Compliance with diets containing different amounts of protein was studied in 15 nonobese type 2 diabetes patients (13 males aged 38-69 y). A method based on interviews and training in the technique of weighed diet records was used. Protein intake recorded by the patients was evaluated on the basis of 24-h nitrogen output (criterion standard measurement). Three diets were prescribed in random order, each lasting 4 wk: usual diet (UD), chicken diet (CD) (both with 1.2-1.5 g protein/kg body wt), and low-protein diet (LPD; with 0.5-0.8 g protein/kg body wt). Diets were isoenergetic and similar in fat content. Nutritional status was not altered during the study according to anthropometric indexes (body mass index, triceps skinfold thickness, midupper arm muscle area, and waist-to-hip ratio) and laboratory data (serum albumin, hematocrit, and lymphocyte values). The correlation of protein intake recorded on the weighed diet records with that estimated by nitrogen output was 0.64 for the UD (P = 0.01), 0.79 for the CD (P < 0.001), and 0.66 for the LPD (P = 0.008). No difference was found in mean protein intake (g/kg body wt) calculated from the weighed diet records and nitrogen output for the UD (1.37 compared with 1.36 g/kg body wt) and CD (1.38 compared with 1.32 g/kg body wt). With the LPD, patients did not consume more protein than prescribed, but underreported their actual protein intake by 13% (0.68 compared with 0.78 g/kg body wt, P < 0.05) . In conclusion, the method of weighed diet records was sufficiently accurate for assessing protein intake in this sample of type 2 diabetes patients.

Introduction: Systemic lupus erythematosus (SLE) is an autoimmune disease, with higher prevalence in women. An incidence peak occurs during the reproductive years, suggesting that estradiol may play a role in the clinical presentation of SLE. Anticardiolipin antibodies (ACA) are associated with antiphospholipid antibody syndrome (APLS), but can be found in patients with SLE without APLS, and relate to cardiovascular risk and nephrite. Objective: This study aimed at assessing whether the presence of ACA is associated with hormonal changes in a sample of women with SLE. Methods: Forty-seven women diagnosed with SLE according to the American College of Rheumatology criteria, aged 30.8 ± 8.12 years, were evaluated. None was on hormonal contraception, and their SLE activity was estimated using the SLE Disease Activity Index (SLEDAI). Patients were stratifi ed, according to the presence or absence of ACA, and estradiol and prolactin levels were measured. Results: Nine (19.1%) of 47 patients were positive for ACA. No differences were found between groups concerning age, duration of disease, and SLEDAI. In contrast, the median estradiol level was lower in the ACA-positive group [46.8 (21.0-72.1) pg/mL] than in the ACA-negative group [122.3 (64.8-172.7) pg/mL, P = 0.004]. Conclusion: These results suggest, for the fi rst time, an inverse association between ACA and estradiol levels in premenopausal SLE patients. Considering that both lower endogenous estradiol levels and ACA positivity are related to atherosclerosis, our fi nding may be clinically relevant in predicting cardiovascular risk and/or APLS development in SLE.

There is strong evidence on influence of sexual hormones in the immunity and development of autoimmune diseases, including systemic lupus erythematosus (SLE), in which particularly the abnormalities observed during pregnancy could play a critical role on SLE manifestations during this period. Prolactin, a pituitary hormone with increased serum levels during pregnancy and puerperium, as well as its high molecular weight isoform, the macroprolactin, has been shown to be elevated in SLE, with correlation to disease activity. However, much about the mechanisms of this association is still unknown and more studies are necessary to further understand of the influence of hormonal alterations in SLE presentation and flare-up.