PÉ DIABÉTICO: PERFIL METABÓLICO E SOCIOECONÔMICO DE PACIENTES ATENDIDOS PELO LABORATÓRIO DE ENSINO E PESQUISA DA UNIVERSIDADE ESTADUAL DE MARINGÁ

O pé diabético é uma das complicações crônicas mais devastadoras em pacientes diabéticos, gerando alto impacto social e econômico, além de diminuir a qualidade de vida. Neste estudo exploratório-descritivo foram avaliados 39 pacientes diabéticos tipo 2 (PDT2), atendidos pelo Laboratório de Ensino e Pesquisa da Universidade Estadual de Maringá (agosto/2009 e abril/2010). Os pacientes foram submetidos a uma entrevista para obtenção de informações sobre o perfil socioeconômico e a avaliação laboratorial da glicemia e lipidemia (perfil metabólico). Os resultados revelaram: prevalência do gênero feminino, média de idade de 60,1 ± 9,5 anos, 71,8% tinham Ensino Fundamental incompleto, 61,5% eram casados, 74,3% eram sedentários, o tempo de doença foi de 9,2 ± 7,3 anos, 53,8% desconheciam os cuidados e complicações do pé e 70,6% estavam com a hemoglobina glicada alterada. Conclui-se que a baixa escolaridade e pouco conhecimento em relação à doença comprometem o processo de autocuidado, aumentando as chances do aparecimento das complicações crônicas

Dexamethasone during pregnancy impairs maternal pancreatic β-cell renewal during lactation

Pancreatic islets from pregnant rats develop a transitory increase in the pancreatic β-cell proliferation rate and mass. Increased apoptosis during early lactation contributes to the rapid reversal of those morphological changes. Exposure to synthetic glucocorticoids during pregnancy has been previously reported to impair insulin secretion, but its impacts on pancreatic islet morphological changes during pregnancy and lactation have not been described. To address this issue, we assessed the morphological and molecular characteristics of pancreatic islets from rats that underwent undisturbed pregnancy (CTL) or were treated with dexamethasone between the 14th and 19th days of pregnancy (DEX). Pancreatic islets were analyzed on the 20th day of pregnancy (P20) and on the 3rd, 8th, 14th and 21st days of lactation (L3, L8, L14 and L21, respectively). Pancreatic islets from CTL rats exhibited transitory increases in cellular proliferation and pancreatic β-cell mass at P20, which were reversed at L3, when a transitory increase in apoptosis was observed. This was followed by the appearance of morphological features of pancreatic islet neogenesis at L8. Islets from DEX rats did not demonstrate an increase in apoptosis at L3, which coincided with an increase in the expression of M2 macrophage markers relative to M1 macrophage and T lymphocyte markers. Islets from DEX rats also did not exhibit the morphological characteristics of pancreatic islet neogenesis at L8. Our data demonstrate that maternal pancreatic islets undergo a renewal process during lactation that is impaired by exposure to DEX during pregnancy

Changes in PGC-1α-Dependent Mitochondrial Biogenesis Are Associated with Inflexible Hepatic Energy Metabolism in the Offspring Born to Dexamethasone-Treated Mothers

In the present study we investigated the participation of hepatic peroxisome proliferator-activated receptor-gamma coactivator 1 alpha (PGC-1α) in the metabolic programming of newborn rats exposed in utero to dexamethasone (DEX). On the 21st day of life, fasted offspring born to DEX-treated mothers displayed increased conversion of pyruvate into glucose with simultaneous upregulation of PEPCK (phosphoenolpyruvate carboxykinase) and G6Pase (glucose-6-phosphatase). Increased oxidative phosphorylation, higher ATP/ADP ratio and mitochondrial biogenesis and lower pyruvate levels were also found in the progeny of DEX-treated mothers. On the other hand, the 21-day-old progeny of DEX-treated mothers had increased hepatic triglycerides (TAG) and lower CPT-1 activity when subjected to short-term fasting. At the mechanistic level, rats exposed in utero to DEX exhibited increased hepatic PGC-1α protein content with lower miR-29a-c expression. Increased PGC-1α content was concurrent with increased association to HNF-4α and NRF1 and reduced PPARα expression. The data presented herein reveal that changes in the transcription machinery in neonatal liver of rats born to DEX-treated mothers leads to an inflexible metabolic response to fasting. Such programming is hallmarked by increased oxidative phosphorylation of pyruvate with impaired FFA oxidation and hepatic TAG accumulation.</jats:p

Gonadectomy and DHEA: metabolic effects in adult female rats fed with high-fat diet.

A privação dos hormônios sexuais em fêmeas contribui para o aparecimento de distúrbios metabólicos e endócrinos devido à ausência de estrógenos. Nesse estudo foi avaliado o efeito da castração e da suplementação com DHEA sobre aspectos metabólicos em ratas. A ovariectomia aumentou a adiposidade e o consumo de ração, diminuiu o consumo hídrico, além de promover resistência à insulina e intolerância à glicose, e o uso do DHEA reduziu a sensibilidade à insulina. Ainda, a castração levou a redução nos níveis plasmáticos de DHEA, estradiol, VLDL-c e triacilglicerol, albumina, uréia e creatinina, e o tratamento com DHEA restaurou parcialmente a concentração de estradiol no grupo OVX+DHEA. E por fim, a ooforectomia reduziu a expressão proteica do IRb, IRS1, PI3K e AKT no fígado, músculo gastrocnêmio ou coração, além diminuir o grau de fosforilação em tirosina da pp185 (IRS1/2). Deste modo, concluímos que a castração promoveu resistência à insulina e intolerância à glicose associada à obesidade, e neste modelo, o uso do DHEA piorou a sensibilidade à insulina nos animais.Deprivation of sex hormones in females contributes to the onset of metabolic and endocrine disorders due loss of estrogen. In this study the effect of castration and supplementation with DHEA on metabolic aspects in rats was evaluated. Ovariectomy increased adiposity and food consumption, decreased water consumption, besides promoting insulin resistance and glucose intolerance, and the use of DHEA reduced insulin sensitivity. Furthermore, castration led to decreasing of DHEA plasma levels, estradiol, VLDL-c and triacylglycerol, albumin, urea and creatinine, and DHEA treatment partially restored the concentration of estradiol in OVX+DHEA group. Finally, ovariectomy reduced the protein expression IRb, IRS1, PI3K and AKT in the liver, gastrocnemius muscle or heart. Indeed, decrease tyrosine phosphorylation status of pp185 (IRS1/2) was observed. Thus, we conclude that castration promoted insulin resistance and glucose intolerance associated with obesity, and in this model, the use of DHEA impairs insulin sensitivity in animals

Oxidative stress parameters as biomarkers of risk factor for diabetic foot among the patients with type 2 diabetes

The aim of this study was to determine whether plasma levels of carbonylated proteins, total antioxidant capacity (TAC) and reduced protein thiols could be suitable biomarkers of risk factors for diabetic foot. Individuals with type 2 diabetes with normal protective sensation (normal foot group) vs. loss of protective sensation and/or signs of peripheral arterial disease and/or foot deformities and/or history of ulcers and/or neuropathic fractures and/or amputation (diabetic foot group) were compared. The diabetic foot group showed higher carbonylated protein levels (P = 0.0457) and lower levels of TAC (P = 0.0148) and reduced protein thiols (P = 0.0088), compared with the normal foot group. In general, several other parameters of risk of diabetes complication (blood levels of glycated hemoglobin, glucose and cholesterol, duration of diabetes, body mass index and waist circumference) showed a tendency of higher values in the diabetic foot group. The results suggest that the plasma levels of carbonylated proteins, TAC and reduced protein thiols could furnish information about the risk of diabetic foot, considering that the changes in these biomarkers were associated with the loss of sensitivity and foot ulcerations

Dexamethasone programs lower fatty acid absorption and reduced PPAR-γ and fat/CD36 expression in the jejunum of the adult rat offspring

The progeny of rats born and breastfed by mothers receiving dexamethasone (DEX) during pregnancy exhibits permanent reduction in body weight and adiposity but the precise mechanisms related to this programming are not fully understood. In order to clarify this issue, the present study investigated key aspects of lipoprotein production and lipid metabolism by the liver and the intestine that would explain the reduced adiposity seen in the adult offspring exposed to DEX in utero. Female Wistar rats were treated with DEX (0.1 mg/kg/day) between the 15th and the 21st days of pregnancy, while control mothers were treated with vehicle. Male offspring born to control mothers were nursed by either adoptive control mothers (CTL/CTL) or DEX-treated mothers (CTL/DEX). Male offspring born to DEX-treated mothers were nursed by either control mothers (DEX/CTL) or adoptive DEX-treated mothers (DEX/DEX). We found that only the male DEX/DEX offspring had reduced adiposity. Additionally, male DEX/DEX progeny had lower circulating triacylglycerol (TAG) levels only in fed-state. The four groups of offspring presented similar energy expenditure, respiratory quotient and very low-density lipoprotein (VLDL) production. On the other hand, DEX/DEX rats displayed reduced TAG levels after gavage with olive oil and reduced expression of fatty acid translocase Cd36 (Fat/Cd36) and peroxisome proliferator-activated receptor γ (Pparg) in the jejunum. Altogether, our study supports the notion that reduced fat absorption by the jejunum may contribute to the lower adiposity of the adult offspring born and breastfed by mothers treated with DEX during pregnancy265CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO - CNPQCOORDENAÇÃO DE APERFEIÇOAMENTO DE PESSOAL DE NÍVEL SUPERIOR - CAPESFUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO - FAPESPnão temnão tem2013/07607-8; 2015/23285-6; 2016/13138-9; 2019/03196-0; 2019/19488-0; 2020/06397-

Agomelatine reduces circulating triacylglycerides and hepatic steatosis in fructose-treated rats

Agomelatine (AGO) is an antidepressant drug with agonistic activity at melatonin receptor 1 (MT1) and MT2 and with neutral antagonistic activity at serotonin receptor 5-HT2C. Although experimental studies show that melatonin reduces hypertriglyceridemia and hepatic steatosis induced by excessive fructose intake, no studies have tested if AGO exerts similar actions. To address this issue we have treated male Wistar rats with fructose (15% in the drinking water) and/or AGO (40 mg/kg/day) for two weeks. AGO reduced body weight gain, feeding efficiency and hepatic lipid levels without affecting caloric intake in fructose-treated rats. AGO has also decreased very low-density lipoprotein (VLDL) production and circulating TAG levels after an oral load with olive oil. Accordingly, treatment with AGO reduced the hepatic expression of fatty acid synthase (Fasn), a limiting step for hepatic de novo lipogenesis (DNLG). The expression of apolipoprotein B (Apob) and microsomal triglyceride transfer protein (Mttp) in the ileum, two crucial proteins for intestinal lipoprotein production, were also downregulated by treatment with AGO. Altogether, the present data show that AGO mimics the metabolic benefits of melatonin when used in fructose-treated rats. This study also suggests that it is relevant to evaluate the potential of AGO to treat metabolic disorders in future clinical trials