RESUMO
BACKGROUND: Type 2 diabetes has been described to be associated with hypothyroidism but we recently found that a decrease in pituitary sensitivity to thyroid hormone is associated with diabetes, obesity, and the metabolic syndrome.We aim to assess the longitudinal nature of this association in the population-based Study of Health in Pomerania(SHIP) in Germany. MATERIALS AND METHODS: 77% of a population-based sample of 4308 participants between 20 and 79 years was followed for 5 years. We studied 2542 participants without diabetes or thyroid medication at baseline and complete data in the variables of interest. Data of baseline thyroxine(fT4) and thyrotropin(TSH) were used to calculate the Parametric Thyroid Feedback Quantile-based Index(PTFQI), which measures whether TSH remains elevated despite fT4 being high. It uses the average population response as reference. PTFQI association with incidence of type 2 diabetes over 5 years was estimated with Poisson regression models adjusted for age, sex, and body mass index(BMI). RESULTS: Compared with the 1st PTFQI quartile, Incidence Rate Ratios (IRR) for diabetes were 1.54(95% CI 0.97 to 2.46), 1.55(0.94 to 2.57), and 1.97(1.27 to 3.10) for the upper quartiles (p-trend=0.004) after adjusting for age and sex. The association remained statistically significant after additionally adjusting for BMI: 1.64(1.05 to 2.59) for the 4th vs the 1st quartile (p-trend=0.043). CONCLUSIONS: An elevation of the pituitary TSH-inhibition threshold is associated with incident type 2 diabetes independently of BMI. The PTFQI might have clinical potential for prognosis and metabolic status monitoring.
RESUMO
Determinar el estadio de fibrosis hepática es esencial en el manejo de la enfermedad hepática en pacientes con hepatitis crónica por virus C. La biopsia hepática ha sido considerada el gold standard para diagnosticar la enfermedad, la actividad necroinflamatoria y el estadio de fibrosis, pero tiene algunas limitaciones técnicas y riesgos. Teniendo en cuenta estas limitaciones, existe cierta exigencia en introducir biomarcadores séricos no invasivos para el diagnóstico de fibrosis que podrían ser capaces de reemplazar parcialmente a la biopsia hepática. El biomarcador sérico ideal debería ser específico para el hígado y fácil de determinar. Los marcadores séricos se dividen en directos e indirectos. Los directos reflejan el recambio de la matriz extracelular, mientras que los indirectos reflejan alteraciones en la función hepática. Aunque todavía está limitado el grado de implementación de los test no invasivos de fibrosis hepática, esta revisión es una visión de conjunto de los biomarcadores, índices y algoritmos diagnósticos de fibrosis hepática estudiados en hepatitis crónica C pero con un interés potencial en otras hepatopatías crónicas (AU)
Precise staging of liver fibrosis is essential in the management of liver disease activity in chronic hepatitis C patients. Liver biopsy has been considered the reference method for diagnosing disease, grading necroinflammatory activity, and staging fibrosis, but it has some technical limitations and risks. Taking into account these limitations, there is a need to introduce non-invasive serum markers for fibrosis that would be able to partially replace liver biopsy. Ideal serum markers should be specific for the liver and easy to perform. Serum markers of hepatic fibrosis are divided into direct and indirect. Direct markers reflect extracellular matrix turnover, whereas indirect markers reflect alterations in hepatic function. The degree of implementation of non-invasive diagnostic tests for liver fibrosis still remains limited. This review provides a current overview of biomarkers, indexes and algorithms for hepatic fibrosis diagnosis in chronic hepatitis C patients (AU)
Assuntos
Feminino , Humanos , Masculino , Biomarcadores/análise , Biomarcadores/metabolismo , Cirrose Hepática/diagnóstico , Hepatite Crônica/diagnóstico , Hepatite C/diagnóstico , Metaloproteases , Fator de Crescimento Transformador beta1 , Fibrose/diagnóstico , Algoritmos , Biomarcadores/sangue , Ensaios de Anticorpos Bactericidas Séricos/métodos , Pró-Colágeno , Ácido Hialurônico , Receptores de Fibrinogênio/análiseRESUMO
La baja incidencia de enfermedades cardiovascularesen los países de la Cuenca Mediterránea, donde elaceite de oliva es la principal fuente de grasa en la alimentación,ha motivado un mejor conocimiento de sucomposición química y el desarrollo de aceites enriquecidosen sus componentes minoritarios. En esta revisiónse recopilan los efectos de diferentes preparaciones delaceite de oliva sobre el desarrollo de la aterosclerosis yel valor pronóstico para la enfermedad de los parámetrosplasmáticos mediante el empleo de un ratón modificadogenéticamente en el que ésta se desarrolla espontáneamente.Las limitaciones del modelo por sus diferenciasmorfológicas y fisiológicas con el hombre se minimizanante la similitud de ambos genomas y el avance de conocimientoque posibilita, ya que efectuar en humanoslas intervenciones recopiladas habría requerido 400 años.Confirmando la tradición de los pueblos mediterráneos,se ha verificado la eficacia del aceite de oliva virgen consumidoprudentemente y en dietas con bajo contenido encolesterol por la relativa escasez de productos de origenanimal. Además, la exploración con herramientas de genómicaha identificado nuevos marcadores de respuestaal aceite. En conclusión, la investigación multidisciplinariadel aceite de oliva virgen extra permite ampliar el conocimientode sus propiedades biológicas (AU)
The low incidence of cardiovascular disease in countriesbordering the Mediterranean basin, where olive oil is themain source of dietary fat, has stimulated interest in thechemical composition of olive oil and in the productionof other oils enriched with its minor components.This review summarizes what has been learned aboutthe effects of different olive oil preparations on thedevelopment of atherosclerosis and about the prognosticvalue of associated plasma variables in the diseasefrom experiments on genetically modified mice thatspontaneously develop atherosclerosis. The limitations ofthis animal model associated with its morphological andphysiological differences with humans are minimized bythe similarity of the two genomes and by the potential forincreased understanding attainable, given that the dietaryinterventions reported here would have taken 400 years toachieve in humans. As observed in traditional Mediterraneanpopulations, it has been confirmed that extra virgin olive oilis beneficial when consumed judiciously and in a diet thatis low in cholesterol due to the relative scarcity of animalproducts. Furthermore, the use of genomic techniqueshas led to the identification of new markers of responseto olive oil. In conclusion, multidisciplinary research intoextra virgin olive oil is expanding our knowledge of thesubstances biological properties (AU)