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There is a high perinatal mortality rate in dogs, estimated at 20%, and one of the leading causes of this rate is hypoglycaemia. Therefore, we aimed to evaluate the efficacy of a hypercaloric supplement containing vitamins and amino acids in newborn puppies presenting hypoglycaemia at birth. Ninety-nine pups were divided into four groups: normoglycaemic caesarean section (NORMOCS), hypoglycaemic caesarean section supplemented with the hypercaloric (SUPLCS), hypoglycaemic caesarean section supplemented with glucose (GLICCS) and eutocic delivery (EUT). We evaluated the following parameters glycaemia, Apgar score, neurological reflexes and rectal temperature of neonates at the following moments 5 min (M5), 30 min (M30) and 60 min (M60) after birth. Brachycephalic dogs were 73.3% (22/30) of caesarean sections (c-sections). The puppy's average glycaemia represented about 90% of the maternal glycaemia, while 15.1% (14/99) of the neonates had hypoglycaemia (<90 mg/dL) at M0 and 46.5% (44/99) at M60. Only four neonates had glycaemia below 40 mg/dL at M30 but without showing any clinical signs. The puppy's fasting while waiting for the intraoperative period and the dam's anaesthetic recovery was considered risk factors for hypoglycaemia. There was no difference in mean blood glucose levels or vitality parameters among puppies from the SUPLCS and GLICCS. In conclusion, the hypercaloric supplement can be used as a replacement for glucose in hypoglycaemic puppies and it can also bring nutritional benefits for the puppy. The prepartum glycaemia of the dam is an important parameter to be measured, and the appropriate management of it reduces the chances of the puppies being born with hypoglycaemia.
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BACKGROUND: Although the importance of walking for promoting a better cardiometabolic health is widely known (this includes both cardiovascular and metabolic/endocrine systems), there is little knowledge regarding its appropriate pace to provide adults with more cardiometabolic benefits. AIM: To analyze the associations between different walking pace categories and cardiometabolic health markers in the adult Chilean population. METHODS: Cross-sectional study. A total of 5520 participants aged 15 to 90 years old from the Chilean National Health Survey (CNHS) 2016-2017 were included. Walking pace categories (slow, average, and brisk) were collected through self-reported methods. Glycaemia, glycosylated hemoglobin (HbA1c), gamma glutamyl transferase (GGT), vitamin D2, vitamin D3, systolic and diastolic blood pressure, and lipid profile (Total, HDL, LDL, VLDL, No HDL cholesterol and triglycerides) were determined using blood sample tests and measured with the standardized methods described in the CNHS 2016-2017. RESULTS: People who had a brisk walking pace were associated with lower levels of glycaemia, HbA1c, GGT, systolic and diastolic blood pressure, and higher vitamin D3 levels compared with those with a slow walking pace. Moreover, people with a brisk walking pace had lower levels of VLDL cholesterol compared with those with a slow walking pace. However, after adjusting the model to include sociodemographic background, nutritional status, and lifestyle variables, the differences remained only for glycaemia, HbA1c and systolic blood pressure levels. CONCLUSIONS: A brisk walking pace was associated with better cardiometabolic health markers and lipid profile compared with a slow walking pace.
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Doenças Cardiovasculares , Humanos , Adulto , Adolescente , Adulto Jovem , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Hemoglobinas Glicadas , Doenças Cardiovasculares/epidemiologia , Chile/epidemiologia , Estudos Transversais , Velocidade de Caminhada , Inquéritos Epidemiológicos , Pressão Sanguínea , Triglicerídeos , Fatores de RiscoRESUMO
Objetivo: Conocer la ocurrencia de periodontitis a partir de un cuestionario de auto-reporte en una población de diabéticos en Montevideo, Uruguay. Materiales y métodos: Fueron invitados los participantes del 1er Encuentro de Diabetes en Uruguay, con diagnóstico de diabetes según auto-reporte, con al menos 18 años de edad y que firmaron el consentimiento informado. En todos los casos, fue aplicado un cuestionario con ocho preguntas previamente validadas al español de forma de estimar la ocurrencia de la Periodontits además de identificar indicadores asociados. Resultados: Un total de 37 personas respondieron el cuestionario suministrado, en su mayoría correspondientes al sexo femenino y de 45 años de edad promedio. La ocurrencia de periodontits fue del 68% de los encuestados, no existiendo diferencias significativas para el tipo de diabetes y las franjas etarias consideradas. Sin embargo las personas que presentaban periodontits tuvieron menos dientes naturales (según auto-reporte) al ser comparados con quienes no tenían periodontitis (27.5 vs. 20.4, p=0.01). Conclusiones: Los resultados del estudio permiten apreciar una condición oral deficitaria en aquellos diabéticos con periodontitis auto-reportada debido a la ocurrencia elevada de la misma así como la menor cantidad de dientes naturales.
Objective: To determine the occurrence of periodontitis from a self-report questionnaire in a population of diabetics in Montevideo, Uruguay. Materials and methods: Participants of the 1st Diabetes Meeting in Uruguay, with a diagnosis of diabetes according to self-report, with at least 18 years of age and signed the informed consent, were invited. In all cases, a questionnaire with eight questions previously validated in Spanish was applied in order to estimate the occurrence of Periodontits in addition to identifying associated indicators. Results: A total of 37 people answered the supplied questionnaire, mostly corresponding to the female sex and an average age of 45 years. The occurrence of periodontitis was 68%, with no significant differences for the type of diabetes and the age groups considered. However, people with periodontitis had fewer natural teeth (according to self-report) when compared to those who did not have periodontitis (27.5 vs. 20.4, p = 0.01). Conclusions: The results of the study allow us to appreciate a poor oral condition in those diabetics with self-reported periodontitis due to its high occurrence as well as the lower number of natural teeth.
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Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Periodontite , Diabetes Mellitus , Autorrelato , Uruguai , Estudos Transversais , Inquéritos e QuestionáriosRESUMO
Low-grade inflammation of the hypothalamus is associated with the disturbance of energy balance. The endocannabinoid system has been implicated in the development and maintenance of obesity as well as in the control of immune responses. The type 2 cannabinoid receptor (CB2) signaling has been associated with anti-inflammatory effects. Therefore, in high fat diet (HFD)-induced obese mice, we modulated CB2 signaling and investigated its effects on energy homeostasis and hypothalamic microgliosis/astrogliosis. We observed no effect on caloric intake and body weight gain in control diet-fed animals that received prolonged icv infusion of the CB2 receptor agonist HU308. Interestingly, we observed a decrease in glucose tolerance in HFD-fed animals treated with HU308. Prolonged icv infusion of HU308 increases astrogliosis in the ventromedial nucleus (VMH) of obese animals and reduced HFD-induced microgliosis in the hypothalamic arcuate (ARC) but not in the paraventricular (PVN) or VMH nuclei. These data indicate that central CB2 signaling modulates glucose homeostasis and glial reactivity in obesogenic conditions, irrespective of changes in body weight.
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Dieta Hiperlipídica , Gliose , Animais , Peso Corporal , Encéfalo , Dieta Hiperlipídica/efeitos adversos , Glucose , Hipotálamo , Camundongos , Obesidade/etiologiaRESUMO
Type 2 diabetes (T2DM) is among the most prevalent metabolic diseases in the world and may result in several long-term complications. The crosstalk between gut microbiota and host metabolism is closely related to T2DM. Currently, fragmented data hamper defining the relationship between probiotics and T2DM. This systematic review aimed at investigating the effects of probiotics on T2DM in animal models. We systematically reviewed preclinical evidences using PubMed/MEDLINE and Scopus databases, recovering 24 original articles published until September 27th, 2019. This systematic review was performed according to PRISMA guidelines. We included experimental studies with animal models reporting the effects of probiotics on T2DM. Studies were sorted by characteristics of publications, animal models, performed analyses, probiotic used and interventions. Bias analysis and methodological quality assessments were examined through the SYRCLE's Risk of Bias tool. Probiotics improved T2DM in 96% of the studies. Most studies (96%) used Lactobacillus strains, and all of them led to improved glycaemia. All studies used rodents as models, and male animals were preferred over females. Results suggest that probiotics have a beneficial effect in T2DM animals and could be used as a supporting alternative in the disease treatment. Considering a detailed evaluation of the reporting and methodological quality, the current preclinical evidence is at high risk of bias. We hope that our critical analysis will be useful in mitigating the sources of bias in further studies.
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Glicemia/metabolismo , Diabetes Mellitus Experimental/terapia , Diabetes Mellitus Tipo 2/terapia , Microbioma Gastrointestinal , Probióticos/administração & dosagem , Animais , Diabetes Mellitus Experimental/sangue , Diabetes Mellitus Experimental/microbiologia , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/microbiologia , Disbiose , Feminino , Interações Hospedeiro-Patógeno , MasculinoRESUMO
A growing body of research indicates that cortisol, the glucocorticoid product of the activation of the hypothalamic-pituitary-adrenal axis, plays a role in the pathophysiology of metabolic syndrome. In this regard, chronic exposure to cortisol is associated with risk factors related to metabolic syndrome like weight gain, type 2 diabetes, hypertension, among others. Mifepristone is the only FDA-approved drug with antiglucocorticoids properties for improved the glycemic control in patients with type 2 patients secondary to endogenous Cushing's syndrome. Mifepristone also have been shown positive effects in rodents models of diabetes and patients with obesity due to antipsychotic treatment. However, the underlying molecular mechanisms are not fully understood. In this perspective, we summarized the literature regarding the beneficial effects of mifepristone in metabolic syndrome from animal studies to clinical research. Also, we propose a potential mechanism for the beneficial effects in insulin sensitivity which involved the regulation of mitochondrial function in muscle cells.
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Resumen ANTECEDENTES: La cetoacidosis diabética es una complicación grave de la diabetes que, a menudo, resulta en una emergencia médica. Puede afectar a mujeres con diabetes tipo 1 y 2 y raramente a mujeres con diabetes gestacional (1-3% de todas las pacientes que cursan con diabetes durante el embarazo). OBJETIVO: Reportar el caso de una paciente embarazada, con cetoacidosis diabética. Por la baja frecuencia de este padecimiento resulta interesante su informe y revisar la bibliografía. CASO CLÍNICO: Paciente de 32 años, con 40.1 semanas de embarazo, con diabetes mellitus tipo 2 descompensada. Acudió a un centro de primer nivel de atención debido a: tensión arterial 145-95 mmHg, dolor en el epigastrio, actividad uterina irregular, náusea y vómito. Fue referida al Hospital General de Chimalhuacán. La paciente ingresó al servicio de Urgencias con: presión arterial 145-96 mmHg, frecuencia cardiaca 87 lpm, temperatura 37.2 oC, frecuencia cardiaca fetal 180 lpm, sostenida. Los estudios de laboratorio reportaron: glucemia de 553 mg/dL, cetonemia, pH 7.3. Debido a la taquicardia fetal sostenida se decidió finalizar el embarazo mediante cesárea. De acuerdo con los criterios diagnósticos de cetoacidosis diabética se estableció el diagnóstico de cetoacidosis diabética moderada. CONCLUSIONES: La cetoacidosis diabética es una complicación rara y grave, con consecuencias nocivas para el feto y la madre. El reconocimiento rápido de los factores precipitantes, la administración inicial de líquidos, insulina y la corrección del desequilibrio hidroelectrolítico son prioridades para revertir la cetoacidosis diabética.
Abstract BACKGROUND: Diabetic ketoacidosis is a serious complication of diabetes that often results in a medical emergency. It usually occurs in patients with type 1 diabetes mellitus, especially newly developed, but it can also affect women with type 2 diabetes and rarely women with gestational diabetes (1-3% of all patients with diabetes during the pregnancy). OBJECTIVE: To present a case report of a pregnant woman who presented with diabetic ketoacidosis, treatment and evolution. Given the low frequency of the pathology, it is interesting to report and review the current literature. CLINICAL CASE: A 32-year-old woman, with the diagnosis of decompensated type 2 diabetes mellitus, 40.1 weeks of gestation, who goes to a first level hospital for presenting; arterial tensions of 145 / 95mmHg, pain in epigastrium, irregular uterine activity, nausea and vomiting for what is referred to the General Hospital of Chimalhuacán. The patient enters the emergency department with, blood pressure 145/96 mmHg, heart rate 87x`, temperature 37.2 °C Fetal heart rate 180 beats per minute sustained, laboratory studies found glycaemia of 553 mg/dL, ketonemia, pH 7.3, fetal heart rate 180 beats per minute sustained so it is decided to terminate the pregnancy by caesarean section. According to the diagnostic criteria of diabetic ketoacidosis, the diagnosis of moderate diabetic ketoacidosis is established. CONCLUSIONS: Diabetic ketoacidosis is a rare but serious complication of diabetes in pregnancy, with harmful consequences for both the fetus and the mother. Rapid recognition of precipitating factors, initial fluid therapy, insulin administration and correction of hydroelectrolytic imbalance are priorities in the management of diabetic ketoacidosis. A multidisciplinary management that includes intensive care unit for the mother and neonatal intensive care, monitoring the maternal response to treatment is essential to reduce morbidity and mortality; fetal monitoring is necessary, as this will be directly affected or benefited according to the maternal response to treatment.
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Introdução: As evidências disponíveis na literatura científica a respeito dos efeitos do controle glicêmico intensivo como estratégia para prevenção de infecção do sítio cirúrgico (ISC) entre receptores de transplante de fígado são limitadas. Objetivo: Avaliar os efeitos de um protocolo intensivo de controle glicêmico pós-operatório, comparativamente a um protocolo institucional padrão, sobre a incidência de ISC entre receptores de transplante de fígado. Método: Ensaio clínico controlado randomizado, paralelo, composto por dois grupos, a saber: receptores de transplante de fígado submetidos ao controle glicêmico intensivo (CGI) (80-130 mg/dL) ou controle glicêmico padrão (CGP) (130-180 mg/dL), até o início da ingestão de alimentos pela via oral ou por cateter nasoentérico. O desfecho primário, ISC, foi avaliado até o 30o dia do pós-operatório. A avaliação foi realizada por um Comitê de Adjudicação cegado, adotando a definição estabelecida pelo Centers for Disease Control and Prevention. A análise dos dados foi realizada por intenção de tratar. As associações foram verificadas utilizando-se os testes Qui-quadrado de Pearson ou Exato de Fisher. As comparações entre médias ou medianas foram feitas por meio dos testes t de Student ou de Mann-Whitney, a depender do atendimento aos pressupostos de normalidade segundo o teste de Kolmogorov-Smirnov. A comparação de médias de glicemia entre os grupos ao longo do tempo foi obtida por meio da Análise de Variâncias (ANOVA) com medidas repetidas. O nível de significância adotado foi de 5%. O número de registro do estudo no ClinicalTrials.gov é NCT03474666. Resultados: Dos 41 receptores de transplante de fígado inscritos para participação no estudo, 20 foram randomicamente alocados no grupo CGI e 21 no grupo CGP. As incidências de ISC foram semelhantes entre os grupos (CGI 3/20 e CGP 5/21) (RR 0,78; IC 95% 0,21-2,88; P=0,695). A média de glicemia, no período inicial de 24 horas após o transplante, foi significativamente inferior no grupo CGI comparativamente ao CGP (145,0 ± 20,7 mg/dL vs. 230,2 ± 51,5 mg/dL; P=0,001). Episódios de hipoglicemia severa não foram observados nos grupos de estudo. Hiperglicemia e hiperglicemia severa foram significativamente menos frequentes no grupo CGI (RR 0,70; IC 95% 0,52-0,93; P=0,009 e RR 0,07; IC 95% 0,01-0,48; P<0,001, respectivamente). O tempo de ventilação mecânica foi semelhante entre os grupos (CGI 19,6 ± 14,7 horas vs. 16,2 ± 11,3 horas; P=0,884). Tendência de menor tempo de internação em UTI foi observada no CGI (8,0 [4,0-13,5 dias]) em comparação ao CGP (11,0 [7,0-15,0 dias]) (P=0,097). O tempo de estadia hospitalar pós-operatória foi significativamente mais breve, em aproximadamente seis dias, no CGI em comparação ao CGP (13,1 ± 5,5 dias vs. 19,3 ± 12,1 dias; P= 0,043). A ocorrência de óbito em até 90 dias após o transplante foi semelhante entre os grupos (CGI 20% vs. 14,3%; P= 0,697). Receptores acometidos por ISC incisional profunda ou órgão/cavidade apresentaram risco superior de óbito comparativamente àqueles que não desenvolveram (RR 4,95; IC 95% 1,54-15,86; P=0,007). Conclusão: Os resultados deste estudo não apontaram redução na incidência de ISC por meio do emprego de um protocolo intensivo de controle glicêmico. Contudo, verificou-se que os receptores alocados no grupo CGI apresentaram médias glicêmicas inferiores, menor incidência de hiperglicemia e hiperglicemia severa, e menor tempo de internação pós-operatória. Considerando que esse estudo foi conduzido em um único centro transplantador de um país em desenvolvimento, sugere-se a realização de estudos multicêntricos a fim de que sejam confirmados os resultados.
Background: The evidence supporting intensive blood glucose control to prevent surgical site infections (SSIs) among liver transplant recipients is insufficient. Aim: To assess the effects of postoperative intensive blood glucose control protocol (IBGC) against standard blood glucose control (SBGC) on the incidence of SSI among adult liver transplant recipients. Methods: This is a parallel-design, randomized controlled trial, comparing two blood glucose control protocol beginning at the time of the post-operative admission of the recipient to the Intensive Care Unit. All recipients who consented to take part in this trial were randomly assigned to either group, IBGC (blood glucose targeted on 80-130 mg/dL) or SBGC (130-180 mg/dL). The primary outcome, SSI was assessed at 30 days by a blind adjudication panel. This trial was approved by the relevant ethics committee before the study initiation and enrolment. Analysis was based on intention-to-treat information. Categorical variables were analysed by Pearson's chi-squared test or Fisher's exact test, as appropriate. Normality was tested using the Kolmogorov-Smirnov test. Continuous variables were analysed by the Student t test for normally distributed data and the Mann-Whitney test for all other data. The comparison between glycaemic levels was calculated using analysis of variance of repeated measures (ANOVA). To keep the level of global significance the Bonferroni correction was used. Statistical significance was set at P= 0.05. The ClinicalTrials.gov identifier is NCT03474666. Results: Of the 41 liver transplant recipients enrolled onto the trial, 20 were randomly allocated to the IBGC group and 21 to the SBGC group. There were no significant differences in SSIs among recipients allocated to either group (RR 0,78, 95% CI 0.21-2.88; P=0.695). Mean blood glucose levels were significantly lower in the IBCG group in the 24-hour period after surgery (145.0 ± 20.7 mg/dL and 230.2 ± 51.6 mg/dL; P=0.001). While there were fewer episodes of hypoglycaemia in the IBGC group, this did not reach statistical significance. There were no episodes of severe hypoglycaemia in either group. Hyperglycaemia and severe hyperglycaemia were significantly more frequent in the SBGC group (RR 0.70, 95% CI 0.52-0.93; P=0.009 and RR 0.07; 95% CI 0.01-0.48; P< 0.001, respectively). The length of mechanic ventilation was similar between the two groups (IBGC 19.6 ± 14.7 h vs 16.2 ± 11.3 h; P=0.884). A tendency of shorter length of ICU stay was detected on the IBGC (8.0 [4.0-13.5 days]) comparatively to the SBGC (11.0 [7.0-15.0 days]) (P=0.097). Length of hospital stay was significantly shorter for recipients in the IBGC group (13.1 ± 5.5 vs 19.3 ± 12.1 days; P=0.043). The occurrence of death was similar between recipients allocated to the IBGC and SBGC (20.0% vs. 14.3%; P=0.697). The risk of death was higher among recipients who developed deep incisional or organ/space SSI comparatively to those who did not (RR 4.95; CI 95% 1.54- 15.86; P=0.007). Conclusion: Although this small trial did not find intensive blood glucose control reduced SSI, it was associated with lower blood glucose levels, fewer episodes of hyperglycaemia and severe hyperglycaemia, and shorter length of hospital stay. Also, this trial was carried out in a single transplant centre in a middle-income country. It would be interesting to see if the results were supported by a multicentre trial.
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Enfermagem Perioperatória , Infecção da Ferida Cirúrgica , Glicemia , Transplante de Fígado , EnfermagemRESUMO
Obesity is mainly caused by intake of a high-fat diet and sedentarism, and is considered a public health issue worldwide. Increased intestinal permeability may favour endotoxaemia generated by lipopolysaccharides, a substance present in the cell membrane of Gram-negative bacteria, and, consequently, an increase in systemic inflammation and metabolic diseases. In contrast (On the other hand), consumption of a healthy diet can help in the prevention and treatment of metabolic syndrome. In this way, chia seeds (Salvia hispanica L.), rich in polyunsaturated fatty acids, may present an anti-inflammatory role. In addition, chia is rich in antioxidants like caffeic and gallic acid and fiber. However, few studies have investigated the relationship between chia seeds, inflammatory mechanisms and intestinal permeability. Therefore, the aim of this study was to analyse the effects of chia administration on metabolism in obese mice. Swiss mice were fed a hyperlipidic diet either supplemented with or without 3% chia flour for 16â¯weeks. The results showed that supplementation could not reduce the deleterious effects of the lipid-rich diet in terms of body composition, glucose intolerance and activity of antioxidants enzymes in the liver. In addition, supplementation with chia in the control diet decreased the amount of occludin in the intestinal colon. In conclusion, although chia did not improve metabolic parameters it seemed to restore the intestinal barriers integrity. The beneficial effects of chia seem to be dependent of the quantity used, since our data conflict with those in the literature; however, it is important to note that other studies, unlike our protocol, used chia in the form of seeds or oil, and not flour.
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Glicemia/metabolismo , Dieta Hiperlipídica , Farinha/análise , Índice Glicêmico , Salvia/química , Animais , Antioxidantes/análise , Biomarcadores/sangue , Peso Corporal , Ácidos Cafeicos/análise , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Fibras na Dieta/análise , Ácidos Graxos Insaturados/análise , Ácido Gálico/análise , Teste de Tolerância a Glucose , Masculino , Camundongos , Camundongos Obesos , Sementes/química , Triglicerídeos/sangueRESUMO
Diabetes mellitus is a global epidemic, characterised as a heterogeneous group of metabolic disorders associated with high risk of CVD. Green banana biomass, which is composed of resistant starches (RS) and cannot be hydrolysed by amylases, delays gastric emptying and modulates insulin sensitivity, thus contributing to improve metabolic disorders. The aim of the present study was to investigate the effects of consumption of RS from green banana biomass on body composition, fasting plasma glucose, glycated Hb (HbA1c) and homeostasis model assessment of insulin resistance in subjects with pre-diabetes or type 2 diabetes on top of treatment. Middle-aged subjects (n 113) of both sexes with pre-diabetes (HbA1c: 5·7-6·4 %) or diabetes (HbA1c ≥ 6·5 %) were randomised to receive nutritional support plus green banana biomass (40 g) (RS: approximately 4·5 g, G1, n 62) or diet alone (G2, n 51) for 24 weeks. Body composition, biochemical analyses and dietary intake were evaluated at the beginning and end of the study. In the experimental group (G1), consumption of RS was associated with reduction in HbA1c (P = 0·0001), fasting glucose (P = 0·021), diastolic blood pressure (P = 0·010), body weight (P = 0·002), BMI (P = 0·006), waist and hip circumferences (P < 0·01), fat mass percentage (P = 0·001) and increase in lean mass percentage (P = 0·011). In controls (G2), reductions were observed in waist and hip circumferences (P < 0·01), HbA1c (P = 0·002) and high-density lipoprotein-cholesterol (P = 0·020). In pre-diabetes or diabetes, non-significant differences were observed in the percentage reduction in HbA1c and fasting glucose in exploratory analyses. Our results indicate that the consumption of bioactive starches is a good dietary strategy to improve metabolic control and body composition.
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Diabetes Mellitus Tipo 2/sangue , Dieta/métodos , Musa , Estado Pré-Diabético/sangue , Amido/administração & dosagem , Biomassa , Glicemia/metabolismo , Composição Corporal/efeitos dos fármacos , Jejum/sangue , Feminino , Hemoglobinas Glicadas/metabolismo , Humanos , Insulina/sangue , Resistência à Insulina , Masculino , Pessoa de Meia-IdadeRESUMO
We tested the hypothesis that rating of perceived exertion (RPE) is a tool as efficient as the heart rate (HR) response to the cardiopulmonary exercise test (CPX) for prescribing and self-regulating high-intensity interval exercise (HIIE), and that metabolic and hemodynamic response to HIIE is superior than to continuous moderate-intensity exercise (MICE) in individuals with type 2 diabetes mellitus (T2DM). Eleven participants (age = 52.3 ± 3 years) underwent HIIE prescribed and self-regulated by RPE (HIIERPE; 25 min), HIIE prescribed and regulated by an individual's HR response to CPX (HIIEHR; 25 min), MICE prescribed and self-regulated by RPE (30 min) and control (30 min of seated resting) intervention in random order. HR, blood pressure (BP), capillary glucose, endothelial reactivity, and carotid-femoral pulse wave velocity were assessed before, immediately after, and 45 min after each intervention. Exercise HR, speed, and distance were measured during exercise sessions. Twenty-four-hour ambulatory BP was measured after each intervention. Exercise HR, speed, and distance were similar between HIIERPE and HIIEHR. BP response was not different among HIIERPE, HIIEHR, and MICE. Capillary glycaemia reduction was greater (P < 0.05) after HIIERPE (48.6 ± 9.6 mg/dL) and HIIEHR (47.2 ± 9.5 mg/dL) than MICE (29.5 ± 11.5 mg/dL). Reduction (P < 0.05) in 24-h (6.7 ± 2.2 mm Hg) and tendency toward reduction (P = 0.06) in daytime systolic (7.0 ± 2.5 mm Hg) ambulatory BP were found only after HIIERPE. These results suggest that HIIE is superior to MICE for reducing glycaemia and ambulatory BP, and that the 6-20 RPE scale is a useful tool for prescribing and self-regulating HIIE in individuals with T2DM.
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Glicemia/metabolismo , Diabetes Mellitus Tipo 2/terapia , Metabolismo Energético , Hemodinâmica , Treinamento Intervalado de Alta Intensidade , Esforço Físico , Adulto , Idoso , Biomarcadores/sangue , Pressão Sanguínea , Monitorização Ambulatorial da Pressão Arterial , Brasil , Estudos Cross-Over , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/fisiopatologia , Teste de Esforço , Feminino , Frequência Cardíaca , Humanos , Masculino , Pessoa de Meia-Idade , Análise de Onda de Pulso , Fatores de Tempo , Resultado do Tratamento , Rigidez VascularRESUMO
Sleep shortening during pregnancy may alter the mother's environment, affecting the offspring. Thus, the present study evaluated the metabolic profile of female offspring from sleep-restricted rats during the last week of pregnancy. Pregnant Wistar rats were distributed into two groups: control (C) and sleep restriction (SR). The SR was performed 20 h/day, from 14th to 20th day of pregnancy. At 2 months, half of the offspring were subjected to ovariectomy (OVX); the others, to sham surgery. Studied groups were Csham, Covx, SRsham and SRovx. Cholesterol (HDL, LDL and C-total), triglycerides (TG) and glucose and insulin tolerance tests (GTT-ITT) were evaluated at 8 months. RSsham presented higher values of TG, while SRovx presented higher TG, LDL and C-total. Basal glucose concentration was increased in SRsham and SRovx. These data suggest that SR during pregnancy may be a risk factor for the development of diseases in adult female offspring.
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Glucose/metabolismo , Homeostase , Lipídeos/análise , Efeitos Tardios da Exposição Pré-Natal/patologia , Privação do Sono/complicações , Animais , Pressão Sanguínea , Feminino , Taxa de Filtração Glomerular , Teste de Tolerância a Glucose , Masculino , Gravidez , Efeitos Tardios da Exposição Pré-Natal/etiologia , Efeitos Tardios da Exposição Pré-Natal/metabolismo , Ratos , Ratos WistarRESUMO
Osteocalcin is no longer regarded as a molecule exclusive to bone remodeling and osteogenesis, but as a hormone with manifold functions. The discovery of the interaction of osteocalcin with the G proteincoupled receptor family C group 6member A (GPRC6A) receptor has accompanied the characterization of several roles that this peptide serves in body regulation and homeostasis. These roles include the modulation of memory in the brain, fertility in the testis, fat accumulation in the liver, incretins release in the intestine and adaptation to exercise in muscle, in addition to the wellknown effects on ßcell proliferation, insulin release and adiponectin secretion. The aim of the present review was to provide a practical update of the multiorgan effects that osteocalcin exerts through its interaction with GPRC6A and the clinical implications of this.
Assuntos
Estruturas Animais/metabolismo , Osteocalcina/metabolismo , Receptores Acoplados a Proteínas G/metabolismo , Animais , Homeostase/fisiologia , HumanosRESUMO
This study aimed to evaluate the longitudinal association of vitamin D status with glycaemia, insulin, homoeostatic model assessment of insulin resistance, adiponectin and leptin. A prospective cohort with 181 healthy, pregnant Brazilian women was followed at the 5th-13th, 20th-26th and 30th-36th gestational weeks. In this cohort, 25-hydroxyvitamin D (25(OH)D) plasma concentrations were analysed using liquid chromatography-tandem MS. Vitamin D status was categorised as sufficient or insufficient using the Endocrine Society Practice Guidelines (≥75/<75 nmol/l) and the Institute of Medicine (≥50/<50 nmol/l) thresholds. Linear mixed-effect regression models were employed to evaluate the association between vitamin D status and each outcome, considering interaction terms between vitamin D status and gestational age (P<0·1). At baseline, 70·7 % of pregnant women had 25(OH)D levels <75 nmol/l and 16 % had levels <50 nmol/l. Women with sufficient vitamin D status at baseline, using both thresholds, presented lower glycaemia than those with insufficient 25(OH)D. Pregnant women with 25(OH)D concentrations <75 nmol/l showed lower insulin (ß=-0·12; 95 % CI -0·251, 0·009; P=0·069) and adiponectin (ß=-0·070; 95 % CI -0·150, 0·010; P=0·085) concentrations throughout pregnancy than those with 25(OH)D levels ≥75 nmol/l. Pregnant women with 25(OH)D <50 nmol/l at baseline presented significantly higher leptin concentrations than those with 25(OH)D levels ≥50 nmol/l (ß=-0·253; 95 % CI -0·044, 0·550; P=0·095). The baseline status of vitamin D influences the biomarkers involved in glucose metabolism. Vitamin D-sufficient women at baseline had higher increases in insulin and adiponectin changes throughout gestation than those who were insufficient.
Assuntos
Adipocinas/sangue , Glicemia/metabolismo , Vitamina D/análogos & derivados , Adiponectina/sangue , Adulto , Brasil , Estudos de Coortes , Diabetes Gestacional/sangue , Diabetes Gestacional/prevenção & controle , Dieta , Feminino , Idade Gestacional , Humanos , Insulina/sangue , Resistência à Insulina , Leptina/sangue , Gravidez , Complicações na Gravidez/sangue , Estudos Prospectivos , Vitamina D/sangue , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/complicaçõesRESUMO
The objective of this research was to evaluate a possible corrective measure against negative metabolic states, as occurs in the advanced stage of gestation in ewes, and that sometimes produces a disease called pregnancy toxaemia. In the present research, we found that the joint administration of i.v. lysine-vasopressin (0.08 IU/kg body weight, BW) and an oral glucose solution (50 g) produces an increase in blood glucose, which persists for some time (up to 6 h); therefore, it could be used in the treatment of pregnancy toxaemia. This therapy is based on the fact that lysine-vasopressin induces gastric groove closure in adult ruminants, enabling orally administered glucose to reach the abomasum directly, from where it rapidly passes into the intestine and is immediately absorbed. We can say that the tested treatment causes a significant increase in blood glucose in ewes affected by toxaemia caused by fasting, which, although less marked than conventional therapy with intravenous drip glucose, remains longer, regularizing other parameters indicative of energy metabolism in fasting ewes.(AU)
Assuntos
Animais , Feminino , Gravidez , Prenhez/metabolismo , Ovinos/metabolismo , Vasopressinas/análise , Jejum Intermitente/fisiologia , Metabolismo Energético/fisiologia , Suco Gástrico/metabolismo , Glucose/administração & dosagemRESUMO
It has been reported that boron induces changes in carbohydrate and lipid metabolism, body weight and inflammatory processes. This is relevant to the biomedical field due to the requirement for developing therapeutic tools with potential application in metabolic disorders affecting humankind. However, most of the reported data from both humans and animals were obtained after boron was administered as borax or boric acid. In this work, we determined the effects of boric, cyclohexylboronic (CHB) and phenylboronic (PBA) acids (10 mg/kg of body weight/daily for two weeks) on the body weight, metabolism and inflammatory markers in the blood of control, fat-feeding and experimental diabetic rats. In particular, we observed the effects of the administration of these compounds on glycaemia and cholesterol, triglyceride, insulin, IL-6 and C-reactive protein levels, as well as visceral fat and body weight. We found different profiles for each boron-containing compound: boric acid induced decreasing body weight, insulin and IL-6 levels; CHB administration induced an increase in body weight and cholesterol but decreased IL-6 levels; and PBA administration induced a decrease in visceral fat and glucose and insulin levels. These results can improve the understanding of boron as a metabolic regulator and help develop new potential strategies to use compounds with this trace element for therapeutic purposes.
Assuntos
Peso Corporal/efeitos dos fármacos , Ácidos Bóricos/farmacologia , Ácidos Borônicos/farmacologia , Metabolismo dos Lipídeos/efeitos dos fármacos , Animais , Glicemia/efeitos dos fármacos , Boro , Inflamação/sangue , Inflamação/metabolismo , Insulina/sangue , Masculino , RatosRESUMO
BACKGROUND: Acute lymphoblastic leukemia (ALL) is associated with higher levels of pro-inflammatory cytokines and oxidative stress. Recently, the levels of extracellular heat shock protein 72 (eHSP72) were found to be elevated in ALL, and its elevation associated with poor prognosis. Therefore, considering the possible role of eHSP72 as a modulator of the immunological system and metabolism, the aim of this study was to describe the response of eHSP72 to the induction phase of chemotherapy, along with metabolic, inflammatory and oxidative stress markers, in children and adolescents newly diagnosed with ALL. METHODS: Nineteen patients were recruited and analysed before and after the induction phase of chemotherapy (with 28 days of duration). Blood samples were taken for the analysis of C-reactive protein (CRP), levels of lipoperoxidation, insulin (and HOMA-IR), cortisol, glucose, lipid profile and eHSP72. RESULTS: We found that induction phase of chemotherapy leads to a drop in glucose levels (from 101.79±19 to 75.8±9.7 mg/dL), improvements on inflammation (CRP levels, p<0.01) and oxidative stress (TBARS levels, p<0.01), reduction on eHSP72 (p=0.03) and improved insulin sensitivity (HOMA-IR, p=0.02). CONCLUSION: Our results indicate that eHSP72 may have an immune and metabolic role and could be used as a marker of the treatment success and metabolic changes in children with ALL.
RESUMO
Las mujeres embarazadas con insulino-sensibilidad disminuida están en riesgo de desarrollar trastornos hipertensivos. Utilizando el corte HOMA-IR en 2,64 la población en estudio fue dividida en dos grupos: (n=154 mujeres embarazadas), las que arrojaron un HOMA-IR basal (HOMA-0) <2,64 (no-insulinorresistentes; n=113) y aquellas con HOMA-0>2,64 (insulinorresistentes, n=41). Se analizaron: a) las concentraciones circulantes de glucosa e insulina durante una prueba de tolerancia oral a 75 g de glucosa (PTOG), y b) las relaciones entre varios parámetros de insulino-sensibilidad y la predicción del desarrollo de trastornos hipertensivos. A las mujeres embarazadas (semana 24-28) se les cuantificaron las concentraciones plasmáticas de glucosa e insulina a ambos tiempos de la PTOG. Se calcularon los valores de HOMA-IR y las relaciones glucosa a insulina (G:I) y se registraron parámetros antropométricos y resultados del embarazo. Las mujeres con HOMA-0 >2,64, aunque con glucemias en ayunas normales, mostraron mayores niveles de insulinemia y de HOMA-IR, y menores valores G:I en ambos tiempos de la PTOG. Estas mujeres embarazadas fueron las que tuvieron un mayor riesgo de desarrollar trastornos hipertensivos y mayores parámetros de morbilidad durante el período estudiado al compararlas con aquellas cuyo HOMA-0 fue <2,64.
Pregnant women with impaired insulin sensitivity are at risk for developing hypertensive disorders. By using a cut-off at 2.64 of the homeostasis model assessment (HOMA-IR) in basal condition (HOMA-0), the population under study (n=154 pregnant women) was split into two groups: 1) with basal HOMA- 0 <2.64 (non-insulin resistant; n=113) and 2) with basal HOMA-0 >2.64 (insulin resistant; n=41). Glucose and insulin circulating levels were analyzed throughout a 2-h oral 75 g glucose tolerance test (OGTT). The relationship between several parameters related to insulin resistance and the prevalence of pregnancy-induced hypertensive disorders was analyzed. Pregnant women (on week 24-28) were submitted to an OGTT, and glucose and insulin plasma concentrations were measured throughout the test. These peripheral metabolites levels and the values of the HOMA-IR and the glucose to insulin ratio (G:I) were analyzed. Anthropometric parameters and pregnancy outcome were recorded. Women with HOMA-0 >2.64 but normal fasting glycemia showed higher insulinemias, G:I values and HOMA-IR values at both times of the OGTT. The latter were at greater risk for developing late pregnancy-induced hypertension compared to women with HOMA-0 ≤2.64.
As mulheres grávidas com diminuição da sensibilidade à insulina correm o risco de desenvolver distúrbios hipertensivos. Usando o corte HOMA-IR 2,64, a população em estudo foi dividida em dois grupos: (n=154 mulheres grávidas), que deram um HOMA-IR basal (HOMA-0) ≤2,64 (não resistentes à insulina; n=113) e aquelas com HOMA-0 >2,64 (resistentes à insulina, n=41). Foram analisadas: a) as concentrações circulantes de glicose e insulina durante uma prova de tolerância oral a 75 g. de glicose (PTOG), e b) as relações entre diversos parâmetros de sensibilidade à insulina e a predição de desenvolver distúrbios de hipertensão. Foram quantificadas nas mulheres grávidas (24-28 semanas) as concentrações plasmáticas de glicose e insulina a ambos os tempos da PTOG. Valores de HOMA-IR foram calculados e as relações glicose a insulina (G:I) e se registraram parâmetros antropométricos e os resultados da gravidez. Mulheres com HOMA-0 >2,64, mas com glicemias em jejuns normais, mostraram níveis mais elevados de insulinemia e de HOMA-IR, e menores valores G:I em ambos os tempos da PTOG. Essas mulheres grávidas foram aquelas que tiveram maior risco de desenvolver distúrbios de hipertensão e maiores parâmetros de morbidade durante o período estudado em comparação com as mulheres cujo HOMA-0 foi ≤2,64.
Assuntos
Humanos , Feminino , Gravidez , Adulto , Glicemia , Resistência à Insulina , Gravidez , Hipertensão Induzida pela Gravidez , Argentina , Prevenção Primária , Antropometria , Saúde Pública , Inquéritos e Questionários , Diabetes Gestacional , Gravidez de Alto Risco , Diabetes Mellitus Tipo 2 , Fator de Crescimento Placentário , InsulinaRESUMO
In order to use and study minimally invasive techniques to reduce side effects of ovarian-hysterectomy (OHE) in bitches, the aim of this study was to compare time, surgical complications, pain and postoperative inflammatory response, caused by single port videolaparoscopic OHE and traditional miniceliotomy with snook hook. Twenty-four healthy bitches were randomly divided in two groups: videolaparoscopy (Video) and miniceliotomy (MiniLap). Surgical time and complications, pain, need for analgesic rescue, C-reactive protein concentration, glycaemia and voluntary food ingestion were evaluated during 24 hours following the procedure and compared statistically. Surgical time (38±7min), surgical complications (17%), postoperative pain intensity, need for analgesic rescue and C-reactive protein concentration were similar between groups (P>0.05). Glycaemia was lower in Video group (P=0.03), animals fed faster and in greater proportion (P=0.02). Thus, it is concluded that both OHE techniques result in similar complications, surgical time and inflammatory response; however, animals on Video group fed more readily and presented lower glycaemia, which point to lower stress levels. These findings validated the indication of this technique.(AU)
Com o intuito de utilizar e estudar técnicas minimamente invasivas que permitam reduzir os efeitos adversos da ovário-histerectomia (OVH) em cadelas objetivou-se comparar: o tempo, as complicações cirúrgicas, a dor e a resposta inflamatória pós-operatória, resultantes da OVH laparoscópica por único portal e a miniceliotomia tradicional com gancho de Snook. Vinte e quatro cadelas hígidas foram aleatoriamente divididas em dois grupos e realizadas a OVH por videolaparoscopia (Vídeo) ou miniceliotomia (MiniLap). Avaliaram-se e compararam-se estatisticamente: o tempo e intercorrências cirúrgicas, a dor, necessidade de resgate analgésico, concentração sérica de proteína C reativa, glicemia e o consumo voluntário de alimento durante as 24 horas subsequentes ao procedimento. O tempo operatório (38±7min), as intercorrências cirúrgicas (17%), a intensidade de dor pós-operatória, a necessidade de resgate analgésico e a concentração sérica de proteína C reativa foram similares entre os grupos (P>0,05). A glicemia foi menor nos animais do grupo Vídeo (P=0,03) e estes se alimentaram mais rapidamente e em maior proporção (P=0,02). Assim, conclui-se que as técnicas de OVH por videolaparoscopia, miniceliotomia resultam em complicações, tempos cirúrgicos e respostas inflamatórias similares, no entanto, os animais submetidos à videolaparoscopia se alimentam mais prontamente e apresentam menor índice glicêmico indicando um nível de estresse menor e este resultado considera-se válido para a indicação desta técnica.(AU)
Assuntos
Animais , Feminino , Cães , Laparoscopia/métodos , Laparoscopia/veterinária , Ovariectomia/métodos , Ovariectomia/veterinária , Histerectomia/métodos , Histerectomia/veterinária , Instrumentos Cirúrgicos/veterinária , Proteína C-Reativa , Glicemia , Complicações Intraoperatórias/veterinária , Dor Pós-Operatória/veterináriaRESUMO
ABSTRACT: In order to use and study minimally invasive techniques to reduce side effects of ovarian-hysterectomy (OHE) in bitches, the aim of this study was to compare time, surgical complications, pain and postoperative inflammatory response, caused by single port videolaparoscopic OHE and traditional miniceliotomy with snook hook. Twenty-four healthy bitches were randomly divided in two groups: videolaparoscopy (Video) and miniceliotomy (MiniLap). Surgical time and complications, pain, need for analgesic rescue, C-reactive protein concentration, glycaemia and voluntary food ingestion were evaluated during 24 hours following the procedure and compared statistically. Surgical time (38±7min), surgical complications (17%), postoperative pain intensity, need for analgesic rescue and C-reactive protein concentration were similar between groups (P>0.05). Glycaemia was lower in Video group (P=0.03), animals fed faster and in greater proportion (P=0.02). Thus, it is concluded that both OHE techniques result in similar complications, surgical time and inflammatory response; however, animals on Video group fed more readily and presented lower glycaemia, which point to lower stress levels. These findings validated the indication of this technique.
RESUMO: Com o intuito de utilizar e estudar técnicas minimamente invasivas que permitam reduzir os efeitos adversos da ovário-histerectomia (OVH) em cadelas objetivou-se comparar: o tempo, as complicações cirúrgicas, a dor e a resposta inflamatória pós-operatória, resultantes da OVH laparoscópica por único portal e a miniceliotomia tradicional com gancho de Snook. Vinte e quatro cadelas hígidas foram aleatoriamente divididas em dois grupos e realizadas a OVH por videolaparoscopia (Vídeo) ou miniceliotomia (MiniLap). Avaliaram-se e compararam-se estatisticamente: o tempo e intercorrências cirúrgicas, a dor, necessidade de resgate analgésico, concentração sérica de proteína C reativa, glicemia e o consumo voluntário de alimento durante as 24 horas subsequentes ao procedimento. O tempo operatório (38±7min), as intercorrências cirúrgicas (17%), a intensidade de dor pós-operatória, a necessidade de resgate analgésico e a concentração sérica de proteína C reativa foram similares entre os grupos (P>0,05). A glicemia foi menor nos animais do grupo Vídeo (P=0,03) e estes se alimentaram mais rapidamente e em maior proporção (P=0,02). Assim, conclui-se que as técnicas de OVH por videolaparoscopia, miniceliotomia resultam em complicações, tempos cirúrgicos e respostas inflamatórias similares, no entanto, os animais submetidos à videolaparoscopia se alimentam mais prontamente e apresentam menor índice glicêmico indicando um nível de estresse menor e este resultado considera-se válido para a indicação desta técnica.