The epidemiology of the most frequent cancers in Poland in 2015-2021 and the impact of the COVID-19 pandemic on cancer incidence.

BACKGROUND: The late diagnosis, despite the improving availability and accessibility of diagnostic procedures during the last decade in Poland and cooperation between specialist cancer centres, remains an unsolved problem. Moreover, the accessibility to healthcare resources and diagnostic procedures has been drastically reduced because of the COVID-19 pandemic in 2019-2020. The study aimed to present the epidemiology of the most frequent cancers diagnosed in Poland as well as the impact of the COVID-19 pandemic on cancers' incidence. METHODS: Depersonalized, epidemiological data was obtained from the National Health Fund of Poland. In this retrospective study, the epidemiological analysis was performed and divided into subregions, according to patients' domicile. For each of the subregions, we have calculated the incidence rate per 100,000 standardized to the European Standard Population 2013. The time points of providing the first healthcare service were considered as the time of cancer diagnosis. RESULTS: In the 2015-2019 period, before the COVID-19 pandemic occurred, the nationwide incidence of analysed cancers remained stable or slightly decreased (as the lung cancer). Simultaneusly, during the same period the prevalence of the prostate cancer has increased and the large differences between subregions with the least and the highest incidence were observed. Subsequently, the incidences of all analyzed cancers decreased in 2020, compared to the period before the COVID-19 pandemic occurred. Then, in 2021 a disproportionate increase in cancers' incidence rates was noted. CONCLUSIONS: Our results show a significant decrease in the incidence rate of the most frequent cancers diagnosed in Poland in 2020 compared to 2019. Subsequently, in 2021 the increase of the incidence ratios was noted, most likely due to the gradual reduction of epidemic restrictions.

The cut-off value for HOMA-IR discriminating the insulin resistance based on the SHBG level in women with polycystic ovary syndrome.

Introduction: The study aimed to estimate the cut-off value for homeostatic model assessment for insulin resistance (HOMA-IR) discriminating the insulin resistance based on the sex hormones binding globulin (SHBG) level in women with polycystic ovary syndrome (PCOS). Materials and methods: Data from medical records of 854 Caucasian women diagnosed with PCOS were analyzed. Anthropometric data, fasting plasma glucose, insulin and SHBG levels were measured. HOMA-IR was calculated with a standard formula. The cut-off value was calculated using receiver-operating characteristics. Results: Circulating SHBG levels below the normal range (26.1 nmol/L) were found in 25.4% of study participants. This subgroup had a significantly higher BMI, fasting glucose and insulin concentrations and HOMA-IR values. Empirical optimal cut-off values for HOMA-IR corresponding to low SHBG levels was ≥2.1 [area under the curve (AUC) 0.73, accuracy 0.65, sensitivity 72.3%, specificity 63.1%, positive predictive value (PPV) 40.0%, negative predictive value (NPV) 87.0%]. Conclusions: Our study suggests that the cut-off point for HOMA-IR discriminating the insulin resistance based on the SHBG level, in young Caucasian women with polycystic ovary syndrome is 2.1, and is consistent with the cut-off value adopted by the European Group for the Study of Insulin Resistance (above 2.0).

The COVID-19 pandemic and epidemiology of the most common cancers in the Subcarpathian and Silesian Provinces of Poland.

INTRODUCTION AND OBJECTIVE: The study aimed to assess the effect of the COVID-19 pandemic and slow cancer burden on the healthcare system of the most frequent cancers in the Subcarpathien and Silesian Provinces of southern Poland in the period 2015-2020. MATERIAL AND METHODS: Depersonalized, epidemiological data were obtained from the branches of the National Health Founf of Poland (NFZ) in the Subcarpathian and Silesian Province. The database contained 7,814,870 healthcare services granted to 385,845 patients with disease entities classified as C00-C97, according to the ICD-10. RESULTS: In the period 2015-2020, cancer diseases were diagnosed in 3,445 per 100,000 citizens of the Subcarpathian Province and 5248 per 100,000 citizens of the Silesian Province. The changes in SMR values due to cancer diseases found in the Subcarpathian Province were characterized by temporal and spatial differentiation. In the period 2016-2019, unencumbered by the COVID-19 pandemic, the SMR values had decreased on average by -13.2% in most counties of the Subcarpathian Province, but in 2020 the SMR values decreased by -14.7% compared to 2019. In the Silesian Province, similar to the Subcarpathian Province, the values of SMR decreased in the period 2016-2019 in all counties (with the exception of the town of Piekary Slaskie), on average, by -11.5%. Subsequently, in 2020, a significant reduction of SMR compared to 2019 was observed on average by -7.9%. CONCLUSIONS: In 2020, a significant reduction in the diagnosis of patients with cancer was found in the one-year perspective study in both Provinces, which suggests the limitation of availability of the specialistic oncologic healthcare services due to the fight against the COVID-19 pandemic. An increased burden of cancers shortly should be expected. Thus, regional and nationwide screening programmes should be introduced to enable diagnosis at the earliest possible stage.

Association Study of the SLC1A2 (rs4354668), SLC6A9 (rs2486001), and SLC6A5 (rs2000959) Polymorphisms in Major Depressive Disorder.

The membrane excitatory amino acid transporter 2 (EAAT2), encoded by SLC1A2, is responsible for the uptake and redistribution of synaptic glutamate. Glycine modulates excitatory neurotransmission. The clearance of synaptic glycine is performed by glycine transporters encoded by SLC6A9 and SLC6A5. Higher synaptic glycine and glutamate levels could enhance the activation of NMDA receptors and counteract the hypofunction of glutamate neurotransmission described in major depressive disorder (MDD). The aim of the study was to assess whether polymorphisms of SCL1A2 (rs4354668), SCL6A5 (rs2000959), and SCL6A9 (rs2486001) play a role in the development of MDD and its clinical picture in the Polish population. The study group consisted of 161 unrelated Caucasian patients with MDD and 462 healthy unrelated individuals for control. Polymorphisms were genotyped with PCR-RLFP assay. We observed that the frequency of genotype CC and allele C of the SLC1A2 polymorphism rs4354668 was twice as high in the MDD group as in control. Such differences were not detected in SLC6A5 and SLC6A9 polymorphisms. No statistically significant association of the studied SNPs (Single Nucleotide Polymorphisms) on clinical variables of the MDD was observed. The current study indicates an association of polymorphism rs4354668 in SCL1A2 with depression occurrence in the Polish population; however, further studies with larger samples should be performed to clarify these findings.

Consequences of Changes in the Liver Allocation System for Transplantation in the Silesian Voivodeship and in the Transplantation Center in Katowice.

BACKGROUND: For a number of years, the system of procured livers for transplantation by transplant centers in a fixed order, regardless of the location of the procurement site, was in force in Poland. In mid-2018, priority was introduced in the collection of livers by a team from a given province. The aim of the study was to evaluate the impact of changing the liver transplantation allocation system at the Katowice Transplant Center (KTW) on the number of transplanted livers and on the selected parameters of donors from which the liver was procured. METHODS: The rates and cold ischemia time (CIT) of procured livers were analyzed. RESULTS: The rate of livers procured by the KTW transplant team increased from 36.6% to 53.3%, and at the same time the rate of livers procured by this team and sent for transplantation in other transplant centers increased. The rate of livers transplanted in the KTW, which were procured in the Silesian Voivodeship, increased from 37.4% to 61.0%, and the rate of livers procured outside the Silesian Voivodeship decreased from 54.8% to 36.4%. The CIT of livers transplanted in the KTW was reduced from 407.5 to 360.0 minutes. The comparative analysis of donor parameters of livers procured by the KTW transplant team and transplanted in Katowice revealed no differences regarding analyzed clinical and biochemical parameters. CONCLUSION: The change in the allocation system increased the number of livers procured by the local team and shortened CIT of livers transplanted at the KTW.

HSPB1 Gene Variants and Schizophrenia: A Case-Control Study in a Polish Population.

Schizophrenia (SCZ) is a severe psychiatric disorder that has a significant genetic component. HSPB1 (HSP27) is known for its neuroprotective functions under stress conditions and appears to play an important role during the development of the central nervous system, which is in agreement with the neurodevelopmental hypothesis of SCZ. The aim of the present case-control study was to investigate whether HSPB1 variants contribute to the risk and clinical features (age of onset, symptoms, and suicidal behavior) of SCZ in a Polish population. To the best of our knowledge, this is the first study that investigated the association between the HSPB1 polymorphisms and SCZ. Three SNPs of HSPB1 (rs2868370, rs2868371, and rs7459185) were genotyped in a total of 1082 (403 patients and 679 controls) unrelated subjects using TaqMan assays. The results showed that the genotypes, alleles, and haplotypes of the three SNPs were not significantly different between the schizophrenic patients and healthy controls either in the overall analysis or in the gender-stratified analysis (all p > 0.05). However, we did find a significant effect of the rs2868371 genotype on the age of onset, negative symptoms, and disorganized symptoms in the five-factor model of PANSS (all p < 0.01). Post hoc comparisons showed that carriers of the rs2868371 G/G genotype had significantly higher negative and disorganized factor scores than those with the C/G and C/C genotypes, respectively. Further investigations with other larger independent samples are required to confirm our findings and to better explore the effect of the HSPB1 polymorphisms on the risk and symptomatology of SCZ.

Prediction of Insulin Resistance and Impaired Fasting Glucose Based on Sex Hormone-Binding Globulin (SHBG) Levels in Polycystic Ovary Syndrome.

OBJECTIVE: Decreased synthesis of sex hormone-binding globulin (SHBG) related to hyperinsulinemia is one of the disturbances characteristic of polycystic ovary syndrome (PCOS). Hyperinsulinemia is a compensatory mechanism for liver insulin resistance (IR); thus, SHBG may be considered as a surrogate marker of liver IR. Therefore, this study aimed to assess the prediction of IR and impaired fasting glucose (IFG) based on SHBG levels in women with PCOS. METHODS: This analysis included data retrieved from medical records of 854 patients with PCOS hospitalized in the Gynecological Endocrinology Clinic from 2012 to 2019. Data including anthropometric parameters, fasting plasma glucose, insulin, and SHBG levels were analyzed. BMI and HOMA-IR were calculated with standard formulas. RESULTS: IFG and IR assessed based on HOMA-IR values > 2.0 were found in 19.5% and 47.8% of the study group, respectively. Empirical optimal cutoff values for SHBG levels were ≤41.5 nmol/L typical for IR (AUC 0.711, sensitivity 61.1%, specificity 71.6%, positive predictive value (PPV) 70.7%, and negative predictive value (NPV) 62.1%). The probability of insulin resistance occurrence for SHBG concentration 26.1 nmol/L (the lower normal range) was 61.6% (95% CI: 57.4%-65.8%). The SHBG concentration of 36.4 nmol/L and 8.1 nmol/L was related to a 10% and 20% probability of IFG, respectively. CONCLUSION: In conclusion, this is the first study estimating the probability of liver IR and IFG occurrence based on SHBG levels in women with PCOS. Despite the low sensitivity, SHBG level below 42 nmol/L should cause closer monitoring for the fatty liver and prediabetes.

Type 1 Diabetic Patients After Simultaneous Pancreas and Kidney Transplantation Have Less Intense Periodontal Inflammation Compared to Kidney Recipients Treated with Insulin.

BACKGROUND Long-term diabetes predisposes to pathological changes in periodontal tissues. Improvement in this respect can be expected in patients after pancreas transplantation. The aim of this study was to assess and compare the intensity of periodontium pathological lesions and inflammation markers concentration in gingival crevicular fluid (GCF) in patients with type 1 diabetes (T1D) after kidney (KTx) or simultaneous pancreas and kidney transplantation (SPK). MATERIAL AND METHODS The study included 20 T1D patients after SPK and 16 after KTx, and 15 non-diabetic kidney recipients (control). Periodontal clinical parameters and concentration of selected biochemical markers of inflammation in GCF were assessed. The following tests were used in statistical data analysis: Shapiro-Wilk test, the t test, the Mann-Whitney U tests, one-way ANOVA with Tukey's post hoc test, and χ² test (also with Yate's correction). Moreover, linear regression and Pearson or Spearman correlation coefficient was used. RESULTS There were no differences in modified Sulcus Bleeding Index (mSBI) and GCF volume between the SPK group and control group, whereas values of these parameters in the KTx group were higher than in the SPK and control groups. Maximal clinical attachment loss and pocket depth and Periotest values were higher in diabetic recipients compared to controls, and did not differ between SPK and KTx. The concentration of IL-1ß, MMP-8, resistin, TNFalpha, and YKL40 in the GCF in the KTx group was higher than in the SPK and control groups. In the combined group of T1D patients, there was a correlation between blood HbA1c and mSBI, GCF volume, and resistin, TNF-alpha and YKL40 concentrations, and between resistin concentration and mSBI. CONCLUSIONS T1D patients after SPK show lower levels of inflammatory markers in GCF and present reduced intensity of periodontitis compared to kidney recipients treated with insulin. The severity of morphological changes in periodontium in T1D patients after KTx or SPK is higher than in non-diabetic kidney recipients.

Beneficial Effect of Successful Simultaneous Pancreas-Kidney Transplantation on Plasma Profile of Metalloproteinases in Type 1 Diabetes Mellitus Patients.

It is not fully elucidated whether the restoring of normal glucose metabolism after successful simultaneous pancreas-kidney transplantation (SPK) improves vascular wall morphology and function in type 1 diabetic (T1D) patients. Therefore, we compared arterial stiffness, assessed by pulse wave velocity (PWV), carotid intima-media thickness (IMT), and biomarkers of arterial wall calcification in T1D patients after SPK or kidney transplantation alone (KTA). In 39 SPK and 39 KTA adult patients of similar age, PWV, IMT, circulating matrix metalloproteinases (MMPs) and calcification biomarkers were assessed at median 83 months post transplantation. Additionally, carotid plaques were visualized and semi-qualitatively classified. Although PWV and IMT values were similar, the occurrence of atherosclerotic plaques (51.3 vs. 70.3%, p < 0.01) and calcified lesions (35.9 vs. 64.9%, p < 0.05) was lower in SPK patients. There were significantly lower concentrations of MMP-1, MMP-2, MMP-3, and osteocalcin in SPK subjects. Among the analyzed biomarkers, only logMMP-1, logMMP-2, and logMMP-3 concentrations were associated with log HbA1c. Multivariate stepwise backward regression analysis revealed that MMP-1 and MMP-3 variability were explained only by log HbA1c. Normal glucose metabolism achieved by SPK is followed by the favorable profile of circulating matrix metalloproteinases, which may reflect the vasoprotective effect of pancreas transplantation.

Mortality due to acute myocardial infarction in the Silesian Voivodship (Poland) in 2009-2014.

OBJECTIVES: According to the Organization for Economic Cooperation and Development (OECD) data, 13% of deaths recorded in the European Union in 2010 were related to coronary heart disease. The Polish Central Statistical Office data show that cardiovascular mortality in 2014 was at the level of 100.1/100 000 general population. The aim of the study was to assess the current burden of deaths due to acute myocardial infarction (AMI) with the assessment of temporal and spatial variability in the Silesian Voivodeship, Poland. MATERIAL AND METHODS: Depersonalized data obtained from the Silesian Voivodeship Branch of the National Health Fund of Poland, based in Katowice, were used as the study material. The death rate due to acute or subsequent myocardial infarction in each of the subregions of the Silesian Voivodeship was standardized to the European Standard Population 2013. The analyses of the annual AMI death rate for 2009-2014 were performed and assigned to all the subregions of the Silesian Voivodeship, according to the patients' domicile. RESULTS: In this study, 37.7% of the patients (N = 20 806) were females, and 30 142 healthcare services were granted to them, accounting for 36.64% of all services provided to all patients. The average patient's age during the service provision was 66±12 years, with women being about 6.5 years older than men (70±12 years vs. 64±11 years, respectively). The standardized death rate (SDR) values in each of the 8 subregions of the Silesian Voivodeship were analyzed. In 2009-2014, a substantial decrease in the SDR was noted in 7 of them, except for the Sosnowiec subregion in which an increase in the average annual SDR value was observed. Moreover, its values were the highest in the whole Silesian Voivodeship. CONCLUSIONS: The obtained results confirmed the spatial variability of mortality due to AMI in the study region. The worst situation was observed in the Sosnowiec subregion in which the number of specific deaths continuously increased, probably due to the limited availability of cardiological and invasive cardiology treatments or adverse health conditions. Int J Occup Med Environ Health. 2021;34(3):363-72.

Pentraxin 3 Levels in Young Women with and without Polycystic Ovary Syndrome (PCOS) in relation to the Nutritional Status and Systemic Inflammation.

OBJECTIVE: The aim of the study was to assess PTX3 levels in PCOS and non-PCOS women in relation to nutritional status and circulating markers of inflammation. METHODS: The study enrolled 99 stable body mass PCOS women (17 normal weight, 21 overweight, and 61 obese) and 61 non-PCOS women (24 normal weight, 19 overweight, and 18 obese). Body composition was assessed by bioimpedance, and plasma levels of pentraxin 3 (PTX3), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and monocyte chemoattractant protein 1 (MCP-1) were measured. Homeostatic model assessment of insulin resistance (HOMA-IR) was made. RESULTS: Plasma PTX3, TNF-α, and IL-6 levels and HOMA-IR were higher in PCOS than in non-PCOS group (p < 0.001). There were positive correlations between log10 (PTX3) and log10 (BMI), waist circumference and fat percentage, as well as log10 (HOMA-IR) and free androgen index but negative between log10 (estradiol) levels in PCOS. While in the non-PCOS group, the correlations between log10 (PTX3) and log10 (BMI), waist circumference and fat percentage, as well as log10 (HOMA-IR) were negative. The positive correlations between PTX3 and MPC-1 and log10 (IL-6) were shown in the PCOS group only. In multivariate regression analyses, variability in PTX3 levels in the PCOS group was proportional to log10 (BMI), waist circumference, and fat percentage, but inversely proportional to log10 (estradiol) levels. While in the non-PCOS group, PTX3 levels were inversely proportional to all anthropometric parameters. CONCLUSIONS: Our results show that the decrease in PTX3 levels observed in obese is distorted in PCOS by microinflammation, and possibly, dysfunction of stroma adipose tissue and liver steatosis is reflected by enhanced insulin resistance.

Plasma sclerostin levels are associated with nutritional status and insulin resistance but not hormonal disturbances in women with polycystic ovary syndrome.

OBJECTIVE: The aim of this study was to evaluate the circulating sclerostin levels with nutritional status, insulin resistance and hormonal disturbances in women with polycystic ovary syndrome (PCOS). PATIENTS AND METHODS: The cross-sectional study involved 98 PCOS inpatients (20 normal weight, 17 overweight and 61 obese) with stable body mass. Body composition was assessed by bioimpedance method in addition to anthropometric measurements (body mass and height). Serum/plasma concentrations of glucose, insulin (with the calculation of homeostatic model assessment insulin resistance-HOMA-IR), estradiol, total testosterone, sex hormone-binding globulin (SHBG) and sclerostin were measured. Free androgen index (FAI) and estradiol/testosterone index were calculated. RESULTS: Plasma sclerostin levels were significantly higher in obese [0.61 (interquartile range 0.53-0.77) ng/mL] than in overweight [0.53 (0.49-0.57) ng/mL] and normal weight [0.49 (0.42-0.54) ng/mL] groups. Plasma sclerostin levels were significantly higher in the subgroup with insulin resistance [0.65 (interquartile range 0.53-0.77) vs. 0.52 (0.46-0.58) ng/mL; p < 0.001], while similar concentrations were observed in subgroups with FAI below and above median. Plasma sclerostin levels variability were explained by BMI (r = 0.40), the percentage of body fat (r = 0.40) and HOMA-IR values (r = 0.34) in multivariable models. CONCLUSIONS: Circulating sclerostin levels in women with PCOS are related to nutritional status and insulin resistance, but not to sex hormone disturbances.

Simultaneously Transplanted Pancreas Improves Salivation and Reduces Oral Fungal Infections Incidence in Type 1 Diabetic Renal Transplant Recipients.

BACKGROUND: Long-lasting diabetes mellitus may lead to numerous pathologies in the oral cavity. The aim of the study was to assess the condition of the oral cavity, caries intensity, salivary parameters, and incidence of oral fungal infections in patients with type 1 diabetes (T1D) and end-stage renal disease (ESRD) after kidney transplantation (KTx) or simultaneous kidney and pancreas transplantation (SPK). METHODS: Twenty-one patients after SPK, 18 T1D patients after KTx, and 14 kidney recipients without diabetes (control group) were included in the study. Donor sources complied with Helsinki Congress and the Declaration of Istanbul. RESULTS: Approximal plague index in SPK (80% [68%-90%]) was comparable to KTx (80% [37.5%-92.5%]) but higher than in control group (46% [35%-50%]). All 3 groups did not differ in terms of decayed-missing-filled tooth index: 22.3 ± 4.8 vs 22.5 ± 4.5 vs 19.1 ± 4.9, respectively. Normal saliva resting secretion and consistency were more common in SPK (71.4% and 52%, respectively) than in KTx (27.8% and 50.0%, respectively). Stimulated saliva volume in the SPK, KTx and controls, pH value, and buffering capacity were comparable. In KTx higher incidence of Candida albicans infection (55.6%) compared with SPK (23.8%) and controls (no infection) was observed. CONCLUSIONS: Simultaneously transplanted pancreas improves salivation and reduces the incidence of oral fungal infections in T1D kidney recipients. The severity of caries is higher and oral hygiene is worse in T1D kidney recipients compared with patients after KTx without diabetes.

Association of HSPA1B Polymorphisms with Paranoid Schizophrenia in a Polish Population.

This study aimed to find the potential association between HSPA1B polymorphisms and risk of paranoid schizophrenia, clinical variables of the disease, and suicidal behavior. A total of 901 unrelated Polish subjects of Caucasian origin (377 schizophrenia patients and 524 controls) were recruited. Four single-nucleotide polymorphisms (SNP) were genotyped using PCR-RFLP (rs539689, rs9281590) and TaqMan assays (rs263979, rs6547452). A strong tendency towards statistical significance (p = 0.051) was observed in rs539689 allele distribution between patients and controls in overall study subjects. After stratification according to gender, we found that rs539689 was significantly associated with schizophrenia in males, but not in females. The minor allele C had a protective effect in males [OR 0.73 (95% CI 0.61-0.88, p < 0.05)]. In addition, two SNPs (rs539689, rs9281590) were significantly associated with PANSS scores. Another important finding was a strong significant association between the HSPA1B rs539689 polymorphism and attempted suicide in schizophrenic patients. The C/C genotype and C allele were protective against suicidal behavior in entire sample (p < 0.001), in males (p < 001), and in females (p < 0.05), although associations were weaker than in males. Our findings support that HSPA1B gene may be involved in susceptibility to schizophrenia and clinical presentation of the disease in a sex-dependent manner, and may play a role in suicidal behavior in the Polish population of schizophrenic patients. Further independent analyses in different populations should be performed to clarify the role of HSPA1B in the pathogenesis of schizophrenia.

The Effectiveness of the Whole Body Cryotherapy Strategies: A Comparison of Different Duration and Temperature on the Antioxidative Status in the Experimental Rat Model.

BACKGROUND: We examined the effectiveness of the systemic cryotherapy in terms of the temperature and duration of the therapeutic series measured by oxidative stress markers in the rat animal model. METHODS: Antioxidants in serum, plasma, liver, and erythrocytes were evaluated in two study groups following 1 min exposure to - 60°C and - 90°C, for 5 and 10 days. RESULTS: Superoxide dismutase activity in the tissues was lower than in the serum. The glutathione peroxidase was significantly higher in - 60°C than in - 90°C, in both 5 and 10 days of exposition. The liver catalase CAT were significantly lower in - 60°C when compared to - 90°C for 5 and 10 sessions of exposure. In all analysed tissues, the sessions of cryotherapy, - 60/5 and - 60/10, were more effective in reduction malondialdehyde than sessions of - 90/5 and - 90/10. The highest total antioxidant capacity was observed in the - 60/5 group. CONCLUSIONS: Whole body cryotherapy based on temperature - 60°C may be considered as more beneficial than - 90°C for most of the oxidative stress (OS) markers measured in the selected tissues. The temp. - 60°C is more beneficial than - 90°C when measured by activity of Total SOD, CAT, and GPx. The therapeutic sessions - 60/10 and - 60/5 were the optimal schemes of WBC model in terms of TAC and MDA amount.

Kidney Function, Nutritional Status, and the Left Ventricle Dysfunction Are Associated with Serum Uric Acid Levels in Patients with Heart Failure with Reduced Ejection Fraction.

OBJECTIVE: The aim of this study was to assess the role of potential factors explaining variability of serum uric acid (SUA) levels in patients with chronic heart failure with reduced ejection fraction (HFrEF) not receiving xanthine oxidase inhibitors and acetylsalicylic acid, with multivariate adaptive regression splines and fuzzy c-regression models. MATERIAL AND METHODS: Between 1998 and 2010, we prospectively enrolled 294 patients (44 females, 250 males; mean age 43.1±11.6 years) not receiving allopurinol or febuxostat, who underwent right ventricular endomyocardial biopsy due to unexplained HFrEF (duration of symptoms ≥6 months) with New York Heart Association functional class II and III and decreased left ventricular ejection fraction <40% in radionuclide study. The following factors were analyzed: left ventricular ejection fraction, concentrations of serum creatinine, high-sensitivity C-reactive protein, N-terminal prohormone of brain natriuretic peptide (NT-proBNP), SUA, glucose, total cholesterol, HDL and LDL fractions of cholesterol, triglycerides, fibrate, D-dimers, and medication. Multivariate Adaptive Regression Splines, local polynomial smoothing with Epanechnikov kernel function as well as the Time Domain Constrained Fuzzy c-Regression Models were used. RESULTS: SUA concentration variability was explained by BMI, eGFR values, serum NT-pro BNP levels and the use of thiazide diuretics. The SUA declined with eGFR and increased with BMI values, serum NT-proBNP levels and the use of thiazide diuretics. A weak negative correlation between log10(SUA) levels and the LVEF was found (r=-0.130; p<0.05). CONCLUSIONS: Kidney function, nutritional status, the use of thiazide diuretics and the severity of left ventricle dysfunction reflected by serum NT-proBNP levels explain the serum uric acid levels variability in patients with HFrEF.

Plasma Level of Retinol-Binding Protein 4, N-Terminal proBNP and Renal Function in Older Patients Hospitalized for Heart Failure.

BACKGROUND/AIM: Elevated plasma concentration of retinol-binding protein 4 (RBP4) has recently emerged as a potential new risk factor for cardiovascular diseases, including hypertension (HT) and coronary artery disease (CAD). Limited data suggest that RBP4 promotes inflammatory damage to cardiomyocytes and participates in the development of heart failure (HF). This study aimed to analyze the relationship between concentrations of plasma RBP4 and serum N-terminal proBNP (NT-proBNP), a powerful biomarker of left ventricle dysfunction, in the older Polish population. METHODS: The study sample consisted of 2,826 (1,487 men) participants of the PolSenior study, aged 65 years and older, including a subgroup hospitalized for HF (n = 282). In all subjects, plasma concentrations of RBP4, interleukin-6 (IL-6), serum level of NT-proBNP, and hs-CRP were measured. Additionally, BMI, estimated glomerular filtration rate (eGFR), and HOMA-IR were calculated. The prevalence of HT, CAD, atrial fibrillation (AF), and medication were considered as potential confounders. RESULTS: Similar RBP4 levels were found in subjects with NT-proBNP < 125 and ≥125 ng/mL, with and without AF, and in the subgroups hospitalized for HF with and without AF. Regression analysis revealed no association between log10(NT-proBNP) and log10(RBP4). Plasma levels of RBP4 were increased by HT occurrence and diuretic therapy, while diminished with regard to female gender, age, eGFR values, AF, and IL-6 levels. CONCLUSION: Our results show that RBP4 is affected by GFR but cannot be considered as an independent biomarker of heart muscle dysfunction.

Type 1 diabetic patients have better endothelial function after simultaneous pancreas-kidney transplantation than after kidney transplantation with continued insulin therapy.

The purpose of this study was to analyse the influence of simultaneous pancreas-kidney or kidney transplantation on endothelial function and systemic inflammation in type 1 diabetic patients with end-stage renal disease. In 39 simultaneous pancreas-kidney, 39 type 1 diabetic kidney and 52 non-diabetic kidney recipients, flow-mediated dilatation was measured. Additionally, blood glycated haemoglobin, serum creatinine and lipids, plasma nitrites [Formula: see text] and nitrates, asymmetric dimethylarginine, soluble vascular cell adhesion molecule-1, intercellular adhesion molecule-1, and E-selectin, high-sensitivity C-reactive protein, tumour necrosis factor-α, interleukin 1ß and interleukin 6 concentrations were assessed. During 58 ± 31 months follow-up period, flow-mediated dilatation and [Formula: see text] were greater in simultaneous pancreas-kidney than in type 1 diabetic kidney recipients [10.4% ± 4.7% vs 7.7% ± 4.2%, p < 0.05 and 0.94 (0.74-1.34) vs 0.24 (0.20-0.43) µmol/L, p < 0.01, respectively]. In type 1 diabetic patients after simultaneous pancreas-kidney or kidney transplantation, [Formula: see text] correlated with flow-mediated dilatation (r = 0.306, p < 0.05) and with blood glycated haemoglobin (r = -0.570, p < 0.001). The difference in [Formula: see text] was linked to blood glycated haemoglobin and estimated glomerular filtration rate, whereas the difference in flow-mediated dilatation was linked to [Formula: see text]. The levels of inflammatory markers (except soluble vascular cell adhesion molecule-1) were similar in simultaneous pancreas-kidney and type 1 diabetic kidney recipients. Improved endothelial function in type 1 diabetic patients with end-stage renal disease after simultaneous pancreas-kidney compared to kidney transplantation is associated with normalisation of glucose metabolism but not with improvement in plasma pro-inflammatory cytokines.

The Effects of Duodenojejunal Omega Switch in Combination with High-Fat Diet and Control Diet on Incretins, Body Weight, and Glucose Tolerance in Sprague-Dawley Rats.

BACKGROUND: Despite excellent results of bariatric surgery in the treatment of type 2 diabetes and weight loss in human subjects, some patients do not obtain desired results. One of the reasons for this is that not all patients follow caloric intake recommendations. AIM: The aim of this study was to investigate the effect of duodenojejunal omega switch (DJOS) surgery on body weight, glucose tolerance, and incretins in rats. METHODS: DJOS and SHAM surgery were performed on rats maintained for 8 weeks on high-fat diet (HF) and control diet (CD), respectively. After surgery, four groups were kept on the same diet as before the surgery, and four groups had a changed diet (CD vs. HF and HF vs. CD) for the next 8 weeks. Glucose tolerance, insulin tolerance, glucose-stimulated insulin, glucagon-like peptide-1 (GLP-1) and gastric inhibitory polypeptide/glucose-dependent insulinotropic polypeptide (GIP) secretion, food intake, and body weight were measured. RESULTS: A change of diet after surgery resulted in reduced glucose tolerance. Plasma insulin levels were lowered between DJOS and SHAM surgeries for the HF/HF and CD/HF groups. DJOS surgery did not reduce body weight in the studied groups, irrespective of diet. In the HF/HF group, ΔGLP-1 was lower for DJOS surgery in comparison with other groups. Differences of weight changes were observed for groups HF/HF and HF/CD. After DJOS surgery, ΔGIP was lower in the CD/HF group compared with HF/HF. CONCLUSIONS: Our results show that applications of different types of diets, before and after surgery, is a sensitive method for studies of mechanism of glucose intolerance after DJOS surgery.

Effect of Whole-Body Cryotherapy on Antioxidant Systems in Experimental Rat Model.

BACKGROUND: The purpose of this study was to verify the effect of whole-body cryotherapy (WBC) in rats on their antioxidant systems, lipid peroxidation products, and their total oxidative status at different exposure times and temperatures. METHODS: Antioxidants in serum, plasma, liver, and erythrocytes were evaluated in two study groups following 1 min of exposure to -60°C and -90°C, for 5 and 10 consecutive days. RESULTS: WBC increased the activity of superoxide dismutase, catalase in the group subjected to 5 and 10 days exposure, -60°C. The glutathione S-transferase activity increased in the groups subjected to 10 days WBC sessions. Total antioxidant capacity increased after 5 and 10 days of 1 min WBC, -60°C; a decrease was observed at -90°C. A decreased level of erythrocyte malondialdehyde concentration was observed at -60°C after 5 and 10 days of cryostimulation. An increased concentration was measured at -90°C after 10 days, and increase of erythrocyte malondialdehyde concentration after 5 days, -90°C. CONCLUSIONS: To the best of our knowledge, this is the first research showing the effect of WBC in rats at different exposure times and temperatures. The effect of cryotherapy on enzymatic and nonenzymatic antioxidant systems was observed in the serum of animals exposed to a temperature of -60°C in comparison to control.