Perivascular Fat and the Microcirculation: Relevance to Insulin Resistance, Diabetes, and Cardiovascular Disease

Type 2 diabetes and its major risk factor, obesity, are a growing burden for public health. The mechanisms that connect obesity and its related disorders, such as insulin resistance, type 2 diabetes, and hypertension, are still undefined. Microvascular dysfunction may be a pathophysiologic link between insulin resistance and hypertension in obesity. Many studies have shown that adipose tissue-derived substances (adipokines) interact with (micro)vascular function and influence insulin sensitivity. In the past, research focused on adipokines from perivascular adipose tissue (PVAT). In this review, we focus on the interactions between adipokines, predominantly from PVAT, and microvascular function in relation to the development of insulin resistance, diabetes, and cardiovascular disease

The Analysis of Epidemiologic Risks of Tularemia in the Natural Focus of a Steppe Type in the Stavropol Krai in 2003–2018 and Ways of Their Minimization

Our purpose was to study epidemiologic risks of people getting infected with tularemia in the natural focus of the steppe type in the Stavropol Krai during the periods of epidemic manifestations of varying intensity in 2003-2018 in order to develop the tactics of their minimization by means of preventive and anti-epidemic measures. Materials and methods. The study was conducted using statistical data and materials of the annual state reports on the sanitary and epidemiologic situation in the Stavropol Krai for 2003–2018. We analyzed all local cases of tularemia registered during the study period (100 cases). Results. The hunting and foodborne (38.0%), household (30.0%) and waterborne (30.0%) epidemiologic types of tularemia were identified. The increased incidence rate was observed in January – March 2017 (42 people). During this period, 47.6% of cases were of hunting-related and foodborne, 30.9% – of waterborne, and 21.5% – of household epidemiologic types of human tularemia. Discussion. In 2003-2018, not only local cases of hunting-related, foodborne and household epidemiologic types of tularemia were registered at the sporadic level, but waterborne tularemia began to prevail in people. There were multiple cases of the disease induced by infected water of local water supply systems. This must be taken into account when carrying out preventive measures. In individuals involved in hunting and cutting hares, vaccination should be carried out additionally in existing enzootic areas of the focus, where the pathogen is currently not detected in the biocenosis. The minimization of epidemiologic risks to public health is facilitated by the constant control of rodent access to local water pipelines in places of increased epizootic activity and epidemic hazard. Timely elimination of design drawbacks in the areas of water intake and sewage treatment plants and preventive disinfestation significantly reduce the risk of multiple incident cases of tularemia.</jats:p

Similarity of cutaneous reactive hyperemia in the forearm of women with and without hyperinsulinemia

OBJECTIVE: The present study was undertaken to assess in pre- and postmenopausal women whether obesity influences cutaneous reactive hyperemia in the forearm. DESIGN: Cross-sectional study. SUBJECTS AND METHODS: Eight lean premenopausal (age 24.6+/-3.5 y, BMI=21.9+/-1.5 kg/m(2), mean+/-1 s.d.), eight obese premenopausal (age 27.8+/-5.1 y, BMI=35.3+/-5.8 kg/m(2)), eight lean postmenopausal (age 56.1+/-8.3 y, BMI=20.2+/-2.2 kg/m(2)) and eight obese postmenopausal women (age 57.4+/-6.1 y, BMI=32.8+/-3 kg/m(2)) were included. Plasma glucose, insulin and lipid profile were determined in fasting state, and a glucose tolerance test was performed. The skin blood flow response to transient occlusion of the forearm circulation (reactive hyperemia, RH) was measured using a laser-Doppler imaging system. RESULTS: Obese women had hyperinsulinemia, suggesting that they were insulin-resistant. The magnitude of the RH was similar in postmenopausal compared to premenopausal women. Obesity did not influence this microvascular response. CONCLUSION: Obesity, which is known to be associated with impaired endothelial-dependent vasodilation in the skeletal musculature, has no effect on the RH of the forearm skin microcirculation