Adiponectin in outpatients with coronary artery disease: independent predictors and relationship with heart failure.

BACKGROUND AND AIMS: Chronic heart failure (HF) is characterised by a neurohormonal dysfunction associated with chronic inflammation. A role of metabolic derangement in the pathophysiology of HF has been recently reported. Adiponectin, an adipose-tissue-derived cytokine, seems to play an important role in cardiac dysfunction. We investigated the variation of circulating adiponectin in patients with coronary artery disease (CAD), with or without HF, in order to identify its independent predictors. METHODS AND RESULTS: A total of 107 outpatients with CAD were enrolled in the study and divided into three groups: CAD without left ventricular systolic dysfunction (group 1); CAD with left ventricular dysfunction without HF symptoms (group 2) and CAD with overt HF (group 3). Plasma adiponectin was determined by enzyme-linked immunosorbent assay. Adiponectin concentrations increased progressively from group 1 (7.6 ± 3.6 ng ml⁻¹) to group 2 (9.1 ± 6.7 ng ml⁻¹) and group 3 (13.7 ± 7.6 ng ml⁻¹), with the difference reaching statistical significance in group 3 versus 1 and 2 (p < 0.001). A multivariable model of analysis demonstrated that the best predictors of plasma adiponectin were body mass index, N-terminal pro-brain natriuretic peptide and high-density lipoprotein cholesterol. However, even after adjusting for all three independent predictors, the increase of adiponectin in group 3 still remained statistically significant (p = 0.015). CONCLUSION: Our data confirm the rise of adiponectin in overt HF. The levels of circulating adipokine seem to be mainly predicted by the metabolic profile of patients and by biohumoral indicators, rather than by clinical and echocardiographic indexes of HF severity.

Changes in dental caries prevalence of school children in Araraquara, SP, Brazil.

The aim of this study was to compare the prevalence of caries in 1989 and 1992 in 7-12 year old school children in Araraquara, SP, Brazil. Systematic random samples were drawn from school children enrolled in the urban public schools and the surveys were carried out by trained examiners using the DMFT index. The results showed that in all ages there was an increase in the percentage of children free of caries for the permanent dentition (from 29.0 per cent in 1989 to 40.6 per cent in 1992). A decrease in the percentage of children classified in the 1-3 DMFT index category (from 40.0 per cent in 1989 to 33.7 per cent in 1992) and a decrease in the percentage of those classified in the 4-6 DMFT index category (from 26.6 per cent to 22.5 per cent) was observed. A slight decrease in the prevalence of children classified in the 7 or more DMFT index category was also observed (from 4.4 per cent to 3.1 per cent). The results obtained suggest that continuing efforts should be made to reduce the percentage of children with experience of caries in order to achieve the WHO/FDI goals for the year 2000.

[Changes in caries prevalence in 7-12-year-old children from Araraquara, São Paulo, Brazil: 1989-1995]. / Mudanças na prevalência de cárie em crianças de sete a 12 anos de Araraquara, São Paulo, Brasil: 1989-1995.

The aim of this study was to compare the prevalence of caries in 7-12-year-old children from Araraquara, São Paulo, Brazil, in 1989 and 1995. Systematic random samples were drawn from the population of children enrolled in public schools. The surveys were carried out by trained examiners using the DMFT index and WHO diagnostic criteria. There was an increase in the percentage of children free of caries in the permanent dentition in all age groups (from 29 per cent in 1989 to 51 per cent in 1995). Amongst 12 year olds, the DMFT index was 3.8 in 1989 and 2.6 in 1995. Decreases were observed in the percentages of children classified in the 1-3 DMFT index category (from 40 per cent in 1989 to 31 per cent in 1995) and in the 4-6 DMFT index category (26.6 per cent in 1989 to 16.5 per cent in 1995). There was also a reduction in the percentage of children with a DMFT of 7 or more (4.4 per cent in 1989 to 1.5 in 1995). The WHO/FDI goal for the year 2000 of a mean DMFT index no more than 3 at the age of 12 years was achieved in this population, and on-going efforts should be made to reduce the percentage of children with caries in order to achieve the WHO/FDI goals for the year 2010.