RESUMO
OBJECTIVE: HIV-1 infection is accompanied by severe metabolic and immune dysfunction. The aim of this study was to evaluate the role of metabolic syndrome (MetS) and antiretroviral therapy (ART) utilization on the adiponectin levels and oxidative stress in patients infected with HIV-1. METHODS: We allocated 285 patients into four groups: group 1: patients without MetS who were not using ART; group 2: patients without MetS using ART; group 3: patients with MetS who were not using ART; and group 4: patients with MetS using ART. Biochemical, immunologic, and oxidative stress parameters were measured. RESULTS: Group 4 exhibited higher lipoperoxides when compared with group 1 (P < 0.0001) and higher advanced oxidation protein products (AOPP) compared with group 2 or group 1 (P < 0.0001). Group 3 also presented higher AOPP than group 2 (P < 0.05). Group 4 showed lower adiponectin levels compared with groups 1 or 2 (P < 0.0001). Similarly, group 3 presented lower adiponectin levels compared with group 2 (P < 0.05) or group 1 (P < 0.0001). Multivariate analysis showed that both an increase in AOPP and a decrease in total radical-trapping antioxidant parameter/uric acid were independently associated with MetS in HIV-1 patients. Regarding immunologic markers of HIV-1 disease progression and viral replication, group 4 exhibited significantly higher CD45(+), CD3(+), and CD4(+) T cells count compared with group 2 (P < 0.01). CONCLUSION: HIV-1-infected patients with MetS exhibited hypoadiponectinemia and increased oxidative stress, and these findings were not influenced by ART use. The findings of the present study allow the suggestion that MetS and inflammation might be mainly responsible for the aforementioned features. More studies are needed to verify whether drugs or food, which yield increased adiponectinemia and decreased oxidative stress, could reduce cardiovascular risk in HIV-infected patients.
Assuntos
Adiponectina/deficiência , Fármacos Anti-HIV/uso terapêutico , Infecções por HIV/complicações , Síndrome Metabólica/sangue , Erros Inatos do Metabolismo/etiologia , Estresse Oxidativo , Adiponectina/sangue , Adulto , Antioxidantes/metabolismo , Biomarcadores/sangue , Doenças Cardiovasculares/etiologia , Feminino , Infecções por HIV/tratamento farmacológico , Infecções por HIV/metabolismo , Infecções por HIV/virologia , HIV-1/crescimento & desenvolvimento , Humanos , Inflamação/metabolismo , Masculino , Síndrome Metabólica/complicações , Erros Inatos do Metabolismo/sangue , Pessoa de Meia-Idade , Análise Multivariada , Carbonilação Proteica , Ácido Úrico/sangueRESUMO
Prolactinomas are prolactin-secreting neoplasias accounting for 40% of the pituitary adenomas. Much is known about the effects of prolactinomas on the reproductive system, but few data are yet available regarding their induced changes on metabolism. This study was aimed at evaluating patients with prolactinomas for insulin resistance and adiponectinemia. Forty patients with prolactinoma were allocated to 2 different groups according to disease control: 20 with uncontrolled disease (UPRL) and 20 with controlled disease in the last 6 months (CPRL). Forty healthy individuals (CG) matched for age, sex, and body mass index were taken as controls. Patients with prolactinoma were compared both as a one group and according to disease control with CG. All subjects were evaluated for waist/hip ratio (WHR), blood pressure, lipid profile, fasting glucose, homeostasis assessment model of insulin resistance (HOMAIR), and adiponectin. Patients with prolactinomas (UPRL+CPRL) showed higher insulin (p<0.05) and HOMAIR (p<0.05), alongside with lower adiponectin levels (p<0.01) than matched controls. When UPRL was compared to CPRL and CG, UPRL was disclosed as a subgroup of significant altered metabolic profile as related to WHR (p<0.01 for comparisons), high-density lipoprotein cholesterol (p<0.05 for comparisons), triglycerides (p<0.05 for comparisons), HOMAIR (p<0.05 and p<0.01, respectively), and adiponectin (p<0.01 for comparisons). All these metabolic abnormalities, except hypoadiponectinemia (p<0.01), were not observed in CPRL. These data suggest that prolactinomas are associated with hypoadiponectinemia, which is further exacerbated in uncontrolled patients when insulin resistance is also prominent.
Assuntos
Erros Inatos do Metabolismo/etiologia , Neoplasias Hipofisárias/complicações , Prolactinoma/complicações , Adiponectina/sangue , Adiponectina/deficiência , Adulto , Glicemia/análise , Estudos de Casos e Controles , HDL-Colesterol/sangue , Feminino , Humanos , Insulina/sangue , Resistência à Insulina , Masculino , Erros Inatos do Metabolismo/sangue , Neoplasias Hipofisárias/sangue , Prolactinoma/sangue , Triglicerídeos/sangueRESUMO
We report a family who experienced an unexplained neonatal death. Twelve years after the death, we retrospectively diagnosed multiple acyl-coenzyme A dehydrogenase deficiency by demonstrating an abnormal acyl-carnitine profile in the child's archived newborn screening card, using tandem mass spectrometry.
Assuntos
Flavoproteínas Transferidoras de Elétrons , Ácidos Graxos Dessaturases/deficiência , Proteínas Ferro-Enxofre , Erros Inatos do Metabolismo/etiologia , Complexos Multienzimáticos/deficiência , Oxirredutases atuantes sobre Doadores de Grupo CH-NH , Morte Súbita do Lactente/etiologia , Acil-CoA Desidrogenase , Humanos , Recém-Nascido , Espectrometria de Massas , Triagem Neonatal , Estudos Retrospectivos , Morte Súbita do Lactente/sangueRESUMO
EL presente trabajo estuvo dirigido a anlizar el avance en el campo de los errores innatos del metabolismo, tanto en el diagnóstico por el laboratorio como en el conocimiento de estas enfermedades en Colombia. Se analizo la forma como se remiten los pacientes, la procedencia de los mismos, la especialidad de los medicos remitentes, la impresion diagnostica y el diagnostico final. Los estudios del laboratorio se enfocaron tomando como base el diagnostico presuntivo, luego se aplicaron baterias de tipo general para carbohidratos, aminoacidopatias, acidurias organicas o para desordenes neurodegenerativos y se fue profundizando hasta llegar al analisis de la enzima o proteina que define el diagnostico. Para tres enfermedades hemos llegado al nivel de DNA. Hace 5 años publicamos los hallazgos efectuados en este campo en la población colombiana. La comparación entre los dos estudios permite evaluar ele avance logrado especialmente con la introduccion de la cromatografia de gas acoplada a la espectometria de masas, para el diagnostico de las acidemias organicas, de nuevas tecnicas enzimaticas para el diagnostico de mucopolisacaridosis y enfermedades neurodegenerativas. Las acidurias glutarica tipo I, tipo II, la piroglutamica y la 3 OH, 3 metilglutarica son los primeros casos que se reportan en Colombia. El porcentaje de pacientes remitidos sin impresion diagnostica o con solicitud de estudio metabolico no definido, bajo del 75 porciento al 25 porciento; lo anterior permite concluir que hemos hecho notables avances diagnosticos y por laboratorio de los EIM en Colombia
Assuntos
Humanos , Erros Inatos do Metabolismo/diagnóstico , Colômbia , Erros Inatos do Metabolismo/classificação , Erros Inatos do Metabolismo/tratamento farmacológico , Erros Inatos do Metabolismo/epidemiologia , Erros Inatos do Metabolismo/etiologia , Erros Inatos do Metabolismo/fisiopatologiaAssuntos
Humanos , Erros Inatos do Metabolismo/classificação , Erros Inatos do Metabolismo/complicações , Erros Inatos do Metabolismo/diagnóstico , Erros Inatos do Metabolismo/dietoterapia , Erros Inatos do Metabolismo/tratamento farmacológico , Erros Inatos do Metabolismo/enzimologia , Erros Inatos do Metabolismo/epidemiologia , Erros Inatos do Metabolismo/etiologia , Erros Inatos do Metabolismo/fisiopatologia , Erros Inatos do Metabolismo/terapiaRESUMO
O autor revisa aqui erros inatos do metabolismo (EIM) que podem ter crises convulsivas entre suas manifestaçöes clínicas. Os mecanismos epileptogênicos distintos de cada EIM säo abordados ou ao menos sugeridos e, a seguir dá-se um roteiro de abordagem diagnóstica das convulsöes, com possível etiologia metabólica