Analysis of clinicopathological characteristics of non-alcoholic fatty liver disease / 中华病理学杂志

Objective: To investigate the clinical and pathologic characteristics of obese adults with nonalcoholic fatty liver disease (NAFLD) and to aid the diagnosis of nonalcoholic steatohepatitis (NASH). Methods: A total of 262 patients eligible for inclusion who received volume reduction metabolism surgery and liver biopsy in the First Affiliated Hospital of Nanjing Medical University from June 2018 to September 2019 were selected. HE staining, reticular fiber staining and Masson staining were performed. Statistical analysis was performed using SPSS 20.0. Results: The patients ranged in age from 18 to 66 years. Among the 262 cases, 65 cases (65/262, 24.8%) were male and 197 cases (197/262, 75.2%) were female. Sixty-one cases (61/262, 23.3%) were non-NAFLD, 201 cases (201/262, 76.7%) were NAFLD including 27 cases (27/201, 13.4%) of nonalcoholic fatty live (NAFL) and 174 cases (174/201, 86.6%) of NASH. The main lesions of NAFLD were in hepatic acinus zone 3. There were significant differences in age, alanine aminotransferase (ALT), glutamic oxaloacetic transaminase (AST), body mass index (BMI), fasting blood-glucose (FPG) and apolipoprotein A (APOA) levels among the non-NAFLD group, NAFL group and NASH group (P<0.05). Patients with BMI≥35 m/kg2 combined with type 2 diabetes had a higher prevalence of NASH. Multiple logistic regression showed that ALT and APOA were independent predictors of NASH (P<0.001, OR=1.05, 95%CI: 1.020-1.082; P=0.027, OR=0.916, 95%CI: 0.878-0.941). Total cholesterol (CHO) and high-density lipoprotein (HDL) were independent predictors of lobular inflammation (P=0.043, 95%CI: 0.010-0.634; P=0.024, 95%CI:-3.068--0.216). AST and HDL were independent predictors of fibrosis stage (P=0.029, 95%CI: 0.001-0.021; P<0.001, 95%CI:-2.670--0.645). Conclusions: Biochemical indicators of NAFLD are closely related to its pathology. The histological lesions of NAFLD are mainly present in hepatic acinar area 3. The diagnosis of NASH is supported by extensive steatosis and high levels of CHO, ALT, AST and BMI, low levels of HDL and ApoA in biochemical markers, but pathological examination is still the gold standard for it.

Microbiota intestinal y modulación del tejido adiposo en la patogénesis de la obesidad / Gut microbiota and modulation of adipose tissue in the pathogenesis of obesity

Las investigaciones realizadas durante el último siglo relacionadas con la descripción de la Microbiota Intestinal (MI) sugieren una relación concreta entre su composición y la salud del huésped. Su desregulación denominada disbiosis intestinal ha sido asociada a distintos tipos de enfermedades gastrointestinales, metabólicas, oncológicas e incluso psiquiátricas. Destacan numerosos reportes que han informado la condición de disbiosis en la obesidad, tanto en modelos animales como humanos de distintos grupos etarios y regiones del mundo. A su vez, la composición del microbioma también ha logrado asociarse a las diferentes comorbilidades de la obesidad, postulando que la MI posee influencia en la disfunción del tejido adiposo (TA), entendiendo que corresponde al principal modulador de la patogénesis de la obesidad. Sin embargo, aún no es posible establecer una explicación mecanicista plausible. Actualmente, la utilización de tecnologías multiómicas, junto con la evaluación de variables fisiológicas, nos podrían proporcionar una mejor comprensión a la incógnita planteada. Frente a esto, el presente trabajo tiene como objetivo revisar los últimos avances en la comprensión de la influencia de la microbiota intestinal en el TA y su contribución a los mecanismos relacionados con la patogénesis de la obesidad. Entre los principales mecanismos identificados, la evidencia reporta nexos fisiológicos entre la composición de la MI y la modulación de inflamación, permeabilidad intestinal y adipogénesis. Las vías implicadas derivan de la influencia de la disbiosis intestinal en el accionar de ácidos grasos de cadena corta, claudinas, macrófagos, oligosacáridos, entre otros. Los mecanismos implicados, principalmente estudiados en modelos animales, deberían ser considerados para su evaluación en próximos estudios longitudinales y experimentales en humanos con el fin de obtener una mayor comprensión sobre la implicancia de cada mecanismo en la patogenia global de la obesidad(AU)

The investigations carried out during the last century related to the description of the Gut Microbiota (GM) suggest a concrete relationship between its composition and the health of the host. Its deregulation called intestinal dysbiosis has been associated with different types of gastrointestinal, metabolic, oncological and even psychiatric diseases. Numerous reports that have described the condition of dysbiosis in obesity stand out, both in animal and human models of different age groups and regions of the world. In turn, the composition of the microbiome has also been associated with the different comorbidities of obesity, postulating that MI has an influence on adipose tissue (AT) dysfunction, understanding that it corresponds to the main modulator of the pathogenesis of obesity. However, it is not yet possible to establish a plausible mechanistic explanation. Currently, the use of multi-omics technologies, together with the evaluation of physiological variables, could provide us with a better understanding of the question raised. In view of this, this review aims to review the latest advances in understanding the influence of the intestinal microbiota on AT and its contribution to the mechanisms related to the pathogenesis of obesity. Among the main mechanisms identified, the evidence reports physiological links between the composition of GM and the modulation of inflammation, intestinal permeability and adipogenesis. The pathways involved derive from the influence of intestinal dysbiosis on the action of short-chain fatty acids, claudins, macrophages, oligosaccharides, among others. The mechanisms involved, mainly studied in animal models, should be considered for evaluation in future longitudinal and experimental studies in humans in order to obtain a better understanding of the implication of each mechanism in the global pathogenesis of obesity(AU)

Acetate wheat starch improving blood glucose response and bilan lipid on obesity dyslipidemia mice

Abstract Resistant starch is particularly concerned with beneficial effects in regulating blood glucose concentration and lipid metabolism, reducing the risk of diabetes and cardiovascular diseases. This study aimed to validate the effects of wheat starch acetate containing 32.1% resistant starch on postprandial blood glucose response and lipid profile on obesity, dyslipidemia Swiss mice induced by a high-fat diet. The result showed that there was a restriction on postprandial hyperglycemia and remained stable for 2 hours after meal efficiently comparing with the control group fed natural wheat starch. Simultaneously, when maintaining the dose of 5g/kg once or twice a day for 8 weeks, wheat starch acetate to be able to reduce body weight and blood glucose, triglyceride, cholesterol levels compared to the control group (p<0.05)

Bioavailability of ellagitannins from cambuci (Campomanesia Phaea Berg) in healthy and obese subjects / Avaliação da biodisponibilidade dos elagitaninos de cambuci (Campomanesia phaea Berg) em indivíduos saudáveis e com sobrepeso/obesidade

Cambuci (Campomanesia phaea Berg) is a native fruit of the Atlantic Coastal Forest, belonging to the Myrtaceae family, rich in ellagitannins (ET), proanthocyanidins and other bioactive phenolic compounds (BPCs) related to beneficial effects to human health, such as systemic inflammation and attenuation of insulin resistance. Evidence indicates that the beneficial effects of some BPCs, such as ellagitannins, are associated to their chronic intake and the action of the metabolites produced. Urolithins are the main metabolites produced after consumption from a rich source of ellagitannins. According to the metabolite produced, subjects can be classified into metabotypes (A, B e 0). However, nothing is known about the uptake and metabolism of BPC from cambuci. Thus, the objectives of this study were the physical-chemical characterization of cambuci pulp, identification of BPC profile and the determination of their bioavailability in healthy and overweight/obese subjects. Therefore, subjects (n = 28, being 15 healthy and 13 overweight/obese) consumed cambuci juice, and their respective urines 24 hours after drinking were collected to identify the metabolites of ellagitannins. Cambuci presented high acidity, with pH values of ~ 2.3 and titratable acidity of ~ 1.9 g citric acid equivalents/100 g fresh weight (FW), and solids content of ~7.5 ° Brix, not being characterized as a very sweet fruit. The total phenolic content was ~ 780 mg gallic acid/100 mL juice. The total amount of flavan-3-ols found in the fruit was 45.45 g/kg dry weight (DW) and the main monomers identified were gallocatechin (22.25 g/kg DW) and epigallocatechin gallate (16.48 g/kg DW). The degree of polymerization of flavan3-ol was 32.78, indicating a high intensity of astringency and low bioavailability. Through LC-MS, 26 BPCs were identified, most of them being derived from ellagitannins, and among those identified, telemagrandin II and, pedunculagin. The total ellagic acid content found was ~6.2 mg/g DW, demonstrating that cambuci is a fruit rich in ellagic acid and its derivatives. The 28 volunteers who consumed cambuci juice for the bioavailability assessment were classified, for the first time, into metabotypes according to the type of urolithin produced. Metabotype A was the most prevalent (64.3%), followed by metabotype B (17.9%) and 0 (17.9%). When analyzed according to nutritional status, metabotype A was prevalent in both groups. In conclusion, the BCP profile of cambuci stands out for the presence of ET, such as telemagrandin II and pedunculagin. Due to the high degree of polymerization, no proanthocyanidin metabolites were observed. Metabotype A was the most prevalent in this study population, and nutritional status may not be a determining factor in the type of urolithin produced

O cambuci (Campomanesia phaea Berg), é um fruto nativo da mata Atlântica, pertencente à família das mirtáceas, rico em elagitaninos (ET), proantocianidinas e outros compostos bioativos fenólicos (CBF) que estão associados a vários efeitos biológicos benéficos à saúde humana, tais como atenuação inflamação sistêmica e da resistência à insulina. Evidências apontam que os efeitos benéficos de alguns CBF, como os elagitaninos, estão associados com sua ingestão crônica e à ação dos metabólitos produzidos. As urolitinas são os principais metabólitos produzidos após o consumo de uma fonte rica em elagitaninos. De acordo com o metabólito produzido, os indivíduos podem ser classificados em metabotipos (A, B e 0). No entanto, nada se sabe sobre a absorção e a metabolização dos CBF do cambuci. Desta forma, os objetivos deste trabalho foram a caracterização físico-química da polpa de cambuci, a identificação dos CBF e a avaliação da biodisponibilidade dos polifenóis presentes no suco deste fruto, em seres humanos saudáveis e com sobrepeso/obesidade. Para tanto, os voluntários (n = 28, sendo 15 saudáveis e 13 obesos) consumiram suco de cambuci, e suas respectivas urinas 24 horas, após a ingestão da bebida, foram coletadas para identificação dos metabólitos de elagitaninos. O cambuci apresentou uma alta acidez, com valores de pH de ~2,3 e acidez total titulável de ~1,9 g equivalentes de ácido cítrico/100 g em base úmida (b.u.), e teor de sólidos solúveis de ~7,5 ºBrix, não sendo, portanto, muito ácido. O teor de fenólicos totais encontrado foi ~ 780 mg equivalentes de ácido gálico/100 mL de suco. A quantidade total de flavan-3-ois encontrada na polpa de cambuci foi de 45,45 g/kg em base seca (b.s.) e os principais monômeros identificados foram a galocatequina (22,25 g/kg b.s.) e a epigalocatequina galato (16,48 g/kg b.s.). O grau de polimerização do flavan-3-ol foi de 32,78 indicando uma alta intensidade de adstringência e baixa biodisponibilidade. Através de LCMS foi feita a identificação de 26 CBF, sendo sua grande maioria derivados de elagitaninos, e dentre os identificados podemos destacar telemagrandina II e pedunculagina. O teor de elagitaninos encontrado foi de ~6,2 mg/g (b.s.), demonstrando que o cambuci é um fruto rico em ácido elágico e seus derivados. Os 28 voluntários que consumiram o suco de cambuci para ensaio de biodisponibilidade foram classificados, pela primeira vez, em metabotipos de acordo com o tipo de urolitina produzida. O metabotipo A foi o mais prevalente (64,3%), seguido pelo metabotipo B (17,9%) e 0 (17,9%). Quando analisados de acordo com o estado nutricional, o metabotipo A foi prevalente em ambos os grupos. Conclui-se, portanto, que o perfil de CBF do cambuci se destaca pela presença de ET, tais como telimagrandina II e pedunculagina. Devido ao alto grau de polimerização não foram observados metabólitos de proantocianidinas. O metabotipo A foi o mais prevalente na população deste estudo, e o estado nutricional pode não ser um fator determinante no tipo de urolitina produzida

Complicaciones nutricionales de la cirugía bariátrica / 9 NUTRITIONAL COMPLICATIONS OF BARIATRIC SURGERY

La cirugía bariátrica es reconocida como una terapia altamente efectiva para la obesidad, ya que logra una pérdida de peso sostenida, una reducción de las comorbilidades y la mortalidad relacionadas con la obesidad; además mejora de la calidad de vida de los pacientes. Sin embargo, las deficiencias nutricionales son un problema inherente en el período postoperatorio y, a menudo, requieren una suplementación de por vida. Los tipos de desnutrición después de la cirugía incluyen desnutrición proteico-energética y deficiencias de micronutrientes, como hierro, ácido fólico, vitamina A y vitamina B12. Lamentablemente, no existen regímenes estandarizados de cuidados posteriores, y los costos de los suplementos nutricionales los pagan los propios pacientes. Esta revisión se enfoca en el estudio de la desnutrición poscirugía bariátrica, recorriendo las principales deficiencias y sus causas

Bariatric surgery is recognized as a highly effective therapy for obesity, as it achieves sustained weight loss, a reduction in comorbidities and obesity-related mortality; It also improves the quality of life of patients. However, nutritional deficiencies are an inherent problem in the postoperative period and often require lifelong supplementation. Types of malnutrition after surgery include protein-energy malnutrition and micronutrient deficiencies, such as iron, folic acid, vitamin A, and vitamin B12. Currently, there are no standardized aftercare systems, and the costs of nutritional supplements are paid by the patients themselves. This review focuses on the study of malnutrition after bariatric surgery, covering the main deficiencies and their causes.

Correlation between COVID-19 severity, body mass index and radiological hepatic morphology / Correlación entre la gravedad de COVID-19, el índice de masa corporal y la morfología hepática radiológica

SUMMARY: Obesity and fatty liver steatosis are already considered metabolic risk factors which may aggravate the severity of COVID-19. This study aims to investigate the correlation between COVID-19 severity, obesity, and liver steatosis and fibrosis. 230 consecutive patients with laboratory-confirmed COVID-19 aged between 15 and 84? years, admitted to a hospital devoted to COVID-19 patients, were enrolled in the study. COVID-19 severity was classified as severe versus non-severe based on admission to ICU. Obesity was assessed by Body Mass Index (BMI). CT-scan was used to check for the liver steatosis. Fibrosis-4 score was calculated. The study was conducted in March-May 2020. Obesity strongly and positively correlated with severe COVID-19 illness r: 0.760 (P<0.001). Hepatic steatosis had rather less of a correlation with COVID-19 severity r: 0.365 (P<0.001). Multivariable-adjusted association between hepatic steatosis or obesity, or both (as exposure) and COVID-19 severity (as the outcome) revealed increased risk of severe COVID-19 illness with obesity (Adjusted model I OR: 465.3, 95 % CI: 21.9-9873.3, P<0.001), with hepatic steatosis (Adjusted model I OR: 5.1, 95 % CI: 1.2-21.0, P<0.025), and with hepatic steatosis among obese patients (Adjusted model I OR: 132, 95 % CI: 10.3-1691.8, P<0.001). Obesity remained the most noticeable factor that strongly correlated with COVID-19 severity, more than liver steatosis. However, the risk to COVID-19 severity was greater in those with both factors: obesity and liver steatosis.

RESUMEN: La obesidad y la esteatosis del hígado graso ya se consideran factores de riesgo metabólico que pueden empeorar la gravedad de la COVID-19. Este estudio tiene como objetivo investigar la correlación entre la gravedad de COVID- 19, la obesidad y la esteatosis y fibrosis hepática. El estudio se realizó en 230 pacientes consecutivos entre 15 y 84 años con COVID-19 confirmado por laboratorio, ingresados en un hospital dedicado a pacientes con COVID-19. La gravedad de COVID-19 se clasificó como grave, versus no grave según el ingreso a la UCI. La obesidad se evaluó mediante el índice de masa corporal (IMC). Se utilizó una tomografía computarizada para verificar la esteatosis hepática. Se calculó la puntuación de Fibrosis-4. El estudio se realizó entre marzo-mayo de 2020. La obesidad se correlacionó fuerte y positivamente con la enfermedad grave de COVID-19 r: 0,760 (P <0,001). La esteatosis hepática tuvo una correlación bastante menor con la gravedad de COVID-19 r: 0.365 (P <0.001). La asociación ajustada multivariable entre la esteatosis hepática u obesidad, o ambas (como exposición) y la gravedad de COVID-19 (como resul- tado) reveló un mayor riesgo de enfermedad grave por COVID- 19 con obesidad (OR del modelo ajustado I: 465,3, IC del 95%: 21,9 -9873,3, P <0,001), con esteatosis hepática (OR del modelo I ajustado: 5,1, IC del 95 %: 1,2-21,0, P <0,025) y con esteatosis hepática entre los pacientes obesos (OR del modelo I ajustado: 132, IC del 95 % : 10,3-1691,8, P <0,001). La obesidad siguió siendo el factor más notable que se correlacionó significativamente con la gravedad de COVID-19, más que la esteatosis hepática. Sin embargo, el riesgo de gravedad de COVID-19 fue mayor en aquellos con ambos factores: la obesidad y esteatosis hepática.

Reconstrucción del pene oculto del adulto: experiencia en un mismo centro / Adult Buried Penis Reconstruction: a single center experience

Introducción. El pene oculto del adulto se presenta como una patología con prevalencia en ascenso, por el incremento de pacientes obesos y diabéticos. Representa un desafío para la reconstrucción en cirugía plástica y urología. El objetivo de este trabajo es describir la experiencia del Hospital Alemán de Buenos Aires en la resolución quirúrgica de esta patología. Métodos y resultados. Durante el año 2019 se realizaron dos cirugías reconstructivas de pacientes con pene oculto del adulto a cargo del Servicio de Cirugía Plástica del Hospital, en conjunto con el Servicio de Urología. El procedimiento fue segmentado en tres partes: Liberación del cuerpo peneano del panículo adiposo, dermolipectomía suprapúbica, y finalmente injerto del pene con piel de espesor total. El tiempo promedio de cirugía fue de 4 horas, sin complicaciones intraoperatorias. En ambos casos hubo prendimiento parcial del injerto, con la necesidad de tratamiento tópico con crema de colagenasa para estimular la cicatrización por segunda intención. La satisfacción funcional de los pacientes fue del 100% en ambos casos; la satisfacción estética fue incompleta. La recuperación de la erección y la función sexual fue completa para ambos. Conclusiones. La reconstrucción del pene oculto del adulto implica el trabajo multidisciplinario sobre una patología con resolución quirúrgica, con buenos resultados funcionales, aunque no exento de complicaciones estéticas.

Introduction. Adult buried penis represents a disease with increasing prevalence, after the ascending incidence of obese and diabetic patients. It represents an urologic and plastic surgery challenge. The aim of this paper is to describe the experience of German Hospital in Buenos Aires on the surgical resolution of this pathological entity. Methods and results. During year 2019 two adult buried penis surgeries were held by the Plastic Surgery service, with participation of the Urology service. The procedure was divided in three steps: Release of the penis from the adipose panicle; suprapubic dermolipectomy; and finally full-thickness skin graft on the penis body. The average surgery time was four hours. In both cases there was partial intake of the skin graft, which needed collagenase topical treatment to stimulate second intention healing. Functional satisfaction was 100% in both cases; aesthetical satisfaction was incomplete. Recovery of penile erection and sexual function was complete in both cases. Conclusions. Adult penis reconstruction implies an interdisciplinary work on a surgically correctable anomaly, with good functional results, although not exempt of aesthetical complications

Effect of the phenolic compounds from Sabara jaboticaba (Plinia jaboticaba (Vell. ) Berg) in reducing health risks caused by obesity / Efeito dos compostos fenólicos da jabuticaba Sabará (Plinia jaboticaba (Vell. ) Berg) na redução dos riscos à saúde causados pela obesidade

Sabara jaboticaba (Plinia jaboticaba (Vell.) Berg) is a Brazilian native fruit from Atlantic Forest, rich in polyphenols and appreciated for consumption both in natura and in various preparations. This study aimed to evaluate whether phenolic compounds of Sabara jaboticaba, in the form of phenolic extract (PEJ), can reduce the health risks caused by obesity and associated health problems induced by a fat-sucrose-rich diet (HFSD) in C57BL/6J mice. Initially, for 14 weeks, 66 8-week-old male mice were randomly distributed into two groups: negative control (CH), fed with standard AIN96M diet and water ad libitum; positive control (HFS), fed with HFSD and water ad libitum. At the end of this stage, 10 animals from each group were euthanized under anesthesia and their organs and tissues collected. The remaining animals were redistributed into four groups for another 14 weeks: group CH, fed a standard diet and water; HFS group, fed with HFSD and water; PEJ1 group, fed with HFSD and PEJ at the dose of 50 mg equivalent of gallic acid (GAE)/kg of body weight (BW); group J100 fed with HFSD and PEJ at the dose of 100 mg GAE/kg BW. Food intake, BW, and fasting blood glucose (FBG) were measured weekly and water (CH and HFS) or PEJ (PEJ1 and PEJ2) were daily administered. In the 26th week the intraperitoneal insulin tolerance test (ipITT) was performed, in the 27th, the oral glucose tolerance test (oGTT), and, in the 28th, the analyzes related to energy homeostasis. At the end of the experiment, the animals were euthanized under anesthesia and their organs and tissues were collected. When compared to the HFS group, animals that received PEJ showed decrease in BW gain of approx. 30% and of approx. 45% in the gain of total white adipose tissues (WAT). In addition, the PEJ groups showed less hypertrophied adipocytes. Inflammation markers were significantly reduced in both treated groups. The FBG was approx. 13% lower for the PEJ groups compared to the HFS group. In addition, the mean values of ipITT, oGTT, insulin and HOMA-IR demonstrated that PEJ increased insulin sensitivity and decreased glucose intolerance. GLUT4 expression in the muscle was also increased in the treated groups. The fecal lipid content was lower in the PEJ groups when compared to the HFS group, suggesting that PEJ inhibited pancreatic lipase activity both in vitro and in vivo. In the PEJ groups, the levels of total cholesterol, LDL and NEFA were reduced and those of HDL increased. The hepatic concentration of TAG was also reduced by PEJ. Energy expenditure and UCP1 expression were higher for both supplemented groups when compared to the HFS group. PEJ positively altered the intestinal microbiota and the analysis of metabolites showed that animals treated with PEJ had different metabolomic profile. Together, these results demonstrated that polyphenols from jaboticaba may be used as adjuvants against obesity and associated health problems

A jabuticaba Sabará (Plinia jaboticaba (Vell.) Berg) é um fruto nativo da Mata Atlântica brasileira, rico em polifenóis e apreciado para o consumo tanto in natura quanto em preparos variados. O objetivo deste trabalho foi avaliar se compostos fenólicos da jabuticaba Sabará, na forma de extrato fenólico (PEJ), são capazes de reduzir os riscos à saúde causados pela obesidade e problemas de saúde associados induzidos por uma dieta rica em lipídios e sacarose (HFSD) em camundongos C57BL/6J. Inicialmente, durante 14 semanas, 66 animais machos com oito semanas de vida foram distribuídos aleatoriamente em dois grupos: controle negativo (CH), alimentado com dieta padrão AIN96M e água ad libitum; controle positivo (HFS), alimentado com HFSD e água ad libitum. Ao final desta etapa, 10 animais de cada grupo foram eutanasiados sob anestesia e seus órgãos e tecidos coletados. Os animais restantes foram redistribuídos em quatro grupos por mais 14 semanas: grupo CH, alimentado com dieta padrão e água; grupo HFS, alimentado com HFSD e água; grupo PEJ1, alimentado com HFSD e PEJ na dose de 50 mg equivalente de ácido gálico (EAG)/kg de massa corporal (m.c.); grupo J100 alimentado com HFSD e PEJ na dose de 100 mg EAG/kg m.c. O consumo de ração, a massa corporal e a glicemia de jejum (FBG) foram medidos semanalmente e as gavagens de água (CH e HFS) ou PEJ (PEJ1 e PEJ2) foram realizadas diariamente. Na 26ª semana foi realizado o teste intraperitoneal de tolerância à insulina (ipITT), na 27ª o teste oral de tolerância à glicose (oGTT) e na 28ª as análises relacionadas a homeostase energética. Ao final do experimento os animais foram eutanasiados sob anestesia e seus órgãos e tecidos coletados. Quando comparados ao grupo HFS, animais que receberam o PEJ apresentaram ganho de massa corporal aprox. 30% menor e aprox. 45% menos massa total de tecidos adiposos brancos (TAB). Além disso, os grupos PEJ apresentaram adipócitos menos hipertrofiados. Marcadores de inflamação foram significativamente reduzidos em ambos os grupos tratados. A FBG foi aprox. 13% inferior para os grupos PEJ em relação ao grupo HFS. Além disso, os valores médios de ipITT, oGTT, insulina e HOMA-IR demonstraram que o PEJ aumentou a sensibilidade à insulina e diminuiu a intolerância à glicose. A expressão do GLUT4 no músculo estava aumentada nos grupos tratados. O conteúdo lipídico fecal dos grupos PEJ foi superior ao do grupo HFS, sugerindo que, assim como ocorreu in vitro, o extrato inibiu a atividade da lipase pancreática in vivo. Os níveis de colesterol total (PEJ1), LDL e NEFA foram reduzidos e os de HDL aumentados. A concentração hepática de TAG também foi reduzida pelo PEJ. O gasto energético e a expressão de UCP1 foram superiores para ambos os grupos suplementados quando comparados ao grupo HFS. PEJ alterou positivamente a microbiota intestinal e a análise de metabólitos mostrou que os animais tratados com PEJ possuíam perfil metabolômico diferente. Em conjunto, estes resultados demonstraram que os CFJS podem ser usados como adjuvantes no combate a obesidade e problemas de saúde associados

Effects of maternal high fat intake during pregnancy and lactation on total cholesterol and adipose tissue in neonatal rats / Efeitos do consumo materno de dieta hiperlipídica durante a gestação e lactação no colesterol total e tecido adiposo de ratos neonatos

Abstract Aim Obesity during pregnancy is one of the most established risk factors for negative long-term programming. The aim of the present study was to investigate the effects of maternal consumption of a high-fat diet during pregnancy and lactation on the weight gain, visceral adipose tissue and cholesterolemia in neonatal rats. Methods Wistar rats were divided into two groups according to the mother's diet during pregnancy and lactation: Control group (CG, n = 12) were the offspring of rats fed a standard diet (4% lipid) and the Test group (TG, n = 12) were pups rats fed on a high fat diet (23% lipid). The weight of the animals was measured on alternate days until the 22nd day of life, when collected visceral adipose tissue and blood were collected for biochemical analysis. For statistical analysis the Student t test, Sidak´s teste and two way ANOVA was used, with p <0.05. Results the test group showed differences in weight gain, visceral adipose tissue and higher cholesterol. Conclusion a maternal exposure to a high-fat diet during pregnancy and lactation can promote changes in weight gain, hypercholesterolemia and an increase in adipose tissue in neonatal rats.

Resumo Objetivo A obesidade durante a gestação é um dos fatores de risco mais estabelecidos para uma programação negativa em longo prazo. O objetivo do presente estudo foi investigar os efeitos do consumo materno de uma dieta hiperlipídica durante a gestação e lactação no aumento do peso, do tecido adiposo visceral e colesterolemia em ratos neonatos. Métodos Ratos Wistar foram divididos em dois grupos de acordo com a dieta da mãe durante a gestação e lactação: grupo controle (GC, n=12) composto por filhotes de ratas alimentadas com uma dieta padrão (lipídios 4%) e o grupo teste (GT, n=12) composto de filhotes de ratas alimentadas com dieta hiperlipídica (lipídios 23%). O peso dos animais foi aferido em dias alternados até o 22° dia de vida, quando foi coletado sangue para análises bioquímicas. Para a análise estatística utilizou-se os seguintes testes: two way ANOVA, teste de Sidak e teste t de Student, com p< 0,05. Resultados O grupo teste mostrou diferença no ganho de peso, no tecido adiposo visceral e nos níveis de colesterol. Conclusão Uma exposição materna a uma dieta hiperlipídica durante a gestação e lactação pode promover maior ganho ponderal, hipercolesterolemia e um aumento do tecido adiposo em ratos neonatos.

Cardiac, Metabolic and Molecular Profiles of Sedentary Rats in the Initial Moment of Obesity / Perfis Cardíaco, Metabólico e Molecular de Ratos Sedentários no Momento Inicial da Obesidade

Abstract Background: Different types of high-fat and/or high-energy diets have been used to induce obesity in rodents. However, few studies have reported on the effects observed at the initial stage of obesity induced by high-fat feeding on cardiac functional and structural remodelling. Objective: To characterize the initial moment of obesity and investigate both metabolic and cardiac parameters. In addition, the role of Ca2+ handling in short-term exposure to obesity was verified. Methods: Thirty-day-old male Wistar rats were randomized into two groups (n = 19 each): control (C; standard diet) and high-fat diet (HF, unsaturated high-fat diet). The initial moment of obesity was defined by weekly measurement of body weight (BW) complemented by adiposity index (AI). Cardiac remodelling was assessed by morphological, histological, echocardiographic and papillary muscle analysis. Ca2+ handling proteins were determined by Western Blot. Results: The initial moment of obesity occurred at the 3rd week. Compared with C rats, the HF rats had higher final BW (4%), body fat (20%), AI (14.5%), insulin levels (39.7%), leptin (62.4%) and low-density lipoprotein cholesterol (15.5%) but did not exhibit alterations in systolic blood pressure. Echocardiographic evaluation did not show alterations in cardiac parameters. In the HF group, muscles were observed to increase their +dT/dt (C: 52.6 ± 9.0 g/mm2/s and HF: 68.0 ± 17.0 g/mm2/s; p < 0.05). In addition, there was no changes in the cardiac expression of Ca2+ handling proteins. Conclusion: The initial moment of obesity promotes alterations to hormonal and lipid profiles without cardiac damage or changes in Ca2+ handling.

Resumo Fundamentos: Diferentes tipos de dietas hiperlipídicas e/ou hipercalóricas têm sido usados para induzir obesidade em roedores. No entanto, poucos estudos relataram os efeitos da obesidade induzida por dieta hiperlipídica em sua fase inicial sobre a remodelação cardíaca funcional e estrutural. Objetivo: Caracterizar o momento inicial da obesidade e investigar parâmetros metabólicos e cardíacos. Além disso, analisar o papel do trânsito de Ca+2 em curtos períodos de exposição à obesidade. Métodos: Ratos Wistar com idade de 30 dias foram distribuídos aleatoriamente em dois grupos (n = 19 em cada grupo): controle (C, dieta padrão) e dieta hiperlipídica (HL, dieta rica em gordura insaturada). O momento inicial da obesidade foi definido por medidas semanais do peso corporal, complementadas pelo índice de adiposidade (IA). A remodelação cardíaca foi avaliada por análise morfológica, histológica, ecocardiográfica e funcional dos músculos papilares. Proteínas envolvidas no trânsito de Ca2+ foram determinadas por Western Blot. Resultados: O momento inicial da obesidade ocorreu na terceira semana. Em comparação aos ratos C, os animais HL apresentaram maior peso corporal final (4%), gordura corporal (20%), IA (14,5%), níveis de insulina (39,7%), leptina (62,4%) e lipoproteína de baixa densidade (15,5%), mas não apresentaram alterações na pressão sistólica. A avaliação ecocardiográfica não mostrou alterações nos parâmetros cardíacos. No grupo HL, observou-se um aumento no +dT/dt (C: 52,6 ± 9,0 g/mm2/s e HL: 68,0 ± 17,0 g/mm2/s; p < 0,05) muscular. Além disso, não houve alterações na expressão cardíaca de proteínas envolvidas no trânsito de Ca2+. Conclusão: O momento inicial da obesidade promove alterações nos perfis hormonais e lipídicos sem causar danos cardíacos ou mudanças no trânsito de Ca2+.

Lean vs. obese mice: the ventral prostate revisited / Ratones magros vs. ratones obesos: revisión de la próstata ventral

Obese mice (C57BL/6J-ob/ob) do not express leptin and develops hyperphagia, decreased energy expenditure, obesity, hyperglycemia, hyperinsulinemia, hypothermia, and infertility. Obesity causes reproductive dysfunction with negative impacts on prostatic structure and fertility. We aimed to compare the structure and molecular aspects of the ventral prostate between of lean and obese (ob/ob) mice. Three months old male lean and obese mice had their prostates dissected and prepared for light microscopy and immunofluorescence. In comparison to the lean mouse, the obese mouse showed a substantial structural modification in the ventral prostate starting with an atrophy of the prostate ventral lobe. Histologically, the acini showed a reduction in size, and in the lumen, we found a mixed secretion PAS positive and negative. Epithelial changes consisted of a hypertrophied acinar epithelium with intraepithelial neoplasia focuses. Also, we observed a marked expression of PCNA and Caspase3 in the epithelium indicating even cellular proliferation as cell death. The stroma showed a high activity of the extracellular matrix remodeling with marked deposition of collagen fibers and smooth muscle cells. Around the ventral region, we observed an increase in the presence of adipose tissue. The expressions of interleukin 6 and tumor necrosis factor alpha were present in the ventral prostate of the obese mice indicating inflammation. In conclusion, obesity negatively modulates prostate in ob/ob mice, directly affecting cellular and structural mechanisms necessary for the maintenance of prostate and reproductive structure.

Los ratones obesos (C57BL / 6J-ob / ob) no expresan leptina y desarrollan hiperfagia, disminución del gasto energético, obesidad, hiperglucemia, hiperinsulinemia, hipotermia e infertilidad. La obesidad causa disfunción reproductiva con impacto negativo sobre la estructura prostática y la fertilidad. El objetivo de nuestro trabajo consistió en comparar la estructura y los aspectos moleculares de la próstata ventral en ratones magros y obesos (ob/ob). Se disecaron las próstatas de ratones machos obesos, de tres meses de edad, y fueron preparadas para visualizarlas por microscopía óptica e inmunofluorescencia. En comparación con el ratón magro, el ratón obeso mostró una sustancial modificación estructural en la próstata ventral comenzando con una atrofia del lóbulo ventral de la próstata. Histológicamente, los acinos mostraron una reducción de tamaño, y en el lumen, encontramos una secreción mixta PAS positiva y negativa. Los cambios epiteliales consistieron en un epitelio acinar hipertrofiado con focos de neoplasia intraepitelial. Además, se observó una marcada expresión de PCNA y Caspase3 en el epitelio, que indica tanto la proliferación celular como la muerte celular. El estroma mostró una alta remodelación de la matriz extracelular con marcada deposición de fibras de colágeno y células de músculo liso. Alrededor de la región ventral, se observó un aumento en la presencia de tejido adiposo. Las expresiones de interleuquina 6 y factor de necrosis tumoral alfa estaban presentes en la próstata ventral de los ratones obesos indicando inflamación. En conclusión, la obesidad modula negativamente la próstata en los ratones ob/ob, afectando directamente los mecanismos celulares y estructurales necesarios para el mantenimiento de la estructura de la próstata y la reproducción.

Ferulic acid lowers body weight and visceral fat accumulation via modulation of enzymatic, hormonal and inflammatory changes in a mouse model of high-fat diet-induced obesity

Previous studies have reported on the glucose and lipid-lowering effects of ferulic acid (FA) but its anti-obesity potential has not yet been firmly established. This study investigated the possible anti-obesitogenic effects of FA in mice fed a high-fat diet (HFD) for 15 weeks. To assess the antiobesity potential of FA, 32 male Swiss mice, weighing 20–25 g (n=6–8 per group) were fed a normal diet (ND) or HFD, treated orally or not with either FA (10 mg/kg) or sibutramine (10 mg/kg) for 15 weeks and at the end of this period, the body weights of animals, visceral fat accumulation, plasma levels of glucose and insulin hormone, amylase and lipase activities, the satiety hormones ghrelin and leptin, and tumor necrosis factor-α (TNF-α) and monocyte chemoattractant protein-1 (MCH-1) were analyzed. Results revealed that FA could effectively suppress the HFD-associated increase in visceral fat accumulation, adipocyte size and body weight gain, similar to sibutramine, the positive control. FA also significantly (P<0.05) decreased the HFD-induced elevations in serum lipid profiles, amylase and lipase activities, and the levels of blood glucose and insulin hormone. The markedly elevated leptin and decreased ghrelin levels seen in HFD-fed control mice were significantly (P<0.05) reversed by FA treatment, almost reaching the values seen in ND-fed mice. Furthermore, FA demonstrated significant (P<0.05) inhibition of serum levels of inflammatory mediators TNF-α, and MCH-1. These results suggest that FA could be beneficial in lowering the risk of HFD-induced obesity via modulation of enzymatic, hormonal and inflammatory responses.

Effect of summer holidays on anthropometric measures and body composition of older adults, inadequacy of body mass index to detect changes during a critical period: a pilot study / Efecto de las vacaciones de verano en la composición corporal de adultos mayores, insuficiencia del índice de masa corporal para detectar cambios durante un período crítico: un estudio piloto

Obesity is a major health problem worldwide. Obesity prevalence in Chilean older adults (OA) is increasing, associated with several negative health outcomes. Therefore, determining critical periods of adiposity increase is relevant in OA. The aim of the study was to assess body composition changes in OA during summer holidays. This observational study involved two test visits, without a control group. Twelve OA (9 females) with an average age of 71.92±6.97 years participated in an initial evaluation (E1) and final evaluation (E2) at the beginning and at the end of the summer in 2015. Weight, height, and body mass index (BMI) were assessed; fat-free mass (FFM), fat mass (FM), and muscular mass (MM) data were collected through foot-to-foot bioimpedance analysis. No significant variations were reported in weight and BMI between E1 and E2. This prevalence was maintained between E1 and E2. The FM significantly increased between E1 (27.63±10.91) and E2 (28.64±11.39) (p= 0.007), while the FFM significantly decreased between E1 (45.38±5.89) and E2 (44.33±5.36) (P= 0.006), also the MM between E1 (43.08±5.62) and E2 (42.07±5.10). Both, weight and BMI are insufficient measures for detecting changes during this critical summer holiday period. However, the body composition measures identified significant changes in the OA during the study.

La obesidad es el principal problema de salud en todo el mundo. La prevalencia de obesidad en adultos mayores (AM) chilenos es cada vez mayor, lo que se ha asociado con varios efectos negativos para la salud. Por lo tanto, la determinación de períodos críticos de aumento de la adiposidad es relevante en AM. El objetivo fue evaluar los cambios de la composición corporal en adultos mayores AM durante las vacaciones de verano. Doce AM participaron en una evaluación inicial (E1) y final (E2) del verano 2015. Se evaluó: peso, talla, índice de masa corporal (IMC), masa libre de grasa (MLG), masa grasa (MG) y masa muscular (MM). No hubo diferencias significativas en peso e IMC. La MG aumentó entre E1 (27,63±10,91) y E2 (28,64±11,39) (p= 0,007), la MLG disminuyó significativamente entre E1 (45,38±5,89) y E2 (44,33±5,36), como también la MM entre E1 (43,08±5,62) y E2 (42,07±5,10). Tanto el peso como el IMC son medidas insuficientes para detectar cambios durante este período crítico de vacaciones de verano. Sin embargo, las medidas de la composición corporal identificaron cambios significativos en AM durante el estudio.

High-intensity interval training beneficial effects in diet-induced obesity in mice: adipose tissue, liver structure, and pancreatic islets / Efectos beneficiosos del entrenamiento con intervalos de alta intensidad en la obesidad inducida por dieta en ratones: tejido adiposo: estructura del hígado e islotes pancreáticos

The study aimed to evaluate the impact of high-intensity interval training (HIIT) on adipose tissue, pancreatic islets and liver in mice fed high-fat diet. C57BL/6 male mice were fed one of two diets: standard chow (Lean group - LE) or a high-fat diet (Obese group ­ OB). After the first 12-weeks, the animals were divided into non-trained (LE-NT and OB-NT), trained groups (LE-T and OB-T), and started the exercise protocol. The HIIT protocol in the trained animals (LE-T and OB-T) compared to their counterparts (LE-NT and OB-NT) led to a reduction in size of the pancreatic islets (LE-T vs. LE-NT -40 %, OB-T vs. OB-NT -22 %) and to an increase in insulin immunodensity in pancreatic islet (LE-T vs. LE-NT +35 %, OB-T vs. OB-NT +31 %). Apart from the above results, in adipose tissue, a decrease of the diameter of adipocytes (LE-T vs. LE-NT -23 %, OB-T vs. OB-NT -12 %), a reduction in adiposity index (LE-T vs. LE-NT -49 %, OB-T vs. OB-NT -24 %) and in the liver, a decrease in the context of hepatic steatosis (LE-T vs. LE-NT -57 %, OB-T vs. OB-NT -77 %). These metabolic changes characterize a benefits performance of the HIIT protocol in swimming. HIIT is able to mitigate the bad effects caused by high-fat diet, even with continued intake of this diet in an animal model. HIIT has the advantage of requiring only a few weekly sessions with short duration in each session. These benefits are important to motivate people who nowadays live with a lack of time condition for these activities.

El objetivo fue evaluar el impacto del entrenamiento con intervalos de alta intensidad (EIAI) sobre el tejido adiposo, el hígado y los islotes pancreáticos en ratones alimentados con dieta alta en grasas. Ratones C57BL/6, machos fueron alimentados con una de dos dietas: dieta estándar (grupo magro - MA) o una dieta alta en grasas (grupo obeso - OB). Después de las primeras 12 semanas, los animales fueron divididos en dos grupos, no entrenados (MA-NE y OB-NE) y grupos entrenados (MA-E y OB-E), y comenzaron el protocolo de ejercicio. El protocolo de IEAI en los animales entrenados (MA-E y OB-E) en comparación con sus contrapartes (MA-NE y OB-NE) condujo a una reducción en el tamaño de los islotes pancreáticos (MA-E vs. MA-NE -40 %, OB-E vs. OB-NE -22 %) y al aumento de la inmunodensidad de insulina en los islotes pancreáticos (MA-E vs. MA-NE +35 %, OB-E vs. OB-NE +31 %). Además, en el tejido adiposo se detectó una disminución del diámetro de los adipocitos (MA-E vs. MA-NE -23 %, OB-E vs. OB-NE -12 %), una reducción en el índice de adiposidad (MA-E vs. MA-NE -49 %, OB-E vs. OB-NE -24 %) y en el hígado una disminución de la esteatosis (MA-E vs. MA-NE -57 %, OB-E vs. OB-NE -77 %). Estos cambios metabólicos caracterizan una actuación beneficiosa del protocolo de EIAI en la natación. El EIAI es capaz de mitigar los efectos negativos causados por la dieta alta en grasas, incluso con la ingesta continuada de esta dieta en el modelo animal. La EIAI tiene la ventaja de requir sólo unas pocas sesiones semanales con corta duración de cada sesión. Estos beneficios son importantes para motivar a la personas en las condiciones de falta de tiempo que tienen en la actualidad.

El órgano adiposo, un arcoiris de regulación metabólica y endocrina / Adipose organ, a metabolic and endocrine regulating rainbow

Introducción: el adipocito es una célula multifuncional e interviene en la homeostasis sistémica a través de la producción de adipocinas. Con la presente revisión se pretende revisar el estado actual del conocimiento respecto al tejido adiposo, y proponer la consolidación del concepto de órgano adiposo. Desarrollo: el tejido adiposo está constituido por diferentes tipos de adipocitos, no solamente el blanco y pardo, sino también el beige, el rosa y la célula estrellada hepática; todos ellos, además, se integran funcionalmente con células no grasas. Este hecho permite la evolución hacia el concepto de órgano adiposo, con funciones metabólicas, endocrinas y regulatorias, tanto a nivel sistémico como local en algunos órganos, como es el caso del adipocito rosa en la glándula mamaria lactante, y de la célula estrellada en el hígado. Estas funciones se ejercen a través de la producción de una gran diversidad de adipocinas, con efectos autocrinos y paracrinos complejos. La transdiferenciación entre diferentes tipos de adipocitos permite entender la importancia de la integración de las funciones en el órgano adiposo. La alteración de la homeostasis de estas células y el desequilibrio en la producción de adipocinas que ocurre como resultado de la obesidad, genera una debacle metabólica que conduce al síndrome metabólico. Conclusiones: el concepto de órgano adiposo permite comprender integralmente la función de los adipocitos en el contexto de la regulación sistémica. La investigación sobre los diferentes tipos de adipocitos ­y sobre el funcionamiento del órgano adiposo en conjunto­ conducirá a un mejor entendimiento de estos procesos, tanto a nivel fisiológico, como patológico(AU)

Introduction: adipocyte is a multifunctional cell that intervenes in the systemic homeostasis through the production of adipokines. The present review intended to revise the present situation of the knowledge on the adipose tissue and to make proposals for the consolidation of the concept of adipose organ. Development: the adipose tissue is made up of different types of adipocytes, not only the white and the brown but also the beige, the pink and the hepatic stellate cell. All of them are functionally integrated with non-fatty cells. This fact allows the evolution into the concept of adipose organ, with metabolic, endocrine and regulatory functions both at the systemic and local levels in some organs, as it happens in the rose adipocyte in the lactating mammary gland and in the hepatic stellate cells. These functions are performed through the production of a wide diversity of adipokines, with complex autocrine and paracrine effects. The transdifferentiation of several types of adipocytes allows understanding the importance of integrating these functions into the adipose organ. The alteration of homeostasis in these cells and the imbalanced production of adipokines that takes place as a result of obesity, generate metabolic chaos leading to metabolic syndrome. Conclusions: the concept of the adipose organ allows understanding in a comprehensive way the function of adipocytes in the systemic regulation. This research on the different types of adipocytes - and on the functioning of the adipose organ as a whole - will lead to a better understanding of these processes at both the physiological and pathological level(AU)

Optimal Cutoff Points of Anthropometric Parameters to Identify High Coronary Heart Disease Risk in Korean Adults

Several published studies have reported the need to change the cutoff points of anthropometric indices for obesity. We therefore conducted a cross-sectional study to estimate anthropometric cutoff points predicting high coronary heart disease (CHD) risk in Korean adults. We analyzed the Korean National Health and Nutrition Examination Survey data from 2007 to 2010. A total of 21,399 subjects aged 20 to 79 yr were included in this study (9,204 men and 12,195 women). We calculated the 10-yr Framingham coronary heart disease risk score for all individuals. We then estimated receiver-operating characteristic (ROC) curves for body mass index (BMI), waist circumference, and waist-to-height ratio to predict a 10-yr CHD risk of 20% or more. For sensitivity analysis, we conducted the same analysis for a 10-yr CHD risk of 10% or more. For a CHD risk of 20% or more, the area under the curve of waist-to-height ratio was the highest, followed by waist circumference and BMI. The optimal cutoff points in men and women were 22.7 kg/m2 and 23.3 kg/m2 for BMI, 83.2 cm and 79.7 cm for waist circumference, and 0.50 and 0.52 for waist-to-height ratio, respectively. In sensitivity analysis, the results were the same as those reported above except for BMI in women. Our results support the re-classification of anthropometric indices and suggest the clinical use of waist-to-height ratio as a marker for obesity in Korean adults.

Efeito dos compostos fenólicos do camu-camu e do cupuaçu no desenvolvimento da obesidade e diabetes mellitus tipo 2 / Effects of camu camu and cupuassu phenolic compounds on obesity and type 2 diabetes mellitus development

A incidência da obesidade e do diabetes do tipo 2 tomou proporções epidêmicas nos últimos anos, atingindo bilhões de indivíduos em todo o mundo. A descoberta de formas inovadoras capazes de reduzir as alterações metabólicas associadas a estas doenças é fundamental para minimizar o seu impacto na qualidade de vida da população e na economia dos países. Muitos estudos têm demonstrado que os compostos bioativos de alimentos possuem efeitos benéficos à saúde. O camu-camu e o cupuaçu são frutas nativas da região amazônica com potencial agroeconômico ainda inexplorado, que contêm um grande número de compostos fitoquímicos que podem atuar sobre o metabolismo corporal. Desta forma, o objetivo deste estudo foi verificar os efeitos dos compostos fenólicos de extratos do camu-camu e do cupuaçu no desenvolvimento da obesidade e do diabetes tipo 2 em ensaios in vivo e in vitro, e identificar os possíveis metabólitos envolvidos nestes efeitos. Os extratos ricos em compostos fenólicos da polpa comercial destes frutos foram extraídos em fase sólida, caracterizados por cromatografia líquida de alta eficiência (CLAE/DAD) e avaliados quanto à inibição da atividade de enzimas digestivas in vitro. Os extratos obtidos foram então testados em duas diferentes concentrações (2,25 e 4,5 mg de equivalentes de catequina/Kg de peso corporal para o cupuaçu; 7 e 14 mg de equivalentes de ácido gálico/Kg de peso corporal para o camu camu) em um modelo animal de obesidade e resistência insulínica induzida por dieta com alto teor de lipídios e sacarose em camundongos C57BL/6J. Foram investigados os efeitos destes compostos sobre as homeostases glicídica e lipídica através de análises séricas, testes de tolerância à insulina e à glicose e conteúdo de lipídios hepáticos e fecais. O extrato do camu camu apresentou flavonóis, ácido elágico e elagitaninos em sua composição. A suplementação com o extrato de compostos fenólicos do camu camu reduziu o ganho de peso corporal e diminuiu a intolerância à glicose e à insulina, independente da dose administrada. No entanto, a administração destes extratos não apresentou efeitos sobre o metabolismo lipídico. Estes resultados foram associados a um possível efeito de saciedade, com consequente redução da ingestão da dieta e da glicolipotoxicidade, e com um efeito anti-inflamatório devido à diminuição dos níveis de proteína C reativa. Já o extrato de cupuaçu apresentou flavanóis, flavonas e proantocianidinas em sua composição. A suplementação com o extrato de cupuaçu na maior dose testada melhorou a homeostase da glicose e principalmente dos lipídios, protegendo o tecido hepático dos danos causados pela dieta com alto teor de lipídios e sacarose. Estes efeitos foram associados à inibição de enzimas digestivas, com consequente menor absorção de lipídios provenientes da dieta, reduzindo assim a resistência à insulina no fígado, a hiperglicemia e a dislipidemia. Ainda, foi avaliada a distribuição de metabólitos no trato gastrointestinal de camundongos após a administração aguda do extrato de cupuaçu. Foi possível identificar a complexa mistura de polifenóis presentes no extrato de cupuaçu ao longo do trato gastrointestinal, que posteriormente foi metabolizada pela microbiota. Entre os metabólitos encontrados estão as agliconas hipolaetina e isoscutelareína, e os metabolitos microbianos da epicatequina como o 3,4-diHPP-2-ol e a 5-(3,4-dihidroxiphenil)-γ-valerolactona. De acordo com estes resultados, as diferenças na composição de compostos fenólicos encontradas entre os extratos das duas frutas foram responsáveis pelos diferentes resultados nos protocolos in vivo e a identificação dos metabólitos microbianos possibilita o conhecimento dos compostos possivelmente implicados nos efeitos benéficos. Novos estudos podem contribuir para um melhor entendimento dos mecanismos, bem como quais metabólitos estão associados aos efeitos benéficos que os compostos presentes nestas duas frutas apresentaram neste estudo

The incidence of obesity and type 2 diabetes reached epidemic proportions in recent years, arriving to billions of people around the world. The discovery of innovative ways that can reduce the metabolic abnormalities associated with these diseases is essential to minimize its impact on the population's quality of life and the economy of the countries. Many studies have demonstrated that food bioactive compounds have beneficial health effects. Camu-camu and cupuassu are native fruits of the Amazon region with unexplored agroeconomic potential, which contain a large number of phytochemical compounds that can act on body metabolism. Thus, the objective of this study was verify the effects of phenolic compounds of camu-camu and cupuassu extracts on the development of obesity and type 2 diabetes in vivo and in vitro, and identfy the possible metabolites involved in these effects. The phenolic compound-rich extracts were obtained from commercial frozen fruit pulps by solid phase extraction, characterized by high-performance liquid chromatography (HPLC/DAD) and evaluated for inhibition of digestive enzymes activities in vitro. Then, the extracts were tested at two different doses (2.25 and 4.5 mg catechin equivalents/kg body weight for cupuassu; 7 and 14 mg of gallic acid equivalents/kg body weight for camu camu) in an animal model (C57BL/6J mice) of obesity and insulin resistance induced by high fat high sucrose diet. The effects of extract supplementation on glucose and lipid homeostasis were assessed by serum analysis, insulin and glucose tolerance tests in mice, and contents of fat in liver and fecal samples. Camu camu extract presented flavonols, ellagic acid and ellagitannins in its composition. Supplementation with camu camu phenolic extract reduced weight gain and decreased glucose and insulin intolerance independent of the dose administered. However, no effects on lipid metabolism were found. These findings were associated with a possible effect of satiety with a consequent reduction in energy intake and glicolipotoxicity, and anti-inflammatory properties. Cupuassu extract presented flavanols, flavones and proanthocyanidins in its composition. Supplementation with cupuacu extract at the highest dose improved glucose homeostasis and plasmatic lipid levels, protecting the liver tissue from damage caused by diet rich in lipids and sucrose. These effects were associated with inhibition of digestive enzymes, with consequent lower absorption of lipids from the diet, thereby reducing the insulin resistance in the liver, the hyperglycemia and dyslipidemia. Furthermore, the distribution of metabolites in the gastrointestinal tract of mice was evaluated after acute administration of cupussu extract by HPLC-ESI-QTOF. We identified the complex mixture of polyphenols present in cupuassu extract along the gastrointestinal tract, which was subsequently metabolized by the intestinal microbiota. Among detected metabolites are hypolaetin and isoscutellarein aglycones and microbial metabolites of epicatechin as 3,4-diHPP-2-ol and 5-(3,4-dihydroxyphenyl)-γvalerolactone. According to these results, the differences in the composition of phenolic compounds found between the two fruit extracts were responsible for the different effects in vivo and identification of microbial metabolites enables the knowledge of the compounds potentially implicated in the beneficial effects. New studies can contribute to a better understanding of the metabolism and mechanisms of action

Ansiedad, depresión y trastorno de la imagen corporal en pacientes que consultan en la unidad de obesidad del hospital de clínicas / Anxiety, depression and body image disorder in patients attending the obesity unit of the hospital de clínicas

La obesidad es una epidemia mundial y constituye una enfermedad de etiología multifactorial. Debido a esta característica, su tratamiento debe ser también multidisciplinario. Existen pocos datos en la literatura acerca de las características emocionales y cognitivas, conductuales y psicopatológicas de los pacientes con obesidad en la edad adulta, sobre todo en nuestra región. El objetivo de este estudio fue identificar la presencia de psicopatología en pacientes que consultan en la Unidad de Obesidad del Hospital de Clínicas. Este estudio observacional, descriptivo, de corte transverso incluyó en forma consecutiva a 69 pacientes que consultaron en la Unidad de Obesidad del Hospital de Clínicas de octubre a noviembre de 2014. El muestreo fue de tipo no probabilístico, de casos consecutivo. El diagnóstico de sobrepeso y obesidad se realizó de acuerdo a la escala de Índice de Masa Corporal (IMC). Las entidades psicopatológicas investigadas fueron ansiedad y depresión mediante la versión española de la HADS (Hospital Anxiety and Depression Scale) que fue autoadministrada. La existencia de trastorno de la imagen corporal también fue evaluada mediante un instrumento autoadministrado. El 88,4% de los pacientes fue de sexo femenino y la edad media 42,8 años (DE: 12,7). El 43% de los pacientes presentó obesidad grado III. La prevalencia de ansiedad fue 18,8% y de depresión 8,7%. El 44,9% de los pacientes presentaron trastorno de la imagen corporal. Los resultados coinciden con los datos encontrados en literatura internacional, encontrando una prevalencia aumentada de psicopatología en pacientes que consultan por Obesidad. Se registraron datos con respecto a descontrol alimentario, lo que indica la necesidad de aplicar herramientas validadas para el diagnóstico de Trastorno por Atracones.

Obesity is a worldwide epidemic disease and it has multifactorial etiology. Due to this, itrequires a multidisciplinary treatment. There are few data about the emotional, cognitive,behavioral and psychopathological features of adult obese patients especially in our region.The objective was to identify the presence of psychopathology in patients consulting at theObesity Unit of the Hospital de Clinicas. The diagnosis of overweight and obesity was doneaccording to the scale of Body Mass Index (BMI). Anxiety and depression were thepsychopathological entities investigated using the Spanish version of the Hospital Anxietyand Depression Scale (HADS) that was self-administered. The presence of body imagedisorder was also evaluated through a self-administered instrument. Of all patients, 88.4%was female and the mean age was 42.8±12.7 years old and 43% of patients belonged to class III obesity. Anxiety had a prevalence of 18.8%, and depression 8.7%. . Body imagedisorders were present in 44.9% of all patients. These results agree with the data found inthe international literature. There was an increased prevalence of psychopathology inpatients consulting for obesity. Uncontrolled eating habits were also recorded suggestingthe need for the application of validated instruments for Binge Eating Disorder.

Obesidad y embarazo / Obesity and pregnancy

Actualmente se considera a la obesidad una patología biológica y social que predispone a varias enfermedades crónicas como la hipertensión arterial, enfermedades cardiovasculares, diabetes tipo II, problemas articulares entre otros, que se ha incrementado en forma alarmante y que también afectan a la mujer durante su etapa reproductiva llevando consigo los riesgos maternos asociados con el exceso de peso, la morbilidad y la mortalidad fetal...

Obesity is currently considered a biological and socialpathology that predisposes humans to several chronicdiseases such as hypertension, cardiovascular disease,type II diabetes, joint problems among others. Obesityhas increased alarmingly and is affecting women duringthe reproductive stage, carrying the maternal risksassociated with excess weight, fetal morbidity and mortality.Body mass is use to assess the weight increase. It is a simpleindicator that measures the relationship between weight andheight and is use to identify overweight and obesity in adults.During the pregnancy stage, there is an increase of maternalweight and changes in body composition, and is related as riskfactor for developing gestational diabetes, insulin resistance, chronic inflammation process and deterioration in carbohydrates tolerance...