OBJECTIVE -We measured plasma markers of endothelial dysfunction, vascular inflammation, and pro-coagulation in obese Hispanic/Latino children and adolescents with normal glucose tolerance and determined their relationship to body composition and indexes of glucose and lipid metabolism. RESEARCH DESIGN AND METHODS-A total of 38 lean or obese Hispanic children and adolescents (10 -18 years of age) were selected. The overweight group (n ϭ 21) had a BMI Ͼ85th percentile for their age and sex, and the lean group (n ϭ 17) had a BMI between the 25th and 50th percentiles. Studies included an oral glucose tolerance test, measurements of plasma glucose and lipids, several markers of endothelial function and inflammation, and determination of body composition by dual X-ray absorptiometry.RESULTS -The obese group had higher systolic blood pressure and plasma triglycerides and was more insulin resistant than the lean group. The obese group also had higher plasma soluble intercellular adhesion molecule (259.5 Ϯ 60.0 vs. 223.2 Ϯ 47.5 ng/ml, P ϭ 0.047), tumor necrosis factor-␣ (2.57 Ϯ 1.1 vs. 1.74 Ϯ 0.6 pg/ml, P ϭ 0.008), high-sensitivity C-reactive protein (2.0 vs. 0.13 mg/l, P Ͻ 0.0001), plasminogen-activated inhibitor-1 (47.0 Ϯ 35.7 vs. 12.0 Ϯ 5.2 ng/ml, P Ͻ 0.0001), tissue plasminogen activator (6.1 Ϯ 1.9 vs. 4.1 Ϯ 0.8 ng/ml, P ϭ 0.001), and white blood cell count (6.9 vs. 5.3 ϫ 10 3 , P ϭ 0.031) and lower levels of adiponectin (8.7 Ϯ 3.3 vs. 12.6 Ϯ 5.2 g/ml, P ϭ 0.022). No significant differences were observed for soluble vascular cell adhesion molecule or interleukin-6. CONCLUSIONS -Overweight Hispanic children and adolescents with normal glucose tolerance exhibit increased plasma markers of endothelial dysfunction and subclinical inflammation in association with obesity and insulin resistance. These abnormalities may predispose them to the development of type 2 diabetes and cardiovascular disease.

Resumo A desnutrição é um fator relevante na evolução dos pacientes com doença renal crônica (DRC) em hemodiálise (HD), estando associada a maior frequência e duração de internações hospitalares. Objetivou-se avaliar o estado nutricional de pacientes com DRC em HD em unidades públicas ou privadas vinculadas ao SUS no Distrito Federal. Dados sociodemográficos, bioquímicos e antropométricos foram obtidos de 96 participantes, sendo 35,5% provenientes de hospitais públicos. Os critérios utilizados para avaliação de desnutrição na DRC foram Índice de Massa Corpórea (IMC) < 23 kg/m2, circunferência muscular do braço (CMB) reduzida e albumina sérica < 3,8 g/dl. Do total de avaliados, 14,6% apresentou desnutrição (60 ± 12 anos; 57% masculino; 69% clínicas privadas); 33,3% apresentou estado nutricional adequado (55 ± 14 anos; 53% masculino; 57% clínicas privadas); 52,1% tinha ao menos uma variável relacionada à desnutrição, onde o IMC abaixo do recomendado foi o mais prevalente (42,7%), seguido da CMB reduzida (41,7%) e da albumina sérica (33,3%). Com base nos resultados conclui-se que ao menos uma variável relacionada ao estado nutricional esteve alterada em metade da amostra estudada, o que reforça a importância da avaliação nutricional no contexto do tratamento da DRC.

We evaluated vascular reactivity after a maximal exercise test in order to determine whether the effect of exercise on the circulation persists even after interruption of the exercise. Eleven healthy sedentary volunteers (six women, age 28 ± 5 years) were evaluated before and after (10, 60, and 120 min) a maximal exercise test on a treadmill. Forearm blood flow (FBF) was measured by venous occlusion plethysmography before and during reactive hyperemia (RH). Baseline FBF, analyzed by the area under the curve, increased only at 10 min after exercise (P = 0.01). FBF in response to RH increased both at 10 and 60 min vs baseline (P = 0.004). Total excess flow for RH above baseline showed that vascular reactivity was increased up to 60 min after exercise (mean ± SEM, before: 526.4 ± 48.8; 10 min: 1053.0 ± 168.2; 60 min: 659.4 ± 44.1 ml 100 ml -1 min -1 . s; P = 0.01 and 0.02, respectively, vs before exercise). The changes in FBF were due to increased vascular conductance since mean arterial blood pressure did not change. In a time control group (N = 5, 34 ± 3 years, three women) that did not exercise, FBF and RH did not change significantly (P = 0.07 and 0.7, respectively). These results suggest that the increased vascular reactivity caused by chronic exercise may result, at least in part, from a summation of the subacute effects of successive exercise bouts.