1
|
Andrade RCGD, Figueiredo RCD, Foss-Freitas MC, Pace AE, Dal Fabbro AL, Franco LJ, Foss MC. Prevalence of diabetes mellitus in the Japanese-Brazilian community of Mombuca, Guatapará, SP. ACTA ACUST UNITED AC 2011; 55:127-33. [DOI: 10.1590/s0004-27302011000200005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2010] [Accepted: 01/26/2011] [Indexed: 11/22/2022]
Abstract
OBJECTIVE: To estimate the prevalence of type 2 diabetes mellitus (DM2) and impaired glucose tolerance (IGT) in the Japanese-Brazilian community of Mombuca in relation to risk factors (FR) for diabetes and cardiovascular disease. SUBJECTS AND METHODS: Cross-sectional study with 131 individuals of Japanese ancestry (69% first generation), aged 20 years or more, submitted to socio-cultural, anthropometric, and biochemistry evaluation. RESULTS: Of the individuals studied (n = 131, age = 55.1 ± 15.9 years), 58.8% were women. The prevalence of DM2 and IGT were 13.7% and 14.5%, respectively. Regarding RF, 76.3% presented dyslipidemia, 52.7% abdominal obesity, 48.1% arterial hypertension, and 42.3% whole body obesity. CONCLUSIONS: The prevalence of DM2, IGT, and RF in this Japanese-Brazilian community was higher than in the adult population of the city of Ribeirão Preto-SP, Brazil, suggesting an increase in risk conditions for these morbidities.
Collapse
|
2
|
Foss-Freitas MC, de Andrade RCG, Figueiredo RC, Pace AE, Martinez EZ, Dal Fabro AL, Franco LJ, Foss MC. Comparison of venous plasma glycemia and capillary glycemia for the screening of type 2 diabetes mellitus in the Japanese-Brazilian community of Mombuca (Guatapará-SP). Diabetol Metab Syndr 2010; 2:6. [PMID: 20180998 PMCID: PMC2828405 DOI: 10.1186/1758-5996-2-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2009] [Accepted: 01/22/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To identify the most appropriate cut-off points of fasting glycemia for the screening of diabetes mellitus type 2 (DM2) with the comparison of the properties of capillary glycemia (CG) and venous blood plasma glycemia (PG) in a population of Japanese origin from the community of Mombuca, Guatapará-SP, Brazil. METHODS This was a population-based descriptive cross-sectional study conducted on a sample of 131 individuals of both genders aged 20 years or more (66.8% of the target population). CG was measured with a glucometer in a blood sample obtained from the fingertip and PG was determined by an enzymatic method (hexokinase) in venous blood plasma, after a 10-14 hour fast in both cases. Data were analyzed by the receiver operating characteristic (ROC) curve in order to identify the best cut-off point for fasting glycemia (CG and PG) for the diagnosis of DM, using the 2-hour plasma glycemia > 200 mg/dl as gold - standard. RESULTS The ROC curve revealed that the best cut-off point for the screening of DM was 110 mg/dl for CG and 105 mg/dl for PG, values that would optimize the relation between individuals with positive and false-positive results. The area under the ROC curve was 0.814 for CG (p < 0.01) and 0.836 for PG (p < 0.01). CONCLUSIONS The cut-off points of 105 mg/dl(5.8 mmol/l) for PG and of 110 mg/dl(6.1 mmol/l) for CG appear to be the most appropriate for the screening of DM2 in the population under study, with emphasis on the fact that the value recommended for CG is 5 mg/dl higher than that for PG, in contrast to WHO recommendations.
Collapse
Affiliation(s)
- Maria Cristina Foss-Freitas
- Departamento de Clinica Médica, Faculdade de Medicina de Ribeirão Preto-USP, (Av. Bandeirantes 3900), Ribeirão Preto-SP(14049-900), Brazil
| | - Regina CG de Andrade
- Faculdade de Ciências Farmacêuticas de Ribeirão Preto-USP, (Av. Bandeirantes 3900), Ribeirão Preto-SP(14049-900), Brazil
| | - Roberta C Figueiredo
- Departamento de Medicina Social, Faculdade de Medicina de Ribeirão Preto-USP, (Av. Bandeirantes 3900), Ribeirão Preto-SP(14049-900), Brazil
| | - Ana Emília Pace
- Escola de Enfermagem de Ribeirão Preto-USP, (Av. Bandeirantes 3900), Ribeirão Preto - SP (14040-902), Brazil
| | - Edson Z Martinez
- Departamento de Medicina Social, Faculdade de Medicina de Ribeirão Preto-USP, (Av. Bandeirantes 3900), Ribeirão Preto-SP(14049-900), Brazil
| | - Amaury L Dal Fabro
- Departamento de Medicina Social, Faculdade de Medicina de Ribeirão Preto-USP, (Av. Bandeirantes 3900), Ribeirão Preto-SP(14049-900), Brazil
| | - Laércio J Franco
- Departamento de Medicina Social, Faculdade de Medicina de Ribeirão Preto-USP, (Av. Bandeirantes 3900), Ribeirão Preto-SP(14049-900), Brazil
| | - Milton C Foss
- Departamento de Clinica Médica, Faculdade de Medicina de Ribeirão Preto-USP, (Av. Bandeirantes 3900), Ribeirão Preto-SP(14049-900), Brazil
| |
Collapse
|
3
|
Yamashita C, Damião R, Chaim R, Harima HA, Kikuchi M, Franco LJ, Ferreira SRG. União interétnica de nipo-brasileiros associada a hábitos alimentares menos saudáveis e ao pior perfil de risco cardiometabólico. ACTA ACUST UNITED AC 2009; 53:485-96. [DOI: 10.1590/s0004-27302009000500002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2009] [Accepted: 06/16/2009] [Indexed: 11/22/2022]
Abstract
OBJETIVO: Casamento interétnico entre brasileiros nikkeis e não nikkeis pode favorecer a ocidentalização da dieta. Compararam-se consumo alimentar, dados clínico-laboratoriais e frequências de doenças metabólicas em população nipo-brasileira, com casamento intraétnico ou interétnico. MÉTODOS: Empregaram-se teste t, Mann-Whitney, qui-quadrado e coeficiente de Pearson. RESULTADOS: Em 1009 nipo-brasileiros havia 18,9% de casamentos interétnicos, mais frequentes entre homens nikkeis. Estes apresentaram maiores médias de IMC, cintura, pressão arterial, glicemia e triglicérides que mulheres. As frequências de obesidade, hipertrigliceridemia e síndrome metabólica foram 47,7%, 68,1% e 45,2%, sendo maiores nos casamentos interétnicos comparados aos intraétnicos. Comparando-se indivíduos com casamento interétnico, hipertrigliceridemia foi mais frequente nos homens e HDL-c baixo nas mulheres. O consumo de calorias, gorduras e dos grupos de álcool, doces e óleos foram maiores nos casamentos interétnicos. Indivíduos casados intraetnicamente consumiam mais carboidratos, proteínas, fibras, vitaminas, minerais, hortaliças, frutas/sucos, cereais e missoshiru. Comparando-se indivíduos com casamento interétnico, homens nikkeis apresentavam padrão mais ocidental que mulheres nikkeis. CONCLUSÃO: Casamento interétnico associa-se a hábitos alimentares menos saudáveis e pior perfil de risco cardiometabólico.
Collapse
|
4
|
Figueiredo RCD, Franco LJ, Andrade RCGD, Foss-Freitas MC, Pace AE, Dal Fabbro AL, Foss MC. Obesidade e sua relação com fatores de risco para doenças cardiovasculares em uma população nipo-brasileira. ACTA ACUST UNITED AC 2008; 52:1474-81. [DOI: 10.1590/s0004-27302008000900011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2008] [Accepted: 10/20/2008] [Indexed: 11/22/2022]
Abstract
OBJETIVO: Descrever associações entre excesso de peso e obesidade abdominal com fatores de risco cardiovascular na população nipo-brasileira de Mombuca, Guatapará, SP. MÉTODOS: Participaram do estudo 131 indivíduos com descendência japonesa (69,2% da primeira e 30,8% da segunda geração), com idade > 20 anos, correspondendo a 66,8% da população residente dessa faixa etária. Os dados foram coletados por meio de questionários padronizados e foram realizados exames clínicos e laboratoriais. RESULTADOS: A prevalência de sobrepeso foi de 29,6% entre os homens e de 25,6% entre as mulheres e a de obesidade foi de 46,3% entre os homens e de 39,0% entre as mulheres. Entre os homens a prevalência de obesidade abdominal foi de 55,6% e entre as mulheres de 20,8%. O índice de massa corpórea foi associado independentemente com triglicérides, circunferência abdominal e idade; a pressão arterial sistólica com a circunferência abdominal. CONCLUSÃO: O presente estudo enfatiza a necessidade de medidas de intervenção para a prevenção da obesidade na população nipo-brasileira de Mombuca.
Collapse
|
5
|
Garofolo L, Barros N, Miranda F, D'Almeida V, Cardien LC, Ferreira SR. Association of Increased Levels of Homocysteine and Peripheral Arterial Disease in a Japanese-Brazilian Population. Eur J Vasc Endovasc Surg 2007; 34:23-8. [PMID: 17482486 DOI: 10.1016/j.ejvs.2007.02.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2006] [Accepted: 02/13/2007] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Our aim was to evaluate the possible association between homocysteine levels and peripheral arterial disease (PAD) in a population-based study of Japanese-Brazilians. MATERIALS AND METHODS This cross-sectional study was derived from a population-based survey on the prevalence of diabetes and associated diseases conducted in Japanese-Brazilians. A total of 1330 male and female subjects aged>or=30 years were submitted to clinical examination and laboratory procedures including homocysteine measurement. The ankle-brachial index (ABI) was calculated; subjects with ABI values <0.9 were diagnosed with PAD. The evaluable population included 1008 subjects. Logistic regression was used taking PAD as the dependent variable. RESULTS Mean age of the population was 56.5 years and overall prevalence of PAD was 20%. A worse cardiovascular profile was found in male patients, including significantly higher homocysteine levels (11.9+/-1.8 vs. 9.1+/-1.1micromol/L, p<0.001). Men with PAD had higher prevalence rates of hyperhomocysteinemia compared to women (22.7% vs 7.6%). Univariate analysis showed an odds ratio of hyperhomocysteinemia for PAD of 1.51 [1.02-2.25] in men and 1.69 [1.06-2.68] in women. After adjustment for other cardiovascular risk factors, higher levels of homocysteine were only significantly related to PAD in men. CONCLUSION In a Japanese-Brazilian population, elevated levels of homocysteine are associated with PAD in men. Prospective studies are necessary to confirm this finding.
Collapse
Affiliation(s)
- L Garofolo
- Post-Graduation Course on Cardiac, Vascular and Thoracic Surgery, Surgery Department, Federal University of Sao Paulo, Sao Paulo, Brazil.
| | | | | | | | | | | |
Collapse
|
6
|
Simony RF, Gimeno SGA, Ferreira SRG, Franco LJ. Which body mass index is best associated with risk of diabetes mellitus and hypertension in a Japanese-Brazilian population? CAD SAUDE PUBLICA 2007; 23:297-304. [PMID: 17221078 DOI: 10.1590/s0102-311x2007000200005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2005] [Accepted: 10/21/2005] [Indexed: 11/21/2022] Open
Abstract
The objective of this study was to evaluate the impact of different body mass index (BMI) ranges associated with the risk of diabetes and hypertension in Japanese-Brazilians. This cross-sectional study was based on data from 1,330 Japanese-Brazilians > 30 years of age who participated in a population-based survey on the prevalence of diabetes mellitus and associated diseases. Glucose tolerance status was classified according to WHO criteria and blood pressure levels according to the VI-JNC. Odds ratios for diabetes and hypertension were calculated for different BMI ranges; for different BMIs, sensitivity and specificity for percentiles 25, 50, 75, 90 and 95 were obtained. Increased odds ratios for diabetes mellitus and hypertension were observed with BMI values > 25kg/m². The 50th percentile corresponded to the highest sensitivity and specificity for the identification of risk for both diseases. Our results suggest that BMI values proposed by WHO should also be useful for this group of Japanese descendants in the assessment of risk for DM and hypertension.
Collapse
Affiliation(s)
- Rosana Farah Simony
- Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brasil.
| | | | | | | |
Collapse
|
7
|
Gimeno SGA, Osiro K, Matsumura L, Massimino FC, Ferreira SRG. Glucose intolerance and all-cause mortality in Japanese migrants. Diabetes Res Clin Pract 2005; 68:147-54. [PMID: 15860243 DOI: 10.1016/j.diabres.2004.09.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2004] [Revised: 08/17/2004] [Accepted: 09/08/2004] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To assess all-cause mortality in a Japanese-Brazilian community according to the categories of glucose tolerance. STUDY DESIGN AND SETTING The cohort consisted of participants examined in two phases of a follow-up study started in 1993 (n=647). They were interviewed and submitted to an oral glucose tolerance test. Student's t-test was used to compare baseline parameters between alive and dead subjects. Cox proportional hazards model was used to estimate crude and adjusted hazard ratios (HR). RESULTS Seventy-one deaths occurred during the study period and a higher proportion of men (62%) was detected. Crude all-cause mortality rate was 16.2/1000 person-year. Vascular disease and cancer were the most frequent causes of deaths (77.3%). A higher mortality rate was observed in subjects with diabetes when compared with the normal glucose tolerant ones (HR: 2.0; 95% CI: 1.1-3.6), independently of age, systolic blood pressure, smoking and history of myocardial infarction. CONCLUSION Also among Japanese living in the Western world, a deleterious role of fasting and 2-h plasma glucose was found on mortality especially among younger subjects.
Collapse
Affiliation(s)
- Suely G A Gimeno
- Preventive Medicine Department, Federal University of São Paulo (UNIFESP-EPM), São Paulo, Brazil.
| | | | | | | | | |
Collapse
|
8
|
Salles GF, Bloch KV, Cardoso CRL. Mortality and predictors of mortality in a cohort of Brazilian type 2 diabetic patients. Diabetes Care 2004; 27:1299-305. [PMID: 15161779 DOI: 10.2337/diacare.27.6.1299] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To investigate mortality rates and predictors of mortality in Brazilian type 2 diabetic patients. RESEARCH DESIGN AND METHODS A prospective follow-up study was carried out with 471 type 2 diabetic outpatients. Primary end points were all-cause, diabetes-related, and cardiovascular deaths. Excess mortality in this cohort was evaluated by calculating standardized mortality ratios (SMRs) in relation to those of the Rio de Janeiro population. Predictors of mortality were assessed by Kaplan-Meier survival curves and by uni- and multivariate Cox survival analyses. RESULTS During a median follow-up of 57 months (range 2-84 months), 121 (25.7%) patients died, 91 (75.2%) from diabetes-related causes and 44 (36.4%) from cardiovascular diseases. After adjusting for age and sex, the all-cause SMR was 3.36 (95% confidence interval [CI] 2.81-4.02) and the cardiovascular SMR was 3.28 (CI 2.44-4.41). In the Cox multivariate analysis, the predictors of mortality were older age, increased 24-h proteinuria, preexisting vascular disease, presence of frequent ventricular premature contractions and prolonged maximum heart rate-corrected QT interval on baseline electrocardiogram, and decreased serum HDL cholesterol. The use of beta-blockers was a protective factor. In Kaplan-Meier curves, these variables were capable of distinguishing subgroups of patients with significantly different prognoses. CONCLUSIONS Brazilian type 2 diabetic patients had a more than threefold excess mortality than the general population, largely because of increased cardiovascular mortality risk. Several clinical, laboratory, and electrocardiographic predictors of mortality were identified that could possibly be modified to decrease the mortality burden of type 2 diabetes in Brazil.
Collapse
Affiliation(s)
- Gil F Salles
- Department of Internal Medicine, Clementino Frago Filho University Hospital, Faculty of Medicine, Federal University of Rio de Janeiro, Rua Croton 72, Jacarepaguá, CEP: 22750-240, Rio de Janeiro, Brazil.
| | | | | |
Collapse
|
9
|
Lerario DDG, Gimeno SG, Franco LJ, Iunes M, Ferreira SRG. [Weight excess and abdominal fat in the metabolic syndrome among Japanese-Brazilians]. Rev Saude Publica 2002; 36:4-11. [PMID: 11887223 DOI: 10.1590/s0034-89102002000100002] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Obesity, especially abdominal, has been associated with cardiovascular risk factors such as dyslipidemia, hypertension and diabetes mellitus (DM). The importance of these risk factors among Japanese-Brazilians was previously shown, although obesity is not a typical characteristic of Japanese migrants. In this study the prevalence of weight excess and central adiposity (CA) among Japanese-Brazilians and their association with metabolic disorders was evaluated. METHODS A sample of 530 1st and 2nd generation Japanese-Brazilians (aged 40 - 79 years) went through anthropometric and blood pressure measurements, lipid profile and oral glucose tolerance tests. The prevalence rate (point and confidence interval) of overweight was calculated using a cut-off value of >26.4 kg/m2. CA diagnosis was based on waist-to-hip circumference ratio (WHR): greater-than-or-equal 0.85 and 0.95 in women and men, respectively. RESULTS The prevalence of weight excess was 22.4% (CI 95% 20.6 - 28.1), and CA was 67.0% (95% CI 63.1 - 70.9). In addition to higher prevalence of DM, hypertension and dyslipidemia, stratifying by BMI and WHR, people with weight excess and CA revealed a poorer metabolic profile: blood pressure levels were significantly higher among those with weight excess with or without CA; CA individuals had higher glucose, triglycerides, total and LDL cholesterol, and lower HDL than those without weight excess or CA; fasting insulinemia was significantly higher among subjects with weight excess (with or without CA) than among those without weight excess or CA. CONCLUSION Comparing subgroups with and without CA supports the hypothesis that abdominal fat accumulation represents a risk factor for insulin resistance-related diseases, even among Japanese descendants. The increased prevalence of metabolic syndrome among Japanese migrants could be attributed to visceral fat deposition, which has been implicated in the genesis of insulin resistance.
Collapse
Affiliation(s)
- Daniel D G Lerario
- Departamento de Medicina, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil.
| | | | | | | | | |
Collapse
|