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Acta Physiologica Sinica ; (6): 263-274, 2021.
Article in Chinese | WPRIM | ID: wpr-878255


The present study aims to investigate the effects of aerobic exercise and resistance exercise on lipid metabolism of skeletal muscle in high-fat diet (HFD)-induced insulin-resistant (IR) rats and the underlying mechanisms. Male Sprague-Dawley (SD) rats at age of 10 weeks were fed with HFD for 10 weeks to establish IR model. The IR rats were then randomly assigned into 3 groups, including IR control (IR) group, aerobic exercise (AE) group and resistance exercise (RE) group. An additional chow diet sedentary control (CON) group was used as well. Fasting blood glucose (FBG), insulin (FIN), glucagon and lipids, as well as triacylglycerol (TG), free fatty acids (FFA), and the protein expression of fatty acid translocase/cluster of differentiation 36 (FAT/CD36), carnitine palmitoyltransferase-1 (CPT-1), stearoyl-CoA desaturase-1 (SCD-1) and peroxisome proliferators-activated receptors γ (PPARγ) in skeletal muscles were measured after 8-week exercise interventions. The results showed that the contents of FBG, FIN, and LDL-C were increased by IR compared with CON group, and significantly decreased by aerobic exercise and resistance exercise; while aerobic exercise induced an increase in HDL-C as well. Furthermore, IR exhibited no significant effects on TG content of skeletal muscles, but significantly increased FFA level. Both aerobic and resistance exercise led to a decrease in TG content, and FFA level was increased by aerobic exercise but deceased by resistance exercise. In addition, the protein expression of FAT/CD36, SCD-1 and PPARγ was increased and that of CPT-1 was decreased by IR, while both types of exercise resulted in a decrease in the protein expression of FAT/CD36, SCD-1 and PPARγ, and an increase in CPT-1. In conclusion, aerobic and resistance exercise may attenuate IR through decreasing HFD-induced ectopic fat deposition and increasing β-oxidation of fatty acids in skeletal muscle cells, and resistance exercise shows a greater improvement in lipid metabolism of skeletal muscles than aerobic exercise.

Animals , Diet, High-Fat , Insulin/metabolism , Insulin Resistance , Lipid Metabolism , Lipids , Male , Muscle, Skeletal/metabolism , Rats , Rats, Sprague-Dawley
Braz. j. med. biol. res ; 54(8): e10782, 2021. tab, graf
Article in English | LILACS | ID: biblio-1249333


We explored the cascade effects of a high fat-carbohydrate diet (HFCD) and pioglitazone (an anti-diabetic therapy used to treat type 2 diabetes mellitus (T2DM)) on lipid profiles, oxidative stress/antioxidant, insulin, and inflammatory biomarkers in a rat model of insulin resistance. Sixty albino rats (80-90 g) were randomly divided into three dietary groups; 1) standard diet; 2) HFCD diet for 12 weeks to induce an in vivo model of insulin resistance; and 3) HFCD diet plus pioglitazone. Blood and tissue samples were taken to assess hepatic function, lipid profiles, oxidative biomarkers, malondialdehyde (MDA) levels, antioxidant defense biomarkers, including reduced glutathione (GSH), superoxide dismutase (SOD), and the inflammatory markers interleukin-6 (IL-6) and tumor necrotic factor (TNF-α). HFCD-fed rats had significantly (P≤0.05) increased serum triacylglycerol (TG), total cholesterol (TC), low-density lipoprotein (LDL), alanine transaminase (ALT), and bilirubin levels, but decreased high-density lipoprotein (HDL) levels compared with the normal group. Moreover, serum leptin, resistin, TNF-α, and IL-6 levels were increased significantly in HFCD animals compared with controls. Similarly, HFCD-induced insulin resistance caused antioxidant and cytokine disturbances, which are important therapy targets for pioglitazone. Importantly, administration of this drug ameliorated these changes, normalized leptin and resistin and inflammatory markers by reducing TNF-α levels. Metabolic cascades of elevated lipid profiles, oxidative stress, insulin, and inflammatory biomarkers are implicated in insulin resistance progression. HFCD induced metabolic cascades comprising hypertriglyceridemia, hyperglycemia, insulin resistance, obesity-associated hormones, and inflammatory biomarkers may be alleviated using pioglitazone.

Animals , Rats , Insulin Resistance , Diabetes Mellitus, Type 2/metabolism , Diabetes Mellitus, Type 2/drug therapy , Carbohydrates/pharmacology , Oxidative Stress , Diet, High-Fat , Pioglitazone/metabolism , Pioglitazone/pharmacology , Insulin/metabolism , Liver/metabolism , Anti-Inflammatory Agents/pharmacology , Antioxidants/pharmacology
Arch. latinoam. nutr ; 69(2): 99-106, jun. 2019. tab, graf
Article in Spanish | LILACS, LIVECS | ID: biblio-1053037


La obesidad infantil representa un factor importante en el desarrollo del síndrome metabólico (SM). En este sentido el factor neurotrófico derivado del cerebro (BDNF: Brain Derived Neurotrophic Factor) interviene en el metabolismo energético así como en vías que controlan el peso corporal y desórdenes metabólicos. El objetivo de este estudio fue determinar si hay una correlación entre el BDNF con los marcadores que definen al síndrome metabólico en una población infantil de México. Se integraron al estudio 100 niños con un rango de edad de 5-13 años, se estratificaron en tres grupos, normo peso, sobrepeso y obesidad, a los cuales se les determinaron las variables antropométricas, percentil de la tensión arterial sistólica y diastólica, concentraciones séricas de glucosa, triglicéridos, colesterol de alta densidad (HDL) y BDNF. Se aplicó ANOVA y una correlación de Pearson. Los resultados muestran que la prevalencia de SM utilizando los criterios de Cook y Weiss fue del 14%, mientras que por la Federación Internacional de Diabetes (IDF) es del 11%. La circunferencia de cintura, triglicéridos, colesterol HDL, presión arterial sistólica/diastólica y glucosa, mostraron diferencias significativas entre los grupos estudiados (*p<0,001). El BDNF se correlacionó positivamente con la desviación estándar del índice de masa corporal de acuerdo con la edad (DE-IMCE) (p=0,01), el percentil del perímetro de la cintura (p=0,00), la presión arterial sistólica (p=0,01) y las concentraciones plasmáticas de glucosa (p=0,02). Estos datos muestran que existe una correlación entre el BDNF con la DE-IMCE, la circunferencia de la cintura, la presión arterial sistólica y glucosa(AU)

Childhood obesity represents an important factor in the development of metabolic syndrome (MS). In this sense, the brain derived neurotrophic factor (BDNF) is involved in energy metabolism as well as in pathways that control body weight and metabolic disorders. The objective of this study was to determine if there is a correlation between BDNF with the markers that define the metabolic syndrome in a child population in Mexico. The study included 100 children with an age range of 5-13 years, stratified into three groups, normal weight, overweight and obesity, which were determined anthropometric variables, percentile of systolic and diastolic blood pressure, concentrations serum glucose, triglycerides, high density cholesterol (HDL) and BDNF. ANOVA and Pearson correlation were applied. The results show that the prevalence of MS using the Cook and Weiss criteria was 14%, while for the International Diabetes Federation (IDF) it is 11%. Waist circumference, triglycerides, HDL cholesterol, systolic/diastolic blood pressure and glucose showed significant differences between the groups studied (*p<0.001). The BDNF was positively correlated with the standard deviation of the body mass index according to age (DE-IMCE) (p=0.01), the percentile of the waist circumference (p=0.00), systolic blood pressure (p=0.01) and plasma glucose concentrations (p=0.02). These data show that there is a correlation between BDNF with DE-IMCE, waist circumference, systolic blood pressure and glucose(AU)

Humans , Male , Female , Child , Body Weights and Measures , Brain-Derived Neurotrophic Factor/analysis , Metabolic Syndrome/physiopathology , Lipid Metabolism , Insulin/metabolism , Anthropometry , Pediatric Obesity , Noncommunicable Diseases
Rev. Assoc. Med. Bras. (1992) ; 65(1): 70-86, Jan. 2019. tab, graf
Article in English | LILACS | ID: biblio-985001


SUMMARY The prevalence of type 2 diabetes mellitus (T2DM) in the elderly grew sharply over the last decade. Reduced insulin sensitivity and secretory capacity, weight gain, sarcopenia, and elevated adiposity are all common metabolic and body changes in the aging population that favor an increased risk of hypoglycemia, frailty syndrome, falls, and cognitive dysfunction. First line antidiabetic therapy is frequently not safe in older individuals because of its high risk of hypoglycemia and prevalent co-morbid diseases, such as chronic kidney disease, osteoporosis, cardiovascular disease, and obesity. Sodium-glucose cotransporter 2 inhibitor (SGLT2i) is a new class of antidiabetic therapy that inhibits glucose and sodium reabsorption on renal proximal convoluted tubule. Its effect is well demonstrated in various clinical scenarios in the younger population. This review and metanalysis describe particularities of the SGLT2i on the elderly, with mechanistic insights of the potential benefit and remaining challenges about the use of these drugs in this important age group. Further, we will present a meta-analysis of the main effects of SGLT2i reported in post-hoc studies in which the median age of the subgroups analyzed was over 60 years. Despite the absence of specific clinical trials for this population, our findings suggest that SGLT2i therapy on older individuals is effective to lower glucose and maintain its effect on systolic blood pressure and body weight.

RESUMO A prevalência da diabetes mellitus tipo 2 em idosos cresceu muito na última década. A redução na sensibilidade à insulina e na capacidade secretora, ganho de peso, sarcopenia e adiposidade elevada são todas alterações metabólicas e corporais comuns entre a população idosa. Essas mudanças críticas favorecem o aumento no risco de hipoglicemia, síndrome de fragilidade, quedas e disfunções cognitivas. A primeira linha de tratamento contra a diabete muitas vezes não é segura para indivíduos mais velhos devido ao alto risco de hipoglicemia e a prevalência de comorbidades patogênicas, como doença renal crônica, osteoporose, doença cardiovascular e obesidade. Os inibidores do cotransportador sódio-glicose 2 (SGLT2) são uma nova classe de tratamento contra a diabete que inibe reabsorção de glicose e sódio na parte convoluta do túbulo proximal. Seu efeito é claramente demonstrado em diversos cenários clínicos em populações mais jovens. Esta revisão e meta-análise descreve as particularidades dos SGLT2 na população idosa, abordando os mecanismos dos potenciais benefícios e desafios ainda presentes do uso destes medicamentos nesse grupo etário tão importante. Além disso, apresentaremos uma meta-análise dos principais efeitos dos SGLT2 encontrados em estudos post-hoc nos quais a idade média dos subgrupos analisados foi acima de 60 anos. Apesar da ausência de ensaios clínicos que incluem essa população, os dados encontrados sugerem que o tratamento com SGLT2 em idosos é eficaz para diminuir os níveis de glicose e tem efeitos na pressão arterial sistólica e no peso corporal.

Humans , Aged , Aged, 80 and over , Diabetes Mellitus, Type 2/drug therapy , Sodium-Glucose Transporter 2 Inhibitors/therapeutic use , Hypoglycemic Agents/therapeutic use , Cardiovascular Diseases/metabolism , Cardiovascular Diseases/drug therapy , Risk Factors , Frail Elderly , Diabetes Mellitus, Type 2/metabolism , Insulin/metabolism , Middle Aged
HU rev ; 45(2): 195-202, 2019.
Article in Portuguese | LILACS | ID: biblio-1048957


Introdução: A síndrome do ovário policístico (SOP) é uma disfunção hormonal que acomete mulheres em idade reprodutiva podendo causar infertilidade, alterações no ciclo menstrual, hirsutismo, presença de cistos nos ovários, amenorreia e distúrbios metabólicos. Dentre as alterações metabólicas, resistência à insulina (RI) está presente em 70,5% das brasileiras com SOP. Objetivo: Revisar sistematicamente a literatura para descrever os efeitos da suplementação de ômega-3 na RI em mulheres com SOP. Materiais e métodos: As buscas pela informação foram realizadas na base de dados PubMed e LILACS utilizando os descritores "síndrome do ovário policístico"; "ácidos graxos ômega-3" e "resistência à insulina", em português e inglês. Resultados: Foram encontrados sessenta estudos e após o crivo metodológico seis foram selecionados para compor esta revisão. Ao total dos ensaios clínicos incluídos nesta revisão, 326 mulheres com faixa etária correspondente a 18-45 anos foram avaliadas com variações de índice de massa corporal entre 25 e 45 kg/m2. A variação de tempo de acompanhamento entre os estudos foi de 2 a 6 meses. Discussão: Em todos os estudos incluídos nesta revisão, a homeostase da glicose sérica foi avaliada pelo índice HOMA. Apenas 1 estudo avaliou o índice quantitativo de verificação da sensibilidade à insulina (QUICK1); 2 estudos avaliaram hemoglobina glicada e índice de sensibilidade à insulina (ISI de Matsuda). A avaliação da insulinemia de jejum foi realizada em 4 estudos. Metade dos estudos incluídos suplementou os pacientes com 1.000 mg de ômega-3 ao dia, enquanto 25% dos estudos utilizou a dosagem de 2000 mg/dia 25% utilizou 4000 mg/dia. A maioria das pesquisas encontradas (67%) descreveu efeito positivo entre a suplementação de ômega-3 e melhora da RI de mulheres com SOP, utilizando os diferentes métodos de dosagem da homeostase da glicose sérica. Conclusão: Conclui-se que o consumo de ômega-3 pode ter efeito positivo sobre a RI.

Introduction: Polycystic ovarian syndrome (PCOS) is a hormonal dysfunction that affects women of childbearing age and can cause infertility, changes in the menstrual cycle, hirsutism, ovarian cysts, amenorrhea, and metabolic disorders. Among the metabolic changes insulin resistance (IR) is present in 70.5% of Brazilians with PCOS. Objective:To systematically review the literature to describe the effects of omega-3 supplementation on IR in women with PCOS. Materials and methods: Information searches were performed in the PubMed and LILACS database using the descriptors "polycystic ovarian syndrome"; "fatty acids omega-3" and "insulin resistance", in Portuguese and English. Results: Sixty studies were found and six were selected to compose this review. In the total of the clinical trials included in this review, 326 women aged 18-45 years were evaluated with variations in body mass index between 25 and 45 kg/m2. The variation in follow-up time between the studies was from 2 to 6 months. Discussion: In all studies included in this review, serum glucose homeostasis was assessed by the HOMA index. Only 1 study evaluated the quantitative index of insulin sensitivity (QUICK1); 2 studies evaluated glycated hemoglobin and insulin sensitivity index (Matsuda ISI). The evaluation of fasting insulinemia was performed in 4 studies. Half of the included studies supplemented patients with 1000 mg omega-3 daily, while 25% of the studies used the dosage of 2000 mg / day 25% used 4000 mg / day. Most of the researches (67%) described a positive effect between omega-3 supplementation and improvement of IR in women with PCOS, using the different dosing methods for serum glucose homeostasis. Conclusion: It is concluded that omega-3 consumption may have a positive effect on IR.

Humans , Female , Adolescent , Adult , Middle Aged , Young Adult , Polycystic Ovary Syndrome/metabolism , Insulin Resistance , Fatty Acids, Omega-3/pharmacology , Dietary Supplements , Blood Glucose/metabolism , Insulin/metabolism
Rev. chil. endocrinol. diabetes ; 12(4): 208-215, 2019. tab, ilus
Article in Spanish | LILACS | ID: biblio-1088029


INTRODUCCIÓN: Si bien, los edulcorantes no nutritivos (ENN) estevia y D-tagatosa han sido reportados como seguros, han demostrado tener algunos efectos metabólicos tras su ingesta. OBJETIVO: Describir los efectos de la ingesta de estevia y D-tagatosa sobre el metabolismo de la glucosa y ácido úrico, y del apetito-saciedad, a partir de la evidencia disponible. MÉTODOS: Revisión descriptiva. Se realizó búsqueda en PubMed utilizando los siguientes términos y palabras clave: "stevia rebaudiana", "tagatose", "D-tagatose", "blood glucose", "insulin", "metabolic processes", "uric acid", "hyperuricemia", "appetite" o "satiety". El análisis de los estudios seleccionados fue discrecional. RESULTADOS: Existen estudios que demuestran efectos beneficiosos tras el consumo de estevia o D-tagatosa sobre el control glicémico, apetito y saciedad tanto en sujetos sanos como con alteraciones en el metabolismo de la glucosa. Por otra parte, un número importante de estudios que evalúan la ingesta de estevia reportan efectos nulos sobre dichos parámetros. En relación al ácido úrico, solo un estudio en sujetos con enfermedad renal crónica reporta aumento en la concentración de ácido úrico plasmático tras la ingesta de 500 mg/día de estevia. Pocos estudios han evaluado el efecto de la ingesta de D-tagatosa sobre uricemia, en sujetos sanos y diabéticos, reportando un aumento transitorio y significativo en los niveles de ácido úrico sérico, sin embargo, no se ha logrado demostrar un efecto hiperuricémico asociado. Es importante destacar que la metodología de los estudios revisados es heterogénea, especialmente en relación al tamaño muestral, tiempo, dosis y vía de adminitración del edulcorante. CONCLUSIÓN: La ingesta de estevia y D-tagatosa ha demostrado efectos beneficiosos sobre el metabolismo de la glucosa, el apetito y la saciedad. El efecto del consumo de D-tagatosa sobre ácido úrico sérico requiere mayor evidencia para demostrar su significancia clínica.

INTRODUCTION: No-nutritive sweeteners stevia and D-tagatose have been reported as safe according to their acceptable daily intake, however, they have been shown to have metabolic effects after their ingestion. OBJECTIVE: To describe the effects of stevia and D-tagatose intake on parameters associated to glucose, uric acid metabolism and on appetite-satiety, considering the available evidence. METHODS: Descriptive review. PubMed search was carried out to identify the totality of the published articles. The following terms and key words were used: "stevia rebaudiana", "tagatose", "D-tagatose", "blood glucose", "insulin", "metabolic processes", "uric acid", "hyperuricemia", "appetite" o "satiety". The analysis of the selected studies was discretionary. RESULTS: studies have shown beneficial effects of stevia and D-tagatose consumption on glycemic control, appetite and satiety in healthy subjects as well as subjects with impairment glucose metabolism. On the other hand, a significant number of studies evaluating estevia intake report null effects on these parameters. In relation to uric acid, only one study in subjects with chronic kidney disease reported an increase in plasmatic uric acid concentration after the intake of 500 mg/day of stevia. Several studies have evaluated the effect of D-tagatose intake on plasmatic uric acid, in healthy and diabetic subjects, reporting a transient and significant increase in serum uric acid levels, however, has not been able to demonstrate an associated hyperuricemic effect. It is important to highlight that the methodology of the studies reviewed is heterogeneous, especially in relation to sample size, dose administered, time and route of exposure to the sweetener. CONCLUSION: Stevia and D-tagatose intake has shown beneficial effects on glucose metabolism, appetite and satiety. The effects of the consumption of both sweeteners on uric acid require further study to demonstrate their clinic significance.

Humans , Sweetening Agents/pharmacology , Uric Acid/metabolism , Blood Glucose/drug effects , Appetite/drug effects , Satiation/drug effects , Stevia/metabolism , Glucose/metabolism , Hexoses/pharmacology , Insulin/metabolism
Actual. osteol ; 13(3): 225-232, Sept - DIc. 2017. ilus
Article in Spanish | LILACS | ID: biblio-1117386


El esqueleto es uno de los sistemas más grandes de un vertebrado y, como tal, es razonable especular que no puede funcionar aislado del resto del organismo. De hecho, sabemos que existen sistemas complejos de regulación cruzada entre el esqueleto y muchos otros órganos. Hoy poseemos herramientas que nos permiten realizar supresión genética en células o tejidos específicos. Esto nos ha permitido comprender cómo los órganos se comunican entre sí y ha revitalizado el concepto de fisiología del organismo como un todo. Efectivamente, los últimos años han sido testigos del descubrimiento de funciones inesperadas que ejerce el esqueleto y que afectan al organismo en su totalidad. Una de tales funciones reconocidas recientemente es el control del metabolismo energético, a través de la secreción de osteocalcina. La osteocalcina es una hormona producida por los osteoblastos que regula la secreción de insulina, la sensibilidad a esta hormona y el metabolismo energético. Los hallazgos iniciales suscitaron varias preguntas fundamentales sobre la naturaleza de la acción de la insulina sobre el hueso. Pero esto solo fue la punta del iceberg. Efectivamente, más adelante se descubrió, mediante el análisis de ratones que carecen del receptor de insulina (Ins R) solamente en osteoblastos, que la acción de la insulina sobre estas células favorecía la homeostasis de la glucosa en todo el cuerpo. Es importante destacar que esta función de la insulina en los osteoblastos opera mediante la regulación negativa de la carboxilación y la biodisponibilidad de la osteocalcina. Más aún, se observó que las vías de señalización de la insulina en los osteoblastos regulan positivamente no solo la formación sino también la resorción del hueso. Curiosamente, parece que las vías de señalización de la insulina en osteoblastos pueden inducir la activación de la osteocalcina mediante la estimulación de la actividad de los osteoclastos. De hecho, el bajo pH generado durante la resorción ósea es suficiente para desencadenar la descarboxilación (y subsiguiente activación) de la osteocalcina. En breve discutiremos dos nuevas proposiciones: 1) los osteoblastos son un blanco utilizado por la insulina para controlar la homeostasis de la glucosa en todo el organismo y 2) la resorción ósea desempeña un papel fundamental en la regulación de la activación de la osteocalcina. (AU)

The skeleton is one of the biggest systems in a vertebrate animal and, as such, it is reasonable to speculate that it cannot function isolated from the rest of the organism. In fact, we know that complex systems exist for the cross-regulation between the skeleton and several other organs. Today, we have the tools that allow us to perform genetic suppression in specific cells or tissues. This has allow us understand the mechanisms by which the organs communicate with each other and has revitalized the concept of organismal physiology as a whole. Studies conducted in recent years have uncovered unexpected functions performed by the skeleton. One of these is the control of global energy metabolism, through the secretion of osteocalcin, a protein produced by osteoblasts that acts as a hormone regulating insulin secretion, insulin sensitivity and energy expenditure. The evidence comes from the analysis of mice lacking insulin receptor (InsR) exclusively in osteoblasts. These mice have a global metabolic phenotype demonstrating that the action of insulin in osteoblasts promotes the homeostasis of glucose throughout the body. This action of insulin in osteoblasts is mediated by the negative regulation of the carboxylation (and bioavailability) of osteocalcin. The decarboxylation (and activation) of osteocalcin, in turn, occurs in the osteoclastic resorption pit. Briefly: the osteoblast is a target used by insulin to control the homeostasis of glucose throughout the body and bone resorption is the mechanism that regulates the activation of osteocalcin. (AU)

Humans , Animals , Mice , Osteocalcin/biosynthesis , Energy Metabolism , Insulin/biosynthesis , Osteoblasts/metabolism , Osteogenesis , Skeleton/physiology , Skeleton/metabolism , Bone Resorption/metabolism , Receptor, Insulin/metabolism , Signal Transduction , Osteocalcin/metabolism , Decarboxylation , Insulin Secretion , Glucose/biosynthesis , Glucose/metabolism , Insulin/metabolism
Arch. endocrinol. metab. (Online) ; 61(4): 361-366, July-Aug. 2017. tab, graf
Article in English | LILACS | ID: biblio-887577


ABSTRACT Objective We evaluated the prevalence of glutamic acid decarboxylase (GADA) and tyrosine phosphatase-protein antibodies (IA2A), their titers and their relation to first phase insulin response (FPIR) and glucose tolerance in autoimmune thyroid diseases (ATDs) patients. Subjects and methods Graves' disease (GD; n = 181) and Hashimoto's thyroiditis (HT; n = 143) patients in addition to healthy controls (n = 93) were studied. Secondly, FPIR and oral glucose tolerance tests (OGTT) were performed in 11 anti-pancreatic islet-cell (+) and in 20 anti-pancreatic-cell (-) patients. Results There was a non significant trend for higher prevalence of GADA positivity in GD vs HT (7.2% vs 2% p = 0.06), but the GADA titers were higher in HT. We also did not find a significant difference in IA2 prevalence (0.7% vs 0.0%) between these two groups or compared to the control group. In the subsequent analysis, low FPIR was found in 10% of these patients but without statistical difference for OGTT between pancreatic antibody-positive and -negative patients. Conclusion A trend for greater prevalence of GADA was observed for GD patients than for HT or control. However, the titers of these autoantibodies were higher in HT patients, but there was no significant relation to insulin secretion and glucose tolerance at that moment and stage of autoimmune diseases.

Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , Autoantibodies/analysis , Blood Glucose/analysis , Graves Disease/enzymology , Protein Tyrosine Phosphatases/immunology , Hashimoto Disease/enzymology , Glutamate Decarboxylase/immunology , Insulin/metabolism , Graves Disease/blood , Protein Tyrosine Phosphatases/blood , Hashimoto Disease/blood , Insulin Secretion , Glucose Tolerance Test , Glutamate Decarboxylase/blood , Insulin/blood
Ann. hepatol ; 16(2): 215-220, Mar.-Apr. 2017. tab
Article in English | LILACS | ID: biblio-887225


ABSTRACT Introduction and aim. The effect of the new direct acting antiviral drugs (DAAs) for chronic hepatitis C (HCV) on glycemic control is unknown. Materials and methods. We conducted a retrospective cohort study of patients who were treated for chronic HCV with direct-acting antiviral medications at a single academic institution between May 2013 and April 2016. Univariate analysis was performed comparing subjects pre- and post-treatment. Results. One hundred seventy-five consecutive adult patients were treated for chronic HCV and met enrollment criteria. The majority (80.8%) were genotype 1 and overall cohort sustained virologic response at week 12 (SVR12) was 97.8%. Thirty-one (18.5%) had diabetes mellitus (DM); twenty-six had pre- and post-treatment HbA1c values. Of these, 76.9% were male and 61.5% had cirrhosis. Ninety-six percent were prescribed sofosbuvir-based therapy and all but one (96.8%) achieved SVR12. Three patients were started on treatment despite meeting the definition for poorly controlled DM (HbA1c > 9 mg/dL). There was no significant difference when comparing pre-treatment (7.36 mg/dL, 95% CI 6.55-8.16) to post-treatment HbA1c (7.11 mg/dL, 95% CI 6.34-7.88, p = 0.268). Thirty-one percent of subjects required dose escalation or the initiation of insulin based therapy during treatment. Discussion. Although chronic HCV is associated with exacerbation of insulin resistance, our results showed HbA1c to be unaffected by eradication of chronic HCV with DAA in diabetic patients with and without cirrhosis. Paradoxically, almost 1/3 of patients required escalation of anti-diabetic therapy during treatment. Long-term studies are warranted to understand the relationship between HCV viral eradication and insulin metabolism.(AU)

Humans , Antiviral Agents/pharmacology , Hepatitis C, Chronic/drug therapy , Glycemic Index , Retrospective Studies , Cohort Studies , Diabetes Mellitus/pathology , Insulin/metabolism
Braz. j. med. biol. res ; 50(5): e5858, 2017. tab, graf
Article in English | LILACS | ID: biblio-839295


Modifications in life-style and/or pharmacotherapies contribute to weight loss and ameliorate the metabolic profile of diet-induced obese humans and rodents. Since these strategies fail to treat hypothalamic obesity, we have assessed the possible mechanisms by which duodenal-jejunal bypass (DJB) surgery regulates hepatic lipid metabolism and the morphophysiology of pancreatic islets, in hypothalamic obese (HyO) rats. During the first 5 days of life, male Wistar rats received subcutaneous injections of monosodium glutamate (4 g/kg body weight, HyO group), or saline (CTL). At 90 days of age, HyO rats were randomly subjected to DJB (HyO DJB group) or sham surgery (HyO Sham group). HyO Sham rats were morbidly obese, insulin resistant, hypertriglyceridemic and displayed higher serum concentrations of non-esterified fatty acids (NEFA) and hepatic triglyceride (TG). These effects were associated with higher expressions of the lipogenic genes and fatty acid synthase (FASN) protein content in the liver. Furthermore, hepatic genes involved in β-oxidation and TG export were down-regulated in HyO rats. In addition, these rats exhibited hyperinsulinemia, β-cell hypersecretion, a higher percentage of islets and β-cell area/pancreas section, and enhanced nuclear content of Ki67 protein in islet-cells. At 2 months after DJB surgery, serum concentrations of TG and NEFA, but not hepatic TG accumulation and gene and protein expressions, were normalized in HyO rats. Insulin release and Ki67 positive cells were also normalized in HyO DJB islets. In conclusion, DJB decreased islet-cell proliferation, normalized insulinemia, and ameliorated insulin sensitivity and plasma lipid profile, independently of changes in hepatic metabolism.

Animals , Male , Duodenum/surgery , Fatty Liver/metabolism , Gastric Bypass/methods , Hypothalamic Diseases/metabolism , Islets of Langerhans/cytology , Islets of Langerhans/metabolism , Jejunum/surgery , Obesity/metabolism , Animals, Newborn , Blood Glucose/metabolism , Cell Proliferation , Cholesterol/blood , Fatty Acid Synthase, Type I/metabolism , Fatty Acids/blood , Fatty Liver/physiopathology , Hypothalamic Diseases/physiopathology , Hypothalamic Diseases/surgery , Insulin Resistance , Insulin/metabolism , Islets of Langerhans/physiopathology , Lipogenesis/genetics , Liver/metabolism , Liver/pathology , Obesity/physiopathology , Obesity/surgery , Pancreas/metabolism , Pancreas/pathology , Random Allocation , Rats, Wistar , Reproducibility of Results , Time Factors , Triglycerides/blood
Motriz (Online) ; 23(spe): e101611, 2017. graf
Article in English | LILACS | ID: biblio-841859


Abstract AIMS Previously, we verified that overtrained mice upregulated the TRB3 levels, its association with Akt, and the hepatic concentrations of glycogen. It is known that APPL1 can limit the interaction between TRB3 and Akt, playing an important role in the glucose homeostasis. Thus, we verified the effects of three overtraining protocols on the hepatic levels of APPL1 and APPL2. METHODS Rodents were divided into control (CT), overtrained by downhill running (OTR/down), overtrained by uphill running (OTR/up) and overtrained by running without inclination (OTR). The hepatic contents of APPL1 and APPl2 were measured by the immunoblotting technique. RESULTS Significant elevation of APPL1 observed in the OTR/down and OTR/up groups, as well as the tendency of increase (p=0.071) observed in the OTR group. CONCLUSION These results indicate that this particular protein is likely to participate in the glucose homeostasis previously observed in response to these OT protocols.(AU)

Animals , Male , Mice , Adaptation, Physiological/physiology , Adaptor Proteins, Signal Transducing/metabolism , Hemostasis/physiology , Insulin/metabolism , Liver/physiology , Resistance Training , Mice, Inbred C57BL
Arch. latinoam. nutr ; 66(4): 294-300, dic. 2016. tab
Article in Spanish | LILACS, LIVECS | ID: biblio-838456


El Índice y Carga Glicémica (IG y CG) categorizan los alimentos según su capacidad de incrementar la glicemia, considerando cantidad y calidad de hidratos de carbono consumidos. Diferentes estudios han postulado que una dieta con IG y CG altos y bajo consumo de fibra incrementan la glicemia e insulinemia, aunque con resultados heterogéneos.El objetivo de este estudio fue analizar la asociación entre IG, CG e ingesta de fibra y valores HOMA-IR en adultos jóvenes. En una muestra representativa de 738 personas que tenían entre 32 y 38 años, nacidos en el Hospital de Limache, Región de Valparaíso, Chile, se recogió información socioeconómica, de salud, se determinó estado nutricional, glicemia, insulina basal y HOMA, y con la encuesta de frecuencia de consumo se estimó IG, CG e ingesta de fibra. Se construyeron modelos de regresión múltiple, controlando efectos de confusión e interacción. En modelos ajustados, se observó que por cada 10 unidades que aumenta el IG y CG de la dieta en individuos con exceso de peso, aumenta el HOMA-IR en 0,31 (p=0,042) y 0,03 (p=0,012), respectivamente y por cada 10 gramos que aumenta la fibra total y soluble, disminuye el HOMA-IR en 0,10 (p=0,04) y 0,62 (p=0,034) respectivamente. En personas sin exceso de peso no hubo estos efectos. Existe una asociación directa entre el aumento de IG y CG de los alimentos y el incremento de HOMA-IR sólo en individuos con exceso de peso y una asociación inversa entre ingesta de fibra dietética total y soluble y HOMA-IR(AU)

Glycemic index, glycemic load and dietary fiber of foods and its association with insulin resistance in Chilean adults. Glycemic index and glycemic load (GI and GL) categorize foods according to their ability to increase blood sugar levels, considering quantity and quality of carbohydrates consumed. Different studies have postulated that a high GI and GL diet and low fiber intake increased glycemia and insulinemia, although with heterogeneous results. The aim of this study was to analyze the association between GI, GL and fiber intake and HOMA-IR values in young adults. In a representative sample of 738 people aged between 32 and 38 years old, born in the Limache’s Hospital, Valparaiso, Chile, socioeconomic and health information, nutritional status, basal glycemia, insulin and HOMA were collected. With a food frequency questionnaire, GI, GL and fiber intake were estimated. Multiple regression models were constructed, controlling confounding and interaction effects. In adjusted models, it was found that for every 10 units that increases diet GI and GL in overweight individuals, HOMA- IR increases in 0.31 (p = 0.042) and 0.03 (p = 0.012) respectively, and for every 10 grams that increases total and soluble fiber intake, HOMA-IR reduces in 0.10 (p = 0.04) and 0.62 (p = 0.034) respectively. In people without overweight such effects were not observed. There was a direct association bet- ween increased GI and GL foods and increased HOMA-IR only in individuals with overweight and an inverse association between total and soluble fiber intake and HOMA-IR(AU)

Insulin Resistance , Dietary Fiber , Glycemic Index , Overweight/etiology , Glycemic Load , Insulin/metabolism , Obesity/etiology , Carbohydrates , Public Health , Chronic Disease , Malnutrition
Arq. bras. oftalmol ; 79(2): 105-110, Mar.-Apr. 2016. tab, graf
Article in English | LILACS | ID: lil-782803


ABSTRACT Purpose: The goal of the present study was to establish a protocol for primary culture of lacrimal gland acinar cells (LGACs) and to assess the effect of adding insulin to the culture media. Methods: LGACs were isolated and cultured from lacrimal glands of Wistar male rats. The study outcomes included cell number, viability, and peroxidase release over time and in response to three concentrations of insulin (0.5, 5.0, and 50.0 μg/mL). Results: In LGAC primary culture, cells started to form clusters by day 3. There was a time-response pattern of peroxidase release, which rose by day 6, in response to carbachol. Culture viability lasted for 12 days. An insulin concentration of 5.0 μg/mL in the culture medium resulted in higher viability and secretory capacity. Conclusions: The present method simplifies the isolation and culture of LGACs. The data confirmed the relevance of adding insulin to maintain LGACs in culture.

RESUMO Objetivo: O objetivo do estudo foi estabelecer um protocolo de cultura primária para o isolamento de células acinares da glândula lacrimal (CAGL) e avaliar a relevância de insulina no meio de cultura. Métodos: CAGL foram isoladas e cultivadas a partir das glândulas lacrimais de ratos Wistar machos. Os parâmetros analisados foram: o número de células, viabilidade e secreção da peroxidase ao longo do tempo e em resposta a três concentrações de insulina (0,5; 5,0 e 50,0 μg/ml). Resultados: Na cultura primária de CAGL as células passaram a se agrupar por volta do dia 3. A secreção de peroxidase em resposta ao carbacol aumentou no dia 6. O período de cultura viável foi limitado à 12 dias. Insulina à 5,0 μg/ml no meio de cultura resultou em viabilidade e capacidade secretora maior. Conclusão: o estudo descreveu um método para simplificar o isolamento e cultivo de CAGL. Os dados apresentados confirmam a importância da insulina na manutenção da cultura de CAGL.

Animals , Male , Acinar Cells/cytology , Primary Cell Culture/standards , Insulin/pharmacology , Lacrimal Apparatus/cytology , Carbachol/metabolism , Cell Count/methods , Cell Separation/methods , Rats, Wistar , Peroxidase/metabolism , Acinar Cells/drug effects , Acinar Cells/metabolism , Insulin/metabolism , Lacrimal Apparatus/metabolism
Article in English | WPRIM | ID: wpr-165886


The prevalence of diabetes mellitus (DM) and associated diseases such as cancers are substantially increasing worldwide. About 80% of the patients with pancreatic cancer have glucose metabolism alterations. This suggests an association between type 2 DM and pancreatic cancer risk and progression. There are hypotheses that show metabolic links between the diseases, due to insulin resistance, hyperglycemia, hyperinsulinemia, low grade chronic inflammation, and alteration in the insulin-insulin-like growth factor axis. The use of diabetes medications can influence the extent of carcinogenesis of the pancreas. This study briefly reviews recent literature on investigation of metabolic link of type 2 DM, risk of carcinogenesis of the pancreas and their association, as well as the current understanding of metabolic pathways implicated in metabolism and cellular growth. The main finding of this review, although there are discrepancies, is that according to most research long-term DM does not raise the risk of pancreatic cancer. The longest duration of DM may reflect hypoinsulinemia due to treatment for hyperglycemia, but recent onset diabetes was associated with increased risk for pancreatic cancer due to hyperinsulinemia and hyperglycemia. In conclusion, the review demonstrates that type 2 DM and the duration of diabetes pose a risk for pancreatic carcinogenesis, and that there is biological link between the diseases.

Diabetes Mellitus, Type 2/complications , Humans , Hyperglycemia/pathology , Insulin/metabolism , Insulin Resistance , Insulin-Like Growth Factor I/metabolism , Pancreatic Neoplasms/epidemiology , Risk Factors
Clin. biomed. res ; 36(3): 148-155, 2016. tab, graf
Article in Portuguese | LILACS | ID: biblio-831715


Introdução: O tecido adiposo é um importante órgão endócrino secretor de adipocinas como a interleucina-6 (IL-6), que estimula a produção de proteínas de fase aguda no fígado, conduzindo a um estado inflamatório subclínico associado ao surgimento de comorbidades presentes na obesidade, como a resistência à insulina (RI). O objetivo deste estudo foi avaliar a concentração de IL-6 em jovens obesos, com sobrepeso e de peso normal, correlacionando as concentrações dessa citocina com biomarcadores de RI. Métodos: Foi conduzido um estudo transversal que envolveu 149 indivíduos: 54 saudáveis (32 mulheres e 22 homens), 27 com sobrepeso (17 mulheres e 10 homens) e 68 obesos (41 mulheres e 27 homens). As medidas antropométricas e as concentrações de IL-6, insulina, hemoglobina glicada e glicose foram determinadas, assim como os cálculos do Modelo de Avaliação da Homeostase (HOMA) e da sensibilidade insulínica (SI). Resultados: Pacientes obesos mostraram níveis de IL-6, glicose, insulina e HOMA significativamente superiores e redução da SI quando comparados com pacientes de peso normal. Correlações positivas foram observadas entre IL-6, glicose, insulina e HOMA. Conclusão: Este estudo sugere que a IL-6 pode ter um papel-chave no desenvolvimento da RI em obesos e que o aumento de sua produção pode contribuir para a inflamação do tecido adiposo e interferir significativamente na atividade da insulina. Embora mais estudos clínicos sejam necessários para elucidar os reais mecanismos de interferência da IL-6 sobre a SI, sugere-se que essa citocina poderá ser, no futuro, uma determinação importante para avaliar e monitorar a RI em obesos jovens (AU)

Introduction: Adipose tissue is a major endocrine organ responsible for secretion of adipokines, such as interleukin-6 (IL-6), which stimulates the production of acute phase proteins in the liver, leading to a proinflammatory condition associated with the development of comorbidities in obesity, such as insulin resistance (IR). The aim of this study was to evaluate the IL-6 concentration in obese, overweight, and normal-weight young adults, correlating the concentrations of this cytokine with IR biomarkers. Methods: A cross-sectional study was conducted involving 149 subjects: 54 healthy subjects (32 women and 22 men), 27 overweight subjects (17 women and 10 men) and 68 obese subjects (41 women and 27 men). The anthropometric measures and IL-6, insulin, glucose, and glycated hemoglobin concentrations were determined, as well as HOMA and insulin sensitivity levels. Results: Obese patients showed significantly higher IL-6 levels of glucose, insulin, and HOMA and lower SI compared with normal-weight patients. Positive correlations were observed between IL-6, glucose, insulin, and HOMA. Conclusions: The present study suggests that IL-6 may have a key role in the development of IR in obese patients, and increasing its production can contribute to inflammation in adipose tissue and significantly interfere with insulin activity. Although further clinical studies are needed to elucidate the actual IL-6 interference mechanisms on SI, we believe that this cytokine may be an important factor to evaluate and monitor IR in obese young adults in the future (AU)

Humans , Adult , Insulin Resistance/physiology , Interleukin-6/blood , Obesity/metabolism , Adipose Tissue/physiopathology , Biomarkers/blood , Body Weight , Insulin/blood , Insulin/metabolism , Interleukin-6/metabolism
Dental press j. orthod. (Impr.) ; 20(2): 55-60, Mar-Apr/2015. tab, graf
Article in English | LILACS | ID: lil-745858


OBJECTIVE: To assess bone thickness for miniscrew placement in the mandible during mixed dentition by using digital volumetric tomograph (DVT). MATERIAL AND METHODS: A total of 15 healthy patients aged 8-10 years old, with early exfoliated mandibular second deciduous molar, were included. DVT images of one quadrant of the mandible were obtained using Kodak extraoral imaging systems and analyzed by Kodak dental imaging software. The error of the method (EM) was calculated using Dahlberg's formula. Mean and standard deviation were calculated at 6 and 8 mm from the cementoenamel junction (CEJ).Paired t-test was used to analyze the measurements. RESULTS: Buccal cortical bone thickness, mesiodistal width and buccolingual bone depth at 6 mm were found to be 1.73 + 0.41, 2.15 + 0.49 and 13.18 + 1.22 mm, respectively; while at 8 mm measurements were 2.42 + 0.34, 2.48 + 0.33 and 13.65 + 1.25 mm, respectively. EM for buccal cortical bone thickness, mesiodistal width and buccolingual bone depth was 0.58, 0.40 and 0.48, respectively. The difference in measurement at 6 and 8 mm for buccal cortical plate thickness (P < 0.05) and buccolingual bone thickness (P < 0.05) was found to be significant, whereas for mesiodistal width it was insignificant (P > 0.05). CONCLUSION: Bone thickness measurement has shown promising evidence for safe placement of miniscrews in the mandible during mixed dentition. The use of miniscrew is the best alternative, even in younger patients. .

OBJETIVO: avaliar, por meio de tomografia volumétrica digital (TVD), a espessura óssea necessária para a instalação de mini-implante na arcada inferior durante a fase de dentição mista. MÉTODOS: um total de 15 pacientes saudáveis, com idades entre 8 e 10 anos, com segundo molar inferior decíduo irrompido recentemente, foram incluídos no presente estudo. Imagens de TVD da hemiarcada inferior foram obtidas utilizando sistemas de imagens extrabucais Kodak. As imagens foram analisadas por meio do programa de imagens Kodak. O erro do método (EM) foi calculado utilizando a fórmula de Dahlberg. Médias e desvios-padrão foram calculados de 6 a 8mm aquém da junção amelocementária. O teste t foi utilizado para a análise das medidas. RESULTADOS: a espessura do osso cortical vestibular, largura mesiodistal e profundidade óssea vestibulolingual, a 6mm, foram de 1,73 + 0,41; 2,15 + 0,49; e 13,18 + 1,22 mm, respectivamente. Já a 8mm, os valores foram de 2,42 + 0,34; 2,48 + 0,33; e 13,65 + 1,25mm. O EM para a espessura do osso cortical vestibular, largura mesiodistal e profundidade óssea vestibulolingual foi de 0,58, 0,40 e 0,48mm, respectivamente. A diferença entre as medidas a 6 e 8mm para a espessura do osso cortical vestibular (p < 0,05) e a espessura óssea vestibulolingual (p < 0,05) foi significativa, embora não tenha sido significativa para a largura mesiodistal (p < 0,05). CONCLUSÃO: a mensuração da espessura óssea demonstra evidências promissoras para a segura instalação de mini-implantes na arcada inferior e na fase de dentição mista. O uso de mini-implantes tem se mostrado a melhor alternativa, mesmo nos casos de pacientes mais jovens. .

Humans , Male , Middle Aged , /genetics , /metabolism , Islets of Langerhans/metabolism , Alleles , Fasting/metabolism , Genome-Wide Association Study/methods , Glucose/genetics , Glucose/metabolism , Insulin Resistance/genetics , Insulin/genetics , Insulin/metabolism , Polymorphism, Single Nucleotide/genetics , Receptor, Insulin/genetics , Receptor, Insulin/metabolism , Signal Transduction/genetics
Cad. saúde pública ; 31(3): 575-585, 03/2015. tab, graf
Article in Portuguese | LILACS | ID: lil-744831


Os gastos com medicamentos correspondem a uma grande parcela do orçamento em saúde. Sendo assim, a produção de conhecimento sobre o uso desses recursos é essencial na tomada de decisão em saúde pública e melhoria da assistência farmacêutica. Este estudo teve como objetivo analisar o processo de endividamento em um hospital universitário de alta complexidade devido ao gasto crescente com a aquisição de mesilato de imatinibe. Por meio de análise documental e registros no Sistema de Informações Hospitalares (SIH) entre 2002 e 2010, realizou-se um estudo descritivo. A partir do caminho da incorporação do medicamento, foram mapeadas as estratégias da indústria farmacêutica e do governo, assim como as respostas governamentais de redução do preço. A sistematização e publicação de informações guardadas em arquivos e na memória podem contribuir para o acompanhamento dos resultados dos programas mantidos pelo Ministério da Saúde.

Medicine expenditures consume a large share of the health budget, so knowledge on the use of these funds is essential for decision-making in public health and improvement of pharmaceutical care. This study analyzed the indebtedness of a high-complexity university hospital due to increased spending on imatinib mesylate. The descriptive study was based on analysis of documents and records in the Hospital Information System (SIH) from 2002 to 2010. Starting with inclusion of the medicine in the budget, the study mapped strategies by the pharmaceutical industry and government, as well as government responses to reduce the product's price. The systematization and publication of information stored in files and electronic databases can help monitor the results of programs funded by the Brazilian Ministry of Health.

Los gastos en medicamentos representan una gran proporción del presupuesto de salud, por lo que la producción de conocimiento sobre el uso de estos recursos es esencial en la toma de decisiones en salud pública y la mejora de la atención farmacéutica. Este estudio tuvo como objetivo analizar el proceso de endeudamiento en un hospital universitario de alta complejidad, debido al aumento de los gastos en la adquisición de mesilato de imatinib. A través del análisis de los documentos y registros en el Sistema de Información Hospitalaria (SIH) entre 2002 y 2010, se realizó un estudio descriptivo. A partir de la incorporación del medicamento, se mapearon las estrategias de la industria farmacéutica y del gobierno, así como las respuestas del gobierno para reducir el precio. La sistematización y publicación de la información almacenada en los archivos y su memoria puede contribuir para el seguimiento de los resultados de los programas mantenidos por el Ministerio de Salud.

Adult , Female , Humans , Male , Middle Aged , Blood Glucose/metabolism , Insulin/metabolism , Prediabetic State , Risk Assessment/methods , Biomarkers/metabolism , /diagnosis , /epidemiology , /etiology , /metabolism , Fasting , Glucose Tolerance Test , Homeostasis , Insulin Resistance/physiology , Insulin-Secreting Cells/metabolism , Linear Models , London/epidemiology , Mass Screening , Prospective Studies , Prediabetic State/complications , Prediabetic State/epidemiology , Prediabetic State/metabolism , Risk Factors , Time Factors
Rev. bras. cir. cardiovasc ; 30(1): 33-39, Jan-Mar/2015. tab
Article in English | LILACS | ID: lil-742888


Introduction: The knowledge of the prevalence of risk factors and comorbidities, as well as the evolution and complications in patients undergoing coronary artery bypass graft allows comparison between institutions and evidence of changes in the profile of patients and postoperative evolution over time. Objective: To profile (risk factors and comorbidities) and clinical outcome (complications) in patients undergoing coronary artery bypass graft in a national institution of great surgical volume. Methods: A retrospective cohort study of patients undergoing coronary artery bypass graft in the hospital Beneficência Portuguesa de São Paulo, from July 2009 to July 2010. Results: We included 3,010 patients, mean age of 62.2 years and 69.9% male. 83.8% of patients were hypertensive, 36.6% diabetic, 44.5% had dyslipidemia, 15.3% were smokers, 65.7% were overweight/obese, 29.3% had a family history of coronary heart disease. The expected mortality calculated by logistic EuroSCORE was 2.7%. The isolated CABG occurred in 89.3% and 11.9% surgery was performed without cardiopulmonary bypass. The most common complication was cardiac arrhythmia (18.7%), especially acute atrial fibrillation (14.3%). Pneumonia occurred in 6.2% of patients, acute renal failure in 4.4%, mediastinites in 2.1%, stroke in 1.8% and AMI in 1.2%. The in-hospital mortality was 5.4% and in isolated coronary artery bypass graft was 3.5%. The average hospital stay was 11 days with a median of eight days (3-244 days). Conclusion: The profile of patients undergoing coronary artery bypass graft surgery in this study is similar to other published studies. .

Introdução: O conhecimento da prevalência dos fatores de risco e comorbidades, bem como a evolução com complicações nos pacientes submetidos à cirurgia de revascularização miocárdica, permite a comparação entre instituições e a comprovação de modificações no perfil de pacientes e na evolução pós-operatória ao longo do tempo. Objetivo: Conhecer o perfil (fatores de risco e comorbidades) e a evolução clínica (complicações) nos pacientes submetidos à cirurgia de revascularização miocárdica em uma instituição nacional de grande volume cirúrgico. Métodos: Estudo de coorte retrospectivo de pacientes submetidos ao procedimento de cirurgia de revascularização miocárdica no Hospital Beneficência Portuguesa de São Paulo, no período de julho de 2009 a julho de 2010. Resultados: Foram incluídos 3010 pacientes, com idade média de 62,2 anos e 69,9% do sexo masculino. 82,8% dos pacientes eram hipertensos, 36,6% diabéticos, 44,5% dislipidêmicos, 15,3% tabagistas, 65,7% com sobrepeso/obesidade e 29,3% tinham antecedentes familiares de doença coronária. A mortalidade média esperada calculada pelo EuroSCORE logístico foi de 2,7%. A cirurgia de revascularização miocárdica isolada ocorreu em 89,3% e em 11,9% foi realizada cirurgia sem circulação extracorpórea. A complicação mais comum foi arritmia cardíaca (18,7%), especialmente a fibrilação atrial aguda (14,3%). Pneumonia ocorreu em 6,2% dos pacientes, lesão renal aguda em 4,4%, mediastinite em 2,1%, acidente vascular encefálico em 1,8% e infarto agudo do miocárdio em 1,2%. A mortalidade intra-hospitalar foi de 5,4% e na cirurgia de revascularização miocárdica isolada foi de 3,5%. O tempo de permanência hospitalar médio foi de 11 dias, com mediana de oito dias (3 - 244 dias). Conclusão: O perfil dos pacientes submetidos à cirurgia de revascularização miocárdica neste estudo assemelha-se ao de outros estudos publicados. .

Animals , Humans , Mice , Gene Expression Profiling , Muscle, Skeletal/pathology , Muscular Atrophy/genetics , Triterpenes/pharmacology , Cell Line , Fasting , Gene Expression Regulation , Gene Expression/drug effects , Hindlimb/innervation , Insulin-Like Growth Factor I/metabolism , Insulin/metabolism , Muscle Denervation , Muscle Fibers, Skeletal/drug effects , Muscle Fibers, Skeletal/metabolism , Muscle Strength/drug effects , Muscle, Skeletal/drug effects , Muscle, Skeletal/metabolism , Muscular Atrophy/drug therapy , Muscular Atrophy/metabolism , Oligonucleotide Array Sequence Analysis , Signal Transduction/drug effects