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1.
Life Sci ; 362: 123363, 2025 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-39761744

RESUMO

AIMS: Type 2 diabetes (T2D) is a prevalent metabolic disease linked to obesity and metabolic syndrome (MS). The glucolipotoxic environment (GLT) impacts tissues causing low-grade inflammation, insulin resistance and the gradual loss of pancreatic ß-cell function, leading to hyperglycemia. We have previously shown that Compound A (CpdA), a plant-derived dissociative glucocorticoid receptor-modulator with inflammation-suppressive activity, displays protective effects on ß-cells in type 1 diabetes murine models. This study aimed to evaluate whether the administration of CpdA can attenuate GLT effects and improve pathophysiological parameters in a murine model of T2D/MS. MAIN METHODS: Eight-week-old male C57BL/6NCrl mice were fed either a standard chow diet or a high-fat/high-sucrose diet (HFHS) for 15 weeks. From week 5 of feeding, each group received i.p. injections of CpdA (2.5 µg/g) or vehicle three times a week. We also examined CpdA in vitro effect against GLT using the insulinoma cell line INS-1E and naïve isolated mouse islets. KEY FINDINGS: CpdA administration in HFHS fed mice improved glucose homeostasis and insulin sensitivity with no apparent side effects. CpdA treatment also preserved pancreatic islet architecture and insulin expression, while reducing hepatic steatosis and visceral adipose tissue inflammation induced by HFHS diet. In vitro assays in INS-1E cells and naïve isolated mouse islets demonstrated that CpdA counteracted GLT-induced inhibition of glucose-stimulated insulin secretion and supported the expression of key ß-cell identity genes under GLT conditions. SIGNIFICANCE: These findings highlight the potential protective effect of CpdA in preserving ß-cell functionality and peripheral tissue physiology in the context of T2D/MS.


Assuntos
Diabetes Mellitus Tipo 2 , Dieta Hiperlipídica , Ilhotas Pancreáticas , Camundongos Endogâmicos C57BL , Receptores de Glucocorticoides , Animais , Masculino , Camundongos , Diabetes Mellitus Tipo 2/metabolismo , Diabetes Mellitus Tipo 2/tratamento farmacológico , Receptores de Glucocorticoides/metabolismo , Dieta Hiperlipídica/efeitos adversos , Ilhotas Pancreáticas/efeitos dos fármacos , Ilhotas Pancreáticas/metabolismo , Ilhotas Pancreáticas/patologia , Células Secretoras de Insulina/efeitos dos fármacos , Células Secretoras de Insulina/metabolismo , Células Secretoras de Insulina/patologia , Modelos Animais de Doenças , Insulina/metabolismo , Resistência à Insulina , Glicemia/metabolismo , Glicemia/efeitos dos fármacos , Glucose/metabolismo
2.
Gynecol Endocrinol ; 41(1): 2450338, 2025 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-39797630

RESUMO

BACKGROUND: There is no strong evidence demonstrating whether or not aerobic exercise in conjunction with resistance exercise improves metabolic diabetes markers in postmenopausal women. OBJECTIVE: To evaluate the effect of aerobic exercise and resistance training on metabolic markers in postmenopausal women with type 2 diabetes mellitus (T2DM) by means of a systematic review and meta-analysis. METHODS: The searches were completed using EMBASE, MEDLINE/PubMed, Scopus and Web of Science databases. This study included non-blinded, single or double-blinded randomized control trials and postmenopausal women diagnosed with T2DM. The imposed intervention was aerobic exercise plus any training protocol to strengthen muscle groups for resistance intervention. The outcomes of interest were the blood glucose levels, insulin secretion, homeostasis model assessment-insulin resistance index (HOMA-IR) and glycated hemoglobin (HbA1c). Risk of Bias tools and GRADE were obligatory. RESULTS: Three studies were included (83 participants). Exercise intervention ranged between two to four days per week. Compared to the control group, in the group submitted to aerobic exercise + resistance training, no significant change was noted for HbA1c (subtotal = mean difference - 0.35 [95% CI: -0.85, 0.15], p = .17, and heterogeneity = 0%) (GRADE: very low), nevertheless, HOMA-IR index was significantly improved (subtotal = mean difference -0.52 [95% CI: -0.99, -0.05], p = .03, and heterogeneity = 0%) (GRADE: very low). CONCLUSION: Despite the very low certainty found in the quality of evidences, our analysis showed that aerobic exercise along with strength exercise seems to improve some metabolic diabetes markers in postmenopausal women with T2DM. There is a need for further studies to support our preliminary findings.


Assuntos
Diabetes Mellitus Tipo 2 , Exercício Físico , Pós-Menopausa , Treinamento Resistido , Diabetes Mellitus Tipo 2/terapia , Diabetes Mellitus Tipo 2/sangue , Humanos , Treinamento Resistido/métodos , Feminino , Exercício Físico/fisiologia , Resistência à Insulina/fisiologia , Glicemia/metabolismo , Glicemia/análise , Terapia por Exercício/métodos , Hemoglobinas Glicadas/análise , Hemoglobinas Glicadas/metabolismo , Pessoa de Meia-Idade
3.
Int Endod J ; 58(3): 467-483, 2025 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-39797578

RESUMO

AIM: This study aimed to explore the possible bidirectional interrelations between fructose-induced metabolic syndrome (MS) and apical periodontitis (AP). METHODOLOGY: Twenty-eight male Wistar rats were distributed into four groups (n = 7, per group): Control (C), AP, Fructose Consumption (FRUT) and Fructose Consumption and AP (FRUT+AP). The rats in groups C and AP received filtered water, while those in groups FRUT and FRUT+AP received a 20% fructose solution mixed with water to induce MS. The groups AP and FRUT+AP had the pulp of their right mandibular first molar exposed to induce AP. Food consumption, murinometric measurements, blood glucose levels and glucose tolerance were monitored. Fifty-six days after the start of the experiment, the animals were euthanized, and serum samples were collected for metabolomic analysis. Mandibles, livers and right kidneys were also collected. The area and volume of the periapical lesions were calculated using micro-computed tomography. Histopathological evaluation was performed. Kruskal-Wallis followed by the Student-Newman-Keuls or Mann-Whitney tests and one-way anova followed by Tukey's or Independent t-test were used for non-parametric and parametric data, respectively (p < .05). Multivariate analysis and variable importance in projection score were applied to assess metabolite profile differences among groups (p < .05). RESULTS: FRUT and FRUT+AP groups showed significantly increased fluid intake, body mass, abdominal circumference, blood glucose levels, liver weight and visceral fat weight (p < .05), indicating the development of MS. The analyses of the metabolite profile suggest increasing glucose, histidine, lactate, fatty acid and phenylalanine in the FRUT+AP group. There were no significant differences in volume and area of periapical lesions in micro-CT analyses (p = .1048 and p = .7494, respectively). Histopathological analysis of the hemimandibles demonstrated areas of inflammatory response, necrosis and microabscess in the periapical region. Hepatic histopathological observations indicated notable differences in cell appearance, with the FRUT and FRUT+AP groups showing signs of microsteatosis. Kidney analysis revealed Bowman's space dilation in the FRUT and AP groups, while the FRUT+AP group exhibited retracted Bowman's space, suggesting a possible alteration in renal filtration capacity. CONCLUSIONS: MS had no impact on the progression of AP in rats. However, AP exacerbated the systemic state affected by MS, with changes in liver and kidney tissues and metabolite levels.


Assuntos
Frutose , Síndrome Metabólica , Periodontite Periapical , Ratos Wistar , Animais , Síndrome Metabólica/metabolismo , Periodontite Periapical/metabolismo , Periodontite Periapical/patologia , Masculino , Ratos , Frutose/efeitos adversos , Modelos Animais de Doenças , Microtomografia por Raio-X , Glicemia/metabolismo
4.
Eur J Sport Sci ; 24(1): 97-106, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-39661009

RESUMO

The incretins (glucose-dependent insulinotropic polypeptide [GIP] and glucagon-like peptide-1 [GLP-1]), along with amylin/islet amyloid polypeptide (IAPP) and insulin-degrading enzyme (IDE), are hormones/enzymes that have been pharmacological targets, such as dipeptidyl peptidase-4 (DPP-4) inhibitors, due to their insulinotropic actions. Physical training is recommended as a treatment for type 2 diabetes mellitus (T2DM); however, its effects on the concentrations of these hormones/enzymes are not well known. Thus, the present study aimed to evaluate the effects of combined training (CT) on the concentrations of hormones/enzymes with insulinotropic actions in individuals with T2DM and overweight. Individuals of both sexes with T2DM (age 51.73 ± 4.19 years; body mass index [BMI] 29.46 ± 3.39 kg/m2) were randomly distributed in the control group (CG, n = 17) and the combined training group (CTG, n = 17). The CT consisted of strength followed by erobic training, 3 times/week, for 16 weeks. Functional variables, body composition, and serum biochemical analyses (clinical markers, GLP-1, GIP, DPP-4, amylin/IAPP, and IDE) were evaluated. The CTG showed a decrease in GLP-1 (pre: 32.8 ± 12.1, post: 28.4 ± 13.5, and p = 0.04) in the group/time analysis. In the evaluation of the Δ% of variation, CTG presented a decrease for GLP-1 (-9.3%; p = 0.03) and amylin/IAPP (-13.4%; p < 0.01), in addition to an increase for DPP-4 (6.2%; p = 0.04) enzyme. CT decreases the baseline levels of important hormones with insulinotropic actions in individuals with T2DM and overweight. The improvement in overall metabolism provided by CT must be the main reason for these effects. These results broaden the understanding of the effects and relationships between CT and glucose metabolism.


Assuntos
Diabetes Mellitus Tipo 2 , Sobrepeso , Humanos , Diabetes Mellitus Tipo 2/terapia , Diabetes Mellitus Tipo 2/metabolismo , Diabetes Mellitus Tipo 2/sangue , Masculino , Pessoa de Meia-Idade , Sobrepeso/terapia , Sobrepeso/metabolismo , Feminino , Peptídeo 1 Semelhante ao Glucagon/sangue , Peptídeo 1 Semelhante ao Glucagon/metabolismo , Polipeptídeo Inibidor Gástrico/sangue , Treinamento Resistido , Polipeptídeo Amiloide das Ilhotas Pancreáticas/sangue , Incretinas/sangue , Glicemia/metabolismo , Índice de Massa Corporal
5.
Br J Hosp Med (Lond) ; 85(11): 1-10, 2024 Nov 30.
Artigo em Inglês | MEDLINE | ID: mdl-39618225

RESUMO

Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are antidiabetic agents that effectively lower blood glucose levels in patients with Type 2 Diabetes Mellitus (T2DM). Beyond their glycemic control properties, SGLT2 inhibitors have demonstrated significant cardiovascular benefits, including reductions in major adverse cardiovascular events. However, the limitations of the pivotal trials investigating these outcomes have not been fully explored. This letter aims to critically assess the major randomized clinical trials that evaluated the cardiovascular effects of SGLT2 inhibitors, highlighting both their strengths and limitations.


Assuntos
Doenças Cardiovasculares , Diabetes Mellitus Tipo 2 , Inibidores do Transportador 2 de Sódio-Glicose , Humanos , Inibidores do Transportador 2 de Sódio-Glicose/uso terapêutico , Diabetes Mellitus Tipo 2/tratamento farmacológico , Doenças Cardiovasculares/tratamento farmacológico , Hipoglicemiantes/uso terapêutico , Hipoglicemiantes/farmacologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Glicemia/efeitos dos fármacos , Glicemia/metabolismo
6.
Proc Natl Acad Sci U S A ; 121(52): e2407225121, 2024 Dec 24.
Artigo em Inglês | MEDLINE | ID: mdl-39700135

RESUMO

Growth hormone (GH) has several metabolic effects, including a profound impact on glucose homeostasis. For example, GH oversecretion induces insulin resistance and increases the risk of developing diabetes mellitus. Here, we show that GH receptor (GHR) ablation in vesicular glutamate transporter 2 (VGLUT2)-expressing cells, which comprise a subgroup of glutamatergic neurons, led to a slight decrease in lean body mass without inducing changes in body adiposity. VGLUT2∆GHR mice exhibited reduced glycemia and improved glucose tolerance and insulin sensitivity. Among different glutamatergic neuronal populations, we found that GHR inactivation in Sim1-expressing cells recapitulated the phenotype observed in VGLUT2∆GHR mice. Furthermore, Sim1∆GHR mice exhibited reduced endogenous glucose production and improved hepatic insulin sensitivity without alterations in whole-body or muscle glucose uptake. Sim1∆GHR mice were protected against acute but not chronic diabetogenic effects of exogenous GH administration. Pharmacological activation of ATP-sensitive potassium channels in the brain normalized blood glucose levels in Sim1∆GHR mice. In conclusion, the absence of GHR signaling in VGLUT2/Sim1-expressing cells causes a persistent reduction in glycemia and improves hepatic insulin sensitivity. Central glucose-sensing mechanisms are likely involved in the reduced glycemia exhibited by Sim1∆GHR mice. The current findings uncover a mechanism involved in the effects of GHR signaling in regulating glucose homeostasis.


Assuntos
Fatores de Transcrição Hélice-Alça-Hélice Básicos , Glicemia , Resistência à Insulina , Receptores da Somatotropina , Proteína Vesicular 2 de Transporte de Glutamato , Animais , Camundongos , Glicemia/metabolismo , Proteína Vesicular 2 de Transporte de Glutamato/metabolismo , Proteína Vesicular 2 de Transporte de Glutamato/genética , Receptores da Somatotropina/metabolismo , Receptores da Somatotropina/genética , Fatores de Transcrição Hélice-Alça-Hélice Básicos/metabolismo , Fatores de Transcrição Hélice-Alça-Hélice Básicos/genética , Hormônio do Crescimento/metabolismo , Masculino , Neurônios/metabolismo , Glucose/metabolismo , Fígado/metabolismo , Camundongos Endogâmicos C57BL
7.
Nutrients ; 16(23)2024 Nov 28.
Artigo em Inglês | MEDLINE | ID: mdl-39683500

RESUMO

BACKGROUND/OBJECTIVES: Goto-Kakizaki (GK) rats exhibit insulin resistance and type 2 diabetes mellitus (T2DM) without obesity. This study explored the effects of ω-3 fatty acid supplementation on T lymphocyte polarization in Wistar (WT) and GK rats. METHODS: They were administered ω-3 fatty acid-rich fish oil (FO) containing eicosapentaenoic (540 mg/g) and docosahexaenoic acids (100 mg/g) by oral gavage at 2 g/kg, thrice a week for 8 weeks. The control groups (WT CT and GK CT) received the same volume of water. The following groups were investigated: GK CT, n = 14; GK ω-3, n = 15; Wistar CT, n = 15; and Wistar ω-3, n = 11. Glucose and insulin tolerance tests (GTT and ITT) were performed. Fasting plasma insulinemia and glycemia were measured. After euthanasia, the lymphocytes were extracted from the mesenteric lymph nodes. RESULTS: The results showed that GK rats supplemented with FO had significantly improved glucose tolerance and insulin sensitivity (kITT). It also promoted greater polarization of lymphocytes toward T regulatory (Treg) features and a reduction in Th1 and Th17 profiles. Additionally, the GK ω-3 group exhibited lower cell proliferation, decreased pro-inflammatory cytokines, and increased IL-10 levels compared to the GK control. CONCLUSIONS: In conclusion, FO supplementation benefited GK rats by improving glucose intolerance, suppressing insulin resistance, and modulating lymphocytes toward Treg polarization.


Assuntos
Glicemia , Diabetes Mellitus Tipo 2 , Suplementos Nutricionais , Ácidos Graxos Ômega-3 , Resistência à Insulina , Ratos Wistar , Animais , Ácidos Graxos Ômega-3/farmacologia , Masculino , Ratos , Diabetes Mellitus Tipo 2/sangue , Glicemia/metabolismo , Glicemia/efeitos dos fármacos , Controle Glicêmico/métodos , Insulina/sangue , Inflamação , Óleos de Peixe/farmacologia , Linfócitos/efeitos dos fármacos , Linfócitos/metabolismo , Citocinas/metabolismo , Citocinas/sangue , Linfócitos T Reguladores/efeitos dos fármacos , Teste de Tolerância a Glucose
8.
Sci Rep ; 14(1): 27820, 2024 11 13.
Artigo em Inglês | MEDLINE | ID: mdl-39537777

RESUMO

The COVID-19 pandemic's prolonged extension may have had a long-term negative impact on weight and metabolic parameters associated with the effectiveness of bariatric surgery. The aim of this study was to assess the impact of the COVID-19 pandemic on cardiometabolic risk markers and weight outcomes of post-bariatric patients. This is a longitudinal study carried out with patients who underwent bariatric surgery before the COVID-19 pandemic. Anthropometric, lipid, glycemic profile, blood pressure, eating behavior and physical activity parameters obtained through face-to-face consultations from 2019 to 2022 were evaluated. An increase in BMI (p = 0.001), percentage of weight gain (p < 0.001), postoperative weight regain rate (p = 0.002), fasting blood glucose (p < 0.001), and glycosylated hemoglobin (p < 0.001) was identified. There were reductions in the percentages of excess weight loss (p = 0.001) and physically active individuals (p = 0.016). These changes were only triggered after the pandemic years. Uncontrolled eating, emotional eating, and physical inactivity were identified as risk factors for weight gain during the pandemic. Prepandemic weight regain rate was risk factor for increased fasting blood glucose. Two years after the pandemic onset, the study participants exhibited increased rates of weight regain, reduced excess weight loss, and an increase in fasting blood glucose and glycosylated hemoglobin parameters.


Assuntos
Cirurgia Bariátrica , COVID-19 , Fatores de Risco Cardiometabólico , Humanos , COVID-19/epidemiologia , Masculino , Estudos Longitudinais , Feminino , Pessoa de Meia-Idade , Adulto , Aumento de Peso , Glicemia/metabolismo , Glicemia/análise , SARS-CoV-2/isolamento & purificação , Pandemias , Redução de Peso , Hemoglobinas Glicadas/metabolismo , Hemoglobinas Glicadas/análise , Índice de Massa Corporal , Fatores de Risco
9.
Int J Mol Sci ; 25(21)2024 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-39518925

RESUMO

Diabetic nephropathy (DN) is a globally widespread complication of diabetes mellitus (DM). Research indicates that pioglitazone and linagliptin mitigate the risk of DN by reducing inflammation, oxidative stress, and fibrosis. The role of tamsulosin in DN is less studied, but it may contribute to reducing oxidative stress and inflammatory responses. The protective effects of combining pioglitazone, linagliptin, and tamsulosin on the kidneys have scarcely been investigated. This study examines the individual and combined effects of these drugs on DN in Wistar rats. Diabetic rats were treated with tamsulosin, pioglitazone, and linagliptin for six weeks. We assessed food and water intake, estimated glomerular filtration rate (eGFR), histological markers, urea, creatinine, glucose, NF-κB, IL-1, IL-10, TGF-ß, and Col-IV using immunofluorescence and qPCR. The DN group exhibited hyperglycaemia, reduced eGFR, and tissue damage. Tamsulosin and linagliptin improved eGFR, decreased urinary glucose, and repaired tissue damage. Pioglitazone and its combinations restored serum and urinary markers and reduced tissue damage. Linagliptin lowered serum creatinine and tissue injury. In conclusion, tamsulosin, linagliptin, and pioglitazone demonstrated renoprotective effects in DN.


Assuntos
Diabetes Mellitus Experimental , Nefropatias Diabéticas , Linagliptina , PPAR gama , Pioglitazona , Ratos Wistar , Animais , PPAR gama/agonistas , PPAR gama/metabolismo , Ratos , Diabetes Mellitus Experimental/tratamento farmacológico , Diabetes Mellitus Experimental/metabolismo , Diabetes Mellitus Experimental/complicações , Pioglitazona/farmacologia , Pioglitazona/uso terapêutico , Masculino , Linagliptina/farmacologia , Linagliptina/uso terapêutico , Nefropatias Diabéticas/tratamento farmacológico , Nefropatias Diabéticas/metabolismo , Nefropatias Diabéticas/patologia , Insuficiência Renal Crônica/tratamento farmacológico , Insuficiência Renal Crônica/metabolismo , Insuficiência Renal Crônica/patologia , Tansulosina/farmacologia , Tansulosina/uso terapêutico , Glicemia/metabolismo , Taxa de Filtração Glomerular/efeitos dos fármacos , Hipoglicemiantes/farmacologia , Hipoglicemiantes/uso terapêutico , Rim/efeitos dos fármacos , Rim/metabolismo , Rim/patologia
10.
Respir Med ; 235: 107859, 2024 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-39536919

RESUMO

This study aimed to evaluate the prevalence of thyroid, glycemic, lipid and metabolic bone disorders among adult patients with pulmonary arterial hypertension (PAH). METHODS: This was an observational cross-sectional clinical study with patients with PAH, matched by sex and age with a control group without PAH. All individuals were enrolled into a clinical assessment, metabolic workup, thyroid ultrasound, and bone densitometry protocol. RESULTS: The PAH group included 35 participants (34 females, 46 ± 15.5 years), and the control group, 40 (39 females, 41.8 ± 13.1 years). There was no difference in body mass index (BMI) between PAH and control group (27.5 ± 5.9 and 26.9 ± 4.3 kg/m2, respectively, p = 0.63; 95 % CI: -1.8, 2.94), neither in physical activity time per week (60.3 ± 103.3 and 98.9 ± 137.6, respectively, p = 0.17; 95 % CI: -95.23, 18.06). Although there was no difference in the prevalence of insulin resistance between the PAH (51.4 %) and the control group (47.5 %), p = 0.74, patients with PAH had a higher median of glycated hemoglobin (A1c) than the control group (6.1 % and 5.57 %, respectively, p = 0.006; 95 % CI: -0.14, 1.22). PAH group presented lower mean total cholesterol (170.46 ± 35.51 mg/dL) and median LDL-cholesterol [105 (83-129) mg/dL, median (P25-P75)] levels than the control group [192.1 ± 34.44 mg/dL, p = 0.009; 95 % CI = -37.76, 5.52 and 121.6 (97-145) mg/dL, p = 0.012; 95 % CI: -34.08, 0.77, respectively]. It was found a higher prevalence of hypothyroidism (22.9 %) in PAH group than in control group (2.5 %), p = 0.007. We found hyperparathyroidism (HPT) among 8 patients of PAH group (23 %), but none in the control group. Considering bone mineral density disorders, 12 patients from PAH group presented low bone mass, osteopenia, or osteoporosis (34 %), and 8 individuals in the control group (20 %), p = 0.032, which represented a 2.13 higher relative risk for those conditions for the former group. The patients with HPT presented a higher creatinine level (0.98 ± 0.12 mg/dL) than the PAH patients with normal parathyroid hormone (0.76 ± 0.14 mg/dL), p = 0.0004; 95 % CI: 0.12, 0.33. The PAH group also presented lower total hip (-0.15 ± 1.25) and femoral neck (-0.14 ± 1.07) bone mineral density (BMD) Z-scores than the control group (0.50 ± 1.13, p = 0.021; 95 % CI: -0.18, -0.027 and 0.35 ± 0.94, p = 0.038; 95 % CI: -0.16, -0.01, respectively). CONCLUSION: In this cohort, the findings of higher A1c levels, hypothyroidism prevalence, lower LDL and total cholesterol levels, and a higher prevalence of hyperparathyroidism, as well as lower total hip and femoral neck BMD Z-scores in the PAH group, compared to the control group and highlighting the dysregulation of various metabolic pathways in patients with HAP, suggesting the need for targeted interventions to enhance patient care. Additionally, they underscore the importance of gaining a deeper understanding of the mechanisms driving these changes and their potential pathophysiological connections to the disease.


Assuntos
Hipertensão Arterial Pulmonar , Humanos , Feminino , Masculino , Pessoa de Meia-Idade , Estudos Transversais , Adulto , Prevalência , Hipertensão Arterial Pulmonar/fisiopatologia , Hipertensão Arterial Pulmonar/metabolismo , Hipertensão Arterial Pulmonar/epidemiologia , Doenças Ósseas Metabólicas/epidemiologia , Doenças Ósseas Metabólicas/metabolismo , Hemoglobinas Glicadas/metabolismo , Glicemia/metabolismo , Doenças da Glândula Tireoide/epidemiologia , Doenças da Glândula Tireoide/metabolismo , Doenças da Glândula Tireoide/complicações , Estudos de Casos e Controles , Resistência à Insulina/fisiologia
11.
Nutrients ; 16(21)2024 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-39519427

RESUMO

Background: Carbohydrate Counting (CC) is important in managing the treatment of Type 1 Diabetes Mellitus (T1DM). This study aimed to evaluate the factors associated with adherence to CC in adults with T1DM in Brazil. Methods: A cross-sectional study was conducted through an online questionnaire. Information was collected on sociodemographic, economic, clinical, and anthropometric factors; knowledge of the CC strategy; the acquisition of supplies; the perception of mathematical skills as a hurdle in adhering to CC; and follow-up with healthcare professionals. Pearson's chi-squared or Fisher's exact test was applied (p < 0.05). Results: Of the 173 participants, 72.8% practiced CC. Practicing CC was associated with having an income higher than three minimum wage equivalents (p = 0.023), and not practicing CC due to the lack of supplies for glucose monitoring was associated with having practiced CC at some point but is currently not practicing (p < 0.001). Not practicing the necessary calculations for CC was associated with "knowing how to do CC but had never done it" and "had done CC at some point but currently not practicing" (p < 0.001). Stopping or having stopped practicing CC due to insufficient materials for glucose monitoring was associated with having practiced CC for a period but is not currently doing so (p < 0.001). Following up with healthcare professionals (p < 0.001) and receiving encouragement from the endocrinologist (p < 0.001) and nutritionist (p = 0.047) were associated with adherence to CC. Conclusions: Having a better financial status, performing the mathematical calculations required for CC, having access to supplies for glucose monitoring, and receiving specialized professional follow-up were factors associated with adherence to CC in Brazil.


Assuntos
Diabetes Mellitus Tipo 1 , Cooperação do Paciente , Humanos , Brasil , Feminino , Adulto , Masculino , Estudos Transversais , Cooperação do Paciente/estatística & dados numéricos , Inquéritos e Questionários , Conhecimentos, Atitudes e Prática em Saúde , Pessoa de Meia-Idade , Carboidratos da Dieta/administração & dosagem , Adulto Jovem , Glicemia/metabolismo , Automonitorização da Glicemia , Fatores Socioeconômicos
12.
Nutrients ; 16(21)2024 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-39519516

RESUMO

Dietary fats influence gene expression and several metabolic pathways. Therefore, it is crucial to study the role of personal genotypes in the interaction between fat consumption and cardiometabolic markers. This research aimed to determine the interaction of the rs708272 polymorphism of CETP and the fatty acid intake with changes in the HOMA-IR in adults living with overweight or obesity. The current study was a secondary analysis of an 8-week controlled clinical trial. The final sample for this analysis comprised 78 Mexican adults with the Cholesteryl Ester Transfer Protein (CETP) rs708272 polymorphism who followed a dietary intervention. Using an interaction analysis, we evaluated the fatty acid intake and the genotypes of rs708272, with changes in blood glucose, insulin, and the HOMA-IR from baseline to endpoint. Our findings suggest a significant interaction between the trans fatty acid intake and the GG genotype with changes in glucose (p = 0.024), insulin (p = 0.004), and the HOMA-IR (p = 0.002). The higher the consumption of trans fatty acids, the less these markers of glucose metabolism were reduced. carriers of the GG genotype may benefit from limiting dietary trans fatty acid intake, as there was no reduction in plasma glucose and insulin despite a hypocaloric dietary intervention in adults with overweight and obesity.


Assuntos
Glicemia , Proteínas de Transferência de Ésteres de Colesterol , Insulina , Obesidade , Ácidos Graxos trans , Humanos , Masculino , Proteínas de Transferência de Ésteres de Colesterol/genética , Feminino , Adulto , Glicemia/metabolismo , Obesidade/genética , Obesidade/dietoterapia , Pessoa de Meia-Idade , Insulina/sangue , Ácidos Graxos trans/administração & dosagem , Biomarcadores/sangue , Polimorfismo de Nucleotídeo Único , Resistência à Insulina/genética , Sobrepeso/genética , Sobrepeso/dietoterapia , Sobrepeso/sangue , Genótipo , México
13.
Biochem Biophys Res Commun ; 739: 150966, 2024 Dec 20.
Artigo em Inglês | MEDLINE | ID: mdl-39547122

RESUMO

The aim of the study was to evaluate the effect of metabolic syndrome (MetS) on female Swiss mice subjected to severe polymicrobial sepsis induced by cecal ligation and puncture (CLP). MetS was induced in neonatal Swiss mice by subcutaneous injection of monosodium glutamate (MSG) at 4 mg/g body weight from day 1 to day 5 after birth, while animals in the control group (CTL) were treated with equimolar saline solution at the same volume and period. On the 75th day of life, the CLP model was used to induce severe polymicrobial sepsis. For inflammatory parameters, we assessed nitric oxide (NO), determined by the cadmium/Griess technique, and quantified IL-6 and IL1ß using the ELISA technique. Glucose levels were measured 24 h before and after CLP using a glucose monitor, and the lipid profile was assessed using commercial kits. Cardiovascular parameters were measured using the CODA platform, and hematological evaluation was determined by standard counting. Unlike male mice, MetS did not alter the survival of females subjected to severe sepsis. Both CTL and MetS CLP groups exhibited hypotension and hypoglycemia, accompanied by leukopenia and increased inflammatory cytokine IL-6. The cytokine IL1ß Only increased in MetS CLP group compared to CTL CLP and MetS Sham. It was also observed that MetS attenuated some parameters during sepsis, such as hematological parameters and resistance to NO increase. We can conclude that the obesity paradox theory is not observed in females. Thus, our findings provide new insights for the literature linking MetS and sepsis.


Assuntos
Síndrome Metabólica , Sepse , Animais , Feminino , Sepse/sangue , Sepse/complicações , Sepse/metabolismo , Camundongos , Síndrome Metabólica/sangue , Síndrome Metabólica/metabolismo , Interleucina-1beta/sangue , Interleucina-1beta/metabolismo , Óxido Nítrico/metabolismo , Óxido Nítrico/sangue , Inflamação/sangue , Interleucina-6/sangue , Glicemia/metabolismo , Masculino
14.
Life Sci ; 359: 123257, 2024 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-39561873

RESUMO

BACKGROUND: Diabetic animals often display dysregulated nitric oxide (NO) metabolism, contributing to vascular dysfunction. This study evaluates the metabolic and vascular effects of organic nitrate isosorbide mononitrate (ISMN) versus inorganic sodium nitrate (NaNO3) in mice with type 1 diabetes mellitus (T1DM) induced by streptozotocin (STZ). EXPERIMENTAL APPROACH: T1DM was induced in male C57Bl6 mice with STZ ip and confirmed by fasting glucose. Mice were treated with ISMN (10 mg·kg-1) or NaNO3 (85 mg·L-1) for 14 days. A combination of in vivo, in vitro, and ex vivo studies assessed cardiometabolic benefits. RESULTS: Both nitrates reduced blood and urinary hyperglycemia in T1DM mice, with ISMN exhibiting more significant reductions in blood glucose. ISMN and NaNO3 similarly reduced water and food intake, urinary volume, glucose intolerance, and insulin resistance while increasing insulin and nitrite levels in serum and urine. Both nitrates improved endothelium-independent vascular function and attenuated reactive oxygen species (ROS) while increasing NO levels in the aortic rings of T1DM mice. Furthermore, both nitrates similarly reduced mean arterial pressure in T1DM mice. CONCLUSION AND IMPLICATIONS: ISMN and NaNO3 have demonstrated comparable hypotensive and antioxidant effects, offering metabolic and vascular benefits in STZ-TDM1 mice. The more pronounced reduction in blood glucose with ISMN treatment compared to NaNO3 is particularly promising. The antihyperglycemic effects of both nitrates were linked to increased serum insulin levels and enhanced insulin sensitivity. These results provide a foundation for future clinical studies to evaluate the potential of ISMN or NaNO3 as antidiabetogenic and antihypertensive adjuvant therapies in diabetic patients.


Assuntos
Glicemia , Diabetes Mellitus Experimental , Camundongos Endogâmicos C57BL , Nitratos , Animais , Masculino , Diabetes Mellitus Experimental/tratamento farmacológico , Diabetes Mellitus Experimental/metabolismo , Camundongos , Nitratos/metabolismo , Glicemia/metabolismo , Glicemia/efeitos dos fármacos , Dinitrato de Isossorbida/análogos & derivados , Dinitrato de Isossorbida/farmacologia , Óxido Nítrico/metabolismo , Estreptozocina , Espécies Reativas de Oxigênio/metabolismo , Insulina/metabolismo , Insulina/sangue , Resistência à Insulina , Diabetes Mellitus Tipo 1/tratamento farmacológico , Diabetes Mellitus Tipo 1/metabolismo
15.
Rev Med Inst Mex Seguro Soc ; 62(6): 1-5, 2024 Nov 04.
Artigo em Espanhol | MEDLINE | ID: mdl-39570777

RESUMO

Background: The Pierde Peso, Gana Vida (Lose Weight, Gain Life) strategy is granted to patients with overweight or obesity, it started in 2022 with the purpose of ordering, integrating and making efficient actions in the care of overweight and obesity, however, its effectiveness is unknown. Objective: To analyze the changes in the following parameters: body weight, waist circumference, glucose, cholesterol and triglycerides in patients who received the strategy in the 35 IMSS state offices during the two semesters of 2022. Material and methods: A retrospective cohort study was conducted including 76,760 patients incorporated into the strategy in the two semesters of 2022. Trend analysis was performed before and after each semester of intervention. Analytical statistics were used for related samples with Student's t-test. SPPSS v25 software was used for data analysis. Results: Patients who received this strategy in each semester presented significant decrease in the parameters: body weight, waist circumference, glucose, cholesterol and triglycerides. Conclusions: The Pierde Peso, Gana Vida strategy makes the actions in obesity care efficient and allows achieving good results in the beneficiaries.


Introducción: la estrategia Pierde Kilos, Gana Vida se otorgó a pacientes con sobrepeso u obesidad. Dio inicio en 2022 con el propósito de ordenar, integrar y hacer eficientes las acciones en la atención del sobrepeso y obesidad, sin embargo, se desconoce su efectividad. Objetivo: analizar los cambios en los siguientes parámetros: peso corporal, circunferencia de cintura, glucosa, colesterol y triglicéridos en los pacientes que recibieron la estrategia en las 35 representaciones estatales del IMSS, durante los dos semestres del 2022. Material y métodos: se realizó un estudio de cohorte retrospectivo que incluyó a 76,760 pacientes incorporados a la estrategia en los dos semestres de 2022. Se realizó análisis de medida de tendencia, del antes y después de cada semestre de intervención. Se utilizó estadística analítica para muestras relacionadas con la prueba t de Student. Para el análisis de los datos se utilizó el software SPPSS v25. Resultados: los pacientes que recibieron esta estrategia en cada semestre presentaron disminución significativa en los parámetros: peso corporal, circunferencia de cintura, glucosa, colesterol y triglicéridos. Conclusiones: la estrategia Pierde Kilos, Gana Vida hace eficientes las acciones en la atención de la obesidad y permite alcanzar buenos resultados en los derechohabientes.


Assuntos
Obesidade , Estudos Retrospectivos , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Adulto , México , Sobrepeso , Circunferência da Cintura , Triglicerídeos/sangue , Colesterol/sangue , Redução de Peso , Programas de Redução de Peso , Glicemia/metabolismo , Glicemia/análise
16.
Nutrients ; 16(22)2024 Nov 16.
Artigo em Inglês | MEDLINE | ID: mdl-39599701

RESUMO

Background/Objectives: Polycystic ovary syndrome is a common endocrine disorder in women of reproductive age characterized by insulin resistance and hormonal imbalances. Recent research suggests that probiotics and synbiotics may improve these parameters by modulating the gut microbiota. This study systematically reviewed randomized clinical trials evaluating the impact of probiotic, prebiotic, and synbiotic supplementation on insulin resistance and hormonal parameters in women with PCOS. Methods: Exhaustive searches were conducted in PubMed, Cochrane CENTRAL, Scopus, Web of Science, and Embase, following PRISMA guidelines. Randomized trials assessing supplementation with probiotics, prebiotics, or synbiotics for at least 8 weeks in women diagnosed with PCOS according to the Rotterdam criteria were included. Data on participants, interventions, and outcomes related to insulin resistance and hormones were extracted. Results: Eleven studies from Iran involving overweight or obese women aged 15 to 48 were included. Probiotic and synbiotic supplementation showed significant improvements in insulin resistance (reductions in HOMA-IR, fasting glucose, and insulin), lipid profiles (decreased LDL and triglycerides; increased HDL), and hormonal balance (increased SHBG, decreased total testosterone). Synbiotics had more pronounced effects than probiotics or prebiotics alone. Adherence was high, and side effects were minimal. Conclusions: Despite promising results, limitations such as small sample sizes, homogeneous populations, and short intervention durations limit the generalization of the findings. Larger, longer, multicenter trials with diverse populations and standardized methodologies are needed to confirm the efficacy and safety of synbiotics in managing PCOS. Integrating these interventions could improve clinical management and quality of life for affected women, but additional evidence is required to support widespread use.


Assuntos
Resistência à Insulina , Síndrome do Ovário Policístico , Prebióticos , Probióticos , Ensaios Clínicos Controlados Aleatórios como Assunto , Simbióticos , Humanos , Síndrome do Ovário Policístico/terapia , Simbióticos/administração & dosagem , Probióticos/administração & dosagem , Probióticos/uso terapêutico , Feminino , Prebióticos/administração & dosagem , Adulto , Adulto Jovem , Adolescente , Pessoa de Meia-Idade , Obesidade/terapia , Obesidade/dietoterapia , Glicemia/metabolismo , Insulina/sangue , Resultado do Tratamento , Globulina de Ligação a Hormônio Sexual/metabolismo , Globulina de Ligação a Hormônio Sexual/análise , Testosterona/sangue
17.
Nutrients ; 16(22)2024 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-39599635

RESUMO

BACKGROUND/OBJECTIVES: The optimal dietary approach for managing glycemic and metabolic control in type 2 diabetes (T2D) is still uncertain, though it should be tailored for clinical settings. Therefore, we sought to assess the impact of a multicomponent nutritional strategy on glycemic control in T2D patients within a public health system. METHODS: NUGLIC was an open-label, parallel-group, superiority, multicenter randomized controlled trial. Participants aged 30 and older with poorly controlled T2D were randomly assigned to either (1) a personalized dietary prescription (control group, n = 185) or (2) a strategy involving targeted nutritional advising, mindfulness techniques, and short message services (NUGLIC [intervention] group, n = 186). The primary outcomes were glycated hemoglobin (HbA1c, %) measured after 24 weeks and glycemic control, defined as having an HbA1c > 7% at baseline and achieving ≤7% after follow-up, or having HbA1c ≤ 7% at baseline and reducing the use of glucose-lowering medications post-follow-up. The secondary outcomes included cardiometabolic features, self-care practices, diet quality, and quality of life. RESULTS: A total of 371 participants were included in an intention-to-treat analysis for the primary outcomes. At six months, both groups exhibited a reduction in HbA1c levels compared to the baseline (NUGLIC group: -0.6% [95% confidence interval (CI) -0.9; -0.3], p < 0.001; control group: -0.5% [95% CI -0.7; -0.3], p < 0.001). However, no significant differences were observed between the groups in terms of HbA1c after follow-up (intervention group: 8.1%; control group: 8.3%; difference: -0.2% [95% CI -0.5; 0.1], p = 0.30) or glycemic control (NUGLIC group: 19.9%; control group: 18.9%; odds ratio 0.96 [95% CI 0.56; 1.67], p = 0.89). While the control group showed an improvement in overall diet quality, no significant differences emerged between the groups by the end of this study (p = 0.13). There were also no significant differences in other secondary outcomes nor in the use of glucose-lowering medications and adverse events after follow-up. CONCLUSIONS: The multicomponent nutritional strategy did not demonstrate superiority over personalized dietary prescriptions in achieving glycemic control for participants with poorly managed T2D. In this sense, both nutritional interventions could be used in clinical practice to improve HbA1c levels, considering the profile and preferences of individuals.


Assuntos
Glicemia , Diabetes Mellitus Tipo 2 , Hemoglobinas Glicadas , Controle Glicêmico , Humanos , Diabetes Mellitus Tipo 2/dietoterapia , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/terapia , Masculino , Feminino , Pessoa de Meia-Idade , Controle Glicêmico/métodos , Hemoglobinas Glicadas/metabolismo , Hemoglobinas Glicadas/análise , Glicemia/metabolismo , Idoso , Qualidade de Vida , Resultado do Tratamento , Adulto
18.
Nutr J ; 23(1): 116, 2024 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-39354466

RESUMO

BACKGROUND: The EAT-Lancet diet is a diet aimed at promoting population and planetary health from the perspective of sustainable diets in terms of environmental and health aspects. This study aimed to assess the association between adherence to the EAT-Lancet diet and cardiometabolic risk factors among adults and elderly individuals in a capital city in the northeastern region of Brazil. METHODS: This is an analytical cross-sectional observational study from a population-based sample conducted between 2019 and 2020, involving 398 non-institutionalized adults and elderly people, of both sexes from "Brazilian Usual Consumption Assessment" study (Brazuca-Natal). There was a 38% response rate due to the suspension of data collection due to the covid-19 pandemic, but According to the comparative analysis of socioeconomic and demographic variables between the surveyed and non-surveyed sectors, losses were found to be random (p = 0.135, Little's MCAR test). Socioeconomic and lifestyle data, anthropometric measurements, and dietary consumption were collected. We used the Planetary Health Diet Index (PHDI) and the Cardiovascular Health Diet Index (CHDI) for cardiovascular health to assess adherence to the diet's sustainability. The evaluated cardiometabolic parameters included fasting blood glucose, triglycerides, total cholesterol, HDL-C, LDL-C, and systolic and diastolic blood pressure measurements. We also assessed the presence of type 2 diabetes mellitus, arterial hypertension, and dyslipidemia. For the data analyses, sample weights and the effect of the study design were taken into account. Pearson's chi-square test was used to evaluate the statistical significance of frequencies. Multiple linear regression models assessed the associations between PHDI and CHDI and its components and the cardiometabolic parameters. RESULTS: The mean PHDI was 29.4 (95% CI 28.04:30.81), on a total score ranging from 0 to 150 points and the mean CHDI was 32.63 (95% CI 31.50:33.78), on a total score ranging from 0 to 110 points. PHDI showed a significant positive association with the final CHDI score and components of fruits, vegetables, and legumes, and a negative association with Ultra-processed Food (UPF) (p < 0.05). Notably, among the most consumed UPF, the following stand out: "packaged snacks, shoestring potatoes, and crackers" (16.94%), followed by margarine (14.14%). The PHDI exhibited a significant association with diabetes and dyslipidemia, as well as with systolic blood pressure, total cholesterol, and LDL-C. CONCLUSIONS: The results suggest that adopting the EAT-Lancet diet is associated with the improvement of key cardiovascular health indicators.


Assuntos
Doenças Cardiovasculares , Humanos , Masculino , Brasil/epidemiologia , Feminino , Estudos Transversais , Pessoa de Meia-Idade , Idoso , Adulto , Doenças Cardiovasculares/epidemiologia , Dieta Saudável/estatística & dados numéricos , Dieta Saudável/métodos , Fatores de Risco Cardiometabólico , COVID-19/epidemiologia , Dieta/métodos , Dieta/estatística & dados numéricos , Glicemia/metabolismo
19.
Clin Neurol Neurosurg ; 247: 108609, 2024 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-39461306

RESUMO

INTRODUCTION: The glucose/potassium index (GPI) has been reported as a predictor biomarker of in-hospital complications in patients with aneurysmal subarachnoid hemorrhage (aSAH). OBJECTIVES: To determine the association between GPI and functional outcome at 3-6 months after discharge in patients diagnosed with aSAH in a Peruvian referral hospital during 2018-2021. MATERIALS AND METHODS: We conducted a retrospective cohort observational study with a secondary database in patients with aSAH during 2018-2021 in a Peruvian referral hospital. We evaluated the relationship between GPI values and motor functionality from 3 m to 6 months post-discharge, using a Poisson family generalized linear model with Log link function and robust variance according to categorization of good and poor outcome. We considered a value of p<0.05 as statistically significant. We used restricted cubic splines with five nodes to evaluate the linear correlation between the 2 main variables. RESULTS: 212 patients were included in the analysis. 21.1 % and 19.3 % had poor outcome at 3 and 6 months after discharge, respectively. Multivariate analysis showed that GPI was not associated with poor outcome at 3 (RR=0.999; 95 %CI=0.979-1.018) or 6 months after discharge (RR=0.979; 95 %CI=0.979-1.020). On the other hand, Splines plots showed no correlation between GPI and modified Rankin. CONCLUSIONS: Despite the usefulness of GPI to prognosticate in-hospital complications, its association with functional outcome is inconclusive.


Assuntos
Glicemia , Potássio , Hemorragia Subaracnóidea , Humanos , Hemorragia Subaracnóidea/sangue , Hemorragia Subaracnóidea/complicações , Masculino , Feminino , Pessoa de Meia-Idade , Prognóstico , Glicemia/metabolismo , Estudos Retrospectivos , Idoso , Potássio/sangue , Adulto , Estudos de Coortes , Biomarcadores/sangue
20.
Int J Mol Sci ; 25(20)2024 Oct 11.
Artigo em Inglês | MEDLINE | ID: mdl-39456742

RESUMO

Diabetes is a metabolic disease with a high worldwide prevalence and an important factor in mortality and disability in the population. Complications can be reduced or prevented with lifestyle changes in physical activity, dietary habits, and smoking cessation. High-protein diets (HPDs, >30% or >1.0 g/Kg/day) decrease hyperglycemia in part due to their content of branched-chain amino acids (BCAAs), mainly leucine. Leucine (and other BCAAs) improve glucose metabolism by directly signaling in the medio-basal hypothalamus (MBH), increasing liver insulin sensitivity. To determine the effectiveness of an HPD to lower hyperglycemia, we analyzed the results of published clinical studies focusing on the levels of fasting plasma glucose and/or glycosylated hemoglobin (HbA1c) in patients with type 2 diabetes mellitus (T2DM). We carried out a systematic search for clinical studies using HPDs. We searched five databases (Scopus, Web of Science, PubMed, Epistemonikos, and Cochrane), collecting 179 articles and finally selecting 8 articles to analyze their results. In conclusion, HPDs are an effective alternative to reduce hyperglycemia in patients with T2DM, especially so-called Paleolithic diets, due to their higher-quality protein from animal and vegetal sources and their exclusion of grains, dairy products, salt, refined fats, and added sugars.


Assuntos
Glicemia , Diabetes Mellitus Tipo 2 , Dieta Rica em Proteínas , Humanos , Glicemia/metabolismo , Diabetes Mellitus Tipo 2/dietoterapia , Diabetes Mellitus Tipo 2/metabolismo , Diabetes Mellitus Tipo 2/sangue , Hemoglobinas Glicadas/metabolismo , Hemoglobinas Glicadas/análise , Hiperglicemia/sangue , Hiperglicemia/dietoterapia , Hiperglicemia/metabolismo
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