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大量先天性全身脂肪营养不良患者的临床和实验室数据。

Clinical and laboratory data of a large series of patients with congenital generalized lipodystrophy.

作者信息

Lima Josivan G, Nobrega Lucia Helena C, de Lima Natalia Nobrega, do Nascimento Santos Maria Goretti, Baracho Maria F P, Jeronimo Selma Maria Bezerra

机构信息

Departamento de Medicina Clínica, Hospital Universitário Onofre Lopes (HUOL)/UFRN, Av. Nilo Peçanha, 620 - Petrópolis, Natal, RN 59012-300 Brazil ; Health Graduate Program, Natal, Brazil.

Departamento de Medicina Clínica, Hospital Universitário Onofre Lopes (HUOL)/UFRN, Av. Nilo Peçanha, 620 - Petrópolis, Natal, RN 59012-300 Brazil.

出版信息

Diabetol Metab Syndr. 2016 Mar 15;8:23. doi: 10.1186/s13098-016-0140-x. eCollection 2016.

Abstract

BACKGROUND

Berardinelli-Seip congenital lipodystrophy (BSCL) was initially described by Berardinelli in Brazil in 1954 and 5 years later by Seip in Norway. It is an autosomal recessive disease that leads to a generalized deficit of body fat, evolving with diabetes and hypertriglyceridemia. The aim of this study was to describe the clinical and laboratory characteristics of a large series of patients with BSCL.

METHODS

This is a cross-sectional study of patients with BSCL. A total of 54 cases of BSCL were diagnosed, treated and followed for the past 17 years. We report clinical and laboratorial data of 44 of those patients.

RESULTS

There was a predominance of female patients (27 patients), and the mean age was 21.3 ± 13.7 years old. The majority of patients (30/44; 68.2 %) were diabetic, and almost half of them (14/30 patients, 46.7 %) were on insulin. The mean body mass index was 19.6 ± 3.3 and the mean body fat measured by dual-energy X-ray absorptiometry (DEXA) was 5.4 ± 0.8 %. Acanthosis nigricans, acromegaloid facies, atrophic cheeks, prognathism, phlebomegaly, and muscle hypertrophy were the most common clinical features. Only two patients had triglyceridemia lower than 150 mg/dl without the use of lipid-lowering drugs. Hyperinsulinemia was present in the majority of patients, and leptin values were very low in all patients.

CONCLUSIONS

We report one of the largest series of patients with BSCL treated at a single medical center. Earlier identification of the mutations and a better understanding of the pathophysiology can aid to better treatment and decrease complications, potentially improving life quality and expectancy.

摘要

背景

贝拉尔迪内利-塞普先天性脂肪营养不良(BSCL)最初由贝拉尔迪内利1954年在巴西描述,5年后由塞普在挪威描述。它是一种常染色体隐性疾病,会导致全身脂肪缺乏,并伴有糖尿病和高甘油三酯血症。本研究的目的是描述一大组BSCL患者的临床和实验室特征。

方法

这是一项对BSCL患者的横断面研究。在过去17年中,共诊断、治疗并随访了54例BSCL患者。我们报告了其中44例患者的临床和实验室数据。

结果

女性患者居多(27例),平均年龄为21.3±13.7岁。大多数患者(30/44;68.2%)患有糖尿病,其中近一半(14/30例患者,46.7%)使用胰岛素治疗。平均体重指数为19.6±3.3,通过双能X线吸收法(DEXA)测量的平均体脂率为5.4±0.8%。黑棘皮症、肢端肥大样面容、萎缩性脸颊、突颌、静脉扩张和肌肉肥大是最常见的临床特征。只有两名患者在未使用降脂药物的情况下甘油三酯水平低于150mg/dl。大多数患者存在高胰岛素血症,所有患者的瘦素值都非常低。

结论

我们报告了在单一医疗中心治疗的最大系列BSCL患者之一。更早地识别突变并更好地理解病理生理学有助于更好地治疗并减少并发症,有可能提高生活质量和预期寿命。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5724/4793761/01dc64418028/13098_2016_140_Fig1_HTML.jpg

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