Lipase lipoprotein gene polymorphisms in elderly with aterosclerosis

BV UNIFESP: Teses e dissertaçõe

Ultrasonographic assessment of thyroid volume in oldest-old individuals

ABSTRACT Objective The aim of this study was to describe the relationship between thyroid volume and age, gender, anthropometric characteristics, and echogenicity in oldest-old subjects in an iodine-sufficient area. Subjects and methods The study included 81 independent elderly individuals aged ≥ 80 years (65 [80.2%] women). We determined these individuals’ anthropometric characteristics, body mass index (BMI), and lean body mass, as well as thyroid volume and echogenicity by ultrasonography. Results We observed that octogenarians and nonagenarians had different profiles of thyroid echogenicity. The volume of the thyroid was smaller in nonagenarians than octogenarians (p = 0.012, r = 0.176), and subjects aged 80–89 years had more often hypoechoic glands than those aged ≥ 90 years (p = 0.01 versus 0.602). Conclusion The identification of ultrasonographic differences in oldest-old individuals will contribute to establishing preclinical markers, such as echogenicity, to identify individuals at risk of developing autoimmune thyroid disease. Future prospective studies should identify if 80–89-year-old individuals with hypoechoic glands progress to hypothyroidism, and if the absence of changes in echogenicity (i.e. a normal thyroid parenchyma) would have a positive impact on longevity among nonagenarians

Scientific evidence for octogenarians and nonagenarians

OBJECTIVE: Evaluate the characteristics of scientific medical studies including patients over 80 years old, from january 2000 to october 2009. METHODS: We searched the eletronic database MEDLINE, and two regional databases (Scielo and Lilacs). We used search terms "octogenarians" or "nonagenarians" at the title, and filter to identify articles in english language, with abstracts and articles with patients over 80 years old. Data were extracted from articles and studies were classified according to level of evidence based on Oxford Center for Evidence-Based Medicine classification. RESULTS: Three hundred ninety-five studies were found at MEDLINE database, the number of studies increased fourfold from 2000 to 2008, 18 studies in 2000 and 63 studies in 2008. The majority of studies were classified as clinical research (291 studies, 73,7%), observational (339 studies, 85,8%) and retrospective (260 studies, 65,8%). Only 6 studies (1,5%) evaluate interventions. Cardiac surgery departments published more among the articles found (106 studies, 26,8%), followed by cardiology (62 studies, 15,7%). American studies wer the most common (128 studies, 32,4%). Only 6,7% were produced by Geriatric departments. CONCLUSION: The number of scientific evidence with very old patients increased in the last years. Clinical research, obsertational studies and retrospectives were the main characteristics found. The best level of evidence found was 1B. Cardiac surgery and cardiology produced more studies. In regional database we found more national studies.</p

Polysomnography in independent elderly: focus on comorbidities

OBJECTIVE: To evaluate the effect of comorbities in sleep of independent elderly patients. METHODS: Independent elderly patients aged &gt; 60 years old that attended the geriatric ambulatory of Escola Paulista de Medicina - Universidade Federal de São Paulo were invited to join the research. The participants were submitted to a wide geriatric evaluation with functional scales (basic and instrumental daily activities), cognitive tests (Mini-Mental State Examination) and Geriatric Depression Scale. After that, all the participants underwent a full night polissomnography (PSG) at sleep laboratory. RESULTS: The mean sleep efficiency was 73.1% ± 14.0; the mean percentage of slow wave sleep (E3+E4) was 17.6% ± 9.6; the percentage of REM sleep was 17.9 ± 6.8; apnea and hypopnea index per hour (AHI/h) mean was 26.3 ± 21.2; dessaturation of oxygen events was 21.9 ± 19.7. The number of comorbidities &gt;5 was associated with higher AHI/h, p=0.01. Spearman's correlation between AHI/h and BMI was 24% (p=0.02, r2=0.055). Simple linear regression analysis was applied to determine whether BMI could predict AHI/h values. The p value was 0.02, which shows a correlation between BMI and AHI/h as a continuous variable. CONCLUSION: Elderlies with &gt; 5 comorbidities had more apnea and hypopnea events and dessaturations during sleep.</p

Apolipoprotein A1 gene polymorphisms as risk factors for hypertension and obesity

Several polymorphisms in apolipoprotein A1 (APOA1) gene have been associated with metabolic diseases. Increased transcription efficiency was observed in -75A allele carriers compared to -75G allele homozygotes. +83C allele was associated with higher body mass index and waist-to-hip ratio in type II diabetes subjects. -75G/A and +83C/T polymorphisms were analyzed by RFLP-PCR in 334 individuals from a Brazilian elderly cohort. APOA1 polymorphisms were associated with age-related morbidities, as well as with triglycerides, total cholesterol, HDL, VLDL, LDL, creatinine, urea, albumin, glycated hemoglobin and fasting glucose serum levels. Allele frequencies were 0.102 and 0.21, respectively, for -75A and +83T. -75G allele showed significant association with hypertension (P = 0.001). An association between +83C allele and obesity was observed (P = 0.040) and this allele also showed an association with hypertension in the presence of cardiovascular disease (P = 0.047). Moreover, +83T allele was associated with lower glycated hemoglobin values (P = 0.026). To our knowledge, there is no data associating this polymorphism with glycated hemoglobin. Furthermore, individuals carrying AT haplotype have lower risk for developing hypertension (P = 0.0002), while GT haplotype carriers present decreased risk to develop obesity comparing to GC haplotype (P = 0.025). APOA1 polymorphisms analysis may be a useful tool to identify risk factors for subjects and families and clarify the physiopathological role of these polymorphisms in age-related diseases, such as hypertension and obesity.Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Universidade Federal de São Paulo, Escola Paulista Med, Dept Morfol & Genet, Disciplina Genet, BR-04023900 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Med, Div Geriatr, São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med, Dept Morfol & Genet, Disciplina Genet, BR-04023900 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Med, Div Geriatr, São Paulo, BrazilWeb of Scienc