Curcumin in Metabolic Health and Disease.

In recent years, epidemiological studies have suggested that metabolic disorders are nutritionally dependent. A healthy diet that is rich in polyphenols may be beneficial in the treatment of metabolic diseases such as polycystic ovary syndrome, metabolic syndrome, non-alcoholic fatty liver disease, cardiovascular disease, and, in particular, atherosclerosis. Curcumin is a polyphenol found in turmeric and has been reported to have antioxidant, anti-inflammatory, hepatoprotective, anti-atherosclerotic, and antidiabetic properties, among others. This review summarizes the influence of supplementation with curcumin on metabolic parameters in selected metabolic disorders.

Lack of Seasonal Variations in Vitamin D Concentrations among Hospitalized Elderly Patients.

BACKGROUND: Generally, most vitamin D in the human body (90-95%) is produced in the skin during exposure to sunlight. The effectiveness of this process depends on several biological and physical factors, e.g., age or latitude. Skin synthesis of vitamin D among elderly people is reduced. The aim of the study was to assess serum 25-hydroxyvitamin D [25(OH)D] seasonal variations in elderly patients hospitalized at the geriatric department. Methods. The study was carried out on 242 patients aged 60 years or older hospitalized at the geriatric department. The study group was categorized by four seasons as well as month. Results. The median (interquartile range) 25(OH)D concentration among all patients (n = 242) was 33.95 (26.96-45.18) nmol/L. There was no statistical significance in the median serum 25(OH)D concentration with regard to each of the four seasons: in the spring 32.95 (25.96-43.68) nmol/L, in the summer 38.69 (27.46-50.67) nmol/L, in the autumn 33.45 (27.08-44.18) nmol/L, in the winter 34.57 (23.46-43.93) nmol/L, (p = 0.48). Conclusion. Vitamin D deficiency was observed in all geriatric patients, irrespective of the season. The results of the study indicate no significant differences in median vitamin D concentration among the hospitalized patients across all four seasons. Even in the summer months, in our climate, it is fairly difficult for an elderly person to produce an adequate amount of vitamin D through the skin. Therefore, proper vitamin D supplementation is recommended and should be implemented in the elderly irrespective of the season.

Assessment of patients with coronary artery disease who may benefit from the use of rivaroxaban in the real world: implementation of the COMPASS trial criteria in the TERCET registry population.

INTRODUCTION: The positive outcomes of the COMPASS trial raise questions about the proportion of patients who could benefit from additional therapy with rivaroxaban in real­world practice. OBJECTIVES: We aimed to identify the proportion of patients from the TERCET registry with significant coronary artery disease (TERCET­CAD) who could benefit from the use of rivaroxaban and to assess their clinical characteristics and long­term prognosis in comparison with the corresponding measures in the COMPASS trial. PATIENTS AND METHODS: The COMPASS criteria were applied in the TERCET­CAD population. Patients who met the criteria of the COMPASS trial were included in the COMPASS­like group. The baseline characteristics and long­term outcomes of the COMPASS­like group were compared with the corresponding measures in the acetylsalicylic acid (ASA)-alone arm from the COMPASS trial. RESULTS: The COMPASS­like group included 3884 patients (31.6%) out of the 12 286 patients constituting the TERCET­CAD population. Patients in the COMPASS­like group were characterized by older age (P <0.001) and a more frequent occurrence of risk factors for CAD than those in the ASA­alone arm of the COMPASS trial. The rate of a composite endpoint in the COMPASS­like group was 9%, and in the ASA­alone arm of the COMPASS trial, it was 6% (P <0.001). CONCLUSIONS: Less than one-third of the TERCET­CAD population met the COMPASS criteria and could potentially benefit from low­dose rivaroxaban therapy. Unfavorable clinical profiles and higher rates of adverse events in the TERCET registry compared with those in the COMPASS trial may predict greater benefits from the implementation of low­dose rivaroxaban in the real­world population.

Serum phosphorus level is related to degree of clinical response to up-titration of heart failure pharmacotherapy.

Serum phosphorus abnormalities may pose a risk on the cardiovascular system. In heart failure (HF) phosphorus homeostatic mechanisms are altered and may be modified by modern HF therapy. The impact of therapy optimization on phosphorus abnormalities and related outcome remains unknown. In 722 patients with HF subjected to treatment up-titration we analyzed the prevalence of serum phosphorus abnormalities and their relation to HF severity on top of optimal treatment, and we assessed adjusted risk of phosphorus abnormalities at different stages of HF. We analyzed predictors of hypo- and hyperphosphatemia and relation to prognosis. Hypophosphatemia was associated with better response to therapy, was more prevalent in milder HF, and the association was independent of age, sex, BMI, etiology of HF, kidney function and the use of diuretics. Hypophosphatemic patients lost more phosphorus into urine. They had also less catabolic profile. Patients with hyperphosphatemia on top of optimal therapy responded worse to treatment. Hyperphosphatemia was more prevalent in advanced HF, but the effect was attenuated after adjustment for potential confounders. Clinical and biochemical profiles of hyperphosphatemics suggested domination of catabolism. Neither hypophosphatemia nor hyperphosphatemia modifies the outcome Serum phosphorus abnormalities are related to HF severity on top of optimal therapy. Hypophosphatemia occurring on HF up-titration therapy likely has a multifactorial pathophysiology comprising of urinary phosphorus wasting and refeeding effects. Hyperphosphatemia is linked to the catabolic profile but the effect of renal impairment can't be ruled out. The prognostic impact of serum phosphorus abnormalities remain to be established.