Giuseppe Repetto

The Role of Ultrasound in the Diagnosis of Hepatic Steatosis in Morbidly Obese Patients

Background: Hepatic steatosis is prevalent in obese patients. Although it requires histology for diagnosis, ultrasound may indicate its presence. We evaluated the importance of ultrasound in the diagnosis of steatosis in morbidly obese patients, and considered its clinical relevance for patients with BMI of 35-40 kg/m2 without co-morbidities. Methods: 187 morbidly obese patients submitted to bariatric surgery were prospectively studied. All patients had ultrasound before the operation, and hepatic biopsies during the operation, which were compared. Results: The prevalence of steatosis histologically was 91.4%. The sensitivity and specificity of ultrasound in diagnosing steatosis was 49.1% and 75%, respectively,with a positive predictive value of 95.4%. Conclusion: The biopsies found a very high prevalence of steatosis in the studied population. The ultrasound results yielded a high positive predictive value (95.4%), suggesting its use as a diagnostic tool for this co-morbidity in morbidly obese patients.The low sensitivity of the method could be related to the lack of objective criteria for the ultrasound diagnosis of steatosis, and probably, technical problems in performing ultrasound in such patients. We believe that in patients with a BMI of 35-40 kg/m2 without other comorbidities, the ultrasound finding of steatosis could be of value as an indication for bariatric surgery.

Hepatic Steatosis In Patients Undergoing Bariatric Surgery and its Relationship to Body Mass Index and Co-Morbidities

Background: Although non-alcoholic hepatitis usually is asymptomatic and benign, this condition may progress to cirrhosis and hepatic failure. Some findings are similar to alcoholic hepatitis, but there is no history of excessive alcohol consumption. Among the factors associated with non-alcoholic hepatitis, obesity, diabetes and dyslipidemia are the most important. Methods: 77 consecutive patients undergoing bariatric surgery had their liver biopsy compared to the presence of co-morbidities and BMI. Results: 67 patients (87.1%) had an abnormal liver biopsy, mostly due to steatosis (83.1%), but also steatohepatitis (2.6%) and cirrhosis (1.3%). The degree of liver damage was related to higher BMI scores. Co-morbidities were present in 46.9% of the patients with hepatic steatosis. Conclusions: The authors suggest that a liver biopsy should be performed in all patients at bariatric surgery, in order to evaluate possible liver damage and to assist postoperative care.

Anti-beta2-glycoprotein I autoantibodies and metabolic syndrome

BACKGROUND: The metabolic syndrome (MetS) is a proatherogenic entity. Autoantibodies to phospholipid cofactors such as beta2-glycoprotein I (beta2-gpI) can influence atheroma appearance. Previous studies confirmed an association of IgA anti-beta2-gpI antibodies with cerebral ischemia, myocardial infarction, peripheral artery disease and carotid disease. OBJECTIVE: This case-control study evaluates a possible association of anti-beta2-gpI and anticardiolipin (aCL) antibodies with non-complicated MetS. METHODS: Cases comprised patients with MetS without history of vascular events; controls included individuals from the Orthopedic Infirmary admitted due to musculoskeletal disorders. Age, sex, race, history of hypertension, smoking, hypercholesterolemia and diabetes mellitus were evaluated as risk factors in both groups. IgG, IgM, and IgA anti-beta2-gpI and aCL antibodies were detected by enzymatic immunoassay. RESULTS: Sixty-eight patients with MetS and 82 controls were studied. Patients with MetS showed mean age higher than controls (P = 0.001), while males (P = 0.003; OR 0.31; 95%CI 0.15-0.16) and Caucasian ethnicity (P = 0.004; OR 0.25; 95%CI 0.10-0.60) predominated in controls. History of hypertension, hypercholesterolemia and diabetes mellitus were more prevalent in cases than in controls (P < 0.05). The frequency of aCL antibodies (all isotypes) and of IgG and IgM anti-beta2 gpI did not significantly differ in cases and controls. IgA anti-beta2-gpI antibodies were significantly more frequent in MetS patients (42.2%) than controls (10.9%) (P < 0.001). The adjusted OR for IgA anti-beta2-gpI antibodies was 3.60 (95%CI 1.55-8.37; P = 0.003). CONCLUSION: The current study shows that elevated levels of IgA autoantibodies to β2-gpI might be independently associated to MetS.BACKGROUND The metabolic syndrome (MetS) is a proatherogenic entity. Autoantibodies to phospholipid cofactors such as beta2-glycoprotein I (beta2-gpI) can influence atheroma appearance. Previous studies confirmed an association of IgA anti-beta2-gpI antibodies with cerebral ischemia, myocardial infarction, peripheral artery disease and carotid disease. OBJECTIVE This case-control study evaluates a possible association of anti-beta2-gpI and anticardiolipin (aCL) antibodies with non-complicated MetS. METHODS Cases comprised patients with MetS without history of vascular events; controls included individuals from the Orthopedic Infirmary admitted due to musculoskeletal disorders. Age, sex, race, history of hypertension, smoking, hypercholesterolemia and diabetes mellitus were evaluated as risk factors in both groups. IgG, IgM, and IgA anti-beta2-gpI and aCL antibodies were detected by enzymatic immunoassay. RESULTS Sixty-eight patients with MetS and 82 controls were studied. Patients with MetS showed mean age higher than controls (P = 0.001), while males (P = 0.003; OR 0.31; 95%CI 0.15-0.16) and Caucasian ethnicity (P = 0.004; OR 0.25; 95%CI 0.10-0.60) predominated in controls. History of hypertension, hypercholesterolemia and diabetes mellitus were more prevalent in cases than in controls (P < 0.05). The frequency of aCL antibodies (all isotypes) and of IgG and IgM anti-beta2 gpI did not significantly differ in cases and controls. IgA anti-beta2-gpI antibodies were significantly more frequent in MetS patients (42.2%) than controls (10.9%) (P < 0.001). The adjusted OR for IgA anti-beta2-gpI antibodies was 3.60 (95%CI 1.55-8.37; P = 0.003). CONCLUSION The current study shows that elevated levels of IgA autoantibodies to β2-gpI might be independently associated to MetS.

Auto-anticorpos anti-β2-glicoproteína I e síndrome metabólica

BACKGROUND: The metabolic syndrome (MetS) is a proatherogenic entity. Autoantibodies to phospholipid cofactors such as beta2-glycoprotein I (beta2-gpI) can influence atheroma appearance. Previous studies confirmed an association of IgA anti-beta2-gpI antibodies with cerebral ischemia, myocardial infarction, peripheral artery disease and carotid disease. OBJECTIVE: This case-control study evaluates a possible association of anti-beta2-gpI and anticardiolipin (aCL) antibodies with non-complicated MetS. METHODS: Cases comprised patients with MetS without history of vascular events; controls included individuals from the Orthopedic Infirmary admitted due to musculoskeletal disorders. Age, sex, race, history of hypertension, smoking, hypercholesterolemia and diabetes mellitus were evaluated as risk factors in both groups. IgG, IgM, and IgA anti-beta2-gpI and aCL antibodies were detected by enzymatic immunoassay. RESULTS: Sixty-eight patients with MetS and 82 controls were studied. Patients with MetS showed mean age higher than controls (P = 0.001), while males (P = 0.003; OR 0.31; 95%CI 0.15-0.16) and Caucasian ethnicity (P = 0.004; OR 0.25; 95%CI 0.10-0.60) predominated in controls. History of hypertension, hypercholesterolemia and diabetes mellitus were more prevalent in cases than in controls (P < 0.05). The frequency of aCL antibodies (all isotypes) and of IgG and IgM anti-beta2 gpI did not significantly differ in cases and controls. IgA anti-beta2-gpI antibodies were significantly more frequent in MetS patients (42.2%) than controls (10.9%) (P < 0.001). The adjusted OR for IgA anti-beta2-gpI antibodies was 3.60 (95%CI 1.55-8.37; P = 0.003). CONCLUSION: The current study shows that elevated levels of IgA autoantibodies to β2-gpI might be independently associated to MetS.BACKGROUND The metabolic syndrome (MetS) is a proatherogenic entity. Autoantibodies to phospholipid cofactors such as beta2-glycoprotein I (beta2-gpI) can influence atheroma appearance. Previous studies confirmed an association of IgA anti-beta2-gpI antibodies with cerebral ischemia, myocardial infarction, peripheral artery disease and carotid disease. OBJECTIVE This case-control study evaluates a possible association of anti-beta2-gpI and anticardiolipin (aCL) antibodies with non-complicated MetS. METHODS Cases comprised patients with MetS without history of vascular events; controls included individuals from the Orthopedic Infirmary admitted due to musculoskeletal disorders. Age, sex, race, history of hypertension, smoking, hypercholesterolemia and diabetes mellitus were evaluated as risk factors in both groups. IgG, IgM, and IgA anti-beta2-gpI and aCL antibodies were detected by enzymatic immunoassay. RESULTS Sixty-eight patients with MetS and 82 controls were studied. Patients with MetS showed mean age higher than controls (P = 0.001), while males (P = 0.003; OR 0.31; 95%CI 0.15-0.16) and Caucasian ethnicity (P = 0.004; OR 0.25; 95%CI 0.10-0.60) predominated in controls. History of hypertension, hypercholesterolemia and diabetes mellitus were more prevalent in cases than in controls (P < 0.05). The frequency of aCL antibodies (all isotypes) and of IgG and IgM anti-beta2 gpI did not significantly differ in cases and controls. IgA anti-beta2-gpI antibodies were significantly more frequent in MetS patients (42.2%) than controls (10.9%) (P < 0.001). The adjusted OR for IgA anti-beta2-gpI antibodies was 3.60 (95%CI 1.55-8.37; P = 0.003). CONCLUSION The current study shows that elevated levels of IgA autoantibodies to β2-gpI might be independently associated to MetS.

Inflammatory markers and antichlamydial antibodies in patients with metabolic syndrome.

FUNDAMENTO: A sindrome metabolica esta associada ao aumento de risco de eventos cardiovasculares. Marcadores inflamatorios e anticorpos anti-Chlamydia tem sido relacionados ao desenvolvimento e a progressao da aterosclerose e dos eventos cardiovasculares. OBJETIVO: Avaliar os marcadores inflamatorios interleucina-6 (IL-6) e fator de necrose tumoral-alfa (TNF-α) e os anticorpos anti-Chlamydia pneumoniae em pacientes com sindrome metabolica (SM), com e sem eventos cardiovasculares. METODOS: Estudo transversal constituido por 147 individuos. Desses, 100 (68%) com SM e sem eventos cardiovasculares; e 47 (32%) com SM e com eventos cardiovasculares. Dos individuos que sofreram eventos cardiovasculares, 13 (6,11%) apresentam infarto agudo do miocardio (IAM), e dez (4,7%), acidente vascular cerebral (AVC). O diagnostico da SM foi determinado pelos criterios do NCEP-ATPIII. RESULTADOS: A media de idade dos sujeitos com eventos cardiovasculares foi de 61,26 ± 8,5 e de 59,32 ± 9,9 nos individuos sem esses eventos (p=0,279), havendo predominio do sexo feminino. O grupo com SM e sem evento apresentou maior peso, altura, IMC e circunferencia abdominal. Para os individuos com eventos cardiovasculares (p=0,001), os marcadores inflamatorios IL-6 e TNF-α e a doenca vascular periferica foram significativamente maiores. Obtiveram-se niveis elevados de anticorpos IgG para Chlamydia pneumoniae no grupo SM, sem eventos e de IgA no grupo com eventos quando comparados os dois grupos. Com relacao ao IAM e ao AVC, os anticorpos anti-Chlamydia pneumoniae nao demonstraram significância estatistica, comparados ao grupo sem eventos cardiovasculares. Associacao foi observada com o uso de estatinas, hipoglicemiantes orais, injetaveis e anti-inflamatorios nao esteroidais no grupo com esses eventos. CONCLUSAO: Marcadores inflamatorios encontram-se significativamente elevados em pacientes com SM, com IAM e AVC. Anticorpos anti-Chlamydia nao mostraram diferenca significativa em pacientes com SM, com e sem eventos.BACKGROUND The metabolic syndrome is associated with increased risk of cardiovascular events. Inflammatory markers and antichlamydial antibodies have been linked to the development and progression of atherosclerosis and cardiovascular events. OBJECTIVE To evaluate the inflammatory markers interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α), as well as anti-chlamydia pneumoniae antibodies, in patients with metabolic syndrome (MS), with and without cardiovascular events. METHODS Cross sectional study consisting of 147 individuals. Out of these, 100 (68%) with MS and without cardiovascular events; and 47 (32%) with MS and with cardiovascular events. Among the individuals who had had cardiovascular events, 13 (6.11%) had acute myocardial infarction (AMI) and ten (4.7%) had cerebrovascular accident (CVA). The diagnosis of MS was determined by the criteria of NCEP-ATPIII. RESULTS The mean age of subjects with cardiovascular events was 61.26 ± 8.5 and 59.32 ± 9.9 in subjects without such events (p = 0.279), with a predominance of females. The weight, height, BMI and waist circumference of the group with MS and without event was greater. Among individuals with cardiovascular events (p = 0.001), the inflammatory markers IL-6 and TNF-α and the peripheral vascular disease were significantly greater. There were high levels of IgG antibodies to C. pneumoniae in the SM group, without events, and of IgA antibodies in the group with events, when the two groups were compared. With respect to AMI and stroke, the anti-chlamydia pneumoniae antibodies showed no statistical significance, compared to the group without cardiovascular events. An association was observed with the use of statins, nonsteroidal anti-inflammatory drugs and injectable, oral hypoglycemic agents, in the group with these events. CONCLUSION The inflammatory markers were significantly elevated in patients with MS, with acute myocardial infarction and stroke. There was no significant difference in anti-chlamydial antibodies in patients with MS, with and without events.

Marcadores inflamatórios e anticorpos anti-chlamydia em pacientes com síndrome metabólica

FUNDAMENTO: A sindrome metabolica esta associada ao aumento de risco de eventos cardiovasculares. Marcadores inflamatorios e anticorpos anti-Chlamydia tem sido relacionados ao desenvolvimento e a progressao da aterosclerose e dos eventos cardiovasculares. OBJETIVO: Avaliar os marcadores inflamatorios interleucina-6 (IL-6) e fator de necrose tumoral-alfa (TNF-α) e os anticorpos anti-Chlamydia pneumoniae em pacientes com sindrome metabolica (SM), com e sem eventos cardiovasculares. METODOS: Estudo transversal constituido por 147 individuos. Desses, 100 (68%) com SM e sem eventos cardiovasculares; e 47 (32%) com SM e com eventos cardiovasculares. Dos individuos que sofreram eventos cardiovasculares, 13 (6,11%) apresentam infarto agudo do miocardio (IAM), e dez (4,7%), acidente vascular cerebral (AVC). O diagnostico da SM foi determinado pelos criterios do NCEP-ATPIII. RESULTADOS: A media de idade dos sujeitos com eventos cardiovasculares foi de 61,26 ± 8,5 e de 59,32 ± 9,9 nos individuos sem esses eventos (p=0,279), havendo predominio do sexo feminino. O grupo com SM e sem evento apresentou maior peso, altura, IMC e circunferencia abdominal. Para os individuos com eventos cardiovasculares (p=0,001), os marcadores inflamatorios IL-6 e TNF-α e a doenca vascular periferica foram significativamente maiores. Obtiveram-se niveis elevados de anticorpos IgG para Chlamydia pneumoniae no grupo SM, sem eventos e de IgA no grupo com eventos quando comparados os dois grupos. Com relacao ao IAM e ao AVC, os anticorpos anti-Chlamydia pneumoniae nao demonstraram significância estatistica, comparados ao grupo sem eventos cardiovasculares. Associacao foi observada com o uso de estatinas, hipoglicemiantes orais, injetaveis e anti-inflamatorios nao esteroidais no grupo com esses eventos. CONCLUSAO: Marcadores inflamatorios encontram-se significativamente elevados em pacientes com SM, com IAM e AVC. Anticorpos anti-Chlamydia nao mostraram diferenca significativa em pacientes com SM, com e sem eventos.BACKGROUND The metabolic syndrome is associated with increased risk of cardiovascular events. Inflammatory markers and antichlamydial antibodies have been linked to the development and progression of atherosclerosis and cardiovascular events. OBJECTIVE To evaluate the inflammatory markers interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α), as well as anti-chlamydia pneumoniae antibodies, in patients with metabolic syndrome (MS), with and without cardiovascular events. METHODS Cross sectional study consisting of 147 individuals. Out of these, 100 (68%) with MS and without cardiovascular events; and 47 (32%) with MS and with cardiovascular events. Among the individuals who had had cardiovascular events, 13 (6.11%) had acute myocardial infarction (AMI) and ten (4.7%) had cerebrovascular accident (CVA). The diagnosis of MS was determined by the criteria of NCEP-ATPIII. RESULTS The mean age of subjects with cardiovascular events was 61.26 ± 8.5 and 59.32 ± 9.9 in subjects without such events (p = 0.279), with a predominance of females. The weight, height, BMI and waist circumference of the group with MS and without event was greater. Among individuals with cardiovascular events (p = 0.001), the inflammatory markers IL-6 and TNF-α and the peripheral vascular disease were significantly greater. There were high levels of IgG antibodies to C. pneumoniae in the SM group, without events, and of IgA antibodies in the group with events, when the two groups were compared. With respect to AMI and stroke, the anti-chlamydia pneumoniae antibodies showed no statistical significance, compared to the group without cardiovascular events. An association was observed with the use of statins, nonsteroidal anti-inflammatory drugs and injectable, oral hypoglycemic agents, in the group with these events. CONCLUSION The inflammatory markers were significantly elevated in patients with MS, with acute myocardial infarction and stroke. There was no significant difference in anti-chlamydial antibodies in patients with MS, with and without events.

Marcadores inflamatorios y anticuerpos anti-chlamydia en pacientes con síndrome metabólico

FUNDAMENTO: A sindrome metabolica esta associada ao aumento de risco de eventos cardiovasculares. Marcadores inflamatorios e anticorpos anti-Chlamydia tem sido relacionados ao desenvolvimento e a progressao da aterosclerose e dos eventos cardiovasculares. OBJETIVO: Avaliar os marcadores inflamatorios interleucina-6 (IL-6) e fator de necrose tumoral-alfa (TNF-α) e os anticorpos anti-Chlamydia pneumoniae em pacientes com sindrome metabolica (SM), com e sem eventos cardiovasculares. METODOS: Estudo transversal constituido por 147 individuos. Desses, 100 (68%) com SM e sem eventos cardiovasculares; e 47 (32%) com SM e com eventos cardiovasculares. Dos individuos que sofreram eventos cardiovasculares, 13 (6,11%) apresentam infarto agudo do miocardio (IAM), e dez (4,7%), acidente vascular cerebral (AVC). O diagnostico da SM foi determinado pelos criterios do NCEP-ATPIII. RESULTADOS: A media de idade dos sujeitos com eventos cardiovasculares foi de 61,26 ± 8,5 e de 59,32 ± 9,9 nos individuos sem esses eventos (p=0,279), havendo predominio do sexo feminino. O grupo com SM e sem evento apresentou maior peso, altura, IMC e circunferencia abdominal. Para os individuos com eventos cardiovasculares (p=0,001), os marcadores inflamatorios IL-6 e TNF-α e a doenca vascular periferica foram significativamente maiores. Obtiveram-se niveis elevados de anticorpos IgG para Chlamydia pneumoniae no grupo SM, sem eventos e de IgA no grupo com eventos quando comparados os dois grupos. Com relacao ao IAM e ao AVC, os anticorpos anti-Chlamydia pneumoniae nao demonstraram significância estatistica, comparados ao grupo sem eventos cardiovasculares. Associacao foi observada com o uso de estatinas, hipoglicemiantes orais, injetaveis e anti-inflamatorios nao esteroidais no grupo com esses eventos. CONCLUSAO: Marcadores inflamatorios encontram-se significativamente elevados em pacientes com SM, com IAM e AVC. Anticorpos anti-Chlamydia nao mostraram diferenca significativa em pacientes com SM, com e sem eventos.BACKGROUND The metabolic syndrome is associated with increased risk of cardiovascular events. Inflammatory markers and antichlamydial antibodies have been linked to the development and progression of atherosclerosis and cardiovascular events. OBJECTIVE To evaluate the inflammatory markers interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α), as well as anti-chlamydia pneumoniae antibodies, in patients with metabolic syndrome (MS), with and without cardiovascular events. METHODS Cross sectional study consisting of 147 individuals. Out of these, 100 (68%) with MS and without cardiovascular events; and 47 (32%) with MS and with cardiovascular events. Among the individuals who had had cardiovascular events, 13 (6.11%) had acute myocardial infarction (AMI) and ten (4.7%) had cerebrovascular accident (CVA). The diagnosis of MS was determined by the criteria of NCEP-ATPIII. RESULTS The mean age of subjects with cardiovascular events was 61.26 ± 8.5 and 59.32 ± 9.9 in subjects without such events (p = 0.279), with a predominance of females. The weight, height, BMI and waist circumference of the group with MS and without event was greater. Among individuals with cardiovascular events (p = 0.001), the inflammatory markers IL-6 and TNF-α and the peripheral vascular disease were significantly greater. There were high levels of IgG antibodies to C. pneumoniae in the SM group, without events, and of IgA antibodies in the group with events, when the two groups were compared. With respect to AMI and stroke, the anti-chlamydia pneumoniae antibodies showed no statistical significance, compared to the group without cardiovascular events. An association was observed with the use of statins, nonsteroidal anti-inflammatory drugs and injectable, oral hypoglycemic agents, in the group with these events. CONCLUSION The inflammatory markers were significantly elevated in patients with MS, with acute myocardial infarction and stroke. There was no significant difference in anti-chlamydial antibodies in patients with MS, with and without events.

Anticuerpos anti-β2-glicoproteína I y síndrome metabólico

BACKGROUND: The metabolic syndrome (MetS) is a proatherogenic entity. Autoantibodies to phospholipid cofactors such as beta2-glycoprotein I (beta2-gpI) can influence atheroma appearance. Previous studies confirmed an association of IgA anti-beta2-gpI antibodies with cerebral ischemia, myocardial infarction, peripheral artery disease and carotid disease. OBJECTIVE: This case-control study evaluates a possible association of anti-beta2-gpI and anticardiolipin (aCL) antibodies with non-complicated MetS. METHODS: Cases comprised patients with MetS without history of vascular events; controls included individuals from the Orthopedic Infirmary admitted due to musculoskeletal disorders. Age, sex, race, history of hypertension, smoking, hypercholesterolemia and diabetes mellitus were evaluated as risk factors in both groups. IgG, IgM, and IgA anti-beta2-gpI and aCL antibodies were detected by enzymatic immunoassay. RESULTS: Sixty-eight patients with MetS and 82 controls were studied. Patients with MetS showed mean age higher than controls (P = 0.001), while males (P = 0.003; OR 0.31; 95%CI 0.15-0.16) and Caucasian ethnicity (P = 0.004; OR 0.25; 95%CI 0.10-0.60) predominated in controls. History of hypertension, hypercholesterolemia and diabetes mellitus were more prevalent in cases than in controls (P < 0.05). The frequency of aCL antibodies (all isotypes) and of IgG and IgM anti-beta2 gpI did not significantly differ in cases and controls. IgA anti-beta2-gpI antibodies were significantly more frequent in MetS patients (42.2%) than controls (10.9%) (P < 0.001). The adjusted OR for IgA anti-beta2-gpI antibodies was 3.60 (95%CI 1.55-8.37; P = 0.003). CONCLUSION: The current study shows that elevated levels of IgA autoantibodies to β2-gpI might be independently associated to MetS.BACKGROUND The metabolic syndrome (MetS) is a proatherogenic entity. Autoantibodies to phospholipid cofactors such as beta2-glycoprotein I (beta2-gpI) can influence atheroma appearance. Previous studies confirmed an association of IgA anti-beta2-gpI antibodies with cerebral ischemia, myocardial infarction, peripheral artery disease and carotid disease. OBJECTIVE This case-control study evaluates a possible association of anti-beta2-gpI and anticardiolipin (aCL) antibodies with non-complicated MetS. METHODS Cases comprised patients with MetS without history of vascular events; controls included individuals from the Orthopedic Infirmary admitted due to musculoskeletal disorders. Age, sex, race, history of hypertension, smoking, hypercholesterolemia and diabetes mellitus were evaluated as risk factors in both groups. IgG, IgM, and IgA anti-beta2-gpI and aCL antibodies were detected by enzymatic immunoassay. RESULTS Sixty-eight patients with MetS and 82 controls were studied. Patients with MetS showed mean age higher than controls (P = 0.001), while males (P = 0.003; OR 0.31; 95%CI 0.15-0.16) and Caucasian ethnicity (P = 0.004; OR 0.25; 95%CI 0.10-0.60) predominated in controls. History of hypertension, hypercholesterolemia and diabetes mellitus were more prevalent in cases than in controls (P < 0.05). The frequency of aCL antibodies (all isotypes) and of IgG and IgM anti-beta2 gpI did not significantly differ in cases and controls. IgA anti-beta2-gpI antibodies were significantly more frequent in MetS patients (42.2%) than controls (10.9%) (P < 0.001). The adjusted OR for IgA anti-beta2-gpI antibodies was 3.60 (95%CI 1.55-8.37; P = 0.003). CONCLUSION The current study shows that elevated levels of IgA autoantibodies to β2-gpI might be independently associated to MetS.

IgA antibodies to Chlamydia trachomatis and metabolic syndrome

Chlamydia pneumoniae may trigger atherogenesis. Chlamydia trachomatis (CT) can also induce endothelial activation. However, its role in metabolic syndrome (METS), a proatherogenic entity, has remained unexplored. In this study the frequencies of IgA and IgG anti‐CT antibodies were evaluated by immunoenzymatic assay in METS patients and healthy controls. The survey included 238 individuals (148 with METS). The mean age was 59.7 years. IgA anti‐CT antibodies were found significantly more frequently in METS patients (16.9%) than in controls (5.6%) (P= 0.015). The role of such IgA response in METS should be further investigated.