Comparison between direct and indirect methods to diagnose malnutrition and cardiometabolic risk in haemodialisys patients.

BACKGROUND: The present study aimed to evaluate the nutritional status of patients undergoing haemodialysis (HD) by comparing nutritional risk scores with biochemical, anthropometric and body composition variables. METHODS: Eighty-five individuals [65.9% male, mean (SD) age 62 (14) years] participated in a cross-sectional study. Global Objective Assessment (GOA) and Modified Global Subjective Assessment (mGSA) scores, as well as biochemical, anthropometric and body composition data, were collected using standardised procedures. RESULTS: The prevalence of malnutrition ranged from 20.0% (% body fat by electrical bioimpedance) to 95.3% (by GOA), depending on the indicator or score used. According to the waist circumference, 61.2% of the individuals presented abdominal obesity and visceral adipose tissue was excessive in 20% of them. Malnutrition diagnosis by GOA showed the relationship between the anthropometric and body composition indicators, as assessed by the extent that the ratings of risk nutritional/mild malnutrition and mainly moderate malnutrition were accompanied by a significant decrease in nutritional status and body composition variables. However, with respect to categories of mGSA, no statistically significant differences were observed for nutritional status and body composition variables. In the receiver operator characteristic curve analyses, mGSA and GOA were good indicators for diagnosing malnutrition because both achieved an AUC > 0.5. CONCLUSIONS: mGSA and GOA were more sensitive with respect to identifying individuals at nutritional risk compared to the isolated anthropometric indicators, thus indicating their utility in diagnostic malnutrition. However, individuals at high nutritional risk also presented cardiometabolic risk, as diagnosed mainly by central fat indicators, suggesting the application of both malnutrition and cardiometabolic risk markers in HD patients.

Eicosapentaenoic acid promotes mitochondrial biogenesis and beige-like features in subcutaneous adipocytes from overweight subjects.

Eicosapentaenoic acid (EPA), a n-3 long-chain polyunsaturated fatty acid, has been reported to have beneficial effects in obesity-associated metabolic disorders. The objective of the present study was to determine the effects of EPA on the regulation of genes involved in lipid metabolism, and the ability of EPA to induce mitochondrial biogenesis and beiging in subcutaneous adipocytes from overweight subjects. Fully differentiated human subcutaneous adipocytes from overweight females (BMI: 28.1-29.8kg/m2) were treated with EPA (100-200 µM) for 24 h. Changes in mRNA expression levels of genes involved in lipogenesis, fatty acid oxidation and mitochondrial biogenesis were determined by qRT-PCR. Mitochondrial content was evaluated using MitoTracker® Green stain. The effects on peroxisome proliferator-activated receptor gamma, co-activator 1 alpha (PGC-1α) and AMP-activated protein kinase (AMPK) were also characterized. EPA down-regulated lipogenic genes expression while up-regulated genes involved in fatty acid oxidation. Moreover, EPA-treated adipocytes showed increased mitochondrial content, accompanied by an up-regulation of nuclear respiratory factor-1, mitochondrial transcription factor A and cytochrome c oxidase IV mRNA expression. EPA also promoted the activation of master regulators of mitochondrial biogenesis such as sirtuin 1, PGC1-α and AMPK. In parallel, EPA induced the expression of genes that typify beige adipocytes such as fat determination factor PR domain containing 16, uncoupling protein 1 and cell death-inducing DFFA-like effector A, T-Box protein 1 and CD137. Our results suggest that EPA induces a remodeling of adipocyte metabolism preventing fat storage and promoting fatty acid oxidation, mitochondrial biogenesis and beige-like markers in human subcutaneous adipocytes from overweight subjects.

Produtos naturais ativadores de PPAR e marcadores associados ao processo inflamatório na Síndrome Metabólica / The inflammatory process in the metabolic syndrome: PPAR activators of natural products and markers associated with metabolic disorders

O processo inflamatório é o elo entre a síndrome metabólica e as doenças cardiovasculares. Para verificar a presença e o grau da inflamação, vários biomarcadores têm sido propostos e investigados. Este trabalho tem como objetivo revisar as recentes pesquisas que associam alguns marcadores expressos no tecido adiposo, enfatizando, dentre eles, a adiponectina, a resistina, a leptina e o transportador de glicose GLUT-4 na síndrome metabólica, a relação da inflamação decorrente desse conjunto de desordens metabólicas sob os receptores proliferadores peroxissomais (PPARs), bem como o efeito de diferentes extratos vegetais e produtos naturais bioativos na ativação desses receptores.

The inflammatory process is the link between metabolic syndrome and cardiovascular diseases. To verify the presence and degree of inflammation, several biomarkers have been proposed and different receptors have been investigated. This study aims to review recent researches involving some markers expressed in the adipose tissue, emphasizing, among them, adiponectin, resistin, leptin and glucose transporter GLUT-4 in the metabolic syndrome, the relationship of inflammation arising from this set of metabolic disorders on the peroxisome proliferator receptors (PPARs) and the effect of different bioactive compounds in the activation of these receptors.