The local concentration of glucocorticoids is intensively regulated by 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD 1). Human 11β-HSD 1 also reversibly catalyzes the inter-conversion of 7α-hydroxy- and 7β-hydroxy-dehydroepiandrosterone (DHEA) into 7-oxo-DHEA. The cohort of 282 obese adolescents, 154 girls (median age 15.31 years, range 14.17-16.68 years) and 128 boys (median age 14.95 years, range 13.87-16.16 years), BMI (Body Mass Index) >90th percentile was examined. In samples collected before and after one month of reductive diet therapy, circulating levels of steroids were analyzed by liquid chromatography-tandem mass spectrometry and radioimmunoassay methods. The model of the treatment efficacy prediction was calculated. A significant reduction in circulating levels of cortisone, E2 and increased levels of 7β-hydroxy-DHEA after the reductive treatment was observed. Levels of cortisol, DHEA, DHT sustained without any significant change. The predictive Orthogonal Projections to Latent Structures (OPLS) model explained 20.1 % of variability of BMI, z-score change by the basal levels of 7α-hydroxy-DHEA, DHEA, cortisol and E2 as the strongest predictors. Reduced levels of circulating cortisone and reduced ratios of oxygenated/reduced metabolites reflect increased reductase activity of 11β-HSD 1 with reduced BMI, z-score. We hypothesize whether these changes can be attributed to the altered activity of 11β-HSD 1 in the liver., L. Máčová, L. Sosvorová, J. Vítků, M. Bičíková, M. Hill, H. Zamrazilová, B. Sedláčková, L. Stárka /., and Obsahuje bibliografii
Cíl: Cílem výzkumného šetření bylo získat informace o protektivních a rizikových faktorech stravování a stravovacích návyků ve vztahu k prevenci kolorektálního karcinomu, a to u záměrně vybrané skupiny adolescentů a dospělých. Výsledky byly porovnávány mezi oběma skupinami a s údaji publikovanými v odborných časopisech. Metodika: Pro výzkum bylo zvoleno kvantitativní dotazníkové šetření za pouţití nestandardizovaného dotazníku vlastní tvorby hodnotícího způsob stravování u obou skupin respondentů. Šetření probíhalo ve dvou záměrně vybraných středních školách a ve čtyřech podnicích v Hradci Králové v období října aţ prosince 2012. Výsledky: Celkem bylo do výzkumného šetření zařazeno 343 respondentů, z toho 123 adolescentů (36 %) a 220 dospělých (64 %). Statistické testování prokázalo, ţe se dospělí stravují kvalitněji neţ adolescenti, přesto však obě skupiny konzumují ovoce a zeleninu v nedostatečném mnoţství a naopak často konzumují červené maso, masné výrobky a potraviny upravené smaţením. Špatné stravovací návyky dosvědčuje i prevalence nadváhy a obezity; 20,4 % dotázaných adolescentů a 63,6 % dospělých má vyšší neţ normální váhu. Třetina adolescentů se navíc stravuje v řetězcích s rychlým občerstvením. Závěr: Zdravá výţiva a vhodné stravovací návyky hrají klíčovou roli v prevenci mnoha onemocnění. Spolu s adekvátní pohybovou aktivitou a nekouřením zásadně sniţují riziko vzniku nejen kolorektálního karcinomu, ale i dalších nádorových i nenádorových onemocnění. Přesto však způsob stravování není ze zdravotního hlediska příznivý a přibývá osob s nadměrnou hmotností., Aim: The aim of the research was to get information about protective and dangerous factors of nutrition and eating habits in relation to the prevention of colorectal cancer. It focuses on intentionally chosen groups of adolescents and adults. The results were compared between both groups of respondents and with information published in professional periodicals. Methods: Quantitative research based on non-standardized questionnaires of own formulation evaluating a way of alimentation of both groups of respondents was chosen. The research took place in two chosen secondary schools and in four companies in Hradec Králové in a period from October to December 2012. Results: The total amount of 343 respondents participated in the research, namely 123 adolescents (36 %) and 220 adults (64 %). Statistical testing has shown that the eating habits of adults are of a higher quality than the eating habits of adolescents. Nevertheless, both groups consume insufficient amount of fruit and vegetables. On the other hand, they frequently consume red meat, meat products and fried food. Bad eating habits are proven even by the quantity of overweight and obesity occurrence; 20,4 % of interviewed adolescents and even 63,6 % of interviewed adults are of a higher than normal weight. Moreover, one third of adolescents eat in fast-foods. Conclusion: Healthy nutrition and correct eating habits play a key role in the prevention of many diseases. Together with adequate physical activity and no smoking they reduce essentially the risk of occurrence not only of colorectal cancer but also of other cancerous and noncancerous diseases. However, the way of alimentation is not beneficial from the point of view of health and the number of people with overweight is increasing., Tereza Dolénková, Pavol Hlúbik, and Literatura
Syndrom polycystických ovarií (PCOS) se považuje za jednu z nejčastěji se vyskytujících endokrinopatií u žen ve fertilním věku. Ženy trpící PCOS jsou ve 30–80 % současně obézní a obezita je často doprovázena hyperinzulinemií a inzulinovou rezistencí, a to i nezávisle na BMI. Většina publikovaných prací prokazuje u žen s PCOS zvýšený výskyt diabetes mellitus 2. typu. U žen s PCOS je 2,89krát vyšší riziko vzniku gestačního diabetu nežli u kontrolních pacientek. Doporučuje se proto provádět screening orálním glukózovým tolerančním testem. Prvním opatřením v péči o obézní pacientky s PCOS je úprava životního stylu, byť chybí pro toto opatření opora v dostatečném množství kontrolovaných studií na toto téma. Pokud nedojde k úpravě porušené glukózové tolerance, je indikován metformin, u nějž ovšem také chybí dostatek údajů o podávání gravidním s cílem prevence rozvoje GDM. PCOS se ovšem vyskytuje až u 30 % žen s diabetes mellitus 1. typu a bývá spojován s terapií inzulinem. Dosavadní pilotní studie prokazují, že se v terapii příznivě uplatňuje metformin, a u žen, které nechtějí otěhotnět, kombinovaná hormonální kontraceptiva s neandrogenními gestageny. Klíčová slova: diabetes mellitus – gestageny – kombinovaná hormonální kontraceptiva – metformin – orální glukózový toleranční test – porušená glukózová tolerance – syndrom polycystických ovarií, Polycystic ovary syndrome (PCOS) is considered one of the most common endocrinopathies in women of childbearing age. 30 – 80 % of women suffering from PCOS are obese and obesity is often accompanied by hyperinsulinemia and insulin resistance, even independently of body mass index. Most of the published works have demonstrated an increased incidence of type 2 diabetes in women with PCOS. There is 2,89 times higher risk of developing gestational diabetes in women with PCOS comparing to control group. Therefore, it is recommended to perform oral glucose tolerance test. It is highly recommended to begin with lifestyle changes as the first step in treating obese woman with PCOS although there is lack of evidence from controlled trials. If impaired glucose tolerance does not improve, metformin is indicated, but there is lack of data on the use in pregnant women as a prevention of GDM development. PCOS occurs in up to 30% of women with type 1 diabetes and is associated with insulin therapy. The existing pilot studies have demonstrated that metformin is useful in therapy. The combined hormonal contraceptives with non-androgenic gestagens are applied in women who do not want to be pregnant. Key words: combined hormonal contraceptives – diabetes mellitus – gestagens – impaired glucose tolerance – metformin – oral glucose tolerance test – polycystic ovary syndrome, and Jana Vrbíková
The gene for connexin 37 (Cx37) is considered to be one of the candidate genes for cardiovascul ar disease. We evaluated the association between Cx37 (1019C>T) gene polymorphism (Pro319Ser) and ankle brachial blood pressure index (ABI) in women with type 1 (n=178) and ty pe 2 (n=111) diabetes, and in women from general population (n=862). All women were genotyped for Cx37 polymorphism. In addition to traditional cardiovascular risk factors, ABI was analyzed. In women with type 1 diabetes, ABI significantly decreased from TT to CC carriers (p for trend= 0.008). A similar trend was seen in women with type 2 diabetes (p=0.050) and in women with waist circumference above 75 th percentile (94 cm; n=208) of the general population (p=0.049). The gene for Cx37 was associated with subclinical atherosclerosis in women with type 1 and 2 diabetes and in women with advanced central obesity. The presence of C allele indicated increased risk., J. Piťha, J. A. Hubáček, P. Piťhová., and Obsahuje bibliografii
a1_Renal transplantation is associated with a large number of risk factors that can have an influe nce on early renal graft function (ERGF). One of these factors could be the increasing number of obese kidney donors. The mechanisms of reduced ERGF in obese kidney donors are still poorly understood. To that end, w e compared ERGF in recipients with body mass index (BMI), perivascular fat and plasma inflammation markers of live kidney donors. We hypothesi zed that the BMI of donors would negatively correlate with an average increase of glomerular filtration rate (GFR ) and that it would also be associated wi th increased perivascular and plasma inflammation markers in the first seven days after transplantation. Between January 2013 and December 2014, some 58 living kidney transplantation pairs were included in the study. Donor and recipient demographic data, preoperative BMI, blood C -reactive protein (CRP) and adiponectin levels, perivascular adipose tissue (PAT) samples and recipient blood creatinine levels were analy zed. The median CRP of donors was 0.68 mg/l (max: 8.66 mg/l, min: 0.33 mg/l), the median of M1 macrophages (CD14+CD16+) in one gram of PAT was 5940 (max: 41 100, min: 248) and the median of adiponectin was 411 930 pg/ml (max: 14 217 000, min: 167 300) in plasma. We did not find any association between early renal graft function and the percentage o f M1 macrophages in donor perirenal adipose tissue (p=0.83, r=0.03, n=58), adiponectin (p=0.65, r=0.06, n=58) or CRP (p=0.16, r=0.2, n=58) in plasma. The obesity level of donors, expressed as BMI, did not correlate with early renal graft function in the first seven days after transplantation. The associations between ERGF and plasma and perivascular fat inflammation markers were not significant., a2_We confirmed a negative correlation between the BMI of recipients and an average increase of GFR in the first sev en days after transplantation (p<0.02, r= -0.325, N=58). We confirmed a negative correlation of adiponectin plasma concentration to the BMI of donors., F. Thieme, L. Janousek, J. Fronek, A. Kralova, S. Cejkova, I. Kralova Lesna, R. Poledne., and Obsahuje bibliografii
Type 2 diabetes (T2D) as well as cardiovascular disease (CVD) represent major complications of obesity and associated metabolic disorders (metabolic sy ndrome). This review focuses on the effects of long-chain n-3 polyunsaturated fatty acids (omega-3) on insulin sensitivity and glucose homeostasis, which are improved by omega-3 in many animal models of metabolic syndrome, but remain frequently unaffected in humans. Here we focus on: (i) mechanistic aspects of omega-3 action, reflecting also our experiments in dietar y obese mice; and (ii) recent studies analysing omega-3’s effects in various categories of human subjects. Most animal experiments document beneficial effects of omega-3 on insulin sensitivity and glucose metabolism even under conditions of established obesity and insulin resistance. Besides positive results obtained in both cross- sectional and prospective cohort studies on healthy human populations, also some intervention studies in prediabetic subjects document amelioration of impaired glucose homeostasis by omega-3. However, the use of omega-3 to reduce a risk of new-onset diabetes in prediabetic subjects still remains to be further characterized. The results of a majority of clinical trials performed in T2D patients suggest that omega-3 have none or marginal effects on metabolic control, while effectively reducing hypertriglyceridemia in these pati ents. Despite most of the recent randomized clinical trials do not support the role of omega-3 in secondary prevention of CVD, this issue remains still controversial. Combined interventions using omega-3 and antidiabetic or hypolipidemic drugs should be further explored and considered for treatment of patients with T2D and other diseases., P. Flachs, M. Rossmeisl, J. Kopecky., and Obsahuje bibliografii a bibliografické odkazy
Increased circulating adhesion molecules in patients with obesity play an important role in the development of endothelial dysfunction/atherosclerosis. The aim of this study was to assess the contribution of various fat depots to the production of adhesion molecules in obesity. 12 women with 1st and 2nd degree of obesity, 13 women with 3rd degree of obesity and 14 lean age-matched women were included into study. Circulating levels of vascular cell adhesion molecule-1 (VCAM-1), intercellular adhesion molecule-1 (ICAM-1), and E-selectin were measured by Luminex kits. mRNA expression of ICAM-1, VCAM-1, E-selectin, monocyte chemoattractant protein-1 (MCP-1), and CD68 in subcutaneous (SAT) and visceral adipose tissue (VAT) was measured by RT-PCR; ICAM-1 and VCAM-1 protein levels by Luminex kits, normalized to protein content. Obesity increased ICAM-1 and VCAM-1 mRNA expression and protein levels and CD68 mRNA expression in VAT. Expression of E-selectin and MCP-1 did not significantly differ between groups. Expression of ICAM-1 and VCAM-1 positively correlated with expression of CD68 in both adipose depots. In VAT, ICAM-1 and VCAM-1 expression and protein levels positively correlated with BMI. Obesity was associated with increased adhesion molecules mRNA expression and protein levels in VAT, but not in SAT. Increased adhesion molecules production in visceral fat may provide a novel direct link between visceral adiposity and increased risk of cardiovascular complications., L. Bošanská ... [et al.]., and Obsahuje bibliografii a bibliografické odkazy
a1_The genes that cause or increase susceptibility to essential hypertension (EH) and related an imal models remain unknown. Their identification is unlikely to be realized with current genetic approaches, because of ambiguities in the genotype-phenotype relationships in these polygenic disorders. In turn, the phenotype is not just an aggregate of traits, but needs to be related to specific components of the circulatory control system at different stages of EH. Hence, clues about important genes must come through the phenotype, reversing the order of current approaches. A recent systems analysis has highlighted major differences in circulatory control in the two main syndromes of EH: 1) stress-and-salt-related EH (SSR-EH) - a constrictor hypertension with low blood volume; 2) hypertensive obesity - SSR-EH plus obesity. Each is initiated through sensitization of central synapses linking the cerebral cortex to the hypothalamic defense area. Several mechanis ms are probably involved, including cerebellar effects on baroreflexes. The result is a sustained increase in sympathetic neural activity at stimulus levels that have no effect in normal subjects. Subsequent progression of EH is largely thro ugh interactions with non-neural mechanisms, including changes in concentration of vascular autacoids (e.g. nitric oxide) and the amplifying effect of structural changes in large resistance vessels. The rising vasoconstriction increases heterogeneity of blood flow, causing rarefaction (decreased microvascular densit y) and deterioration of vital organs. SSR-EH also increases food intake in response to stress, but only 40% of these individual s develop hypertensive obesity. Their brain ignores the adiposity signals that normally reduce eating., a2_Hyperinsulinemia masks the sympathetic vasoconstriction through its dilator action, rais es blood volume, whilst renal nephropathy and other diabetic complications are common. In each syndrome the neural and non-neural determinants of hypertension provide targets fo r identifying high BP genes. Reading the genome from the phenotype will require new approaches, such as those used in developmental genetics. In addition, transgenic technology may help verify hypotheses and examine whether an observed effect is through single or multiple mechanisms. To obtain answers will require substantial collaborative efforts between physiologists and geneticists., P. I. Korner., and Obsahuje bibliografii
Recent studies focused on epicardial fat, formerly relatively neglected component of the heart, have elucidated some of its key roles. It possesses several properties that can distinguish it from other adipose tissue depots. Its unique anatomical location in the heart predisposes the epicardial fat to be an important player in the physiological and biochemical regulation o f cardiac homeostasis. Obesity is associated with an increase in epicardial fat mass. Excess of cardiac fat can contribute to greater left ventricular mass and work, diastolic dysfunction and attenuated septal wall thickening. Imbalance in adipokines levels secreted in autocrine or paracrine fashion by epicardial fat can contribute to the activation of the key atherogenic pathways in the setting of metabolic syndrome. Epicardial fat has also been identified as an important source of pro-inflammatory mediato rs worsening endothelial dysfunction, eventually leading to coronary artery disease. Increased production of pro-inflammatory factors by epicardial fat can also contribute to systemic insulin resistance in patients undergoing cardiac surgery. Here we revie w the most important roles of epicardial fat with respect to heart disease in the context of other underlying pathologies such as obesity and type 2 diabetes mellitus., Z. Matloch, T. Kotulák, M. Haluzík., and Obsahuje bibliografii
Gastrointestinal hormones play an important role in the neuroendocrine regulation of food intake and postprandial satiety. Ghrelin is a 28-amino acid orexigenic peptide produced mainly by the stomach that is involved in both the long-term regulation of body weight and the short-term regulation of postprandial satiety. Impairments in ghrelin secretion may in concert with other factors play an important role in the development of both obesity and anorexia nervosa. Despite an intensive research the critical factors regulating physiological postprandial ghrelin response in healthy individuals and its modification by the presence of obesity and anorexia nervosa are only partially understood. The potential contribution of ghrelin to the differences of diet- vs. surgical-induced weight losses in morbidly obese patients is now also being recognized. The aim of this review is to summarize the current knowledge about the physiology and pathophysiology of ghrelin and to discuss its potential in the prevention and/or treatment of obesity and anorexia nervosa., I. Dostálová, M. Haluzík., and Obsahuje seznam literatury