ABSTRACT
RESUMEN Introducción: El síndrome metabólico se asocia con un mayor riesgo de padecer diabetes, por lo que su identificación clínica ayuda a identificar a estos pacientes con alto riesgo. Objetivo: Determinar las combinaciones de síndrome metabólico para el riesgo de diabetes mellitus tipo 2 en una muestra de pobladores peruanos. Métodos: Análisis secundario de un estudio de cohorte de 5 años, de la base de datos del estudio PERU MIGRANT. Los componentes alterados del síndrome metabólico fueron lipoproteínas de alta densidad bajo, hipertrigliceridemia; glucosa, presión arterial y cintura abdominal elevadas. En total 35 subgrupos de componentes: 5 grupos para cada uno de los 5 componentes, 10 grupos de combinaciones de 2 componentes y 3 componentes, 5 grupos para la combinación de 4 componentes. Resultados: En el análisis de regresión múltiple, la glucosa como factor independiente presentó un RR estadísticamente significativo (RR= 9,02; IC: 95 % 2,45 - 33,24; p= 0,001). La combinación de 2 factores, presentaron un RR estadísticamente significativo, la glucosa - cintura abdominal (RR= 7,28; IC: 95 % 1,21 - 43,64; p= 0,030) y glucosa - alta densidad bajo (RR= 10,94; IC: 95 % 2,71 - 44,23; p= 0,001). Finalmente, la combinación de glucosa - lipoproteínas de alta densidad - cintura abdominal tenían 7,80 veces el riesgo de presentar diabetes mellitus tipo 2 versus quienes no lo presentaban (RP= 7,80; IC: 95 % 1,39 - 43,77; p= 0,020). Conclusión: Las combinaciones que incluyen al mismo tiempo glucosa - lipoproteínas de alta densidad - cintura abdominal, fueron las combinaciones que más asociaron.
ABSTRACT Introduction: Metabolic syndrome is associated with an increased risk of diabetes, so its clinical identification helps to identify these patients at high risk. Objective: To determine the combinations of metabolic syndrome for the risk of type 2 diabetes mellitus in a sample of Peruvian population. Methods: 5-year cohort study of secondary analysis of the PERU MIGRANT study database. The altered components of the metabolic syndrome were low high-density lipoprotein, hypertriglyceridemia; and elevated glucose, blood pressure and waist circumference. In total 35 subgroups of metabolic syndrome components: 5 groups for each of the 5 components, 10 groups for combinations of 2 components and 3 components, 5 groups for the combination of 4 components. Results: In the multiple regression analysis, only G as an independent factor presented a statistically significant relative risk (RR= 9.02; 95 % CI 2.45 - 33.24; p= 0.001). In relation to the combination of 2 factors, only the combination of glucose-elevated abdominal waist (RR= 7.28; 95 % CI 1.21 - 43.64; p= 0.030) and glucose-high-density lipoprotein (RR= 10.94; 95 % CI 2.71 - 44.23; p= 0.001) presented a statistically significant relative risk. Finally, patients with the glucose-high-density lipoprotein-abdominal waist combination had 7.80 times the risk of presenting type 2 diabetes mellitus versus those who did not (PR= 7.80; CI: 95 % 1.39 - 43.77; p= 0.020). Conclusion: The combinations that include at the same time glucose - high density lipoproteins - abdominal waist, were the most associated combinations.
ABSTRACT
Objetivo: Validar la fórmula de Friedewald para la determinación de los valores de colesterol LDL en bovinos, una especie con patrón metabólico HDL. Materiales y Métodos: Fueron tomadas 100 muestras de sangre de bovinos de diferente edad, raza y sexo. Luego de extraer el suero, fueron determinados los niveles de colesterol LDL mediante el método directo, posteriormente se determinaron los mismos valores utilizando la fórmula de Friedewald. Los resultados fueron analizados estadísticamente mediante ANOVA de una vía. Resultados: El método directo reportó valores (mg/dl) de promedio, mínimo, máximo, y desviación estándar de 40,769; 2,438; 126,751; 29,814, respectivamente, y el método de Friedewald mostró resultados en promedio, mínimo, máximo y desviación estándar de 34,659; 1,349; 145,31; 29,108, correspondientemente. El valor de P en el test F en la comparación del método Directo vs. Friedewald fue mayor o igual a 0,05 (0,154), por lo cual no se evidenció diferencia significativa a un nivel de confianza del 95% entre los valores obtenidos por los dos métodos. Conclusión: Puede ser utilizada la fórmula de Friedewald para la determinación del colesterol LDL en especies con patrón HDL.
Objective: To validate Friedewald's formula for determing LDL cholesterol levels in cattle, species with HDL metabolic pattern. Materials and Methods: One hundred (100) blood samples from different age, race and gender cattle were taken. After removing the serum, the LDL cholesterol levels were determined using the direct method and later the same values were determined using Friedewald's formula. Results were statistically analyzed using one-way ANOVA. Results: The direct method reported values (mg/dl) of average, minimum range, maximum range, and standard deviation of 40.769, 2.438, 126.751, 29.814, respectively, and Friedewald method results showed minimum, maximum and standard deviation averages of 34.659, 1.349, 145.31, 29.108, respectively. The value of P in the F test Direct in the comparison of the direct method and Friedewald's method was greater than or equal to 0.05 (0.154), reason why no significant difference was evident at a level of confidence of 95% between the values obtained through the two methods. Conclusion: Friedewald's formula can be used for determining LDL cholesterol in species with HDL pattern.
ABSTRACT
O principal distúrbio metabólico decorrente do Diabetes mellitus tipo 2 e da Síndrome Metabólica corresponde a alterações no metabolismo lipídico. Portanto, torna-se importante a melhor compreensão de alguns aspectos do metabolismo de lipoproteínas plasmáticas. Nesse sentido, a avaliação do metabolismo dos quilomícrons e da transferência de lípides de lipoproteínas plasmáticas para a lipoproteína de alta densidade (HDL), pode fornecer informações importantes relacionadas com o processo aterogênico. No presente estudo, foram estudados 15 indivíduos portadores de Diabetes mellitus tipo 2, 15 indivíduos com Síndrome Metabólica e 14 controles normolipidêmicos. Foi avaliada a cinética plasmática de uma nanoemulsão lipídica artificial com comportamento metabólico similar ao dos quilomícrons naturais, marcada com triglicérides (TG-3H) e éster de colesterol (EC-14C) radioativos. A nanoemulsão de quilomícrons artificiais foi injetada endovenosamente e amostras de sangue foram coletadas durante intervalos préestabelecidos. As curvas de decaimento plasmático dos lípides radioativos da nanoemulsão foram traçadas e as taxas fracionais de remoção (TFR) foram calculadas por análise compartimental. Para avaliação da transferência de lípides foi utilizada uma nanoemulsão semelhante a LDL (LDE) marcada com TG-3H e colesterol livre-14C (CL-14C) ou fosfolípides-14C (PL-14C) e EC-3H, como doadora de lípides para a HDL. Após incubação in vitro da LDE com o plasma, seguiu-se a precipitação das lipoproteínas que contem apolipoproteína B, restando no sobrenadante apenas a HDL. As taxas de transferência de lípides foram expressas em % de radioatividade encontrada no sobrenadante. Também foi determinado o diâmetro da HDL por espalhamento de luz. A TFR-EC dos grupos DM2 (p <0,05) e SM (p <0,01) comparado ao grupo controle apresentou-se diminuída, enquanto que as TFR-TG foram similares nos três grupos. Houve maior transferência de fosfolípides e colesterol nos grupos DM2 e SM...
The main metabolic disturbances occurring as a result of type 2 diabetes mellitus (DM2) and Metabolic Syndrome (MetS) are alterations in the metabolism of lipids. It is therefore, important to better understand the aspects by which plasma lipoproteins are metabolized. The evaluation of chylomicron metabolism and lipid transfer of high density lipoprotein (HDL) can thus yield useful information regarding the atherosclerotic process. In this study, 15 Type 2 Diabetes individuals, 15 Metabolic Syndrome individuals and 14 normolipidemic control individuals were studied. The plasmatic kinetics of an artificial lipidic nanoemulsion mimicking the behavior of natural chylomicrons were evaluated. This artificial chylomicron nanoemulsion, labele with radioactive triglycerides (TG-3H) and radioactive cholesteryl oleate (CO-14C) was injected intravenously and blood samples collected at pre-established time intervals. The plasmatic decay curve of the radioactive lipids of the nanoemulsion was traced and the fractional clearance rate calculated (FCR) through compartmental analysis. In order to evaluate the lipid transfer, we used a nanoemulsion similar to LDL., labeled with TG-3H and free cholesterol -14C (CL-14C) or with phospholipids -14C (PL-14C) and CO-3H, as a lipid donator to HDL. After in vitro nanoemulsion incubation with the plasma, the lipoproteins containing apolipoprotein B were precipitated, resulting in a supernatant containing HDL. The lipid transfer rates were expressed in % of radioactivity measured in the supernatant. It was also determined the diameter of the HDL using light scattering technique. The TFR-EC for the DM2 (p <0.05) and MetS (p <0.01) groups when compared to the control group was reduced. The TFR-TG, on the other hand, remained similar in all three groups. The transfer of phospholipids and cholesterol for the DM2 (p<0.001) and MetS groups was greater than that of the control group (p<0.001)...