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Csép Katalin

incident diabetes mellitus in middle-aged adults: the Framingham Offspring Study. Arch Intern Med. 2007;167:1068-1074. 26. Carlos Lorenzo, Steven M. Haffner, Alena Stancakova, Markku Laakso. Relation of Direct and Surrogate Measures of Insulin Resistance to Cardiovascular Risk Factors in Nondiabetic Finnish Offspring of Type 2 Diabetic Individuals. J Clin Endocrinol Metab. 2010;95:5082-5090. 27. Mottillo S, Filion K, Genest J, et al. The Metabolic Syndrome and Cardiovascular Risk - A Systematic Review and Meta-Analysis. J Am Coll Cardiol

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Atsuhiko Ota, Takeshi Masue, Nobufumi Yasuda, Akizumi Tsutsumi, Yoshio Mino, Hiroshi Ohara and Yuichiro Ono

: A review and meta-analysis. Am J Public Health. 1994; 84:1086-93. 14. Stevens KR, Munoz LR. Cigarette smoking: evidence to guide measurement. Res Nurs Health. 2004; 27: 281-92. 15. Hagimoto A, Nakamura M, Morita T, Masui S, Oshima A. Smoking cessation patterns and predictors of quitting smoking among the Japanese general population: a 1-year follow-up study. Addiction. 2010; 105:164-73. 16. Honjo K, Iso H, Inoue M, Tsugane S; JPHC Study Group. Smoking cessation: predictive factors among middle-aged Japanese. Nicotine

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Ermira Krasniqi, Mynyr Koni, Idriz Berisha and Arben Boshnjaku

measure in an outpatient setting. J Clin Hypertens (Greenwich) 2008;10(5):348-54. 5. Bardel A, Wallander MA, Svärdsudd K. Reported current use of prescription drugs and some of its determinants among 35 to 65-year-old women in mid-Sweden: A population-based study. J Clin Epidemiol 2000;53(6):637-43. 6. Mijnarends DM, Koster A, Schols JM, et al. Physical activity and incidence of sarcopenia: the population-based AGES-Reykjavik study. Age Ageing 2016;45(5):614-20. 7. Myers J, Prakash M, Froelicher V, et al. Exercise capacity and mortality among men

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Caterina Grif, C Rădulescu, S Voidăzan, Carmen Popa and O Grama

. J Pregnancy. 2011;2011:640-715. 13. Figueras F, Eixarch E, Meler E et al. Small-for-gestational-age fetuses with normal umbilical artery Doppler have suboptimal perinatal and neurodevelopmental outcome. Eur J Obstet Gynecol Reprod Biol. 2008;136(1):34-38. 14. Simanaviciute D, Gudmundsson S. Fetal middle cerebral to uterine artery pulsatility index ratios in normal and pre-eclamptic pregnancies. Ultrasound Obstet Gynecol. 2006;28:794-801. 15. Odibo AO, Riddick C, Pare E, Stamilio DM, Macones GA. Cerebroplacental

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Verica Milošević and Vladimir Ajdžanović

-pituitary sensitivity to estrogen. JAMA 2004; 292(24): 2991-6. 8. Downs JL, Wise PM. The role of the brain in female reproductive aging. Mol Cell Endocrinol 2009; 299(1): 32-8. 9. Mercuri N, Petraglia F, Genazzani AD, Amato F, Sgherzi MR, Maietta-Latessa A, De Leo V, Nappi C, Genazzani AR. Hormonal treatments modulate pulsatile plasma growth hormone, gonadotrophin and osteocalcin levels in postmenopausal women. Maturitas 1993; 17(1): 51-62. 10. Sekulić M, Lovren M, Milošević V. Immunoreactive TSH cells in the pituitary of female middle-aged

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Lars Uhrenholt, Lene Warner Thorup Boel and Asser Hedegaard Thomsen

, Yantsides C. The Effect of an All-Ages Bicycle Helmet Law on Bicycle-Related Trauma. J Community Health 2016; 41(6):1160-1166. [21] Rivara FP, Thompson DC, Thompson RS. Epidemiology of bicycle injuries and risk factors for serious injury. Inj Prev 1997; 3(2):110-114. [22] Munkholm J, Thomsen AH, Lynnerup N. [Fatal bicycle accidents involving right turning heavy goods vehicles--forensic pathological findings]. Ugeskr Laeger 2007; 169(3):232-235. [23] Havarikommissionen for Vejtrafikulykker. Ulykker mellem højresvingende lastbiler og ligeudkørende

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Katalin Csép, Eszter Szigeti and Krisztina Szalman


Objective: Methylene-tetrahydrofolate reductase (MTHFR) is involved in adapting metabolism to environmental challenges by various mechanisms, including the control of gene expression by epigenetic and post-translational changes of transcription factors. Though a metabolic syndrome candidate gene, association studies of its common polymorphism rs1801133 (MTHFR-Ala222Val) remain inconclusive with important ethnic differences, and the effect on disease progression was not addressed.

Methods: 307 middle-aged metabolic syndrome patients in a central Romanian hospital setting were investigated metabolically, and genotyped by PCR-RFLP. Disease progression was assessed by the age of onset of metabolic components, as well as development of non-alcoholic fatty liver disease and atherosclerotic complications.

Results: The minor allele frequency of rs1801133 was 30.13%. Metabolic parameters showed no statistically significant differences according to genotype, but variant carriers developed dysglycemia and dyslipidemia earlier (53.28±10.8 vs 59.44±9.31 years, p<0.05 and 58.57±11.31 vs 64.72±10.6 years, p<0.1).While the polymorphism did not influence hepatic complications, an inverse association was found for manifest atherosclerosis (OR=0.49, p=0.006, 95%CI:0.29-0.81), which may be folate-status dependent, and needs further investigations. Simultaneous analysis with transcription factor polymorphisms (rs1801282, rs8192678) showed that the more protective genotypes were present the later metabolic disturbances developed, and in the presence of the other two variants the apparent protective cardiovascular effect disappeared.

Conclusions: The common functional polymorphism rs1801133 may influence metabolic syndrome progression, the age of onset of components and development of atherosclerotic complications. Besides simple additive effects, complex mitigating and aggravating variant interactions may exist, and the protective or predisposing outcome may depend on modifiable environmental factors.

Open access

Man Lidia, Pitea Ana Maria, Chinceșan Mihaela Ioana, Man A, Mărginean Oana and Baghiu Maria Despina

concentrations do not refl ect nutritional state in children with cerebral palsy. J Pediatr. 2005;147(5):695-7. 33. Bennett F, Walker S, Gaskin P, Powell C. Fasting levels of serum glucose, cholesterol and triglyceride at age eleven to twelve years in stunted and non-stunted Jamaican children. Acta Pædiatrica. 2002;91(9):903-8. 34. Bandsma RHJ, Spoelstra MN, Mari A, et al. Impaired Glucose Absorption in Children with Severe Malnutrition. J Pediatr. 2011;158(2):282-287.e1. 35. Das BK, Ramesh J, Agarwal JK, Mishra OP, Bhatt RP

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Theodora Temelkova-Kurktschiev, Tsvetan Stefanov, Carsta Koehler, Elena Henkel, Frank Schaper and Markolf Hanefeld


AIM: To examine the relationship between physical activity (PA) and various cardiometabolic risk factors during an oral glucose tolerance test (OGTT), including glycemic spikes (PGS) in individuals at risk for type 2 diabetes.

SUBJECTS AND METHODS: A total of 949 middle-aged subjects from the Risk factors in Impaired Glucose Tolerance for Atherosclerosis and Diabetes (RIAD) trial aged 40-70 years were included in the present cross-sectional analysis. Standard 75 g OGTT was performed and blood was collected every 30 min for 2 hours for measurements of plasma glucose (PG) and other cardiometabolic risk factors. PA was assessed using interviewer-administered questionnaire.

RESULTS: Post-challenge PGS and maximal PG (PGmax) during OGTT were significantly lower in individuals with high PA vs. individuals with low PA even after body mass index (BMI) adjustment (p = 0.026 and p = 0.035, respectively). In univariate analysis post-challenge PG 30, 60, 90, and 120 minutes, PGS and PGmax during OGTT were significantly inversely correlated to PA. This correlation was attenuated but remained significant after adjustment for BMI. Fasting PG and glycosylated hemoglobin were not correlated to PA. Significantly higher fasting and post-challenge insulin levels were found among subjects with low vs. subjects with medium (p < 0.05) and high PA (p < 0.05). Post-challenge C-peptide and proinsulin levels were significantly lower in participants with high vs. participants with low PA (p < 0.05 for all). The relationship between 2-h PG and PA was observed also in lean subjects and in subjects with normal fasting glucose. In multivariate analysis PA was a significant independent determinant of 2-h PG.

CONCLUSION: We found a strong inverse relationship between PA and various post-challenge cardiometabolic parameters during OGTT, including glycemic spikes, in a population at risk for diabetes. This relationship was only partially dependent on BMI.

Open access

Nitu Radu, Bordei Petru, Baz Radu and Ispas Viorel


Are described morphological features of myocardial bridges at the anterior interventricular artery obtained from the analysis of 274 cases with 312 myocardial bridges detected by angioCT performed over a period of 3.5 years on a total of 2857 subjects. CT examinations were performed on 1496 females, aged 56-79 years, and 1361 male subjects aged 34-74 years. At the level of the anterior interventricular artery we encountered 231 cases with myocardial bridges (84.31% of the total number of cases), being 267 myocardial bridges (85.58% of the total bridges analyzed). In the case of single myocardial bridges of the anterior interventricular artery, in 65 cases (33.33% of the 195 cases) they were located in the upper third of the artery, 32 cases were female (31.68% of female myocardial bridges) and 33 in male sex (35.11% of male myocardial bridges). In 129 cases (66.67%) were located in the middle third of the artery, 69 cases were female (63.30% female myocardial bridges) and 60 cases in male (64.89% of male myocardial bridges). In one case with three myocardial bridges, the inferior myocardial bridge was located in the lower third of the anterior interventricular artery. The length of the myocardial bridge was between 11.9 and 73.1 mm, for the female gender being 11.9-28.7 mm, and male 9.4-73.1 mm. The thickness of the myocardial bridge was found between 0.9-5.7 mm, for the female gender being 0.9-5.2 mm, and for the male the thickness was 1.7-5.7 mm. The caliber of the tunneling artery was found between 1.2-2.5 mm in female gender, for the male gender 1.3-4 mm.