RESUMO
Cellulite constitutes a major aesthetic concern affecting the majority of post-adolescent women. Current epidemiological evidence supports that the prevalence of cellulite is significantly higher in industrialized societies indicating that environmental factors have crucial role in its pathogenesis and perpetuation. Endocrine disrupting chemicals, which exist ubiquitously in the environment, are able to alter hormonal and homeostatic systems. Several of them exert agonist effects by binding to estrogen receptors and mimicking the biological activity of estrogens. Since elevated estrogen concentration is prerequisite for cellulite, the present article suggests that endocrine disrupting chemicals may be key determinants in the initiation and deterioration of cellulite either by stimulating estrogen receptors or increasing their circulating levels due to interference with enzymes and binding proteins.
Assuntos
Celulite/metabolismo , Disruptores Endócrinos/química , Exposição Ambiental , Hormônios/metabolismo , Compostos Benzidrílicos/química , Estrogênios/química , Homeostase , Humanos , Inflamação , Modelos Teóricos , Fenóis/química , Ácidos Ftálicos/química , Receptores de Estrogênio/metabolismo , Compostos de Trialquitina/química , Raios UltravioletaRESUMO
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RESUMO
BACKGROUND: The aim of this study was to investigate the effects of aliskiren on vascular function and endothelial progenitor cells (EPCs) in patients with type 2 diabetes and essential hypertension. METHODS: The study enrolled type 2 diabetic patients aged >50 years under stable glycemic control and first diagnosed mild essential hypertension. In phase A (n = 20), patients received aliskiren 150-300 mg daily for 3 months. In phase B (n = 12), hydrochlorothiazide (HCTZ) 12.5-25mg daily substituted for aliskiren for 3 more months. At baseline and at the end of each phase, we assessed (i) brachial blood pressure (BBP); (ii) central aortic systolic pressure (CSP), aortic augmentation index (Aix), and pulse wave velocity (PWV) as markers of arterial stiffness; (iii) brachial artery flow-mediated dilatation (FMD) as a marker of endothelial function; (iv) left ventricular (LV) twisting and untwisting as markers of LV function and (v) EPC numbers in culture of peripheral blood mononuclear cells. RESULTS: Aliskiren similarly reduced BBP and CSP, increased FMD (P < 0.001) and EPC numbers (P < 0.001), decreased PWV and Aix (P < 0.05), and improved LV twisting and untwisting (P < 0.05). Although substitution of HCTZ sustained BBP at similar levels, CSP and echocardiographic indices nearly returned at baseline levels, and the improvement of FMD, PWV, Aix, and EPC numbers was abolished. CONCLUSIONS: Aliskiren had a favorable effect on endothelial function and EPCs, reduced arterial stiffness, and improved LV twisting and untwisting. These effects were independent of BBP lowering, as they were not observed after the achievement of similar values of BBP with HCTZ.
Assuntos
Amidas/uso terapêutico , Anti-Hipertensivos/uso terapêutico , Diabetes Mellitus Tipo 2/tratamento farmacológico , Células Progenitoras Endoteliais/efeitos dos fármacos , Endotélio Vascular/efeitos dos fármacos , Fumaratos/uso terapêutico , Hemodinâmica/efeitos dos fármacos , Hipertensão/tratamento farmacológico , Idoso , Pressão Arterial/efeitos dos fármacos , Biomarcadores/sangue , Células Cultivadas , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/fisiopatologia , Diuréticos/uso terapêutico , Substituição de Medicamentos , Células Progenitoras Endoteliais/metabolismo , Endotélio Vascular/metabolismo , Endotélio Vascular/fisiopatologia , Feminino , Humanos , Hidroclorotiazida/uso terapêutico , Hipertensão/sangue , Hipertensão/diagnóstico , Hipertensão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Fatores de Tempo , Resultado do Tratamento , Rigidez Vascular/efeitos dos fármacos , Vasodilatação/efeitos dos fármacos , Função Ventricular Esquerda/efeitos dos fármacosRESUMO
Diabetes mellitus (DM) is recognised as a major health problem. Ninety-nine percent of diabetics suffer from type 2 DM and 10% from type 1 and other types of DM. The number of diabetic patients worldwide is expected to reach 380 millions over the next 15 years. The duration of diabetes is an important factor in the pathogenesis of complications, but other factors frequently coexisting with type 2 DM, such as hypertension, obesity and dyslipidaemia, also contribute to the development of diabetic angiopathy. Microvascular complications include retinopathy, nephropathy and neuropathy. Macroangiopathy mainly affects coronary arteries, carotid arteries and arteries of the lower extremities. Eighty percent of deaths in the diabetic population result from cardiovascular incidents. DM is considered an equivalent of coronary heart disease (CHD). Stroke and peripheral artery disease (PAD) are other main manifestations of diabetic macroangiopathy. Diabetic cardiomyopathy (DC) represents another chronic complication that occurs independently of CHD and hypertension. The greater susceptibility of diabetic patients to infections completes the spectrum of the main consequences of DM. The serious complications of DM make it essential for physicians to be aware of the screening guidelines, allowing for earlier patient diagnosis and treatment.