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1.
PLoS One ; 14(12): e0223788, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31830050

RESUMO

PURPOSE: To evaluate the prevalence and epidemiological characteristics of diabetic retinopathy (DR) in Slovakian patients with Type 1 and 2 diabetes mellitus (DM) in the DIARET SK study. PATIENTS AND METHODS: An epidemiological multi-center survey that included 4,078 adult patients (aged ≥18 years) from 51 diabetologists and 47 ophthalmologists. Data were collected from February to December 2015. RESULTS: The final data set consisted of 4,014 patients; 3,700 were enrolled (Type 2 DM = 3,405, Type 1 DM = 295) using a quasi-random approach; 16 (Type 2 DM = 15, Type 1 DM = 1) patients in the pre-specified group had DM duration of <5 years with a history of DR while 298 patients (Type 2 DM = 204, Type 1 DM = 94) had DM duration of ≥ 20 years. The mean (standard deviation [SD]) age of patients at diagnosis for Types 2 and 1 DM was 53.4 (9.5) and 27.6 (12.9) years, respectively. The mean (SD) glycated hemoglobin (HbA1c) was 7.5 (1.4) and 8.5 (1.6) in Types 2 and 1 DM patients, respectively, whereas a slightly higher proportion of patients had >11.0 HbA1c in Type 1 DM (5.8%) than Type 2 (2.0%). The mean (SD) duration of Type 2 DM was shorter compared with Type 1 (7.5 [5.2] vs 10.3 [6.9] years). In Type 2 DM patients, there were 516 (15.5%) cases of DR, 19 (0.56%) of proliferative DR (PDR), and 106 (3.11%) of diabetic macular edema (DME). In Type 1 DM patients, there were 86 (29.15%) cases of DR, 10 (3.39%) PDR, and 12 (4.07%) DME. CONCLUSIONS: In Slovakian patients with DM, the duration of disease and higher HbA1c were the most prevalent factors that contributed to the development of DR and DME.

2.
J Diabetes Res ; 2019: 5158308, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31886279

RESUMO

Type 2 diabetes (T2D) is an independent risk factor of stroke and systemic embolism in patients with atrial fibrillation (AF), and T2D patients with AF-associated stroke seem to have worse clinical outcome and higher risk of unfavorable clinical course compared to individuals without this metabolic disorder. Long-term anticoagulation is indicated in majority of T2D patients with AF to prevent adverse AF-associated embolic events. Direct oral anticoagulants (DOACs), direct oral thrombin inhibitor dabigatran, and direct oral factor Xa inhibitors, rivaroxaban, apixaban, and edoxaban, have emerged as a preferred choice for long-term prevention of stroke in AF patients offering potent and predictable anticoagulation and a favorable pharmacology with low risk of interactions. This article reviews the current data regarding the use of DOACs in individuals with T2D and AF.

3.
Transplant Proc ; 51(10): 3259-3264, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31732198

RESUMO

Practically all kidney allograft recipients require immunosuppressive therapy to prevent rejection and loss of the allograft. The aim of this study was to determine the occurrence of biopsy-proven acute rejection in low-immunologic risk kidney transplant recipients according to the type of induction (basiliximab vs low-dose of rabbit antithymocyte globulin [rATG], 3.5 mg/kg). MATERIALS AND METHODS: A total of 125 patients after primary kidney transplant were included in the retrospective analysis with 6-month follow-up. The immunosuppression regimen included tacrolimus, mycophenolic acid, and corticoids. RESULTS: We did not find any significant difference in the occurrence of acute rejection or difference in the occurrence of infection complications. Patients in the rATG group had a significantly longer period of cold ischemia, more frequently received kidney transplants from expanded criteria donors, and had significantly more mismatches in HLA-DR. Delayed graft function (DGF) was identified as an independent risk factor for biopsy-proven acute rejection (hazard ratio, 3.4859; P = .003). There was comparable incidence of DGF between the 2 groups despite that there were several factors that are more commonly associated with DGF in the rATG group. CONCLUSION: Patients with low immunologic risk and high risk of DGF benefit from the rATG induction in dose of 3.5 mg/kg without the increased risk of infection complications with the assumption of good graft function in long-term post-transplant period.

4.
Vnitr Lek ; 65(7-8): 475-482, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31487990

RESUMO

INTRODUCTION: Acute pulmonary embolism, usually caused by thromboembolism is still a serious medical problem in spite of technical progress in diagnostics, as well as the enhancements in prophylactic and therapeutic options. AIM: The evaluation of characteristic, incidence, diagnostic, treatment and mortality rate of patients with pulmonary embolism hospitalized at the 1st Internal Clinic, University Hospital in Martin, within the years 1996-2017. METHODS: The authors offer retrospective analysis of 699 (359 men) patients with pulmonary embolism. Diagnosis was confirmed by angiography, perfusion scan or computed tomography. The data of patients were collected continuously and they are archived at the workplace of the authors. RESULTS: Patients with explicitly confirmed pulmonary embolism created 1.01 % of all hospitalized patients with average age 60.2. The average age of men was lower compared to women (56.6 vs 65.9). As high-risk pulmonary embolism presented 14.88 %, intermediate-risk 40.77 % and low-risk 44.34 % patients with pulmonary embolism. The source of pulmonary embolism was detected in 46.35 % and risk factors were detected in 52.79 % patients with pulmonary embolism. With thrombolytic therapy were treated 23.18 % of all patient with pulmonary embolism and intracranial bleeding occurred in 0.28 % of them. Early mortality rate was 7.58 % of all patients with pulmonary embolism. CONCLUSION: The authors detected increasing occurrence of patients with pulmonary embolism and from 2005 increasing occurrence of non-provoked pulmonary embolism. An average age in the patients with non-provoked pulmonary embolism compared to patients with provoked pulmonary was lower in men (53.5 vs 60.9) as well in women (56 vs 67.7). Patients with non-provoked pulmonary embolism compared to patients with provoked pulmonary were more frequent hospitalized because acute coronary syndrome (5.03 % vs 2.91 %) as well ischemic stroke (7.16 % vs 5.61 %) within one year after pulmonary embolism.


Assuntos
Embolia Pulmonar , Angiografia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Embolia Pulmonar/diagnóstico , Embolia Pulmonar/etiologia , Embolia Pulmonar/terapia , Estudos Retrospectivos , Fatores de Risco , Terapia Trombolítica
5.
Semin Thromb Hemost ; 45(8): 846-850, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31537027

RESUMO

Dabigatran etexilate, a direct thrombin inhibitor, is now frequently used for long-term pharmacological prevention of stroke or systemic embolism in patients with atrial fibrillation. However, such long-term dabigatran therapy (DT) significantly increases the risk of upper gastrointestinal (GI) bleeding. This increased risk of gastric bleeds might be reduced with gastroprotective agents, such as proton pump inhibitors (PPIs). PPIs coadministrated with dabigatran reduce the risk of upper GI bleeding in patients on long-term oral DT. Nevertheless, there is heated discussion regarding interactions between PPI and dabigatran that lead to decreases in dabigatran plasma levels. This article reviews up to date data about the risk of gastric bleeding on dabigatran, the impact of PPI on the reduction of gastric bleeding, and the interaction between PPI and dabigatran leading to decreased dabigatran plasma levels.

6.
J Thromb Thrombolysis ; 48(4): 619-622, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31264059

RESUMO

Very limited but promising experiences with the use of direct factor Xa inhibitors for the treatment of heparin-induced thrombocytopenia (HIT) have been reported. This contribution features our first experience with the use of apixaban (without a pre-treatment with parenteral anticoagulant) to treat a case of HIT which developed in a patient after multiple heart replacement surgery. Apixaban was effective, well tolerated and safe. An apixaban-calibrated chromogenic anti-Xa activity assessment was used to monitor apixaban activity throughout the therapy. Patient continued on apixaban for the prevention of thrombosis in the settings of atrial fibrillation. No ischemic or bleeding events occurred during the clinical follow up and the platelet count was stable. Our experience suggests that apixaban might be effectively used for the treatment of HIT and for the long-term prevention of embolism in patients after multiple valve replacement with biological prostheses and atrial fibrillation.

7.
Pediatr Cardiol ; 40(7): 1431-1438, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31327027

RESUMO

Venous thromboembolism (VTE) is a rare, but life-threatening disease in those who have not reached their adulthood. This condition is usually treated with heparin or low molecular weight heparins which require parenteral administration and, in case of unfractionated heparin, also frequent laboratory monitoring and dose adjustment. Direct oral anticoagulants (DOACs)-direct thrombin inhibitor dabigatran, and direct oral factor Xa inhibitors rivaroxaban, apixaban, and edoxaban-are currently frequently used for the prevention and treatment of VTE in adult population. In fact, these agents offer several advantages compared to traditional agents, such as oral route of administration, short on-set and off-set of action, predictable pharmacologic profile with low risk of food and drug interactions, and no need for routine laboratory assessment of anticoagulant activity. However, clinical experience with these directly acting oral anticoagulants in pediatric population is very limited as these drugs had been tested and are used mostly in adult individuals. This article reviews the current data from pre- and post-marketing studies reporting the use of DOACs for the treatment of VTE in pediatric patients.


Assuntos
Inibidores do Fator Xa/administração & dosagem , Tromboembolia Venosa/tratamento farmacológico , Administração Oral , Criança , Ensaios Clínicos como Assunto , Inibidores do Fator Xa/farmacologia , Humanos
9.
BMC Nephrol ; 20(1): 272, 2019 Jul 18.
Artigo em Inglês | MEDLINE | ID: mdl-31319808

RESUMO

BACKGROUND: Acute kidney injury (AKI) affects approximately 13% of patients undergoing major abdominal surgery, and is a common and important clinical sign of perioperative injury. The aim of our analysis was to identify risk factors for AKI in elderly patients with no known kidney disease at the time of surgery, and to evaluate their 30-day, 12-month and 5-year survival. METHODS: We performed a retrospective analysis on a group of 785 patients after liver resection to determine the incidence of complications (AKI - according to KDIGO classification, sepsis, cardiovascular and surgical complications). All patients had normal kidney function prior to surgery. We determined risk factors for the development of AKI for two groups of patients, stratified for age: patients younger than 65 years, and patients older than 65 years. RESULTS: The incidence of complications was significantly higher in the group of patients older than 65 years (n = 76) than in younger patients (n = 119) (P = 0.0496). In the group of younger patients, significantly worse 30-day survival was observed for patients who developed AKI (P = 0.0004). We identified the following independent risk factors for AKI: male gender (HR 10,3834; P = 0,0238), histological identification of colorectal carcinoma metastases (HR 2,8651; P = 0,0499), surgery duration longer than 300 min (HR 6,0096; P < 0,0001), blood loss of more than 500 ml (HR 10,5857; P = 0,0012), and the need for more than 500 ml of fresh frozen plasma during surgery ml (HR 2,4878; P < 0,0317). Age was not confirmed to be an independent risk factor for AKI in our study. CONCLUSION: Approaches to treatment should be highly individualized, with assessment of several variables. According to our findings, age should not present a contraindication for the indication of a patient for surgery.

10.
Vnitr Lek ; 65(4): 264-272, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31091945

RESUMO

Insulin resistance (IR) is defined as insufficient insulin metabolic effect in target tissues, including glucose utilisation in skeletal muscle, suppression of hepatic glucose production and suppression of lipolysis in fat tissue. Primary IR originates as consequence of rare monogenetic defects of insulin receptor or molecules includes to post-receptor insulin signal cascade. Secondary IR originates mainly as a result of metabolic or hormonal changes, most commonly in visceral obesity by multifactorial postreceptor inhibition of insulin signal and it is associated with metabolic syndrome and type 2 diabetes mellitus. It is also present in endocrinopathies with overproduction of contraregulatory insulin hormones (cortisol, growth hormone, catecholamines) and using of some drugs (mainly steroids, immunosuppressive treatment). In practice IR is usually diagnosed by glycemic parameters with confirmation of prediabetic states and type 2 diabetes mellitus. The healthy life style and physical activity associated with weight loss are the most important for type 2 diabetes prevention. According to actual international guidelines metformin is only antidiabetic drug which is possible to use in prediabetic states with high risk of type 2 diabetes development, mainly in obese subjects with BMI > 35 kg/m2, age under 60 years and in women with history of gestational diabetes.


Assuntos
Diabetes Mellitus Tipo 2 , Hipoglicemiantes , Resistência à Insulina , Glicemia , Diabetes Mellitus Tipo 2/tratamento farmacológico , Feminino , Humanos , Hipoglicemiantes/uso terapêutico , Insulina
11.
Vnitr Lek ; 65(1): 30-36, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30823835

RESUMO

Adenosintriphosphate is basic unit of cellular energetics, although during situations of high energy demand, cell had developed metabolic inert molecules - phosphagens - including phosphocreatine. Nowadays there are not so many recent publications describing positive effect of phosphocreatine supplementation., its potential benefit in supplementation is mainly in cardiology - acute myocardial infarction, acute or chronic heart failure. Another field of medicine with potential use of phosphocreatine is nephrology - in dialysis patients, or in psotemnopausal women in prevention of osteoporosis. In following article, we present review of studies describing positive effect of using phosphocreatine in specific group of patients in internal medicine. Key words: ATP - ischemia - phosphagens - phosphocreatine.


Assuntos
Metabolismo Energético , Fosfocreatina , Trifosfato de Adenosina , Feminino , Insuficiência Cardíaca/tratamento farmacológico , Humanos , Medicina Interna/tendências , Miocárdio , Fosfocreatina/uso terapêutico
12.
Vnitr Lek ; 65(1): 45-50, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30823837

RESUMO

Relation between oncological diseases and venous thrombo-embolism (VTE) is well known for almost 2 centuries. In 1823 Bouillaud assumed by three patients with tumor and recent deep vein thrombosis (DVT), that peripheral edema of lower limbs emerges as a result of „obturation“ of veins by „fibrinous coagulum“ (caillot fibrineux), which was induced by oncological disease. French physician Armand Trousseau wrote about this relation in his book „Phlegmasia alba dolens” again in the year 1865. Many studies were developed in times of Bouillaud a Trousseau, which just confirmed existence of relation between tumor and VTE. Oncological disease presents a significant risk factor of formation of VTE. Recent references favorising the use of light molecular weight heparin (LMWH) in long-term anticoagulation therapy of patients with cancer. Recently we have just few clinical data about efficiency and safety of direct oral anticoagulants (DOACs) in oncological patients, however many meta-analysis of clinical studies has shown benefit of therapy with DOACs towards conventional therapy. Key words: direct oral anticoagulants (DOACs) - oncology - venous thromboembolism.


Assuntos
Anticoagulantes , Tromboembolia Venosa , Trombose Venosa , Administração Oral , Anticoagulantes/uso terapêutico , Hemorragia , Heparina de Baixo Peso Molecular , Humanos , Neoplasias/complicações , Tromboembolia Venosa/complicações , Tromboembolia Venosa/prevenção & controle
14.
J Diabetes Complications ; 33(4): 315-322, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30755355

RESUMO

INTRODUCTION: Sex differences are defined as biology-linked differences between women and men that occur through the sex chromosomes and their effects on organ systems. MATERIAL AND METHODS: The objective of this prospective study was to determine risk factors for post-transplant diabetes mellitus (PTDM) in men and women. RESULTS: A total of 417 patients (271 men and 146 women) were included in the monitored group. Age at the time of kidney transplantation (KT) >60 years and hypovitaminosis D at the time of KT (<20 µg/l) were identified as independent risk factors for PTDM in both men and women. It was further confirmed as an independent risk factor for men a waist circumference at the time of KT >94 cm, C-peptide at the time of KT >5 ng/ml, HOMA-IR >2 and triacylglycerols at the time of KT >1.7 mmol/l. In case of women, the dominant factor was BMI at the time of KT >30 kg/m2 and menopause at the time of KT. A significant decrease in C-peptide was recorded in women with PTDM. CONCLUSION: It was confirmed that there are gender differences with regard to the development of PTDM after KT. Women show pancreas ß cell dysfunction, whereas insulin resistance and metabolic syndrome are dominant in men.

15.
Artigo em Inglês | MEDLINE | ID: mdl-30198520

RESUMO

INTRODUCTION: Hormone changes during pregnancy lead to increased plasma lipid levels. When there is added disorder of lipid metabolism, this otherwise physiological change can cause extremely high triglyceride levels with potentionally life-threatening complications, such as non-biliary acute pancreatitis. MATERIALS AND METHODS: We present a case report of a 27-year-old pregnant woman with familial hyperchylomicronemia and a history of 7 hypertriglyceridemia-induced acute pancreatitis attacks. Three attacks occured during her first pregnancy with the last one leading to its termination at 33 weeks owing to the death of the fetus. During her second pregnancy, standard treatment was not able to lower the triglyceride levels sufficiently and she suffered another acute pancreatitis attack. Therapeutic plasma exchange was therefore chosen as the treatment method. RESULTS AND CONCLUSION: Plasma exchange was succesful in the secondary prevention of acute pancreatitis attack and she delivered a healthy baby at 36 weeks of gestation. Treatment was very well tolerated by the mother and the fetus and this supports the use of apheresis as a safe and efficient method in tackling gestational hypertriglyceridemia.


Assuntos
Hipertrigliceridemia/prevenção & controle , Pancreatite/prevenção & controle , Troca Plasmática , Complicações na Gravidez/terapia , Adulto , Feminino , Humanos , Hipertrigliceridemia/sangue , Hipertrigliceridemia/terapia , Pancreatite/sangue , Pancreatite/terapia , Gravidez , Complicações na Gravidez/sangue , Resultado da Gravidez , Terceiro Trimestre da Gravidez , Prevenção Secundária
17.
Am J Ther ; 26(3): e308-e313, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-28452843

RESUMO

BACKGROUND: Proton pump inhibition (PPI) administrated together with dabigatran reduces the risk of gastrointestinal hemorrhage. However, there is a discussion regarding possible PPI-dabigatran interaction that may reduce the efficacy of this therapy. STUDY QUESTION: To determine the impact of concomitant PPI on dabigatran plasma levels in patients with nonvalvular atrial fibrillation (NV-AF). STUDY DESIGN: A pilot prospective study in patients with NV-AF on dabigatran therapy was performed; 31 patients were enrolled. PPI with either omeprazole or pantoprazole was administrated in 19 patients. MEASURES AND OUTCOMES: Blood samples were taken for the assessment of the dabigatran trough and peak levels. Dabigatran concentration was measured with the Hemoclot Thrombin Inhibitor Assay. RESULTS: There were significant differences in dabigatran trough level comparing patients treated with PPI and patients without PPI (58.86 ± 36.76 ng/mL vs. 110.72 ± 88.47 ng/mL, P < 0.05). Similarly, there were significant differences in dabigatran peak level between compared groups (88.0 ± 20.5 ng/mL vs. 174.4 ± 139.64 ng/mL, P < 0.05). CONCLUSIONS: This pilot study demonstrated the interaction between PPI and dabigatran levels in patients with NV-AF.


Assuntos
Anticoagulantes/farmacocinética , Fibrilação Atrial/tratamento farmacológico , Dabigatrana/farmacocinética , Hemorragia Gastrointestinal/prevenção & controle , Inibidores da Bomba de Prótons/farmacocinética , Idoso , Idoso de 80 Anos ou mais , Anticoagulantes/efeitos adversos , Dabigatrana/efeitos adversos , Interações de Medicamentos , Feminino , Hemorragia Gastrointestinal/induzido quimicamente , Humanos , Masculino , Pessoa de Meia-Idade , Omeprazol/administração & dosagem , Omeprazol/farmacocinética , Pantoprazol/administração & dosagem , Pantoprazol/farmacocinética , Projetos Piloto , Estudos Prospectivos , Inibidores da Bomba de Prótons/administração & dosagem
18.
J Thromb Thrombolysis ; 47(1): 140-145, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30288664

RESUMO

Proton pump inhibition (PPI) reduces gastrointestinal bleeding on direct oral anticoagulants. However, PPI may affect dabigatran on-treatment levels; and there is no information regarding the effect of PPI on xabans on-treatment activity. Thus, the aim of this study was to determine the impact of PPI on therapeutic anti-Xa activity in rivaroxaban- and apixaban-treated patients with atrial fibrillation (AF). This single-centre pilot prospective study enrolled 77 consecutive xabans-treated patients (42 rivaroxaban-treated and 35 apixaban-treated patients) with AF. PPI was administrated in 44 patients. Trough and peak anti-Xa activity was assessed with factor Xa-calibrated anti-Xa chromogenic analysis. There were no significant differences in trough anti-Xa activity comparing PPI-treated patients and patients without PPI (80.5 ± 66.5 ng/mL in PPI group vs. 71.6 ± 64.1 ng/mL in non-PPI group, p = 0.57, Table 2). Similarly, there were no significant differences in peak anti-Xa activity between compared groups (175.2 ± 102.5 ng/mL in PPI group vs. 202.9 ± 84.1 ng/mL in non-PPI group, p = 0.21). This pilot study did not reveal significant changes in xabans on-treatment anti-Xa activity according the PPI status.


Assuntos
Fibrilação Atrial/tratamento farmacológico , Inibidores do Fator Xa/farmacologia , Inibidores da Bomba de Prótons/farmacologia , Anticoagulantes/farmacologia , Interações de Medicamentos , Inibidores do Fator Xa/uso terapêutico , Hemorragia Gastrointestinal/induzido quimicamente , Hemorragia Gastrointestinal/tratamento farmacológico , Humanos , Projetos Piloto , Estudos Prospectivos , Pirazóis/uso terapêutico , Piridonas/uso terapêutico , Rivaroxabana/uso terapêutico
19.
Artigo em Inglês | MEDLINE | ID: mdl-31895873

RESUMO

BACKGROUND: Several studies demonstrated that proton pump inhibitors (PPI) co-administrated with dabigatran in patients with atrial fibrillation (AF) decreased dabigatran trough and peak plasma levels. However, is still unknown whether this interaction is reversible or not, and whether the withdrawal of PPI would lead to normalization of dabigatran plasma levels. AIM OF STUDY: The aim of this study was to determine the effect of PPI withdrawal on dabigatran plasma levels in patients with AF. METHODS: This pilot prospective study enrolled 23 AF patients on long-term dabigatran and PPI therapy (omeprazole 20 mg twice daily or pantoprazole 40 mg once daily). Dabigatran trough and peak levels (ng/mL) were tested on PPI and after a 2 week period of PPI withdrawal with Hemoclot® Thrombin Inhibitor Assay. RESULTS: The analysis of dabigatran plasma levels demonstrated significant elevation in trough dabigatran levels after two weeks of PPI withdrawal (97.2±79.7 versus 163.8±105.5 ng/mL; p < 0.05). Moreover, significantly higher peak dabigatran levels were observed after two weeks of PPI withdrawal (142.4±102.8 versus 255±129.5 ng/mL; p ≤ 0.001). CONCLUSIONS: This study showed that a 2 week period of PPI withdrawal lead to a significant increase in dabigatran trough and peak plasma levels in patients with AF.

20.
Obes Facts ; 11(6): 454-464, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30537756

RESUMO

BACKGROUND: To report changes in body composition and biochemical parameters in patients with type 1 diabetes mellitus (T1D) after switching from multiple daily injection (MDI) to continuous subcutaneous insulin infusion (CSII). METHODS: 31 patients switched over from MDI to CSII. Body composition, biochemical parameters, glycaemic variability (GV) and level of physical activity were evaluated before and 6 months on CSII. RESULTS: In both sexes, we found an increase in skeletal muscle mass (SMM), (p = 0.008; 0.008). In men, there was mainly a decrease in visceral fat area (VFA), (p = 0.028) and in women there was decrease of total body fat (TBF), (p = 0.020) and non-significant decrease of VFA (p = 0.098). SMM inversely correlated with VFA in men (p = -0.001) and with TBF in women (p = -0.005 ). GV was decreased generally and correlated inversely with TBF in men only (p = -0.026). Physical activity was increased and correlated inversely with VFA in men (p = -0.002) and in women (p = -0.006). CONCLUSIONS: Using CSII in T1D leads to a significant increase of SMM in both sexes to a decrease of VFA in men and to a non-significant decrease of VFA in women. Changes in adipose tissue and SMM were also related to increased physical activity and to decreased GV.


Assuntos
Tecido Adiposo/efeitos dos fármacos , Distribuição da Gordura Corporal , Diabetes Mellitus Tipo 1/tratamento farmacológico , Grelina/sangue , Sistemas de Infusão de Insulina , Insulina/administração & dosagem , Leptina/sangue , Músculo Esquelético/efeitos dos fármacos , Tecido Adiposo/metabolismo , Adulto , Idoso , Glicemia/efeitos dos fármacos , Glicemia/metabolismo , Composição Corporal/efeitos dos fármacos , Peso Corporal/efeitos dos fármacos , Diabetes Mellitus Tipo 1/metabolismo , Diabetes Mellitus Tipo 1/patologia , Feminino , Hemoglobina A Glicada/efeitos dos fármacos , Hemoglobina A Glicada/metabolismo , Humanos , Injeções Subcutâneas , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/patologia , Tamanho do Órgão/efeitos dos fármacos , Circunferência da Cintura
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