Proceedings of the 24th Paediatric Rheumatology European Society Congress: Part three

From Springer Nature via Jisc Publications Router.Publication status: PublishedHistory: collection 2017-09, epub 2017-09-0

The impact of dietary habits and nutritional intervention on metabolic syndrome parameters in hospitalized schizophrenic patients

Do danas, ni u općoj populaciji ni u osoba oboljelih od shizofrenije, nije definiran nutritivni pristup koji bi bio najadekvatniji za tretman metaboličkog sindroma. U ovom istraživanju cilj je bio utvrditi učestalost metaboličkog sindroma i prehrambene navike u hospitaliziranih osoba oboljelih od shizofrenije dobi ≥ 18 godina (n = 259). Utvrđena prevalencija metaboličkog sindroma iznosila je 47,9 %, a između ispitanika s i bez metaboličkog sindroma nije bilo statistički značajne razlike s obzirom na prehrambene navike. Određeni ispitanici s metaboličkim sindromom (n = 79) uključeni su u randomizirani kontrolirani pokus koji je za primarni cilj imao utvrditi utjecaj nutritivne intervencije, odnosno primjene dijetetskog pristupa za sprječavanje hipertenzije (DASH dijete) na metabolički sindrom i njegove parametre. Ukupno je 67 ispitanika (n = 33 u eksperimentalnoj skupini i n = 34 u kontrolnoj skupini) završilo istraživanje u trajanju od tri mjeseca. Eksperimentalna skupina dobivala je obroke pripremljene prema načelima DASH dijete s restrikcijom energijskog unosa od otprilike 400 kcal/dan u usporedbi sa standardnom bolničkom prehranom koju je dobivala kontrolna skupina. Obje su skupine tijekom intervencije sudjelovale u programu nutritivnih edukacija. Nakon tri mjeseca došlo je do statistički značajnog smanjenja prevalencije metaboličkog sindroma i u eksperimentalnoj (prevalencija nakon intervencije 75,8 %; p = 0,002) i u kontrolnoj skupini (prevalencija nakon intervencije 67,7 %; p = 0,0003). Između eksperimentalne i kontrolne skupine nije bilo statistički značajne razlike u prevalenciji metaboličkog sindroma i njegovih parametara. Iako DASH dijeta u usporedbi sa standardnom bolničkom prehranom nije rezultirala statistički značajnim smanjenjem prevalencije metaboličkog sindroma i njegovih parametara, dovela je do značajnih poboljšanja kakvoće prehrane i prehrambenih navika hospitaliziranih osoba oboljelih od shizofrenije s metaboličkim sindromom.Until today, the nutritional approach that would be the most efficient in the treatment of metabolic syndrome has not been defined neither in the general population nor in people diagnosed with schizophrenia. The present study aimed to determine the prevalence of metabolic syndrome and the dietary habits in hospitalized patients diagnosed with schizophrenia aged ≥ 18 years (n = 259). The overall prevalence of metabolic syndrome was 47.9 %. There were no statistically significant differences found between the participants with and without metabolic syndrome with respect to dietary habits. Several participants with metabolic syndrome (n = 79) were included in a randomized controlled trial which primary outcome was to determine the impact of the Dietary Approaches to Stop Hypertension (DASH) diet nutritional intervention on metabolic syndrome and its parameters. A total of 67 participants (n = 33 in the experimental group and n = 34 in the control group) completed a three-month study. The experimental group received meals prepared according to the principles of the DASH diet with an energy intake restriction of approximately 400 kcal/day compared to the standard hospital diet given to the control group. Both groups participated in a nutritional education program. Upon the expiry of the three months' period, the metabolic syndrome prevalence significantly decreased in both the experimental (prevalence after the intervention 75.8 %; p = 0.002) and the control group (prevalence after the intervention 67.7 %; p = 0.0003). At the end of the intervention, there were no statistically significant differences in the prevalence of metabolic syndrome and its parameters between the groups. However, although the DASH diet when compared to the standard hospital diet did not result in a statistically significant reduction of the prevalence of metabolic syndrome and its parameters, it led to significant improvements in diet quality and dietary habits of hospitalized schizophrenic patients with metabolic syndrome

The Effects of the Dietary Approaches to Stop Hypertension (DASH) Diet on Metabolic Syndrome in Hospitalized Schizophrenic Patients: A Randomized Controlled Trial

The relationship between the Dietary Approaches to Stop Hypertension (DASH) diet and metabolic syndrome (MetS) in people with schizophrenia is unknown and remains to be investigated. Therefore, we have conducted a three-month parallel-group randomized controlled trial. Sixty-seven hospitalized schizophrenic patients with MetS [n = 33 in the intervention group (IG) and n = 34 in the control group (CG)] completed the intervention. The IG followed the DASH diet with the caloric restriction of approximately 1673.6 kJ/day (400 kcal/day) when compared to the standard hospital diet followed by the CG. Simultaneously, both groups participated in a nutrition counseling program. Anthropometric and biochemical parameters and blood pressure were measured at the baseline and after three months, while nutrient intakes during the intervention were assessed using three non-consecutive 24-hour dietary recalls. The analyses were carried out based on the per-protocol approach. At three months, the MetS prevalence significantly decreased in both the IG and the CG (75.8%, p = 0.002, and 67.7%, p = 0.0003, respectively; odds ratio = 0.9; 95% confidence interval = 0.43–1.87). No significant differences in the prevalence of MetS and its features were found between the groups

The impact of dietary habits and nutritional intervention on metabolic syndrome parameters in hospitalized schizophrenic patients

Do danas, ni u općoj populaciji ni u osoba oboljelih od shizofrenije, nije definiran nutritivni pristup koji bi bio najadekvatniji za tretman metaboličkog sindroma. U ovom istraživanju cilj je bio utvrditi učestalost metaboličkog sindroma i prehrambene navike u hospitaliziranih osoba oboljelih od shizofrenije dobi ≥ 18 godina (n = 259). Utvrđena prevalencija metaboličkog sindroma iznosila je 47,9 %, a između ispitanika s i bez metaboličkog sindroma nije bilo statistički značajne razlike s obzirom na prehrambene navike. Određeni ispitanici s metaboličkim sindromom (n = 79) uključeni su u randomizirani kontrolirani pokus koji je za primarni cilj imao utvrditi utjecaj nutritivne intervencije, odnosno primjene dijetetskog pristupa za sprječavanje hipertenzije (DASH dijete) na metabolički sindrom i njegove parametre. Ukupno je 67 ispitanika (n = 33 u eksperimentalnoj skupini i n = 34 u kontrolnoj skupini) završilo istraživanje u trajanju od tri mjeseca. Eksperimentalna skupina dobivala je obroke pripremljene prema načelima DASH dijete s restrikcijom energijskog unosa od otprilike 400 kcal/dan u usporedbi sa standardnom bolničkom prehranom koju je dobivala kontrolna skupina. Obje su skupine tijekom intervencije sudjelovale u programu nutritivnih edukacija. Nakon tri mjeseca došlo je do statistički značajnog smanjenja prevalencije metaboličkog sindroma i u eksperimentalnoj (prevalencija nakon intervencije 75,8 %; p = 0,002) i u kontrolnoj skupini (prevalencija nakon intervencije 67,7 %; p = 0,0003). Između eksperimentalne i kontrolne skupine nije bilo statistički značajne razlike u prevalenciji metaboličkog sindroma i njegovih parametara. Iako DASH dijeta u usporedbi sa standardnom bolničkom prehranom nije rezultirala statistički značajnim smanjenjem prevalencije metaboličkog sindroma i njegovih parametara, dovela je do značajnih poboljšanja kakvoće prehrane i prehrambenih navika hospitaliziranih osoba oboljelih od shizofrenije s metaboličkim sindromom.Until today, the nutritional approach that would be the most efficient in the treatment of metabolic syndrome has not been defined neither in the general population nor in people diagnosed with schizophrenia. The present study aimed to determine the prevalence of metabolic syndrome and the dietary habits in hospitalized patients diagnosed with schizophrenia aged ≥ 18 years (n = 259). The overall prevalence of metabolic syndrome was 47.9 %. There were no statistically significant differences found between the participants with and without metabolic syndrome with respect to dietary habits. Several participants with metabolic syndrome (n = 79) were included in a randomized controlled trial which primary outcome was to determine the impact of the Dietary Approaches to Stop Hypertension (DASH) diet nutritional intervention on metabolic syndrome and its parameters. A total of 67 participants (n = 33 in the experimental group and n = 34 in the control group) completed a three-month study. The experimental group received meals prepared according to the principles of the DASH diet with an energy intake restriction of approximately 400 kcal/day compared to the standard hospital diet given to the control group. Both groups participated in a nutritional education program. Upon the expiry of the three months' period, the metabolic syndrome prevalence significantly decreased in both the experimental (prevalence after the intervention 75.8 %; p = 0.002) and the control group (prevalence after the intervention 67.7 %; p = 0.0003). At the end of the intervention, there were no statistically significant differences in the prevalence of metabolic syndrome and its parameters between the groups. However, although the DASH diet when compared to the standard hospital diet did not result in a statistically significant reduction of the prevalence of metabolic syndrome and its parameters, it led to significant improvements in diet quality and dietary habits of hospitalized schizophrenic patients with metabolic syndrome

Metabolic Syndrome and Dietary Habits in Hospitalized Patients with Schizophrenia: A Cross-Sectional Study

Background and Objectives: The true prevalence of metabolic syndrome (MetS) and the reason for it being higher in patients with schizophrenia when compared to general population have not yet been fully determined. Although being considered as one of the major causes, currently there are limited findings regarding differences in dietary patterns of schizophrenic patients with and without MetS. The present study aimed to determine the prevalence of MetS among hospitalized patients with schizophrenia, to investigate the differences in socio-demographic, clinical, and lifestyle characteristics between participants with and without MetS, with the special emphasis being put on their dietary habits, and to ascertain the correlation between dietary habits and MetS components. Materials and Methods: A cross-sectional study included 259 hospitalized patients with schizophrenia aged ≥ 18 years. All participants underwent basic anthropometric measurements, blood sampling and blood pressure assessment, and provided relevant socio-demographic and lifestyle information. The presence of MetS was determined according to the Joint Interim Statement definition and dietary habits were assessed using a non-quantitative food frequency questionnaire. Results: The overall prevalence of MetS was 47.9%. No socio-demographic or lifestyle differences were found between participants with and without MetS. A large number of participants (42.9%) reported consuming carbonated soft drinks on a daily basis. Daily frequency of fruit (11.6%) and vegetables intake (29.3%) was far below recommended. Dietary habits of participants with and without MetS did not significantly differ, while consumption frequencies of some of the studied food and beverage items and groups significantly correlated with certain MetS components (such as statistically significant positive correlation between cured meat products consumption frequency and waist circumference, as well as between red meat consumption frequency and systolic blood pressure). Conclusions: The concept of the present study did not allow us to distinguish to what extent the participants’ dietary habits were influenced by independent procurement of food products, nor has it allowed us to quantify the portion sizes of consumed food and beverage items and groups. Nevertheless, the findings indicate the need for early identification of individuals with high MetS risk and for the incorporation of nutritional support programs into hospital treatment of patients with schizophrenia

METABOLIC SYNDROME AND GUT MICROBIOTA - A REVIEW

The relationship between gut microbiota and human health is complex, and the role of gut microbiota in pathogenesis of various diseases has been in the focus during the last decade. There is accumulating evidence that dysbiosis can be linked to different diseases, such as metabolic syndrome (MetS). Still, there is no consensus on the most appropriate tools and approaches for microbiota analyses. Numerous factors - diet, lifestyle, chemical microenvironment etc. influence the composition of gut microbiota. We aimed to analyze the current state of the knowledge on complex interplay between gut microbiota and development of MetS, as a basis for future research. The permanent interplay between immune system, metabolism, and gut microbiota plays a significant role in the homeostasis control and potential obesity development. Increased energy harvest from the diet, changes in gene expression, energy expenditure and storage are mentioned to lead to inflammation, insulin resistance and MetS. Most of the data on its mechanisms were from mouse models, so the question of their informativeness for human microbiota research arose. Current state of the literature (using PubMed database), including GWAS studies of obesity in mice, suggests that they are relevant for human studies of microbiota composition change in response to diet. Besides the role of Firmicutes/Bacteroidetes ratio in predisposition to obesity, its difference in obese and lean humans and its decrease with weight loss, confirms the dominating role of nutrition in shaping gut microbiota composition and functions. There is an increasing evidence that microbiota can inflict their reach on physiological functions outside the gastrointestinal tract, and can therefore possibly manipulate our eating behaviour, using metabolic, neural, immune and endocrine pathways. Our findings implicate a deeper host-microbiota relationship than previously realized, which may contribute to broader and multilayer approaches in future research of gut microbiota and shaping of prevention strategies for tackling MetS

METABOLIC SYNDROME AND GUT MICROBIOTA - A REVIEW

The relationship between gut microbiota and human health is complex, and the role of gut microbiota in pathogenesis of various diseases has been in the focus during the last decade. There is accumulating evidence that dysbiosis can be linked to different diseases, such as metabolic syndrome (MetS). Still, there is no consensus on the most appropriate tools and approaches for microbiota analyses. Numerous factors - diet, lifestyle, chemical microenvironment etc. influence the composition of gut microbiota. We aimed to analyze the current state of the knowledge on complex interplay between gut microbiota and development of MetS, as a basis for future research. The permanent interplay between immune system, metabolism, and gut microbiota plays a significant role in the homeostasis control and potential obesity development. Increased energy harvest from the diet, changes in gene expression, energy expenditure and storage are mentioned to lead to inflammation, insulin resistance and MetS. Most of the data on its mechanisms were from mouse models, so the question of their informativeness for human microbiota research arose. Current state of the literature (using PubMed database), including GWAS studies of obesity in mice, suggests that they are relevant for human studies of microbiota composition change in response to diet. Besides the role of Firmicutes/Bacteroidetes ratio in predisposition to obesity, its difference in obese and lean humans and its decrease with weight loss, confirms the dominating role of nutrition in shaping gut microbiota composition and functions. There is an increasing evidence that microbiota can inflict their reach on physiological functions outside the gastrointestinal tract, and can therefore possibly manipulate our eating behaviour, using metabolic, neural, immune and endocrine pathways. Our findings implicate a deeper host-microbiota relationship than previously realized, which may contribute to broader and multilayer approaches in future research of gut microbiota and shaping of prevention strategies for tackling MetS

Carboplatin resistant human laryngeal carcinoma cells are cross resistant to curcumin due to reduced curcumin accumulation

Curcumin is a natural compound that exhibits a wide range of beneficial effects, among them the anti-tumor activity. Recently it was shown that curcumin may be efficient against drug resistant tumor cells. The goal of our investigation was to examine if human laryngeal carcinoma cells resistant to carboplatin display sensitivity to curcumin, as compared to parental cells, and if this sensitivity is altered, to determine the molecular mechanisms that are responsible for it. We found that carboplatin resistant 7T cells were also cross resistant to curcumin. After the treatment with equimolar concentration of curcumin, 7T cells exhibited lower intracellular accumulation of curcumin which coincided with reduced formation of reactive oxygen species (ROS), diminished lipid and DNA damage followed by reduced induction of apoptosis and expression of heat shock protein 70 (Hsp70), as compared to parental HEp-2 cells. However, after the treatment with equitoxic concentration of curcumin, intracellular accumulation and all the explored downstream effects were similar in both cell lines suggesting that resistance of 7T cells to curcumin was based on its reduced intracellular accumulation. Since curcumin accumulates mostly in the membranes, we explored the fatty acid composition of both cell lines, but we did not find any difference between them

Secondary polycythemia in acutely ill COVID-19 patients is associated with higher mortality but not markedly higher thrombotic risk

Secondary polycythemia is commonly observed among patients with chronic pulmonary diseases. However, its significance in the context of Coronavirus disease 2019 (COVID-19) is unknown. We retrospectively evaluated a total of 5872 hospitalized COVID-19 patients with mostly severe and critical symptoms, and without prior or subsequently diagnosed myeloproliferative neoplasm. Patients were stratified based on admission hemoglobin into four subgroups: anemia (hemoglobin 165 g/L for females and >185 g/L for males). Among 5872 patients, a total of 158 (2.7%) had mild and 25 (0.4%) severe polycythemia. Polycythemia was significantly associated with higher respiratory and functional impairment, reduced plasma volume, higher serum osmolarity and comorbidity burden specific to the degree of polycythemia. Patients presenting with mild (odds ratio (OR) = 1.63, p = .003) and severe polycythemia (OR = 4.98, p < .001) had increased risk of death in comparison to patients with normal hemoglobin, whereas no significant associations with venous thromboembolism, arterial thrombosis nor major bleeding were observed. Anemia was associated with higher risk of death (OR = 1.42, p < .001), venous thromboembolism (OR = 1.34, p < .006) and major bleeding (OR = 2.27, p < .001) in comparison to normal hemoglobin. Associations of polycythemia and anemia with mortality diminished, and anemia with venous thromboembolism and major bleeding persisted, after multivariate adjustments for age, sex, comorbidities, COVID-19 severity and functional status. Secondary polycythemia in hospitalized COVID-19 patients without prior of subsequently diagnosed myeloproliferative neoplasm is rare and is associated with high mortality, increasing with degree of polycythemia, but not markedly higher thrombotic ris