Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 8.013
Filtrar
1.
Kardiologiia ; 60(8): 98-105, 2020 Sep 17.
Artigo em Russo | MEDLINE | ID: mdl-33155965

RESUMO

Aim To study the role of inflammation markers and endothelial dysfunction in predicting the risk of cardiovascular event following a percutaneous coronary intervention (PCI) in patients with ischemic heart disease (IHD) and metabolic syndrome (MS).Materials and methods 80 patients (72 men; median age, 56 (50;63) years) with IHD and PCI were evaluated. Based on the presence of MS according to NCEP-ATP III criteria, patients were divided into two groups, group 1 without MS (n=32) and group 2 with MS (n=48). The control age- and sex-matched group included 15 people without cardiovascular diseases. Serum concentrations of tumor necrosis factor α (TNFα), interleukin 6 (IL-6), IL-10, lipoprotein-associated phospholipase A2 (LP-PLA2), and endothelin 1 were measured by enzyme-linked immunosorbent assay (ELISA). Patients were followed up for 12 months after PCI with evaluation of the incidence of adverse cardiovascular events. Statistical analysis was performed with Statistica 10.0 and Medcalc 19.2.6 software. Differences between variables were considered statistically significant at р<0.05. Potential predictors were determined by the ROC analysis with construction of ROC curves, calculation of AUC (area under the curve), identification of COP (cut-off point by the Youden's index), and sensitivity (Se) and specificity corresponding to the COP.Results Patients with MS had statistically significantly higher serum levels of inflammatory markers than patients of the control group. Concentration of the intravascular inflammation marker, PL-PLA2, was 2.7 times higher in group 1 and 5.1 times higher in group 2 than in the control group (р<0.001). Concentrations of endothelin 1 were 1.9 times higher in group 1 and 3.7 times higher in the MS group compared to the control. At one year after PCI, the incidence of adverse outcomes in the form of cardiovascular events was higher for patients with MS: 10 (20.8 %) cases of stent restenosis and 13 (27.1 %) episodes of coronary atherosclerosis progression according to results of repeated coronarography vs. 2 (6.3%) restenosis cases (χ2-10.853; р=0.002) and 2 (6.3%) episodes of atherosclerosis progression (χ2-23.651; р=0.001) for patients without MS. The groups did not differ in rates of myocardial infarction and cardiac death. The most significant predictors of unfavorable prognosis were LP-PLA2 concentration >983.83 ng/ml (area under the ROC curve, 0.867; sensitivity, 80 %; specificity, 100%; р<0.001) and endothelin 1 overexpression >0.852 fmol/ml (area under the ROC curve, 0.885; sensitivity, 85.5 %; specificity, 83.6 %; р<0.001).Conclusion Patients with MS were characterized by more pronounced imbalance of pro- and anti-inflammatory factors. Concentrations of LP-PLA2 >983.83 ng/ml and endothelin 1 >0.852 fmol/ml were shown to be predictors of unfavorable prognosis for patients with IHD and MS after PCI with coronary stenting.


Assuntos
Doença da Artéria Coronariana , Síndrome Metabólica , Intervenção Coronária Percutânea , Doença da Artéria Coronariana/cirurgia , Humanos , Inflamação , Masculino , Síndrome Metabólica/complicações , Síndrome Metabólica/diagnóstico , Pessoa de Meia-Idade , Intervenção Coronária Percutânea/efeitos adversos , Prognóstico , Fatores de Risco , Stents
2.
Eur J Endocrinol ; 183(6): R167-R183, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33105105

RESUMO

Overt hypogonadism in men adversely affects body composition and metabolic health, which generally improve upon testosterone (TS) therapy. As obese men often display lower serum TS levels, in particular when they present with the metabolic syndrome (MetS) or type 2 diabetes (T2DM), there have been claims that androgen therapy prevents or reverses obesity and improves metabolic health. This has contributed to the increase in TS prescriptions during the past two decades. In this narrative review, based on findings from larger observational studies and randomized controlled intervention trials, we evaluate whether low TS predicts or predisposes to obesity and its metabolic consequences, and whether obese men with low TS are truly hypogonadal. We further describe the mechanisms underlying the bi-directional relationships of TS levels with obesity and metabolic health, and finally assess the evidence for TS therapy in men with obesity, MetS and/or T2DM, considering efficacy, safety concerns and possible alternative approaches. It is concluded that low serum sex hormone-binding globulin and total TS levels are highly prevalent in obese men, but that only those with low free TS levels and signs or symptoms of hypogonadism should be considered androgen deficient. These alterations are reversible upon weight loss. Whether low TS is a biomarker rather than a true risk factor for metabolic disturbances remains unclear. Considering the limited number of sound TS therapy trials have shown beneficial effects, the modest amplitude of these effects, and unresolved safety issues, one cannot in the present state-of-the-art advocate TS therapy to prevent or reverse obesity-associated metabolic disturbances. Instead, the focus should remain on lifestyle measures and management of obesity-related consequences.


Assuntos
Diabetes Mellitus Tipo 2/tratamento farmacológico , Terapia de Reposição Hormonal/métodos , Hipogonadismo/tratamento farmacológico , Síndrome Metabólica/tratamento farmacológico , Obesidade/tratamento farmacológico , Testosterona/uso terapêutico , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/complicações , Humanos , Hipogonadismo/sangue , Hipogonadismo/complicações , Masculino , Síndrome Metabólica/sangue , Síndrome Metabólica/complicações , Obesidade/sangue , Obesidade/complicações , Estudos Observacionais como Assunto , Ensaios Clínicos Controlados Aleatórios como Assunto , Globulina de Ligação a Hormônio Sexual/análise , Testosterona/sangue , Resultado do Tratamento
3.
J Med Life ; 13(3): 289-292, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33072198

RESUMO

Metabolic syndrome is one of the actual problems of modern medicine because of its high prevalence in the general population and its essential role in the development and progression of cardiovascular diseases. In the last decade, studying the relationship between metabolic syndrome and periodontal diseases has attracted many scientists' attention. Based on this, the study of the clinical features of periodontal diseases in the early stages of metabolic syndrome is relevant and necessary for timely and successful pathogenetic therapy. The purpose of our study was to investigate and analyze the prevalence and intensity of periodontal disease in people with metabolic syndrome. To solve this goal, we surveyed 190 people with metabolic syndrome who were registered at the endocrinological clinic in Chernivtsi. They formed the main observation group. The comparison observation group included 90 people without metabolic disorders. The age of the patients ranged from 25 to 55 years. Periodontal disease was detected in 155 of 190 patients with metabolic syndrome (81.58 ± 2.82%). In 90 patients without endocrinological pathology, the prevalence of periodontal disease was 1.2 times lower (65.56 ± 5.04%; p <0.01). Generalized periodontitis prevailed in the structure of periodontal diseases in patients with metabolic syndrome: 26.45±3.56% cases were in the second stage of generalized periodontitis (GP), and 21.94±3.33% in the third stage of GP, р<0.01. Therefore, the metabolic syndrome, as a state with a high risk of diabetes development, creates conditions for the formation and rapid progression of inflammatory-destructive periodontal lesions.


Assuntos
Síndrome Metabólica/complicações , Doenças Periodontais/epidemiologia , Doenças Periodontais/patologia , Adulto , Progressão da Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Inquéritos e Questionários
4.
Nat Commun ; 11(1): 4718, 2020 09 18.
Artigo em Inglês | MEDLINE | ID: mdl-32948777

RESUMO

Disturbances in glucose homeostasis and low-grade chronic inflammation culminate into metabolic syndrome that increase the risk for the development of type 2 diabetes mellitus (T2DM). The recently discovered group 2 innate lymphoid cells (ILC2s) are capable of secreting copious amounts of type 2 cytokines to modulate metabolic homeostasis in adipose tissue. In this study, we have established that expression of Death Receptor 3 (DR3), a member of the TNF superfamily, on visceral adipose tissue (VAT)-derived murine and peripheral blood human ILC2s is inducible by IL-33. We demonstrate that DR3 engages the canonical and/or non-canonical NF-κB pathways, and thus stimulates naïve and co-stimulates IL-33-activated ILC2s. Importantly, DR3 engagement on ILC2s significantly ameliorates glucose tolerance, protects against insulin-resistance onset and remarkably reverses already established insulin-resistance. Taken together, these results convey the potent role of DR3 as an ILC2 regulator and introduce DR3 agonistic treatment as a novel therapeutic avenue for treating T2DM.


Assuntos
Tecido Adiposo/metabolismo , Diabetes Mellitus Tipo 2/metabolismo , Linfócitos/metabolismo , Membro 25 de Receptores de Fatores de Necrose Tumoral/metabolismo , Adipócitos/metabolismo , Adolescente , Adulto , Idoso , Animais , Citocinas/metabolismo , Proteínas de Ligação a DNA/genética , Feminino , Glucose/metabolismo , Homeostase , Humanos , Imunidade Inata , Resistência à Insulina , Interleucina-33/metabolismo , Gordura Intra-Abdominal/metabolismo , Masculino , Síndrome Metabólica/complicações , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Pessoa de Meia-Idade , Membro 25 de Receptores de Fatores de Necrose Tumoral/uso terapêutico , Adulto Jovem
5.
J Int Acad Periodontol ; 22(4): 223-230, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-32980834

RESUMO

AIMS: To investigate the use of ω-3 fatty acids and low-dose aspirin as adjuncts to periodontal debridement in a patient with periodontitis and metabolic syndrome. METHODS: Periodontal and systemic parameters were assessed at baseline and 6 months. Gingival crevicular fluid was analyzed for interleukin (IL)-1ß, IL-6 and interferon (IFN)-γ levels by multiplex ELISA at baseline, 3 and 6 months. RESULTS: The treatment was effective in reducing probing depth, clinical attachment level, bleeding on probing and plaque index, and glycated hemoglobin, triglycerides IL-1ß, IL-6 and IFN-γ levels over time. CONCLUSIONS: The adjunctive use of ω-3 and low-dose aspirin to periodontal debridement might have potential benefits in the treatment of periodontitis in a patient with metabolic syndrome.


Assuntos
Periodontite Crônica , Ácidos Graxos Ômega-3 , Síndrome Metabólica , Aspirina , Líquido do Sulco Gengival , Humanos , Síndrome Metabólica/complicações , Síndrome Metabólica/tratamento farmacológico , Perda da Inserção Periodontal , Índice Periodontal , Bolsa Periodontal
6.
Glob Heart ; 15(1): 58, 2020 08 19.
Artigo em Inglês | MEDLINE | ID: mdl-32923351

RESUMO

Whilst current public health measures focused on good hygiene practices and limiting person-to-person transmission contribute effectively in managing the COVID-19 pandemic, they will not prevent all individuals from becoming infected. Thus, it is of importance to explore what individuals could do to mitigate adverse outcomes. The value of beneficial health behaviours and a healthy lifestyle to improve immune functioning and lower adverse consequences of COVID-19 are increasingly being emphasized. Here we discuss seven key health behaviours and corresponding recommendations that may assist in reducing unfavourable COVID-19 outcomes.


Assuntos
Doenças Cardiovasculares/complicações , Doenças Cardiovasculares/prevenção & controle , Infecções por Coronavirus/complicações , Comportamentos Relacionados com a Saúde , Estilo de Vida Saudável , Síndrome Metabólica/complicações , Síndrome Metabólica/prevenção & controle , Pneumonia Viral/complicações , Humanos , Pandemias , Guias de Prática Clínica como Assunto
7.
J Assoc Physicians India ; 68(10): 44-46, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32978925

RESUMO

Background: Psoriasis patients are at increased risk of developing metabolic diseases. Proinflammatory cytokines such as IFN-γ, IL-17, IL-23, and TNF-α,IGF that are increased in psoriasis play an important role in the development of diabetes mellitus(DM), hypertension, dyslipidemia, obesity, insulin resistance and their complications. Aims: To study prevalence of insulin resistance (IR) using HOMA-IR index in psoriasis patients and its association with severity of psoriasis. To study prevalence of metabolic diseases, macro and microvascular complications of these diseases in psoriasis. Materials and methods: A hospital based case control study was conducted involving 102 psoriasis patients and 102 age and sex matched controls. All patients were analysed for the presence of metabolic diseases and their complications. Results: Mean age of cases was 38.41±16.37 years. Majority of cases(58.8%) as well as controls (55.9%) were males. Prevalence of hypertension, prediabetes, DM, raised TG, low HDL, MetS and IR was 46.1%, 28.4%, 27.5%, 42.2%, 31.4%, 31.4% and 48% respectively in cases as compared to 26.5%, 13.7%, 11.8%, 24.3%, 16.7%, 10.8% and 26.5% respectively in controls. However there was no significant difference in obesity (29.4% vs 21.6%, p=0.2024) and LDL among the cases and controls(14.7 %vs 10.8%,p= 0.4). Prevalence of all the metabolic disorders except LDL was significantly higher in cases as compared to that in controls. Prominent complications noted were retinopathy, neuropathy and CVD. With increased psoriasis severity insulin resistance increased. Conclusion: There is a positive correlation of psoriasis with IR and it is associated with increased risk of metabolic diseases and their complications.


Assuntos
Resistência à Insulina , Doenças Metabólicas/epidemiologia , Doenças Metabólicas/etiologia , Síndrome Metabólica/complicações , Síndrome Metabólica/epidemiologia , Psoríase/complicações , Psoríase/epidemiologia , Adulto , Estudos de Casos e Controles , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Adulto Jovem
8.
Medicine (Baltimore) ; 99(39): e22336, 2020 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-32991446

RESUMO

Over the past decades, the incidence of prostate cancer in Taiwan kept rising. Many possible factors including the utility of prostate specific antigen tests, lifestyle remodeling, and patient's comorbidities may contribute to the increasing of incidence or prostate cancer. We aim to use the nationwide Health and Welfare Database (HWD) to investigate possible associated factors.We used HWD, a nationwide database of medical information, to assess the incidence of prostate cancer, utilization of prostate-specific antigen (PSA) test, and underlying diseases of patients and to evaluate whether there was a common trend among these factors.In total, 32,508 patients with newly diagnosed prostate cancer from 2006 to 2013 were identified. The incidence rate of prostate cancer per 100,000 men increased from 35.47 in 2006 to 52.87 in 2012. The number of patients with prostate cancer and underlying diseases related to metabolic syndrome increased every year. The number of total PSA tests and patients undergoing PSA testing, as well as average times of PSA testing per person in the whole population, increased every year. The average PSA test times of patients with newly diagnosed prostate cancer within 3 years before the diagnosis of prostate cancer also increased every year. There was a high correlation between the average PSA test times and the number of patients with newly diagnosed prostate cancer (r = 0.9734).The trends of incidence of prostate cancer, utilization of PSA testing, and underlying diseases related to metabolic syndrome at the diagnoses of cancer were similar, increasing every year in the study period. The results suggested that increasing use of PSA tests may increase the diagnosis of prostate cancers. Underlying diseases related to metabolic syndrome might also affect the incidence of prostate cancer.


Assuntos
Programas de Rastreamento/métodos , Síndrome Metabólica/epidemiologia , Antígeno Prostático Específico/normas , Neoplasias da Próstata/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Comorbidade/tendências , Bases de Dados Factuais , Humanos , Incidência , Estilo de Vida , Masculino , Síndrome Metabólica/complicações , Pessoa de Meia-Idade , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/patologia , Taiwan/epidemiologia
10.
J Med Life ; 13(2): 200-205, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32742514

RESUMO

The work assessed the state of the intestinal microbiocenosis in 52 puerperae at the in whom the pregnancy developed against the background of the metabolic syndrome. The diagnosis of metabolic syndrome was determined according to the criteria approved by the World Health Organization for pregnant women. The state of intestinal microbiocenosis was assessed by a bacteriological examination of feces immediately after delivery. The content of the main representatives of the obligate microflora (bifidobacteria, lactobacilli, native intestinal bacilli, fecal streptococci) and facultative (conditionally pathogenic) microorganisms (representatives of the genus Prоteus, Klebsiella, pathogenic strains of E. coli, Staphylococcus epidermidis, Enterobacter, Citrobacter, Clostridium difficile, Candida fungi) was determined. Cultures were made on appropriate growth media. At the time of birth, all patients of group I showed signs of intestinal microbiocenosis disorder. At the same time, 13 (54.2%) puerperae were diagnosed signs of dysbiosis of II degree, 9 (37.5%) with signs of III degree, which were generally characterized by a significant decrease in the content of the main representatives of obligate microflora (Bifidobacterium, Lactobacillus, Escherichia coli, Fecal streptococci) with simultaneous high contamination of Candida albicans and Clostridium difficile. So, it can be considered as a possible predictor of very early preterm birth in women with MS. In pregnant women with MS, but who gave timely birth (group II), dysbiotic disorders were detected to a lesser extent. Thus, in 13 (46.4%) patients, initial signs of intestinal dysbiosis (first degree) were detected in 4 (14.3%) patients (second degree). In 11 (39.3%) puerperae of group II, microbial indices indicated normal eubiotic ratios.


Assuntos
Disbiose/microbiologia , Disbiose/patologia , Intestinos/microbiologia , Intestinos/patologia , Síndrome Metabólica/complicações , Trabalho de Parto Prematuro/microbiologia , Adulto , Bifidobacterium/fisiologia , Escherichia coli/fisiologia , Fezes/microbiologia , Feminino , Humanos , Recém-Nascido , Lactobacillus/fisiologia , Gravidez , Adulto Jovem
12.
PLoS One ; 15(8): e0231234, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32804947

RESUMO

Cardiometabolic syndrome has become a global health issue. Heart failure is a common comorbidity of cardiometabolic syndrome. Successful drug development to prevent cardiometabolic syndrome and associated comorbidities requires preclinical models predictive of human conditions. To characterize the heart failure component of cardiometabolic syndrome, cardiometabolic, metabolic, and renal biomarkers were evaluated in lean and obese ZSF1 19- to 32-week-old male rats. Histopathological assessment of kidneys and hearts was performed. Cardiac function, exercise capacity, and left ventricular gene expression were also analyzed. Obese ZSF1 rats exhibited multiple features of human cardiometabolic syndrome by pathological changes in systemic renal, metabolic, and cardiovascular disease circulating biomarkers. Hemodynamic assessment, echocardiography, and decreased exercise capacity confirmed heart failure with preserved ejection fraction. RNA-seq results demonstrated changes in left ventricular gene expression associated with fatty acid and branched chain amino acid metabolism, cardiomyopathy, cardiac hypertrophy, and heart failure. Twelve weeks of growth differentiation factor 15 (GDF15) treatment significantly decreased body weight, food intake, blood glucose, and triglycerides and improved exercise capacity in obese ZSF1 males. Systemic cardiovascular injury markers were significantly lower in GDF15-treated obese ZSF1 rats. Obese ZSF1 male rats represent a preclinical model for human cardiometabolic syndrome with established heart failure with preserved ejection fraction. GDF15 treatment mediated dietary response and demonstrated a cardioprotective effect in obese ZSF1 rats.


Assuntos
Fator 15 de Diferenciação de Crescimento/metabolismo , Fator 15 de Diferenciação de Crescimento/farmacologia , Síndrome Metabólica/metabolismo , Animais , Biomarcadores/metabolismo , Coração/fisiologia , Insuficiência Cardíaca/fisiopatologia , Ventrículos do Coração/fisiopatologia , Rim/metabolismo , Masculino , Síndrome Metabólica/complicações , Miocárdio/metabolismo , Obesidade/complicações , Ratos , Ratos Endogâmicos , Ratos Zucker , Volume Sistólico/fisiologia , Função Ventricular Esquerda/efeitos dos fármacos , Função Ventricular Esquerda/fisiologia
13.
Orv Hetil ; 161(35): 1456-1465, 2020 08.
Artigo em Húngaro | MEDLINE | ID: mdl-32822324

RESUMO

INTRODUCTION: Fatty liver can develop as a result of diseases, surgical procedures, medicaments, malnutrition or excessive alcohol consumption, however, fat and poor fiber feeding can be attributed as the primary cause. Non-alcoholic fatty liver can be found in 20-30% of the population. Generally, alimentary-induced fatty liver in early state is described as uncomplicated liver injury. AIM: The aim of our research was to study the effect of fat rich nutrition on the gut-liver axis by routine laboratory, analytical and histological methods in rats. METHODS: We also examined the redox parameters of the liver and of the bowel. Fatty acid composition and element content of liver were measured. RESULTS: Significant changes were found in parameters of redox homeostasis as well as alterations in liver enzymes and metabolites. The changes could be detected in the liver, blood and bowel parts. The development of fatty liver is associated with the decrease of transmethylation capacity. Fatty acid composition and metal ion homeostasis were also altered in liver. Histological examinations showed that hepatocytes were swollen in the central part of the liver lobules, showed droplets and pycnotic nuclei, which were characterized by fatty degeneration. Small and large bowel enterocytes were damaged, sometimes pushed from the surface, and sometimes inflammatory reactions in the mucous membrane were observed. CONCLUSION: Our results suggest that alimentary fatty liver in early state is not considered simply as a reversible alteration because it alters the entire body's redox homeostasis and establishes heart and serious metabolic diseases as well as hasten the development of gastrointestinal tumors. Orv Hetil. 2020; 161(35): 1456-1465.


Assuntos
Dieta Hiperlipídica , Inflamação/patologia , Fígado/patologia , Hepatopatia Gordurosa não Alcoólica , Animais , Ácidos Graxos , Hepatócitos , Intestinos/patologia , Síndrome Metabólica/complicações , Ratos
14.
Medicine (Baltimore) ; 99(28): e21153, 2020 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-32664149

RESUMO

BACKGROUND: The prevalence of obesity among women is increasing. Obesity is associated with various metabolic syndromes; conventional treatments are limited and may induce serious adverse events due to polytherapy regimens. Currently, demands for complementary and alternative medicine that has a proven safety profile for the treatment of obesity with or without metabolic risk factors are increasing.Our team of preclinical experts reported a significant anti-obesity effect of the Korean herbal medicine, Galgeun-tang (GGT). Thus, we designed this trial to explore the effects of GGT among obese women to accumulate optimal clinical evidence.Obesity is not only a component of metabolic syndrome and a factor associated with an increased risk of cardiovascular disease but is also related to insulin resistance. Previous research has confirmed that an increasing body mass index is highly related with increased risk of metabolic syndrome among overweight and obese individuals. The effectiveness of the Korean medicine herbal formula, GGT on obesity has been previously reported. The objective of this study is to assess the efficacy and safety of GGT for weight loss among obese Korean women with or without high risk for metabolic syndrome. METHODS/DESIGN: This study is a randomized, double-blinded, placebo-controlled, multi-center clinical trial. A total of 160 participants will be randomly distributed in 2 groups, the GGT group or the placebo group in a 1:1 ratio using a web-based randomization system. Each group will be administered GGT or placebo 3 times a day for 12 weeks. The primary endpoint is to assess the change in weight from baseline. The secondary endpoints are the following: the changes in body composition measurements, anthropomorphic measurements, obesity screening Laboratory tests, patient self-reported questionnaires, and economic evaluation outcomes. Adverse events will also be reported. DISCUSSION: The findings of this study will confirm methodologies regarding the efficacy and safety of GGT for weight loss among obese Korean women with or without metabolic risk factors.


Assuntos
Medicina Herbária/normas , Síndrome Metabólica/tratamento farmacológico , Obesidade/terapia , Fitoterapia/métodos , Plantas Medicinais , Adulto , Idoso , Método Duplo-Cego , Feminino , Humanos , Síndrome Metabólica/complicações , Síndrome Metabólica/epidemiologia , Pessoa de Meia-Idade , Obesidade/complicações , Obesidade/epidemiologia , Prevalência , República da Coreia/epidemiologia , Fatores de Risco , Resultado do Tratamento , Adulto Jovem
15.
PLoS One ; 15(7): e0235331, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32645005

RESUMO

BACKGROUND: More advanced knowledge is needed on how COPD alters the clinical presentation of obstructive sleep apnea (OSA) and how the association of both diseases, known as 'overlap syndrome' (OVS), impacts on cardiovascular health. OBJECTIVE: To investigate differences between patients with OVS and those with moderate-to-severe OSA alone. METHODS: A cross-sectional study conducted in the French National Sleep Apnea Registry between January 1997 and January 2017. Univariable and multivariable logistic regression models were used to compare OVS versus OSA alone on symptoms and cardiovascular health. RESULTS: 46,786 patients had moderate-to-severe OSA. Valid spirometry was available for 16,466 patients: 14,368 (87%) had moderate-to-severe OSA alone and 2098 (13%) had OVS. A lower proportion of OVS patients complained of snoring, morning headaches and excessive daytime sleepiness compared to OSA alone (median Epworth Sleepiness Scale score: 9 [interquartile range (IQR) 6-13] versus 10 (IQR 6-13), respectively; P <0.02). Similarly, a lower proportion of OVS patients (35.6% versus 39.4%, respectively; P <0.01) experienced sleepiness while driving. In contrast, 63.5% of the OVS population experienced nocturia compared to 58.0% of the OSA population (P<0.01). Apnea hypopnea index (36 [25; 52] vs 33.1 [23.3; 50]), oxygen desaturation index (28 [15; 48] vs 25.2 [14; 45]) and mean nocturnal SaO2 (92 [90; 93.8] vs 93 [91.3; 94]) were significantly more altered in the OVS group. Associated COPD had no effect on the prevalence of hypertension and stroke. After controlling for main confounders, COPD severity was associated in a dose-response relationship with a higher prevalence of coronary heart disease, heart failure and peripheral arteriopathy. CONCLUSIONS: In adults with moderate-to-severe OSA, OVS was minimally symptomatic, but exhibited higher odds for prevalent coronary heart disease, heart failure and peripheral arteriopathy.


Assuntos
Doença Pulmonar Obstrutiva Crônica/epidemiologia , Síndromes da Apneia do Sono/epidemiologia , Doenças Cardiovasculares/complicações , Comorbidade , Estudos Transversais , Feminino , Humanos , Modelos Logísticos , Masculino , Síndrome Metabólica/complicações , Pessoa de Meia-Idade , Análise Multivariada
16.
PLoS One ; 15(7): e0236752, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32726371

RESUMO

OBJECTIVES: To apply spinal cord injury (SCI) specific waist circumference (WC) cutoff point to identify risks of 1) obesity, 2) metabolic syndrome (MetS), 3) cardiovascular disease (CVD). METHODS: Thirty-six men with chronic SCI underwent anthropometric measurements, dual-energy x-ray absorptiometry (DXA), and magnetic resonance imaging (MRI) to measure total and regional adiposity. An SCI specific WC cutoff point of 86.5 cm was applied to the existing general population criteria. Pearson chi-square (χ2) analyses tested the difference in the number of participants classified as obese using the SCI specific cutoff point compared to the general population criteria. Sensitivity and specificity analyses relative to percentage body fat mass and visceral adipose tissue was used to assess classification performance of this cutoff point. The interrater reliability for three definitions of MetS was assessed using Cohen's Kappa (κ) values. Linear regression analyses were utilized to propose SCI specific Framingham Coronary Heart Disease Risk Score (FRS) cutoff value. RESULTS: Using SCI specific WC cutoff point of 86.5 cm, 36% of participants were classified as obese compared to only 3% when using WC of 102 cm (P < 0.001). Relative to percentage body fat mass, the general population WC cutoff point of 102 cm had a sensitivity of 6.3% and specificity of 100% both which changed to 68.8% and 90%, respectively, with a SCI specific cutoff point of 86.5 cm. Similar results were obtained when using visceral adipose tissue as a reference. The Kappa (κ) values improved substantially after using SCI specific criteria (0.95 ± 0.05) compared to the general population criteria (0.47 ± 0.28) for three definitions of MetS. The SCI specific FRS cutoff value of 6 was predicted after applying a WC cutoff of 86.5 cm. CONCLUSIONS: Using the existing general population criteria underestimated persons with SCI who are at risk of developing obesity, MetS, and CVD. The recommended SCI specific criteria are likely to distinguish those at risks of developing comorbidities and allow healthcare providers to intervene in a timely manner.


Assuntos
Doenças Cardiovasculares/complicações , Síndrome Metabólica/complicações , Obesidade/complicações , Traumatismos da Medula Espinal/complicações , Circunferência da Cintura , Adolescente , Adulto , Composição Corporal , Doenças Cardiovasculares/epidemiologia , Humanos , Metabolismo dos Lipídeos , Masculino , Síndrome Metabólica/epidemiologia , Pessoa de Meia-Idade , Obesidade/epidemiologia , Reprodutibilidade dos Testes , Medição de Risco , Traumatismos da Medula Espinal/metabolismo , Adulto Jovem
17.
PLoS One ; 15(7): e0236526, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32722703

RESUMO

Metabolic syndrome (MetS) is a worldwide health concern related to cardiovascular disease. Stress at work increases the risk for MetS, whereas physical activity and cardiorespiratory fitness (CF) have been shown to be potential buffers against stress. The aim of this study was to test the stress-buffering effects of physical activity and CF on the relationship between work stress and MetS. In a prospective study, we followed 97 police officers (mean age = 39.7 years; mean body mass index = 25.74 kg/m2) over one year and assessed MetS, as defined by the National Cholesterol Education Program Adult Treatment Panel III. Stress at work was measured with the Job Content Questionnaire, as well as the Effort-Reward Imbalance Questionnaire. Physical activity was assessed objectively via 7-day accelerometry. CF was assessed with the Åstrand bicycle ergometer test. Hierarchical linear regression models were carried out to predict MetS at follow-up (mean overall MetS score = 1.22), after controlling for baseline levels and sociodemographic background (mean overall MetS score = 1.19). Higher CF levels were significantly associated with lower MetS risk at follow-up (ß = -.38). By contrast, no main effects were found for physical activity and work stress. However, high effort and demand were significantly correlated with increased blood pressure (effort: r = .23 for systolic blood pressure; r = .21 for diastolic blood pressure) and waist circumference (effort: r = .26; demand: r = .23). Moreover, no significant interaction effects occurred between work stress and CF/physical activity. The results emphasize the importance of high levels of CF in the prevention of MetS in police officers. Accordingly, provision of regular training opportunities and repeated CF testing should be considered as a strategy in overall corporate health promotion.


Assuntos
Aptidão Cardiorrespiratória/psicologia , Exercício Físico , Síndrome Metabólica/fisiopatologia , Síndrome Metabólica/psicologia , Estresse Ocupacional/complicações , Polícia/psicologia , Adulto , Feminino , Humanos , Masculino , Síndrome Metabólica/complicações , Estresse Ocupacional/fisiopatologia , Estresse Ocupacional/psicologia , Fatores de Risco
18.
Expert Rev Gastroenterol Hepatol ; 14(10): 867-872, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32705906

RESUMO

The pandemic Sars-CoV-2 infection represents a dramatic health challenge worldwide. Pneumonia is considered the major damage caused by the virus. However, recent data have highlighted the impact of the Sars-CoV-2 related disease namely COVID-19 on the liver. Hepatic abnormalities significantly increase during COVID-19 and a more severe infection occurs in patients with pre-existing liver diseases, among which the most frequent is metabolic-associated fatty liver disease (MAFLD). It has been described that MAFLD patients had a higher risk of progression to severe COVID-19, higher abnormal liver tests and longer viral shedding time. The presence of fibrosis in MAFLD patients is another risk factor for severity of COVID-19. Due to the overgrowing prevalence of MAFLD, it could be speculated that a large proportion of the population might be at risk of severe COVID-19 and the identification of these patients possibly by using liver enzymes as risk predictors may be crucial for an early diagnosis and for the management of the infection.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Fígado Gorduroso/epidemiologia , Síndrome Metabólica/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Idoso , Comorbidade , Fígado Gorduroso/etiologia , Feminino , Saúde Global , Humanos , Masculino , Síndrome Metabólica/complicações , Prevalência , Fatores de Risco
19.
J Int Med Res ; 48(7): 300060520939746, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32722979

RESUMO

The novel coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 infection is a serious global concern. Increased morbidity and mortality is associated with older age, male gender, cardiovascular disease, diabetes, and smoking. As COVID-19 spreads from coastal borders, both state to state and country to country, our understanding of its pathophysiology has evolved. Age and type 2 diabetes mellitus (T2DM) play especially important roles in COVID-19 progression. T2DM is an age-related disease associated with metabolic syndrome, obesity, insulin resistance (hyperinsulinemia), hyperlipidemia, hypertension, hyperglycemia, and endothelial activation and dysfunction. This review evaluates the relationships and intersection between endothelial cell activation and dysfunction in T2DM and COVID-19. COVID-19 induces multiple injuries of the terminal bronchioles and alveolar blood-gas barrier and associated ultrastructural tissue remodeling. COVID-19 may unmask multiple vulnerabilities associated with T2DM including damage to the endothelial glycocalyx and multiple end-organ macro and microvascular diseases. Unmasking existing vulnerabilities in diabetic patients with COVID-19 is important. Globally, we must come together to better understand why T2DM is associated with increased COVID-19 morbidity and mortality.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Infecções por Coronavirus/fisiopatologia , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/fisiopatologia , Células Endoteliais/fisiologia , Síndrome Metabólica/complicações , Síndrome Metabólica/fisiopatologia , Pneumonia Viral/complicações , Pneumonia Viral/fisiopatologia , Animais , Barreira Alveolocapilar/patologia , Barreira Alveolocapilar/fisiopatologia , Bronquíolos/patologia , Bronquíolos/fisiopatologia , Comorbidade , Infecções por Coronavirus/epidemiologia , Diabetes Mellitus Tipo 2/epidemiologia , Reposicionamento de Medicamentos , Células Endoteliais/patologia , Humanos , Síndrome Metabólica/epidemiologia , Modelos Biológicos , Pandemias , Pneumonia Viral/epidemiologia , Alvéolos Pulmonares/fisiologia , Alvéolos Pulmonares/fisiopatologia , Ratos , Cicatrização/fisiologia
20.
Life Sci ; 256: 117962, 2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-32534040

RESUMO

AIMS: The aim of the present study was to evaluate the oral resveratrol effects associated with diet and physical training changes on anthropometric and biochemical parameters. MAIN METHODS: 25 individuals aged from 30 to 60 years old; with Body Mass Index (BMI) ≥ 30 kg/m2 were included in the study. Following the primary evaluation (anthropometric and clinical), the patients were randomly divided into 2 groups: (1) Placebo: Physical activity program + Diet + Placebo; (2) Resveratrol: Physical activity program + Diet + Resveratrol (RVS) (250 mg/day) for three months. Anthropometric and biochemical parameters were evaluated at baseline and after the treatment period. KEY FINDINGS: The main findings showed that the resveratrol supplementation improved total cholesterol (TC), High-density Lipoprotein cholesterol (HDL-c), Very-low density Lipoprotein cholesterol (VLDL-c), urea, creatinine and albumin serum levels. SIGNIFICANCE: These findings indicate that this polyphenol may be an option to potentiate the beneficial effects induced by dietary and physical activity programs in the Metabolic Syndrome (MetS) treatment.


Assuntos
Suplementos Nutricionais , Estilo de Vida , Síndrome Metabólica/complicações , Síndrome Metabólica/tratamento farmacológico , Obesidade/complicações , Resveratrol/administração & dosagem , Resveratrol/uso terapêutico , Administração Oral , Adulto , Metabolismo Energético/efeitos dos fármacos , Feminino , Humanos , Lipídeos/sangue , Masculino , Síndrome Metabólica/sangue , Pessoa de Meia-Idade , Obesidade/sangue , Placebos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA