IntroductionObesity and inadequate vitamin D status are associated with endothelial dysfunction and cardiovascular disease. We evaluated the associations between vitamin D status (i.e. serum levels of 25-hydroxyvitamin D (25(OH)D)), biomarkers of endothelial dysfunction (i.e. serum concentrations of soluble intercellular adhesion molecule 1 (sICAM-1) and soluble E-selectin (sE-selectin)), inflammatory markers (i.e. high-sensitivity C-reactive protein (hsCRP) and fibrinogen) and cardiometabolic risk factors.Material and methodsFifty obese (body mass index (BMI) ≥ 30 kg/m2) non-diabetic adults (mean age: 36.2 ±5.4 years) without pre-existing cardiovascular abnormalities and 25 clinically healthy, normal weight and age-matched individuals were included. Anthropometric parameters, markers of glucose and lipid metabolism, and serum levels of inflammatory and endothelial dysfunction biomarkers were assessed in all subjects.ResultsThe mean serum 25(OH)D level was significantly lower in the obese group than in controls (33.5 ±15.2 vs. 60.1 ±23.1 nmol/l; p < 0.001). In the obese group, sE-selectin (36.4 (32.1–47.2) vs. 32.4 (24.6–35.5) ng/ml, p < 0.05) and hsCRP (6.0 ±3.4 vs. 3.5 ±1.0 mg/l, p < 0.05) were significantly higher in individuals with lower than median vitamin D levels (i.e. 31 nmol/l) compared with those with higher vitamin D levels. In multivariable linear regression analysis, hsCRP (β = –0.43; p < 0.001) and sE-selectin (β = –0.30; p = 0.03) were independently and significantly associated with serum 25(OH)D levels in the obese group.ConclusionsVitamin D levels may be related to increased levels of biomarkers of endothelial dysfunction and inflammation in obese non-diabetic individuals.
Background: Endothelin-1 (ET-1) is potent vasoconstrictor peptide which is able to contribute to the functional and structural renal changes. The aim of this study was to investigate the relationship between plasma concentration of ET-1 and indices of renal function in patients with diabetic nephropathy. Methods: We measured plasma ET-1 levels in 99 patients with type 2 diabetes, divided into two groups according to the values of their glomerular filtration rate (GFR): group I (GFR ! 60 mL/min/1.73 m
SummaryBackgroundChronic kidney disease (CKD) is one of the most significant global health problems accompanied by numerous complicatons, with constant increase in the number of affected people. This number is much higher in early phases of disease and patients are mostly asymptomatic, so early detection of CKD is crucial. The aim was examination of the prevalence of CKD in the general population of males in Vojvodina, based on estimated glomerular filtration rate (eGFR) and urine albumin/creatinine ratio (ACR), and exploring the determinants and awareness of CKD.MethodsThis cross-sectional study included 3060 male examinees from the general population, over 18 years of age, whose eGFR and ACR were calculated, first morning urine specimen examined, arterial blood pressure measured and body mass index calculated. Standard biochemistry methods determined creatinine, urea, uric acid and glucose serum concentrations as well as albumin and creatinine urine levels.ResultsPrevalence of CKD in the adult male population is 7.9%, highest in men over 65 years of age (46.7%), while in the other age groups it is 3.6–12.6%. The largest number of examinees with a positive CKD marker suffer from arterial hypertension (HTA) and diabetes mellitus (DM). Only 1.3% of examinees with eGFR<60 ml/min/1.73 m2 and/or ACR≥ 3 mg/mmol had been aware of positive CKD biomarkers.ConclusionsObtained results show the prevalence of CKD in adult males is 7.9%, HTA and DM are the most important CKD risk factors and the level of CKD awareness is extremely low (1.3%) indicating the necessity for introduction of early stage disease recognition measures, including raising CKD awareness.
Background: Biomarkers are commonly used to estimate the presence of subclinical cardiovascular disease (CVD) in patients with essential arterial hypertension (HT). In addition to known association between cystatin C and glomerular filtration rate (GFR), elucidating the association between cystatin C and vascular biomarkers (intima-media thickness of common carotid arteries (CCIMT), carotid plaque and renal artery resistance index (RRI)) in patients with unresponsive hypertensive phenotype could be of significant clinical interest.Methods: Participants (n = 200, median age 58 (52–64) years, 49% female) under treatment with antihypertensive drugs were stratified into two subgroups based on their blood pressure level as having responsive hypertension (RHT – compliant and responsive to treatment, n = 100), or nonresponsive (URHT – compliant but nonresponsive to treatment, n = 100). GFR was measured by isotopic (slope-intercept) method (99m Tc diethylene triamine penta-acetic acid – mGFR).Results: The URHT group had significantly higher median cystatin C serum concentration (p = 0.02) and CCIMT (p = 0.00) compared to the RHT group, with no significant difference in RRI (p = 0.51) and mGFR among subgroups [69.9 ± 28.2 vs 76.74 ± 23.61 ml/min/1.73m2, p = 0.27]. In the URHT group, cystatin C was found to be associated with CCIMT (p = 0.02), hsCRP (p = 0.01) and duration of HT (p = 0.02), independently of mGFR and age. Independent predictors of URHT phenotype were CCIMT (p= 0.02) and hsCRP (p= 0.04).Conclusion: In addition to GFR, cystatin C serum concentration is positively and independently associated with CCIMT in patient with URHT phenotype and subclinical CVD. Prospective larger studies should further investigate the clinical importance of this relationship.
CLMD and vitamin D deficiency may commonly be present in obese non-diabetic subjects. Individually and combined, both deficiencies predispose non-diabetic patients to increased risk of cardiometabolic diseases. Maintaining normal Mg status may improve the beneficial effects of vitamin D on cardiometabolic risk indicators.
Introduction: Obesity is associated with wide variety of electrocardiographic (ECG) abnormalities. Prolonged QTc interval is common in obesity and it represents a delayed ventricular repolarisation which is associated with ventricular arrhythmias, syncope and sudden cardiac death. The aim of our study is to evaluate the effects of weight reduction on QTc interval in obese subjects. Materials and Methods: The study included 74 obese subjects aged 41.78 ± 10.70 years, treated with a lowcalorie diet (800 kcal/day) for two weeks. All patients underwent a standard resting 12-lead surface ECG before and after the treatment. QTc intervals were corrected by Bazett's formula. Results: The average loss in body weight was 10.26 ± 3.63%, and the average reduction in body mass index was 9.39 ± 4.23%. There were statistically significant differences for all electrocardiographic parameters (p<0.01) except for the QTc dispersion (p>0.05) before and after the treatment with low-calorie diet. Heart rate was also statistically significant reduced after the low-calorie diet treatment. Prevalence of prolonged QTc interval was 24.32% before and 9.21% after the treatment. Conclusion: The results show that obesity causes prolongation of QTc interval. Significant weight reduction of about 10% leads to favorable electrocardiographic changes and significant shortening of the QTc interval.
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