Infectious Diseases Division.
Federal University of the Triângulo Mineiro.
Medicine (Baltimore). 2020 Dec 18;99(51):e23773. doi: 10.1097/MD.0000000000023773.
Chagas disease affects approximately 7 million people, causing disability and mortality in the most productive life stages of infected individuals. Considering the lifestyle of the world population, metabolic syndrome is a synergistic factor for an increased cardiovascular risk of patients with Chagas disease.This study transversally evaluated the metabolic and immunological profiles of patients with indeterminate (IF) and cardiac (CF) forms of Chagas disease and their correlations with left ventricular dysfunction (LVD).Clinical and electrical bioimpedance analysis, levels of cytokines (interferon [IFN]-γ, tumor necrosis factor [TNF]-α, interleukin [IL]-17, IL-10, and IL-33) and adipocytokines (adiponectin, leptin, and resistin), metabolic syndrome components, and brain natriuretic peptide (BNP) levels were assessed in 57 patients (13 IF and 44 CF) with a mean age of 61.63 ± 12.1 years. Chest x-ray, electrocardiogram, and echocardiogram were performed to classify the clinical forms.The CF group had a higher number of individuals with metabolic syndrome components blood pressure altered, while more participants in the CF group with LVD had low high-density lipoprotein (HDL) levels. The IF group had more participants with a higher waist-to-hip ratio (WHR). No significant difference was observed between metabolic syndrome, cytokine and adipocytokine level, and clinical forms of the disease or in relation to LVD.Individuals with the IF showed metabolic and immunological profiles compatible with increased disease control, whereas those with CF showed marked inflammatory immune response.
恰加斯病影响约 700 万人，导致感染者在最具生产力的生命阶段残疾和死亡。考虑到世界人口的生活方式，代谢综合征是增加恰加斯病患者心血管风险的协同因素。本研究横断评估了不确定（IF）和心脏（CF）形式的恰加斯病患者的代谢和免疫特征及其与左心室功能障碍（LVD）的相关性。临床和电生物阻抗分析、细胞因子（干扰素[IFN]-γ、肿瘤坏死因子[TNF]-α、白细胞介素[IL]-17、IL-10 和 IL-33）和脂肪细胞因子（脂联素、瘦素和抵抗素）水平、代谢综合征成分和脑利钠肽（BNP）水平在 57 例（13 例 IF 和 44 例 CF）患者中进行评估，平均年龄为 61.63 ± 12.1 岁。进行胸部 X 线、心电图和超声心动图检查以对临床形式进行分类。CF 组有更多的代谢综合征成分（血压改变）个体，而更多的 CF 组伴有 LVD 的患者有较低的高密度脂蛋白（HDL）水平。IF 组有更多的参与者有较高的腰臀比（WHR）。代谢综合征、细胞因子和脂肪细胞因子水平以及疾病的临床形式之间或与 LVD 之间均未观察到显著差异。IF 组的个体表现出代谢和免疫特征，提示疾病控制得到改善，而 CF 组则表现出明显的炎症免疫反应。
