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1.
Sci Rep ; 13(1): 17453, 2023 10 14.
Article in English | MEDLINE | ID: mdl-37838751

ABSTRACT

Subjects with Asperger's syndrome without intellectual disabilities have significant difficulties in establishing social relationships despite their IQ being within the normal range. One of the effects of social deficit is depression. The question arises whether loneliness and dimensions of meaning in life correlate with the severity of depression and whether the average severity of depression, loneliness and dimensions of meaning in life differentiate the following groups: people with Asperger's syndrome and depression, people with Asperger's syndrome without depression, people with depression without Asperger's syndrome and healthy subjects. The study was conducted on a total of 170 people, including: 43 people with Asperger's syndrome and depression, 41 people with Asperger's syndrome without depression, 40 people with depression without Asperger's syndrome and 46 healthy people (without Asperger's syndrome and without depression). All were administered a demographic survey, Beck Depression Inventory II (BDI-II), De Jong Gierveld Loneliness Scale, Life Attitude Profile-Revised. Asperger's syndrome and depressive episodes were diagnosed on the basis of ICD-10 research criteria still applicable in Poland. In the group with Asperger's syndrome and depression the highest levels of loneliness and the lowest values of the dimensions of the sense of meaning in life, except for the acceptance of death, were observed. This result was significantly different from the results obtained in the other study groups. Both in people with Asperger's syndrome without depression and in people with depression without Asperger's syndrome, the values of the dimensions of the sense of meaning in life and the level of loneliness differ significantly from the results obtained in the control group. The BDI-II scores correlated positively with the loneliness values and negatively with the sense of meaning in life values in all groups. The results indicate that both suffering from depression and having Asperger's syndrome are associated with an increased sense of loneliness and a reduced sense of meaning in life. People with Asperger's syndrome and depression have the highest values of loneliness and the lowest values of dimensions of the sense of meaning of life compared to the other groups studied. The limitation of the work is the deliberate selection of groups, because it would be interesting to answer the question whether Asperger's syndrome is a risk factor for depression in the population.


Subject(s)
Asperger Syndrome , Humans , Asperger Syndrome/diagnosis , Asperger Syndrome/epidemiology , Pilot Projects , Loneliness , Interpersonal Relations , International Classification of Diseases
2.
Cells ; 12(18)2023 09 07.
Article in English | MEDLINE | ID: mdl-37759451

ABSTRACT

BACKGROUND: It is well known that oxidative stress plays an important role in the development of non-alcoholic fatty liver disease (NAFLD). It has been suggested that an insufficient antioxidant defense system composed of antioxidant enzymes, including catalase (CAT) and nonenzymatic molecules, is a key factor triggering oxidative damage in the progression of liver disease. Therefore, the aim of our study was to assess whether the level of CAT and -262 C/T polymorphism in the promoter of CAT (rs1001179) are associated with NAFLD. METHODS: In total, 281 adults (152/129 female/male, aged 65.61 ± 10.44 years) were included in the study. The patients were assigned to an NAFLD group (n = 139) or a group without NAFLD (n = 142) based on the results of an ultrasound, the Hepatic Steatosis Index, and the Fatty Liver Index (FLI). CAT levels were determined using an ELISA test, and genomic DNA was extracted via the standard phenol/chloroform-based method and genotyped via RFLP-PCR. RESULTS: The CAT level was decreased in NAFLD patients (p < 0.001), and an ROC analysis revealed that a CAT level lower than 473.55 U/L significantly increases the risk of NAFLD. In turn, genotyping showed that the CT genotype and the T allele of -262 C/T CAT polymorphism elevate the risk of NAFLD. The diminished CAT level in the NAFLD group correlated with increased FLI, waist circumference and female gender. CONCLUSION: The obtained results support observations that oxidative damage associated with NAFLD may be the result of a decreased CAT level as a part of the antioxidant defense system.


Subject(s)
Catalase , Non-alcoholic Fatty Liver Disease , Female , Humans , Male , Alleles , Antioxidants , Catalase/genetics , Genotype , Non-alcoholic Fatty Liver Disease/genetics , Tomography, X-Ray Computed , Middle Aged , Aged
3.
Int J Mol Sci ; 24(14)2023 Jul 11.
Article in English | MEDLINE | ID: mdl-37511066

ABSTRACT

Oxidative stress is one of the pillars crucial in the development of a non-alcoholic fatty liver disease (NAFLD) and may cause DNA damage. Since the main pathway responsible for the repair of oxidative DNA damage is the base-excision repair (BER) pathway, we examined the relationship between the presence of different genetic variants of BER-associated genes and the risk of NAFLD. The study evaluates seven single nucleotide polymorphisms (SNPs) within five genes, hOGG1, APEX1, NEIL1, LIG3, LIG1, in 150 NAFLD patients and 340 healthy controls. The genotyping was performed using TaqMan probes and the results were presented as odds ratio with its corresponding 95% confidence interval. The following SNPs were assessed in the study: hOGG1 (rs1052133), APEX1 (rs176094 and rs1130409), NEIL1 (rs4462560), LIG3 (rs1052536), LIG3 (rs4796030), and LIG1 (rs20579). Four of the investigated SNPs, i.e., rs176094, rs1130409, rs4462560 and rs4796030, were found to be associated with NAFLD risk. Furthermore, the occurrence of insulin resistance in patients with steatosis depended on various LIG3 genetic variants. The findings imply the impact of genes involved in BER on NAFLD and fatty liver-related insulin sensitivity.


Subject(s)
DNA Glycosylases , Non-alcoholic Fatty Liver Disease , Humans , Polymorphism, Single Nucleotide , Non-alcoholic Fatty Liver Disease/genetics , Genetic Predisposition to Disease , DNA Repair/genetics , DNA Damage , Case-Control Studies , DNA Glycosylases/genetics
4.
Nutrients ; 15(13)2023 Jun 22.
Article in English | MEDLINE | ID: mdl-37447164

ABSTRACT

There is a need to introduce standardized treatment options for non-alcoholic fatty liver disease (NAFLD) due to its global prevalence and the complications of this disease. Many studies have revealed that food-derived substances may be beneficial in dealing with this disease. Therefore, this review aims to evaluate the recently published studies on the food-derived treatment options for NAFLD. A comprehensive search of the PubMed database using keywords such as "NAFLD", "nutrition", "food", "derived", "therapy", and "guidelines" yielded 219 relevant papers for our analysis, published from 2004 to 2023. The results show the significant benefits of food-derived treatment in NAFLD therapy, including improvements in liver histology, hepatic fat amounts, anthropometric measures, lipid profile, and other metabolic measures. The availability of the substances discussed makes them a significant adjuvant in the treatment of this disease. The usefulness of Viusid as additional therapy to diet and physical activity should be emphasized due to improvements in liver histology; however, many other substances lead to a decrease in liver fat amounts including, e.g., berberine or omega-3 fatty acids. In addition, the synbiotic Protexin seems to be useful in terms of NAFLD treatment, especially because it is effective in both obese and lean subjects. Based on the latest research results, we suggest revising the therapeutic recommendations for patients suffering from NAFLD.


Subject(s)
Non-alcoholic Fatty Liver Disease , Humans , Non-alcoholic Fatty Liver Disease/metabolism , Liver/metabolism , Food , Diet , Nutritional Status
5.
J Clin Med ; 12(13)2023 Jul 03.
Article in English | MEDLINE | ID: mdl-37445503

ABSTRACT

BACKGROUND: The increasing prevalence of type 2 diabetes mellitus (T2DM) and non-alcoholic fatty liver disease (NAFLD) states a serious problem for public health. The introduction of effective methods of treatment and prevention is crucial to avoid complications of these diseases. Among them, we can specify psychological factors that affect everyday life and determine the patient's attitude towards therapy, and what follows, their compliance in treatment. The literature indicates these connections in various ways; in our study, we extend this view to include a broader perspective of human personality. OBJECTIVE: We decided to investigate the associations between personality factors and metabolic parameters in patients with NAFLD and T2DM in order to better understand the patient's approach to the treatment of a chronic disease, such as those mentioned, and to establish the basis for further research implementing psychological interventions in the treatment of NAFLD and T2DM. METHODS: One hundred participants with NAFLD and T2DM underwent blood tests and anthropometric measures. Each of them was asked to complete five questionnaires evaluating their personality properties. RESULTS: We revealed that a rise in body mass index is related to a fall in the emotional intelligence factor of utilizing emotions, and a rise in emotional perception. The decrease in task-oriented coping style and a rise in emotion-oriented coping style are associated with a waist-hip ratio increase. The increase in fasting plasma glucose is predicted by a decrease in task-oriented coping style score. A fall in social diversion coping style score is associated with a high-density lipoprotein increase; in turn, a triglycerides increase is connected with a decline in rhythmicity score. CONCLUSIONS: The personality factors are in relationship in the management of NAFLD and T2DM. They affect a patient's approach to treatment, which is very important, because we know lifestyle and dietary interventions are an important part of the treatment of these diseases. The compliance manifests by lifestyle modifications, taking medications regularly, measuring blood glucose, and inspection visits in outpatients' clinics are a large part of a diabetic's life. Future studies introducing psychological intervention to improve, e.g., coping styles or rhythmicity are needed to implement new methods of patient management.

6.
Int J Mol Sci ; 24(11)2023 Jun 02.
Article in English | MEDLINE | ID: mdl-37298632

ABSTRACT

The prevalence of metabolic-related disorders, such as non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (DM2), has been increasing. Therefore, developing improved methods for the prevention, treatment, and detection of these two conditions is also necessary. In this study, our primary focus was on examining the role of chronic inflammation as a potential link in the pathogenesis of these diseases and their interconnections. A comprehensive search of the PubMed database using keywords such as "non-alcoholic fatty liver disease", "type 2 diabetes mellitus", "chronic inflammation", "pathogenesis", and "progression" yielded 177 relevant papers for our analysis. The findings of our study revealed intricate relationships between the pathogenesis of NAFLD and DM2, emphasizing the crucial role of inflammatory processes. These connections involve various molecular functions, including altered signaling pathways, patterns of gene methylation, the expression of related peptides, and up- and downregulation of several genes. Our study is a foundational platform for future research into the intricate relationship between NAFLD and DM2, allowing for a better understanding of the underlying mechanisms and the potential for introducing new treatment standards.


Subject(s)
Diabetes Mellitus, Type 2 , Non-alcoholic Fatty Liver Disease , Humans , Non-alcoholic Fatty Liver Disease/diagnosis , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/epidemiology , Inflammation/metabolism , Signal Transduction
7.
Biomedicines ; 11(4)2023 Apr 04.
Article in English | MEDLINE | ID: mdl-37189715

ABSTRACT

In clinical practice, we often deal with patients who suffer from non-alcoholic fatty liver disease (NAFLD) concurrent with type 2 diabetes mellitus (T2DM). The etiopathogenesis of NAFLD is mainly connected with insulin resistance (IR) and obesity. Similarly, the latter patients are in the process of developing T2DM. However, the mechanisms of NAFLD and T2DM coexistence have not been fully elucidated. Considering that both diseases and their complications are of epidemic proportions and significantly affect the length and quality of life, we aimed to answer which of these diseases appears first and thereby highlight the need for their diagnosis and treatment. To address this question, we present and discuss the epidemiological data, diagnoses, complications and pathomechanisms of these two coexisting metabolic diseases. This question is difficult to answer due to the lack of a uniform procedure for NAFLD diagnosis and the asymptomatic nature of both diseases, especially at their beginning stages. To conclude, most researchers suggest that NAFLD appears as the first disease and starts the sequence of circumstances leading ultimately to the development of T2DM. However, there are also data suggesting that T2DM develops before NAFLD. Despite the fact that we cannot definitively answer this question, it is very important to bring the attention of clinicians and researchers to the coexistence of NAFLD and T2DM in order to prevent their consequences.

8.
Front Psychiatry ; 14: 1077940, 2023.
Article in English | MEDLINE | ID: mdl-37065892

ABSTRACT

Background: Compared to their peers, medical students are more exposed to stress, and many present symptoms of depression, making them a group prone to experiencing mental illnesses. Objective: This study investigates a potential link between the occurrence of symptoms of depression and the dominating type of affective temperament in young people studying at a medical university. Methods: One hundred thirty-four medical students were surveyed using two validated questionnaires; the Polish versions of Beck's Depression Inventory-II (BDI-II) and the Temperament Evaluation of the Memphis, Pisa, and San Diego Autoquestionnaire (TEMPS-A). Results: The data analysis revealed a significant link between symptoms of depression and affective temperaments, most significantly in subjects with an anxious temperament. Conclusion: This study confirms the role of various affective temperaments as a risk factor for mood disorders, specifically depression.

9.
Int J Mol Sci ; 24(6)2023 Mar 10.
Article in English | MEDLINE | ID: mdl-36982387

ABSTRACT

Several studies report elevated blood platelet activation and altered platelet count in COVID-19 patients, but the role of the SARS-CoV-2 spike protein in this process remains intriguing. Additionally, there is no data that anti-SARS-CoV-2 neutralizing antibodies (nAb) may attenuate spike protein activity toward blood platelets. Our results indicate that under in vitro conditions, the spike protein increased the collagen-stimulated aggregation of isolated platelets and induced the binding of vWF to platelets in ristocetin-treated blood. The spike protein also significantly reduced collagen- or ADP-induced aggregation or decreased GPIIbIIIa (fibrinogen receptor) activation in whole blood, depending on the presence of the anti-spike protein nAb. Our findings suggest that studies on platelet activation/reactivity in COVID-19 patients or in donors vaccinated with anti-SARS-CoV-2 and/or previously-infected COVID-19 should be supported by measurements of spike protein and IgG anti-spike protein antibody concentrations in blood.


Subject(s)
COVID-19 , Humans , COVID-19/metabolism , Spike Glycoprotein, Coronavirus/metabolism , SARS-CoV-2/metabolism , Blood Platelets/metabolism , Antibodies, Viral , Antibodies, Neutralizing
10.
Pol Merkur Lekarski ; 51(1): 59-63, 2023.
Article in English | MEDLINE | ID: mdl-36960902

ABSTRACT

Music therapy is a therapeutic method used in dealing with people suffering from various somatic and mental disorders. The pa¬per discusses the current state of knowledge about the use of music therapy in the management of people suffering from obesity. Attention was paid to the possible positive effect of music therapy on weight control. It also reviews the literature of controlled clinical trials conducted over the past 10 years on the importance of music therapy in the treatment of obesity. These studies show that music therapy can have a positive effect on both weight loss and maintaining an adequate caloric supply of food. The small number of studies, however, does not allow to formulate precise conclusions and unambiguous conclusions. The issue of the ef¬fect of music therapy on the clinical condition of patients suffering from obesity requires further research.


Subject(s)
Mental Disorders , Metabolic Syndrome , Music Therapy , Humans , Music Therapy/methods , Metabolic Syndrome/therapy , Mental Disorders/therapy , Anxiety/therapy , Obesity/complications , Obesity/therapy
11.
Article in English | MEDLINE | ID: mdl-36901082

ABSTRACT

Clinical and epidemiological studies have demonstrated a relationship between alcohol addiction and mood disorders. Alcohol-dependent patients with depression tend to demonstrate clinically more severe manic symptoms, which complicates the process of diagnosis and therapy. However, the predictors indicating the risk of mood disorders in addicted patients remain unclear. The aim of the study was to examine the relationship between personal dispositions, bipolar traits, depth of addiction, quality of sleep, and depressive symptoms in alcohol-dependent men. The study group comprised 70 men (age M = 46.06, SD = 11.29) diagnosed with alcohol addiction. The participants completed a battery of questionnaires: BDI, HCL-32, PSQI, EPQ-R and MAST. The results were tested using Pearson's correlation quotient and general linear model. The findings indicate that some of the studied patients are likely to have mood disorders of clinically significant severity. High neuroticism and poor sleep quality are independent predictors of depressive symptoms in alcohol-dependent patients. Among the components of sleep quality, problems with falling asleep and waking up at night appear to be most strongly associated with depressive symptoms. The intensity of depressive symptoms may relate to the intensity of certain bipolar features, such as risk-taking activity and irritability. High neuroticism and poor sleep quality are independent predictors of depressive symptoms in the studied group.


Subject(s)
Alcoholism , Bipolar Disorder , Sleep Initiation and Maintenance Disorders , Male , Humans , Depression , Temperament , Sleep Quality
12.
J Clin Med ; 12(5)2023 Feb 26.
Article in English | MEDLINE | ID: mdl-36902639

ABSTRACT

Non-alcoholic fatty liver disease (NAFLD) is a serious health problem due to its high incidence and consequences. In view of the existing controversies, new therapeutic options for NAFLD are still being sought. Therefore, the aim of our review was to evaluate the recently published studies on the treatment of NAFLD patients. We searched for articles in the PubMed database using appropriate terms, including "non-alcoholic fatty liver disease", "nonalcoholic fatty liver disease", "NAFLD", "diet", "treatment", "physical activity", "supplementation", "surgery", "overture" and "guidelines". One hundred forty-eight randomized clinical trials published from January 2020 to November 2022 were used for the final analysis. The results show significant benefits of NAFLD therapy associated with the use of not only the Mediterranean but also other types of diet (including low-calorie ketogenic, high-protein, anti-inflammatory and whole-grain diets), as well as enrichment with selected food products or supplements. Significant benefits in this group of patients are also associated with moderate aerobic physical training. The available therapeutic options indicate, above all, the usefulness of drugs related to weight reduction, as well as the reduction in insulin resistance or lipids level and drugs with anti-inflammatory or antioxidant properties. The usefulness of therapy with dulaglutide and the combination of tofogliflozin with pioglitazone should be emphasized. Based on the results of the latest research, the authors of this article suggest a revision of the therapeutic recommendations for NAFLD patients.

13.
Healthcare (Basel) ; 11(3)2023 Feb 02.
Article in English | MEDLINE | ID: mdl-36767008

ABSTRACT

Obesity is a growing civilization problem, associated with a number of negative health consequences affecting almost all tissues and organs. Currently, obesity treatment includes lifestyle modifications (including diet and exercise), pharmacologic therapies, and in some clinical situations, bariatric surgery. These treatments seem to be the most effective method supporting the treatment of obesity. However, they are many limitations to the options, both for the practitioners and patients. Often the comorbidities, cost, age of the patient, and even geographic locations may influence the choices. The pharmacotherapy of obesity is a fast-growing market. Currently, we have at our disposal drugs with various mechanisms of action (directly reducing the absorption of calories-orlistat, acting centrally-bupropion with naltrexone, phentermine with topiramate, or multidirectional-liraglutide, dulaglutide, semaglutide). The drugs whose weight-reducing effect is used in the course of the pharmacotherapy of other diseases (e.g., glucose-sodium cotransporter inhibitors, exenatide) are also worth mentioning. The obesity pharmacotherapy is focusing on novel therapeutic agents with improved safety and efficacy profiles. These trends also include an assessment of the usefulness of the weight-reducing properties of the drugs previously used for other diseases. The presented paper is an overview of the studies related to both drugs currently used in the pharmacotherapy of obesity and those undergoing clinical trials, taking into account the individual approach to the patient.

14.
Article in English | MEDLINE | ID: mdl-36767486

ABSTRACT

The onset of schizophrenia symptoms usually occurs in early youth. As a result, the parents of these patients usually become their caregivers. The role of a caregiver for a person with schizophrenia is a considerable mental and physical burden. Therefore, an interesting issue is what motivates these people to take up this challenge. It is probable that, apart from the moral imperative or kinship, the factor determining this decision is the personality structure of the caregiver. The aim of our study was to compare the structure of temperament (according to the model of temperament as formal characteristics of behavior developed by Jan Strelau) in caregivers of young adults (age 18-25 years) with schizophrenia with the structure of temperament of parents of healthy young adults still living in the family home under their care. The study group consisted of 64 people (51 women), who were taking care of young adults (aged 18-25 years) with schizophrenia, while the control group (53 people, 42 women) consisted of parents of healthy adults still living in the family home. Both groups were asked to complete a questionnaire of the authors' own design on their demographic data as well as The Formal Characteristics of Behavior-Temperament Inventory to assess the temperament traits. The results were given in the number of points obtained on average in each dimension. Both groups did not differ in terms of size and age, with women predominating. Caregivers of young adults with schizophrenia had higher values of briskness (43.22 ± 4.45 vs. 42.90 ± 3.98, p = 0.032), emotional reactivity (46.02 ± 4.39 vs. 41.01 ± 3.12, p = 0.012) and activity level (44.01.89 ± 4.15 vs. 37.59 ± 4.77, p = 0.022) compared to the control group. The remaining dimensions of temperament: perseverance, sensory sensitivity, rhythmicity, and endurance did not differentiate between the two groups. The temperament structure of caregivers of young people with schizophrenia differs from the temperament structure of caregivers of healthy adults. Caregivers of sick people have higher values of briskness, emotional reactivity, and activity level compared to the control group.


Subject(s)
Schizophrenia , Temperament , Adolescent , Young Adult , Humans , Female , Adult , Caregivers/psychology , Personality , Personality Disorders
15.
Front Psychiatry ; 14: 1296385, 2023.
Article in English | MEDLINE | ID: mdl-38188044

ABSTRACT

Introduction: The COVID-19 epidemic has provided opportunity to study the impact of a well-defined severe illness on the development of a depressive episode and the associated sense of loneliness and lack of meaning in life. Materials and Methods: The aim of the study was to assess the occurrence of a reactive depressive episode, the severity of depression, a sense of loneliness and meaning in life in subjects who approximately a year earlier than the date of the study had suffered from a pulmonary form of SARS-CoV-2 infection with radiologically documented interstitial lesions of the lungs, requiring and not requiring hospitalization compared to people who did not develop the disease as a result of infection with that virus. The study included 63 subjects hospitalized for pulmonary lesions, 67 not hospitalized and 60 healthy controls. The severity of depressive symptoms was measured using a Polish-language standardized version of the Beck Depression Inventory, a sense of loneliness using the De Jong Gierveld Loneliness Scale, and a sense of meaning in life using the Life Attitude Profile-Revised. Results: The frequency of depression and its severity were found to be the highest in hospitalized patients compared to those treated at home and healthy people. A significant difference in the frequency of depression and its severity between outpatients and healthy people was also observed. The feeling of loneliness turned out to be greatest in the group of hospitalized people. Also, the severity of loneliness was found to be higher in the outpatient compared to the control group. The sense of meaning in life reached its lowest level among hospitalized patients, was moderately reduced in the outpatient group, and typical of the Polish population in the control group. Discussion: Both pulmonary SARS-CoV-2 infection and hospitalization have been shown to be a risk factor for depression, increased feeling of loneliness and a reduced sense of meaning in life. The effect of trauma and the presence of depression can be the explanation for the increased sense of loneliness after the illness and the partial breakdown of the lifeline manifested by a decrease in the sense of meaning in life.

16.
Biomedicines ; 10(9)2022 Sep 11.
Article in English | MEDLINE | ID: mdl-36140354

ABSTRACT

Irisin is a cytokine involved in many metabolic pathways occurring, among others, in muscles, adipose tissue and liver. Thus, fluctuations in irisin levels are suggested to be related to metabolic diseases. Therefore, the purpose of our study was to evaluate whether irisin may be associated with non-alcoholic fatty liver disease (NAFLD). A total of 138 patients (70/68 male/female, mean age 65.61 ± 10.44 years) were enrolled in the study. The patients were assigned to the NAFLD group (n = 72, including 46 patients with type 2 diabetes (T2DM]) and the group without NAFLD (n = 66, 31 patients with T2DM). NAFLD was diagnosed based on ultrasound examination, Hepatic Steatosis Index (HSI) and Fatty Liver Index. Baseline anthropometric, blood pressure and biochemical parameters were collected. The serum irisin level was determined using an ELISA test. We observed that NAFLD was associated with an increased concentration of irisin. Moreover, Spearman correlations and linear regression analysis revealed that irisin level correlates with some anthropometric and biochemical parameters such as body mass index, glycated hemoglobin, aspartic aminotransferase, creatinine and urea. Logistic regression analysis depicted that odds for NAFLD increase 1.17 times for each 1 µg/mL rise of irisin concentration. Finally, ROC analysis showed that the concentration of irisin possesses a discriminate capacity for NAFLD and optimal cut points concentration could be designed. The risk of NAFLD in the subgroup with irisin concentration above 3.235 µg/mL was 4.57 times higher than in patients with the lower concentration of irisin. To conclude, the obtained results suggest that irisin concentration is associated with some anthropometric and biochemical parameters and should be further investigated toward its usage as a diagnostic biomarker of NAFLD.

17.
Endokrynol Pol ; 73(5): 872-884, 2022.
Article in English | MEDLINE | ID: mdl-35971924

ABSTRACT

Research results indicate the presence of an association between mental disorders, certain antipsychotics, and the risk of developing prediabetes (preDM) and specific type diabetes mellitus (DM). However, there are no precise recommendations for their diagnosis and treatment. The obtained data suggest the necessity to perform diagnostics of carbohydrate disorders at the onset of the first symptoms of psychosis, even before the implementation of antipsychotic drugs, and the oral glucose tolerance test (OGTT) seems to be the optimal tool. There is a lot of controversy regarding the timing of control tests addressing the development of dysglycaemia during the use of antipsychotic drugs. We suggest that it should be carried out during the first 4-8 weeks, and in the absence of disorders it should be repeated once a year or with a change in antipsychotic treatment. The diagnostic regimen should then include the need for OGTT supported by routine determination of the percentage of glycated haemoglobin. If dysglycaemia is diagnosed, the therapeutic management should include non-pharmacological management and hypoglycaemic agents. These recommendations should be individually tailored to each patient and take into account the presence of obesity, which is often found in this group of patients. Weight reduction can be achieved with a properly balanced diet, physical effort, and in justified situations also with drugs effectively reducing body weight. For this reason, drugs are recommended that, if preDM and DM are diagnosed, simultaneously lower glucose levels and reduce body weight. So far, effectiveness in this area has been demonstrated for 2 incretinomimetics: exenatide and liraglutide. Due to the mechanism of preDM/DM development in patients using antipsychotics, the usefulness of other hypoglycaemic drugs with insulin-sensitizing potential - metformin and pioglitazone - has also been suggested. To date, there has been no research on the benefits of other hypoglycaemic drugs in this group of patients.


Subject(s)
Antipsychotic Agents , Diabetes Mellitus, Type 2 , Hyperglycemia , Prediabetic State , Humans , Antipsychotic Agents/adverse effects , Hyperglycemia/chemically induced , Hyperglycemia/drug therapy , Hypoglycemic Agents/therapeutic use , Body Weight , Diabetes Mellitus, Type 2/drug therapy , Blood Glucose
18.
Nutrients ; 14(5)2022 Mar 04.
Article in English | MEDLINE | ID: mdl-35268058

ABSTRACT

BACKGROUND: The aim of the study was to evaluate the relationship between polyphenol or polyunsaturated fatty acids (PUFAs) consumption and the selected metabolic and inflammatory markers in type 2 diabetes (T2DM) patients. METHODS: The study enrolled 129 diabetics (49 men, mean age 64.1 ± 9.8 years) with different amounts of polyphenol and PUFAs consumption. RESULTS: A significant effect of polyphenol or PUFAs omega-3 consumption on fasting glucose concentration (FG) or glycated haemoglobin fraction (HbA1c) was reported. A negative association was observed between FG and total polyphenol, flavonoid, flavan-3-ol and stilbene intake. In the group with high flavonoid intake, the FG was significantly lower compared to the group characterised by low flavonoid intake. Polyphenols, except stilbenes, did not modulate HbA1c. Additionally, higher consumption of PUFAs omega-3 significantly decreased HbA1c, and the intake of eicosapentaenoic (EPA) and docosahexaenoic (DHA) acids negatively and significantly correlated with FG and HbA1c. Further analysis confirmed a significant association between EPA + DHA intake and HbA1c, with significant interactions with age and gender or with body mass index and waist-to-hip ratio. The dietary intake of polyphenols or PUFAs was independent of familial diabetes or diabetic diet application. CONCLUSIONS: Our study indicates a positive effect of high consumption of flavonoids, omega-3 PUFAs and stilbenes on the markers of carbohydrate metabolism balance and the absence of such an effect on other cardiometabolic markers and inflammatory conditions.


Subject(s)
Diabetes Mellitus, Type 2 , Fatty Acids, Omega-3 , Aged , Eating , Fatty Acids, Unsaturated , Humans , Male , Middle Aged , Polyphenols
19.
J Clin Med ; 11(5)2022 Mar 02.
Article in English | MEDLINE | ID: mdl-35268466

ABSTRACT

The incidence of nonalcoholic fatty liver disease (NAFLD) is growing worldwide. Epidemiological data suggest a strong relationship between NAFLD and T2DM. This is associated with common risk factors and pathogenesis, where obesity, insulin resistance and dyslipidemia play pivotal roles. Expanding knowledge on the coexistence of NAFLD and T2DM could not only protect against liver damage and glucotoxicity, but may also theoretically prevent the subsequent occurrence of other diseases, such as cancer and cardiovascular disorders, as well as influence morbidity and mortality rates. In everyday clinical practice, underestimation of this problem is still observed. NAFLD is not looked for in T2DM patients; on the contrary, diagnosis for glucose metabolism disturbances is usually not performed in patients with NAFLD. However, simple and cost-effective methods of detection of fatty liver in T2DM patients are still needed, especially in outpatient settings. The treatment of NAFLD, especially where it coexists with T2DM, consists mainly of lifestyle modification. It is also suggested that some drugs, including hypoglycemic agents, may be used to treat NAFLD. Therefore, the aim of this review is to detail current knowledge of NAFLD and T2DM comorbidity, its prevalence, common pathogenesis, diagnostic procedures, complications and treatment, with special attention to outpatient clinics.

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