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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
1

Avaliação da função tubular renal, pressão arterial, perfil metabólico e inflamatório em um grupo de obesos / Assessment of renal function, blood pressure, metabolic and inflammatory profile in a group of obese

Almeida, Amanda Roberta de, 1976- 24 August 2018 (has links)
Orientadores: Jose Antonio Rocha Gontijo, Sarah Monte Alegre / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-24T10:43:55Z (GMT). No. of bitstreams: 1 Almeida_AmandaRobertade_D.pdf: 2198169 bytes, checksum: 7c24ef7c416a9b7492db15a314337669 (MD5) Previous issue date: 2013 / Resumo: A obesidade é considerada um importante problema de saúde pública, sendo classificada como uma epidemia global, podendo ser definida como uma doença que pode causar ou exacerbar problemas de saúde. Nos últimos anos, o crescimento do número de indivíduos com sobrepeso e obesidade revela um quadro epidemiológico preocupante. Este aumento de peso causa hipertrofia e/ou hiperplasia dos adipócitos, podendo constituir situações relacionadas à gênese do processo fisiopatológico da obesidade e suas complicações. Dentre as complicações, o aumento na produção de citocinas corrobora para o desenvolvimento de um quadro inflamatório, que está associado à resistência à insulina e hipertensão arterial, caracterizado como Síndrome Metabólica. Este processo inflamatório está também relacionado à função renal, sugerindo que o rim desempenha um papel no clearance das citocinas envolvidas no processo inflamatório. Observa-se também a hiperinsulinemia presente em grande parcela de indivíduos obesos, contribuindo para alterações na função renal. A patologia renal em paciente obeso é conhecida como glomerulopatia relacionada à obesidade. No obeso a taxa de filtração elevada leva a uma vasodilatação da arteríola aferente com consequente elevação da fração de filtração, como resultado de uma hiperfiltração glomerular seguido de dano renal. Este trabalho procurou entender as implicações da obesidade, sem qualquer outra co-morbidade associada, sobre a função tubular renal, a pressão arterial, os perfis metabólico e inflamatório em um grupo de voluntários obesos comparados a um grupo de controles eutróficos. Os voluntários foram submetidos ao clearance de lítio e creatinina, juntamente com o teste de tolerância oral à glicose. Foi avaliada a função tubular renal, os perfis metabólico, lipídico e inflamatório. Os voluntários obesos apresentaram fenótipos diferentes para a resistência à insulina e pressão arterial, contudo, o perfil inflamatório e a função tubular renal foram similares. O perfil insulinêmico mostrou diferença importante entre os grupos de obesos quando comparados ao controle. O presente estudo demonstrou que a obesidade no grupo estudado, pode ocorrer com poucas alterações fisiopatológicas. Nós aventamos a hipótese que estas alterações, particularmente as metabólicas, são acentuadas ou associadas à elevação do status inflamatório dos voluntários obesos, mas por outro lado, são atenuadas possivelmente pela elevada concentração sérica de adiponectina no grupo normo-insulinêmico, quando comparado aos voluntários hiperinsulinêmicos. Assim, é possível, que os indivíduos do grupo obeso normo-insulinêmicos possam tardiamente evoluir para hiperinsulinemia reciprocamente à redução dos níveis de adiponectina / Abstract: Obesity is considered an important public health problem, being classified as a global epidemic, which can be defined as a disease that can cause or exacerbate health problems. In recent years, the growth in the number of individuals with overweight and obesity reveals an epidemiological framework concern. This increase in weight cause hypertrophy and/or Adipocyte hyperplasia and may constitute situations related to the genesis of the pathophysiological process of obesity and its complications. Among its complications, the increase in the production of cytokines supports for the development of an inflammatory process, which is associated with insulin resistance and hypertension, characterized as metabolic syndrome. This inflammatory process is also related to kidney function, suggesting that the kidney plays a role in the clearance of cytokines involved in the inflammatory process. It is also observed hyperinsulinemic present in large proportion of obese individuals, contributing to changes in renal function. Renal changes in obese patient is known as glomerulopathy related to obesity. In the obese high filtration rate leads to vasodilation of the afferent arteriole with consequent elevation of the filtration fraction, as a result of glomerular Hyperfiltration followed by renal damage. Thus, this work sought to understand the implications of obesity, with no other associated co-morbidity, on renal tubular function, blood pressure, and inflammatory and metabolic profiles in a group of obese volunteers compared to a group of eutrophic controls. Obese volunteers showed different phenotypes for insulin resistance, blood pressure, inflammatory profile and renal tubular function were similar. Insulinemia profile showed significant difference for the obese groups compared to controls. The present study showed that obesity, at least in a specific group, can occur without major patho-physiological changes. We may state the hypothesis that these amendments, particularly the metabolic, are accentuated or associated with elevation of inflammatory status of obese volunteers, but on the other hand, are attenuated possibly by the high concentration of serum adiponectin in normo-insulinemic group when compared to the hyperinsulinemic volunteers. Thus, it is possible however, that individuals of the obese group normo-insulinemic can later evolve to hyperinsulinemic reciprocally to reduction of adiponectin levels / Doutorado / Fisiopatologia Médica / Doutora em Ciências
2

Microalbuminuria, heavy metals and cardiovascular risk factors in Hong Kong Chinese school children.

January 2011 (has links)
Xiao, Kang. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2011. / Includes bibliographical references (leaves 83-103). / Abstracts in English and Chinese. / Abstract --- p.I / 摘要 --- p.VI / Chapter Chapter 1 --- Background --- p.1 / Chapter 1.1 --- Introduction --- p.1 / Chapter 1.2 --- Albuminuria --- p.3 / Chapter 1.2.1 --- Definition --- p.3 / Chapter 1.2.2 --- Albuminuria in adolescents/children --- p.6 / Chapter 1.2.3 --- Prevalence of albuminuria in adults and adolescents --- p.8 / Chapter 1.2.4 --- Pathogenesis of albuminuria --- p.10 / Chapter 1.3 --- CVD and risk factors --- p.12 / Chapter 1.4 --- The associations between microalbuminuria and CVD risk factors --- p.17 / Chapter 1.5 --- Heavy metals --- p.18 / Chapter 1.5.1 --- Definition of heavy metals --- p.18 / Chapter 1.5.2 --- Adverse effects of heavy metals --- p.19 / Chapter 1.5.3 --- Heavy metals exposure In Hong Kong population: the local scene --- p.28 / Chapter 1.6 --- MicroRNAs --- p.29 / Chapter 1.6.1 --- The discovery of microRNAs --- p.29 / Chapter 1.6.2 --- The biogenesis of microRNAs --- p.30 / Chapter 1.6.3 --- The function of microRNAs --- p.31 / Chapter 1.7 --- Hypothesis --- p.40 / Chapter Chapter 2 --- Methodology --- p.41 / Chapter 2.1 --- Population --- p.41 / Chapter 2.2 --- Laboratory assays --- p.42 / Chapter 2.3 --- Statistical analysis --- p.44 / Chapter Chapter 3 --- Results --- p.46 / Chapter 3.1 --- Demographic and baseline clinical data --- p.46 / Chapter 3.2 --- Microalbuminuria and cardiovascular risk factors --- p.48 / Chapter 3.3 --- Microalbuminuria and heavy metals --- p.51 / Chapter 3.4 --- Microalbuminuria and miRNAs --- p.54 / Chapter 3.5 --- "Microalbuminuria, miRNAs, heavy metals and cardiovascular risk factors" --- p.57 / Chapter 3.6 --- miRNAs and heavy metals --- p.60 / Chapter Chapter 4 --- Discussion --- p.62 / Chapter 4.1 --- Heavy metals and microalbuminuria --- p.62 / Chapter 4.2 --- Heavy metals and CVD risk factors --- p.68 / Chapter 4.3 --- Microalbuminuria and CVD risk factors --- p.75 / Chapter 4.4 --- miRNAs and Heavy metals --- p.76 / Chapter 4.5 --- miRNAs and microalbuminuria --- p.77 / Chapter 4.6 --- Conclusion --- p.79 / Acknowledgement --- p.82 / References --- p.83

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