Challenges for conducting blood collection and biochemical analysis in a large multicenter school-based study with adolescents: lessons from ERICA in Brazil

Cureau, Felipe Vogt; Bloch, Kátia Vergetti; Henz, Aline; Schaan, Camila Wohlgemuth; Klein, Carlos Henrique; Oliveira, Cecília Lacroix de; Giannini, Denise Tavares; Leon, Elisa Brosina de; Abreu, Gabriela de Azevedo; Teló, Gabriela Heiden; Dias, Glauber Monteiro; Carvalho, Kênia Mara Baiocchi de; Barufaldi, Laura Augusta; Kuschnir, Maria Cristina Caetano; Szklo, Moysés; Montenegro, Renan Magalhães; Silva, Thiago Luiz Nogueira da; Ekelund, Ulf; Schaan, Beatriz D.

doi:10.1590/0102-311x00122816

Cited by 32 publications

(21 citation statements)

References 17 publications

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“…Lipid and insulin abnormalities were defined following Brazilian guidelines as previously reported: total cholesterol ≥150 mg/dL; HDL‐cholesterol ≤45 mg/dL; LDL‐cholesterol ≥100 mg/dL; triglycerides ≥100 mg/dL; and insulin ≥15 mU/L . All blood samples were analyzed in a single laboratory following a standardized protocol …”

Section: Methodsmentioning

confidence: 99%

Prevalence of type 2 diabetes among adolescents in Brazil: Findings from Study of Cardiovascular Risk in Adolescents (ERICA)

et al. 2019

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Background Type 2 diabetes mellitus (T2DM) in adolescents represents a clinical challenge related to lifestyle and obesity; however, only a few data are available in developing countries. Therefore, our aim was to investigate the prevalence of T2DM and prediabetes among Brazilian adolescents, as well as to describe the cardio‐metabolic profile according to the diagnosis. Methods This is a cross‐sectional school‐based multicenter study including youth aged 12 to 17 years from cities with more than 100 000 inhabitants in Brazil (n = 37 854 students). Fasting glucose, hemoglobin A1c (HbA1c) and other cardio‐metabolic risk factors were measured. Prediabetes was defined by glucose levels 100 to 125 mg/dL or HbA1c 5.7% to 6.4%. T2DM was defined by self‐report, glucose ≥126 mg/dL or HbA1c ≥ 6.5%. Multinomial logistic regression was used to estimate the odds ratio (OR) of prediabetes or T2DM according to covariates. Results Prevalences of prediabetes and T2DM were 22.0% (95% confidence interval [CI] 20.6%‐23.4%) and 3.3% (95% CI 2.9%‐3.7%), respectively. This estimates represented 213 830 adolescents living with T2DM and 1.46 million adolescents with prediabetes in Brazil. Prevalences of cardio‐metabolic risk factors were higher in adolescents with prediabetes and T2DM. In the multinomial logistic model, obesity (OR 1.59, 95% CI 1.20‐2.11), high waist circumference (OR 1.51, 95% CI 1.13‐2.01), and skipping breakfast (OR 1.48, 95% CI 1.21‐1.81) were associated with an increased OR for T2DM, while studying at rural area (OR 0.56, 95% CI 0.41‐0.78) was associated with a decreased OR for T2DM. Conclusions The prevalence of T2DM and prediabetes was high among Brazilian adolescents, which highlights that this disease became a public health challenge not only among adults in Brazil.

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Section: Methodsmentioning

confidence: 99%

Prevalence of type 2 diabetes among adolescents in Brazil: Findings from Study of Cardiovascular Risk in Adolescents (ERICA)

et al. 2019

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“…These cities are located in four of the five Brazilian macroregions, and the sample was representative at a municipality level. A full description of the study design, data collection and blood sampling is available elsewhere [21, 22].…”

Section: Methodsmentioning

confidence: 99%

“…Intra and inter-assay coefficients of variation were < 5%, following the manufacturer instructions. Laboratory analyses were performed by a single laboratory using frozen serum (− 80 °C) and following a standardized protocol [21]. Thereafter, for data analyses, adiponectin concentrations were categorized into sex and age-specific quartiles (Additional file 1: Table S1).…”

Section: Methodsmentioning

confidence: 99%

Higher adiponectin concentrations are associated with reduced metabolic syndrome risk independently of weight status in Brazilian adolescents

Sparrenberger

Sbaraini

Teló

et al. 2019

Diabetol Metab Syndr

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Objective To evaluate the association between adiponectin concentrations and metabolic syndrome (MetS) risk and to investigate if this association is independent of weight status in adolescents. Methods Adiponectin concentrations and MetS risk were assessed in 4546 Brazilian adolescents (12–17 years old) enrolled in The Study of Cardiovascular Risks in Adolescents (“ERICA”), a cross-sectional multicenter study in Brazil. For analyses, adiponectin was categorized in sex and age-specific quartiles and MetS risk was expressed as a continuous score, calculated as the average of the standardized values (z-score) of the five MetS components. Multiple linear regression models were used to investigate the association between the quartiles of adiponectin and MetS risk. Results Adiponectin was inversely associated with waist circumference and log-transformed triglycerides, and positively associated with HDL-c. We also observed an inverse association between adiponectin concentrations and MetS risk. After adjustment for sociodemographic variables, physical activity, skipping breakfast and body mass index (BMI), higher quartiles of adiponectin remained inversely associated with waist circumference and MetS risk. A direct association between adiponectin and HDL-c was also observed. In further analysis, the sample was stratified by weight status and an inverse association between quartiles of adiponectin and MetS risk was observed in both normal weight and overweight/obese adolescents. Conclusion Higher adiponectin concentrations were independently and inverse associated with MetS risk in Brazilian adolescents, even after adjusting for BMI. These results were similar in normal weight and overweight/obese adolescents, suggesting that adiponectin may play a role in early development of MetS. Electronic supplementary material The online version of this article (10.1186/s13098-019-0435-9) contains supplementary material, which is available to authorized users.

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“…The adolescents were instructed to fast for 12 hours before sample collection and completed a questionnaire for compliance confirmation. A single reference laboratory (central unit) was used for all the biochemical analyses: triglycerides (TG), HDL-C, glucose, glycated hemoglobin, fasting insulin, and total count levels were evaluated [14]. The LDLc level was calculated using the Friedewald equation [15].…”

Section: Data Collectionmentioning

confidence: 99%

Prevalence of Combined Lipid Abnormalities in Brazilian Adolescents and Its Association with Nutritional Status: Data from the Erica Study

et al. 2020

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Background: Cardiovascular diseases are the leading cause of death in Brazil and worldwide. The growing incidence of obesity in children and adolescents and its association with lipid abnormalities may worsen this scenario, mainly in developing countries where obesity has reached epidemic levels. Dyslipidemias have several patterns, and the combination of some lipid abnormalities may have higher atherogenic potential. Objectives: To evaluate the prevalence of single or multiple combined lipid abnormalities in adolescents and its association with nutritional status assessed by body mass index. Methods: Data were obtained from the Study of Cardiovascular Risks in Adolescents (ERICA), a school-based, national representative study with Brazilian adolescents between 12 and 17 years of age. Adolescents whose lipid profiles were available were included, and lipid abnormalities were defined as LDL-C ≥ 100 mg/dL, HDL-C < 45 mg/dL, and tryglicerides (TG) ≥ 100 mg/dL. We assessed the prevalence of single or combined lipid abnormalities and correlated this nutritional status with body mass index of low weight, normal, overweight, and obesity. Results: A total of 38,069 adolescents were included, with more than 24,000 of them presenting at least one lipid abnormality (64.7%), and 3.7% showing alterations in all of them. The most prevalent combination was high TG with low HDL-C levels. The higher the BMI, the more lipid abnormalities were found. Conclusions: In this large and representative sample of Brazilian adolescents, the majority had at least one lipid abnormality. Higher BMI was associated with a higher prevalence of combined lipid abnormalities. Highlights:-There is a high prevalence of Brazilian adolescents with dyslipidemias.-BMI was associated with a higher prevalence of combined lipid abnormalities.-BMI can be considered as an indicator of the diagnosis of dyslipidemia in adolescents.

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Challenges for conducting blood collection and biochemical analysis in a large multicenter school-based study with adolescents: lessons from ERICA in Brazil

Cited by 32 publications

References 17 publications

Prevalence of type 2 diabetes among adolescents in Brazil: Findings from Study of Cardiovascular Risk in Adolescents (ERICA)

Prevalence of type 2 diabetes among adolescents in Brazil: Findings from Study of Cardiovascular Risk in Adolescents (ERICA)

Higher adiponectin concentrations are associated with reduced metabolic syndrome risk independently of weight status in Brazilian adolescents

Prevalence of Combined Lipid Abnormalities in Brazilian Adolescents and Its Association with Nutritional Status: Data from the Erica Study

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