SÍNDROME DE GILBERT E SUA RELAÇÃO COM DOENÇAS CARDIOVASCULARES

2021 ◽  
Vol 8 (3) ◽  
pp. 130-135
Author(s):  
Pedro Ithalo Francisco da Silva ◽  
Wagner Bernardo da Silva ◽  
Beatriz Maria da Conceição Murilo ◽  
Davi Azevedo Ferreira ◽  
Flávia Negromonte Souto Maior

RESUMO Introdução: A Síndrome de Gilbert (SG), caracterizada pelo aumento moderado de bilirrubina não conjugada (BNC), pode coexistir com outras condições mais clinicamente significativas e interferir em seus parâmetros clínicos e diagnósticos. Objetivo: Identificar na literatura a relação da Síndrome de Gilbert com doenças cardiovasculares (DCV), além de trazer uma visão geral sobre a associação da bilirrubina ao metabolismo lipídico alterado e a outros parâmetros hematológicos. Método: Trata-se de uma revisão integrativa, utilizando como fontes de pesquisa a SciELO, LILACS, PubMed e periódicos da CAPES. Artigos de revisão, relatos de casos, teses, dissertações e monografias foram excluídos. Os descritores “Doença de Gilbert”, “doenças cardiovasculares”, “hiperbilirrubinemia” e “testes hematológicos” foram utilizados no idioma inglês e seus correspondentes em português, empregando o operador booleano “AND”. Resultados: A busca nas bases de dados resultou na seleção de 11 artigos, publicados entre 2011 e 2017, que permitiram especular evidências sobre a relação existente entre a hiperbilirrubinemia leve na SG com as DCV. Níveis de estresse oxidativo reduzido, atenuação de ativação plaquetária e de processos pró-inflamatórios, hipocolesterolemia e outros achados foram associados à concentração de BNC. Conclusão: Os estudos evidenciaram possíveis mecanismos que podem contribuir para a redução do risco de DCV em indivíduos com SG, principalmente na incidência de arritmias cardíacas, doença arterial coronariana e cardiopatias ateroscleróticas. Palavras-chave: Doença de Gilbert; UDP-glucuronosiltransferase; Hiperbilirrubinemia; Doenças Cardiovasculares; Testes Hematológicos.   ABSTRACT Introduction: Gilbert's Syndrome (GS), characterized by a moderate increase in unconjugated bilirubin (UCB), can coexist with other more clinically significant conditions and interfere with its clinical and diagnostic parameters. Objective: To identify in the literature the relationship between Gilbert's Syndrome and cardiovascular diseases (CVD), in addition to providing an overview of the association of bilirubin with altered lipid metabolism and other hematological parameters. Method: This is an integrative review, using SciELO, LILACS, PubMed and CAPES journals as research sources. Review articles, case reports, theses, dissertations and monographs were excluded. The descriptors "Gilbert Disease", "cardiovascular diseases", "hyperbilirubinemia" and "hematologic tests" were used in english and their correspondents in portuguese, using the boolean operator "AND". Results: The search in the databases resulted in the selection of 11 articles, published between 2011 and 2017, which allowed speculating evidence on the relationship between mild hyperbilirubinemia in GS and CVD. Levels of reduced oxidative stress, attenuation of platelet activation and pro-inflammatory processes, hypocholesterolemia and other findings were associated with UCB concentration. Conclusion: The studies showed possible mechanisms that can contribute to the reduction of CVD risk in individuals with GS, mainly in the incidence of cardiac arrhythmias, coronary artery disease and atherosclerotic heart diseases. Keywords: Gilbert Disease; UDP-glucuronosyltransferase; Hyperbilirubinemia; Cardiovascular Diseases; Hematologic Tests

1997 ◽  
Vol 8 (10) ◽  
pp. 1049-1051 ◽  
Author(s):  
E. Wasserman ◽  
A. Myara ◽  
F. Lokiec ◽  
F. Goldwasser ◽  
F. Trivin ◽  
...  

2020 ◽  
Vol 2 (1) ◽  
pp. 38-43
Author(s):  
Luiz Severo Bem Junior ◽  
Gustavo De Souza Andrade ◽  
Joao Ribeiro Memória Júnior ◽  
Hildo Rocha Cirne de Azevedo Filho

Terson's sign (TS) is classically defined as vitreous hemorrhage associated with subarachnoid hemorrhage of aneurysmal origin, being an important predictor of severity, indicating greater morbidity and mortality when compared to patients without the sign. The objective of this study is to review the relationship of Terson syndrome/Terson sign with the prognosis of aneurysmal subarachnoid hemorrhage. A search for original articles, research and case reports was performed on the PubMed, Scielo, Cochrane and ScienceDirect platform, with the following descriptors: Terson sign and subarachnoid hemorrhage. Retrospective, prospective articles and case reports published in the last 5 years and which were in accordance with the established objective and inclusion criteria were selected. Ten (10) articles were selected, in which the available results show an unfavorable prognostic relationship of TS and subarachnoid hemorrhage, because these patients had a worse clinical status assessed on the Glasgow scales ≤ 8, Hunt & Hess > III, Fisher > 3, in addition to intracranial hypertension and location of the aneurysm in the anterior communicating artery complex. The early recognition of this condition described by Albert Terson in 1900 brought an important contribution to neurosurgery, being recognized until nowadays.


2018 ◽  
Vol 24 (24) ◽  
pp. 2876-2882 ◽  
Author(s):  
Kailash Prasad

Cardiovascular diseases (CVD) may be mediated through increases in the cardiovascular risk factors. Hemoglobin A1c (HbA1c) also called glycated hemoglobin is presently used for the diagnosis and management of diabetes. It has adverse effects on cardiovascular system. This review deals with its synthesis and effects on the cardiovascular system. The serum levels of HbA1c have been reported to be affected by various factors including, the lifespan of erythrocytes, factors affecting erythropoiesis, agents interfering glycation of Hb, destruction of erythrocytes, drugs that shift the formation of Hb, statins, and drugs interfering the HbA1c assay. Levels of HbA1c are positively correlated with serum glucose and advanced glycation end products ( AGE), but no correlation between AGE and serum glucose. AGE cannot replace HbA1c for the diagnosis and management of diabetes because there is no correlation of AGE with serum glucose, and because the half-life of protein with which glucose combines is only 14-20 days as compared to erythrocytes which have a half-life of 90-120 days. HbA1c is positively associated with CVD such as the carotid and coronary artery atherosclerosis, ischemic heart disease, ischemic stroke and hypertension.HbA1c induces dyslipidemia, hyperhomocysteinemia, and hypertension, and increases C-reactive protein, oxidative stress and blood viscosity that would contribute to the development of cardiovascular diseases. In conclusion, HbA1c serves as a useful marker for the diagnosis and management of diabetes. AGE cannot replace HbA1c in the diagnosis and management of diabetes. There is an association of HbA1c with CVD which be mediated through modulation of CVD risk factors.


2018 ◽  
Vol 24 (3) ◽  
pp. 341-358 ◽  
Author(s):  
Xiaotong Ji ◽  
Yingying Zhang ◽  
Guangke Li ◽  
Nan Sang

Recently, numerous studies have found that particulate matter (PM) exposure is correlated with increased hospitalization and mortality from heart failure (HF). In addition to problems with circulation, HF patients often display high expression of cytokines in the failing heart. Thus, as a recurring heart problem, HF is thought to be a disorder characterized in part by the inflammatory response. In this review, we intend to discuss the relationship between PM exposure and HF that is based on inflammatory mechanism and to provide a comprehensive, updated evaluation of the related studies. Epidemiological studies on PM-induced heart diseases are focused on high concentrations of PM, high pollutant load exposure in winter, or susceptible groups with heart diseases, etc. Furthermore, it appears that the relationship between fine or ultrafine PM and HF is stronger than that between HF and coarse PM. However, fewer studies paid attention to PM components. As for experimental studies, it is worth noting that coarse PM may indirectly promote the inflammatory response in the heart through systematic circulation of cytokines produced primarily in the lungs, while ultrafine PM and its components can enter circulation and further induce inflammation directly in the heart. In terms of PM exposure and enhanced inflammation during the pathogenesis of HF, this article reviews the following mechanisms: hemodynamics, oxidative stress, Toll-like receptors (TLRs) and epigenetic regulation. However, many problems are still unsolved, and future work will be needed to clarify the complex biologic mechanisms and to identify the specific components of PM responsible for adverse effects on heart health.


BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e046015
Author(s):  
Hui Zhang ◽  
Xiaoyu Chen ◽  
Peipei Han ◽  
Weibo Ma ◽  
Yuanyuan Zhang ◽  
...  

ObjectiveThe purpose of this study is to investigate the mediating effect of physical performance on the relationship between night sleep duration and risk of cardiovascular disease (CVD) in elderly Chinese without CVD.Methods782 participants without CVD over 65 years (average: 70.82±3.86 years, 448 women) were included in this study. CVD risk was calculated by the Framingham Risk Score and participants were divided into four groups of night sleep duration (in hours): <7 hours, ≥7–8 hours, >8–9 hours and >9 hours. Upper extremity function was measured by grip strength and lower extremity function was measured by the Short Physical Performance Battery (SPPB), consisting of balance, 4 m walk and chair stands tests.ResultsAfter adjusting for covariates, long night sleep duration (>9 hours) and CVD risk were significantly positively associated compared with moderate night sleep duration (≥7–8 hours) (β=1.152; 95% CI 0.05 to 2.25). SPPB total score (indirect effect ab=−0.122; 95% CI −0.291 to –0.0008) rather than grip strength partially mediated the relationship between long night sleep duration and CVD risk, in which chair stands played a major mediating role (indirect effect ab=−0.171; 95% CI −0.040 to –0.0006), while balance (indirect effect ab=−0.016; 95% CI −0.100 to 0.063) and 4 m walk (indirect effect ab=0.048; 95% CI −0.066 to 0.201) did not.ConclusionsLower extremity function, especially lower limb muscle strength, partially mediates a positive association between long night sleep duration and CVD risk in the elderly without CVD. Suitable interventions for physical performance and sleep may minimise the risk of subsequent CVD.


2021 ◽  
Author(s):  
Yuki Fujimaki ◽  
Takehiko Soutome ◽  
Takayuki Tanaka ◽  
Takeshi Shiba ◽  
Misa Watanabe

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Peter Piko ◽  
Zsigmond Kosa ◽  
Janos Sandor ◽  
Roza Adany

AbstractCardiovascular diseases (CVDs) are the number one cause of death globally, and the early identification of high risk is crucial to prevent the disease and to reduce healthcare costs. Short life expectancy and increased mortality among the Roma are generally accepted (although not indeed proven by mortality analyses) which can be partially explained by the high prevalence of cardiovascular risk factors (CVRF) among them. This study aims to elaborate on the prevalence of the most important CVD risk factors, assess the estimation of a 10-year risk of development of fatal and nonfatal CVDs based on the most used risk assessment scoring models, and to compare the Hungarian general (HG) and Roma (HR) populations. In 2018 a complex health survey was accomplished on the HG (n = 380) and HR (n = 347) populations. The prevalence of CVRS was defined and 10-year cardiovascular risk was estimated for both study populations using the following systems: Framingham Risk Score for hard coronary heart disease (FRSCHD) and for cardiovascular disease (FRSCVD), Systematic COronary Risk Evaluation (SCORE), ACC/AHA Pooled Cohort Equations (PCE) and Revised Pooled Cohort Equations (RPCE). After the risk scores had been calculated, the populations were divided into risk categories and all subjects were classified. For all CVD risk estimation scores, the average of the estimated risk was higher among Roma compared to the HG independently of the gender. The proportion of high-risk group in the Hungarian Roma males population was on average 1.5–3 times higher than in the general one. Among Roma females, the average risk value was higher than in the HG one. The proportion of high-risk group in the Hungarian Roma females population was on average 2–3 times higher compared to the distribution of females in the general population. Our results show that both genders in the Hungarian Roma population have a significantly higher risk for a 10-year development of cardiovascular diseases and dying from them compared to the HG one. Therefore, cardiovascular interventions should be focusing not only on reducing smoking among Roma but on improving health literacy and service provision regarding prevention, early recognition, and treatment of lipid disorders and diabetes among them.


2021 ◽  
pp. 1-37
Author(s):  
Laury Sellem ◽  
Bernard Srour ◽  
Kim G. Jackson ◽  
Serge Hercberg ◽  
Pilar Galan ◽  
...  

Abstract In France, dairy products contribute to dietary saturated fat intake, of which reduced consumption is often recommended for cardiovascular disease (CVD) prevention. Epidemiological evidence on the association between dairy consumption and CVD risk remains unclear, suggesting either null or inverse associations. This study aimed to investigate the associations between dairy consumption (overall and specific foods) and CVD risk in a large cohort of French adults. This prospective analysis included participants aged ≥ 18 years from the NutriNet-Santé cohort (2009–2019). Daily dietary intakes were collected using 24h-dietary records. Total dairy, milk, cheese, yogurts, fermented and reduced-fat dairy intakes were investigated. CVD cases (n=1,952) included cerebrovascular (n=878 cases) and coronary heart diseases (CHD, n=1,219 cases). Multivariable Cox models were performed to investigate associations. This analysis included n=104,805 French adults (mean age at baseline 42.8 years (SD 14.6)), mean follow-up 5.5 years (SD 3.0, i.e. 579,155 persons years). There were no significant associations between dairy intakes and total CVD or CHD risks. However, the consumption of at least 160 g/d of fermented dairy (e.g. cheese and yogurts) was associated with a reduced risk of cerebrovascular diseases compared to intakes below 57 g/d (HR=0.81 [0.66-0.98], p-trend=0.01). Despite being a major dietary source of saturated fats, dairy consumption was not associated with CVD or CHD risks in this study. However, fermented dairy was associated with a lower cerebrovascular disease risk. Robust randomized controlled trials are needed to further assess the impact of consuming different dairy foods on CVD risk and potential underlying mechanisms.


Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 912
Author(s):  
Mai Matsumoto ◽  
Hiroyuki Suganuma ◽  
Naoki Ozato ◽  
Sunao Shimizu ◽  
Mitsuhiro Katashima ◽  
...  

Consumption of fruits and vegetables rich in carotenoids has been widely reported to prevent cardiovascular diseases. However, the relationship between serum carotenoid concentrations and visceral fat area (VFA), which is considered a better predictor of cardiovascular diseases than the body-mass index (BMI) and waist circumference, remains unclear. Therefore, we examined the relationship in healthy individuals in their 20s or older, stratified by sex and age, to compare the relationship between serum carotenoid concentrations and VFA and BMI. The study was conducted on 805 people, the residents in Hirosaki city, Aomori prefecture, who underwent a health checkup. An inverse relationship between serum carotenoid concentrations and VFA and BMI was observed only in women. In addition, the results were independent of the intake of dietary fiber, which is mainly supplied from vegetables as well as carotenoids. This suggests that consumption of a diet rich in carotenoids (especially lutein and beta-carotene) is associated with lower VFA, which is a good predictor of cardiovascular disease, especially in women. This study is the first to comprehensively evaluate the association between serum carotenoid levels and VFA in healthy individuals.


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