Assuntos
Canais Epiteliais de Sódio , Hipertensão , Pressão Sanguínea , Humanos , Rim , Cloreto de Sódio na DietaRESUMO
BACKGROUND: Cardiovascular diseases (CVD) are the main cause of death and disability in developed countries. In most cases, the progress of CVD is influenced by environmental factors and multifactorial inheritance. The purpose of this study was to investigate the association between APOE genotypes, cardiovascular risk factors, and a non-invasive measure of arterial stiffness in the Brazilian population. METHODS: A total of 1493 urban Brazilian individuals were randomly selected from the general population of the Vitoria City Metropolitan area. Genetic analysis of the APOE polymorphism was conducted by PCR-RFLP and pulse wave velocity analyzed with a noninvasive automatic device. RESULTS: Age, gender, body mass index, triglycerides, creatinine, uric acid, blood glucose, blood pressure phenotypes were no different between ε2, ε3 and ε4 alleles. The ε4 allele was associated with higher total-cholesterol (p < 0.001), LDL-C (p < 0.001), total-cholesterol/HDL-C ratio (p < 0.001), LDL/HDL-C ratio (p < 0.001), lower HDL-C values (p < 0.001) and higher risk to obesity (OR = 1.358, 95% CI = 1.019-1.811) and hyperuricemia (OR = 1.748, 95% CI = 1.170-2.611). Nevertheless, pulse wave velocity (p = 0.66) measures were no different between genotypes. The significant association between APOE genotypes and lipid levels persisted after a 5-year follow-up interval, but no interaction between time and genotype was observed for lipids longitudinal behavior. CONCLUSION: The ε4 allele of the APOE gene is associated with a worse lipid profile in the Brazilian urban population. In our relatively young sample, the observed effect of APOE genotype on lipid levels was not translated into significant effects in arterial wall stiffness.
Assuntos
Apolipoproteínas E/genética , Artérias/fisiopatologia , Doenças Cardiovasculares/genética , Lipídeos/sangue , Polimorfismo Genético/genética , Adulto , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Feminino , Predisposição Genética para Doença/genética , Humanos , Lipídeos/genética , Masculino , Pessoa de Meia-IdadeRESUMO
BACKGROUND: The alpha1A-adrenergic receptor (alpha1A-AR) regulates the cardiac and peripheral vascular system through sympathetic activation. Due to its important role in the regulation of vascular tone and blood pressure, we aimed to investigate the association between the Arg347Cys polymorphism in the alpha1A-AR gene and blood pressure phenotypes, in a large sample of Brazilians from an urban population. METHODS: A total of 1568 individuals were randomly selected from the general population of the Vitória City metropolitan area. Genetic analysis of the Arg347Cys polymorphism was conducted by polymerase chain reaction/restriction fragment length polymorphism. We have compared cardiovascular risk variables and genotypes using ANOVA, and Chi-square test for univariate comparisons and logistic regression for multivariate comparisons. RESULTS: Association analysis indicated a significant difference between genotype groups with respect to diastolic blood pressure (p = 0.04), but not systolic blood pressure (p = 0.12). In addition, presence of the Cys/Cys genotype was marginally associated with hypertension in our population (p = 0.06). Significant interaction effects were observed between the studied genetic variant, age and physical activity. Presence of the Cys/Cys genotype was associated with hypertension only in individuals with regular physical activity (odds ratio = 1.86; p = 0.03) or younger than 45 years (odds ratio = 1.27; p = 0.04). CONCLUSION: Physical activity and age may potentially play a role by disclosing the effects of the Cys allele on blood pressure. According to our data it is possible that the Arg347Cys polymorphism can be used as a biomarker to disease risk in a selected group of individuals.
Assuntos
Pressão Sanguínea/genética , Doenças Cardiovasculares/genética , Hipertensão/genética , Receptores Adrenérgicos alfa 1/genética , Adulto , Fatores Etários , Brasil , Doenças Cardiovasculares/metabolismo , Doenças Cardiovasculares/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Atividade Motora , Razão de Chances , Polimorfismo Genético , Fatores de Risco , População UrbanaRESUMO
OBJECTIVE: To assess the effectiveness of a manual-based cognitive behavior therapy adapted to a group format in a sample of Brazilian obese subjects with binge-eating disorder. METHOD: In an open trial, 21 obese subjects with binge-eating disorder received a group cognitive-behavioral therapy program. Changes in binge-eating frequency, weight, body shape concerns, and depressive symptoms were compared between baseline and the end of the study. RESULTS: The mean frequency of binge-eating episodes significantly decreased from baseline to post-treatment (p < 0.001), with a binge eating remission rate of 76.1% at the end of the trial. Depressive symptoms and body shape concern also improved (p < 0.001). In addition, weight loss was statistically and clinically significant. CONCLUSION: The use of this adapted manual-based cognitive behavior therapy in this sample resulted in a marked improvement in binge-eating, weight, body shape concern, and depressive symptoms related to binge-eating disorder.
Assuntos
Bulimia Nervosa/terapia , Terapia Cognitivo-Comportamental/métodos , Obesidade/terapia , Adolescente , Adulto , Imagem Corporal , Índice de Massa Corporal , Peso Corporal , Brasil , Bulimia Nervosa/fisiopatologia , Terapia Cognitivo-Comportamental/normas , Transtorno Depressivo/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/psicologia , Escalas de Graduação Psiquiátrica , Inquéritos e Questionários , Resultado do Tratamento , Redução de PesoRESUMO
OBJECTIVE: To assess the effectiveness of a manual-based cognitive behavior therapy adapted to a group format in a sample of Brazilian obese subjects with binge-eating disorder. METHOD: In an open trial, 21 obese subjects with binge-eating disorder received a group cognitive-behavioral therapy program. Changes in binge-eating frequency, weight, body shape concerns, and depressive symptoms were compared between baseline and the end of the study. RESULTS: The mean frequency of binge-eating episodes significantly decreased from baseline to post-treatment (p < 0.001), with a binge eating remission rate of 76.1 percent at the end of the trial. Depressive symptoms and body shape concern also improved (p < 0.001). In addition, weight loss was statistically and clinically significant. CONCLUSION: The use of this adapted manual-based cognitive behavior therapy in this sample resulted in a marked improvement in binge-eating, weight, body shape concern, and depressive symptoms related to binge-eating disorder.
OBJETIVO: Avaliar a efetividade da terapia cognitivo-comportamental baseada em um manual adaptado para o formato de grupo em uma amostra brasileira de obesos com transtorno da compulsão alimentar periódica. MÉTODO: Em um estudo aberto, 21 pacientes obesos com transtorno da compulsão alimentar periódica participaram de um programa da terapia cognitivo-comportamental em grupo. A freqüência da compulsão alimentar, o peso corporal, o grau de satisfação com a forma corporal e os sintomas depressivos foram avaliados no início do tratamento e no final do estudo. RESULTADOS: Houve uma redução estatisticamente significativa da freqüência média de episódios de compulsão alimentar entre a linha de base e o final do tratamento (p < 0,001), com uma taxa de remissão de episódios no final do estudo de 76,1 por cento. Foi observada, também, uma redução significativa dos sintomas depressivos e da insatisfação com a forma corporal (p < 0,001). Adicionalmente, a perda de peso foi clínica e estatisticamente significativa. CONCLUSÃO: A utilização de terapia cognitivo-comportamental baseada em um manual adaptado para o transtorno da compulsão alimentar periódica resultou em melhora significativa da compulsão alimentar, do peso corporal, da preocupação com a forma corporal e dos sintomas depressivos associados ao transtorno da compulsão alimentar periódica nessa amostra.
Assuntos
Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Bulimia Nervosa/terapia , Terapia Cognitivo-Comportamental/métodos , Obesidade/terapia , Imagem Corporal , Índice de Massa Corporal , Peso Corporal , Brasil , Bulimia Nervosa/fisiopatologia , Terapia Cognitivo-Comportamental/normas , Transtorno Depressivo/diagnóstico , Obesidade/psicologia , Escalas de Graduação Psiquiátrica , Inquéritos e Questionários , Resultado do Tratamento , Redução de PesoRESUMO
The purpose of the present study was to evaluate the clinical usefulness of the Portuguese version of the Binge Eating Scale (BES) to assess binge eating disorder (BED) in a clinical sample. The BES is a self-reported instrument developed to identify binge eaters within the obese population. The scale, at the cutoff point of 17, was compared with the Structured Clinical Interview for the DSM-IV-Patient version (SCID-I/P). It was administered to 178 obese Brazilian women, aged 18 to 60 years, seeking treatment for obesity at an outpatient clinic. To assess the test-retest reliability, 121 individuals filled the instrument again 15 days later. The Portuguese version of BES showed a sensitivity of 97.8%, a specificity of 47.7%, a positive predictive value of 66.7% and a negative predictive value of 95.3%. The test-retest reliability, measured by kappa statistics, was 0.66. Cronbach's alpha was 0.89. These results suggest that the BES is valid as a screening instrument for BED in obese Brazilian women seeking treatment for obesity.
Assuntos
Bulimia Nervosa/diagnóstico , Manual Diagnóstico e Estatístico de Transtornos Mentais , Entrevista Psicológica , Obesidade/psicologia , Inventário de Personalidade/estatística & dados numéricos , Adolescente , Adulto , Índice de Massa Corporal , Brasil , Bulimia Nervosa/epidemiologia , Bulimia Nervosa/psicologia , Comorbidade , Estudos Transversais , Humanos , Masculino , Computação Matemática , Pessoa de Meia-Idade , Obesidade/epidemiologia , Psicometria/estatística & dados numéricos , Reprodutibilidade dos TestesRESUMO
We compared sociodemographic characteristics and psychiatric status in obese Brazilian patients who did (n=32) and did not (n=33) meet DSM-IV criteria for binge-eating disorder (BED). The sample's mean age was 35.0 years (+/-10.5), with 92.3% of individuals being female and 41.5% having some higher education. Obese binge eaters (OBE) were significantly more likely than obese non-binge eaters to meet criteria for a current diagnosis of any axis I disorder, any mood disorder and any anxiety disorder. Specifically, OBE patients were characterized by significantly higher rates of current and lifetime histories of major depressive disorder. Similar to patients from developed countries, Brazilian patients with BED display increased rates of psychiatric comorbidity, particularly mood and anxiety disorders.