Hypothalamic inflammation and the development of an obese phenotype induced by high-fat diet consumption is exacerbated in alpha7 nicotinic cholinergic receptor knockout mice.

Hypothalamic inflammation and metabolic changes resulting from the consumption of high-fat diets have been linked to low grade inflammation and obesity. Inflammation impairs the hypothalamic expression of α7 nicotinic acetylcholine receptor (α7nAChR). The α7nAChR is described as the main component of the anti-inflammatory cholinergic pathway in different inflammation models. To assess whether the reduction in α7nAChR expression exacerbates hypothalamic inflammation induced by a high-fat diet (HFD), were used male and female global α7nAChR knockout mouse line in normal or high-fat diet for 4 weeks. Body weight gain, adiposity, glucose homeostasis, hypothalamic inflammation, food intake, and energy expenditure were evaluated. Insulin sensitivity was evaluated in neuronal cell culture. Consumption of an HFD for 4 weeks resulted in body weight gain and adiposity in male Chrna7-/- mice and the hypothalamus of male Chrna7-/- mice showed neuroinflammatory markers, with increased gene expression of pro-inflammatory cytokines and dysregulation in the nuclear factor kappa B pathway. Moreover, male Chrna7-/- mice consuming an HFD showed alterations in glucose homeostasis and serum of Chrna7-/- mice that consumed an HFD impaired insulin signalling in neuronal cell culture experiments. In general, female Chrna7-/- mice that consumed an HFD did not show the phenotypic and molecular changes found in male mice, indicating that there is sexual dimorphism in the analysed parameters. Thus, receptor deletion resulted in increased susceptibility to hypothalamic inflammation and metabolic damage associated with HFD consumption in male mice.

NUTRITIONAL INDICATORS OF MALNUTRITION IN HOSPITALIZED PATIENTS.

BACKGROUND: Malnutrition is associated with clinical factors, including longer hospital stay, increased morbidity and mortality and hospital costs. OBJECTIVE: To investigate the prevalence of malnutrition using different nutritional indicators and to identify factors that contribute to malnutrition in hospitalized patients. METHODS: We investigated anthropometric, laboratory standards, nutritional risk screening (NRS), subjective global assessment (SGA), mini nutritional assessment and habitual energy consumption (HEC). Chi-square, Fisher's exact test, Mann-Whitney test and univariate and multiple Cox regression analysis were used, at 5% significance level. RESULTS: It was found 21.01% of malnourished individuals by ASG; a total of 34.78% with nutritional risk according to NRS and 11.59% with low weight (BMI). There was no statistically significant difference in the prevalence of malnutrition by ASG (P=0.3344) and nutritional risk by NRS (P=0.2286), among the types of disorders. Patients with nutritional risk were of higher median age (64.5 vs 58.0 years; P=0.0246) and had lower median values of HEC (1362.1 kcal vs 1525 kcal, P=0.0030), of calf circumference (32.0 cm vs 33.5 cm, P=0.0405) of lymphocyte count (1176.5 cell/mm3 vs 1760.5 cell/ mm3, P=0.0095); and higher percentage of low body weight according to the BMI (22.9% vs 5.6%; P=0.0096). Lymphocyte count was associated with nutritional risk (P=0.0414; HR= 1.000; IC95%= 0.999; 1.000). CONCLUSION: NRS was more sensitive than other indicators in the diagnosis of malnutrition. Patients at risk were older and had lower HEC values, calf circumference, BMI and lymphocyte count. Low lymphocyte count was considered a factor associated with nutritional risk by the NRS.

Indicadores nutricionais de desnutrição em pacientes hospitalizados / Nutritional indicators of malnutrition in hospitalized patients

ABSTRACT BACKGROUND: Malnutrition is associated with clinical factors, including longer hospital stay, increased morbidity and mortality and hospital costs. OBJECTIVE: To investigate the prevalence of malnutrition using different nutritional indicators and to identify factors that contribute to malnutrition in hospitalized patients. METHODS: We investigated anthropometric, laboratory standards, nutritional risk screening (NRS), subjective global assessment (SGA), mini nutritional assessment and habitual energy consumption (HEC). Chi-square, Fisher's exact test, Mann-Whitney test and univariate and multiple Cox regression analysis were used, at 5% significance level. RESULTS: It was found 21.01% of malnourished individuals by ASG; a total of 34.78% with nutritional risk according to NRS and 11.59% with low weight (BMI). There was no statistically significant difference in the prevalence of malnutrition by ASG (P=0.3344) and nutritional risk by NRS (P=0.2286), among the types of disorders. Patients with nutritional risk were of higher median age (64.5 vs 58.0 years; P=0.0246) and had lower median values of HEC (1362.1 kcal vs 1525 kcal, P=0.0030), of calf circumference (32.0 cm vs 33.5 cm, P=0.0405) of lymphocyte count (1176.5 cell/mm3 vs 1760.5 cell/ mm3, P=0.0095); and higher percentage of low body weight according to the BMI (22.9% vs 5.6%; P=0.0096). Lymphocyte count was associated with nutritional risk (P=0.0414; HR= 1.000; IC95%= 0.999; 1.000). CONCLUSION: NRS was more sensitive than other indicators in the diagnosis of malnutrition. Patients at risk were older and had lower HEC values, calf circumference, BMI and lymphocyte count. Low lymphocyte count was considered a factor associated with nutritional risk by the NRS.

RESUMO CONTEXTO: A desnutrição está associada a fatores clínicos, incluindo maior tempo de internação, aumento da morbimortalidade e custos hospitalares. OBJETIVO: Investigar a prevalência de desnutrição por diferentes indicadores nutricionais e identificar fatores que contribuem para a desnutrição em pacientes hospitalizados. MÉTODOS: Investigou-se indicadores antropométricos, laboratoriais, nutritional risk screening, avaliação subjetiva global (ASG), mini avaliação nutricional e consumo energético habitual (CEH). Utilizou-se os testes qui-quadrado, exato de Fisher, Mann-Whitney e análise de regressão de Cox univariada e múltipla, com nível de significância de 5%. RESULTADOS: Verificou-se 21,01% de desnutridos pela ASG; 34,78% com risco nutricional pelo NRS e 11,59% com baixo peso pelo índice de massa corporal (IMC). Não houve diferença estatisticamente signi­ficante da prevalência de desnutrição pela ASG (P=0,3344) e de risco nutricional pelo NRS (P=0,2286), entre os tipos de doenças. Os pacientes com risco nutricional apresentaram maior mediana de idade (64,5 vs 58,0 anos; P=0,0246) e menores valores medianos no CEH (1362,1 kcal vs 1525 kcal, P=0,0030); na circunferência de panturrilha (CP) (32,0 cm vs 33,5 cm, P=0,0405); na contagem de linfócitos (CL) (1176,5 cel/mm3 vs 1760,5 cel/mm3, P=0,0095); e maior percentual de baixo peso pelo IMC (22,9% vs 5,6%; P=0,0096). A CL foi associada ao risco nutricional (P=0,0414; HR=1,000; IC95%= 0,999; 1,000). CONCLUSÃO: O NRS foi mais sensível que outros indicadores no diagnóstico de desnutrição. Pacientes com risco apresentaram mais idade e valores menores de CEH, CP, IMC e CL. A baixa CL foi considerada fator associado ao risco nutricional pelo NRS.