Rates of obesity (OB) are escalating among Canadian children and youth and the obesogenic environment is likely to cause further increases. An important aspect in providing clinical care to OB children is to have accurate assessment measures, particularly of their body composition and cardiorespiratory fitness. This project entails three interrelated projects aiming to develop novel cardiorespiratory fitness and body composition measurement techniques for an OB pediatric population. The purpose of the first project was to validate a new submaximal fitness protocol specifically geared towards OB children and youth. The second objective of this thesis involved assessing cardiorespiratory efficiency utilizing the Oxygen Uptake efficiency slope. The purpose of the third project was to determine the validity of a half-body scan methodology for measuring body composition in obese children and youth. The goal of developing these novel measurement techniques is improved design and evaluation of interventions aimed at managing pediatric obesity.

Rates of obesity (OB) are escalating among Canadian children and youth and the obesogenic environment is likely to cause further increases. An important aspect in providing clinical care to OB children is to have accurate assessment measures, particularly of their body composition and cardiorespiratory fitness. This project entails three interrelated projects aiming to develop novel cardiorespiratory fitness and body composition measurement techniques for an OB pediatric population. The purpose of the first project was to validate a new submaximal fitness protocol specifically geared towards OB children and youth. The second objective of this thesis involved assessing cardiorespiratory efficiency utilizing the Oxygen Uptake efficiency slope. The purpose of the third project was to determine the validity of a half-body scan methodology for measuring body composition in obese children and youth. The goal of developing these novel measurement techniques is improved design and evaluation of interventions aimed at managing pediatric obesity.

The global epidemic of obesity is rapidly becoming a major public health problem in many parts of the world. Unhealthy diets and physical inactivity are two modifiable risk factors for prevention of obesity and its associated chronic diseases. Their influence on muscle energy metabolism and fat mass is not completely elucidated. A decreased capacity for fatty acid oxidation (FAO) may be a metabolic risk factor for weight gain and is found to be depressed in obese individuals; and exercise training may promote an increased capacity for FAO. In addition to the interest in whole-body FAO, the role of site specific lipid accumulation including visceral adipose tissue (VAT), intrahepatic lipids (IHL) and intramyocellular lipids (IMCL) has become a focus of interest because of their reported association with insulin resistance (IR), a key metabolic defect associated with obesity and type 2 diabetes mellitus (T2DM). However, ambiguity persists regarding the importance of IMCL as a metabolic substrate for energy production in obesity. A better understanding of the factors regulating FAO, body fat distribution and IMCL mobilisation is important for the development of interventions allowing effective treatment of conditions in which these are disturbed. The study of individuals with metabolic myopathies can give more information about the energy metabolism of muscle. McArdle disease (MD) affects glucose availability to muscle for energy production. Investigations into IMCL storage and mobilisation in MD have not been reported. The aims of this thesis are to investigate 1) the effects of weight-loss via dietary restriction plus modest but clinically-relevant exercise training on FAO, body fat distribution and mobilisation of IMCL during exercise in obese non-diabetic adults; 2) the effect of an exercise training intervention on IMCL storage and mobilisation in a subject with MD. All obese subjects underwent a 4 month lifestyle intervention with weekly meetings with a dietitian and an exercise physiologist. Of the 92 subjects, 73 completed the intervention. They showed significant decreases in body weight (8%), fat mass (14%) and total cholesterol (5%). The exercise prescription of 1500 kcal.week-1 resulted in variable compliance with the prescription (1224 ± 1085 kcal.week-1) measured by heart rate monitor. Those who did most exercise and also those who had less weekly variability in their exercise, had greater reductions in body weight and fat mass. The total activity energy expenditure measured by accelerometry did not change post-intervention but there was a reduction in low intensity activity and an increase in moderate and high intensity activity. A submaximal treadmill test and resting metabolic rate (RMR) using indirect calorimetry was measured before and after the intervention to investigate factors regulating FAO and energy expenditure. Subjects showed increases in FAO without change in energy expenditure for the same walking speed post intervention, but the volume of exercise completed during the intervention was not associated with these changes. To investigate body fat distribution in obesity, VAT, IHL and soleus muscle IMCL was measured in a sub-group of 18 males by magnetic resonance imaging (MRI) and spectroscopy (MRS) along with measurement of maximal aerobic capacity. Fitness increased significantly with significant decreases in VAT (29%) and IHL (54%), without significant change in IMCL. Subjects who had the greatest decrease in VAT were those who exercised for longer durations during the intervention. IHL was the only measure of excess lipid that correlated with IR. The measurement of IMCL before and after 1-hour of cycle ergometer exercise showed no significant mobilisation of IMCL either at baseline or after the lifestyle intervention. The intensity of the acute exercise was adjusted to correspond to each individual’s maximal fatty acid oxidation (MFAO) which increased by over 60% post intervention. In the subject with MD, an 8 week exercise training intervention without dietary intervention increased IMCL stores by 27%, but there was no marked change in IMCL with acute exercise at both time points. The findings of this thesis demonstrate that a clinically relevant and achievable lifestyle intervention incorporating weight loss through diet and objectively measured exercise can achieve improvements in blood lipid profile, body composition and FAO. The differential effects of the intervention on the various fat depots and their associations to metabolic markers suggest that individualised strategies may be required dependent upon body fat distribution. The non detection of mobilisation of IMCL by MRS suggests that these lipids may not be present as a substrate source in this population but rather an ectopic lipid depot related to increased energy consumption in diet. The relatively low capacity for FAO in both the obese and MD subjects may have affected the results. This thesis discusses implications for clinical practice, discusses novel findings related to the energy metabolism in obesity and MD and informs clinical and basic science about important future directions.

The global epidemic of obesity is rapidly becoming a major public health problem in many parts of the world. Unhealthy diets and physical inactivity are two modifiable risk factors for prevention of obesity and its associated chronic diseases. Their influence on muscle energy metabolism and fat mass is not completely elucidated. A decreased capacity for fatty acid oxidation (FAO) may be a metabolic risk factor for weight gain and is found to be depressed in obese individuals; and exercise training may promote an increased capacity for FAO. In addition to the interest in whole-body FAO, the role of site specific lipid accumulation including visceral adipose tissue (VAT), intrahepatic lipids (IHL) and intramyocellular lipids (IMCL) has become a focus of interest because of their reported association with insulin resistance (IR), a key metabolic defect associated with obesity and type 2 diabetes mellitus (T2DM). However, ambiguity persists regarding the importance of IMCL as a metabolic substrate for energy production in obesity. A better understanding of the factors regulating FAO, body fat distribution and IMCL mobilisation is important for the development of interventions allowing effective treatment of conditions in which these are disturbed. The study of individuals with metabolic myopathies can give more information about the energy metabolism of muscle. McArdle disease (MD) affects glucose availability to muscle for energy production. Investigations into IMCL storage and mobilisation in MD have not been reported. The aims of this thesis are to investigate 1) the effects of weight-loss via dietary restriction plus modest but clinically-relevant exercise training on FAO, body fat distribution and mobilisation of IMCL during exercise in obese non-diabetic adults; 2) the effect of an exercise training intervention on IMCL storage and mobilisation in a subject with MD. All obese subjects underwent a 4 month lifestyle intervention with weekly meetings with a dietitian and an exercise physiologist. Of the 92 subjects, 73 completed the intervention. They showed significant decreases in body weight (8%), fat mass (14%) and total cholesterol (5%). The exercise prescription of 1500 kcal.week-1 resulted in variable compliance with the prescription (1224 ± 1085 kcal.week-1) measured by heart rate monitor. Those who did most exercise and also those who had less weekly variability in their exercise, had greater reductions in body weight and fat mass. The total activity energy expenditure measured by accelerometry did not change post-intervention but there was a reduction in low intensity activity and an increase in moderate and high intensity activity. A submaximal treadmill test and resting metabolic rate (RMR) using indirect calorimetry was measured before and after the intervention to investigate factors regulating FAO and energy expenditure. Subjects showed increases in FAO without change in energy expenditure for the same walking speed post intervention, but the volume of exercise completed during the intervention was not associated with these changes. To investigate body fat distribution in obesity, VAT, IHL and soleus muscle IMCL was measured in a sub-group of 18 males by magnetic resonance imaging (MRI) and spectroscopy (MRS) along with measurement of maximal aerobic capacity. Fitness increased significantly with significant decreases in VAT (29%) and IHL (54%), without significant change in IMCL. Subjects who had the greatest decrease in VAT were those who exercised for longer durations during the intervention. IHL was the only measure of excess lipid that correlated with IR. The measurement of IMCL before and after 1-hour of cycle ergometer exercise showed no significant mobilisation of IMCL either at baseline or after the lifestyle intervention. The intensity of the acute exercise was adjusted to correspond to each individual’s maximal fatty acid oxidation (MFAO) which increased by over 60% post intervention. In the subject with MD, an 8 week exercise training intervention without dietary intervention increased IMCL stores by 27%, but there was no marked change in IMCL with acute exercise at both time points. The findings of this thesis demonstrate that a clinically relevant and achievable lifestyle intervention incorporating weight loss through diet and objectively measured exercise can achieve improvements in blood lipid profile, body composition and FAO. The differential effects of the intervention on the various fat depots and their associations to metabolic markers suggest that individualised strategies may be required dependent upon body fat distribution. The non detection of mobilisation of IMCL by MRS suggests that these lipids may not be present as a substrate source in this population but rather an ectopic lipid depot related to increased energy consumption in diet. The relatively low capacity for FAO in both the obese and MD subjects may have affected the results. This thesis discusses implications for clinical practice, discusses novel findings related to the energy metabolism in obesity and MD and informs clinical and basic science about important future directions.

Submitted by Luciana Ferreira (lucgeral@gmail.com) on 2016-08-17T15:19:39Z No. of bitstreams: 2 Dissertação - Lana Pacheco Franco - 2016.pdf: 2286916 bytes, checksum: 906480e497d4f4ed792e28ce7d57d9b7 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2016-08-17T15:21:10Z (GMT) No. of bitstreams: 2 Dissertação - Lana Pacheco Franco - 2016.pdf: 2286916 bytes, checksum: 906480e497d4f4ed792e28ce7d57d9b7 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2016-08-17T15:21:10Z (GMT). No. of bitstreams: 2 Dissertação - Lana Pacheco Franco - 2016.pdf: 2286916 bytes, checksum: 906480e497d4f4ed792e28ce7d57d9b7 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2016-05-03 / This study aimed to assess whether polymorphisms in the apolipoprotein E gene and food consumption are related to lipid profile of adults with Normal-Weight Obesity Syndrome. Methodology: this was an analytical cross-sectional study, including adults with Normal-Weight Obesity Syndrome. Socioeconomic, health and lifestyle questionnaires were administered. Anthropometric variables, body composition and blood pressure were evaluated. Dietary intake, lipid profile and genotyping of polymorphisms rs7412 and rs429358 in the apolipoprotein E gene were evaluated. Results: from the 115 individuals, 72.2% were women. The median age was 22.6 years (21.4 – 25.2). Only 6.0% of women and no man had increased waist circumference. No women and 6.2% of men had changes in blood pressure. When traditional lipid profile was assessed, 52.5% had dyslipidemia. When apolipoprotein concentrations were included, the prevalence was 73.0%. There was a positive relationship between the presence of allele ε2 and apolipoprotein A1 levels (ε2ε3 versus ε3ε3: β = 21.3; 95% CI = 4.2 to 38.3; p = 0.015) and between ε4 allele and apolipoprotein B (ε4 versus ε2: β = 14.8; 95% CI = 0.08 a 29.5; p = 0.049 and ε4 versus ε3: β = 9.1; 95% CI = 0.6 a 17.6; p = 0.036). Carriers of ε2 allele had 81% less chance of presenting dyslipidemia compared to ε3ε3 individuals (OR = 0.2; 95% CI = 0,04 a 0,8; p = 0.027). Associations between body fat distribution and lipid profile and between food consumption and lipid profile were observed and differed among genotypes. Conclusion: both polymorphisms in the apolipoprotein E gene and the food consumption were associated with lipid profile of adults with Normal-Weight Obese Syndrome. This was the first study to describe the apolipoprotein E genotype and to analyze relationships between genetic profile, food intake and lipid profile of subjects with Normal-Weight Obesity Syndrome. / Avaliar se polimorfismos no gene da apolipoproteína E relacionam-se com consumo alimentar e perfil lipídico de indivíduos adultos com a Síndrome do Obeso Eutrófico. Metodologia: foi realizado estudo transversal analítico, incluindo adultos com Síndrome do Obeso Eutrófico. Foram aplicados questionários socioeconômico, de saúde e estilo de vida e avaliadas variáveis antropométricas, de composição corporal e pressão arterial. Determinou-se o consumo alimentar, o perfil lipídico e o genótipo referente aos polimorfismos rs7412 e rs429358 no gene da apolipoproteína E. Resultados: dos 115 indivíduos avaliados, 72,2% eram mulheres. A mediana de idade foi de 22,6 anos (21,4 – 25,2). Apenas 6,0% das mulheres apresentaram aumento da circunferência da cintura e 6,2% dos homens, alterações na pressão arterial. Quando avaliado o perfil lipídico tradicional, 52,5% dos indivíduos apresentaram dislipidemias. Incluindo-se as concentrações de apolipoproteínas A1 e B, a prevalência foi de 73,0%. O alelo ε2 relacionou-se à maior concentração de apolipoproteína A1 (ε2ε3 versus ε3ε3: β = 21,3 IC 95% = 4,2 a 38,3 p = 0,015) e o alelo ε4, à maior concentração de apolipoproteína B (ε4 versus ε2: β = 14,8 IC 95% = 0,1 a 29,5 p = 0,049 e ε4 versus ε3: β = 9,1 IC 95% = 0,6 a 17,6 p = 0,036). Carreadores do alelo ε2 apresentaram chance 81% menor de desenvolver dislipidemia em comparação aos homozigotos ε3ε3 (OR = 0,2 IC 95% = 0,04 a 0,8 p = 0,027). Associações entre a distribuição da gordura corporal, o consumo alimentar e o perfil lipídico foram observadas e diferiram entre os genótipos. Conclusão: tanto os polimorfismos no gene da apolipoproteína E quanto o consumo alimentar foram associados ao perfil lipídico de adultos com a Síndrome do Obeso Eutrófico. Este foi o primeiro trabalho a descrever o genótipo da apolipoproteína E e a analisar suas relações com consumo alimentar e perfil lipídico nessa população.

Made available in DSpace on 2014-08-20T13:58:02Z (GMT). No. of bitstreams: 1 Tese_Doutorado_Ricardo_Noal.pdf: 5115920 bytes, checksum: 769b0ebccd0e351c00cd523fb3bbba48 (MD5) Previous issue date: 2011-06-14 / Obesity, as well as impaired lung function, is associated with significant morbidity and mortality. Few studies have evaluated the effect of adiposity on lung function in adolescents. This study was conducted to evaluate the effect of body mass index and sum of skinfolds (triceps and subscapular) on pulmonary function (forced expiratory volume in one second and forced vital capacity) of adolescents in the study there longitudinal live births in 1993, Pelotas - Brazil. Teenagers aged between 14 and 15 years were interviewed (n = 4349), follow-up rate of 85.7% of the original cohort, measured (n = 4110) and their lung function measured (n = 4006). It was observed through a cross-sectional analysis, after controlling for confounding factors during the gestational period, the body mass index presents. Overall direct effect on lung function while the sum of skinfolds opposite effect. The longitudinal analysis allowed us to observe that adolescents, regardless of sex, which remained in the lower tertiles of body mass index during follow-up had lower levels of lung function than those who remained in the middle tercile. The boys who remained in the highest tertile of skinfold thickness had lower lung function values. These findings suggest that low body mass index and the large sum of skinfold thicknesses have negative impact on lung function in adolescents. / A obesidade, assim como a redução da função pulmonar, esta associada à morbidade e mortalidade. Poucos estudos avaliaram o efeito da adiposidade sobre a função pulmonar em adolescentes. Esse estudo foi realizado com objetivo de avaliar o efeito do índice de massa corporal e do somatório das pregas cutâneas (tricipital e subescapular) sobre a função pulmonar (volume expiratório forçado no primeiro segundo e capacidade vital forçada) de adolescentes pertencentes ai estudo longitudinal dos nascidos vivos em 1993, Pelotas Brasil. Os adolescentes com idade entre 14 e 15 anos foram entrevistados (n=4349), taxa de acompanhamento de 85,7% da coorte original, medidos (n=4110) e sua função pulmonar avaliada (n=4006). Observou-se através de uma análise transversal que, após controle para fatores de confusão desde o período gestacional, o índice de massa corporal apresenta de maneira geral efeito direto sobre a função pulmonar ao passo que o somatório de pregas cutâneas efeito inverso. A análise longitudinal permitiu observar que os adolescentes, independentemente do sexo, que permaneceram nos menores tercis do índice de massa corporal durante o acompanhamento apresentaram menores valores de função pulmonar em relação aos que permaneceram no tercil médio. Os meninos que permaneceram no maior tercil de pregas cutâneas apresentaram menores valores de função pulmonar. Esses achados sugerem que o baixo índice de massa corporal e o elevado somatório de pregas cutâneas apresentam impacto negativo sobre a função pulmonar de adolescentes.

Rates of obesity (OB) are escalating among Canadian children and youth and the obesogenic environment is likely to cause further increases. An important aspect in providing clinical care to OB children is to have accurate assessment measures, particularly of their body composition and cardiorespiratory fitness. This project entails three interrelated projects aiming to develop novel cardiorespiratory fitness and body composition measurement techniques for an OB pediatric population. The purpose of the first project was to validate a new submaximal fitness protocol specifically geared towards OB children and youth. The second objective of this thesis involved assessing cardiorespiratory efficiency utilizing the Oxygen Uptake efficiency slope. The purpose of the third project was to determine the validity of a half-body scan methodology for measuring body composition in obese children and youth. The goal of developing these novel measurement techniques is improved design and evaluation of interventions aimed at managing pediatric obesity.

Introdução: O aumento alarmante da obesidade em todo mundo é um fator independente para o aumento da prevalência de doenças crônicas, como diabetes, hipertensão arterial e doença hepática gordurosa não alcoólica (DHGNA). A DHGNA engloba um amplo espectro de doença desde esteatose simples sem sinais inflamatórios, evoluindo para esteatohepatite (ENA) e até cirrose. Por ser uma patologia multifatorial sua patogênese e terapêutica ainda apresentam pontos obscuros. A resistência à insulina é um dos fatores que já foram determinados como importantes na fisiopatogênese da DHGNA e, está diretamente relacionado ao estilo de vida e hábitos alimentares. Objetivo: Avaliar a correlação entre a presença da gordura visceral e subcutânea à resistência insulínica, síndrome metabólica, medidas antropométricas e hábitos alimentares em pacientes portadores DHGNA. Resultados: Sessenta por cento dos pacientes com DHGNA apresentavam Síndrome Plurimetabólica de acordo com os critérios do ATP III. Dentre os critérios mais prevalentes da síndrome metabólica, níveis baixos HDL e circunferência de cintura (CC) aumentada ocorreram em 56%. Ao dividirmos os pacientes em grupos, os critérios se modificaram. Nos pacientes portadores de esteatose simples, o critério mais prevalente foi CC 77%. Já naqueles com ENA o aumento do nível de triglicérides ocorreu em 68% dos pacientes, sendo o de maior prevalência. As correlações entre CT e IMC (p=0,001), CC (p=0,003) e percentual de massa gorda (p=0,031), apresentam significância estatística negativa entre os pacientes com DHGNA. Não houve significância estatística entre CT e HOMA, ingestão total de energia, proteínas, carboidratos e lipídios nestes pacientes mesmo quando foram divididos de acordo com o grau de inflamação, esteatose e ENA. Por outro lado, a CC ao ser correlacionada com IMC (p=0,000), HOMA (p=0,049), ingestão total de energia (p=0,043), lipídios e dos ácidos graxos mono (p=0,020) e poliinsaturados (0,045) apresentaram significância estatística nos pacientes com DHGNA. Quando divididos segundo o grau de esteatose houve correlação positiva entre CC e HOMA (p=0,045) nos pacientes com esteatose simples. Já nos pacientes portadores de ENA houve correlação positiva entre CC e ingestão total de calorias (p=0,031). Houve diferença estatística positiva quanto ao consumo de lipídios totais (p=0,005) entre o grupo de esteatose e ENA, onde os pacientes com ENA, tinham um maior consumo de lipídios. Conclusões: A circunferência de cintura se mostrou melhor parâmetro de diagnóstico complementar ao ser comparado com a tomografia computadorizada em pacientes com DHGNA. Ao associarmos o IMC com a CC conseguimos obter uma avaliação nutricional mais fidedigna dos riscos de doenças decorrentes da síndrome metabólica. O alto consumo de lipídios apresentou correlação positiva com maior grau de inflamação em pacientes com DHGNA. / Introduction: The dramatic increasing of obesity in the world is a predictive factor to increase the prevalence of chronic diseases, as type II diabetes, hypertension and Nonalcoholic fatty liver disease (NAFLD). It is part of large spectrum of liver damage ranging from simple steatosis and cirrhosis. The pathogenesis of NAFLD is multifactorial and some points in the mechanisms and therapeutic still unknown. The insulin resistance is the major risk factors, recognized in the pathophysiology of NAFLD and it is strongly related with life style and diet. Objective: Evaluate the correlation between visceral and subcutaneous fat with insulin resistance, presence of metabolic syndrome, anthropometric measurements and dietary intake in patients with NAFLD. Results: Sixty percent of patients with NAFLD, classified by ATPIII criteria, had the metabolic syndrome. Waist circumference and low HDL -C were the most positive criteria, observed in 56% of total cases. However the criteria modifies when the group were divided. In patients with simple steatosis WC was the most prevalent criteria 77%, where as in NASH patients the high level of TGL 68%, was the most prevalent. Correlations between CT and BMI (p=0,001), WC (p=0,033) and fat mass (p =0,031) had a negative statistic significant correlation in all cases of NAFLD. No significant associations were found between CT (umbilical circumference) and fat mass, WC, HOMA, Intake of calories, carbohydrates, proteins, lipids and fat acids in patients divided in steatosis and NASH patients. The correlation between Waist circumference (WC) with BMI (p=0,000), HOMA (p:0,049), total of energy intake (p=0,043) , monounsaturated (p:0,020) and polyunsaturated (p:0,045) fat acids intake showed a statistic significance in all cases of NAFLD. Significant different correlations were found as the group were divided in steatosis and NASH cases. The values of fat mass correlated with WC was (p: 0,045) in the steatosis group where as in NASH patients the only correlation found was WC and total consumption of daily energy (p=0,031). NASH patients showed a statistic higher intake of lipids (p=0,005), compared with steatosis patients. Conclusions: CT measurement of visceral fat did not contribute to differential diagnosis as much as WC in patients with NAFLD. The use of both measurements BMI and WC showed to be a better predictor of the risks of Metabolic Syndromes. NASH subjects had a higher intake o total fat as well as of lipid fractions.

Introdução: O aumento alarmante da obesidade em todo mundo é um fator independente para o aumento da prevalência de doenças crônicas, como diabetes, hipertensão arterial e doença hepática gordurosa não alcoólica (DHGNA). A DHGNA engloba um amplo espectro de doença desde esteatose simples sem sinais inflamatórios, evoluindo para esteatohepatite (ENA) e até cirrose. Por ser uma patologia multifatorial sua patogênese e terapêutica ainda apresentam pontos obscuros. A resistência à insulina é um dos fatores que já foram determinados como importantes na fisiopatogênese da DHGNA e, está diretamente relacionado ao estilo de vida e hábitos alimentares. Objetivo: Avaliar a correlação entre a presença da gordura visceral e subcutânea à resistência insulínica, síndrome metabólica, medidas antropométricas e hábitos alimentares em pacientes portadores DHGNA. Resultados: Sessenta por cento dos pacientes com DHGNA apresentavam Síndrome Plurimetabólica de acordo com os critérios do ATP III. Dentre os critérios mais prevalentes da síndrome metabólica, níveis baixos HDL e circunferência de cintura (CC) aumentada ocorreram em 56%. Ao dividirmos os pacientes em grupos, os critérios se modificaram. Nos pacientes portadores de esteatose simples, o critério mais prevalente foi CC 77%. Já naqueles com ENA o aumento do nível de triglicérides ocorreu em 68% dos pacientes, sendo o de maior prevalência. As correlações entre CT e IMC (p=0,001), CC (p=0,003) e percentual de massa gorda (p=0,031), apresentam significância estatística negativa entre os pacientes com DHGNA. Não houve significância estatística entre CT e HOMA, ingestão total de energia, proteínas, carboidratos e lipídios nestes pacientes mesmo quando foram divididos de acordo com o grau de inflamação, esteatose e ENA. Por outro lado, a CC ao ser correlacionada com IMC (p=0,000), HOMA (p=0,049), ingestão total de energia (p=0,043), lipídios e dos ácidos graxos mono (p=0,020) e poliinsaturados (0,045) apresentaram significância estatística nos pacientes com DHGNA. Quando divididos segundo o grau de esteatose houve correlação positiva entre CC e HOMA (p=0,045) nos pacientes com esteatose simples. Já nos pacientes portadores de ENA houve correlação positiva entre CC e ingestão total de calorias (p=0,031). Houve diferença estatística positiva quanto ao consumo de lipídios totais (p=0,005) entre o grupo de esteatose e ENA, onde os pacientes com ENA, tinham um maior consumo de lipídios. Conclusões: A circunferência de cintura se mostrou melhor parâmetro de diagnóstico complementar ao ser comparado com a tomografia computadorizada em pacientes com DHGNA. Ao associarmos o IMC com a CC conseguimos obter uma avaliação nutricional mais fidedigna dos riscos de doenças decorrentes da síndrome metabólica. O alto consumo de lipídios apresentou correlação positiva com maior grau de inflamação em pacientes com DHGNA. / Introduction: The dramatic increasing of obesity in the world is a predictive factor to increase the prevalence of chronic diseases, as type II diabetes, hypertension and Nonalcoholic fatty liver disease (NAFLD). It is part of large spectrum of liver damage ranging from simple steatosis and cirrhosis. The pathogenesis of NAFLD is multifactorial and some points in the mechanisms and therapeutic still unknown. The insulin resistance is the major risk factors, recognized in the pathophysiology of NAFLD and it is strongly related with life style and diet. Objective: Evaluate the correlation between visceral and subcutaneous fat with insulin resistance, presence of metabolic syndrome, anthropometric measurements and dietary intake in patients with NAFLD. Results: Sixty percent of patients with NAFLD, classified by ATPIII criteria, had the metabolic syndrome. Waist circumference and low HDL -C were the most positive criteria, observed in 56% of total cases. However the criteria modifies when the group were divided. In patients with simple steatosis WC was the most prevalent criteria 77%, where as in NASH patients the high level of TGL 68%, was the most prevalent. Correlations between CT and BMI (p=0,001), WC (p=0,033) and fat mass (p =0,031) had a negative statistic significant correlation in all cases of NAFLD. No significant associations were found between CT (umbilical circumference) and fat mass, WC, HOMA, Intake of calories, carbohydrates, proteins, lipids and fat acids in patients divided in steatosis and NASH patients. The correlation between Waist circumference (WC) with BMI (p=0,000), HOMA (p:0,049), total of energy intake (p=0,043) , monounsaturated (p:0,020) and polyunsaturated (p:0,045) fat acids intake showed a statistic significance in all cases of NAFLD. Significant different correlations were found as the group were divided in steatosis and NASH cases. The values of fat mass correlated with WC was (p: 0,045) in the steatosis group where as in NASH patients the only correlation found was WC and total consumption of daily energy (p=0,031). NASH patients showed a statistic higher intake of lipids (p=0,005), compared with steatosis patients. Conclusions: CT measurement of visceral fat did not contribute to differential diagnosis as much as WC in patients with NAFLD. The use of both measurements BMI and WC showed to be a better predictor of the risks of Metabolic Syndromes. NASH subjects had a higher intake o total fat as well as of lipid fractions.

Die vorliegende Untersuchung wurde am International Livestock Centre for Africa (ILCA), jetzt International Livestock Research Institute (ILRI) auf der Versuchsstation Debre Birhan in Äthiopien durchgeführt. Diese Untersuchung ist Teil eines panafrikanischen ILRI-Forschungsprogramms zur Untersuchung und Charakterisierung einheimischer kleiner Wiederkäuer im Sub-Saharischen Afrika auf genetische Resistenz gegenüber Endoparasiten. Das Ziel dieser Arbeit bestand darin, Ergebnisse zu verschaffen, die zum Verständnis der relativen Leistung zweier äthiopischer Hochlandschafrassen (Horroschaf und Menzschaf) unter Stationsbedingungen dienen sollen. Horro-Lämmer (2,43±0,03 kg) waren signifikant (p / This study has been carried out at the former International Livestock Centre for Africa (ILCA), that is now the International Livestock Research Institute (ILRI) experiment station at Debre Birhan, Ethiopia. This research is part of an ILCA (now ILRI) Pan-African research programme designed to investigate and characterise genetic resistance to endoparasites in some indigenous small ruminants in sub-Saharan Africa. The present study was, therefore, undertaken in an attempt to generate information that may contribute towards the understanding of the relative performance of two highland sheep (Horro and Menz) of Ethiopia under station management conditions. Horro lambs were significantly heavier (P