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Ferreira JRS, Zandonade E, de Paula Alves Bezerra OM, Salaroli LB. Insulin resistance by the triglyceride-glucose index in a rural Brazilian population. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2022; 66:848-855. [PMID: 35929905 PMCID: PMC10118758 DOI: 10.20945/2359-3997000000509] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
Objective The aim of this study was to estimate the prevalence of insulin resistance (IR) in a rural population in Brazil, to verify its association with sociodemographic, labor, lifestyle, and health factors. Subjects and methods This is a cross-sectional study with 790 farmers in the state of Espírito Santo/Brazil. Triglyceride-glucose (TyG) was calculated and a cut-off point of Ln 4.52 was used. A hierarchical logistic regression for the association of insulin resistance with sociodemographic, labor, lifestyle and health variables of farmers living in Espírito Santo was performed. Results The prevalence of insulin resistance was 33.7% (n = 266), and the association with insulin resistance was found in the age group 31 to 40 years of age (OR = 1.85; 95% CI 1.19-2.87); in smokers or former smokers (OR = 1.63; 95% CI 1.08-2.48) and overweight (OR = 3.06; 95% CI 2.22-4.23). Conclusion The prevalence of insulin resistance was high in a rural population of Brazil, and was mainly associated with age, smoking and obesity. The use of TyG as an instrument for assessing the health of individuals living in areas where access to health services is difficult, such as rural areas, can represent an important advance in terms of health promotion, protection and recovery. In addition, by identifying the risk factors associated with IR, as well as their consequences, a more adequate scheme for the prevention and treatment of these comorbidities can be defined.
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Affiliation(s)
| | - Eliana Zandonade
- Programa de Pós-graduação em Saúde Pública, Universidade Federal do Espírito Santo (UFES), Vitória, ES, Brasil
| | | | - Luciane Bresciani Salaroli
- Programa de Pós-graduação em Saúde Pública, Universidade Federal do Espírito Santo (UFES), Vitória, ES, Brasil
- Programa de Pós-graduação em Nutrição e Saúde, Universidade Federal do Espírito Santo (UFES), Vitória, ES, Brasil
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Ferreira JRS, Zandonade E, de Paula Alves Bezerra OM, Salaroli LB. Cutoff point of TyG index for metabolic syndrome in Brazilian farmers. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2021; 65:704-712. [PMID: 34591406 PMCID: PMC10065379 DOI: 10.20945/2359-3997000000401] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Thus, the aim of this study was to identify the cutoff point of the TyG index for the diagnosis of insulin resistance (IR), according to two different diagnostic criteria of metabolic syndrome in a rural Brazilian population. METHODS The study population consisted of 790 family farmers from 18 to 59 years old. The triglyceride-glucose index (TyG index) was calculated, and the Metabolic Syndrome was defined using the NCEP-ATPIII and IDF criteria. Mann-Whitney U test was used to analyze the association of quantitative and qualitative variables. When the qualitative variable had three or more categories, the comparison between the means was performed by the Kruskal-Wallis test (using the Mann-Whitney U Test two by two to identify the differences). For correlations, Spearman's correlation test was used. The cutoff values of TyG index for MetS were obtained using the Receiver Operating Characteristic (ROC) curve analysis with the area under the curve (AUC) and the Youden Index. RESULTS The median TyG values increased according to the aggregation of the components of MetS. The AUCs and Youden's cutoff point for TyG index according to the NCEP and IDF diagnostic criteria were 0.873, Ln 4.52 (sensitivity: 84.30%; specificity: 75.75%), and 0.867, Ln 4.55 (sensitivity: 80.0%; specificity: 79.82%), respectively. CONCLUSION A cutoff point of Ln 4.52 was defined, and it can be used both in clinical practice and epidemiological studies. It represents an important tool for promotion, protection and recovery health of rural populations.
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Affiliation(s)
- Júlia Rabelo Santos Ferreira
- Programa de Pós-Graduação em Saúde Coletiva (PPGSC), Universidade Federal do Espírito Santo (UFES), Vitória, ES, Brasil
| | - Eliana Zandonade
- Programa de Pós-Graduação em Saúde Coletiva (PPGSC), Universidade Federal do Espírito Santo (UFES), Vitória, ES, Brasil
| | | | - Luciane Bresciani Salaroli
- Programa de Pós-Graduação em Saúde Coletiva (PPGSC), Universidade Federal do Espírito Santo (UFES), Vitória, ES, Brasil.,Programa de Pós-Graduação em Nutrição e Saúde (PPGNS), Universidade Federal do Espírito Santo (UFES), Vitória, ES, Brasil,
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Martins-Silva T, Vaz JDS, Mola CLD, Assunção MCF, Tovo-Rodrigues L. Prevalence of obesity in rural and urban areas in Brazil: National Health Survey, 2013. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2019; 22:e190049. [PMID: 31460664 DOI: 10.1590/1980-549720190049] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 07/13/2018] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVE To investigate the role of the domiciliary situation in the prevalence of general and abdominal obesity through the National Health Survey of 2013. METHODOLOGY General obesity (body mass index ≥ 30 kg/m2) and abdominal obesity (waist circumference ≥ 102 cm in men and ≥ 88 cm in women) in rural and urban areas were described according to sex and macroregion. Crude and adjusted Poisson regression models were used to test the association between obesity and household situation, with the significance level of 5%. RESULTS The study included 59,226 individuals. Out of these, 20.7% presented general obesity and 38% abdominal obesity (higher in women: 24.3 and 52%, respectively). The highest prevalences of general obesity were observed in southern urban areas, for both sexes (20.8% in men and 26.5% in women). In rural areas, the highest prevalences were observed for the central-west region (17.2%) in men and in the south region (27.4%) in women. In males, after adjusting for demographic variables, living in rural areas was associated with lower prevalences of general obesity in the North (prevalence ratios - PR = 0.60; confidence interval of 95% - 95%CI 0.40 - 0.89) and Northeast (PR = 0.47, 95%CI 0,38 - 0.59), and for abdominal obesity in all regions. For women in the Midwest, the rural household situation was associated with lower prevalences of obesity. (PR = 1.11, 95%CI 1.01 - 1.23). CONCLUSIONS The results evidenced the role of the domiciliary situation among outcomes at the national level, with lower prevalence of general and abdominal obesity in men living in rural areas. However, higher prevalences were found among women, especially for abdominal obesity.
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Affiliation(s)
- Thais Martins-Silva
- Programa de Pós-graduação em Epidemiologia, Faculdade de Medicina, Universidade Federal de Pelotas - Pelotas (RS), Brasil
| | - Juliana Dos Santos Vaz
- Programa de Pós-graduação em Epidemiologia, Faculdade de Medicina, Universidade Federal de Pelotas - Pelotas (RS), Brasil.,Faculdade de Nutrição, Universidade Federal de Pelotas - Pelotas (RS), Brasil
| | - Christian Loret de Mola
- Programa de Pós-graduação em Epidemiologia, Faculdade de Medicina, Universidade Federal de Pelotas - Pelotas (RS), Brasil.,Faculdade de Enfermagem, Universidade Federal de Pelotas - Pelotas (RS), Brasil
| | - Maria Cecília Formoso Assunção
- Programa de Pós-graduação em Epidemiologia, Faculdade de Medicina, Universidade Federal de Pelotas - Pelotas (RS), Brasil
| | - Luciana Tovo-Rodrigues
- Programa de Pós-graduação em Epidemiologia, Faculdade de Medicina, Universidade Federal de Pelotas - Pelotas (RS), Brasil
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Salaroli LB, Cattafesta M, Molina MDCB, Zandonade E, Bissoli NS. Insulin resistance and associated factors: a cross-sectional study of bank employees. Clinics (Sao Paulo) 2017; 72:224-230. [PMID: 28492722 PMCID: PMC5401617 DOI: 10.6061/clinics/2017(04)06] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 02/14/2017] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE: Insulin resistance is characterized by the failure of target cells to respond to normal levels of circulating insulin, and this condition is related to cardiovascular disease. This study sought to evaluate the prevalence of insulin resistance and its association with markers of metabolic abnormalities and metabolic syndrome in bank employees. METHODS: A cross-sectional study was performed on 498 working men and women aged ≥20 years old. The Homeostasis Model Assessment (HOMA-IR) was used to determine the presence of insulin resistance based on cut-off values of ≤2.71 for normal insulin levels and >2.71 for insulin resistance, as established for the adult Brazilian population. RESULTS: It was observed that the 52 (10.4%) overweight individuals with insulin resistance were 4.97 times (95%CI 1.31-18.83) more likely to have high HOMA-IR values than the normal-weight participants; among those who were obese, the likelihood increased to 17.87 (95%CI 4.36-73.21). Individuals with large waist circumferences were 3.27 times (95%CI 1.03-10.38) more likely to develop insulin resistance than those who were within normal parameters. The HOMA-IR values differed between subjects with and without metabolic syndrome, with values of 2.83±2.5 and 1.10±0.81 (p=0.001), respectively. The levels of insulin, ultrasensitive C-reactive protein and uric acid were also associated with insulin resistance. CONCLUSION: The prevalence of insulin resistance among bank employees is high, and insulin resistance is associated with and serves as a marker of metabolic syndrome. Cardiovascular disease and metabolic syndrome-associated metabolic abnormalities were observed, and insulin resistance may be a risk factor in this group of professionals.
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Affiliation(s)
- Luciane Bresciani Salaroli
- Programa de Pós Graduação em Saúde Coletiva, Programa de Pós Graduação em Nutrição e Saúde, Departamento de Educação Integrada em Saúde, Universidade Federal do Espírito Santo, Vitória, ES, BR
- Corresponding author. E-mail:
| | - Monica Cattafesta
- Programa de Pós Graduação em Nutrição e Saúde, Universidade Federal do Espírito Santo, Vitória, ES, BR
| | - Maria del Carmen Bisi Molina
- Programa de Pós Graduação em Saúde Coletiva, Programa de Pós Graduação em Nutrição e Saúde, Departamento de Educação Integrada em Saúde, Universidade Federal do Espírito Santo, Vitória, ES, BR
| | - Eliana Zandonade
- Programa de Pós Graduação em Saúde Coletiva, Universidade Federal do Espírito Santo, Vitória, ES, BR
| | - Nazaré Souza Bissoli
- Programa de Pós Graduação em Ciências Fisiológicas, Universidade Federal do Espírito Santo, Vitória, ES, BR
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Heitor SFD, Rodrigues LR, Tavares DMDS. Fatores associados às complicações metabólicas e alimentação em idosos da zona rural. CIENCIA & SAUDE COLETIVA 2016; 21:3357-3366. [DOI: 10.1590/1413-812320152111.11592015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Accepted: 09/16/2015] [Indexed: 11/21/2022] Open
Abstract
Resumo Este estudo objetivou avaliar fatores associados às complicações metabólicas e de alimentação em idosos da zona rural de Uberaba, Minas Gerais, norteados pelo Guia “10 passos para uma alimentação saudável para pessoas idosas” do Ministério da Saúde. Realizado inquérito domiciliar com 833 pessoas, 60 anos ou mais de idade, sem declínio cognitivo. Os dados foram coletados utilizando questionário de frequência alimentar, aferição de medidas antropométricas; submetidos à análise descritiva, taxa de prevalência e teste qui-quadrado (p < 0,05). As complicações metabólicas foram associadas ao sexo feminino (p = 0,001) e ao sobrepeso (p = 0,006). Mulheres se adequaram a cinco passos: número de refeições, ingestão adequada de leite e carnes magras, consumo reduzido de refrigerantes, doces e sal, prática de atividade física, não fumar e não ingerir bebida alcoólica; enquanto os homens seguiam três passos: consumo adequado de cereais, de arroz com feijão e de água. Idosos com menos de 80 anos aderiram mais ao consumo de água. Três passos se associaram ao peso normal, dois à classificação sem risco para complicações metabólicas e nenhum à escolaridade. Conclui-se que a dieta dos idosos rurais não está adequada às recomendações de alimentação saudável do Ministério da Saúde.
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Abstract
BACKGROUND The ultrasensitive C-reactive protein (us-CRP) is used for the diagnosis of cardiovascular disease, but it is not well described as a marker for the diagnosis of metabolic syndrome (MS). METHODS An observational and transversal study of bank employees evaluated anthropometric, hemodynamic, and biochemical data. CRP values were determined using commercial kits from Roche Diagnostics Ltd, and MS criteria were analyzed according to National Cholesterol Education Program's - Adult Treatment Panel III (NCEP/ATP III). RESULTS A total of 88 individuals had MS, and 77.3% (n=68) of these showed alterations of us-CRP (P=0.0001, confidence interval [CI] 0.11-0.34). Individuals with MS had higher mean values of us-CRP in global measures (P=0.0001) and stratified by sex (P=0.004) than individuals without the syndrome. This marker exhibited significant differences with varying criteria for MS, such as waist circumference (P=0.0001), triglycerides (P=0.002), and diastolic blood pressure (P=0.007), and the highest levels of us-CRP were found in individuals with more MS criteria. CONCLUSION us-CRP was strongly associated with the presence of MS and MS criteria in this group of workers. us-CRP is a useful and effective marker for identifying the development of MS and may be used as a reference in routine care.
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Affiliation(s)
- Monica Cattafesta
- Postgraduate Program in Nutrition and Health, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil
| | - Nazaré Souza Bissoli
- Postgraduate Program in Physiological Sciences, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil
| | - Luciane Bresciani Salaroli
- Postgraduate Program in Nutrition and Health, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil
- Postgraduate Program in Public Health, Department of Health Integrated Education, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil
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Martins NPF, Tavares DMDS. Health behaviors and anthropometric variables among older adults with and without hypertension. TEXTO & CONTEXTO ENFERMAGEM 2015. [DOI: 10.1590/0104-07072015000470014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The objective was to describe socioeconomic, demographic and morbidity and compare the prevalence and odds of prevalence of health behaviors, overweight, abdominal circumference and indicative of depression among those with and without hypertension. It is cross-sectional study of rural elderly. We conducted descriptive analysis, chi-square test and multiple binary logistic regression (p<0,05). Predominated, for both groups, age 60├70, married, 4├8 years, income of a minimum wage and living with their spouse. Elderly patients with hypertension had lower odds of prevalence for alcohol and smoking and higher odds of overweight, abdominal circumference inappropriate and indicative of depression compared to those without hypertension. Reinforces health actions directed to the rural elderly, through the cessation of smoking and alcohol consumption, weight control and reduction of abdominal circumference among those with hypertension.
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Faria ERD, Faria FRD, Franceschini SDCC, Peluzio MDCG, Sant?Ana LFDR, Novaes JFD, Ribeiro SMR, Ribeiro AQ, Priore SE. Resistência à insulina e componentes da síndrome metabólica, análise por sexo e por fase da adolescência. ACTA ACUST UNITED AC 2014; 58:610-8. [DOI: 10.1590/0004-2730000002613] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Accepted: 05/05/2014] [Indexed: 11/22/2022]
Abstract
Objetivo: Analisar a influência dos componentes da síndrome metabólica na resistência à insulina, por sexo e fase da adolescência. Sujeitos e métodos: Avaliaram-se dados bioquímicos, clínico, de estilo de vida e composição corporal de 800 adolescentes de 10 a 19 anos, de ambos os sexos, de Viçosa-MG/Brasil, divididos em fases: inicial (10 a 13 anos), intermediária (14 a 16 anos) e final (17 a 19 anos). Resultados: 10,3 e 3,4% apresentavam, respectivamente, resistência à insulina e síndrome metabólica. Na fase inicial, observaram-se maior prevalência de dislipidemia e na intermediária, de hiperuricemia e excesso de gordura corporal. O sexo feminino apresentou maior prevalência de dislipidemia, excesso de gordura corporal e resistência à insulina e o masculino, maior prevalência de HDL baixo, hiperuricemia e pressão arterial alterada. Os da fase inicial apresentaram maiores valores de colesterol total, LDL, HDL, triglicerídeos, glicemia de jejum e relação cintura/quadril, ficaram menos tempo sentados e realizavam maior número de refeições (p < 0,05) em relação às outras fases. O modelo final, ajustado por sexo, foi diferente para cada fase da adolescência. Conclusões: A resistência à insulina está associada à inadequação na composição corporal, nos níveis bioquímicos e no estilo de vida, sendo os fatores associados diferentes em cada fase da adolescência. Arq Bras Endocrinol Metab. 2014;58(6):610-8
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da Silva EF, Paniz VMV, Laste G, Torres ILDS. [The prevalence of morbidity and symptoms among the elderly: a comparative study between rural and urban areas]. CIENCIA & SAUDE COLETIVA 2014; 18:1029-40. [PMID: 23670380 DOI: 10.1590/s1413-81232013000400016] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2011] [Accepted: 10/20/2011] [Indexed: 02/04/2023] Open
Abstract
A cross-sectional study was conducted with the elderly population in rural and urban areas characterized by the prevalence of morbidity and symptoms, and 229 elderly people were interviewed. The average age was 72.3, of which 57.2% lived in the rural zone and 56.3% were female. The morbidities most reported were insomnia (37.7%), anxiety (32.1%), depression (26.7%), and in the rural zone it was diabetes (13.3%). In this zone, Alzheimer's disease was more prevalent among the elderly who handled pesticides (21.7%). The most prevalent symptoms among urban zone residents were: cough/runny nose and sight alterations (41.2%), allergy/itching (11.4%). In the rural zone, dry mouth (25.4%), sight alterations (35.6%) and leg pain (66.1%) were also more prevalent among those who used pesticides. The inadequate use of Individual Protection Equipment was 85.4%, and 45.1% also disposed of pesticide packaging inappropriately. The setting up of public health programs is necessary to promote health among the elderly and the potential exposure to pesticides for this population should be seen as a health risk determinant.
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Rocha-e-Silva M. Metabolic and infectious pathologies in Brazilian medical literature: a review. Clinics (Sao Paulo) 2010; 65:809-14. [PMID: 20835560 PMCID: PMC2933115 DOI: 10.1590/s1807-59322010000800012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2010] [Accepted: 06/17/2010] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE This review of original reports on metabolic and infectious diseases that were recently published in Brazilian journals is designed to inform the readership of CLINICS about their content. METHODS I conducted a search in PubMed for original research articles (clinical or basic research) recently published (2008-2009) by Brazilian medical and biological periodicals. Papers on metabolic pathologies were retrieved by searching for appropriate keywords such as metabolic syndrome and obesity. Papers on infectious disease were obtained by entering 15 different keywords for the most commonly occurring pathologies. Review articles, editorials, letters to the editor, and case reports were manually excluded. Selected titles were then categorized into appropriate sub-categories. RESULTS This search produced a total of 123 articles, which filtered down to 72 articles after eliminating editorials, review articles, letters to the Editor and case reports. Reviewed periodicals were Arquivos Brasileiros de Cardiologia, Arquivos Brasileiros de Endocrinologia e Metabologia, Brazilian Journal of Biological and Medical Research, Brazilian Journal of Infectious Diseases, Jornal de Pediatria, Jornal de Pneumologia, Revista da Associação Médica Brasileira, Revista da Escola de Enfermagem da Universidade de São Paulo, and São Paulo Medical Journal. The articles were then briefly summarized.
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