Effects of passion fruit (Passiflora tenuifila Killip) intake on eutrophic and obese subjects: Lipidomic approach

Obesity and overweight result in metabolic changes that build up as risk factors for the development of the main non-communicable diseases. Among these alterations, dyslipidemia is an important risk factor for cardiovascular diseases (CDV) and is expressed in elevated plasma levels of triacylglycerols, cholesterol, and low-density-lipoprotein (LDL, VLDL) and decreased plasma levels of high-density lipoprotein (HDL). Passiflora tenuifila Killip is a native passion fruit species of the Brazilian Midwest region and is a good source of proanthocyanidins and dietary fibers. Proanthocyanidins are a class of phenolic compounds that are attributed with improving lipoprotein profile properties, translated as improved LDL/HDL ratio. Fibers are fermented by the gut microbiota and produce short-chain fatty acids (SCFA), also involved in the regulation of energetic metabolism.. A 30-consecutive-day-long intervention with lyophilized P. tenuifila flour was performed in eutrophic and obese subjects. Passion fruit ingestion increased fecal production of acetate, key SCFA in the modulation of lipid metabolism; reduced body fat percentage in all subjects; and reduced total cholesterol (TC) of subjects who presented basal CT > 130 mg/dL. After the intervention, plasma lipidomic analysis detected 44 statistically significant lipids, regardless of BMI. Considering the study population with altered TC, reduced levels of glycerophospholipids were observed, a lipid class studied for their involvement in CVD. The intake of P. tenuifila contributed to the improvement in cardiovascular risk markers and acts on lipid metabolism. These effects may be due to synergic action between the bioactive compounds in the fruit. Still, other studies are necessary to identify mechanisms related to the action of bioactives of P. tenuifila, which can be better directed by this lipidomic approach

A obesidade e o sobrepeso são preocupações resultam em alterações metabólicas que se acumulam como fatores de risco para o desenvolvimento a longo prazo das principais doenças crônicas não transmissíveis. Dentre essas alterações, a dislipidemia um importante fator de risco para doenças cardiovasculares (DCV), expressa em níveis plasmáticos elevados de triacilgliceróis, colesterol e das lipoproteínas de baixa densidade (VLDL, LDL), e níveis diminuídos da lipoproteína de alta densidade (HDL). Passiflora tenuifila Killip é uma espécie de maracujá nativa da região Centro-Oeste brasileira, e é uma boa fonte de proantocianidinas e fibras alimentares. As proantocianidinas são compostos fenólicos com reportados efeitos na melhora do perfil de lipoproteínas, traduzida como a relação LDL/HDL. As fibras são fermentadas pela microbiota intestinal e produzem ácidos graxos de cadeia curta (AGCC), metabólitos também envolvidos na regulação do metabolismo energético.. Assim, a lipidômica não-target é aplicada como ferramenta exploratória neste estudo: uma intervenção de 30 dias consecutivos de ingestão de P. tenuifila na forma de farinha liofilizada em indivíduos eutróficos e obesos. O consumo do maracujá promoveu aumento da produção fecal de acetato, AGCC importante na modulação do metabolismo lipídico; a redução do percentual de gordura corporal em todos os indivíduos; e redução do colesterol total (CT) para os indivíduos com CT > 130 mg/dL. A análise lipidômica do plasma detectou 44 lipídios estatisticamente relevantes, independentemente do IMC, após a intervenção. Considerando a população do estudo com CT alterado, foi observada uma redução de glicerofosfolipídios, classe de lipídios estudada pelo seu envolvimento em DCV. Assim, a ingestão de P. tenuifila contribui para a melhora nos marcadores de risco cardiovascular e atua no metabolismo lipídico. Estes efeitos podem ser decorrentes de sinergia entre os diversos compostos bioativos do fruto. Ainda, outros estudos são necessários para identificar mecanismos relacionados a ação dos bioativos da P. tenuifila e estes podem ser mais bem direcionados pela lipidômica

Acetate wheat starch improving blood glucose response and bilan lipid on obesity dyslipidemia mice

Abstract Resistant starch is particularly concerned with beneficial effects in regulating blood glucose concentration and lipid metabolism, reducing the risk of diabetes and cardiovascular diseases. This study aimed to validate the effects of wheat starch acetate containing 32.1% resistant starch on postprandial blood glucose response and lipid profile on obesity, dyslipidemia Swiss mice induced by a high-fat diet. The result showed that there was a restriction on postprandial hyperglycemia and remained stable for 2 hours after meal efficiently comparing with the control group fed natural wheat starch. Simultaneously, when maintaining the dose of 5g/kg once or twice a day for 8 weeks, wheat starch acetate to be able to reduce body weight and blood glucose, triglyceride, cholesterol levels compared to the control group (p<0.05)

Síndrome coronario agudo y densidad mineral ósea en mujeres en etapa de climaterio / Acute Coronary Syndrome and Bone Mineral Density in Women during their Climacteric Stage

Introducción: Se ha descrito una probable asociación entre la presencia de osteopenia/osteoporosis y el riesgo incrementado de cardiopatía isquémica. Objetivo: Determinar la posible asociación entre la presencia de síndrome coronario agudo y la densidad mineral ósea disminuida, así como la relación de ambas condiciones con algunos factores de riesgo cardiovascular y variables de la esfera reproductiva en mujeres en etapa de climaterio. Método: Se realizó un estudio transversal descriptivo con 72 mujeres (34 con síndrome coronario agudo y 38 sin síndrome coronario agudo), que fueron seleccionadas de bases de datos del Instituto de Cardiología y Cirugía Cardiovascular. La densidad mineral ósea se determinó mediante absorciometría dual de rayos X en columna lumbar. Las pruebas Chi cuadrado y U de Mann Whitney permitieron evaluar la posible relación entre variables. Resultados: El 55,9 por ciento de las pacientes con síndrome coronario agudo y el 60,5 por ciento de las mujeres sin síndrome coronario agudo tenían densidad mineral ósea disminuida. En las mujeres con densidad mineral ósea disminuida (n=42): 81 por ciento presentaron obesidad abdominal, 78,6 por ciento dislipoproteinemia, 83,3 por ciento hipertensión arterial y 76,2 por ciento refirieron el antecedente familiar de cardiopatía isquémica. Conclusiones: En las mujeres en etapa de climaterio estudiadas no se demostró asociación entre la presencia de síndrome coronario agudo y la densidad mineral ósea disminuida. Tampoco existió relación entre la presencia de síndrome coronario agudo y la densidad mineral ósea disminuida con factores de riesgo cardiovascular, ni con las variables de la esfera reproductiva(AU)

Introduction: A probable association has been described between the presence of osteopenia/osteoporosis and the increased risk of ischemic heart disease. Objective: To determine the possible association between the presence of acute coronary syndrome and decreased bone mineral density, as well as the relationship of both conditions with some cardiovascular risk factors and variables of the reproductive sphere in women during the climacteric stage. Method: A descriptive and cross-sectional study was carried out with 72 women (34 with acute coronary syndrome and 38 without acute coronary syndrome), who were selected from databases of the Institute of Cardiology and Cardiovascular Surgery. Bone mineral density was determined by dual lumbar spine X-ray absorptiometry. The chi-square and Mann Whitney U tests allowed to evaluate the possible relationship between variables. Results: 55.9 percent of the patients with acute coronary syndrome and 60.5 percent of the women without acute coronary syndrome had decreased bone mineral density. Among women with decreased bone mineral density (n=42), 81 percent had abdominal obesity, 78.6 percent had dyslipoproteinemia, 83.3 percent had arterial hypertension, and 76.2 percent had a family history of ischemic heart disease. Conclusions: In the women in the climacteric stage studied, no association was shown between the presence of acute coronary syndrome and decreased bone mineral density. There was no relationship either between the presence of acute coronary syndrome and decreased bone mineral density with cardiovascular risk factors, or with variables in the reproductive sphere(AU)

Lípidos anormales e inmunidad adquirida Síndrome de Deficiencia: Asociación de Suero Lípidos con estatus de VIH / Abnormal Lipids and Acquired Immune Deficiency Syndrome: Association of Serum Lipids with HIV Status

Context and Aim: Hematological abnormalities are amongst the most common complications of infection with HIV.There have been quite a few studies on the alterations in lipid profile, too, though the results have largely been inconclusive. The present study was carried-out to assess CD4 cell counts and lipid profile in the HIV infected and AIDS patients in the Indian population and correlates them with the sero-negative controls. Materials and Methods: The present study was designed as a cross-sectional, hospital-based study to assess CD4 cell counts and lipid profile in the HIV infected and AIDS patients in the Indian population and correlates them with the sero-negative controls. Evaluation of lipid profile was done using Erba EM 360, an automated analyzer powered by a diffraction grating photometer while CD4 cell counts were evaluated using Partec Cyflow Counter. Statistical analysis used: The data was analyzed using SPSS version 15.0 (SPSS Inc., Chicago, IL, USA). Comparison of the said parameters was done using Analysis of Variance (ANOVA) and posthoc Games-Howell test. p-value of <0.05 was considered statistically significant. Results: The levels of total cholesterol and low-density lipoproteins (LDLs) were significantly decreased while triglycerides and very low density lipoproteins (VLDLs) were significantly increased in the HIV infected and AIDS patients when compared with the sero-negative controls. Conclusion: Total cholesterol, LDLs, triglycerides and VLDLs were significantly altered in the HIV infected and AIDS patients when compared with the sero-negative controls.

Lysosomal acid lipase deficiency in Brazilian children: a case series / Deficiência de lipase ácida lisossomal em crianças brasileiras: casuística

Abstract Objective: To describe the demographic, clinical, laboratory and molecular characteristics of patients with lysosomal acid lipase deficiency. Methods: A retrospective review of the medical records of children with the disease. Results: Seven children with lysosomal acid lipase deficiency (5 male; 2 female); 6 were mixed race, and 1 was black. The mean ages at the first onset of symptoms and at diagnosis were 5.0 years (4 months to 9 years) and 6.9 years (3-10 years), respectively. Symptom manifestations at onset were: 3 patients had abdominal pain, one had bone/joint pain due to rickets, and 1 had chronic diarrhea and respiratory insufficiency due to interstitial pneumonitis. One was asymptomatic, and clinical suspicion arose due to hepatomegaly. Six patients had hepatomegaly, and none had splenomegaly. Two patients were siblings. Enzymatic assay and molecular analysis confirmed the diagnoses. Genetic analysis revealed a rare pathogenic variant (p.L89P) in three patients, described only once in medical literature and never described in Brazil. None of those patients were related to each other. Lysosomal acid lipase deficiency was previously described as an autosomal recessive disease, but three patients were heterozygous and undoubtedly had the disease (low enzyme activity, suggestive lab findings and clinical symptoms). Conclusion: This case series supports that lysosomal acid lipase deficiency can present with highly heterogeneous signs and symptoms among patients, but it should be considered in children presenting with gastrointestinal symptoms associated with dyslipidemia. We describe a rare variant in three non-related patients that may suggest a Brazilian genotype for lysosomal acid lipase deficiency.

Resumo: Objetivo: Descrever as características demográficas, clínicas, laboratoriais e moleculares de pacientes com deficiência de lipase ácida lisossomal. Métodos: Análise retrospectiva dos prontuários médicos de crianças com a deficiência de lipase ácida lisossomal. Resultados: Sete crianças com deficiência de lipase ácida lisossomal (5 M:2F); seis eram pardas e uma negra. As faixas etárias no início dos sintomas e no diagnóstico foram 5 anos (4 meses a 9 anos) e 6,9 anos (3 a 10 anos), respectivamente. As manifestações dos sintomas no início foram as que seguem: três pacientes apresentaram dor abdominal, um apresentou dor nos ossos/articulações devido a raquitismo e um apresentou diarreia crônica e insuficiência respiratória devido à pneumonite intersticial. Os outros não apresentaram sintomas e a suspeita clínica surgiu devido à hepatomegalia. Seis pacientes apresentaram hepatomegalia e um apresentou esplenomegalia. Dois pacientes eram irmãos. O ensaio enzimético e a análise molecular confirmaram os diagnósticos. A análise genética revelou uma variante patogênica rara (p.L89P) em três pacientes, descrita uma única vez na literatura médica e nunca descrita no Brasil. Nenhum desses pacientes tinha parentesco com os outros. A deficiência de lipase ácida lisossomal foi anteriormente descrita como uma doença recessiva autossômica, porém três pacientes eram heterozigotos e, sem dúvida, apresentaram a doença (atividade enzimática baixa, achados laboratoriais sugestivos e sintomas clínicos). Conclusão: Esta casuística afirma que a deficiência de lipase ácida lisossomal pode se manifestar com sinais e sintomas altamente heterogêneos entre os pacientes, porém deve ser considerada em crianças que apresentam sintomas gastrointestinais associados à dislipidemia. Descrevemos uma variante rara em três pacientes não relacionados que pode sugerir um genótipo brasileiro para deficiência de lipase ácida lisossomal.

Effect of physical exercise on the renal structures of ovariectomized female LDL knockout mice / Efecto del ejercicio físico sobre las estructuras renales de ratones hembras con LDL ovariectomizadas

SUMMARY: The reduction of ovarian function and a decrease in estrogen levels marked by menopause are related to increased susceptibility to develop dyslipidemia. These alterations in the lipid profile can have consequences in renal tissue and generate injuries that may progress to renal failure. The practice of physical activity is an important factor for the treatment and prevention of dyslipidemia and its consequences. The objective of this study is to observe the effects of physical exercise on the right kidney of ovariectomized female LDL knockout mice. Animals were submitted to moderate physical exercise, sacrificed, and the right kidney was removed for morphometric and stereological analysis. The results showed that dyslipidemia promoted a decrease in the areas of the corpuscle and renal glomerulus, in the volume density of light in both the proximal and distal convoluted tubules, and an increase in capsular space, particularly more marked in the proximal tubules. We also observed that physical exercise decreased the analyzed parameters. Our results suggest the association of physical training and dyslipidemia presents a tendency to reduce the dimensions of morphometric and stereological parameters of the kidney. These changes may be related to metabolic and physiological adaptation of renal tissue during physical exercise.

RESUMEN: La reducción de la función ovárica y una disminución en los niveles de estrógeno, marcados por la menopausia, se relacionan con una mayor susceptibilidad a desarrollar dislipidemia. Estas alteraciones en el perfil lipídico pueden tener consecuencias en el tejido renal y generar lesiones que pueden progresar a insuficiencia renal. La práctica de la actividad física es un factor importante para el tratamiento y la prevención de la dislipidemia y sus consecuencias. El objetivo de este estudio fue observar los efectos del ejercicio físico en el riñón derecho de ratones hembras con LDL ovariectomizados. Los animales fueron sometidos a ejercicio físico moderado, se sacrificaron y se extrajo el riñón derecho para el análisis morfométrico y estereológico. Los resultados mostraron que la dislipidemia promovió una disminución en las áreas del corpúsculo y el glomérulo renal, en la densidad volumétrica de la luz en los túbulos contorneados proximales y distales, y un aumento en el espacio capsular, particularmente más marcado en los túbulos proximales. También observamos que el ejercicio físico disminuyó los parámetros analizados. Nuestros resultados sugieren que la asociación del entrenamiento físico y la dislipidemia presentan una tendencia a reducir las dimensiones de los parámetros morfométricos y estereológicos del riñón. Estos cambios pueden estar relacionados con la adaptación metabólica y fisiológica del tejido renal durante el ejercicio físico.

Effects of ursolic acid on glucose metabolism, the polyol pathway and dyslipidemia in non-obese type 2 diabetic mice.

Ursolic acid (UA) is a pentacyclic triterpenoid compound that naturally occurs in fruits, leaves and flowers of medicinal herbs. This study investigated the dose-response efficacy of UA (0.01 and 0.05%) on glucose metabolism, the polyol pathway and dyslipidemia in streptozotocin/nicotinamide-induced diabetic mice. Supplement with both UA doses reduced fasting blood glucose and plasma triglyceride levels in non-obese type 2 diabetic mice. High-dose UA significantly lowered plasma free fatty acid, total cholesterol and VLDL-cholesterol levels compared with the diabetic control mice, while LDL-cholesterol levels were reduced with both doses. UA supplement effectively decreased hepatic glucose-6-phosphatase activity and increased glucokinase activity, the glucokinase/glucose-6-phosphatase ratio, GLUT2 mRNA levels and glycogen content compared with the diabetic control mice. UA supplement attenuated hyperglycemia-induced renal hypertrophy and histological changes. Renal aldose reductase activity was higher, whereas sorbitol dehydrogenase activity was lower in the diabetic control group than in the non-diabetic group. However, UA supplement reversed the biochemical changes in polyol pathway to normal values. These results demonstrated that low-dose UA had preventive potency for diabetic renal complications, which could be mediated by changes in hepatic glucose metabolism and the renal polyol pathway. High-dose UA was more effective anti-dyslipidemia therapy in non-obese type 2 diabetic mice.

Avaliação dos fatores que caracterizam a berinjela (Solanum melongena L. ) como um alimento funcional / Evaluation factors featuring eggplant (Solanum melongena L. ) as a functional food

Currently, the role of healthy food is to optimize the nutrition of individuals, providing not only increased health and well-being, but also reduced risks of developing diseases caused by poor diets. Functional foods contain substances with different biological functions, called bioactive compounds, which can modulate the physiology of the body, ensuring the maintenance of health. Eggplant (Solanum melongena L.) has been cited by several authors as one of the vegetables that can be classified as functional food. The lay population has used eggplant in different ways, without criteria and evidence from studies with different objectives. Among its main uses, the treatment and/or prevention of dyslipidemia and as adjuvant in weight loss can be highlighted. This work aims to study and analyze the most recent publications in order to justify the characterization of eggplant (Solanum melongena L.) as a functional food. To this end, a literature review of articles was conducted in the Scielo, Medline, Pubmed, Bireme, and Lilacs databases, as well as in books and journals from 1992 to 2012. The selection of bibliographic reference sought to select studies that investigated the chemical composition of eggplant, elucidated its habitual use by populations, and attempted to demonstrate its functional properties. Although some studies have demonstrated the effectiveness of eggplant, more accurate investigations with standardized methodologies are needed. These further studies should address the usual forms of consumption by the population and the correlation of these forms with the objectives of the proposed use.

Actualmente, el papel de la alimentación considerada saludable es el de optimizar la nutrición de las personas, garantizándoles el aumento de la salud y del bienestar, al mismo tiempo que reduce el riesgo de desarrollar enfermedades causadas por la mala alimentación. Los alimentos funcionales presentan sustancias, denominadas compuestos bioactivos, que tienen diferentes funciones biológicas y que son capaces de modular la fisiología del organismo, garantizando el mantenimiento de la salud. La berenjena (Solanum melongena L.) ha sido citada por muchos autores como una de las hortalizas que se puede clasificar como alimento funcional. La berenjena ha sido utilizada por la población de diversas formas, aunque sin evidencias ni pruebas que lo respalden, y con diversos objetivos, entre los que podemos destacar el tratamiento y/o prevención de la dislipidemia y el auxilio en el adelgazamiento. Este trabajo tiene como objetivo estudiar y analizar las publicaciones más recientes que justifiquen la clasificación de la berenjena (Solanum melongena L.) como un alimento funcional. Para la estructuración de este estudio se realizó una revisión bibliográfica de artículos en las bases de datos Scielo, Medline, Pubmed, Bireme, Lilacs, así como en libros y revistas científicas, teniendo en cuenta el período de 1992 a 2012. La selección de la referencia bibliográfica intentó seleccionar aquellos estudios que investigaron la composición química de la berenjena, dilucidaron su uso habitual en las poblaciones y trataron de demostrar sus propiedades funcionales. Aunque algunos estudios han demostrado la eficacia de la berenjena, se necesitan investigaciones más precisas, con metodologías estandarizadas, que tengan en cuenta las formas habituales de consumo y las relacionen con los objetivos propuestos para su uso.

Atualmente o papel da alimentação considerada saudável é otimizar a nutrição dos indivíduos garantindo a estes o aumento da saúde e do bem-estar como também reduzir o risco de desenvolver doenças decorrentes da má alimentação. Os alimentos funcionais apresentam substâncias com distintas funções biológicas, denominadas compostos bioativos, que são capazes de modular a fisiologia do organismo, garantindo a manutenção da saúde. A berinjela (Solanum melongena L.) tem sido citada por diversos autores como um dos vegetais que podem ser classificados como alimento funcional. A utilização da berinjela vem sendo feita pela população leiga sob diversas formas, mesmo sem critérios e comprovações por estudos com objetivos diversos, entre eles destaca-se sua utilização para o tratamento e/ou prevenção da dislipidemia e também como coadjuvante na perda de peso. Este trabalho tem como objetivo estudar e analisar as publicações mais recentes que justifiquem a caracterização da berinjela (Solanum melongena L.) como um alimento funcional. Para a estruturação deste estudo, foi realizada uma revisão da literatura em artigos nas bases de dados Scielo, Medline, Pubmed, Bireme, Lilacs bem como em livros e revistas científicas, considerando o período de 1992 a 2012. A seleção da referência bibliográfica preocupou-se em selecionar os estudos que pesquisaram a composição química da berinjela, elucidaram seu uso habitual nas populações, bem como tentaram demonstrar suas propriedades funcionais. Apesar de alguns estudos demonstrarem a eficácia da berinjela, são necessárias investigações mais precisas, com metodologias padronizadas, realizadas com as formas habituais de consumo entre a população e relacioná-las com os objetivos propostos do seu uso.

Quercetin and β-sitosterol prevent high fat diet induced dyslipidemia and hepatotoxicity in Swiss albino mice.

High fat diet group showed a significant rise in serum and hepatic total cholesterol, triglyceride and atherogenic index which are major biomarkers of dyslipidemia and cardiovascular risk. The liver function markers, lipid peroxidation and proinflammatory cytokine levels were elevated in high fat diet group whereas antioxidant levels significantly reduced. These findings manifest hepatic damage which was further confirmed by histological findings. Quercetin and β-sitosterol though structurally different yet both ameliorate the sickening changes in different mechanism. The current investigation is perhaps the first report of the mechanistic role of two polyphenols over dyslipidemia and subsequent hepatotoxicity.

Prevalencia de hipertensión arterial y dislipidemias en adultos del páramo del Estado Mérida y su relación con obesidad: resultados preliminares del estudio VEMSOLS / Prevalence of hypertension and dyslipidemia in adults from venezuelan Andes (Mérida) and its relationship with obesity: preliminary results from the VEMSOLS study

Determinar la prevalencia hipertensión arterial(HTA) y dislipidemias en una población adulta del páramo del Estado Mérida (Venezuela), y su relación con el grado de obesidad. Fueron estudiados 138 sujetos (87 mujeres y 51 hombres) adultos obtenidos por un muestreo aleatorio simple proveniente de una población rural de Los Andes que habita a más de 3 000 metros sobre el nivel del mar. Cada sujeto fue evaluado en su vivienda y se midió presión arterial, peso, talla y se analizó la concentración plasmática de colesterol total, HDL colesterol, LDL colesteroly triglicéridos en ayunas. La prevalencia de HTA fue del 25,0%. Las dislipidemias más prevalentes fueron la hipertrigliceridemia (45%) y la disminución del HDL-Col(hipoalfalipoproteinemia) (43,1%); esta última más frecuente en mujeres (55,1%) que en hombres (20,8%). Sin embargo, prevalencia de dislipidemia aterogénica definida como hipertrigliceridemia + HDL-Col bajo (16,8%) fue similar enambos sexos. La hipercolesterolemia, LDL-Col elevado y la dislipidemia mixta (hipercolesterolemia+hipertrigliceridemia) se encontraron en el 22,1%, 12,9% y 20,0% de la población respectivamente, sin diferencia según género. Se observó una mayor prevalencia de HTA y dislipidemia aterogénica en sujetoscon sobrepeso y obesidad en ambos sexos. Los datos presentados son resultados preliminares del Estudio Venezolano de Síndrome Metabólico, Obesidad y Estilo devida (VEMSOLS). Se encontró que en el páramo del Estado Mérida (Venezuela) la prevalencia de HTA y dislipidemia es significativa y se incrementa en la misma medida con la presencia de sobrepeso u obesidad.

The objective of this study was to assess the prevalence of hypertension and dyslipidemia in an adult population from mountains of Venezuelan Andes (Mérida), and its relationship with the degree of obesity. One hundred thirty-eight subjects (87 women and 51 men) obtained by simple random sampling from a rural population that inhabits the Andes over 3 000 meters above sea level were studied. Each participant was evaluated in their home and blood pressure, weight, height, and fasting blood lipids (total cholesterol, HDL cholesterol, LDL cholesterol and triglycerides) were measured. The prevalence of hypertension was 25.0%. The most prevalent dyslipidemias were hypertriglyceridemia (45%) y low HDL-Chol (hypoalphalipoproteinemia) (43.1%), being the last more frequent in females (55.1%) than males (20.8%). However,atherogenic dyslipidemia prevalence, defined by hypertriglyceridemia+low HDL-Chol (16.8%), was similar in males and females. Hypercholesterolemia, high LDL-Chol and mixed dyslipidemia (hypercholesterolemia+hypertriglyceridemia ) were present in 22.1%, 12.9% and 20.0% respectively with no difference by gender. Both hypertension and atherogenic dyslipidemia prevalence increased in subjects with overweight and obesity. Data presented are preliminary results of the Venezuelan Metabolic Syndrome, Obesity and Lifestyle Study (VEMSOLS). The prevalence of hypertension and dyslipidemias in a population of Venezuelan Andes (Mérida) is significant and equally incerased in both overweight and obese subjects.

Grasa epicárdica: un nuevo indicador de riesgo cardiometabólico / Epicardia fat: new cardiometabolic risk marker

La grasa epicárdica es el verdadero depósito de grasa del corazón y puede ser observada y medida utilizando ecocardiografía estandar en dos dimensiones. La vista en eje paraesternal largo y paraesternal corto permite medir con mayor precisión el espesor de la grasa epicárdica sobre el ventriculo derecho. La medición ecocardiográfica de la grasa epicárdica tiene varias ventajas incluyendo bajo costo, fácil accesibilidad y buena reproducibilidad, y además se correlaciona positivamente con el síndrome metabólico, resistencia insulínica, enfermedad arterial coronaria y aterosclerosis subclínica, y por tanto puede servir como una herramienta sencilla para la predicción del riesgo cardiometabólico.

Epicardial fat is the true visceral fat depot of the heart and it can be visulized and measured using standard two-dimensional echocardiography. Standar parasternal long-axis and short-axis views permit the most accurate measurement of epicardial fat thickness overlying the right ventricle. Echocardiographic epicardial fat measurement has several advantages, including low cost, easy accessibility and good reproducibility, and also it correlates with metabolic syndrome, insulin resistance, coronary artery disease, and subclinical atherosclerosis, and therefore it might serve as a simple tool for cardiometabolic risk prediction.

Evaluación de las alteraciones lipídicas en el síndrome de ovarios poliquísticos y su relación con la resistencia a la insulina / Assessment of the lipid alterations in polycystic ovaries syndrome and its relation to insulin-resistance

El síndrome de ovarios poliquísticos excede el eje reproductivo por su frecuente asociación con alteraciones metabólicas y cardiovasculares. Objetivo: basado en lo anterior se realizó un estudio descriptivo transversal para determinar la frecuencia y las características de las alteraciones lipídicas en un grupo de mujeres con síndrome de ovarios poliquísticos y su relación con las alteraciones en la sensibilidad a la insulina. Se estudiaron 23 mujeres según los criterios de la Androgen Excess Society, se realizaron determinaciones hormonales y lipídicas así como glucemia e insulinemia en ayunas para evaluar sensibilidad a la insulina. Resultados: 95,6 por ciento de las pacientes presentaron dislipidemia. La disminución de las lipoproteínas de alta densidad (cHDL) y apolipoproteínas (Apo) A-I fueron las alteraciones lipídicas más frecuentes (91,3 y 87,0 por ciento, respectivamente) mientras que el aumento de los triglicéridos (Tg) y del colesterol total (Ct) fueron infrecuentes (13 y 4,3 por ciento, respectivamente). Los índices lipídicos calculados: Tg/cHDL, Ct/cHDL, cHDL/cLDL y Apo B/A-I tuvieron valores medios superiores en las mujeres con insulinorresistencia, el índice Apo B/A-I fue el que mostró mayor diferencia en mujeres con insulinorresistencia y sin esta. La frecuencia de las alteraciones lipídicas en las mujeres estudiadas fue alta pero no todas se relacionan con la insulinorresistencia, lo cual sugiere que en la expresión del síndrome de ovarios poliquísticos podrían intervenir múltiples factores metabólicos y hormonales(AU)

The polycystic ovaries syndrome to exceed the reproductive axis due to its frequent association with metabolic and cardiovascular alterations. Objetive: based on above mentioned a cross-sectional and descriptive study was conducted to determine the frequency and the characteristic of lipid alterations en a group of women diagnosed with polycystic ovaries and its relation to alterations in insulin-sensitivity. Methods: twenty three women were studied according to Androgen Excess Society criteria, hormonal and lipid determinations were made as well as fasting glycemia and insulinemia to assess the insulin-sensitivity. RESULTS: the 95,6 percent of patients presenting with dyslipemia. The more frequent lipid alterations were a decrease of the high density lipoproteins (cHDL) and apolipoproteins (Apo) (91,3 and 87,0 percent, respectively) whereas the increase of triglycerides(Tg) and the total cholesterol (tC) were infrequent (13 and 4,3 percent, respectively). The estimated lipid rates: Tg/cHDL, Ct/cHDL, cHDL/cLDL and Apo B/A-I had higher mean values in women with insulin-resistance; the Apo B/A-I rate had the greater difference in women with insulin-resistance and without it. The lipid alterations frequency in study women suggest that in expression of polycystic ovaries syndrome could be involved many metabolic and hormonal factors(AU)

Manejo integral de las dislipidemias en niños y adolescentes: [revisión] / Integral management of dyslipidemias in children and adolescents: [review]

Las enfermedades cardiovasculares constituyen la primera causa de morbimortalidad a nivel mundial y nacional. La enfermedad arterial coronaria y periférica se encuentra íntimamente ligada a los niveles elevados de lípidos en sangre. La aterosclerosis es una enfermedad que puede iniciarse en los primeros años de vida y manifestarse con severidad en la etapa adulta, si no se realizan medidas correctivas en el paciente de riesgo. Con el objetivo de actualizar las pautas nacionales para el manejo del paciente con dislipidemia, se reunieron un grupo de investigadores venezolanos en el año 2010, a propósito del III Consenso Nacional para el Manejo del Paciente con Dislipidemia. Se presentan las conclusiones y recomendaciones del grupo de trabajo: Manejo Integral de las Dislipidemias en niños y adolescentes. Se incluyen las estrategias para prevención, recomendaciones generales para la población pediátrica, con énfasis en recomendaciones individuales para niños y adolescentes de alto riesgo.

Cardiovascular diseases are the leading cause of morbidity and mortality at global and national levels. Coronary and peripheral arterial disease is closely linked to high lipid levels in blood. Atherosclerosis is a disease that can begin in the first years of life and be clinical with severity in adult life, if you do not perform corrective action in patient at risk. With the objective of updating national guidelines for the management of Dyslipidemia patients met Venezuelan researchers in 2010 concerning III National Consensus for the Management of Patient with Dyslipidemia, then presented the conclusions and recommendations of the Working Group: Integral Management of Dyslipidemias in children and adolescents. It includes strategies for prevention, general recommendations for the pediatric population, with enphasis on high risk children and adolescents.

role of dyslipidaemia in pathogenesis of familial dilated cardiomyopathy and nonischemic heart failure

This study had been designed to evaluate the serum lipid profile concentrations in patients with familial dilated cardiomyopathy [FDCM] and nonischemic DCM, and search for a correlation between serum lipid concentrations and the severity of heart failure. This case controlled study was conducted in Department of Cardiology in Ibn Albitar Hospital, Baghdad and in Department of Physiological Chemistry, College of Medicine, University of Baghdad from January 2005 to November 2005. Fifty-one patients DCM were included in this study, 7 patients with FDCM [40-70 years], and the remainder 44 patients with nonischemic DCM [19-72 years old]. Twenty-five healthy subjects [21-60 years] taken as a control group. Investigations included serum estimation of total cholesterol [Tch], triglyceride [TG], low density lipoprotein-cholesterol [LDL-C], high density lipoprotein-cholesterol [HDL-C], HDL-C/LDL-C ratio and Tch/LDL-C ratio in patient and control groups. Some of the echocardiographic parameters were also measured in all patients. The mean [ +/- SD] values of serum concentrations of Tch and LDL-C did not differ significantly between patient groups and controls. Serum TG concentration was significantly increased in patients with FDCM and nonischemic DCM when compared with healthy controls [p<0.018, p<0.011; respectively]. Serum HDL-C concentration was significantly decreased in nonischemic DCM patients compared with controls [p<0.0001]. An important significant correlations were also observed between the serum lipid concentrations and the echocardiographic values in patient groups. Our data revealed that lipid profile abnormalities, in particular high serum TG and low serum HDL-C concentrations, may contribute to the development of FDCM and nonischemic DCM

Ações do cilostazol, um inibidor da fosfodiesterase tipo III, no metabolismo lipídico do período pós-prandial, no perfilinflamatório e na atividade da óxido nítrico sintetase: [revisão] / Effects of cilostazol, a phosphodiesterase type III inhibitor, on postprandial lipemia, inflammatory biomarkers and nitric oxide synthase production metabolism: [review]

A aterosclerose é uma doença caracterizada por inflamação vascular, sendo a proteína C-reativa ultrassensível, a interleucina-6 e o óxido nítrico, alguns de seus marcadores, e cujas complicações incluem o infarto agudo do miocárdio e o acidente vascular cerebral. Uma das principais causas de aterosclerose é a dislipidemia. O cilostazol atua como vasodilatador, antiagregante de plaquetas e antitrombótico. Essa droga também promove a diminuição de triglicerídeos e o aumento de lipoproteínas de alta densidade em diabéticos e em doentes com doença arterial obstrutiva periférica, podendo interferir na aterosclerose. Baseados nesses dados, há a possibilidade de efeitos benéficos do cilostazol na lipemia pós-prandial, nos mediadores da inflamação e na função endotelial.

Atherosclerosis is a disorder that is characterized by vascular inflammation, with ultra-sensitive C-reactive protein, interleukin-6 and nitric oxide being some of its biomarkers, and whose complications include acute myocardial infarction and stroke. One of the main causes of atherosclerosis is dyslipidemia. Cilostazol acts as a vasodilator, antiplatelet, and antithrombotic agent. It also promotes triglycerides decrease and high density lipoproteins increase in diabetics and in patients with obstructive peripheral arterial disease, potentially interfering with atherosclerosis. Based on these data, cilostazol may have beneficial effects on postprandial lipemia, inflammatory mediators, and endothelial function.

Prevalência de síndrome metabólica nos pacientes atendidos no ambulatório médico da UNESC / Prevalence of metabolic syndrome in patients from UNESC ambulatory

Objetivo: Estimar a prevalência e verificar o perfil epidemiológico dos pacientes com o diagnóstico daSíndrome Metabólica, atendidos no Ambulatório Clínico da Universidade do Extremo Sul Catarinense (UNESC).Métodos: Foi realizado um estudo observacional, descritivo, transversal, numa amostragem de 675 prontuários para o diagnóstico de Síndrome Metabólica pelos critérios do International Diabetes Federation(IDF) que apresentavam pelo menos um critério para a suspeita clínica. As variáveis analisadas foram: idade,sexo, raça, pressão arterial, diabete melito tipo 2, índice de massa corporal, circunferência abdominal, colesteroltotal, HDL-colesterol e triglicerídeos. Para análise estatística utilizou-se o teste qui-quadrado ou de Fishere análise de variância (ANOVA One-Way) e teste t-Student, com significância de 5%. Resultados: Cento e cinquenta e sete pacientes (23,2%) preencheram os critérios para o diagnóstico de Síndrome Metabólica. Com idade média de 52,4 anos;115 (73,2%) eram mulheres; 85 (54,1%) da raça branca; 98 (63,2%) tinham sobrepeso e obesidade tipo I comincidência maior nas mulheres (75,6%); circunferência abdominal média de 98,6 cm nos homens e 103,4 cm nasmulheres; 58 (41,7%) apresentaram HDL-colesterol menor que 40 mg/dL significativamente maior nos homens - p=0,000001); 98,5% apresentaram triglicerídeos e” 150 mg/dL; colesterol médio de 230,1 mg/dL nos homens e 199,4 mg/dL( significativamente maior nos homens - p=0,005); 78 (62,3%) com hipertensão arterial sistêmica e 60 (38,2%) com diabete melito.(significativamente maior nos homens - p=0,010). Conclusão: Encontramos alta prevalência de Síndrome Metabólica entre os pacientes atendidos noAmbulatório Clínico da UNESC (157 pacientes - 23,2%), principalmente em mulheres. Os homens apresentaramsignificância estatística em relação ao HDL-colesterol baixo, hipercolesterolemia e diabete melito quando comparado às mulheres.

Objective: Estimate the prevalence and verify the epidemiologic profile of patients with Metabolic Syndromereceived in UNESC Clinical Ambulatory (University of Extreme South of Santa Catarina). Methods: It was performed an observational, descriptive and transversal study in a sample of 675 records for diagnose of Metabolic Syndrome by the criterias fromInternational Diabetes Federation (IDF) which showed al least one criteria for the clinical suspected. It was analised age, sex, race, blood pressure, diabetes mellitus type II, body mass index, abdominal circumference, totalcholesterol, HDL-cholesterol and triglycerides levels. For the statistic analysis it was used the chi-square or Fisher test and variable analysis (ANOVA One-Way) e t-Studenttest, with significance of 5%. Results: One hundred and fifty seven patients(23.2)% had diagnose of Metabolic Syndrome. With mean age of 52.4 years old; 115 (73.2%) were women; 85(54.1%) caucasian; 98 (63.2%) had 61.9% had overweight and obesity type I with more incidence in women (75.6%); mean abdominal circumference of 98.6 cm in men and 103.4 cm in women; 58 (41.7%) hadHDL-cholesterol levels lower than 40 mg/L significantly higher in men – p=0.000001); 98.5% presentedtriglycerides e”150 mg/dL; mean cholesterol of 230.1 mg/dL in men and 199.4 mg/dL (significantly higher inmen – p=0.005); 78 (62.3%) with systemic arterial hypertension and 60 (38.2%) with diabetes mellitus(significantly higher in men – p=0.010).Conclusion: We found high prevalence of Metabolic Syndrome in UNESC Clinical Ambulatory (157 patients – 23.2%), mainly in women. Men had statisticsignificance of low HDL-cholesterol,hypercholesterolemia and DM as women.

Efecto del consumo de aguacate (persea amaricana mill): sobre el perfil lipídico en adultos con dislipidemia / Effect of consumption of avocado (persea americana mill): on the lipid profile in adults with dyslipidemia

Las dislipidemias son desórdenes metabólicos frecuentes, que se constituyen en un importante factor de riesgo de enfermedades, las cuales tienen como sustrato anatómico la aterosclerosis. El objetivo de este trabajo fue determinar el efecto del consumo de aguacate sobre los niveles plasmáticos de lípidos en individuos con dislipidemia. La muestra se conformó con 14 hombres: 6 (Grupo control) (GA) y 8 (Grupo experimental) (GB). Ambos grupos se evaluaron antropométricamente según los criterios de OMS y cumplieron una dieta (según los criterios de American Heart Association), más GA consumió 30 cc de aceite de maiz y el GB consumió 30 cc de grasa basados en aguacate en el almuerzo durante 30 días. Se midió Colesterol total, lipoproteínas de alta densidad (c-HDL), lipoproteínas de baja densidad (c-LDL), lipoproteínas de muy baja densidad (c-VLDL) y triacilglicéridos (TG) al inicio, 15 y 30 días. Para el análisis estadístico se aplicó T-student para datos no pareados (p < 0,005) con el programa SPSS 10 para Windows. El GA inició con CT= 232,6±37,1 mg/dL y finalizó con 206,7±34,8 mg/dL (p<0,000) (-13%). El GB inició con valores de CT= 222,9±15,2 mg/dL y finalizo en 206,3±17,2 mg/dL (p<0,000)(-9,2%). A los 30 días se encontró que TG disminuyeron 10,3% y c-HDL aumentó 6,3% en el grupo B; mientrasque c-LDL y c-VLDL tuvieron una disminución porcentual similar para ambos grupos. Se concluye que el consumo de aguacate en una comida mixta hipograsa puede ser beneficioso como estrategia terapéutica en la alimentación de adultos con esta patología.

Dyslipidemia are common metabolic disorder, which constitute a major risk factor for diseases which have the anatomic substrate atherosclerosis. The aim of this study was to determine the effect of the avocado on the plasma levels of lipids in subjects with dyslipidemia. The sample was formed with 14 men: 6 (control group) (GA) and 8 (experimental group) (GB). Anthropometrically Both groups were evaluated according to WHO criteria and met a diet (as determined by American Heart Association), consumed more GA 30 cc of corn oil and the GB consumed 30 cc of fat in the avocado-based lunch for 30 days. Measured total cholesterol, high-density lipoprotein (HDL-C), low density lipoprotein (LDL-c), very low density lipoproteins (VLDL-c) and Triacilglycerides (TG) at baseline, 15 and 30 days. For statistical analysis was applied to T-student data is not matched (p < 0.005) with the program SPSS 10 for Windows. The GA started with TC = 232.6 ± 37.1 mg/ dL and ended with 206.7 ± 34.8 mg/dL (p < 0.000) (-13%). GB began with the values of CT = 222.9 ± 15.2 mg/dL and finished at 206.3 ± 17.2 mg/dL (p < 0.000) (-9.2%). For the 30 days it was found that TG decreased 10.3% and increased HDL-c 6.3% in group B, while c-c-VLDL and LDL had a similar percentage decline for both groups. We conclude that consumption of avocado in a mixed meal hipograsa can be beneficial as a therapeutic strategy in the nutrition of adults with this condition.

Síndrome de ovario poliquístico: tratamiento con metformin / Policystic varian syndrome: treatment with metformin

Evaluar la eficacia del metformin en la modificación de la función ovárica y factores de riesgo cardiovasculares, en pacientes con síndrome de vario poliquístico iperinsulinismo. Estudio experimental y prospectivo en pacientes que consultaron entre agosto 2005 y julio 2006 con diagnóstico de síndrome de ovario poliquístico de hiperinsulinismo; se determinaron las modificaciones en el perfil hormonal, riesgos cardiovasculares y patrón Doppler posterior al tratamiento con metformin con dosis de 00 g/día. Servicio de Fertilidad de la Maternidad “Concepción Palacios”. Hubo un descenso significativo del peso, IMC, ICC, TA, concentraciones de LH, prolactina y andrógenos al culminar los 3 meses con metformin (P<0,05), con mejoría significativa del perfil lipídico pero no generaron grandes cambios en la categorización del riesgo cardiovascular global. El IR ovárico presentó valores inicialmente altos que descendieron posterior al tratamiento. El ICC presentó correlación directa y significativa sobre el IR ovárico, mientras el peso corporal, IMC y la glicemia 120 min influenciaron sobre las cifras de TAS. Se debe considerar al metformin como una alternativa terapéutica para el manejo integral de a paciente on síndrome de vario poliquístico.

Prevalencia de la enfermedad hepática alcohólica y algunos factores de riesgo en pacientes que acuden a los ambulatorios de Barquisimeto

Para determinar la prevalencia de enfermedad hepática alcohólica y algunos factores de riesgo en pacientes que acuden a los Ambulatorios de Barquisimeto, Estado Lara, se realizo esta investigacion con 268 sujetos, entre 18 y 65 anos de edad, de ambos sexos y sin patologías hepáticas previas. La prevalencia general de enfermedad hepática alcohólica fue 3,7 por ciento; la prevalencia de enfermedad hepática alcohólica no cirrótica fue 2,2 por ciento; la enfermedad hepática alcohólica no cirrótica con sospecha de cirrosis represento el 1,12 por ciento y la enfermedad hepática alcohólica cirrótica 0,38 por ciento, los enfermos fueron mayoritariamente hombres. En consumidores de alto riesgo, estos resultados se triplicaron. En resumen, las prevalencias de enfermedad hepática alcohólica y enfermedad hepática alcohólica cirrótica fueron superiores a las reportadas internacionalmente, hallazgos debidos, probablemente, a la elevada frecuencia de consumo de alto riesgo. Se requieren estudios analíticos observacionales para confirmar la anterior aseveracion, así como, los resultados relacionados con el mayor riesgo que aparentemente demostraron los hombres sobre las mujeres

A research to determine the prevalence of alcoholic liver disease and some risk factors in patients who visit the outpatient centers of Barquisimeto, Lara State, was carried out. The sample was made up of 268 individuals between 18 and 65 years old, both male and female, without any previous liver pathologies. The general prevalence of alcoholic liver disease was 3.7 percent and 2.2 percent for non-cirrhotic alcoholic liver disease, for non-cirrhotic alcoholic liver disease with suspected cirrhosis 1.12 percent and 0.38 percent for cirrhotic alcoholic liver disease, being always predominated in male individuals. In patients with highrisk consumption, the results were threefold. In conclusion, the prevalence of alcoholic liver disease and non-cirrhotic alcoholic liver disease were above those internationally reported. This is due to, probably, the increased frequency of high-risk consumption. Analytic observational studies are required to confirm the previous affirmation as well as the results related with the greater risk that apparently was demonstrated by men over women

Para determinar o predomínio da doença hepática alcoólica e alguns fatores de risco em pacientes que freqüentam o ambulatorios de Barquisimeto, Estado Lara, foi realizado a pesquisa com 268 sujeitos, dentre 18 e 65 anos de idade, de ambos os sexos e sem patologias hepáticas previas. O predomínio geral da doença hepática alcoólica foi 3,7 por cento; o predomínio da doença hepática alcoólica nao-cirrótica foi 2,2 por cento; A doença hepática alcoólica nao-cirrótica com suspeita de cirroses representou o 1,12 por cento e a doença hepática alcoólica cirrótica 0,38 por cento, os doentes foram na maior parte homens. Nos consumidores de alto risco, os resultados se triplicaram. Em resumo, o predomínio da doença hepática alcoólica e doença hepática alcoólica cirrótica foi superior as descobertas internacionais, devido a elevada frequencia de consumo de alto risco. Se requerer de estudos analíticos de observaçào para confirmar a primeira hipótese, assim como também, os resultados relacionados com o alto risco predominante em homens com relação às mulheres

Manejo de las dislipidemias en niños y adolescentes: [revisión] / Management of dyslipidemias in children and adolescents: [review]

Evidencia reciente confirma que la enfermedad cardiovascular se inicia en la infancia, y la dislipidemia es uno de los principales factores de riesgo asociados. La detección precoz de la hipercolesterolemia en niños con factores de riesgo, previene la morbimortalidad cardiovascular en el adulto. Se propone un esquema de detección y manejo de la dislipidemia, basado en la experiencia de grupos de expertos, así como medidas dietéticas y terapéuticas a seguir. Se debe hacer hincapié en cambios de estilo de vida a largo plazo, recomendando hábitos alimentarios saludables y ejercicio ya que la obesidad es la causa mas frecuente de dislipidemia en el niño. Existen varias alternativas farmacológicas, y en su uso y selección se debe evaluar el riesgo en forma individual, tomando en cuenta la edad, los niveles séricos de lípidos, la magnitud y el número de eventos cardiovasculares en familiares y los posibles efectos secundarios. Actualmente las estatinas están tomando un papel importante en el tratamiento de la hipercolesterolemia familiar en niños sin embargo se requieren más estudios a fin de establecer su seguridad en este grupo de edad. En vista que la hipercolesterolemia es un factor de riesgo modificable y determinante en la enfermedad cardiovascular, todas las intervenciones que se puedan hacer en la niñez, ofrecen una oportunidad de prevención.

Recent evidence corroborate that cardiovascular disease begins in childhood and that hyperlipidemia is one of the main associated risk factors. Early screening of hypercholesterolemia in high risk children should be performed in order to prevent cardiovascular morbidity and mortality in adulthood. An approach for detection and management of hypercholesterolemia is proposed with dietary and therapeutic strategies based on the experience of expert groups. Since obesity is the most common cause of hyperlipidemia in children, special emphasis should be made in long lasting lifestyle changes. Treatment always must include dietary modifications and exercise. Several pharmacologic alternatives are available, and when deciding its use, the child's risk must be individually analyzed, considering age, type and degree of dyslipidemia, and possible adverse effects. Since hypercholesterolemia is a modifiable and determinant risk in cardiovascular disease, all interventions done in childhood offer the opportunity of cardiovascular disease prevention in adulthood.