Análise dos critérios de definição da síndrome metabólica em pacientes com diabetes melito tipo 2

Methyl Chavicol and Its Synthetic Analogue as Possible Antioxidant and Antilipase Agents Based on the In Vitro and In Silico Assays

This study investigated the in vitro and in silico biological properties of the methyl chavicol (MC) and its analogue 2-[(4-methoxyphenyl)methyl]oxirane (MPMO), emphasizing the antioxidant and antilipase effects. MPMO was synthesized from MC that reacted with meta-chloroperbenzoic acid and, after separation and purification, was identified by ¹H and ¹³C NMR and GC-MS. The antioxidant activity was investigated by DPPH, cooxidation β-carotene/linoleic acid, and thiobarbituric acid assays. With the use of colorimetric determination, the antilipase effect on the pancreatic lipase was tested, while the molecular interaction profiles were evaluated by docking molecular study. MC (IC₅₀ = 312.50 ± 2.28 μg/mL) and MPMO (IC₅₀ = 8.29 ± 0.80 μg/mL) inhibited the DPPH free radical. The inhibition of lipid peroxidation (%) was 73.08 ± 4.79 and 36.16 ± 4.11 to MC and MPMO, respectively. The malonaldehyde content was significantly reduced in the presence of MC and MPMO. MC and MPMO inhibited the pancreatic lipase in 58.12 and 26.93%, respectively. MC and MPMO (−6.1 kcal·mol⁻¹) produced a binding affinity value lower than did diundecylphosphatidylcholine (−5.6 kcal·mol⁻¹). These findings show that MC and MPMO present antioxidant and antilipase activities, which may be promising molecular targets for the treatment of diseases associated with oxidative damage and lipid metabolism.

[Degree of physical activity and metabolic syndrome: a cross-sectional study among the Khisêdjê group in the Xingu Indigenous Park, Brazil]

This study aimed to verify the existence of an association between degree of physical activity and presence of metabolic syndrome in the Khisêdjê indigenous group. The authors evaluated 170 individuals 20 years or older, based on demographic data, physical examination, and laboratory tests. The data were analyzed with the chi-square test (p < 0.05), crude and adjusted prevalence ratios (point and 95% confidence intervals), and Student's t-test. Satisfactory results were observed in relation to cardiorespiratory endurance, flexibility, bending of arms and trunk, and measurement of physical activity according to the number of steps/day. Prevalence of metabolic syndrome was 27.8% and was higher in women, the 39-49-year and ≥ 50-year age groups, and in individuals with lower performance on the cardiorespiratory endurance test, horizontal impulse, and number of steps/day. The results indicate the need for greater surveillance in the control and prevention of risk factors for metabolic syndrome.

Comprometimento sensório-motor dos membros inferiores em diabéticos do tipo 2

INTRODUÇÃO: A alta incidência do Diabetes mellitus (DM) na população torna essa patologia alvo de muitas pesquisas. Uma das complicações do DM é a neuropatia periférica crônica caracterizada por atrofia e degeneração axonal e/ou alteração da célula de Schwann. A fisioterapia atua na estimulação da regeneração da fibra nervosa, o que reduz o risco de desenvolvimento do pé diabético. OBJETIVO: Identificar o comprometimento da sensibilidade nos membros inferiores (MMII) de diabéticos e verificar fatores que contribuíram para o desenvolvimento do pé diabético, como glicemia, hemoglobina glicada (HbA1c), tempo de diagnóstico, pressão arterial e antropometria. MATERIAIS E MÉTODOS: Os diabéticos foram avaliados na Associação dos Diabéticos de Bauru, participaram de entrevista e foram submetidos a antropometria, triagem pressórica e teste neurossensorial no Sistema Pontuação Clínica Toronto (SPCT). RESULTADOS: Os 68 pacientes (61,76% mulheres e 38,23% homens) tinham 62,93 ± 9,64 anos, apresentaram pressão sistólica de 132,54 ± 17,95 mmHg e diastólica 80,39 ± 11,35 mmHg, índice de massa corpórea 30,34 ± 5,80 kg/m², glicemia 149,20 ± 60,37mg/dL, HbA1c 7,72 ± 1,4%; tempo de diagnóstico de um a 34 anos. Dentre eles, 80,88% apresentavam sobrepeso; 72,06%, hipertensão arterial; 42,64%, dislipidemia; 14,7%, problemas renais; e 17,64%, vasculares. Pelo SPCT, 97,05% apresentavam neuropatia, 95,59% com simetria. Na avaliação, 57,35% apresentavam alteração sensitiva protetora; 60,29%, sensibilidade térmica; 26,47%, tátil; 17,64%, vibratória; 7,35%, dolorosa; e 1,47%, alteração cinestésica. Nos pés, 72,05% apresentavam pele ressecada; 64,70%, fissuras; 54,41%, calosidade; e 44,11%, micose; 50% referiram dor; 39,7%, dormência; 41,17%, parestesia; 27,94%, ataxia. Reflexos estavam ausentes ou diminuídos em 14,71% dos indivíduos; desses, 38,23% no Aquileu. Observou-se correlação positiva entre o SPCT com a glicemia e a circunferência abdominal e a hemoglobina glicada com a glicemia. CONCLUSÃO: Houve grande incidência de neuropatia simétrica; alteração de sensibilidade com presença de sinais clínicos, sintomas, arreflexia e hiporeflexia; e incidência de obesidade e hipertensão associadas. Faz-se necessário o acompanhamento da fisioterapia na avaliação da sensibilidade para prevenir, reduzir sintomas e melhorar a circulação sanguínea em MMII.

Estresse em mulheres com Diabetes mellitus tipo 2

OBJETIVO: O objetivo do estudo foi investigar a relação entre estresse e Diabetes Mellitus Tipo 2 em mulheres. MÉTODO: Estudo transversal prospectivo, desenvolvido com 147 mulheres, utilizando a Escala de Estresse Percebido (PSS). RESULTADOS: Houve associação entre as variáveis testadas, sendo possível inferir que as mulheres com estresse elevado são as que vivenciaram sofrimento e apresentam controle glicêmico alterado, ou seja, com valores superiores a 180 mg/dL. A maioria relatou sofrimento decorrente de problemas nas relações interpessoais, óbito, doença de familiares e solidão. CONCLUSÃO: Mulheres com DM2 que convivem com estresse e/ou sofrimento constituem grupo vulnerável ao desenvolvimento de agravos à saúde demandando aos serviços de saúde o desenvolvimento de estratégias que modifiquem esta situação.

[Critical analysis of the American Diabetes Association dietary recommendations for cardiovascular disease in diabetes mellitus]

Cardiovascular disease (CVD) is the main cause of mortality among patients with diabetes mellitus (DM), and dietary intervention is an essential measure to prevent and treat this complication. The aim of this manuscript was to review scientific evidence that underlies the dietetic recommendations of the American Diabetes Association (ADA) for prevention and treatment of CVD in patients with DM. The ADA guidelines are mostly based on studies performed on patients with CVD and without DM. The evidence-based dietary recommendations for patients with DM are to increase the intake of fish and soluble fibers. Although DM has been considered as an equivalent of established CVD, the adoption of the same dietary recommendations for patients without DM and with CVD for all patients with DM is still questionable -- especially considering the peculiarities of CVD in DM. Randomized clinical trials including patients with DM should provide further information regarding the benefits of these dietary interventions for CVD.

Relationship between insulin and hypogonadism in men with metabolic syndrome

OBJECTIVE

To evaluate the incidence of hypogonadism in men with metabolic syndrome and its correlation with serum insulin levels.

METHODS

Observational, transversal study with 80 men with metabolic syndrome. The individuals were divided into two groups: Group 1: 56 patients (70%) with total testosterone > 300 ng/dL (normal gonadal function); Group 2: 24 patients (30%) with total testosterone < 300 ng/dL (hypogonadic).

RESULTS

The subjects from Group 2 compared to Group 1 presented higher body mass index (BMI), waist and hip circumferences, insulin, homeostasis model assessment insulin resistance index (Homa-IR) and beta cell (Homa-beta), and triglycerides, but lower SHBG and free testosterone values. Inverse correlations between insulin levels and total testosterone and SHBG, as well as between Homa-IR and total testosterone were observed.

CONCLUSION

In this series of men with metabolic syndrome, hypogonadism was associated with insulin resistance and may be a marker of metabolic abnormalities.

[Dietary factors and metabolic syndrome]

The role of diet in metabolic syndrome (MS) has been studied regarding each one of its components: obesity, high blood pressure, dyslipidemia, and abnormal glucose metabolism. However, few studies evaluated the effects of diet in the presence of MS as a unique independent disease. The aim of this manuscript was to review the role of dietary factors and dietary recommendations for MS. Recently some studies demonstrated that intake of whole-grain foods were negatively associated with MS. Foods with high glycemic index were positively associated with insulin resistance and the prevalence of MS. Following a Mediterranean-style diet caused a reduction in the number of MS components. Also, the adoption of the DASH diet improved the profile of all MS components. A total daily energy intake to obtain and/or to maintain a desirable weight is recommended for patients with MS. The fat content, especially from saturated fat, and cholesterol must be reduced and the intake of whole-grain foods, fruits, and vegetables must be increased. Probably, dietary fibers have an important role in the management of MS. New studies to evaluate the role of diet in the presence and development of MS are needed.