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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Introdu&#231;&#227;o</span><p id="par0005" class="elsevierStylePara elsevierViewall">A resistina &#233; uma adipocitocina com fun&#231;&#245;es biol&#243;gicas pleiotr&#243;picas&#46;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">1</span></a> Foi inicialmente estudada em camundongos&#44; nos quais mostra liga&#231;&#227;o com obesidade e diabetes&#59;<a class="elsevierStyleCrossRefs" href="#bib0135"><span class="elsevierStyleSup">1&#8211;4</span></a> em virtude de sua a&#231;&#227;o mediadora da resist&#234;ncia &#224; insulina&#44; foi denominada resistina&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">5</span></a> Em seres humanos&#44; &#233; expressa principalmente em leuc&#243;citos e macr&#243;fagos e estimula c&#233;lulas imunes a promover a secre&#231;&#227;o de citocinas pr&#243;&#8208;inflamat&#243;rias&#44; como TNF&#8208;alfa&#44; IL &#40;interleucina&#41;&#8208;1B e IL&#8208;6 por meio da via de sinaliza&#231;&#227;o do fator nuclear KB<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">6</span></a> e est&#225; ligada &#224; disfun&#231;&#227;o endotelial&#46; Obesidade&#44; aterosclerose&#44; eventos cardiovasculares e doen&#231;as autoimunes foram associados &#224; eleva&#231;&#227;o dos n&#237;veis s&#233;ricos de resistina&#46;<a class="elsevierStyleCrossRefs" href="#bib0160"><span class="elsevierStyleSup">6&#44;7</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">A psor&#237;ase &#233; uma doen&#231;a inflamat&#243;ria cr&#244;nica cut&#226;nea associada &#224; obesidade&#44; resist&#234;ncia &#224; insulina e doen&#231;as cardiometab&#243;licas<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">8&#8211;10</span></a>&#44; nas quais a resistina pode desempenhar papel ativo&#46; Entretanto&#44; os estudos sobre essa associa&#231;&#227;o apresentam resultados contradit&#243;rios&#46; Metan&#225;lise incluindo nove estudos de caso&#8208;controle com pacientes caucasianos e asi&#225;ticos sugeriu que os n&#237;veis de resistina eram acentuadamente mais altos em pacientes com psor&#237;ase do que nos controles&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">11</span></a> Alguns autores encontraram associa&#231;&#227;o da concentra&#231;&#227;o de resistina com a atividade da doen&#231;a &#40;medida pelo escore PASI &#91;do ingl&#234;s <span class="elsevierStyleItalic">Psoriasis Area Severity Index</span>&#93;&#44; ou &#205;ndice de &#193;rea e Gravidade da Psor&#237;ase&#41;&#44; enquanto outros n&#227;o encontraram essa associa&#231;&#227;o&#46;<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">8&#44;12</span></a> O envolvimento ungueal &#233; outro aspecto cl&#237;nico associado aos n&#237;veis de resistina&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">12</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Psor&#237;ase cut&#226;nea &#233; doen&#231;a multiforme com diversas variantes cl&#237;nicas&#59; a mais comum &#233; a psor&#237;ase vulgar ou psor&#237;ase em placas&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">13</span></a> Ela tamb&#233;m pode afetar as unhas e o couro cabeludo e&#44; em quase 30&#37; dos casos&#44; evoluir para artrite psori&#225;sica&#44; que pode assumir v&#225;rios padr&#245;es&#44; afetando quase todas as articula&#231;&#245;es do corpo&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">13</span></a> Al&#233;m disso&#44; a taxa de associa&#231;&#227;o com comorbidades como obesidade&#44; diabetes&#44; hipertens&#227;o etc&#46;&#44; pode contribuir para a heterogeneidade da popula&#231;&#227;o estudada&#46; Essa variedade pode ser ainda mais amplificada por fatores gen&#233;ticos predisponentes que mudam de acordo com a regi&#227;o geogr&#225;fica da popula&#231;&#227;o estudada&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">9</span></a> Assim&#44; os resultados encontrados nos n&#237;veis de resistina podem sofrer influ&#234;ncia dessa diversidade e isso pode explicar algumas das discrep&#226;ncias encontradas&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Neste trabalho&#44; os autores estudaram uma amostra de pacientes brasileiros com psor&#237;ase com o objetivo de comparar os n&#237;veis de resistina em pacientes com psor&#237;ase e controles e verificar se esses n&#237;veis diferem em pacientes com psor&#237;ase de acordo com o espectro cl&#237;nico apresentado&#44; atividade da doen&#231;a e fatores de risco cardiovascular associados&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Material e m&#233;todos</span><p id="par0025" class="elsevierStylePara elsevierViewall">Este &#233; um estudo transversal aprovado pelo Comit&#234; de &#201;tica em Pesquisa local sob o n&#250;mero de protocolo 4&#46;166&#46;908&#46; Todos os participantes assinaram o termo de consentimento livre e informado&#46; Para serem inclu&#237;dos&#44; os pacientes com psor&#237;ase deveriam ter o diagn&#243;stico de psor&#237;ase feito por um dermatologista certificado ou comprovado na histopatologia e ter mais de 18 anos de idade&#46; Os pacientes foram recrutados em ambulat&#243;rios de dermatologia e reumatologia de um &#250;nico centro terci&#225;rio de sa&#250;de no per&#237;odo de 20 de abril a 21 de dezembro e inclu&#237;dos de acordo com a ordem de agendamento e disposi&#231;&#227;o para participar do estudo&#46; Indiv&#237;duos com quaisquer outras doen&#231;as inflamat&#243;rias cr&#244;nicas associadas&#44; insufici&#234;ncia renal cr&#244;nica ou gravidez foram exclu&#237;dos&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">A coleta de dados incluiu&#58;<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">a&#41;</span><p id="par0035" class="elsevierStylePara elsevierViewall">Dados epidemiol&#243;gicos &#40;idade&#44; sexo&#44; etnia autodeclarada&#44; tabagismo&#44; etilismo&#44; pr&#225;tica de exerc&#237;cios f&#237;sicos &#91;pelo menos 30 minutos&#44; tr&#234;s vezes&#47;semana&#93;&#41;&#46;</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">b&#41;</span><p id="par0040" class="elsevierStylePara elsevierViewall">Dados cl&#237;nicos&#58;</p></li></ul></p><p id="par0045" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0010"><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">&#8208;</span><p id="par0050" class="elsevierStylePara elsevierViewall">Sobre a psor&#237;ase&#58; tipo de psor&#237;ase&#44; escore PASI&#44;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">14</span></a> envolvimento ungueal e do couro cabeludo e tratamento utilizado&#59;</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">&#8208;</span><p id="par0055" class="elsevierStylePara elsevierViewall">Sobre a artrite psori&#225;sica&#58; subtipo de envolvimento articular&#44; presen&#231;a de dactilite&#44; uve&#237;te&#44; atividade da doen&#231;a medida por DAPSA &#40;do ingl&#234;s <span class="elsevierStyleItalic">Disease Activity in Psoriatic Arthritis</span>&#41;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">15</span></a> e tratamento utilizado&#46; O escore PASI foi calculado considerando&#8208;se a gravidade do envolvimento cut&#226;neo &#40;eritema&#44; infiltra&#231;&#227;o e descama&#231;&#227;o&#41; e a porcentagem de &#225;rea afetada&#46; Esse &#237;ndice vai de 0 a 72&#44; com valores mais altos significando doen&#231;a mais grave&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">14</span></a> DAPSA &#233; a medida da atividade da artrite psori&#225;sica que leva em considera&#231;&#227;o o n&#250;mero de articula&#231;&#245;es sens&#237;veis e tumefeitas&#44; a percep&#231;&#227;o dos pacientes sobre a atividade da doen&#231;a&#44; a dor e os n&#237;veis de prote&#237;na C&#8208;reativa&#46; Valores &#8804; 4 significam remiss&#227;o da artrite&#59;<span class="elsevierStyleHsp" style=""></span>&#62; 4 e &#8804; 14&#44; baixa atividade da doen&#231;a&#59;<span class="elsevierStyleHsp" style=""></span>&#62; 14 e &#8804; 28&#44; atividade moderada&#59; e<span class="elsevierStyleHsp" style=""></span>&#62; 28&#44; alta atividade da doen&#231;a&#59;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">15</span></a></p></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">&#8208;</span><p id="par0060" class="elsevierStylePara elsevierViewall">Sobre fatores de risco cardiovascular&#58; medida de altura e peso para c&#225;lculo do &#237;ndice de massa corporal &#40;IMC&#41;&#44; circunfer&#234;ncia abdominal e press&#227;o arterial&#59; dados sobre a coexist&#234;ncia de diabetes&#44; dislipidemia&#44; hipertens&#227;o&#46; Os pacientes foram classificados como tendo ou n&#227;o s&#237;ndrome metab&#243;lica&#44; de acordo com os crit&#233;rios do NCEP&#8208;ATP III&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">16</span></a></p></li></ul></p><p id="par0065" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0015"><li class="elsevierStyleListItem" id="lsti0030"><span class="elsevierStyleLabel">c&#41;</span><p id="par0070" class="elsevierStylePara elsevierViewall">Dados bioqu&#237;micos&#58; n&#237;veis de colesterol total&#44; HDL&#8208;colesterol ou lipoprote&#237;na de alta densidade&#44; LDL&#8208;colesterol ou lipoprote&#237;na de baixa densidade&#44; triglicer&#237;deos&#44; glicemia de jejum&#44; hemoglobina A1c&#44; hemograma&#44; VHS ou velocidade de hemossedimenta&#231;&#227;o e PCR ou prote&#237;na C&#8208;reativa foram medidos&#46;</p></li><li class="elsevierStyleListItem" id="lsti0035"><span class="elsevierStyleLabel">d&#41;</span><p id="par0075" class="elsevierStylePara elsevierViewall">Medida da espessura da camada m&#233;dia da car&#243;tida&#58; a medida da espessura da camada &#237;ntima&#8208;m&#233;dia carot&#237;dea &#40;eIMC&#41; foi realizada por um &#250;nico investigador&#44; cego para dados cl&#237;nicos&#44; com aparelho de ultrassom Esaote&#174; de alta resolu&#231;&#227;o&#44; modelo MyLab40&#44; em modo B e com transdutor linear de 18<span class="elsevierStyleHsp" style=""></span>MHz&#46; Os pacientes foram estudados em ambiente silencioso&#44; com ar condicionado a 22<span class="elsevierStyleHsp" style=""></span>&#176;C&#44; em dec&#250;bito dorsal&#44; com o pesco&#231;o estendido em rota&#231;&#227;o de 45&#176; contralateral ao lado examinado&#46; A art&#233;ria car&#243;tida foi observada nos planos transversal e longitudinal&#59; a medida foi realizada a uma dist&#226;ncia de 10 a 20<span class="elsevierStyleHsp" style=""></span>mm da bifurca&#231;&#227;o carot&#237;dea&#44; na parede distal do vaso&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">17</span></a> O exame foi realizado em ambos os lados&#59; para fins estat&#237;sticos&#44; foi considerado o valor mais alto&#46; Os valores de refer&#234;ncia utilizados foram 0&#44;4 a 0&#44;7<span class="elsevierStyleHsp" style=""></span>mm como eIMC normal&#59; 0&#44;8 a 1&#44;4<span class="elsevierStyleHsp" style=""></span>mm como eIMC espessada &#40;aterosclerose subcl&#237;nica&#41;&#59; e valores maiores ou iguais a 1&#44;5<span class="elsevierStyleHsp" style=""></span>mm&#44; como ateroma&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">18</span></a></p></li><li class="elsevierStyleListItem" id="lsti0040"><span class="elsevierStyleLabel">e&#41;</span><p id="par0080" class="elsevierStylePara elsevierViewall">Dosagem de resistina&#58; 5<span class="elsevierStyleHsp" style=""></span>mL de sangue venoso foram coletados de veia perif&#233;rica e o soro foi separado em al&#237;quotas e conservado em freezer a &#8722;80<span class="elsevierStyleHsp" style=""></span>&#176;C at&#233; a dosagem&#46; A medida foi realizada utilizando kit ELISA comercial &#40;Elabscience&#44; EUA&#41;&#44; com faixa de detec&#231;&#227;o de 0&#44;31&#8764;2 ng&#47;mL&#46;</p></li></ul></p><p id="par0085" class="elsevierStylePara elsevierViewall">A coleta de dados epidemiol&#243;gicos&#44; dados cl&#237;nicos&#44; coleta de sangue e a medida da eIMC foram realizadas simultaneamente&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Como controle&#44; foram inclu&#237;dos os acompanhantes dos pacientes&#44; pareados por sexo e idade e sem nenhuma doen&#231;a inflamat&#243;ria cr&#244;nica&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">An&#225;lise estat&#237;stica</span><p id="par0095" class="elsevierStylePara elsevierViewall">A distribui&#231;&#227;o dos dados num&#233;ricos obtidos foi estudada pelo teste de Shapiro&#8208;Wilk e sua compara&#231;&#227;o foi realizada pelo teste <span class="elsevierStyleItalic">t</span> n&#227;o pareado ou teste de Mann&#8208;Whitney&#46; Os dados nominais foram comparados usando o teste de Fisher e qui&#8208;quadrado&#46; Estudos de correla&#231;&#227;o dos n&#237;veis de resistina com as vari&#225;veis num&#233;ricas estudadas &#40;idade&#44; perfil lip&#237;dico e glic&#234;mico&#44; VHS&#44; PCR&#44; PASI&#44; DAPSA&#44; IMC e eIMC&#41; foram realizados pelo teste de Spearman&#46; O n&#237;vel de signific&#226;ncia adotado foi de 0&#44;05&#46; Os estudos foram realizados com o MedCalc&#174; Statistical Software vers&#227;o 20&#46;015 &#40;MedCalc Software Ltd&#44; Ostend&#44; B&#233;lgica&#59; <a href="https://www.medcalc.org;/">https&#58;&#47;&#47;www&#46;medcalc&#46;org&#59;</a> 2021&#41;&#46;</p></span></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Resultados</span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Descri&#231;&#227;o da amostra estudada e compara&#231;&#227;o entre pacientes com psor&#237;ase e controles</span><p id="par0100" class="elsevierStylePara elsevierViewall">Aproximadamente 119 indiv&#237;duos foram inclu&#237;dos&#58; 34 controles e 85 indiv&#237;duos com psor&#237;ase&#44; dos quais 42 &#40;49&#44;4&#37;&#41; com envolvimento apenas cut&#226;neo e 43 &#40;50&#44;6&#37;&#41; com artrite psori&#225;sica associada&#46; A descri&#231;&#227;o da amostra de psor&#237;ase estudada &#233; mostrada na <a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0105" class="elsevierStylePara elsevierViewall">A <a class="elsevierStyleCrossRef" href="#tbl0010">tabela 2</a> mostra a compara&#231;&#227;o entre pacientes com psor&#237;ase e controles&#46; Os dados s&#227;o pareados para idade&#44; sexo e etnia e que tabagismo era mais comum entre os pacientes com psor&#237;ase&#46; Os pacientes com psor&#237;ase apresentaram maior &#237;ndice de massa corporal&#44; mais diabetes <span class="elsevierStyleItalic">mellitus</span> &#40;DM&#41;&#44; hipertens&#227;o arterial e s&#237;ndrome metab&#243;lica do que os controles&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0110" class="elsevierStylePara elsevierViewall">A compara&#231;&#227;o dos resultados de medida da eIMC e n&#237;veis s&#233;ricos de resistina entre pacientes com psor&#237;ase e controles &#233; mostrada na <a class="elsevierStyleCrossRef" href="#fig0005">figura 1</a>&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Estudo dos n&#237;veis s&#233;ricos de resistina segundo vari&#225;veis de pacientes com psor&#237;ase</span><p id="par0115" class="elsevierStylePara elsevierViewall">Os valores dos n&#237;veis s&#233;ricos de resistina segundo as vari&#225;veis epidemiol&#243;gicas&#44; cl&#237;nicas e terap&#234;uticas s&#227;o mostrados na <a class="elsevierStyleCrossRef" href="#tbl0015">tabela 3</a>&#44; revelando que pacientes com s&#237;ndrome metab&#243;lica e com DM apresentaram n&#237;veis s&#233;ricos mais elevados de resistina&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0120" class="elsevierStylePara elsevierViewall">A <a class="elsevierStyleCrossRef" href="#tbl0020">tabela 4</a> apresenta os resultados da correla&#231;&#227;o dos n&#237;veis s&#233;ricos de resistina com perfil lip&#237;dico e glic&#234;mico&#44; VHS&#44; PCR&#44; PASI&#44; DAPSA&#44; idade&#44; IMC e eIMT&#46; Colesterol total e triglic&#233;rides que mostraram correla&#231;&#227;o positiva modesta&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Discuss&#227;o</span><p id="par0125" class="elsevierStylePara elsevierViewall">Os resultados do presente estudo confirmaram a alta associa&#231;&#227;o da psor&#237;ase com fatores de risco ateroscler&#243;tico&#46; De fato&#44; esses pacientes tamb&#233;m apresentaram valores elevados de eIMC&#44; mostrando os resultados dessa associa&#231;&#227;o&#46; Os n&#237;veis s&#233;ricos de resistina foram maiores na psor&#237;ase do que nos controles&#44; e essa adipocina pode ser um dos atores subjacentes ao quadro encontrado&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Entretanto&#44; quando a amostra de pacientes com psor&#237;ase foi estudada&#44; os valores observados dos n&#237;veis de resistina n&#227;o se associaram ao grau de envolvimento cut&#226;neo nem &#224; presen&#231;a ou atividade da doen&#231;a naqueles com artrite psori&#225;sica&#46; No entanto&#44; &#233; importante observar que os pacientes com psor&#237;ase estudados na presente amostra tinham baixo grau de envolvimento cut&#226;neo medido pelo escore PASI&#44; bem como a mediana do &#237;ndice inflamat&#243;rio no caso de artrite era compat&#237;vel com baixa atividade da doen&#231;a&#46; Os pacientes da presente amostra eram provenientes de um ambulat&#243;rio de servi&#231;o de sa&#250;de terci&#225;rio que trata pacientes de maneira intensiva&#44; visando a remiss&#227;o da doen&#231;a&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">O estudo dos n&#237;veis s&#233;ricos de resistina em associa&#231;&#227;o com o escore PASI tem mostrado resultados contradit&#243;rios&#46; Takahashi et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">8</span></a> estudando pacientes japoneses com psor&#237;ase&#44; encontraram associa&#231;&#227;o entre os n&#237;veis de resistina e os escores PASI e que os n&#237;veis s&#233;ricos de resistina diminu&#237;ram com o tratamento&#46; Coban et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">19</span></a> estudando pacientes na Turquia com psor&#237;ase avaliando a associa&#231;&#227;o do escore PASI com v&#225;rias adipocinas antes e ap&#243;s o tratamento&#44; n&#227;o conseguiram provar que os n&#237;veis s&#233;ricos de resistina diminu&#237;ram com a melhora do escore PASI&#46; &#214;zdemir et al&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">12</span></a> tamb&#233;m n&#227;o encontraram nenhuma correla&#231;&#227;o entre n&#237;veis de resistina e PASI&#44; mas uma correla&#231;&#227;o positiva com o escore NAPSI &#40;<span class="elsevierStyleItalic">Nail Psoriasis Severity Index</span>&#41;&#46; Essas discrep&#226;ncias podem ser parcialmente explicadas pelo diferente espectro da doen&#231;a dos pacientes psori&#225;sicos&#44; como mencionado anteriormente&#44; mas tamb&#233;m pela influ&#234;ncia dos regimes de tratamento adotados&#44; como a terapia anti&#8208;TNF alfa&#46; A resistina n&#227;o apenas estimula a secre&#231;&#227;o de TNF alfa&#44; como tamb&#233;m tem sua produ&#231;&#227;o induzida por essa mesma citocina&#44; sugerindo a exist&#234;ncia de um ciclo patog&#234;nico que favorece a produ&#231;&#227;o de citocinas inflamat&#243;rias&#44; juntamente com a secre&#231;&#227;o de resistina&#46;<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">20&#44;21</span></a> No presente estudo&#44; os n&#237;veis de resistina nos indiv&#237;duos em uso de terapia anti&#8208;TNF n&#227;o diferiu daqueles que n&#227;o a usavam&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">Aqui&#44; as vari&#225;veis ligadas aos n&#237;veis de resistina foram as de comorbidades como dislipidemia e diabetes&#46; Essa associa&#231;&#227;o n&#227;o se restringe &#224; psor&#237;ase&#44; e &#233; observada em outras situa&#231;&#245;es cl&#237;nicas&#44; como em pacientes com sobrepeso e obesidade com DM tipo 1&#44;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">22</span></a> doen&#231;a renal cr&#244;nica&#44;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">23</span></a> doen&#231;a arterial coronariana e no acidente vascular cerebral aterotromb&#243;tico&#44;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">24</span></a> sugerindo que a expans&#227;o e a desregula&#231;&#227;o do tecido adiposo branco associada &#224; obesidade leva &#224; secre&#231;&#227;o de adipocitocina e a inflama&#231;&#227;o &#233; o elo subjacente nesse contexto&#46; Os macr&#243;fagos que se infiltram no tecido adiposo branco encontrados na gordura visceral e da pele s&#227;o considerados uma das principais fontes de resistina em seres humanos&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">25</span></a> Pacientes com psor&#237;ase s&#227;o mais frequentemente obesos do que a popula&#231;&#227;o em geral&#44; como observado no presente estudo&#44; e a obesidade foi considerada fator de risco para o aparecimento de psor&#237;ase&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">26</span></a> Curiosamente&#44; Toussirot et al&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">26</span></a> descobriram que a gordura visceral se acumula mais em pacientes apenas com psor&#237;ase cut&#226;nea do que naqueles com psor&#237;ase e artrite associada&#46; Os autores n&#227;o conseguiram comprovar diferen&#231;as nos n&#237;veis de resistina nos grupos com e sem artrite&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">Um achado inesperado foi a falta de correla&#231;&#227;o entre os n&#237;veis de resistina e eIMC&#44; embora a eIMC fosse maior em pacientes com psor&#237;ase do que nos controles&#46; Uma poss&#237;vel explica&#231;&#227;o &#233; que os n&#237;veis s&#233;ricos de resistina refletem a medida dessa mol&#233;cula em um &#250;nico momento&#44; enquanto a aterosclerose &#233; um processo constru&#237;do ao longo de um per&#237;odo&#46; Al&#233;m disso&#44; vale a pena notar que as medidas de eIMC nos pacientes com psor&#237;ase n&#227;o foram muito altas &#40;valor m&#233;dio de 0&#44;68<span class="elsevierStyleHsp" style=""></span>mm e valor superior de 0&#44;85<span class="elsevierStyleHsp" style=""></span>mm&#41;&#44; provavelmente em decorr&#234;ncia de uma vigil&#226;ncia cl&#237;nica rigorosa&#59; isso pode ter tido alguma influ&#234;ncia nos resultados&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">Este trabalho &#233; limitado por seu desenho transversal e pelo n&#250;mero restrito de pacientes inclu&#237;dos&#46; Seu principal valor &#233; demonstrar que existe associa&#231;&#227;o dos n&#237;veis de resistina em pacientes com psor&#237;ase&#44; principalmente naqueles com comorbidades&#44; e que as comorbidades s&#227;o&#44; provavelmente&#44; o principal alvo do tratamento para evitar a eleva&#231;&#227;o dessa adipocitocina s&#233;rica nesse cen&#225;rio&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Conclus&#227;o</span><p id="par0155" class="elsevierStylePara elsevierViewall">Este estudo mostrou que&#44; em uma amostra de pacientes brasileiros com psor&#237;ase&#44; os n&#237;veis s&#233;ricos de resistina est&#227;o elevados e associados &#224; presen&#231;a de DM e s&#237;ndrome metab&#243;lica e correlacionam&#8208;se com n&#237;veis de triglic&#233;rides s&#233;ricos e colesterol total&#46; N&#227;o foi encontrada nenhuma correla&#231;&#227;o dos n&#237;veis s&#233;ricos de resistina com a atividade da doen&#231;a ou eIMC&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Aprova&#231;&#227;o &#233;tica</span><p id="par0160" class="elsevierStylePara elsevierViewall">Todos os procedimentos realizados em estudos envolvendo participantes humanos estavam de acordo com os padr&#245;es &#233;ticos do comit&#234; de pesquisa institucional e com a Declara&#231;&#227;o de Helsinki de 1964 e suas emendas posteriores ou padr&#245;es &#233;ticos compar&#225;veis&#46; Este estudo foi aprovado pelo Comit&#234; de &#201;tica em Pesquisa da Faculdade de Medicina Evang&#233;lica Mackenzie sob o protocolo n&#250;mero 4&#46;166&#46;908&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Suporte financeiro</span><p id="par0180" class="elsevierStylePara elsevierViewall">Nenhum&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Contribui&#231;&#227;o dos autores</span><p id="par0185" class="elsevierStylePara elsevierViewall">Sofia Makishi Schlenker&#58; Aprova&#231;&#227;o da vers&#227;o final do manuscrito&#59; concep&#231;&#227;o e planejamento do estudo&#59; elabora&#231;&#227;o e reda&#231;&#227;o do manuscrito&#59; obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; participa&#231;&#227;o efetiva na orienta&#231;&#227;o da pesquisa&#59; participa&#231;&#227;o intelectual em conduta proped&#234;utica e&#47;ou terap&#234;utica de casos estudados&#59; revis&#227;o cr&#237;tica da literatura&#59; revis&#227;o cr&#237;tica do manuscrito&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">Sofia Inez Munhoz&#58; Aprova&#231;&#227;o da vers&#227;o final do manuscrito&#59; concep&#231;&#227;o e planejamento do estudo&#59; elabora&#231;&#227;o e reda&#231;&#227;o do manuscrito&#59; obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; participa&#231;&#227;o efetiva na orienta&#231;&#227;o da pesquisa&#59; participa&#231;&#227;o intelectual em conduta proped&#234;utica e&#47;ou terap&#234;utica de casos estudados&#59; revis&#227;o cr&#237;tica da literatura&#59; revis&#227;o cr&#237;tica do manuscrito&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">Andr&#233; Rochinski Busanello&#58; Aprova&#231;&#227;o da vers&#227;o final do manuscrito&#59; obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; participa&#231;&#227;o intelectual em conduta proped&#234;utica e&#47;ou terap&#234;utica de casos estudados&#59; revis&#227;o cr&#237;tica da literatura&#46;</p><p id="par0200" class="elsevierStylePara elsevierViewall">Matheus Guedes Sanches&#58; Aprova&#231;&#227;o da vers&#227;o final do manuscrito&#59; obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; participa&#231;&#227;o intelectual em conduta proped&#234;utica e&#47;ou terap&#234;utica de casos estudados&#59; revis&#227;o cr&#237;tica da literatura</p><p id="par0205" class="elsevierStylePara elsevierViewall">Barbara Stadler Kahlow&#58; Aprova&#231;&#227;o da vers&#227;o final do manuscrito&#59; obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; participa&#231;&#227;o intelectual em conduta proped&#234;utica e&#47;ou terap&#234;utica de casos estudados&#59; revis&#227;o cr&#237;tica da literatura</p><p id="par0210" class="elsevierStylePara elsevierViewall">Renato Nisihara&#58; An&#225;lise estat&#237;stica&#59; Aprova&#231;&#227;o da vers&#227;o final do manuscrito&#59; elabora&#231;&#227;o e reda&#231;&#227;o do manuscrito&#59; obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; participa&#231;&#227;o intelectual em conduta proped&#234;utica e&#47;ou terap&#234;utica de casos estudados&#59; revis&#227;o cr&#237;tica da literatura&#59; revis&#227;o cr&#237;tica do manuscrito</p><p id="par0215" class="elsevierStylePara elsevierViewall">Thelma Skare&#58; An&#225;lise estat&#237;stica&#59; aprova&#231;&#227;o da vers&#227;o final do manuscrito&#59; concep&#231;&#227;o e planejamento do estudo&#59; elabora&#231;&#227;o e reda&#231;&#227;o do manuscrito&#59; 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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Fundamentos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A psor&#237;ase &#233; uma doen&#231;a proteica associada a v&#225;rias comorbidades que podem ter n&#237;veis aumentados de adiponectinas&#44; como a resistina&#46; Isso pode afetar o risco ateroscler&#243;tico do paciente&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objetivo</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudar os n&#237;veis de resistina em amostra de pacientes brasileiros com psor&#237;ase e sua associa&#231;&#227;o com o quadro cl&#237;nico&#44; comorbidades e espessura da camada intima&#8208;m&#233;dia carot&#237;dea &#40;eIMC&#41;&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">M&#233;todos</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Este &#233; um estudo transversal envolvendo 119 indiv&#237;duos&#58; 34 controles saud&#225;veis e 85 pacientes com psor&#237;ase&#44; dos quais 42 apenas com acometimento cut&#226;neo e 43 com artrite psori&#225;sica&#46; Dados cl&#237;nicos e epidemiol&#243;gicos&#44; escores PASI &#40;do ingl&#234;s <span class="elsevierStyleItalic">Psoriasis Area and Severity Index</span>&#41; e DAPSA &#40;do ingl&#234;s <span class="elsevierStyleItalic">Disease Activity in PSoriatic Arthritis</span>&#41;&#44; perfil lip&#237;dico&#44; eIMC por ultrassom foram coletados de prontu&#225;rios m&#233;dicos&#46; Os n&#237;veis s&#233;ricos de resistina foram medidos por ELISA&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Os pacientes com psor&#237;ase apresentaram n&#237;veis de resistina mais elevados &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;009&#41; e pior eIMC &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;0002&#41; do que os controles&#46; Na amostra de pacientes com psor&#237;ase&#44; n&#227;o foram encontradas associa&#231;&#245;es dos n&#237;veis de resistina com achados epidemiol&#243;gicos&#44; cl&#237;nicos e &#237;ndices de atividade&#46; N&#237;veis s&#233;ricos de resistina foram associados &#224; presen&#231;a de diabetes &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;008&#41; e s&#237;ndrome metab&#243;lica &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41; e correlacionados com colesterol total &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;26&#41; e triglic&#233;rides &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;33&#41;&#44; mas n&#227;o com eIMC&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Limita&#231;&#245;es do estudo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Este trabalho &#233; limitado por seu desenho transversal e pelo n&#250;mero limitado de pacientes inclu&#237;dos&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Conclus&#227;o</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Os n&#237;veis s&#233;ricos de resistina est&#227;o elevados em pacientes com psor&#237;ase&#46; Nesta amostra&#44; os &#237;ndices cl&#237;nicos&#44; epidemiol&#243;gicos e de atividade n&#227;o estavam associados aos n&#237;veis s&#233;ricos de resistina&#44; mas os fatores de risco ateroscler&#243;tico mostraram essa associa&#231;&#227;o&#46;</p></span>"
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Psor&#237;ase em placas &#8211; &#40;n&#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">71&#47;85 <span class="elsevierStyleBold">&#8208;</span> 83&#44;5&#37;&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>Palmoplantar&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">13&#47;85 <span class="elsevierStyleBold">&#8208;</span> 15&#44;2&#37;&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>Pustular&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">2&#47;85 <span class="elsevierStyleBold">&#8208;</span> 2&#44;3&#37;&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>Eritrod&#233;rmica&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">2&#47;85 <span class="elsevierStyleBold">&#8208;</span> 2&#44;3&#37;&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="elsevierStyleItalic">Envolvimento ungueal &#40;n&#41;</span>&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">38&#47;85 <span class="elsevierStyleBold">&#8208;</span> 44&#44;7&#37;&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="elsevierStyleItalic">Envolvimento do couro cabeludo &#40;n&#41;</span>&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">57&#47;85 <span class="elsevierStyleBold">&#8208;</span> 67&#44;0&#37;&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="elsevierStyleItalic">PASI &#8211; mediana &#40;IIQ&#41;</span>&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">2&#44;9 &#40;0&#44;6<span class="elsevierStyleBold">&#8208;</span>6&#44;6&#41;&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="elsevierStyleItalic">Artrite</span><a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&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">43&#47;85 <span class="elsevierStyleBold">&#8208;</span> 50&#44;5&#37;&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>Poliarticular &#8211; &#40;n&#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">18&#47;43 <span class="elsevierStyleBold">&#8208;</span> 41&#44;8&#37;&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>Oligoarticular &#8211; &#40;n&#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">20&#47;43 <span class="elsevierStyleBold">&#8208;</span> 46&#44;5&#37;&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>Interfal&#226;ngica distal &#8211; &#40;n&#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&#47;43 <span class="elsevierStyleBold">&#8208;</span> 11&#44;6&#37;&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>Envolvimento axial &#8211;&#40;n&#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">14&#47;43 <span class="elsevierStyleBold">&#8208;</span> 32&#44;5&#37;&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>DAPSA &#8211; mediana &#40;IIQ&#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">14&#44;00 &#40;4&#44;27<span class="elsevierStyleBold">&#8208;</span>22&#44;16&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\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>Metotrexato&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">24&#47;85 <span class="elsevierStyleBold">&#8208;</span> 28&#44;2&#37;&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>Acitretina&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">5&#47;85 <span class="elsevierStyleBold">&#8208;</span> 5&#44;8&#37;&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>Leflunomida&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">3&#47;85 <span class="elsevierStyleBold">&#8208;</span> 3&#44;5&#37;&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>Anti&#8208;TNF&#8208;alfa&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">21&#47;85 <span class="elsevierStyleBold">&#8208;</span> 24&#44;7&#37;&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>Anti&#8208;IL&#8208;17&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">10&#47;85 <span class="elsevierStyleBold">&#8208;</span> 11&#44;7&#37;&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>Anti&#8208;IL&#8208;12&#47;23&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">9&#47;85 <span class="elsevierStyleBold">&#8208;</span> 10&#44;5&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">51&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#44;93&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">42&#47;43&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">34&#47;11&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">0&#44;10&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><span class="elsevierStyleItalic">Origem &#233;tnica autodeclarada</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#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="" valign="\n
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                  \t\t\t\t">&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="" valign="\n
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                  \t\t\t\t">&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><span class="elsevierStyleHsp" style=""></span>Caucasianos&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 &#40;81&#44;1&#37;&#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">29 &#40;85&#44;2&#37;&#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="" valign="\n
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                  \t\t\t\t">&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><span class="elsevierStyleHsp" style=""></span>Afrodescendentes&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">16 &#40;18&#44;8&#37;&#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 &#40;14&#44;7&#37;&#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="" valign="\n
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                  \t\t\t\t">&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><span class="elsevierStyleItalic">Tabagismo &#40;n&#41;</span>&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="" valign="\n
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                  \t\t\t\t">&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="" valign="\n
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                  \t\t\t\t">&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">0&#44;002&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><span class="elsevierStyleHsp" style=""></span>Atual&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&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">2&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="" valign="\n
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                  \t\t\t\t">&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><span class="elsevierStyleHsp" style=""></span>Ex&#8208;tabagista&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">17&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">2&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="" valign="\n
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                  \t\t\t\t">&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><span class="elsevierStyleHsp" style=""></span>N&#227;o&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">46&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&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="" valign="\n
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                  \t\t\t\t">&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><span class="elsevierStyleItalic">Pr&#225;tica de exerc&#237;cios &#40;n&#41;</span>&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">33 &#40;38&#44;8&#37;&#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">12 &#40;35&#44;2&#37;&#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;83&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><span class="elsevierStyleItalic">Etilismo &#40;n&#41;</span>&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">29 &#40;34&#44;1&#37;&#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">13 &#40;38&#44;2&#37;&#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;70&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="elsevierStyleBold">Fatores de risco cardiovascular</span></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><span class="elsevierStyleItalic">Mediana de &#237;ndice de massa corporal &#8211; kg&#47;m</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">&#40;IIQ&#41;</span>&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">28&#44;9 &#40;26&#44;0<span class="elsevierStyleBold">&#8208;</span>32&#44;3&#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">26&#44;4 &#40;22&#44;3<span class="elsevierStyleBold">&#8208;</span>31&#44;1&#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"><span class="elsevierStyleBold">0&#44;05</span>&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><span class="elsevierStyleItalic">Hipertens&#227;o arterial &#40;n&#41;</span>&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">41 &#40;48&#44;2&#37;&#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">7 &#40;20&#44;5&#37;&#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"><span class="elsevierStyleBold">0&#44;005</span><a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">a</span></a>&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><span class="elsevierStyleItalic">Diabetes mellitus &#40;n&#41;</span>&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 &#40;25&#44;8&#37;&#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">2 &#40;5&#44;8&#37;&#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"><span class="elsevierStyleBold">0&#44;01</span><a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">b</span></a>&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><span class="elsevierStyleItalic">Dislipidemia &#40;n&#41;</span>&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">42 &#40;49&#44;4&#37;&#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">10 &#40;29&#44;4&#37;&#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;10&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><span class="elsevierStyleItalic">Circunfer&#234;ncia abdominal &#40;cm&#41; &#40;IIQ&#41;</span>&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">102 &#40;96&#44;0<span class="elsevierStyleBold">&#8208;</span>111&#44;8&#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">94 &#40;84&#44;5<span class="elsevierStyleBold">&#8208;</span>107&#44;0&#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"><span class="elsevierStyleBold">0&#44;01</span>&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><span class="elsevierStyleItalic">Mediana de colesterol total <span class="elsevierStyleBold">&#8208;</span> mg&#47;dL &#40;IIQ&#41;</span>&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">193&#44;0 &#40;170&#44;0<span class="elsevierStyleBold">&#8208;</span>225&#44;0&#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">195&#44;0 &#40;157&#44;0<span class="elsevierStyleBold">&#8208;</span>217&#44;0&#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;49&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><span class="elsevierStyleItalic">Mediana de HDL&#8208;colesterol <span class="elsevierStyleBold">&#8208;</span> mg&#47;dL &#40;IIQ&#41;</span>&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">45&#44;0 &#40;40&#44;0<span class="elsevierStyleBold">&#8208;</span>53&#44;8&#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">48&#44;9 &#40;44&#44;9<span class="elsevierStyleBold">&#8208;</span>56&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;06&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
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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><span class="elsevierStyleItalic">Mediana de LDL&#8208;colesterol <span class="elsevierStyleBold">&#8208;</span> mg&#47;dL &#40;IIQ&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;15&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
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                  \t\t\t\t"><span class="elsevierStyleItalic">Envolvimento do couro cabeludo</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;73&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">DAPSA&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;07&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"><span class="elsevierStyleBold">&#8208;</span>0&#44;34 a 0&#44;46&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;72&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">Taxa de hemossedimenta&#231;&#227;o&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"><span class="elsevierStyleBold">&#8208;</span>0&#44;22&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"><span class="elsevierStyleBold">&#8208;</span>0&#44;46 a 0&#44;05&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;10&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">Prote&#237;na C&#8208;reativa&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;05&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"><span class="elsevierStyleBold">&#8208;</span>0&#44;34 a 0&#44;46&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;72&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">&#205;ndice de massa corporal&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;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"><span class="elsevierStyleBold">&#8208;</span>0&#44;01 a 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">0&#44;05&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">Circunfer&#234;ncia abdominal&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;13&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"><span class="elsevierStyleBold">&#8208;</span>0&#44;13 a 0&#44;38&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;32&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">Colesterol total&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;26&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;003 a 0&#44;49&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"><span class="elsevierStyleBold">0&#44;04</span>&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">HDL&#8208;colesterol&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;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"><span class="elsevierStyleBold">&#8208;</span>0&#44;24 a 0&#44;28&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;86&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">LDL&#8208;colesterol&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;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
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">&#8208;</span>0&#44;16 a 0&#44;36&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;42&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">Triglic&#233;rides&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;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">0&#44;07 a 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"><span class="elsevierStyleBold">0&#44;01</span>&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">Glicemia&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;14&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"><span class="elsevierStyleBold">&#8208;</span>0&#44;13 a 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">0&#44;29&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">Hemoglobina A1c&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"><span class="elsevierStyleBold">&#8208;</span>0&#44;15 a 0&#44;38&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;37&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">eIMC&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"><span class="elsevierStyleBold">&#8208;</span>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"><span class="elsevierStyleBold">&#8208;</span>0&#44;40 a 0&#44;17&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;41&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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        "descripcion" => array:1 [
          "pt" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Avalia&#231;&#227;o da correla&#231;&#227;o dos n&#237;veis s&#233;ricos de resistina com marcadores inflamat&#243;rios&#44; perfil glic&#234;mico e lip&#237;dico&#44; idade&#44; dados antropom&#233;tricos e espessura da camada &#237;ntima&#8208;m&#233;dia carot&#237;dea &#40;eIMC&#41;</p>"
        ]
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      "titulo" => "Refer&#234;ncias"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Resistin&#44; a novel host defense peptide of innate immunity"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "Y&#46; Li"
                            1 => "Q&#46; Yang"
                            2 => "D&#46; Cai"
                            3 => "H&#46; Guo"
                            4 => "J&#46; Fang"
                            5 => "H&#46; Cui"
                          ]
                        ]
                      ]
                    ]
                  ]
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                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Front Immunol&#46;"
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                        "paginaFinal" => "807"
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              "identificador" => "bib0140"
              "etiqueta" => "2"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Resistin and obesity&#8208;associated insulin resistance"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "C&#46;M&#46; Steppan"
                            1 => "M&#46;A&#46; Lazar"
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                        ]
                      ]
                    ]
                  ]
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                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Trends Endocrinol Metab&#46;"
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                        "volumen" => "13"
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                      ]
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effects of resistin expression on glucose metabolism and hepatic insulin resistance"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "F&#46; Li"
                            1 => "J&#46; He"
                            2 => "Z&#46; Li"
                            3 => "Z&#46; Luo"
                            4 => "L&#46; Yan"
                            5 => "Y&#46; Li"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s12020-009-9148-4"
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                        "tituloSerie" => "Endocrine&#46;"
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                        "paginaInicial" => "243"
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                        "link" => array:1 [
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Regulation of insulin signalling&#44; glucose uptake and metabolism in rat skeletal muscle cells upon prolonged exposure to resistin"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "R&#46; Palanivel"
                            1 => "A&#46; Maida"
                            2 => "Y&#46; Liu"
                            3 => "G&#46; Sweeney"
                          ]
                        ]
                      ]
                    ]
                  ]
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                    0 => array:2 [
                      "doi" => "10.1007/s00125-005-0060-z"
                      "Revista" => array:6 [
                        "tituloSerie" => "Diabetologia&#46;"
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                        "volumen" => "49"
                        "paginaInicial" => "183"
                        "paginaFinal" => "190"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Resistin&#58; a journey from metabolism to cancer"
                      "autores" => array:1 [
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                          "autores" => array:5 [
                            0 => "A&#46; Deb"
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                            2 => "P&#46; Ramteke"
                            3 => "F&#46;K&#46; Bhati"
                            4 => "M&#46;K&#46; Bhat"
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                      ]
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                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Transl Oncol&#46;"
                        "fecha" => "2021"
                        "volumen" => "14"
                        "paginaInicial" => "101"
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