Peripheral insulin resistance is early, progressive, and correlated with cachexia in Walker-256 tumor-bearing rats.

Insulin (INS) resistance is often found in cancer-bearing, but its correlation with cachexia development is not completely established. This study investigated the temporal sequence of the development of INS resistance and cachexia to establish the relationship between these factors in Walker-256 tumor-bearing rats (TB rats). INS hepatic sensitivity and INS resistance-inducing factors, such as free fatty acids (FFA) and tumor necrosis factor-α (TNF-α), were also evaluated. Studies were carried out on Days 2, 5, 8, and/or 12 after inoculation of tumor cells in rats. The peripheral INS sensitivity was assessed by the INS tolerance test and the INS hepatic sensitivity in in situ liver perfusion. TB rats with 5, 8, and 12 days of tumor, but not 2 days, showed decreased peripheral INS sensitivity (INS resistance), retroperitoneal fat, and body weight, compared to healthy rats, which were more pronounced on Day 12. Gastrocnemius muscle wasting was observed only on Day 12 of tumor. The peripheral INS resistance was significantly correlated (r = -.81) with weight loss. Liver INS sensitivity of TB rats with 2 and 5 days of tumor was unchanged, compared to healthy rats. TB rats with 12 days of tumor showed increased plasma FFA and increased TNF-α in retroperitoneal fat and liver, but not in the gastrocnemius, compared to healthy rats. In conclusion, peripheral INS resistance is early, starts along with fat and weight loss and before muscle wasting, progressive, and correlated with cachexia, suggesting that it may play an important role in the pathogenesis of the cachectic process in TB rats. Therefore, early correction of INS resistance may be a therapeutic approach to prevent and treat cancer cachexia.

Body mass index and abdominal waist values are related to increased cardiometabolic risk in schoolchildren aged five to ten years.

OBJECTIVE: To evaluate the frequency of obesity and cardiometabolic risk in schoolchildren under ten years old. METHODS: This is a cross-sectional study with schoolchildren (n=639) aged five to ten years in a municipally of southern of Brazil. The cardiometabolic risk was calculated from values of body mass index (BMI), waist circumference (WC), diastolic (DBP) and systolic blood pressure (SBP), blood glucose levels, triglycerides and total cholesterol (TC). Odds ratio (OR), Spearman correlation and principal component analysis (PCA) were analyzed. RESULTS: Independent of sex, elevated WC and BMI were related to higher values of SBP, DBP, and TC in schoolchildren. The frequency of cardiometabolic risk was 6.0% in girls and 9.9% in boys. Schoolchildren with elevated values of SBP, triglycerides and TC presented high OR for cardiometabolic risk. PCA indicated that schoolchildren with high WC (p>80) presented more frequently altered glucose levels, triglycerides, and TC. CONCLUSIONS: Obesity, especially when associated with elevated WC, is related to metabolic dysfunctions and cardiometabolic risk in schoolchildren under ten years of age. These findings indicate the urgency of stablishing metabolic risk for this age group, enabling early diagnosis and adequate treatment, to prevent the development of diabetes and cardiovascular dysfunction throughout life.

Impact of Roux-en-Y Gastric Bypass and Vertical Gastrectomy on weight loss: a retrospective and longitudinal study in the State of Paraná, Brazil.

AIM: to compare the impact of Roux's Y Gastric Bypass (RYGB) and Sleeve Gastrectomy (SG) techniques on body weight reduction over 1 and 5 years after bariatric surgery in obese patients in the state of Paraná. METHODS: longitudinal and retrospective study, conducted between January 2010 and December 2013, with 737 patients of both sexes submitted to RYGB or SG and evaluated in the preoperative, 1 and 5 years after bariatric surgery (BS). Age, height, body weight, Body Mass Index (BMI), biochemical and pressure parameters were recorded. RESULTS: of the total of patients, men represented lower frequency, were slightly older, with higher body weight, BMI and worse metabolic and pressure conditions than women in pre-BS (p<0.05). Regardless of sex, RYGB and SG were effective in promoting body weight reduction and BMI in 1 and 5 years after BS; the RYGB technique had greater impact on these variables in both sexes (p<0.05). The highest percentage of lost weight was observed in women who underwent the RYGB technique in the first year after BS. Five years after BS, the RYGB technique promoted a higher rate of body weight reduction in men and women compared to the SG technique (p<0.05). CONCLUSION: regardless of sex, the RYGB technique promotes a higher degree of body weight reduction and BMI over time compared to the SG; having its biggest impacts in the 1 year after BS, especially in women.

Body mass index and abdominal waist values are related to increased cardiometabolic risk in schoolchildren aged five to ten years / Valores do índice de massa corpórea e circunferência abdominal estão relacionados a elevado risco cardiometabólico em escolares com idade de cinco a dez anos

ABSTRACT Objective: To evaluate the frequency of obesity and cardiometabolic risk in schoolchildren under ten years old. Methods: This is a cross-sectional study with schoolchildren (n=639) aged five to ten years in a municipally of southern of Brazil. The cardiometabolic risk was calculated from values of body mass index (BMI), waist circumference (WC), diastolic (DBP) and systolic blood pressure (SBP), blood glucose levels, triglycerides and total cholesterol (TC). Odds ratio (OR), Spearman correlation and principal component analysis (PCA) were analyzed. Results: Independent of sex, elevated WC and BMI were related to higher values of SBP, DBP, and TC in schoolchildren. The frequency of cardiometabolic risk was 6.0% in girls and 9.9% in boys. Schoolchildren with elevated values of SBP, triglycerides and TC presented high OR for cardiometabolic risk. PCA indicated that schoolchildren with high WC (p>80) presented more frequently altered glucose levels, triglycerides, and TC. Conclusions: Obesity, especially when associated with elevated WC, is related to metabolic dysfunctions and cardiometabolic risk in schoolchildren under ten years of age. These findings indicate the urgency of stablishing metabolic risk for this age group, enabling early diagnosis and adequate treatment, to prevent the development of diabetes and cardiovascular dysfunction throughout life.

RESUMO Objetivo: Avaliar a frequência de obesidade e risco cardiometabólico em escolares menores de dez anos de idade. Métodos: Este é um estudo transversal com escolares (n=639) com idade de cinco a dez anos de um município do Sul do Brasil. O risco cardiometabólico foi calculado com base nos valores do índice de massa corpórea (IMC), circunferência da cintura (CC), pressão arterial sistólica (PAS) e diastólica (PAD), valores sanguíneos de glicose, triglicerídeos e colesterol total. Odds ratio (OR), correlação de Spearman e análise de componentes principais (PCA) foram obtidos. Resultados: Independentemente do sexo, CC e IMC aumentados foram relacionados com maiores valores de PAS, PAD e colesterol total. A frequência de risco cardiometabólico foi de 6,0% nas meninas e 9,9% nos meninos. Escolares com elevados valores de PAS, triglicerídeos e colesterol total tinham alto OR para risco cardiometabólico. A PCA mostrou que escolares com alta CC (p>80) apresentam mais frequentemente alterações nos níveis sanguíneos de glicose, triglicerídeos e colesterol total. Conclusões: A obesidade, especialmente quando associada a elevados valores de CC, está relacionada com disfunções metabólicas e risco cardiometabólico em escolares menores de dez anos de idade. Estes achados indicam a urgência de estabelecer o risco metabólico para essa faixa etária, possibilitando o diagnóstico precoce, o adequado tratamento para evitar o desenvolvimento de diabetes e disfunções cardiovasculares ao longo da vida.

Impact of Roux-en-Y Gastric Bypass and Vertical Gastrectomy on weight loss: a retrospective and longitudinal study in the State of Paraná, Brazil / O impacto do Bypass Gástrico em Y de Roux e da Gastrectomia Vertical na perda de peso: um estudo retrospectivo e longitudinal no Estado do Paraná, Brasil

ABSTRACT Aim: to compare the impact of Roux's Y Gastric Bypass (RYGB) and Sleeve Gastrectomy (SG) techniques on body weight reduction over 1 and 5 years after bariatric surgery in obese patients in the state of Paraná. Methods: longitudinal and retrospective study, conducted between January 2010 and December 2013, with 737 patients of both sexes submitted to RYGB or SG and evaluated in the preoperative, 1 and 5 years after bariatric surgery (BS). Age, height, body weight, Body Mass Index (BMI), biochemical and pressure parameters were recorded. Results: of the total of patients, men represented lower frequency, were slightly older, with higher body weight, BMI and worse metabolic and pressure conditions than women in pre-BS (p<0.05). Regardless of sex, RYGB and SG were effective in promoting body weight reduction and BMI in 1 and 5 years after BS; the RYGB technique had greater impact on these variables in both sexes (p<0.05). The highest percentage of lost weight was observed in women who underwent the RYGB technique in the first year after BS. Five years after BS, the RYGB technique promoted a higher rate of body weight reduction in men and women compared to the SG technique (p<0.05). Conclusion: regardless of sex, the RYGB technique promotes a higher degree of body weight reduction and BMI over time compared to the SG; having its biggest impacts in the 1 year after BS, especially in women.

RESUMO Objetivo: comparar o impacto das técnicas Bypass Gástrico em Y de Roux (BGYR) e Gastrectomia Vertical (GV) na redução do peso corporal ao longo de 1 e 5 anos após a cirurgia bariátrica em pacientes obesos no Estado do Paraná. Métodos: estudo longitudinal e retrospectivo, realizado entre janeiro de 2010 a dezembro de 2013, com 737 pacientes de ambos os sexos submetidos a BGYR ou GV e avaliados no pré-cirúrgico, 1 e 5 anos após Cirurgia Bariátrica (CB). Foram registrados idade, estatura, peso corporal, Índice de Massa Corpórea (IMC), parâmetros bioquímicos e pressóricos. Resultados: do total de pacientes, homens representavam menor frequência, eram ligeiramente mais velhos, com maior peso corporal, IMC e pior condição metabólica e pressórica que mulheres no pré-CB (p<0,05). Independente do sexo, BGYR e GV foram efetivas em promover redução do peso corporal e IMC em 1 e 5 anos pós-CB; tendo a técnica de BGYR maior impacto nestas variáveis em ambos os sexos (p<0,05). A maior porcentagem de peso perdido foi observada em mulheres submetidas a técnica da BGYR no primeiro ano após a CB. Cinco anos após a CB, a técnica de BGYR promoveu maior taxa de redução de peso corporal em homens e mulheres comparado a técnica da GV (p<0,05). Conclusão: independente do sexo a técnica de BGYR promove maior grau de redução do peso corporal e IMC ao longo do tempo em comparação com a GV; tendo seus maiores impactos no 1 ano pós-CB sobretudo em mulheres.

Vitamin D supplementation combined with aerobic physical exercise restores the cell density in hypothalamic nuclei of rats exposed to monosodium glutamate.

BACKGROUND & AIMS: In view of the increase in the prevalence of obesity and metabolic syndrome in childhood and adolescence, this study proposed the early and combined use of treatments to restore brain areas related to satiety. The vitamin D supplementation, aerobic exercise and the combination of these interventions on the structure of arcuate (ARC) and ventromedial (VMH) nuclei of hypothalamus were investigated in monosodium glutamate (MSG)-treated rats. METHODS: Wistar rats were separated into five groups: Control group (CT); Obese group injected with MSG (OB); Obese group supplemented with vitamin D (OBvd); Obese group submitted to forced swimming training (OBexe) and Obese group treated with vitamin D supplementation and forced swimming training (OBvd + exe). RESULTS: In the OB group, the visceral fat weight was significantly higher, there was a reduction in the number of glial cells in the ARC nucleus and also in the number of neurons in the ARC and VMH nuclei. Aerobic exercise was able to reduce the visceral fat weight in the OBexe group. The combination of treatments used in the OBvd + exe group reversed the loss of neurons and glial cells produced by MSG in the ARC nucleus. All treated groups exhibited a higher number of neurons in VMH nucleus, but an increase in the glial cells were observed only in the OBexe and OBvd + exe groups. CONCLUSIONS: The effectiveness of obesity treatment can be favored through the early and combined use of vitamin D supplementation and aerobic exercise, since these therapies are able to restore brain nuclei involved in the control of food intake.

Phenylhydrazine-induced anaemia reduces subcutaneous white and brown adipose tissues in hypothalamic obese rats.

NEW FINDINGS: What is the central question of this study? Can an anaemic state modify adiposity and metabolic parameters in hypothalamic obese rats? What is the main finding and its importance? Hypothalamic obese rats do not display iron deficiency. However, the pharmacological induction of anaemia in hypothalamic obese rats resulted in reduced adiposity, characterized by a decrease in subcutaneous white and brown adipose tissue depots. These findings suggest that iron imbalance in obesity may elevate lipolysis. ABSTRACT: Iron imbalance is frequent in obesity. Herein, we evaluated the impact of anaemia induced by phenylhydrazine on adiposity and metabolic state of hypothalamic obese rats. Hypothalamic obesity was induced by high doses of monosodium glutamate (MSG; 4 g/kg) administered to neonatal male rats (n = 20). Controls (CTL; non-obese rats) received equimolar saline (n = 20). Rats were weaned at 21 days of life. At 70 days, half of the rats received three intraperitoneal doses of phenylhydrazine (PHZ; 40 mg/kg/dose) or saline solution. Body weight and food intake were followed for 4 weeks after PHZ administration. At 92 days, rats were killed and blood was collected for microcapillary haematocrit (Hct) analysis and plasma quantification of glucose, triglycerides, total cholesterol and iron levels. The liver, the spleen, and the white (WAT) and brown (BAT) adipose tissues were excised, weighed and used for histology. MSG-treated rats developed obesity, hypertriglyceridaemia and insulin resistance, compared to CTL rats, without changes in iron levels and Hct. PHZ administration reduced plasma iron levels and promoted similar tissue injuries in the spleen and liver from MSG and CTL rats. However, in MSG-treated rats, PHZ decreased fasting glucose levels and Hct, as well as diminishing the subcutaneous WAT and BAT mass. Although MSG-obesity does not affect plasma iron levels and Hct by itself, PHZ-induced anaemia associated with obesity induces a marked drop in subcutaneous WAT and BAT mass, suggesting that iron imbalance may lead to increased lipolytic responses in obese rats, compared to lean rats.

Myeloperoxidase as an important predictor of cardiovascular risk in individuals with rheumatoid arthritis.

BACKGROUND: Rheumatoid arthritis is an inflammatory disease with joint manifestations. In the presence of extra-articular manifestations, the morbidity and severity of the disease increase. Glucocorticoid is used as a treatment and may result in side effects related to cardiovascular risk. METHODS: This was a cross-sectional study including 59 volunteers with rheumatoid arthritis receiving treatment at a hospital of Campos Gerais that aimed to establish the relation between cardiovascular risk, glucocorticoid treatment and myeloperoxidase in these patients. Subjects were divided into two groups: using (n = 39) and without glucocorticoids (n = 20). They underwent clinical evaluation, physical examination and blood samples were taken. Statistical analysis was performed using Student's t test and Mann-Whitney test. Logistic regression was performed to assess the cardiovascular risk. The significance level was 5% (α = 0.05). Calculations were performed using the Statistical Package for the Social Science version 21.0. RESULTS: There has been a significant difference between groups in blood glucose values (p = 0.012), which can be explained by the different percentage of diabetic patients in the groups. When assessing cardiovascular risk using the predictors of glucocorticoid dose, time of glucocorticoid use, myeloperoxidase, and C-reactive protein together, these were responsible for significantly predicting this risk (p = 0.015). CONCLUSION: A significant relation between the predictor myeloperoxidase alone was also demonstrated (p = 0.037), it may be an important predictor of cardiovascular risk among individuals with rheumatoid arthritis.

The Vagus Nerve and Spleen: Influence on White Adipose Mass and Histology of Obese and Non-obese Rats.

The vagus nerve (VN) and spleen represent a complex interface between neural and immunological functions, affecting both energy metabolism and white adipose tissue (WAT) content. Here, we evaluated whether vagal and splenic axis participates in WAT mass regulation in obese and non-obese male Wistar rats. High doses of monosodium glutamate (M; 4 g/Kg) were administered during the neonatal period to induce hypothalamic lesion and obesity (M-Obese rats). Non-obese or Control (CTL) rats received equimolar saline. At 60 days of life, M-Obese and CTL rats were randomly distributed into experimental subgroups according to the following surgical procedures: sham, subdiaphragmatic vagotomy (SV), splenectomy (SPL), and SV + SPL (n = 11 rats/group). At 150 days of life and after 12 h of fasting, rats were euthanized, blood was collected, and the plasma levels of glucose, triglycerides, cholesterol, insulin, and interleukin 10 (IL10) were analyzed. The visceral and subcutaneous WAT depots were excised, weighed, and histologically evaluated for number and size of adipocytes as well as IL10 protein expression. M-Obese rats showed higher adiposity, hyperinsulinemia, hypertriglyceridemia, and insulin resistance when compared with CTL groups (p < 0.05). In CTL and M-Obese rats, SV reduced body weight gain and triglycerides levels, diminishing adipocyte size without changes in IL10 expression in WAT (p< 0.05). The SV procedure resulted in high IL10 plasma levels in CTL rats, but not in the M-Obese group. The splenectomy prevented the SV anti-adiposity effects, as well as blocked the elevation of IL10 levels in plasma of CTL rats. In contrast, neither SV nor SPL surgeries modified the plasma levels of IL10 and IL10 protein expression in WAT from M-Obese rats. In conclusion, vagotomy promotes body weight and adiposity reduction, elevating IL10 plasma levels in non-obese animals, in a spleen-dependent manner. Under hypothalamic obesity conditions, VN ablation also reduces body weight gain and adiposity, improving insulin sensitivity without changes in IL10 protein expression in WAT or IL10 plasma levels, in a spleen-independent manner. Our findings indicate that the vagal-spleen axis influence the WAT mass in a health state, while this mechanism seems to be disturbed in hypothalamic obese animals.

Vagotomy and Splenectomy Reduce Insulin Secretion and Interleukin-1ß.

OBJECTIVES: This study aimed to evaluate the effect of vagotomy, when associated with splenectomy, on adiposity and glucose homeostasis in Wistar rats. METHODS: Rats were divided into 4 groups: vagotomized (VAG), splenectomized (SPL), VAG + SPL, and SHAM. Glucose tolerance tests were performed, and physical and biochemical parameters evaluated. Glucose-induced insulin secretion and protein expression (Glut2/glucokinase) were measured in isolated pancreatic islets. Pancreases were submitted to histological and immunohistochemical analyses, and vagus nerve neural activity was recorded. RESULTS: The vagotomized group presented with reduced body weight, growth, and adiposity; high food intake; reduced plasma glucose and triglyceride levels; and insulin resistance. The association of SPL with the VAG surgery attenuated, or abolished, the effects of VAG and reduced glucose-induced insulin secretion and interleukin-1ß area in ß cells, in addition to lowering vagal activity. CONCLUSIONS: The absence of the spleen attenuated or blocked the effects of VAG on adiposity, triglycerides and glucose homeostasis, suggesting a synergistic effect of both on metabolism. The vagus nerve and spleen modulate the presence of interleukin-1ß in ß cells, possibly because of the reduction of glucose-induced insulin secretion, indicating a bidirectional flow between autonomous neural firing and the spleen, with repercussions for the endocrine pancreas.

Vagotomy associated with splenectomy reduces lipid accumulation and causes kidneys histological changes in rats with hypothalamic obesity.

PURPOSE: To evaluate the influence of autonomic vagal and splenic activities on renal histomorphometric aspects in obese rats. METHODS: Thirty male Wistar rats were used, of which, 24 received subcutaneous injections of monosodium glutamate (MSG) during the first 5 days of life (4 g/kg body weight) and six control animals received injections of saline solution (CON). Five experimental groups were organized (n = 6/group): falsely-operated control (CON-FO); falsely-operated obese (MSG-FO); vagotomized obese (MSG-VAG); splenectomized obese (MSG-SPL); vagotomized and splenectomized obese (MSG-VAG-SPL). RESULTS: The MSG-FO group animals showed a significant reduction in body weight and nasal-anal length when compared to CON-FO group animals (p < 0.05). The MSG-VAG-SPL group showed significant reduced in most biometric parameters associated with obesity. Falsely-operated obese animals showed a significant reduction in renal weight, glomerular diameters, glomerular tuff and capsule areas and Bowman's space compared to CON-FO group animals (p < 0.05). There was a significant reduction in diameter, glomerular tuft and capsule areas, and Bowman's space in MSG-VAG, MSG-SPL, MSG-VAG-SPL groups when compared to the MSG-FO group. CONCLUSIONS: Vagotomy associated with splenectomy induces a reduction in the adiposity and causes histological changes in the kidney of obese rats.

Maternal Roux-en-Y gastric bypass surgery reduces lipid deposition and increases UCP1 expression in the brown adipose tissue of male offspring.

Maternal obesity induced by cafeteria diet (CAF) predisposes offspring to obesity and metabolic diseases, events that could be avoided by maternal bariatric surgery (BS). Herein we evaluated whether maternal BS is able to modulate brown adipose tissue (BAT) morphology and function in adult male rats born from obese female rats submitted to Roux-en-Y gastric bypass (RYGB). For this, adult male rat offspring were obtained from female rats that consumed standard diet (CTL), or CAF diet, and were submitted to simulated operation or RYGB. Analysis of offspring showed that, at 120 days of life, the maternal CAF diet induced adiposity and decreased the expression of mitochondrial Complex I (CI) and Complex III (CIII) in the BAT, resulting in higher accumulation of lipids than in BAT from offspring of CTL dams. Moreover, maternal RYGB increased UCP1 expression and prevented excessive deposition of lipids in the BAT of adult male offspring rats. However, maternal RYGB failed to reverse the effects of maternal diet on CI and CIII expression. Thus, maternal CAF promotes higher lipid deposition in the BAT of offspring, contributing to elevated adiposity. Maternal RYGB prevented obesity in offspring, probably by increasing the expression of UCP1.

Physical exercise associated with vitamin D chronic supplementation reduces kidney injury induced by monosodium glutamate.

The aim was to evaluate the effects of chronic vitamin D (VD) supplementation associated with regular swimming over renal histomorphometric aspects in obese rats. Thirty Wistar male rats (5 days old) were used. Twenty four rats were given subcutaneous injections of monosodium glutamate (MSG; 4 g/kg), and six control rats were given an equimolar saline solution. At 21-days-old, the MSG-treated rats were randomly distributed among sedentary animals (S) and exercised (E, swimming; 3x/week). These groups were subdivided into groups orally supplemented with VD (12 µg/kg; 3x/week) or not supplemented (NS), totaling Five experimental groups (n = 6 rats/group): MSG, MSG-SVD, MSG-ENS, MSG-EVD and control groups. In MSG-obese rats, there was such as a decrease in the diameter of the, glomerular tuft, Bowman's capsule, Bowman's space areas, and renal cortical thickness, compared to the control group. In MSG-SVD, MSG-ENS, and MSG-EVD animals, there was an increase in the cortical thickness in relation to the MSG group. In MSG-ENS and MSG-EVD animals, there was a reduction of tubular degeneration in relation to the MSG group. We conclude that physical exercise associated with Vitamin D supplementation can prevent of renal injury, increasing the thickness of the renal cortex and decrease the tubular degeneration.

Splenic participation in glycemic homeostasis in obese and non-obese male rats.

We evaluated the effects of splenectomy on glucose homeostasis in obese and non-obese rats. Obesity was induced by subcutaneous injections of monosodium glutamate (MSG; 4g/kg) in neonatal rats. Control (non-obese) animals received equimolar saline. Splenectomy (SPL) was performed at 21 or 60 days of life (SPL21 and SPL60) in MSG obese and non-obese groups. Glucose tolerance, insulin resistance (IR), adiposity, histology of white adipose tissue (WAT) depots and glucose-induced insulin secretion (GIIS) in isolated pancreatic islets were evaluated at 90 days of life. In non-obese, despite of hyperphagia, the spleen ablation reduced body weight gain and energy efficiency, without changes in GIIS or IR. Slight reduction in glucose tolerance and augmented adipocyte size in subcutaneous WAT was noted in non-obese SPL21 group. In MSG-SPL21 rats was observed augmented body weight gain and energy efficiency, without alter adipocyte size. In contrast, MSG-SPL60 rats had lower body weight gain, reduced energy efficiency and smaller adipocyte size in WAT visceral depot in relation to MSG non-operated. Spleen ablation reduced insulin plasma levels in the MSG-SPL21 and MSG-SPL60 groups. Moreover, splenectomy reduced GIIS and improved glucose tolerance in MSG-SPL21 group. In MSG-SPL60 rats were observed reduction in IR, without changes in GIIS, despite of elevated glucokinase expression in pancreatic islets. In conclusion, spleen ablation reduces body weight in non-obese rats and slightly modifies glucose homeostasis. In contrast, in MSG-induced obesity, absence of the spleen can ameliorate glucose tolerance and reduce insulin secretion, improving insulin sensitivity.

Dietary habits, anthropometric and metabolic profile of adolescents born prematurely / Perfil alimentar, metabólico e antropométrico de adolescentes nascidos prematuros

INTRODUCTION: Prematurity may be related to the early onset of obesity and metabolic syndrome in adolescence. Breastfeeding and feeding are crucial factors in the genesis of cardio metabolic riskOBJECTIVE: To analyze the relationship between the type of breastfeeding and eating habits with the blood pressure, lipid, glycemic and anthropometric profile of adolescents born prematurelyMETHODS: Cross-sectional study with 50 adolescents born prematurely in western Paraná, Brazil, aged 10 to 19 years. Data on birth, breastfeeding and feeding using the 24-hour Food Consumption Marker were evaluated. Weight, height, abdominal circumference (AC), blood pressure (BP) were verified; concentrations of glucose, total cholesterol (TC) and triglycerides (TG) were measured by capillary puncture. Data analysis using descriptive statistics and analysis of varianceRESULTS: Out of total, 78% eat in front of screens and 52% do not take the main meals during the day. Regardless of the amount of meals a day, the lipid, glycemic and AC profiles did not show a statistically significant difference between the groups. There is a statistically significant association between BP and number of meals (p = 0.01), TC and breastfeeding (p = 0.03) and TG with consumption of sausages (p = 0.02) and products rich in carbohydrates (p = 0.01). Most of them (72%) consumed cow's milk before completing one year and only 30% received exclusive breastfeeding until six months of age. Related other values, 30% had high BP, 22% and 41% high TC and TG, respectively. Of the 30% overweight, 60% had high BP, 53% high TG, 33% high TC and 33% percentile AC ≥90CONCLUSION: Breastfeeding did not influence the metabolic profile, but it was evidenced as risk factors for adolescents to develop future cardiovascular problems due to prematurity, inadequate eating habits, overweight, alterations in abdominal circumference, blood pressure and lipid profile

INTRODUÇÃO: A prematuridade pode estar relacionada à instalação precoce de obesidade e síndrome metabólica na adolescência. O aleitamento e a alimentação são fatores cruciais na gênese do risco cardiometabólicoOBJETIVO: Analisar a relação do tipo de aleitamento e hábitos alimentares com o perfil pressórico, lipídico, glicêmico e antropométrico de adolescentes nascidos prematurosMÉTODO: Estudo transversal com 50 adolescentes nascidos prematuros no oeste do Paraná, com idades entre 10 e 19 anos. Avaliaram-se dados do nascimento, aleitamento e alimentação (Marcador de Consumo Alimentar de 24 horas). Verificou-se peso, altura, circunferência abdominal (CA), pressão arterial (PA); dosadas concentrações de glicose, colesterol total (CT) e triglicerídeos (TG) por punção capilar. Análise de dados por estatística descritiva e análise de variânciaRESULTADOS: 78% realizavam alimentação em frente a telas e 52% não realizavam todas as principais refeições do dia; independentemente da quantidade de refeições diárias, os perfis lipídico, glicêmico e CA não apresentaram diferença estatística significante entre os grupos. Observou-se associação estatisticamente significante entre PA e número de refeições (p=0,01), CT e aleitamento materno (p=0,03) e TG com consumo de embutidos (p=0,02) e produtos ricos em carboidratos (p=0,01). Para 72% foi ofertado leite de vaca antes de completar um ano e somente 30% receberam aleitamento materno exclusivo até os seis meses de idade. Na amostra, 30% apresentaram PA elevada, 22% e 41% CT e TG elevados, respectivamente. Dos 30% com excesso de peso, 60% apresentaram PA elevada, 53% TG, 33% CT elevado e 33% percentil CA ≥90CONCLUSÃO: O aleitamento não influenciou no perfil metabólico, porém se evidenciou como fatores de risco para os adolescentes desenvolverem problemas cardiovasculares futuros à prematuridade, hábitos alimentares inadequados, excesso de peso, CA e perfil pressórico e lipídico alterados

DUODENAL-JEJUNAL BYPASS REDUCES LIPID ACCUMULATION IN THE BROWN ADIPOSE TISSUE OF HYPOTHALAMIC OBESE RATS.

BACKGROUND: Effects of duodenal-jejunal bypass surgery (DJB) on the proliferation of nuclei and the area of adipocytes in the brown adipose tissue of obese rats. Thermogenic activity in the brown adipose tissue (BAT) of obese individuals is reduced, and this condition may be modified by bariatric surgery (BS). AIM: To characterize fat deposition in BAT from hypothalamic obese (HyO) rats submitted to duodenal-jejunal-bypass (DJB) surgery. METHODS: For induction of hypothalamic obesity, newborn male Wistar rats were treated with subcutaneous injections of monosodium glutamate (MSG). The control (CTL) group received saline solution. At 90 days, the HyO rats were submitted to DJB or sham operation, generating the HyO-DJB and HyO-SHAM groups. At 270 days, the rats were euthanized, and the BAT was weighed and submitted to histological analysis. RESULTS: Compared to BAT from CTL animals, the BAT from HyO-SHAM rats displayed increased weight, hypertrophy with greater lipid accumulation and a reduction in nucleus number. DJB effectively increased nucleus number and normalized lipid deposition in the BAT of HyO-SHAM rats, similar to that observed in CTL animals. CONCLUSION: DJB surgery avoided excessive lipid deposition in the BAT of hypothalamic obese rats, suggesting that this procedure could reactivate thermogenesis in BAT, and contribute to increase energy expenditure.

Correlação de adolescentes nascidos prematuros com os fatores socioeconômicos e seus perfis antropométrico, lipídico, glicêmico e pressórico / Correlation of adolescents born preterm with socioeconomic factors and their anthropometric, lipid, glycemic and blood pressure profiles

Introdução: adolescentes nascidos prematuros apresentam maior risco para diversos agravos à saúde; associado ao seu contexto socioeconômico, podem apresentar uma vulnerabilidade maior para desenvolvimento de doenças cardiovasculares. Objetivo: analisar os perfis lipídico, glicêmico, pressórico e antropométrico em relação aos fatores socioeconômicos de adolescentes nascidos prematuros. Métodos: estudo epidemiológico, transversal. Coletou-se os dados em Unidade Básica de Saúde (UBS) mediante instrumento com variáveis sociodemográficas, clínicas, medidas antropométricas, pressão arterial e coleta por punção capilar de glicose, colesterol total e triglicerídeos. A amostra foi do tipo conveniência, constituída por 50 adolescentes nascidos prematuros no recorte temporal de 1998 a 2006. Dados analisados por estatística descritiva e análise de associação, os adolescentes foram agrupados em clusters quanto à renda familiar, escolaridade materna, atividade física e de lazer e correlacionados aos perfis pressórico, lipídico, glicêmico e antropométrico. Resultados: a prevalência de síndrome metabólica nos adolescentes nascidos prematuros foi de 8%, sendo que adolescentes cujos pais ou responsáveis tinham renda de até um salário mínimo apresentaram maior taxa de risco cardiovascular quando comparados àqueles com renda maior ou igual a quatro salários mínimos. A escolaridade materna esteve associada ao perfil lipídico, com maior ocorrência de alteração quanto menor a escolaridade da mãe. Mesmo entre os que praticavam atividade física, 33% apresentaram pressão arterial elevada e 22% apresentaram colesterol total e triglicerídeos elevados. Conclusão/Consideração final: a prematuridade associada a fatores socioeconômicos como a escolaridade materna e renda familiar incorre em maior risco cardiovascular, detectado pela alteração no perfil lipídico e pressórico.(AU)

Introduction: adolescents born prematurely present higher risk for several health problems; associated with their socioeconomic context, they may be more vulnerable to the development of cardiovascular diseases. Objective: to analyze the lipid, glycemic, blood pressure and anthropometric profiles in relation to the socioeconomic factors of adolescents born prematurely. Methods: epidemiological, cross-sectional study. Data were collected in the Basic Health Unit using an instrument with sociodemographic and clinical variables, anthropometric measurements, blood pressure and collection by capillary puncture of glucose, total cholesterol and triglycerides. The convenience sample consisted of 50 adolescents born prematurely in the time frame from 1998 to 2006. Data analyzed by descriptive statistics and association analysis, the adolescents were grouped into clusters regarding family income, maternal education, physical activity and leisure and correlated with blood pressure, lipid, glycemic and anthropometric profiles. Results: the prevalence of metabolic syndrome in adolescents born prematurely was 8%, and adolescents whose parents or guardians had an income of up to one minimum wage had a higher rate of cardiovascular risk when compared to those with an income greater than or equal to four minimum wages. Maternal education was associated with the lipid profile, with a higher occurrence of alterations, when the mother's education was lower. Even among those who practiced physical activity, 33% had high blood pressure and 22% had total cholesterol and high triglycerides. Conclusion/Final consideration: prematurity associated with socioeconomic factors such as maternal education and family income incurs a greater risk for cardiovascular problems, detected by changes in the lipid and blood pressure profile.(AU)

Swimming training reduces glucose-amplifying pathway and cholinergic responses in islets from lean- and MSG-obese rats.

Here, we investigate the effects of exercise training on glucose- and cholinergic-induced insulin secretion in pancreatic islets from obese and lean rats. Male Wistar rats were treated with monosodium glutamate (MSG) for the first 5 days of life, while control (CON) rats received saline. At 21 days, the rats were divided into exercised (EXE) and sedentary (SED) groups. The EXE rats swam for 30 minutes, three times/week, for 10 weeks. After this, MSG-SED rats showed hyperglycaemia, hypertriglyceridaemia and hyperinsulinaemia. Besides, islets from MSG-SED rats exhibited increased glucose-stimulated insulin secretion (GSIS), followed by impaired glucose sensitivity, absence of glucose-amplifying pathway and weak cholinergic response. In contrast, adiposity, hyperinsulinaemia and hypertriglyceridaemia were reduced in MSG-EXE rats. Moreover, islets from MSG-EXE rats exhibited lower GSIS and improved islet glucose sensitivity, without restoration of the glucose-amplifying pathway or alteration in the weak cholinergic effect of these islets. In islets from CON-EXE rats we also observed reduced GSIS and absence of glucose-amplifying effects and an accentuated reduction in cholinergic insulinotropic responses, without effect on glucose sensitivity in pancreatic islets from this group. Neither obesity nor exercise modified Muscarinic Receptor 3 (M3R) immunocontent or its downstream pathways (PKC and PKA). Moreover, only CON-EXE showed increased GSIS in the presence of calcium blocker, Thapsigargin. In conclusion, swimming training reduces GSIS and cholinergic responsiveness in isolated pancreatic islets from lean and hypothalamic obese rats, which could be due to the inhibition of glucose-amplifying pathways.

Duodenal-jejunal bypass reduces lipid accumulation in the brown adipose tissue of hypothalamic obese rats / Derivação duodeno-jejunal reduz o acúmulo de lipídios no tecido adiposo marrom de ratos com obesidade hipotalâmica

ABSTRACT Background: Thermogenic activity in the brown adipose tissue (BAT) of obese individuals is reduced, and this condition may be modified by bariatric surgery (BS). Aim: To characterize fat deposition in BAT from hypothalamic obese (HyO) rats submitted to duodenal-jejunal-bypass (DJB) surgery. Methods: For induction of hypothalamic obesity, newborn male Wistar rats were treated with subcutaneous injections of monosodium glutamate (MSG). The control (CTL) group received saline solution. At 90 days, the HyO rats were submitted to DJB or sham operation, generating the HyO-DJB and HyO-SHAM groups. At 270 days, the rats were euthanized, and the BAT was weighed and submitted to histological analysis. Results: Compared to BAT from CTL animals, the BAT from HyO-SHAM rats displayed increased weight, hypertrophy with greater lipid accumulation and a reduction in nucleus number. DJB effectively increased nucleus number and normalized lipid deposition in the BAT of HyO-SHAM rats, similar to that observed in CTL animals. Conclusion: DJB surgery avoided excessive lipid deposition in the BAT of hypothalamic obese rats, suggesting that this procedure could reactivate thermogenesis in BAT, and contribute to increase energy expenditure.

RESUMO Racional: A atividade termogênica no tecido adiposo marrom (TAM) de indivíduos obesos encontra-se reduzida, condição que pode ser modificada pela cirurgia bariátrica(CB). Objetivo: Verificar o efeito da derivação duodeno-jejunal (DDJ) sobre a morfologia do TAM de ratos com obesidade hipotalâmica. Métodos: Para indução da obesidade hipotalâmica (OHi), ratos Wistar neonatos receberam injeções subcutâneas de glutamato monossódico (MSG). O grupo controle (CTL) recebeu solução salina. Aos 90 dias, os ratos OHi foram submetidos à DDJ (grupo OHi-DDJ) ou a falsa operação (grupo OHi-FO). Aos 270 dias, eles foram eutanasiados e o TAM foi pesado e submetido à análise histológica. Resultados: Em comparação com os animais CTL, o TAM dos ratos OHi-FO apresentou aumento do peso, hipertrofia dos adipócitos com acúmulo de lipídios e redução do número de núcleos. A DDJ reduziu a deposição de gordura e o número de núcleos no TAM de ratos OHi-DDJ em comparação com os OHi-FO, com valores similares aqueles dos animais CTL. Conclusões: A DDJ foi capaz de evitar a deposição excessiva de lipídios no TAM de ratos com obesidade hipotalâmica, sugerindo que a cirurgia bariátrica poderia reativar a termogênese neste tecido adiposo, contribuindo para aumentar o gasto energético.

Evolução do perfil lipídico, glicêmico e pressórico de prematuros: estudo longitudinal / Evolution of the lipid, glycemic and blood pressure profile of premature infants: a longitudinal study

Objetivo: Relacionar a evolução do perfil lipídico, glicêmico e pressórico de prematuro do nascimento aos 2 anos de idade corrigida com a classificação de peso ao nascer e sexo. Metodologia: Estudo longitudinal, amostra inicial de 71 prematuros, destes, 31 completaram o acompanhamento ambulatorial. Avaliados ao nascer, alta, 6 meses e 2 anos de idade corrigida (peso, idade gestacional, perfil lipídico, glicêmico, pressão arterial). Resultados: Glicemia, colesterol total, pressão arterial e triglicerídeos, não foram estatisticamente significantes em relação ao peso ao nascer e ao longo do seguimento. Colesterol total (p=0,18) e glicemia sofreram efeito de interação com o sexo. Pressão arterial acima do esperado aos 2 anos. Crescimento foi uniforme independente do sexo. Conclusão: O perfil lipídico, glicêmico e pressórico dos prematuros ao longo do acompanhamento não foi influenciado pela classificação de peso ao nascer. O sexo influenciou as concentrações de colesterol e a glicemia.

Objective: To relate the evolution of the lipid, glycemic and blood pressure profile of premature infants from birth to 2 years corrected age with the classification of birth weight and sex. Methodology: Longitudinal study, initial sample of 71 premature infants, of which 31 completed outpatient follow-up. Evaluated at birth, discharge, 6 months and 2 years corrected age (weight, gestational age, lipid, glycemic, blood pressure profile). Results: Blood glucose, total cholesterol, blood pressure and triglycerides were not statistically significant in relation to birth weight nor throughout follow-up. Total cholesterol (p=0.18) and blood glucose underwent interaction with sex. Blood pressure was higher than expected at 2 years old. Growth was uniform regardless of sex. Conclusion: The lipid, glycemic and blood pressure profile of premature infants during follow-up was not influenced by the birth weight classification. The cholesterol and blood glucose concentrations were influenced by sex.