Factors Associated with Length of Hospitalization in Patients with Diabetes and Mild COVID-19: Experiences from a Tertiary University Center in Serbia.

Background and Objectives: During the COVID-19 pandemic, there was an increased number of hospitalized COVID-19-positive patients suffering from type 2 diabetes mellitus (T2DM). The objective of this research study was to explore factors associated with the length of hospitalization of patients with T2DM and the mild form of COVID-19. Material and Methods: This retrospective cohort study involved all patients who tested positive for COVID-19 and those who were treated in the dedicated COVID-19 department of the University Clinical Center (UCC) in Nis between 10 September 2021 and 31 December 2021. Upon admission, patients underwent blood tests for biochemical analysis, including blood count, kidney and liver function parameters (C-reactive protein (CRP), creatinine kinase, and D-dimer), and glycemia and HbA1c assessments. Additionally, all patients underwent lung radiography. Univariate and multivariate regression analyses were employed to assess the impact of specific factors on the length of hospitalization among patients with T2DM. Results: Out of a total of 549 treated COVID-19-positive patients, 124 (21.0%) had T2DM, while 470 (79.0%) did not have diabetes. Among patients with T2DM, men were significantly younger than women (60.6 ± 16.8 vs. 64.2 ± 15.3, p < 0.01). The average hospitalization length of patients with diabetes was 20.2 ± 9.6 (5 to 54 days), and it was significantly longer than for patients without diabetes, at 15.0 ± 3.4, which ranged from 3 days to 39 (t-test ≈ 5.86, p < 0.05). According to the results of the univariate regression analysis, each year of age is associated with an increase in the length of hospital stay of 0.06 days (95% CI: 0.024 to 0.128, p = 0.004). Patients who received oxygen therapy were treated for 2.8 days longer than those who did not receive oxygen treatment (95% CI: 0.687 to 4988, p = 0.010), and each one-unit increase in CRP level was associated with a 0.02-day reduction in the length of hospitalization (95% CI: 0.004 to 0.029, p = 0.008). Based on the results of the multivariate regression analysis, each year of age is associated with an increase in the length of hospitalization by 0.07 days (95% CI: 0.022 to 0.110, p = 0.003). Patients who received oxygen therapy were treated for 3.2 days longer than those who did not receive oxygen therapy (95% CI: 0.653 to 5726, p = 0.014), and each unit increase in CRP level was associated with a 0.02-day reduction in the length of hospitalization (95% CI: 0.005 to 0.028, p = 0.004). Conclusions: Based on the presented results, COVID-19-positive patients with diabetes had, on average, longer hospitalizations than COVID-19 patients without diabetes. The hospital treatment of patients with T2DM and a milder form of COVID-19 was associated with older age, the use of oxygen therapy, and elevated CRP values. Patients who received oxygen therapy were treated approximately 3 days longer than those who did not receive this therapy.

Okara-Enriched Gluten-Free Bread: Nutritional, Antioxidant and Sensory Properties.

The aim of this study was to produce an eco-innovative gluten-free bread with a pleasant taste and a unique formulation that includes the highest quality grains and pseudocereals (buckwheat; rice; and millet); and okara; a by-product of soy milk production. The mixture of pseudocereal and cereal flour contained buckwheat flour 45%, rice flour 33%, and millet flour 22%. Three gluten-free breads; each containing different contents of gluten-free flour (90%, 80%, and 70%, respectively); okara (10%, 20%, and 30%, respectively); and a control sample (without okara); were prepared and subjected to sensory evaluation. The okara-enriched gluten-free bread with the highest sensory score was selected for further analysis of physico-chemical (total proteins; total carbohydrates; insoluble fiber; soluble fiber; sugars; total lipids; saturated fatty acids; and salt) and functional properties (total phenolic content and antioxidant properties). The highest sensory scores were obtained for 30% okara-enriched gluten-free bread including taste; shape; odor; chewiness; and cross-section properties; classifying this bread in the category of very good quality and excellent quality (mean score 4.30 by trained evaluators and 4.59 by consumers). This bread was characterized by a high content of dietary fiber (14%), the absence of sugar; low content of saturated fatty acids (0.8%), rich source of proteins (8.8%) and certain minerals (e.g.,; iron; zinc); and low energy value (136.37 kcal/100g DW). Total phenolic content was 133.75 mgGAE/100g FW; whereas ferric reducing power; ABTS radical cation; and DPPH radical scavenging activity were 119.25 mgAA/100g FW; 86.80 mgTrolox/100g FW; and 49.92 mgTrolox/100g FW; respectively. Okara addition in gluten-free bread production enables the formulation of high-nutritive; good antioxidative; low-energy bread; and better soy milk waste management.

Subclinical hypothyroidism: association with cardiovascular risk factors and components of metabolic syndrome.

The aim of this cross-sectional study was to evaluate the cardiovascular risk in patients with subclinical hypothyroidism (SH) and metabolic syndrome (MetS) components. The study included 60 patients with SH and a control group of 60 healthy volunteers, gender and age matched, with normal thyroid-stimulating hormone (TSH) and free thyroxin (FT4) concentration. The following measurements were made in all participants: TSH, FT4, thyroid peroxidase antibodies, anti-thyroglobulin antibodies, body mass index (BMI), waist circumference, blood pressure, fasting plasma glucose, total cholesterol (TC), low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides (TG), TC/HDL cholesterol and LDL/HDL cholesterol ratio, basal insulin level and homeostatic model assessment insulin resistance (HOMA-IR) index. MetS was diagnosed according to the National Cholesterol Education Program Adult Treatment Panel III criteria. The results showed that the following indices were statistically significantly higher in the SH group: BMI (p < 0.05), diastolic blood pressure (p < 0.001), TC (p < 0.05), TG (p < 0.05) and basal insulin level (p < 0.05). Although MetS parameters were present in a higher per cent in the SH group, there was a significantly higher number of patients with hypertension and decreased HDL cholesterol (p < 0.05). More frequently, MetS was diagnosed in SH patients (46.67%) than in the control group (33.33%), although the difference was not statistically significant. These results indicated that the traditional cardiovascular risk factors were more frequently present in SH patients as compared to euthyroid participants. Our results did not confirm significantly higher presence of MetS in SH patients in comparison with euthyroid respondents.

Nutritional behavior and motives of college students for the choice of traditional food in the Republic of Serbia.

The aim of this study was to investigate the eating behavior of college students and the reasons for consuming traditional food and to compare the motives for choosing traditional food with the research conducted in 6 European countries. This research was conducted using anonymous online questionnaires. The majority of surveyed students are physically active (75%) and live with their families (57.0%), which can have a positive impact on their diet and a lower level of consumption of "fast-food" (17.5%). Respondents have bad habits in terms of consuming cigarettes (65.0%), alcohol (73.0%) and energy drinks (75.0%). Most students consume all regular meals (73.0%). Based on the Body Mass Index (BMI) of respondents, they belong to the categories: underweight (12%), normal weight (34%), pre-weight (17%), obese (37%); however, 55.0% believed to have "ideal weight". The reasons for choose particular food are: it is not genetically modified, it tastes good, it is nutritious, it makes them happy, it was produced/packaged in an environmentally friendly and ethical way, while the price of food is not important. Connection with family (81%) and food being tasty (54%) are the main reasons for consuming traditional food. When buying traditional food, respondents (59%) generally do not check the declaration on the product. These results indicate the need to educate students about the harmfulness of cigarettes, alcoholic and energy drinks, the importance of BMI and declaration on the product. Comparing obtained results with the results in 6 European countries it can be noticed that the answers of the respondents in Serbia were the most similar to those obtained in Poland.

The hypertriglyceridemic waist phenotype and metabolic syndrome by differing criteria in type 2 diabetic patients and their relation to lipids and blood glucose control.

BACKGROUND: Metabolic syndrome (MetS) describes clustering of obesity, dyslipidemia, hyperglycemia and hypertension and increases risk for cardiovascular disease and type 2 diabetes. The 'hypertriglyceridemic waist' phenotype (HTGW) represents a simple approach to identifying individuals with increased risk. The aim of the study was to determine the prevalence of HTGW and MetS in type 2 diabetic patients, and to examine their relation to lipids and blood glucose control. MATERIAL AND METHODS: 300 type 2 diabetic patients were analysed, and their history of diabetes, anthropometric measures, measurements of blood pressure (BP), lipids and glycemic control parameters were taken. RESULTS: In type 2 diabetic patients, the prevalence of MetS was 71.0% by the AHA/NHLBI definition and 75.33% by the IDF definition. The prevalence was 62.58% and 66.45% in men, and 80% and 84.83% in women by the same definitions, respectively. There were 41.33% of patients with HTGW (42.76% among women and 40% among men). There were statistically significant differences of age, fasting plasma glucose (FPG) and postprandial glucose (PPG) in women with and without MetS according to both definitions, and of total and LDL cholesterol with and without MetS according to AHA/NHLBI (but not IDF). In men, there were statistically significant differences of total cholesterol and of HbA(1c) with and without MetS according to AHA/NHLBI (but not IDF). Women with HTGW had higher levels of total and LDL cholesterol, systolic and diastolic BP. Men with HTGW had higher levels of total cholesterol, diastolic BP, HbA(1c), FPG and PPG. CONCLUSIONS: Determining MetS or HTGW helps identify those with increased cardiovascular risk.