ABSTRACT
The association or interaction of histocompatibility antigens (HLA) and acanthosis nigricans with type A insulin resistance was studied in 13 patients (10 from family I, 2 from family II and an isolated case) for both sexes. HLA typing for the A, B, C and D antigens was performed by a standard microcytotoxicity test for all patients and for 100 normal controls from the same geographic area. The frequency of HLA B8 was 21% in the control group and 100% in patients with acanthosis nigricans. The frequency of HLA A1B8 was 15% in controls and 73% n acanthotic patients. All the members of family I presenting the association of a possibile insulin receptor defect (most likely provided by patient 2) with HLA B8 (provided by patient I) showed a more pronunced clinical and laboratory expression of insulin resistance. These data suggest that class I antigens of major histocompatibility complex (MHC), A1 and/or B8, may be involved in the pathogenesis of some forms of insulin resistance such as acanthosis nigricans (type A syndrome), possibly by a molecular interaction of the antigens with insulin receptors
Subject(s)
Humans , Child , Adolescent , Adult , Middle Aged , Male , Female , Acanthosis Nigricans/genetics , HLA Antigens/genetics , Insulin Resistance/genetics , Acanthosis Nigricans/complications , Blood Glucose/analysis , Glucose Tolerance Test , Insulin Resistance/complications , PedigreeSubject(s)
Humans , Male , Female , HLA Antigens/genetics , Diabetes Mellitus, Type 1/genetics , Gene Frequency , Brazil , Genetics, PopulationSubject(s)
B-Lymphocytes , Diabetes Mellitus , Diet , Immunotherapy , Interferons , Niacinamide , Superoxide DismutaseSubject(s)
Adolescent , Adult , Middle Aged , Humans , Male , Female , Autonomic Nervous System Diseases , Diabetic Neuropathies , Valsalva Maneuver , Diabetes MellitusABSTRACT
Os autores procuram estabelecer uma correlacao entre a duracao do diabete melito (DM) e a presenca de complicacoes cronicas como retinopatia, neuropatia e glomerulosclerose, bem como determinar a prevalencia global destas complicacoes em pacientes diabeticos do tipo juvenil e do tipo maturidade. Para tanto, estudaram 67 pacientes com DM do tipo juvenil e 245 pacientes com DM do tipo maturidade fazendo uso de insulina, e observaram que as complicacoes microangiopaticas como um todo eram mais frequentes nos pacientes com DM tipo maturidade do que naqueles com DM tipo juvenil O aumento destas complicacoes foi processivo em relacao a duracao do DM nos dois grupos. Com base no que observaram, e com a finalidade de diminuir sua progressao atraves de medidas terapeuticas apropriadas recomendam que a presenca das complicacoes seja pesquisada rotineiramente
Subject(s)
Child , Adolescent , Adult , Middle Aged , Humans , Diabetic Nephropathies , Diabetic Neuropathies , Diabetic Retinopathy , Proteinuria , Diabetes MellitusABSTRACT
Os autores estudaram 253 pacientes diabeticos acompanhados durante 48 meses, com o objetivo de determinar a prevalencia de hiperlipidemia e estabelecer uma correlacao entre as complicacoes micro e macroangiopaticas da sindrome diabetica com elevacao dos lipidios plasmaticos. Nao encontraram relacao evidente entre a microangiopatia diabetica - retinopatia - e hiperlipidemia, constatando porem, que os pacientes diabeticos hiperlipidemicos apresentaram uma prevalencia de doencas vasculares macroangiopaticas, especialmente a cardiopatia isquemica, cerca de duas vezes maior do que os pacientes nao diabeticos. Com base nos resultados, concluiram que a hiperlipidemia, principalmente a hipercolesterolemia constitui fator de risco independente para a aceleracao da doenca macrovascular em pacientes com diabete melito