Background/Objectives: Approximately 25% of the world’s population and more than 60% of patients with type 2 diabetes (T2D) have metabolic-dysfunction-associated steatotic liver disease (MASLD). The association between these pathologies is an important cause of morbidity and mortality in Brazil and worldwide due to the high frequency of advanced fibrosis and cirrhosis. The objective of this study was to determine the epidemiologic and clinical-laboratory profile of patients with T2D and MASLD treated at an endocrinology reference service in a state in northeastern Brazil, and to investigate the association of liver fibrosis with anthropometric and laboratory measurements. Methods: A cross-sectional study was performed in a specialized outpatient clinic with 240 patients evaluated from July 2022 to February 2024, using a questionnaire, physical examination, laboratory tests, and liver elastography with FibroScan^®. Results: Estimates showed that women (adjusted OR = 2.69, 95% CI = 1.35–5.35, p = 0.005), obesity (adjusted OR = 2.23, 95% CI = 1.22–4.07, p = 0.009), high GGT (adjusted OR = 3.78, 95% CI = 2.01–7.14, p < 0. 001), high AST (adjusted OR = 6.07, 95% CI = 2.27–16.2, p < 0.001), and high ALT (adjusted OR = 3.83, 95% CI = 1.80–8.11, p < 0.001) were associated with the risk of liver fibrosis even after adjusted analysis. Conclusions: The study findings suggested that female sex and BMI were associated with an increased risk of liver fibrosis, highlighting the importance of comprehensive evaluation of these patients. In addition, FIB-4 and MAF-5 provided a good estimate of liver fibrosis in our population and may serve as a useful tool in a public health setting with limited resources.

The aim of this study was to analyze the association between birth by cesarean section and central adiposity in adolescents in São Luís, Maranhão State, Brazil. This was a cohort study that included 601 participants evaluated at birth and at 18-19 years. At birth we assessed type of delivery, maternal education, family income, maternal marital status, maternal body mass index before pregnancy, prenatal care, maternal smoking habit, gestational age at delivery and intrauterine growth restriction. In the adolescents, we evaluated central adiposity using the dual X-ray energy absorptiometry method. The indicators of central fat used were the trunk-to-total fat mass ratio (T/T), the android-to-gynoid fat mass ratio (A/G), the trunk-to-limb fat mass ratio (T/Lb), and the trunk-to-leg fat mass ratio (T/Lg). A theoretical model for the study of associations was developed using directed acyclic graphs, which allowed selecting the variables that required minimum adjustment for inclusion in the predictive model of exposure to cesarean delivery. The data were analyzed with marginal structural models weighted by the inverse of the probability of selection. A total of 38.6% of the adolescents studied were delivered by cesarean section. There was no significant difference in the central adiposity of adolescents delivered by cesarean section according to the indicators used: T/T ( coefficient = -0.003; 95%CI: -0.013; 0.007), A/G (coefficient = 0.001; 95%CI: -0.015; 0.018); T/Lb (coefficient = -0.016; 95%CI: -0.048; 0.016); T/Lg (coefficient = 0.014; 95%CI: -0.060; 0.030). In conclusion, there was no association between cesarean section delivery and greater central adiposity in the studied adolescents.

Type 1 diabetes (T1D) is a chronic disease characterized by the immune-mediated destruction of the pancreatic beta cells responsible for insulin production. The secreted insulin and C-peptide are equimolar. Due to its longer half-life, C-peptide has become a safer means of assessing the pancreatic reserve. C-peptide levels were evaluated in a population of patients with T1D, focusing on the relationship between this variable and other factors. In addition, the influence of C-peptide on metabolic control and microvascular complications was investigated. This cross-sectional study included 95 patients who had been diagnosed with T1D at least five years earlier. These patients were evaluated using a clinical demographic survey, anthropometric data, laboratory tests, and fundoscopy. This study showed that 29.5% of patients had residual insulin secretion, which correlated directly with their age at diagnosis. No statistically significant differences in metabolic control or microvascular complications were observed between the C-peptide level groups. In addition, our results indicate that ancestry does not influence the persistence of residual C-peptide function in our highly mixed population. It is recommended that future research consider incorporating new variables, such as HLA and pancreatic autoimmunity, as factors that may influence residual β-cell function.

Patients with type 1 diabetes (T1D) have a higher risk of developing cardiovascular disease (CVD), which is a major cause of death in this population. This study investigates early markers of CVD associated with clinical data and autosomal ancestry in T1D patients from an admixed Brazilian population. A cross-sectional study was conducted with 99 T1D patients. The mean age of the study sample was 27.6 years and the mean duration of T1D was 14.4 years. The frequencies of abnormalities of the early markers of CVD were 19.6% in the ankle-brachial index (ABI), 4.1% in the coronary artery calcium score (CACS), and 5% in the carotid Doppler. A significant percentage of agreement was observed for the comparison of the frequency of abnormalities between CACS and carotid Doppler (92.2%, p = 0.041). There was no significant association between the level of autosomal ancestry proportions and early markers of CVD. The ABI was useful in the early identification of CVD in asymptomatic young patients with T1D and with a short duration of disease. Although CACS and carotid Doppler are non-invasive tests, carotid Doppler is more cost-effective, and both have limitations in screening for CVD in young patients with a short duration of T1D. We did not find a statistically significant relationship between autosomal ancestry proportions and early CVD markers in an admixed Brazilian population.

Este trabalho tem por objetivo verificar a etiologia de pancreatite aguda que apresenta maior mortalidade. Foi feita revisão sistemática de estudo nas bases de dados Pubmed e Web of Science. Os descritores utilizados foram “etilogy”, “acute pancreatitis’’, ‘‘cases fatality” or ‘‘mortality”. Os estudos foram rastreados por título e resumo, seguida da leitura completa daqueles considerados elegíveis. Foram identificados 17 artigos e 11 foram incluídos no estudo por fazer parte da análise quantitativa do preenchimento. A mortalidade geral por pancreatite aguda variou de 2,7 a 11,8% nos artigos desta revisão sistemática. Os artigos classificaram as etiologias da pancreatite aguda em alcoólica, biliar, idiopática e todas as outras etiologias foram incluídas em causas diversas. A maior prevalência de mortalidade nos artigos foi em ordem decrescente para a idiopática (4 artigos), causas diversas (4 artigos) e alcoólica (3 artigos). Os percentuais de mortalidade por etiologia dessa doença variaram de 3,7 a 24,0% para causas diversas, 0 a 16,5% para idiopática, 0,8 a 15,3 para alcoólica e 0,5 a 8,9% para biliar. A pancreatite de origem biliar não foi apontada por nenhum artigo como sendo a de maior mortalidade por pancreatite aguda, apesar de ter sido a etiologia mais prevalente no diagnóstico de pancreatite aguda nos artigos desta revisão sistemática (5 artigos). É necessária a realização de novos estudos que considerem a análise de todas as etiologias da pancreatite aguda a fim de auxiliarem na construção de conhecimentos para evitar maior mortalidade por estas causam de pancreatite aguda.

COVID-19 é uma doença altamente contagiosa causada pelo SARS-CoV-2, um vírus de RNA envelopado de fita simples pertencente à família beta-coronavírus. O SARS-CoV-2 está filogeneticamente relacionado ao SARS-CoV-1, o vírus que causa a síndrome respiratória aguda grave (SARS). Assim como o SARS-CoV-1, o SARS-CoV-2 infecta tecidos humanos entrando nas células por meio do receptor da enzima conversora de angiotensina 2 (ACE2). Foi alarmante que, durante o surto de SARS-CoV-1, muitos pacientes infectados tivessem distúrbios da glândula tireoide, causando até danos celulares graves. Como o SARS-CoV-2 é semelhante ao SARS-CoV-1, os pesquisadores começaram a avaliar a possibilidade de desenvolver doenças da tireoide, especialmente a tireoidite subaguda, em pacientes infectados. Objetivo: Estabelecer uma possível relação entre o desenvolvimento de distúrbios da tireoide e o processo infeccioso causado pela infecção por SARS-CoV-2. Método: Revisão de literatura, apoiada em resultados obtidos em estudos relacionados ao tema. Resultados: Estudos realizados nas diferentes fases da infecção por SARS-COV-2 sugerem a existência de associação entre a infecção por SARS-CoV-2 e alterações na função tireoidiana. Conclusão: Embora a maioria dos pacientes seja eutireoidiana ou tenha tireoidite subaguda, outras doenças tireoidianas podem se manifestar durante a infecção por SARS-CoV-2, indicando a importância da avaliação da função tireoidiana em pacientes hospitalizados, sintomáticos e assintomáticos.