Search

Background Abnormal cellular lipid metabolism appears to underlie SARS-CoV-2 cytotoxicity and may involve inhibition of peroxisome proliferator activated receptor alpha (PPARα). Fenofibrate, a PPAR-α activator, modulates cellular lipid metabolism. Fenofibric acid has also been shown to affect the dimerization of angiotensin-converting enzyme 2, the cellular receptor for SARS-CoV-2. Fenofibrate and fenofibric acid have been shown to inhibit SARS-CoV-2 replication in cell culture systems in vitro. Methods We randomly assigned 701 participants with COVID-19 within 14 days of symptom onset to 145 mg of fenofibrate (nanocrystal formulation with dose adjustment for renal function or dose-equivalent preparations of micronized fenofibrate or fenofibric acid) vs. placebo for 10 days, in a double-blinded fashion. The primary endpoint was a ranked severity score in which participants were ranked across hierarchical tiers incorporating time to death, duration of mechanical ventilation, oxygenation parameters, subsequent hospitalizations and symptom severity and duration. ClinicalTrials.gov registration: NCT04517396. Findings: Mean age of participants was 49 ± 16 years, 330 (47%) were female, mean BMI was 28 ± 6 kg/m2, and 102 (15%) had diabetes mellitus. A total of 41 deaths occurred. Compared with placebo, fenofibrate administration had no effect on the primary endpoint. The median (interquartile range [IQR]) rank in the placebo arm was 347 (172, 453) vs. 345 (175, 453) in the fenofibrate arm (P = 0.819). There was no difference in various secondary and exploratory endpoints, including all-cause death, across randomization arms. These results were highly consistent across pre-specified sensitivity and subgroup analyses. Conclusion Among patients with COVID-19, fenofibrate has no significant effect on various clinically relevant outcomes.

Introduction: Hyperlipidemia, traditionally defined with fasting lipid values, is a common cardiovascular risk factor, particularly in patients with insulin resistance, prediabetes and type 2 diabetes mellitus (DM). Nonfasting triglyceride levels (TG), however, have shown a stronger association with heart disease and stroke than fasting levels, independent of traditional CV risk factors. The objective of this study was to determine the relationship between TG and glucose levels after administration of a sucrose load (equal parts glucose and fructose) in individuals without a previous diagnosis of DM. Hypothesis: Sugar as a sole energy source will elicit both a lipemic and a glycemic response. Methods: We use a unique dataset from a single health clinic in Barranquilla, Colombia in which 1,446 adults aged 18 to 80 years (mean age, 49 years, 3 months, 77 percent female) were enrolled from 2002 - 2005. Serum TG and glucose levels were measured after an overnight fast and at two hours after administration of 75 gm of mixed carbohydrate in the form of Panela, a mixed carbohydrate made from an unrefined whole cane sugar used in beverages and in cooking in this area of Colombia. A solid form of sucrose, it contains equal parts of glucose and fructose. Regression analysis was performed to evaluate factors associated with the glycemic and lipemic responses. Results: We found that the absolute 2-hour glucose (range: 32-526 mg/dL) is significantly associated (p Conclusion: These data suggest that a diet rich in refined carbohydrate may pose a significant risk for hyperlipidemia, particularly in younger patients. The independent role of fructose as a trigger for de novo lipogenesis may be relevant in the observed response

Se ha hecho énfasis en la relación que existe entre la producción de tumores hipofisiarios y el déficit hormonal debido a falla en el órgano Terminal. Se hace énfasis en la importancia de un tratamiento sustitutivo adecuado en pacientes con menopausia precoz no sólo como suplencia hormonal sino para prevenir la aparición posterior de tumores hipofisiarios.

Se estudiaron 21 controles y 43 pacientes con baja talla, analizándoles T3, T4 y TSH basal y post-TRH, HGH post-ejercicio y carpograma. Se clasificó desarrollo sexual según Tanner. Las edades de los pacientes variaron entre 4 y 16 años con promedio de 11.34. Los pacientes fueron clasificados según respuesta de TSH al TRH en tres grupos: hipotiroideos, dudosos y “normales”.

Se presenta el caso de una niña de siete años con diagnóstico de pubertad precoz. Se plantean los diagnósticos diferenciales, los posibles mecanismos fisiopatológicos, se hace una breve revisión bibliográfica y se discute el caso.

En este artículo se revisan las endocrinopatías más frecuentes y sus repercusiones sobre el sistema cardiovascular, así como manifestaciones clínicas, diagnóstico y tratamiento.

Se estudiaron 12 pacientes con osteoporosis, con edades promedio de 75 a 79 años. Se les evaluó su capacidad funcional en escala de 0 a 3 y dolor osteoarticular en escala de 0 a 5 repitiendo las evaluaciones semanalmente durante el período experimental de 13 semanas. Los resultados obtenidos sugieren que el tratamiento de la osteoporosis con calcitonina asociado con medidas generales de higiene, ejercicio, aporte adecuado de sol y calcio puede ser beneficioso para el manejo de la osteoporosis senil.

Objective The association between parity and type 2 diabetes has been studied in developed countries and in Singapore and Chinese women but not in Hispanics. Herein we evaluated the association between parity (number of live births) with diabetes in a group of Hispanic postmenopausal women from Colombia. Research design and methods Herein we evaluated the association between parity and diabetes in a population of 1,795 women from Colombia. Women were divided in birth categories (0 [referent], 1 or 2, 3–5, 6 or > births). Medical history of diabetes and anthropometric characteristics were recorded. Logistic regressions were performed in order to find the association between parity and diabetes in bivariable and multivariable models after controlling for age, body mass index (BMI), waist hip ratio (WHR) and diabetes family history, among other variables. Results In our study, there was an association between parity and diabetes after adjusting for age, BMI and diabetes family history in the multiparous women groups when compared to the women with no births (Referent group) [1–2 births vs. referent OR 5.2 (95 CI 1.2–22.9), 3–5 births vs. referent OR 5.5 (1.3–23.0) and ≥6 births vs. referent OR 7.5 (1.8–31.8), respectively]. The association was maintained in two of the groups in the multivariable analysis [OR 5.0 (1.1–22.9) and 5.3 (1.2–23.5)], for 1 or 2 births and 6 or > births versus 0 births, respectively. Positive diabetes family history and WHR were also associated with an increased risk of diabetes [OR 4.6 (3.0–7.0) and 4.1 (2.0–8.1), respectively]. Conclusions In postmenopausal Hispanic women, multiparity, as well as a positive family history of diabetes and a high waist-hip ratio were associated with higher diabetes risk.