The effect of bariatric-metabolic surgery on selected components of metabolic syndrome and visceral adipose tissue - the pilot study.

The aim of this study was to monitor changes in the components of the metabolic syndrome defined by Adult Treatment Panel III and the risk of adipose tissue. The study population consisted of 45 patients (30 women, 15 men) who underwent one bariatric procedure - partial jejuno-ileal derivation (n=17), sleeve resection (n=14) or laparoscopic gastric - plication (n=14). Components of metabolic syndrome such as waist circumference, morning glycemia/antihypertension, TAG, HDL cholesterol and blood pressure (BP)/antihypertension were monitored in probands. In addition, Dual Energy X-Ray Absorciometry measurements were performed. Parameters were monitored over the course of one year. The study shows that it is an effective method of weight reduction for the study population with metabolic effects in the risk components of metabolic syndrome - fasting glycemia, increase in HDL cholesterol and reduction in triacylglycerols in the blood, reduction in waist circumference and BP or direct disappearance of metabolic syndrome. Significantly, of the entire cohort, 68.9 % of the probands studied showed signs of metabolic syndrome when measured before the intervention. At the end of follow-up, only 22.2 % of probands showed metabolic syndrome. It was also found that if the amount of visceral fat was reduced, the overall risk of metabolic syndrome was also reduced. The study demonstrates a significant positive effect of bariatric surgery on parameters of metabolic syndrome. The study also showed a positive effect of reduced visceral fat volume on the components of metabolic syndrome.

Physiologic risk factors for early acute kidney injury in severely injured patients.

BACKGROUND: The evaluation of the predictive value of the neutrophil gelatinase-associated lipocalin (NGAL) for an early acute kidney injury (AKI) development in severely injured patients. Determination of the time-dependent roles of trauma-related physiologic markers of tissue hypoxia, systemic inflammation and rhabdomyolysis in AKI development. METHODS: 81 adult patients were screened for the presence of AKI for eight consecutive days following the injury. Arterial levels of plasma NGAL, lactate, interleukin-6, procalcitonin, and myoglobin were investigated at 24 hours (T1), 48 hours (T2), and 96 hours (T3) after the injury. RESULTS: The incidence of AKI was 32.1 %. Patients with AKI were older, but no significant difference in injury severity was observed. NGAL levels were significantly higher in the AKI group at T1, T2, and T3 when compared to the non-AKI group. Lactate levels were significantly higher in the AKI group at T2 only, and IL-6 levels were significantly higher in the AKI group at T2 and T3. Procalcitonin and myoglobin levels were significantly higher in the AKI group at T1, T2, and T3, when compared to the non-AKI group. Positive correlations were found between plasma NGAL and all screened physiological factors at all defined time points. CONCLUSION: Development of AKI after blunt trauma is very complex and multifactorial. Activation of the systemic inflammatory response and rhabdomyolysis (high concentration of myoglobin) were strongly involved in AKI development. Blood NGAL levels after injury were significantly higher in patients, who developed posttraumatic AKI. Plasma NGAL, lactate, procalcitonin, interleukin-6, and myoglobin had potential to be useful parameters for risk stratification and prediction of AKI after trauma (Tab. 6, Ref. 40).

Body Size, Bone Mineral Density, and Body Composition in Obese Women After Laparoscopic Sleeve Gastrectomy: A 1-Year Longitudinal Study.

Changes in body weight, waist and hip circumferences, body composition, and skeletal status in women after bariatric surgery were evaluated. Thirty-six women [mean age 41.2 ± (SD) 9.5 years, weight 115.7±18.0 kg, and BMI 42.1±5.3 kg/m(2)] underwent laparoscopic sleeve gastrectomy. Bone mineral density (BMD) at lumbar spine, femoral neck, total hip, and total body, and body composition were evaluated at baseline and 3, 6, and 12 months after surgery.Weight, BMI, waist and hip circumferences decreased significantly. Total body bone mineral content (TBBMC) increased by 2.5±3.5%, and fat, lean body mass, total mass and fat-% decreased significantly by 38.9±12.0%, 15.4±5.9%, 26.5±8.1%, and 17.6±8.9%, respectively. Slight decreases in total body (0.6±2.2%) and spine (1.2±7.1%) BMD were not significant, whereas total hip and femoral neck BMD decreased significantly by 5.3±8.2%, and 6.2±7.0% (p<0.001). Change (Δ) in TBBMC correlated only with Δ in weight (r=0.38, p<0.05) whereas Δ in all other body composition parameters correlated significantly with Δ in body weight and circumferences (r=0.46-0.98). The Δ in BMD (except total body BMD) correlated significantly with Δ in body composition parameters (r=0.34-0.59). Baseline fat and lean content besides changes in body fat and lean mass accounted for bone changes. In conclusion, bone loss after bariatric surgery is related to post-operative changes in body composition, as well as to weight loss and decrease in waist and hip circumferences.

IL-6 and CRP response to maximal exercise intervention.

AIM: The purpose of this study was to investigate the recovery pattern of the plasma inflammatory markers interleukin-6 (IL-6) and C-reactive protein (CRP) after the single-bout maximal exercise. The exercise of different type (continuous vs. intermittent) was performed and also compared in this study. METHODS: Following baseline testing, 30 males were divided into three experimental groups, which completed continuous or intermittent all-out exercise of similar duration or no exercise intervention (Control group). Blood was sampled before and 1 h, 3 h, 5 h after exercise. Serum was analysed for IL-6, CRP, lactate, creatinine, uric acid, cortisol, creatine kinase, lactate dehydrogenase and myoglobin. Diet was standardized during recovery monitoring. RESULTS: Serum IL-6 and CRP concentrations were not significantly changed in the pre- to post-exercise values comparison. These results are evident in both exercise intervention groups as well as in the control group. The only exception is the significant (P=0.03) IL-6 decrease (28.2%) in continuous exercise protocol 3 h after the exercise. Significant changes (P<0.05) were also observed in lactate, cortisol, uric acid and myoglobin, when pre-exercise vs. post-exercise recovery values were compared CONCLUSION: The exercise of all-out intensity and relatively short duration, no matter what type, does not elicit a significant change in the inflammatory markers IL-6 and CRP for the 1h to 5h period of rest following the exercise.

[Bone mineral density in patients with chronic renal failure at the start of haemodialysis therapy]. / Kostní minerální denzita u nemocných s chronickým selháním ledvin pri zahájení hemodialyzacní lécby.

AIM: To determine bone mineral density (BMD) in nephrology patients at the start of haemodialysis therapy and its dependence on some laboratory and clinical characteristics of the study set. METHODS: There were 73 newly haemodialyzed patients accepted in the 3 months period from the beginning of the chronic haemodialysis program. Each patient underwent measurements BMD with DXA method in the area of lumbar spine and the left hip. Ca, P and parathormone values were measured once per month during 3 months before BMD determination. 25-OH vitamin D, estradiol and blood pH were determined only once before the densitometry examination. RESULTS: BMD in the osteoporosis zone was measured most often in the area of femoral neck in the whole group (prevalence 35 %) and also in the single groups of patients (men, women, non-diabetics, diabetics). In women, BMD findings corresponding to osteoporosis values in the total hip were significantly more often (p < 0.01). In the area of femoral neck and lumbar spine the percentage of women and men in single groups (osteoporosis, osteopenia and normal values) was without any statistical differentiation. Diabetics and non-diabetics did not distinguish in the number of findings osteoporosis and osteopenia in any followed areas of skeleton. As the significant factors predicating BMD there were found: calcium level and sex for the area of the total hip, calcium level, blood pH and height for the femoral neck, and sex for the lumbar spine only. The certain degree of vitamin D deficiency was measured in nearly all patients (mean 11.5 ± 7.4 µg/l), and hypocalcaemia was demonstrated in one fifth of patients. CONCLUSION: Bone mineral density values and some laboratory parameters affecting bone metabolism are often abnormal in the patients entering the chronic haemodialysis program and must be taken into consideration.

Antioxidant status, lipoprotein profile and liver lipids in rats fed on high-cholesterol diet containing currant oil rich in n-3 and n-6 polyunsaturated fatty acids.

Plant-based n-3 polyunsaturated fatty acids (PUFA) possess a prospective antiatherogenic potential. Currant oil from Ribes nigrum L. is one of the few plant oils containing PUFAn-3 (15.3 mol%) in addition to PUFAn-6 (60.5 mol%). This study was aimed at comparing the effects of currant oil with those of lard fat, rich in saturated (43.8 mol%) and monounsaturated (47.0 mol%) fatty acids, on antioxidant parameters, the lipoprotein profile and liver lipids in rats fed on 1 % (w/w) cholesterol diets containing either 10 % of currant oil (COD) or lard fat (LFD). After 3 weeks of feeding, the COD induced a significant decrease in blood glutathione (GSH) and an increase in Cu(2+) induced oxidizability of serum lipids, but did not affect liver GSH and t-butyl hydroperoxide-induced lipoperoxidation of liver microsomes. Although the COD did not cause accumulation of liver triacylglycerols as LFD, the lipoprotein profile (VLDL, LDL, HDL) was not significantly improved after COD. The consumption of PUFAn-3 was reflected in LDL as an increase in eicosapentaenoic and docosahexaenoic acid. These results suggest that currant oil affects positively the lipid metabolism in the liver, above all it does not cause the development of a fatty liver. However, adverse effects of currant oil on the antioxidant status in the blood still remain of concern.

Pharmacokinetic study of iodine-labeled silibinins in rat.

The very low bioavailability of silibinin (silybin, SB), the main antioxidant flavonolignan of silymarin from Silybum marianum L. (Asteraceae), requires sensitive methods to study the modulation of silibinin bioavailability. To evaluate the potential for use of radiolabeled silibinin, two silibinin derivatives, separated by HPLC after iodination ((125)I-SB(1) and (125)I-SB(2)) and their complexes 1 : 1 with phosphatidylcholine ((125)I-SPC(1) and (125)I-SPC(2)) were administered concurrently with a single intragastric dose of 5.0 mg or 50 mg of unlabeled silibinin (alone or as a constituent of the complex) per kg of body weight in a comparative study of bioavailability in the rat. Pharmacokinetic parameters as well as organ uptake of (125)I-SB(1)-derived radioactivity showed a dose-response pattern. The parameters of bioavailability after (125)I-SPC(1) intake were not influenced by unlabeled silibinin (complexed with phosphatidylcholine), since maximal levels were achieved by the lower dose of unlabeled compound. The superior bioavailability of (125)I-SPC(1) was obvious at the lower dose of unlabeled compound as elevated AUC and RA(max) (maximal percentage of administered radioactivity), and increased radioactivity in liver, kidney, spleen and heart. An absence of these characteristics with (125)I-SB(2) and (125)I-SPC(2) suggests the use of(125)I-SB(1) for studies of modulation of its bioavailability in vivo in rat.

Determination of adenosine deaminase activity in human erythrocytes by on-column capillary isotachophoresis-capillary zone electrophoresis in the presence of electroosmotic flow.

Transient capillary isotachophoresis (CITP)-capillary zone electrophoresis (CZE) in presence of electroosmotic flow (EOF) was utilized for the measurement of adenosine deaminase activity in human erythrocytes. Phosphates, dominant anions of the sample matrix, were used as leading ions for transient isotachophoresis, and borates (0.3 M, pH 10) were used as terminating ions and background electrolyte for CZE. Final experimental conditions made it possible to inject 70% of the total capillary volume (1.45 microL) with the sample. Enzymatic conversion products (inosine and hypoxanthine), present in the sample in the low-micromolar range, were determined using optimized conditions. The limit of detection was 28 nM using UV detection at 202 nm. The presented data shows that CITP-CZE can be performed in uncoated capillaries in the presence of strong EOF.