Impact of dietary intake, lifestyle and biochemical factors on metabolic health in obese adolescents.

BACKGROUND AND AIMS: Obesity devoid of metabolic abnormalities is known as metabolically healthy obesity (MHO). The aim of the study was to examine determinants of MHO during adolescence. METHODS AND RESULTS: From among 710 obese adolescents, 43 girls and 57 boys were classified as metabolically unhealthy (abdominal obesity and ≥2 risk components of metabolic syndrome). MHO (absence of any cardiometabolic risk factor) was found in 211 girls and 131 boys (regardless of waist circumference) and in 33 girls and 27 boys (without abdominal obesity). Laboratory and anthropometric parameters, dietary records and various lifestyle factors were compared between MHO vs. those unhealthy. The prevalence of MHO regardless of waist circumference was higher in girls than in boys (53.1 vs. 41.9%) but comparable when abdominal obesity was excluded (8.3 vs. 8.6%). Anthropometric variables, levels of gamma-glutamyl transferase, total and low-density lipoprotein cholesterol in both genders, hs-C-reactive protein in girls and alanine aminotransferase in boys differentiated the two metabolic phenotypes. Uric acid was related to metabolic health only in the analysis of MHO without abdominal obesity. Total hours of sleep, bedtime, time of the last daily meal, regular meal consumption and protein intake in boys and screen time, the score of disinhibition and diet composition in girls were found to impact cardiometabolic health. CONCLUSIONS: In obese adolescents, metabolic health was related to anthropometric and biochemical parameters and only weak associations were found with most of the lifestyle factors studied. Uric acid concentration associated with metabolic health when abdominal obesity was excluded.

Adenovirus 36 infection: a role in dietary intake and response to inpatient weight management in obese girls.

Human adenovirus 36 (Adv36) increases adiposity and is more prevalent in overweight and obese children. Dietary intake in animal models is comparable regardless of Adv36 status. The effects of Adv36 on obesity treatment outcomes have not been clarified. The aim of this study is to investigate the pre-treatment dietary intake and the response to a 4-week inpatient weight management in 184 obese adolescent girls aged 13.0-17.9 years with respect to the presence of Adv36 antibodies. Evaluation of 3-day dietary records did not show any difference in daily intake of energy and essential nutrients between Adv36 antibody positive and negative girls. After the intervention Adv36 positive girls presented with significantly greater decrease of waist circumference (P=0.020), z-score of waist circumference (P=0.024), waist-to-hip ratio (P=0.007) and weight-to-height ratio (P=0.019) compared with Adv36 negative girls. On the contrary, the sum of four skinfolds decreased significantly more in Adv36 negative than in Adv36 positive individuals (P=0.013). Neither body fat percentage nor metabolic and hormonal parameters showed any significant relevance to Adv36 status in response to weight loss intervention. In conclusion, energy restriction in Adv36 antibody positive girls was associated with greater decrease of abdominal obesity and preservation of subcutaneous fat tissue than in those antibody negative.

Clinical and laboratory characteristics of 1179 Czech adolescents evaluated for antibodies to human adenovirus 36.

BACKGROUND: Human adenovirus 36 (Adv36) is associated with obesity in children. Most prior studies have been small and the association of Adv36 status with markers of metabolic risks has been inconsistent. OBJECTIVES: To determine the prevalence of Adv36 antibodies in different weight categories of adolescents and to evaluate the association of Adv36 infection with anthropometric parameters and cardiometabolic health risks. SUBJECTS AND METHODS: In 1179 Czech adolescents (85 underweight, 506 normal weight, 160 overweight and 428 obese), the following variables were evaluated: anthropometric (body weight, height, body mass index, circumferences, fat mass), blood pressure, biochemical and hormonal (lipid profile, glucose, insulin, liver enzymes, adiponectin) and Adv36 antibodies (enzyme-linked immunosorbent assay). RESULTS: Of the total cohort, 26.5% were positive for Adv36 antibodies (underweight: 22.3%; normal weight: 21.5%; overweight: 40.0% and obese: 28.0%). The odds ratio for Adv36 antibody positivity evaluated vs normal weight was 2.61 for overweight (95% confidence interval (CI): 1.77-3.86, P<0.001) and 1.46 for obesity (95% CI: 1.07-1.99, P=0.016). A significantly higher prevalence of Adv36 infection was observed in female subjects (32.5%) in comparison to male subjects (19.7%; P<0.001). Adv36 positivity of the whole cohort was significantly related to body weight (P=0.042), body mass index (P=0.015), hip circumference (P=0.004), body height z-score (P=0.029), and total body fat (P=0.000) and trunk fat (P=0.000). Adv36 antibody-positive girls demonstrated significantly higher body height (167.8 vs 165.0 cm, P=0.01) and waist circumference (77.0 vs 72.0 cm, P=0.01). Infected adolescents exhibited significantly higher levels of total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C), but lower levels of blood glucose. Liver enzymes were significantly increased only in Adv36-positive boys. CONCLUSION: These results demonstrated an association of Adv36 antibodies with obesity and an even greater association with overweight. Adv36 positivity was related to increased fat mass, levels of TC and LDL-C, but to decreased level of blood glucose. No relation to adiponectin levels was revealed.

Association of obesity susceptibility gene variants with metabolic syndrome and related traits in 1,443 Czech adolescents.

Genome-wide association studies have revealed several gene variants associated with obesity; however, only a few studies have further investigated their association with metabolic syndrome. We performed a study of eleven variants in/near genes TMEM18, SH2B1, KCTD15, PCSK1, BDNF, SEC16B, MC4R, and FTO in Czech adolescents and analysed their association with obesity, metabolic syndrome and related traits. Genotyping was performed in 1,443 adolescents aged 13.0-17.9 years. Anthropometric parameters, biochemical parameters and blood pressure were assessed. Metabolic syndrome was defined according to the International Diabetes Federation. The FTO rs9939609 variant was associated with overweight/obesity (OR 1.40, 95% CI 1.21-1.63, P < 0.001). The minor allele of TMEM18 rs7561317 was related to underweight (OR 1.78, 95% CI 1.14-2.79, P = 0.015). BDNF rs925946 and MC4R rs17782313 were associated with metabolic syndrome (OR 1.53, 95% CI 1.14-2.04, P = 0.005; 1.51, 95% CI 1.12-2.04, P = 0.009). The PCSK1 rs6235 variant was negatively related to increased blood glucose (OR 0.69, 95% CI 0.49-0.97, P = 0.040). In conclusion, the FTO variant was associated with overweight/obesity in Czech adolescents. Moreover, MC4R and BDNF variants increased the risk of metabolic syndrome, probably through their effect on abdominal obesity. The PCSK1 variant may have a protective role in the development of type 2 diabetes.

7-oxygenated derivatives of dehydroepiandrosterone and obesity.

7-hydroxy/oxo derivatives of dehydroepiandrosterone are potential regulators of the local cortisol activity due to their competition in the cortisolcortisone balance mediated by 11ß-hydroxysteroid dehydrogenase. 7-hydroxy-dehydroepiandrosterone is marketed as anti-obesity medication, though no clinical study aimed at the benefit of administering 7-oxygenated derivatives of dehydroepiandrosterone has appeared until now. We tried to show whether there exist differences in levels of circulating 7-hydroxy/oxo-dehydroepiandrosterone derivatives between lean and obese boys and girls. From a cohort of adolescents investigated within the frame of anti-obesity programme 10 obese boys and 10 obese girls were compared with age-matched lean boys and girls in their anthropometric data, and concentrations of both epimers of 7-hydroxy-dehydroepiandrosterone and 7-oxo-dehydroepiandrosterone were determined by the RIA method. The basal levels of 7α-hydroxy-dehydroepiandrosterone were significantly higher in obese boys than in lean boys but not in girls. The association was found for anthropometric parameters and 7α-hydroxy-dehydroepiandrosterone, however again only in boys and not in girls. Higher levels of 7α-hydroxy-dehydroepiandrosterone its positive association with anthropometric data in obese boys may serve as a sign that, at least in boys, 7-oxygenated 5-ene-steroids may take part in regulating the hormonal signal for fat formation or distribution.

Prevalence of obesity and metabolic syndrome in adult population of selected regions of the Czech Republic. Relation to eating habits and smoking.

Prevalence of the metabolic syndrome is around 25% in Europe but its occurrence grows in both genders with increasing age and weight. Lifestyle factors may contribute to the risk of developing metabolic syndrome. The objective of this study was to determine the relationship between metabolic syndrome and eating habits as well as length of sleep and smoking. Participants (519 women and 286 men aged 18-65 years) were chosen by random selection and questioned about their eating habits, sleep length and smoking. This information was combined with anthropometric and clinical parameters of metabolic syndrome. The female group was divided into two subgroups depending on climacteric stage (before and after menopause). Metabolic syndrome prevalence does not differ between regions in neither female (29.9%) nor male (32.5%) group. Body mass index ≥25 was detected in 50.4% of all women and 65.7% of men; 23.5% of all women and 21.7% men had body mass index ≥30. In conclusion, metabolic syndrome prevalence was proved to depend on eating habits and family heredity. Positive correlation between the above mentioned factors demonstrated itself in the total sample but not in individual regions. Metabolic syndrome prevalence in Czech adults is comparable with neighbouring countries. No significant interregional differences in metabolic syndrome prevalence within the Czech Republic were detected. In conclusion, relationship between eating habits and metabolic syndrome was confirmed.

The fatty acid composition of serum phospholipids in adolescents is associated with body composition in early adulthoods: an eight-year follow-up study.

The fatty acid composition is associated with obesity. Omega 3 polyunsaturated fatty acid (PUFA) could have a beneficial role in the prevention and treatment of many disorders, including cardiometabolic diseases. A cohort of 84 men and 131 women were examined in adolescence and after 8 years. Body weight (BW) and fat mass (FM) were measured. The composition of fatty acids (FAs) of serum phospholipids was assessed using gas chromatography. Statistics: PLS method. Aim: to determine the relationships between FAs in adolescence and FM (explanatory variable 1, EV1) and BW (explanatory variable 2, EV2) in adulthood. In the predictive models, a cluster of FAs in boys explained 47.2 % of EV1 and a cluster of 6 FAs in girls explained 32.3 % of EV1 measured in adulthood. FAs measured in adolescents explained 23.7 % of EV2 in early adults regardless of gender. A significant negative association was found between 18:1n-9c and EV1 in males and EV2 in both genders. We found a significant negative association between 18:2n-6 and 20:0 and both EV1 and EV2. In all analyses, we found a significant negative association of 20:1n-9 and 18:3n-3 with EV1-2 in both genders. A significant positive association was found in 20:3n-6 with EV1 and EV2 in males. 20:4n-6 was positively associated with EV1 in females and EV2 in both genders. A positive association between FM and very long chain n- 6 PUFAs was also observed. It is concluded that serum MUFAs and essential PUFAs in adolescence are associated with lower BW and FM in adulthood.

Role of the PPARalpha Leu162Val and PPARgamma2 Pro12Ala gene polymorphisms in weight change after 2.5-year follow-up in Czech obese women.

The aim of this study was to investigate the possible effect of PPARalpha and PPARgamma2 variants on weight and eating attitudes as well as on their changes after 2.5-year follow-up. The study was carried out in 246 Czech non-diabetic obese women (age 49.0 +/- 11.9 years; BMI 38.1 +/- 7.0 kg/m(2)). The comprehensive weight management programme included lowenergy diet, increased physical activity and lifestyle modification. Anthropometric parameters (body weight and height, waist and hip circumferences) and body composition were measured. The Three-Factor Eating Questionnaire and Beck Depression Inventory were evaluated. At baseline and after the follow-up period, fasting levels of serum glucose, plasma adiponectin, ghrelin, leptin, and lipid profile were determined. The dependence of monitored parameters on the Pro12Ala in PPARgamma2 and Leu162Val in PPARalpha and stage of the treatment (baseline; 2.5- year follow-up) was evaluated using the repeated measures ANOVA model. The cohort was re-examined after 2.5 years, independent of regular checkups and adherence to lifestyle recommendation. Significant favourable changes in anthropometric indexes, lipid profile, leptin, ghrelin and adiponectin levels as well as in dietary restraint and hunger scores were revealed at 2.5-year check-up. However, no changes in the scores of disinhibition and depression were demonstrated. Despite several observed significant differences between carriers and non-carriers of the minor alleles at baseline and at the follow-up, the repeated measures ANOVA did not reveal any significant effect of the PPARalpha and PPARgamma2 polymorphisms on anthropometric, biochemical, hormonal and psycho-behavioural characteristics, neither at baseline nor at the 2.5-year follow-up.

Melanocortin pathways: suppressed and stimulated melanocortin-4 receptor (MC4R).

Leptin-melanocortin pathway plays an essential role in the body weight regulation. Enhanced melanocortin signaling in the hypothalamus results in both decreased food intake and increased energy expenditure. The discovery of monogenic obesities with dysfunction of melanocortin-4 receptor (MC4R) greatly contributed to understanding of energy balance regulation. This review presents phenotypical characterization and prevalence of the MC4R gene mutations. Genome-wide association studies revealed that MC4R gene is significantly related not only to monogenic obesities but also to common obesity. An interaction of variants in the MC4R gene with fat mass and obesity associated (FTO) gene significantly increases the risk for obesity, particularly in adolescence. On the other hand, about 15 % of the MC4R gene variants result in a gain of function that protects against obesity and is associated with favorable metabolic profile. Long-term attempts to activate the MC4R have recently been finalized by a discovery of setmelanotide, a novel specific MC4R agonist that is devoid of untoward cardiovascular side-effects. The employment of specific MC4R agonists may open new horizons not only in the treatment of rare monogenic obesities but also in some common obesities where stimulation of MC4R could be achieved.

Plasma obestatin levels in normal weight, obese and anorectic women.

Obestatin is a recently discovered peptide produced in the stomach, which was originally described to suppress food intake and decrease body weight in experimental animals. We investigated fasting plasma obestatin levels in normal weight, obese and anorectic women and associations of plasma obestatin levels with anthropometric and hormonal parameters. Hormonal (obestatin, ghrelin, leptin, insulin) and anthropometric parameters and body composition were examined in 15 normal weight, 21 obese and 15 anorectic women. Fasting obestatin levels were significantly lower in obese than in normal weight and anorectic women, whereas ghrelin to obestatin ratio was increased in anorectic women. Compared to leptin, only minor differences in plasma obestatin levels were observed in women who greatly differed in the amount of fat stores. However, a negative correlation of fasting obestatin level with body fat indexes might suggest a certain role of obestatin in the regulation of energy homeostasis. A significant relationship between plasma obestatin and ghrelin levels, independent of anthropometric parameters, supports simultaneous secretion of both hormones from the common precursor. Lower plasma obestatin levels in obese women compared to normal weight and anorectic women as well as increased ghrelin to obestatin ratio in anorectic women might play a role in body weight regulation in these pathologies.

Role of hereditary factors in weight loss and its maintenance.

The prevalence of obesity is increasing worldwide at an alarming rate in both developed and developing countries. Obesity is a chronic complex disease of multifactorial origin resulting from a long-term positive energy balance, in which both genetic and environmental factors are involved. Genetically prone individuals are the first to accumulate fat in the present obesogenic environment. Obesity increases the risks of type 2 diabetes, hypertension, cardiovascular disease, dyslipidemia, arthritis, and several cancers and reduces the average life expectancy. Implementation of effective strategies in prevention and management of obesity should become an important target in health care systems. Weight changes throughout life depend on the interaction of behavioral, genetic and environmental factors. Weight loss in response to weight management shows a wide range of interindividual variation which is largely influenced by genetic determinants. The strong control of weight loss by genotype was confirmed by twin and family studies. Recently, special attention has been paid to nutritional, hormonal, psychobehavioral and genetic factors which can predict the response to weight reduction programme. In this article currently available data on the role of obesity candidate gene polymorphisms in weight loss and maintenance are reviewed. It is believed that an elucidation of the genetic component in the prognosis of weight management could assist in the development of more effective and individually tailored therapeutic strategies.

Neuromedin beta: P73T polymorphism in overweight and obese subjects.

Neuromedin beta (NMB) is a member of the bombesin-like peptide family expressed in brain, gastrointestinal tract, pancreas, adrenals and adipose tissue. The aim of our study was to compare the frequency of P73T polymorphism in overweight and obese patients (37 men: age 50.6+/-11.7 years, BMI 41.1+/-7.8 kg/m(2); 255 women: age 49.0+/-11.9 years, BMI 37.9+/-6.8 kg/m(2)) with that of healthy normal weight subjects (51 men: age 28.2+/-7.1 years, BMI 22.3+/-2.0 kg/m(2); 104 women: age 29.1+/-9.1 years, BMI 21.5+/-1.9 kg/m(2)) and to investigate the polymorphism's influence on anthropometric, nutritional and psychobehavioral parameters in overweight/obese patients both at the baseline examination and at a control visit carried out 2.5 years later, regardless of the patient s compliance with the weight reduction program. No significant differences in the genotype distribution were demonstrated between normal weight and overweight/obese subjects. Male T allele non-carriers compared to T allele carriers had higher energy (p=0.009), protein (p=0.018) and fat (p=0.002) intakes and hunger score (p=0.015) at the beginning of treatment. Male T allele non-carriers had a more favorable response to weight management at the follow-up, as they exhibited a significant reduction in waist circumference, energy intake and depression score as well as a significant increase in dietary restraint. No significant differences between carriers and non-carriers were demonstrated in women at the baseline examination. Both female T allele carriers and non-carriers demonstrated similar significant changes in nutritional parameters and in restraint score at the follow-up. Nevertheless, only female non-carriers showed a significant decrease in the hunger score.

Dynamic changes of orexin A and leptin in obese children during body weight reduction.

In this study, we describe changes of plasma levels of the hypothalamic neuropeptide orexin A in obese children during the reduction of body weight and its relationship to other biochemical and anthropometrical parameters. We measured orexin A fasting plasma levels by the RIA method in 58 obese children--33 girls and 25 boys; mean age 13.1+/-0.38 years (range 7-18.5) before and after 5 weeks of weight-reduction therapy. Leptin, IGF-1, and IGFBP-3 levels were measured in all the subjects and were compared to orexin A levels and anthropometrical data. Average weight in subjects before weight-reduction was 74.2+/-2.79 kg and after weight-loss 67.4+/-2.60 kg (p<0.0001). Orexin A levels before the therapy were 33.3+/-1.97 pg/ml and after the therapy 51.7+/-3.07 pg/ml (p<0.0001). Levels of orexin A were not significantly different between girls and boys (p=0.7842). We found negative correlation between orexin A and age (r = -0.5395; p<0.0001), body height (r = -0.4751; p=0.0002), body weight (r = -0.4030; p=0.0017) and BMI (r = -0.2607; p=0.0481). No correlation was found between orexin A and IGF-1, IGFBP-3 or leptin. Orexin A plasma levels increased during body weight loss, whereas the reverse was true for leptin levels. These findings support the hypothesis that orexin A may be involved in regulation of nutritional status in children.

[Influence of early postnatal nutrition in preterm infants on their anthropometric and hormonal characteristics at the age of 10 years]. / Vliv casné postnatální výzivy u predcasne narozených detí na jejich antropometrické a hormonální charakteristiky ve veku 10 let.

BACKGROUND: [corrected] A protective effect of breast feeding on the development of obesity has been clearly demonstrated. Several studies associated higher protein intake in postnatal period with the earlier "adiposity rebound" and the higher BMI in later life. METHODS AND RESULTS: Twenty eight girls born at 34th week of pregnancy (weight: 2.22+/-0.31 kg, length: 45.2+/-2.5 cm, BMI: 11.0+/-1.5 kg/m(2)), were subdivided in two groups differing in protein intake during the first postnatal month due to either breast feeding or formula feeding (113.5+/-18.7 g/month vs. 174.00+/-14.3 g/month; p<0.0001). Groups did not differ in average body weight, height and BMI at birth. Anthropometric and hormonal characteristics, body composition, energy and macronutrient intakes were determined at the age of 10 years in girls together with parental BMI. Association between the early postnatal nutrition and anthropometric and hormonal indexes at 10 years was evaluated. No significant differences between the groups in anthropometric and hormonal characteristics were found at 10 years except for IGF-1 which was significantly higher in the group with increased postnatal protein intake. Protein intake during the first postnatal month was not related to fat mass and leptin levels at 10 years. Protein intake during the first postnatal month significantly correlated with IGF-l level, BMI and body circumferences at 10 years. Postnatal fat intake correlates with body circumferences and IGF-1 and also with sagital diameter and leptin at 10 years. CONCLUSIONS: Early postnatal nutrition could encode IGF-1 in later life and this way may be involved in body size programming. Factor analysis revealed IGF-1 as a link between the postnatal energy and macronutrient intake and anthropometric indices and leptin at the age of 10 years.

[Evaluation of results of iodine prophylaxis in Czech Republic]. / Hodnocení výsledku jodové profylaxe v ceské republice.

BACKGROUND: Improvement of system of iodine prophylaxis in Czech Republic resulted in compensation of iodine deficiency. Effects of increased iodine intake on the status of thyroid gland (volume, function, autoimmune disorders) should be determined. The aim of the study was to evaluate those effects in an epidemiological survey. METHODS AND RESULTS: A randomly selected sample of adult population (18-65 years old) from 3 regions was investigated using the same methods at the interval of 5 years. A significant increase of ioduria was proved with the marked increase of prevalence of high category (over 300 ug of I per 100 mL of urine). Volume of the thyroid gland decreased significantly in women, not in men. No significant changes of TSH were observed, however FT4 level slightly, but significantly increased. CONCLUSIONS: Repeated epidemiological survey of the randomly selected sample of adult population in 3 regions verified the effectiveness of improved iodine prophylaxis with not unequivocally positive increase of high (supraphysiological) category of ioduria. Decrease of thyroid volume was proved in women only, a tendency of mild (clinically not important) increase of thyroid function was also observed.

[Prevalence of C-reactive protein levels in adult population in two regions in the czech republic and their relation to body composition]. / Prevalence hladin C-reaktivního proteinu u dospelé populace dvou regionu Ceské republiky a jejich vztah k telesnému slození.

UNLABELLED: Increased concentration of high sensitivity C-reactive protein (hsCRP) is the new predictor of myocardial infarction, brain strokes, damage peripheral veins and sudden death. The aim of the study was to give an overview of current prevalence of individual risky concentrations of hsCRP in the adult population in two regions in the Czech Republic and to find a relationship to the indicators of fat tissue quantity. METHODS: test involved a representative sample of 516 adults aged 18 to 65 years (191 men and 322 women), with permanent residence in the Jablonec nad Nisou a Príbram regions. Period of testing: spring of 2004 and 2005. HsCRP was determined using the latex immunoprecipitation method with turbidimetric measurement on Cobas Integra 400 plus analyzer. The risk of cardiovascular disease (CVD) was set according to the scale derived by the American Heart Association. Body fat was measured with TANITA BF 410 MA, Omron and a calliper on 4 places on the body. Waist circumference was measured half-way between the anthropometric landmarks of the iliocristale and the lower angle of the ribs. Body mass index (BMI) was calculated using Quetelet formula: weight/height2. Statistical processing was done with Statgraphics Plus, version 7.1, using categorical data analysis with the chi2 statistic and Spearman's correlation analysis. RESULTS: 20.2% of cases with high CVD risk were identified in the whole sample of adults. Levels of hsCRP exceeding 10 mg/l (infectious disease indicator) at the time of the test were found in 3.9% cases (5.6% in the Jablonec region, 2.3% in the Príbram region). There were no significant regional differences for individual CVD risk categories; however, there was statistically significant difference between the two regions in terms of average hsCRP levels (with higher levels in the Jablonec region). Gender had a statistically significant impact on hsCRP levels: high CVD risk was recorded in 14.8% men and in 23.3% women. Levels of CRP indicating inflammatory disease were more frequent in women (4.7%) than in men (2.6%). The frequency of risk levels of hsCRP in adults significantly grows with age. Spearman's correlation analysis showed the closest relationship between hsCRP and body fat weight (r(S) = 0.5124). A statistically important positive CRP levels relationship was shown both in subcutaneous fat and visceral fat. CONCLUSION: One fifth of the adult population in two regions of the Czech Republic have at the present time levels of hsCRP which indicate a high cardiovascular risk. The risk is higher in women than in men and it doubles starting at 50 years of age and over. Positive correlation between hsCRP levels and body fat indicators was conformed both for visceral and subcutaneous fat.

[Changes in iodine supply in adult Czech population after iodine deficit eradication and causes. Random study of adults in two regions in the Czech republic with in between period of 5 years]. / Zmeny v zásobeni jodem Ceské dospelé populace po eradikaci jodového deficitu a jejich príciny. Randomizovaná studie dospelé populace dvou regionu Ceské republiky s odstupem 5 let.

INTRODUCTION: By iodine, similar to many other elements that are important for human body, the daily intake has some limitations. Neither deficiency, nor surplus are required. In the second half of the nineties in the 20th century, iodine deficiency in Czech republic could have been eradicated to a great extent. However, changes in iodine supply in population still have to be monitored, looking for the causes in nutrition. AIM: To monitor the changes in ioduria in adult population and search for causes of these changes in dietary habits. METHODS: In 1999, 2000, 2004 and 2005, urinary iodine was determined in randomly selected population of 1139 adults aged 18 to 65, domiciled in the regions Jablonec nad Nisou or Príbram. The measurement of iodine was based on alcaline ashing of urine specimens preceding Sandell-Koldhoff reaction. The information about possible nutrition sources of iodine (seafood, milk, salt, eggs, mineral water) was found out through questionnaires and controlled interviews. RESULTS: During the respective 5 years, significant increase of the mean level of urinary iodine from 117 +/- 3.09 microg/l to 193 +/- 8.17 microg/l occured. In both regions, significant increased frequency of supernormal values of urinary iodine (over 300 microg/l) occured: from 0% to 13-18%. However, the changes in the region Jablonec nad Nisou were more positive than in the other one: decrease of below-normal urinary iodine concentration (50 to 99 microg/l) from 43% to 22% in the region Jablonec nad Nisou was found, while the number of below-normal urinary iodine concentration in the other region increased from 24% to 33% and the number of adults with optimum iodine concentration has also decreased (from 75% to 53%). Nutrition changes of possible influence on the urinary iodine concentration (seafood, milk, eggs, salt, mineral water with iodine) were observed and significant increase in consumption of eggs, mineral water with iodine and milk was found out. The consumption of mineral water with iodine has increased from 5% to 10% in Jablonec nad Nisou and from 15% to 26% in Príbram. Multi-factor analysis of four major nutrition sources of iodine (consumption of milk, seafood, eggs and salt) has proven the biggest influence of regular egg and milk consumption on urinary iodine concentration in adults.

Obesity and infection: reciprocal causality.

Associations between different infectious agents and obesity have been reported in humans for over thirty years. In many cases, as in nosocomial infections, this relationship reflects the greater susceptibility of obese individuals to infection due to impaired immunity. In such cases, the infection is not related to obesity as a causal factor but represents a complication of obesity. In contrast, several infections have been suggested as potential causal factors in human obesity. However, evidence of a causal linkage to human obesity has only been provided for adenovirus 36 (Adv36). This virus activates lipogenic and proinflammatory pathways in adipose tissue, improves insulin sensitivity, lipid profile and hepatic steatosis. The E4orf1 gene of Adv36 exerts insulin senzitizing effects, but is devoid of its pro-inflammatory modalities. The development of a vaccine to prevent Adv36-induced obesity or the use of E4orf1 as a ligand for novel antidiabetic drugs could open new horizons in the prophylaxis and treatment of obesity and diabetes. More experimental and clinical studies are needed to elucidate the mutual relations between infection and obesity, identify additional infectious agents causing human obesity, as well as define the conditions that predispose obese individuals to specific infections.

Steroid hormones related to 11beta-hydroxysteroid dehydrogenase type 1 in treated obesity.

The local concentration of glucocorticoids is intensively regulated by 11beta-hydroxysteroid dehydrogenase type 1 (11beta-HSD 1). Human 11beta-HSD 1 also reversibly catalyzes the inter-conversion of 7alpha-hydroxy- and 7beta-hydroxy-dehydroepiandrosterone (DHEA) into 7-oxo-DHEA. The cohort of 282 obese adolescents, 154 girls (median age 15.31 years, range 14.17-16.68 years) and 128 boys (median age 14.95 years, range 13.87-16.16 years), BMI (Body Mass Index) >90th percentile was examined. In samples collected before and after one month of reductive diet therapy, circulating levels of steroids were analyzed by liquid chromatography-tandem mass spectrometry and radioimmunoassay methods. The model of the treatment efficacy prediction was calculated. A significant reduction in circulating levels of cortisone, E2 and increased levels of 7beta-hydroxy-DHEA after the reductive treatment was observed. Levels of cortisol, DHEA, DHT sustained without any significant change. The predictive Orthogonal Projections to Latent Structures (OPLS) model explained 20.1 % of variability of BMI, z-score change by the basal levels of 7alpha-hydroxy-DHEA, DHEA, cortisol and E2 as the strongest predictors. Reduced levels of circulating cortisone and reduced ratios of oxygenated/reduced metabolites reflect increased reductase activity of 11beta-HSD 1 with reduced BMI, z-score. We hypothesize whether these changes can be attributed to the altered activity of 11beta-HSD 1 in the liver.

Association of plasma lipids fatty acid composition with metabolic profile of Czech adolescents.

Obesity in childhood increases the risk of obesity in adulthood and is predictive for the development of metabolic disorders. The fatty acid composition is associated with obesity and obesity-associated disorders. We investigated the relationship between serum fatty acids composition, adiposity, lipids profile, parameters of glucose metabolism and leptin. The study subjects were 380 adolescents aged 15.0-17.9 years. The study's variables included anthropometric measurements, levels of serum lipids and hormonal parameters. Individual fatty acids were determined in plasma by gas-liquid chromatography. Palmitoleic acid (16:1n-7, PA) significantly positively correlated with percentage of body fat. Saturated fatty acids in phospholipids (PL) positively correlated with BMI and percentage of body fat. PA content in all lipids classes positively correlated with total cholesterol (TC), HDL cholesterol, triglycerides (TG) levels. Stearoyl-CoA desaturase (SCD) activity positively correlated with percentage of body fat and positive correlations of SCD and PA level with leptin were found. Plasma PA content and SCD are associated with adiposity and leptin in obese adolescents. No significant correlation between PA level and insulin resistance was found. Palmitoleate positively correlated with TC, HDL cholesterol, TG and LDL cholesterol levels.