Newly proposed insulin resistance indexes called TyG-NC and TyG-NHtR show efficacy in diagnosing the metabolic syndrome.

PURPOSE: Obesity and insulin resistance are considered cardinal to the pathophysiology of metabolic syndrome. Several simple indexes of insulin resistance calculated from biochemical or anthropometric variables have been proposed. The study aimed to assess the diagnostic accuracy of indirect insulin resistance indicators in detecting metabolic syndrome in non-diabetic patients, including TG/HDLc, METS-IR, TyG, TyG-BMI, TyG-WC, TyG-WHtR, and new indicators TyG-NC (TyG-neck circumference) and TyG-NHtR (Tyg-neck circumference to height ratio). METHODS: The diagnostic accuracy of eight insulin resistance indexes was assessed using the receiver operating characteristic curves (ROC curves) in 665 adult non-diabetic patients. Then, the analysis was performed after the division into groups with proper body mass index, overweight and obese. RESULTS: All indexes achieved significant diagnostic accuracy, with the highest AUC (area under the curve) for TyG (0.888) and Tg/HDLc (0.874). The highest diagnostic performance in group with the proper body mass index was shown for TyG (0.909) and TyG-BMI (0.879). The highest accuracy in the group of overweight individuals was presented by TyG (0.884) and TG/HDLc (0.855). TG/HDLc and TyG showed the highest AUC (0.880 and 0.877, respectively) in the group with obesity. Both TyG-NC and TyG-NHtR reached significant areas under the curve, which makes them useful diagnostic tests in metabolic syndrome. CONCLUSIONS: Indirect indices of insulin resistance, including proposed TyG-NC and TyG-NHtR, show an essential diagnostic value in diagnosing metabolic syndrome. TyG and TG/HDLc seem to be the most useful in the Caucasian population.

Impulse oscillometry in the diagnosis of airway resistance in chronic obstructive pulmonary disease.

Spirometry is a standard lung function test for diagnosis and staging of chronic obstructive pulmonary disease (COPD). Impulse oscillometry (IOS) can be complementary to spirometry, especially in patients at advanced age and with physical or mental disorders who cannot be diagnosed through spirometry. The aim of this study was to compare IOS and spirometry in the assessment of airway obstruction in COPD. The study was conducted in 112 stable COPD patients, including 29 females and 83 males of the mean age of 69±11 years. The oscillometric evaluation included total (R5), peripheral (R5-R20), and negative reactance (X5), which were compared with the predicted forced expiratory volume in 1 s (FEV1%pred). The findings show a significantly negative correlation between FEV1%pred and the R5, R5-R20, and X5. COPD patients had increased R5, R5-R20, and X5. The severity of bronchial obstruction found by impulse oscillometry correlated well the spirometric assessment. IOS is a simple to perform test that may be helpful for functional examination of COPD patients.

Does berberine impact anthropometric, hepatic, and metabolic parameters in patients with metabolic dysfunction-associated fatty liver disease? Randomized, double-blind placebo-controlled trial.

Globally, the metabolic dysfunction-associated fatty liver disease (MAFLD) holds the position as the most widespread chronic liver condition. Berberine (BBR) shows promise as a natural compound for managing obesity, hepatic steatosis, and metabolic disorders. The study aimed to investigate the effectiveness of BBR in addressing factors linked to MAFLD. This is a randomized, double-blind, and placebo-controlled clinical trial. Seventy individuals with MAFLD were enrolled in this study and randomly assigned in a 1:1 ratio to two groups. BBR (1500 mg/day) or placebo was administrated orally for 12 weeks. Selected anthropometric, hepatic, and metabolic parameters were assessed. After a 12-week intervention, the BBR group demonstrated a statistically significant decrease in alanine transaminase (ALT) p=0.0105, and de Ritis ratio p=0.0011 compared to the control group. In both groups we observed a decrease in trunk fat (kg) - BBR group p=0.0185, and placebo group p=0.0323. After three months, a significant divergence between the BBR and placebo groups was evident in the alteration of Δ total cholesterol (TC) p=0.0009, favoring the BBR group. Nevertheless, there were no significant differences detected in other lipid and glucose parameters. In the BBR group, we found significant correlations between changes and amelioration of certain variables: Δ body mass index (BMI) correlated with ΔALT (r=0.47; p=0.0089) and D aspartate aminotransferase (AST) (r=0.47; p=0.0081) levels; Δ trunk fat with Δ fatty liver index (FLI) (r=0.55; p=0.0337), Δ homeostasis model assessment for insulin resistant index (HOMA-IR) (r=0.37; p=0.0020), and AST (r=0.42; p=0.0202); D the de Ritis ratio correlated with Δ fibrosis-4 index (FIB-4) levels (r=0.59; p=0.0011); and ΔFLI correlated with ΔHOMA-IR (r=0.37; p=0.0409) and Δ visceral adiposity index (VAI) (r=0.54; p=0.0019), while no significant differences were observed in the Placebo group. The results show that BBR appears to be a bioactive compound that positively impacts MAFLD, however, additional research with extended intervention durations is required to fully assess its efficacy and potential clinical use.

Supplementation with L-arginine favorably influences plasminogen activator inhibitor type 1 concentration in obese patients. A randomized, double blind trial.

BACKGROUND: Elevated plasminogen activator inhibitor type 1 (PAI 1) plays an important role in the pathogenesis of excess blood coagulability in obese patients. L-arginine supplementation has shown to be associated with enhanced cardiovascular and metabolic health. The aim of the study was to assess the effect of L-arginine supplementation on PAI 1 concentration and to evaluate the relation to changes in nitric oxide (NO) plasma level, insulin sensitivity (M value), and total antioxidant status (TAS) in obese patients. MATERIAL/SUBJECTS AND METHODS: A randomized, double-blind, placebo-controlled study was conducted from March 2010 to June 2011. Eightyeight obese patients were randomly assigned to receive either 9 g of L-arginine or placebo daily for 6 months. At baseline and after 6 months, selected anthropometrical measurements and blood biochemical analyses were performed, and PAI 1, NO, TAS levels were assessed. Insulin sensitivity was evaluated using the hyperinsulinemic euglycemic clamp technique. RESULTS: We found that 6-month L-arginine supplementation resulted in significant decrease of PAI 1. Significant increase of NO, TAS, and insulin sensitivity level were noticed. In a group of patients treated with L-arginine, negative correlation between a change of insulin sensitivity value and a change of PAI 1 concentration was found. CONCLUSIONS: The present findings demonstrate favorable influence of L-arginine supplementation on PAI 1 concentration in obese patients. Beneficial influence is related to insulin sensitivity improvement. The potential therapeutic role of L-arginine administration in patients with obesity needs further investigation.

Evaluation of insulin resistance, tumor necrosis factor alpha, and total antioxidant status in obese patients smoking cigarettes.

INTRODUCTION AND BACKGROUND: Obesity and smoking are leading causes of morbidity and mortality worldwide. Cross-sectional studies indicate that heavy smoking may be associated with a greater risk of obesity. While there are important unresolved issues in relation to the effect of smoking on body weight, there is increasing evidence that smoking is conducive to a greater accumulation of visceral fat and greater insulin resistance. AIM: of this study was to determine the potential influences of obesity and smoking on tumor necrosis factor alpha (TNF-α), total antioxidant status (TAS), and insulin resistance. SUBJECTS AND METHODS: 30 obese nonsmokers, 30 obese smokers, 30 normal-weight smokers, and 30 healthy volunteers (the control) were studied. In all subjects, assessments of TNF-α, TAS, and insulin were made. Insulin resistance was evaluated according to the homeostasis model assessment-insulin resistance (HOMA-IR) protocol. RESULTS: TNF-α concentrations, as well as insulin resistance levels, in obese patients significantly exceeded those observed in the control. Compared to the control, obese patients presented significantly lower TAS levels. In the group of obese patients who actively smoked cigarettes, further increases in TNF-α and insulin resistance, as well as decreases in TAS level, were noticed. TNF-α concentration and insulin resistance levels were significantly higher, while TAS was lower in normal-weight smoking subjects, compared to the control. A positive correlation between TNF-α and HOMA-IR was found in the overall population. CONCLUSIONS: Obesity may evoke inflammatory processes, oxidative stress, and insulin resistance, all of which are aggravated by cigarette smoking. TNF-α should be considered in the complex pathogenesis of insulin resistance in obese patients who actively smoke.

The evaluation of selected serum mineral concentrations and their association with insulin resistance in obese adolescents.

BACKGROUND: In obesity, elevated insulin resistance is observed, which may be associated with disturbances in mineral status in the body. The few studies concerning the status of minerals and their relationships with insulin resistance and body composition in adolescent populations have brought inconclusive results. AIM: of this study is, thus, to assess serum mineral concentration in obese adolescents, and to evaluate their potential association with insulin resistance. SUBJECTS AND METHODS: Seventy-eight obese adolescents and 20 healthy volunteers aged 12-18 years were recruited for the study. Selected anthropometrical measurements and levels of iron, zinc, copper, calcium, and magnesium were assessed in serum. Insulin resistance in the participants was evaluated according to the homeostatic model of assessment for insulin resistance (HOMA-IR) protocol. Levels of iron, zinc, copper, calcium, and magnesium were assessed in serum. RESULTS: Obese subjects had significantly higher HOMA-IR indices than the control group. Compared to healthy subjects, the serum concentration of zinc, calcium, and magnesium was significantly lower in obese subjects. A significant inverse relation was found between HOMA-IR and zinc levels in serum. CONCLUSIONS: Obese adolescents have a poorer mineral status (especially zinc) than adolescents of normal weight, which can contribute to insulin resistance.

Adropin as a potential protective factor of metabolic complications in obese pregnant women with hyperglycaemia diagnosed in early pregnancy.

Adropin is a hormone which increases insulin sensitivity. It enhances the oxygenation of glucose in the muscles. The 91 obese pregnant women (BMI >30 kg/m2) with gestational diabetes mellitus (GDM) diagnosed in the first half of pregnancy has been recruited to the study group. The control group consisted of 10 age matched and homogeneous pregnant women with BMI <25 kg/m2. Blood samples were collected on visit V1 - between the 28th and 32nd week and on visit V2 - between the 37th and 39th week of gestation. The ELISA test was used to measure the adropin level. The results in the study group and the control group were compared. Blood samples were collected at the same visits. The median concentration of adropin was 442.2 pg/ml on V1 and 453.1 pg/ml on V2. The increase was significant (p<0.05). Results were significantly lower in the control group's patients, i.e. 57.0 pg/ml (p<0.001) on V1 and 107.9 pg/ml on V2 (p<0.001). The higher adropin level on the V1 and V2 visits were related to patients' lower BMI and better metabolic control. The increase in the adropin level in the third trimester may have been involved in the weight gain reduction, whereas better dietary adherence might have had a compensatory effect on increasing insulin resistance. However, the small control group is a limitation of this study.

The effect of oral L-arginine supplementation on fasting glucose, HbA1c, nitric oxide and total antioxidant status in diabetic patients with atherosclerotic peripheral arterial disease of lower extremities.

INTRODUCTION: Numerous studies indicate hyperglycemia and oxidative stress as factors responsible for endothelium dysfunction and the following development of angiopathy. Increased production of free radicals by vascular endothelium causes disturbance in production and/or decreases bioaccessibility of nitric oxide (NO). It has been suggested that L-arginine supplementation is a reasonable method to increase endothelium NO production and lower free radicals formation. There is a growing number of evidence showing that dietary supplementation of arginine reverses endothelial dysfunction associated with major cardiovascular risk factors and ameliorates many common cardiovascular disorders. OBJECTIVE: The aim of the study was to evaluate the potential influence of two-months oral L-arginine supplementation on fasting glucose, HbA1c, nitric oxide and total antioxidant status (TAS). MATERIALS AND METHODS: 38 patients with atherosclerotic peripheral arterial disease of lower extremities at Fontaine's stage II and coexisting type 2 diabetes and 12 healthy volunteers as control group were studied. All patients were treated with oral L-arginine (3 x 2 g/day) for two months. Fasting glucose, HbAlc, nitric oxide and total antioxidant status (TAS) were measured before and after the study. RESULTS: Fasting glucose and HbAlc did not change significantly after L-arginine treatment. Statistically significant increase in NO concentration and TAS level was found. CONCLUSIONS: Oral two-month supplementation with L-arginine (3 x 2 g/day) had no effect on fasting glucose and HbA1 level in diabetic patients with atherosclerotic peripheral arterial disease of lower extremities at Fontaine's stage II. The supplementation of L-arginine led to substantial increase in NO concentration and TAS level in these patients, suggesting its indirect antioxidative effect.

Effect of 3-month L-arginine supplementation on insulin resistance and tumor necrosis factor activity in patients with visceral obesity.

BACKGROUND: The role of tumor necrosis factor alpha (TNF-alpha), one of the adipose tissue products, in the pathogenesis of insulin resistance is well-documented. Many recent studies have shown beneficial influence of L-arginine supplementation on cardiovascular system. However, molecular mechanisms of its positive actions are not fully elucidated. AIM: The aim of the study was to evaluate the influence of L-arginine supplementation on tumor necrosis factor alpha, insulin resistance and selected anthropometric and biochemical parameters in patients with visceral obesity. PATIENTS AND METHODS: 60 patients with visceral obesity were randomly assigned to either receive 9 g of L-arginine or placebo for 3 months. 20 healthy lean subjects were used as control. Selected anthropometrical measurements and blood biochemical analyses were performed at baseline and after 3-months. TNF-alpha and its soluble receptor 2 (sTNFR2) were assessed in both treated groups. Insulin resistance in the participants was evaluated according to the homeostasis model assessment-insulin resistance (HOMA-IR) protocol. RESULTS: The concentration of insulin, TNF-a and sTNFR2 and HOMA-IR level in both obese groups significantly exceeded these observed in the control. Basal TNF-alpha and sTNFR2 concentrations were positively correlated with basal body mass index (BMI), waist circumference, percent of body fat and HOMA-IR. We found that 3-month L-arginine supplementation resulted in significant decrease of HOMA-IR and insulin concentration. Only insignificant tendency to decrease of TNF-alpha and sTNFR2 was observed. CONCLUSIONS: Our results confirm TNF-alpha role in the complex pathogenesis of insulin resistance in patients with visceral obesity. 3-months L-arginine supplementation in a dose of 9 g improves insulin sensitivity in patients with visceral obesity with no impact on tumor necrosis factor alpha concentration.

Leptin and vascular endothelial growth factor A: a cross-talk in obese women with gestational diabetes and with diabetes in pregnancy - a cohort study.

Vascular endothelial growth factor A (VEGF A) synthesis is intensified by leptin in: hypoxia-inducible factor 1 alpha (HIF-1A) and nuclear factor kappa-light-chain-enhancer of activated B cells (NfκB)-dependent manners. The study aimed to investigate the association between leptin and VEGF A serum levels in obese women with hyperglycaemia in the third trimester of pregnancy. Sixty obese pregnant women with hyperglycaemia were divided into groups according to body mass index (BMI): group 1: BMI 30.0-34.9 kg/m2; group 2: BMI 35.0-39.9 kg/m2; group 3: BMI ≥40 kg/m2. On the enrolment visit, waist circumference, body mass and height were measured. At visit 1 (V1; gestational week (GW) 28-32) and visit 2 (V2; GW 36-38), anthropometric, blood pressure and heart rate measurements, and blood sample collection were performed. Blood levels of leptin, VEGF A, VEGF receptor 2, HIF-1A, NfκB, interleukin 1 alpha, protein delta homolog 1, nitric oxide and glycated haemoglobin were determined. To analyse the predictors of the biochemical parametres involved in leptin and VEGF A cross-talk, multivariate logistic regression was implemented. Positive correlations between serum levels of leptin and VEGF A were found. Serum level of HIF-1A at V1 was a predictor for the highest quartile of the serum levels of VEGF A at V1 and V2. Leptin serum level at V1 was a predictor for the highest quartile of HIF-1A serum concentration at V2. In group 3 HIF-1A level was higher at V2 compared to V1. We conclude that in obese women with hyperglycaemia in the third trimester of pregnancy there is a significant positive influence of serum leptin on VEGF A synthesis and serum level and HIF-1A seems to play more important role in leptin and VEGF A cross-talk than NfκB.

Assessment of progranulin and FAM19A5 protein blood levels in patients with metabolic syndrome.

Progranulin and family with sequence similarity 19, member A5 (FAM19A5) protein are adipokines with growing importance in the context of metabolic diseases. The study aimed to determine the serum concentration of progranulin and FAM19A5 in people with metabolic syndrome (MS) compared to those without MS. The concentration of progranulin and FAM19A5 was determined in 45 people with MS (group A) and in 35 healthy people without MS (group B). Body composition analysis, blood pressure, blood oxygen saturation and anthropometric measurements were performed. There were no differences in the blood levels of progranulin and FAM19A5 between the groups. In group A, the level of progranulin was 29.25±36.92 pg/ml and in group B it was 46.00±60.12pg/ml (p=0.2693). The level of FAM19A5 was 163.16±55.11 pg/ml and 197.57±112.89 pg/ml (p=0.1341) in subjects with and without metabolic syndrome, respectively. In group A, there was a correlation between FAM19A5 and diastolic blood pressure (DBP) (R= -0.40) and high-density lipoprotein (HDL) level (R= -0.37). In group B, correlations were found between progranulin and waist circumference (R= -0.43) and progranulin and triglyceride (TG) levels (R= -0.42). Both groups together showed correlations between progranulin level and body mass index (R= -0.24), HDL (R=0.25) and TG levels (R= -0.25) and between FAM19A5 level and DBP (R= -0.34). In conclusion, patients with and without MS do not differ in the range of progranulin and FAM19A5 serum levels. In patients with MS, elevated FAM19A5 serum levels may be an indicator of dyslipidaemia development. FAM19A5 appears to be a better predictor of MS than progranulin.

Supplementation with L-arginine does not influence arterial blood pressure in healthy people: a randomized, double blind, trial.

BACKGROUND AND OBJECTIVES: It cannot be excluded that supplementation with L-arginine, by improving function of endothelium and hypotensive effect, can be advantegeous in prevention of cardiovascular diseases in healthy people. However, reports about hypotensive effect of L-arginine in healthy people are unclear. Moreover, no research including ambulatory blood pressure measurement (ABPM) has been conducted so far. Therefore, the aim of our study was to show if 4-week supplementation of healthy people with L-arginine influences blood pressure measured with ABPM. MATERIALS AND METHODS: The study was carried out on 19 healthy people randomized to 6 g/24-hour, 12 g/24-hours of L-arginine or placebo. ABPM was carried out 4 times: before randomization, after 2 and 4 weeks of supplementation and 2 weeks after finishing supplementation. RESULTS: It was found that 4 weeks of supplementation of healthy people with L-arginine (6 or 12 g/24-hour) led to nonsignificant decrease of systolic and diastolic blood pressure; the decrease was greater during night. CONCLUSION: These findings showed that supplementation with L-arginine is not necessarily advantageous in healthy people.

Resistin is not a useful insulin resistance marker for non-obese patients.

Resistin, an adipokine produced in fat tissue, may be linked to insulin resistance (IR) and type 2 diabetes. Previous data are controversial and have focused mainly on obese patients. We aimed to evaluate whether resistin plays a role in the development of IR in normal-weight individuals. The study involved 77 normal-weight participants. We defined IR using different indexes and cut-off points. Resistin, fasting insulin, glucose, and lipids concentrations and anthropometric parameters were measured. Serum resistin concentration was not associated with IR. Resistin concentration was weakly related to age in all insulin-sensitive groups and low-density lipoprotein cholesterol concentration in all IR groups. Moreover, a weak negative correlation between high-density lipoprotein cholesterol and resistin concentrations was observed in the IR group categorised by the 1.69 cut-off of the homeostasis model assessment of IR. The data suggest that resistin is not a useful marker for the prediction of IR in normal-weight individuals.

Influence of L-arginine on the nitric oxide concentration and level of oxidative stress during ischemia-reperfusion injury in a rat model.

OBJECTIVE: This study aimed at evaluating whether supplementation of L-arginine in the course of ischemia and reperfusion syndrome after acute, experimental ischemia of the hind legs of the rat, could influence nitric oxide (NO) concentration and selected biochemical parameters concentration related to the oxidative stress. MATERIAL AND METHODS: The study included 64 male Wistar rats. The animals were divided into four groups: Group I = control, Group II = placebo, Group III = L-arginine (500 mg/kg body mass/day for 5 days, p.o.), Group IV = L-arginine and nonspecific nitric oxide synthase (NOS) inhibitor - N(G)-Nitro-L-arginine-methyl ester (L-NAME) (75 micromol/ rat/day for 5 days, p.o.). Each group was further divided into subgroups: 1 = animals not subjected to ischemia and reperfusion, 2 = animals underwent 4-hour ischemia and subsequent reperfusion. Animals from Subgroup 2 were anesthetized and submitted to acute tourniquet ischemia of the hind limb. Blood samples were collected from all anesthetized rats by puncturing the right ventricle to assess total antioxidant status, lipids' peroxide concentration and nitric oxide concentration before ischemia and at 4th hour of ischemia and at 30th, 60th or 120th minute of reperfusion. RESULTS: We found that administration of L-arginine to rats resulted in significant increase of NO, level of total antioxidant status (TAS), and decrease of lipid' peroxide concentration when compared to the control and placebo groups. All these laboratory changes were progressing along with lengthening of reperfusion time. Simultaneous application of L-NAME led to reversal of phenomena caused by L-arginine. CONCLUSIONS: The present results suggest that L-arginine may protect tissues and organs against ischemia-reperfusion injury. The potential therapeutic role of L-arginine administration in prevention and treatment of ischemia-reperfusion syndrome consequences needs further investigation in humans.

Plasma homocysteine is a determinant of tissue necrosis factor-alpha in hypertensive patients.

Chronic sub-clinical inflammation observed in hypertension plays a prominent role in the progression of atherosclerosis. Accumulating evidence suggests that homocysteine (Hcy) can cause inflammation. The aim of this study was to compare the predictive utility of Hcy and lipid measures as determinants of inflammation in hypertensive patients. We studied a group of 100 patients (45.0+/-12.2 years old) with essential hypertension and a control group of 40 healthy volunteers (44.0+/-8.7 years old). We found that plasma total Hcy (tHcy), tumor necrosis factor alpha (TNF-alpha), interleukin 6 (IL-6), and C-reactive protein (CRP) were significantly higher in hypertensive patients compared with the control group. The subgroup of hypertensive patients with obesity had higher levels of TNF-alpha (p<0.001), IL-6 (p<0.01), and tHcy (p=0.063), compared with the subgroup of hypertensive patients without obesity. The subgroup of patients with a history of myocardial infarction or stroke had significantly higher levels of tHcy, TNF-alpha, IL-6, and CRP compared to patients with a negative history of vascular events. In the group of hypertensive patients, a strong positive correlation between tHcy and TNF-alpha was observed (r=0.48; p<0.001). In contrast, no correlation was observed between TNF-alpha and any of the lipid measures. In multivariate regression analysis tHcy, but not lipids, was an independent predictor of TNF-alpha. In conclusion, our findings show that plasma tHcy is a determinant of TNF-alpha in hypertension and that obesity or a history of vascular events aggravates inflammation in patients with hypertension. A positive correlation between Hcy and TNF-alpha suggests a mechanism underlying the pro-atherogenic properties of Hcy.

The influence of orlistat, metformin and diet on serum levels of insulin-like growth factor-1 in obeses women with and without insulin resistance.

A range of studies showed confusing data about the relationship between obesity, weight reduction and circulating total insulin-like growth factor -1 (IGF-1). The aim of the study was to compare the influence of orlistat (IO), metformin (IM), or calorie-restricted diet (LC) on IGF-1, with special respect to insulin-resistance status. One hundred and fourteen obese women aged from 18 to 40 years were divided into insulin sensitive (IS) and insulin resistant (IR) groups and received a low calorie diet (LC), or an isocaloric diet and 500 mg metformin twice daily (IM), or isocaloric diet with 120 mg orlistat three times daily (IO). Before and after the intervention anthropometric parameters, serum lipid profile, serum concentrations of alanine aminotransferase, aspartate aminotransferase, insulin, glucose, IGF-1, HOMA-IR (homeostatic model assessment), and visceral adiposity index (VAI), and their changes were registered. Although the reductions in weight and body fat were comparable in IS and IR groups, only women with IR showed a significant increase in IGF-1 concentration as a result of all interventions. We found significant positive correlations of ΔIGF-1 with initial and Δ values of: HOMA-IR, triglyceride/high-density cholesterol ratio, VAI. IR premenopausal women show significant increase in IGF-1 serum concentrations regardless the method of intervention. The increase in IGF-1 was parallel to the improvement of insulin resistance parameters.

Beneficial dose-independent influence of Camellia sinensis supplementation on lipid profile, glycemia, and insulin resistance in an NaCl-induced hypertensive rat model.

Green tea extract exerts favorable influence on the lipid profile and insulin resistance in the high-sodium intake arterial hypertension. A high-sodium diet (HSD) was introduced to thirty Wistar rats to create a model of hypertension. Rats were randomized into three groups, 10 animals each. The SK group consumed HSD. The SH2 group consumed HSD with 2 g of green tea extract in kg of diet. The SH4 group was fed HSD with 4 g of green tea extract in kg of diet. After six-week trial blood samples were collected. The serum concentrations of glucose, insulin and lipids were estimated, and insulin sensitivity was calculated using homeostatic model assessment (HOMA). Neither the high-sodium diet nor supplementation with green tea extract had any significant influence on the body mass of the animals in either group. Total cholesterol (TCH) and low-density lipoproteins (LDL) cholesterol serum concentrations were significantly smaller in both supplemented groups than in the SK group. The insulin level in the SH2 rats and HOMA in SH2 and SH4 groups were found to be significantly smaller than in the SK group. There were no differences in glucose concentrations between groups. Within the whole population, statistically significant positive correlations between HOMA and LDL, TCH were found. We conclude that in NaCl-induced hypertensive Wistar rats, supplementation with green tea extract produced a dose-independent beneficial and parallel effect on the lipid profile and insulin resistance.

Influence of insulin therapy on expression of chemokine receptor CCR5 and selected inflammatory markers in patients with type 2 diabetes mellitus.

OBJECTIVE: Leukocyte migration to the subendothelial space is considered crucial in the initiation of atherosclerosis. There is increasing evidence that overexpression of chemokine receptors contribute to this process. CCR5 is one of the receptors present on peripheral T lymphocytes, monocytes and macrophages. We decided to evaluate the expression of CCR5 on monocytes and macrophages in peripheral blood and selected inflammatory markers in patients with type 2 diabetes mellitus before and after the initiation of insulin therapy. MATERIAL AND METHODS: A total of 10 patients with newly diagnosed type 2 diabetes and 6 healthy control subjects were studied. Assessment of CCR5 expression on the surface of monocytes and macrophages in peripheral blood was performed using flow cytometry before the initiation of insulin therapy and after 5-week treatment. Serum concentrations of RANTES, TNF-alpha, IL-6 and hsCRP were assessed. RESULTS: When compared to control subjects, we observed higher densities of CCR5 on the surface of peripheral blood monocytes and macrophages and higher concentrations of RANTES, TNF-alpha, IL-6 and hsCRP before insulin therapy. After 5-week insulin therapy, there was a significant decrease in the expression of CCR5 on the surface of these cells and a significant fall in serum levels of RANTES, IL-6, TNF-alpha and hsCRP. CONCLUSIONS: Type 2 diabetes leads to an increase in the inflammatory process, and insulin therapy inhibits the early stages of this process.

The relation between osteoprotegerin, inflammatory processes, and atherosclerosis in patients with metabolic syndrome.

OBJECTIVE: To evaluate osteoprotegerin serum concentration (and compare with healthy controls), to estimate the relationship between serum osteoprotegerin and lipid parameters, insulin resistance, and selected inflammatory factors, and to assess the relationship between osteoprotegerin and intima media thickness in patients with metabolic syndrome. PATIENTS AND METHODS: A total of 70 individuals aged 18-65 years with metabolic syndrome were enrolled. Anthropometric parameters, including body weight, body mass index, waist circumference, and waist-hip ratio, were assessed. The relative and absolute fat tissue contents were evaluated. Serum glucose, insulin, osteoprotegerin, C-reactive protein, and lipid profile were determined. Insulin resistance was calculated using Homeostasis Model Assessment. Intima media complex thickness was evaluated in each participant. RESULTS: No significant differences were observed between patients and the controls with respect to lipid and carbohydrate profiles. Osteoprotegerin was significantly elevated in metabolic syndrome patients compared to the controls. Both C-reactive protein serum concentration and insulin resistance increased in the metabolic syndrome patients. Significant positive correlations between osteoprotegerin serum concentration and body mass index, waist-hip ratio, C-reactive protein serum concentration, and insulin resistance, were documented in patients with metabolic syndrome. CONCLUSIONS: Patients with metabolic syndrome have increased osteoprotegerin serum levels than healthy individuals. Osteoprotegerin plays an important role in the development of arteriosclerosis, and the effect of osteoprotegerin on intima media thickness strongly depends on the extent of the arteriosclerotic changes that occur in metabolic syndrome.

Late-onset Pompe disease in a 54 year-old sportsman with an episode of syncope: a case report.

Pompe disease is an extra-rare metabolic storage disease with deficiency of acid-alpha-glucosidase (GAA) enzyme activity, which leads to the pathologic accumulation of glycogen in target tissues (skeletal muscles, heart, brain). Clinical features and severity vary by the age of onset, rate of extent of organ involvement. In the late-onset Pompe disease (LOPD) form, essential cardiomyopathy seems to be uncommon. Muscles weakness and respiratory failure are the main symptoms of adult patient with Pompe disease. In presented case LOPD coupled with patient's regular sporting activity and healthy diet, which may explain the low intensity of the symptoms and the slow progress of the disease, lack of skeletal muscles weakness and lack of brain manifestation. Myocardial storage deposits are the only abnormalities found.