Disfunção arterial como possível mecanismo de agressão cardíaca em pacientes com diabetes mellitus tipo II. Estudo Doppler-ecocardiográfico

OBJETIVO: Avaliar a estrutura e função do ventrículo esquerdo (VE) e a rigidez arterial em portadores de diabetes mellitus tipo II. MÉTODOS: Foram estudados 13 doentes diabéticos de ambos os sexos (55±8 anos) sem outras doenças. A estrutura e função do VE foram avaliadas por meio de ecodopplercardiografia associada à monitorização não invasiva da pressão arterial (PA). Os resultados foram comparados aos obtidos em grupo de indivíduos normais de mesma idade (n=12). RESULTADOS: Não houve diferenças entre os grupos quanto a PA diastólica, dimensões das câmaras esquerdas e índices de função sistólica e diastólica. Os pacientes diabéticos apresentaram índice de massa do VE (101±10 vs 80±14g/m²; p<0,001) e índice de rigidez arterial sistêmica (0,86±0,26 vs 0,69±0,19mmHg/mL; p<0,05) significantemente maiores que os controles. CONCLUSÃO: O diabetes mellitus está associado a aumento da rigidez arterial sistêmica e esse fator poderia contribuir para seus efeitos adversos sobre o VE.

RENAL EXCRETION OF ZINC IN NORMAL INDIVIDUALS DURING ZINC TOLERANCE-TEST AND GLUCOSE-TOLERANCE TEST

The urinary excretion, renal clearance, and tubular reabsorption of zinc were investigated in 30 adult healthy subjects under basal conditions and during the zinc and glucose tolerance tests. After a 12h overnight fast, each subject was submitted to renal clearance of zinc. The procedures were performed between 8.00 and 12.00 a.m., after emptying the bladder and ingestion of 4 ml deionized water/kg body weight at 8.00 a.m. The first urine sample was collected at 10.00 a.m., and the second at 12.00 a.m. A dose of 110 mg ZnSO4.7H(2)O was administered orally to each subject, diluted in 20 mi deionized water, at time 0 min. Blood samples were collected from an antecubital vein at times -30, 0, and 30 min and at 30 min intervals up to 240 min. Glucose was administered intravenously (0.5 ml 50%/kg body weight) during the first 3 min of the test, and blood samples were collected from an unconstricted, contralateral, antecubital vein at times -30, 0, 3, 5, 10, 20, 30, 45, 60, and 90 min. The results showed that urinary zinc excretion, and renal zinc clearance were significantly higher during the zinc and glucose tolerance tests than in the control condition. on the other hand, renal zinc clearance was more elevated during the glucose tolerance test than during the zinc tolerance test. Variations in zinc tubular reabsorption and glomerular filtration rate were not detected. The results suggest that urinary excretion and renal clearance of zinc in healthy subjects increase during acute zinc ingestion and glucose infusion. Although zinc ingestion raised urinary zinc excretion, glucose infusion was more effective in increasing renal zinc clearance. These normal parameters are important in the investigation of diabetic patients with serum and urine zinc changes.

Alloxan-Induced Diabetes Triggers the Development of Periodontal Disease in Rats

Background. Periodontal disease in diabetic patients presents higher severity and prevalence; and increased severity of ligature-induced periodontal disease has been verified in diabetic rats. However, in absence of aggressive stimuli such as ligatures, the influence of diabetes on rat periodontal tissues is incompletely explored. The aim of this study was to evaluate the establishment and progression of periodontal diseases in rats only with diabetes induction. Methodology/Principal Findings. Diabetes was induced in Wistar rats (n = 25) by intravenous administration of alloxan (42 mg/kg) and were analyzed at 1, 3, 6, 9 and 12 months after diabetes induction. The hemimandibles were removed and submitted to radiographical and histopathological procedures. A significant reduction was observed in height of bone crest in diabetic animals at 3, 6, 9 and 12 months, which was associated with increased numbers of osteoclasts and inflammatory cells. The histopathological analyses of diabetic rats also showed a reduction in density of collagen fibers, fibroblasts and blood vessels. Severe caries were also detected in the diabetic group. Conclusions/Significance. The results demonstrate that diabetes induction triggers, or even co-induces the onset of alterations which are typical of periodontal diseases even in the absence of aggressive factors such as ligatures. Therefore, diabetes induction renders a previously resistant host into a susceptible phenotype, and hence diabetes can be considered a very important risk factor to the development of periodontal disease.

Renal excretion of zinc in normal individuals during zinc tolerance test and glucose tolerance test

The urinary excretion, renal clearance, and tubular reabsorption of zinc were investigated in 30 adult healthy subjects under basal conditions and during the zinc and glucose tolerance tests. After a 12h overnight fast, each subject was submitted to renal clearance of zinc. The procedures were performed between 8.00 and 12.00 a.m., after emptying the bladder and ingestion of 4 ml deionized water/kg body weight at 8.00 a.m. The first urine sample was collected at 10.00 a.m., and the second at 12.00 a.m. A dose of 110 mg ZnSO47H2O was administered orally to each subject, diluted in 20 ml deionized water, at time 0 min. Blood samples were collected from an antecubital vein at times -30, 0, and 30 min and at 30 min intervals up to 240 min. Glucose was administered intravenously (0.5 ml 50%/kg body weight) during the first 3 min of the test, and blood samples were collected from an unconstricted, contralateral, antecubital vein at times -30, 0, 3, 5, 10, 20, 30, 45, 60, and 90 min. The results showed that urinary zinc excretion, and renal zinc clearance were significantly higher during the zinc and glucose tolerance tests than in the control condition. On the other hand, renal zinc clearance was more elevated during tile glucose tolerance test than during the zinc tolerance test. Variations in zinc tubular reabsorption and glomerular filtration rate were not detected. The results suggest that urinary excretion and renal clearance of zinc in healthy subjects increase during acute zinc ingestion and glucose infusion, Although zinc ingestion raised urinary zinc excretion, glucose infusion was more effective in increasing renal zinc clearance. These normal parameters are important in the investigation of diabetic patients with serum and urine zinc changes.

Hypertensive disorders in pregnant women with diabetes mellitus

The present study was performed to assess the rate of hypertensive complications in diabetic pregnant patients and the influence of White's classification and the quality of the diabetic control. This study included 169 diabetic pregnant women who had delivered at the University Hospital of Botucatu Brazil from 1980 to 1981. The hypertensive disorders occurred in 29.8% of the cases. The incidence of the hypertensive process was the same in all classes of diabetic patients, and it was independent of the glycemic control. In patients with gestational diabetes (classes A and AB), chronic hypertension was the commnest type found; in patients with short-term diabetes (classes B and C) pregnancy-induced hypertension (PIH) and chronic hypertension with superimposed PIH was the most frequent type, and diabetic patients with vasculopathies (classes D-R) had preeclampsia and chronic hypertension with superimposed preeclampsia as the commonest type found.

Hypochlorous acid inhibition by acetoacetate: Implications on neutrophil functions

Type-1 diabetic patients experience hyperketonemia caused by an increase in fatty acid metabolism. Thus, the aim of this study was to measure the effect of ketone bodies as suppressors of oxidizing species produced by stimulated neutrophils. Both acetoacetate and 3-hydroxybutyrate have suppressive effect on the respiratory burst measured by luminol-enhanced chemiluminescence. Through measurements of hypochlorous acid production, using neutrophils or the myeloperoxidase/H2O2/Cl- system, it was found that acetoacetate but not 3-hydroxybutyrate is able to inhibit the generation of this antimicrobial oxidant. The superoxide anion scavenging properties were confirmed by ferricytochrome C reduction and lucigenin-enhanced chemiluminescence assays. However, ketone bodies did not alter the rate of oxygen uptake by stimulated neutrophils, measured with an oxygen electrode. A strong inhibition of the expression of the cytokine IL-8 by cultured neutrophils was also observed; this is discussed with reference to the antioxidant-like property of acetoacetate. © 2004 Pharmaceutical Society of Japan.

Frutose em humanos: Efeitos metabólicos, utilização clínica e erros inatos associados

This article reviews the metabolism of fructose and sorbitol, their main clinical indications and the consequences of inadequate use. Fructose, an important carbohydrate in the diet, is present mostly in fruits and vegetables; it can also be synthesized from glucose in the organism, through the sorbitol. Fructose is known for its metabolism's inherent errors, whose clinical manifestations are potentially serious, as well as for its use as a glucose substitute in the diabetic patients' diet, due to its metabolism not being dependent from insulin. In the last years, especially in developed countries, the consumption of fructose has increased considerably, due to its use as a sweetener in industrialized foods. However, adverse side-effects may occur with the excessive ingestion of fructose, such as the increase in blood's triglycerides and cholesterol. Therefore, to know which are the patients' normal blood levels is quite important for establishing the safe amount of fructose to be prescribed, as well as for allowing the screening of metabolism diseases associated with fructose.

Efeito do extrato aquoso de Allium sativum L. sobre parâmetros bioquímicos de ratas com diabete induzido por Streptozotocin

Many plants, even without scientific confirmation, are used in Brazil as hypoglycemic. The objective of the present work was to study the influence of the Allium sativum treatment, plant known popularly as garlic, on characteristic biochemical parameters in streptozotocin-induced diabetic rats. Female Wistar rats were injected with 40 mg kg-1 streptozotocin (STZ). Oral administration of an aqueous extract of A. sativum was given to the diabetic animals in 2 doses: 200 and 400 mg kg-1 (n=6 animals/group). Diabetic rats given distilled water constituted the control group. After 28 days of treatment, the female rats were anesthetized and died by decapitation for collection of the blood for biochemical determinations and retreat of liver samples for hepatic glycogen dosage. The treatment with Allium sativum in the doses of 200 and 400 mg kg-1 alter no concentrations of total proteins, hepatic glycogen, triglycerides and VLDL, but it promoted reduction in the total cholesterol rate (control=280.5 ± 30.9; 200 mg kg-1 A. sativum =169.9 ± 19.5 and 400 mg kg-1 A. sativum =148.4 ± 26.6 mg dL-1) and LDL (control=128.8± 25.3; 200 mg kg-1 A. sativum = 41.4 ± 16.2 and 400 mg kg-1 A. sativum=42.0 ± 26.0 mg dL-1). The extract presented beneficial effect because it decreased 13.0% of glycemia in the highest dose. Therefore, the of garlic extract reduced the HDL concentration in two tested doses (control= 81.4 ± 30.2; 200 mg kg-1 A. sativum=49.6 ± 14.3 and 400 mg kg-1 A. sativum=41.7 ± 16.1 mg dL -1), presenting impaired effect. Thus, the garlic extract showed efficiency in the analyzed experimental conditions, and it could be used as complementary therapy to diabetic patients.

Homogenous demineralized dentin matrix for application in cranioplasty of rabbits with alloxan-induced diabetes: Histomorphometric analysis

Purpose: The aim of this work was to evaluate the bone-repair process after implantation of homogenous demineralized dentin matrix (HDDM) slices in surgical defects created in the parietal bones of rabbits with alloxan-induced diabetes. Materials and Methods: Forty-eight rabbits were selected and divided into 4 groups of 12 rabbits: the control group, diabetic rabbits (D), diabetic rabbits with a PTFE barrier (D-PTFE), and diabetic rabbits with a PTFE barrier and with slices of homogenous demineralized dentin matrix (D-PTFE+HDDM). The diabetic animals received a single dose of alloxan monohydrate (90 mg/kg) intravenously on the marginal ear vein, and their blood glucose was verified daily. The rabbits were sacrificed after 15, 30, 60, and 90 days. The histologic findings show both better bone structure and significantly greater bone density, as determined by histomorphometric analysis, for the D-PTFE + HDDM group than for the other 3 groups (P < .01). It was also observed that the mean bone density increased gradually from 15 to 90 days (except in the D-PTFE group). Conclusion: It was concluded that the HDDM was biocompatible with the bone repair of diabetic rabbits and that HDDM slices stimulated bone tissue formation. Facilitation of bone repair with HDDM could be useful in diabetic patients.

Lipoperoxidação, perda de viabilidade celular e diminuição da liberação de IL-8 de neutrófilos humanos na presença de corpos cetônicos

Type-1 diabetes patients suffer from frequent episodes of acidosis caused by an increased fatty acid metabolism and consequently increased plasma level of acetoacetate (AcAc) and β-hydroxybutyrate (β-HOB). This article describes a study of the effects of pathological concentrations of AcAc and β-HOB on lipoperoxidation, cell viability and the release of the CXCL8 (IL-8) cytokine by activated neutrophils. Neutrophils from healthy donors were isolated by density gradient (Histopaque® 1077/1119) and incubated with the ketone bodies. Lipoperoxidation was determined as thiobarbituric acid reactive substances (TBARS). The cell viability was evaluated by the release of intracellular lactate dehydrogenase. The release of CXCL8 was measured by ELISA in a 24-h culture of opsonized zymosan-stimulated neutrophils. AcAc, but not β-HOB, provoked a dose-dependent increase in the neutrophil membrane lipoperoxidation (p<0.05; r =0.9915). In the cytotoxicity assay, a dose-dependent release of LDH was observed when the neutrophils were incubated with AcAc in concentrations up to 40 mM (p<0.05). β-HOB was devoid of effect. The release of CXCL8 was inhibited by AcAc and β-HOB in a dose-dependent manner. In conclusion, these results suggest that the accumulation of ketone bodies in diabetic patients could be involved in their usually increased susceptibility to infection.

Associação entre doenças crônicas em adultos e redução dos níveis de atividade física

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Parâmetros da marcha, pressões plantares e equilíbrio corporal de diabéticos neuropatas e vasculopatas, com o uso de palmilhas

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Diabetes mellitus tipo 2 e esquema terapêutico: impacto da prática de atividades físicas sobre o custo do tratamento ambulatorial em Unidade Básica de Saúde da cidade de Bauru -SP

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Influência da inibição da NADPH oxidase sobre o redemodelamento cardíaco de ratos com diabetes mellitus

Pós-graduação em Fisiopatologia em Clínica Médica - FMB

Avaliação do sinal insulínico em ratos adultos com doença periodontal

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)