Amorin Remus Popa

Prevalence of diabetes mellitus and prediabetes in the adult Romanian population: PREDATORR study†

The PREDATORR (PREvalence of DiAbeTes mellitus, prediabetes, overweight, Obesity, dyslipidemia, hyperuricemia and chronic kidney disease in Romania) study is the first national study analyzing the prevalence of diabetes mellitus (DM) and prediabetes, and their association with cardiometabolic, sociodemographic, and lifestyle risk factors in the Romanian population aged 20–79 years.

Epidemiology of Diabetes Mellitus: A Current Review

Abstract Diabetes mellitus represents worldwide an extremely important public health problem considering its high prevalence, the serious complications triggered by the disease, the associated rate of mortality and, not the least, the extremely high economic and social costs. In 1995 approximately 135 million persons were affected by diabetes and an increase of 300 million cases was estimated by the year 2025. At the end of 2012 a number of 347 million persons with diabetes was estimated, with a prediction of 552 million cases in 2030, that is 9.9% from the world’s adult population. The question asked on an annual basis is: „Diabetes where do we go? Can we stop the dramatic evolution?”

Evolution assessment of head and neck infections in diabetic patients – A case control study

This research aimed to assess the occurrence and progression of head and neck infections in diabetic compared to non-diabetic patients. A retrospective study was carried out over a period of 10 years in 899 patients with head and neck infections. The patients who met the inclusion criteria were divided into cases and controls according to the presence/absence of diabetes. Seventy-three patients (8%, 95% CI [6.45%-10.12%]) were included in the case group and 826 (92%, 95% CI [89.87%-93.55%]) were assigned to the control group. The extension of the infection proved to be significantly (p < 0.001) higher in diabetic patients compared to non-diabetic patients. The difference between the two groups was statistically significant (Mann-Whitney U statistics = 18205.500, p < 1.56 · 10(-8)). A more than 10 year history of diabetes was statistically related to a wider extent of head and neck infections (p < 0.001). Diabetes proved to be associated with large necrotic areas and the spread of head and neck infections to more than two cavities.

The prediction and assessment of cardiovascular and renal disease in type 2 diabetes. A current review

Abstract According to the current guidelines all type 2 diabetes (T2DM) subjects are at high cardiovascular (CV) risk. Scientists are researching the issue of further risk stratification among already high-risk patients, improved cost-effective risk stratification tools being under development. The assessment of the CV risk with the help of prediction models developed for the general population is considered to be not accurately enough for high risk individuals, therefore the current interest for identifying novel biomarkers and the development of specifically designed risk-scores for individuals with diabetes.

THE RELATION BETWEEN METABOLIC SYNDROME AND TESTOSTERONE LEVEL

Abstract Metabolic syndrome is a group of conditions that increases the risk of developing diabetes and cardiovascular diseases. The most important pathogenic factors for metabolic syndrome are insulin resistance and obesity. The clinical presentation of this syndrome results from its influence on glucose and fat metabolism. Testosterone deficiency has a prevalence of up to 50% in men with metabolic syndrome and type 2 diabetes mellitus. A low level of testosterone is a factor for cardiovascular diseases and predictor of metabolic syndrome and, on the other hand, the components of metabolic syndrome can lead to low testosterone. This article reveals the bidirectional link between low testosterone level or hypogonadism and metabolic syndrome.

Nocturnal Hypoglycemia in Type 2 Diabetes

Abstract Background and aims: It is known that the majority of critical unacknowledged hypoglycemia has an increased incidence in patients with type 1 diabetes (T1DM) with a long evolution. The aim of this research is to evaluate the variability of glucose level and hypoglycemic events in patients with type 2 diabetes (T2DM) having pharmacological interventions with hypoglycemic risk. These events are sometimes asymptomatic also in T2DM: frequently in elderly, patients with autonomic neuropathy, or having a long evolution of disease. Material and method: This analysis includes 72 patients with T2DM, with a relative good metabolic control, and possible glucose fluctuations. Glucose variability was appreciated using continuous glucose monitoring systems (CGMS) used for more than 72 hours in hospital or ambulatory setting. Results: The incidence, duration and severity of hypoglycemia are not correlated with HbA1c value, age, disease duration or treatment. Approximately a quarter of patients had nocturnal hypoglycemia and in 37,5% of events hypoglycemia was prolonged, more 45 minutes. Clinical manifestations in diurnal hypoglycemia were presents in only 40% of the recorded events. Conclusions: The study suggested that CGMS is beneficial for patients with type 2 diabetes, with hypoglycemic risk and complications, to adjusted medication, education and prevention the cardiovascular events.

Predictive Value of Updating te Score Cardiovascular Risk Assessment Engine with Novel Biomarkers in a Type 2 Diabetes Population

Abstract Background and Aims: The aim of the study was to estimate the predictive value of some new biomarkers in the assessment of cardiovascular disease (CVD) risk in a type 2 diabetes (T2DM) population and to perform a correlation between the SCORE risk results and the risk profile estimated by the use of these biomarkers. Finally, we aimed to establish if the CVD risk assessment can be improved by adding the biomarkers into the SCORE risk equation. Material and Methods: In the study population the CVD risk assessment was performed using the SCORE High Risk Chart. The new individual biomarkers were: estimated glomerular filtration rate (eGFR), urinary albumin excretion (UAE) rate, albumin/creatinine ratio (UACR), cystatin C, plasminogen activator inhibitor-1 (PAI-1), high-sensitivity C-reactive protein (hs-CRP), high density lipoprotein cholesterol (HDL) and apolipoprotein B (apo-B). Results: The SCORE risk prediction model results were significantly altered by adding in the equation apo-B and HDLc values. An increase of one standard deviation of the apo-B values caused the increase of the SCORE results with 0.19 standard deviations while an increase of one standard deviation of the HDLc values decreased the SCORE results with 0.26 standard deviations. Conclusions: Advanced lipid testing, including the measurement of apo-B, provides a more comprehensive cardiac risk assessment and should be used in the development of specifically designed risk-scores for T2DM individuals.

Abdominal Obesity – A Cardiometabolic Risk Factor

Abstract Background and aims: In the modern society, obesity represents an important health issue, both because the great number of obese patients in the developed and developing countries and the complications that occur in obese patients, accompanied by an increased risk for cardio-metabolic complications, cancer and death. Material and methods: Among the numerous data recorded in the literature, I made reference to about 30 articles supporting certain hypotheses or truths regarding the pathogenesis of obesity and its cardio-metabolic consequences.

Orectic And Anorectic Peptides And Their Implication In Obesity And The Metabolic Syndrome

Abstract Background and aims: Cardiovascular diseases, diabetes mellitus, the metabolic syndrome and obesity are now globally widespread clinical conditions, addressing different ages, lately extending to young and children. The causes are multiple, involving an interaction between individual genetic risk factors and environmental factors. Many studies showed the importance of the hypothalamic neuropeptides and other neuropeptides in the regulation of the balance between food intake and energy consumption. We reviewed 25 recent research studies describing the physiological and physiopathological mechanisms of the orectic and anorectic peptides and their interaction to adjust the balance between food intake and energy expenditure. Conclusions: The hypothalamus, through its nuclei (arcuate and paraventricular) controls the balance between food intake and energy expenditure. The proopiomelanocortin (POMC) / Cocaine and amphetamine-related transcript (CART) neurons represent the anorectic centre. The neurons that release neuropeptide Y (NPY) and agouti-related protein (AgRP) by stimulation form the orectic centre. The neuropeptide Y (NPY) is the main hypothalamic orectic neuropeptide. Its action, besides stimulating the orectic effect, is to modulate the release of other hypothalamic orectic and anorectic neuropeptides. In addition, the energy balance is regulated by adipokines released by the adipose cells, hormones and neurotransmitters, blood glucose level and other metabolites.

An Epidemiological Study Regarding Obesity Prevalence In A Rural Area Of Bihor County

Abstract Background and aims: A high prevalence of obesity is found at global and national level, representing an important problem for the public health. The purpose of this work was to develop preventive medicine by performing an epidemiological study in order to identify people with obesity. We also aimed to analyze obesity prevalence and the influence of the family medical history of obesity in the analyzed population segment. Material and methods: Between 2011 and April 2014 we have been working on a descriptive, observational study in a rural zone of Bihor County – the Curtuiuseni village. Results: In a relatively young population (average age around 50 years) the obesity prevalence was high (21.41%). The risk of obesity in the population with a positive family history of obesity was 2.2 higher compared with the population without. Abdominal obesity was more frequent in females (59.24%) than males (34.27%). Conclusion: We found a high prevalence of obesity (21.41%) in a rural population of Bihor County, but lower than the country average (31.40%). Pathological waist circumference, representing a risk factor for cardiometabolic diseases, was found in 48.32% of cases.