Ocena stężeń FGF-21 — nowej adipocytokiny w cukrzycy typu 2

Introduction: Fibroblast growth factor 21 FGF-21 is a newly discovered adipocytokine which may play a vital role in improvement of insulin sensitivity and pathogenesis of type 2 diabetes. The aim of the study was to assess FGF-21 concentrations in the serum of patients with type 2 diabetes, in comparison to a control group, and evaluate the possible relationships between the studied cytokine and selected clinical and biochemical parameters Material and methods: The study was conducted in 64 patients with type 2 diabetes, 28 women and 36 men aged 47-70 (median age 61.5), with a median duration of diabetes of 8.5 years. In fasting serum samples, concentrations of glucose, insulin, lipids profile parameters, creatinine, C-reactive protein (CRP), fibrinogen, HbA1c, adiponectin, and FGF-21 were determined. The control group comprised 20 healthy persons matched for age to the study group, with no disturbances in carbohydrate metabolism: 14 women and 8 men. Results: We found significant differences concerning the medians of body mass index (BMI) 32.4 kg/m2 v. 24.1 kg/m2, p < 0.001; waist circumference 114 cm v. 81 cm, p < 0.001; HDL cholesterol 42.5 mg/dl v. 62.5 mg/dl, p < 0.001; triglyceride (TG) 152 mg/dl v. 99 mg/dl, p < 0.01 in the studied group, in comparison with the control group, respectively. In patients with diabetes, median FGF-21 concentration was 239.9 pg/ml and was significantly greater in comparison to the control group: 112.6 pg/ml p < 0.01. Median adiponectin concentration in patients with type 2 diabetes was significantly lower in comparison to the control group, 7.5 ng/ml v. 9.95 ng/ml, p < 0.05. Significant correlations between FGF-21 concentrations and adiponectin (r = -0.24, p < 0.05), weight (r = 0.27, p < 0.05), glucose (r = 0.27, p < 0.05), HDL cholesterol (r = -0.26, p < 0.05), TG (r = 0.27, p < 005), and estimated glomerular filtration rate (eGFR) (r = -0.28, p < 0.05) were observed. No significant correlations between FGF-21 and parameters of metabolic control, markers of inflammatory status, and insulin resistance, or the presence of vascular complications of diabetes, were noticed. Conclusions: On the basis of the conducted studies it can be concluded that the greater FGF-21 concentration observed in the examined group of patients with type 2 diabetes may result from a compensatory reaction to metabolic disturbances or tissue resistance to this cytokine. The negative correlation between FGF-21 and eGFR suggests renal elimination of the examined compound. (Pol J Endocrinol 2010; 61 (1): 50-54)Wstęp: Czynnik wzrostu fibrolastów 21 (FGF-21, fibroblast growth factor 21) jest stosunkowo niedawno odkrytą adipokiną, mogącą odgrywać istotną rolę w poprawie insulinowrażliwości i patogenezie cukrzycy tytu 2. Celem pracy była ocena stężenia FGF-21 w surowicy krwi pacjentów cukrzycą typu 2 w porównaniu z grupą kontrolną, oraz znalezienie zależności pomiędzy tą cytokiną a innymi parametrami klinicznymi i biochemicznymi. Materiał i metody: Badania wykonano u 64 pacjentów z cukrzycą typu 2, w tym 28 kobiet i 36 mężczyzn w wieku 47-70 lat (średnia wieku 61,5), z medianą czasu trwania choroby 8,5 roku. W próbkach krwi pobranej na czczo wykonywano oznaczenia stężeń glukozy, insuliny, białka C-reaktywnego (CRP, C-reactive protein), fibrynogenu, lipidogramu, kreatyniny, HbA1c, adiponektyny i FGF-21. Grupę kontrolną stanowiło 20 osób (14 kobiet i 8 mężczyzn) z medianą wieku 58 lat, bez zaburzeń gospodarki węglowodanowej. Wyniki: W grupie badanej stwierdzono, w porównaniu z grupą kontrolną, istotne różnice w zakresie median wskaźnika masy ciała (BMI, body mass index) 32,4 kg/m2 v. 24,1 kg/m2, p < 0,001; obwodu talii 114 cm v. 81 cm, p < 0,001; cholesterolu frakcji HDL 42,5 mg/dl v. 62,5 mg/dl, p < 0,001; triglicerydów (TG, triglyceride) 152 mg/dl v. 99 mg/dl, p < 0,01. U pacjentów z cukrzycą mediana stężenia FGF-21 wynosiła 239,8 pg/ml i była istotnie wyższa w porównaniu z grupą kontrolną: 112,6 pg/ml, p < 0,001. Mediana stężenia adiponektyny u pacjentów z cukrzycą była istotnie niższa w porównaniu z grupą kontrolną, 7,5 ng/ml v. 9,95 ng/ml, p < 0,01. Zaobserwowano istotne zależności pomiędzy stężeniami FGF-21 a adiponektyną (r = -0,24, p < 0,05), masą ciała (r = 0,27, p < 0,05), glukozą (r = 0,27, p < 0,05), cholesterolem frakcji HDL (r = -0,26, p < 0,05), TG (r = 0,27, p < 005) oraz wielkością przesączania kłębuszkowego (eGFR, estimated glomerular filtration rate) (r = -0,28, p < 0,05). Nie znaleziono istotnych zależności pomiędzy stężeniem FGF-21 a parametrami wyrównania metabolicznego, wykładnikami stanu zapalnego i insulinooporności, jak również obecnością powikłań naczyniowych choroby. Wnioski: Na podstawie przeprowadzonych badań można przypuszczać, że obserwowane wyższe stężenia FGF-21 w badanej grupie pacjentów z cukrzycą typu 2, mogą wynikać z kompensacyjnej reakcji na zaburzenia metaboliczne bądź też są wynikiem tkankowej oporności na tę cytokinę. Ujemna korelacja stężeń FGF-21 z eGFR sugeruje eliminację drogą nerkową badanego związku. (Endokrynol Pol 2010; 61 (1): 50-54

Reasons for delay in treatment of breast cancer detected due to breast self-examination in women from the Lubelskie Region

Objectives: A delay in diagnosis and treatment of breast cancer patients is observed despite access to modern diagnostic methods. The aim of the study was to evaluate time between the first symptoms of breast cancer and treatment commencement, as well as to analyze reasons for the delay. Materials and methods: The research was conducted on 260 breast cancer patients treated at the Oncology Center in Lublin between 2008 and 2011. ‘Patient delay’ was defined as the time gap of >3 months between first symptoms of cancer and the doctor’s appointment and ‘system delay’ as the time gap of >1 month between the first medical consultation and commencement of treatment. Results: Mean patient delay was 32.2 ± 63.8 weeks. The main reasons were: disregard of symptoms (51%) and fear of being diagnosed with cancer (48%). Factors which significantly influenced the length of patient delay included: age >65 years, non-regular gynecologic care, lack of prior cancer screening and lack of family history of breast cancer. Mean system delay was 3.1 ± 2.9 weeks. Tumors < 5cm in diameter and clinical presentation other than a tumor, significantly influenced the system delay. Conclusions: A significant delay in diagnosis and treatment of breast cancer remains to be noted. Delay in seeking medical help was observed in 20% of the patients, whereas the referral was delayed due to system fault in 38% of the cases. Contrary to popular belief, patient delay (mean 32.2 ± 63.8 weeks) is 10 times longer than system delay (3.1 ± 2.9 weeks), suggesting an urgent need for further education of the general public and creating more accessible medical care

Myeloperoxidase level and inflammatory markers and lipid and lipoprotein parameters in stable coronary artery disease

Abstract Background Myeloperoxidase (MPO) impairing endothelial functions. We investigated whether increasing concentration of myeloperoxidase (MPO) and inflammatory markers induce progression and incident acute coronary syndrome (ACS) in stable coronary artery disease (SCAD) patients. Therefore, the concentration of MPO, lipids, lipoproteins (apo(apolipoprotein) AI, apoB, lipoprotein associated phospholipase A2 (LpPLA2) level), inflammatory markers (high sensitivity C-reactive protein (hsCRP), tumor necrosis factor-α (TNF-α), interleukine-6 (IL-6) concentration) were examined. Methods This study concerned 67 SCAD patients divided into groups: all patients, patients with MPO  300 ng/ml concentration and 15 controls. ApoAI, apoB and hsCRP levels were examined using the immunonephelometric method, and MPO, LpPLA2, IL-6, TNF-α concentration was performed by using Quantikine ELISA kit R&D Systems. Results In the all patients, and in group with MPO 200–300 ng/ml TC, LDL-C, nonHDL-C, LpPLA2 concentration and TC/HDL-C, LDL-C/HDL-C ratios were insignificant, and significantly higher concentration of TG, apoB, MPO, inflammatory markers and TG/HDL-C, MPO/apoAI, MPO/HDL-C ratios but HDL-C, apoAI level and HDL-C/apoAI ratio were significantly reduced. In the group of patients with MPO  300 ng/ml concentration of TC, LDL-C, nonHDL-C, apoAII, LpPLA2 and LDL-C/HDL-C ratios were not significant, but HDL-C and apoAI concentrations were significantly decreased. The concentrations of TG, apoB, MPO and inflammatory markers and TG/HDL-C, MPO/apoAI, MPO/HDL-C ratios were significantly increased compared to the controls. The apoAI concentration was significantly decreased and the concentration of MPO and hsCRP as well as MPO/apoAI and MPO/HDL-C ratios were significantly higher as compared to the group of patients with MPO  300 ng/ml showed a positive correlation between the concentration of MPO and the level of hsCRP and IL-6, and a negative correlation between MPO/apoAI ratio and the concentration of HDL-C, apoAI and apoAII. Conclusion The results suggest that moderate dyslipidemia and dyslipoproteinemia deepening of inflammation, and inflammation slowly induce increase MPO concentration which decrease apoAI and HDL-C level and disturb HDLs function. The increasing MPO level and MPO/HDL-C, MPO/apoAI ratios can differentiate the SCAD patients at the risk of acute coronary syndrome (ACAD) and stroke

γ-amino butyric acid (GABA) level as an overall survival risk factor in breast cancer

Introduction The γ-amino butyric acid (GABA) plays important role in the proliferation and migration of cancer cells. The aim of the study was to evaluate the level of GABA in breast cancer, in relation to clinical and epidemiological data. Material and Methods The study was conducted on 89 patients with breast cancer in stage I-II. GABA level was assessed using spectrofluorometric method in tumour homogenates. Immunoexpression of E-cadherin was evaluated histologically on paraffin fixed specimens. Overall and disease-free survival was assessed for a 15-year interval period. Results Median overall survival was significantly longer (127.2 months) in patients with a high level of GABA (>89.3 μg/1), compared with a group with a low level of the amino acid (106.4 months). Disease-free survival was insignificantly different – 99 and 109 months, respectively. A significantly longer overall survival (131.2 months) was seen among patients with a high level of GABA and positive E-cadherin immunoexpression, compared with a group characterized by a low level of GABA and lack of E-cadherin immunorectivity (98.1 months). The co-existence of negative immunoexpression of E-cadherin and low GABA concentration resulted in a six-fold increase in the risk of death (HR=6.03). Conclusions GABA has a significant prognostic value in breast cancer. Co-existence of a low level of GABA and loss of E-cadherin immune-expression seems to be a new, independent, and negative prognostic marker of the neoplasm

γ-amino butyric acid (GABA) level as an overall survival risk factor in breast cancer

Introduction The γ-amino butyric acid (GABA) plays important role in the proliferation and migration of cancer cells. The aim of the study was to evaluate the level of GABA in breast cancer, in relation to clinical and epidemiological data. Material and Methods The study was conducted on 89 patients with breast cancer in stage I-II. GABA level was assessed using spectrofluorometric method in tumour homogenates. Immunoexpression of E-cadherin was evaluated histologically on paraffin fixed specimens. Overall and disease-free survival was assessed for a 15-year interval period. Results Median overall survival was significantly longer (127.2 months) in patients with a high level of GABA (>89.3 μg/1), compared with a group with a low level of the amino acid (106.4 months). Disease-free survival was insignificantly different – 99 and 109 months, respectively. A significantly longer overall survival (131.2 months) was seen among patients with a high level of GABA and positive E-cadherin immunoexpression, compared with a group characterized by a low level of GABA and lack of E-cadherin immunorectivity (98.1 months). The co-existence of negative immunoexpression of E-cadherin and low GABA concentration resulted in a six-fold increase in the risk of death (HR=6.03). Conclusions GABA has a significant prognostic value in breast cancer. Co-existence of a low level of GABA and loss of E-cadherin immune-expression seems to be a new, independent, and negative prognostic marker of the neoplasm

Analiza obrazu klinicznego niedoczynności tarczycy u kobiet w okresie menopauzy

The objective of this retrospective study was to analyze the clinical picture of hypothyroidism in women, inrelation to their menopausal status. Materials and methods: A total of 694 female ambulatory patients were divided into 3 groups: group I – 258menstruating patients aged up to 45, group II – 124 perimenopausal patients aged between 46 and 52, group III– 312 postmenopausal patients aged over 52. Medical documentation of the patients with hypothyroidism wasevaluated in terms of the selected features of their medical history and clinical picture of the disease. Results: The main cause of hypothyroidism was the chronic autoimmune thyroid gland inflammation; ingroup I it concerned 62.8% of patients, in the remaining two groups it was 50.0% and 51.6%, respectively. Analysing the prevalence of clinical symptoms it was found that the most frequent ones were: weight gain (18.6%),weakness (16.3%) and drowsiness (14.7%). In group II the prevailing symptoms were: hypertension (37.1%),weight gain (21.8%), drowsiness and weakness (12.1%) whereas in group III hypertension (60.3%), symptoms ofischemic heart disease (24.4%) and weight gain (14.4%) were dominant. Mean daily doses of levothyroxine usedin the 3 groups of patients were 90 μg, 81 μg ,74 μg, respectively. In women from groups II and III, a lipid balancedisorder (hypercholesterolemia) was observed significantly more often than in younger patients. Conclusions: Hyperthyroidism was diagnosed most frequently in postmenopausal women. The main causeof hypothyroidism was the chronic autoimmune thyroid gland inflammation. In postmenopausal women unusualclinical symptoms of hyperthyroidism dominated, which resulted from the coexistence of other diseases,mainly cardiovascular disorders. A 24-hour long-dose of levothyroxine in postmenopausal women was lower ascompared to menstruating women. Hypercholesterolemia was a considerably frequent element of the clinicalpicture of hypothyroidism in postmenopausal women

The Effect of Citric Acid, NaCl, and CaCl2 on Qualitative Changes of Horse Meat in Cold Storage

In this study, we aimed to analyze the effect of citric acid, NaCl, and CaCl2 on the qualitative changes of horse meat during cold storage. The study material was the longest dorsal muscles (M. longissimus dorsi (LM)) obtained from twelve half-carcasses of horses. The muscle was cut into five steaks, each of which was about 3 cm thick. One sample was kept as a control sample, and the remaining ones were treated with NaCl, citric acid, and CaCl2 (0.2 M and 0.3 M). The study material was obtained 24 h after the slaughter of the animals and was marinated in solution (citric acid and 0.2 M and 0.3 M calcium chloride) and by sprinkling and rubbing (sodium chloride). The applied treatments significantly (p &le; 0.05) improved the texture parameters of horse meat (univariate analysis of variance). Citric acid caused deterioration of the study material with respect to the binding and retention of intrinsic water. Among the tested material, the lightest color of the meat was obtained for sample marinated in 0.3 M CaCl2. However, the darkest color of the meat was obtained after the addition of NaCl