Introdução: Existe crescente interesse em identificar marcadores de risco para eventos cardiovasculares em pacientes com HIV/aids. Atualmente observa-se alteração do perfil epidemiológico desses pacientes, com diminuição da mortalidade por infecção e comorbidades e aumento por eventos cardiovasculares. A elasticidade arterial, principalmente dos pequenos vasos, tem sido investigada como alteração precoce de evento cardiovascular. Objetivo: Avaliar a relação entre elasticidade arterial e outros indicadores de risco cardiovascular como fatores demográficos e socioeconômicos, hábitos de vida, estado nutricional e marcadores inflamatórios. Métodos: Foram selecionados aleatoriamente 132 indivíduos voluntários em tratamento regular com antirretrovirais em ambulatório especializado em HIV/aids, com idade entre 19 e 59 de ambos os sexos. A elasticidade arterial dos grandes vasos (LAEI) e pequenos vasos (SAEI) foi investigada pelo equipamento HDI/ PulseWaveTM CR-2000 Cardio Vascular Profiling System®. Foram determinados colesterol total e frações, triglicérides, proteína C-reativa, fibrinogênio, medidas antropométricas e de avaliação de composição corporal, fumo, consumo de bebidas alcoólicas, uso de drogas, prática de atividade física, além de avaliação de fatores demográficos e socioeconômicos e imunológicos (carga viral, T-CD4, T-CD8). Para investigar a associação entre LAEI e SAEI e outros fatores de risco cardiovascular utilizou-se análise de regressão linear múltipla. Resultados: Em relação à elasticidade dos grandes e pequenos vasos, 71,97 por cento e 32,58 por cento , respectivamente, dos participantes foram classificados com elasticidade normal. Observou-se associação positiva entre LAEI e peso (p<0,001) e associações negativas entre LAEI e prega cutânea subescapular (p<0,001) e linfócitos T-CD4 (p<0,02). Verificou-se associação negativa de LAEI com sexo (p<0,02), mostrando que o sexo feminino está relacionado com menor elasticidade. Houve associação positiva entre SAEI e peso (p<0,001) e associações negativas entre SAEI e prega cutânea subescapular (p<0,001), idade (p<0,01) e linfócitos totais (p<0.01). Conclusão: As alterações de elasticidade arterial em pacientes HIV/aids apresentaram relação com outros fatores de risco cardiovascular. SAEI mostrou-se diminuído na maioria dos participantes, sendo uma alteração que pode identificar a disfunção endotelial antes que a doença se torne clinicamente aparente. A monitoração constante da elasticidade arterial através de método não invasivo pode se tornar uma importante ferramenta na predição e prevenção de eventos cardiovasculares em pacientes HIV/aids / Introduction: There is a growing interest in identifying markers of risk for cardiovascular events in patients with HIV / AIDS. Currently there is a change in the epidemiological profile of patients with reduced mortality from infections and comorbidities and increased cardiovascular events. The arterial elasticity, mainly of small vessels, has been investigated as early alteration of cardiovascular events. Objective: To evaluate the relationship between arterial elasticity and other cardiovascular risk factors such as demographic and socioeconomic factors, lifestyle habits, nutritional status and inflammatory markers. Methods: We randomly selected 132 individuals volunteers, ages between 19 and 59, of both sexes, regularly treated with antiretrovirals in specialized clinics on HIV / AIDS. Arterial elasticity of the large (LAEI) and small (SAEI) vessels were investigated by the equipment HDI/ PulseWaveTM CR-2000 Cardio Vascular Profiling System®. We determined total cholesterol, HDL, triglycerides, C-reactive protein, fibrinogen, and anthropometric assessment of body composition, smoking, alcohol consumption, drug use, physical activity, and evaluation of demographic, socio-economic and immunological (viral load, T-CD4, T-CD8) factors. The association between LAEI and SAEI and other cardiovascular risk factors were assessed by multiple linear regression. Results: Regarding the elasticity of large and small vessels, 71.97 per cent and 32.58 per cent , respectively, of the participants were classified as having normal elasticity. We observed a positive association between LAEI and weight (p <0.001) and negative associations between LAEI and subscapular skinfold (p <0.001) and CD4 counts (p <0.02). There was a negative association of LAEI with gender (p <0.02), showing that female gender is associated with lower elasticity. There was a positive association between SAEI and weight (p <0.001) and negative associations between SAEI and subscapular skinfold (p <0.001), age (p <0.01) and total lymphocytes (p <0.01). Conclusion: Changes in arterial elasticity in patients with HIV / AIDS correlate with other cardiovascular risk factors. SAEI was altered in most participants, a change that can identify endothelial dysfunction before the disease becomes clinically apparent. The constant monitoring of arterial elasticity through noninvasive method may become an important tool in the prediction and prevention of cardiovascular events in HIV / aids patients

Submitted by Renata Lopes (renatasil82@gmail.com) on 2016-07-22T13:08:31Z No. of bitstreams: 1 fabianaalmeidadasilva.pdf: 1594039 bytes, checksum: 77b77016a1e251abcae4fd0a6aa49147 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2016-07-22T15:42:20Z (GMT) No. of bitstreams: 1 fabianaalmeidadasilva.pdf: 1594039 bytes, checksum: 77b77016a1e251abcae4fd0a6aa49147 (MD5) / Made available in DSpace on 2016-07-22T15:42:20Z (GMT). No. of bitstreams: 1 fabianaalmeidadasilva.pdf: 1594039 bytes, checksum: 77b77016a1e251abcae4fd0a6aa49147 (MD5) Previous issue date: 2016-03-18 / Introdução: As doenças cardiovasculares representam a principal causa de morbidade e mortalidade mundial e seu desenvolvimento se associa a comportamentos alimentares. Objetivos: Investigar a relação entre a frequência de refeições diárias e o hábito de consumo do café da manhã (CM) com fatores de risco para doenças cardiovasculares (FRC) em crianças e adolescentes. Métodos: Realizou-se estudo transversal com uma amostra de 708 escolares (7 a 14 anos) residentes na cidade de Juiz de Fora, MG. Um questionário semiestruturado foi aplicado para coleta de variáveis demográficas, socioeconômicas e comportamentais. Para a obtenção do consumo diário de energia foram utilizados recordatórios alimentares de 24 horas e registros alimentares de três dias. Medidas de peso, altura, gordura corporal, perímetro da cintura e pressão arterial também foram realizadas. Por fim, coletaram-se amostras de sangue para análises de colesterol total (CT), lipoproteína de baixa (LDL) e de alta densidade (HDL), triglicerídeos e glicemia. A normalidade dos dados foi verificada pelo teste Kolmogorov-Smirnov e o teste de Mann-Whitney foi utilizado para verificar diferenças significativas nos valores de medidas de tendência central. Além disso, modelos de regressão de Poisson foram construídos para avaliar o quanto os comportamentos alimentares foram associados aos FRC. Resultados: Realizar ≥ 4 refeições diárias foi mais prevalente entre as crianças que entre os adolescentes (80,1% vs. 68,8%, p= 0,003) e mais prevalente entre o sexo masculino em comparação ao sexo feminino (77,9% vs. 66,6%, p= 0,001). Frequência de refeições < 4 se associaram, em crianças, a renda familiar < 3 salários (p= 0,021) e em adolescentes, ao número de filhos na família > 2 (p= 0,010). Ainda na faixa etária de 10 a 14 anos, < 4 refeições se relacionou a maior prevalência de excesso de peso (p= 0,032) e LDL (p= 0,030) elevados, após ajustes. Omitir o CM foi mais comum entre os adolescentes em comparação com as crianças (30,0% vs. 22,0%; p = 0,035) e entre as meninas em comparação com os meninos (33,1% vs. 22,1%; p = 0,001). Após ajustes, a omissão do CM se associou, em crianças, a valores aumentados de pressão arterial diastólica (p= 0,003), CT (p= 0,001) e LDL (p< 0,001) e em adolescentes, não foram encontradas associações. Conclusão: Comportamentos alimentares como maiores frequências de refeições diárias e consumo do CM estão relacionados à FRC, em crianças e adolescentes e devem ser considerados em discussões e ações de promoção à saúde. / Introduction: Cardiovascular diseases are the leading cause of morbidity and mortality worldwide and its development is associated with eating habits. Objectives: Investigate the relationship between the frequency of meals and breakfast consumption habit (CM) with risk factors for cardiovascular disease (CRF) in children and adolescents. Methods: A crosssectional study with a sample of 708 schoolchildren (7-14 years) living in the city of Juiz de Fora, MG. A semi-structured questionnaire was used to collect sociodemographic, behavioral and relating to eating habits variables. To obtain the daily energy intake were used food 24hour recalls and food records three days. Weight, height, body fat, waist circumference and blood pressure were also performed. Finally, they collected blood samples for analysis of total cholesterol (TC), low lipoprotein (LDL) and high density (HDL) cholesterol, triglycerides and glucose levels. Data normality was verified by the Kolmogorov-Smirnov test and the MannWhitney test was used to identify significant differences in the values of central tendency. Moreover, Poisson regression models were constructed to evaluate how dietary habits were associated with the CRF. Results: Perform ≥ 4 meals was more prevalent among children than among adolescents (80.1% vs. 68.8%, p = 0.003) and more prevalent among males compared to females (77.9% vs. 66.6%, p = 0.001). Meal frequency < 4 were associated in children, family income < 3 minimum wages (p = 0.021) and in adolescents, the number of children in the family > 2 (p = 0.010). Even in the age group 10-14 years < 4 meals was related to associated with increased prevalence of overweight (p = 0.032) and LDL (p = 0.030) higher, after adjustments. Omit the CM was more common among adolescents compared to children (30.0% vs. 22.0%; p = 0.035) and among girls compared to boys (33.1% vs. 22.1%; p = 0.001). After adjustments, the omission of breakfast was associated in children, increased levels of diastolic blood pressure (DBP) (p = 0.003), CT (p = 0.001) and LDL (p <0.001) and in adolescents, associations were not found. Conclusion: Dietary habits as higher frequency of daily meals and CM consumption are related to the CRF, in children and adolescents and should be considered in discussions and health promotion actions.

Submitted by Renata Lopes (renatasil82@gmail.com) on 2017-03-29T13:45:50Z No. of bitstreams: 1 reginacoelimachado.pdf: 584182 bytes, checksum: 3aff2dbd317552baf0742fe28f1db537 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2017-03-30T11:21:05Z (GMT) No. of bitstreams: 1 reginacoelimachado.pdf: 584182 bytes, checksum: 3aff2dbd317552baf0742fe28f1db537 (MD5) / Made available in DSpace on 2017-03-30T11:21:05Z (GMT). No. of bitstreams: 1 reginacoelimachado.pdf: 584182 bytes, checksum: 3aff2dbd317552baf0742fe28f1db537 (MD5) Previous issue date: 2009-11-11 / Avalia risco cardiovascular na síndrome metabólica. Não existe consenso sobre o escore mais apropriado para detecção do RCV nesta população. O objetivo é avaliar o risco de doença arterial coronariana (DAC) em indivíduos não diabéticos portadores de SM, com base em três diferentes escores. Foram avaliados trinta e nove indivíduos portadores de SM, por meio do Escore de Risco de Framingham (ERF), pelo ERF modificado pela IV Diretriz Brasileira sobre Dislipidemias e Aterosclerose (ERF-mod) e pelo Prospective Cardiovascular Münster Study (PROCAM). Todos os indivíduos foram submetidos a avaliação clínica, eletrocardiograma de repouso, ecocardiograma, monitorização ambulatorial da pressão arterial, índice tibial-braquial (ITB) além de dosagens de glicose, creatinina, colesterol total, colesterol HDL, triglicérides e microalbuminúria. O LDL colesterol foi estimado pela fórmula de Friedwald. A média de idade foi de 4421,0 anos, com predomínio de mulheres (31/39). Seis (15,4%) indivíduos eram tabagistas e 21 (53,8%) eram hipertensos. O perfil lipídico mostrou níveis baixos de colesterol HDL em 35 (89,7%) dos casos e níveis elevados de triglicérides, colesterol total e colesterol LDL em 28 (71,8%), 19 (48,7%) e 15 (38,5%) dos casos, respectivamente. Microalbuminúria foi diagnosticada em 23 (59%) dos indivíduos, hipertrofia do ventrículo esquerdo (HVE) em três (7,7%) e doença vascular periférica em cinco (12,8%) pacientes. O risco estimado de DAC pelo ERF foi baixo (<10%) em 35 (89,7%) indivíduos e médio (10 a 20%) em quatro (10,3%), não sendo detectado alto risco em nenhum caso. Por outro lado, quando foram considerados fatores agravantes sugeridos pela IV Diretriz Brasileira sobre Dislipidemias e Aterosclerose, o ERF-mod detectou cinco casos (12,8%) de baixo risco, 30 (76,9%) casos de médio risco e quatro (10,3%) de alto risco. Quando se aplicou o PROCAM, 29 (74,4%) indivíduos continuaram na faixa de baixo risco (<10%), sete (17,9%) apresentaram médio risco (10-20%) e três (7,7%), alto risco para doença coronariana em 10 anos. A utilização do ERF parece subestimar o RCV em portadores de SM não diabéticos. Por outro lado, a utilização do ERF-mod ou, alternativamente, do PROCAM parecem mais adequados para a estimativa do RCV nessa população. / It evaluates cardiovascular risk (CVR) in metabolic syndrome. There is no agreement about the best score to estimate the CVR in this population. The objective is to assess the coronary heart disease (CHD) risk in non-diabetic patients with MS using three different scores. Thirty nine subjects with MS were evaluated by the Framingham Risk Score (FRS), FRS modified by IV Diretriz Brasileira sobre Dislipidemias e Aterosclerose (mod-FRS) and by Prospective Cardiovascular Münster Study (PROCAM). All the subjects were submitted to clinical evaluation, electrocardiogram, echocardiogram, ambulatorial blood pressure monitorization, ankle brachial index (ABI) and dosages of glucose, creatinine, total cholesterol, HDLcholesterol, triglycerides and microalbuminúria. LDL-cholesterol was estimated by Friedwald’s formula. Mean age was 4421.0 years and most of individuals were female (31/39). Six subjects (15,4%) were smokers and 21 (53,8%) were hypertensive. Low HDL-cholesterol was detected in 35 (89,7%) individuals and high triglycerides, total cholesterol and LDL-cholesterol levels were observed in 28 (71,8%), 19 (48,7%) e 15 (38,5%) individuals, respectively. Microalbuminuria was diagnosed in 23 (59%) subjects, left ventricular hypertrophy in three (7,7%) and peripheral vascular disease in five (12,8%). Based in the FRS the CHD risk in 10 years was considered low in 35 (89,7%) individuals and intermediate in four (10,3%), with no patient in high risk group. On the other hand, the mod-FRS detected five (12,8%) subjects in low risk, 30 (76,9%) in the intermediate and four (10,3%) individuals in the high risk group. According to PROCAM 29 (74,4%) individuals were in low risk, seven (17,9%) in the intermediate and three (7,7%) in high risk group. In non-diabetic subjects with MS the FRS underestimates the CHD risk, whereas the mod-FRS and alternatively, the PROCAM seem to be more accurate in estimating this risk.

Submitted by Geandra Rodrigues (geandrar@gmail.com) on 2018-10-16T12:24:43Z No. of bitstreams: 1 erasmomontesassisdebem.pdf: 4791475 bytes, checksum: cfd6c5aa9d6a3f4aae2609029ad1623a (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2018-10-16T14:35:24Z (GMT) No. of bitstreams: 1 erasmomontesassisdebem.pdf: 4791475 bytes, checksum: cfd6c5aa9d6a3f4aae2609029ad1623a (MD5) / Made available in DSpace on 2018-10-16T14:35:24Z (GMT). No. of bitstreams: 1 erasmomontesassisdebem.pdf: 4791475 bytes, checksum: cfd6c5aa9d6a3f4aae2609029ad1623a (MD5) Previous issue date: 2018-07-30 / Com o processo de envelhecimento ocorrem modificações no perfil antropométrico e fisiológico, podendo ser acompanhado pelo aumento da prevalência de doenças cardiometabólicas, como a hipertensão arterial sistêmica. É possível que a presença da hipertensão arterial sistêmica possa estar associada à piora de parâmetros de saúde nos idosos. O objetivo do presente estudo foi comparar os aspectos antropométricos, cardiovasculares e de aptidão física entre normotensos e hipertensos idosos. Setenta e quatro idosos (68,5±1,1 anos) sem complicações osteomusculares foram estratificados em dois grupos: normotenso (G1) e hipertenso (G2). Estes indivíduos participaram de uma entrevista estruturada para obtenção de dados sobre perfil da caracterização sócio demográfica, características gerais, condição de saúde e física. Em seguida foram realizadas as avaliações cardiometabólicas, antropométricas e de aptidão física. Os dados contínuos foram comparados através do Teste-T independente e as relações dos dados discretos foram testadas através do teste qui-quadrado. Em comparação com os normotensos, os hipertensos apresentaram maior circunferência de cintura (93,3±1,9 vs. 99,1±2,0 cm; P=0,023, respectivamente) e maior duplo produto (9339,5±217,8 vs. 10605,4±283,3 mmHg.bpm; P=0,001, respectivamente). Ocorreu relação significante entre o grupo hipertenso e a maior presença de diabetes (5,4% vs. 20,3%; 0,043), dislipidemia (2,7% vs. 21,6%; 0,005) e risco cardiovascular muito aumentado (18,9% vs. 41,9%; 0,029). Não ocorreram relações significantes entre a presença de hipertensão arterial sistêmica e as variáveis de sobrepeso (26,8% vs. 42,3%; 0,306) e presença de cardiopatia (4,1% vs. 12,2%; 0,163). Nos testes de aptidão física, não ocorreram diferenças significantes entre os grupos normotensos e hipertensos (Resistência abdominal: 4,0±1,6 vs. 2,6±1,1 repetições; P=0,462. Flexibilidade de membros inferiores: 23,0±2,4 vs. 22,6±1,9 centímetros; P=0,878. Flexibilidade de ombros: -2,8±1,3 vs. -5,5±1,5 centímetros; P=0,157. Potência de membros inferiores: 13,1±1,2 vs. 12,0±0,9 centímetros; P=0,460. Força de membros superiores: 26,8±1,7 vs. 26,6±1,6 kg; P=0,955), respectivamente. Pode-se concluir que os hipertensos idosos apresentaram relação com o maior risco cardiovascular e apresentaram maior trabalho cardíaco em repouso. Embora os hipertensos apresentem diferenças antropométricas e cardiovasculares, eles apresentam aptidão física similar aos normotensos. / With the aging process changes occur in the anthropometric and physiological profile, and may be accompanied by an increase in the prevalence of cardiometabolic diseases, such as systemic arterial hypertension. It is possible that the presence of systemic arterial hypertension will be associated with worsening of health parameters in older adults. The aim of the present study is to relate the anthropometric, cardiovascular and physical fitness aspects among normotensive and hypertensive elderly subjects. Seventy-four elders (68.5 ± 1.1 years) without osteomuscular complications were stratified into two groups: normotensive (G1) and hypertensive (G2). These subjects underwent a structured interview so data on profile of demographic partner characterization general characteristics, health and physical conditions could be obtained. Then, cardiometabolic, anthropometric and physical fitness evaluations were performed. The continuous data were compared by independent t-test and the discrete data ratios were tested by the qui square test. Compared with normotensive subjects, hypertensive patients presented higher waist circumference (93.3 ± 1.9 vs. 99.1 ± 2.0 cm, P = 0.023, respectively) and higher heart rate product (9339.5 ± 217.8 vs. 10605.4 ± 283.3 mmHg.bpm, P = 0.001, respectively). A significant relation was observed between hypertensive group and diabetes (5.4% vs. 20.3%, 0.043), dyslipidemia (2.7% vs. 21.6%, and 0.005) and increased cardiovascular risk (18.9% vs. 41.9%, 0.029). There were no significant relation between the presence of systemic arterial hypertension and the variables of overweight (26.8% vs. 42.3%, 0.306) and presence of heart disease (4.1% vs. 12.2%, 0.163). In the physical fitness tests, there were no significant differences between the normotensive and hypertensive groups (Abdominal resistance: 4.0±1.6 vs. 2.6±1.1 repetitions; P=0.462. Flexibility of lower limbs: 23.0±2.4 vs. 22.6±1.9 cm; P=0.878. Shoulder flexibility: -2.8±1.3 vs. -5.5±1.5 cm; P=0.157. Power of lower limbs: 13.1±1.2 vs. 12.0±0.9 cm; P=0.460. Upper limb strength: 26.8±1.7 vs. 26.6±1.6 kg; P=0.955), respectively. It can be concluded that elderly hypertensive subjects were associated with higher cardiovascular risk and presented higher cardiac work at rest. Although the hypertensive patients present anthropometric and cardiovascular differences, they present physical fitness similar to normotensive ones.

Abstract It has been proposed that in addition to oral glucose tolerance test, detected by impaired fasting glucose (IFG), impaired glucose tolerance (IGT), glycosylated hemoglobin (HbA1c 5.7–6.4%) can be used for screening individuals at high risk of developing type 2 diabetes and CVD. The aim of the present study was to assess whether the use of ADA 2010 prediabetes definition, especially the use of HbA1c 5.7–6.4% may detect different individuals with prediabetes as compared to the use of IFG or IGT, and whether the traditional CVD-risk factors differed between these definitions. Furthermore, the aim was to study if the inflammatory mediators associated with cardiovascular disease are increased in prediabetes and to assess the power of HbA1c 5.7–6.4%, 2-h glucose, and fasting glucose predicting type 2 diabetes and CVD. The present study consisted of the Oulu 35 population. This prospective population-based study was conducted in 1990–2008 to assess the prevalence of type 2 diabetes and glucose abnormalities. All inhabitants of the City of Oulu, Finland, born in 1935 and living in Oulu on 1st October 1990 (n=1,008), were invited to participate 1990–1992 (831 enrolled). At the baseline of the present study 1996–1998, 815 were invited and 593 (73%) of them enrolled. Prediabetes was classified as IFG (fasting blood glucose, FBG 5.6–6.0 mmol/L), IGT (2-hour BG &#8805;7.8 and &#60;11.1 mmol/L) and/or HbA1c 5.7–6.4%. Inflammation was measured with IL-1Ra, IL-8 and RANTES. Prevalence of isolated prediabetes in this population was common with limited overlap between the three different definitions. Differences in CVD risk factors were observed between the three hyperglycemia groups. Isolated HbA1c was associated with overweight and more adverse lipid profile. Low-grade inflammation (measured by IL-1Ra, IL-8 and RANTES) was associated with prediabetes with levels comparable to those with diabetes. The association was independent of visceral adiposity. Finally, HbA1c and 2-h glucose, but not fasting glucose, predicted CVD in 10 years follow-up in women, but not in men. In conclusion, this study demonstrates that HbA1c 5.7–6.4% detects partly different individuals with prediabetes as compared to IFG and IGT. Using only fasting glucose and HbA1c for screening, many subjects at high risk for diabetes and CVD would be missed. However, HbA1c 5.7-6.4% diagnose individuals with high traditional cardiovascular risk factors. Prediabetes is associated with inflammation measured with IL-1Ra, IL-8 and RANTES. Finally, 2-h glucose value is important in screening subjects in high risk for diabetes and CVD. / Tiivistelmä Vuonna 2010 Amerikan diabetesyhdistys (ADA) esitti sokerihemoglobiinin HbA1c 5.7-6.4&#160;% -arvoa diabeteksen esiasteeksi kohonneen paastosokerin (IFG) ja heikentyneen sokerinsiedon (IGT) lisäksi. Tämän tutkimuksen tarkoituksena oli selvittää, miten ADA 2010 -määritelmä diabeteksen esiasteista löytää riskihenkilöitä ja mitkä ovat perinteiset sydän- ja verisuonisairauksien riskitekijät eri ryhmillä (IFG, IGT ja HbA1c 5.7–6.4%). Tulehdusmarkkereita ja näiden eroja määritettiin verrattuna diabeetikoihin ja terveisiin henkilöihin. Lisäksi selvitettiin, kuinka nämä eri diabeteksen esiasteet ennustavat sydän- ja verisuonisairauksien syntyä. Tutkimusaineistona oli Oulu 35 aineisto, jota on tutkittu v. 1990–2008 tyypin 2 diabeteksen ja sokerihäiriöiden esiintyvyyden selvittämiseksi. Ensimmäinen seurantatutkimus tässä ikäkohortissa, joka on nykyisen tutkimuksen alkuvaihe, tehtiin 1996–1998. Osallistujia oli tällöin 593. Seuraava seurantatutkimus tehtiin 2007–2008. Diabeteksen esiasteeksi määritettiin IFG (kohonnut paastoverensokeri, FBG 5.6–6.0 mmol/L), IGT (2-tunnin verensokeri BG &#8805;7.8 ja &#60;11.1 mmol/L) ja HbA1c 5.7–6.4%. Diabeteksen esiasteiden esiintyvyys tässä aineistossa oli huomattava ja määritelmät löysivät vain vähän samoja ihmisiä. Perinteisissä sydän- ja verisuonisairauksien riskitekijöissä oli selkeitä eroja: henkilöt, joilla oli HbA1c 5.7–6.4%, olivat selkeästi enemmän ylipainoisia ja vyötärölihavia, sekä heillä oli huonommat rasva-arvot (HDL ja triglyseridit). HbA1c ja IGT ennustivat sydän- ja verisuonitautien ilmaantumista naisilla, mutta eivät miehillä. Kaikki nämä määritelmät ennustivat diabeteksen syntyä, mutta ei-diabeetikoilla vain 2 tunnin sokeri ennusti sydän- ja verisuonitautia. Sen sijaan matala-asteinen tulehdusreaktio mitattuna IL-1Ra, IL-8 and RANTES- tulehdusmarkkereilla liittyi jo diabeteksen esiasteeseen (ADA 2010) yhtä paljon kuin diabeetikoilla, eikä tämä selittynyt vyötärölihavuudella. Tutkimus osoitti, että diabeteksen eri esiasteet diagnosoivat eri ihmisiä. Jos 2- tunnin sokerirasitusta ei käytettäisi, jäisi runsaasti todellisessa sydän- ja verisuonisairauksien riskissä olevia henkilöitä löytymättä. Toisaalta sokerihemoglobiini HbA1c 5.7–6.4% löytää eri ihmisiä, joilla perinteiset riskitekijät sydän- verisuonisairauksille ovat yleisemmät, joten senkin käyttö voi diabeteksen seulonnassa olla parempi kuin paastosokerin, joka löysi selkeästi huonommin riskihenkilöitä. Sokerirasituskoe on edelleen tärkeä riskihenkilöiden seulonnassa.

Abstract Abdominal obesity in adults is associated with insulin resistance. The purpose of the present study was to examine insulin resistance-associated abnormalities during military service as well as the effect of smoking on these abnormalities. In 1995 we invited all the 1268 servicemen attending military service in the Ostrobothnian Brigade and in 1997 all the 106 servicemen in the First Signal Company for measurements at the beginning of their service. Metabolic syndrome was defined: hyperinsulinemia (fasting insulin ≥ 13.0  mU/l) and dyslipidemia (triglycerides ≥ 1.7 mmol/l and/or total cholesterol/HDL cholesterol > 5) at the same time. Metabolic syndrome was present in 10% of the servicemen who had a body mass index > 27 kg/m2. Metabolic syndrome was present in 1% of all servicemen. None of the servicemen of normal weight had metabolic syndrome. Smoking increased the prevalence of metabolic syndrome sixfold. The mean weight of servicemen in the Ostrobothnian Brigade increased by 4,6 kg during the service. In the First Signal Company, weight did not change during the service. Total cholesterol, HDL and LDL cholesterol increased in both groups. Two out of three servicemen had increased their exercise activity and their consumption of doughnuts/confectionary during the service. Consumption frequence of doughnuts increased by 166%. Apparently, the changes in the diet had a major effect on lipids, and the beneficial effect of increased exercise could not compensate for it. Smokers had lower levels of adiponectin than non-smokers at the beginning of the service. During the service, the levels of adiponectin decreased. The decrease of adiponectin was related to a decrease in QUICKI but not to smoking. Thus, the decreased adioponectin level was due to a decrease of insulin sensitivity caused by diet. Overweighted servicemen should decrease their weight. I suggest that preventive health education should be pointed to overweighted servicemen. The aim should be to decrease obesity and to abandon smoking. By these means we could reduce or prevent arteriosclerosis and diabetes in the future. This is a common challenge for primary health care in Finland and the Finnish military forces. / Tiivistelmä Aikuisten keskivartalolihavuuteen liittyy insuliiniresistenssiä ja metabolista oireyhtymää, jotka ennakoivat tulevaa diabetestä ja valtimonkovetustautia. Nuorten ylipainoisuus on huomattavasti yleistymässä. Useat nuoret tupakoivat. Tässä väitöskirjatyössä tutkittiin insuliiniresistenssiin liittyviä kardiovaskulaarisia riskitekijöitä varusmiespalvelun aikana ja tupakoinnin yhteyttä näihin riskitekijöihin. Tutkimusaineiston muodostivat kaikki 1 268 Pohjan Prikaatissa vuonna 1995 ja kaikki 106 1. Viestikomppaniassa tammikuussa 1997 palvelunsa aloittanutta varusmiestä. Metabolinen oireyhtymä (MBO) määriteltiin siten, että varusmiehellä oli yhtä aikaa hyperinsulinemia (paastoinsuliini ≥ 13,0 mU/l) ja dyslipidemia (triglyseridipitoisuus ≥ 1,7 mmol/l ja/tai kokonaiskolesteroli/HDL-kolesteroli > 5). Näin määritelty MBO löytyi 10 %:lta niistä varusmiehistä, joiden painoindeksi oli yli 27 kg/m2. MBO esiintyi 1 %:lla kaikista varusmiehistä. Kenelläkään normaalipainoisella ei havaittu metabolista oireyhtymää. Painoindeksi yli 27 kg/m2 esiintyi 11 %:lla varusmiehistä. Tupakointi lisäsi MBO:n esiintymisriskiä kuusinkertaisesti. Pohjan Prikaatin varusmiesten paino lisääntyi 4,6 kg, mutta 1. Viestikomppanian varusmiesten paino ei muuttunut varusmiespalvelun aikana. Kuitenkin kokonaiskolesterolin, HDL- ja LDL-kolesterolin pitoisuudet lisääntyivät molemmilla. Ravinto- ja liikuntakyselytutkimus osoitti, että kahdella kolmesta varusmiehestä liikunnan määrä ja munkkien/kahvileipien käyttö lisääntyi varusmiespalvelun aikana. Munkkien käyttökerrat lisääntyivät 166 %. Ilmeisesti ruokavalion muutoksen aiheuttama "rasvarasitus" ja sen haitallinen vaikutus lipideihin oli niin merkittävä, että se mitätöi lisääntyneen liikunnan tuoman hyödyn. Tupakoivien adiponektiinipitoisuudet olivat varusmiespalvelun alussa matalampia kuin tupakoimattomien. Adiponektiinipitoisuudet vähenivät varusmiespalvelun aikana tupakoivilla ja tupakoimattomilla. QUICKI-indeksin pieneneminen oli itsenäinen selittäjä adiponektiinipitoisuuden muutokselle. Siten adiponektiinipitoisuuden vähenemisen syy oli ruokavalion aiheuttama insuliiniherkkyyden heikkeneminen varusmiespalvelun aikana ja se ei riippunut tupakoinnista. Ylipainoiset kutsuntaikäiset nuoret miehet ja varusmiehet tulisi saada laihtumaan. Suosittelen juuri heille suunnattua täsmäehkäisyä, joka tähtää painonpudotukseen ja tupakoimattomuuteen, sillä ylipainolla ja tupakoinnilla on selvä haitallinen vaikutus insuliiniresistenssiin liittyviin kardiovaskulaarisiin riskitekijöihin jo nuoruusvuosien aikana. Puuttumalla ajoissa vaaratekijöihin valtimonkovetustaudin ja diabeteksen kehittymistä voidaan hidastaa tai estää. Tämä on yhteinen haaste suomalaiselle perusterveydenhuollolle ja puolustusvoimille.

Background: Multiple lines of evidence implicate the insulin-like growth factor(IGF) group of proteins in human type 2 diabetes. The actions of IGF-I and IGF-IIare modulated through their interaction with IGF binding proteins. A holisticapproach to study the IGF system is preferable to analyses of individual proteininteractions as the inter-relationships between these proteins are complex. Inparticular, the associations of IGF-II and its associated binding proteins withcardiovascular risk have been inadequately studied. This study aimed to study indetail the genotype and phenotype interactions of the IGF system with longitudinalcardiovascular risk factor trends and phenotypic outcomes in type 2 diabetes.Methods: 1000 subjects of predominantly Caucasian origin from the SalfordDiabetes Cohort were studied. Measurements of IGF proteins (IGF-I, IGF-II,IGFBP-1, IGFBP-2 and IGFBP-3) were performed in 554 of these patients. 991Caucasian subjects were successfully genotyped for 76 single nucleotidepolymorphisms (SNPs) related to ten genes in the IGF system. In this project weanalysed associations of the studied SNPs with the measured IGF proteins as well aslongitudinal risk factor trends. In addition, the baseline concentrations of themeasured proteins were studied for associations with cardiovascular risk factortrends and vascular outcomes.Results: This project demonstrates for the first time that high serum IGF-IIconcentration at baseline predicts longitudinal increases in high-density lipoproteincholesterol. High baseline IGF-II was also observed to predict longitudinal weightloss. High baseline concentration of IGFBP-2 (which has a preferential associationof IGF-II over IGF-I) was associated with a number of favourable longitudinalcardiovascular risk trends like increased HDL cholesterol and decreased diastolicblood pressure. However high IGFBP-2 was also associated with deterioration inrenal function and increased all-cause and cardiovascular mortality. The IGF2 geneand the genes encoding IGFBP-2 and IGFBP-5 (proteins with IGF-II bindingaffinity) were also associated with longitudinal trends in renal function, bloodpressure and cholesterol concentration.Discussion: This study is the most detailed exploration to date of the genotype andphenotype interactions of the IGF system in a Caucasian population with type 2diabetes. Results from this study strongly hint that changes in IGF-II bioavailabilitymay influence inter-individual variations in cardiovascular risk. The precisebiological role of IGF-II merits clarification in future expression studies in renal,adipose and vascular tissues. Replication of significant results in an independentdiabetes cohort and measurement of other IGF binding proteins will be performed inthe next stage of this study.

Submitted by Fabio Sobreira Campos da Costa (fabio.sobreira@ufpe.br) on 2016-04-18T13:17:39Z No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Tese Tiago Araújo.compressed.pdf: 7089899 bytes, checksum: 0d9fa1d7f42954a36ff78b4171da7ef7 (MD5) / Made available in DSpace on 2016-04-18T13:17:39Z (GMT). No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Tese Tiago Araújo.compressed.pdf: 7089899 bytes, checksum: 0d9fa1d7f42954a36ff78b4171da7ef7 (MD5) Previous issue date: 2015-04-30 / CAPEs / O presente estudo teve como objetivo investigar a relação entre hiperuricemia, distúrbios metabólicos e as atividades biológicas de Myrciaria cauliflora, Crataeva tapia e Indigofera suffruticosa. Para tanto, foi realizado inicialmente um estudo populacional, com 3620 voluntários, adultos, homens, não diabéticos, do Nordeste brasileiro. Obesidade abdominal e hipertrigliceridemia foram avaliadas para a identificação do fenótipo denominado Cintura Hipertrigliceridêmica (CHTG) e para a avaliação da influência desses distúrbios metabólicos sobre a hiperuricemia. Posteriormente, estudos com modelo animal (Mus musculus) foram conduzidos. Assim, extratos orgânicos (etéreo, acetônico e metanólico) foram preparados a partir do epicarpo de frutos maduros de M. cauliflora, denominados, sequencialmente, de MCEE, MCAE e MCME, nas concentrações de 200mg/Kg e de 400mg/Kg. Análise fitoquímica e estudo da toxicidade oral desses extratos foram realizadas. MCAE foi administrado durante 14 dias em camundongos com diabetes induzida por aloxana; e avaliação do perfil glicídico, lipídico, de função renal e hepática e análise histológica do pâncreas foram realizadas. Atividade anti-hiperuricêmica de MCAE, em modelo de oxonato de potássio, também foi investigada. MCEE, MCAE e MCME foram usados para a avaliação de: atividade anti-inflamatória, usando os modelos de edema de pata e de peritonite; atividade antinociceptiva, nos modelos de dor induzida por ácido acético e de placa quente; atividade antioxidante, por ensaio com 2,2-difenil-β- picrilhidrazil; e atividade antitumoral, contra tumor sólido de carcinoma de Ehrlich. Lectina de C. tapia foi purificada e testada para avaliação de atividade hipoglicêmica. Extratos etéreo, clorofórmico e acetônico de folhas de I. suffruticosa foram preparados, analisados fitoquimicamente e testados contra cepas de S. aureus. Como principais resultados, este estudo demonstrou que: obesidade abdominal e hipertrigliceridemia, isoladas, mostraram significativas razões de chance (RC) sobre a presença de hiperuricemia, porem o fenótipo CHTG demonstrou o maior efeito (RC = 4,3), especialmente após o uso dos pontos de corte obtidos especificamente para a população do estudo; hiperuricemia apresentou uma forte associação com alto risco de morte por evento cardiovascular em dez anos (RC = 3,5); 200mg/Kg/dia e 400mg/Kg/dia de MCAE causou uma redução significativa da glicose plasmática e redução nos níveis séricos de triglicerídios, uréia, creatinina e transaminases, aumento de HDL-colesterol, melhora do aspecto morfológico das ilhotas pancreáticas e diminuição de cerca de 50% nos níveis de ácido úrico; MCEE, MCAE e MCME apresentaram relevante atividade antioxidante e produziram reduções significativas da resposta inflamatória, de nocicepção e da massa tumoral; lectina de C. tapia provocou redução significativa nos níveis de glicose, melhora das funções e dos aspectos morfológicos dos rins, pâncreas e fígado de camundongos diabéticos; o extrato acetônico de folhas de I. suffruticosa foi um potente inibidor de S. aureus, seguido pelo extrato clorofórmico, melhorando também sinergisticamente o efeito da eritromicina. Portanto, hiperuricemia está bastante relacionada com o fenótipo CHTG em homens do Nordeste do Brasil, podendo elevar em muito o risco cardiovascular desses indivíduos. M. cauliflora demonstrou um grande potencial terapêutico para hiperuricemia e as condições metabólicas associadas e, assim como lectina de C. tapia, demonstrou ser um agente promissor para o tratamento da diabetes; enquanto que I. suffruticosa mostrou-se ser bastante promissora contra S. aureus. / This study aimed to investigate the relationship among hyperuricemia, metabolic disorders and the biological activities of Myrciaria cauliflora, Crataeva tapia e Indigofera suffruticosa. Therefore, it was initially performed a population study, with 3620 volunteers, adults, men, non-diabetic, from northeastern Brazil. Abdominal obesity and hypertriglyceridemia were evaluated for the identification of phenotype referred as Hypertriglyceridemic Waist (HTGW) and to assess the influence of these metabolic disorders hyperuricemia. Later, animal model studies (Mus musculus) were conducted. Thus, organic extracts (ether, acetone, and methanol) were prepared from ripe fruit epicarp of M. cauliflora referred to, sequentially, MCEE, MCAE, and MCME, at concentrations of 200mg/Kg and 400mg/Kg. Phytochemical analysis and study of oral toxicity of these extracts were made. MCAE was administered for 14 days in mice with alloxan-induced diabetes; and evaluation of glucose profile, lipid, renal and hepatic function and histological analysis of the pancreas were performed. Anti-hyperuricemic activity of MCAE, in potassium oxonate model, was investigated. MCEE, MCAE, and MCME were used for evaluation of: anti-inflammatory activity, using the rat paw edema model and peritonitis; antinociceptive activity, in models of pain induced by acetic acid and hot plate; antioxidant activity, by 2,2-diphenyl-β-picrylhydrazyl assay; and antitumor activity against solid tumor of Ehrlich carcinoma. Lectin of C. tapia was purified and tested for evaluation of hypoglycemic activity. Ether, chloroform and acetone extracts of leaves of I. suffruticosa were prepared, phytochemically analyzed and tested against strains of S. aureus. As main results, this study demonstrated that: abdominal obesity and hypertriglyceridemia, isolated, showed significant odds ratios (OR) for the presence of hyperuricemia, but HTGW phenotype demonstrated the most effect (OR = 4.3), especially after use the cutoffs obtained specifically for the study population; hyperuricemia showed a strong association with high risk of cardiovascular events death in ten years (OR = 3.5); 200mg/Kg/dia and 400mg/Kg/dia of MCAE caused a significant reduction in plasma glucose and reduction in serum levels of triglycerides, urea, creatinine and transaminases, increase in HDL-cholesterol, improvement in the morphological appearance of the pancreatic islets and decrease about 50% in the levels of uric acid; MCEE, MCAE, and MCME presented significant antioxidant activity and produced significant reductions in the inflammatory response, nociception and of the tumor mass; C. tapia lectin caused a significant reduction in glucose levels, improved the function and morphology of the kidneys, pancreas and liver of diabetic mice; and the acetone extract from the leaves of I. suffruticosa was a potent inhibitor of S. aureus followed by chloroform extract, also synergistically improving the effect of erythromycin. Therefore, hyperuricemia is closely related to the HTGW phenotype in men in Northeast Brazil, and can significantly increase the cardiovascular risk of these individuals. M. cauliflora demonstrated a great therapeutic potential for hyperuricemia and associated metabolic conditions, as well as C. tapia lectin proved to be a promising agent for the treatment of diabetes; while I. suffruticosa shown to be quite promising against S. aureus.

Submitted by Nadir Basilio (nadirsb@uninove.br) on 2018-07-19T18:55:06Z No. of bitstreams: 1 Adilson Santos Andrade de Sousa.pdf: 1247821 bytes, checksum: 9a8380bf13484c105223476f4ae7b8b5 (MD5) / Made available in DSpace on 2018-07-19T18:55:06Z (GMT). No. of bitstreams: 1 Adilson Santos Andrade de Sousa.pdf: 1247821 bytes, checksum: 9a8380bf13484c105223476f4ae7b8b5 (MD5) Previous issue date: 2018-04-29 / Patients with peripheral arterial disease have low levels of physical activity and high cardiovascular risk. Although peripheral arterial disease has a similar prevalence between men and women, studies have shown that the consequences of the disease are extremely different between the sexes. Studies show that women have lower functional capacity and lower levels of physical activity than men. However, the sexes are different from the barriers to the practice of physical activity and cardiovascular health indicators have not yet been studied. Objective: To compare the barriers to the practice of physical activity, cardiovascular function and arterial rigidity among men and women with peripheral arterial disease. Material and Method: this is a descriptive epidemiological study. The study included 267 patients with peripheral arterial disease and symptoms of intermittent claudication divided into two studies, 102 patients in the first study and 167 patients in the second study. The patients were submitted to the evaluation of physical activity level and barriers to the practice of physical activity, as well as cardiovascular health indicators (auscultatory arterial pressure, autonomic cardiovascular modulation, and arterial stiffness). Results: Women had a higher rate of increase by 34% compared to men who presented 29%, women had a rate of increase corrected by 75 beats per minute 31%, men had 25%. Women with peripheral arterial disease had lower levels of physical activity with moderate and vigorous intensity and reported more frequently than the following barriers to physical activity: lack of companionship to practice physical activity, fear of physical activity aggravate the disease, no place to sit when pain is felt and no place to practice physical activity. Conclusion: Regarding the cardiovascular variables, women present higher reflected wave indicators than men, as well as presented more barriers to physical activity compared to men. / Pacientes com doença arterial periférica apresentam baixos níveis de atividade física e elevado risco cardiovascular. Embora a doença arterial periférica tenha prevalência similar entre homens e mulheres, estudos têm mostrado que as consequências da doença são extremamente diferentes entre os sexos. Estudos mostram que as mulheres apresentam menor capacidade funcional e menores níveis de atividade física do que os homens. Porém, o quanto os sexos são diferentes às barreiras para a prática de atividade física e os indicadores de saúde cardiovascular ainda não foram estudados. Objetivo: Comparar as barreiras para a prática de atividade física, função cardiovascular e rigidez arterial entre homens e mulheres com doença arterial periférica. Material e Método: trata-se de um estudo epidemiológico descritivo. Fizeram parte do estudo 267 pacientes com doença arterial periférica e sintomas de claudicação intermitente divididos em dois estudos, no primeiro estudo foram 102 pacientes e no segundo estudo 167 pacientes. Os pacientes foram submetidos à avaliação do nível de atividade física e das barreiras para a prática de atividade física, bem como dos indicadores da saúde cardiovascular (pressão arterial auscultatória, modulação autonômica cardiovascular, e rigidez arterial).Resultados: As mulheres apresentaram maior índice de aumento 34% em comparação aos homens que apresentaram 29%, as mulheres apresentaram um índice de aumento corrigido por 75 batimentos por minuto 31%, os homens apresentaram 25%. As mulheres com doença arterial periférica apresentaram menores níveis de atividade física com intensidade moderada e vigorosa e reportam mais frequentemente que as seguintes barreiras para a prática de atividade físca: falta de companhia para a prática de atividade física, medo da atividade física agravar a doença, não ter lugar para sentar quando sente dor e não ter lugar para a prática de atividade física. Conclusão: Com relação às variáveis cardiovasculares as mulheres apresentam maiores indicadores de onda refletida do que os homens, bem como apresentaram mais barreiras para a prática de atividade física em comparação aos homens.

Introdução: O trato gastrointestinal humano é composto por uma comunidade microbiana diversificada que atua no controle da saúde. Estudos recentes demonstraram que o equilíbrio da microbiota intestinal é afetado na doença renal crônica (DRC), ocasionando o quadro de disbiose intestinal. Estes estudos sugeriram uma associação da disbiose intestinal com complicações metabólicas como acúmulo de toxinas urêmicas, progressão da DRC, inflamação e risco cardiovascular. Diante disso, medidas com o objetivo de restaurar o equilíbrio da microbiota intestinal são sugeridas, tais como a ingestão oral de probióticos, mas poucos estudos têm abordado o efeito destes suplementos na progressão da DRC e no risco cardiovascular destes pacientes. Objetivo: Avaliar o efeito do consumo de probióticos em fatores associados com progressão da DRC e risco cardiovascular de pacientes com DRC. Material e métodos: Trata-se de um estudo clínico controlado por placebo registrado no Clinical Trials NCT03400228. O estudo incluiu 30 pacientes adultos com DRC nos estágios 3 a 5 não em diálise, com função renal estável e proteinúria igual ou superior a 500 mg. A coleta de dados ocorreu entre novembro de 2015 até dezembro de 2017. O protocolo do estudo constou de período de washout de 4 semanas e randomização dos pacientes para o grupo de intervenção (GI, suplemento com probiótico) ou para o grupo controle (GC, maltodextrina). Foi realizado avaliação basal e após 24 semanas de consumo de probiótico ou placebo. Todos os pacientes receberam a orientação de consumir 2 sachês por dia do probiótico ou do placebo (maltodextrina). Foram avaliadas variáveis demográficas, clínicas, nutricionais, hábito intestinal e exames laboratoriais com amostras sanguíneas e urinárias. Resultados: Dos 30 pacientes incluídos, 20 completaram as 24 semanas do estudo, sendo 10 no grupo intervenção e 10 no grupo placebo. Após o uso de probiótico houve aumento na taxa de filtração glomerular estimada (p<0,001) e diminuição nos níveis séricos de creatinina (p<0,001), ureia (p=0,015), proteína C reativa (p=0,03), hormônio da paratireóide (p=0,03) e potássio (p=0,012), em comparação ao grupo placebo. Os efeitos positivos do probiótico na taxa de filtração glomerular estimada e na diminuição dos níveis séricos de creatinina e ureia permaneceram após análise de regressão multivariada. Não houveram diferenças significativas nos parâmetros urinários entre os grupos. Sintomas de constipação (p<0,001) e consistência fecal (p=0,016) apresentaram melhora no grupo intervenção versus placebo. Conclusão: A suplementação de probióticos melhorou os marcadores de função renal e reduziu inflamação, além de auxiliar na melhora dos sintomas de constipação intestinal em pacientes com DRC. / Introduction: The human gastrointestinal tract is colonized by a diversified microbial community that acts in control of health. Recent studies have shown that intestinal microbiota balance is affected in chronic kidney disease (CKD) leading to intestinal dysbiosis. These studies have suggested association of intestinal dysbiosis with several metabolic disorders such as accumulation of uremic toxins, progression of CKD, inflammation and cardiovascular risk. Therefore, interventional measurement that improve intestinal microbiota balance are suggested such as supplementation of probiotics, however few studies evaluated the effect of these supplements on the progression of CKD and cardiovascular risk in CKD patients. Aim: The purpose of the study was to evaluate the effects of probiotic supplementation on the factors associated with progression of CKD and cardiovascular risk in patients with CKD. Desing and Methods: This was a randomized, double-blind, placebo-controlled study. Thirty patients with CKD stages 3 to 5 not on dialysis, with stable renal function and protein-creatinine ratio > 0.50 were included. Data collection was between November 2015 and December 2017. Study protocol was 4-week washout period, patients randomized to intervention group (IG, probiotic supplement) or control group (CG, maltodextrin), and follow for 24 weeks. Renal function, C-reactive protein (CRP), bone and mineral metabolism, nutritional, and lipid profile markers and intestinal habit were measured at baseline and 24 weeks of study. Results: From 30 patients included in this study, 20 completed the 24 study weeks, 10 in the TG and 10 in PG. After probiotic supplementation, there was increase in estimated glomerular filtration rate (p<0.001) and decrease in serum creatinine 8 (p<0.001), urea (p=0.015), C-reactive protein (p=0.030), parathyroid hormone (p=0.03), and potassium (p=0.012) levels compared to CG. The beneficials effects of probiotics on estimated glomerular filtration rate and serum creatinine, urea, and Creactive protein remained after multivariate linear regression. There were no significant differences in the urinary parameters between the two groups. Symptoms of constipation (p<0.001) and stool consistency (p=0.016) improved in IG compared to CG. Conclusion: Probiotic supplementation improved markers of renal function and reduced inflammation. In addition, it improved the symptoms of intestinal constipation in patients with CKD.