Joanna Gierach

Correlation between Body Mass Index and Waist Circumference in Patients with Metabolic Syndrome.

Metabolic syndrome is defined as a group of coexisting metabolic risk factors, such as central obesity, lipid disorders, carbohydrate disorders, and arterial hypertension. According to the 2005 IDF criteria, subsequently revised in 2009, abdominal obesity is identified as the waist circumference of ≥80 cm in women and ≥94 cm in men. It is responsible for the development of insulin resistance. The aim of our study was to demonstrate a correlation between waist circumference (WC) and body mass index (BMI) in patients with metabolic syndrome in relation with hypertension, lipid disorders, and carbohydrate disorders. A cross-sectional two-site study was conducted in the Kuyavian-Pomeranian Voivodeship for 24 months. The study group consisted of 839 patients with diagnosed metabolic syndrome: 345 men (41.1%) and 494 women (58.9%) aged 32–80. In the study group, WC was found to be significantly correlated with BMI (R = 0.78, P < 0.01). The presence of overweight in men (BMI 25, 84 kg/m2) and even normal body weight in women (BMI 21,62 kg/m2) corresponds to an increased volume of visceral tissue in the abdomen. Introduction of primary prophylaxis in those people to limit the development of diabetes mellitus type 2 and cardiovascular diseases should be considered.

Value of oral glucose tolerance test in the acute phase of myocardial infarction

BackgroundAlthough European guidelines advise oral glucose tolerance test (OGTT) in patients with acute myocardial infarction (AMI) before or shortly after hospital discharge, data supporting this recommendation are inconclusive. We aimed to analyze whether disturbances in glucose metabolism diagnosed before hospital discharge in AMI patients represents a latent pre-existing condition or rather temporary finding. Additionally, we planned to investigate the value of pre-selected glycemic control parameters as predictors of long-term glucometabolic state.MethodsWe assessed admission glycemia, glycated hemoglobin, mean blood glucose concentration on days 1 and 2 in 200 patients with a first AMI but without overt disturbances of glucose metabolism. We also performed OGTT at discharge and 3 months after discharge.ResultsThe prevalence of disturbances in glucose metabolism (as assessed by OGTT) at 3 months was significantly lower than at discharge (29% vs. 48%, p = 0.0001). Disturbances in glucose metabolism were not confirmed in 63% of patients with impaired glucose tolerance and in 36% of patients with diabetes mellitus diagnosed during the acute phase of AMI. Age >77 years, glucose ≥12.06 mmol/l at 120 minutes during OGTT before discharge and mean blood glucose level on day 2 >7.5 mmol/l were identified as independent predictors of disturbances in glucose metabolism at the 3-month follow-up.ConclusionsDisturbances in glucose metabolism observed in patients with a first AMI are predominantly transient. Elderly age, high plasma glucose concentration at 120 minutes during OGTT at discharge and elevated mean blood glucose level on day 2 were associated with sustained disturbances in glucose metabolism.

The Correlation between LDL-C and Non-HDL-C Levels and Cardiovascular Events in Patients with Metabolic Syndrome

In 1988 Reaven described polymorphic metabolic abnormalities involving the incidence of insulin resistance with compensatory hyperinsulinemia, type 2 diabetes mellitus, arterial hypertension and hypercholesterolemia also known as Reaven’s syndrome or syndrome X. The aim of the study was to evaluate if cardiovascular risk in patients with metabolic syndrome [MetS] correlate with LDL-C and non-HDL-C levels. The study was a prospective, twocenter screening study of 36-month duration located in University Hospital No.1 in Bydgoszcz, Poland and District Hospital in WA„Â…brzezno, Poland. The study included 906 participants (460 females [F], 446 males [M], aged 32-76 years), with a confirmed diagnosis of metabolic syndrome according to the 2005 IDF criteria. The study showed that LDL-C and non-HDL-C levels are connected with increased level of triglycerides and impaired fasting glucose. Levels of LDL-C and non-HDL-C also influenced hypertension and hypoalfalipoproteinemia to a lesser extent and exerted the least influence in individuals with type 2 diabetes mellitus. The study proved that the components of metabolic syndrome, especially abdominal obesity, hypertriglyceridemia, and impaired fasting glucose have a major impact on the level of LDL and non-HDL-C, which is associated with a higher cardiovascular risk.

Evaluation of lipid profiles in patients with metabolic syndrome according to cardiovascular risk calculated on the basis of the SCORE chart.

INTRODUCTION Metabolic syndrome predicts the development of CVD. Lipid abnormalities probably have an important influence on the increase of cardiovascular death risk. The SCORE chart includes only total cholesterol level, which may be inadequate. The aim of our study was to evaluate the lipid profile in patients with metabolic syndrome according to the cardiovascular risk calculated on the basis of the SCORE chart. MATERIAL AND METHODS The study participants comprised 974 patients with metabolic syndrome. The 10-year death risk of cardiovascular disease was calculated on the basis of SCORE chart in all patients. The study group was divided in three subgroups depending on the risk level calculated by SCORE scale. RESULTS There was a significantly higher level of LDL-C fraction in the subgroup of very high CV risk in comparison to the group of medium and high CV risk. The level of non-HDL-C was also significantly higher in the group with SCORE ≥ 10 compared to the remaining subgroups of medium and high CV risk. CONCLUSIONS Increased CV risk in this group of patients may be associated not only with higher TC level, but also the other lipid fractions. The assessment of the CV risk on the basis of the SCORE chart, which includes only TC level, may be inadequate. A modification of the SCORE chart for the European population should be considered (inclusion of LDL-C level, or in selected cases non-HDL-C level instead of TC level). (Endokrynol Pol 2016; 67 (3): 265-270).

Congenital vascular malformations in scintigraphic evaluation

Summary Background Congenital vascular malformations are tumour-like, non-neoplastic lesions caused by disorders of vascular tissue morphogenesis. They are characterised by a normal cell replacement cycle throughout all growth phases and do not undergo spontaneous involution. Here we present a scintigraphic image of familial congenital vascular malformations in two sisters. Material/Methods A 17-years-old young woman with a history of multiple hospitalisations for foci of vascular anomalies appearing progressively in the upper and lower right limbs, chest wall and spleen. A Parkes Weber syndrome was diagnosed based on the clinical picture. Due to the occurrence of new foci of malformations, a whole-body scintigraphic examination was performed. A 12-years-old girl reported a lump in the right lower limb present for approximately 2 years, which was clinically identified as a vascular lesion in the area of calcaneus and talus. Phleboscintigraphy visualized normal radiomarker outflow from the feet via the deep venous system, also observed in the superficial venous system once the tourniquets were released. In static and whole-body examinations vascular malformations were visualised in the area of the medial cuneiform, navicular and talus bones of the left foot, as well as in the projection of right calcaneus and above the right talocrural joint. Conclusions People with undiagnosed disorders related to the presence of vascular malformations should undergo periodic follow-up to identify lesions that may be the cause of potentially serious complications and to assess the results of treatment. Presented scintigraphic methods may be used for both diagnosing and monitoring of disease progression.

Carcinoid tumors – retrospective analysis of patients hospitalized between 2001 and 2012 year in Department of Endocrinology and Diabetology of Ludwik Rydygier Collegium Medicum in Bydgoszcz

Gastro-entero-pancreatic neuroendocrine neoplasms (GEP-NENs) originate from diffuse endocrine system (DES). Over 50% of diagnosed neuroendocrine neoplasms (NENs) are carcinoid tumors, secreting mainly serotonine. The incidence of carcinoids in general population is estimated to be 2.9 cases/100000 inhabitants/year. In our study we aimed at analyzing retrospectively patients with diagnosed carcinoid tumors, hospitalized between the years 2001 and 2012 in the Department of Endocrinology and Diabetology of Nicolaus Copernicus University Collegium Medicum in Bydgoszcz. The study group consists of 39 patients (20 women and 19 men) aged between 36 and 70, with diagnosed carcinoid. All patients have determined chromogranin A concentration (CgA), urinary excretion of 5-hydroxyindoleacetic acid (5-HIAA) in 48-hours urine sample, urinary excretion of catecholamine hormones (norepinephrine, epinephrine and dopamine), vanillylmandelic acid (VMA) and homovanillic acid (HVA) in 24-hours urine sample. Ultrasonography (US), computed tomography (CT), magnetic resonance imaging (MRI), endoscopic ultrasound (EUS) and somatostatin receptor scintigraphy (SRS) with 99mTc-Depreotide have been performed. The diagnosis of the carcinoid tumor is often problematic because of its slow growth and uncharacteristic symptoms. And often the localization of the primary tumor cannot be determined. Somatostatin analogues can help to control symptoms of the carcinoid syndrome