STARENJE, VARIJABILNOST SRČANE FREKVENCIJE I METABOLIČKI UTJECAJ PRETILOSTI

The relationship between aging and changes in heart rate variability (HRV) could depend on the metabolic profile of obese people, i.e. metabolically healthy obese (MHO) and metabolically unhealthy obese (MUO). We aimed to determine the age at which obesity related autonomic dysfunction becomes significant and whether it decreases differently according to metabolic profile. We analyzed HRV in 99 adults using Wildman’s criteria for metabolic profile and 5-minute HRV for autonomic nervous system. In MHO, high frequency (HF) decreased in the 4th decade of life. In MUO, standard deviation of R-R intervals (SDNN), root mean square of successive differences of all R-R intervals (RMSSD), number of adjacent intervals differing by more than 50 ms expressed as percentage of all intervals in the collecting period (pNN50), HF, low frequency (LF), LF/HF (LF divided by HF) and total power (TP) decreased in the 4th decade of life (partial shared variance 28%-36%). In conclusion, an age dependent decrease of HRV occurs in MUO between the third and fifth decade of life. In MHO, HF significantly decreases around the age of 40 years. Cardiometabolic profile influences metabolic aging, altering the autonomic nervous system.Dobne promjene u varijabilnosti srčane frekvencije (HRV) mogu zavisiti o metaboličkom profilu pretilih osoba, tj. metaboličkin zdrave (MHO) i metabolički rizične pretile osobe (MUO). Željeli smo utvrditi dob u kojoj nastupa autonomna disfunkcija povezana s pretilošću te opada li HRV različito kod osoba različitog metaboličkog profila. Analizirali smo HRV kod 99 odraslih osoba uz primjenu Wildmanovih kriterija metaboličkog profila i HRV kao aktivnosti autonomnog živčanog sustava. Kod MHO, visoka frekvencija (HF) opadala je u 4. desetljeću života. Kod MUO su standardna devijacija svih R-R intervala (SDNN), kvadratni korijen srednje razlike između sukcesivnih normalnih R-R intevala (RMSSD), postotak sukcesivnih R-R intervala vrijednost kojih prelazi 50 ms (pNN50), HF, niska frekvencija (LF), omjer LF i HF (LF/HF) i ukupna spektralna snaga (TP) opadali u 4. desetljeću života (parcijalna podijeljena varijanca 28%-36%). U zaključku, utvrđen je od dobi zavisan pad HRV kod MUO između trećeg i petog desetljeća života. Kod MHO osoba HF je značajno opala oko 40. godine života. Kardiometabolički profil utječe na starenje remeteći funkcije autonomnog živčanog sustava

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

Attitudes of medical and allied medical students from Serbia toward whole body donation

Anatomy, one of the key pre-clinical subjects in medical and allied medical disciplines, has traditionally relied on instruction based on the utilization of cadavers. Acquiring cadavers for anatomy education has presented a challenge in many countries. This challenge has been met through the organization of well informed and culturally sensitive body donation programs. Attitudes of the general population, medical professionals and students are important in devising these programs. The aim of this study was to investigate attitudes of medical and allied medical students from the University of Novi Sad toward whole body donation. A survey was carried out on the first and third year students enrolled in all degrees taught at the University and the sixth year medical students. A large number of respondents (87.38%) perceived cadavers as important in anatomy education. The majority of students (51.26%) would support the body donation of a stranger, while a much smaller proportion of respondents would become donors (19.51%) or support their family members (21.67%) to bequeath their body. There were differences in attitudes toward body donation related to respondents’ year of study, ethnicity and religion. The main reasons for donation were altruistic, while the main reasons not to donate were lack of information and religious factors. Most of the respondents were in favor of introducing memorial services for the body donors. The results of the study highlight the importance of a culturally sensitive approach to students in the anatomy laboratories and the enrichment of anatomy education through the humanities. They also underscore the significance of well-organised and informative body donation programs.15 page(s

Somatotype characteristics of normal-weight and obese women among different metabolic subtypes

ABSTRACT Background: Obesity is a well known risk factor for the development of metabolic abnormalities. However, some obese people are healthy and on the other hand some people with normal weight have adverse metabolic profile, therefore it can be assumed that there is a difference in physical characteristics amongst these people. The aim of this study was to establish whether there are somatotype differences between metabolically healthy and metabolically obese women who are obese or of normal weight. Subjects and methods: Study included 230 women aged 44.76 ± 11.21y. Metabolic status was assessed according to IDF criteria, while somatotype was obtained using Heath &amp; Carter method. Results: Significant somatotype differences were observed in the group of women with normal-weight: metabolically healthy women had significantly lower endomorphy, mesomorphy and higher ectomorphy compared to metabolically obese normal-weight women (5.84-3.97-2.21 vs. 8.69-6.47-0.65). Metabolically healthy obese women had lower values of endomorphy and mesomorphy and higher values of ectomorphy compared to &apos;at risk&apos; obese women but the differences were not statistically significant (7.59-5.76-0.63 vs. 8.51-6.58-0.5). Ectomorphy was shown as an important determinant of the favorable metabolic profile (cutoff point was 0.80). Conclusion: We concluded that, in addition to fat mass, metabolic profile could be predicted by the structure of lean body mass, and in particular by body linearity. Arch Endocrinol Metab. 2016;60(1):60-

Secular trend of head and face shape in adult population of Vojvodina (Serbia)

Background: Different populations show variation in the pattern of change in craniofacial dimensions over time. Earlier studies of craniofacial traits in the Republic of Serbia were carried out, without any particular reference to secular changes. Aim: The aim of the study is to determine possible changes in craniofacial dimensions among the adult population of Vojvodina (Serbia) during a 33 year period. Subjects and methods: The findings of the study are based on the comparison of data from two cross-sectional surveys. The earlier research was conducted in 1975 (n = 2600) and the second from 2001–2006 (n = 4504). Four craniofacial dimensions and body height were analysed. Results: In terms of the head dimensions, head length in males has increased substantially, while head breadth has decreased in both sexes. The total change in the cephalic index is 0.58 (males) and 0.48 (females) units per decade. Morphological face height has substantially increased, while face breadth has decreased in both sexes over this period. The total change in the facial index per decade is 0.75 units in males and 0.98 in females. Conclusion: The results point to a trend of head and face shape remodelling toward a narrower head and more elongated face, consistent with ongoing dolichocephalisation

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

Vitamin D and Dysfunctional Adipose Tissue 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 evaluated the relation between vitamin D and adipocytokines derived from adipose tissue. We studied 50 obese individuals who were classified into different subgroups according to medians of observed anthropometric parameters (body mass index, body fat percentage, waist circumference, and trunk fat mass). There was a negative correlation between vitamin D level and leptin and resistin (r = -.61, P LT .01), while a positive association with adiponectin concentrations was found (r = .7, P LT .001). Trend estimation showed that increase in vitamin D level is accompanied by intensive increase in adiponectin concentrations (growth coefficient: 12.13). In conclusion, 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

Somatotype characteristics of normal-weight and obese women among different metabolic subtypes

ABSTRACT Background Obesity is a well known risk factor for the development of metabolic abnormalities. However, some obese people are healthy and on the other hand some people with normal weight have adverse metabolic profile, therefore it can be assumed that there is a difference in physical characteristics amongst these people. The aim of this study was to establish whether there are somatotype differences between metabolically healthy and metabolically obese women who are obese or of normal weight. Subjects and methods Study included 230 women aged 44.76 ± 11.21y. Metabolic status was assessed according to IDF criteria, while somatotype was obtained using Heath & Carter method. Results Significant somatotype differences were observed in the group of women with normal-weight: metabolically healthy women had significantly lower endomorphy, mesomorphy and higher ectomorphy compared to metabolically obese normal-weight women (5.84-3.97-2.21 vs. 8.69-6.47-0.65). Metabolically healthy obese women had lower values of endomorphy and mesomorphy and higher values of ectomorphy compared to ‘at risk’ obese women but the differences were not statistically significant (7.59-5.76-0.63 vs. 8.51-6.58-0.5). Ectomorphy was shown as an important determinant of the favorable metabolic profile (cutoff point was 0.80). Conclusion We concluded that, in addition to fat mass, metabolic profile could be predicted by the structure of lean body mass, and in particular by body linearity