Efeitos da rosiglitazona sobre a função endotelial em indivíduos não-diabéticos com síndrome metabólica

Abstract

OBJECTIVETo evaluate the effects of rosiglitazone (ROSI), an insulin-sensitizer, on endothelial function and endothelial activation markers in a group of non-diabetic subjects with metabolic syndrome. METHODSA group of eighteen subjects (12 women, 6 men), mean age 41.2 ± 9.7 and BMI 37.8 ± 6.1 Kg/m 2 , was treated with rosiglitazone 8 mg/day for 12 weeks. Another group of nine healthy subjects, mean age 26.1 ± 4.4 and BMI 21.7 ± 1.7 Kg/m 2 , was studied at baseline to compare vasodilator response. Endothelial function was evaluated by venous occlusion plethysmography after intra-arterial infusions of acetylcholine (Ach) and sodium nitroprusside (SNP). The following were measured: glucose, insulin, lipids, fi brinogen, and high-sensitivity C-reactive protein (CRP). HOMA and QUICKI indexes were calculated to quantify insulin resistance (IR). RESULTSThere was an improvement in insulin resistance, as evidenced by lower HOMA-R and higher QUICKI index, as well as a decrease in CRP and fi brinogen levels. Endothelium-dependent vasodilation also improved, as evidenced by greater increment in blood fl ow after Ach and greater decrement in vascular resistance. No difference in endothelium-independent vasodilation was noted. CONCLUSIONRosiglitazone treatment reduced insulin resistance, fi brinogen, and CRP levels and improved endothelial function in non-diabetic subjects with metabolic syndrome. These data suggest that rosiglitazone plays a role in the regulation of endothelial function in patients at high cardiovascular risk. KEY WORDSEndothelium, metabolic syndrome, rosiglitazone.

Intra- and inter-tester reproducibility of venous occlusion plethysmography: comparison between a manual and a semi-automatic method of blood flow analysis

“…In addition, other aspects that improve the VOP reproducibility that should be carefully taken into consideration are the standardization of data acquisition regarding proper strain gauge size, the positioning of the strain gauge on the largest diameter of the limb and the twin strain gauge tubing that should run parallel around the limb (Whitney 1953, Joyner et al 2001. Aspects that decrease the biological variability are the standardization of the following factors: time of the day of the evaluation (Panza et al 1991), fasting or diet (Sundberg 1995), previous physical activity (Bousquet-Santos et al 2005), smoking (Stoner et al 2004), alcohol consumption (Tawakol et al 2004) and usage of medicines (Bahia et al 2006, Macedo et al 2008 or supplements (Taddei et al 1998). Finally, since the BF is directly influenced by blood pressure, the report of the VOP results as vascular resistance (MBP divided by BF), or its reciprocal, vascular conductance (BF divided by MBP), has been shown to improve the accuracy and reproducibility of the VOP (Thijssen et al 2005).…”