RESUMEN
BACKGROUND: emerging evidence suggests that elevated liver enzymatic activity is associated with diabetes. The purpose was to investigate the prevalence of elevated liver enzymes and its relationship between impaired fasting glucose (IFG) and undiagnosed diabetes in family medicine practice. METHODS: a cross-sectional prospective analytic study was conducted in a representative sample of 100 patients aged 25 to 60 years who underwent to a screening for diabetes. Risk factors, BMI, waist circumference, blood pressure, fasting glucose, lipid profile, alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyltransferase (GGT) and C-reactive protein were evaluated. The relationships between liver enzymes, undiagnosed diabetes and IFG were analyzed through c(2) and Student's t test to identify differences in continuous variables. RESULTS: the prevalence found in undiagnosed diabetes were ALT 16.9 %, AST 15.8 % and GGT 20.6 % and in IFG were 76.3 %, 68.4 % and 77.8 % respectively. The relationships between elevated ALT (0.001) and GGT (0.000) with undiagnosed diabetes and IFG were statistically significant. CONCLUSION: elevated ALT or GGT raise the possibility of undiagnosed type 2 diabetes mellitus in family practice.
Asunto(s)
Diabetes Mellitus/metabolismo , Enzimas/metabolismo , Ayuno/metabolismo , Glucosa/metabolismo , Hígado/enzimología , Adulto , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios ProspectivosRESUMEN
BACKGROUND: High IgE levels are frequent in allergic patients. The relationship between allergy and infections is controversial. Some diseases with cellular immunodeficiencies as well as with infections have high IgE levels, such as: hyper-IgE, Netherton, Wiskott-Aldrich, DiGeorge syndromes, AIDS, etc. In a previous retrospective study we found a high percentage of concurrent infections (two or more simultaneous infections) in atopic patients with IgE levels above 200 IU (OR 3.31; CI 95% 1.3 to 8.04; p < 0.01). The Th1/Th2 paradigm tries to explain the IgE elevation in atopy. A minor Th1 function would favor infectious processes by a reduction in TNF-alpha and IFNg. OBJECTIVE: To demonstrate if atopic patients with high IgE levels (> 200 IU) have more frequency of concurrent infections than patients with low levels. PATIENTS AND METHODS: In a cross sectional study we included patients with atopic rhinitis, asthma or both, in order to find upper and lower respiratory tract infections. RESULTS: We studied 143 patients (IgE mean, 389.07; SD 606.21). IgE levels were higher in children (521.25 UI) than in adults (204.03 UI) (p < 0.05). 73.44% of the patients had sinusitis; 5.59% pharyngotonsillitis; 17.93% otitis, and 7.74% laryngitis, without IgE mean differences. 42.84% had concurrent infections (IgE 296.16 IU) vs 57.15% without this processes (460.4 IU) (p = 0.11). When IgE levels were classified in high and low levels, with 200 IU as end point, we did not find differences in the number of infectious diseases. CONCLUSIONS: In this study high IgE levels did not have correlation with the higher frequency of concurrent infections.
Asunto(s)
Asma/sangre , Inmunoglobulina E/sangre , Infecciones del Sistema Respiratorio/etiología , Rinitis Alérgica Perenne/sangre , Rinitis Alérgica Perenne/complicaciones , Rinitis Alérgica Estacional/sangre , Rinitis Alérgica Estacional/complicaciones , Adolescente , Adulto , Niño , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Infecciones del Sistema Respiratorio/epidemiologíaRESUMEN
Se reporta el caso documentado de un varón de 26 años de edad con diagnóstico de lupus eritematoso sistémico (LES) de un año de evolución en quien se demostró ausencia de IgA. La agravación del problema a pesar de las medidas de tratamiento que se describen, condujo a la muerte del paciente. Se discute la posible contribución de la deficiencia de IgA facilitando manifestaciones de hipersensibilidad a medicamentos y se cometa la utilidad de determinar inmunodeficiencia IgA en pacientes con LES para conocer si existe participación de este hecho en el comportamiento clínico