Avaliação da vasorreatividade cerebral, um marcador substituto da doença cerebrovascular, na deficiência congênita e isolada de GH
Autor(a) principal: | |
---|---|
Data de Publicação: | 2020 |
Tipo de documento: | Dissertação |
Idioma: | por |
Título da fonte: | Repositório Institucional da UFS |
Texto Completo: | http://ri.ufs.br/jspui/handle/riufs/17156 |
Resumo: | Introduction: Cerebrovascular disease is a major cause of death and disability. Overweight, diabetes mellitus, arterial hypertension, dyslipidemia, sedentary lifestyle and smoking are risk factors for cardiovascular and cerebrovascular disease. The role of the GH/IGF-I axis in the risk of cerebrovascular disease is controversial. Patients with GH deficiency (GHD) in the setting of hypopituitarism often exhibit cerebrovascular disease predisposing factors, as low nitric oxide generation, endothelial dysfunction, increased visceral fat mass, increased levels of LDL cholesterol, and increased intima-media thickness (IMT), an alternative marker of atherosclerosis. However, several confounders such as the primary hypothalamic-pituitary lesion, hormonal replacement therapies, consequences of surgery and radiotherapy, may influence this relationship. Objective: to evaluate cerebral vasoreactivity, a surrogate marker of cerebrovascular disease, in adult subjects with untreated isolated growth hormone deficiency (IGHD) due to c.57 + 1G> A mutation in the GH releasing hormone (GHRH) receptor gene. Methods: This is a cross-sectional study with 25 IGHD adult subjects and 25 age- and gendermatched controls. Interview, physical examination, laboratory exams with metabolic profile, calculus of the Framingham risk score, IMT measurement and transcranial Doppler were performed. The intracranial hemodynamics was evaluated by mean flow velocity (MFV), pulsatility (PI) and resistance indexes (RI), and the breath holding index, this one after vasodilatory stimulus of hypercapnia. Results: IGHD and control groups were similar with regard to cardiovascular risk factors, including the Framingham risk score. Carotid intima-media thickness, mean flow velocity, pulsatility, resistance and apnea indices were also similar between groups. There was a positive correlation between age with IMT, age with PI and age with RI, as well as 2-hour glucose in oral glucose tolerance test with IMT and with RI and between IMT with PI and IMT with RI. Conclusion: Lifetime, untreated IGHD does not cause impaired cerebral vasoreactivity. |
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Coutinho, Cindi Guimarães MarinhoOliveira, Manuel Hermínio de Aguiar2023-02-15T14:06:31Z2023-02-15T14:06:31Z2020COUTINHO, Cindi Guimarães Marinho. Avaliação da vasorreatividade cerebral, um marcador substituto da doença cerebrovascular, na deficiência congênita e isolada de GH. 2020. 69 f. Dissertação (Mestrado em Ciências da Saúde) - Universidade Federal de Sergipe, Aracaju, 2020.http://ri.ufs.br/jspui/handle/riufs/17156Introduction: Cerebrovascular disease is a major cause of death and disability. Overweight, diabetes mellitus, arterial hypertension, dyslipidemia, sedentary lifestyle and smoking are risk factors for cardiovascular and cerebrovascular disease. The role of the GH/IGF-I axis in the risk of cerebrovascular disease is controversial. Patients with GH deficiency (GHD) in the setting of hypopituitarism often exhibit cerebrovascular disease predisposing factors, as low nitric oxide generation, endothelial dysfunction, increased visceral fat mass, increased levels of LDL cholesterol, and increased intima-media thickness (IMT), an alternative marker of atherosclerosis. However, several confounders such as the primary hypothalamic-pituitary lesion, hormonal replacement therapies, consequences of surgery and radiotherapy, may influence this relationship. Objective: to evaluate cerebral vasoreactivity, a surrogate marker of cerebrovascular disease, in adult subjects with untreated isolated growth hormone deficiency (IGHD) due to c.57 + 1G> A mutation in the GH releasing hormone (GHRH) receptor gene. Methods: This is a cross-sectional study with 25 IGHD adult subjects and 25 age- and gendermatched controls. Interview, physical examination, laboratory exams with metabolic profile, calculus of the Framingham risk score, IMT measurement and transcranial Doppler were performed. The intracranial hemodynamics was evaluated by mean flow velocity (MFV), pulsatility (PI) and resistance indexes (RI), and the breath holding index, this one after vasodilatory stimulus of hypercapnia. Results: IGHD and control groups were similar with regard to cardiovascular risk factors, including the Framingham risk score. Carotid intima-media thickness, mean flow velocity, pulsatility, resistance and apnea indices were also similar between groups. There was a positive correlation between age with IMT, age with PI and age with RI, as well as 2-hour glucose in oral glucose tolerance test with IMT and with RI and between IMT with PI and IMT with RI. Conclusion: Lifetime, untreated IGHD does not cause impaired cerebral vasoreactivity.Introdução: A doença cerebrovascular é uma das principais causas de morte e incapacidade. A obesidade, o diabetes mellitus, a hipertensão arterial, a dislipidemia, o sedentarismo e o tabagismo são fatores de risco para doenças cardiovasculares e cerebrovasculares. O papel do eixo GH / IGF-I no risco da doença cerebrovascular é controverso. Pacientes com deficiência de GH (DGH) no cenário de hipopituitarismo geralmente exibem fatores predisponentes à doença cerebrovascular, como baixa geração de óxido nítrico, disfunção endotelial, aumento da massa de gordura visceral, aumento dos níveis de colesterol LDL e aumento da espessura médio-intimal carotídea (EMIC), um marcador alternativo da aterosclerose. No entanto, vários fatores confundidores, como lesão primária hipotalâmica-hipofisária, terapias de reposição hormonal, consequências de cirurgia e radioterapia, podem influenciar essa relação. Objetivo: Avaliar a vasorreatividade cerebral, um marcador substituto de doença cerebrovascular, em indivíduos adultos com deficiência isolada e congênita de hormônio de crescimento (DIGH), não tratada, devido à mutação c.57 + 1G> A no gene do receptor do hormônio liberador do GH (GHRH). Métodos: Trata-se de um estudo transversal com 25 indivíduos adultos com DIGH e 25 controles pareados por idade e sexo. Entrevista, exame físico, exames laboratoriais com perfil metabólico, cálculo do escore de risco de Framingham, medição da EMIC e Doppler transcraniano foram realizados. A hemodinâmica intracraniana foi avaliada pela velocidade média de fluxo (VMF), índices de pulsatilidade (IP) e de resistência (IR) e o índice de apneia, este pós estímulo vasodilatador com hipercapnia. Resultados: Os grupos DIGH e controle foram semelhantes no tocante aos fatores de risco cardiovasculares, inclusive o escore de risco de Framingham. A espessura médio-intimal carotídea, a velocidade média de fluxo, os índices de pulsatilidade, de resistência e de apneia também foram similares entre os grupos. Houve correlação positiva entre idade com EMIC, idade com IP e idade com IR, bem como entre glicemia de 2 horas ao teste oral de tolerância à glicose com EMIC e com IR e entre a EMIC com IP e a EMIC com IR. Conclusão: a DIGH congênita não tratada não causa comprometimento da vasorreatividade cerebral.AracajuporDoença cerebrovascularReceptor do GHRHHormônio do crescimentoVasoreatividade cerebralDoppler transcranianoCerebrovascular diseaseGHRH receiverGrowing hormoneCerebral vasoreactivityTranscranial DopplerCIENCIAS DA SAUDEAvaliação da vasorreatividade cerebral, um marcador substituto da doença cerebrovascular, na deficiência congênita e isolada de GHinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisPós-Graduação em Ciências da SaúdeUniversidade Federal de Sergipereponame:Repositório Institucional da UFSinstname:Universidade Federal de Sergipe (UFS)instacron:UFSinfo:eu-repo/semantics/openAccessLICENSElicense.txtlicense.txttext/plain; charset=utf-81475https://ri.ufs.br/jspui/bitstream/riufs/17156/1/license.txt098cbbf65c2c15e1fb2e49c5d306a44cMD51ORIGINALCINDI_GUIMARAES_MARINHO_COUTINHO.pdfCINDI_GUIMARAES_MARINHO_COUTINHO.pdfapplication/pdf2668305https://ri.ufs.br/jspui/bitstream/riufs/17156/2/CINDI_GUIMARAES_MARINHO_COUTINHO.pdf50557727bc691f44f56198c488d55595MD52TEXTCINDI_GUIMARAES_MARINHO_COUTINHO.pdf.txtCINDI_GUIMARAES_MARINHO_COUTINHO.pdf.txtExtracted texttext/plain93427https://ri.ufs.br/jspui/bitstream/riufs/17156/3/CINDI_GUIMARAES_MARINHO_COUTINHO.pdf.txtef55f7e5e21d5aab71e520b9cae39d5eMD53THUMBNAILCINDI_GUIMARAES_MARINHO_COUTINHO.pdf.jpgCINDI_GUIMARAES_MARINHO_COUTINHO.pdf.jpgGenerated Thumbnailimage/jpeg1180https://ri.ufs.br/jspui/bitstream/riufs/17156/4/CINDI_GUIMARAES_MARINHO_COUTINHO.pdf.jpgb7c1f47d86e2db203a0aff3a596bfcffMD54riufs/171562023-02-15 11:06:31.159oai:ufs.br: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Repositório InstitucionalPUBhttps://ri.ufs.br/oai/requestrepositorio@academico.ufs.bropendoar:2023-02-15T14:06:31Repositório Institucional da UFS - Universidade Federal de Sergipe (UFS)false |
dc.title.pt_BR.fl_str_mv |
Avaliação da vasorreatividade cerebral, um marcador substituto da doença cerebrovascular, na deficiência congênita e isolada de GH |
title |
Avaliação da vasorreatividade cerebral, um marcador substituto da doença cerebrovascular, na deficiência congênita e isolada de GH |
spellingShingle |
Avaliação da vasorreatividade cerebral, um marcador substituto da doença cerebrovascular, na deficiência congênita e isolada de GH Coutinho, Cindi Guimarães Marinho Doença cerebrovascular Receptor do GHRH Hormônio do crescimento Vasoreatividade cerebral Doppler transcraniano Cerebrovascular disease GHRH receiver Growing hormone Cerebral vasoreactivity Transcranial Doppler CIENCIAS DA SAUDE |
title_short |
Avaliação da vasorreatividade cerebral, um marcador substituto da doença cerebrovascular, na deficiência congênita e isolada de GH |
title_full |
Avaliação da vasorreatividade cerebral, um marcador substituto da doença cerebrovascular, na deficiência congênita e isolada de GH |
title_fullStr |
Avaliação da vasorreatividade cerebral, um marcador substituto da doença cerebrovascular, na deficiência congênita e isolada de GH |
title_full_unstemmed |
Avaliação da vasorreatividade cerebral, um marcador substituto da doença cerebrovascular, na deficiência congênita e isolada de GH |
title_sort |
Avaliação da vasorreatividade cerebral, um marcador substituto da doença cerebrovascular, na deficiência congênita e isolada de GH |
author |
Coutinho, Cindi Guimarães Marinho |
author_facet |
Coutinho, Cindi Guimarães Marinho |
author_role |
author |
dc.contributor.author.fl_str_mv |
Coutinho, Cindi Guimarães Marinho |
dc.contributor.advisor1.fl_str_mv |
Oliveira, Manuel Hermínio de Aguiar |
contributor_str_mv |
Oliveira, Manuel Hermínio de Aguiar |
dc.subject.por.fl_str_mv |
Doença cerebrovascular Receptor do GHRH Hormônio do crescimento Vasoreatividade cerebral Doppler transcraniano |
topic |
Doença cerebrovascular Receptor do GHRH Hormônio do crescimento Vasoreatividade cerebral Doppler transcraniano Cerebrovascular disease GHRH receiver Growing hormone Cerebral vasoreactivity Transcranial Doppler CIENCIAS DA SAUDE |
dc.subject.eng.fl_str_mv |
Cerebrovascular disease GHRH receiver Growing hormone Cerebral vasoreactivity Transcranial Doppler |
dc.subject.cnpq.fl_str_mv |
CIENCIAS DA SAUDE |
description |
Introduction: Cerebrovascular disease is a major cause of death and disability. Overweight, diabetes mellitus, arterial hypertension, dyslipidemia, sedentary lifestyle and smoking are risk factors for cardiovascular and cerebrovascular disease. The role of the GH/IGF-I axis in the risk of cerebrovascular disease is controversial. Patients with GH deficiency (GHD) in the setting of hypopituitarism often exhibit cerebrovascular disease predisposing factors, as low nitric oxide generation, endothelial dysfunction, increased visceral fat mass, increased levels of LDL cholesterol, and increased intima-media thickness (IMT), an alternative marker of atherosclerosis. However, several confounders such as the primary hypothalamic-pituitary lesion, hormonal replacement therapies, consequences of surgery and radiotherapy, may influence this relationship. Objective: to evaluate cerebral vasoreactivity, a surrogate marker of cerebrovascular disease, in adult subjects with untreated isolated growth hormone deficiency (IGHD) due to c.57 + 1G> A mutation in the GH releasing hormone (GHRH) receptor gene. Methods: This is a cross-sectional study with 25 IGHD adult subjects and 25 age- and gendermatched controls. Interview, physical examination, laboratory exams with metabolic profile, calculus of the Framingham risk score, IMT measurement and transcranial Doppler were performed. The intracranial hemodynamics was evaluated by mean flow velocity (MFV), pulsatility (PI) and resistance indexes (RI), and the breath holding index, this one after vasodilatory stimulus of hypercapnia. Results: IGHD and control groups were similar with regard to cardiovascular risk factors, including the Framingham risk score. Carotid intima-media thickness, mean flow velocity, pulsatility, resistance and apnea indices were also similar between groups. There was a positive correlation between age with IMT, age with PI and age with RI, as well as 2-hour glucose in oral glucose tolerance test with IMT and with RI and between IMT with PI and IMT with RI. Conclusion: Lifetime, untreated IGHD does not cause impaired cerebral vasoreactivity. |
publishDate |
2020 |
dc.date.issued.fl_str_mv |
2020 |
dc.date.accessioned.fl_str_mv |
2023-02-15T14:06:31Z |
dc.date.available.fl_str_mv |
2023-02-15T14:06:31Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/masterThesis |
format |
masterThesis |
status_str |
publishedVersion |
dc.identifier.citation.fl_str_mv |
COUTINHO, Cindi Guimarães Marinho. Avaliação da vasorreatividade cerebral, um marcador substituto da doença cerebrovascular, na deficiência congênita e isolada de GH. 2020. 69 f. Dissertação (Mestrado em Ciências da Saúde) - Universidade Federal de Sergipe, Aracaju, 2020. |
dc.identifier.uri.fl_str_mv |
http://ri.ufs.br/jspui/handle/riufs/17156 |
identifier_str_mv |
COUTINHO, Cindi Guimarães Marinho. Avaliação da vasorreatividade cerebral, um marcador substituto da doença cerebrovascular, na deficiência congênita e isolada de GH. 2020. 69 f. Dissertação (Mestrado em Ciências da Saúde) - Universidade Federal de Sergipe, Aracaju, 2020. |
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http://ri.ufs.br/jspui/handle/riufs/17156 |
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por |
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por |
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openAccess |
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Pós-Graduação em Ciências da Saúde |
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Universidade Federal de Sergipe |
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