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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introdu&#231;&#227;o</span><p id="par0005" class="elsevierStylePara elsevierViewall">A PON1 &#233; uma enzima de 43kDa expressa em humanos&#44; sobretudo no f&#237;gado&#44; detectada no plasma ligada &#224;s Apo&#8208;prote&#237;nas A<span class="elsevierStyleInf">1</span> e J das part&#237;culas da lipoprote&#237;na de alta densidade &#40;HDL&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">1</span></a> A enzima impede o dano oxidativo aos fosfolip&#237;dios das lipoprote&#237;nas&#44; em especial na lipoprote&#237;na de baixa densidade &#40;LDL&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">1&#44;2</span></a> Dessa maneira a PON1 previne o efeito pr&#243;&#8208;inflamat&#243;rio dos lipoper&#243;xidos na camada &#237;ntima dos vasos sangu&#237;neos e sua maior atividade repercute em redu&#231;&#227;o do risco de doen&#231;a cardiovascular &#40;DCV&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0160"><span class="elsevierStyleSup">2&#44;3</span></a> Essa enzima hidrolisa um amplo espectro de substratos&#44; mas sua atividade arilesterase &#40;fenilacetato&#41; &#233; especialmente importante para redu&#231;&#227;o do dano endotelial e DCV&#46;<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">1&#8211;3</span></a> A PON1 sofre importante influ&#234;ncia de polimorfismos gen&#233;ticos e fatores nutricionais&#46;<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">1&#44;3&#44;4</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">O gene da <span class="elsevierStyleItalic">PON1</span> se localiza no cromossomo humano 7&#44; exibe 9 &#233;xons e codifica uma prote&#237;na com 354 amino&#225;cidos&#46;<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">1&#44;5</span></a> Mais de 200 polimorfismos foram descritos nesse gene&#46;<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">1&#44;3</span></a> No entanto&#44; o polimorfismo caracterizado na regi&#227;o promotora <span class="elsevierStyleItalic">PON1</span><span class="elsevierStyleItalic">C&#40;&#8208;107&#41;T</span> exerce efeito significativo na enzima&#44; &#233; um forte preditor de sua atividade arilesterase&#46;<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">5&#44;6</span></a> O alelo <span class="elsevierStyleItalic">&#8211;107C</span> proporciona n&#237;veis de PON1 at&#233; duas vezes mais elevados do que aqueles observados com o <span class="elsevierStyleItalic">alelo &#8211;107T&#46;</span><a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">5&#44;6</span></a> H&#225; evid&#234;ncias de que esse polimorfismo no promotor do gene <span class="elsevierStyleItalic">PON1</span> se localiza no ponto de liga&#231;&#227;o do fator de transcri&#231;&#227;o <span class="elsevierStyleItalic">Sp1&#46;</span><a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">5&#44;6</span></a> Portanto&#44; a presen&#231;a do alelo C resulta em maior express&#227;o do gene <span class="elsevierStyleItalic">PON1</span> e maior atividade s&#233;rica da enzima&#46;<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">5&#44;6</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Dentre os fatores nutricionais&#44; os &#225;cidos graxos monoinsaturados e as vitaminas antioxidantes&#44; a exemplo das vitaminas C e E&#44; aparecem como respons&#225;veis pelo aumento da atividade da PON1&#46;<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">7&#8211;10</span></a> Da mesma forma um maior consumo de frutas&#44; verduras e legumes se associou a uma atividade mais elevada da enzima&#46;<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">9&#44;10</span></a> Por outro lado&#44; estudos indicam que o excesso de peso repercute em menor atividade da PON1&#44; inclusive na inf&#226;ncia&#46;<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">11&#8211;13</span></a> A inf&#226;ncia &#233; um per&#237;odo vulner&#225;vel da vida&#44; contudo na atualidade as crian&#231;as est&#227;o expostas a m&#250;ltiplos fatores de risco cardiovasculares e metab&#243;licos&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">14</span></a> Sabe&#8208;se que a alimenta&#231;&#227;o das crian&#231;as brasileiras &#233; pobre em frutas&#44; legumes e verduras e rica em bebidas a&#231;ucaradas&#44; biscoitos recheados&#44; hamb&#250;rgueres&#44; salgados e embutidos&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">15</span></a> Al&#233;m disso&#44; o expressivo aumento da preval&#234;ncia do excesso de peso a partir dos 5 anos correlaciona&#8208;se diretamente ao incremento de morbidades associadas na popula&#231;&#227;o infantil&#46;<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">15&#44;16</span></a> Essa alimenta&#231;&#227;o de m&#225; qualidade e o excesso de peso predisp&#245;em ao ac&#250;mulo de esp&#233;cies reativas de oxig&#234;nio&#44; ao dano oxidativo as membranas biol&#243;gicas e ao in&#237;cio de doen&#231;as&#44; em particular DCV&#46;<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">11&#44;12&#44;16</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Nesse contexto&#44; o objetivo deste estudo foi investigar a influ&#234;ncia da alimenta&#231;&#227;o&#44; do estado nutricional e do polimorfismo gen&#233;tico <span class="elsevierStyleItalic">C&#40;&#8208;107&#41;T</span> sobre a atividade arilesterase da enzima antiaterog&#234;nica PON1 na inf&#226;ncia&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">M&#233;todos</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Amostra</span><p id="par0025" class="elsevierStylePara elsevierViewall">Estudo transversal feito com crian&#231;as entre 5 e 8 anos incompletos&#44; de ambos os sexos&#44; atendidas no Ambulat&#243;rio de Pediatria da Faculdade de Medicina da Universidade Federal de Pelotas &#40;UFPEL&#41;&#44; na cidade de Pelotas &#8211; RS&#46; O protocolo de pesquisa foi aprovado pelo Comit&#234; de &#201;tica em Pesquisa da Faculdade de Medicina da UFPEL &#40;504&#46;362&#47;2013&#41;&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Crian&#231;as diagnosticadas com doen&#231;as hep&#225;ticas&#44; paralisia cerebral&#44; displasia &#243;ssea ou neoplasias&#44; aquelas portadoras de necessidades especiais &#40;f&#237;sicas ou motoras&#41; e altera&#231;&#245;es gen&#233;ticas&#44; como s&#237;ndrome de Down e talassemia&#44; foram exclu&#237;das do estudo&#46; Os respons&#225;veis das crian&#231;as eleg&#237;veis foram devidamente esclarecidos e convidados&#44; os que autorizaram a participa&#231;&#227;o no estudo assinaram um Termo de Consentimento Livre Esclarecido &#8211; TCLE&#46; O assentimento da crian&#231;a foi questionado oralmente antes do in&#237;cio das avalia&#231;&#245;es e respeitada sua decis&#227;o&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Foram entrevistadas 227 crian&#231;as&#44; dessas 193 atenderam aos crit&#233;rios de inclus&#227;o&#44; houve cinco recusas &#40;2&#44;6&#37;&#41;&#46; Noventa e uma crian&#231;as &#40;49&#44;7&#37;&#41; n&#227;o completaram o protocolo do estudo&#44; caracterizaram&#8208;se como perdas&#46; Destaca&#8208;se como causa dessas perdas o n&#227;o comparecimento ao laborat&#243;rio para coleta de sangue &#40;40&#44;0&#37;&#41;&#46; No fim&#44; o estudo contou com a participa&#231;&#227;o de 97 crian&#231;as&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Dados sociodemogr&#225;ficos&#44; antropometria e coleta de sangue</span><p id="par0040" class="elsevierStylePara elsevierViewall">Os respons&#225;veis responderam a um question&#225;rio sociodemogr&#225;fico&#44; de comportamento e de consumo alimentar das crian&#231;as&#44; foram feitas medidas antropom&#233;tricas e foi a coleta de sangue em laborat&#243;rio de an&#225;lises cl&#237;nicas&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">As duas primeiras categorias de vari&#225;veis do question&#225;rio foram renda familiar &#40;em R&#36; convertidos a sal&#225;rios m&#237;nimos vigentes&#41;&#44; idade da m&#227;e &#40;anos completos&#41;&#44; escolaridade materna &#40;anos completos de estudo&#41;&#44; n&#250;mero de pessoas no domic&#237;lio e tempo &#40;em horas&#41; frente a telas &#40;computador&#44; celular&#44; tablet&#44; videogames&#44; televis&#227;o&#41;&#46; A cor da pele foi observada e classificada como branca ou n&#227;o branca&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">O peso e altura foram coletados com balan&#231;a plataforma digital &#40;Welmy&#174;&#41;&#44; com capacidade de 150<span class="elsevierStyleHsp" style=""></span>kg e precis&#227;o de 100<span class="elsevierStyleHsp" style=""></span>g e estadi&#244;metro acoplado com capacidade de 200<span class="elsevierStyleHsp" style=""></span>cm e precis&#227;o de 0&#44;5<span class="elsevierStyleHsp" style=""></span>cm&#46; Para avaliar o estado nutricional usou&#8208;se o &#205;ndice de Massa Corporal &#40;IMC&#41; para idade em escore&#8208;z&#44; segundo recomenda&#231;&#227;o da Organiza&#231;&#227;o Mundial da Sa&#250;de de 2007&#44;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">17</span></a> por meio do programa AnthroPlus&#46; Crian&#231;as com IMC&#8208;para&#8208;idade &#62;<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>1DP foram classificadas com excesso de peso&#46; A circunfer&#234;ncia da cintura foi aferida na linha da cintura&#44; no ponto m&#233;dio entre a &#250;ltima costela e a crista il&#237;aca&#46; O referencial de compara&#231;&#227;o foi o proposto por Freedman et al&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">18</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">Ap&#243;s jejum de 12 horas amostras de 5<span class="elsevierStyleHsp" style=""></span>mL de sangue foram coletadas&#44; aliquotadas e congeladas a &#8208;80<span class="elsevierStyleSup">o</span>C para an&#225;lises posteriores&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Determina&#231;&#227;o da atividade arilesterase da PON1</span><p id="par0060" class="elsevierStylePara elsevierViewall">A atividade arilesterase da PON1 foi medida em amostras de soro com o uso de fenilacetato como substrato&#46; A atividade enzim&#225;tica foi calculada a partir da velocidade de forma&#231;&#227;o de fenol atrav&#233;s do aumento da absorb&#226;ncia a 270<span class="elsevierStyleHsp" style=""></span>nm&#44; temperatura de 25<span class="elsevierStyleHsp" style=""></span>&#176;C&#44; em espectrofot&#244;metro &#40;FEMTO&#174;&#41;&#46; As amostras foram dilu&#237;das 1&#58;3 em 20<span class="elsevierStyleHsp" style=""></span>mM de Tamp&#227;o Tris&#47;HCl &#40;Sigma Chemical Co&#44; St&#46; Louis&#44; USA&#41;&#44; pH 8&#44;0&#44; com 1<span class="elsevierStyleHsp" style=""></span>mM de CaCl<span class="elsevierStyleInf">2</span> &#40;Vetec Chemical Co&#44; RJ&#44; Br&#41;&#46; A solu&#231;&#227;o reagente foi composta pelo tamp&#227;o&#44; ao qual foi adicionado 1<span class="elsevierStyleHsp" style=""></span>mM de fenilacetato &#40;Sigma Chemical Co&#44; St&#46; Louis&#44; USA&#41;&#46; A rea&#231;&#227;o foi determinada ap&#243;s 20 segundos de reten&#231;&#227;o e a absorb&#226;ncia medida por 80 segundos&#46; Considerou&#8208;se uma unidade de atividade arilesterase da PON1 igual a 1<span class="elsevierStyleHsp" style=""></span>&#956;M de fenol&#47;minuto e essa foi expressa em U&#47;mL&#44; com base no coeficiente de extin&#231;&#227;o de fenol&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">16</span></a> As an&#225;lises foram em duplicata e amostras em branco com &#225;gua deionizada foram usadas para corrigir a hidr&#243;lise n&#227;o enzim&#225;tica&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Extra&#231;&#227;o do DNA e an&#225;lise do polimorfismo PON1 C&#40;&#8208;107&#41;T</span><p id="par0065" class="elsevierStylePara elsevierViewall">O DNA foi extra&#237;do das amostras de sangue que continham EDTA de acordo com procedimento padr&#227;o descrito previamente por Kanai et al&#46;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">19</span></a> e quantificado em espectrofot&#244;metro&#46; As amostras de DNA foram dilu&#237;das para concentra&#231;&#227;o de 50 ng&#47;mL&#46; A genotipagem dos indiv&#237;duos para o polimorfismo PON1 C&#40;&#8208;107&#41;T foi feita atrav&#233;s da t&#233;cnica de <span class="elsevierStyleItalic">restriction fragment length polymorphism</span> &#40;RFLP&#41; de acordo com o validado por Campo et al&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">20</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">Brevemente&#44; um fragmento de 240pb da regi&#227;o do promotor do gene da PON1 foi amplificado por PCR em 35 ciclos &#40;5<span class="elsevierStyleHsp" style=""></span>min a 94<span class="elsevierStyleHsp" style=""></span>&#176;C&#44; seguido por 45s a 94<span class="elsevierStyleHsp" style=""></span>&#176;C &#40;desnatura&#231;&#227;o&#41;&#44; 45s a 67<span class="elsevierStyleHsp" style=""></span>&#176;C &#40;anelamento&#41; e 45s a 72<span class="elsevierStyleHsp" style=""></span>&#176;C &#40;extens&#227;o&#41;&#44; seguido de 5<span class="elsevierStyleHsp" style=""></span>min a 72&#176; C&#41;&#46; Para tal foram usados os <span class="elsevierStyleItalic">primers</span>&#58; <span class="elsevierStyleItalic">forward</span> 5&#8217;AGCTAGCTGCGGACCCGGCGGGGAGGaG3&#8217; e <span class="elsevierStyleItalic">reverse</span> 5&#8217;GGCTGCAGCCCTCACCACAACCC3&#8217;&#46; A letra min&#250;scula no <span class="elsevierStyleItalic">primer forward</span> indica um erro de pareamento proposital introduzido no amplicon para gerar um s&#237;tio de restri&#231;&#227;o para a enzima <span class="elsevierStyleItalic">Bsr</span>BI&#44; pois n&#227;o h&#225; s&#237;tio de restri&#231;&#227;o espec&#237;fico que corte a sequ&#234;ncia original do DNA&#46; A digest&#227;o foi feita atrav&#233;s da incuba&#231;&#227;o da amostra de PCR com 3 UI da enzima <span class="elsevierStyleItalic">Bsr</span>BI &#40;New England Bio Labs&#44; Cambridge&#44; UK&#41; por duas horas a 37&#176; C&#46; Ap&#243;s a digest&#227;o os fragmentos de DNA foram separados por eletroforese em gel de agarose &#40;Kasvi&#44; Paran&#225;&#44; BR&#41; de 3&#37;&#44; corados com SYBR Safe &#40;Applied Biosystems&#41;&#46; O alelo C foi identificado pela presen&#231;a dos fragmentos de 28 e 212 pb&#44; enquanto o alelo T resultou em um fragmento de 240 pb n&#227;o digerido&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">&#205;ndice de Qualidade da Alimenta&#231;&#227;o</span><p id="par0075" class="elsevierStylePara elsevierViewall">O &#205;ndice de Qualidade da Alimenta&#231;&#227;o &#40;IQA&#41; foi elaborado com refer&#234;ncia no &#205;ndice de Alimenta&#231;&#227;o do Escolar &#40;Ales&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0255"><span class="elsevierStyleSup">21&#44;22</span></a> Por&#233;m&#44; a quest&#227;o sobre o local das refei&#231;&#245;es foi colocada no lugar da original que investigava consumo de peixe&#46; O IQA baseou&#8208;se&#58; 1&#41; na identifica&#231;&#227;o de componentes comportamentais das crian&#231;as&#44; especificamente do h&#225;bito de fazer desjejum e de fazer as refei&#231;&#245;es &#224; mesa&#59; 2&#41; na frequ&#234;ncia do consumo alimentar&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">A cada frequ&#234;ncia espec&#237;fica foi atribu&#237;da uma pontua&#231;&#227;o positiva ou negativa &#40;material suplementar&#41;&#46; Para os alimentos de alta qualidade nutricional&#44; como fruta&#44; verdura&#44; legume&#44; feij&#227;o e leite&#44; foi acrescido um ponto quando consumidos diariamente&#46; No caso de consumo menor do que sete vezes por semana &#40;duas a quatro vezes&#44; a depender do alimento&#41;&#44; foi subtra&#237;do um ponto&#46; J&#225; para alimentos de baixa qualidade nutricional&#44; como doce&#44; biscoito&#44; refrigerante&#44; salgadinho&#44; fritura&#44; maionese&#44; macarr&#227;o instant&#226;neo e hamb&#250;rguer&#44; foi acrescido um ponto quando n&#227;o consumidos ou consumidos raramente&#46; Al&#233;m disso&#44; foi subtra&#237;do um ponto para a frequ&#234;ncia di&#225;ria desses alimentos&#46; A pontua&#231;&#227;o m&#225;xima do IQA correspondeu a 15 pontos&#46; A distribui&#231;&#227;o das pontua&#231;&#245;es totais em tercis originou tr&#234;s categorias de qualidade da alimenta&#231;&#227;o&#58; baixa &#40;&#8804; 3 escore&#8208; p25&#41;&#44; m&#233;dia &#40;4 a 6 escores&#8208;p50&#41; e boa &#40;&#8805; 7 escores&#8208;p75&#41;&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">An&#225;lises estat&#237;sticas</span><p id="par0085" class="elsevierStylePara elsevierViewall">Os dados foram digitados no Microsoft Excel 2013 e analisados no programa STATA vers&#227;o 12&#46;0 &#40;Stata Corp&#46;&#44; College Station&#44; USA&#41;&#46; A normalidade dos dados foi testada a partir do teste de Shapiro&#8208;Wilk&#44; as vari&#225;veis s&#227;o apresentadas como frequ&#234;ncia absoluta e relativa&#44; m&#233;dia e desvio&#8208;padr&#227;o &#40;DP&#41;&#44; mediana e intervalo interquartil &#40;IIQ&#41;&#8208; p25&#8208;75&#46; Os testes U de Mann&#8208;Whitney ou Kruskal&#8208;Wallis foram usados para comparar os escores entre duas ou tr&#234;s categorias de vari&#225;veis&#46; O qui&#8208;quadrado foi usado para testar o equil&#237;brio de Hardy&#8208;Weinberg &#40;EHW&#41;&#44; com as frequ&#234;ncias observadas e as esperadas&#46; Na an&#225;lise n&#227;o ajustada foi usada a regress&#227;o linear simples para estimar a atividade da PON1 de acordo com o gen&#243;tipo&#46; As an&#225;lises ajustadas foram feitas por meio de regress&#227;o linear m&#250;ltipla com quatro modelos diferentes&#58; Modelo 1 &#61; incluiu vari&#225;veis sociodemogr&#225;ficas de escolaridade materna&#44; renda familiar&#44; n&#250;mero de pessoas no domic&#237;lio&#44; cor da pele e sexo&#59; Modelo 2 &#61; incluiu as frequ&#234;ncias absolutas de consumo alimentar dos alimentos de alta qualidade nutricional&#44; ao ajuste do modelo 1&#59; Modelo 3 &#61; incluiu as frequ&#234;ncias de consumo alimentar dos alimentos de baixa qualidade nutricional&#44; ao ajuste do modelo 2&#59; Modelo 4 &#61; incluiu o escore z do IMC ao ajuste do modelo 3&#46; Examinou&#8208;se a mudan&#231;a no coeficiente determina&#231;&#227;o &#40;R<span class="elsevierStyleSup">2</span>&#41; ajustado&#44; o n&#237;vel de signific&#226;ncia adotado foi de p &#60; 0&#44;05&#46;</p></span></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Resultados</span><p id="par0090" class="elsevierStylePara elsevierViewall">As caracter&#237;sticas da amostra e o escore do IQA s&#227;o apresentados na <a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#46; O sexo masculino representou 50&#44;5&#37; &#40;n &#61; 49&#41;&#44; 39&#44;2&#37; &#40;n &#61; 38&#41; tinham idade igual a 6 anos&#44; a maioria 87&#44;6&#37; &#40;n &#61; 85&#41; era de pele branca&#44; a renda familiar foi de 2 ou menos sal&#225;rios m&#237;nimos e 50&#44;5&#37; &#40;n &#61; 49&#41; permaneciam mais de duas horas&#47;dia em atividade sedent&#225;ria&#46; A circunfer&#234;ncia da cintura ficou abaixo do percentil de risco para 65&#44;0&#37; &#40;n &#61; 63&#41; da amostra e 55&#44;0&#37; &#40;n &#61; 53&#41; se encontravam eutr&#243;ficos&#46; A atividade arilesterase da PON1 correspondeu &#224; mediana de 90&#44;0 &#40;15&#8208;30&#41; U&#47;mL e 51&#44;5&#37; &#40;n &#61; 50&#41; das crian&#231;as tinham PON1 inferior a esse valor&#46; Quanto ao IQA&#44; a pontua&#231;&#227;o mediana foi de 5&#44;0 &#40;3&#44;0&#8208;7&#44;0&#41; pontos e n&#227;o houve diferen&#231;a significativa entre as pontua&#231;&#245;es segundo as caracter&#237;sticas da amostra&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall">A frequ&#234;ncia dos gen&#243;tipos para o polimorfismo <span class="elsevierStyleItalic">PON1 C&#40;&#8208;107&#41;T</span> foi de 54&#44;6&#37; &#40;53&#47;97&#41; para o gen&#243;tipo CT&#44; 31&#44;0&#37; &#40;30&#47;97&#41; para o gen&#243;tipo CC e 14&#44;4&#37; &#40;14&#47;97&#41; para o gen&#243;tipo TT&#46; A distribui&#231;&#227;o dos gen&#243;tipos mostrou que a popula&#231;&#227;o est&#225; em equil&#237;brio de Hardy&#8208;Weinberg &#40;p &#61; 0&#44;22&#41;&#46; A frequ&#234;ncia al&#233;lica foi de 58&#44;0&#37; para o alelo C e 42&#44;0&#37; para o alelo T&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">A <a class="elsevierStyleCrossRef" href="#fig0005">figura 1</a> mostra a influ&#234;ncia do gen&#243;tipo e da qualidade da alimenta&#231;&#227;o sobre a PON1&#46; A atividade arilesterase foi significativamente mais elevada no gen&#243;tipo CC comparada &#224; dos gen&#243;tipos CT e TT &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>A&#41;&#46; A PON1 mostrou n&#237;vel intermedi&#225;rio de atividade no gen&#243;tipo heterozigoto&#44; por&#233;m n&#227;o houve diferen&#231;a significativa comparada &#224; do gen&#243;tipo TT &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>A&#41;&#46; A enzima n&#227;o mostrou diferen&#231;a significativa entre as tr&#234;s categorias de qualidade da alimenta&#231;&#227;o&#44; conforme a distribui&#231;&#227;o das pontua&#231;&#245;es do IQA em tercis &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>B&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0105" class="elsevierStylePara elsevierViewall">A an&#225;lise bruta e ajustada da associa&#231;&#227;o entre a atividade da PON1 e o polimorfismo <span class="elsevierStyleItalic">PON1 C&#40;&#8208;107&#41;T</span> s&#227;o apresentados na <a class="elsevierStyleCrossRef" href="#tbl0010">tabela 2</a>&#46; Na an&#225;lise bruta as associa&#231;&#245;es foram altamente significativas&#46; Quando a an&#225;lise foi ajustada para as vari&#225;veis sociodemogr&#225;ficas&#44; de consumo alimentar e de estado nutricional&#44; a associa&#231;&#227;o entre a enzima e o polimorfismo manteve&#8208;se significativa&#46; No ajuste do modelo 1 a inclus&#227;o das vari&#225;veis sociodemogr&#225;ficas resultou num coeficiente de determina&#231;&#227;o ajustado foi de 11&#44;6&#37;&#46; J&#225; no ajuste do modelo 2 a inclus&#227;o da frequ&#234;ncia do consumo de alimentos saud&#225;veis explicou uma variabilidade de 14&#44;8&#37; na atividade da PON1&#46; A porcentagem de varia&#231;&#227;o da PON1 atribu&#237;da aos fatores gen&#233;ticos e nutricionais &#233; mostrada na &#40;<a class="elsevierStyleCrossRef" href="#fig0010">fig&#46; 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Discuss&#227;o</span><p id="par0110" class="elsevierStylePara elsevierViewall">Neste estudo mostrou&#8208;se que fatores nutricionais&#44; a exemplo da dieta e IMC&#44; combinados ao polimorfismo <span class="elsevierStyleItalic">PON1C&#40;&#8208;107&#41;T</span>&#44; s&#227;o previsores da atividade arilesterase da PON1 na inf&#226;ncia&#46; Al&#233;m disso&#44; foram significativos para explicar uma varia&#231;&#227;o de 14&#44;8&#37; na enzima&#46; O gen&#243;tipo CC e os alimentos saud&#225;veis&#44; de boa qualidade nutricional foram os fatores que destacadamente influenciaram a uma maior atividade enzim&#225;tica&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">O &#237;ndice de qualidade de alimenta&#231;&#227;o de escolares &#233; um instrumento pr&#225;tico e adequado &#224; realidade brasileira para monitorar a alimenta&#231;&#227;o de crian&#231;as&#46;<a class="elsevierStyleCrossRefs" href="#bib0255"><span class="elsevierStyleSup">21&#44;22</span></a> Uma alimenta&#231;&#227;o de m&#233;dia e boa qualidade conforme verificada no atual estudo n&#227;o significa adequa&#231;&#227;o do ponto de vista nutricional&#46; Isso foi evidenciado pela baixa pontua&#231;&#227;o atingida nos tercis mais elevados de distribui&#231;&#227;o do IQA&#46; Molina et al&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">22</span></a> avaliaram a qualidade da alimenta&#231;&#227;o de 1282 escolares e verificaram pontua&#231;&#245;es similares &#224;s que definiram a alimenta&#231;&#227;o das crian&#231;as deste estudo&#46; Al&#233;m disso&#44; Molina et al&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">22</span></a> encontraram que a maioria dos escolares consumia uma alimenta&#231;&#227;o de baixa qualidade&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Estudos sugerem uma modula&#231;&#227;o diet&#233;tica da enzima e atribuem aos antioxidantes&#44; a exemplo de vitaminas e compostos fen&#243;licos&#44; efeito protetor a sua estrutura e fun&#231;&#227;o&#46;<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">3&#44;4&#44;9</span></a> Neste estudo a presen&#231;a de alimentos de boa qualidade nutricional combinada ao polimorfismo <span class="elsevierStyleItalic">PON1C&#40;&#8208;107&#41;T</span> alterou de forma positiva a atividade da PON1&#46; Esse resultado pode ser atribu&#237;do a uma maior participa&#231;&#227;o das frutas&#44; legumes e verduras na dieta de uma parcela das crian&#231;as&#46;<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">3&#44;4&#44;9</span></a> Em particular&#44; um estudo de interven&#231;&#227;o mostrou que o consumo de seis por&#231;&#245;es di&#225;rias de frutas&#44; verduras e legumes impactou no aumento de 7&#37; na atividade arilesterase da PON1&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">9</span></a> Jarvik et al&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">10</span></a> mostraram que a atividade da PON1 correlacionou&#8208;se positiva e significativamente com o maior consumo alimentar de vitaminas antioxidantes&#44; em especial das vitaminas C e E&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Diversas pesquisas investigam a rela&#231;&#227;o entre a enzima e o estado nutricional em diferentes fases do ciclo vital&#46;<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">11&#8211;13&#44;16&#44;23&#8211;25</span></a> No entanto&#44; poucas referiram aumento da enzima associada ao IMC conforme observado no atual estudo&#46;<a class="elsevierStyleCrossRefs" href="#bib0215"><span class="elsevierStyleSup">13&#44;24&#44;25</span></a> As diverg&#234;ncias quanto ao efeito do IMC sobre a enzima podem decorrer da idade dos indiv&#237;duos selecionados&#44; uma vez que muitas amostras misturam crian&#231;as e adolescentes&#46; A obesidade nessas duas fases da vida cursa com diferen&#231;as que v&#227;o desde o tempo de exposi&#231;&#227;o ao aumento do tecido adiposo&#44; do n&#237;vel das citocinas pr&#243;&#8208;inflamat&#243;rias at&#233; o status hormonal&#46;<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">11&#44;23&#8211;25</span></a>Um maior tempo de exposi&#231;&#227;o ao excesso de peso e um aumento do estado inflamat&#243;rio&#44; ainda que esse seja de baixo grau&#44; podem refletir num efeito inibit&#243;rio sobre a enzima&#46;<a class="elsevierStyleCrossRefs" href="#bib0275"><span class="elsevierStyleSup">25&#44;26</span></a> Por&#233;m&#44; na inf&#226;ncia o aumento de peso e de forma&#231;&#227;o de esp&#233;cies reativas de oxig&#234;nio poderiam ser compensados pela eleva&#231;&#227;o da enzima&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">13</span></a> Conv&#233;m registrar que a natureza complexa da obesidade limita as especula&#231;&#245;es&#44; pois al&#233;m dos aspectos citados ainda h&#225; influ&#234;ncias do estilo de vida e da atividade f&#237;sica&#46;<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">16&#44;27</span></a> Em particular&#44; Koncsos et al&#46;<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">27</span></a> ao avaliar 151 crian&#231;as constataram que ap&#243;s uma mudan&#231;a no estilo de vida houve aumento da PON1&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">O polimorfismo <span class="elsevierStyleItalic">PON1 C&#40;&#8208;107&#41;T</span> influenciou na PON1&#44; o gen&#243;tipo CC foi relacionado a uma maior atividade&#44; o TT a uma menor atividade e o CT a um efeito intermedi&#225;rio&#46; Os polimorfismos da regi&#227;o <span class="elsevierStyleItalic">&#8208;107C&#47;T</span> t&#234;m maior efeito sobre a atividade arilesterase da enzima&#44; contribuem com 25&#37; da variabilidade de sua express&#227;o em adultos brancos&#46;<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">5&#44;6</span></a> Esses polimorfismos afetam a express&#227;o da prote&#237;na e a concentra&#231;&#227;o enzim&#225;tica&#44; indiv&#237;duos portadores do alelo T podem ter a produ&#231;&#227;o da enzima afetada&#46;<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">5&#44;6</span></a> Deakin et al&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">5</span></a> destacam um mecanismo molecular no polimorfismo <span class="elsevierStyleItalic">C&#40;&#8208;107&#41;T</span> do gene da <span class="elsevierStyleItalic">PON1</span> que envolve o fator de transcri&#231;&#227;o <span class="elsevierStyleItalic">Sp1</span>&#46; A presen&#231;a do alelo C na regi&#227;o promotora resulta em maior express&#227;o do gene <span class="elsevierStyleItalic">PON1</span> e&#44; consequentemente&#44; maior n&#237;vel de prote&#237;na na circula&#231;&#227;o e aumento na atividade da enzima&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">6</span></a> Isso condiz com a associa&#231;&#227;o entre o alelo C e maiores concentra&#231;&#227;o e atividade s&#233;rica da enzima&#44; indica que o fator de transcri&#231;&#227;o se liga a essa regi&#227;o do promotor&#44; mas com maior afinidade para a variante<span class="elsevierStyleItalic">&#8208;107C</span>&#46;<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">5&#44;6</span></a> A variante <span class="elsevierStyleItalic">&#8208;107T</span> interrompe a sequ&#234;ncia de reconhecimento do fator de transcri&#231;&#227;o <span class="elsevierStyleItalic">Sp1</span>&#44; resulta em menor concentra&#231;&#227;o de PON1 para esse gen&#243;tipo&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">5</span></a></p><p id="par0135" class="elsevierStylePara elsevierViewall">O efeito do gen&#243;tipo CC sobre a atividade da PON1 visto no atual estudo j&#225; foi apresentado em outros trabalhos com crian&#231;as na mesma faixa et&#225;ria&#46;<a class="elsevierStyleCrossRefs" href="#bib0215"><span class="elsevierStyleSup">13&#44;28</span></a> Em especial&#44; Uliano et al&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">13</span></a> mostraram que crian&#231;as com o gen&#243;tipo CC para o polimorfismo <span class="elsevierStyleItalic">PON1 C&#40;&#8722;107&#41;T</span> apresentaram maior atividade s&#233;rica da enzima do que as portadoras do gen&#243;tipo TT&#46; Ainda&#44; Huen et al&#46;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">28</span></a> constataram que a atividade da PON1 em crian&#231;as com gen&#243;tipo CC foi maior do que naquelas com o gen&#243;tipo TT&#46; A frequ&#234;ncia dos gen&#243;tipos observada neste estudo est&#225; de acordo com a de outras pesquisas&#46;<a class="elsevierStyleCrossRefs" href="#bib0290"><span class="elsevierStyleSup">28&#8211;30</span></a> Por exemplo&#44; a coorte Chamacos feita com crian&#231;as da mesma faixa et&#225;ria registrou frequ&#234;ncia similar a encontrada neste estudo&#46;<a class="elsevierStyleCrossRefs" href="#bib0290"><span class="elsevierStyleSup">28&#44;30</span></a></p><p id="par0140" class="elsevierStylePara elsevierViewall">Os resultados do presente estudo devem ser ponderados frente a seus pontos fortes e suas limita&#231;&#245;es&#46; Entre os pontos fortes encontra&#8208;se a sele&#231;&#227;o de uma amostra de crian&#231;as em fase precoce do desenvolvimento e isenta doen&#231;as cr&#244;nicas&#46; Ainda&#44; a identifica&#231;&#227;o de um polimorfismo associado a atividade de uma enzima cardioprotetora&#46; Entre as limita&#231;&#245;es est&#225; o m&#233;todo de avalia&#231;&#227;o diet&#233;tica&#44; que estima apenas a qualidade da dieta e n&#227;o estima a quantidade&#44; pode a frequ&#234;ncia do consumo ser subestimada&#46; O n&#250;mero de perdas de acompanhamento que implicou uma amostra reduzida&#44; frente &#224; estimada&#44; e limita a validade estat&#237;stica das probabilidades encontradas&#46; No entanto&#44; as an&#225;lises ajustadas foram esclarecedoras quanto &#224;s influ&#234;ncias mais relevantes para predizer a variabilidade da enzima na amostra&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">Conclui&#8208;se que na inf&#226;ncia uma alimenta&#231;&#227;o de boa qualidade&#44; com maior participa&#231;&#227;o de alimentos saud&#225;veis&#44; foi importante para predizer a atividade da enzima cardioprotetora PON1 combinada ao polimorfismo <span class="elsevierStyleItalic">C&#40;&#8208;107&#41;T</span> do gene da <span class="elsevierStyleItalic">PON1</span>&#46; Esse resultado estimula a orienta&#231;&#227;o para o alcance das metas de consumo de alimentos como frutas&#44; legumes e verduras na inf&#226;ncia&#44; especialmente na perspectiva de prevenir DCV precoce&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Financiamento</span><p id="par0150" class="elsevierStylePara elsevierViewall">Coordena&#231;&#227;o de Aperfei&#231;oamento do Pessoal de N&#237;vel Superior &#40;Capes&#41;&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Conflitos de interesse</span><p id="par0155" class="elsevierStylePara elsevierViewall">Os autores declaram n&#227;o haver conflitos de interesse&#46;</p></span></span>"
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              "titulo" => "Dados sociodemogr&#225;ficos&#44; antropometria e coleta de sangue"
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              "titulo" => "Determina&#231;&#227;o da atividade arilesterase da PON1"
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              "titulo" => "Extra&#231;&#227;o do DNA e an&#225;lise do polimorfismo PON1 C&#40;&#8208;107&#41;T"
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              "titulo" => "&#205;ndice de Qualidade da Alimenta&#231;&#227;o"
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            1 => "Nutri&#231;&#227;o infantil"
            2 => "Estado nutricional"
            3 => "Frequ&#234;ncia g&#234;nica"
            4 => "Preven&#231;&#227;o de doen&#231;a"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The cardioprotective enzyme paraoxonase&#8208;1 &#40;PON1&#41; suffers an important influence from genetic polymorphisms and nutritional factors&#46; The aim of this study was to investigate the influence of diet&#44; nutritional status&#44; and the <span class="elsevierStyleItalic">C&#40;&#8208;107&#41;T</span> polymorphism on PON1 arylesterase activity in children&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">This was a cross&#8208;sectional study with 97 children&#44; aged between 5 and 8 years&#44; of both genders&#44; from a pediatric outpatient clinic in southern Brazil&#46; A sociodemographic&#44; behavioral&#44; and food consumption questionnaire was applied&#44; and anthropometric measurements and laboratory blood samples were taken&#46; PON1 arylesterase activity was measured by phenol extinction &#40;U&#47;mL&#41;&#44; and DNA extraction and analysis of the <span class="elsevierStyleItalic">PON1 C&#40;&#8208;107&#41;T</span> polymorphism were performed&#46; The Hardy&#8211;Weinberg equilibrium was tested with the chi&#8208;squared test and linear regression was used to estimate PON1 activity according to four adjustment models&#44; with an acceptable error of 5&#37;&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">In the sample&#44; the male gender accounted for 50&#46;5&#37;&#44; 39&#46;2&#37; were 6 years of age&#44; 54&#46;5&#37; had normal weight&#44; and 51&#46;5&#37; had PON1 activity below the median &#40;90&#46;0&#44; 15&#8211;30<span class="elsevierStyleHsp" style=""></span>U&#47;mL&#41;&#46; Genotype frequency was 54&#46;6&#37; &#40;53&#47;97&#41;&#44; 31&#46;0&#37; &#40;30&#47;97&#41;&#44; and 14&#46;4&#37; &#40;14&#47;97&#41;&#44; respectively&#44; for CT&#44; CC&#44; and TT&#44; consistent with the Hardy&#8211;Weinberg equilibrium &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>0&#46;22&#41;&#46; In the regression analysis&#44; the model that included sociodemographic variables as well as frequency of consumption of fruits&#44; vegetables&#44; legumes&#44; dairy products&#44; and beans estimated a variability of 14&#46;8&#37; in PON1 activity combined with the <span class="elsevierStyleItalic">PON1 C&#40;&#8208;107&#41;T</span> polymorphism&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">During childhood&#44; a good&#8208;quality diet with greater inclusion of healthy foods was important to predict the activity of the cardioprotective enzyme PON1 combined with the <span class="elsevierStyleItalic">C&#40;&#8208;107&#41;T</span> polymorphism of the PON1 gene&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">A enzima cardioprotetora Paraoxonase 1 &#40;PON1&#41; sofre importante influ&#234;ncia de polimorfismos gen&#233;ticos e fatores nutricionais&#46; O objetivo deste estudo foi investigar a influ&#234;ncia da alimenta&#231;&#227;o&#44; do estado nutricional e do polimorfismo <span class="elsevierStyleItalic">C&#40;&#8208;107&#41;T</span> sobre a atividade arilesterase da PON1 em crian&#231;as&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudo transversal com 97 crian&#231;as entre 5 e 8 anos&#44; de ambos os sexos&#44; de um ambulat&#243;rio de pediatria no sul do Brasil&#46; Realizou-se question&#225;rio sociodemogr&#225;fico&#44; de comportamento e de consumo alimentar&#44; medidas antropom&#233;tricas e coleta de sangue em laborat&#243;rio&#46; A atividade arilesterase da PON1 foi mensurada pela extin&#231;&#227;o de fenol &#40;U&#47;mL&#41;&#44; realizada extra&#231;&#227;o do DNA e an&#225;lise do polimorfismo <span class="elsevierStyleItalic">PON1 C&#40;&#8208;107&#41;T&#46;</span> O equil&#237;brio de Hardy&#8208;Weinberg foi testado com qui&#8208;quadrado e usada regress&#227;o linear para estimar a atividade da PON1 segundo quatro modelos de ajuste&#44; erro aceit&#225;vel de 5&#37;&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Na amostra o sexo masculino representou 50&#44;5&#37;&#44; 39&#44;2&#37; tinham 6 anos&#44; 54&#44;5&#37; eram eutr&#243;ficos e 51&#44;5&#37; tinha atividade da PON1 inferior &#224; mediana &#40;90&#44;0&#59;15&#8208;30<span class="elsevierStyleHsp" style=""></span>U&#47;ml&#41;&#46; A frequ&#234;ncia dos gen&#243;tipos foi 54&#44;6&#37; &#40;53&#47;97&#41;&#44; 31&#44;0&#37; &#40;30&#47;97&#41; e 14&#44;4&#37; &#40;14&#47;97&#41;&#44; respectivamente&#44; para CT&#44; CC e TT&#44; estiveram em equil&#237;brio de Hardy&#8208;Weinberg &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;22&#41;&#46; Na an&#225;lise de regress&#227;o o modelo que incluiu vari&#225;veis sociodemogr&#225;ficas&#44; de frequ&#234;ncia do consumo de frutas&#44; verduras&#44; legumes&#44; latic&#237;nios e feij&#245;es estimou uma variabilidade de 14&#44;8&#37; na atividade da PON1 combinada ao polimorfismo <span class="elsevierStyleItalic">PON1 C&#40;&#8208;107&#41;T&#46;</span></p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclus&#245;es</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Na inf&#226;ncia uma alimenta&#231;&#227;o de boa qualidade&#44; com maior participa&#231;&#227;o de alimentos saud&#225;veis foi importante para predizer a atividade da enzima cardioprotetora PON1 combinada ao polimorfismo <span class="elsevierStyleItalic">C&#40;&#8208;107&#41;T</span> do gene da <span class="elsevierStyleItalic">PON1</span>&#46;</p></span>"
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          0 => array:2 [
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          2 => array:2 [
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0035">Como citar este artigo&#58; Sigales TS&#44; Uliano G&#44; Muniz L&#44; Barros C&#44; Schneider A&#44; Valle SC&#46; Influence of nutritional factors and the <span class="elsevierStyleItalic">PON1 C&#40;&#8208;107&#41;T</span> polymorphism on paraoxonase&#8208;1 activity in childhood&#46; J Pediatr &#40;Rio J&#41;&#46; 2020&#59;96&#58;495&#8211;502&#46;</p>"
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            "titulo" => "Material suplementar"
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        "descripcion" => array:1 [
          "pt" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Atividade arilesterase da PON1&#44; de acordo com o gen&#243;tipo do polimorfismo <span class="elsevierStyleItalic">PON1 C&#40;&#8208;107&#41;T</span> &#40;A&#41; e de acordo com o IQA &#40;B&#41; de crian&#231;as entre 5 e 8 anos incompletos &#40;n &#61; 97&#41;&#44; Pelotas&#8208;RS&#46; Os dados s&#227;o apresentados como m&#233;dia &#177; dp&#44; letras diferentes indicam p &#60; 0&#44;05&#44; Anova de uma via&#46;</p>"
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      1 => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Figura 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
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        "figura" => array:1 [
          0 => array:4 [
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            "Tamanyo" => 341733
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        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Variabilidade da atividade arilesterase da PON1 explicada pelo polimorfismo <span class="elsevierStyleItalic">PON1 C&#40;&#8208;107&#41;T</span>&#44; fatores sociodemogr&#225;ficos e nutricionais em crian&#231;as entre 5 e 8 anos incompletos &#40;n &#61; 97&#41;&#44; Pelotas&#8208;RS&#46;</p>"
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          "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">n&#44; n&#250;mero de indiv&#237;duos&#59; dp&#44; desvio&#8208;padr&#227;o&#46;</p>"
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#37; &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Sexo</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Feminino&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">49&#44;49 &#40;48&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#44;04&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">4&#44;79&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Masculino&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">50&#44;51 &#40;49&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">5&#44;10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">4&#44;64&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Idade</span><a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>5 anos&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">34&#44;02 &#40;33&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;84&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;04&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>6 anos&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39&#44;18 &#40;38&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">5&#44;44&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">4&#44;43&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>7 anos&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">26&#44;80 &#40;26&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">4&#44;80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">4&#44;68&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Cor da pele</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Branca&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">87&#44;63 &#40;85&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">5&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">4&#44;78&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>N&#227;o branca&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#44;37 &#40;12&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">5&#44;58&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Renda familiar</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#8804; 2 sal&#225;rios m&#237;nimos&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">84&#44;54 &#40;82&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#44;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;54&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#62; 2 sal&#225;rios m&#237;nimos&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&#44;36 &#40;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#44;33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#44;55&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Tempo frente a tela</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#8804; 2 horas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">49&#44;48 &#40;40&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#44;75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;48&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#62; 2 horas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">50&#44;52 &#40;49&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;75&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">4&#44;81&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Circunfer&#234;ncia da cintura</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Adequada&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">64&#44;95 &#40;63&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;95&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;89&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Elevada&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33&#44;05 &#40;33&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#44;27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;37&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Classifica&#231;&#227;o do &#237;ndice de massa corporal</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Eutrofia&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">5&#44;15&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Excesso de peso&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">45&#44;36 &#40;44&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Paraoxonase1</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">5&#44;06&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#8805; 90 U&#47;mL&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">4&#44;44&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">86&#44;36&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>CC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&#44;27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;7&#44;99&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;39&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">105&#44;22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="7" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="7" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">An&#225;lise ajustada</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="7" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Modelo 1</span><a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">a</span></a></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>TT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">77&#44;37&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;16&#44;28&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">REF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;011</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#44;60</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">REF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>CT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#44;59&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;7&#44;54&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">83&#44;96&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>CC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27&#44;75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;8&#44;23&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;48&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">105&#44;12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="7" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="7" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Modelo 2</span><a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">b</span></a></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>TT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">71&#44;19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;18&#44;87&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">REF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;011</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&#44;80</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">REF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>CT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#44;25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;7&#44;89&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">81&#44;44&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>CC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30&#44;32&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;8&#44;27&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;53&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">101&#44;51&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="7" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="7" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Modelo 3</span><a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">c</span></a></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>TT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">69&#44;31&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;19&#44;88&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">REF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;048</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#44;90</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">REF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>CT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#44;71&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;8&#44;17&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">80&#44;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>CC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">31&#44;41&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;8&#44;64&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;55&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&#44;72&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="7" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="7" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Modelo 4</span><a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">d</span></a></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>TT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">68&#44;76&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;19&#44;77&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">REF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;041</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#44;00</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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Artigo Original
Influence of nutritional factors and the PON1 C(‐107)T polymorphism on paraoxonase‐1 activity in childhood
Influência de fatores nutricionais e do polimorfismo PON1 C(‐107)T sobre a atividade da Paraoxonase 1 na infância
Tainá S. Sigalesa, Gabriela Ulianob, Ludmila Muniza, Carlos Barrosa, Augusto Schneidera, Sandra C. Vallea,
Autor para correspondência
sandracostavalle@gmail.com

Autor para correspondência.
a Universidade Federal de Pelotas (UFPel), Faculdade de Nutrição, Pelotas, RS, Brasil
b Universidade Federal de Pelotas (UFPel), Hospital Universitário, Pelotas, RS, Brasil
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mas sua atividade arilesterase &#40;fenilacetato&#41; &#233; especialmente importante para redu&#231;&#227;o do dano endotelial e DCV&#46;<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">1&#8211;3</span></a> A PON1 sofre importante influ&#234;ncia de polimorfismos gen&#233;ticos e fatores nutricionais&#46;<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">1&#44;3&#44;4</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">O gene da <span class="elsevierStyleItalic">PON1</span> se localiza no cromossomo humano 7&#44; exibe 9 &#233;xons e codifica uma prote&#237;na com 354 amino&#225;cidos&#46;<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">1&#44;5</span></a> Mais de 200 polimorfismos foram descritos nesse gene&#46;<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">1&#44;3</span></a> No entanto&#44; o polimorfismo caracterizado na regi&#227;o promotora <span class="elsevierStyleItalic">PON1</span><span class="elsevierStyleItalic">C&#40;&#8208;107&#41;T</span> exerce efeito significativo na enzima&#44; &#233; um forte preditor de sua atividade arilesterase&#46;<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">5&#44;6</span></a> O alelo <span class="elsevierStyleItalic">&#8211;107C</span> proporciona n&#237;veis de PON1 at&#233; duas vezes mais elevados do que aqueles observados com o <span class="elsevierStyleItalic">alelo &#8211;107T&#46;</span><a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">5&#44;6</span></a> H&#225; evid&#234;ncias de que esse polimorfismo no promotor do gene <span class="elsevierStyleItalic">PON1</span> se localiza no ponto de liga&#231;&#227;o do fator de transcri&#231;&#227;o <span class="elsevierStyleItalic">Sp1&#46;</span><a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">5&#44;6</span></a> Portanto&#44; a presen&#231;a do alelo C resulta em maior express&#227;o do gene <span class="elsevierStyleItalic">PON1</span> e maior atividade s&#233;rica da enzima&#46;<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">5&#44;6</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Dentre os fatores nutricionais&#44; os &#225;cidos graxos monoinsaturados e as vitaminas antioxidantes&#44; a exemplo das vitaminas C e E&#44; aparecem como respons&#225;veis pelo aumento da atividade da PON1&#46;<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">7&#8211;10</span></a> Da mesma forma um maior consumo de frutas&#44; verduras e legumes se associou a uma atividade mais elevada da enzima&#46;<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">9&#44;10</span></a> Por outro lado&#44; estudos indicam que o excesso de peso repercute em menor atividade da PON1&#44; inclusive na inf&#226;ncia&#46;<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">11&#8211;13</span></a> A inf&#226;ncia &#233; um per&#237;odo vulner&#225;vel da vida&#44; contudo na atualidade as crian&#231;as est&#227;o expostas a m&#250;ltiplos fatores de risco cardiovasculares e metab&#243;licos&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">14</span></a> Sabe&#8208;se que a alimenta&#231;&#227;o das crian&#231;as brasileiras &#233; pobre em frutas&#44; legumes e verduras e rica em bebidas a&#231;ucaradas&#44; biscoitos recheados&#44; hamb&#250;rgueres&#44; salgados e embutidos&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">15</span></a> Al&#233;m disso&#44; o expressivo aumento da preval&#234;ncia do excesso de peso a partir dos 5 anos correlaciona&#8208;se diretamente ao incremento de morbidades associadas na popula&#231;&#227;o infantil&#46;<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">15&#44;16</span></a> Essa alimenta&#231;&#227;o de m&#225; qualidade e o excesso de peso predisp&#245;em ao ac&#250;mulo de esp&#233;cies reativas de oxig&#234;nio&#44; ao dano oxidativo as membranas biol&#243;gicas e ao in&#237;cio de doen&#231;as&#44; em particular DCV&#46;<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">11&#44;12&#44;16</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Nesse contexto&#44; o objetivo deste estudo foi investigar a influ&#234;ncia da alimenta&#231;&#227;o&#44; do estado nutricional e do polimorfismo gen&#233;tico <span class="elsevierStyleItalic">C&#40;&#8208;107&#41;T</span> sobre a atividade arilesterase da enzima antiaterog&#234;nica PON1 na inf&#226;ncia&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">M&#233;todos</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Amostra</span><p id="par0025" class="elsevierStylePara elsevierViewall">Estudo transversal feito com crian&#231;as entre 5 e 8 anos incompletos&#44; de ambos os sexos&#44; atendidas no Ambulat&#243;rio de Pediatria da Faculdade de Medicina da Universidade Federal de Pelotas &#40;UFPEL&#41;&#44; na cidade de Pelotas &#8211; RS&#46; O protocolo de pesquisa foi aprovado pelo Comit&#234; de &#201;tica em Pesquisa da Faculdade de Medicina da UFPEL &#40;504&#46;362&#47;2013&#41;&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Crian&#231;as diagnosticadas com doen&#231;as hep&#225;ticas&#44; paralisia cerebral&#44; displasia &#243;ssea ou neoplasias&#44; aquelas portadoras de necessidades especiais &#40;f&#237;sicas ou motoras&#41; e altera&#231;&#245;es gen&#233;ticas&#44; como s&#237;ndrome de Down e talassemia&#44; foram exclu&#237;das do estudo&#46; Os respons&#225;veis das crian&#231;as eleg&#237;veis foram devidamente esclarecidos e convidados&#44; os que autorizaram a participa&#231;&#227;o no estudo assinaram um Termo de Consentimento Livre Esclarecido &#8211; TCLE&#46; O assentimento da crian&#231;a foi questionado oralmente antes do in&#237;cio das avalia&#231;&#245;es e respeitada sua decis&#227;o&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Foram entrevistadas 227 crian&#231;as&#44; dessas 193 atenderam aos crit&#233;rios de inclus&#227;o&#44; houve cinco recusas &#40;2&#44;6&#37;&#41;&#46; Noventa e uma crian&#231;as &#40;49&#44;7&#37;&#41; n&#227;o completaram o protocolo do estudo&#44; caracterizaram&#8208;se como perdas&#46; Destaca&#8208;se como causa dessas perdas o n&#227;o comparecimento ao laborat&#243;rio para coleta de sangue &#40;40&#44;0&#37;&#41;&#46; No fim&#44; o estudo contou com a participa&#231;&#227;o de 97 crian&#231;as&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Dados sociodemogr&#225;ficos&#44; antropometria e coleta de sangue</span><p id="par0040" class="elsevierStylePara elsevierViewall">Os respons&#225;veis responderam a um question&#225;rio sociodemogr&#225;fico&#44; de comportamento e de consumo alimentar das crian&#231;as&#44; foram feitas medidas antropom&#233;tricas e foi a coleta de sangue em laborat&#243;rio de an&#225;lises cl&#237;nicas&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">As duas primeiras categorias de vari&#225;veis do question&#225;rio foram renda familiar &#40;em R&#36; convertidos a sal&#225;rios m&#237;nimos vigentes&#41;&#44; idade da m&#227;e &#40;anos completos&#41;&#44; escolaridade materna &#40;anos completos de estudo&#41;&#44; n&#250;mero de pessoas no domic&#237;lio e tempo &#40;em horas&#41; frente a telas &#40;computador&#44; celular&#44; tablet&#44; videogames&#44; televis&#227;o&#41;&#46; A cor da pele foi observada e classificada como branca ou n&#227;o branca&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">O peso e altura foram coletados com balan&#231;a plataforma digital &#40;Welmy&#174;&#41;&#44; com capacidade de 150<span class="elsevierStyleHsp" style=""></span>kg e precis&#227;o de 100<span class="elsevierStyleHsp" style=""></span>g e estadi&#244;metro acoplado com capacidade de 200<span class="elsevierStyleHsp" style=""></span>cm e precis&#227;o de 0&#44;5<span class="elsevierStyleHsp" style=""></span>cm&#46; Para avaliar o estado nutricional usou&#8208;se o &#205;ndice de Massa Corporal &#40;IMC&#41; para idade em escore&#8208;z&#44; segundo recomenda&#231;&#227;o da Organiza&#231;&#227;o Mundial da Sa&#250;de de 2007&#44;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">17</span></a> por meio do programa AnthroPlus&#46; Crian&#231;as com IMC&#8208;para&#8208;idade &#62;<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>1DP foram classificadas com excesso de peso&#46; A circunfer&#234;ncia da cintura foi aferida na linha da cintura&#44; no ponto m&#233;dio entre a &#250;ltima costela e a crista il&#237;aca&#46; O referencial de compara&#231;&#227;o foi o proposto por Freedman et al&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">18</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">Ap&#243;s jejum de 12 horas amostras de 5<span class="elsevierStyleHsp" style=""></span>mL de sangue foram coletadas&#44; aliquotadas e congeladas a &#8208;80<span class="elsevierStyleSup">o</span>C para an&#225;lises posteriores&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Determina&#231;&#227;o da atividade arilesterase da PON1</span><p id="par0060" class="elsevierStylePara elsevierViewall">A atividade arilesterase da PON1 foi medida em amostras de soro com o uso de fenilacetato como substrato&#46; A atividade enzim&#225;tica foi calculada a partir da velocidade de forma&#231;&#227;o de fenol atrav&#233;s do aumento da absorb&#226;ncia a 270<span class="elsevierStyleHsp" style=""></span>nm&#44; temperatura de 25<span class="elsevierStyleHsp" style=""></span>&#176;C&#44; em espectrofot&#244;metro &#40;FEMTO&#174;&#41;&#46; As amostras foram dilu&#237;das 1&#58;3 em 20<span class="elsevierStyleHsp" style=""></span>mM de Tamp&#227;o Tris&#47;HCl &#40;Sigma Chemical Co&#44; St&#46; Louis&#44; USA&#41;&#44; pH 8&#44;0&#44; com 1<span class="elsevierStyleHsp" style=""></span>mM de CaCl<span class="elsevierStyleInf">2</span> &#40;Vetec Chemical Co&#44; RJ&#44; Br&#41;&#46; A solu&#231;&#227;o reagente foi composta pelo tamp&#227;o&#44; ao qual foi adicionado 1<span class="elsevierStyleHsp" style=""></span>mM de fenilacetato &#40;Sigma Chemical Co&#44; St&#46; Louis&#44; USA&#41;&#46; A rea&#231;&#227;o foi determinada ap&#243;s 20 segundos de reten&#231;&#227;o e a absorb&#226;ncia medida por 80 segundos&#46; Considerou&#8208;se uma unidade de atividade arilesterase da PON1 igual a 1<span class="elsevierStyleHsp" style=""></span>&#956;M de fenol&#47;minuto e essa foi expressa em U&#47;mL&#44; com base no coeficiente de extin&#231;&#227;o de fenol&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">16</span></a> As an&#225;lises foram em duplicata e amostras em branco com &#225;gua deionizada foram usadas para corrigir a hidr&#243;lise n&#227;o enzim&#225;tica&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Extra&#231;&#227;o do DNA e an&#225;lise do polimorfismo PON1 C&#40;&#8208;107&#41;T</span><p id="par0065" class="elsevierStylePara elsevierViewall">O DNA foi extra&#237;do das amostras de sangue que continham EDTA de acordo com procedimento padr&#227;o descrito previamente por Kanai et al&#46;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">19</span></a> e quantificado em espectrofot&#244;metro&#46; As amostras de DNA foram dilu&#237;das para concentra&#231;&#227;o de 50 ng&#47;mL&#46; A genotipagem dos indiv&#237;duos para o polimorfismo PON1 C&#40;&#8208;107&#41;T foi feita atrav&#233;s da t&#233;cnica de <span class="elsevierStyleItalic">restriction fragment length polymorphism</span> &#40;RFLP&#41; de acordo com o validado por Campo et al&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">20</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">Brevemente&#44; um fragmento de 240pb da regi&#227;o do promotor do gene da PON1 foi amplificado por PCR em 35 ciclos &#40;5<span class="elsevierStyleHsp" style=""></span>min a 94<span class="elsevierStyleHsp" style=""></span>&#176;C&#44; seguido por 45s a 94<span class="elsevierStyleHsp" style=""></span>&#176;C &#40;desnatura&#231;&#227;o&#41;&#44; 45s a 67<span class="elsevierStyleHsp" style=""></span>&#176;C &#40;anelamento&#41; e 45s a 72<span class="elsevierStyleHsp" style=""></span>&#176;C &#40;extens&#227;o&#41;&#44; seguido de 5<span class="elsevierStyleHsp" style=""></span>min a 72&#176; C&#41;&#46; Para tal foram usados os <span class="elsevierStyleItalic">primers</span>&#58; <span class="elsevierStyleItalic">forward</span> 5&#8217;AGCTAGCTGCGGACCCGGCGGGGAGGaG3&#8217; e <span class="elsevierStyleItalic">reverse</span> 5&#8217;GGCTGCAGCCCTCACCACAACCC3&#8217;&#46; A letra min&#250;scula no <span class="elsevierStyleItalic">primer forward</span> indica um erro de pareamento proposital introduzido no amplicon para gerar um s&#237;tio de restri&#231;&#227;o para a enzima <span class="elsevierStyleItalic">Bsr</span>BI&#44; pois n&#227;o h&#225; s&#237;tio de restri&#231;&#227;o espec&#237;fico que corte a sequ&#234;ncia original do DNA&#46; A digest&#227;o foi feita atrav&#233;s da incuba&#231;&#227;o da amostra de PCR com 3 UI da enzima <span class="elsevierStyleItalic">Bsr</span>BI &#40;New England Bio Labs&#44; Cambridge&#44; UK&#41; por duas horas a 37&#176; C&#46; Ap&#243;s a digest&#227;o os fragmentos de DNA foram separados por eletroforese em gel de agarose &#40;Kasvi&#44; Paran&#225;&#44; BR&#41; de 3&#37;&#44; corados com SYBR Safe &#40;Applied Biosystems&#41;&#46; O alelo C foi identificado pela presen&#231;a dos fragmentos de 28 e 212 pb&#44; enquanto o alelo T resultou em um fragmento de 240 pb n&#227;o digerido&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">&#205;ndice de Qualidade da Alimenta&#231;&#227;o</span><p id="par0075" class="elsevierStylePara elsevierViewall">O &#205;ndice de Qualidade da Alimenta&#231;&#227;o &#40;IQA&#41; foi elaborado com refer&#234;ncia no &#205;ndice de Alimenta&#231;&#227;o do Escolar &#40;Ales&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0255"><span class="elsevierStyleSup">21&#44;22</span></a> Por&#233;m&#44; a quest&#227;o sobre o local das refei&#231;&#245;es foi colocada no lugar da original que investigava consumo de peixe&#46; O IQA baseou&#8208;se&#58; 1&#41; na identifica&#231;&#227;o de componentes comportamentais das crian&#231;as&#44; especificamente do h&#225;bito de fazer desjejum e de fazer as refei&#231;&#245;es &#224; mesa&#59; 2&#41; na frequ&#234;ncia do consumo alimentar&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">A cada frequ&#234;ncia espec&#237;fica foi atribu&#237;da uma pontua&#231;&#227;o positiva ou negativa &#40;material suplementar&#41;&#46; Para os alimentos de alta qualidade nutricional&#44; como fruta&#44; verdura&#44; legume&#44; feij&#227;o e leite&#44; foi acrescido um ponto quando consumidos diariamente&#46; No caso de consumo menor do que sete vezes por semana &#40;duas a quatro vezes&#44; a depender do alimento&#41;&#44; foi subtra&#237;do um ponto&#46; J&#225; para alimentos de baixa qualidade nutricional&#44; como doce&#44; biscoito&#44; refrigerante&#44; salgadinho&#44; fritura&#44; maionese&#44; macarr&#227;o instant&#226;neo e hamb&#250;rguer&#44; foi acrescido um ponto quando n&#227;o consumidos ou consumidos raramente&#46; Al&#233;m disso&#44; foi subtra&#237;do um ponto para a frequ&#234;ncia di&#225;ria desses alimentos&#46; A pontua&#231;&#227;o m&#225;xima do IQA correspondeu a 15 pontos&#46; A distribui&#231;&#227;o das pontua&#231;&#245;es totais em tercis originou tr&#234;s categorias de qualidade da alimenta&#231;&#227;o&#58; baixa &#40;&#8804; 3 escore&#8208; p25&#41;&#44; m&#233;dia &#40;4 a 6 escores&#8208;p50&#41; e boa &#40;&#8805; 7 escores&#8208;p75&#41;&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">An&#225;lises estat&#237;sticas</span><p id="par0085" class="elsevierStylePara elsevierViewall">Os dados foram digitados no Microsoft Excel 2013 e analisados no programa STATA vers&#227;o 12&#46;0 &#40;Stata Corp&#46;&#44; College Station&#44; USA&#41;&#46; A normalidade dos dados foi testada a partir do teste de Shapiro&#8208;Wilk&#44; as vari&#225;veis s&#227;o apresentadas como frequ&#234;ncia absoluta e relativa&#44; m&#233;dia e desvio&#8208;padr&#227;o &#40;DP&#41;&#44; mediana e intervalo interquartil &#40;IIQ&#41;&#8208; p25&#8208;75&#46; Os testes U de Mann&#8208;Whitney ou Kruskal&#8208;Wallis foram usados para comparar os escores entre duas ou tr&#234;s categorias de vari&#225;veis&#46; O qui&#8208;quadrado foi usado para testar o equil&#237;brio de Hardy&#8208;Weinberg &#40;EHW&#41;&#44; com as frequ&#234;ncias observadas e as esperadas&#46; Na an&#225;lise n&#227;o ajustada foi usada a regress&#227;o linear simples para estimar a atividade da PON1 de acordo com o gen&#243;tipo&#46; As an&#225;lises ajustadas foram feitas por meio de regress&#227;o linear m&#250;ltipla com quatro modelos diferentes&#58; Modelo 1 &#61; incluiu vari&#225;veis sociodemogr&#225;ficas de escolaridade materna&#44; renda familiar&#44; n&#250;mero de pessoas no domic&#237;lio&#44; cor da pele e sexo&#59; Modelo 2 &#61; incluiu as frequ&#234;ncias absolutas de consumo alimentar dos alimentos de alta qualidade nutricional&#44; ao ajuste do modelo 1&#59; Modelo 3 &#61; incluiu as frequ&#234;ncias de consumo alimentar dos alimentos de baixa qualidade nutricional&#44; ao ajuste do modelo 2&#59; Modelo 4 &#61; incluiu o escore z do IMC ao ajuste do modelo 3&#46; Examinou&#8208;se a mudan&#231;a no coeficiente determina&#231;&#227;o &#40;R<span class="elsevierStyleSup">2</span>&#41; ajustado&#44; o n&#237;vel de signific&#226;ncia adotado foi de p &#60; 0&#44;05&#46;</p></span></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Resultados</span><p id="par0090" class="elsevierStylePara elsevierViewall">As caracter&#237;sticas da amostra e o escore do IQA s&#227;o apresentados na <a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#46; O sexo masculino representou 50&#44;5&#37; &#40;n &#61; 49&#41;&#44; 39&#44;2&#37; &#40;n &#61; 38&#41; tinham idade igual a 6 anos&#44; a maioria 87&#44;6&#37; &#40;n &#61; 85&#41; era de pele branca&#44; a renda familiar foi de 2 ou menos sal&#225;rios m&#237;nimos e 50&#44;5&#37; &#40;n &#61; 49&#41; permaneciam mais de duas horas&#47;dia em atividade sedent&#225;ria&#46; A circunfer&#234;ncia da cintura ficou abaixo do percentil de risco para 65&#44;0&#37; &#40;n &#61; 63&#41; da amostra e 55&#44;0&#37; &#40;n &#61; 53&#41; se encontravam eutr&#243;ficos&#46; A atividade arilesterase da PON1 correspondeu &#224; mediana de 90&#44;0 &#40;15&#8208;30&#41; U&#47;mL e 51&#44;5&#37; &#40;n &#61; 50&#41; das crian&#231;as tinham PON1 inferior a esse valor&#46; Quanto ao IQA&#44; a pontua&#231;&#227;o mediana foi de 5&#44;0 &#40;3&#44;0&#8208;7&#44;0&#41; pontos e n&#227;o houve diferen&#231;a significativa entre as pontua&#231;&#245;es segundo as caracter&#237;sticas da amostra&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall">A frequ&#234;ncia dos gen&#243;tipos para o polimorfismo <span class="elsevierStyleItalic">PON1 C&#40;&#8208;107&#41;T</span> foi de 54&#44;6&#37; &#40;53&#47;97&#41; para o gen&#243;tipo CT&#44; 31&#44;0&#37; &#40;30&#47;97&#41; para o gen&#243;tipo CC e 14&#44;4&#37; &#40;14&#47;97&#41; para o gen&#243;tipo TT&#46; A distribui&#231;&#227;o dos gen&#243;tipos mostrou que a popula&#231;&#227;o est&#225; em equil&#237;brio de Hardy&#8208;Weinberg &#40;p &#61; 0&#44;22&#41;&#46; A frequ&#234;ncia al&#233;lica foi de 58&#44;0&#37; para o alelo C e 42&#44;0&#37; para o alelo T&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">A <a class="elsevierStyleCrossRef" href="#fig0005">figura 1</a> mostra a influ&#234;ncia do gen&#243;tipo e da qualidade da alimenta&#231;&#227;o sobre a PON1&#46; A atividade arilesterase foi significativamente mais elevada no gen&#243;tipo CC comparada &#224; dos gen&#243;tipos CT e TT &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>A&#41;&#46; A PON1 mostrou n&#237;vel intermedi&#225;rio de atividade no gen&#243;tipo heterozigoto&#44; por&#233;m n&#227;o houve diferen&#231;a significativa comparada &#224; do gen&#243;tipo TT &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>A&#41;&#46; A enzima n&#227;o mostrou diferen&#231;a significativa entre as tr&#234;s categorias de qualidade da alimenta&#231;&#227;o&#44; conforme a distribui&#231;&#227;o das pontua&#231;&#245;es do IQA em tercis &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>B&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0105" class="elsevierStylePara elsevierViewall">A an&#225;lise bruta e ajustada da associa&#231;&#227;o entre a atividade da PON1 e o polimorfismo <span class="elsevierStyleItalic">PON1 C&#40;&#8208;107&#41;T</span> s&#227;o apresentados na <a class="elsevierStyleCrossRef" href="#tbl0010">tabela 2</a>&#46; Na an&#225;lise bruta as associa&#231;&#245;es foram altamente significativas&#46; Quando a an&#225;lise foi ajustada para as vari&#225;veis sociodemogr&#225;ficas&#44; de consumo alimentar e de estado nutricional&#44; a associa&#231;&#227;o entre a enzima e o polimorfismo manteve&#8208;se significativa&#46; No ajuste do modelo 1 a inclus&#227;o das vari&#225;veis sociodemogr&#225;ficas resultou num coeficiente de determina&#231;&#227;o ajustado foi de 11&#44;6&#37;&#46; J&#225; no ajuste do modelo 2 a inclus&#227;o da frequ&#234;ncia do consumo de alimentos saud&#225;veis explicou uma variabilidade de 14&#44;8&#37; na atividade da PON1&#46; A porcentagem de varia&#231;&#227;o da PON1 atribu&#237;da aos fatores gen&#233;ticos e nutricionais &#233; mostrada na &#40;<a class="elsevierStyleCrossRef" href="#fig0010">fig&#46; 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Discuss&#227;o</span><p id="par0110" class="elsevierStylePara elsevierViewall">Neste estudo mostrou&#8208;se que fatores nutricionais&#44; a exemplo da dieta e IMC&#44; combinados ao polimorfismo <span class="elsevierStyleItalic">PON1C&#40;&#8208;107&#41;T</span>&#44; s&#227;o previsores da atividade arilesterase da PON1 na inf&#226;ncia&#46; Al&#233;m disso&#44; foram significativos para explicar uma varia&#231;&#227;o de 14&#44;8&#37; na enzima&#46; O gen&#243;tipo CC e os alimentos saud&#225;veis&#44; de boa qualidade nutricional foram os fatores que destacadamente influenciaram a uma maior atividade enzim&#225;tica&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">O &#237;ndice de qualidade de alimenta&#231;&#227;o de escolares &#233; um instrumento pr&#225;tico e adequado &#224; realidade brasileira para monitorar a alimenta&#231;&#227;o de crian&#231;as&#46;<a class="elsevierStyleCrossRefs" href="#bib0255"><span class="elsevierStyleSup">21&#44;22</span></a> Uma alimenta&#231;&#227;o de m&#233;dia e boa qualidade conforme verificada no atual estudo n&#227;o significa adequa&#231;&#227;o do ponto de vista nutricional&#46; Isso foi evidenciado pela baixa pontua&#231;&#227;o atingida nos tercis mais elevados de distribui&#231;&#227;o do IQA&#46; Molina et al&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">22</span></a> avaliaram a qualidade da alimenta&#231;&#227;o de 1282 escolares e verificaram pontua&#231;&#245;es similares &#224;s que definiram a alimenta&#231;&#227;o das crian&#231;as deste estudo&#46; Al&#233;m disso&#44; Molina et al&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">22</span></a> encontraram que a maioria dos escolares consumia uma alimenta&#231;&#227;o de baixa qualidade&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Estudos sugerem uma modula&#231;&#227;o diet&#233;tica da enzima e atribuem aos antioxidantes&#44; a exemplo de vitaminas e compostos fen&#243;licos&#44; efeito protetor a sua estrutura e fun&#231;&#227;o&#46;<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">3&#44;4&#44;9</span></a> Neste estudo a presen&#231;a de alimentos de boa qualidade nutricional combinada ao polimorfismo <span class="elsevierStyleItalic">PON1C&#40;&#8208;107&#41;T</span> alterou de forma positiva a atividade da PON1&#46; Esse resultado pode ser atribu&#237;do a uma maior participa&#231;&#227;o das frutas&#44; legumes e verduras na dieta de uma parcela das crian&#231;as&#46;<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">3&#44;4&#44;9</span></a> Em particular&#44; um estudo de interven&#231;&#227;o mostrou que o consumo de seis por&#231;&#245;es di&#225;rias de frutas&#44; verduras e legumes impactou no aumento de 7&#37; na atividade arilesterase da PON1&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">9</span></a> Jarvik et al&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">10</span></a> mostraram que a atividade da PON1 correlacionou&#8208;se positiva e significativamente com o maior consumo alimentar de vitaminas antioxidantes&#44; em especial das vitaminas C e E&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Diversas pesquisas investigam a rela&#231;&#227;o entre a enzima e o estado nutricional em diferentes fases do ciclo vital&#46;<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">11&#8211;13&#44;16&#44;23&#8211;25</span></a> No entanto&#44; poucas referiram aumento da enzima associada ao IMC conforme observado no atual estudo&#46;<a class="elsevierStyleCrossRefs" href="#bib0215"><span class="elsevierStyleSup">13&#44;24&#44;25</span></a> As diverg&#234;ncias quanto ao efeito do IMC sobre a enzima podem decorrer da idade dos indiv&#237;duos selecionados&#44; uma vez que muitas amostras misturam crian&#231;as e adolescentes&#46; A obesidade nessas duas fases da vida cursa com diferen&#231;as que v&#227;o desde o tempo de exposi&#231;&#227;o ao aumento do tecido adiposo&#44; do n&#237;vel das citocinas pr&#243;&#8208;inflamat&#243;rias at&#233; o status hormonal&#46;<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">11&#44;23&#8211;25</span></a>Um maior tempo de exposi&#231;&#227;o ao excesso de peso e um aumento do estado inflamat&#243;rio&#44; ainda que esse seja de baixo grau&#44; podem refletir num efeito inibit&#243;rio sobre a enzima&#46;<a class="elsevierStyleCrossRefs" href="#bib0275"><span class="elsevierStyleSup">25&#44;26</span></a> Por&#233;m&#44; na inf&#226;ncia o aumento de peso e de forma&#231;&#227;o de esp&#233;cies reativas de oxig&#234;nio poderiam ser compensados pela eleva&#231;&#227;o da enzima&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">13</span></a> Conv&#233;m registrar que a natureza complexa da obesidade limita as especula&#231;&#245;es&#44; pois al&#233;m dos aspectos citados ainda h&#225; influ&#234;ncias do estilo de vida e da atividade f&#237;sica&#46;<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">16&#44;27</span></a> Em particular&#44; Koncsos et al&#46;<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">27</span></a> ao avaliar 151 crian&#231;as constataram que ap&#243;s uma mudan&#231;a no estilo de vida houve aumento da PON1&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">O polimorfismo <span class="elsevierStyleItalic">PON1 C&#40;&#8208;107&#41;T</span> influenciou na PON1&#44; o gen&#243;tipo CC foi relacionado a uma maior atividade&#44; o TT a uma menor atividade e o CT a um efeito intermedi&#225;rio&#46; Os polimorfismos da regi&#227;o <span class="elsevierStyleItalic">&#8208;107C&#47;T</span> t&#234;m maior efeito sobre a atividade arilesterase da enzima&#44; contribuem com 25&#37; da variabilidade de sua express&#227;o em adultos brancos&#46;<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">5&#44;6</span></a> Esses polimorfismos afetam a express&#227;o da prote&#237;na e a concentra&#231;&#227;o enzim&#225;tica&#44; indiv&#237;duos portadores do alelo T podem ter a produ&#231;&#227;o da enzima afetada&#46;<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">5&#44;6</span></a> Deakin et al&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">5</span></a> destacam um mecanismo molecular no polimorfismo <span class="elsevierStyleItalic">C&#40;&#8208;107&#41;T</span> do gene da <span class="elsevierStyleItalic">PON1</span> que envolve o fator de transcri&#231;&#227;o <span class="elsevierStyleItalic">Sp1</span>&#46; A presen&#231;a do alelo C na regi&#227;o promotora resulta em maior express&#227;o do gene <span class="elsevierStyleItalic">PON1</span> e&#44; consequentemente&#44; maior n&#237;vel de prote&#237;na na circula&#231;&#227;o e aumento na atividade da enzima&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">6</span></a> Isso condiz com a associa&#231;&#227;o entre o alelo C e maiores concentra&#231;&#227;o e atividade s&#233;rica da enzima&#44; indica que o fator de transcri&#231;&#227;o se liga a essa regi&#227;o do promotor&#44; mas com maior afinidade para a variante<span class="elsevierStyleItalic">&#8208;107C</span>&#46;<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">5&#44;6</span></a> A variante <span class="elsevierStyleItalic">&#8208;107T</span> interrompe a sequ&#234;ncia de reconhecimento do fator de transcri&#231;&#227;o <span class="elsevierStyleItalic">Sp1</span>&#44; resulta em menor concentra&#231;&#227;o de PON1 para esse gen&#243;tipo&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">5</span></a></p><p id="par0135" class="elsevierStylePara elsevierViewall">O efeito do gen&#243;tipo CC sobre a atividade da PON1 visto no atual estudo j&#225; foi apresentado em outros trabalhos com crian&#231;as na mesma faixa et&#225;ria&#46;<a class="elsevierStyleCrossRefs" href="#bib0215"><span class="elsevierStyleSup">13&#44;28</span></a> Em especial&#44; Uliano et al&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">13</span></a> mostraram que crian&#231;as com o gen&#243;tipo CC para o polimorfismo <span class="elsevierStyleItalic">PON1 C&#40;&#8722;107&#41;T</span> apresentaram maior atividade s&#233;rica da enzima do que as portadoras do gen&#243;tipo TT&#46; Ainda&#44; Huen et al&#46;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">28</span></a> constataram que a atividade da PON1 em crian&#231;as com gen&#243;tipo CC foi maior do que naquelas com o gen&#243;tipo TT&#46; A frequ&#234;ncia dos gen&#243;tipos observada neste estudo est&#225; de acordo com a de outras pesquisas&#46;<a class="elsevierStyleCrossRefs" href="#bib0290"><span class="elsevierStyleSup">28&#8211;30</span></a> Por exemplo&#44; a coorte Chamacos feita com crian&#231;as da mesma faixa et&#225;ria registrou frequ&#234;ncia similar a encontrada neste estudo&#46;<a class="elsevierStyleCrossRefs" href="#bib0290"><span class="elsevierStyleSup">28&#44;30</span></a></p><p id="par0140" class="elsevierStylePara elsevierViewall">Os resultados do presente estudo devem ser ponderados frente a seus pontos fortes e suas limita&#231;&#245;es&#46; Entre os pontos fortes encontra&#8208;se a sele&#231;&#227;o de uma amostra de crian&#231;as em fase precoce do desenvolvimento e isenta doen&#231;as cr&#244;nicas&#46; Ainda&#44; a identifica&#231;&#227;o de um polimorfismo associado a atividade de uma enzima cardioprotetora&#46; Entre as limita&#231;&#245;es est&#225; o m&#233;todo de avalia&#231;&#227;o diet&#233;tica&#44; que estima apenas a qualidade da dieta e n&#227;o estima a quantidade&#44; pode a frequ&#234;ncia do consumo ser subestimada&#46; O n&#250;mero de perdas de acompanhamento que implicou uma amostra reduzida&#44; frente &#224; estimada&#44; e limita a validade estat&#237;stica das probabilidades encontradas&#46; No entanto&#44; as an&#225;lises ajustadas foram esclarecedoras quanto &#224;s influ&#234;ncias mais relevantes para predizer a variabilidade da enzima na amostra&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">Conclui&#8208;se que na inf&#226;ncia uma alimenta&#231;&#227;o de boa qualidade&#44; com maior participa&#231;&#227;o de alimentos saud&#225;veis&#44; foi importante para predizer a atividade da enzima cardioprotetora PON1 combinada ao polimorfismo <span class="elsevierStyleItalic">C&#40;&#8208;107&#41;T</span> do gene da <span class="elsevierStyleItalic">PON1</span>&#46; Esse resultado estimula a orienta&#231;&#227;o para o alcance das metas de consumo de alimentos como frutas&#44; legumes e verduras na inf&#226;ncia&#44; especialmente na perspectiva de prevenir DCV precoce&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Financiamento</span><p id="par0150" class="elsevierStylePara elsevierViewall">Coordena&#231;&#227;o de Aperfei&#231;oamento do Pessoal de N&#237;vel Superior &#40;Capes&#41;&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Conflitos de interesse</span><p id="par0155" class="elsevierStylePara elsevierViewall">Os autores declaram n&#227;o haver conflitos de interesse&#46;</p></span></span>"
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              "titulo" => "Dados sociodemogr&#225;ficos&#44; antropometria e coleta de sangue"
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              "titulo" => "Determina&#231;&#227;o da atividade arilesterase da PON1"
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              "titulo" => "&#205;ndice de Qualidade da Alimenta&#231;&#227;o"
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            1 => "Nutri&#231;&#227;o infantil"
            2 => "Estado nutricional"
            3 => "Frequ&#234;ncia g&#234;nica"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The cardioprotective enzyme paraoxonase&#8208;1 &#40;PON1&#41; suffers an important influence from genetic polymorphisms and nutritional factors&#46; The aim of this study was to investigate the influence of diet&#44; nutritional status&#44; and the <span class="elsevierStyleItalic">C&#40;&#8208;107&#41;T</span> polymorphism on PON1 arylesterase activity in children&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">This was a cross&#8208;sectional study with 97 children&#44; aged between 5 and 8 years&#44; of both genders&#44; from a pediatric outpatient clinic in southern Brazil&#46; A sociodemographic&#44; behavioral&#44; and food consumption questionnaire was applied&#44; and anthropometric measurements and laboratory blood samples were taken&#46; PON1 arylesterase activity was measured by phenol extinction &#40;U&#47;mL&#41;&#44; and DNA extraction and analysis of the <span class="elsevierStyleItalic">PON1 C&#40;&#8208;107&#41;T</span> polymorphism were performed&#46; The Hardy&#8211;Weinberg equilibrium was tested with the chi&#8208;squared test and linear regression was used to estimate PON1 activity according to four adjustment models&#44; with an acceptable error of 5&#37;&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">In the sample&#44; the male gender accounted for 50&#46;5&#37;&#44; 39&#46;2&#37; were 6 years of age&#44; 54&#46;5&#37; had normal weight&#44; and 51&#46;5&#37; had PON1 activity below the median &#40;90&#46;0&#44; 15&#8211;30<span class="elsevierStyleHsp" style=""></span>U&#47;mL&#41;&#46; Genotype frequency was 54&#46;6&#37; &#40;53&#47;97&#41;&#44; 31&#46;0&#37; &#40;30&#47;97&#41;&#44; and 14&#46;4&#37; &#40;14&#47;97&#41;&#44; respectively&#44; for CT&#44; CC&#44; and TT&#44; consistent with the Hardy&#8211;Weinberg equilibrium &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>0&#46;22&#41;&#46; In the regression analysis&#44; the model that included sociodemographic variables as well as frequency of consumption of fruits&#44; vegetables&#44; legumes&#44; dairy products&#44; and beans estimated a variability of 14&#46;8&#37; in PON1 activity combined with the <span class="elsevierStyleItalic">PON1 C&#40;&#8208;107&#41;T</span> polymorphism&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">During childhood&#44; a good&#8208;quality diet with greater inclusion of healthy foods was important to predict the activity of the cardioprotective enzyme PON1 combined with the <span class="elsevierStyleItalic">C&#40;&#8208;107&#41;T</span> polymorphism of the PON1 gene&#46;</p></span>"
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      "pt" => array:3 [
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">A enzima cardioprotetora Paraoxonase 1 &#40;PON1&#41; sofre importante influ&#234;ncia de polimorfismos gen&#233;ticos e fatores nutricionais&#46; O objetivo deste estudo foi investigar a influ&#234;ncia da alimenta&#231;&#227;o&#44; do estado nutricional e do polimorfismo <span class="elsevierStyleItalic">C&#40;&#8208;107&#41;T</span> sobre a atividade arilesterase da PON1 em crian&#231;as&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudo transversal com 97 crian&#231;as entre 5 e 8 anos&#44; de ambos os sexos&#44; de um ambulat&#243;rio de pediatria no sul do Brasil&#46; Realizou-se question&#225;rio sociodemogr&#225;fico&#44; de comportamento e de consumo alimentar&#44; medidas antropom&#233;tricas e coleta de sangue em laborat&#243;rio&#46; A atividade arilesterase da PON1 foi mensurada pela extin&#231;&#227;o de fenol &#40;U&#47;mL&#41;&#44; realizada extra&#231;&#227;o do DNA e an&#225;lise do polimorfismo <span class="elsevierStyleItalic">PON1 C&#40;&#8208;107&#41;T&#46;</span> O equil&#237;brio de Hardy&#8208;Weinberg foi testado com qui&#8208;quadrado e usada regress&#227;o linear para estimar a atividade da PON1 segundo quatro modelos de ajuste&#44; erro aceit&#225;vel de 5&#37;&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Na amostra o sexo masculino representou 50&#44;5&#37;&#44; 39&#44;2&#37; tinham 6 anos&#44; 54&#44;5&#37; eram eutr&#243;ficos e 51&#44;5&#37; tinha atividade da PON1 inferior &#224; mediana &#40;90&#44;0&#59;15&#8208;30<span class="elsevierStyleHsp" style=""></span>U&#47;ml&#41;&#46; A frequ&#234;ncia dos gen&#243;tipos foi 54&#44;6&#37; &#40;53&#47;97&#41;&#44; 31&#44;0&#37; &#40;30&#47;97&#41; e 14&#44;4&#37; &#40;14&#47;97&#41;&#44; respectivamente&#44; para CT&#44; CC e TT&#44; estiveram em equil&#237;brio de Hardy&#8208;Weinberg &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;22&#41;&#46; Na an&#225;lise de regress&#227;o o modelo que incluiu vari&#225;veis sociodemogr&#225;ficas&#44; de frequ&#234;ncia do consumo de frutas&#44; verduras&#44; legumes&#44; latic&#237;nios e feij&#245;es estimou uma variabilidade de 14&#44;8&#37; na atividade da PON1 combinada ao polimorfismo <span class="elsevierStyleItalic">PON1 C&#40;&#8208;107&#41;T&#46;</span></p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclus&#245;es</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Na inf&#226;ncia uma alimenta&#231;&#227;o de boa qualidade&#44; com maior participa&#231;&#227;o de alimentos saud&#225;veis foi importante para predizer a atividade da enzima cardioprotetora PON1 combinada ao polimorfismo <span class="elsevierStyleItalic">C&#40;&#8208;107&#41;T</span> do gene da <span class="elsevierStyleItalic">PON1</span>&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Objetivo"
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          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "M&#233;todos"
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          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclus&#245;es"
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      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0035">Como citar este artigo&#58; Sigales TS&#44; Uliano G&#44; Muniz L&#44; Barros C&#44; Schneider A&#44; Valle SC&#46; Influence of nutritional factors and the <span class="elsevierStyleItalic">PON1 C&#40;&#8208;107&#41;T</span> polymorphism on paraoxonase&#8208;1 activity in childhood&#46; J Pediatr &#40;Rio J&#41;&#46; 2020&#59;96&#58;495&#8211;502&#46;</p>"
      ]
    ]
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      0 => array:1 [
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          0 => array:4 [
            "apendice" => "<p id="par0165" class="elsevierStylePara elsevierViewall"><elsevierMultimedia ident="upi0005"></elsevierMultimedia></p>"
            "etiqueta" => "Appendix B"
            "titulo" => "Material suplementar"
            "identificador" => "sec0070"
          ]
        ]
      ]
    ]
    "multimedia" => array:5 [
      0 => array:7 [
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        "etiqueta" => "Figura 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 2630
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            "Tamanyo" => 234440
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        "descripcion" => array:1 [
          "pt" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Atividade arilesterase da PON1&#44; de acordo com o gen&#243;tipo do polimorfismo <span class="elsevierStyleItalic">PON1 C&#40;&#8208;107&#41;T</span> &#40;A&#41; e de acordo com o IQA &#40;B&#41; de crian&#231;as entre 5 e 8 anos incompletos &#40;n &#61; 97&#41;&#44; Pelotas&#8208;RS&#46; Os dados s&#227;o apresentados como m&#233;dia &#177; dp&#44; letras diferentes indicam p &#60; 0&#44;05&#44; Anova de uma via&#46;</p>"
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      1 => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Figura 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 1404
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            "Tamanyo" => 341733
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        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Variabilidade da atividade arilesterase da PON1 explicada pelo polimorfismo <span class="elsevierStyleItalic">PON1 C&#40;&#8208;107&#41;T</span>&#44; fatores sociodemogr&#225;ficos e nutricionais em crian&#231;as entre 5 e 8 anos incompletos &#40;n &#61; 97&#41;&#44; Pelotas&#8208;RS&#46;</p>"
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        "detalles" => array:1 [
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        "tabla" => array:3 [
          "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">n&#44; n&#250;mero de indiv&#237;duos&#59; dp&#44; desvio&#8208;padr&#227;o&#46;</p>"
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#37; &#40;n&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">M&#233;dia&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Sexo</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Feminino&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">49&#44;49 &#40;48&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">5&#44;04&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">4&#44;79&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Masculino&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">50&#44;51 &#40;49&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">5&#44;10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">4&#44;64&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Idade</span><a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>5 anos&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">34&#44;02 &#40;33&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;84&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;04&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>6 anos&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">39&#44;18 &#40;38&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">5&#44;44&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">4&#44;43&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>7 anos&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">26&#44;80 &#40;26&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">4&#44;80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">4&#44;68&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Cor da pele</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Branca&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">87&#44;63 &#40;85&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">5&#44;00&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">4&#44;78&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>N&#227;o branca&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#44;37 &#40;12&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">5&#44;58&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">4&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Renda familiar</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#8804; 2 sal&#225;rios m&#237;nimos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">84&#44;54 &#40;82&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#44;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;54&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#62; 2 sal&#225;rios m&#237;nimos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&#44;36 &#40;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#44;33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#44;55&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Tempo frente a tela</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#8804; 2 horas&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">49&#44;48 &#40;40&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#44;75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;48&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#62; 2 horas&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">50&#44;52 &#40;49&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">4&#44;75&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">4&#44;81&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " colspan="4" align="left" valign="\n
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                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Circunfer&#234;ncia da cintura</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Adequada&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">64&#44;95 &#40;63&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;95&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;89&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Elevada&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33&#44;05 &#40;33&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">5&#44;27&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " colspan="4" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Excesso de peso&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>CC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&#44;27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;7&#44;99&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;39&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">105&#44;22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="7" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="7" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">An&#225;lise ajustada</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="7" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Modelo 1</span><a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">a</span></a></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>TT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">77&#44;37&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;16&#44;28&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">REF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;011</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#44;60</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">REF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>CT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#44;59&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;7&#44;54&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">83&#44;96&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>CC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27&#44;75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;8&#44;23&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;48&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">105&#44;12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="7" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="7" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Modelo 2</span><a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">b</span></a></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>TT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">71&#44;19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;18&#44;87&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">REF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;011</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&#44;80</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">REF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>CT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#44;25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;7&#44;89&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">81&#44;44&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>CC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30&#44;32&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;8&#44;27&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;53&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">101&#44;51&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="7" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="7" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Modelo 3</span><a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">c</span></a></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>TT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">69&#44;31&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;19&#44;88&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">REF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;048</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#44;90</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">REF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>CT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#44;71&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;8&#44;17&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">80&#44;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>CC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">31&#44;41&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;8&#44;64&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;55&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&#44;72&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="7" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="7" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Modelo 4</span><a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">d</span></a></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>TT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">68&#44;76&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;19&#44;77&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">REF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;041</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#44;00</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">REF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
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