Menopauza kao nezavisni prediktor povišenih vrednosti retinolvezujućeg proteina 4 u serumu

Aim: Retinol-binding protein 4 (RBP4) is a novel adipokine closely related to insulin resistance. However, data on the influence of menopausal status on serum RBP4 are scarce. Therefore, the aim of the current study was to examine whether RBP4 levels are associated with menopausal status per se, independently of insulin resistance. Methods: A total of 30 premenopausal and 100 postmenopausal women non-treated with medications were included in the cross-sectional study. Anthropometric and biochemical parameters, as well as blood pressure (BP) were obtained. The homeostasis model assessment of insulin resistance (HOMA-IR) and estimated glomerular filtration rate (eGFR) were calculated. Results: Postmenopausal women displayed higher RBP4 and an unfavorable cardiometabolic profile, compared to premenopausal ones. Multiple linear regression analysis showed that in addition to high triglycerides level (beta=0.315; p=0.002), decreased eGFR (beta=-0.258; p=0.004) and high systolic BP (beta=0.418; p=0.028), menopause per se is an independent predictor of higher RBP4 levels (beta=0.240; p=0.016), (R2-adjusted=0.310; F=6,522; p lt 0.001). Conclusions: Serum RBP4 levels are dependent of menopausal status, which should be taken into account when examining the role of this adipokine in cardiometabolic diseases' occurrence.Cilj: Retinol-vezujući protein 4 (RBP4) je novi adipokin, usko povezan sa insulinskom rezistencijom. Međutim, nema dovoljno podataka u literaturi o uticaju menopauze na vrednosti ovog proteina u serumu. Zato je cilj ove studije bio da se ispita da li je povezanost menopauze i RBP4 nezavisna ili je posredovana insulinskom rezistencijom. Metode: Ukupno 30 žena u premenopauzi i 100 žena u postmenopauzi, koje nisu na terapiji su uključene u studiju preseka. Mereni su antropometrijski i biohemijski parametri, kao i krvni pritisak (KP), HOMA indeksi, procenjena jačina glomerularne filtracije (JGF) i izračunati su. Rezultati: Kod žena u postmenopauzi zabeležene su veće vrednosti RBP4 i nepovoljniji kardiometabolički profil, u poređenju sa ženama u premenopauzi. Višestruka linearnaregresiona analiza je pokazala da su više vrednosti triglicerida (beta=0,315; p=0,002), smanjena JGF (beta=-0,258; p=0,004), više vrednosti sistolnog KP (beta=0,418; p=0,028), i menopauza (beta=0,240; p=0,016), nezavisni prediktori povišenih vrednosti RBP4 u serumu (R2-adjusted=0,310; F=6,522; p lt 0,001). Zaključak: Menopauza utiče na vrednosti RBP4 u serumu, što treba uzeti u obzir prilikom ispitivanja uloge ovog adipokina u pojavi kardiometaboličkih poremećaja

Indeks telesne mase i insulinska rezistencija kao nezavisni prediktori hipertenzije kod žena u postmenopauzi

Aim: Although previous studies confirmed the association between obesity and hypertension, the underlying pathophysiological mechanism is not well elucidated, specially considering the fact that discordant results exist when examining the independent role of obesity and/or insulin resistance on risk for hypertension onset. Therefore, we aimed to examine if obesity [as measured with body mass index (BMI)] is a predictor for hypertension, independently of insulin resistance [as measured with Homeostasis model assessment of insulin resistance (HOMA-IR)] in the cohort of postmenopausal women. Methods: A total of 150 postmenopausal women non-treated with medications(among them 44.7% hypertensive)were included in cross-sectional study. Anthropometric and biochemical parameters, so as blood pressure were obtained. HOMA-IR was calculated. Results: Multivariate logistic regression analysisrevealed that both, BMI and HOMA-IR were the independent predictors of blood pressure in postmenopausal women (OR=1.240, p=0.035 and OR=2.419, p=0.008, respectively). Rise in BMI for 1 kg/m2 enhanced the probability for higher blood pressure by 24%. Also, elevation in HOMA-IR for 1 unit, rose the probability for higher blood pressure almost 2.5 times. Even 47% of variation in blood pressure could be explained with this Model. Also, this Model correctly classified 76% of postmenopausal women having hypertension. Conclusions: Both, obesity and insulin resistance are the independent predictors of blood pressure in postmenopausal women.Cilj: Premda su ranije studije potvrdile vezu između gojaznosti i hipertenzije, patofiziološki mehanizam ove povezanosti još uvek nije rasvetljen, naročito što postoje oprečni rezultati kada je u pitanju nezavisna uloga gojaznosti i/ili insulinske rezistencije u nastanku hipertenzije. Stoga je cilj studije bio da se ispita da li je gojaznost [merena indeksom telesne mase (ITM)] prediktor za nastanak hipertenzije, nezavisno od insulinske rezistencije [merene HOMA indeksom (HOMA-IR)] u kohorti žena u postmenopauzi. Metode: Ukupno 150 žena u postmenopauzi koje nisu na terapiji (među njima 44,7% sa hipertenzijom) su uključene u studiju preseka. Antropometrijski i biohemijski parametri, kao i krvni pritisak su mereni. HOMA-IR je računat. Rezultati: Multivarijantna logistička regresiona analiza je pokazala da su i ITM (OR=1,240; p=0,035) i HOMA-IR (OR=2,419; p=0,008)nezavisni prediktori krvnog pritiska kod žena u postmenopauzi. Povećanje ITMza1 kg/m2 povećava verovatnoću za pojavu hipertenzije za 24%. Takođe, porast HOMA-IR za 1 jedinicu povećava verovatnoću za pojavu hipertenzije za skoro 2,5 puta. Čak 47% varijacije u vrednosti krvnog pritiska može biti objašnjeno ovim modelom. Takođe, ovaj model je ispravno klasifikovao 76% žena u postmenopauzi koje imaju hipertenziju. Zaključak: I gojaznost, i insulinska rezistencija su nezavisni prediktori krvnog pritiska kod žena u postmenopauzi

Da li je endokan novi potencijalni biomarker za steatozu i fibrozu jetre?

Studies that evaluated endocan levels in nonalcoholic fatty liver disease (NAFLD) and liver fibrosis are scarce. We aimed to explore endocan levels in relation to different stages of liver diseases, such as NAFLD, as determined with fatty liver index (FLI) and liver fibrosis, as assessed with BARD score. A total of 147 participants with FLI≥60 were compared with 64 participants with FLI <30. An FLI score was calculated using waist circumference, body mass index, gamma-glutamyl transferase and triglycerides. Patients with FLI≥60 were further divided into those with no/mild fibrosis (BARD score 0-1 point; n=23) and advanced fibrosis (BARD score 2-4 points; n=124). BARD score was calculated as follows: diabetes mellitus (1 point) + body mass index≥28 kg/m2 (1 point) + aspartate amino transferase/alanine aminotransferase ratio≥0.8 (2 points). Endocan was independent predictor for FLI and BARD score, both in univariate [OR=1.255 (95% CI= 1.104-1.426), P=0.001; OR=1.208 (95% CI=1.029- 1.419), P=0.021, respectively] and multivariate binary logistic regression analysis [OR=1.287 (95% CI=1.055- 1.570), P=0.013; OR=1.226 (95% CI=1.022-1.470), P=0.028, respectively]. Endocan as a single predictor showed poor discriminatory capability for steatosis/fibrosis [AUC=0.648; (95% CI=0.568-0.727), P=0.002; AUC= 0.667 (95% CI=0.555-0.778), P=0.013, respectively], whereas in a Model, endocan showed an excellent clinical accuracy [AUC=0.930; (95% CI=0.886-0.975), P<0.001, AUC=0.840 (95% CI=0.763-0.918), P<0.001, respectively]. Endocan independently correlated with both FLI and BARD score. However, when tested in models (with other biomarkers), endocan showed better discriminatory ability for liver steatosis/fibrosis, instead of its usage as a single biomarkerUvod: Nema mnogo studija koje su ispitivale vrednosti endokana kod obolelih od nealkoholne steatoze i fibroze jetre. Naš cilj je bio da se ispita nivo endokana u različitim stadijumima oboljenja jetre, kao što su nealkoholna steatoza jetre, predstavljena indeksom masne jetre (FLI) i fibroza jetre, predstavljena BARD skorom. Metode: Ukupno 147 učesnika sa FLI≥60 poređeno je sa 64 učesnika sa FLI <30. FLI skor je izračunat koriste i vrednosti obim struka, indeksa telesne mase, aktivnosti gama-glutamil transferaze i vrednosti triglicerida. Ispitanici sa FLI≥60 su dalje podeljeni u 2 grupe: bez fibroze/blaga fibroza (BARD skor 0–1 poen; n=23) i uznapredovala fibroza (BARD skor 2–4 poena; n=124). BARD skor je računat na sledeći način: e erna bolest (1 poen) + indeks telesne mase≥28 kg/m2 (1 poen) + odnos aspartat aminotransferaza/alanin aminotransferaza≥0,8 (2 poena). Rezultati: Endokan je nezavisan prediktor FLI i BARD skora, kako u univarijantnoj [OR=1,255 (95% CI=1,104– 1,426), P=0,001; odnosno OR=1,208 (95% CI=1,029– 1,419), P=0,021], tako i u multivarijantnoj binarnoj logističkoj regresionoj analizi [OR=1.287 (95% CI=1,055– 1,570), P=0,013; odnosno OR=1,226 (95% CI=1,022– 1,470), P=0,028]. Endokan kao samostalan prediktor pokazao je slabu diskriminatornu mo za steatozu/fibrozu jetre [AUC=0,648; (95% CI=0,568–0,727), P=0,002; odnosno AUC=0,667 (95% CI=0,555–0,778), P=0,013], ali je u Modelu pokazao odličnu kliničku tačnost [AUC=0,930; (95% CI=0,886–0,975), P<0,001; odnosno AUC=0,840 (95% CI=0,763–0,918), P<0,001]. Zaključak: Endokan je nezavisno povezan kako sa FLI, tako i sa BARD skorom. Ipak, u modelu (sa drugim biomarkerima), endokan je pokazao bolju diskriminatornu sposobnost za steatozu/fibrozu jetre

Cardiovascular risk assessed by reynolds risk score in relation to waist circumference in apparently healthy middle-aged population in Montenegro

Reynolds Risk Score (RRS) is regarded as a good screening tool for cardiovascular disease (CVD) risk. Since CVD is the leading cause of death in Montenegro, we aimed to assess the risk of CVD as assessed by RRS and to examine its association with cardiometabolic parameters in apparently healthy middle-aged population. In addition, we aimed to test whether obesity had an independent influence on RRS. A total of 132 participants (mean age 56.2 +/- 6.73 years, 69% females) were included. Body mass index (BMI), waist circumference (WC), blood pressure (BP) and biochemical parameters (fasting glucose, insulin, lipid parameters, creatinine and high sensitivity C-reactive protein) were determined. Insulin resistance (HOMA-IR) and glomerular filtration rate (eGFR) were calculated. Compared with females, a significantly higher number of males were in the high RRS subgroup (chi(2) =45.9, p lt 0.001). Furthermore, significantly higher fasting glucose (p=0.030), insulin, HOMA-IR, triglycerides (p lt 0.001 all), anthropometric parameters (e.g., BMI and WC; p=0.004 and p lt 0.001, respectively), and creatinine, but lower eGFR and HDL-c (p lt 0.001 both) were recorded in the high-risk subgroup compared with low and medium risk subgroups. In all participants, in addition to LDL-c, diastolic BP and creatinine, WC was independently positively associated with RRS (beta=0.194, p=0.006; lt b> beta=0186, p=0.001; beta=0167, p=0.001; and beta=0.305, p=0.019, respectively), and 40% of variation in RRS could be explained with this model. In conclusion, middle-aged population with higher WC should be screened for RRS in order to estimate CVD risk

Endocan and a novel score for dyslipidemia, oxidative stress and inflammation (DOI score) are independently correlated with glycated hemoglobin (HbA1c) in patients with prediabetes and type 2 diabetes

Introduction: We aimed to examine serum endocan level and the summary involvement of dyslipidemia, oxidative stress (OS) and inflammation by calculation of its comprehensive score (i.e. Dyslipidemia-Oxy-Inflammation (DOI) score) in relation to glucoregulation in subjects with prediabetes and overt type 2 diabetes (T2D). Material and methods: A total of 59 patients with prediabetes and 102 patients with T2D were compared with 117 diabetes-free controls. Glycated hemoglobin (HbA1c), inflammation, OS and lipid parameters were measured. Associations of clinical data with HbA1c level were tested with univariate and multivariate logistic ordinal regression analysis. HbA1c as a dependent variable is given at the ordinal level (i.e. 6.4%, respectively). Results: Endocan was significantly higher in the T2D group than in the controls. As endocan concentration rose by 1 unit, the probability for higher HbA1c concentration increased by more than 3 times (OR = 3.69, 95% CI: 1.84-7.01, p < 0.001). Also, a rise in the dyslipidemia score, oxy score, inflammation score and DOI score by 1 unit increased the probability of higher HbA1c concentration by 19%, 13%, 51% and 11%, respectively. In the models, after adjustment for confounding variables, endocan and DOI score remained independent predictors of HbA1c level. Conclusions: Endocan and DOI score are independently correlated with HbA1c in patients with prediabetes and overt T2D

Body mass index is independently associated with xanthine oxidase activity in overweight/obese population

Purpose: The pathophysiological mechanism of the relationship between xanthine oxidase (XO) activity and obesity has not been completely elucidated. Since inflammation and oxidative stress are regarded as key determinants of enlarged adipose tissue, we aimed to investigate the association between oxidative stress (as measured with XO activity), inflammation [as measured with high-sensitivity C-reactive protein (hsCRP)] and obesity [as measured with body mass index (BMI)]. In addition, we wanted to examine whether hsCRP itself plays an independent role in XO activity increase or it is only mediated through obesity. Methods: A total of 118 overweight/obese volunteers (mean age 54.76 ± 15.13 years) were included in the current cross-sectional study. Anthropometric, biochemical parameters, and blood pressure were obtained. Results: Significant differences between age, BMI, waist circumference, concentrations of uric acid and hsCRP, as well as xanthine dehydrogenase (XDH) activities were evident among XO tertile groups. Multiple linear regression analysis revealed that BMI (beta = 0.241, p = 0.012) and XDH (beta = − 0.489, p &lt; 0.001) are the independent predictors of XO activity (R2-adjusted = 0.333), whereas hsCRP lost its independent role in XO activity prediction. Conclusion: Obesity (as determined with increased BMI) is an independent predictor of high XO activity in overweight/obese population. Level of Evidence: Level V: cross-sectional descriptive study

Xanthine oxidase and uric acid as independent predictors of albuminuria in patients with diabetes mellitus type 2

Xanthine oxidase (XO) is an important enzyme responsible for conversion of purine bases to uric acid and represents the major source of reactive oxygen species (ROS) production in circulation. Since pathophysiological mechanism of the relationship between XO activity and urinary albumin excretion (UAE) rate is not well elucidated, we aimed to investigate this association in patients with diabetes mellitus type 2 (DM2). In addition, we wanted to examine whether uric acid itself plays an independent role in albuminuria onset and progression, or it is only mediated through XO activity. A total of 83 patients with DM2 (of them 56.6% females) were included in this cross-sectional study. Anthropometric, biochemical parameters and blood pressure were obtained. Multivariate logistic regression analysis showed that uric acid and XO were the independent predictors for albuminuria onset in patients with DM2 [odds ratio (OR) 1.015, 95% CI (1.008-1.028), p = 0.026 and OR 1.015, 95% CI (1.006-1.026), p = 0.040, respectively]. Rise in uric acid for 1 mu mol/L enhanced the probability for albuminuria by 1.5%. Also, elevation in XO activity for 1 U/L increased the probability for albuminuria for 1.5%. A total of 66.7% of variation in UAE could be explained with this Model. Both XO and uric acid are independently associated with albuminuria in diabetes. Better understanding of pathophysiological relationship between oxidative stress and albuminuria could lead to discoveries of best pharmacological treatment of XO- and/or uric acid-induced ROS, in order to prevent albuminuria onset and progression

Organic and conventional milk - insight on potential differences

Purpose - The purpose of this paper is to investigate if there is a difference in hygiene parameters of raw milk produced in organic and conventional farm of similar size. In parallel, the aim was to determine if there are differences in pasteurized organic and conventional milk samples delivered on the market. Design/methodology/approach - Raw milk samples were analyzed for aerobic colony count (ACC), somatic cell count (SCC), acidity, temperature, fat and protein content. On the other side, final products of organic and conventional pasteurized milk with 2.8 percent declared milk fat were analyzed for Raman spectroscopy, color change and sensorial difference. Findings - Results of raw milk analysis showed statistically significant differences in fat content, SCC, acidity, temperature and ACC (p (lt) 0.05). It is of note that ACC for organic milk were lower for approx. 1 log CFU/ml compared to conventional milk samples. Pasteurized organic milk samples had a significantly higher L* value than those samples originating from conventional farms, indicating that organic is "more white" compared to conventional milk. According to the results of triangle test, with 95 percent confidence no more than 10 percent of the population is able to detect a difference. Research limitations/implications - A limitation of this research is the fact that good veterinary practices at farms, namely, animal health and adequate usage of medicine for treating the animals, animal welfare and animal feeding were not analyzed. Originality/value - This study analyzed potential differences in organic and conventional milk at two important production stages of the milk chain - at receipt at dairy plant (raw milk) and perceived by consumers (final product)