Janusz Gumprecht

Publications of Janusz Gumprecht

• Phalangeal Quantitative Ultrasound Measurements in Chronic Hemodialysis Patients: A 4-Year Follow-Up.

  Authors: Joanna Zywiec, Wojciech Pluskiewicz, Piotr Adamczyk, Alina Skubala, Janusz Gumprecht

  Ultrasound in medicine & biology. 04/2012;

  In the course of chronic kidney disease, bone metabolism disturbances occur and become aggravated simultaneously with the progression of renal disorder, worsening patients' quality of life. WeIn the course of chronic kidney disease, bone metabolism disturbances occur and become aggravated simultaneously with the progression of renal disorder, worsening patients' quality of life. We conducted a 4-year follow-up to assess phalangeal quantitative ultrasound (QUS) measurements in 32 patients undergoing chronic hemodialysis (17 males and 15 females) whose mean ages were 56.3 ± 15.2 years. The QUSs of hand phalanges were performed using DBM 1200 (IGEA, Carpi, Italy) and are expressed as amplitude-dependent speed of sound (Ad-SoS), Z-scores, and T-scores. In comparison with the age-, sex-, and body mass index-adjusted control group, QUS parameters were significantly decreased in all patients undergoing dialysis. During the 4-year follow-up, Ad-SoS and T-scores in all study groups sloped significantly with time. The significant negative relationships between follow-up Ad-SoS results and both baseline and follow-up parathormone values were demonstrated. Our results confirm a high prevalence of bone disturbances in patients undergoing chronic hemodialysis, and they do not improve during renal replacement therapy. The parathormone level seems to be an important agent in influencing bone status, but further studies are needed to understand the other risk factors in kidney-related bone disease.

• [Effects of glucagon-like peptide 1 and its receptor agonist - liraglutide on cardiovascular system].

  Authors: Grzegorz Gajos, Adam Stefański, Janusz Gumprecht

  Kardiologia polska. 01/2011; 69(7):709-16.

• Blood glucose level on admission determines in-hospital and long-term mortality in patients with ST-segment elevation myocardial infarction complicated by cardiogenic shock treated with percutaneous coronary intervention.

  Authors: Damian Pres, Mariusz Gasior, Krzysztof Strojek, Marek Gierlotka, Michał Hawranek, Andrzej Lekston, Krzysztof Wilczek, Mateusz Tajstra, Janusz Gumprecht, Lech Poloński

  Kardiologia polska. 07/2010; 68(7):743-51.

  It has been shown that hyperglycaemia is associated with increased in-hospital and long-term mortality in patients with myocardial infarction (MI). There are only a few reports on the relationshipIt has been shown that hyperglycaemia is associated with increased in-hospital and long-term mortality in patients with myocardial infarction (MI). There are only a few reports on the relationship between glycaemia in the acute phase of MI complicated by cardiogenic shock (CS) and prognosis. To assess the relationship between blood glucose level on admission and in-hospital as well as long-term mortality in patients with acute ST-segment elevation MI (STEMI) complicated by CS treated with percutaneous coronary intervention (PCI). Consecutive patients with STEMI complicated by CS treated with PCI were included. For the purpose of this analysis, the patients were divided into two groups: the first group included patients with glycaemia on admission < 7.8 mmol/L, and the other group patients with glycaemia > or = 7.8 mmol/L (hyperglycaemia group). Selected parameters from the in-hospital and long-term follow-up were compared between the two groups. Due to a possible linear relationship between blood glucose and mortality in multivariate analysis, glucose level on admission was treated as a continuous variable. The primary outcomes included in-hospital, 1-year and 5-year mortality. Out of 3166 consecutive patients with STEMI, 258 had CS and available data on glycaemia. In patients with hyperglycaemia on admission, we observed higher in-hospital (41.5% vs 28%, p = 0.041), 1-year (51.4% vs 34.7%, p = 0.015) and 5-year (65.8% vs 43.3%, p = 0.034) mortality in comparison to the patients with blood glucose < 7.8 mmol/L. The multivariate analysis revealed that blood glucose level on admission (per each glycaemia increment by 1 mmol/L) was an independent prognostic factor of in-hospital (OR 1.08, 95% CI 1.02-1.14, p = 0.0044), 1-year (HR 1.04, 95% CI 1.01-1.06, p = 0.005) and 5-year mortality (HR 1.03, 95% CI 1.01-1.05, p = 0.045). Of note, the diagnosis of diabetes mellitus had no influence on in-hospital and long-term mortality. Elevated blood glucose level on admission, regardless of the diagnosis of diabetes mellitus, results in increased in-hospital and long-term mortality in patients with STEMI complicated by CS and treated with PCI.

• Expression profile of significant immortalization genes in colon cancer.

  Authors: Agnieszka Witkowska, Janusz Gumprecht, Joanna Glogowska-Ligus, Grzegorz Wystrychowski, Aleksander Owczarek, Malgorzata Stachowicz, Alina Bocianowska, Ewa Nowakowska-Zajdel, Urszula Mazurek

  International journal of molecular medicine. 03/2010; 25(3):321-9.

  Cancer is a disease of genomic instability, a multistep process involving numerous mutations and chromosomal aberrations. Telomeres are highly specialized structures at the ends of chromosomes andCancer is a disease of genomic instability, a multistep process involving numerous mutations and chromosomal aberrations. Telomeres are highly specialized structures at the ends of chromosomes and function to stabilize and protect the ends of linear chromosomes, therefore determining cellular immortalization. Homeostasis of telomere length is a multifactor-dependent process. Since cellular immortalization is an early and essential step towards cancer, the aim of the present study was to determine immortalization genes that are significant in colon cancer and assess their usefulness in the early diagnosis of this tumor. Expression profiles of 119 transcripts known to be involved in cellular immortalization were assessed with oligonucleotide microarrays in 13 probes of colon adenocarcinoma (low and high clinical stages) and 9 probes of controls (normal colon tissue) and were compared among these groups with the use of the Significant Analysis Microarray (SAM) software and independently verified with the effect size parameter. Eighteen genes with significantly differential expression between high clinical stage colon cancer and the control group, and 21 with differential expression between low clinical stage colon cancer and the control group were identified. Nine genes showing altered expression in both low and high clinical stage colon cancer: ACD (TPP1), DKC1 and ERCC1, MYC, MAX, NBN, NOLA2, PRKDC and HSP82 should, in particular, be the subjects of further studies including QRT-PCR methods.

• Prognosis in diabetic patients with acute myocardial infarction treated invasively is related to renal function.

  Authors: Jacek Kowalczyk, Radoslaw Lenarczyk, Krzysztof Strojek, Teresa Zielinska, Janusz Gumprecht, Agnieszka Sedkowska, Tomasz Kukulski, Marcin Swierad, Oskar Kowalski, Beata Sredniawa, Lech Polonski, Marian Zembala, Zbigniew Kalarus

  Medical science monitor : international medical journal of experimental and clinical research. 02/2010; 16(2):CR67-74.

  The prevalence of diabetes mellitus (DM) and chronic kidney disease (CKD) is rapidly increasing. Both comorbidities are considered significant risk factors for cardiovascular complications. The aimThe prevalence of diabetes mellitus (DM) and chronic kidney disease (CKD) is rapidly increasing. Both comorbidities are considered significant risk factors for cardiovascular complications. The aim of the study was to evaluate the impact of DM with and without CKD on prognosis in patients with acute myocardial infarction (AMI) treated invasively. This single-center prospective study encompassed 3334 AMI-patients without cardiogenic shock, who were divided into 2 major groups: 999 patients with type 2 DM diagnosed prior to or during index hospitalization, and 2335 non-diabetics. All diabetic patients were divided with respect to their renal status into: diabetics with CKD (DM-CKD; n=264) and without (DM-nCKD; n=735). Short- and long-term outcomes were compared between study groups. Independent predictors of death and composite end-point were selected with multivariate Cox-regression model. Mortality rates were significantly higher in DM group compared to nDM in all observation periods. DM-CKD was associated with excessive total mortality (35.6%) when compared to DM-nCKD (11.6%, P<0.001) and to nDM (9.8%, P<0.001). Mortality and major adverse cardiovascular event rates did not differ significantly between DM-nCKD and nDM groups. Diabetes coexisting with CKD was one of the strongest independent risk factors for death (hazard ratio 1.93; confidence interval 1.79-2.07; P<0.001). The prognosis in diabetics with AMI is significantly related to renal function. Diabetics without CKD had similar prognosis to non-diabetics. Multivariate analyses showed that unlike diabetes without renal dysfunction, DM-CKD was an independent risk factor for cardiovascular complications and total mortality.

• Continuous glucose monitoring system in 72-hour glucose profile assessment in patients with end-stage renal disease on maintenance continuous ambulatory peritoneal dialysis.

  Authors: Alina Skubala, Joanna Zywiec, Katarzyna Zełobowska, Janusz Gumprecht, Władysław Grzeszczak

  Medical science monitor : international medical journal of experimental and clinical research. 02/2010; 16(2):CR75-83.

  Glucose has been the main osmole used in conventional peritoneal fluids (PDFs) since the beginning of continuous ambulatory peritoneal dialysis (CAPD). There is much concern regarding the possibleGlucose has been the main osmole used in conventional peritoneal fluids (PDFs) since the beginning of continuous ambulatory peritoneal dialysis (CAPD). There is much concern regarding the possible risk to the good level of glycemia control lately observed. The aim of this study was to analyze, with the use of 72-hour continuous glucose monitoring system (CGMS), the influence of PDFs containing supra-physiological glucose concentrations on daily glucose profile in patients with end stage renal disease (ESRD) undergoing CAPD therapy. There were 30 diabetic and non-diabetic patients on CAPD using conventional 1.36% or 2.27% glucose PDFs examined in the study, with a control group of 13 healthy volunteers. All participants underwent 72-hour CGMS and HbA1c evaluation. There was the whole area under the curve (AUC) of each 24-hour glucose profile and of glucose excursion above 90 mg/dl estimated. The high transport status appeared to significantly influence the mean maximum glucose value and its increment following peritoneal exchange (PE) in the study group and in a subgroup of diabetic patients, whereas in non-diabetics the mean 24-hour glucose concentration was importantly influenced. The percentage of glucose levels in the range above 90 mg/dl was significantly influenced by higher glucose concentration in the PDFs, as well as higher peritoneal transport status. The outcomes indicate that dialysate glucose concentration, as well as type of peritoneal transport, influence the occurrence of persistent hyperglycemia state, and suggest that CAPD may predispose to appearance of glycemic disorders.

• The role of glucagon-like peptide 1 in glucose homeostasis and in other aspects of human physiology.

  Authors: Edward Franek, Grzegorz Gajos, Janusz Gumprecht, Adam Krętowski, Barbara Zahorska-Markiewicz, Maciej Małecki

  Polskie archiwum medycyny wewnetrznej. 11/2009; 119(11):743-751.

  This paper reviews the structure, function, and pathophysiology of glucagon-like peptide 1 (GLP-1). It describes the physiology and pathophysiology of the incretin axis, of which GLP-1 is aThis paper reviews the structure, function, and pathophysiology of glucagon-like peptide 1 (GLP-1). It describes the physiology and pathophysiology of the incretin axis, of which GLP-1 is a component, as well as the biosynthesis, secretion, activity, and degradation of this intestinal hormone. Effects of GLP-1 on the endocrine function of the pancreas, cardiovascular system, central nervous system, and on water-electrolyte balance have been also presented.

• Mitogenic potency of insulin glargine

  Authors: Katarzyna Zelobowska, Janusz Gumprecht, Wladyslaw Grzeszczak

  Endokrynologia Polska. 01/2009; 60(1):34-9.

  The goal of diabetes mellitus treatment is to maintain long-term near-normoglycaemia to prevent the onset or progression of long-term complications. In order to achieve tight glycaemic control andThe goal of diabetes mellitus treatment is to maintain long-term near-normoglycaemia to prevent the onset or progression of long-term complications. In order to achieve tight glycaemic control and improve the quality of life for diabetic patients, a number of novel insulin preparations, insulin analogues, have been constructed thanks to recombinant DNA technologies and advanced protein chemistry. Because structurally modified insulins may differ from human insulin not only in metabolic but also in mitogenic potencies there were concerns raised about the possibility of increased insulin analogue proliferative action or tumourigenesis. In vitro and in vivo studies on insulin analogues in comparison to endogenous insulin have been performed to closely monitor the insulin analogue action profiles. Insulin glargine was the only one presenting a significant increase in affinity to insulin-like growth factor type 1 (IGF-1) receptor. However, there was controversy regarding the safety of insulin glargine use because of its potential risk of mitogenicity but it proved to be true only for human osteosarcoma cells Saos/B10. Outcomes of the studies performed on lines other than cancer cells and on animals did not present any increased mitogenic activity nor mitogenic potency of insulin glargine in comparison to human insulin.

• Effect of blood glucose levels on prognosis in acute myocardial infarction in patients with and without diabetes, undergoing percutaneous coronary intervention.

  Authors: Mariusz Gasior, Damian Pres, Gabriela Stasik-Pres, Piotr Lech, Marek Gierlotka, Michał Hawranek, Krzysztof Wilczek, Bozena Szyguła-Jurkiewicz, Andrzej Lekston, Zbigniew Kalarus, Krzysztof Strojek, Janusz Gumprecht, Lech Poloński

  Cardiology journal. 01/2008; 15(5):422-30.

  Background: Diabetes mellitus (DM) is a significant factor regarding poor outcome in patients with myocardial infarction. Recently a new prognostic factor is under consideration - a baseline glucoseBackground: Diabetes mellitus (DM) is a significant factor regarding poor outcome in patients with myocardial infarction. Recently a new prognostic factor is under consideration - a baseline glucose level on admission. We sought to assess the influence of blood glucose levels on admission on prognosis of patients with acute ST-segment elevation myocardial infarction (STEMI) treated with percutaneous coronary intervention (PCI). Methods and results: Consecutive patients treated with PCI for STEMI were analyzed. Presence or absence of DM was the first grouping criterion. The secondary criterion was the blood glucose level on admission [threshold >/= 7.8 mmol/L (140 mg/dL)]. Hyperglycemic and non-hyperglycemic subgroups were selected within both DM and non-DM groups according to the threshold. One-year mortality of diabetics was 16.0%. There was no significant difference in 1-year mortality between hyperglycemic and non-hyperglycemic patients with DM. One-year mortality in the non-DM group was 5.6%. Patients without DM but with hyperglycemia showed a higher 1-year mortality rate than non-hyperglycemic patients (8.51% vs. 3.68%, p = 0.001). Multivariate analysis revealed that in the non-DM group blood glucose level (per 1 mmol/L) on admission was a factor affecting 1-year mortality [HR = 1.09 (1.01-1.17)]. Conclusions: Elevated blood glucose levels in STEMI affect the prognosis of patients without DM; however, it is not an independent death risk factor of patients with DM treated with PCI.

• ACE gene I/D polymorphism and the presence of renal failure or hypertension in autosomal dominant polycystic kidney disease (ADPKD).

  Authors: Janusz Gumprecht, Marcin Jan Zychma, Dariusz Karasek, Wladyslaw Grzeszczak

  Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association. 06/2007; 22(5):1483.

• Different types of renal dysfunction in patients with acute myocardial infarction treated with percutaneous coronary intervention.

  Authors: Jacek Kowalczyk, Radoslaw Lenarczyk, Oskar Kowalski, Beata Sredniawa, Agata Musialik-Lydka, Mariusz Gasior, Lech Polonski, Marian Zembala, Janusz Gumprecht, Zbigniew Kalarus

  Journal of interventional cardiology. 04/2007; 20(2):143-52.

  The prognostic significance of different types of renal dysfunction in patients with acute myocardial infarction (AMI) treated with percutaneous coronary intervention (PCI) has not been wellThe prognostic significance of different types of renal dysfunction in patients with acute myocardial infarction (AMI) treated with percutaneous coronary intervention (PCI) has not been well characterized. The single-center AMI registry encompassed 1,486 consecutive AMI patients treated with PCI, who were followed by mean 29.7 months. Subjects with an estimated glomerular filtration rate <60 mL/min per 1.73 m2 at baseline were selected (n = 283, 19.0%) and incorporated into the chronic kidney disease (CKD) group. The control group consisted of 1,203 subjects with normal renal function (81.0%). The CKD patients were divided into subgroups: with contrast-induced nephropathy - CKD + CIN (n = 68, 4.6%) and without - CKD-CIN (n = 215, 14.5%). Remote mortality rate was significantly higher in CKD group (34.6%) and in particular subgroups: CKD + CIN (47.0%), CKD-CIN (31.0%) than in controls (9.1%, P < 0.001 for all study groups vs controls). Multivariate analysis identified CKD as an independent predictor of any-cause death in the whole population (hazard ratio [HR] 1.77, 95% confidence interval [CI] 1.60-1.94, P < 0.001). Similarly, CKD + CIN contrary to CKD-CIN had significant and independent influence on remote survival in study population (HR 2.16, 95% CI 1.95-2.37, P < 0.001). CKD and its types have significant, negative influence on long-term survival in AMI patients treated with PCI. It is especially strongly expressed in those CKD patients who develop contrast-induced nephropathy, which occurrence is an independent risk factor of mortality associated with over twofold increase of death hazard.

• Simvastatin-induced rhabdomyolysis in a CsA-treated renal transplant recipient.

  Authors: Janusz Gumprecht, Marcin Zychma, Władysław Grzeszczak, Roman Kuźniewicz, Wacław Burak, Joanna Zywiec, Dariusz Karasek, Ireneusz Otulski, Mariusz Mosur

  Medical science monitor : international medical journal of experimental and clinical research. 10/2003; 9(9):CS89-91.

  BACKGROUND: Cardiovascular disease is the most common cause of morbidity and mortality among long-term renal transplant recipients, and hyperlipidemia is an important risk factor for the developmentBACKGROUND: Cardiovascular disease is the most common cause of morbidity and mortality among long-term renal transplant recipients, and hyperlipidemia is an important risk factor for the development of cardiovascular and peripheral vascular disease. The prevalence of post-transplantation hyperlipidemia ranges from 16% to 78% of recipients. Lipid-lowering strategy with the use of statins has been shown shown to reduce the cardiovascular risks related to hyperlipidemia, but concomitant use of HMG-CoA reductase inhibitors and cyclosporine A may increase the risk of rhabdomyolysis or myoglobinuric acute graft failure due to drug-drug interactions with cyclosporine A. CASE REPORT: We describe the case of a 53-year-old woman, a renal transplant recipient, who developed rhabdomyolysis following simvastatin lipid-lowering therapy. Immunosuppressive treatment included cyclosporine A, azathioprine and prednisone. After 32 days of simvastatin treatment she was hospitalized for profound muscle pain and weakness with a rise in serum creatine kinase to 60.000 IU/l and serum creatinine to 147 Kmol/l. No further deterioration in renal graft function during hospitalization was observed. 10 days after simvastatin was stopped and the daily CyA dose was reduced the patient was asymptomatic, with serum creatine kinase 67 IU/l and serum creatinine level within normal range. CONCLUSIONS: Renal transplant recipients treated with cyclosporin A, and also receiving statins for postransplantational hyperlipidemia, as well as for the prophylaxis of chronic rejection, should be monitored carefully both for CyA blood levels and for possible muscle toxicity.

• [Role of other than renin-angiotensin system genes in the development of renal failure]

  Authors: Marcin Zychma, Janusz Gumprecht, Władysław Grzeszczak, Dariusz Moczulski, Ewa Zukowska-Szczechowska

  Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego. 12/2002; 13 Suppl 1:53-4.

• [Role of renin-angiotensin system genes in the development of renal failure]

  Authors: Janusz Gumprecht, Władysław Grzeszczak, Marcin Zychma, Ewa Zukowska-Szczechowska

  Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego. 12/2002; 13 Suppl 1:51; discussion 52.

• [The prevalence of renal failure in Polish population--epidemiological study]

  Authors: Dariusz Moczulski, Władysław Grzeszczak, Katarzyna Gosek, Janusz Gumprecht, Marcin Zychma

  Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego. 12/2002; 13 Suppl 1:49; discussion 50.

• Methylenetetrahydrofolate reductase gene C677T polymorphism, plasma homocysteine and folate in end-stage renal disease dialysis and non-dialysis patients.

  Authors: Marcin J Zychma, Janusz Gumprecht, Wladyslaw Grzeszczak, Ewa Zukowska-Szczechowska

  Nephron. 10/2002; 92(1):235-9.

  BACKGROUND: It has been recently suggested that the presence of the methylenetetrahydrofolate reductase gene 677TT genotype is associated with younger age at initiation of dialysis, thus raising aBACKGROUND: It has been recently suggested that the presence of the methylenetetrahydrofolate reductase gene 677TT genotype is associated with younger age at initiation of dialysis, thus raising a hypothesis that younger renal patients carrying the TT genotype are at higher risk to develop end-stage renal disease. The aim of this study was to test the association between the C677T polymorphism and the presence of end-stage renal disease using a family-based study design. MATERIAL AND METHOD: C677T polymorphism was genotyped in a group of 247 family trios (offspring affected with end-stage renal disease, dialysed or conservatively treated, and both parents). Transmission/disequilibrium test (TDT) was used to evaluate allele transmission from heterozygous parents to affected offspring. RESULTS: The TDT analysis revealed no significant deviation in the transmission of the MTHFR C677T alleles to CRF patients (51 vs. 49% for the C allele and T allele transmission, respectively). We observed a significant relationship between MTHFR genotypes and total plasma homocysteine (tHcy), as well as folate concentration. Also, plasma tHcy and folate were negatively correlated. CONCLUSION: Our results did not show any association between the MTHFR reductase C677T polymorphism and the increased risk of the development of end-stage renal disease. Whether this polymorphism contributes to the faster rate of decline of renal function in renal patients, must be evaluated further.

• Angiotensin I-converting enzyme and chymase gene polymorphisms - relationship to left ventricular mass in type 2 diabetes patients.

  Authors: Janusz Gumprecht, Marcin Zychma, Władysław Grzeszczak, Beata Łacka, Wacław Burak, Mariusz Mosur, Jacek Kaczmarski, Ireneusz Otulski, Tomasz Stokłosa, Piotr Czank

  Medical science monitor : international medical journal of experimental and clinical research. 09/2002; 8(8):CR603-6.

  BACKGROUND: Type 2 diabetic patients are at increased risk for cardiovascular morbidity and mortality. Increased left ventricular mass also predicts a higher incidence of cardiovascular events.BACKGROUND: Type 2 diabetic patients are at increased risk for cardiovascular morbidity and mortality. Increased left ventricular mass also predicts a higher incidence of cardiovascular events. Angiotensin II is a potent mediator of myocardial growth, and angiotensin II can be produced in the heart by angiotensin I-converting enzyme (ACE) and heart chymase (CMA). The aim of this study was to establish the role of ACE gene insertion/deletion (I/D) and CMA gene CMA/B polymorphisms in determining left ventricular mass in type 2 diabetic patients. MATERIAL/METHODS: Echocardiographic measurements, ACE gene I/D and CMA/B genotypes were determined in 154 type 2 diabetic patients. RESULTS: Mean LVMI was higher among DD homozygotes compared to heterozygotes and II homozygotes (128.9 g/m2 vs. 120.5 g/m2 and 120.4 g/m2, respectively), but the difference was not statistically significant (ANOVA P=0.12). A similar effect was observed for the CMA/B polymorphism, where mean LVMI were 126.6 g/m2, 122.1 g/m2 and 118.2 g/m2, for carriers of AA, AG and GG genotype, respectively (not statistically significant, P=0.33). ACE I/D and CMA/B polymorphism were also analyzed jointly, and carriers of both DD and AA genotypes were found to have significantly higher LVMI values (P=0.05) than non-carriers (133.0 g/m2 and 121.2 g/m2, for 21 DD and AA carriers vs. 133 non-carriers). In multivariate analysis, the presence of DD and AA genotypes was independently associated with LVMI (P=0.04). CONCLUSIONS: Our results may suggest the additive effect of ACE and CMA gene polymorphisms on the increase in left ventricular mass in NIDDM patients.

• Sulfonylurea receptor gene 16-3 polymorphism - association with sulfonylurea or insulin treatment in type 2 diabetic subjects.

  Authors: Marcin J Zychma, Janusz Gumprecht, Krzysztof Strojek, Władysław Grzeszczak, Dariusz Moczulski, Wanda Trautsolt, Dariusz Karasek

  Medical science monitor : international medical journal of experimental and clinical research. 08/2002; 8(7):CR512-5.

  BACKGROUND: The presence of a complex phenotype of type 2 diabetes results from impaired insulin secretion and action, whereas the mechanism of action of sulfonylurea derivatives, most commonly usedBACKGROUND: The presence of a complex phenotype of type 2 diabetes results from impaired insulin secretion and action, whereas the mechanism of action of sulfonylurea derivatives, most commonly used in the treatment of type 2 diabetes, is based on their ability to directly inhibit the ATP-sensitive potassium channel (KATP), which leads to b-cell depolarization, subsequent influx of calcium and then insulin exocytosis. It has recently been demonstrated in healthy subjects that molecular variants of the gene encoding for the KATP subunit - sulfonylurea receptor gene (SUR1) are associated with a decreased response of insulin secretion to intravenous injection of tolbutamide, a sulfonylurea derivative. In this study we tested whether a molecular variant of the SUR1 gene, 16-3t, has a different distribution in type 2 diabetic patients with early failure of sulfonylurea therapy, compared to patients treatable with sulfonylurea despite long diabetes duration. MATERIAL/METHODS: The SUR1 polymorphism was genotyped in 68 type 2 diabetic patients who required insulin treatment and had known diabetes duration L 5 years, compared to 99 patients receiving oral agents (sulfonylurea alone or in combination with metformin or acarbose) with known diabetes duration of at least 15 years. RESULTS: We observed no significant differences in SUR1 16-3t genotype distributions or allele frequencies between the two examined groups. CONCLUSIONS: Our study provides evidence against a major impact of the SUR1 c16-3t polymorphism on the long-term effectiveness of therapy with sulfonylurea derivatives in type 2 diabetic patients.

• [The influence of respiratory insufficiency on autonomic nervous system function in infants]

  Authors: Kamila Gumprecht, Bogusława Sieroń-Rokicka, Janusz Gumprecht, Władysław Grzeszczak

  Wiadomości lekarskie (Warsaw, Poland : 1960). 02/2002; 55(7-8):373-81.

  The aim of the study was to examine the influence of the respiratory insufficiency in infants treated conservatively or with the use of mechanical lung ventilation, on cardiovascular activity of theThe aim of the study was to examine the influence of the respiratory insufficiency in infants treated conservatively or with the use of mechanical lung ventilation, on cardiovascular activity of the autonomic nervous system and interdependence of the sympathic and parasympathic system in infants. The cardiovascular autonomic nervous system functions were estimated by the power spectrum analysis of the heart rate variability (PS/HRV) using MEDEA HRV system. HRV spectrum analysis was limited to low (LF: 0.05-0.2 Hz) and high (HF: 0.2-0.6 Hz) frequency components, which were indicators of the sinoatrial node modulation by sympathic (LF) or parasympathic (HF) nervous system. LF/HF ratio presents the independence of the sympathic and parasympathic nervous system activity, and the total power spectrum of the HRV is the whole vegetative system activity index. The medical research was carried out in 44 infants. They included 29 infants with respiratory insufficiency conservatively treated in intensive care unit and 15 healthy control subjects. All infants with respiratory insufficiency were examined twice: during respiratory insufficiency and after recovery (40-64 days from first examination). Healthy infants were examined only once. According to the HRV parameters analysis it was proved that in infants respiratory insufficiency has significant influence on the increased cardiovascular activity of the parasympathic system, and increased cardiovascular activity of the autonomic nervous system. Respiratory insufficiency significantly changes relationship between cardiovascular activity of the sympathic and parasympathic nervous system. Regression of respiratory insufficiency symptoms causes the normalisation of both sympathic and parasympathic activity.

• The polymorphism in insulin receptor substrate-1 gene and birth weight in neonates at term.

  Authors: Edyta Simońska-Cichocka, Janusz Gumprecht, Marcin Zychma, Agnieszka Witkowska, Hanna Misiołek, Helena Slawska, Anna Oslislo, Władysław Grzeszczak

  Endokrynologia Polska. 59(3):212-6.

  Background: The mutation of the IRS-1 gene is one of the genetic risk factors which, it is speculated, is associated with insulin resistance or predisposition to type 2 diabetes. The aim of our studyBackground: The mutation of the IRS-1 gene is one of the genetic risk factors which, it is speculated, is associated with insulin resistance or predisposition to type 2 diabetes. The aim of our study was to evaluate the association between the Gly972Arg polymorphism in the IRS-1 gene and birth weight in newborn children with adequate gestational age. Material and methods: 100 newborn children with adequate gestational age (38-42 weeks), whose mother had no disorders during pregnancy, were studied. Genomic DNA was extracted from umbilical cord blood leukocytes, and Gly972Arg polymorphism in the IRS-1 gene was genotyped using the PCR-based method. Results: Birth weight was significantly lower in the newborn with the IRS-1 Gly972Arg polymorphism compared with a control group (3161.75 +/- 380.86 g vs. 3427.92 +/- 468.86 g). Body length and head circumference at birth were also lower in the neonates with that polymorphism (54.38 +/- 3.13 cm vs. 52.69 +/- 2.91 cm, and 34.08 +/- 1.47 vs. 33.63 +/- 0.81, respectively). Conclusions: The results suggest that the Gly972Arg genotype is associated with lower birth weight, body length and head circumference in neonates with adequate gestational age.