Hypertension and beyond — does circulating irisin matter?

Irisin is a myokine secreted by skeletal muscles. It has been proposed to drive the brown-fat-like conversion of the white adipose tissue. By enhancing energy expenditure, irisin may affect systemic metabolism and be associated with insulin resistance; however, the mechanism(s) of action still remain largely unexplained. The discovery of irisin can contribute to the exploration of the novel and effective therapeutic targets or therapeutic strategies of metabolic diseases or metabolism-associated health issues. In this review, based on the recent literature (from 2013 to 2015 inclusive), we will systematically discuss the associations of irisin with obesity, type 2 diabetes, lipid disorders, and hypertension. We also introduce unanswered questions for future research.Irisin is a myokine secreted by skeletal muscles. It has been proposed to drive the brown-fat-like conversion of the white adipose tissue. By enhancing energy expenditure, irisin may affect systemic metabolism and be associated with insulin resistance; however, the mechanism(s) of action still remain largely unexplained. The discovery of irisin can contribute to the exploration of the novel and effective therapeutic targets or therapeutic strategies of metabolic diseases or metabolism-associated health issues. In this review, based on the recent literature (from 2013 to 2015 inclusive), we will systematically discuss the associations of irisin with obesity, type 2 diabetes, lipid disorders, and hypertension. We also introduce unanswered questions for future research

Nadciśnienie i inne choroby metaboliczne — czy krążąca iryzyna ma znaczenie?

Iryzyna jest miokiną wydzielaną przez mięśnie szkieletowe. Uważa się, że prowadzi do przemiany białej tkanki tłuszczowej w tkankę tłuszczową brunatnopodobną. Przez zwiększanie wydatku energetycznego może wpływać na metabolizm układowy i może być związana z opornością na insulinę. Mechanizm(y) tego działania nadal pozostają w znacznym stopniu niewyjaśnione. Odkrycie iryzyny może przyczynić się do poznania nowych i skutecznych strategii terapeutycznych w chorobach metabolicznych bądź też w zagadnieniach zdrowotnych związanych z metabolizmem. W poniższym opracowaniu opartym o aktualne publikacje (od 2013 do 2015) autorzy omawiają związek iryzyny z otyłością, cukrzycą typu 2, zaburzeniami lipidowymi i nadciśnieniem. Przedstawiają także pytania, na ktore nie znamy obecnie odpowiedzi, a ktore powinny stanowić przedmiot dalszych badań

Deaths, disability-adjusted life years and years of life lost due to elevated systolic blood pressure in Poland: estimates for the Global Burden of Disease Study 2016

Introduction. High systolic blood pressure (SBP) is a well-known risk factor for major adverse cardiovascular outcomes; however, data regarding disease burden due to high SBP in the Polish population are scarce. Material and methods. We extracted and analyzed the latest country-, gender-, age- and year-specific estimates from the Global Burden of Disease (GBD) Study 2016 for SBP-related mortality, years of life lost (YLLs), disability-adjusted life years (DALYs), and attributable risk factors in Poland in 2016. In the GBD 2016, the term ‘high SBP’ refers to SBP of at least 110−115 mmHg. Results. High SBP was attributable to (per 100,000) 106,043.16 deaths (95% UI [Uncertainty Interval]: 88,207–121,849) that was 27.22% of all deaths in Poland in 2016; 1,751,844.69 DALYs (95% UI: 1,525,188–1,966,25) and 1,497,959.71 YLLs (95% UI: 1,287,279–1,497,959). In males, DALYs attributable to high SBP were higher by 34% and YLLs by 23%, while in females death rates were higher by 14%. SBP was highly attributable to ischemic heart disease, stroke, and chronic kidney disease (63.7%, 63,1%, and 59.1%, respectively). In the GBD hierarchy, high SBP was the most common risk factor, followed by smoking, high body mass index (BMI), high total cholesterol levels, alcohol use, and high fasting plasma glucose levels. Conclusions. In Poland, SBP of at least 110–115 mmHg remains one of the largest risks for loss of good health; greater than smoking, high cholesterol levels, or high BMI. With the population aging globally, the burden due to high SBP is expected to increase further

Visceral fat reference values derived from healthy European men and women aged 20-30 years using GE Healthcare dual-energy x-ray absorptiometry.

Dual energy X-ray absorptiometry (DXA) is an established technique used in clinical and research settings to evaluate total and regional fat. Additionally, recently developed software allow to quantify visceral adipose tissue (VAT). Currently, there are no reference values available for GE Healthcare DXA systems for VAT. The aim of this study was to develop reference values for VAT in healthy European adults aged 20-30 years using a GE Healthcare Prodigy densitometer along with the dedicated CoreScan application. We also assessed the associations of VAT with traditional cardiometabolic risk factors. In 421 participants (207 men; 214 women), we performed DXA whole-body scans and calculated total body fat (BF) and VAT (in gender-specific percentiles). We also measured blood pressure and fasting glucose, insulin, and blood lipids. Males, in comparison with females, had 2-fold greater VAT both in units of mass (542 ± 451 g; 95% CI: 479.6‒605.1 g vs. 258 ± 226 g; 95% CI: 226.9‒288.6 g) and volume (570 ± 468 cm3; 95% CI: 505.1‒635.2 cm3 vs. 273 ± 237 cm3; 95% CI: 240.6‒305.3 cm3). They also had significantly higher the VAT/BF ratio. VAT showed a stronger positive correlation than BF with blood pressure, triglycerides, LDL-cholesterol, glucose, insulin, and homeostasis model assessment-insulin resistance index and a stronger negative correlation with HDL-cholesterol. Among these variables, VAT had the highest area under the curve for triglycerides ≥150 mg/dL (0.727 in males and 0.712 in females). In conclusion, we provide reference values for VAT obtained from healthy adults using the GE Healthcare DXA. These values may be useful in the diagnosis of visceral obesity, for identifying subjects with high obesity-related risks, in epidemiological studies, as a target for therapies, and in physically trained individuals. In both genders, VAT was associated with traditional cardiometabolic risk factors, particularly hypertriglyceridemia

Implementation of an enhanced recovery after surgery (ERAS) protocol in a gynaecology department – the follow-up at 1 year

Aim of the study : An ERAS protocol provides the latest perioperative care principles, whose primary aim is to reduce complication rates, and therefore mortality. The aim of this study is to establish the progress of the ERAS pathway implementation in our gynaecology department. Material and methods : This was a retrospective analysis of two sets of 100 consecutive medical records: patients treated before (PRE-ERAS) and after (ERAS) introduction of the ERAS protocol. All patients were comparable and all underwent major gynaecological surgery. Patients as well as medical and nursing staff were informed about the proposed preparation, surgical management and postoperative routine. Results and conclusions : Patients were given supper and drank water during the night. Laparoscopic surgery was used in 44% and spinal anaesthesia was given for open surgery in 43 study patients. Use of drains was reduced only by 23%, bowel preparation by 15%. Intravenous fluid administration was reduced by 22%. Use of postoperative morphine was minimised to 12 patients. Postoperative nausea was managed with the regular use of anti-emetics. Anti-coagulation was given to 80% of the study group. Difficulties in the introduction of the ERAS protocol were due to refusal by some patients to mobilise and eat early postoperatively. Patients in the ERAS programme group were discharged earlier. Further information about the ERAS protocol in the media would facilitate patients’ education among conservative society. In order to introduce new and innovative treatment methods, one has to take into account the cultural and ideological factors, especially when patient involvement is essential

AUC values and cut-off points for VAT volume by gender.

<p>AUC values and cut-off points for VAT volume by gender.</p

Receiver operating characteristics of VAT for identifying triglyceride level ≥150 mg/dL in males (left) and females (right).

<p>P refers to logistic regression model.</p

Descriptive characteristics of participants by gender.

<p>Descriptive characteristics of participants by gender.</p

Receiver operating characteristics of VAT for identifying waist circumference ≥94 cm in males (left) and ≥80 cm in females (right).

<p>P refers to logistic regression model.</p

Correlation coefficients between VAT, body fat, anthropometric indices, blood pressure, blood lipids and HOMA-IR (males and females combined).

<p>Correlation coefficients between VAT, body fat, anthropometric indices, blood pressure, blood lipids and HOMA-IR (males and females combined).</p