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R Albero Gamboa

Publications and source records attributed to R Albero Gamboa.

16 recordsLinked to original sources
PubMed1999

[Leptin in the endocrinology of obesity].

The article summarizes the endocrinology axis in relation to leptin in the obesity. There is a glucocorticoid hypothesis in the obesity origin. Human plasma leptin levels are elevated in Cushing's syndrome and there is a robust leptin secretory responses to dexamethasone. Obesity impacts on reproductive function in man and women. Leptin levels are higher in women than in men and a critical blood leptin level is necessary to trigger reproductive ability in women. The relationship between body mass index and circulating leptin varies during the course of spontaneous cycles in women, the best correlation occurring during the luteal phase when progesterone and leptin concentrations are highest. Obesity is associated with a decrease in growth hormone (GH) and reversible with weight loss. The influence of body composition on GH secretion in the obesity may be mediated through leptin, acting as a peripheral signal from adipose tissue. Thyroid dysfunction appear not associated with alterations in serum leptin levels. There is a significant relationship between insulin and leptin, but it is not immediate, since type 2 diabetics show similar leptin levels to those of nondiabetic humans of the same body mass index.

Adult↗
PubMed1998

[Diabetes in hemodialysis: study of differential factors].

OBJECTIVES: In uremic patients with diabetes mellitus, morbi-mortality on maintenance hemodialysis is considerably higher than in nondiabetic patients. This is mainly due to age, seniority and quality of the hemodialysis therapy, nutritional status, plasmatic lipid levels and associated pathology. We compare all these factors in the uremic patients under hemodialysis in diabetics and non-diabetics. METHODS: We have studied 307 uremic patients under hemodialysis therapy during 199 and 1996. Sixty of them had been diagnosticated of diabetes mellitus (19.6%), 17 were type I (DM-I) and 27 were type II (DM-II). We selected two control groups no-diabetics, one for each subgroup of diabetics with similar characteristics in age, sex and hemodialysis seniority. The control group for DM-I were 34 patients and for DM-II were 54 patients. RESULTS: Ideal body weight percentage, body mass index, mid-arm muscle circumference percentil, serum albumin and prealbumin are subnormal for DM-I. By considering whole nutritional date, a moderate to severe malnutrition was observed in 79% of DM-I patients, 50.4% of all non diabetics and only in 30.6% of patients included in the DM-II group. However, DM-II patients present hypertrigliceridemia and a decrease in HDL cholesterol and apolipoprotein A levels with a high atherogenic index. Significantly higher rates of associated pathology were observed among both types of diabetic patients than their control groups and especially referred to cardiovascular and neurological diseases. CONCLUSIONS: In conclusion, diabetes mellitus is an increasing incidence pathology in hemodialysis programs, that is associated to a higher morbi-mortality because vascular disease. Undernutrition is the main factor in DM-II whereas hyperlipidemia is in DM-II.

Adult↗
PubMed1996

[Lipid metabolism and new dietetic recommendations in diabetes mellitus].

Abnormalities of plasma lipids are highly prevalent in both types of diabetes, but there are important quantitative and qualitative differences that this paper reviews. The importance of abnormalities in lipoprotein metabolism as determinant of vascular risk in general population is similar in diabetes, where there is chronic hyperglycemia associated, but it is considered as an independent vascular risk factor. People with IDDM in adequate glycemic control generally have plasma lipid concentrations in normal levels, but in NIDDM, even in good glycemic control, there are another factors associated and usually there are hypertriglyceridemia and total hypercholesterolemia with reduced HDL fraction. Carbohydrate-rich diet increase plasma triglyceride levels and low HDL-cholesterol levels in the majority of studies. Substitute monounsaturated fats in the diet to replace saturated fats lowers total cholesterol and LDL fraction and increase HDL, in addition it acts over others vascular risk factors. These findings were taken into account by ADA and recently revises their 1986 dietary recommendations with the same goals of medical nutrition therapy but with individualized approach appropriate for the personal life style to facilitate adherence to achieve the glycemic, lipid body weight and blood pressure aims with a good quality of live.

Cholesterol↗
PubMed1996

[Pseudo-idiopathic hypoparathyroidism].

Hypoparathyroidism can exist due to one or more of the following pathogenic mechanisms: 1) Parathyroid Hormone (PTH) deficit, b) biologically inactive PTH, c) PTH antagonists and d) target tissues defects. Biologically inactive PTH secretion, also named pseudo-idiopathic hypoparathyroidism, is an exceptional cause of hypoparathyroidism. We report a case of a patient with this illness. A 71-year-old male with a past history of cataracts since he was 48 was admitted to our hospital. Laboratory data showed a total calcium of 4.82 mg/dl, ionized calcium of 2.72 mg/dl, serum phosphate 5.30 mg/dl, intact PTH 83 pg/ml (N 15-60), osteocalcin 2,4 ng/ml (N 9-30), tubular resorption of phosphate 96% and 1.25 di-hydroxycholecalciferol 7 pg/ml (N 18-78); creatinine and magnesium values were between normal limits. The Ellsworth-Howard test showed a normal response of both urinary c-AMP excretion and phosphaturia to PTH. We review the diagnostic clues of hypoparathyroidism and the value of the Ellsworth-Howard test in order to enable distinction between the several variants of the syndrome.

Aged↗
PubMed1993

[The fructosamine monitoring of the effect on glycemic control of hypocaloric parenteral nutritional support with glycerol].

The objective of this paper is to examine the usefulness of plasmatic fructosamine finding as an indicator of glycemic control in patients with hypocaloric parenteral nutrition with glycerol. Thirty abdominal surgery patients were studied. None displayed malnutrition, diabetes mellitus, hepatopathy, nephropathy or hyperlipemia in the preoperative stage or during the five days of postoperative recovery they were administered hypocaloric parenteral nutrition with glycerol. Their plasma levels of glucose, fructosamine, triglycerides, albumin and total proteins were found in the preoperative stage and on the first and fourth day of postoperative recovery. Following surgery, findings showed an increase in triglycerides and a decrease in the protein compartment, while glycemia levels remained steady. Furthermore there was a positive correlation between the figures for glycemia and later fructosamine figures. The conclusion was that providing hypocaloric nutrition with glycerol does not increase fructosamine levels. This confirmed prior observations on the slightness of its effect on hydrocarbonic metabolisms.

Abdomen↗
PubMedDate not supplied

[The outlook for hormonal therapy in nutrition].

When the supply of energetic substrates is insufficient to slow the development of the catabolism, the next step is to focus on the neuro-endocrine mechanism which regulates the anabolism-catabolism balance. In this work, we review the endocrine response to stress and its implications in protein metabolism, in order to evaluate the different therapeutic possibilities available. Pharmacological blocking of the secretion of catabolic hormones (glucagon and catecholamines) has been unsuccessful up to now. Insulin is the only hormone which produces anabolism in all energetic substrates, but the results published about its administration with glucose and amino acids and its effects upon the nitrogen balance are controversial. The administration of anabolic steroids such as nandrolone, stanolone, and methenolone are usually associated with protein anabolism with minimum androgenizing action. The most recent works lead to the study of the effects of the use of GH and IGF-1 with clearly hopeful results. We have not yet acquired enough experience to use these methods in the habitual clinical practice. At the moment, the clinical studies are in the experimental stage and their application in nutrition is not accepted by the official authorities.

Energy Metabolism↗
PubMedDate not supplied

[Rate of protein catabolism as an indicator of protein ingestion in uremic patients on hemodialysis].

Protein catabolic rate (PCR) has been proposed as a indirect index of dietary protein intake, but its sensitivity has been discussed. In a group of 140 chronic uremic patients undergoing maintenance hemodialysis, we evaluated the nutritional status (body mas index: BMI, triceps skinfold thickness: TST, arm muscle circumference: AMC, serum total proteins, albumin and lymphocytes) and its relation with dietary survey and PCR levels. PCR was correlated positively with Kt/V (p: 0.0001, r: 0.45) and with seric albumin (p: 0.01, r: 0.22), whereas dietary protein intake by dietary survey (g/Prot/Kg/day) was correlated strongly with anthropometric measurements like BMI, AMC (p: 0.0001) and less with Kt/V (p: 0.01), but not with serum albumin. PCR was correlated with dietary survey results: g Prot/Kg/day (p: 0.04, r: 0.18) and Kcal/Kg/day (p: 0.03, r:0.2). The results suggest that nutritional parameters with slow evolution as anthropometric measurements could be related with usual dietary intake (dietary survey), whereas serum albumin (that vary early with recent changes of dietary intake) could be related better with a biochemical index like PCR, in these way both determinations are complementary.

Adult↗