Melissa Orlandin Premaor, Fabio Vasconcellos Comim, Juliet E Compston
{"title":"Obesity and fractures.","authors":"Melissa Orlandin Premaor, Fabio Vasconcellos Comim, Juliet E Compston","doi":"10.1590/0004-2730000003274","DOIUrl":"https://doi.org/10.1590/0004-2730000003274","url":null,"abstract":"<p><p>Until recently obesity was believed to be protective against fractures. However, a report from a Fracture Liaison Clinic in the UK (2010) reported a surprisingly high proportion of obese postmenopausal women attending the clinic with fractures, and in the GLOW study (2011), a similar prevalence and incidence of fractures in obese and non-obese postmenopausal women was observed. Subsequently, other studies have demonstrated the importance of obesity in the epidemiology of fractures. Obese women are at increased risk of fracture in ankle, leg, humerus, and vertebral column and at lower risk of wrist, hip and pelvis fracture when compared to non-obese women. In men, it has been reported that multiple rib fractures are associated with obesity. Furthermore, falls appear to play an important role in the pathogenesis of fractures in obese subjects. Regarding hip fracture and major fractures, the FRAX algorithm has proven to be a useful predictor in obese individuals. Obese people are less likely to receive bone protective treatment; they have a longer hospital stay and a lower quality of life both before and after fracture. Moreover, the efficacy of antiresorptive therapies is not well established in obese people. The latter is a field for future research. </p>","PeriodicalId":8395,"journal":{"name":"Arquivos brasileiros de endocrinologia e metabologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1590/0004-2730000003274","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32621291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sergio Setsuo Maeda, Victoria Z C Borba, Marília Brasilio Rodrigues Camargo, Dalisbor Marcelo Weber Silva, João Lindolfo Cunha Borges, Francisco Bandeira, Marise Lazaretti-Castro
{"title":"Recommendations of the Brazilian Society of Endocrinology and Metabology (SBEM) for the diagnosis and treatment of hypovitaminosis D.","authors":"Sergio Setsuo Maeda, Victoria Z C Borba, Marília Brasilio Rodrigues Camargo, Dalisbor Marcelo Weber Silva, João Lindolfo Cunha Borges, Francisco Bandeira, Marise Lazaretti-Castro","doi":"10.1590/0004-2730000003388","DOIUrl":"https://doi.org/10.1590/0004-2730000003388","url":null,"abstract":"<p><strong>Objective: </strong>The objective is to present an update on the diagnosis and treatment of hypovitaminosis D, based on the most recent scientific evidence.</p><p><strong>Materials and methods: </strong>The Department of Bone and Mineral Metabolism of the Brazilian Society of Endocrinology and Metabology (SBEM) was invited to generate a document following the rules of the Brazilian Medical Association (AMB) Guidelines Program. Data search was performed using PubMed, Lilacs and SciELO and the evidence was classified in recommendation levels, according to the scientific strength and study type.</p><p><strong>Conclusion: </strong>A scientific update regarding hypovitaminosis D was presented to serve as the basis for the diagnosis and treatment of this condition in Brazil.</p>","PeriodicalId":8395,"journal":{"name":"Arquivos brasileiros de endocrinologia e metabologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1590/0004-2730000003388","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32621286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Francisco Bandeira, Aline G Costa, Manoel Aderson Soares Filho, Larissa Pimentel, Lourena Lima, John P Bilezikian
{"title":"Bone markers and osteoporosis therapy.","authors":"Francisco Bandeira, Aline G Costa, Manoel Aderson Soares Filho, Larissa Pimentel, Lourena Lima, John P Bilezikian","doi":"10.1590/0004-2730000003384","DOIUrl":"https://doi.org/10.1590/0004-2730000003384","url":null,"abstract":"<p><p>Several factors are involved in determining bone quality including bone density, bone turnover, the extent of trabecular bone connectivity, cortical porosity and geometry. Metabolically active and in a continuous process of remodeling, approximately 20% of bone tissue is renewed annually. Bone turn over markers (BTM) are frequently used in clinical trials and to provide valid information about the effectiveness of osteoporosis treatment, reflecting the state of bone metabolism and its response to treatment, although they are not useful alone to estimate bone loss. In this review the behavior of BTM from different clinical trials or different osteoporotic drugs will be addressed. </p>","PeriodicalId":8395,"journal":{"name":"Arquivos brasileiros de endocrinologia e metabologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1590/0004-2730000003384","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32621238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Bone disease in hypoparathyroidism.","authors":"Bart L Clarke","doi":"10.1590/0004-2730000003399","DOIUrl":"https://doi.org/10.1590/0004-2730000003399","url":null,"abstract":"<p><p>Hypoparathyroidism is a rare disorder that may be acquired or inherited. Postsurgical hypoparathyroidism is responsible for the majority of acquired hypoparathyroidism. Bone disease occurs in hypoparathyroidism due to markedly reduced bone remodeling due to the absence or low levels of parathyroid hormone. Chronically reduced bone turnover in patients with hypoparathyroidism typically leads to higher bone mass than in age- and sex-matched controls. Whether this increased bone density reduces fracture risk is less certain, because while increased bone mineralization may be associated with increased brittleness of bone, this does not appear to be the case in hypoparathyroidism. Treatment of hypoparathyroidism with recombinant parathyroid hormone may reduce bone mineral density but simultaneously strengthen the mechanical properties of bone. </p>","PeriodicalId":8395,"journal":{"name":"Arquivos brasileiros de endocrinologia e metabologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1590/0004-2730000003399","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32621243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Juliana de Paulo, Juliana Gabriel Ribeiro de Andrade, Ana Paula dos Santos, Vera Lúcia Gil-da-Silva-Lopes, Gil Guerra-Júnior, Andréa Trevas Maciel-Guerra
{"title":"[The use of FISH on buccal smear to investigate mosaicism with a 45,X cell line: study on healthy men and patients with disorders of sex development].","authors":"Juliana de Paulo, Juliana Gabriel Ribeiro de Andrade, Ana Paula dos Santos, Vera Lúcia Gil-da-Silva-Lopes, Gil Guerra-Júnior, Andréa Trevas Maciel-Guerra","doi":"10.1590/0004-2730000002853","DOIUrl":"https://doi.org/10.1590/0004-2730000002853","url":null,"abstract":"<p><strong>Objective: </strong>To verify whether fluorescence in situ hybridization (FISH) of cells from the buccal epithelium could be employed to detect cryptomosaicism with a 45,X lineage in 46,XY patients.</p><p><strong>Subjects and methods: </strong>Samples of nineteen 46,XY healthy young men and five patients with disorders of sex development (DSD), four 45,X/46,XY and one 46,XY were used. FISH analysis with X and Y specific probes on interphase nuclei from blood lymphocytes and buccal epithelium were analyzed to investigate the proportion of nuclei containing only the signal of the X chromosome.</p><p><strong>Results: </strong>The frequency of nuclei containing only the X signal in the two tissues of healthy men did not differ (p = 0.69). In all patients with DSD this frequency was significantly higher, and there was no difference between the two tissues (p = 0.38), either.</p><p><strong>Conclusions: </strong>Investigation of mosaicism with a 45,X cell line in patients with 46,XY DSD or sterility can be done by FISH directly using cells from the buccal epithelium.</p>","PeriodicalId":8395,"journal":{"name":"Arquivos brasileiros de endocrinologia e metabologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1590/0004-2730000002853","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32430001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marcos M Lima-Martínez, Gabriel López-Mendez, Rodolfo Odreman, José H Donis, Mariela Paoli
{"title":"Epicardial adipose tissue thickness and its association with adiponectin in metabolic syndrome patients from Mérida, Venezuela.","authors":"Marcos M Lima-Martínez, Gabriel López-Mendez, Rodolfo Odreman, José H Donis, Mariela Paoli","doi":"10.1590/0004-2730000002888","DOIUrl":"https://doi.org/10.1590/0004-2730000002888","url":null,"abstract":"<p><strong>Objective: </strong>To study the relationship between epicardial adipose tissue (EAT) thickness and plasma levels of adiponectin in Venezuelan patients.</p><p><strong>Subjects and methods: </strong>Thirty-one patients diagnosed with metabolic syndrome (study group) and 27 controls were selected and tested for glycemia, lipids, and adiponectin. EAT thickness, ejection fraction, diastolic function, left ventricular mass (LVM), and left atrial volume (LAV) were determined by transthoracic echocardiography.</p><p><strong>Results: </strong>EAT thickness was greater in metabolic syndrome patients (5.69 ± 1.12 vs. 3.52 ± 0.80 mm; p = 0.0001), correlating positively with body mass index (BMI) (r = 0.661; p = 0.0001); waist circumference (WC) (r = 0.664; p = 0.0001); systolic (SBP) (r = 0.607; p = 0.0001), and diastolic blood pressure (DBP) (r = 0.447; p = 0.0001); insulin (r = 0.505; p = 0.0001); Tg/HDL-C ratio (r = 0.447; p = 0.0001), non-HDL-C (r = 0.353; p = 0.007); LAV (r = 0.432; p = 0.001), and LVM (r = 0.469; p = 0.0001). EAT thickness correlated negatively with adiponectin (r = -0.499; p = 0.0001).</p><p><strong>Conclusion: </strong>A significant association exists between EAT thickness and both metabolic syndrome components and adiponectin concentration, a link that might be used as a biomarker for this disease.</p>","PeriodicalId":8395,"journal":{"name":"Arquivos brasileiros de endocrinologia e metabologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1590/0004-2730000002888","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32432037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Payam Farahbakhsh Farsi, Abolghassem Djazayery, Mohammad Reza Eshraghian, Fariba Koohdani, Ali Akbar Saboor-Yaraghi, Hoda Derakhshanian, Mahnaz Zarei, Mohammad Hassan Javanbakht, Mahmoud Djalali
{"title":"Effects of supplementation with omega-3 on insulin sensitivity and non-esterified free fatty acid (NEFA) in type 2 diabetic patients.","authors":"Payam Farahbakhsh Farsi, Abolghassem Djazayery, Mohammad Reza Eshraghian, Fariba Koohdani, Ali Akbar Saboor-Yaraghi, Hoda Derakhshanian, Mahnaz Zarei, Mohammad Hassan Javanbakht, Mahmoud Djalali","doi":"10.1590/0004-2730000002861","DOIUrl":"https://doi.org/10.1590/0004-2730000002861","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to determine the role of omega-3 supplementation on NEFA concentration, insulin sensitivity and resistance, and glucose and lipid metabolism in type 2 diabetic patients.</p><p><strong>Subjects and methods: </strong>Forty-four type 2 diabetic patients were randomly recruited into two groups. Group A received 4 g/day omega-3 soft gels, and group B received a placebo for 10 wks. Blood samples were collected after 12-h fast. Physical activity records, three-day food records, and anthropometric measurements were obtained from all participants at the beginning and end of the study.</p><p><strong>Results: </strong>Omega-3 supplementation caused a significant reduction in NEFA in the intervention group compared with the placebo group (P = 0.009). Additionally, the administration of omega-3 resulted in significantly greater changes (Diff) for the intervention group in various parameters, such as insulin and Quicki indices compared with the placebo group (P < 0.05).</p><p><strong>Conclusions: </strong>Omega-3 fatty acid supplementation in type 2 diabetic patients improved insulin sensitivity, probably due to the decrease in NEFA concentrations.</p>","PeriodicalId":8395,"journal":{"name":"Arquivos brasileiros de endocrinologia e metabologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1590/0004-2730000002861","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32430002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Relation between ultra-sensitive C-reactive protein, diabetes and periodontal disease in patients with and without myocardial infarction.","authors":"Francina Escobar Arregoces, Catalina Latorre Uriza, Juliana Velosa Porras, Maria Beatriz Ferro Camargo, Alvaro Ruiz Morales","doi":"10.1590/0004-2730000002899","DOIUrl":"https://doi.org/10.1590/0004-2730000002899","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to evaluate the impact of diabetes and periodontal disease in us-CRP, an inflammatory marker in patients with and without acute myocardial infarction (AMI).</p><p><strong>Subjects and methods: </strong>A case-control study was conducted in 401 subjects aged between 30 and 75 years, living in Bogotá D.C. (Colombia). Patients arriving at the emergency room of the San Ignacio University Hospital with AMI were included into the case group. The control group was defined as those subjects without AMI. The following blood tests were performed: complete blood count (CBC), glycemia, total cholesterol, triglycerides, cHDL, cLDL, and us-CRP. Patients with infections or antibiotic treatment within the last three months, who had received periodontal treatment within the six months prior to the study entry, had oral ulcerations, or less than seven teeth were excluded from the study. Periodontal disease was diagnosed based on the 1999 Armitage's classification.</p><p><strong>Results: </strong>The mean us-CRP value found in diabetic patients with severe chronic periodontitis was 5.31 mg/L (SD 6.82), and 2.38 mg/L (SD 4.42) in non-diabetic patients, being statistically significant (p = 0.000).</p><p><strong>Conclusion: </strong>Diabetes had an impact in periodontal disease and us-CRP. In patients with AMI, DM and PD considerably increased the us-CRP.</p>","PeriodicalId":8395,"journal":{"name":"Arquivos brasileiros de endocrinologia e metabologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1590/0004-2730000002899","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32432038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Joelma Ines Tagliapietra Barros, Francisco Vagnaldo Fechine, Renan Magalhães Montenegro Júnior, Otoni Cardoso do Vale, Virgínia Oliveira Fernandes, Marcellus Henrique Loiola Ponte de Souza, Gilmara Holanda da Cunha, Manoel Odorico de Moraes, Catarina Brasil d'Alva, Maria Elisabete Amaral de Moraes
{"title":"Effect of treatment with sitagliptin on somatosensory-evoked potentials and metabolic control in patients with type 2 diabetes mellitus.","authors":"Joelma Ines Tagliapietra Barros, Francisco Vagnaldo Fechine, Renan Magalhães Montenegro Júnior, Otoni Cardoso do Vale, Virgínia Oliveira Fernandes, Marcellus Henrique Loiola Ponte de Souza, Gilmara Holanda da Cunha, Manoel Odorico de Moraes, Catarina Brasil d'Alva, Maria Elisabete Amaral de Moraes","doi":"10.1590/0004-2730000002914","DOIUrl":"https://doi.org/10.1590/0004-2730000002914","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effect of sitagliptin on somatosensory-evoked potentials (SEPs) and metabolic control in patients with type 2 diabetes mellitus without clinical diabetic neuropathy.</p><p><strong>Materials and methods: </strong>Interventional, prospective, and open study. Patients with less than six months from the diagnosis were included. Examinations of SEPs and laboratory tests at fasting and after food stimulation were performed before and after three months of treatment with sitagliptin (100 mg/day).</p><p><strong>Results: </strong>There was a reduction in the mean levels of HbA1c (P < 0.0001), fasting glucose (P = 0.001), total cholesterol (P = 0.019), and ALT (P = 0.022). An increase in active GLP-1 was found at the end of the study (P = 0.0025). Several SEPs showed statistically significant differences when analyzed before and after treatment with sitagliptin.</p><p><strong>Conclusion: </strong>The results give a glimpse of the possible use of sitagliptin in the treatment of some neurodegenerative conditions of the peripheral nervous system, in addition to its already established role in glycemic control.</p>","PeriodicalId":8395,"journal":{"name":"Arquivos brasileiros de endocrinologia e metabologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1590/0004-2730000002914","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32432039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Andrea E Scaramuzza, Valentina Comaschi, Matteo Ferrari, Gian Vincenzo Zuccotti
{"title":"Sensor-augmented pump and Down syndrome: a new tool in tricky patients.","authors":"Andrea E Scaramuzza, Valentina Comaschi, Matteo Ferrari, Gian Vincenzo Zuccotti","doi":"10.1590/0004-2730000002948","DOIUrl":"https://doi.org/10.1590/0004-2730000002948","url":null,"abstract":"W e read with great interest the paper by Piccini and cols. (1) published in the July issue of this Journal. Some years ago, we published the first report ever (to the best of our knowledge) of successful treatment of a girl with Down syndrome, Hashimoto’s thyroiditis and celiac disease with continuous subcutaneous insulin infusion (2). Since then, her glycemic control was kept constant and, most of the time, in the target range (HbA1c in 2009: 7.75 ± 0.21%; HbA1c in 2010: 7.35 ± 0.19%; HbA1c in 2011: 7.42 ± 0.30%). At the end of 2011, sensor-augmented pump was initiated (Animas® VibeTM, West Chester, PA, USA) because of both a quite high glycemic variability and the parents’ request, and her HbA1c kept improving (HbA1c in 2012: 7.30 ± 0.20%; HbA1c in 2013: 7.10 ± 0.28%). CSII has been recognized as effective and safe in pediatric (3) and in adult patients (4), not only in the short run, but even after many years (5). In patients with Down syndrome and type 1 diabetes, glycemic control may sometimes be particularly tricky (6,7). In our patient, as well as in the one of Piccini and cols. (1), CSII was a safe and effective way to manage diabetes. For a successful CSII therapy in a patient with Down syndrome, whose mental function may be impaired, the collaboration of a highly motivated and compliant family is essential, as well as a skilled multidisciplinary diabetes team (8). Given all of this, pump increased the patient’s and family’s flexibility, as we had previously reported (2). The significant improvement in the glycemic control observed, and the high level of acceptance of CSII therapy observed in both our case and in that of Piccini and cols. is worth the effort of the patient’s family and of the diabetes team in ensuring that the patient has a flexible life. Perhaps CSII therapy might be taken into account when considering insulin therapy in patients with Down’s syndrome.","PeriodicalId":8395,"journal":{"name":"Arquivos brasileiros de endocrinologia e metabologia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32429859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}