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

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

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

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 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