Jacek Brodowski

Fall Risk Factors in Community-Dwelling Elderly Depending on Their Physical Function, Cognitive Status and Symptoms of Depression

Falls are the leading cause of unintentional injuries and injury-related disability, morbidity and mortality in the geriatric population. Therefore, they may also lower quality of life. The aim of this study was to analyze the fall risk factors in the community-dwelling elderly depending on their physical function, cognitive status and symptoms of depression. The study involved 304 individuals aged 65–100 years with a mean age of 78.6 ± 7.4. This survey-based study was conducted using the Geriatric Environmental Inquiry, the Barthel Scale (BS), the Abbreviated Mental Test Score (AMTS), the Geriatric Depression Scale (GDS) and the Tinetti Test (TT). There was a statistically significant correlation between the BS, the TT and the incidence of falls (p < 0.05). The number of falls correlated significantly with the results of the BS (R = −0.39), the GDS (R = 0.18), and the TT (R = −0.40). A statistically significant correlation was also noted between the TT results and the results of the BS (R = 0.77), the AMTS (R = 0.40) and the GDS (R = −0.37). The incidence of falls may significantly increase in people with a lower functional status, which may be related to cognitive process disturbances and lower affective functioning. A comprehensive geriatric assessment, related to all aspects of advanced-age patients’ efficiency, is recommended. Fall prevention strategies should include actions undertaken to evaluate and treat depression and cognitive disturbances.

The bone mass density in postmenopausal women using hormonal replacement therapy in relation to polymorphism in vitamin D receptor and estrogen receptor genes

The aims of the study were as follows: (1) To identify the differences in spinal body mass density (BMD) in relation to polymorphism in vitamin D receptor (VDR) and estrogen receptor-α (ERα) genes in untreated women with postmenopausal osteoporosis. (2) To assess the efficacy of treatment in women with postmenopausal osteoporosis in relation to polymorphism in VDR and ERα genes. (3) To find the estradiol concentration necessary to protect bone tissue in patients with a given polymorphism in VDR and ERα genes. Methods. The study included 44 postmenopausal women with primary osteoporosis who used cyclic hormonal replacement therapy (HRT) for a year. The polymorphism of ERα and VDR genes were evaluated. We also determined the age, body mass index and spinal BMD before and after 12 months of administration the HRT. Results. We found a significant spinal BMD increase, what is connected with ERα genotype and both VDR and ERα genes. There is no such a correlation observed in polymorphism of VDR gene. Conclusions. (1) There is no relationship between VDR and ERα genes polymorphism and the stage of osteoporosis related to the spinal BMD value before treatment. (2) The XX, PP or Bb markers or only X, P, B alleles are connected with a significant decrease of treatment efficacy. (3) Estradiol serum concentration before and during HRT is not dependent on the polymorphism of VDR and ERα genes.

Serum Mg and Zn levels in postmenopausal women

Approximately 30% of a womans life is spent in the postmenopausal period. This is when steroid hormone deficiency is often accompanied by mineral homeostasis perturbations and deficiencies that could be related to the intensity of any clinical symptoms. The aim of this study was to assess how serum Mg and Zn levels in postmenopausal women correlate with climacteric symptoms, body mass index (BMI), and the time interval since the final menstruation. The study involved 171 healthy, postmenopausal women, who had had their final menstruation at least one year prior to the study and who did not use menopausal hormone therapy. Both hypomagnesaemia and hypozincaemia were detected in the postmenopausal women involved in this study. The analysis revealed statistically significant differences between serum Mg levels, depending on the time interval since the final menstruation (p<0.05). No statistically significant differences were found in serum Mg and Zn levels between women as regards the severity of the climacteric symptoms or BMI (p>0.05). In conclusion, serum Mg and Zn concentrations in postmenopausal women, not using MHT, were low. The average serum Mg levels decreased considerably with the time since the final menstruation. No correlation between BMI and worsening of climacteric symptoms and serum Mg and Zn concentrations in postmenopausal women, not using MHT was found.

Hormone concentrations in the homogenates of ovarian tissue and blood serum in postmenopausal women not using hormone therapy

Ovaries in postmenopausal women synthesize steroids, mostly androgens. Removal of the ovaries after menopause may be reflected by menopausal symptoms and arterial hypertension observed during postoperative period, along with a significantly increased risk of death due to cardiovascular complications. It is not understood if the clinical consequences of gonad removal at different time points after menopause are similar. The aim of this study was to evaluate ovarian steroidogenesis and consequently to define the role of the ovaries in postmenopausal women depending on the time after menopause. Concentrations of hormones were determined in ovarian homogenates and serum of postmenopausal women. This study included 207 postmenopausal women. They were divided into groups depending on the time after menopause. All participants had laparotomic removal of the ovaries. Concentrations of estradiol, testosterone and androstenedione were measured in ovarian homogenate and serum. The study revealed that ovarian homogenate and serum concentrations of estradiol, testosterone and androstenedione were the highest in women up to 5 years after menopause and since then significantly decreased. This study showed that testosterone, androstenedione and estradiol are synthesized in the postmenopausal ovaries. The peak synthesis of these hormones occurs up to 5 years after menopause and significantly decreases thereafter.

Searching for the relationship between the parameters of metabolic syndrome and the rs17782313 (T>C) polymorphism of the MC4R gene in postmenopausal women

Metabolic syndrome (MS) is widespread in the human population, and its incidence is continuously increasing, generating serious health problems. The purpose of this study was to find the relationship between the parameters of MS and the melanocortin type 4 receptor (MC4R) gene polymorphism in postmenopausal women. The study involved 344 healthy Polish women, who had their last menstrual cycle 1 year ago or earlier. The study included blood analysis, survey, and body measurements. The mean age was 58.5±6.6 years. An increased body mass index was observed in 65.7% and abdominal obesity in 80.3% of the study population. MS was diagnosed in 40.7% of all participants, including 39.3% of women with the T/T genotype and 44.7% of those with the C/X genotype (χ2 test; P>0.05). A logistic regression model showed that the probability of MS was higher in patients with the C/X genotype (odds ratio =1.25) (χ2 test; P>0.05). The study concluded that MS is a very common condition among postmenopausal women. The C/X genotype of the MC4R gene seems to predispose postmenopausal women to developing some MS symptoms.

The role of serological testing for Chlamydia trachomatis in differential diagnosis of pelvic pain.

INTRODUCTION Pelvic pain is typically associated with pelvic inflammatory disease (PID). The most common cause of PID is Chlamydia trachomatis. The aim of this study was to verify the role of serological testing for Chlamydia trachomatis in patients with suspected PID. MATERIALS AND METHOD The retrospective study included 185 patients with pelvic pain hospitalized at the Department of Obstetrics and Gynecology in 2003 and 2004. Titers of anti-Chlamydia trachomatisIgG and IgA were measured by means ELISA immunoassays. Erythrocyte sedimentation rate (ESR), serum concentration of C-reactive protein (CRP) and leukocyte count (WBC) were also determined. Final diagnosis was established on the basis of laparoscopic examination. RESULTS The presence of anti-Chlamydia trachomatis antibodies correlated significantly with abnormal values of ESR, WBC and CRP. The most common laparoscopic pathology were pelvic adhesions, typically found in women with elevated titers of anti-Chlamydia trachomatis IgG. Cconclusion. Serological examination for Chlamydia trachomatis is helpful in evaluation of patients with suspected PID. Elevated titers of anti-Chlamydia trachomatis antibodies are frequently associated with laparoscopic evidence of pelvic adhesions and inflammation.

Association between depression, parameters of adiposity and genetic polymorphisms of pro-inflammatory cytokines: IL-1α, IL-1β, IL-2 and IL-6 in subjects over 55 years old

BACKGROUND During the last few decades, adiposity has become a relatively common phenomenon worldwide. The available data on the effects of pro-inflammatory factors in both depression and adiposity has been attracting great attention. AIM We sought to assess the prevalence of -889C>T IL-1α, -31T>C and -511C>T IL-1β, -330T>G IL-2 and -174G>C IL-6 genes and their association with adiposity and depression in Polish subjects. METHODS A cohort study was conducted in 2013/2014, covering a sample of 297 individuals (217 female and 80 male). Anthropometric data was handled using the BIA analysis method, while for genotyping PCR-RFLP techniques were used. RESULTS A positive correlation between depression and anthropometric parameters: adipose tissue (in kg) and adipose tissue (in %) (R=0.135 and p=0.02, R=0.114 and p<0.05, respectively) was found. No association between studied polymorphisms and depression was observed. CONCLUSION Although it was not possible to demonstrate any influence of the studied polymorphisms as the genetic modulator of depression, authors believe that the presented data are noticeable and may provide the basis for future studies on larger groups.

Associations between the components of metabolic syndrome and the polymorphisms in the peroxisome proliferator-activated receptor gamma ( PPAR-γ ), the fat mass and obesity-associated ( FTO ), and the melanocortin-4 receptor ( MC4R ) genes

Introduction: Metabolic syndrome (MetS) is regarded as a set of abnormalities, increasing the risk of serious functioning disorders. It can develop as a result of genetic predisposition. Aim: The aim of this study was to establish associations between MetS-related abnormalities and the PPAR-γ rs1801282, FTO rs9939609, and MC4R rs17782313 polymorphisms. Material and methods: The study involved 425 women aged 45-60 years. The participants were surveyed and subjected to anthropometric, biochemical and genetic analysis. Results:In the recessive inheritance model for the FTO polymorphism, a statistically significant relationship was demonstrated between the A/A genotype and glycemia. The results obtained in the codominant and overdominant models for the PPAR-y polymorphism showed a tendency to statistical significance (the C/G genotype inclined to hypertriglyceridemia), and were statistically significant in the codominant, dominant, and recessive models (the C/C genotype predisposed to increased blood pressure). Conclusions: 1. MetS-related abnormalities can be genetically determined, however only some of these relationships can be demonstrated due to the categorical division of symptoms according to the IDF criteria from 2009. 2. The A/A genotype of the FTO rs9939609 polymorphism increases the risk of hyperglycemia, and the C/C genotype of the PPAR-γ rs1801282 variant entails elevated blood pressure in 45-60-year-old women.

Serum magnesium and zinc levels in postmenopausal women depending on their menopausal status and the severity of climacteric symptoms

Wstęp: Magnez (Mg) i cynk (Zn) mogą wpływać na występowanie i nasilenie objawów wypadowych u kobiet po menopauzie. Cel pracy: Celem badań była ocena stężenia Mg i Zn w surowicy u kobiet po menopauzie w zależności od nasilenia objawów wypadowych oraz czasu, który upłynął od ostatniej miesiączki. Materiał i metody: Badaniem objęto 161 kobiet w wieku pomenopauzalnym, którym oznaczono stężenie Mg i Zn w surowicy krwi żylnej. Średnia wieku badanych kobiet wynosiła 56 ± 4 lata. Kobiety te nie stosowały menopauzalnej terapii hormonalnej (MHT), a ostatnia miesiączka wystąpiła u nich minimum rok przed włączeniem do badania. Badane kobiety były zdrowe, nie stosowały diet eliminacyjnych. Wyniki: U badanych kobiet zdiagnozowano hypomagnezemię i hypocynkemię. Analiza danych wykazała istotne statystycznie różnice pomiędzy stężeniem Mg w zależności od czasu, jaki upłynął od ostatniej miesiączki (p < 0,05). Najniższe średnie stężenie Mg wykazano w surowicy kobiet, u których menopauza wystąpiła ponad 10 lat wcześniej. Nie stwierdzono istotnych statystycznie zmian w zależności od nasilenia objawów klimakterium (p > 0,05). Wnioski: 1. U kobiet po menopauzie, niestosujących MHT stężenie Mg i Zn w surowicy utrzymuje się na niskim poziomie, a dodatkowo, średnie stężenie Mg zmniejsza się istotnie wraz z upływem czasu od ostatniej miesiączki. 2. Stężenie Mg i Zn w surowicy nie wpływa na nasilenie objawów wypadowych u kobiet po menopauzie niestosujących MHT. Słowa kluczowe: menopauza, objawy wypadowe, Mg, Zn, hipomagnezemia, hipocynkemia.