Total and high-molecular-weight adiponectin levels and prediction of insulin resistance.

INTRODUCTION: Adiponectin is a peptide secreted by adipocytes; its reduction is associated with obesity-related disorders, including insulin resistance (IR). The study analysed levels of total adiponectin and its high-molecular-weight (HMW) oligomer in a group of metabolically healthy adults and in patients with type 2 diabetes mellitus (T2DM) to evaluate these levels as potential predictors of the presence of IR. MATERIALS AND METHODS: The study comprised 269 metabolically healthy adults and 300 patients with T2DM. Anthropometric and bio-chemical indices were measured, including total and HMW adiponectin levels; the Homeostatic Model Assessment of IR (HOMA-IR) index was calculated, and logistic regression analysis was used to predict the presence of IR. RESULTS: In healthy individuals, both total and HMW adiponectin levels were significantly higher than in diabetic patients. Total and HMW adiponectin levels were moderately correlated with the HOMA-IR index. Logistic regression analysis showed that increased levels of both total adiponectin (odds ratio [OR] 0.598, 95% confidence interval [CI] 0.483-0.723) and the HMW form (OR 0.360, 95% CI 0.242-0.511) are protective factors for the development of IR. The cut-off levels were 4.22 mg/L for total adiponectin and 2.75 mg/L for HMW adiponectin. The results are valid for middle-aged European adults. CONCLUSIONS: Adiponectin levels below the indicated cut-offs may predict a potential risk for the development of IR.

A study evaluating noise levels at selected schools in the Czech Republic.

OBJECTIVE: Worldwide, primary schools are the most important segment of childhood education. The main disturbing source of noise in schools is human speech, the primary component of the learning process. School noise has a negative impact on information processing, teachers and pupils, and communication in the classroom. The study aimed at assessing A-weighted sound pressure levels in primary school classrooms. It was concerned with A-weighted sound pressure levels and their fluctuation during various classes. METHODS: The noise was measured with the static calibrated Brüel and Kjær 2260 Investigator sound level meter. The sound pressure levels were measured twice in 12 classes as 11 different subjects were taught to reduce the uncertainty of results due to their potential variability in time. From the instantaneous values, LA (t), equivalent continuous A-weighted sound pressure levels (LAeq,T) and LAmax were calculated. RESULTS: The mean equivalent A-weighted sound pressure level during lessons irrespective of age and subjects taught was 68.0 ± 3.4 dB (uncertainty of measurement). The highest levels of noise were in physical education and arts; the lowest levels were found for English taught as a foreign language. There were no statistically significant differences in LAeq,T depending on the numbers of children in the classes. The main source of noise is pupils. Attention should be paid to negative feelings of noise to reduce LAeq,T in schools. CONCLUSIONS: Continuous noise pollution, in combination with stress and the mentally demanding nature of the teaching profession, may lead to numerous negative effects on human personality.

Primary and secondary prevention of colorectal cancer in the Czech Republic.

Colorectal cancer is one of the most frequent malignancies in the Czech Republic and worldwide. Also, a high prevalence of overweight and obesity, a high proportion of smokers in the population, and one of the highest per capita alcohol consumption rates are typical for the Czech population. The role of general practitioners in the prevention of colorectal cancer is crucial. In primary prevention, the doctor should emphasise the importance of a healthy lifestyle - a balanced diet rich in fruits and vegetables, maintaining a normal body weight, adequate physical activity, and non-smoking. In secondary prevention, patients should be informed about the possibilities of colorectal cancer screening and the benefits of early detection of the disease. Participation rates of the target population for colorectal cancer screening are low. Steps leading to increased participation in colorectal cancer screening (including postal invitations) play an important role in influencing the mortality of colorectal cancer.

Total and High Molecular Weight Adiponectin Levels and Prediction of Cardiovascular Risk in Diabetic Patients.

The study aimed at assessing the potential use of lower total and HMW adiponectin levels for predicting cardiovascular risk in patients with type 2 diabetes mellitus (T2DM). Concentrations of total adiponectin or high molecular weight (HMW) adiponectin decrease in association with the development of metabolic dysfunction such as obesity, insulin resistance, or T2DM. Increased adiponectin levels are associated with a lower risk for coronary heart disease. A total of 551 individuals were assessed. The first group comprised metabolically healthy participants (143 females, and 126 males) and the second group were T2DM patients (164 females, and 118 males). Both total adiponectin and HMW adiponectin in diabetic patients were significantly lower when compared with the group of metabolically healthy individuals. There was a weak monotonic correlation between HMW adiponectin levels and triglycerides levels. Binary logistic regression analysis, gender adjusted, showed a higher cardiovascular risk in diabetic persons when both total adiponectin (OR = 1.700) and HMW adiponectin (OR = 2.785) levels were decreased. A decrease in total adiponectin levels as well as a decrease in its HMW adiponectin is associated with a higher cardiovascular risk in individuals with T2DM. This association suggests that adiponectin levels may be potentially used as an epidemiological marker for cardiovascular risk in diabetic patients.

Evaluation of insulin resistance and metabolic syndrome in a group of obese Czech children.

OBJECTIVE: The study aimed to determine the incidence of metabolic syndrome (MS) in a group of Czech obese children, to evaluate the incidence of insulin resistance according to HOMA-IR in this group, and to consider the diagnostic value of HOMA-IR in early MS detection in obese children using the logistic regression models for analyzing the relations between HOMA IR and MS. SUBJECTS AND METHODS: Anthropometric and laboratory examinations were performed in a group of 274 obese children aged 10-17 years. RESULTS: MS was established in 102 subjects (37%). The presence of insulin resistance according to HOMA-IR >3.16 was ascertained in 53% of the subjects. HOMA-IR limit was exceeded by 70% in the MS (+) group and by 43% in children in the MS (-) (p<0.0001) category. CONCLUSION: The relatively high incidence of insulin resistance in obese children without MS questions the prevailing diagnostic criteria of, perhaps, falsely excluding some cases of, MS.

Adipocyte fatty acid binding protein and C-reactive protein levels as indicators of insulin resistance development.

BACKGROUND: Adipocyte fatty acid-binding protein (aFABP) has recently been identified as a potential circulating marker for metabolic syndrome. C-reactive protein (CRP), a sensitive marker of inflammation, is increased in individuals with diabetes and metabolic syndrome due to the development of subclinical inflammation. The study uses logistic regression models to analyze the relations between aFABP and CRP along with other parameters of insulin resistance. The objective was to investigate the potential use of aFABP and CRP levels as tools in the diagnosis of the metabolic syndrome. METHODS AND RESULTS: The following groups were studied: healthy individuals (A, n=122), obese individuals (B, n=213) and patients diagnosed with metabolic syndrome (C, n=79). Obese persons in Group B had parameters suggestive of early insulin resistance: hypertension, hyperglycaemia, QUICKI (0.305) and higher aFABP levels as compared with the healthy subjects. Group C individuals were diagnosed with metabolic syndrome, as evidenced by the QUICKI markers for insulin resistance (0.293), high aFABP levels (35.3 mg/l). CRP concentrations were lowest in Group A healthy individuals (0.67 mg/l), higher in Group B obese subjects (2.65 mg/l) and highest in Group C patients with metabolic syndrome (3.62 mg/l). Logistic regression models showed an association of aFABP and CRP with BMI (OR 1.12 and 1.39, compared Group A vs C). An association of aFABP and CRP with the QUICKI index showed OR 1.48 and 1.37 (Group A vs C); with triglyceride levels showed OR 1.68 and 1.52 (Group A vs C). An association of aFABP and CRP with glycaemia showed OR 1.48 and 1.51 (Group A vs C), with insulinaemia showed OR 1.44 and 1.38 (Group A vs C) respectively. CONCLUSIONS: AFABP levels were higher in obese individuals and highest in those with metabolic syndrome. CRP concentrations were increased in obese persons whereas individuals with metabolic syndrome were found to have high-risk CRP levels. Logistic regression models showed an association of aFABP and CRP with BMI as well as an association of aFABP and CRP with parameters of insulin resistance, namely the QUICKI index, triglyceride levels, glycaemia and insulinaemia. Both methods are of diagnostic benefit for predicting metabolic syndrome, especially in previously untreated patients.

Genetic syndromes associated with renal cell carcinoma: a review.

AIMS: A review of recent knowledge on heredital syndromes related to renal cell carcinoma. METHODS: Aim of this review was to summarize the recent knowledge of genetic syndromes associated with renal cell carcinoma. RESULTS: Summary of incidence and factors modulating risk of hereditary renal cell carcinoma development. CONCLUSIONS: Hereditary forms of RCC are relatively rare. Their study is beneficial in many ways. In individuals at a higher risk of a hereditary syndrome, the knowledge of hereditary forms may help to significantly decrease the impact of the hereditary disease. In the general population, knowledge acquired by the study of hereditary forms of RCC may in the future contribute to both diagnosis and treatment of sporadic tumours.