RESUMO
The aim of the study was to assess the effect of sitagliptin addition on the epicardial adipose tissue (EAT) thickness in subjects with type 2 diabetes mellitus inadequately controlled on metformin monotherapy. This was a 24-week interventional pilot study in 26 consecutive type 2 diabetic patients, 14 females and 12 males average age of 43.8 ± 9.0 years, with Hemoglobin A1c (HbA1c) ≥ 7% on metformin monotherapy. Subjects who met the inclusion criteria were added on sitagliptin and started on sitagliptin/metformin combination at the dosage of 50 mg/1000 mg twice daily. EAT and visceral and total body fat were measured, respectively, with echocardiography and bioelectrical impedance analysis at baseline and after 24 weeks of sitagliptin/metformin treatment in each subject. HbA1c and plasma lipids were also measured. EAT decreased significantly from 9.98 ± 2.63 to 8.10 ± 2.11 mm, p = 0.001, accounting for a percentage of reduction (∆%) of -15% after 24 weeks of sitagliptin addition, whereas total body fat percentage, visceral fat, and body mass index (BMI), decreased by 8, 12, and 7%, respectively (p = 0.001 for all). After 6 month, EAT ∆% was significantly correlated with ∆% of visceral fat (r = 0.456; p = 0.01), whereas no correlation with either BMI ∆% (r = 0.292; p = 0.147) or HbA1c ∆% was found. The addition of Sitagliptin produced a significant and rapid reduction of EAT, marker of organ-specific visceral fat, in overweight/obese individuals with type 2 diabetes inadequately controlled on metformin monotherapy. EAT as measured with ultrasound can serve as no invasive and accurate marker of visceral fat changes during pharmaceutical interventions targeting the fat.
Assuntos
Tecido Adiposo/patologia , Diabetes Mellitus Tipo 2/tratamento farmacológico , Diabetes Mellitus Tipo 2/patologia , Hipoglicemiantes/farmacologia , Obesidade/patologia , Pericárdio/patologia , Fosfato de Sitagliptina/farmacologia , Tecido Adiposo/efeitos dos fármacos , Adiposidade , Adolescente , Adulto , Idoso , Composição Corporal/efeitos dos fármacos , Diabetes Mellitus Tipo 2/complicações , Quimioterapia Combinada , Impedância Elétrica , Feminino , Hemoglobinas Glicadas/análise , Hemoglobinas Glicadas/metabolismo , Humanos , Lipídeos/sangue , Masculino , Metformina/uso terapêutico , Pessoa de Meia-Idade , Obesidade/complicações , Pericárdio/efeitos dos fármacos , Projetos Piloto , Adulto JovemRESUMO
La esquizencefalia es un desorden de la migración neuronal, caracterizada por hendiduras de sustancia gris en los hemisferios cerebrales que se extienden desde la superficie pial a los ventrículos laterales. Esta patología es el resultado final de una amplia variedad de factores genéticos, tóxicos, metabólicos y de agentes infecciosos que ocurren durante un período crítico del desarrollo cerebral. Esta malformación puede ser unilateral o bilateral y puede ser dividida en dos subtipos: de ¨labios cerredos" o tipo I, o de "Labios abierto" o tipo II. Presentamos el caso de una paciente demenina de 37 años de edad con epilepsia y hallazgos neurorradiológicos de esquizencefalia de "labios cerrados" bilateral
Schizencephaly is a rare developmental of neuronal migration, characterized by congenital clefts spanning the cerebral hemisphere from the pial surface to the lateral ventricle and lined by cortical gray matter. The lesion is the final result of a variety of etiologies including genetic, toxic, metabolic and infectious agents during a critical period of the development of the brain. This malformation can be unilateral or bilateral and may be divided in two subtypes: "closed tips" or type I and "open tips" or type II. We present 37 years old female patient with epilepsy and neuroradiological findings of bilateral "closed lips" schizencephaly
Assuntos
Humanos , Adulto , Feminino , Epilepsia/diagnóstico , Epilepsia/terapia , Esquizofrenia Catatônica/patologia , Fenobarbital/uso terapêutico , Inconsciência/diagnóstico , Córtex Cerebral/anormalidades , Fenobarbital/farmacologia , Tomografia/métodosRESUMO
En años recientes el concepto clásico del sistema renina angiotensina ha experimentado cambios sustanciales. La identificación de los nuevos componentes del sistema renina angiotensina ha contribuido a modificar nuestro entendimiento acerca de su función en condiciones fisiológicas así como en diversas enfermedades. En este artículo de revisión nos enfocaremos en el papel de este sistema endocrino en el riesgo cardiometabólico.
In the past few years the classical concept of the reninangiotensin system has experienced substantial changes. The identification of the new components of the reninangiotensin system have contributed to switch our understanding about its function in physiological situations and in several diseases. In this review we will focus on the role of this endocrine system in the cardiometabolic risk.
