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1.
Zhonghua Nei Ke Za Zhi ; 58(10): 751-757, 2019 Oct 01.
Artigo em Chinês | MEDLINE | ID: mdl-31594173

RESUMO

Objective: To investigate the characteristics of body composition (BC) in gout patients and its clinical significance. Methods: Consecutive gout patients were recruited between August 2017 and December 2018. Demographic information, clinical characteristics and comorbidities were collected. BC was assessed by bioelectric impedance analysis including body fat percentage (BF%), trunk and limb BF%, appendicular skeletal muscle index. Overfat was defined by BF% ≥25% for male and ≥35% for female. The association between BC and serum uric acid (sUA) was evaluated by multiple linear regression. Results: A total of 362 gout patients were recruited with median age 38 (30, 52) years, 96.1% (348/362) were male. Mean sUA was (551±133) µmol/L. The mean BF% was (25.8±6.4)% with 53.6%(194/362) patients overfat. Male gout patients with overfat showed more affected joints [4(2, 6) vs. 2(2, 5)], higher sUA [(576±126)µmol/L vs. (523±134) µmol/L], higher prevalence of dyslipidemia [70.1%(131/187) vs. 54.0%(87/161)], metabolic syndrome [60.8%(118/187) vs. 28.0%(47/161)], fatty liver [58.2%(113/187) vs. 35.1%(59/161)] and hypertension [44.4%(83/187) vs. 25.5%(41/161)] than male patients with normal fat (all P<0.05). Their BF%, trunk BF% and limb BF% were positively correlated with the numbers of affected joints, sUA, metabolic syndrome, fatty liver, and hypertension, respectively (r=0.154-0.435, all P<0.05). Multivariable linear regression suggested that BF% (ß=4.29, P=0.020) and trunk BF% (ß=9.11, P=0.007), but not limb BF%, were positively correlated with sUA. Conclusion: Overfat is very common in gout patients. The proportion of trunk fat in male patients is positively correlated with sUA. When assessing obesity in gout patients clinically, body composition analysis should be performed simultaneously.


Assuntos
Composição Corporal/fisiologia , Gota/diagnóstico , Obesidade/epidemiologia , Ácido Úrico/sangue , Adulto , Dislipidemias/epidemiologia , Feminino , Gota/sangue , Gota/epidemiologia , Humanos , Hipertensão/sangue , Hipertensão/epidemiologia , Masculino , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/sangue , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Obesidade/sangue , Prevalência
2.
Medicine (Baltimore) ; 98(40): e17153, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31577706

RESUMO

The present study evaluated the association between appendectomy and rheumatoid arthritis (RA) using a national sample cohort of the Korean population. In this cohort study, the Korean National Health Insurance Service-National Sample Cohort of individuals ≥20 years old was collected from 2002 to 2013. A total of 14,995 appendectomy participants were 1:4 matched with 59,980 control subjects for age, group, sex, income group, region of residence, hypertension, diabetes, and dyslipidemia. We analyzed the occurrence of RA in both the appendectomy and control groups. Appendectomies were identified using operation codes for appendicitis only. RA was defined by International Classification of Disease-10 codes (M05 or M06) and medication histories. Crude and adjusted hazard ratios (HRs) were analyzed using a stratified Cox proportional hazard model. Subgroup analyses were performed on groups stratified by age and sex. The adjusted HR for RA was 1.02 (95% confidence interval = 0.76-1.38) in the appendectomy group (P = .883). In all of the subgroup analyses according to age and sex, the adjusted HRs for RA were not higher in the appendectomy group than those in the control group. We could not identify any significant relationship between appendectomy and RA.


Assuntos
Apendicectomia/estatística & dados numéricos , Apendicite/cirurgia , Artrite Reumatoide/epidemiologia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Depressão/epidemiologia , Dislipidemias/epidemiologia , Feminino , Seguimentos , Humanos , Hipertensão/epidemiologia , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Características de Residência , Fatores de Risco , Fatores Sexuais , Fatores Socioeconômicos , Adulto Jovem
3.
J Assoc Physicians India ; 67(7): 30-33, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31559765

RESUMO

Objectives: Individual with diabetes may have several from of Dyslipidemia. Dyslipidemia has been considered to be factor that plays a risk in progression of micro vascular disease, especially in diabetes.1 The present study is intended to Study of correlation between Apolipoprotein B and Dyslipidemia in type 2 diabetes patients and prevalence of dyslipidemia in type 2 diabetic patients. Material and Methods: Prospective cross- sectional study conducted on 100 cases of type 2 diabetes mellitus. Groups are divided according to A/C ratio and association of dyslipidemia was seen. Serum Apolipoprotein B was measured using immunoturbidimetric method. Results: Pearson's correlation analysis of Apo B with lipid parameters in diabetic patients showed that, LDL, TC and Tg were positively correlated with Apo- B. There was a positive and linear correlation between LDL and Tg. Apo- B was negatively correlated with HDL-C. Conclusion: The majority of patients studied had low HDL-C, elevated non HDL- C, elevated total cholesterol, elevated triglycerides, elevated LDL -C and elevated apo B. Apolipoprotein B had a positive linear correlation with total cholesterol, triglycerides, LDL-C, non-HDL-C. The strongest positive correlation was with nonHDL-C. Patients with low HDL-C had high apo B levels.


Assuntos
Apolipoproteínas B/metabolismo , Diabetes Mellitus Tipo 2/epidemiologia , Dislipidemias/epidemiologia , Proteinúria/metabolismo , HDL-Colesterol , Humanos , Estudos Prospectivos , Centros de Atenção Terciária , Triglicerídeos
4.
Wien Klin Wochenschr ; 131(17-18): 395-403, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31493100

RESUMO

BACKGROUND: Liver disease impacts on hepatic synthesis of lipoproteins and lipogenesis but data on dyslipidemia during disease progression are limited. We assessed the patterns of dyslipidemia in (i) different liver disease etiologies and discriminated (ii) non-advanced (non-ACLD) from advanced chronic liver disease (ACLD) as it is unclear how progression to ACLD impacts on dyslipidemia-associated cardiovascular risk. METHODS: Patients with alcoholic liver disease (n = 121), hepatitis C (n = 1438), hepatitis B (n = 384), metabolic/fatty liver disease (n = 532), cholestatic liver disease (n = 119), and autoimmune hepatitis (n = 114) were included. Liver stiffness ≥15 kPa defined ACLD. Dyslipidemia was defined as total cholesterol >200 mg/dL, low-density lipoprotein (LDL)-cholesterol >130 mg/dL and triglycerides >200 mg/dL. RESULTS: Across all etiologies, total cholesterol levels were significantly lower in ACLD, when compared to non-ACLD. Accordingly, LDL-cholesterol levels were significantly lower in ACLD due to hepatitis C, hepatitis B, metabolic/fatty liver disease and autoimmune hepatitis. Triglyceride levels did not differ due to disease severity in any etiology. Despite lower total and LDL cholesterol levels in ACLD, etiology-specific dyslipidemia patterns remained similar to non-ACLD. Contrary to this "improved" lipid status in ACLD, cardiovascular comorbidities were more prevalent in ACLD: arterial hypertension was present in 26.6% of non-ACLD and in 55.4% of ACLD patients (p < 0.001), and diabetes was present in 8.1% of non-ACLD and 25.6% of ACLD patients (p < 0.001). CONCLUSION: Liver disease etiology is a major determinant of dyslipidemia patterns and prevalence. Progression to ACLD "improves" serum lipid levels while arterial hypertension and diabetes mellitus are more prevalent. Future studies should evaluate cardiovascular events after ACLD-induced "improvement" of dyslipidemia.


Assuntos
Dislipidemias , Hepatopatias , Adulto , LDL-Colesterol/sangue , Dislipidemias/epidemiologia , Feminino , Humanos , Hepatopatias/epidemiologia , Hepatopatias/etiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Triglicerídeos/sangue
5.
Rev Fac Cien Med Univ Nac Cordoba ; 76(3): 159-163, 2019 08 29.
Artigo em Espanhol | MEDLINE | ID: mdl-31465183

RESUMO

Background: Excess weight (EW) and alterations in lipid metabolism constitute risk factors for cardiovascular disease in adults and children. Prevalence of dyslipidemia in schoolchildren from Jujuy with EW is analyzed in this study. Methods: Cross-sectional descriptive study of 891 schoolchildren 10-14 years old (367 girls; 524 boys) from the province of Jujuy (Northwestern Argentina). Prevalence of dyslipidemia for Overweight (OW) and Obesity (OB) were calculated, according to the International Obesity Task Force cut-off points. Prevalence of lipid alterations were analyzed and 7 dyslipidemic profiles were established. Comparisons and associations between variables were analyzed by Chi-square test. Crude and adjusted odds ratio were estimated from a logistic regressions. Results: Regardless of sex and nutritional status, 13.7%, 21.8%, and 16.5% of schoolchildren showed high values of total cholesterol, triglycerides, and LDL cholesterol, respectively, and 20.3% had low HDL cholesterol. Significantly higher values of HDL cholesterol were found in OW, and of triglycerides in OB. A significant association was recorded between OB and high triglycerides. Schoolchildren with OB have a 54% more chances of showing at least one lipid alteration. Conclusion: EW, and especially OB, constitutes an important risk factor in the development of dyslipidemia in schoolchildren from Jujuy.


Assuntos
Dislipidemias/sangue , Dislipidemias/etiologia , Sobrepeso/complicações , Adolescente , Argentina/epidemiologia , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/etiologia , Criança , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Estudos Transversais , Dislipidemias/epidemiologia , Feminino , Humanos , Masculino , Obesidade/complicações , Sobrepeso/epidemiologia , Prevalência , Instituições Acadêmicas , Triglicerídeos/sangue
6.
Medicine (Baltimore) ; 98(31): e16323, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31374004

RESUMO

The aim of this study was to conduct a more comprehensive analysis of the association between psoriasis and abnormal lipid metabolism.The case-control study included 222 psoriatic patients and 445 non-psoriatic control patients matched for age and gender. Clinical parameters included age, gender, and body mass index (BMI). Serum lipid levels were recorded and included cholesterol (CHO), triglycerides (TG), low-density lipoprotein (LDL), high density lipoprotein (HDL), phospholipids (PLIP), free fatty acids (FFA), lipoprotein (a) [Lp(a)], and apolipoproteins (apoA1, apoB, and apoE). Statistical analysis was carried out through the IBM Statistical Package for the Social Studies version 23.0.Compared with controls, levels of BMI and the prevalence of obesity were significantly higher in psoriatic patients. The results revealed that when compared to controls, significant elevation of serum TG (P <.001) and Lp(a) (P = .022) was observed. Levels of HDL (P <.001) and apoA1 (P <.001) were significantly lower in psoriatic patients. There was no significant difference in CHO (P = .367), LDL (P = .400), apoB (P = .294), apoE (P = .05), PLIP (P = .931) and FFA (P = .554) between patients and controls. The levels of CHO, TG, PLIP, FFA, and apoE were positively correlated with BMI level.Dyslipidemia was more common in psoriatic patients, compared with non-psoriatic controls.


Assuntos
Dislipidemias/etiologia , Obesidade/etiologia , Psoríase/complicações , Adulto , Idoso , Apolipoproteínas B/análise , Apolipoproteínas B/sangue , Apolipoproteínas E/análise , Apolipoproteínas E/sangue , Índice de Massa Corporal , Estudos de Casos e Controles , China/epidemiologia , LDL-Colesterol/análise , LDL-Colesterol/sangue , Dislipidemias/epidemiologia , Dislipidemias/fisiopatologia , Feminino , Humanos , Lisina Acetiltransferase 5/análise , Lisina Acetiltransferase 5/sangue , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Obesidade/fisiopatologia , Psoríase/epidemiologia , Psoríase/fisiopatologia
7.
Expert Opin Drug Saf ; 18(9): 829-840, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31304808

RESUMO

Introduction: Efficient antiretroviral-treatment (ART) generally allows control of HIV infection. However, persons-living-with-HIV (PLWH), when aging, present a high prevalence of metabolic diseases. Area covered: Altered adiposity, dyslipidemias, insulin resistance, diabetes, and their consequences are prevalent in PLWH and could be partly related to ART. Expert opinion: At first, personal and lifestyle factors are involved in the onset of these complications. The persistence of HIV in tissue reservoirs could synergize with some ART and enhance metabolic disorders. Altered fat repartition, diagnosed as lipodystrophy, has been related to first-generation nucleoside-reverse-transcriptase-inhibitors (NRTIs) (stavudine zidovudine) and some protease inhibitors (PIs). Recently, use of some integrase-inhibitors (INSTI) resulted in weight/fat gain, which represents a worrisome unresolved situation. Lipid parameters were affected by some first-generation NRTIs, non-NRTIs (efavirenz) but also PIs boosted by ritonavir, with increased total and LDL-cholesterol and triglycerides. Insulin resistance is common associated with abdominal obesity. Diabetes incidence, high with first-generation-ART (zidovudine, stavudine, didanosine, indinavir) has declined with contemporary ART close to that of the general population. Metabolic syndrome, a dysmetabolic situation with central obesity and insulin resistance, and liver steatosis are common in PLWH and could indirectly result from ART-associated fat gain and insulin resistance. All these dysmetabolic situations increase the atherogenic cardiovascular risk.


Assuntos
Fármacos Anti-HIV/efeitos adversos , Infecções por HIV/tratamento farmacológico , Doenças Metabólicas/induzido quimicamente , Tecido Adiposo/efeitos dos fármacos , Fármacos Anti-HIV/administração & dosagem , Dislipidemias/induzido quimicamente , Dislipidemias/epidemiologia , Glucose/metabolismo , Humanos , Estilo de Vida , Metabolismo dos Lipídeos/efeitos dos fármacos , Doenças Metabólicas/epidemiologia , Fatores de Risco
8.
Pan Afr Med J ; 32: 141, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31308859

RESUMO

Introduction: Sickle cell anaemia (SCA) is an inherited abnormality of haemoglobin associated with reduced life expectancy. Patients' complications include dyslipideamia. This study was aimed at determining the artherogenic index of plasma (AIP) in sickle cell anaemia patients and compares the value to HbAA controls value. A high AIP is strongly predictive of elevated cardiovascular risk. Methods: A comparative study was conducted among SCA patients attending the haematology clinic, Lagos State University Teaching Hospital (LASUTH) and HbAA Phenotype controls. A total of 304 participants were recruited consisting of equal numbers of SCA and HbAA controls. Single lipid profiles were done; logarithms of triglycerides/high density lipoprotein were calculated to obtain AIP and lipid profile ratios established for all participants. Results: There were lower mean values of Total Cholesterol (TC), High Density Lipoprotein(HDL) and Low Density Lipoprotein (LDL) amongst SCD participants than controls and higher mean values of triglycerides (TG) and Very Low Density Lipoprotein (VLDL) in SCD p < 0.05. The AIP in SCD ranges from -0.62 to 1.32 while that of controls ranges from -0.56 to 0.61.The mean AIP were 0.14 ± 0.29 and -0.009 ± 0.26 in SCD and controls respectively. P value = 0.002. Conclusion: AIP value is higher in sickle cell anaemia than controls, the former have lower mean values of TC, HDL and LDL and higher mean values of TG and VLDL.


Assuntos
Anemia Falciforme/complicações , Colesterol/sangue , Dislipidemias/epidemiologia , Lipídeos/sangue , Adolescente , Adulto , Anemia Falciforme/sangue , Aterosclerose/sangue , Aterosclerose/etiologia , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Estudos de Casos e Controles , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Feminino , Hospitais Universitários , Humanos , Masculino , Nigéria , Fatores de Risco , Adulto Jovem
9.
Medicine (Baltimore) ; 98(23): e15878, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31169693

RESUMO

Obesity is a significant public health concern that predisposes individuals to a high risk of premature mortality. Previous studies also reported that low serum concentrations of AMY1 have been associated with obesity. The aimed of the study to assess the relationship between salivary amylase (AMY1) activity and body mass index (BMI) in Saudi male and female adults in Riyadh. This study included a total of 200 (100 individuals who were overweight and obese and 100 who had normal body weight [control individuals]) Saudi participants aged 20 to 50 years old. They were recruited from physical fitness clubs and were school employees in Riyadh City. The dietary food intake was assessed using a 24-hour dietary recall. The activity of the AMY1 was measured using a microplate fluorescence reader. A significant (P ≤ .05) increase was observed in the incidence of hypertension, dyslipidemia, diabetes mellitus (DM), and family history of overweight and obesity in overweight and obese individuals than in the control individuals, and these were in parallel to the significant increase in weight, waist circumference (WC), hip circumference (HC), systolic blood pressure (SBP), diastolic blood pressure (DBP), and BMI. A significant (P ≤ .05) increase was also observed in the carbohydrate and total fat dietary intake of overweight and obese individuals in relation to the respective dietary reference intake (DRI) values. AMY1 activity was significantly lower than the reference values in the overweight and obese group. Furthermore, AMY1 activity was significantly (P ≤ .05) reverse with weight, WC, HC, and BMI in both males and females in the overweight and obese group. In conclusion, the Saudi overweight and obese population seems to be at risk of low AMY1, which correlates with their obesity.


Assuntos
Amilases/análise , Obesidade/epidemiologia , Saliva/química , Adulto , Biomarcadores , Pressão Sanguínea , Índice de Massa Corporal , Pesos e Medidas Corporais , Diabetes Mellitus/epidemiologia , Dieta , Dislipidemias/epidemiologia , Ingestão de Energia , Feminino , Predisposição Genética para Doença , Humanos , Hipertensão/epidemiologia , Masculino , Pessoa de Meia-Idade , Sobrepeso/epidemiologia , Arábia Saudita/epidemiologia , Adulto Jovem
10.
High Blood Press Cardiovasc Prev ; 26(3): 199-207, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31236902

RESUMO

Proprotein convertase subtilisin/kexin type 9 (PCSK9)-related discoveries of the turn of the century have translated into substantial novelty in dyslipidemia treatment in the last 5 years. With chronic preventable atherosclerotic cardiovascular diseases (ASCVD) representing an epidemic of morbidity and mortality worldwide, low-density lipoprotein cholesterol (LDL-c) reduction represents a public health priority. By overcoming two major statin-related issues, namely intolerance and ineffectiveness, PCSK9 inhibitors have offered a safe and effective option in selected clinical settings where LDL-c reduction is required. Herein, we recapitulate recent findings, clinical applications, and ASCVD prevention potential of PCSK9 inhibition, with focus on anti-PCSK9 monoclonal antibodies, evolocumab and alirocumab.


Assuntos
Anticorpos Monoclonais/uso terapêutico , Anticolesterolemiantes/uso terapêutico , Aterosclerose/prevenção & controle , LDL-Colesterol/sangue , Dislipidemias/tratamento farmacológico , Pró-Proteína Convertase 9/antagonistas & inibidores , Inibidores de Serino Proteinase/uso terapêutico , Animais , Anticorpos Monoclonais/efeitos adversos , Anticolesterolemiantes/efeitos adversos , Aterosclerose/sangue , Aterosclerose/enzimologia , Aterosclerose/epidemiologia , Biomarcadores/sangue , Dislipidemias/sangue , Dislipidemias/enzimologia , Dislipidemias/epidemiologia , Humanos , Guias de Prática Clínica como Assunto , Pró-Proteína Convertase 9/metabolismo , Fatores de Risco , Inibidores de Serino Proteinase/efeitos adversos , Resultado do Tratamento
12.
Medicine (Baltimore) ; 98(21): e15764, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31124964

RESUMO

Migraine is thought to be associated with Bell palsy. This study aimed to investigate the risk of Bell palsy in migraine patients.The Korean National Health Insurance Service-National Sample Cohort was collected from 2002 to 2013. A total of 45,164 migraine patients were matched for age, sex, income, region of residence, hypertension, diabetes, and dyslipidemia and compared with 180,656 controls. The migraine group included participants diagnosed with migraine [International Classification of Disease (ICD)-10: G43] who underwent treatment more than once. Participants with Bell palsy were included on the basis of the ICD-10 (G510) and treatment with steroids. A history of hypertension, diabetes, and dyslipidemia was determined using ICD-10 codes. Crude (simple) and adjusted hazard ratios (HRs) of Bell palsy in migraine patients were analyzed using the Cox proportional hazards model. Subgroup analyses were conducted based on age and sex.Bell palsy occurred in 0.6% (262/44,902) of the migraine group and 0.5% (903/179,753) of the control group. The adjusted HR of Bell palsy was 1.16 in the migraine group compared with the control group [95% confidence interval (95% CI) = 1.01-1.33, P = .34]. Among age-related subgroups, participants ≥30 and <60 years old in the migraine subgroup demonstrated a 1.28-times higher risk of Bell palsy than the control group (95% CI = 1.05-1.57, P = .014).Migraine increased the risk of Bell palsy in the total population. Among age subgroups, migraine patients ≥30 and <60 years old had an increased risk of Bell palsy.


Assuntos
Paralisia de Bell/epidemiologia , Transtornos de Enxaqueca/epidemiologia , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Diabetes Mellitus/epidemiologia , Dislipidemias/epidemiologia , Feminino , Seguimentos , Humanos , Hipertensão/epidemiologia , Lactente , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , República da Coreia/epidemiologia , Características de Residência , Fatores de Risco , Fatores Sexuais , Fatores Socioeconômicos , Adulto Jovem
13.
Medicine (Baltimore) ; 98(21): e15782, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31124971

RESUMO

This study aims to investigate urban-rural differences in characteristics and risk factors of ischemic stroke in northern China.The present cross-sectional study was based on the High-risk Population Screening and Intervention Project for Stroke. The cluster sampling method was used to select urban and rural screening sites in northern China. By collecting information and screening the data, patients with ischemic stroke were obtained and a control group with similar gender, age, and regional distribution was selected among the nonischemic stroke patients. Then, the demographic and risk factors of patients with ischemic stroke were described and analyzed.The prevalence of ischemic stroke in northern China was 2.88%, with a greater prevalence in rural areas than in urban areas (3.32% vs 2.43%), and a greater prevalence in males than in females (3.06% vs 2.73%). Furthermore, rural stroke patients were younger than urban stroke patients. Hypertension, family history of stroke, and smoking were the top 3 independent risk factors for ischemic stroke. Overweight/obesity and low education were associated with increased ischemic stroke in urban areas, while low education was associated with less ischemic stroke in rural areas. In addition, the prevalence of alcoholism, dyslipidemia, diabetes, and obvious overweight/obesity was greater in urban areas, while high-salt diet and low education and income were more prevalent in rural regions. Moreover, the smoking index was higher in rural areas than in urban areas.The characteristics and risk factors of ischemic stroke differ between rural and urban areas, which could be used to design specific preventative measures.


Assuntos
Programas de Rastreamento/estatística & dados numéricos , População Rural/estatística & dados numéricos , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/etiologia , População Urbana/estatística & dados numéricos , Adulto , China/epidemiologia , Análise por Conglomerados , Estudos Transversais , Diabetes Mellitus/epidemiologia , Dislipidemias/complicações , Dislipidemias/epidemiologia , Escolaridade , Feminino , Humanos , Hipertensão/complicações , Hipertensão/epidemiologia , Renda/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Sobrepeso/complicações , Sobrepeso/epidemiologia , Prevalência , Fatores de Risco , Fatores Sexuais , Fumar/efeitos adversos , Fumar/epidemiologia
14.
Minerva Med ; 110(5): 401-409, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31081312

RESUMO

BACKGROUND: Obesity, type 2 diabetes (T2D), dyslipidemia, arterial hypertension as well as hepatic steatosis (HS) are common conditions that can affect clinical outcomes of patients with chronic hepatitis C (CHC) who achieved sustained virologic response (SVR). The aim of this study was to assess the impact of metabolic cofactors on the occurrence of clinical events during follow-up (FU) in a group of CHC long-term responders (LTRs) to interferon- (IFN) based therapy. METHODS: A total of 5172 medical records of CHC patients enrolled from 1990 to 2011 were examined; 1034 of 5172 (20%) patients were treated with IFN-based therapy and 382 of 1034 (37%) of them achieved SVR. A total of 188 (49%) LTRs underwent liver biopsy before antiviral treatment. Data on liver and cardiometabolic events such as cirrhosis and its complications, hepatocellular carcinoma, coronary artery disease, arterial hypertension, impaired fasting glucose (IFG)/type 2 diabetes (T2D) and dyslipidemia, were collected over time. RESULTS: The mean age of the whole cohort was 46±12 years and 114/188 (61%) patients were males. HS was found in 82 of 188 (43.6%) patients and most of them were infected by HCV genotype 3a. The prevalence of obesity, IFG/T2D, dyslipidemia and arterial hypertension was 4.3%, 6.9%, 37.2%, and 5.9%, and was similarly distributed among patients with and without HS. Cirrhosis was histologically diagnosed in 18 of 188 (9.6%) patients. After a median follow-up of 11 years (range 3-21 years), the cumulative incidence of cardiovascular events, IFG/T2D and dyslipidemia was higher in CHC-LTRs who had HS at baseline compared to those without HS (1.2%, 2.3%, and 3.0% vs. 0.4%, 0.8%, and 2.5%, respectively). At multivariable Cox regression analysis, HS was significantly associated to the development of cardiovascular events and IFG/T2D (HR=5.2, 95% CI: 1.3-20.7, P=0.019, and HR=2.6, 95% CI: 1.1-6.2, P=0.027, respectively). CONCLUSIONS: In CHC-LTRs, HS at baseline may predispose to the development of cardiovascular events and T2D during follow-up emphasizing the importance of an accurate counseling in order to prevent extra-hepatic complications.


Assuntos
Antivirais/uso terapêutico , Hepatite C Crônica/metabolismo , Interferons/uso terapêutico , Adulto , Biópsia , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/prevenção & controle , Comorbidade , Dislipidemias/complicações , Dislipidemias/epidemiologia , Dislipidemias/metabolismo , Feminino , Seguimentos , Genótipo , Glucose/metabolismo , Hepacivirus/genética , Hepacivirus/isolamento & purificação , Hepatite C Crônica/complicações , Hepatite C Crônica/tratamento farmacológico , Hepatite C Crônica/virologia , Humanos , Hipertensão/complicações , Hipertensão/epidemiologia , Hipertensão/metabolismo , Insulina/metabolismo , Cirrose Hepática/etiologia , Cirrose Hepática/patologia , Cirrose Hepática/prevenção & controle , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Obesidade/epidemiologia , Obesidade/metabolismo , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Resultado do Tratamento
15.
Zhonghua Xin Xue Guan Bing Za Zhi ; 47(5): 360-366, 2019 May 24.
Artigo em Chinês | MEDLINE | ID: mdl-31142079

RESUMO

Objective: To investigate the blood lipid levels and prevalence of dyslipidemia in people with hypertension and diabetes in Henan province. Methods: From April 2016 to April 2017, multi-stage cluster sampling was adopted to investigate 71 285 local residents aged between 35 and 75 from 6 districts and counties in Henan province including Zhongmu county of Zhengzhou city, Huojia county of Xinxiang city, Hualong district of Puyang city, Qi county of Hebi city, Xigong district of Luoyang city, and Wugang city of Pingdingshan city. Blood samples were collected. According to the diagnostic criteria of hypertension and diabetes, the study population was divided into control group (n=29 427), hypertension group (n=21 965), diabetes group (n=8 009) and hypertension-diabetes group (n=11 884). Comparisons on blood lipid levels and dyslipidemia between 4 groups were performed. Results: The total cholesterol (TC) level of all subjects was 4.37 (3.78, 5.05) mmol/L. The triglyceride (TG) level was 1.27 (0.97, 1.80) mmol/L, the low-density lipoprotein cholesterol (LDL-C) level was 2.34 (1.88, 2.88) mmol/L and the high-density lipoprotein cholesterol (HDL-C) level was 1.31 (1.08, 1.59) mmol/L. Except for the TC level in women aged 65-75 years and LDL-C levels in women aged 55-64 and 65-75 years, there were significant differences in TC, TG, LDL-C and HDL-C levels between subjects of control group, hypertension group, diabetes group, and hypertension-diabetes group in different age ranges (including 35-44, 45-54, 55-64,and 65-75 years) and genders(all P<0.01).Except for the LDL-C and HDL-C in men aged 35-44 years and LDL-C in women aged 65-75 years, there were significant differences in the dyslipidemia rates of TC, TG, LDL-C and HDL-C between subjects of control group, hypertension group, diabetes group and hypertension-diabetes group in different age ranges and genders(P<0.01 or <0.05). After adjusting for age, gender, smoking, drinking, snoring, region, and body mass index, multivariate logistic regression analysis showed that hypertension (OR=1.221, 95%CI 1.113-1.339, P<0.01), diabetes (OR=1.636, 95%CI 1.461-1.833, P<0.01) and hypertension-diabetes (OR=1.832, 95%CI 1.658-2.023, P<0.01) were independent risk factors for TC abnormality. Hypertension (OR=1.566, 95%CI 1.478-1.659, P<0.01), diabetes (OR=2.182, 95%CI 2.031-2.342, P<0.01) and hypertension-diabetes (OR=2.655, 95%CI 2.492-2.829, P<0.01) were also independent risk factors for TG abnormality. Diabetes (OR=1.510, 95%CI 1.309-1.742, P<0.01) and hypertension-diabetes (OR=1.461, 95%CI 1.285-1.661, P<0.01) were independent risk factors for LDL-C abnormality. Diabetes (OR=1.261, 95%CI 1.180-1.346, P<0.01) and hypertension-diabetes (OR=1.195, 95%CI 1.126-1.268, P<0.01) were independent risk factors for HDL-C abnormality. Conclusion: The prevalence of dyslipidemia in patients with hypertension and diabetes is high in Henan province, so adequate blood lipid education and control should be applied to people with risk factors as soon as possible.


Assuntos
Diabetes Mellitus , Dislipidemias , Hipertensão , Lipídeos , Adulto , Idoso , China/epidemiologia , HDL-Colesterol , Diabetes Mellitus/epidemiologia , Dislipidemias/epidemiologia , Feminino , Humanos , Hipertensão/epidemiologia , Lipídeos/sangue , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Triglicerídeos/sangue
16.
High Blood Press Cardiovasc Prev ; 26(3): 191-197, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31041682

RESUMO

The atherosclerotic alterations that are the basis of cardiovascular diseases can start already in childhood. For this reason the prevention of cardiovascular diseases should be undertaken very early both in the general population and, in a targeted manner, in subjects at cardiovascular risk. Preventive strategies should include measures to encourage physical activity and correct eating habits and to reduce exposure to pollutants. The main actors responsible for carrying out these preventive interventions are the local and national political authorities. Moreover, particular attention should be paid to the first thousand days of life starting from conception, to prevent unfavorable epigenetic modifications. In addition to initiatives aimed at the general population, interventions should be planned by the medical community to assess the individual risk profile. The current obesity epidemic has in fact made it relatively frequent even among children and adolescents to find some cardiovascular risk factors known in adults such as arterial hypertension, dyslipidemia, glucose metabolism disorders and increased of uric acid values. The purpose of this review is to indicate lines of intervention for cardiovascular prevention in children and adolescents.


Assuntos
Doenças Cardiovasculares/prevenção & controle , Síndrome Metabólica/terapia , Serviços Preventivos de Saúde/métodos , Adolescente , Idade de Início , Pressão Arterial , Biomarcadores/sangue , Glicemia/metabolismo , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/fisiopatologia , Criança , Comorbidade , Dislipidemias/sangue , Dislipidemias/epidemiologia , Dislipidemias/terapia , Transtornos do Metabolismo de Glucose/sangue , Transtornos do Metabolismo de Glucose/epidemiologia , Transtornos do Metabolismo de Glucose/terapia , Nível de Saúde , Humanos , Hipertensão/epidemiologia , Hipertensão/fisiopatologia , Hipertensão/terapia , Hiperuricemia/sangue , Hiperuricemia/epidemiologia , Hiperuricemia/terapia , Lipídeos/sangue , Síndrome Metabólica/sangue , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/fisiopatologia , Obesidade Pediátrica/epidemiologia , Obesidade Pediátrica/fisiopatologia , Obesidade Pediátrica/terapia , Fatores de Proteção , Fatores de Risco , Ácido Úrico/sangue , Ganho de Peso
17.
Medicine (Baltimore) ; 98(20): e15581, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31096461

RESUMO

There is a dearth of accurate information about the associations between risk factors and type 2 diabetes in mainland China. We conducted a systematic review and meta-analysis to explore the spatio-temporal patterns of the associations between common risk factors and type 2 diabetes in adults at least 18 years old in mainland China.We searched English and Chinese databases from January 1st, 1997 to December 31st, 2017 for relevant observational studies. Overall and stratification analyses including secular trends and temporal distributions were conducted, odds ratio (OR) and 95% confidence interval (CI) were calculated by applying random-effects model.Thirty-five studies were included. Type 2 diabetes was positively associated with a family history of type 2 diabetes (OR 2.89, 95%CI 2.38-3.49), hypertension (OR 2.73, 95%CI 2.25-3.36), central obesity (OR 2.28, 95%CI 1.94-2.68), dyslipidemia (OR 2.23, 95%CI 1.70-2.91), hypertriglyceridemia (OR 2.18, 95%CI 1.64-2.92), general obesity (OR 1.90, 95%CI 1.66-2.18), hypercholesterolemia (OR 1.65, 95%CI 1.32-2.06), smoking (OR 1.26, 95%CI 1.13-1.40), and drinking (OR 1.20, 95%CI 1.05-1.36), whereas a negative association with female gender (OR 0.87, 95%CI 0.78-0.97) existed. Except for female gender and drinking, the pooled effects of temporal and spatial stratification for the other five risk factors were consistent with the above results. For temporal stratification, the ORs of general obesity increased gradually during the periods of 1992 to 2005, 2006 to 2010, and 2011 to 2017, while the ORs of a family history declined. For regional stratification, the magnitudes of ORs for hypertension, dyslipidemia, and hypercholesterolemia in northern areas were larger than that in southern areas, while opposite situation occurred for a family history. Except for the factor a family history, provincial results for the other nine risk factors differed from the overall results and among provinces.Effect differences existed for modifiable and non-modifiable risk factors in secular trends and regional distribution, which is of potential public health importance for type 2 diabetes prevention.


Assuntos
Diabetes Mellitus Tipo 2/epidemiologia , Fatores Etários , Consumo de Bebidas Alcoólicas/epidemiologia , China/epidemiologia , Dislipidemias/epidemiologia , Predisposição Genética para Doença , Humanos , Hipertensão/epidemiologia , Obesidade Abdominal/epidemiologia , Estudos Observacionais como Assunto , Fatores de Risco , Fatores Sexuais , Fumar/epidemiologia , Análise Espaço-Temporal
18.
Medicine (Baltimore) ; 98(20): e15631, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31096476

RESUMO

Thyroid function may alter carbohydrate metabolism via influence of insulin, which may in terms of derangement of thyroid function and insulin function result in the development of type 2 diabetes mellitus (T2D). We investigated the association of thyroid disorders with T2D by a cohort study of the Taiwan nationwide health insurance database.A sub-dataset of the National Health Insurance Research Database (NHIRD) was used in this study. The thyroid disease (both hyper- and hypo-thyroidism) group was chosen from patients older than 18 years and newly diagnosed between 2000 and 2012. The control group consisted of randomly selected patients who never been diagnosed with thyroid disease and 4-fold size frequency matched with the thyroid disease group. The event of this cohort was T2D (ICD-9-CM 250.x1, 250.x2). Primary analysis was performed by comparing the thyroid disease group to the control group and the second analysis was performed by comparing the hyperthyroidism subgroup, hypothyroidism subgroup, and control group.The occurrence of T2D in the thyroid disease group was higher than the control group with hazard ratio (HR) of 1.23 [95% confidence interval (CI) = 1.16-1.31]. Both hyperthyroidism and hypothyroidism were significantly higher than control. Significantly higher HR was also seen in female patients, age category of 18 to 39-year-old (y/o) and 40 to 64 y/o subgroups. Higher occurrence of T2D was also seen in thyroid disease patients without comorbidity than in the control group with HR of 1.47 (95% CI = 1.34-1.60). The highest HR was found in the half-year follow-up.There was a relatively high risk of T2D development in patients with thyroid dysfunctions, especially in the period of 0.5 to 1 year after presentation of thyroid dysfunctions. The results suggest performing blood sugar tests in patients with thyroid diseases for early detection and treatment of T2D.


Assuntos
Diabetes Mellitus Tipo 2/epidemiologia , Hipertireoidismo/epidemiologia , Hipotireoidismo/epidemiologia , Adolescente , Adulto , Fatores Etários , Idoso , Estudos de Coortes , Comorbidade , Dislipidemias/epidemiologia , Feminino , Humanos , Hipertensão/epidemiologia , Masculino , Pessoa de Meia-Idade , Programas Nacionais de Saúde/estatística & dados numéricos , Obesidade/epidemiologia , Modelos de Riscos Proporcionais , Fatores de Risco , Fatores Sexuais , Taiwan/epidemiologia , Testes de Função Tireóidea , Adulto Jovem
19.
Methodist Debakey Cardiovasc J ; 15(1): 55-61, 2019 Jan-Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31049150

RESUMO

Plasma cholesterol levels of high-density lipoproteins (HDL) have been associated with cardioprotection for decades. However, there is an evolving appreciation that this lipoprotein class is highly heterogeneous with regard to composition and functionality. With the advent of advanced lipid-testing techniques and methods that allow both the quantitation and recovery of individual particle populations, we are beginning to connect the functionality of HDL subspecies with chronic metabolic diseases. In this review, we examine type 2 diabetes (T2D) and explore our current understanding of how obesity, insulin resistance, and hyperglycemia affect, and may be affected by, HDL subspeciation. We discuss mechanistic aspects of how insulin resistance may alter lipoprotein profiles and how this may impact the ability of HDL to mitigate both atherosclerotic disease and diabetes itself. Finally, we call for more detailed studies examining the impact of T2D on specific HDL subspecies and their functions. If these particles can be isolated and their compositions and functions fully elucidated, it may become possible to manipulate the levels of these specific particles or target the protective functions to reduce the incidence of coronary heart disease.


Assuntos
Diabetes Mellitus Tipo 2/sangue , Dislipidemias/sangue , Lipoproteínas HDL/sangue , Biomarcadores/sangue , Glicemia/metabolismo , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/prevenção & controle , Dislipidemias/diagnóstico , Dislipidemias/tratamento farmacológico , Dislipidemias/epidemiologia , Humanos , Hipolipemiantes/uso terapêutico , Insulina/sangue , Resistência à Insulina , Obesidade/sangue , Obesidade/epidemiologia
20.
Rev Saude Publica ; 53: 44, 2019.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31066822

RESUMO

OBJECTIVE: To verify the prevalence of chronic kidney disease and the factors associated to it in older adults (≥ 60 years). METHODS: This is a population-based research conducted in 2014, involving 1,016 older adults living in urban and rural areas of the municipality of Rio Branco, Acre. Chronic kidney disease was defined by glomerular filtration rate < 60 ml/min/1.73 m 2 , estimated by the equations of the Chronic Kidney Disease Epidemiology Collaboration, and the presence of albuminuria > 29 mg/g. Association measure were estimated by gross and adjusted odds ratio (OR), with a confidence level of 95% (95%CI). RESULTS: The overall prevalence of chronic kidney disease was 21.4% in older adults, with the associated factors age, diabetes (OR = 3.39; 95%CI 2.13-5.40), metabolic syndrome (OR = 2.49; 95%CI 1.71-3.63), self-assessment of poor health (OR = 1.79; 95%CI 1.10-2.91), arterial hypertension (OR = 1.82; 95%CI 1.04-3.19) and obesity (OR = 1.69; 95%CI 1.02-2.80). CONCLUSIONS: The prevalence of chronic kidney disease was high in older adults, being associated with age, self-assessment of health as bad or very bad, obesity, diabetes and metabolic syndrome.


Assuntos
Insuficiência Renal Crônica/epidemiologia , Insuficiência Renal Crônica/etiologia , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Albuminúria , Brasil/epidemiologia , Creatinina/sangue , Complicações do Diabetes/epidemiologia , Autoavaliação Diagnóstica , Dislipidemias/complicações , Dislipidemias/epidemiologia , Feminino , Taxa de Filtração Glomerular , Humanos , Hipertensão/complicações , Hipertensão/epidemiologia , Masculino , Síndrome Metabólica/complicações , Síndrome Metabólica/epidemiologia , Pessoa de Meia-Idade , Obesidade/complicações , Obesidade/epidemiologia , Prevalência , Fatores de Risco , Fatores Sexuais
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