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1.
Nutr Metab Cardiovasc Dis ; 31(11): 3227-3235, 2021 10 28.
Artigo em Inglês | MEDLINE | ID: mdl-34629249

RESUMO

BACKGROUND AND AIMS: It is known that the highest COVID-19 mortality rates are among patients who develop severe COVID-19 pneumonia. However, despite the high sensitivity of chest CT scans for diagnosing COVID-19 in a screening population, the appearance of a chest CT is thought to have low diagnostic specificity. The aim of this retrospective case-control study is based on evaluation of clinical and radiological characteristics in patients with COVID-19 (n = 41) and no-COVID-19 interstitial pneumonia (n = 48) with mild-to-moderate symptoms. METHODS AND RESULTS: To this purpose we compared radiological, clinical, biochemical, inflammatory, and metabolic characteristics, as well as clinical outcomes, between the two groups. Notably, we found similar radiological severity of pneumonia, which we quantified using a disease score based on a high-resolution computed tomography scan (COVID-19 = 18.6 ± 14.5 vs n-COVID-19 = 23.2 ± 15.2, p = 0.289), and comparable biochemical and inflammatory characteristics. However, among patients without diabetes, we observed that COVID-19 patients had significantly higher levels of HbA1c than n-COVID-19 patients (COVID-19 = 41.5 ± 2.6 vs n-COVID-19 = 38.4 ± 5.1, p = 0.012). After adjusting for age, sex, and BMI, we found that HbA1c levels were significantly associated with the risk of COVID-19 pneumonia (odds ratio = 1.234 [95%CI = 1.051-1.449], p = 0.010). CONCLUSIONS: In this retrospective case-control study, we found similar radiological and clinical characteristics in patients with COVID-19 and n-COVID-19 pneumonia with mild-to-moderate symptoms. However, among patients without diabetes HbA1c levels were higher in COVID-19 patients than in no-COVID-19 individuals. Future studies should assess whether reducing transient hyperglycemia in individuals without overt diabetes may lower the risk of SARS-CoV-2 infection.


Assuntos
COVID-19/diagnóstico por imagem , Doenças Pulmonares Intersticiais/diagnóstico por imagem , Pneumonia/diagnóstico por imagem , Idoso , Idoso de 80 Anos ou mais , COVID-19/sangue , Estudos de Casos e Controles , Diabetes Mellitus/sangue , Feminino , Hemoglobina A Glicada/análise , Humanos , Doenças Pulmonares Intersticiais/sangue , Masculino , Pessoa de Meia-Idade , Pneumonia/sangue , Estudos Retrospectivos , Fatores de Risco , SARS-CoV-2 , Índice de Gravidade de Doença , Tomografia Computadorizada por Raios X/métodos
2.
Nutr Metab Cardiovasc Dis ; 31(11): 3024-3030, 2021 10 28.
Artigo em Inglês | MEDLINE | ID: mdl-34625361

RESUMO

BACKGROUND AND AIMS: Triglyceride-Glucose (TyG) index is an accurate biomarker of insulin resistance, which is potentially associated with adverse cardiovascular events. We aimed to assess the dose-response relationship between Triglyceride-Glucose (TyG) Index and Major Adverse Cardiovascular Events (MACE) in patients with Acute Coronary Syndrome (ACS). METHODS AND RESULTS: A systematic literature search was performed using PubMed, Scopus, and Embase for records published from the inception up until 7 February 2021. Studies that fulfilled all of these criteria were included: 1) prospective or retrospective observational studies reporting patients with ACS and 2) assessing the impact of TyG index on MACE with at least three quantitative classifications. The outcome of interest is MACE across the TyG index intervals. MACE was a composite of all-cause mortality, myocardial infarction, unstable angina pectoris, target vessel revascularization, cerebrovascular accidents, and heart failure. The effect estimates were reported as relative risks (RRs). There are 13,684 subjects from 4 studies included in this meta-analysis. This meta-analysis showed that the highest category of TyG index was associated with twofold MACE (RR 2.09 [1.59, 2.76], p < 0.001; I2: 68.4%, p = 0.02) compared to the lowest category in patients with ACS. Dose-response meta-analysis showed that the relationship between TyG index and MACE was non-linear (p < 0.001), with statistical significance reached around TyG index 8.9 and increased non-linearly. The dose-response curve became significantly steeper after TyG index of 9.1-9.2. CONCLUSION: TyG index was associated with MACE in patients with ACS in a non-linear fashion. PROSPERO: CRD42021235765.


Assuntos
Síndrome Coronariana Aguda/sangue , Glicemia/metabolismo , Diabetes Mellitus/sangue , Resistência à Insulina , Triglicerídeos/sangue , Síndrome Coronariana Aguda/diagnóstico , Síndrome Coronariana Aguda/mortalidade , Síndrome Coronariana Aguda/terapia , Biomarcadores/sangue , Diabetes Mellitus/diagnóstico , Progressão da Doença , Humanos , Revascularização Miocárdica , Valor Preditivo dos Testes , Prognóstico , Medição de Risco , Fatores de Risco
3.
Nutr Metab Cardiovasc Dis ; 31(11): 3176-3183, 2021 10 28.
Artigo em Inglês | MEDLINE | ID: mdl-34629254

RESUMO

BACKGROUND AND AIMS: High hemoglobin A1c (HbAlc) level is associated with increased cardiovascular disease risk and thromboembolic events [1]. The study sought to explored the association between HbAlc and left atrial appendage flow velocity (LAAV) among non-valvular atrial fibrillation (AF) patients. METHODS AND RESULTS: A total of 249 consecutive non-valvular AF patients who underwent transesophageal echocardiography (TEE) were divided into two subgroups according to the median of LAAV level (<45 cm/s, ≥45 cm/s). Blood samples and other baseline clinical data of all patients were collected and analyzed. The low LAAV group included 126 patients and the high LAAV group included 123 patients. Patients in the low LAAV group were older and had a higher percentage of persistent AF, chronic heart failure, and higher CHA2DS2-VASc score (P < 0.05). HbAlc level in the low LAAV group was significantly higher than the high LAAV group [6.1 (5.7-6.5)% vs 5.9 (5.6-6.2)%, P = 0.010]. The low LAAV group had larger left atrial diameter (LAD), left atrial area (LAA), higher left atrial pressure (LAP), and lower left ventricular ejection fraction (LVEF) (P < 0.05). Spearman rank correlation analysis showed that the HbAlc level was negatively correlated with LAAV (r = -0.211, P = 0.001). Multivariate analysis indicated that female gender (OR = 2.233, 95% CI 1.110-4.492, P = 0.024), persistent AF (OR = 6.610, 95% CI 3.109-14.052, P < 0.001), and HbAlc (OR = 1.903, 95% CI 1.092-3.317, P = 0.023) were independent factors that associated with low LAAV in AF patients. CONCLUSION: Increased HbAlc level is associated with decreased LAAV and may reflect a low contractile function of the left atrial appendage.


Assuntos
Apêndice Atrial/fisiopatologia , Fibrilação Atrial/fisiopatologia , Função do Átrio Esquerdo , Diabetes Mellitus/sangue , Hemoglobina A Glicada/metabolismo , Idoso , Apêndice Atrial/diagnóstico por imagem , Fibrilação Atrial/diagnóstico por imagem , Fibrilação Atrial/etiologia , Biomarcadores/sangue , Velocidade do Fluxo Sanguíneo , Circulação Coronária , Diabetes Mellitus/diagnóstico , Ecocardiografia Doppler , Ecocardiografia Transesofagiana , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição de Risco , Fatores de Risco , Regulação para Cima
4.
Mol Med ; 27(1): 129, 2021 10 18.
Artigo em Inglês | MEDLINE | ID: mdl-34663207

RESUMO

BACKGROUND: Host inflammation contributes to determine whether SARS-CoV-2 infection causes mild or life-threatening disease. Tools are needed for early risk assessment. METHODS: We studied in 111 COVID-19 patients prospectively followed at a single reference Hospital fifty-three potential biomarkers including alarmins, cytokines, adipocytokines and growth factors, humoral innate immune and neuroendocrine molecules and regulators of iron metabolism. Biomarkers at hospital admission together with age, degree of hypoxia, neutrophil to lymphocyte ratio (NLR), lactate dehydrogenase (LDH), C-reactive protein (CRP) and creatinine were analysed within a data-driven approach to classify patients with respect to survival and ICU outcomes. Classification and regression tree (CART) models were used to identify prognostic biomarkers. RESULTS: Among the fifty-three potential biomarkers, the classification tree analysis selected CXCL10 at hospital admission, in combination with NLR and time from onset, as the best predictor of ICU transfer (AUC [95% CI] = 0.8374 [0.6233-0.8435]), while it was selected alone to predict death (AUC [95% CI] = 0.7334 [0.7547-0.9201]). CXCL10 concentration abated in COVID-19 survivors after healing and discharge from the hospital. CONCLUSIONS: CXCL10 results from a data-driven analysis, that accounts for presence of confounding factors, as the most robust predictive biomarker of patient outcome in COVID-19.


Assuntos
COVID-19/diagnóstico , Quimiocina CXCL10/sangue , Doença da Artéria Coronariana/diagnóstico , Diabetes Mellitus/diagnóstico , Hipertensão/diagnóstico , Biomarcadores/sangue , Proteína C-Reativa/metabolismo , COVID-19/sangue , COVID-19/imunologia , COVID-19/mortalidade , Comorbidade , Doença da Artéria Coronariana/sangue , Doença da Artéria Coronariana/imunologia , Doença da Artéria Coronariana/mortalidade , Creatina/sangue , Diabetes Mellitus/sangue , Diabetes Mellitus/imunologia , Diabetes Mellitus/mortalidade , Feminino , Hospitalização , Humanos , Hipertensão/sangue , Hipertensão/imunologia , Hipertensão/mortalidade , Imunidade Humoral , Imunidade Inata , Inflamação , Unidades de Terapia Intensiva , L-Lactato Desidrogenase/sangue , Contagem de Leucócitos , Linfócitos/imunologia , Linfócitos/patologia , Masculino , Pessoa de Meia-Idade , Neutrófilos/imunologia , Neutrófilos/patologia , Prognóstico , Estudos Prospectivos , Estudos Retrospectivos , SARS-CoV-2 , Índice de Gravidade de Doença , Análise de Sobrevida
5.
Nutrients ; 13(10)2021 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-34684324

RESUMO

Granular study of metabolic responses to alterations in the ratio of dietary macro-nutrients can enhance our understanding of how dietary modifications influence patients with impaired glycemic control. In order to study the effect of diets enriched in fat or carbohydrates, fifteen healthy, normal-weight volunteers received, in a cross-over design, and in a randomized unblinded order, two weeks of an iso-caloric high-fat diet (HFD: 60E% from fat) and a high-carbohydrate diet (HCD: 60E% from carbohydrates). A mixed meal test (MMT) was performed at the end of each dietary period to examine glucose clearance kinetics and insulin and incretin hormone levels, as well as plasma metabolomic profiles. The MMT induced almost identical glycemia and insulinemia following the HFD or HCD. GLP-1 levels were higher after the HFD vs. HCD, whereas GIP did not differ. The HFD, compared to the HCD, increased the levels of several metabolomic markers of risk for the development of insulin resistance, e.g., branched-chain amino acid (valine and leucine), creatine and α-hydroxybutyric acid levels. In normal-weight, healthy volunteers, two weeks of the HFD vs. HCD showed similar profiles of meal-induced glycemia and insulinemia. Despite this, the HFD showed a metabolomic pattern implying a risk for a metabolic shift towards impaired insulin sensitivity in the long run.


Assuntos
Voluntários Saudáveis , Adaptação Fisiológica , Adulto , Apetite , Glicemia/metabolismo , Estudos Cross-Over , Diabetes Mellitus/sangue , Dieta Hiperlipídica , Carboidratos da Dieta , Análise Discriminante , Feminino , Polipeptídeo Inibidor Gástrico/sangue , Peptídeo 1 Semelhante ao Glucagon/sangue , Controle Glicêmico , Humanos , Incretinas/sangue , Insulina/sangue , Resistência à Insulina , Análise dos Mínimos Quadrados , Masculino , Metaboloma , Fatores de Risco
6.
Nutrients ; 13(10)2021 Oct 11.
Artigo em Inglês | MEDLINE | ID: mdl-34684558

RESUMO

Markers of iron metabolism are altered in new-onset diabetes, but their relationship with metabolic signals involved in the maintenance of energy balance is poorly understood. The primary aim was to explore the associations between markers of iron metabolism (hepcidin and ferritin) and markers of energy balance (leptin, ghrelin, and the leptin/ghrelin ratio) in both the fasted and postprandial states. These associations were also studied in the sub-groups stratified by diabetes status. This was a cross-sectional study of individuals without disorders of iron metabolism who were investigated after an overnight fast and, in addition, some of these individuals underwent a mixed meal test to determine postprandial responses of metabolic signals. The associations between hepcidin, ferritin, and leptin, ghrelin, leptin/ghrelin ratio were studied using several multiple linear regression models. A total of 76 individuals in the fasted state and 34 individuals in the postprandial state were included. In the overall cohort, hepcidin was significantly inversely associated with leptin (in the most adjusted model, the ß coefficient ± SE was -883.45 ± 400.94; p = 0.031) and the leptin/ghrelin ratio (in the most adjusted model, the ß coefficient ± SE was -148.26 ± 61.20; p = 0.018) in the fasted state. The same associations were not statistically significant in the postprandial state. In individuals with new-onset prediabetes or diabetes (but not in those with normoglycaemia or longstanding prediabetes or diabetes), hepcidin was significantly inversely associated with leptin (in the most adjusted model, the ß coefficient ± SE was -806.09 ± 395.44; p = 0.050) and the leptin/ghrelin ratio (in the most adjusted model, the ß coefficient ± SE was -129.40 ± 59.14; p = 0.037). Leptin appears to be a mediator in the link between iron metabolism and new-onset diabetes mellitus. These findings add to the growing understanding of mechanisms underlying the derangements of glucose metabolism.


Assuntos
Metabolismo Energético/fisiologia , Jejum/sangue , Ferritinas/sangue , Hepcidinas/sangue , Período Pós-Prandial/fisiologia , Estudos Transversais , Diabetes Mellitus/sangue , Feminino , Grelina/sangue , Humanos , Leptina/sangue , Modelos Lineares , Masculino , Refeições/fisiologia , Pessoa de Meia-Idade
7.
PLoS One ; 16(10): e0257940, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34618834

RESUMO

The objective of this study was to examine the link between systemic and general psychosocial stress and cardiovascular disease (CVD) risk in a group of U.S. Latinos as a function of acculturation and education within the blended guiding conceptual framework of the biopsychosocial model of the stress process plus the reserve capacity model. We analyzed data from self-identifying Mexican-origin adults (n = 396, 56.9% female, Mage = 58.2 years, 55.5% < 12 years of education, 79% U.S.-born) from the Texas City Stress and Health Study. We used established measures of perceived stress (general stress), neighborhood stress and discrimination (systemic stress) to capture psychosocial stress, our primary predictor. We used the atherosclerotic CVD calculator to assess 10-year CVD risk, our primary outcome. This calculator uses demographics, cholesterol, blood pressure, and history of hypertension, smoking, and diabetes to compute CVD risk in the next 10 years. We also created an acculturation index using English-language use, childhood interaction, and preservation of cultural values. Participants reported years of education. Contrary to expectations, findings showed that higher levels of all three forms of psychosocial stress, perceived stress, neighborhood stress, and perceived discrimination, predicted lower 10-year CVD risk. Acculturation and education did not moderate the effects of psychosocial stress on 10-year CVD risk. Contextualized within the biopsychosocial and reserve capacity framework, we interpret our findings such that participants who accurately reported their stressors may have turned to their social networks to handle the stress, thereby reducing their risk for CVD. We highlight the importance of examining strengths within the sociocultural environment when considering cardiovascular inequities among Latinos.


Assuntos
Doenças Cardiovasculares/epidemiologia , Diabetes Mellitus/epidemiologia , Fatores de Risco de Doenças Cardíacas , Hipertensão/epidemiologia , Aculturação , Adulto , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/patologia , Doenças Cardiovasculares/psicologia , Criança , Colesterol/sangue , Diabetes Mellitus/sangue , Diabetes Mellitus/patologia , Diabetes Mellitus/psicologia , Feminino , Hispano-Americanos/psicologia , Humanos , Hipertensão/sangue , Hipertensão/patologia , Hipertensão/psicologia , Masculino , Americanos Mexicanos/psicologia , Características de Residência , Fumar , Estresse Psicológico/fisiopatologia
8.
Front Endocrinol (Lausanne) ; 12: 727419, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34589058

RESUMO

Background: Blood parameters, such as neutrophil-to-lymphocyte ratio, have been identified as reliable inflammatory markers with diagnostic and predictive value for the coronavirus disease 2019 (COVID-19). However, novel hematological parameters derived from high-density lipoprotein-cholesterol (HDL-C) have rarely been studied as indicators for the risk of poor outcomes in patients with severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) infection. Here, we aimed to assess the prognostic value of these novel biomarkers in COVID-19 patients and the diabetes subgroup. Methods: We conducted a multicenter retrospective cohort study involving all hospitalized patients with COVID-19 from January to March 2020 in five hospitals in Wuhan, China. Demographics, clinical and laboratory findings, and outcomes were recorded. Neutrophil to HDL-C ratio (NHR), monocyte to HDL-C ratio (MHR), lymphocyte to HDL-C ratio (LHR), and platelet to HDL-C ratio (PHR) were investigated and compared in both the overall population and the subgroup with diabetes. The associations between blood parameters at admission with primary composite end-point events (including mechanical ventilation, admission to the intensive care unit, or death) were analyzed using Cox proportional hazards regression models. Receiver operating characteristic curves were used to compare the utility of different blood parameters. Results: Of 440 patients with COVID-19, 67 (15.2%) were critically ill. On admission, HDL-C concentration was decreased while NHR was high in patients with critical compared with non-critical COVID-19, and were independently associated with poor outcome as continuous variables in the overall population (HR: 0.213, 95% CI 0.090-0.507; HR: 1.066, 95% CI 1.030-1.103, respectively) after adjusting for confounding factors. Additionally, when HDL-C and NHR were examined as categorical variables, the HRs and 95% CIs for tertile 3 vs. tertile 1 were 0.280 (0.128-0.612) and 4.458 (1.817-10.938), respectively. Similar results were observed in the diabetes subgroup. ROC curves showed that the NHR had good performance in predicting worse outcomes. The cutoff point of the NHR was 5.50. However, the data in our present study could not confirm the possible predictive effect of LHR, MHR, and PHR on COVID-19 severity. Conclusion: Lower HDL-C concentrations and higher NHR at admission were observed in patients with critical COVID-19 than in those with noncritical COVID-19, and were significantly associated with a poor prognosis in COVID-19 patients as well as in the diabetes subgroup.


Assuntos
COVID-19/sangue , HDL-Colesterol/sangue , Diabetes Mellitus/sangue , Idoso , Biomarcadores/sangue , COVID-19/diagnóstico , COVID-19/mortalidade , China , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/mortalidade , Feminino , Humanos , Estimativa de Kaplan-Meier , Leucócitos/citologia , Masculino , Pessoa de Meia-Idade , Prognóstico , Curva ROC , Estudos Retrospectivos , Índice de Gravidade de Doença
10.
Nutrients ; 13(9)2021 Sep 17.
Artigo em Inglês | MEDLINE | ID: mdl-34579110

RESUMO

Vitamin B6 is a fascinating molecule involved in the vast majority of changes in the human body because it is a coenzyme involved in over 150 biochemical reactions. It is active in the metabolism of carbohydrates, lipids, amino acids, and nucleic acids, and participates in cellular signaling. It is an antioxidant and a compound with the ability to lower the advanced glycation end products (AGE) level. In this review, we briefly summarize its involvement in biochemical pathways and consider whether its deficiency may be associated with various diseases such as diabetes, heart disease, cancer, or the prognosis of COVID-19.


Assuntos
Fenômenos Fisiológicos da Nutrição , Estado Nutricional , Deficiência de Vitamina B 6/complicações , Vitamina B 6/sangue , COVID-19/sangue , Diabetes Mellitus/sangue , Cardiopatias/sangue , Humanos , Neoplasias/sangue , Fatores de Risco , SARS-CoV-2 , Transdução de Sinais
11.
Endocrinol Diabetes Metab ; 4(4): e00291, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34505406

RESUMO

AIM: Diabetes has been identified as a risk factor for poor outcomes in patients with COVID-19. We examined the association of hyperglycaemia, both in the presence and absence of pre-existing diabetes, with severity and outcomes in COVID-19 patients. METHODS: Data from 74,148 COVID-19-positive inpatients with at least one recorded glucose measurement during their inpatient episode were analysed for presence of pre-existing diabetes diagnosis and any glucose values in the hyperglycaemic range (>180 mg/dl). RESULTS: Among patients with and without a pre-existing diabetes diagnosis on admission, mortality was substantially higher in the presence of high glucose measurements versus all measurements in the normal range (70-180 mg/dl) in both groups (non-diabetics: 21.7% vs. 3.3%; diabetics 14.4% vs. 4.3%). When adjusting for patient age, BMI, severity on admission and oxygen saturation on admission, this increased risk of mortality persisted and varied by diabetes diagnosis. Among patients with a pre-existing diabetes diagnosis, any hyperglycaemic value during the episode was associated with a substantial increase in the odds of mortality (OR: 1.77, 95% CI: 1.52-2.07); among patients without a pre-existing diabetes diagnosis, this risk nearly doubled (OR: 3.07, 95% CI: 2.79-3.37). CONCLUSION: This retrospective analysis identified hyperglycaemia in COVID-19 patients as an independent risk factor for mortality after adjusting for the presence of diabetes and other known risk factors. This indicates that the extent of glucose control could serve as a mechanism for modifying the risk of COVID-19 morality in the inpatient environment.


Assuntos
Glicemia , COVID-19/epidemiologia , Diabetes Mellitus/epidemiologia , Hiperglicemia/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , COVID-19/sangue , COVID-19/mortalidade , Diabetes Mellitus/sangue , Diabetes Mellitus/mortalidade , Feminino , Humanos , Hiperglicemia/sangue , Hiperglicemia/mortalidade , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Taxa de Sobrevida
13.
Rev. bras. med. esporte ; 27(3): 311-314, July-Sept. 2021. tab
Artigo em Inglês | LILACS | ID: biblio-1288589

RESUMO

ABSTRACT Introduction Diabetes is a metabolic disease characterized by hyperglycemia. It is a metabolic syndrome in which blood sugar levels increase due to defects in insulin secretion or impaired function, or even both defects. Object To understand the effect of diabetic patients in controlling blood sugar through physical exercise, the paper analyzes the correlation between the exercise status and physiological indicators of diabetic patients in our hospital. Methods We randomly selected 41 diabetic patients and monitored their exercise. At the same time, we check the physiological indicators of the patients after the exercise is completed and analyze the control of blood sugar by sports. Results After healthy physical exercise, the blood sugar level of diabetic patients tended to stabilize, and the glycosylated hemoglobin level decreased. The blood sugar levels of patients who did not participate in healthy physical exercises were not stable, and their glycosylated hemoglobin levels did not improve. Conclusion Healthy sports is a simple, easy, safe and effective adjuvant therapy for the prevention and treatment of diabetes, and it is worthy of clinical promotion. Level of evidence II; Therapeutic studies - investigation of treatment results.


RESUMO Introdução O diabetes é uma doença metabólica caracterizada por hiperglicemia. É uma síndrome metabólica em que os níveis de açúcar no sangue aumentam devido a defeitos na secreção de insulina ou função prejudicada, ou mesmo ambos os defeitos. Objetivo Para compreender os pacientes diabéticos no controle da glicemia por meio do exercício físico, o artigo analisa a correlação entre o estado de exercício e os indicadores fisiológicos de pacientes diabéticos em nosso hospital. Métodos Selecionamos aleatoriamente 41 pacientes diabéticos e monitoramos seus exercícios. Ao mesmo tempo, verificamos os indicadores fisiológicos dos pacientes após a realização do exercício e analisamos o controle da glicemia pelo esporte. Resultados Após exercícios físicos saudáveis, o nível de açúcar no sangue de pacientes diabéticos tendeu a se estabilizar e o nível de hemoglobina glicosilada diminuiu. Os níveis de açúcar no sangue dos pacientes que não praticavam exercícios físicos saudáveis não foram estáveis e os níveis de hemoglobina glicosilada não melhoraram. Conclusão O esporte saudável é uma terapia adjuvante simples, fácil, segura e eficaz para a prevenção e tratamento do diabetes e merece divulgação clínica. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.


RESUMEN Introducción la diabetes es una enfermedad metabólica caracterizada por hiperglucemia. Es un síndrome metabólico en el que los niveles de azúcar en sangre aumentan debido a defectos en la secreción de insulina o función alterada, o incluso a ambos defectos. Objeto Para comprender a los pacientes diabéticos en el control de la glucemia a través del ejercicio físico, el trabajo analiza la correlación entre el estado de ejercicio y los indicadores fisiológicos de los pacientes diabéticos en nuestro hospital. Métodos Seleccionamos aleatoriamente a 41 pacientes diabéticos y monitoreamos su ejercicio. Al mismo tiempo, verificamos los indicadores fisiológicos de los pacientes una vez finalizado el ejercicio y analizamos el control del azúcar en sangre mediante los deportes. Resultados Después de un ejercicio físico saludable, el nivel de azúcar en sangre de los pacientes diabéticos tendió a estabilizarse y el nivel de hemoglobina glicosilada disminuyó. Los niveles de azúcar en sangre de los pacientes que no participaron en ejercicios físicos saludables no fueron estables y sus niveles de hemoglobina glicosilada no mejoraron. Conclusión El deporte saludable es una terapia adyuvante simple, fácil, segura y eficaz para la prevención y el tratamiento de la diabetes y es digno de promoción clínica. Nivel de evidencia II; Estudios terapéuticos: investigación de los resultados del tratamiento.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Glicemia/análise , Hemoglobina A Glicada/análise , Exercício Físico/fisiologia , Diabetes Mellitus/sangue
14.
PLoS One ; 16(9): e0257789, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34570804

RESUMO

The most well-known and widely used mathematical representations of the physiology of a diabetic individual are the Sorensen and Hovorka models as well as the UVAPadova Simulator. While the Hovorka model and the UVAPadova Simulator only describe the glucose metabolism of a subject with type 1 diabetes, the Sorensen model was formulated to simulate the behaviour of both normal and diabetic individuals. The UVAPadova model is the most known model, accepted by the FDA, with a high level of complexity. The Hovorka model is the simplest of the three models, well documented and used primarily for the development of control algorithms. The Sorensen model is the most complete, even though some modifications were required both to the model equations (adding useful compartments for modelling subcutaneous insulin delivery) and to the parameter values. In the present work several simulated experiments, such as IVGTTs and OGTTs, were used as tools to compare the three formulations in order to establish to what extent increasing complexity translates into richer and more correct physiological behaviour. All the equations and parameters used for carrying out the simulations are provided.


Assuntos
Glucose/fisiologia , Insulina/fisiologia , Modelos Biológicos , Simulação por Computador , Diabetes Mellitus/sangue , Humanos
15.
Clin Appl Thromb Hemost ; 27: 10760296211045902, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34590493

RESUMO

INTRODUCTION: Diabetes is the most common of comorbidity in patients with SARS-COV-2 pneumonia. Coagulation abnormalities with D-dimer levels are increased in this disease. OBJECTIFS: We aimed to compare the levels of D-dimer in diabetic and non-diabetic patients with COVID 19. A link between D-dimer and mortality has also been established. MATERIALS: A retrospective study was carried out at the University Hospital Center of Oujda (Morocco) from November 01st to December 01st, 2020. Our study population was divided into two groups: a diabetic group and a second group without diabetes to compare clinical and biological characteristics between the two groups. In addition, the receiver operator characteristic curve was used to assess the optimal D-dimer cut-off point for predicting mortality in diabetics. RESULTS: 201 confirmed-COVID-19-patients were included in the final analysis. The median age was 64 (IQR 56-73), and 56% were male. Our study found that D-dimer levels were statistically higher in diabetic patients compared to non-diabetic patients. (1745 vs 845 respectively, P = 0001). D-dimer level > 2885 ng/mL was a significant predictor of mortality in diabetic patients with a sensitivity of 71,4% and a specificity of 70,7%. CONCLUSION: Our study found that diabetics with COVID-19 are likely to develop hypercoagulation with a poor prognosis.


Assuntos
COVID-19/sangue , Diabetes Mellitus/sangue , Produtos de Degradação da Fibrina e do Fibrinogênio/análise , SARS-CoV-2 , Trombofilia/sangue , Idoso , Área Sob a Curva , Biomarcadores , Proteína C-Reativa/análise , COVID-19/complicações , COVID-19/epidemiologia , Comorbidade , Complicações do Diabetes/sangue , Complicações do Diabetes/epidemiologia , Diabetes Mellitus/epidemiologia , Feminino , Mortalidade Hospitalar , Humanos , Hipertensão/epidemiologia , Inflamação/imunologia , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Estresse Oxidativo , Prognóstico , Curva ROC , Estudos Retrospectivos , Fatores de Risco , Trombofilia/etiologia , Trombofilia/imunologia
16.
PLoS One ; 16(9): e0256986, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34469502

RESUMO

Glycemic control is essential to manage metabolic diseases such as diabetes. Frequent measurements of systemic glucose levels with prompt managements can prevent organ damages. The eye is a glucose highly demanding organ in our body, and the anterior chamber (AC) in the eye has been suggested for a noninvasive blood glucose monitoring site. However, calculating blood glucose levels from measuring glucose levels in AC has been difficult and unclear. In this study, we aimed to examine glucose levels from AC and find a correlation with blood glucose levels. A total of 30 patients with cataracts (men and women, study 1; 7 and 3, study 2; 9 and 11) who visited Keio University Hospital from 2015 to 2018 and agreed to participate in this study were recruited. Glucose levels from AC and the blood were examined by a UV-hexokinase or H2O2-electrode method before/during the cataract surgery. These values were analyzed with regression analyses depending on the groups (blood glucose-ascending and descending groups). In the blood glucose-descending group, glucose levels from AC were strongly correlated with blood glucose levels (a high R2 value, 0.8636). However, the relatively moderate correlation was seen in the blood glucose-ascending group (a low R2 value, 0.5228). Taken together, we showed different correlation ratios on glucose levels between AC and the blood, based on blood glucose dynamics. Stacking data regarding this issue would enable establishing noninvasive blood glucose monitoring from measuring glucose levels in AC more correctly, which will be helpful for proper and prompt managements for glucose-mediated complications.


Assuntos
Câmara Anterior/química , Automonitorização da Glicemia/métodos , Glicemia/análise , Diabetes Mellitus/diagnóstico , Glucose/análise , Idoso , Idoso de 80 Anos ou mais , Câmara Anterior/cirurgia , Glicemia/efeitos dos fármacos , Extração de Catarata , Diabetes Mellitus/sangue , Diabetes Mellitus/tratamento farmacológico , Feminino , Humanos , Hipoglicemiantes/administração & dosagem , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
17.
PLoS One ; 16(9): e0255730, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34478451

RESUMO

OBJECTIVE: To evaluate the glycemic profile and its association with sociodemographic, anthropometric, clinical and lifestyle factors of Munduruku indigenous people. METHOD: Cross-sectional study with a quantitative and analytical approach, a total of 459 indigenous people (57.1% men, aged 36.3 ± 14.7 years old) belonging to the Munduruku ethnic group from the Kwatá-Laranjal Indigenous Land, in Amazonas, Brazil, were selected by probabilistic sampling in all households in the four most populous villages. Sociodemographic and anthropometric variables, blood pressure levels and lipid profile were evaluated. Fasting capillary blood glucose was measured with a digital device. The associations were assessed by multinomial logistic regression, and p-values≤0.05 were considered significant. RESULTS: For pre-diabetes, prevalence was 74.3% and, for diabetes, 12.2%. The variables associated with the risk for pre-diabetes were the following: age (OR = 1.03; 95% CI = 1.00 - 1.06) and obesity (OR = 9.69; 95% CI = 1.28 - 73.58). The positive associations indicating risk for diabetes were as follows: age (OR = 1.05; 95% CI = 1.03 - 1.08), overweight (OR = 4.17; 95% CI = 1.69 - 10.32) and obesity (OR = 35.26; 95% CI = 4.12 - 302.08). CONCLUSIONS: The risks associated with pre-diabetes and diabetes among the Munduruku indigenous people revealed a worrying index. It is necessary to consider changes in eating habits and lifestyle, as well as possible environmental and social changes that can affect this and other groups, with emphasis on those who live in vulnerable conditions.


Assuntos
Glicemia/análise , Diabetes Mellitus/epidemiologia , Hipertensão/fisiopatologia , Povos Indígenas/estatística & dados numéricos , Obesidade/fisiopatologia , Estado Pré-Diabético/epidemiologia , Adulto , Brasil/epidemiologia , Estudos Transversais , Diabetes Mellitus/sangue , Feminino , Humanos , Estilo de Vida , Masculino , Estado Pré-Diabético/sangue , Prevalência , Fatores de Risco
18.
Signal Transduct Target Ther ; 6(1): 300, 2021 08 11.
Artigo em Inglês | MEDLINE | ID: mdl-34381015

RESUMO

Elderly people and patients with comorbidities are at higher risk of COVID-19 infection, resulting in severe complications and high mortality. However, the underlying mechanisms are unclear. In this study, we investigate whether miRNAs in serum exosomes can exert antiviral functions and affect the response to COVID-19 in the elderly and people with diabetes. First, we identified four miRNAs (miR-7-5p, miR-24-3p, miR-145-5p and miR-223-3p) through high-throughput sequencing and quantitative real-time PCR analysis, that are remarkably decreased in the elderly and diabetic groups. We further demonstrated that these miRNAs, either in the exosome or in the free form, can directly inhibit S protein expression and SARS-CoV-2 replication. Serum exosomes from young people can inhibit SARS-CoV-2 replication and S protein expression, while the inhibitory effect is markedly decreased in the elderly and diabetic patients. Moreover, three out of the four circulating miRNAs are significantly increased in the serum of healthy volunteers after 8-weeks' continuous physical exercise. Serum exosomes isolated from these volunteers also showed stronger inhibitory effects on S protein expression and SARS-CoV-2 replication. Our study demonstrates for the first time that circulating exosomal miRNAs can directly inhibit SARS-CoV-2 replication and may provide a possible explanation for the difference in response to COVID-19 between young people and the elderly or people with comorbidities.


Assuntos
COVID-19/genética , Diabetes Mellitus/genética , MicroRNAs/genética , Glicoproteína da Espícula de Coronavírus/genética , Adulto , Fatores Etários , Idoso , COVID-19/sangue , COVID-19/patologia , COVID-19/virologia , China , MicroRNA Circulante/sangue , MicroRNA Circulante/genética , Estudos de Coortes , Diabetes Mellitus/sangue , Diabetes Mellitus/patologia , Diabetes Mellitus/virologia , Exercício Físico , Exossomos/genética , Exossomos/metabolismo , Exossomos/virologia , Feminino , Regulação da Expressão Gênica , Células HEK293 , Interações Hospedeiro-Patógeno/genética , Humanos , Masculino , MicroRNAs/sangue , Pessoa de Meia-Idade , SARS-CoV-2/genética , SARS-CoV-2/crescimento & desenvolvimento , SARS-CoV-2/metabolismo , Glicoproteína da Espícula de Coronavírus/sangue , Replicação Viral
19.
J Fam Pract ; 70(6S): S65-S70, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34432627

RESUMO

LEARNING OBJECTIVES: At the end of the activity, participant will be able to: • Identify patients who could benefit from continuous glucose monitoring (CGM) vs fingerstick blood glucose monitoring. • List the types of information provided by CGM systems. • Interpret CGM data using the ambulatory glucose profile (AGP) to assess if the patient is achieving targets established by the International Consensus on Time in Range. • Modify the treatment plan based on CGM data to improve patient outcomes.


Assuntos
Automonitorização da Glicemia , Diabetes Mellitus/sangue , Gerenciamento Clínico , Autogestão , Humanos
20.
Ann Clin Lab Sci ; 51(4): 535-539, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34452892

RESUMO

OBJECTIVE: Routine monitoring of hemoglobin A1c (HbA1c) is the standard of care in diabetes mellitus (DM), but adhering to regular laboratory appointments may be challenging when access to care is limited, such as during the initial wave of the COVID-19 pandemic in the United States in 2020. MATERIALS: We evaluated trends in patient encounters and laboratory testing for DM in a pediatric healthcare system from March to September 2019 and during the same period in 2020. RESULTS: Evaluation of 17,367 patient encounters illustrated that the pandemic was associated with significantly fewer in-person office visits and point-of-care HbA1c tests for patients with DM in 2020 relative to 2019. A separate analysis of 7,193 HbA1c results measured by point-of-care testing in the general population found a significant increase in the number of measured HbA1c >14 % in May 2020 relative to 2019, but other measured HbA1c values did not differ. As a means to address lapses in the monitoring of HbA1c due to the pandemic, we evaluated the use of the dried blood spot (DBS) matrix for measurement of HbA1c by the Vitros 5600 chemistry analyzer. DBS HbA1c was well correlated to whole blood (r=0.9889) and exhibited intra- and inter-assay precision from 0.5-3.5%. CONCLUSION: DBS measurement of HbA1c presents a viable alternative to routine in-person laboratory monitoring of DM.


Assuntos
Coleta de Amostras Sanguíneas/métodos , COVID-19/epidemiologia , Diabetes Mellitus/sangue , Diabetes Mellitus/epidemiologia , Teste em Amostras de Sangue Seco/tendências , Hemoglobina A Glicada/análise , Telemedicina/tendências , Adolescente , Adulto , Idoso , COVID-19/prevenção & controle , Criança , Pré-Escolar , Diabetes Mellitus/diagnóstico , Teste em Amostras de Sangue Seco/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , SARS-CoV-2/isolamento & purificação , Telemedicina/métodos , Estados Unidos/epidemiologia , Adulto Jovem
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