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1.
PLoS One ; 15(8): e0238351, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32857825

RESUMO

The purpose of this study was to evaluate the association between the presence of Metabolic Syndrome (MetS) and idiopathic sudden sensorineural hearing loss (ISSHL) and the impact of MetS on recovery of patients with ISSHL. 39 Patients with ISSHL and 44 controls were enrolled in this study. Demographic, clinical characteristics and hearing recovery were evaluated. MetS was defined according to the diagnostic criteria of International Diabetes Federation (IDF) consensus definition. Patients affected by ISSHL presented a body mass index (BMI), waist circumference, waist hip ratio (WHR), fasting glucose and blood pressure significantly higher compared to controls. Considering patients with central obesity, 5 controls and 15 ISSHL patients met the criteria of MetS. According to Siegel criteria, a complete or partial recovery was observed in 60% of patients with MetS and in 91,66% of patients without MetS. MetS was associated with ISSHL and this association negatively influenced the hearing recovery of these patients.


Assuntos
Perda Auditiva Neurossensorial/epidemiologia , Perda Auditiva Súbita/epidemiologia , Síndrome Metabólica/epidemiologia , Feminino , Perda Auditiva Neurossensorial/fisiopatologia , Perda Auditiva Neurossensorial/terapia , Perda Auditiva Súbita/fisiopatologia , Perda Auditiva Súbita/terapia , Humanos , Masculino , Síndrome Metabólica/fisiopatologia , Síndrome Metabólica/terapia , Pessoa de Meia-Idade , Obesidade/epidemiologia , Obesidade/fisiopatologia , Obesidade/terapia , Recuperação de Função Fisiológica
2.
Diabetes Metab Syndr ; 14(5): 809-814, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32540733

RESUMO

BACKGROUND AND AIMS: Many patients with coronavirus disease 2019 (COVID-19) have comorbidities related to metabolic syndrome (MS) during the disease course. Its presence in different ethnicities and continents places MS as an important risk factor for COVID-19. Adequate understanding of the interplay between MS, COVID-19 and proposed therapies is required for optimum management of these patients. METHODS: We systematically searched the PubMed and Google Scholar databases until June 1st, 2020 and accessed the full text on COVID-19 and MS to prepare a narrative review on this topic. RESULTS: Patients with metabolic disorders like obesity, diabetes, cardiovascular and liver disease may face a higher risk of infection of COVID-19, greatly affecting the development and prognosis of the disease, being associated with significantly worse outcome in these patients. The proposed drugs that are in clinical trial for COVID-19 treatment must be carefully considered for clinical use, especially in patients with MS. CONCLUSION: MS is a risk factor influencing the progression and prognosis of COVID-2019. The drugs currently evaluated for the infection treatment are promising but need further studies to prove their efficacy and safety, due to the adverse effects may be exacerbated by combination therapy or due to viral infection. The development of a vaccine for immunization is still the best long-term solution.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/terapia , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Betacoronavirus/fisiologia , Comorbidade , Infecções por Coronavirus/complicações , Infecções por Coronavirus/diagnóstico , Progressão da Doença , Humanos , Síndrome Metabólica/complicações , Pandemias , Pneumonia Viral/complicações , Pneumonia Viral/diagnóstico , Prognóstico , Fatores de Risco , Índice de Gravidade de Doença
3.
Ann Biol Clin (Paris) ; 78(3): 261-264, 2020 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-32420889

RESUMO

Leptin and adiponectin are two adipokines currently used as biomarkers for diagnostic orientation and phenotyping in syndromes of lipodystrophy and severe insulin resistance. The level of these biomarkers also has an impact on the therapeutic management of the patients. These aspects, as well as our experience as a reference center, are described in this brief overview.


Assuntos
Adiponectina/fisiologia , Resistência à Insulina , Leptina/fisiologia , Lipodistrofia/diagnóstico , Síndrome Metabólica/diagnóstico , Adiponectina/sangue , Biomarcadores/análise , Biomarcadores/sangue , Humanos , Resistência à Insulina/fisiologia , Leptina/sangue , Lipodistrofia/patologia , Lipodistrofia/terapia , Síndrome Metabólica/terapia , Fenótipo , Índice de Gravidade de Doença
4.
Artigo em Inglês | MEDLINE | ID: mdl-32456272

RESUMO

Insulin resistance is a central mediating factor of the metabolic syndrome (MetS), with exercise training and metformin proven antidotes to insulin resistance. However, when the two therapies are combined there is conflicting data regarding whether metformin blunts or improves exercise training-induced adaptations. The volume of exercise (duration, intensity, and frequency) on the interaction of exercise training and metformin has yet to be investigated. The aim of this study is therefore to explore the impact of a combination of different exercise volumes and metformin on MetS severity. This is a secondary analysis of data from one of the sites of the 'Exercise in Prevention of Metabolic Syndrome' (EX-MET) study. Ninety-nine adults with MetS were randomized into a 16-week exercise program completing either: (i) moderate-intensity continuous training (MICT) at 60-70% of peak heart rate (HRpeak) for 30 min/session (n = 34, 150 min/week); (ii) high-volume high-intensity interval training (HIIT) consisting of 4 × 4 min bouts at 85-95% HRpeak, interspersed with 3 min of active recovery at 50-70% HRpeak (n = 34, 38 min/session, 114 min/week); or (iii) low volume HIIT, 1 × 4 min bout of HIIT at 85-95% HRpeak (n = 31, 17 min/session, 51 min/week). Metformin intake was monitored and recorded throughout the trial. MetS severity was calculated as z-scores derived from MetS risk factors assessed at pre- and post-intervention. Sixty-five participants had complete pre- and post-intervention data for MetS z-score, of which 18 participants (28%) were taking metformin. Over the 16-week intervention, a similar proportion of participants clinically improved MetS severity (Δ ≥ -0.87) with metformin (8/18, 44%) or without metformin (23/47, 49%) (p = 0.75). While there were no between-group differences (p = 0.24), in those who did not take metformin low-volume HIIT had more likely responders (10/15, 67%) compared to MICT (6/16, 38%) and high-volume HIIT (7/16, 44%). In those taking metformin, there was a lower proportion of participants who clinically improved MetS severity following high-volume HIIT (1/6, 17%) compared to MICT (2/4, 50%) and low-volume HIIT (5/8, 63%), but with no between-group difference (p = 0.23). Moreover, in those who performed high-volume HIIT, there was a statistically significantly higher proportion (p = 0.03) of likely non-responders with improved MetS severity in participants taking metformin (4/6, 67%) compared to those not taking metformin (3/16, 19%). In individuals with MetS, the effect of high volume HIIT on MetS severity may be blunted in those taking metformin. These findings need to be confirmed in a larger study.


Assuntos
Treinamento Intervalado de Alta Intensidade , Hipoglicemiantes , Resistência à Insulina , Síndrome Metabólica , Metformina , Adulto , Exercício Físico , Feminino , Humanos , Hipoglicemiantes/administração & dosagem , Masculino , Síndrome Metabólica/terapia , Metformina/administração & dosagem , Pessoa de Meia-Idade
5.
Zhen Ci Yan Jiu ; 45(1): 62-5, 2020 Jan 25.
Artigo em Chinês | MEDLINE | ID: mdl-32144911

RESUMO

OBJECTIVE: To investigate the clinical effect of acupoint thread-embedding therapy at different intervals in the treatment of metabolic syndrome, and to find the optimal treatment interval. METHODS: A total of 70 patients with metabolic syndrome were randomly divided into treatment group 1 (n=35)and treatment group 2(n=35). Both groups were given acupoint thread-embedding therapy at Zhongwan (CV12), bilateral Liangmen (ST21), bilateral Huaroumen (ST24), bilateral Tianshu (ST25), bilateral Daimai (GB26), Guanyuan (CV4), bilateral Dachangshu (BL25), bilateral Pishu (BL20), bilateral Zusanli (ST36), bilateral Yinlingquan (SP9), and bilateral Fenglong (ST40), and the treatment interval was 7 d for treatment group 1 and 14 d for treatment group 2. Each course of treatment was 42 d, and both groups were treated for 2 courses. Waist circumfe-rence (WC), hip circumference (HC), waist-hip ratio (WHR), body mass index (BMI), serum triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), fasting plasma glucose (FPG), and glycosylated hemoglobin (Hb1Ac) were measured before and after treatment to analyze clinical outcome, and adverse reactions were recorded. RESULTS: After treatment, both groups had significant reductions in WC, HC, WHR, BMI, TG, LDL-C, FPG and Hb1Ac (P<0.05) and a significant increase in HDL-C (P<0.05). Compared with treatment group 1, treatment group 2 had significant increases in WC, WHR, BMI, TG, LDL-C, FPG and Hb1Ac (P<0.05) and a significant reduction in HDL-C (P<0.05). There was no significant difference in the incidence rate of adverse reactions between the two groups (P>0.05). CONCLUSION: Under the premise of ensuring efficacy and safety, an interval of 7 d is the optimal interval for acupoint thread-embedding therapy in the clinical intervention of metabolic syndrome.


Assuntos
Pontos de Acupuntura , Síndrome Metabólica , Índice de Massa Corporal , Humanos , Síndrome Metabólica/terapia , Relação Cintura-Quadril
6.
Int J Surg ; 75: 139-147, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32014594

RESUMO

PURPOSE: Sleeve gastrectomy (SG) is an effective procedure to treat morbid obesity. SG induces remission of type 2 diabetes and metabolic syndrome and improves non-alcoholic fatty liver disease (NAFLD). However, it is imperative to clarify the extent to which these beneficial effects may be attributed to SG among other concomitant changes including postoperative diet. The current study addresses this question in a rodent model of obesity by subjecting it to SG, normal diet, or a combination of the two. METHODS: Male Wistar-rats were fed with either high fat diet (HF, n = 32) or received chow diet (CD, n = 8). After 15 weeks, the HF-fed rats underwent either SG or sham operation, following which they were randomised to either continue HF or switched to CD for another 6 weeks. Body weight, fasting blood glucose level, blood pressure, and adipokine expression (leptin, adiponectin, MCP-1) in the adipose tissue along with triglycerides level in the blood serum were assessed to evaluate metabolic function. Hepatic function was assessed by histological evaluation of liver fibrosis (Hydroxyproline, Sirius Red) and reverse transcription polymerase chain reaction (RT-PCR) of the inflammation marker monocyte chemoattractant protein-1 (MCP-1). RESULTS: Postoperative dietary change improved adipose tissue inflammation and arterial blood pressure regardless of the surgical intervention, while SG improved hyperglycaemia, blood triglyceride levels and, regardless of the postoperative diet, hepatic inflammation and fibrosis. However, combined administration of SG with post-operative normal diet was the most effective with regard to reducing the body weight. CONCLUSION: HF for 15 weeks induced obesity with metabolic syndrome and NAFLD in rats. SG and dietary intervention improved metabolic state and NAFLD; however, their combination was significantly more effective.


Assuntos
Gastrectomia/métodos , Fígado/fisiopatologia , Obesidade Mórbida/cirurgia , Tecido Adiposo/metabolismo , Tecido Adiposo/patologia , Animais , Dieta Hiperlipídica , Modelos Animais de Doenças , Masculino , Síndrome Metabólica/terapia , Hepatopatia Gordurosa não Alcoólica/terapia , Obesidade Mórbida/fisiopatologia , Ratos , Ratos Wistar
7.
J Am Osteopath Assoc ; 120(2): 107-117, 2020 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-31985761

RESUMO

In this highly digitalized era, sleep disorders are becoming more common and are associated with an increased burden of chronic disease. Shift workers are at an increased risk for both sleep disorders and metabolic syndrome. In this article, the authors outline the connection between circadian discordance, hormonal imbalance, and the development of metabolic syndrome in shift workers. Based on a literature review of animal model studies, observational studies, and clinical trials conducted between August and October of 2018, the authors offer several clinical interventions, including work schedules, light therapy, medications, and dietary habits to improve the circadian synchronicity of shift workers and reduce their risk of morbidity and mortality. It is important for physicians to be familiar with the consequences of shift work and ways to mitigate the risks for this patient population.


Assuntos
Síndrome Metabólica/etiologia , Síndrome Metabólica/terapia , Jornada de Trabalho em Turnos/efeitos adversos , Transtornos do Sono do Ritmo Circadiano/etiologia , Transtornos do Sono do Ritmo Circadiano/terapia , Comportamento Alimentar , Humanos , Manipulação Osteopática , Fototerapia
8.
Clin Chim Acta ; 503: 90-98, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31968211

RESUMO

Fecal microbiota transplantation (FMT) is the introduction (transplantation) of gut microbiota obtained from the faeces of a healthy donor into the patient's gastrointestinal tract. Most often, such therapy is used the treatment of gastrointestinal diseases caused by the activity of pathogenic or conditionally pathogenic microorganisms, however, recently an increasing number of studies have reported the use of fecal microbiota transplantation for the treatment of diseases such as metabolic syndrome, diabetes, cancer and Parkinson's disease. This review article presents the results of studies concerning the impact of FMT on weight gain, immunological response and the treatment of neurological and gastrointestinal diseases and cancer. The procedure of fecal microbiota transplantation and possible side effects that may appear in FMT recipients are also described.


Assuntos
Transplante de Microbiota Fecal/métodos , Terapêutica/métodos , Transplante de Microbiota Fecal/efeitos adversos , Gastroenteropatias/terapia , Humanos , Síndrome Metabólica/terapia , Neoplasias/terapia , Doenças do Sistema Nervoso/terapia , Doença de Parkinson/terapia , Terapêutica/efeitos adversos
9.
Res Q Exerc Sport ; 91(3): 415-424, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31906814

RESUMO

Metabolic syndrome (MetS) is a growing epidemic related with higher values of blood pressure (BP) and autonomic dysfunction. Scientific evidence has been indicating that functional resistance training (FRT) is superior over conventional (CRT) for muscle fatigue and pain, yet its effects on autonomic modulation (AM), BP and heart rate in MetS are unclear. We theorized that FRT can be superior to CRT in MetS patients because of larger muscle activation. This study compares FRT and CRT on AM, blood pressure, heart rate and muscle strength. Thirty-eight sex and age matched individuals (40 to 60 years) were randomized for FRT or CRT, with training intensity varying gradually from 30%-100% of one maximal repetition test (1MR), 3 times/week for 30 sessions. All outcomes were evaluated at baseline and post training. AM was assessed by heart rate variability (mean RR, RMSSD, SDNN, LF, HF, TINN, RRtri, SD1 and SD2). BP (mmHg) was obtained by cuff measures. Muscle strength was assessed by 1MR. An increase in cardiac parasympathetic activity was observed in individuals allocated to FRT in comparison to CRT group (RMSSD ∆40%; SD1 ∆39%; and HF ms 2 ∆80%). Moreover, just FRT was capable of reducing BP post intervention (SBP from 129.21 ± 19.02 to 118.94 ± 14.14 mmHg, p < .009,/d/ = 0.49; DBP from 85.26 ± 11.48 to 77.76 ± 8.93 mmHg, p < .01,/d/ = 0.51). Both groups had a similar increase in muscle strength and no changes between HR. Progressive FRT was more beneficial to CRT regarding AM, increasing vagal activity, and reducing blood pressure in MetS individuals.


Assuntos
Pressão Sanguínea/fisiologia , Terapia por Exercício/métodos , Frequência Cardíaca/fisiologia , Síndrome Metabólica/fisiopatologia , Síndrome Metabólica/terapia , Força Muscular/fisiologia , Treinamento de Resistência , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/fisiologia , Sistema Nervoso Simpático/fisiopatologia
10.
Gut ; 69(3): 502-512, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31147381

RESUMO

OBJECTIVE: Bariatric surgery improves glucose metabolism. Recent data suggest that faecal microbiota transplantation (FMT) using faeces from postbariatric surgery diet-induced obese mice in germ-free mice improves glucose metabolism and intestinal homeostasis. We here investigated whether allogenic FMT using faeces from post-Roux-en-Y gastric bypass donors (RYGB-D) compared with using faeces from metabolic syndrome donors (METS-D) has short-term effects on glucose metabolism, intestinal transit time and adipose tissue inflammation in treatment-naïve, obese, insulin-resistant male subjects. DESIGN: Subjects with metabolic syndrome (n=22) received allogenic FMT either from RYGB-D or METS-D. Hepatic and peripheral insulin sensitivity as well as lipolysis were measured at baseline and 2 weeks after FMT by hyperinsulinaemic euglycaemic stable isotope (2H2-glucose and 2H5-glycerol) clamp. Secondary outcome parameters were changes in resting energy expenditure, intestinal transit time, faecal short-chain fatty acids (SCFA) and bile acids, and inflammatory markers in subcutaneous adipose tissue related to intestinal microbiota composition. Faecal SCFA, bile acids, glycaemic control and inflammatory parameters were also evaluated at 8 weeks. RESULTS: We observed a significant decrease in insulin sensitivity 2 weeks after allogenic METS-D FMT (median rate of glucose disappearance: from 40.6 to 34.0 µmol/kg/min; p<0.01). Moreover, a trend (p=0.052) towards faster intestinal transit time following RYGB-D FMT was seen. Finally, we observed changes in faecal bile acids (increased lithocholic, deoxycholic and (iso)lithocholic acid after METS-D FMT), inflammatory markers (decreased adipose tissue chemokine ligand 2 (CCL2) gene expression and plasma CCL2 after RYGB-D FMT) and changes in several intestinal microbiota taxa. CONCLUSION: Allogenic FMT using METS-D decreases insulin sensitivity in metabolic syndrome recipients when compared with using post-RYGB-D. Further research is needed to delineate the role of donor characteristics in FMT efficacy in human insulin-resistant subjects. TRIAL REGISTRATION NUMBER: NTR4327.


Assuntos
Transplante de Microbiota Fecal , Derivação Gástrica , Glucose/metabolismo , Resistência à Insulina , Síndrome Metabólica/metabolismo , Adulto , Idoso , Ácidos e Sais Biliares/análise , Quimiocina CCL2/sangue , Quimiocina CCL2/genética , Metabolismo Energético , Ácidos Graxos Voláteis/análise , Fezes/química , Microbioma Gastrointestinal , Trânsito Gastrointestinal , Expressão Gênica , Humanos , Lipólise , Masculino , Síndrome Metabólica/fisiopatologia , Síndrome Metabólica/terapia , Metabolômica , Pessoa de Meia-Idade , Gordura Subcutânea/metabolismo , Doadores de Tecidos , Adulto Jovem
11.
Phytother Res ; 34(2): 295-305, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31667949

RESUMO

Changes in the global economy resulted in sedentary lifestyle and excessive calorie intake, increasing the incidence of metabolic diseases, which subsequently became a universal public concern. The difficulties of managing chronic diseases did not dampen researchers' enthusiasm for studying new therapeutics or adjuvant treatments. Cordyceps spp. is a kind of traditional Chinese herbal medicine; however, our understanding of this medicine remains at an initial stage. Recently, an increasing number of studies have demonstrated the potential of Cordyceps as a therapeutic agent for the effective treatment of metabolic-related disorders by exerting a variety of activities, including but not limited to anti-inflammatory, immunoregulatory, hypoglycemic, renoprotective and cardiovascular-protective effects. This article reviews the potential efficacy and underlying mechanisms of Cordyceps and its major bioactive ingredients in metabolic syndrome and its associated comorbidities.


Assuntos
Cordyceps/química , Medicina Tradicional Chinesa , Doenças Metabólicas/terapia , Animais , Desoxiadenosinas/farmacologia , Cloridrato de Fingolimode/farmacologia , Polissacarídeos Fúngicos/farmacologia , Humanos , Síndrome Metabólica/terapia , Peptídeos/farmacologia
12.
Chin J Nat Med ; 17(11): 835-841, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31831130

RESUMO

The probiotic Akkermansia muciniphila (A. muciniphila) is an intestinal bacterium that was first identified in human feces in 2004. Its specialization in mucin degradation makes it a key microorganism that maintains intestinal mucosal barrier function. As an unique representative strain of the phylum Verrucomicrobia that can be cultured in vitro, A. muciniphila is much easier to detect by metagenomic analysis of intestinal flora. In the past few years, A. muciniphila has been getting increasing attention for the positive correlation between its intestinal colonization and host homeostatic metabolism. In this review, we summarize the relationship between A. muciniphila and host health and diseases, especially focusing on metabolic diseases and related mechanisms, as well as the natural food and drug-derived substrates affecting its colonization in the host, expecting to provide evidence and clues for the development of drugs targeting A. muciniphila.


Assuntos
Doenças Metabólicas/terapia , Síndrome Metabólica/terapia , Probióticos , Verrucomicrobia , Animais , Microbioma Gastrointestinal , Humanos , Doenças Metabólicas/microbiologia , Síndrome Metabólica/microbiologia
13.
PLoS One ; 14(12): e0225893, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31821339

RESUMO

High-intensity interval training (HIIT), is effective to improve cardiorespiratory fitness (CRF) and metabolic syndrome (MetS) components in adults. However, it is unclear if CRF and MetS components respond similarly in men and women after HIIT. For 16 weeks, 63 women (53±7 years) and 56 men (55±8 years) with MetS underwent a three day/week HIIT program. Bodyweight and composition, VO2MAX, surrogate parameters of CRF (Ventilatory threshold (VT), oxygen uptake efficiency slope (OUES) and VE/VCO2 slope), maximal rate of fat oxidation (MFO), and MetS components were assessed before and after training. All reported variables were analyzed by split-plot ANOVA looking for time by sex interactions. Before training men had higher absolute values of VO2MAX (58.6%), and MFO (24.6%), while lower body fat mass (10.5%) than women (all P<0.05). After normalization by fat-free mass (FFM), VO2MAX remained 16.6% higher in men (P<0.05), whereas differences in MFO disappeared (P = 0.292). After intervention VO2MAX (P<0.001), VO2 at VT (P<0.001), OUES (P<0.001), and VE/VCO2 slope (P<0.001) increased without differences by sex (P>0.05). After training MetS Z-score (P<0.001) improved without differences between men and women (P>0.05). From the MetS components, only blood pressure (P<0.001) and waist circumference (P<0.001) improved across time, without differences by sex. In both, women and men, changes in OUES (r = 0.685 and r = 0.445, respectively), and VO2 at VT (r = 0.378, and r = 0.445, respectively), correlated with VO2MAX. While only bodyweight changes correlated with MetS Z-score changes (r = 0.372, and = 0.300, respectively). Despite baseline differences, 16-weeks of HIIT similarly improved MetS, cardiorespiratory and metabolic fitness in women and men with MetS. This suggests that there are no restrictions due to sex on the benefits derived from an intense exercise program in the health of MetS participants. Trial Registration: clinicaltrials.gov NCT03019796.


Assuntos
Terapia por Exercício , Treinamento Intervalado de Alta Intensidade , Síndrome Metabólica , Adulto , Idoso , Peso Corporal , Feminino , Humanos , Masculino , Síndrome Metabólica/patologia , Síndrome Metabólica/fisiopatologia , Síndrome Metabólica/terapia , Pessoa de Meia-Idade , Fatores de Tempo , Circunferência da Cintura
14.
BMC Endocr Disord ; 19(1): 136, 2019 Dec 11.
Artigo em Inglês | MEDLINE | ID: mdl-31829172

RESUMO

BACKGROUND: Abdominal obesity and presence of the metabolic syndrome (MetS) significantly increase the risk of developing diseases such as Type 2 diabetes mellitus (T2DM) with escalating emergence of MetS and T2DM constituting a significant public health crisis worldwide. Lower prevalence of inflammatory and metabolic diseases such as T2DM in countries with higher incidences of helminth infections suggested a potential role for these parasites in the prevention and management of certain diseases. Recent studies confirmed the potential protective nature of helminth infection against MetS and T2DM via immunomodulation or, potentially, alteration of the intestinal microbiota. This Phase 1b safety and tolerability trial aims to assess the effect of inoculation with helminths on physical and metabolic parameters, immune responses, and the microbiome in otherwise healthy women and men. METHODS: Participants eligible for inclusion are adults aged 18-50 with central obesity and a minimum of one additional feature of MetS recruited from the local community with a recruitment target of 54. In a randomised, double-blind, placebo-controlled design, three groups will receive either 20 or 40 stage three larvae of the human hookworm Necator americanus or a placebo. Eligible participants will provide blood and faecal samples at their baseline and 6-monthly assessment visits for a total of 24 months with an optional extension to 36 months. During each scheduled visit, participants will also undergo a full physical examination and complete diet (PREDIMED), physical activity, and patient health (PHQ-9) questionnaires. Outcome measurements include tolerability and safety of infection with Necator americanus, changes in metabolic and immunological parameters, and changes in the composition of the faecal microbiome. DISCUSSION: Rising cost of healthcare associated with obesity-induced metabolic diseases urgently calls for new approaches in disease prevention. Findings from this trial will provide valuable information regarding the potential mechanisms by which hookworms, potentially via alterations in the microbiota, may positively influence metabolic health. TRIAL REGISTRATION: The protocol was registered on ANZCTR.org.au on 05 June 2017 with identifier ACTRN12617000818336. Alternatively, a Google search using the above trial registration number will yield a direct link to the trial protocol within the ANZCTR website.


Assuntos
Síndrome Metabólica/terapia , Necatoríase , Obesidade/complicações , Terapia com Helmintos/métodos , Adolescente , Adulto , Animais , Diabetes Mellitus Tipo 2/prevenção & controle , Método Duplo-Cego , Fezes/microbiologia , Feminino , Microbioma Gastrointestinal/fisiologia , Humanos , Imunomodulação , Larva , Masculino , Síndrome Metabólica/imunologia , Síndrome Metabólica/microbiologia , Pessoa de Meia-Idade , Necator americanus , Necatoríase/imunologia , Necatoríase/microbiologia , Placebos , Queensland , Terapia com Helmintos/efeitos adversos , Resultado do Tratamento
15.
Prensa méd. argent ; 105(11): 827-835, dic2019. tab
Artigo em Inglês | LILACS, BINACIS | ID: biblio-1049981

RESUMO

The metabolic syndrome (MetS) or insulin resistance syndrome is widespread and multi-factorial disorder. This article aims to assess and observe samples with the MetS to start efforts to take the proper treatments to minimize the risk of cardiovascular diseases. Additionally, we evaluate the association of Helicobacter pylori (H. Pylori) Ab tests with MetS. To meet this goal, 350 reviewers of K1 Hospital are participated in this work for six months from October 2016 to March 2017. The patients (N=350) are divided into two groups, a group subjects with MetS (N=109), whereas the latter is without MetS (N=241). A venous blood sample is taken after 8 hours of fasting to measure fasting blood glucose, H. Pylori Ab test and other required biochemical assays. Additionally, blood pressure (BP), Body Mass Index (BMI) (i.e. weight and height), and waist circumference are measured. The assays revealed that the frequency of MetS is 31.1% as per the modified National Cholesterol Education Program Adult Treatment Panel III (NCEP: ATPIII) criteria. Furthermore, a statistically significant age (p=0.02) corresponded higher rate of MetS cases is larger than 40 years old (i.e. 69%). Moreover, BMI recorded as (27.6 ± 4.4 vs 31.4 ± 4.5, p <0.001), height (169 ± 8.4 vs 168.1 ± 8.5, p ≤ 0.11), weight (78.8 ± 12.3 vs 88.6 ± 13.2, p<0.01) and waist circumference (83.3 ± 16.1 vs 96.3 ± 11.6, p<0.001). Besides, BP showed positively correlation with systolic (120.3 ± 10.6 vs 130.6 ± 10.8, p<0.04) and diastolic (70.9 ± 0.9 vs 80.8 ± 10, p<0.01). The biochemical assays for employees with and without MetS are mean values of fasting Serum glucose (5.3 ± 1.4 vs 7.5 ± 3.2, p ≤ 0.001). The highest average total cholesterol recorded as (4.3 ± 1.3 vs 4.9 ± 1.3, p ≤ 0.001), serum triglyceride (2 ± 1.5 vs 2.8 ± 1.2, p ≤ 0.001) and lower HDL levels (1.2 ± 0.5 vs 0.8 ± 0.1, p ≤ 0.001). Accordingly, the results showed that H. Pylori infection is associated significantly with metabolic syndrome. In consequence, the outcome demonstrated high rates of obesity and overweight in MetS cases


Assuntos
Humanos , Doenças Cardiovasculares/terapia , Estudos de Casos e Controles , Helicobacter pylori , Infecções por Helicobacter/terapia , Técnicas de Laboratório Clínico , Síndrome Metabólica/terapia , Diabetes Mellitus Tipo 2/terapia
16.
Biomedica ; 39(4): 647-662, 2019 12 01.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31860177

RESUMO

Introduction: Identifying the most effective interventions to reverse the metabolic syndrome can be key in the design of clinical strategies to prevent progression to type 2 diabetes mellitus and cardiovascular disease. Objective: To estimate the effect size of the interventions used for the reversal of metabolic syndrome. Materials and methods: We searched in Embase and Medline databases for randomized clinical trials with an outcome defined as the reversal of the metabolic syndrome diagnosis. We classified the interventions in four dimensions: 1) lifestyle (diet and exercise); 2) pharmaceuticals; 3) a combination of both, and 4) control groups, and we conducted a mixed treatment comparison analysis. Results: Additional to the previous meta-analysis published by Dunkley, et al. in 2012, we dentified two other studies. Lifestyle interventions had 2.61 more chances to achieve the reversal of the metabolic syndrome than the control group, with a credible interval between 1.00 and 5.47. Pharmaceutical treatments showed a 3.39 higher chance of reversing the syndrome compared with the control group, but the credible interval was estimated from 0.81 to 9.99. Lifestyle interventions had 1.59 more chance of reversal than the pharmaceutical treatments. Conclusion: Diet and physical activity-based interventions had a higher probability of effectiveness to reverse a metabolic syndrome diagnosis.


Assuntos
Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Hipoglicemiantes/uso terapêutico , Estilo de Vida , Síndrome Metabólica/terapia , Teorema de Bayes , Doenças Cardiovasculares/prevenção & controle , Terapia Combinada/métodos , Intervalos de Confiança , Diabetes Mellitus Tipo 2/prevenção & controle , Dieta , Exercício Físico , Humanos , Síndrome Metabólica/diagnóstico
17.
BMC Cardiovasc Disord ; 19(1): 304, 2019 12 19.
Artigo em Inglês | MEDLINE | ID: mdl-31881981

RESUMO

BACKGROUND: Adverse childhood experiences (ACEs) are associated with risk of poor adult health, including cardiometabolic diseases. Little is known about the correlates of ACEs for adults who have already developed cardiometabolic diseases, or who are at elevated risk. METHODS: Adult primary care patients with cardiometabolic disease (hypertension, diabetes, stroke, angina, myocardial infarction, coronary artery bypass graft, angioplasty) or with a risk factor (obesity, smoking, high cholesterol, family history) were surveyed regarding ACEs, psychological distress, attachment insecurity, quality of life, behavior change goals, stages of change, and attitudes toward potential prevention strategies. RESULTS: Of 387 eligible patients, 74% completed the ACEs survey. Exposure to ACEs was reported by 174 participants (61%). Controlling for age, gender, relationship status and income, number of ACEs was associated with psychological distress (F = 3.7, p = .01), quality of life (F = 8.9, p = .001), attachment anxiety (F = 3.4, p = .02), drinking alcohol most days (F = 4.0, p = .008) and smoking (F = 2.7, p = .04). Greater ACE exposure was associated with less likelihood of selecting diet or physical activity as a behavior change goal (linear-by-linear association p = .009). Stage of change was not associated with ACEs. ACEs exposure was not related to preferred resources for behavior change. CONCLUSIONS: ACEs are common among patients at cardiometabolic risk and are related to quality of life, psychological factors that influence cardiometabolic outcomes and behavior change goals. ACEs should be taken into account when managing cardiometabolic risk in family medicine.


Assuntos
Experiências Adversas da Infância , Cardiopatias/epidemiologia , Síndrome Metabólica/epidemiologia , Atenção Primária à Saúde , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Consumo de Bebidas Alcoólicas/efeitos adversos , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/psicologia , Estudos Transversais , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Nível de Saúde , Cardiopatias/diagnóstico , Cardiopatias/psicologia , Cardiopatias/terapia , Humanos , Masculino , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/psicologia , Síndrome Metabólica/terapia , Pessoa de Meia-Idade , Apego ao Objeto , Ontário/epidemiologia , Prevalência , Prognóstico , Angústia Psicológica , Qualidade de Vida , Medição de Risco , Fatores de Risco , Fumar/efeitos adversos , Fumar/epidemiologia , Fumar/psicologia , Adulto Jovem
18.
Nutrients ; 12(1)2019 Dec 23.
Artigo em Inglês | MEDLINE | ID: mdl-31877968

RESUMO

Recent evidence suggests that replacing saturated fat with unsaturated fat is beneficial for cardiovascular health. This study compared the effects of Brazil nut oil (BNO) and soybean oil (SO) supplementation for 30 days on anthropometric, blood pressure, biochemical, and oxidative parameters in patients with metabolic syndrome (MS). Thirty-one patients with MS were randomly allocated to receive 30 sachets with 10 mL each of either BNO (n = 15) or SO (n = 16) for daily supplementation. Variables were measured at the beginning of the study and after 30 days of intervention. No change in anthropometric and blood pressure variables were observed (p > 0.05). Total (p = 0.0253) and low-density lipoprotein (p = 0.0437) cholesterol increased in the SO group. High-density lipoprotein cholesterol decreased (p = 0.0087) and triglycerides increased (p = 0.0045) in the BNO group. Malondialdehyde levels decreased in the BNO group (p = 0.0296) and total antioxidant capacity improved in the SO group (p = 0.0110). Although the addition of oils without lifestyle interventions did not affect anthropometric findings or blood pressure and promoted undesirable results in the lipid profile in both groups, daily supplementation of BNO for 30 days decreased lipid peroxidation, contributing to oxidative stress reduction.


Assuntos
Bertholletia/química , Doenças Cardiovasculares/fisiopatologia , Síndrome Metabólica/fisiopatologia , Óleos Vegetais/administração & dosagem , Óleo de Soja/administração & dosagem , Adulto , Idoso , Antioxidantes/análise , Biomarcadores/análise , Glicemia/análise , Pressão Sanguínea , Composição Corporal , Suplementos Nutricionais , Método Duplo-Cego , Ácidos Graxos Insaturados/análise , Feminino , Humanos , Lipídeos/sangue , Masculino , Síndrome Metabólica/terapia , Pessoa de Meia-Idade , Nozes/química , Placebos , Óleos Vegetais/química , Fatores de Risco , Óleo de Soja/química
19.
J Med Food ; 22(12): 1199-1207, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31747330

RESUMO

This study researched the effects of Lactobacillus plantarum PMO 08 alone and combined with chia seeds on metabolic syndrome and parameters related to microbiota modulation and intestinal barrier integrity in obese mice fed high-fat diets (HFDs; 45% kcal fat). Male C57BL/6J mice were acclimated for a period of 2 weeks and then randomly separated into five groups depending on whether they received a normal diet (ND group), an HFD (HFD group), an HFD with L. plantarum (PMO group), an HFD with L. plantarum combined with chia seeds (PMOChia group), or an HFD with chia seeds (Chia group). Serum lipid profiles and related markers (cholesterol metabolism-related gene expression) were measured. Intestinal barrier integrity was assessed by measuring occludin mRNA expression of tight junction proteins. Mucosal bacteria were checked with quantitative reverse transcript polymerase chain reaction (qRT-PCR). After 16 weeks of feeding, the PMO group showed significantly lower serum total cholesterol, low-density lipoprotein cholesterol levels, atherogenic index, and cardiac risk factors compared to the HFD group. Moreover, the hepatic mRNA expression of SREBP2 (sterol regulatory element binding protein 2), a protein related to cholesterol metabolism, was significantly downregulated in the PMO group. We also found a positive synergistic effect in the PMOChia group, as manifested by the hepatic mRNA expression of hepatic CYP7A1 (cholesterol 7α-hydroxylase), strengthening of the gut barrier function, and the promotion of more L. plantarum in the colonic mucosa than in either the HFD or PMO group. In conclusion, our results indicate that PMO 08 may protect against metabolic syndrome by exerting effects on the regulation of lipid metabolism. Although the effects of chia seeds alone remain uncertain based on this experiment, its combination with PMO 08 was demonstrated to improve multiple beneficial effects of PMO 08 in obese mice fed HFD, which is a promising possibility for future research.


Assuntos
Dieta Hiperlipídica/efeitos adversos , Lactobacillus plantarum/fisiologia , Síndrome Metabólica/terapia , Salvia/química , Sementes/química , Animais , Peso Corporal , Colesterol/análise , Colesterol 7-alfa-Hidroxilase/metabolismo , Mucosa Intestinal/metabolismo , Mucosa Intestinal/microbiologia , Intestinos/microbiologia , Metabolismo dos Lipídeos/efeitos dos fármacos , Fígado/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Obesos , Probióticos/uso terapêutico , RNA Mensageiro/metabolismo , Fatores de Risco , Proteínas de Junções Íntimas/metabolismo , Triglicerídeos/análise
20.
Rev Esp Salud Publica ; 932019 Nov 12.
Artigo em Espanhol | MEDLINE | ID: mdl-31708572

RESUMO

OBJECTIVE: Social support can introduce favorable changes in lifestyle to reduce the cardiovascular risk. The aim of this study was to verify these changes in the clinical population participating in this study and present the psychometric properties of the scales of social support for 'Eating Habits' and 'Exercise' in patients diagnosed with metabolic syndrome. METHODS: 135 participants attending a programme for changing lifestyle habits. Sociodemographic, psychological, and lifestyle variables were assessed at the Hospital Universitario Virgen de las Nieves (HUVN) in Granada (Spain) between 2013 and 2014. The following procedures were used: Confirmatory factor analysis (CFA), internal consistency, sensibility to change and temporal stability. RESULTS: The AFC confirmed the original structure of both scales, except for the exclusion of factor 2 (family) from the social support scale for the year. For the social support scale, the local adjustment, all items presented high values of factor loads and individual reliability (λ≥0.64 and R2≥0.41, respectively). For the exercise scale, the local adjustment, the items presented high values of factor loads and individual reliability (λ≥0.62 and R2≥0.38, respectively). Internal consistency values were between adequate and excellent, with Cronbach's alpha figures between 0.714 and 0.864. Regarding sensitivity to change, the experimental group increased the perception of social support for food and exercise. The control group did not show significant differences. CONCLUSIONS: Our results show adequate indices for validity and reliability of the measures. Both measures appeared to be useful to assess social support in patients diagnosed with metabolic syndrome.


Assuntos
Dieta Saudável/psicologia , Exercício Físico/psicologia , Comportamento Alimentar/psicologia , Indicadores Básicos de Saúde , Síndrome Metabólica/psicologia , Testes Psicológicos , Apoio Social , Adulto , Idoso , Análise Fatorial , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Síndrome Metabólica/terapia , Pessoa de Meia-Idade , Psicometria , Reprodutibilidade dos Testes , Espanha
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