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Costela Lăcrimioara Șerban, Denis Mihai Șerban, Ștefania Ioana Butica and Diana Lungeanu

Abstract

Since their publication in 1965, the Bradford Hill criteria for causality have been largely used as a framework for causal inference in epidemiology. We aim at employing this classical approach to shed new light onto the web of causation of childhood obesity. Although the fundamental cause of obesity is the long-term imbalance between energetic need and intake, this medical condition is multifactorial in its origin, influenced by genetic, behavioral, socioeconomic, and environmental factors. This imbalance leads to accumulation of excessive adipose tissue. Observational studies tend to mostly quantify association between dietary factors and accumulation of adipose tissue. On the other hand, multivariate analysis proved some of these associations to be spurious, therefore prospective trials are needed to demonstrate causality. Short term experimental studies have been conducted to identify unique dietary pattern changes on specific outcomes, but long term, community-based studies would offer more comprehensive answers on dietary pattern effects. We conducted a literature review on PubMed, Scopus, Web of Science, and Google Scholar. From a total of 323 papers identified at first stage, we further discuss the applicability of Bradford Hill criteria for 31 articles, by examples of dietary patterns and accumulation of excess body fat as exposure-response associations. We also put forward and analyzed the evidence prospective studies would bring, as foundation for future interventions.

Open access

Rucsandra Dănciulescu Miulescu, Anna Maria Tinu, Denisa Margină, Daniela Grădinaru, Anca Ungurianu and Loreta Guja

Abstract

Hypertriglyceridemia is defined as a value of fasting serum triglyceride over 150 mg/dl. The classification of hypertriglyceridemia according to the Endocrinology Society include mild and moderate hypertriglyceridemia, severe hypertriglyceridemia and very severe hypertriglyceridemia. Mild and moderate hypertriglyceridemia increase the risk for cardiovascular events while severe and very severe hypertriglyceridemia is a risk factor for acute pancreatitis. Conventional pharmacological therapy of hypertriglyceridemia includes: fibrates, niacin, statins, ezetimibe, omega-3-fatty acid. Other triglyceridelowering therapies are represented by plasmapheresis and lipoprotein lipase gene therapy. The present work refers to a 59-year old man without history of family diabetes, dyslipidemia, premature coronary artery disease, diagnosed with T2DM in 2012, from 2014 on insulin treatment; he was hospitalized for endocrine evaluation. History: high blood pressure for approximately 25 years, chronic kidney disease, very severe hypertriglyceridemia, thyroid papillary carcinoma. The patient followed treatment with hypoglycemic, hypolipemic, low salt content diet, fibrates, statins, omega-3-fatty acid. Due to the fact that the patient did not respond to conventional therapy plasmapheresis was considered.

Open access

Kateryna Moshenets

Abstract

Background and aims: to develop a prognostic mathematical model for risk of microangiopathy in patients with diabetes mellitus type 1 (T1DM). Materials and methods: 62 T1DM patients were divided into 2 groups according to НвА1с level: group 1 (n=18) with НвА1с ≤ 7.0% and group 2 (n=44) with НвА1с > of 7.0%. HbA1c, Cpeptide, blood creatinine, estimated glomerular filtration rate (eGFR) CKD-EPI, first morning urinary albumin excretion (AU) were determined. Blood glucose levels were conducted by CGMS (Continuous Glucose Monitoring System). All patients were followed for 3 months. Rank correlation method was used. Results: We established the direct correlation between HbA1c the AU level ρ=0.29 (р<0.016) at the beginning and ρ=0.4 (р=0.021) after 3 months. AU level has a direct correlation with blood glucose range, at the beginning ρ=0.51 (р<0.001) and after 3 months ρ=0.48 (р=0.004) visits. We made the mathematical description of this dependence. Each additional unit of blood glucose range is accompanied by increasing an average level AU level by 0.4816 mg/l. Conclusion: our mathematical equation of dependence between AU level and blood glucose range gives the opportunities to predict diabetic kidney disease progression in T1DM patients.

Open access

Victoria Serhiyenko, Ludmila Serhiyenko and Alexandr Serhiyenko

Abstract

Background and Aims: Diabetic cardiac autonomic neuropathy (DCAN) in type 2 diabetes (T2D) is among the strongest and independent risk markers for future global and cardiac mortality. Material and Methods: Thirty-six patients suffering from T2D and confirmed DCAN were enrolled in this investigation. Depending on the prescribed therapy, patients were allocated into two groups: group 1 was comprised of 15 patients to whom standard hypoglycemic treatment was prescribed (control group), the second received standard hypoglycemic treatment and omega-3 polyunsaturated fatty acids (ω-3 PUFAs, n = 21). The duration of the study was three month. Results: In subjects with T2D and DСAN prescription of ω-3 PUFAs was associated with a significant decrease of aorta augmentation index (AIxao), pulse wave velocity (PWV) during the active period of the day and decrease of AIxao, brachial augmentation index and PWV during the passive period of the day compared with the control group. Therefore, three month of ω-3 PUFAs supplementation to patients with confirmed DCAN and T2D promotes to improvement of arterial stiffness indices. Conclusions: In patients with T2D and СAN treatment with ω-3 PUFAs improved arterial stiffness parameters. The effectiveness of ω-3 PUFAs is not connected with optimization of glycemic control, but is rather the result of a direct drug action on the studied parameters.

Open access

Іnna Krynytska, Mariya Marushchak, Inna Birchenko and Ivan Klishch

Abstract

Background and aims: Diabetes mellitus (DM) is a significant public health issue, being one of the major contributors to morbidity and mortality in the modern societies. Chronic hyperglycemia produces significant physiological, biochemical, and histological changes in the affected organisms. This study aims to evaluate the markers of endogenous intoxication in rats with diabetes mellitus combined with carrageenan-induced enterocolitis. Materials and methods: Diabetes mellitus was induced by a single intraperitoneal administration of streptozotocin (Sigma Aldrich, USA, at a dose of 60 mg/kg body weight). Carrageenan-induced enterocolitis was modeled by giving the animals free access to 1.0 % solution of carrageenan in drinking water for 1 month. The syndrome of endogenous intoxication was assessed by quantification of low and medium molecular weight substances in blood plasma, red blood cell suspension and urine using extraction-spectrophotometric method. Results: The increase in endogenous intoxication in streptozotocin-induced diabetes combined with chronic enterocolitis can mainly be attributed to the catabolic pool of blood plasma substances of low and medium molecular weight. The index of distribution of low- and medium-molecular-weight substances between blood plasma proteins and glycocalyx of erythrocytes in the experimental groups increased simultaneously with the quantities of investigated fractions in the erythrocyte suspension measured at the wavelengths of 242, 254 and 280 nm. Conclusions: We observed upsurge of endogenous intoxication markers in the rats with diabetes mellitus. Endotoxicosis became even more evident in the rats with diabetes mellitus combined with carrageenan-induced enterocolitis.

Open access

Anca Jivanescu, Luciana Goguta, Armina Stemper, Raul Rotar and Luminita Nica

Abstract

Introduction. The most frequent oral complications of diabetes are periodontal disease and caries. If left untreated, these may lead to tooth loss, with a significant psychological impact, especially in young patients. Case report. This case report presents a type 1 diabetes young female patient with periodontal disease, poor decay control and tooth loss, that create functional and esthetic issues. After consulting the diabetes specialist, an interdisciplinary dental treatment plan which comprise surgical, periodontal, endodontic and prosthetic rehabilitation was initiated. Long-term provisional computer-aided design and computer-aided manufacturing (CAD-CAM) fixed partial dentures were fabricated to stabilize the occlusion and to obtain in short term an optimal functional and esthetic rehabilitation. Conclusion. This case reveals a consistent collaboration between the prosthodontist, periodontist and endodontist, with an effective monitoring from the diabetes specialist, that conduct to a successful oral rehabilitation for a young female patient with type I diabetes.

Open access

Mohamed Abdelhaq Abbes and Karima Bereksi-Reguig

Abstract

Background and aims: The influence of a low caloric diet with exercise were studied on several biochemical parameters including the lipid profile and atherogenic indices in overweight subjects including obesity with hypertension. Material and method: The study focused on 327 patients (144 men and 183 women) aged 54-73 years selected randomly, We chose hypertensives who live in the city of Tiaret and are over 50 years old, because it is the age group most affected by hypertension in Algeria and even in the world. We invited the subjects of our study to follow a program involving a low caloric diet, which was characterized by the suppression of the consumption of sucrose and refined white flour and by the choice of low-fat products, especially dairy products. Results: We observed a decrease in the mean value of blood pressure with its two components, systolic and diastolic. Systolic blood pressure ranged from 13.06 ± 1.40 cm Hg for the overall sample to 13.01 ± 1.12 cm Hg after the six-month program. The same finding is made for diastolic pressure, which decreased by 1.58% for the study population. For biochemical parameters, we observe a decrease in the mean value of all parameters after participation in the low-calorie diet and physical activity program, with the exception of HDL-c, which experienced an increase of 6.25%. Conclusions: The hypocaloric diet with exercise that we proposed to a group of hypertensives showed its effectiveness. A healthy lifestyle including a healthy and balanced diet with physical activity therefore allow better management of the hypertensive subject and could actually prevent atherosclerosis.

Open access

Nartyr Sunarti, Sri Lestari Sulistyo Rini, Hemi Sinorita and Dini Ariani

Abstract

Background and aims: High levels of non-HDL and atherogenic cholesterol can induce inflammation, and as risk factor for cardiovascular diseases. This study was to evaluate the effects of fiber-rich snacks on non-HDL cholesterol, atherogenic index, and Creactive protein (CRP) levels in type 2 diabetes patients (T2DM). Material and Methods: Twenty T2DM patients, were recruited from the Policlinic of Endocrine, Dr. Sardjito General Hospital, Yogyakarta, Indonesia. The subjects received daily 32g fiber-rich snacks made of Dioscorea esculenta, arrowroot, cassava and pumpkin for 4 weeks. Fasting non-HDL cholesterol, atherogenic index, CRP and HbA1c levels were measured before and after intervention. Paired t-test was used to evaluate the results. Results: The fiber-rich snack intervention in T2DM patients significantly reduced levels of non-HDL cholesterol and CRP levels (p<0.05), but the decreased the atherogenic index was not significant (p>0.05). The intervention also significantly reduced the CRP levels (p<0.05) but did not affect HbA1c levels. Body weight, body mass index (BMI), waist circumference decreased significantly after consuming the snacks (p<0.05). Conclusions: This study showed fiber-rich snack has a positive effect in improving non-HDL cholesterol, atherogenic index and CRP levels but does not affect HbA1c levels in T2DM patients.

Open access

Kateryna Posokhova, Iryna Stechyshyn, Inna Krynytska, Mariya Marushchak, Inna Birchenko and Ivan Klishch

Abstract

Background and aims: Diabetes mellitus (DM) is a multifactorial metabolic disorder characterized by hyperglycaemia caused by insulin deficiency or insulin resistance. It is a global public health problem. This study aimed to determine specific pharmacological effect of quercetin in water soluble and liposomal preparations in experimental diabetes mellitus. Material and methods: We examined the effect of Corvitin and Lipoflavone (at the dose of 10 mg / kg body weight) in a comparative study in white rats with type 1 diabetes and type 2 diabetes coupled with obesity. To simulate the forms of diabetes mellitus most analogous to those in humans we used Streptozotocin at the doses of 30 mg / kg and 50 mg / kg. We tested the levels of glucose, glycosylated hemoglobin, C-reactive protein, and interleukins 6 and 4 in the blood. Results: In animals with type 1 and type 2 diabetes Lipoflavone significantly reduces glucose and glycosylated hemoglobin levels compared to the rats treated with Corvitin. When administered to animals with diabetes, the effect of quercetin in liposomal form on the concentrations of IL-6, IL-4 and Creactive protein is also larger compared to the water-soluble form. Conclusions: Water soluble quercetin preparation Corvitin and to a larger extent liposomal preparation of this flavonoid, Lipoflavone, show anti-inflammatory effect and restore key parameters of carbohydrate metabolism in experimental type 1 diabetes mellitus and type 2 diabetes coupled with obesity, reducing blood glucose and glycosylated hemoglobin levels.