Prevalencia de síndrome metabólico y relación con eventos cardiovasculares, supervivencia y función del injerto en pacientes con trasplante renal / Prevalence of metabolic syndrome and its relationship with cardiovascular events, survival and graft function in patients with a kidney transplant

Resumen Introducción: el síndrome metabólico en pacientes trasplantados tiene una prevalencia entre 20 a 65%1). Objetivo: estimar la prevalencia de síndrome metabólico al momento del trasplante renal y su asociación con el desarrollo de eventos cardiovasculares, supervivencia del paciente y pérdida del injerto. Métodos: estudio de cohorte retrospectiva, en el que se incluyeron pacientes con transplante renal entre los años 2004 y 2014. Se evaluó la asociación entre síndrome metabólico previo al trasplante y el desenlace compuesto de eventos cardiovasculares, pérdida del injerto y muerte por cualquier causa. Se efectuó un análisis univariado y multivariado tomando como significancia estadística una p <0,05. Resultados: se incluyeron 185 pacientes. La prevalencia del síndrome metabólico al momento del trasplante fue de 39%; en el análisis univariado no se encontró una asociación significativa entre la presencia de síndrome metabólico al momento del trasplante y el desenlace compuesto de eventos cardiovasculares, pérdida del injerto o muerte por cualquier causa (RR 1,81, IC 95% 0,86- 3,82, p= 0,11). Las variables relacionadas con el desenlace compuesto fueron diabetes mellitus (OR=3,62 IC 95% 1,084-12,1 p=0,026) y tiempo de trasplante renal (OR=1,05 IC 95% 1,007-1,09 p=0,36). Conclusiones: no hubo una asociación significativa entre el síndrome metabólico al momento del trasplante renal y el desarrollo de eventos cardiovasculares, pérdida del injerto y muerte por cualquier causa. Esto puede estar relacionado con la baja incidencia de eventos en nuestra población y el tiempo de seguimiento.

Abstract Introduction: Metabolic syndrome has a prevalence of between 20% and 65% in transplanted patients. Objective: To estimate the prevalence of metabolic syndrome at the time of kidney transplant, and its relationship with the development of cardiovascular events, patient survival, and loss of the graft. Methods: A retrospective cohort study that included patients with a kidney transplant between the years 2004 and 2014. An analysis was made of the relationship between metabolic syndrome prior to the transplant and the composite outcome of cardiovascular events, loss of the graft, and death by any cause. A univariate and multivariate analysis was performed taking a P<.05 as statistically significant. Results: The study included 185 patients. The prevalence of metabolic syndrome at the time of the transplant was 39%. In the univariate analysis, no significant relationship was found between the presence of metabolic syndrome at the time of the transplant and the composite outcome of cardiovascular events, loss of the graft, and death by any cause (RR 1.81, 95% CI; 0.86- 3.82, P=.11). The variables associated with a composite outcome were, diabetes mellitus (OR=3.62 95% CI; 1.084-12.1, P=.026), and time of kidney transplant (OR=1.05, 95% CI; 1.007-1.09, P=.36). Conclusions: There was no significant relationship between metabolic syndrome at the time of kidney transplant and the development of cardiovascular events, loss of the graft, and death by any cause. This could be related to the low incidence of events in the population studied and the follow-up time.

Characterization of Lactobacillus fermentum UCO-979C, a probiotic strain with a potent anti-Helicobacter pylori activity

Background: Helicobacter pylori is considered as the main risk factor in the development of gastric cancer. In the present study, we performed a detailed characterization of the probiotic properties and the anti-H. pylori activity of a previously isolated lactobacillus strain ­ Lactobacillus fermentum UCO-979C ­ obtained from human gut. Results: The strain tolerated pH 3.0; grew in the presence of 2% bile salts; produced lactic acid and hydrogen peroxide; aggregated in saline solution; showed high hydrophobicity; showed high adherence to glass; Caco-2 and gastric adenocarcinoma human cells (AGS) cells; showed an efficient colonization in Mongolian Gerbils; and potently inhibited the growth and urease activity of H. pylori strains. L. fermentum UCO-979C significantly inhibited H. pylori-induced IL-8 production in AGS cells and reduced the viability of H. pylori. With regard to innocuousness, the strain UCO-979C was susceptible to several antibiotics and did not produce histamine or beta-haemolysis in blood agar containing red blood cells from various origins. Conclusion: The results demonstrated that L. fermentum UCO-979C is a very good candidate as a probiotic for the protection of humans against H. pylori infections.