Evaluation of Anticancer and Anti-Inflammatory Activities of Some Synthetic Rearranged Abietanes.

Synthesis of the rearranged abietane diterpenes pygmaeocins C and D, viridoquinone, saprorthoquinone, and 1-deoxyviroxocine has been successfully achieved. The anticancer and anti-inflammatory activities of selected orthoquinonic compounds 5, 7, 13, and 19, as well as pygmaeocin C (17), were evaluated for the first time. The antitumor properties were assessed using three cancer cell lines: HT29 colon cancer cells, Hep G2 hepatocellular carcinoma cells, and B16-F10 murine melanoma cells. Compounds 5 and 13 showed the highest cytotoxicity in HT29 cells (IC50 = 6.69 ± 1.2 µg/mL and IC50 = 2.7 ± 0.8 µg/mL, respectively). Cytometric studies showed that this growth inhibition involved phase S cell cycle arrest and apoptosis induction, possibly through the activation of the intrinsic apoptotic pathway. Morphological apoptotic changes, including nuclear fragmentation and chromatin condensation, were also observed. Furthermore, the anti-inflammatory activity of these compounds was evaluated on the basis of their ability to inhibit nitric oxide production on the lipopolysaccharide activated RAW 264.7 macrophage cell line. Although all compounds showed high anti-inflammatory activity, with percentages between 40 and 100%, the highest anti-inflammatory potential was obtained by pygmaeocin B (5) (IC50NO = 33.0 ± 0.8 ng/mL). Our results suggest that due to their dual roles, this type of compound could represent a new strategy, contributing to the development of novel anticancer agents.

HE4, Ca125 and ROMA algorithm for differential diagnosis between benign gynaecological diseases and ovarian cancer.

The aim of this study is to evaluate the diagnostic performance of human epididymis protein 4 (HE4), cancer antigen 125 (Ca125) and the risk of ovarian malignancy algorithm (ROMA) in discriminating ovarian cancer from other benign gynaecological diseases. Serum levels of HE4 and Ca125 were measured in 119 women with benign gynaecological diseases, 29 patients with primary ovarian cancer, 32 patients with ovarian cancer on chemotherapy treatment (18 of them with progressive disease), 6 patients treated and free of disease and 32 healthy women. Sensitivity, specificity, positive and negative predictive values and positive and negative likelihood ratios (LR ±) were calculated. Receiver operator characteristic (ROC) curves were constructed, and the areas under the curve (AUC) were calculated. High serum levels for HE4, Ca125 and ROMA were observed in cancer patients. HE4 was elevated in 12.6 %, Ca125 in 21 % and ROMA in 9.2 % in the benign group, but HE4 was not elevated in endometriosis. The AUC values for HE4, Ca125 and ROMA were 0.92, 0.911 and 0.945 respectively. The sensitivity for discriminating ovarian cancer from benign gynaecological diseases was 86.2 % for HE4 and Ca125 and 93.1 % for ROMA. The specificity was 87.4, 78.9 and 90.7 % for HE4, Ca125 and ROMA. The overall positive likelihood ratio (LR+) was 6.84 for HE4, 4.1 for Ca125 and 10.01 for ROMA. In premenopausal women, LR + was 11.86 for HE4, 5.11 for ROMA and 2.02 for Ca125. HE4 might be significant in the differential diagnosis of ovarian cancer. HE4 seems to be superior to Ca125 in terms of diagnostic performance of all premenopausal women. ROMA could help to discriminate in cases with any doubt with a high diagnostic accuracy.

[Use of procalcitonin and C-reactive protein as infection markers in febrile neutropenic patients undergoing haematopoietic stem cell transplant]. / Utilización de procalcitonina y proteína C reactiva como marcadores de infección en la neutropenia febril de pacientes sometidos a trasplante de progenitores hematopoyéticos.

INTRODUCTION AND OBJECTIVE: Neutropenia is a frequent sign in patients who are going to have a haematopoietic stem cell transplant (HSCT). Infection is an important complication in these patients, which is favoured by immunosuppression and the degree of neutropenia. This study aims to evaluate the diagnostic usefulness of procalcitonin (PCT) and C-reactive protein (CRP) in onco-haematological patients undergoing chemotherapy and HSCT to determine the origin of the fever. PATIENTS AND METHODS: PCT and CRP values were measured in 30 episodes of febrile neutropenia: before starting chemotherapy, appearance of neutropenia, onset of fever, days 1, 2, 3 and 6 after the onset of fever, and when the febrile episode ended. The episodes were classified as 5 bacteraemia, 3 microbiologically documented infections, 10 clinical infections, and 12 fevers of unknown origin. RESULTS: The highest PCT mean values corresponded to the group of patients with bacteraemia. Statistically significant differences (P=.04) were found on the second day after the onset of fever. The cut-off point of 0.5ng/ml showed a sensitivity of 66% and a specificity of 75%. PCR results showed statistically significant differences on days 1, 2 and 3 after the onset of fever (P=.01, P=.003, and P=.002, respectively). The cut-off point of 7.5mg/L had a sensitivity of 88% and a specificity of 58%. CONCLUSIONS: The combination of PCT and CRP is an insufficient method to detect bacterial infections and may not replace the proper clinical and microbiological diagnosis.

[Correlation between aPTT and antifactor Xa to determine therapeutic ranges for unfractionated heparin]. / Correlación de valores de TTPa con anti factor Xa para establecer rango terapéutico en tratamiento anticoagulante con heparina sódica.

BACKGROUND: The therapeutic range (TR) of activated partial thromboplastin time (aPTT) for unfractionated heparin (UFH) dosing was established in the 1970 decade. Since then aPTT determination has changed. Current TR may be sub or supra-therapeutic depending on the reagents of the test, and therefore, responsible for complications of therapy. AIM: To establish the TR for UFH dosing in our institution using antifactor Xa analysis as reference standard. MATERIAL AND METHODS: After obtaining an informed consent, 43 blood samples were obtained for aPTT determination and antifactor Xa assay in 23 patients treated with intravenous UFH. Samples were processed at Emergency and Hemostasis Labs. We excluded patients receiving other anticoagulants, with thrombophilia, pregnancy or liver disease. RESULTS: Mean aPTT values in the Hemostasis and Emergency labs ​​were 57.1 ± 18.9 and 56.6 ± 18.3 seconds, respectively (p = 0.77). The squared correlation coefficients between aPTT and antifactor Xa at hemostasis and emergency labs were R2 0.5 and 0.45 respectively, p < 0.001. Using a linear regression analysis, therapeutic aPTT range values ​​in our laboratory were established between 50 and 80 seconds, corresponding to antifactor Xa values of 0.3 to 0.7 IU/mL. CONCLUSIONS: According to current recommendations, validation of aPTT determination with reference techniques should be done in every institution.

Expanding the Palette of SWIR Emitting Nanoparticles Based on Au Nanoclusters for Single-Particle Tracking Microscopy.

Single-molecule localization microscopy has proved promising to unravel the dynamics and molecular architecture of thin biological samples down to nanoscales. For applications in complex, thick biological tissues shifting single-particle emission wavelengths to the shortwave infrared (SWIR also called NIR II) region between 900 to 2100 nm, where biological tissues are more transparent is key. To date, mainly single-walled carbon nanotubes (SWCNTs) enable such applications, but they are inherently 1D objects. Here, 0D ultra-small luminescent gold nanoclusters (AuNCs, <3 nm) and ≈25 nm AuNC-loaded-polymeric particles that can be detected at the single-particle level in the SWIR are presented. Thanks to high brightness and excellent photostability, it is shown that the dynamics of the spherical polymeric particles can be followed at the single-particle level in solution at video rates for minutes. We compared single particle tracking of AuNC-loaded-polymeric particles with that of SWCNT diffusing in agarose gels demonstrating the specificity and complementarity of diffusion properties of these SWIR-emitting nano-objects when exploring a complex environment. This extends the library of photostable SWIR emitting nanomaterials to 0D nano-objects of variable size for single-molecule localization microscopy in the second biological window, opening unprecedented possibilities for mapping the structure and dynamics of complex biological systems.

Rescue by pneumoenema under general anaesthesia of apparently non-reducible intestinal intussusception.

UNLABELLED: When an enema in the radiology unit is unsuccessful in treating intussusception, patients must undergo surgery. A further attempt at reduction under general anaesthesia in the operating room prior to laparotomy could avoid surgical intervention. A prospective study was carried out from 2002 to 2010 on paediatric patients with intestinal intussusception who underwent a deinvagination procedure in radiology with no anaesthesia. Unresolved cases were included in either group 3a (direct surgery) or group 3b (pneumoenema under general anaesthesia in the operating room), depending if the paediatric surgeon on duty wanted or not to participate in the study. Ninety-eight patients were included in the study. Six patients (group 1) were immediately operated after diagnosis because peritonitis was clinically suspected. Sixty-seven patients were successfully treated with an anaesthesia-free procedure in the radiology department (group 2). Of the 25 cases with initial treatment failure (group 3), 11 were assigned to group 3a (immediate laparotomy) and 14 to group 3b (pneumoenema with general anaesthesia). All patients in the 3b group were successfully treated by this procedure. There were no differences between the groups in terms of age, sex or evolution time. The average length of hospital stay and the number of repeated hospitalizations were significantly higher for group 3a. CONCLUSION: We consider that general anaesthesia increases effective reduction pressures and could avoid many surgeries in apparently non-reducible intestinal intussusceptions.

Improvement in the Management of Oral Anticoagulation in Patients with Atrial Fibrillation in Primary Health Care.

(1) Background: Evaluation and improvement of the management of patients with atrial fibrillation in treatment with oral anticoagulants from primary health care. (2) Methods: prospective quasi-experimental study, conducted on 385 patients assisted with Atrial Fibrillation (AF) at the Las Fuentes Norte Health Center, before and after the implementation of actions to improve oral anticoagulants management from October 2015 to July 2017. (3) Results: The ACO-ZAR I study revealed that the population with AF presents a global prevalence of 1.7%, an indication of oral anticoagulants of 92.1%, undertreatment of 24%, suboptimal control of vitamin K antagonists of 43%, use of antiaggregant as primary prevention of 13.42%, and primary health care monitoring of 34%. The implementation of activities aimed at improving the management of oral anticoagulants in the ACO-ZAR II study achieves a reduction in undertreatment up to 16%, in the use of antiaggregant up to 9%, and in suboptimal control up to 30%, as well as an increase in control from primary health care up to 69.2% and of the penetrance of direct oral anticoagulants up to 28%. (4) Conclusions: In conclusion, the application of activities aimed at optimizing the management of oral anticoagulants in health center patients allowed the improvement of risk assessment and registration, undertreatment, use of antiaggregant, suboptimal control of vitamin K antagonists, control by primary health care center, and the penetrance of direct oral anticoagulants.

[Diagnostic value of procalcitonin, interleukin 8, interleukin 6, and C-reactive protein for detecting bacteremia and fungemia in cancer patients]. / Valor diagnóstico de la procalcitonina, la interleucina 8, la interleucina 6 y la proteína C reactiva en la detección de bacteriemia y fungemia en pacientes con cáncer.

BACKGROUND AND OBJECTIVE: Bacteremia is one of the most important causes of morbidity and mortality in cancer patients. The aim of this study was to evaluate the diagnostic usefulness of procalcitonin (PCT), interleukin 8 (IL-8), interleukin 6 (IL-6), and C-reactive protein (CRP) in the detection of bacteremia in cancer patients. PATIENTS AND METHODS: PCT, IL-8, IL-6, and CPR levels were measured in 2 groups of cancer patients who had fever: one group with true bacteremia and another without bacteremia. RESULTS: Seventy-nine febrile episodes were analyzed in 79 patients, 43 men and 36 women. Forty-four patients were in the true bacteremia group. Significant differences in PCT (P<0.001), IL-8 (P<0.001), and IL-6 (P=0.002) values were found between patients with and without true bacteremia. CPR results were not significantly different between the groups (P=0.23). The cut-off point for PCT was 0.5 ng/mL and this parameter yielded the best specificity at 91.4%, with a sensitivity of 59.1%. CONCLUSIONS: Among the infection markers studied, PCT provided the most information for diagnosing bacteremia in cancer patients.

N-[3-(2,6-Dimethylanilino)-1-methylbut-2-enylidene]-2,6-dimethylanilinium chloride.

The title salt, C(21)H(27)N(2) (+)·Cl(-) resulted from the condensation between 2,6-dimethyl-aniline and acetyl-acetone in acidified ethanol. The bulky cation is stabilized in a ß-imino-enamine tautomeric form, and presents a W-shaped conformation. The benzene rings are arranged almost parallel, with a dihedral angle of 6.58 (4)° between the mean planes. Both N-H groups in the cation form strong hydrogen bonds with two symmetry-related chloride anions. The resulting supra-molecular structure is a one dimensional polymer running along [001], alternating cations and anions. The π-π inter-action observed in the mol-ecule, characterized by a centroid-centroid separation of 4.298 (4) Å, is thus extended to the chains, with separations of 5.222 (4) Šbetween benzene rings of neighbouring cations in the crystal.

High prevalence of bleeders of unknown cause among patients with inherited mucocutaneous bleeding. A prospective study of 280 patients and 299 controls.

BACKGROUND AND OBJECTIVES: Mucocutaneous bleeding (MCB) is the main expression of inherited disorders of primary hemostasis. However, the relative prevalence of these disorders, their clinical differential diagnosis, and the proportion of patients with MCB of unknown cause (BUC) after an initial comprehensive laboratory testing are unknown. DESIGN AND METHODS: We studied prospectively 280 consecutive patients with MCB and 299 matched controls, using strict inclusion and exclusion criteria. A single physician recorded the clinical data in a bleeding score and estimated the severity of bleeding in clinical categories. Laboratory criteria for the diagnosis of von Willebrand's disease (VWD) and platelet function defects were established from reference values derived from controls. RESULTS: Fifty patients (17.9%) had VWD (type 1VWD=45, type 2=5). Platelet function defects and mild clotting factor deficiencies were found in 65 (23.2%) and 11 (3.9%) patients, respectively. Thirteen (11.5%) patients had combined defects. The remaining 167(59.6%) patients had BUC, with prolonged bleeding time in 18.6% as their only abnormality. All these disorders, including BUC, were clinically undistinguishable. Moreover, no relationship was found between the severity of bleeding and VWF/platelet function variables. INTERPRETATION AND CONCLUSIONS: The diagnostic efficacy of a first laboratory testing in patients with hereditary MCB is 40.4%. Most patients have a disease(s) of high prevalence but unknown pathogenesis. Concurrent bleeding disorders in the same patient are frequent. Our results support the proposal that low plasma VWF levels, but also platelet function defects, should be considered risk factors rather than unequivocal causes of hemorrhages.

How many patients with rheumatic diseases and TNF inhibitors treatment have latent tuberculosis?

OBJECTIVES: Spanish clinical guidelines recommend screening patients for tuberculosis (TB) before TNF inhibitors (TNFi) treatment. Our objective was to estimate the prevalence of TST seroconversion as an estimation of the prevalence of latent TB in patients with rheumatic diseases and TNFi treatment that have already been screened for tuberculosis. METHODS: TST, booster and chest x-ray were performed to patients with rheumatic diseases, TNFi treatment, negative tuberculin skin tests before treatment and that were attending the rheumatology Department of three different hospitals in Barcelona. According to the Spanish Society Rheumatology guidelines, these patients had not received TB prophylaxis treatment. RESULTS: One hundred and forty patients were included in the study. The tuberculin skin test was positive in 4.28% (n=6) of the patients. 50% of the patients were undergoing TNFi ≤ 2 years, being two of the patients only one year on the TNFi when a positive TST was detected. This shows that a conversion of the TST can occur even few months or years after the TNFi is started. CONCLUSIONS: The present study observed that 4.28% of patients with rheumatic diseases on TNFi who did not have performed a pre-treatment TB prophylaxis, had a conversion of the TST. Moreover, the conversion of the TST had been within the first two years of treatment in half of the patients of our cohort. In spite of these results, false TST positives in the diagnosis of latent TB cannot be excluded as an explanation for our results.

[Effect of a high fat or high carbohydrate breakfast on postprandial lipid profile in healthy subjects with or without family history of type 2 diabetes mellitus]. / Efecto de un desayuno con alto contenido en grasa o en carbohidratos sobre el perfil de lípidos posprandial en individuos sanos con y sin antecedente familiar de diabetes mellitus tipo 2.

The objective of this study was to evaluate the effect of a high fat or high carbohydrate breakfast on postprandial lipid profile in healthy subjects with or without family history of type 2 diabetes mellitus. A single blind, controlled clinical trial with parallel groups was performed in 20 healthy subjects; 10 subjects with family history of type 2 diabetes mellitus and 10 individuals without that background. Each group was randomized to receive a high fat or high carbohidrate breakfast. A metabolic profile that included fasting and postprandial lipids, as well as, the assessment of insulin sensitivity were performed. Lower high-lipoprotein cholesterol (p < 0.02) and apolipoprotein A1 (p < 0.03) concentrations were found in subjects with family history of type 2 diabetes mellitus than those without that background. In this same above mentioned group with the high carbohydrate breakfast, there were significant increments in apoliprotein B at minute 300 (p < 0.03) and in triglycerides at minute 360 (p < 0.03). In the group without family history of diabetes that received the high fat breakfast, there were increments in triglycerides (p < 0.03) and very-low density lipoprotein concentrations at minute 180 (p < 0.03). In conclusion, healthy subjects with family history of type 2 diabetes showed some atherogenic characteristics in their metabolic profile, and the high carbohydrate breakfast produced in them increments in apolipoprotein B and in triglycerides, meanwhile that, in those subjects without such background the high fast breakfast produced unfavorable effects on their lipid concentrations.

Correlación de valores de TTPa con anti factor Xa para establecer rango terapéutico en tratamiento anticoagulante con heparina sódica / Correlation between aPTT and antifactor Xa to determine therapeutic ranges for unfractionated heparin

Background: The therapeutic range (TR) of activated partial thromboplastin time (aPTT) for unfractionated heparin (UFH) dosing was established in the 1970 decade. Since then aPTT determination has changed. Current TR may be sub or supra-therapeutic depending on the reagents of the test, and therefore, responsible for complications of therapy. Aim: To establish the TR for UFH dosing in our institution using antifactor Xa analysis as reference standard. Material and Methods: After obtaining an informed consent, 43 blood samples were obtained for aPTT determination and antifactor Xa assay in 23 patients treated with intravenous UFH. Samples were processed at Emergency and Hemostasis Labs. We excluded patients receiving other anticoagulants, with thrombophilia, pregnancy or liver disease. Results: Mean aPTT values in the Hemostasis and Emergency labs ​​were 57.1 ± 18.9 and 56.6 ± 18.3 seconds, respectively (p = 0.77). The squared correlation coefficients between aPTT and antifactor Xa at hemostasis and emergency labs were R2 0.5 and 0.45 respectively, p < 0.001. Using a linear regression analysis, therapeutic aPTT range values ​​in our laboratory were established between 50 and 80 seconds, corresponding to antifactor Xa values of 0.3 to 0.7 IU/mL. Conclusions: According to current recommendations, validation of aPTT determination with reference techniques should be done in every institution.

Expresionismo y revolución: el abismo de la realidad / Expressionism and revolution: the abism of the reality / Expressionismo e revolução: o abismo da realidade

En este estudio se plantea el paso de la conciencia expresionista a la conciencia crítica; es decir, la evolución del Expresionismo artístico hacia la creación de la Teoría Crítica sociológica en la Alemania de la República de Weimar. De este modo, se repasan los procesos sociales y culturales que dieron lugar a un tipo de Arte en el que se reflejaban las profundas y dramáticas contradicciones de las primeras décadas del siglo XX, subrayándose por tanto como la Escuela de Frankfurt en su primera Generación (Adorno, Horkheimer, Benjamín) significó el punto de inflexión fundamental para analizar y entender filosófica y sociológicamente estas complejas y profundas contradicciones colectivas, así como sus consecuencias históricas posteriores.

This study emerges from the expressionist consciousness about the critical consciousness; in other words, the evolution of the artistic expresionism toward the creation of the critical Theory in the Germany of the Republic of Weimar. In this way, the social and cultural processes that gave place to a type of Art in which there were reflected the deep and dramatic contradictions of the first decades of the XXth century are revised, being underlined, therefore, that the School of Frankfurt in his First Generation (Adorno, Horkheimer, Benjamin) is the point of fundamental inflection to analyse and to understand philosophical and sociologically these complex and deep collective contradictions, as well as its subsequent and later historical consequences.

Neste estudo expõe o a passagem da consciência expressionista para consciência crítica; isto é, a evolução do Expressionismo artístico até a criação da Teoria Crítica sociológica na Alemanha na República de Weimar. O texto faz uma revisão dos processos sociais e culturais que deram lugar a um tipo de Arte na qual se reflete as profundas e dramáticas contradições das primeiras décadas do século XX, destacando-se como a Escola de Frankfurt, em sua primeira Geração (Adorno, Horkheimer, Bejamin), significou o ponto de inflexão fundamental para analisar e endender filosófica e sociologicamente estas complexas e profundas contradições coletivas, assim como suas consequências históricas posteriores.

[Primary thrombophilia. Report of 93 cases and 12 asymptomatic relatives]. / Trombofilia primaria: detección y manifestación clínica en 105 casos.

BACKGROUND: Thrombophilia is defined as an altered hemostasis that predisposes to thrombosis. It can be primary when there is a family clustering of the disease or secondary, when it is associated to an acquired risk factor. AIM: To report clinical features in a series of patients with primary thrombophilia. MATERIAL AND METHODS: Review of clinical records of patients with thrombotic episodes that lead to the suspicions of primary thrombophilia. Analysis of asymptomatic adult close relatives of these patients. RESULTS: We report 93 subjects (56 females, age range 14-77 years) with repeated episodes of thrombosis and a family history of thrombosis and 12 asymptomatic close relatives. Seventy one percent had the first thrombotic episode before the age of 40 years, 62% had more than one thrombotic episode and 37% had a family history of thrombosis. Twenty four percent had protein C deficiency, 24% had antithrombin III deficiency, 18% had resistance to activated C protein by factor V Leiden, 10% had protein S deficiency, and 10% had the G20210 mutation of prothrombin gene. Among acquired defects studied simultaneously, 30% had lupus anticoagulant and 11% had hyperhomocysteinemia. Twenty four percent of cases had more than one thrombophilic risk factor. Among asymptomatic relatives, five had factor V Leiden, four had protein C deficiency and three had the G20210 mutation of prothrombin gene. CONCLUSIONS: Thrombophilia must be suspected in young subjects with thrombotic episodes and a family history. The type of coagulation defect will determine prognosis, and the type of treatment.

Hazard Analyses of Foods Prepared by Inhabitants Near Lake Titicaca in the Peruvian Sierra.

Hazard analyses of food preparation practices were conducted in two households in an Andean Indian Pueblo near Puno, Peru and in a house on the outskirts of this city. These analyses consisted of watching all steps of preparation, recording temperatures throughout all these steps, and collecting samples of food and testing them for common foodborne pathogens and indicator organisms. Only cereal-potato soup (a very popular and inexpensive food in the region), kidney stew, and parched cereal were prepared during the survey. The soups boiled during cooking and most of them were eaten during the first serving. Vegetative forms of pathogenic bacteria would have been killed during cooking, but heat-resistant spores would have survived. Leftovers in the pueblo homes, when there were any, remained without heat on the clay stoves on which they had been cooked until eaten or reheated. In the other household, cooked foods were moved from the stove to an earthen floor and kept there until reheating. Under this condition, cooling was more rapid than when left on stoves. The interval of time that cooked foods were between 49°C (120°F) and 21°C (70°F) during holding was less than 4 h, thereby limiting spore germination and bacterial multiplication. In the only household in which foods were reheated, they boiled. Critical control points for food preparation in homes are cooking, holding between cooking and serving, and reheating.

Thrombin generation in platelet-poor plasma is normal in patients with hereditary mucocutaneous haemorrhages.

Mild hereditary bleeding disorders presenting with mucocutaneous haemorrhages are usually difficult to diagnose. We measured thrombin generation in platelet-poor plasma (TG-PPP) in 206 patients with a clinically unequivocal bleeding tendency: 45 with von Willebrand disease (vWD), 49 with platelet aggregation/secretion defects (PASD), 10 with a combination of both and 102 who did not fit the diagnostic criteria for any known haemostatic disorder. TG-PPP was not significantly different from controls in all patient groups, indicating that an abnormality in the plasmatic clotting system is unlikely to contribute to the bleeding in patients with type 1 vWD and PASD. In patients with undiagnosed mild hereditary bleeding disorders, there must be other mechanisms which explain the abnormal haemorrhagic tendency, most likely as yet unrecognized defects in platelet-vessel wall interaction. As a next step we plan to investigate thrombin generation in PRP.

[Effect of oral inulin administration on lipid profile and insulin sensitivity in subjects with obesity and dyslipidemia]. / Efecto de la administración oral de inulina sobre el perfil de lípidos y la sensibilidad a la insulina en individuos con obesidad y dislipidemia.

BACKGROUND: Inulin is a non absorbable polysaccharide with prebiotic effects, whose influence on blood lipids or insulin sensitivity is not well known: AIM: To assess the effect of oral administration of inulin on lipid profile and insulin sensitivity in dyslipidemic obese subjects. MATERIAL AND METHODS: A clinical trial, double blind, randomized with placebo was carried out in 12 obese, hypertrygliceridemic and hypercholesterolemic subjects between 19 and 32 years old. The subjects were randomized to receive 7 g/day of inulin or placebo in the morning, during 4 weeks. Biochemical and metabolic profiles and euglycemic-hyperinsulinemic clamp technique for assessing insulin sensitivity, before and after pharmacological intervention were performed. RESULTS: After inulin administration, there was a significant reduction of total cholesterol (248.7 +/- 30.5 and 194.3 +/- 39.8 mg/dL; p = 0.028), low density lipoprotein (LDL), cholesterol (136.0 +/- 27.8 and 113.0 +/- 36.2 mg/dL; p = 0.028), very low density lipoproteins (VLDL) (45.9 +/- 18.5 and 31.6 +/- 7.2 mg/dL; p = 0.046) and trygliceride concentrations (235.5 +/- 85.9 and 171.1 +/- 37.9 mg/dL; p = 0.046). No effect of inulin on insulin sensitivity was observed. CONCLUSIONS: The oral inulin administration reduced total cholesterol, LDL cholesterol, VLDL and trygliceride levels in dyslipidemic and obese subjects, without modifications in the insulin sensitivity.