RESUMO
OBJECTIVE: The objective of this study was to evaluate and correlate hematologic indices, vitamin B12 levels, and depression in patients with suspected laryngopharyngeal reflux (LPR) treated with proton pump inhibitor (PPI). METHODS: This was a prospective study with a population (n = 23) consisted of patients with suspected LPR and treated with 2 daily doses of Omeprazole 40 mg (80 mg or full dose). The study volunteers performed a complete blood count and vitamin B12 dosage before and after 3 and 6 months of treatment, as well as depression screening using the Center of Epidemiologic Studies-Depression (CES-D) questionnaire before and after 6 months of treatment. Scores greater than 16 were considered as suggestive of depression. RESULTS: The mean score on the CES-D scale of study participants at baseline significantly decreased after 6 months of treatment. A significant decrease was observed in the red blood cells count (RBC) after 6 months in relation to 3 months. Significant increases in mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) were observed from 3 months to 6 months in this study. Vitamin B12 levels increased significantly between baseline and after 6 months of treatment. CONCLUSION: Decreased scores on the CES-D scale were associated with increased MCV values, with no association with vitamin B12 levels. However, vitamin B12 levels also increased significantly after 6 months of treatment with PPI.
RESUMO
A Síndrome Metabólica (SM) caracteriza-se como um distúrbio complexo representado por um conjunto de fatores de risco cardiovascular, tendo sua frequência estimada entre 20% a 25% da população adulta mundial. Os diversos componentes da SM são responsáveis por alterações estruturais e funcionais de grandes artérias, dentre as quais destaca-se a diminuição da complacência arterial como um importante marcador de risco cardiovascular. A medida da Velocidade de Onda de Pulso (VOP) configura-se como um método relevante na avaliação da rigidez arterial. Discute-se, nesta revisão, os principais mecanismos pelos quais os componentes da SM atuam provocando estas alterações vasculares, a relevância destas modificações e o reflexo da influência terapêutica nestes casos. A revisão bibliográfica foi realizada através de consulta às bases de dados eletrônicos Medline, Lilacs e Pubmed, entre os anos de 2008 e 2009. Foram utilizados os descritores metabolic syndrome, pulse wave velocity e arterial stiffness, nos idiomas português e inglês, sendo selecionados estudos datados entre 1962 e 2009. Observou-se através dos estudos revisados que os componentes da SM atuam através de diferentes mecanismos para promover o aumento da VOP. A principal alteração vascular relacionada a estes componentes foi a diminuição da complacência das grandes artérias. A avaliação da complacência arterial através da medida da VOP permite o acompanhamento dos resultados obtidos através das intervenções terapêuticas e a identificação precoce destas alterações vasculares. Desta forma, torna-se possível a adoção de uma medida terapêutica precoce, possibilitando diminuir significativamente a progressão destas alterações vasculares e, portanto, reduzir a mortalidade cardiovascular destes pacientes.
The metabolic syndrome (MS) is characterized as a complex disorder represented by a set of cardiovascular risk factors, its frequency estimated between 20% to 25% of the adult population worldwide. The various components of MS are responsible for structural and functional alterations of large arteries, among which a decrease in arterial compliance stands out as an important cardiovascular risk marker. Measurement of Pulse Wave Velocity (PWV) figures as a relevant method in the evaluation of arterial stiffness. This review discusses the main mechanisms by which components of MS act causing these vascular changes, the relevance of these changes and the reflex of treatment influence in these cases. A literature review was conducted by consulting electronic databases Medline, Pubmed and Lilacs between years 2008 and 2009. Metabolic syndrome, pulse wave velocity and arterial stiffness, and their Portuguese equivalents, were the search words used, selecting studies dating from 1962 to 2009. The reviewed studies showed that the components of MS act through different mechanisms to promote the increase of PWV. The main change related to these vascular components was decreased compliance of large arteries. Assessment of arterial compliance by measuring PWV allows tracking the results obtained through therapeutic interventions and early identification of these vascular changes. It thus becomes possible to adopt an early treatment measure, which allows to slow down the progression of these vascular changes significantly and therefore reduce cardiovascular mortality in these patients.
