RESUMO
Our aim was to investigate the effects of 12 weeks of CT (ie, high-intensity interval and resistance training) in Mapuche adults from Chile and in their peers of European descent. In total, 96 hyperglycemic adult women (mean age 46 years [95% confidence interval; 38, 53]) were divided in four groups: Mapuche CT (Map-CT, n = 14) or control group (Map-CG, n = 44), and European CT (Eur-CT, n = 14) or control group (Eur-CG, n = 23). The following endpoints were analyzed at baseline and after 12 weeks: anthropometric (body mass, body mass index, waist circumference), body composition (fat mass, muscle mass, lean mass), cardiovascular (systolic [SBP]/diastolic [DBP] blood pressure), metabolic (blood fasting glucose and total cholesterol), and muscle strength (handgrip of dominant/non-dominant arm). There were significant positive changes in body mass, body fat, and muscle mass (P < 0.0001) in both Map-CT and Eur-CT groups, whereas waist circumference was decreased significantly only in the Eur-CT group (P < 0.0001). Both Map-CT and Eur-CT groups showed decreased levels of fasting glucose (P < 0.05) and total cholesterol after the intervention (P < 0.0001). Also, both Map-CT (P < 0.05) and Eur-CT (P = 0.01) groups showed a lowered SBP. Finally, significant increases were observed after training in handgrip strength (dominant arm) in Map-CT and Eur-CT groups (both P < 0.0001). CT led to similar improvements in cardiometabolic risk factors for metabolic syndrome development in Mapuche and European participants, with additional improvements in other anthropometric, body composition, cardiovascular, metabolic, and muscle strength parameters related to the prevention of metabolic syndrome. These results suggest future more complex studies.
Assuntos
Doenças Cardiovasculares/etnologia , Treinamento Intervalado de Alta Intensidade , Hiperglicemia/etnologia , Síndrome Metabólica/etnologia , Treinamento Resistido , Adulto , Idoso , Glicemia/análise , Pressão Sanguínea , Composição Corporal , Índice de Massa Corporal , Doenças Cardiovasculares/prevenção & controle , Chile , Colesterol/sangue , Feminino , Força da Mão , Humanos , Hiperglicemia/fisiopatologia , Indígenas Sul-Americanos , Síndrome Metabólica/prevenção & controle , Pessoa de Meia-Idade , Fatores de Risco , Circunferência da CinturaRESUMO
OBJECTIVE: To evaluate the metabolic profile of Chilean and Argentinian women with polycystic ovary syndrome (PCOS) according to the Rotterdam criteria. DESIGN: Observational cross-sectional study. SETTING: Academic centers. PATIENT(S): Women with PCOS, aged 18-39 years: 220 Chilean (PCOSCh) and 206 Argentinian (PCOSAr). INTERVENTION(S): Physical examination, fasting blood samples for androgens, gonadotropins, metabolic parameters, and a transvaginal ultrasound. MAIN OUTCOME MEASURE(S): Comparative analysis of the metabolic profile in both populations divided into four phenotypes. RESULT(S): The distribution of the different phenotypes was different in both populations. PCOSCh women showed a higher body mass index and a higher percentage of metabolic syndrome in all phenotypes compared with the PCOSAr women. The PCOSAr women exhibited a statistically significantly higher diastolic blood pressure in phenotypes A, B, and C and a higher percentage of hypertension in phenotypes A and D compared with the PCOSCh women. CONCLUSION(S): The data show differences in the metabolic profile of both populations. PCOSCh women presented with greater metabolic alterations such as dysglycemia and dyslipidemia and a higher prevalence of metabolic syndrome, independent of the phenotype. The PCOSAr patients showed more elevated blood pressure. Ethnic diversity associated with environmental factors are fundamental elements in the analysis of the PCOS phenotypes.
Assuntos
Etnicidade , Síndrome Metabólica/etnologia , Síndrome do Ovário Policístico/etnologia , Adolescente , Adulto , Androgênios/sangue , Argentina/epidemiologia , Biomarcadores/sangue , Índice de Massa Corporal , Chile/epidemiologia , Estudos Transversais , Dislipidemias/diagnóstico , Dislipidemias/etnologia , Jejum/sangue , Feminino , Gonadotropinas/sangue , Humanos , Hiperglicemia/diagnóstico , Hiperglicemia/etnologia , Hipertensão/diagnóstico , Hipertensão/etnologia , Modelos Logísticos , Síndrome Metabólica/sangue , Síndrome Metabólica/diagnóstico , Análise Multivariada , Razão de Chances , Fenótipo , Síndrome do Ovário Policístico/sangue , Síndrome do Ovário Policístico/diagnóstico por imagem , Prevalência , Fatores de Risco , Ultrassonografia , Adulto JovemRESUMO
Altered sex hormone levels are thought to play an important role in adult-onset diseases including obesity, cardiovascular disease, and diabetes. They contribute to these complex diseases through changes in their availability, which is influenced, in part, by binding proteins. Insulin resistance, which is characteristic of these diseases, along with increased insulin secretion, is a physiologic change that occurs normally during pregnancy. To determine the relationship between insulin resistance and sex hormone levels, we examined the associations of sex hormone-binding globulin (SHBG) and testosterone with measures of glycemia and insulinemia in a healthy pregnant population. We measured fasting serum SHBG and testosterone levels in 215 Hispanic mothers of Mexican ancestry from the HAPO Study cohort and tested for associations between SHBG and testosterone levels and maternal plasma glucose and C-peptide. After adjusting for confounding variables, serum total testosterone (TT) was positively associated with fasting C-peptide (0.18 µg/l higher for TT higher by 1 SD, p=0.001) and 1-h C-peptide (0.79 µg/l higher for TT higher by 1 SD, p<0.001). Free testosterone (FT) was also positively associated with fasting C-peptide (0.19 µg/l higher for FT higher by 1 SD, p<0.001), and 1-h C-peptide (0.83 µg/l higher for FT higher by 1 SD, p<0.001). Although these findings are from a single cohort, this study provides evidence for an association between testosterone and C-peptide during pregnancy in a nondiabetic Hispanic obstetric population.
Assuntos
Peptídeo C/sangue , Hiperglicemia/sangue , Complicações na Gravidez/sangue , Testosterona/sangue , Glicemia/metabolismo , Estudos de Coortes , Feminino , Humanos , Hiperglicemia/etnologia , Insulina/sangue , Americanos Mexicanos , México/etnologia , Gravidez , Complicações na Gravidez/etnologia , Resultado da Gravidez , Globulina de Ligação a Hormônio Sexual/metabolismo , Estados UnidosRESUMO
OBJECTIVE: Diabetes is a major cause of functional decline among older adults, but the role of glycemic control remains unclear. This article assesses whether better glycemic control is associated with better maintenance of lower-extremity function over time in older adults with diabetes. RESEARCH DESIGN AND METHODS: Participants (n = 119) in the San Antonio Longitudinal Study of Aging, ages 71-85, who met American Diabetes Association diabetes criteria were followed over a 36-month period. Seven measures of A1C (HbA(1c)) were obtained at 6-month intervals; three measures of lower-extremity function were obtained at 18-month intervals using the Short Physical Performance Battery (SPPB). A two-step analytic approach was used, first, to identify distinct glycemic control classes using latent growth mixture modeling and, second, to examine trajectories of lower-extremity function based on these classes using path analysis. RESULTS: Two glycemic control classes were identified: a poorer control class with higher means (all >7%) and higher within-subject variability in HbA(1c) and a better control class with lower means (all <7%) and lower within-subject variability. The short-term and long-term maintenance of lower-extremity function, assessed by the association between the first and second SPPB measures and the first and third SPPB measures, were both greater in the better control class than in the poorer control class. CONCLUSIONS: Among older adults with diabetes, better glycemic control may improve both short-term and long-term maintenance of lower-extremity function.
Assuntos
Complicações do Diabetes/etnologia , Hiperglicemia/etnologia , Americanos Mexicanos/estatística & dados numéricos , Limitação da Mobilidade , População Branca/estatística & dados numéricos , Atividades Cotidianas , Idoso , Idoso de 80 Anos ou mais , Envelhecimento , Complicações do Diabetes/tratamento farmacológico , Avaliação da Deficiência , Feminino , Humanos , Hiperglicemia/tratamento farmacológico , Incidência , Perna (Membro) , Estudos Longitudinais , Masculino , Atividade Motora , PrevalênciaRESUMO
OBJECTIVE: We investigated whether lifestyle-induced changes in dietary fat quality are related to improvements on glucose metabolism disturbances in Japanese Brazilians at high risk of type 2 diabetes. METHODS: One hundred forty-eight first- and second-generation subjects with impaired glucose tolerance or impaired fasting glycemia who attended a lifestyle intervention program for 12 mo were studied in the city of Bauru, State of São Paulo, Brazil. Dietary fatty acid intakes at baseline and after 12 mo were estimated using three 24-h recalls. The effect of dietary fat intake on glucose metabolism was investigated by multiple logistic regression models. RESULTS: At baseline, mean +/- standard deviation age and body mass index were 60+/-11 y and 25.5+/-4.2kg/m(2), respectively. After 12 mo, 92 subjects had normal plasma glucose levels and 56 remained in prediabetic conditions. Using logistic regression models adjusted for age, gender, generation, basal intake of explanatory nutrient, energy intake, physical activity, and waist circumference, the odds ratios (95% confidence intervals) for reversion to normoglycemia were 3.14 (1.22-8.10) in the second tertile of total omega-3 fatty acid, 4.26 (1.34-13.57) in the second tertile of eicosapentaenoic acid, and 2.80 (1.10-7.10) in the second tertile of linolenic acid. Similarly, subjects in the highest tertile of omega-3:omega-6 fatty acid ratio showed a higher chance of improving glucose disturbances (2.51, 1.01-6.37). CONCLUSIONS: Our findings support the evidence of an independent protective effect of omega-3 fatty acid and of a higher omega-3:omega-6 fatty acid ratio on the glucose metabolism of high-risk individuals.
Assuntos
Glicemia , Dieta , Ácidos Graxos Ômega-3/administração & dosagem , Ácidos Graxos Ômega-6/administração & dosagem , Intolerância à Glucose/dietoterapia , Hiperglicemia/dietoterapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Registros de Dieta , Método Duplo-Cego , Ácido Eicosapentaenoico/administração & dosagem , Feminino , Intolerância à Glucose/etnologia , Humanos , Hiperglicemia/etnologia , Japão/etnologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Ácido alfa-Linolênico/administração & dosagemRESUMO
The metabolic syndrome was designed to identify individuals at high risk for the development of type 2 diabetes and cardiovascular disease. Compared with whites, blacks have higher rates of diabetes and cardiovascular disease. Paradoxically, blacks have a lower prevalence of the metabolic syndrome. According to the criteria set by National Cholesterol Education Treatment Program-Adult Treatment Panel III, to diagnose the metabolic syndrome, 3 of 5 characteristics must be present. These characteristics are low high-density lipoprotein levels, increased triglyceride levels, central obesity, hypertension, and fasting hyperglycemia. Examining each of these factors individually, blacks are more likely than whites to have obesity, hypertension, and diabetes. In contrast, blacks are less likely than whites to have either elevated triglyceride or low high-density lipoprotein levels. Ethnic differences in lipid levels may largely explain why blacks have a lower than expected prevalence of the metabolic syndrome. In this review we will describe in children and adults ethnic differences in the epidemiologic study of conditions associated with the metabolic syndrome, as well as focus on each of the parameters of the metabolic syndrome. Overall, we conclude that an ethnic-specific formulation of the lipid criteria in the metabolic syndrome may lead to better identification of blacks at high risk for development of diabetes and cardiovascular disease.
Assuntos
Negro ou Afro-Americano/estatística & dados numéricos , Lipoproteínas HDL/sangue , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/etnologia , Triglicerídeos/sangue , Adulto , Fatores Etários , Índice de Massa Corporal , Criança , Pré-Escolar , Diabetes Mellitus/etnologia , Dislipidemias/etnologia , Humanos , Hiperglicemia/etnologia , Hipertensão/etnologia , Resistência à Insulina/etnologia , Síndrome Metabólica/sangue , Obesidade/etnologia , Fatores de Risco , Estados Unidos/epidemiologia , Adulto JovemRESUMO
OBJECTIVES: To evaluate factors related to the incidence of diabetic retinopathy (DR) in a population of African descent, after 9 years of follow-up. DESIGN: Population-based cohort study; 81% participation after 9 years. PARTICIPANTS: Three hundred twenty-four participants of the Barbados Eye Studies, with diabetes mellitus (DM) at baseline and at risk for developing DR during follow-up. METHODS: Diabetes-related changes were assessed by masked gradings of baseline and follow-up photographs using a standardized system. The 9-year cumulative incidence of DR was based on participants with DM and free of retinopathy at baseline; incidence rates were estimated by the product-limit approach. Cox regression models for discrete-time data were used to evaluate risk factors associated with the 9-year incidence of DR. RESULTS: Multivariate analyses revealed that older age at DM onset decreased the 9-year risk of DR development; for each 10 years of older age at onset, the risk of DR decreased by 30% (risk ratio [RR], 0.7; 95% confidence interval [CI], 0.56-0.96). The risk of DR doubled among persons with DM duration between 5 and 9 years (RR, 2.1; 95% CI, 1.2-3.6) versus those with shorter durations; it also doubled in those treated with oral medications or insulin at baseline versus those treated with diet only. Antihypertensive treatment halved the risk of DR versus no treatment (RR, 0.5; 95% CI, 0.3-0.9) and high systolic or diastolic blood pressure (BP) increased risk. Thus, DR risk increased by 30% for every 10 mmHg of higher systolic BP at baseline (RR, 1.3; 95% CI, 1.1-1.4) or of BP increase from baseline to the 4-year follow-up (RR, 1.3; 95% CI, 1.1-1.4). Diabetic retinopathy risk similarly increased with each 1% of higher glycosylated hemoglobin level at baseline (RR, 1.3; 95% CI, 1.2-1.5). CONCLUSIONS: The long-term follow-up of persons with DM in this population of African origin, where disease prevalence is high, identified important potentially modifiable risk factors for DR. Findings suggest that efforts to achieve optimal glycemic and BP control may reduce the vision-threatening complications of DM.
Assuntos
População Negra , Pressão Sanguínea , Retinopatia Diabética/etnologia , Hiperglicemia/etnologia , Hipertensão/etnologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Anti-Hipertensivos/uso terapêutico , Barbados/epidemiologia , Estudos de Coortes , Retinopatia Diabética/tratamento farmacológico , Retinopatia Diabética/fisiopatologia , Progressão da Doença , Feminino , Seguimentos , Humanos , Hiperglicemia/tratamento farmacológico , Hiperglicemia/fisiopatologia , Hipertensão/tratamento farmacológico , Hipertensão/fisiopatologia , Incidência , Insulina/uso terapêutico , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de RiscoRESUMO
OBJECTIVE: To evaluate risk factors for the 4-year incidence of cortical and posterior subcapsular (PSC) lens opacities. DESIGN: Population-based cohort study with 85% participation at 4-year follow-up. PARTICIPANTS: Three thousand one hundred ninety-three black participants of the Barbados Eye Studies, Barbados, West Indies, of whom 2040 and 2954 were free of cortical and PSC lens opacities, respectively, at baseline. METHODS: The standardized protocol at baseline and follow-up included an interview, anthropometric and blood pressure measurements, and ophthalmic measurements including slitlamp lens grading, fundus photography, and an ophthalmologic examination. Factors associated with incident cortical and PSC opacities (Lens Opacities Classification System II, > or =2) were evaluated by logistic regression. Main Outcome Measure Relative risks (RRs) with 95% confidence intervals. RESULTS: The 4-year incidence of cortical lens opacities was 22.2% (452/2040); the factors increasing risk were older age, female gender (RR = 1.3), low socioeconomic status (RR = 1.4), and a history of diabetes mellitus (RR = 2.4), while aspirin use was associated with a lower RR (RR = 0.2; 95% confidence interval, 0.1-0.8), a result based on small numbers. The 4-year incidence of PSC opacities was lower at 3.3% (97/2954), and risk also increased with age and a history of diabetes mellitus (RR = 2.9). A dose-response relationship was evident between incident opacities and increased levels of glycosylated hemoglobin at baseline, with the highest risk of cortical (RR = 3.60; 95% confidence interval, 2.23-5.81) and PSC (RR = 4.93; 95% confidence interval, 2.69-9.05) opacities at more than an 11.5% glycosylated hemoglobin level. CONCLUSIONS: Diabetes mellitus and hyperglycemia are major modifiable risk factors for the development of cortical and PSC lens opacities in this African-descent population with a high rate of diabetes mellitus. Prevention and improved control of diabetes mellitus are likely to reduce the burden of cataract. The finding of a reduced incidence of cortical lens opacities in aspirin users merits further investigation, given its potential for cataract prevention.