Background and objectives The calcimimetic cinacalcet reduced the risk of death or cardiovascular (CV) events in older, but not younger, patients with moderate to severe secondary hyperparathyroidism (HPT) who were receiving hemodialysis. To determine whether the lower risk in younger patients might be due to lower baseline CV risk and more frequent use of cointerventions that reduce parathyroid hormone (kidney transplantation, parathyroidectomy, and commercial cinacalcet use), this study examined the effects of cinacalcet in older ($65 years, n=1005) and younger (,65 years, n=2878) patients.Design, setting, participants, & measurements Evaluation of Cinacalcet HCl Therapy to Lower Cardiovascular Events (EVOLVE) was a global, multicenter, randomized placebo-controlled trial in 3883 prevalent patients on hemodialysis, whose outcomes included death, major CV events, and development of severe unremitting HPT. The age subgroup analysis was prespecified.Results Older patients had higher baseline prevalence of diabetes mellitus and CV comorbidity. Annualized rates of kidney transplantation and parathyroidectomy were .3-fold higher in younger relative to older patients and were more frequent in patients randomized to placebo. In older patients, the adjusted relative hazard (95% confidence interval) for the primary composite (CV) end point (cinacalcet versus placebo) was 0.70 (0.60 to 0.81); in younger patients, the relative hazard was 0.97 (0.86 to 1.09). Corresponding adjusted relative hazards for mortality were 0.68 (0.51 to 0.81) and 0.99 (0.86 to 1.13). Reduction in the risk of severe unremitting HPT was similar in both groups. ConclusionsIn the EVOLVE trial, cinacalcet decreased the risk of death and of major CV events in older, but not younger, patients with moderate to severe HPT who were receiving hemodialysis. Effect modification by age may be partly explained by differences in underlying CV risk and differential application of cointerventions that reduce parathyroid hormone.
Angiotensin-converting enzyme (ACE) inhibitors are known to reduce blood pressure and proteinuria in a variety of different glomerular diseases. Nonetheless, a marked interindividual difference in the efficacy of these agents exists. The activity of the ACE and therefore of the renin-angiotensin-aldosterone system (RAAS) has been shown to be under genetic influence. Patients with a deletion genotype at the intron 16 of the ACE gene have been shown to exhibit higher activity of plasmatic ACE when compared to patients with the insertion genotype. We therefore studied prospectively the hemodynamic and antiproteinuric effect of a 6-month therapy with enalapril in patients with biopsy-proven proteinuric glomerular diseases and the DD (n = 10) and ID/II (n = 26) genotype. Although patients with the DD genotype received a slightly higher dose of enalapril, blood pressure and proteinuria did not change significantly. However, both were significantly reduced in the II/ID group after 10 weeks and 6 months of therapy. Creatinine clearance decreased steadily in DD patients. In II/ID patients, creatinine clearance was reduced significantly after 10 weeks of therapy but increased again thereafter and the value at 6 months was again comparable to the one obtained in the DD patients. We conclude from our study that the ACE genotype influences the blood pressure-lowering and antiproteinuric effect of enalapril in patients with proteinuric glomerular disease.
Introducción. La variabilidad genética del polimorfismo del gen APOE se considera un importante factor asociado a la predisposición a las enfermedades que afectan el metabolismo lipídico, a las enfermedades coronarias y a la enfermedad de Alzheimer, entre otras. En este sentido, es útil conocer este factor de riesgo en diferentes poblaciones y grupos étnicos. Objetivos. Analizar el polimorfismo del gen APOE y determinar las frecuencias alélicas y genotípicas de una muestra representativa de la población de Barranquilla, Colombia. Materiales y métodos. Se hizo en Barranquilla un estudio descriptivo y comparativo de 227 individuos no relacionados. Resultados. El alelo ε3 se presentó con mayor frecuencia (85 %), seguido del alelo ε4 (13 %) y, con menor frecuencia, el alelo ε2 (1,8 %). Los genotipos observados fueron los siguientes: ε3/ε3 en 71,8 %, ε3/ε4 en 24,2 %, ε2/ε3 en 2,2 %, ε2/ε4 en 1,3 % y ε4/ε4 en 0,4 %. El genotipo ε2/ε2 no se encontró en este estudio. La muestra representativa de la población estaba en equilibrio de Hardy-Weinberg. Conclusiones. Las frecuencias alélicas ε3 y el genotipo ε3/ε3 encontrados en la población estudiada, fueron similares a lo informado por la literatura científica en países como Brasil, México y Colombia, y en algunos grupos étnicos amerindios colombianos. No se encontró el genotipo ε2/ε2, resultado que coincide con otras poblaciones estudiadas a nivel mundial. La frecuencia del alelo ε4 y sus genotipos asociados en esta población, podría estar relacionada con la presencia de enfermedades como la hipercolesterolemia, el infarto de miocardio y la enfermedad de Alzheimer.Palabras clave: apolipoproteínas E, polimorfismo genético, población, alelos, Colombia. doi: http://dx.doi.org/10.7705/biomedica.v36i1.2612 APOE gene polymorphism analysis in Barranquilla, ColombiaIntroduction: The genetic variability present in the APOE gene polymorphism is considered an important factor associated with predisposition to diseases affecting lipid metabolism, as well as heart diseases and Alzheimer's disease, among others. Understanding it as a risk factor in different populations and ethnic groups is a useful tool. Objective: To analyze the APOE gene polymorphism and determine allelic and genotypic frequencies of a representative sample of population from Barranquilla, Colombia. Materials and methods:We performed a descriptive and comparative study. The sample size was 227 unrelated individuals from Barranquilla, Colombia Results: The most frequent allele was the ε3, with 85%, followed by the ε4 allele (13%) and ε2 (1.8%). The genotypes found were: ε3/ε3: 71.8%, ε3/ε4: 24.2%, ε2/ε3: 2.2%, ε2/ε4: 1.3% and ε4/ε4: 0.4%. The ε2/ε2 genotype was not found in this study. The sample exhibited the Hardy-Weinberg equilibrium. Conclusion: The frequency of the ε3 allele and the ε3/ε3 genotype was similar to that reported in the literature in countries like Brazil, Mexico, Colombia, and in some Colombian Amerindian ethnic groups. The ε2/ε2 genotype was absent. This result is consistent with those found in oth...
Objective: To study the NAT2 gene polymorphisms 481T, 590A and 857A in the Chimila, Wiwa and Wayuu indigenous groups of the Colombian Caribbean to determine the frequencies of the allelesNAT2*4, NAT2*5, NAT2*6, and NAT2*7 and to determine the types of acetylators present in these populations. Methods: A total of 202 subjects were studied: 47 Chimila, 55 Wiwa, and 100 Wayuu. The polymorphisms were idenjpgied using a real-time PCR method for allelic discrimination designed using Taqman of Applied Biosystems. Results: The following alleles were found at the highest frequency in the following groups: the NAT2*4 allele (wild type) in the Wayuu group (55.3%), the NAT2*5 allele in the Wiwa group (34.5%), and the NAT2*7 allele in the Chimila group (24.2%). A higher frequency of the rapid acetylator status was found in the Wayuu group (31.3%) and Chimila group (29.5%) compared with the Wiwa group (12.7%). The intermediate acetylator status distribution was very similar in all three groups, and the frequency of the slow acetylator status was higher in the Wiwa group (32.7%) compared with the Chimila and Wayuu groups (20.5% and 21.2%, respectively). Conclusion: The results demonstrated the allelic distribution and pharmacogenetic differences of the three groups studied and revealed the most frequent acetylator status and phenotype. Because of the high prevalence of slow acetylators, a greater incidence of tuberculosis (TB) drug-induced hepatotoxicity is predicted in these populations, with a higher frequency in the Wiwa group.
An insertion/deletion polymorphism has been described for the gene that encodes the angiotensin-converting enzyme. The deletion allele is associated with higher angiotensin-converting enzyme plasma levels, which ultimately might lead to increased angiotensin II concentrations. Because angiotensin II is a mediator for progressive renal injury, this study determined the frequency of distribution of the angiotensin-converting enzyme insertion/deletion polymorphism in 106 hemodialysis patients and in a group of 95 healthy control patients. There was no difference between the two groups as far as the distribution of the insertion and deletion allele was concerned. Of the total hemodialysis population, 26.4% exhibited the deletion/deletion genotype, as compared with 37.9% of the healthy control population. Also, when patients with terminal renal failure as a result of glomerular disease were analyzed separately, the frequency of the deletion/deletion genotype was identical to that of the control group. Furthermore, the frequency of hypertension, coronary artery disease, left ventricular hypertrophy, and dilated cardiomyopathy, were analyzed according to the angiotensin-converting enzyme genotype, but the deletion allele could not be defined as a risk factor in the study's hemodialysis population. It was therefore concluded that the angiotensin-converting enzyme insertion/deletion polymorphism is not a major risk factor for development of end-stage renal failure. Additionally, in hemodialysis patients, there is no association between the risk for cardiovascular diseases and the angiotensin-converting enzyme genotype.
Background and Aims Frailty is known as a biological syndrome of decreased reserves and resistance to stress, with a decline of multiple physiological systems, causing vulnerability. Its prevalence ranges from 10-80 %. The etiopathogenesis is multifactorial, based on the loss of muscle mass associated with aging or sarcopenia. Chronic Kidney Disease (CKD) is a model of accelerated aging, with impaired physical function, frailty and cognitive decline. The main theorical frameworks on frailty are the one advocated by Linda Fried, in which she develops a phenotype as a risk situation for developing disability and one advocated by Kennet Rockwood which establishes that frailty consists of addition of various health conditions including comorbidity and disability. Our objective was to evaluate frailty in stage 5 CKD in haemodialysis, measured by clinical scale and to relate it to the body composition measured by bioimpedance. Method Cross-sectional study in 40 subjects with CKD in hospital haemodialysis, 70.5±13.03 years, 62.5% male. 40% Diabetic Nephropathy, 10% Glomerulopathies, 7.5% Nephroangiosclerosis, 2.5% Chronic Tubule-Interstitial Nephropathies, 32.5% Unknow, 2.5% Others. 35% arteriovenous fistula, 10% arteriovenous graft, 55% central venous catheter. Hemodialysis type: 40% High Flux, 45% Online postdilutional Haemodiafiltration, 10% Acetate Free Biofiltration. Fragility was measured by the Rockwood clinical scale: not fragile (1-4), moderately fragile (5-6) and severely fragile (7-9). Body composition was estimated by monofrequency bioimpedance measurement. Chi-Cuadrado was used to study differences between dichotomous variables and ANOVA for continuous variables. Spearman correlation´s was used to examinate the intensity of association between two quantitative variables. Statistical analysis was performed with SPSS 13.0. Results 42.5% of the subjects presented a degree of fragility ≥5, severely fragile 27.5%. The results are shown in the Tables 1 and 2. Conclusion The degree of frailty is greater in the elderly. Measurement of body composition by bioimpedance can be useful to indirectly asses frailty. The phase angle could be an indicator of fragility, since in more fragile subjects its value decreases, its physiological role remains to be elucidated. There is a positive trend to an increase in extracellular water in more fragile subjects, keeping the subjects in their dry weight, so it will be necessary to evaluate what is due.
Introducción. La obesidad se considera un grave problema de salud pública y por ello se hacen esfuerzos en la búsqueda de genes como el LEP, el LEPR y el MC4R del sistema leptina-melanocortina, el cual opera en la regulación neuroendocrina de la ingestión y el equilibrio energético e influye en la patogenia de la enfermedad. Los resultados contradictorios en torno a la asociación de estos genes con la obesidad plantean la necesidad de nuevas investigaciones.Objetivo. Analizar los polimorfismos rs2167270 del gen LEP, rs1137101 del gen LEPR y rs17782313 del gen MC4R asociados con la obesidad y sus variables clínicas y bioquímicas en una muestra de pacientes adultos de Barranquilla.Materiales y métodos. Se estudiaron 111 personas obesas y 155 no obesas como controles. Los polimorfismos se determinaron mediante reacción en cadena de la polimerasa (PCR) en tiempo real. Se tomaron las medidas antropométricas, se evaluó la presión arterial y se hicieron pruebas bioquímicas.Resultados. No se encontraron diferencias estadísticas en la frecuencia alélica y genotípica de los polimorfismos en los grupos estudiados. En cuanto a las variables clínicas y bioquímicas, el genotipo CC del polimorfismo rs17782313 del gen MC4R, se asoció con un aumento de la presión arterial sistólica y, el alelo T y su genotipo homocigoto, con una disminución del colesterol HDL en los obesos. No se evidenció ningún efecto de los otros polimorfismos en estas variables.Conclusiones. Los polimorfismos rs2167270 del gen LEP, rs1137101 del gen LEPR y rs17782313 del gen MC4R, no se asociaron con obesidad en la población analizada. Se encontró que el polimorfismo rs17782313 del gen MC4R influyó en el aumento de la presión arterial sistólica y la disminución del colesterol HDL en las personas obesas.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
334 Leonard St
Brooklyn, NY 11211
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.