Navegando por Palavras-chave "Metabolic syndrome X"
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- ItemAcesso aberto (Open Access)Association between sex hormone-binding globulin (SHBG) and metabolic syndrome among men(Associação Paulista de Medicina - APM, 2014-01-01) Callou, Emmanuela Quental [UNIFESP]; Sá, Francisco Carleial Feijó de; Oliveira, Kelly Cristina de [UNIFESP]; Feres, Fausto; Verreschi, Ieda Therezinha do Nascimento [UNIFESP]; Universidade Federal do Ceará; Universidade Federal de São Paulo (UNIFESP); Instituto Dante Pazzanese de CardiologiaCONTEXT AND OBJECTIVE:Metabolic syndrome consists of a set of factors that imply increased risk of cardiovascular diseases. The objective here was to evaluate the association between sex hormone-binding globulin (SHBG), sex hormones and metabolic syndrome among men.DESIGN AND SETTING:Retrospective analysis on data from the study Endogenous oestradiol but not testosterone is related to coronary artery disease in men, conducted in a hospital in São Paulo.METHODS:Men (aged 40-70) who underwent coronary angiography were selected. The age, weight, height, waist circumference, body mass index and prevalence of dyslipidemia, hypertension and diabetes of each patient were registered. Metabolic syndrome was defined in accordance with the criteria of the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (NCEP-ATPIII). Serum samples were collected to assess the levels of glucose, total cholesterol, HDL-cholesterol (high density lipoprotein), triglycerides, albumin, SHBG, estradiol and total testosterone (TT). The levels of LDL-cholesterol (low density lipoprotein) were calculated using Friedewald's formula and free testosterone (FT) and bioavailable testosterone (BT) using Vermeulen's formula.RESULTS:141 patients were enrolled in the study. The prevalence of metabolic syndrome was significantly higher in the first SHBG tercile than in the second and third terciles. A statistically significant positive association between the SHBG and TT values was observed, but no such association was seen between SHBG, BT and FT.CONCLUSION:Low serum levels of SHBG are associated with higher prevalence of metabolic syndrome among male patients, but further studies are required to confirm this association.
- ItemAcesso aberto (Open Access)Consenso Brasileiro sobre antipsicóticos de segunda geração e distúrbios metabólicos(Associação Brasileira de Psiquiatria - ABP, 2008-03-01) Elkis, Helio; Gama, Clarissa Severino; Suplicy, Henrique; Tambascia, Marcos; Bressan, Rodrigo Affonseca [UNIFESP]; Lyra, Ruy; Cavalcante, Saulo; Minicucci, Walter; Universidade de São Paulo (USP); Hospital de Clínicas de Porto Alegre Serviço de Psiquiatria; Associação Brasileira para o Estudo da Obesidade e da Síndrome Metabólica; Sociedade Brasileira de Diabetes; Universidade Federal de São Paulo (UNIFESP); Sociedade Brasileira de Endocrinologia e MetabologiaOBJECTIVE: To discuss current aspects of use of antipsychotics considering their metabolic side effects profile, which includes weight gain, dyslipidemias, diabetes and metabolic syndrome. Such metabolic effects increase the risk of mortality by cardiovascular disease, which is the leading cause of death among schizophrenic patients. METHOD: A consensus meeting was held, with participation of endocrinologists and psychiatrists specialists in schizophrenia and, based on a literature review, an article was elaborated emphasizing practical and helpful recommendations to clinicians. RESULTS AND CONCLUSIONS: Monitoring metabolic side effects is essential to patients taking antipsychotics, particularly in the case of second generation antipsychotics. Efficacy and tolerability should be carefully balanced in all phases of treatment.
- ItemAcesso aberto (Open Access)Consequências metabólicas na SAOS não tratada(Sociedade Brasileira de Pneumologia e Tisiologia, 2010-06-01) Carneiro, Glaucia [UNIFESP]; Fontes, Francisco Hora; Togeiro, Sonia Maria [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Escola Federal de Medicina de Salvador Departamento de Clínica MédicaThere is a recognized association between obstructive sleep apnea syndrome and metabolic syndrome, designated syndrome Z. The criteria for metabolic syndrome include at least three of the following factors: central obesity (waist circumference > 102 cm for males and > 88 cm for females); triglycerides > 150 mg/dL; HDL cholesterol < 40 mg/dL for males and < 50 mg/dL for females; arterial blood pressure > 130/85 mmHg; and fasting glucose > 100 mg/dL. Central obesity is associated with OSAS and metabolic syndrome, and there is evidence that obstructive sleep apnea is an independent risk factor for obesity, glucose intolerance and insulin resistance. The implied mechanisms result from the activation of the sympathetic nervous system and of the hypothalamus-hypophysis-adrenal axis; activation of pro-inflammatory markers, such as IL-6 and TNF-α; and the reduction in adiponectin levels, principally triggered by intermittent hypoxemia related to apnea. Despite such evidence, the results are controversial regarding the benefits of treating sleep apnea with CPAP in the presence of these metabolic alterations. In addition, the few studies that have addressed sleep apnea as a risk factor for dyslipidemia have presented conflicting results. Population-based, longitudinal controlled studies are necessary in order to elucidate the interaction between sleep apnea and metabolic consequences so that these individuals are properly treated.
- ItemAcesso aberto (Open Access)Metabolic syndrome and associated factors in children and adolescents of a Brazilian municipality(Aula Medica Ediciones, 2014-04-01) Dias Pitangueira, Jacqueline Costa; Silva, Luciana Rodrigues; Portela de Santana, Monica Leila; Monteiro da Silva, Maria da Conceicao; Farias Costa, Priscila Ribas de; D'Almeida, Vânia [UNIFESP]; Oliveira Assis, Ana Marlucia de; Univ Fed Reconcavo Bahia; Universidade Federal da Bahia (UFBA); Univ Fed Bahia; Universidade Federal de São Paulo (UNIFESP)Background: the risk factors associated to metabolic syndrome (MS) have been extensively studied in adults, but in children and adolescents it is poorly explored.Objective: To identify the prevalence of MS and associated factors in children and adolescents.Methods: A cross-sectional study with 540 children and adolescents from 7 to 14 years of age. the socioeconomic, demographic and lifestyle data and the family history of chronic diseases were reported by the individual and/or guardian and recorded in a structured questionnaire. Biochemical tests (fasting blood glucose, triacylglycerols, reduced high-density lipoprotein, very-low-density lipoprotein, homocysteine and cysteine), an anthropometric assessment and a blood pressure measurement were performed. MS was defined according to the criteria of the National Cholesterol Education Program Adult Treatment Panel III adapted by Ferranti. A Poisson regression was used to identify the factors statistically associated with MS.Results: the MS prevalence was 12.8%, in which the most frequent component was a decreased high-density lipoprotein level (58.2%), followed by hypertriglyceridemia (41.8%), elevated blood pressure (29.1%), increased waist circumference (26.7%) and hyperglycemia (7.2%). Associations between metabolic syndrome and overweight [prevalence ratio (PR): 2.2 (1.22-3.95)], father education [PR: 2.19 (1.10-4.37)], serum very low-density lipoprotein concentration [PR: 1.08 (1.04-1.11)] and concomitantly increased serum homocysteine and cysteine concentrations [PR: 2.58(1.32-5.04)] were observed.Conclusions: the MS prevalence is high in children and adolescents and it is increased in patients with overweight, higher father education, increased serum very-low-density lipoprotein concentrations and a concomitant serum homocysteine and cysteine high levels.
- ItemAcesso aberto (Open Access)Perfil nutricional e metabólico de adultos do povo Kawaiwete (Kaiabi) da aldeia Kwarujá, Parque Indígena do Xingu, Brasil(Universidade Federal de São Paulo (UNIFESP), 2017-04-28) Haquim, Vanessa Moreira [UNIFESP]; Franco, Maria do Carmo Pinho [UNIFESP]; Pititto, Bianca de Almeida [UNIFESP]; http://lattes.cnpq.br/8433932854107690; http://lattes.cnpq.br/0138099513326464; http://lattes.cnpq.br/3895675896903998; Universidade Federal de São Paulo (UNIFESP)Introdução: As doenças metabólicas têm sido uma das principais causas de morbimortalidade em países desenvolvidos e em desenvolvimento. No entanto, ainda são escassos os estudos que avaliam a ocorrência de doenças como diabetes tipo II, hipertensão, dislipidemias e outras desordens metabólicas associadas à obesidade no campo da saúde indígena. O número crescente do surgimento dessas doenças torna-se motivo de preocupação na medida em que eles indicam uma nova realidade entre os povos indígenas. Objetivo: Avaliar o perfil nutricional e metabólico de adultos indígenas do povo Kawaiwete que habitam a aldeia Kwarujá do Parque Indígena do Xingu no ano de 2013. Métodos: Trata-se de um estudo do tipo transversal, de base populacional, realizado a partir de dados secundários disponibilizados pelo Distrito Sanitário Especial Indígena Xingu (Mato Grosso - Brasil), e de banco de dados obtido por meio de fichas médicas e relatórios técnicos disponibilizados pelo Projeto Xingu, programa de extensão da Universidade Federal de São Paulo. Foram avaliados 62 indígenas (33 mulheres e 29 homens) maiores de 19 anos da etnia Kawaiwete no ano de 2013. Para o estudo atual foram analisadas as frequências de estado nutricional, composição corporal (por meio do aparelho de impedância bioelétrica modelo tetrapolar) e fatores de risco cardiometabólicos. A síndrome metabólica foi determinada pela presença de pelo menos três dos seguintes componentes: obesidade central, níveis pressóricos elevados, hipertrigliceridemia, baixo HDL-colesterol e intolerância à glicose. Para a análise estatística, utilizou-se o programa SPSS® (versão 22). Resultados: Do total dos 62 indígenas avaliados identificou-se em 25,8% a presença de síndrome metabólica. Em relação ao perfil nutricional e de fatores de risco cardiometabólicos, 35,5% apresentaramsobrepeso, 4,8% obesidade, 24,2% níveis pressóricos elevados, 25,8% pré-diabetes, 29,0% LDL-c elevado, 67,7% HDL-c reduzido e 17,7% hipertrigliceridemia. Em comparação aos homens, as mulheres apresentaram pior perfil cardiometabólico no que se refere à presença de obesidade central (31,0% vs.81,8%, p=<0,001), tolerância à glicose diminuída (4,8% vs.17,7%, p=0,031), LDL-colesterol elevado (13,8% vs. 42,4%, p=0,013) e à média do percentual de massa adiposa (16,5±6,1 vs. 26,7±6,3, p=<0,001). Apesar de não haver diferença estatisticamente significativa, as mulheres apresentaram 33,3% de síndrome metabólica, enquanto os homens apresentaram 17,2%. Os resultados mostraram que todos os indígenas que possuíam a síndrome apresentaram obesidade central, porém nem todos tinham IMC elevado, portanto, a medida da circunferência abdominal se apresentou um melhor parâmetro do que o índice de massa corporal (IMC) para identificar o perfil de risco cardiometabólico nessa população. Observou-se que, entre os indígenas, o IMC, a circunferência abdominal e o percentual de massa adiposa também se associaram de forma direta com a presença síndrome metabólica, enquanto que o percentual de massa muscular de forma indireta. Na análise de regressão múltipla, essas variáveis persistiram correlacionadas de forma independente de sexo e idade com a síndrome metabólica. Conclusão: O presente estudo possibilitou a identificação de uma população que se encontra com um risco cardiometabólico elevado, sendo o sexo feminino o grupo mais comprometido. Esforços devem ser empreendidos no sentido de compreender melhor os determinantes dessa situação de saúde e de controlar os fatores de risco para esta população.
- ItemAcesso aberto (Open Access)Relationship between cardiovascular risk factors and the echogenicity and pattern of the carotid intima-media complex in men(Associação Paulista de Medicina - APM, 2014-01-01) Sarmento, Priscilla Lopes da Fonseca Abrantes [UNIFESP]; Plavnik, Frida Liane; Scaciota, Andrea; Lima, Joab Oliveira; Miranda, Robson Barbosa; Ajzen, Sergio Aron [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade Federal da Paraíba Department of Statistics; Faculdade de Medicina do ABC Department of SurgeryCONTEXT AND OBJECTIVE:The thickness of the carotid intima-media complex (C-IMC) is considered to be a marker of early atherosclerosis, but visual and echogenic changes to the C-IMC can also be noted. The objective here was to evaluate the relationship between cardiovascular risk factors and the echogenicity of the C-IMC and identify those most associated with an abnormal C-IMC.DESIGN AND SETTING:Cross-sectional study in the ultrasound sector of the Department of Diagnostic Imaging, Universidade Federal de São Paulo.METHODS:Eighty men were evaluated. Measurements of arterial blood pressure, waist circumference (WC), lipid profile, fasting glucose, uric acid and high-sensitivity C-reactive protein were obtained. The thickness of the C-IMC was measured by means of B-mode ultrasound, and the intima-media gray-scale mean (IM-GSM) and standard deviation (IM-SD) were calculated.RESULTS:The following were discriminating variables: fasting glucose (r2 = 0.036; P = 0.013), uric acid (r2 = 0.08; P = 0.03), IM-SD (r2 = 0.43; P < 0.001), IM-GSM (r2 = 0.35; P < 0.001) and thickness of the C-IMC (r2 = 0.29; P < 0.001). IM-GSM showed significant correlations with WC (r = -0.22; P = 0.005), fasting glucose (r = -0.24; P = 0.002) and high-density lipoprotein cholesterol (HDL-C) (r = 0.27; P = 0.0007).CONCLUSION:IM-GSM showed correlations with WC, fasting glucose and HDL-C. However, uric acid and IM-SD presented the greatest discriminating impact. These results suggest that visual changes in C-IMC may help identify patients with potential cardiovascular risk, independently of the thickness of the C-IMC.
- ItemSomente MetadadadosVisfatin is a positive predictor of bone mineral density in young survivors of acute lymphocytic leukemia(Springer Japan Kk, 2017) Siviero-Miachon, Adriana Aparecida [UNIFESP]; Spinola-Castro, Angela Maria [UNIFESP]; Lee, Maria Lúcia de Martino [UNIFESP]; Calixto, Antonio Ramos; Geloneze, Bruno; Lazaretti-Castro, Marise [UNIFESP]; Guerra-Junior, GilBone mass acquisition may be compromised in survivors of childhood acute lymphocytic leukemia due to various factors, including adiposity. Fat accumulation can affect bone through the direct effect of adipokines or indirectly through the state of chronic inflammation. The aim of this study was to evaluate the effect of body composition and adipokines on bone mass in survivors of acute lymphocytic leukemia. This was a cross-sectional study of 56 survivors aged between 15 and 24 years, 44.6 % of whom received cranial radiotherapy (18-24 Gy), assessed according to body fat, lean mass, and bone mineral density (dual energy X-ray absorptiometry), computed tomography scan-derived abdominal adipose tissue, and adipokines by a multiple regression analysis. Both lumbar spine L-1-L-4 (trabecular bone) and total body (cortical bone) bone mineral density were positively correlated with visfatin (p < 0.050). Lean mass index was positively correlated, while waist-to-height ratio was negatively correlated with cortical bone (p < 0.010). Low bone mineral density for chronological age was detected in 5.4 % of patients in total body, and 8.9 % at the lumbar spine. In survivors of acute lymphocytic leukemia, visfatin may play an important role in the complex relationship between body composition and bone. At present, visfatin may represent a model for further study of bone metabolism, and could possibly explain the unknown mechanisms linking bone metabolism and cancer.
- ItemAcesso aberto (Open Access)Weight gain, dyslipidemia and altered parameters for metabolic syndrome on first episode psychotic patients after six-month follow-up(Associação Brasileira de Psiquiatria - ABP, 2007-12-01) Attux, Cecília [UNIFESP]; Quintana, Maria Inês [UNIFESP]; Chaves, Ana Cristina [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)OBJECTIVES: Obesity and metabolic abnormalities are frequent in psychotic patients, including first-episode psychosis. We evaluated weight and metabolic parameters in first-episode psychotic outpatients from the First Episode Psychosis Program, Universidade Federal de São Paulo (UNIFESP). METHOD: Weight, height, waist and hip circumferences, glucose and lipid levels were measured at baseline and after a six-month period. RESULTS: Fifty-seven patients were included and 44 (77.2%) of them finished the study. Patients had a median age of 26.3 years, 60% were men and 43% had a diagnosis of schizophrenia at the endpoint. Weight and BMI values increased significantly during the follow-up (p < 0.01). The average weight gain at the follow-up was 10.1% of the baseline weight (SD = 11.9). Only women presented significant waist abnormalities: at the first assessment the waist mean was 79.12 cm (SD = 10.68) and 6 months later it had increased to 89.65 cm (SD = 11.19, z = -3.182, p = 0.001). After 6 months, the total cholesterol (p = 0.004), and triglyceride levels (p = 0.016) increased, while HDL-cholesterol levels decreased (p = 0.025). During the follow-up period one patient (2.3%) developed diabetes mellitus, one (2.3%) presented altered fasting glucose, 12 (27.2%) patients developed at least two altered parameters for metabolic syndrome and 3 (6.8%) patients developed metabolic syndrome (p = 0.001). DISCUSSION: The results of this study showed that in a short period of time individuals under antipsychotic treatment had their weight increased significantly and developed important metabolic abnormalities. CONCLUSIONS: Clinicians should be aware of these risks, choose an antipsychotic that causes less weight gain and should monitor these patients carefully, and recommend prophylactic measures as diet restriction and physical activities.