Relationship between the FTO genotype and early chronic kidney disease in type 2 diabetes : the mediating role of central obesity, hypertension, and high albuminuria

Introduction: Single nucleotide polymorphisms (SNP) in the fat mass and obesity-associated (FTO) gene have been associated with type 2 diabetes (T2D) and its complications. The aim of the present research was to investigate which and how (directly or indirectly) clinical and metabolic variables mediate the association between fat mass and the FTO gene and early chronic kidney disease (CKD) in individuals with T2D. Methods: This cross-sectional study was conducted in a sample of 236 participants with T2D (53.4% women, mean age 60 ± 10 years). DNA samples were genotyped for the rs7204609 polymorphism (C/T) in the FTO gene. Clinical, anthropometric, and metabolic data were collected. Path analysis was used to evaluate the associations. Results: Of the sample, 78 individuals with T2D had CKD (33%). Presence of the risk allele (C) was higher among participants with CKD (21.8 vs. 10.8%; p = 0.023). This polymorphism was positively associated with higher waist circumference, which in turn was associated with higher glycated hemoglobin and higher blood pressure. A higher blood-pressure level was associated with higher urinary albumin excretion (UAE) and as expected, higher UAE was associated with CKD. Path analysis showed an indirect relationship between the FTO gene and early CKD, mediated by waist circumference, blood-pressure levels, and UAE. Conclusions: These findings suggest that the C allele may contribute to genetic susceptibility to CKD in individuals with T2D through the presence of central obesity, hypertension, and high albuminuria

Cashew nut (Anacardium occidentale L.) and cashew nut oil reduce cardiovascular risk factors in adults on weight-loss treatment: a randomized controlled three-arm trial (Brazilian Nuts Study)

IntroductionCashew nut contains bioactive compounds that modulate satiety and food intake, but its effects on body fat during energy restriction remains unknown. This study aimed to assess the effects of cashew nut and cashew nut oil on body fat (primary outcome) as well as adiposity, cardiometabolic and liver function markers (secondary outcomes).Materials and methodsAn eight-week (8-wk) randomized controlled-feeding study involved 68 adults with overweight/obesity (40 women, BMI: 33 ± 4 kg/m2). Participants were randomly assigned to one of the energy-restricted (−500 kcal/d) groups: control (CT, free-nuts), cashew nut (CN, 30 g/d), or cashew nut oil (OL, 30 mL/d). Body weight, body composition, and blood collection were assessed at the baseline and endpoint of the study.ResultsAfter 8-wk, all groups reduced significantly body fat (CT: −3.1 ± 2.8 kg; CN: −3.3 ± 2.7 kg; OL: −1.8 ± 2.6 kg), body weight (CT: −4.2 ± 3.8 kg; CN: −3.9 ± 3.1 kg; OL: −3.4 ± 2.4 kg), waist (CT: −5.1 ± 4.6 cm; CN: −3.9 ± 3.9 cm; OL: −3.7 ± 5.3 cm) and hip circumferences (CT: −2.9 ± 3.0 cm; CN: −2.7 ± 3.1 cm; OL: −2.9 ± 2.3 cm). CN-group reduced liver enzymes (AST: −3.1 ± 5.3 U/L; ALT: −6.0 ± 9.9 U/L), while the OL-group reduced LDL-c (−11.5 ± 21.8 mg/dL) and atherogenic index (−0.2 ± 0.5). Both intervention groups decreased neck circumference (CN: −1.0 ± 1.2 cm; OL: −0.5 ± 1.2 cm) and apo B (CN: −6.6 ± 10.7 mg/dL; OL: −7.0 ± 15.3 mg/dL).ConclusionAfter an 8-wk energy-restricted intervention, all groups reduced body fat (kg), weight, and some others adiposity indicators, with no different effect of cashew nut or cashew nut oil. However, participants in the intervention groups experienced additional reductions in atherogenic marker, liver function biomarkers, and cardiovascular risk factors (neck circumference and apo B levels), with these effects observed across the OL group, CN group, and both intervention groups, respectively.Clinical trial registration:https://ensaiosclinicos.gov.br/rg/RBR-8xzkyp2, identifier 8xzkyp2

Selenium antioxidant effects and its link with inflammation and metabolic syndrome.

O estado inflamat?rio cr?nico e de baixo grau bem como o estresse oxidativo associados ? s?ndrome metab?lica s?o fatores de risco relevantes para o desenvolvimento de doen?as cardiovasculares. Neste contexto, o sel?nio ? um mineral essencial que se encontra associado com o correto funcionamento dos principais processos metab?licos celulares. Estudos in vitro e in vivo em modelos experimentais de s?ndrome metab?lica, bem como em humanos, tem investigado o efeito do sel?nio sobre a express?o e secre??o de biomarcadores de inflama??o e de estresse oxidativo. Para obten??o dos artigos sobre efeitos antioxidantes do sel?nio foram feitas pesquisas nos websites cient?ficos. Na literatura encontramos numerosos artigos sobre os diferentes par?metros modulados pelas concentra??es plasm?ticas de sel?nio, incluindo a prote?na-C reativa, a interleucina-6, o fator de necrose tumoral-?, a interleucina-1??e a prote?na transportadora de retinol-4. Esta revis?o teve por objetivo discutir o papel do sel?nio nos processos inflamat?rios e de estresse oxidativo, associados ? s?ndrome metab?lica.The mild chronic inflammation and oxidative stress associated with metabolic syndrome are relevant risk factors for the development of cardiovascular diseases. In this context, selenium is an essential mineral associated with the correct functioning of the main metabolic processes of the cell. In vitro and in vivo studies in experimental metabolic syndrome models as well as in humans have investigated the effect of selenium on the expression and secretion of inflammation and oxidative stress biomarkers. Articles on the antioxidant effects of selenium were sought in scientific websites. There are a great number of studies in the literature on the different parameters modulated by blood selenium levels, such as C-reactive protein, interleukin-6, tumor necrosisfactor-alpha, interleukin-1 beta and retinol binding protein 4. The objective of this review is to discuss the role of selenium in inflammatory and oxidative stress processes associated with the metabolic syndrome

Dietary Pattern and Macronutrients Profile on the Variation of Inflammatory Biomarkers: Scientific Update

It is known that the dietary pattern and macronutrients profile may influence the expression and secretion of inflammatory biomarkers, and the low-grade inflammation is associated with the manifestation of noncommunicable chronic diseases. Therefore, this review aimed to present and discuss the role of dietary patterns and macronutrients on the variation of inflammatory markers related to NCD risk. Scientific evidences within the last five years based on clinical trials, case-controls, cohorts, and cross-sectional studies indicate that normocaloric, carbohydrate-moderated, low-glycemic index, protein-moderated, monounsaturated and polyunsaturated fatty acid-rich, omega-3, and low-saturated fat diets display positive effects on the inflammatory state, both in healthy individuals and in those with cardiovascular risk, although the second group seems to benefit more from changes in the dietary profile

VALIDAÇÃO DA SÍNDROME METABÓLICA E DE SEUS COMPONENTES AUTODECLARADOS NO ESTUDO CUME

RESUMO O objetivo deste estudo foi analisar a validade dos diagnósticos autodeclarados de síndrome metabólica (SM) e de seus componentes pelos participantes da Coorte de Universidades Mineiras (CUME). Uma subamostra de 172 participantes da coorte (33 homens e 139 mulheres, idade 38 ± 11 anos) foi aleatoriamente selecionada para este estudo. A presença de SM foi definida segundo os critérios da International Diabetes Federation (IDF). Dados de peso, altura, pressão arterial, concentração sérica de glicose, triglicerídeos e HDL-c foram autodeclarados em questionário online da coorte e as mesmas variáveis foram aferidas presencialmente mediante protocolo padronizado em laboratórios das instituições de ensino superior envolvidas no projeto. Os dados autodeclarados e aferidos foram comparados por meio de coeficiente de correlação intraclasse (CCI), coeficiente Kappa (k) e diferenças entre medidas autodeclaradas e aferidas segundo a metodologia de Bland e Altman. As prevalências da SM foram de 4,7%e 5,2%, de acordo com os dados autodeclarados e aferidos, respectivamente. O coeficiente Kappa entre diagnósticos de SM autodeclarado e aferido foi 0,814, indicando concordância quase perfeita, situação similar à observada para a obesidade (k=0,882). Os demais componentes da SM apresentaram concordâncias moderadas (k=0,41 a 0,60). Os CCIs também indicaram excelente concordância para peso, estatura, IMC e HDL-c, respectivamente, 0,989, 0,995, 0,983 e 0,761. A glicose apresentou baixa concordância (CCI: 0,336). Concluiu-se que participantes do projeto CUME forneceram informações válidas para os diagnósticos autodeclarados de SM e de seus componentes

Risk and protective factors for Long COVID in Brazilian adults (CUME Study)

BackgroundMost people recover from COVID-19, however, between 5 to 20% have experienced new, recurring, or continuous health problems four or more weeks after being infected, a phenomenon called Long COVID, and whose reasons for its manifestation are incipient. Our objective was to analyse the risk and protective factors for Long COVID in Brazilian adults participating in the CUME Study.MethodsThe CUME Study is a prospective cohort conducted with graduates from federal universities in the State of Minas Gerais, Brazil. In this study, 390 participants who answered the baseline questionnaire in 2016 and the third follow-up questionnaire in 2022 (which contained a block of questions about occurrence of COVID-19 and Long COVID) were included. The diagnosis of Long COVID was based on self-reporting of persistence of signs and symptoms of COVID-19 between 30 days and 6 months after remission of the disease. To estimate the risk and protective factors for Long COVID, a hierarchical multivariate statistical analysis was conducted using the Poisson regression technique.ResultsLong COVID was observed in 48.9% of the participants. The following characteristics were identified as risk factors for the outcome: female sex (RR = 1.56; 95% CI = 1.22–1.99); prior diagnosis of hypertension (RR = 1.46; 95% CI = 1.19–1.80); having contracted COVID-19 in the first (RR =1.38; 95% CI = 1.07–1.79) or in the second waves (RR = 1.33; 95% CI = 1.07–1.65) of the pandemic period; and having presented three or more signs and symptoms during the acute phase of COVID-19 (RR = 2.99; 95% CI = 1.08–8.24). On the other hand, having a doctoral/postdoctoral educational level (RR = 0.69; 95% CI = 0.50–0.94) was identified as a protective factor for the outcome.ConclusionHealth system managers and healthcare professionals should be aware of the socioeconomic profile and disease history of patients who have had COVID-19 because women, people with a prior diagnosis of hypertension, and those who manifested multiple signs and symptoms of COVID-19 during the acute phase of the disease were at greater risk of developing Long COVID

Diet Macronutrient profile influence on the serum leptin level, energy balance, and satiety

A composição da dieta parece interferir na leptinemia, no metabolismo energético e na ingestão alimentar exercendo um papel fundamental na regulação do balanço energético. O presente estudo teve como objetivo investigar o efeito de dietas ricas em sacarose (DRS) e em lipídio (DRL) nas concentrações de glicose e leptina séricas em jejum e pós-prandial, na oxidação de carboidrato e de lipídio, na termogênese induzida pela dieta (TID), nas sensações de fome, saciedade e desejo prospectivo ao alimento em mulheres com peso normal e sobrepeso, bem como a interação entre as variáveis estudadas. Foram selecionadas 20 mulheres hígidas, 13 com peso normal (grupo G1) e 7 com sobrepeso (grupo G2). O protocolo de estudo foi baseado nas seguintes determinações: antropometria e composição corporal, glicose e leptina séricas, metabolismo energético, saciedade e palatabilidade das dietas. Os valores de leptina sérica de jejum e pós-prandiais foram maiores em G2, para todas as dietas (p0,05), o que sugere um efeito inibitório na saciedade pelo lipídio. Quanto menor a leptinemia de jejum, maior a vontade de comer algo doce e algo gorduroso, possivelmente, pelos menores níveis em jejum terem menor efeito anorexígeno. Em suma, o presente estudo confirma a influência do perfil de macronutrientes da dieta e da composição corporal na leptinemia e no balanço energético e sugere alguns dos possíveis mecanismos envolvidos nesta regulação, seja pela dieta ou composição corporal, seja pela interação entre os fatores endócrinos, metabólicos e nutricionais estudados.The composition of diet seems to interfere on the leptin concentration, energy metabolism, and food intake, so, it plays regulator role in the energy balance. The present study seeks to investigate the effect of high-sucrose (HSD) and high-lipid (HLD) diets on glucose and leptin concentrations in fasting and postprandial, carbohydrate and lipid oxidation and diet induced thermogenesis (DIT), hungry, satiety sensations and prospective food consumption in normal-weight and overweight women, as well as the presence of interaction between the variables studied. Twenty healthy women were selected, 13 normal-weight (G1 group) and 7 overweight (G2 group). The study protocol was based in the follow determinations: anthropometry and body composition, serum glucose and leptin level, energy metabolism, satiety, and diets palatability. The fasting and postprandial leptin values were higher in G2, for all diets (p0,05), what suggest its inhibitory effect on satiety. The lower fasting leptin concentration induced higher desire to eat something sweet and fatty, probably, by the lower leptin concentration has the lower anorexigen effect. Thus, the present study confirms the diet macronutrients profile and body composition influence the leptin concentration and energy balance, and suggests some possible mechanisms involved in this regulation, by diet or body composition or by interaction between endocrine, metabolic, and nutritional factors studied.Coordenação de Aperfeiçoamento de Pessoal de Nível Superio

Polymorphism related to cardiovascular risk in hemodialysis subjects: a systematic review

ABSTRACT Cardiovascular disease (CVD) is one of the leading causes of mortality in hemodialysis (HD) subjects. In addition to the traditional risk factors that are common in these individuals, genetic factors are also involved, with emphasis on single nucleotide polymorphs (SNPs). In this context, the present study aims to systematically review the studies that investigated the polymorphisms associated with cardiovascular risk in this population. In general, the SNPs present in HD individuals are those of genes related to inflammation, oxidative stress and vascular calcification, also able of interfering in the cardiovascular risk of this population. In addition, polymorphisms in genes related to recognized risk factors for CVD, such as dyslipidemia, arterial hypertension and left ventricular hypertrophy, also influence cardiovascular morbidity and mortality