Juliusz Przysławski

Faecal elastase-1 test is superior to faecal lipase test in the assessment of exocrine pancreatic function in cystic fibrosis.

Background and aims: Direct tests are characterized by the highest sensitivity and specificity. However, their practical use, especially in children, is limited. Among the indirect tests, the highest sensitivity and specificity was documented for faecal elastase‐1 test, yet the value of faecal lipase test in cystic fibrosis (CF) has not been defined. Therefore, the aim of the present study was to compare the sensitivity and the specificity of the faecal lipase test to the faecal elastase‐1 test in the assessment of exocrine pancreatic function in children with CF. Methods: The study comprised 90 CF patients and 95 healthy subjects (HS). In all subjects, faecal elastase‐1 concentrations (ELISA) and lipase activities (ELISA) were measured. The presence of pancreatic insufficiency was documented by the determination of faecal fat excretion in 78 pancreatic insufficient and by the secretin‐cholecystokinin test in 12 CF patients without steatorrhoea. Sensitivity and specificity of the faecal elastase‐1 test and faecal lipase test were analysed and, in 50 HS, sample‐to‐sample and day‐to‐day variations were determined. Results: With cut‐off levels providing the same specificity for both tests (95.8%), the sensitivity of the faecal elastase‐1 test (91.1%) was significantly higher (p > 0.0036) than that of the faecal lipase test (76.7%). Sample‐to‐sample (mean ± SEM: 13.2 ± 1.2% vs 23.4 ± 2.2%) and day‐to‐day variations (mean ± SEM: 16.3 ± 1.2% vs 32.5 ± 2.6%) were significantly lower (p > 0.0001) for elastase‐1 than for lipase measurements.

Dietary Habits and Nutritional Status of Female Adolescents from the Great Poland Region

Dietary Habits and Nutritional Status of Female Adolescents from the Great Poland Region The aim of this study was to assess the nutritional status and dietary habits among female adolescents. Four hundred seventy nine subjects aged from 17 to 18 years, from secondary schools of the Great Poland Region participated in the study. Anthropometric parameter measurements included those of body height and mass, skinfold thickness and circumferences of waist, hip and arm. The measurements served to calculate the percentage of fat mass and arm muscle area. Nutritional questionnaires were used to estimate the frequency and intake of selected food products. Mean values of body height and mass were approximately in the 50th percentile. However, 13.7% of females were underweight, 7.7% were overweight and 1.2% were obese. Cluster analysis resulted in 3 clusters, of which the second one showed the most detrimental nutritional habits. This cluster was characterised by the lowest intake of dairy products, fruits and vegetables, fish, meat and also by frequent long breaks between meals (longer than 5 hours). Improper nutritional behavior is a frequent finding in female adolescents, in Poland. Nevertheless, overweight and obesity are not more common than in other countries. Studies in this area should be continued and extended.

Association of PPAR-γ2 and β3-AR Polymorphisms With Postmenopausal Hypertension.

The aim of this study was to test the association of peroxisome proliferator‐activated receptor (PPAR‐γ2) (Pro12Ala, C1431T) and β3‐AR (Trp64Arg) polymorphisms with metabolic, nutritional, and blood pressure parameters in 271 postmenopausal women (151 hypertensive and 120 normotensive controls). The TaqMan genotyping assay and restriction fragment length polymorphism methods were used to determine the distributions of selected alleles and genotype frequencies. Nutritional status was determined by a bioimpedance method and dietary habits were assessed via 7‐day dietary recall. The distribution of selected genotypes and allele frequencies did not differ between hypertensive women and normal controls after analysis by chi‐square test. The postmenopausal hypertensive women were older and had higher body fat mass, serum glucose, and triglyceride levels. The cluster analysis showed that the hypertensive group with Pro12Pro genotype had highest pulse pressure and mean arterial pressure values when compared with Pro12Ala patients. In the logistic regression analysis, blood glucose (Pro12Ala polymorphism) and energy intake (C1431Tand T1431T polymorphisms) determined hypertension.

Vegetarian diet alters the assessment of exocrine pancreatic function with the use of fecal tests.

Vegetarian diets are becoming increasingly popular, yet the assessment of pancreatic function tests in vegetarians is sparse. Chronic pancreatitis and exocrine pancreatic insufficiency are more common than previously thought. Therefore, a means of accurately measuring pancreatic function in vegetarian subjects is needed. Direct pancreatic function tests, such as the secretincholecystokinin-test (SCT), have the highest sensitivity and specificity. However, they have some major disadvantages, including invasiveness and availability, which make them unsuited for routine use (1). Among the indirect tests, the measurement of fecal enzyme concentrations/activities is the easiest. Fecal elastase-1 is probably the most sensitive and specific of the indirect tests (2). However, there are no data regarding the specificity of these tests in vegetarians. In the current study we investigated the impact of vegetarian diet on the specificity of fecal tests of pancreatic function.

Comparison of antioxidative properties of raw vegetables and thermally processed ones using the conventional and sous-vide methods

The study determines the antioxidant properties of methanol vegetable extracts from raw vegetables, conventionally cooked vegetables and sous-vide. In the research, two methods were used: free radical scavenging DPPH (µM Trolox) and the reduction of Fe3+to Fe2+ - FRAP (µM Fe2+). Antioxidative properties for raw vegetables were obtained with the range of 7.47-235 (µM Trolox/100g of vegetables) and 2.66-103 (µM Fe2+/100g of vegetables), for vegetables after the conventional cooking process 6.15-657 (µM Trolox/100g of vegetables) and 3.03-99.9 (µM Fe2+/100g of vegetables), for vegetables after the sous-vide process 4.45-648 (µM Trolox/100g of vegetables) and 3.06-99.9 (µM Fe2+/100g of vegetables). For some vegetables, an increase in the antioxidative potential was observed as a result of cooking processes; however, it was much higher for the sous-vide technique. All results were subjected to a one-way analysis of variance (ANOVA) and, if significant differences were revealed, the POST-HOC Duncan test was used (α=0.05).

Klinische Aspekte der Verwendung von Phytosterolen in der Ernährung des Menschen

In der vorliegenden Arbeit wird die effektive Verabreichung von pflanzlichen Sterolen in der Ernährung des Menschen behandelt. Hauptsächlich werden ihr positiver Einfluss auf die Senkung der Cholesterinkonzentration in der LDL-Fraktion und die zu beobachtenden Änderungen in der Serumkonzentration der Fraktion hervorgehoben, die mit der Absorption und Cholesterinsynthese verbunden sind. Es scheint, dass eine Verwendung von Phytosterolen in der Ernährung eine durchaus positive Rolle in der Dyslipidämieprophylaxe spielen kann.

Genetic and Non-Genetic Determinants of the Pharmacological Activity of Statins

Statins are cholesterol-lowering agents which belong to the group of the most commonly prescribed drugs. The use of statins has become the standard treatment in patients with an increased risk of cardiovascular and coronary heart diseases. However, many clinical studies have shown that 13 - 75% of patients fail to achieve LDL-cholesterol and total cholesterol target levels. The clinical implications of insufficient response include cardiovascular complications caused by atherosclerosis leading to acute myocardial infarction, stroke and death. The mechanism underlying statin resistance has been associated with genetic polymorphisms and nongenetic factors (e.g. concomitant diseases, drug-drug interactions, interactions with food and dietary supplements). The article provides a comprehensive update of the current knowledge regarding the role of genetic polymorphism and non-genetic determinants of cholesterol-lowering effect of statins. Dietary aspects of statin efficacy were also presented. The Pubmed search was performed to identify relevant papers from the last ten years which were included in the review. Consideration of the genetic and non-genetic determinants of pharmacological action of statins as well as mechanisms of drug-drug interactions may be useful in clinical practice for improving safety and efficacy of statin treatment.

The gene-diet associations in postmenopausal women with newly diagnosed dyslipidemia

ObjectivesThe aim of this study was to determine the relationship between polymorphisms of peroxisome proliferator activated receptor - PPAR gamma-2 (Pro12Ala, C1431T) and beta 3-adrenergic receptor - ADRB3 (Trp64Arg) and dietary habits in a group of postmenopausal women who were not under hypolipidemic treatment.DesignGenetic, nutritional and anthropometric parameters were measured in 213 dyslipidemic (LDL ≥115 mg/dL) and 58 normolipidemic (LDL<115) postmenopausal women. The PCR-RFLP method were used to determine the distributions of selected alleles and genotype frequencies. Dietary intake of basic components and fatty acids was obtained from a 7-day weighed food record and the bio-impedance method was used to determine nutritional status.ResultsNearly 79% of analyzed women were in the firsttime-diagnosed dyslipidemic state. The dyslipidemic subjects were characterized with higher intake of energy, fat, and saturated fatty acids (SFA). The analysis of the same polymorphisms showed association at the P value <0.05 with nutrients (fat, SFA, and polyunsaturated fatty acid - PUFA and saccharose) and elevated LDL level. Higher PUFA intake in a group of women with the protective Ala12/X polymorphism did not increase the risk of dyslipidemia even though they were characterized by visceral distribution of fat. The Arg64/X polymorphism and higher intake of energy, fat, and arachidic acid intake (C20:0) were associated with dyslipidemic state.ConclusionBoth nutritional and genetic factors are related to lipid profile. The identification of gene-diet associations is likely to provide useful information about the etiology of postmenopausal dyslipidemia and help in effective treatment.

Impact of the PPAR gamma-2 gene polymorphisms on the metabolic state of postmenopausal women

The relationship Pro12Ala (rs1801282) and C1431T (rs3856806) polymorphisms of PPAR gamma-2 with glucose and lipid metabolism is not clear after menopause. We investigated the impact of the Pro12Ala and C1431T silent substitution in the 6th exon in PPAR gamma-2 gene on nutritional and metabolic status in 271 postmenopausal women (122 lean and 149 obese). The general linear model (GLM) approach to the two-way analysis of variance (ANOVA) was used to infer the interactions between the analysed genotypes. The frequency of the Pro-T haplotype was higher in obese than in lean women (p<0.0349). In the analysed GLM models according to obesity status, the C1431C genotype was related to a lower glucose concentration (β=−0.2103) in lean women, and to higher folliculotropic hormone FSH levels (β=0.1985) and lower waist circumferences (β=−0.1511) in obese women. The influence of C1431C was present regardless of the occurrence of the Pro12Ala polymorphism. The co-existence of the C1431C and Pro12Pro genotypes was related to lower values for triceps skinfold thickness compared those for the T1241/X and Ala12/X polymorphisms (β=−0.1425). The presence of C1431C decreased the differences between triceps values that were determined by Pro or Ala allele. In conclusion, C1431T polymorphism seems to have a more essential influence on anthropometric and biochemical parameters than is the case with Pro12Ala polymorphism.

Lipid Profile and Non-Cholesterol Sterols in Obese Women's Serum after Supplementing with Plant Stanol Ester

Background: The aim of this study was to assess the influence of increased plant stanol ester intake on lipid profile and serum ratio of non-cholesterol sterols to cholesterol in obese women (50 years of age) with dyslipidemia. Methods: 90 females were assigned into 2 treatment groups: For a period of 4 weeks, group 1 was receiving a yoghurt, enriched with 2 g of plant stanol ester (PS group), and group 2 was receiving a yoghurt drink without extra stanols. Anthropometric measurements included body height and weight. Lipid profile was determined by commercially available enzymatic methods. Serum non-cholesterol sterols and stanols concentrations were quantitated by gas chromatography. The study was single-blind and placebo-controlled. Results: The yoghurt drink enriched with plant stanol ester significantly reduced serum total cholesterol, LDL cholesterol, and non-HDL cholesterol levels (p < 0.05). No changes were observed in HDL cholesterol and triacylglycerol levels. The highest drop of LDL cholesterol was noted in the upper quartile of total cholesterol concentrations. In the PS group the statistically significant (p < 0.0001) changes were also observed in serum ratios of non-cholesterol sterols to cholesterol: campesterol, sitosterol, sitostanol, and avenasterol. Conclusion: Plant stanol esters influence the concentration of total cholesterol, particularly LDL cholesterol. This effect seems to be related to the reduced dietary cholesterol absorption.