Biochemical and nutritional evaluation of patients with visceral leishmaniasis before and after treatment with leishmanicidal drugs.
BACKGROUND
Visceral leishmaniasis (VL) is caused by the intracellular protozoan Leishmania donovani complex. VL may be asymptomatic or progressive and is characterized by fever, anemia, weight loss and the enlargement of the spleen and liver. The nutritional status of the patients with VL is a major determinant of the progression, severity and mortality of the disease, as it affects the clinical progression of the disease. Changes in lipoproteins and plasma proteins may have major impacts in the host during infection. Thus, our goal was evaluate the serum total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides, glucose, albumin, globulin and total protein levels, as well as the body composition, of VL patients before and after treatment.


METHODS
Nutritional evaluation was performed using the bioelectrical impedance analysis (BIA) to assess body composition. Biochemical data on the serum total cholesterol, HDL, LDL, triglycerides, glucose, albumin, globulin and total protein were collected from the medical charts of the patients.


RESULTS
BIA indicated that both pre-treatment and post-treatment patients exhibited decreased phase angles compared to the controls, which is indicative of disease. Prior to treatment, the patients exhibited lower levels of total body water compared to the controls. Regarding the biochemical evaluation, patients with active VL exhibited lower levels of total cholesterol, HDL, LDL and albumin and higher triglyceride levels compared to patients after treatment and the controls. Treatment increased the levels of albumin and lipoproteins and decreased the triglyceride levels.


CONCLUSIONS
Our results suggest that patients with active VL present biochemical and nutritional changes that are reversed by treatment.
Departamento de Doenças Tropicais, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, São PauloSP.
Mariana
M
Gatto
Departamento de Doenças Tropicais, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, São PauloSP.
Mariana Miziara
MM
de Abreu
Departamento de Doenças Tropicais, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, São PauloSP.
Karen Ingrid
KI
Tasca
Setor de Moléstias Infecciosas, Hospital Estadual de Bauru, BauruSP.
José Cláudio
JC
Simão
Departamento de Doenças Tropicais, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, São PauloSP.
Carlos Magno Castelo Branco
CM
Fortaleza
Departamento de Doenças Tropicais, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, São PauloSP.
Paulo Câmara Marques
PC
Pereira
Departamento de Doenças Tropicais, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, São PauloSP.
Sueli Aparecida
SA
Calvi
D000293:Adolescent; D000328:Adult; D000418:Albumins / Q000032:analysis; D000981:Antiprotozoal Agents / Q000627:therapeutic use*; D015992:Body Mass Index; D005260:Female; D005916:Globulins / Q000032:analysis; D005947:Glucose / Q000032:analysis; D006801:Humans; D007898:Leishmaniasis, Visceral / Q000097:blood* / Q000188:drug therapy*; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D011506:Proteins / Q000032:analysis; D055815:Young Adult
D000418:Albumins; D000981:Antiprotozoal Agents; D005916:Globulins; D008055:Lipids; D011506:Proteins; D005947:Glucose