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BACKGROUND/OBJECTIVES: Proinflammatory cytokines are increased in obese adipose tissue, including inflammasome key masters. Conversely, IL-18 protects against obesity and metabolic dysfunction. We focused on the IL-18 effect in controlling adipose tissue remodeling and metabolism. MATERIALS/SUBJECTS AND METHODS: We used C57BL/6 wild-type (WT) and interleukine-18 deficient (IL-18-/-) male mice fed a chow diet and samples from bariatric surgery patients. RESULTS: IL-18-/- mice showed increased adiposity and proinflammatory cytokine levels in adipose tissue, leading to glucose intolerance. IL-18 was widely secreted by stromal vascular fraction but not adipocytes from mice's fatty tissue. Chimeric model experiments indicated that IL-18 controls adipose tissue expansion through its presence in tissues other than bone marrow. However, IL-18 maintains glucose homeostasis when present in bone marrow cells. In humans with obesity, IL-18 expression in omental tissue was not correlated with BMI or body fat mass but negatively correlated with IRS1, GLUT-4, adiponectin, and PPARy expression. Also, the IL-18RAP receptor was negatively correlated with IL-18 expression. CONCLUSIONS: IL-18 signaling may control adipose tissue expansion and glucose metabolism, as its absence leads to spontaneous obesity and glucose intolerance in mice. We suggest that resistance to IL-18 signaling may be linked with worse glucose metabolism in humans with obesity.
Subject(s)
Adipose Tissue , Interleukin-18 , Mice, Inbred C57BL , Obesity , Animals , Interleukin-18/metabolism , Mice , Male , Adipose Tissue/metabolism , Humans , Obesity/metabolism , Glucose Intolerance/metabolism , Disease Models, Animal , Mice, KnockoutABSTRACT
ABSTRACT Although some studies have investigated the role of nutritional intervention on migraine, they had focused on triggers or on weight change and, to the best of our knowledge, none studied diet quality. Objective To investigate whether nutritional intervention focused on improving diet quality and healthy weight can promote improvement in clinical parameters of women with migraine. Methods Non-controlled and non-randomized intervention study conducted for 90 days. Women received an individualized diet meal plan and nutritional orientation according to their nutritional diagnosis. Anthropometric, clinical and nutritional data were measured once a month. Diet energy content and macronutrients were evaluated using 24-hour dietary recall. Diet quality was assessed through the Brazilian Healthy Eating Index-Revised (BHEI-R). The Migraine Disability Assessment and Headache Impact Test version 6 were used to assess the severity of migraine, and the Beck Depression Inventory evaluated depressive symptoms. Results Fifty-two women aged 44.0 ± 13.0 years were enrolled. Anthropometric characteristics, energy, macronutrients and fiber intake did not change after intervention. However, the BHEI-R scores improved after 60 and 90 days of intervention. Concurrent to this, the Beck Depression Inventory scores and Headache Impact Test scores decreased after 60 and 90 days, respectively. The change in the BHEI-R score was negatively correlated with the migraine severity as assessed by the Headache Impact Test at the end of the intervention. Conclusions We concluded that the management of diet quality may be a good strategy for improving migraine severity, regardless of the nutritional status and weight change.
RESUMO Estudos investigaram o papel da intervenção nutricional, focada no consumo de alimentos "gatilhos" ou na alteração de peso, na melhora da migrânea. Porém, mudanças na qualidade da dieta ainda não foram abordadas. Objetivo Investigar se intervenção nutricional focada na qualidade da dieta e peso saudável pode melhorar parâmetros clínicos em mulheres com migrânea. Métodos Estudo de intervenção, não controlado e não randomizado. As mulheres receberam plano alimentar individualizado e orientações nutricionais, conforme o diagnóstico nutricional. Dados antropométricos, clínicos e alimentares foram medidos uma vez por mês durante três meses. Recordatório alimentar de 24 horas forneceu informações sobre o consumo alimentar. Qualidade da dieta foi avaliada pelo Índice Brasileiro de Alimentação Saudável (IQD-R). Os questionários Migraine Disability Test (MIDAS) e Headache Impact Test, versão 6 (HIT-6) avaliaram a incapacidade gerada pela enxaqueca e o Inventário de Depressão de Beck (BDI) investigou sintomas depressivos. Resultados Cinquenta e duas mulheres com 44,0 ± 13,0 anos participaram da amostra. Características antropométricas e consumo de energia, macronutrientes e fibras não se alteraram depois da intervenção. No entanto, os escores do IQD-R melhoraram após 60 e 90 dias de intervenção. Os escores do BDI e do HIT-6 diminuíram após 60 e 90 dias, respectivamente. A mudança no escore do IQD-R correlacionou de maneira negativa com a gravidade da enxaqueca avaliada pelo HIT-6 ao final da intervenção. Conclusões O manejo da qualidade da dieta pode ser estratégia para melhorar a gravidade da migrânea, independente do estado nutricional e da mudança de peso dos pacientes.
Subject(s)
Humans , Female , Adult , Middle Aged , Diet, Healthy/methods , Migraine Disorders/diet therapy , Time Factors , Severity of Illness Index , Nutrition Assessment , Pilot Projects , Anthropometry , Nutritional Status , Surveys and Questionnaires , Treatment Outcome , Statistics, Nonparametric , Disability Evaluation , Overweight/physiopathology , Feeding Behavior/physiology , Migraine Disorders/physiopathologyABSTRACT
ABSTRACT: The present study evaluated the effects of baru nut consumption on body weight, percent adiposity, amount of adipose tissue and blood levels in obese male Swiss mice. After inducing obesity by providing high-glucose diet (60 days), the mice were divided into 4 groups (7 animals per group) and were fed on a control diet (C), high-glucose diet (HG) or high-glucose diet added with baru (HGBA) or soybean oil (HGSO). Groups fed with diet HGBA had a decrease in the weight gain and glucose and triglyceride levels when compared to diet HG. Aimals fed with HG exhibited a higher proportion of epididymal and retroperitoneal adipose tissue. The inclusion of baru nut in the diet improved the control of weight gain and glucose and triglyceride levels in obese mice.
RESUMO: Este estudo analisou os efeitos do consumo de amêndoas de baru no peso corporal, percentagem de adiposidade, quantidade de tecido adiposo e parâmetros sanguíneos em camundongos Swiss machos e obesos. Após indução da obesidade pelo consumo de dieta hiperglicídica (60 dias), os camundongos foram divididos em 4 grupos (7 animais por grupo) e, consumiram dieta controle (C), hipergicídica (HG) ou hiperglicídica com adição de baru (HGBA) ou óleo de soja (HGOS). O grupo que ingeriu HGBA teve redução no ganho de peso e níveis de glicose e triglicérides comparados ao tratamento com dieta HG. Os animais alimentados com HG exibiram uma maior proporção de tecido adiposo epididimal e retroperitoneal. Conclui-se que a inclusão de amêndoa de baru na dieta melhora o controle do ganho de peso e os níveis de glicose e triglicérides em camundongos obesos.
ABSTRACT
O objetivo deste estudo foi analisar a validade dos diagnósticos autodeclarados de síndrome metabólica (SM) e de seus componentes pelos participantes da Coorte de Universidades Mineiras (CUME). Uma subamostra de 172 participantes da coorte (33 homens e 139 mulheres, idade 38 ± 11 anos) foi aleatoriamente selecionada para este estudo. A presença de SM foi definida segundo os critérios da International Diabetes Federation (IDF). Dados de peso, altura, pressão arterial, concentração sérica de glicose, triglicerídeos e HDL-c foram autodeclarados em questionário online da coorte e as mesmas variáveis foram aferidas presencialmente mediante protocolo padronizado em laboratórios das instituições de ensino superior envolvidas no projeto. Os dados autodeclarados e aferidos foram comparados por meio de coeficiente de correlação intraclasse (CCI), coeficiente Kappa (k) e diferenças entre medidas autodeclaradas e aferidas segundo a metodologia de Bland e Altman. As prevalências da SM foram de 4,7%e 5,2%, de acordo com os dados autodeclarados e aferidos, respectivamente. O coeficiente Kappa entre diagnósticos de SM autodeclarado e aferido foi 0,814, indicando concordância quase perfeita, situação similar à observada para a obesidade (k=0,882). Os demais componentes da SM apresentaram concordâncias moderadas (k=0,41 a 0,60). Os CCIs também indicaram excelente concordância para peso, estatura, IMC e HDL-c, respectivamente, 0,989, 0,995, 0,983 e 0,761. A glicose apresentou baixa concordância (CCI: 0,336). Concluiu-se que participantes do projeto CUME forneceram informações válidas para os diagnósticos autodeclarados de SM e de seus componentes.
The aim of this study was to analyze the validity of self-reported diagnoses of metabolic syndrome (MetS) and its components through participantsof the Cohort of Universities of Minas Gerais (CUME). A subsample of 172 cohort participants (33 males and 139 females, age 38 ± 11 years) wasrandomly selected for this study. The presence of MetS was defined according to the criteria of the International Diabetes Federation (IDF). Data onweight, height, blood pressure, and serum concentration of glucose, triglycerides and HDL-c were self reported in an online cohort questionnaire, andthe same variables were measured using a standardized protocol in laboratories of higher education institutions involved in the project. Self-reportedand measured data were compared by means of intraclass correlation coefficient (ICC), Kappa coefficient (k) and differences between self-reported andmeasured data, according to the Bland and Altman method. The prevalence of MetS was 4.7% and 5.2% according to self-reported and measured data, respectively. The Kappa coefficient between diagnoses of self-reported and measured MetS was 0.814, indicating almost perfect agreement, a situationsimilar to that observed for obesity (k = 0.882). The other components of MetS had moderate agreement (k = 0.41 to 0.60). The ICC also indicated excellent agreement for weight, height, BMI and HDL-c, respectively, 0.989, 0.995, 0.983 and 0.761. Glucose presented low agreement (ICC: 0.366). The study concludes that the CUME project participants provided valid information for the self-reported diagnoses of MetS and its components.
El objetivo de este estudio fue analizar la validez de los diagnósticos autodeclarados de síndrome metabólico (SM) y de sus componentes por los participantes de la Cohorte de Universidades Mineras (CUME). Para este estudio fue aleatoriamente seleccionada una submuestra de 172 participantes de la cohorte (33 hombres y 139 mujeres, edad 38 ± 11 años). La presencia de SM fue definida según los criterios de la International Diabetes Federation(IDF). Los datos de peso, altura, presión arterial, concentración sérica de glucosa, triglicéridos y HDL-c fueron autodeclarados en un cuestionario en líneade la cohorte y las mismas variables fueron evaluadas presencialmente mediante un protocolo estandarizado en laboratorios de las instituciones deenseñanza superior involucradas en el proyecto. Los datos autodeclarados y evaluados se compararon mediante el coeficiente de correlación intraclase(CCI), el coeficiente Kappa (k) y las diferencias entre medidas autodeclaradas y evaluadas según la metodología de Bland y Altman. Las prevalenciasde la SM fueron del 4,7% y del 5,2% de acuerdo con los datos autodeclarados y evaluados, respectivamente. El coeficiente Kappa entre diagnósticos de SM autodeclarado y constatado fue 0,814, indicando concordancia casi perfecta, situación similar a la observada para la obesidad (k = 0,882). Losdemás componentes de SM presentaron concordancias moderadas (k = 0,41 a 0,60). Los CCI también indicaron una excelente concordancia para peso,estatura, IMC y HDL-c, respectivamente, 0,989, 0,995, 0,983 y 0,761. La glucosa presentó baja concordancia (CCI: 0,336). Se concluye que los participantes del proyecto CUME proporcionaron información válida para los diagnósticos autodeclarados de SM y sus componentes.
Subject(s)
Humans , Chronic Disease , Metabolic Syndrome , Risk Factors , Self Report , Validation Studies as TopicABSTRACT
ABSTRACT Objective Increased arterial intima-media thickness has been observed in adults with congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency (21-OHD). CAH has also been associated with obesity, insulin resistance, and hypertension. The aim of the present study was to compare youths with CAH with healthy, normal-weight individuals, evaluating carotid intima-media thickness (CIMT) and indicative factors of cardiovascular risk to seek for abnormalities in the CAH group. Subjects and methods Clinical, biochemical, and ultrasonographic evaluations, according to published criteria, were performed in 113 subjects (5 to 20 years old): 40 patients with 21-OHD and 73 healthy individuals matched for gender, pubertal status, and age. Results Most CAH patients were female (80%), salt-losers (72.5%), and pubescent (80%); 10 (25%) patients were overweight. An increase in CIMT was observed both on the right (p = 0.0240) and left (p = 0.0003) sides in 38 CAH patients compared with the healthy individuals. The body mass index, BMI/age Z score, and systolic blood pressure (SBP) were higher in patients compared with controls (p < 0.000 and p = 0.0219, respectively). Conclusions Findings of increased CIMT, BMI, and SBP in young patients with 21-OHD indicate the need for early identification and intervention regarding cardiovascular risk. Validating these findings might result in improved therapeutic approaches for children with 21-OHD in the future. Arch Endocrinol Metab. 2015;59(6):541-7.
Subject(s)
Adolescent , Child , Child, Preschool , Female , Humans , Male , Young Adult , Adrenal Hyperplasia, Congenital , Arterial Pressure/physiology , Atherosclerosis , Body Mass Index , Carotid Intima-Media Thickness , Adrenal Hyperplasia, Congenital/metabolism , Cardiovascular Diseases/diagnosis , Carotid Arteries , Overweight , Risk FactorsABSTRACT
O objetivo com esta pesquisa foi caracterizar o estado nutricional e o consumo alimentar de pacientes com síndrome de ovários policísticos (SOPC). Trata-se de estudo transversal realizado com portadoras de SOPC atendidas pela Equipe de Nutrição em serviço de atenção secundária à saúde. Foram obtidas informações sociodemográficas e perfil de saúde, medidas antropométricas, dados bioquímicos e do consumo alimentar. Participaram do estudo 54 mulheres, com média de 31,31± 5,76 anos, sendo 63% classificadas com algum grau de obesidade, 74,1% com risco cardiovascular segundo a razão cintura-quadril e 90,8% com circunferência de cintura aumentada. Houve correlação positiva entre a resistência insulina, mensurada pelo índice HOMA-IR, e índice de massa corporal (r=0,729; p=0,028). Além disso, houve elevada prevalência de consumo insuficiente de calorias (73,6%), carboidratos (54,7%) e micronutrientes (cálcio - 96,2%; ferro - 98,1%), contrastando com 71,7% de ingestão excessiva de lipídeos. Não houve associação entre estado nutricional, parâmetros bioquímicos e consumo alimentar (p>0,05). Concluiu-se que pacientes diagnosticadas com SOPC apresentam alta prevalência de obesidade e inadequações nutricionais, denotando importância de medidas de intervenção nutricional como parte do tratamento não farmacológico.
The present study aims at characterizing the nutritional status and food intake of patients with Polycystic Ovary Syndrome (PCOS). It is a cross-sectional study performed in patients with PCOStreated in secondary health care service by nutrition specialists.socio-demographic information, health profile, anthropometric measurements, biochemical and food intake data were obtained. The study included 54 women with an average age of 31.31 ±5.76 years: 63% were classified as obese at different levels; 74.1% presented cardiovascular risk according to waist-hip ratio, and 90.8% an increased waist circumference. Correlations between insulin resistance, measured by HOMA-IR index, and body mass index (r = 0.729, p = 0.028) were observed. Evaluation of nutritional intake revealed an insufficient amount of calories (73.6%), carbohydrates (54.7%), and micronutrients (calcium, 96.2%; iron, 98.1%). However 71.7% presented an excessive intake of lipids.There was no association between nutritional status, biochemical parameters and food intake (p> 0.05). PCOS patients present a high prevalence of obesity and nutritional inadequacies. Therefore, nutritional intervention strategies constitute important tools as a non-pharmacological treatment.
Este estudio buscó caracterizar el estado nutricional y consumo alimentario de las pacientes con Síndrome de Ovario Poliquístico (SOPQ). Se trata de un estudio transversal realizado con pacientes con SOPQ atendidas por el Equipo de Nutrición en servicios de atención secundaria de la salud. Se obtuvieron informaciones sociodemográficas y el perfil de salud, medidas antropométricas, datos bioquímicos y del consumo alimentario. En el estudio participaron 54 mujeres con edad promedio de 31,31± 5,76 años: 63% clasificadas con algún grado de obesidad; 74,1% con riesgo cardiovascular según la relación cintura-cadera y 90,8% con aumento de la circunferencia de cintura. Hubo correlación positiva entre la resistencia a la insulina, mensurada por el índice HOMA-IR, y el índice de masa corporal (r=0,729, p=0,028). Además, hubo elevada prevalencia de consumo insuficiente de calorías (73,6%), carbohidratos (54,7% y micronutrientes (calcio - 96,2%; hierro - 98.1%, en contraste con el 71,7% de ingesta excesiva de lípidos. No hubo asociación entre el estado nutricional, parámetros bioquímicos y consumo de alimentos (p>0,05). Pacientes diagnosticadas con SOPQ presentan una alta prevalencia de obesidad y deficiencias nutricionales. Por lo tanto, las medidas de intervención nutricional son herramientas importantes como parte del tratamiento no farmacológico.
Subject(s)
Humans , Female , Adolescent , Middle Aged , Young Adult , Eating , Nutritional Status , Health Profile , Women's Health , Polycystic Ovary Syndrome/complicationsABSTRACT
A desnutrição acomete 40% a 45% dos pacientes no momento da admissão hospitalar e essa situação se agrava com o avançar dos dias de internação, favorecendo complicações da doença e o aumento da morbimortalidade. O objetivo com este texto foi investigar o déficit nutricional de idosos internados em um hospital de pronto-socorro de Belo Horizonte-MG. Trata-se de um estudo transversal com idosos internados de outubro a novembro de 2008, em um hospital de pronto-socorro de Belo Horizonte. Aplicou-se a miniavaliação nutricional e foram aferidas as medidas de circunferências do braço e da panturrilha, além da altura do joelho. Os dados clínicos foram obtidos dos prontuários dos pacientes. Foram realizadas análise descritiva e os testes t de Student, qui-quadrado e exato de Fisher. Foram avaliados 169 idosos, 62,7% mulheres, com média de idade de 72,7 ± 8,8 anos. Verificou-se que 42 (24,9%) dos idosos apresentavam risco nutricional e 25 (14,8%), desnutrição, sendo a prevalência dessa condição significativamente superior entre as mulheres (20,7% vs. 4,7% dos homens, p=0,023). Identificou-se que, nos últimos meses, 36,7% dos idosos perderam peso, 32% reduziram a ingestão alimentar e 42% apresentaram dificuldade em deambular. Essas condições foram significativamente associadas ao déficit nutricional (P<0,05). Adicionalmente, o estado nutricional debilitado foi associado ao sexo feminino, maior idade, presença de depressão e doenças cardiovasculares. Os resultados comprovaram que houve elevada prevalência de déficit nutricional entre os idosos, associada, principalmente, a fatores clínicos, físicos e consumo alimentar. Esses achados permitirão direcionar estratégias de intervenção nutricional precoces à população de risco, visando minimizar o agravamento do estado nutricional e consequentes complicações do quadro clínico.
INTRODUCTION: Malnutrition affects 40 to 45% of the patients at the time of hospitalization and this situation worsens as the stay lengthens. This favors the occurrence of disease complications and increases morbid-mortality. OBJECTIVE: To investigate nutritional deficits among elderly people admitted in an emergency hospital. METHODS: This cross-sectional study was performed among hospitalized elderly patients in Belo Horizonte, Minas Gerais, between October and November, 2008. The Mini-Nutritional Assessment was used and measures of arm and calf circumference and knee height were obtained. Clinical data were obtained from the patients' medical files. Descriptive analysis, Student's t-test, chi-square and Fisher exact tests were performed. RESULTS: 169 elderly people (62.7% women) with a mean age of 72.7 ± 8.8 years were evaluated. Forty-two (24.9%) subjects presented nutritional risk and 25 (14.8%) presented malnutrition. This condition was significantly more prevalent among female patients (20.7% vs. 4.7% for male; p = 0.023). It was found that, over the last few months, 36.7% of the patients had lost weight, 32% had reduced their food intake and 42% presented difficulty in walking. These conditions were significantly associated with nutritional deficits (p < 0.05). furthermore, debilitated nutritional status was associated with female sex, greater age, presence of depression and cardiovascular diseases. CONCLUSION: Nutritional deficits among elderly patients were highly prevalent and were associated mainly with clinical, physical and food consumption factors. These findings will enable early nutritional intervention strategies towards risk populations in order to minimize the worsening of nutritional status and consequent complications of clinical conditions.
INTRODUCCIÓN: La desnutrición afecta entre 40 y 45% de los pacientes que ingresan en el hospital. Este cuadro se agrava a medida que se prolonga la internación, que favorece las complicaciones de la enfermedad y aumenta la morbimortalidad. OBJETIVO: Investigar el déficit nutricional de ancianos internados en un hospital de urgencias de Belo Horizonte (Minas Gerais). MÉTODOS: estudio transversal con ancianos internados entre octubre y noviembre de 2008 en Belo Horizonte. Se aplicó la Mini Evaluación Nutricional y midieron las circunferencias del brazo y pantorrilla, además de la altura de la rodilla. De los prontuarios de los pacientes se obtuvieron los datos clínicos. Se realizó el análisis descriptivo, pruebas t de Student, Chi-cuadrado y test exacto de Fisher. RESULTADOS: se evaluaron 169 ancianos, 62,7% mujeres, con promedio de 72,7 ± 8,8 años. 42 (24,9%) de los ancianos presentaban riesgo nutricional y 25 (14,8%) desnutrición, significativamente superior entre las mujeres (20,7% contra 4,7% de los hombres, p=0,023). Se identificó que en los últimos meses 36,7% de los ancianos había perdido peso, 32% reducido la ingesta alimentaria y 42% tenido dificultad para deambular. Estas condiciones fueron significativamente asociadas al déficit nutricional (P<0,05). Además, el estado nutricional debilitado fue asociado al sexo femenino, más edad, depresión y enfermedades cardiovasculares. CONCLUSIÓN: elevada prevalencia de déficit nutricional entre los ancianos relacionada, sobre todo, con factores clínicos, físicos y consumo alimentario. Estos hallazgos permitirán orientar estrategias de intervención nutricional precoces para la población de riesgo buscando minimizar la agudización del estado nutricional y consecuentes complicaciones clínicas.