Alejandra Arbeláez

Circulating hepcidin in type 2 diabetes: A multivariate analysis and double blind evaluation of metformin effects.

SCOPE Very few studies have evaluated serum hepcidin in patients with type 2 diabetes and they have reported conflicting results. In addition, the effect of antidiabetic drugs on circulating hepcidin has not been explored so far. The aims of the study were to evaluate hepcidin concentrations and hepcidin/ferritin ratio in type 2 diabetes subjects and healthy non-diabetic controls and to evaluate the effect of metformin on hepcidin concentrations. METHODS AND RESULTS Study 1: Cross-sectional multivariate study of 239 non-diabetic individuals and 65 people with type 2 diabetes. The multivariate analysis included covariates of chronic inflammation, BMI, pharmacological treatment, menopausal status and insulin resistance. Study 2: Randomized, double-blinded, placebo-controlled 4-month trial metformin compared to placebo among 36 type 2 diabetic patients. In both groups diet was controlled by maintaining a hypocaloric intake across the trial. Hepcidin levels were significantly lower in patients with type 2 diabetes than in non-diabetic individuals either in crude or adjusted regression models (P<0.05). Hepcidin decreased in both arms of the trial (Placebo, p = 0.004; metformin, p = 0.022). CONCLUSION Circulating hepcidin was significantly and independently lower in type 2 diabetes. Metformin treatment is not associated with reductions in hepcidin but hypocaloric diet could be involved.

Falta de relación entre el nivel de actividad física con marcadores de riesgo cardiovascular y síndrome metabólico en hombres aparentemente sanos

BACKGROUND The World Health Report 2002 estimated that sedentary is one of the main 10 causes of morbidity and mortality and the proportion of people whose health is at risk due to sedentary life is approximately 60%. OBJECTIVE To assess the relationship of the physical activity level with cardiovascular risk factors and metabolic syndrome in 61 healthy men. METHODS The short version of the International Physical Activity Questionnaire (IPAQ) recommended by the World Health Organization was used as a valid measure to estimate two categories of physical activity, such as: low level (insufficient and sedentary) and vigorous level (moderate and very active). Cardiovascular risk factors and metabolic syndrome were defined according to criteria of the National Cholesterol Education Program of the United States and International Diabetes Federation respectively. Serum levels of C-reactive protein and ferritin were also measured, and insulin sensitivity was estimated by the Homeostatic Model Assessment-Insulin Resistance (HOMA-IR). RESULTS Mean age of study population was 47.1 ± 6.9 years. 17 participants (28%) had metabolic syndrome. There were no differences between the categories of low and vigorous level physical activity, or relationship with total physical activity (MET × week). No association was seen between low levels of physical activity and metabolic syndrome criteria. CONCLUSIONS The high prevalence of physical inactivity found in study participants using the IPAQ questionnaire was not associated to cardiovascular risk factors and metabolic syndrome.

Association of Self‐Reported Familial History of Cardiometabolic Disease with Metabolic Syndrome in Apparently Healthy Urban Colombian Men

Evidence about the relationship between familial history (FH) of cardiometabolic disease (CMD) and metabolic syndrome (MetS) in Latin American populations is scarce. The aim of this study was to evaluate the relationship of FH of CMD and of dyslipidemia and obesity with MetS in healthy men.

Los niveles de ferritina y los marcadores de riesgo cardiovascular se correlacionan con mayor tiempo sedentario auto-reportado en hombres aparentemente sanos

Objective: to evaluate the correlation between serum ferritin and cardiovascular risk markers with the time of self-reported physical activity and sedentary life style in apparently healthy men. Methods: we included 69 men from three private and public companies in the metropolitan area of Cali, Colombia, aged between 25 and 64. The short version of the International Physical Activity Questionnaire (IPAQ) was applied, and were grouped in four categories of physical activity: 1. Minutes of intense physical activity (IFA)/week. 2. Minutes of moderate physical activity (MFA)/week. 3. Minutes of walk/week. 4. Minutes of sitting/day. Cardiovascular risk markers were defined based on the criteria of the ATP-III and the International Diabetes Federation. Results: positive correlations were found in subjects who self-reported more time in sedentary activities according to the IPAQ category (average minutes sitting/day) in anthropometric indicators: percentage of body fat (rho = 0.249, p <0.05), mass index (rho = 0.268, p <0.05) and waist circumference (rho = 0.266, p <0.05). This same behavior was observed in biochemical variables: ferritin (rho = 0.247, p <0.05), triglycerides (rho = 0.258, p <0.05), insulin (rho = 0.284, p <0.05) and HOMA index (rho = 0.261). Also, lower levels of HDL-C were evidenced with lower levels of physical activity (rho =- 0.279, P <0.05). Conclusions: sedentary time (minutes sitting/week) reported by the subjects correlated positively with ferritin levels as well as with insulin resistance and cardiovascular risk markers. The body iron deposits estimated as serum ferritin, when related to sedentary lifestyle parameters, behave as a potential marker of cardiovascular risk.

C-Reactive Protein, Waist Circumference, and Family History of Heart Attack are Independent Predictors of Body Iron Stores in Apparently Healthy Premenopausal Women

Ferritin levels have been associated with metabolic syndrome and insulin resistance. The aim of the present study was to evaluate the prediction of ferritin levels by variables related to cardiometabolic disease risk in a multivariate analysis. For this aim, 123 healthy women (72 premenopausal and 51 posmenopausal) were recruited. Data were collected through procedures of anthropometric measurements, questionnaires for personal/familial antecedents, and dietary intake (24-h recall), and biochemical determinations (ferritin, C reactive protein (CRP), glucose, insulin, and lipid profile) in blood serum samples obtained. Multiple linear regression analysis was used and variables with no normal distribution were log-transformed for this analysis. In premenopausal women, a model to explain log-ferritin levels was found with log-CRP levels, heart attack familial history, and waist circumference as independent predictors. Ferritin behaves as other cardiovascular markers in terms of prediction of its levels by documented predictors of cardiometabolic disease and related disorders. This is the first report of a relationship between heart attack familial history and ferritin levels. Further research is required to evaluate the mechanism to explain the relationship of central body fat and heart attack familial history with body iron stores values.