Metabolic Syndrome – ABC CARDIOL

IJCS

ORIGINAL ARTICLE

Physical-Functional Profile of Obese Individuals With or Without Metabolic Syndrome Classified by Cardiovascular Risk

Daniela Barreto de Moraes et al. Vanessa Kelly da Silva Lage Joyce Noelly Vitor Santos Jaqueline de Paula Chaves Freitas … Ana Carolina Barbosa Farnezi Gabriele Teixeira Gonçalves Maria Thereza Otoni Figueiró Tamara Cunha Thyago José Silva Jousielle Márcia dos Santos Elizabethe Adriana Esteves Alessandro Sartorio Redha Taiar Ana Cristina Rodrigues Lacerda Vanessa Amaral Mendonça

Abstract

Background:

Obesity is strongly associated with increased cardiovascular risk (CVR) and the development of metabolic syndrome (MS), conditions that negatively affect body composition, metabolic profile, and functional capacity. CVR stratification may contribute to a better understanding of these alterations and to the development of early intervention strategies.

Objectives:

To evaluate the physical–functional profile of obese individuals with and without MS, classified according to CVR, and to compare biochemical, body composition, and functional parameters among these groups.

Methods:

This cross-sectional study included 212 obese individuals allocated into four groups: control with low CVR (CLR, n = 63), control with intermediate/high CVR (CHR, n = 33), MS with low CVR (SLR, n = 55), and MS with intermediate/high CVR (SHR, n = 61). Body composition, blood metabolic parameters, and functional performance were assessed using sit-to-stand tests. Group comparisons were performed using one-way ANOVA or Kruskal–Wallis tests, followed by Tukey’s or Dunn’s post hoc tests, with significance set at p < 0.05.

Results:

MS was present in 54.7% of the sample, and approximately 44% exhibited intermediate/high CVR. The CLR group showed lower visceral adiposity and waist circumference (WC) values (p 0.05).

Conclusions:

Individuals with lower CVR showed better sit-to-stand performance, while poorer performance was observed in participants with MS, particularly when associated with higher CVR. Sit-to-stand tests may provide useful complementary information for assessing physical performance in this population.

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Original Article

Assessment of Cardiovascular-Metabolic Risk in Wistar Rats Fed a Hypercaloric Diet Supplemented with Selenium: A Preclinical Animal Study

Matheus Von Jelita Salina et al. Vitor Hugo Moro Pironatto André Amaro Mamédio dos Santos Tiago Daniel Gueiber … Luiz Gustavo Lima Eduardo Machado Dechandt Camila Cury Caruso Pedro Henrique Karpinski Thiago Martins Figueiredo Alceu de Oliveira Toledo-Junior Camila Marinelli Martins Ricardo Zanetti Gomes

Abstract

Background:

Residual cardiovascular risk persists even with adequate serum LDL-c control through statins, possibly due to dysfunctions in serum triglycerides and HDL-c. Elevated TG and reduced HDL-c are associated with metabolic syndrome and cardiovascular diseases. The TG/HDL-c ratio may predict these risks. Selenium, an antioxidant cofactor, may modulate these alterations, especially in diets that dysregulate serum lipid metabolism.

Objectives:

To evaluate the effects of selenium supplementation on the cardiometabolic risk (CMR) of Wistar rats exposed to a high-fat hyperglycemic diet (HHD).

Methods:

For 11 weeks, 55 female Wistar rats were divided into the following five groups: standard diet (SD), SD + _ContinuousSe, HHD, HHD + _LateSe, and HHD + _EarlySe. Selenium was supplemented using sodium selenite (1 mg/kg). We performed one-way ANOVA, Kruskal–Wallis, and post hoc tests, adopting a significance level of p < 0.05.

Results:

Total cholesterol increased in HHD + _LateSe compared to SD (p = 0.032) and to HHD (p = 0.013). HDL-c increased in HHD + _LateSe compared to SD (p = 0.004) and to HHD (p = 0.008). LDL-c increased in HHD + _LateSe compared to HHD (p = 0.008). TG decreased in HHD + _LateSe (p = 0.006) and in HHD + _EarlySe (p = 0.016) compared to SD. TG/HDL-c ratio decreased in HHD + _LateSe compared to SD (p < 0.001) and SD + _ContinuousSe (p = 0.013); and in HHD + _EarlySe compared to SD (p = 0.005).

Conclusion:

Selenium supplementation showed potential to increase HDL-c and reduce TG, key diagnostic components of metabolic syndrome. It also demonstrated potential to lower the TG/HDL-c ratio, a possible predictor of CMR, in rats fed HHD. Further studies are needed in subjects with high CMR and statin use to better define the clinical response to this therapy.

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Original Article

Analysis of the Prevalence of Metabolic Syndrome and NCEP ATP III Criteria in Older People

João Pedro de Sousa Palmeira et al. Mateus Cardoso Oliveira Emille Silva Santos Renata Sigler … Lorena Andrade Nunes Cézar Augusto Casotti

Abstract

Background:

Metabolic syndrome (MS) is a cluster of conditions, including hypertension, dyslipidemia, and abdominal obesity, associated with increased cardiovascular risk. In the elderly population, the prevalence of MS varies widely depending on region, lifestyle, and diagnostic criteria. Understanding the components that contribute most to MS can aid in targeted health interventions.

Objective:

This study aimed to investigate the prevalence of MS and identify which components most influence its diagnosis among older adults.

Methods:

This is an epidemiological, cross-sectional study conducted from January to December 2022, with people aged 60 or over, of both sexes. Data were obtained in three steps (interviews, clinical examinations, and laboratory tests). Data were entered in duplicate and analyzed using PAST software. The criteria and cutoff points adopted to diagnose MS were those proposed by NCEP ATP III.

Results:

This study evaluated 127 older people, 63% female. The prevalence of MS was 40%, and the most prevalent component was arterial hypertension. Hypertriglyceridemia, waist circumference, and high blood glucose were the components of MS that contributed to 68.2% of the diagnosis of this condition.

Conclusions:

The prevalence of MS was high in the population assessed. Hypertension was the most prevalent component, and hypertriglyceridemia was the component that most explained it.

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Original Article

Correlation of Diagnostic Components of Metabolic Syndrome with Electrocardiographic and Echocardiographic Alterations in Patients with Obesity

Alan Souza da Luz et al. João Gabriel da Costa Ramos Carolina Heitmann Mares Azevedo Ribeiro Roberto Márcio de Oliveira Júnior … Antônio Carmo da Costa Siqueira Neto Ralf Cardoso Mudesto Oliveira

Abstract

Introduction:

Metabolic syndrome (MS) and obesity are risk factors for cardiovascular diseases (CVD). However, the development of cardiovascular pathologies in obese individuals without MS is being investigated.

Objective:

To investigate whether there are similar electrocardiographic (ECG) and echocardiographic changes in individuals with obesity with and without MS.

Methodology:

A retrospective, descriptive cross-sectional study was carried out with obese patients at a university hospital in Belém, Pará, Brazil. Anthropometric, laboratory, ECG and echocardiographic data were evaluated in both populations. The chi-square test was used to describe the relationship between variables among groups; hypothesis tests with p < 0.05 were considered statistically significant values.

Results:

The study evaluated 100 individuals with obesity, 60 of whom had MS. The average age was 54 years, and the female sex was prevalent. Systolic blood pressure, HDL, and waist circumference were altered in both groups. Systemic arterial hypertension and low HDL demonstrated 4.27 times and 3.32 times greater likelihood of presenting changes in the ECG and echocardiogram for both groups. On the ECG, diffuse changes in ventricular repolarization were observed in both groups. On echocardiography, left ventricular diastolic dysfunction and left ventricular hypertrophy were present in both populations studied.

Conclusion:

Obese individuals without MS present a similar risk, requiring adequate attention to their cardiac health.

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Editorial

Increased Circulating Fetuin-A Levels in Patients With Atrial Fibrillation: Are We Really There?

Claudia da Silva Fragata

Fetuin-A is a protein almost exclusively secreted by the liver. Circulating fetuin-A levels are elevated in humans with metabolic syndrome and insulin resistance, conditions that are associated with increased risk of cardiovascular disease. Fetuin-A is a natural inhibitor of the insulin-stimulated insulin receptor tyrosine kinase and was shown to induce insulin resistance in rodents.^, Studies in humans have demonstrated that circulating fetuin-A levels are positively associated with fat accumulation in the liver, insulin resistance, and metabolic syndrome. To our knowledge, the potential association between fetuin-A and atrial fibrillation (AF) has not been studied to date. Therefore, the present study aimed to determine circulating fetuin-A levels in AF patients and revealed that higher plasma fetuin-A levels were associated with AF after adjustments for some confounding factors.

Fetuin-A seems to be involved in many normal and pathological processes, such as in response to systemic inflammation, hepatocyte-growth-factor activity and regulation of insulin activity, inhibition of unwanted mineralization, osteogenesis, and bone resorption.

[…]

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Original Article

Association of Dietary Inflammatory Potential in Metabolically Healthy and Metabolically Unhealthy Obese Individuals

Lara Ribeiro Pinto et al. Luciana Nicolau Aranha Ronir Raggio Luiz Gláucia Maria Moraes de Oliveira Glorimar Rosa

Abstract

Introduction:

Currently, two types of phenotypes have been recognized in individuals who are obese. Among the factors related to lifestyle, diet has a relevant influence, although there is no consensus regarding the role of diet in metabolic phenotypes; furthermore, diet is a strong moderator of chronic systemic inflammation.

Objective:

Investigate dietary inflammatory potential between metabolic phenotypes and to compare the differences between anti-inflammatory and pro-inflammatory diets in individuals with the same phenotype.

Methods:

This is a cross-sectional observational study that utilized the database of 533 individuals divided into 4 groups, according to metabolic phenotype and dietary inflammatory characteristic. Sociodemographic, clinical, anthropometric and biochemical characteristics were evaluated and the inflammatory index of the diet was calculated.

Results:

The mean Dietary Inflammatory index (DII) of the total sample was 0.974±1.02, with a maximum of 4.34 and a minimum of −1.74. In the metabolically unhealthy groups, we found a statistical difference in relation to systolic blood pressure when comparing the anti-inflammatory [median 120 (110.0-130.0)] and pro-inflammatory diets [median 130 (120.0-140.0); p = 0.022], and mean isoprostane concentrations were lower in the metabolically healthy group with anti-inflammatory diet. In regression analysis, the only variable that demonstrated a higher risk of alterations in all groups when compared to the metabolically healthy and anti-inflammatory group were isoprostane concentrations.

Conclusion:

We are able to conclude that an anti-inflammatory diet is associated with lower oxidative stress in metabolically healthy obese, and a pro-inflammatory diet is associated with higher systolic blood pressure values.

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Review Article

One Size Does Not Fit All: The Need to Rethink the Metabolic Syndrome in Women

Maria Cristina Costa de Almeida et al. Marildes Luiza Castro Larissa Espíndola Neto Luciana Nicolau Aranha … Thaís Salim Gláucia Maria Moraes de Oliveira

Abstract

Metabolic syndrome (MetS) is increasing at epidemic proportions worldwide. MetS and its components are frequent among Brazilian women (41.8%). Women are affected by changes in adipose tissue distribution, lipid profile, insulin resistance (IR), and vascular remodeling during their lives. These changes result from the lack of estrogen after menopause. There have been various attempts to propose a uniform origin for the clustering of the MetS components, including genetics, IR, obesity, lifestyle, sleep disturbances, inflammation, fetal and neonatal programming, and disturbed circadian rhythm of the body functions. The proinflammatory and prothrombotic state in MetS is well-defined. Socioeconomic and lifestyle-related factors are also essential triggers of MetS, which is associated with a higher risk for coronary artery diseases (CAD) and stroke in women. Population measures in health and community medicine, such as continuing education on the importance of lifestyle change to reduce cardiovascular risks from early childhood, are fundamental strategies. Statins reduce high-sensitivity C-reactive protein blood levels and treat high cholesterol. According to the patient, hypoglycemic agents, such as dipeptidyl peptidase-4 (DPP-4) inhibitors, glucagon-like peptide-1(GLP-1a), and sodium-glucose transport protein 2 (SGLT2) inhibitors, in addition to metformin, have their indication due to their beneficial cardiometabolic and vascular effects. Angiotensin-converting enzyme inhibitor (ACEI) and angiotensin-receptor blocker (ARB) should be the first choice to treat hypertension in postmenopausal womem. The recognition of the different gender- and age-specific risk factors, allowing for specific and targeted interventions, is fundamental, especially for women.

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Original Article

Food Consumption and Health Outcomes in Women During the COVID-19 Pandemic

Mariana Barbosa Lopes et al. Luciana Nicolau Aranha Lara Ribeiro Pinto Paula Critina Moreira dos Santos Lino … Ronir Raggio Luiz Gláucia Maria Moraes de Oliveira Glorimar Rosa

Abstract

Background

The COVID-19 pandemic has changed food consumption.

Objective

Evaluate the association between metabolic phenotypes, changes in food consumption during the pandemic, and health outcomes in obese women.

Methods

Cross-sectional observational study including 491 women without previous diagnosis of chronic diseases, evaluated according to metabolic phenotype. During the pandemic, a subsample was re-evaluated by online questionnaires via Google Forms. Analyzed anthropometric, biochemical, and dietary data as well as health outcomes (coronary artery disease, type 2 diabetes, hypertension, dyslipidemia or death). Information on mortality was collected from the Internal Affairs Office of the State of Rio de Janeiro and the Health Department of the State of Rio de Janeiro. Statistical analysis was performed using the statistical program SPSS 21, with Mann-Whitney test, Pearson’s chi-squared, Spearman correlation, and binary logistic regression, at a significance level of 5%.

Results

The anthropometric, glucose, and lipid profiles showed significant differences between the metabolically healthy and metabolically unhealthy groups (p = 0.00). Before the pandemic, women in the metabolically unhealthy group had higher dietary intakes of lipids (p = 0.01), saturated fat (p = 0.01) and sodium (p = 0.04), during the pandemic, they consumed more energy (p = 0.04), lipids (p = 0.02), saturated fat (p = 0.02), proteins (p = 0.03) and sodium from ultra-processed foods (p = 0.03). Consequently, health outcomes were more prevalent in the metabolically unhealthy group (p = 0.00).

Conclusion

Observed that metabolically healthy women had qualitatively better food intake and fewer health outcomes throughout the study.

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Editorial

Does Gluten Decrease (or Increase) Metabolic Syndrome Risk?

Sérgio Girão Barroso et al. Caroline Luiza Codonho Castro

Overall, weight gain and obesity are consequences of chronic energy imbalance, in which energy intake exceeds energy expenditure and leads to excessive energy (fat) storage. If gluten is a causative factor for weight gain, the underlying mechanisms remain unknown, and studies on non-coeliac individuals are scarce. Over recent years, gluten free diet (GFD) has become popular as books and social media have suggested that gluten consumption causes overweight and metabolic syndrome (MS) parameters. However, data supporting such statement are often feeble and questionable.

Firstly, due to its gluten content, wheat has likely been one of the most maligned foods over the past years. Nonetheless, whole wheat products are held as a good source of indigestible dietary fiber and other bioactive components. Avoiding wheat consumption could thus be associated with decreasing fiber and other beneficial constituents in the diet, and increasing glycemic index. Currently, three conditions require treatment with GFD: wheat allergy, non-coeliac gluten-sensitivity, and coeliac disease (CD).^,

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Review Article

Does a Gluten-free Diet Improve Metabolic Syndrome Parameters? A Systematic Review

Luciana Gonçalves Orange et al. Maria Izabel Siqueira de Andrade Cybelle Rolim Lima Keila Fernandes Dourado … Thayná Menezes Santos Marina Moraes Petribu Priscilla Regia de Andrade Calaça Silvia Alves Silva

Abstract

To review scientific evidence on the effects of a gluten-free diet on body composition and improvement of clinical and biochemical parameters of metabolic syndrome. The Preferred Reporting Items for Systematic Reviews and Meta-Analyzes – PRISMA guidelines were followed. A literature search was performed in the PubMed, ScienceDirect, Trip Database, Bireme and Scielo databases, without language restriction, until March 2021. The terms “gluten-free diet”, “obesity”, “metabolic syndrome”, and “weight loss”, and Boolean operators (AND/OR) were used. The clinical hypothesis was structured according to the acronym PICOT. Randomized clinical trials with adult and elderly humans without a diagnosis of celiac disease, consuming a gluten-free diet, evaluating associations of the effects of this diet on weight loss and metabolic syndrome components were considered eligible. To assess the risk of bias, the RoB2 was used. A total of 3,198 articles were identified and, after the screening and evaluation of pre-defined eligibility criteria, four studies were included in the qualitative analysis. Weight loss was not associated with a gluten-free diet. However, individuals under a gluten-free diet had lower mean waist circumference, fat percentage (-2.3%) and serum triglyceride levels. The impact of a gluten-free diet on metabolic syndrome parameters is still controversial. In individuals without gluten sensitivity or celiac disease, the consumption of a gluten-free diet appears to provide no nutritional benefit.

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Original Article

Analysis of the Influence of Abdominal Obesity on Systemic Arterial Hypertension and on the Lipid Profile on Cardiometabolic Risk Stratification in Adult Women

Iury Matheus Lima Cavalcanti et al. Cristian Rodrigues do Nascimento Pedro Pereira Tenório Tiago Ferreira da Silva Araújo

Abstract

Background:

Obesity is a public health problem and has been associated with the development of metabolic disorders that have a strong relationship with the onset of cardiovascular diseases (CVD).

Objective:

The objective was to analyze the influence of abdominal obesity (AO) on systemic arterial hypertension (SAH) and on the lipid profile in cardiovascular risk stratification in adult women.

Methods:

Altogether, 91 women participated in the research. Lifestyle information was collected, in addition to the analysis of clinical measures of cardiovascular risk and biochemical parameters. Unpaired Student’s t-test, logistic regression, and Pearson’s correlation were performed for data analysis, with a value of p <0.05 considered significant.

Results:

The prevalence of AO was 62.6%. Logistic regression showed that AO increased the chance of developing SAH by 2.9-fold. The same behavior was observed in the TG/HDL-c lipid ratio (3.93 ± 0.3 vs. 2.16 ± 0.2), representing an 82% increase in obese women. The present study also demonstrated that the best anthropometric parameter to analyze cardiovascular risk in the studied population was the waist/height ratio (AUC = 0.707).

Conclusions:

It can therefore be concluded that AO plays a significant role in the development of SAH and changes in lipid values that predict increased cardiovascular risk, configuring a strong influence factor for CVD.

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Original Article

Cardiovascular Risk Factors in Haul Truck Operators of the Mining Sector Working a Rotational Schedule

Rafaela Aparecida Mendonça Marques et al. Priscila Pena Camargo Gabriela Guerra Leal Souza Graziela Dutra Rocha Gouvea … Virgínia Capistrano Fajardo Raimundo Marques do Nascimento Neto André Luis Silva Fernando Luiz Pereira de Oliveira

Abstract

Background:

Due to the growing concern about work-related social and health aspects, occupational health and safety has become relevant.

Objective:

This work aims to develop a model to assist cardiovascular risk management in a team of haul truck operators, who work in rotating shifts at a mining company in Brazil.

Methods:

This longitudinal study evaluated risk factors for cardiovascular diseases of 191 mineworkers at three times points – 2010, 2012, and 2015. In addition, the risk of developing cardiovascular diseases was calculated, and the risk factors were analyzed using the chi-square test, the U Mann-Whitney test, and binary logistic regression. The significance level was set at 5%.

Results:

In the study period, body weight, body mass index (BMI), waist-to-height ratio (WHR), systolic (SBP), and diastolic blood pressure (DBP), total cholesterol, high-density lipoprotein cholesterol (HDL-C), and triglycerides levels of the study group increased. In 2015, there was a high prevalence of alcohol intake, overweight or obesity, central obesity, inadequate WHR, high blood pressure, total cholesterol above 190 mg/dL, and triglycerides above 150 mg/dL. An association was identified between increased cardiovascular risk and age, SBP, HDL-C, low-density lipoprotein cholesterol (LDL-C), and elevated glucose levels.

Conclusion:

Intense interventions for reduction and prevention of elevated alcohol intake, blood pressure levels, WHR, metabolic syndrome, blood glucose, and LDL-C levels, and low HDL-C levels are needed. In addition, a close monitoring of mine workers over 38 years of age who smoke, consume alcoholic beverages, and have altered blood glucose levels is important.

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Editorial

Abdominal Subcutaneous Adipose Tissue, Diet, and Risk of Cardiovascular Disease: What do we Know?

Camila Weschenfelder et al. Penny M. Kris-Etherton

Excess adiposity increases the risk of cardiovascular disease (CVD) due to dyslipidemia, systemic inflammation and other risk factors. The distribution of body fat depots, and central adiposity in particular, is related to cardiometabolic diseases. The different adipose tissue depots in the body, ie, epicardial adipose tissue, visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT), have different biochemical characteristics and produce unique biologically active molecules that affect normal and pathological processes related to CVD risk.^, Abdominal SAT is classified as superficial or deep. Deep subcutaneous adipose tissue (DSAT) has a higher ratio of saturated to monounsaturated fatty acids, and, consequently, is more saturated than superficial subcutaneous adipose tissue (SSAT). Despite being in the subcutaneous compartment, DSAT differs from VAT because of differences in gene transcription, having different metabolic functions than SSAT.

In Acute Coronary Syndrome (ACS) patients, coronary plaque instability is related to abnormal abdominal fat distribution. Analyses of the abdominal fat distribution of ACS patients have demonstrated that both VAT and SAT are positively correlated with vessel and plaque volumes, but not with plaque tissue components, the fibrous and lipid content of plaque. However, considering coronary plaque characteristics, a higher VAT/SAT ratio was independently associated with a higher percentage of plaque lipid content, with a lower percentage of fibrous volumes and a thinner fibrous cap thickness, characteristics that define greater plaque rupture vulnerability and a high risk for coronary events.

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Original Article

Metabolic Syndrome and Risk of Cardiovascular Diseases in Female Breast Cancer Survivors

Leandro Marque da Silva et al. José Albuquerque de Figueiredo Neto

Abstract

Background

The implementation of intensive therapy protocols increases the probability of adverse events in patients with breast cancer (BC). Components of metabolic syndrome (MS) are among these events.

Objective

To verify the prevalence of MS and cardiovascular disease (CVD) risk in female BC survivors.

Materials and Methods

This is a descriptive, observational, cross-sectional study. Our sample comprised 60 women without BC (G1) and 60 women who had survived BC (G2). We collected sociodemographic, anthropometric, tumor, and clinical data. After variable analysis, the participants received positive or negative MS diagnoses and a 10-year CVD risk stratification. The significance level adopted for the analyses was 5% ( p < 0.05) and the confidence interval (CI) was 95%. For comparing categorical data, we used the chi-squared, Fisher’s exact, or G tests; for comparing continuous data, we used the parametric Student’s t-test and the non-parametric Mann-Whitney test.

Results

Both groups presented overweight and an increased waist-to-hip ratio. Weight, body mass index, abdominal circumference, hip circumference, and low-density cholesterol were variables that presented statistically significant differences between groups. MS was diagnosed in 32% of women in G1 and 45% of those in G2. Regarding the 10-year risk for CVD, most women were in the low-risk stratum: the mean total risk of CVD occurrences was 7.48% in G1 and 7.70% in G2.

Conclusion

We observed a higher prevalence of MS among women who survived BC, possibly due to overweight, as well as a low 10-year risk for CVD after cancer treatment. Although we did not observe a statistically significant difference, we suggest the adoption of a healthy lifestyle and rigorous control of cardiometabolic risk factors.

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Editorial

Epicardial Fat Thickness: a Promising Cardiovascular Risk Factor that Requires in-Depth Studies

Roberto M. Saraiva et al. Andréa Rodrigues da Costa

This issue of the International Journal of Cardiovascular Sciences presents a paper by Castanheira et al. that addresses epicardial fat (EF) thickness in an elderly Portuguese population. They describe the mean values of EF thickness and its correlation with anthropometric, echocardiographic, and clinical variables in these individuals.

EF is the visceral adipose tissue located between the myocardium and the visceral pericardium, and commonly found in the atrioventricular and interventricular grooves. EF has several physiological roles, including local effects on the heart, in a paracrine manner.^– EF can be measured non-invasively by echocardiography, and the measurement of EF thickness by 2D echocardiography has been proposed as a surrogate for visceral fat, since it is easier to perform as compared with direct measures such as computed tomography and magnetic resonance imaging (MRI). In addition, a significant correlation between EF and visceral fat measurements by MRI was demonstrated.

[…]

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Editorial

Metabolic Syndrome

Elizabete Viana de Freitas et al. Kalil Lays Mohallem

Introduction

Metabolic Syndrome (MS) is a complex disorder characterized by a group of Risk Factors (RF), including changes in glycemic levels, insulin resistance, lipid profile, blood pressure levels and central obesity (visceral adipose tissue – VAT), which increase the incidence of cardiovascular diseases often associated with ageing.

It is estimated to affect over 20% of the global adult population, and women are at greater risk. Central (visceral) obesity is thought to be the predominant RF for MS, especially among overweight and low-educated elderly.

[…]

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Original Article

Dietary Fat Intake and its Association with Adiposity and Inflammatory Markers in Individuals at Cardiometabolic Risk

Fernanda Santos Fortes et al. Alinne Paula de Almeida Carla de Oliveira Barbosa Rosa Brenda Kelly Souza Silveira … Nínive de Almeida Reis Helen Hermana Miranda Hermsdorff

Abstract

Background

Fatty acids are important components of diet that may influence the development of CVD.

Objective

To verify the relationship of dietary fatty acids with cardiometabolic markers in individuals at the cardiometabolic risk.

Methods

This cross-sectional study involved 282 subjects (116 M/166 F, 42 ± 16 years) attended the Cardiovascular Health Care Program, Universidade Federal de Viçosa (Brazil). Anthropometric and body composition measurements as well as metabolic and inflammatory markers were assessed by standard procedures. Demographic and lifestyle variables were obtained by semi-structured questionnaire. Food consumption was evaluated by 24h recall. Student’s t-test or Mann-Whitney-U test and chi-square test were used, considering the statistical significance level of 5% probability.

Results

Individuals who eaten fat, fatty acids saturated and fatty acids polyunsaturated above recommendation (> 35, 7%, and 10% of caloric intake) were more likely to be overweight (p < 0.05). Those individuals with higher intake of medium-chain fatty saturated acids (≥ 1.05 g/d) had lower values (p < 0.05) of body mass index, waist circumference, waist-hip ratio and waist-height ratio and higher values (p < 0.05) of total leukocytes, C-reactive protein and total cholesterol, and LDL. Subjects with higher of palmitoleic acid intake (≥ 0.94 g/d) presented higher values of BMI, fat percentage and HOMA-IR (p < 0.05).

Conclusion

This cross-sectional study found different associations of dietary fat and cardiometabolic risk related to adiposity and inflammatory markers, according with chain-size and saturation, indicating the need the more detailed on the dietary assessment of obese patients to identify risk factors and established best strategies to control. (Int J Cardiovasc Sci. 2020; [online].ahead print, PP.0-0)

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Editorial

Obesity: A Risk Marker or an Independent Risk Factor for Coronary Artery Disease?

Tufi Dippe Jr et al. Rodrigo Julio Cerci

We congratulate Pereira et al. for their study investigating the role of obesity as a risk factor for coronary artery disease (CAD) using coronary computed tomography angiography. The study included 1,383 patients, none with a history of CAD.

Obesity is a multifactorial chronic disease, characterized by accumulation of subcutaneous and visceral fat, that predisposes individuals to metabolic disorders. Several mechanisms are involved in the association between obesity and atherosclerosis, including lipid abnormalities, insulin resistance, chronic inflammation, endothelial dysfunction, reduction of fibrinolysis and hypercoagulability. In addition, the production of proinflammatory cytokines, such as IL-6, TNF-alpha, MCP-1 and leptin contributes to chronic subclinical inflammation. More recent data have indicated that impaired autophagy and altered gut microbiome homeostasis are contributing factors for the development of atherosclerosis in obese individuals.

[…]

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Original Article

Association between Central Obesity and Biochemical Markers of Cardiometabolic Risk in Elderly Attended in Geriatric Ambulatory – Lagarto/SE

Ana Caroline de Souza Almeida et al. Carolina Cunha de Oliveira Emanuelle Dias Costa Adenilda Queiroz S Deiró

Abstract

Backgroud:

Central obesity, especially visceral adipose tissue (VAT), represents a health risk due to its endocrine and metabolic capacity, contributing to the development of the atherogenic profile and strongly associating with cardiovascular morbimortality.

Objective:

To identify the association between central obesity and biochemical markers of cardiometabolic risk in elderly patients treated at a geriatric outpatient clinic in Lagarto-SE.

Method:

This is a cross-sectional study of 159 elderly people of both sexes. Central adiposity was considered an independent variable, identified by measuring the Waist Circumference (WC). Total Cholesterol (TC), LDL-c, HDL-c, non-HDL-c, triglycerides, glycemia and Castelli I and II indices were considered dependent variables. Pearson’s chi-square test was used to evaluate the association between central obesity and biochemical markers of cardiometabolic risk. Those with p < 0.20 were used in the bivariate regression analysis, adopting a 95% confidence interval.

Results:

Mean age was 70.9 ± 7.5 years. Central obesity was present in 43.2% of males and 56.8% of females (p = 0.002). There was statistically significant association between HDL-c, HDL-C and Castelli I Index and central obesity. Individuals with central obesity are 2.48 and 3.13 times more likely to develop changes in HDL-C and Castelli I index, respectively.

Conclusion:

There is an association between central obesity and biochemical markers of cardiometabolic risk in the elderly.

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Original Article

Cardiovascular Risk and Metabolic Syndrome in Individuals with Mental Disorders

Sarah de Melo Rocha Cabral et al. Marize Melo dos Santos

Abstract

Background:

Patients with mental disorders are more susceptible to cardiovascular diseases and metabolic disorders compared to the general population.

Objective:

To evaluate cardiovascular risk and metabolic syndrome in individuals with mental disorders.

Materials and methods:

A cross-sectional study, conducted at the Psychosocial Care Centers. Socioeconomic, clinical, biochemical and anthropometric data were collected using a standard form. Cardiovascular risk was assessed by the Framingham risk score. Metabolic syndrome (MS) was determined by the World Health- Organization (WHO), the National Cholesterol Education Program (NCEP) and the International Diabetes Federation (IDF) criteria. Data were analyzed by descriptive statistics, and associations were evaluated by the chi-square test and Fisher’s exact test, as well as Odds Ratio. The significance level adopted for all statistical tests was 5%.

Results:

The chance of individuals diagnosed with MS be at intermediate-to-high cardiovascular risk was greater (12.22, 8.01 and 6.23 times higher according to WHO, NCEP and IDF criteria, respectively) than those without MS.

Conclusion:

A high percentage of patients with mental disorders were at intermediate / high cardiovascular risk, and this was significantly associated with MS.

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Original Article

Endothelial Dysfunction and Pulse Wave Reflection in Women with Polycystic Ovarian Syndrome

Marcelo Burlá et al. Ana Rosa Cunha Ronaldo Gismondi Wille Oigman … Mario Fritsch Neves Fernanda Medeiros

Abstract

Background:

Patients with polycystic ovarian syndrome (PCOS) have an increased prevalence of metabolic syndrome and traditional atherosclerotic risk factors, such as dyslipidemia, diabetes and hypertension. Endothelial function and vascular stiffness are surrogate markers of early atherosclerosis, able to predict cardiovascular events.

Objective:

To compare endothelial function and pulse wave reflection between women with PCOS and healthy controls.

Methods:

Observational and cross-sectional study that included women with PCOS, age between 18 and 40 years-old and body mass index between 25.0 and 35.0 kg/m², and healthy controls. Rotterdan criteria was used to diagnose PCOS. Subjects underwent clinical and anthropometric evaluation, laboratory and hormonal assays and imaging tests to measure pulse wave velocity (PWV), augmentation index (AIx) and brachial artery flow-mediated vasodilation (FMD). Kolmogorov-Smirnov test showed normal distribution of most parameters. Unpaired Student t-test was used with significance level established at p < 0.05.

Results:

A total of 52 patients were included, 29 (56%) in PCOS group and 23 (44%) in control group. Clinical and laboratory parameters were similar between the groups. Women with PCOS had lower FMD (8.8 ± 1.0 vs 12.8 ± 1.2%, p = 0.021); PWV and AIx were similar between the groups (7.5 ± 0.2 vs 7.5 ± 0.3 m/s, p = 0.671 and 21.0 ± 1 vs. 20 ± 2%, p = 0.716, respectively). In the PCOS group, women with higher testosterone levels had higher AIx (25 ± 2 vs. 17 ± 3%, p = 0.045).

Conclusions:

PCOS women had endothelial dysfunction and those with higher testosterone levels had higher pulse wave reflection as compared with controls.

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IJCS

Original Article

Prevalence of Physical Inactivity and its Effects on Blood Pressure and Metabolic Parameters in a Brazilian Urban Population

Geiza da Graça Leite Rissardi et al. José Paulo Cipullo Gisela Cipullo Moreira Luiz Alberto Souza Ciorlia … Cláudia Bernardi Cesarino Luiz Tadeu Giollo Junior Angelina Zanesco José Fernando Vilela-Martin

Abstract

Background:

Cardiovascular disease is the leading cause of mortality in the world and physical inactivity represents an important risk factor.

Objective:

This study aimed to evaluate the prevalence of physical inactivity in the adult population and its effects on blood pressure, blood glucose and lipid profile.

Methods:

A population-based cross-sectional study with stratified simple random sampling was conducted in 1,717 adults divided by age groups: 18-39, 40-49, 50-59, 60-69 and ≥ 70 years. The participants answered the physical activity questionnaire and were classified as physically active or inactive. The bootstrap statistical method was used to assess physical activity, associated with lipid profile and blood glucose levels. The level of significance was 5%.

Results:

The prevalence of physical inactivity in the general population was 65.8%. There was a significant difference in the group older than 70 years. There was a significant decrease in physical activity in the group with lower educational level, with a significant difference between social classes AB and C. The prevalence of hypertension was 27.5% among physically inactive and 21.4% among active individuals (p = 0.04). The prevalence of metabolic syndrome was 26.1% in inactive and 16.7% in the active individuals (p = 0.007). Total cholesterol, low-density lipoprotein and triglycerides levels were more elevated in the physically inactive group, which was not observed with high-density lipoprotein levels. Blood glucose was also higher in the inactive group.

Conclusion:

This study shows a high prevalence of physical inactivity and a positive correlation between risk factors for cardiovascular disease, mainly blood pressure, glucose and lipids profiles. (Int J Cardiovasc Sci. 2018; [online].ahead print, PP.0-0)

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