Antônio Carlos Brandão

Prevalência de síndrome metabólica em indivíduos brasileiros pelos critérios de NCEP-ATPIII e IDF

OBJECTIVE: To analyze the biochemical profile and to characterize metabolic syndrome (MS) in patients with cardiologic medical assistance using NCEP-ATPIII and IDF definitions. METHODS: Two hundred patients and 140 controls were studied, considering total cholesterol (TC), HDL-cholesterol (HDLc), LDL-cholesterol (LDLc), VLDL-cholesterol (VLDLc), triglycerides (TG), fasting glycemia, abdominal waist and hypertension. Significance level was defined as P<0.05. RESULTS: Patients showed increased glycemia levels (103±31.4mg/dL) and reduced HDLc levels (48±13.4mg/dL) when compared to controls (88±29.7mg/dL, P<0.0001 and 53±15.9mg/dL, P=0.0075; respectively). Male controls 31-50 years old showed increased TC levels (215±40.4mg/dL), LDL-cholesterol (134±34mg/dL), VLDL-cholesterol (30±11.8mg/dL) and TG (150±59.4mg/dL) when compared to women (185±38.2mg/dL, P=0.0137; 111±35.8mg/dL; P=0.0324; 19±9.7mg/dL; P=0.0009; 93±49mg/dL, P=0.0010; respectively). Women over 50 years of age showed increased TC concentrations (216±35.9mg/dL), HDL-cholesterol (54±12.8mg/dL) and LDL-cholesterol (138±30.8mg/dL) when compared to men (190±44.7mg/dL, P=0.0103; 47±14.5mg/dL, P=0.0229; 119±33.3mg/dL; P=0.0176; respectively). NCEP-ATPIII and IDF definitions had characterized MS in 35.5% and 46% of patients, respectively, bolding glycemia, TG and hypertension. CONCLUSION: Elevated glycemia levels and reduced HDLc levels were detected in patients. Altered lipid profile observed in men 31-50 years old signals higher risk for cardiovascular diseases in young adults, while a similar profile in aged women can reflect hormonal physiological changes. Both definitions for MS diagnosis discriminate patients from controls, especially IDF, sometimes with lower capacity to determine high risk for cardiovascular complications. The high prevalence of MS in patients, even with cardiologic medical assistance, suggests predisposition for cardiovascular manifestations in Brazilian individuals.

Association of apolipoprotein E polymorphism in late-onset Alzheimer's disease and vascular dementia in Brazilians

The genetic basis for dementias is complex. A common polymorphism in the apolipoprotein E (APOE) gene is considered to be the major risk factor in families with sporadic and late-onset Alzheimers disease as well as in the general population. The distribution of alleles and genotypes of the APOE gene in late-onset Alzheimers disease (N = 68), other late-life dementias (N = 39), and in cognitively normal controls (N = 58) was determined, as also was the risk for Alzheimers disease associated with the epsilon4 allele. Peripheral blood samples were obtained from a total of 165 individuals living in Brazil aged 65-82 years. Genomic DNA was amplified by the polymerase chain reaction and the products were digested with HhaI restriction enzyme. APOE epsilon2 frequency was considerably lower in the Alzheimers disease group (1%), and the epsilon3 allele and epsilon3/epsilon3 genotype frequencies were higher in the controls (84 and 72%, respectively) as were the epsilon4 allele and epsilon3/epsilon4 genotype frequencies in Alzheimers disease (25 and 41%, respectively). The higher frequency of the epsilon4 allele in Alzheimers disease confirmed its role as a risk factor, while epsilon2 provided a weak protection against development of the disease. However, in view of the unexpectedly low frequency of the epsilon4 allele, additional analyses in a more varied Brazilian sample are needed to clarify the real contribution of apolipoprotein E to the development of Alzheimers disease in this population.

Impact of Genetic Variants of Apolipoprotein E on Lipid Profile in Patients with Parkinson's Disease

The pathogenesis of Parkinsons disease (PD) seems to involve genetic susceptibility to neurodegeneration. APOE gene has been considered a risk factor for PD. This study aimed to evaluate the association of APOE polymorphism with PD and its influence on lipid profile. We studied 232 PD patients (PD) and 169 individuals without the disease. The studied polymorphism was analyzed by PCR/RFLP. The Fishers exact test, chi-square, ANOVA, and t-test (P < 0.05) were applied. The APOE3/3 genotype was prevalent in PD patients and Controls (P = 0.713) followed by APOE3/4 (P = 0.772). Both groups showed recommended values for lipid profile, with increase in the values of total cholesterol and LDLc, as well as decreased values of triglycerides in PD patients compared with Controls (P < 0.05 for all of them). Increased levels of HDLc, in PD patients, were associated with the APOE3/3 versus APOE-/4 genotypes (P = 0.012). The APOE polymorphism does not distinguish PD patients from Controls, as opposed to the lipid profile alone or in association with APOE. Furthermore, a relationship between increase of HDLc levels and APOE3 in homozygous was found in PD patients only.

Anticardiolipin Antibodies as a Risk Factor of Atherosclerosis in Intermittent Claudication

Anticardiolipin antibodies have been associated as a risk factor of atherosclerosis. The aim of this study was to evaluate the association between anticardiolipin antibodies and intermittent claudication. Forty consecutive patients (33 men, 7 women; age range: 45-84 years, mean 65.5) who were seen in the angiology and vascular surgery department with intermittent claudication were evaluated. Exclusion criteria included prior revascularization, angioplasty, or a history of thrombosis of a lower limb. Forty individuals (23 men, 17 women; age range: 58-82 years, mean 67.1) who attended a support group for senior citizens and who were apparently healthy formed the control group. Anticardiolipin antibodies were evaluated by means of enzyme-linked immunosorbent assay (ELISA) for quantitative measurement of immunoglobulin G (IgG) and IgM antibodies against cardiolipins in serum. IgG levels were considered normal when <7, borderline from 7 to 10, and elevated at >10 GPL units/mL; IgM levels were normal when <4, borderline from 4 to 7, and elevated at >7 MPL, as recommended by the test manufacturers. Statistical analysis used the relative risk test with a confidence interval of 95%. Twenty-three patients from the study group and 6 individuals from the control group were found to have elevated levels of anticardiolipin antibodies giving a relative risk of 3.833 (ranging from 1.749 to 8.4; p value <0.0001). In conclusion, patients who have elevated levels of anticardiolipin antibodies present a 3.8 times greater risk of developing intermittent claudication.

Effects of Statin and Aerobic Physical Exercise Association in the Cardiomyocytes of the Rat: Morphometric Study

Sao Paulo State Univ, FCT Unesp, Physiotherapy Dept, BR-19060900 Presidente Prudente, SP, Brazil

Effect of Statins and Aerobic Physical Exercise on Liver Function in Dyslipidemic Rats: Morphometric Study

^len^aThe present study was carried out to evaluate the effect of statins associated with physical exercise (PE) in liver cells in dyslipidemic rats through cariometry. The animals were divided into six groups: animals subjected to a hypercholesterolemic diet (HD), simvastatin, with (G1) and without (G2) physical exercise (PE); HD submitted (G3) or not (G4) to PE, and commercial food diet (F) with (G5) and without (G6) PE. Histological analysis of the liver was performed by staining the slides with hematoxylin and eosin. The cariometric study included measuring the major and minor diameters of the hepatocytes nuclei. The Shapiro-Wilk test was also performed. To determine the differences among the groups, the Kruskal-Wallis Test with Dunns post-test were conducted. The significance level was set at 5%. No difference was found in the hepatocytes nuclei between G5 and G6. When these groups were related with G3 and G4, reduced nuclei were observed. There was no difference between G1 and G6. The comparison between G6 and G2 showed that the nuclei in G2 were smaller. No difference was detected between G5 and G1. Changes were observed in the nuclei shape in G2 in comparison to G1. Considering G2 and G3, a decrease in the size of nuclei was observed in G3. On the other hand, G2 showed changes in shape in the comparative analysis with G4. The size and shape of G1 nuclei were larger than G3 as well as changes in shape were observed when compared to G4. G4 showed smaller nuclei than G3. Therefore, F, associated or not with the practice of PE, does not alter the size and shape of the hepatocytes nuclei; HD combined with sedentarism influences changes in the morphometric parameters of hepatocytes; and the association of simvastatin and PE seems to protect the hepatocytes nuclei with regard to HD.^les

Acknowledgement to the Reviewers

Chris T. Bolliger, Tygerberg, South Africa Raphael Borie, Paris, France Piera Boschetto, Ferrara, Italy Gabriel T. Bosslet, Indianapolis, USA Louis-Philippe Boulet, Sainte-Foy, Canada A. Bourdin, Montpellier, France John Brannan, Sydney, Australia Joerg Brederlau, Berlin, Germany E.C. Breen, La Jolla, USA Fabienne Bregeon, Marseille, France Pilar Brito-Zeron, Barcelona, Spain Dunja Bruder, Braunschweig, Germany Guy G. Brusselle, Gent, Belgium Martin H. Brutsche, St. Gallen, Switzerland Antonio Bugalho, Lisbon, Portugal Janette Burgess, Camperdown, Australia Umberto Campia, Chicago, USA Giorgio Walter Canonica, Genova, Italy Andre Capderou, Le Plessis Robinson, France Gaetano Caramori, Ferrara, Italy Pierluigi Carratu, Bari, Italy Laura Carrozzi, Pisa, Italy C.R.F. Carvalho, Sao Paulo, Brazil Gian Luca Casoni, Forli, Italy Loris Ceron, Carbonera, Italy Stefania Cerri, Portland, USA Indranil Chakravorty, London, UK Rachel Chambers, London, UK Shi-Chuan Chang, Taipei, Taiwan Ling Chen, Baltimore, USA Alfredo Chetta, Parma, Italy Carlo Chezzi, Parma, Italy Prashant N. Chhajed, Mumbai, India Doo-Sup Choi, Rochester, USA Marco Matteo Ciccone, Bari, Italy Michal Ciurzynski, Warsaw, Poland Donald W. Cockcroft, Saskatoon, Canada Henri Colt, Irvine, USA Alison Condliffe, Cambridge, UK Marco Confalonieri, Trieste, Italy Claudius Conrad, Boston, USA Vittoria Conti, Rome, Italy Robalo Cordeiro, Coimbra, Portugal Massimo Corradi, Parma, Italy Raja Abboud, Vancouver, Canada Yossef Aelony, Rancho Palos Verdes, USA Michalis Agrafiotis, Magoula, Greece Khalid Al Shafi, London, UK Ghada Alsaleh, Illkirch, France Nicolino Ambrosino, Cisanello, Pisa, Italy Kayvan Amjadi, Ottawa, Canada Asha Anandiah, Boston, USA Stephan Andreas, Immenhausen, Germany Jouke T. Annema, Leiden, The Netherlands Katerina Antoniou, Heraklion, Greece Balazs Antus, Budapest, Hungary Juan Carlos Arevalo, Salamanca, Spain Christine Armbruster, Vienna, Austria Laurent Arnaud, Paris, France Hormoz Ashtyani, Hackensack, USA John D. Aubert, Lausanne, Switzerland Najib Ayas, Vancouver, Canada Imran Aziz, Wigan, UK Chung-Xue Bai, Shanghai, China Kristina Bailey, Omaha, USA Petros Bakakos, Athens, Greece Bruno Balbi, Veruno, Italy Ferran Barbe, Lleida, Spain Xavier Basagana Flores, Barcelona, Spain Sandip Basu, Bombay, India Salvatore Battaglia, Palermo, Italy Sevim Bavbek, Ankara, Turkey Gillian Beamer, Columbus, USA H.D. Becker, Heidelberg, Germany Jurgen Behr, Bochum, Germany Carolyn Behrendt, Duarte, USA Maria Belvisi, London, UK Norbert Berend, Glebe, Australia Gidon Berger, Haifa, Israel Robert Berkowitz, Hackensack, USA Nitin Bhatt, Columbus, USA Luca Bianchi, Lumezzane, Italy Andrea Bianco, Campobasso, Italy Semra Bilaceroglu, Izmir, Turkey Jose Blanquer, Valencia, Spain Alexander Blau, Berlin, Germany Konrad E. Bloch, Zurich, Switzerland

LEP -2548G>A Polymorphism of the Leptin Gene and Its Influence on the Lipid Profile in Obese Individuals

Background/Aim: We studied the molecular pathogenesis of obesity, involving complex interactions between environmental and genetic factors, with a focus on the leptin gene. It was our aim to characterize the LEP -2548G>A leptin polymorphism and lipid profile in obese and normal-weight individuals. Methods: A total of 212 individuals were divided into the study group including 136 obese patients (body mass index, BMI ≥30) and the control group with 76 normal-weight individuals (BMI >18.5 and ≤24.9). DNA was amplified by polymerase chain reaction and restriction fragment length polymorphism. The lipid profile was analyzed by enzymatic colorimetric methods. The level of significance was set at p < 0.05. Results: There was a prevalence of the GA genotype in both groups. However, comparative group analysis showed an association of the recessive model (AA+GA) with increased triglycerides (TG) and decreased high-density lipoprotein cholesterol (HDL-C) levels in the study group. Conclusion: This study did not confirm an association between obesity and the LEP -2548G>A polymorphism. However, AA+GA genotypes, in the presence of obesity, seem to contribute to a reduction in HDL-C and an increase in TG compared with normal-weight individuals. This should be confirmed in further studies.

Polimorfismo genético do fibrinogênio na doença arterial periférica

The objective of this study was to analyze the frequencies of the alleles and genotypes of the gene encoder of the fibrinogen b-chain in patients suffering from peripheral artery disease. A total of 62 male Caucasoid patients with ages varying from 38 to 79 years old were studied. All the patients had clinical symptoms of peripheral artery disease, which was later confirmed by angiography. Forty of the patients had atherosclerotic obstructions of the iliac, femoral or carotid arteries and 22 suffered from aneurysms of the thoracic, abdominal or thoracoabdominal aortas. All the patients were submitted to surgery. A control group was formed of 62 individuals, with ages ranging from 43 to 80 years old, without clinical histories or alterations in their clinical examinations of peripheral artery disease. Individuals with renal disease, liver disease or diabetes mellitus were excluded. Analysis of the fibrinogen b-chain was performed using polymerase chain reaction and restriction fragment length polymorphism with Bcl I endonuclease. Three genotypes, B1/B1, B1/B2 and B2/B2 were identified. Statistical analysis was made using the Fisher Exact test, odds ratio, Kruskal-Wallis test and variance analysis (ANOVA). A p-value = 0.05 was considered significant. The B1 allele was the most prevalent in both patients and the control group (0.819 and 0.857, respectively), with prevalence of the B1/B1 genotype in patients and controls (65.9% vs. 71.4% respectively), followed by B1/B2 (31.8% vs. 28.6% respectively). No significant difference was observed in relation to the Bcl I polymorphisms of the fibrinogen b-chain and obstructive and aneurysmal peripheral artery disease. In conclusion, the B1 and B2 polymorphisms of the fibrinogen b-chain and their respective genotypes do not have any influence in peripheral artery disease.