The effects of humic water on endothelial cells under hyperglycemic conditions: inflammation-associated parameters.

Humic waters (HW) are globally unique, deep underground, dark-brown waters containing humic acids, and they present numerous therapeutic activities including anti-inflammatory. In the present study, we use HW from source in Poland. Diabetes has become an epidemic and is a risk factor of cardiovascular diseases. Hyperglycemia in diabetes is responsible for damaging of the endothelium and increases inflammation on the surface of the vascular lining. The inflammatory process in diabetes is associated with the secretion of inflammatory cytokines by endothelial cells, e.g., tumor necrosis factor alpha (TNFα) and interleukin 6 (IL-6), and with the reduction of cell proliferation. In the study, we used cultures of endothelial cells (HUVEC line-human umbilical vein endothelial cells) with the addition 30 mM/L of glucose in the culture medium which imitated the conditions of uncontrolled diabetes. The addition of HW in the proper volume to the culture medium causes reduction of inflammation by significant decrease in inflammatory cytokines such as TNFα and IL-6 and also leads to enhancement of the cell proliferation. It appears that the adverse effects of hyperglycemia on vascular endothelial cells may be corrected by addition of humic water. The above promising results of in vitro tests provide an opportunity to the possible use of humic water in the supportive treatment of endothelial dysfunction disorders in diabetes. However, this issue requires further clinical research.

Low-level laser irradiation modifies the effect of hyperglycemia on adhesion molecule levels.

Endothelium plays a key role in maintaining vascular homeostasis by secreting active factors involved in many biological processes such as hemostasis, angiogenesis, and inflammation. Hyperglycemia in diabetic patients causes dysfunction of endothelial cells. Soluble fractions of adhesion molecules like sE-selectin and vascular cell adhesion molecule (sVCAM) are considered as markers of endothelial damage. The low-level laser therapy (LLLT) effectively supports the conventional treatment of vascular complications in diabetes, for example hard-to-heal wounds in patients with diabetic foot syndrome. The aim of our study was to evaluate the effect of low-energy laser at the wavelength of 635 nm (visible light) and 830 nm (infrared) on the concentration of adhesion molecules: sE-selectin and sVCAM in the supernatant of endothelial cell culture of HUVEC line. Cells were cultured under high-glucose conditions of 30 mM/L. We have found an increase in sE-selectin and sVCAM levels in the supernatant of cells cultured under hyperglycemic conditions. This fact confirms detrimental influence of hyperglycemia on vascular endothelial cell cultures. LLLT can modulate the inflammation process. It leads to a decrease in sE-selectin and sVCAM concentration in the supernatant and an increase in the number of endothelial cells cultured under hyperglycemic conditions. The influence of LLLT is greater at the wavelength of 830 nm.

Low-level laser irradiation effect on endothelial cells under conditions of hyperglycemia.

Diabetes mellitus is considered to be a very serious lifestyle disease leading to cardiovascular complications and impaired wound healing observed in the diabetic foot syndrome. Chronic hyperglycemia is the source of the endothelial activation. The inflammatory process in diabetes is associated with the secretion of inflammatory cytokines by endothelial cells, e.g., tumor necrosis factor-alpha (TNF-α) and interleukin 6 (IL-6). The method of phototherapy using laser beam of low power (LLLT-low-level laser therapy) effectively supports the conventional treatment of diabetic vascular complications such as diabetic foot syndrome. The aim of our study was to evaluate the effect of low-power laser irradiation at two wavelengths (635 and 830 nm) on the secretion of inflammatory factors (TNF-α and IL-6) by the endothelial cell culture-HUVEC line (human umbilical vein endothelial cell)-under conditions of hyperglycemia. It is considered that adverse effects of hyperglycemia on vascular endothelial cells may be corrected by the action of LLLT, especially with the wavelength of 830 nm. It leads to the reduction of TNF-α concentration in the supernatant and enhancement of cell proliferation. Endothelial cells play an important role in the pathogenesis of diabetes; however, a small number of studies evaluate an impact of LLLT on these cells under conditions of hyperglycemia. Further work on this subject is warranted.

Effect of LLLT on endothelial cells culture.

Growth factors as vascular endothelial growth factor (VEGF), produced by the endothelial cells, take an essential part in pathological and physiological angiogenesis. The possibility of angiogenesis modulation by application of laser radiation may contribute to the improvement of its use in this process. Thus, the aim of the study was to investigate the influence of low-level laser therapy (LLLT) on the proliferation of endothelial cells, secretion of VEGF-A and presence of soluble VEGF receptors (sVEGFR-1 and sVEGFR-2) in the medium after in vitro culture. Isolated human umbilical vein endothelial cells (HUVECs) were irradiated using a diode laser at a wavelength of 635 nm and power density of 1,875 mW/cm(2). Depending on radiation energy density, the experiment was conducted in four groups: I 0 J/cm(2) (control group), II 2 J/cm(2), III 4 J/cm(2), and IV 8 J/cm(2). The use of laser radiation wavelength of 635 nm, was associated with a statistically significant increase in proliferation of endothelial cells (p = 0.0041). Moreover, at 635-nm wavelength, all doses of radiation significantly reduced the concentration of sVEGFR-1 (p = 0.0197).

Insulin resistance as estimated by the homeostatic method at diagnosis of gestational diabetes: estimation of disease severity and therapeutic needs in a population-based study.

BACKGROUND: Chronic insulin resistance, exacerbated in the course of pregnancy, is an important pathophysiologic mechanism of gestational diabetes mellitus (GDM). We hypothesise that the degree of insulin resistance, assessed at diagnosis of GDM, is a parameter of its pathophysiologic heterogeneity and/or severity. Thus, it offers potential to open new avenues for the personalization of therapy in affected women. METHODS: 1254 Polish Caucasian women with GDM were recruited into the study. The following parameters were assessed in the course of the study: body mass index (BMI), parity, weight gain during pregnancy, glycated haemoglobin, glucose level during an oral glucose tolerance test (OGTT), insulin, insulin resistance and insulin secretion. The severity of GDM was assessed based on insulin use and daily insulin dose during gestation. In order to evaluate insulin secretion and insulin resistance the homeostatic method was used (HOMA-B and HOMA-IR, respectively). We compared all the metabolic parameters and methods of treatment of GDM in women subdivided by quartiles of insulin resistance. RESULTS: The HOMA-IR in the whole population ranged from 0.34 to 20.39. The BMI, fasting insulin, fasting glucose and insulin dose per day increased along with increasing quartiles (HOMA-IR > 1.29). We observed a decrease of HOMA-B in the third quartile (1.92-2.89) compared with the first quartile (0.34-1.29). Insulin treatment was associated with HOMA-IR (<1.29 vs. >2.89), OR: 3.37, fasting glucose (≤6.11 vs. >6.11 mmol/dl), OR: 2.61, age (≤30 vs. >30 y. o.), OR: 1.54, and BMI (<25 vs. ≥25 kg/m2), OR: 1.45. Maximum insulin dose was associated with HOMA-IR, OR: 2.00, after adjustment for family history of diabetes, and 2-h OGTT glucose. CONCLUSION: Insulin resistance assessed by the HOMA index at diagnosis is associated with the severity and pathophysiological heterogeneity of GDM. A HOMA-IR >1.29 points to the major role of insulin resistance, indicating the need for a treatment aimed at improving tissue sensitivity to insulin. A HOMA-IR 1.29-2.89 suggests reduced insulin secretion, which is an indication for the introduction of insulin therapy. A HOMA-IR >2.89 indicates insufficient compensation for insulin resistance, which suggests the need for a treatment aimed at improving susceptibility of tissues to insulin combined with insulin therapy.

Adiponectin and endothelial markers in postmenopausal women taking oral or transdermal hormone therapy.

OBJECTIVE: To assess the concentration of adiponectin, soluble E-selectin, soluble thrombomodulin and tissue activator plasminogen antigen in postmenopausal women who received oral or transdermal hormone therapy. DESIGN: Case-control study. SETTING: Polish university hospitals. POPULATION: Seventy-six healthy postmenopausal women. METHOD: Forty-six women who received oral (n = 26) or transdermal (n = 20) hormone therapy and a control group without such medication (n = 30), all aged 44-58 years. MAIN OUTCOME MEASURES: Plasma concentrations of adiponectin, soluble E-selectin, soluble thrombomodulin and tissue activator plasminogen antigen by enzyme-linked immunosorbent assay. RESULTS: We found a significantly higher concentration of adiponectin in women on oral and transdermal therapy in comparison to the control group and a significantly lower concentration of soluble E-selectin in women who received oral hormone therapy vs. the control group. A significantly higher concentration of tissue activator plasminogen antigen was obtained in the group of women using transdermal menopausal hormone therapy compared with those receiving oral therapy and with the control group. CONCLUSIONS: Reduced levels of soluble E-selectin in women using menopausal hormone therapy could lead to reduction in the intensity of expression of the adhesion factors on the surface of the vascular endothelium. Menopausal hormone therapy might have advantageous effects on vascular endothelial function through adiponectin. Transdermal therapy may have adverse effects associated with elevated tissue activator plasminogen antigen levels and thereby the higher risk of ischemic heart disease.

Triglycerides as an early pathophysiological marker of endothelial dysfunction in nondiabetic women with a previous history of gestational diabetes.

OBJECTIVE: To investigate whether baseline triglyceride levels are associated with early glucose dysregulation and/or cardiovascular risk in women with a previous history of gestational diabetes. DESIGN: Prospective postpregnancy cohort study. SETTING: Polish university hospitals. SAMPLE: Participants included 125 women with previous gestational diabetes and 40 women with normal glucose regulation during pregnancy. METHODS: All women were studied 2-24 months (mean 12 ± 10 months) after the index pregnancy. Women with previous gestational diabetes were divided into tertiles in accordance with baseline triglyceride levels. MAIN OUTCOME MEASURES: We assessed glucose regulation (oral glucose tolerance test), insulin resistance (homeostasis model assessment), markers of endothelial dysfunction (soluble: intercellular adhesion molecule-1, vascular cell adhesion molecule-1, E-selectin, tissue plasminogen activator antigen, von Willebrand factor antigen), fibrinolysis (plasminogen activator inhibitor antigen), inflammation (high-sensitivity C-reactive protein) and lipid levels. RESULTS: Women with previous gestational diabetes (78% normal glucose regulation, 22% impaired glucose tolerance) had a high cardiometabolic risk profile compared with control women (100% normal glucose regulation). Baseline triglycerides >0.83 mmol/l were associated with a higher prevalence of impaired glucose tolerance, higher high-sensitivity C-reactive protein and triglyceride/high-density lipoprotein-cholesterol ratio. Triglycerides >1.22 mmol/l were associated with higher body fat indexes, higher insulin resistance, higher levels of endothelial dysfunction biomarkers, higher plasminogen activator inhibitor antigen and dyslipidemia. Only E-selectin was independently associated with triglyceride levels. CONCLUSIONS: Baseline triglyceride levels are a cardiovascular risk marker as well as a pathophysiological parameter independently associated with endothelial dysfunction in nondiabetic women with previous gestational diabetes at 2-24 months after an index pregnancy. Normalization of triglycerides should be included in preventive therapy after a pregnancy complicated by gestational diabetes.

Tissue factor-dependent coagulation activation in intracranial neoplasms: a comparative study.

The aim of the study was to investigate the concentration and activity of tissue factor (TF) and Tissue factor pathway inhibitor (TFPI) as well as the concentration of thrombin-antithrombin (TAT) complexes in patients with primary and metastatic intracranial neoplasms. The study included 69 patients with an average age of 62 years. Twenty-one patients were diagnosed with gliomas, 18 meningioma stage II (M) patients, and 30 metastatic brain tumour cases (Meta). The control group consisted of 30 individuals with a mean age of 57 years. In the plasma of all the participants and in tumour tissue-derived homogenate, the concentrations and activities of TF, TFPI, the concentration of TAT complexes and the concentration of total protein were measured. The results were converted per 1 mg of protein. The concentration of TF was over 80 times higher in the tumour tissue-derived homogenate in respect to patients' plasma levels. Plasma TF activity in intracranial cancer patients was almost six times higher compared with noncancer counterparts, while in the tumour tissue-derived homogenate it was more than 14 times higher than in the intracranial cancer patients' plasma, whereas the concentration of TFPI in the tumour tissue-derived homogenate was significantly lower than in the patients' plasma. However, a significantly higher TFPI activity in the tumour tissue derived than in the patients' plasma was reported. The high concentration and activity of TF, along with the coexisting low concentration and activity of TFPI in the plasma of intracranial tumour patients, is associated with a higher prothrombotic risk in these patients.

Cardiomyopathy in the mouse model of Duchenne muscular dystrophy caused by disordered secretion of vascular endothelial growth factor.

BACKGROUND: Duchenne muscular dystrophy (DMD) is a genetic neuromuscular disorder that affects skeletal muscles and cardiac muscle tissue. In some cases, myocardial injury secondary to hypoxia can lead to dilative cardiomyopathy (DCM). A genetic defect in the dystrophin gene may increase the susceptibility of myocardium to hypoxia. Available data suggest that this may be caused by impaired secretion of NO, which is bound with secretion of VEGF-A. MATERIAL/METHODS: Male mice C57BI/10ScSn mdx (animal model of DMD) and healthy mice C57BI/10ScSn were exposed to hypobaric hypoxia in low-pressure chambers. Their hearts were harvested immediately after and 1, 3, 7, and 21 days after exposure to hypoxia. Normobaric mice were used as controls. The expression of VEGF-A in myocardium and cardiac vessel walls was evaluated using immunohistochemistry, Western blotting, and in situ hybridization. RESULTS: VEGF-A expression in myocardium and vessel walls of healthy mice peaked 24 hours after exposure to hypoxia. The expression of VEGF-A in vessel walls was similar in dystrophic and healthy mice; however, VEGF-A expression in the myocardium of dystrophic mice was impaired, peaking around day 7. In the heart, the total level of VEGF depends on VEGF expression in myocardium, not in vessel endothelium, and our research demonstrates that the expression of VEGF is dystrophin-dependent. CONCLUSIONS: Disordered secretion of VEGF-A in hypoxic myocardium caused the total level of this factor to be impaired in the heart. This factor, which in normal situations protect against hypoxia, promotes the gradual progression of cardiomyopathy.

No relationship between the length of the left coronary artery main stem and the type of coronary vasculature in human fetuses from a morphological perspective.

BACKGROUND: The aim of this study was to evaluate whether the type of heart vasculature is in any way related to the length of the main stem of the left coronary artery. The study was inspired by publications describing a shorter main stem of the left coronary artery in adults with left coronary artery predominance, also associated with a worse clinical outcome. Such relationships have not been been examined in a fetus. A short main stem of the left coronary artery is thought to convey faster progression of atheromatosis in coronary arteries. MATERIAL/METHODS: This investigation was performed on 187 fetuses of both sexes at the Nicolaus Copernicus University Department of Histology and Embryology. Vasculature types were determined in line with criteria set by Adachi. All fetuses had been delivered naturally. None of them had any signs of malformations or developmental abnormalities. Prior to examination, all fetuses had been conserved for a 3-month period in 9% formaldehyde solution. Statistical analysis was carried out using Statistica software for Windows. RESULTS: The length of the left main stem was found to be related to the type of vasculature, though this relationship did not achieve statistical significance. There were no differences in relation to gender or type of vasculature or between analyzed sub-groups. CONCLUSIONS: There was no relationship between the length of the main stem and dominance of the coronary artery in this study.

Impaired fasting glucose as a marker of heterogeneity of gestational diabetes mellitus. A study of 1025 women living in the region of Kuyavia and Pomerania in Poland.

INTRODUCTION: Gestational diabetes mellitus (GDM) is a heterogeneous disease. We hypothesized that fasting hyperglycaemia, defined as impaired fasting glycaemia (IFG), is a marker of metabolic heterogeneity of GDM. The aim of this study was to compare selected metabolic parameters in two groups of women with GDM, one with normal fasting glycaemia (NFG GDM) and another with IFG, to test this hypothesis. MATERIAL AND METHODS: Metabolic parameters of 1025 women with GDM (mean age 29 years): glucose and insulin at 0 OGTT, glucose at 2-h oral glucose tolerance test (OGTT), body mass index before pregnancy, parity, and gestational age at diagnosis of GDM were analyzed. Insulin resistance and beta-cell function were evaluated by HOMA indexes (HOMA-IR and HOMA-B) at the diagnosis of GDM. RESULTS: The IFG GDM group (23%) consisted of isolated IFG (30%), IFG/IGT (60%), and IFG/DM (10%). The NFG GDM group (77%) consisted of isolated IGT (98%) and NFG/DM (2%). Women with IFG GDM were characterized by higher prepregnancy BMI, earlier diagnosis of GDM, higher HOMA-IR (p < 0.03), and lower HOMA-B (p < 0.01) compared to NFG GDM. In the IFGGDM group, DM was characterized by lower HOMA-B compared with isolated IFG and IFG/IGT. In the NFG GDM group, isolated IGT and DM were characterized by similar HOMA-IR and HOMA-B. CONCLUSIONS: Impaired fasting glucose distinguishes more severe metabolic phenotypes of GDM compared toGDM with normal fasting glucose concentrations.

[Protein C system in patients with idiopathic pulmonary fibrosis--preliminary report]. / Uklad bialka C u chorych na samoistne wlóknienie pluc--obserwacje wstepne.

INTRODUCTION: The natural anticoagulant-activated protein C system plays an important role in the pathogenesis of idiopathic pulmonary fibrosis. The purpose of this study was to evaluate the concentration of protein C (PC), protein S (PS), thrombomodulin (TM), selectin E (sSelE), and thrombin-antithrombin complex (TAT) in patients with idiopathic pulmonary fibrosis (IPF). MATERIAL AND METHODS: Study group consisted of 11 patients aged 51.5 +/- 8.62 years with idiopathic pulmonary fibrosis and 20 healthy adults as control. Concentration of PC, PS TM, sSelE and TAT in plasma with ELISA method was assessed. RESULTS: We observed significantly lower plasma concentration of PC (98.24 +/- 16.17% vs. 130.59 +/- 19.03%), PS (71.31 +/- +/- 12.95% vs. 93.47 +/- 18.63%), TM (2.67 +/- 0.40 ng/ml vs. 3.99 +/- 1.16 ng/ml) and significantly higher level of TAT complex (Me = 4.00 mg/ml vs. 2.20 mg/ml) and sSelE (Me = 36.40 ng/ml vs. 22.84 ng/ml) in patients with idiopathic pulmonary fibrosis as compared to controls. CONCLUSION: In presented pilot study we observed decreased activity of protein C system and increased thrombin generation in peripheral blood of patients with idiopathic pulmonary fibrosis.

Thrombin activatable fibrinolysis inhibitor (TAFI) in cord blood.

Thrombin activatable fibrinolysis inhibitor (TAFI) is a plasma zymogene (procarboxypeptidase B) which can decrease fibrinolysis and thus act as a haemostatic factor. TAFI is now extensively studied in many complications as well as in physiological and complicated pregnancy. The question we posed in the present study was whether TAFI antigen is present in cord blood plasma. The study group consisted of 38 parturient women, 26 primiparous and 12 multiparous with normal course of pregnancy and delivery. The cord blood was sampled from the cord vein, and the mother's blood from the antecubital vein. 3.2% sodium citrate was used as an anticoagulant. TAFIa/ai antigen was measured by ELISA method. TAFIa/ai antigen was identified in all samples of cord blood plasma. Its level was 91.50 ng/ml (range: 71.76 - 160.77 ng/ml) vs. 55.46 ng/ml (range: 39.77 - 68.54 ng/ml ) in the mother's blood, which means that the level of TAFIa/ai antigen was significantly higher in fetal blood than in maternal blood (p<0.00001). TAFIa/ai antigen is an integral component of cord blood plasma. The concentration of TAFIa/ai antigen is about two times higher in fetal blood than in maternal blood.

Morphometrical analysis of the human suprarenal gland between the 4th and 7th months of gestation.

The present study's purpose has been to examine the development of the human suprarenal glands (SGs) during the prenatal period. Special attention was paid to sexual dimorphism and the differences between the parameters of the right and left SGs. Specimens were obtained from 187 human fetuses spontaneously aborted between the 4th and 7th months of gestation. The SGs were dissected from the fetuses after an immersion and preservation period of 3-24 months in 9% formalin solution. The mass and linear dimensions of each isolated SG were obtained, and these data revealed a progressive two-fold increase between the 4th and 7th months of gestation. There was a gradual reduction in the ratio of the SG mass to the overall mass of the fetus with a marked decrease evident between the 4th and 5th months. Statistical analysis of both SGs showed significant differences between sexes in the mass and in the thickness of the left SG during the 5th and 6th months of gestation. Differences in the mass and linear dimensions of the left and right SGs were recorded from the 5th month of gestation to the 7th month. The mass and volume of the left SGs were higher than those on the right side. This allometric analysis provides data from a large sample of human fetuses and will later aid in microscopic and ultrasonographic studies.

Endothelial function in patients with chest pain and normal coronary angiograms.

BACKGROUND: A normal coronary angiogram is found in about 20% of patients who undergo coronary angiography due to chest pain. In some of them syndrome X is diagnosed. Endothelial dysfunction is one possible cause of this pathology. AIM: To compare the endothelial function estimated by two different methods in patients with typical or atypical anginal pain and with no chest pain. METHODS: Fifty-three patients who underwent coronary angiography due to suspected coronary artery disease and who had a normal coronary angiogram were included in the study: 34 patients had typical anginal pain (group 1) and 19 patients had atypical chest pain (group 2). The control group consisted with 20 subjects without chest pain. The plasma concentration of such endothelial markers as von Willebrand factor (vWF), thrombomodulin (TM), endothelin 1 (ET-1), tissue plasminogen activator (tPA), plasminogen activator inhibitor type 1 (PAI-1) and C-reactive protein were measured. We also determined endothelial-dependent brachial arterial dilatation (flow-mediated dilation, FMD). RESULTS: The groups of patients were different with regard to the factors of known effects on endothelial function but endothelial markers were not different in all groups with two exceptions. The concentration of tPA was the highest in patients with typical chest pain and the concentration of PAI-1 was the highest in patients without chest pain. The FMD values were low in all patients and there were no significant differences in the FMD values between the three analysed groups. We did not find any correlation between the concentration of examined endothelial markers and FMD. A non-significant relationship between the presence of classical risk factors and decreased FMP was observed. We have found a significant relationship between the number of risk factors and FMD, tPA, PAI-1 and hsCRP. CONCLUSIONS: The assessment of endothelial function using FMD or estimation of endothelial markers is not useful to differentiate chest pain.

A preliminary estimation of tissue factor pathway inhibitor (TFPI) and protein C in patients with intracranial tumors.

BACKGROUND: In patients with intracranial tumors, hypercoagulability is observed due to brain tissue and tumor cells being the source of tissue factor. OBJECTIVES: The aim of the study was to assess tissue factor (TF), tissue factor pathway inhibitor (TFPI) and protein C in the plasma and tumor tissue homogenate in patients with intracranial tumors. MATERIAL AND METHODS: The study included 77 patients; 24 patients were diagnosed with glioma, 20 patients with meningioma and 33 patients with metastatic tumors; mean age - 54 years. The material for the study was the plasma and tumor tissue homogenate sampled during surgery. The control group consisted of 30 controls; mean age - 51 years. In the plasma of all the participants and in tumor tissue homogenate, the concentrations of TF-Ag, TFPI-Ag and protein C activity, and the concentration of total protein were measured. The results were converted per mg of protein. RESULTS: In patients with intracranial tumors, elevated concentrations of TF-Ag, TFPI-Ag and protein C activity were noted, also after the conversion per mg of protein. A 100-fold higher concentration of TF per 1 mg of protein was found in tumor tissue compared to the patients' plasma. In tumor tissue homogenate, a lower TFPI concentration and a lower protein C activity were recorded. CONCLUSIONS: The study confirmed the essential prothrombotic properties in patients with intracranial tumors, expressed with an elevated TF level, as well as a tremendous amount of TF in tumor tissue homogenate derived from tumors. The elevated concentration of TFPI and protein C activity converted per mg of total protein should be analyzed in terms of their pleiotropic function, along with the participation in hemostasis control. It seems that the reduced protein C activity and low TFPI level are associated with the enormous TF value in tumor tissue homogenates.

[Insulin secretion at the diagnosis of gestational diabetes is lower in multiparas than in primiparas]. / Sekrecja insuliny przy rozpoznaniu cukrzycy ciezarnych jest mniejsza u wieloródek niz u pierwiastek.

UNLABELLED: Gestational diabetes mellitus (GDM) has heterogeneous ethiopathogenesis, pathophysiology and clinical features. OBJECTIVES: The aim of the study was to evaluate some of anthropometric parameters, clinical features and indices of insulin resistance and beta cell function in GDM women in first pregnancy and in GDM women in third and following pregnancies. MATERIAL AND METHODS: 877 GDM women, aged 18-48 years were studied. Both groups were compared according to age, BMI before pregnancy, week of GDM diagnosis, weight gain during pregnancy, fasting blood glucose, fasting serum insulin level, HbA1c, insulin resistance and beta-cell function indices. All parameters except BMI were evaluated at GDM diagnosis. RESULTS: Multiparas were older, with higher BMI and lower beta-cell function indices. CONCLUSION: At the moment of GDM diagnosis, insulin secretion evaluated by HOMA indices are lower in multiparas in comparison to primaparas.

[Tissue plasminogen activator (t-PA) and plasminogen activator inhibitor-1 (PAI-1) in children with ulcerative colitis]. / Tkankowy aktywator plazminogenu (t-PA) i inhibitor tkankowego aktywatora plazminogenu (PAI-1) u dzieci chorych na wrzodziejace zapalenie jelita grubego.

UNLABELLED: The analysis of bibliography referring to the role of haemostasis disturbances in pathogenesis of ulcerative colitis in children revealed considerable discrepancies in the obtained findings of the study and some controversies in their interpretation. The aim of the study was the assessment of tissue plasminogen activator (t-PA) and its inhibitor (PAI-1) in children with ulcerative colitis. MATERIAL AND METHODS: The 22 children with ulcerative colitis were included in our investigation, there were 7 girls and 15 boys whose mean age was 15, 55 (+/- 3.0) years. The reference group was made up of 22 children suffering from celiac disease covering the period of full compensation in the range of similar age and sex. Blood was drawn from the cubital vein in the morning with minimal stasis into a tube containing 3.2% sodium citrate at the ratio of 1:10. The levels of t-PA and PAI-1 were measured with ELISA. RESULTS: In children with ulcerative colitis and in the control group we found out similar concentration of antigen tissue plasminogen activator (t-PA:Ag). In the group of children with ulcerative colitis under investigation a mean concentration of antigen inhibitor plasminogen activator (PAI-1:Ag) was statistically higher. CONCLUSIONS: Elevation of PAI-1:Ag concentration in plasma of the children suffering from ulcerative colitis may confirm the participation of PAI-1 in inflammatory reaction of disease- induced changes in colon mucosa.

Effect of a 3-Week Low-Calorie Diet and Balneological Treatment on Selected Coagulation Parameters in Morbidly Obese Patients.

BACKGROUND: The most common cause of death among people with obesity are cardiovascular complications as a result of a hypercoagulability state. OBJECTIVES: The purpose of the study was to assess the potential of coagulation system activation depending on the tissue factor and to analyze of the influence of a 3-week low-calorie diet and balneological treatment on selected coagulation parameters in morbidly obese patients. MATERIAL AND METHODS: The study included 36 patients (28 females and 8 males; mean age 46) with the value of BMI > 40 kg/m2. The study was designed in two stages: baseline and after 21-days. The evaluation of tissue factor (TF), tissue factor pathway inhibitor (TFPI), von Willebrand factor (vWF), fibrinogen, D-dimer, thrombin-antithrombin complexes (TAT), and the activity of antithrombin (AT) was performed in patients before and after the treatment. The control group consisted of 24 healthy volunteers (16 females and 8 males) at a mean age of 39 with BMI . 24.9 kg/m2. RESULTS: There were significantly higher levels of TF, TFPI, fibrinogen, TAT complexes and D-dimer in the study group as compared to the controls. Moreover, there were no significant changes in the parameters studied before and after the treatment. In the group of obese patients, there were significant positive correlations between the concentrations of vWF and BMI and BMI changes and a significant negative correlation between the WHR changes and TFPI concentration. CONCLUSIONS: The study confirmed that morbidly obese patients represent a high risk of hypercoagulability state, despite no clinical evidence, which could be due to the great inhibitory potential of TFPI in suppressing the extrinsic pathway of the coagulation system. However, the lack of effect of the 3-week exposure to the LCD and balneological treatment in morbidly obese subjects indicates that substantial fat mass must be reduced before adequate hemostasis is re-established.

Associations between selected angiographic parameters and the number of CD34⁺ cells and plasma levels of vascular endothelial growth factor and angiogenin in patients with ST-segment elevation myocardial infarction.

INTRODUCTION: Left ventricular (LV) function and prognosis in patients after myocardial infarction are associated with some angiographic parameters. OBJECTIVES: The aim of the study was to assess the associations between the TIMI score in the infarct-related artery (IRA) before percutaneous coronary intervention (PCI), myocardial blush grade (MBG) following effective PCI, and the extent of collaterals measured using the Rentrop scale and plasma levels of vascular endothelial growth factor (VEGF) and angiogenin, number of CD34⁺ cells, as well as LV ejection fraction (LVEF) and wall motion score index (WMSI). PATIENTS AND METHODS: In 62 patients with the first ST-segment elevation myocardial infarction (STEMI) treated with PCI and bare metal stent implantation, plasma VEGF and angiogenin levels as well as the number of CD34⁺ cells were assessed before PCI, 24 hours after PCI, at discharge, and at 30 days following STEMI. LVEF and WMSI were evaluated by echocardiography at discharge and at 1 and 6 months after STEMI. RESULTS: Patients with TIMI 0-1 flow in the IRA before PCI (64.6% of the patients) had significantly higher troponin I and VEGF levels as well as a higher number of CD34⁺ cells than patients with TIMI 3 flow. Patients with TIMI 0-1 flow also had worse LV systolic function at 1 and 6 months following STEMI. Neither the MBG grade nor the Rentrop score showed associations with the mobilization of CD34⁺ cells, VEGF and angiogenin levels, and parameters of L V systolic function. CONCLUSIONS: Early patency of the IRA and lower myocardial necrosis seem to be more important for LV function assessed in patients 6 months after STEMI than mobilization of CD34⁺ cells and levels of angiogenic factors.