Submitted by Rosina Valeria Lanzellotti Mattiussi Teixeira (rosina.teixeira@unisantos.br) on 2017-09-19T18:35:59Z No. of bitstreams: 1 Michel Jorge Dias.pdf: 1948643 bytes, checksum: 3d6a04a73d791af1eb3dad8d02b6c7a3 (MD5) / Made available in DSpace on 2017-09-19T18:35:59Z (GMT). No. of bitstreams: 1 Michel Jorge Dias.pdf: 1948643 bytes, checksum: 3d6a04a73d791af1eb3dad8d02b6c7a3 (MD5) Previous issue date: 2017-03-30 / Introduction: Motoboys are subject to cardiovascular risk matters that can negatively influence their ability to work, as well as cardiovascular risks or diseases itself. Objective: To compare the risks of cardiovascular venture and the minimums according to the work shift and a working day. Methodology: This is a cross-sectional, quantitative study, composed of registered motoboys without union of the syndicate of Cajazeiras - PB. The professionals were invited to join the study, which is a convenience sample, totaling 95 interviewed. The motoboys respond to a questionnaire about socio-demographic data, health and lifestyle, work and also performed blood collection to determine the plasma concentrations of glycemia, total cholesterol and fractions, in addition to triglycerides. Subsequently, cardiovascular risk was calculated based on the Framingham Global Score. The variables were described by ways of relative and absolute frequencies, measures of central tendency (average) and dispersion (standard deviation). The Kruskal-Wallis or Mann-Whitney tests were used to compare the variables of the non-parametric variables according to the work shift and the daily work day, and for the parametric oscilations the ANOVA or t- Student The qualitative variables were evaluated by the proportionality test (Chi-square and Fisher's Exact), according to the work shift and the daily workday. In all tests the level of 5% of statistical significance was adopted. Results: The average age of participants was 37,1 years; 59% was classified as mature, 96,8% were non-smokers, 57,9% were alcoholic, and 41,1% Of sedentary. Regarding the work characteristics, the predominance was 51,5% working morning and afternoon (daytime), 97.3% working from Monday to Saturday, 43,1% with a daily workday of eleven hours or more, 66,3% reported having a moderate necessity for recovery after work and 67,4% reported having a low capacity for work rate. Regarding cardiovascular risk factors, 84,2% of the interviewees were overweight and 80% had a high cervical perimeter. On the other hand, 67,4% had normal systemic arterial pressure, and 85,3% had a low-waist / hip ratio. As for the lipid profile, 52,6% had high cholesterol levels, 51,6% had high LDL-cholesterol, 56,8% had low HDL-cholesterol levels, 41,1% had high triglyceride levels and less 10% have high blood glycose levels. Regarding the Framingham Risk Score, the study showed that 51,6% of mototaxis are at risk for cardiovascular events. A higher proportion of motoboys with hypertriglyceridemia was evidenced in the professionals of the day shift and at night until 10 p.m. (p<0.05). There was a higher proportion of mototaxis with high glycemia among those working six to eight hours (p<0.01). The highest proportion of hypertriglyceridemia was among those who worked 11 hours or more (p<0.04). There was no significant alteration between insomnia regarding cardiovascular risk factors. Conclusion: The cardiovascular risk factors and the sleep aspects of the mototaxistas had little difference in the shifts and working days. There was also no difference in cardiovascular risk factors due to insomnia symptoms. On the other hand, the prevalence of cardiovascular risk factors, insomnia symptoms and risk for cardiovascular events were high. / Introdução: Os mototaxistas são trabalhadores submetidos a condições de trabalho que podem prejudicar sua saúde, aumentando assim, o risco para o desenvolvimento de fatores de risco cardiovascular. Objetivo: Comparar os fatores de risco cardiovascular e os aspectos de sono de acordo com o turno de trabalho e a jornada de trabalho. Métodos: Trata-se de um estudo transversal, realizado com mototaxistas cadastrados no sindicato de Cajazeiras ¿ PB, onde a amostra foi composta por 95 profissionais. Os mototaxistas responderam a um questionário sobre dados sociodemográficos, saúde e estilo de vida, trabalho, e também realizaram coleta de sangue para determinação das concentrações plasmáticas de glicemia, colesterol total e frações, além dos triglicerídeos. Posteriormente, o risco cardiovascular foi calculado com base no Escore Global de Framingham. As variáveis foram descritas por meio de frequências relativa e absoluta, medidas de tendência central (média) e de dispersão (desvio padrão). Para comparação das médias das variáveis não paramétricas, de acordo com o turno de trabalho e a jornada diária de trabalho, realizou-se os testes Kruskal-Wallis ou Mann-Whitney, e para as variáveis paramétricas realizou-se os testes ANOVA ou t-student. As variáveis qualitativas foram avaliadas pelo teste de proporção (Qui-quadrado e Exato de Fisher), de acordo com o turno de trabalho e a jornada diária de trabalho. Em todos os testes foi adotado o nível de 5% de significância estatística. Resultados: A média de idade dos participantes foi de 37,1 anos, sendo que 59% foi classificada como idade madura, 96,8% referiram não ser fumantes, 57,9% ingerem bebidas alcoólicas, e apresentando percentual de 41,1% de sedentários. Sobre as características de trabalho, foi observado a predominância de 51,5% trabalhando de manhã e tarde (diurno), 97,3% trabalhando de segunda a sábado, 43,1% com jornada de trabalho diária de onze horas ou mais, 66,3% referiram ter uma necessidade de recuperação moderada após o trabalho e 67,4% apontaram ter um índice de capacidade para o trabalho baixo. Com relação aos fatores de risco cardiovascular, 84,2% dos entrevistados apresentam excesso de peso e 80% possuem elevado perímetro cervical. Por outro lado, 67,4% apresentam normalidade na pressão arterial sistêmica, e 85,3% com uma relação cintura/quadril considerada de baixo risco. Quanto ao perfil lipídico, verificamos que 52,6% apresentam níveis elevados de colesterol, 51,6% com elevado LDL-colesterol, 56,8% com níveis baixos de HDL-colesterol, 41,1% apresentam níveis elevados de triglicerídeos e menos de 10% apresentam níveis elevados de glicemia. Com relação ao Escore do risco de Framingham, o estudo evidenciou que 51,6% dos mototaxistas apresentam risco para eventos cardiovasculares. Foi evidenciado uma maior proporção de mototaxistas com hipertrigliceridemia nos profissionais do turno diurno e noite até às 22hs (p<0,05). Houve uma maior proporção de mototaxistas com elevada glicemia entre os que trabalham de seis a oito horas (p<0,01). Já a maior proporção de hipertrigliceridemia foi entre os que trabalhavam 11 horas ou mais (p<0,04). Não houve diferença significativa entre a insônia quanto aos fatores de risco cardiovascular. Conclusão: Os fatores de risco cardiovasculares e os aspectos de sono dos mototaxistas pouco diferiram pelos turnos e jornadas de trabalho. Também não foi verificada diferença dos fatores de risco cardiovascular pelos sintomas de insônia. Por outro lado, as prevalências dos fatores de risco cardiovasculares, dos sintomas de insônia e do risco para os eventos cardiovasculares foram elevadas.

Thesis (M.Sc. (Human Movement Science))--North-West University, Potchefstroom Campus, 2007.

Background: A sedentary lifestyle diminishes quality of life (QOL) and contributes to increasing prevalence of obesity, diabetes and cardiovascular diseases (CVD), and thus increases the economic burden on health care and society. Expensive and tightly controlled lifestyle interventions reduce cardiovascular risk and onset of diabetes. Transferring these findings to the primary care setting is of clinical importance. The primary aim of this thesis was to apply a lifestyle intervention program in the primary care setting among individuals with moderate-to-high risk for CVD, and evaluate the effects on physical activity, cardiovascular risk factor levels and QOL. A secondary aim was to investigate the cost-effectiveness. Methods: A randomized controlled trial with one intervention group (n=75) and one control group (n=76) with follow-up at 3, 12, 24 and 36 months was used. Patients with the diagnosis obesity, hypertension, dyslipidemia, type 2 diabetes or any combination thereof (mean age 54 yr, 57% female) were recruited from a primary health centre in northern Sweden. The three-month intervention period consisted of group-based supervised exercise sessions and diet counselling, followed by regular, but sparse, group meetings with a behavioural approach during three years. Clinical measurements included anthropometrics, aerobic fitness, blood pressure and metabolic traits. Questionnaires on self-reported physical activity, stages of change for physical activity, and QOL were used. In a cost-utility analysis the costs, gained quality-adjusted life years (QALY), and savings in health care were considered. Probability of cost-effectiveness was described using Net Monetary Benefit Method. Results: Overall, the lifestyle intervention generated beneficial improvements in anthropometrics, blood pressure, aerobic fitness and activity level, and QOL, compared to the control group which only received one information meeting.  At 36 months, intention-to-treat analyses showed that lifestyle modification reduced waist circumference (–2.2 cm), waist-hip ratio (–0.02), systolic blood pressure (–5.1 mmHg), and diastolic blood pressure (–1.6 mmHg) and significantly improved aerobic fitness (5%).  BMI, lipid or glucose values did not differ between groups. Progression to active stages of change for physical activity and increases in time spent exercising and total physical activity were reported. Both physical and mental dimensions of QOL were improved during the study period, but after 3 years differences persisted mainly in physical dimensions. Cost per gained QALY was low, 1668-4813 USD (savings not counted). Visits to family physicians significantly decreased and there was a net saving of 47 USD per participant. Probabilities of cost-effectiveness were 89-100% when 50 000 USD was used as threshold of willingness to pay for a gained QALY. Conclusions: A group-based lifestyle intervention program in a primary health care setting favourably influences cardiovascular risk-factor profiles, increases physical activity level, and improves several dimensions of QOL in high-risk individuals, at least up to 3 years. The intervention method was highly cost-effective in relation to standard care. The results emphasize the advantage of an intervention that combines supervised exercise with regular follow-ups for reaching long term effects.  The study high-lights the feasibility of lifestyle interventions in the primary care setting and the importance of health care professionals supporting change in lifestyle.

Background: In the past 37 years, increased efforts have been directed toward a better understanding of the importance of Hcy in disease and it has now become clear that hyperhomocysteinemia is a major independent risk factor for CVD. Extensive research on the influence of vitamin supplementation leading to reductions in Hcy levels and improvements in cardiovascular function has been done. The importance of exercise in the lowering of cardiovascular risk factors, as well as its favourable influence on cardiovascular function has also been indicated in several studies, however, the limited number of studies investigating the effect of exercise on Hcy concentrations revealed contradicting results. Furthermore, a relationship between Hcy concentration and cardiovascular function with the intervention of an exercise training and a vitamin supplementation programme respectively has also not been investigated. Objective: The objective of this study was to examine the effect of a 12-week exercise training and a 12-week vitamin supplementation intervention respectively on tHcy concentrations and cardiovascular function, and whether the change in tHcy concentration within the different interventions correlated with the change in cardiovascular function. Methods: In a randomised controlled cross-over intervention study, 52 men matched for age, cardiorespiratory fitness levels and cardiovascular risk factors were randomly assigned to one of 3 groups (Group A = exercise training programme, 20-30min. at 70-80% of HRmax; Group B = 400 g folic acid and 25 g vitamin B12 supplement; Group C = control). Group A and B were crossed over for phase 11, and Group C remained the control. The questionnaires were completed, and the body composition variables (BMI, WHR and body fat percentage), cardiovascular function (Finometer), tHcy concentrations and VO2max, were measured before and after each 12-week intervention period. A 6-week washout period separated the crossovers. Results: The ANCOVA, adjusted for age and BMI, showed that the percentage change from baseline to end, corrected for baseline of the tHcy concentration increased significantly (p ≤ .05) by 9.7% with the exercise training intervention and decreased significantly (p ≤ .05) by 12.9%, with the vitamin supplementation intervention. The ANCOVA of the percentage change from baseline to end in cardiovascular function showed that the vitamin supplementation intervention resulted in improvements in cardiovascular function (decreased resting MAP, TPR and increased resting SV, CO, Cw) in comparison to the impairment in cardiovascular function with the exercise training intervention (increased resting DBP, MAP and TPR). The relationship between the tHcy concentration and cardiovascular function at baseline and within each of the different interventions were assessed by partial correlations adjusted for age, BMI and VO2max. Significant (p ≤ .05) relationships only occurred within the vitamin supplementation intervention, where decreased percentage change in tHcy concentration significantly correlated with increased percentage change of resting SV and CO and decreased percentage change of resting TPR. Conclusion: The general conclusion that can be drawn is that a 12-week vitamin supplementation intervention showed increased health related results, e.g. a significant reduction in tHcy concentration, an improvement in cardiovascular function and a significant positive relationship between these b o factors, in comparison to the 12-week exercise training intervention that significantly increased the tHcy concentration and did not show increased health related results. Due to inadequate compliance to the exercise training intervention, no conclusion can be drawn with regard to the effect of exercise training on tHcy concentrations and cardiovascular function. / Thesis (M.Sc. (Human Movement Science))--North-West University, Potchefstroom Campus, 2007

A prevalência de sobrepeso e obesidade entre crianças e adolescentes tem aumentado em países em desenvolvimento e desenvolvidos, ocasionando um sério problema de saúde pública. A obesidade na adolescência pode alterar o perfil lipídico, principalmente quando acompanhada de uma baixa aptidão cardiorrespiratória. A obesidade, bem como as dislipidemias são considerados importantes fatores de risco para a doença arterial coronariana. O presente estudo teve como objetivo avaliar a correlação entre o perfil lipídico, bem como outros marcadores de risco para doença arterial coronariana, e a aptidão cardiorrespiratória de crianças e adolescentes obesos, de ambos os gêneros. Um total de 63 crianças e adolescentes obesos, entre 11 e 17 anos, foi incluído em um estudo transversal, realizado na cidade de Porto Alegre. Foi utilizado o pacote estatístico SPSS, versão 10.0 para Windows. Foram aplicados o teste t para amostras independentes e o teste de Mann-Whitney para identificar diferenças entre gêneros e estágio maturacional quando a distribuição apresentava-se normal e não-normal, respectivamente. Utilizou-se a correlação de Pearson ou Spearman para dados paramétricos e não-paramétricos, respectivamente. Não encontramos correlação significativa entre o pic2 o V& O e os marcadores de risco para doença coronariana TG, CT, HDL-C, LDL-C, ApoA1, ApoB, Não-HDL-C, CT/HDL, LDL-C/HDL-C, insulina, glicose, índice HOMA-IR e PCRus. Do total de crianças e adolescentes avaliados, somente um indivíduo, do gênero masculino, não apresentava nenhum parâmetro metabólico alterado. Encontramos uma prevalência precoce importante de indivíduos com hipercolesterolemia (15,0%); hipertrigliceridemia (23,3%); hiperglicemia (35,6%); hiperinsulinemia (40,4%); valores altos de LDL-C (16,7%), PCRus (38,3%) e Não-HDL-C (26,7%); e valores baixos de HDL-C (21,7%) e do VO2pico (93,5% da meninas e 100% dos meninos). Concluindo, apesar de não encontrarmos correlação significativa entre o perfil lipídico e a aptidão cardiorrespiratória de crianças e adolescentes obesos neste estudo, uma prevalência alta de dislipidemias e outros marcadores de risco coronariano alterados foram encontrados. / The prevalence of overweight children and adolescents has been increasing in both developed and developing countries, creating a serious public health problem. Obesity in adolescence can alter the lipid profile mainly when accompanied by a low cardiorespiratory fitness. Obesity and dislipidemy are well-established risk factors for the coronary artery disease. The aim of the present study was to evaluate the correlation among the lipid profile, as well as other risk markers for the coronary artery disease, and the cardiorespiratory fitness of obese children and adolescents of both genders. A total of 63 children and adolescents between 11 and 17 years old were included in this cross-sectional study, developed in the city of Porto Alegre. Statistical analysis was performed by the software SPSS, version 10.0 for Windows. The T-test for independent samples and the Mann-Whitney test were applied to identify differences among gender and pubertal stage when the distribution was normal and abnormal, respectively. The Pearson’s or the Spearman’s correlation was used for parametric and nonparametric data, respectively. We did not find significant correlation between pea2 k V& O and the risk markers for the coronary disease TG, TC, HDL-C, LDL-C, non-HDL-C, TC/HDL, insulin, glucose, HOMA-IR values, and PCRus. Among all individuals evaluated, only one person – a male – did not show any altered metabolic parameter. We found an important precocious prevalence of individuals with hypercholesterolemia (15%); hypertriglyceridemia (23.3%); borderline hyperglycemia (35.6%); hyperinsulinemia (40.4%); high values of LDLC (16.7%), PCRus (38.3%), non-HDL-C (26.7%); and low values of HDL-C (21.7%) and 2 peak V& O (93.5% of the girls and 100% of the boys). In conclusion, although we did not find any significant correlation between lipid profile and cardiorespiratory fitness in obese children of both genders in this study, a high prevalence of undesirable lipid levels and other altered coronary risk markers were found.

Background. The incidence of starting renal replacement therapy (RRT) among young people (< 20 years of age) in 2013 in Scotland was 7.7 per million (age-related) population. Little knowledge exists about cardiovascular risk factors (CVRFs), long-term survival and cardiovascular disease (CVD) outcomes in patients who initiated RRT in childhood. The main source of routine data for these patients is available from the European Society of Paediatric Nephrology/European Renal Association- European Dialysis and Transplant Association (ESPN/ERA-EDTA) registry. In Scotland nationally comprehensive data on patients receiving RRT is available from the Scottish Renal Registry (SRR). Aim and objectives. The overall aim of the thesis is to review relevant literature and conduct retrospective cohort studies describing CVRF prevalence, all-cause mortality and incidence of CVD outcomes in patients who initiated RRT in childhood. ESPN/ERA-EDTA registry data were used to describe the prevalence of anaemia, hypertension, dyslipidaemia and BMI categories and their association with all-cause and CV mortality. SRR data were used to describe all-cause mortality and CVD incidence and their association with age at start of RRT, sex, primary renal disease (PRD), type of RRT and period of start of RRT. Methods. Systematic searches were performed to identify relevant literature. For the ESPN/ERA-EDTA analyses patients who started RRT between 0 and 20 years of age and who had CVRF data were included. Patients were followed from date of first CVRF measurement until the earliest of death, loss to follow-up, reaching 20 years of age or the end of follow-up (December 31st 2012). Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality, comparing patients with and without each CVRF. For the SRR analyses, patients who started RRT under 18 years of age in the period from 1963 to 2013 were included in the analyses. To describe CVD incidence the SRR data were linked to national registers for death and CVD hospital admissions available from 1981 onwards. These analyses, therefore, included patients who started RRT between 1981 and 2013 with follow-up until first CVD event after start of RRT, end of follow-up period or censoring at death. Cox proportional hazard models were used to examine the association of age at initiation of RRT, sex, PRD, type of RRT and period of initiation of RRT with all-cause mortality and CVD incidence. Results. The systematic reviews revealed a gap in current knowledge about CVD incidence and the association of CVRFs with CVD outcomes in patients who initiated RRT in childhood. In total, 7,845 patients were included in the ESPN/ERA-EDTA registry analysis. The mean age of the patients was 9.5 (SE 0.06) years, 58.9% were male, and the most common PRD was congenital anomalies of kidney and urinary tract (CAKUT). The prevalence of dyslipidaemia, hypertension, anaemia overweight/obesity and underweight was 87.5%, 79.3%, 36.0%, 29.9% and 4.3%, respectively. During median follow-up of 3.7 (IQR 1.7-6.8) years 357 patients died. HRs for anaemia were 2.19 (95% CI 1.64-2.93) and 2.55 (95% CI 1.27-5.12) for all-cause and CVD mortality, respectively. The HR for all-cause mortality for underweight was 1.81 (95% CI 1.30-2.53). No other studied CVRFs were statistically significantly associated with all-cause and CVD mortality. In total, 479 patients were included in the SRR analyses of all-cause mortality. The most common PRD was CAKUT and 55.3% of patients were male. During a median follow-up of 18.3 (IQR 8.7-27.0 years) years 126 patients died. Twenty-year survival among patients initiated RRT in childhood was 77.6% (95% CI 73.8-81.3). Age at start of RRT, PRD and type of RRT were significantly associated with all-cause mortality. HR for all-cause mortality for patients who started RRT under 2 years of age was 2.50 (95% CI 1.19-5.25) compared to patients who started RRT at 12 to 18 years old. HR for all-cause mortality for patients with PRD other than CAKUT or glomerulonephritis (GN) was 1.58 (95% CI 1.05-2.39) compared to patients with CAKUT. HRs for all-cause mortality for patients who only received either HD or PD during follow-up were 19.4 (95% CI 10.4-36.4 and 19.5 (9.65-39.7), respectively, compared to patients who received a renal transplant. In total, 381 patients were included in the SRR analyses of CVD incidence. During a median of 12.9 (IQR 5.6-21.5) years of follow-up after initiation of RRT 134 patients (35.2%) developed CVD. The overall crude CVD incidence was 2.6 (95% CI 2.2-3.0) per 100 person-years. HRs for CVD were 1.69 (95% CI 1.05-2.74) for males compared to females, 1.72 (95% CI 1.02-2.91) for PRD other than CAKUT or GN compared to CAKUT and 8.38 (95% CI 3.31-21.23) and 7.30 (95% CI 2.30-23.16) for patients who only received either HD or PD during follow-up, respectively, compared to patients who received a renal transplant. Conclusions. This thesis has contributed to knowledge about CVRF prevalence, longer-term survival and CVD outcomes in patients who initiated RRT in childhood by identifying high prevalence of CVRFs and that CVD is a common complication. This study did not investigate whether anaemia, hypertension, dyslipidaemia and obesity are associated with a higher risk of developing CVD after start of RRT. Future research is needed to study whether treatment of anaemia, hypertension, dyslipidaemia and controlling body weight will reduce the risk of CVD and mortality in patients who initiated RRT in childhood.

A prevalência de sobrepeso e obesidade entre crianças e adolescentes tem aumentado em países em desenvolvimento e desenvolvidos, ocasionando um sério problema de saúde pública. A obesidade na adolescência pode alterar o perfil lipídico, principalmente quando acompanhada de uma baixa aptidão cardiorrespiratória. A obesidade, bem como as dislipidemias são considerados importantes fatores de risco para a doença arterial coronariana. O presente estudo teve como objetivo avaliar a correlação entre o perfil lipídico, bem como outros marcadores de risco para doença arterial coronariana, e a aptidão cardiorrespiratória de crianças e adolescentes obesos, de ambos os gêneros. Um total de 63 crianças e adolescentes obesos, entre 11 e 17 anos, foi incluído em um estudo transversal, realizado na cidade de Porto Alegre. Foi utilizado o pacote estatístico SPSS, versão 10.0 para Windows. Foram aplicados o teste t para amostras independentes e o teste de Mann-Whitney para identificar diferenças entre gêneros e estágio maturacional quando a distribuição apresentava-se normal e não-normal, respectivamente. Utilizou-se a correlação de Pearson ou Spearman para dados paramétricos e não-paramétricos, respectivamente. Não encontramos correlação significativa entre o pic2 o V& O e os marcadores de risco para doença coronariana TG, CT, HDL-C, LDL-C, ApoA1, ApoB, Não-HDL-C, CT/HDL, LDL-C/HDL-C, insulina, glicose, índice HOMA-IR e PCRus. Do total de crianças e adolescentes avaliados, somente um indivíduo, do gênero masculino, não apresentava nenhum parâmetro metabólico alterado. Encontramos uma prevalência precoce importante de indivíduos com hipercolesterolemia (15,0%); hipertrigliceridemia (23,3%); hiperglicemia (35,6%); hiperinsulinemia (40,4%); valores altos de LDL-C (16,7%), PCRus (38,3%) e Não-HDL-C (26,7%); e valores baixos de HDL-C (21,7%) e do VO2pico (93,5% da meninas e 100% dos meninos). Concluindo, apesar de não encontrarmos correlação significativa entre o perfil lipídico e a aptidão cardiorrespiratória de crianças e adolescentes obesos neste estudo, uma prevalência alta de dislipidemias e outros marcadores de risco coronariano alterados foram encontrados. / The prevalence of overweight children and adolescents has been increasing in both developed and developing countries, creating a serious public health problem. Obesity in adolescence can alter the lipid profile mainly when accompanied by a low cardiorespiratory fitness. Obesity and dislipidemy are well-established risk factors for the coronary artery disease. The aim of the present study was to evaluate the correlation among the lipid profile, as well as other risk markers for the coronary artery disease, and the cardiorespiratory fitness of obese children and adolescents of both genders. A total of 63 children and adolescents between 11 and 17 years old were included in this cross-sectional study, developed in the city of Porto Alegre. Statistical analysis was performed by the software SPSS, version 10.0 for Windows. The T-test for independent samples and the Mann-Whitney test were applied to identify differences among gender and pubertal stage when the distribution was normal and abnormal, respectively. The Pearson’s or the Spearman’s correlation was used for parametric and nonparametric data, respectively. We did not find significant correlation between pea2 k V& O and the risk markers for the coronary disease TG, TC, HDL-C, LDL-C, non-HDL-C, TC/HDL, insulin, glucose, HOMA-IR values, and PCRus. Among all individuals evaluated, only one person – a male – did not show any altered metabolic parameter. We found an important precocious prevalence of individuals with hypercholesterolemia (15%); hypertriglyceridemia (23.3%); borderline hyperglycemia (35.6%); hyperinsulinemia (40.4%); high values of LDLC (16.7%), PCRus (38.3%), non-HDL-C (26.7%); and low values of HDL-C (21.7%) and 2 peak V& O (93.5% of the girls and 100% of the boys). In conclusion, although we did not find any significant correlation between lipid profile and cardiorespiratory fitness in obese children of both genders in this study, a high prevalence of undesirable lipid levels and other altered coronary risk markers were found.

A prevalência de sobrepeso e obesidade entre crianças e adolescentes tem aumentado em países em desenvolvimento e desenvolvidos, ocasionando um sério problema de saúde pública. A obesidade na adolescência pode alterar o perfil lipídico, principalmente quando acompanhada de uma baixa aptidão cardiorrespiratória. A obesidade, bem como as dislipidemias são considerados importantes fatores de risco para a doença arterial coronariana. O presente estudo teve como objetivo avaliar a correlação entre o perfil lipídico, bem como outros marcadores de risco para doença arterial coronariana, e a aptidão cardiorrespiratória de crianças e adolescentes obesos, de ambos os gêneros. Um total de 63 crianças e adolescentes obesos, entre 11 e 17 anos, foi incluído em um estudo transversal, realizado na cidade de Porto Alegre. Foi utilizado o pacote estatístico SPSS, versão 10.0 para Windows. Foram aplicados o teste t para amostras independentes e o teste de Mann-Whitney para identificar diferenças entre gêneros e estágio maturacional quando a distribuição apresentava-se normal e não-normal, respectivamente. Utilizou-se a correlação de Pearson ou Spearman para dados paramétricos e não-paramétricos, respectivamente. Não encontramos correlação significativa entre o pic2 o V& O e os marcadores de risco para doença coronariana TG, CT, HDL-C, LDL-C, ApoA1, ApoB, Não-HDL-C, CT/HDL, LDL-C/HDL-C, insulina, glicose, índice HOMA-IR e PCRus. Do total de crianças e adolescentes avaliados, somente um indivíduo, do gênero masculino, não apresentava nenhum parâmetro metabólico alterado. Encontramos uma prevalência precoce importante de indivíduos com hipercolesterolemia (15,0%); hipertrigliceridemia (23,3%); hiperglicemia (35,6%); hiperinsulinemia (40,4%); valores altos de LDL-C (16,7%), PCRus (38,3%) e Não-HDL-C (26,7%); e valores baixos de HDL-C (21,7%) e do VO2pico (93,5% da meninas e 100% dos meninos). Concluindo, apesar de não encontrarmos correlação significativa entre o perfil lipídico e a aptidão cardiorrespiratória de crianças e adolescentes obesos neste estudo, uma prevalência alta de dislipidemias e outros marcadores de risco coronariano alterados foram encontrados. / The prevalence of overweight children and adolescents has been increasing in both developed and developing countries, creating a serious public health problem. Obesity in adolescence can alter the lipid profile mainly when accompanied by a low cardiorespiratory fitness. Obesity and dislipidemy are well-established risk factors for the coronary artery disease. The aim of the present study was to evaluate the correlation among the lipid profile, as well as other risk markers for the coronary artery disease, and the cardiorespiratory fitness of obese children and adolescents of both genders. A total of 63 children and adolescents between 11 and 17 years old were included in this cross-sectional study, developed in the city of Porto Alegre. Statistical analysis was performed by the software SPSS, version 10.0 for Windows. The T-test for independent samples and the Mann-Whitney test were applied to identify differences among gender and pubertal stage when the distribution was normal and abnormal, respectively. The Pearson’s or the Spearman’s correlation was used for parametric and nonparametric data, respectively. We did not find significant correlation between pea2 k V& O and the risk markers for the coronary disease TG, TC, HDL-C, LDL-C, non-HDL-C, TC/HDL, insulin, glucose, HOMA-IR values, and PCRus. Among all individuals evaluated, only one person – a male – did not show any altered metabolic parameter. We found an important precocious prevalence of individuals with hypercholesterolemia (15%); hypertriglyceridemia (23.3%); borderline hyperglycemia (35.6%); hyperinsulinemia (40.4%); high values of LDLC (16.7%), PCRus (38.3%), non-HDL-C (26.7%); and low values of HDL-C (21.7%) and 2 peak V& O (93.5% of the girls and 100% of the boys). In conclusion, although we did not find any significant correlation between lipid profile and cardiorespiratory fitness in obese children of both genders in this study, a high prevalence of undesirable lipid levels and other altered coronary risk markers were found.

Orientador: Mara Patrícia Traína Chacon Mikahil / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Educação Física / Made available in DSpace on 2018-08-17T08:14:35Z (GMT). No. of bitstreams: 1 Souza_GiovanaVerginiade_M.pdf: 994644 bytes, checksum: e9b0cd62bacf4084a01b3c0b64c36702 (MD5) Previous issue date: 2010 / Resumo: A inatividade física aliada ao envelhecimento é um dos principais fatores de risco para as doenças cardiovasculares (DCV). A associação do treinamento com pesos (TP) e aeróbio (TA), ou seja, o treinamento concorrente (TC) tem sido recomendado como prevenção destes fatores de risco cardiovascular. Desta forma o objetivo deste estudo foi comparar as respostas de três tipos de treinamento físico sobre circunferência de cintura (CC), perfil lipídico (HDL, LDL e TG), glicose plasmática, pressão arterial (PA), aptidão aeróbia e força muscular em homens não ativos de meia-idade. Os voluntários (n=50) foram subdivididos em quatro grupos, sendo: três grupos submetidos a 16 semanas de treinamento: aeróbio (TA, n =15), com pesos (TP, n=10) e concorrente (TC, n=13) e grupo controle (GC, n=12), o qual não realizou nenhum tipo de atividade física. Os principais achados deste estudo mostraram após os períodos de treinamento alterações importantes quanto a redução da CC nos grupos TA e TC; reduções no LDL para TP e TC e no triglicerídeos (TG) para todos os grupos treinamento; para o HDL ocorreu aumento apenas para o TA. Para as variáveis funcionais, ocorreram aumentos para o *VO2pico* para os grupos TA e TC, e aumentos na força máxima de membros superiores para TP e TC e dos membros inferiores para todos os grupos treinamento. Nossa hipótese de que o TC realizado com duração da sessão e frequencia semanal similar ao TA e ao TP resulte em respostas mais efetivas no controle dos fatores de risco de doenças cardiovasculares foi confirmada pelos presentes achados. Novas propostas de periodizações de treinamento concorrente ainda são necessárias, em especial, para períodos de treinamento mais prolongados no grupo etário estudado. / Abstract: Physical inactivity along ageing is one of the main risk factors of coronary heart disease (CHD). The association of resistance- (RT) and endurance training (ET), in other words, concurrent training (CT) has been recommended as prevention of these cardiovascular risk factors. In this way, the aim of the study was to compare responses of three different physical training regimes on waist circumference, lipid profile, plasma glucose, blood pressure, cardiorespiratory fitness and muscle strength in non-active middle-aged men. The subjects (n=50) were subdivided into four groups, where: three groups performed 16 weeks of training: endurance (ET, n =15), resistance (RT, n=10) and concurrent (CT, n=13), and control group (CG, n=12), which did not perform any kind of physical activity. The main findings of this study showed after the training periods important alterations related to reduction on waist circumference WC in ET and CT groups; reductions in low-density lipoprotein cholesterol (LDL-C) levels in RT and CT groups and in triglycerides (TG) for all training groups; related to high-density lipoprotein (HDL) levels there was an increase only in ET group. For functional variables there was an increase in VO2peak only in ET and CT groups, and an increase in maximal muscle strength for upper body in RT and CT groups. Our hypothesis that CT performed with session durations and weekly frequency similar to ET and RT results in more effective responses in controlling cardiovascular risk factors was confirmed by the present data. New periodizations proposals for concurrent training are still necessary, in special, for longer training periods. / Mestrado / Ciencia do Desporto / Mestre em Educação Física

Submitted by Geyciane Santos (geyciane_thamires@hotmail.com) on 2015-07-01T13:29:52Z No. of bitstreams: 2 Dissertação -Pilar Maria de Oliveira Moraes 1.pdf: 186319 bytes, checksum: b1332ee55824a51f80b4f32860e1af90 (MD5) Dissertação -Pilar Maria de Oliveira Moraes 2.pdf: 604576 bytes, checksum: 341618618f83b7aceabf5e7fc3c2d051 (MD5) / Approved for entry into archive by Divisão de Documentação/BC Biblioteca Central (ddbc@ufam.edu.br) on 2015-07-07T13:41:41Z (GMT) No. of bitstreams: 2 Dissertação -Pilar Maria de Oliveira Moraes 1.pdf: 186319 bytes, checksum: b1332ee55824a51f80b4f32860e1af90 (MD5) Dissertação -Pilar Maria de Oliveira Moraes 2.pdf: 604576 bytes, checksum: 341618618f83b7aceabf5e7fc3c2d051 (MD5) / Approved for entry into archive by Divisão de Documentação/BC Biblioteca Central (ddbc@ufam.edu.br) on 2015-07-07T13:39:34Z (GMT) No. of bitstreams: 2 Dissertação -Pilar Maria de Oliveira Moraes 1.pdf: 186319 bytes, checksum: b1332ee55824a51f80b4f32860e1af90 (MD5) Dissertação -Pilar Maria de Oliveira Moraes 2.pdf: 604576 bytes, checksum: 341618618f83b7aceabf5e7fc3c2d051 (MD5) / Approved for entry into archive by Divisão de Documentação/BC Biblioteca Central (ddbc@ufam.edu.br) on 2015-07-07T14:35:48Z (GMT) No. of bitstreams: 2 Dissertação -Pilar Maria de Oliveira Moraes 1.pdf: 186319 bytes, checksum: b1332ee55824a51f80b4f32860e1af90 (MD5) Dissertação -Pilar Maria de Oliveira Moraes 2.pdf: 604576 bytes, checksum: 341618618f83b7aceabf5e7fc3c2d051 (MD5) / Made available in DSpace on 2015-07-07T14:35:49Z (GMT). No. of bitstreams: 2 Dissertação -Pilar Maria de Oliveira Moraes 1.pdf: 186319 bytes, checksum: b1332ee55824a51f80b4f32860e1af90 (MD5) Dissertação -Pilar Maria de Oliveira Moraes 2.pdf: 604576 bytes, checksum: 341618618f83b7aceabf5e7fc3c2d051 (MD5) Previous issue date: 2010-12-14 / Outras / This study aims to identify cardiovascular risk factors and the impact of nutritional intervention in the industrial sector workers in Greater Metropolitan Belém, Pará, companies accredited to the Workers' Food Program (WFP). We studied 97 employees of the Experimental group (ExpG) and 90 control group (GCON), were included in the randomization workers showed that cardiovascular risk factors for elevated waist circumference (WC). Participated in the randomization of 18 workers and 20 ExpG GCON. For the randomization tests, we used the paired Student t test and Wilcoxon test. Anthropometric variables were identified as Body Mass Index (BMI) and WC, blood levels of cholesterol, triglycerides and glucose levels and socioeconomic characteristics, and used the chi-square test for evaluating the results. The analysis of food consumption was made by means of food frequency questionnaire using a methodology based on the level of consumption: <0.33. Food consumption low,> 0.33 and <0.66 average consumption of food;> 0.66 Food consumption high. It was identified a young population, most living with a partner, with family incomes from 1 to 2 minimum wages, having completed high school. Before the dietary intervention was observed anthropometric findings with a high prevalence of overweight and high levels of lipid fractions in GExp and GCON. The consumption of foods considered cardiovascular risk was high when compared to consumption of foods considered protective in GExp and GCON. The characteristics found related to lifestyle were the improvement in the practice of smoking revealed a low percentage of smokers and former smokers, moderate, moderate to high alcohol consumption and low frequency of physical activity in both groups. After randomization the GCON showed only one variable with significant difference and there is a decrease in systolic blood pressure. In the analysis of anthropometric findings were observed high prevalence of overweight and high levels of lipid fractions in both groups before the intervention and significant improvement of nutritional values in the intervention group nutrition. In the experimental group, there was a significant difference in three variables: the average decrease in BMI, HDL cholesterol increased, demonstrating an apparent improvement after intervention and LDL cholesterol and a decrease of the mean, ie, demonstrating beneficial effects of the action guideline the group of workers ExpG. There was a decrease in CC ExpG signaling a decrease in an important risk factor for developing cardiovascular disease does so with GCON. The action of nutritional intervention results showed significant improvements for the group that was submitted when associated with the control group, confirming that the nutrition education strategy proposed in the TSP, it has practical effects of positive health worker. / Este estudo tem por objetivo identificar os fatores de riscos cardiovasculares e o impacto da intervenção nutricional em trabalhadores do setor industrial na Região Metropolitana de Belém-Pará, de empresas credenciadas ao Programa de Alimentação do Trabalhador (PAT). Foram estudados 97 trabalhadores do Grupo Experimento (GEXP) e 90 do Grupo Controle (GCON), sendo incluídos na randomização trabalhadores que apresentaram fatores de risco cardiovascular elevados para Circunferência de Cintura(CC). Participaram da randomização 18 trabalhadores do GEXP e 20 do GCON. Para análises da randomização, foi utilizado o teste t de Student pareado e o teste de Wilcoxon. Foram identificadas variáveis antropométricas como Índice de Massa Corporal (IMC) e CC, níveis sanguíneos de colesterol, triglicerídeos e glicemia e características socioeconômicas, sendo usado o teste Qui-quadrado para avaliação dos resultados. A análise do consumo alimentar foi feita por meio de questionário de frequência alimentar utilizando a metodologia baseada no nível de consumo:< 0,33. Alimento de consumo baixo; >0,33 e <0,66 alimento de consumo médio; >0,66 Alimento de consumo elevado. Foi identificado uma população jovem, a maioria residindo com companheiro, com renda familiar de 1 a 2 salários mínimos, possuindo ensino médio completo. Antes da intervenção nutricional foi observado resultados antropométricos com alta prevalência de excesso de peso e índices elevados de frações lipídicas no GEXP e GCON. O consumo de alimentos considerados de risco cardiovascular foi elevado quando comparado ao consumo de alimentos considerados protetores no GEXP e GCON. As características encontradas relacionadas ao estilo de vida foram: a melhoria na prática do tabagismo revelando um percentual baixo de fumante e um moderado de ex-fumantes, moderado a alto consumo de álcool e baixa freqüência de atividade física nos dois grupos. Após a randomização o GCON apresentou apenas uma variável com diferença significativa, verificando-se diminuição da pressão arterial sistólica, podendo ser atribuída a Síndrome do Jaleco Branco, presença do profissional de saúde associada a elevação de pressão arterial. Na análise dos resultados antropométricos foram observados alta prevalência de excesso de peso e índices elevados de frações lipídicas nos dois grupos antes da intervenção nutricional. No grupo experimental, verificou-se a diferença significativa em três variáveis: diminuição da média do IMC, aumento do colesterol HDL, demonstrando aparente melhora após intervenção e o colesterol LDL, com a diminuição da média, ou seja, demonstrando efeitos benéficos da ação orientadora para o grupo de trabalhadores do GEXP. Houve diminuição CC no GEXP sinalizando uma diminuição de um fator de risco importante para desenvolvimento de doenças cardiovascular o mesmo não acontecendo com o GCON. A ação de intervenção nutricional apresentou resultados importantes de melhorias para o grupo a que foi submetido quando associado ao grupo controle, confirmando que a estratégia de educação nutricional proposta no PAT, tem efeitos práticos positivos para a saúde do trabalhador.