Zinco e risco cardiovascular de pacientes nefropatas em tratamento de hemodiálise / Zinc and cardiovascular risk in nephropathic patients undergoing hemodialysis treatment / Zinc y riesgo cardiovascular de pacientes con enfermedad del riñón en tratamiento de hemodiálisis

Objetivo: Investigar a relação entre concentração de zinco e risco cardiovascular em pacientes com insuficiência renal crônica em hemodiálise. Métodos: Estudo analítico, retrospectivo e transversal, realizado em Fortaleza, Ceará, em 2012, do qual participaram 43 adultos com insuficiência renal crônica em hemodiálise (grupo HD) e 35 saudáveis (CO - controle). Coletaram-se dados socioeconômicos e bioquímicos (colesterol total - CT, lipoproteína de baixa densidade - LDL, lipoproteína de muito baixa densidade - VLDL, lipoproteína de alta densidade - HDL e triglicerídeos - TG); determinou-se zinco plasmático por espectrometria de emissão óptica com plasma acoplado; coletou-se perfil lipídico do grupo HD do prontuário e do grupo CO por meio de kit Bioclin®. Obteve-se colesterol não-HDL pela fórmula: não-HDL = CT ­ HDL-c. Calculou-se risco cardiovascular pela razão TG/HDL, considerando risco quando >3,8. Análises por meio de testes t de Student, Pearson ou Spearman. Resultados: O zinco do grupo HD encontrou-se abaixo da referência e menor (p<0,001) em relação ao controle (68,40µg/dL e 85,53µg/dL, respectivamente). HDL no grupo HD mostrou-se abaixo da recomendação (39,64±11,58). VLDL (29,02±14,03mg/dL) do grupo HD foi maior (p<0,001) que no CO (15,47±10,65mg/dL). LDL do grupo HD maior que no CO (p=0,05) e o TG no grupo HD (145,14±70,15mg/dL) maior (p<0,001) que no CO (77,35±53,25mg/dL). Encontrou-se razão TG/HDL no grupo HD de 4,02±2,60 (p=0,04), indicando maior risco cardiovascular. Pacientes com maior relação TG/HDL apresentaram menores níveis de zinco (p=0,011). Conclusão: Os pacientes em hemodiálise apresentaram deficiência de zinco e possuíam elevado risco cardiovascular, porém sem correlação entre zinco e perfil lipídico.

Objective: To assess the relationship between zinc concentration and cardiovascular risk in patients with chronic renal failure on hemodialysis. Methods: Analytical retrospective cross-sectional study carried out in Fortaleza, Ceará, Brazil, in 2012 with 43 adult patients with chronic renal failure on hemodialysis (HD group) and 35 healthy individuals (control group). Socioeconomic and biochemical (total cholesterol - TC, low density lipoprotein - LDL, very low density lipoprotein - VLDL, high density lipoprotein - HDL and triglycerides - TG) were collected. Plasma zinc was determined using coupled plasma optical emission spectrometry. HD group' lipid profile was collected from medical records, and the controls' lipid profile was analyzed using the Bioclin® kit. Non-HDL cholesterol was = CT ­ HDL-C. Cardiovascular risk was assessed using the TG/HDL ratio, with risk when >3.8. Student's t test, Pearson's test or Spearman's test were used. Results: Zinc was below the recommended and lower (p<0.001) in the HD group (68.40µg/dL and 85.53µg/dL, respectively). HDL-c in the HD group was below the recommended (39.64±11.58). VLDL (29.02±14.03 mg/dL) in HD patients was higher (p<0.001) than in controls (15.47±10.65 mg/dL). LDL was higher in the HD group than in controls (p=0.05) and TG in the HD group (145.14±70.15 mg/dL) was higher (p<0.001) than in controls (77.35±53.25 mg/dL). The TG/HDL ratio in the HD group was 4.02±2.60 (p=0.04), indicating a higher cardiovascular risk. Individuals with higher TG/HDL had lower zinc (p=0.011). Conclusion: Patients on hemodialysis presented with zinc deficiency and high cardiovascular risk, but there was no correlation between zinc levels and lipid profile.

Objetivo: Investigar la relación entre la concentración de zinc y el riesgo cardiovascular de pacientes con insuficiencia renal crónica en hemodiálisis. Métodos: Estudio analítico, retrospectivo y transversal realizado en Fortaleza, Ceará, en 2012, en el cual participaron 43 pacientes adultos con insuficiencia renal crónica en hemodiálisis (grupo HD) y 35 saludables (grupo CO - control). Se recogieron los datos socioeconómicos y bioquímicos (colesterol total - CT, lipoproteína de baja densidad - LDL, lipoproteína de muy baja densidad - VLDL, lipoproteína de alta densidad - HDL y triglicéridos - TG); se determinó el zinc plasmático por la espectrometría de emisión óptica por el plasma de acoplamiento inductivo; se recogió el perfil lipídico del grupo HD del historial clínico y el del grupo control a través del kit Bioclin®. Se obtuvo el colesterol no-HDL por la fórmula: no-HDL = CT ­ HDL-c. Se calculó el riesgo cardiovascular por la razón TG/HDL considerando riesgo cuando ≥3,8. Los análisis fueron a través de la prueba t de Student, Pearson o Spearman. Resultados: El zinc del grupo HD fue menor y abajo de la referencia (p<0,001) en comparación con el control (68,40µg/dL y 85,53µg/dL, respectivamente). La HDL del grupo HD se mostró abajo de la recomendación (39,64±11,58). El VLDL (29,02±14,03mg/dL) del grupo HD ha sido mayor (p<0,001) que en el CO (15,47±10,65mg/dL). La LDL del grupo HD ha sido mayor que en el CO (p=0,05) y el TG en el grupo HD (145,14±70,15mg/dL) mayor (p<0,001) que en el CO (77,35±53,25mg/dL). Se encontró la razón TG/HDL en el grupo HD de 4,02±2,60 (p=0,04) con menores niveles de zinc (p=0,011). Conclusión: Los pacientes en hemodiálisis presentaron deficiencia de zinc y tenían elevado riesgo cardiovascular, sin embargo, sin relación entre el zinc y el perfil lipídico.

AssociaþÒo entre índice glicÛmico e carga glicÛmica dietéticos e doenþa hepática gordurosa nÒo alcoólica em idosos / [Relationship between dietary glycemic index and glycemic load and nonalcoholic fatty liver disease in elderly].

OBJECTIVE: To investigate if there is an association between glycemic index (GI) and glycemic load (GL) of the diet and the presence of nonalcoholic fatty liver disease (NAFLD) in the elderly. METHODS: Retrospective study, composed of 229 patients seen at the Outpatient Clinic of Arterial Hyperten- sion in a public hospital, 103 carriers and 126 noncarriers of NAFLD. Food intake was analyzed to GI and GL. RESULTS: We found a high prevalence of inadequate dietary GI, with an average of 62.0 +/- 6.3 among patients with NAFLD and 62.5 +/- 6.5 among patients without NAFLD. The same occurred with the GL, 101.7 +/- 33.3 and 101.4 +/- 40.2, respectively, between carriers and noncarriers of the disease. There was no statistical difference between the values of GI and GL found in the diet of patients with and without NAFLD. CONCLUSION: In the evaluated group there was no association between GI and GL dietetic with NAFLD, but the findings put all of the patients at higher risk for the development of chronic diseases.