Search

Diabetes is one of the main health concerns, especially in developed countries. During the last few decades, the percentage of diabetic persons is constantly increasing. Although the genetic factors have a strong influence in the development of diabetes, environmental influence (physical inactivity, inadequate nutrition leading to obesity) also have an important impact. The main objective of this investigation was to evaluate the possible influence of organic sprouted whole wheat grain flourless bread Tonus® (product of Trivit, Becej, Serbia) on DNA damage at various stages of progression through type 2 diabetes mellitus (T2DM). In addition to control (non-diabetic) subjects we analyzed obese, pre-diabetic and diabetic patients, for a total of four experimental groups. All subjects used to eat Mediterranean diet for at least two years before being included in our study. In each of four groups we had five persons practicing the Mediterranean diet but instead of bread they consumed flourless bread Tonus®. The DNA damage was evaluated on peripheral blood mononuclear cells by alkaline single cell gel electrophoresis (Comet) assay at the very beginning (before starting the Tonus® bread diet), and after exactly the three months of consumption of Tonus® bread. Statistical analysis revealed that only in patients with type Dijabetes predstavlja jedan od glavnih zdravstvenih problema, naročito u razvijenim zemljama. Tokom poslednjih nekoliko decenija neprekidno se povećava procenat osoba obolelih od dijabetesa. Mada genetički faktori imaju snažan uticaj na razvoj dijabetesa, uticaji sredine (fizička neaktivnost, nepravilna ishrana koja dovodi do gojaznosti) takođe imaju veliki uticaj na razvoj ove bolesti. Tokom nekoliko poslednjih decenija procenat osoba sa dijabetesom se konstantno povećava. Glavni cilj ovog istraživanja bio je da se proceni mogući uticaj organskog hleba bez brašna od celih proklijalih zrna pšenice, Tonus® (Trivit, Bečej, Serbia) na oštećenja DNK u različitim stadijumima progresije kroz tip 2 dijabetes melitus. Pored kontrolne grupe (zdrave osobe), analizirali smo gojazne, predijabetičare i dijabetičare, što čini ukupno četiri eksperimentalne grupe. Sve osobe su koristile Mediteransku ishranu najmanje dve godine pre nego su uključene u ovu studiju. U svakoj grupi imali smo pet osoba koje su upražnjavale Mediteransku ishranu, ali su umesto uobičajenog hleba konzumirali hleb bez brašna Tonus®. Oštećenja DNK su evaluirana alkalnom verzijom elektoroforeze DNK pojedinačnih ćelija (komet test) na samom početku (pre uvođenja hleba Tonus® u ishranu) i tačno nakon tri meseca konzumiranja hleba Tonus®. Statistička analiza otkrila je da samo kod pacijenata sa dijabetesom tipa 2 konzumiranje Tonus hleba dovodi do smanjenja oštećenja DNK u poređenju sa stepenom oštećenja DNK kod ovih pacijenata pre nego su otpočeli dijetu sa hlebom Tonus. Pretpostaljamo da je pad hiperinsulinemije usled konzumiranja hleba Tonus mogao da bude jedan od glavnih uzroka smanjenja oštećenja DNK.

Background/Aim. Metabolic syndrome (MS) is characterized by basic cluster risk factors ? waist circumference (WC), glucoregulation disorders, hypertension, hypertriglyceridemia, low HDL-cholesterol followed by associated factors such as insulin resistance (IR), C-reactive protein (CRP), uric acid, plasminogen activator inhibitor-1 (PAI-1), fibrinogen, hyperhomocysteinemia (HHcy), nonalcoholic fatty liver disease (NAFLD) and microalbuminuira. The aim of this study was to analyze basic and associated factors of MS in patients with and without MS as well as correlation of siMS score, siMS risk score with basic and confounding factors of MS. Methods. The study included 148 overweight [body mass index (BMI) 25?30 kg/m2 and obese patients (BMI > 30 kg/m2)], age 30?75 years, classified into two groups: I ? with MS (68 patients); II ? without MS (80 patients). For quantification of MS, siMS score was used as a method, and siMS risk score was used as atherosclerotic complications risk indicator. Results. Patients with MS had statistically higher values of WC, hypertension, triglycerides (p < 0.001), glycemia (p = 0.006), as well as values of associated factors of MS [homeostatic model assessment (HOMA-IR)] (p = 0.002), CRP (p = 0.01), uric acid (p < 0.001), alanin transaminase (ALT) (p = 0.007) i gammaglutamyl transferase (GGT) (p = 0.001) and lower values of HDL-cholesterol (p < 0.001) compared to patients without MS. siMS score has shown correlation with associated factors of MS (log HOMA IR, logCRP, uric acid, (p < 0.001), fibrinogen (p = 0.005), liver enzymes logALT (p = 0.001) and log GGT (p < 0.001) and renal parametars (creatinine (p = 0.013) and serum protein (p = 0.006). siMS risk score correlated significantly with homocysteine, platelets, uric acid, blood urea nitrogen, albumins and proteins. Conclusion. In our study we found that patients with MS had higher values of associated factors of MS (HOMA-IR, CRP, uric acid, ALT, GGT), which was confirmed by correlation with siMS score. siMS score further indicated that IR, CRP, fibrinogen, uric acid and NAFLD are associated factors of MS. siMS risk score is another score that indicated that obesity and hyperprotein diet aggravates HHCy with age, increasing the risk for renal dysfunction and promoting atherosclerotic complications.

Background: Abdominal adiposity has a central role in developing insulin resistance (IR) by releasing pro-inflammatory cytokines. Patients with metabolic syndrome (MS) have higher values of homocysteine. Hyperhomocysteinemia correlates with IR, increasing the oxidative stress. Oxidative stress causes endothelial dysfunction, hypertension and atherosclerosis. The objective of the study was to examine the correlation of homocysteine with siMS score and siMS risk score and with other MS co-founding factors. Methods: The study included 69 obese individuals (age over 30, body mass index [BMI] >25 kg/m2), classified into two groups: I-with MS (33 patients); II-without MS (36 patients). Measurements included: anthropometric parameters, lipids, glucose regulation parameters and inflammation parameters. IR was determined by homeostatic model assessment for insulin resistance (HOMA-IR). ATP III classification was applied for diagnosing MS. SiMS score was used as continuous measure of metabolic syndrome. Results: A significant difference between groups was found for C-reactive protein (CRP) (p1c (p=0.047), HOMA-IR (p=0.008) and negatively with ApoE (p=0.042). Conclusions: Correlation of siMS score with homocysteine, fibrinogen, CRP and acidum uricum indicates that they are co-founding factors of MS. siMS risk score correlation with homocysteine indicates that hyperhomocysteinemia increases with age. Hyperhomocysteinemia is linked with genetic factors and family nutritional scheme, increasing the risk for atherosclerosis.

BackgroundWe evaluated the qualitative characteristics of high-density lipoprotein (HDL) particles in metabolically healthy and unhealthy overweight and obese subjects.MethodsThe study involved 115 subject individuals classified as metabolically healthy and unhealthy, as in overweight and obese groups. Commercial enzyme-linked immunosorbent assay (ELISA) kits were used to measure oxidized HDL (OxHDL) and serum amyloid A (SAA) concentrations. Lipoprotein subfractions were separated using nondenaturing gradient gel electrophoresis.ResultsAn independent association was shown between increased OxHDL/HDL-cholesterol ratio and the occurrence of metabolically unhealthy phenotype in the overweight and obese groups. The OxHDL/HDL-cholesterol ratio showed excellent and acceptable diagnostic accuracy in determination of metabolic health phenotypes (overweight group, AUC = 0.881; obese group, AUC = 0.765). Accumulation of smaller HDL particles in metabolically unhealthy subjects was verified by lipoprotein subfraction analysis. SAA concentrations did not differ significantly between phenotypes.ConclusionsIncreased OxHDL/HDL-cholesterol ratio may be a potential indicator of disturbed metabolic health in overweight and obese individuals.

BackgroundNon-alcoholic fatty liver disease is a frequent ailment with known complications, including those within the cardiovascular system. Associations between several indicators of high-density lipoprotein metabolism and function with clinical and laboratory parameters for the assessment of fatty liver index, a surrogate marker of non-alcoholic fatty liver disease, were evaluated.MethodsThe study comprised 130 patients classified according to fatty liver index values: fatty liver index ResultsIncreased lecithin–cholesterol acyltransferase activity correlated with increased fatty liver index ( P ConclusionsHigher lecithin–cholesterol acyltransferase activity is associated with elevated fatty liver index values. Significant independent association between triglycerides and lecithin–cholesterol acyltransferase activity might indicate a role of hypertriglyceridaemia in alterations of lecithin–cholesterol acyltransferase activity in individuals with elevated fatty liver index.

The pathological mechanisms that link the metabolic syndrome (MS) and colorectal cancer (CRC) are most probably related to abdominal obesity and insulin resistance. This study aimed to assess the relationship between MS and its clinical characteristics, with CRC. We investigated the changes in the appearance of MS features three months after surgical treatment, and its relationship with the concentration of tumor and inflammation markers. The retrospective cohort study was performed on 193 patients who were diagnosed with CRC and consequently surgically treated (at the Department of General Surgery, Clinical Hospital Center “Bežanijska kosa”, Belgrade). The included patients were divided into two groups based on the presence of MS. Body mass index (BMI), waist circumference, blood pressure, blood glucose, triglycerides (TG), high density lipoproteins – cholesterol (HDL-C), carcinoembryonic antigen (CEA), α-fetoprotein (AFP), carbohydrate antigen 19-9 (CA 19-90) and C-reactive protein (CRP) were analyzed at the time when the CRC diagnosis was made and three months after surgery. We observed a significant decrease in the number of patients with MS three months postoperatively compared to the number of patients in the preoperative period (106 versus 81; p

Introduction/Objective. There are controversial data in the literature on the topic of effects of alcohol on insulin secretion, apoptosis, and necrosis of the endocrine and exocrine pancreas. The goal of this research was to determine how alcohol affects the insulin secretion and viability of human adult pancreatic islets in vitro during a seven-day incubation. Methods. Human pancreatic tissue was digested with Collagenase XI, using a non-automated method. Cultures were incubated in Roswell Park Memorial Institute (RPMI) medium containing alcohol (10 μl of alcohol in 100 ml of medium). Insulin stimulation index (SI) and viability of the islets were determined on the first, third, and seventh day of cultivation. Results. Analysis of the viability of the islets showed that there wasn’t significant difference between the control and the test group. In the test group, viability of the cultures declined with the time of incubation. SI of the test group was higher compared to the control group, by 50% and 25% on the first and third day of cultivation, respectively. On the seventh day, insulin secretion was reduced by 25%. The difference was not statistically significant (p > 0.05). In the test group, significant decline in insulin secretion was found on the third and seventh day of incubation (p ≤ 0.05). Conclusion. Alcohol can increase or decrease insulin secretion of islets cultures, which may result in an inadequate response of pancreatic β-cells to blood glucose, leading to insulin resistance, and increased risk of developing type 2 diabetes. [Project of the Serbian Ministry of Education, Science and Technological Development, Grant no. 41002]

Background: Central obesity is the source of inflammatory factors, causing endothelial dysfunction. In central nervous system, inflammatory factors mediate neurotransmitter metabolism promoting excitotoxicity and increase oxidative stress, and a major clinical symptom is depression. Mediterranean diet (MD) resulted as a good prevention method for depression. Aim: To examine the relationship of depression with abdominal obesity and metabolic syndrome (MS) criteria, blood pressure, lipids, glycaemia and inflammation factors. Analysing effects of MD on weight correction, abdominal obesity and consequent less score points in Hamilton scale for depression. Methods: Study included 36 adolescents and youth (16-30 years) and 22 adults over 30 years, overweight and obese patients with MS, diagnosed with depression using Hamilton scale. MS was diagnosed using ATP III classification criteria. The following parameters were observed: BMI, waist circumference (WC), blood pressure, lipids, CRP and basal glycaemia and insulin. Seven day scheduled MD was used by patients. Results: Correlation is found between Hamiltonu2019s scale score and body weight, BMI, WC (p0.5). Hamiltonu2019s scale and Hamiltonu2019s scale score correlated with insulin (p0.5). Conclusions: Mediterranean diet resulted with reduced values of Hamiltonu2019s scale score, waist circumference, insulinemia and CRP in patients with MS and depression. Positive correlation of Hamiltonu2019s scale score with glycaemia and insulinemia suggest importance of insulin resistance and glucoregulation disorder on occurrence and stage of depression in obese patients with metabolic syndrome. CRP is useful marker for low grade inflammation in obese patients with MS, hence depression. Mediterranean diet resulted with reduced values of Hamiltonu2019s scale score, waist circumference, insulinemia and CRP in patients with MS and depression. Positive correlation of Hamiltonu2019s scale score with glycaemia and insulinemia suggest importance of insulin resistance and glucoregulation disorder on occurrence and stage of depression in obese patients with metabolic syndrome. CRP is useful marker for low grade inflammation in obese patients with MS, hence depression. Abdominal obesity accompanied with hyperinsulinemia, insulin resistance, lipid status alteration, hypertension, inflammation factors are pronounced in patients with depression. Chemokines and cytokines produced by white adipose tissue may contribute to widespread immune activation, potentially causing or execerbating diseases associated with inflammation such as type 2 diabetes, cardiovascular disease and depression. Mediterranean diet may be used in prevention and treatment of depression in patients with metabolic syndrome.

Background: Obesity is followed by insulin resistance (IR) and low grade inflammation. In patients with metabolic syndrome (MS) and clinicaly evident vascular complications homocystein values are higher. Hyperhomocysteinemia correlates with hyperinsulinemia and IR, resulting in oxidative stress, which causes endothelial lesions and dysfunction, promoting atherosclerosis and hypertension. Objectives:To examine homocystein levels in patients with and without MS, and find correlation between factors of MS and homocystein values. Methods:The study included 76 obese individuals (age over 30, body mass index (BMI) >25 kg/m2) classified into two groups: I- with MS (35 patients); II- without MS (41 patients). OGTT was used to evaluate the extent of glucoregulation disorder. IDF classification was applied for diagnosing MS. Si MS risk score by Soldatovic I et all 2016 was used. IR was determined by HOMA IR. Serum CRP was measured by immunometric assay. Microalbuminuria was determined immuno-nephelometrically. Homocysteine was determined by immunoassay FPIA-Abbot. Results: Patients with MS had increased WC: (I-110.6u00b115.4, II-95.6u00b115.4cm), BMI: (I-35.3u00b16.6, II-30.4u00b17.4kg/m2), blood pressure (I-136.4u00b113.9/90.5u00b19.5, II- 118.4u00b112.2/78.1u00b19.7mmHg), glycaemia (I- 5.4u00b11.6, II- 4.8u00b10.8mmol/l), HOMA IR (I- 8.8u00b19.4, II- 5.3u00b13.8mmol/u00b5U/ml), triglycerides (I- 2.17u00b10.95, II- 1.45u00b10.7mmol/l), CRP (I- 7.0u00b10.0, II- 3.7u00b13.8mg/l), microalbuminuria (I- 87.4u00b181, II- 56.4u00b156.9mg/24h), homocysteine (I- 13.0u00b13.2, II- 11.8u00b13.7u00b5mol/l) and decreased HDL (I- 1.07u00b10.2, II- 1.35u00b10.35mmol/l). Statistical significance between groups was found for WC, BMI, systolic and diastolic pressure, triglycerides, HDL-cholesterol (p

Background: In obese patients, abdominal obesity is accompanied with hyperinsulinism, increased insulin resistance (IR), decreased insulin sensitivity and decreased antioxidant status. Abdominal obesity, hypertension, hypertriglyceridemia, thrombotic and inflammatory factors, IR, hyperhomocysteinemia and microalbuminuria as markers of endothelial dysfunction are increased in patients with metabolic syndrome (MS). IR results in fat deposition in the liver and occurrence of non-alcoholic fat liver disease (NAFLD). NAFLD is the liver sign of MS. Objectives: This study analyzes siMS score, as a method for quantification of MS, prediabetes, IR, thrombotic and inflammatory factors, NAFLD, microalbuminuria, homocysteine and antioxidant status in obese children, adolescents and youth.Methods: The study included 205 obese individuals with Preu2013MS and MS (age 7-30) classified according to age I-children (7-15), II-adolescents (16-20) and III-youth (20-30). IDF classification was applied for diagnosing MS. Patients with less than three criteria indicated below were considered pre-MS. siMS risk score by Soldatovic I et al 2016 was used. siMS score = 2*Waist/Height + Gly/5.6 + Tg/1.7 + TAsystolic/130-HDL/1.02 or 1.28 (for male or female subjects, respectively). IR was determined by homeostatic model assessment (HOMA-IR). Serum CRP was measured by immunometric assay. Plasminogen activator inhibitor (PAI-1) was determined by plasminogen substrate essay. Microalbuminuria was determined immuno-nephelometrically. Homocysteine was determined by immunoassay FPIA-Abbot. FLI = (e 0.953*loge (triglycerides) + 0.139*BMI + 0.718*loge (GGT) + 0.053*waist circumference - 15.745) / (1 + e 0.953*loge (triglycerides) + 0.139*BMI + 0.718*loge (GGT) + 0.053*waist circumference - 15.745) * 100. Activities of markers of antioxidant defense, superoxide dismutase (SOD) and glutathione peroxidase (GPX) were determined in erythrocytes.Results: siMS score increases considerably with age, (I- 2.71u00b10.49, II- 2.81u00b10.90, III- 3.18u00b10,89). Patients had increased waist circumference (WC): (I- 90.5u00b113.5, II- 99.4u00b117.1, III- 104.8u00b118.1cm), blood pressure (I- 113.0u00b112/75u00b18.7, II- 122.0u00b110.8/80.1u00b19.2, III- 125.4u00b116.0/81.8u00b110.9mmHg), insulin mean value (I- 63.6u00b142.4, II- 63.1u00b153.2, III- 71.9u00b112.6U/ml), HOMA-IR (I- 5.4u00b12.8, II- 6.6u00b19.9, III- 8.8u00b112.6 mmol/u00b5U/ml), triglycerides (I- 1.36u00b10.64, II- 1.43u00b10.81, III- 1.76u00b11.02mmol/l), CRP (I- 4.1u00b14.2, II- 4.9u00b15.9, III- 6.1u00b15.9mg/l), PAI-1 (I- 4.8u00b12.6, II- 6.2u00b11.54, III- 6.3u00b11.15U/ml) and microalbuminuria (I- 35.2u00b144.8, II- 34.7u00b128.7, III- 36.5u00b130.4mg/24h), and decreased HDL (I- 1.15u00b10.25, II- 1.24u00b10.5, III- 1.16u00b10.3mmol/l), SOD (I- 1050.5u00b1137.2, II- 1127.3u00b1225.5, III- 1125.5u00b1179.9 U/gHb), GPX (I- 29.4u00b13.1, II- 19.2u00b115.1, III- 33.8u00b111.4U/gHb). Prediabetes increases with age, IFG (I- 2.1, II- 10.8, III- 13.8%) and IGT (I- 4.2, II- 4.0, III- 5.5%). FLI increases considerably with age (I- 2.52u00b15.7, II- 10.5u00b116.4, III- 15.8u00b123.8), as homocysteine (I- 8.6u00b13.7, II- 10.6u00b13.8, III- 11.4u00b13,5u00b5mol/l) and HbAlC (I- 5.2u00b10.42, II- 5.2u00b10.44, III- 5.6u00b10.7%). Correlations: HOMA-IR with BMI, WC, blood pressure, triglycerides, basal, 30 min, 120 min and mean insulinemia, basal glycemia (p

Objective To evaluate siMS score and siMS risk score, novel continuous metabolic syndrome scores as methods for quantification of metabolic status and risk. Materials and Methods Developed siMS score was calculated using formula: siMS score = 2*Waist/Height + Gly/5.6 + Tg/1.7 + TAsystolic/130—HDL/1.02 or 1.28 (for male or female subjects, respectively). siMS risk score was calculated using formula: siMS risk score = siMS score * age/45 or 50 (for male or female subjects, respectively) * family history of cardio/cerebro-vascular events (event = 1.2, no event = 1). A sample of 528 obese and non-obese participants was used to validate siMS score and siMS risk score. Scores calculated as sum of z-scores (each component of metabolic syndrome regressed with age and gender) and sum of scores derived from principal component analysis (PCA) were used for evaluation of siMS score. Variants were made by replacing glucose with HOMA in calculations. Framingham score was used for evaluation of siMS risk score. Results Correlation between siMS score with sum of z-scores and weighted sum of factors of PCA was high (r = 0.866 and r = 0.822, respectively). Correlation between siMS risk score and log transformed Framingham score was medium to high for age groups 18+,30+ and 35+ (0.835, 0.707 and 0.667, respectively). Conclusions siMS score and siMS risk score showed high correlation with more complex scores. Demonstrated accuracy together with superior simplicity and the ability to evaluate and follow-up individual patients makes siMS and siMS risk scores very convenient for use in clinical practice and research as well.

83rd EAS Congress, EAS 2015