Nível de irisina sérica, resistência à insulina e perfis lipídicos em pacientes com hidradenite supurativa: um estudo de caso‐controle | Anais Brasileiros de Dermatologia (Portuguese)

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Acredita‐se que ela inicie com queratinização perturbada do infundíbulo folicular e resulte da oclusão do acroinfundíbulo folicular terminal, leva à recorrência de nódulos inflamatórios dolorosos, abscessos, fístulas e cicatrizes. A HS afeta principalmente as áreas intertriginosas com glândulas apócrinas, mais comumente as axilas e regiões inguinais e anogenitais.<a class="elsevierStyleCrossRefs" href="#bib0180">1,2</a> A prevalência de HS relatada na literatura varia entre 0,2% e 4%.<a class="elsevierStyleCrossRef" href="#bib0190">3</a> Um estudo realizado com 1.776 pacientes com HS observou que dislipidemia, obesidade, síndrome metabólica (SM), hipertensão, diabetes mellitus (DM), doença da tireoide, síndrome do ovário policístico (SOP) e distúrbios psiquiátricos ocorreram em taxas aumentadas em pacientes com HS.<a class="elsevierStyleCrossRef" href="#bib0195">4</a> Além disso, Egeberg et al. relataram que a HS estava associada a um risco significativamente aumentado de infarto do miocárdio, acidente vascular cerebral isquêmico e morte associada a doença cardiovascular (DCV).<a class="elsevierStyleCrossRef" href="#bib0200">5</a> Consequentemente, a HS começa a ser reconhecida como uma condição inflamatória sistêmica.<a class="elsevierStyleCrossRef" href="#bib0205">6</a>A resistência à insulina (RI) é um forte preditor de DM tipo 2 e também desempenha um papel importante no risco de SM e dislipidemia. Sabe‐se que o risco de aterosclerose, DCV e eventos cardiovasculares adversos maiores é mais significativo em pacientes com DM, SM e dislipidemia.<a class="elsevierStyleCrossRef" href="#bib0210">7</a> Os tecidos adiposo e muscular secretam citocinas e outros peptídeos, denominados adipocinas e miocinas, que regulam o metabolismo humano por meio da comunicação tecidual, essencial para manter a homeostase metabólica. Akdoğan et al. encontraram níveis mais altos de visfatina (uma adipocina) em pacientes com HS do que em controles saudáveis pareados por idade e sexo.<a class="elsevierStyleCrossRef" href="#bib0215">8</a> A irisina é uma nova miocina, processada a partir do produto do gene da fibronectina de tipo III, proteína com conteúdo de domínio 5 (FNDC5) antes de ser liberada na circulação e regulada pelo coativador gama 1‐alfa do receptor ativado por proliferador de peroxissoma (PGC‐1α).<a class="elsevierStyleCrossRef" href="#bib0220">9</a> Essa miocina é secretada principalmente pelo músculo esquelético e a possível relação entre obesidade e distúrbios metabólicos associados, incluindo sensibilidade à insulina, foi investigada na literatura.<a class="elsevierStyleCrossRef" href="#bib0225">10</a> Alguns autores presumiram que a irisina poderia ser um indicador de gordura corporal, visto que estava elevada em indivíduos obesos e com SM em muitos estudos.<a class="elsevierStyleCrossRef" href="#bib0230">11</a>Este estudo teve como objetivo avaliar os níveis séricos de irisina, perfis lipídicos, frequência de RI e SM em pacientes com HS e compará‐los com controles saudáveis.MétodosO estudo incluiu 37 pacientes (M/F: 9/28) e 37 controles saudáveis pareados por sexo, idade e índice de massa corporal (IMC; M/F: 11/26) que atenderam aos critérios de inclusão: idade ≥ 18 anos, histórico negativo de câncer e diagnóstico de HS confirmado por dermatologistas, de acordo com a definição de Dessau.<a class="elsevierStyleCrossRef" href="#bib0185">2</a> Os critérios de exclusão foram gravidez; lactação; infecção ativa ou crônica; presença de outra doença dermatológica ou doença metabólica prévia (distúrbios da tireoide, DM, MS, SOP e síndrome de Cushing, entre outras) ou doenças autoimunes ou do tecido conjuntivo; história documentada de eventos cardiovasculares adversos maiores, doença renal ou hepática crônica e uso atual de agentes anti‐hiperlipidêmicos, tratamentos antidiabéticos ou outros agentes que podem afetar o metabolismo de carboidratos (p.ex., corticosteroides, retinoides). Nenhum dos participantes estava sob qualquer restrição alimentar ou tratamento sistêmico para HS por pelo menos seis meses antes da inclusão no estudo. Foram excluídos aqueles que praticavam esportes profissionais. Todos os participantes assinaram um termo de consentimento livre e esclarecido antes de sua inclusão no estudo, que foi aprovado pelo Comitê de Ética.Dados demográficos, incluindo idade, sexo, tabagismo, consumo diário de álcool, duração da doença e gravidade da doença foram registrados. A gravidade da doença foi avaliada no momento do exame clínico com estadiamento de Hurley. Circunferência da cintura (CC; cm), altura (m), peso (kg), pressão arterial sistólica (PA), PA diastólica e IMC (kg/m2) foram registrados para todos os pacientes e controles.Amostras de sangue de sangue venoso periférico foram coletadas após um jejum noturno em todos os participantes e colesterol total sérico (TC), colesterol de lipoproteína de alta densidade (HDL‐c), colesterol de lipoproteína de baixa densidade (LDL‐c), triglicérides, glicose, insulina, níveis de proteína C‐reativa (PCR), velocidade de hemossedimentação (VHS) e parâmetros hematológicos foram avaliados. Para a análise da irisina, as amostras de sangue foram centrifugadas por 15min a 1.000g e o soro foi armazenado a −80°C. Os níveis séricos de irisina foram medidos por ensaio de imunoabsorção enzimática (ELISA) fornecido pelo ElabScience Kit (Wuhan, China, Catolog n° E‐EL‐H2254) com intervalo de ensaio: 0,16–10 ng/mL e sensibilidade de 0,10 ng/mL. As amostras foram avaliadas com diluição 1/10, com coeficiente de variação intraensaio de 4,8% e coeficiente de variação interensaio de 5,6%.A SM foi diagnosticada pela presença de três ou mais critérios de acordo com o Painel de Tratamento de Adultos III do National Cholesterol Education Program (ATP‐III): CC > 102cm nos homens ou > 88cm nas mulheres; hipertrigliceridemia ≥ 150mg/dL; HDL‐c < 40mg/dL em homens e < 50mg/dL em mulheres; PA ≥ 130/85mmHg ou uso atual de medicamento para hipertensão; glicose plasmática em jejum ≥ 110mg/dL. O modelo de avaliação da homeostase da resistência à insulina (HOMA‐IR) foi calculado pela fórmula: nível de insulina em jejum (μIU/mL) × nível de glicose em jejum (mg/dL)/405. IR foi definida como HOMA‐IR > 2,5.<a class="elsevierStyleCrossRefs" href="#bib0235">12,13</a>Os dados foram analisados com IBM SPSS 15.0 para Windows v.21.0. (IBM Corp., Armonk, NY). As estatísticas descritivas foram apresentadas como números e porcentagens para variáveis categóricas e médias e desvios‐padrão para variáveis numéricas, quando apropriado. Quando as suposições paramétricas foram atendidas, o teste t de Student para amostras independentes foi usado para comparar variáveis numéricas entre pacientes e controles. O teste U de Mann‐Whitney foi usado para comparar variáveis numéricas quando as suposições paramétricas não foram atendidas. O teste do qui‐quadrado foi usado para comparar as diferenças entre os grupos nas variáveis categóricas. O coeficiente de correlação de Spearman foi considerado para analisar a associação entre as variáveis numéricas. O nível de significância foi definido como p < 0,05.ResultadosA <a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a> apresenta os principais achados demográficos e clínicos de 37 pacientes e 37 controles. Os pacientes e o grupo controle, pareados por IMC, idade e sexo, foram semelhantes em altura, peso, hábitos de fumar e consumo excessivo de álcool. A duração média da doença foi de 85,6 ± 88,9 meses. Embora o IMC tenha sido semelhante nos grupos (p=0,068), o grupo HS apresentou CC significativamente maior do que os controles saudáveis (p < 0,001). A RI foi observada em 45,9% dos pacientes e em 8,1% dos controles (p=0,003), enquanto a SM foi observada em 32,4% dos pacientes e em 5,4% dos controles (p < 0,001). Oito pacientes com HS (21,6%) foram classificados como estágio I de Hurley, 14 (37,8%) como estágio II e 15 (40,5%) como estágio III.<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>Os níveis de triglicérides, glicose plasmática e insulina foram significativamente maiores no grupo HS e não foi observada diferença estatisticamente significativa em termos de CT, HDL‐c e LDL‐c entre pacientes e controles (<a class="elsevierStyleCrossRef" href="#tbl0010">tabela 2</a>). Os valores médios de irisina foram 37,4 ± 32,6 nos pacientes e 26,2 ± 24,7 nos controles, mas essa diferença não foi estatisticamente significativa (p=0,217). PCR, VHS, leucócitos e neutrófilos foram significativamente maiores em pacientes com HS. A CC foi positivamente correlacionada com a irisina nos grupos paciente (r=0,495, p=0,002) e controle (r=0,484, p=0,002). O IMC teve correlação positiva com a irisina apenas no grupo controle (r=0,523, p=0,002). O HDL‐c foi negativamente correlacionado com irisina (r=−0,495, p=0,005); por sua vez, o LDL‐c foi positivamente correlacionado com a irisina (r=0,327, p=0,048) no grupo controle. Os resultados da análise de correlação de Spearman não mostraram correlação adicional entre a irisina e os outros parâmetros investigados.<elsevierMultimedia ident="tbl0010"></elsevierMultimedia>Não foram observadas diferenças significativas nos valores de irisina e HOMA‐IR nas comparações de acordo com os estágios de Hurley em pacientes com HS (<a class="elsevierStyleCrossRef" href="#tbl0015">tabela 3</a>).<elsevierMultimedia ident="tbl0015"></elsevierMultimedia>DiscussãoO presente estudo demonstrou que os pacientes com HS apresentam RI e SM significativamente maiores quando comparados com o grupo controle pareado por idade, sexo e IMC. Além disso, os níveis de CC, triglicérides, glicose plasmática em jejum e insulina foram estatisticamente maiores em pacientes com HS. Em estudos anteriores, os pacientes com HS apresentaram IMC mais elevados do que os controles saudáveis de mesma idade e sexo. No presente estudo, os autores compararam o IMC entre os dois grupos para eliminar possíveis fatores de confusão para a homeostase metabólica. É importante observar que a CC ainda era significativamente maior no grupo de pacientes (p < 0,001). Anteriormente, Miller et al. encontraram resultados semelhantes na CC, bem como aumento do IMC e razão cintura‐quadril em pacientes com HS quando comparados com controles.<a class="elsevierStyleCrossRef" href="#bib0245">14</a> Esses autores também observaram maior taxa metabólica basal prevista para os grupos HS quando comparados com controles saudáveis e sugeriram que o aumento da taxa metabólica basal em pacientes com HS pode refletir um metabolismo disfuncional, contribuir para o alto teor de gordura corporal. Além disso, sabe‐se que o risco cardiovascular é maior em pacientes obesos, principalmente naqueles com fenótipo adiposo abdominal/visceral.<a class="elsevierStyleCrossRef" href="#bib0250">15</a> Portanto, os presentes achados podem indicar que os pacientes com HS apresentam maior risco de eventos cardiovasculares.Em consonância com os presentes achados, Vilanova et al. incluíram 76 pacientes com HS e 61 controles saudáveis e relataram que a prevalência de SM foi três vezes mais maior em pacientes com HS do que em indivíduos controles. Em uma análise multivariada, após ajuste para idade, sexo e IMC, esses autores observaram que a HS é um fator de risco significativo para RI.<a class="elsevierStyleCrossRef" href="#bib0255">16</a> Nesse sentido, Vita et al. afirmaram que a desregulação da sinalização de mTORC1 é a chave do aumento de RI em HS: mTORC1 ativa a S6 quinase (S6K) e S6K causa fosforilação e degradação do substrato do receptor de insulina 1/2, prejudica assim a sinalização da insulina.<a class="elsevierStyleCrossRef" href="#bib0260">17</a> Outra possível explicação para a associação entre HS e RI pode ser a presença de inflamação crônica por citocinas pró‐inflamatórias, como o TNF‐α. Assim, a superprodução de TNF‐α pode prejudicar a sinalização da insulina por meio da inibição da atividade da tirosina quinase do receptor de insulina, suprime a secreção de adiponectina pelos adipócitos. A adiponectina é conhecida como uma molécula anti‐inflamatória que também regula a sensibilidade à insulina. Malara et al. observaram que os pacientes com HS apresentavam níveis reduzidos de adiponectina quando comparados com controles saudáveis pareados por sexo e idade.<a class="elsevierStyleCrossRef" href="#bib0265">18</a>No presente estudo, SM (definida de acordo com os critérios do ATPIII) foi observada com maior frequência em pacientes com HS do que no grupo controle. A HS foi associada com MS e obesidade em estudos anteriores.<a class="elsevierStyleCrossRef" href="#bib0270">19</a> Não surpreendentemente, o risco de morte associada a DCV foi maior em pacientes com HS em comparação com controles em estudos anteriores.<a class="elsevierStyleCrossRef" href="#bib0275">20</a> Kohorst et al. concluíram que esse risco era maior do que o observado em pacientes com psoríase.<a class="elsevierStyleCrossRef" href="#bib0205">6</a> Além disso, Gonzalez‐Lopez et al. observaram que há um desenvolvimento prematuro e acelerado de aterosclerose em pacientes com HS, sugeriram que a própria HS pode ser um fator de risco independente para DCV aterosclerótica precoce e eventos cardiovasculares adversos importantes relacionados.<a class="elsevierStyleCrossRef" href="#bib0280">21</a> Foi relatado que a prevalência de dislipidemia é maior em pacientes com HS do que na população normal. <a class="elsevierStyleCrossRef" href="#bib0285">22</a> No presente estudo, uma diferença estatisticamente significativa foi observada apenas nos níveis de triglicérides plasmáticos, e não nos níveis de CT ou LDL‐c em pacientes com HS.A irisina é uma miocina que leva ao aumento do gasto de energia devido à sua capacidade de estimular o “escurecimento” do tecido adiposo branco.<a class="elsevierStyleCrossRef" href="#bib0290">23</a> Em nosso estudo, os níveis plasmáticos de irisina foram mais elevados em pacientes com HS do que nos controles; no entanto, essa diferença não foi estatisticamente significativa (p=0,217). Huh et al. relataram que pacientes diabéticos tinham níveis mais elevados de irisina e afirmaram que a irisina era um preditor independente de DM.<a class="elsevierStyleCrossRef" href="#bib0295">24</a> Em outro estudo, mulheres com SOP que estavam com sobrepeso ou obesas tinham níveis elevados de irisina (∼ 15%‐20%) quando comparadas com controles de peso normal.<a class="elsevierStyleCrossRef" href="#bib0300">25</a> Da mesma maneira, foi relatado que a perda de peso (−6,31 ± 0,195%) leva a uma diminuição significativa na circulação da irisina (15%) e que a recuperação do peso faz com que os níveis de irisina voltem aos valores basais.<a class="elsevierStyleCrossRef" href="#bib0305">26</a> Crujerias et al. afirmam que, em indivíduos saudáveis, a maior parte da irisina é produzida nas células musculares, mas, na obesidade, a quantidade de irisina secretada pelo tecido adiposo é provavelmente maior.<a class="elsevierStyleCrossRef" href="#bib0310">27</a> No presente estudo, os grupos de pacientes e controle foram pareados por IMC. Portanto, essa diferença nos níveis de irisina não pode ser atribuída ao aumento do tecido adiposo. Além disso, estudos mostraram que existe uma correlação positiva entre irisina e HOMA‐IR.<a class="elsevierStyleCrossRefs" href="#bib0315">28,29</a> Assim, pacientes com HS podem ter níveis mais elevados de irisina devido aos valores mais elevados de HOMA‐IR, mas essa correlação foi estatisticamente insignificante (r=0,036, p=0,836). Além disso, os níveis de irisina estão associados positivamente ao risco de SM em indivíduos caucasianos (OR=9,44).<a class="elsevierStyleCrossRef" href="#bib0325">30</a>Níveis aumentados de irisina foram associados a eventos cardiovasculares adversos maiores em pacientes com doença coronariana estabelecida após intervenção coronária percutânea.<a class="elsevierStyleCrossRef" href="#bib0330">31</a> Em um estudo recente, Baran et al.<a class="elsevierStyleCrossRef" href="#bib0335">32</a> descobriram que os níveis séricos de irisina estavam insignificantemente aumentados em pacientes com psoríase quando comparados com controles saudáveis (p=0,38). Eles também observaram uma relação estatística positiva entre a irisina e a lipocalina‐2 (LCN‐2).<a class="elsevierStyleCrossRef" href="#bib0340">33</a> A LCN‐2 tem sido associada a IR, DM e disfunção endotelial induzida por obesidade. Baran et al. também relataram que a LCN‐2 sérica estava significativamente superexpressada em pacientes com psoríase em comparação com indivíduos saudáveis. Curiosamente, Wolk et al. encontraram expressão de LCN‐2 fortemente elevada em lesões de HS; esses autores afirmaram que granulócitos e queratinócitos eram as fontes dessa expressão. Eles sugeriram que a LCN‐2 pode servir como um biomarcador sanguíneo para a avaliação objetiva da atividade inflamatória em HS.<a class="elsevierStyleCrossRef" href="#bib0345">34</a> Em uma pesquisa posterior, esses autores relataram que a prevalência de HS aumentou em pacientes com psoríase.<a class="elsevierStyleCrossRef" href="#bib0350">35</a> Os resultados semelhantes de estudos com irisina e LCN‐2 em pacientes com HS e psoríase podem indicar uma possível ligação patogenética entre essas duas condições.O ponto forte do presente estudo é que ele foi o primeiro a avaliar a irisina em HS e suas relações com RI e outros parâmetros metabólicos. No entanto, existem algumas limitações. Primeiramente, uma pequena amostra foi avaliada. Em segundo lugar, embora indivíduos que praticam esportes profissionais não tenham sido incluídos (visto que a irisina é uma miocina), a atividade física e o nível de exercício dos pacientes e controles não foram documentados.ConclusãoPacientes com HS apresentam níveis plasmáticos de glicose, insulina, triglicerídeos e irisina sérica mais elevados em jejum do que os controles. Uma frequência aumentada de IR e SM foi observada em HS. Os resultados do presente estudo apontam a necessidade de mais atenção para a associação entre HS e homeostase metabólica desregulada; os médicos devem estar cientes das consequências clínicas e da carga geral de comorbidades em pacientes com HS.Suporte financeiroNenhum.Contribuição dos autoresEzgi Özkur: Análise estatística; aprovação da versão final do manuscrito; concepção e planejamento do estudo; elaboração e redação do manuscrito; obtenção, análise e interpretação dos dados; participação efetiva na orientação da pesquisa; participação intelectual em conduta propedêutica e/ou terapêutica de casos estudados; revisão crítica da literatura; revisão crítica do manuscrito.Yasemin Erdem: Aprovação da versão final do manuscrito; elaboração e redação do manuscrito.İlknur Kıvanç Altunay: Revisão crítica da literatura.Damla Demir: Obtenção, análise e interpretação dos dados.Nurcihan Çalışkan Dolu: Obtenção, análise e interpretação dos dados.Erdinç Serin: Revisão crítica da literatura.Aslı Aksu Çerman: Concepção e planejamento do estudo; participação efetiva na orientação da pesquisa.Conflitos de interesseNenhum." "textoCompletoSecciones" => array:1 [ "secciones" => array:11 [ 0 => array:3 [ "identificador" => "xres1434522" "titulo" => "Resumo" "secciones" => array:6 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Fundamentos" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Objetivo" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Métodos" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Resultados" ] 4 => array:2 [ "identificador" => "abst0025" "titulo" => "Limitação do estudo" ] 5 => array:2 [ "identificador" => "abst0030" "titulo" => "Conclusão" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1309558" "titulo" => "Palavras‐chave" ] 2 => array:2 [ "identificador" => "sec0005" "titulo" => "Introdução" ] 3 => array:2 [ "identificador" => "sec0010" "titulo" => "Métodos" ] 4 => array:2 [ "identificador" => "sec0015" "titulo" => "Resultados" ] 5 => array:2 [ "identificador" => "sec0020" "titulo" => "Discussão" ] 6 => array:2 [ "identificador" => "sec0025" "titulo" => "Conclusão" ] 7 => array:2 [ "identificador" => "sec0030" "titulo" => "Suporte financeiro" ] 8 => array:2 [ "identificador" => "sec0035" "titulo" => "Contribuição dos autores" ] 9 => array:2 [ "identificador" => "sec0040" "titulo" => "Conflitos de interesse" ] 10 => array:1 [ "titulo" => "Referências" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2019-10-16" "fechaAceptado" => "2020-04-09" "PalabrasClave" => array:1 [ "pt" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palavras‐chave" "identificador" => "xpalclavsec1309558" "palabras" => array:3 [ 0 => "Doenças metabólicas" 1 => "Hidradenite supurativa" 2 => "Insulina" ] ] ] ] "tieneResumen" => true "resumen" => array:1 [ "pt" => array:3 [ "titulo" => "Resumo" "resumen" => "FundamentosA hidradenite supurativa é uma doença inflamatória crônica da pele do acroinfundíbulo folicular terminal. ObjetivoAvaliar os níveis séricos de irisina, glicose plasmática, insulina e lipídios na hidradenite supurativa e elucidar possíveis associações com a atividade da doença e parâmetros inflamatórios ou metabólicos. MétodosEste estudo tipo caso‐controle incluiu 37 pacientes (M/F: 9/28) e 37 controles saudáveis pareados por sexo, idade e índice de massa corporal (M/F: 11/26). Dados demográficos, estadiamento de Hurley, glicose em jejum, insulina, colesterol total, colesterol de lipoproteína de alta densidade, colesterol de lipoproteína de baixa densidade, triglicerídeos, níveis de proteína C‐reativa, taxa de sedimentação de eritrócitos, parâmetros hematológicos e irisina sérica foram avaliados. ResultadosO grupo com hidradenite supurativa apresentou circunferência da cintura significativamente maior do que os controles (p < 0,001). A resistência à insulina, definida como valores acima de 2,5 no modelo de avaliação da homeostase da resistência à insulina, foi observada em 45,9% dos pacientes e em 8,1% dos controles (p=0,003), enquanto a síndrome metabólica foi observada em 32,4% dos pacientes e em 5,4% dos controles (p < 0,001). Além disso, os níveis plasmáticos de triglicérides, glicose e insulina foram significativamente maiores nos pacientes com hidradenite supurativa (p=0,013, p=0,001 e p=0,004, respectivamente). O nível médio de irisina foi insignificantemente maior no grupo com hidradenite supurativa (37,4 ± 32,6) do que nos controles (26,2 ± 24,7, p=0,217). Limitação do estudoA prática e os níveis de atividade física dos participantes não foram documentados. ConclusãoEste estudo indica que os pacientes com hidradenite supurativa têm níveis séricos de irisina, glicose plasmática em jejum, insulina e triglicérides mais elevados do que os controles saudáveis. Assim, os autores sugerem que pacientes com hidradenite supurativa devam ser avaliados e monitorados quanto à resistência à insulina e síndrome metabólica." "secciones" => array:6 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Fundamentos" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Objetivo" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Métodos" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Resultados" ] 4 => array:2 [ "identificador" => "abst0025" "titulo" => "Limitação do estudo" ] 5 => array:2 [ "identificador" => "abst0030" "titulo" => "Conclusão" ] ] ] ] "NotaPie" => array:2 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Como citar este artigo: Özkur E, Erdem Y, Altunay İK, Demir D, Dolu NÇ, Serin E, et al. Serum irisin level, insulin resistance, and lipid profiles in patients with hidradenitis suppurativa: a case‐control study. An Bras Dermatol. 2020;95:708–13." ] 1 => array:2 [ "etiqueta" => "☆☆" "nota" => "Trabalho realizado na Universidade de Ciências da Saúde, Şişli Etfal Training and Research Hospital, Istambul, Turquia." ] ] "multimedia" => array:3 [ 0 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Tabela 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Tabela " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "HOMA‐IR, modelo de avaliação da homeostase da resistência à insulina; IMC, índice de massa corporal." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="2" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Pacientes com HS (n = 37)</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="2" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Controles (n = 37)</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " rowspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p</th></tr><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Média ± DP \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Mín‐máx (Mediana) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Média ± DP \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Mín‐máx (Mediana) \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Idade (anos) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">34,6 ± 10,9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">17−62 (34) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">36,2 ± 9,5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">18−51 (35) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0,423 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="6" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Sexo, n (%)</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Feminino \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 (24,3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11 (29,7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0,601 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Masculino \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">28 (75,7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">26 (70,3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Altura (cm) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">170,9 ± 8,6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">150−191 (170) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">172,5 ± 7,5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">157−185 (172) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0,341 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Peso (kg) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">85,8 ± 20,6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">40−130 (82) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">79,2 ± 18,8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">49−110 (80) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0,161 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">IMC (kg/m2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">29,3 ± 6,4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16−42,4 (27,9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">27,1 ± 5,0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">21,3−36,1 (25,1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0,068 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Duração da doença (meses) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">85,6 ± 88,9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Fumante atual, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20 (54,1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15 (40,5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0,244 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Consumo excessivo de álcool, n (%) (>2 doses por dia) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 (27,0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11 (29,7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0,797 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Pressão arterial sistólica (mmHg) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">116,6 ± 12,7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">90−150 (120) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">115,4 ± 9,0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">100−130 (120) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0,612 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Pressão arterial diastólica (mmHg) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">67,7 ± 16,3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10−95 (70) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">65,0 ± 8,0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">40−80 (60) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0,070 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Circunferência da cintura (cm) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">98,8 ± 19,1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">50−145 (98) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">79,9 ± 14,0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">60−105 (80) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">< 0,001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Síndrome metabólica, n (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 (32,4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 (5,4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0,003 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Resistência à insulina, n (%)(HOMA‐IR > 2,5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">17 (45,9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 (8,1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">< 0,001 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="6" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="6" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Estadiamento de Hurley, n (%)</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 (21,6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14 (37,8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15 (40,5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2467473.png" ] ] ] ] "descripcion" => array:1 [ "pt" => "Achados demográficos e clínicos de pacientes com hidradenite supurativa e controles saudáveis" ] ] 1 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Tabela 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Tabela " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "CT, colesterol total sérico; HDL‐c, colesterol lipoproteína de alta densidade; HOMA‐IR, modelo de avaliação da homeostase da resistência à insulina; LDL‐c, colesterol lipoproteína de baixa densidade; PCR, níveis de proteína C‐reativa; VHS, velocidade de hemossedimentação; VPM, volume plaquetário médio." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="2" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Pacientes com HS (n = 37)</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="2" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Controles (n = 37)</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Média ± DP \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Mín‐máx (mediana) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Média ± DP \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Mín‐máx (mediana) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">CT (mg/dL) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">192,8 ± 42,3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">104−298 (192) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">186,1 ± 37,8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">115−290 (184) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0,489 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">HDL‐c (mg/dL) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">47,5 ± 16,2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">26−126 (45) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">46,1 ± 10,9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">27−71 (44) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0,991 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">LDL‐c (mg/dL) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">112,8 ± 33,9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11−178 (117) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">122,3 ± 28,0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">69−190 (121) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0,420 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Triglicérides (mg/dL) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">171,8 ± 147,6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">50−886 (140) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">102,8 ± 49,0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">30−244 (102) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0,013 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Glicemia plasmática em jejum (mg/dL) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">99,5 ± 14,1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">76−142 (98) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">89,8 ± 8,5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">75−116 (89) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0,001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Insulina plasmática em jejum (μIU/mL) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11,6 ± 8,8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3,1−56,1 (10) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8,1 ± 3,0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3,5−21,5 (8,1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0,004 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">HOMA‐IR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2,93 ± 2,65 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0,73−16,8 (2,48) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1,8 ± 0,74 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0,77−5,11 (1,86) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0,001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Irisina (ng/mL) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">37,4 ± 32,6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1,05−121,7 (34,2) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">26,2 ± 24,7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1,8−113,9 (19,4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0,217 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PCR (mg/dL) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8,0 ± 8,6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0,1−39,9 (5,5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5,9 ± 16,6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0−101,5 (2,4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0,002 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">VHS (mm/h) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">17,1 ± 14,7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2−76 (12) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12,5 ± 13,0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2−55 (7,5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0,021 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Plaquetas (106/mm3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">286,1 ± 72,2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">138−488 (277) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">272,2 ± 60,7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">165−465 (254) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0,312 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Hemoglobina (g/dL) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14,1 ± 1,9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9,7−16,5 (14,6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14,4 ± 1,5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10,4−17 (14,7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0,733 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Leucócitos (109/mm3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8,9 ± 2,2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5,9−15,5 (8,6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6,9 ± 1,5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4,2−10,2 (6,7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">< 0,001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Neutrófilos (109/mm3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8,8 ± 12,9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3,3−61,8 (4,8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15,3 ± 48,6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2,1−288 (4,15) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0,012 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2467471.png" ] ] ] ] "descripcion" => array:1 [ "pt" => "Comparação dos parâmetros laboratoriais em pacientes com hidradenite supurativa e controles saudáveis" ] ] 2 => array:8 [ "identificador" => "tbl0015" "etiqueta" => "Tabela 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at3" "detalle" => "Tabela " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "HOMA‐IR, modelo de avaliação da homeostase da resistência à insulina." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="6" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Estadiamento de Hurley</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="2" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">1</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="2" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">2</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="2" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">3</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Média ± DP \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Mín‐máx (mediana) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Média ± DP \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Mín‐máx (mediana) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Média ± DP \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Mín‐máx (mediana) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">HOMA‐IR \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2,51 ± 2,24 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0,73−7,88(1,69) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2,48 ± 0,91 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1,05−4,25 (2,36) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3,58 ± 3,74 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1,13−16,77 (2,66) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0,241 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Irisina \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">34,9 ± 30,3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2,4−75,9(37,7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">39,2 ± 42,4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1,1−121,7(29) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">36,9 ± 23,5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3,6−78(37,4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0,795 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2467472.png" ] ] ] ] "descripcion" => array:1 [ "pt" => "Comparação dos valores médios do modelo de avaliação da homeostase da resistência à insulina e nível de irisina em pacientes com hidradenite supurativa em relação ao estadiamento de Hurley" ] ] ] "bibliografia" => array:2 [ "titulo" => "Referências" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:35 [ 0 => array:3 [ "identificador" => "bib0180" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical practice Hidradenitis suppurativa" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "G.B.E. 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Estatísticas

Investigação

Nível de irisina sérica, resistência à insulina e perfis lipídicos em pacientes com hidradenite supurativa: um estudo de caso‐controle

Ezgi Özkura,

Autor para correspondência

ezgierdal@hotmail.com

Autor para correspondência.

, Yasemin Erdema, İlknur Kıvanç Altunaya, Damla Demira, Nurcihan Çalışkan Dolub, Erdinç Serinb, Aslı Aksu Çermana

a Departamento de Dermatologia, University of Health Sciences, Şişli Etfal Training and Research Hospital, Istambul, Turquia

b Departamento de Bioquímica, University of Health Sciences, Şişli Etfal Training and Research Hospital, Istambul, Turquia

Lido

8267

Vezes
que se leu este artigo

3168

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5099

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e 4&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">3</span></a> Um estudo realizado com 1&#46;776 pacientes com HS observou que dislipidemia&#44; obesidade&#44; s&#237;ndrome metab&#243;lica &#40;SM&#41;&#44; hipertens&#227;o&#44; diabetes <span class="elsevierStyleItalic">mellitus</span> &#40;DM&#41;&#44; doen&#231;a da tireoide&#44; s&#237;ndrome do ov&#225;rio polic&#237;stico &#40;SOP&#41; e dist&#250;rbios psiqui&#225;tricos ocorreram em taxas aumentadas em pacientes com HS&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">4</span></a> Al&#233;m disso&#44; Egeberg et al&#46; relataram que a HS estava associada a um risco significativamente aumentado de infarto do mioc&#225;rdio&#44; acidente vascular cerebral isqu&#234;mico e morte associada a doen&#231;a cardiovascular &#40;DCV&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">5</span></a> Consequentemente&#44; a HS come&#231;a a ser reconhecida como uma condi&#231;&#227;o inflamat&#243;ria sist&#234;mica&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">6</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">A resist&#234;ncia &#224; insulina &#40;RI&#41; &#233; um forte preditor de DM tipo 2 e tamb&#233;m desempenha um papel importante no risco de SM e dislipidemia&#46; Sabe&#8208;se que o risco de aterosclerose&#44; DCV e eventos cardiovasculares adversos maiores &#233; mais significativo em pacientes com DM&#44; SM e dislipidemia&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">7</span></a> Os tecidos adiposo e muscular secretam citocinas e outros pept&#237;deos&#44; denominados adipocinas e miocinas&#44; que regulam o metabolismo humano por meio da comunica&#231;&#227;o tecidual&#44; essencial para manter a homeostase metab&#243;lica&#46; Akdo&#287;an et al&#46; encontraram n&#237;veis mais altos de visfatina &#40;uma adipocina&#41; em pacientes com HS do que em controles saud&#225;veis pareados por idade e sexo&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">8</span></a> A irisina &#233; uma nova miocina&#44; processada a partir do produto do gene da fibronectina de tipo III&#44; prote&#237;na com conte&#250;do de dom&#237;nio 5 &#40;FNDC5&#41; antes de ser liberada na circula&#231;&#227;o e regulada pelo coativador gama 1&#8208;alfa do receptor ativado por proliferador de peroxissoma &#40;PGC&#8208;1&#945;&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">9</span></a> Essa miocina &#233; secretada principalmente pelo m&#250;sculo esquel&#233;tico e a poss&#237;vel rela&#231;&#227;o entre obesidade e dist&#250;rbios metab&#243;licos associados&#44; incluindo sensibilidade &#224; insulina&#44; foi investigada na literatura&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">10</span></a> Alguns autores presumiram que a irisina poderia ser um indicador de gordura corporal&#44; visto que estava elevada em indiv&#237;duos obesos e com SM em muitos estudos&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">11</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Este estudo teve como objetivo avaliar os n&#237;veis s&#233;ricos de irisina&#44; perfis lip&#237;dicos&#44; frequ&#234;ncia de RI e SM em pacientes com HS e compar&#225;&#8208;los com controles saud&#225;veis&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">M&#233;todos</span><p id="par0025" class="elsevierStylePara elsevierViewall">O estudo incluiu 37 pacientes &#40;M&#47;F&#58; 9&#47;28&#41; e 37 controles saud&#225;veis pareados por sexo&#44; idade e &#237;ndice de massa corporal &#40;IMC&#59; M&#47;F&#58; 11&#47;26&#41; que atenderam aos crit&#233;rios de inclus&#227;o&#58; idade &#8805; 18 anos&#44; hist&#243;rico negativo de c&#226;ncer e diagn&#243;stico de HS confirmado por dermatologistas&#44; de acordo com a defini&#231;&#227;o de Dessau&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">2</span></a> Os crit&#233;rios de exclus&#227;o foram gravidez&#59; lacta&#231;&#227;o&#59; infec&#231;&#227;o ativa ou cr&#244;nica&#59; presen&#231;a de outra doen&#231;a dermatol&#243;gica ou doen&#231;a metab&#243;lica pr&#233;via &#40;dist&#250;rbios da tireoide&#44; DM&#44; MS&#44; SOP e s&#237;ndrome de Cushing&#44; entre outras&#41; ou doen&#231;as autoimunes ou do tecido conjuntivo&#59; hist&#243;ria documentada de eventos cardiovasculares adversos maiores&#44; doen&#231;a renal ou hep&#225;tica cr&#244;nica e uso atual de agentes anti&#8208;hiperlipid&#234;micos&#44; tratamentos antidiab&#233;ticos ou outros agentes que podem afetar o metabolismo de carboidratos &#40;p&#46;ex&#46;&#44; corticosteroides&#44; retinoides&#41;&#46; Nenhum dos participantes estava sob qualquer restri&#231;&#227;o alimentar ou tratamento sist&#234;mico para HS por pelo menos seis meses antes da inclus&#227;o no estudo&#46; Foram exclu&#237;dos aqueles que praticavam esportes profissionais&#46; Todos os participantes assinaram um termo de consentimento livre e esclarecido antes de sua inclus&#227;o no estudo&#44; que foi aprovado pelo Comit&#234; de &#201;tica&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Dados demogr&#225;ficos&#44; incluindo idade&#44; 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velocidade de hemossedimenta&#231;&#227;o &#40;VHS&#41; e par&#226;metros hematol&#243;gicos foram avaliados&#46; Para a an&#225;lise da irisina&#44; as amostras de sangue foram centrifugadas por 15<span class="elsevierStyleHsp" style=""></span>min a 1&#46;000<span class="elsevierStyleHsp" style=""></span>g e o soro foi armazenado a &#8722;80<span class="elsevierStyleHsp" style=""></span>&#176;C&#46; Os n&#237;veis s&#233;ricos de irisina foram medidos por ensaio de imunoabsor&#231;&#227;o enzim&#225;tica &#40;ELISA&#41; fornecido pelo ElabScience Kit &#40;Wuhan&#44; China&#44; Catolog n&#176; E&#8208;EL&#8208;H2254&#41; com intervalo de ensaio&#58; 0&#44;16&#8211;10 ng&#47;mL e sensibilidade de 0&#44;10 ng&#47;mL&#46; As amostras foram avaliadas com dilui&#231;&#227;o 1&#47;10&#44; com coeficiente de varia&#231;&#227;o intraensaio de 4&#44;8&#37; e coeficiente de varia&#231;&#227;o interensaio de 5&#44;6&#37;&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">A SM foi diagnosticada pela presen&#231;a de tr&#234;s ou mais crit&#233;rios de acordo com o Painel de Tratamento de Adultos III do National Cholesterol Education Program &#40;ATP&#8208;III&#41;&#58; CC &#62; 102<span class="elsevierStyleHsp" style=""></span>cm nos homens ou &#62; 88<span class="elsevierStyleHsp" style=""></span>cm nas mulheres&#59; hipertrigliceridemia &#8805; 150<span class="elsevierStyleHsp" style=""></span>mg&#47;dL&#59; HDL&#8208;c &#60; 40<span class="elsevierStyleHsp" style=""></span>mg&#47;dL em homens e &#60; 50<span class="elsevierStyleHsp" style=""></span>mg&#47;dL em mulheres&#59; PA &#8805; 130&#47;85<span class="elsevierStyleHsp" style=""></span>mmHg ou uso atual de medicamento para hipertens&#227;o&#59; glicose plasm&#225;tica em jejum &#8805; 110<span class="elsevierStyleHsp" style=""></span>mg&#47;dL&#46; O modelo de avalia&#231;&#227;o da homeostase da resist&#234;ncia &#224; insulina &#40;HOMA&#8208;IR&#41; foi calculado pela f&#243;rmula&#58; n&#237;vel de insulina em jejum &#40;&#956;IU&#47;mL&#41; &#215; n&#237;vel de glicose em jejum &#40;mg&#47;dL&#41;&#47;405&#46; IR foi definida como HOMA&#8208;IR &#62; 2&#44;5&#46;<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">12&#44;13</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">Os dados foram analisados com IBM SPSS 15&#46;0 para Windows v&#46;21&#46;0&#46; &#40;IBM Corp&#46;&#44; Armonk&#44; NY&#41;&#46; As estat&#237;sticas descritivas foram apresentadas como n&#250;meros e porcentagens para vari&#225;veis categ&#243;ricas e m&#233;dias e desvios&#8208;padr&#227;o para vari&#225;veis num&#233;ricas&#44; quando apropriado&#46; Quando as suposi&#231;&#245;es param&#233;tricas foram atendidas&#44; o teste <span class="elsevierStyleItalic">t</span> de Student para amostras independentes foi usado para comparar vari&#225;veis num&#233;ricas entre pacientes e controles&#46; O teste U de Mann&#8208;Whitney foi usado para comparar vari&#225;veis num&#233;ricas quando as suposi&#231;&#245;es param&#233;tricas n&#227;o foram atendidas&#46; O teste do qui&#8208;quadrado foi usado para comparar as diferen&#231;as entre os grupos nas vari&#225;veis categ&#243;ricas&#46; O coeficiente de correla&#231;&#227;o de Spearman foi considerado para analisar a associa&#231;&#227;o entre as vari&#225;veis num&#233;ricas&#46; O n&#237;vel de signific&#226;ncia foi definido como p &#60; 0&#44;05&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Resultados</span><p id="par0050" class="elsevierStylePara elsevierViewall">A <a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a> apresenta os principais achados demogr&#225;ficos e cl&#237;nicos de 37 pacientes e 37 controles&#46; Os pacientes e o grupo controle&#44; pareados por IMC&#44; idade e sexo&#44; foram semelhantes em altura&#44; peso&#44; h&#225;bitos de fumar e consumo excessivo de &#225;lcool&#46; A dura&#231;&#227;o m&#233;dia da doen&#231;a foi de 85&#44;6 &#177; 88&#44;9 meses&#46; Embora o IMC tenha sido semelhante nos grupos &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;068&#41;&#44; o grupo HS apresentou CC significativamente maior do que os controles saud&#225;veis &#40;p &#60; 0&#44;001&#41;&#46; A RI foi observada em 45&#44;9&#37; dos pacientes e em 8&#44;1&#37; dos controles &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;003&#41;&#44; enquanto a SM foi observada em 32&#44;4&#37; dos pacientes e em 5&#44;4&#37; dos controles &#40;p &#60; 0&#44;001&#41;&#46; Oito pacientes com HS &#40;21&#44;6&#37;&#41; foram classificados como est&#225;gio I de Hurley&#44; 14 &#40;37&#44;8&#37;&#41; como est&#225;gio II e 15 &#40;40&#44;5&#37;&#41; como est&#225;gio III&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall">Os n&#237;veis de triglic&#233;rides&#44; glicose plasm&#225;tica e insulina foram significativamente maiores no grupo HS e n&#227;o foi observada diferen&#231;a estatisticamente significativa em termos de CT&#44; HDL&#8208;c e LDL&#8208;c entre pacientes e controles &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabela 2</a>&#41;&#46; Os valores m&#233;dios de irisina foram 37&#44;4 &#177; 32&#44;6 nos pacientes e 26&#44;2 &#177; 24&#44;7 nos controles&#44; mas essa diferen&#231;a n&#227;o foi estatisticamente significativa &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;217&#41;&#46; PCR&#44; VHS&#44; leuc&#243;citos e neutr&#243;filos foram significativamente maiores em pacientes com HS&#46; A CC foi positivamente correlacionada com a irisina nos grupos paciente &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;495&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;002&#41; e controle &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;484&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;002&#41;&#46; O IMC teve correla&#231;&#227;o positiva com a irisina apenas no grupo controle &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;523&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;002&#41;&#46; O HDL&#8208;c foi negativamente correlacionado com irisina &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#44;495&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;005&#41;&#59; por sua vez&#44; o LDL&#8208;c foi positivamente correlacionado com a irisina &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;327&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;048&#41; no grupo controle&#46; Os resultados da an&#225;lise de correla&#231;&#227;o de Spearman n&#227;o mostraram correla&#231;&#227;o adicional entre a irisina e os outros par&#226;metros investigados&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">N&#227;o foram observadas diferen&#231;as significativas nos valores de irisina e HOMA&#8208;IR nas compara&#231;&#245;es de acordo com os est&#225;gios de Hurley em pacientes com HS &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabela 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Discuss&#227;o</span><p id="par0065" class="elsevierStylePara elsevierViewall">O presente estudo demonstrou que os pacientes com HS apresentam RI e SM significativamente maiores quando comparados com o grupo controle pareado por idade&#44; sexo e IMC&#46; Al&#233;m disso&#44; os n&#237;veis de CC&#44; triglic&#233;rides&#44; glicose plasm&#225;tica em jejum e insulina foram estatisticamente maiores em pacientes com HS&#46; Em estudos anteriores&#44; os pacientes com HS apresentaram IMC mais elevados do que os controles saud&#225;veis de mesma idade e sexo&#46; No presente estudo&#44; os autores compararam o IMC entre os dois grupos para eliminar poss&#237;veis fatores de confus&#227;o para a homeostase metab&#243;lica&#46; &#201; importante observar que a CC ainda era significativamente maior no grupo de pacientes &#40;p &#60; 0&#44;001&#41;&#46; Anteriormente&#44; Miller et al&#46; encontraram resultados semelhantes na CC&#44; bem como aumento do IMC e raz&#227;o cintura&#8208;quadril em pacientes com HS quando comparados com controles&#46;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">14</span></a> Esses autores tamb&#233;m observaram maior taxa metab&#243;lica basal prevista para os grupos HS quando comparados com controles saud&#225;veis e sugeriram que o aumento da taxa metab&#243;lica basal em pacientes com HS pode refletir um metabolismo disfuncional&#44; contribuir para o alto teor de gordura corporal&#46; Al&#233;m disso&#44; sabe&#8208;se que o risco cardiovascular &#233; maior em pacientes obesos&#44; principalmente naqueles com fen&#243;tipo adiposo abdominal&#47;visceral&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">15</span></a> Portanto&#44; os presentes achados podem indicar que os pacientes com HS apresentam maior risco de eventos cardiovasculares&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Em conson&#226;ncia com os presentes achados&#44; Vilanova et al&#46; inclu&#237;ram 76 pacientes com HS e 61 controles saud&#225;veis e relataram que a preval&#234;ncia de SM foi tr&#234;s vezes mais maior em pacientes com HS do que em indiv&#237;duos controles&#46; Em uma an&#225;lise multivariada&#44; ap&#243;s ajuste para idade&#44; sexo e IMC&#44; esses autores observaram que a HS &#233; um fator de risco significativo para RI&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">16</span></a> Nesse sentido&#44; Vita et al&#46; afirmaram que a desregula&#231;&#227;o da sinaliza&#231;&#227;o de mTORC1 &#233; a chave do aumento de RI em HS&#58; mTORC1 ativa a S6 quinase &#40;S6K&#41; e S6K causa fosforila&#231;&#227;o e degrada&#231;&#227;o do substrato do receptor de insulina 1&#47;2&#44; prejudica assim a sinaliza&#231;&#227;o da insulina&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">17</span></a> Outra poss&#237;vel explica&#231;&#227;o para a associa&#231;&#227;o entre HS e RI pode ser a presen&#231;a de inflama&#231;&#227;o cr&#244;nica por citocinas pr&#243;&#8208;inflamat&#243;rias&#44; como o TNF&#8208;&#945;&#46; Assim&#44; a superprodu&#231;&#227;o de TNF&#8208;&#945; pode prejudicar a sinaliza&#231;&#227;o da insulina por meio da inibi&#231;&#227;o da atividade da tirosina quinase do receptor de insulina&#44; suprime a secre&#231;&#227;o de adiponectina pelos adip&#243;citos&#46; A adiponectina &#233; conhecida como uma mol&#233;cula anti&#8208;inflamat&#243;ria que tamb&#233;m regula a sensibilidade &#224; insulina&#46; Malara et al&#46; observaram que os pacientes com HS apresentavam n&#237;veis reduzidos de adiponectina quando comparados com controles saud&#225;veis pareados por sexo e idade&#46;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">18</span></a></p><p id="par0075" class="elsevierStylePara elsevierViewall">No presente estudo&#44; SM &#40;definida de acordo com os crit&#233;rios do ATPIII&#41; foi observada com maior frequ&#234;ncia em pacientes com HS do que no grupo controle&#46; A HS foi associada com MS e obesidade em estudos anteriores&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">19</span></a> N&#227;o surpreendentemente&#44; o risco de morte associada a DCV foi maior em pacientes com HS em compara&#231;&#227;o com controles em estudos anteriores&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">20</span></a> Kohorst et al&#46; conclu&#237;ram que esse risco era maior do que o observado em pacientes com psor&#237;ase&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">6</span></a> Al&#233;m disso&#44; Gonzalez&#8208;Lopez et al&#46; observaram que h&#225; um desenvolvimento prematuro e acelerado de aterosclerose em pacientes com HS&#44; sugeriram que a pr&#243;pria HS pode ser um fator de risco independente para DCV ateroscler&#243;tica precoce e eventos cardiovasculares adversos importantes relacionados&#46;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">21</span></a> Foi relatado que a preval&#234;ncia de dislipidemia &#233; maior em pacientes com HS do que na popula&#231;&#227;o normal&#46; <a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">22</span></a> No presente estudo&#44; uma diferen&#231;a estatisticamente significativa foi observada apenas nos n&#237;veis de triglic&#233;rides plasm&#225;ticos&#44; e n&#227;o nos n&#237;veis de CT ou LDL&#8208;c em pacientes com HS&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">A irisina &#233; uma miocina que leva ao aumento do gasto de energia devido &#224; sua capacidade de estimular o &#8220;escurecimento&#8221; do tecido adiposo branco&#46;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">23</span></a> Em nosso estudo&#44; os n&#237;veis plasm&#225;ticos de irisina foram mais elevados em pacientes com HS do que nos controles&#59; no entanto&#44; essa diferen&#231;a n&#227;o foi estatisticamente significativa &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;217&#41;&#46; Huh et al&#46; relataram que pacientes diab&#233;ticos tinham n&#237;veis mais elevados de irisina e afirmaram que a irisina era um preditor independente de DM&#46;<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">24</span></a> Em outro estudo&#44; mulheres com SOP que estavam com sobrepeso ou obesas tinham n&#237;veis elevados de irisina &#40;&#8764; 15&#37;&#8208;20&#37;&#41; quando comparadas com controles de peso normal&#46;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">25</span></a> Da mesma maneira&#44; foi relatado que a perda de peso &#40;&#8722;6&#44;31 &#177; 0&#44;195&#37;&#41; leva a uma diminui&#231;&#227;o significativa na circula&#231;&#227;o da irisina &#40;15&#37;&#41; e que a recupera&#231;&#227;o do peso faz com que os n&#237;veis de irisina voltem aos valores basais&#46;<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">26</span></a> Crujerias et al&#46; afirmam que&#44; em indiv&#237;duos saud&#225;veis&#44; a maior parte da irisina &#233; produzida nas c&#233;lulas musculares&#44; mas&#44; na obesidade&#44; a quantidade de irisina secretada pelo tecido adiposo &#233; provavelmente maior&#46;<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">27</span></a> No presente estudo&#44; os grupos de pacientes e controle foram pareados por IMC&#46; Portanto&#44; essa diferen&#231;a nos n&#237;veis de irisina n&#227;o pode ser atribu&#237;da ao aumento do tecido adiposo&#46; Al&#233;m disso&#44; estudos mostraram que existe uma correla&#231;&#227;o positiva entre irisina e HOMA&#8208;IR&#46;<a class="elsevierStyleCrossRefs" href="#bib0315"><span class="elsevierStyleSup">28&#44;29</span></a> Assim&#44; pacientes com HS podem ter n&#237;veis mais elevados de irisina devido aos valores mais elevados de HOMA&#8208;IR&#44; mas essa correla&#231;&#227;o foi estatisticamente insignificante &#40;r<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;036&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;836&#41;&#46; Al&#233;m disso&#44; os n&#237;veis de irisina est&#227;o associados positivamente ao risco de SM em indiv&#237;duos caucasianos &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>9&#44;44&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">30</span></a></p><p id="par0085" class="elsevierStylePara elsevierViewall">N&#237;veis aumentados de irisina foram associados a eventos cardiovasculares adversos maiores em pacientes com doen&#231;a coronariana estabelecida ap&#243;s interven&#231;&#227;o coron&#225;ria percut&#226;nea&#46;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">31</span></a> Em um estudo recente&#44; Baran et al&#46;<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">32</span></a> descobriram que os n&#237;veis s&#233;ricos de irisina estavam insignificantemente aumentados em pacientes com psor&#237;ase quando comparados com controles saud&#225;veis &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;38&#41;&#46; Eles tamb&#233;m observaram uma rela&#231;&#227;o estat&#237;stica positiva entre a irisina e a lipocalina&#8208;2 &#40;LCN&#8208;2&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">33</span></a> A LCN&#8208;2 tem sido associada a IR&#44; DM e disfun&#231;&#227;o endotelial induzida por obesidade&#46; Baran et al&#46; tamb&#233;m relataram que a LCN&#8208;2 s&#233;rica estava significativamente superexpressada em pacientes com psor&#237;ase em compara&#231;&#227;o com indiv&#237;duos saud&#225;veis&#46; Curiosamente&#44; Wolk et al&#46; encontraram express&#227;o de LCN&#8208;2 fortemente elevada em les&#245;es de HS&#59; esses autores afirmaram que granul&#243;citos e queratin&#243;citos eram as fontes dessa express&#227;o&#46; Eles sugeriram que a LCN&#8208;2 pode servir como um biomarcador sangu&#237;neo para a avalia&#231;&#227;o objetiva da atividade inflamat&#243;ria em HS&#46;<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">34</span></a> Em uma pesquisa posterior&#44; esses autores relataram que a preval&#234;ncia de HS aumentou em pacientes com psor&#237;ase&#46;<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">35</span></a> Os resultados semelhantes de estudos com irisina e LCN&#8208;2 em pacientes com HS e psor&#237;ase podem indicar uma poss&#237;vel liga&#231;&#227;o patogen&#233;tica entre essas duas condi&#231;&#245;es&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">O ponto forte do presente estudo &#233; que ele foi o primeiro a avaliar a irisina em HS e suas rela&#231;&#245;es com RI e outros par&#226;metros metab&#243;licos&#46; No entanto&#44; existem algumas limita&#231;&#245;es&#46; Primeiramente&#44; uma pequena amostra foi avaliada&#46; Em segundo lugar&#44; embora indiv&#237;duos que praticam esportes profissionais n&#227;o tenham sido inclu&#237;dos &#40;visto que a irisina &#233; uma miocina&#41;&#44; a atividade f&#237;sica e o n&#237;vel de exerc&#237;cio dos pacientes e controles n&#227;o foram documentados&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Conclus&#227;o</span><p id="par0095" class="elsevierStylePara elsevierViewall">Pacientes com HS apresentam n&#237;veis plasm&#225;ticos de glicose&#44; insulina&#44; triglicer&#237;deos e irisina s&#233;rica mais elevados em jejum do que os controles&#46; Uma frequ&#234;ncia aumentada de IR e SM foi observada em HS&#46; Os resultados do presente estudo apontam a necessidade de mais aten&#231;&#227;o para a associa&#231;&#227;o entre HS e homeostase metab&#243;lica desregulada&#59; os m&#233;dicos devem estar cientes das consequ&#234;ncias cl&#237;nicas e da carga geral de comorbidades em pacientes com HS&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Suporte financeiro</span><p id="par0100" class="elsevierStylePara elsevierViewall">Nenhum&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Contribui&#231;&#227;o dos autores</span><p id="par0105" class="elsevierStylePara elsevierViewall">Ezgi &#214;zkur&#58; An&#225;lise estat&#237;stica&#59; aprova&#231;&#227;o da vers&#227;o final do manuscrito&#59; concep&#231;&#227;o e planejamento do estudo&#59; elabora&#231;&#227;o e reda&#231;&#227;o do manuscrito&#59; obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; participa&#231;&#227;o efetiva na orienta&#231;&#227;o da pesquisa&#59; participa&#231;&#227;o intelectual em conduta proped&#234;utica e&#47;ou terap&#234;utica de casos estudados&#59; revis&#227;o cr&#237;tica da literatura&#59; revis&#227;o cr&#237;tica do manuscrito&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Yasemin Erdem&#58; Aprova&#231;&#227;o da vers&#227;o final do manuscrito&#59; elabora&#231;&#227;o e reda&#231;&#227;o do manuscrito&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">&#304;lknur K&#305;van&#231; Altunay&#58; Revis&#227;o cr&#237;tica da literatura&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Damla Demir&#58; Obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Nurcihan &#199;al&#305;&#351;kan Dolu&#58; Obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Erdin&#231; Serin&#58; Revis&#227;o cr&#237;tica da literatura&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Asl&#305; Aksu &#199;erman&#58; Concep&#231;&#227;o e planejamento do estudo&#59; participa&#231;&#227;o efetiva na orienta&#231;&#227;o da pesquisa&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Conflitos de interesse</span><p id="par0140" class="elsevierStylePara elsevierViewall">Nenhum&#46;</p></span></span>"
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    "fechaRecibido" => "2019-10-16"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Fundamentos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A hidradenite supurativa &#233; uma doen&#231;a inflamat&#243;ria cr&#244;nica da pele do acroinfund&#237;bulo folicular terminal&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objetivo</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Avaliar os n&#237;veis s&#233;ricos de irisina&#44; glicose plasm&#225;tica&#44; insulina e lip&#237;dios na hidradenite supurativa e elucidar poss&#237;veis associa&#231;&#245;es com a atividade da doen&#231;a e par&#226;metros inflamat&#243;rios ou metab&#243;licos&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">M&#233;todos</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Este estudo tipo caso&#8208;controle incluiu 37 pacientes &#40;M&#47;F&#58; 9&#47;28&#41; e 37 controles saud&#225;veis pareados por sexo&#44; idade e &#237;ndice de massa corporal &#40;M&#47;F&#58; 11&#47;26&#41;&#46; Dados demogr&#225;ficos&#44; estadiamento de Hurley&#44; glicose em jejum&#44; insulina&#44; colesterol total&#44; colesterol de lipoprote&#237;na de alta densidade&#44; colesterol de lipoprote&#237;na de baixa densidade&#44; triglicer&#237;deos&#44; n&#237;veis de prote&#237;na C&#8208;reativa&#44; taxa de sedimenta&#231;&#227;o de eritr&#243;citos&#44; par&#226;metros hematol&#243;gicos e irisina s&#233;rica foram avaliados&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">O grupo com hidradenite supurativa apresentou circunfer&#234;ncia da cintura significativamente maior do que os controles &#40;p &#60; 0&#44;001&#41;&#46; A resist&#234;ncia &#224; insulina&#44; definida como valores acima de 2&#44;5 no modelo de avalia&#231;&#227;o da homeostase da resist&#234;ncia &#224; insulina&#44; foi observada em 45&#44;9&#37; dos pacientes e em 8&#44;1&#37; dos controles &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;003&#41;&#44; enquanto a s&#237;ndrome metab&#243;lica foi observada em 32&#44;4&#37; dos pacientes e em 5&#44;4&#37; dos controles &#40;p &#60; 0&#44;001&#41;&#46; Al&#233;m disso&#44; os n&#237;veis plasm&#225;ticos de triglic&#233;rides&#44; glicose e insulina foram significativamente maiores nos pacientes com hidradenite supurativa &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;013&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;001 e p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;004&#44; respectivamente&#41;&#46; O n&#237;vel m&#233;dio de irisina foi insignificantemente maior no grupo com hidradenite supurativa &#40;37&#44;4 &#177; 32&#44;6&#41; do que nos controles &#40;26&#44;2 &#177; 24&#44;7&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;217&#41;&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Limita&#231;&#227;o do estudo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">A pr&#225;tica e os n&#237;veis de atividade f&#237;sica dos participantes n&#227;o foram documentados&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Conclus&#227;o</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Este estudo indica que os pacientes com hidradenite supurativa t&#234;m n&#237;veis s&#233;ricos de irisina&#44; glicose plasm&#225;tica em jejum&#44; insulina e triglic&#233;rides mais elevados do que os controles saud&#225;veis&#46; Assim&#44; os autores sugerem que pacientes com hidradenite supurativa devam ser avaliados e monitorados quanto &#224; resist&#234;ncia &#224; insulina e s&#237;ndrome metab&#243;lica&#46;</p></span>"
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      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Como citar este artigo&#58; &#214;zkur E&#44; Erdem Y&#44; Altunay &#304;K&#44; Demir D&#44; Dolu N&#199;&#44; Serin E&#44; et al&#46; Serum irisin level&#44; insulin resistance&#44; and lipid profiles in patients with hidradenitis suppurativa&#58; a case&#8208;control study&#46; An Bras Dermatol&#46; 2020&#59;95&#58;708&#8211;13&#46;</p>"
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      1 => array:2 [
        "etiqueta" => "&#9734;&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Trabalho realizado na Universidade de Ci&#234;ncias da Sa&#250;de&#44; &#350;i&#351;li Etfal Training and Research Hospital&#44; Istambul&#44; Turquia&#46;</p>"
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">IMC &#40;kg&#47;m</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Dura&#231;&#227;o da doen&#231;a &#40;meses&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Fumante atual&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Consumo excessivo de &#225;lcool&#44; n&#160;&#40;&#37;&#41; &#40;&#62;2 doses por dia&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Press&#227;o arterial sist&#243;lica &#40;mmHg&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Press&#227;o arterial diast&#243;lica &#40;mmHg&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Circunfer&#234;ncia da cintura &#40;cm&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">S&#237;ndrome metab&#243;lica&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Resist&#234;ncia &#224; insulina&#44; n &#40;&#37;&#41;</span><span class="elsevierStyleItalic">&#40;HOMA&#8208;IR &#62; 2&#44;5&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3 &#40;8&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Estadiamento de Hurley&#44; n&#160;&#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t">14 &#40;37&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">15 &#40;40&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr></tbody></table>
                  """
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                0 => "xTab2467473.png"
              ]
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        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Achados demogr&#225;ficos e cl&#237;nicos de pacientes com hidradenite supurativa e controles saud&#225;veis</p>"
        ]
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          "leyenda" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">CT&#44; colesterol total s&#233;rico&#59; HDL&#8208;c&#44; colesterol lipoprote&#237;na de alta densidade&#59; HOMA&#8208;IR&#44; modelo de avalia&#231;&#227;o da homeostase da resist&#234;ncia &#224; insulina&#59; LDL&#8208;c&#44; colesterol lipoprote&#237;na de baixa densidade&#59; PCR&#44; n&#237;veis de prote&#237;na C&#8208;reativa&#59; VHS&#44; velocidade de hemossedimenta&#231;&#227;o&#59; VPM&#44; volume plaquet&#225;rio m&#233;dio&#46;</p>"
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Pacientes com HS &#40;n <span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span> 37&#41;</th><th class="td" title="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">M&#233;dia &#177; DP&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">M&#237;n&#8208;m&#225;x &#40;mediana&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">M&#233;dia &#177; DP&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">M&#237;n&#8208;m&#225;x &#40;mediana&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">CT &#40;mg&#47;dL&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;489&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">HDL&#8208;c &#40;mg&#47;dL&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">26&#8722;126 &#40;45&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">27&#8722;71 &#40;44&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;991&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">LDL&#8208;c &#40;mg&#47;dL&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">11&#8722;178 &#40;117&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">122&#44;3 &#177; 28&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">69&#8722;190 &#40;121&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;420&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Triglic&#233;rides &#40;mg&#47;dL&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">171&#44;8 &#177; 147&#44;6&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">50&#8722;886 &#40;140&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">102&#44;8 &#177; 49&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">30&#8722;244 &#40;102&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;013&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Glicemia plasm&#225;tica em jejum &#40;mg&#47;dL&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">99&#44;5 &#177; 14&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">76&#8722;142 &#40;98&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">89&#44;8 &#177; 8&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">75&#8722;116 &#40;89&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Insulina plasm&#225;tica em jejum &#40;&#956;IU&#47;mL&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#44;6 &#177; 8&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;1&#8722;56&#44;1 &#40;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">8&#44;1 &#177; 3&#44;0&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3&#44;5&#8722;21&#44;5 &#40;8&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">0&#44;004&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">HOMA&#8208;IR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">2&#44;93 &#177; 2&#44;65&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">1&#44;8 &#177; 0&#44;74&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;77&#8722;5&#44;11 &#40;1&#44;86&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Irisina &#40;ng&#47;mL&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">37&#44;4 &#177; 32&#44;6&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1&#44;05&#8722;121&#44;7 &#40;34&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">26&#44;2 &#177; 24&#44;7&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1&#44;8&#8722;113&#44;9 &#40;19&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                            3 => "S&#46; Fisher"
                            4 => "G&#46; Shalom"
                            5 => "D&#46; Comaneshter"
                          ]
                        ]
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                      "doi" => "10.1016/j.jaad.2020.12.018"
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                        "tituloSerie" => "J Am Acad Dermatol&#46;"
                        "fecha" => "2018"
                        "volumen" => "S0190&#8211;9622"
                        "numero" => "18"
                        "paginaInicial" => "32962"
                        "paginaFinal" => "32971"
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Informação do artigo

ISSN: 26662752
Idioma original: Português

DOI:10.1016/j.abdp.2020.04.007

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