RESUMEN

Las enfermedades tiroideas, después de la diabetes mellitus, se encuentran entre los trastornos endocrinos más comunes durante el embarazo, con una incidencia del 5-10%. Es importante su detección y tratamiento precoz ya que puede tener consecuencias negativas tanto para la madre como para el feto. El hipertiroidismo se encuentra en menor frecuencia que el hipotiroidismo durante el embarazo, entre 0,1-1%. Se caracteriza por presentar tirotropina baja con hormonas tiroideas elevadas, siendo la enfermedad de Graves la causa más frecuente (el 85% de los casos). A continuación se expone el caso de un lactante con hipertiroidismo primario de etiología autoinmune, hijo de una madre sin diagnóstico previo de hipertiroidismo durante la gestación (AU)

Thyroid diseases, after diabetes mellitus, are among the most common endocrine disorders during pregnancy, with an incidence of 5-10%. Early detection and treatment is important, as they can have negative consequences for both the mother and the foetus. Hyperthyroidism is less frequent than hypothyroidism during pregnancy, being between 0.1% and 1%. It is characterised by a low thyrotropin with elevated thyroid hormones, with Graves’ disease being the most frequent cause (85% of cases). The following is the case of an infant with primary hyperthyroidism of autoimmune origin, the son of a mother without previous diagnosis of hyperthyroidism during gestation (AU)

Asunto(s)

RESUMEN

Introducción. Los auto-anticuerpos son marcadores útiles en el inicio de la diabetes mellitus autoinmune, como apoyo diagnóstico. El objetivo de este trabajo fue conocer la prevalencia de autoanticuerpos en el inicio de diabetes en nuestro medio, medidos mediante ELISA y valorar su papel diagnóstico en diabetes autoinmune. Material y métodos. Muestra de 111 pacientes con diabetes de inicio: 61 tipo 1 (incluye 12 diabetes autoinmune latente del adulto [LADA]) y 50 tipo 2. Grupo control 64 no diabéticos. Se analizaron antidescarboxilasa del ácido glutámico GADA, anti-tirosina fosfatasa de membrana IA-2 y anti-insulina IAA, mediante enzimoinmunoanálisis ELISA en microplaca. Se realizó estudio observacional descriptivo para valoración de pruebas diagnósticas. Programa estadístico PASW Statistics versión 18. Resultados. GADA(+): 78,7% DM1; 83,3% LADA; 2,0% DM2; 1,6% control. IA-2(+): 52,2% DM1; 45,5% LADA; 16,4% DM2; 12,5% control. IAA(+): 10,3% DM1; 18% LADA; 6,0% DM2; 1,7% control. GADA e IA-2 diferenciaron significativamente (p<0,0001) a los pacientes con diabetes autoinmune. No así IAA. Área bajo curva receiver operating characteristics (ROC): GADA=0,90 (p<0,0001); IA-2=0,74 (p<0,0001); IAA=0,57 (p=0,126). Criterio límite GADA(+) > 5,5 U/mL (sensibilidad 79%, especificidad 98%) e IA-2(+) > 6,0 U/mL (sensibilidad 54%, especificidad 84%). Análisis de factores riesgo asociados: Odds ratio GADA=51,44 e IA-2=4,64. Conclusiones. En nuestro estudio, la prevalencia de GADA en el inicio de diabetes es alta y su determinación eficaz en el diagnóstico de diabetes autoinmune. IA-2 incrementó 4,6 veces la probabilidad diagnóstica. IAA medidos mediante nuestro test ELISA no han mostrado valor como marcadores en la diabetes autoinmune, aunque esto no descarta su utilidad en otras patologías (AU)

Autoantibodies are useful markers for clinical onset of autoimmune diabetes, and as a diagnostic supports. The aim of this study was to determine the prevalence of autoantibodies at the onset diabetes mellitus in our environment, measured by an ELISA technique, and to assess its role as autoimmune diabetes diagnostic support. Material and methods. A sample of 111 patients with diabetes onset was studied, which included, 61 type 1 diabetes (12 Latent Autoimmune Diabetes in Adults (LADA) and 50 type 2 diabetes. Control group: 64 non-diabetics. Antibodies glutamic acid decarboxylase antibodies (GADA), membrane phosphatase anti-tyrosine (IA-2), and anti-insulin (IAA) were determined by enzyme immunoassay ELISA microplates. A descriptive observational study was conducted to the measure diagnostic tests using the software PASW Statistics version 18. Results. GADA(+): 78.7% DM1; 2.0% DM2; 1.6% control. IA-2(+): 52.2% DM1; 45.5% LADA; 16.4% DM2; 12.5% control. IAA(+): 10.3% DM1; 18.0% LADA; 6.0% DM2; 1.7% control. Comparing means, autoimmune diabetics were significantly differentiated (P<.0001) by GADA and IA-2 values, but not with IAA. The area under the Curve using software Receiver Operating Characteristics (ROC): GADA=0.90 (P<.0001), IA-2=0.74 (P<.0001), IAA=0.57 (P=.126). Optimal cut off for GADA>5.5U/mL (sensitivity 79%, specificity 98%) and IA-2>6.0U/mL (sensitivity 54%, specificity 84%). On analysing risk factors associated with autoimmune diabetes diagnosis, the calculated Odds ratio gave GADA=51.44 and IA-2=4.64. Conclusions. In this study GADA(+) prevalence is high at diabetes onset, and its calculation has been effective for autoimmune diabetes diagnosis. IA-2 increases diagnostic probability 4.6 times. Anti-insulin antibodies measured by ELISA test did not demonstrate value for autoimmune diabetes diagnosis and classification, although its usefulness is not excluded for the diagnosis support of other diseases (AU)

Asunto(s)

RESUMEN

Aging is a complex process associated with a diminished ability to respond to stress, a progressive increase in free radical generation and a decline in immune function. Melatonin, a molecule with a great functional versatility exerts anti-oxidant, oncostatic, immunomodulatory, and anti-aging properties. Melatonin levels drop during aging and it has been speculated that the loss of melatonin may accelerate aging. This study was designed to elucidate whether aging involves responsiveness to reduced melatonin. Melatonin membrane receptor (MT1 and MT2) expression and MT1 protein expression were analyzed in extrapineal tissues (thymus, spleen, liver, kidney, and heart) of 3- and 12-month-old rats using real time polymerase chain reaction and western blotting analysis. Moreover, melatonin in tissues was measured by high performance liquid chromatography. We report for the first time, an age-related reduction in mRNA MT1 and MT2 expression levels as well as MT1 protein expression in all tissues tested except the thymus, where surprisingly, both melatonin receptor levels were significantly higher in 12-month-old rats and MT1 protein expression maintained unchanged with age. Diminished melatonin concentrations were measured in spleen, liver, and heart during aging. As a conclusion, physiological aging seems to exert responsiveness to melatonin and consequently, the loss of this potent anti-oxidant may contribute to onset of aging.

Asunto(s)