G. Paragh

Relationship of Serum Resistin Level to Traits of Metabolic Syndrome and Serum Paraoxonase 1 Activity in a Population with a Broad Range of Body Mass Index

UNLABELLED The relationship between resistin, one of the adipokines, and metabolic syndrome is not fully elucidated. Altered activity of the HDL-associated antioxidant enzyme paraoxonase 1 (PON1) that participates in the antioxidant defense mechanisms of HDL may have an important role in the obesity-related accelerated atherosclerosis. Inverse associations of PON1 with obesity and serum levels of leptin have been demonstrated. Our aim was to investigate the association of serum levels of resistin with (i) PON1 activity, and (ii) parameters of metabolic syndrome, including some that are additional for research. A total of 74 Caucasian subjects were recruited into the study and divided into 3 age and sex-matched groups. Group 1, 25 non-diabetic overweight/obese subjects with BMI of 28-39.9 kg/m (2); group 2, 25 non-diabetic obese patients with BMI >or=40 kg/m (2); and the control group 3, 24 healthy, normal-weight control subjects. Serum levels of resistin were correlated negatively with BMI (r=-0.27, P<0.05), waist circumference (r=-0.28, P<0.05), serum levels of leptin (r=-0.28, P<0.05), non-esterified fatty acids (NEFA) (r=-0.23, P<0.05), and HbA (1C) (r=-0.26, P<0.05), systolic BP (r=-0.28, P<0.05), and lipid peroxidation (measured by TBARS) (r=-0.40, P<0.01), and correlated positively with PON1 (r=0.24, P<0.05). No association was detected between the serum concentrations of resistin and the following investigated parameters: diastolic BP, levels of uric acid, glucose, insulin, or insulin resistance (measured by homeostasis model assessment, HOMA-IR), triglyceride, total cholesterol, LDL-C, and HDL-C. During multiple regression analyses BMI and TBARS were independent predictors of PON1, while age, gender, blood pressure, HOMA-IR, LDL-C, HDL-C, and resistin were not. CONCLUSIONS Among the study subjects, serum levels of resistin showed a positive, although not independent correlation with serum PON1, and a negative correlation with numerous parameters of the metabolic syndrome (i.e. adiposity, blood pressure, levels of leptin, free fatty acid, glycosylated hemoglobin, and lipid peroxidation). BMI and TBARS are independent predictors of PON1 activity.

The Importance of Bioimpedance (BIA) Analysis and Cardio Tens (24-h ABPM and ECG) Monitoring in the Dialysis Programme

The authors performed bioimpedance analysis and Cardio Tens (24-h ABPM and ECG) monitoring in 66 patients (28 males, 38 females) treated in the chronic haemodialysis programme. They investigated the correlations between the body weights before, during and after dialysis, the changes of the water compartments and fat body weight, and the recorded values of blood pressure and ECG alterations. On the basis of the measurements by this non-invasive method it is concluded that, as a result of dialysis and ultrafiltration, the total body weight and total body water are decreasing in a greater extent in men than in women. By gradually decreasing the body weight, the optimal dry weight could be attained, which resulted in the reduction of blood pressure or even normotension. In the course of dialysis the values of bioimpedance and bioreactance increase. The intradialytic hypotensive indispositions were accompanied by a significant reduction of bioreactance (n=16). The BMI, total body weight and total body water hyperlipidaemic, hypalbuminic patients with treatment-resistant hypertension are considerably larger than those of the patients with normal blood pressure (p<0.01). During Cardio Tens monitoring 53% of the patients proved to be dippers, 47% of whom had ST depression, while in 73% of the non-dippers ischaemic alterations were encountered together with high hyperbaric impact values. The total body weights and total water compartments of patients returning to dialysis with an excess body weight of more than 3.5 kg were significantly larger than of patients who were cooperative and had no oedemas. In the last hour of dialysis and during the following few hours, arrhythmias and ST depressions of the cardiovascularly instable patients appeared more frequently. The total water compartments of these patients are significantly larger than normotensive, normolipaemic patients with appropriate serum albumin concentrations. The importance of the BIA and Cardio Tens monitoring in determining the optimal dry body weight and improving the cardiovascular condition of the patients is emphasized.

Clinical significance of and treatment options for increased lipoprotein(a)

Lipoprotein(a) has been shown to be associated with an increased incidence of cardiovascular diseases for decades. However, only recent research revealed more about its physiological function and its role in the development of cardiovascular diseases. The authors summarize the physiological role of lipoprotein(a), causes and treatment of elevated lipoprotein(a) level, and the association between lipoprotein(a) and cardiovascular diseases.

[Becoming more "goal-oriented" in therapy of dyslipidemias: results of the Hungarian MULTI GAP 2010].

A korabbi vizsgalatok azt mutattak, hogy a nagy kockazatu betegek jelentős resze nem eri el az LDL-C-celertekeket, es az alkalmazott lipidcsokkentő kezeles ellenere az ajanlottnal magasabb trigliceridszinttel es alacsony HDL-C-szinttel is rendelkeznek. Celok: A szerzők a 2008. es 2009. evi felmeresekhez hasonloan, a jelen vizsgalatban is a cardiovascularis esemenyen atesett betegek dyslipidaemiajanak kezelesi strategiajat elemeztek. Modszerek: A MULTI GAP (MULTI Goal Attainment Problem) 2010 vizsgalatban standard strukturalt kerdőivek segitsegevel 2332 beteg adatai kerultek feldolgozasra. Az elemzesben az osszkoleszterin-, LDL-C- mellett a HDL-C- es atherogen koleszterin- (A-C), illetve a triglicerid-celerteket elerők aranya is kiertekelesre kerult. Eredmenyek: A vizsgalt betegek 15%-a (n = 355) nem reszesult lipidcsokkentő kezelesben. A szakorvosok altal kezelt betegek 44%-a elerte a 2,5 mmol/l LDL-C-celerteket. A HDL-C-celerteket a nagy rizikoju betegek 61%-a, mig a triglicerid-celerteket a betegek 43%-...

Noninvasive Pulse Wave Analysis for Monitoring the Cardiovascular Effects of Pneumoperitoneum During Laparoscopic Cholecystectomy

Aims: Peritoneal insufflation results in hemodynamic changes during laparoscopic cholecystectomy. The aim of the present work to test whether non-invasive applanation tonometry is suitable for reflecting these hemodynamic alterations. Patients and methods: 41 patients undergoing laparoscopic cholecystectomies were monitored using SphygmoCor pulse wave analysing system. Peripheral blood pressures (PBP), central aortic blood pressures (CBP), augmentation index (ALX@HR75) and subendocardial viability ration (SVR) were measured at rest (Phase 1), after anesthetic induction (Phase 2), after peritoneal inflation (Phase 3) and after peritoneal deflation. Results: Induction of anesthesia resulted in a statistically significant reduction in both the peripheral blood pressure and central aortic pressures, accompanied by a decrease in augmentation pressure and augmentation index. Peripheral blood pressures did not change markedly along with the peritoneal cavity insufflation, except for the moderate increase in systolic blood pressure. In contrast to this, a marked increase could be observed in central aortic pressure values that was accompanied by increased augementation pressure and augmentation index, indicating a rise in peripheral arterial stiffness. Conclusions: Sphigmocor pulse wave analysis system can be reliably used for detecting and monitoring cardiovascular changes occuring during laparoscopic cholecystectomy.