Effect of Oral Nutritional Supplements with Sucromalt and Isomaltulose versus Standard Formula on Glycaemic Index, Entero-Insular Axis Peptides and Subjective Appetite in Patients with Type 2 Diabetes: A Randomised Cross-Over Study.

Oral diabetes-specific nutritional supplements (ONS-D) induce favourable postprandial responses in subjects with type 2 diabetes (DM2), but they have not been correlated yet with incretin release and subjective appetite (SA). This randomised, double-blind, cross-over study compared postprandial effects of ONS-D with isomaltulose and sucromalt versus standard formula (ET) on glycaemic index (GI), insulin, glucose-dependent insulinotropic polypeptide (GIP), glucagon-like peptide 1 (GLP-1) and SA in 16 individuals with DM2. After overnight fasting, subjects consumed a portion of supplements containing 25 g of carbohydrates or reference food. Blood samples were collected at baseline and at 30, 60, 90, 120, 150 and 180 min; and SA sensations were assessed by a visual analogue scale on separate days. Glycaemic index values were low for ONS-D and intermediate for ET (p < 0.001). The insulin area under the curve (AUC0-180 min) (p < 0.02) and GIP AUC (p < 0.02) were lower after ONS-D and higher GLP-1 AUC when compared with ET (p < 0.05). Subjective appetite AUC was greater after ET than ONS-D (p < 0.05). Interactions between hormones, hunger, fullness and GI were found, but not within the ratings of SA; isomaltulose and sucromalt may have influenced these factors.

[Not Available]. / Formulación de barras nutricionales con proteínas lácteas: índice glucémico y efecto de saciedad.

Se ha estudiado el índice glicémico, la carga glicémica y el efecto de saciedad producido en adultos jóvenes (12 hombres y 8 mujeres) por el consumo de tres tipos de barritas nutricionales formuladas con proteínas lactoséricas (LS), caseínas (CS) o hidratos de carbono (HC) frente a un control (C). Los valores de glucemia en la sangre a los 30 min fueron significativamente mayores (p < 0,05) para la barra HC (129 ± 8 mg/dl) frente a las barras CS (103 ± 6 mg/dl) y LS (86 ± 8 mg/dl). Asimismo, también se encontraron diferencias estadísticamente significativas (p < 0,05) entre los índices glicémicos de los tres tipos de barras estudiadas (LS = 11,5 ± 3,9; CS = 40,7 ± 6,5; HC = 68,8 ± 13,0). Por otro lado, las barritas nutricionales formuladas con proteínas lácteas (LS y CS) muestran un efecto de saciedad mucho más intenso y prolongado que la formulada con hidratos de carbono (HC), lo que pone de manifiesto el potencial de estas proteínas para ser utilizadas en la formulación de productos para diabéticos y dietéticos.

Formulación de barras nutricionales con proteínas lácteas: índice glucémico y efecto de saciedad / Formulation of nutritional bars with dairy proteins: glycemic index and satiety effect

Se ha estudiado el índice glicémico, la carga glicémica y el efecto de saciedad producido en adultos jóvenes (12 hombres y 8 mujeres) por el consumo de tres tipos de barritas nutricionales formuladas con proteínas lactoséricas (LS), caseínas (CS) o hidratos de carbono (HC) frente a un control (C). Los valores de glucemia en la sangre a los 30 min fueron significativamente mayores (p < 0,05) para la barra HC (129 ± 8 mg/dl) frente a las barras CS (103 ± 6 mg/dl) y LS (86 ± 8 mg/dl). Asimismo, también se encontraron diferencias estadísticamente significativas (p < 0,05) entre los índices glicémicos de los tres tipos de barras estudiadas (LS = 11,5 ± 3,9; CS = 40,7 ± 6,5; HC = 68,8 ± 13,0). Por otro lado, las barritas nutricionales formuladas con proteínas lácteas (LS y CS) muestran un efecto de saciedad mucho más intenso y prolongado que la formulada con hidratos de carbono (HC), lo que pone de manifiesto el potencial de estas proteínas para ser utilizadas en la formulación de productos para diabéticos y dietéticos (AU)

It has been studied in young adults (12 men and 8 women) the glycemic index, glycemic load and satiety effect produced by three types of nutritional bars formulated with whey proteins (LS), caseins (CS) or carbohydrates (HC) against a control group (C). It has been found significant differences (p < 0.05) in relation to blood sugar levels for HC bar (129 ± 8 mg/dl) against CS bar (103 ± 6 mg/dl) and LS bar (86 ± 8 mg/dl) after 30 min of its intake. Furthermore, it has also been found significant differences (p < 0.05) between glycemic index of three types of studied bars (LS = 11.5 ± 3.9; CS = 40.7 ± 6.5; HC = 68.8 ± 13.0). On the other hand, nutritional bars formulated with dairy proteins (LS y CS) showed a satiety effect more heavy and prolonged than carbohydrate bar (HC). The results reveal that dairy proteins may be used as functional ingredients to develop diabetic and dietary supplies (AU)

[Not Available]. / Utilización de las proteínas séricas y caseínas como suplementos dietéticos para la prolongación del efecto de saciedad en mujeres obesas.

It has been studied the effect of three kinds of supplements (whey, casein and maltodextrin, as control) in the regulation of food intake and satiety of 60 overweight women. After 10 weeks, significant differences (p < 0.001) were found with regard to reduction of weight, IMC, % fat and waist circumference in the whey group against casein and control groups. A higher decrease of energy intake (-383 kcal/day) was also found in women who ate whey supplements, while in the casein and control group the decrease was only -144 and -70 kcal/day respectively. Finally, satiety effect was more efficiently promoted by whey against casein and maltodextrins.

Se estudió el consumo de tres tipos de suplementos, proteínas del lactosuero, caseínas y maltodextrinas (control) en la disminución de la ingesta energética y prolongación del efecto de saciedad de 60 mujeres obesas. Después de 10 semanas, la reducción del peso corporal, IMC, % de grasa corporal y circunferencia de la cintura fue significativamente mayor (p < 0,001) en el grupo que consumió las proteínas lactoséricas frente a los otros dos grupos (control y caseínas). También se observa un descenso en la ingesta energética de -383 kcal/día en las mujeres que consumieron las proteínas de lactosuero frente a un descenso de -144 kcal/día en el grupo de caseínas y de tan solo -70 kcal/día en el grupo control. Finalmente la regulación del efecto de saciedad mediante escala visual analógica fue también más efectiva en el caso de las proteínasséricas, que en el caso de las caseínas y maltodextrinas.

Utilización de las proteínas séricas y caseínas como suplementos dietéticos para la prolongación del efecto de saciedad en mujeres obesas / Using whey proteins and caseins as dietetic supplements in regulation of satiating effect of overweight women

Se estudió el consumo de tres tipos de suplementos, proteínas del lactosuero, caseínas y maltodextrinas (control) en la disminución de la ingesta energética y prolongación del efecto de saciedad de 60 mujeres obesas. Después de 10 semanas, la reducción del peso corporal, IMC, % de grasa corporal y circunferencia de la cintura fue significativamente mayor (p < 0,001) en el grupo que consumió las proteínas lactoséricas frente a los otros dos grupos (control y caseínas). También se observa un descenso en la ingesta energética de -383 kcal/día en las mujeres que consumieron las proteínas de lactosuero frente a un descenso de -144 kcal/día en el grupo de caseínas y de tan solo -70 kcal/día en el grupo control. Finalmente la regulación del efecto de saciedad mediante escala visual analógica fue también más efectiva en el caso de las proteínas séricas, que en el caso de las caseínas y maltodextrinas (AU)

It has been studied the effect of three kinds of supplements (whey, casein and maltodextrin, as control) in the regulation of food intake and satiety of 60 overweight women. After 10 weeks, significant differences (p < 0.001) were found with regard to reduction of weight, IMC, % fat and waist circumference in the whey group against casein and control groups. A higher decrease of energy intake (-383 kcal/day) was also found in women who ate whey supplements, while in the casein and control group the decrease was only -144 and -70 kcal/day respectively. Finally, satiety effect was more efficiently promoted by whey against casein and maltodextrins (AU)

[SNACK HIGH WHEY PROTEIN IMPROVES THE LEVEL OF SATIETY AND REDUCES APPETITE HEALTHY WOMEN]. / LA MERIENDA CON ELEVADA PROTEÍNA DE LACTOSUERO MEJORA EL NIVEL DE SACIEDAD Y DISMINUYE EL APETITO EN MUJERES SANAS.

BACKGROUND: the nutritional content and energy density of foods is related to greater control of appetite, satiety and reducing food intake. METHODS/SUBJECTS: the randomized crossover study included 20 healthy women, aged 20 and 30 years with a BMI of 20 to 24.9 kg/m2 and who completed that included 3 day trial comparing 8 hours 130 kcal snacks consumed afternoon: yoghurt with added whey protein (PSL), biscuits and chocolate. Participants consumed a standardized menu; snack was consumed 3 hours after lunch. Perceived hunger and fullness were evaluated during the afternoon until dinner voluntary intake ad libitum. They repeat the same snack 3 times. RESULTS: consumption of yogurt with PSL led to a further reduction of appetite in the afternoon in front of the snack of chocolate and biscuits (p < 0.001). No differences of appetite in the afternoon between chocolate vs cookies but significant difference between yogurt with PSL and other treatments (p < 0.001) were detected. At snack, yogurt there was a significant reduction in caloric intake compared to other snacks (p < 0.001) and a later request for dinner with about 45 minutes apart. CONCLUSIONS: snacks with less energy density and rich in protein (yogurt with PSL) improve the control of appetite, satiety and reduces food intake in healthy women later.

Antecedentes: el contenido nutricional y la densidad energética de los alimentos están relacionados con un mayor control del apetito, la saciedad y la reducción de la ingesta de alimentos. Material y métodos: el estudio consistió en un diseño cruzado aleatorizado que incluyó 20 mujeres sanas, con edades entre 20 y 30 años y con un IMC de 20 y 24,9 kg/m2 que se sometieron durante tres días a una prueba de ocho horas comparando meriendas de 130 kcal consumidas por la tarde: yogur con adición de proteína de suero de leche (PSL), galletas y chocolate. Consumieron un menú estandarizado; la merienda se consumía tres horas después del almuerzo. El hambre percibida y la plenitud se evaluaron durante la tarde hasta el consumo voluntario de la cena ad libitum. Resultados: el consumo de yogur con PSL ocasionó una mayor reducción del apetito y un aumento de la saciedad tras su ingesta y hasta la cena, respecto a la merienda de chocolate y galletas (p < 0,001), no existiendo diferencias entre estas últimas. La merienda de yogur con PSL ocasionó una reducción significativa de la ingesta calórica en la cena, en comparación con las otras meriendas (p < 0,001) y una solicitud más tardía de alimentos de hasta 45 minutos. Conclusiones: las meriendas con baja densidad energética y ricas en proteína (y concretamente el yogur con PSL), pueden ser una solución eficaz para mejorar el control del apetito y reducir la ingesta de alimentos en mujeres sanas.

La merienda con elevada proteína de lactosuero mejora el nivel de saciedad y disminuye el apetito en mujeres sanas / Snack high whey protein improves the level of satiety and reduces appetite healthy women

Antecedentes: el contenido nutricional y la densidad energética de los alimentos están relacionados con un mayor control del apetito, la saciedad y la reducción de la ingesta de alimentos. Material y métodos: el estudio consistió en un diseño cruzado aleatorizado que incluyó 20 mujeres sanas, con edades entre 20 y 30 años y con un IMC de 20 y 24,9 kg/m2 que se sometieron durante tres días a una prueba de ocho horas comparando meriendas de 130 kcal consumidas por la tarde: yogur con adición de proteína de suero de leche (PSL), galletas y chocolate. Consumieron un menú estandarizado; la merienda se consumía tres horas después del almuerzo. El hambre percibida y la plenitud se evaluaron durante la tarde hasta el consumo voluntario de la cena ad libitum. Resultados: el consumo de yogur con PSL ocasionó una mayor reducción del apetito y un aumento de la saciedad tras su ingesta y hasta la cena, respecto a la merienda de chocolate y galletas (p < 0,001), no existiendo diferencias entre estas últimas. La merienda de yogur con PSL ocasionó una reducción significativa de la ingesta calórica en la cena, en comparación con las otras meriendas (p < 0,001) y una solicitud más tardía de alimentos de hasta 45 minutos. Conclusiones: las meriendas con baja densidad energética y ricas en proteína (y concretamente el yogur con PSL), pueden ser una solución eficaz para mejorar el control del apetito y reducir la ingesta de alimentos en mujeres sanas (AU)

Background: the nutritional content and energy density of foods is related to greater control of appetite, satiety and reducing food intake. Methods/Subjects: the randomized crossover study included 20 healthy women, aged 20 and 30 years with a BMI of 20 to 24.9 kg/m2 and who completed that included 3 day trial comparing 8 hours 130 kcal snacks consumed afternoon: yoghurt with added whey protein (PSL), biscuits and chocolate. Participants consumed a standardized menu; snack was consumed 3 hours after lunch. Perceived hunger and fullness were evaluated during the afternoon until dinner voluntary intake ad libitum. They repeat the same snack 3 times. Results: consumption of yogurt with PSL led to a further reduction of appetite in the afternoon in front of the snack of chocolate and biscuits (p < 0.001). No differences of appetite in the afternoon between chocolate vs cookies but significant difference between yogurt with PSL and other treatments (p < 0.001) were detected. At snack, yogurt there was a significant reduction in caloric intake compared to other snacks (p < 0.001) and a later request for dinner with about 45 minutes apart. Conclusions: snacks with less energy density and rich in protein (yogurt with PSL) improve the control of appetite, satiety and reduces food intake in healthy women later (AU)

[Effect of the intake of an integral bread formulated with gum from Hymenaea courbaril on the concentrations of blood lipids of patients with mild-moderate dyslipidemia]. / Efecto de la ingesta de un pan integral formulado con goma de Hymenaea courbaril, en las concentraciones de lípidos sanguíneos de pacientes con dislipidemia leve-moderada.

The seeds of Hymenaea courbaril (Caesalpiniace), a species widely disseminated in Venezuela, produce a clear and soluble gum. The dietetic fiber content (60.7%) of the gum was used as a good criterion for the formulation of integral bread in a diet for dyslipidemia patients. The proximal composition of the integral bread was determined. The product acceptability evaluation was done by a comparison test and by a hedonic scale. The experimental design was carried out with a total of 30 male volunteers with dyslipidemia. They were divided into two groups: Group A was fed with a modified diet, which included bread prepared with the H. courbaril gum; and Group B received the same diet without the gum, based on the American Dietetic Association recommendations. Both groups were maintained on their respective diets for six weeks. The lipid profile was determined in each patient, before starting the diets and after the specified period. The bread formula contained 17.60% protein, 1.19% fat and 0.97% crude fiber, in accordance with standards established by COVENIN. The paired preference test showed grater acceptance of the bread prepared with a gum concentration of 7% and low fat content. Significant decreases in the concentrations of triacylglycerol and VLDL-cholesterol were observed in Group A. These findings suggest a possible use of the H. courbaril gum, as a diet modifier for dyslipidemic patients.

Efecto de la ingesta de un pan integral formulado con goma de Hymenaea courbaril, en las concentraciones de lípidos sanguíneos de pacientes con dislipidemia leve-moderada / Effect of the intake of an integral bread formulated with gum from Hymenaea courbaril on the concentrations of blood lipids of patients with mild-moderate dyslipidemia

Hymenaea courbaril (Caesalpiniace), especie ampliamente diseminada en Venezuela, produce una goma clara y soluble en la semilla. El contenido de fibra dietética de la goma (60,7%) se usó como criterio para la formulación de un pan integral en la dieta para pacientes con dislipidemia. Se determinó la composición proximal del pan integral. La aceptabilidad del producto se evaluó por una prueba de comparación y por una escala hedónica. El diseño experimental, se hizo con una muestra de 30 voluntarios masculinos que presentaban dislipidemia. Se dividieron en dos grupos: el grupo A, se alimentó con una modificación de la dieta, que contenía un pan preparado con goma de H. courbaril, y el grupo B, recibió la dieta, sin la goma, con base en las recomendaciones de la Asociación Americana de Dietética (Control). Ambos grupos se mantuvieron en sus respectivas dietas durante 6 semanas. El perfil lipídico, se determinó en cada paciente, antes de iniciar la dieta y después del período señalado. El pan formulado, contenía 17,60% de proteínas; 1,19% de grasa y 0,97% de fibra cruda, de conformidad con lo establecido por las normas COVENIN. El Test de par de preferencia, demostró la mayor aceptación por el pan preparado con una concentración de goma al 7,0%, y un bajo contenido de grasa. Se produjo una disminución significativa en la concentración de triacilglicéridos y VLDL-colesterol en el grupo A. Estos hallazgos sugieren un posible uso de la goma de H. courbaril, como una modificación de la dieta, para pacientes con dislipidemia.

The seeds of Hymenaea courbaril (Caesalpiniace), a species widely disseminated in Venezuela, produce a clear and soluble gum. The dietetic fiber content (60.7%) of the gum was used as a good criterion for the formulation of integral bread in a diet for dyslipidemia patients. The proximal composition of the integral bread was determined. The product acceptability evaluation was done by a comparison test and by a hedonic scale. The experimental design was carried out with a total of 30 male volunteers with dyslipidemia. They were divided into two groups: Group A was fed with a modified diet, which included bread prepared with the H. courbaril gum; and Group B received the same diet without the gum, based on the American Dietetic Association recommendations. Both groups were maintained on their respective diets for six weeks. The lipid profile was determined in each patient, before starting the diets and after the specified period. The bread formula contained 17.60% protein, 1.19% fat and 0.97% crude fiber, in accordance with standards established by COVENIN. The paired preference test showed grater acceptance of the bread prepared with a gum concentration of 7% and low fat content. Significant decreases in the concentrations of triacylglycerol and VLDL-cholesterol were observed in Group A. These findings suggest a possible use of the H. courbaril gum, as a diet modifier for dyslipidemic patients.

Lipoprotein(a): from molecules to therapeutics.

Lipoprotein (a) [Lp(a)] was discovered by Kare Berg in 1963 from the study of low-density lipoprotein genetic variants. Lp(a) contains a unique protein, apolipoprotein(a), which is linked to the Apo B-100 through a disulfide bond that gives it a great structural homology with plasminogen, and confers it atherogenic and atherothrombotic properties. Interest in Lp(a) has increased because an important association between high plasma levels of Lp(a) and coronary artery disease and cerebral vascular disorders has been demonstrated. Numerous case control studies have confirmed that hyper-Lp(a) is a risk factor for premature cardiovascular disease. Lp(a) is identified as a genetic trait with autosomal transmission, codified by one of the most studied polymorphic genes in humans. It has been demonstrated that variations in this gene are a major factor in the serum levels of Lp(a). Variations differ considerably between individuals and sex across populations. Various approaches to drug treatment using fibric acid derivatives, growth hormone, insulin-like growth factor-1, alcohol extracted soy protein, niacin, and exercise have been proven to decrease Lp(a) in high risk patients, but none has really been an effective therapeutic option for successfully reducing Lp(a) plasma levels.

Latent Autoimmune Diabetes in Adults: a case report.

Latent Autoimmune Diabetes in Adults (LADA) is an autoimmune endocrine disorder in which despite the presence of antipancreatic islets antibodies in the moment of diagnostics, the progression to beta-cell secretory insufficiency is slow. It is often confused with others types of diabetes and therefore the management is frequently inadequate. We report a clinical case of a 23-year-old man with diagnosis of type 2 diabetes since 6 months ago, poorly controlled with a sulfonylurea, who initially presented 2 months ago from polyuria, polydipsia, and asthenia and 6 kg weight loss. History of past illness was negative, however, his mother relates exclusive breastfeeding during the first 15 days of life and later (until the 6 months) he was fed with infant formula (S-26). Family history revealed a first-degree relative (father) with diabetes mellitus secondary to steroid administration due to diagnosis of bone marrow hypoplasia. Also presents second-degree family history (uncle and grandfather) of type 2 diabetes mellitus. There were no pathologic findings at the physical examination. Anthropometry and laboratory tests were as follows: body mass index (BMI) = 19.66 kg/m, basal and postprandial glycemia = 108, and 276 mg/dL respectively, glycated haemoglobin = 8.9%, basal and postprandial C-peptide (2 hours) = 1.9, and 3.2 ng/mL, homeostasis model assessment of beta cell function: 87.5%, homeostasis model assessment of insulin resistance: 1.6. LADA presumptive diagnosis was confirmed with presence of autoantibodies anti-tyrosin-phosphatase and GAD65. At the time of diagnosis, individuals with LADA present an onset age <50, BMI <25 kg/m2, low magnitude postprandial and basal hyperglycemia, normal or close to normal C-peptide values, and thus not occur with acute hyperglycemic crises. Insulin therapy preserves pancreatic b-cell function, at the point that eventually prescribed insulin doses need to be reduced.

The Maracaibo city metabolic syndrome prevalence study: design and scope.

The metabolic syndrome (MS) is a conglomerate of interrelated risk factors-including obesity, atherogenic dyslipidemia, arterial hypertension, and insulin resistance-which exponentially increase the risk of developing cardiovascular disease and type 2 diabetes mellitus. The purpose of this study was to determine the prevalence of MS according to the criteria published by the International Diabetes Federation, in individuals of both sexes over 18 years of age. This is a cross-sectional study based on MS prevalence in a representative sample from the Maracaibo district, Zulia State. The population of Maracaibo, according to the last census in 2001, was 1,219,927 habitants, with a 2007 population estimation of 1,428,043 habitants according to the National Institute of Statistics (NIS). Likewise, NIS projects that for the year 2009, 59.7% of the population of Venezuela will have individuals over 18 years of age. Using these data, the sample for Maracaibo District corresponds to 1986 individuals with or above 18 years of age. The data recollection was conducted by health professionals and medicine students, previously trained. The participants were subject to inquiry previous written consent and a medical examination, and qualitative variables such as smoking habit, socioeconomic status, physical activity, race, alcoholism, and nutritional habits, and quantitative ones like blood pressure, anthropometry, and blood works were determined. There is clear evidence that there is a lack of research and validated values to use as reference in our country and maybe in Latin America. Taking into account all that has been exposed here, this study will serve as a pilot for the numerous statistical determinations that will soon come afterward, providing first-hand accurate evidence on the behavior of the MS in the Latin American populace.

Novel mutations identification in exon 4 of LDLR gene in patients with moderate hypercholesterolemia in a Venezuelan population.

Familial hypercholesterolemia (FH) is an autosomal dominant disease characterized by increase in low-density lipoprotein (LDL) cholesterol levels and premature coronary artery disease. In Venezuela, the molecular basis of FH has not been characterized, thus, the aim of this study was to investigate mutations in the exon 4 of the LDLR (LDL-receptor) gene in 225 Venezuelan mixed race individuals (65 hypercholesterolemic and 160 normolipidemic). The exon 4 of the LDLR gene was screened by polymerase chain reaction-single strand conformational polymorphism (PCR-SSCP) analysis and DNA sequencing. Additionally, ApoB-100 gene mutations were investigated. Different LDLR gene mutations were identified in 5 hypercholesterolemic patients (7.7%), 3 missense mutations (4.6%), and 2 frameshift mutations (3%). All mutations were heterozygous. The missense mutations included the amino acid substitution p.E180K, p.R194S, and p.C152G. The frameshift mutations are caused by insertions resulting in the creation of stop codons: p.D157fsX158 and p.S173fsX174, which could code for truncated LDLR of 157 and 173 amino acids, respectively. The apoB gene mutations were not detected in any of our patients and to our knowledge 4 mutations identified in this study have not been reported previously, this study being the first comprehensive mutation analysis of the LDLR causing FH in our region. The early identification of individuals at risk allows changes in lifestyle, including dietary intervention, followed by drug treatment.

Infección por Chlamydia trachomatis en mujeres consultantes en Maracaibo, Venezuela / Chlamydia trachomatis infection in females consulting health centres in Maracaibo, Venezuela

Objetivo Evaluar la prevalencia de infecciones por Chlamydia trachomatis en un grupo de mujeres sintomáticas y asintomáticas que asistieron a control en servicios de ginecología en centros de salud de Maracaibo, estado Zulia. Métodos Se incorporaron al estudio 168 pacientes que asistieron a dos centros de salud de Maracaibo. Se llevó a cabo evaluación ginecológica basada en examen pélvico, de áreas profundas de la vagina y cuello uterino. Las pacientes fueron clasificadas en grupos etarios y de acuerdo a la presencia de manifestaciones clínicas. Para investigar C. trachomatis, se aplicaron dos ensayos de amplificación de ADN del plásmido endógeno y del gen OMP1, a partir de hisopados endocervicales. Resultados Se evaluaron 168 pacientes, 81 (48,2 por ciento) sintomáticas y 87 (51,8 por ciento) asintomáticas. Se encontró una prevalencia de 7,7 por ciento en la población total evaluada. La prevalencia fue de 9,9 por ciento y 5,8 por ciento para las pacientes sintomáticas y asintomáticas, respectivamente (p>0,05). El grupo de pacientes de 18-28 años exhibió la más alta prevalencia (13,7 por ciento) (p=0,0322). Las manifestaciones clínicas predominantes fueron secreción mucopurulenta (35,8 por ciento) y cervicitis (21 por ciento). C. trachomatis fue detectada en 7,1 por ciento pacientes con secreción mucopurulenta y 23,5 por ciento casos de cervicitis, pero no se demostró asociación significativa entre infección y manifestaciones clínicas individuales (p>0,05). Conclusión Se encontró una mediana prevalencia de infecciones por C. trachomatis en la población evaluada, exhibiendo mayor frecuencia en mujeres jóvenes. Este microorganismo debería ser investigado en mujeres jóvenes sexualmente activas, independientemente de su condición sintomática o asintomática.

Objective Evaluating Chlamydia trachomatis infection prevalence in a group of symptomatic and asymptomatic females attending gynaecology services in health centres in Maracaibo in the state of Zulia in Venezuela. Methodology 168 patients attending two health centres in Maracaibo were included in this study. Gynaecological evaluation was based on examining the pelvis, deep areas of the vagina and the cervix. Patients were classified into groups according to age and the presence of clinical manifestations. Two DNA amplification assays of endogenous plasmid and the omp1 gene taken from endocervical swabs were used for investigating C. trachomati. Results 168 patients were evaluated; 81 (48,2 percent) were symptomatic and 87 (51,8 percent) asymptomatic, A 7,7 percent prevalence (p>0.05) was found in the total population (9,9 percent prevalence for symptomatic patients and 5,8 percent for asymptomatic ones). The 18- 28 year old patient group exhibited the highest prevalence (13,7 percent) (p=0.0322). The predominant clinical manifestations were mucopurulent secretion (35,8 percent) and cervicitis (21 percent). C. trachomatis was detected in 7,1 percent of patients having mucopurulent secretion and 23,5 percent of cervicitis cases; however, no significant association between infection and individual clinical manifestations was shown (p>0.05). Conclusion Medium C. trachomatis infection prevalence was found In the population being assessed here, the highest frequency being exhibited in young females. This microorganism should be investigated in sexually-active young women, regardless of their symptomatic or asymptomatic status.

Pharmacologic management of isolated low high-density lipoprotein syndrome.

High-density lipoprotein (HDL) cholesterol is a heterogeneous group of lipoproteins exhibiting a variety of properties like prostacyclin production stimulation, decrease in platelet aggregation, endothelial cell apoptosis inhibition, and low-density lipoprotein oxidation blockade. Epidemiologic studies have shown an inverse relation between HDL cholesterol levels and cardiovascular risk. Low HDL cholesterol is associated with increased risk for myocardial infarction, stroke, sudden death, peripheral artery disease, and postangioplasty restenosis. In contrast, high HDL levels are associated with longevity and protection against atherosclerotic disease development. Given the evolving epidemic of obesity, diabetes mellitus, and metabolic syndrome, the prevalence of low HDL will continue to rise. In the United States, low HDL is present in 35% of men, 15% of women, and approximately 63% of patients with coronary artery disease. Data extracted from the Framingham study highlight that 1-mg increase in HDL levels decreases by 2% to 3% the risk of cardiovascular disease. There is no doubt regarding clinical importance about isolated low HDL, but relatively few clinicians consider a direct therapeutic intervention of this dyslipidemia. In this sense, lifestyle measures should be the first-line strategy to manage low HDL levels. On the other hand, pharmacologic options include niacin, fibrates, and statins. Fibrates appear to reduce risk preferentially in patients with low HDL with metabolic syndrome, whereas statins reduce risk across all levels of HDL. Torcetrapib, a cholesteryl esters transfer protein inhibitor, represented a hope to raise this lipoprotein; however, all clinical trials on this drug had ceased after ILLUMINATE, RADIANCE and ERASE trials had recorded an increase in mortality, rates of myocardial infarction, angina, and heart failure. In the near future, drugs as beta-glucans, Apo-A1 mimetic peptides, and ACAT inhibitors, are the new promises to treat this condition.

[Chlamydia trachomatis infection in females consulting health centres in Maracaibo, Venezuela]. / Infección por Chlamydia trachomatis en mujeres consultantes en Maracaibo, Venezuela.

OBJECTIVE: Evaluating Chlamydia trachomatis infection prevalence in a group of symptomatic and asymptomatic females attending gynaecology services in health centres in Maracaibo in the state of Zulia in Venezuela. METHODOLOGY: 168 patients attending two health centres in Maracaibo were included in this study. Gynaecological evaluation was based on examining the pelvis, deep areas of the vagina and the cervix. Patients were classified into groups according to age and the presence of clinical manifestations. Two DNA amplification assays of endogenous plasmid and the omp1 gene taken from endocervical swabs were used for investigating C. trachomati. RESULTS: 168 patients were evaluated; 81 (48,2 %) were symptomatic and 87 (51,8 %) asymptomatic, A 7,7 % prevalence (p>0.05) was found in the total population (9,9 % prevalence for symptomatic patients and 5,8 % for asymptomatic ones). The 18- 28 year old patient group exhibited the highest prevalence (13,7 %) (p=0.0322). The predominant clinical manifestations were mucopurulent secretion (35,8 %) and cervicitis (21 %). C. trachomatis was detected in 7,1 % of patients having mucopurulent secretion and 23,5 % of cervicitis cases; however, no significant association between infection and individual clinical manifestations was shown (p>0.05). CONCLUSION: Medium C. trachomatis infection prevalence was found In the population being assessed here, the highest frequency being exhibited in young females. This microorganism should be investigated in sexually-active young women, regardless of their symptomatic or asymptomatic status.

Perfil lipídico en mujeres premenopáusicas y posmenopáusicas / Lipid profile in premenopausal and postmenopausal women

Comparar la composición lipídica entre mujeres posmenopáusicas y premenopáusicas. Se seleccionaron 100 mujeres (50 posmenopáusicas y 50 premenopáusicas), para determinar colesterol total, triglicéridos, LDL and HDL colesterol, así como subfracciones HDL2 y HDL3, VLDL, IDL, LDL colesterol. Consulta de menopausia del Hospital Central “Dr. Urquinaona”, Maracaibo. El intervalo de edad fue de 47 ± 1,5 años para las mujeres premenopáusicas y 51 ± 3,0 años para las posmenopáusicas (P < 0,05). Las mujeres menopáusicas presentaron valores más altos de colesterol total, LDL colesterol, IDL colesterol y triglicéridos (P < 0,05). Ninguna de las mujeres posmenopáusicas presentó hipertrigliceridemia y los valores promedios fueron más altos en este grupo que en las premenopáusicas (P < 0,05). La posmenopausia (mediante la conjunción entre el envejecimiento e hipoestrogenismo) produce un estado pro-aterogénico, demostrado por: incremento de los triglicéridos, colesterol y LDL colesterol. Las concentraciones de triglicéridos en la LDL colesterol y modificaciones de la HDL colesterol pueden alterar su función en el transporte reverso del colesterol.

Effect of cigarette smoking on the oxidant/antioxidant balance in healthy subjects.

BACKGROUND AND PURPOSE: Cigarette smoking has been associated with the development of cardiovascular disease and cancer. Even though the molecular mechanism(s) are not clear, the pathology has been related to oxygen free radicals present in cigarette smoke. Thus, the main objective of this study was to establish the changes in the oxidation/antioxidation balance induced by cigarette smoking. METHODS: Thirty healthy subjects (15 smokers and 15 nonsmokers) of both sexes were studied. The smokers group had smoked a mean of 14 cigarettes per day for an average of 4.5 years. Fasting serum levels of malondialdehyde (MDA), a marker of oxidative stress, nitric oxide (NO), reduced glutathione (GSH), and vitamin C (ascorbic and dehydroascorbic acids) were measured. RESULTS: Fasting NO concentration was significantly higher in smokers (51.3 +/- 5.3 microM) than in nonsmokers (35.2 +/- 4.8 microM, P < 0.05). The smokers had significantly higher serum dehydroascorbic acid levels (2.4 +/- 0.5 mg/dL, P < 0.03) than the nonsmokers (1.08 +/- 0.08 mg/dL). No significant differences were observed in the levels of ascorbic acid, MDA, and GSH between the smokers and nonsmokers. CONCLUSIONS: Our results suggest that exposure to cigarette smoke increases NO synthesis, such that NO may act in a compensatory way as an inhibitor of lipid peroxidation. Smoking also activates other antioxidative mechanisms such as involving vitamin C. These protective mechanisms appear to be enough in preventing accumulation of oxidative products such as MDA and avoiding oxidative damage.

Elevados niveles séricos de lipoproteína (a) en una población afro-venezolana / High serum (a) in a afro-venezuelan population

Altas concentraciones de Lipoproteína (a) [Lp)a)] son consideradas un factor de riesgo independiente para la enfermedad cardiovascular, sin embargo su determinación no se realiza como prueba de rutina en la evaluación de dicho riesgo. El propósito de este estudio fue determinar los niveles séricos de Lp(a) en individuos de las poblaciones de Maracaibo, una localidad con predominio blanco-hispánico, y de Bobures, una localidad afrovenezolana, ambas ubicadas en el Estado Zulia, Venezuela. para ello se seleccionaron al azar un total de 112 individuos, 57 de Maracaibo (edad promedio 41,8 ± 13,5 años), y 55 de Bobures (edad promedio 31,4 ± 17,4 años) a los cuales se les determinó en condiciones basales glicemia, perfil lípidico y Lp(a). Para la cuantificación sérica de Lp(a) fue utilizado un Kit comercial basado en ELISA de doble anticuerpo monoclonal contra apo-B100 y contra apo(a) (Heber Biotech BioSCREEN Lp(a), La Habana, Cuba). El colesterol total y el colesterol de HDL fueron significativamente más elevados en los individuos de Maracaibo que en los de Bobures (p<0.009 y p<0.001 respectivamente), mientras que los niveles de Lp(a) séricos fueron significativamente más elevados (p<0.001 en la población afrovenezolana (media de 59,0 mg/dl) que en los blancos hispánicos) (media de 29,0 mg/dl). Nuestros rsultados sugieren que la población afrovenezolana estudiada al tener concentraciones de Lp(a) dos veces más elevada que la muestra de blancos-hispánicos estudiados y por encima del rango normal de 30 mg/dl, tienen un mayor riesgo de enfermedad cardiovascular, por lo tanto deben ser realizados estudios destinados a determinar de los subtipos de Lp(a) presentes en esta población

Elevados niveles séricos de lipoproteína (a) en una población afro-venezolana / High serum (a) in a afro-venezuelan population

Altas concentraciones de Lipoproteína (a) [Lp)a)] son consideradas un factor de riesgo independiente para la enfermedad cardiovascular, sin embargo su determinación no se realiza como prueba de rutina en la evaluación de dicho riesgo. El propósito de este estudio fue determinar los niveles séricos de Lp(a) en individuos de las poblaciones de Maracaibo, una localidad con predominio blanco-hispánico, y de Bobures, una localidad afrovenezolana, ambas ubicadas en el Estado Zulia, Venezuela. para ello se seleccionaron al azar un total de 112 individuos, 57 de Maracaibo (edad promedio 41,8 ± 13,5 años), y 55 de Bobures (edad promedio 31,4 ± 17,4 años) a los cuales se les determinó en condiciones basales glicemia, perfil lípidico y Lp(a). Para la cuantificación sérica de Lp(a) fue utilizado un Kit comercial basado en ELISA de doble anticuerpo monoclonal contra apo-B100 y contra apo(a) (Heber Biotech BioSCREEN Lp(a), La Habana, Cuba). El colesterol total y el colesterol de HDL fueron significativamente más elevados en los individuos de Maracaibo que en los de Bobures (p<0.009 y p<0.001 respectivamente), mientras que los niveles de Lp(a) séricos fueron significativamente más elevados (p<0.001 en la población afrovenezolana (media de 59,0 mg/dl) que en los blancos hispánicos) (media de 29,0 mg/dl). Nuestros rsultados sugieren que la población afrovenezolana estudiada al tener concentraciones de Lp(a) dos veces más elevada que la muestra de blancos-hispánicos estudiados y por encima del rango normal de 30 mg/dl, tienen un mayor riesgo de enfermedad cardiovascular, por lo tanto deben ser realizados estudios destinados a determinar de los subtipos de Lp(a) presentes en esta población(AU)

High serum Lipoprotein (a) [Lp(a)] concentrations are considered an independent risk factor for cardiovascular disease. Lp(a) is not usually included as a marker in the routine measurement of the evaluation and management of cardiovascular disease. The goal of this study was to determine the serum Lp(a) levels in two Venezuelas population, Maracaibo, a white-hispanic population, and Bobures, an afro-venezuelan population which has a high prevalence of cardiovascular disease. A total of 112 subjects, 57 from Maracaibo (aged 41,8 ± 13,5 years) and 55 from Bobures (aged 31,4 ± 17,4 years), were selected randomly. Fasting glycemia, lipid profile and Lp(a) concentrations were measured throughout. Serum Lp(a) was measured using a commercial kit (Heber Biotech BioSCREEN Lp(a), La Habana, Cuba). Serum total cholesterol and HDL cholesterol levels were significantly higher in Maracaibo than Bobures subjects (p<0.009 and p<0.001 respectively); whereas Lp(a) levels were significantly higher (p<0.001) in afro-venezuelan (mean 59.0 mg/dl) than in white-hispanic subjects (mean 29.0 mg/dl). Our results suggest that afro-venezuelan population had high serum Lp(a) and low HDL-cholesterol concentrations which could be related with the high prevalence of mortality from cardiovascular disease in this population(AU)