Cardiometabolic Changes in Different Gonadal Female States Caused by Mild Hyperuricemia and Exposure to a High-Fructose Diet.

BACKGROUND: The objective of this study is to observe if mild hyperuricemia and a high-fructose diet influence the cardiovascular and metabolic systems in hypogonadic female Wistar rats compared to normogonadic female rats. METHODS: Fifty-six (56) adult female Wistar rats were used in the present work. Animals were divided into two groups: normogonadic (NGN) and hypogonadic (HGN). These groups were also divided into four subgroups in accordance with the treatment: control with only water (C), fructose (F), oxonic acid (OA), and fructose + oxonic acid (FOA). Lipid profile, glycemia, uric acid, and creatinine determinations were assessed. Cardiovascular changes were evaluated by measuring blood pressure, myocyte volume, fibrosis, and intima-media aortic thickness. RESULTS: HGN rats had higher levels of total cholesterol (TC) (p < 0.01) and noHDLc (p < 0.01), in addition to higher levels of uric acid (p < 0.05). The OA group significantly increased myocyte volume (p < 0.0001) and the percentage of fibrosis as well as the group receiving FOA (p < 0.001) in both gonadal conditions, being greater in the HGN group. Hypogonadic animals presented a worse lipid profile. CONCLUSION: Mild hyperuricemia produces hypertension together with changes in the cardiac hypertrophy, fibrosis, and increased thickness of the intima media in hypogonadic rats fed high-fructose diet.

Límites de referencia de las concentraciones de lípidos en embarazos no complicados / Reference limits for lipids during pregnancy without complications

Resumen OBJETIVO: Definir los límites de referencia de las concentraciones de lípidos en gestaciones no complicadas. MATERIALES Y MÉTODOS: Estudio observacional, retrospectivo y analítico efectuado en pacientes embarazadas sanas atendidas en el servicio de Obstetricia del Hospital Churruca-Visca de Buenos Aires, Argentina. Criterios de inclusión: pacientes embarazadas con edad entre 14 y 43 años. Criterios de exclusión: pacientes en tratamiento farmacológico que pudiera afectar el metabolismo lipídico o tener complicaciones obstétricas o neonatales. RESULTADOS: Se estudiaron 163 embarazadas con edad promedio de 27.2 ± 6.5 años, que se categorizaron en cuatro grupos. En el primer trimestre el colesterol no HDL fue significativamente diferente entre las cuatro categorías de IMC (p < 0.05). En el segundo trimestre se encontraron iguales resultados para colesterol no HDL y LDL (p < 0.05) mientras que las concentraciones de triglicéridos fueron significativamente diferentes de acuerdo con las cinco categorías de edad (p < 0.05). En el tercer trimestre no se encontraron diferencias en las concentraciones de lípidos por edad ni por IMC. Tampoco se obtuvieron diferencias por ganancia de peso (menos o más de 10 kg). CONCLUSIONES: Las concentraciones de lípidos y lipoproteínas se incrementaron a lo largo del embarazo. No hubo diferencia significativa entre mujeres con bajo y peso normal versus sobrepeso-obesidad. Es necesario reunir más información de valores de referencia de lípidos y lipoproteínas para poder definir el estado de dislipidemia en las embarazadas.

Abstract OBJECTIVE: To define the reference limits of lipid concentrations in uncomplicated gestations. MATERIALS AND METHODS: Observational, retrospective and analytical study carried out in healthy pregnant patients treated in the obstetrics service of the Churruca-Visca Hospital. Inclusion criteria: being pregnant and between 14 and 43 years of age. Exclusion criteria: being in pharmacological treatment that could affect lipid metabolism or have obstetric or neonatal complications. RESULTS: 163 pregnant women were studied with an average age of 27.2 ± 6.5 years, which was categorized into four groups. In the first trimester non-HDL cholesterol was significantly different among the four categories of BMI (p <0.05). In the second quarter, the same results were found for non-HDL and LDL cholesterol (p <0.05), while triglyceride concentrations were significantly different according to the five age categories (p <0.05). In the third quarter there were no differences in lipid concentrations by age or BMI. Nor were differences obtained by weight gain (less or more than 10 kg). CONCLUSIONS: Lipid and lipoprotein concentrations increased during pregnancy. There was no significant difference between women with low and normal weight versus overweight-obesity. It is necessary to gather more information on reference values of lipids and lipoproteins in order to define the state of dyslipidemia in pregnant women.

Prevalence of cardiovascular risk factors among Latin American adolescents: a multilevel analysis.

High blood pressure (HBP) and obesity is a well-established major risk factor for stroke and coronary heart disease. However, the literatures are scarce about these informations in adolescents from low-and-middle income countries. This school-based survey was carried out among students from Maringá (Brazil) and Buenos Aires (Argentina) selected random sampling. We studied 991 Brazilian adolescents (54.5% girls) in the age range of 14-18 years. In Argentina, we studied 933 adolescents (45.9% female) in the age range of 11-17 years. The outcomes of this study are general obesity, abdominal obesity and HBP. The associated factors analysed were gender, age and health behaviours. The prevalence of obesity was 5.8% in Brazil and 2.8% in Argentina, the prevalence of abdominal obesity was 32.7% in Brazil and 11.1% in Argentina, the prevalence of HBP was 14.9% in Brazil and 13.5% in Argentina. The multilevel analysis showed that older adolescents (>14 years old) have a little likelihood of being overweight, whereas male adolescents are more likely to be obese and have HBP. The abdominal obesity in both indicators were not associated with the independent variables. The prevalence of cardiovascular risk factors is high in Latin American adolescents independent of each country, and was associated with male gender.

Relación entre circunferencia de cintura y factores de riesgo metabólicos en mujeres argentinas / Relationship Between Waist Circumference and Metabolic Risk Factors in Argentine Women

Introducción: El síndrome metabólico (SM) agrupa factores de riesgo para enfermedad cardiovascular. Dentro de estos factores se encuentra la obesidad central, evaluada generalmente a través de la circunferencia de la cintura (CC) Objetivo: Analizar el comportamiento de las distintas variables que agrupan el SM (definición ATP III) en relación a los cambios en la CC. Sujetos: Se incluyeron 253 mujeres que concurrieron al Servicio de Endocrinología. Se evaluaron medidas antropométricas y presión arterial, así como glucemia en ayunas y lipidograma. Las pacientes fueron agrupadas por quintilos por CC: Q1 (56-80 cm), Q2 (80.1-89 cm), Q3 (89.1-96 cm), Q4 (96.1-103 cm) y Q5 (103.1-150 cm. Resultados: Existe una correlación positiva entre la CC y el IMC (p < 0,0001, r: 0,87).Asimismo, se observa una correlación positiva entre la CC y los valores de triglicéridos (p <0,0001, r: 0,28), glucemia (p = 0,0001, r: 0,24), presión arterial (PA) sistólica (p < 0,0001, r: 0,27) y diastólica (p < 0,0007, r: 0,21) y una correlación negativa entre la CC y los niveles de HDL (p < 0,0001, r: -0,25). Conclusiones: A medida que aumenta la CC, aumentan los factores de riesgo cardiovasculares (presión arterial diastólica, glucemia, triglicéridos, descenso del HDL).

Introduction: Metabolic syndrome (MS) is a group of risk factors for cardiovascular disease. These factors include central obesity, usually assessed through waist circumference (WC). Objective: To analyze the behavior of the different MS variables (ATP III definition) in relation to changes in WC. Subjects: We included 253 women who attended the Service of Endocrinology. We performed anthropometric, blood pressure, fasting glucose and lipid profile measurements. Patients were grouped into quintiles by WC: Q1 (56-80 cm), Q2 (80.1-89 cm), Q3 (89.1-96 cm), Q4 (96.1-103 cm) and Q5 (103.1-150 cm. Results: There is a positive correlation between WC and BMI (p < 0.0001, r = 0.87). In addition, there is a positive correlation between WC and triglyceride levels (p < 0.0001, r: 0.28), glucose (p = 0.0001, r = 0.24), systolic blood pressure (BP) (p < 0.0001, r = 0.27) and diastolic BP (p <0.0007, r: 0.21) and a negative correlation between WC and HDL levels (p < 0.0001, r = -0.25). Conclusions: As WC increases, cardiovascular risk factors (diastolic blood pressure, blood glucose, triglycerides, decreased HDL) increase.

Relación entre circunferencia de cintura y factores de riesgo metabólicos en mujeres argentinas / Relationship Between Waist Circumference and Metabolic Risk Factors in Argentine Women

Introducción: El síndrome metabólico (SM) agrupa factores de riesgo para enfermedad cardiovascular. Dentro de estos factores se encuentra la obesidad central, evaluada generalmente a través de la circunferencia de la cintura (CC) Objetivo: Analizar el comportamiento de las distintas variables que agrupan el SM (definición ATP III) en relación a los cambios en la CC. Sujetos: Se incluyeron 253 mujeres que concurrieron al Servicio de Endocrinología. Se evaluaron medidas antropométricas y presión arterial, así como glucemia en ayunas y lipidograma. Las pacientes fueron agrupadas por quintilos por CC: Q1 (56-80 cm), Q2 (80.1-89 cm), Q3 (89.1-96 cm), Q4 (96.1-103 cm) y Q5 (103.1-150 cm. Resultados: Existe una correlación positiva entre la CC y el IMC (p < 0,0001, r: 0,87).Asimismo, se observa una correlación positiva entre la CC y los valores de triglicéridos (p <0,0001, r: 0,28), glucemia (p = 0,0001, r: 0,24), presión arterial (PA) sistólica (p < 0,0001, r: 0,27) y diastólica (p < 0,0007, r: 0,21) y una correlación negativa entre la CC y los niveles de HDL (p < 0,0001, r: -0,25). Conclusiones: A medida que aumenta la CC, aumentan los factores de riesgo cardiovasculares (presión arterial diastólica, glucemia, triglicéridos, descenso del HDL).(AU)

Introduction: Metabolic syndrome (MS) is a group of risk factors for cardiovascular disease. These factors include central obesity, usually assessed through waist circumference (WC). Objective: To analyze the behavior of the different MS variables (ATP III definition) in relation to changes in WC. Subjects: We included 253 women who attended the Service of Endocrinology. We performed anthropometric, blood pressure, fasting glucose and lipid profile measurements. Patients were grouped into quintiles by WC: Q1 (56-80 cm), Q2 (80.1-89 cm), Q3 (89.1-96 cm), Q4 (96.1-103 cm) and Q5 (103.1-150 cm. Results: There is a positive correlation between WC and BMI (p < 0.0001, r = 0.87). In addition, there is a positive correlation between WC and triglyceride levels (p < 0.0001, r: 0.28), glucose (p = 0.0001, r = 0.24), systolic blood pressure (BP) (p < 0.0001, r = 0.27) and diastolic BP (p <0.0007, r: 0.21) and a negative correlation between WC and HDL levels (p < 0.0001, r = -0.25). Conclusions: As WC increases, cardiovascular risk factors (diastolic blood pressure, blood glucose, triglycerides, decreased HDL) increase.(AU)

Síndrome metabólico y riesgo cardiovascular en estudiantes adolescentes de la ciudad de Buenos Aires / Metabolic syndrome and cardiovascular risk factors in adolescent students from Buenos Aires

La obesidad en la infancia está asociada con dislipemia, hipertensión arterial, intolerancia a la glucosa y predisposición temprana a enfermedad cardiovascular. La obesidad abdominal juega un rol central en el Síndrome Metabólico (SM), entidad que predispone a los individuos afectados al desarrollo de diabetes y enfermedad cardiovascular en la adultez. La insulinorresistencia que acompaña al SM puede evaluarse a través de distintos marcadores El objetivo de este trabajo fue evaluar la presencia de SM y de factores de riesgo cardiovascular (RCV) (dislipemias, hipertensión arterial y obesidad) y de marcadores metabólicos (Apo B y PCR ultrasensible) en nuestra población de adolescentes. Fueron evaluados 943 estudiantes adolescentes (429 mujeres y 541 varones), entre 11 y 14 años, de escuelas secundarias de la Universidad de Buenos Aires. Se midieron parámetros antropométricos y se determinaron las concentraciones plasmáticas de glucemia, lípidos, apolipoproteína B (apo B) y PCR ultrasensible (PCRus). Los varones presentaron mayor peso (p= 0.004), mayor circunferencia de cintura (p= 0.0002) y mayor presión arterial sistólica y diastólica (p= 0.008 y p= 0.002 respectivamente) con respecto a las mujeres. También presentaron mayor nivel de glucemia (p= 0.04) y menor nivel de HDL-colesterol (p= 0.004). No hubo diferencia significativa en los niveles plasmáticos de triglicéridos, PCRus y apo B entre ambos sexos. La presencia de SM fue de 5,45% en varones y de 1,63% en mujeres. El grupo de adolescentes con SM presentó mayor peso, IMC, circunferencia de cintura, presión sistólica y diastólica, como también valores más elevados de glucemia, triglicéridos y menor HDL-colesterol, siendo las diferencias significativas. Los niveles séricos de ApoB fueron mayores en el grupo con SM (p= 0.001). En conclusión, este estudio muestra la presencia de SM y de factores de riesgo cardiometabólico con incremento de apoB en edades tempranas, por lo cual su detección precoz en niños y adolescentes, ayudaría a implementar medidas preventivas.

Obesity in the infancy is associated with dyslipidemia, hypertension, glucose intolerance and early development of cardiovascular risk. Abdominal obesity associated with metabolic syndrome predisposes to diabetes mellitus and cardiovascular disease in adulthood. Insulin resistance is present in this syndrome and should be evaluated. The aim of the study was to evaluate the presence of metabolic syndrome (MS) and cardiovascular risk (dyslipidemia, hypertensión and obesity) and metabolic risk markers (apolipoprotein B and high sensitivity C-reactive protein) in this group of adolescents. We evaluated 943 adolescents from high school (429 women y 541men), ages between 11 and 14. Weight, height, body mass index (BMI), waist circumference (WC) and blood pressure were determined in all subjects. Fasting serum concentrations of glucose, lipids, apolipoprotein B (apoB) and high sensitivity C-reactive protein (hs-CRP) were measured. Boys showed higher weight (p= 0.004), higher WC (p= 0.0002) and higher systolic and diastolic blood pressure (p= 0.008 y p= 0.002)) than girls. They also showed higher glycemia (p= 0.04) and lower HDLcolesterol levels (p= 0.004). There were no differences in triglycerides, hs-CRP and apo B levels between both sexes. The frequency of MS was 5.45% in males and 1.63% in females. The group with MS had higher weight, BMI, WC, and systolic and diastolic blood pressure as well as higher glucose and triglycerides and lower HDL-cholesterol levels Although no differences in hs-CRP were observed between groups, hs-CRP correlated with WC (r=0.14, p<0.001) and BMI (r=0.17, p< 0.001). ApoB levels were higher in the group with MS (p= 0.001). In conclusion this study shows the presence of MS and cardiovascular risk factors with high apo B levels at early age. Early detection of children and adolescents with metabolic abnormalities should be useful to implement strategies to avoid the development of cardiovascular disease in later life.

Papillary carcinoma in thyroglossal duct cyst.

OBJECTIVE: To report the management and outcome of three cases of papillary carcinoma (PC) in thyroglossal duct cysts (TGCs). METHODS: We present case reports of one female and two male patients between the ages of 22 and 46 years who had TGCs. In addition, we discuss the theories about the pathogenesis of TGC carcinoma (de novo versus metastatic lesions). RESULTS: In all three patients, we found a TGC that contained a vegetating mass. Subsequent pathologic examination revealed the presence of a PC. All patients underwent total thyroidectomy, and two of them concurrently had PC in the thyroid gland. Besides the PC in the TGC, the first patient had a "cold" scintigraphic thyroid nodule that was also a PC, whereas the second patient had a thyroid microcarcinoma that had not been detected before surgical intervention. The third patient did not have carcinoma of the thyroid, but the histologic pattern of the gland resembled that observed in de Quervain's disease. We interpreted this finding as "palpation thyroiditis." The patients received postoperative 131I and suppressive therapy with levothyroxine. During a follow-up period of 2 to 12 years (mean, 5.8), we found no recurrence of the disease, and serum thyroglobulin remained undetectable in all cases. CONCLUSION: Although use of total thyroidectomy followed by radioiodine therapy and suppressive treatment with levothyroxine is a matter of debate in patients with PC in TGCs, we conclude that this approach yields a favorable outcome in most cases, especially when the thyroid is also involved by the PC, and allows a better postoperative follow-up.