Helen Hermana Miranda Hermsdorff

Gordura visceral, subcutânea ou intramuscular: onde está o problema?

The adipose tissue is a dynamic organ that secrets several factors, denominated adipokines. They are associated, directly or indirectly, in a process that contributes to atherosclerosis, hypertension, insulinic resistance and diabetes type 2, dyslipidemias, presenting the link between adiposity, metabolic syndrome and cardiovascular diseases. In the obesity, body fat depots are increased, presenting eventual elevation in the adipokines expression and secretion. The different fat depots, visceral, abdominal subcutaneous, gluteal-femoral subcutaneous and intramuscular adipose tissue, have different metabolic and endocrine degrees, interfering, therefore, with specific form in the process associated with body adiposity in obese and diabetics subjects. The present study seeks to discuss the endocrine and metabolic role of each adipose tissue compartment, by way to assess their contribution to the complications linked to obesity.

Saturated fatty acids trigger TLR4-mediated inflammatory response.

Toll-like receptors (TLR) mediate infection-induced inflammation and sterile inflammation by endogenous molecules. Among the TLR family, TLR4 is the best understood. However, while its downstream signaling pathways have been well defined, not all ligands of TLR4 are currently known. Current evidence suggests that saturated fatty acids (SFA) act as non-microbial TLR4 agonists, and trigger its inflammatory response. Thus, our present review provides a new perspective on the potential mechanism by which SFAs could modulate TLR4-induced inflammatory responses: (1) SFAs can be recognized by CD14-TLR4-MD2 complex and trigger inflammatory pathways, similar to lipopolysaccharide (LPS). (2) SFAs lead to modification of gut microbiota with an overproduction of LPS after a high-fat intake, enhancing this natural TLR4 ligand. (3) In addition, this metabolic endotoxemia leads to an oxidative stress thereby producing atherogenic lipids - oxLDL and oxidized phospholipids - which trigger CD36-TLR4-TLR6 inflammatory response. (4) Also, the high SFA consumption increases the lipemia and the mmLDL and oxLDL formation through oxidative modifications of LDL. The mmLDL, unlike oxLDL, is involved in activation of the CD14-TLR4-MD2 inflammatory pathway. Those molecules can induce TLR4 inflammatory response by MyD88-dependent and/or MyD88-independent pathways that, in turn, promotes the expression of proinflammatory transcript factors such as factor nuclear kappa B (NF-κB), which plays a crucial role in the induction of inflammatory mediators (cytokines, chemokines, or costimulatory molecules) implicated in the development and progression of many chronic diseases.

Association of Body Fat Distribution with Proinflammatory Gene Expression in Peripheral Blood Mononuclear Cells from Young Adult Subjects

Peripheral blood mononuclear cells (PBMC) measurements have proved useful in recent studies to discern peripheral biomarkers for common complex diseases and for understanding host responses to drugs and nutrition in personalized medicine. Despite the initial promising data from PBMC, there is little information, however, on inflammatory and immune gene regulation in the context of body fat distribution and metabolic features in healthy adults. We investigated the putative association of body fat distribution and related-metabolic features with mRNA levels of proinflammatory markers in PBMC. This study enrolled 136 healthy subjects (85 females/51 males; age: 21.5 +/- 2.5 years). Anthropometrical, clinical, metabolic, and proinflammatory variables were assessed with validated tools. Interestingly, in normal-weight subjects with lower truncal fat (TF) values, mRNA levels of ICAM1, IL1R1, IL6, and TNF-alpha in PBMC were lower (p < 0.05), compared to normal-weight individuals with higher TF (>58.5/50.2% for men/women, respectively) and overweight/obese subjects [body mass index (BMI) >25 kg/m(2)]. After regression analyses were performed, individuals with the highest tertiles of TF and waist circumference displayed higher mRNA gene expressions as well as circulating proinflammatory (C-reactive protein and IL6) and metabolic (blood pressure, HOMA-IR, and LDL-c:HDL-c ratio) variables values (p < 0.05), independent from gender. Our findings collectively suggest that the mRNA expression of certain proinflammatory markers in PBMC is associated with body fat distribution in healthy adult subjects, which in turn, was also related to metabolic features and plasma proinflammatory markers concentrations.

Anti-inflammatory Properties of Orange Juice: Possible Favorable Molecular and Metabolic Effects

The low-grade inflammation has been recognized as the link between adiposity and the risk of chronic metabolic disorders. Thus, increased concentrations of inflammatory markers, such as interleukins and tumor necrosis factor alpha have been found in obese individuals. In turn, diet can positively or negatively influence on the risk of chronic metabolic diseases by modulating the inflammatory status. In this context, orange juice consumption can play a role in modulation of inflammatory markers through bioactive compounds, such as the flavonoids (hesperidin, naringenin). According to this review, orange juice appears to mediate the inflammatory response in plasma level and gene expression, and in postprandial and chronic (≥7 consecutive days) periods. The current findings suggest that orange juice could be a dietary feature for prevention and treatment of chronic diseases, although more studies are necessary to evaluate the physiological and molecular mechanisms involved.

Red but not white meat consumption is associated with metabolic syndrome, insulin resistance and lipid peroxidation in Brazilian middle-aged men

Background The influence of diet on metabolic syndrome and oxidative stress are not completely known. Design This cross-sectional study assessed the association of red meat and white meat consumption with metabolic syndrome, insulin resistance and lipid peroxidation in Brazilian middle-aged men. Methods A total of 296 subjects (age: 50.5 ± 5.0 years, body mass index: 25.8 ± 3.5 kg/m2) were evaluated. Anthropometry, lifestyle features, blood biochemical parameters, diagnosis of metabolic syndrome, homeostatic model assessment for insulin resistance, a lipid peroxidation marker (oxidized low-density lipoprotein) and triglycerides:high-density lipoprotein cholesterol ratio were assessed. Dietary intake was estimated by a food frequency questionnaire. Results The subjects included in the highest tertile red meat (≥81.5 g/d) and saturated fatty acid from red meat consumption (≥4.3 g/d) had higher occurrence of central obesity (nearly 60%, p < 0.01), hypertriglyceridaemia (nearly 43%, p < 0.01) and metabolic syndrome (35%, p < 0.01). They also had higher values of homeostatic model assessment for insulin resistance, oxidized low-density lipoprotein, and triglycerides:high-density lipoprotein cholesterol ratio, regardless of interfering factors. There were no associations of highest white meat tertile (≥39.4 g/d) and saturated fatty acid from white meat (≥1.0 g/d) consumption with the assessed parameters (p > 0.05). Conclusions Red meat consumption was cross-sectionally associated with the occurrence of central obesity, hypertriglyceridaemia, and metabolic syndrome as well as with higher homeostatic model assessment for insulin resistance, oxidized low-density lipoprotein concentrations and triglycerides:high-density lipoprotein cholesterol ratio. The content of saturated fatty acid from red meat consumption may be a factor that contributed to this relationship, while white meat consumption was not associated with metabolic syndrome and the assessed biomarkers.

Gender-specific relationships between plasma oxidized low-density lipoprotein cholesterol, total antioxidant capacity, and central adiposity indicators

Background: Oxidative stress has a pivotal role in the onset of obesity-related chronic diseases. This study assessed potential gender differences in the associations of adiposity (total vs. central) with oxidative stress markers in healthy young adults. Methods: This cross-sectional study enrolled 272 subjects (97 males, 175 females; 22 ± 3 years, body mass index 22.0 ± 2.8 kg/m2). Body composition, cardiometabolic and lifestyle features, oxidized low-density lipoprotein cholesterol (ox-LDL) concentrations, plasma total antioxidant capacity (TAC), and glutathione peroxidase (GPx) activity in erythrocytes were determined by validated procedures. Results: Compared to women, men had statistically higher concentrations of ox-LDL (61.7 vs. 53.5 U/l, p = 0.022). In analyses with the whole sample, those individuals included in the highest tertile of central adiposity indicators (waist circumference, WC, or waist-to-hip ratio, WHR) presented higher ox-LDL and lower TAC values (p < 0.01), while no statistical differences were found across tertiles of total body fat. WHR values were more strongly associated with ox-LDL and TAC concentrations, compared to other adiposity indicators, with higher slopes for women. Sex differences in ox-LDL concentrations were abolished (p > 0.05) after individual pairing of men and women for WC (53.8 vs. 61.6 U/l, p = 0.225) or WHR (56.1 vs. 56.3 U/l, p = 0.471). No differences were found in GPx values concerning gender or adiposity indicators. Conclusions: Plasma ox-LDL and TAC values were more strongly influenced by central adiposity indicators (WHR and WC) in women than in men, suggesting that the change of the gynoid to android pattern phenotype among young women could lead to a steeper unfavourable redox status compared to men.

Tendência da mortalidade por doenças neoplásicas em 10 capitais brasileiras, de 1980 a 2000

O objetivo deste estudo foi analisar a tendencia da mortalidade por doencas neoplasicas, segundo sexo e faixa etaria, no periodo de 1980 a 2000, em 10 capitais brasileiras. Para tanto, realizou-se um estudo ecologico de serie temporal, utilizando dados de obitos de individuos acima de 30 anos de ambos os sexos. Os dados de mortalidade foram obtidos do Sistema de Informacao sobre Mortalidade do Ministerio da Saude (SIM/MS/DATASUS). Utilizou-se a padronizacao dos coeficientes de mortalidade pelo metodo direto e o metodo de regressao linear simples. O coeficiente medio padronizado de mortalidade por neoplasia, estimado entre 1980 e 2000, foi de 10.239 mortes, com aumento de 5.220 mortes por 100 mil habitantes ao ano. Os coeficientes de mortalidade foram maiores no sexo masculino e individuos acima de 60 anos. Observou-se tendencia crescente da mortalidade nas capitais analisadas, em ambos os grupos etarios, sendo maior nas capitais das regioes Centro-Oeste, Norte e Nordeste e na populacao acima de 60 anos. A elevada mortalidade para o sexo masculino e a populacao idosa deve-se, provavelmente, a maior exposicao aos fatores de risco ambientais e a maior prevalencia de cânceres letais entre os homens. As capitais das regioes Sul e Sudeste seguem tendencia crescente, porem com incremento menor comparado as demais, provavelmente devido aos maiores avancos no processo de transicao demografica e epidemiologica, e melhores servicos de assistencia medica. Este estudo mostrou que a mortalidade por neoplasia aumentou ao longo da serie temporal, podendo se tornar a principal causa de morte no Brasil.

Benefits and relationship of steps walked per day to cardiometabolic risk factor in Brazilian middle-aged men

OBJECTIVES We evaluated the benefits and relationship of the number of steps per day to the cardiometabolic risk factors: adiposity indicators; insulin resistance; and metabolic syndrome (MetS) in apparently healthy Brazilian middle-aged men. DESIGN Cross-sectional. METHODS Apparently healthy men (age: 50 ± 5 years; n=299) were studied. The number of steps per day was measured by pedometer. The adiposity indicators (waist circumference, total body fat, android and gynoid body fat), serum insulin, glucose and triglycerides, triglycerides/high-density lipoprotein cholesterol (HDL-c) ratio, homeostasis model assessment of insulin resistance (HOMA-IR) and MetS were assessed. Subjects were placed in groups to reflect different levels of steps per day (average of 7 consecutive days): Group 1<10,000 and Group 2 ≥ 10,000. Relationships among variables were measured by multiple linear regressions and the Spearman correlation coefficient as appropriate (p<0.05). RESULTS The cardiometabolic risk factors were lower (p<0.05) in Group 2 than in Group 1. The number of steps per day was a negative predictive factor for total body fat, android and gynoid body fat and HOMA-IR independent of age, working position, android fat, overweight/obesity prevalence, and triglycerides/HDL-c ratio. Moreover, there was a negative correlation between the number of steps and total body fat, android and gynoid body fat, HOMA-IR and MetS. CONCLUSIONS Brazilian middle-aged men performing more than 10,000 steps per day have better cardiometabolic conditions than those walking fewer than 10,000 steps. The number of steps per day is inversely related to the indicators of total and regional adiposity, insulin resistance and MetS.

Leptina e sua influência na patofisiologia de distúrbios alimentares

A leptina e uma proteina secretada pelos adipocitos com papel regulador em varios sistemas do organismo, como sistema imune, respiratorio e reprodutivo, bem como no balanco energetico via acao hipotalâmica. Sua acao primaria ocorre no nucleo hipotalâmico arqueado, no qual inicia uma cascata de eventos para inibicao da ingestao energetica e aumento do gasto energetico. As concentracoes de leptina sao influenciadas pela adiposidade, fatores hormonais e nutricionais. A restricao e os episodios de compulsao alimentar, presentes na anorexia nervosa e bulimia, respectivamente, sao considerados, na literatura cientifica, fatores determinantes na leptinemia. Seus niveis tambem alterados no tratamento desses disturbios alimentares sugerem uma relacao entre as alteracoes neuroendocrinas e consequentes modificacoes nos sinais de fome e saciedade, com a patogenia ou manutencao dos quadros clinicos. Trabalhos tem encontrado impacto dessas alteracoes na saude dos pacientes, em curto e longo prazos. Esta revisao tem como objetivo esclarecer quais sao as funcoes da leptina nos tecidos nervoso e periferico, quais os mecanismos que interferem na sua concentracao nos disturbios alimentares e como isso reflete na saude do paciente anorexico ou bulimico.

Relation between uric acid and metabolic syndrome in subjects with cardiometabolic risk

Objective To identify possible relations between serum uric acid levels and metabolic syndrome and its components in a population with cardiometabolic risk. Methods This cross-sectional study included 80 subjects (46 women), with mean age of 48±16 years, seen at the Cardiovascular Health Program. Results The prevalence of hyperuricemia and metabolic syndrome was 6.3% and 47.1%, respectively. Uric acid level was significantly higher in individuals with metabolic syndrome (5.1±1.6mg/dL), as compared to those with no syndrome or with pre-syndrome (3.9±1.2 and 4.1±1.3mg/dL, respectively; p<0.05). The uric acid levels were significantly higher in men presenting abdominal obesity, and among women with abdominal obesity, lower HDL-c levels and higher blood pressure (p<0.05). Conclusion Uric acid concentrations were positively related to the occurrence of metabolic syndrome and its components, and there were differences between genders. Our results indicate serum uric acid as a potential biomarker for patients with cardiometabolic risk.