Effect of glucocorticoids on glyceroneogenesis in adipose tissue: A systematic review.

Glyceroneogenesis is important for the maintenance of fat content in white adipose tissue (WAT). An increase in WAT, and especially the pattern of fat distribution, specifically in visceral depots, potentially contributes to cardiovascular and metabolic diseases, such as type 2 diabetes mellitus, myocardial infarction and hypertension. Recent studies have shown important differences in glyceroneogenesis of different fat sites under the administration of glucocorticoids (GCs). Such differences need to be analysed with criteria evidencing the parameter studied, the type of corticoid, the form of administration and also the tissue studied. PubMed, Scopus and Virtual Health Library were used to search for articles that analysed the effect of GCs on glyceroneogenesis in different sites of adipose tissue in mammals and primary cultures. GCs decrease the glyceroneogenesis in epididymal WAT (EWAT) and also decrease the expression of the mRNA, content and activity of phosphoenolpyruvate carboxykinase (PEPCK-C), key enzyme of glyceroneogenesis. However, in retroperitoneal WAT (RWAT), although there is no consensus about the effect of GCs on PEPCK mRNA, GCs increase PEPCK-C activity and glyceroneogenesis flux. In inguinal WAT (IWAT) an in vitro study showed an increase in the PEPCK mRNA induced by dexamethasone. However, prednisolone does not change glyceroneogenesis flux. In interscapular brown adipose tissue (IBAT) prednisolone or dexamethasone does not change PEPCK-C activity in control diet-fed rats but led to a decrease in PEPCK-C activity in fasted- or high-fat/low-carbohydrate diet-fed rats, as well as in suckling rats. Despite that fact that GCs have different potencies, the same dose of dexamethasone reduces PEPCK-C activity in EWAT, but not in RWAT and IBAT from control-diet fed rats. In summary, the data presented in this article show that GCs differentially regulate glyceroneogenesis in different sites of adipose tissue. Further experiments are needed to firmly establish our hypothesis and clarify the mechanisms involved.

Space-time analysis of the incidence of human visceral leishmaniasis (VL) and prevalence of canine VL in a municipality of southeastern Brazil: Identification of priority areas for surveillance and control.

Human and canine visceral leishmaniasis (HVL and CVL, respectively) represent serious public health issues in Brazil. The surveillance and control measures currently employed have had limited effect in impeding the territorial expansion of the disease and in reducing the number of cases. We have investigated the space-time distribution of HVL incidence rates and CVL prevalence in the coverage areas of the 148 primary healthcare units in Belo Horizonte (MG, Brazil) during a 6-year period in order to identify those that should be prioritized for disease control actions. Data were smoothed using the empirical Bayes method and analyzed by space-time scanning and application of univariate global Moran's I index and local indicators of spatial association (LISA) statistics to identify spatial autocorrelations. Point data of CVL were analyzed using the Kernel method. Bivariate global Moran's I and LISA techniques were employed to identify spatial correlations between HVL and CVL. Based on our results, we were able to formulate two proposals for establishing the prioritization of coverage areas, namely: (i) classification of maximum priority areas as identified by bivariate LISA for HVL and CVL, and (ii) combination of maximum priority areas with high priority areas as identified by univariate LISA for HVL. According to our proposals, 27 coverage areas in Belo Horizonte were categorized as maximum priority and a further 13 were classified as high priority. Our proposals, which are based on practical, feasible and inexpensive statistical tools, will contribute to a better understanding of VL distribution in urban settings and improving the efficiency of governmental control programs.