Ana Karina Teixeira da Cunha França

Background/Objectives: The prevalence of metabolic syndrome (MetS) is increasing worldwide, and an increasing number of cases are diagnosed in younger age groups. This study aimed to propose predictive models based on demographic, anthropometric, and non-invasive clinical variables to predict MetS in adolescents. Methods: A total of 2064 adolescents aged 18–19 from São Luís-Maranhão, Brazil were enrolled. Demographic, anthropometric, and clinical variables were considered, and three criteria for diagnosing MetS were employed: Cook et al., De Ferranti et al. and the International Diabetes Federation (IDF). A feed-forward artificial neural network (ANN) was trained to predict MetS. Accuracy, sensitivity, and specificity were calculated to assess the ANN’s performance. The ROC curve was constructed, and the area under the curve was analyzed to assess the discriminatory power of the networks. Results: The prevalence of MetS in adolescents ranged from 5.7% to 12.3%. The ANN that used the Cook et al. criterion performed best in predicting MetS. ANN 5, which included age, sex, waist circumference, weight, and systolic and diastolic blood pressure, showed the best performance and discriminatory power (sensitivity, 89.8%; accuracy, 86.8%). ANN 3 considered the same variables, except for weight, and exhibited good sensitivity (89.0%) and accuracy (87.0%). Conclusions: Using non-invasive measures allows for predicting MetS in adolescents, thereby guiding the flow of care in primary healthcare and optimizing the management of public resources.

Background/Objectives: the prevalence of metabolic syndrome (MetS) is increasing worldwide, and an increasing number of cases are diagnosed in younger age groups. This study aimed to propose predictive models based on demographic, anthropometric and clinical non-invasive variables to predict MetS in adolescent. Methods: a total of 2,064 adolescents aged 18-19 from São Luís-Maranhão-Brazil were enrolled. Demographic, anthropometric, and clinical variables were considered, and three criteria for diagnosing MetS were employed: Cook et al. (2003), De Ferranti et al. (2004), and the International Diabetes Federation (IDF, 2007). A feed-forward artificial neural network (ANN) was trained to predict MetS. Accurate, sensitivity, and specificity were calculated to assess the ANN performance. The ROC curve was constructed, and the area under the curve was analyzed to assess the discriminatory power of the networks. Results: the prevalence of MetS in adolescents ranged from 5.7% to 12.3%. The ANN that used the Cook et al. criterion performed best in predicting MetS. ANN 5, which included age, sex, waist circumference, weight, and systolic and diastolic blood pressure, showed the best performance and discriminatory power (sensitivity, 89.8%; accuracy, 86.8%). ANN 3 considered the same variables, except for weight, and exhibited good sensitivity (89.0%) and accuracy (87.0%). Conclusions: using non-invasive measures allows for predicting MetS in adolescents, thereby guiding the flow of care in primary healthcare and optimizing the management of public resources.

A doença renal crônica representa um desafio de saúde pública de abrangência global, devido suas elevadas taxas de morbidade e mortalidade com um significativo impacto socioeconômico, apresentando altos custos ao longo do tratamento, além de ser um importante fator de risco para a presença, gravidade e progressão das doenças cardiovasculares. Este estudo objetiva avaliar a associação do índice tornozelo-braquial como preditor de doença cardiovascular em portadores de doença renal crônica não dialítica acompanhados no Hospital Universitário da Universidade Federal do Maranhão. Estudo analítico, longitudinal, do tipo coorte com 128 indivíduos nos estágios 3a, 3b e 4, avaliados em três momentos: t1 (inclusão), t2 (12 meses), t3 (24 meses). A coleta de dados foi obtida por aplicação de um questionário para obter informações referentes aos dados demográficos, socioeconômicos e clínicos. Para avaliar a relação do índice tornozelo-braquial e escore de cálcio foi ajustado o modelo linear de efeitos mistos, considerando o escore de cálcio como variável dependente e tendo como variáveis independentes o índice tornozelo-braquial e algumas características clínicas dos pacientes nos diferentes momentos do estudo. Para realização dos testes estatísticos e ajuste dos modelos foi utilizado o programa R. O nível de significância considerado foi de 5%. Houve predominância de indivíduos no estágio 3b da doença renal crônica, observou-se tendência de diminuição do índice tornozelo-braquial e elevação do escore de cálcio em todos os estágios da doença. O índice tornozelo-braquial nos três momentos não apresentou diferença entre os grupos (p-valor 0,685). Entretanto, houve diferença em relação ao tempo (p-valor 0,045). O escore de cálcio também não apresentou diferença entre os grupos, apenas no tocante ao tempo (p-valor < 0,001). Na relação do índice tornozelo-braquial com o Escore de Cálcio, a glicemia apresentou correlação positiva (r 0,99 e p-valor 0,0004) e o índice tornozelo-braquial apresentou correlação negativa (p-valor 0,0047). Houve uma tendência a redução do índice tornozelo-braquial, que permaneceu nos estágios da doença renal crônica. O escore de cálcio, aumentou, principalmente no estágio 4 da doença renal.

This study aimed to identify the dietary patterns (DPs) of adolescents and assess indicators of subclinical inflammation. It was a cross-sectional study aligned with the RPS cohort with data from São Luís, Maranhão, Brazil. We evaluated 511 adolescents between 18–19 years old. DPs were identified with a factor analysis of the principal components. Nutritional status was assessed with body mass index and body fat percentages. Hierarchical modeling was performed using a linear regression to estimate the beta coefficient (β) of the independent variables with the dependent variables interleukin-6 and high-sensitivity C-reactive protein (hs-CRP). Five DPs were identified: energy-dense, sugar-sweetened beverages and breakfast cereals, prudent, traditional Brazilian and alcoholic and energy beverages. Greater adherence to the prudent DP was associated with a lower concentration of interleukin-6 (β = −0.11; p value = 0.040). Greater adherence to the DP “traditional Brazilian” and “alcoholic and energy beverages” were associated with increased IL-6, mediated by the nutritional status. A higher BMI (β = 0.36; p value = p value = 0.014) were associated with higher hs-CRP concentrations. The nutritional status and “prudent” pattern were associated with inflammatory biomarkers. These findings show that a higher consumption of fresh and minimally processed foods and the adequacy of the nutritional status are protective factors for the inflammatory process.

Background: Traditional methods for assessing individual energy consumption often involve lengthy and intricate procedures. This study aims to introduce an Energy Consumption Estimation Scale, utilizing Item Response Theory (IRT) for adolescents aged 18–19 years. Methods: This psychometric investigation applies IRT to 93 items extracted from a validated food frequency questionnaire. The study encompasses a representative sample of 2515 adolescents from the São Luís birth cohort in Brazil. The latent trait, energy intake, is derived using IRT and subsequently validated through hierarchical multiple linear regression modeling. Significance was established at p < 0.05. Results: A Samejima’s model was successfully fitted (CFI and TLI > 0.9 and RMSEA < 0.08), effectively capturing variations across all energy consumption levels. Factors associated with the latent trait demonstrate consistent behavioral patterns. Adolescents with higher energy intake exhibited increased consumption of dairy products, artificially sweetened beverages, and seasonal fruits and vegetables. Conclusions: The proposed Energy Consumption Estimation Scale demonstrates a reliable measurement of energy intake and serves as a practical and concise alternative for assessing energy consumption among adolescents. These findings suggest the potential for adapting similar models for different age groups and incorporating diverse food items based on the obtained results.