Association of Val16Ala Polymorphism of Manganese Superoxide Dismutase (MnSOD) with Food Intake and Cardiometabolic Risk Factors in the Elderly in Primary Care in Porto Alegre.

BACKGROUND: The aging process causes physiological changes on its own. The combination of an unhealthy lifestyle with the presence of genetic polymorphisms, such as the Val16Ala of the antioxidant enzyme manganese-dependent superoxide dismutase (MnSOD) may contribute to a greater occurrence of cardiometabolic risk factors. OBJECTIVE: This study aimed to verify the association of Val16Ala-MnSOD polymorphism with food intake, caloric expenditure, and cardiometabolic risk factors in the elderly. METHODS: A cross-sectional study with a sample size of 270 elderly individuals assisted in primary health care in the city of Porto Alegre, RS, Brazil. Val16Ala polymorphism, glucose, lipid profile, insulin, HOMA-IR, blood pressure, waist circumference, PCR-us, IL-6, food consumption, and caloric expenditure were evaluated. RESULTS: The average age of the elderly was 68.6 ± 7.6 years. There were statistically significant differences regarding the consumption of two or more servings of fruits and vegetables daily between the elderly VV versus AV (P=0.017). There were also statistically significant differences regarding the consumption of two or more daily servings of legumes and eggs between the elderly AA versus VV (P=0.002). The median of insulin was higher in the elderly AA versus AV (P=0.025) and the median of HOMA-IR was higher in the elderly VV versus AV (P=0.029). AA elderly individuals had higher means of high-density lipoprotein (HDL-c), compared to AV (P=0.029). CONCLUSION: The results suggest that Val16Ala -MnSOD polymorphism is associated with the consumption of fruits, vegetables, legumes, and eggs, as well as with cardiometabolic risk factors in the elderly.

Effects of Spices (Saffron, Rosemary, Cinnamon, Turmeric and Ginger) in Alzheimer's Disease.

Alzheimer's disease (AD) is the most prevalent dementia in the elderly, causing disability, physical, psychological, social, and economic damage to the individual, their families, and caregivers. Studies have shown some spices, such as saffron, rosemary, cinnamon, turmeric, and ginger, have antioxidant and anti-inflammatory properties that act in inhibiting the aggregation of acetylcholinesterase and amyloid in AD. For this reason, spices have been studied as beneficial sources against neurodegenerative diseases, including AD. In this sense, this study aims to present a review of some spices (Saffron, Rosemary, Cinnamon, Turmeric and Ginger) and their bioactive compounds, most consumed and investigated in the world regarding AD. In this article, scientific evidence is compiled in clinical trials in adults, the elderly, animals, and in vitro, on properties considered neuroprotective, having no or negative effects on neuroprotection of these spices and their bioactive compounds. The importance of this issue is based on the pharmacological treatment for AD that is still not very effective. In addition, the recommendations and prescriptions of these spices are still permeated by questioning and lack of robust evidence of their effects on neurodegeneration. The literature search suggests all spices included in this article have bioactive compounds with anti-inflammatory and antioxidant actions associated with neuroprotection. To date, the amounts of spice ingestion in humans are not uniform, and there is no consensus on its indication and chronic consumption guarantees safety and efficacy in neuroprotection. Therefore, clinical evidence on this topic is necessary to become a formal adjuvant treatment for AD.

Crosstalk between Gut Microbiota and Central Nervous System: A Focus on Alzheimer's Disease.

The role of diet and gut microbiota in the pathophysiology of neurodegenerative diseases, such as Alzheimer's, has recently come under intense investigation. Studies suggest that human gut microbiota may contribute to the modulation of several neurochemical and neurometabolic pathways, through complex systems that interact and interconnect with the central nervous system. The brain and intestine form a bidirectional communication axis, or vice versa, they form an axis through bi-directional communication between endocrine and complex immune systems, involving neurotransmitters and hormones. Above all, studies suggest that dysbiotic and poorly diversified microbiota may interfere with the synthesis and secretion of neurotrophic factors, such as brain-derived neurotrophic factor, gammaaminobutyric acid and N-methyl D-Aspartate receptors, widely associated with cognitive decline and dementia. In this context, the present article provides a review of the literature on the role of the gutbrain axis in Alzheimer's disease.

Idade, sexo, raça/etnia são fatores intrínsecos associados à perda de massa muscular: uma revisão sistemática / Age, sex, race/ethnicity are factors associated with loss of muscle mass intrinsic: a review systematic

Fatores intrínsecos podem estar envolvidos com a perda de massa muscular ou com a sarcopenia em humanos, como por exemplo, idade, sexo e raça. O objetivo dessa revisão foi verificar se idade, sexo e raça/etnia estão associados a perda de massa muscular ou sarcopenia. Realizou-se uma busca no mês de agosto de 2015 nas bases de dados Web of Science, Embase, PubMed e LILACS, com o intuito de identificar estudos que investigaram a perda de massa muscular e/ou sarcopenia em amostras compostas por homens e mulheres com idade acima de 18 anos, diferentes grupos étnicos, nos idiomas português e inglês, entre os anos de 2005 e 2015. Os critérios de elegibilidade foram os seguintes: indivíduos com idade igual ou superior a 18 anos; homens e mulheres de diferentes raças/etnias, onde o desfecho final deveria consistir na associação entre sarcopenia e/ou perda de massa muscular com sexo, idade e raça/etnia. 136 artigos relacionados ao tema foram capturados, porém apenas sete estudos foram incluídos, pois preencheram os critérios de inclusão. Os resultados demonstram que mulheres negras apresentam significativamente maior massa livre de gordura e índice de massa livre de gordura do que mulheres brancas, porém essas variáveis são semelhantes entre homens negros e brancos. Homens e mulheres negras apresentam significativamente perda mais precoce de massa muscular quando comparada com brancos. Idosos negros (homens e mulheres) também apresentam uma redução de força muscular quando comparados com idosos brancos. Para ambos os sexos, após o ponto de corte de 27 anos de idade a massa muscular começa a declinar, porém Afro-Americanos apresentaram os maiores valores de massa muscular, seguidos por brancos, hispânicos e asiáticos. Sexo e idade são fatores intrínsecos que podem afetar a massa muscular, no entanto a raça/etnia pode modular de forma diferente essa perda ao longo do processo de envelhecimento....(AU)

Intrinsic factors may be involved with muscle loss or sarcopenia in humans, such as age, sex and race. The objective of this review was to determine whether age, gender and race / ethnicity are associated with muscle mass loss or sarcopenia. Carried out a search during August 2015 in the databases Web of Science, Embase, PubMed and LILACS, in order to identify studies that investigated the muscle mass loss and/or sarcopenia in samples with men and women with age above 18 years, different ethnic groups, in Portuguese and English, between 2005 and 2015. The eligibility criteria were as follows: individuals aged over 18 years; men and women of different races/ethnicities, where the final outcome should be the association between sarcopenia and/or muscle mass loss with age, sex and race/ethnicity. 136 papers related to the topic were captured, but only seven studies were included because it fulfilled the inclusion criteria. The results show that black women have significantly higher fat free mass and free fat mass index than white women, but these variables are similar between black and white men. Black men and women have significantly earlier muscle mass loss compared to whites. Black elderly (men and women) also showed a reduction in muscle strength when compared with white elderly. For both sexes, after the cut-off point of 27 years old muscle mass begins to decline, but African-Americans had the highest muscle mass, followed by white, Hispanic and Asian. Gender and age are intrinsic factors that can affect muscle mass, however race/ethnicity may modulate differently this loss during the aging process....(AU)

Inflammation, Oxidation, Caloric Expenditure and Cognitive Impairment in Brazilian Elderly Assisted at Primary Care.

Cognitive impairment (CI) has a multifactorial etiology. Some studies have suggested that inflammatory, oxidative and antioxidant status and physical activity are associated with CI. However, the evidence on this subject is still controversial. The goal of this study was to verify the association of caloric expenditure by physical activity, oxidative, antioxidant power and inflammatory biomarkers with CI in older adults. We performed a cross-sectional study of 424 elderly (224 with normal cognitive function and 200 with CI) patients from the Family Health Strategy in Porto Alegre, Rio Grande do Sul, Brazil. The variables investigated were sociodemographic, biochemical, inflammatory (hs-CRP, IL-6), oxidative (TBARS, AOPP), antioxidant power (FRAP) biomarkers, energy expenditure, and cognitive function. The instruments used were the Minnesota Leisure Time Physical Activity Questionnaire + Compendium of Physical Activities, classification of energy costs of human physical activities (for physical activity evaluation and measurement of energy expenditure in METs), and a battery of neuropsychiatric instruments (for cognitive ability assessment). We found statistically significant differences only with respect to HDL-c and age (higher averages in the CI group; P<0.05). We observed no differences between the groups with respect to biochemical, inflammatory, oxidative and FRAP biomarkers or caloric expenditure. Logistic regression showed that HDL-c (OR=1.02 [IC=95%; 1.01-1.04]; P=0.011), and age (OR=1.05 [IC=95%; 1.02-1.08]; P=0.004) are independent factors associated with CI. Our results suggest that the biochemical (except HDL-c), inflammatory, oxidative, and FRAP biomarkers investigated and caloric expenditure are not associated with CI in the elderly assisted at primary care.

Effectiveness of pilates method for the posture and flexibility of women with hyperkyphosis / Eficácia do método pilates para a postura e flexibilidade em mulheres com hipercifose

O objetivo do estudo foi avaliar a eficácia do método Pilates em melhorar a postura e a flexibilidade em mulheres com hipercifose. Foi conduzido um ensaio clínico, controlado e randomizado com 41 mulheres (média de idade= 59 ± 9 anos), divididas aleatoriamente em dois grupos: 22 no grupo de intervenção e 19 no grupo controle. As participantes passaram por dois conjuntos iguais de mensurações, antes e depois de um período de treinamento/ controle, que foram compostos por: características sociodemográficas e clínicas, peso, altura, índice de massa corporal (IMC), percentual de gordura corporal (três pregas cutâneas), razão quadril-cintura (medidas das circunferências). Além desses, o grau de cifose foi mensurado pelo ângulo de Cobb através de um exame radiológico (Raio-X) com o paciente em pé, a flexibilidade foi medida com um flexímetro e a postura analisada através de quatro fotografias (visão anterior, perfil direito e esquerdo e posterior) com o software Fisimetrix. Todas as medições foram realizadas pelo mesmo observador, que foi treinado e cegado quanto à alocação dos sujeitos. Os exercícios foram realizados duas vezes por semana (60 minutos cada aula) durante 30 semanas. Antes do estudo, os dois grupos não diferiram estatisticamente em nenhuma das características analisadas. Após o estudo foram detectadas diferenças significativas entre os dois grupos em termos de: ângulo da cifose torácica (grupo experimental= -8,0 ± 7,5 graus; grupo controle= -0,6 ± 3,4 graus; p <0,001), flexibilidade de todos os movimentos da região cervical e do tronco, IMC (p <0,001), percentual de gordura corporal (p <0,001) e todos os movimentos (p <0,05), com exceção da flexão anterior do tronco. Portanto, o método Pilates é eficaz em melhorar a postura e flexibilidade em mulheres mais velhas com hipercifose, bem como em reduzir a gordura corporal.

The aim of the study was to evaluate the effectiveness of the Pilates method in improving posture and flexibility in women with hyperkyphosis. A randomized controlled trial was performed with 41 women (mean age of 59 ± 9 years) randomized into two groups: 22 in the intervention group and 19 in the control group. Subjects undertook two equal sets of assessment, before and after a training/ control period, which comprised of sociodemografic and clinical characteristics, height, weight, body mass index (BMI), body fat percentage (three skin fold measurement), waist-hip ratio (circumference measurements). In addition to these, the degree of kyphosis was measured by the Cobb angle on a standing lateral radiograph, flexibility was measured with a fleximeter and posture assessment was carried out with theFisimetrix software through four view photographs (front, right profile, left profile and back). All measurements were carried out by the same observer, who was trained and blinded with respect to the subjects’ group allocation. The exercises were carried out twice a week (60-minute class) for 30 weeks. Before the study, the two groups did not differ statistically in terms of any of the characteristics analyzed. After the study, statistically significant differences were found between the two groups in terms of: kyphosis angle (experimental group = -8,0 ± 7,5 degrees; control group = -0,6 ± 3,4 degrees; p <0,001), flexibility of all cervical region and trunk movements, BMI (p <0,001), body fat percentage (p <0,001) e all body movements (p <0,05), except for trunk flexion. Therefore, the Pilates method is effective in improving posture and flexibility in women with hyperkyphosis as well as reducing body fat.

Anticorpos contra LDL-ox e síndrome coronariana aguda / Antibodies against OxLDL and acute coronary syndrome

FUNDAMENTO: A oxidação da lipoproteína de baixa densidade (LDL-ox) induz à formação de epítopos imunogênicos na molécula. A presença de autoanticorpos contra a LDL-ox tem sido demonstrada no soro de pacientes com doença arterial coronariana (DAC). Contudo, o papel desses autoanticorpos na fisiopatologia das síndromes coronarianas agudas (SCA) e o seu significado clínico permanecem indefinidos. OBJETIVO: Avaliar a associação entre autoanticorpos contra a LDL-ox e SCA. MÉTODOS: Os títulos de imunoglobulina G autoanticorpos contra a LDL-ox por cobre (antiLDL-ox) e contra o peptídeo sintético D derivado da apolipoproteína B (antipeptD) foram determinados por ensaio imunoenzimático (ELISA) em 90 pacientes, nas primeiras 12h de SCA (casos) e em 90 pacientes com DAC crônica (controles). RESULTADOS: Os resultados mostraram que os títulos de antiLDL-ox foram significativamente mais elevados (p = 0,017) nos casos (0,40 ± 0,22), do que nos controles (0,33 ± 0,23). Por outro lado, os títulos de antipeptD foram significativamente menores (p < 0,01) nos casos (0,28 ± 0,23) do que nos controles (0,45 ± 0,30). A diferença dos títulos de ambos anticorpos entre os dois grupos estudados foi independente de idade, sexo, hipertensão arterial, diabete melito, dislipidemia, índice de massa corporal, tabagismo, perfil lipídico, uso de estatinas e história familiar de DAC. CONCLUSÃO: Os resultados mostraram que os títulos de antiLDL-ox foram significativamente mais elevados nos pacientes com síndrome coronariana aguda quando comparados aos pacientes com doença arterial coronariana e podem estar associados à instabilidade da placa aterosclerótica.

BACKGROUND: The oxidation of low-density lipoprotein (oxLDL) induces the formation of immunogenic epitopes in molecules. The presence of autoantibodies against oxLDL has been demonstrated in the serum of patients with coronary artery disease (CAD). However, the role of these autoantibodies in the pathophysiology of acute coronary syndromes (ACS) and their clinical significance remain undefined. OBJECTIVE: To evaluate the association between antibodies against oxLDL and ACS. METHODS: Titers of IgG autoantibodies against oxLDL by copper (anti-oxLDL) and anti-D synthetic peptide derived from apolipoprotein B (antipeptD) were determined by Enzyme-linked immunosorbent assay (ELISA) in 90 patients, in the first 12 hours of ACS (cases) and in 90 patients with chronic CAD (controls). RESULTS: The results showed that the titers of anti-oxLDL were significantly higher (p = 0.017) in cases (0.40 ± 0.22) than in controls (0.33 ± 0.23). On the other hand, the titers of antipeptD were significantly lower (p < 0.01) in cases (0.28 ± 0.23) than in controls (0.45 ± 0.30). The difference in the titers of both antibodies between the two groups was independent of age, sex, hypertension, diabetes mellitus, dyslipidemia, body mass index, smoking, lipid profile, statin use and family history of CAD. CONCLUSION: The results showed that the titers of anti-oxLDL were significantly higher in patients with acute coronary syndrome as compared to patients with coronary artery disease and may be associated with atherosclerotic plaque instability.

Antibodies against oxLDL and acute coronary syndrome.

BACKGROUND: The oxidation of low-density lipoprotein (oxLDL) induces the formation of immunogenic epitopes in molecules. The presence of autoantibodies against oxLDL has been demonstrated in the serum of patients with coronary artery disease (CAD). However, the role of these autoantibodies in the pathophysiology of acute coronary syndromes (ACS) and their clinical significance remain undefined. OBJECTIVE: To evaluate the association between antibodies against oxLDL and ACS. METHODS: Titers of IgG autoantibodies against oxLDL by copper (anti-oxLDL) and anti-D synthetic peptide derived from apolipoprotein B (antipeptD) were determined by Enzyme-linked immunosorbent assay (ELISA) in 90 patients, in the first 12 hours of ACS (cases) and in 90 patients with chronic CAD (controls). RESULTS: The results showed that the titers of anti-oxLDL were significantly higher (p = 0.017) in cases (0.40 +/- 0.22) than in controls (0.33 +/- 0.23). On the other hand, the titers of antipeptD were significantly lower (p < 0.01) in cases (0.28 +/- 0.23) than in controls (0.45 +/- 0.30). The difference in the titers of both antibodies between the two groups was independent of age, sex, hypertension, diabetes mellitus, dyslipidemia, body mass index, smoking, lipid profile, statin use and family history of CAD. CONCLUSION: The results showed that the titers of anti-oxLDL were significantly higher in patients with acute coronary syndrome as compared to patients with coronary artery disease and may be associated with atherosclerotic plaque instability.

Association among oxidized LDL levels, MnSOD, apolipoprotein E polymorphisms, and cardiovascular risk factors in a south Brazilian region population.

Oxidized LDL (ox-LDL) is involved in the initiation and progression of atherosclerosis. Many factors can affect the LDL oxidation such as oxidative stress. The present study tested whether ox-LDL levels would be associated with apolipoprotein E (APOE), manganese superoxide dismutase (MnSOD) Ala16Val polymorphisms, and classic cardiovascular risk factors. ox-LDL levels were measured by thiobarbituric acid-reactive substances and both polymorphisms were determined by polymerase chain reaction/restriction fragment length polymorphism in a sample of 252 subjects (70 men, 182 women, mean age, 54-85 years). Subjects with ox-LDL >or=0.5 nmol/mg apoprotein were considered the high level group (HLG, N = 82) and subjects with ox-LDL <0.5 nmol/mg apoprotein were considered the expected level group (ELG, N = 170). Classic risk factors were also evaluated. The results showed that diabetes mellitus was more prevalent in HLG, whereas other cardiovascular risk factors were similar between groups. The APOE genotype frequencies did not differ between HLG and ELG subjects. However, AA genotype from MnSOD polymorphism was more frequent in ELG (chi(2) = 8.48; P = 0.014). AV and VV subjects from ELG present highest ox-LDL levels (OR = 3.61; CI95% = 1.42-9.17) than AA. Additional analysis did not find gene-gene interactions associated with ox-LDL levels. Multivariate analysis showed that diabetes and the MnSOD polymorphism were independent factors associated with higher ox-LDL levels in HLG. The results suggest that an important framework on modulation of the redox status influenced by genetic polymorphisms could affect the cardiovascular homeostasis.

Fisiopatologia e aspectos inflamatórios da aterosclerose / Physiopathology and inflammatory aspects of atherosclerosis

O objetivo deste trabalho foi apresentar e avaliar o que tem se descoberto recentemente sobre fisiopatologia, epidemiologia e aspectos inflamatórios envolvidos na aterosclerose dentro de uma pespectiva multidisciplinar. Foram realizadas compilações bibliográficas sobre artigos científicos originais e de revisão em revistas indexadas no Medline no período de 1970 ao atual que envolvesse assuntos relacionados à aterosclerose. A revisão sugere que a aterosclerose é uma doença multifatorial com forte componente genético, ambiental e de resposta inflamatória, associada ao envelhecimento. No entanto, ainda a sua etiologia não está completamente esclarecida. O entendimento da biologia básica da inflamação na aterosclerose proporcionaria um melhor suporte clínico que poderia alterar o caminho da prática da medicina preventiva e propiciar benefícios para a saúde pública.