Browsing by Author "Fardella, C."

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    Central Obesity and the Metabolic Syndrome Are Associated with Portal and Not Systemic Hypercortisolism Supported by the Raise of Urinary Corticosteroid Metabolites
    (2010) Baudrand, R.; Campino, C.; Carvajal, C. A.; Olivieri, O.; Guidi, G.; Faccini, G.; Pasini, F.; Sateler, J.; Cornejo, J.; San Martin, B.; Dominguez, J. M.; Mosso, L. M.; Owen, G.; Kalergis, A. M.; Fardella, C.; NCD Risk Factor Collaboration (NCD-RisC)
    Background: There is paucity of information about bone metabolism during pregnancy or breast feeding in teenagers. Aim: To study bone turnover at the end of pregnancy and during breast feeding in teenagers and correlate it with environmental, hormonal or nutritional variables. Subjects and methods: Thirty teenagers during their breast feeding period after a first pregnancy and 30 nulliparous girls matched for age, age of menarche and body mass index were assessed three weeks after delivery (period 1), at six months of breast feeding (period 2) and one year after the lactating period (period 3). Calcium intake and plasma calcium, phosphorus, alkaline phosphatases, parathormone, estradiol and prolactin were measured. Calcium, creatinine and hydroxypyroline were also measured in a morning urine samples. Results: Lactating and control girls were aged 16.3+/-0.8 and 16.1+/-0.7 years old respectively. Calcium intake in lactating and control girls was 798+/-421 and 640+/-346 g/day respectively in period 1, 612+/-352 and 592+/-309 mg/day in period 2 and 495+/-180 and 456+/-157 g/day in period 3. During periods 1 and 2, lactating girls had higher alkaline phosphatases (161+/-37 compared to 119+/-28 U/l and 149+/-37 compared to 106+/-23 U/l), parathormone (4.3+/-2.6 compared to 2/8+/-0.8 ng/dl and 3.6+/-1.6 compared to 3.0+/-0.9 ng/dl) and urinary hydroxyproline (95+/-16 compared to 63+/-15 mg/g creatinine and 84+/-19 compared to 59+/-15 mg/g creatinine). No differences were observed in period 3. No correlation between bone turnover variables, body mass index or hormonal parameters, was observed. Conclusions: In teenagers, there is an increase in bone turnover at the end of pregnancy, that persists during the lactating period. These changes are not relaxed to nutritional or hormonal variables.
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    Neutral endopeptidase and angiotensin I converting enzyme insertion/deletion gene polymorphism in humans
    (2004) Braun, S.; Chamorro, G.; Córdova, S.; Fardella, C.; Godoy, I.; Jalil, J.E.; Lavandero, S.; Michel, J-B.; Oliveri, C.; Ocaranza Jeraldino, María Paz
    Neutral endopeptidase (NEP) hydrolyses angiotensins (Ang) I and II and generates angiotensin-(1-7) [Ang-(17)]. In humans, the insertion/deletion (I/D) angiotensin- I converting enzyme ( ACE) gene polymorphism determined plasma ACE levels by 40%. In rats,
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    Visceral Hypercortisolism Observed in Central Obesity and Metabolic Syndrome Is Associated with Insulin Resistance and Beta Cell Dysfunction.
    (2010) Baudrand, R.; Campino, C.; Carvajal, C. A.; Olivieri, O.; Guidi, G.; Faccini, G.; Pasini, F.; Sateler, J.; Cornejo, J.; San Martin, B.; Dominguez, J. M.; Tabilo, C.; Mosso, L. M.; Owen, G.; Kalergis, A. M.; Fardella, C.
    There is evidence that primary aldosteronism (PA) may be common in patients with essential hypertension (EH) when determinations of serum aldosterone (SA), plasma renin activity(PRA), and the SA/PRA ratio are used as screening. An inherited form of primary hyperaldosteronism is the glucocorticoid-remediable aldosteronism (GRA) caused by an unequal crossing over between the CYP11B1 and CYP11B2 genes that results in a chimeric gene, which has aldosterone synthase activity regulated by ACTH. The aim of this study was to evaluate the prevalence of PA and the GRA in 305 EH patients and 205 normotensive controls. We measured SA (1-16 ng/dL) and PRA (1-2.5 ng/mL . h) and calculated the SA/PRA ratio in all patients. A SA/PRA ratio level greater than 25 was defined as being elevated. PA was diagnosed in the presence of high SA levels (>16 ng/dL), low PRA levels (<0.5 ng/mL . h), and very high SA/PRA ratio (>50). Probable PA was diagnosed when the SA/PRA ratio was more than 25 but the other criteria were not present. A Fludrocortisone test was done to confirm the diagnosis. GRA was differentiated from other forms of PA by: the aldosterone suppression test with dexamethasone, the high levels of 18-hydroxycortisol, and the genetic detection of the chimeric gene. In EH patients, 29 of 305 (9.5%) had PA, 13 of 29 met all the criteria for PA, and 16 of 29 were initially diagnosed as having a probable PA and confirmed by the fludrocortisone test. Plasma potassium was normal in all patients. The dexamethasone suppression test was positive for GRA in 10 of 29 and 18-hydroxycortisol levels were high in 2 of 29 patients who had also a chimeric gene. In normotensive subjects, 3 of 205 (1.46%) had PA, and 1 of 205 had a GRA. In summary, we found a high frequency of normokalemic PA in EH patients. A high proportion of PA suppressed SA with dexamethasone, but only a few had a chimeric gene or high levels of 18-hydroxycortisol. These results emphasize the need to further investigate EH patients.