Evaluation of epicardial fat tissue thickness as a marker of cardiovascular risk in patients with subclinical hypothyroidism.

BACKGROUND: Epicardial fat thickness (EFT) has been evaluated as a marker of cardiovascular disease, with good correlation with classical cardiovascular risk factors in the general population. The aim of this study was to evaluate the EFT in subclinical hypothyroidism (SCH), in comparison to a group without thyroid dysfunction. METHODS: A cross-sectional study was performed with 100 participants, including 52 SCH patients and 48 individuals without any thyroid dysfunction (euthyroid group-EU). Transthoracic echocardiography (TE), thyroid hormone levels, lipid profile, and assessment of body composition by bioelectrical impedance (BIA) and anthropometry were measured in all subjects. RESULTS: The SCH and EU groups were comparable with respect to age, gender, and Framingham risk scores. Serum thyroid-stimulating hormone (TSH) was 6.7 ± 1.4 mIU/L in the SCH group and 2.0 ± 0.84 mIU/L in the control group. EFT was similar in both groups (SCH 3.5 ± 1.3 mm, EU 3.5 ± 1.1 mm, p = 0.43). EFT showed a slight trend for a positive correlation with serum TSH in the SCH group (r s = 0.263, p = 0.05). EFT correlated with the body fat percentage in the SCH group (r s = 0.350, p = 0.03) and EU group (r s = 0.033, p = 0.04). EFT in this cohort was not independently correlated to changes in TSH and Framingham risk score. CONCLUSIONS: EFT determination by TE does not seem to be a good marker of cardiovascular risk in SCH patients with serum TSH <10.0 mIU/L and no pre-existing cardiovascular morbidity.

The effectiveness of relative dose response to retinol intake as an evaluation of vitamin A status of cirrhotic patients.

BACKGROUND: The liver is the main organ involved in homeostasis, metabolism and the storage of retinol. During the fibrotic process, hepatic stellate cells lose their lipid drops, and retinol reserves may deplete. Thus, the present study aimed to evaluate serum retinol levels (RL), hepatic retinol storage and dietary vitamin A intake in cirrhotic patients. METHODS: RL were measured by high-performance liquid chromatography in fifty-eight cirrhotic patients. Fasting RL <1.05 µmol L⁻¹ indicates vitamin A deficiency (VAD). A relative dose response (RDR) to oral retinol ≥20% indicates an inadequate hepatic retinol reserve (positive test). Severe malnutrition was defined as a mid-arm muscle circumference (MAMC) and/or triceps skinfold thickness (TSF) below the 5th percentile and moderate malnutrition as MAMC and/or TSF below the 10th percentile. Vitamin A daily intake was estimated by a specific questionnaire. The Child-Pugh classification of liver disease severity and the Model for End-Stage Liver Disease were used. RESULTS: Low RL were found in 60% of the patients. Twenty-three cirrhotic patients had adequate fasting RL (RL = 1.34; 1.05-2.12 µmol L⁻¹) and negative RDR, indicating efficient liver stores. Among thirty-five cirrhotic patients with low RL, 43% had negative RDR (RL = 0.42; 0.06-0.82 µmol L⁻¹) and 57% had positive RDR (RL = 0.45; 0.09-0.93 µmol L⁻¹). Malnutrition (36%) and inadequate vitamin A intake (55%) were not associated with fasting RL or RDR. CONCLUSIONS: VAD was highly prevalent in cirrhotic patients. However, in those with low serum RL and negative RDR, factors other than inadequate vitamin A intake, such as impaired hepatic vitamin A mobilization and intestinal vitamin A malabsorption, which were not examined in the present study, could have influenced the negative results obtained by the RDR method.

Inhibition of bacterial translocation by chronic ethanol consumption in the rat.

Chronic ethanol ingestion has been associated with small intestine morphological changes, disrupted host mucosal defenses and bacterial overgrowth. Since bacterial translocation (BT) may result from such alterations, we have investigated the potential effect of chronic ethanol consumption on BT. For this purpose, male Wistar rats were fed a liquid diet containing 5% v/v ethanol for 4 weeks (EG, n=16), and a pair-fed group received equal daily amounts of calories in a similar diet without ethanol (PFG, n=16). On experimental day 29, distal ileum ligature and small intestine inoculation of a tetracycline-resistant E. coli strain (Tc E. coli R6) followed by duodenal ligature was performed. After 1 or 5 h post inoculation, mesenteric lymph nodes, liver, spleen and kidney were excised. Unexpectedly, rats of the EG presented markedly less BT to the mesenteric lymph nodes (p<0.001) and to the other organs examined compared to rats of the PFG. This BT inhibition was observed at 1 and 5 h after bacterial inoculation, and may be attributed exclusively to chronic ethanol ingestion. Since alcoholism is well known to decrease host immunity, these results suggest that other factors, independent of the immune function, may be involved in the BT inhibition observed in this study.

Plasma-kallikrein clearance during liver regeneration after partial hepatectomy in the rat.

AIMS/BACKGROUND: The liver clears circulating plasma-kallikrein through a receptor-mediated endocytosis process: an initial fast phase is followed by a slow exponential phase. METHODS: To determine whether the clearance rate of plasma-kallikrein is affected during liver regeneration, we perfused isolated rat livers with rat plasma-kallikrein (rPK) at 0, 1, 2, 3 and 7 days after partial hepatectomy or sham operation. RESULTS: Liver regeneration was followed by the expression of the proliferating-cell nuclear antigen (PCNA) labeling index. The serum concentration of alpha2-macroglobulin, an acute phase protein in rats, was measured. At day 1, the fast phase of rPK clearance rate increased in hepatectomized rats when compared with day 0 (4.9+/-0.4 and 3.7+/-0.4 mU/g liver min, p<0.05). However, at day 2, the rPK fast phase clearance rate dropped significantly (2.6+/-0.2, p<0.05), when compared with day 1. No difference was found among the sham groups at different days of hepatectomy. These changes seem to be independent of the acute phase reaction. The regenerative liver weight increased continuously during the observation period. PCNA expression increased significantly after hepatectomy, with maximal PCNA-labeling indices at days 1 and 2, declining thereafter. CONCLUSION: The rPK fast phase clearance rate changes during liver regeneration, with a zenith occurring when PCNA labeling index is maximal (day 1) and a nadir occurring at the mitotic phase (day 2).

Ileum brush border alkaline phosphatase activity in an experimental model of chronic alcoholism after small bowel proximal resection in the rat.

Literature reports that chronically ingested ethanol induces changes in the morphology of the small bowel mucous membranes. It has a topical toxic effect on the epithelium of the proximal jejunum and a blood-borne effect on the epithelium of the ileum because its absorption is almost complete in the stomach, duodenum and proximal jejunum. In addition there are also reports showing stimulation of enterocyte proliferation after segmental intestine resection. In this report we compare a group of rats submitted to resection of the proximal jejunum and fed a liquid diet containing 35% of the total calories intake as ethanol for four weeks to its control pair-fed group. In both groups we studied the mucosal alkaline phosphatase (APase) activity by histochemical as well as biochemical methods. We found a decreased APase activity in the homogenate of the intestinal mucous membrane in the alcoholic group and a reduced enzymatic activity in the brush border of the ileum enterocytes, as demonstrated by histochemical qualitative and densitometric assays. The result suggests that this change in APase activity of the brush border may represent enterocyte immaturity induced by long-standing ethanol intake in the remnant ileum after proximal resection.

Effect of chronic ethanol consumption on the activities of residual small bowel brush-border enzymes after proximal jejunum resection in the rat.

Ethanol consumption has a toxic effect on the epithelium of the small bowel, but enterocyte maturity is very difficult to measure under these circumstances. However, when ethanol intake is combined with enterectomy, enterocyte immaturity is greater, permitting an easier separation of these two effects. In a group of rats (13 male Wistar rats weighing approximately 220 g) fed a liquid diet containing 35% ethanol for 4 weeks after resection of the proximal jejunum, the residual small intestine brush border maltase, sucrase, and lactase activities were similar to those of a pair-fed control group (13 animals). However, alkaline phosphatase activity was decreased in the mucosa and in the enterocyte brush border, probably because of the lower activity of this enzyme in the jejunum-ileum remnant of the alcoholic group.