BackgroundVisceral obesity is associated with higher occurrence of cardiovascular events. There are few studies about the accuracy of anthropometric clinical indicators, using Computed Tomography (CT) as the gold standard. We aimed to determine the accuracy of anthropometric clinical indicators for discrimination of visceral obesity.MethodsCross-sectional study with 191 adults and elderly of both sexes. Variables: area of visceral adipose tissue (VAT) identified by CT, Waist-to-Height Ratio (WHtR), Conicity index (C index), Lipid Accumulation Product (LAP) and Visceral Adiposity Index (VAI). ROC analyzes.ResultsThere were a strong correlation between adiposity indicators and VAT area. Higher accuracy of C index and WHtR (AUC≥0.81) than the LAP and the VAI was observed. The higher AUC of LAP and VAI were observed among elderly with areas of 0.88 (CI: 0.766–0.944) and 0.83 (CI: 0.705–0.955) in men and 0.80 (CI: 0.672–0.930) and 0.71 (CI: 0.566–0.856) in women, respectively. The cutoffs of C index were 1.30 in elderly, in both sexes, with sensitivity ≥92%, the LAP ranged from 26.4 to 37.4 in men and from 40.6 to 44.0 in women and the VAI was 1.24 to 1.45 (sens≥76.9%) in men and 1.46 to 1.84 in women.ConclusionBoth the anthropometric indicators, C Index and WHtR, as well as LAP and VAI had high accuracy in visceral obesity discrimination. So, they are effective in cardiovascular risk assessment and in the follow-up for individual and collective clinical practice.
Background: Adiposity indicators can be used as predictors of cardiovascular risk in the elderly. However, there are only a very few studies that deal with the accuracy of adiposity indicators as predictors of metabolic syndrome (MS) in the elderly. We evaluated the performance of adiposity indicators of MS prediction in the elderly. Methods: A cross-sectional study with 203 elderly people of both genders. Variables: MS defined by harmonized criteria, waist circumference (WC), waist-to-height ratio (WHtR), conicity index (CI), lipid accumulation product (LAP), and visceral adiposity index (VAI). Area under the receiver operating characteristic curve (AUC), sensitivity (sens) and specificity (spec). Results: The WC, WHtR, and LAP indicators showed the highest AUC, with values greater than 0.84. For the general population, WHtR and LAP had the highest Youden index values, identifying a point of approximately 0.55 (sens: 85.6%; spec: 80.4%) for WHtR and 32.3 (sens: 81.1%; spec: 75.0%) for LAP. When analyzed by gender, it was observed that the WC and WHtR had the highest Youden index values for prediction of MS in both genders. The CI and VAI showed the lowest discriminatory power for MS. Conclusion: Both the adiposity indicators, WC and WHtR, as well as LAP, had high accuracy in MS discrimination. Therefore, they are effective in MS assessment in the elderly and during follow-up for individual and collective clinical practice.
The prevalence of sarcopenia was high among the elderly living in long-term institutions, especially among men. Elderly with thinness showed greater impairment of muscle reserves, while the state of obesity was protective.
As a common problem in long-term care facilities (LTCFs), anemia affects 25–63% of the elderly. The aim of the present study was to describe the prevalence and characteristics of anemia and its associated factors in the institutionalized elderly. The cross-sectional study was carried out with three hundred thirteen individuals aged ≥ 60 years, of both genders, living in long-term care facilities for the elderly in Salvador, Bahia, Brazil. Poisson regression (PR) with robust variance estimates was used to assess the factors related to anemia. The prevalence of anemia was 38%. Mild anemia was predominant in both genders (male: 26.8%; female: 21.1%), as normocytic and normochromic anemia, with no anisocytosis (69.75%). Anemia was associated with thinness (PR: 1.68; 95% CI: 1.04–2.72) and with moderate (PR: 1.98; 95% CI: 1.07–3.63) and total (PR: 2.61; 95% CI: 1.34–5.07) dependence in the final model. Severe dependence exhibited borderline significance (PR: 1.94; 95% CI: 1.00–3.77). The prevalence of anemia was high in the institutionalized elderly in both genders, with characteristics suggesting chronic diseases as the causal factor, and the frequency of occurrence was higher in thinness elderly with moderate to total dependence.
RESUMOObjetivo: Avaliar a associação entre bioimpedância elétrica (BIA) e gordura visceral (GV) em adultos e idosos. Sujeitos e métodos: Estudo transversal, 191 indivíduos (52% mulheres, 49% idosos), estratificados por sexo, grupo etário e massa corporal. Obtiveram-se dados sobre tomografia computadorizada (área de GV) e BIA (percentual de gordura corporal total (%GCT-BIA), ângulo de fase, reactância e resistência). Análise estatística: Coeficiente de Correlação de Pearson, Anova, Qui-quadrado de Pearson, Curva ROC. Resultados: Áreas de GV ≥ 130 cm 2 foram mais observadas em idosos e em homens. Entre as mulheres adultas, mostrou-se correlação mais forte entre GV e %GCT-BIA. Os demais grupos apresentaram resultados semelhantes e correlações estatisticamente significantes. As correlações entre GV e ângulo de fase foram fracas e sem significância estatística. As análises da Curva ROC indicaram os seguintes %GCT-BIA que identificaram excesso de GV: homens: 21,5% (adultos), 24,25% (idosos); mulheres: 35,05% (adultas), 38,45% (idosas), com sensibilidade de 78,6%, 82,1%, 83,3%, 66,7% e especificidade de 70,6%, 62,5%, 79,1%, 69%, respectivamente. Conclusão: BIA apresentou satisfatória sensibilidade e especificidade para predizer GV, entretanto, outros aparelhos e técnicas devem ser investigados para melhorar essa predição.Arq Bras Endocrinol Metab. 2013;57(1):27-32 Descritores Gordura visceral; impedância elétrica; tomografia computadorizada ABSTRACT Objective: To evaluate the association between electrical bioimpedance analysis (BIA) and visceral fat (VF) in adult and elderly patients. Subjects and methods: This was a cross-sectional study, with a sample of 191 subjects (52% women, 49% elderly) stratified by sex, age and body mass. Computerized tomography (VF area) and BIA (percentage of total body fat (%TBF-BIA), phase angle, reactance and resistance) data were generated. Statistical analysis was based on Pearson's Correlation Coefficient, Anova, Pearson's Chi-square, and ROC curves. Results: VF areas ≥ 130 cm 2 were more prevalent among the elderly and among men. Adult females showed a stronger correlation between GV and %TBF-BIA. The other groups showed similar results and statistically significant correlations. Correlations between GV and phase angle were weak and not statistically significant. ROC Curves analyzes showed the following %TBF-BIA, which identified excess VF: for male subjects: 21.5% (adults) and 24.25% (elderly); for female subjects: 35.05% (adults) and 38.45% (elderly) with sensitivity of 78.6%, 82.1%, 83.3%, and 66.7%, and specificity of 70.6%, 62.5%, 79.1%, and 69%, respectively. Conclusion: BIA was found to have satisfactory sensitivity and specificity to predict VF; however, other devices and other techniques should be investigated to improve VF prediction.
Context Sarcopenia, besides having an impact on functional capacity, has been associated with increased hospitalization and mortality, and stands out as an essential cause of disability among older people. Objective We conducted a systematic review and meta-analysis of published studies comparing the calories and nutrients ingested by elderly people with and without sarcopenia. Data sources MEDLINE/PubMed, Scopus, LILACS, Cochrane Library, and Scielo databases were searched. Study Selection Studies comparing calories and nutrient intake among elderly people diagnosed with sarcopenia and people without sarcopenia were included. Data Analysis Mean differences and 95% confidence intervals (CIs) were calculated, and heterogeneity was assessed using I2 test. Results A total of 23 studies fulfilled the inclusion criteria. The average number of calories and nutrients ingested were significantly lower in elderly study participants with sarcopenia compared with those without sarcopenia. The meta-analyses showed that the average number of calories ingested (n = 19 studies; mean difference, −156.7 kcal; 95%CI, −194.8 to −118.7) were significantly lower in those with sarcopenia than in elderly participants without sarcopenia. Compared to those without sarcopenia, elderly people with sarcopenia consumed lower amounts of proteins; carbohydrates; saturated fatty acids; vitamins A, B12, C, and D; and minerals such as calcium, magnesium, sodium, and selenium. Conclusions The evidence so far available suggests a difference in caloric, macronutrient (ie, proteins, carbohydrates, saturated fatty acids), and micronutrient (ie calcium, magnesium, sodium, selenium, and vitamins A, B12, C, and D) intake among the elderly with and without sarcopenia. Additional studies are needed to define the best interventions to improve the consumption of calories and nutrients by the aging population.
Background: Androgenic obesity is associated with a higher risk of metabolic disorders, thus favoring the occurrence of cardiovascular diseases and other morbidities.
The article aimed to critically analyse studies which evaluated the capacity of anthropometric and clinical indicators to predict MetS in the elderly. Bibliographical research was performed using the electronic databasese Medline/PubMed, LILACS e SciELO , references from selected articles and contact with several authors. Twenty one articles involving anthropometric and clinical indicators in the elderly were analysed, using different MS criteria. Fourteen studies report anthropometric indicators, being the waist circumference (WC) and waist-to-height ratio (WHtR), described as the best MS predictors, with the area under the ROC curve (AUC) over 0.70 (p < 0.05). The neck circumference was also described as an alternative indicator but with less discriminatory power. Lipid accumulation product (LAP) was the parameter with the best performance to identify MS, with an AUC over 0.85 and efficiency greater than 70%. The WC, WHtR and LAP indicators were the most sensitive for predicting MS. The use of these parameters may facilitate the early identification of MS, with good accuracy and low cost. In addition, it is important to determine specific cutoff points for the elderly, since obesity alone does not appear to be a strong predictor of MS in the elderly.
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