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Background and Objectives: Non-alcoholic fatty liver disease is a worldwide significant public health problem, particularly in patients with type 2 diabetes mellitus. Identifying possible risk factors for the disease is mandatory for a better understandingand management of this condition. Patatin-like phospholipase domain-containing protein 3 (PNPLA3) has been linked to the development and evolution of fatty liver but not to insulin resistance. The aim of this study isto evaluate the relationships between PNPLA3 and fatty liver, metabolic syndrome and subclinical atherosclerosis. Materials and Methods: The study group consisted of patients with type 2 diabetes mellitus without insulin treatment. The degree of liver fat loading was assessed by ultrasonography, and subclinical atherosclerosis was assessed using carotid intima-media thickness (CIMT). PNPLA3 rs738409 genotype determination was performed by high-resolution melting analysis that allowed three standard genotypes: CC, CG, and GG. Results: Among the 92 patients, more than 90% showed various degrees of hepatic steatosis, almost 62% presented values over the normal limit for the CIMT. The majority of the included subjects met the criteria for metabolic syndrome. Genotyping of PNPLA3 in 68 patients showed that the difference between subjects without steatosis and subjects with hepatic steatosis was due to the higher frequency of genotype GG. The CC genotype was the most common in the group we studied and was significantly more frequent in the group of subjects with severe steatosis; the GG genotype was significantly more frequent in subjects with moderate steatosis; the frequency of the CG genotype was not significantly different among the groups.When we divided the group of subjects into two groups: those with no or mild steatosis and those with moderate or severe steatosis it was shown that the frequency of the GG genotype was significantly higher in the group of subjects with moderate or severe steatosis. PNPLA3 genotypes were not associated with metabolic syndrome, subclinical atherosclerosis, or insulin resistance. Conclusions: Our results suggest that PNPLA3 does not independently influence cardiovascular risk in patients with type 2 diabetes mellitus. The hypothesis that PNPLA3 may have a cardioprotective effect requires future confirmation.
Assuntos
Diabetes Mellitus Tipo 2 , Lipase/genética , Proteínas de Membrana/genética , Hepatopatia Gordurosa não Alcoólica , Espessura Intima-Media Carotídea , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/genética , Predisposição Genética para Doença , Genótipo , Humanos , Fígado , Hepatopatia Gordurosa não Alcoólica/complicações , Hepatopatia Gordurosa não Alcoólica/diagnóstico por imagem , Hepatopatia Gordurosa não Alcoólica/genética , Polimorfismo de Nucleotídeo ÚnicoRESUMO
Background This study aimed to establish the reliability and validity of the Anti-Fat Attitudes (AFA) questionnaire and the Beliefs About Obese Persons (BAOP) scale. Methodology A convenience sample of 257 students from three distinct sections of the University of Medicine and Pharmacy "Grigore T. Popa" Iasi (Medical Faculty, Nutrition and Dietetics, and Nursing) participated in an observational study. Construction validity was tested with exploratory factor analysis. The students completed a form containing sociodemographic data, the AFA questionnaire, and the BAOP scale. Weight and height were self-reported and used to determine the body mass index. Results The value of the Cronbach alpha coefficient for the AFA questionnaire indicated adequate internal consistency (0.862). The exploratory factor analysis identified the following three factors corresponding to the original questionnaire: Dislike, Fear of Fat, and Willpower. We validated a single-factor structure of the BAOP scale, which had adequate internal consistency (0.781). There were statistically significant differences (AFA: p = 0.02; BAOP: p = 0.03) between the scores of the students from Nutrition and Dietetics, Nursing, and General Medicine. Conclusions This study demonstrated that the AFA questionnaire and the BAOP scale could be used to evaluate weight stigma in healthcare students, providing a useful tool to assess the effects of weight stigma awareness interventions in this population.
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Healthy dietary patterns during pregnancy are crucial for ensuring maternal and foetal health outcomes. Numerous methodologies exist for assessing the diet of pregnant women, including dietary patterns and various appraisal tools of diet quality. This study aimed to assess the dietary patterns and diet quality of pregnant women and to investigate the relationship between dietary patterns, diet quality estimators, and the adequacy of nutrient intake. EPIC FFQ was applied to a sample of 251 pregnant women, and questionnaires were interpreted with the FETA program. Dietary patterns were then determined by means of principal component analysis. Our results showed a substantial association between dietary patterns and total diet quality, as measured by the Diet Quality Index for Pregnancy (DQI-Pc), PURE Healthy Diet Score, and FIGO Diet Quality Score. We also found correlations between certain dietary patterns and particular nutrient intakes recommended by the European Food Safety Authority during pregnancy. The most deficient intake was registered for iron (86.1%), zinc (87.3%) and magnesium (79.3%), posing a threat to normal bone development, anaemia prophylaxis, and immune status. These results highlight the importance of assessing and understanding eating habits during pregnancy in order to achieve optimal outcomes for both the mother and the foetus.
Assuntos
Dieta Saudável , Dieta , Comportamento Alimentar , Humanos , Feminino , Gravidez , Adulto , Dieta/normas , Dieta/estatística & dados numéricos , Dieta Saudável/estatística & dados numéricos , Fenômenos Fisiológicos da Nutrição Materna , Gestantes , Inquéritos sobre Dietas , Adulto Jovem , Inquéritos e Questionários , Análise de Componente Principal , Padrões DietéticosRESUMO
Type 2 diabetes mellitus (T2DM) has become a global epidemic. To effectively control T2DM, individuals must adhere to a high-quality diet that encompasses not only healthy dietary patterns but also promotes positive eating behaviors. We conducted a cross-sectional study on 314 patients with T2DM, and we evaluated the diet quality and also examined the associations between eating behavior, diet quality, and anthropometric and clinical factors in T2DM patients. We used the Diet Quality Index-International and Dutch Eating Behavior Questionnaire to assess dietary characteristics. We found that women had a significantly higher diet quality than men (61.40 vs. 58.68, p = 0.002) but were also more prone to emotional eating (2.00 vs. 1.53, p < 0.001) and restrained eating (2.39 vs. 2.05, p = 0.002). Restrained eating correlated with duration of diabetes (r = -0.169, p = 0.003), body mass index (r = 0.182, p = 0.001), and external eating with glycated hemoglobin (r = 0.114, p = 0.044). Patients with emotional eating had a higher vitamin C adequacy score (ß = 0.117, p = 0.045). External eating was positively associated with grain adequacy (ß = 0.208, p < 0.001) and negatively associated with empty-calorie food moderation score (ß = -0.125, p = 0.032). For restrained eating, we found associations with vitamin C adequacy (ß = -0.138, p = 0.017) and fruit adequacy (ß = 0.125, p = 0.033). In conclusion, the results of this study provide valuable insight into dietary behavior and emphasize the importance of promoting healthy eating habits for T2DM patients.
Assuntos
Diabetes Mellitus Tipo 2 , Comportamento Alimentar , Humanos , Diabetes Mellitus Tipo 2/psicologia , Feminino , Estudos Transversais , Masculino , Pessoa de Meia-Idade , Comportamento Alimentar/psicologia , Idoso , Adulto , Dieta Saudável , Dieta , Índice de Massa Corporal , Inquéritos e Questionários , Emoções , Hemoglobinas Glicadas/análise , Hemoglobinas Glicadas/metabolismoRESUMO
Diet and eating behavior both play a crucial role in the prevention and management of type 2 diabetes mellitus (T2DM). The main objective of this study was to investigate the relationship between dietary intake and eating behavior in a population of patients with T2DM. A cross-sectional study was performed using 416 patients with T2DM and their dietary intake and eating behavior were assessed with validated questionnaires. Women scored significantly higher than men for emotional and restrained eating (p < 0.001). Correlation analyses showed that emotional eaters consumed significantly more calories (r = 0.120, p = 0.014) and fat (r = 0.101, p = 0.039), as well as non-alcoholic beverages for women (r = 0.193, p = 0.003) and alcohol for men (r = 0.154, p = 0.038). Also, individuals who ate based on external cues consumed significantly more calories (r = 0.188, p < 0.001) and fat (r = 0.139, p = 0.005). These results demonstrate that eating behavior influences dietary intake. Understanding this relationship could optimize diabetes management and allow for more individualized nutritional guidance.
Assuntos
Diabetes Mellitus Tipo 2 , Masculino , Humanos , Feminino , Estudos Transversais , Ingestão de Alimentos/psicologia , Dieta/psicologia , Ingestão de Energia , Comportamento Alimentar/psicologia , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Pregnancy is a critical period for both woman and baby from a nutritional perspective. Nutritional education is considered an important tool for promoting a healthy lifestyle, but has not been studied as a determinant for maternal use of supplements during pregnancy, especially in Romania, where evidence about pregnancy and nutrition is scarce. This study aimed to evaluate the relationship between nutritional knowledge and the use of folic acid, iron and multivitamin supplements during pregnancy and to assess the influence of socio-demographic factors and prenatal care. METHODS: We conducted a cross-sectional study on a sample of 400 pregnant women admitted to the Cuza-Voda Obstetrics and Gynaecology Clinical Hospital in Iasi, Romania, during August-September 2010. We collected self-reported data regarding socio-demographic characteristics, number of prenatal check-ups and the use of folic acid, iron and multivitamin supplements during pregnancy. We assessed nutritional knowledge using a standardized questionnaire divided into three sections: general nutritional recommendations for pregnant women; the roles of nutrients; and sources of nutrients. We used logistic regression to analyse the associations between these factors. RESULTS: The prevalence of the use of supplements during pregnancy was 48% for folic acid, 45.3% for iron and 68% for multivitamins. Above-average nutritional knowledge was independently associated with the use of folic acid (aOR, 4.7; 95% CI, 1.6-13.8), iron (aOR, 2.6; 95% CI, 1.2-5.7) and multivitamins (aOR, 2.8; 95% CI, 1.2-6.8). The use of folic acid was independently associated with a higher level of formal education (aOR, 5.2; 95% CI, 2.1-12.8) and an early start in prenatal care (aOR, 3.4; 95% CI, 1.0-11.1). Women with a higher education (aOR, 2.3; 95% CI, 1.1-4.9), more than 10 prenatal visits (aOR, 7.2; 95% CI, 3.4-15.0) and those who received advice on breastfeeding (aOR, 2.0; 95% CI, 1.1-3.5) were more likely to use iron during pregnancy. Similar results were found when analysing the contributing factors for the use of multivitamins: more than 12 years of schooling (aOR, 3.4; 95% CI, 1.4-7.9) and appropriate prenatal care (aOR, 9.4; 95% CI, 4.5-19.5). CONCLUSIONS: Level of nutritional knowledge has a strong independent association with the use of supplements during pregnancy.
Assuntos
Suplementos Nutricionais/estatística & dados numéricos , Ácido Fólico/administração & dosagem , Conhecimentos, Atitudes e Prática em Saúde , Ferro/administração & dosagem , Fenômenos Fisiológicos da Nutrição Pré-Natal , Vitaminas/administração & dosagem , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Gravidez , Cuidado Pré-Natal , Romênia , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto JovemRESUMO
OBJECTIVE: Ghrelin is believed to influence weight evolution after bariatric surgery. Helicobacter pylori (H. pylori) infection may influence ghrelin plasma levels by affecting the ghrelin-producing cells (GPC) in the stomach. The purpose of the study was to characterize the GPC distribution in the stomach in overweight patients and the influence of H. pylori infection on them. PATIENTS, MATERIALS AND METHODS: The study group included 21 obese patients undergoing bariatric surgery with ghrelin levels and anti-H. pylori antibodies previously measured, and upper gastrointestinal endoscopy with histological evaluation of H. pylori infection performed. Immunohistochemical expression of ghrelin was quantified in gastric resection specimens. RESULTS: The results showed a higher number of GPC in the obese women than in men (p>0.05). The highest number of GPC was detected in the gastric body, followed by the fundus and antral region (p<0.001). GPC number correlated inversely with anthropometric parameters: weight (p=0.011), body mass index (BMI) (p=0.017), waist circumference (WC) (p=0.066) was lower in patients with H. pylori infection (p>0.05) or gastritis (p>0.05), the number decreasing with the increase in depth of gastritis lesion (p>0.05). CONCLUSIONS: The present study fulfills the characterization of GPC in obese patients, showing a higher number in women than in men, their predominant location in the gastric body, and their relationship with the anthropometric parameters (weight, BMI, WC), H. pylori infection and gastritis lesions. These results open broad perspectives for a deeper understanding of the ghrelin involvement in the obesity pathogenic mechanism, associated or not with other gastric conditions.
Assuntos
Grelina/metabolismo , Helicobacter pylori/metabolismo , Obesidade/sangue , Estômago/fisiopatologia , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/patologia , Adulto JovemRESUMO
Aim: To estimate specific nutrient intake in patients with type 2 diabetes. Materials and Methods: The study was conducted on a group of subjects with type 2 diabetes. The collected data included: anthropometry, lifestyle, blood measurements, and the mean daily nutrient intake assessed by the EPIC food frequency questionnaire. Results: The study group included 101 subjects with type 2 diabetes mellitus (DM) with a mean age of 60.6±10 years, of which 45 men (59±10.6 years) and 56 women (62±9.6 years). The average energy intake was 1714.4±713.9 Kcal/day, with a statistically significant gender difference (1877.7±850.9 kcal/day for men, 1583.1±554.9 kcal/day for women, p = 0.039, and the average daily micronutrient intake was 2.44±1.44 µg/day for vitamin D, 724.5µ263.2 mg/day for Calcium (Ca), 266.7±98 mg/day for magnesium (Mg), which was low compared to dietary recommendations. Calcium intake was correlated with intake of carbohydrates, saturated fatty acids (SFA), monounsaturated fatty acids (MUFA), fiber and energy. Vitamin D intake was correlated only with protein intake (R=0.695), while magnesium intake correlated with intake of fibers, energy, carbohydrates and SFA. Conclusions: Our study in patients with type 2 diabetes showed a reduced average intake of calcium, magnesium and vitamin D compared to standard recommendations, requiring an individualized approach.
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Cálcio/administração & dosagem , Diabetes Mellitus Tipo 2 , Ingestão de Energia , Magnésio/administração & dosagem , Vitamina D/administração & dosagem , Vitaminas/administração & dosagem , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Política Nutricional , Fatores SexuaisRESUMO
Ghrelin is a gut peptide composed of 28 amino acids mostly secreted in the gastric fundus mucosa. It was isolated and described in 1999 by Kojima et al. and only three years later its specific receptor, GHSR1a, was also identified. Ghrelin, the endogenous ligand for the GH secretagogue receptor, is the only peripheral orexigenic hormone that activates the receptors to be found especially in the appetite center (hypothalamus and pituitary gland). Ghrelin is present in human plasma in two forms: an inactive form known as deacylated ghrelin, and an active form called acylated ghrelin synthesized under the action of ghrelin O-acyltransferase enzyme (GOAT). The literature even mentions an extremely complex ghrelin/GOAT/GHSR system involved in the regulation of human energy, metabolism and adaptation of energy homeostasis to environmental changes. In humans, there is a preprandial rise and a postprandial fall in plasma ghrelin levels, which strongly suggest that the peptide plays a physiological role in meal initiation and may be employed in determining the amount and quality of ingested food. Besides the stimulation of food intake, ghrelin determines a decrease in energy expenditure and promotes the storage of fatty acids in adipocytes. Thus, in the human body ghrelin induces a positive energy balance, an increased adiposity gain, as well as an increase in caloric storage, seen as an adaptive mechanism to caloric restriction conditions. In the current world context, when we are witnessing an increasing availability of food and a reduction of energy expenditure to a minimum level, these mechanisms have become pathogenic. As a consequence, the hypothesis that ghrelin is involved in the current obesity epidemic has been embraced by many scholars and researchers.
Assuntos
Peso Corporal , Metabolismo Energético , Grelina/metabolismo , Obesidade/metabolismo , Adiposidade , Animais , Regulação do Apetite , Ingestão de Energia , Comportamento Alimentar , Homeostase , Humanos , Obesidade/etiologia , Obesidade/fisiopatologia , Transdução de SinaisRESUMO
Nonalcoholic fatty liver disease is the most common cause of liver disease in the Western world. Liver biopsy is considered the gold standard in the diagnosis and progression of the disease and its usefulness cannot be neglected in terms of research. But in current clinical practice, liver biopsy tends to be replaced by less expensive and noninvasive methods allowing the identification of cardiovascular and metabolic risks. Given the fact that a small percentage of individuals with nonalcoholic fatty liver disease will progress to cirrhosis, attention will be focused more on cardiovascular risk as nonalcoholic fatty liver is now regarded as a distinct component of the metabolic syndrome. The aim of the clinician is to identify the early stages of fatty liver, using in this purpose simple and easily accessible methods. Many techniques have been proposed for the diagnosis of nonalcoholic fatty liver, from simple clinical factors (anthropometric indices measuring,blood pressure) laboratory biomarkers, imaging methods and scores, which should allow early treatment. This review describes different methods for identifying nonalcoholic fatty liver and various stages of this disease.
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Fígado/patologia , Hepatopatia Gordurosa não Alcoólica/patologia , Biomarcadores/análise , Biópsia , Diagnóstico por Imagem/métodos , Progressão da Doença , Humanos , Cirrose Hepática/patologia , Hepatopatia Gordurosa não Alcoólica/diagnósticoRESUMO
AIM: The aim of this study was to assess the preoperative nutritional status of patients undergoing thoracic surgery using different nutritional tools. MATERIAL AND METHOD: . We conducted a prospective study on a sample of 43 thoracic patients, including 23 with neoplasms and 20 with non-neoplastic pathology who underwent thoracic surgery procedures between July-September 2011, in the Thoracic Surgery Clinic in Iasi. Weight and height were measured and body mass index (BMI) was calculated. WHO classification for BMI categories was used. Preoperative serum level of transthyretin (TTR) and demographic data (gender, age) were also assessed. All patients were examined by the Subjective Global Assessment (SGA) and the Nutritional Risk Screening 2002 (NRS 2002). RESULTS: After performing SGA, 67.9% of the patients were well-nourished, 21.4% were moderately or suspected of being malnourished and 10.7% were severely malnourished. The level of TTR was significantly lower in the moderately or severely malnourished group, compared to those considered well-nourished. According to NRS-2002, 42.9% of the patients were considered at nutritional risk. The level of TTR of these patients was lower than the level of TTR of the patients without nutritional risk, but without statistical significance. CONCLUSIONS: Subjective Global Assessment (SGA) and the Nutritional Risk Screening 2002 (NRS 2002) are useful in identifying patients with nutritional risk, so that appropriate nutritional management could be initialised even before surgery.
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Pneumopatias/cirurgia , Desnutrição/diagnóstico , Desnutrição/etiologia , Estado Nutricional , Pré-Albumina/metabolismo , Cuidados Pré-Operatórios , Cirurgia Torácica , Adulto , Idoso , Biomarcadores/sangue , Índice de Massa Corporal , Peso Corporal , Feminino , Humanos , Pneumopatias/sangue , Pneumopatias/diagnóstico , Neoplasias Pulmonares/cirurgia , Masculino , Pessoa de Meia-Idade , Avaliação Nutricional , Estudos Prospectivos , Fatores de Risco , Inquéritos e Questionários , Fatores de Tempo , Redução de PesoRESUMO
AIM: The aim of the study was to explore the anthropometric maternal characteristics and prenatal care as determinants of pregnancy weight gain. MATERIAL AND METHODS: We conducted a cross-sectional study on a total of 400 pregnant women admitted to Cuza-Voda Obstetrics and Gynecology Clinical Hospital, Iasi. Information on demographic characteristics, number of prenatal visits, and education on nutrition and food changes occurring during pregnancy were recorded in a structured questionnaire. Anthropometric parameters analyzed were pregestational BMI (body mass index) and weight gain during pregnancy. RESULTS: Weight gain was associated with pregestational BMI category. An increase in weight more than recommended occured more frequently in overweight (53.1%) and obese women (66.7%) (p < 0.001). Weight gain during pregnancy was related to area of residence, age, APCU (adequate prenatal care utilization) index. The multivariate analysis identified the following variables as significant determinants of pregnancy weight gain: inadequate prenatal care, BMI and changes in diet. CONCLUSIONS: Pregestational BMI and changes in diet during pregnancy identified as determinants of weight gain suggests that overweight and underweight women must carefully be counseled regarding recommendations for weight gain in pregnancy. Tracking diet changes is important to ensure that a weight gain lies within the guidelines recommendations.
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Dieta , Sobrepeso/prevenção & controle , Cuidado Pré-Natal , Aumento de Peso , Adulto , Índice de Massa Corporal , Peso Corporal , Estudos Transversais , Feminino , Humanos , Educação de Pacientes como Assunto , Gravidez , Complicações na Gravidez/prevenção & controle , Fatores de Risco , Inquéritos e QuestionáriosRESUMO
Ghrelin is an important neuroendocrine peptide having as main purpose the stimulation of growth hormone (GH) secretion. It is also an important regulator of the long-term energy balance and short-term nutritional intake. Ghrelin has several other biological actions, among which the capacity to regulate gastrointestinal motility, to modulate the reproductive and stress axes as well as the glucose metabolism, and other well-defined actions within the cardiovascular and renal physiology. Due to its numerous effects, ghrelin is considered on one hand a potential target in the treatment of obesity and on the other, a therapeutic option in other dysfunctions and illnesses.
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Caquexia/metabolismo , Grelina/metabolismo , Hormônio do Crescimento Humano/metabolismo , Inflamação/metabolismo , Obesidade/metabolismo , Índice de Massa Corporal , Caquexia/fisiopatologia , Sistema Cardiovascular/metabolismo , Motilidade Gastrointestinal/efeitos dos fármacos , Glucose/metabolismo , Homeostase , Humanos , Inflamação/fisiopatologia , Sistemas Neurossecretores/metabolismo , Obesidade/fisiopatologia , Reprodução/efeitos dos fármacos , Estresse Fisiológico/efeitos dos fármacos , Sistema Urogenital/metabolismoRESUMO
UNLABELLED: The aim of this study was to evaluate comparatively the predictive power of body mass index (BMI) and waist circumference (WC), two anthropometric parameters used in daily practice, for detecting cardio-metabolic diseases, in a rural community in north-east Romania. MATERIAL AND METHODS: We evaluated 3248 persons, aged 19 or over, for whom we collected the following data: medical history, anthropometric parameters, blood pressure value and biochemical parameters. RESULTS AND CONCLUSIONS: Both WC and BMI help correctly determine the presence of arterial hypertension, diabetes and dislipidemia. However, the cut-off value of each of these parameters differs for each pathology. The predictive value of WC for different cardio-metabolic diseases is maintained even at normal or borderline overweight values of BMI.
Assuntos
Índice de Massa Corporal , Doenças Cardiovasculares/prevenção & controle , Obesidade/prevenção & controle , População Rural/estatística & dados numéricos , Circunferência da Cintura , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Obesidade/epidemiologia , Sobrepeso/prevenção & controle , Pobreza , Valor Preditivo dos Testes , Prevalência , Fatores de Risco , Romênia/epidemiologia , Sensibilidade e EspecificidadeRESUMO
AIM: Obstructive Sleep Apnea Syndrome (OSAS) is an under diagnosed condition with significant consequences on health. The aim of this study is to estimate the prevalence of symptoms and key features of OSAS in a rural population. MATERIAL AND METHODS: 254 subjects were enrolled. We measured height (H) and weight (W), calculated body mass index (BMI) and determined glycated hemoglobin (HbA1c). Information about age, gender, medical history (diabetes, hypertension) was collected. All the participants filled in the Berlin questionnaire, which has separate questions regarding the symptoms of OSAS. RESULTS: Snoring was reported by 44.1% of the subjects, observed apneas by 6.7% and excessive daytime sleepiness by 36.6%. All symptoms were more frequently reported by women. A higher percentage of obese, hypertensive and diabetics reported snoring (p < 0.001). When analyzing gender differences, the significance was maintained, except for diabetic men. Witnessed apneas were more prevalent in hypertensive subjects (p = 0.034), but were significantly associated with hypertension only in (p = 0.003). No correlation was found regarding excessive daytime sleepiness and the risk factors studied. CONCLUSIONS: Prevalence of OSAS symptoms and risk factors in this rural population was noticeable and efforts for early diagnosis and treatment are recommended.
Assuntos
População Rural/estatística & dados numéricos , Apneia Obstrutiva do Sono/epidemiologia , Adulto , Idoso , Biomarcadores/sangue , Estatura , Índice de Massa Corporal , Peso Corporal , Estudos Transversais , Complicações do Diabetes/epidemiologia , Distúrbios do Sono por Sonolência Excessiva/epidemiologia , Feminino , Hemoglobinas Glicadas/análise , Humanos , Hipertensão/epidemiologia , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Prevalência , Fatores de Risco , Romênia/epidemiologia , Apneia Obstrutiva do Sono/sangue , Apneia Obstrutiva do Sono/diagnóstico , Ronco/epidemiologia , Inquéritos e QuestionáriosRESUMO
AIM: To evaluate the prevalence of steatosis and to assess its correlations with the classical cardiovascular (CV) risk factors, components of metabolic syndrome (MS) in a rural population. MATERIAL AND METHODS: A sample of 254 subjects was enrolled in the study. Collected data included: age, gender, complete medical history, anthropometric and blood pressure (BP) measurements. The biological evaluation included metabolic and hepatic parameters. Ultrasound evaluation of steatosis relied on the criteria of the National Health and Nutrition Examination Survey (NHANES) III. RESULTS: Two thirds of the study population were obese or overweight (64.96%); 32.66% had systolic BP and 27.16% diastolic BP levels higher than normal. 38% of the subjects had abnormal fasting blood glucose levels, 14.56% having glycated hemoglobin (HbA1c) values corresponding to pre-diabetes, and 9.84% to overt diabetes; 8% had low HDL-cholesterol and 14.96% high triglycerides (Tg) levels. MS was present in 50.8% of individuals. Only 10.8% of all subjects did not have an ultrasound appearance of steatosis; 28.8% had moderate and 32% severe steatosis. There were statistically significant differences in subjects with steatosis vs. subjects without steatosis with regard to body mass index (BMI), WC, presence of MS, and BP and Tg levels, but not to ALAT, ASAT and GGT values. CONCLUSIONS: The important prevalence of obesity, fasting hyperglycamia, steatosis and MS shows a particularly metabolic fragile population; early diagnosis and interventional strategies are mandatory.
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Doenças Cardiovasculares/complicações , Fígado Gorduroso/complicações , Síndrome Metabólica/complicações , Obesidade/complicações , Adulto , Idoso , Biomarcadores/sangue , Determinação da Pressão Arterial , Índice de Massa Corporal , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/fisiopatologia , HDL-Colesterol/sangue , Estudos Transversais , Diagnóstico Precoce , Fígado Gorduroso/sangue , Fígado Gorduroso/epidemiologia , Fígado Gorduroso/fisiopatologia , Feminino , Teste de Tolerância a Glucose/métodos , Hemoglobinas Glicadas/metabolismo , Humanos , Masculino , Síndrome Metabólica/sangue , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/fisiopatologia , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica , Obesidade/sangue , Obesidade/epidemiologia , Obesidade/fisiopatologia , Sobrepeso/complicações , Prevalência , Medição de Risco , Fatores de Risco , Romênia/epidemiologia , População Rural/estatística & dados numéricos , Estudos de Amostragem , Triglicerídeos/sangueRESUMO
AIM: Diabetic neuropathy (DN) is the main cause of foot ulceration. One of the earliest modifications is the loss of normal sudomotor function, a sign of autonomic neuropathy. The aim of this study is to evaluate sudomotor dysfunction using a new tool (Neuropad) in diabetic patients with foot ulceration. MATERIAL AND METHODS: We included 58 diabetic patients with foot ulceration admitted in 2010 in the Clinical Center for Diabetes, Nutrition and Metabolic Diseases. We collected data regarding age, gender, type and duration of diabetes, glycated hemoglobin (HbAlc), history of amputations and duration of hospital admission. Peripheral neuropathy was evaluated through the Neuropathy Disability Score (NDS) and autonomic neuropathy was tested through Neuropad. RESULTS: 95% of patients had NDS > or = 6, among which 76% had also positive Neuropad test. Patients with both peripheral and autonomic neuropathy had longer duration of diabetes (p = 0.027) but similar HbA1c as patients with only peripheral neuropathy (p = 0.09). The former also had longer duration of current admission (p = 0.022) and a higher percentage of these patients had history of amputations (p = 0.041). CONCLUSIONS: Neuropad is a reliable, easy to use test for the diagnosis of autonomic neuropathy, which puts patients at greater risk for foot ulceration and amputation.
Assuntos
Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 2/complicações , Pé Diabético/diagnóstico , Exame Neurológico , Kit de Reagentes para Diagnóstico , Algoritmos , Sistema Nervoso Autônomo/fisiopatologia , Biomarcadores , Coleta de Dados , Diabetes Mellitus Tipo 1/sangue , Diabetes Mellitus Tipo 2/sangue , Pé Diabético/fisiopatologia , Neuropatias Diabéticas/diagnóstico , Diagnóstico Precoce , Feminino , Úlcera do Pé/diagnóstico , Hemoglobinas Glicadas/análise , Humanos , Indicadores e Reagentes/farmacologia , Masculino , Pessoa de Meia-Idade , Exame Neurológico/métodos , Seleção de Pacientes , Valor Preditivo dos Testes , Sensibilidade e Especificidade , Limiar Sensorial , SudoreseRESUMO
Non-alcoholic fatty liver disease (NAFLD) covers a spectrum of liver disease from steatosis to non-alcoholic steatohepatitis (NASH) and cirrhosis. Most NAFLD patients are hyperinsulinaemic and more insulin resistant compared with nonsteatotic healthy subjects, and there is a near universal association between NAFLD and insulinresistance (IR) irrespective of obesity. The metabolic syndrome (MS) is highly prevalent in the general adult population (approximatively 22%) and it carries an increased cardiovascular morbidity and mortality. Pathophysiologic considerations, clinical associations, and laboratory investigations support that IR and hyperinsulinaemia have a central role in pathogenesis of both MS and NAFLD. The fatty liver is resistant to the action of insulin to suppress hepatic glucose production, which results in hyperglycaemia and, further, in hyperinsulinemia. The MS is associated with maldistribution of body fat, increased free fatty acids (FFAs) and IR, leading to type 2 diabetes, hypertension, dyslipidemia. Visceral fat is an important clinical marker of metabolic cardiovascular risk and a marker of IR in multiple tissues, independent of body mass index (BMI). NAFLD and atherosclerosis share common molecular mediators and NAFLD itself might play an early role in the development and progression of atherosclerosis. These data suggest that NAFLD should be considered part of a multi-organ system derangement in insulin sensitivity, and help explain why NAFLD is so closely linked with diabetes, MS and is an important risk factor for coronary heart disease. NAFLD may be the hepatic manifestation of the MS and raises the possibility that it may play an early role in the etiology of MS.
Assuntos
Fígado Gorduroso/complicações , Síndrome Metabólica/etiologia , Tecido Adiposo , Índice de Massa Corporal , Doenças Cardiovasculares/etiologia , Diabetes Mellitus Tipo 2/etiologia , Fígado Gorduroso/epidemiologia , Fígado Gorduroso/metabolismo , Humanos , Síndrome Metabólica/complicações , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/metabolismo , Hepatopatia Gordurosa não Alcoólica , Prevalência , Fatores de Risco , Romênia/epidemiologiaRESUMO
BACKGROUND AND AIMS: Prevention and reduction of cardio-vascular mortality are in relationship with understanding and being able to modify risk factors, among which overweight and obesity become the most significant. The aim of this paper is to define cardio-metabolic risk factors which are specific to the studied population, and also to find elements of lifestyle that lead to overweight. We targeted smoking, alcohol consumption, stress, physical exercise, income and educational level. MATERIAL AND METHODS: We studied a sample of 172 subjects, representative for the population of Deleni, a rural community in Iasi County; among these subjects, 67 were men, 105 were women, with an average age of 54. For each a chart was filled, containing demographic data, socio-economic status, personal and family medical history. We measured anthropometric parameters: weight (W), height (H), waist circumference (WC) and we calculated body mass index (BMI), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR). We performed interviews to fill in a food frequency questionnaire, the Perceived Stress Scale and the International Physical Activity Questionnaire. RESULTS: In the lot studied, 44.2% are overweight and 18.6% are obese, the majority of these being women. Regarding WC, among normal weight, 52.4% have large WC (> or = 94cm for men and > or = 80cm for women). Obesity markers positively correlate with increase in age and decrease in income (p=0.024), with low educational level, regular consumption of coffee (p=0.093), and negatively correlate with excessive alcohol consumption (p=0.049) and smoking (p=0.003). As expected, there is an inverse relationship between increased physical exercise and BMI (p=0.015) and a direct relationship between increased stress level and WC. CONCLUSIONS: Anthropometric parameters are sensible markers in evaluating the influence of lifestyle on cardio-metabolic risk.