Programação fetal e alterações metabólicas em escolares: metodologia de um estudo caso‑controle
Programação fetal e alterações metabólicas em escolares: metodologia de um estudo caso‑controle
Data
2016
Autores
Lobato, Jackeline Christiane Pinto
Costa, Antonio José Leal
Kale, Pauline Lorena
Cavalcanti, Maria de Lourdes Tavares
Kuschnir, Maria Cristina Caetano
Velarde, Luis Guillermo Coca
Nóbrega, Antonio Cláudio Lucas da
Olej, Beni
Duarte, Luciana de Barros
Szklo, Moyses
Journal Title
Journal ISSN
Volume Title
Publisher
Revista Brasileira de Epidemiologia
Resumo
Objetivo: Descrever a metodologia de um estudo sobre associações entre crescimento intrauterino restrito (CIUR) e prevalência de sobrepeso, obesidade e hipertensão arterial em escolares. Métodos: O estudo, conduzido em dois estágios, foi desenvolvido em 2 escolas municipais de Niterói (RJ) de junho a dezembro de 2010, sendo elegíveis todos os escolares de 6 a 14 anos. O primeiro estágio consistiu em um inquérito nutricional e de potenciais fatores de risco. Foram aplicados questionários aos responsáveis e adolescentes. Concomitantemente, foram selecionados os participantes de um estudo caso‑controle, com casos prevalentes definidos como todos os escolares que apresentaram excesso de peso (Z-score de índice de massa corporal — IMC/idade/sexo > +1,00). O grupo controle consistiu em uma amostra aleatória da população de estudo do inquérito, o que permitiu o cálculo de razões de prevalências. Foram realizados bioimpedância elétrica, exames de sangue, ultrassonografia da carótida e entrevistas. As variáveis proxy de CIUR foram definidas a partir de informações sobre peso ao nascer (PN) e idade gestacional (IG). Adicionalmente, foram coletadas informações sobre os dois primeiros anos de vida dos escolares a partir de seus prontuários médicos. Resultados: Entre os 1.040 escolares elegíveis, participaram do estudo 795 escolares (76,4%). A taxa de retorno do questionário enviado para os responsáveis foi de 85,1%. Para o estudo caso‑controle, 62,5% (n = 363) dos selecionados participaram, resultando em uma razão caso:controle de 1:1,8. Foram localizados 55,8% (n = 444) dos prontuários, dos quais em 65,7% (n = 292) foram coletadas informações dos primeiros anos de vida. Conclusão: O presente estudo permitirá a análise de múltiplos desfechos e exposições relacionados ao CIUR e alterações metabólicas.
Objective: To describe the methodological features of a study on the association between restricted intrauterine growth and prevalence of overweight, obesity and hypertension in school aged children. Methods: The study was conducted in two stages in two public schools in Niterói (RJ), from June through December 2010. All students aged 6 to 14 years were eligible to participate. The first stage consisted of an interview to collect information on demographic variables, diet and other variables. A sample was selected for the second stage, in order to conduct an equivalent of a case‐cohort study. There was an interval of about 15 days between the two stages. Cases were overweight students, defined as a Z‐score for BMI/age/sex > +1.00 in the first stage. Controls were selected by using a random schedule in which the sample frame was the whole cohort. Bioelectrical impedance analysis, carotid ultrasound to measure intimal‐medial thickness, blood measurements and interviews were obtained. Gestational age and weight at birth were used to define proxy variables of restricted intrauterine growth. Early health information was obtained from medical registers. Results: The study participation was 76.4% (n = 795) out of 1,040 eligible to participate). 85.1% of parent’s questionnaires were returned. 62.5% of the eligible children participated in the case‐control study (case: control ratio = 1:1.8). Early life health information was obtained from 292 children. Conclusion: The present study has the potential to provide important information about multiple outcomes and exposures related to restricted intrauterine growth and metabolic abnormalities.
Objective: To describe the methodological features of a study on the association between restricted intrauterine growth and prevalence of overweight, obesity and hypertension in school aged children. Methods: The study was conducted in two stages in two public schools in Niterói (RJ), from June through December 2010. All students aged 6 to 14 years were eligible to participate. The first stage consisted of an interview to collect information on demographic variables, diet and other variables. A sample was selected for the second stage, in order to conduct an equivalent of a case‐cohort study. There was an interval of about 15 days between the two stages. Cases were overweight students, defined as a Z‐score for BMI/age/sex > +1.00 in the first stage. Controls were selected by using a random schedule in which the sample frame was the whole cohort. Bioelectrical impedance analysis, carotid ultrasound to measure intimal‐medial thickness, blood measurements and interviews were obtained. Gestational age and weight at birth were used to define proxy variables of restricted intrauterine growth. Early health information was obtained from medical registers. Results: The study participation was 76.4% (n = 795) out of 1,040 eligible to participate). 85.1% of parent’s questionnaires were returned. 62.5% of the eligible children participated in the case‐control study (case: control ratio = 1:1.8). Early life health information was obtained from 292 children. Conclusion: The present study has the potential to provide important information about multiple outcomes and exposures related to restricted intrauterine growth and metabolic abnormalities.
Description
Palavras-chave
Obesidade, Retardo do crescimento fetal, Doenças metabólicas, Criança, Adolescente, Peso ao nascer, Obesity, Fetal growth retardation, Metabolic diseases, Child, Adolescent, Birth weight.
Citação
Lobato JC, Costa AJ, Kale PL, Cavalcanti Mde L, Kuschnir MC, Velarde LG, Nóbrega AC, Olej B, Duarte Lde B, Szklo M. Fetal programming and metabolic abnormalities: design of a case-control study. Rev Bras Epidemiol. 2016 Mar;19(1):52-62. English, Portuguese. doi: 10.1590/1980-5497201600010005.