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Previous issue date: 2018-03-15 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Introduction: The phase angle is considered an important prognostic marker because it
reflects cellular health. Inadequate physical activity and sitting time are associated with a
significant number of chronic noncommunicable diseases. Recent studies suggest that
these two factors may be associated with phase angle values.
Objective: to verify the association of phase angle with physical activity
Methodology: the thesis will present two articles: a systematic review with metaanalysis
and a cross-section article. Meta-analysis: We searched the following databases:
MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, SciELO,
LILACS, SPORTDiscus, Scopus and Web of Science. Two reviewers independently
assessed eligibility criteria and bias risks. The results were synthesized using random
effects models. The association between physical activity and phase angle was evaluated
considering the design of the study. Cross-sectional study: individuals over 11 years of
age, of both sexes, who met bioimpedance assessment criteria and without diagnosis of
chronic disease, were invited to participate in the study. The phase angle evaluation was
performed using Ottoboni's Biospace equipment, model InBodyS10. Physical activity
level and sitting time were assessed using the International Physical Activity
Questionnaire (IPAQ). The association between the phase angle and the predictor
variables was evaluated using a univariate and multivariate generalized linear model
(GLM). All variables with a value of p <0.20 were included in the multivariate model. In
the final model, only the variables with p <0.05 were included.
Results: Systematic Review: Nine studies, totaling 575 participants, were included in
the meta-analysis. The results of cross-sectional studies indicate that the active subjects
presented a mean value of higher phase angle when compared to controls (DM = 0.70,
95% CI 0.48 to 0.92, P <0.001), with low heterogeneity (I2 = 0%, P = 0.619). In the crosssectional
analysis, the differences between health status and type of physical activity
evaluation were not significant (P = 0.332, P <0.253). In longitudinal studies (clinical
trial and follow-up), mean values of final phase angle increased significantly compared
to baseline (DM = 0.30, 95% CI 0.11 to 0.49, P <0.001), with low heterogeneity (I2 =
13%, P = 0.331). The differences were not significant in relation to the state of health and
the type of longitudinal study (clinical trials or follow-up studies) (P = 0.900; 0.989).
Evidence of publication bias was not observed, and the overall risk of bias was moderate
to high. Cross-sectional article: 1228 subjects were included. The multivariate
generalized linear model showed that both physical activity (? = 0.164, 95% CI 0.071 to
0.256, P = 0.001) and sitting time (? = 0.152, 95% CI 0.063 to 0, 242, P = 0.001) were
determinant for the phase angle. As well as sex, body mass index and age, also remained
associated with phase angle (? = -0.890, 95%CI -0.975 to -0.806, P <0.001; ? = 0.037,
95%CI 0.029 to 0,045, p <0.001 e; ? = -0.006, 95%CI -0.008 to -0.003 P<0.001,
respectively).
Conclusion: The results of the systematic review and the cross-sectional article suggest
an association of phase angle with physical activity and sitting time. Among the main
factors that may explain the positive effect of physical activity on the phase angle are the
increase in cell membrane integrity and the change in intracellular content, these factors
reflecting the cellular health and, consequently, the health of the individual. / Introdu??o: O ?ngulo de fase est? sendo considerado um importante marcador
progn?stico, pois reflete a sa?de celular. A atividade f?sica inadequada e o tempo sentado
est?o associados a um n?mero importante de doen?as cr?nicas n?o transmiss?veis.
Estudos recentes sugerem que esses dois fatores podem estar associados com os valores
do ?ngulo de fase.
Objetivo: verificar a associa??o do ?ngulo de fase com a atividade f?sica.
Metodologia: a tese ir? apresentar dois artigos: uma revis?o sistem?tica com metan?lise
e um artigo transversal. Metan?lise: foram realizadas buscas nas seguintes bases de
dados: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, SciELO,
LILACS, SPORTDiscus, Scopus e Web of Science. Dois revisores avaliaram
independentemente os crit?rios de elegibilidade e o risco de vi?s. Os resultados foram
sintetizados mediante modelos de efeitos aleat?rios. A associa??o entre atividade f?sica e
?ngulo de fase foi avaliada considerando o desenho do estudo. Artigo transversal: os
indiv?duos com mais de 11 anos de idade, de ambos os sexos, que atendiam aos crit?rios
de avalia??o da bioimped?ncia e sem diagn?stico de doen?a cr?nica, foram convidados a
participar do estudo. A avalia??o do ?ngulo de fase foi realizada usando o equipamento
Biospace, modelo InBodyS10, da Ottoboni. O n?vel de atividade f?sica e o tempo sentado
foram avaliados com o question?rio internacional de atividade f?sica (IPAQ). A
associa??o entre o ?ngulo de fase e as vari?veis preditoras foram avaliadas utilizando um
modelo linear generalizado univari?vel e multivari?vel (MLG). Todas as vari?veis com
um valor de p <0,20 foram inclu?das no modelo multivari?vel. No modelo final, apenas
as vari?veis com p <0,05 foram inclu?das.
Resultados: Revis?o Sistem?tica: Nove estudos, totalizando 575 participantes, foram
inclu?dos na metan?lise. Os resultados dos estudos transversais indicam que os sujeitos
ativos apresentaram um valor m?dio de ?ngulo de fase superior quando comparado aos
controles (DM = 0,70; IC 95%: 0,48 a 0,92, P <0,001), com baixa heterogeneidade (I2 =
0%; P = 0,619). Na an?lise transversal, as diferen?as entre o estado de sa?de e o tipo de
avalia??o da atividade f?sica n?o foram significativas (P = 0,332; P <0,253). Nos estudos
longitudinais (ensaio cl?nico e acompanhamento), os valores m?dios do ?ngulo de fase
finais aumentaram significativamente comparando com os valores iniciais (DM = 0,30;
IC 95%: 0,11 a 0,49, P <0,001), com heterogeneidade baixa (I2 = 13%, P = 0,3314). As
diferen?as n?o foram significativas, em rela??o ao estado de sa?de e ao tipo de estudo
longitudinal (ensaios cl?nicos ou estudos de seguimento) (P = 0,900; 0,989). N?o
encontramos evid?ncia de vi?s de publica??o e o risco geral de vieses foi de moderado a
alto. Artigo transversal: foram inclu?dos 1228 indiv?duos. O modelo linear generalizado
multivari?vel mostrou que tanto a atividade f?sica (? = 0,164, IC95% 0,071 a 0,256, P=
0,001) como o tempo sentado (? = 0,152, IC95% 0,063 a 0,242, P= 0,001) foram
determinantes para o ?ngulo de fase. Assim como o sexo, o ?ndice de massa corporal e a
idade tamb?m permaneceram associados com o ?ngulo de fase (? = -0,890, IC95% -0,975
a -0,806, P <0,001; ? = 0,037, IC95% 0,029 a 0,045, p <0,001 e; ? = -0,006, IC95% -
0,008 a -0,003 P<0,001, respectivamente).
Conclus?o: Os resultados da revis?o sistem?tica e do artigo transversal sugerem uma
associa??o do ?ngulo de fase com a atividade f?sica e com o tempo sentado. Entre os
principais fatores que podem explicar o efeito positivo da atividade f?sica sobre o ?ngulo
de fase est?o o aumento da integridade da membrana celular e a mudan?a no conte?do
intracelular, fatores estes que refletem a sa?de celular e, consequentemente, a sa?de do
indiv?duo.
| Identifer | oai:union.ndltd.org:IBICT/oai:tede2.pucrs.br:tede/8107 |
| Date | 15 March 2018 |
| Creators | Mundstock, Eduardo |
| Contributors | Mattiello, Rita, Baptista, Rafael Reimann |
| Publisher | Pontif?cia Universidade Cat?lica do Rio Grande do Sul, Programa de P?s-Gradua??o em Medicina/Pediatria e Sa?de da Crian?a, PUCRS, Brasil, Escola de Medicina |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/doctoralThesis |
| Format | application/pdf |
| Source | reponame:Biblioteca Digital de Teses e Dissertações da PUC_RS, instname:Pontifícia Universidade Católica do Rio Grande do Sul, instacron:PUC_RS |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 3098206005268432148, 500, 500, 500, 600, 600, -224747486637135387, -969369452308786627, 5178284805913411594, 2075167498588264571 |
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