AIM: In patients with liver cirrhosis, hypoalbuminemia causes edema and ascites, and a reduction in the quality of life. Since musculature is catabolized to supply amino acids for albumin synthesis in malnutritional c...AIM: In patients with liver cirrhosis, hypoalbuminemia causes edema and ascites, and a reduction in the quality of life. Since musculature is catabolized to supply amino acids for albumin synthesis in malnutritional cirrhotic patients, muscular volume is hypothesized to play an important role in albumin production. Therefore, we investigated the correlation between serum albumin levels and the fat-free mass (FFM) in cirrhotic patients.METHODS: Fifty-seven patients (26 males and 31 females)with compensated liver cirrhosis were evaluated. Patients with edema or ascites were excluded from the study.Healthy volunteers (n = 104; 48 males and 56 females)were also evaluated as controls. FFM was measured using 5-500 kHz multifrequency bioelectric impedance analysis.To minimize the difference in FFM distribution between males and females, we introduced a new marker, relative FFM (rFFM), which represents the ratio of FFM in a patient relative to that in a volunteer of the same height. Following FFM measurement, the serum albumin levels of patients were assayed monthly.RESULTS: In patients with active cirrhosis (alanine aminotransaminase [ALT] ＞50 U/L), both albumin (the difference between maximum and minimum levels) and the standard deviation of albumin levels (SD-albumin) during the observation period showed a significant correlation with rFFM. Multiple linear regression analysis using variables such as rFFM, platelet number, and serum cholesterol levels,choline esterase, albumin, bilirubin, and ALT revealed that rFFM and ALT were significant and independent factors that influenced albumin or SD-albumin in cirrhotic patients.CONCLUSION: Our results indicate that cirrhotic patients with high rFFM showed less of a decrease in albumin levels, and that the muscle volume is one of the most important factors for maintaining serum albumins level in active cirrhosis. Exercise and protein-rich nutrition at the early stage of liver cirrhosis may be advisable for maintaining or increasing muscular volume.展开更多
BACKGROUND: It is well established that the human aging process is associated with a significant decline in neuromuscular function and performance. Twin studies demonstrate that genetic factors partially explain the i...BACKGROUND: It is well established that the human aging process is associated with a significant decline in neuromuscular function and performance. Twin studies demonstrate that genetic factors partially explain the inter-individual variation of fat-free mass (FFM) and muscle strength. PURPOSE: To examine the association between the polymorphism of the gene IGF-2 with phenotypes strength and muscle mass of elderly women pre and post resistance training. METHODS: 76 elderly women participated in this analysis. These volunteers, who should be sedentary for at least 6 months before the study, were assigned four groups in relation to allele GAGG, AA, GAAA and GG. The first analysis compared 60 elderly women with GG and GA allele (GAGG) versus 16 elderly women with AA allele. The second analysis compared 54 elderly women with GA and AA (GAAA) versus 22 elderly women GG allele. The Body mass index, fat free mass, fat mass and Isokinetic Muscle Peak Torque were measured. All volunteers were participating in the Resistance Training program. The DNA was extracted from peripheral venous blood leukocytes using a salting out protocol. The primer for IGF-II gene exon 9 was 5’-GTCCCTGAACCAGCAAAGAG-3’ 0.5 μM (0.625 μl) Primer R-5’-TGATGGAAAAGGGAGTGAGG-3’ 0.5 μM (0.625 μl), Taq DNA Polimerase enzime 0.5 U (0.1 μl), água milli-Q (3.8 μl) 5 hg de DNA (3 μl). PCR amplification was performed in a programmable thermal cycler GeneAmp? PCR System 9700. RESULTS: The results of the first analysis GAGG × AA versus the group AA showed the relative increase in knee extensor peak torque relative and also in the fat-free mass and showed a decrease in the fat mass percentage in the GAGG group. The second analysis considered the group GAAA versus group GG showed decreases in the fat-free mass percentage in the GAAA group, also showed the relative increase in the fat-free mass in the GG group and decrease in the fat mass percentage in the GG group. CONCLUSIONS: The results of this study show that 24 weeks of the resistance training improved strength and muscle mass and decreased the fat mass. The results confirm this assertion and suggest the G allele presents more influence over the A allele, in relation to phenotypes strength and muscle mass in elderly women after resistance training.展开更多
Importance:Body fluid dynamics and renal maturation status vary during the neonatal period.We hypothesized that differences in peak and trough gentamicin concentrations could be expected.Objective:To predict the peak ...Importance:Body fluid dynamics and renal maturation status vary during the neonatal period.We hypothesized that differences in peak and trough gentamicin concentrations could be expected.Objective:To predict the peak and trough gentamicin concentrations in critically ill neonates and to predict the changes in the predicted peak plasma concentrations of gentamicin following fat-free mass dosing.Methods:Critically ill neonates that received gentamicin and have gentamicin concentration measured were recruited.Fat mass was estimated using skinfold thicknesses.Changes in the peak plasma concentrations(Cmax)using whole-body weight(estimated using the current dosing regimen)and predicted concentrations following the fat-free mass-based dosing were the outcome measures.Results:Eighty-nine critically ill neonates were recruited.Sub-therapeutic Cmax was estimated using the current dosing regimen in 32.6%,and 22.5%neonates following the first and second doses of gentamicin.Preterm neonates had significantly higher fat mass compared to term neonates.All except one had Cmax above 12μg/ml after the first dose and all had after the second gentamicin dose following the predicted fat-free massbased gentamicin dosing.The recommended doses are as follows:extreme preterm:7.95 mg/kg every 48 h;very preterm:7.30 mg/kg every 36-48 h;late preterm:5.90 mg/kg every 36-48 h;and term neonates at 5.10 mg/kg every 24 h.Interpretation:Fat-free mass dosing may be considered for obtaining optimal therapeutic effects in the neonatal population.展开更多
血脂代谢异常和肾脏异位脂质沉积与肾脏病的发生和发展密切相关,特别是在糖尿病肾病中更为明显。临床上常用的治疗高胆固醇血症的药物,如他汀类、依泽麦布和前蛋白转化酶枯草溶菌素9(proprotein convertase subtilisin/Kexin type 9,PCS...血脂代谢异常和肾脏异位脂质沉积与肾脏病的发生和发展密切相关,特别是在糖尿病肾病中更为明显。临床上常用的治疗高胆固醇血症的药物,如他汀类、依泽麦布和前蛋白转化酶枯草溶菌素9(proprotein convertase subtilisin/Kexin type 9,PCSK9)抑制剂,虽都能有效降低血脂水平,但均不能延缓肾脏病进展。近年来,越来越多的研究开始关注游离脂肪酸(free fat acids,FFA)对肾脏的影响。慢性肾脏病(chronic kidney disease,CKD)患者存在明显的脂肪酸代谢紊乱,这种异常参与肾脏病进展,FFA的转运蛋白在肾脏疾病中的作用机制逐渐被认识。本文就近端肾小管上皮细胞表达的脂肪酸转运蛋白2(fatty acid transport protein 2,FATP2)的临床前研究做一综述。展开更多
文摘AIM: In patients with liver cirrhosis, hypoalbuminemia causes edema and ascites, and a reduction in the quality of life. Since musculature is catabolized to supply amino acids for albumin synthesis in malnutritional cirrhotic patients, muscular volume is hypothesized to play an important role in albumin production. Therefore, we investigated the correlation between serum albumin levels and the fat-free mass (FFM) in cirrhotic patients.METHODS: Fifty-seven patients (26 males and 31 females)with compensated liver cirrhosis were evaluated. Patients with edema or ascites were excluded from the study.Healthy volunteers (n = 104; 48 males and 56 females)were also evaluated as controls. FFM was measured using 5-500 kHz multifrequency bioelectric impedance analysis.To minimize the difference in FFM distribution between males and females, we introduced a new marker, relative FFM (rFFM), which represents the ratio of FFM in a patient relative to that in a volunteer of the same height. Following FFM measurement, the serum albumin levels of patients were assayed monthly.RESULTS: In patients with active cirrhosis (alanine aminotransaminase [ALT] ＞50 U/L), both albumin (the difference between maximum and minimum levels) and the standard deviation of albumin levels (SD-albumin) during the observation period showed a significant correlation with rFFM. Multiple linear regression analysis using variables such as rFFM, platelet number, and serum cholesterol levels,choline esterase, albumin, bilirubin, and ALT revealed that rFFM and ALT were significant and independent factors that influenced albumin or SD-albumin in cirrhotic patients.CONCLUSION: Our results indicate that cirrhotic patients with high rFFM showed less of a decrease in albumin levels, and that the muscle volume is one of the most important factors for maintaining serum albumins level in active cirrhosis. Exercise and protein-rich nutrition at the early stage of liver cirrhosis may be advisable for maintaining or increasing muscular volume.
基金National Council for Scientific and Technological Development (CNPq)Catholic University
文摘BACKGROUND: It is well established that the human aging process is associated with a significant decline in neuromuscular function and performance. Twin studies demonstrate that genetic factors partially explain the inter-individual variation of fat-free mass (FFM) and muscle strength. PURPOSE: To examine the association between the polymorphism of the gene IGF-2 with phenotypes strength and muscle mass of elderly women pre and post resistance training. METHODS: 76 elderly women participated in this analysis. These volunteers, who should be sedentary for at least 6 months before the study, were assigned four groups in relation to allele GAGG, AA, GAAA and GG. The first analysis compared 60 elderly women with GG and GA allele (GAGG) versus 16 elderly women with AA allele. The second analysis compared 54 elderly women with GA and AA (GAAA) versus 22 elderly women GG allele. The Body mass index, fat free mass, fat mass and Isokinetic Muscle Peak Torque were measured. All volunteers were participating in the Resistance Training program. The DNA was extracted from peripheral venous blood leukocytes using a salting out protocol. The primer for IGF-II gene exon 9 was 5’-GTCCCTGAACCAGCAAAGAG-3’ 0.5 μM (0.625 μl) Primer R-5’-TGATGGAAAAGGGAGTGAGG-3’ 0.5 μM (0.625 μl), Taq DNA Polimerase enzime 0.5 U (0.1 μl), água milli-Q (3.8 μl) 5 hg de DNA (3 μl). PCR amplification was performed in a programmable thermal cycler GeneAmp? PCR System 9700. RESULTS: The results of the first analysis GAGG × AA versus the group AA showed the relative increase in knee extensor peak torque relative and also in the fat-free mass and showed a decrease in the fat mass percentage in the GAGG group. The second analysis considered the group GAAA versus group GG showed decreases in the fat-free mass percentage in the GAAA group, also showed the relative increase in the fat-free mass in the GG group and decrease in the fat mass percentage in the GG group. CONCLUSIONS: The results of this study show that 24 weeks of the resistance training improved strength and muscle mass and decreased the fat mass. The results confirm this assertion and suggest the G allele presents more influence over the A allele, in relation to phenotypes strength and muscle mass in elderly women after resistance training.
文摘Importance:Body fluid dynamics and renal maturation status vary during the neonatal period.We hypothesized that differences in peak and trough gentamicin concentrations could be expected.Objective:To predict the peak and trough gentamicin concentrations in critically ill neonates and to predict the changes in the predicted peak plasma concentrations of gentamicin following fat-free mass dosing.Methods:Critically ill neonates that received gentamicin and have gentamicin concentration measured were recruited.Fat mass was estimated using skinfold thicknesses.Changes in the peak plasma concentrations(Cmax)using whole-body weight(estimated using the current dosing regimen)and predicted concentrations following the fat-free mass-based dosing were the outcome measures.Results:Eighty-nine critically ill neonates were recruited.Sub-therapeutic Cmax was estimated using the current dosing regimen in 32.6%,and 22.5%neonates following the first and second doses of gentamicin.Preterm neonates had significantly higher fat mass compared to term neonates.All except one had Cmax above 12μg/ml after the first dose and all had after the second gentamicin dose following the predicted fat-free massbased gentamicin dosing.The recommended doses are as follows:extreme preterm:7.95 mg/kg every 48 h;very preterm:7.30 mg/kg every 36-48 h;late preterm:5.90 mg/kg every 36-48 h;and term neonates at 5.10 mg/kg every 24 h.Interpretation:Fat-free mass dosing may be considered for obtaining optimal therapeutic effects in the neonatal population.
文摘血脂代谢异常和肾脏异位脂质沉积与肾脏病的发生和发展密切相关,特别是在糖尿病肾病中更为明显。临床上常用的治疗高胆固醇血症的药物,如他汀类、依泽麦布和前蛋白转化酶枯草溶菌素9(proprotein convertase subtilisin/Kexin type 9,PCSK9)抑制剂,虽都能有效降低血脂水平,但均不能延缓肾脏病进展。近年来,越来越多的研究开始关注游离脂肪酸(free fat acids,FFA)对肾脏的影响。慢性肾脏病(chronic kidney disease,CKD)患者存在明显的脂肪酸代谢紊乱,这种异常参与肾脏病进展,FFA的转运蛋白在肾脏疾病中的作用机制逐渐被认识。本文就近端肾小管上皮细胞表达的脂肪酸转运蛋白2(fatty acid transport protein 2,FATP2)的临床前研究做一综述。
