Avaliação prospectiva das repercussões no perfil lipídico das cirurgias que envolvem lipoaspiração e dermolipectomias / Prospective assessment of the repercussions on the lipid profile of surgeries involving liposuction and dermolipectomies

Introdução: Lipoaspiração associada a dermolipectomias é o procedimento cirúrgico mais comumente realizado em cirurgia plástica. Apesar de ser considerada uma cirurgia extremamente segura, algumas considerações devem ser levantadas a respeito dos possíveis efeitos metabólicos que essas cirurgias possam causar. O desenvolvimento da técnica tumescente de lipoaspiração permitiu a remoção de grande quantidade de gordura de modo mais seguro. O objetivo é comparar as variações do perfil lipídico em pós-operatório precoce e tardio de pacientes submetidos à lipoaspiração e dermolipectomias. Métodos: Entre outubro de 2006 e junho de 2012, 40 pacientes do sexo feminino candidatas a cirurgias que envolviam lipoaspiração e dermolipectomias foram acompanhadas prospectivamente e o perfil lipídico foi analisado por meio de exames no pré-operatório e no pós-operatório. As cirurgias realizadas foram: mamoplastia + lipoaspiração, abdominoplastia + lipoaspiração e lipoabdominoplastia + mamoplastia. Resultados: Das 40 pacientes que foram acompanhadas no estudo, 20 pacientes do sexo feminino foram selecionadas (após a aplicação dos critérios de exclusão). Em consonância com nosso estudo, Cazes, em 1996, demonstrou que após 12 meses de pós-operatório de lipoabdominoplastia não houve alteração do perfil lipídico das pacientes. Conclusão: Após análise pré- e pós-operatória de 20 pacientes, observamos que não há alterações estatísticas significantes em relação ao perfil lipídico com tendência de equilíbrio das aferições em um ano em patamares próximos aos observados no pré-operatório.

Introduction: Liposuction associated with dermolipectomies is the most commonly performed surgical procedure in plastic surgery. Although regarded as an extremely safe surgery, some considerations must be taken on the possible metabolic effects of these surgeries. The development of the tumescent technique in liposuction allowed the safer removal of large amounts of fat. The objective is to compare lipid profile variations in the early and late postoperative period in patients undergoing liposuction and dermolipectomies. Methods: Between October 2006 and June 2012, 40 female patients who were candidates for surgeries involving liposuction and dermolipectomies were prospectively followed, and the lipid profile was analyzed through preoperative and postoperative examinations. The surgeries performed were mammoplasty + liposuction, abdominoplasty + liposuction, and lipoabdominoplasty + mammoplasty. Results: Of the 40 female patients who were followed, 20 were selected (after applying the exclusion criteria). In agreement with our study, in 1996, Cazes showed that there were no changes in the lipid profile of patients 12 months after lipoabdominoplasty. Conclusion: After a preoperative and postoperative analysis of 20 patients, it was observed that there were no statistically significant changes in the lipid profile and that the measurements after 1 year were close to those obtained in the preoperative period.

Efeito hepatoprotetor do consumo crônico de dieptanoína e trieptanoína contra a esteatose em ratos / Hepatoprotective effect of diheptanoin and tritreptanoin chronic consumption against steatosis in rats

OBJETIVO: Avaliar o efeito do consumo crônico de di e trieptanoínas sobre a esteatose hepática (EH) em ratos. METODOLOGIA: Ratos Wistar submetidos à dieta AIN-93 com 0 por cento, 30 por cento ou 50 por cento de substituição do óleo por óleo rico em di e trieptanoína, grupos TAGC(7)0, TAGC(7)30 e TAGC(7)50, respectivamente, por nove meses. O grupo-controle recebeu ração Labina®. Analisaram-se histologia e provas de função e lesão hepática, glicemia e perfil lipídico sérico. Realizaram-se análise de variância, teste F, teste de Dunnet e análises de regressão uni e multivariadas (p < 0,05). RESULTADOS: TAGC(7)0, TAGC(7)30 e TAGC(7)50 desenvolveram EH; 80 por cento de casos graves no TAGC(7)0 contra 40 por cento no TAGC(7)50. Os pesos absoluto (PAF) e relativo do fígado (PRF) foram maiores em TAGC(7)0 e TAGC(7)30 e a glicemia foi maior em TAGC(7)30 e TAGC(7)50, que no grupo-controle. Colesterol total, LDL-c, LDL-c/HDL-c e proteínas totais foram maiores no grupo-controle. O óleo experimental reduziu o PRF e determinou tendência de redução do peso corporal, PAF, percentual de lipídios hepáticos e graus de EH (GHE). As variáveis explicativas para GHE foram peso final, glicemia, albumina, HDL-c, LDL-c, LDL-c/HDL-c, VLDL-c e fosfatase alcalina. CONCLUSÕES: Sugere-se que di e trieptanoínas exerçam efeito hepatoprotetor contra a EH, em ratos, em uma feição dose-dependente.

OBJECTIVE: to evaluate the effect of chronic consumption of di- and triheptanoin on hepatic steatosis (HS) in rats. METHODOLOGY: Wistar rats were submitted to a diet AIN-93 with 0, 30 or 50 percent of its oil substituted with an oil rich in di- and triheptanoin, groups TAGC(7)0, TAGC(7)30 and TAGC(7)50 respectively, for nine months. The control group received Labina®. Liver histology, hepatic lesion and function proofs, glycemia and lipid profile, were performed. Variance analyses, F-test, Dunnet´s test and uni- and multivariate regression analyses were performed (p<0.05). RESULTS: TAGC(7)0, TAGC(7)30 and TAGC(7)50 developed HS; 80 percent of severe cases in TAGC(7)0, as against 40 percent in TAGC(7)50. The absolute (ALW) and relative (RLW) liver weights were higher in TAGC(7)0 and TAGC(7)30, and glycemia was greater in TAGC(7)30 and TAGC(7)50, than in the Control. Total cholesterol, LDL-c, LDL-c/HDL-c and total proteins were higher in the Control. The experimental oil reduced RLW and showed a tendency in the reduction of body weight, ALW, percentage of hepatic lipids and the severity of HS. The explanatory variables in relation to HS were final weight, glycemia, albumin, HDL-c, LDL-c, LDL-c/HDL-c, VLDL-c and alkaline phosphatase. CONCLUSIONS: It is suggested that di- and triheptanoin have a hepatoprotector effect against HS, in rats, in a dose-dependant manner.

Acylglycerol synthesis in liver of type II diabetic rats fed a diet supplemented with either N-6 or N-3 fatty acids

Liver is one of the tissues most actively involved in triacylglycerol synthesis and secretion. Hypertriglyceridemia is commonly associated with the diabetic state which has been detected in very young rats after the induction of experimental diabetes. In the present work, acylglycerol synthesis in liver of streprozotocintreated rats, fed a diet supplemented with n-3 and n-6 fatty acids, was studied. At the onset of the experiment, plasma triacylglycerol levels increased significantly in diabetic animals when compared to controls. Two weeks after the dietary treatment, the aforementoined parameter decreased in diabetic animals consuming either n-6 or n-3 fatty acids. In control rats, n-3 fatty acids depressed triacyglycerol synthesis in liver microsomes. In the diabetic group both diets increased diacylglycerol and triacylglycerol synthesis. The addition on liver cytosolic fraction from control rats to the incubation medium, stimulated the triacylglycerol synthesis in all the groups. Nevertheless, the radioactivity recovered in the neutral lipid fractions was lower in the samples from rats fed n-3 fatty acids compared to n-6. We conclude that dietary n-3 fatty acids decreased significantly triacylglycerol plasma levels in diabetic rats probably through the inhibiton of liver triacylglycerol secretion. In addition, there probably is an n-3 fatty sensitive factor in the liver cytosolic fraction able to depress triglyceride synthesis.

Genetic & cultural determinants of high-density lipoprotein cholesterol & serum triglycerides among Marwaris of Calcutta.

A genetic epidemiological study of serum lipid and lipoprotein levels was conducted among families of Marwaris residents in Calcutta. A total of 210 families, comprising over 100 individuals, were studied. Analyses were performed to estimate the genetic and environmental effects on the determination of high density lipoprotein cholesterol (HDL-C) and serum triglycerides (TG). Familial correlations for HDL-C and TG were estimated: parent-child and sib-sib correlations were found to be significant. Spouse correlations were not significant. Correlations between environments of siblings were significant. Genetic analysis of data on HDL-C and TG performed under a path model, taking genetic transmission and possible environmental associations among family members into account, indicated that lipid and lipoprotein levels adjusted and standardized for age, gender, education, occupation and disease status are primarily determined by genetic factors. The effects of environmental factors were also significant, although in comparison with genetic factors these effects were much smaller. The estimated genetic heritability for HDL-C was approximately 80 per cent, while that for TG was approximately 55 per cent. The genetic effects and environmental effects were not significantly different between adults and children.

The role of insulin in the control of hepatic fatty acid and glycerolipid metabolism assessed by studies in vivo

The liver secretes triacylglycerol-rich very-low-density lipoproteins (VLDL). Teleologically, it would be expected that during the prandial/early absorptive periodo the rate of hepatic VLDL secretion would be inhibited, in view of the concomitant secretation of chylomicrons from the gut. Such inhibition would limit the extent and duration of post-prandial hyperlipaemia. Experiments in wich the fatty acids of the liver were labelled specifically in rats in vivo show that, during a meal, triacylglycerol secretion was inhibited through a combination of diversion of flux towards phospholipid synthesis, and inhibition of the fractional rate of secretion of triacylglycerol. These adaptations occur even in diabetic rats, indicating that insulin is not obligatorily involved in mediating them. It is suggested that uptake of osmolytes (e.g. amino acids that are cotransported with Na+ions into hepatocytes) from the portal circulation may result in increased hepatocyte volume and that this, in turn, alters fatty acid and glycerolipid metabolism independently of, but possibly in synergy with, insulin action.