RESUMO
BACKGROUND: Real life implementation studies performed in different settings have proved that lifestyle interventions in the prevention of type 2 diabetes (DM2) can be effective, although the weight reduction results are typically modest compared to randomized control trials. Our objective was to identify the factors that predict successful weight loss in a less intensive, lower budget, real life setting lifestyle diabetes prevention intervention. METHODS: Study participants (n = 175) with increased DM2 risk (Finnish Diabetes Risk Score (FINDRISC) > 14) but no diabetes at baseline received ten group lifestyle counselling sessions, physical activity and motivation sessions during a ten-month intervention. Stepwise regression analysis was used to determine demographic, clinical, and lifestyle predictors of successful weight reduction defined as a reduction of ≥5% of the initial body weight. RESULTS: At 12 months following the initiation of the intervention, 23.4% of study participants lost ≥5% weight (mean loss of 7.9 kg, SD = 5.8). Increased physical activity (44% vs 25%, p = 0.03), decreased total fat consumption (88% vs 65%, p = 0.006) and adherence to four-five lifestyle goals (71% vs 46%, p = 0.007) were more often reported among those who managed to lose ≥5% weight versus those who did not. In a multivariate analysis, meeting the ≥5% weight loss goal was most effective in individuals with a higher baseline BMI (OR 1.1, 95%CI 1.0-1.2), baseline and medium versus higher education (OR 5.4, 95% CI 1.2-24.7) and a history of increased glucose (OR 2.6, 95%CI 1.1-1.3). A reduction of total fat in the diet was an independent lifestyle predictor, increasing the probability of successful weight loss by 3.8 times (OR 3.8, 95% CI 1.2-11.4). CONCLUSION: Baseline higher BMI, lower education and a history of increased glucose predicted the successful weight loss among individuals with a high risk for the DM2 following lifestyle intervention in a real life primary health care setting. People who manage to lose weight more often adhere to lifestyle changes, while the reduction of total fat in diet independently predicts successful weight loss. Further studies exploring the predictors of success in implementation studies in DM2 prevention should help health care providers redesign interventions to improve their effectiveness and outcomes. TRIAL REGISTRATION: ISRCTN, ID ISRCTN96692060 , registered 03.08.2016 retrospectively.
Assuntos
Diabetes Mellitus Tipo 2/prevenção & controle , Estilo de Vida , Atenção Primária à Saúde , Redução de Peso , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do TratamentoRESUMO
The series of 1,2,4-triazole derivatives containing methacrylic acid moiety were synthesized in reaction of N3-substituted amidrazones with itaconic anhydride. Preliminary calculated bioavailability parameters of obtained compounds suggested good penetration via cell membranes and their good absorption after oral intake. Antimicrobial evaluation in vitio showed diverse activity of obtained triazoles mainly on Gram-positive bacterial strains. One derivative was also examined to determine the effect on the central nervous system of mice.
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Antibacterianos/farmacologia , Sistema Nervoso Central/efeitos dos fármacos , Triazóis/farmacologia , Animais , Antibacterianos/farmacocinética , Masculino , Metacrilatos/farmacologia , Camundongos , Testes de Sensibilidade MicrobianaRESUMO
A set of arylpiperazine derivatives with imide fragments, 1-(1H-pyrrol-1-ylmethyl)-10-oxa-4-azatricyclo[5.2.1.0(2,6)-]dec-8-ene-3,5-dione connected by propyl and butyl linkers, were synthesized and tested for the potential anxiolytic and antidepressant activities. Compounds 3a and 3b demonstrated antidepressant activity in the forced swimming tests in mice and were devoid of neurotoxic effects. (chimney test in mice).
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Ansiolíticos/síntese química , Antidepressivos/síntese química , Piperazinas/síntese química , Animais , Ansiolíticos/química , Ansiolíticos/farmacologia , Antidepressivos/química , Antidepressivos/farmacologia , Masculino , Camundongos , Atividade Motora/efeitos dos fármacos , Piperazinas/química , Piperazinas/farmacologiaRESUMO
BACKGROUND: The aim of this study was to evaluate the prevalence of alcoholic (ASH) and non-alcoholic steatohepatitis (NASH) in alcoholics by non-invasive biochemical markers: AshTest and NashTest. METHODS: The tested group consisted of 142 alcoholic patients. All biochemical markers were assessed using the recommended methods. RESULTS: The highest values of AshTest and NashTest were observed in the highest H3 score and N2 score, respectively. The distribution of AshTest scores was the following: H0 - 94.1%, H1 - 5.2%, H2 - 0%, and H3 - 0.7%, while for NashTest was: N0 - 56.6%, N1 - 38.2% and N2 - 5.1%. In summary, alcoholic steatohepatitis was present only in 5.9% of alcoholics and non-alcoholic steatohepatitis in 43.3% of patients. Co-occurrence of ASH and NASH was observed in 3.7% of patients. The BMI, mean glucose, and triglyceride levels were significantly different between NashTest scores, but not between AshTest scores. These results may evidence that non-alcoholic steatohepatitis is associated with metabolic risk factors such as diabetes mellitus, dyslipidemia, and obesity. The MCV value and AST/ALT ratio were higher in alcoholic steatohepatitis than in non-alcoholic steatohepatitis. CONCLUSIONS: In conclusion, the prevalence of non-alcoholic steatohepatitis in alcoholics is higher than of alcoholic steatohepatitis, as estimated by non-invasive tests. Co-occurrence of alcoholic steatohepatitis and non-alcoholic steatohepatitis in alcoholic patients is low and the high prevalence of non-alcoholic steatohepatitis is related with high occurrence of metabolic risk factors.
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Alcoolismo/complicações , Fígado Gorduroso/epidemiologia , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Adulto , Idoso , Fígado Gorduroso/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/complicações , Prevalência , Adulto JovemRESUMO
The aim of this study was to assess the effect of a combined 14-day treatment with rosuvastatin (10 mg/kg) and fluoxetine (10 mg/kg) on selected biochemical parameters of oxidative stress in the blood of rats. The activity of glutathione peroxidase (GPX), glutathione reductase (GR) and the total antioxidant status (TAS) were determined. A combined 14-day treatment with rosuvastatin and fluoxetine significantly increases glutathione peroxidase and glutathione reductase activity and decreases the level of TAS. Rosuvastatin administered to rats caused a decrease in the glutathione peroxidase activity and an increase in the glutathione reductase activity but did not affect the level of TAS. A 14-day treatment with fluoxetine exerted practically no effect on the investigated parameters of oxidative stress in rats. The abovementioned changes in the biochemical parameters after the combined treatment with rosuvastatin and fluoxetine may imply an imbalance in prooxidant and antioxidant levels in the combined treatment with rosuvastatin and fluoxetine.
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Fluoxetina/farmacologia , Estresse Oxidativo , Rosuvastatina Cálcica/farmacologia , Animais , Glutationa Peroxidase/metabolismo , Glutationa Redutase/metabolismo , Masculino , Ratos , Ratos WistarRESUMO
Patients, affected by neoplastic disease, take usually other drugs and this may lead to a number of often rather unpredictable interactions. The statins are among the most commonly prescribed drugs in medicine but have also adverse side effects and come into interactions with other drugs. The aim of this study was to investigate the cytotoxic effect of methotrexate (5.5 or 16.5 micromol/L), simvastatin (100 or 300 micromol/L) and their combination on green monkey kidney (GMK) cells culture using cytotoxicity detection kit LDH. Besides, the effect of above drugs on the cells viability was estimated by MTT test. After 6, 12 or 24 h of simultaneous incubation of GMK cells with methotrexate (5.5 micromol/L) and simvastatin (100 micromol/L) the cytotoxicity (about 10%) of the drugs was found in LDH test. Cytotoxicity of combination: methotrexate (5.5 micromol/L) with simvastatin (300 micromol/L) after 6 or 12 h of incubation with GMK cells was similar (about 10%), but after 24 h of incubation, cytotoxicity increased to 21%. The significant increase of the cytotoxicity (about 30%) was found after 24 h incubation of GMK cells with methotrexate (16.5 micromol/L) and simvastatin (100 micromol/L). In the MTT assay, the decrease in the cells viability was found also after 12 and 24 h of GMK cells incubation with methotrexate (5.5 or 16.5 micromol/L) and simvastatin (100 or 300 micromol/L). These results suggest the adverse effect of combined application of both drugs on GMK cells especially after 24 h of incubation.
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Antineoplásicos/toxicidade , Inibidores de Hidroximetilglutaril-CoA Redutases/toxicidade , Rim/efeitos dos fármacos , Metotrexato/toxicidade , Sinvastatina/toxicidade , Animais , Linhagem Celular , Sobrevivência Celular/efeitos dos fármacos , Chlorocebus aethiops , Relação Dose-Resposta a Droga , Interações Medicamentosas , Rim/metabolismo , Rim/patologia , L-Lactato Desidrogenase/metabolismo , Polimedicação , Fatores de TempoRESUMO
The aim of the present study was to assess the impact of combined therapy with rosuvastatin (10 mg/kg) and amitriptyline (10 mg/kg) on oxidation-reduction status in the blood of rats. After 2-week application of drugs alone or their combination, the activity of glutathione peroxidase (GPX), glutathione reductase (GR) and total antioxidant status (TAS) were determined. It was noticed that combined therapy with rosuvastatin and amitriptyline significantly increased the activity of GPX in comparison to the group receiving only rosuvastatin and decreased the activity of GR in comparison to groups receiving only rosuvastatin or amitriptyline. However, the activity of these enzymes as a result of combined therapy was placed in the level of the control groups. Our studies indicated that the combined therapy with both drugs caused an increase of TAS compared to the groups of animals receiving only one of these drugs. The results indicate on the oxidation-reduction balance and increasing the antioxidant status in rats treated with rosuvastatin and amitriptyline.
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Amitriptilina/farmacologia , Antidepressivos Tricíclicos/farmacologia , Fluorbenzenos/farmacologia , Inibidores de Hidroximetilglutaril-CoA Redutases/farmacologia , Estresse Oxidativo/efeitos dos fármacos , Pirimidinas/farmacologia , Sulfonamidas/farmacologia , Animais , Glutationa Peroxidase/metabolismo , Glutationa Redutase/metabolismo , Injeções Intraperitoneais , Masculino , Oxirredução , Ratos , Ratos Wistar , Rosuvastatina CálcicaRESUMO
UNLABELLED: The diagnosis of alcoholic liver disease, steatosis, fibrosis and alcoholic steatohepatitis, can be evaluated by means of non-invasive biochemical biomarkers: SteatoTest, FibroTest and AshTest. The aim of the study was to evaluate the diagnostic usefulness of these tests for the detection of steatosis, fibrosis and alcoholic steatohepatitis in alcohol abusing patients. MATERIAL AND METHODS: The experimental group comprised 137 alcohol-dependent subjects. The control group was consisted of 50 healthy social drinkers. Ten biochemical assays were determined according to methods recommended by the provider of the tests - BioPredictive company. The scores were computed by the company according to the bilateral agreement. RESULTS: The diagnostic sensitivity and specificity were as follows: 61.9% and 93.9% for SteatoTest, 61.3% and 93.9% for FibroTest and 9.6% and 93.9% forAsh Test. The diagnostic power of Steato Test (A UC = 0.806) and FibroTest (AUC = 0.795) were significantly higher than the diagnostic power of AshTest (AUC = 0.626) but did not differ from each other. The probability of a positive test results of Steato Test and FibroTest is 10-times more likely in alcoholics than in healthy individuals. CONCLUSION: SteatoTest and FibroTest can be useful diagnostic tool for the detection of liver steatosis and fibrosis in alcohol-dependent patients but cannot differentiate of these clinical conditions.
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Alcoolismo/sangue , Alcoolismo/diagnóstico , Detecção do Abuso de Substâncias/métodos , Adulto , Idoso , Biomarcadores/análise , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sensibilidade e Especificidade , Adulto JovemRESUMO
Anxiety is one of the psychological factors associated with body weight experienced by people attempting to live up to expectations of an ideal body shape. The stigma of excessive or too low body weight and the stigmatization of people because of it is becoming a widespread problem with negative psychological and social consequences. One effect of the strong social pressure of beauty standards dependent on low body weight is the development of eating disorders and negative societal attitudes toward overweight or obese people. Research conducted to date has mainly focused on one dimension of weight-related anxiety-the fear of getting fat. Ongoing research has also revealed the other side of weight-related anxiety-fear of weight loss. Therefore, the purpose of the present project was to develop a two-dimensional scale to diagnose the level of weight-related anxiety and to preliminarily test the psychometric properties of the emerging constructs. Results: the BMAS-20 weight-related anxiety scale in both Polish and English versions was developed and its psychometric properties were confirmed. The components of body weight-change anxiety that emerged were: anxiety about getting fat and anxiety about losing weight. It was found that both AGF and ALW may have a protective function related to awareness of the negative consequences of poor eating and the health risks associated with it. Above-normal levels of anxiety may be a predictor of psychopathology. Both AGF and ALW are associated with symptoms of depression.
Assuntos
Imagem Corporal , Obesidade , Humanos , Imagem Corporal/psicologia , Obesidade/psicologia , Medo/psicologia , Ansiedade/psicologia , Sobrepeso/psicologia , Magreza , Índice de Massa Corporal , Peso CorporalRESUMO
BACKGROUND: In manufacturers' trials, vaccination against COVID-19 proved to be safe and effective. The officially reported frequency of vaccine adverse events (VAEs) in Poland is lower than that declared by the manufacturers. The anti-vaccination activists questioned the trustworthiness of official data. OBJECTIVES: The aim was to explore the real-life prevalence of VAEs in general practice settings and the factors that may influence it. METHODS: In this pragmatic, mixed prospective and retrospective study, patients vaccinated against COVID-19 between May and October 2021 in three GP practices in Krakow, Poland, were enrolled. Their demographic (age, sex, level of education) and clinical data (weight and height, smoking status, history of allergies, COVID-19 and chronic diseases) were collected. Then, they were interviewed about VAEs they experienced. RESULTS: Out of 1530 patients invited to participate, 1051 (69%) agreed and were eligible for analyses. Only 8.8% did not report any VAE. Pain at the injection site was the most frequently reported reaction (800, 76.2%). The most prevalent systemic ones were excessive fatigue/lethargy (527, 50.6%), sleep/circadian rhythm disturbances (433, 41.6%) and headache (399, 38.3%). Fifty required medical assistance - 39 experienced presyncope (3.7%) and 11 loss of consciousness (1.1%). Only two others were hospitalised. Females, younger adults, those with higher education and with a history of COVID-19 reported systemic VAEs more frequently, while those who were older and obese were less likely to report local reactions. CONCLUSION: Although more than 90% of patients vaccinated against COVID-19 in general practice settings may experience VAEs, in short-term observation, the vast majority are localised and mild.
Assuntos
Vacinas contra COVID-19 , COVID-19 , Adulto , Feminino , Humanos , Vacinas contra COVID-19/efeitos adversos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Estudos Retrospectivos , Medicina de Família e Comunidade , Polônia/epidemiologia , Estudos ProspectivosRESUMO
N-Substituted amides of endo-3-(3-methylthio-1,2,4-triazol-5-yl)bicyclo[2.2.1]hept-5-ene-2-carboxylic acid and 1-(5-methylthio-1,2,4-triazol-3-yl)cyclohexane-2-carboxylic acid were prepared by the condensation reaction of endo-S-methyl-N1-(bicyclo[2.2.1]hept-5-ene-2,3-dicarbonyl)isothiosemicarbazide and S-methyl-N1-(cyclohexane-2,3-dicarbonyl)isothiosemicarbazide with primary amines. The synthesized compounds were screened for their microbiological and pharmacological activities.
Assuntos
Amidas/química , Analgésicos/farmacologia , Ácidos Carboxílicos/farmacologia , Analgésicos/química , Anti-Infecciosos/química , Anti-Infecciosos/farmacologia , Bactérias/classificação , Bactérias/efeitos dos fármacos , Ácidos Carboxílicos/química , Fungos/classificação , Fungos/efeitos dos fármacos , Testes de Sensibilidade MicrobianaRESUMO
Obesity has reached epidemic proportions. With the increase in the number of obese people, we have also witnessed a rise in the stigmatisation of this population. The aim of our study was to: (I) validate Polish versions of the attitude toward obese people (ATOP) scale, the beliefs about obese persons (BAOP) scale, and translate the obesity risk knowledge scale (ORK-10); (II) analyse the relationship between personality and the knowledge about obesity, as well as attitudes and beliefs towards obese people. METHODS: The translation procedure was based on the principles of intercultural validation scales. The study was conducted on a group of 306 individuals, including 189 females and 117 males. RESULTS: The original three-factor structure of the ATOP scale was confirmed in the Polish version. Factor analysis confirmed the one-factor structure of the BAOP scale in the Polish version. A very strong correlation was found between ATOP/BAOP and ORK-10. The correlation of personality with ATOP/BAOP scales was at a low level. Regression analysis indicated that knowledge of obesity risk predicted ATOP and BAOP by more than 58% and 50%, in turn, personality only 20% and 3.7%, respectively. CONCLUSION: The polish versions of ATOP, BAOP and ORK-10 scales are fully useful measurement tools. The knowledge about obesity risk is associated with beliefs and attitudes about obese people.
Assuntos
Atitude , Obesidade , Masculino , Feminino , Humanos , Polônia , Inquéritos e Questionários , Obesidade/epidemiologia , PersonalidadeRESUMO
INTRODUCTION: In the wake of COVID-19 primary care practices have had to overcome and to adapt to several challenges in providing quality care. An international consortium led by Ghent University, Belgium, set up the PRICOV-19 project to study how primary care practices in 38 countries responded to the new challenges. OBJECTIVE: The aim of the study was to describe how Covid-19 impacted the organisation of primary care practices in rural and urban environments in Poland, including the organisation of patient flows, infection prevention, information processing, and communication. MATERIAL AND METHODS: This is cross-sectional questionnaire-based survey among primary care practices. In Poland, the survey was distributed among primary care practices in 16 Polish regions. 180 practices participated in the study. In the analysis of the data U-Mann Whitney or t-test for independent groups, and Wilcoxon test were used to compare the organisation of care before and since the pandemic. RESULTS: Over two-thirds of practices made considerable changes in their structure due to COVID-19; over three-quarters introduced security procedures for phone registrations, but only a quarter still offered consultations without a prior appointment. The use of video consultation quadrupled, and teleconsultations became almost universal. Rural practices were significantly more likely to offer active care for deprived patient groups. A significant increase in infection prevention measures occurred in both urban and rural practices. CONCLUSIONS: COVID-19 brought challenges that spurred changes to the organisation of primary care practices as they sought to continue offering quality care. Despite these hardships, new opportunities for effective changes to clinical operations and organization have emerged and will benefit global health systems in the face of new crises.
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COVID-19 , Humanos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Polônia/epidemiologia , Pandemias/prevenção & controle , Estudos Transversais , Atenção Primária à SaúdeRESUMO
COVID-19 proved that primary care (PC) providers have an important role in managing health emergencies, such as epidemics. Little is known about the preparedness of primary care practice infrastructure to continue providing high quality care during this crisis. The aim of this paper is to describe the perceived limitations to the infrastructure of PC practices during COVID-19 and to determine the factors associated with a higher likelihood of infrastructural barriers in providing high quality care. This paper presents the results of an online survey conducted between November 2020 and November 2021 as a part of PRICOV-19 study. Data from 4974 practices in 33 countries regarding perceived limitations and intentions to make future adjustments to practice infrastructure as a result of the COVID-19 pandemic were collected. Approximately 58% of practices experienced limitations to the building or other practice infrastructure to provide high-quality and safe care during the COVID-19 pandemic, and in 54% making adjustments to the building or the infrastructure was considered. Large variations between the countries were found. The results show that infrastructure constraints were directly proportional to the size of the practice. Better pandemic infection control equipment, governmental support, and a fee-for-service payment system were found to be associated with a lower perceived need for infrastructural changes. The results of the study indicate the need for systematic support for the development of practice infrastructure in order to provide high-quality, safe primary care in the event of future crises similar to the COVID-19 pandemic.
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COVID-19 , Humanos , COVID-19/epidemiologia , Pandemias/prevenção & controle , Inquéritos e Questionários , Qualidade da Assistência à Saúde , Atenção Primária à SaúdeRESUMO
A nationwide cross-sectional study, LIPIDOGRAM2015, was carried out in Poland in the years 2015 and 2016. A total of 438 primary care physicians enrolled 13,724 adult patients that sought medical care in primary health care practices. The prevalence of hypertension, diabetes mellitus, dyslipidaemia, and CVD were similar in urban and rural areas (49.5 vs. 49.4%; 13.7 vs. 13.1%; 84.2 vs. 85.2%; 14.4 vs. 14.2%, respectively). The prevalence of obesity (32.3 vs. 37.5%, p < 0.01) and excessive waist circumference (77.5 vs. 80.7%, p < 0.01), as well as abdominal obesity (43.2 vs. 46.4%, p < 0.01), were higher in rural areas in both genders. Mean levels of LDL-C (128 vs. 130 mg/dL, p = 0.04) and non-HDL-C (147 vs. 148 mg/dL, p = 0.03) were slightly higher in rural populations. Altogether, 14.3% of patients with CVD from urban areas and 11.3% from rural areas reached LDL <70 mg/dL (p = 0.04). There were no important differences in the prevalence of hypertension, diabetes, dyslipidaemia, and CVD, or in mean levels of blood pressure, cholesterol fractions, glucose, and HbA1c between Polish urban and rural primary care patient populations. A high proportion of patients in cities and an even-higher proportion in rural areas did not reach the recommended targets for blood pressure, LDL-C, and HbA1c, indicating the need for novel CVD-prevention programs.
RESUMO
INTRODUCTION: An adverse event is an incident induced while providing health care services or resulting from it, not related to the natural course of a given disease or health condition, which causes or is likely to cause negative consequences for the patient, including their death, a threat to life, the necessity of hospitalisation or its prolongation, permanent or considerable health detriment; or is a foetal disease, congenital defect or the result of foetal damage. OBJECTIVE: The aim of this analysis is to explore the problem of the occurrence of adverse events from the perspective of doctors and ward nurses who manage wards. MATERIAL AND METHODS: The research on the occurrence of adverse events among doctors and nurses (the management staff) was conducted with the use of a postal survey. RESULTS: It was ascertained that 86.5% of the medical personnel had taken part in an adverse event, of which 20.2% took part in an occurrence associated with pharmacotherapy, 16.2% - in an event related to diagnostics and diagnosis, or an infection - 15.7%. 14.2% of respondents were involved in an occurrence linked to a medical device malfunction, and 14.1% - in an adverse event related to an operation. CONCLUSIONS: The adverse events most often identified in the nursing professional group are occurrences associated with pharmacotherapy, and in the doctors' professional group - occurrences related to diagnostics and diagnosis. The research established that the most frequent reason for not informing patients about the occurrence of an adverse event is fear of their filing a complaint. Medical management staff show high acceptance of an adverse event reporting system as a tool for improving patient safety.
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Atitude do Pessoal de Saúde , Erros Médicos/estatística & dados numéricos , Recursos Humanos de Enfermagem/estatística & dados numéricos , Médicos/estatística & dados numéricos , Hospitais , PolôniaRESUMO
3-[(1-Methylpyrrol-2-yl)methyl]-4-substituted 4,5-dihydro-1H-1,2,4-triazol-5-ones were obtained by the cyclization reaction of 1-[(1-methylpyrrol-2-yl)acetyl]-4-substituted semicarbazides in alkaline medium. The effects of the synthesized compounds of the central nervous system of mice were studied.
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Triazóis/farmacologia , Analgésicos/farmacologia , Animais , Sistema Nervoso Central/efeitos dos fármacos , Avaliação Pré-Clínica de Medicamentos , Imobilização , Masculino , Camundongos , Desempenho Psicomotor/efeitos dos fármacos , Sono/efeitos dos fármacos , Tiopental/farmacologia , Triazóis/químicaRESUMO
In the reaction of (2,4-dioxothiazolidin-5-yl)acetyl chloride with 1,2,4-triazole, 4-phenyl-1,2,4-triazolin-5-one and 4-phenyl-1,2,4-triazolin-5-thione, the new corresponding amides (2-4) were obtained. For compounds 2 and 4 effects on central nervous system (CNS) of mice were studied.
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Amidas/síntese química , Fármacos do Sistema Nervoso Central/síntese química , Tiazolidinas/química , Triazóis/química , Amidas/química , Amidas/farmacologia , Animais , Fármacos do Sistema Nervoso Central/química , Fármacos do Sistema Nervoso Central/farmacologia , Masculino , CamundongosRESUMO
Skeletal muscle wasting, associated with aging, may be regulated by the inflammatory cytokines as well as by insulin-like growth factor 1 (IGF-1). l-carnitine possesses anti-inflammatory properties and increases plasma IGF-1 concentration, leading to the regulation of the genes responsible for protein catabolism and anabolism. The purpose of the present study was to evaluate the effect of a 24-week l-carnitine supplementation on serum inflammatory markers, IGF-1, body composition and skeletal muscle strength in healthy human subjects over 65 years of age. Women between 65 and 70 years of age were supplemented for 24 weeks with either 1500 mg l-carnitine-l-tartrate or an isonitrogenous placebo per day in a double-blind fashion. Before and after the supplementation protocol, body mass and composition, as well as knee extensor and flexor muscle strength were determined. In the blood samples, free carnitine, interleukin-6, tumor necrosis factor-α, C-reactive protein and IGF-1 were determined. A marked increase in free plasma carnitine concentration was observed due to l-carnitine supplementation. No substantial changes in other parameters were noted. In the current study, supplementation for 24 weeks affected neither the skeletal muscle strength nor circulating markers in healthy women over 65 years of age. Positive and negative aspects of l-carnitine supplementation need to be clarified.
Assuntos
Carnitina/administração & dosagem , Músculo Esquelético/efeitos dos fármacos , Idoso , Anti-Inflamatórios/administração & dosagem , Biomarcadores/sangue , Composição Corporal , Índice de Massa Corporal , Proteína C-Reativa/metabolismo , Carnitina/sangue , Suplementos Nutricionais , Método Duplo-Cego , Feminino , Humanos , Fator de Crescimento Insulin-Like I/genética , Fator de Crescimento Insulin-Like I/metabolismo , Interleucina-6/sangue , Força Muscular/efeitos dos fármacos , Músculo Esquelético/fisiologia , Projetos Piloto , Fator de Necrose Tumoral alfa/sangueRESUMO
Lifestyle interventions in type 2 diabetes (DM2) prevention implementation studies can be effective and lasting. Long-term weight loss maintenance enhances the intervention effect through a significant decrease in diabetes incidence over time. Our objective was to identify factors predicting long-term successful weight reduction maintenance achieved during a DM2 prevention program in patients with high DM2 risk in primary health care. Study participants (n = 263), middle-aged, slightly obese with baseline increased DM2 risk (Finnish Diabetes Risk Score (FINDRISC)>14), but no diabetes were invited to receive 11 lifestyle counselling sessions, guided physical activity sessions and motivational support during 10-months. The study participants had three clinical examinations during the study (baseline, one and three years). Stepwise regression analysis was used to determine demographic, clinical, and lifestyle predictors of weight reduction maintenance two years after the discontinuation of the intervention. Out of 105 patients who completed all three examinations (baseline age 56.6 (standard deviation (SD) = 10.7), body mass index 31.1 kg/m2 (SD = 4.9), FINDRISC 18.6 (SD = 3.1)), 73 patients (70%) showed weight loss during the intervention (mean weight loss 4.2 kg, SD = 5.1). The total weight loss achieved in the maintainers (27 of 73 study participants) two years after the intervention had finished was 6.54 kg (4.47 kg+2.0 kg). The non-maintainers, on the other hand, returned to their initial weight at the start of the intervention (+0.21 kg). In multivariable analysis baseline history of increased glucose (odds ratio (OR) = 3.7; 95% confidence interval (CI) 1.0-13.6) and reduction of total fat in diet during follow-up (OR = 4.3; 95% CI 1.5-12.2) were independent predictors of successful weight loss. Further studies exploring predictors of weight loss maintenance in diabetes prevention are needed to help health care providers to redesign interventions and improve long-term outcomes of real life interventions.