Is vitamin D deficiency an independent risk factor for obesity and abdominal obesity in women?

Introduction: Vitamin D has been determined to have some effects on b cell function and insulin sensitivity, and it is known that type 2 diabetes mellitus and hyperparathyroidism can cause obesity. The aim of our study was to investigate if vitamin D deficiency without diabetes mellitus and metabolic syndrome is associated with obesity and abdominal obesity. Material and methods: The study included 276 healthy premenopausal women. To exclude other causes of obesity, postmenopausal women and subjects with diabetes mellitus and metabolic syndrome were excluded. Women were divided into two groups depending on their 25-hydroxyvitaminD3 [25(OH)D3] levels: subjects with vitamin D deficiency (Group 1) and subjects without vitamin D deficiency (Group 2). Body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) were compared between the two groups. Results: BMI, WC, WHR, rates of obesity, and abdominal obesity according to WC and WHR of Group 2 were lower than those of Group 1 (p = 0.0005, p = 0.0001, p = 0.0045, p = 0.032, p = 0.002, p = 0.011, respectively). 25(OH)D3 levels negatively correlated with BMIs (r = &#8211;0.480, p < 0.0001), WCs (r = &#8211;0.480, p < 0.0001) and WHRs (r = &#8211;0.312, p < 0.05). There were no differences between serum parathormone, calcium and phosphorus levels of Group 1 and 2 (p = 0.239, p = 0.354, p = 0.95, respectively). Conclusion: Vitamin D deficiency without diabetes mellitus and hyperparathyroidism may be associated with obesity and abdominal obesity.Wstęp: Wykazano, że witamina D wpływa na czynność komórek &beta; i wrażliwość na insulinę. Wiadomo również, że cukrzyca typu 2 i nadczynność przytarczyc mogą powodować otyłość. Celem badania było ustalenie, czy niedobór witaminy D u osób bez cukrzycy i zespołu metabolicznego wiąże się z otyłością i otyłością brzuszną. Materiał i metody: Do badania włączono 276 zdrowych kobiet przed menopauzą. W celu wyeliminowania innych przyczyn otyłości z badania wykluczono kobiety po menopauzie, chore na cukrzycę i osoby, u których rozpoznano zespół metaboliczny. Uczestniczki badania podzielono na 2 grupy w zależności od stężenia witaminy 25-hydroksyD3 [25(OH)D3]: grupa 1 &#8212; osoby z niedoborem witaminy D, grupa 2 &#8212; osoby z prawidłowym stężeniem witaminy D. Porównano wskaźniki masy ciała (BMI, body mass index), obwody talii (WC, waist circumference) i współczynniki talia/biodra (WHR, waist-to-hip ratio) w obu grupach. Wyniki: Wartości BMI, WC, WHR, odsetek osób otyłych i częstość otyłości brzusznej, określone na podstawie WC i WHR, były mniejsze w grupie 2, niż w grupie 1, (odpowiednio p = 0,0005; p = 0,0001; p = 0,0045; p = 0,032; p = 0,002; p = 0,011). Stężenia 25(OH)D3 były ujemnie skorelowane z wartościami BMI (r = &#8211;0,480; p < 0,0001); WC (r = &#8211;0,480; p < 0,0001) i WHR (r = &#8211;0,312; p < 0,05). Nie stwierdzono różnic między grupami pod względem stężeń parathormonu, wapnia i fosforu w surowicy (odpowiednio p = 0,239; p = 0,354; p = 0,95). Wnioski: Niedobór witaminy D u osób bez cukrzycy i nadczynności przytarczyc może się wiązać z otyłością i otyłością brzuszną

Wpływ chorób autoimmunologicznych tarczycy na rozwój otyłości brzusznej i hiperlipidemii

Background: Thyroid autoimmunity has been suggested as a risk factor for atherosclerosis independent of thyroid function in several studies. The aim of this study was to investigate whether thyroid autoimmunity had any effect on hyperlipidaemia, obesity and abdominal obesity independent of thyroid function. Material and methods: 184 premenopausal female patients with Hashimoto&#8217;s thyroiditis (HT) and 150 healthy premenopausal female volunteers as control group (CG) were included in the study. According to thyroid function status, the patients were divided into three subgroups: overt hypothyroid patients (ohp), subclinical hypothyroid patients (shp) and euthyroid patients (ep). Body mass index (BMI), waist to hip ratios, waist circumference (WC), and serum lipid levels of all the participants were determined. These parameters of ep were compared with those of ohp, shp and CG. Relationships among thyroid stimulating hormone (TSH), thyroid autoantibodies and lipid levels were investigated. Results: There were no significant differences between serum total cholesterol and low density lipoprotein cholesterol (LDL-C) levels of ohp and ep with HT (P = 0.18, P = 0.07 respectively) and LDL-C levels of ep were higher than those of CG (P = 0.03, P = 0.042, respectively). Although TSH levels did not correlate with serum lipid levels, levels of anti-thyroid peroxidase antibody correlated with triglyceride levels and WCs (r = 0.158; P = 0.013, r = 0.128; P = 0.048 respectively) and negatively correlated with high density lipoprotein cholesterol (HDL-C) levels (r = &#8211;0.137; P = 0.031). Levels of anti-thyroglobulin antibody also correlated with triglyceride and nonHDL-C levels (r = 0.208; P = 0.007, r = 0.158; P = 0.043 respectively). Conclusion: Thyroid autoimmunity may have some effects on hyperlipidaemia and abdominal obesity independent of thyroid function. (Pol J Endocrinol 2011; 62 (5): 421&#8211;428)Wstęp: Wyniki badań wskazują, że choroby autoimmunologiczne tarczycy są czynnikiem ryzyka miażdżycy, bez względu na czynność tego narządu. Celem badania było ustalenie, czy obecność chorób autoimmunologicznch tarczycy niezależnie od jej funkcji wpływa na rozwój hiperlipidemii, otyłości i otyłości brzusznej. Materiał i metody: Do badania włączono 184 kobiet przed menopauzą z zapaleniem tarczycy typu Hashimoto (HT) i 150 zdrowych ochotniczek przed menopauzą, które stanowiły grupę kontrolną (CG). Chore podzielono na 3 podgrupy w zależności od stanu czynnościowego tarczycy: osoby z jawną niedoczynnością tarczycy (ohp), z bezobjawową niewydolnością tarczycy (shp) i osoby z eutyreozą (ep). U wszystkich uczestniczek badania określono wskaźnik masy ciała (BMI), wskaźnik talia/biodra, obwód talii i stężenia lipidów w surowicy. Powyższe parametry porównano między grupą ep i pozostałymi grupami (ohp, shp, CG). Zbadano zależności między stężeniem TSH, przeciwciał przeciwtarczycowych i stężeniami lipidów. Wyniki: Nie stwierdzono istotnych różnic między stężeniami cholesterolu całkowitego i cholesterolu frakcji LDL między grupami ohp i ep (odpowiednio p = 0,18 i p = 0,07). Stężenia cholesterolu frakcji LDL w grupie ep były wyższe niż w grupie CG (odpowiednio p = 0,03 i p = 0,042). Stężenia TSH nie korelowały ze stężeniami lipidów w surowicy, jednak stwierdzono prostą zależność między stężeniami przeciwciał przeciw peroksydazie tarczycowej i stężeniami triglicerydów oraz obwodem talii (odpowiednio r = 0,158; p = 0,013, r = 0,128; p = 0,048) i odwrotną zależność między cholesterolem frakcji HDL (r = &#8211;0,137; p = 0,031). Stężenia przeciwciał przeciw tyreoglobulinie korelowały ze stężeniami triglicerydów i cholesterolu nie-HDL (odpowiednio r = 0,208; p = 0,007, r = 0,158; p = 0,043). Wnioski: Choroby autoimmunologiczne tarczycy mogą wpływać na rozwój hiperlipidemii i otyłości brzusznej niezależnie od stanu czynnościowego tego narządu. (Endokrynol Pol 2011; 62 (5): 421&#8211;428

Application of alternative anthropometric measurements to predict metabolic syndrome

OBJECTIVE: The association between rarely used anthropometric measurements (e.g., mid-upper arm, forearm, and calf circumference) and metabolic syndrome has not been proven. The aim of this study was to assess whether mid-upper arm, forearm, calf, and waist circumferences, as well as waist/height ratio and waist-to-hip ratio, were associated with metabolic syndrome. METHODS: We enrolled 387 subjects (340 women, 47 men) who were admitted to the obesity outpatient department of Istanbul Medeniyet University Goztepe Training and Research Hospital between September 2010 and December 2010. The following measurements were recorded: waist circumference, hip circumference, waist/height ratio, waist-to-hip ratio, mid-upper arm circumference, forearm circumference, calf circumference, and body composition. Fasting blood samples were collected to measure plasma glucose, lipids, uric acid, insulin, and HbA1c. RESULTS: The odds ratios for visceral fat (measured via bioelectric impedance), hip circumference, forearm circumference, and waist circumference/hip circumference were 2.19 (95% CI, 1.30-3.71), 1.89 (95% CI, 1.07-3.35), 2.47 (95% CI, 1.24-4.95), and 2.11(95% CI, 1.26-3.53), respectively. The bioelectric impedance-measured body fat percentage correlated with waist circumference only in subjects without metabolic syndrome; the body fat percentage was negatively correlated with waist circumference/hip circumference in the metabolic syndrome group. All measurements except for forearm circumference were equally well correlated with the bioelectric impedance-measured body fat percentages in both groups. Hip circumference was moderately correlated with bioelectric impedance-measured visceral fat in subjects without metabolic syndrome. Muscle mass (measured via bioelectric impedance) was weakly correlated with waist and forearm circumference in subjects with metabolic syndrome and with calf circumference in subjects without metabolic syndrome. CONCLUSION: Waist circumference was not linked to metabolic syndrome in obese and overweight subjects; however, forearm circumference, an unconventional but simple and appropriate anthropometric index, was associated with metabolic syndrome and bioelectric impedance-measured visceral fat, hip circumference, and waist-to-hip ratio

Concentrations of Connective Tissue Growth Factor in Patients with Nonalcoholic Fatty Liver Disease: Association with Liver Fibrosis

Aim: In this study, we aimed to investigate the relationship between the histological fibrosis stage of nonalcoholic fatty liver disease (NAFLD) and serum connective tissue growth factor (CTGF) to determine the usefulness of this relationship in clinical practice. Methods: Serum samples were collected from 51 patients with biopsy-proven NAFLD and 28 healthy controls, and serum levels of CTGF were assayed by ELISA. Results: Levels of CTGF were significantly higher in patients with NAFLD compared with controls (P = 0.001). The serum CTGF levels were significantly increased, that correlated with histological fibrosis stage, in patients with NAFLD [in patients with no fibrosis (stage 0) 308.2 ± 142.9, with mild fibrosis (stage 1–2) 519.9±375.2 and with advanced fibrosis (stage 3–4) 1353.2 ± 610 ng/l, P < 0.001]. Also serum level of CTGF was found as an independent predictor of histological fibrosis stage in patients with NAFLD (β = 0.662, t = 5.6, P < 0.001). The area under the ROC curve was estimated 0.931 to separate patients with severe fibrosis from patients with other fibrotic stages. Conclusion: Serum levels of CTGF may be a clinical utility for distinguishing NAFLD patients with and without advanced fibrosis

Hand functions in type 1 and type 2 diabetes mellitus

Introduction/Objective. Hand functions have an enormous impact on activities of daily living in patients with diabetes mellitus (DM), such as self-care, administering insulin injections, and preparing and eating meals. The aim of the study was to evaluate hand functions and grip strength in patients with type 1 and type 2 DM. Methods. This was an observational case-control study investigating the hand functions and grip strength in patients with type 1 and type 2 DM. The study comprised 41 patients with type 1 DM aged 25–50 years sex- and age-matched, 40 non-diabetic controls, and 91 patients with type 2 DM aged 40–65 years sex- and age-matched 60 non-diabetic controls. Patients with documented history of diabetic sensorimotor neuropathy and adhesive capsulitis were excluded. The Duruoz Hand Index was used to assess the functional hand disability. Grip strength was tested with a calibrated Jamar dynamometer. Results. The Duruoz Hand Index scores in patients with type 2 DM were significantly higher than in persons in the control group (p 0.05). Grip strength values of patients with type 1 DM were significantly lower compared to those in the control group (p < 0.05), whereas there was no significant difference between patients with type 2 DM and their control group. There was a negatively significant correlation between grip strength and the Duruoz Hand Index scores in patients with both type 1 and type 2 DM (p < 0.05). Conclusion. Patients with type 1 DM and type 2 DM have different degrees of hand disability as compared to healthy control groups

Frequency of Cardiovascular Risk Factors and Metabolic Syndrome in Patients with Chronic Kidney Disease

Objective: Metabolic syndrome is a clustering of cardio-metabolic risk factors. Cardiovascular disease is the main cause of morbidity and mortality in end-stage renal disease. The aim of this study was to elucidate the frequency of traditional and novel cardiovascular and metabolic syndrome risk factors in patients with chronic kidney disease. Identification of these risk factors will allow for precautions to be taken earlier to prevent cardiovascular diseases and metabolic syndrome in chronic kidney disease patients

Assessment of endothelial function in patients with nonalcoholic fatty liver disease

In this study, we aimed to evaluate the endothelial functions in patients with nonalcoholic fatty liver disease (NAFLD). In this observational case-control study, a total of 51 patients with NAFLD in study group and a total of 21 with age- and sex-equivalent individuals in control group were enrolled. In both patients and control groups, levels of asymmetric dimethylarginine (ADMA), systemic endothelial function (brachial artery flow-mediated dilation) (FMD) and carotid artery intima-media thickness (C-IMT) were measured. FMD and C-IMT were evaluated by vascular ultrasound. Plasma levels of ADMA were measured by ELISA. C-IMT was significantly higher in patients with NAFLD group than control group (0.67 +/- A 0.09 vs. 0.52 +/- A 0.11 mm, P < 0.001). The average C-IMT measurements were found in groups of control, simple steatosis, and NAFLD with (borderline and definite) NASH as 0.52 +/- A 0.11, 0.63 +/- A 0.07, and 0.68 +/- A 0.1 mm, respectively. The differences between groups were significant (P < 0.001). Measurement of brachial artery FMD was significantly lower in patients with NAFLD group compared to control group (7.3 +/- A 4.8 vs. 12.5 +/- A 7.1 %, P < 0.001). FMD measurements in groups of control, the simple steatosis, and NAFLD with NASH as 12.5 +/- A 7.1, 9.64 +/- A 6.63, and 7.03 +/- A 4.57 %, respectively, and the differences were statistically significant (P < 0.001). The increase in C-IMT and decrease in FMD was independent from metabolic syndrome and it was also more evident in patients with simple steatosis and NASH compared to control group. There was no significant difference between the control and NAFLD groups in terms of plasma ADMA levels (0.61 +/- A 0.11 vs. 0.69 +/- A 0.37 mu mol/L, P = 0.209). Our data suggested that NAFLD is associated with endothelial dysfunction and increased earlier in patients with atherosclerosis compared to control subjects