Circadian rhythm of carbohydrate metabolism in health and disease

The article presents a review of the main circadian mechanisms regulating carbohydrate metabolism and their role in maintenance of energy homeostasis; the molecular genetic structure of the circadian system is also discussed. The role of adipose tissue and other organs and systems in the maintenance of circadian rhythm of carbohydrate metabolism, both in health and in obesity and diabetes, is highlighted. Particular attention is paid to diurnal rhythms of endocrine factors responsible for metabolic patterns of hormones such as cortisol, growth hormone and melatonin. Gender differences in the circadian regulation of energy and carbohydrate metabolism are also discussed, as well as their changes in different age periods. Article provides detailed review of the mechanisms of glucose utilization, reactivity of the pancreatic islets and peripheral insulin sensitivity shifts at different time periods of the day in people with normal body weight, android and gynoid types of obesity, both in women and men. Protective factors of energy metabolism circadian regulation structure preventing the development of diabetes mellitus and cardiovascular disease in individuals with so-called “metabolically healthy” obesity type are discussed. Article provides a review of various pathways of circadian rhythm disturbances, mechanisms of their development, as well as exogenous and endogenous factors leading to carbohydrate metabolic circadian rhythm misalignment, such as shift work, untiming of natural and artificial lighting, jet lags, sleep disorders. Represented data contribute to a new look at the pathogenesis of obesity and carbohydrate metabolism disorders in various types of obesity in men and women, that provides basis for searching for new effective methods of prevention and treatment of these conditions, elaboration of evidence-based diets and physical activity recommendations, as well as approaches to their medical treatment

Eating behavior features and preferred diets in underweight and obese young men

BACKGROUND: Actual nutrition and eating behavior features affect the formation of excess or underweight which in turn are risk factors for the development of chronic non-infectious diseases.AIM: To assess eating behavior features and consumption of basic nutrients in relation to metabolic disorders in underweight and obese young men of military age.MATERIALS AND METHODS: The study enrolled 86 young men aged 18 to 23 years that were referred by military enlistment office due to violations in body weight and examined in the hospital. Participants were divided into 2 groups depending on the value of the body mass index (BMI): group 1 (n=41) — underweight (Uw) young men; group 2 (n=45) — obese (Ob) young men. Anthropometric, hormonal and biochemical parameters of the body were measured; the type of eating disorder (ED) was evaluated using the Dutch DEBQ questionnaire, the presence and severity of anxiety and depressive disorders were assessed using the Hospital Anxiety and Depression Scale; assessment of the actual diet was performed using «Somatonic» computer soft.RESULTS: Absolute intake of all essential nutrients was higher in Ob young men; the relative consumption of protein and cholesterol was higher in Uw young men, whereas relative fats intake was higher in Ob group. EDs were statistically significantly more common in Ob young men. The values of all anthropometric indicators were higher in Ob group, while Uw young men predominantly demonstrated deficiency of the body fat component which did not affect key hormonal and metabolic indicators values. In Ob young men carbohydrate metabolism hormonal regulation disorders along with increased blood pressure were revealed.CONCLUSION: The ratio of proteins and fats intake should be taken into account in dietary regimens composition; Uw young men need to increase the proportion of fat and reduce protein intake, whereas Ob young men on the contrary need to reduce the proportion of fat and increase amount of proteins enhancing energy expenditure due to the specific dynamic food action

Hormonal characteristics of androgen status and their relationship with the anthropometric and metabolic parameter in men depending on the severity of hypertension

Background. According to the literature data, long-term and poorly controlled hypertension (HTN) leads to target organs damage, and in some cases, to the development of associated diseases, the severity of which in men may be partly due to the characteristics of the androgenic status.The aim: to reveal the features of hormonal indicators of androgen status and their relationship with the anthropometric and metabolic characteristics of the therapeutic clinic male patients, depending on the severity of HTN.Materials and methods. 296 men aged 59,0 [54,0; 65,0] years with confirmed HTN were examined. All study participants in the morning on an empty stomach underwent anthropometry, determination of metabolic and androgenic status, and assessment of comorbid burden. Depending on the severity of hypertension, all patients were divided into two groups (G): G1 (n = 134) – patients with hypertension without a history of coronary artery disease or stroke; G2 (n = 162) – patients with hypertension with a history of ischemic heart disease (IHD) and/or stroke.Results. In male patients of G2 with severe HTN, a decrease in the levels of free testosterone (FT) and, to a greater extent, dehydroepiandrosterone sulfate (DHEA-S), as well as total cholesterol, high and low density lipoproteins, was revealed. The correlation analysis performed revealed statistically significant negative correlations between the levels of total testosterone (TT) and FT with body mass index, the value of the ratio of waist circumference to hips, only the level of FT – with the presence of IHD, chronic heart failure (CHF), disorders of carbohydrate metabolism and abdominal type of fat distribution, and the level of DHEA-S – with the presence of IHD and CHF.Conclusion. A decrease in FT and DHEA-S is associated with early progression of atherosclerosis and the risk of developing HTN-associated cardiovascular events, which can aggravate the course of HTN

Association of сarriage of the rs4646994 polymorphism of the ACE gene with obesity and androgen deficiency in men

BACKGROUND: Obesity and androgen deficiency (AnD) are characterized by similar disturbances in metabolic parameters, the presence of signs of insulin resistance, metabolic syndrome, the risk of developing cardiovascular diseases (CVD) and vascular complications. These facts indicate the possibility of the presence of common mechanisms that determine the predisposition to the development of obesity and AnD, which may include genetic factors, in particular, the rs4646994 polymorphism of the ACE gene, which, according to recent data, is associated with the risk of developing CVD, hypertension, and obesity.AIM: To study the association of the carriage of polymorphic variants of the rs4646994 locus of the ACE gene with the features of anthropometric and androgenic status in men.MATERIALS AND METHODS: In the period from April 2020 to October 2021 there were observed male patients aged 18–75 years old, who were hospitalized in a therapeutic hospital because of comorbid somatic pathology (hypertension, coronary heart disease, dorsopathy, vegetative-vascular dystonia, gastroesophageal reflux disease, and others). Anthropometry, a study of the content of hormones of the reproductive system in the blood serum using enzyme-linked immunosorbent assay (ELISA), as well as a genetic study for the carriage of polymorphic variants of the rs4646994 locus of the ACE gene by the polymerase chain reaction (PCR) method, followed by electrophoresis of PCR products, were carried out. RESULTS: 82 patients took part in research. According to the results of genetic analysis, 17 people were assigned to the group of homozygotes for the wild type (I/I, G1), 41 people were assigned to the group of heterozygotes (I/D, G2), and 41 people were assigned to the group of homozygotes for the mutant allele (D/D, G3) 24 people. Body weight, chest circumference, waist and hips, body mass index in patients carrying the D allele of the rs4646994 polymorphism were statistically significantly higher than in I/I homozygotes. Differences in hormonal status also turned out to be statistically significant: patients from G1 compared with G2 and G3 had higher levels of total testosterone; from G1 compared to G3 — a higher level of free testosterone.CONCLUSION: An association of the carriage of the D allele of the rs4646994 polymorphic locus of the ACE gene with overweight and ADI was revealed

Association of comorbid somatic pathology with fat distribution type and body mass index in men

The purpose of the study was to investigate the effect of overweight, obesity and fat distribution type on the severity of comorbid somatic pathology in men. Material and methods. 216 men, aged from 22 to 78 years, who were patients of therapeutic clinic from 2018 to 2019 years, were observed. Height, body weight, waist (WC) and hip (HC) circumference were measured using standard anthropometric procedures, and then WC/HC and body mass index (BMI) were calculated. Clinical signs of aging were estimated by using the AMS questionnaire. The CIRS was scored from the medical records after hospitalization. Results and discussion. It was shown that overweight and obesity increase the burden of cardiovascular, endocrine and general comorbidity in men. Nevertheless, the burden of cardiovascular pathology did not differ between overweight and obesity men. The contribution of fat distribution type in separate BMI-groups is different. The upper fat distribution type in normal body weight increases the burden of vascular pathology, in overweight – vascular pathology and endocrine system, in obesity – cardiovascular pathology, and general comorbidity in men. Conclusion. Thus, the BMI ≥ 25 kg/m2 is associated with an increase burden of cardiovascular, endocrine and general comorbidity and upper fat distribution type increases the burden of vascular pathology in men

COMPARATIVE ANALYSIS OF MARKERS EFFICIENCY OF VISCERAL OBESITY DETECTION IN MEN WITH METABOLIC SYNDROME

The purpose of the study was to carry out comparative and quantitative assessment of surrogate markers of visceral obesity and their connection with the severity of clinical, biochemical and hormonal disorders in men with the metabolic syndrome and obesity. Material and methods. 136 men, aged from 23 to 68 years, who were patients of therapeutic clinic were observed. Clinical, anthropometric, biochemical and hormonal screening was taken. Transthoracic echocardiography was performed in all patients. Criteria of international experts’ consensus in the fields of cardiology and endocrinology (2009) were used to identify metabolic syndrome. Results and discussion. It was shown that among the all surrogate markers of visceral obesity (waist circumference; waist circumference measured in the lying position; waist circumference measured without the thickness of the subcutaneous tissue; the ratio of waist circumference to the circumference of the hips; sagittal abdominal diameter; thickness of epicardial adipose tissue) the largest number of statistically significant correlations with the clinical-biochemical, hormonal and adipokine characteristics of men was found for the waist circumference, measured in the lying position, and the waist circumference, measured without the thickness of the subcutaneous tissue. Intermediate position among the estimated markers was taken by a waist circumference measured in a standing position. Fewer number of correlation connections were revealed for thickness of the epicardial fat, sagittal abdominal diameter and the ratio of waist circumference to the circumference of the hips. Conclusion. The received results demonstrate objectivity of the selection of the surrogate markers of the severity of visceral obesity reviewed in the study, among which the waist circumference measured in the lying position had the greatest efficiency

Association of rs9939609 polymorphism in the FTO gene with features of androgen status in men

The purpose of the study was to investigate the association of carriage of rs9939609 polymorphism in the FTO gene with features of androgen status in men.Material and methods. The observational one-stage examination of 139 male patients aged 22 to 69 years, admitted to a therapeutic hospital in a planned manner has been carried out in the Clinic of the Federal Research Center for Fundamental and Translational Medicine in the period 2020–2021. All fasting men in the morning (8:00–8:30) were carried out of an anthropometric examination to determine physical development, sampling of venous blood from the cubital vein to assess the hormonal parameters of androgen status, and taking a sample of the buccal epithelium for molecular genetic research. Based on the carriage of the rs9939609 (T>A) polymorphism of the FTO gene, the following groups (G) of patients were distinguished: G1 – wild-type homozygotes (WT/WT), G2 – heterozygotes (WT/A), G3 – homozygotes for the mutant allele (A/A).Results and discussion. The statistically significant differences were found in the levels of total testosterone between G1 and G3 (11.6 vs 14.5 nmol/L, p = 0.010), as well as free testosterone in G1 compared to G2 (0.233 vs 0.287 nmol/L, p = 0.012) and G3 (0.233 vs 0.321 nmol/L, p = 0.002) when analyzing the clinical-anthropometric and hormonal features of the androgen status of the examined male patients in the selected groups. Assessment of the association revealed statistically significant positive correlations between the carriage of the mutant allele and the levels of total (r = 0.247; p = 0.013) and free (r = 0.296; p = 0.003) testosterone, and negative - with the frequency of androgen deficiency according to the free testosterone criteria (r = –0.240; p = 0.016).Conclusions. It has been shown that the carriage of the A/A genotype of rs9939609 polymorphism of the FTO gene is associated with an increase in the levels of total and free testosterone, that indicates a protective effect against the development of androgen deficiency in men. The obtained results suggest that this effect is due to the epigenetic effect of the FTO gene protein product on the expression of other genes involved in the synthesis of androgens in the gonads, but also in the adrenal cortex since no association of the carriage of the rs9939609 polymorphism of the FTO gene with the DHEA-C level was found

The features of psychological state, eating behavior, hormonal and adipokine regulation of metabolism in men with subcutaneous and abdominal fat distribution

BACKGROUND: development of obesity and obesity related conditions are directly associated with eating disorders and psychological state. There is increasing focus on the assessment the characteristics of these indicators in men with subcutaneous and central fat distribution, which are associated with various hormonal and adipokine mechanisms that effect on parameters of metabolism and eating behavior. AIMS: to study the characteristics of the psychologycal state, eating behavior and their relationship with hormonal and adipokine status in men with different fat distribution. MATERIALS AND METHODS: a single-center, cross-sectional study of 99 men aged 27 to 68 years was performed. 4 groups of men were formed after anthropometric examination. Group 1 (comparison) consisted of men with normal body weight. Group 2 consisted of overweight men, class I obesity and lower subcutaneous fat distribution (SFD). Group 3 consisted of overweight men, men with class I obesity and abdominal fat distribution (AFD); group 4 - men with class II obesity and class III obesity AFD. Eating behavior were determined with DEBQ questionnaire, severity of anxiety-depressive disorders were investigated with the Hospital Anxiety and Depression Scale; body image satisfaction was assessed with body image questionnaire. Serum glucose, triglycerides, insulin, leptin and adiponectin were estimated. RESULTS: it was shown, that men with AFD had severe metabolic disorders: hyperglycemia, hypertriglyceridemia, hyperinsulinemia and insulin resistance, hyperleptinemia and hypoadiponectinemia, than men with SFD. Men with AFD had an external type of eating behavior, with sever expressed depressive disorders and body image dissatisfaction. Men with SFD had an emotional type of eating behavior and higher body image satisfaction. A comparative analysis between men from 3 and 4 groups with AFD showed that in group 4 in men had higher hyperleptinemia and insulin resistance and there are no differences in severity of eating disorders, anxiety and depression between the groups. CONCLUSIONS: adipose tissue topography is associated with the psychophysiological, metabolic, hormonal and adipokine characteristics that underlie the development of primary obesity in men

Метаболический синдром и его компоненты как критерии оценки эффективности лечения гипертонической болезни

Purpose of the study was to evaluate the effectiveness of complex treatment of essential hypertension based on the definition of risk of development, frequency and severity of metabolic syndrome (MS) and its components before and after treatment in male patients of the therapeutic clinic.Materials and methods. The study included 123 patients hospitalized with a main diagnosis of hypertension. In addition to the main examination, anthropometric, instrumental and hormonal-biochemical examination was additionally carried out. A point assessment of deviation degree and additional components of MS from reference was defined. In accordance with the received sum of points each patient was assigned a specific stratification category in relation to MS: lack of risk of development, existence of low, moderate or high risk of development and also light, medium or heavy severity of MS. Repeated examination was carried out in 14 days from initiation of treatment. The effectiveness of treatment was estimated as significant improvement, improvement, without change, deterioration, or significant deterioration depending on change of sum of points.Results. Before the start of treatment, 22.8% of the examined patients had a moderate or high risk of developing MS, and 77.2% had MS of varying degrees of severity. After 14 days the number of patients with MS decreased by 14.6%, and the number of patients with risk of its development increased to 37.4%. In 14 days the number of patients with MS decreased by 14.6%, and the number of patients with risk of his development increased to 37.4%. Among all components of the MS, the greatest number of cases of improvement was noted for hypertension. Significant improvement from the carried-out therapy was revealed in 17.9%, improvement in 39.0%, lack of changes in 37.4% and deterioration in 5.7% of patients.Conclusion. The employment of the method of Point assessment of degree of risk development and severity of MS, as a cluster of risk factors for the development of cardiovascular diseases, in patients with essential hypertension allowed the estimation of efficiency of the carried-out therapy and the individualization of a treatment regimen.Цель исследования. Оценить эффективность комплексной терапии гипертонической болезни у пациентов мужского пола терапевтической клиники на основании определения риска развития, частоты встречаемости и тяжести метаболического синдрома (МС) и его компонентов до и после лечения.Материалы и методы. Обследовали 123 пациента с основным диагнозом «гипертоническая болезнь». Дополнительно к основному проводили антропометрическое, инструментальное и гормонально-биохимическое обследования. Выполняли балльную оценку степени отклонения основных и дополнительных компонентов МС от референсных значений. В соответствии с полученной суммой баллов у каждого пациента определяли конкретную стратификационную категорию по отношению к МС: отсутствие риска развития, наличие незначительного, умеренного или высокого риска развития, а также легкой, средней или тяжелой степени тяжести МС. Повторное обследование выполняли через 14 дней от начала лечения. Эффективность лечения оценивали как значимое улучшение, улучшение, без изменений, ухудшение или значимое ухудшение в зависимости от изменения суммы баллов.Результаты. До начала лечения 22,8% обследованных пациентов имели умеренный и высокий риски развития МС, а 77,2% – непосредственно МС различной степени тяжести. Через 14 дней количество пациентов с МС снизилось на 14,6%, а количество пациентов с риском его развития увеличилось до 37,4%. Из всех компонентов МС наибольшее количество случаев улучшения было отмечено по артериальной гипертензии. Значимое улучшение от проводимой терапии было выявлено у 17,9%, улучшение – у 39,0%, отсутствие изменений – 37,4% и ухудшение – у 5,7% пациентов.Заключение. Применение методики балльной оценки степени риска развития и тяжести МС как кластера факторов риска развития сердечно-сосудистых заболеваний у пациентов с гипертонической болезнью позволило оценить эффективность проводимой терапии и индивидуализировать схемы лечения

An Updated Review of Interventions that Include Promotion of Physical Activity for Adult Men

The marked disparity in life expectancy between men and women suggests men are a vulnerable group requiring targeted health promotion programs. As such, there is an increasing need for health promotion strategies that effectively engage men with their health and/or illness management. Programs that promote physical activity could significantly improve the health of men. Although George et al. (Sports Med 42(3):281, 30) reviewed physical activity programs involving adult males published between 1990 and 2010, developments in men’s health have prompted the emergence of new sex- and gender-specific approaches targeting men. The purpose of this review was to: (1) extend and update the review undertaken by George et al. (Sports Med 42(3):281, 30) concerning the effectiveness of physical activity programs in males, and (2) evaluate the integration of gender-specific influences in the content, design, and delivery of men’s health promotion programs. A search of MEDLINE, CINAHL, ScienceDirect, Web of Science, PsycINFO, the Cochrane Library, and the SPORTDiscus databases for articles published between January 2010 and August 2014 was conducted. In total, 35 studies, involving evaluations of 31 programs, were identified. Findings revealed that a variety of techniques and modes of delivery could effectively promote physical activity among men. Though the majority of programs were offered exclusively to men, 12 programs explicitly integrated gender-related influences in male-specific programs in ways that recognized men’s interests and preferences. Innovations in male-only programs that focus on masculine ideals and gender influences to engage men in increasing their physical activity hold potential for informing strategies to promote other areas of men’s health