BEATRIZ HELENA CARVALHO TESS
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Medicina Preventiva, Faculdade de Medicina - Docente
LIM/39 - Laboratório de Processamento de Dados Biomédicos, Hospital das Clínicas, Faculdade de Medicina
LIM/39 - Laboratório de Processamento de Dados Biomédicos, Hospital das Clínicas, Faculdade de Medicina
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- Metabolic status is not associated with job stress in individuals with obesity: the ELSA-Brasil baseline(2021) IMBIRIBA, Lia; TESS, Beatriz H.; GRIEP, Rosane H.; FONSECA, Maria J. M.; PEREIRA, Alexandre C.; DINIZ, Maria F. S.; LOTUFO, Paulo A.; BENSENOR, Isabela M.; SANTOS, Itamar S.Purpose Job stress has proven to be a relevant cause of stress for adults, but its effect on the development of metabolic alterations in individuals with obesity is still poorly explored. We aimed to investigate the association between job stress and metabolically unhealthy obesity (MUO) phenotype in participants with obesity at the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) baseline assessment. Methods This study analyzed data collected at the baseline examination between 2008 and 2010. A total of 2371 individuals with obesity were included. Two metabolic phenotypes were characterized based on the US National Health and Nutrition Examination Survey criteria. The job stress scale was based on the Brazilian version of the Swedish Demand-Control-Support Questionnaire. The association between job stress domains and MUO phenotype was assessed by binary logistic models. Results In our sample, 1297 (54.7%) participants were women, mean age was 49.6 +/- 7.1 years and 1696 (71.5%) had MUO. Low skill discretion was associated with MUO after adjustment for age, sex and race. However, in fully-adjusted models, the MUO phenotype was not associated with high job demand (odds ratio [OR] = 1.05; 95% confidence interval [95%CI] 0.82-1.35), low skill discretion (OR = 1.26; 95%CI 0.95-1.68), low decision authority (OR = 0.94; 95%CI 0.70-1.25) nor low social support (OR = 0.93; 95%CI 0.71-1.20). Conclusion We found a significant association between low skill discretion and an adverse metabolic profile in models adjusted for age, sex and race. No associations were significant between job stress domains and the metabolic profile of individuals with obesity in full models.
- The prevalence of metabolically healthy obesity: a systematic review and critical evaluation of the definitions used(2014) REY-LOPEZ, J. P.; REZENDE, L. F. de; PASTOR-VALERO, M.; TESS, B. H.We performed a systematic review of the prevalence of metabolically healthy obesity (MHO). Medline, Web of Science and EMBASE were searched for original articles from inception to November 2013. Only prospective and cross-sectional studies were included. After screening 478 titles, we selected 55 publications, of which 27 were population-based studies and were used in the narrative synthesis. From the 27 studies, we identified 30 definitions of metabolic health, mainly based on four criteria: blood pressure, high-density lipoprotein cholesterol, triglycerides and plasma glucose. Body mass index 30kgm(-2) was the main indicator used to define obesity (74% of the studies). Overall, MHO prevalence ranged between 6% and 75%. In the studies that stratified the analysis by sex, prevalence was higher in women (seven out of nine studies) and in younger ages (all four studies). One-third of the studies (n=9) reported the response rate. Of these, four reported a response rate of 70% and they showed MHO prevalence estimates between 10% and 51%. The heterogeneity of MHO prevalence estimates described in this paper strengthens calls for the urgent need for a commonly established metabolic health definition.
- The Edmonton Obesity Staging System: assessing a potential tool to improve the management of obesity surgery in the Brazilian public health services(2020) OGASSAVARA, Nicolas Chiu; DIAS, Joao Gabriel Magalhaes; PAJECKI, Denis; SIQUEIRA, Jose de Oliveira; SANTO, Marco Aurelio; TESS, Beatriz HelenaBackground: Limited access to publicly funded, insurance-covered, and self-paid obesity surgery is a reality worldwide. Waiting lists for procedures are usually based on chronologic criteria and body mass index (BMI)-defined obesity categorization. Obesity classification systems assess overall health and have been proposed as an alternative. Objective: To investigate the correlation between BMI-based classification and the Edmonton Obesity Staging System (EOSS) to support current evidence that the assessment of the clinical severity of obesity could be a helpful tool to maximize access to surgery. Setting: University hospital, Brazil. Methods: Retrospective analysis of all 2011 to 2014 adult patients who underwent obesity surgery under the public health system. Data on sex, age, presurgical BMI, and co-morbidities were extracted from hospital records. Spearman correlation coefficients were used to assess the strength and direction of the relationship between BMI classification and EOSS. Results: Of 565 patients, 79% were female, mean age 44.1 +/- 10.9 years and mean BMI 46.9 +/- 6.2 kg/m(2). The most common EOSS stage was 2 (86.5%), followed by stages 3 (8.5%) and 1 (4.9%). There was no correlation between the severity of obesity measured by BMI and EOSS (p = - .030, P = .475). Older patients had higher Edmonton scores (p = .308, P < .001). No difference was observed regarding sex. Conclusions: No correlation was found between EOSS and BMI and between these and sex. Age correlated with both obesity indicators. EOSS was reproducible in Brazilian surgical patients and may be an important tool from a health services perspective contributing to the more efficient use of limited resources for obesity surgery.
conferenceObject CHARACTERISTICS OF PATIENTS UNDERGOING BARIATRIC SURGERY IN A BRAZILIAN MEDICAL SCHOOL HOSPITAL(2016) OGASSAVARA, N. C.; DIAS, J. G. M.; PAJECKI, D.; SANTO, M. A.; TESS, B. H.- PERFORMANCE IN PHYSICAL FITNESS TESTS OF ADOLESCENTS WITH EXCESS OF WEIGHT: ARE THEY BETTER THAN THEIR EUTROPHIC PEERS?(2019) PORTELLA, Giovana Chekin; PORTELLA, Daniel Leite; SIQUEIRA, Jose Oliveira; TESS, Beatriz Helena
- Fasting insulin resistance affects the prevalence of metabolically healthy obesity in Brazilian adolescents(2019) MARRA, Nivea Fazanaro; FERNANDES, Maria Teresa Bechere; MELO, Maria Edna de; CRUZ, Rodrigo Marques da; TESS, Beatriz HelenaAim We aimed to assess the influence of fasting insulin resistance on metabolically healthy obesity (MHO) prevalence in adolescents and to identify associated factors. Methods This retrospective, registry-based, cross-sectional study included 418 (51.9% girls) 10- to 18-year-old adolescents with obesity from a tertiary outpatient clinic in Sao Paulo, Brazil, between 2009 and 2013. The prevalence of MHO was estimated according to two definitions: (i) no cardiometabolic risk factors (CMRF) by the International Diabetes Federation parameters and (ii) no CMRF and homeostatic model assessment for insulin resistance <3.16. Adjusted prevalence ratios and 95% confidence intervals (CI) evaluated the association of gender, age, pubertal stages, skin colour and degree of obesity with MHO. Results Metabolically healthy obesity prevalence was lower in definition II than definition I (12.7%; 95% CI 9.1-16.3% versus 43.1%; 95% CI 38.0-48.2%, respectively). Adjusted results showed negative association between severe obesity and MHO by both definitions (p <= 0.01). Male and later pubertal stages were also less likely to have MHO, but neither remained significant in definition II. Conclusion Metabolically healthy obesity prevalence decreased when insulin resistance was part of the definition. Detecting pre-clinical insulin resistance may improve the management of treatment-seeking adolescents, especially when they present no CMRF.
conferenceObject COMPARISON BETWEEN THE EDMONTON OBESITY STAGING SYSTEM (EOSS) AND THE BMI CLASSIFICATION IN PATIENTS SUBMITTED TO BARIATRIC SURGERY IN BRAZIL Multidisciplinary care (Primary care, Medical Management)(2019) PAJECKI, D.; SANTO, M. A.; OGASSAVARA, N. C.; DIAS, J. G. M.; SIQUEIRA, J. D. O.; TESS, B. H.; SILVA, M. B. D. B. E.