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.

Carbohydrate and lipid disorders and adipokines levels in relation to body mass index in hypertensive patients / Trastorno del metabolismo de carbohidratos y lípidos y los niveles de adipoquinas en relación con el índice de masa corporal en pacientes con hipertensión

Abstract: Obesity is considered as a valid risk factor for cardiovascular disease, due to the fact that the risk of morbidity and mortality from various causes in obese people is significantly higher. Exact mechanisms of metabolic disorders in hypertension with obesity is still discussible. The aim of the study - to determine the peculiarities of carbohydrate, lipid metabolism changes and activity of adipokines and interleukin-22, in patients with hypertension according to nutritional status. Methods: 80 patients (37 males and 43 females) with essential hypertension (EH) of average age 60.17 years were examined. Carbohydrate, lipid profiles, apolipoprotein B (apo B), tumor necrosis factor-α (TNF-α), plasminogen activator inhibitor-1 (PAI-1), adiponectin, interleukin-22 (IL-22) were estimated. Results: In patients with EH and obesity was found carbohydrates metabolism abnormalities, that was manifested as hyperinsulinemia, glucose and HbA1c levels elevation and insulin resistance (according to HOMA index). Lipid metabolism disorders were observed as valid increasing of triglycerides and apo B. Body mass index elevation was associated with progressive increasing of TNF-α and PAI-1 concentration with reducing of adiponectin level in the patients with EH. Positive relationships between TNF- and HbA1c, apo B; PAI-1 with glucose levels: negative correlation adiponectin with body mass and waist to hip ratio were detected in the patients with obesity associated (BMI ≥ 30 kg/m2) EH. Positive significant correlations between apo B and insulin levels, HOMA index, and TNF-α concentration were defined. IL-22 in overweigh and obese patients was significantly higher, correlates negatively with HDL-C. Conclusion: In patients with EH and obesity the adipokine dysfunction was revealed, that correlates with carbohydrate and lipid parameters that indicate increased proinflammatory and prothrombogenic processes.(AU)

Resumen: La obesidad se considera un factor de riesgo válido para las enfermedades cardiovasculares, debido a que el riesgo de morbilidad y mortalidad por diversas causas en personas obesas es significativamente mayor. Los mecanismos exactos de los trastornos metabólicos en la hipertensión con obesidad todavía son discutibles. El objetivo del estudio - determinar las peculiaridades de los carbohidratos, los cambios en el metabolismo de los lípidos y la actividad de las adipoquinas y la interleucina 22, en pacientes con hipertensión según el estado nutricional. Métodos: Se examinaron 80 pacientes (37 hombres y 43 mujeres) con hipertensión esencial (HE) de edad promedio de 60.17 años. Se estimaron los perfiles de carbohidratos, lípidos, apolipoproteína B (apo B), factor de necrosis tumoral-α (TNF-α), inhibidor activador del plasminógeno-1 (PAI-1), adiponectina, interleucina-22 (IL-22). Resultados: En pacientes con HE y obesidad se encontraron anomalías en el metabolismo de los carbohidratos, que se manifestaron como hiperinsulinemia, elevación de los niveles de glucosa y HbA1c y resistencia a la insulina (según el índice HOMA). Se observaron trastornos del metabolismo de los lípidos como aumento válido de triglicéridos y apo B. La elevación del índice de masa corporal se asoció con el aumento progresivo de la concentración de TNF-α y PAI-1 con la reducción del nivel de adiponectina en los pacientes con HE. Relaciones positivas entre TNF- y HbA1c, apo B; PAI-1 con niveles de glucosa: se detectaron correlaciones negativas de adiponectina con masa corporal y relación cintura-cadera en los pacientes con obesidad (IMC ≥ kg/m2) asociada con HE. Se definieron correlaciones positivas significativas entre los niveles de apo B e insulina, el índice HOMA y la concentración de TNF-α. La IL-22 en pacientes con sobrepeso y obesos fue significativamente mayor, se correlaciona negativamente con HDL-C. Conclusión: En pacientes con HE y obesidad se reveló la disfunción de la adipoquina, que se correlaciona con parámetros de carbohidratos y lípidos que indican un aumento de los procesos proinflamatorios y protrombogénicos.(AU)

Xantomas eruptivos como primera expresión de dislipidemias y diabetes en un paciente con pancreatitis aguda / Eruptive xanthomas as first expression of dislipidemia and diabetes on a patient with acute pancreatitis

El xantomas eruptivos constituyen una entidad poco frecuente. Son una expresión clínica de trastornos severos del metabolismo lipídico, primario o secundario. En ocasiones se resentan asociados a condiciones que amenazan la vida del paciente. Clínicamete se manifiestan como pápulas amarillento-anaranjadas, de aparición súblita, asintomáticas. El estudio histopatológico evidencia macrófagos espumosos dérmicos. Si bien suelen ser autorresolutivos, el tratamiento de las alteraciones metabólicas y subyacentes acelera su desaparición y disminuye las complicaciones asociadas, como pancreatitis aguda y ateroesclerosis. Se presenta el caso clínico de un paciente con pancratitis aguda grave, que 15 días previos había comenzado con una erupción papular, que ante ojos avezados, podría haber alertado de la condición metabólica bajo la que se encontraba...

Eimeria stiedai: metabolism of lipids, proteins and glucose in experimentally infected rabbits, Oryctolagus cuniculus

Rabbits were experimentally infected with sporulated Eimeria stiedai oocysts. A total of 50 white adult rabbits,New Zealand race, were distributed into two groups: group A was infected with 1x104 sporulated Eimeria stiedai oocysts, while group B was inoculated with distilled water as a control. The animals generally displayed increased levels of total protein, globulin, total cholesterol, LDL-c and triacylglycerols; however, total levels of liver lipids and HDL-c decreased, and plasma glucose levels varied during the experimental period. In sum, Eimeria stiedai infection of rabbits caused a considerable number of changes in the metabolism of lipids, proteins and glucose, which is likely due to direct effects of liver cirrhosis on normal body function

Eimeria stiedai: metabolism of lipids, proteins and glucose in experimentally infected rabbits, Oryctolagus cuniculus

Rabbits were experimentally infected with sporulated Eimeria stiedai oocysts. A total of 50 white adult rabbits,New Zealand race, were distributed into two groups: group A was infected with 1x104 sporulated Eimeria stiedai oocysts, while group B was inoculated with distilled water as a control. The animals generally displayed increased levels of total protein, globulin, total cholesterol, LDL-c and triacylglycerols; however, total levels of liver lipids and HDL-c decreased, and plasma glucose levels varied during the experimental period. In sum, Eimeria stiedai infection of rabbits caused a considerable number of changes in the metabolism of lipids, proteins and glucose, which is likely due to direct effects of liver cirrhosis on normal body function (AU)