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Objective. The aim of the present study was to assess insulin-like growth factor 1 (IGF-1) and IGF-binding protein 3 (IGFBP3) as markers of insulin resistance in patients with prediabetes and type 2 diabetes mellitus (TDM2). Patients and Methods. This observational clinical study included 76 obese/overweight patients at the age of 45–75 years with T2DM on oral diabetic medication and ultrasonographically or by a computerized tomography (CT) diagnosed liver steatosis. Correlation analysis was performed between plasma levels of insulin, C-peptide, IGF-1, IGFBP3 and HOMA indexes on the one hand and between plasma levels of ALT, AST, triglyceride, cholesterol, and HDL cholesterol and body mass index (BMI) of patients on the other hand. In case of significant partial correlation coefficients, a multiple linear regression model with IGF-1 and IGFBP3 used as outcome variables adjusted for age and sex groups was calculated. According to these regression models, ROC curves were prepared with HOMA index=3 used as a classificator of insulin resistance. Results. Significant correlation was found between C-peptide and IGF-1 (r=0.24, p≤0.05), C-peptide and IGFBP3 (r=0.24, p≤0.05), IGFBP3 and cholesterol (r=0.22, p≤0.05) IGFBP3 and ALT (r=0.19, p≤0.05), HOMA index and triglycerides (r=0.22, p≤0.05), and HOMA index and ALT (r=0.23, p≤0.05). Significant correlation adjusted for age and gender was found between C-peptide and IGF-1 plasma levels (R2=0.20, p Conclusion. Our results demonstrate a fundamental role of IGF-1 and IGFBP3 in the patho-physiology of hepatic insulin resistance and suggest them as indirect indicators of the hepatic insulin resistance.

Vascular aging, characterized by structural and functional alterations of the vascular wall, is a hallmark of aging and is tightly related to the development of cardiovascular mortality and age-associated vascular pathologies. Over the last years, extensive and ongoing research has highlighted several sophisticated molecular mechanisms that are involved in the pathophysiology of vascular aging. A more thorough understanding of these mechanisms could help to provide a new insight into the complex biology of this non-reversible vascular process and direct future interventions to improve longevity. In this review, we discuss the role of the most important molecular pathways involved in vascular ageing including oxidative stress, vascular inflammation, extracellular matrix metalloproteinases activity, epigenetic regulation, telomere shortening, senescence and autophagy.

Impairment of the arteries is a product of sustained exposure to various deleterious factors and progresses with time; a phenomenon inherent to vascular aging. Oxidative stress, inflammation, the accumulation of harmful agents in high cardiovascular risk conditions, changes to the extracellular matrix, and/or alterations of the epigenetic modification of molecules, are all vital pathophysiological processes proven to contribute to vascular aging, and also lead to changes in levels of associated circulating molecules. Many of these molecules are consequently recognized as markers of vascular impairment and accelerated vascular aging in clinical and research settings, however, for these molecules to be classified as biomarkers of vascular aging, further criteria must be met. In this paper, we conducted a scoping literature review identifying thirty of the most important, and eight less important, biomarkers of vascular aging. Herein, we overview a selection of the most important molecules connected with the above-mentioned pathological conditions and study their usefulness as circulating biomarkers of vascular aging.

The determination of carbohydrate deficient transferrin (CDT) concentration is primarily used in social security studies as a proof of regular alcohol consumption exceeding the amount of 60 grams per day. Aims: The present study was performed to investigate into how carbohydrate deficient transferrin CDT values in serum are affected by the so-called food supplements and chemicals included in doping lists. Methods: The investigation was carried out in 15 bodybuilders of two sport clubs and in 10 boxers. All sportsmen were males. In both groups serum carbohydrate deficient transferrin (CDT%), median red blood cell volume and (MCV) gamma-glutamyl-transpeptidase (GGT) values were measured. Results: The authors found a significant difference between the two groups only in carbohydrate deficient transferrin CDT% that was the CDT% value in bodybuilders was twice as high as in boxers. Conclusion: Not all the details of the specificity of carbohydrate deficient transferrin (CDT) concentration are known, however, the remarkably high sensitivity of the method makes it suitable and probably cost-financially effective for serving as a pre-screening tool in doping tests. Orv. Hetil., 2012, 153, 514–517.

The non-alcoholic fatty liver (NAFLD) is an aquired metabolic liver disease as a consequence of triglyceride accummulation within the liver cells. It is accompanied by necrobiotic inflammatory reaction, fibrosis and also by liver cirrhosis. Its differentiation from alcoholic fatty liver (AFLD) looks sometimes to be difficult. It is simple knowing the clear anamnesis, but if the individual does not want to inform us about the alcohol consumption, the differentiation is not very easy. Aim of the study: The aim was to determine the value of carbohydrate deficient transferrin (CDT) in patients with non-alcoholic fatty liver, as well as to analyse the high values according to the anamnesis. Patients and methods: The group of patients consisted of 39 individuals, whose ultrasound examination showed the signs characteristic of fatty liver. The sex rate was: 21 female and 18 male patients. The values of CDT, body mass index (BMI) and HOMA index were determined. The mean value of CDT was: 239±0,52% (in ma...

A nem alkoholos zsírmáj (NAFLD) szerzett metabolikus májbetegség, amely a májsejtekben a trigliceridek lerakódása következtében jön létre és együtt jár nekrobiotikus gyulladásos reakcióval, fibrosissal és akár májcirrhosissal. Alkoholos eredetű zsírmájtól (AFLD) való elkülönítése néha gondot okoz. Az anamnézis ismeretében ez egyszerűbb, de ha az egyén az alkoholfogyasztásra vonatkozóan nem nyilatkozik, az elkülönítés nehézségbe ütközhet. Célkitűzés: Célunk volt a szénhidrátszegény transzferrin (CDT) meghatározása nem alkoholos zsírmájban szenvedő betegeknél, valamint a vizsgálat során észlelt kiugró értékek elemzése a betegek anamnézise alapján. Betegek és módszerek: A vizsgált csoportot 39 beteg alkotta, akiknél a hasi ultrahangvizsgálat a zsírmájra jellemző alaki eltérést mutatott. Közülük 21 nőbeteg és 18 férfi beteg volt. A betegeknél a CDT mérésén kívül meghatároztuk a testtömegindex- (BMI-) értéket és a HOMA-indexet. Eredmények: A betegek életkorában nem találtunk szignifikáns eltérést a nemek között. A CDT átlagértéke 2,39±0,52% volt, a férfiaknál 2,51±0,61, a nőknél 2,28±0,4; a nemek szerinti csoportfelosztásnál nem találtunk szignifikáns eltérést a csoportok között. A CDT-értékek eloszlása normális mintázatot mutatott. A BMI a túlsúlyosság tartományába esett, és ennél az értéknél sem volt szignifikáns eltérés a nemek között. Következtetés: Eredményeink alapján is valószínűsíthető, hogy az NAFLD és az AFLD a CDT% értéke alapján is elkülöníthető, és ez az érték a gamma-glutamil-transzpeptidáz értékénél specifikusabb markernek tekinthető, de esetében is fontos az anamnézis, az egyéb tényezők figyelembevétele és a lehető legtüzetesebb tisztázása.

Increased prevalence of insulin resistance in patients with nonalcoholic fatty liver disease (NAFLD) has been demonstrated in various studies. However, there are only few references regarding the relationship between plasma insulin values or insulin sensitivity index and the biochemical severity of liver infiltration. The aim of this study was to examine a relationship between symptoms of the metabolic syndrome, i.e. insulin resistance, body weight and plasma lipoproteins and the laboratory parameters of liver fatty infiltration in patients with nonalcoholic fatty liver disease. There was found a significant positive correlation between plasma insulin and alaninaminotransferase ( r = 0.359, p < 0.01) and a significant positive correlation between plasma insulin and aspartateaminotransferase ( r = 0.42, p < 0.01). Additionally, a significant positive correlation was found between the index of insulin resistance (HOMA index) and alaninaminotransferase ( r = 0.637, p < 0.01) and a significant positive correl...

Non-alcoholic fatty liver disease (NAFLD) is an acquired metabolic disease of the liver caused by accumulation of triglycerides in the hepatocytes followed by necrobiotic inflammatory reaction, fibrosis, and even cirrhosis. The accumulation of fatty acids in consequence of insulin resistance lies in the background of the process; the next step of pathogenesis is activation of microsomal polysubstrate systems and the oxidative stress caused by the released free radicals. Obesity, insulin resistance, diabetes mellitus and hyperlipidaemia are important pathogenetic factors. Patients with cholelithiasis and with a history of diabetes mellitus are known to have complications of cholelithiasis more frequently in comparison to those without diabetes. Objective: The aim of the study was the observation of the incidence of cholelithiasis and its complications in patients with NAFLD, as well as the comparison of the incidence of cholelithiasis between healthy persons and patients with NAFLD. Method: Abdominal ultra...

The determination of carbohydrate deficient transferrin (CDT) concentration is primarily used in social security studies as a proof of regular alcohol consumption exceeding the amount of 60 grams per day.The present study was performed to investigate into how carbohydrate deficient transferrin CDT values in serum are affected by the so-called food supplements and chemicals included in doping lists.The investigation was carried out in 15 bodybuilders of two sport clubs and in 10 boxers. All sportsmen were males. In both groups serum carbohydrate deficient transferrin (CDT%), median red blood cell volume and (MCV) gamma-glutamyl-transpeptidase (GGT) values were measured.The authors found a significant difference between the two groups only in carbohydrate deficient transferrin CDT% that was the CDT% value in bodybuilders was twice as high as in boxers.Not all the details of the specificity of carbohydrate deficient transferrin (CDT) concentration are known, however, the remarkably high sensitivity of the method makes it suitable and probably economically effective as a pre-screening tool in doping tests.

Bevezetés: A nem alkoholos zsírmáj szerzett metabolikus májbetegség, amely a májsejtekben a trigliceridek lerakódása következtében jön létre, és együtt jár nekrobiotikus gyulladásos reakcióval, fibrosissal és akár májcirózissal is. A nem alkoholos zsírmáj patogenezisében jelentős kóroki tényezők az elhízás, az inzulinrezisztencia, a 2-es típusú diabetes mellitus és a hyperlipidaemia, tehát a metabolikus szindróma egyes megnyilvánulási formái. Ismert, hogy azon epekövességben szenvedő betegeknél, akik anamnézisében diabétesz is szerepel, gyakoribbak az alapbetegség szövődményei. Célkitűzés: A kutatás célja az epekövességnek, továbbá szövődményei előfordulásának megfigyelése nem alkoholos zsírmájban szenvedő betegeknél, valamint az epekövesség gyakoriságának összehasonlítása nem alkoholos zsírmájban szenvedő betegek és egészségesek között. Módszer: A hasi ultrahang-vizsgálati leleteket elemezték ambuláns, illetőleg bentfekvő betegeknél, a megfigyelésből kizárták a súlyos társbetegségekben szenvedő betegeket. A vizsgált betegcsoport válogatott betegmintának tekinthető. A két valószínűségi változó függetlenségének vizsgálatakor a χ 2 próbát alkalmaztuk. Eredmények: A vizsgált betegek 38%-ánál a steatosis jelenlétét, és 16%-ban az epekövesség jelenlétét tudták igazolni. A nem alkoholos zsírmáj kétszeri gyakorisággal fordul elő epekövesség és szövődményei miatt vizsgált betegeknél (33%), mint az epekövesség a nem alkoholos zsírmáj irányában vizsgált betegeknél (16%). Az epekövesség szövődményei gyakrabban fordultak elő azon betegeknél, akiknél nem alkoholos zsírmáj diagnózisát is véleményezték, mint azoknál, akiknél ez nem volt jelen. A χ 2 -próba nem hozott szignifikáns eredményt az epekövesség és a zsírmáj függetlenségét illetően. Következtetés: A nem alkoholos zsírmáj kóroki tényezői szerepet játszhatnak az epekövesség kialakulásában, így valószínűsíthető, hogy a nem alkoholos zsírmáj gyorsabban alakul ki az adott közös kóroki tényezők hatására, mint az epekövesség.

Hepatorenal syndrome. Hepatorenal syndrome is a functional renal failure in state of portal hypertension caused by splanchnic vasodilatation that brings decrease of renal perfusion. The inductive factors include acute alcoholic hepatitis, non-adequate diuretic therapy, infections and bleeding from upper parts of gastrointestinal tract. Recognition of pathophysiological mechanisms of hepatorenal syndrome helped the elaboration of therapeutic schemes. The treatment is successful in improvement of renal functions in many patients but it is very expensive.

The liver steatosis is a frequent human disease. The most frequent cause of the process is the alcohol consumption. But it also may arise without significant alcohol abuse. This pathogenetic process is called non-alcoholic steatohepatitis (NASH), that is characterized by the same conditions like the alcoholic steatohepatitis. In the pathogenesis of the NASH various factors participate i.e. obesity, diabetes mellitus type II, hyperlipidaemia, pregnancy, variable chemotoxins, parenteral nutrition, jejunoileal bypass, chronic inflammatory diseases, protein deficient nutrition and inborn metabolic diseases. Pathobiochemically the process consists of oxidative stress and lipid peroxidation. This condition comes from the progressive accumulation of the free fatty acids in mitochondria and from the induction of cytochrome P450, CYP 2E1 isoform in hepatocytes and Kupffer cells. The free fatty acids and ketons can cause the induction of CYP 2E1 system, that is why diabetes mellitus and obesity are the two most important factors in the NASH pathogenesis. This article is concerned mainly in the explanation of NASH pathomechanism.