Resumo Fundamento A ação do peptídeo natriurético atrial (ANP) na natriurese, diurese e vasodilatação, resistência à insulina, fígado, rim e tecido adiposo pode contribuir para o desenvolvimento metabólico e cardiovascular saudável. Embora o nível circulante de ANP seja reduzido em pacientes com obesidade, sua resposta à perda de peso ainda é pouco explorada em populações pediátricas. Objetivo Avaliar os efeitos das variações do ANP em resposta à intervenção interdisciplinar para perda de peso na Síndrome Metabólica (SMet) e nos riscos cardiometabólicos em adolescentes com obesidade. Métodos 73 adolescentes com obesidade participaram de uma terapia interdisciplinar para perda de peso de 20 semanas, incluindo uma abordagem clínica, nutricional, psicológica e de exercícios físicos. A composição corporal, análises bioquímicas e pressão sanguínea foram avaliadas. A SMet foi classificada de acordo com a Federação Internacional de Diabetes (IDF) (2007). Após o tratamento, os voluntários foram divididos de acordo com os níveis de plasma do ANP aumento (n=31) ou ANP redução (n=19). Resultados Ambos os grupos apresentaram redução significativa de peso corporal, índice de massa corporal (IMC) e circunferências de cintura, pescoço e quadril (CC, CP e CQ, respectivamente), e aumento da massa livre de gordura (MLG). É interessante observar que houve uma redução significativa na gordura corporal, na razão de TG/HDL-c e na prevalência de SMet (de 23% para 6%) somente no grupo com ANP aumento. Conclusão Este estudo sugere que o aumento nos níveis séricos de ANP após a terapia para perda de peso pode estar associado a melhorias nos riscos cardiometabólicos e na prevalência reduzida de SMet em adolescentes com obesidade.

Abstract Background The action of atrial natriuretic peptide (ANP) on natriuresis, diuresis and vasodilatation, insulin resistance, liver, kidney, and adipose tissue may contribute to the healthy metabolic and cardiovascular development. Even though the circulating level of ANP is reduced in patients with obesity, its response to weight loss remains poorly explored in pediatric populations. Objective To evaluate the effects of ANP variations in response to interdisciplinary weight loss intervention on metabolic syndrome (MetS) and cardiometabolic risks in adolescents with obesity. Methods 73 adolescents with obesity attended a 20-week clinical interdisciplinary weight loss therapy including clinical, nutritional, psychological and exercise training approach. Body composition, biochemical analyses and blood pressure were evaluated. MetS was classified according to the International Diabetes Federation (IDF) (2007). After the treatment, volunteers were divided according to Increasing (n=31) or Decreasing (n=19) ANP plasma levels. Results Both groups present significant reduction of body weight, Body Mass Index (BMI), waist, neck and hip circumferences (WC, NC and HC, respectively) and increasing fat-free mass (FFM). Interestingly, a significant reduction in body fat, TG/HDL-c ratio and MetS prevalence (from 23% to 6%) was observed in the Increased ANP group only. Conclusion This study suggests that an increase in ANP serum levels after weight loss therapy could be associated with improvements in cardiometabolic risks and the reduced prevalence of MetS in adolescents with obesity.

Abstract: This study aimed to analyze oxidative stress and the activity of antioxidant enzymes in the salivary glands of streptozotocin (STZ)-induced diabetic rats with ad libitum consumption of chamomile tea in substitution of water for 21 days. Rats were divided in two control groups (untreated control and treated control) and two diabetic groups (untreated diabetic and treated diabetic). Superoxide dismutase (SOD), glutathione peroxidase (GPx), catalase (CAT) activities, total antioxidant status (TAS), and malondialdehyde (MDA) concentrations were determined. The chemical composition of the chamomile essential oil revealed 39 compounds, accounting for 93.5% of the total oils. The polyphenolic profile of the tea showed the presence of apigenin, luteolin, umbelliferone, and esculetin. SOD, GPx, CAT, and TAS levels were lower in the parotid (PA) diabetic glands, but treatment increased their concentration in both the submandibular (SM) and PA diabetic salivary glands. Increased MDA levels were observed in the PA diabetic glands, which were decreased by the consumption of chamomile tea with a reduction in hyperglycemia compared to that in untreated diabetic rats. However, the SM diabetic glands showed no difference in the MDA content. The consumption of chamomile tea prevented oxidative stress in the PA glands of diabetic rats, exhibiting hypoglycemic and antioxidant effects. Thus, chamomile tea could be a potential candidate for preventing oral complications in diabetes mellitus.

ABSTRACT Objective: To investigate the effects of an interdisciplinary intervention on biomarkers of inflammation and their relationship with fibroblast growth factor 21 (FGF21) concentrations in women with overweight and obesity. Subjects and methods: Thirty-one women were enrolled in a 12-week interdisciplinary weight loss program delivered by a team comprising an endocrinologist, nutritionist and exercise physiologist. Body composition; anthropometric measures; metabolic and inflammatory markers including adiponectin, leptin, and atrial natriuretic peptide (ANP) were assessed at baseline and post-therapy. The homeostasis model assessment of insulin resistance (HOMA-IR) and the homeostasis model assessment of adiponectin (HOMA-AD) were calculated. The participants were divided into two groups: those with increased FGF21, and those with decreased FGF21. Results: The sample comprised women aged 32 ± 5 years with a body mass index of 33.64 ± 3.49 kg/m2. Body weight, waist circumference and leptin concentration were decreased in the whole sample after therapy. However, only the group with an increase in FGF21 concentration presented significant improvements in adiponectin concentration and adiponectin/leptin ratio. Moreover, although there was a reduction of leptin in both groups, it was greater in the increased FGF21 groups. There was a reduction in ANP in the decreased FGF21 group. Conclusions: Changes in FGF21 concentrations were different among the women participating in the weight loss program, with some having increased levels and some reduced levels. Furthermore, improvements in adiponectin and the adiponectin/leptin ratio were found only in the group with increased FGF21 concentration.

Abstract Introduction Although the pathogenesis of sudden sensorineural hearing loss (SSNHL) has been discussed in the literature, many unclear points remain. Several authors have hypothesized that oxidative stress plays a role in the pathogenesis of noise-related hearing loss, as well as in drug- and aging-related hearing loss. Reactive oxygen species (ROS) may contribute to the pathogenesis of SSNHL in a similar way as in cases of ototoxicity, noise-induced hearing loss and presbyacusis. Objective The aim of the present study was to find potential peripheral biomarkers to show the levels of oxidative stress in samples of peripheral blood collected from SSNHL patients with and withouth metabolic disease. Methods In total, 80 consecutive patients with SSNHL were evaluated in the otolaryngology emergency room and outpatient clinic of a tertiary hospital between May 2017 and May 2019. All patients underwent detailed anamnesis, physical examination, audiometry, magnetic resonance imaging (MRI) of the inner ears, and blood tests for serum lipids and plasma activity of thiobarbituric acid reactive species (TBARS). Results No significant effect of malondialdehyde (MDA) activity was observed regarding the hearing recovery of patients who developed SSNHL. Conclusion We did not observe a significant correlation between the concentration of TBARs in the peripheral blood or the presence of arterial hypertension and the severity of the initial hearing loss or the prognosis of hearing recovery in patients with SSNHL. The concentration of TBARs in the peripheral blood may not adequately represent the abnormalities that occur in the intracoclear environment.

ABSTRACT Objective Fibroblast growth factor 21 (FGF21) is among the activators that can stimulate thermogenesis in the white adipose tissue and brown adipose tissue. People with obesity have elevated blood levels of FGF21, but also develop resistance to its action, impairing its beneficial role. Inversely, clinical treatments to weight loss has been pointed out as an important therapy for increasing and recovering sensitivity to FGF21. The aim was to analyse the effect of long-term weight loss interdisciplinary intervention on FGF21 and body composition. Subjects and methods Eighty-six post-pubertal obese adolescents (14-19 years-old), were submitted to 20 weeks of weight loss therapy (clinical, nutritional, psychological and physical exercise support). Anthropometric measures, body composition and rest metabolic rate (RMR) by bioelectrical impedance, and serum FGF21 sample by ELISA were evaluated. The adolescents were grouped according to FGF21 individual delta variations after therapy: Higher Increase (HI); lower increase (LI); lower decrease (LD); higher decrease (HD). Results All groups present weight loss. Only in FGF21 ≥ 76,5 pg/mL variation the free-fat-mass and rest metabolic rate were preserved and to others group these variables were significantly reduced. Conclusion High increase in FGF21 can contribute to preservation of FFM and RMR after weight loss therapy, could have important implications for energy balance regulation. Future studies are necessary to continue determining the role of magnitude effects of FGF21 levels in obesity to improve clinical practice, especially in paediatrics population.

Abstract Background: obesity is a chronic disease associated with inadequate eating habits and reduced levels of physical activity. Because of obesity, the risk for comorbidities is increased, especially for cardiovascular diseases, insulin resistance, and increased pro-inflammatory factors. The aim of the present investigation was to analyze potential correlations between pro/anti-inflammatory adipokines, glycemic index, and other markers of diet quality using a metabolic profile in women undergoing interdisciplinary weight loss therapy. Methods: thirty-two women with obesity were enrolled in a 12-week program of interdisciplinary therapy combining a clinical, nutritional, and physical exercise approach. Body composition, quality of diet, metabolic profile, and pro/anti-inflammatory adipokines were analyzed. Results: the therapy showed to be effective in reducing body weight (from 93.16 ± 16.96 to 88.36 ± 16.23; p = 0.0000001), body mass index (from 34.01 ± 4.00 to 32.29 ± 3.96; p = 0.0000001), and body fat (from 38.25 ± 5.05 to 36.13 ± 5; p = 0.0000001). There was also an improvement in lipid profile, including total cholesterol (from 196.16 ± 34.78 to 183.53 ± 43.15; p = 0.001), non-HDL-cholesterol (from 142 ± 30.05 to 1333.69 ± 35.41; p = 0.01), VLDL-cholesterol (from 27.13 ± 12.4 to 22.06 ± 8.55; p = 0.002), triglycerides (from 135.88 ± 61.21 to 110.75 ± 43.09; p = 0.002) and glucose metabolism, including glucose (from 97.13 ± 10.43 to 92.6 ± 6.6; p = 0.004), and insulin (from 13.05 ± 5.54 to 11.29 ± 4.85; p = 0.03). As for food intake, there was a decrease in calorie consumption (from 1991.45 ± 677.78 to 1468.88 ± 390.56; p = 0.002), carbohydrates (from 50.37 ± 6 to 47.04 ± 8.67; p = 0.04), lipids (from 31.83 ± 5.53 to 30.37 ± 7.04; p = 0.3), and glycemic load (from 80.53 ± 39.88 to 54.79 ± 23.69; p = 0.02), and an increased consumption of proteins (from 18.3 ± 2.39 to 22.89 ± 4.9; p = 0.002). Positive correlations were demonstrated between insulin concentration and waist circumference (r = 0.82; p = 0.003); leptin and body fat and abdominal circumference (r = 0.74; p = 0.01); and LDL-cholesterol fraction and total cholesterol consumption (r = 0.69; p = 0.027). Negative correlations were demonstrated between leptin and monosaturated fat consumption (r = -0.71; p = 0.02); and adiponectin and liver enzyme GGT levels (r = -0.65; p = 0.04). Conclusions: interdisciplinary therapy had positive effects on inflammatory state, mediated by leptin, adiponectin, and quality of diet. Our findings suggest the effectiveness and clinical relevance of the interdisciplinary clinical therapy applied for obesity.

Resumen Introducción: la obesidad es una enfermedad crónica asociada con hábitos alimentarios inadecuados y niveles reducidos de actividad física. Debido a la obesidad, el riesgo de comorbilidad aumenta, especialmente el de las enfermedades cardiovasculares, la resistencia a la insulina y el aumento de los factores proinflamatorios. El objetivo de la presente investigación fue analizar las posibles correlaciones entre las adipocinas pro/antiinflamatorias, el índice glucémico y otros marcadores de calidad de la dieta con el perfil metabólico en mujeres sometidas a terapia interdisciplinaria para perder peso. Métodos: treinta y dos mujeres con obesidad participaron en 12 semanas de terapia interdisciplinaria en la que se combinaron los enfoques clínico, nutricional y de ejercicio físico. Se analizaron la composición corporal, la calidad de la dieta, el perfil metabólico y las adipocinas pro/antiinflamatorias. Resultados: la terapia demostró ser efectiva para reducir el peso corporal (de 93,16 ± 16,96 a 88,36 ± 16,23; p = 0,0000001), el índice de masa corporal (de 34,01 ± 4,00 a 32,29 ± 3,96; p = 0,0000001) y la grasa corporal (de 38,25 ± 5,05 a 36,13 ± 5,00; p = 0,0000001). También hubo una mejora del perfil lipídico, incluidos el colesterol total (de 196,16 ± 34,78 a 183,53 ± 43,15; p = 0,001), el colesterol no HDL (de 142,00 ± 30,05 a 1333,69 ± 35,41; p = 0,01), el VLDL-colesterol (de 27,13 ± 12,4 a 22,06 ± 8,55; p = 0,002), y el metabolismo de la glucosa, incluyendo la glucosa (de 97,13 ± 10,43 a 92,6 ± 6,6; p = 0,004) y la insulina (de 13,05 ± 5,54 a 11,29 ± 4,85; p = 0,03). En cuanto a la ingesta de alimentos, hubo disminución en el consumo de calorías (de 1991,45 ± 677,78 a 1468,88 ± 390,56; p = 0,002), carbohidratos (de 50,37 ± 6,00 a 47,04 ± 8,67; p = 0,04), lípidos (de 31,83 ± 5,53 a 30,37 ± 7,04; p = 0,3) y carga glucémica (de 80,53 ± 39,88 a 54,79 ± 23,69; p = 0,02), y aumento del consumo de proteínas (de 18,3 ± 2,39 a 22,89 ± 4,90; p = 0,002). Se demostraron correlaciones positivas entre la concentración de insulina y la circunferencia de la cintura (r = 0,82; p = 0,003); la leptina, la grasa corporal y la circunferencia abdominal (r = 0,74; p = 0,01), y la fracción de colesterol LDL y el consumo total de colesterol (r = 0,69; p = 0,027). Se demostraron correlaciones negativas entre la leptina y el consumo de grasa monosaturada (r = -0,71; p = 0,02), y la adiponectina y la enzima hepática GGT (r = -0,65; p = 0,04). Conclusiones: la terapia interdisciplinaria tuvo efectos positivos sobre el estado inflamatorio, mediado por la leptina, la adiponectina, y la calidad de la dieta. Nuestros hallazgos sugieren la efectividad y la relevancia clínica de la terapia clínica interdisciplinaria aplicada a la obesidad.

O presente estudo teve como objetivo analisar os efeitos agudos e de curta duração de duas intensidades de exercício aeróbio sobre a concentração circulante de IL-6 e IL-10. Quinze homens jovens fisicamente ativos (21,0 ± 1,9 anos) foram submetidos a duas sessões de exercício (“crossover”): alta intensidade de exercício (AIE)- (80% VO2pico), e baixa intensidade de exercício (BIE)- (40% VO2pico), com intervalo de sete dias (“Wash out”). Amostras de sangue foram coletadas em tubos com EDTA, antes do exercício (basal), imediatamente após o exercício (agudo) e após 2 h de recuperação passiva. As concentrações séricas de IL-6 e IL-10 foram determinadas com a utilização de kits comerciais de ELISA. Os resultados demonstraram elevação aguda da IL- 6, em resposta ao AIE em relação ao BIE (p < 0,05), enquanto que a IL-10 apresentou maior redução sistêmica aguda para BIE em comparação a AIE (p < 0,05). Não houve diferença na variação das citocinas após 2 h do término do exercício. Conclui-se que ambas as sessões agudas de exercício são capazes de modular a concentração circulante destas citocinas, e que a magnitude das alterações são dependentes da intensidade do esforço.

The aim of this study was to analyze the acute and short-term effects of high and low exercise intensities on IL-6 and IL-10. Fifteen young healthy physically active males (21.0 ± 1.9 yrs) were submitted to 2 experimental trials (cross-over) with a 7-dais wash-out: high exercise intensity (80% VO2peak) and low exercise intensity (40% VO2peak) session. Blood samples were collected before exercise (baseline), immediately after exercise (acute), and two hours after the end of the exercise session (2 h). IL-6 and IL-10 circulating levels were determinate by ELISA. The results demonstrated an acute increase in IL-6 levels after high intensity compared to low intensity exercise (p < 0.05), however, IL-10 presented an acute decrease in response to low intensity exercise (p < 0.05). No effects were observed after 2 h of recovery from the session. Thus we conclude that acute exercise sessions are able to modulate the circulating levels of the studies cytokines, and the magnitudes of these changes are dependent of the exercise intensity.

The high glycemic index diet was an independent predictor to explain changes in agouti-related protein in obese adolescents. Background & Aims: The role of diet glycemic index (GI) in the control of orexigenic and anorexigenic factors of the energy balance is still not clear. The present study aimed to assess whether the habitual diet, according to different GI foods, exerts influence on regulation of energy balance markers and the effects of interdisciplinary intervention in obese adolescents. Methods: A total of 55 obese adolescents, aged from 14 to 19 years, were submited to one year of interdisciplinary therapy and were divided in two groups, according to the predominant dietary pattern of food intake: high-GI group (H-GI; n = 29) and moderate/low-GI group (M/L-GI; n = 26). Results: The concentration of orexigenic factor AgRP (p < 0.01), visceral fat (p=0.04) and visceral/subcutaneous ratio (p = 0.03) were higher in the group of H-GI when compared with M/L-GI group. Moreover, the habitual consumption of H-GI foods was an independent predictor to explain changes in AgRP concentrations. After one year of interdisciplinary therapy, the adolescents presented significant reductions in body weight, total body fat (%), visceral and subcutaneous fat and HOMA-IR, as well as a significant increase of fat free mass (%). Conclusions: Our results may suggest that habitual H-GI diet could upregulate orexigenic pathways, contributing to vicious cycle between undesirable diets, deregulates energy balance and predispose to obesity. One the other hand, one year of interdisciplinary therapy can significant improves metabolic profile and central obesity in adolescents.

La Dieta de alto índice glucémico es un predictor independiente para explicar los cambios en la proteína relacionada al agouti en adolescentes obesos. Introducción y objetivos: El papel de la dieta de índice glucémico (GI) en el control de los factores orexigénicos y anorexígenos del balance de energía todavía no está claro. El presente estudio tuvo como objetivo evaluar si la dieta habitual, de acuerdo con diferentes alimentos con IG, ejerce influencia sobre la regulación de los marcadores del balance de energía y los efectos de la intervención interdisciplinaria en adolescentes obesos. Métodos: Un total de 55 adolescentes obesos, con edades de 14 a 19 años, han sido sometidos a un año de tratamiento interdisciplinario y se dividieron en dos grupos, de acuerdo al patrón de dieta predominante de la ingesta de alimentos: el grupo IG alto (H-GI; n = 29) y GI moderada/bajo grupo (M/L-GI, n = 26). Resultados: La concentración de orexigenic factor de AgRP (p < 0,01), la grasa visceral (p = 0,04) y la relación visceral/subcutánea (p = 0,03) fueron mayores en el grupo de H-GI en comparación con el grupo M/L-GI. Por otra parte, el consumo habitual de alimentos H-GI fue un predictor independiente para explicar los cambios en las concentraciones de AgRP. Después de un año de tratamiento interdisciplinario, los adolescentes presentan una reducción significativa en el peso corporal, la grasa corporal total (%), visceral y la grasa subcutánea y el HOMA-IR, así como un aumento significativo de la masa libre de grasa (%). Conclusiones: Nuestros resultados pueden sugerir que la dieta H-GI habitual podría upregulate vías orexigénicos, contribuyendo al círculo vicioso entre las dietas indeseables, desregula el equilibrio energético y predisponen a la obesidad. Uno por otro lado, un año de tratamiento interdisciplinario puede perfil metabólico mejora significativa y la obesidad central en los adolescentes.

FUNDAMENTO: O processo aterosclerótico no nível endotelial começa em idade precoce e parece estar associado com a obesidade e suas comorbidades como a resistência insulínica. OBJETIVO: O objetivo deste estudo foi verificar a influência da resistência insulínica em marcadores inflamatórios e subclínicos de aterosclerose em adolescentes obesos. MÉTODOS: Sessenta e seis adolescentes obesos pós-púberes foram divididos em dois grupos de acordo com o índice de resistência insulínica estimado pelo Modelo de Avaliação da Homeostase (HOMA-RI): com resistência insulínica (RI) n = 39 e sem resistência insulínica (NRI) n = 27, e foram submetidos a uma intervenção interdisciplinar ao longo de um ano. A espessura mediointimal da artéria carótida comum (EMIC), e o tecido adiposo visceral e subcutâneo foram determinados por ultrassonografia. A composição corporal, pressão arterial, índice HOMA-RI, perfil lipídico e as concentrações de adipocinas [leptina, adiponectina, e inibidor do ativador do plasminogênio-1 (PAI-1)] foram analisados antes e após a terapia. RESULTADOS: Ambos os grupos apresentaram melhoras significativas na composição corporal, estado inflamatório (redução da concentração de leptina e PAI 1; aumento de adiponectina plasmática) e redução da EMIC. Apenas o grupo NRI mostrou correlação positiva entre as alterações na gordura visceral (∆Visceral) e mudanças na EMIC (∆ EMIC) (r = 0,42, p < 0,05). A análise por regressão linear simples revelou o ∆Visceral ser um preditor independente para a redução da EMIC nesse grupo (R2 ajustado = 0,14, p = 0,04). Os valores finais da EIMC permaneceram significativamente maiores no grupo RI, quando comparado com grupo NRI. CONCLUSÃO: A presença de resistência insulínica pode prejudicar mudanças na EMIC levando ao desenvolvimento precoce da aterosclerose em adolescentes obesos submetidos a uma intervenção interdisciplinar.

BACKGROUND: The atherosclerotic process at the endothelial level begins in early ages and seems to be associated with obesity and its comorbidities as insulin resistance. OBJECTIVE: The aim of this study was to verify the influence of insulin resistance on inflammatory and subclinical markers of atherosclerosis in obese adolescents. METHODS: Sixty-six post-pubescent obese adolescents were divided in two groups according to homeostasis model assessment of insulin resistance (HOMA-IR) measurement: with insulin resistance (IR) n=39 and without insulin resistance (NIR) n=27, and submitted to an interdisciplinary intervention over the course of 1 year. Common carotid artery intima-media thickness (cIMT), visceral and subcutaneous adipose tissue was determined by ultrasound. Body composition, blood pressure, HOMA-IR, lipid profile and adipokines concentrations [leptin, adiponectin, and plasminogen activator inhibitor type (PAI-1)] were analyzed before and after the therapy. RESULTS: Both groups presented significant improvements in body composition, inflammatory state (reduction of leptin and PAI-1 concentration; increasing of plasma adiponectin) and reduction of cIMT. Only NIR group showed positive correlation between changes in visceral fat (∆Visceral) and changes in cIMT (∆ cIMT) (r = 0.42; p < 0.05). Simple linear regression analyze revealed ∆Visceral to be an independent predictor to reduction of cIMT in this group (R2 adjusted = 0.14, p = 0.04). The final values of cIMT remained significantly higher in IR group when compared to NIR group. CONCLUSION: The presence of insulin resistance can impair changes in cIMT leading to early development of atherosclerosis in obese adolescents submitted to an interdisciplinary intervention..

A obesidade é uma doença complexa de etiologia multifacetada, com sua própria fisiopatologia, comorbidades e capacidades desabilitantes. Aceitar a obesidade como uma doença é fundamental para o seu tratamento. Atualmente, o tecido adiposo é um dos principais focos das pesquisas em obesidade, devido a uma revolução no entendimento da função biológica desse tecido desde a última década. Já está muito claro que o tecido adiposo branco secreta múltiplos peptídeos bioativos, denominados adipocinas (proteínas sintetizadas e secretadas pelo tecido adiposo). Dessa forma, o objetivo deste trabalho de revisão foi investigar a relação entre obesidade e adipocinas inflamatórias, buscando discutir o papel do exercício físico no tratamento dessa patologia. Os resultados demonstram que uma das mais importantes descobertas das pesquisas recentes em obesidade é o conceito de que ela é caracterizada por uma inflamação crônica. Dentre todas as adipocinas, sem dúvida, a IL-6, o TNF-α, a leptina (pró-inflamatórias) e a adiponectina (anti-inflamatória) vêm recebendo atenção especial da literatura especializada. O aumento da concentração dessas adipocinas promove grande impacto em diversas funções corporais que estão fortemente correlacionadas com doenças cardiovasculares. Uma vez que a obesidade é considerada uma doença inflamatória e o exercício físico modula de forma direta tais processos, é essencial que tenhamos como um dos objetivos principais de nossos programas de exercícios físicos a melhora da resposta inflamatória de obesos.

Obesity is a complex disease with a multifaceted etiology with its own physiopathology, co-morbidities and disabiliting capacities. It is crucial that obesity is acknowledged as a disease in order to treat it. Nowadays, the adipose tissue is the main focus of obesity research due to the improvement in the last decade on biological function of this tissue. It is now clear that white adipose tissue release a large amount of bioactive peptides called adipokines (which are proteins synthesized and released by adipose tissue). Thus, the aim of this review was to investigate the relationship between obesity and inflammatory adipokines, trying to discuss the role of physical exercise in the treatment of this pathology. The results have shown that one of the most important recent discoveries is the concept that obesity is characterized by a chronic inflammation state. Among all adipokines, IL-6, TNF- α, leptin (pro-inflammatory) and adiponectin (anti-inflammatory), have received special attention from the specialized literature. High concentration of these adipokines promotes impact in several body functions, which is strongly linked with cardiovascular diseases. Since obesity is considered an inflammatory disease, and exercise directly modulates this process, it is essential that one of the main aims of exercise therapies is the improvement of the inflammatory response of obese individuals.

Desde o descobrimento da leptina, avanços consideráveis foram obtidos na caracterização dos mecanismos hipotalâmicos do controle da ingestão alimentar e, atualmente, a oxintomodulina é reconhecida como um regulador da homeostase energética. O presente artigo de revisão enfoca algumas das mais relevantes inter-relações do hormônio oxintomodulina com o apetite, a homeostase energética e aspectos de seu papel na bioquímica e fisiologia nutricional. A oxintomodulina é um peptídeo intestinal anorexígeno produzido pelas células L do intestino. Recentes estudos têm demonstrado que em longo prazo a administração de oxintomodulina reduz a ingestão alimentar e o ganho de peso. Pesquisas em humanos têm verificado que o seu uso reduz o consumo energértico em 25%. Portanto, a oxintomodulina representa uma potente terapia anti-obesidade. Entretanto, o mecanismo de ação da oxintomodulina ainda é desconhecido. Atuais evidências sugerem que tem ação via receptor do peptídeo semelhante ao glucagon 1. Além disso, a literatura mostra que, juntamente com a adoção de hábitos saudáveis e a mudança do estilo de vida, a oxintomodulina pode proporcionar menor avanço da obesidade.

Since the discovery of leptin, great advances occurred in the characterization of hypothalamic mechanisms involved in the control of food intake and oxyntomodulin is currently recognized as a homeostasis energy regulator. This review discusses the most important interrelationships between the hormone oxyntomodulin and appetite, energy homeostasis and aspects of its role in nutritional biochemistry and physiology. Oxyntomodulin is an anorexigenic peptide produced by the L cells of the small intestine. Recent studies have shown that long-term use of oxyntomodulin in rats leads to reduced food intake and weight gain. Studies in humans have demonstrated that its administration reduces food intake by 25%. Therefore, oxyntomodulin represents a potent anti-obesity therapy. However, its mechanism of action is unknown. Current evidence suggests that it acts via the peptide receptor similar to glucagon 1. Moreover, the literature shows that together with the adoption of healthy habits and lifestyle changes, oxyntomodulin can reduce weight gain.

A obesidade vem se tornando uma das maiores epidemias mundiais, dessa forma, conhecer sua etiologia e mecanismos que regulam seu desenvolvimento é de grande relevância para o seu Tratamento. Portanto, o objetivo do presente estudo foi avaliar os efeitos da obesidade exógena induzida pela dieta de cafeteria e da atividade física crônica em ratos, sobre a adiposidade e a concentração sérica dos hormônios reguladores do balanço energético (leptina e grelina). Foram utilizados 32 ratos Wistar machos, divididos em quatro grupos: Sedentário alimentado com dieta padrão (SN), sedentário alimentado com dieta de cafeteria (SC), treinado alimentado com dieta padrão (TN) e treinado alimentado com dieta de cafeteria (TC). A dieta de cafeteria aumentou significativamente a adiposidade central (RET) e visceral (EPI) (p<0,05), induzindo a obesidade. Por outro lado, o treinamento físico minimizou o efeito da dieta de cafeteria, diminuindo tanto a adiposidade central como a visceral. A atividade física crônica não impediu o desenvolvimento da hiperleptinemia nos ratos normocalóricos e alimentados com dieta de cafeteria. Observou-se ainda que decorrente do treinamento físico e consequente redução de massa, nos animais normocalóricos, houve diminuição na concentração plasmática de grelina. Concluímos com este estudo que a qualidade da dieta e a quantidade de tecido adiposo, apresentaram-se como importantes reguladores da concentração plasmática de hormônios reguladores do balanço energético, reforçando a importância de uma dieta adequada e da atividade física contínua na manutenção do peso corporal no combate aos efeitos deletérios da obesidade.

Obesity is becoming one of the biggest worldwide epidemics. Therefore, knowing its etiology and mechanisms that regulate its development is of great relevance for its treatment. Thus, the aim of the present study was to evaluate the effects of obesity induced by the palatable hyperlipidic diet and of the chronic physical activity in rats, on the adiposity and the serum concentration of regulating hormones of the energy balance (leptin and ghrelin). 32 male Wistar rats were divided in four groups: Sedentary fed with chow diet (SN), sedentary fed with cafeteria diet (SC), trained fed with chow diet (TN) and trained fed with cafeteria diet (TC). The cafeteria diet led to a significant increase of central (RET) and visceral (EPI) adiposity (p<0.05). Conversely,the exercise training minimized the effect of the cafeteria diet, diminishing the central and visceral adiposity. Leptin was also increased in the groups fed with the cafeteria diet, suggesting increase of the resistance to the action of this hormone. Chronic physical activity did not hinder the development of hyperleptinemia. Reduction in the serum ghrelin concentration was observed only in the normocaloric group. Therefore,it has been concluded that the quality of diet and the quantity of adipose tissue mass behaved as important regulators of the serum concentration of leptin and ghrelin, reinforcing the importance of a suitable diet and continuous physical activity in the maintenance of body weight in the combat to the deleterious effects of obesity.