Background and Aims: We evaluated adipose tissue-derived hormones, body composition, serum metabolic profile, levels of brain-derived neurotrophic factor (BDNF), and the association of these parameters with the clinical outcome in patients with COVID-19. We sought to examine whether obesity, sex, and age influence the adipose tissue endocrine response to the disease.Methods: This prospective study investigated 145 hospitalized patients with COVID-19. Patients were categorized based on their body mass index (BMI), sex and age, and were also classified regarding their outcome after hospitalization as: (a) Non-ICU: patients hospitalized who did not receive intensive care; (b) ICU-survivor: patients admitted to the intensive care unit and discharged; (c) ICU-death: patients who died. Blood samples were collected by the hospital staff between the first and third day of hospitalization. Serum leptin, adiponectin and BDNF concentrations, triglycerides, total cholesterol and cholesterol fractions were performed following the manufacturer's guidelines.Results: We demonstrate that BDNF levels predict intensive care (IC) need (p < 0.01). This association was found to be stronger in patients >60y (p = 0.026). Neither leptin nor adiponectin concentration was associated with IC requirement or with patient's outcome, while the BDNF/adiponectin ratio was closely associated with worsened outcomes (p < 0.01). BDNF concentration was similar between sexes, however tended to be lower in male patients (p = 0.023). In older patients, BDNF concentration was lower than that of younger patients (p = 0.020). These age and sex-specific differences should be considered when employing these potential markers for prognosis assessment. While appetite and body composition regulating hormones secreted by the white adipose tissue are not reliable predictors of disease severity, the ratio BDNF/adiponectin was indicative of patient status.Conclusion: Thus, we propose that serum BDNF content and BDNF/adiponectin ratio may serve as tools predicting worsened prognosis in COVID-19, especially for male patients.
Introdução: O resveratrol é uma fitoalexina natural cujos principais benefícios devem-se às suas propriedades antiinflamatórias e antioxidantes. Os seus efeitos sugerem que este é um suplemento útil para a redução da inflamação, podendo desempenhar um papel fundamental na prevenção das doenças cardiovasculares. Este promove a vasodilataçãopela indução da síntese de óxido nítrico (NO), possui atividade antitrombótica e evita a agregação plaquetária. O fator de crescimento endotelial vascular (VEGF) é responsável pela angiogénese, sendo a sua expressão influenciada pelo resveratrol. Objetivos: Avaliar o efeito do resveratrol no perfil vascular pela determinação da pressão arterial e dos biomarcadoresinterleucina-6 (IL-6), proteína C reativa (PCR), VEGF e NO. Material e Métodos: 27 alunos com idades compreendidas entre os 18 e os 22 anos foram divididos em grupo controlo (GC) e grupo de intervenção (GI), que consumiram placebo e 100 mg de resveratrol por dia, respetivamente, durante 1 mês. A pressão arterial foi medida com aparelho automáticovalidado. Os níveis de PCR foram obtidos por imunoturbidimetria, os de IL-6 e VEGF por slot blot e a quantificação de NO por espectrofotometria. Resultados: Entre os grupos observou-se uma diminuição da pressão arterial braquial e central (??0.05). A variação negativa no NO apresentou-se superior no GC apesar das diferenças não serem significativas (p>0,05). Nos restantes marcadores avaliados não se observaram diferenças significativas. Conclusões: A ingestão regular de resveratrol parece ser uma abordagem preventiva a nível vascular, dado que modula positivamente o perfil vascular, reduzindo a pressão arterial. A variação nos níveis de NO poderá ajudar a explicar os benefícios verificados.
Aim: In the Azerbaijan national sample, to investigate gender-specific associations between educational level and body mass parameters: body mass index (BMI), waist circumference (WC), abdominal obesity (AO), as well as the links between education and cardio-metabolic risk (CMR) components -arterial hypertension (AH) and diabetes mellitus (DM).Material and methods: The study included people 760aged 24-84 years: 290 men and 470 women. Response rate was 82,3%.Results: Higher-educated people demonstrated lower levels of BMI and WC, lower prevalence of AO and clinical states associated with increased BM -AH and AH + AO (ð<0,001). Higher-educated individuals also had minimal age-related gradient in BM and WC increase (ð<0,001). Educational differences in BM were observed in subjects aged over 25 years (educational status is defined by this age), and were maximal in workingage individuals under 60 years. In older individuals, the association between education and BM was less clear. In men, education was not significantly associated with BM parameters, while in women, this association was statistically significant (ð<0,001). In lower-educated women, odds ratios (ORs) for AO, AH, and their combination were, respectively, 2,4 (95% CI 2,0-2.9), 1,6 (95% CI 1,4-1,95), and 1,95 (95% CI 1,6-2,4). In women with secondary education, respective ORs were 1,95 (95% CI 1,7-2,3), 1,2 (95% CI 1,0-1,4), and 1,5 (95% CI 1,2-1,8), comparing to their peers with higher education. Among men, OR for AH was 1,6 (95% CI 1,3-1,9) in the lower-educated and 1,3 (95% CI 1,1-1,6) in those with secondary education.Conclusion: Among women, educational level was significantly linked to BM parameters and BM-related characteristics of AH and AO. In men, this association was observed for AH only.
There are controversies about the possible benefits of off pump coronary artery bypass grafting (OPCABG) compared to on-pump coronary artery bypass grafting (ONCABG). For a better perspective on this important issue, we performed a meta-analysis of randomized controlled trials, comparing the two techniques. The objective of this study was to verify which technique applied in Coronary Artery Bypass Surgery, OPCABG or ONCABG, provides better results through a meta-analysis of published randomized trials comparing the two techniques. We carried out a computer-based literature search in PubMed, Embase, B-on and Science Direct from March 2009 to January 2010. The studies covered were recovered according to predetermined criteria. A systematic review of randomized clinical trials was performed in order to evaluate the differences between the two revascularization techniques (OPCABG versus ONCABG) regarding mortality and morbidity. Selected studies did not include patients at high risk and long-term longitudinal evaluations. The meta-analysis focused on nine randomized clinical trials, corresponding to a total of 75,086 patients, and compared OPCABG to ONCABG. Regarding mortality, a reduction of 18% in the risk of cardiovascular mortality (OR: 0.82, 95%CI: 0.70 to 0.98, p = 0.03) and 27% in the risk of stroke postoperatively (OR: 0.73, 95%CI: 0.63 to 0.85, p = 0.0001) were observed, both in favor of OPCABG. Concerning the occurrence of complications associated with the procedure, no significant differences were found between the two surgical techniques, particularly with regard to the occurrence of kidney complications (OR: 0.97, 95%CI: 0.84-1.14, p = 0, 74) and sepsis (OR 0.98, 95%CI: 0.64-1.51, p = 0.93, respectively). Off-pump CABG significantly reduces the occurrence of major cardiovascular events (mortality and CVA) compared to on-pump CABG surgery.
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