RESUMO
Diabetic kidney disease (DKD) remains the leading cause of chronic kidney disease (CKD) worldwide. The pathogenesis of DKD is influenced by functional, histopathological, and immune mechanisms, including NLRP3 inflammasome activity and oxidative stress. The sodium-glucose cotransporter 2 inhibitors (SGLT2i) have shown metabolic benefits and the ability to slow the progression of DKD in several clinical studies over the years. Recent studies suggest that the antidiabetic activity also extends to inhibition of the inflammatory response, including modulation of the NLRP3 inflammasome, reduction of pro-inflammatory markers and reduction of oxidative stress. Here we review the efficacy of SGLT2i in the treatment of CKD and discuss the role of the inflammatory response in the development of DKD, including its relationship to the NLRP3 inflammasome and oxidative stress.
Assuntos
Nefropatias Diabéticas , Inflamassomos , Proteína 3 que Contém Domínio de Pirina da Família NLR , Inibidores do Transportador 2 de Sódio-Glicose , Humanos , Inibidores do Transportador 2 de Sódio-Glicose/uso terapêutico , Inibidores do Transportador 2 de Sódio-Glicose/farmacologia , Proteína 3 que Contém Domínio de Pirina da Família NLR/antagonistas & inibidores , Proteína 3 que Contém Domínio de Pirina da Família NLR/metabolismo , Nefropatias Diabéticas/tratamento farmacológico , Nefropatias Diabéticas/metabolismo , Inflamassomos/antagonistas & inibidores , Estresse Oxidativo/efeitos dos fármacosRESUMO
Although the studied polymorphisms affect muscular proteins, aerobic adaptations, and recovery, their influence on the anthropometric variables and performance in ultramarathon runners is still poorly understood. This study aimed to determine the influence of ACTN3 R577X, ACE I/D, and CK MM A/G NcoI polymorphisms on the changes in the anthropometric variables and running time of 105 km mountain runners, in which 22 male Brazilian elite athletes (35.9 ± 6.5 years) were evaluated. Genotyping of the R577X (RR, RX, and XX), ACE I/D (DD, ID, and II), and CK MM A/G Ncol (AA, AG, and GG) polymorphisms was performed using the Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP) technique with DNA extracted from saliva. Body composition was determined via bioimpedance. Pre- and post-race weight differences were observed on athletes with the AA genotype (77.1 ± 5.9 kg; 74.6 ± 5.6 kg) compared with those with the AG genotype (74.5 ± 8.0 kg; 68 ± 5.1 kg) (p = 0.02; p = 0.02). The RR genotype showed a correlation between BMI and running time (R = 0.97; p = 0.004). The genotype II showed a correlation with % fat and fat mass concerning running time (R = 0.91; p = 0.003; R = 0.99; p < 0.0001). The AA genotype was associated with post-race weight and lean mass loss, while the RR genotype correlated with BMI, and the genotype II correlated with % body fat and fat mass in relation to times in the 105 km mountain ultramarathon.
RESUMO
Aim: To assess the effect of bariatric surgery on the lean mass of women after one year of the procedure, comparing its outcomes upon the classification from both the Foundation of the National Institutes of Health (FNIH) and the European Working Group on Sarcopenia in the Elderly People (EWGSOP). Material and methods: Twenty-eight obese women aged 40.5 ± 9.8 yrs who underwent Roux-en-Y gastric bypass (RYGB) were included. 27 of them were reassessed after 6 months of surgery, and 16 completed the one-year follow-up. Pre-sarcopenia condition was assessed through a handgrip strength test and body composition by dual-energy X-ray absorptiometry (DXA). Total body mass, body mass index, and lean mass (LM) were collected prior to, 6 and 12 months after RYGB surgery. Results: All subjects reassessed after 12 months were diagnosed with pre-sarcopenia according to the FNIH classification criteria, while according to the EWGSOP2 Consensus they presented normal values. LM represented 14% of the influence on handgrip strength (p = .049) after 6 months of surgery; however, its influence on strength after 12 months increased to 30% (p = .028). Conclusion: The FNIH classification is the most effective criteria since it uses LM content as the first test, considering that strength capacity needs more time to be affected by the surgical procedure. On the other hand, the EWGSOP2 classification should not be applied to determine the loss of LM in younger populations regardless of what may have caused such changes.
Assuntos
Derivação Gástrica , Sarcopenia , Idoso , Feminino , Humanos , Estados Unidos , Sarcopenia/diagnóstico por imagem , Sarcopenia/etiologia , Força da Mão , Absorciometria de Fóton/efeitos adversos , Derivação Gástrica/efeitos adversos , National Institutes of Health (U.S.) , PrevalênciaRESUMO
OBJECTIVES: To assess the relationship between postural changes, osteoarthritis (OA) and bone mineral density (BMD) in postmenopausal women. METHODS: A total of 127 Brazilian women, aged 45 years or older, were included in this retrospective study. Subjects were divided in two groups: study group with postural changes (SG) and control group without postural changes (CG). Possible postural changes considered were scoliosis, kyphosis and lordosis. All women underwent BMD assessment and OA was identified at the region of the hip and lumbar spine by dual energy X-ray absorptiometry (DXA) analysis. RESULTS: SG was older (66.0 ± 7.3 years) than the CG (61.0 ± 8.6 years). In the entire sample we found thirteen women with OA and low BMD. Overall, the lumbar spine area was more affected by OA than the hip. The value of BMD T-score accounted for up to 77% of the changes observed in the SG group. CONCLUSION: Postural changes identified in women are directly related to aging and associated with bone loss and joint degeneration. Postural changes may be the primary sign of frailty as a result of body adaptation to pain related to musculoskeletal diseases.
Assuntos
Doenças Ósseas Metabólicas , Osteoartrite , Osteoporose Pós-Menopausa , Feminino , Humanos , Densidade Óssea , Estudos Retrospectivos , Pós-Menopausa , Osteoartrite/diagnóstico por imagem , Absorciometria de Fóton , Vértebras Lombares/diagnóstico por imagem , Osteoporose Pós-Menopausa/diagnóstico por imagemRESUMO
AIM: To analyze the influence of body components on bone mineral density (BMD) in women from perimenopause to old age. MATERIAL AND METHODS: A total of 117 women were allocated into three groups according to the reproductive stage (STRAW): perimenopausal (PEM, N = 28, mean age 44.8 ± 3.6), early postmenopausal (EPM, N = 36, mean age 51.4 ± 2.8) and late postmenopausal (LPM, N = 53; mean age 64.0 ± 1.7). Total body mass, body mass index (BMI), lean mass (LM), fat mass (FM), fat percentage (FP) and BMD at the lumbar spine (lBMD) and femoral neck (fBMD) were assessed. RESULTS: BMI, FM, LM and BMD values decreased from PEM to LPM. The total effect of FM on fBMD and lBMD was of 42% and 8% for PEM, 28% and 33% for EMP and 9% and 1% for LPM respectively. Additionally, the total effect of LM on fBMD and lBMD was 48% and 3% for PEM, 54% and 53% for EMP and 9% and 11% for LPM women respectively. CONCLUSION: BMI, LM, and FM decreased with aging. All these components had great influence on both fBMD and lBMD in EMP women. Conversely, in PEM these parameters only had influence on femoral BMD, but not on lumbar spine. These data suggests that LM is the most important component in BMD for women older than 50 years old, particularly in the hip.
Assuntos
Envelhecimento/fisiologia , Antropometria , Densidade Óssea/fisiologia , Perimenopausa/fisiologia , Pós-Menopausa/fisiologia , Adulto , Idoso , Composição Corporal/fisiologia , Índice de Massa Corporal , Feminino , Colo do Fêmur , Humanos , Vértebras Lombares , Pessoa de Meia-Idade , Magreza/fisiopatologiaRESUMO
RESUMO O objetivo deste estudo foi verificar o efeito da massagem ou pseudomassagem no desempenho do salto vertical. Quinze participantes foram submetidos aleatoriamente a três condições experimentais: massagem, pseudomassagem e repouso. A condição de massagem exigiu três saltos verticais unipodais seguidos de dois minutos de massagem manual nos músculos flexores plantares e, antes de executar outros três saltos, foi aplicada a Escala de Recuperação de Qualidade Total (TQR). As duas condições a seguir foram estruturadas com os mesmos procedimentos, no entanto, os participantes foram submetidos à pseudomassagem (simples-cego) ou a dois minutos de descanso. Os resultados não mostraram diferenças estatísticas na altura do salto entre as análises pré e pós, nem entre as condições experimentais (massagem 18,7 ± 4,1 vs. 18,2 ± 4,1; pseudomassagem 19,1 ± 4,0 vs. 18,3 ± 3,8; descanso 19,0 ± 4,0 vs. 18,7 ± 3,9 cm). Também não houve diferenças estatísticas no TQR entre as condições experimentais (massagem 16,2 ± 4,3; pseudomassagem 16,4 ± 3,9; descanso 15,9 ± 2,6 ua). Tanto a massagem quanto a pseudomassagem não afetaram o desempenho no salto vertical e na TQR.
ABSTRACT The aim of this study was to verify the effect of massage or pseudo massage on vertical jump performance. Fifteen participants were randomly subjected to three experimental conditions: massage, pseudo massage and rest. The massage condition required three unipodal vertical jumps followed by two minutes of manual massage on plantar flexor muscles and, before performing another three jumps, the Total Quality Recover Scale (TQR) was applied. The two following conditions were structured with the same procedures, although participants were submitted either at pseudo massage (single-blinded) or two minutes of rest. Results showed no statistical differences on jump height between pre and post analysis nor between experimental conditions (massage 18.7 ± 4.1 vs 18.2 ± 4.1; pseudo massage 19.1 ± 4.0 vs 8.3 ± 3.8; rest 19.0 ± 4.0 vs 18.7 ± 3.9 cm). There were also no statistical differences in the TQR results between experimental conditions (massage 16.2 ± 4.3; pseudo massage 16.4 ± 3.9; rest 15.9 ± 2.6 ua). Both massage and pseudo massage did not affect performance on vertical jump and TQR.
Assuntos
Humanos , Masculino , Adulto , Placebos , Massagem/instrumentação , Relaxamento , Homens , MúsculosRESUMO
Aim: To analyze the effects of body weight loss on bone mineral density (BMD) on hip (Hip BMD) and lumbar spine (Lumbar BMD) after six months of bariatric surgery. Bariatric surgery is an effective treatment for morbid obesity. Nonetheless, there are scant data on the effect of weight bearing on bone structure.Material and methods: Seventeen obese women aged 41.2 ± 11.3 yrs. who underwent Roux-en-Y gastric bypass (RYGB) were included. Body composition assessments were performed through dual-energy X-ray absorptiometry immediately before and after 6-months RYGB. Data collected pre- and post-RYGB included total body weight, body mass index (BMI), lean body mass (LM), fat mass (FM) and bone mineral content. The pre- (PRE) and post-operative (POST) results were compared.Results: Lumbar BMD POST presented a non-significant loss of 1.8% whereas Hip BMD POST showed a significant loss of 17.8%. The analysis demonstrated that BMI and LM PRE explained 26% and 49%, respectively, of Hip BMD PRE variability. In addition, LM POST explained 30% of hip BMD POST variability and was not significant for Lumbar BMD POST.Conclusions: Obesity and rapid weight loss showed direct influence in Hip BMD after six months of bariatric surgery. However, its effect on the lumbar spine area was smaller due to the higher capacity of the spine to dissipate loads through its curvature.
Assuntos
Cirurgia Bariátrica/efeitos adversos , Composição Corporal/fisiologia , Densidade Óssea/fisiologia , Obesidade Mórbida/cirurgia , Absorciometria de Fóton , Adulto , Cirurgia Bariátrica/estatística & dados numéricos , Índice de Massa Corporal , Brasil/epidemiologia , Feminino , Seguimentos , Derivação Gástrica/efeitos adversos , Derivação Gástrica/estatística & dados numéricos , Quadril , Humanos , Estudos Longitudinais , Vértebras Lombares , Pessoa de Meia-Idade , Obesidade Mórbida/epidemiologia , Obesidade Mórbida/metabolismo , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Resultado do TratamentoRESUMO
ABSTRACT The aim of the present study was to identify the most used techniques by medalists and defeated athletes during the Brazilian Shotokan Karate Championship of 2017. Eleven fights involving thirteen athletes (28.5±3.7yrs.) who competed in the category "up to 65 Kg 1st KYU" were investigated. Analysis were conducted by six specialists through the observation and register technique using the tactical and technical spreadsheet Scout Karate. The Anova test was used to compare actions and techniques mostly used. The Chi-square test for independent samples was used to verify the existence of significant differences among the techniques used by the winning and defeated athletes (p<0.05). Results show that the most frequent attack during fights was the "Mawashi geri", 26.3±1.5 times, followed by "Gyaku zuki" with 19.5±2.0 times (p<0.01). The most visualized tactical action during combats was the attack with 47.5±5.5 times (p<0.01). "Mawashi geri" was the mostly used attack (p=0.01) performed by winners (71.4%) when compared with the defeated athletes (28.6%). The results indicate that the "Mawashi geri" attack was the most assertive decision used in the category "up to 65 Kg 1st KYU".
RESUMO O objetivo do presente estudo foi identificar as técnicas mais utilizadas por medalhistas e atletas derrotados durante o Campeonato Brasileiro de Karatê Shotokan de 2017. Onze lutas envolvendo treze atletas com 28.5 ± 3.7 anos que disputaram a categoria 1º. KYU até 65 kg foram investigados. A análise foi realizada por seis especialistas por meio da observação e registro de técnicas utilizando planilha tática e técnica de Scout de Karatê. O teste Anova foi utilizado para comparar as ações e técnicas mais utilizadas. O teste do qui-quadrado para amostras independentes foi utilizado para verificar a existência de diferenças significativas entre as técnicas utilizadas pelos atletas vencedores e derrotados (p<0.05). Os resultados mostram que o ataque mais frequente durante as lutas foi "Mawashi geri", 26.3 ± 1.5 vezes, seguido de "Gyaku zuki" com 19.5 ± 2.0 vezes (p<0.01). A ação tática mais visualizada durante os combates foi o ataque com 47.5 ± 5.5 vezes (p<0.01). "Mawashi geri" foi o ataque mais usado (p=0.01) pelos vencedores 71.4% quando comparado com os atletas derrotados 28.6%. Em conclusão o ataque "Mawashi geri" foi a decisão mais assertiva usada na categoria até 65 Kg.