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1.
Nutr Metab Cardiovasc Dis ; 31(10): 2860-2869, 2021 09 22.
Artigo em Inglês | MEDLINE | ID: mdl-34353703

RESUMO

BACKGROUND AND AIM: Addressing chronic problems requires a model of care that promotes self-management of the disease and facilitates adherence to treatment. This project was designed to enhance patient's clinical and functional outcomes through a Comprehensive Model to be implemented in our health system and to evaluate the results. METHODS AND RESULTS: Different population stratification tools were tested and designed to classify subjects according to different variables. We have developed a program to detect and screen cardiometabolic risk by integrating most of the Chronic Care Model recommendations through in-house developed management software (MoviHealth®). From the results, 1317 subjects were evaluated (27% of the whole population) during the first year of follow-up which significantly improved for all variables along the follow-up period. The blood pressure of the hypertensive population in 2010 and 2015 showed the importance of enrollment of subjects and the optimization of the blood pressure control. The result of HbA1c observed in 2010 decreased progressively to 7.1 ± 1.4% in 2015, and dyslipidemia levels improved gradually. The number of cardiovascular events requiring hospitalization decreased significantly (48%), from 1.9 events per 100 subjects in 2011 to 0.98 in 2015. CONCLUSION: Our program has combined strategies for the prevention and control of non-communicable diseases, incorporating interventions to control risk factors and to reduce morbidity and mortality. It also had improvements in life quality, accessibility to health-care services, and the promotion of self-care.


Assuntos
Doenças Cardiovasculares/prevenção & controle , Diabetes Mellitus/terapia , Dislipidemias/terapia , Hipertensão/terapia , Síndrome Metabólica/terapia , Serviços Preventivos de Saúde , Adulto , Idoso , Idoso de 80 Anos ou mais , Argentina/epidemiologia , Biomarcadores/sangue , Glicemia/metabolismo , Pressão Sanguínea , Fatores de Risco Cardiometabólico , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/epidemiologia , Dislipidemias/diagnóstico , Dislipidemias/epidemiologia , Feminino , Seguimentos , Hemoglobina A Glicada/metabolismo , Nível de Saúde , Humanos , Hipertensão/diagnóstico , Hipertensão/epidemiologia , Lipídeos/sangue , Masculino , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/epidemiologia , Pessoa de Meia-Idade , Prognóstico , Avaliação de Programas e Projetos de Saúde , Fatores de Proteção , Qualidade de Vida , Medição de Risco , Fatores de Tempo , Adulto Jovem
2.
Nutrients ; 13(7)2021 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-34371884

RESUMO

The dietary supplement, trans-resveratrol and hesperetin combination (tRES-HESP), induces expression of glyoxalase 1, countering the accumulation of reactive dicarbonyl glycating agent, methylglyoxal (MG), in overweight and obese subjects. tRES-HESP produced reversal of insulin resistance, improving dysglycemia and low-grade inflammation in a randomized, double-blind, placebo-controlled crossover study. Herein, we report further analysis of study variables. MG metabolism-related variables correlated with BMI, dysglycemia, vascular inflammation, blood pressure, and dyslipidemia. With tRES-HESP treatment, plasma MG correlated negatively with endothelial independent arterial dilatation (r = -0.48, p < 0.05) and negatively with peripheral blood mononuclear cell (PBMC) quinone reductase activity (r = -0.68, p < 0.05)-a marker of the activation status of transcription factor Nrf2. For change from baseline of PBMC gene expression with tRES-HESP treatment, Glo1 expression correlated negatively with change in the oral glucose tolerance test area-under-the-curve plasma glucose (ΔAUGg) (r = -0.56, p < 0.05) and thioredoxin interacting protein (TXNIP) correlated positively with ΔAUGg (r = 0.59, p < 0.05). Tumor necrosis factor-α (TNFα) correlated positively with change in fasting plasma glucose (r = 0.70, p < 0.001) and negatively with change in insulin sensitivity (r = -0.68, p < 0.01). These correlations were not present with placebo. tRES-HESP decreased low-grade inflammation, characterized by decreased expression of CCL2, COX-2, IL-8, and RAGE. Changes in CCL2, IL-8, and RAGE were intercorrelated and all correlated positively with changes in MLXIP, MAFF, MAFG, NCF1, and FTH1, and negatively with changes in HMOX1 and TKT; changes in IL-8 also correlated positively with change in COX-2. Total urinary excretion of tRES and HESP metabolites were strongly correlated. These findings suggest tRES-HESP counters MG accumulation and protein glycation, decreasing activation of the unfolded protein response and expression of TXNIP and TNFα, producing reversal of insulin resistance. tRES-HESP is suitable for further evaluation for treatment of insulin resistance and related disorders.


Assuntos
Hesperidina/administração & dosagem , Resistência à Insulina , Obesidade/terapia , Sobrepeso/terapia , Resveratrol/administração & dosagem , Adulto , Pressão Sanguínea/efeitos dos fármacos , Índice de Massa Corporal , Proteínas de Transporte/sangue , Correlação de Dados , Estudos Cross-Over , Suplementos Nutricionais , Método Duplo-Cego , Quimioterapia Combinada , Dislipidemias/sangue , Dislipidemias/terapia , Feminino , Transtornos do Metabolismo de Glucose/sangue , Transtornos do Metabolismo de Glucose/terapia , Glicosilação/efeitos dos fármacos , Humanos , Inflamação , Mediadores da Inflamação/sangue , Leucócitos Mononucleares/metabolismo , Masculino , Obesidade/sangue , Sobrepeso/sangue , Aldeído Pirúvico/sangue , Fator de Necrose Tumoral alfa/sangue
3.
Nutr Metab Cardiovasc Dis ; 31(9): 2619-2627, 2021 08 26.
Artigo em Inglês | MEDLINE | ID: mdl-34353699

RESUMO

BACKGROUND AND AIMS: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the sole causative agent of coronavirus infectious disease-19 (COVID-19). METHODS AND RESULTS: We performed a retrospective single-center study of consecutively admitted patients between March 1st and May 15th, 2020, with a definitive diagnosis of SARS-CoV-2 infection. The primary end-point was to evaluate the association of lipid markers with 30-days all-cause mortality in COVID-19. A total of 654 patients were enrolled, with an estimated 30-day mortality of 22.8% (149 patients). Non-survivors had lower total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-c) levels during the entire course of the disease. Both showed a significant inverse correlation with inflammatory markers and a positive correlation with lymphocyte count. In a multivariate analysis, LDL-c ≤ 69 mg/dl (hazard ratio [HR] 1.94; 95% confidence interval [CI] 1.14-3.31), C-reactive protein >88 mg/dl (HR 2.44; 95% CI, 1.41-4.23) and lymphopenia <1000 (HR 2.68; 95% CI, 1.91-3.78) at admission were independently associated with 30-day mortality. This association was maintained 7 days after admission. Survivors presented with complete normalization of their lipid profiles on short-term follow-up. CONCLUSION: Hypolipidemia in SARS-CoV-2 infection may be secondary to an immune-inflammatory response, with complete recovery in survivors. Low LDL-c serum levels are independently associated with higher 30-day mortality in COVID-19 patients.


Assuntos
COVID-19/sangue , LDL-Colesterol/sangue , Dislipidemias/sangue , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , COVID-19/diagnóstico , COVID-19/mortalidade , COVID-19/terapia , Regulação para Baixo , Dislipidemias/diagnóstico , Dislipidemias/mortalidade , Dislipidemias/terapia , Feminino , Humanos , Mediadores da Inflamação/sangue , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Espanha , Fatores de Tempo
4.
Vasc Health Risk Manag ; 17: 389-394, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34262283

RESUMO

Background: The World Health Organization (WHO) proposed the integrated care for older people (ICOPE) screening tool to identify functional impairment. We explore the association of geriatric functional impairment and hypertension, diabetes, dyslipidemia in the community-dwelling elderly. Methods: We enrolled individuals aged at least 65 with hypertension, diabetes, or dyslipidemia; or those aged at least 75 from May to July 2019. We applied ICOPE tools to evaluate six function assessments: cognitive decline, limited mobility, malnutrition, visual impairment, hearing loss, and depressive symptoms. Factors were analyzed using stepwise multivariable linear regression for ICOPE scores and logistic regression for geriatric functional impairment. All analyses were adjusted for age and glomerular filtration rate. Results: We enrolled 457 participants including 303 (66.3%) participants with hypertension, 296 (64.8%) diabetes, and 221 (48.4%) dyslipidemia. Seventy-eight (17.1%) participants have at least one geriatric functional impairment, including 41 (25.9%) participants aged ≥ 75 and 37 (12.4%) aged 65-74. The ICOPE score (0.4 ± 0.6) of participants aged at least 75 was higher than that (0.1 ± 0.4) of the participants aged 65-74 (p < 0.001). Dyslipidemia (p = 0.002) was positively associated with ICOPE score. Dyslipidemia (odds ratio: 2.15, 95% confidence interval: 1.27-3.70, p = 0.005), not hypertension (p = 0.3) and diabetes (p = 0.9), was associated with geriatric functional impairment. Visual impairment was the most common function impairment. Female was linked to limited mobility, renal function was associated with mobility (p < 0.001) and nutrition (p = 0.02). Conclusion: Dyslipidemia but not hypertension, diabetes is linked to geriatric functional impairment in community-dwelling elderly. Lower renal function is associated with decreased mobility and nutrition. More studies are needed to determine if treatment of dyslipidemia reduces geriatric functional impairment.


Assuntos
Dislipidemias/diagnóstico , Idoso Fragilizado , Fragilidade/diagnóstico , Avaliação Geriátrica , Vida Independente , Afeto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Cognição , Estudos Transversais , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/fisiopatologia , Diabetes Mellitus/psicologia , Dislipidemias/fisiopatologia , Dislipidemias/psicologia , Dislipidemias/terapia , Feminino , Fragilidade/fisiopatologia , Fragilidade/psicologia , Fragilidade/terapia , Estado Funcional , Taxa de Filtração Glomerular , Audição , Humanos , Hipertensão/diagnóstico , Hipertensão/fisiopatologia , Hipertensão/psicologia , Rim/fisiopatologia , Masculino , Saúde Mental , Limitação da Mobilidade , Estado Nutricional , Valor Preditivo dos Testes , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Fatores Sexuais , Visão Ocular
6.
J Bodyw Mov Ther ; 26: 227-232, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33992249

RESUMO

INTRODUCTION: The aim of the present study was to verify the effects of a Pilates training on total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), glucose and C-reactive protein (CRP) levels, as well as on functionality of postmenopausal women with dyslipidemia. METHOD: This randomized study involved 35 sedentary women with dyslipidemia, aged between 60 and 75 years. One group participated in a Pilates exercises training with two to four weekly sessions during 10 weeks (Pilates group, n = 20) and the other group did not perform any intervention (control group, n = 6). Biochemical analyses and functionality parameters were measured before and after the 10 weeks. RESULTS: No significant differences were observed in TC, TG, LDL and HDL for both groups. Regarding glucose and CRP levels, significant reductions were observed in both groups after the intervention period. In functional parameters, both groups significantly increased their 30-s chair stand test values. On the other hand, only the Pilates group presented significant increments in the 6-min walk test (p < 0.05). CONCLUSION: Pilates training did not change lipid or lipoprotein levels, but improved cardiorespiratory fitness of elderly women with dyslipidemia.


Assuntos
Dislipidemias , Técnicas de Exercício e de Movimento , Idoso , Dislipidemias/terapia , Feminino , Humanos , Lipídeos , Lipoproteínas , Pessoa de Meia-Idade , Triglicerídeos
7.
Cardiovasc Ther ; 2021: 5546800, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33976708

RESUMO

Background and Aims: A relevant role is emerging for functional foods in cardiovascular prevention. The aim of this study was to assess the effect of a nutraceutical multitargeted approach on lipid profile and inflammatory markers along with vascular remodelling in a cohort of dyslipidemic subjects without history of cardiovascular (CV) disease. Methods and Results: We enrolled 25 subjects (mean age 48.2 years) with low to moderate CV risk profile and total cholesterol (TC) levels between 150 and 250 mg/dl. The patients were assigned to receive for one year a tablet/die of a nutraceutical combination containing red yeast rice (RYR) extract (Monacolin 3 mg/tablet) and coenzyme Q10 (30 mg/tablet). Treatment with the nutraceutical compounds led to a significant reduction of TC (from 227 to 201 mg/dl, p < 0.001), LDL-c (from 150 to 130 mg/dl, p = 0.001), triglycerides (from 121 to 109 mg/dl, p = 0.013), non-HDL-cholesterol (from 168 to 141 mg/dl, p < 0.001), hs-CRP (from 1.74 to 1.20 mg/l, p = 0.015), and osteoprotegerin (from 1488 to 1328 pg/ml, p = 0.045). Levels of HDL-c, Lp(a), glucose, liver enzyme, CPK, or creatinine did not change over time. An ultrasound study was performed to assess changes in mean carotid intima-media thickness (IMT) and maximum IMT (M-MAX) as well as modification in local carotid stiffness by means of determining the carotid compliance coefficient (CC) and distensibility coefficient (DC). At the end of the treatment, we observed small but significant reductions in both mean-IMT (from 0.62 to 0.57 mm, p = 0.022) and M-MAX (from 0.79 to 0.73 mm, p = 0.002), and an improvement in carotid elasticity (DC from 22.4 to 24.3 × 10-3/kPa, p = 0.006 and CC from 0.77 to 0.85 mm2/kPa, p = 0.019). Conclusions: A long-term treatment with a combination of RYR and coenzyme Q10 showed lipid-lowering activity along with a reduction of inflammatory mediators and an improvement of vascular properties in young subjects with a low-to-moderate CV risk profile.


Assuntos
Produtos Biológicos , Doenças Cardiovasculares/prevenção & controle , Dislipidemias/terapia , Lipídeos/sangue , Ubiquinona/análogos & derivados , Remodelação Vascular , Adulto , Proteína C-Reativa/análise , Espessura Intima-Media Carotídea , Suplementos Nutricionais , Dislipidemias/sangue , Dislipidemias/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ubiquinona/administração & dosagem
8.
Biomolecules ; 11(5)2021 04 23.
Artigo em Inglês | MEDLINE | ID: mdl-33922449

RESUMO

Obesity has achieved epidemic status in the United States, resulting in an increase in type 2 diabetes mellitus, dyslipidemia, and cardiovascular disease. Numerous studies have shown that inflammation plays a key role in the development of insulin resistance and diabetic complications. HDL cholesterol levels are inversely associated with coronary heart disease in humans. The beneficial effect of HDL is due, in part, to apolipoproteins A-I and E, which possess anti-inflammatory properties. The functional quality of HDL, however, may be reduced in the context of diabetes. Thus, raising levels of functional HDL is an important target for reducing inflammation and diabetic complications. Apo A-I possesses eight alpha-helical sequences, most of which form class A amphipathic helical structures. Peptides belonging to this class inhibit atherogenesis in several mouse models. Additional peptides based on structural components of apoE have been shown to mediate a rapid clearance of atherogenic lipoproteins in dyslipidemic mice. In this review, we discuss the efficacy of apolipoprotein mimetic peptides in improving lipoprotein function, reducing inflammation, and reversing insulin resistance and cardiometabolic disease processes in diabetic animals.


Assuntos
Apolipoproteínas/uso terapêutico , Dislipidemias/terapia , Inflamação/terapia , Animais , Apolipoproteína A-I/química , Apolipoproteína A-I/metabolismo , Apolipoproteínas E/química , Aterosclerose/complicações , Biomimética/métodos , Doenças Cardiovasculares/complicações , Colesterol/química , Complicações do Diabetes/tratamento farmacológico , Diabetes Mellitus Tipo 2/complicações , Modelos Animais de Doenças , Humanos , Camundongos , Peptídeos/uso terapêutico
9.
BMC Med Educ ; 21(1): 232, 2021 Apr 22.
Artigo em Inglês | MEDLINE | ID: mdl-33888107

RESUMO

BACKGROUND: Psychiatry and Family Medicine residents frequently see patients with comorbid mental and physical disorders. Little is known about the difference in knowledge of Psychiatry residents and Family Medicine residents regarding management of common conditions they encounter. This study aimed to assess the knowledge of Psychiatry and Family Medicine residents regarding medical management of schizophrenia, hypertension, diabetes mellitus, and dyslipidemia, as the findings could help to refine the training curriculum for residency training. METHODS: A cross-sectional survey design was used. Psychiatry and Family Medicine residents pursuing their residency in Singapore were recruited from November 2019 to June 2020. The survey questionnaire consisted of questions which assessed the knowledge regarding medical management of schizophrenia, hypertension, diabetes mellitus, and dyslipidemia. Descriptive statistics were used to describe the demographic data; T-tests or Mann-Whitney U tests to compare the differences between groups; and multiple regression analyses to assess the factors associated with Psychiatry residents' knowledge of hypertension, diabetes mellitus, and dyslipidemia. RESULTS: Fifty-seven out of 70 (81.4%) Psychiatry residents and 58 out of 61 (95.1%) Family Medicine residents participated in the study. The majority of Psychiatry residents encountered patients with hypertension (93.0%), diabetes mellitus (87.7%) and dyslipidemia (91.2%) on a daily to weekly basis. Psychiatry residents had higher scores on questions about schizophrenia versus Family Medicine residents (mean 50.70 versus 43.28, p < 0.001). However, Psychiatry residents scored lower on questions about hypertension (mean 33.86 versus 40.98, p < 0.001), diabetes mellitus (mean 45.68 versus 49.79, p = 0.005) and dyslipidemia (mean 37.04 versus 44.31, p < 0.001). Receiving undergraduate medical education locally, compared to receiving it overseas, was associated with better knowledge of hypertension (beta = 0.515, p = 0.009) and dyslipidemia (beta = 0.559, p = 0.005); while younger age (26-30 versus > 35 and 31-35 versus > 35) was associated with better knowledge of hypertension (beta = 1.361, p = 0.002 and beta = 1.225, p = 0.003). A significant proportion of Psychiatry residents (61.4%) did not agree that the training provided to manage hypertension, diabetes mellitus, and dyslipidemia was adequate. Similarly, majority of Family Medicine residents (62.1%) did not agree that they had adequate training to manage schizophrenia. CONCLUSIONS: This study raises the awareness of Psychiatry residents' sense of discomfort in managing hypertension, diabetes mellitus, or dyslipidemia and conversely Family Medicine residents in management of schizophrenia, which can be further addressed during the training postings within the residency programs. Future studies are needed to look at local (such as training curriculum) and systemic factors (such as practice trends and culture) in order to better align residency selection criteria and training foci with real world practice factors over time.


Assuntos
Diabetes Mellitus , Dislipidemias , Hipertensão , Internato e Residência , Psiquiatria , Esquizofrenia , Estudos Transversais , Currículo , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/terapia , Dislipidemias/epidemiologia , Dislipidemias/terapia , Medicina de Família e Comunidade/educação , Humanos , Hipertensão/terapia , Psiquiatria/educação , Esquizofrenia/terapia , Singapura
10.
Exp Gerontol ; 150: 111355, 2021 07 15.
Artigo em Inglês | MEDLINE | ID: mdl-33865923

RESUMO

The hormonal modifications observed in post-menopausal are related to increased adiposity and alteration in the lipid profile besides physical and psychological changes. Physical exercises may attenuate these conditions and have been associated with low-grade inflammatory status, reducing the risk of cardiovascular diseases. This study aimed to evaluate the influence of dyslipidemia on the effect of physical exercise on inflammatory markers IL6, IL10, and TNF-α in obese post-menopausal women. A randomized clinical trial was carried out in seventy women divided into four groups: exercise without dyslipidemia (EG/n = 11); exercise with dyslipidemia (EGD = 24); control with dyslipidemia (CGD/n = 22); and control without dyslipidemia (CG/n = 13). The serum values of IL-6, IL-10, and TNF-α were measured before and after the intervention period, and the exercise program lasted 20 weeks, in three weekly sessions of 75 min each, with aerobic and strength exercises. The comparison of means was performed using the ANOVA test, repeated measures to analyze the interaction between the group and intervention time. There were a significant reduction in IL-6 values and an increase in IL-10/IL-6 and IL-10/TNF-α ratios only in the EG group. For serum TNF-α values, the EG and EGD groups showed significant reductions. The groups that practiced exercises did not present significant variation in the levels of IL-10. However, the CGD and GC groups showed a significant reduction in IL-10 after the intervention period.


Assuntos
Dislipidemias , Pós-Menopausa , Biomarcadores , Dislipidemias/terapia , Exercício Físico , Feminino , Humanos , Obesidade/terapia , Fator de Necrose Tumoral alfa
11.
Glob Heart ; 16(1): 15, 2021 02 17.
Artigo em Inglês | MEDLINE | ID: mdl-33833939

RESUMO

Background: SARS-CoV-2 pandemic has modified the cardiovascular care of ambulatory patients. The aim of this survey was to study changes in lifestyle habits, treatment adherence, and mental health status in patients with cardiometabolic disease, but no clinical evidence of COVID-19. Methods: A cross-sectional survey was conducted in ambulatory patients with cardiometabolic disease using paper/digital surveys. Variables investigated included socioeconomic status, physical activity, diet, tobacco use, alcohol intake, treatment discontinuation, and psychological symptoms. Results: A total of 4,216 patients (50.9% males, mean age 60.3 ± 15.3 years old) from 13 Spanish-speaking Latin American countries were enrolled. Among the study population, 46.4% of patients did not have contact with a healthcare provider, 31.5% reported access barriers to treatments and 17% discontinued some medication. Multivariate analysis showed that non-adherence to treatment was more prevalent in the secondary prevention group: peripheral vascular disease (OR 1.55, CI 1.08-2.24; p = 0.018), heart failure (OR 1.36, CI 1.05-1.75; p = 0.017), and coronary artery disease (OR 1.29 CI 1.04-1.60; p = 0.018). No physical activity was reported by 38% of patients. Only 15% of patients met minimum recommendations of physical activity (more than 150 minutes/week) and vegetable and fruit intake. Low/very low income (45.5%) was associated with a lower level of physical activity (p < 0.0001), less fruit and vegetables intake (p < 0.0001), more tobacco use (p < 0.001) and perception of depression (p < 0.001). Low educational level was also associated with the perception of depression (OR 1.46, CI 1.26-1.70; p < 0.01). Conclusions: Patients with cardiometabolic disease but without clinical evidence of COVID-19 showed significant medication non-adherence, especially in secondary prevention patients. Deterioration in lifestyle habits and appearance of depressive symptoms during the pandemic were frequent and related to socioeconomic status.


Assuntos
COVID-19 , Doenças Cardiovasculares/terapia , Depressão/psicologia , Diabetes Mellitus/terapia , Dieta , Dislipidemias/terapia , Exercício Físico , Cooperação e Adesão ao Tratamento/estatística & dados numéricos , Adulto , Idoso , Consumo de Bebidas Alcoólicas/epidemiologia , Arritmias Cardíacas/terapia , Fatores de Risco Cardiometabólico , Fumar Cigarros/epidemiologia , Doença da Artéria Coronariana/terapia , Escolaridade , Feminino , Acesso aos Serviços de Saúde , Insuficiência Cardíaca/terapia , Humanos , Hipertensão/terapia , América Latina/epidemiologia , Masculino , Saúde Mental , Pessoa de Meia-Idade , Pacientes Ambulatoriais , Doenças Vasculares Periféricas/terapia , SARS-CoV-2 , Prevenção Secundária , Classe Social , Inquéritos e Questionários
12.
Rev. fitoter ; 19(1): 5-13, mar. 2021. tab, graf, ilus
Artigo em Espanhol | IBECS | ID: ibc-202035

RESUMO

El rizoma de cúrcuma es una conocida especia proveniente del sudeste asiático que se utiliza ampliamente en la medicina ayurvédica para el tratamiento de patologías ginecológicas, alteraciones hepáticas, enfermedades infecciosas o alteraciones dermatológicas tales como psoriasis, dermatitis o acné. En la actualidad está cobrando especial interés por su efecto antiinflamatorio y antioxidante, sirviendo de base para el uso de esta planta medicinal en el tratamiento de patologías que cursan con inflamación o estrés oxidativo. En este sentido el rizoma de cúrcuma se ha propuesto como tratamiento del síndrome metabólico, cuya prevalencia está creciendo en los últimos años y que se caracteriza por la presencia de patologías subyacentes como son la obesidad, la diabetes, las dislipemias y la hipertensión arterial. Esta revisión recoge el potencial terapéutico de la cúrcuma en el síndrome metabólico en base a las evidencias obtenidas en diversos estudios clínicos y preclínicos


Turmeric rhizome, a well-known spice from the southeast of Asia, is widely used in. Ayurvedic medicine for the treatment of gynecological pathologies, liver disorders, infectious diseases or dermatological disorders such as psoriasis, dermatitis or acne. Currently, it is gaining interest due to its antiinflammatory and antioxidant effect, serving as the basis for the use of this plant in inflammatory diseases or pathologies that occur with oxidative stress. Turmeric rhizome has been proposed as a treatment for metabolic syndrome, which has an increasing prevalence in the last years and is characterized by a combination of underlying pathologies such as obesity, diabetes, dyslipidemia and hypertension. This paper aims to review the therapeutic potential of turmeric rhizome in metabolic syndrome, based on the evidences obtained from clinical and preclinical studies


O rizoma de cúrcuma, uma especiaria bem conhecida do sudeste da Ásia, é amplamente utilizado na medicina ayurvédica para o tratamento de patologias ginecológicas, doenças hepáticas e doenças infecciosas ou dermatológicas, como psoríase, dermatite ou acne. Atualmente, assiste-se a um crescente interesse na sua utilização, principalmente devido ao seu efeito antiinflamatório e antioxidante, que suportam a utilização desta planta em doenças inflamatórias ou patologias que ocorrem devido ao stress oxidativo. O rizoma de cúrcuma tem sido proposto como tratamento para a síndrome metabólica, que apresenta prevalência crescente nos últimos anos e é caracterizada por uma combinação de patologias de base, como obesidade, diabetes, dislipidemia e hipertensão.Este trabalho tem como objetivo fazer uma revisão do potencial terapêutico do rizoma de cúrcuma na síndrome metabólica com base nas evidências obtidas em estudos clínicos e pré-clínicos publicados na literatura científica


Assuntos
Humanos , Síndrome Metabólica/terapia , Curcumina/uso terapêutico , Anti-Inflamatórios/uso terapêutico , Diabetes Mellitus Tipo 2/terapia , Antioxidantes/uso terapêutico , Medicina Ayurvédica/métodos , Curcuma , Obesidade/terapia , Dislipidemias/terapia , Fator de Necrose Tumoral alfa/síntese química
14.
Pediatrics ; 147(3)2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33526606

RESUMO

OBJECTIVES: In this report, we compare weight loss, comorbidity resolution, nutritional abnormalities, and quality of life between younger and older adolescents after metabolic and bariatric surgery. METHODS: From March 2007 to December 2011, 242 adolescents (≤19 years of age) who underwent bariatric surgery at 5 clinical centers in the United States were enrolled in the prospective, multicenter, long-term outcome study Teen-Longitudinal Assessment of Bariatric Surgery. Outcome data from younger (13-15 years; n = 66) and older (16-19 years; n = 162) study participants were compared. Outcomes included percent BMI change, comorbidity outcomes (hypertension, dyslipidemia, and type 2 diabetes mellitus), nutritional abnormalities, and quality of life over 5 years post surgery. RESULTS: Baseline characteristics, except for age, between the 2 cohorts were similar. No significant differences in frequency of remission of hypertension (P = .84) or dyslipidemia (P = .74) were observed between age groups. Remission of type 2 diabetes mellitus was high in both groups, although statistically higher in older adolescents (relative risk 0.86; P = .046). Weight loss and quality of life were similar in the 2 age groups. Younger adolescents were less likely to develop elevated transferrin (prevalence ratio 0.52; P = .048) and low vitamin D levels (prevalence ratio 0.8; P = .034). CONCLUSIONS: The differences in outcome of metabolic and bariatric surgery between younger and older adolescents were few. These data suggest that younger adolescents with severe obesity should not be denied consideration for surgical therapy on the basis of age alone and that providers should consider adolescents of all ages for surgical therapy for obesity when clinically indicated.


Assuntos
Cirurgia Bariátrica , Diabetes Mellitus Tipo 2/terapia , Dislipidemias/terapia , Hipertensão/terapia , Obesidade Pediátrica/cirurgia , Adolescente , Fatores Etários , Índice de Massa Corporal , Comorbidade , Dislipidemias/epidemiologia , Feminino , Humanos , Hipertensão/epidemiologia , Masculino , Transtornos Nutricionais/terapia , Obesidade Mórbida/epidemiologia , Obesidade Mórbida/cirurgia , Prevalência , Estudos Prospectivos , Qualidade de Vida , Indução de Remissão/métodos , Fatores de Tempo , Transferrina/metabolismo , Resultado do Tratamento , Estados Unidos/epidemiologia , Deficiência de Vitamina D/epidemiologia , Perda de Peso , Adulto Jovem
15.
Arch Cardiovasc Dis ; 114(2): 132-139, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33546998

RESUMO

Low-density lipoprotein cholesterol is a well-known causal factor for atherosclerotic cardiovascular disease, and is the primary target of lipid-lowering therapy. There is, however, still a substantial risk of atherosclerotic cardiovascular disease events despite intensive statin therapy, and data from clinical trials suggest that an elevated concentration of triglycerides is a marker of residual cardiovascular risk on low-density lipoprotein-lowering therapy. Serum triglycerides are a biomarker for triglyceride-rich lipoproteins, and several lines of evidence indicate that triglyceride-rich lipoproteins and their cholesterol-enriched remnant particles are associated with atherogenesis. Moreover, genetic data in humans strongly suggest that the remnants of triglyceride-rich lipoproteins are a causal cardiovascular risk factor. Although lifestyle changes remain the cornerstone of management of hypertriglyceridaemia, a recent trial with high doses of the omega-3 fatty acid icosapent ethyl showed a significant reduction in cardiovascular events that was not explained by the reduction in triglycerides alone. In patients with elevated triglycerides, several novel drugs are in development to reduce the residual risk on statin therapy linked to an excess of atherogenic triglyceride-rich lipoproteins. In this review, we provide an update on the biology, epidemiology and genetics of triglycerides, and the risk of atherosclerotic cardiovascular disease.


Assuntos
Aterosclerose/sangue , Dislipidemias/sangue , Triglicerídeos/sangue , Animais , Aterosclerose/diagnóstico , Aterosclerose/epidemiologia , Aterosclerose/prevenção & controle , Biomarcadores/sangue , Dislipidemias/diagnóstico , Dislipidemias/epidemiologia , Dislipidemias/terapia , Fatores de Risco de Doenças Cardíacas , Humanos , Hipolipemiantes/uso terapêutico , Prognóstico , Medição de Risco , Comportamento de Redução do Risco
17.
Dtsch Med Wochenschr ; 146(2): 75-84, 2021 01.
Artigo em Alemão | MEDLINE | ID: mdl-33465803

RESUMO

The updated guidelines for the management of dyslipidaemias 2019 sticks to the concept of individual risk-based intervention strategies, but intensifies LDL-C goals. Next to the established SCORE system non-invasive imaging techniques such as coronary CT or ultrasound of carotid or femoral arteries are now recommended for improved risk stratification. Screening for lipoprotein(a) identifies persons at higher cardiovascular risk. Non-statin trials with ezetimibe and PSCK9-inhibitors demonstrated further relative risk reduction for cardiovascular events. Cardiovascular risk reduction depends on the absolute lowering of LDL-C, duration of therapy and the individual cardiovascular risk. For patients at very high risk the new LDL-C goal is < 1.4 mmol/l (55 mg/dl) and reduction of ≥ 50 % from baseline. The overall aim is to reduce "cholesterol life years".


Assuntos
Dislipidemias , Anticolesterolemiantes/uso terapêutico , Doenças Cardiovasculares , LDL-Colesterol/sangue , Dislipidemias/complicações , Dislipidemias/diagnóstico , Dislipidemias/epidemiologia , Dislipidemias/terapia , Humanos , Guias de Prática Clínica como Assunto , Fatores de Risco
18.
Asia Pac J Public Health ; 33(1): 46-52, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33030030

RESUMO

This study involved an age-period-cohort analysis of the consultation rate and prevalence of dyslipidemia in Japan, based on Patient Survey data from 1999 to 2017 and open data of national database of health insurance claims and specific health checkups in Japan from 2013 to 2016. Our results showed that the consultation rates were lower than the prevalence, regardless of age, year, and sex, and particularly among middle-aged and male respondents. Additionally, both the consultation rate and prevalence increased with increasing age to a greater extent among women than men, and the degree of increase in the consultation rate was larger than that in prevalence among women. Furthermore, although the cohort effect on prevalence began to decrease among men in cohorts born in approximately 1960, the effect decreased among women in cohorts born between the 1930s and 1960s and exhibited an increasing trend thereafter.


Assuntos
Dislipidemias/epidemiologia , Dislipidemias/terapia , Encaminhamento e Consulta/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Bases de Dados Factuais , Feminino , Humanos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Inquéritos e Questionários
19.
Muscle Nerve ; 63(3): 285-293, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33098165

RESUMO

Diabetic peripheral neuropathy and metabolic syndrome (MetS) are both global health challenges with well-established diagnostic criteria and significant impacts on quality of life. Clinical observations, epidemiologic evidence, and animal models of disease have strongly suggested MetS is associated with an elevated risk for cryptogenic sensory peripheral neuropathy (CSPN). MetS neuropathy preferentially affects small unmyelinated axons early in its course, and it may also affect autonomic and large fibers. CSPN risk is linked to MetS and several of its components including obesity, dyslipidemia, and prediabetes. MetS also increases neuropathy risk in patients with established type 1 and type 2 diabetes. In this review we present animal data regarding the role of inflammation and dyslipidemia in MetS neuropathy pathogenesis. Several studies suggest exercise-based lifestyle modification is a promising treatment approach for MetS neuropathy.


Assuntos
Neuropatias Diabéticas/diagnóstico , Síndrome Metabólica/diagnóstico , Doenças do Sistema Nervoso Periférico/diagnóstico , Cirurgia Bariátrica , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 1/metabolismo , Diabetes Mellitus Tipo 1/terapia , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/metabolismo , Diabetes Mellitus Tipo 2/terapia , Neuropatias Diabéticas/etiologia , Neuropatias Diabéticas/fisiopatologia , Neuropatias Diabéticas/terapia , Dietoterapia , Progressão da Doença , Dislipidemias/epidemiologia , Dislipidemias/metabolismo , Dislipidemias/terapia , Exercício Físico , Humanos , Hipoglicemiantes/uso terapêutico , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/metabolismo , Síndrome Metabólica/terapia , Obesidade/epidemiologia , Obesidade/metabolismo , Obesidade/terapia , Doenças do Sistema Nervoso Periférico/epidemiologia , Doenças do Sistema Nervoso Periférico/fisiopatologia , Doenças do Sistema Nervoso Periférico/terapia , Estado Pré-Diabético/diagnóstico , Estado Pré-Diabético/epidemiologia , Estado Pré-Diabético/metabolismo , Fatores de Risco , Neuropatia de Pequenas Fibras/diagnóstico , Neuropatia de Pequenas Fibras/epidemiologia , Neuropatia de Pequenas Fibras/fisiopatologia , Neuropatia de Pequenas Fibras/terapia , Topiramato/uso terapêutico
20.
Int J Clin Pract ; 75(3): e13784, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33095960

RESUMO

BACKGROUND: Elevated levels of blood lipids are considered a major modifiable risk factor for the development of cardiovascular diseases. The optimal management of dyslipidaemia remains inadequate worldwide. Accordingly, there is an increasing need to evaluate the basis that health care providers are using to control dyslipidaemia. AIM: To evaluate the awareness of Jordanian physicians about the American College of Cardiology/American Heart Association (ACC/AHA) guidelines for dyslipidaemia management. METHOD: A written questionnaire was distributed to 250 physicians from different areas of Jordan during 7 months period (from February 2018 until the end of August 2018). The target population is composed of the following categories: juniors, residents, fellows and consultants who were recruited from private, government and military practice settings. The validated developed questionnaire was distributed by trained medical personnel. RESULTS: A total of 207 physicians filled and handed back the questionnaire. The response rate was 82.8%. Generally, there was a difference in the level of knowledge between physicians (juniors/ residents/ consultants) while there was no difference between genders or practice settings (private or government). The current study showed that the awareness of physicians in different areas of Jordan regarding the 2013 (ACC/AHA) dyslipidaemia guidelines is suboptimal. CONCLUSION: Results indicated low levels of knowledge of 2013 ACC/AHA guidelines for the management of dyslipidaemia among physicians in Jordan. Hence, multiple interventions are needed to be implemented in order to increase the level of awareness among Jordanian physicians.


Assuntos
Dislipidemias , Médicos , American Heart Association , Colesterol , Dislipidemias/terapia , Feminino , Humanos , Jordânia , Masculino , Estados Unidos
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