1
|
Yang X, Chen X, Xu H, Deng H, Yao B, Xu W, Lin Q. Relations Between Body Fat Mass and Insulin Resistance in Non-Obese Patients with Idiopathic Hypogonadotropic Hypogonadism and Normal Glucose Tolerance. Horm Metab Res 2022; 54:671-676. [PMID: 36206760 DOI: 10.1055/a-1933-3009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
The purpose of this study was to investigate the relationship between body fat mass and insulin resistance in non-obese patients with idiopathic hypogonadotropic hypogonadism (IHH) and normal glucose tolerance. A total of 42 patients with IHH and normal glucose tolerance, and BMI lower than 28 kg/m2 were recruited. Patients were required to have a normal glucose tolerance test for inclusion in the study. Ten Healthy subjects were recruited as control group. Laboratory studies included fasting insulin, testosterone, and lipids. Waist circumference (WC), weight, and body fat mass were measured, and waist-to-hip ratio (WHR), body mass index (BMI), HOMA-IR, and logHOMA-B were calculated. Data were compared between groups, and linear regression was used to determine relations. Blood pressure, fasting glucose, BMI, WHR, and lipids were similar between the groups. Fasting insulin levels (15.61±7.66 mIU/l vs. 7.60±3.84 mIU/l), logHOMA-B (2.39±0.29 vs. 2.03±0.21), HOMA-IR (3.38±1.71 vs. 1.64±0.91), and body fat mass (30.49±9.46% vs. 21.11±4.31%) were significantly greater in the IHH group compared with those in control group (all p<0.05). Multivariable linear regression showed that in IHH patients body fat mass was an independent predictor of fasting insulin level (β=0.71, p<0.01), logHOMA-B (β=0.02, p<0.05), and HOMA-IR (β=0.14, p<0.05). Body fat mass is an independent predictor of insulin resistance in non-obese IHH patients with normal glucose tolerance.
Collapse
Affiliation(s)
- Xubin Yang
- Department of Endocrinology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Xueyan Chen
- Department of Endocrinology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Huan Xu
- Department of Endocrinology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Hongrong Deng
- Department of Endocrinology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Bin Yao
- Department of Endocrinology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Wen Xu
- Department of Endocrinology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Qiongyan Lin
- Department of Endocrinology, Jieyang People's Hospital, Jieyang, China
| |
Collapse
|
2
|
Ranadive SM, Lofrano-Porto A, Soares EMKVK, Eagan L, Porto LGG, Smith DL. Low testosterone and cardiometabolic risks in a real-world study of US male firefighters. Sci Rep 2021; 11:14189. [PMID: 34244582 PMCID: PMC8270893 DOI: 10.1038/s41598-021-93603-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 06/10/2021] [Indexed: 11/10/2022] Open
Abstract
Low serum total testosterone (TT) is associated with increased cardiovascular risk and metabolic derangements, with fatty liver (FL) emerging as an additional cardiometabolic threat. We investigated the associations between TT and cardiometabolic (CM) health in 298 US male firefighters. Cross-sectional data from occupational health examination were analyzed. TT was categorized as low (< 264 ng/dL), borderline (264–399 ng/dL), and reference (400–916 ng/dL). Conventional CM risk factors were compared among TT categories, and between firefighters with and without FL. 81% of firefighters were obese/overweight; almost 40% had FL. In the low-TT group, only 3.1% had normal BMI, while 78.1% had FL. The low-TT group had a worse CM profile, independently of age and BMI, and a fourfold higher adjusted odds of having FL. FL was associated with lower TT, regardless of age, BMI and HbA1c. Having a FL, HbA1c ≥ 5.7% or triglycerides ≥ 150 mg/dL increased the odds for low-TT by 4.1, 2.7 and 6.6 times, respectively. These real-world data reveal strong associations between low-TT and CM risk factors and support a call for action towards screening for low-TT and FL, regardless of age, BMI or dysmetabolic conditions in firefighters. Recognizing cardiometabolic risks in firefighters provides an opportunity to lessen cardiovascular diseases burden.
Collapse
Affiliation(s)
- Sushant M Ranadive
- Department of Kinesiology, School of Public Health, University of Maryland, College Park, MD, USA
| | - Adriana Lofrano-Porto
- Adrenal and Gonadal Diseases Clinic, Section of Endocrinology and Metabolism of the University Hospital, Graduate Program in Health Sciences, University of Brasilia, UnB, Brasília, Brazil
| | - Edgard M K V K Soares
- Study Group on Exercise and Physical Activity Physiology and Epidemiology (GEAFS), Exercise Physiology Laboratory, Faculty of Physical Education, University of Brasilia, UnB, Brasília, Brazil
| | - Lauren Eagan
- Department of Kinesiology, School of Public Health, University of Maryland, College Park, MD, USA
| | - Luiz Guilherme Grossi Porto
- Study Group on Exercise and Physical Activity Physiology and Epidemiology (GEAFS), Exercise Physiology Laboratory, Faculty of Physical Education, University of Brasilia, UnB, Brasília, Brazil
| | - Denise L Smith
- First Responder Health and Safety Lab, Department of Health and Human Physiological Sciences, Skidmore College, Saratoga Springs, NY, USA.
| |
Collapse
|
3
|
Lofrano-Porto A, Soares EMKVK, Matias A, Porto LGG, Smith DL. Borderline-low testosterone levels are associated with lower left ventricular wall thickness in firefighters: An exploratory analysis. Andrology 2020; 8:1753-1761. [PMID: 32633472 PMCID: PMC7693063 DOI: 10.1111/andr.12860] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 06/30/2020] [Accepted: 07/01/2020] [Indexed: 12/20/2022]
Abstract
Background Low endogenous testosterone has been associated with increased cardiovascular risk in men. Objectives To determine the prevalence of low serum testosterone level (TT) in a cohort of male US career firefighters and to examine its relation with left ventricular wall thickness (LVWT). Materials and Methods We conducted a cross‐sectional study among 341 career firefighters, (age: 37.5 ± 10.3 years; BMI: 28.9 ± 4.5 kg/m2), who underwent an occupational medical screening examination. TT quartiles were determined, and LVWT distribution among them was plotted. Then, TT values were categorized as low (<264 ng/dL), borderline (264‐399 ng/dL), reference range (400‐916 ng/dL), and high (>916 ng/dL). To further investigate the association of mildly decreased TT on LVWT, we divided the borderline group into borderline‐low (264‐319 ng/dL) and borderline‐high (320‐399 ng/dL) ranges. LVWT values were classified as low LVWT when <0.6 cm. A multivariate model was used to compare LVWT, age, BMI, systolic blood pressure (SBP), and HbA1c among groups by TT values. Results The prevalence of low TT was 10.6% and of borderline was 26.4%, while 58.7% had levels in the reference range. The low‐TT group was older and had higher BMI and SBP as compared to the reference group (P < .01). LVWT values were different among groups (P = .04) and significantly lower in firefighters with borderline‐low TT as compared to the reference group (P < .05). This finding also occurred within obese firefighters (P = .03). The borderline‐low group had a higher adjusted risk for a low LVWT as compared to the reference group [OR: 4.11 (95% CI: 1.79‐9.43)]. Discussion Our findings highlight the possible relationship between a mild reduction in testosterone levels (borderline) and lower LVWT. Conclusions A high prevalence of subnormal TT levels (low and borderline: 37%) was observed in this relatively homogeneous cohort of career firefighters. Mildly decreased TT levels and lower LVWT might represent a preclinical condition and a window of opportunity for cardiovascular preventive interventions in firefighters.
Collapse
Affiliation(s)
- Adriana Lofrano-Porto
- Adrenal and Gonadal Diseases Clinic, Section of Endocrinology and Metabolism of the University Hospital, Molecular Pharmacology Laboratory, Graduate Program in Health Sciences, University of Brasilia - UnB, Brasilia, Brazil
| | - Edgard M K V K Soares
- Faculty of Physical Education, Exercise Physiology Laboratory, Study Group on Exercise and Physical Activity Physiology and Epidemiology, University of Brasilia - UnB, Brasilia, Brazil
| | - Alexs Matias
- Department of Health and Human Physiological Sciences, Skidmore College, First Responder Health and Safety Laboratory, Saratoga Springs, NY, USA
| | - Luiz Guilherme Grossi Porto
- Faculty of Physical Education, Exercise Physiology Laboratory, Study Group on Exercise and Physical Activity Physiology and Epidemiology, University of Brasilia - UnB, Brasilia, Brazil.,Department of Environmental Health, Harvard T.H. Chan School of Public Health (collaborator), Boston, MA, USA
| | - Denise L Smith
- Department of Health and Human Physiological Sciences, Skidmore College, First Responder Health and Safety Laboratory, Saratoga Springs, NY, USA
| |
Collapse
|
4
|
Molina-Vega M, Muñoz-Garach A, Damas-Fuentes M, Fernández-García JC, Tinahones FJ. Secondary male hypogonadism: A prevalent but overlooked comorbidity of obesity. Asian J Androl 2019; 20:531-538. [PMID: 29974886 PMCID: PMC6219298 DOI: 10.4103/aja.aja_44_18] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Male hypogonadism associated with obesity is a very prevalent condition and is increasing in parallel with the epidemic prevalence of obesity. Low testosterone levels promote higher fat mass with reduced lean mass. Male hypogonadism is related to an increase in associated cardiometabolic complications, such as hypertension, type 2 diabetes mellitus, the metabolic syndrome, and cardiovascular disease. Its influence as a comorbidity of obesity is becoming more evident and should be evaluated and treated in at-risk patients. Mechanisms involved in this relationship include body composition changes, the presence of adipokines, insulin resistance, and other factors, some of which are still unknown. Weight loss and treatment to replace testosterone levels improve the metabolic profile and quality of life in patients with obesity and hypogonadism; these beneficial effects depend on treatment modality and duration of therapy. The use of testosterone replacement therapy may be indicated, as it has not been shown to increase cardiovascular risk, and retrospective studies suggest a reduction in events in men with metabolic syndrome and type 2 diabetes.
Collapse
Affiliation(s)
- MarIa Molina-Vega
- Department of Endocrinology and Nutrition, Virgen de la Victoria Universitary Hospital, Malaga 29010, Spain
| | - Araceli Muñoz-Garach
- Department of Endocrinology and Nutrition, Virgen de la Victoria Universitary Hospital, Malaga 29010, Spain.,Institute of Biomedical Research in Málaga (IBIMA), Virgen de la Victoria Universitary Hospital, Malaga 29010, Spain
| | - Miguel Damas-Fuentes
- Department of Endocrinology and Nutrition, Virgen de la Victoria Universitary Hospital, Malaga 29010, Spain
| | - José Carlos Fernández-García
- Department of Endocrinology and Nutrition, Virgen de la Victoria Universitary Hospital, Malaga 29010, Spain.,Institute of Biomedical Research in Málaga (IBIMA), Virgen de la Victoria Universitary Hospital, Malaga 29010, Spain.,CIBER Pathophysiology of Obesity and Nutrition (CB06/003), Institute of Health Carlos III (ISCIII), Madrid 28029, Spain
| | - Francisco J Tinahones
- Department of Endocrinology and Nutrition, Virgen de la Victoria Universitary Hospital, Malaga 29010, Spain.,Institute of Biomedical Research in Málaga (IBIMA), Virgen de la Victoria Universitary Hospital, Malaga 29010, Spain.,CIBER Pathophysiology of Obesity and Nutrition (CB06/003), Institute of Health Carlos III (ISCIII), Madrid 28029, Spain
| |
Collapse
|
5
|
Haymana C, Sonmez A, Aydogdu A, Tapan S, Basaran Y, Meric C, Baskoy K, Dinc M, Yazici M, Taslipinar A, Barcin C, Yilmaz MI, Bolu E, Azal O. Visceral adiposity index and triglyceride/high-density lipoprotein cholesterol ratio in hypogonadism. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2017; 61:282-287. [PMID: 28225990 PMCID: PMC10118811 DOI: 10.1590/2359-3997000000236] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 10/10/2016] [Indexed: 11/21/2022]
Abstract
Background Cardiometabolic risk is high in patients with hypogonadism. Visceral adiposity index (VAI) and triglyceride/high-density lipoprotein cholesterol (TG/HDL-C) ratio are the practical markers of atherosclerosis and insulin resistance and independent predictors of cardiaovascular risk. To date, no study has evaluated VAI levels and TG/HDL-C ratio in hypogonadism. Subjects and methods A total of 112 patients with congenital hypogonadotrophic hypogonadism (CHH) (mean age, 21.7 ± 2.06 years) and 124 healthy subjects (mean age, 21.5 ± 1.27 years) were enrolled. The demographic parameters, VAI, TG/HDL-C ratio, asymmetric dimethylarginine (ADMA), high-sensitivity C-reactive protein (hs-CRP), and homeostatic model assessment of insulin resistance (HOMA-IR) levels were measured for all participants. Results The patients had higher total cholesterol (p = 0.04), waist circumference, triglycerides, insulin, and HOMA-IR levels (p = 0.001 for all) than the healthy subjects. VAI and ADMA and TG/HDL-C levels were also higher in patients than in healthy subjects (p < 0.001 for all). VAI was weakly correlated with ADMA (r = 0.27, p = 0.015), HOMA-IR (r = 0.22, p = 0.006), hs-CRP (r = 0.19, p = 0.04), and total testosterone (r = -0.21, p = 0.009) levels, whereas TG/HDL-C ratio was weakly correlated weakly with ADMA (r = 0.30, p = 0.003), HOMA-IR (r = 0.22, p = 0.006), and total testosterone (r = -0.16, p = 0.03) levels. Neither VAI nor TG/HDL-C ratio determined ADMA, HOMA-IR, and hs-CRP levels. Conclusions The results of this study demonstrate that patients with hypogonadism have elevated VAI and TG/HDL-C ratio. These values are significantly correlated with the surrogate markers of endothelial dysfunction, inflammation, and insulin resistance. However, the predictive roles of VAI and TG/HDL-C ratio are not significant. Prospective follow-up studies are warranted to clarify the role of VAI and TG/HDL-C ratio in predicting cardiometabolic risk in patients with hypogonadism.
Collapse
Affiliation(s)
- Cem Haymana
- Department of Endocrinology and Metabolism, Gulhane School of Medicine, Ankara, Turkey
| | - Alper Sonmez
- Department of Endocrinology and Metabolism, Gulhane School of Medicine, Ankara, Turkey
| | - Aydogan Aydogdu
- Department of Endocrinology and Metabolism, Gulhane School of Medicine, Ankara, Turkey
| | - Serkan Tapan
- Department of Biochemistry, Gulhane School of Medicine, Ankara, Turkey
| | - Yalcin Basaran
- Department of Endocrinology and Metabolism, Gulhane School of Medicine, Ankara, Turkey
| | - Coskun Meric
- Department of Endocrinology and Metabolism, Gulhane School of Medicine, Ankara, Turkey
| | - Kamil Baskoy
- Department of Endocrinology and Metabolism, Gulhane School of Medicine, Haydarpasa Training Hospital, Istanbul, Turkey
| | - Mustafa Dinc
- Department of Endocrinology and Metabolism, Gulhane School of Medicine, Ankara, Turkey
| | - Mahmut Yazici
- Department of Endocrinology and Metabolism, Gulhane School of Medicine, Ankara, Turkey
| | - Abdullah Taslipinar
- Department of Endocrinology and Metabolism, Gulhane School of Medicine, Ankara, Turkey
| | - Cem Barcin
- Department of Cardiology, Gulhane School of Medicine, Ankara, Turkey
| | | | - Erol Bolu
- Department of Endocrinology and Metabolism, Memorial Atasehir Hospital, Istanbul, Turkey
| | - Omer Azal
- Department of Endocrinology and Metabolism, Gulhane School of Medicine, Ankara, Turkey
| |
Collapse
|
6
|
Montanino Oliva M, Minutolo E, Lippa A, Iaconianni P, Vaiarelli A. Effect of Myoinositol and Antioxidants on Sperm Quality in Men with Metabolic Syndrome. Int J Endocrinol 2016; 2016:1674950. [PMID: 27752262 PMCID: PMC5056296 DOI: 10.1155/2016/1674950] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 09/07/2016] [Indexed: 01/21/2023] Open
Abstract
This prospective longitudinal study investigated the effects of a dietary supplement in patients affected by reduced sperm motility (asthenospermic males) with metabolic syndrome. The product tested was Andrositol®, which contains myoinositol (MI) as principal compound, in association with other molecules, and the parameters evaluated were semen characteristics as well as hormone and metabolic profiles. The inclusion criteria were subjects aged over 18 years, with asthenospermia and metabolic syndrome. The exclusion criteria were presence of cryptorchidism, varicocele, and prostatitis. For this study, 45 males who had such features were enrolled. Their selection was made according to the 2010 World Health Organization (WHO) criteria (5th Edition) for the Evaluation of Human Semen. Hormone and metabolic profiles and semen parameters were assessed at the beginning of the study and after three months of treatment with Andrositol. The differences between the values before and after the supplementation were found statistically significant. Andrositol normalized the metabolic profile of these patients, improving their insulin sensitivity. Moreover, testosterone levels were increased and the semen characteristics, such as sperm concentration, motility, and morphology, highly improved. In conclusion, the association of MI with other molecules (micronutrients and vitamins) could be an effective therapy for metabolic disorders, as well as hormonal and spermatic changes responsible for male infertility.
Collapse
Affiliation(s)
- Mario Montanino Oliva
- Department of Obstetrics & Gynecology, Santo Spirito Hospital, 00193 Rome, Italy
- Altamedica IVF Unit, 00198 Rome, Italy
- *Mario Montanino Oliva:
| | | | | | | | - Alberto Vaiarelli
- Reproductive Medicine Unit, University Hospital, 98122 Messina, Italy
| |
Collapse
|
7
|
Systematic Literature Review of the Epidemiology of Nongenetic Forms of Hypogonadism in Adult Males. ACTA ACUST UNITED AC 2014. [DOI: 10.1155/2014/190347] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
This study summarizes the literature on the prevalence, incidence, and proportion of patients receiving treatment for male hypogonadism and a systematic literature search was performed for articles published in the last 20 years. Of the 97 studies identified, 96 examined the prevalence, 2 examined the incidence, and 4 examined the proportion of males with hypogonadism patients receiving treatment. Based on studies conducted in Europe and USA, the prevalence of hypogonadism in the general population ranged from 2.1% to 12.8% of middle-aged to older men, with an estimated incidence of 12 new cases per 1,000 person-years. Prevalence was higher among patients with comorbid conditions, such as type 2 diabetes mellitus and obesity. Approximately 10–12% of men with hypogonadism were receiving testosterone treatment. This literature review suggests that there is potentially a significant burden of hypogonadism in the general population. Burden seems to increase with age and in the presence of certain disease conditions. Data suggests that many hypogonadal men who may benefit from testosterone replacement are not receiving treatment. This may be the result of underdiagnosis of the disease, lack of awareness by patients or physicians, irregularities surrounding the diagnostic criteria, and deficiency of long-term safety studies.
Collapse
|
8
|
de Sá EQC, de Sá FCF, Oliveira KC, Feres F, Verreschi ITN. Association between sex hormone-binding globulin (SHBG) and metabolic syndrome among men. SAO PAULO MED J 2014; 132:111-5. [PMID: 24714992 PMCID: PMC10896580 DOI: 10.1590/1516-3180.2014.1322666] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Revised: 07/14/2013] [Accepted: 07/16/2013] [Indexed: 11/22/2022] Open
Abstract
CONTEXT AND OBJECTIVE Metabolic syndrome consists of a set of factors that imply increased risk of cardiovascular diseases. The objective here was to evaluate the association between sex hormone-binding globulin (SHBG), sex hormones and metabolic syndrome among men. DESIGN AND SETTING Retrospective analysis on data from the study "Endogenous oestradiol but not testosterone is related to coronary artery disease in men", conducted in a hospital in São Paulo. METHODS Men (aged 40-70) who underwent coronary angiography were selected. The age, weight, height, waist circumference, body mass index and prevalence of dyslipidemia, hypertension and diabetes of each patient were registered. Metabolic syndrome was defined in accordance with the criteria of the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (NCEP-ATPIII). Serum samples were collected to assess the levels of glucose, total cholesterol, HDL-cholesterol (high density lipoprotein), triglycerides, albumin, SHBG, estradiol and total testosterone (TT). The levels of LDL-cholesterol (low density lipoprotein) were calculated using Friedewald's formula and free testosterone (FT) and bioavailable testosterone (BT) using Vermeulen's formula. RESULTS 141 patients were enrolled in the study. The prevalence of metabolic syndrome was significantly higher in the first SHBG tercile than in the second and third terciles. A statistically significant positive association between the SHBG and TT values was observed, but no such association was seen between SHBG, BT and FT. CONCLUSION Low serum levels of SHBG are associated with higher prevalence of metabolic syndrome among male patients, but further studies are required to confirm this association.
Collapse
Affiliation(s)
| | | | | | - Fausto Feres
- MD, PhD. Cardiologist and Hemodynamicist, Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil
| | | |
Collapse
|
9
|
Rocha-e-Silva M. Metabolic and infectious pathologies in Brazilian medical literature: a review. Clinics (Sao Paulo) 2010; 65:809-14. [PMID: 20835560 PMCID: PMC2933115 DOI: 10.1590/s1807-59322010000800012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2010] [Accepted: 06/17/2010] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE This review of original reports on metabolic and infectious diseases that were recently published in Brazilian journals is designed to inform the readership of CLINICS about their content. METHODS I conducted a search in PubMed for original research articles (clinical or basic research) recently published (2008-2009) by Brazilian medical and biological periodicals. Papers on metabolic pathologies were retrieved by searching for appropriate keywords such as metabolic syndrome and obesity. Papers on infectious disease were obtained by entering 15 different keywords for the most commonly occurring pathologies. Review articles, editorials, letters to the editor, and case reports were manually excluded. Selected titles were then categorized into appropriate sub-categories. RESULTS This search produced a total of 123 articles, which filtered down to 72 articles after eliminating editorials, review articles, letters to the Editor and case reports. Reviewed periodicals were Arquivos Brasileiros de Cardiologia, Arquivos Brasileiros de Endocrinologia e Metabologia, Brazilian Journal of Biological and Medical Research, Brazilian Journal of Infectious Diseases, Jornal de Pediatria, Jornal de Pneumologia, Revista da Associação Médica Brasileira, Revista da Escola de Enfermagem da Universidade de São Paulo, and São Paulo Medical Journal. The articles were then briefly summarized.
Collapse
|