RESUMO
Although, in randomized clinical trials, once-weekly subcutaneous semaglutide (OW s.c.) has demonstrated superior efficacy in comparison with placebo and active controls in terms of glycemic control and body weight reduction in patients with type 2 diabetes mellitus (T2DM), these results need to be confirmed in a real-world (RW) setting. An RW ambispective study (6 months retrospective and 6 months prospective) was conducted in 10 tertiary hospitals in Spain. We evaluated changes in HbA1c and body weight in patients with T2DM treated with semaglutide OW s.c. Additionally, we analyzed different subgroups of patients treated with semaglutide OW s.c. as an add-on to glucose-lowering therapy. A total of 752 patients with a mean age of 60.2 years, a mean HbA1c level of 8.5%, a mean body weight of 101.6 kg, and a mean T2DM duration of 10 years were included. At 12 months, compared with baseline, there was a mean difference of -2.1% in HbA1c levels (p < 0.001) and a mean difference of 9.2 kg in body weight (p < 0.001). Moreover, there were statistically significant differences (p < 0.001) between baseline and month 12 in both HbA1c and body weight in the four subgroups receiving semaglutide OW s.c. as an add-on to glucose-lowering therapy. Semaglutide OW s.c. was well tolerated, with gastrointestinal disorders being the most commonly reported side effects. In this RW study, 12 months of treatment with semaglutide OW s.c. in patients with T2DM was associated with significant and clinically relevant improvements in glycemic control and weight loss, regardless of the glucose-lowering therapy received, and the overall safety profile was positive.
Assuntos
Diabetes Mellitus Tipo 2 , Peptídeos Semelhantes ao Glucagon , Hemoglobinas Glicadas , Hipoglicemiantes , Humanos , Diabetes Mellitus Tipo 2/tratamento farmacológico , Diabetes Mellitus Tipo 2/sangue , Masculino , Feminino , Pessoa de Meia-Idade , Peptídeos Semelhantes ao Glucagon/administração & dosagem , Peptídeos Semelhantes ao Glucagon/efeitos adversos , Espanha , Hemoglobinas Glicadas/análise , Hipoglicemiantes/administração & dosagem , Idoso , Injeções Subcutâneas , Estudos Prospectivos , Glicemia/efeitos dos fármacos , Estudos Retrospectivos , Redução de Peso/efeitos dos fármacos , Peso Corporal/efeitos dos fármacos , Resultado do Tratamento , Esquema de Medicação , Controle Glicêmico/métodosRESUMO
Associations between dyslipidemia and metabolic dysfunction-associated steatotic liver disease (MASLD) have been reported. Previous studies have shown that the triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio may be a surrogate marker of MASLD, assessed by liver ultrasound. However, no studies have evaluated the utility of this ratio according to biopsy-proven MASLD and its stages. Therefore, our aim was to evaluate if the TG/HDL-C ratio allows for the identification of biopsy-proven MASLD in patients with obesity. We conducted a case-control study in 153 patients with obesity who underwent metabolic surgery and had a concomitant liver biopsy. Fifty-three patients were classified as no MASLD, 45 patients as metabolic dysfunction-associated steatotic liver-MASL, and 55 patients as metabolic dysfunction-associated steatohepatitis-MASH. A receiver operating characteristic (ROC) analysis was performed to assess the accuracy of the TG/HDL-C ratio to detect MASLD. We also compared the area under the curve (AUC) of the TG/HDL-C ratio, serum TG, and HDL-C. A higher TG/HDL-C ratio was observed among patients with MASLD, compared with patients without MASLD. No differences in the TG/HDL-C ratio were found between participants with MASL and MASH. The greatest AUC was observed for the TG/HDL-C ratio (AUC 0.747, p < 0.001) with a cut-off point of 3.7 for detecting MASLD (sensitivity = 70%; specificity = 74.5%). However, no statistically significant differences between the AUC of the TG/HDL-C ratio and TG or HDL-C were observed to detect MASLD. In conclusion, although an elevated TG/HDL-C ratio can be found in patients with MASLD, this marker did not improve the detection of MASLD in our study population, compared with either serum TG or HDL-C.
Assuntos
HDL-Colesterol , Fígado Gorduroso , Doenças Metabólicas , Obesidade , Triglicerídeos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Biópsia , Estudos de Casos e Controles , HDL-Colesterol/sangue , Fígado Gorduroso/sangue , Fígado Gorduroso/complicações , Fígado Gorduroso/diagnóstico , Fígado Gorduroso/patologia , Doenças Metabólicas/sangue , Doenças Metabólicas/complicações , Doenças Metabólicas/diagnóstico , Doenças Metabólicas/patologia , Obesidade/sangue , Obesidade/complicações , Obesidade/patologia , Curva ROC , Triglicerídeos/sangue , Biomarcadores/sangueRESUMO
Despite the abundance of registered clinical trials worldwide, the availability of effective drugs for obesity treatment is limited due to their associated side effects. Thus, there is growing interest in therapies that stimulate energy expenditure in white adipose tissue. Recently, we demonstrated that the delivery of a miR-21 mimic using JetPEI effectively inhibits weight gain in an obese mouse model by promoting metabolism, browning, and thermogenesis, suggesting the potential of miR-21 mimic as a treatment for obesity. Despite these promising results, the implementation of more advanced delivery system techniques for miR-21 mimic would greatly enhance the advancement of safe and efficient treatment approaches for individuals with obesity in the future. Our objective is to explore whether a new delivery system based on gold nanoparticles and Gemini surfactants (Au@16-ph-16) can replicate the favorable effects of the miR-21 mimic on weight gain, browning, and thermogenesis. We found that dosages as low as 0.2 µg miR-21 mimic /animal significantly inhibited weight gain and induced browning and thermogenic parameters. This was evidenced by the upregulation of specific genes and proteins associated with these processes, as well as the biogenesis of beige adipocytes and mitochondria. Significant increases in miR-21 levels were observed in adipose tissue but not in other tissue types. Our data indicates that Au@16-ph-16 could serve as an effective delivery system for miRNA mimics, suggesting its potential suitability for the development of future clinical treatments against obesity.
Assuntos
Nanopartículas Metálicas , MicroRNAs , Obesidade , Animais , Camundongos , Tecido Adiposo Marrom/metabolismo , Metabolismo Energético , Ouro/farmacologia , Concentração de Íons de Hidrogênio , Camundongos Endogâmicos C57BL , MicroRNAs/genética , Obesidade/tratamento farmacológico , Termogênese , Aumento de PesoRESUMO
CONTEXT: Metabolic dysfunction-associated steatotic liver disease (MASLD) is characterized by the intracellular lipid accumulation in hepatocytes. Excess caloric intake and high-fat diets are considered to significantly contribute to MASLD development. OBJECTIVE: To evaluate the hepatic and serum fatty acid (FA) composition in patients with different stages of MASLD, and their relationship with FA dietary intake and MASLD-related risk factors. METHODS: This was a case-control study in patients with obesity undergoing bariatric surgery at a university hospital between January 2020 and December 2021. Participants were distributed in 3 groups: no MASLD (n = 26), steatotic liver disease (n = 33), and metabolic dysfunction-associated steatohepatitis (n = 32). Hepatic and serum FA levels were determined by gas chromatography-mass spectrometry. Nutritional status was evaluated using validated food frequency questionnaires. The hepatic expression of genes involved in FA metabolism was analyzed by reverse transcription quantitative polymerase chain reaction. RESULTS: The hepatic, but not serum, FA profiles were significantly altered in patients with MASLD compared with those without MASLD. No differences were observed in FA intake between the groups. Levels of C16:0, C18:1, and the C18:1/C18:0 ratio were higher, while C18:0 levels and C18:0/C16:0 ratio were lower in patients with MASLD, being significantly different between the 3 groups. Hepatic FA levels and ratios correlated with histopathological diagnosis and other MASLD-related parameters. The expression of genes involved in the FA metabolism was upregulated in patients with MASLD. CONCLUSION: Alterations in hepatic FA levels in MASLD patients were due to enhancement of de novo lipogenesis in the liver.
Assuntos
Ácidos Graxos , Fígado Gorduroso , Lipidômica , Fígado , Obesidade , Humanos , Masculino , Feminino , Estudos de Casos e Controles , Adulto , Pessoa de Meia-Idade , Fígado/metabolismo , Fígado/patologia , Obesidade/metabolismo , Obesidade/complicações , Ácidos Graxos/metabolismo , Fígado Gorduroso/metabolismo , Fígado Gorduroso/patologia , Metabolismo dos Lipídeos , Cirurgia BariátricaRESUMO
Esta investigación se ha llevado a cabo para conocer las diferencias en las variables temporales que conforman la competencia docente "Tiempo de compromiso motor" en la clase de Danza Clásica, bien acompañada de música grabada o por profesor pianista acompañante de danza. Se ha procedido al análisis de 50 grabaciones con ambos soportes musicales en un Conservatorio Superior de Danza de 89 alumnas que realizaban sus clases en un aula de ballet. Los resultados obtenidos destacan que según el soporte musical utilizado hay diferencias en las categorías de "Tiempo de Tarea" y "Tiempo de Organización", mostrándose un mayor valor en el "Tiempo de Tarea" en las sesiones en las que se utilizó la música en vivo, así como un menor tiempo en la "Organización", por lo que emplear la música en vivo podría proporcionar sesiones más productivas y con menor pérdida de tiempo
Esta pesquisa foi realizada com o objetivo de conhecer as diferenças nas variáveis temporais que compõem a competência docente, "Tempo de compromisso motor" nas aulas de Dança Clássica, seja acompanhado por música gravada ou por professor pianista acompanhando a dança. A análise de 50 gravações com ambos os suportes musicais foi realizada em um Conservatório Superior de Dança de 89 alunos que realizaram suas aulas em uma sala de ballet. Os resultados obtidos destacam que, de acordo com o suporte musical utilizado, existem diferenças nas categorias de "Tempo de Tarefa" e "Tempo de Organização", mostrando um maior valor no "Tempo de Tarefa" nas sessões em que a música ao vivo foi utilizada, bem como um menor tempo na "Organização", de modo que o uso de música ao vivo poderia proporcionar sessões mais produtivas com menor perda de tempo
This study looked into time variable differences in the teaching competence "Time of motor commitment" in Classical Dance lessons accompanied by either recorded music or a pianist teacher. Fifty recordings of 89 students of a Higher Education Dance Conservatory were analyzed in their ballet lessons with both musical supports. The results show differences in the categories of "Task Time" and "Organization Time" according to the musical support used, showing longer "Task Time" and shorter "Organization time" in lessons with live music. Therefore, live music could provide more productive lessons with less loss of time
Assuntos
Humanos , Masculino , Feminino , Adulto , Dança , Música , Tempo , Docentes/educaçãoRESUMO
Determinar la masa grasa y sus diferencias estimadas por técnicas de antropometría y bioimpedancia eléctrica de cuerpo entero, así como presentar datos de masa muscular esquelética en jóvenes en edad escolar, por métodos antropométricos. Método: Se ha procedido a la valoración de la composición corporal de 75 niños y 75 niñas de entre 12 y 18 años, mediante técnicas antropométricas y de bioimpedancia eléctrica de cuerpo entero para estimar la masa grasa (Slaughter y Houtkooper, respectivamente), así como la masa muscular esquelética (Poortmans). El análisis estadístico consistió en un estudio comparativo entre métodos que se realizó mediante la prueba de la t de Student, un estudio correlacional mediante el coeficiente de correlación de Spearman, así como un estudio de concordancia entre métodos mediante los procedimientos de Bland-Altman. Resultados: No existen diferencias significativas de la masa grasa determinada por ambos métodos (p > 0.05). Existen diferencias estadísticas en la masa muscular esquelética entre niños y niñas (p < 0.05). El estudio de concordancia muestra pequeñas diferencias entre métodos con errores proporcionales para el grupo de niños, no así en niñas,y con muy amplios límites de concordancia entre métodos. Conclusiones: En general, se puede concluir que la metodología antropométrica y de bioimpedancia eléctrica para la estimación de la composición corporal no son intercambiables para valoraciones longitudinales, en niños en edad escolar de 12 a 18 años, y aunque se observan pequeñas diferencias, existe un efecto de error proporcional entre método...