Metabolic syndrome, adipokines and sex hormone concentrations in middle-aged women

The incidence of metabolic syndrome (MetS) increases with age, something which is more noticeable in women, particularly perimenopausal women. Weight gain and the development of abdominal obesity are considered to be the main cause of increased risk of MetS and cardiometabolic factors in perimenopausal women. Increased visceral adipose tissue correlates with elevated insulin resistance, inflammation, hypertension and hyperlipidaemia in middle-aged women. In recent years, particular attention has been drawn to the endocrine role of adipose tissue, mainly visceral adipose tissue, and the concentrations of adipokines and inflammation markers such as: leptin, adiponectin, free fatty acids, adipocyte fatty acid binding protein, C-reactive protein (CRP), and inflammatory cytokines. The development of abdominal obesity is mostly associated with a loss of the protective role of oestrogens and a relative increase of circulating androgens. After menopause, the adipose tissue serves as the primary source of oestrogen production via aromatisation that converts androstenedione and testosterone to oestrone and 17b-oestradiol (E2), respectively. Studies looking at the relation between menopause and MetS conducted over the past years have mostly focused on the analysis of such hormone balance parameters as: E2, free oestradiol, oestrone and androgenic indicators: total testosterone, free testosterone, sex hormone binding globulin or dehydroepiandrosterone sulfate. In most cases, the results of the research indicate a greater importance of androgenic markers in the assessment of MetS and cardiometabolic risk factors occurrence in perimenopausal and postmenopausal women

Obesity phenotypes: normal-weight individuals with metabolic disorders versus metabolically healthy obese

According to recent studies, adipose tissue secretes a large number of bioactive proteins, which affect the whole body metabolism. The amount of adipose tissue is the main factor that explains metabolic disorders; however, obesity is not necessarily the result of increased body weight. Interestingly, there is a subgroup of patients with normal weight and high-risk metabolic profile. Consequently, they are significantly more likely to have metabolic disorders or cardiovascular disease (CVD). Conversely, some individuals, called metabolically healthy obese (MHO), demonstrate a favourable metabolic profile despite having high BMI index and excessive adipose tissue. The aim of this paper is to review recent studies about obesity phenotypes. Better understanding of differences between metabolically obese normal-weight (MONW) and MHO may improve the therapy and treatment of metabolic health in all obese patients. Equally importantly, it may lead to an increase in early detection of individuals with metabolic disorders, regardless of their body mass value or BMI.

Application of Timber and Wood-based Materials in Architectural Design using Multi-objective Optimisation Tools

Digital fabrication leads architects and structural engineers to modify the design optimisation methodology. The designers, as never before, are facing new technologies developed in the search for new materials based, among others, on wood components and the improvement of manufacturing methods at the same time. In this process, the material and manufacturing technology adjustment to desired aesthetic outcomes is possible not only by the material used but also by the self-organisation of the structure's optimisation. New fabrication techniques linked with topology optimising software change traditional load-bearing systems designing using timber and wood-based materials. Multi-objective optimisation research indicates that timber might be a comprehensive material based on various applications from low-tech to cutting-edge contemporary fabrication technologies. The article presents new tools and methods for the optimisation of structural elements. A case study based on interdisciplinary architectural and structural optimisation suggests the possible effective research-based design. Comparing contemporary buildings with wood load-bearing structures explains timber usage's diversity and characteristics in modern design

Members of the Polish Legions in Szadek – armed fighting and socio-political activity

This article presents biographical sketches of two soldiers of the Polish Legions – Ignacy Kobacki and Herakliusz Konstanty Iglikowski, who fought for Poland’s independence in 1915-1917 and in the Polish Army in 1918-1922. They both were connected with Szadek through place of residence and vocational activity in the interwar period and during the German occupation, and in the case of one of them also in the communist period. They came from different backgrounds and represented different political options, but what they had in common was their fight in the Polish Legions and later active involvement in the political and social activity in Szadek.Treść artykułu stanowią rysy biograficzne dwóch żołnierzy Legionów Polskich – Ignacego Kobackiego oraz Herakliusza Konstantego Iglikowskiego, walczących o niepodległość Polski w latach 1915–1917 oraz w wojsku polskim w latach 1918–1922. Obaj byli związani z miejscowością Szadek poprzez zamieszkanie, pracę zawodową (zarówno w okresie międzywojennym, jak i podczasem okupacji niemieckiej), a w przypadku jednego z nich także z okresem PRL-u. Żołnierze pochodzili z różnych miejscowości i środowisk, reprezentowali również odmienne nurty polityczne. Łączyła ich jednak wspólna legionowa przeszłość, wspólny szlak bojowy w Legionach Polskich z tym samym wrogiem. Obie postacie to ludzie czynu i determinacji w realizacji zadań jakie stawiała przed nimi przynależność narodowa. Obydwaj urodzili się w okresie niewoli narodowej. Wspólnym mianownikiem ich biografii jest epizod legionowy oraz bogata działalność polityczna i samorządowa na terenie Szadku, już w okresie, gdy armia przeszła w stan pokojowy

NEN — the role of somatostatin receptor scintigraphy in clinical setting

Detection of neuroendocrine neoplasms (NENs) and monitoring of their response to therapy is still challenging due to huge heterogeneity of that group of tumors. Actually, NENs visualization is mainly based on molecular imaging while in the past it was relied on less effective structural imaging including CT and MRI. Molecular imaging techniques in combination with structural imaging (hybrid imaging), especially in patients with well-differentiated NENs, in addition to morphological provide the functional information about tumor which benefits in a more accurate patient management, including more sensitive visualization of primary tumors, more precise staging and better therapy follow-up. Overexpression of somatostatin receptors (SSTR) on NENs’ cell membrane was a basis for development of somatostatin receptor scintigraphy (SRS) using single photon emission tomography SPECT, which is today a well-established standard in molecular imaging of NENs, and further imaging improvement in the field of positron emission tomography (PET). Use of hybrid imaging (SPECT/CT, PET/CT) increased sensitivity of examination, mainly resulting in better detection of small lesions. Generally, somatostatin receptor imaging with PET/CT is an emerging technique, although still with limited access, but due to several advantages over SSTR SPECT/CT, should be used if available. It is worth mentioning, that both SSTR PET/CT and SSTR SPECT/CT have some limitations, such as relatively low detection rate of benign insulinomas, poorly differentiated GEP-NETs and liver metastases. For that reason further improvement of NETs imaging is necessary. The most promising new tracers’ families are based on SSTR antagonists, 64Cu-radiolabeled ligands and glucagon-like peptide-1 receptor (GLP-1R) imaging. Finally, in case of poor-differentiated neuroendocrine cancers 18F-FDG PET/CT may be beneficial in comparison with molecular imaging based on somatostatin receptor modalities

Renal tubulointerstitial tissue damage, central pressure and vascular function in patients with untreated primary arterial hypertension

Background The aim of the study was to examine the correlation of the conventional method of arterial pressure measurement in the brachial artery and non-invasive aortic pressure measurement by applanation tonometry with vascular and left ventricular structure and function. An attempt was made at determining a correlation of morphological and functional changes within the cardiovascular system with selected parameters of renal filtration function and the renal interstitium in patients with previously untreated primary arterial hypertension.Material and methods 25 patients with untreated primary arterial hypertension without albuminuria and 15 healthy volunteers underwent arterial pressure measurement with a standard mercury sphygmomanometer using the Korotkoff technique and non-invasive measurement of aortic pressure by applanation tonometry using a SphygmoCor device. For all subjects, the concentrations of creatinine, uric acid, 1,25(OH)2D3, erythropoietin, and 25-hour NAG excretion were determined and GFR was estimated using the MDRD equation. PWV measurement was performed using a SphygmoCor device, whereas IMT was measured by ultrasound.Results Hypertensive patients showed higher values of arterial pressure compared to the control group: SBP, DBP, PP, MAP, as well as CSP, CDP, CPP and MCAP. In both the studied and the control group, the following statistically significant positive correlations were found: CPP vs IMT and CPP vs AIx. Only in the studied group, the following positive linear correlations were found: NAG vs PWV (R = 0.46; p = 0.019); NAG vs IMT (R = 0.36; p = 0.078). In the multiple regression model, a statistically significant positive effect was found of PWV and IMT [PWV (b 0.41; p = 0.0158), IMT (b 0.49; p = 0.0048)] on the dependent variable NAG (R2 = 0.503) in hypertensive patients. eGFR or uric acid concentration in serum included additionally in the model had no statistically significant effect on the dependent variable NAG (p = 0.9307 and p = 0.4938, respectively).Conclusions Damage to the renal tubulointerstitial tissue in hypertensive patients is concomitant with a decrease in vascular resistance. CPP may constitute a useful parameter for assessing the development of atherosclerotic lesions in vessels and the function of the left ventricle of the heart.Background The aim of the study was to examine the correlation of the conventional method of arterial pressure measurement in the brachial artery and non-invasive aortic pressure measurement by applanation tonometry with vascular and left ventricular structure and function. An attempt was made at determining a correlation of morphological and functional changes within the cardiovascular system with selected parameters of renal filtration function and the renal interstitium in patients with previously untreated primary arterial hypertension.Material and methods 25 patients with untreated primary arterial hypertension without albuminuria and 15 healthy volunteers underwent arterial pressure measurement with a standard mercury sphygmomanometer using the Korotkoff technique and non-invasive measurement of aortic pressure by applanation tonometry using a SphygmoCor device. For all subjects, the concentrations of creatinine, uric acid, 1,25(OH)2D3, erythropoietin, and 25-hour NAG excretion were determined and GFR was estimated using the MDRD equation. PWV measurement was performed using a SphygmoCor device, whereas IMT was measured by ultrasound.Results Hypertensive patients showed higher values of arterial pressure compared to the control group: SBP, DBP, PP, MAP, as well as CSP, CDP, CPP and MCAP. In both the studied and the control group, the following statistically significant positive correlations were found: CPP vs IMT and CPP vs AIx. Only in the studied group, the following positive linear correlations were found: NAG vs PWV (R = 0.46; p = 0.019); NAG vs IMT (R = 0.36; p = 0.078). In the multiple regression model, a statistically significant positive effect was found of PWV and IMT [PWV (b 0.41; p = 0.0158), IMT (b 0.49; p = 0.0048)] on the dependent variable NAG (R2 = 0.503) in hypertensive patients. eGFR or uric acid concentration in serum included additionally in the model had no statistically significant effect on the dependent variable NAG (p = 0.9307 and p = 0.4938, respectively).Conclusions Damage to the renal tubulointerstitial tissue in hypertensive patients is concomitant with a decrease in vascular resistance. CPP may constitute a useful parameter for assessing the development of atherosclerotic lesions in vessels and the function of the left ventricle of the heart

Influence of body weight on intensity of inflammation status in healthy perimenopausal and postmenopausal women

WSTĘP. Okres okołomenopauzalny i pomenopauzalny jest związany z wygasaniem funkcji jajników i zwiększonym ryzykiem wystąpienia nadwagi oraz otyłości. Obniżone stężenie hormonów płciowych oraz otyłość brzuszna mogą wpływać na nasilenie procesów zapalnych. W niniejszej pracy zbadano związek pomiędzy zaburzeniami hormonalnymi i wskaźnikami zapalnymi oraz wskaźnikami masy ciała u kobiet w okresie około- i pomenopauzalnym. MATERIAŁ I METODY. Badaniem objęto 41 zdrowych, niepalących kobiet we wczesnej fazie perimenopauzy (PERI) i 39 kobiet w okresie pomenopauzalnym (POST). W próbkach krwi oznaczono 17β-estradiol, hormon folikulotropowy (E2, FSH; Roche Diagnostics), fibrynogen i białko C-reaktywne (hsCRP; Dade Behring). Oceniono parametry antropometryczne: wskaźnik masy ciała (BMI, body mass index), obwód talii i bioder, wskaźnik talia–biodra (WHR, waist-hip ratio). WYNIKI. Znacznie wyższe wartości BMI obserwowane były u kobiet POST, w porównaniu z kobietami PERI. Wykazano istotne korelacje pomiędzy wskaźnikami masy ciała a stężeniem białka C-reaktywnego (CRP, C-reactive protein) i fibrynogenu jedynie u kobiet po menopauzie. W badaniu regresji wielokrotnej stężenie CRP i fibrynogenu niezależnie korelowało z BMI. Nie stwierdzono zależności między stężeniem E2 i FSH a wskaźnikami zapalnymi. Wartości CRP powyżej 3 mg/l występowały 4-krotnie częściej u otyłych kobiet POST w porównaniu z kobietami PERI, niezależnie od ich masy ciała. Podwyższone wartości fibrynogenu obserwowano natomiast zarówno u otyłych kobiet PERI, jak i POST. WNIOSKI. W populacji klinicznie zdrowych kobiet w okresie pomenopauzalnym nasilenie stanu zapalnego jest uzależnione przede wszystkim od masy ciała i rozmieszczenia tkanki tłuszczowej, nie zależy natomiast bezpośrednio od stężenia hormonów płciowych.INTRODUCTION. Perimenopause and postmenopause are associated with cessation of ovarian function and increased risk of overweight and obesity. Sex hormone deficiency as well as abdominal obesity may influence inflammatory status. We investigated the relationship between hormonal status and inflammatory and body mass markers in women during menopausal transition. MATERIAL AND METHODS. Study included 41 early perimenopausal (PERI) and 39 postmenopausal (POST) healthy nonsmoking women. Blood was assayed for 17ß-estradiol, and follicle-stimulating hormone (E2, FSH; Roche Diagnostics), fibrinogen and C-reactive protein (hsCRP; Dade Behring). Anthropometric parameters (body mass index [BMI], waist, hip circumference, waist to hip ratio [WHR]) were measured. RESULTS. Markedly higher values of BMI were found in POST women compared with the PERI group. Significant correlations between markers of obesity and levels of CRP and fibrinogen were found in POST women. In multiple regression analysis, CRP and fibrinogen independently correlated with BMI. No relations between markers of inflammation and E2 or FSH were observed. Values of CRP above 3 mg/l were observed fourfold more frequently in obese POST, comparing to PERI women independently on their body weight. Increased values of fibrinogen were found in obese PERI as well as in obese POST women. CONCLUSIONS. Intensity of inflammation status seems to be related mainly to BMI and distribution of adipose tissue. Changes in the concentrations of sex hormones at the menopausal transition did not directly influence the inflammation state in clinically healthy women

The long-term follow up of the patient with gastrinoma — the diagnostics and therapeutics problems

Guzy typu gastrinoma należą do wysokozróżnicowanych nowotworów neuroendokrynnych. U około połowy pa­cjentów zmiany przerzutowe w wątrobie i węzłach chłonnych stwierdzane są w momencie rozpoznania. W pracy opisano 46-letnią pacjentkę z dolegliwościami bólowymi jamy brzusznej i biegunkami. W 2005 roku w tomografii komputerowej (TK) uwidoczniono guza okolicy wnęki śledziony. Śródoperacyjnie stwierdzono obecność guza ogona trzustki. Pacjentka przebyła zabieg dystalnej pankreatektomii ze splenektomią. W badaniu histopatologicznym wykazano utkanie guza typu gastrinoma. Do 2007 roku nie stwierdzano zmian w kontrolnych badaniach obrazowych. W wykonanej w 2007 roku scyntygrafii receptorowej odnotowano ognisko patologicznego gromadzenia znacznika w segmencie 6. wątroby oraz obecność zwiększonego wychwytu znacznika w segmentach 2. i 7. W badaniu TK potwierdzono obecność zmiany ogniskowej w segmencie 6. wątroby. Ze względu na rozsiew choroby nowotworowej oraz dodatni wynik scyntygrafii receptorowej pacjentka została zakwalifikowana do leczenia radioizotopowego. Po leczeniu radioizotopowym do leczenia włączono długodziałający analog somatostatyny. Stwierdzana w kontrolnych badaniach scyntygrafii receptorowej oraz TK regresja opisywanych wcześniej zmian przerzutowych w wątrobie utrzymywała się przez 5 lat po zakończeniu leczenia radioizotopowego. Z uwagi na pojawienie się nowego ogniska przerzutowego w wątrobie pacjentka została zakwalifikowana do zabiegu przezskórnej termoablacji zmiany. Obecnie w badaniu ultrasonograficznym w wątrobie widocznych jest kilka zmian poniżej 1 cm średnicy — zaplanowano poszerzenie diagnostyki obrazowej. Opisany przypadek prezentuje wieloletni przebieg choroby u pacjentki z guzem trzustki typu gastrinoma. Wskazuje na konieczność stosowania różnych uzupełniających się metod diagnostyki obrazowej. Przedstawia również różne, także zwykle uzupełniające się, opcje postępowania terapeutycznego w przypadku pacjentów z guzami typu gastrinoma. Gastrinomas are well differentiated neuroendocrine neoplasms. About fifty percent of patients present with liver and lymph nodes metastases at the time of diagnosis. 46 years old woman with abdominal pain and diarrhea. In computed tomography (CT) performed in 2005 tumor of the hiatus of the spleen was revealed. Intraoperatively tumor of the pancreatic tail was found. Patient underwent distal pancreatectomy with splenectomy. Histopathological examination confirmed gastrinoma. There were no pathological findings on imaging examinations till 2007. Somatostatin receptor scintigraphy (SRS) performed in 2007 revealed pathological focal uptake in the 6th segment of the liver and increased uptake of the tracer in segments 2 and 7. CT confirmed the presence of the lesion in the 6th segment. Due to dissemination of the disease and positive result of SRS patient underwent peptide receptor radionuclide therapy (PRRT). Thereafter therapy with long-acting somatostatin analogue was started. Remission of the disease observed in SRS and CT lasts for five after PRRT. Due to the presence of the new metastatic lesion in the liver patient underwent thermal ablation of the lesion. The latter ultrasound examination revealed few small (less than 1 cm in diameter) lesions in the liver — further imaging examinations are planned. Presented case shows long time course of the disease in a patient with gastrinoma. We would like to emphasize the necessity of the use of different, usually complementary, imaging methods. We wanted also to present differ­ent, also usually complementary, therapeutic options in case of such a patients