Lipoatrofia por inyección de esteroides - Diagnóstico y tratamiento / Lipoatrophy by injection of steroids - Diagnosis and treatment

Existen diferentes opciones para el tratamiento de la lipoatrofi a secundaria a la inyección local de esteroides. Presentamos las diferentes alternativas de tratamiento y sus resultados sobre cuatro pacientes con diferente grado de lesión y en diferentes áreas corporales.

There are diff erent options for the treatment of lipoatrophy secondary to the local injection of steroids. We present the diff erent treatment alternatives and their results on four patients with diff erent degrees of injury and in diff erent body areas.

Lipohypertrophy among insulin-treated patients

Objective: To evaluate insulin injection practice, prevalence and risk factors of lipohypertrophy [LH] among insulin-treated patients

Design: A Retrospective Study

Setting: Two Primary Health Centers, Bahrain

Method: Ninety-five insulin-treated patients were included in the study from 3 January 2016 to 31 May 2016. The following data were documented: age, sex, educational level, type of diabetes, duration of diabetes, duration of insulin treatment, number of injections, type of insulin, daily insulin dose, needle size, site of injection, frequency of needle change, frequency of injection site rotation and frequency of checking the injection site. Diabetes control and Body Mass Index [BMI] were documented. Ultrasound examination of the injection site was performed

Result: Ninety-five insulin-treated patients were included in the study

Thirty-five [36.8%] patients had LH. Seventy-two [75.8%] patients were obese females with poorly controlled type 2 diabetes

Forty-seven [49.5%] patients were using insulin for less than five years. Ninety-three [97.8%] patients were using <6 mm needle; 85 [89.5%] were using the needle once at a time and were doing daily rotation

The injection site was never checked in all except one [1.1%] patient

There was a highly significant statistical association between LH and level of education, the number of injections and the site of injection. Mean subcutaneous fat thickness were 12.3 mm [arm], 17.8 mm [thigh] and 23.3 mm [abdomen]

Conclusion: Lipohypertrophy is prevalent among our patients and could be related to improper insulin injection technique and lack of regular check of the injection sites. Therefore, patients and health providers' education is necessary to reduce its prevalence

Long term excessive Zn-supplementation promotes metabolic syndrome-X in Wistar rats fed sucrose and fat rich semisynthetic diet.

During the last two decades Zinc (Zn) as a micronutrient is being used indiscriminately in agricultural and husbandry practices and also in baby foods and multivitamin supplements with a view that Zn is non-toxic and promotes linear growth and body weight in the consumers. The long-term effect of increasing Zn load in the body has not been worked out so far. In this study, three groups of rats were fed on a semi-synthetic diet containing 20 mg (control, group-I), 40 mg (group-II) and 80 mg Zn /kg (group-III) diet respectively for 6 months. The results revealed that the gain in body weight increased in rats in Zn-concentration dependent manner. The urine examined on weekly basis showed glucosuria in group-II on week 10 and in group-III on week 8 and thereafter. The arterial blood pressure was significantly higher in group-II and III than their control counter parts on monthly basis. Histochemical examination of skin revealed an increase in the number of adipocytes filled with triglycerides making a subcutaneous fatty tissue thicker in group-II and group-III than that of control group. The blood profile after 180 days of dietary treatment, displayed a significant rise in glucose, total lipids, cholesterol, triglycerides, LDL-cholesterol, VLDL-cholesterol, insulin, cortisol and aldosterone whereas HDL-cholesterol, T3, T4 and TSH showed a reduction in their levels in the blood serum. The tissue metal status showed an increase of Zn, Cu and Mg in the serum, a rise in Zn in liver, hair and abdominal muscles and fall in Cu and Mg concentrations in liver, hair and abdominal muscles. This data suggest that Zn in excess in diet when fed for longer periods of time induces metabolic syndrome-X.

Association of anti-obesity activity of N-acetylcysteine with metallothionein-II down-regulation

People with upper body or visceral obesity have a much higher risk of morbidity and mortality from obesity-related metabolic disorders than those with lower body obesity. In an attempt to develop therapeutic strategies targeting visceral obesity, depot- specific differences in the expression of genes in omental and subcutaneous adipose tissues were investigated by DNA array technology, and their roles in adipocyte differentiation were further examined. We found that levels of metallothionein-II (MT-II) mRNA and protein expression were higher in omental than in subcutaneous adipose tissues. The study demonstrates that MT-II may play an important role in adipocyte differentiation of 3T3L1 preadipocytes, and that N-acetylcysteine (NAC) inhibits the adipocyte differentiation of 3T3L1 cells by repressing MT-II in a time- and dose-dependent manner. Furthermore, the intraperitoneal administration of NAC to rats and mice resulted in a reduction of body weights, and a marked reduction in visceral fat tissues. These results suggest that MT-II plays important roles in adipogenesis, and that NAC may be useful as an anti-obesity drug or supplement.