RESUMO
Aim: Visceral obesity is one of the most intensely researched cardiometabolic risk factors in recent years; nonetheless, its accurate assessment remains a challenge in regions were socioeconomic conditions hinder the widespread use of diagnostic methods for this purpose, such as imaging tests. In this setting, Visceral Adiposity Index (VAI) may be a useful tool. Thus, the objective of this study was to determine the VAI cutoff in adult population from Maracaibo City, Venezuela. Methods: This is a descriptive, cross-sectional study with multi-staged sampling; 2026 subjects of both genders aged ≥18 years were selected from this database and had their VAI calculated. In order to determine VAI cutoffs, subsamples of metabolically healthy and sick individuals were determined, with 599 and 286 subjects, respectively. Gender-specific and general ROC curves were plotted in order to identify the most suitable cutoff according to sensitivity and specificity. Results: Median VAI in the selected sample was 1.67 (0.97-2.78). The optimal cutoff was determined to be 1.91, with 70.3% sensitivity, 70.3% specificity [AUC = 0.777 (0.745-0.808)]. No differences were found between genders. Analysis by age revealed VAI to have greater predictive power among subjects aged < 30 years (cutoff: 1.53), 78.6% sensitivity, 72.8% specificity [AUC = 0.797 (0.709-0.884)]. Conclusion: We suggest a VAI cutoff of 1.9 for define dysfunctional adiposity in our population, with age being an important factor in the epidemiologic behavior of this variable, particularly in younger individuals.
Objetivo: La obesidad central es uno de los factores de riesgo cardiometabólicos emergente más evaluado durante los últimos años, sin embargo, su medición de forma precisa resulta un reto en aquellas poblaciones cuyas condiciones económicas dificultan la realización de métodos diagnósticos complejos, como pruebas de imagen. Por ello el objetivo de este estudio es determinar el punto de corte del índice de adiposidad visceral (VAI) en sujetos adultos de la ciudad de Maracaibo, Venezuela. Métodos: Se seleccionó a 2.026 individuos de ambos sexos, mayores de 18 años, de la base de datos del Estudio de prevalencia de síndrome metabólico en la ciudad de Maracaibo, un estudio descriptivo, transversal, con muestreo multietápico. El VAI se calculó para cada sexo y para la estimación del punto corte se seleccionó a 599 sujetos sanos y 286 enfermos, realizándose curvas COR para identificar el mejor valor de acuerdo con la sensibilidad y la especificidad. Resultados: El promedio de VAI en la muestra seleccionada fue 1,67 (0,97-2,78). El punto de corte fue 1,91 (70,3% de sensibilidad y 70,3% de especificidad) con AUC = 0,777 (0,745-0,808), sin diferencias en el punto de corte según sexo. En el análisis por grupos etarios la mayor capacidad predictiva fue para el grupo < 30 años con AUC = 0,797 (0,709-0,884), con un punto de corte de 1,53 (78,6% de sensibilidad y 72,8% de especificidad). Conclusión: El punto de corte indicado para VAI en nuestra población es de 1,9; considerando la edad como un factor importante en su comportamiento, especialmente en los grupos más jóvenes.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Síndrome Metabólica/epidemiologia , Obesidade Abdominal/complicações , Venezuela/epidemiologia , Estudos Transversais/estatística & dados numéricos , Obesidade Abdominal/diagnósticoRESUMO
Sedentarism is considered a risk factor for coronary heart disease and death from any cardiovascular disease. The International Physical Activity Questionnaire (IPAQ) assesses physical activity in metabolic equivalents, using 4 dimensions: occupation, transportation, household activities, and leisure-time physical activity. The purpose of this investigation was to assess physical activity levels in the patients enrolled in the Maracaibo City Metabolic Syndrome Prevalence Study, currently undertaken by the "Dr. Félix Gómez" Endocrine-Metabolic Research Center. Two thousand one hundred eight individuals were recruited and subjected to a standard Medical chart, Graffar scale, and IPAQ long form, applied by trained personnel. Description of the population was done using mean, SD, and coefficient of variation. IPAQ scores were analyzed as medians and distributed by percentiles. From the 2108 individuals, 46.9% were men and 53.1% were women. The most prevalent physical activity was high physical activity with 39.9%, followed by moderate physical activity with 36.9% and low physical activity with 23.2%. Medians for each IPAQ dominion were occupation with 0.00 (0.00-66.00), transportation with 165.00 (0.00-463.00), household activities with 772.50 (0.00-2520.00), and leisure time with 0.00 (0.00-594.00). Using leisure-time scores, a new reclassification was conducted, obtaining 1245 subjects with 0 metabolic equivalents in this dominion. From this new subsample, 43.6% had High physical activity, 56.95% had Moderate physical activity, and 91% had Low physical activity, demonstrating an important overestimation in the former sample results. IPAQ overestimates moderate and vigorous activity in the adult population of the Maracaibo Municipality. Overestimation is mainly located in the household- and gardening-related activity.
Assuntos
Exercício Físico , Atividades de Lazer , Atividade Motora , Inquéritos e Questionários , Adolescente , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ocupações/estatística & dados numéricos , Comportamento Sedentário , Meios de Transporte/estatística & dados numéricos , Venezuela , Adulto JovemRESUMO
It has already been a decade and a half since the discovery of adiponectin and its role as an insulin sensitizer and only 7 years since its receptors, AdipoR1 and AdipoR2, were described. A single-nucleotide polymorphism (SNP) is a DNA sequence variation that affects only one nucleotide; it may vary from one population to another with different predisposing factors to diseases and other ailments. Once some of the effects of adiponectin and its receptors were known, it was not long until an effort was made to find the associations between specific SNPs of the genes of this hormone and its receptors as genetic risk factors for insulin resistance, type 2 diabetes mellitus, and metabolic syndrome, although these genes were investigated as possible candidates related to the development of these metabolic disorders. All of these possible associations were studied in different populations from France, Finland, the United Kingdom, North America, and Japan, showing hardly concluding results, and because of that it is highly controversial to directly associate one of the genes mentioned above to insulin resistance, type 2 diabetes mellitus, and metabolic syndrome. All of these inconsistencies lead to a review that summarizes the SNPs of the genes of adiponectin, AdipoR1, and AdipoR2 that are mostly related to insulin resistance syndrome, type 2 diabetes mellitus, and metabolic syndrome, although presenting the possible factors that should be taken into account to homogenize the results obtained until now.
Assuntos
Diabetes Mellitus Tipo 2/genética , Resistência à Insulina/genética , Síndrome Metabólica/genética , Adiponectina/genética , Animais , Predisposição Genética para Doença , Humanos , Polimorfismo de Nucleotídeo Único , Receptores de Adiponectina/genética , Fatores de RiscoRESUMO
Existe un creciente uso de los alcohol-azúcares como el lactitol en la industria de los alimentos. El estrés oxidativo juega un papel importante en la génesis de patologías digestivas que van desde inflamación hasta cáncer. El propósito de este estudio fue determinar el efecto del lactitol sobre el malondialdehído (MDA), óxido nítrico (NO), glutation reducido (GSH), ácido ascórbico y ácido dehidroascórbico como marcadores del balance oxidación/antioxidación. Para ello se utilizaron 80 ratas macho Sprague-Dawley divididas en cuatro grupos , tres experimentales de 20 animales, a los cuales se les administró por sonda orogástrica, lactitol en dosis de 0,3; 1,0 y 5,0 g/Kg/día durante 12 semanas y un grupo control que recibió solución salina fisiológica por el mismo período de tiempo. El lactitol administrado en dosis de 0,3; 1,0 y 5,0 g/Kg/día produjo un incremento significativo (P<0,05) del GSH (326,5 ± 13,0 µg/ml; 328,5 ± 9,2 µg/ml y 398,2 ± 11,8 µg/ml) al ser comparado con sus respectivos valores basales (285,8 ± 4,0 µg/ml; 280,0 ± 6,2 µg/ml y 279,5 ± 9,1 µg/ml). El lactitol a dosis de 5 g/Kg/día produjo el más alto incremento de la concentración de GSH y al mismo tiempo provocó una disminución significativa del los niveles de NO (33,0 ± 1,2 µM) cuando se comparó con su concentración basal (46,2 ± 2,8 µM). No fueron observados cambios significativos sobre el resto de los marcadores del balance oxidación/antioxidación. Aunque el lactitol es un alcohol-azúcar que no se absorbe a nivel del tracto gastrointestinal, es posible que los productos finales obtenidos luego de su metabolismo por las bacterias intestinales, induzcan efectos sistémicos que pueden afectar el balance oxidación/antioxidación a favor de la antioxidación.
Sugar alcohols such as lactitol are increasingly being used in the food industry. Tissue oxidative stress is an important contributor to the genesis of inflammatory bowel disease and cancer. The purpose of this study was to determine the effect of lactitol on malondialdehyde (MDA), reduced glutathione (GSH), nitric oxide (NO), dehydroascorbic and ascorbic acid as redox markers. Eighty Sprague Dawley rats were divided into four groups; three experimental groups which received lactitol through an oral catheter at doses of 0.3; 1.0; 5 g/kg/day and an experimental group to which saline solution was administered during 12 weeks. Lactitol at doses of 0.3; 1.0; 5 g/kg/day produced a significant increase (P<0.05) on GSH (326.5 ± 13.0 µg/ml; 328.5 ± 9.2 µg/ml y 398.29 ± 11.8 µg/ml respectively) when compared with their respective basal values (285.8 ± 4.0 µg/ml; 280.0 ± 6.2 µg/ml y 279.5 ± 9.1 µg/ml). Lactitol dose of 5g/kg/day produced the highest increase on GSH levels and at the same time elicited a significant decrease on NO levels (33.0 ± 1.2 µM) when compared with basal values (46.2 ± 2.8 µM). No significant changes were observed on the remaining redox markers. Although lactitol is a sugar alcohol that is not absorbed in the small bowel, it is possible that its metabolisms end products, under intestinal bacterial effects, alter the redox balance in favor of antioxidants.
Assuntos
Animais , Ratos , Álcoois Açúcares/análise , Álcoois Açúcares/efeitos adversos , Antioxidantes/efeitos adversos , Glutationa Redutase , Oxidantes/efeitos adversos , Óxido Nítrico/deficiência , Ratos Sprague-DawleyRESUMO
UNLABELLED: The introduction of fat and carbohydrates replacers has been a revolutionary advance in treating obesity and diabetes mellitus. Since these materials have shown to have beneficial effects on the metabolic profiles of diabetic patients, they should be useful in designing specific foods for patients with diabetes. OBJECTIVE: To compare metabolic and anthropometric improvements elicited by a diet based on the American Diabetic Association's nutrition recommendations with a modified, low-energy diet incorporating fat replacers and non-sucrose sweeteners. DESIGN: A total of 16 male, well controlled type 2 diabetes patients were divided into two groups of eight; one group received the diet based on the American Diabetic Association's nutrition recommendations, and the other was fed a modified, low-calorie diet containing a fat replacer (beta-glucans derived from oats) and the sweeteners, sucralose and fructose. Both groups were maintained on their respective diets for 4 weeks. All patients performed daily aerobic exercise consisting of walking for 60 minutes. Body weight, body mass index, basal glycemia, hemoglobin HbA1C, and lipid profile were determined in each patient before starting the diets and after 4 weeks of dietary intervention. RESULTS: Both diets produced significant improvements in weight, body mass index, lipid profile, basal glucose, and HbA1C. However, the experimental diet was superior to the American Diabetic Association's diet in improving metabolic and anthropometric profile: greater increase in HDL cholesterol and larger decreases in HbA1C, weight, and body mass index. CONCLUSIONS: A diet incorporating a fat replacer and non-sucrose sweeteners produced a greater improvement in metabolic and anthropometric variables in well controlled type 2 diabetic patients when compared with a diet based on American Diabetic Association's nutrition recommendations.
Assuntos
Diabetes Mellitus Tipo 2/dietoterapia , Diabetes Mellitus Tipo 2/tratamento farmacológico , Dieta para Diabéticos , Glucanos/administração & dosagem , Sacarose/análogos & derivados , Edulcorantes/administração & dosagem , beta-Glucanas , Biomarcadores/sangue , Glicemia/metabolismo , Índice de Massa Corporal , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Diabetes Mellitus Tipo 2/prevenção & controle , Dieta para Diabéticos/estatística & dados numéricos , Exercício Físico , Feminino , Frutose/administração & dosagem , Hemoglobinas Glicadas/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Sacarose/administração & dosagem , Fatores de Tempo , Resultado do Tratamento , Triglicerídeos/sangueRESUMO
Trimetazidine is a drug with cardioprotective properties used in coronary artery disease. Its effect has been attributed to the inhibition of the long chain fatty acids intramitochondrial transport via carnitine-palmitoyl-transferase-1. Clinical evidence supports the possibility that trimetazidine is able to improve the fasting glycemia in diabetic patients. For this reason, the objective of the present study was to determine the effect of trimetazidine on serum glucose of Sprague-Dawley rats with fasting hyperglycemia. All animals received water and food "ad libitum." Blood glucose was measured weekly to confirm fasting hyperglycemia in rats. The rats were treated for 1 month with trimetazidine (1 mg/kg), and blood samples were collected (in the fasting period) on the last day of treatment (the 30th day); and then on the 15th day posttreatment, measurements of plasma glucose were taken. Fasting plasma levels after 30 days of trimetazidine administration decreased significantly from 141.2 +/- 3.3 mg/dL (pre-drug) to 120.9 +/- 5.8 mg/dL (P<0.01). 15 days after the end of treatment, fasting plasma glucose levels (137.0 +/- 7.0 mg/dL) were close to the pretreatment levels but significantly different (P<0.05) from levels on day 30 of treatment. These data suggest that trimetazidine improved blood glucose utilization in rats with fasting hyperglycemia.