5 research outputs found
Physical training effect in obese mice with non-alcoholic fatty liver disease: aspects related to insulin resistance and inflammation
A Doença HepĂĄtica Gordurosa NĂŁo AlcoĂłlica (DHGNA), compreende um amplo espectro de condiçÔes que variam desde uma esteatose simples, Ă s condiçÔes mais graves como Esteatohepatite NĂŁo AlcoĂłlica (EHNA) fibrose hepĂĄtica e cirrose. Entre os fatores relacionados a progressĂŁo da doença, a inflamação e a resistĂȘncia Ă insulina sĂŁo apontados como fundamentais. AlĂ©m disso, o recente aumento considerĂĄvel no nĂșmero de casos desta doença se deve em parte, ao comportamento sedentĂĄrio e reduçÔes drĂĄsticas no nĂvel de atividade fĂsica. Mudanças nos hĂĄbitos de vida sĂŁo essenciais para prevenção e controle da DHGNA. Objetivo: Avaliar o efeito do treinamento fĂsico aerĂłbio de 8 semanas em aspectos relacionados com a resistĂȘncia Ă insulina e resposta inflamatĂłria em camundongos obesos com DHGNA MĂ©todos: Foram utilizados 14 camundongos ob/ob com 6 semanas de vida divididos em dois grupos de estudo: sedentĂĄrio e treinado. Os animais do grupo treinado realizaram 5 sessĂ”es semanais de 60 minutos de treinamento fĂsico em esteira rolante com intensidade constante de 60% da velocidade mĂĄxima obtida atravĂ©s do teste de esforço fĂsico. Os animais do grupo sedentĂĄrio nĂŁo realizavam o treinamento fĂsico. ApĂłs o perĂodo de 8 semanas, os animais foram submetidos a eutanĂĄsia e amostras de tecido hepĂĄtico e pancreĂĄtico, foram coletadas para verificar caracterĂsticas histolĂłgicas, avaliação dos genes relacionados com a resposta inflamatĂłria e resistĂȘncia Ă insulina. Foram coletados os tecidos adiposos para verificar a diferença na quantidade de gordura encontrada em cada regiĂŁo do animal. Para obtenção do material genĂ©tico, foi realizado a extração do RNA por TRIzolÂź e apĂłs a verificação de quantidade e integridade do material, foi realizado a reação em cadeia polimerase, atravĂ©s do equipamento Rotor Gene RG - 3000. Foi utilizado o teste-t, ANOVA one way e pĂłs teste de Bonferroni de comparaçÔes mĂșltiplas para os dados paramĂ©tricos e testes de Mann-Whitney com pĂłs-teste Dunn\'s de comparaçÔes mĂșltiplas para dados nĂŁo paramĂ©tricos. Em relação aos escores histolĂłgicos foi utilizado o teste Qui-quadrado com exato de Fisher. Foram consideradas variĂĄveis significativas quando o p < 0,05. Todos os cĂĄlculos e anĂĄlises foram realizados com o software GraphPad Prism V6.0 (GraphPad Software Inc). Resultados: Foram observadas diferenças significantes para peso corporal (p=0.008), evolução de peso (p=0.03), consumo de ração (p < 0.0001) alĂ©m de diminuição no conteĂșdo de gordura da regiĂŁo retroperitonial (p=0.03). AlĂ©m disso, foram observadas diferenças significantes para velocidade pico (p=0.03), distĂąncia (p=0.01) e tempo (p=0.006). A anĂĄlise histolĂłgica nĂŁo mostrou diferenças estatĂsticas entre os grupos em ambos os ĂłrgĂŁos. Nas anĂĄlises de expressĂŁo gĂȘnica, foram observadas diferenças significantes nos genes de GLUT-2 (p=0.03), IL-6 (p= 0.01) e IL-10 (p=0.03) hepĂĄticos. Em relação ao pĂąncreas, foi observada diferença significante para os genes de IRS-2 (p=0.004), GLUT-2 (p=0.03), IL-6 (p=0.002) e IL-10 (p=0.008). ConclusĂŁo: Um protocolo de treinamento fĂsico de 8 semanas foi capaz de atenuar o ganho de peso corporal, consumo alimentar e gerar efeitos positivos na expressĂŁo de genes relacionados com resistĂȘncia Ă insulina e inflamação no fĂgado e pĂąncreas de camundongos ob-obNon-alcoholic Fatty Liver Disease (NAFLD) encompasses a wide spectrum of pathologies from hepatic steatosis, nonalcoholic steatohepatitis (NASH), fibrosis and cirrhosis. Insulin resistance and inflammation are reported as the main factors for disease progression. Moreover, the increase in the number of new cases of NAFLD can be explained by sedentary behavior and drastic reductions in physical activity levels, therefore, lifestyle modifications are essencial for prevention and control of the disease. Objective: Evaluate the effect of 8 weeks of aerobic training on insulin resistance and inflammatory response in obese mice (ob/ob) with NAFLD. Methods: Male ob/ob mice were randomly divided into sedentary (n=7) and trained (n=7) groups. Aerobic training consisted of 5 weekly sessions, 60 min per session at 60% of the maximum speed of the running test. Hepatic and pancreatic samples were collected to evaluate histological features and gene expression associated with insulin resistance and inflammatory response after 8 week experiment protocol. RNA was performed by TRIzolÂź. PCR experiments were performed using the Rotor Gene RG - 3000. Parametric data were assessed by t-test, ANOVA one way and Bonferroni test for multiple comparisons. Non-parametric data were assessed by the Mann-Whitney tests with Dunn\'s post-test of multiple comparisons. Histological analysis was assessed by chi-square test with Fisher\'s exact test. Significant variables were considered when p < 0.05. All the analyzes were performed by GraphPad Prism V6.0 software (GraphPad Software Inc). Results: Reductions in body weight (p = 0.008), weight evolution (p = 0.03), food intake (p < 0.0001) and fat content were observed in trained group. Moreover, the trained group showed better results in peak velocity (p=0.03) physical effort tolerance (p=0.006) and distance (p=0.01). Histological analysis showed no statistical differences between groups in both organs. Gene expression showed differences in IL-6 (p= 0.01), IL-10 (p=0.03) and GLUT-2 (p=0.03) in hepatic analysis, between groups. Pancreatic gene expression showed difference between groups in IRS-2 (p=0.004), GLUT-2 (p=0.03), IL-6 (p=0.002) and IL-10 (p=0.008) analysis. Conclusions: An 8-week physical training protocol was able to attenuate body weight gain, food intake and generate positive effects on gene expression related to insulin resistance and inflammation in both liver and pancreas of ob/ob mic
Fatty Pancreas: Disease or Finding?
Despite a growing number of investigative studies on pancreatic fat deposition, there remains no clear indication regarding the clinical relevance of fat infiltration in the pancreas, also called fatty pancreas (FP). An individualâs body weight is correlated with their pancreatic weight. Moreover, lipid infiltration causes disorders that compromise not only morphology but also metabolic functions. Fat infiltration leads to insulin resistance, type II diabetes mellitus, and pancreatic cancer; however, knowledge about pancreatic fat content and aspects related to the clinical profile remains unclear in the literature. The present review describes the current knowledge of FP, including its pathophysiology and clinical implications, as well as lifestyle changes in FP
Biochemical markers and levels of physical activity related to the hepatic condition of patients infected by the hepatitis C virus
Study aim: The study is quantitative, with a cross-sectional comparison design, and aimed to verify the association between physical activity (PA) levels and biochemical markers linked to liver function of patients infected with hepatitis C virus (HCV). Material and methods: The following biochemical variables were analyzed: alanine aminotransferases (ALT), gamma-glutamyl transpeptidase (ÎłGt), and alkaline phosphatase (FA), these being good markers for hepatic damage, besides glycemia, HDL, LDL, and triglycerides. The International Physical Activity Questionnaire (IPAQ), short version, was used to evaluate the levÂels of physical activity, being classified as active and physically inactive. Results: The sample consisted of 84 individuals aged 56.2 ± 11.6 years; there was a predominance of males, patients with difÂferent socioeducational patterns and those followed up for more than 6 months in the hepatology service with positive serology for HCV and HCV (RNA+), attending the Institute of Liver and Transplants of Pernambuco (IFP). The results obtained in this study indicate smaller values of the median with maximum and minimum scores of the analyzed parameters in patients considÂered to be physically active (ALT: p = 0.43, FA: p = 0.86 and ÎłGt: p = 0.15, glycemia: p = 0.22, LDL: p = 0.58, HDL: P = 0.004, triglycerides: p = 0.47), in comparison with the physically inactive patients. It is concluded that patients who have a higher level of physical activity present lower values of biochemical markers, positively affecting their hepatic condition. Conclusions: There was only a significant difference in the HDL variable, but the patients with a lower level of physical activÂity showed greater values in general, less in the triglyceride variability. In order to test these and other important variables and improve the quality of life and health by a more direct method
Biochemical markers and levels of physical activity related to the hepatic condition of patients infected by the hepatitis C virus
Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries
Background
Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks.
Methods
The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned.
Results
A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31).
Conclusion
Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)