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1.
Objective
To assess the impact of providing integrated psycho-socio-economic support to drug resistant tuberculosis (DRTB) patients on the treatment outcome under programmatic conditions.Study design
Retrospective cohort study.Setting
An urban district TB centre in India under the Revised National Tuberculosis Control Programme.Participants
A cohort of 123 patients who started DRTB treatment between June 2010 and May 2013.Methods
Patients started on treatment for DRTB between June 2010 and May 2013 who were provided with the integrated support package for at least 3 months formed the supported group while the other patients of the cohort formed the non-supported group. The treatment outcomes and sputum culture conversion rates were compared between the two groups.Results
The supported group consisted of 60 patients and the non-supported group of 63 patients. The treatment success rate was found to be significantly higher in the supported group (65% vs 46.03%; p = 0.0349). Support duration was significantly associated with lower incidence of death [HR 0.876, 95% CI 0.811–0.947; p = 0.0009] and loss to follow up [OR: 0.752, 95% CI 0.597–0.873; p = 0.0023]. The treatment failure rate was higher in the supported group (16.66% vs 4.76%) with 60% of the failures in the supported group occurring after 24 months of compliant treatment. There was no significant association found between support duration and treatment failure or sputum culture conversion.Conclusion
Integrated support seems to significantly increase the treatment success rate and improve survival and treatment adherence of DRTB patients. However, early diagnosis and effective pharmacotherapy are crucial for reducing treatment failures. 相似文献2.
Konstantinos Douros Maria-Ioanna Thanopoulou Barbara Boutopoulou Anna Papadopoulou Anastassios Papadimitriou Andrew Fretzayas Kostas N. Priftis 《Allergologia et immunopathologia》2019,47(3):209-213
Introduction
There is accumulated evidence supporting a beneficial role of Mediterranean diet (MD) in the control of asthma symptoms. The aim of this study was to investigate the relationships between adherence to MD and serum levels of certain cytokines namely, interleukin (IL)-4, and IL-17 known to have a pathogenetic role in the airway changes associated with asthma.Methods
We measured serum IL-4, IL-33, and IL-17, in 44 asthmatic and 26 healthy children, 5–15 years old. Their adherence to MD was estimated with the Mediterranean Diet Quality Index for children and adolescents (KIDMED) score.Results
KIDMED score did not differ between the two groups (P = 0.59) and was not correlated with any of the three measured cytokines. However, when the analysis was restricted only to asthmatic children, the KIDMED score was correlated with IL-4, IL-33, and IL-17 (Beta: ?0.56, P = 0.007; Beta: 0.57, P = 0.010; Beta: ?0.62, P = 0.017, respectively).Conclusion
Our results indicate that MD can modulate the production of some of the main inflammatory mediators of asthma, in asthmatic children. 相似文献3.
Borja Suberviola Bernardo Alio Lavin Andrés Fernando Jimenez Sonia Perez-San Martin Maite Garcia-Unzueta Miguel Santibañez 《Enfermedades infecciosas y microbiología clínica》2019,37(4):239-243
Background
The aim of this study was to assess the prognostic value of vitamin D, vitamin D binding protein (VDBP) and vitamin D-related peptides in septic shock patients in relation to hospital mortality.Methods
This is a single-center, prospective, observational study that included all consecutive patients meeting criteria for septic shock who were admitted to the ICU. VDBP, 25-hydroxy vitamin D, 1,25-dihydroxy vitamin D, cathelicidin and beta-defensin levels were determined in blood samples obtained on admission to the ICU.Results
Seventy-five patients were studied. The best area under the curve (AUC) for prediction of in-hospital mortality was for VDBP (0.78), with a negative predictive value of 85.45% for the optimal cut-off point. VDBP was also the only variable that had a statistically significant association with a higher risk of in-hospital mortality, regardless of other assessed variables and pre-determined confounders: adjusted odds ratio of 5.20 (95% confidence interval: 1.21–22.36). When restricted to patients with vitamin D insufficiency (n = 54), the AUC was 0.77, and the adjusted OR 12.22 (95% CI: 1.46–102.14; p = 0.021) for in-hospital mortality.Conclusions
VDBP levels showed a statistically significant association with in-hospital mortality, supporting the clinical utility of VDBP as a good prognostic marker in septic shock patients. Vitamin D and vitamin D-related peptides are not associated with in-hospital mortality. These results should be confirmed in a multicentre study with a larger sample size. 相似文献4.
Background
Quality of life, which is impaired in patients with chronic spontaneous urticaria (CSU), is influenced by comorbid mental disorders. Headaches could be another comorbid mental disorder that affects quality of life in children with CSU.Objectives
To investigate the effect of headaches on urticaria symptoms, disease activity and quality of life in children with CSU.Methods
A total of 83 patients with CSU were enrolled in the study and were separated into two groups as those with or without headache. Demographic and clinical characteristics were studied with the Urticaria Activity Score (UAS7), Urticaria Control test (UCT) and Chronic Urticaria Quality of Life Questionnaire (CU-Q2QoL). The headache questionnaire designed according to the Department of International Classification of Headache Disorders, second edition (ICHD-II) was used and VAS (Visual Analogue Scale) and NRS (Numerical Rating Scale) were used to assess the pain measurement. In patients diagnosed with migraine, the paediatric Migraine Disability Assessment Scale (PedMIDAS) was applied.Results
CU-QoL total scores were significantly higher in patients with CSU with headache than in those without headache (p = 0.015). In the five domains of CU-QoL, impact of daily life activities domain and sleep problems domain had higher scores in CSU with headache (p = 0.008, 0.028, respectively). There was no significant relationship between UCT, UAS and CU-QoL and headache severity (p < 0.05). No differences were found between the groups in respect of duration of urticaria, UAS7 and UCT.Conclusion
Headache may be an important factor that affects and impairs quality of life in children with chronic urticaria. 相似文献5.
Guilherme Bricks Jorge Figueiredo Senise Henrique Pott-Jr Giuliano Grandi Dimas Carnaúba-Jr Hamilton Antonio Bonilha de Moraes Celso Franscisco Hernandes Granato Adauto Castelo 《The Brazilian journal of infectious diseases》2019,23(1):45-52
Background
Hepatitis E virus (HEV) infection in patients with pre-existing liver disease has shown high morbidity and lethality. The consequences of HEV superinfection in patients with chronic hepatitis C virus (HCV) infection are not fully understood. This study aimed to evaluate the association between the presence of anti-HEV antibodies, liver cirrhosis, and insulin resistance.Methods
A total of 618 patients chronically infected with HCV were included from three reference centers for viral hepatitis in São Paulo, Brazil. Presence of anti-HEV IgG was assessed by enzyme-linked immunosorbent assay (WANTAI HEV-IgG ELISA).Results
The seroprevalence of anti-HEV in patients with cirrhosis was significantly higher than in patients without cirrhosis (13.2% vs 8%, OR = 1.74, p = 0.04). Seropositivity for anti-HEV, adjusted for sex, age, and HCV genotype showed an association trend with hepatic cirrhosis (aOR = 1.75, p = 0.059). Presence of HEV antibodies, adjusted for age, body mass index and cirrhosis, was shown to be independently associated with insulin resistance (aOR: 4.39; p = 0.045).Conclusion
Patients with chronic hepatitis C are under risk of hepatitis E virus superinfection in Brazil. The trend toward association between cirrhosis and previous HEV infection suggests that it may accelerate liver fibrosis in patients with chronic hepatitis C. In addition, previous infection by HEV is independently associated with insulin resistance in the studied population, which may be an extra-hepatic manifestation of hepatitis E that persists after resolution of the active infection, and may contribute to fibrosis progression. 相似文献6.
Objective
The purpose of this systematic review was to examine the effect of antipsychotic medication on dysphagia based on clinical case reports.Patients and methods
Literature searches were performed using the electronic databases PubMed and Embase. In PubMed, we used the MeSH terms “antipsychotic agents” OR “tranquilizing agents” combined with “deglutition disorders” OR “deglutition”. In Embase, we used the Emtree terms “neuroleptic agents” combined with “swallowing” OR “dysphagia”. Two reviewers assessed the eligibility of each case independently.Results
A total of 1043 abstracts were retrieved, of which 36 cases met the inclusion criteria; 14 cases were related to typical antipsychotics and 22 to atypical antipsychotics. Dysphagia occurred together with extrapyramidal symptoms in half of the cases and was the only prominent symptom in the other half. The most common strategy against dysphagia was changing to another antipsychotic (n = 13, 36.1%).Conclusions
The data from this review indicate that antipsychotics can increase the prevalence of dysphagia. 相似文献7.
Julio E. González-Aguirre Claudia Paola Rivera-Uribe Erick Joel Rendón-Ramírez Rogelio Cañamar-Lomas Juan Antonio Serna-Rodríguez Roberto Mercado-Longoría 《Archivos de bronconeumología》2019,55(4):195-200
Introduction
Invasive respiratory support is a cornerstone of Critical Care Medicine, however, protocols for withdrawal of mechanical ventilation are still far from perfect. Failure to extubation occurs in up to 20% of patients, despite a successful spontaneous breathing trial (SBT).Methods
We prospectively included ventilated patients admitted to medical and surgical intensive care unit in a university hospital in northern Mexico. At the end of a successful SBT, we measured diaphragmatic shortening fraction (DSF) by the formula: diaphragmatic thickness at the end of inspiration – diaphragmatic thickness at the end of expiration/diaphragmatic thickness at the end of expiration × 100, and the presence of B-lines in five regions of the right and left lung. The primary objective was to determine whether analysis of DSF combined with pulmonary ultrasound improves prediction of extubation failure.Results
Eighty-two patients were included, 24 (29.2%) failed to extubation. At univariate analysis, DSF (Youden's J: >30% [sensibility and specificity 62 and 50%, respectively]) and number of B-lines regions (Youden's J: >1 zone [sensibility and specificity 66 and 92%, respectively]) were significant related to extubation failure (area under the curve 0.66 [0.52–0.80] and 0.81 [0.70–0.93], respectively). At the binomial logistic regression, only the number of B-lines regions remains significantly related to extubation failure (OR 5.91 [2.33–14.98], P < .001).Conclusion
In patients with a successfully SBT, the absence of B-lines significantly decreases the probability of extubation failure. Diaphragmatic shortening fraction analysis does not add predictive power over the use of pulmonary ultrasound. 相似文献8.
Sumal Nandasena Chaminda Senavirathna Champa Munasinghe Chapa Wijesena Ridmi Sucharitharathna 《The Indian journal of tuberculosis》2019,66(1):76-80
Background
Tuberculosis (TB) is an infectious bacterial disease; remains as one of the important public health problem affecting every part of the world. Substantial number of TB cases are reported from Sri Lanka every year irrespective of its strong preventive health system. The aim of this analysis is to describe the characteristics of TB patients and to assess the factors associated with sputum conversion. This analysis was based on the data from the District Chest Clinic of Kalutara district, Sri Lanka.Methods
Information of all newly diagnosed and registered patients in the District Chest Clinic, Kalutara in year 2013 were ascertained. Out of 687 newly reported TB patients, 669 records were included in final analysis.Results
Majority of patients were males (n = 451, 67.4%), in the age group of 36–60 years (n = 306, 45.7%) and underweight (n = 359, 61.7%). Substantial proportion of normal weight or overweight adult patients (92.1%) had sputum conversion at 2–3 months as compared to underweight adult patients (82.5%) (p = 0.034). Those who smoke tobacco is less likely to have sputum conversion at 2–3 months as compared to non-smokers (90.2% vs. 82.1%, p = 0.045).Conclusion
Provision of good nutrition, maintaining of appropriate body mass index (i.e., BMI), and abstinence from smoking and alcohol consumption are important for sputum conversion among smear-positive pulmonary TB patients. 相似文献9.
N.F. Benatta D.D. Batouche S. Benouaz M.A. Djazouli 《Annales de cardiologie et d'angeiologie》2019,68(2):94-97
Introduction
Infectious endocarditis (IE) is a serious disease that has continued to evolve in diagnostic and therapeutic terms.Aim
To analyze the diagnostic and out come profile.Methods
We collected 57 (IE) cases with a definite diagnosis according to the modified Duke criteria. Patients were admitted consecutively to the Cardiology Department of the Oran university hospital from January 2011 to June 2017. Among the variables studied: clinical data, paraclinic data, therapeutic management and hospital outcome.Results
The mean age was 40.5 ± 15 years (extreme 16–67 years), with a male predominance (sex-ratio = 1.5). This was a native valve IE in 70% of cases, on valve prosthesis in 15.5% of patients, on congenital heart disease in 2% and on pacemaker probe in 4% of cases. The entrance door was dominated by oral origin. Blood cultures were positive only in 51% of cases. The most commonly implicated organism in staphylococci in 22.6%, streptococcus in 18.9% and brucellosis in 3.8%. Ultrasound data revealed vegetation (83%), cardiac abscess (19%), valvular perforation (15.1%) and prosthesis disintegration (7.5%). Complications were mainly neurological complications (27%) and hemodynamics (26%). Cardiac surgery occurred in 29% of patients. Hospital mortality was 26%, predictive factors were staphylococcal AI (P < 0.001), cardiac insufficiency (P < 0.001) and neurological complications (P = 0.04).Conclusion
Infectious endocarditis is a serious disease in the absence of surgery. The diagnosis is based on echocardiography in the first place and blood cultures. The population is often young revealing the EI by complications; its prevention is the best way to improve its prognosis. 相似文献10.
Miguel Liern Anabella Collazo Maylin Valencia Alejandro Fainboin Lorena Isse Cristian Costales-Collaguazo Federico Ochoa Graciela Vallejo Elsa Zotta 《Nefrología : publicación oficial de la Sociedad Espa?ola Nefrologia》2019,39(2):177-183
Introduction
Fabry disease (FD) is a hereditary disorder caused by a deficiency of α-galactosidase A enzyme activity. The transmission of the disorder is linked to the X chromosome.Objectives
The objectives of the study were: 1. To quantify the presence of podocytes in paediatric patients with FD and compare them with the value of the measured podocyturia in healthy controls. 2. To determine whether a greater podocyturia is related to the onset of pathological albuminuria in patients with FD. 3. To determine the risk factors associated with pathological albuminuria.Methods
We performed an analytical, observational study of Fabry and control subjects, which were separated into 2 groups in accordance with the absence of the disease (control group) or the presence of the disease (Fabry group).Results
We studied 31 patients, 11 with FD and 20 controls, with a mean age of 11.6 years.The difference between the mean time elapsed from the diagnosis of FD to the measurement of podocyturia (40 months) and the onset of pathological albuminuria (34 months) was not significant (p = 0.09). Podocytes were identified by staining for the presence of synaptopodin and the mean quantitative differences between both podocyturias were statistically significant (p = 0.001). Albuminuria was physiological in 4 of the patients with FD and the relative risk to develop pathological albuminuria according to podocyturia was 1.1 in the control group and 3.9 in the Fabry group, with a coefficient of correlation between podocyturia and albuminuria in the Fabry group of 0.8354. Finally, the 2 risk factors associated with the development of pathological albuminuria were podocyturia (OR: 14) and being aged over 10 years (OR: 18). We found no significant risk with regard to glomerular filtrate renal (GFR) (OR: 0.5) or gender (OR: 1.3). The mean GFR remained within normal values.Conclusion
The detection of podocyturia in paediatric patients with FD could be used as an early marker of renal damage, preceding and proportional to the occurrence of pathological albuminuria. 相似文献11.
M.C. Mboup J. Mingou D.M. Ba K. Dia P.D. Fall 《Annales de cardiologie et d'angeiologie》2019,68(2):115-119
Introduction
Acute coronary syndromes have been rarely studied in the female population in Sub-Saharan Africa. This Sub-Saharan serie has shown an increase in the prevalence of acute coronary syndromes among the female population, compared to previous studies. Through this retrospective study, we evaluated the epidemiological, clinical, paraclinical, therapeutic and evolutionary features of acute coronary syndromes on women at the Principal Hospital of Dakar.Methodology
This was a retrospective study of patients hospitalized for acute coronary syndrome over a period of 5 years from January 1st, 2010 to December 31st, 2014, at the Cardiology Department of the Principal Hospital of Dakar.Results
The prevalence of diabetes and obesity was statistically higher for women than for men. Atypical symptomatology was much more apparent (P = 0.0000), admission times at the emergency department for acute coronary syndromes were relatively longer ( = 0.005). Therapeutically, medical care was almost identical regardless of gender.Conclusion
In Senegal, acute coronary syndrome in women is characterized by the atypical symptomatology with delayed diagnosis and management. The fight against this reputedly masculine pathology requires a good awareness campaign. 相似文献12.
María Victoria Rubio Rubio Luis Miguel Lou Arnal José Antonio Gimeno Orna Paula Munguía Navarro Alex Gutiérrez-Dalmau Elena Lambán Ibor Javier Paúl Ramos Raquel Pernaute Lavilla Belén Campos Gutiérrez Alberto San Juan Hernández-Franch 《Nefrología : publicación oficial de la Sociedad Espa?ola Nefrologia》2019,39(2):141-150
Introduction
Conservative Management (CM) has become a therapeutic option in Advanced Chronic Kidney Disease in the elderly. However, there is a lack of evidence about prognosis of these patients in terms of survival and health related quality of life (HRQoL).Objective
Establish predictive variables associated with mortality and analyse HRQoL in CM patients.Patients and methods
Prospective cohort study. An assessment of renal function parameters and a comprehensive geriatric assessment were made, including: analysis of comorbidity, functional, cognitive, fragility, nutritional, social and HRQoL status.Results
82 patients with a mean age of 84 years and significant pluripathology were studied: 56% had history of vascular event and Charlson > 8. The mortality rate was 23/1,000 patients per month, with a homogeneous mortality rate after 6 months.Survival differed significantly depending on whether they presented with a previous vascular event (36.7 vs. 14.8; p = 0.028), Charlson score ≥ 10 (42 vs. 17; p = 0.002), functional status (48.4 vs. 19; p = 0.002) and fragility (27 vs. 10; p = 0.05).Mortality predictors included eGFR and proteinuria, the presence of previous vascular events, Charlson comorbidity score, malnutrition-inflammation parameters (albumin and MNA score), degree of dependency, physical HRQoL and increase of PTH level. The presence of previous vascular event, comorbidity, decreased albumin and elevated PTH were independent predictors of mortality. HRQoL remained stable over time and no significant worsening occurred during treatment.Conclusions
Having knowledge of the factors associated with mortality and HRQoL assessment can be a useful tool to helping decision making during CM. Previous vascular events, comorbidity, decreased albumin and increased PTH were independent predictors of mortality. 相似文献13.
14.
S. Miceli Sopo G. Gurnari S. Monaco A. Romano L. Liotti B. Cuomo I. Dello Iacono L. Badina G. Longo M. Calvani A. Giannone C. Calabrò G. Scala M.C. Verga 《Allergologia et immunopathologia》2019,47(3):277-281
Introduction and objectives
The reproducibility of the adverse reaction increases the suggestiveness of a history of food allergy. However, the positive predictive value (PPV) of multiple adverse reaction episodes for the diagnosis of IgE-mediated food allergy is not known. This evaluation was the objective of our study.Patients and methods
We retrospectively studied 180 children with a history of non-anaphylactic adverse reactions after the ingestion of a food. All children had the prick test positive for the offending food and performed the oral food challenge (OFC) within 12 months after the last adverse reaction episode (ARE). We have evaluated whether increasing the number of ARE increased the probability that the OFC would be positive (failed).Results
93 patients (52%) presented one ARE, 49 (27%) presented two ARE, 24 (13%) presented three ARE, 14 (8%) patients presented ≥ four ARE. The OFC was positive in 94/180 (52%). The outcome of the OFC was found to be positively correlated with the number of ARE (OR = 1.56; 95% CI = 1.16–2.09; p = 0.003). A PPV = 100% was observed with a number of ARE ≥ five.Conclusions
The number of ARE is an important predictor of the diagnosis of food allergy, although less than we would have imagined. The number of ARE could be used to increase the predictability of the diagnostic tests currently in use, to define clinical prediction rules alternative to OFC and easy to use in clinical practice. 相似文献15.
Zoraida Verde Catalina Santiago Luis M. Chicharro Fernando Bandrés Félix Gómez-Gallego Jose Miguel Rodríguez González-Moro Pilar de Lucas 《Archivos de bronconeumología》2019,55(3):128-133
Introduction
Cigarette smoking is a major risk factor in the development of chronic obstructive pulmonary disease (COPD). Serotonin levels have been associated with COPD and smoking has been as a significant modulator. Elevated levels of serotonin are responsible for bronchoconstriction and pulmonary vasoconstriction and also nicotine dependence, thus serotonin response could be affected by genetic polymorphisms in transporters and receptors of serotonin.Objectives
The aim of the current study was to analyze the effect of SLC6A4 (5HTT_LPR) (rs25531) and HTR2A-1438G/A (rs6311) genetic polymorphisms on the relation between smoking habits and COPD.Methods
The association between SLC6A4 (5HTT_LPR) (rs25531), HTR2A-1438G/A (rs6311), smoking degree and COPD was analyzed in a total of 77 COPD patients (active smokers) and 90 control subjects (active healthy smokers). The DNA was extracted of peripheral leukocytes samples and genotyping was performed using an allele specific polymerase chain reaction.Results
The distribution of SLC6A4 genotypes did not vary between healthy smokers and COPD patients (P = 0.758). On the other hand, the A allele of HTR2A (rs6311) was significantly associated with COPD incidence in the trend model (P = 0.02; 1.80 [1.04–3.11]). Among all smokers, this allele was also associated with the number of pack years smoked (P = 0.02) and also, we observed a marginal association with FEV1/FVC values (P = 0.06).Conclusion
Our results point a possible role of the A allele of HTR2A (rs6311) in COPD pathogenesis, suggesting that this effect depends partly on tobacco consumption due to a gene-by-environment interaction. 相似文献16.
17.
Monica Baumgardt Bay Marise Reis de Freitas Marcia Cavalcante Vinhas Lucas Elizabeth Cristina Fagundes de Souza Angelo Giuseppe Roncalli 《The Brazilian journal of infectious diseases》2019,23(1):2-7
Background
Men who have sex with men (MSM) account for the highest prevalence of HIV in Brazil. HIV testing allows to implement preventive measures, reduces transmission, morbidity, and mortality.Methods
We conducted a cross-sectional study to evaluate HIV testing during lifetime, factors associated with the decision to test, knowledge about HIV transmission, and use of condoms between MSM from the city of Natal, northeast Brazil.Results
Out of 99 participants, 62.6% had been tested for HIV during lifetime, 46.2% in the last year. The most frequent reported reason to be tested for HIV infection was curiosity (35.5%). Correct knowledge about HIV was observed in only 9.2% of participants. In multivariate analysis, age (PR 0.95; 95%CI, 0.91–0.99; p = 0.041) and previous syphilis test (PR 4.21; 95%CI, 1.52–11.70; p = 0.006) were associated with HIV testing.Conclusions
The frequency of HIV testing among MSM from Natal is rather low, especially in younger MSM, and knowledge about HIV transmission is inappropriate. 相似文献18.
Marine Sarfati-Lebreton Laurence Toqué Jean-Baptiste Philippe Jean-Baptiste Finel Antoine Hamy Stéphanie Mucci 《Annales d'endocrinologie》2019,80(2):101-109
Objectives
Multinodular goiter is a common disorder, found in 5% of the general population. If only one thyroid lobe is affected, hemithyroidectomy may be preferred to total thyroidectomy, to limit the risk of complications and avoid hormone replacement therapy, but incurs a risk of subsequent completion thyroidectomy. The aim of the present study is to determine whether the arguments in favor of hemithyroidectomy are justified and whether it still provides real benefit.Methods
A retrospective observational study based on prospective data included all patients who underwent surgery for goiter or nodule in our center between September 2010 and September 2014. Rates of hormone replacement 6 months after hemithyroidectomy, postoperative complications and completion thyroidectomy during the postoperative year due to the discovery of carcinoma were analyzed.Results
Four hundred and ninety-three patients were studied: 335 with total thyroidectomy and158 with hemithyroidey. The rate of hormone replacement 6 months after hemithyroidectomy was 84.4%. The rate of definitive hypocalcemia was 6.3% in total thyroidectomy and zero in hemithyroidectomy (P < 0.05). There was no significant difference between groups in terms of recurrent laryngeal nerve palsy (1.8% versus 1.9%; P = 1) or hematoma (1.2% versus 3.5%; P = 0.15). A total of 11.3% of hemithyroidectomies required completion due to discovery of carcinoma (mean interval between surgeries 3.58 ± 2.5 months).Conclusions
This study suggests that hemithyroidectomy does not in fact avoid the risk of hormone replacement and places the patient at risk of completion thyroidectomy. However, it does avoid a 6% rate of hypocalcemia. We would recommend hemithyroidectomy only in case of single toxic or euthyroid nodule with healthy contralateral lobe and/or refusal of hormone replacement by the patient. 相似文献19.
C. Bétry E. Meugnier M. Pflieger G. Grenet S. Hercberg P. Galan E. Kesse-Guyot H. Vidal M. Laville 《Diabetes & metabolism》2019,45(2):152-159
Aim
Ageing is often associated with metabolic abnormalities such as insulin resistance, although some people remain metabolically healthy throughout their lives. The aim of this study was to gain more insight into metabolic health with increasing age.Methods
Two groups of robust and of frail subjects, respectively, were identified based on a composite ageing indicator and recruited from the French SU.VI.MAX 2 cohort of older disease-free subjects. In all, 14 men and 12 women, aged 67 ± 4 years, with similar anthropometric and metabolic characteristics at baseline (BMI: 24.5 ± 2.9 kg.m?2) were included in the Compaliclamp study. Skeletal muscle biopsy was performed to assess expression of a set of metabolic and sirtuin (SIRT) genes. Also, whole-body substrate oxidation and insulin sensitivity were determined using the euglycaemic–hyperinsulinaemic clamp and indirect calorimetry techniques.Results
Robust subjects were more insulin-sensitive, oxidized more lipid in a fasting state and stored more glucose during the euglycaemic – hyperinsulinaemic clamp than did frail subjects. At the gene-expression level in skeletal muscle, carnitine palmitoyltransferase 1b (CPT1b) messenger RNA (mRNA) levels were around four times higher in the robust compared with frail counterparts. Moreover, both SIRT2 and SIRT6 expression was lower in robust subjects and correlated with CPT1b expression.Conclusion
CPT1b overexpression could be helping to maintain metabolic health with increasing age. Thus, it is suggested that targeting CPT1b expression might be an interesting strategy to counteract frailty at an early stage. In addition, future studies should examine the role of sirtuin in CPT1b expression regulation. 相似文献20.
Imen Wahabi Sondess Hadj Fredj Malek Nefzi Rym Dabboubi Hajer Siala Fatma Khalsi Khedija Bousetta Taieb Messaoud 《Allergologia et immunopathologia》2019,47(2):159-165