Navegando por Palavras-chave "Resistência insulínica"

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    Acesso aberto (Open Access)
    Avaliação da doença hepática gordurosa não alcoólica em pacientes com ataxia-telangiectasia: associação com biomarcadores relacionados ao metabolismo da glicose
    (Universidade Federal de São Paulo (UNIFESP), 2015-07-31) Rafael, Marina Neto [UNIFESP]; Sarni, Roseli Oselka Saccardo [UNIFESP];   Costa-Carvalho, Beatriz Tavares [UNIFESP]; http://lattes.cnpq.br/1072990929102111; http://lattes.cnpq.br/1760819469047929; http://lattes.cnpq.br/8688005976305799; Universidade Federal de São Paulo (UNIFESP)
    Introdução:A ataxia telangiectasia (A-T) é uma doença neurodegenerativa, que cursa com imunodeficiência em graus variáveis, disfunção mitocondrial, exacerbação do estresse oxidativo e risco aumentado para o desenvolvimento de diabetes e aterosclerose. Objetivo: Avaliar a presença de esteatose hepática e de alterações na alanina aminotransferase (ALT) em pacientes com A-T e verificar a associação com biomarcadores relacionados ao metabolismo lipídico e da glicose. Métodos: Estudo transversal envolvendo os pacientes com diagnóstico de A-T (n=18), de ambos os sexos, com idades entre 5 e 25 anos. Foram avaliados: estado nutricional, ultrassonografia (US) hepática, biomarcadores relacionados ao metabolismo lipídico, da glicose (teste de tolerância oral à glicose com determinação da insulina), função hepática, perfil lipídico e proteína C reativa ultrassensível. Resultados:A mediana de idade foi de 13,1 anos (5,0;25,4); 15 (83%) eram do gênero masculino e 9 (50%) pré-púberes. Desnutrição foi observada em 6/18 (33,5%), dislipidemia em 10/18 (55,5%), alteração do metabolismo de glicose em 8/12 (66,6%), sendo um paciente diabético. Esteatose hepática foi avaliada por US em 11/17 (61,1 %) pacientes, e 7/17 (41,2%) apresentavam esteatohepatite (esteatose hepática e ALT > 40 U/L). As concentrações de ALT correlacionaram-se de forma direta com a idade (r = 0,792; p < 0,001) e soma de insulina (r = 0,782; p = 0,004), sendo esta, maior nos pacientes com esteatose e esteatohepatite em relação aos sem alterações hepáticas [sem esteatose: 82,2 uU/L (19,1;153,3) vs com esteatose: 148,1 uU/L (63,2; 415,9) vs com esteatohepatite 590 uU/L (194,8;2431,9); p = 0,047]. Conclusão: Pacientes com A-T apresentam alterações hepáticas sugestivas de esteatohepatite que se associaram com resistência insulínica. Tais alterações podem complicar a evolução da doença.
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    Ovarian activity before and after gonadal suppression by GnRH-a in patients with polycystic ovary syndrome, hyperandrogenism, hyperinsulinism and acanthosis nigricans
    (Associação Médica Brasileira, 1998-06-01) Motta, Eduardo Leme Alves da [UNIFESP]; Baracat, Edmund Chada [UNIFESP]; Haidar, Mauro Abi [UNIFESP]; Juliano, I. [UNIFESP]; Lima, Geraldo Rodrigues de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVE: To investigate the ovarian activity before and after gonadal suppression with GnRH-analog in patients with PCO, hyperandrogenism, hyperinsulinism and acanthosis nigricans. DESIGN: Controlled clinical study. SETTING: Tertiary academic medical center. PATIENTS: Six patients with clinical findings of PCO, hirsutism and acanthosis nigricans. INTERVENTIONS: Morning blood samples in the follicular phase to determine the steroid levels, glucose and insulin curve, comparing to a control group. Administration for 2 consecutive months of a GnRH-analog, comparing, in the study group, the free testosterone levels before and after ovarian suppression. MAIN OUTCOME MEASURE: Determination of insulin levels in PCO, hirsutism and acanthotic patients and the free-testosterone levels before and after gonadal suppression. RESULTS: Insulin levels were significantly higher in the study group when compared to normal women during the glycemic test. We also found a significant decrease in the free-testosterone levels after 2 months of gonadal suppression with GnRH-analog when compared to the initial time. CONCLUSIONS: Patients with PCO, hirsutism and acanthosis nigricans present high levels of insulin, suggesting an ovarian hyperesponsiveness, which is not sustained when gonadotrophic blockage was achieved.
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    Resistência insulínica em adolescentes
    (Universidade Federal de São Paulo (UNIFESP), 2010-02-24) Cavali, Monica de Lima Raeder [UNIFESP]; Schimith Escrivão, Maria Arlete Meil [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Objective: To evaluate the effect of insulin resistance (IR) in adolescents with and without excess weight. Design and Methods: We performed a cross-sectional study with 334 adolescents of both sexes aged 14-19 years and Tanner stage≥4. Body mass index (BMI), arterial blood pressure, glycemia, insulin, lipid profile, hepatic transaminases, steatosis by ultrasonography and body composition by Dual x-ray absorptiometry (DXA) were evaluated. IR was calculated by HOMA-IR. Results: Adolescents with IR had significantly higher means for BMI, arterial blood pressure, total and trunk fat mass, and higher risks (OR) for excess weight (24.67), presence of steatosis (5.41), hypertension (2.51) and low high-density lipoprotein cholesterol (HDLc) (2.22). Conclusions: The group of adolescents with IR had higher risks for metabolic disorders and elevated BMI. These results emphasize the need of early recognition and adequate treatment of excess weight.
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    Acesso aberto (Open Access)
    Síndrome metabólica: comparação de critérios diagnósticos
    (Sociedade Brasileira de Pediatria, 2010-08-01) Cavali, Monica de Lima Raeder [UNIFESP]; Schimith Escrivão, Maria Arlete Meil [UNIFESP]; Brasileiro, Rosana Sarmento [UNIFESP]; Taddei, Jose Augusto de Aguiar Carrazedo [UNIFESP]; Universidade Estadual de Campinas (UNICAMP); Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVE: To propose a new criterion for the diagnosis of metabolic syndrome (MS) in adolescents and to check its consistency with those proposed by Jolliffe and Janssen and by the International Diabetes Federation (IDF). METHOD: This is a cross-sectional study of 80 obese adolescents aged 14 to 19 years. Anthropometric (weight, height, and waist circumference) and laboratory (fasting triglycerides, HDLc, glucose, and insulin) parameters, as well as blood pressure were evaluated. The HOMA-IR index was used to characterize insulin resistance, and the presence of steatosis was assessed by hepatic ultrasound. Agreement analyses across the three criteria were made using the kappa coefficient. RESULTS: The prevalence of MS was 13.5, 15, and 25% for IDF and Jolliffe and Janssen's criteria and the proposed method, respectively. A nearly perfect agreement between Jolliffe and Janssen's and IDF (kappa = 0.94) criteria and a moderate agreement between the new criteria and the previous two (kappa = 0.46 and 0.41, respectively) were observed. CONCLUSIONS: The highest prevalence of MS was observed with the criterion proposed in this study, which included steatosis and insulin resistance as parameters, thus being able to diagnose a larger number of adolescents at metabolic risk.