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Introducción. La enfermedad hepática grasa no alcohólica (EHGNA) es la hepatopatía crónica más común en el mundo, y en aproximadamente el 10 % de los casos progresará a cirrosis o a carcinoma hepatocelular. La presencia de fibrosis hepática es el mejor predictor de esta progresión, pero su diagnóstico mediante biopsia hepática es invasivo y con riesgo de complicaciones (alrededor del 2,5 %). Existen puntajes no invasivos que se han desarrollado y validado para estadificar la fibrosis, pero no conocemos su rendimiento en la población colombiana. El objetivo de este estudio fue evaluar el desempeño de los puntajes fibrosis-4 (FIB-4), la relación AST/ALT y el índice AST/plaquetas (APRI) para la detección de fibrosis avanzada en pacientes colombianos con EHGNA. Metodología. Estudio observacional tipo transversal de pacientes con EHGNA, que entre 2008 y 2022 tuvieran disponible el resultado de una biopsia hepática. Se hizo una descripción demográfica básica y se calculó el FIB-4, la relación AST/ALT y el APRI con los laboratorios más recientes previos al procedimiento. Posteriormente se calcularon valores de sensibilidad, especificidad, valores predictivos, razones de verosimilitud y área bajo la curva-característica operativa del receptor (AUC-ROC) para los puntos de corte evaluados previamente en la literatura. Resultados. Se incluyeron 176 pacientes, de los cuales el 14,3 % tenían fibrosis avanzada. El FIB-4 presentó el mejor rendimiento con un valor AUC-ROC de 0,74 para el punto de corte de 1,30 y 2,67. En segundo lugar, estuvo la relación AST/ALT con un valor AUC-ROC de 0,68 con el punto de corte de 0,8, y finalmente el APRI con valor AUC-ROC 0,62 con el punto de corte de 1. Conclusión. En la población analizada los tres puntajes tienen menor rendimiento diagnóstico comparado a los resultados reportados en Europa y Japón. El FIB-4 es el único que alcanza una AUC-ROC con rendimiento razonable, con la limitación que 27,4 % obtuvieron un resultado indeterminado.
Introduction. Non-alcoholic fatty liver disease (NAFLD) is the most prevalent chronic liver disease worldwide, with approximately 10% of cases progressing to cirrhosis or hepatocellular carcinoma. Liver fibrosis presence is the best predictor of this progression, yet its diagnosis through liver biopsy is invasive and poses risk of complications. Although non-invasive scoring systems have been developed and validated for fibrosis staging, their performance remains unexplored in the Colombian population. This study aims to assess the efficacy of the fibrosis-4 (FIB-4) score, AST/ALT ratio, and AST to platelet ratio index (APRI) in detecting advanced fibrosis among Colombian NAFLD patients. Methods. This cross-sectional observational study included NAFLD patients with available liver biopsy results from 2008 to 2022. Basic demographic characteristics were described, and FIB-4, APRI, and AST/ALT ratio were calculated using the latest laboratory data before the procedure. Subsequently, sensitivity, specificity, predictive values, likelihood ratios, and the area under the receiver operating characteristic curve (AUC-ROC) were computed for previously assessed cutoff points. Results. A total of 176 patients were included, among whom 14.3% had advanced fibrosis. FIB-4 demonstrated superior performance with an AUC-ROC value of 0.74 for cutoff points of 1.30 and 2.67. Following was the AST/ALT ratio with an AUC-ROC value of 0.68 for cutoff point of 0.8, and finally, APRI with an AUC-ROC of 0.62 for the cutoff point of 1. Conclusion. All three scores have lower diagnostic efficacy compared to results reported in Europe and Japan. FIB-4 is the only one that achieves an acceptable AUC-ROC performance with the limitation that an indeterminate result was obtained in 27,4% of the sample.
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Introducción: las enzimas y marcadores del perfil hepático permiten evaluar la funcionalidad y condición del hígado. Sus elevaciones pueden ser silentes y con cierta prevalencia en muchos adultos. Objetivo: determinar las principales alteraciones en el hepatograma en pacientes que acuden a consulta médica de rutina. Metodología: estudio descriptivo, prospectivo y transversal realizado a partir de resultados de laboratorio de historias clínicas de 364 pacientes de todas las edades y ambos sexos pertenecientes a un policlínico del distrito de Villa el Salvador, Perú desde enero de 2021 a julio de 2022. Las variables fueron: edad, sexo, valores de transaminasa glutámico pirúvica (TGP), transaminasa glutámico oxalacética (TGO), bilirrubina directa, indirecta y total, albúmina, globulinas y fosfatasa alcalina (FA). Resultados: en el promedio total de la muestra, la TGP fue alta (51,05 U/L), así como la bilirrubina total (1,50 mg/dL) y la FA (135,84 U/L). La TGP fue alta en hombres (54,92 U/L) y mujeres (48,86 U/L). La TGO fue normal en mujeres y alta en hombres (48,24 U/L). La bilirrubina indirecta fue alta en hombres (1,33 mg/dL). La FA fue más alta en ambos sexos (143,28 U/L en hombres y 126,38 en mujeres). Según grupo etario, los valores de TGO fueron más altos en el grupo de edad igual o mayor a 40 años (49,99 U/L). Los valores de TGP fueron elevados en ambos sexos (55,96 U/L en hombres y 50,90 U/L en mujeres), así como en la bilirrubina total, la que fue más alta en el grupo de edad igual o mayor a 40 años (2,03 mg/dL). La bilirrubina indirecta, albúmina y FA fueron normales en el grupo de edad igual o menor de 39 años, pero fueron elevadas en el grupo de edad igual o mayor a 40 años (1,13 mg/dL, 5,77 gr/dL y 147,95 U/L, respectivamente). Conclusiones: existen alteraciones en el perfil hepático en pacientes asintomáticos en la muestra estudiada. A pesar de no ser elevaciones significativamente grandes, se recomienda identificar y tratar las posibles causas que pudieran desencadenar dichas elevaciones, así como la realización de más estudios similares a nivel nacional para caracterizar el perfil hepático de nuestra población.
Introduction: The enzymes and markers of the liver profile allow us to evaluate the functionality and condition of the liver. Their elevations may be silent and have a certain prevalence in many adults. Objective: To determine the main alterations in the hepatogram in patients who attend routine medical consultation. Methodology: Descriptive, prospective and cross-sectional study carried out based on laboratory results from medical records of 364 female and male patients of all ages attending a polyclinic in the district of Villa El Salvador, Peru from January 2021 to July 2022. The variables were: age, sex, values ââof alanine aminotransferase (ALT), aspartate transaminase (AST), direct, indirect and total bilirubin, albumin, globulins and alkaline phosphatase (ALP). Results: In the total average of the sample, ALT was high (51.05 U/L), as well as total bilirubin (1.50 mg/dL) and ALP (135.84 U/L). ALT was high in men (54.92 U/L) and women (48.86 U/L) while AST was normal in women and high in men (48.24 U/L). Indirect bilirubin was high in men (1.33 mg/dL) and ALP was higher in both sexes (143.28 U/L in men and 126.38 in women). According to age group, AST values ââwere highest in the age group equal to or greater than 40 years (49.99 U/L). ALT values ââwere high in both sexes (55.96 U/L in men and 50.90 U/L in women), as well as total bilirubin, which was highest in the age group equal to or greater than 40 years (2.03 mg/dL). Indirect bilirubin, albumin and ALP were normal in the age group equal to or less than 39 years, but were elevated in the age group equal to or greater than 40 years (1.13 mg/dL, 5.77 gr/dL and 147.95 U/L, respectively). Conclusions: There are alterations in the liver profile of asymptomatic patients in the sample studied. Although they are not significantly large elevations, it is recommended to identify and treat the possible causes that could trigger these elevations, as well as carrying out more similar studies at a national level to characterize the liver profile of our population.
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Introducción: la alanina aminotransferasa es un nexo importante en el metabolismo de aminoácidos y carbohidratos, asimismo es un marcador de inflamación hepática. Estudios previos mostraron la relación entre la diabetes mellitus y esta enzima bajo diferentes contextos clínicos. Objetivo: evaluar la correlación entre glucosa basal y alanina aminotransferasa tanto en pacientes con diabetes mellitus tipo 2 como sin ella. Metodología: estudio observacional, analítico y transversal realizado desde enero de 2021 a junio de 2022 con una población de 566 pacientes dividida en grupos con diabetes mellitus tipo 2 (n 224) y sin diabetes mellitus tipo 2 (n 342). Fueron incluidos los pacientes de edad igual o mayor a 18 años con y sin diabetes mellitus tipo 2. Se excluyó a pacientes con patologías múltiples y/o con diagnóstico de diabetes inferior a 6 meses. Se realizó el análisis inferencial con la prueba de correlación de Spearman y la prueba de normalidad de Kolmogorov-Smirnov. Los datos fueron procesados con el software SPSS statistics 25™. Resultados: la correlación entre glucosa y alanina aminotransferasa en sujetos sin diabetes fue 0,212 (p=0,003) y la correlación entre glucosa y alanina aminotransferasa en aquellos con diabetes fue -0,434 (p=0,015). Conclusiones: la alanina aminotransferasa se relaciona con mayor intensidad en pacientes con diabetes mellitus tipo 2 que en aquellos sin diabetes. La correlación moderada y negativa en sujetos con diabetes mellitus tipo 2 indicaría alteraciones en la interacción entre la alanina aminotransferasa y la glucosa en los que la hiperglucemia sostenida tendría un papel relevante, probablemente por un incremento en la actividad de transaminación.
Introduction: Alanine aminotransferase is an important nexus in the metabolism of amino acids and carbohydrates, and is also a marker of liver inflammation. Previous studies showed the relationship between diabetes mellitus and this enzyme under different clinical contexts. Objective: To evaluate the correlation between basal glucose and alanine aminotransferase both in patients with and without type 2 diabetes mellitus. Methodology: Observational, analytical, and cross-sectional study conducted from January 2021 to June 2022 with a population of 566 patients divided into groups with type 2 diabetes mellitus (n 224) and without it (n 342). Patients aged 18 years or older with and without type 2 diabetes mellitus were included. Patients with multiple pathologies and/or diagnosed with diabetes less than 6 months were excluded. Inferential analysis was performed with Spearman's correlation test and the Kolmogorov-Smirnov normality test. The data was processed with the SPSS statistics 25™ software. Results: The correlation between glucose and alanine aminotransferase in subjects without diabetes was 0.212 (p=0.003) and the correlation between glucose and alanine aminotransferase in those with diabetes was -0.434 (p=0.015). Conclusions: Alanine aminotransferase is associated with greater intensity in patients with type 2 diabetes mellitus than in those without diabetes. The moderate and negative correlation in subjects with type 2 diabetes mellitus would indicate alterations in the interaction between alanine aminotransferase and glucose in which sustained hyperglycemia would play a relevant role, probably due to an increase in transamination activity.
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Abstract Introduction: Estimating and monitoring changes in liver function tests is necessary to prevent the occurrence of chronic liver disease in HIV patients undergoing highly active antiretroviral therapy (HAART). Objective: To determine the variation liver profile test levels in HIV patients undergoing HAART. Materials and methods: Retrospective longitudinal study conducted in 100 HIV patients treated at the Hospital Nacional Hipólito Unanue, Lima, Peru, between 2015 and 2017. Patients in all stages of clinical infection under HAART and with liver function panel results for alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT), and total protein (TP) were included. Three follow-up liver function tests (every 3 months) were performed while undergoing HAART and participants were categorized as having normal or elevated levels for all liver markers. Differences between the samples analyzed were determined using the paired-samples T test, with a 95% confidence interval and a significance level of p<0.05. Results: Participants' mean age was 33±9.56 years and 67% were male. Mean serum AST, ALT and ALP values decreased between the first and the third measurement (p=0.021, p=0.076 and p=0.002, respectively). No significant differences in GGT and TP levels were observed between the three measurements, nor between patients with normal and elevated AST, ALT, ALP and TP values, but significant differences were observed for GGT (p=0.010). Conclusions: Variations in liver marker levels were observed in all participants, with a decreasing trend in AST, ALT and ALP between the early and late stages of HAART, implying that this therapy could play a role in liver tissue damage.
Resumen Introducción. Para prevenir el desarrollo de enfermedad hepática crónica en pacientes con VIH, durante la terapia antirretroviral de gran actividad (TARGA) se deben estimar y monitorear cambios en el perfil hepático. Objetivo. Determinar la variación de las concentraciones del perfil hepático en pacientes con VIH durante la TARGA. Materiales y métodos. Estudio retrospectivo longitudinal realizado en 100 pacientes con VIH atendidos en el Hospital Nacional Hipólito Unanue, Lima, Perú, entre 2015 y 2017. Se incluyeron pacientes en todos los estadios de infección clínica que estuvieran recibiendo TARGA y en los que se contara con resultados del perfil hepático para alanina aminotransferasa (ALT), aspartato aminotransferasa (AST), fosfatasa alcalina (FA), gammaglutamiltranspeptidasa (GGT) y proteínas totales (PT). Se realizaron tres análisis de control de la función hepática durante la TARGA (1 cada 3 meses) y los participantes se agruparon en niveles normales y elevados para todos los marcadores hepáticos. Las diferencias entre las muestras analizadas fueron determinadas mediante la prueba t-Student para muestras relacionadas, con un intervalo de confianza de 95% y un nivel de significancia de p<0.05. Resultados. La edad promedio fue de 33±9.56 años y el 67% fueron varones. Los valores séricos promedio de AST, ALT y FA disminuyeron entre la primera y la tercera medición (p=0.021, p=0.076 y p=0.002, respectivamente). No se observaron diferencias significativas en los niveles de GGT y PT entre las tres mediciones, ni entre los pacientes con valores normales y elevados para AST, ALT, FA y PT, pero sí para GGT (p=0.010). Conclusiones. Se observaron variaciones en los niveles de los marcadores hepáticos de todos los participantes, con una tendencia a la reducción en AST, ALT y FA entre las etapas iniciales y finales de la terapia, lo que implica que la TARGA podría ejercer un rol en el daño tisular hepático.
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La hepatopatía crónica más prevalente en el mundo es la esteatosis hepática no alcohólica. Así, se realizó una investigación con el objetivo de determinar los factores asociados a esa patología en pacientes atendidos en el Centro de salud tipo B Chambo, Ecuador, durante 2020. Se realizó un estudio con enfoque cuantitativo, de tipo no experimental, correlacional y retrospectivo. Las historias clínicas seleccionadas aportaron los datos de las variables de interés. La media de la edad de los involucrados fue de 54,43 ± 8,10 años. El 60,38% tenía hipertensión arterial, el 52,83% diabetes mellitus, el 62,26% sobrepeso u obesidad y el 49,06% dislipidemia, determi-nando que estas comorbilidades tuvieron una relación significativa con la enfermedad objeto de estudio, la que resultó más incidente en edades mayores de 50 años. Las personas sedentarias o con bajos niveles de actividad física mostraron de ALT y AST.
The most prevalent chronic liver disease in the world is nonalcoholic fatty liver disease. Thus, research aimed to determine the factors associated with this pathology in patients treated at the Type B Chambo Health Center, Ecuador, during 2020. A study was carried out with a quantitati-ve, non-experimental, correlational, and retrospective approach. The selected medical records provided the information for the variables of interest. The mean age of the population was 54.43 ± 8.10 years of age. 60.38% had arterial hypertension, 52.83% diabetes mellitus, 62.26% overweight or obesity and 49.06% dyslipidemia. It was determined that these comorbidities had a significant relationship with the disease under study, which was more incident in ages older than 50. Sedentary people or those ones with low levels of physical activity showed ALT and AST.
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Humanos , Masculino , Femenino , Persona de Mediana Edad , Comorbilidad , Factores Abióticos , Hepatopatías , Ejercicio Físico , Colesterol , SobrepesoRESUMEN
Introducción: La enfermedad hepática grasa no alcohólica se caracteriza por un aumento de la acumulación de lípidos (triglicéridos) de forma macrovesicular, en más de 5 % de los hepatocitos, asociado o no a inflamación y/o fibrosis hepática. Objetivo: Caracterizar a pacientes con enfermedad hepática grasa no alcohólica según variables de interés para el estudio. Método: Se realizó un estudio descriptivo y transversal de 95 pacientes atendidos en el Servicio de Gastroenterología del Hospital General Docente Dr. Juan Bruno Zayas Alfonso de Santiago de Cuba, desde junio hasta diciembre de 2018. Entre las variables figuraron: edad, sexo, factores de riesgo, resultados de exámenes complementarios, ecografía hepática y factores de pronósticos clínicos para la fibrosis. Resultados: En la serie predominaron los grupos etarios de 35-44 y de 45-54 años (65,2 %, respectivamente), el sexo femenino, la obesidad como principal factor de riesgo (50,5 %), la transaminasa glutámico pirúvica-alanina aminotransferasa (39,0 %) entre los exámenes complementario con valores alterados y la esteatosis hepática moderada como hallazgo ecográfico (55,8 %), entre otros. Conclusiones: La enfermedad hepática grasa no alcohólica prevaleció en los pacientes entre 35-54 años, donde la obesidad constituyó el factor de riesgo más importante; asimismo, un mayor número de pacientes presentó cifras elevadas de transaminasa glutámico pirúvica-alanina aminotransferasa y los hallazgos ecográficos revelaron la primacía de la esteatosis moderada. La presencia de 4 o más factores pronósticos constituyó un riesgo para el desarrollo de fibrosis hepática.
Introduction: The non alcoholic fatty hepatic disease is characterized by an increase of the lipids accumulation (triglycerides) in a macrovesicular way, in more than 5 % of the hepatic cells, associated or not with inflammation and/or hepatic fibrosis. Objective: To characterize patients with non alcoholic fatty hepatic disease according to variables of interest for the study. Method: A descriptive and cross-sectional study of 95 patients assisted in the Gastroenterology Service of Dr. Juan Bruno Zayas Alfonso Teaching General Hospital was carried out in Santiago de Cuba, from June to December, 2018. Among the variables figured: age, sex, risk factors, results of complementary exams, hepatic echography and clinical prognosis factors for the fibrosis. Results: In the series there was a prevalence of the 35-44 and 45-54 age groups (65.2 %, respectively), female sex, obesity as main risk factor (50.5 %), transaminase glutamic piruvic-alanineaminotransferase (39.0 %) among the complementary exams with altered values and the moderate fatty liver as echographic finding (55.8 %), among others. Conclusions: The non alcoholic fatty hepatic disease prevailed in patients between 35-54 years, where obesity constituted the most important risk factor; also, a greater number of patients presented high figures of transaminase glutamic piruvic-alanineaminotransferase and the echographic findings revealed the primacy of the moderate steatosis. The presence of 4 or more prognosis factors constituted a risk for the development of hepatic fibrosis.
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Enfermedad del Hígado Graso no Alcohólico/epidemiología , Enfermedad del Hígado Graso no Alcohólico/diagnóstico por imagen , Atención Secundaria de Salud , Alanina TransaminasaRESUMEN
Fatigue is defined as the inability to maintain muscle power and strength, impairing performance. Nutritional interventions have been used to delay this phenomenon, such as glutamine and alanine supplementation. These amino acids might attenuate several causes of fatigue, since they are important energy substrates, transport ammonia avoiding the accumulation of this toxic metabolite and attenuate muscle damage and oxidative stress. Thus, the aim of this study was to evaluate the effects of glutamine and alanine supplementation on central and muscle fatigue parameters of rats submitted to resistance training (RT). Forty adult Wistar rats (60 days) were distributed into five groups: SED (sedentary, receiving water), CON (trained, receiving water), ALA, G+A and DIP (trained and supplemented with alanine, glutamine and alanine in their free form, and Lalanyl-L-glutamine, respectively). Trained groups underwent a ladder-climbing exercise, with progressive loads, for eight weeks. Supplements were diluted in water to a 4% concentration and offered ad libitum during the last 21 days of experiment. RT increased plasma glucose, the muscle concentrations of ammonia and glutathione (GSH) and the muscle damage parameters - plasma creatine kinase (CK) and lactate dehydrogenase (LDH), whereas decreased muscle glycogen. G+A supplementation prevented the increase of muscle ammonia by RT, while ALA and G+A administration reduced plasma CK and LDH, and DIP supplementation increased the muscle content of glycogen and LDH. Contrary to expectations, DIP administration increased central fatigue parameters, such as plasma concentration of free fatty acids (FFA), hypothalamic content of serotonin and serotonin/dopamine ratio. Despite these results, there was no difference between groups in the maximum carrying capacity (MCC) tests. In conclusion, supplementation with glutamine and alanine improves some fatigue parameters, but does not affect physical performance of rats submitted to RT
O termo fadiga é definido como a incapacidade de manutenção da força e da potência musculares, prejudicando a performance. Intervenções nutricionais têm sido utilizadas para retardar este fenômeno, como a suplementação com glutamina e alanina. Estes aminoácidos poderiam atenuar diversas causas de fadiga, pois são importantes substratos energéticos, carreiam amônia evitando o acúmulo deste metabólito tóxico e atenuam a lesão muscular e o estresse oxidativo. Logo, o objetivo deste estudo foi avaliar os efeitos da suplementação com glutamina e alanina sobre parâmetros de fadiga central e muscular em ratos submetidos ao treinamento resistido (TR). Foram utilizados 40 ratos Wistar adultos (60 dias de idade), distribuídos nos grupos: SED (não treinados, recebendo água), CON (treinados, recebendo água), ALA, G+A e DIP (treinados e suplementados com alanina, glutamina e alanina livres, e L-alanil-L-glutamina, respectivamente). Os grupos treinados realizaram um exercício de escalada em escada, com aumento progressivo de carga, durante oito semanas. A suplementação foi diluída a 4% em água e ofertada via oral, ad libitum, durante os últimos 21 dias de experimento. O TR aumentou a glicemia, as concentrações musculares de amônia e de glutationa (GSH) e os parâmetros de lesão muscular - creatina quinase (CK) e lactato desidrogenase (LDH) no plasma, enquanto reduziu o glicogênio no músculo. A suplementação com G+A preveniu o aumento de amônia muscular promovido pelo TR, enquanto a administração de ALA e G+A reduziu as concentrações de CK e LDH no plasma, e a suplementação com DIP aumentou o conteúdo muscular de glicogênio e de LDH. Ao contrário do esperado, a administração de DIP aumentou parâmetros de fadiga central, como as concentrações plasmáticas de ácidos graxos livres, o conteúdo hipotalâmico de serotonina e a razão serotonina/dopamina. Apesar disso, não houve diferença entre os grupos nos testes de carga máxima. Em conclusão, a suplementação com glutamina e alanina melhora alguns parâmetros de fadiga, mas não afeta o desempenho físico em ratos submetidos ao TR
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Animales , Masculino , Femenino , Ratas , Suplementos Dietéticos/clasificación , Alanina/antagonistas & inhibidores , Fatiga/clasificación , Glutamina/antagonistas & inhibidores , Glucemia/inmunología , Agua/farmacología , Ejercicio Físico/fisiología , Entrenamiento de Fuerza/métodos , Rendimiento Físico FuncionalRESUMEN
La alanina aminotransferasa (ALT) es una enzima citoplasmática, más específi ca de daño hepático, la cual ha sido cuantifi cada en líquido crevicular; sin embargo, son escasos los reportes que señalan que la saliva pueda ser una herramienta de utilidad para la medición de esta enzima. El objetivo del estudio es identifi car los niveles de la enzima ALT en saliva no estimulada de pacientes sanos y pacientes con periodontitis, antes y después del tratamiento periodontal no quirúrgico. Material y métodos: Se evaluaron 24 pacientes con periodontitis moderada a avanzada generalizada (n = 16) y pacientes con periodonto sano (n = 8) que acudieron a la Clínica de Periodoncia de la Unidad Médico Didáctica de la Universidad Autónoma de Aguascalientes, donde al grupo experimental se le realizó tratamiento periodontal no quirúrgico. Se recolectó saliva no estimulada antes y después del tratamiento periodontal para evaluar los niveles de ALT, procesando su lectura con un analizador semiautomático para química clínica. Resultados: En el grupo experimental se encontró una concentración de ALT de 52.47 ± 72.68, que disminuye a 14.95 ± 16.88 posterior a la terapia periodontal, a diferencia del grupo control con una media de 4.488 ± 3.229, se detectó una media de 5.638 ± 5.935 posterior al tratamiento periodontal. Conclusión: En los pacientes que fueron sometidos al tratamiento periodontal no quirúrgico, la concentración de ALT tiende a disminuir de manera notable; sin embargo, los resultados mostrados no fueron estadísticamente significativos (AU)
Alanine aminotransferase (ALT) is a cytoplasmic enzyme, more specific for liver damage, which has been quantifi ed in crevicular fl uid, however there are few reports that saliva can be a useful tool for the measurement of this enzyme. The objective of the study is to identify the levels of the ALT enzyme in unstimulated saliva of healthy patients and patients with periodontitis, before and after the non-surgical periodontal treatment. Material and methods: 24 patients with moderate to advanced generalized periodontitis (n = 16) and patients with healthy periodontium (n = 8) who attended the Periodontics Clinic of the Didactic Medical Unit of the Autonomous University of Aguascalientes where the experimental group underwent non-surgical periodontal treatment. Unstimulated saliva was collected before and after the periodontal treatment to evaluate the ALT levels, processing its reading with a semi-automatic analyzer for clinical chemistry. Results: In the experimental group, an ALT concentration of 52.47 ± 72.68 was found, decreasing to 14.95 ± 16.88 after periodontal therapy, unlike the control group with a mean of 4.488 ± 3.229, fi nding an average of 5.638 ± 5.935 after periodontal treatment. Conclusion: In patients who underwent non-surgical periodontal treatment, the concentration of ALT tends to decrease signifi cantly, however the results shown were not statistically significant (AU)
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Humanos , Masculino , Femenino , Periodontitis , Saliva/inmunología , Alanina Transaminasa/inmunología , Facultades de Odontología , Epidemiología Descriptiva , Estudios Prospectivos , Estudios Longitudinales , Raspado Dental/métodos , MéxicoRESUMEN
Objetivo: Evaluar la alanina aminotransferasa (ALT) como marcador en el diagnóstico de síndrome metabólico (SM) y riesgo cardiovascular (RCV) en niños con obesidad exógena. Materiales y métodos: Estudio transversal. Se incluyeron niños con obesidad exógena de 2 a 14 años, atendidos en la Unidad de Endocrinología Pediátrica del Hospital Nacional Cayetano Heredia, entre el 2014 al 2018. Se definió enfermedad hepática no alcohólica (EHNA) considerando dos puntos de corte de ALT; en mujeres: >22,1U/L y >44U/L, en varones: >25,8U/L y >50U/L. Se definió SM según la Academia Americana de Pediatría y RCV con TG/HDL-C ≥3,5. Aplicamos Chi cuadrado, considerándose significativo p<0,05. Estimamos sensibilidad(S), especificidad (E) y likelihood ratios (LR). Resultados: Se incluyeron 347 niños obesos (54,7% varones). La frecuencia de EHNA fue de 23,1%. La sensibilidad y especificidad para el diagnóstico de SM con ALT >22,1U/L y >25,8U/L fue 79,4% y 37,6% respectivamente y, con ALT>44U/L y >50U/L fue 28,6% y 83,3%. La ALT con punto de corte mayor en conjunto con TG/HDL-C≥3,5 mostró una especificidad del 96,9% y un likelihood ratio + (LR+) de 6,7. Conclusión: La ALT con un punto de corte >44U/L en mujeres y >50U/L en varones, es un marcador bioquímico útil en la identificación de SM y riesgo cardiovascular en niños con obesidad exógena desde los primeros años de vida.
Objective: To assess alanine aminotransferase (ALT) as a marker for diagnosing metabolic syndrome (MS) and cardiovascular risk in children with exogenous obesity. Materials and Methods: This is a cross-sectional study. Children with exogenous obesity between 2 and 14 years of age seen in the Pediatric Endocrinology Unit at Cayetano Heredia Hospital between 2014 and 2018 were included. Non alcoholic liver disease was defined considering two ALT cutoff points: >22.1 U/L and >44 U/L in females and >25.8 U/L and >50 U/L in males. MS was defined according to the American Academy of Pediatrics criteria, and cardiovascular risk was defined with TG/HDL-C ratio ³3.5. We used chi-square test, and p<0.05 was deemed as significant. We estimated sensitivity (S), specificity (E) and likelihood ratios (LR). Results: Three-hundred and forty-seven obese children were included (54.7% were male). Non-alcoholic liver disease frequency was 23.1%. Sensitivity and specificity values for diagnosing MS with ALT >22.1 U/L and >25.8 U/L were 79.4% and 37.6%, respectively; and with ALT >44 U/L and 50 U/L these values were 28.6% and 83.3%. ALT levels with higher cutoff values, together with a ³3.5 TG/HDL-C ratio showed 96.9% specificity and 6.7 likelihood ratio (LR+). Conclusion: ALT levels with a >44 U/L cutoff value in females and >50 U/L in males is a useful biochemical marker for identifying MS and determining cardiovascular risk in children with exogen obesity during their early years of life.
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INTRODUCTION: Introduction: the beta-alanine (BA) is one of the ergogenic aid most used by athletes, but the majority of the studies center the research on chronic supplementation. Objectives: to determine the acute effect of BA supplementation on a limited time test (LTT) at maximum aerobic speed (MAS) on endurance athletes. Material and method: eleven endurance athletes (VO2max 61.6 ± 9.5 mLO2â¢kg-1â¢min-1) were part of the study. The study consisted of a double-blind, cross-over intra-subject design, and the BA supplementation was 30 mgâ¢kg-1 or placebo (PL) 60 minutes before completing a LTT. The variables were: time and distance in LTT, and post-effort lactate concentrations ([La]) in minutes 1, 3, 5, 7, and 9. The Student's t test was used for the analysis and the size of the effect (SE) was measured through Cohen's d test. Results: the time on LTT showed significant differences between BA and PL (p = 0.047; SE = 0.48). No significant differences were seen between both groups (p = 0.071; SE = 0.48), and [La] showed significant differences between both groups in minutes 3, 5 and 7, respectively (p < 0.05). Conclusion: acute supplementation with BA showed a significant increase in the execution time in LTT in the intensities connected to MAS. Hence, acute supplementation with BA is an ergogenic aid that could be considered by resistance athletes in order to increase the athletic performance.
INTRODUCCIÓN: Introducción: la beta-alanina (BA) es una de las ayudas ergogénicas más utilizadas actualmente por deportistas, pero la mayoría de los estudios centran su investigación en la suplementación prolongada. Objetivos: determinar el efecto agudo de la suplementación con BA sobre una prueba de tiempo límite (PTL) a velocidad aeróbica máxima (VAM) en atletas de resistencia. Material y método: once atletas de resistencia (VO2máx 61,6 ± 9,5 mLO2â¢kg-1â¢min-1) fueron parte del estudio. El diseño fue doble ciego, cruzado intrasujeto, y la suplementación de BA fue de 30 mgâ¢kg-1 o placebo (PL) 60 minutos antes de completar una PTL. Las variables fueron: tiempo y distancia en la PTL y concentraciones de lactato ([La]) postesfuerzo en los minutos 1, 3, 5, 7 y 9. Para el análisis se utilizó una prueba t de Student y el tamaño del efecto (TE) se realizó mediante la prueba d de Cohen. Resultados: el tiempo en la PTL evidenció diferencias significativas entre la BA y PL (p = 0,047; TE = 0,48). No se observaron diferencias significativas en distancia entre ambos grupos (p = 0,071; TE = 0,48) y las [La] evidenciaron diferencias significativas entre ambos grupos en los minutos 3, 5 y 7, respectivamente (p < 0,05). Conclusión: la suplementación aguda con BA evidenció aumentos significativos en el tiempo de ejecución en la PTL a intensidades correspondientes a VAM. Por lo anterior, la suplementación aguda con BA es una ayuda ergogénica que podría ser considerada por los atletas de resistencia para aumentar el rendimiento deportivo.
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Atletas , Rendimiento Atlético , Suplementos Dietéticos , Resistencia Física/efectos de los fármacos , Carrera/fisiología , beta-Alanina/farmacología , Adolescente , Adulto , Umbral Anaerobio/efectos de los fármacos , Estudios Cruzados , Método Doble Ciego , Femenino , Humanos , Masculino , Sustancias para Mejorar el Rendimiento , Adulto JovenRESUMEN
Resumen El albendazol es un medicamento usado para tratar infecciones por helmintos y usualmente presenta pocos o ningún efecto secundario. A pesar de que hay un incremento transitorio de enzimas hepáticas luego de su uso, existe poca evidencia en la literatura en la que se reporte lesión hepática luego de automedicación con albendazol. En este informe, el paciente se presentó con hepatitis aguda luego de automedicarse con albendazol. El paciente cuenta además con una historia de episodios similares después de haber usado el fármaco. Se evaluada la causalidad con el método de evaluación de causalidad de Roussel Uclaf del Concejo para Organizaciones Internacionales de Ciencias Médicas, cuyo resultado fue un puntaje de 10, lo que indicó una alta probabilidad de lesión hepática inducida por albendazol al cabo de realizarse una investigación rigurosa y de excluir otras posibles causas de la condición física del paciente. En conclusión, aunque es ideal agilizar el proceso para combatir a los helmintos, es necesario intensificar la necesidad de monitorizaciones de calidad para evitar reacciones adversas como la hepatitis inducida por medicamentos. Asimismo, la automedicación de cualquier medicamento debe ser siempre evitada.
Abstract Albendazole is used to treat helminth infections and usually has minimal or no side effects. A transient increase in liver enzymes is common following its use, but little evidence of albendazole-induced liver damage has been reported in the literature. This study presents a patient who developed acute hepatitis following self-medication with albendazole. The patient also had a history of similar episodes in the past after using the drug. After a thorough investigation and exclusion of all other causes of the patient's clinical condition, the Roussel Uclaf Causality Assessment Method of the Council for International Organizations of Medical Sciences scale yielded a score of 10 points, indicating a high probability of albendazole-induced liver damage. In conclusion, expediting the process of combating helminths is ideal, but quality monitoring is required to avoid adverse reactions such as drug-induced hepatitis. Moreover, self-medication with any drug should always be discouraged.
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Humanos , Femenino , Adulto , Albendazol , Enfermedad Hepática Inducida por Sustancias y Drogas , Hepatitis , Automedicación , Efecto Rebote , Helmintos , HígadoRESUMEN
Objetivo: esta pesquisa baseou-se na determinação sérica de marcadores biológicos importantes, em indivíduos oncológicos, para uma possível detecção prognóstica de cân- cer colorretal, tais como o CEA (antígeno carcinoembrionário), as aminotransferases (ALT e AST) e a bilirrubina total (BT) e suas frações direta (BD) e indireta (BI). Métodos: prontuários arquivados de indivíduos (n=80), atendidos no ambulatório e sob internação do setor de oncologia do Hospital Barão de Lucena, localizado em Recife, Pernambuco, Brasil, foram catalogados para análise. O estudo de coorte transversal foi adotado para se avaliar a prevalência de positividade do CEA, correlacionada com os índices séricos eleva- dos das bilirrubinas e aminotransferases. Resultados: o percentual mais elevado de indivíduos com valores alterados, em cada marcador biológico analisado, correspondeu ao sexo masculino, com a maior diferença observada para BI (44,0% vs. 18,2%). O percentual de resultados com alteração para AST, BT, BD e BI foi correspondentemente maior entre os indivíduos que expressaram valores de CEA alterados, com as duas maiores diferenças constatadas para BT (20,6% vs.8,7%) e BI (35,3% vs.19,6%). Conclusão: a associação dos biomarcardores séricos (CEA, bilirrubinas e aminotransferases) não demonstrou resultados significativos. Entretanto, valores do CEA alterados não podem ser desconsiderados, pois, quando averiguados isoladamente, inferem um possível risco de desenvolvimento de neoplasias do sistema digestório, principalmente na região colorretal, assim como da mama, do pulmão e do ovário.
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Aspartato Aminotransferasas , Bilirrubina , Biomarcadores , Antígeno Carcinoembrionario , Alanina TransaminasaRESUMEN
Objetivos: Enzimas hepáticas elevadas são um cenário comum encontrado pelos médicos na prática clínica. O objetivo desse estudo é auxiliar os profissionais de saúde na condução desses casos, revisando possíveis causas tanto hepáticas, quanto extra-hepáticas para este achado e como prosseguir com a avaliação diagnóstica frente ao mesmo. Métodos: As buscas foram realizadas nas bases de dados MEDLINE e LILACS. A estratégia de busca foi desenvolvida utilizando-se os seguintes termos de pesquisa: "transaminases" OR "alanina transaminase" OR "aspartato transaminase". Os critérios de elegibilidade foram: estudos realizados em humanos, adultos, maiores de 19 anos, estudos com texto disponível, publicados em português, espanhol ou inglês a partir de 2012. Resultados: De um total de 1219 artigos que foram encontrados nas bases de dados, 20 foram incluídos nessa revisão. Foram selecionados 11 artigos com base na relevância clínica e fator de impacto das revistas. Conclusões: A alteração dos níveis das enzimas hepáticas em um paciente assintomático é um problema comum encontrado no cenário médico. A anamnese, exame físico e avaliação laboratorial são fundamentais para o diagnóstico. Dessa forma, uma abordagem sistemática pode auxiliar na condução ao correto diagnóstico, sendo necessário, por vezes, o auxílio de um especialista.
Aims: Elevated liver enzymes are a common scenario found by doctors in clinical practice. The aim of this study is to assist health care professionals in the conduct of these cases, reviewing possible causes so much liver as liver extra for this found and how to proceed with the diagnostic evaluation it. Methods: The searches were performed in the MEDLINE and LILACS databases. The search strategy was developed using the following search terms: "transaminases" OR "alanine transaminase" OR "aspartate transaminase". The eligibility criteria were: studies in humans, adults over 19 years, studies with available text, published in Portuguese, Spanish or English from 2012 up. Results: Of a total of 1219 articles that were found in the databases, 20 were included in this review. Based on 11 articles based on the clinical relevance and impact factor of the journals. Conclusions: Changing liver enzyme levels in an asymptomatic patient is a common problem found in the medical setting. Anamnesis, physical examination and laboratory evaluation are fundamental for diagnosis. In this way, a systematic approach can help in conducting the correct diagnosis, sometimes requiring the assistance of a specialist.
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Aspartato Aminotransferasas , Alanina Transaminasa , Transaminasas , Biomarcadores , Pruebas de Función HepáticaRESUMEN
Abstract We investigated the effects of glutamine and alanine supplementation on body composition of rats submitted to resistance exercise. Wistar rats were submitted to eight-week of resistance exercise, which consisted of climbing a ladder with progressive loads (25-100% of body weight). In the last 21 days of training, animals were supplemented with L-glutamine and L-alanine, as a dipeptide or in their free form (DIP, GLN + ALA and ALA groups), or water (SED and CTRL groups). RE attenuated body weight gain and lipid contents of CTRL group (p < 0.05 vs. SED) and DIP supplementation promoted an increase in tibialis muscle weight, as well as in protein content (p < 0.05 vs. CTRL). Taken together, our data indicated that resistance exercise improves body composition and dipeptide potentiated the muscle hypertrophic effect.
Resumo Foram investigados os efeitos da suplementação com glutamina e alanina na composição corporal de ratos submetidos a exercício resistido. Ratos Wistar foram submetidos, durante oito semanas, ao exercício resistido, que consistia em subir uma escada com cargas progressivas (25 a 100% do peso corporal). Nos últimos 21 dias de treinamento, os animais foram suplementados com L-glutamina e L-alanina, como dipeptídeo ou em sua forma livre (DIP, GLN + ALA ALA e grupos) ou água (grupos SED e CTRL). Exercício resistido atenuou o ganho de peso corporal e conteúdo lipídico do CTRL (p < 0,05 vs. SED) e o DIP promoveu aumento no peso do músculo tibial, bem como no teor de proteína (p < 0,05 vs. CTRL). Os nossos dados indicam que o exercício resistido, melhora a composição corporal e dipeptídeo potencializa o efeito hipertrófico muscular.
Resumen Se investigaron los efectos de la glutamina y la alanina en la composición corporal de ratones sometidos a ejercicio de resistencia. Algunos ratones Wistar fueron sometidos a 8 semanas de ejercicio de resistencia, que consistía en subir una escalera con cargas progresivas (del 25 al 100% de la masa corporal). En los últimos 21 días, los animales recibieron un suplemento de L-glutamina y L-alanina, en forma de dipéptido o en su forma libre (grupos DIP, GLN + ALA y ALA) o agua (grupos SED y CTRL). El ejercicio de resistencia redujo el aumento de masa corporal y la concentración de lípidos del CTRL (p <0,05 vs. SED). La suplementación con DIP promovió un aumento de peso del músculo tibial, así como en el contenido de proteína (p < 0,05 frente a CTRL). Nuestros resultados indican que el ejercicio de resistencia mejora la composición corporal y el DIP potencia el efecto hipertrófico.
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El objetivo del trabajo consistió en determinar la relación entre las transaminasas séricas y los componentes del Síndrome Metabólico (SM) en una población adulta mayor de 65 años de la sierra ecuatoriana. La misma estuvo formada por 387 adultos mayores de Cuenca-Ecuador. El diagnóstico de SM se realizó mediante los criterios del ATPIII-2005. Para la cuantificación de las transaminasas, alanina aminotransferasa (ALT) y aspartato aminotransferasa (AST) se usó el espectrofotómetro Génesis 20 con el reactivo de Wiener lab. Se compararon los grupos con y sin SM mediante el test t de Student. La correlación de Pearson se usó para medir la asociación entre los componentes del SM y de las transaminasas. La prevalencia del SM fue de 57,4% y de transaminasas alteradas del 12,4% y 9,0% para AST y ALT, respectivamente. Aunque se halló una correlación entre las AST, triglicéridos y C-HDL, no se encontró asociación directa entre el SM y las transaminasas. Estos resultados indican que es necesario profundizar el rol de las transaminasas séricas en la población de adultos mayores.
The objective of the present work was to determine the relationship between serum transaminases and the Metabolic Syndrome (MS) components in an elderly population from the Ecuadorian highlands. Said population was composed of 387 elderly people from Cuenca-Ecuador. The diagnosis of MS was made using the ATPIII-2005 criteria. For the quantification of transaminases alanine aminotransferase (ALT) and aspartate aminotransferase (AST), the Genesis 20 spectrophotometer was used with the reactive from the commercial house Wiener lab. The groups with and without MS were compared using Student's t test. Pearson's correlation was used to measure the association between SM components and transaminases. The prevalence of MS was 57.4%, for impaired transaminases 12.4% and 9.0% for AST and ALT respectively. Although a correlation was found between AST, triglycerides and C-HDL, no direct association between SM and transaminases was found. These results indicate that it is necessary to make more studies in the role of serum transaminases in the elderly population.
O objetivo do trabalho consistiu em determinar a relação entre as transaminases séricas e os componentes da Síndrome Metabólica (SM) numa população de adultos de mais de 65 anos da serra equatoriana. A população esteve constituída por 387 adultos idosos da Bacia-Equador. O diagnóstico de SM foi feito com base nos critérios do ATPIII-2005. Para a quantificação das transaminases alanina aminotransferase (ALT) e aspartato aminotransferase (AST) utilizou-se o espectrofotômetro Genesis 20 com o reagente de Wiener lab. Foram comparados os grupos com e sem SM utilizando o teste t de Student. Utilizou-se a correlação de Pearson para medir a associação entre os componentes da SM e das transaminases. A prevalência de SM foi de 57,4% e para transaminases alteradas de 12,4% e 9,0% para AST e ALT, respectivamente. Embora tenha sido encontrada correlação entre AST, triglicérides e C-HDL, não foi encontrada associação direta entre a SM e as transaminases. Estes resultados indicam que é necessário fazer mais estudos sobre o papel das transaminases séricas na população idosa.
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Humanos , Masculino , Femenino , Anciano , Anciano , Síndrome Metabólico , Transaminasas , Alanina Transaminasa , Aspartato Aminotransferasas , Bioquímica , EcuadorRESUMEN
Subprojeto 1: Determinação do efeito anti-inflamatório e citoprotetor da suplementação com L-glutamina e L-alanina, ou com L-alanil-L-glutamina (DIP) em ratos submetidos a treinamento resistido. Exercícios intensos reduzem a disponibilidade de glutamina, comprometendo a função imune e a recuperação de atletas. O objetivo do estudo foi avaliar os efeitos da suplementação oral crônica com L-glutamina e L-alanina, nas formas livres ou como dipeptídeo (DIP), sobre parâmetros de lesão, inflamação e citoproteção em ratos Wistar adultos submetidos a treinamento resistido (TR). Neste estudo, o TR reduziu a concentração de glutamina no plasma e no músculo EDL. No entanto, este efeito foi atenuado pelos suplementos contendo L-glutamina, os quais aumentaram os conteúdos da proteína de resposta ao estresse (HSP70) em células do sistema imune (PBMC) e no EDL, concomitantemente à redução da ativação do NF-kB e a da concentração de citocinas no EDL. O efeito protetor das suplementações também foi evidenciado pela atenuação de marcadores de lesão (CK e LDH) e inflamação (TNF-α e IL-1ß), bem como pelo aumento nas concentrações de marcadores anti-inflamatórios (IL-6, IL-10 e MCP-1) no plasma. Nossos resultados sugerem que a suplementação oral crônica com L-glutamina (administrada com L-alanina livre ou como DIP) promoveu efeitos citoprotetores mediados pela HSP70 em resposta à lesão e inflamação induzidas pelo TR. Subprojeto 2: Efeitos da L-alanil-L-glutamina sobre as vias de sinalização da insulina e da mTOR/S6K, e citoproteção em células musculoesqueléticas C2C12. O dipeptídeo L-alanil-L-glutamina é conhecido por modular o metabolismo e a viabilidade celular. Contudo, os efeitos sobre os componentes clássicos das vias de sinalização da insulina e da mTOR/S6K, bem como o efeito citoprotetor em células musculares, são pouco esclarecidos. O objetivo deste estudo foi investigar o efeito do DIP sobre as vias de sinalização da insulina e da mTOR/S6K em miotubos C2C12, em condições normais ou resistentes à insulina. A exposição crônica à insulina (24h) promoveu resistência à insulina, reduzindo os conteúdos totais do receptor beta (IR-ß) e do substrato do receptor de insulina (IRS-1), e diminuindo a fosforilação de IRS-1, AKT e P44/42 MAPK. Adicionalmente, houve redução na expressão do transportador de glicose (GLUT4) e HSP70, redução da viabilidade celular e menor fosforilação de p70S6k e S6, proteínas relacionadas à síntese proteica. Em contraste, a suplementação com DIP aumentou os conteúdos totais de IR-ß e IRS-1 e a fosforilação de IRS-1 e AKT. A glicólise anaeróbia e a capacidade glicolítica, além da fosforilação de p70S6k e S6, foram aumentadas pelo DIP em condições normais e na resistência à insulina. Nestas condições experimentais, nossos resultados sugerem que a suplementação com DIP melhorou as vias de sinalizações da insulina e da mTOR/S6K, aumentou a captação e metabolização da glicose, independente da estimulação com insulina e, finalmente, promoveu citoproteção resgatando parcialmente as células de um estado resistente à insulina, por meio do aumento de HSP70 e ativação das etapas finais da via mTOR/S6K.
Subproject 1: Determination of the anti-inflammatory and cytoprotective effects of supplementation with L-glutamine and L-alanine, or with L-alanyl-L-glutamine in rats submitted to resistance training. Intense exercise reduces glutamine availability, compromising immune function and recovery of athletes. The objective of the study was to evaluate the effects of chronic oral supplementation with L-glutamine and L-alanine, in their free form or as dipeptide (DIP), on muscle damage, inflammation and cytoprotection in adult Wistar rats submitted to resistance training (RT). In this study, RT reduced glutamine concentration in plasma and EDL muscle. However, this effect was attenuated by supplements containing L-glutamine, which increased the contents of the stress response protein (HSP70) in immune system cells (PBMC) and EDL, concomitantly with the reduction of NF-kB activation and the concentration of cytokines in EDL. The protective effect of supplementation was also evidenced by attenuation of lesion markers (CK and LDH) and inflammation (TNF-α and IL-1ß), as well as by the increase in anti-inflammatory plasma markers (IL-6, IL-10 and MCP-1). Our results suggest that chronic oral supplementation with L-glutamine (administered along with free L-alanine or as DIP) promoted HSP70-mediated cytoprotective effects in response to RT-induced injury and inflammation. Subproject 2: Effects of L-alanyl-L-glutamine on the components of insulin and mTOR/ S6K signaling pathways and cytoprotection in C2C12 musculoskeletal cells. The dipeptide L-alanyl-L-glutamine is known to modulate metabolism and cell viability. However, the effects on the classical components of insulin and mTOR/ S6K signaling pathways, as well as the cytoprotective effect on muscle cells, are poorly understood. The aim of this study was to investigate the effect of DIP on insulin and mTOR/ S6K signaling pathways in C2C12 myotubes, under normal or insulin resistant conditions. Chronic insulin exposure (24h) promoted insulin resistance, reducing the total contents of the insulin receptor (IR-ß) and the insulin receptor substrate (IRS-1), and decreasing the phosphorylation of IRS-1, AKT and P44/ 42 MAPK. In addition, there was a reduction in the expression of glucose transporter (GLUT4) and HSP70, reduction of cell viability and defective phosphorylation of p70S6k and S6, which are related to protein synthesis. On the other hand, DIP supplementation increased the total contents of IR-ß and IRS-1 and the phosphorylation of IRS-1 and AKT. Anaerobic glycolysis and glycolytic capacity, in addition to phosphorylation of p70S6k and S6, were increased by DIP under normal conditions and in insulin resistance. In our experimental conditions, our results suggest that DIP supplementation improved the signaling pathways of insulin and mTOR/ S6K, increased glucose uptake and metabolism, independent of insulin stimulation, and finally promoted cytoprotection by partially rescuing the cells of an insulin resistant state, by increasing HSP70 and activating the final stages of the mTOR/ S6K pathway.
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Animales , Masculino , Ratas , Heridas y Lesiones , Glutamina/efectos adversos , Inflamación , Insulina/análisis , Ejercicio Físico , Alanina/efectos adversosRESUMEN
To assess the relationship between the degree of waist circumference (WC) and nonalcoholic fatty liver disease (NAFLD) in obese adolescents of both genders, analyzed according to quartiles of WC. Methods: Cross-sectional study that involved 247 obese adolescents aged 1219 years. Mean values of the nutritional parameters and serum analyses were compared with the groups using the independent t-test. Pearson correlation coefficient was used to determine the relationship of the parameters studied. Chi-square test for trend was used to determine the relationship between the prevalence of the NAFLD and WC quartile by gender. Results: NAFLD were presented in 60% of the study participants. Obese adolescents in the 3rd and 4th quartiles of WC presented higher prevalence of NAFLD when compared with that in the 1st quartile in both genders. The NAFLD patients had significantly higher values for body weight, BMI (body mass index), BAZ-score (BMI-for-age z-scores), total fat (% and kg), WC, visceral fat, insulin, insulin resistance index (HOMA-IR), aspartate aminotransferase and alanine aminotransferase, when compared with non-NAFLD obese adolescents. Conclusions: In conclusion, the results presented here suggest that an increase in WC can reliably predict the risk of NAFLD in obese adolescents. This is a low cost and easy-to-use tool that can help in screening in adolescents.
Avaliar a associação entre o grau de circunferência da cintura (CC) e doença hepática gordurosa não alcoólica (DHGNA) em adolescentes obesos de ambos os sexos, avaliados de acordo com quartis de CC. Métodos: Estudo transversal que envolveu 247 adolescentes obesos entre 12 a 19 anos. Os valores médios dos parâmetros nutricionais e as analises séricas foram comparados com o teste t independente. O coeficiente de correlação de Pearson foi usado para determinar a relação entre os parâmetros estudados. O teste do qui-quadrado de tendência foi usado para determinar a relação entre a prevalência da DHGNA e quartil da CC por sexo. Resultados: DHGNA estava presente em 60% dos participantes do estudo. Adolescentes obesos nos quartis 3 e 4 de CC apresentaram maior prevalência de DHGNA quando comparados com aqueles no primeiro quartil em ambos os sexos. Os pacientes com DHGNA tinham valores significativamente mais elevados de peso corporal, IMC (índice de massa corporal), IMC/I (IMC para idade) z-escore, gordura total (% e kg), CC, gordura visceral, insulina, índice de resistência à insulina (HOMA-IR), aspartato aminotransferase e alanina aminotransferase quando comparados com adolescentes obesos sem DHGNA. Conclusões: Os resultados aqui apresentados sugerem que um aumento da CC pode predizer com segurança o risco de DHGNA em adolescentes obesos. Essa é uma ferramenta de baixo custo e fácil de usar que pode ajudar na triagem de adolescentes.
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Humanos , Masculino , Femenino , Adolescente , Circunferencia de la Cintura , Enfermedad del Hígado Graso no Alcohólico , Obesidad , Alanina Transaminasa , Aspartato AminotransferasasRESUMEN
OBJECTIVE: To assess the relationship between the degree of waist circumference (WC) and nonalcoholic fatty liver disease (NAFLD) in obese adolescents of both genders, analyzed according to quartiles of WC. METHODS: Cross-sectional study that involved 247 obese adolescents aged 12-19 years. Mean values of the nutritional parameters and serum analyses were compared with the groups using the independent t-test. Pearson correlation coefficient was used to determine the relationship of the parameters studied. Chi-square test for trend was used to determine the relationship between the prevalence of the NAFLD and WC quartile by gender. RESULTS: NAFLD were presented in 60% of the study participants. Obese adolescents in the 3rd and 4th quartiles of WC presented higher prevalence of NAFLD when compared with that in the 1st quartile in both genders. The NAFLD patients had significantly higher values for body weight, BMI (body mass index), BAZ-score (BMI-for-age z-scores), total fat (% and kg), WC, visceral fat, insulin, insulin resistance index (HOMA-IR), aspartate aminotransferase and alanine aminotransferase, when compared with non-NAFLD obese adolescents. CONCLUSIONS: The results presented here suggest that an increase in WC can reliably predict the risk of NAFLD in obese adolescents. This is a low cost and easy-to-use tool that can help in screening in adolescents.
Asunto(s)
Enfermedad del Hígado Graso no Alcohólico/diagnóstico , Obesidad Infantil/complicaciones , Circunferencia de la Cintura , Adolescente , Alanina Transaminasa/sangre , Aspartato Aminotransferasas/sangre , Índice de Masa Corporal , Estudios Transversales , Humanos , Resistencia a la Insulina , Enfermedad del Hígado Graso no Alcohólico/sangre , Estado Nutricional , Obesidad Infantil/sangre , Adulto JovenRESUMEN
Introducción: la enfermedad celíaca es una enfermedad autoinmune provocada por la ingestión de gluten que afecta aproximadamente al 0,5%-1% de la población mundial. Las señales extraintestinales incluyen elevados niveles de alanina-aminotransferasa (ALT). Objetivo: evaluar los efectos de una dieta libre de gluten en los niveles ALT en pacientes con enfermedad celíaca. Métodos: este estudio transversal se llevó a cabo en la clínica ambulatoria de gastroenterología de un hospital universitario. Resultados: se incluyeron veintiséis pacientes con enfermedad celíaca con edad de 34,1 ± 11,4 años; 15,4% fueron hombres. Los sujetos del estudio tenían un nivel promedio de ALT de 54,6 ± 36,3 (mediana 40,5) U/L. Hubo una mayor proporción de individuos con hepatitis B en el grupo con ALT ≥50 U/L en comparación con sujetos con ALT <50 U/L. Entre los pacientes evaluados después del tratamiento con dieta libre de gluten se observó una reducción significativa de los valores de ALT (36,0 versus 31,0 U/l; p= 0,008). Conclusión: el treinta y cinco por ciento de los pacientes con enfermedad celíaca tenía ALT por encima del tercil superior. Se encontraron niveles más altos de ALT en pacientes con hepatitis viral B y en aquéllos que no se adhirieron a la dieta. Hubo una reducción de aminotransferasas como resultado de una dieta libre de gluten.
Introduction: Celiac disease is an autoimmune disease triggered by ingestion of gluten. It affects approximately 0.5% to 1% of the world population. Extra intestinal manifestations include elevated alanine aminotransferase (ALT) levels. Objective: The objective of this study was to evaluate the effects of a gluten-free diet on ALT levels in patients with celiac disease. Methods: This cross-sectional study was conducted in the gastroenterology outpatient clinic of a university hospital. Results: Twenty-six patients with celiac disease were included. Average patient age was 34.1 ± 11.4 years, and 15.4% of the patients were men. Study subjects had a mean ALT level of 54.6 ± 36.3 U/L (median 40.5). There was a higher proportion of individuals with hepatitis B in the group with ALT ≥ 50 U/L than in the group of subjects with ALT < 50 U/L. Among patients tested after treatment with a gluten-free diet, we observed a significant reduction in ALT values (36.0 vs. 31.0 U/L; P = 0.008). Conclusion: Thirty-five percent of celiac disease patients had ALT levels above the upper tertile. Higher ALT levels were found in patients with viral hepatitis B and in those who do not adhere to the diet. There was a reduction of aminotransferases with a gluten-free diet.
Asunto(s)
Humanos , Masculino , Femenino , Alanina Transaminasa , Enfermedad Celíaca , Dieta Sin Gluten , TransaminasasRESUMEN
A Síndrome Metabólica (SM) é uma doença que envolve diversas alterações metabólicas, dentre elas, dislipidemia, intolerância à glicose, obesidade e hipertensão arterial. A alteração nos níveis das enzimas hepáticas tem se mostrado um marcador útil no diagnostico da SM. Há poucos trabalhos avaliando essas enzimas em indivíduos com sobrepeso com e sem SM. O presente trabalho avaliou os níveis séricos das enzimas hepáticas (ALT, AST,GGT) bem como a proteína C reativa (PCR) como marcador inflamatório em indivíduos com sobrepeso, come sem SM. Foram avaliados 97 indivíduos, sendo 41 controles saudáveis eutróficos (EU), 28 indivíduos com sobrepeso sem SM (OSSM) e 28 indivíduos com sobrepeso com SM (OCSM). As análises de colesterol total,HDL-C. LDL-C, triacilglicerol, glicose, ALT, AST e GGT foram efetuadas em um auto-analisador bioquímico.A determinação de PCR foi realizada por enzima imunoensaio em micropartículas (MEIA). Utilizou-se o teste não paramétrico de Kruskal-Wallis e os resultados foram apresentados sob a forma de mediana (mínimo máximo).Correlação de Spearman foi utilizada neste estudo. Os níveis séricos das enzimas hepáticas (ALT, AST e GGT) não diferiram entre o grupo EU e o grupo OSSM, entretanto, houve diferença estatisticamente significativa quando esses parâmetros foram comparados entre EU e OCSM e OSSM e OCSM (p<0,001). Níveis plasmáticos de glicose foram positivamente correlacionados com ALT, AST e GGT. O grupo OCSM apresentou aumento significativo nos níveis séricos de PCR quando comparado aos demais grupos (p<0,001).Conclui-se que o sobrepeso não foi capaz de alterar os níveis das enzimas hepáticas e da PCR e que a elevação dos níveis séricos de GGT pode ser considerada um fator de risco adicional para SM.
Metabolic syndrome (MetS) is a disease that involves several metabolic changes, including dyslipidemia, glucose intolerance, obesity and hypertension. The changes in liver enzyme levels have been shown to be a useful marker in the diagnosis of MetS. There are few studies evaluating these enzymes in overweight individuals with or without MetS. This study evaluated the serum levels of liver enzymes (ALT, AST, and GGT) as well as C-reactive protein (CRP) as inflammatory markers in overweight individuals with and without MS. We studied 97 subjects, 41 eutrophic healthy controls (EU), 28 overweight individuals without MetS (OSSM) and 28 overweight individuals with MetS (OCSM). Analyses of total cholesterol, HDL-C, LDL-C, triacylglycerol, fasting glucose, ALT, AST and GGT were performed in a biochemical auto analyzer. The determination was performed by CRP enzyme in microparticles (MEIA). The nonparametric Kruskal-Wallis test was performed and the results were presented as median (minimum-maximum). Spearman correlation was also performed in this study. Serum levels of liver enzymes (ALT, AST and GGT) did not differ between group EU and group OSSM, however, statistically significant differences when these parameters were compared between EU and OCSM and OSSM and OCSM (p <0.001). Glucose levels were positively correlated with ALT, AST and GGT.The group showed a significant increase in serum CRP when compared to other groups (p <0.001). We conclude that overweight was not able to alter the levels of liver enzymes and CRP levels and the elevation of serum GGT may be considered an additional risk factor for MetS.