SW patients also received fludrocortisone (50 mu g/day). Metabolic syndrome (MetS) was defined by the NCEP ATPIII criteria and obesity by BMI >= 30 kg/m(2). NR3C1 alleles were genotyped, and association analyses with phenotype were carried out with Chi-square, t-test and regression analysis. Results: Obesity and MetS were observed in 23.5% and 7.3% of patients, respectively, and were not correlated with GC doses and treatment duration. BMI was positively correlated with blood pressure (BP), triglycerides (TG), LDL-c levels and HOMA-IR and inversely correlated with HDL-c levels. BclI and A3669G variants were found in 26.4% and 9.6% of alleles, respectively. Heterozygotes for the BclI polymorphism presented with higher BMI (29 kg/m(2) +/- 5.3 vs. 26 kg/m(2) +/- 5.3, respectively) and waist circumference (89 cm +/- 12.7 vs. 81 cm +/- 13, respectively) compared to wild-type subjects. Hypertension was found in 12% of patients and heterozygotes for the BclI polymorphism presented higher systolic BP than wild type subjects. Low HDL-c and high TG levels were identified in 30% and 10% of patients, respectively, and were not associated with the NR3C1 polymorphisms. A3669G carriers and non-carriers did not differ. Conclusion: In addition to GC therapy, the BclI GR variant might play an important role in obesity susceptibility in CAH patients. Genotyping of GR polymorphisms could result in the identification of a subgroup at risk patients, allowing for the establishment of personalized treatment and the avoidance of long-term adverse consequences.

Caracterização de eventos extremos do nível do mar em Santos e sua correspondência com as reanálises do modelo do NCEP no sudoeste do Atlântico Sul

Este trabalho tem como objetivo identificar a influência atmosférica em escala sinótica sobre o oceano, para eventos extremos de maré meteorológica na costa sudeste brasileira. Para isso foram utilizados dados de elevação do nível do mar do Porto de Santos-SP, campos de vento e pressão em superfície das reanálises do modelo do NCEP abrangendo o Atlântico Sul, no período de 1951 a 1990. Foi possível identificar a variabilidade sazonal e o padrão de evolução dos sistemas atmosféricos associados aos eventos extremos, de grande relevância para aplicações em prognósticos e alertas a autoridades. O outono e inverno apresentaram a maior ocorrência de extremos positivos (40,2 % e 30,8 % respectivamente), enquanto a primavera e o inverno foram as estações com maior número de extremos negativos (47,2 % e 32,3 % respectivamente). Os resultados mostram que os casos mais importantes de sobre-elevação do nível do mar ocorrem com a evolução e persistência de sistemas de baixa pressão sobre o oceano, com ventos de sudoeste acima de 8 m/s, juntamente com o anticiclone da retaguarda posicionado sobre o continente.

Prevalência de síndrome metabólica diagnosticada pelos critérios NCEP-ATP III e IDF em pacientes em hemodiálise

Introdução: A Síndrome Metabólica (SM) tem alta prevalência em hemodiálise (HD) e é fator de risco para doenças cardiovasculares, que são a principal causa de mortalidade na doença renal crônica (DRC). Objetivo: Analisar a frequência do diagnóstico de SM em pacientes em hemodiálise e a diferença na prevalência segundo os critérios do NCEPATP III e do IDF. Métodos: Pacientes de duas clínicas de Fortaleza, com tempo de diálise superior a 3 meses e idade maior ou igual a 18 anos, foram submetidos à medição da circunferência abdominal, pressão arterial (PA), dosagens de glicose, triglicerídeos e HDL-colesterol em jejum. Resultados: Foram incluídos 115 pacientes e a prevalência de SM foi de 41,7% segundo o NCEP-ATP III e de 42,6% segundo o IDF. Entre os 48 pacientes com diagnóstico de SM, de acordo com NCEP-ATP III, 87,5% foram diagnosticados pelo IDF. Entre os 67 pacientes não portadores de SM pelo NCEP-ATP III, 89,5% também não foram diagnosticados pelo IDF. As variáveis da SM segundo o NCEP que tiveram maior prevalência foram o HDL-col alterado em 83,4% dos pacientes e a PA alterada ou uso de anti-hipertensivos em 81,3%. Conclusão: A frequência de SM na população em estudo foi elevada, independentemente do critério utilizado. As variáveis que mais contribuíram para o diagnóstico de SM foram a dislipidemia e a PA. A avaliação rotineira do diagnóstico de SM em HD deve ser implementada, uma vez que pacientes em diálise com SM tem aumento do número de hospitalizações e do risco de eventos cardiovasculares.

The mean evolution and variability of the Asian summer monsoon: Comparison of ECMWF and NCEP-NCAR reanalyses

The behavior of the Asian summer monsoon is documented and compared using the European Centre for Medium-Range Weather Forecasts (ECMWF) Reanalysis (ERA) and the National Centers for Environmental Prediction-National Center for Atmospheric Research (NCEP-NCAR) Reanalysis. In terms of seasonal mean climatologies the results suggest that, in several respects, the ERA is superior to the NCEP-NCAR Reanalysis. The overall better simulation of the precipitation and hence the diabatic heating field over the monsoon domain in ERA means that the analyzed circulation is probably nearer reality. In terms of interannual variability, inconsistencies in the definition of weak and strong monsoon years based on typical monsoon indices such as All-India Rainfall (AIR) anomalies and the large-scale wind shear based dynamical monsoon index (DMI) still exist. Two dominant modes of interannual variability have been identified that together explain nearly 50% of the variance. Individually, they have many features in common with the composite flow patterns associated with weak and strong monsoons, when defined in terms of regional AIR anomalies and the large-scale DMI. The reanalyses also show a common dominant mode of intraseasonal variability that describes the latitudinal displacement of the tropical convergence zone from its oceanic-to-continental regime and essentially captures the low-frequency active/break cycles of the monsoon. The relationship between interannual and intraseasonal variability has been investigated by considering the probability density function (PDF) of the principal component of the dominant intraseasonal mode. Based on the DMI, there is an indication that in years with a weaker monsoon circulation, the PDF is skewed toward negative values (i,e., break conditions). Similarly, the PDFs for El Nino and La Nina years suggest that El Nino predisposes the system to more break spells, although the sample size may limit the statistical significance of the results.

The prediction of extratropical storm tracks by the ECMWF and NCEP ensemble prediction systems

The prediction of extratropical cyclones by the European Centre for Medium Range Weather Forecasts (ECMWF) and the National Centers for Environmental Prediction (NCEP) Ensemble Prediction Systems (EPS) has been investigated using an objective feature tracking methodology to identify and track the cyclones along the forecast trajectories. Overall the results show that the ECMWF EPS has a slightly higher level of skill than the NCEP EPS in the northern hemisphere (NH). However in the southern hemisphere (SH), NCEP has higher predictive skill than ECMWF for the intensity of the cyclones. The results from both EPS indicate a higher level of predictive skill for the position of extratropical cyclones than their intensity and show that there is a larger spread in intensity than position. Further analysis shows that the predicted propagation speed of cyclones is generally too slow for the ECMWF EPS and show a slight bias for the intensity of the cyclones to be overpredicted. This is also true for the NCEP EPS in the SH. For the NCEP EPS in the NH the intensity of the cyclones is underpredicted. There is small bias in both the EPS for the cyclones to be displaced towards the poles. For each ensemble forecast of each cyclone, the predictive skill of the ensemble member that best predicts the cyclones position and intensity was computed. The results are very encouraging showing that the predictive skill of the best ensemble member is significantly higher than that of the control forecast in terms of both the position and intensity of the cyclones. The prediction of cyclones before they are identified as 850 hPa vorticity centers in the analysis cycle was also considered. It is shown that an indication of extratropical cyclones can be given by at least 1 ensemble member 7 days before they are identified in the analysis. Further analysis of the ECMWF EPS shows that the ensemble mean has a higher level of skill than the control forecast, particularly for the intensity of the cyclones, 2 from day 3 of the forecast. There is a higher level of skill in the NH than the SH and the spread in the SH is correspondingly larger. The difference between the ensemble mean and spread is very small for the position of the cyclones, but the spread of the ensemble is smaller than the ensemble mean error for the intensity of the cyclones in both hemispheres. Results also show that the ECMWF control forecast has ½ to 1 day more skill than the perturbed members, for both the position and intensity of the cyclones, throughout the forecast.

A Tropospheric Assessment of the ERA-40, NCEP, and JRA-25 Global Reanalyses in the Polar Regions

The reliability of the global reanalyses in the polar regions is investigated. The overview stems from an April 2006 Scientific Committee on Antarctic Research (SCAR) workshop on the performance of global reanalyses in high latitudes held at the British Antarctic Survey. Overall, the skill is much higher in the Arctic than the Antarctic, where the reanalyses are only reliable in the summer months prior to the modern satellite era. In the Antarctic, large circulation differences between the reanalyses are found primarily before 1979, when vast quantities of satellite sounding data started to be assimilated. Specifically for ERA-40, this data discontinuity creates a marked jump in Antarctic snow accumulation, especially at high elevations. In the Arctic, the largest differences are related to the reanalyses depiction of clouds and their associated radiation impacts; ERA-40 captures the cloud variability much better than NCEP1 and JRA-25, but the ERA-40 and JRA-25 clouds are too optically thin for shortwave radiation. To further contrast the reanalyses skill, cyclone tracking results are presented. In the Southern Hemisphere, cyclonic activity is markedly different between the reanalyses, where there are few matched cyclones prior to 1979. In comparison, only some of the weaker cyclones are not matched in the Northern Hemisphere from 1958-2001, again indicating the superior skill in this hemisphere. Although this manuscript focuses on deficiencies in the reanalyses, it is important to note that they are a powerful tool for climate studies in both polar regions when used with a recognition of their limitations.

A comparison of extra-tropical cyclones in recent re-analyses; ERA-Interim, NASA MERRA, NCEP CFSR and JRA-25

Extra-tropical cyclones are identified and compared using data from four recent re-analyses for the winter periods in both hemispheres. Results show the largest differences occur between the older lower resolution JRA25 re-analysis when compared with the newer high resolution re-analyses, in particular in the Southern Hemisphere (SH). Spatial differences between the newest re-analyses are small in both hemispheres and generally not significant except some common regions associated with cyclogenesis close to orography. Intensities are generally related to spatial resolution except NASA-MERRA which has larger intensities for several different measures. Matching storms between re-analyses shows the number matched between ERA-Interim and the other re-analyses are similar in the Northern Hemisphere (NH). In the SH the number matched between JRA25 and ERA-Interim is lower than in the NH, but for NASA-MERRA and NCEP-CFSR the number matched is similar to the NH. The mean separation of the identically same cyclones is typically less than 20 geodesic in both hemispheres for the latest re-analyses, whereas JRA25 compared with the other re-analyses has a broader distribution in the SH indicating greater uncertainty. The instantaneous intensity differences for matched storms shows narrow distributions for pressure while for winds and vorticity the distributions are much broader indicating larger uncertainty typical of smaller scale fields. Composite cyclone diagnostics show that cyclones are very similar between the re-analyses, with differences being related to the intensities, consistent with the intensity results. Overall, results show NH cyclones correspond well between re-analyses, with a significant improvement in the SH for the latest re-analyses, indicating a convergence between re-analyses for cyclone properties.

Decadal Variabilities and Trends in the Southwest Atlantic in a model forced with NCEP Reanalysis from 1960 to 2012

Analysis of the NCAR/NCEP Reanalysis show changes in the atmospheric circulation in the Southern hemisphere, with a strengthening and poleward displacement of the westerlies. Because the wind is one of the main sources of the ocean's kinetic energy, a numerical experiment with the Hybrid Coordinate Ocean Model (HYCOM) was forced with monthly means of the NCAR/NCEP Reanalysis products to investigate the effects of the changes in the wind on the ocean circulation in a geographical domain defined by 98W – 114E; 65S – 60N. The results show good agreement with other models and with available satellite data. In the western sector of the South Atlantic there are several indications of changes such as a poleward displacement of the Brazil-Malvinas Confluence and positive trends in temperature and salinity of the southwestern region of the subtropical gyre

Decadal Variabilities and Trends in the Southwest Atlantic in a model forced with NCEP Reanalysis from 1960 to 2012

Analysis of the NCAR/NCEP Reanalysis show changes in the atmospheric circulation in the Southern hemisphere, with a strengthening and poleward displacement of the westerlies. Because the wind is one of the main sources of the ocean's kinetic energy, a numerical experiment with the Hybrid Coordinate Ocean Model (HYCOM) was forced with monthly means of the NCAR/NCEP Reanalysis products to investigate the effects of the changes in the wind on the ocean circulation in a geographical domain defined by 98W – 114E; 65S – 60N. The results show good agreement with other models and with available satellite data. In the western sector of the South Atlantic there are several indications of changes such as a poleward displacement of the Brazil-Malvinas Confluence and positive trends in temperature and salinity of the southwestern region of the subtropical gyre.