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1.
Braz. j. biol ; 83: 1-8, 2023. tab, ilus, graf
Article in English | LILACS, VETINDEX | ID: biblio-1469007

ABSTRACT

Consuming a high-fat diet causes a harmful accumulation of fat in the liver, which may not reverse even after switching to a healthier diet. Different reports dealt with the role of purslane as an extract against high-fat diet; meanwhile, it was necessary to study the potential role of fresh purslane as a hypolipidemic agent. This study is supposed to investigate further the potential mechanism in the hypolipidemic effect of fresh purslane, by measuring cholesterol 7a-hydroxylase (CYP7A1) and low-density lipoprotein receptor (Ldlr). Rats were divided into two main groups: the first one is the normal control group (n=7 rats) and the second group (n=28 rats) received a high fat diet for 28 weeks to induce obesity. Then the high fat diet group was divided into equal four subgroups. As, the positive control group still fed on a high fat diet only. Meanwhile, the other three groups were received high-fat diet supplemented with a different percent of fresh purslane (25, 50 and 75%) respectively. At the end of the experiment, rats were sacrificed and samples were collected for molecular, biochemical, and histological studies. Current study reported that, supplementation of fresh purslane especially at a concentration of 75% play an important role against harmful effects of high-fat diet at both cellular and organ level, by increasing CYP7A1 as well as Ldlr mRNA expression. Also, there were an improvement on the tested liver functions, thyroid hormones, and lipid profile. Fresh purslane plays the potential role as a hypolipidemic agent via modulation of both Ldlr and Cyp7A, which will point to use fresh purslane against harmful effects of obesity.


O consumo de uma dieta rica em gordura causa um acúmulo prejudicial de gordura no fígado, que pode não reverter mesmo após a mudança para uma dieta mais saudável. Diferentes relatórios trataram do papel da beldroega como um extrato contra uma dieta rica em gordura; entretanto, foi necessário estudar o papel potencial da beldroega fresca como agente hipolipemiante. Este estudo pretende investigar mais profundamente o mecanismo potencial no efeito hipolipidêmico da beldroega fresca, medindo o colesterol 7a-hidroxilase (CYP7A1) e o receptor de lipoproteína de baixa densidade (Ldlr). Os ratos foram divididos em dois grupos principais: o primeiro é o grupo controle normal (n = 7 ratos) e o segundo grupo (n = 28 ratos) recebeu dieta rica em gorduras por 28 semanas para induzir a obesidade. Em seguida, o grupo de dieta rica em gordura foi dividido em quatro subgrupos iguais. Como, o grupo de controle positivo ainda se alimentava apenas com dieta rica em gordura. Enquanto isso, os outros três grupos receberam dieta rica em gordura suplementada com diferentes porcentagens de beldroegas frescas (25%, 50% e 75%), respectivamente. Ao final do experimento, os ratos foram sacrificados e amostras coletadas para estudos moleculares, bioquímica e histológicos. O estudo atual relatou que a suplementação de beldroegas frescas, especialmente a uma concentração de 75%, desempenha papel importante contra os efeitos prejudiciais da dieta rica em gordura em nível celular e orgânico, aumentando a expressão de CYP7A1 e Ldlr mRNA. Além disso, houve melhora nas funções hepáticas testadas, nos hormônios tireoidianos e no perfil lipídico. Beldroegas frescas desempenham papel potencial como agente hipolipemiante por meio da modulação de Ldlr e Cyp7A, o que apontará para o uso de beldroegas frescas contra os efeitos nocivos da obesidade.


Subject(s)
Animals , Rats , Diet, High-Fat , Fatty Liver/drug therapy , Fatty Liver/veterinary , Obesity/drug therapy , Portulaca , Mice, Obese
2.
Hepatología ; 4(1): 75-89, 2023. fig
Article in Spanish | LILACS, COLNAL | ID: biblio-1415978

ABSTRACT

La interrupción de la simbiosis que existe entre el cuerpo humano y su microbioma puede resultar en una disbiosis, un desequilibrio en la interacción huésped-microbiota, que puede asociarse al desarrollo de diversas enfermedades como el síndrome de intestino irritable, hígado graso no alco-hólico, enfermedad hepática alcohólica y cirrosis, entre otras. En ciertas condiciones patológicas y por múltiples factores de riesgo, la capacidad de autorregulación del intestino se puede alterar, contribuyendo al incremento de la permeabilidad con inflamación intestinal crónica. El diagnóstico y el tratamiento, así como la relación entre la permeabilidad intestinal, la disbiosis y las patologías gastrointestinales y hepatobiliares, todavía no tienen estudios clínicos validados o con el soporte científico adecuado, por lo que se realiza una revisión de la literatura con la finalidad de aportar conceptos que puedan orientar con respecto a la importancia del estudio del microbioma humano en estas enfermedades.


Disruption of the symbiosis that exists between the human body and its microbiome can result in dys-biosis, an imbalance in the host-microbiota interaction, which may be associated with the develop-ment of various diseases such as irritable bowel syndrome, non-alcoholic fatty liver disease, alcoholic liver disease and cirrhosis, among others. In certain pathological conditions and due to multiple risk factors, the self-regulating capacity of the intestine may be lost, contributing to increased permeability with chronic intestinal inflammation. Its diagnosis and treatment as well as the relationship between intestinal permeability, dysbiosis and gastrointestinal and hepatobiliary pathologies have not been validated in clinical studies or have adequate scientific support, so a review of the literature is carried out in order to provide concepts that can guide with respect to the importance of the study of the human microbiome in these diseases


Subject(s)
Humans , Permeability , Dysbiosis , Microbiota , Gastrointestinal Microbiome , Risk Factors , Irritable Bowel Syndrome , Fatty Liver , Non-alcoholic Fatty Liver Disease , Gastrointestinal Diseases , Liver Diseases, Alcoholic
3.
Rev. Ciênc. Méd. Biol. (Impr.) ; 21(3): 562-568, 20221229. tab
Article in Portuguese | LILACS | ID: biblio-1416293

ABSTRACT

Introdução: o consumo de álcool é um fator de risco bem conhecido para induzir doença crônica do fígado. O álcool também é um cofator na patogênese induzida pelo vírus da hepatite C (VHC). A infecção crônica pelo VHC pode exacerbar a lesão hepática alcoólica por mecanismos que incluem aumento do estresse oxidativo. Portanto o VHC, concomitantemente com o consumo excessivo de álcool, induz diversos mecanismos fisiopatogênicos que contribuem para a diminuição da depuração viral e para a lesão hepática. Objetivos: 1 ­ avaliar a frequência de esteato-hepatite alcoólica em biópsias de pacientes portadores do vírus da hepatite C; 2 ­ estudar os estágios da fibrose hepática nesses pacientes versus pacientes com e sem ingestão de álcool; 3 ­ analisar os escores bioquímicos e antropométricos desses pacientes. Metodologia: estudo de corte transversal, com pacientes acompanhados no núcleo de hepatologia do Hospital Prof. Edgard Santos da Universidade Federal da Bahia, portadores de hepatite C, com laudos de biópsias disponíveis para avaliar presença de esteato-hepatite alcoólica comprovada pelo registro de consumo de gramas de álcool. Foram considerados etilistas homens que consumiam mais de 30 g por dia e mulheres com consumo maior do que 20 g por dia. As variáveis utilizadas basearam-se em critérios histológicos, epidemiológicos e clínicos aplicados a esses pacientes. Resultados: a amostra total de pacientes portadores de hepatite C analisados foi de 335, sendo 100 indivíduos considerados com ingestão elevada de álcool, e 28,9% dos casos da amostra. A presença de esteatose hepática sem esteato-hepatite foi em 34 indivíduos (10,15%), e os casos de esteato-hepatite aparecem em um total de 30 indivíduos (8,96%). A carga viral elevada dos pacientes, tendo como referência >800.000, esteve em n=102, com 30,4% dos casos de VHC. Conclusão: observou-se, na população de estudo, 43 % os portadores de VHC com uso excessivo de alcool, 8,9 6% tinham esteato-hepatiits e 10,15 % esteatose. Além disso, verificou-se que mais da metade desses pacientes (56,6%) apresentaram grau de fibrose moderada e 53,3%, atividade necroinflamatória leve. A comorbidade mais comum observada foi hipertensão arterial sistêmica (HAS), em 40% dos pacientes.


Introduction: alcohol consumption is a well-known risk factor for inducing chronic liver disease, alcohol is also a cofactor in the pathogenesis induced by Hepatitis C Virus (HCV). Chronic HCV infection can exacerbate alcoholic liver damage by mechanisms including increased oxidative stress. Therefore, HCV, concomitantly with excessive alcohol consumption, induces several pathophysiological mechanisms, which contribute to the decrease in viral clearance and liver damage. Objectives: 1 ­ to assess the frequency of alcoholic steatohepatitis in biopsies of patients with the hepatitis C virus, 2 ­ to study the stages of liver fibrosis in these patients versus in patients with or without alcohol intake, 3 ­ analyze biochemical and anthropometric scores of these patients. Methodology: cross-sectional study, with patients monitored at the hepatology center of Hospital Prof. Edgard Santos from the Federal University of Bahia, carriers of hepatitis C with biopsy reports available to assess the presence of alcoholic steatohepatitis proven by recording the consumption of grams of alcohol, considered an alcoholic being a man, who consumed more than 30 g per day and being woman more than 20g a day. The variables used were based on histological, epidemiological and clinical criteria applied to these patients. Results: the total sample of patients with hepatitis C analyzed was (n=335), with n=100 individuals considered to have high alcohol intake, and 28.9% of the cases in the sample. The presence of hepatic steatosis without steatohepatitis was in 34 individuals (10.15%), and cases of steatohepatitis appear in a total of n=30 individuals (8.96%).The high viral load of patients, with >800,000 as reference, was n=102, with 30.4% of cases of HCV. Conclusion: it was observed, in the study population, 43% of HCV carriers with excessive alcohol use, 8.96% had steatohepatitis and 10.15% steatosis. Furthermore, it was found that more than half of these patients (56.6%) had a moderate degree of fibrosis and 53.3% had mild necroinflammatory activity. The most common comorbidity observed was systemic arterial hypertension (SAH), in 40% of patients.


Subject(s)
Humans , Male , Female , Fibrosis , Hepatitis C , Hepacivirus , Ethanol , Fatty Liver , Binge Drinking , Liver , Liver Cirrhosis , Epidemiology, Descriptive , Cross-Sectional Studies
4.
Rev. urug. cardiol ; 37(1): e702, jun. 2022. tab
Article in Spanish | LILACS, UY-BNMED, BNUY | ID: biblio-1390041

ABSTRACT

La preeclampsia se puede asociar a una patología poco frecuente como es el hígado graso agudo del embarazo. Se reporta el caso clínico de una paciente de 35 años, tercigesta, cursando embarazo gemelar que presenta preeclampsia con elementos de gravedad, asociada a hígado graso agudo del embarazo. Se realiza diagnóstico y tratamiento precoz de ambas patologías, presentando buena evolución materno-fetal.


Preeclampsia can be associated with acute fatty liver of pregnancy, a rare disease. This report describes the case of a 35-year-old patient, gravida 3, pregnant with twins, who presented with severe pre-eclampsia associated with acute fatty liver of pregnancy. Early diagnosis and treatment of both pathologies was performed, resulting in good maternal-fetal evolution.


A pré-eclâmpsia pode estar associada a uma patologia rara, como o fígado gorduroso agudo da gravidez. Neste relato, apresentamos uma paciente de 35 anos, terciária, em gestação gemelar, apresentando pré-eclâmpsia grave, associada a esteatose hepática aguda na gestação. É realizado diagnóstico e tratamento precoces de ambas as patologias, apresentando boa evolução materno-fetal.


Subject(s)
Humans , Female , Pregnancy , Adult , Pre-Eclampsia/diagnosis , Fatty Liver/diagnosis , Pre-Eclampsia/therapy , Pregnancy Complications/diagnosis , Pregnancy Complications/therapy , Cesarean Section , Acute Disease , Hepatic Insufficiency/diagnosis , Hepatic Insufficiency/therapy , Renal Insufficiency/diagnosis , Renal Insufficiency/therapy , Fatty Liver/therapy , Pregnancy, Twin
5.
Rev. colomb. gastroenterol ; 37(1): 24-32, Jan.-Mar. 2022. tab, graf
Article in English | LILACS | ID: biblio-1376902

ABSTRACT

Abstract Introduction: Cirrhosis is the final stage of chronically progressive liver diseases of various etiologies. It is a common disease, with a variable prevalence in each country. Its peak incidence occurs between 40 and 50 years of age, predominantly in men. Aims: To compare a cohort of patients diagnosed with cirrhosis, evaluate their complications and survival according to etiology, describe clinical and laboratory aspects, and determine the role of a fatty liver. Materials and methods: A retrospective cohort study was carried out with patients who held a specialized hepatology consultation in the center of liver and digestive diseases (CEHYD) in Bogotá, Colombia, between January 2010 and June 2019. Results: We reviewed a total of 1,200 medical records (56.8 % women). There were no statistically significant differences in median survival between groups by etiology, sex, presence or absence of complications, or Child. We noted that the older the age at the diagnosis of cirrhosis, the higher the risk of death; HR 1.04 (95 % CI 1.02-1.075). For each month that follow-up increases, the risk of death decreases by 90 %; HR 0.1 (95 % CI 0.03-0.29). For each month that the follow-up of complications increases, the risk of death is reduced by 2 %; HR 0.98 (95 % CI 0.97-0.99). Conclusions: Survival by etiology was similar in the different groups. Nonalcoholic steatohepatitis (NASH) was the leading cause of cirrhosis in this cohort. Efforts should focus on its diagnosis and management in the early stages.


Resumen Introducción: la cirrosis es el estadio final de enfermedades hepáticas crónicamente progresivas de diferentes etiologías. Es una enfermedad frecuente, con una prevalencia variable en cada país. Su pico de incidencia se presenta entre los 40 y 50 años, predominantemente en hombres. Objetivos: comparar una cohorte de pacientes con diagnóstico de cirrosis, evaluar sus complicaciones y sobrevida de acuerdo con su etiología, describir los aspectos clínicos y de laboratorio, y determinar el papel del hígado graso. Materiales y métodos: se realizó un estudio de cohorte retrospectiva, en donde se incluyeron pacientes que asistieron a consulta especializada de hepatología en el centro de enfermedades hepáticas y digestivas (CEHYD), en la ciudad de Bogotá, durante enero de 2010 y junio de 2019. Resultados: se revisaron un total de 1200 historias clínicas (56,8 % mujeres). No se evidenció diferencias estadísticamente significativas en las medianas de sobrevida entre los grupos por etiologías, sexo, presencia o no de complicaciones, o Child. Se evidenció que entre mayor edad en el diagnóstico de cirrosis, el riesgo de muerte es mayor; HR 1,04 (IC 95 % 1,02-1,075). Por cada mes que aumenta el seguimiento se reduce el riesgo de muerte en 90 %; HR 0,1 (IC 95 % 0,03-0,29). Por cada mes que aumenta el seguimiento de las complicaciones se reduce el riesgo de muerte en 2 %; HR 0,98 (IC 95 % 0,97-0,99). Conclusiones: La sobrevida por etiología fue similar en los diferentes grupos. La esteatohepatitis no alcohólica (NASH) fue la principal causa de cirrosis en esta cohorte. Se deben orientar esfuerzos a su diagnóstico y manejo en fases tempranas.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Survival , Fibrosis , Fatty Liver , Non-alcoholic Fatty Liver Disease , Patients , Medical Records , Disease , Incidence , Cohort Studies , Death , Liver Diseases
7.
Article in Chinese | WPRIM | ID: wpr-927896

ABSTRACT

Objective: To investigate the effects of continuous exercise training (CT) and high-intensity interval exercise training (HIIT) on liver lipid metabolism and the correlation of the level of fibroblast growth factor 21(FGF21) in serum and liver tissues. Methods: Male SD rats were randomly divided into normal diet group (N) and obesity model group (H) after 1 week of adaptive feeding. Rats in the obesity model group were fed with 45% high-fat diet for about 8 weeks, and 20% weight increase compared with normal rats was considered as obesity. The rats were divided into normal diet control group (LC), normal diet HIIT group (LHI), normal diet CT group (LCT), High fat diet-induced obese control group (OC), obese HIIT group (OHI), and obese CT group (OCT) (n=10). Exercised rats were given weight-bearing swimming training intervention for 8 weeks. Blood samples were collected at least 24h after the last exercise intervention to detect the serum levels of inflammatory factors and FGF21. Liver tissue samples were collected to detect the lipid content, lipid metabolic enzyme content and FGF21 expression level. Results: Compared with LC group, the body weight, serum inflammatory factors levels and hepatic triglyceride content were increased significantly (P<0.05). Hepatic triglyceride content was downregulated in LHI group and FGF21 expression level was enhanced in LCT group (P<0.05). Compared with OC group, the body weight and hepatic triglyceride content were decreased significantly (P<0.05), mitochondrial CPT-1β and β-HAD enzyme contents in liver were increased significantly (P<0.05) in OHI group, the contents of LPL and FAT/CD36 enzyme in liver and the levels of FGF21 in serum and liver of OCT group were increased significantly (P<0.05). Conclusion: Both exercise modes can reduce the body weight in normal and obese rats, and lipid deposition in the liver of obese rats. HIIT has a more significant effect on alleviating liver lipid deposition in obese rats by upregulating mitochondrial lipid oxidation level in normal and obese rats. CT improves the levels of FGF21 in serum and liver tissues of normal and obese rats, enhances enzyme contents that involved in fatty acids uptake to the liver, which has limited effect on alleviating lipid deposition in liver of obese rats.


Subject(s)
Animals , Male , Rats , Body Weight , Diet, High-Fat/adverse effects , Fatty Liver , Fibroblast Growth Factors , Obesity/metabolism , Rats, Sprague-Dawley , Triglycerides
8.
Pesqui. vet. bras ; 42: e06953, 2022. tab, ilus
Article in English | LILACS, VETINDEX | ID: biblio-1356553

ABSTRACT

In order to determine the main anatomopathological findings of Testudines necropsied in the Distrito Federal, all necropsy records performed at the "Laboratório de Patologia Veterinária" of the "Universidade de Brasília" (LPV-UnB) on Testudines during the period from January 2008 to July 2020 were reviewed. The 72 cases reviewed were grouped and classified according to species, sex, origin, season of occurrence, and diagnosis. In 69.44% of the cases the species was informed in the necropsy protocols, which included Phrynops geoffroanus (38%), Trachemys dorbigni (36%), Chelonoidis carbonaria (14%), Chelonoidis denticulata (10%) and Podocnemis expansa (2%). In 30.55% of the cases this parameter was not informed and were classified only as Testudines. In 41.66% of the cases the sex was informed, being female 22.22%, male 19.44%, and 58.33% were not informed. Of these animals 79.16% were from environmental agencies and 20.84% from zoos and/or guardians. In 70.83% of the animals analyzed they were directly related to the autumn and winter seasons, with June being the most frequent month (29.17%). The conclusive diagnosis was possible in 68.05% of the cases. The category of disorders caused by injurious agents (48.97%) was the most prevalent, followed by inflammatory disorders (32.65%) and nutritional and metabolic disorders (28.57%). The main diagnoses were carapace and/or plastron fracture with 30.61%, hepatic steatosis (20.40%) and pneumonia (10.22%). Most cases of carapace or plastron fracture and hepatic steatosis occurred in animals from environmental agencies.(AU)


Com o objetivo de determinar os principais achados anatomopatológicos de Testudines necropsiados no Distrito Federal, foram revisadas todas as fichas de necropsia realizadas no Laboratório de Patologia Veterinária da Universidade de Brasília (LPV-UnB) em Testudines, durante o período de janeiro de 2008 a julho de 2020. Os 72 casos revisados foram agrupados e classificados quanto à espécie, sexo, procedência, estação do ano de ocorrência e diagnóstico. Em 69,44% dos casos havia a espécie informada nos protocolos de necropsia, que incluíam Phrynops geoffroanus (38%), Trachemys dorbigni (36%), Chelonoidis carbonaria (14%), Chelonoidis denticulata (10%) e Podocnemis expansa (2%). Em 30,55% dos casos não tiveram esse parâmetro informado e foram classificados apenas como Testudines. Em 41,66% casos foi informado o sexo, sendo fêmea 22,22%, macho 19,44% e não informados 58,33%. Destes animais 79,16% eram de órgão ambiental e 20,84% de zoológicos e ou tutores. Em 70,83% dos animais analisados tiveram direta relação com as estações de outono e inverno, sendo o mês de junho o mais frequente (29,17%). O diagnóstico conclusivo foi possível em 68,05% dos casos. A categoria de distúrbios causados por agentes lesivos (48,97%) foi a mais prevalente, seguido por distúrbios inflamatórios (32,65%) e dos distúrbios nutricionais e metabólicos (28,57%). Os principais diagnósticos foram fratura de carapaça e ou plastrão com 30,61%, esteatose hepática (20,40%) e pneumonia (10,22%). A maior parte dos casos de fratura de carapaça ou plastrão e de esteatose hepática ocorreram em animais provenientes de órgão ambiental.(AU)


Subject(s)
Animals , Pneumonia/mortality , Turtles/anatomy & histology , Turtles/injuries , Fractures, Bone/mortality , Fatty Liver/mortality , Autopsy/veterinary
9.
Chinese Journal of Hepatology ; (12): 224-229, 2022.
Article in Chinese | WPRIM | ID: wpr-935931

ABSTRACT

Objective: To investigate the effect of berberine on programmed necrosis of hepatocytes induced by metabolic-associated fatty liver disease (MAFLD) in mice and its related molecular mechanism. Methods: Twenty male C57BL/6N mice were randomly divided into four groups (n=5 in each group): control group (S), fatty liver group (H), berberine group(B), nuclear factor erythroid 2-related factor 2 inhibitor group (Nrf2), and all-trans-retinoic acid (ATRA) group (A). Serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), triglycerides (TG), total cholesterol (TC), tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) concentrations were detected at the end of week 12 to calculate fatty liver index (liver mass/body mass ratio). Liver tissue was stained with HE, Masson and Oil Red O, and SAF score was used to evaluate the degree of liver injury. The expression levels of hepatic programmed necrosis-related proteins, namely receptor-interacting protein kinase 3 (RIPK3), phosphorylated mixed series protease-like domain (p-MLKL) and Nrf2 were detected by Western blot method. One-way ANOVA was used for intragroup comparisons and LSD-t tests were used for intergroup comparisons. Results: Compared with S group, H group serum ALT, AST, LDH, TG, TC, TNF-α, IL-1β levels and fatty liver index were significantly increased. The liver tissue was filled with vacuolar-like changes and inflammatory cell infiltration. Numerous red lipid droplets were observed with oil red O staining. Collagen fiber hyperplasia was evident with Masson staining. SAF scores (6.60 ± 0.55 and 0.80 ± 0.45) were significantly increased. The expressions of RIPK3 and p-MLKL were up-regulated. Nrf2 level was relatively increased, and the differences were statistically significant (P < 0.05). Compared with H group, berberine intervention group liver biochemical indexes, lipid levels, pro-inflammatory mediator expression, fatty liver index, and SAF score were significantly reduced, and the expression of RIPK3 and p-MLKL were down-regulated, while Nrf2 levels were further increased, and the differences were statistically significant (P<0.05). Compared with B group, treatment with Nrf2 inhibitor had antagonized the protective effect of berberine on fatty liver. Serum ALT, AST, LDH, TG, TC and TNF-α, IL-1β levels, fatty liver index, and SAF scores were significantly increased and the expressions of RIPK3 and p-MLKL were relatively increased, and the differences were statistically significant (P < 0.05). Conclusion: Berberine can significantly improve the metabolic-associated fatty liver disease injury in mice, and its mechanism is related to activation of Nrf2 and inhibition of programmed necrosis of hepatocytes.


Subject(s)
Animals , Male , Mice , Berberine/therapeutic use , Fatty Liver , Mice, Inbred C57BL , NF-E2-Related Factor 2/metabolism , Necrosis
10.
Pesqui. vet. bras ; 42: e06953, 2022. tab, ilus
Article in English | LILACS, VETINDEX | ID: biblio-1487685

ABSTRACT

In order to determine the main anatomopathological findings of Testudines necropsied in the Distrito Federal, all necropsy records performed at the "Laboratório de Patologia Veterinária" of the "Universidade de Brasília" (LPV-UnB) on Testudines during the period from January 2008 to July 2020 were reviewed. The 72 cases reviewed were grouped and classified according to species, sex, origin, season of occurrence, and diagnosis. In 69.44% of the cases the species was informed in the necropsy protocols, which included Phrynops geoffroanus (38%), Trachemys dorbigni (36%), Chelonoidis carbonaria (14%), Chelonoidis denticulata (10%) and Podocnemis expansa (2%). In 30.55% of the cases this parameter was not informed and were classified only as Testudines. In 41.66% of the cases the sex was informed, being female 22.22%, male 19.44%, and 58.33% were not informed. Of these animals 79.16% were from environmental agencies and 20.84% from zoos and/or guardians. In 70.83% of the animals analyzed they were directly related to the autumn and winter seasons, with June being the most frequent month (29.17%). The conclusive diagnosis was possible in 68.05% of the cases. The category of disorders caused by injurious agents (48.97%) was the most prevalent, followed by inflammatory disorders (32.65%) and nutritional and metabolic disorders (28.57%). The main diagnoses were carapace and/or plastron fracture with 30.61%, hepatic steatosis (20.40%) and pneumonia (10.22%). Most cases of carapace or plastron fracture and hepatic steatosis occurred in animals from environmental agencies.


Com o objetivo de determinar os principais achados anatomopatológicos de Testudines necropsiados no Distrito Federal, foram revisadas todas as fichas de necropsia realizadas no Laboratório de Patologia Veterinária da Universidade de Brasília (LPV-UnB) em Testudines, durante o período de janeiro de 2008 a julho de 2020. Os 72 casos revisados foram agrupados e classificados quanto à espécie, sexo, procedência, estação do ano de ocorrência e diagnóstico. Em 69,44% dos casos havia a espécie informada nos protocolos de necropsia, que incluíam Phrynops geoffroanus (38%), Trachemys dorbigni (36%), Chelonoidis carbonaria (14%), Chelonoidis denticulata (10%) e Podocnemis expansa (2%). Em 30,55% dos casos não tiveram esse parâmetro informado e foram classificados apenas como Testudines. Em 41,66% casos foi informado o sexo, sendo fêmea 22,22%, macho 19,44% e não informados 58,33%. Destes animais 79,16% eram de órgão ambiental e 20,84% de zoológicos e ou tutores. Em 70,83% dos animais analisados tiveram direta relação com as estações de outono e inverno, sendo o mês de junho o mais frequente (29,17%). O diagnóstico conclusivo foi possível em 68,05% dos casos. A categoria de distúrbios causados por agentes lesivos (48,97%) foi a mais prevalente, seguido por distúrbios inflamatórios (32,65%) e dos distúrbios nutricionais e metabólicos (28,57%). Os principais diagnósticos foram fratura de carapaça e ou plastrão com 30,61%, esteatose hepática (20,40%) e pneumonia (10,22%). A maior parte dos casos de fratura de carapaça ou plastrão e de esteatose hepática ocorreram em animais provenientes de órgão ambiental.


Subject(s)
Animals , Fractures, Bone/mortality , Fatty Liver/mortality , Pneumonia/mortality , Turtles/anatomy & histology , Turtles/injuries , Autopsy/veterinary
11.
São Paulo; s.n; 2022. 82 p.
Thesis in Portuguese | LILACS | ID: biblio-1437488

ABSTRACT

Nas últimas décadas, países, como o Brasil, têm apresentado uma curva ascendente na incidência de doenças cardiovasculares (DCV), representando cerca de 30% das mortes totais e 72% da mortalidade por DCNT no Brasil. O atual padrão alimentar brasileiro é caracterizado pelo elevado consumo de alimentos industrializados, com alta densidade calórica e rico em açúcares de adição, onde se destaca o elevado consumo de sacarose e, consequentemente, de glicose e frutose. Ao contrário da frutose encontrada naturalmente em frutas e vegetais, o consumo excessivo exerce múltiplos efeitos negativos à saúde, destacando-se as dislipidemias, hiperuricemia e resistência à insulina e, possivelmente, o RCV. Poucos estudos têm avaliado a interação entre o consumo de frutose e aspectos culturais específicos. O objetivo deste estudo foi avaliar o papel da frutose no risco cardiovascular em descendentes alemães que mantêm a cultura germânica preservada. Trata-se de um estudo com dados primários do momento basal da Coorte "Vida e Saúde em Pomerode (SHIP-BRAZIL)" baseado na avaliação direta de dados socioeconômicos, culturais, clínicos e dietéticos (Questionário de frequência alimentar). Com base na avaliação fenotípica (etnia autodeclarada) e comportamentos sociais (falar alemão em casa, frequentar associação comunitária/cultural e relatar esforços para manter os hábitos alemães no Brasil por meio das vestimentas, músicas e culinária), os indivíduos foram classificados em grupos Germânico e Não germânico. A partir do sangue coletado foram analisados o perfil lipídico (Colesterol total - CT, HDL-c, LDL-c, VLDL, Não-HDL, triglicerídeos - TG), Índice de Castelli I (ICI), Índice de Castelli II (ICII), enzimas hepáticas (gama-glutamiltransferase - GGT, aspartato aminotransferase - AST e alanina minotransferase - ALT), glicose e frutose plasmática. Todos os testes estatísticos foram analisados no programa Statistical Package for the Social Siences® (SPSS) versão 20.0, sendo o nível de significância de p<0,05. Da amostra investigada (n=597), 68,3% pertençam ao grupo Germânico, onde o sexo feminino foi o mais frequente em ambos os grupos (Germânicos= 56,7%; Não germânicos= 57,5%, p=0,892), e predominantemente adultos entre 30 e 60 anos. Em relação às doenças autorrelatadas, o grupo Germânico apresentou maior prevalência de HAS (41,9% versus 24,7%; p<0,001) que o grupo Não germânico, sendo confirmado pela maior frequência no uso de medicamentos anti-HAS (35,1% versus 21,7%; p=0,002) e pela maior pressão arterial sistólica observada (126 mmHg versus 121 mmHg; p<0,001) e valores superiores no sexo masculino. Os homens do grupo Germânico apresentaram valores superiores de peso, IMC e CC quando comparados às mulheres e ao grupo Não germânico. Perfil oposto foi observado para o percentual de MG que foi superior no grupo feminino. A classificação dos parâmetros antropométricos confirmou que o grupo Germânico teve maior risco de complicações cardiovasculares associado à elevada CC (72% versus 53%. p<0,001). Embora os grupos Germânico e Não germânico tenham apresentado perfil lipídico e enzimas hepáticas semelhantes, os indivíduos do sexo masculino em ambos os grupos apresentaram maiores valores de glicemia, frutose, enzimas hepáticas e ICI e II, assim como menor valores de HDL-c, quando comparados às mulheres. Embora o autorrelato de diagnóstico de esteatose hepática no grupo Germânico tenha sido cerca de três vezes superior ao grupo Não germânico, os resultados de ultrassonografia hepática não identificaram diferenças, segundo grupos e sexo. A estimativa do risco cardiovascular mostrou que os indivíduos do grupo Não germânico apresentaram maior frequência de alto risco cardiovascular. A frutose plasmática não se correlacionou com o consumo de frutose (r= -0,013; p=0,556), entretanto, a avaliação dos grupos alimentares segundo grau de processamento mostrou que o grupo Germânico teve maior consumo de alimentos processados e ultraprocessados, caracterizado principalmente pelo elevado consumo de sucos, refrigerantes, doces e feijoada/feijão tropeiro. Em conjunto, destacou-se o elevado consumo de alimentos ricos em sacarose e consequentemente em frutose. Observamos que a frutose plasmática no grupo Germânico se correlacionou positivamente com a CC (p=0,001), perfil lipídico (TG, TG/HDL, p<0,001), enquanto observou-se correlação negativa com o HDL-c (p<0,001). Essas correlações foram mais robustas no grupo Não germânico. Os indivíduos do grupo Germânico apresentaram um risco de ter elevada concentração de frutose 75% superior ao grupo Não germânico. No modelo múltiplo, os indivíduos do grupo Germânico apresentaram o dobro de chances de terem HAS, e CC com valores indicativos de elevado RCV, porém menor chance de terem DLP. A inclusão da frutose no modelo de regressão mostrou tendência de maior RCV nos indivíduos germânicos com maior concentração de frutose no plasma. No modelo ajustado pela idade e sexo, a HAS perde a significância, enquanto a associação com a frutose se torna significativa. No modelo que também inclui o consumo de álcool, tabagismo e uso de medicamentos como variável de ajuste, apenas CC e DLP se mantiveram associados à preservação da cultura germânica. Com base nestes resultados podemos concluir que a preservação da cultura germânica se associou ao elevado consumo de frutose e essa manteve relação com elevada adiposidade, pressão arterial, diabetes mellitus e esteatose hepática, entretanto não houve impacto no perfil lipídico e na estimativa do risco cardiovascular.


In recent decades, countries such as Brazil have shown an upward curve in the incidence of cardiovascular diseases (CVD), representing about 30% of total deaths and 72% of NCD mortality in Brazil. The current Brazilian dietary pattern is characterized by high consumption of processed foods, with high caloric density and rich in added sugars, where the high consumption of sucrose and, consequently, glucose and fructose stand out. Unlike the fructose found naturally in fruits and vegetables, excessive consumption exerts multiple negative effects on health, especially dyslipidemia, hyperuricemia, insulin resistance, and possibly cardiovascular risk. Few studies have evaluated the interaction between fructose intake and culturally specific aspects. The aim of this study was to evaluate the role of fructose on cardiovascular risk in German descendants who maintain preserved Germanic culture. This is a study with primary data from the baseline moment of the "Life and Health in Pomerode (SHIP-BRAZIL) Cohort" based on direct assessment of socioeconomic, cultural, clinical and dietary data (Food Frequency Questionnaire). Based on phenotypic evaluation (self-reported ethnicity) and social behaviors (speaking German at home, attending community/cultural associations, and reporting efforts to maintain German habits in Brazil through dress, music, and cooking), the individuals were classified into Germanic and Non-Germanic groups. From the blood collected, the lipid profile was analyzed (total cholesterol - TC, HDL-c, LDL-c, VLDL, Non-HDL, triglycerides - TG), Castelli Index I (ICI), Castelli Index II (ICII), liver enzymes (gamma-glutamyltransferase - GGT, aspartate aminotransferase - AST and alanine aminotransferase - ALT), plasma glucose and fructose. All statistical tests were analyzed using the Statistical Package for the Social Siences® (SPSS) version 20.0 software, with a significance level of p<0.05. Of the investigated sample (n=597), 68.3% belonged to the Germanic group, where the female gender was the most frequent in both groups (Germanic= 56.7%; Non-Germanic= 57.5%, p=0.892), and predominantly adults between 30 and 60 years old. Regarding self-reported diseases, the Germanic group showed higher prevalence of HAS (41.9% versus 24.7%; p<0.001) than the Non-Germanic group, being confirmed by the higher frequency in the use of anti-SAH medications (35.1% versus 21.7%; p=0.002) and by the higher systolic blood pressure observed (126 mmHg versus 121 mmHg; p<0.001) and higher values in males. Men in the Germanic group had higher weight, BMI and WC values when compared to women and the Non-Germanic group. Opposite profile was observed for the percentage of FM that was higher in the female group. The classification of anthropometric parameters confirmed that the Germanic group had a higher risk of cardiovascular complications associated with high WC (72% versus 53%. p<0.001). Although the Germanic and Non-Germanic groups had similar lipid profile and liver enzymes, male subjects in both groups had higher blood glucose, fructose, liver enzymes and ICI and II values, as well as lower HDL-c values, when compared to females. Although the self-reported diagnosis of hepatic steatosis in the Germanic group was about three times higher than in the non-Germanic group, the liver ultrasound results did not identify differences according to groups and sex. Estimation of cardiovascular risk showed that individuals in the Non-Germanic group had a higher frequency of high cardiovascular risk. Plasma fructose did not correlate with fructose consumption (r= -0,013; p=0.556), however, the evaluation of food groups according to the degree of processing showed that the Germanic group had higher consumption of processed and ultra-processed foods, characterized mainly by high consumption of juices, soft drinks, sweets and feijoada/tropical beans. Together, the high consumption of foods rich in sucrose and consequently in fructose stood out. We observed that plasma fructose in the Germanic group correlated positively with WC (p=0.001), lipid profile (TG, TG/HDL, p<0.001), while a negative correlation was observed with HDL-c (p<0.001). These correlations were more robust in the Non-Germanic group. Individuals in the Germanic group had a 75% higher risk of having high fructose concentration than the Non-Germanic group. In the multiple models, individuals in the Germanic group were twice as likely to have HAS, and CC with values indicative of high CRV, but less likely to have DLP. The inclusion of fructose in the regression model showed a trend towards higher CVR in Germanic subjects with higher plasma fructose concentration. In the model adjusted for age and sex, SAH loses significance, while the association with fructose becomes significant. In the model that also includes alcohol consumption, smoking, and medication use as adjustment variables, only WC and DLP remained associated with Germanic culture preservation. Based on these results we can conclude that the preservation of Germanic culture was associated with high fructose consumption and this maintained a relationship with high adiposity, blood pressure, diabetes mellitus, and hepatic steatosis; however there was no impact on lipid profile and cardiovascular risk estimation.


Subject(s)
Humans , Male , Female , Fatty Liver , Feeding Behavior , Fructose , Heart Disease Risk Factors
12.
ABC., imagem cardiovasc ; 35(3): eabc280, 2022. tab, ilus
Article in Portuguese | LILACS | ID: biblio-1411955

ABSTRACT

Cor triatriatum é um anomalia cardíaca congênita rara frequentemente diagnosticada na primeira infância. Este estudo de caso apresenta um adulto com um achado acidental de cor triatriatum sinistrum. Com base na apresentação clínica, o paciente foi tratado de forma conservadora. São apresentados achados de imagens ecocardiográficas de cor triatriatum sinistrum deste paciente juntamente de revisão narrativa da literatura sobre essa doença.(AU)


Cor triatriatum is a rare congenital heart anomaly often diagnosed in early childhood. This case study features an adult with an incidental finding of cor triatriatum sinistrum. Based on the clinical presentation, the patient was treated conservatively. Cor triatriatum sinistrum echocardiographic image findings of this patient are presented along with a narrative review of the literature about this disease. (AU)


Subject(s)
Humans , Male , Middle Aged , Cor Triatriatum/complications , Cor Triatriatum/diagnostic imaging , Incidental Findings , Heart Atria/abnormalities , Magnetic Resonance Spectroscopy/methods , Echocardiography, Doppler/methods , Echocardiography, Transesophageal/methods , Echocardiography, Three-Dimensional/methods , Fatty Liver/complications , Heart Septal Defects, Atrial/complications , Kidney/injuries , Myocardial Infarction/genetics
13.
Infectio ; 25(4): 250-255, oct.-dic. 2021. tab
Article in Spanish | LILACS, COLNAL | ID: biblio-1286718

ABSTRACT

Resumen Introducción: Las alteraciones de la bioquímica hepática son frecuentes en los pacientes con infección por VIH, la etiología es variada, la esteatosis hepática es frecuente con una prevalencia estimada del 60% Objetivos: Caracterizar las alteraciones hepáticas en una serie de pacientes con infección por VIH en un centro de investigación de Bogotá Colombia durante el periodo 2009 - 2019. Materiales y Métodos: Estudio descriptivo, retrospectivo, observacional de pacientes con infección por VIH que asistieron a un centro de investigación durante los años 2009-2019. Resultados: 94% fueron hombres y 6% mujeres con edad promedio de 44 años, 92,5% de los pacientes presentaba uso de terapia antiretroviral. Las principales hepatopatías fueron la coinfección VIH-Hepatitis C y el hígado graso en iguales porcentajes, 31,3%. El promedio del indice HOMA fue de 2,58. Discusión: Las enfermedades hepáticas son una causa importante de morbimortalidad en pacientes con infección por VIH, las coinfecciones virales y el hígado graso pueden ser muy frecuentes en nuestro medio a diferencia de otros estudios Conclusiones: Este es el primer estudio a nivel local en describir las alteraciones hepáticas en pacientes con VIH, las comorbilidades no SIDA, juegan un papel importante dentro de la enfermedad. La hepatitis C continúa siendo una coinfección frecuente en la población VIH.


Abstract Introduction: Alterations in liver biochemistry are frequent in patients with HIV infection, the etiology is varied and includes multiple causes, liver steatosis is one of the most frequent with an estimated prevalence of 60% after the appearance of antiretroviral treatment Objectives: To characterize liver disorders in a series of patients with HIV infection at a research center in Bogotá Colombia during the period 2009-2019. Materials and Methods: Descriptive, retrospective, observational study of patients with HIV infection who attended a disease research center during the years 2009-2019. Results: 67 clinical histories were reviewed, 94% were men and 6% women with an average age of 44 years, 92.5% of the patients had use of anti-retroviral therapy and the diagnosis of HIV was known 11.7 years ago on average. The main liver diseases were HIV-Hepatitis C coinfection and fatty liver in equal percentages, 31.3%. The average HOMA index was 2.58. Discussion: Liver diseases are an important cause of morbidity and mortality in patients with HIV infection. Viral coinfections and fatty liver can be very frequent in our setting, unlike other studies. Conclusions: This is the first study locally to describe the liver disorders in patients with HIV, non-AIDS comorbidities, including fatty liver, play an important role in the disease and could behave like the general population. Hepatitis C continues to be a frequent coinfection in the HIV population.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , HIV Infections , Liver Diseases , Therapeutics , Prevalence , Acquired Immunodeficiency Syndrome , Hepatitis C , Colombia , Fatty Liver , Liver
14.
Article in Spanish | LILACS | ID: biblio-1353033

ABSTRACT

Introducción: la obesidad aumenta el riesgo a padecer de enfermedades crónicas no transmisibles (ECNT) y afecta el curso de enfermedades de origen infeccioso. Objetivo: examinar la literatura sobre cómo influye la obesidad en la gravedad del cuadro clínico de algunas de las enfermedades no transmisibles y transmisibles de mayor impacto en el Perú. Métodos: investigación documental. Se hace un análisis de contenidos de artículos y documentos de estudios desarrollados en diversos contextos asociados a la presencia de obesidad junto con infecciones o ECNT y en base de datos. Resultados: la condición de obesidad alcanzada por malos hábitos de consumo y baja actividad física, es la principal responsable del elevado índice de las ECNT y por consecuente de las tasas de mortalidad. Conclusiones: el exceso de peso afecta al sistema inmunológico, contribuyendo específicamente en los fenómenos exacerbados de respuesta inflamatoria sistémica, determinada por el aumento de secreción de adipocitoquinas, que predispone al organismo a desarrollar y contraer ECNT y enfermedades infecciosas. (AU)


Introduction: Obesity increases the risk of chronic non-communicable diseases (NCDs) and affects the course of diseases of infectious origin. Objective: Reviewing the literature on how obesity influences the severity of the clinical picture of some of the non-communicable and communicable diseases of greatest impact in Peru. Methods:Documentary research, from studies developed in various contexts associated with the presence of obesity along with infections or NCDs. Results: The condition of obesity reached by bad consumption habits and low physical activity is the main responsible for the high rate of NCDs, consequently, mortality. Conclusions: Excess weight affects the immune system, contributing specifically to exacerbated phenomena of a systemic inflammatory response, determined by increased secretion of adipocytokines, which predisposes the body to develop and contract NCDs and infectious diseases. (AU)


Subject(s)
Humans , Virus Diseases , Chronic Disease , Communicable Diseases , Coronavirus , Diabetes Mellitus , Fatty Liver , Neoplasms , Obesity
15.
Rev. Méd. Inst. Mex. Seguro Soc ; 59(6): 465-472, dic. 2021. tab
Article in Spanish | LILACS | ID: biblio-1354746

ABSTRACT

Introducción: la enfermedad del hígado graso no alcohólico (EHGNA) tiene graves implicaciones para la salud y, asociada a la epidemia de obesidad, es una tendencia creciente. Objetivo: detectar la presencia de hígado graso en niños con sobrepeso y obesidad, así como evaluar los factores asociados con una mayor posibilidad de presentar un resultado positivo en la detección. Metódos: se realizó un estudio de tipo transversal en una unidad médica del segundo nivel de atención médica en el que fueron reclutados 102 niños. Los niveles séricos de alanina aminotransferasa (ALT) fueron cuantificados y se realizaron ecografías hepáticas. Modelos de regresión logística múltiple fueron utilizados para evaluar los factores asociados con la presencia de EHGNA (infiltración grasa en la ecografía y ALT > 52U/L para niños y > 44 U/L para niñas). Resultados: la prevalencia de EHGNA fue del 10,8%. En el análisis multivariante, una relación entre cintura y cadera ≥ 1 se asoció con una mayor posibilidad de EHNGA (razón de momios (RM) = 4.96, IC del 95%: 1.17 - 20.90). Conclusiones: nuestros hallazgos indican que uno de cada diez niños sobrepeso y obesidad tiene datos sugestivos de EHGNA y está en riesgo de presentar sus consecuencias para la salud.


Background: Non-alcoholic fatty liver disease (NAFLD) has serious health implications and upward trends of the disease, accompanied by the obesity epidemic worldwide. Objective: To screen for fatty liver in overweight and obese children and evaluate the factors associated with an increased likelihood of presenting a positive-screen result. Methods: In a cross-sectional study, 102 children were recruited at a secondary care medical unit. Serum alanine aminotransferase (ALT) levels were quantified and hepatic ultrasounds were performed; multiple logistic regression models were used to evaluate factors associated with the increased odds of presenting with NAFLD (fatty infiltration on ultrasound and ALT > 52 U/L for boys and > 44 U/L for girls). Results: The overall prevalence of NAFLD was 10.8%. In multivariate analysis, a waist-to-hip ratio ≥ 1 was associated with increased odds of screening positive for NAFLD (odds ratio (OR) = 4.96, 95% CI 1.17-20.90). Conclusions: Our findings indicate that one out of ten children with overweight or obesity has data suggestive of NAFLD and is at risk of presenting its consequences on health.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Child Health , Overweight , Fatty Liver , Non-alcoholic Fatty Liver Disease , Mexico , Secondary Care , Mass Screening , Cross-Sectional Studies , Multivariate Analysis , Impacts of Polution on Health , Obesity
16.
Rev. Ciênc. Méd. Biol. (Impr.) ; 20(2): 277-285, set 29, 2021. tab, fig
Article in Portuguese | LILACS | ID: biblio-1354479

ABSTRACT

Introdução: a infecção crônica pelo vírus da hepatite C (HCV) e a obesidade podem induzir esteatose hepática e diabetes mellitus (DM). Objetivo: avaliar a prevalência de obesidade e de distúrbios metabólicos em pacientes com HCV; estudar a prevalência de HCV e os distúrbios metabólicos em pacientes obesos. Comparar o perfil glicêmico entre os grupos. Metodologia: estudo analítico, com pacientes acompanhados nos ambulatórios de Hepatite C e Obesidade. Variáveis analisadas: glicemia, hemoglobina glicada (A1C), esteatose hepática, HCV, estágio de fibrose hepática e dados sociodemográficos. Resultados: no ambulatório de obesidade 45 pacientes foram avaliados, dos quais 6,7% tinham hepatite C, 40% DM e 61-73% esteatose hepática. As médias das enzimas hepáticas (U/L) foram: AST 22,9; ALT 25,2; FAL 146,5 e GGT 63. Nos obesos com DM, 72,2% apresentavam A1C < 7%. A segunda amostra continha 159 portadores de HCV do ambulatório de hepatologia: 17,9% tinham obesidade, 18,9% DM e 27% esteatose hepática. As médias das enzimas hepáticas (U/L) consistiram em: AST 70,5; ALT 90,6; FAL 108,5 e GGT 131,7. Entre os diabéticos com HCV, 52% não apresentavam A1C < 7%. Conclusão: foi encontrada alta prevalência de hepatite C em pacientes com obesidade (6,7%) quando comparados com a população de Salvador (1,5-1,8%). Os distúrbios metabólicos foram mais frequentes entre obesos, porém os diabéticos com obesidade revelaram A1C menores do que os diabéticos com HCV, sugerindo, neste estudo, que pode existir interferência viral no controle glicídico. A esteatose hepática foi mais prevalente entre obesos.


Introduction: Hepatitis C virus infection (HCV) and Obesity can to induce hepatic steatosis and diabetes mellitus (DM). Objectives: to evaluate the prevalence of obesity and metabolic disorders in HCV viremic patients. To study the prevalence of hepatitis C and metabolic disorders in patients with obesity. To compare glycemic profile between the groups. Methods: analytical study, with patients followed up at hepatitis C and Obesity outpatient clinics patients. Variables studied: blood glucose, glycated hemoglobin (A1C), hepatic steatosis, HCV, hepatic fibrosis stage and sociodemographic data. Results: in Obesity clinic sample 45 patients were evaluated, 6,7% was hepatitis C, 40% DM and 61% -73% hepatic steatosis. Mean of liver enzymes levels (U/L) were: AST 22.9; ALT 25.2; FAL 146.5 and GGT 63. In obese with DM, 72.2% of them were able to maintain A1C < 7%. The second sample contained 159 HCV carriers at the hepatology clinic, 17,9% was Obesity, 18,9% DM and 27% hepatic steatosis. Averages of serum liver enzymes level (U/ L) were: AST 70.5; ALT 90.6; FAL 108.5 and GGT 131.7. Among diabetics with HCV, 52% are unable to maintain A1C < 7%. Conclusions: found high prevalence of hepatitis C in patients with obesity (6.7%) when compared to the population of Salvador (1.5%-1.8%). Metabolic disorders were more frequent in the obese group, but diabetics with obesity have lower A1C values than diabetics with HCV, suggesting, in this study, that there may be a viral interference with glycid control. Liver steatosis is more prevalent among obese people


Subject(s)
Humans , Male , Female , Comorbidity , Prevalence , Hepatitis C , Diabetes Mellitus , Obesity , Blood Glucose , Glycated Hemoglobin , Laboratory and Fieldwork Analytical Methods , Epidemiology, Descriptive , Fatty Liver
17.
Rev. Ciênc. Méd. Biol. (Impr.) ; 20(2): 307-313, set 29, 2021. tab
Article in Portuguese | LILACS | ID: biblio-1354495

ABSTRACT

Introdução: a doença hepática gordurosa não alcoólica (DHGNA) é caracterizada pela infiltração gordurosa do fígado em indivíduos sem histórico de ingestão significativa de álcool ou de outras doenças hepáticas. A DHGNA é subdividida em fígado gorduroso não alcoólico e esteato-hepatite não alcoólica (NASH). A resistência à insulina e o diabetes mellitus tipo 2 (DM2) apresentam importante associação com DHGNA. Objetivos: avaliar a prevalência de DHGNA, predita por ultrassonografia, em pacientes com DM2 hospitalizados, verificando sua associação com tempo de DM2, comorbidades, terapêutica previamente utilizada, parâmetros antropométricos e controle glicêmico e pressórico. Metodologia: estudo observacional, transversal e analítico, realizado nas enfermarias de Clínica Médica e de Endocrinologia do Hospital Universitário Alcides Carneiro envolvendo pacientes adultos com DM2. Foram excluídos pacientes com outras hepatopatias diagnosticadas, com histórico de etilismo significativo ou que não aceitaram participar da pesquisa. Resultados: a amostra válida foi de 20 pacientes, com média de idade de 62,9 anos (± 10,9). A prevalência de DHGNA foi de 40%. Houve associação estatisticamente significativa entre DHGNA e maiores níveis de índice de massa corpórea (IMC) (p = 0,025) e de circunferência abdominal (CA) (p = 0,041). Entre as comorbidades, houve relação entre DHGNA e hipotireoidismo (p = 0,049). Conclusão: Apesar das limitações relacionadas ao tamanho da amostra, observa-se que a DHGNA está associada à obesidade central, o que é apontado pelos maiores níveis de IMC e de CA, de forma que uma abordagem multidisciplinar pode impedir o desenvolvimento ou a progressão de DHGNA.


Introduction: Non-alcoholic fatty liver disease (NAFLD) is characterized by fatty infiltration of the liver in individuals without a history of significant alcohol intake or other liver diseases. NAFLD is subdivided into non-alcoholic fatty liver and non-alcoholic steatohepatitis (NASH). Insulin resistance and type 2 diabetes mellitus (DM2) have an important association with NAFLD. Objectives: to evaluate the prevalence of NAFLD, predicted by ultrasound, in hospitalized patients with DM2, checking its association with DM2 duration, comorbidities, previously used therapy, anthropometric parameters and glycemic and blood pressure control. Methodology: observational, cross-sectional and analytical study, carried out in the Medical Clinic and Endocrinology wards of the Hospital Universitário Alcides Carneiro, involving adult patients with DM2. Patients with other diagnosed liver diseases, with a history of significant alcoholism or who did not want to participate in the research were excluded. Results: the valid sample consisted of 20 patients, with a mean age of 62.9 years (± 10.9). The prevalence of NAFLD was 40%. There was a statistically significant association between NAFLD and higher levels of body mass index (BMI) (p = 0.025) and waist circumference (WC) (p = 0.041). Among comorbidities, there was a relationship between NAFLD and hypothyroidism (p = 0.049). Conclusion: despite the limitations related to the sample size, it is observed that NAFLD is associated with central obesity, which is pointed out by the higher levels of BMI and WC, so that a multidisciplinary approach can prevent the development or progression of NAFLD.


Subject(s)
Humans , Animals , Male , Adult , Aged , Diabetes Mellitus , Fatty Liver , Non-alcoholic Fatty Liver Disease , Obesity , Laboratory and Fieldwork Analytical Methods , Cross-Sectional Studies , Observational Study
18.
Int. j. morphol ; 39(4): 1096-1101, ago. 2021. tab
Article in English | LILACS-Express | LILACS | ID: biblio-1385475

ABSTRACT

SUMMARY: Obesity and fatty liver steatosis are already considered metabolic risk factors which may aggravate the severity of COVID-19. This study aims to investigate the correlation between COVID-19 severity, obesity, and liver steatosis and fibrosis. 230 consecutive patients with laboratory-confirmed COVID-19 aged between 15 and 84? years, admitted to a hospital devoted to COVID-19 patients, were enrolled in the study. COVID-19 severity was classified as severe versus non-severe based on admission to ICU. Obesity was assessed by Body Mass Index (BMI). CT-scan was used to check for the liver steatosis. Fibrosis-4 score was calculated. The study was conducted in March-May 2020. Obesity strongly and positively correlated with severe COVID-19 illness r: 0.760 (P<0.001). Hepatic steatosis had rather less of a correlation with COVID-19 severity r: 0.365 (P<0.001). Multivariable-adjusted association between hepatic steatosis or obesity, or both (as exposure) and COVID-19 severity (as the outcome) revealed increased risk of severe COVID-19 illness with obesity (Adjusted model I OR: 465.3, 95 % CI: 21.9-9873.3, P<0.001), with hepatic steatosis (Adjusted model I OR: 5.1, 95 % CI: 1.2-21.0, P<0.025), and with hepatic steatosis among obese patients (Adjusted model I OR: 132, 95 % CI: 10.3-1691.8, P<0.001). Obesity remained the most noticeable factor that strongly correlated with COVID-19 severity, more than liver steatosis. However, the risk to COVID-19 severity was greater in those with both factors: obesity and liver steatosis.


RESUMEN: La obesidad y la esteatosis del hígado graso ya se consideran factores de riesgo metabólico que pueden empeorar la gravedad de la COVID-19. Este estudio tiene como objetivo investigar la correlación entre la gravedad de COVID- 19, la obesidad y la esteatosis y fibrosis hepática. El estudio se realizó en 230 pacientes consecutivos entre 15 y 84 años con COVID-19 confirmado por laboratorio, ingresados en un hospital dedicado a pacientes con COVID-19. La gravedad de COVID-19 se clasificó como grave, versus no grave según el ingreso a la UCI. La obesidad se evaluó mediante el índice de masa corporal (IMC). Se utilizó una tomografía computarizada para verificar la esteatosis hepática. Se calculó la puntuación de Fibrosis-4. El estudio se realizó entre marzo-mayo de 2020. La obesidad se correlacionó fuerte y positivamente con la enfermedad grave de COVID-19 r: 0,760 (P <0,001). La esteatosis hepática tuvo una correlación bastante menor con la gravedad de COVID-19 r: 0.365 (P <0.001). La asociación ajustada multivariable entre la esteatosis hepática u obesidad, o ambas (como exposición) y la gravedad de COVID-19 (como resul- tado) reveló un mayor riesgo de enfermedad grave por COVID- 19 con obesidad (OR del modelo ajustado I: 465,3, IC del 95%: 21,9 -9873,3, P <0,001), con esteatosis hepática (OR del modelo I ajustado: 5,1, IC del 95 %: 1,2-21,0, P <0,025) y con esteatosis hepática entre los pacientes obesos (OR del modelo I ajustado: 132, IC del 95 % : 10,3-1691,8, P <0,001). La obesidad siguió siendo el factor más notable que se correlacionó significativamente con la gravedad de COVID-19, más que la esteatosis hepática. Sin embargo, el riesgo de gravedad de COVID-19 fue mayor en aquellos con ambos factores: la obesidad y esteatosis hepática.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Fatty Liver/pathology , Fatty Liver/diagnostic imaging , COVID-19/pathology , Obesity/pathology , Severity of Illness Index , Tomography, X-Ray Computed , Body Mass Index , Liver Cirrhosis/pathology , Liver Cirrhosis/diagnostic imaging
19.
Int. j. morphol ; 39(3): 732-738, jun. 2021. ilus, tab
Article in English | LILACS-Express | LILACS | ID: biblio-1385401

ABSTRACT

SUMMARY: Nonalcoholic fatty liver disease (NAFLD) might progress the steatosis to nonalcoholic steatohepatitis (NASH), reaching a cirrhosis state and possibly hepatocellular carcinoma. The liver of three-month-old C57BL/6J mice (wild-type, WT group, n=10) and leptin- deficient obese mice (ob/ob group, n=10) were studied, focusing on the mechanisms associated with the activation of the hepatic stellate cells (HSCs) and pro-fibrogenesis. The obese ob/ob animals' liver showed steatosis, increased lipogenesis gene expressions, inflammation, increased pro-inflammatory gene expressions, inflammatory infiltrate, and potential apoptosis linked to a high Caspase 3 expression. In ob/ob mice, liver sections were labeled in the fibrotic zones by anti-alpha-smooth muscle actin (alpha-SMA) and anti-Reelin, but not in the WT mice. Moreover, the alpha-SMA gene expression was higher in the ob/ob group's liver than the WT group. The pro-fibrogenic gene expressions were parallel to anti- alpha-SMA and anti-Reelin immunofluorescence, suggesting HSCs activation. In the ob/ob animals, there were increased gene expressions involved with lipogenesis (Peroxisome proliferator-activated receptor-gamma, Cell death-inducing DFFA-like effector-c, Sterol regulatory element-binding protein-1c, and Fatty acid synthase), pro-fibrogenesis (Transforming growth factor beta1, Smad proteins- 3, Yes-associated protein-1, Protein platelet-derived growth factor receptor beta), pro-inflammation (Tumor necrosis factor-alpha, and Interleukin-6), and apoptosis (Caspase 3). In conclusion, the results in obese ob/ob animals provide a clue to the events in humans. In a translational view, controlling these targets can help mitigate the hepatic effects of human obesity and NAFLD progression to NASH.


RESUMEN: La enfermedad del hígado graso no alcohólico (HGNA) puede progresar de la esteatosis a esteatohepatitis no alcohólica (ENA), alcanzando un estado de cirrosis y posiblemente carcinoma hepatocelular. Se estudió el hígado de ratones C57BL / 6J de tres meses de edad (tipo salvaje, grupo WT, n = 10) y ratones obesos con deficiencia de leptina (grupo ob/ob, n = 10), centrándose en los mecanismos asociados con la activación de las células estrelladas hepáticas (HSC) y profibrogénesis. El hígado de los animales obesos ob/ob mostró esteatosis, aumento de la expresión génica de la lipogénesis, inflamación, aumento de la expresión génica proinflamatoria, infiltrado inflamatorio y posible apoptosis ligada a una alta expresión de Caspasa 3. En ratones ob/ob, las sec- ciones de hígado se marcaron en las zonas fibróticas con anti-alfa- actina de músculo liso (alfa-SMA) y anti-Reelin, pero no en los ratones WT. Además, la expresión del gen alfa-SMA fue mayor en el hígado del grupo ob/ob que en el grupo WT. Las expresiones génicas profibrogénicas fueron paralelas a la inmunofluorescencia anti-alfa-SMA y anti-Reelin, lo que sugiere la activación de las HSC. En los animales ob/ob, hubo un aumento de las expresiones génicas involucradas con la lipogénesis (receptor activado por proliferador de peroxisoma gamma, efector c similar a DFFA inductor de muerte celular, proteína de unión al elemento regulador de esterol-1c y sintasa de ácidos grasos), pro-fibrogénesis (factor de crecimiento transformante beta 1, proteínas Smad-3, proteína-1 asociada a Yes, receptor beta del factor de crecimiento derivado de plaquetas de proteínas), proinflamación (factor de necrosis tumoral alfa e interleucina-6) y apoptosis (caspasa 3). ). En conclusión, los resultados en animales obesos ob/ob proporcionan una pista de los eventos en humanos. Desde un punto de vista traslacional, el control de estos objetivos puede ayudar a mitigar los efectos hepáticos de la obesidad humana y la progresión de HGNA a ENA.


Subject(s)
Animals , Mice , Leptin/deficiency , Fatty Liver/pathology , Photomicrography , Apoptosis , Microscopy, Confocal , Lipogenesis/genetics , Caspase 3/metabolism , Hepatic Stellate Cells/ultrastructure , Fatty Liver/genetics , Real-Time Polymerase Chain Reaction , Non-alcoholic Fatty Liver Disease/pathology , Inflammation/genetics , Liver/ultrastructure , Liver Cirrhosis/genetics , Liver Cirrhosis/pathology , Mice, Inbred C57BL , Obesity
20.
Revista Digital de Postgrado ; 10(1): 275, abr. 2021. tab
Article in Spanish | LILACS, LIVECS | ID: biblio-1147596

ABSTRACT

El hígado graso del embarazo es una patología poco frecuente en la especialidad obstétrica, cuyo diagnóstico se realiza basado en los criterios de Swansea, muchas veces es un diagnóstico que se realiza por exclusión; usualmente se presenta entre las semanas 30 y 35 del embarazo, y la cura definitiva se realiza con la interrupción expedita del mismo; con una tasa de recuperación casi del 100% si se realiza la interrupción oportuna y una tasa de mortalidad materno fetal actual del 10%. Es importante estar atentos a la ganancia ponderal de la embarazada durante el control prenatal, la epigastralgia, y los signos clínicos asociados a hipoglicemia(AU)


Fatty liver of pregnancy is a rare pathology in obstetrics, whose diagnosis is made based on the Swansea criteria, many times it is a diagnosis that is made by exclusion; It usually occurs between weeks 30 and 35, and the definitive cure is carried out with the expeditious interruption of pregnancy; with a recovery rate of almost 100% if timely interruption is made and a current maternal-fetal mortality rate of 10%. It is important to be attentive to the weight gain of the pregnant woman during prenatal control, epigastric pain, and clinical signs associated with hypoglycemia


Subject(s)
Humans , Female , Pregnancy , Pregnancy Complications/diagnosis , Fatty Liver/diagnosis , Pregnancy Complications/surgery , Pregnancy Trimester, Third , Cesarean Section , Acute Disease , HELLP Syndrome/diagnosis , Diagnosis, Differential , Fatty Liver/surgery , Fatty Liver/complications , Hypoglycemia/diagnosis , Jaundice/complications , Jaundice/diagnosis
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