Serum ADMA concentration – an independent factor determining FMD impairment in cardiac syndrome X

Mechanisms of decreased endogenous vascular reactivity in individuals with cardiac syndrome X (CSX) are not fully understood

Regular consumption of vitamin D-fortified yogurt drink (Doogh) improved endothelial biomarkers in subjects with type 2 diabetes: a randomized double-blind clinical trial

<p>Abstract</p> <p>Background</p> <p>Endothelial dysfunction has been proposed as the underlying cause of diabetic angiopathy that eventually leads to cardiovascular disease, the major cause of death in diabetes. We recently demonstrated the ameliorating effect of regular vitamin D intake on the glycemic status of patients with type 2 diabetes (T2D). In this study, the effects of improvement of vitamin D status on glycemic status, lipid profile and endothelial biomarkers in T2D subjects were investigated.</p> <p>Methods</p> <p>Subjects with T2D were randomly allocated to one of the two groups to receive either plain yogurt drink (PYD; containing 170 mg calcium and no vitamin D/250 mL, n₁= 50) or vitamin D3-fortified yogurt drink (FYD; containing 170 mg calcium and 500 IU/250 mL, n₂= 50) twice a day for 12 weeks. Anthropometric measures, glycemic status, lipid profile, body fat mass (FM) and endothelial biomarkers including serum endothelin-1, E-selectin and matrix metalloproteinase (MMP)-9 were evaluated at the beginning and after the 12-week intervention period.</p> <p>Results</p> <p>The intervention resulted in a significant improvement in fasting glucose, the Quantitative Insulin Check Index (QUICKI), glycated hemoglobin (HbA1c), triacylglycerols, high-density lipoprotein cholesterol (HDL-C), endothelin-1, E-selectin and MMP-9 in FYD compared to PYD (<it>P </it>< 0.05, for all). Interestingly, difference in changes of endothelin-1, E-selectin and MMP-9 concentrations in FYD compared to PYD (-0.35 ± 0.63 versus -0.03 ± 0.55, <it>P </it>= 0.028; -3.8 ± 7.3 versus 0.95 ± 8.3, <it>P </it>= 0.003 and -2.3 ± 3.7 versus 0.44 ± 7.1 ng/mL, respectively, <it>P </it>< 0.05 for all), even after controlling for changes of QUICKI, FM and waist circumference, remained significant for endothelin-1 and MMP-9 (<it>P </it>= 0.009 and <it>P </it>= 0.005, respectively) but disappeared for E-selectin (<it>P </it>= 0.092). On the contrary, after controlling for serum 25(OH)D, the differences disappeared for endothelin-1(<it>P </it>= 0.066) and MMP-9 (<it>P </it>= 0.277) but still remained significant for E-selectin (<it>P </it>= 0.011).</p> <p>Conclusions</p> <p>Ameliorated vitamin D status was accompanied by improved glycemic status, lipid profile and endothelial biomarkers in T2D subjects. Our findings suggest both direct and indirect ameliorating effects of vitamin D on the endothelial biomarkers.</p> <p>Trial registration</p> <p>ClinicalTrials.gov: <a href="http://www.clinicaltrials.gov/ct2/show/NCT01236846">NCT01236846</a></p

Exclusion from service consumption in Polish health care system

Purpose: The scientific objective of this research was to determine social groups affected by exclusion in Polish health care. Materials and methods: Survey was carried out among local government units and nongovernmental organizations by using authorial questionnaire distributed towards representative research group selected. Results: This work depicts activities of social welfare centers in cooperation with non-profit sector entities, in the field of exclusion from the access to health care benefits in Poland, appointing circumstances, causes and the range of this exclusion. It presents the results of the countrywide research in the context of structure and tasks of the health care, but also two points of view (institutional and social one) for resolving the same population issues. Conclusions: On the basis of the conducted analyses it has been stated that social exclusion, in the field of health care, is a significant social problem, but the biggest difficulty is the access to the rehabilitation benefits and pharmacological therap

Ocena metabolizmu kostnego i ryzyka złamań u otyłych mężczyzn

INTRODUCTION: Obesity and metabolic syndrome are increasingly common in the adult population. There is a well- -known relationship between those two conditions and cardiovascular diseases; nonetheless, not much is known about how obesity and metabolic syndrome affect bone metabolism and fracture risk. The study aimed to assess the parameters of bone metabolism, as well as assess their relationship with the risk of fractures in obese men with central obesity and metabolic syndrome, and to compare the obtained results with those of healthy controls. MATERIAL AND METHODS: The study involved 36 obese men (body mass index – BMI ≥ 30) with central obesity (waist circumference – WC ≥ 94) and 10 healthy men as controls, aged 54–77. The FRAX (Fracture Risk Assessment Tool) calculator was used to measure the 10-year fracture risk. The levels of bone metabolism markers osteoprotegerin (OPG), C-terminal telopeptide (CTX1), and fibroblast growth factor 23 (FGF-23) were determined in the patients. RESULTS: The FRAX parameter was significantly lower (p < 0.001) in the obese men when compared to the controls. A significant negative correlation between FRAX and BMI (p < 0.001) was observed in the obese men, but not in the healthy subjects. There was also a negative correlation between FRAX and WC (p < 0.001), again only among the obese subjects. A positive correlation (p < 0.01) between FGF-23 and FRAX was found in the non-obese group. CONCLUSIONS: Obese men have a lower 10-years fracture risk compared to the healthy controls. Additionally, the increased BMI and waist circumference in the obese men were found to be associated with a reduced bone fracture risk, whereas no similar relationship in controls was observed. Moreover, higher FGF-23 levels in the healthy males was correlated with an increased 10-year fracture risk.WSTĘP: Otyłość oraz zespół metaboliczny coraz częściej występują w populacji osób dorosłych. Powszechnie znany jest związek wymienionych zaburzeń ze zwiększonym prawdopodobieństwem wystąpienia chorób układu sercowo-naczyniowego, jednakże mniej oczywisty jest ich wpływ na metabolizm kostny oraz ryzyko złamań. Celem badania była ocena parametrów metabolizmu kostnego, ich związku z ryzykiem złamań u otyłych mężczyzn z otyłością brzuszną oraz zespołem metabolicznym, a także porównanie uzyskanych wyników z wynikami osób zdrowych. MATERIAŁ I METODY: W badaniu wzięło udział 36 otyłych mężczyzn (body mass index – BMI ≥ 30) ze współistniejącą otyłością trzewną (obwód talii – waist circumference – WC ≥ 94) oraz 10 zdrowych mężczyzn z grupy kontrolnej, w wieku 54–77 lat. Do oceny ryzyka złamań zastosowano kalkulator FRAX (Fracture Risk Assessment Tool). U pacjentów oznaczono stężenia markerów metabolizmu kostnego: osteoprotegeryny (OPG), C-końcowego usieciowanego telopeptydu łańcucha kolagenu typu I (CTX1) oraz czynnika wzrostu fibroblastów 23 (fibroblast growth factor 23 – FGF-23). WYNIKI: U osób otyłych FRAX był istotnie niższy (p < 0,001) niż w grupie kontrolnej. Zaobserwowano ujemną korelację między FRAX i BMI (p < 0,001) u otyłych mężczyzn. U zdrowych osób taka korelacja nie wystąpiła. Jedynie u osób otyłych stwierdzono również ujemną korelację między FRAX i WC (p < 0,001). Obecnej w grupie osób zdrowych pozytywnej korelacji (p < 0,01) między FGF-23 i FRAX nie obserwowano u otyłych mężczyzn. WNIOSKI: U otyłych mężczyzn stwierdzono mniejsze 10-letnie ryzyko złamań w porównaniu z osobami zdrowymi. Dodatkowo wykazano, że w grupie pacjentów otyłych większe BMI oraz obwód talii wiązały się z mniejszym ryzykiem złamań kości, natomiast u osób bez otyłości taka zależność nie występowała. Ponadto u zdrowych mężczyzn większe stężenie FGF-23 było skorelowane ze zwiększonym 10-letnim ryzykiem złamań