ResumoObjetivo: Determinar, entre um grupo de crianças e adolescentes eutróficos, os valores de glicemia e insulinemia de jejum e de índice homeostasis model assessment (HOMA). Métodos: Estudo de corte transversal realizado em duas escolas públicas de Ribeirão Preto (SP). Foram obtidas medidasantropométricas, dados pessoais e colhida amostra de sangue venoso de 447 crianças e adolescentes eutróficos, de ambos os sexos, com idades entre 7 e 17,9 anos, maturadores médios. Mediram-se glicemia de jejum e insulinemia de jejum e calculou-se o HOMA. Utilizando o teste de Mann-Whitney, foram realizadas comparações entre os valores obtidos para meninos e meninas em cada faixa etária. Posteriormente, utilizando o teste de Kruskal-Wallis, foram comparados os valores em cada faixa etária para meninos e meninas.Resultados: Entre as meninas, os valores de glicemia apresentaram variação entre 7 a 8,9 anos (p = 0,0005). Para ambos os sexos, em relação à insulinemia, ocorreu variação de acordo com a idade (p < 0,001), com valores mais elevados na faixa de 13 a 14,9 anos. Os valores de HOMA apresentaram variação significativa de acordo com a idade (p < 0,001) para meninos e meninas, com valores crescentes até a faixa de 13 a 14,9 anos. Conclusões:Os dados apontam para a necessidade do estabelecimento de curvas de referência para os três indicadores.J Pediatr (Rio J). 2008;84(2):136-140: Obesidade, hiperinsulinismo, insulina, hiperglicemia, síndrome X metabólica. AbstractObjective: To determine fasting glycemia and insulinemia levels and the HOMA index in a group of children and adolescents with normal body mass index (BMI).Methods: This was a cross-sectional study conducted at two public schools in Ribeirão Preto, SP, Brazil. A total of 447 children and adolescents of both sexes, with normal BMI, aged 7 to 17.9 years and of average maturity for their age, underwent anthropometric measurements and provided personal data and a sample of venous blood so that glycemia, insulinemia and HOMA index could be determined. The results obtained for boys and girls were compared for each age range using the Mann-Whitney test. The results within each age band were then compared for boys and girls using the Kruskal-Wallis test. Results:Glycemia results varied from 7 to 8.9 years (p = 0.0005). Fasting insulinemia varied significantly with age in both sexes (p < 0.001), with the highest values observed among children aged 13 to 14.9 years. HOMA indices varied significantly with age in both boys and girls (p < 0.001), with values that increased progressively up to the age band of 13 and 14.9 years.Conclusions: These data demonstrate the necessity of establishing reference curves for these three indicators. J Pediatr (Rio J)
ResumoObjetivo: Avaliar sensibilidade e especificidade de duas tabelas de referência para circunferência abdominal em crianças na detecção de valores elevados de índice de massa corporal, colesterol total, insulinemia de jejum, leptinemia de jejum e homeostasis model assessment. Métodos:Foram avaliados 624 indivíduos, de ambos os sexos, com idades entre 7 e 18 anos, provenientes de duas escolas públicas, obtendo-se amostra de sangue venoso em jejum para dosagens de insulina, glicemia, leptina e colesterol total. Peso, estatura e circunferência abdominal foram aferidos de acordo com recomendações internacionais. AbstractObjective: To evaluate the sensitivity and specificity of two pediatric abdominal circumference reference tables to detect abnormally high body mass index, total cholesterol, fasting blood insulin and leptin levels, and homeostasis model assessment values. Methods:A total of 624 male and female subjects, with ages ranging from 7 to 18 years, were evaluated. All children were recruited from two public schools. Venous blood samples were collected for determination of fasting plasma insulin, glucose, leptin, and total cholesterol levels. Weight,
ResumoObjetivo: Avaliar fatores determinantes de anemia e deficiência de ferro em crianças das duas creches da cidade de Pontal, sudeste do Brasil.Métodos: Estudo transversal foi realizado avaliando-se 192 crianças com idades entre 12 e 72 meses. Dados pessoais (idade, sexo, uso de ferro medicamentoso, duração do aleitamento materno, tipo de parto, cuidados pré-natais, peso e estatura) e dados sócio-econômicos (número de co-habitantes, escolaridade dos pais e renda per capita familiar) foram obtidos e correlacionados com hemoglobina, receptores de transferrina, ferritina e anemia ferropriva.Resultados: A idade foi a variável mais afetada pelo estado nutricional de ferro, correlacionando-se com maiores valores de hemoglobina e ferritina e menores valores de receptor de tranferrina, sendo que menos anemia ferropriva foi detectada quanto maior a idade. As outras variáveis estudadas não apresentaram correlação com o estado nutricional de ferro.Conclusão: Os dados sugerem que as estratégias de controle para essa população de crianças pré-escolares devem ser direcionadas especialmente para aquelas de menor idade. AbstractObjective: To examine the determining factors of anemia and iron deficiency in children attending two day care centers in the town of Pontal, southeast of Brazil.Methods: Cross-sectional study was conducted in 192 children aged 12 to 72 months. Personal data (age, sex, use of medicinal iron supplements, duration of breast-feeding, type of delivery, prenatal care, weight, and height), and socioeconomic data (number of coinhabitants, parental schooling, and per capita family income) were obtained and evaluated together with hemoglobin, serum transferrin receptor, ferritin, and iron deficiency anemia.Results: Age was the variable that most affected iron nutritional status, with higher hemoglobin values, lower transferrin receptor concentrations, higher ferritin values and lower iron deficiency anemia being detected with increasing age. The other studied variables did not show any correlation with iron nutritional status. Conclusion:The obtained data suggest that control strategies for this preschool population should be especially directed at younger children.
Results indicate that the table by Taylor et al. is best for screening purposes, as it identifies individuals at higher risk of presenting abnormal test results. On the other hand, the reference table by Freedman et al. is more suitable for clinical practice, as it could be used to replace laboratory measurements, such as blood insulin or leptin levels, which may not be available at all sites.
Objective: To determine fasting glycemia and insulinemia levels and the HOMA index in a group of children and adolescents with normal body mass index (BMI).Methods: This was a cross-sectional study conducted at two public schools in Ribeirão Preto, SP, Brazil. A total of 447 children and adolescents of both sexes, with normal BMI, aged 7 to 17.9 years and of average maturity for their age, underwent anthropometric measurements and provided personal data and a sample of venous blood so that glycemia, insulinemia and HOMA index could be determined. The results obtained for boys and girls were compared for each age range using the Mann-Whitney test. The results within each age band were then compared for boys and girls using the Kruskal-Wallis test.Results: Glycemia results varied from 7 to 8.9 years (p = 0.0005). Fasting insulinemia varied significantly with age in both sexes (p < 0.001), with the highest values observed among children aged 13 to 14.9 years. HOMA indices varied significantly with age in both boys and girls (p < 0.001), with values that increased progressively up to the age band of 13 and 14.9 years.Conclusions: These data demonstrate the necessity of establishing reference curves for these three indicators.J Pediatr (Rio J). 2008;84(2):136-140: Obesity, hyperinsulinism, insulin, metabolic syndrome X.
The obtained data suggest that control strategies for this preschool population should be especially directed at younger children.
Objective: To evaluate biochemical and physiological variables in overweight/obese and normal body weight female adolescents and assess whether cardiovascular risk factors, postulated as components of the metabolic syndrome, are already present in this age group.Methods: Cross-sectional study comparing all girls aged between 12 and 18 years from a highschool in Ribeirão Preto, São Paulo, Brazil. Girls were divided in two groups: overweight/obese (n=30) and control (n=39). The following were evaluated: weight, height, skinfolds, circumferences of the abdomen and hip and biochemical parameters (glucose, insulin, lipid profile, urea, creatinine, fibrinogen, PAI-1, ferritin, sodium and microalbuminuria).Results: Overweight and obese girls had higher levels of blood pressure, glucose, triglycerides, uric acid, PAI-1, fibrinogen and insulin, and lower HDL cholesterol compared with the control group. The analysis of risk factors clusters showed that 76.7% of adolescents from the overweight/obese group had two or more risk factors associated with metabolic syndrome, while 79.5% of the adolescents in the control group had one or none risk factors. Microalbuminuria and serum ferritin did not show differences between groups.Conclusion: Overweight/obese female adolescents already have hypertension, dyslipidemia, disfibrinolisys, hyperinsulinemia and clusters of cardiovascular risk factors.Key-words: obesity; hyperinsulinism; insulin; metabolic syndrome X; cardiovascular diseases; adolescent. RESUMOObjetivo: Avaliar parâmetros bioquímicos e fisiológicos em adolescentes do sexo feminino com sobrepeso/obesidade ou com peso corporal normal e avaliar se fatores de risco cardiovascular, postulados como componentes da síndrome metabólica, já estão presentes nessa faixa etária.Métodos: Estudo transversal, tendo-se comparado a totalidade de meninas com idades entre 12 e 18 anos de um colégio de Ribeirão Preto, divididas em dois grupos: sobrepeso/obesidade (n=30) e controle (n=39). De cada menina, foram avaliados parâmetros antropométricos (peso, estatura, dobras cutâneas, circunferências do abdome e do quadril) e bioquímicos (glicose, insulina, lipidograma, ureia, creatinina, fibrinogênio, PAI-1, ferritina, sódio e microalbuminúria).Resultados: As adolescentes com sobrepeso/obesidade apresentaram níveis maiores de pressão arterial, glicose, triglicérides, ácido úrico, PAI-1, fibrinogênio e insulina e níveis menores de colesterol-HDL em relação ao grupo controle. A análise de alterações e formação de clusters de fatores de risco demonstrou que 76,7% das adolescentes do grupo sobrepeso apresentaram dois ou mais fatores de risco relacionados à síndrome metabólica, enquanto 79,5% das adolescentes do grupo controle apresentaram nenhuma ou apenas uma alteração. Os parâmetros microalbuminúria e ferritina sérica não apresentaram alterações e diferenças entre os grupos.Conclusões: Adolescentes do sexo feminino com sobrepeso/ obesidade já apresentam hipertensão, dislipidemias, disfibrinólise, hiperinsulinemia e clusters de fatores de ...
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