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1.
Rev Med Suisse ; 16(687): 578-581, 2020 Mar 25.
Artigo em Francês | MEDLINE | ID: mdl-32216180

RESUMO

It is well demonstrated that physical activity can improve the control of diseases such as diabetes, or dyslipidemia. Introduction of regular and frequent physical activity is also part of the useful measures in the management of excess weight. It is therefore surprising that the prescription of physical activity for the treatment of these diseases is still not part of the curriculum of medical studies, and that reimbursement remains very scarce. This article summarizes the state of scientific knowledge in the field and outlines their clinical application.


Assuntos
Exercício Físico/fisiologia , Doenças Metabólicas/terapia , Dislipidemias/terapia , Humanos , Ganho de Peso
2.
PLoS One ; 15(2): e0228932, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32040532

RESUMO

Although the beneficial effects of probiotics in the prevention or treatment of metabolic disorders have been extensively researched, the precise mechanisms by which probiotics improve metabolic homeostasis are still not clear. Given that probiotics usually exert a comprehensive effect on multiple metabolic disorders, defining a concurrent mechanism underlying the multiple effects is critical to understand the function of probiotics. In this study, we identified the SIRT1-dependent or independent PGC-1α pathways in multiple organs that mediate the protective effects of a strain of Lactobacillus plantarum against high-fat diet-induced adiposity, glucose intolerance, and dyslipidemia. L. plantarum treatment significantly enhanced the expression of SIRT1, PPARα, and PGC-1α in the liver and adipose tissues under HFD-fed condition. L. plantarum treated mice also exhibited significantly increased expressions of genes involved in bile acid synthesis and reverse cholesterol transport in the liver, browning and thermogenesis of adipose tissue, and fatty acid oxidation in the liver and adipose tissue. Additionally, L. plantarum treatment significantly upregulated the expressions of adiponectin in adipose tissue, irisin in skeletal muscle and subcutaneous adipose tissue (SAT), and FGF21 in SAT. These beneficial changes were associated with a significantly improved HFD-induced alteration of gut microbiota. Our findings suggest that the PGC-1α-mediated pathway could be regarded as a potential target in the development of probiotics-based therapies for the prevention and treatment of metabolic disorders.


Assuntos
Dieta Hiperlipídica/efeitos adversos , Doenças Metabólicas/prevenção & controle , Coativador 1-alfa do Receptor gama Ativado por Proliferador de Peroxissomo/metabolismo , Probióticos/uso terapêutico , Tecido Adiposo/metabolismo , Adiposidade , Animais , Ácidos e Sais Biliares/biossíntese , Colesterol/metabolismo , Dislipidemias/metabolismo , Dislipidemias/prevenção & controle , Dislipidemias/terapia , Microbioma Gastrointestinal , Intolerância à Glucose/metabolismo , Intolerância à Glucose/prevenção & controle , Intolerância à Glucose/terapia , Lactobacillus plantarum/fisiologia , Metabolismo dos Lipídeos , Fígado/metabolismo , Masculino , Doenças Metabólicas/metabolismo , Doenças Metabólicas/terapia , Camundongos , Camundongos Endogâmicos C57BL , Transdução de Sinais , Sirtuína 1/metabolismo
3.
Ann Biol Clin (Paris) ; 77(6): 605-618, 2019 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-31859638

RESUMO

Inborn errors of metabolism (IEM) are rare diseases caused by mutations in genes encoding enzymes or carriers. Qualitative or quantitative protein deficiency induces both an accumulation of precursor metabolites and a lack of products downstream of the blockade. Pregnancy in patients with IEM is a condition likely to promote metabolic decompensation. In this review, we presented liver symptoms described during pregnancy in a context of hepatic IEM. In particular, we detailed clinical and biological abnormalities specifically occurring in tyrosinemia type I, Wilson disease, and main urea cycle defects. In the case of hepatic IEM, depending on the deficit, pregnant women have an increased risk of pre-eclampsia and HELLP syndrome, as well as hyperammonemia. Wilson disease, and principal urea cycle defects. Multidisciplinary consultation is essential for the optimal management of pregnant women with IEM as well as newborns.


Assuntos
Hepatopatias/etiologia , Erros Inatos do Metabolismo/complicações , Complicações na Gravidez/etiologia , Criança , Feminino , Humanos , Recém-Nascido , Comunicação Interdisciplinar , Hepatopatias/epidemiologia , Hepatopatias/terapia , Doenças Metabólicas/complicações , Doenças Metabólicas/epidemiologia , Doenças Metabólicas/genética , Doenças Metabólicas/terapia , Erros Inatos do Metabolismo/epidemiologia , Erros Inatos do Metabolismo/terapia , Equipe de Assistência ao Paciente/organização & administração , Gravidez , Complicações na Gravidez/epidemiologia , Complicações na Gravidez/terapia , Fatores de Risco
4.
Vet Clin North Am Equine Pract ; 35(3): 399-417, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31587976

RESUMO

The donkey evolved under harsh and arid environmental conditions, developing unique energy-efficiency traits, with an efficiency to rapidly mobilize fat in situations of increased energy demands or when food is scarce. This evolution has led to an inherent predisposition of donkeys to obesity, dyslipidemias, insulin dysregulation/metabolic syndrome, pituitary pars intermedia dysfunction, and endocrinopathic laminitis. Marked differences have been described in hormone dynamics and testing protocols for the diagnosis of these endocrine and metabolic diseases in donkeys compared with horses, underlining the necessity of a species-specific approach in order to avoid misdiagnosis, unnecessary or inadequate treatments, and additional costs.


Assuntos
Doenças do Sistema Endócrino/veterinária , Equidae , Doenças dos Cavalos/diagnóstico , Doenças Metabólicas/veterinária , Animais , Doenças do Sistema Endócrino/diagnóstico , Doenças do Sistema Endócrino/metabolismo , Doenças do Sistema Endócrino/terapia , Doenças dos Cavalos/metabolismo , Doenças dos Cavalos/terapia , Cavalos , Doenças Metabólicas/diagnóstico , Doenças Metabólicas/metabolismo , Doenças Metabólicas/terapia
5.
Nat Rev Endocrinol ; 15(12): 701-712, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31616073

RESUMO

Of all the novel glucoregulatory molecules discovered in the past 20 years, bile acids (BAs) are notable for the fact that they were hiding in plain sight. BAs were well known for their requirement in dietary lipid absorption and biliary cholesterol secretion, due to their micelle-forming properties. However, it was not until 1999 that BAs were discovered to be endogenous ligands for the nuclear receptor FXR. Since that time, BAs have been shown to act through multiple receptors (PXR, VDR, TGR5 and S1PR2), as well as to have receptor-independent mechanisms (membrane dynamics, allosteric modulation of N-acyl phosphatidylethanolamine phospholipase D). We now also have an appreciation of the range of physiological, pathophysiological and therapeutic conditions in which endogenous BAs are altered, raising the possibility that BAs contribute to the effects of these conditions on glycaemia. In this Review, we highlight the mechanisms by which BAs regulate glucose homeostasis and the settings in which endogenous BAs are altered, and provide suggestions for future research.


Assuntos
Ácidos e Sais Biliares/metabolismo , Pesquisa Biomédica/tendências , Glucose/metabolismo , Índice Glicêmico/fisiologia , Insulina/metabolismo , Animais , Humanos , Doenças Metabólicas/metabolismo , Doenças Metabólicas/terapia
6.
PLoS Med ; 16(10): e1002952, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31665140

RESUMO

BACKGROUND: Nutritional supplements may improve development of infants born small (preterm or small for gestational age [SGA]) but may increase the risk of later metabolic disease. We conducted a systematic review and meta-analysis to assess the effects of macronutrient supplements for infants born small on later development and metabolism. METHODS AND FINDINGS: We searched OvidMedline, Embase, Cochrane CENTRAL, and Cochrane Database of Systematic Reviews from inception to April 1, 2019, and controlled-trials.com, clinicaltrials.gov, and anzctr.org.au. Randomised or quasirandomised trials were included if the intention was to increase macronutrient intake to improve growth or development of infants born small and assessed post-discharge outcomes. Co-primary outcomes were cognitive impairment and metabolic risk, evaluated in toddlers (<3 years), childhood (3 to 8 years), and adolescence (9 to 18 years). Two reviewers independently extracted data. Quality was assessed using the Cochrane Risk of Bias tool, and data were pooled using random-effect models. Twenty-one randomised and one quasirandomised trial of variable methodological quality involving 3,680 infants were included. In toddlers born small, supplementation did not alter cognitive impairment (relative risk [RR] 1.00; 95% confidence interval [CI] 0.67 to 1.49; P = 0.99), and there were no differences in cognitive scores (mean difference [MD] 0.57; 95% CI -0.71 to 1.84; P = 0.38) or motor scores (MD 1.16; 95% CI -0.32 to 2.65; P = 0.12) between supplemented and unsupplemented groups. However, fewer supplemented children had motor impairment (RR 0.76; 95% CI 0.62 to 0.94; P = 0.01). In subgroup analyses, supplementation improved cognitive scores in boys (MD 5.60; 95% CI 1.07 to 10.14; P = 0.02), but not girls born small (MD -2.04; 95% CI -7.04 to 2.95; P = 0.42), and did not alter cognitive or motor scores in the subgroup of children born SGA. In childhood, there was no difference in cognitive impairment (RR 0.81; 95% CI 0.26 to 2.57; P = 0.72) or cognitive scores (MD 1.02; 95% CI -1.91 to 3.95; P = 0.50) between supplemented and unsupplemented groups. There were also no differences in blood pressure, triglyceride, and low-density lipoprotein (LDL) concentrations (all P > 0.05). However, supplemented children had lower fasting glucose (mmol/L: MD -0.20; 95% CI -0.34 to -0.06; P = 0.005) and higher high-density lipoprotein (HDL) concentrations (mmol/L: MD 0.11; 95% CI 0.02 to 0.19; P = 0.02). In subgroup analyses, there was no evidence of differences in blood pressure between supplemented and unsupplemented groups in boys or girls born small, or in SGA children. In adolescence, there was no difference between supplemented and unsupplemented groups in blood pressure, triglycerides, LDL and HDL concentrations, fasting blood glucose, insulin resistance, and fasting insulin concentrations (all P > 0.05). Limitations include considerable unexplained heterogeneity, low to very low quality of the evidence, and limited data beyond early childhood. CONCLUSIONS: In this systematic review and meta-analysis of randomised trials, we found no evidence that early macronutrient supplementation for infants born small altered later cognitive function, although there was some evidence that supplementation may decrease motor impairment in toddlers. Contrary to the findings from observational studies, evidence from randomised trials suggests that early macronutrient supplementation for infants born small improves some metabolic outcomes in childhood. PROSPERO REGISTRATION: CRD42019127858.


Assuntos
Deficiências do Desenvolvimento/terapia , Suplementos Nutricionais , Doenças Metabólicas/terapia , Nutrientes , Adolescente , Criança , Pré-Escolar , Deficiências do Desenvolvimento/complicações , Deficiências do Desenvolvimento/prevenção & controle , Feminino , Idade Gestacional , Humanos , Fenômenos Fisiológicos da Nutrição do Lactente , Recém-Nascido , Doenças do Recém-Nascido , Recém-Nascido Prematuro , Recém-Nascido Pequeno para a Idade Gestacional , Masculino , Doenças Metabólicas/complicações , Doenças Metabólicas/prevenção & controle , Gravidez , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
7.
Actual. osteol ; 15(2): 78-93, mayo - ago. 2019. ilus.
Artigo em Espanhol | LILACS | ID: biblio-1048450

RESUMO

Los hallazgos osteológicos se intensi!caron en los últimos años. Se demostró que el esqueleto se comporta, además de sus funciones clásicas, como un órgano de secreción endocrina que sintetiza al menos dos hormonas: el factor de crecimiento de !broblastos 23 (FGF-23) y la osteocalcina (Ocn). La Ocn es un péptido pequeño que contiene 3 residuos de ácido glutámico. Estos residuos se carboxilan postraduccionalmente, quedando retenida en la matriz ósea. La forma decarboxilada en el primer residuo de ácido glutámico (GluOcn) fue reportada por poseer efectos biológicos; la resorción ósea es el mecanismo clave para su bioactivación. La presente revisión se centra en los conocimientos actuales sobre la función hormonal de la Ocn. A la fecha se reporta que la Ocn regularía el metabolismo energético aumentando la proliferación de células ` pancreáticas, y la secreción de insulina y de adiponectina. Sobre el músculo esquelético actuaría favoreciendo la absorción y el catabolismo de nutrientes. La función reproductiva masculina estaría regulada mediante el estímulo a las células de Leydig para sintetizar testosterona; en el desarrollo cerebral y la cognición, la Ocn aumentaría la síntesis de neurotransmisores monoaminados y disminuiría el neurotransmisor inhibidor GABA. Si bien son indispensables mayores evidencias para dilucidar los mecanismos reguladores por medio de los cuales actuaría la Ocn, los resultados enumerados en los distintos estudios experimentales establecen la importancia de este novedoso integrante molecular. Dilucidar su rol dentro de estos procesos interrelacionados en seres humanos abriría la posibilidad de utilizar a la Ocn en el tratamiento de enfermedades endocrino-metabólicas. (AU)


Osteological !ndings have intensi!ed in recent years. The skeleton behaves as an endocrine secretion organ that synthesizes at least two hormones: osteocalcin (Ocn) and !broblast growth factor 23 (FGF-23). Ocn is a small peptide that contains 3 glutamic acid residues. After translation, these residues are carboxylated to make possible its retention into the bone matrix. Decarboxylation on the !rst glutamic acid residue (GluOcn) has been reported to have biological effects. Bone resorption is the key mechanism for its bioactivation. This review focuses on current knowledge on Ocn hormonal function. It has been reported that Ocn regulates energy metabolism by increasing the proliferation of pancreatic ` cells, and the secretion of insulin and adiponectin. On the skeletal muscle, it may act by favoring the absorption and catabolism of nutrients. Male reproductive function might be regulated by stimulating Leydig cells to synthesize testosterone. Regarding brain development and cognition, Ocn would increase monoamine neurotransmitters synthesis and decrease inhibitory neurotransmitter GABA. Although more evidence is needed to elucidate the regulatory mechanisms of Ocn, different experimental studies establish the importance of this novel molecular mediator. Clarifying its role within interrelated processes in humans, might open the possibility of using Ocn in different treatments of endocrine-metabolic diseases. (AU)


Assuntos
Animais , Osteocalcina/metabolismo , Osteocalcina/uso terapêutico , Esqueleto/fisiologia , Esqueleto/metabolismo , Esqueleto/patologia , Varfarina/uso terapêutico , Doenças Cardiovasculares/prevenção & controle , Osteocalcina/biossíntese , Osteocalcina/química , Diabetes Mellitus Tipo 2/prevenção & controle , Doenças do Sistema Endócrino/terapia , Metabolismo Energético/fisiologia , Células Secretoras de Insulina/fisiologia , Fertilidade , Fatores de Crescimento de Fibroblastos/metabolismo , Genitália Masculina/metabolismo , Infertilidade/prevenção & controle , Doenças Metabólicas/terapia , Neoplasias/prevenção & controle
8.
EBioMedicine ; 44: 716-729, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31201141

RESUMO

The importance of the commensal microbiota to human health and well-being has become increasingly evident over the past decades. From a therapeutic perspective, the popularity of fecal microbiota transplantation (FMT) to restore a disrupted microbiota and amend imbalances has increased. To date, most clinical experience with FMT originates from the treatment of recurrent or refractory Clostridioides difficile infections (rCDI), with resolution rates up to 90%. In addition to CDI, a role for the intestinal microbiome has been implicated in several disorders. FMT has been tested in several randomized controlled trials for the treatment of inflammatory bowel disease, irritable bowel disease and constipation with mixed results. FMT has also been explored for extra-gastrointestinal disorders such as metabolic syndrome, hepatic encephalopathy and graft-versus-host disease. With the exception of recurrent CDI, FMT is currently used in experimental settings only and should not yet be offered as standard care. In addition, it is critical to further standardize and optimize procedures for FMT preparation. This includes determination of active components of FMT to develop (personalized) approaches to treat disease.


Assuntos
Infecções por Clostridium/microbiologia , Infecções por Clostridium/terapia , Clostridium difficile/fisiologia , Transplante de Microbiota Fecal , Microbioma Gastrointestinal , Animais , Gastroenteropatias/etiologia , Gastroenteropatias/terapia , Humanos , Doenças do Sistema Imunitário/etiologia , Doenças do Sistema Imunitário/terapia , Transtornos Mentais/etiologia , Transtornos Mentais/terapia , Doenças Metabólicas/etiologia , Doenças Metabólicas/terapia , Doenças do Sistema Nervoso/etiologia , Doenças do Sistema Nervoso/terapia
9.
J Microbiol Biotechnol ; 29(6): 845-855, 2019 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-31216840

RESUMO

Synthetic biology builds programmed biological systems for a wide range of purposes such as improving human health, remedying the environment, and boosting the production of valuable chemical substances. In recent years, the rapid development of synthetic biology has enabled synthetic bacterium-based diagnoses and therapeutics superior to traditional methodologies by engaging bacterial sensing of and response to environmental signals inherent in these complex biological systems. Biosynthetic systems have opened a new avenue of disease diagnosis and treatment. In this review, we introduce designed synthetic bacterial systems acting as living therapeutics in the diagnosis and treatment of several diseases. We also discuss the safety and robustness of genetically modified synthetic bacteria inside the human body.


Assuntos
Bactérias/genética , Terapia Biológica , Biologia Sintética , Animais , Técnicas Biossensoriais , Doenças Transmissíveis/diagnóstico , Doenças Transmissíveis/terapia , Sistemas de Liberação de Medicamentos , Engenharia Genética , Humanos , Doenças Metabólicas/diagnóstico , Doenças Metabólicas/prevenção & controle , Doenças Metabólicas/terapia , Neoplasias/diagnóstico , Neoplasias/terapia
10.
Curr Obes Rep ; 8(3): 317-332, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31175629

RESUMO

PURPOSE: In this review, we summarize current evidence on the gut microbiome and microbial metabolites in relation to obesity and obesity-associated metabolic disorders. Special emphasis is given on mechanisms interconnecting gut microbiome and microbial metabolites with metabolic disorders as well as on potential preventive and therapeutic perspectives with a "bench to bedside" approach. RECENT FINDINGS: Recent data have highlighted the role of gut dysbiosis in the etiology and pathogenesis of metabolic disorders, including obesity, metabolic syndrome, type 2 diabetes mellitus, and non-alcoholic fatty liver disease. Overall, most studies have demonstrated a reduction in gut microbiome diversity and richness in obese subjects, but there is still much debate on the exact microbial signature of a healthy or an obese gut microbiome. Despite the controversial role of an altered gut microbiome as a cause or consequence of obesity in human studies, numerous animal studies and certain human studies suggest beneficial metabolic effects of certain microbial intestinal metabolites, such as butyrate, that could be used in the prevention and treatment of obesity and its comorbidities. More randomized controlled trials and larger prospective studies including well-defined cohorts as well as a multi-omics approach are warranted to better identify the associations between the gut microbiome, microbial metabolites, and obesity and its metabolic complications.


Assuntos
Microbioma Gastrointestinal/fisiologia , Doenças Metabólicas/complicações , Metaboloma/fisiologia , Obesidade/complicações , Animais , Butiratos/metabolismo , Butiratos/farmacologia , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/metabolismo , Diabetes Mellitus Tipo 2/prevenção & controle , Disbiose/complicações , Humanos , Intestinos/microbiologia , Doenças Metabólicas/metabolismo , Doenças Metabólicas/prevenção & controle , Doenças Metabólicas/terapia , Síndrome Metabólica/complicações , Hepatopatia Gordurosa não Alcoólica/complicações , Obesidade/metabolismo , Obesidade/prevenção & controle , Obesidade/terapia , Polissacarídeos/metabolismo , Prebióticos , Simbióticos
11.
Rev Med Suisse ; 15(650): 976-983, 2019 May 08.
Artigo em Francês | MEDLINE | ID: mdl-31066530

RESUMO

Fecal microbiota transplantation (FMT) is approved as a safe and effective treatment of recurrent Clostridium difficile infections. The technique is now being studied for other indications, usually involving chronic inflammation, metabolic disorders, or autoimmunity, for which the gut microbiota appears to play a key role. We detail thereafter, according to their degree of evidence, the potential future indications, in which FMT has already been tried on Humans. Except for ulcerative colitis and metabolic syndrome, the methodology of the published trials is often insufficiently described and inhomogeneous. Further randomized placebo-controlled trials and standardization of practice will be needed to confirm these preliminary but encouraging results.


Assuntos
Infecções por Clostridium , Colite Ulcerativa , Transplante de Microbiota Fecal , Microbioma Gastrointestinal , Doenças Metabólicas , Infecções por Clostridium/terapia , Fezes , Humanos , Doenças Metabólicas/terapia , Resultado do Tratamento
12.
Am J Physiol Endocrinol Metab ; 317(1): E11-E24, 2019 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-30964704

RESUMO

The health-promoting effects of physical activity to prevent and treat metabolic disorders are numerous. However, the underlying molecular mechanisms are not yet completely deciphered. In recent years, studies have referred to the liver as an endocrine organ, since it releases specific proteins called hepatokines. Some of these hepatokines are involved in whole body metabolic homeostasis and are theorized to participate in the development of metabolic disease. In this regard, the present review describes the role of Fibroblast Growth Factor 21, Fetuin-A, Angiopoietin-like protein 4, and Follistatin in metabolic disease and their production in response to acute exercise. Also, we discuss the potential role of hepatokines in mediating the beneficial effects of regular exercise and the future challenges to the discovery of new exercise-induced hepatokines.


Assuntos
Citocinas/metabolismo , Exercício Físico/fisiologia , Fígado/metabolismo , Doenças Metabólicas/metabolismo , Animais , Diabetes Mellitus Tipo 2/metabolismo , Humanos , Resistência à Insulina/fisiologia , Doenças Metabólicas/terapia , Hepatopatia Gordurosa não Alcoólica/metabolismo , Obesidade/metabolismo
13.
J Med Syst ; 43(5): 135, 2019 Apr 04.
Artigo em Inglês | MEDLINE | ID: mdl-30949846

RESUMO

This study conducts a mapping study to survey the landscape of health chatbots along three research questions: What illnesses are chatbots tackling? What patient competences are chatbots aimed at? Which chatbot technical enablers are of most interest in the health domain? We identify 30 articles related to health chatbots from 2014 to 2018. We analyze the selected articles qualitatively and extract a triplet for each of them. This data serves to provide a first overview of chatbot-mediated behavior change on the health domain. Main insights include: nutritional disorders and neurological disorders as the main illness areas being tackled; "affect" as the human competence most pursued by chatbots to attain change behavior; and "personalization" and "consumability" as the most appreciated technical enablers. On the other hand, main limitations include lack of adherence to good practices to case-study reporting, and a deeper look at the broader sociological implications brought by this technology.


Assuntos
Comportamentos Relacionados com a Saúde , Aprendizado de Máquina , Telemedicina/métodos , Envio de Mensagens de Texto , Interface Usuário-Computador , Comportamento Aditivo/diagnóstico , Comportamento Aditivo/terapia , Comunicação , Nível de Saúde , Humanos , Internet , Saúde Mental , Doenças Metabólicas/diagnóstico , Doenças Metabólicas/terapia , Doenças do Sistema Nervoso/diagnóstico , Doenças do Sistema Nervoso/terapia , Transtornos Nutricionais/diagnóstico , Transtornos Nutricionais/terapia
14.
Medicine (Baltimore) ; 98(8): e14543, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30813162

RESUMO

BACKGROUND: Herbal medicines have the potential to be alternative treatments for metabolic diseases. This systematic review will assess the efficacy of herbal medicines in treating metabolic diseases with blood stasis. METHODS AND ANALYSIS: We will search MEDLINE, the Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, 2 Korean medical databases (OASIS, NDSL), a Chinese database (China National Knowledge Infrastructure, CNKI), and a Japanese database (J-STAGE) for relevant literature. We will include all randomized controlled trials (RCTs) or quasi-RCTs evaluating the effectiveness of herbal medicine. Participants of both sexes and of any age with clinically diagnosed metabolic disease with blood stasis will be included. Primary outcomes will include Blood-stasis syndrome score, TC, TG, HDL-C and LDL-C. Secondary outcomes will Blood pressure, FBS. ECG, prevalence rate of heart disease, and response rate. The risk of bias will be assessed using the Cochrane tool for assessing risk of bias. DISCUSSION: The findings of this study will provide a summary of the current state of evidence regarding the effectiveness of types of herbal medicine in managing metabolic disease with blood stasis. In addition, this review will be expected to provide a base for clinical trials to confirm the efficacy of herbal medicine for treatments of metabolic disease with blood stasis. TRIAL REGISTRATION NUMBER: PROSPERO 2018 CRD42018090179.


Assuntos
Transtornos da Coagulação Sanguínea/terapia , Medicina Herbária/métodos , Doenças Metabólicas/terapia , Fitoterapia/métodos , Transtornos da Coagulação Sanguínea/complicações , Feminino , Humanos , Masculino , Doenças Metabólicas/complicações , Plantas Medicinais/efeitos dos fármacos , Projetos de Pesquisa , Resultado do Tratamento
15.
Curr Obes Rep ; 8(3): 210-219, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30919312

RESUMO

PURPOSE OF REVIEW: Research over the past decade has shown that immunologic and metabolic pathways are intricately linked. This burgeoning field of immunometabolism includes intrinsic and extrinsic pathways and is known to be associated with obesity-accelerated metabolic disease. Intrinsic immunometabolism includes the study of fuel utilization and bioenergetic pathways that influence immune cell function. Extrinsic immunometabolism includes the study of immune cells and products that influence systemic metabolism. RECENT FINDINGS: Th2 immunity, macrophage iron handling, adaptive immune memory, and epigenetic regulation of immunity, which all require intrinsic metabolic changes, play a role in systemic metabolism and metabolic function, linking the two arms of immunometabolism. Together, this suggests that targeting intrinsic immunometabolism can directly affect immune function and ultimately systemic metabolism. We highlight important questions for future basic research that will help improve translational research and provide therapeutic targets to help establish new treatments for obesity and associated metabolic disorders.


Assuntos
Obesidade/imunologia , Obesidade/metabolismo , Obesidade/terapia , Imunidade Adaptativa , Tecido Adiposo/imunologia , Tecido Adiposo/metabolismo , Animais , Metabolismo Energético , Epigênese Genética , Humanos , Imunidade , Memória Imunológica , Ferro/metabolismo , Macrófagos/imunologia , Macrófagos/metabolismo , Doenças Metabólicas/terapia , Redes e Vias Metabólicas , MicroRNAs/imunologia , MicroRNAs/metabolismo
16.
Trends Endocrinol Metab ; 30(3): 147-149, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30704823

RESUMO

The interplay between cell/tissue damage caused by metabolic dysfunction and regenerative potential remains elusive. The tissue engineering and regenerative medicine (TERM) field is now facing a worldwide epidemic of obesity. This Forum article uncovers prospective questions to be addressed in TERM toward the development of effective regenerative therapies adjusted to these new demands.


Assuntos
Doenças Metabólicas/terapia , Medicina Regenerativa/métodos , Humanos , Engenharia Tecidual/métodos
18.
BMC Pediatr ; 19(1): 12, 2019 01 08.
Artigo em Inglês | MEDLINE | ID: mdl-30621667

RESUMO

BACKGROUND: Physical activity (PA) is associated with a diverse range of health benefits. International guidelines suggest that children should be participating in a minimum of 60 min of moderate to vigorous intensity PA per day to achieve these benefits. However, current guidelines are intended for healthy children, and thus may not be applicable to children with a chronic disease. Specifically, the dose of PA and disease specific exercise considerations are not included in these guidelines, leaving such children with few, if any, evidence-based informed suggestions pertaining to PA. Thus, the purpose of this narrative review was to consider current literature in the area of exercise as medicine and provide practical applications for exercise in five prevalent pediatric chronic diseases: respiratory, congenital heart, metabolic, systemic inflammatory/autoimmune, and cancer. METHODS: For each disease, we present the pathophysiology of exercise intolerance, summarize the pediatric exercise intervention research, and provide PA suggestions. RESULTS: Overall, exercise intolerance is prevalent in pediatric chronic disease. PA is important and safe for most children with a chronic disease, however exercise prescription should involve the entire health care team to create an individualized program. CONCLUSIONS: Future research, including a systematic review to create evidence-based guidelines, is needed to better understand the safety and efficacy of exercise among children with chronic disease.


Assuntos
Doenças Autoimunes/terapia , Terapia por Exercício , Exercício Físico , Cardiopatias/congênito , Cardiopatias/terapia , Inflamação/terapia , Doenças Metabólicas/terapia , Neoplasias/terapia , Doenças Respiratórias/terapia , Criança , Doença Crônica/terapia , Terapia por Exercício/métodos , Humanos
19.
Artigo em Inglês | IBECS | ID: ibc-177002

RESUMO

Patients with HIV infection have a higher cardiovascular risk than the general population. The identification of patients with high CVR, the implementation of preventive measures and the control of modifiable risk factors, especially in patients on antiretroviral therapy should be part of the management of HIV infection. This document updates the recommendations published in 2014, mainly regarding lipid, glucose, arterial hypertension alterations and cardiovascular risk (CVR). The objective of metabolic monitoring is A1 C ≤7%, similar to that of non-infected population, individualising by age, life expectancy, comorbidities, hypoglycaemia risk and costs. Cardiovascular risk should be calculated in all HIV patients with a risk calculator available for clinical use, even though we recommend the use of REGICOR tables as we are treating the Spanish population. Proper measurement of blood pressure should be a routine practice in the care of patients with HIV infection. The aim of this document is to provide tools for the diagnosis and appropriate treatment of the main metabolic alterations to serve as a reference to professionals who care for people with HIV infection


Los pacientes con infección por el VIH presentan un riesgo cardiovascular (RCV) mayor que la población general. La identificación de los pacientes con elevado RCV, la puesta en marcha de medidas preventivas y el control de los factores de riesgo modificables, especialmente en pacientes en tratamiento antirretroviral, deben formar parte del manejo del VIH. El presente documento actualiza las recomendaciones publicadas en el año 2014, sobre todo en lo referente a las alteraciones lipídicas, glucídicas, de hipertensión arterial y RCV. El objetivo de control metabólico es una A1c ≤ 7%, similar a la de la población no infectada, individualizando según edad, expectativa de vida, comorbilidades, riesgo de hipoglucemias y costes. En todos los pacientes con VIH debe calcularse el RCV con alguna calculadora de riesgo disponible para uso clínico, si bien recomendamos el uso de las tablas de Regicor, al tratarse de población española. La medición correcta de la tensión arterial debe ser una práctica rutinaria en la atención a los pacientes con infección por el VIH. El objetivo de este documento es proporcionar herramientas para el diagnóstico y tratamiento adecuado de las principales alteraciones metabólicas para que sirvan de consulta a los profesionales que atienden a personas con el VIH


Assuntos
Humanos , Doenças Metabólicas/etiologia , Doenças Cardiovasculares/etiologia , Infecções por HIV/complicações , Doenças Metabólicas/diagnóstico , Doenças Cardiovasculares/diagnóstico , Doenças Metabólicas/terapia , Doenças Cardiovasculares/terapia , Conferências de Consenso como Assunto , Estilo de Vida Saudável , Fatores de Risco
20.
Trends Cardiovasc Med ; 29(3): 141-147, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30126689

RESUMO

Alterations in gut microbiota composition and its metabolic activity are emerging as one of the most powerful determinants of cardiovascular disease. Although our knowledge of the precise molecular mechanisms by which gut microbiota influences cardiometabolic homeostasis is still limited, a growing body of knowledge has recently been uncovered about the potential modulation of microbiome for cardiovascular diagnostic and therapeutic aspects. The multitude of interactions between the microorganisms inhabiting the digestive tract and the host has been recognized crucial in the development and progression of atherosclerosis, obesity, diabetes and hypertension. Here, we summarize the role of gut microbiota in host physiology as well as in the pathophysiology of the most common cardio-metabolic disorders, discussing the potential therapeutic opportunities offered by interventions aimed at modifying microbiome composition and activity.


Assuntos
Bactérias/metabolismo , Doenças Cardiovasculares/microbiologia , Microbioma Gastrointestinal , Doenças Metabólicas/microbiologia , Animais , Antibacterianos/administração & dosagem , Bactérias/efeitos dos fármacos , Bactérias/enzimologia , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/terapia , Disbiose , Inibidores Enzimáticos/uso terapêutico , Exercício Físico , Microbioma Gastrointestinal/efeitos dos fármacos , Interações Hospedeiro-Patógeno , Humanos , Doenças Metabólicas/diagnóstico , Doenças Metabólicas/terapia , Prebióticos/administração & dosagem , Probióticos/administração & dosagem , Comportamento de Redução do Risco
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