ABSTRACT
Prolactin (PRL) is a hormone characterized by its immunomodulatory properties. The aim of this study was to evaluate the prevalence of thyroid autoimmunity in patients with prolactinoma. Seventy-seven patients and 56 healthy individuals in the control group, sex and age matched, had their serum PRL, free tetraiodothyronine, thyroid-stimulating hormone and anti-thyroid peroxidase (anti-TPO) levels measured. The prevalence of anti-TPO for patients was 13% and 8.9% for control group (p = 0.58). The analysis of subgroups of patients, divided in accordance with tumor size at diagnosis, showed no significant difference in the frequency of anti-TPO. However, when they were divided in accordance with the prolactin levels at the moment of the study, 18.8% with valid hyperprolactinemia and 3.4% without hyperprolactinemia had positive autoantibody (p = 0.07). In conclusion, there was no greater prevalence of thyroid autoimmunity in patients with prolactinoma. Nevertheless, those with valid hyperprolactinemia showed a greater tendency for positive autoantibody anti-TPO
Subject(s)
Humans , Autoimmune Diseases , Thyroid Diseases , Hyperprolactinemia , ProlactinABSTRACT
Although there are specific guidelines regarding the treatment of dyslipidemia in highly risk patients, these recommendations are usually inadequately followed. The aim of this study is to investigate risk factors in patients with increased cardiovascular risk currently treated in Brazil and Venezuela. Medical charts of 412 patients were selected in 4 institutions. Patients were divided into groups according to the use of lipid-lowering drugs (LLD), particularly statins. Patients who did not use LLD showed higher levels of total cholesterol (p< 0.001), LDL cholesterol (p< 0,001) and HDL cholesterol (p< 0.001), besides lower levels of triglycerides (p< 0.001). The use of statins was associated with a decrease in levels of total cholesterol (from 251.0 +/- 40.0 to 196.0 +/- 46.0), LDL cholesterol (from 168.0 +/- 36.0 to 116.0 +/- 39.0), HDL cholesterol (from 51.0 +/- 46.0 to 46.0 +/- 12.0) and triglycerides (from 181.0 +/- 120.0 to 160.0 +/-79.0). Finally, only a small percentage of patients, even those under treatment with LLD, showed cholesterol levels according to currently available guidelines. Therefore, although the guidelines for the treatment of dyslipidemia are widely known, only a small percentage of patients achieve adequate levels of cholesterol. It is necessary to decrease lipid levels of these patients by increasing the dose of the statins or using a second drug.
Subject(s)
Cardiovascular Diseases/etiology , Hyperlipidemias/metabolism , Lipids/blood , Body Mass Index , Brazil , Cardiovascular Diseases/diagnosis , Cholesterol/blood , Female , Humans , Hydroxymethylglutaryl-CoA Reductase Inhibitors/administration & dosage , Hydroxymethylglutaryl-CoA Reductase Inhibitors/metabolism , Hyperlipidemias/drug therapy , Hypolipidemic Agents/administration & dosage , Hypolipidemic Agents/metabolism , Hypolipidemic Agents/therapeutic use , Male , Retrospective Studies , Risk Factors , VenezuelaABSTRACT
Embora existam recomendações especificas envolvendo o tratamento das dislipidemias em pacientes com alto risco, estas recomendações dificilmente são seguidas adequadamente. O objetivo deste estudo é investigar fatores de risco em pacientes com alto risco cardiovascular acompanhados ambulatorialmente no Brasil e Venezuela. Os prontuários de 412 pacientes foram selecionados em 4 instituições. Os pacientes foram divididos conforme a utilização de hipolipemiantes. Pacientes sem hipolipemiantes apresentavam níveis mais elevados de colesterol total (p< 0,001), LDL colesterol (p< 0,001) e HDL colesterol (p< 0,001), além de menores níveis de triglicérides (p< 0,001). O uso de hipolipemiantes foi associado à diminuição dos níveis de colesterol total (251,0 ± 40,0 para 196,0 ± 46,0), LDL colesterol (168,0 ± 36,0 para 116,0 ± 39,0), HDL colesterol (51,0 ± 46,0 para 46,0 ± 12,0) e triglicérides (181,0 ± 120,0 para 160,0 ± 79,0). Concluímos que apenas um pequeno percentual de pacientes, mesmo em uso de estatinas, apresenta níveis de colesterol compatível com os atualmente recomendados. Desta forma, embora as recomendações para tratamento das dislipidemias sejam bem conhecidas, um pequeno percentual de pacientes atinge os valores desejados de colesterol. É necessário um melhor controle dos níveis lipídicos dos pacientes, tanto através da utilização de doses maiores de estatinas como da utilização da associação de hipolipemiantes.
Subject(s)
Female , Humans , Male , Cardiovascular Diseases/etiology , Hyperlipidemias/metabolism , Lipids/blood , Hypolipidemic Agents/administration & dosage , Hypolipidemic Agents/metabolism , Hypolipidemic Agents/therapeutic use , Body Mass Index , Brazil , Cardiovascular Diseases/diagnosis , Cholesterol/blood , Hydroxymethylglutaryl-CoA Reductase Inhibitors/administration & dosage , Hydroxymethylglutaryl-CoA Reductase Inhibitors/metabolism , Hyperlipidemias/drug therapy , Retrospective Studies , Risk Factors , VenezuelaABSTRACT
Este trabalho é uma revisão bibliográfica, que trata da relação entre a síndrome de resistência à insulina e o diabetes mellitus não-insulinodependente. Foram abordados a epidemiologia, etiologia, fisiopatologia e complicações do diabetes do tipo 2. Buscou-se também correlacionar os mecanismos da síndrome de resistência à insulina com o diabetes do tipo 2, ressaltando-se a participação de fatores como obesidade visceral, lipotoxicidade e glicotoxicidade no desenvolvimento de resistência à insulina e também à hiperinsulinemia, destacando-se a importância dessas alterações metabólicas na gênese do diabetes do tipo 2, não com o papel exclusivo, mas ao lado de uma predisposição genética e estilo de vida adotado pela maioria das pessoas de grandes centros populacionais
