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Hiperleptinemia como factor de riesgo en hipertensión arterial asociada a obesidad
Hyperleptinemia as a risk factor in obesity-related hypertension
Cleto álvarez-Aguilaraa,**
Autor para correspondencia
calvareza@yahoo.com.mx

Correspondencia:Dr. C. Álvarez-Aguilar. Unidad de Investigación en Epidemiología Clínica. Hospital General Regional No. 1 IMSS. Delegación Michoacán.Avda. Madero Poniente, 1200. 58000 Morelia. Michoacán. México
, I Lourdes Mondragón-Jiménezb, Anel Gómez-Garcíacc, Ramón Paniagua-Sierradd, Dante Amatodd
a Unidad de Investigación en Epidemiología Clínica del HGR No. 1 IMSS. Morelia. Michoacán. México
b Laboratorio de Investigación en Diabetes Mellitus tipo 2. Centro de Investigación Biomédica de Michoacán. México
c Unidad de Investigación en Enfermedades Nefrológicas.Hospital de Especialidades Centro Médico
d Nacional Siglo XXI. IMSS. México, D.F. México
Jesús Ramírez-Enríquez
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        "resumen" => "<span class="elsevierStyleSectionTitle">FUNDAMENTO Y OBJETIVO</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Algunas observaciones otorgan un papel relevante al hongo Alternaria alternata como desencadenante de crisis de asma de riesgo vital &#40;ARV&#41;&#46; El objetivo de este trabajo fue determinar si las crisis de ARV de los pacientes sensibilizados a Alternaria cursan con un perfil cl&#237;nico diferencial&#46;</p> <span class="elsevierStyleSectionTitle">Pacientes y m&#233;todo</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio descriptivo y multic&#233;ntrico &#40;33 hospitales espa&#241;oles&#41; de 194 pacientes incluidos de forma prospectiva por padecer una crisis de ARV&#46; Se recogieron las caracter&#237;sticas y el curso cl&#237;nico de la crisis&#44; y cuando alcanzaron la estabilidad cl&#237;nica se les practicaron una espirometr&#237;a&#44; pruebas cut&#225;neas de alergia y determinaci&#243;n de IgE a Alternaria&#46; Se estableci&#243; la sensibilizaci&#243;n a Alternaria cuando la prueba cut&#225;nea o bien la IgE espec&#237;fica resultaron positivas&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">En 20 de los pacientes &#40;10&#37;&#41; se pudo constatar sensibilizaci&#243;n a Alternaria&#46; En comparaci&#243;n con el grupo de pacientes no sensibilizados&#44; los sensibilizados a Alternaria resultaron ser significativamente m&#225;s j&#243;venes&#44; con una media &#40;DE&#41; de edad de 35 &#40;15&#41; frente a 50 &#40;21&#41; a&#241;os &#40;p &#60; 0&#44;001&#41;&#59; su ingreso hospitalario fue m&#225;s corto &#8211;6&#44;5 &#40;5&#44;5&#41; frente a 9 &#40;7&#41; d&#237;as &#40;p &#61; 0&#44;039&#41;&#8211;&#59; se constat&#243; una mayor proporci&#243;n de muertes o secuelas neurol&#243;gicas graves &#8211;el 15 frente al 3&#37; &#40;p &#61; 0&#44;026&#41;&#8211;&#59; presentaron un mayor porcentaje de casos con sensibilizaci&#243;n a otros al&#233;rgenos &#8211;el 68 frente al 22&#37; &#40;p &#61; 0&#44;003&#41;&#8211; y una menor broncodilataci&#243;n tras la inhalaci&#243;n de salbutamol &#8211;el 6 frente al 10&#37; &#40;p &#61; 0&#44;013&#41;&#8211;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Las caracter&#237;sticas cl&#237;nicas constatadas en las crisis de ARV de los pacientes sensibilizados a Alternaria parecen distinguirlos como fenotipo particular&#46; Una conducta de evitaci&#243;n espec&#237;fica podr&#237;a comportar efectos beneficiosos al prevenir crisis de ARV en los pacientes sensibilizados&#46;</p>"
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