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BACKGROUND: It has been described that physiological changes in glucose metabolism, represented by insulin resistance (IR), are predicted during pubertal evolution, and obesity may be associated with its persistence even at the end of puberty. The aim of this study was to investigate the prevalence of IR in female adolescents with possible associated factors and evaluate the relationship of time since menarche (< 2 vs. ≥ 2 years) in the occurrence of IR in two Brazilian capital cities: Porto Velho (RO) and Porto Alegre (RS). METHODS: This is a cross-sectional school-based study, using information from the Study of Cardiovascular Risks (ERICA) database for adolescents aged 12-17 years, enrolled in public and private schools, in municipalities with more than 100,000 inhabitants in Brazil, between 2013 and 2014. The present study included 889 adolescents, 382 in Porto Velho (PVh) and 507 in Porto Alegre (PoA). The homeostasis model assessment for insulin resistance (HOMA-IR) ≥ 3.16 and fasting insulin ≥ 15 mU/L was used to determine the outcome variable of IR. Estimates of crude and adjusted prevalence ratios with confidence intervals of 95% were calculated using Poisson regression with robust variance. Sociodemographic, behavioral, reproductive and nutritional characteristics were considered as potential confounding factors in multivariable models based on a conceptual framework of IR determination. RESULTS: In the total sample, the prevalence of IR was 22.03% (95% CI 17.84-26.89). After adjusting the models, age 15-17 years and time since menarche ≥ 2 years were found to act as protective factors for IR; in contrast, the highest probability of IR was observed in black adolescents, with increased waist circumference (WC) and overweight/obesity (Ow/Ob). The protective effect of two or more years since menarche (post-menarche) was observed for both higher HOMA-IR and fasting insulin in PVh; in PoA, such protection was maintained only for fasting insulin ≥ 15 mU/L after adjustments in the multivariate models. CONCLUSIONS: IR is more prevalent during the peri-menarche period, especially in younger and black adolescents, compared to their white and post-menarche counterparts. The association between Ow/Ob and high WC with the occurrence of IR was independent of age and ethnicity variables.

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INTRODUCTION: Obesity is a chronic disease with a multifactorial etiology, brought about by a set of genetic, environmental and psychological factors. This may generate comorbidities that affect the quality of life and involve other risks to healthOBJECTIVE: To describe the prevalence of overweight and obesity in school children and adolescents in Porto Velho - Rondônia, Brazil in the period 2013-2016METHODS: This study included 4165 schoolchildren aged 9 to 18 years. The students were classified as overweight and obese, according to the z score of the body mass index (BMI) for age and calculated according the WHO AnthroPlus program. Subsequently, BMI for age was categorized according to the criteria proposed by the World Health Organization (WHO, 2007): overweight (≥ score z +1 ≤ z + 2) and obese (≥ score z +2). Prevalence calculations were performed using the SPSS version 20.0 programRESULTS: Overall, the prevalence of overweight was 27.1%, being overweight 18.8% and obese 8.3%, in private schools 21.4% and 9.8%, public schools 17.0% and 7.2% respectively. The east zone predominated in both education networks 18.8% and 8.3% respectively. In males, the highest prevalence was at nine years old, 30.7% and 23.0%, and female, 24.3% and 13.8%CONCLUSION: The magnitude of the prevalence of overweight and obesity was high and worrying among schoolchildren and adolescents in the city of Porto Velho, which demonstrates the need for public health actions aimed at the family unit, regardless of the social segment

INTRODUÇÃO: A obesidade é uma doença crônica com etiologia multifatorial, provocada por um conjunto de aspectos genéticos, ambientais e psicológicos. Esta pode gerar comorbidades que afetam a qualidade de vida e implicam em outros riscos à saúdeOBJETIVO: Descrever a prevalência de sobrepeso e obesidade em crianças e adolescentes escolares em Porto Velho - RO, Brasil. 2013-2016MÉTODO: Este estudo incluiu 4165 escolares de 9 a 18 anos. Os escolares foram classificados como sobrepeso e obeso, de acordo com o escore z do índice de massa corporal (IMC) para idade e calculado com auxílio do programa WHO AnthroPlus. Posteriormente, o IMC para idade foi categorizado conforme os critérios propostos pela Organização Mundial da Saúde (OMS, 2007): sobrepeso (≥escore z +1 ≤ z + 2) e obeso (≥ escore z +2). Os cálculos de prevalências foram feitos com o auxílio do programa SPSS versão 20.0RESULTADOS: As prevalências de excesso de peso foram elevadas de 27,1%, sobrepeso 18,8% e obeso 8,3%, escolas particulares 21,4% e 9,8%, públicas 17,0% e 7,2% respectivamente. A zona leste predominou em ambas as redes de ensino 18,8% e 8,3% respectivamente. No sexo masculino a maior prevalência foi aos nove anos 30,7% e 23,0% e feminino 24,3% e 13,8%CONCLUSÃO: A magnitude da prevalência de sobrepeso e obeso foi elevada e preocupante em escolares da cidade de Porto Velho, o que demonstra a necessidade de ações de saúde pública voltadas à unidade familiar, independentemente do segmento social

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Abstract Objective: To analyze the association between age at menarche and variables of body composition in girls from the Northern region of Brazil, the Brazilian Legal Amazon. Method: The sample was composed of 926 school girls, aged between 8 and 18 years, divided into two groups, those who had (G1; n = 727; 72.5%) and had not undergone menarche (G2; n = 199; 21.5%), from public and private schools, using the stratified random proportional sampling technique. Weight, fat weight, muscle weight, and body mass index were measured using bioimpedance analysis. Body height was measured using a stadiometer. Age at menarche was obtained using the conventional method. For the evaluation of sexual maturation, self-assessment was performed according to criteria described by Tanner. Results: The highest cumulative distribution of menarche was found at age 11, and presented significant differences between G1 and G2 at ages 11 and 12 years in all variables of body composition, except body mass index Z-score. Fat and muscle mass were associated with age at menarche. Conclusion: The present results support the notion of menarche anticipation in girls from Brazilian Amazon and its association with body composition. Further studies are needed to investigate the influence of other possible factors that may interfere with the time of growth spurt, thus determining the timing of puberty in these girls in comparison to other regions of Brazil.

Resumo Objetivo Analisar a associação entre idade da menarca e variáveis da composição corporal em meninas na região norte do Brasil, a Amazônia brasileira. Método A amostra foi composta por 926 meninas em idade escolar, entre 8 e 18 anos, divididas em dois grupos, com presença de menarca (G1), n = 727 (72,5%) e ausência (G2) n = 199 (21,5%), provenientes de escolas públicas e privadas, com a técnica de amostragem aleatória estratificada proporcional. Peso, massa de gordura, massa muscular e índice de massa corporal foram medidos através da análise de bioimpedância. A altura foi medida com um estadiômetro. A idade da menarca foi obtida pelo método status quo. Para a avaliação da maturação sexual, a autoavaliação foi realizada de acordo com os critérios descritos por Tanner. Resultados A maior distribuição cumulativa da menarca foi encontrada aos 11 anos e apresentou diferenças significativas entre a presença e ausência de menarca aos 11 e 12 anos em todas as variáveis de composição corporal, exceto o escore-z do índice de massa corporal. Massa de gordura e massa muscular foram associadas com a idade da menarca. Conclusão Os resultados apresentados corroboram a antecipação da menarca em meninas da Amazônia brasileira e sua associação com a composição corporal. Mais estudos são necessários para investigar a influência de outros possíveis fatores que podem interferir na época do estirão de crescimento e determinar, assim, a ocorrência da puberdade em meninas amazônicas em comparação com as de outras regiões do Brasil.

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OBJECTIVE: To analyze the association between age at menarche and variables of body composition in girls from the Northern region of Brazil, the Brazilian Legal Amazon. METHOD: The sample was composed of 926 school girls, aged between 8 and 18 years, divided into two groups, those who had (G1; n=727; 72.5%) and had not undergone menarche (G2; n=199; 21.5%), from public and private schools, using the stratified random proportional sampling technique. Weight, fat weight, muscle weight, and body mass index were measured using bioimpedance analysis. Body height was measured using a stadiometer. Age at menarche was obtained using the conventional method. For the evaluation of sexual maturation, self-assessment was performed according to criteria described by Tanner. RESULTS: The highest cumulative distribution of menarche was found at age 11, and presented significant differences between G1 and G2 at ages 11 and 12 years in all variables of body composition, except body mass index Z-score. Fat and muscle mass were associated with age at menarche. CONCLUSION: The present results support the notion of menarche anticipation in girls from Brazilian Amazon and its association with body composition. Further studies are needed to investigate the influence of other possible factors that may interfere with the time of growth spurt, thus determining the timing of puberty in these girls in comparison to other regions of Brazil.

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ABSTRACT Objective: To identify the prevalence of physical inactivity in adolescent students in the city of Porto Velho, RO, Northern Brazil, and its associated factors. Methods: School-based study, conducted with 2,694 adolescents. The self-reported variable for outcome was physical inactivity. Factors associated with inactive behavior were verified by multiple logistic regression. The independent variables were inserted into the model in hierarchical blocks. Results: The overall prevalence of inactive behavior was 39.5%. Females showed a higher prevalence of physical inactivity (46.2%) than males (31.4%). Adolescents in private schools and with reports of negative health perception had a high prevalence of physical inactivity. Regarding associated factors, the female sex showed a magnitude of association of 1.84 with physical inactivity. Being in a private school was associated with a 2.54 times greater chance of physical inactivity compared to public school students. Going to school by bus, car or motorcycle was associated with a 1.29 and 1.63 higher chance of physical inactivity respectively. Adolescents who reported having a negative health perception had 1.29 higher chance of physical inactivity, while having excess body fat showed magnitude of association of 1.36 in adolescents. Conclusions: There was a high prevalence of physical inactivity in the studied adolescents. Considering that the behavior of physical inactivity adopted during adolescence may continue in adulthood, the promotion of actions that can change this behavior may improve health in the future as well as quality of life.

RESUMO Objetivo: Identificar a prevalência do comportamento inativo de estudantes adolescentes da cidade de Porto Velho, RO, Brasil, e os fatores associados a ele. Métodos: Estudo de base escolar realizado com 2.694 adolescentes. A variável autorreferida à exposição ao desfecho foi a inatividade física. Verificam-se os fatores associados ao comportamento inativo pela regressão logística múltipla. As variáveis independentes foram inseridas no modelo em blocos hierarquizados. Resultados: A prevalência geral de comportamento inativo foi de 39,5%. O sexo feminino mostrou maior prevalência de comportamento inativo (46,2%) do que o masculino (31,4%). Adolescentes em escolas particulares e com relatos de percepção de saúde negativa apresentaram alta prevalência de comportamento inativo. Na verificação dos fatores associados, o sexo feminino mostrou magnitude de associação de 1,84 com o comportamento inativo. Estar institucionalizado em escola particular mostrou 2,54 vezes mais chance de ter comportamento inativo em comparação aos estudantes das escolas públicas. A locomoção para escola por ônibus e carro ou motocicleta revelou magnitudes de associação com o comportamento inativo de 1,29 e 1,63, respectivamente. Adolescentes que apontaram a percepção de saúde negativa tiveram 1,29 mais chance de ter comportamento inativo em relação ao relato de saúde positiva, enquanto ter excesso de gordura corporal mostrou magnitude de associação de 1,36 em adolescentes. Conclusões: A prevalência de comportamento inativo foi alta em estudantes adolescentes. Considerando que o comportamento inativo adotado durante a adolescência pode permanecer nos anos posteriores, sugere-se a promoção de ações para a modificação de comportamento visando à melhoria da saúde e qualidade de vida.

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OBJECTIVE: To identify the prevalence of physical inactivity in adolescent students in the city of Porto Velho, RO, Northern Brazil, and its associated factors. METHODS: School-based study, conducted with 2,694 adolescents. The self-reported variable for outcome was physical inactivity. Factors associated with inactive behavior were verified by multiple logistic regression. The independent variables were inserted into the model in hierarchical blocks. RESULTS: The overall prevalence of inactive behavior was 39.5%. Females showed a higher prevalence of physical inactivity (46.2%) than males (31.4%). Adolescents in private schools and with reports of negative health perception had a high prevalence of physical inactivity. Regarding associated factors, the female sex showed a magnitude of association of 1.84 with physical inactivity. Being in a private school was associated with a 2.54 times greater chance of physical inactivity compared to public school students. Going to school by bus, car or motorcycle was associated with a 1.29 and 1.63 higher chance of physical inactivity respectively. Adolescents who reported having a negative health perception had 1.29 higher chance of physical inactivity, while having excess body fat showed magnitude of association of 1.36 in adolescents. CONCLUSIONS: There was a high prevalence of physical inactivity in the studied adolescents. Considering that the behavior of physical inactivity adopted during adolescence may continue in adulthood, the promotion of actions that can change this behavior may improve health in the future as well as quality of life.

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Abstract The aim of this study was to identify the prevalence and concordance of excess weight (BMI) and body fat (fat %) in adolescents of both sexes from cities of Rio Branco-AC and Porto Velho-RO. This study evaluated 4,310 adolescents, 2,167 from Rio Branco and 2,143 from Porto Velho. No difference (p=0.46) for excess weight between adolescents from Rio Branco (34.8%) and Porto Velho (33.8%) was observed. Fat percentage was significantly higher (p<0.01) in adolescents from Porto Velho (59.8%) compared to those from Rio Branco (44.3%). In intra-pubertal and pubertal stages, moderate concordance was identified (p<0.01) and in pre-pubertal stage, substantial concordance was observed (p<0.01). Thus, the findings of this study point out the adequacy of screening and diagnosis of obesity and overweight, which will enable earlier approach and treatment of adolescents.

Resumo O objetivo deste estudo foi verificar a prevalência e a concordância de excesso de peso (IMC) e de gordura corporal (% gordura) em adolescentes de ambos os sexos das cidades de Rio Branco-AC e Porto Velho-RO. Participaram do estudo 4.310 adolescentes, sendo 2.167 de Rio Branco e 2.143 de Porto Velho. Não houve diferença (p=0,46) entre o excesso de peso nos adolescentes de Rio Branco (34.8%) e de Porto Velho (33.8%). O % gordura foi significativamente maior (p=<0,01) nos adolescentes de Porto Velho (59,8%) em relação aos de Rio Branco (44,3%). Nos estágios intra-púbere e púbere foram identificadas moderadas concordâncias (p=0,01) e no estádio pré-púbere foi observado substancial concordância (p=0,01). Assim, os achados do presente estudo apontam para a necessidade da adequação do rastreamento da obesidade e sobrepeso que possibilitará identificação mais precoce e tratamento dos adolescentes.

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INTRODUCTION: Overweight has been reported as a public health problem. Consequently, this suggests epidemiological studies for nutritional surveillance. OBJECTIVE: To analyze the prevalence and factors associated with overweight among high school students in Capital of the Brazilian Western Amazon. METHODS: Cross-sectional study of 2694 adolescents from public and private schools. They collected demographic, socioeconomic and sedentary behavior through self-responded questionnaire. Overweight rating followed the recommendations of the World Health Organization (2007). The prevalence rates were calculated, odds ratio and their confidence intervals were calculated at 95%. They identified the factors associated with excess weight by multiple binary logistic regression. RESULTS: The overall prevalence of overweight was 24.2% and 26.3% for males and 22.4% for females. After adjustment factors associated with overweight were economic class A / B (OR = 1.30, 95% CI 1.02 to 1.45), private school type (OR = 1.21, 95% CI 1,02-1.46) and poor health perception (OR = 1.27, 95% CI 1.03 to 1.58). It was concluded that excess weight showed high prevalence in economy class adolescents and B and private schools in Porto Velho, RO, Brazil. CONCLUSION: Therefore, the practice of physical activity associated with a diet should be encouraged, in addition to reducing sedentary behavior, to prevent the development of overweight and obesity.

INTRODUÇÃO: O excesso de peso tem sido reportado como um problema de saúde pública. Por conseqüência, essa situação sugere a realização de estudos epidemiológicos voltados para a vigilância nutricional. OBJETIVO: Analisar a prevalência e fatores associados ao excesso de peso entre escolares do ensino médio em Capital da Amazônia Ocidental Brasileira. MÉTODO: Estudo descritivo transversal com 2694 adolescentes de escolas públicas e privadas. Foram coletadas informações demográficas, socioeconómica e comportamento sedentário por meio de questionário auto respondido. A classificação de excesso de peso seguiu as recomendações da Organização Mundial da Saúde (2007). Foram calculadas as prevalências, razão de chance e seus respectivos intervalos de confiança em 95%. Identificaram-se os fatores associados ao excesso de peso por regressão logística binaria múltipla. RESULTADOS: A prevalência geral de excesso de peso foi 24,2%, sendo 26,3% para o sexo masculino e 22,4% para o feminino. Após análise ajustada os fatores associados ao excesso de peso foram classe económica A/B (OR = 1,30; IC95%=1,02 - 1,45), tipo de escola privada (OR = 1,21; IC95%=1,02 - 1,46) e percepção de saúde insatisfatória (OR = 1,27; IC95%= 1,03 - 1,58). Concluiu-se que excesso de peso apresentou elevada prevalência em adolescentes de classe econômica A e B e escolas privadas de Porto Velho, RO, Brasil. CONCLUSÃO: Portanto, a prática de atividade física associada uma dieta alimentar deve ser estimulada, além da redução ao comportamento sedentário, para prevenir o desenvolvimento de sobrepeso e obesidade.

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