Current Issue : October - December Volume : 2013 Issue Number : 4 Articles : 6 Articles
Background: Multidisciplinary intervention is an alternative for the treatment of children and adolescent obese.\r\nHowever, the influence of age and menarcheal status in the pattern of metabolic response of obese girls has not\r\nbeen investigated. The following study examined the effects of a 12-week multidisciplinary intervention on\r\nmetabolic health in overweight girls and the contribution of age and menarcheal status on the resulting changes.\r\nMethods: Eighty-eight overweight girls (10 - 16 years) were considered initially for this study and randomly\r\nassigned (intervention group: n = 58; control group: n = 30). Forty-six girls completed the intervention program and\r\n16 girls completed the follow-up for the control group. The 12-week intervention included aerobic exercises (three\r\ntimes per week) and nutritional intervention. Anthropometrical measures (body mass, body mass index and waist\r\ncircumference), menarcheal status and metabolic profiles including glucose, insulin, triglycerides (TG), total\r\ncholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were\r\nassessed in the beginning and after of intervention. Additionally, were calculated homeostatic model assessmentinsulin\r\nresistance (HOMA-IR) and quantitative insulin sensitivity check index (QUICKI).\r\nResults: After 12-week, girls decreased significantly the body mass (76.6 �± 14.7 to 75.7 �± 14.6 kg) body mass index\r\n(30.1 �± 4.0 to 29.4 �± 4.0 kg/m2) and waist circumference (98.9 �± 10.9 to 96.5 �± 11.4 cm). There were differences in\r\nHDL-C (43.1 �± 8.2 to 50.3 �± 9.4 mg/dl), TG (120.9 �± 64.3 to 93.3 �± 47.9 mg/dl) and insulin (16.9 �± 7.6 to 15.6 �± 9.8 mg/\r\ndl). Relative contribution of age was significant only for within-subject variability in waist circumference.\r\nConclusions: The multidisciplinary based on aerobic training intervention used in this study produced substantial\r\nbenefits on metabolic health indicators in overweight girls. The changes observed were not related to interindividual\r\nvariability in age and maturity status....
Background: The dipeptidyl peptidase-4 (DPP4) enzyme is a novel adipokine potentially involved in the\r\ndevelopment of the metabolic syndrome (MetS). Previous observations demonstrated higher visceral adipose tissue\r\n(VAT) DPP4 gene expression in non-diabetic severely obese men with (MetS+) vs. without (MetS-) MetS. DPP4\r\nmRNA abundance in VAT correlated also with CpG site methylation levels (%Meth) localized within and near its\r\nexon 2 (CpG94 to CpG102) in non-diabetic severely obese women, regardless of their MetS status. The actual study\r\ntested whether DPP4 %Meth levels in VAT are different between MetS- and MetS+ non-diabetic severely obese\r\nsubjects, whether variable metabolic and plasma lipid profiles are observed between DPP4 %Meth quartiles, and\r\nwhether correlation exists in DPP4 %Meth levels between VAT and white blood cells (WBCs).\r\nMethods: DNA was extracted from the VAT of 26 men (MetS-: n=12, MetS+: n=14) and 79 women (MetS-: n=60;\r\nMetS+: n=19), as well as from WBCs in a sub-sample of 17 women (MetS-: n=9; MetS+: n=8). The %Meth levels of\r\nCpG94 to CpG102 were assessed by pyrosequencing of sodium bisulfite-treated DNA. ANOVA analyses were used to\r\ncompare the %Meth of CpGs between MetS- and MetS+ groups, and to compare the metabolic phenotype and\r\nplasma lipid levels between methylation quartiles. Pearson correlation coefficient analyses were computed to test\r\nthe relationship between VAT and WBCs CpG94-102 %Meth levels.\r\nResults: No difference was observed in CpG94-102 %Meth levels between MetS- and MetS+ subjects in VAT\r\n(P=0.67), but individuals categorized into CpG94-102 %Meth quartiles had variable plasma total-cholesterol\r\nconcentrations (P=0.04). The %Meth levels of four CpGs in VAT were significantly correlated with those observed in\r\nWBCs (r=0.55-0.59, P=0.03).\r\nConclusions: This study demonstrated that %Meth of CpGs localized within and near the exon 2 of the DPP4 gene\r\nin VAT are not associated with MetS status. The actual study also revealed an association between the %Meth of\r\nthis locus with plasma total-cholesterol in severe obesity, which suggests a link between the DPP4 gene and\r\nplasma lipid levels....
Background: The purpose of the present study was to examine the effects of eight weeks of resistance training\r\n(RT) on anthropometric, cardiovascular and biochemical risk factors of metabolic syndrome (MetS), and\r\nneuromuscular variables on overweight/obese women.\r\nMethods: Fourteen middle-aged (33.9 Ã?± 8.6 years) overweight/obese women (body mass index - BMI 29.6 Ã?± 4.1 kg/m2)\r\nunderwent 24 sessions (3 times/week) of a whole body RT program with 3 sets of 8ââ?¬â??12 repetitions maximum (RM). The\r\nfollowing variables were evaluated: maximum strength on chest press and frontal lat pull-down; isometric hand-grip\r\nstrength; biceps brachii (BB) and rectus femoris (RF) muscle thickness, body mass; BMI; body adiposity index (BAI); waist,\r\nhip and neck circumferences; visceral fat volume; blood glucose; glycated hemoglobin (HbA1c); insulin; HDL-C and\r\ntriglycerides.\r\nResults: There was an increase of chest press (from 52.9 Ã?± 9.7 to 59.8 Ã?± 7.7 kg; P = 0.02) and front lat pull-down\r\n(from 51.5 Ã?± 7.5 to 57.6 Ã?± 9.2 kg; P = 0.01) muscle strength, isometric handgrip (P = 0.02) and RF muscle thickness\r\n(from 42.2 Ã?± 8.5 to 45.1 Ã?± 7.3 mm; P = 0.02) after the 8 week RT program. There were no statistically significant\r\nalterations on plasma glucose, HbA1c, insulin, triglycerides, HDL-C, anthropometric indexes and BB muscle thickness\r\n(p > 0.05).\r\nConclusions: A RT program without caloric restriction promotes an increase on muscle thickness and strength, with\r\nno effects on risk factors of MetS in overweight/obese women....
The management of T2DM requires aggressive treatment to achieve glycemic and cardiovascular risk factor goals.\r\nIn this setting, metformin, an old and widely accepted first line agent, stands out not only for its antihyperglycemic\r\nproperties but also for its effects beyond glycemic control such as improvements in endothelial dysfunction,\r\nhemostasis and oxidative stress, insulin resistance, lipid profiles, and fat redistribution. These properties may have\r\ncontributed to the decrease of adverse cardiovascular outcomes otherwise not attributable to metformin�s mere\r\nantihyperglycemic effects. Several other classes of oral antidiabetic agents have been recently launched, introducing\r\nthe need to evaluate the role of metformin as initial therapy and in combination with these newer drugs. There is\r\nincreasing evidence from in vivo and in vitro studies supporting its anti-proliferative role in cancer and possibly a\r\nneuroprotective effect. Metformin�s negligible risk of hypoglycemia in monotherapy and few drug interactions of\r\nclinical relevance give this drug a high safety profile. The tolerability of metformin may be improved by using an\r\nappropiate dose titration, starting with low doses, so that side-effects can be minimized or by switching to an\r\nextended release form. We reviewed the role of metformin in the treatment of patients with type 2 diabetes and\r\ndescribe the additional benefits beyond its glycemic effect. We also discuss its potential role for a variety of insulin\r\nresistant and pre-diabetic states, obesity, metabolic abnormalities associated with HIV disease, gestational diabetes,\r\ncancer, and neuroprotection....
Background: The cerebrovasuclar artery disease as a common complication of type-2 diabetes mellitus (T2DM)\r\ncaused huge economic burden and lives threatening to patients. We evaluated the prevalence and morphology of\r\ncarotid and cerebrovascular atherosclerotic plaques in T2DM patients with transient ischemic attack (TIA) or stroke\r\nusing multidetector CT (MDCT).\r\nMethods: 64-MDCT and dual-source CT (DSCT) angiographies were performed in 195 T2DM patients with TIA or\r\nstroke (mean age 65.7+/-12.8 years; 118 men) between January 2009 to August 2011. During the process, plaque\r\ntype, its distribution, extensive and obstructive natures were determined for each segment derived from the\r\npatients.\r\nResults: Atherosclerotic plaques were detected in 183 (93.8%) patients. A total of 1056 segments with plaque were\r\nidentified, of which 450 (42.6%) were non-calcified, 192 (18.2%) were mixed and 414 (39.2%) calcified ones. Among\r\nthem, 562 (53.2%) resulted in mild stenosis, 291 (27.6%) moderate stenosis, 170 (16.1%) severe stenosis and 33\r\n(3.1%) occlusion. Non-calcified plaques contributed 91.8% to non-obstructive lumen narrowing, while mixed and\r\ncalcified plaques contributed 89.0% and 65.0% respectively.\r\nConclusions: MDCT angiography detected a high prevalence of plaques in T2DM patients with TIA or stroke. A\r\nrelatively high proportion of plaques were non-calcified, as well as with non-obstructive stenosis. MDCT\r\nangiography might further enhance the detection and management of carotid and cerebrovascular atherosclerosis\r\nin T2DM patients with TIA and stroke....
Introduction: Over the past decade, numerous non-skeletal diseases have been reported to be associated with\r\nvitamin D deficiency including type2 diabetes mellitus (T2DM). Different studies provide evidence that vitamin D\r\nmay play a functional role in glucose tolerance through its effects on insulin secretion and insulin sensitivity. This\r\nstudy evaluates the effects of vitamin D supplementation on insulin resistance in T2DM.\r\nMethod: Through a before-after study, 100 patients with T2DM, 30ââ?¬â??70 years old, were recruited from an Arak\r\ndiabetes clinic as consecutive attenders. Participants were assessed for clinical and biochemistry. Serum insulin and,\r\n25(OH)D concentration, and HOMA-IR was calculated. All measurements were performed at the beginning and the\r\nend of the study. Patients received 50,000 unit of vitamin D3 orally per week for eight weeks, Statistical analysis was\r\nmade using SPSS17. The results were analyzed by descriptive tests, and a comparison between variables were\r\nmade using paired T-tests or Wilcoxon tests, as appropriate.\r\nResults: 100 participants including 70 women (70%) and 30 men (30%) took part in the study. All results were\r\npresented as MeanÃ?±SD, or medians of non-normally distributed.\r\n24% of the participants were Vitamin D deficient {serum 25(OH)D = 20 ng/ml(50 nmol/l)}.\r\nMean serum 25 (OH) D concentration was 43.03Ã?± 19.28 ng/ml (107.5Ã?±48.2 nmol/l).\r\nThe results at baseline and at the end, for FPG were 138.48Ã?±36.74 and 131.02Ã?±39 mg/dl (P=0.05), for insulin,\r\n10.76Ã?±9.46 and 8.6Ã?±8.25 Ã?µIu/ml (P=0.028) and for HOMA-IR, 3.57Ã?±3.18 and 2.89Ã?±3.28 (P=0.008) respectively.\r\nConclusion: Our data showed significant improvements in serum FPG, insulin and in HOMA-IR after treatment with\r\nvitamin D, suggested that vitamin D supplementation could reduce insulin resistance in T2DM....
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