Jornal da Síndrome Metabólica

Obesity is a global epidemic affecting over a third of the adult population. Within the obese, subgroups have been identified, including the metabolically healthy obese (MHO) and the fit/fat phenotypes. The MHO phenotype was traditionally thought to have lower cardiovascular risk than the ‘typically obese’, a notion that is being challenged by recent data. Similarly, the emerging fit/fat phenotype is raising questions about the impact of obesity on mortality and cardiovascular risk. The present narrative review provides an overview of these phenotypes and summarizes current evidence and viewpoints regarding the same. The review then incorporates this data into a format that can be utilized by clinicians and researchers to aid clinical decision-making.

Many factors may increase the risk of fibrosis development in chronic viral hepatitis infections. As the burden of obesity and metabolic syndrome has been increasing in recent years, there is growing concern regarding the association between metabolic factors and chronic viral hepatitis cases. However data regarding the influence of metabolic syndrome on progression of fibrosis in chronic hepatitis B virus (HBV) infection is limited. Metabolic syndrome is a constellation of problems that includes insulin resistance, obesity, hypertension, and hyperlipidemia. Initially, epidemiologic data demonstrated that HBsAg-positive serostatus was positively correlated with a high risk of metabolic syndrome; later on, HBV was considered as a “metabolovirus” because the gene expression of HBV and key metabolic genes in hepatocytes was found to be similarly regulated. Metabolic syndrome is not only found to accelerate the progression of liver disease in patients with chronic HBV infection but also found to induce cirrhosis or even hepatocellular carcinoma development. This review article it is aimed to highlight the association of metabolic syndrome with chronic HBV infection.

Background: Sickle cell diseases (SCDs) are chronic inflammatory process on capillary level. We tried to understand whether or not there are some positive correlations between stroke and severity of SCDs.
Methods: All patients with SCDs were taken into the study.
Results: The study included 343 patients (169 females and 174 males). There were 30 cases (8.7%) with stroke. The mean ages were similar in both groups (32.5 versus 29.1 years in the stroke group and other, respectively, p>0.05). The female ratios were similar in both groups, too (43.3% versus 49.8%, respectively, p>0.05). Prevalences of associated thalassemia minors were also similar in them (73.3% versus 65.1%, respectively, p>0.05). Smoking was higher among the stroke cases (26.6% versus 13.0%, p<0.05). Mean white blood cell count, hematocrit value, and mean platelet count of the peripheric blood were similar in both groups (p>0.05 for all). On the other hand, although the painful crises per year, tonsilectomy, priapism, ileus, pulmonary hypertension, chronic obstructive pulmonary disease, coronary heart disease, chronic renal disease, rheumatic heart disease, avascular necrosis of bones, cirrhosis, and mortality were all higher in the stroke group, the differences were only significant for digital clubbing, leg ulcers, and acute chest syndrome (p<0.05 for all), probably due to the small sample size of the stroke group.
Conclusion: SCDs are chronic destructive process on capillaries iniatiating at birth, and terminate with early organ failures in life. Probably stroke is one of the terminal consequences of the inflammatory process that may indicate shortened survival in such cases.