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1.
J Plant Physiol ; 248: 153136, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32120144

RESUMO

Elicited broccoli suspension-cultured cells (SCC) provide a useful system for obtaining bioactive compounds, including glucosinolates (GS) and phenolic compounds (PCs). In this work, coronatine (Cor) and methyl jasmonate (MJ) were used to increase the bioactive compound production in broccoli SCC. Although the use of Cor and MJ in secondary metabolite production has already been described, information concerning how elicitors affect cell metabolism is scarce. It has been suggested that Cor and MJ trigger defence reactions affecting the antioxidative metabolism. In the current study, the concentration of 0.5 µM Cor was the most effective treatment for increasing both the total antioxidant capacity (measured as ferulic acid equivalents) and glucosinolate content in broccoli SCC. The elicited broccoli SCC also showed higher polyphenol oxidase activity than the control cells. Elicitation altered the antioxidative metabolism of broccoli SCC, which displayed biochemical changes in antioxidant enzymes, a decrease in the glutathione redox state and an increase in lipid peroxidation levels. Furthermore, we studied the effect of elicitation on the protein profile and observed an induction of defence-related proteins. All of these findings suggest that elicitation not only increases bioactive compound production, but it also leads to mild oxidative stress in broccoli SCC that could be an important factor triggering the production of these compounds.

2.
Med. clín (Ed. impr.) ; 152(11): 438-441, jun. 2019. tab
Artigo em Inglês | IBECS | ID: ibc-183904

RESUMO

Objective: To analyze the effect of sodium glucose cotransporter 2 (SGLT2) inhibitors in a group of insulin-dependent type 2 diabetes mellitus (T2D) patients. Patients and methods: One hundred and five insulin treated T2D patients were enrolled. Primary endpoints were: fasting plasma glucose, HbA1c, weight, total insulin doses (TDI), total basal insulin (TDB) and total rapid insulin (TDR). Secondary variables were: total cholesterol, LDL cholesterol (cLDL), HDL cholesterol (cHDL), triglycerides and systolic (SBP) and diastolic (DBP) blood pressure. Safety and tolerance were evaluated through the appearance of severe hypoglycemia, ketoacidosis and infections. Results: After 4 months follow-up, a 0.7 (1.0)% HbA1c reduction was found, accompanied by a −2.8 (11.5) UI/day TDI decrease. Weight dropped for 73.7% of patients, with an average −2.0 (2.7) kg reduction. A global cHDL increase was noted after treatment, while no differences were observed for total cholesterol, triglycerides or cLDL. SBP dropped significantly, but no change in DBP was observed. Conclusion: The use of SGLT2 inhibitors in insulin treated T2D patients resulted in reduction of HbA1c, which was associated to weight loss, cHDL increase and SBP decrease


Objetivo: Analizar el efecto de los inhibidores del cotransportador sodio glucosa tipo 2 (iSGLT2) en u grupo de pacientes con diabetes mellitus tipo 2 (DM2) tratados con insulina. Pacientes y métodos: Seleccionamos ciento cinco pacientes con diabetes tipo 2 tratados con insulina. Los objetivos primarios: glucosa plasmática ayunas, HbA1c, peso, dosis total de insulina (DTI), dosis de insulina basal (DTB), dosis de insulina rápida (DTR). Como secundarios: Colesterol total, LDL colesterol (cLDL), HDL colesterol (cHDL), triglicéridos and tensión sistólica (TAS) and diastólica (TAD). La seguridad y tolerancia se valoró como hipoglucemia, cetoacidosis o infecciones. Resultados: Tras 4 meses, la HbA1c se redujo en 0,7 (1,0)% acompañado de una disminución en DTI de −2,8 (11,5) UI/día. El 73,7% de los pacientes perdieron peso, con un descenso medio de −2,0 (2,7) kg. El cHDL aumentó, mientras que no observamos diferencias en el colesterol total, triglicéridos o cLDL. TAS disminuyó significativamente sin observar cambios en TAD. Conclusión: El uso de iSGLT2 en pacientes con DM2 tratados con insulina reduce la HbA1c asociando pérdida de peso, aumento enl cHDL y descenso en TAS


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Inibidores do Transportador 2 de Sódio-Glicose/uso terapêutico , Diabetes Mellitus Tipo 2/tratamento farmacológico , Resultado do Tratamento , Estudos Retrospectivos
3.
Med Clin (Barc) ; 152(11): 438-441, 2019 06 07.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-30503071

RESUMO

OBJECTIVE: To analyze the effect of sodium glucose cotransporter 2 (SGLT2) inhibitors in a group of insulin-dependent type 2 diabetes mellitus (T2D) patients. PATIENTS AND METHODS: One hundred and five insulin treated T2D patients were enrolled. Primary endpoints were: fasting plasma glucose, HbA1c, weight, total insulin doses (TDI), total basal insulin (TDB) and total rapid insulin (TDR). Secondary variables were: total cholesterol, LDL cholesterol (cLDL), HDL cholesterol (cHDL), triglycerides and systolic (SBP) and diastolic (DBP) blood pressure. Safety and tolerance were evaluated through the appearance of severe hypoglycemia, ketoacidosis and infections. RESULTS: After 4 months follow-up, a 0.7 (1.0)% HbA1c reduction was found, accompanied by a -2.8 (11.5) UI/day TDI decrease. Weight dropped for 73.7% of patients, with an average -2.0 (2.7) kg reduction. A global cHDL increase was noted after treatment, while no differences were observed for total cholesterol, triglycerides or cLDL. SBP dropped significantly, but no change in DBP was observed. CONCLUSION: The use of SGLT2 inhibitors in insulin treated T2D patients resulted in reduction of HbA1c, which was associated to weight loss, cHDL increase and SBP decrease.

4.
Planta ; 246(1): 19-32, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28492986

RESUMO

MAIN CONCLUSION: Glucosinolates are biologically active compounds which are involved in plant defense reaction. The use of plant in vitro cultures and genetic engineering is a promising strategy for their sustainable production. Glucosinolates are a class of secondary metabolites found mainly in Brassicaceae, which contain nitrogen and sulfur in their structures. Glucosinolates are divided into three groups depending on the amino acid from which they are biosynthesized. Aliphatic glucosinolates are generally derived from leucine, valine, methionine, isoleucine and alanine while indole and aromatic glucosinolates are derived from tryptophan and phenylalanine or tyrosine, respectively. These compounds are hydrolyzed by the enzyme myrosinase when plants are stressed by biotic and abiotic factors, obtaining different degradation products. Glucosinolates and their hydrolysis products play an important role in plant defense responses against different types of stresses. In addition, these compounds have beneficial effect on human health because they are strong antioxidants and they have potent cardiovascular, antidiabetic, antimicrobial and antitumoral activities. Due to all the properties described above, the demand for glucosinolates and their hydrolysis products has enormously increased, and therefore, new strategies that allow the production of these compounds to be improved are needed. The use of plant in vitro cultures is emerging as a biotechnological strategy to obtain glucosinolates and their derivatives. This work is focused on the biosynthesis of glucosinolates and the bioactivity of these compounds in plants. In addition, a detailed study on the strategies used to increase the production of several glucosinolates, in particular those synthesized in Brassicaceae, using in vitro plant cultures has been made. Special attention has been paid for increasing the production of glucosinolates and their derivatives using metabolic engineering.


Assuntos
Vias Biossintéticas/fisiologia , Glucosinolatos/metabolismo , Arabidopsis/genética , Arabidopsis/metabolismo , Vias Biossintéticas/genética , Brassicaceae/genética , Brassicaceae/metabolismo , Glicosídeo Hidrolases/genética , Glicosídeo Hidrolases/metabolismo
5.
Plant Physiol Biochem ; 99: 73-8, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26741536

RESUMO

In this work, suspension-cultured cells of Linum usitatissimum L. were used to evaluate the effect of two types of cyclodextrins, ß-glucan and (Z)-3-hexenol separately or in combination on phytosterol and tocopherol production. Suspension-cultured cells of L. usitatissimum were able to produce high levels of phytosterols in the presence of 50 mM methylated-ß-cyclodextrins (1325.96 ± 107.06 µg g dry weight(-1)) separately or in combination with ß-glucan (1278.57 ± 190.10 µg g dry weight(-1)) or (Z)-3-hexenol (1507.88 ± 173.02 µg g dry weight(-1)), being cyclodextrins able to increase both the secretion and accumulation of phytosterols in the spent medium, whereas ß-glucan and (Z)-3-hexenol themselves only increased its intracellular accumulation. Moreover, the phytosterol values found in the presence of hydroxypropylated-ß-cyclodextrins were lower than those found in the presence of methylated-ß-cyclodextrins in all cases studied. However, the results showed that the presence of methylated-ß-cyclodextrins did not increase the tocopherols production and only an increase in tocopherol levels was observed when cells were elicited with 50 mM hydroxypropylated-ß-cyclodextrins in combination with ß-glucan (174 µg g dry weight(-1)) or (Z)-3-hexenol (257 µg g dry weight(-1)). Since the levels of tocopherol produced in the combined treatment were higher than the sum of the individual treatments, a synergistic effect between both elicitors was assumed. To sum up, flax cell cultures elicited with cyclodextrins alone or in combination with ß-glucan or (Z)-3-hexenol were able produce phytosterols and tocopherols, and therefore, these elicited suspension-cultured cells of L. usitatissimum can provide an alternative system, which is at the same time more sustainable, economical and ecological for their production.


Assuntos
Linho/metabolismo , Fitosteróis/biossíntese , Tocoferóis/metabolismo , Reatores Biológicos/normas , Técnicas de Cultura de Células , Células Cultivadas , Ciclodextrinas/farmacologia , Sinergismo Farmacológico , Linho/efeitos dos fármacos , Hexanóis/farmacologia , beta-Glucanas/farmacologia
6.
Obes Surg ; 26(8): 1836-42, 2016 08.
Artigo em Inglês | MEDLINE | ID: mdl-26661106

RESUMO

BACKGROUND: Specific data is needed to safely expand bariatric surgery and to preserve good surgical outcomes in response to the non-stop increase in obesity prevalence worldwide. OBJECTIVE: The aims of this study are to provide an overview of the baseline characteristics, type of surgery, and 30-day postoperative morbidity and mortality in patients undergoing bariatric surgery in Spanish public hospitals, and evaluate changes throughout the 2000-2014 period. MATERIAL AND METHODS: This is a descriptive study using data from the RICIBA, a computerized multicenter and multidisciplinary registry created by the Obesity Group of the Endocrinology and Nutrition Spanish Society. Three periods according to the date of surgery were created: January 2000 to December 2004 (G1), January 2005 to December 2009 (G2), and January 2010 to December 2014 (G3). RESULTS: Data from 3843 patients were available (44.8 ± 10.5 years, a 3:1 female-to-male ratio, 46.9 ± 8.2 kg/m(2)). Throughout the 15-year period assessed, candidate patients for bariatric surgery were progressively older and less obese, with an increase in associated comorbidities and in the prevalence of men. The global trend also showed a progressive decrease in Roux-en-Y gastric bypass, the most performed bariatric procedure (75.1 % in G1, 69.3 % in G2, and 42.6 % in G3; p < 0.001), associated with a parallel increase in sleeve gastrectomy (0.8 % in G1, 18.1 % in G2, and 39.6 % in G3; p < 0.001). An overall mortality rate of 0.3 % was reported. CONCLUSIONS: Data from Spain is similar to data observed worldwide. Information recorded in the National Registries like RICIBA is necessary in order to safely expand bariatric surgery in response to increasing demand.


Assuntos
Cirurgia Bariátrica/estatística & dados numéricos , Obesidade Mórbida/cirurgia , Cirurgia Bariátrica/métodos , Cirurgia Bariátrica/tendências , Comorbidade , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade Mórbida/mortalidade , Período Pós-Operatório , Prevalência , Sistema de Registros , Espanha/epidemiologia
7.
Clin Nutr ; 34(5): 962-7, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25466952

RESUMO

BACKGROUND: Malnutrition in hospitalized patients is associated with an increased risk of death, in both the short and the long term. AIMS: The purpose of this study was to determine which nutrition-related risk index predicts long-term mortality better (three years) in patients who receive total parenteral nutrition (TPN). METHODS: This prospective, multicenter study involved noncritically ill patients who were prescribed TPN during hospitalization. Data were collected on Subjective Global Assessment (SGA), Nutritional Risk Index (NRI), Geriatric Nutritional Risk Index (GNRI), body mass index, albumin and prealbumin, as well as long-term mortality. RESULTS: Over the 1- and 3-year follow-up periods, 174 and 244 study subjects (28.8% and 40.3%) respectively, died. Based on the Cox proportional hazards survival model, the nutrition-related risk indexes most strongly associated with mortality were SGA and albumin (<2.5 g/dL) (after adjustment for age, gender, C-reactive protein levels, prior comorbidity, mean capillary blood glucose during TPN infusion, diabetes status prior to TPN, diagnosis, and infectious complications during hospitalization). CONCLUSIONS: The SGA and very low albumin levels are simple tools that predict the risk of long-term mortality better than other tools in noncritically ill patients who receive TPN during hospitalization.


Assuntos
Desnutrição/epidemiologia , Nutrição Parenteral Total , Adulto , Idoso , Glicemia/metabolismo , Índice de Massa Corporal , Peso Corporal , Proteína C-Reativa/metabolismo , Comorbidade , Estado Terminal , Ingestão de Energia , Seguimentos , Avaliação Geriátrica , Hospitalização , Humanos , Pacientes Internados , Tempo de Internação , Desnutrição/diagnóstico , Pessoa de Meia-Idade , Avaliação Nutricional , Estado Nutricional , Modelos de Riscos Proporcionais , Estudos Prospectivos , Medição de Risco , Albumina Sérica/metabolismo , Adulto Jovem
8.
Nutrition ; 31(1): 58-63, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25441588

RESUMO

OBJECTIVE: Hypoglycemia is a common problem among hospitalized patients. Treatment of hyperglycemia with insulin is potentially associated with an increased risk for hypoglycemia. The aim of this study was to determine the prevalence and predictors of hypoglycemia (capillary blood glucose <70 mg/dL) in hospitalized patients receiving total parenteral nutrition (TPN). METHODS: This prospective multicenter study involved 19 Spanish hospitals. Noncritically ill adults who were prescribed TPN were included, thus enabling us to collect data on capillary blood glucose and insulin dosage. RESULTS: The study included 605 patients of whom 6.8% (n = 41) had at least one capillary blood glucose <70 mg/dL and 2.6% (n = 16) had symptomatic hypoglycemia. The total number of hypoglycemic episodes per 100 d of TPN was 0.82. In univariate analysis, hypoglycemia was significantly associated with the presence of diabetes, a lower body mass index (BMI), and treatment with intravenous (IV) insulin. Patients with hypoglycemia also had a significantly longer hospital length of stay, PN duration, higher blood glucose variability, and a higher insulin dose. Multiple logistic regression analysis showed that a lower BMI, high blood glucose variability, and TPN duration were risk factors for hypoglycemia. Use of IV insulin and blood glucose variability were predictors of symptomatic hypoglycemia. CONCLUSIONS: The occurrence of hypoglycemia in noncritically ill patients receiving PN is low. A lower BMI and a greater blood glucose variability and TPN duration are factors associated with the risk for hypoglycemia. IV insulin and glucose variability were predictors of symptomatic hypoglycemia.


Assuntos
Hipoglicemia/epidemiologia , Nutrição Parenteral Total/efeitos adversos , Administração Intravenosa , Idoso , Glicemia/metabolismo , Índice de Massa Corporal , Estado Terminal , Relação Dose-Resposta a Droga , Feminino , Hospitalização , Humanos , Hipoglicemia/etiologia , Insulina/administração & dosagem , Insulina/efeitos adversos , Tempo de Internação , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Estado Nutricional , Prevalência , Estudos Prospectivos , Fatores de Risco , Espanha/epidemiologia
9.
Endocr Pract ; 21(1): 59-67, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25148810

RESUMO

OBJECTIVE: The prevalence of carbohydrate metabolism disorders in patients who receive total parenteral nutrition (TPN) is not well known. These disorders can affect the treatment, metabolic control, and prognosis of affected patients. The aims of this study were to determine the prevalence in noncritically ill patients on TPN of diabetes, prediabetes, and stress hyperglycemia; the factors affecting hyperglycemia during TPN; and the insulin therapy provided and the metabolic control achieved. METHODS: We undertook a prospective multicenter study involving 19 Spanish hospitals. Noncritically ill patients who were prescribed TPN were included, and data were collected on demographic, clinical, and laboratory variables (glycated hemoglobin, C-reactive protein [CRP], capillary blood glucose) as well as insulin treatment. RESULTS: The study included 605 patients. Before initiation of TPN, the prevalence of known diabetes was 17.4%, unknown diabetes 4.3%, stress hyperglycemia 7.1%, and prediabetes 27.8%. During TPN therapy, 50.9% of patients had at least one capillary blood glucose of >180 mg/dL. Predisposing factors were age, levels of CRP and glycated hemoglobin, the presence of diabetes, infectious complications, the number of grams of carbohydrates infused, and the administration of glucose-elevating drugs. Most (71.6%) patients were treated with insulin. The mean capillary blood glucose levels during TPN were: known diabetes (178.6 ± 46.5 mg/dL), unknown diabetes (173.9 ± 51.9), prediabetes (136.0 ± 25.4), stress hyperglycemia (146.0 ± 29.3), and normal (123.2 ± 19.9) (P<.001). CONCLUSION: The prevalence of carbohydrate metabolism disorders is very high in noncritically ill patients on TPN. These disorders affect insulin treatment and the degree of metabolic control achieved.


Assuntos
Diabetes Mellitus/epidemiologia , Hiperglicemia/epidemiologia , Insulina/uso terapêutico , Nutrição Parenteral Total/efeitos adversos , Estado Pré-Diabético/epidemiologia , Adulto , Idoso , Glicemia/análise , Diabetes Mellitus/metabolismo , Feminino , Humanos , Hiperglicemia/metabolismo , Masculino , Pessoa de Meia-Idade , Estado Pré-Diabético/metabolismo , Prevalência , Estudos Prospectivos
10.
J Clin Sleep Med ; 9(11): 1165-71, 2013 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-24235898

RESUMO

OBJECTIVE: To evaluate the relation between obstructive sleep apnea (OSA) and left ventricular mass (LVM) in morbid obesity and the influence of gender, menopausal status, anthropometry, body composition, hypertension, and other cardiovascular risk factors in this relationship. DESIGN: Cross-sectional descriptive study. METHODS: Polysomnographic and echocardiographic studies were performed in a cohort of 242 patients (86 men, 100 premenopausal (PreM) and 56 postmenopausal (PostM) women), with grade II obesity and above (BMI: 43.7 ± 0.4 kg/m(2)) to investigate OSA and LVM respectively. Anthropometry, body composition, glucose tolerance, and blood pressure were also recorded. RESULTS: OSA to different degrees was diagnosed in 76.2% of the patients (n: 166), its prevalence being 90.9% (n: 70) for men, and 76% (n: 38) and 63.8% (n: 58) for PostM and PreM women, respectively (p < 0.01). LVM excess was greatest for PostM women (90.2%), followed by men (81.9%) and PreM females (69.6%) (p < 0.01). LVM values increased in accordance to OSA severity (absence, 193.7 ± 6.9 g; mild, 192.6 ± 7.8 g; moderate, 240.5 ± 12.5 g; severe, 273.6 ± 14.6 g; p < 0.01). LVM magnitude correlated with the menopausal state, age, central adiposity, hypertension (HT), type 2 diabetes (DM), desaturation index (DI), and apnea-hypopnea index (AHI) (r = 0.41; p < 0.01). The relationship between LVM and AHI persisted in the multivariate analysis (ß = 0.25; p < 0.05) after adjusting for age, gender, menopausal state, BMI, waist circumference, neck circumference, DI, fasting plasma glucose, DM, and HT. But if tobacco habits are included, the statistical difference disappears (ß = 0.22; p = 0.06). CONCLUSIONS: Morbid obesity is frequently associated with abnormal LVM, particularly in patients with OSA; this association is independent of HT, BMI, body composition, and other clinical factors, supporting a direct role of OSA on LVM in morbid obesity. This suggests that OSA and LVM might be taken as predictors of the cardiovascular risk in these patients.


Assuntos
Doenças Cardiovasculares/epidemiologia , Ventrículos do Coração/anatomia & histologia , Obesidade Mórbida/epidemiologia , Apneia Obstrutiva do Sono/epidemiologia , Adulto , Antropometria/métodos , Composição Corporal , Doenças Cardiovasculares/fisiopatologia , Comorbidade , Estudos Transversais , Ecocardiografia/métodos , Feminino , Humanos , Hipertensão/epidemiologia , Hipertensão/fisiopatologia , Masculino , Menopausa , Obesidade Mórbida/fisiopatologia , Tamanho do Órgão , Polissonografia/métodos , Fatores de Risco , Índice de Gravidade de Doença , Fatores Sexuais , Apneia Obstrutiva do Sono/fisiopatologia , Espanha/epidemiologia
11.
Rev. esp. cardiol. (Ed. impr.) ; 66(10): 812-818, oct. 2013. ^f812^l818
Artigo em Espanhol | IBECS | ID: ibc-115597

RESUMO

Introducción y objetivos. La cirugía bariátrica es una herramienta eficaz de control metabólico para pacientes obesos diabéticos. El objetivo de este trabajo es determinar la evolución del peso y el metabolismo glucídico y lipídico en pacientes obesos diabéticos intervenidos de cirugía bariátrica, durante los primeros 4 años tras la intervención. Métodos. Estudio retrospectivo de 104 pacientes (71 mujeres; media de edad, 53,0 ± 0,9 años; índice de masa corporal, 46,8 ± 0,7) con diabetes mellitus tipo 2 de una mediana de 3 años de evolución, a los que se practicó bypass gástrico proximal laparoscópico. Resultados. La glucemia y la concentración de glucohemoglobina descendieron durante los primeros 1-3 meses y se mantuvieron estables hasta los 4 años, lo que permitió eliminar el tratamiento hipoglucemiante al 80% de los pacientes. No observamos diferencias en función del índice de masa corporal, tiempo de evolución de la diabetes mellitus o el tratamiento antidiabético previo. El peso descendió hasta los 15-24 meses, con ligera recuperación posterior. Los valores de colesterol total, triglicéridos y lipoproteínas de baja densidad mejoraron significativamente, y se había obtenido valores objetivo en alrededor del 80% de los pacientes a partir de 12 meses. Estos descensos no se correlacionaron con los cambios de peso. Las lipoproteínas de alta densidad descendieron hasta los 12 meses, con una pequeña recuperación posterior, a pesar de lo cual el 85% de los pacientes presentaban valores objetivo 24 meses tras la cirugía. Conclusiones. La cirugía bariátrica es eficaz para el tratamiento de pacientes diabéticos obesos, mejora su control metabólico y reduce el riesgo cardiovascular (AU)


Introduction and objectives. Bariatric surgery is a valuable tool for metabolic control in obese diabetic patients. The aim of this study was to determine changes in weight and carbohydrate and lipid metabolism in obese diabetic patients during the first 4 years after bariatric surgery. Methods. A retrospective study was performed in 104 patients (71 women; mean age, 53.0 [0.9] years; mean body mass index, 46.8 [0.7]) with type 2 diabetes mellitus (median duration, 3 years) who underwent laparoscopic proximal gastric bypass. Results. Blood glucose levels and glycated hemoglobin concentrations decreased during the first 1-3 postoperative months. Values stabilized for the rest of the study period, allowing hypoglycemic treatment to be discontinued in 80% of the patients. No significant differences were observed as a function of the body mass index, diabetes mellitus duration, or previous antidiabetic treatment. Weight decreased during the first 15-24 months and slightly increased afterward. Levels of total cholesterol, triglycerides, and low-density lipoprotein significantly decreased, and target values were reached after 12 months in 80% of the patients. No correlation was found between these reductions and weight loss. Similarly, high-density lipoprotein concentrations decreased until 12 months after surgery. Although concentrations showed a subsequent slight increase, target or lower high-density lipoprotein values were achieved at 24 months postintervention in 85% of the patients. Conclusions. Bariatric surgery is effective for the treatment of obese diabetic patients, contributing to their metabolic control and reducing their cardiovascular risk (AU)


Assuntos
Humanos , Masculino , Feminino , Obesidade/complicações , Cirurgia Bariátrica , Fatores de Risco , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/prevenção & controle , Hipercolesterolemia/complicações , Hipercolesterolemia/diagnóstico , Hipoglicemia/complicações , Hipoglicemia/diagnóstico , Lipoproteínas HDL/análise , Lipoproteínas LDL/análise , Estudos Retrospectivos , Complicações do Diabetes/diagnóstico , Índice de Massa Corporal , Glicemia/análise , Índice Glicêmico
12.
Rev Esp Cardiol (Engl Ed) ; 66(10): 812-8, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24773862

RESUMO

INTRODUCTION AND OBJECTIVES: Bariatric surgery is a valuable tool for metabolic control in obese diabetic patients. The aim of this study was to determine changes in weight and carbohydrate and lipid metabolism in obese diabetic patients during the first 4 years after bariatric surgery. METHODS: A retrospective study was performed in 104 patients (71 women; mean age, 53.0 [0.9] years; mean body mass index, 46.8 [0.7]) with type 2 diabetes mellitus (median duration, 3 years) who underwent laparoscopic proximal gastric bypass. RESULTS: Blood glucose levels and glycated hemoglobin concentrations decreased during the first 1-3 postoperative months. Values stabilized for the rest of the study period, allowing hypoglycemic treatment to be discontinued in 80% of the patients. No significant differences were observed as a function of the body mass index, diabetes mellitus duration, or previous antidiabetic treatment. Weight decreased during the first 15-24 months and slightly increased afterward. Levels of total cholesterol, triglycerides, and low-density lipoprotein significantly decreased, and target values were reached after 12 months in 80% of the patients. No correlation was found between these reductions and weight loss. Similarly, high-density lipoprotein concentrations decreased until 12 months after surgery. Although concentrations showed a subsequent slight increase, target or lower high-density lipoprotein values were achieved at 24 months postintervention in 85% of the patients. CONCLUSIONS: Bariatric surgery is effective for the treatment of obese diabetic patients, contributing to their metabolic control and reducing their cardiovascular risk.


Assuntos
Cirurgia Bariátrica/métodos , Doenças Cardiovasculares/epidemiologia , Diabetes Mellitus Tipo 2/epidemiologia , Obesidade Mórbida/cirurgia , Medição de Risco , Adulto , Glicemia/metabolismo , Índice de Massa Corporal , Doenças Cardiovasculares/metabolismo , Doenças Cardiovasculares/prevenção & controle , Estudos de Coortes , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/metabolismo , Feminino , Seguimentos , Humanos , Lipoproteínas HDL/metabolismo , Masculino , Pessoa de Meia-Idade , Obesidade Mórbida/diagnóstico , Obesidade Mórbida/epidemiologia , Obesidade Mórbida/metabolismo , Estudos Retrospectivos , Comportamento de Redução do Risco , Análise de Sobrevida , Fatores de Tempo , Resultado do Tratamento , Perda de Peso
13.
Diabetes Care ; 36(5): 1061-6, 2013 May.
Artigo em Inglês | MEDLINE | ID: mdl-23223407

RESUMO

OBJECTIVE: Hyperglycemia may increase mortality in patients who receive total parenteral nutrition (TPN). However, this has not been well studied in noncritically ill patients (i.e., patients in the nonintensive care unit setting). The aim of this study was to determine whether mean blood glucose level during TPN infusion is associated with increased mortality in noncritically ill hospitalized patients. RESEARCH DESIGN AND METHODS: This prospective multicenter study involved 19 Spanish hospitals. Noncritically ill patients who were prescribed TPN were included prospectively, and data were collected on demographic, clinical, and laboratory variables as well as on in-hospital mortality. RESULTS: The study included 605 patients (mean age 63.2 ± 15.7 years). The daily mean TPN values were 1.630 ± 323 kcal, 3.2 ± 0.7 g carbohydrates/kg, 1.26 ± 0.3 g amino acids/kg, and 0.9 ± 0.2 g lipids/kg. Multiple logistic regression analysis showed that the patients who had mean blood glucose levels >180 mg/dL during the TPN infusion had a risk of mortality that was 5.6 times greater than those with mean blood glucose levels <140 mg/dL (95% CI 1.47-21.4 mg/dL) after adjusting for age, sex, nutritional state, presence of diabetes or hyperglycemia before starting TPN, diagnosis, prior comorbidity, carbohydrates infused, use of steroid therapy, SD of blood glucose level, insulin units supplied, infectious complications, albumin, C-reactive protein, and HbA1c levels. CONCLUSIONS: Hyperglycemia (mean blood glucose level >180 mg/dL) in noncritically ill patients who receive TPN is associated with a higher risk of in-hospital mortality.


Assuntos
Estado Terminal/mortalidade , Mortalidade Hospitalar , Hiperglicemia/etiologia , Hiperglicemia/mortalidade , Nutrição Parenteral Total/efeitos adversos , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
14.
Endocrinol. nutr. (Ed. impr.) ; 55(9): 420-432, nov. 2008. ilus
Artigo em Espanhol | IBECS | ID: ibc-70731

RESUMO

La obesidad abdominal (OA) constituye, junto con la resistencia insulínica, la base fisiopatológica del síndrome metabólico. El exceso de tejido adiposo visceral (TAV) desempeña un papel clave en las comorbilidades de la OA. La esteatosis multiorgánica promociona la resistencia insulínica, el estrés oxidativo y la inflamación, lo que da lugar a disfunción endotelial y arteriosclerosis. El exceso de TAV conduce a un perfil metabólico de riesgo independientemente de la cifra de índice de masa corporal. Los recientes estudios epidemiológicos defienden que es necesario medir sistemáticamente el perímetro de cintura (PC) en lav aloración de la obesidad, así como incluir el valor del PC y los parámetros de síndrome metabólico en las escalas de valoración del riesgo cardiometabólico. La potencial capacidad patógena de la OA debe ser tenida en cuenta en la valoración de cualquier cuadro en que el riesgo cardiometabólico sea un objetivo de acción preventiva o terapéutica (AU)


Abdominal obesity (AO), together with insulin resistance, forms the pathophysiological basis of metabolic syndrome. Excess visceral adipose tissue(VAT) plays a key role in the comorbidity associated with AO. Multiorgan steatosispromotes insulin resistance, oxidative stress and inflammation, giving rise to endothelial dysfunction andatherosclerosis. Excess VAT leads to ametabolic risk profile regardless of body mass index. Recent epidemiological studies confirm the need to measure waist circumference when evaluating obese patients and to include this value and metabolic syndrome parameters in scales to assess cardio metabolic risk. The pathogenic capacity of AO should be taken into account when evaluating any condition in which reducing cardiometabolic risk is a preventive or therapeutic goal (AU)


Assuntos
Humanos , Obesidade Mórbida/fisiopatologia , Síndrome Metabólica/fisiopatologia , Fatores de Risco , Estresse Oxidativo , Resistência à Insulina , Inflamação/fisiopatologia , Doenças Cardiovasculares/prevenção & controle
15.
Endocrinol Nutr ; 55(9): 420-32, 2008 Oct.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-22974455

RESUMO

Abdominal obesity (AO), together with insulin resistance, forms the pathophysiological basis of metabolic syndrome. Excess visceral adipose tissue (VAT) plays a key role in the comorbidity associated with AO. Multiorgan steatosis promotes insulin resistance, oxidative stress and inflammation, giving rise to endothelial dysfunction and atherosclerosis. Excess VAT leads to a metabolic risk profile regardless of body mass index. Recent epidemiological studies confirm the need to measure waist circumference when evaluating obese patients and to include this value and metabolic syndrome parameters in scales to assess cardiometabolic risk. The pathogenic capacity of AO should be taken into account when evaluating any condition in which reducing cardiometabolic risk is a preventive or therapeutic goal.

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