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1.
Arch. latinoam. nutr ; Arch. latinoam. nutr;74(3): 199-205, oct. 2024. tab
Artigo em Inglês | LIVECS, LILACS | ID: biblio-1585283

RESUMO

Introduction: Abdominal obesity is the excess of deposits of fat in the abdominal region and it is an independent risk factor for cardiovascular disease. Hypertension is a metabolic risk factor for non-communicable diseases, and it is the leading cause of premature death in the world. Objective: to determine the association between abdominal obesity and hypertension, hyperglycemia, and hyperlipidemia history in Panamanian college students. Materials and methods: Analytical cross- sectional study carried out in 434 college students from four different cities of a private university in Panamá. Every participant in the study signed written consent. Abdominal obesity was established as a waist circumference of ≥80 cm in women and ≥90 cm in men. Hypertension, hyperglycemia, and hyperlipidemia history were established with the basic questionnaire in the STEPS World Health Organization Instrument. Descriptive, as well as bivariate and multivariate analysis, were realized using logistic regression models. Results: 36.41% of participants had abdominal obesity (no statistically significant difference was found by sex). 14.29%, 9.22%, and 13.82% of the students surveyed reported a history of hypertension, hyperglycemia, and hyperlipidemia respectively (no statistically significant difference was found by sex). After adjusting by sex, age, and socioeconomic level, abdominal obesity was associated with hypertension antecedent (OR=2.06, CI 95%: 1.183-3.597, p=0.011). Conclusions: Students who evidenced abdominal obesity were more likely to have a hypertension history. The study recommends implementing strategies that promote healthy living habits to reduce future cardiovascular risk in the Panamanian university population(AU)


Introducción: La obesidad abdominal es el exceso de grasa en la región abdominal y un factor de riesgo de enfermedad cardiovascular. La hipertensión es un factor de riesgo metabólico asociado a enfermedades no transmisibles, y es la causa principal de muerte prematura en el mundo. Objetivo: Determinar la asociación entre la obesidad abdominal y los antecedentes de hipertensión, hiperglucemia e hiperlipidemia en universitarios panameños. Materiales y métodos: Estudio transversal analítico realizado en 434 universitarios de cuatro ciudades de una universidad privada de Panamá. Cada participante firmó el consentimiento informado. La obesidad abdominal fue establecida con una circunferencia de la cintura ≥80 cm en mujeres and ≥90 cm en hombres. Los antecedentes de hipertensión, hiperglucemia e hiperlipidemia fueron establecidos mediante el Cuestionario Básico del Instrumento STEPS de la OMS. Análisis descriptivos, bivariados y multivariados fueron realizados utilizando modelos de regresión logística. Resultados: El 36,41 % de los participantes registró obesidad abdominal (no hubo diferencia estadísticamente significativa según sexo): El 14,29 %, 9,22 % y el 13,82 % de los participantes reportaron antecedente de hipertensión, hiperglucemia e hiperlipidemia respectivamente (no hubo diferencia estadísticamente significativa según sexo). Después de ajustar por sexo, edad, y nivel socioeconómico, la obesidad abdominal se asoció con el antecedente de hipertensión (OR=2,06, IC 95 %: 1,183-3,597, p=0,011). Conclusiones: Los estudiantes que evidenciaron obesidad abdominal tuvieron una mayor probabilidad de antecedente de hipertensión. Se recomienda la implementación de estrategias para promover hábitos saludables y reducir el riesgo cardiovascular en la población universitaria panameña(AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Estudantes , Universidades , Circunferência da Cintura , Obesidade Abdominal , Hipertensão , Doenças Cardiovasculares , Fatores de Risco , Hiperglicemia , Hiperlipidemias
2.
Clin Investig Arterioscler ; 36(1): 22-32, 2024.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-37438221

RESUMO

BACKGROUND: Cardiovascular disease (CVD) represents the primary cause of death and disability globally, with elevated cholesterol as one of the leading risk factors for CVD. We describe the clinical characteristics, treatment patterns, and effectiveness of evolocumab in treating hyperlipidemia. METHODS: Observational study conducted through a chart review of patients with hyperlipidemia receiving evolocumab as part of clinical management in Colombia. RESULTS: This study included 115 patients treated with evolocumab. A total of 101 patients (87.8%) had a history of CVD, 13 (11.3%) familial hypercholesterolemia (FH), and 23 (20%) type 2 diabetes. Thirty-nine patients reported intolerance to any statin (33.9%). The median value of LDL-C before initiation of evolocumab was 147mg/dL (IQR: 122.5-183.7mg/dL). Within the first 3 months of treatment, LDL-C value dropped to a median value of 53mg/dL (IQR: 34.0-95.5mg/dL), showing a reduction of 63.9%. The median LDL-C values remained below 45mg/dL until the end of follow-up. Among the patients with available data, up to 61% achieved an LDL-C level below 55mg/dL at the 10-12-month follow-up. A total of 72% of patients were persistent with treatment. Safety results showed a low frequency of hospitalizations (≤2%) and treatment-emergent adverse drug reactions (5.2%). No serious adverse events were reported. CONCLUSIONS: Evolocumab was associated with reductions in LDL-C levels, with a relative decrease of 63.9% within the first 3 months of treatment. Low rates of interruptions due to adverse events and adequate medication persistence was reported.


Assuntos
Anticorpos Monoclonais Humanizados , Anticolesterolemiantes , Doenças Cardiovasculares , Diabetes Mellitus Tipo 2 , Inibidores de Hidroximetilglutaril-CoA Redutases , Hiperlipidemias , Humanos , Anticolesterolemiantes/efeitos adversos , Colômbia , LDL-Colesterol , Hiperlipidemias/tratamento farmacológico , Anticorpos Monoclonais/uso terapêutico , Diabetes Mellitus Tipo 2/complicações , Resultado do Tratamento , Inibidores de Hidroximetilglutaril-CoA Redutases/efeitos adversos , Doenças Cardiovasculares/prevenção & controle , Doenças Cardiovasculares/induzido quimicamente
3.
Rheumatology (Oxford) ; 63(3): 772-779, 2024 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-37307082

RESUMO

OBJECTIVES: Our primary objective was to quantify damage burden measured by Damage Index for Antiphospholipid Syndrome (DIAPS) in aPL-positive patients with or without a history of thrombosis in an international cohort (the APS ACTION cohort). Secondly, we aimed to identify clinical and laboratory characteristics associated with damage in aPL-positive patients. METHODS: In this cross-sectional study, we analysed the baseline damage in aPL-positive patients with or without APS classification. We excluded patients with other autoimmune diseases. We analysed the demographic, clinical and laboratory characteristics based on two subgroups: (i) thrombotic APS patients with high vs low damage; and (ii) non-thrombotic aPL-positive patients with vs without damage. RESULTS: Of the 826 aPL-positive patients included in the registry as of April 2020, 586 with no other systemic autoimmune diseases were included in the analysis (412 thrombotic and 174 non-thrombotic). In the thrombotic group, hyperlipidaemia (odds ratio [OR] 1.82; 95% CI 1.05, 3.15; adjusted P = 0.032), obesity (OR 2.14; 95% CI 1.23, 3.71; adjusted P = 0.007), aß2GPI high titres (OR 2.33; 95% CI 1.36, 4.02; adjusted P = 0.002) and corticosteroid use (ever) (OR 3.73; 95% CI 1.80, 7.75; adjusted P < 0.001) were independently associated with high damage at baseline. In the non-thrombotic group, hypertension (OR 4.55; 95% CI 1.82, 11.35; adjusted P = 0.001) and hyperlipidaemia (OR 4.32; 95% CI 1.37, 13.65; adjusted P = 0.013) were independent predictors of damage at baseline; conversely, single aPL positivity was inversely correlated with damage (OR 0.24; 95% CI 0.075, 0.77; adjusted P = 0.016). CONCLUSIONS: DIAPS indicates substantial damage in aPL-positive patients in the APS ACTION cohort. Selected traditional cardiovascular risk factors, steroids use and specific aPL profiles may help to identify patients more prone to present with a higher damage burden.


Assuntos
Síndrome Antifosfolipídica , Hiperlipidemias , Humanos , Síndrome Antifosfolipídica/complicações , Estudos Transversais , Sistema de Registros , Anticorpos Antifosfolipídeos
4.
Braz J Biol ; 83: e275382, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37909591

RESUMO

Significant risk factors for atherosclerosis include hyperlipidemia and oxidative stress, which together rank as three of the most significant risk factors for cardiovascular diseases. Securigera securidaca lowers cholesterol levels in diabetic rats' blood. This investigation's objective was to determine how methanolic extracts affected the flowers, leaves, and seeds of plants in rats that were fed a high-fat diet (HFD). Five groups of animals were created (n = 5). A total of 35 days, divided into two intervals, were used for the study. Rats received HFD during the first 15-day interval, while during the second 20-day interval, they also received extracts or the Atorvastatin reference drug. The extract of seeds has a high phenol content as well as DPPH radical antioxidant activity. Extracts were given at a dose of 200 mg/kg; p.o. Methanolic treatment of S. securidaca flowers, leaves, and seeds in HFD-induced hyperlipidemic rats resulted in significant reductions in total cholesterol, triglycerides, LDLC, and VLDL-C levels. HDL-C levels increased significantly because of the leaves. While in hyperlipidemic rats, seeds significantly reduced the activities of the enzymes ALT and ALP. The findings showed that, to a certain extent, seeds, flowers, and leaves may have benefits in reducing hyperlipidemia brought on by HFD in terms of lipid profiles and liver function enzymes. The findings of this study indicate a promising application prospect, but more research is needed to determine the exact mechanism of these novel compounds as antihyperlipidemic agents and to clarify their potential combination effect with synthetic drugs such as Atorvastatin. Combinations can reduce the dose of chemical medications required, which lowers the risk of side effects.


Assuntos
Diabetes Mellitus Experimental , Hiperlipidemias , Securidaca , Ratos , Animais , Hiperlipidemias/induzido quimicamente , Hiperlipidemias/tratamento farmacológico , Hipolipemiantes/farmacologia , Hipolipemiantes/uso terapêutico , Ratos Wistar , Dieta Hiperlipídica/efeitos adversos , Atorvastatina/farmacologia , Atorvastatina/uso terapêutico , Atorvastatina/análise , Diabetes Mellitus Experimental/tratamento farmacológico , Metanol/análise , Metanol/uso terapêutico , Extratos Vegetais/farmacologia , Extratos Vegetais/uso terapêutico , Extratos Vegetais/química , Sementes , Antioxidantes/farmacologia , Antioxidantes/uso terapêutico , Antioxidantes/análise , Flores , Colesterol
5.
Appl Physiol Nutr Metab ; 48(10): 789-798, 2023 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-37311253

RESUMO

Nuts are important sources of antioxidants that combat oxidative stress and improve lipid profile as well as vascular function. However, the intake of typical Brazilian nuts and its acute effect on cardiovascular health needs to be better understood. Thus, the present study aimed to evaluate the acute effect of a beverage containing cashew (Anacardium occidentale L.) and Brazil nuts (Bertholletia excelsa H.B.K.) on postprandial oxidative stress, lipemia, and blood pressure of adult women aged 20 to 55 years with cardiometabolic risk. This was an acute, randomized, parallel arm, controlled clinical trial. The participants received either a beverage containing nuts (30 g Brazil nuts + 15 g cashew nuts) or a beverage without nuts with similar macronutrient composition. Oxidative stress markers and lipid profiles were evaluated at fasting and 4 h after beverage consumption. Blood pressure was measured during fasting and after beverage intake (1, 2, 3, and 4 h). In the postprandial state, there was a greater reduction in malondialdehyde levels in the intervention group compared to the control group (-12.3 ± 0.59 vs. -10.7 ± 0.43 µmol/mL; p < 0.05), which was positively correlated with the concentrations of TG (r = 0.399; p < 0.05), VLDL (r = 0.399; p < 0.05), TG/HDL (r = 0.380; p < 0.05), and blood pressure (iAUC SBP r = 0.391; p < 0.05, iAUC DBP r = 0.409; p < 0.05). The remaining oxidative stress markers showed similar postprandial changes between groups. In women with cardiometabolic risk, a beverage containing Brazilian nuts promoted a significant acute reduction on postprandial malondialdehyde levels. The study was registered in the Brazilian Clinical Trials Registry-ReBEC (protocol: RBR-3ntxrm).


Assuntos
Anacardium , Doenças Cardiovasculares , Hiperlipidemias , Adulto , Humanos , Feminino , Nozes , Pressão Sanguínea , Brasil , Estresse Oxidativo , Lipídeos , Doenças Cardiovasculares/prevenção & controle , Malondialdeído
6.
Med. infant ; 30(2): 137-144, Junio 2023. tab
Artigo em Espanhol | LILACS, UNISALUD, BINACIS | ID: biblio-1443590

RESUMO

Los informes de laboratorio tienen impacto en las decisiones médicas. El ayuno es un factor preanalítico "controlable" que influye en los distintos parámetros bioquímicos. El objetivo del presente trabajo es poner en discusión la realización en pediatría de análisis clínicos con la indicación de un ayuno fisiológico , analizando resultados obtenidos por diferentes autores y evaluando las diferencias clínicas encontradas según los criterios de calidad establecidos por el laboratorio de Química Clínica. La mayoría de los individuos durante el día se encuentran en estado postprandial. Los resultados del perfil lipídico en ayunas no representan las concentraciones reales promedios de los lípidos plasmáticos de un paciente. El ayuno no sería crítico en la etapa de pesquisa , pero puede ser relevante para establecer un diagnóstico certero o inicio de tratamiento. En el caso de la glucemia si se indica en el control rutinario del paciente, y no hay sospecha de alteraciones en el metabolismo de los hidratos de carbono la glucemia sin ayuno puede ser solicitada comparando la misma con valores de corte adecuado. Las diferentes guías nacionales e internacionales recomiendan que la elección de la métrica para la evaluación, control y seguimiento de pacientes con diagnóstico de diabetes se realicen según el objetivo terapéutico. En los trabajos analizados, observamos que varios parámetros bioquímicos presentaron diferencias estadísticas, aunque las diferencias clínicas no fueron relevantes y permanecieron dentro de los intervalos de referencia. El factor limitante para evaluar parámetros bioquímicos sin ayuno es la falta de valores de referencia adecuados. Hay evidencia suficiente para que tanto el perfil lipídico, la glucemia como el resto de los parámetros bioquímicos del laboratorio de química clínica, sean solicitados con la indicación de un ayuno fisiológico de 2, 4 o 6 horas, dependiendo siempre del motivo de consulta y/o la edad del paciente. Es esencial extender la evaluación a otros analitos en población pediátrica, así como evaluar nuevos puntos de corte para parámetros bioquímicos sin ayuno (AU)


Laboratory reports have an impact on medical decision-making. Fasting is a "controllable" preanalytical factor that influences the different biochemical parameters. The aim of this study is to discuss the performance of clinical analyses in pediatrics with the indication of physiological fasting, analyzing results obtained in different disciplines, and evaluating the clinical differences found according to the quality criteria established by the clinical chemistry laboratory. During the day, most patients are in a postprandial state. Fasting lipid profile results do not represent the actual average plasma lipid concentrations of a patient. Fasting would not be critical in the screening stage, but it may be relevant to establish an accurate diagnosis or initiate treatment. Regarding glycemia, if it is indicated in the routine control of the patient and there is no suspicion of alterations in carbohydrate metabolism, non-fasting glycemia can be requested, comparing it with adequate cut-off values. Different national and international guidelines recommend that the choice of metrics for the evaluation, control, and follow-up of patients with diabetes should be made according to the therapeutic objective. In the studies analyzed, we found that several biochemical parameters presented statistical differences, although the clinical differences were not relevant and remained within the reference range. The limiting factor in the evaluation of biochemical parameters without fasting is the lack of adequate reference values. There is sufficient evidence that the lipid profile, glycemia, and the remaining biochemical parameters of the clinical chemistry laboratory should be requested with the indication of a physiological fast of 2, 4, or 6 hours, always depending on the reason for consultation and/or the patient's age. It is essential to extend the evaluation to other analytes in the pediatric population, as well as to evaluate new cut-off points for biochemical parameters without fasting (AU)


Assuntos
Humanos , Pré-Escolar , Criança , Adolescente , Valores de Referência , Jejum/sangue , Testes de Química Clínica/métodos , Fatores de Risco de Doenças Cardíacas , Pediatria , Período Pós-Prandial , Hiperlipidemias/diagnóstico
7.
J Am Heart Assoc ; 12(10): e027433, 2023 05 16.
Artigo em Inglês | MEDLINE | ID: mdl-37158060

RESUMO

Background The Latino population is a growing and diverse share of the US population. Previous studies have examined Latino immigrants as a homogenous group. The authors hypothesized that there would be heterogeneity in cardiovascular disease risk factors among Latino immigrant subgroups (from Mexico, Puerto Rico, Cuba, Dominican Republic, Central America, or South America) compared with non-Latino White adults. Methods and Results A cross-sectional analysis of the 2010 to 2018 National Health Interview Survey (NHIS) among 548 739 individuals was performed. Generalized linear models with Poisson distribution were fitted to compare the prevalence of self-reported hypertension, overweight/obesity, diabetes, high cholesterol, physical inactivity, and current smoking, adjusting for known confounders. The authors included 474 968 non-Latino White adults and 73 771 Latino immigrants from Mexico (59%), Puerto Rico (7%), Cuba (6%), Dominican Republic (5%), Central America (15%), and South America (9%). Compared with White adults, Mexican immigrants had the highest prevalence of overweight/obesity (prevalence ratio [PR], 1.17 [95% CI, 1.15-1.19]); Puerto Rican individuals had the highest prevalence of diabetes (PR, 1.63 [95% CI, 1.45-1.83]); individuals from Central America had the highest prevalence of high cholesterol (PR, 1.16 [95% CI, 1.04-1.28]); and individuals from the Dominican Republic had the highest prevalence of physical inactivity (PR, 1.25 [95% CI, 1.18-1.32]). All Latino immigrant subgroups were less likely to be smokers than White adults. Conclusions The authors observed advantages and disparities in cardiovascular disease risk factors among Latino immigrants. Aggregating data on Latino individuals may mask differences in cardiovascular disease risk and hinder efforts to reduce health disparities in this population. Study findings provide Latino group-specific actionable information and targets for improving cardiovascular health.


Assuntos
Doenças Cardiovasculares , Fatores de Risco de Doenças Cardíacas , Hispânico ou Latino , Adulto , Humanos , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etnologia , Colesterol , Estudos Transversais , Diabetes Mellitus/epidemiologia , Hispânico ou Latino/etnologia , Hispânico ou Latino/estatística & dados numéricos , Hipercolesterolemia , Hiperlipidemias , Obesidade/epidemiologia , Sobrepeso , Prevalência , Porto Rico/etnologia , Fatores de Risco , Estados Unidos/epidemiologia , Cuba/etnologia , América Central/etnologia , México/etnologia , América do Sul/etnologia , República Dominicana/etnologia , Brancos/estatística & dados numéricos
8.
Adv Exp Med Biol ; 1408: 25-47, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37093420

RESUMO

Hemostasis preserves blood fluidity and prevents its loss after vessel injury. The maintenance of blood fluidity requires a delicate balance between pro-coagulant and fibrinolytic status. Endothelial cells (ECs) in the inner face of blood vessels maintain hemostasis through balancing anti-thrombotic and pro-fibrinolytic activities. Dyslipidemias are linked to hemostatic alterations. Thus, it is necessary a better understanding of the underlying mechanisms linking hemostasis with dyslipidemia. Statins are drugs that decrease cholesterol levels in the blood and are the gold standard for treating hyperlipidemias. Statins can be classified into natural and synthetic molecules, approved for the treatment of hypercholesterolemia. The classical mechanism of action of statins is by competitive inhibition of a key enzyme in the synthesis pathway of cholesterol, the HMG-CoA reductase. Statins are frequently administrated by oral ingestion and its interaction with other drugs and food supplements is associated with altered bioavailability. In this review we deeply discuss the actions of statins beyond the control of dyslipidemias, focusing on the actions in thrombotic modulation, vascular and cardiovascular-related diseases, metabolic diseases including metabolic syndrome, diabetes, hyperlipidemia, and hypertension, and chronic diseases such as cancer, chronic obstructive pulmonary disease, and chronic kidney disease. Furthermore, we were prompted to delved deeper in the molecular mechanisms by means statins regulate coagulation acting on liver, platelets, and endothelium. Clinical evidence show that statins are effective regulators of dyslipidemia with a high impact in hemostasis regulation and its deleterious consequences. However, studies are required to elucidate its underlying molecular mechanism and improving their therapeutical actions.


Assuntos
Doenças Cardiovasculares , Dislipidemias , Inibidores de Hidroximetilglutaril-CoA Redutases , Hiperlipidemias , Trombose , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Células Endoteliais , Hemostasia , Trombose/prevenção & controle , Doenças Cardiovasculares/tratamento farmacológico , Colesterol , Dislipidemias/tratamento farmacológico
9.
J Nephrol ; 36(6): 1549-1559, 2023 07.
Artigo em Inglês | MEDLINE | ID: mdl-37029883

RESUMO

INTRODUCTION AND AIM: In the general population, high levels of lipoprotein(a) (Lp(a)) are an independent risk factor for atherosclerotic cardiovascular diseases. However, the information available in patients with chronic kidney disease (CKD) is less robust. The main objective of this updated systematic review of prospective studies was to analyze the association between elevated Lp(a) levels and cardiovascular outcomes or death in patients with CKD. METHODS: The PRISMA guidelines were used to carry out this systematic review. Randomized clinical trials or prospective observational studies that evaluated the association between Lp(a) levels and cardiovascular outcomes or death in CKD patients were searched in the current literature. RESULTS: Fifteen studies including 12,260 individuals were identified and considered eligible for this systematic review. In total, 14 prospective cohorts and one post-hoc analysis of a randomized clinical trial were analyzed. Eight studies evaluated hemodialysis patients, one study analyzed patients on peritoneal dialysis, while six studies evaluated subjects with different stages of CKD. Median follow-up duration ranged from 1 to 8.6 years. Our findings showed that elevated Lp(a) values were associated with a higher risk of cardiovascular events or death in most studies, despite adjusting for traditional risk factors. CONCLUSION: The findings of this systematic review show that there is a positive association between Lp(a) levels and fatal and non-fatal cardiovascular events in patients with CKD.


Assuntos
Doenças Cardiovasculares , Hiperlipidemias , Insuficiência Renal Crônica , Humanos , Estudos Prospectivos , Lipoproteína(a) , Insuficiência Renal Crônica/complicações , Insuficiência Renal Crônica/diagnóstico , Insuficiência Renal Crônica/terapia , Diálise Renal , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Fatores de Risco , Ensaios Clínicos Controlados Aleatórios como Assunto , Estudos Observacionais como Assunto
10.
Eur J Nutr ; 62(5): 2269-2278, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37083722

RESUMO

PURPOSE: Resistant starch (RS) content has exhibited beneficial effects on glycemic control; however, few studies have investigated the effects of this substance on postprandial responses and appetite in subjects with type 2 diabetes (T2D). Here, we aimed to examine the effects of RS from two sources on glycemic response (GR), postprandial lipemia, and appetite in subjects with T2D. METHODS: In a randomized and crossover study, 17 subjects with T2D consumed native banana starch (NBS), high-amylose maize starch (HMS) or digestible maize starch (DMS) for 4 days. On day 5, a 6-h oral meal tolerance test (MTT) was performed to evaluate glycemic and insulinemic responses as well as postprandial lipemia. Besides, subjective appetite assessment was measured using a visual analogue scale. RESULTS: NBS induced a reduction on fasting glycemia, glycemia peak and insulinemic response during MTT. However, no modifications on postprandial lipemia were observed after RS treatments. Both NBS and HMS reduced hunger and increased satiety. CONCLUSION: NBS supplementation induced more beneficial effects on glycemic metabolism than HMS even when all interventions were matched for digestible starch content. RS intake did not modify postprandial lipemia, however, positively affected subjective appetite rates. TRIAL REGISTRATION: This trial was retrospectively registered at www.anzctr.org.au (ACTRN12621001382864) on October 11, 2021.


Assuntos
Diabetes Mellitus Tipo 2 , Hiperlipidemias , Humanos , Apetite , Amido Resistente/farmacologia , Estudos Cross-Over , Glicemia/metabolismo , Insulina , Amido/metabolismo , Período Pós-Prandial
11.
Sci Rep ; 13(1): 1831, 2023 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-36726019

RESUMO

We analyze the effect of obesity on the incidence of hypertension, hyperlipidemia and diabetes in USA using a health production theoretical framework along with a bivariate flexible semi-parametric recursive copula model that account for endogeneity. In this approach, the effects of control variables are flexibly determined using additive predictors that allow for a variety of effects. Our findings suggest that there exist a positive and significant effect of obesity on the prevalence of all chronic diseases examined. In particular, after endogeneity is accounted for, the probability of having hypertension, hyperlipidemia and diabetes for obese individuals are, respectively, 35%, 28% and 11% higher than those under the obesity threshold. These findings suggest that lowering obesity rates could lead to significant reductions in the morbidity and mortality associated with these diseases.


Assuntos
Diabetes Mellitus , Hiperlipidemias , Hipertensão , Doenças Metabólicas , Humanos , Obesidade/complicações , Obesidade/epidemiologia , Diabetes Mellitus/epidemiologia , Hiperlipidemias/epidemiologia , Hipertensão/epidemiologia , Prevalência , Doença Crônica
12.
São Paulo; s.n; 2023. 37 p
Tese em Português | Coleciona SUS, Sec. Munic. Saúde SP, HSPM-Producao, Sec. Munic. Saúde SP | ID: biblio-1516187

RESUMO

Introdução: O termo diabetes mellitus (DM) descreve um distúrbio metabólico de etiologia múltipla caracterizado por hiperglicemia crônica decorrente de uma secreção deficiente de insulina e/ou incapacidade da mesma exercer adequadamente a sua função. Os efeitos desta enfermidade incluem danos a longo prazo, disfunção e falência de vários órgãos. Dentro deste contexto, a resistência à insulina e hiperinsulinemia são as principais forças motrizes no desenvolvimento da dislipidemia e representam um elo importante entre a obesidade e o desenvolvimento do diabetes tipo 2 e doenças cardiovasculares (DCV). Objetivo : Por conta da já determinada relação entre dislipidemia, DM e DCV, pretende se analisar os perfis lipídicos de pacientes com diabetes tipo II com eventos macrovasculares estabelecidos. Metodologia : Estudo observacional transversal, do tipo retrospectivo. Foram avaliados 60 pacientes atendidos no Ambulatório de Diabetes da especialidade de Endocrinologia e Metabologia do Hospital do Servidor Público Municipal de São Paulo , no período de janeiro a julho de 2022, através da análise de prontuários. Os pacientes foram divididos em dois grupos de acordo com os valores de triglicérides (TG): TG acima de 200 mg/dl e TG abaixo de 200 mg/dl, a fim de organizar e estabelecer os valores de colesterol de lipoproteína de baixa densidade (LDL) e colesterol de lipoproteína de não alta densidade (não HDL), preconizados como meta pela Sociedade Brasileira de Diabetes. Os pacientes também foram divididos de acordo com a medicação utilizada para o tratamento da dislipidemia. Resultados: A amostra foi composta majoritariamente por mulheres (56,7%), idosos (70%) e etnia caucasiana (6 6,7%). Nota se não alcance das metas lipídicas em 93,2% dos pacientes com níveis de TG menor es que 200mg/dL e em 100% dos pacientes com níveis de TG maior es que 200mg/dL, mesmo em uso , pela maioria, de medicação adequada (estatina de alta potência 71,7%). Dentre os 6 indivíduos que utilizavam fibrato, 2 obedeciam aos critérios do uso desta medicação, no determinado momento da coleta de dados, para redução do risco cardiovascular, que são: valores de TG maiores que 204 mg/dL e valores de HDL menores que 34 mg/d L . No estudo, os valores de LDL variaram de 39,0 a 249,0 mg/dL, com média 88,5 ± 36,7, enquanto os valores de não HDL variaram de 53,0 a 295,0 mg/dL, com média 117,3 ± 44,4. Triglicérides variou de 51,0 a 609,0 mg/dL, apresentando média 171,2 ± 101,8. Não houve associação significativa entre meta para colesterol e características sociodemográficas como sexo (p=0,076), idade (p=0,547) e etnia (p=0,582). Assim como também não houve associação significativa entre meta para colesterol e potência no uso das estatinas (p=0,903). Conclusão: O estudo exibiu um perfil lipídico desfavorável, a análise correta dos valores lipídicos e alcance das metas dos valores de colesterol em pacientes com diabetes classificados como muito alto risco cardiovascular é fundamental para evitar novos eventos macrovasculares. Neste trabalho, ficou evidente a quantidade de fatores que podem influenciar na obtenção dos níveis lipídicos desejados e preconizado s por diversas diretrizes. Palavras chave: Diabetes Mellitus. Hiperlipidemias. Doenças Cardiovasculares. Angiopatias Diabéticas.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Doenças Cardiovasculares , Diabetes Mellitus , Angiopatias Diabéticas , Hiperlipidemias , Inibidores de Hidroximetilglutaril-CoA Redutases/administração & dosagem , Diabetes Mellitus Tipo 2/complicações , HDL-Colesterol/análise , LDL-Colesterol/análise
13.
Braz. J. Pharm. Sci. (Online) ; 59: e21820, 2023. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1439542

RESUMO

ABSTRACT Diabetes is a life-threatening disease, and currently available synthetic medicines for treating diabetes are associated with various side effects. Therefore, there is an unmet need to develop herbal remedies against diabetes as an alternative to synthetic medicines. Although local healers use the roots of Spermadicyton suaveolens (SS) to manage diabetes, there is negligible research to validate its antidiabetic properties. The present investigation aims to the assess the antioxidant, antidiabetic, and antihyperlipidemic potential of the ethanolic extract of S. Suaveolen's roots (EESS) on streptozotocin (STZ) induced diabetic rats. The extract was screened for in vitro antioxidant and antidiabetic activity. The in vivo antidiabetic potential of EESS (at 200 and 400 mg/kg) was studied on STZ-induced diabetic rats for 20 days. The EESS displayed significant (p<0.05) antidiabetic and antioxidant properties. The administration of 200 mg/kg and 400 mg/kg EESS in STZ-induced diabetic rats significantly reduced hyperglycemia, and restored antioxidant enzymes and lipid profile-a high density lipoprotein (HDL) increased by the administration of a single dose of streptozotocin. Thus, EESS could be a promising herbal medicine in the treatment of diabetes and hyperlipidemia


Assuntos
Animais , Masculino , Ratos , Extratos Vegetais/análise , Estreptozocina/efeitos adversos , Diabetes Mellitus Experimental/induzido quimicamente , Hipoglicemiantes/efeitos adversos , Antioxidantes/farmacologia , Técnicas In Vitro/métodos , Medicina Herbária/classificação , Medicamento Fitoterápico , Medicamentos Sintéticos/efeitos adversos , Hiperlipidemias/complicações
14.
Medicentro (Villa Clara) ; 26(3): 544-561, jul.-set. 2022. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-1405656

RESUMO

RESUMEN Introducción: Las alteraciones del metabolismo lipídico constituyen un problema de salud muy frecuente, que se incrementan con la edad del individuo. Objetivo: Determinar la asociación entre factores de riesgo de enfermedad aterogénica en pacientes geriátricos atendidos en consulta del Hospital Universitario Clínico-Quirúrgico «Arnaldo Milián Castro¼. Métodos: Se realizó un estudio observacional, descriptivo, transversal, durante el período de septiembre de 2018 a septiembre de 2019. La muestra quedó conformada por 198 pacientes geriátricos, elegidos por muestreo probabilístico sistemático. Resultados: Predominó el sexo masculino; la edad de 60 a 69 años para ambos sexos, y el color de la piel blanca. Los factores clínicos de riesgo aterogénico más frecuentes fueron la hipertensión arterial y la diabetes mellitus. El perfil lipídico se caracterizó por valores elevados de colesterol total, VLDLc, LDLc, triglicéridos, apolipoproteína B, ambos índices lipídicos, y bajos de HDLc y apolipoproteínas A1. Conclusiones: Todas las determinaciones lipídicas mostraron significación estadística al relacionarlas con la edad, no siendo así con el sexo. La hipertensión arterial y la cardiopatía isquémica se asociaron de forma significativa con valores no deseables de colesterol total, VLDLc, LDLc, triglicéridos, apoproteína B y ambos índices lipídicos. La diabetes mellitus y el alcoholismo se asociaron con alteraciones de todas las fracciones lipídicas, excepto HDLc y apoproteína A1, respectivamente. Los pacientes fumadores presentaron valores no deseados de VLDLc, LDLc, e índice aterogénico, y los obesos de colesterol total, LDLc, triglicéridos y apoproteína B.


ABSTRACT Introduction: alterations in lipid metabolism are a very frequent health problem, which increase with the age of the individual. Objective: to determine the association among risk factors for atherogenic disease in geriatric patients treated in the consultation from "Arnaldo Milián Castro" Clinical and Surgical University Hospital. Methods: an observational, descriptive and cross-sectional study was carried out from September 2018 to September 2019. The sample was made up of 198 geriatric patients, chosen by systematic probabilistic sampling. Results: male gender, age from 60 to 69 years for both genders and white skin color predominated. The most frequent clinical atherogenic risk factors were arterial hypertension and diabetes mellitus. The lipid profile was characterized by high values of total cholesterol, VLDLc, LDLc, triglycerides, apolipoprotein B, both lipid indices, and low levels of HDLc and apolipoproteins A1. Conclusions: all lipid determinations showed statistical significance when relating them to age, but not to gender. Arterial hypertension and ischemic heart disease were significantly associated with undesirable values ​​of total cholesterol, VLDLc, LDLc, triglycerides, apoprotein B and both lipid indices. Diabetes mellitus and alcoholism were associated with alterations in all lipid fractions, except HDLc and apoprotein A1, respectively. Smokers had undesirable values ​​of VLDLc, LDLc, and atherogenic index, and obese patients of total cholesterol, LDLc, triglycerides, and apoprotein B.


Assuntos
Hiperlipidemias , Idoso , Fatores de Risco
15.
Int J Med Mushrooms ; 24(9): 49-61, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36004709

RESUMO

The abandonment of traditional foods in the Mexican diet is one of the causes for the increase in diseases associated with obesity. Edible mushrooms have been a part of the Mexican diet since pre-Hispanic times. There is clear evidence that Pleurotus ostreatus (Po) contains bioactive compounds that have beneficial health effects. In the present study, we carried out a 3-month nutritional intervention in which we randomized 30 participants into two groups: one that consumed a healthy diet with regional foods without the inclusion of edible mushrooms (HD, n = 15) and one that consumed a healthy diet with regional foods alongside 1 kg of P. ostreatus (four portions of 250 g) per week (HD+ P. ostreatus, n = 15). We evaluated anthropometric measurements, lipid parameters, glucose levels, and blood pressure in inhabitants of San Miguel Tianguistenco, Puebla, a rural area of Mexico. For the HD group, the triglyceride levels decreased in women and the glucose levels decreased in men, and in the HD+ P. ostreatus group, visceral fat, glucose, triglyceride, and cholesterol levels decreased in women, and glucose and triglyceride levels decreased in men. Analysis of the intake of macro- and micronutrients in the community showed a high intake of energy, fat, and sugar, and a low intake of fiber, B complex vitamins, and minerals, indicators of an unbalanced diet. It is essential to create strategies that promote the inclusion of edible mushrooms as a part of a heathy diet in rural areas of Mexico to improve the actual health and nutrition of the residents.


Assuntos
Agaricales , Hiperlipidemias , Ostreidae , Pleurotus , Animais , Suplementos Nutricionais , Feminino , Glucose , Humanos , Gordura Intra-Abdominal , Masculino , México , População Rural , Triglicerídeos
16.
J Lipid Res ; 63(7): 100233, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35605678

RESUMO

Saroglitazar, being a dual PPAR-α/γ agonist, has shown beneficial effect in diabetic dyslipidemia and hypertriglyceridemia. Fibrates are commonly used to treat severe hypertriglyceridemia. However, the effect of saroglitazar in patients with moderate to severe hypertriglyceridemia was not evaluated. We conducted a study to compare the efficacy and safety of saroglitazar (4 mg) with fenofibrate (160 mg) in patients with moderate to severe hypertriglyceridemia. This was a multicenter, randomized, double-blinded, double-dummy, active-control, and noninferiority trial in adult patients with fasting triglyceride (TG) levels of 500-1,500 mg/dl. The patients were randomized in a 1:1 ratio to receive daily dose of saroglitazar or fenofibrate for 12 weeks. The primary efficacy end point was the percent change in TG levels at week 12 relative to baseline. The study comprised of 41 patients in the saroglitazar group and 41 patients in the fenofibrate group. We found that the percent reduction from baseline in TG levels at week 12 was significantly higher in the saroglitazar group (least square mean = -55.3%; SE = 4.9) compared with the fenofibrate group (least square mean = -41.1%; SE = 4.9; P = 0.048). Overall, 37 treatment-emergent adverse events (AEs) were reported in 24 patients (saroglitazar: 13; fenofibrate: 11). No serious AEs were reported, and no patient discontinued the study because of AEs. We conclude that saroglitazar (4 mg) is noninferior to fenofibrate (160 mg) in reducing TG levels after 12 weeks of treatment, was safe, and well tolerated.


Assuntos
Fenofibrato , Hiperlipidemias , Hipertrigliceridemia , Fenilpropionatos , Adulto , Método Duplo-Cego , Fenofibrato/efeitos adversos , Humanos , Hipertrigliceridemia/induzido quimicamente , Hipertrigliceridemia/tratamento farmacológico , Hipolipemiantes/efeitos adversos , Fenilpropionatos/efeitos adversos , Pirróis/efeitos adversos , Triglicerídeos
17.
BMC Complement Med Ther ; 22(1): 62, 2022 Mar 08.
Artigo em Inglês | MEDLINE | ID: mdl-35260150

RESUMO

BACKGROUND: The objective of this in vivo study is to evaluate in five rat models the pharmacologic effects and toxicity of a commercial hydro-alcoholic extract, GlucoMedix®, derived from Stevia rebaudiana and the pentacyclic chemotype of Uncaria Tomentosa (Willd.) DC, for use as a treatment for metabolic syndrome. The extract contains phytochemicals of Stevia (e.g., steviol glycosides) and Uncaria (e.g., pentacyclic oxindole alkaloids, but lacks tetracyclic oxindole alkaloids). METHODS: The pharmacologic assessments in three rat models include reductions in chemically induced hyperglycemia, hyperlipidemia (cholesterol and triglycerides), and hypertension, all of which are comorbidities of metabolic syndrome. Acute toxicity and 28-day subacute toxicity were assessed in rat models at doses higher than those used in the efficacy models. RESULTS: The acute oral toxicity was evaluated in Holtzman rats and the extract did not produce acute toxic effects or lethality, with the LD50 > 5000 mg/kg (extract wet weight). Furthermore, subacute oral toxicity was evaluated in rats for 28 days at daily doses as high as 2000 mg/kg without toxicity or abnormal clinical chemistry or hematological effects. Daily oral doses of 250 - 1000 mg/kg were used to evaluate the treatment effects in hyperglycemic (alloxan-induced and glibenclamide-controlled), hyperlipidemic (cholesterol-induced and atorvastatin-controlled), and hypertensive (L-NAME-induced and enalapril-controlled) rat models. Alloxan-induced hyperglycemia was reduced in a dose-dependent manner within 28 days or less. Cholesterol-induced hyperlipidemic rats exhibited dose-dependent reductions in cholesterol and triglycerides at 21 days. Furthermore, GlucoMedix® produced a dose-dependent decrease in systolic and diastolic arterial blood pressure in L-NAME-induced hypertensive rats at 28 days. CONCLUSIONS: The five in vivo rat models revealed that the all-natural phytotherapy GlucoMedix® is a safe and effective treatment for hyperglycemia, hyperlipidemia, and hypertension. This extract is expected to affect multiple comorbidities of metabolic syndrome, without any acute or subacute oral toxicity in humans. Although multiple prescription drugs are well known for the treatment of individual comorbidities of metabolic syndrome, no drug monotherapy concurrently treats all three comorbidities.


Assuntos
Unha-de-Gato , Hiperglicemia , Hiperlipidemias , Hipertensão , Síndrome Metabólica , Stevia , Animais , Hiperglicemia/tratamento farmacológico , Hiperlipidemias/tratamento farmacológico , Hipertensão/tratamento farmacológico , Síndrome Metabólica/tratamento farmacológico , Extratos Vegetais/uso terapêutico , Ratos
18.
Obes Surg ; 32(3): 652-659, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-34988897

RESUMO

BACKGROUND: The prevalence of super obesity has increased considerably in recent years, representing up to the 0.5% of the population. Even though bariatric surgery induces significant weight loss in these patients, it has been reported that up to 50% of the patients with super obesity will fail according to the current primary response criteria. OBJECTIVE: To evaluate and compare different primary response criteria and their impact regarding comorbidities remission. PATIENTS AND METHODS: A total of 104 patients with super obesity who underwent Roux-en-Y gastric bypass (RYGB) were identified in our institution from March 2004 to February 2019. An evaluation of the primary response at a 2-year follow-up was made using different criteria. A multivariate analysis was made to evaluate related variables to comorbidities remission. RESULTS: Two years later, the rate of patients who achieved an EWL > 50%, %EWL > 70%, and BMI < 35 kg/m2 were 84.5%, 52.1%, and 62%, respectively. Regarding the comorbidities, 85%, 84.8%, and 81.1% of the patients improved or remitted T2D, HBP, and hyperlipidemia, respectively. An EWL > 50% 2 years later was related to complete remission of hyperlipidemia (p = 0.047), whereas weight regain above 10% is a risk factor for failure of complete remission of HBP in 3 years. CONCLUSIONS: More than 75% of patients with super obesity yield an EWL > 50% 2 years later. In terms of hyperlipidemia, it is desirable to achieve an EWL of at least 50%. Whereas for T2D and HBP, a minimum of 25% TWL yields 72% and 60.5% of complete remission.


Assuntos
Diabetes Mellitus Tipo 2 , Derivação Gástrica , Hiperlipidemias , Obesidade Mórbida , Índice de Massa Corporal , Diabetes Mellitus Tipo 2/epidemiologia , Humanos , Hiperlipidemias/epidemiologia , Hiperlipidemias/cirurgia , Obesidade , Obesidade Mórbida/cirurgia , Estudos Retrospectivos , Resultado do Tratamento
19.
Hematol., Transfus. Cell Ther. (Impr.) ; 44(1): 56-62, Jan.-Mar. 2022. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1364891

RESUMO

Abstract Introduction Lipoprotein apheresis (LA) is an extracorporeal therapy which removes apolipoprotein B-containing particles from the circulation. We evaluated techniques and efficiency of lipoprotein apheresis procedures applied to patients with familial and non-familial hypercholesterolemia (FH) at our center. Methods We retrospectively evaluated 250 LA procedures applied to 27 patients with dyslipidemia between March 2011 and August 2019. Results A total of 27 patients, of whom 19 (70.4%) were male and 8 (29.6%), female, were included. Eighteen (66.7%), 6 (22.2%) and 3 (11.1%) patients were diagnosed with non-FH, homozygous FH (HoFH) and heterozygous FH (HeFH), respectively. Two different apheresis techniques, direct adsorption of lipoproteins (DALI) (48.8%) and double filtration plasmapheresis (DFPP) (51.2%), were used. The change in the serum total cholesterol (TC) level was the median 302 mg/dl (171-604 mg/dl) (60.4%) in HoFH patients, 305 mg/dl (194-393 mg/dl) (60.8%) in HeFH patients and 227 mg/dl (75-749 mg/dl) (65.3%) in non-FH patients. The change in the serum low-density lipoprotein (LDL) level was the median 275 mg/dl (109-519 mg/dl) (64.2%), 232 mg/dl (207-291 mg/dl) (64.5%) and 325 mg/dl (22-735 mg/dl) (70.9%) in patients with HoFH, HeFH and non-FH, respectively. A significantly effective reduction in serum lipid levels, including TC, LDL and triglycerides, was achieved in all patients, regardless of the technique, p< .001. The decrease in the serum TC and LDL levels was significantly higher in the DFPP, compared to the DALI, being 220 mg/dl (-300 to 771) vs 184 mg/dl (64-415), p< .001 and 196 mg/dl (11-712) vs 157 mg/dl (54-340), p< .001, respectively. Conclusions Our results showed that LA is a highly effective treatment in reducing serum lipid levels and safe, without any major adverse event.


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Adulto Jovem , Remoção de Componentes Sanguíneos , Lipoproteínas , Hiperlipidemias
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