Vesna Dimitrijevic-Sreckovic

Prothrombogenic factors and reduced antioxidative defense in children and adolescents with pre-metabolic and metabolic syndrome.

Abstract Background: The aim of this study was to examine prothrombogenic factors and antioxidative defense in obese children and adolescents with pre-metabolic and metabolic syndrome, and to analyze insulin secretion and resistance, early glycoregulation disorders and lipid status. Methods: Insulin sensitivity was determined using the homeostasis model assessment for insulin resistance (HOMA-IR), while insulin secretion was determined using the homeostasis model assessment β (HOMA-β). Prothrombogenic factors analyzed were plasma plasminogen activator inhibitor-1 (PAI-1) and fibrinogen. Superoxide dismutase and glutathione peroxidase were measured as markers of antioxidative defense. Results: Patients with metabolic syndrome were characterized with increased body mass index (BMI), waist circumference, and HOMA-IR and HOMA-β levels, and all had increased blood pressure and triglyceride levels, low high-density lipoprotein cholesterol levels, increased PAI-1 levels and reduced antioxidative defense levels. Patients with pre-metabolic syndrome had higher levels of basal and mean insulinemia during an oral glucose tolerance test, higher levels of HOMA-β and lower levels of antioxidative defense compared to patients with metabolic syndrome. Conclusions: Negative correlations between antioxidative defense parameters and BMI, abdominal obesity, insulin secretion, systolic blood pressure and atherogenic lipid factors, as well as correlations between PAI-1 and insulin resistance and basal glycemia in the metabolic syndrome group contribute to accelerated atherosclerosis. Positive correlations between PAI-1 and waist circumference and BMI, and negative correlations between BMI and antioxidative defense in the pre-metabolic syndrome patients show that this early stage preceding the metabolic syndrome is also characterized by atherosclerotic complication risks and evident hyperinsulinism and insulin resistance. Clin Chem Lab Med 2007;45:1140–4.

Characterisation of dietary fibre components in cereals and legumes used in Serbian diet

The typical Serbian diet is characterised by high intake of cereal products and also legumes are often used. The content of total fibre as well as certain fibre fractions was determined in cereals, cereal products, and cooked legumes. The content of total fibre in cooked cereals and cereal products ranged from 2.5 to 20.8 g/100 g, and in cooked legumes from 14.0 to 24.5 g/100 g (on dry matter basis). Distribution of analysed fibre fractions and their quantities differed significantly depending on food groups. Fructans and arabinoxylans were the most significant fibre fractions in rye flakes, and β-glucan in oat flakes, cellulose and resistant starch were present in significant amounts in peas and kidney beans. When the size of regular food portions was taken into consideration, the best sources of total dietary fibre were peas and kidney beans (more than 11 g/serving). The same foods were the best sources of cellulose (4.98 and 3.56 g/serving) and resistant starch (3.90 and 2.83 g/serving). High intake of arabinoxylans and fructans could be accomplished with cooked wheat (3.20 g and 1.60 g/serving, respectively). Oat (1.39 g/serving) and barley flakes (1.30 g/serving) can be recommended as the best sources of β-glucan.

siMS Score: Simple Method for Quantifying Metabolic Syndrome

Objective To evaluate siMS score and siMS risk score, novel continuous metabolic syndrome scores as methods for quantification of metabolic status and risk. Materials and Methods Developed siMS score was calculated using formula: siMS score = 2*Waist/Height + Gly/5.6 + Tg/1.7 + TAsystolic/130—HDL/1.02 or 1.28 (for male or female subjects, respectively). siMS risk score was calculated using formula: siMS risk score = siMS score * age/45 or 50 (for male or female subjects, respectively) * family history of cardio/cerebro-vascular events (event = 1.2, no event = 1). A sample of 528 obese and non-obese participants was used to validate siMS score and siMS risk score. Scores calculated as sum of z-scores (each component of metabolic syndrome regressed with age and gender) and sum of scores derived from principal component analysis (PCA) were used for evaluation of siMS score. Variants were made by replacing glucose with HOMA in calculations. Framingham score was used for evaluation of siMS risk score. Results Correlation between siMS score with sum of z-scores and weighted sum of factors of PCA was high (r = 0.866 and r = 0.822, respectively). Correlation between siMS risk score and log transformed Framingham score was medium to high for age groups 18+,30+ and 35+ (0.835, 0.707 and 0.667, respectively). Conclusions siMS score and siMS risk score showed high correlation with more complex scores. Demonstrated accuracy together with superior simplicity and the ability to evaluate and follow-up individual patients makes siMS and siMS risk scores very convenient for use in clinical practice and research as well.

Liver function test changes in centrally obese youth with metabolic syndrome in a Serbian population.

OBJECTIVE The aim of this study was to investigate the association between metabolic syndrome and liver enzymes in overweight and obese adolescents and young adults. METHODS A total of 126 overweight and obese adolescents and young adults (age, 15-26 years), 55 (43.6%) with metabolic syndrome and 71 (56.4%) without metabolic syndrome, were studied. RESULTS Patients with metabolic syndrome had significantly higher alanine aminotransferase (ALT), γ-glutamyl transpeptidase (GGT), and alkaline phosphatase (ALP) levels compared to patients without metabolic syndrome [36.5±22.2 vs. 29.4±17.8 IU/L (P=0.043), 33.8±17.8 vs. 26.9±18.4 IU/L (P=0.002), and 84.3±32.2 vs. 75.7±29.5 IU/L (P=0.063)]. Aspartate aminotransferase (AST) levels were similar in both groups (24.1±9.8 vs. 23.3±9.0 IU/L, P=0.674). Elevated AST, ALT, GGT, and ALP levels were observed in 6, 15, 18, and 5 patients (11%, 27%, 14%, and 9%) with metabolic syndrome compared to 6, 17, 6, and 4 (8%, 24%, 8% and 5%) patients without metabolic syndrome (P=0.872, P=0.826, P<0.001, and P=0.035). In multivariate regression models adjusted for age and gender, metabolic syndrome was not a significant predictor of ALT (P=0.967), GGT (P=0.526), and ALP levels (P=0.221), but insulin resistance was a significant predictor for ALT and GGT levels (P=0.001, P=0.028). CONCLUSION Changes in liver function tests were observed in obese patients with metabolic syndrome, compared to patients without metabolic syndrome, especially in ALT and GGT levels. Insulin resistance is an independent pathogenic mechanism in liver function test changes regardless of metabolic syndrome in nondiabetic centrally obese youth.

Metabolic control and diabetic retinopathy in patients with diabetes type 2

ZusammenfassungZIELSETZUNG: Die Bewertung der Korrelation zwischen Wechselstoffkontrolle und Präsenz und Schweregrad der diabetischen Retinopathie (DR) bei Patienten mit Typ-2-Diabetes. METHODEN: Diese Querschnittstudie umfasste 80 Patienten, die in vier Gruppen eingeordnet wurden, nach der Dauer der Krankheit: de novo; bis zu 10 Jahren; 11 bis 20 Jahre; und über 20 Jahre. Um die Stoffwechselkontrolle zu bewerten wurden bei jedem Patient die folgenden Parameter getestet: glycosiliertes Hämoglobin (HbA1c), Gesamtcholesterinspiegel (TC), High-Density Lipoprotein Cholesterin (HDL-C), Low-Density Lipoprotein Cholesterin (LDL-C) und Triglyceride (TG). Abhängig von der Änderung an der Netzhaut wurden die Patienten nach der Klassifizierung der Amerikanischen Akademie für Augenheilkunde eingeordnet. ERGEBNISSE: Patienten mit DR hatten deutlich erhöhte HbA1c-Werte (9,5 ± 1,83%) und verringerte HDL-C-Werte (1,1 ± 0,21 mmol/L) im Vergleich zu Patienten ohne DR (6,9 ± 1,29%, t = 5,088; p < 0,001 und 1,3 ± 0,25 mmol/L, t = 3,022; p < 0,01). Die Präsenz und der Schweregrad der DR standen in positiver Wechselwirkung mit HbA1c-Werten (p < 0,001) und schlechter glykämischer Kontrolle (p < 0,001), während sich HDL-C Werte umgekehrt proportional zur Präsenz (p < 0,01) und zum Schweregrad der DR (p < 0,05) verhielten. SCHLUSSFOLGERUNG: Schlechte Stoffwechselkontrolle, gemessen anhand erhöhter HbA1c-Werte und verringerter HDL-C-Werte, steht in Wechselwirkung mit der Präsenz und dem Schweregrad der DR.SummaryAIM: To evaluate the correlation between metabolic control and the presence and severity level of diabetic retinopathy (DR) in patients with diabetes type 2. METHODS: This cross-sectional study included 80 patients divided into four groups according to the duration of the disease: de novo; up to 10 years; from 11 to 20 years; and over 20 years. In order to evaluate the metabolic control each patient was tested for: glycosylated hemoglobin (HbA1c), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and triglycerides (TG). According to eye fundus changes patients were classified following the American Academy of Ophthalmology classification. RESULTS: The patients with DR had significantly increased values of HbA1c. (9.5 ± 1.83%) and decreased values of HDL-C (1.1 ± 0.21 mmol/L) compared to patients without DR (6.9 ± 1.29%, t = 5.088; p < 0,001) and (1.3 ± 0.25 mmol/L, t = 3.022; p < 0.01) respectively. The presence and severity level of DR correlated positively with HbA1c values (p < 0.001) and poor glycaemic control (p < 0.001) while HDL-C values correlated inversely with the presence (p < 0.01) and severity level of DR (p < 0.05). CONCLUSION: Poor metabolic control determined by the increased values of HbA1c and decreased values of HDL-C correlates with the presence and severity of DR.

Homocysteine is the confounding factor of metabolic syndrome-confirmed by siMS score

Abstract Background: Abdominal adiposity has a central role in developing insulin resistance (IR) by releasing pro-inflammatory cytokines. Patients with metabolic syndrome (MS) have higher values of homocysteine. Hyperhomocysteinemia correlates with IR, increasing the oxidative stress. Oxidative stress causes endothelial dysfunction, hypertension and atherosclerosis. The objective of the study was to examine the correlation of homocysteine with siMS score and siMS risk score and with other MS co-founding factors. Methods: The study included 69 obese individuals (age over 30, body mass index [BMI] >25 kg/m2), classified into two groups: I-with MS (33 patients); II-without MS (36 patients). Measurements included: anthropometric parameters, lipids, glucose regulation parameters and inflammation parameters. IR was determined by homeostatic model assessment for insulin resistance (HOMA-IR). ATP III classification was applied for diagnosing MS. SiMS score was used as continuous measure of metabolic syndrome. Results: A significant difference between groups was found for C-reactive protein (CRP) (p<0.01) apolipoprotein (Apo) B, HOMA-IR and acidum uricum (p<0.05). siMS risk score showed a positive correlation with homocysteine (p=0.023), while siMS score correlated positively with fibrinogen (p=0.013), CRP and acidum uricum (p=0.000) and homocysteine (p=0.08). Homocysteine correlated positively with ApoB (p=0.036), HbA1c (p=0.047), HOMA-IR (p=0.008) and negatively with ApoE (p=0.042). Conclusions: Correlation of siMS score with homocysteine, fibrinogen, CRP and acidum uricum indicates that they are co-founding factors of MS. siMS risk score correlation with homocysteine indicates that hyperhomocysteinemia increases with age. Hyperhomocysteinemia is linked with genetic factors and family nutritional scheme, increasing the risk for atherosclerosis.

Pre- and postoperative characteristics of metabolic syndrome in patients with colorectal cancer

The pathological mechanisms that link the metabolic syndrome (MS) and colorectal cancer (CRC) are most probably related to abdominal obesity and insulin resistance. This study aimed to assess the relationship between MS and its clinical characteristics, with CRC. We investigated the changes in the appearance of MS features three months after surgical treatment, and its relationship with the concentration of tumor and inflammation markers. The retrospective cohort study was performed on 193 patients who were diagnosed with CRC and consequently surgically treated (at the Department of General Surgery, Clinical Hospital Center “Bežanijska kosa”, Belgrade). The included patients were divided into two groups based on the presence of MS. Body mass index (BMI), waist circumference, blood pressure, blood glucose, triglycerides (TG), high density lipoproteins – cholesterol (HDL-C), carcinoembryonic antigen (CEA), α-fetoprotein (AFP), carbohydrate antigen 19-9 (CA 19-90) and C-reactive protein (CRP) were analyzed at the time when the CRC diagnosis was made and three months after surgery. We observed a significant decrease in the number of patients with MS three months postoperatively compared to the number of patients in the preoperative period (106 versus 81; p<0.001). CRP levels were significantly decreased postoperatively compared to the preoperative period in patients with MS (p<0.001). AFP concentrations were significantly decreased (p<0.001), while CEA and CA 19-9 were significantly increased postoperatively compared to preoperatively (p<0.001, p<0.001). Further studies should be conducted in order to examine the influence of MS and its characteristics solely on CRC prognosis and its overall effect on CRC treatment. https://doi.org/10.2298/ABS160608079G Received: June 8, 2016; Revised: June 15, 2016; Accepted: June 16, 2016; Published online: September 14, 2016 How to cite this article: Gacic J, Dimitrijevic-Sreckovic V, Gacic D, Petricevic S, Sreckovic B, Lazic B, Đorđevic A, Đukanovic B, Ranđelovic T. Pre- and postoperative characteristics of metabolic syndrome in patients with colorectal cancer. Arch Biol Sci. 2017;69(2):215-22.