Risco cardiovascular aumentado e o papel da síndrome metabólica em idosos hipertensos

The effect of bariatric-metabolic surgery on selected components of metabolic syndrome and visceral adipose tissue - the pilot study

The aim of this study was to monitor changes in the components of the metabolic syndrome defined by Adult Treatment Panel III and the risk of adipose tissue. The study population consisted of 45 patients (30 women, 15 men) who underwent one bariatric procedure - partial jejuno-ileal derivation (n=17), sleeve resection (n=14) or laparoscopic gastric - plication (n=14). Components of metabolic syndrome such as waist circumference, morning glycemia/antihypertension, TAG, HDL cholesterol and blood pressure (BP)/antihypertension were monitored in probands. In addition, Dual Energy X-Ray Absorciometry measurements were performed. Parameters were monitored over the course of one year. The study shows that it is an effective method of weight reduction for the study population with metabolic effects in the risk components of metabolic syndrome - fasting glycemia, increase in HDL cholesterol and reduction in triacylglycerols in the blood, reduction in waist circumference and BP or direct disappearance of metabolic syndrome. Significantly, of the entire cohort, 68.9 % of the probands studied showed signs of metabolic syndrome when measured before the intervention. At the end of follow-up, only 22.2 % of probands showed metabolic syndrome. It was also found that if the amount of visceral fat was reduced, the overall risk of metabolic syndrome was also reduced. The study demonstrates a significant positive effect of bariatric surgery on parameters of metabolic syndrome. The study also showed a positive effect of reduced visceral fat volume on the components of metabolic syndrome.

Predictive Models of Muscle Strength in Older People with Type 2 Diabetes Mellitus

Purpose

To propose predictive models for absolute muscle strength (AMS) of elderly people with type 2 Diabetes Mellitus (DM2) in primary health care.

Patients and Methods

The cross-sectional study was conducted with 138 elderly diabetics. The AMS was measured by a JAMAR® hydraulic handgrip dynamometer, determined by the sum of both hands. The following indices were evaluated: waist-to-height ratio (WHtR), body mass index (BMI), Lipid Accumulation Product (LAP), Triglyceride/High Density Lipoprotein (TG/HDL) ratio and platelet/lymphocyte ratio (PLR). Multiple linear regression was used in the statistical analysis.

Results

The final regression model indicated 66.4% (R²=0.66) of the variation in AMS. WHtR decreased AMS by 41.1% (β = -0.19; t = -3.70; p < 0.001), while PLR by 11.3% (β = -0.12; t = -2.36; p = 0.020). Male sex increased AMS by 10.6% (β = 0.32; t = 4.16; p < 0.001), and lean mass (LM) by 0.89% (β = 0.46; t = 6.03; p < 0.001).

Conclusion

WHtR and PLR predicted a decrease, while male sex and LM predicted an increase in AMS. It is suggested that these markers be used as screening measures for variation in AMS in older adults with DM2. These results have relevant practical application in primary health care since the markers are easy to use.

Síndrome metabólica em idosos diabéticos tipo 2 atendidos em ambulatório de uma capital brasileira

Objetivo: identificar a prevalência de síndrome metabólica e seus fatores associados em idosos com diabetes mellitus tipo 2. Métodos: estudo descritivo observacional realizado com idosos diagnosticados com diabetes mellitus tipo 2, no período de 2017-2018, recrutados no Ambulatório de Nutrição/Diabetes do Núcleo de Assistência ao Idoso da Universidade Federal de Pernambuco. Foram coletados os dados: sexo e faixa etária e, para a avaliação antropométrica dos participantes, foram mensurados o índice de massa corporal e a circunferência de cintura. Também foram coletados os valores de colesterol total e frações, além de glicemia em jejum, hemoglobina glicosilada e diagnóstico prévio de hipertensão arterial. Para analisar os dados obtidos foram utilizados os testes t de Student, Qui-quadrado de Pearson e teste de MannWhitney. Para as análises, foi adotado um intervalo de confiança de 95% e nível de significância de 0,05. Resultados: a amostra foi de 273 participantes, com média de idade de 68,77±5,65 anos e cerca de 89,8% (n=158) apresentaram síndrome metabólica. A presença dessa condição foi associada a valores maiores de peso corporal (p=0,04), índice de massa corporal (p=0,003), circunferência de cintura (p<0,001) e glicemia em jejum (p=0,007). Conclusões: ocorreu alta prevalência de síndrome metabólica nos idosos estudados com essa condição associada a valores maiores de peso corporal, índice de massa corporal, circunferência de cintura e glicemia em jejum. Esses achados demonstram a importância na identificação precoce e na intervenção preventiva dessas condições na população idosa, diminuindo a morbimortalidade por ocorrência de eventos cardiovasculares e melhorando sua qualidade de vida.