Justyna Nowak

Obesity, adipose tissue function and the role of vitamin D

Introduction Obesity is not just a cosmetic problem. Pathological accumulation of body fat can cause many health problems: insulin resistance, impaired glucose tolerance, and diabetes mellitus type 2. It may also increase morbidity and mortality. Adipose tissue plays an important role in body homeostasis by producing and secreting several bioactive proteins known as adipokines: adiponectin, leptin, resistin, visfatin, and apelin, which are involved in the regulation of food intake, glucose and lipid metabolism, and insulin action. There can be observed nutritional deficiencies, despite increased food intake, in morbidly obese people. Data concerning concentrations of serum 25(OH)D3 presented an inverse correlation with obesity parameters like: BMI (body mass index), waist circumference, fat mass or percentage of body fat. Also, higher insulin sensitivity was associated with higher concentrations of vitamin D. Conclusions Studies published up to now suggest that vitamin D plays an important role in adipose tissue function and could be involved in the synthesis and modulation of adipokine production. This article is a review of the literature on fatty tissue function and the role of vitamin D in obesity.

Relationship Between Plasma Pentraxin 3 Concentration and Platelet Indices in Patients With Stable Coronary Artery Disease

Few reports have analyzed the effect of pentraxin 3 (PTX3) on platelets and their activation. We explored the association between plasma PTX3 and platelet indices. Forty-nine patients with stable coronary artery disease (CAD) were enrolled. Based on median PTX3, the study population was divided into group 1 (n = 25; PTX3 ≤ 0.98 ng/mL) and group 2 (n = 24; PTX3 > 0.98 ng/mL). Platelet indices investigated included mean platelet volume (MPV), platelet distribution width (PDW), platelets and large cell ratio (P-LCR), MPV to platelet count ratio (MPV/PC), platelet to lymphocyte ratio (PLR), and MPV to lymphocyte ratio (MPVLR). Patients with lower PTX3 had a higher lymphocyte count. Platelet count was similar in both groups. Notwithstanding, patients with higher PTX3 concentrations had elevated MPV (8.3 vs 10.0 fL; P < .001) and PDW (9.4 vs 12.4 fL; P < .001). However, the MPV/PC ratio was similar in both groups. Thromboinflammatory biomarkers (PLR, MPVLR) were also elevated in group 2. Pentraxin 3showed a strong, positive correlation with MPV (r = .75, P < .01) and PDW (r = .80, P < .01), and weak to moderate correlation with MPVLR. In conclusion, PTX3 is associated with larger platelet size as assessed by platelet volume indices. There is a strong correlation between plasma PTX3 level and MPV and PDW.

[Arsenic - Poison or medicine?].

Arsenic (As) is commonly known as a poison. Only a few people know that As has also been widely used in medicine. In the past years As and its compounds were used as a medicine for the treatment of such diseases as diabetes, psoriasis, syphilis, skin ulcers and joint diseases. Nowadays As is also used especially in the treatment of patients with acute promyelocytic leukemia. The International Agency for Research on Cancer (IARC) has recognized arsenic as an element with carcinogenic effect evidenced by epidemiological studies, but as previously mentioned it is also used in the treatment of neoplastic diseases. This underlines the specificity of the arsenic effects. Arsenic occurs widely in the natural environment, for example, it is present in soil and water, which contributes to its migration to food products. Long exposure to this element may lead to liver damages and also to changes in myocardium. Bearing in mind that such serious health problems can occur, monitoring of the As presence in the environmental media plays a very important role. In addition, the occupational risk of As exposure in the workplace should be identified and checked. Also the standards for As presence in food should be established. This paper presents a review of the 2015 publications based on the Medical database like PubMed and Polish Medical Bibliography. It includes the most important information about arsenic in both forms, poison and medicine.

Usefulness of a new anthropometric indicator – VAI (Visceral Adiposity Index) in the evaluation of metabolic and hormonal disorders in women with polycystic ovary syndrome

BACKGROUND Visceral adiposity index (VAI) is a new anthropometric indicator that makes it possible to define the risk of obesity-related cardiometabolic complications even before the diagnosis of metabolic syndrome. OBJECTIVES Evaluating the usefulness of VAI in order to differentiate metabolically unhealthy women (MU-PCOS) and defining the usefulness of this index in everyday practice. MATERIAL AND METHODS A prospective study was conducted among 43 women who met the Rotterdam criteria for diagnosing polycystic ovarian syndrome. Body composition was measured using bioelectrical impedance analysis. Statistical analysis was performed using STATISTICA v. 10 and relevant statistical tests. The adopted significance level was p = 0.05. RESULTS Based on the study results, a significant positive correlation was found between the value of VAI and the concentration of insulin (r = 0.33; p < 0.01), HOMA index (r = 0.46; p < 0.01) and FAI (r = 0.54; p < 0.01). It was also shown that there is a significant negative correlation between VAI and the concentration of SHBG (r = -0.53; p < 0.01) and HDL cholesterol (r = -0.88; p < 0.01). In the group of metabolically unhealthy women, the research showed a significantly higher value of free testosterone, SHGB, DHEAS and FAI (p < 0.05). CONCLUSIONS Visceral adiposity index makes it possible to introduce early prevention of metabolic disorders (including cardiometabolic disorders), as well as to evaluate the increase of hyperandrogenemia in women with polycystic ovary syndrome. The use of the cut-off point of VAI = 1.675 is a simple way to evaluate women with MU-PCOS.

Guidelines for dietary management of menopausal women with simple obesity

The problem of obesity affects all age groups. It is also observed among menopausal women. Menopause is the time in a womans life when, as a consequence of hormonal changes occurring in the body, the risk of overweight and obesity increases significantly and, therefore, so does the risk of metabolic and cardiovascular diseases. Excess body weight in menopausal women may also be of social and psychological importance since the occurring symptoms may considerably decrease quality of life and sexual activity of these women. Reduction of body weight in obese menopausal women should play a vital role in treatment of this group of patients. Therefore, adequate management seems to be essential, and it should involve dietary, pharmacological and/or surgical treatment, depending on the patients needs. Following a rational weight loss plan provided by a dietician under medical supervision may contribute to improvement of the health condition and quality of life. It is recommended to observe the guidelines on dietary management described in this article by adjusting a diet plan individually. The following work constitutes a review of articles from 2004-2014 which are available in the PubMed medical knowledge base and the Polish Medical Bibliography (Polska Bibliografia Lekarska). For this purpose, the following controlled vocabulary has been used: menopausal woman, menopausal diet, menopausal weight gain, menopausal weight loss, dietary management in menopause.

Platelet Volume Measurements—EDTA, Citrate, or Both?

We appreciate the comments made by Dr Yildirim and colleagues. First, we agree that preanalytical factors play a key role in obtaining reliable results and that such errors can result in erroneous conclusions. Thus, all blood samples in our study were tested within 1 hour of collection. Second, we used ethylenediaminetetraacetic acid (EDTA) for whole blood anticoagulation. Some reports demonstrated that the mean platelet volume (MPV) increases with the use of EDTA due to platelet swelling, thus, suggesting the use of acid citrate as anticoagulant. However, most studies indicate that MPV can be measured accurately by both methods of anticoagulation—EDTA and citrate—if analysis is performed within 1 hour of sampling. Dastjerdi et al evaluated whether EDTAand citrate-based anticoagulated blood samples can be used interchangeably for MPV measurement. In the 61 patients, there was a close correlation between MPV as measured in EDTA and citrate, but MPV measured from EDTA samples was 0.66 fL (9%) greater than when collected in citrate. Both methods also showed a significant negative correlation between platelet count and MPV. The study indicates that MPV can be measured accurately by both methods of anticoagulation, EDTA and citrate, if the analysis is performed within 1 hour of sampling. Lance et al also demonstrated that platelets swell until 120 minutes in EDTA and until 60 minutes in citrate. So they suggest that optimal measuring time should not exceed 120 minutes. Interestingly, they demonstrated that the platelet count was most stable in EDTA. As to plateletcrit, it provides data regarding total platelet mass, whereas MPV and platelet larger cell ratio (P-LCR) are indicators of circulating larger platelets (>12 fL) and have also been used to monitor platelet activity. These are the reasons why we chose to study the associations of MPV and P-LCR with pentraxin 3 (PTX3) and C-reactive protein (CRP). Furthermore, there is paucity of data on the role of plateletcrit in stable coronary artery disease. Therefore, we did not record this variable in our study. Notwithstanding, the authors make an interesting point for future studies. Regarding correlation between CRP and platelet to lymphocyte ratio (PLR), and lack thereof between PTX3 and PLR, we speculate that different mechanisms underlie this phenomenon. One possibility might be the local nature of PTX3 actions in contrast to the systemic actions of CRP. However, we cannot exclude that our results are limited by a relatively small sample size.

The influence of insulin resistance on selected anthropometric and biochemical parameters in women with Polycystic Ovary Syndrome- preliminary report

MATERIALS AND METHODS: The study included a group of 45 women diagnosed with Polycystic Ovary Syndrome based on of the 2003 Rotterdam criteria. Insulin resistance was assess with HOMA-IR index. In accordance with the guidelines of the European Group for the Study of Insulin Resistance, we adopted HOMA-IR < 2 as the valid values. Body composition was measured with TANITA BC-420 Analyzer. We assumed a significance level α = 0.05. INTRODUCTION: Polycystic Ovary Syndrome is the most common recognized endocrinopathy in women. The syndrome is often accompanied by obesity and insulin resistance.