Association of serum bilirubin, selected iron status indicators and body composition in non-obese, normoglycemic subjects

Background: Recently cardiometabolic risk reduction has been observed in patients with slightly elevatedbilirubin concentration, as well as increased risk in subjects with excessive iron reserves. The aim of thisstudy was to evaluate the relationship between overweight and/or abdominal obesity, serum bilirubin andselected iron status indicators levels in non-obese subjects. Methods: The study group consisted of 80 healthy, non-obese subjects aged 25–40 years. In all subjectstotal and direct bilirubin (T-BIL, D-BIL), iron (Fe), transferrin (TRSF), ferritin (FERR) and hepcidin (HEPC)measurements were performed. Anthropometric parameters (BMI, waist circumference, WHR) weremeasured and body composition (% of body fat, muscles and level of visceral fat) was evaluated usingbody segment analyzer. Results: Men showed significantly higher values of waist circumference, WHR, muscle mass, visceral fatlevel and FERR and HEPC concentrations, compared to women. Lower concentrations of T-BIL, D-BIL andhigher concentration of FERR, HEPC occurred in the overweight group. In all subjects and in the overweightgroup T-BIL, D-BIL showed negative correlations with BMI, waist circumference, fat mass and visceral fatlevel, while for FERR, HEPC those correlations were positive. Overweight subjects had an approximately4-fold higher incidence of low T-BIL, D-BIL levels (p < 0,001), as well as nearly 2-fold higher incidence ofhigh transferrin level (p = 0,02). Conclusions: Overweight subjects have lower bilirubin levels and higher levels of factors potentially contributingto increased oxidative stress, for example ferritin and hepcidin. Serum bilirubin, ferritin and hepcidinconcentration are related to body composition indicators, particullary fat mass and visceral fat level

Association of serum adiponectin and visfatin with body composition and selected biochemical cardiometabolic risk factors in non-obese individuals with normal fasting glycaemia

Background: Adipose tissue produces many metabolically active substances such as adiponectin and visfa-tin. Both have potential anti-inflammatory, anti-atherogenic, and increasing insulin sensitivity properties. We evaluated the diagnostic value of serum adiponectin and visfatin as potential cardiometabolic risk factors. Subjects and methods: Sixty non-smoking, non-obese subjects aged 25–40 years with normal fasting glycaemia were included in the study. In all subjects serum fasting lipid profile, CRP, glucose, insulin, and apolipoprotein AI and B measurements were performed on an automatic analyser, while adiponectin and visfatin were measured using manual enzyme-linked immunosorbent assay (ELISA). Blood pressure measurements, body composition analysis using bioimpedance method (BIA), and basic anthropometric measurements (weight, BMI, WHR) were performed. Results: In the study group the concentration of adiponectin and visfatin was significantly inversely and moder-ately related with the amount of visceral fat, BMI, and waist circumference, while an inverse weak relationship with HOMA-IR and insulin level was observed. Moreover, adiponectin was weakly inversely related with CRP but positively with HDL-C and apolipoprotein AI. The prevalence of subjects with CRP < 1 mg/L was signifi-cantly higher at the highest adiponectin and visfatin concentrations (third tertile). At the lowest adiponectin concentrations (first tertile) the percentage of subjects with elevated apoB ≥ 100 mg/dL was increased. Conclusion: The relationship of serum adiponectin and visfatin with the amount of visceral fat, lipid profile, apolipoproteins, and CRP suggests their potential diagnostic value in the assessment of cardiometabolic risk. The predictive value of both adipocytokines should be confirmed in a large population-based study

Association of serum total bilirubin with traditional and novel cardiovascular risk factors in apparently healthy subjects

Background. Bilirubin is considered as one of the strongest endogenous antioxidants. Recent studies suggest that high total bilirubin levels are associated with lower cardiovascular disease (CVD) risk. The aim of this study was to evaluate a the relationship between serum total bilirubin and traditional as well as new risk factors for CVD in apparently healthy subjects. Materials and methods. Study included 60 non-smoking, non-obese individuals (30 females, 30 males) with normal fasting glucose, aged 25–40 years. In all subjects basic anthropometric indicators (weight, WHR, BMI), blood pressure and laboratory tests: serum total bilirubin (Bil-T), lipid profile, CRP, plasma glucose, apolipoproteins AI and B and 25-hydroxyvitamin D were performed. Subjects were divided into two groups of relative CVD risk, specified by total bilirubin levels: low-risk (≥ 13.7 μmol/L) and high-risk (< 13.7 μmol/L). Results. Total bilirubin ranged 6.16–32.15 μmol/L. In the study group 58% of subjects had Bil-T values above 13.7 μmol/L. Higher values occurred more frequently in men (70%) and in subjects aged 30–40 years (71%). Statistically significant relationship between Bil-T, and traditional and new risk factors for CVD was found. Bil-T correlated negatively with non-HDL-C, LDL-C, systolic blood pressure as well as with apoB: apoAI ratio, apolipoprotein B, TC:HDL-C and TC. A weak positive correlation was found between serum Bil-T and HDL-C. Additionally, negative correlations with CRP and positive with 25-hydroxyvitamin D were observed in women. In subjects with low CVD risk, the prevalence of low LDL-C concentration (< 2.59 mmol/L) was nearly three-fold higher compared with high-risk groups. Furthermore, in low-risk group the prevalence of serum CRP < 1 mg/L and HDL-C levels > 1.55 mmol/L was 2-fold and 3-fold higher, respectively, and higher incidence of low apoB:apoAI values (<0.6) was observed. Conclusions. Serum total bilirubin may play an important role in reducing the risk of CVD, therefore its assay seems to be valuable for more accurate assessment of cardiovascular risk in young, non-obese, non-diabetic individuals

How Do Apolipoproteins ApoB and ApoA-I Perform in Patients with Acute Coronary Syndromes

Acute coronary syndromes are the leading cause of hospitalization and death. Results from recent stu - dies suggest that apolipoprotein measurement and apoB: apoA-I are superior to traditional lipids in the estimation of coro nary risk. We compared apolipoprotein concentrations and apoB:apoA-I with traditional lipid measures and athe ro - genic indices in patients diagnosed with acute coronary syndromes (ACS) within 6 hrs from the onset of chest pain. A study group consisted of 227 patients diagnosed with ACS (STEMI=60, NSTEMI=66 and UA=105). Clinically healthy volunteers (n=85) served as controls. Measure ments of cardiac TnI, lipid profile, hsCRP, apolipoprotein A-I and apoB100 were performed and apoB:apoA-I, TC-HDL-C, LDL-C:HDL-C ratios were calculated. Patients had increased LDL-C (>3.0 mmol/L) and non-HDL-C (>3.4 mmol/L). Triglycerides were below the cut-off value, but patients had significantly higher TG concentrations and lower HDL-C compared to controls (p<0.001). Apo B and apoA-I con - cen tration in patients remained within the accepted range. Atherogenic indices TC:HDL-C, LDL-C:HDL-C and apoB: apoA-I were significantly increased in patients. ApoB:apoA-I ratio in ACS males was within low risk whereas in females corresponded to medium risk. ApoB:apoA-I and LDL-C:HDLC ratios were of good diagnostic utility for discrimination between patients and controls (AUC 0.71 and 0.79; respec - tively). ApoB:apoA-I and LDL-C:HDL-C were of very good diagnostic utility for discrimination between STEMI patients and controls (AUC 0.80 and 0.84). We could not show the superiority of apoB:apoA-I over LDL-C:HDL-C as the discr i - Introduction According to data published in the National Reg - istry of Acute Coronary Syndromes (PL-ACS) every year in Poland 140.000 subjects are diagnosed with acute coronary syndromes (ACS) (1). Acute coronary syndromes are a group of disorders developing as a consequence of atherosclerosis and characterized by changes in the coronary circulation, whose common feature is the significant reduction or cessation of blood flow in the coronary arteries. The most com - mon cause of circulatory disorders is a blood clot formed at the rupture of atherosclerotic plaque. No vel cardiac biomarkers are used to identify patients with ACS even when there is no evidence of cardio my ocyte damage (myeloperoxidase, ischemia-modi fied albu - min, heart-fatty acid binding protein). Simi la rly, novel biomarkers are assessed that may be re gar ded as risk discriminators of cardiovascular disease (CVD) with a predictive value for future events. Apolipoprotein B (apo B) and apolipoprotein A-I (apo A-I), either sepa - rately or together as a cal cu lated apoB:apoA-I ratio, may predict CVD risk more accurately than traditional lipid pro file measurement. Each proatherogenic lipoprotein fraction: VLDL, IDL, and LDL contains one apo B molecule per par - ticle, therefore the serum concentration of apo B re - flects the total number of atherogenic particles (2). HDL is the only antiatherogenic lipoprotein and its major structural protein is apo A-I. This protein pro - duced both in the liver and intestine is involved in reverse cholesterol transport carrying excess choles - terol from peripheral tissues back to the liver for ex - cretion (3). In spite of the availability of standardized com - mer cial assays, apo B and/or apoA-I are not yet widely measured in routine medical laboratory prac tice. Data sug gest that measurement of apo B po ten tially could pro vide several advantages over the con ventional measu re ment of LDL-cholesterol (LDL-C) and non- HDL-C as a cardiovascular disease risk in dex. Apo B can be mea sured directly and with a high accuracy and pre cision in the nonfasting state (4). The reliability and reproducibility of apo B assays are comparable to those expected for non-HDL-C, a meas ure of all the cholesterol in atherogenic lipo proteins (5). The optimal value for LDL-cholesterol (LDL-C) is <2.6 mmol/L, for non-HDL-C it is <3.4 mmol/L and the opti mal apo B concentration is <0.9 g/L (6). Results above these values indicate an increased risk of CVD including acute coronary syndromes. Even the most accurate determinations of LDL-C or non- HDL-C, obta ined after calculation of other para me - ters, do not fully reflect the proatherogenic impact of apo B containing lipoproteins. Studies showed that in sub jects with normal or slightly increased concen - trations of LDL-C, apo B is a better indicator of CVD risk. This comes from the fact that even with a slightly elevated concentration of LDL-C in the blood, with conco mittant hypertriglyceridemia and low HDL-C, very often an increase of small dense LDL particles occurs (7). Small dense LDL have up to 25% lower cho lesterol content per one apo B molecule than large LDL particles (8). Cardiovascular risk is more directly related to the number and size of atherogenic parti cles than to their cholesterol concentration (4, 7, 9). The concentration of apo AI in the circulation is approximately 1–1.3 g/L, and the majority of this protein (99%) is a part of HDL. Concentration of apo A-I below 1.2 g/L is related to greater risk of CVD (10). The cholesterol content of HDL particles is influ enced by blood triglyceride concentration and in, general, hypertriglyceridemia is associated with low HDL-C and low apo A-I values (11, 12). The most use ful as a predictor of CVD risk seems to be the cal culated apoB:apoA-I ratio (13). Previous reports have shown that an apoB:apoA-I ratio of <0.7 and <0.6 for men and women respectively is associated with low risk for cardiovascular disease. ApoB:apoA-I corresponds to the relationship between proathero genic apo B-con - taining lipoproteins and anti-athero genic HDL fraction (13). The advantage of calcula ting this ratio is that the concentrations of both apo lipoproteins are not influ - enced by a nonfasting state and during daytime. In addi tion, with regard to the tests performed after acute coronary syndromes have occurred, it does not matter how much time has elap sed since the blood collection. This is a valuable piece of information, because in pa - tients sus pected with ACS the credibility of lipid mea - surement is questioned if the blood was collected within 24 hours after the incident. Results from recent studies suggested that the se rum concentration of apo B and apo A-I as well as the apoB:apoA-I ratio are related to the occurrence of ACS in different ethnic populations (8). We aimed to com pare apolipoprotein concentrations and the apoB: apoA-I ratio with the traditional lipid measures in patients diag nosed with acute coronary syndromes. 238 Sypniewska et al.: Apolipoproteins B and A-I in acute coronary syndromes mination power of both was almost identical. Determination of apolipoproteins should not be recommended for routine clinical use, however, incorporating apoB and apoB:apoA-I into risk assessment could provide additional important information on cardiovascular risk

Occurrence of hyperlipidemia in relation to body mass index in school children aged 9–11

Background. There is a link between lipid disorders and body mass and the occurrence of cardiovascular diseases. This study aimed at establishing the prevalence of lipid abnormalities in relation to body mass in children aged 9–11. Materials and methods. The study involved 232 presumably healthy school children aged 9-11. Fasting venous blood samples were taken from every child to assess the lipid profile: total cholesterol (TC), LDL cholesterol (LDL-C, direct measurement), HDL cholesterol (HDL-C) and triglycerides (TG). Anthropometric measurements were performed including height and weight, followed by calculating the body mass index (BMI) by using an online “OLAF” calculator. Results. The prevalence of hypercholesterolemia and an elevated concentration of LDL-C in the group of children was high and equaled 51.1% and 34.6%, respectively. Hypertriglyceridemia in the respective age groups of 9 and 10–11 years was found to be: 41.6% and 27.7%. Only in 9.5% of children the level of HDL-C was lower than optimal. The percentage of overweight was two-fold higher among boys than in girls (13.6 v. 6.9%), similarly the percentage of obesity was higher in boys compared with that in girls (15.5 v. 10.3%). Conclusions. In school children aged 9–11 the dominant and most frequent lipid abnormality, not associated with an increased body mass, was hypercholesterolemia followed by hypertriglyceridemia. Overweight and obesity were strongly related to gender and much more frequent among boys. There should be more attention paid to dyslipidemia and body weight already in childhood in the context of health policy and prevention

Fibulin-1 is associated with cardiovascular risk in non-obese, non-diabetic individuals

Background. Fibulin-1 (FBLN1) is an extracellular matrix protein that appears in blood vessels. Recentstudies have confirmed its role in atherogenesis, vascular complications and cardiovascular disease inchronic diseases such as diabetes mellitus. The aim of this study was to evaluate the association betweenserum fibulin-1 and biochemical indicators of cardiovascular risk: lipid profile, apolipoproteins B, AI, vitamin25(OH)D and high sensitivity troponin T (hs-cTnT) in non-diabetic subjects.Materials and methods. The study consisted of 120 normoglycaemic, non-smoking, non-obese Caucasiansubjects aged 25–40 (66 women and 54 men). Serum FBLN1 and plasma fasting glucose, lipid profile, C-reactive protein, insulin, glycated haemoglobin, apolipoproteins B100 and AI, total 25(OH)D, and hs-cTnT measurements were performed. Anthropometric parameters, HOMA-IR and atherogenic index (apoB:apoAI) were calculated. Carotid intima-media thickness (IMT) was measured using an ultrasoundmethod. Subjects were divided by FBLN1 tertiles.Results. FBLN1 was significantly higher in women than in men (1.06 vs. 0.96; p &lt; 0.05). FBLN1 positively correlated,when adjusted for age, BMI and blood pressure, with lipid profile, atherogenic index, apolipoprotein B (R = 0.28;p &lt; 0.016), and hs-cTnT (R=0.39; p &lt; 0.003) and negatively with 25(OH)D. ApoB and hscTnT were significantly associatedwith fibulin-1 concentration and, together with 25(OH)D, explained 19% of its variation. FBLN1 ≥1.0 ng/mLpredicted atherogenic risk with OR = 3.11 and 4.26 for having elevated apolipoprotein B and hs-TnT.Conclusions. Fibulin-1 might be a promissing risk factor for cardiovascular risk in young, non-obese,non-diabetic individuals, but this requires further investigation.Background. Fibulin-1 (FBLN1) is an extracellular matrix protein that appears in blood vessels. Recentstudies have confirmed its role in atherogenesis, vascular complications and cardiovascular disease inchronic diseases such as diabetes mellitus. The aim of this study was to evaluate the association betweenserum fibulin-1 and biochemical indicators of cardiovascular risk: lipid profile, apolipoproteins B, AI, vitamin25(OH)D and high sensitivity troponin T (hs-cTnT) in non-diabetic subjects.Materials and methods. The study consisted of 120 normoglycaemic, non-smoking, non-obese Caucasiansubjects aged 25–40 (66 women and 54 men). Serum FBLN1 and plasma fasting glucose, lipid profile, C-reactive protein, insulin, glycated haemoglobin, apolipoproteins B100 and AI, total 25(OH)D, andhs-cTnT measurements were performed. Anthropometric parameters, HOMA-IR and atherogenic index (apoB:apoAI) were calculated. Carotid intima-media thickness (IMT) was measured using an ultrasoundmethod. Subjects were divided by FBLN1 tertiles.Results. FBLN1 was significantly higher in women than in men (1.06 vs. 0.96; p &lt; 0.05). FBLN1 positively correlated,when adjusted for age, BMI and blood pressure, with lipid profile, atherogenic index, apolipoprotein B (R = 0.28;p &lt; 0.016), and hs-cTnT (R=0.39; p &lt; 0.003) and negatively with 25(OH)D. ApoB and hscTnT were significantly associatedwith fibulin-1 concentration and, together with 25(OH)D, explained 19% of its variation. FBLN1 ≥1.0 ng/mLpredicted atherogenic risk with OR = 3.11 and 4.26 for having elevated apolipoprotein B and hs-TnT.Conclusions. Fibulin-1 might be a promissing risk factor for cardiovascular risk in young, non-obese,non-diabetic individuals, but this requires further investigation

Enmarcando la Participación de los Hombres en la Igualdad de Género en Europa: Entre Política Institucionalizada y No Institucionalizada

In order to reach the main goal of the paper, the identification of the impact and effectiveness of strategies and measures which promote gender equality not only in connection to women but also men, an overview of institutionalised practices, men’s involvement in gender equality strategies like gender mainstreaming, as well as men’s participation in international and national networks, organisations and groups are presented. The identification of specific forms of institutionalised and non-institutionalised practices and politics is based on the theoretical model proposed by Michael Messner (2000) and concerns the situation in the European Union.Con el propósito de alcanzar el objetivo principal de este artículo, se presenta el análisis de cómo se han identificado los efectos y la eficacia de las estrategias y medidas que promuevan la igualdad de género, no sólo en relación a las mujeres sino también con los hombres. A la vez también se presenta una visión general de las prácticas institucionalizadas relacionadas con la participación de los hombres en la igualdad de género, como por ejemplo la integración de la perspectiva transveral de género, la participación de los hombres en redes nacionales e internacionales. Dicha identificación de formas específicas de política institucionalizada y no institucionalizada tienen su fundamento en el modelo teórico propuesto por Michael Messner (2000), el cual se refiere a la situación en la Unión Europea

Comparison of two different methods for routine 25(OH)D measurement in paediatric serum samples

Over the last decade interest in automated assays for 25-hydroxy-vitamin D measurement have greatly increased. The presence of different metabolites of vitamin D in the blood influences measurement of its concentration. In paediatric subjects the basic interference is due to the presence of 3-epi-25(OH)D2/D3, which  despite their biological inactivity, influences the total concentration of 25(OH)D. Aim: We assessed the analytical performance and usefulness of two different assays for measurement of total 25(OH)D in children. Materials and Methods: The study was performed in blood samples taken from 100 school-children aged 9–11 years. In all serum samples 25(OH)D total concentration was measured with the use of chemilumi-nescent assay, which is known to show no cross-reactivity with 3-epi-25(OH)D, and with the use of a newly developed enzyme-immunosorbent method. Results: The mean 25(OH)D concentration in children measured with enzyme-immunosorbent assay (EIA) was significantly higher, at 28.06 ng/mL, than with the chemiluminescent assay (CLIA), at 21.13 ng/mL;   &lt; 0.0001. In children with optimal weight the average 25(OH)D was 32.93 ng/ml (EIA) and 21.5 ng/mL (CLIA) (p &lt; 0.0001), respectively, whereas in a subgroup with overweight/obesity the mean concentra-tion of 25(OH)D was similar, at 23.2 ng/ml (EIA) and 20.76 ng/ml (CLIA) (p = 0.15). The nonparametric Spearman’s rank correlation of two methods equalled 0.47; 95%CI (0.11 to 0.60) with a significance level  p &lt; 0.0001. The calculated concordance correlation coefficient between two methods in the whole group was 0.26; 95%CI (0.17 to 0.35). In a subgroup of children with optimal body mass (N = 50) the concor-dance correlation coefficient was 0.18; 95%CI (0.06 to 0.29), whereas in children with overweight/obesity (N = 50) it was 0.44; 95%CI (0.29 to 057). Mean bias for the enzyme-immunosorbent method equalled 18.7%; +/- 1.96 SD (101.3% to -64%). Conclusions: With reference to 25(OH)D measurement in children, Spearman’s correlation coefficient indicated “moderate correlation” between the two compared methods, whereas the strength of agree-ment (concordance) between both methods was characterised as “poor”. The proper selection of assay for accurate assessment of vitamin D status in paediatric samples is necessary to avoid misdiagnosis

25-hydroxyvitamin D insufficiency in children with newly diagnosed asthma

Background. 25-hydroxyvitamin D [25(OH)D] deficiency seems to be related to the development of asthma. Any evaluation of the relationship between asthma and 25(OH)D deficiency must consider the association between increased airway responsiveness, eosinophil counts and serum immunoglobulin E (IgE), and 25(OH)D as a potential player in airway remodelling. Objective. We assessed the association of 25(OH)D with markers of atopy and eosinophilic inflammation in children with newly diagnosed asthma. Methods. The study included 165 children aged 2–12 years. The diagnosis of asthma was performed by an experienced paediatric pulmonologist. Allergic asthma was diagnosed in 106 children, and non-allergic asthma in ten; in 49 children, asthma was excluded. Fasting blood was collected for cell counts, and serum was obtained to measure lipids, C-reactive protein (hsCRP), 25(OH)D and IgE. Results. Children with asthma had significantly lower 25(OH)D (p &lt; 0.001). Both groups had similar lipid values. Elevated total IgE concentration and eosinophil counts were found in asthmatics; neutrophils were similar in asthmatic and reference groups. There was a strong tendency to higher eosinophil counts in 25(OH)D-deficient children (&lt; 20 ng/mL) with atopic asthma (p &lt; 0.08). Conclusion. In children with asthma, 25(OH)D insufficiency/deficiency is associated with higher eosinophil counts and IgE. 25(OH)D monitoring is important in the prevention and management of children with asthm

Quantum gravity from the point of view of locally covariant quantum field theory

We construct perturbative quantum gravity in a generally covariant way. In particular our construction is background independent. It is based on the locally covariant approach to quantum field theory and the renormalized Batalin-Vilkovisky formalism. We do not touch the problem of nonrenormalizability and interpret the theory as an effective theory at large length scales