16 research outputs found
Arterial hypertension in patients with obstructive sleep apnea
W pracy przedstawiono zwi膮zki mi臋dzy nadci艣nieniem t臋tniczym a obturacyjnym bezdechem
艣r贸dsennym. Zaprezentowano epidemiologi臋 i wsp贸lne mechanizmy odpowiedzialne
za powy偶sze jednostki chorobowe. Ukazano tak偶e mo偶liwo艣ci terapeutyczne
leczenia nadci艣nienia t臋tniczego u tych chorych.This paper presents an overview of the relations between hypertension and obstructive
sleep apnea. Epidemiology and common mechanisms responsible for the development
of both conditions are discussed. Moreover therapeutic options for the management of
this group of patients are described
Wp艂yw wybranych technik fizjoterapeutycznych na redukcj臋 masy cia艂a u os贸b oty艂ych
Obesity is a serious and growing health problem, which often is accompanied by other diseases,
such as cardiovascular diseases, type 2 diabetes, obstructive sleep apnea and
osteoarthritis.
The purpose of this paper is to present the influence of selected physical exercises in managing
obesity. Positive effects of physical activity manifest among other in: weight loss,
improvement of cardiovascular system function, reducing the severity of risk factors in disorders
co-occurring with obesity and improving the quality of life. Physiotherapy techniques
are important means of supporting dietary weight reduction.Oty艂o艣膰 stanowi powa偶ny i narastaj膮cy problem zdrowotny, kt贸remu cz臋sto towarzysz膮 inne
jednostki chorobowe, takie jak: choroby sercowo-naczyniowe, cukrzyca typu 2, obturacyjny
bezdech senny czy choroba zwyrodnieniowa staw贸w.
Celem niniejszej pracy jest przedstawienie wp艂ywu wybranych 膰wicze艅 fizycznych
w walce z oty艂o艣ci膮. Pozytywne efekty aktywno艣ci fizycznej przejawiaj膮 si臋 mi臋dzy innymi:
zmniejszeniem masy cia艂a, zwi臋kszeniem wydolno艣ci uk艂adu kr膮偶enia, z艂agodzeniem
stopnia nasilenia czynnik贸w ryzyka w chorobach wsp贸艂wyst臋puj膮cych z oty艂o艣ci膮 oraz
popraw膮 jako艣ci 偶ycia. Techniki fizjoterapeutyczne s膮 istotnym 艣rodkiem wspomagaj膮cym
post臋powanie dietetyczne w redukcji masy cia艂a
Costs of diagnosis and treatment of hypertension in the department of internal diseases
Following paperwork is the attempt to calculate the costs of hypertension diagnostics and treatment.
The examined group consisted of 110 hypertensives. The evaluated period was 3 months.
Hypertensives were divided into several groups with reference to the accompanying diseases.
The average stay in hospital was 8.5 day. It was stated that the largest share in the costs
were expenses related to the diagnostics and so called hotels, whereas much less expensive
was the pharmacotherapy. (Forum Zaburzen Metabolicznych 2011, vol. 2, no 3, 177–183)Niniejsza praca jest pr贸b膮 oszacowania koszt贸w diagnostyki i leczenia nadci艣nienia t臋tniczego
na oddziale internistycznym. Badan膮 populacj臋 stanowi艂o 110 chorych na nadci艣nienie
t臋tnicze. Ocenie podlega艂 3-miesi臋czny okres. Chorych podzielono na kilka grup w zale偶no艣ci
od rodzaj贸w chor贸b towarzysz膮cych. 艢redni pobyt na oddziale trwa艂 8,5 dnia. Stwierdzono,
偶e najwi臋kszy udzia艂 w kosztach stanowi艂y nak艂ady finansowe na diagnostyk臋 oraz
tak zwane koszty hotelowe. Znaczniej mniej kosztowa艂a stosowana farmakoterapia.
(Forum Zaburze艅 Metabolicznych 2011, tom 2, nr 3, 177–183
Ocena jako艣ci 偶ycia dzieci i m艂odzie偶y choruj膮cych na nadci艣nienie t臋tnicze — metody pomiaru, zastosowania, problemy i bariery
Background Arterial hypertension (AH) is a chronic disease
increasingly often diagnosed in children. Apart from
survival rate, the assessment of circulatory competence and
the adverse effects of pharmacotherapy, the quality of life
(QOL) assessment is another indicator of how efficient the
chosen treatment of arterial hypertension is.
The aim of the research was to close-up the quality of life
measurement methods as well as to blow the whistle on
the possibilities and barriers, conducting this kind of opinion
amongst children and the youth in the European
Union countries.
Material and methods A review of current literature and
internet resources concerning this subject was made.
Results Resulting the analysis we explained the genesis,
definition and conception of the quality of life. Moreover
in the paper are presented information about questionnaires,
available language versions of the European Union
countries, used for the evaluation of the quality of life in
children and adolescents with hypertension. The research
specifically focuses on the presented problems and obstacles
by indicating analysis of quality of life amongst children
and the youth in the European Union countries. Furthermore,
a presentation of appliance and the meaning of
the obtained results in clinical practice were made.
Conclusions The concept of quality of life, despite the
highlighted problems and barriers, will continue to flourish
as it appeals to the effects of treatment from the perspective
of quality of life giving medicine a chance to show
long-term success in controlling diseases.
Arterial Hypertension 2011, vol. 15, no 1, pages 21–28Wst臋p Nadci艣nienie t臋tnicze nale偶y do chor贸b przewlek艂ych,
kt贸re coraz cz臋艣ciej diagnozuje si臋 u dzieci.
Obecnie jednym z istotnych wska藕nik贸w skuteczno艣ci
leczenia nadci艣nienia t臋tniczego jest ocena jako艣ci
偶ycia uwarunkowana stanem zdrowia
(HRQL). Celem pracy by艂o przybli偶enie Czytelnikowi
metod pomiaru jako艣ci 偶ycia oraz zwr贸cenie
uwagi na mo偶liwo艣ci oraz bariery przeprowadzenia
takiej oceny w danej grupie badawczej.
Materia艂 i metody Dokonano przegl膮du najnowszej literatury
i zasob贸w internetowych dotycz膮cych tematu.
Wyniki W wyniku przeprowadzonej analizy wyja艣niono
genez臋, definicj臋 i koncepcje jako艣ci 偶ycia.
Ponadto w pracy przedstawiono informacje dotycz膮ce
dost臋pnych kwestionariuszy, w wersji j臋zykowej
kraj贸w Unii Europejskiej, s艂u偶膮cych do pomiaru jako艣ci
偶ycia dzieci i m艂odzie偶y z nadci艣nieniem t臋tniczym.
W pracy skoncentrowano si臋 g艂贸wnie na
przedstawieniu problem贸w i barier przeprowadzenia
oceny jako艣ci 偶ycia w艣r贸d dzieci i m艂odzie偶y
w krajach Unii Europejskiej. Ponadto przedstawiono
zastosowania i znaczenie uzyskanych wynik贸w
w praktyce klinicznej.
Wnioski Koncepcja jako艣ci 偶ycia, mimo podkre艣lanych
problem贸w i barier, nadal b臋dzie si臋 dynamicznie
rozwija膰, gdy偶 odwo艂anie si臋 do efekt贸w leczenia
z perspektywy jako艣ci 偶ycia daje medycynie szans臋
pokazania d艂ugotrwa艂ych sukces贸w w opanowaniu
chor贸b.
Nadci艣nienie T臋tnicze 2011, tom 15, nr 1, strony 21–2
Apelin in pathogenesis of cardiovascular diseases - actual state of knowledge
Apelina jest now膮 cytokin膮 o udowodnionej funkcji
w wielu uk艂adach biologicznych, a szczeg贸lnie
w uk艂adzie kr膮偶enia. Wywodzi si臋 z jednego genu
i posiada kilka izoform, kt贸re r贸偶ni膮 si臋 d艂ugo艣ci膮
艂a艅cucha polipeptydowego i aktywno艣ci膮 biologiczn膮.
Apelina wywiera efekt biologiczny przy
udziale receptora APJ. Wykazuje strukturalne podobie艅stwo
do uk艂adu RAA. Najwi臋ksze st臋偶enia
mRNA apeliny i jej receptora zaobserwowano we
wsierdziu oraz w 艣r贸db艂onku i kom贸rkach mi臋艣ni
g艂adkich naczy艅 krwiono艣nych, co wi膮偶e si臋 z jej
dzia艂aniem inotropowym dodatnim i hipotensyjnym.
Podkre艣la si臋 pozytywn膮 rol臋 apeliny w pocz膮tkowych
stadiach niewydolno艣ci mi臋艣nia sercowego.
Zwraca si臋 uwag臋 na jej ujemn膮 korelacj臋
z warto艣ci膮 skurczowego ci艣nienia t臋tniczego
u pacjent贸w z pierwotnym nadci艣nieniem t臋tniczym.
Postuluje si臋 r贸wnie偶 jej udzia艂 w chorobie
niedokrwiennej serca. Ponadto apelina wp艂ywa na
proliferacj臋 kom贸rek 艣r贸db艂onka i formacj臋 naczy艅.
Rola apeliny w gospodarce w臋glowodanowej
polega na zmniejszaniu insulinooporno艣ci i poprawie
tolerancji glukozy w pocz膮tkowym etapie
rozwoju cukrzycy typu 2. Ze wzgl臋du na udzia艂
apeliny w modyfikacji dzia艂ania insuliny por贸wnuje
si臋 jej rol臋 do roli adipocytokin zwi膮zanych
z patogenez膮 oty艂o艣ci i insulinooporno艣ci, takich
jak: wisfatyna, adiponektyna, leptyna, rezystyna,
a tak偶e TNF-a. Apelina wp艂ywa r贸wnie偶 na sekrecj臋
wielu hormon贸w oraz jest markerem kom贸rek
endokrynnych w przewodzie pokarmowym. Dok艂adne
poznanie mechanizmu jej dzia艂ania w organizmie
cz艂owieka i funkcji w poszczeg贸lnych
uk艂adach wymaga dalszych bada艅, kt贸re mog膮
przyczyni膰 si臋 do rozwoju dzia艂a艅 terapeutycznych,
szczeg贸lnie w chorobach uk艂adu sercowo-naczyniowego.Apelin is a new cytokine with proven functions in the cardiovascular
system. It is derived from a single gene and has
several isoforms that differ in polypeptide chain length and
biological activity. In its biological effect participates APJ-receptor. Apelin shows structural similarity to the RAS.
The highest concentrations of apelin mRNA and its
receptor was observed in the endocardium and the endothelium
of smooth muscle cells of blood vessels, which
facts relate to its inotropic positive action and hypotensive
effect. The positive role of apelin in the early stages
of cardiac failure is emphasized. Furthermore, the negative
correlation between its concentration and the value
of systolic blood pressure in patients with essential arterial
hypertension, gained attention. Its participation in
coronary artery disease is also called on. Moreover apelin
affects endothelial cell proliferation and vascular formation.
Apelin also plays the role in carbohydrates utilization
by reducing insulin resistance and improving glucose
tolerance in the early stage of development of type 2
diabetes. Due to its participation in modification of insulin
action, the effect of apelin is being compared to the
role of adipocytokines associated with the pathogenesis
of obesity and insulin resistance, such as, wisfatin,
adiponectin, leptin, resistin, and TNF-α. Apelin also influences
the secretion of several hormones and it is
a marker of endocrine cells in the gastrointestinal tract.
More elaborated knowledge of the mechanism of apelin
action in the human and its function in various systems,
requires further research that may contribute to the development of therapeutic effects, especially in cardiovascular
diseases
The assessment of adiponectin and insulin concentrations selected metabolic parameters, family history and anthropometric factors in young population with primary arterial hypertension
Wst臋p Tkanka t艂uszczowa jest obszarem syntezy
licznych biologicznie aktywnych substancji. Jedn膮
z nich jest adiponektyna, kt贸r膮 coraz cz臋艣ciej kojarzy
si臋 jako zbli偶on膮 do czynnik贸w ryzyka w rozwoju
chor贸b sercowo-naczyniowych.
Celem badania by艂a ocena st臋偶enia adiponektyny,
insuliny, ocena wybranych parametr贸w metabolicznych,
wywiadu rodzinnego i wska藕nik贸w antropometrycznych
u m艂odych os贸b z pierwotnym nadci艣nieniem
t臋tniczym.
Materia艂 i metody W badaniu wzi臋艂o udzia艂 33 dotychczas
nieleczonych m艂odych pacjent贸w z pierwotnym
nadci艣nieniem t臋tniczym. Grup臋 kontroln膮 stanowi艂o
14 odpowiednio dobranych zdrowych os贸b.
U wszystkich badanych dokonano pomiar贸w wska藕nik贸w
antropometrycznych, ci艣nienia t臋tniczego
i czynno艣ci serca, oznaczono w surowicy st臋偶enie
frakcji lipidowych oraz adiponektyny i insuliny.
Wyniki W grupie os贸b z nadci艣nieniem t臋tniczym,
w stosunku do grupy kontrolnej, stwierdzono znamiennie
wy偶sze warto艣ci ci艣nienia t臋tniczego skurczowego
(140 ± 14 mm Hg vs. 113 ± 8 mm Hg)
i rozkurczowego (81 ± 8 mm Hg vs. 71 ± 7 mm Hg),
masy cia艂a (89,7 ± 25,8 kg vs. 62,9 ± 12,7 kg), BMI
(27,5 ± 6,2 kg/m2 vs. 22,1 ± 1,3 kg/m2), st臋偶enia
trigliceryd贸w (1,6 ± 1,2 mmol/l vs. 0,8 ± 0,3 mmol/l)
i insuliny (42,4 ± 68,1 μjm./ml vs. 16,7 ± 14,6
μjm./ml). St臋偶enie adiponektyny w grupie badanej
by艂o istotnie ni偶sze ni偶 w grupie kontrolnej (14,0 ±
± 4,5 μg/ml vs. 18,2 ± 6,1 μg/ml). Podobnie wywiad
rodzinny w kierunku nadci艣nienia t臋tniczego by艂 cz臋艣ciej
obserwowany w grupie os贸b choruj膮cych na nadci艣nienie
t臋tnicze (78,8% vs. 35,7%). W grupie badanej
wyst膮pi艂a istotna dodatnia korelacja pomi臋dzy st臋偶eniem
adiponektyny a st臋偶eniem cholesterolu frakcji
HDL oraz ujemna - mi臋dzy st臋偶eniem adiponektyny
a st臋偶eniem trigliceryd贸w, mas膮 cia艂a i BMI.
Wnioski 1. Adiponektyna mo偶e by膰 traktowana jako
niezale偶ny od czynnik贸w ryzyka biomarker rozwoju
nadci艣nienia t臋tniczego.
2. Ze wzgl臋du na cz臋ste wsp贸艂istnienie hipoadiponektynemii
z nadci艣nieniem t臋tniczym i oty艂o艣ci膮
mo偶e ona odgrywa膰 rol臋 w ich patogenezie.Background Adipose tissue is a place where many bioactive
substances are synthetized. One of them is adiponectin,
which more and more often comes close to be regarded as
one of the cardiovascular risk factors.
The aim of this paper was to estimate the concentrations
of adiponectin and insulin, selected metabolic parameters,
family history and anthropometric factors in young population
with primary arterial hypertension.
Material and methods 33 young patients with essential
arterial hypertension were included in this study. The
control group consisted of 14 properly chosen healthy
people. The anthropometric, blood pressure and heart
rate measurements were taken. Serum concentrations
of total cholesterol, lipoprotein fractions, adiponectin
and insulin were assessed.
Results In group of patients with arterial hypertension
compared to control group significantly higher values of
systolic (140 ± 14 mm Hg vs. 113 ± 8 mm Hg) and
diastolic (81 ± 8 mm Hg vs. 71 ± 7 mm Hg) blood pressure, body mass (89.7 ± 25.8 kg vs. 62.9 ± 12.7 kg)
and BMI (27.5 ± 6.2 kg/m² vs. 22.1 ± 1.3 kg/m²) were
found and increased values of triglycerides (1.6 ±
± 1.2 mmol/l vs. 0.8 ± 0.3 mmol/l) and insulin (42.4 ±
± 68.1 μIU/ml vs. 16.7 ± 14.6 μIU/ml) concentrations
were stated. The concentration of adiponectin were significantly
lower (14.0 ± 4.5 μg/ml vs. 18.2 ± 6.1 μg/ml)
in patients with arterial hypertension. The positive family
history of arterial hypertension occurred more frequently
in examined group (78.8% vs. 35.7%). In examined group the
important positive correlation between adiponectin and
HDL-cholesterol concentrations were revealed as well as
negative one between adiponectin and concentration of
triglycerides, body mass and BMI.
Conclusions 1. Adiponectin could be treated as independent
from risk factors biomarker of development of arterial
hypertension.
2. Due to frequent coexistence with arterial hypertension
and obesity low adiponectin concentration could play a
role in their pathogenesis
The insulin sensitivity and adiponectin in patients with obesity and hypertension
Wst臋p Celem pracy by艂a ocena stopnia insulinowra偶liwo艣ci
tkankowej (warto艣膰 M) u pacjent贸w
z oty艂o艣ci膮 oraz oty艂o艣ci膮 wsp贸艂istniej膮c膮 z nadci艣nieniem
t臋tniczym. W obu grupach oceniano r贸wnie偶
osoczowe st臋偶enie adiponektyny (APM1) oraz korelacje
mi臋dzy APM1 i M.Materia艂 i metody Grup臋 1 stanowi艂o 10 pacjent贸w
z izolowan膮 oty艂o艣ci膮 (SBP 127,9 ± 19,6 mm Hg,
DBP 79,5 ± 10,9 mm Hg, wiek 37,6 ± 11,1 roku, BMI
36,1 ± 7,3 kg/m2). Grup臋 2 stanowi艂o 17 pacjent贸w
z nadci艣nieniem i oty艂o艣ci膮 (SBP 171,1 ± 6,8 mm Hg,
DBP 92,2 ± 9,4 mm Hg, wiek 38,6 ± 11,2, BMI
33,2 ± 6,9 kg/m2). Grup臋 kontroln膮 stanowi艂o 10 os贸b
z prawid艂owymi warto艣ciami BMI oraz ci艣nienia t臋tniczego.
Insulinowra偶liwo艣膰 oceniano metod膮 klamry
euglikemicznej (wg Ferranniniego w modyfikacji de
Fronzo). St臋偶enie APM1 oznaczono metod膮 RIA
(Linco Research, Stany Zjednoczone).
Wyniki Nie by艂o istotnych r贸偶nic warto艣ci M mi臋dzy
grupami 1 i 2 (3,08 ± 1,11 vs. 2,47 ± 0,32 mg/kg/min), wyniki te by艂y natomiast znacz膮co ni偶sze
ni偶 warto艣膰 uzyskana w grupie kontrolnej (9,4 ± 0,65 mg/kg/min). St臋偶enie APM1 by艂o istotnie
ni偶sze w grupie 1 i 2 ni偶 w grupie kontrolnej (odpowiednio
24,8 ± 6,3; 22,2 ± 12,6; 48,5 ± 14,1 mg/ml).
Nie obserwowano natomiast istotnych statystycznie
r贸偶nic APM1 mi臋dzy grup膮 1 a 2. Najsilniejsze korelacje
mi臋dzy APM1 a M wyst膮pi艂y w grupie 2 (r = 0,62, p < 0,05).
Wnioski Oty艂o艣膰 wi膮偶e si臋 z obni偶on膮 insulinowra偶liwo艣ci膮
tkankow膮 oraz hipoadiponektynemi膮.
Wsp贸艂wyst臋powanie oty艂o艣ci i nadci艣nienia t臋tniczego
powoduje dalszy spadek warto艣ci M i APM1. Dodatnia
korelacja mi臋dzy APM1 a warto艣ci膮 M wskazuje
na potencjalny udzia艂 tego bia艂ka w patogenezie
insulinooporno艣ci.Background The aim of this study was the assessment of
the level of insulin sensitivity (M value) in patients with
obesity or obesity and hypertension. We measured
adiponectin (APM1) in those patients and looked for the
correlation between M and APM1.
Materials and methods Group 1 — 10 patients with
isolated obesity (SBP 127.9 ± 19.6 mm Hg, DBP 79.5 ± 10,9 mm Hg, age 37.6 ± 11.1 years, BMI 36.1 ± 7.3 kg/m2).
Group 2 - 17 patients with hypertension and obesity
(SBP 171.1 ± 6.8 mm Hg, DBP 92.2 ± 9.4 mm Hg, age
38.6 ± 11.2 years, BMI 33.2 ± 6.9 kg/m2). Control group
- 10 healthy person. Insulin sensitivity was measured using
the euglicemic metabolic clamp (Ferrannini/de Fronzo).
APM1 was measured by RIA (Linco Research, USA).
Results There were no significant differences in M value
between group 1 and 2 (3.08 ± 1.11 vs. 2.47 ± 0.32 mg/kg/min), but both results were significantly lower than those
in control group (9.4 ± 0.65 mg/kg/min). The APM1 was
significantly lower in groups 1 and 2 than in control group
(24.8 ± 6.3; 22.2 ± 12.6; 48.5 ± 14.1 mg/ml, respectively).
But there were no differences between APM1 in groups
1 and 2. Most significant correlation between APM1 and
M was in group 2 (r = 0.62, p < 0.05).
Conclusion Obesity is connected with low insulin sensitivity
and hipoadiponectinemia. Comorbidity of obesity
and hypertension leads to further lowering of M and APM1
values. The relationship between M and APM1 emphases
the role of those adipocytokin in pathogenesis of insulin
resistance
Comparative studies on promotion of health and life style of hospital staff in Sweden and Poland
Introduction. Recently, an increase has been observed in the number of patients suffering from diseases which are the consequence of an anti-health life style; therefore it is necessary to undertake proper actions in this area, including those addressed to hospital staff. Objectives. 1) Comparison of self-reported state of health and life style between hospital staff in Sweden and Poland, and the motivation of these employees to change the to-date life style for one that is more health promoting. 2) Presentation, based on Swedish experiences in the field of health promotion in hospitals, of the possibilities to implement these changes in Polish conditions. Material and method. The study covered the staff from the following hospitals: 1) hospitals in Ostergotland County, Sweden, and 2) the Ludwik Perzyna Regional Polyclinical Hospital in Kalisz, Poland. The studies were conducted in parallel in Sweden and in Poland during the fourth quarter 2010. The research instrument was a questionnaire form. Results. The following measures should be undertaken by the staff of Polish hospitals: an increase in the consumption of fruit and vegetables, physical activity, organization of workshops aimed at the shaping of skills of coping with stress and relieving stress, assistance in reducing body weight and increasing physical activity. Obligatory breaks at work should be introduced for the consumption of meals and intake of beverages, including water, promotion of fluid replacement would reduce fatigue. An obligatory lunchtime would allow each employee to consume a decent meal, and consequently have respite away from one's own work activities. In order to have a well-functioning staff an employer should, in his/her own interest, decrease potential sick absenteeism, provide incentives for motor activity, e.g. by the organization of groups, reduction of weekly working time on behalf of documented physical activity, or financial support for the purchase of tickets for various forms of physical exercises. Promotion of collective exercise, e.g. common nordic walking for 30 min. during lunch, competition in the largest number of steps made. Promotion of healthy nutrition by the preparation of recipes for meals, several exemplary healthy meals in the form of a healthy alternative breakfast. During this event, a basket of fruit is provided, instead of cakes and sweets. Conclusions. 1) The life style of the staff of health care facilities is more health promoting in Sweden than in Poland. 2) It is possible to change the life style of employees of health care facilities into one that is more health promoting. Changes in this area have been made in Sweden with a great success; therefore, it is worthwhile implementing in Poland these Swedish experiences which may function also in Polish conditions. 3) The foundations of health promotion in enterprises have been known for a long time; however, considering the fact that the comparative studies show that these foundations are more advanced in Sweden, it is necessary that Polish employers devote more attention to this problem, and become interested in Swedish experiences in this area
Leptin and insulin concentrations, lipid profile and anthropometric parameters in young adults with primary arterial hypertension
Wst臋p U os贸b choruj膮cych na pierwotne nadci艣nienie
t臋tnicze bardzo cz臋sto wsp贸艂istniej膮 nadmierna masa
cia艂a oraz liczne zaburzenia metaboliczne, takie jak:
hiperleptynemia, zwi臋kszona insulinooporno艣膰, podwy偶szone
st臋偶enie cholesterolu ca艂kowitego i frakcji
LDL, obni偶one st臋偶enie cholesterolu frakcji HDL. Rola
ka偶dego z tych zaburze艅 z osobna w podwy偶szaniu
warto艣ci ci艣nienia t臋tniczego czy rozwoju nadci艣nienia
budzi wiele kontrowersji. Celem badania by艂a ocena st臋偶enia leptyny, insuliny,
profilu lipidowego oraz wska藕nika masy cia艂a (BMI)
u m艂odych os贸b z pierwotnym nadci艣nieniem t臋tniczym.
Materia艂 i metody W badaniu wzi臋艂o udzia艂 56 pacjent贸w
w wieku 16-31 lat z pierwotnym nadci艣nieniem
t臋tniczym. Grup臋 kontroln膮 stanowi艂o 10 odpowiednio
dobranych pod wzgl臋dem p艂ci i wieku
zdrowych os贸b. U wszystkich badanych przeprowadzono
pomiary antropometryczne, ci艣nienia t臋tniczego
(SBP, DBP), pobrano krew celem oznaczenia
st臋偶enia leptyny, insuliny i lipid贸w.
Wyniki W grupie os贸b z nadci艣nieniem t臋tniczym
stwierdzono znamiennie wy偶sze warto艣ci ci艣nienia
t臋tniczego skurczowego (138,8 ± 13,2 mm Hg vs.
113,4 ± 8,4 mm Hg) i rozkurczowego (81,9 ±
8,4 mm Hg vs. 71,4 ± 7,3 mm Hg), masy cia艂a (87,02
± 25,10 kg vs. 62,93 ± 12,77 kg), BMI (27,26 ± 6,29 kg/
/m2 vs. 22,19 ± 3,47 kg/m2), a tak偶e wy偶sze st臋偶enia
trigliceryd贸w (1,60 ± 1,28 mmol/l vs. 0,85 ±
0,39 mmol/l) i insuliny (37,48 ± 55,77 µjm./ml vs.
16,70 ± 14,67 µjm./ml) w surowicy w stosunku do
grupy kontrolnej. Nie wykazano istotnej statystycznie
r贸偶nicy w st臋偶eniach leptyny, cholesterolu ca艂kowitego,
frakcji LDL ani frakcji HDL w grupie badanej w stosunku
do grupy kontrolnej. Wykazano istotn膮 dodatni膮
korelacj臋 mi臋dzy st臋偶eniami insuliny, leptyny, tr贸jgliceryd贸w
i BMI. Wywiad rodzinny w kierunku nadci艣nienia
t臋tniczego by艂 istotnie cz臋艣ciej obci膮偶ony w grupie
os贸b choruj膮cych na nadci艣nienie (80,3% vs. 40,0%).
Wnioski U m艂odych os贸b st臋偶enie leptyny koreluje
z BMI, st臋偶eniem insuliny i tr贸jgliceryd贸w, ale nie
z nadci艣nieniem t臋tniczym. Osoby z pierwotnym
nadci艣nieniem t臋tniczym i nadmiern膮 mas膮 cia艂a
charakteryzuj膮 si臋 wy偶sz膮 insulinemi膮.Background In subjects with primary arterial hypertension
often coexists excessive body mass and metabolic abnormalities
like hiperleptinemia, increased insulin resistance, higher
total cholesterol and LDL-cholesterol concentrations and
lower HDL-cholesterol level. The role of each of these abnormalities
itself in elevation of blood pressure or arterial
hypertension development remains controversial.
The aim of this paper was to estimate concentrations
of leptin, insulin, lipid profile and body mass index in
young population with primary arterial hypertension.
Material and methods 56 patients aged 16-31 with essential
arterial hypertension were qualified to this study. The
control group consisted of 10 carefully selected healthy people
according to sex and age. The anthropometric, blood
pressure and heart rate measurements were taken. In blood
serum the concentration of leptin and insulin, total cholesterol,
triglycerides and LDL and HDL-cholesterol were
assessed.
Results In the group of people with arterial hypertension
compared to the control group significantly higher values
of systolic (138.8 ± 13.2 mm Hg vs. 113.4 ± 8.4 mm Hg)
and diastolic (81.9 ± 8.4 mm Hg vs. 71.4 ± 7.3 mm Hg)
blood pressure, body mass (87.02 ± 25.10 kg vs. 62.93 ± 12.77 kg) and BMI (27.26 ± 6.29 kg/m² vs. 22.19 ± 3.47
kg/m²) and increased values of triglycerides (1.60 ± 1.28
mmol/l vs. 0.85 ± 0.39 mmol/l) and insulin (37.48 ±
55.77 µIU/ml vs. 16.70 ± 14.67 µIU/ml) concentrations
were observed. The assessment did not reveal significant
differences in leptin, total cholesterol, LDL-cholesterol,
HDL-cholesterol concentrations and heart rate
between the examined and the control group. The positive
family history through arterial hypertension occurred
more frequently in the examined group (80.3%
vs. 40.0%).
Conclusions In young adults the leptin concentration correlates
with BMI and insulin concentration but not with
arterial hypertension. Subjects with essential arterial hypertension
and excessive body mass have higher levels of
insulin concentration
The estimation of intima–media thickness and selected metabolic parameters in young population with essential arterial hypertension
Wst臋p Obecno艣膰 czynnik贸w ryzyka sercowo-naczyniowego
mo偶na stwierdzi膰 ju偶 w populacji wieku
rozwojowego. W tym czasie nie dochodzi jeszcze do
rozwoju mia偶d偶ycogennych jednostek klinicznych,
ale wczesna identyfikacja os贸b w populacji zagro偶onej
jest priorytetem.
Materia艂 i metody Do badania zakwalifikowano 37
chorych z pierwotnym nadci艣nieniem t臋tniczym, dotychczas
nieleczonych. Wykonano badania antropometryczne,
dokonano pomiaru ci艣nienia t臋tniczego,
oznaczono st臋偶enia cholesterolu ca艂kowitego i tr贸jgliceryd贸w.
Pomiaru grubo艣ci IMC t臋tnic szyjnych wsp贸lnych dokonano metod膮 ultrasonograficzn膮.
Grup臋 kontroln膮 stanowi艂o 21 odpowiednio dobranych
zdrowych os贸b.
Wyniki W grupie os贸b z nadci艣nieniem t臋tniczym
stwierdzono znamiennie wi臋ksze warto艣ci masy cia艂a
i BMI, zwi臋kszone warto艣ci cholesterolu i tr贸jgliceryd贸w
w stosunku do grupy kontrolnej. Wykazano,
偶e w grupie z nadci艣nieniem t臋tniczym grubo艣膰
IMC by艂a wi臋ksza ni偶 u os贸b zdrowych i wynosi艂a
odpowiednio: w prawej t臋tnicy szyjnej wsp贸lnej:
0,057 ± 0,019 cm, w lewej: 0,052 ± 0,015 cm.
W grupie os贸b z populacji kontrolnej 艣rednia grubo艣膰
IMC w prawej i lewej t臋tnicy szyjnej wsp贸lnej
by艂a taka sama i wynosi艂a 0,041 ± 0,001 cm.
Wnioski
1. W populacji m艂odych doros艂ych z pierwotnym
nadci艣nieniem t臋tniczym stwierdza si臋 obecno艣膰 licznych
czynnik贸w ryzyka sercowo-naczyniowego,
w tym zwi臋kszon膮 grubo艣膰 IMC t臋tnic szyjnych.
2. Pomiar grubo艣ci IMC t臋tnic szyjnych u m艂odych
os贸b z nadci艣nieniem t臋tniczym jest jedn膮 z nieinwazyjnych
metod oceny zaawansowania procesu
mia偶d偶ycowego, koreluj膮c膮 z obecno艣ci膮 innych
czynnik贸w ryzyka.Background The presence of cardio-vascular risk factors
could already been stated in developmental age. In this
time the disease entities connected with atheromatosis have
not been yet developed although early identification of people
from risk population is the priority.
Material and methods 37 treatmentnaive patients with essential
arterial hypertension were qualified to this study.
The anthropometric and blood pressure measurements
were taken. The concentration of total cholesterol and
triglicerides were assessed. The common carotid artery intima-media thickness (cIMT) was estimated by high-resolution
B-mode ultrasound. The control group consisted
of 21 properly chosen healthy people.
Results In arterial hypertension group compared to control
group significantly higher values of body weight and
body mass index (BMI) and increased values of total cholesterol
and triglicerides concentrations were found. The
values of intima-media thickness were higher in group
of hypertensive youths compared to healthy ones. They
equal respectively 0.057 ± 0.019 cm in right common carotid
artery and 0.052 ± 0.015 cm in left common carotid
artery. The values in both common carotid arteries in control
group were the same and equal 0.041 ± 0.001 cm. Conclusions 1. In the population of young adults with
essential hypertension numerous cardio-vascular risk factors
including higher common carotid artery intima–media
thickness were present. 2. The estimation of carotid
artery intima–media thickness in young hypertensive
adults is one of the noninvasive methods of assessment of
atherogenesis progression with correlation of other risk
factors