Activación de sensores del estrés del retículo endoplásmico por dietas asociadas a enfermedades metabólicas y COVID-19 / Activation of endoplasmic reticulum stress sensors by metabolic disease-associated diets and COVID-19

El retículo endoplásmico es un organelo abundante, dinámico y sensor de energía. Sus abundantes membranas, rugosa y lisa, se encuentran distribuidas en diferentes proporciones dependiendo del linaje y requerimiento celular. Su función es llevar a cabo la síntesis de proteínas y lípidos, y es el almacén principal de Ca2+ intracelular. La sobrecarga calórica y la glucolipotoxicidad generada por dietas hipercalóricas provoca la alteración del retículo endoplásmico, activando la respuesta a proteínas mal plegadas (UPR, Unfolded Protein Response, por sus siglas en inglés) como reacción al estrés celular relacionado con el retículo endoplásmico y cuyo objetivo es restablecer la homeostasis del organelo al disminuir el estrés oxidante, la síntesis de proteínas y la fuga de Ca2+. Sin embargo, durante un estrés crónico, la UPR induce formación de especies reactivas de oxígeno, inflamación y apoptosis, exacerbando el estado del retículo endoplásmico y propagando un efecto nocivo para los demás organelos. Es por ello que el estrés del retículo endoplásmico se ha considerado un inductor del inicio y desarrollo de enfermedades metabólicas, incluido el agravamiento de COVID-19. Hasta el momento, existen pocas estrategias para reestablecer la homeostasis del retículo endoplásmico, las cuales son dirigidas a los sensores que desencadenan la UPR. Por tanto, se justifica con urgencia la identificación de nuevos mecanismos y terapias novedosas relacionadas con mitigar el impacto del estrés del retículo endoplásmico y las complicaciones asociadas.

The endoplasmic reticulum is an abundant, dynamic and energy-sensing organelle. Its abundant membranes, rough and smooth, are distributed in different proportions depending on the cell lineage and requirement. Its function is to carry out protein and lipid synthesis, and it is the main intracellular Ca2+ store. Caloric overload and glycolipotoxicity generated by hypercaloric diets cause alteration of the endoplasmic reticulum, activating the Unfolded Protein Response (UPR) as a reaction to cellular stress related to the endoplasmic reticulum and whose objective is to restore the homeostasis of the organelle by decreasing oxidative stress, protein synthesis and Ca2+ leakage. However, during chronic stress, the UPR induces reactive oxygen species formation, inflammation and apoptosis, exacerbating the state of the endoplasmic reticulum and propagating a deleterious effect on the other organelles. This is why endoplasmic reticulum stress has been considered an inducer of the onset and development of metabolic diseases, including the aggravation of COVID-19. So far, few strategies exist to reestablish endoplasmic reticulum homeostasis, which are targeted to sensors that trigger UPR. Therefore, the identif ication of new mechanisms and novel therapies related to mitigating the impact of endoplasmic reticulum stress and associated complications is urgently warranted.

Complicações metabólicas relacionadas à terapia de nutrição parenteral em pacientes hospitalizados / Metabolic complications related to parenteral nutrition therapy in hospitalized patients

Investigar as complicações metabólicas relacionadas à administração da terapia nutricional parenteral (TNP) e sua relação com o desfecho clínico de pacientes hospitalizados. Métodos: Estudo longitudinal retrospectivo realizado com pacientes internados em hospital público referência no atendimento de urgências e emergências da cidade de Goiânia no período de setembro de 2020 a fevereiro de 2021. A coleta de dados foi realizada por meio de consulta aos prontuários eletrônicos. As informações foram coletadas após o primeiro dia de uso da NP até o desfecho clínico -alta, óbito ou descontinuidade da NP. Resultados: A amostra foi constituída por 28 pacientes em uso de nutrição parenteral no hospital durante a etapa de coleta dedados. Desses pacientes a maioria era do sexo masculino, com média de idade de 46,78 anos. As indicações mais frequentes para o uso da terapia nutricional parenteral foram: repouso,abdome agudo e pós-operatório. As complicações mais prevalentes foram a hipocalemia, hipomagnesemia, uremia e a hiponatremia e o desfecho clínico mais frequente foi o óbito. Encontrou-se relação entre desfecho clínico e presença de hipernatremia (p=0,010), ocorrendo a alta hospitalar exclusivamente naqueles pacientes que não apresentaram hipernatremia. E ainda houve relação marginal (p=0,053) entre desfecho clínico e local da internação, sendo que foi mais frequente o óbito naqueles admitidos na unidade de terapia intensiva. Conclusão: Não houve associação entre a TNP e as complicações metabólicas. Todavia, observou-se relação entre hipernatremia e mortalidade, sendo esta mais prevalente em pacientes internados nas unidades de terapia intensiva (UTIs). Nessa amostra, a complicação metabólica mais observada foi a hipocalemia

To investigate the metabolic complication related to administration of the Parenteral Nutrition Therapy (PNT) and their relation to the clinical outcome of hospitalized patients. Methods: retrospective longitudinal study carried with interned patients at a public hospital of standart in the urgency and emergency care from the Goiânia city during the period from september2020 to february 2021. The data capture was realized through consultation to the electronic record. The information was collected after the first day use of NP to clinical outcome -discharge, death or discontinuation of NP. Results: The sample was composed by 28 patients in use of parenteral nutrition at hospital during the data capture. The majority of these patients were male, with mean age of 46-78 anos. The indications more frequent to the use of parenteral nutrition therapy were: rest, acute abdomen and pos-operative. The complications more prevalent were hypokalemia, hypomagnesemia, uremia and hyponatremia. And the clinical outcome more frequent was death. A relationship between clinical outcome and hypernatremia presence (p=0,010) was found, occurring the hospitalar discharge exclusively in those patients which did not submit to hypernatremia. And there was still a marginal relationship (p=0,053) between clinical outcome and hospitalization, which was more frequent the death in those admitted in intensive care units. Conclusion: There was no association between the PNT and the metabolic complications. However, there was an observed relationship between hypernatremia and mortality, while more prevalent in patients staying in the intensive care unit (ICU). In this sample, the metabolic complication most observed was hypokalemia

Recent research on inherited metabolic diseases in children / 中国当代儿科杂志

With the improvement in the research level and the diagnosis and treatment technology of inherited metabolic diseases (IMD), the research on pediatric IMD in China has made great progress, but there is still some distance from the international level. Due to the vast territory of China and the uneven distribution of medical resources, the regional characteristics of IMD remain unclear in China, and there are many problems and difficulties in early diagnosis and treatment. Therefore, it is necessary to improve the understanding of pediatric IMD among pediatricians, so as to improve the diagnosis and treatment level, achieve an early identification, diagnosis, and treatment of pediatric IMD, and effectively reduce the fatality and disability rates of children with IMD. This article reviews the research progress of IMD in children in China, and analyzes the features of representative IMDs. Citation:Chinese Journal of Contemporary Pediatrics, 2022, 24(3): 326-331.

Pre-conception carrier screening for 21 inherited metabolic diseases in a Chinese population / 中华医学遗传学杂志

OBJECTIVE@#To determine the carrier rate for 21 inherited metabolic diseases among a Chinese population of childbearing age.@*METHODS@#A total of 897 unrelated healthy individuals (including 143 couples) were recruited, and DNA was extracted from their peripheral blood samples. Whole exome sequencing (WES) was carried out to screen potential variants among 54 genes associated with 21 inherited metabolic diseases. Pathogenic and likely pathogenic variants and unreported loss-of-function variants were analyzed.@*RESULTS@#One hundred fourty types of pathogenic/likely pathogenic variants (with an overall number of 183) and unreported loss-of-function variants were detected, which yield a frequency of 0.20 per capita. A husband and wife were both found to carry pathogenic variants of the SLC25A13 gene and have given birth to a healthy baby with the aid of preimplantation genetic diagnosis. The detected variants have involved 40 genes, with the most common ones including ATP7B, SLC25A13, PAH, CBS and MMACHC. Based on the Hardy-Weinberg equilibrium, the incidence of the 21 inherited metabolic diseases in the population was approximately 1/1100, with the five diseases with higher incidence including citrullinemia, methylmalonic acidemia, Wilson disease, glycogen storage disease, and phenylketonuria.@*CONCLUSION@#This study has preliminarily determined the carrier rate and incidence of 21 inherited metabolic diseases among a Chinese population of childbearing age, which has provided valuable information for the design of neonatal screening program for inherited metabolic diseases. Pre-conception carrier screening can provide an important measure for the prevention of transmission of Mendelian disorders in the population.

Clinicopathological features of hepatic fibrinogen storage disease in children / 中华病理学杂志

Objective: To investigate the clinicopathological and molecular characteristics of hepatic fibrinogen storage disease (FSD) in children. Methods: The clinical, histopathologic, immunophenotypic, ultrastructural and gene sequencing data of 4 FSD cases were collected from September 2019 to January 2021 in the Children's Hospital of Fudan University, Shanghai, China. Retrospective analysis and literature review were conducted. Results: There were 4 cases of FSD, 3 males and 1 female, aged 3 years and 3 months to 6 years (median age, 3 years and 4 months). The clinical manifestations were abnormal liver function and abnormal blood coagulation function, for which 2 cases had family genetic history. Liver biopsies revealed that, besides liver steatosis, fibrosis and inflammation, there were single or multiple eosinophilic inclusion bodies of various sizes and surrounding transparent pale halo in hepatocytes. Immunohistochemistry showed that the inclusion bodies were positive for anti-fibrinogen. Under the electron microscope, they corresponded to the dilated cisternae of the rough endoplasmic reticulum, which were occupied by compactly packed tubular structures and arranged into a fingerprint-like pattern with curved bundles. Gene sequencing revealed that the 2 cases of FGG mutation were located in exon 8 c.1106A>G (p.His369Arg) and c.905T>C (p.Leu302Pro), and 1 case was located in exon 9 c.1201C>T (p.Arg401Trp). No pathogenic variant was detected in the other case. Conclusions: FSD is a rare genetic metabolic disease and clinically manifests as abnormal liver function with hypofibrinogenemia. In the background of liver steatosis, fibrosis and inflammation, there are eosinophilic inclusions with pale halo in the hepatocytic cytoplasm, which can be identified by anti-fibrinogen immunohistochemical staining. The fingerprint-like structures under electron microscope are helpful for the diagnosis, while FGG sequencing detects the pathogenic mutation of exon 8 or 9 that can clearly explain the phenotype. However, the diagnosis of FSD cannot be completely ruled out if the relevant mutations are not detected.

Research progress on the relationship between HIV infection, antiretroviral therapy, and diabetes mellitus / 中华流行病学杂志

The expectancy and quality of life among people with HIV have improved remarkably with the widespread use of antiretroviral therapy (ART). In the meantime, the risks for HIV-related metabolic diseases have increased significantly, in particular diabetes mellitus. Multi-factors coeffect to increasing the risk of diabetes mellitus among HIV patients. Recently, growing of research has reported an association between HIV infections and ART and the development of diabetes mellitus. In this article, we summarize the recent studies investigating HIV infection and ART in diabetes mellitus to clarify their mechanism on the development of diabetes.

Research progress on the application of time-restricted eating in adult obesity and related metabolic diseases / 中华预防医学杂志

The soaring prevalence of obesity and its complications presents a significant health care burden, and there is currently a lack of effective and sustainable treatment methods. Time-restricted eating (TRE) is a specific intermittent fasting (IF) protocol involving consistent fasting and eating periods within a 24-hour cycle. Time-restricted eating can restore robust circadian rhythms and improve metabolic health, providing an emerging dietary strategy for the prevention and treatment of obesity and related metabolic diseases. Previous TRE trials laid the groundwork, and indicate a need for further clinical research including large-scale controlled trials to determine TRE efficacy and the mechanisms by which it may affect humans.

Joint Association of Metabolic Health and Obesity with Ten-Year Risk of Cardiovascular Disease among Chinese Adults / 生物医学与环境科学（英文）

OBJECTIVE@#This study aims to investigate the association of metabolic phenotypes that are jointly determined by body mass index (BMI) or fat mass percentage and metabolic health status with the ten-year risk of cardiovascular disease (CVD) among Chinese adults.@*METHODS@#Data were obtained from a cross-sectional study. BMI and body fat mass percentage (FMP) combined with the metabolic status were used to define metabolic phenotypes. Multiple linear regression and logistic regression were used to examine the effects of metabolic phenotypes on CVD risk.@*RESULTS@#A total of 13,239 adults aged 34-75 years were included in this study. Compared with the metabolically healthy non-obese (MHNO) phenotype, the metabolically unhealthy non-obese (MUNO) and metabolically unhealthy obese (MUO) phenotypes defined by BMI showed a higher CVD risk [odds ratio, OR (95% confidence interval, CI): 2.34 (1.89-2.89), 3.45 (2.50-4.75), respectively], after adjusting for the covariates. The MUNO and MUO phenotypes defined by FMP showed a higher CVD risk [ OR (95% CI): 2.31 (1.85-2.88), 2.63 (1.98-3.48), respectively] than the MHNO phenotype. The metabolically healthy obese phenotype, regardless of being defined by BMI or FMP, showed no CVD risk compared with the MHNO phenotype.@*CONCLUSION@#General obesity without central obesity does not increase CVD risk in metabolically healthy individuals. FMP might be a more meaningful factor for the evaluation of the association of obesity with CVD risk. Obesity and metabolic status have a synergistic effect on CVD risk.

Exercise regulates lipid metabolism via lipophagy and its molecular mechanisms / 生理学报

Lipophagy is a kind of selective autophagy, which can selectively identify and degrade lipid droplets and plays an important role in regulating cellular lipid metabolism and maintaining intracellular lipid homeostasis. Exercise can induce lipophagy and it is also an effective means of reducing body fat. In this review, we summarized the relationship between exercise and lipophagy in the liver, pancreas, adipose tissue, and the possible molecular mechanisms to provide a new clue for the prevention and treatment of fatty liver, obesity and other related metabolic diseases by exercise.

Mechanisms of Dangua Recipe in Improving Glycolipid Metabolic Disorders Based on Transcriptomics / 中国结合医学杂志

OBJECTIVE@#To explore the mechanisms of Dangua Recipe (DGR) in improving glycolipid metabolism based on transcriptomics.@*METHODS@#Sprague-Dawley rats with normal glucose level were divided into 3 groups according to a random number table, including a conventional diet group (Group A), a DGR group (Group B, high-calorie diet + 20.5 g DGR), and a high-calorie fodder model group (Group C). After 12 weeks of intervention, the liver tissue of rats was taken. Gene sequence and transcriptional analysis were performed to identify the key genes related to glycolipid metabolism reflecting DGR efficacy, and then gene or protein validation of liver tissue were performed. Nicotinamide phosphoribosyl transferase (Nampt) and phosphoenolpyruvate carboxykinase (PEPCK) proteins in liver tissues were detected by enzyme linked immunosorbent assay, fatty acid synthase (FASN) protein was detected by Western blot, and fatty acid binding protein 5 (FABP5)-mRNA was detected by quantitative real-time polymerase chain reaction. Furthermore, the functional verification was performed on the diabetic model rats by Nampt blocker (GEN-617) injected in vivo. Hemoglobin A@*RESULTS@#Totally, 257 differential-dominant genes of Group A vs. Group C and 392 differential-dominant genes of Group B vs. Group C were found. Moreover, 11 Gene Ontology molecular function terms and 7 Kyoto Encyclopedia of Genes and Genomes enrichment pathways owned by both Group A vs. Group C and Group C vs. Group B were confirmed. The liver tissue target validation showed that Nampt, FASN, PEPCK protein and FABP5-mRNA had the same changes consistent with transcriptome. The in vivo functional tests showed that GEN-617 increased body weight, HbA@*CONCLUSION@#Nampt activation was one of the mechanisms about DGR regulating glycolipid metabolism.

Mortalidad por COVID-19 en México y las enfermedades metabólicas durante el año crítico de la pandemia / COVID-19 mortality in Mexico and metabolic diseases during a critical pandemic year

Conocer la asociación específica de las enfermedades metabólicas en la mortalidad por COVID-19, ocurrida en México durante el año crítico de la pandemia de marzo 2020 a marzo 2021. Método. Se utilizó la base nacional de COVID-19 de la Dirección General de Epidemiología. Se analizaron los casos positivos que presentaron las enfermedades metabólicas: cardiovasculares, hipertensión, diabetes y obesidad. Se realizó un análisis descriptivo para conocer la distribución de los casos fallecidos y no fallecidos. Se empleó la prueba de ji cuadrada para la diferencia de las proporciones. Se utilizaron análisis de regresión logística para conocer la asociación entre las enfermedades metabólicas y la mortalidad por COVID-19 en personas positivas al virus SARS-CoV-2. Los datos fueron ajustados por edad y sexo. Resultados. Se observó la asociación de las enfermedades metabólicas en la mortalidad. La diabetes tuvo mayor porcentaje de letalidad 18,4%. Cuando se conjuntaron las enfermedades cardiovasculares y diabetes el porcentaje de letalidad subió a 31,5%; la conjunción de las enfermedades cardiovasculares, con hipertensión y diabetes fue la de mayor porcentaje de letalidad 38,7%. La obesidad fue la que tuvo menor incidencia. Conclusiones. Las enfermedades metabólicas en México son un problema de salud pública que afectó la mortalidad por covid-19. Es prioritario atender con políticas públicas preventivas y efectivas en favor de un modelo de consumo alimentario sano, acorde con las necesidades nutrimentales de la población(AU)

To know the specific association of metabolic disease on COVID-19 mortality, occurred during the critical year of the pandemic, from march 2020 to march 2021. Method: The Covid-19 national base of the General Directorate of Epidemiology was used. Positive cases of metabolic diseases were analyzed: cardiovascular disease, hypertension, diabetes and obesity. A descriptive analysis was carried out to find out the distribution of deceased and non-deceased cases. The chi-square test was used for the difference in proportions. Logistic regression analysis was used to understand the association between metabolic diseases and COVID 19 mortality in people who tested positive for the SARS-CoV-2 virus. The data were adjusted for age and gender. Results: The association of metabolic diseases on mortality was observed. Diabetes had a higher percentage of lethality 18,4%. When cardiovascular disease and diabetes were combined, the fatality rate rose to 31,5%; the combination of cardiovascular diseases, with hypertension and diabetes was the highest percentage of lethality 38,7%. Obesity had the least incidence. Conclusions: Metabolic diseases in México are a public health problem that affected COVID-19 mortality. It is a priority to deal with preventive and effective public policies in favor of a healthy food consumption model, in line with the nutritional needs of the population(AU)

Análise de componentes principais dos fatores de risco em adolescentes com excesso de peso antes e após um programa de intervenção / Analysis of principal components of risk factors in overweight adolescents before and after an intervention program

O objetivo do estudo é verificar o agrupamento dos fatores de risco cardiometabólicos e as possíveis mudanças deste, após um programa de intervenção interdisciplinar realizado com adolescentes com sobrepeso/obesidade. Os sujeitos foram alocados em dois grupos: grupo intervenção e grupo controle. O grupo intervenção participou de um programa com a duração de seis meses, com sessões três vezes por semana, que incluiu sessões com exercícios físicos, orientações nutricionais e psicológicas. Foram realizadas avaliações antropométricas, pressão arterial, aptidão cardiorrespiratória e coleta sanguínea para avaliação da glicose e perfil lipídico, antes e após o período de intervenção. Análise de componentes principais foi realizada para verificar o agrupamento dos fatores de risco nos períodos pré e pós-intervenção. A análise fatorial agrupou os componentes em três fatores no momento pré-intervenção, no grupo intervenção, que representou 83,88% da variância total do modelo. Já, no grupo controle, no período pré e pós-intervenção, e na avaliação pós-intervenção do grupo intervenção, os componentes foram agrupados em dois fatores centrais, que explicam, respectivamente, 68,38%, 71,23%, 75,19% da variância total do modelo. O grupo intervenção apresentou mudanças no agrupamento das variáveis nos resultados pós-intervenção, em comparação com o pré-teste. Nenhum componente central, que inter-relacionasse todos os demais fatores, nas quatro análises realizadas, foi encontrado. Entretanto, as variáveis antropométricas aparecem como os componentes de maior carga fatorial, agrupadas no fator 1, em todas as análises realizadas, fator que explica a maior variância total em torno das variáveis iniciais. (AU)

The objective of the study is to verify the grouping of cardiometabolic risk factors and their possible changes after an interdisciplinary intervention program performed with overweight/obese adolescents. The subjects were allocated in two groups: the intervention group and the control group. The intervention group participated in a program lasting six months, with sessions three times a week, which included sessions with physical exercises, nutritional and psychological orientations. Anthropometric evaluations, blood pressure, cardiorespiratory fitness, and blood collection were performed for evaluation of glucose and lipid profile before and after the intervention period. Main component analysis was performed to verify the grouping of risk factors in the pre-and post-intervention periods. The factorial analysis grouped the components into three factors at the pre-intervention time, in the intervention group, which represented 83.88% of the total variance of the model. In the control group, in the pre-and post-intervention period, and in the post-intervention evaluation of the intervention group, the components were grouped into two central factors, which explain, respectively, 68.38%, 71.23%, 75, 19% of the total variance of the model. The intervention group presented changes in the grouping of the variables in the post-intervention results, compared to the pre-test. No central component, which interrelated all the other factors, was found in the four analyzes. However, the anthropometric variables appear as the components of higher factor load, grouped in factor 1, in all the analyzes performed, a factor that explains the largest total variance around the initial variables. (AU)

Glycemic safety of a maximum aerobic test in type 1 diabetics and their correlation with health parameters / Segurança glicêmica de um teste aeróbico máximo em pessoas com diabetes tipo 1 e sua correlação com parâmetros de saúde

To verify the glycemic safety of a maximal cardiorespiratory test (V̇ O2max) in T1DM patients and correlate the maximum cardiorespiratory values with metabolic control parameters such as glycemia, glycated hemoglobin, time of diagnosis (TD), and fat (body [GC] and visceral [GV]). The cross-sectional study evaluated ten T1DM patients (age 24.9 ± 7.5 years; time of diagnosis 11.5 ± 7.4; body mass index 22 ± 2 kg/m2 ). Metabolic glycemic control variables (before and after), glycated hemoglobin (HbA1c), time since diagnosis and total and visceral fat were collected. The CENESP maximum test protocol was used on the treadmill with direct maximal oxygen uptake (V̇ O2max). Normality test, paired t-test and correlations (p <0.05) were performed. In the results, blood glucose pre 189 ± 67 mg/dL vs. post 172 ± 66 mg/dL (p = 0.140). The V̇ O2max with a regular average score for men and women (37.4 ± 6.6 ml.kg.min-1). There was a negative and almost perfect correlation with TD, GC and GV (p = 0.028, p <0.000, and p <0.000). We conclude that is possible to perform a CENESP maximal with glycemic safe in T1DM. However, TD, GC, and GV negatively interfere with cardiorespiratory fitness and should be verified before the test. (AU)

Verificar a segurança glicêmica de um teste cardiorrespiratório máximo (V̇ O2max) em pacientes com diabetes mellitus tipo 1 (DM1) e correlacionar os valores com parâmetros de controle metabólico como glicemia, hemoglobina glicada, tempo de diagnóstico (DT) e gordura (corporal[GC] e visceral[GV]). O estudo transversal avaliou dez DM1 (idade 24,9 ± 7,5 anos; tempo de diagnóstico 11,5 ± 7,4; índice de massa corporal 22 ± 2 kg/m2). Foram coletadas variáveis de controle glicêmico metabólico (antes e depois), hemoglobina glicada (HbA1c), tempo de diagnóstico e gordura total e visceral. O protocolo de teste máximo do CENESP foi utilizado na esteira com consumo máximo direto de oxigênio (V̇ O2max). Teste de normalidade, teste t pareado e correlações (p<0,05) foram realizados. Nos resultados, glicemia pré 189 ± 67 mg/dL vs. pós 172 ± 66 mg/dL (p = 0,140). O V̇ O2max com pontuação média regular para homens e mulheres (37,4 ± 6,6 ml.kg.min-1). Houve correlação negativa e quase perfeita com DT, GC e GV (p = 0,028; p < 0,000 e p < 0,000). Concluímos que é possível realizar um CENESP máximo com segurança glicêmica no DM1. No entanto, DT, GC e GV interferem negativamente na aptidão cardiorrespiratória e devem ser verificados antes do teste.

Niveles séricos de interleucina-6 en pacientes con diabetes tipo 2 y su correlación con el perfil lipídico / Serum levels of interleukin-6 in patients with type 2 diabetes and its correlation with the lipid profile

La diabetes mellitus es una enfermedad metabólica caracterizada por hiperglucemia, a consecuencia de defectos en la producción, secreción y/o acción de la insulina, produciendo alteraciones en el metabolismo de los hidratos de carbono, lípidos y proteínas; asociado a un proceso inflamatorio crónica en un plazo variable, que provocara lesiones macro y microvasculares. Objetivo: Evaluar los niveles séricos de interleucina-6 (IL-6) en pacientes diabéticos tipo 2 y su correlación con el perfil lipídico. Métodos: Se realizó estudio descriptivo analítico y transversal, comprendido por 60 adultos de ambos sexos entre 30 a 60 años, con diabetes mellitus tipo 2 que acudieron a consulta de Endocrinología del Hospital Militar Universitario Dr. Carlos Arvelo. Se les determino glucemia basal, interleucina-6, perfil lipídico, resultados relacionados con parámetros antropométricos, composición corporal, la edad y tiempo de evolución de la diabetes. Resultados: La edad promedio de 51,60 años ± 6,51, donde el 71,6% correspondieron al sexo femenino y el 28,3% al masculino, tiempo de evolución de la diabetes entre 1 mes y 37 años, con un promedio de 10,97 años. Se presentó correlación positiva baja y estadísticamente significativa entre interleucina 6 y los parámetros de triglicéridos, VLDL y no-HDL Conclusión: Se encontró valores elevados de IL-6 en todos los pacientes diabéticos tipo 2, así como una correlación positiva entre IL-6 y las lipoproteínas ricas en triglicéridos. Esto respalda la idea de que la hipertrigliceridemia puede causar cambios inflamatorios en pacientes diabéticos y esto elevaría el riesgo cardiovascular de estos pacientes(AU)

Disfunções metabólicas e vertigem: apresentação e revisão dos métodos diagnósticos / Metabolic dysfunctions and vertigo: presentation and review of diagnostic methods

Contexto: A tontura é um sintoma de alta prevalência e as labirintopatias de causas metabólicas destacam-se como uma das mais frequentes em nosso meio. Distúrbios do metabolismo glicêmico, disfunções tireoidianas e dislipidemias são as principais. Objetivos: Os objetivos deste estudo são descrever a porcentagem das principais disfunções metabólicas nos pacientes com vertigem e revisar os métodos diagnósticos. Desenho e local: Estudo observacional de pacientes atendidos no setor de Otoneurologia do Instituto Penido Burnier. Métodos: Avaliação de 506 pacientes com vertigem por meio da análise do hormônio tireoestimulante, glicemia de jejum, hemoglobina glicada, insulina de jejum, curvas glicoinsulinêmica de três horas, colesterol total e suas frações (lipoproteína de alta densidade [HDL] e lipoproteína de baixa densidade [LDL]) e triglicerídeos. Foi feita a comparação entre os sexos e com os dados encontrados na população geral. Resultados: Níveis de HDL, triglicerídeos e glicemia de jejum foram mais alterados no sexo masculino e o colesterol total foi mais elevado no sexo feminino. A elevação do HOMA (homeostatic model assessment) foi a alteração mais significante encontrada no grupo em estudo comparando com a população geral, entretanto as curvas glicoinsulinêmicas mostraram mais alterações em comparação ao HOMA. Discussão: A análise do HOMA e da curva glicoinsulinêmica mostrou que a porcentagem de alteração é diferente entre os métodos, não havendo concordância entre eles. O HOMA não substitui as curvas na investigação dos pacientes com vertigem e suspeita de distúrbios do metabolismo glicêmico. Conclusão: É alta a porcentagem das disfunções metabólicas na população com vertigem, justificando a investigação laboratorial neste grupo de pacientes.

Factores asociados al autocuidado de la salud en los pacientes diabéticos / Factors associated with self-care in diabetic patients

La diabetes es una enfermedad que afecta a la población mundial, y los adultos mayores son los más propenso a padecerla, como consecuencia a los niveles de estrés y malos hábitos alimenticios que llevaron a lo largo de su vida productiva. Es por ello, que el: Objetivo de esta investigación es, describir los factores asociados al autocuidado de la salud en los pacientes diabéticos. Materiales y métodos: Investigación documental. Se incluyeron estudios de cohortes que analizaron diagnóstico y tratamiento oportuno en el autocuidado de pacientes diabéticos en bases de datos electrónicas, como lo son Porta Scielo, PubMed, Medline PLUS, Embase, Scopus y Web of Science, del 2015 al 2020. Las medidas de autocuidado son habilidades que los individuos practican para el mantenimiento de su salud, sobre todo cuando hay una patología de base que ponga en riesgo el estado de salud y el bienestar en general. Resultado: La diabetes es una enfermedad complicada, requiere vigilancia constante, conocimiento de la enfermedad y del apoyo de varios especialistas en salud, la mayor parte del cuidado y control debe prevenir del paciente mismo. Es importante que los pacientes no solo perciban los daños o la severidad de la ausencia de autocuidado, lo que puede influir en el adecuado control de la diabetes mellitus, sino que se le proporcione mediante la educación para la salud, estrategias que faciliten en ellos el aprendizaje de habilidades que le permitan percibir los beneficios de la adopción de estilos de vida saludables. Conclusiones: el equipo básico de salud desempeña un rol importante en la realización de acciones que faciliten el autocuidado en los pacientes diabéticos, lo que puede constituir una vía para que las personas tomen decisiones serias respecto al mantenimiento de un adecuado estado de su salud. Por ende, es necesario que se realicen programas que desarrollen el ajuste adecuado de expectativas, objetivos definidos, el manejo adecuado del refuerzo, el incremento del sentimiento de autoeficacia, el autocontrol, y que brinden alternativas que favorezcan un autocuidado óptimo(AU)

Diabetes is a disease that affects the world population, and older adults are the most prone to suffer from it, as a consequence of the levels of stress and poor eating habits that they led throughout their productive lives. That is why the: Objective of this research is to describe the factors associated with self-care of health in diabetic patients. Materials and methods: Documentary research. Cohort studies that analyzed diagnosis and timely treatment in the self-care of diabetic patients were included in electronic databases, such as Porta Scielo, PubMed, Medline PLUS, Embase, Scopus and Web of Science, from 2015 to 2020. The measures of Self-care are skills that individuals practice to maintain their health, especially when there is an underlying pathology that puts the state of health and well-being in general at risk. Result: Diabetes is a complicated disease, it requires constant vigilance, knowledge of the disease and the support of various health specialists, most of the care and control must be prevented by the patient himself. It is important that patients not only perceive the damage or the severity of the absence of self-care, which can influence the adequate control of diabetes mellitus, but that it is provided through health education, strategies that facilitate in them the learning skills that allow you to perceive the benefits of adopting healthy lifestyles. Conclusions: the basic health team plays an important role in carrying out actions that facilitate self-care in diabetic patients, which can constitute a way for people to make serious decisions regarding the maintenance of an adequate state of their health. Therefore, it is necessary to carry out programs that develop the adequate adjustment of expectations, defined objectives, the adequate management of reinforcement, the increase of the feeling of self-efficacy, self-control, and that provide alternatives that favor a more optimal self-care(AU)

Milk yield and composition in dairy cows with post-partum disorders / [Produção e composição do leite em vacas com desordens no pós-parto]

This study aimed to determine the impact of different post-partum disorders on milk yield and composition. One hundred and fifteen Holstein cows from a commercial dairy farm located in the state of Rio Grande do Sul in southern Brazil were monitored up to 62 days post-partum. During this period, body condition score evaluation and animal clinical examination were conducted. Percentages of fat, protein, and lactose, as well as somatic cells score, were determined in milk samples. The AST activity and concentrations of NEFA, calcium, and BHBA, were analyzed in blood samples. The occurrence of clinical disorders was identified in 30 (26%) cows. Subclinical disorders were identified in 64 (56%) cows. Only 21 (18%) cows did not suffer any kind of disorder within the studied period. In this study, no significant differences were found in milk production, protein, and somatic cell count in clinical, subclinical, and healthy cows. Milk fat and the fat: protein quotient (F:P) were higher in cows with clinical disorders and the 6 to 21 days in milk, and lactose were lower in cows with clinical disorders and the 22 to 42 days in milk (P<0.05).(AU)

O objetivo deste estudo foi determinar o impacto de diferentes distúrbios após o parto na produção de leite e em sua composição. Cento e quinze vacas Holandesas de uma fazenda de gado leiteiro, localizada em estado da região Sul do Brasil, foram monitoradas até 62 dias após o parto. Durante esse período, foram realizadas avaliações do escore de condição corporal e exame clínico nos animais. As porcentagens de gordura, proteína e lactose, bem como o escore de células somáticas, foram determinadas nas amostras de leite. A atividade do AST e as concentrações de NEFA, cálcio e BHBA foram analisadas em amostras de sangue. A ocorrência de distúrbios clínicos foi identificada em 30 (26%) vacas, os distúrbios subclínicos foram identificados em 64 (56%) vacas. Apenas 21 (18%) vacas não sofreram nenhum tipo de distúrbio ao longo do período estudado. Neste estudo, não foram encontradas diferenças significativas na produção do leite, proteína e na contagem de células somáticas em vacas com doenças clínicas, subclínicas e saudáveis. No leite, a gordura e o quociente gordura e proteína (G:P) foram maiores em vacas com doença clínica no período de seis a 21 dias de lactação, e a lactose foi menor em vacas com doença clínica no período de 22 a 42 dias de lactação (P<0,05).(AU)