RESUMO
Dietary factors play a role in modulating chronic inflammation and in the development of CVD. We aimed to investigate the association between the dietary inflammatory index (DII) and cardiometabolic risk factors among adolescents. A total of 31 684 Brazilian adolescents (aged 12-17 years) from the Study of Cardiovascular Risks in Adolescents (ERICA) were included. Dietary intake was assessed using a 24-h dietary recall. The energy-adjusted dietary inflammatory index (E-DII) score was calculated based on data for twenty-five available nutrients. The anthropometric profile, blood pressure, lipid profile, glucose, Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) and glycated Hb were measured. Poisson regression models were used to examine the associations between sex-specific quartiles of the E-DII and cardiometabolic risk factors. In the energy-adjusted models, when comparing a high pro-inflammatory diet (quartile 4) with an anti-inflammatory diet (quartile 1), there was a positive association with high HOMA-IR among boys (prevalence ratios (PR)Q4 = 1·37, 95 % CI: 1·04, 1·79); and with high fasting glucose (PRQ4 = 1·96, 95 % CI: 1·02, 3·78), high TAG (PRQ4 = 1·92, 95 % CI: 1·06, 3·46), low HDL-cholesterol (PRQ4 = 1·16, 95 % CI: 1·02, 1·32) and high LDL-cholesterol (PRQ4 = 1·93, 95 % CI: 1·12, 3·33) among girls. Additionally, a moderately pro-inflammatory diet was positively associated with high HOMA-IR (PRQ2 = 1·14, 95 % CI: 1·02, 1·29) among girls and high total cholesterol (PRQ3 = 1·56, 95 % CI: 1·20, 2·01) among boys. In conclusion, this study provides new evidence on the association between inflammatory diets with cardiometabolic risk factors among adolescents.
Assuntos
Doenças Cardiovasculares , Resistência à Insulina , Masculino , Feminino , Humanos , Adolescente , Fatores de Risco , Estudos Transversais , Fatores de Risco Cardiometabólico , Brasil , Dieta/efeitos adversos , Glucose , Colesterol , Índice de Massa CorporalRESUMO
BACKGROUND: Individuals with type 1 diabetes (T1D) are exposed to an elevated risk of automobile accidents especially because of hypoglycemia that impairs physiological and defense responses. OBJECTIVES: To assess local risk factors for traffic events in T1D adult Brazilian patients. METHODS: This is a prospective study and 12-month follow-up to assess predictors for traffic events on a cohort of drivers with T1D (n = 168) in Brazil. The inclusion criteria for participants were Brazilian nationality, age ≥ 18 years-old, diagnosis of T1D for more than one year, driving license B, C or D categories (four-wheel vehicles), driving three-times per week or more, and checking blood glucose twice-daily or more. The primary outcome was hypoglycemia driving mishaps assessed by a seven-query questionnaire about the past 30 days. Secondary outcomes included driving mishaps not related to hypoglycemia. Statistical analysis was performed through Poisson regression models with robust variance estimarion, in which the measure of association is the relative risk. RESULTS: A total of 109 participants completed the 12-month follow-up. Most of them were men (66%) and 37 ± 11 years-old, and had a mean HbA1c of 8.2% (66 mmol/mol). In the follow up, the incidence of traffic events was high (70.6%); however, only a minority was attributed to hypoglycemia as the cause of the reported event (19.3%). The best predictors for new traffic events due to hypoglycemia were those related to driving characteristics. The best of them was a history of episodes of hypoglycemia while driving [RR 3.40 (1.22-9.43); p < 0.05]. CONCLUSIONS: We found that previous episodes of hypoglycemia while driving significantly increase the risk of new traffic events and are the best predictor for it. This highlights the need to assess the risks of traffic accidents especially in people who have had experienced episodes of hypoglycemia while driving.
Assuntos
Condução de Veículo , Diabetes Mellitus Tipo 1 , Hipoglicemia , Acidentes de Trânsito , Adolescente , Adulto , Brasil/epidemiologia , Diabetes Mellitus Tipo 1/epidemiologia , Humanos , Hipoglicemia/epidemiologia , Hipoglicemia/etiologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de RiscoRESUMO
Background: The SAMe-TT2R2 score was introduced to identify atrial fibrillation patients with a high risk of not achieving a good time in therapeutic range (TTR) during vitamin K antagonists (VKA) therapy. Objective: The aim of this study was to evaluate this score in venous thromboembolism (VTE) patients. Patients and methods: A retrospective cohort study of patients receiving care at the outpatient anticoagulation clinic of a tertiary care teaching hospital. Patients were classified as having low (score 0-1) or high risk (score ≥2) of not achieving a good TTR. The area under the ROC curve was calculated to assess the ability of the score to predict a TTR ≥ 65%. Adverse event-free survival curves according to the SAMe-TT2 R2 score were calculated by the Kaplan-Meier method and compared by the log-rank test. A p-value < 0.05 was considered statistically significant. Results: We investigated 111 patients during a median follow-up of 2.3 (0.7-6.4) years. Mean age was 54.1 ± 15.7 years and 71 (64.0%) were women. Low- and high-risk groups had similar mean TTR (51.9 vs. 49.6%; p = 0.593). The two groups did not differ significantly in the percentage of patients achieving a TTR ≥ 65% (35.6 vs. 25.8%; p =0.370). The c-statistic was 0.595 (p = 0.113) for TTR ≥ 65%. Adverse event-free survival during anticoagulation was also similar in both groups (p = 0.136).Conclusions: The SAMe-TT2R2 score does not seem to be a useful tool in oral anticoagulation decision-making for patients with VTE and should not be used in this setting