Association between sarcopenic obesity with insulin resistance and metabolic syndrome. / Asociación entre obesidad sarcopénica con resistencia a la insulina y síndrome metabólico.

BACKGROUND: There is a debate as to whether sarcopenic obesity leads to an increased risk of metabolic syndrome (MS) in young adults. OBJECTIVE: To determine the association between sarcopenic obesity with MS and insulin resistance (IR). METHODS: A 5-year retrospective cross-sectional study. Subjects of the specialty consultation between 18 and 55 years old, with BMI≥35 with comorbidity or BMI≥40 with and without comorbidity were included. The association was calculated using an odds ratio (OR) with 95% confidence intervals (95% CI). RESULTS: Two hundred and fifty-four subjects were analyzed, 76.4% were women and average age was 38.36±8.78 years. The OR of IR in subjects with or without sarcopenic obesity was 2.224 (95% CI, 1127 to 4389, P=.02). The OR of MS in subjects with or without sarcopenia was 1.045 (95% CI, 0.624 to 1.748, P=.868). A difference was found between the fat mass in the group with IR vs. without IR of 60.58±14.4kg vs. 53.98±12.2kg (P<.001); likewise, between the BMI and muscle mass of 46.15±6.78kg/m2 vs. 43.51±6.11kg/m2 (P<.05) and 30.05±7.48kg vs. 27.86±5.91kg (P<.05) respectively. CONCLUSION: The association between sarcopenic obesity with IR in young adults was significant, but not with MS. Our findings emphasize the need to become aware of the importance of maintaining lean mass in obese subjects.

Septic shock from disseminated tuberculosis with splenic tuberculous abscess.

Splenic tuberculosis is a little-known and difficult to diagnose entity due to its low presentation of symptoms. It corresponds to one of the forms of extrapulmonary presentation of the disease, which in turn have a greater association with immunocompromised states such as diabetes mellitus. We present the case of a patient with diabetes mellitus who was admitted in the context of septic shock secondary to a probable splenic abscess, requiring surgical intervention. A total splenectomy was performed, managing to isolate Mycobacterium tuberculosis from the surgical specimen.

La tuberculosis esplénica es poco conocida y de difícil diagnóstico por su escasa presentación de síntomas. Corresponde a una de las formas de presentación extrapulmonar de la enfermedad, las cuales tienen mayor asociación con estados de inmunocompromiso, como la diabetes mellitus. Presentamos el caso de un paciente con diabetes mellitus que ingresó con choque séptico secundario a un probable absceso esplénico, requiriendo intervención quirúrgica en la que se llevó a cabo esplenectomía total y estudio histopatológico, con identificación de Mycobacterium tuberculosis en la pieza quirúrgica.