Σκοπός της μελέτης ήταν: (1) να προσδιοριστεί η συχνότητα της διαταραχής ανοχής στη γλυκόζη (IGT) και του σακχαρώδη διαβήτη τύπου II (ΣΔII) σε παχύσαρκα παιδιά και εφήβους στην Ελλάδα και (2) να καθοριστεί εάν οι συγκεντρώσεις γλυκόζης και ινσουλίνης νηστείας μπορούν να προβλέψουν τη διαταραχή ανοχής στη γλυκόζη (IGT)) στα παιδιά αυτά σε σχέση με τα επίπεδα της λεπτίνης, της γκρελίνης, της αδιπονεκτίνης και της σωματομεδίνης, και την έκκριση της αυξητικής ορμόνης (GH) και της θυρεοειδοτρόπου ορμόνης (TSH) κατά τη διάρκεια του 24ωρου μαζί με την ημερήσια έκκριση της κορτιζόλης. Έγινε καμπύλη σακχάρου (OGTT) μαζί με επίπεδα ινσουλίνης σε 117 παχύσαρκα παιδιά και εφήβους 12,1  2,7 ετών και μελετήθηκαν τα επίπεδα της λεπτίνης, της γκρελίνης, της αδιπονεκτίνης και της σωματομεδίνης (IGF-I) κατά τη δοκιμασία ανοχής στη γλυκόζη (OGTT). Επίσης, μελετήθηκαν τα επίπεδα της 24ωρης έκκρισης της GH και της TSH και της ημερήσιας έκκρισης της κορτιζόλης. Χρησιμοποιήθηκαν οι δείκτες HOMA-IR και ο ινσουλινογόνος δείκτης για την εκτίμηση της αντίστασης της ινσουλίνης και της λειτουργίας των β κυττάρων, αντίστοιχα. 17 ασθενείς (14,5%) είχαν IGT και σε κανένα δε διαγνώστηκε ΣΔII. Τα ποσοστά IGT και ΣΔΙΙ ήταν χαμηλότερα από αυτά μιας πολυεθνικής Αμερικανικής μελέτης. Η διαφορά εντοπίστηκε κυρίως στα προεφηβικά παιδιά (9% έναντι 25,4%), ενώ δεν παρατηρήθηκε διαφορά στους εφήβους (18% έναντι 21%). Ωστόσο, τα ποσοστά IGT ήταν υψηλότερα από αυτά που βρέθηκαν σε άλλες μελέτες από την Ευρώπη. Η γλυκόζη νηστείας, η ινσουλίνη και ο δείκτης HOMA-IR δεν προέβλεψαν την εμφάνιση IGT, όμως, η απόλυτη τιμή της ινσουλίνης στις 2 ώρες της OGTT και ο δείκτης AUCG προέβλεψαν την εμφάνιση IGT. Τα επίπεδα λεπτίνης και γκρελίνης ήταν υψηλότερα στα κορίτσια. Υπήρχε συσχετισμός μεταξύ BMI και λεπτίνης νηστείας, BMI και αδιπονεκτίνης, σωματομεδίνης (IGF-I) και λεπτίνης νηστείας, ενώ δεν υπήρχε καμιά συσχέτιση με τα επίπεδα της κορτιζόλης ή με τα 24ωρα επίπεδα της αυξητικής ορμόνης και της θυρεοειδοτρόπου ορμόνης. Συμπερασματικά, η OGTT φαίνεται να έχει τη δυνατότητα να προβλέψει την IGT, ενώ οι τιμές γλυκόζης και ινσουλίνης νηστείας και οι τιμές του δείκτη HOMA-IR, αν και υψηλότερες στους ασθενείς με IGT και ενδεικτικές για αντίσταση στην ινσουλίνη, δεν μπορούν να προβλέψουν την IGT. / The aims of the present study were: (1) to determine the prevalence of impaired glucose tolerance (IGT) and diabetes mellitus II (DMII) in obese children and adolescents of Greek origin and (2) to study the concentrations of leptin, ghrelin, adiponectin and IGF-I during an oral glucose tolerance test as well as the 24-hour concentrations of growth hormone (GH) and thyrotropin secreting hormone (TSH), and the diurnal secretion of cortisol in these children. A total of 117 obese children and adolescents aged 12.1  2.7 years underwent an oral glucose tolerance test (OGTT) and the concentrations of leptin, ghrelin, adiponectin and IGF-I were studied during the duration of the OGTT in relation to the 24-hour secretion of GH and TSH and the diurnal secretion of cortisol. For the estimation of insulin resistance and beta cell function the homeostatic model assessment (HOMA-IR) and the insulinogenic index, respectively, were used. A total of 17 patients (14.5%) had IGT and none had DMII. The overall prevalence rates of both IGT and DMII observed in the obese children and adolescents were lower than those reported in a recent multiethnic US study. Nevertheless, the difference between the data of this study and those of the US study was mostly due to the prepubertal children (9% vs. 25.4%), while no difference was observed in the pubertal population (18% vs. 21%). The prevalence rates of IGT in this study though, were greater than those reported in other European studies. Fasting glucose, insulin and HOMA-IR values were not predictive of IGT. The absolute value of insulin at 2h of the OGTT combined with the time-integrated glycemia (AUCG) strongly predicted IGT, whereas higher area under the curve for insulin (AUCI) values were found to be protective. Leptin and ghrelin concentrations were higher in the females. There was a correlation found between BMI and fasting leptin, BMI and adiponectin, IGF-I and fasting leptin although there was no correlation found with the GH, TSH or cortisol concentrations. In conclusion, the OGTT seems to be capable of predicting IGT whereas the fasting glucose and insulin concentrations are unable to predict glucose intolerance since HOMA-IR values, although higher in IGT subjects and indicative of insulin resistance, cannot accurately predict IGT.

No description available.

L’axe cerveau-intestin désigne l’interaction bidirectionnelle entre le cerveau et le tube digestif. Bien que la leptine, hormone produite par le tissu adipeux, participe à la régulation de cet axe, son mode d’action dans le système nerveux entérique a été peu étudié. A l’heure actuelle, une relation étroite entre une perturbation de l’axe cerveau-intestin et la schizophrénie est supposée. Par conséquent, les objectifs de ce travail étaient d’évaluer 1) les effets ex vivo de la leptine dans la neurotransmission entérique chez le rat et 2) les altérations périphériques dans un modèle neurodéveloppemental de la schizophrénie (NVHL) chez le rat. Nous avons montré que la leptine module l’activité des neurones entériques inhibiteurs et excitateurs dans le jéjunum et le côlon proximal. L’implication des neurones afférents primaires intrinsèques a été discutée. Chez les rats NVHL, nous avons mis en évidence une réduction de la masse corporelle, des variations hormonales, une inflammation du jéjunum et des altérations motrices digestives. La relation entre les troubles périphériques, notamment vagaux, et la physiopathologie de la schizophrénie a été discutée. / The brain-gut axis refers to the bidirectional interaction between the gut and the brain. Although leptin, a hormone released from fat tissue, is involved in the brain-gut axis control, its mechanism of action in the enteric nervous system has not been studied so far. Nowadays, brain-gut axis dysfunctions are supposed to be in close connection with schizophrenia. Therefore, the goals of this work were to determine 1) the effects of leptin on rat enteric nervous system neurotransmission and 2) peripheral alterations in the NVHL neurodevelopmental rat model of schizophrenia. We showed that leptin modulates inhibitory and excitatory enteric motor neurons activity in jejunum and proximal colon. Implication of intrinsic primary afferent neurons was discussed. In NVHL rats, we showed a decrease in body mass, some hormonal variations, jejunal inflammation and gastro-intestinal mechanical activities alterations. The relation peripheral alterations, like vagus nerve dysfunction, and the physiopathology of schizophrenia was discussed.

Made available in DSpace on 2015-07-22T20:49:46Z (GMT). No. of bitstreams: 0 Previous issue date: 2009-07-29 / Background The mechanisms responsible for the uraemic anorexia are poorly understood. In children and adults with chronic kidney disease (CKD) increased levels of the orexigenic hormone ghrelin are often found. However, no data exits in relationship to concentration of acylated ghrelin in pediatric patients with CKD. Methods Cross-sectional study of acylated and total ghrelin plasma levels in pediatric patients with mild CKD undergoing conservative treatment (MCKD group, n = 19) and patients with end stage renal disease undergoing hemodialysis (ESRD group, n = 24) compared with healthy controls (n =20). The correlations between total or acyl ghrelin with leptin, GH, IGF-I, glomerular filtration rate (GFR) and anthropometric and nutritional measurements were also undertaken. Results ESRD patients had significantly lower BMI Z-score and energy intake while both ESRD and MCKD groups had lower height-for-age Z-score than control group. ESRD patients also exhibited higher total ghrelin levels (2009.7±1278.0 pg/ml, mean±SD) than either MCKD (1117.5±891.9 pg/ml) or controls (655.3±255.6 pg/ml). However, plasma acyl ghrelin levels did not differ between groups. The ESRD group had normal GH but low IGF-I levels. When all 43 uraemic subjects were combined, total ghrelin correlated positively with GH (r =0.340, p=0.0255) and negatively with IGF-I (r= - 0.415, p=0.0057) and GFR (r= -0.534, p<0.0002). Both total and acyl ghrelin correlated negatively with nutritional status. Conclusion The present findings suggest that most of the increased total ghrelin in CKD pediatric patients is desacylated. As desacyl ghrelin has been shown to inhibit feeding, its high levels may contribute to malnutrition and growth deficit in CKD patients. / TEDE / BV UNIFESP: Teses e dissertações

Made available in DSpace on 2015-07-22T20:50:31Z (GMT). No. of bitstreams: 0 Previous issue date: 2009-08-26 / Obesidade, hipertensão, dislipidemia e diabetes tipo 2 são os principais fatores de risco que caracterizam a síndrome metabólica quando presentes simultaneamente. Com o aumento dos níveis de leptina em quadros de obesidade e a correlação desta patologia com a hipertensão, objetivou-se neste trabalho o estudo das possíveis implicações do hormônio leptina na hipertensão de forma central e periférica e a interação com o principal sistema no controle da pressão arterial (PA), o sistema renina-angiotensina (SRA). Neste trabalho nós mostramos que camundongos com mutação espontânea no gene da leptina, ob/ob, ou no receptor de leptina, db/db apresentam deficiências no controle da PA e ritmo circadiano, alterações no SRA e disfunção autonômica. Em camundongos ob/ob, a atividade da ECA, uma das principais enzimas do SRA, apresentou-se reduzida em condições basais e foi restabelecida após o tratamento agudo com leptina. Cronicamente, a administração de leptina aumentou a atividade dessa enzima e a concentração de fatores que compõem o SRA, como o peptídeo vasoconstritor angiotensina II em camundongos ob/ob. No entanto, não houve aumento da PA. Os camundongos ob/ob apresentaram menor baroreflexo, diminuição da ativação parassimpática e aumento da ativação simpática. Os camundongos db/db também apresentaram o mesmo fenótipo. O tratamento com leptina provocou diminuição do peso e restabeleceu a disfunção autonômica em camundongos ob/ob. Surpreendentemente, o tratamento com enalapril também restabeleceu o tônus autônomo, simpático e parassimpático, assim como o baroreflexo em ob/ob e db/db sugerindo a importância da angiotensina II no controle autônomo concomitante com a ausência na sinalização de leptina. Nossos dados sugerem uma nova interação da via de leptina com o SRA, sendo a angiotensina II um possível fator necessário para a manutenção da ativação autonômica e sobrevivência desses camundongos. / The leptin deficient ob/ob mice are insulin resistant and obese. However, the control of blood pressure in this model is not well defined. The goal of this study was to evaluate the role of leptin and the renin-angiotensin system (RAS) in the cardiovascular abnormalities observed in obesity using a model lacking leptin. Leptin is a hormone related to metabolism. It also influences blood pressure, but the mechanisms triggered in this process are not yet elucidated. Angiotensin-I converting enzyme (ACE) regulates cardiovascular functions and recently has been associated with metabolism control and obesity. Here we tried to answer the question whether ACE and leptin could influence blood pressure control being a link between renin-angiotensin system and obesity in ob/ob mice, a model lacking leptin. These mice are obese and diabetic, but have normal 24h mean arterial pressure. Our results show that plasma and lung ACE activities as well as ACE mRNA expression were significantly decreased in ob/ob mice. In agreement with these findings, the hypotensive effect produced by enalapril administration was attenuated in the obese mice. Plasma renin, angiotensinogen, angiotensin I, bradykinin and angiotensin 1-7 were increased, whereas plasma angiotensin II concentration was unchanged in obese mice. Leptin chronic infusion increased renin activity and angiotensin II concentration in both groups and increased ACE activity in ob/ob mice. Acute leptin infusion could restore ACE activity in leptin deficient mice. Moreover, the effect of ACE inhibitor on blood pressure during leptin treatment was not changed in lean, but increased four times in obese mice. In a second part of the study we measured blood pressure in ob/ob and control animals by radiotelemetry combined with fast Fourier transformation before and after both leptin and enalapril treatment. Autonomic function was assessed pharmacologically. Blood pressure during daytime was slightly higher in the ob/ob compared to control mice while no difference in heart rate was observed. Blood pressure response to trimetaphane and heart rate response to metoprolol were greater in ob/ob mice than in control littermates indicating an activated sympathetic nervous system. Heart rate response to atropine was attenuated. Baroreflex sensitivity and heart rate variability were blunted in ob/ob mice, while low frequency of systolic blood pressure variability was found increased. Chronic leptin replacement reduced blood pressure and reversed the impaired autonomic function observed in ob/ob mice. Inhibition of ACE by enalapril treatment had similar effects prior loss of weight. These findings suggest that the RAS is involved in the autonomic dysfunction caused by the lack of leptin in ob/ob mice. In summary, our findings show that the RAS is altered in ob/ob mice, with markedly reduced ACE activity, which suggests a possible correlation between RAS and leptin. These results point to an important interplay between the angiotensinergic and the leptinergic systems and may contribute to clarify the role played by these systems in the pathogenesis of obesity, hypertension, and metabolic syndrome. / TEDE / BV UNIFESP: Teses e dissertações

Made available in DSpace on 2016-06-02T19:22:04Z (GMT). No. of bitstreams: 1 2977.pdf: 497005 bytes, checksum: de1ddd4b87d6bd92e7b994ebcb91ba87 (MD5) Previous issue date: 2010-05-14 / Objective: To determine the effect of a resistance training program on body composition andplasmatic concentrations of leptin and resistin in pos-menopausal women.Methods: Twenty-three post-menopausal women (mean age = 56.52 ± 4.42 years) were submitted to12 months of resistance training, twice a week. The training program was performed in 3 sets of 8-10RMs maximal repetitions with an intensity of 75-85% of 1RM. Body composition (DXA), musclestrength (bench press, leg press 45º, arm curl), plasmatic concentration of resistin and leptin wereassessed before and after the training program. Paired Student s t test was used for Bodycomposition, muscle strength and plasmatic concentration of resistin and leptin and non-parametricWilcoxon test for variables of quality of life. Significance level was set at 5%.Results: After the resistance training program, there was a significant increase in muscle strengthand lean mass, and a significant reduction in body weight, fat percentage, fat mass, andconcentrations of leptin and resistin with consequent improvement in quality of life.Conclusions: the interpretation of the results shows that resistance exercise can have significanthealth benefits and quality of life and reduce the concentrations of Leptin and Resistin induced byaging in postmenopausal women. / Objetivo: determinar o efeito produzido por um Programa de Treinamento de Força sobre asvariáveis de Composição Corporal, concentrações plasmáticas de Leptina e Resistina e qualidade devida em mulheres pós-menopáusicas.Métodos: 23 mulheres pós-menopáusicas (56,52 ± 4,42 anos) realizaram durante doze meses umprograma de Treinamento de Força em intensidades entre 75 e 80% de 1 RM, com 3 séries entre 8-10 Repetições Máximas, duas vezes por semana. A força máxima foi testada no supino, leg press 450e rosca direta. Variáveis de Composição Corporal (DXA), Força Muscular, concentração plasmáticade Resistina e Leptina e Qualidade de Vida (SF-36) foram realizadas antes e a após o período detreinamento. Para comparação entre valores iniciais e finais. Foi aplicado o teste t Pareado para asvariáveis de composição corporal, força muscular, Leptina e Resistina e o teste não paramétrico deWilcoxon para as variáveis de Qualidade de Vida. O nível de significância utilizado para asconclusões das analises estatísticas foi de 5%.Resultados: Além do esperado aumento de força, houve redução significativa nos valores de PesoCorporal, % Gordura, Massa Gorda e aumento nos valores de massa magra com conseqüentemelhoria na Qualidade de Vida. Houve redução significativa também nas concentrações plasmáticasde Leptina e Resistina quando comparados os valores pré e pós-treinamento.Conclusão: a interpretação dos resultados permite concluir que o Treinamento de Força podeacarretar importantes benefícios para a saúde e qualidade de vida além de reduzir as concentraçõesde Leptina e Resistina em mulheres pós-menopáusicas.

Title: Acipimox during Short-Term Exercise Exerts A Negative Feedback of Growth Hormone on Ghrelin Secretion in Patients with Bulimia Nervosa and in Healthy Women: The Role of Lipolysis Objective: Eating disorders, such as bulimia nervosa (BN) and anorexia nervosa (AN), are characterized by abnormal eating behavior. The main features of BN are binge-eating and inappropriate compensatory methods to prevent weight gain. The appetite-modulating peptide ghrelin is secreted by the stomach and shows a strong release of growth hormone (GH). A potential GH-ghrelin feedback loop between stomach and the pituitary has been recently reported. Acipimox (Aci), an analogue of nicotinic acid, inhibits lipolysis in adipose tissue (AT) and reduces plasma glycerol and free fatty acids (FFA) levels. Exercise and Aci are stimulators of GH secretion. We suppose that a negative feedback from increased GH levels during exercise may play a role in reducing plasma ghrelin levels. We surmised that altered baseline activity and exercise-induced activation of the sympathetic nervous system (SNS) results in excessive stimulation of lipolysis associated with negative energy balance and may lead to abnormal AT metabolism in patients with BN. Disruption of the gut-brain-AT axis might be involved in the pathogenesis of BN. The...

Neste estudo, foi avaliada a relação entre polimorfismos dos genes da leptina (LEP) e receptores da leptina (LEPR) e parâmetros antropométricos, leptinemia glicemia e lipídeos séricos, em indivíduos da população brasileira. Foram incluídos 238 indivíduos com idade entre 30 e 80 anos. Foram medidos o índice de massa corporal (IMC), a cintura abdominal (CA) e a razão cintura quadril (RCQ). Amostras de sangue periférico foram obtidas para análise do perfil bioquímico e extração de DNA. Os polimorfismos de nuleotideo único (SNPs) LEP G-2548A e LEPR Lys109Arg, Gln223Arg e Lys656Asn foram detectados por PCR-RFLP. Os SNPs LEPR Lys109Arg e Gln223Arg foram associados com obesidade e com IMC e CA aumentados (p<0.05). Estes polimorfismos também foram associados com leptina e glicose elevada (p<0,05). O perfil lipídico sérico foi influenciado pelo polimorfismo LEPR Lys109Arg (p<0.05). A relação entre os SNPs LEPR Lys109Arg e Gln223Arg e o perfil lipídico foi modificada pelo gênero. Os haplótipos LEP G-2548/ LEPR Lys109Arg foram relacionados com diferenças no IMC de obesos. Os haplotipos LEPR Lys109Arg/Gln223Arg foram associados com diferenças na CA e glicemia e lipídeos séricos. Em conclusão, os polimorfismos LEPR Lys109Arg e Gln223Arg estão associados com obesidade e alterações de leptina, glicose e lipídeos circulantes de forma dependente do gênero. / We have assessed the relationship between polymorphisms of the leptin (LEP) and the leptin receptor (LEPR) genes and anthropometric parameters, plasma leptin and glucose and serum lipids in individuals of the Brazilian population. We included 238 individuais with 30 to 80 years. Body mass index (BMI), abdominal circumference (AC) and waist-to-hip ratio (WHR) were measured. Peripheral blood samples were collected for analysis of the biochemical profile and DNA extraction. The single nucleotide polymorphisms (SNP) LEP G-2548A and LEPR Lys109Arg, Gln223Arg and Lys656Asn were detected by PCR-RFLP. The SNPs LEPR Lys109Arg and Gln223Arg were associated with obesity and with increased BMI and AC (p <0.05). These polymorphisms were also associated with increase leptin and glucose (p<0,05). The serum lipid profile was influenced by the LEPR Lys 1 09Arg (p<0.05). The relationship between the SNPs LEPR Lys 1 09Arg and Gln223Arg and the lipid profile was modified by gender. The haplotypes LEP G-2548A1 LEPR Lys109Arg were related with differences on BMI in obese group. The haplotypes LEPR Lys109Arg/Gln223Arg were associated with differences on AC, glucose and serum lipids. In conclusion, the LEPR Lys109Arg and Gln223Arg polymorphisms are associated with obesity and alterations in blood leptin, glucose and lipids in a gender-dependent manner.

INTRODUÇÃO: A cardiopatia chagásica crônica (CCC) apresenta características específicas, tais como: disfunção autonômica e atividade inflamatória exacerbada. Esta fisiopatologia sugere que alguns parâmetros metabólicos podem estar alterados em pacientes chagásicos. O objetivo deste estudo foi avaliar os parâmetros metabólicos e inflamatórios nas diversas formas evolutivas de doença de Chagas e sua correlação com medidas de avaliação do Sistema Nervoso Autônomo (SNA). MÉTODOS: Foram avaliados 60 indivíduos divididos em 4 grupos (n=15): Grupo controle (GC), Grupo FI - forma indeterminada, Grupo ECG- cardiopatia chagásica com alteração eletrocardiográfica sem disfunção ventricular e Grupo IC - cardiopatia chagásica com disfunção ventricular e insuficiência cardíaca. Todos os grupos foram pareados de acordo com sexo, idade e índice de massa corporal. Os pacientes realizaram dosagens sanguíneas de insulina, leptina, adiponectina, interleucina-6 (IL- 6) e fator de necrose tumoral-alfa (TNF-alfa) pelo método de ELISA. O SNA foi avaliado através da variabilidade da frequência cardíaca no holter 24 horas e no teste de inclinação postural. Os valores de RMSSD, pNN50 e do componente alta frequência (AF) foram utilizados como estimativa da atividade parassimpática. Os valores do componente de baixa frequência (BF) estimaram a atividade simpática. A análise estatística foi feita utilizando-se a ANOVA ou teste de Kruskal-Wallis para a comparação entre os grupos, o coeficiente de Spearman para a análise das correlações e a regressão linear múltipla para a análise multivariada. RESULTADOS: A leptina e insulina não apresentaram diferenças significativas entre os grupos [Leptina: GC=3,42 (7,43); FI=3,03 (6,53); ECG=5,56 (6,2); IC=2,86 (2,67) ng/ml; p=0,626. Insulina: GC=3,41 (1,98); FI=4,31 (2,85); ECG=4,30 (3,06); IC=4,58 (2,88) ng/ml; p=0,901] A adiponectina apresentou níveis maiores nos grupos ECG e IC [GC=4766,5 (5529,5); FI= 4003,5 (2482,5); ECG= 8376,5 (8388,5); IC= 8798 (4188) ng/ml; p < 0,001]. IL-6 e TNF-alfa foram maiores no Grupo IC [IL-6: GC=1,85 (6,41); FI=1,58 (1,91); ECG=1,0 (1,57); IC= 31,44 (72,19) pg/ml; p=0,001. TNF-?: GC=22,57 (88,2); FI=19,31 (33,16); ECG=12,45 (3,07); IC=75,15 (278,57) pg/ml; p=0,04]. A insulina, leptina e TNF-alfa não apresentaram correlações significativas com medidas de avaliação do SNA. A adiponectina apresentou correlação positiva com o componente AF (r= 0,336; p= 0,009) e correlação negativa com o componente BF (r= -0,336; p= 0,009). A interleucina-6 apresentou correlação positiva com o componente AF (r= 0,419; p=0,004) e correlação negativa com o componente BF (r= -0,393; p= 0,007). Porém, na análise multivariada apenas a adiponectina apresentou correlação significativa com medidas de função do SNA. CONCLUSÃO: A adiponectina foi maior nos grupos ECG e IC. A IL-6 e o TNF-alfa foram maiores no grupo IC. O aumento dos níveis de adiponectina esteve associado a diminuição da atividade simpática e predomínio da atividade parassimpática. / BACKGROUND: Chagas disease (CD) has specific characteristics such as autonomic dysfunction and increased inflammatory activity. This pathophysiology suggests that metabolic parameters can be altered in patients with CD. The aim of this study was to evaluate the metabolic and inflammatory parameters in different forms of CD and their correlation with Autonomic Nervous System (ANS) measures. METHODS: We evaluated 60 subjects divided into 4 groups (n=15): control group (CG), group IF (indeterminate form); group ECG (ECG abnormalities and normal left ventricular function in echocardiogram) and HF group (heart failure with left ventricular dysfunction). All groups were matched for age, sex and body mass index. The patients underwent insulin, adiponectin, leptin, interleukin-6 (IL-6) and tumor necrosis factor-alfa (TNF-alfa) measurements by ELISA. The Autonomic Nervous System was assessed by heart rate variability in 24-hour Holter and tilt test. RMSSD, pNN50 and High Frequency (HF) component values were used to estimate parasympathetic activity and low frequency (LF) components were used to estimate sympathetic activity. Statistical analyses were performed using ANOVA or Kruskal- Wallis tests to compare groups. Spearman coefficient was used for correlation analysis and linear regression for multivariate analysis. RESULTS: No significant differences were observed in leptin and insulin levels between groups. [Leptin: CG=3.42 (7.43); IF=3.03 (6.53); ECG=5.56 (6.2); HF=2.86 (2.67) ng/ml; p=0.626. Insulin: CG=3.41 (1.98); IF=4.31 (2.85); ECG=4.30 (3.06); HF=4.58 (2.88) ng/ml; p=0.901]. Adiponectin was higher in ECG and HF groups. [CG=4766.5 .(5529.5); IF= 4003.5 (2482.5); ECG= 8376.5 (8388.5); HF= 8798 (4188) ng/ml; p < 0.001)]. IL-6 and TNF-alfa were higher in HF group. [IL-6: CG=1.85 (6.41); IF=1.58 (1.91); ECG=1.0 (1.57); HF= 31.44 (72.19) pg/ml; p=0.001. TNF-alfa: CG=22.57 (88.2); IF=19.31 (33.16); ECG=12.45 (3.07); HF=75.15 (278.57) pg/ml; p=0.04]. Insulin, leptin and TNF-alfa did not correlate with autonomic dysfunction. Adiponectin correlated positively with HF component (r=0.336; p= 0.009) and inversely with LF component (r= -0.336; p=0.009). IL-6 correlated positively with HF component (r= 0.419; p=0.004) and inversely with LF component (r= -0.393; p= 0.007). However, in multivariate analysis only adiponectin correlated significantly with ANS measures. CONCLUSION: Adiponectin levels were higher in ECG and HF groups. IL-6 and TNF-alfa were higher in HF group. Higher levels of adiponectin were associated with reduced sympathetic activity and predominance of parasympathetic activity

Title: Acipimox during Short-Term Exercise Exerts A Negative Feedback of Growth Hormone on Ghrelin Secretion in Patients with Bulimia Nervosa and in Healthy Women: The Role of Lipolysis Objective: Eating disorders, such as bulimia nervosa (BN) and anorexia nervosa (AN), are characterized by abnormal eating behavior. The main features of BN are binge-eating and inappropriate compensatory methods to prevent weight gain. The appetite-modulating peptide ghrelin is secreted by the stomach and shows a strong release of growth hormone (GH). A potential GH-ghrelin feedback loop between stomach and the pituitary has been recently reported. Acipimox (Aci), an analogue of nicotinic acid, inhibits lipolysis in adipose tissue (AT) and reduces plasma glycerol and free fatty acids (FFA) levels. Exercise and Aci are stimulators of GH secretion. We suppose that a negative feedback from increased GH levels during exercise may play a role in reducing plasma ghrelin levels. We surmised that altered baseline activity and exercise-induced activation of the sympathetic nervous system (SNS) results in excessive stimulation of lipolysis associated with negative energy balance and may lead to abnormal AT metabolism in patients with BN. Disruption of the gut-brain-AT axis might be involved in the pathogenesis of BN. The...