The burden of physical activity on type 2 diabetes public healthcare expenditures among adults: a retrospective study

<p>Abstract</p> <p>Background</p> <p>Determinants of public healthcare expenditures in type 2 diabetics are not well investigated in developing nations and, therefore, it is not clear if higher physical activity decreases healthcare costs. The purpose of this study was to analyze the relationship between physical activity and the expenditures in public healthcare on type 2 diabetes mellitus treatment.</p> <p>Methods</p> <p>Cross-sectional study carried out in Brazil. A total of 121 type 2 diabetics attended to in two Basic Healthcare Units were evaluated. Public healthcare expenditures in the last year were estimated using a specific standard table. Also evaluated were: socio-demographic variables; chronological age; exogenous insulin use; smoking habits; fasting glucose test; diabetic neuropathy and anthropometric measures. Habitual physical activity was assessed by questionnaire.</p> <p>Results</p> <p>Age (r = 0.20; p = 0.023), body mass index (r = 0.33; p = 0.001) and waist-to-hip ratio (r = 0.20; p = 0.025) were positively related to expenditures on medication for the treatment of diseases other than diabetes. Insulin use was associated with increased expenditures. Higher physical activity was associated with lower expenditure, provided medication for treatment of diseases other than diabetes (OR = 0.19; p = 0.007) and medical consultations (OR = 0.26; p = 0.029).</p> <p>Conclusions</p> <p>Type 2 diabetics with higher enrollment in physical activity presented consistently lower healthcare expenditures for the public healthcare system.</p

Resting heart rate as a predictor of metabolic dysfunctions in obese children and adolescents

<p>Abstract</p> <p>Background</p> <p>Recent studies have identified that a higher resting heart rate (RHR) is associated with elevated blood pressure, independent of body fatness, age and ethnicity. However, it is still unclear whether RHR can also be applied as a screening for other risk factors, such as hyperglycemia and dyslipidemia. Thus, the purpose of the presented study was to analyze the association between RHR, lipid profile and fasting glucose in obese children and adolescents.</p> <p>Methods</p> <p>The sample was composed of 180 obese children and adolescents, aged between 7-16 years. Whole-body and segmental body composition were estimated by Dual-energy X-ray absorptiometry. Resting heart rate (RHR) was measured by heart rate monitors. The fasting blood samples were analyzed for serum triglycerides, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and glucose, using the colorimetric method.</p> <p>Results</p> <p>Fasting glucose, TC, triglycerides, HDL-C, LDL-C and RHR were similar in both genders. The group of obese subjects with a higher RHR presented, at a lower age, higher triglycerides and TC. There was a significant relationship between RHR, triglycerides and TC. In the multivariate model, triglycerides and TC maintained a significant relationship with RHR independent of age, gender, general and trunk adiposity. The ROC curve indicated that RHR has a high potential for screening elevated total cholesterol and triglycerides as well as dyslipidemia.</p> <p>Conclusion</p> <p>Elevated RHR has the potential to identify subjects at an increased risk of atherosclerosis development.</p

Agregação de fatores de risco cardiovascular e ocorrência de hipertensão arterial em adultos sedentários

OBJETIVO: Analisar em uma grande amostra de adultos sedentários a possível associação entre hipertensão arterial e baixa aptidão cardiorrespiratória, obesidade geral e central. MÉTODOS: A amostra foi composta por 1.092 adultos sedentários brasileiros (429 homens e 633 mulheres). Pressão arterial foi acessada e hipertensão arterial diagnosticada. Três fatores de risco cardiovascular foram considerados: obesidade geral (índice de massa corporal), obesidade abdominal (circunferência de cintura) e baixa aptidão cardiorrespiratória (teste submáximo em cicloergômetro). RESULTADOS: A taxa de hipertensão arterial foi de 9,3% (IC95% = 7,6 - 11,2). Houve associação entre mais alta prevalência de hipertensão arterial e diagnóstico de obesidade (p = 0,001), valores elevados de circunferência de cintura (p = 0,001) e baixo VO2máx (p = 0,013). Independentemente de idade e sexo, indivíduos sedentários com simultaneamente baixo consumo máximo de oxigênio e obesidade geral (RP = 5,21 [IC95% = 8,94 - 3,03]; p = 0,001) ou abdominal (RP = 4,05 [IC95% = 2,22 - 7,40]; p = 0,001) apresentaram maior probabilidade de ser hipertenso que os sedentários com nenhum fator de risco. CONCLUSÃO: Adultos sedentários, independentemente de sexo e idade, a presença de baixa aptidão cardiorrespiratória está associada à hipertensão arterial apenas quando também há obesidade geral ou abdominal, indicando que a interação destas variáveis tem relevante peso na gênese da doença.OBJETIVO: Analizar, en una muestra grande de adultos sedentarios, la posible vinculación entre hipertensión arterial y reducción de aptitud cardiorrespiratoria, con más obesidad general y central. MÉTODOS: La muestra se compuso de 1.092 adultos sedentarios brasileños (429 hombres y 663 mujeres). La presión arterial fue evaluada y la hipertensión arterial fue diagnosticada. Tres factores de riesgo cardiovascular fueron considerados: obesidad general (índice de masa corporal), obesidad central (circunferencia de la cintura) y baja aptitud cardiorrespiratoria (prueba submáxima de ergometría en bicicleta). RESULTADOS: La tasa de hipertensión arterial fue 9,3% (IC95% = 7,6 - 11,2). Hubo asociación entre la prevalencia más alta de hipertensión arterial y el diagnóstico de obesidad (p = 0,001), valores altos de circunferencia de cintura (p = 0,001) y bajo VO2max (p = 0,013). Independientemente de edad y sexo, los individuos sedentarios con, simultáneamente, baja aptitud cardiorrespiratoria, y obesidad general (RP = 5,21 [IC95% = 8,94 - 3,03]; p = 0,001) y central (RP = 4,05 [IC95% = 2,22 - 7,40]; p = 0,001) presentaron más probabilidades de ser hipertensos que los sedentarios con ningún factor de riesgo cardiovascular. CONCLUSIÓN: En adultos sedentarios, sin considerar sexo ni edad, la presencia de baja aptitud cardiorrespiratoria está vinculada a la hipertensión arterial solamente cuando hay adiposidad general o central, indicando que la interacción de estas variables tiene peso relevante en la génesis de la enfermedad.OBJECTIVE: To analyze in a large sample of sedentary adults the possible association between arterial hypertension and decreased physical fitness, and increased general and central obesity. METHODS: The sample was composed by 1,092 (429 male and 663 female) Brazilian sedentary adults. Blood pressure was assessed and arterial hypertension was diagnosed. Three cardiovascular risk factors were considered: general obesity (body mass index), central obesity (waist circumference) and decreased physical fitness (submaximal bicycle ergometer test). RESULTS: Arterial hypertension rate was 9.3% (95% CI = 7.6 - 11.2). There was association between higher occurrence of arterial hypertension and the diagnosis of obesity (p=0.001), elevated values of WC (p = 0.001) and reduced values of VO2max (p = 0.013). Independently of gender and age, sedentary individuals with simultaneous decreased physical fitness plus general (PR=5.21 [95% CI = 8.94-3.03]; p=0.001) and central (PR = 4.05 [95% CI = 2.22-7.40]; p = 0.001) obesity presented higher likelihood to have arterial hypertension than sedentary individuals with none cardiovascular risk factor. CONCLUSION: Sedentary adults, independently of both gender and age, the presence of low cardiorespiratory fitness is associated with increased occurrence of arterial hypertension only when there is either increased central or general adiposity indicating that the interaction of these variables have relevant burden in the genesis of the disease.Universidade Católica de Brasília Programa de Pós-Graduação em Educação FísicaUniversidade Federal do Vale do São FranciscoUniversidade Estadual Paulista Departamento de Educação FísicaUNIVASFUEL Departamento de Educação FísicaUniversidade Católica de BrasíliaUniversidade Estadual Paulista Departamento de Educação Físic