Influence of Vitamin D Deficiency on Cardiometabolic Risk in Obesity

Vitamin D deficiency and dysfunctional adipose tissue are involved in the development of cardiometabolic disturbances (eg, hypertension, insulin resistance, type 2 diabetes mellitus, obesity, and dyslipidemia). We studied 50 obese (body mass index [BMI]: 43.5 ± 9.2 kg/m2 ) and 36 normal weight participants (BMI: 22.6 ± 1.9 kg/m2 ). Obese individuals were classified into different subgroups according to medians of observed anthropometric parameters (BMI, body fat percentage, waist circumference, and trunk fat mass). The prevalence of vitamin D deficiency (25-hydroxyvitamin D, 25 (OH)D < 50 nmol/L) was 88% among obese patients and 31% among nonobese individuals; 25(OH)D were lower in the obese group (27.3 ± 13.7 vs 64.6 ± 21.3 nmol/L, p < .001). There was a negative correlation between vitamin D and anthropometric indicators of obesity: BMI: (r = - 0.64, p < .001), waist circumference (r = -0.59; p < .001), and body fat percentage (r = -0.64; p < .001) as well with fasting plasma insulin (r = -0.35; p < .001) and homeostasis model assessment of insulin resistance (r = - 0.35; p < .001). There was a negative correlation between vitamin D level and leptin and resistin (r = -.61; p < .01), while a positive association with adiponectin concentrations were found (r = .7; p < .001). Trend estimation showed that increase in vitamin D level is accompanied by intensive increase in adiponectin concentrations (growth coefficient: 12.13). In conclusion, we observed a higher prevalence of vitamin D deficiency among obese participants and this was associated with a proatherogenic cardiometabolic risk profile. In contrast, a positive trend was established between vitamin D and the protective adipocytokine adiponectin. The clinical relevance of this relationship needs to be investigated in larger studies

Metabolic dysregulation in obese women and the carcinogenesis of gynecological tumors: A review

Obesity is a significant health issue associated with increased cancer risks, including gynecological malignancies. The worldwide rise in obesity rates is significantly impacting both cancer development and treatment outcomes. Adipose tissue plays a crucial role in metabolism, secreting various substances that can influence cancer formation. In obese individuals, dysfunctional adipose tissue can contribute to cancer development through inflammation, insulin resistance, hormonal changes, and abnormal cholesterol metabolism. Studies have shown a strong correlation between obesity and gynecological cancers, particularly endometrial and breast cancers. Obesity not only increases the risk of developing these cancers but is also associated with poorer outcomes. Additionally, obesity affects the perioperative management of gynecological cancers, requiring specialized care due to increased complications and resistance to therapy. Treatment strategies for managing metabolic dysregulation in patients with gynecological cancers include weight management, statin therapy, and insulin-sensitizing medications. Emerging studies suggest that interventions like intermittent fasting and caloric restriction may enhance the effectiveness of cancer treatments. Furthermore, targeting cholesterol metabolism, such as with statins or proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, shows potential in cancer therapy. In conclusion, addressing metabolic issues, particularly obesity, is crucial in preventing and treating gynecological malignancies. Personalized approaches focusing on weight management and metabolic reprogramming may improve outcomes in these patients

The impact of currently used oral antihyperglycemic drugs on dysfunctional adipose tissue

Obesity is a disease with pandemic frequency, often accompanied by chronic metabolic and organic complications. Type 2 diabetes mellitus (T2DM) is among the most common metabolic complications of obesity. The first step in the treatment of T2DM is medical nutrition therapy combined with moderate physical activity and with advice to patients to reduce their body weight. Pharmacotherapy starts with metformin, and in the case of inadequate therapeutic response, another antihyperglycemic agent should be added. The most clinical experience exists with sulfonylurea agents, but their use is limited due to high incidence of hypoglycemia and increase in body weight. Based on the fact that dysfunction of adipose tissue can lead to the development of chronic degenerative complications, precise use of drugs with a favorable effect on the functionality of adipose tissue represents an imperative of modern T2DM treatment. Antihyperglycemic drugs of choice in obese individuals are those which cause maturation of adipocytes, improvement of secretion of protective adipokines, and redistribution of fat mass from visceral to subcutaneous depots. Oral antihyperglycemic agents that can affect the functionality of adipose tissue are metformin, SGLT-2 inhibitors, DPP-4 inhibitors, and thiazolidinediones

Influence of Vitamin D Deficiency on Cardiometabolic Risk in Obesity

Vitamin D deficiency and dysfunctional adipose tissue are involved in the development of cardiometabolic disturbances (eg, hypertension, insulin resistance, type 2 diabetes mellitus, obesity, and dyslipidemia). We studied 50 obese (body mass index [BMI]: 43.5 ± 9.2 kg/m2 ) and 36 normal weight participants (BMI: 22.6 ± 1.9 kg/m2 ). Obese individuals were classified into different subgroups according to medians of observed anthropometric parameters (BMI, body fat percentage, waist circumference, and trunk fat mass). The prevalence of vitamin D deficiency (25-hydroxyvitamin D, 25 (OH)D < 50 nmol/L) was 88% among obese patients and 31% among nonobese individuals; 25(OH)D were lower in the obese group (27.3 ± 13.7 vs 64.6 ± 21.3 nmol/L, p < .001). There was a negative correlation between vitamin D and anthropometric indicators of obesity: BMI: (r = - 0.64, p < .001), waist circumference (r = -0.59; p < .001), and body fat percentage (r = -0.64; p < .001) as well with fasting plasma insulin (r = -0.35; p < .001) and homeostasis model assessment of insulin resistance (r = - 0.35; p < .001). There was a negative correlation between vitamin D level and leptin and resistin (r = -.61; p < .01), while a positive association with adiponectin concentrations were found (r = .7; p < .001). Trend estimation showed that increase in vitamin D level is accompanied by intensive increase in adiponectin concentrations (growth coefficient: 12.13). In conclusion, we observed a higher prevalence of vitamin D deficiency among obese participants and this was associated with a proatherogenic cardiometabolic risk profile. In contrast, a positive trend was established between vitamin D and the protective adipocytokine adiponectin. The clinical relevance of this relationship needs to be investigated in larger studies

Clostridioides Difficile Infection before and during Coronavirus Disease 2019 Pandemic&mdash;Similarities and Differences

The aim of this study was to investigate the differences of Clostridioides difficile infection (CDI) during the COVID-19 pandemic compared to the pre-COVID-19 era. CDI patients treated at the Clinic for Infectious Diseases, Clinical Center of Vojvodina, Serbia during 2017&ndash;2019 (n = 304) were compared with COVID-19/CDI patients treated in period September 2021&ndash;September 2022 (n = 387). Groups were compared by age, gender, comorbidities, previous medications, laboratory findings, and outcome within 30 days. In the CDI/COVID-19 group, we found: greater percentage of males 59.8% vs. 42.6% (p &le; 0.001), older age 72.8 &plusmn; 9.4 vs. 65.6 &plusmn; 11.7 (p &le; 0.001), higher Charlson comorbidity score (CCS) (3.06 &plusmn; 1.54 vs. 2.33 &plusmn; 1.34 (p &le; 0.001), greater percentage of chronic renal failure (33.9% vs. 23.4% (p = 0.003), malignances (24.3% vs. 13.5% (p &le; 0.001), chronic obstructive pulmonary disease (22.7% vs. 15.5% (p = 0.017), higher usage of macrolide (38.5% vs. 8.6% (p &le; 0.001), greater percentage of patients with hypoalbuminemia &le;25 g/L (19.6% vs. 12.2% (p &le; 0.001), lower percentage of patients with elevated creatinine (&ge;200 mmol/L) (31.5% vs. 43.8%) (p = 0.002), and greater percentage of lethal outcome 29.5% vs. 6.6% (p &le; 0.001). In the prediction of lethal outcome multivariate regression analysis extracted as an independent predictor, only higher CRP values in the non-COVID-19 group and in the COVID-19 group: older age (p &le; 0.001), CCS (p = 0.019) and CRP (p = 0.015). COVID-19 changes the disease course of CDI and should be taken into consideration when managing those patients