Olanzapine, weight change and metabolic effects: a naturalistic 12-month follow up.

OBJECTIVE: Olanzapine is an atypical antipsychotic drug used to treat schizophrenia. Some of the adverse effects related to its use are obesity, hyperlipidemia, type 2 diabetes and hypertension, which may result in development of metabolic syndrome. This study aimed to investigate a possible increase in some anthropometric and biochemical parameters, and the existence of any correlation between them in Brazilian patients with schizophrenia treated with olanzapine in the mid term. METHODS: Thirty subjects with schizophrenia were evaluated, 16 women and 14 men, aged between 18 and 47 years. All patients underwent blood collection and anthropometric measurements at four different times during 12 months of follow up; thus each patient was his or her own control. RESULTS: Evaluation of some anthropometric measurements showed significant differences when comparing the mean values obtained in each of the different data collection times (p < 0.05). However, the biochemical indicators of development of metabolic syndrome measured in our study did not show the same rate of increment, with only the total cholesterol and glucose levels presenting statistically significant changes (p < 0.05), but without the same magnitude of weight change. CONCLUSION: We conclude that medium-term treatment with olanzapine promoted a substantial weight gain and increased visceral fat, while the metabolic profile did not show the same magnitude of change, suggesting a dissociation between weight gain and blood parameters, despite the severe weight gain observed among subjects evaluated.

Estudo do comportamento cortisol, gh e insulina apos uma sessao de exercicio resistido agudo / Study of the behavior of cortisol, gh and insulin after a session of acute resisted exercise / Estudio del comportamiento de cortisol, gh e insulina despues de uma sesion de ejercicio resistido agudo

INTRODUÇÃO: Muitos trabalhos têm estudado o comportamento hormonal nos exercício resistido, entretanto poucos relacionam os hormônios cortisol, GH e insulina. OBJETIVO: Estudar os ajustes das concentrações plasmáticas dos hormônios cortisol, GH e insulina em exercícios resistidos de mesma intensidade com relação à massas musculares distintas. MÉTODOS: Dez voluntários, com 20,3 ± 4,2 anos, 74,1 ± 10,2 kg de peso, 177,2 ± 4,6 cm de estatura e 23,8 ± 3,2 kg/m2 de IMC, realizaram uma sessão de leg press (LP) e supino reto (SR) com quatro séries com 10 repetições a 70% 1 RM com três minutos de intervalo. Foram coletadas amostras de sangue para dosagem das concentrações plasmáticas de cortisol, GH e insulina em repouso (Pré) e em 0' (Rec. 0'), 30' (Rec. 30') e 90' (Rec. 90') de recuperação. RESULTADOS: As concentrações plasmáticas de cortisol foram significativamente reduzidas ao final da recuperação em LP (2,20±0,37 ng/dl para 1,33±0,38ng/dl) em relação à pré-dosagem. As concentrações de GH e insulina elevaram-se significativamente durante a recuperação. GH em LP foi significativamente maior em Rec. 0' (2,75±3,29 ng/ml para 9,60±5,32 ng/dl) do que em pré. A insulina elevou-se significativamente em Rec. 30' em LP (14,70±7,92 ulU/ml para 21,66 ± 8,61 ulU/ml) e em SR (6,17 ± 2,99 ulU/ml para 19,70 ± 13,8 ulU/ml) em relação à pré. As concentrações plasmáticas de insulina pré em LP foram significativamente superiores a SR (14,70 ulU/ml e 6,17 ± 2,99 ulU/ml). CONCLUSÃO: O exercício resistido promoveu diferentes ajustes nas concentrações hormonais de cortisol, GH e insulina durante o período de recuperação. .

INTRODUCTION: Many works have studied the hormonal behavior in resistance exercise, however, few relate the cortisol, GH and insulin hormones. OBJECTIVE: To study the adjustments of plasma concentrations of the cortisol, GH and insulin hormones in resisted exercises of the same relative intensity with different muscle musses. METHODS: Ten volunteers, aged 20.3 ± 4.2 years, weight 74.1 ± 10.2 Kg, 177.2 ± 4.6 cm of stature and 23.8 ± 3.2 Kg/m2 of BMI, underwent a session of leg press (LP) and bench press (BP) with four sets of 10 repetitions at 70% 1 RM with three minutes apart. We collected blood samples to measure plasma concentrations of cortisol, GH and insulin at rest (Pre) and 0' (Rec. 0'), 30' (Rec. 30') and 90' (Rec. 90') of recovery. RESULTS: Plasma concentrations of cortisol decreased significantly at the end of the recovery in LP (2.20 ± 0.37 ng/dl to 1.33 ± 0.38 ng/dl) compared to pre. The GH and insulin concentrations significantly increased during recovery. GH was significantly higher in LP Rec. 0' (2.75 ± 3.29 ng/ml to 9.60 ± 5.32 ng/dl) than in pre. Insulin was significantly elevated in Rec. 30' in LP (14.70 ± 7.92 ulU/ml to 21.66 ± 8.61 ulU/ml) and BP (6.17 ± 2.99 ulU/ml to 19.70 ± 13.8 ulU/ml) for pre. The plasma insulin concentrations pre PL were significantly higher in the BP (14.70 ulU/ml and 6.17 ± 2.99 ulU/ml). CONCLUSION: Resisted exercise promoted different adjustments in hormone concentrations of cortisol, GH and insulin during the recovery period. .

INTRODUCCIÓN: Muchos trabajos han estudiado el comportamiento hormonal en el ejercicio de resistencia, sin embargo, pocos se refieren el cortisol, GH y las hormonas insulina. OBJETIVO: Estudiar los ajustes de las concentraciones plasmáticas de las hormonas cortisol, GH e insulina en ejercicios resistidos, de igual intensidad, en relación con las masas musculares diferentes. MÉTODOS: Diez voluntarios, con 20,3 ± 4,2 años, 74,1 ± 10,2 kg de peso, 177,2 ± 4,6 cm de estatura y 23,8 ± 3,2 kg/m2 de IMC, realizaron una sesión de leg press (LP) y supino recto (SR) con cuatro series, de 10 repeticiones a 70% 1 RM, con tres minutos de intervalo. Se recolectaron muestras de sangre para dosificación de las concentraciones plasmáticas de cortisol, GH e insulina en reposo (Pré) y en 0' (Rec. 0'), 30' (Rec. 30') y 90' (Rec. 90') de recuperación. RESULTADOS: Las concentraciones plasmáticas de cortisol se redujeron significativamente al final de la recuperación en LP (2,20±0,37 ng/dl para 1,33±0,38ng/dl) en relación con la predosificación. Las concentraciones de GH e insulina aumentaron significativamente durante la recuperación. GH en LP fue significativamente mayor en Rec. 0' (2,75±3,29 ng/ml para 9,60±5,32 ng/dl) en comparación con la predosificación. La insulina se elevó significativamente en Rec. 30' en LP (14,70±7,92 ulU/ml para 21,66 ± 8,61 ulU/ml) y en SR (6,17 ± 2,99 ulU/ml para 19,70 ± 13,8 ulU/ml) en relación con la predosificación. Las concentraciones plasmáticas de insulina, predosificación, en LP fueron significativamente superiores a SR (14,70 ulU/ml y 6,17 ± 2,99 ulU/ml). CONCLUSIÓN: El ejercicio resistido causó diferentes ajustes en las concentraciones hormonales de cortisol, GH e insulina durante el período de recuperación. .

Lack of Correlation between Periodontitis and Renal Dysfunction in Systemically Healthy Patients.

OBJECTIVES: The aim of this study was to assess a suggested association between periodontitis and renal insufficiency by assaying kidney disease markers. METHODS: VARIABLES USED TO DIAGNOSE PERIODONTITIS WERE: (i) probing pocket depth (PPD), (ii) attachment loss (AL), (iii) bleeding on probing (BOP), (iv) plaque index (PI) and (v) extent and severity index. Blood and urine were collected from 60 apparently healthy non-smokers (men and women), consisting of a test group of 30 subjects with periodontitis (age 46±6 yrs) and a control group of 30 healthy subjects (age 43±5 yrs). Kidney function markers (urea, creatinine, uric acid and albumin contents) were measured in the serum and urine. Also, the glomerular filtration rate was estimated from creatinine clearance, from the abbreviated Modification of Diet in Renal Disease formula and from the albumin : creatinine ratio in a 24-h sample of urine. RESULTS: It was found that the control group had a greater mean number of teeth than the test group and that the two groups also differed in PPD, AL, BOP and PI, all these variables being higher in the test group (P=0.006). For the extent and severity index of both PPD and AL, the test group had much higher medians of both extent and severity than the control group (P=0.001). With regard to kidney function, none of the markers revealed a significant difference between the control and test groups and all measured values fell within the reference intervals. CONCLUSIONS: It is proposed that severe periodontitis is not associated with any alteration in kidney function.

[Fasting leptinemia in eutrophic children and adolescents]. / Leptinemia de jejum em crianças e adolescentes eutróficos.

OBJECTIVE: To determine, in a group of eutrophic children and adolescents, the values of fasting leptinemia and its correlation with age and body mass index. METHODS: A cross-sectional study conducted in two public schools in Ribeirao Preto, Brazil. Anthropometric measurements and venous blood samples were obtained for determination of fasting leptinemia of 448 eutrophic and medium mature children and adolescents, of both genders, aged between 7 and 17.9 years. Using the Mann-Whitney test, comparisons were made between the concentrations obtained for boys and girls in each age group. Subsequently, using the Kruskal-Wallis test, values were compared in each age group and, using the Spearman correlation test, the correlations between fasting leptinemia and age and between fasting leptinemia and the z-scores of body mass index were assessed. RESULTS: Fasting leptinemia values differed between boys and girls in all age groups and it was higher for girls. Among boys, the values of leptinemia did not show statistically significant variation; among girls, there was variability, with gradual increase according to age group. The correlation study showed positive correlation between leptinemia and z-scores of body mass index in both genders and between leptinemia and age only for girls. CONCLUSION: The data show the necessity of establishing reference curves for fasting leptinemia taking into account gender age and body mass index.

Leptinemia de jejum em crianças e adolescentes eutróficos / Fasting leptinemia in eutrophic children and adolescents

OBJETIVO: Determinar, em um grupo de crianças e adolescentes eutróficos, os valores de leptinemia de jejum e sua correlação com idade e Índice de Massa Corporal (IMC). MÉTODOS: Estudo de corte transversal realizado em duas escolas públicas de Ribeirão Preto, Brasil. Foram obtidos medidas antropométricas e amostra de sangue venoso em jejum para dosagem da leptinemia de 448 crianças e adolescentes eutróficos, maturadores médios, de ambos os sexos, com idades entre 7 e 17,9 anos. Utilizando-se o teste de Mann-Whitney foram realizadas comparações entre as concentrações obtidas para meninos e meninas em cada faixa etária. Posteriormente, utilizandose o teste de Kruskal-Wallis, foram comparados os valores em cada faixa etária e, por meio do teste de correlação de Spearman, foi avaliada a correlação entre a leptinemia de jejum e a idade e entre leptinemia de jejum e o escore z do IMC. RESULTADOS: O valores de leptinemia de jejum diferiram entre meninos e meninas em todas as faixas etárias sendo sempre mais elevados para as meninas. Entre os meninos, os valores de leptinemia não apresentam variação estatisticamente significativa; entre as meninas, observou-se variabilidade, com aumento progressivo de acordo com a faixa etária. O estudo de correlação, mostrou que a leptinemia apresenta correlação positiva com o escore z do índice de massa corporal em ambos os sexos. Em relação à idade, observou-se correlação apenas entre as meninas. CONCLUSÃO: Os dados apontam para a necessidade do estabelecimento de curvas de referência para a leptinemia de jejum que levem em conta o sexo, a idade e o IMC.

OBJECTIVE: To determine, in a group of eutrophic children and adolescents, the values of fasting leptinemia and its correlation with age and body mass index. METHODS: A cross-sectional study conducted in two public schoolsin Ribeirao Preto, Brazil. Anthropometric measurements and venous blood samples were obtained for determination of fasting leptinemia of 448 eutrophic and medium maturers children and adolescents, of both genders, aged between 7 and 17.9 years. Using the Mann-Whitney test, comparisons were made between the concentrations obtained for boys and girls in each age group. Subsequently, using the Kruskal-Wallis test, values were compared in each age group and, using the Spearman correlation test, the correlations between fasting leptinemia and age and between fasting leptinemia and the z-scores of body mass index were assessed. RESULTS: Fastingleptinemia values differed between boys and girls in all age groups and it was higher for girls. Among boys, the values of leptinemia did not show statistically significant variation; among girls, there was variability, with gradual increase according to age group. The correlation study showed positive correlation between leptinemia and z-scores of body mass index in both genders and between leptinemia and age only for girls. CONCLUSION: The data show the necessity of establishing reference curves for fasting leptinemia taking into account gender age and body mass index.

Decrease in circulating glucose, insulin and leptin levels and improvement in insulin resistance at 1 and 3 months after gastric bypass.

BACKGROUND: Hyperglycemia, insulin resistance and hyperleptinemia are some of the consequences of obesity. Gastric bypass for morbid obesity provides gastric restriction with decreased energy absorption. To confirm and extend previous reports in the literature, we evaluated the plasma glucose, serum insulin and leptin and insulin resistance of patients preoperatively and 1 and 3 months after Roux-en-Y gastric bypass (RYGBP). METHODS: We determined body mass index (BMI), plasma glucose (glucose-oxidase method), serum leptin (immunoassay) and insulin (chemiluminescent immunometric assay), and insulin resistance index (IRI) by Homeostasis Model Assessment (HOMA) of 20 patients with morbid obesity both preoperatively and 1 and 3 months after RYGBP. RESULTS: Patients showed a mean decrease in weight of 8 kg/month. Glycemia was above reference levels in 65% of the preoperative patients but dropped significantly 1 month postoperatively, serum insulin and leptin levels and the HOMA index also decreasing significantly in the same period. The percentage of patients with preoperative elevated serum insulin and leptin relative to reference levels decreased significantly following RYGBP. We also observed a weak but significant correlation between BMI and glucose, BMI and insulin, and leptin and insulin. CONCLUSIONS: The beneficial effects of bariatric surgery are already noticeable 1 month postoperatively, the reduction in insulin levels being more important for leptin reduction than decreased BMI. Leptin appeared to be subject to multifactorial control and showed a larger reduction than body weight.