Bioimpedância elétrica e gordura visceral: uma comparação com a tomografia computadorizada em adultos e idosos

Effect of liraglutide on cardiometabolic profile and on bioelectrical impedance analysis in patients with obesity and metabolic syndrome

Metabolic syndrome (MetS) and obesity represent a public health problem worldwide. Bioelectrical impedance analysis (BIA) is a practical and effective way of evaluating body composition, especially abdominal fat. Liraglutide, a GLP-1 analog, reduces body weight and improves cardiometabolic parameters. In this prospective non-randomized intervention study, we evaluated the effect of 6 months of treatment with liraglutide (n = 57) on the clinical, laboratory and BIA findings of adult sex-stratified patients diagnosed with obesity and MetS, compared to a control group receiving sibutramine (n = 46). The groups were statistically similar with regard to the age of females (p = 0.852) and males (p = 0.657). Almost all anthropometric and BIA variables were higher in the treatment group than in the comparative group (p < 0.05). Abdominal circumference (AC) decreased significantly more in the treatment group. In males, body weight and fat mass also decreased (p < 0.05). Liraglutide treatment was associated with a greater reduction in trunk fat mass (FMT) (p < 0.05). AC and FMT were strongly correlated (rho = 0.531, p < 0.001) in the treatment group. In the multiple regression analysis, liraglutide treatment remained independently associated with FMT. Treatment with liraglutide for 6 months promoted weight loss, improved cardiometabolic and inflammatory parameters and led to a significant reduction in FMT correlated with AC in obese MetS patients of both sexes.

The Effects of Workplace Stressors on Dietary Patterns among Workers at a Private Hospital in Recôncavo of Bahia, Brazil: A Longitudinal Study before and during the COVID-19 Pandemic

Working in a hospital environment is known for presenting unhealthy features that affect the workers' health-features which have currently been intensified due to the COVID-19 pandemic. Hence, this longitudinal study aimed to ascertain the level of job stress before and during the COVID-19 pandemic, how this changed, and its association with the dietary patterns of hospital workers. Data on sociodemographic, occupational, lifestyle, health, anthropometric, dietetic, and occupational stress were collected before and during the pandemic from 218 workers at a private hospital in the Recôncavo of Bahia, Brazil. McNemar's chi-square test was used for comparison purposes, Exploratory Factor Analysis to identify dietary patterns, and Generalized Estimating Equations to evaluate the interested associations. During the pandemic, participants reported increased occupational stress, shift work, and weekly workloads, compared with before the pandemic. Additionally, three dietary patterns were identified before and during the pandemic. No association was observed between changes in occupational stress and dietary pattens. However, COVID-19 infection was related to changes in pattern A (0.647, IC95%0.044;1.241, p = 0.036) and the amount of shift work related to changes in pattern B, (0.612, IC95%0.016;1.207, p = 0.044). These findings support calls to strengthen labour policies to ensure adequate working conditions for hospital workers in the pandemic context.

Dietary Patterns, Occupational Stressors and Body Composition of Hospital Workers: A Longitudinal Study Comparing before and during the COVID-19 Pandemic

This longitudinal study aimed to evaluate the association between dietary patterns and the body composition of hospital workers subjected to occupational stressors before and during the COVID-19 pandemic. Data on sociodemographic, occupational, lifestyle, anthropometric, food consumption and occupational stress were collected before and during the COVID-19 pandemic. A total of 218 workers from a private hospital in Santo Antônio de Jesus, Bahia, Brazil were included in the study. After evaluating the normality of the data, parametric or non-parametric tests were used to characterize the sample. Dietary pattern was defined with Exploratory Factor Analysis and Structural Equation Modeling was used to test the desired association. During the pandemic, work per shift increased by 8.2% (p = 0.004) and working hours > 40 h/week increased by 9.2% (p = 0.006). Despite the higher prevalence of low occupational stress (85.8% vs. 72.1%), high stress increased by 13.7% from 2019 to 2020 (p < 0.001) and 30.3% reported a positive mediating effect on the variables of body composition, body mass index (b = 0.478; p < 0.001), waist circumference (b = 0.395; p = 0.001), fat-free mass (b = 0.440; p = 0.001) and fat mass (b = -0.104; p = 0.292). Therefore, a dietary pattern containing high-calorie foods was associated with changes in the body composition of hospital workers, including occupational stressors as mediators of this relationship.

Association between occupational stress, work shift and health outcomes in hospital workers of the Recôncavo of Bahia, Brazil: the impact of COVID-19 pandemic

The aim of this study was to ascertain the level of occupational stress before and during the COVID-19 pandemic, how it changed and its association with health outcomes of hospital workers in the Recôncavo of Bahia, Brazil. A longitudinal study was conducted with 218 hospital workers over 18 years old. A semi-structured questionnaire was used for collecting sociodemographic, occupational, lifestyle, anthropometric and health data. The main exposures were occupational stress, assessed through Job Content Questionnaire and classified according to the Demand-Control Model and reported shift work. Health outcomes considered were nutritional status assessed by BMI, waist circumference and body fat percentage, health self-perception and cardiovascular risk factors. We used McNemar χ2 or Wilcoxon tests to compare the levels of exposure and outcome variables before and during the pandemic, and OR to evaluate associations between changes in occupational stress and shift work with health outcomes. During the pandemic, participants reported increased occupational stress and shift work and lower self-perceived health and had higher BMI and cardiovascular risk factors, compared with before the pandemic. No association was observed between change in occupational stress and health outcomes. However, increased amount of shift work was related to increased BMI in the overall sample (OR 3·79, 95 % CI (1·40, 10·30)) and in health workers (OR 11·56; 95 % CI (2·57, 52·00)). These findings support calls to strengthen labour policies to ensure adequate working conditions for hospital workers in context of the COVID-19 pandemic.

The association between body composition and metabolically unhealthy profile of adults with normal weight in Northwest China

Objective

Related evidences of metabolically unhealthy profile of adults with normal weight are not well characterized in the Chinese population. This is because they cannot be effectively identified by regular measurements (such as body mass index [BMI]). To overcome this gap in literature, this study aimed at investigating the association between body composition and metabolically unhealthy profile in Chinese adults with normal weight.

Methods

A total of 5427 individuals with normal-weight were recruited from 15820 people living in Ningxia Hui Autonomous Region in Northwest China. Normal-weight was defined as a BMI of 18.5–23.9 kg/m². Metabolically unhealthy profile was assessed by the National Cholesterol Education Program Adult Treatment Panel III (ATP III). Metabolically unhealthy normal-weight (MUHNW) profile was defined in individuals who had normal weight and at least two cardiometabolic risk factors. Generalized linear model was used to investigate the association between body composition measured by bioelectrical impedance and metabolically unhealthy profile in adults with normal-weight.

Results

The percentage of metabolically unhealthy profile was 35.86% in adults with normal weight. Different MUHNW distributions were found between males and females depending on age. The percentage of the MUHNW profile significantly increased in women after the age of 55, contrary to men. The association between body composition and MUHNW was affected by age and sex. The increased adiposity indices (fat mass index [FMI], visceral fat level [VFL], waist circumference [WCF]), and reduced skeletal muscle mass ratio [SMR] showed significant differences between MUHNW and metabolically healthy with normal weight (MHNW) (p < 0.05).

Conclusion

The distribution of MUHNW differed between ages and sexes. FMI, VFL, WCF and SMR could be responsible for the MUHNW adults, providing a new insight into the potential metabolic risks for the adults with normal weight in China. This directs us in the management of the MUHNW for their early prevention.

The Prediction of Human Abdominal Adiposity Based on the Combination of a Particle Swarm Algorithm and Support Vector Machine

Background: Abdominal adiposity is an important risk factor of chronic cardiovascular diseases, thus the prediction of abdominal adiposity and obesity can reduce the risks of contracting such diseases. However, the current prediction models display low accuracy and high sample size dependence. The purpose of this study is to put forward a new prediction method based on an improved support vector machine (SVM) to solve these problems. Methods: A total of 200 individuals participated in this study and were further divided into a modeling group and a test group. Their physiological parameters (height, weight, age, the four parameters of abdominal impedance and body fat mass) were measured using the body composition tester (the universal INBODY measurement device) based on BIA. Intelligent algorithms were used in the modeling group to build predictive models and the test group was used in model performance evaluation. Firstly, the optimal boundary C and parameter gamma were optimized by the particle swarm algorithm. We then developed an algorithm to classify human abdominal adiposity according to the parameter setup of the SVM algorithm and constructed the prediction model using this algorithm. Finally, we designed experiments to compare the performances of the proposed method and the other methods. Results: There are different abdominal obesity prediction models in the 1 KHz and 250 KHz frequency bands. The experimental data demonstrates that for the frequency band of 250 KHz, the proposed method can reduce the false classification rate by 10.7%, 15%, and 33% in relation to the sole SVM algorithm, the regression model, and the waistline measurement model, respectively. For the frequency band of 1 KHz, the proposed model is still more accurate. (4) Conclusions: The proposed method effectively improves the prediction accuracy and reduces the sample size dependence of the algorithm, which can provide a reference for abdominal obesity.

Prevalence, temporal trend and associated factors with excess body weight in mothers of children under five years

ABSTRACT Objective This study aims to evaluate the prevalence, temporal trends and associated factors with excess weight in mothers of children under five years of age. Methods This is a time-series study using data from two household surveys conducted in 2005 and 2015. A total of 1,436 mothers were evaluated in 2005, and 690 were evaluated in 2015. The dependent variables were excess body weight (Body Mass Index [BMI] ≥25.0kg/m2), high percentage of Body Fat (%BF ≥33%) and abdominal obesity (waist circumference >80cm). The independent variables were the socioeconomic and demographic factors. The changes that occurred between the two surveys were expressed in percentages, and the measure of association was the Prevalence Ratio, calculated by Poisson regression, in both the crude and multivariate analyses. Results There were increases of 33.2%, 59.2% and 31.0%, respectively, for the prevalence of excess weight (PR=1.33, 95% Confidence Interval [CI]:1.21-1.46), abdominal obesity (PR=1.59, 95% CI:1.43-1.77) and high %BF (PR=1.31, 95% CI:1.07-1.60). The factors independently associated with excess weight and abdominal obesity were the highest age group (>30 years), menarche ≤12 years and higher parity (>2 children). The same was observed for high %BF, except for the loss of significance in the adjusted analysis for the variable menarche ≤12 years. Conclusion The prevalence of high body adiposity is a problem of relevant importance in the studied population and has presented an upward trend in the last 10 years. Women over 30 years and with more than two children should be given priority in prevention and control.

Can neck circumference predict insulin resistance in older people? A cross-sectional study at primary care in Brazil

This study focused on the correlation between neck circumference and other anthropometric measurements and cardiovascular risk factors and insulin resistance in the elderly in Niterói, Rio de Janeiro State, Brazil. This was a cross-sectional study in 411 patients seen in primary care. Anthropometric measurements including neck circumference, body mass index (BMI), waist circumference (WC), and waist-hip ratio (WHR) were recorded. Bioelectrical impedance analysis (BIA) estimated the percentage of total body fat (%TBF). Insulin resistance was estimated by HOMA-IR (homeostasis model assessment IR index). The data were analyzed by the Mann-Whitney test and the correlation between numerical variables by Spearman's test. Receiver operating characteristic (ROC) was used to assess the anthropometric measurements' predictive capacity to diagnosis insulin resistance. Neck circumference was positively correlated with WC, BMI, WHR, %TBF, and HOMA-IR in both sexes. In women, neck circumference showed higher AUC (area under the curve) for insulin resistance. In men, WC showed higher AUC, followed by BMI and neck circumference. The current study in Southeast Brazil suggests that neck circumference can predict insulin resistance, an important marker of cardiovascular risk in the elderly population treated in primary care.