Obesity Archives - Revista Brasileira de Ginecologia e Obstetrícia

  • Original Article

    Skeletal muscle mass obtained by anthropometric equation and presence of sarcopenia in postmenopausal women

    Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo9

    Summary

    Original Article

    Skeletal muscle mass obtained by anthropometric equation and presence of sarcopenia in postmenopausal women

    Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo9

    DOI 10.61622/rbgo/2024AO09

    Views204

    Abstract

    Objective:

    To analyze the amount of muscle and the presence of sarcopenia in postmenopausal women using different methods, verifying the agreement between them as to skeletal muscle mass (SMM).

    Methods:

    This cross-sectional observational study was conducted with postmenopausal women aged ≥ 50 years. SMM was obtained from a predictive equation, Bioelectrical Impedance (BIA), and Dual Energy X-Ray Absorptiometry (DXA). The skeletal muscle mass index (SMI) and the appendicular skeletal muscle mass index (ASMI) were calculated. The cut-off point of SMI was determined for the population itself. The agreement between the SMI obtained using the different methods was verified. Sarcopenia was diagnosed according to the criteria proposed by the European Working Group on Sarcopenia in Older People 2 (EWGSOP2). The significance level adopted for all tests was 5.0%.

    Results:

    A total of 112 women were evaluated, with an average age of 66.1 ± 5.65 years. Among them, 51.8% were sufficiently active and 43.8% were overweight and obese. The SMI cut-offs were 6.46 kg/m2 for the predictive equation and 7.66 kg/m2 for BIA, with high sensitivity and specificity. There was an excellent agreement in the identification of SMM by the predictive equation (0.89 [0.824-0.917], p < 0.001) and BIA (0.92 [0.883-0.945], p < 0.001), in reference to DXA. The prevalence of sarcopenia was 0.9%, 1.8%, and 2.7% according to BIA, DXA, and the predictive equation, respectively.

    Conclusion:

    The predictive equation showed the expected agreement in estimating skeletal muscle mass in postmenopausal women, offering a viable and accurate alternative.

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    Skeletal muscle mass obtained by anthropometric equation and presence of sarcopenia in postmenopausal women
  • Original Article

    Sociodemographic and reproductive risk factors associated with metabolic syndrome in a population of Brazilian women from the city of Ribeirão Preto: a cross-sectional study

    Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo8

    Summary

    Original Article

    Sociodemographic and reproductive risk factors associated with metabolic syndrome in a population of Brazilian women from the city of Ribeirão Preto: a cross-sectional study

    Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo8

    DOI 10.61622/rbgo/2024AO08

    Views173

    Abstract

    Objective:

    To identify sociodemographic and reproductive risk factors associated with MetS in women in their fourth decade of life.

    Methods:

    Cohort study conducted on women born from June 1978 to May 1979 in Ribeirão Preto, Brazil. Sociodemographic, clinical, and obstetric data were collected by interview and clinical evaluation. Univariable and multivariable binomial logistic regression models were constructed to identify the risk factors of metabolic syndrome and the adjusted relative risk (RR) was calculated.

    Results:

    The cohort included 916 women, and 286 (31.2%) of them have metabolic syndrome. MetS was associated with lack of paid work (RR 1.49; 95% CI 1.14-1.95), marital status of without a partner (RR 1.33; 95% CI 1.03-1.72), low educational level (less than 8 years of schooling [RR 1.72; 95% CI 1.23-2.41], 8 to 12 years of schooling [RR 1.37; 95% CI 1.06-1.76], when compared with more than 12 years of schooling), and teenage pregnancy (RR 2.00; 95% CI 1.45-2.77). There was no association between MetS, and the other covariates studied.

    Conclusion:

    Metabolic syndrome in a population of women in the fourth decade of life was associated with lack of employment, lack of a partner, low educational level, and teenage pregnancy.

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  • Original Article

    Immobilization, Lymphedema, and Obesity are Predictive Factors in the Development of Adhesive Capsulitis in Breast Cancer Patients

    Revista Brasileira de Ginecologia e Obstetrícia. 2023;45(10):594-602

    Summary

    Original Article

    Immobilization, Lymphedema, and Obesity are Predictive Factors in the Development of Adhesive Capsulitis in Breast Cancer Patients

    Revista Brasileira de Ginecologia e Obstetrícia. 2023;45(10):594-602

    DOI 10.1055/s-0043-1772479

    Views12

    Abstract

    Objective

    Adhesive capsulitis is a condition characterized by shoulder pain and stiffness. Breast cancer treatment has been linked to the development of this condition, but its mechanisms are still little known. This study's objective was to identify predictors factors associated with the development of adhesive capsulitis in breast cancer patients.

    Methods

    A case control study was performed with women undergoing treatment for breast cancer in a single center. The sampling was nonprobabilistic and consecutive. Adhesive capsulitis was defined as constant pain associated with decreased active and passive shoulder movement in anterior elevation, external rotation at 0°/90° abduction, and internal rotation at 90° abduction. The study group consisted of patients with shoulder pain and range of motion limitations, while the control group consisted of women without any shoulder abnormalities. Sociodemographic and clinical variables were collected. A univariate logistic regression was used to assess the influence of variables on the studied outcome. For p< 0.20, a multivariate logistic regression was used. The probability of null hypothesis rejection was 5%.

    Results

    A total of 145 women were assessed, with 39 (26.9%) on the study group and 106 (73.1%) on the control group. The majority was under 60 years old. In the multivariate analysis, variables correlated to the outcome under study were shoulder immobilization (OR = 3.09; 95% CI: 1.33–7.18; p = 0.009), lymphedema (OR = 5.09; 95% CI: 1.81–14.35; p = 0.002), and obesity (OR = 3.91; 95% CI: 1.27–12.01; p = 0.017).

    Conclusion

    Lymphedema, postsurgery immobilization, and obesity are predictive factors for the development of adhesive capsulitis in breast cancer patients.

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  • Original Article

    The Relationship between Bone Mineral Densitometry and Visceral Adiposity Index in Postmenopausal Women

    Revista Brasileira de Ginecologia e Obstetrícia. 2023;45(2):082-088

    Summary

    Original Article

    The Relationship between Bone Mineral Densitometry and Visceral Adiposity Index in Postmenopausal Women

    Revista Brasileira de Ginecologia e Obstetrícia. 2023;45(2):082-088

    DOI 10.1055/s-0043-1764497

    Views18

    Abstract

    Objective

    It was aimed to compare visceral adiposity index (VAI) levels in patients with normal bone mineral density (BMD), osteopenia, and osteoporosis.

    Methods

    One hundred twenty postmenopausal women (40 with normal BMD, 40 with osteopenia, and 40 with osteoporosis) between the ages of 50 to 70 years were included in the study. For females, the VAI was calculated using the formula (waist circumference [WC]/[36.58 + (1.89 x body mass index (BMI))]) x (1.52/High-density lipoprotein [HDL]-cholesterol [mmol/L]) x (triglyceride [TG]/0.81 [mmol/L]).

    Results

    The time of menopause from the beginning was similar in all groups. Waist circumference was found to be higher in those with normal BMD than in the osteopenic and osteoporotic groups (p = 0.018 and p < 0.001, respectively), and it was also higher in the osteopenic group than in the osteoporotic group (p = 0.003). Height and body weight, BMI, blood pressure, insulin, glucose, HDL-cholesterol, and homeostasis model assessment-insulin resistance (HOMA-IR) levels were similar in all groups. Triglyceride levels were found to be higher in the normal BMD group, compared with the osteoporotic group (p = 0.005). The level of VAI was detected as higher in those with normal BMD, compared with the women with osteoporosis (p = 0.002). Additionally, the correlation analysis showed a positive correlation between dual-energy X-ray absorptiometry (DXA) spine T-scores, WC, VAI, and a negative correlation between DXA spine T-scores and age.

    Conclusion

    In our study, we found higher VAI levels in those with normal BMD, compared with women with osteoporosis. We consider that further studies with a larger sample size will be beneficial in elucidating the entity.

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    The Relationship between Bone Mineral Densitometry and Visceral Adiposity Index in Postmenopausal Women
  • Original Article

    Association of Obesity and Surgery Outcomes in Patients with Endometrial Cancer: A Single-Center Analysis

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(12):1117-1121

    Summary

    Original Article

    Association of Obesity and Surgery Outcomes in Patients with Endometrial Cancer: A Single-Center Analysis

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(12):1117-1121

    DOI 10.1055/s-0042-1759632

    Views5

    Abstract

    Objective

    Although obesity can result in high morbidity and mortality in surgical outcomes because of multiple comorbidities, determinants of outcome in obese patients who underwent endometrial cancer surgery remain unclear. The aim of this study is to assess the relationship between body mass index (BMI) and surgical outcomes in obese patients with endometrial cancer.

    Methods

    An institutional retrospective review of the demographic details, clinical characteristics, and follow-up data of 142 patients with endometrial cancer who underwent surgery during a 72-month period was performed. The patients were divided into three groups based on their BMI; patients with BMI < 25 were identified as normal weight, patients with BMI between 25 and 30 were accepted as overweight, and those with BMI ≥ 30 kg/m2 were identified as obese. The groups' demographic and clinical variables were compared.

    Results

    Of the 142 patients, 42 were in the normal weight group, 55 in the overweight group, and 45 in the obese group. Age, surgical procedures, blood loss, preoperative health status, and metastatic lymph nodes did not show a significant difference between groups. However, surgery time and total lymph nodes were higher in the obese group. (p = 0.02, p = 0.00, and p = 0.00, respectively). Common complications were anemia, fever, intestinal injury, deep vein thrombosis, fascial dehiscence and urinary infection. There was no significant difference according to the complications.

    Conclusion

    Our results indicated that higher BMI was significantly associated with a longer duration of endometrial cancer surgery. Minimally invasive surgeries and conventional laparotomy could be performed safely in obese patients.

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  • Original Article

    Does Obesity Aggravate Climacteric Symptoms in Postmenopausal Women?

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(6):586-592

    Summary

    Original Article

    Does Obesity Aggravate Climacteric Symptoms in Postmenopausal Women?

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(6):586-592

    DOI 10.1055/s-0042-1745789

    Views35

    Abstract

    Objective

    To determine if there is a correlation between body mass index (BMI) and climacteric symptoms in postmenopausal women.

    Methods

    The study sample was composed of 109 postmenopausal women with a mean age of 57 ± 8 years, mean body mass index (BMI) of 30 ± 6 kg/m2, and 8 ± 8 years after menopause. For the assessment of the climacteric symptoms, the Blatt-Kupperman Index (BKI), the Menopause Rating Scale (MRS), and the Cervantes Scale (CS) were used. Data analysis was performed through the Chi-squared test, analysis of variance (ANOVA) with the Bonferroni post hoc test, and multiple linear regression. The level of significance adopted was of p < 0.05. The statistical analyses were performed using the Statistical Package for the Social Sciences (IBM SPSS Statistics for Windows, IBM Corp., Armonk, NY, United States) software, version 26.0.

    Results

    The multiple linear regression showed a positive association (p<0.01) between BMI values and menopause symptoms when adjusted for age and time after menopause in the 3 questionnaires used (BKI: B = 0.432; CS: B = 304; and MRS: B = 302). Regarding symptom scores, the obese women had higher mean scores (p<0.05) when compared to eutrophic women (BKI = 28 ± 10 and 20 ± 10; and MRS = 20 ± 10 and 13±7, respectively). In the Chi-squared analysis, 28% of obese women had severe symptoms and 46% had moderate symptoms, while only 1% and 46% of eutrophic women had these same symptoms.

    Conclusion

    There is an association between BMI and climacteric symptoms, and overweight or obese women have more intense and moderate symptoms than eutrophic women.

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  • Original Article

    Polycystic Ovary Syndrome and Metabolic Syndrome: Clinical and Laboratory Findings and Non-Alcoholic Fatty Liver Disease Assessed by Elastography

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(3):287-294

    Summary

    Original Article

    Polycystic Ovary Syndrome and Metabolic Syndrome: Clinical and Laboratory Findings and Non-Alcoholic Fatty Liver Disease Assessed by Elastography

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(3):287-294

    DOI 10.1055/s-0041-1741032

    Views19

    Abstract

    Objective

    To evaluate the association between polycystic ovary syndrome (PCOS) and metabolic syndrome (MetS), adding liver assessment through elastography and ultrasound, for correlation with non-alcoholic fatty liver disease (NAFLD). Metabolic syndrome occurs in~43% of women with PCOS, and NAFLD is the hepatic expression of MetS.

    Methods

    One hundred women, 50 with PCOS and 50 controls, matched by age (18- 35 years) and body mass index (BMI) were included, restricted to patients with overweight and obesity grade 1, at the Assis Chateaubrian Maternity School, Universidade Federal do Ceará, Brazil. For the diagnosis of PCOS, we adopted the Rotterdam criteria, and for the diagnosis of MetS, the criteria of the National Cholesterol Education Program (NCEP/ATP III). Hepatic elastography and ultrasound were performed to assess liver stiffness and echotexture, respectively.

    Results

    The average ages were 29.1 (±5.3) and 30.54 (±4.39) years, for the PCOS and the control group, respectively. Patients with PCOS had a risk 4 times higher of having MetS, odds ratio (95% confidence interval)=4.14, than those in the control group. Women with PCOS had higher average of abdominal circumference (100.9±9.08 cm vs 94.96±6.99 cm) and triglycerides (162±54.63 mg/dL vs 137.54±36.91mg/dL) and lower average of HDL cholesterol (45.66±6.88 mg/dL vs 49.78±7.05 mg/dL), with statistically significant difference. Hepatic steatosis was observed on ultrasound in women with PCOS; however, with no statistically significant difference. There was no change to NAFLD at elastography in any group.

    Conclusion

    Women with PCOS had 4-fold higher frequency of MetS andmore hepatic steatosis, with no statistically significant difference. There was no change in liver stiffness between the groups at elastography. The results can be extended only to populations of overweight and obesity grade 1, with PCOS or not. They cannot be generalized to other untested groups.

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  • Original Article

    Adrenal Androgen Predictive Effects on Clinical andMetabolic Abnormalities of Polycystic Ovary Syndrome

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(2):142-153

    Summary

    Original Article

    Adrenal Androgen Predictive Effects on Clinical andMetabolic Abnormalities of Polycystic Ovary Syndrome

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(2):142-153

    DOI 10.1055/s-0041-1741030

    Views13

    Abstract

    Objective

    To examine the possible effects of adrenal prohormones in the prediction of clinical and metabolic abnormalities in women with polycystic ovary syndrome (PCOS).

    Methods

    The present study enrolled 299 normal cycling non-PCOS, 156 normoandrogenemic, and 474 hyperandrogenemic women with PCOS. Baseline characteristics were compared using a chi-squared test or analysis of variance (ANOVA) as appropriate. The roles of adrenal prohormones and their ratios with total testosterone in predicting co-occurring morbidities in women PCOS were evaluated using univariate and multivariate logistic regression analyses.

    Results

    Adrenal hyperandrogenism per dehydroepiandrosterone sulfate (DHEAS) levels were found in 32% of women with PCOS. In non-PCOS women, dehydroepiandrosterone (DHEA) and its sulfate had no predictive role concerning clinical, anthropometric, and metabolic parameters. In PCOS women, mainly in the hyperandrogenemic group, DHEA showed to be a significant predictor against most anthropometric-metabolic index abnormalities (odds ratio [OR]=0.36-0.97; p<0.05), and an increase in triglycerides (TG) levels (OR=0.76; p=0.006). Dehydroepiandrosterone sulfate presented a few predictive effects regarding PCOS-associated disorders. In controls, DHEAS predicted against the increase in estimated average glucose (OR= 0.38; p=0.036). In the normoandrogenic group, it predicted against elevation in the waist/hip ratio (WHR) (OR= 0.59; p=0.042), and in hyperandrogenemic PCOS women, it predicted against abnormality in the conicity index (CI) (OR=0.31; p=0.028).

    Conclusion

    Dehydroepiandrosterone was shown to be a better predictor of abnormal anthropometric and biochemical parameters in women with PCOS than DHEAS. Thus, regarding adrenal prohormones, DHEA measurement, instead of DHEAS, should be preferred in PCOS management. The effects of androgen prohormones on the prediction of PCOS abnormalities are weak.

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