RESUMO
OBJECTIVE: To evaluate the association of birthweight and weight gain during different periods in childhood with the prevalence of hypertriglyceridemic waist phenotype (HWP). METHODS: In 1982, all hospitals births in Pelotas, South Brazil, were identified, and the 5914 liveborn were examined and their mothers interviewed. This population has been followed for several times. In 2004-05, we tried to follow the whole cohort and the subjects were interviewed, examined, and a blood sample was collected. HWP was defined as a triglycerides ≥ 2 mmol/L and a waist circumference ≥ 90 cm for men, and triglycerides ≥ 1.5 mmol/L and waist circumference ≥ 85 cm for woman. Poisson regression with robust adjustment of the variance was used to obtain adjusted estimates of the prevalence ratio. RESULTS: Subjects whose weight-for-age z-score at mean age of 42 months was one or more standard deviation above the mean, according to gender and age, were 8.77 (95% confidence interval: 2.60; 29.64) times more likely of presenting the HWP than those subjects whose weight-for-age z-score at 42 months was more than one standard deviation below the mean. Among those subjects whose birthweight was adequate-for-gestational age (AGA), conditional weight at 20 months was positively associated to the risk of HWP [relative risk: 1.59 (95%: confidence interval: 1.32; 1.92)], whereas for small for gestational age (SGA) subjects conditional weight was not associated with HWP [relative risk: 1.05 (95% confidence interval: 0.77; 1.43)], p-value for interaction 0.08. CONCLUSION: Early weight gain among SGA infants, did not increase the risk of HWP in early adulthood, whereas among those who were AGA, early weight gain increased the risk of the having the phenotype in early adulthood.
Assuntos
Peso ao Nascer , Cintura Hipertrigliceridêmica/fisiopatologia , Fenótipo , Aumento de Peso , Adolescente , Brasil/epidemiologia , Criança , Pré-Escolar , Feminino , Humanos , Cintura Hipertrigliceridêmica/epidemiologia , Lactente , Recém-Nascido , Masculino , Adulto JovemAssuntos
Adenoma Hipofisário Secretor de ACT/diagnóstico , Adenoma/diagnóstico , Síndrome de Cushing/diagnóstico , Imageamento Tridimensional/métodos , Imageamento por Ressonância Magnética/métodos , Hormônio Adrenocorticotrópico/metabolismo , Feminino , Humanos , Aumento da Imagem , Pessoa de Meia-IdadeRESUMO
Descrevemos o caso de paciente que apresentou massa em supra-renal direita na ultra-sonografia abdominal durante investigaçäo de dor abdominal, caracterizando um incidentaloma de supra-renal; a tomografia computadorizada confirmou a presença de lesäo. A avaliaçäo endócrina detectou perda do ritmo circadiano do cortisol e sua näo supressibilidade pela dexametasona, caracterizando síndrome de Cushing. Entretanto a paciente näo apresentava as características clínicas da síndrome, o que sugeriu o diagnóstico de síndrome de Cushing subclínica. a paciente foi submetida a cirurgia laparoscópica para ressecçäo da glândula adrenal direita cujo diagnóstico anátomo-patológico foi de adenoma de supra renal. Uma nova avaliaçäo do cortisol foi feita após a cirurgia com resultados normais. Pretendemos sugerir neste relato um manejo nacional e com baixos custos, dos incidentalomas de supra-renal.