RESUMO
Bariatric surgery (BS) is considered the only effective method to treat refractory obesity. This study evaluated the clinical-nutritional behavior of obese patients submitted to Roux-en-Y gastric bypass. This cross-sectional and analytical study evaluated weight, Body Mass Index (BMI), weight loss percentage (% WLP), excess weight loss (%EWL) and clinical manifestations. Results were evaluated considering a significance level of 5%. The sample was composed of 37 obese patients, mainly females (n = 26), median age of 40 years. Progressive and significant reduction of weight (128.2 +/- 21.5 vs. 104.4 +/- 18.2 kg), BMI (49.3 +/- 7.7 vs. 40.4 +/- 6.8 kg/m2) and consequent increase in the %WLP (18.6 +/- 3.9%) and %EWL (39.4 +/- 10.6%) were observed over 90 days of follow-up (P < 0.001). Significant increase in the number of patients presenting alopecia (10 vs. 18) and diminished events of dumping syndrome (9 vs 8) and xerostomia (21 vs. 11) were evidenced between 30 and 90 postoperative days. There was also significant reduction in the levels of fasting glucose (100.9 +/- 32.0 vs 83.0 +/- 12.3 mg/dL), total cholesterol (208.1 +/- 38.5 vs. 173.3 +/- 48.2 mg/dL), triglycerides (150.9 +/- 7.7 vs. 102.2 +/- 27.3 mg/dL), hemoglobin (13.3 +/- 1.4 vs. 12.6 +/- 1.0 g/dL) and hematocrit (41.1 +/- 3.8 vs. 39.2 +/- 3.3%) at 90 postoperative day compared to the preoperative period (P < 0.005). We conclude that BS is an effective treatment for weight loss and improved lipid and glycemic profiles. However, the frequency of alopecia and significant reduction in the hemoglobin and hematocrit levels at 90 posotperative day deserves attention.
Assuntos
Derivação Gástrica/métodos , Obesidade/cirurgia , Adolescente , Adulto , Índice de Massa Corporal , Estudos Transversais , Feminino , Derivação Gástrica/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade , Estado Nutricional , Fatores de Tempo , Resultado do Tratamento , Redução de Peso , Adulto JovemRESUMO
FUNDAMENTO: A doença valvar pode cursar com insuficiência cardíaca (IC), anemia e disfunção renal (DR), aumentando o risco nutricional e piorando o prognóstico dos pacientes. OBJETIVO: Avaliar a prevalência de anemia e DR em pacientes portadores de valvopatias com ou sem IC, bem como estabelecer correlação com o estado nutricional. MÉTODOS: Foram avaliados 104 pacientes internados na enfermaria de valvopatias do PROCAPE/UPE, no período de ago-out/2008. Os dados foram obtidos das fichas de acompanhamento nutricional e dos prontuários. As variáveis coletadas foram: sexo, idade, estado nutricional segundo o índice de massa corpórea (IMC), presença de IC, anemia, DR. Considerou-se como anemia valores de hemoglobina < 13 g/dl nos homens e < 12 g/dl nas mulheres. A DR foi estabelecida de acordo com a taxa de filtração glomerular (TGF), sendo calculada pela fórmula proposta por Cockcroft e Gault. RESULTADOS: A prevalência de anemia e DR em pacientes com IC foi de 71,1 por cento e de 68,8 por cento, e nos pacientes sem IC foi de 48,1 por cento e de 60,0 por cento, respectivamente, com diferença estatisticamente significativa para anemia (p = 0,022). Dos pacientes, 48,1 por cento estavam eutróficos, 26,9 por cento com excesso de peso e 25,0 por cento com algum grau de desnutrição. Os pacientes com IC apresentaram uma frequência maior de baixo peso (p = 0,020). O estado nutricional não apresentou associação com anemia (p = 0,117), mas apresentou associação com DR, sendo a função renal diminuída mais frequente nos pacientes com baixo peso (p = 0,000). CONCLUSÃO: Houve significância estatística quando comparamos as prevalências de desnutrição, anemia e DR entre pacientes com e sem IC.
BACKGROUND: Valvular disease can course with heart failure (HF), anemia and renal dysfunction (RD), increasing the nutritional risk and worsening patient prognosis. OBJECTIVE: To evaluate the prevalence of anemia and RD in patients with valvulopathy with or without HF, as well as establish a correlation with the nutritional status. METHODS: A total of 104 patients admitted at the Clinic of Valvulopathy of PROCAPE/UPE, during the period of Aug-Oct/2008. The data were obtained from the nutritional and medical follow-up files. The collected variables were: sex, age, nutritional status according to the body mass index (BMI), presence of HF, anemia and RD. Anemia was considered when hemoglobin values were < 13 g/dl in men and < 12 g/dl in women. RD was established according to the glomerular filtration rate (GFR) and it was calculated through the formula proposed by Cockcroft and Gault. RESULTS: The prevalence of anemia and RD was 71.1 percent and 68.8 percent, and 48.1 percent and 60.0 percent, in patients with and without HF, respectively, with a statistically significant difference for anemia (p = 0.022). Of the patients, 48.1 percent were eutrophic, 26.9 percent had excess weight and 25.0 percent presented some degree of malnutrition. The patients with HF presented a higher frequency of low weight (p = 0.020). The nutritional status was not associated with anemia (p = 0.117), but it was associated with RD, with renal function being decreased more often in patients with low weight (p = 0.000). CONCLUSION: When the prevalence of malnutrition, anemia and RD was compared between patients with and without HF, it showed statistical significance.
Assuntos
Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Anemia/epidemiologia , Insuficiência Cardíaca/epidemiologia , Doenças das Valvas Cardíacas/epidemiologia , Nefropatias/epidemiologia , Desnutrição/epidemiologia , Distribuição por Idade , Anemia/etiologia , Brasil/epidemiologia , Estudos Transversais , Insuficiência Cardíaca/complicações , Insuficiência Cardíaca/fisiopatologia , Doenças das Valvas Cardíacas/complicações , Doenças das Valvas Cardíacas/fisiopatologia , Nefropatias/etiologia , Desnutrição/etiologia , Estado Nutricional , Prevalência , Prognóstico , Fatores de Risco , Distribuição por SexoRESUMO
BACKGROUND: Valvular disease can course with heart failure (HF), anemia and renal dysfunction (RD), increasing the nutritional risk and worsening patient prognosis. OBJECTIVE: To evaluate the prevalence of anemia and RD in patients with valvulopathy with or without HF, as well as establish a correlation with the nutritional status. METHODS: A total of 104 patients admitted at the Clinic of Valvulopathy of PROCAPE/UPE, during the period of Aug-Oct/2008. The data were obtained from the nutritional and medical follow-up files. The collected variables were: sex, age, nutritional status according to the body mass index (BMI), presence of HF, anemia and RD. Anemia was considered when hemoglobin values were < 13 g/dl in men and < 12 g/dl in women. RD was established according to the glomerular filtration rate (GFR) and it was calculated through the formula proposed by Cockcroft and Gault. RESULTS: The prevalence of anemia and RD was 71.1% and 68.8%, and 48.1% and 60.0%, in patients with and without HF, respectively, with a statistically significant difference for anemia (p = 0.022). Of the patients, 48.1% were eutrophic, 26.9% had excess weight and 25.0% presented some degree of malnutrition. The patients with HF presented a higher frequency of low weight (p = 0.020). The nutritional status was not associated with anemia (p = 0.117), but it was associated with RD, with renal function being decreased more often in patients with low weight (p = 0.000). CONCLUSION: When the prevalence of malnutrition, anemia and RD was compared between patients with and without HF, it showed statistical significance.