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Brown RCC, Coombes JS, Conley MM, Webb L, Mayr HL, Isbel NM, Jegatheesan DK, Macdonald GA, Burton NW, Kelly JT, Hickman IJ, Keating SE. Evaluating the Potential of a Novel Metabolic Syndrome Severity Score to Inform Exercise Interventions for People with Complex Chronic Conditions. Metab Syndr Relat Disord 2024; 22:516-524. [PMID: 38801006 DOI: 10.1089/met.2024.0031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2024] Open
Abstract
Aims: Exercise interventions positively affect numerous cardiometabolic risk factors. To better evaluate the health effects of exercise training, it may be more appropriate to evaluate risk factors together. The Metabolic Syndrome Severity Score (MetSSS) is a composite score representing cardiometabolic risk. Purpose: To evaluate the relationships between physical activity, neuromuscular fitness, exercise capacity, and the MetSSS in a heterogenous sample of people with complex chronic disease. Material and Methods: Fifty-three people with kidney or liver disease and at least one feature of the metabolic syndrome (MetS) were included. Pearson correlations were conducted between physical activity, neuromuscular fitness, exercise capacity, and the MetSSS. Linear regressions were performed for multi-level categorical variables. Independent variables with an association with MetSSS (P ≤ 0.2) were included in a multiple regression analysis. Results: The 6-minute walk test (6MWT) distance was inversely and independently associated with MetSSS [standardized beta coefficient (β) = -0.31, P = 0.04]. No relationship was found between MetSSS and physical activity or neuromuscular fitness. Mean 6MWT in the highest tertile was 550 m (range: 505-620 m) and 346 m (range: 233-408 m) in the lowest. The analysis showed a medium-large between-group effect for the difference in MetSSS for the lowest and highest tertile of 6MWT [Eta squared (η2) = 0.16, P = 0.01]. Conclusions: Exercise capacity was inversely and independently associated with MetSSS in people with complex chronic disease. Clinical trials with exercise interventions are needed to further investigate if improvements in exercise capacity result in clinically significant changes in the MetSSS.
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Affiliation(s)
- Riley C C Brown
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
- Centre for Research on Exercise, Physical Activity & Health, The University of Queensland, Brisbane, Australia
| | - Jeff S Coombes
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
- Centre for Research on Exercise, Physical Activity & Health, The University of Queensland, Brisbane, Australia
| | - Marguerite M Conley
- Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, Australia
| | - Lindsey Webb
- Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, Australia
| | - Hannah L Mayr
- Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, Australia
- Faculty of Medicine, The University of Queensland, Brisbane, Australia
- Centre for Functioning and Health Research, Metro South Health, Brisbane, Australia
| | - Nicole M Isbel
- Faculty of Medicine, The University of Queensland, Brisbane, Australia
- Department of Nephrology, Princess Alexandra Hospital, Brisbane, Australia
| | - Dev K Jegatheesan
- Faculty of Medicine, The University of Queensland, Brisbane, Australia
- Department of Nephrology, Princess Alexandra Hospital, Brisbane, Australia
| | - Graeme A Macdonald
- Faculty of Medicine, The University of Queensland, Brisbane, Australia
- Translational Research Institute, Brisbane, Australia
- Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Australia
| | - Nicola W Burton
- School of Applied Psychology, Griffith University, Brisbane, Australia
- Menzies Health Institute Queensland, Griffith University, Queensland, Australia
- Centre for Mental Health, Griffith University, Brisbane, Australia
| | - Jaimon T Kelly
- Centre for Online Health, The University of Queensland, Brisbane, Australia
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia
| | - Ingrid J Hickman
- Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Shelley E Keating
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
- Centre for Research on Exercise, Physical Activity & Health, The University of Queensland, Brisbane, Australia
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de Carvalho Costa IMNB, Silva DGD, Oliveira JLM, Silva JRS, Pereira LMC, Alves LVS, de Andrade FA, Góes Jorge JD, Oliveira LMSMD, Almeida RRD, Oliveira VB, Martins LS, Costa JO, de Souza MFC, Voci SM, Almeida-Santos MA, Abreu VV, Aidar FJ, Baumworcel L, Sousa ACS. Adherence to secondary prevention measures after acute coronary syndrome in patients associated exclusively with the public and private healthcare systems in Brazil. Prev Med Rep 2022; 29:101973. [PMID: 36161134 PMCID: PMC9502285 DOI: 10.1016/j.pmedr.2022.101973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 07/28/2022] [Accepted: 08/27/2022] [Indexed: 11/24/2022] Open
Abstract
Adherence to secondary prevention measures after acute coronary syndrome (ACS) is essential to prevent disease recurrence. In Brazil, the Brazilian Unified Health System (SUS, in Portuguese), and the private healthcare system (PHCS) coexist. We aimed to evaluate the adherence to secondary prevention in patients with ACS who were assisted by either SUS or PHCS. In this longitudinal prospective study, patients with ACS were admitted to the four cardiological reference hospitals of Sergipe, three of which assisted PHCS users, and one, SUS users. We analyzed the two patient care models with multiple logistic regression models for adherence to physical activity, pharmacotherapy, and smoking cessation. We enrolled 581 volunteers in this study: 44.1 % from SUS and 55.9 % from PHCS. PHCS users showed greater adherence to pharmacotherapy at both 30 and 180 (p = 0.001) days after ACS with better results in all classes of medications (p < 0.05) than SUS users did. They also showed better adherence to physical activity (p = 0.047). There was no distinction between the groups regarding smoking cessation. The secondary prevention measures after ACS were more effective in PHCS users than in SUS users due to better adherence, especially to pharmacotherapy and regular physical activity.
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Affiliation(s)
| | - Danielle Góes da Silva
- Program of Post-Graduation in Nutrition Sciences, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
| | - Joselina Luzia Meneses Oliveira
- Program of Post-Graduation in Health Sciences, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
- Department of Medicine, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
- São Lucas Clinic and Hospital / Rede D Or São Luiz, Aracaju, Sergipe, Brazil
- Division of Cardiology, University Hospital, Federal University of Sergipe, Aracaju, Sergipe, Brazil
| | - José Rodrigo Santos Silva
- Department of Statistics and Actuarial Sciences, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
| | | | - Luciana Vieira Sousa Alves
- Program of Post-Graduation in Health Sciences, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
| | | | - Juliana de Góes Jorge
- Program of Post-Graduation in Health Sciences, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
- Department of Physiotherapy, Tiradentes University, Aracaju, Sergipe, Brazil
| | | | - Rebeca Rocha de Almeida
- Program of Post-Graduation in Health Sciences, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
| | - Victor Batista Oliveira
- Program of Post-Graduation in Health Sciences, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
| | - Larissa Santos Martins
- Program of Post-Graduation in Nutrition Sciences, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
| | - Jamille Oliveira Costa
- Program of Post-Graduation in Health Sciences, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
| | | | - Silvia Maria Voci
- Program of Post-Graduation in Nutrition Sciences, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
| | - Marcos Antonio Almeida-Santos
- São Lucas Clinic and Hospital / Rede D Or São Luiz, Aracaju, Sergipe, Brazil
- Postgraduate Program in Health and Environment, Tiradentes University, Aracaju, Sergipe, Brazil
| | - Victoria Vieira Abreu
- Program of Post-Graduation in Nutrition Sciences, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
| | - Felipe J. Aidar
- Group of Studies and Research in Performance, Sport, Health and Paralympic Sports – GEPEPS, Federal University of Sergipe (UFS), São Cristóvão, Sergipe, Brazil
| | - Leonardo Baumworcel
- São Lucas Clinic and Hospital / Rede D Or São Luiz, Aracaju, Sergipe, Brazil
| | - Antônio Carlos Sobral Sousa
- Program of Post-Graduation in Health Sciences, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
- Department of Medicine, Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
- São Lucas Clinic and Hospital / Rede D Or São Luiz, Aracaju, Sergipe, Brazil
- Division of Cardiology, University Hospital, Federal University of Sergipe, Aracaju, Sergipe, Brazil
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