Maria-Antonieta Montano-Reyes’s research while affiliated with Médica Sur Clinic Foundation and other places

The expected survival rate in patients with liver cirrhosis has increased in recent years, putting them into a clinical scenario in which cardiovascular disease and metabolic syndrome could be common causes of morbidity and mortality. This study aimed to analyze the prevalence of metabolic syndrome and other risk factors and estimate the risk of cardiovascular disease in patients with liver cirrhosis. We conducted a cross-sectional study assessing the patients' lifestyle, and their anthropometric and biochemical data. Their metabolic syndrome and estimates of their risk of cardiovascular disease were calculated, comparing patients with and without liver cirrhosis. The study included 355 patients (99 cirrhotic and 256 non-cirrhotic patients). There were no differences between them in the prevalence of metabolic syndrome (39.4% vs. 45.7%, P = 0.340). In patients with liver cirrhosis, the mean values of criteria for metabolic syndrome increased as the model end-stage liver disease (MELD) score increased (P = 0.01). The mean value of a 10-year risk for cardiovascular disease was lower in the cirrhotic patients (3.4 +/- 3.5% vs. 5.8 +/- 6.8%, P = 0.001). Metabolic syndrome is prevalent in patients with liver cirrhosis, but their estimated risk for cardiovascular disease is lower than in non-cirrhotics. The MELD score is a good marker for assessing the severity of the metabolic syndrome in this group.

Objective: Objective: Objective: Objective: Objective: Although the information on metabolic syndrome is overwhelming, reports regarding workers are scarce, especially those evaluating cardiovascular disease. Using biochemical mark-ers, we investigated the prevalence of metabolic syndrome and cardiovascular risk in nurses at University Hospital, Mexico City. Methods: Methods: Methods: Methods: Methods: This was a cross-sectional study; 78% (n = 479) of nurses from our hospital participated. Anthropometric, diet, lipid and lipoprotein data, and ultrasensitive measures of C-reactive protein were obtained. Metabolic syndrome was assessed accord-ing to the ATP III criteria. Risk of cardiovascular disease was deter-mined by C-reactive protein levels and low-density lipoprotein/ high-density lipoprotein and cholesterol/high-density lipoprotein ratios. Results: Results: Results: Results: Results: Among 370 participating nurses, the prevalence of metabolic syndrome was 12.4%. The prevalence of BMI ≥ 27 was 82.6% in those with metabolic syndrome, and 28.1% in those without metabolic syndrome (P < 0.05), and the prevalence of BMI ≥ 30 was 69.6% in those with metabolic syndrome and 13.3% in those without metabolic syndrome (P < 0.05). High levels of C-reactive protein (> 3 mg/L) were observed in 61% of nurses with metabolic syndrome and 27% of those without metabolic syndrome (P < 0.05). Subjects with metabolic syndrome more commonly had a moderate or high risk of cardiovascular disease, according to cholesterol/lipids ratios. Conclusions: Conclusions: Conclusions: Conclusions: Conclusions: The prevalence of met-abolic syndrome was similar to that in the general population. However, a high prevalence of overweight and obesity among nurses with metabolic syndrome could be a determinant of a fu-ture cardiovascular disease.

To summarize the evidence available for the clinical effectiveness of insulin sensitizers in the treatment of nonalcoholic fatty liver disease (NAFLD) systematically. Relevant articles were located using computer-assisted searches of Medline (1966-March 2006), EMBASE (1988-March 2006), CINAHL (1982-March 2003), Educational Resource Information Center (1966-March 2006), Library, Information Science and Technology Abstracts (1967-March 2006), Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects (1994-2006), dissertations in ProQuest and FirstSearch databases. Manual searches were made in the abstracts from meetings of the American Gastroenterological Association (1999-2006), and the American Association for the Study of Liver Diseases (2003-2005). Studies were retrieved using the following selection criteria: (1) clinical trials using insulin sensitizers in subjects with NAFLD, (2) adult patients, (3) published as full manuscripts or abstracts, and (4) English, Spanish, German, and French languages only. Data were abstracted independently by two reviewers following standardized procedures. A face-to-face comparison of data was conducted to ensure the completeness and reliability of the abstraction process. Nine studies were included, six using metformin and three using thiazolidinediones. Only two studies were placebo-controlled trials. The median sample size for all studies was 18 subjects. In the placebo-controlled trials, metformin improved insulin resistance markers and liver function tests, but not histological scores. In the single-arm trials, metformin and thiazolidinediones improved insulin resistance markers and liver function tests, and beneficial histological changes were reported. There is limited high-quality information available from which to draw categorical conclusions about the clinical use of insulin sensitizers in NAFLD. Current information indicates that the use of insulin sensitizers in NAFLD improves insulin resistance and liver function. Histological changes must be corroborated in randomized controlled trials.