Factores del síndrome metabólico en el riesgo cardiovascular en pobladores peruanos / Factors of Metabolic Syndrome in Cardiovascular Risk among Peruvian Populations

Objetivo: Determinar la incidencia de los factores del síndrome metabólico en el riesgo cardiovascular en pobladores del distrito de Ayacucho en Perú. Método: Enfoque cuantitativo, diseño correlacional causal. La muestra fue de 140 pobladores mayores de 18 años a quienes se les realizó el dosaje serológico y se tomaron las medidas antropométricas necesarias mediante el uso de equipos biomédicos calibrados y específicos para cada parámetro. Se utilizó como instrumento la Tabla de cálculo de Síndrome Metabólico (ALAD) y la tabla de Framinghan. Resultados: Se determinó que el Síndrome Metabólico incide significativamente (0,000) en el Riesgo Cardiovascular con un J2= 15,432 (1) y una influencia de 16,8 por ciento enfatizado por el coeficiente de Pseudo-R2 Nagelkerke. Conclusión: Se concluye que el síndrome metabólico incide en el riesgo cardiovascular de los pobladores evaluados, debido a que presentaron niveles bajo de colesterol HDL, triglicéridos altos, un incremento de perímetro abdominal y hábitos de fumar, siendo estos factores determinantes para incrementar el riesgo cardiovascular (AU)

Objective: To determine the incidence of metabolic syndrome factors on cardiovascular risk in inhabitants of the district of Ayacucho in Peru. Methods: Quantitative approach, causal correlational design. The sample consisted of 140 inhabitants over 18 years of age who underwent serological dosage and the necessary anthropometric measurements were taken using calibrated and specific biomedical equipment for each parameter. The Metabolic Syndrome Calculation Table (ALAD) and the Framinghan table were used as instruments. Results: It was determined that the Metabolic Syndrome has a significant influence (0.000) on Cardiovascular Risk with a J2= 15.432 (1) and an influence of 16.8 percent emphasized by the Pseudo-R2 Nagelkerke coefficient. Conclusion: It is concluded that the metabolic syndrome has an impact on the cardiovascular risk of the population evaluated, because they presented low HDL cholesterol levels, high triglycerides, an increase in abdominal perimeter and smoking habits, these being determining factors to increase cardiovascular risk(AU)

Efecto del extracto hidroalcohólico de la planta Lampaya medicinalis Phil. (Verbenaceae) sobre la esteatosis inducida in vitro en hepatocitos humanos / Effect of the hydroalcoholic extract of the plant Lampaya medicinalis Phil. (Verbenaceae) on in vitro-induced steatosis in human hepatocytes

INTRODUCCIÓN: La enfermedad del hígado graso no alcohólico (EHGNA) es la forma más común de enfermedad hepática. A nivel celular se caracteriza por la acumulación de triglicéridos (TG) en forma de gotas lipídicas (GL) dando lugar a esteatosis e inflamación. Entre los factores relevantes para la síntesis de TG se encuentran las enzimas DGAT1/2 que catalizan la etapa final de la síntesis de TG, y la proteína FABP4 que transporta lípidos intracelulares y se expresa en modelos de enfermedad hepática dependiente de obesidad. Por otra parte, TNF-α es una reconocida citoquina involucrada en el proceso inflamatorio en la EHGNA. La medicina popular del norte de Chile ha utilizado la planta Lampaya medicinalis Phil. (Verbenaceae) para el tratamiento de algunas enfermedades inflamatorias. OBJETIVO: Evaluar el efecto de un extracto hidroalcóholico de lampaya (EHL) sobre la esteatosis y expresión de marcadores de inflamación en hepatocitos tratados con ácidos grasos. Diseño experimental: Estudio in vitro en cultivos de la línea celular humana HepG2 tratadas con ácido oleico (AO) y ácido palmítico (AP). MÉTODOS: Se incubó hepatocitos HepG2 con AO/AP por 24 horas en presencia o no de EHL. Se evaluó la presencia de GL y el contenido de TG intracelulares por Oil Red O y Nile Red, respectivamente. La expresión de DGAT1/2, FABP4 y TNF-α fue evaluada por qPCR. RESULTADOS: Los hepatocitos tratados con AO/AP mostraron un aumento en las GL y TG, así como una mayor expresión de DGAT2 en comparación al control. El cotratamiento con EHL revirtió los efectos inducidos por AO/AP. CONCLUSIONES: EHL revierte el incremento en las GL, TG y en la expresión de DGAT2 inducido por AO/AP en células HepG2. Estos hallazgos sugieren un efecto hepatoprotector de la Lampaya contra la esteatosis, y apoyarían su uso complementario en el tratamiento de patologías con componente inflamatorio como la EHGNA.

Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease. At the cellular level, it is characterized by the accumulation of triglycerides (TG) in the form of lipid droplets (LD), which leads to steatosis and inflammation. Among relevant factors for TG synthesis are the enzymes DGAT1/2 catalyzing the final stage of TG synthesis, and the protein FABP4 which transports intracellular lipids and is expressed in cell models of obesity-dependent liver disease. Additionally, TNF-α is a cytokine involved in the inflammatory process associated to NAFDL. Lampaya medicinalis Phil. (Verbenaceae) is a plant used in folk medicine in northern Chile to treat some inflammatory diseases. OBJECTIVE: To evaluate the effect of the hydroalcoholic extract of lampaya (HEL) on steatosis and the expression of inflammatory markers in hepatocytes treated with fatty acids. Study design: In vitro study in cultures of the human HepG2 cell line treated with oleic acid (OA) and palmitic acid (PA). METHODS: HepG2 hepatocytes were incubated with OA/PA for 24 hours in the presence and absence of HEL. The formation of LD and the accumulation of intracellular TG were assessed by Oil Red O and Nile Red, respectively. The expression of DGAT1/2, FABP4 and TNF-α was assessed by qPCR. RESULTS: The treatment with OA/PA increased the levels of LD and TG as well as the expression of DGAT2 in HepG2 hepatocytes compared to control cells. HEL cotreatment counteracted OA/PA-induced effects. CONCLUSIONS: HEL prevents the increase in LD and TG levels and DGAT2 expression induced by OA/PA in HepG2 cells. These findings suggest that lampaya may have a protective effect against hepatic steatosis, which would support its complementary use in the treatment of pathologies associated with inflammation, such as NAFLD.

Influence of weight gain on the lipid profile of adolescents / Influencia de la ganancia de peso sobre el perfil lipídico en adolescentes

The objective of this study was to assess the influence of weight gain on the lipid profile of 135 adolescents between 10 - 14 years at baseline and 15 - 19 years at follow-up, enrolled in public schools in Recife, Brazil. The results showed that a BMI z-score correlated with triglycerides (TG) and with high density trigliceride lipopoteine ratio (TG/HDL-c) in males. In females, high z-score correlated with total cholesterol (TC) and low density lipoprotein (LDL-c). In males, for each unit increase in z-score, TG increased by 14.7 mg/dL and the TG/HDL-c ratio increased by 0.4. Among females, TC increased by 9.4 mg/dL, LDL-c increased by 11.6 mg/dL, non-HDL cholesterol increased by 11.8 mg/dL, and HDL-c decreased by 2.3 mg/dL. In males, excessive weight gain was associated with an increase in TG and TG/HDL-c; in females, it was associated with a higher increase in TG/HDL-c and non-HDL cholesterol. However, z-score variation can be a good predictor of lipid profile changes, even in those that are within the normal range.

El objetivo de este estudio fue evaluar la influencia del aumento de peso en el perfil lipídico de 135 adolescentes de edades entre 10 y 14 años de edad al inicio del estudio y de 15 a 19 años en el seguimiento. Los adolescentes pertenecían a escuelas públicas de Recife, Brasil. Los resultados mostraron que el alto puntaje z de indice de masa corporase (IMC) correlacionaba con triglicéridos (TG) y con relación de triglicéridos con lipoproteínas de alta densidad (TG/HDL-c) en los hombres. En las mujeres, puntaje z de IMC se correlacionó con CT y lipoproteína de baja densidad (LDL-c). En los hombres, por cada unidad de aumento en el puntaje z, los TG aumentaron en 14,7 mg/dL y la relación TG / HDL-c aumentó en 0,4; en las mujeres, el CT aumentó en 9,4 mg/dL, el LDL-c aumentó en 11,6 mg/dL, el colesterol no HDL aumentó en 11,8 mg / dL y el HDL-c disminuyó en 2,3 mg/dL. En los hombres, el aumento de peso excesivo se asoció con un aumento de TG y TG/HDL-c; en las mujeres, con un aumento mayor en TG/HDL-c y colesterol no HDL. Sin embargo, la variación z-score puede ser un buen predictor de cambios en el perfil lipídico, incluso en aquellos que se encuentran dentro del rango normal.

High-fat diet augments ovariectomy-induced bone resorption in rats / Dieta rica en grasas aumenta la resorción ósea inducida por ovariectomía en ratas

Menopause complications such as cardiovascular and bone diseases represent a major public health concern. We sought to determine whether a high-fat diet (HFD) can augment ovariectomy-induced bone resorption in a rat model of menopause possibly via the upregulation of the inflammatory biomarkers and dyslipidemia. Rats were either ovariectomized and fed a standard laboratory chow (model group) or were ovariectomized and fed with a HFD for 15 weeks before being sacrificed. Ovariectomy significantly (p<0.05) increased body weight, dyslipidemia, insulin resistance, pro-inflammatory cytokines tumor necrosis factor-a (TNF-α) and interleukin-6 (IL-6), and biomarker of bone resorption, nuclear factor-kB (NF-kB), which were augmented by feeding animals with a HFD. This was confirmed through immunohistochemical study, where ovariectomy induced expression of p65/NF-kB protein in tibia bone sections of the model group, which were augmented by HFD. HFD augments ovariectomy-induced bone resorption through increased inflammatory biomarkers and NF-kB in rats.

Las complicaciones de la menopausia, como las enfermedades cardiovasculares y óseas, representan un importante problema de salud pública. Intentamos determinar si una dieta alta en grasas (HFD) puede aumentar la resorción ósea inducida por ovariectomía en un modelo de menopausia en ratas, a través de la regulación positiva de los biomarcadores inflamatorios y la dislipidemia. Las ratas fueron ovariectomizadas y alimentadas con una comida estándar de laboratorio (grupo modelo) o fueron ovariectomizadas y alimentadas con un HFD durante 15 semanas antes de ser sacrificadas. La ovariectomía aumentó significativamente (p <0,05) el peso corporal, dislipidemia, resistencia a la insulina, citocinas proinflamatorias, factor de necrosis tumoral a (TNF-α) e interleucina-6 (IL-6), y el biomarcador de resorción ósea, factor nuclear-kB (NF-kB), que se aumentaron alimentando animales con un HFD. Esto se confirmó a través del estudio inmunohistoquímico, donde la ovariectomía indujo la expresión de la proteína p65 / NF-kB en secciones de hueso de tibia del grupo modelo, que fueron aumentadas por HFD. HFD aumenta la resorción ósea inducida por ovariectomía a través del aumento de biomarcadores inflamatorios y NF-kB en ratas.

Sericin as treatment of obesity: morphophysiological effects in obese mice fed with high-fat diet / Sericina como tratamento da obesidade: efeitos morfofisiológicos de camundongos obesos por dieta hiperlipídica

ABSTRACT Objective To investigate the effects of sericin extracted from silkworm Bombyx mori cocoon on morphophysiological parameters in mice with obesity induced by high-fat diet. Methods Male C57Bl6 mice aged 9 weeks were allocated to one of two groups - Control and Obese, and fed a standard or high-fat diet for 10 weeks, respectively. Mice were then further subdivided into four groups with seven mice each, as follows: Control, Control-Sericin, Obese, and Obese-Sericin. The standard or high fat diet was given for 4 more weeks; sericin (1,000mg/kg body weight) was given orally to mice in the Control-Sericin and Obese-Sericin Groups during this period. Weight gain, food intake, fecal weight, fecal lipid content, gut motility and glucose tolerance were monitored. At the end of experimental period, plasma was collected for biochemical analysis. Samples of white adipose tissue, liver and jejunum were collected and processed for light microscopy analysis; liver fragments were used for lipid content determination. Results Obese mice experienced significantly greater weight gain and fat accumulation and had higher total cholesterol and glucose levels compared to controls. Retroperitoneal and periepididymal adipocyte hypertrophy, development of hepatic steatosis, increased cholesterol and triglyceride levels and morphometric changes in the jejunal wall were observed. Conclusion Physiological changes induced by obesity were not fully reverted by sericin; however, sericin treatment restored jejunal morphometry and increased lipid excretion in feces in obese mice, suggesting potential anti-obesity effects.

RESUMO Objetivo Investigar os efeitos da sericina extraída de casulos de Bombyx mori na morfofisiologia de camundongos com obesidade induzida por dieta hiperlipídica. Métodos Camundongos machos C57Bl6, com 9 semanas de idade, foram distribuídos em Grupos Controle e Obeso, que receberam ração padrão para roedores ou dieta hiperlipídica por 10 semanas, respectivamente. Posteriormente, os animais foram redistribuídos em quatro grupos, com sete animais cada: Controle, Controle-Sericina, Obeso e Obeso-Sericina. Os animais permaneceram recebendo ração padrão ou hiperlipídica por 4 semanas, período no qual a sericina foi administrada oralmente na dose de 1.000mg/kg de massa corporal aos Grupos Controle-Sericina e Obeso-Sericina. Parâmetros fisiológicos, como ganho de peso, consumo alimentar, peso das fezes em análise de lipídios fecais, motilidade intestinal e tolerância à glicose foram monitorados. Ao término do experimento, o plasma foi coletado para dosagens bioquímicas e fragmentos de tecido adiposo branco; fígado e jejuno foram processados para análises histológicas, e amostras hepáticas foram usadas para determinação lipídica. Resultados Camundongos obesos apresentaram ganho de peso e acúmulo de gordura significativamente maior que os controles, aumento do colesterol total e glicemia. Houve hipertrofia dos adipócitos retroperitoneais e periepididimais, instalação de esteatose e aumento do colesterol e triglicerídeos hepáticos, bem como alteração morfométrica da parede jejunal. Conclusão O tratamento com sericina não reverteu todas as alterações fisiológicas promovidas pela obesidade, mas restaurou a morfometria jejunal e aumentou a quantidade de lipídios eliminados nas fezes dos camundongos obesos, apresentando-se como potencial tratamento para a obesidade.

Avaliação prospectiva das repercussões no perfil lipídico das cirurgias que envolvem lipoaspiração e dermolipectomias / Prospective assessment of the repercussions on the lipid profile of surgeries involving liposuction and dermolipectomies

Introdução: Lipoaspiração associada a dermolipectomias é o procedimento cirúrgico mais comumente realizado em cirurgia plástica. Apesar de ser considerada uma cirurgia extremamente segura, algumas considerações devem ser levantadas a respeito dos possíveis efeitos metabólicos que essas cirurgias possam causar. O desenvolvimento da técnica tumescente de lipoaspiração permitiu a remoção de grande quantidade de gordura de modo mais seguro. O objetivo é comparar as variações do perfil lipídico em pós-operatório precoce e tardio de pacientes submetidos à lipoaspiração e dermolipectomias. Métodos: Entre outubro de 2006 e junho de 2012, 40 pacientes do sexo feminino candidatas a cirurgias que envolviam lipoaspiração e dermolipectomias foram acompanhadas prospectivamente e o perfil lipídico foi analisado por meio de exames no pré-operatório e no pós-operatório. As cirurgias realizadas foram: mamoplastia + lipoaspiração, abdominoplastia + lipoaspiração e lipoabdominoplastia + mamoplastia. Resultados: Das 40 pacientes que foram acompanhadas no estudo, 20 pacientes do sexo feminino foram selecionadas (após a aplicação dos critérios de exclusão). Em consonância com nosso estudo, Cazes, em 1996, demonstrou que após 12 meses de pós-operatório de lipoabdominoplastia não houve alteração do perfil lipídico das pacientes. Conclusão: Após análise pré- e pós-operatória de 20 pacientes, observamos que não há alterações estatísticas significantes em relação ao perfil lipídico com tendência de equilíbrio das aferições em um ano em patamares próximos aos observados no pré-operatório.

Introduction: Liposuction associated with dermolipectomies is the most commonly performed surgical procedure in plastic surgery. Although regarded as an extremely safe surgery, some considerations must be taken on the possible metabolic effects of these surgeries. The development of the tumescent technique in liposuction allowed the safer removal of large amounts of fat. The objective is to compare lipid profile variations in the early and late postoperative period in patients undergoing liposuction and dermolipectomies. Methods: Between October 2006 and June 2012, 40 female patients who were candidates for surgeries involving liposuction and dermolipectomies were prospectively followed, and the lipid profile was analyzed through preoperative and postoperative examinations. The surgeries performed were mammoplasty + liposuction, abdominoplasty + liposuction, and lipoabdominoplasty + mammoplasty. Results: Of the 40 female patients who were followed, 20 were selected (after applying the exclusion criteria). In agreement with our study, in 1996, Cazes showed that there were no changes in the lipid profile of patients 12 months after lipoabdominoplasty. Conclusion: After a preoperative and postoperative analysis of 20 patients, it was observed that there were no statistically significant changes in the lipid profile and that the measurements after 1 year were close to those obtained in the preoperative period.

Evaluation of the racial difference in body condition score and parameters of lipid metabolism in Purebred Arabian horses and Thoroughbred horses trained for racing / Avaliação da diferença racial na condição de escore corporal e parâmetros do metabolismo lipídico em cavalos Puro Sangue Árabes e Puro Sangue Ingleses treinados para corrida

This study investigated the existence of difference of fat deposition and lipid metabolism in horses with different races and skills that were used for the same kind of sport. 20 Purebred Arabian and 20 Thoroughbred horses trained for flat race were evaluated. The analyses performed were body condition score, weight and blood collected for determination of triglycerides, total cholesterol and non-esterified fatty acids. Ultrasonography of the thickness of the subcutaneous fat layer was performed on the Longissimus dorsi muscle between the 17th and 18th rib, the thickness of the subcutaneous fat layer on the Gluteus medius muscle using the acetabulum as reference, and the cross section of the same muscle. Race-trained Arabian horses showed greater fat layer deposition in the Gluteus medius and Longissimus dorsei muscles than Thoroughbred horses. These facts indicate that there is a metabolic difference, besides the phenotype, between the races. They also indicate the need to study specific physical conditioning programs for each kind of race.(AU)

Foi investigada a existência de diferença na deposição de gordura e no metabolismo lipídico em cavalos de duas raças distintas, com aptidões diferentes, porém, utilizadas para o mesmo esporte. Foram avaliados 20 cavalos Puro Sangue Árabe e 20 cavalos Puro Sangue Ingleses treinados para corrida. As avaliações foram escore de condição corporal, peso e colheita de sangue para determinação de triglicerídeos, colesterol total e ácidos graxos não esterificados. Foi realizada a ultrassonografia da espessura de camada de gordura subcutânea sobre o músculo Longissimus dorsi entre a 17º e 18º costela, a espessura de camada de gordura subcutânea sobre o músculo glúteo médio utilizando o acetábulo como referência e o corte transversal do mesmo músculo. Os cavalos Árabes de corrida apresentaram maior deposição de gordura na camada subcutânea dos músculos glúteo médio e Longissimus dorsei que os cavalos Puro Sangue Ingleses. Tais fatos indicam uma diferença racial que o treinamento, ainda que semelhante a todos, não foi capaz de igualar.(AU)

Valoración del riesgo cardiovascular en varones conductores profesionales del área mediterránea española y variables asociadas / Assessment of cardiovascular risk in male professional drivers of the Spanish mediterranean area and associated variables

INTRODUCCIÓN: El riesgo cardiovascular es una de las principales pre ocupaciones de los servicios de salud laboral. MATERIAL Y MÉTODOS: Se realiza un estudio retrospectivo y transversal en 2944 varones conductores profesionales (487 taxistas, 908 con ductores de autobús y 1549 conductores de camión) y se valoran diferentes variables relacionadas con riesgo cardiovascular. RESULTADOS: El 27,4% de los conductores son obesos, el 25% hiper tensos, un 48% presentan valores elevados de colesterol y un 29,5% triglicéridos altos, mientras la hiperglucemia aparece en el 6,5%. Un 15,8% cumplen los criterios de síndrome metabólico, un 2,6% presentan valores elevados en la escala REGICOR y un 7,9% en la escala SCORE. El riesgo elevado de padecer diabetes tipo 2 con la escala Findrisk aparece en el 13% de los conductores. CONCLUSIONES: Globalmente, el colectivo de taxistas es el que presenta peores resultados en todas las variables relacionadas con riesgo cardiovascular.

INTRODUCTION: Cardiovascular risk is one of the main concerns of occupational health services. MATERIAL AND METHODS: A retrospective and cross-sectional study was conducted in 2944 professional male drivers (487 taxi drivers, 908 bus drivers and 1549 truck drivers) and different variables related to cardiovascular risk were assessed. RESULTS: 27.4% of the drivers are obese, 25% hypertensive, 48% have high cholesterol and 29.5% high triglycerides, while hyperglycemia appears in 6.5%. 15.8% met the metabolic syndrome criteria, 2.6% presented high values on the REGICOR scale and 7.9% on the SCORE scale. The high risk of type 2 diabetes with the Findrisk scale appears in 13% of drivers. CONCLUSIONS: Globally the group of taxi drivers is the one that pres ents worse results in all the variables related to cardiovascular risk.

Alteración de los analitos medibles del síndrome metabólico en el laboratorio clínico en pacientes de consulta externa del cantón de Guápiles en el año 2015 / Alteration of measurable analytes of the metabolic syndrome in the clinical laboratory in outpatient patients of the canton of Guapiles in 2015

Resumen:Justificación: conocer el nivel de alteración de los componentes del síndrome metabólico en la población permite evaluar el riesgo de desarrollar diabetes mellitus tipo 2 y enfermedades cardiovasculares.Objetivo: comparar los valores sanguíneos de tres analitos del síndrome metabólico (triglicéridos, glucosa y colesterol HDL) en adultos de ambos sexos de Consulta Externa del Hospital de Guápiles, en el año 2015, con respecto a los valores de referencia según la NCEP ATP III.Métodos: se tomaron valores de glucosa, triglicéridos y colesterol HDL de la base de datos del Laboratorio del Hospital de Guápiles, del año 2015. Luego se procedió a determinar por sexo, por grupo de edad y en forma combinada (hombres y mujeres) la alteración, absoluta y porcentual, de cada analito con respecto a los valores de referencia de la NCEP ATP III. Además, se determinó el perfil de alteración (frecuencia absoluta y porcentaje) por sexo, por grupo de edad y combinado.Resultados: en las mujeres el HDL-C es el parámetro más alterado, con un 75.3% de las pacientes teniéndolo disminuido. Lo mismo sucede analizando por grupo de edad. En los hombres el parámetro más alterado es también el HDL-C (60.1 %), seguido de los triglicéridos (53.8 %). En las mujeres la alteración únicamente del HDL-C es la situación más común (31.1%), seguida de la alteración conjunta de TRG-HDL-C (22.6 %). En los hombres la situación se invierte: la alteración de TRG-HDL-C es la más frecuente (25.4 %), seguida de la de HDL-C (13.8 %).Discusión: los parámetros que más se alteraron fueron los lipídicos. Además, conforme aumentaba la edad se incrementaban el porcentaje de valores alterados y el porcentaje de pacientes con los tres analitos alterados. El aumento del sedentarismo, del sobrepeso y de la obesidad con la edad ayuda a explicar este fenómeno.

Abstract:Justification: Knowing the degree of alteration in the metabolic syndrome's components within the target population allows us to evaluate the risk of developing type 2 diabetes mellitus and cardiovascular diseases.Objective: To compare the blood values of three analytes of the metabolic syndrome (triglycerides, glucose, and HDL cholesterol) taken from adult outpatients from Hospital de Guápiles, from both sexes, during the year 2015, in accordance to the reference values of NCEP ATP III.Methods: Glucose, triglycerides, and HDL cholesterol values were taken from Hospital de Guápiles' Laboratory, belonging to the year 2015. The absolute and percentage alteration of each analyte was determined according to sex, age group, as well as in a joint manner (both men and women), following the reference values of NCEP ATP III.The alteration profile (absolute frequency and percentage) was also determined according to sex, age group, andin a joint manner.Results: HDL-C in women is the most altered parameter, with a 73% of the patients exhibiting it diminished. The same occurs when analyzing it by age group. In men the most altered parameter is also HDL-C (60.1%), followed by triglycerides (53.8%). The most common situation for women is the exclusive alteration of HDCL-C (3.1%), followed by the joint alteration of TRG-HDL-C (22.6%). For men it is rather the opposite: TRG-HDL-C is the most frequent (25.4), being followed by HDL-C (13-8%).Discussion: The most altered parameters were lipids. Also, as the age increased, so did the percentage of altered values, as well as the percentage of patients who had the three analytes altered. The age-related increase of a sedentary lifestyle, and overweight condition and obesity helps to explain this phenomenon.

Adiponectina determinaría el predominio de VLDL alteradas en el síndrome metabólico / Adiponectin would determine the predominance of altered VLDL in metabolic syndrome / Adiponectina iria determinar o predomínio de VLDL alteradas na síndrome metabólica

El objetivo del trabajo fue evaluar si la reducción de adiponectina (ADP) en el síndrome metabólico (SMet), influencia las características aterogénicas de VLDL. Se estudiaron 45 pacientes con SMet y 15 controles sanos. En suero en ayunas se midió perfil lipídico, ácidos grasos libres (AGL), ADP, se aisló VLDL (d<1,006 g/L) caracterizándola en su composición química y tamaño (HPLC-exclusión molecular). En plasma post-heparínico se determinó la actividad de lipoproteína lipasa (LPL). En SMet VLDL mostró incremento de masa, número de partículas, contenido en triglicéridos-VLDL y mayor proporción de VLDL grandes (p<0,05). El incremento de AGL correlacionó con la masa de VLDL (r=0,36; p=0,009), número de partículas-VLDL (r=0,45; p=0,0006) y %-VLDL grandes (r=0,32; p=0,02). SMet mostró descenso en ADP (7,4±4,8 vs. 15,5±7,2 μg/mL, p=0,01) y en actividad de LPL (p=0,01), que correlacionaron entre si (r=0,38; p=0,01; ajustado por HOMA-IR y cintura: β=0,35; p=0,02). ADP correlacionó negativamente con AGL y %-VLDL grandes (p<0,03). Se concluye que en SMet la disminución de ADP favorecería la secreción de VLDL sobre-enriquecidas en triglicéridos y de mayor tamaño, y además retardaría el catabolismo de VLDL mediado por LPL, resultando en la acumulación de VLDL alteradas en circulación con características aterogénicas.

The aim of the work was to evaluate whether the reduction of adiponectin (ADP) in metabolic syndrome (MetS) affects the atherogenic features of VLDL. A total of 45 patients with MetS (ATPIII) and 15 healthy controls were studied. In fasting serum, lipid profile, free fatty acids (FFA) and ADP were determined. VLDL was isolated (d<1.006 g/L) and characterized in chemical composition and size (size exclusion-HPLC). In post-heparin plasma, lipoprotein lipase (LPL) activity was measured. In MetS, VLDL showed increased total mass, particle number, VLDL-triglyceride content and higher large-VLDL proportion (p<0.05). The increase in FFA correlated with VLDL mass (r=0.36; p=0.009), VLDL particle number (r=0.45; p=0.0006) and large-VLDL proportion (r=0.32; p=0.02). MetS patients showed a decrease in ADP (7.4±4.8 vs. 15.5±7.2 μg/mL, p=0.01) and in LPL activity (p=0.01), that positively correlated between them (r=0.38; p=0.01; adjusted by HOMA-IR and waist: β=0.35; p=0.02). ADP inversely correlated with FFA and large-VLDL% (p<0.03). It can be concluded that in MetS, decreased ADP would favour the secretion of triglyceride over-enriched and larger VLDL particles, and also would delay VLDL catabolism mediated by LPL, resulting in the accumulation of altered VLDL with atherogenic characteristics.

O objetivo do trabalho foi avaliar se a redução da adiponectina (ADP) na síndrome metabólica (SM), afeta as características aterogênicas das VLDL. Foram estudados 45 indivíduos com SM e 15 controles saudáveis. Em jejum, foi medido em soro o perfil lipídico, ácidos graxos livres (AGL) e ADP. Foram isoladas as VLDL (d <1,006 g / L) caracterizando-as em relação a sua composição química e tamanho (HPLC- exclusão molecular). No plasma pós-heparina foi medida a atividade da lipoproteína lipase (LPL). Em indivíduos com SM, as VLDL apresentaram aumento de massa, número de partículas, conteúdo de triglicerídeos -VLDL e maior proporção de VLDL grandes (p<0,05). O aumento de AGL correlacionou com a massa de VLDL (r=0,36; p=0,009), número de partículas -VLDL (r=0,45; p=0,0006) e percentual -VLDL grandes (r=0,32; p=0,02). A SM mostrou uma diminuição em ADP (7,4±4,8 vs. 15,5±7,2 μg/mL, p=0,01) e em atividade de LPL (p=0,01), que correlacionaram entre eles (r=0,38; p=0,01; ajustada por HOMA-IR e cintura: β=0,35; p=0,02). A ADP correlacionou em forma negativa com AGL e %-VLDL grandes (p<0,03). A conclusão é que em indivíduos com SM, a diminuição da ADP iria favorecer a secreção de VLDL super-enriquecidas em triglicerídeos e de maior tamanho, e também atrasaria o catabolismo das VLDL mediado por LPL, resultando na acumulação de VLDL alteradas em circulação com características aterogênicas.

Valores de LDL-Colesterol Estimados pela Equação de Friedewald são Afetados pelo Controle do Diabetes / Low-Density Lipoprotein Values Estimated by Friedewald Equation are Affected by Diabetes Control

Fundamento: A equação de Friedewald (EF) é amplamente utilizada para estimar o LDL-c sem utilizar ultracentrifugação. Entretanto, a equação tem limitações em determinados cenários clínicos. Objetivo: O nosso objetivo era investigar a possível importância das diferenças entre a EF e a medição direta de LDL-c em pacientes com diabetes. Métodos: Realizamos um estudo transversal entre 466 pacientes com doença coronária estável. Colesterol total, triglicérides, HDL-c e LDL-c foram coletados, e a EF foi calculada. A acurácia foi calculada como percentagem de estimativas dentro de 30% (P30) do LDL medido. O viés foi calculado como a diferença média entre o LDL-c medido e o estimado. A concordância entre os métodos foi avaliada utilizando gráficos de Bland-Altman. Resultados: O viés foi de 3,7 (p=0,005) e 1,1 mg/dl (p=0,248), e a acurácia foi de 86% e 93% em pacientes diabéticos e não-diabéticos, respectivamente. Entre os pacientes com diabetes, o viés foi de 5 mg/dl (p=0,016) e 1,93 mg/dl (p=0,179), e a acurácia foi de 83% e 88% em indivíduos com hemoglobina A1c superior a 8 mg/dl versus abaixo do ponto de corte, respectivamente. O viés foi similar em pacientes sem diabetes comparados com pacientes com diabetes e HbA1C < 8 (1,1 e 1,93 mg/dl). Conclusão: A EF é imprecisa entre indivíduos gerais com diabetes. Porém, ao estratificar pacientes com diabetes em bom e mau controle da doença, o primeiro grupo se comporta como se não tivesse diabetes, com uma boa correlação entre o LDL-c calculado e o mensurado. É importante saber quando é razoável usar a EF, porque uma estimativa imprecisa dos níveis de LDL-c pode resultar no subtratamento da dislipidemia e predispor estes pacientes a eventos agudos

Background: Friedewald equation (FE) is widely used to estimate the LDL-c without the use of ultra-centrifugation. However, the equation has limitations in some clinical settings. Objective: Our goal was to investigate the potential importance of differences between FE and direct measurement of LDL-c in patients with diabetes. Methods: We conducted a cross-sectional study among 466 patients with stable coronary disease. Total cholesterol, triglycerides, HDL-c and LDL-c were collected, and FE was calculated. Accuracy was calculated as the percentage of estimates within 30% (P30) of measured LDL. Bias was calculated as the mean difference between measured and estimated LDL-c. Agreement between methods was evaluated using BlandAltman plots.Results: Bias was 3.7 (p=0.005) and 1.1 mg/dl (p=0.248), and accuracy was 86% and 93% in diabetic and non-diabetic patients, respectively. Among patients with diabetes, bias was 5 mg/dl (p=0.016) and 1.93 mg/dl (p=0.179), and accuracy was 83% and 88% in subjects with Hemoglobin A1C above 8 mg/dl versus below cutoff point, respectively. Bias was similar in patients without diabetes compared to patients with diabetes and HbA1C < 8 (1.1 and 1.93 mg/dl). Conclusion: FE is inaccurate among overall individuals with diabetes. However, when stratifying patients with diabetes into good and poor disease control, the first group behaves as if it does not have diabetes, with a good correlation between calculated and measured LDL-c.It is important to know when is it reasonable to use FE because an inaccurate estimation of LDL-c levels could result in undertreatment of dyslipidemia and predispose these patients to acute events

Somatotype characteristics of normal-weight and obese women among different metabolic subtypes

ABSTRACT Background Obesity is a well known risk factor for the development of metabolic abnormalities. However, some obese people are healthy and on the other hand some people with normal weight have adverse metabolic profile, therefore it can be assumed that there is a difference in physical characteristics amongst these people. The aim of this study was to establish whether there are somatotype differences between metabolically healthy and metabolically obese women who are obese or of normal weight. Subjects and methods Study included 230 women aged 44.76 ± 11.21y. Metabolic status was assessed according to IDF criteria, while somatotype was obtained using Heath & Carter method. Results Significant somatotype differences were observed in the group of women with normal-weight: metabolically healthy women had significantly lower endomorphy, mesomorphy and higher ectomorphy compared to metabolically obese normal-weight women (5.84-3.97-2.21 vs. 8.69-6.47-0.65). Metabolically healthy obese women had lower values of endomorphy and mesomorphy and higher values of ectomorphy compared to ‘at risk’ obese women but the differences were not statistically significant (7.59-5.76-0.63 vs. 8.51-6.58-0.5). Ectomorphy was shown as an important determinant of the favorable metabolic profile (cutoff point was 0.80). Conclusion We concluded that, in addition to fat mass, metabolic profile could be predicted by the structure of lean body mass, and in particular by body linearity.

Efeitos de fontes orgânicas de cobre e enxofre sobre os parâmetros bioquímicos no soro de ovinos / Effects of organic and inorganic copper and sulphur supplementation on blood biochemical parameters in sheep

Minerais são componentes essenciais na dieta, exercendo diversas funções no organismo animal onde o uso de sais orgânicos visa aumentar a disponibilidade dos inerais no trato digestório. O perfil metabólico auxilia na avaliação de índices produtivos, para tanto, se faz análises de componentes bioquímicos do sangue. O objetivo foi estudar os efeitos que fontes orgânicas e inorgânicas de cobre e enxofre possuem nos parâmetros bioquímicos. O experimento foi realizado na FZEA/USP, para tanto 40 ovinos foram distribuídos em 10tratamentos: 1) dieta basal; 2) dieta contendo Mo; 3) dieta basal+ Cu inorg + S inorg; 4) dieta basal + Cu inorg + S org; 5) dieta basal + Cu org + S inorg; 6) dieta basal + Cu org + S org; 7) dieta com Mo + Cu inorg + S inorg; 8) dieta com Mo + Cu inorg + S org; 9) dieta com Mo + Cu org + S inorg; 10) dieta com Mo + Cu org + S org. De acordo com cada tratamento houve a inclusão de 10mgkg-1 de MS de Cu inorgânico ou orgânico ou 10 mg kg-1 de MS de Mo ou 0,2% de S inorgânico ou orgânico. Os animais receberam dieta única duas vezes ao dia com inclusão de volumoso num total de 3% do peso vivo. O experimento teve duração de 84 dias, com coletas a cada 28 dias para estudo de glicose, ureia, albumina, colesterol, triglicerídeos. Os parâmetros foram analisados com estrutura fatorial 2 x 2 x 2 (com e sem Mo, Cu orgânico e inorgânico e S orgânico e inorgânico) e uma dieta basal e uma basal mais molibdênio, em delineamento inteiramente casualizado, com um nível de significância de 5%. Os teores séricos de glicose, ureia, albumina e colesterol não apresentaram diferença significativa entre tratamentos e tempo, tão pouco foram influenciados (p>0.05) pelos tratamentos, sendo as médias 64,8mg dl-1; 30,0mg dl-1; 2,78mg L-1; 72,2mg dl-1respectivamente, apresentando-se dentro da normalidade. Os teores de triglicerídeos nos tratamentos (28.8; 34.8; 30.8; 36.9; 34.3; 27.0; 31.6; 32.1; 34.6; 31.1mg dl-1) foram influenciados pela interação Cu x S...

Minerals are essential components in the diet, exercising various functions in the animal. There are many studies to find better results for the organic sources of minerals, and one of the reasons for that is to avoid the negative interactions. The metabolic profile helps in assessment of production indices, therefore analyzes blood biochemical components. The objective of this study was to investigate the effects of organic and inorganic copper and sulphur supplementation on blood biochemical parameters in sheep. The experiment was conducted at the FZEA/USP. Total 40 weaned sheep were divided in a completely randomized design with 10 treatments: 1) basal diet; 2) basal diet plus Mo; 3) basal diet + inorganic Cu + inorganic S; 4) basal diet + inorganic Cu + organic S; 5) basal diet + organic Cu + inorganic S; 6) basal diet + organic Cu + organic S; 7) diet plus Mo + inorganic Cu + inorganic S; 8) diet plus Mo + inorganic Cu + organic S; 9) diet plus Mo + organic Cu + inorganic S; 10) diet plus organic Cu + organic S. According each treatment was added 10mg kg-1 MS inorganic or organic Cu or 10mg kg-1 MS Mo or 0.2% S inorganic or organic. The animals were fed twice a day, a total of 3% of body weight. The experiment lasted 84 days, blood was sampled every 28 days to study glucose, urea, albumin, cholesterol and triglycerides. The parameters were analyzed with factorial structure 2 x 2 x 2 (with and without Mo, organic and inorganic Cu and organic and inorganic S) and a basal diet and a basal diet plus Mo, with 5% significance. Serum levels of glucose, urea, albumin and cholesterol showed no significant difference between treatment and time (p> 0.05). It observed means of 64.8mg dl- 1; 30.0mg dl -1; 2.78mg L -1; 72.2mg dl- 1 respectively for glucose, urea, albumin and cholesterol. Serum levels of triglycerides in the treatments (28.8; 34.8; 30.8; 36.9; 34.3; 27.0; 31.6; 32.1; 34.6; 31.1mg dl- 1) were influenced by interaction Cu x S, triglycerides decreased...

Metabolic effects of high sucrose and saturated oil feeding on insulin resistance in Sprague-Dawley rats.

In this study, we explored the effects of long-term consumption of a high-sugar high-fat diet on glucose tolerance and insulin resistance in rats. Rats were fed with either standard rat chow diet (NC group) or high-sugar high-fat diet (HSHF group) for 16 weeks. The HSHF group showed significantly higher fasting insulin level than NC group. Following intraperitoneal glucose challenge, blood glucose and insulin levels in the NC and HSHF groups increased. However, the magnitude of the response in NC group was low compared to HSHF group. Insulin resistance was higher in HSHF group and insulin sensitivity decreased significantly (P <0.05) in HSHF group in contrast to NC group. Low-density lipoprotein-cholesterol (LDL-C) and triglyceride (TG)/high-density lipoprotein-cholesterol (HDL-C) levels showed significant increase in HSHF group, while triglyceride and total cholesterol levels did not show any difference. The study demonstrated that feeding high-sugar high-fat diet to the experimental Sprague-Dawley rats for 16 weeks increased possibility of insulin resistance in them but did not turn them hyperglycemic or diabetic. Thus, they prove to be a suitable animal model to explore various aspects of insulin resistance.

Serum lipoprotein ratios as markers of insulin resistance: A study among non-diabetic acute coronary syndrome patients with impaired fasting glucose.

Background & objectives: Recent data suggest that insulin resistance can predict cardiovascular disease independently of the other risk factors, such as hypertension, visceral obesity or dyslipidaemia. However, the majority of available methods to evaluate insulin resistance are complicated to operate, expensive, and time consuming. This study was undertaken to assess whether serum lipoprotein ratios could predict insulin resistance in non-diabetic acute coronary syndrome (ACS) patients. Methods: Ninety non-diabetic patients with impaired fasting glucose admitted with a diagnosis of ACS were included in the study. At the time of admission fasting glucose and insulin concentrations were measured. The homeostatic model assessment-insulin resistance (HOMA-IR) was used for insulin resistance. The fasting serum total cholesterol (TC), triglycerides (TG) and high density lipoprotein cholesterol (HDL-C) levels were checked, and then TC/HDL-C and TG/HDL-C ratios were calculated. The areas under the curves (AUC) of the receiver operating characteristic (ROC) curves were used to compare the power of these serum lipoprotein ratios as markers. Results: Lipoprotein ratios were significantly higher in patients with HOMA-IR index > 2.5 as compared to patients with index <2.5 (P < 0.05). Both TG/HDL-C and TC/HDL-C ratios were significantly correlated with HOMA-IR (P<0.05). The area under the ROC curve of the TG/HDL-C and TC/HDL-C ratio for predicting insulin resistance was 0.80 (95% CI, 0.67 to 0.93), 0.78 (95% CI, 0.65 to 0.91), respectively. Interpretation & conclusions: The findings of this study demonstrate that serum lipoprotein ratios can provide a simple means of identifying insulin resistance and can be used as markers of insulin resistance and cardiovascular diseases risk in adult non-diabetic patients.

Antioxidant and anti hyperglycemic role of wine grape powder in rats fed with a high fructose diet

BACKGROUND: Metabolic syndrome is a growing worldwide health problem. We evaluated the effects of wine grape powder (WGP), rich in antioxidants and fiber, in a rat model of metabolic syndrome induced by a high fructose diet. We tested whether WGP supplementation may prevent glucose intolerance and decrease oxidative stress in rats fed with a high fructose diet. METHODS: Male Sprague-Dawley rats weighing 180 g were divided into four groups according to their feeding protocols. Rats were fed with control diet (C), control plus 20 % WGP (C + WGP), 50 % high fructose (HF) or 50 % fructose plus 20 % WGP (HF + WGP) for 16 weeks. Blood glucose, insulin and triglycerides, weight, and arterial blood pressure were measured. Homeostasis model assessment (HOMA) index was calculated using insulin and glucose values. A glucose tolerance test was performed 2 days before the end of the experiment. As an index of oxidative stress, thio-barbituric acid reactive substances (TBARS) level was measured in plasma and kidney, and superoxide dismutase was measured in the kidney. RESULTS: Thiobarbituric acid reactive substances in plasma and renal tissue were significantly higher when compared to the control group. In addition, the area under the curve of the glucose tolerance test was higher in HF fed animals. Furthermore, fasting blood glucose, plasma insulin levels, and the HOMA index, were also increased. WGP supplementation prevented these alterations in rats fed with the HF diet. We did not find any significant difference in body weight or systolic blood pressure in any of the groups. CONCLUSIONS: Our results show that WGP supplementation prevented hyperglycemia, insulin resistance and reduced oxidative stress in rats fed with HF diet. We propose that WGP may be used as a supplement in human food as well.

Lipoaspiração: atualização dos fatores de riscos metabólicos e sua importância clínico-cirúrgica / Liposuction: an actualization of the risk factors and their clinical and surgical relevance

A lipoaspiração permanece como um dos procedimentos mais realizados pelos cirurgiões plásticos (1-3). O aumento da segurança no ambiente cirúrgico, o refinamento da técnica e a satisfação das pacientes contribuem para a popularidade desta intervenção idealizada por Ilouz, em 1979 (4). Tem-se observado, ainda, tanto no ambiente médico quanto na mídia, uma crescente preocupação não apenas com a nova forma dos pacientes, mas também com a segurança. O tecido adiposo atua como um verdadeiro órgão endócrino e é o principal depósito de triglicerídeos, que têm uma relação clássica com doença aterosclerótica e resistência insulínica (6, 7). Estudos recentes ligaram ainda o metabolismo lipídico dos adipócitos à manutenção de um estado inflamatório sistêmico de baixo grau, através de vários mediadores (8-10). Há evidências científicas (11) que mostram o aumento do percentual de obesos em nosso país e uma importante taxa de pessoas, com sobrepeso. Este estudo também relaciona a prevalência de diabetes e de hipertensão. A clássica inter-relação entre a quantidade de gordura corporal e as chamadas doenças metabólicas tem suscitado a investigação dos elementos envolvidos neste processo e de tratamentos para o controle dos mesmos. A descoberta da leptina na década de 1990 (12) chamou a atenção para a propriedade reguladora do tecido adiposo. Estudos posteriores (5, 13) relacionaram ainda a síntese de outros fatores. Decidimos fazer uma revisão da literatura para esclarecer o estágio atual das pesquisas, tentando ordená-las de forma didática para melhor compreensão e auxílio para uma conduta mais segura e eficiente nos pacientes submetidos à lipoaspiração.

Liposuction is one of the most frequently performed procedures by plastic surgeons. The increased safety associated with the surgical settings, technical refinements, and level of patient satisfaction have contributed to the popularity gained by this intervention since it was first introduced by Ilouz in 1979 (4). Moreover, among medical communities and the media, concerns have risen regarding not only the drastic changes in patients' appearance but also the safety of the procedure. Fat tissue is known to act as a legitimate endocrine organ (5), being the primary depository for triglycerides, which classically relate to atherosclerosis and insulin resistance (6, 7). Recent work has linked lipid metabolism in adipocytes to the maintenance of low levels of systemic inflammation through a series of mediators (8-10). Scientific evidence (11) revealed an increase in the percentage of obese people in our country, as well as a considerable proportion of overweight people. This study also investigates the relationship between the prevalence of diabetes and hypertension. The classic association between body mass index and common metabolic diseases has led to investigations focused on several factors involved in this relationship, along with research work directed at the treatments available. The discovery of leptin in the 1990s (12) highlights the regulatory properties of the adipose tissue, whereas recent studies (5, 13) have established a link with the synthesis of other factors. In this study, we aimed to perform a review of literatures that discuss the current state-of-the-art of scientific research, in which we organized published works in a didactic manner in order to facilitate better understanding, and promote the safety and efficacy of liposuction.

Association of serum total bilirubin levels with diastolic dysfunction in heart failure with preserved ejection fraction

BACKGROUND: Left ventricular diastolic dysfunction is one of the main characteristics of heart failure patients with a preserved left ventricular ejection fraction. As bilirubin is regarded as an important endogenous antioxidant molecule, serum total bilirubin levels were compared between heart failure patients with a preserved left ventricular ejection fraction and normal controls in this study. We recruited 327 heart failure patients with a preserved left ventricular ejection fraction and 200 healthy controls. Patients were divided into 4 subgroups by their comprehensive echocardiographic manifestations, 1-mild, 2-moderate, 3-severe (reversible restrictive), 4-severe (fixed restrictive). Total bilirubin levels were compared using stepwise multiple regressions adjusted for selected factors. RESULTS: After adjusting for gender, age, smoking, systolic blood pressure, diastolic blood pressure, total cholesterol and triglyceride, serum total bilirubin levels were significantly lower in the heart failure group compared with the control group (P < 0.01). Patients in the subgroup (4-severe) showed significantly (P < 0.05) lower levels of total bilirubin when compared with the subgroup (1-mild). CONCLUSIONS: TB level was negatively correlated with left ventricular diastolic dysfunction in heart failure patients with a preserved left ventricular ejection fraction, which might provide a new insight into the complicated mechanisms of heart failure with a preserved left ventricular ejection fraction.

Effect of Bilirubin on Triglyceride Synthesis in Streptozotocin-Induced Diabetic Nephropathy

We aimed to elucidate the effect of bilirubin on dyslipidemia and nephropathy in a diabetes mellitus (DM) type I animal model. Sprague-Dawley rats were separated into control, DM, and bilirubin-treated DM (Bil) groups. The Bil group was injected intraperitoneally with 60 mg/kg bilirubin 3 times per week and hepatoma cells were cultured with bilirubin at a concentration of 0.3 mg/dL. The Bil group showed lower serum creatinine levels 5 weeks after diabetes onset. Bilirubin treatment also decreased the amount of mesangial matrix, lowered the expression of renal collagen IV and transforming growth factor (TGF)-beta1, and reduced the level of apoptosis in the kidney, compared to the DM group. These changes were accompanied by decreased tissue levels of hydrogen superoxide and NADPH oxidase subunit proteins. Bilirubin decreased serum total cholesterol, high-density lipoprotein cholesterol (HDL-C), free fatty acids, and triglycerides (TGs), as well as the TG content in the liver tissues. Bilirubin suppressed protein expression of LXRalpha, SREBP-1, SCD-1, and FAS, factors involved in TG synthesis that were elevated in the livers of DM rats and hepatoma cells under high-glucose conditions. In conclusion, bilirubin attenuates renal dysfunction and dyslipidemia in diabetes by suppressing LXRalpha and SREBP-1 expression and oxidative stress.