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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

The typical Serbian diet is characterised by high intake of cereal products and also legumes are often used. The content of total fibre as well as certain fibre fractions was determined in cereals, cereal products, and cooked legumes. The content of total fibre in cooked cereals and cereal products ranged from 2.5 to 20.8 g/100 g, and in cooked legumes from 14.0 to 24.5 g/100 g (on dry matter basis). Distribution of analysed fibre fractions and their quantities differed significantly depending on food groups. Fructans and arabinoxylans were the most significant fibre fractions in rye flakes, and beta-glucan in oat flakes, cellulose and resistant starch were present in significant amounts in peas and kidney beans. When the size of regular food portions was taken into consideration, the best sources of total dietary fibre were peas and kidney beans (more than 11 g/serving). The same foods were the best sources of cellulose (4.98 and 3.56 g/serving) and resistant starch (3.90 and 2.83 g/serving). High intake of arabinoxylans and fructans could be accomplished with cooked wheat (3.20 g and 1.60 g/serving, respectively). Oat (1.39 g/serving) and barley flakes (1.30 g/serving) can be recommended as the best sources of beta-glucan.

The aim of this study was to investigate the association between metabolic syndrome and liver enzymes in overweight and obese adolescents and young adults.A total of 126 overweight and obese adolescents and young adults (age, 15-26 years), 55 (43.6%) with metabolic syndrome and 71 (56.4%) without metabolic syndrome, were studied.Patients with metabolic syndrome had significantly higher alanine aminotransferase (ALT), γ-glutamyl transpeptidase (GGT), and alkaline phosphatase (ALP) levels compared to patients without metabolic syndrome [36.5±22.2 vs. 29.4±17.8 IU/L (P=0.043), 33.8±17.8 vs. 26.9±18.4 IU/L (P=0.002), and 84.3±32.2 vs. 75.7±29.5 IU/L (P=0.063)]. Aspartate aminotransferase (AST) levels were similar in both groups (24.1±9.8 vs. 23.3±9.0 IU/L, P=0.674). Elevated AST, ALT, GGT, and ALP levels were observed in 6, 15, 18, and 5 patients (11%, 27%, 14%, and 9%) with metabolic syndrome compared to 6, 17, 6, and 4 (8%, 24%, 8% and 5%) patients without metabolic syndrome (P=0.872, P=0.826, P0.001, and P=0.035). In multivariate regression models adjusted for age and gender, metabolic syndrome was not a significant predictor of ALT (P=0.967), GGT (P=0.526), and ALP levels (P=0.221), but insulin resistance was a significant predictor for ALT and GGT levels (P=0.001, P=0.028).Changes in liver function tests were observed in obese patients with metabolic syndrome, compared to patients without metabolic syndrome, especially in ALT and GGT levels. Insulin resistance is an independent pathogenic mechanism in liver function test changes regardless of metabolic syndrome in nondiabetic centrally obese youth.

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

Liberase HI has many advantages over traditional collagenases. Liberase performs the rapid dissociation of human pancreata and allows for the preservation of the morphological and functional integrity of isolated islets. The aim of this study was to investigate the effect of different concentrations of Liberase HI (1.5, 2.5 and 3.5 mg/ml) on the yield, viability and function of islets isolated by a non-automated method. Based on our results, the Liberase HI concentration 1.5 mg/ml is recommended for this method of isolation. .

We investigated the influence of short-term culture in vitro on the appearance of apoptosis of human fetal pancreatic islets (HFIs) and its effect on the mass and insulin-secretory capacity (ISC) of ?-cells. It was found that apoptosis was present from the end of the culture period, increasing as a function of time and leading to decrease of ?-cell mass. At the same time, ISC decreased. The decrease of ?-cell mass and ISC may influence significantly the clinical outcome of HFIs transplantation in type 1 diabetic patients.

PURPOSE: Metabolic syndrome denotes a common cluster of naturally connected risk factors including obesity, elevated blood pressure, insulin resistance, dyslipidemia, proinflammatory state and prothrombotic state. Anterior ischemic optic neuropathy is an acute ischaemic disorder of the optic nerve head and may lead to severe visual loss. METHODS: We considered three patients with moderate degree of diabetic retinopathy and anterior ischemic optic neuropathy. They were submitted to endocrinological examination and the diagnosis of metabolic syndrome was established. RESULTS: Cardiological examination revealed that blood pressure control was not optimal. The signs of left ventricular hypertrophy and diastolic dysfunction were confirmed by echocardiography. They are possible markers of preclinical cardiovascular disease. CONCLUSION: We observed that a variety of well-known risk factors in metabolic syndrome may be involved in serious eye and cardiological complications. The early diagnosis and treatment of these patients can not only improve visual function but also prevent cardiovascular complications.OBJETIVO: A síndrome metabólica indica um grupo comum dos seguintes achados clinicos: obesidade, hipertensão arterial, variações nos níveis de glicemia, dislipidemia, estado proinflamatório e o estado protrombótico. Neuropatia óptica isquêmica anterior é um distúrbio agudo isquêmico da cabeça do nervo óptico que pode levar à perda de visão. MÉTODOS: Consideramos três pacientes com retinopatia diabética não proliferativa moderada e neuropatia óptica isquêmica anterior. Os pacientes foram examinados por endocrinologistas e o diagnóstico de síndrome metabólica foi confirmado. RESULTADOS: O exame cardiológico revelou que o controle da pressão sangüínea não era adequado e tal anormalidade foi corrigida. A ecocardiografia confirmou os indícios de hipertrofia ventricular esquerda e disfunção diastólica. Estes são os marcadores possiveis da doença cardiovascular pré-clinica. CONCLUSÃO: Concluímos que os fatores de risco bem conhecidos, combinados na síndrome metabólica levaram às complicações oculares e às complicações cardiológicas. O diagnóstico anticipado e o tratamento destes pacientes pode não apenas melhorar a função visual mas também impedir as complicações cardiovasculares.

Cilj naše studije bio je odrediti međusobne odnose između „prve", neenzim-ske, te „druge", enzimske crte antioksidacijske zaštite u bolesnika s šećernom bolesti tipa 2 i očitovanim kardiovaskularnim komplikacijama. Drugi je cilj bio utvrditi odnose između prooksidacijskih (lipidni status) i antioksidacijskih parametara u ispitivanih bolesnika. Materijali i metode: U našu je studiju parova bilo uključeno ukupno 117 bolesnika s šećernom bolesti tipa (69 sa, te 48 bez kardiovaskularnih komplikacija) i 42 zdrava ispitanika. Određivani su sljedeći antioksidacijski enzimski parametri: eritrociti, Cu, Zn-SOD, glutation-peroksidaza (GPx) i glutation-reduk-taza (GR), kao i ukupni antioksidacijski status (engl. total antioxidant status, TAS), te bilirubin, mokraćna kiselina, ukupni proteini, albumin i haptoglobin. Enzimski antioksidacijski parametri i TAS analizirani su pomoću komercijalnih testova tvrtke RandoxLtd, V. Britanija, koji se temelje na spektrofotometrij-skim metodama, dok su ostali neenzimski i lipidni parametri određeni standardnim laboratorijskim metodama. Rezultati: U odnosu na zdrave ispitanike, bolesnici s šećernom bolesti tipa 2 i kardiovaskularnim komplikacijama imali su značajno niže vrijednosti en-zimskih antioksidansa (P < 0,001) i više vrijednosti ukupnog bilirubina (P = 0,050), mokraćne kiseline (P < 0,001) i haptoglobina (P < 0,001). Slaba je pozitivna korelacija utvrđena između SOD i GPx (R = 0,289, P = 0,028) te između SOD i GR (R = 0,259, P = 0,045), a slaba negativna korelacija zabilježena je između GPx i mokraćne kiseline (R = - 0,35, P = 0,009) te GPx i ukupnog bilirubina (R = - 0,40, P = 0,018). TAS je slabo korelirao s trigliceridima (R = 0,32, P = 0,037), a GPx i GR su korelirali s HDL-kolesterolom (R = 0,457, P = 0,007; te R = 0,466, P = 0,001). Zaključci: Temeljem dobivenih rezultata može se zaključiti da bolesnici s šećernom bolesti tipa 2 imaju značajno promijenjenu antioksidacijsku zaštitu, uz različiti stupanj neravnoteže između skupa neenzimskih tvari i aktivnosti enzimskih antioksidanasa, koja ovisi o tome jesu li se kardiovaskularne komplikacije pojavile ili ne., The objective of our study was to determine the interrelations between the "first", non-enzymatic, and the "second", enzymatic line of antioxidant defense in patients with type 2 diabetes mellitus and manifested cardiovascular complications. The second aim was to determine the relations between pro-oxidant (lipid status) and antioxidant parameters in patients under observation. Methods: In our case-control study, a total of 117 type 2 diabetic patients (69 with and 48 without cardiovascular complications) and 42 healthy subjects were included. Antioxidant enzymatic parameters: erythrocyte, Cu,Zn-SOD, glutathione peroxidase (GPx) and glutathione reductase (GR), as well as total antioxidant status (TAS), bilirubin, uric acid, total proteins, albumin and haptoglobin were determined. The enzymatic antioxidant parameters and TAS were analyzed using commercial tests manufactured by Randox Ltd. UK, based on spectrophotometer methods, while the other non-enzymatic and lipid parameters were determined by standard laboratory methods. Results: In relation to healthy subjects, type 2 diabetics with cardiovascular complications had significantly lower values of enzymatic antioxidants (P < 0.001), and higher values of total bilirubin (P = 0.050), uric acid (P < 0.001) and haptoglobin (P < 0.001). Weak positive correlation was found between SOD and GPx (R = 0.289, P = 0.028) and between SOD and GR (R = 0.259, P = 0.045), while weak negative correlation was obtained between GPx and uric acid (R = -0.35, P = 0.009), GPx and total bilirubine (R = -0.40, P = 0.018). TAS correlated weakly with triglycerides (R = 0.32, P = 0.037), while GPx and GR correlated with HDL-cholesterol (R = 0.457, P = 0.007; and R = 0.466, P = 0.001). Conclusions: Based on the obtained results, it may be concluded that type 2 diabetic patients have significantly modified antioxidant defense, with a varying degree of imbalance between the "pool" of non-enzymatic substances and the activity of enzymatic antioxidants, which depends on whether they have or not manifested cardiovascular complications.

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.

The Influence of Type And Duration of Cardiovascular Complications On Antioxidative Parameter Values In Type 2 Diabetic Patients It is well established that type 2 diabetes mellitus is associated with highly increased risk of coronary heart disease, cardiovascular disease (CVD), and total mortality. CVD is the leading cause of death of people with diabetes. The aim of our study was to test the effect of type and duration of cardiovascular complications on antioxidant parameter values: superoxide dismutase (SOD), glutathione peroxidase (GPx), glutathione reductase (GR) and total antioxidant status in patients with type 2 diabetes mellitus and manifested cardiovascular complications. Out of 100 subjects included in the study, 69 subjects were type 2 diabetic patients with cardiovascular complications and 31 age-matched controls. Statistical data processing revealed significantly lower antioxidant defense (p

Summary: Oxidative stress and hyperglycemia play an important role in the aethiology of vascular complications in diabetes. Hyperglycemia induces a large number of alterations in vascular tissue that potentially accelerate the atherosclerotic process. Nonenzymatic glycosylation of proteins and lipids which can interfere with their normal function by disrupting molecular conformation, alter enzymatic activity, reduce degradative capacity and interfere with receptor recognition, oxidative stress and protein kinase C activations are the major processes that encompass most of the pathological alterations in the diabetic vasculature. Diabetes-associated oxidative stress is a consequence of both increased production of free radicals and reduced capacity for antioxidative defense. The aim of this study was to test the parameters of antioxidative defense: superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), glutathione reductase (GR) and total antioxidant status (TAS), in type 2 diabetic patients with and without cardiovascular complications in order to determine the effect of hyperglycemia on the extent of disorders of antioxidative parameters. Sixty nine type 2 diabetic patients with cardiovascular complications, along with 48 diabetics without complications and 42 healthy subjects were examined. Determination of antioxidant parameters was performed using commercial tests manufactured by Randox Laboratories, UK, based on spectrophotometer determination methods. Statistical data processing revealed significantly lower SOD, GSH-Px, GR and TAS values in type 2 diabetic patients with cardiovascular complications in comparison to the control group (p

Previous studies have suggested that the multiple transplants might be equally metabolically efficient to a single regimen for human adult islets. The aim of this study was to compare immunological and metabolic parameters after each of the two regimens of human fetal islets (HFI). Group A single transplants (n = 9) had 180 +/- 20 x 1000 HFI equivalents (IEQs) implanted via a single intramuscular injection. In group B multiple transplants (n = 8) islets were implanted by three consecutive injections of 60 +/- 10 x 1000 IEQs at 7-day intervals. We analyzed the immunological parameters of CD4/CD8 T lymphocyte ratios; islet cell antibodies (ICAs) and insulin antibodies (IAs). We estimated insulin secreting capacity (ISC) as the metabolic parameter. We observed that the CD4+/CD8+ T-cell ratio increased, peaking on day 90, in similar fashion in both groups: day -1: A = 1.18 +/- 0.03 versus B = 1.19 +/- 0.04; on day 90: A = 1.79 +/- 0.09, versus B = 1.75 +/- 0.08 (P = NS) immediately before the decrease in C-peptide levels. Thereafter the ratios rapidly decreased without statistical differences. The levels of ICAs did not change. The levels of IAs, which were increased before transplant, then decreased without statistical differences between the groups. The values of ISC increased after transplant and then decreased similar to the T-cell ratio. Our results demonstrated that regimens of multiple and single HFIs did not show differences in the kinetics of the immunological response presumably mediating graft destruction. The CD4/CD8 ratio increased as the C-peptide level decreased, peaking on day 90 at the time of a decrease in C-peptide. These results may be useful for clinical studies of HFIs for type 1 diabetic patients.

OBJECTIVE—To investigate the role of dietary factors in the development of type 2 diabetes. RESEARCH DESIGN AND METHODS—In the context of the Multinational MGSD Nutrition Study, three groups of subjects were studied: 204 subjects with recently diagnosed diabetes (RDM), 42 subjects with undiagnosed diabetes (UDM) (American Diabetes Association criteria—fasting plasma glucose [FPG] ≥126 mg/dl), and 55 subjects with impaired fasting glucose (IFG) (FPG ≥110 and RESULTS—Compared with control subjects, RDM more frequently had a family history of diabetes (49.0 vs. 14.2%; P < 0.001), exercised less (exercise index 53.5 vs. 64.4; P < 0.01), and more frequently had sedentary professions (47.5 vs. 27.4%; P < 0.001). Carbohydrates contributed less to their energy intake (53.5 vs. 55.1%; P < 0.05), whereas total fat (30.2 ± 0.5 vs. 27.8 ± 0.5%; P < 0.001) and animal fat (12.2 ± 0.3 vs. 10.8 ± 0.3%; P < 0.01) contributed more and the plant-to-animal fat ratio was lower (1.5 ± 0.1 vs. 1.8 ± 0.1; P < 0.01). UDM more frequently had a family history of diabetes (38.1 vs. 19.0%; P < 0.05) and sedentary professions (58.5 vs. 34.1%; P < 0.05), carbohydrates contributed less to their energy intake (47.6 ± 1.7 vs. 52.8 ± 1.4%; P < 0.05), total fat (34.7 ± 1.5 vs. 30.4 ± 1.2%; P < 0.05) and animal fat (14.2 ± 0.9 vs. 10.6 ± 0.7%; P < 0.05) contributed more, and the plant-to-animal fat ratio was lower (1.6 ± 0.2 vs. 2.3 ± 0.4; P < 0.05). IFG differed only in the prevalence of family history of diabetes (32.7 vs. 16.4%; P < 0.05). CONCLUSIONS—Our data support the view that increased animal fat intake is associated with the presence of diabetes.

Starting from the evidence-based health benefits that resistant starch (RS) shows when added to the diet, our aim in this study was to evaluate the effects of increased fibre intake with two different levels of RS coming from regular daily consumed foods on normalization of glycaemia within lifestyle intervention in the population with risk factors for developing diabetes. Study included 47 overweight and obese men and women with disordered glucoregulation and dyslipidaemia, aged between 45-74, divided into RS and Fibre group. Participants were subjected to the lifestyle and dietary intervention with low-fat and high-fibre (> 25 g/day) diet for 12 months and were offered two different dietary advices aimed at increasing total fibre intake in Fibre group and at increasing RS intake in RS group. The intake of macronutrients and total fibre was similar between groups at the end of the study, but achieved RS intake was two times higher in the RS group. Decrease in total cholesterol and non-HDL-cholesterol was more pronounced in RS group in comparison with Fibre group (p = 0.010, p = 0.031, respectively), whereas in Fibre group, a more pronounced effect on glucoregulation was observed: significant fall in glycaemia after 2-h oral glucose tolerance test (7.93 vs 6.96 mmol/L, p = 0.034). At the end of the study, RS-rich diet failed to affect glycaemic control in prediabetic obese individuals in contrast to the regular fibre-rich diet, which indicated that fibre profile could be an important determinant of the effect of dietary intervention.

It has been verified that serum N-acetyl-β-D-glucosaminidase (NAG) activity is elevated in diabetes, but there are no reports about changes of the sialic acid (SA) content in the carbohydrate parts of NAG A form and its influence on total NAG activity changes in type 1 diabetes mellitus patients without and with secondary complications. NAG A forms were isolated, purified and characterized from the serum of 81 IDDM patients with and without secondary complications (retinopathy, polyneuropathy and nephropathy) and 25 healthy persons. The content of α-2,6-bound SA and isoenzyme patterns of purified A form, total NAG and A form activities were determined. In all diabetic groups, A form sialylation levels were 2-3.5 times lower compared to control, while their acidities (fractions with pI 4.25-5.1) increased, particularly with progression of secondary complications. Total serum NAG activities and percentages of A form were significantly higher (P

The aim of this study was to compare efficacy of two enzymes, Liberase HI and Collagenase XI in human adult pancreatic islet isolation.Pancreatic tissue samples were digested either with Liberase HI or Collagenase XI, using a non-automated method. We investigated the effect of both enzymes on yield, function and percent viability of the islets.No significant differences were found regarding islet yield when comparing Liberase HI to Collagenase XI. Viability of Collagenase-isolated islets was initially lower, but following 3 days of culture they attained a higher viability than the Liberase treated islets. Although the stimulation index tended to be higher in the Liberase-isolated islets no significant differences were observed between the two enzymes, except on the first day of cultivation; SI values for all Liberase concentrations were significantly higher than for Collagenase (p0.05).We conclude that during the isolation procedure using Collagenase XI, the functional capacity of the isolated islets decline, but this is restored during a subsequent cultivation. On the other hand, during digestion with Liberase HI, the islets suffer less functional damage, resulting in better preservation of their functional capacity immediately after the isolation, as well as the subsequent 7 days of cultivation.

PURPOSE: Metabolic syndrome denotes a common cluster of naturally connected risk factors including obesity, elevated blood pressure, insulin resistance, dyslipidemia, proinflammatory state and prothrombotic state. Anterior ischemic optic neuropathy is an acute ischaemic disorder of the optic nerve head and may lead to severe visual loss. METHODS: We considered three patients with moderate degree of diabetic retinopathy and anterior ischemic optic neuropathy. They were submitted to endocrinological examination and the diagnosis of metabolic syndrome was established. RESULTS: Cardiological examination revealed that blood pressure control was not optimal. The signs of left ventricular hypertrophy and diastolic dysfunction were confirmed by echocardiography. They are possible markers of preclinical cardiovascular disease. CONCLUSION: We observed that a variety of well-known risk factors in metabolic syndrome may be involved in serious eye and cardiological complications. The early diagnosis and treatment of these patients can not only improve visual function but also prevent cardiovascular complications.

Background/Aim. During the first 10 years over 50% of diabetes patients develop erectile dysfunction (ED). It is more severe and resistant to therapy than in male patients with normal glucoregulation. The purpose of this pilot study was to estimate the tadalafil (Cialis) efficacy and safety in male patients with diabetes mellitus (DM), together with moderate to severe ED. Methods. The study included 30 male patients with diagnozed type 1 or type 2 DM together with ED. ED was estimated through the International Index of Erectile Function (IIEF-6), Sexual Encounter Profile (SEP) questionnaire and prostaglandin test, at the beginning of the research and three months after the 20 mg tadalafil therapy initiation, once a week (on Fridays). Glycosylated haemoglobin in blood (HbA1c) values were also monitored. According to the ED severity (IIEF values at the beginning of the therapy) the patients were divided into 2 groups. The previous experience with sildenafil citrate (Viagra) and prostaglandin E1 intracavernous therapy was recorded. Results. Tadalafil significantly improved ED (p < 0.001) for 7.40 points of the IIEF score, i.e. for 58% and 60% towards SEP2 and SEP3 questionnaire, respectively. Compared to the previous ED therapy subjectively better tadalafil experience was recorded. Each group experienced a significant improvement in IIEF score (p < 0.001), more significantly in the group 2 (8.26?1.49 points) compared with the medium improvement in the group 1 (6.27?1.35 points). After three months HbA1c values decreased for 2.26?1.62 (p < 0.001). Conclusion. Tadalafil is an effective tool for treating ED in diabetes patients. In some situations tadalafil application could replace prostaglandin test. The sexual sphere motivation leads to the improvement of glucoregulation in DM patients. .

Background: The aim of this study was to examine prothrombogenic factors and antioxidative defense in obese children and adolescents with pre-metabolic and metabolic syndrome, and to analyze insulin secretion and resistance, early glycoregulation disorders and lipid status. Methods: Insulin sensitivity was determined using the homeostasis model assessment for insulin resistance (HOMA-IR), while insulin secretion was determined using the homeostasis model assessment (HOMA-β). Prothrombogenic factors analyzed were plasma plasminogen activator inhibitor-1 (PAI-1) and fibrinogen. Superoxide dismutase and glutathione peroxidase were measured as markers of antioxidative defense. Results: Patients with metabolic syndrome were characterized with increased body mass index (BMI), waist circumference, and HOMA-IR and HOMA-β levels, and all had increased blood pressure and triglyceride levels, low high-density lipoprotein cholesterol levels, increased PAI-1 levels and reduced antioxidative defense levels. Patients with pre-metabolic syndrome had higher levels of basal and mean insulinemia during an oral glucose tolerance test, higher levels of HOMA-β and lower levels of antioxidative defense compared to patients with metabolic syndrome. Conclusions: Negative correlations between antioxidative defense parameters and BMI, abdominal obesity, insulin secretion, systolic blood pressure and atherogenic lipid factors, as well as correlations between PAI-1 and insulin resistance and basal glycemia in the metabolic syndrome group contribute to accelerated atherosclerosis. Positive correlations between PAI-1 and waist circumference and BMI, and negative correlations between BMI and antioxidative defense in the pre-metabolic syndrome patients show that this early stage preceding the metabolic syndrome is also characterized by atherosclerotic complication risks and evident hyperinsulinism and insulin resistance.

83rd EAS Congress, EAS 2015