Navegando por Assunto "Risco cardiovascular"

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A influência dos níveis séricos de IGF-1 no perfil lipídico e glicêmico de acromegálicos em um Centro de Especialidades Médicas no Pará
(Centro Universitário do Estado do Pará, 2021) Pereira, Caroline de Oliveira; Ferraz, Louise Paiva; Bastos, Fabíola de Arruda; Caldato, Milena Coelho Fernandes; http://lattes.cnpq.br/9477878606835309; http://lattes.cnpq.br/9386935778704228
Introduction: Acromegaly is an insidious and rare disease, associated with a high mortality rate, which results from the pathological autonomous overproduction of growth hormone (GH) and the subsequent increase in insulin-like growth factor-1 (IGF-1) levels. Chronic hypersecretion of these hormones causes several metabolic changes, among which we can highlight lipolysis, atherosclerotic processes, hyperinsulinemia, gluconeogenesis and peripheral insulin resistance. These changes in lipid and glycemic metabolism are related to an increased risk of cardiovascular events in acromegalic patients, being today the second most common cause of mortality in these patients. As a result, it is necessary to assess whether the control of the disease also corresponds to a better metabolic control of these patients, resulting in a lower cardiovascular risk and a lower mortality rate. Objectives: To evaluate the influence of IGF-1 levels on the lipid and glycemic profile of acromegalic patients treated at the Cesupa Medical Specialties Center. Methodology: This is an epidemiological, cross-sectional and descriptive study, based on an exploratory analysis of the medical records of the Endocrinology Service of the Cesupa Medical Specialties Center (CEMEC) from August 2019 to June 2020. Results: When comparing acromegaly activity in the first and last consultation, it was found that there was an increase in disease control, from 22.2% to 71.1%. As for the glycemic profile, the glycemia of diabetic acromegalic patients was statistically higher than that of non-diabetics, both in the first assessment (Mean ± SD: 135.8 ± 59.4 vs 95.1 ± 15.2; P <0.001), and in the latter (Mean ± SD: 98.6 ± 13.2 vs 84.0 ± 11.1; P <0.001). When observing diabetic acromegalic patients, there was a significant decrease in the levels of IGF-1 (mean ± SD: 480.9 ± 250.5 vs 189.5 ± 91.5, P <0.001) and IGF-1 by LSN ( mean ± SD: 1.8 ± 1.0 vs 1.0 ± 0.6, P <0.001), when comparing the two assessments. It was possible to observe, comparing the laboratory parameters between the first and last evaluation, that in the uncontrolled acromegaly at the end (n = 13), there was a decrease in the total cholesterol levels (Mean ± SD: 179.3 ± 30.0 vs 155, 9 ± 28.8; P = 0.018) and, significant increase in HDL (Mean ± SD: 46.8 ± 14.3 vs 53.3 ± 7.9; P = 0.048). For patients with controlled acromegaly at the end (n = 32), there was a significant increase in the HDL level (Mean ± SD: 46.3 ± 26.0 vs 58.0 ± 24.2; P = 0.003) and a decrease in levels of IGF-1, GH, total cholesterol, LDL and TG. Conclusion: These results suggest that most of the acromegalics under study had control of the disease by reducing the levels of IGF-1, evidencing success in their therapeutic conduct. Concomitantly, the majority also obtained improvement in the levels of glucose, glycated hemoglobin, total cholesterol and HDL. This suggests that controlling disease activity is one of the most important interventions for reducing cardiovascular risk in these patients.
Avaliação do risco cardiovascular em pacientes com lúpus eritematoso sistêmico atendidos no CEMEC
(Centro Universitário do Estado do Pará, 2019-05-20) Borborema, Augusto Lopes Pereira de; Santos, Felipy Chaves dos; Cristino, Sônia Conde; Rodrigues, Fabíola Brasil Barbosa; http://lattes.cnpq.br/2425897539868497; http://lattes.cnpq.br/7942684022038270; Ohashi, Claudia Barros; http://lattes.cnpq.br/0889116450004563; Costa, Alberto Freire Sampaio; http://lattes.cnpq.br/8830564785408868
Introduction: Systemic Lupus Erythematosus - SLE is a disease of autoimmune origin with a large number of clinical and laboratory manifestations. The pathophysiological nature of lupus involves both chronic and atherosclerotic inflammatory processes, which gives pathology an important role in the genesis of changes related to the cardiovascular system. In this context, it is essential to use the Framingham score in an attempt to estimate the cardiovascular risk in lupus patients and the interaction with traditional and non-traditional risk factors. Objectives: General: To evaluate cardiovascular risk in patients with Systemic Lupus Erythematosus in follow-up at CEMEC. Specific: To establish the prevalence of cardiovascular risk factors in SLE patients followed at CEMEC; 3) To characterize the epidemiological profile of patients with SLE treated at CEMEC; 4) Describe the characteristics of patients with SLE treated at CEMEC and relate it to cardiovascular risk. Methods: A research protocol was developed in which patient information is fundamental to the research: age, sex, time of illness, smoking, systolic blood pressure, total cholesterol, HDL, diabetes, medications in use and type of SLE. The search for data was based on the analysis of medical records of patients with SLE treated at CEMEC. Subsequently, these data were applied to the Framingham score. Results: It was observed that of the 68 patients who met the inclusion and exclusion criteria, 88.2% were female, 33.8% were in the age group below 30 years of age and 44.1% (n = 30) present a disease time between 6 and 10 years. Cutaneous involvement was the most prevalent, with 88.2% of cases. Regarding cardiovascular risk, 94.1% of the patients presented low risk, 1.5% medium risk and 4.4% high risk. The Immunossupressor / Immunomodulator class is part of the treatment of 92.6% of the patients. Conclusion: The study concludes that the Framingham score was not able to correctly identify cardiovascular risk in SLE patients.