Agnieszka Zak-Gołab

Publications of Agnieszka Zak-Gołab

• [Vitamin K, bone metabolism and vascular calcification in chronic kidney disease].

  Authors: Agnieszka Zak-Gołab, Bogusław Okopień, Jerzy Chudek

  Przegla̧d lekarski. 01/2011; 68(9):629-32.

  Atherosclerosis is the main cause of morbidity and mortality in the general population, and premature death in patients with chronic kidney disease (CKD) especially dialysis ones. Besides the typicalAtherosclerosis is the main cause of morbidity and mortality in the general population, and premature death in patients with chronic kidney disease (CKD) especially dialysis ones. Besides the typical cardiovascular risk factors there is a considerable vascular calcification of intima media in these patients. Vitamin K - dependent proteins play an essential role in the pathogenesis of mineral and bone disorders related to CKD, including vascular calcification. Vitamin K is a family of vitamins, varying in the number of isoprenoid groups (saturated or unsaturated) connected into 2-methyl-1,4-naphthoquinone ring in C3 position. Vitamin K-dependent proteins require carboxylation (VKDPs) for biological activation. The coagulant factors are the most well-known VKDPs, but the role of the other proteins, like Matrix Gla Protein (MGP), Growth Arrest Specific Gene 6 (Gas-6) and osteocalcin has been recently discovered. MGP prevents vascular calcification and Gas-6 affects vascular smooth muscle cell apoptosis and movement. Carboxylation of osteocalcin promotes bone formation. Additionally vitamin K increases proliferation of osteoblasts and apoptosis of osteoclasts, influencing on bone remodeling. There is few studies indicating for decreased consumption of vitamin K in the general population. The restrictive diet recommended for dialysis patients additionally diminishes its daily supply, increasing the chance for vitamin K deficiency in this population. Clinical consequences of inhibition of epoxide reductase by generally used anticoagulants, that inhibiting vitamin K cycle and preventing gamma-carboxylation of Gla proteins, in the peripheral tissue is hardly known. This paper summaries the state of the art knowledge focused on the role of vitamin K in mineral and bone metabolism disorders in CKD patients.

• [Diagnostic value of antineutophil cytoplasmic antibodies].

  Authors: Agnieszka Zak-Gołab, Antoni Hrycek, Michał Holecki, Jerzy Chudek

  Wiadomości lekarskie (Warsaw, Poland : 1960). 01/2011; 64(1):37-42.

  Antineutrophil cytoplasmic antibodies (ANCA) constitute a family of auto-antibodies directed against various components of the neutrophil cytoplasm. The indirect immunofluorecence assays detectedAntineutrophil cytoplasmic antibodies (ANCA) constitute a family of auto-antibodies directed against various components of the neutrophil cytoplasm. The indirect immunofluorecence assays detected three fluorescent staining patterns: cANCA--cytoplasmic; pANCA--perinuclear and aANCA--atypical. Occurence ANCA is mainly associated with Wegener's granulomatosis and vasculitis, but they are also detected in autoimmune diseases (eg. in systemic lupus erythematosus, in rheumathoid arthritis, Sjögren's syndrome, in dermatomyositis) and in inflamatory bowel diseases (Crohn disease, colitis ulcerosa). Presence of ANCA was found also in primary sclerosing cholangitis, in chronic infections and in person using some kinds of drugs. The aim of the study was to review recent investigations concerning prevalence of ANCA and their diagnostic value not only for vasculitis but also for the other disease in which they are detected.

• The indexes of arterial structure and function in women with simple obesity: a preliminary study.

  Authors: Katarzyna Mizia-Stec, Zbigniew Gasior, Barbara Zahorska-Markiewicz, Michał Holecki, Maciej Haberka, Magdalena Mizia, Szymon Gomułka, Agnieszka Zak-Gołab, Adrianna Gościńska

  Heart and vessels. 07/2008; 23(4):224-9.

  Obesity is associated with an increased risk of cardiovascular disorders. The aim of the present study was to compare the indexes of arterial structure and function in women with simple obesity andObesity is associated with an increased risk of cardiovascular disorders. The aim of the present study was to compare the indexes of arterial structure and function in women with simple obesity and healthy individuals. Twenty-two women with simple obesity (body mass index [BMI]: 33.6 +/- 2.9 kg/m(2), age: 29.7 +/- 6.2 years), and 34 healthy women were included in the study. Healthy subjects were divided into two subgroups according to their age (<35 and >45 years): Control A-16 young women (age <35 years, BMI: 24.0 +/- 3.0 kg/m(2)), and Control B-18 older women (age >45 years, BMI: 25.8 +/- 2.9 kg/m(2)). Noninvasive, high-resolution, vascular ultrasound was used to evaluate the endothelial-dependent vasodilatation: flow-mediated dilatation of brachial artery (FMD); the arterial structure: intima-media thickness (IMT) of common carotid artery (CCA); and the compliance parameters corresponding to structural changes in large arteries (PWV: pulse wave velocity; PP: pulse pressure; TAC: total arterial compliance; Ao C: aorta compliance, CCA C: CCA compliance, stiffness indexes). Endothelial-dependent vasodilatation as represented by FMD was comparable in the obese group (16.8% +/- 7.9%; median: 15.5%) and healthy subjects (Control A: 14.1% +/- 4.7%; median: 13.6%; Control B: 13.9% +/- 6.5%; median: 13.0%). The mean value of IMT was significantly increased (P < 0.05) in Control B group (0.67 +/- 0.07 mm) in comparison to both obese patients (0.58 +/- 0.09 mm) and Control A group (0.53 +/- 0.05 mm). The compliance parameters (PWV, AoC, CCA C, stiffness indexes) were impaired in obese patients and Control B patients as compared to Control A individuals. PWV and stiffness indexes were significantly increased, and the AoC, CCA C-diameter, CCA C-area were significantly decreased. Simple obesity constitutes an important risk factor accelerating arterial stiffness in women.

• Long-term effects of lipase inhibition by orlistat on gastric emptying and orocecal transit time of a solid meal.

  Authors: Piotr Kocełak, Barbara Zahorska-Markiewicz, Krzysztof Jonderko, Magdalena Olszanecka-Glinianowicz, Agnieszka Zak-Gołab, Michał Holecki, Magdalena Kamińska, Małgorzata Szymszal

  Journal of gastroenterology. 01/2008; 43(8):609-17.

  BACKGROUND: We assessed the impact of a prolonged lipase inhibition upon gastric emptying (GE) and orocecal transit time (OCTT) of a 355-kcal low-fat solid meal. METHODS: In double-blind manner, 40BACKGROUND: We assessed the impact of a prolonged lipase inhibition upon gastric emptying (GE) and orocecal transit time (OCTT) of a 355-kcal low-fat solid meal. METHODS: In double-blind manner, 40 obese women BMI > 30 kg/m2, randomly allocated into two equal groups, took orally t.i.d. 120 mg orlistat or placebo during 8 weeks of a weight-reducing management. At randomization and after 2 months, GE was measured simultaneously with OCTT by means of a 13C-octanoic acid and a hydrogen breath test, respectively. Lipolytic activity was evaluated with a 13C-mixed triglyceride breath test (13C-MTGBT). RESULTS: A profound lipase inhibition by orlistat was confirmed by a 79.5% +/- 16.9% reduction of the cumulative 6-h 13C recovery with 13CMTGBT. GE remained unchanged either in the orlistat (T1/2, 188 +/- 35 min start versus 198 +/- 36 min end) or the placebo (T1/2, 191 +/- 35 min start versus 180 +/- 39 min end) group. OCTT increased from 208 +/- 54 min to 271 +/- 64 min (P < 0.01) after orlistat treatment and did not change significantly (216 +/- 76 vs. 234 +/- 72 min) in the placebo group. CONCLUSIONS: No adverse effect on the GE and a moderate prolongation of the OCTT of a low-fat solid meal is to be expected under a prolonged treatment with orlistat at a typical dosage regimen.

• Influence of calcium and vitamin D supplementation on weight and fat loss in obese women.

  Authors: Michał Holecki, Barbara Zahorska-Markiewicz, Andrzej Wiecek, Katarzyna Mizia-Stec, Teresa Nieszporek, Agnieszka Zak-Gołab

  Obesity facts. 01/2008; 1(5):274-9.

  Dairy products not only reduce the risk of hypertension and cardiovascular diseases but may play a role in the treatment of obesity. As there is some evidence that calcium (Ca) and vitamin D may playDairy products not only reduce the risk of hypertension and cardiovascular diseases but may play a role in the treatment of obesity. As there is some evidence that calcium (Ca) and vitamin D may play a role in effective weight management, we decided to evaluate the influence of Ca and vitamin D supplementation on weight and fat loss in obese women. Forty obese women were enrolled in this study. Subjects were divided into 2 groups comparable with body mass index (BMI) and age. Group 1 was provided with calcium carbonate and 1-(OH)-vitamin D supplementation. Group 2 was provided with only a diet. Subjects participated in a 3-month weight reduction therapy (balanced diet, modification of life style, and regular physical exercise). Blood samples (serum concentration of Ca, phosphorus (P), parathormone (PTH), 25-(OH)-D3) and clinical characteristics (weight, height, BMI, body composition) were taken at baseline and after the 3-month program. No significant differences of body weight, body fat content, serum parathormone, 25-(OH)-D3 concentration, and plasma total Ca and P concentration were observed between analyzed groups both before and after the treatment. Additionally, we did not observe any significant influence of Ca and vitamin D supplementation on weight and fat loss. Ca plus vitamin D supplementation during a 3-month low caloric diet has no additional effect on weight and fat loss in obese women.

• The influence of weight loss on serum osteoprotegerin concentration in obese perimenopausal women.

  Authors: Michał Holecki, Barbara Zahorska-Markiewicz, Joanna Janowska, Teresa Nieszporek, Katarzyna Wojaczyńska-Stanek, Agnieszka Zak-Gołab, Andrzej Wiecek

  Obesity (Silver Spring, Md.). 09/2007; 15(8):1925-9.

  OBJECTIVE: To assess the influence of weight reduction therapy on serum osteoprotegerin (OPG) concentration in obese patients and compare these results with normal-weight controls. RESEARCH METHODSOBJECTIVE: To assess the influence of weight reduction therapy on serum osteoprotegerin (OPG) concentration in obese patients and compare these results with normal-weight controls. RESEARCH METHODS AND PROCEDURES: Forty-three obese women (BMI, 36.7 +/- 4.1 kg/m2; mean age, 50.1 +/- 4.5 years) were studied. The control group consisted of 19 normal-weight women (BMI, 24.2 +/- 2.1 kg/m2; mean age, 53.8 +/- 5.2 years). In all patients, serum concentrations of OPG, C telopeptide of type I collagen containing the cross-linking site (CTX), osteocalcin, parathormone, 25-(OH)-D3 (vitamin D), and total calcium and phosphorus were assessed before and after a 3-month weight reduction therapy. RESULTS: In obese subjects, serum concentrations of OPG, 25-(OH)-D3, osteocalcin, total calcium, and phosphorus were significantly lower, and serum concentration of parathormone was significantly higher, before weight reduction therapy in comparison with normal-weight controls. After weight reduction, a significantly higher serum concentration of 25-(OH)-D3 and CTX and significantly lower concentration of OPG were found. DISCUSSION: Serum concentration of OPG was significantly lower in obese patients in comparison with normal-weight controls. Weight reduction therapy resulted in further decrease in OPG serum concentrations. Therefore, OPG cannot be treated as a protective factor from bone loss in obese patients.

• Osteoprotegerin--does it play a protective role in the pathogenesis of bone loss in obese perimenopausal women?

  Authors: Michał Holecki, Barbara Zahorska-Markiewicz, Joanna Janowska, Katarzyna Mizia-Stec, Agnieszka Zak-Gołab, Magdalena Olszanecka-Glinianowicz, Katarzyna Wojaczyńska-Stanek, Teresa Nieszporek, Andrzej Wiecek

  Endokrynologia Polska. 58(1):7-10.

  INTRODUCTION: Assessment of serum osteoprotegerin (OPG) concentrations in obese patients in comparison to healthy controls and evaluation of a possible correlation between OPG and other markers ofINTRODUCTION: Assessment of serum osteoprotegerin (OPG) concentrations in obese patients in comparison to healthy controls and evaluation of a possible correlation between OPG and other markers of bone turnover or calcitropic hormones. MATERIAL AND METHODS: 50 obese perimenopausal women without concomitant diseases (BMI 36.7 +/- 4.1 kg/m(2), mean age 50.4 +/- 4.9 yrs). The control group consisted of 19 healthy women (BMI 24.2 +/- 2.1 kg/m(2); mean age 53.8 +/- 5.1 yrs). In all patients serum concentration of OPG, C telopeptide of type I collagen containing the crosslinking site (CTX), osteocalcin, parathormone (PTH) and vitamin D (25-OH-D(3)) was assessed. Dual energy x-ray absorptiometry (the DXA method) of the lumbar spine and femoral neck was performed using a Lunar DPXL to measure bone marrow density (BMD). RESULTS: In obese perimenopausal women serum OPG, osteocalcin and 25-OH-D(3) levels were significantly lower, and the serum PTH level was significantly higher in comparison to healthy controls. A significantly positive correlation was found between serum OPG level and age in both obese and control subjects. CONCLUSION: The serum OPG level in obese perimenopausal women is significantly lower in comparison to healthy controls and does not correlate significantly with biochemical markers of bone turnover, calcitropic hormones and BMD. It probably cannot play a protective role in the pathogenesis of bone loss in obese perimenopausal women.

• [Impact of the mass-reductive therapy with orlistat on 25-(OH)-D3 and PTH concentration in sera of obese, menopausal women]

  Authors: Michał Holecki, Barbara Zahorska-Markiewicz, Teresa Nieszporek, Magdalena Olszanecka-Glinianowicz, Katarzyna Mizia-Stec, Agnieszka Zak-Gołab, Piotr Kocełak, Agata Fryźlewicz-Moska, Andrzej Wiecek

  Endokrynologia Polska. 56(3):240-5.

  Epidemiological studies suggest a protective influence of obesity against postmenopausal bone loss. Lower risk of osteoporotic fractures was described in obese patients. However there were only a fewEpidemiological studies suggest a protective influence of obesity against postmenopausal bone loss. Lower risk of osteoporotic fractures was described in obese patients. However there were only a few studies which examined the effect of weight reduction on bone metabolism and results of these studies are controversial. The aim of the study was to evaluate the influence of weight reduction program using Orlistat on bone metabolism in perimenopausal women. Twenty obese women with simple obesity and without concomitant diseases (BMI 37.1 +/- 3.0 kg/m2, mean age 49.8 +/- 4.6 yrs) were enrolled into this study. The control group consisted of 20 healthy women (mean age 53.5 +/- 5.4 yrs, BMI 24.1 +/- 2.2 kg/m2). All patients have participated in a 3-month weight reduction therapy that consisted of: a 1000-1200 kcal/ day balanced diet (daily calcium consumption about 500mg), Orlistat 3 x 120mg a day and regular physical exercises. Before the weight reduction therapy and after 10% reduction of body weight, serum concentrations of PTH, 25-(OH)-D3, total calcium and phosphorus, total cholesterol were assessed. Dual energy x-ray absorptiometry (DEXA method) of lumbar spine and femoral neck, measuring BMD was performed once, after a 3-month weight reduction therapy using Lunar DPXL. All these measurements were performed only once in control subjects. After a 3-month weight reduction program in patients treated with Orlistat the mean weight loss was 11.6 +/- 5.1 kg which is 12.1 +/- 4.78 %. BMI decreased from 37.1 +/- 3.0 kg/m2 at baseline to 32.6 +/- 2.7 kg/m2 post-treatment. The body weight reduction resulted in significant decrease of body fat and total cholesterol concentration. In obese subjects serum concentration of 25-(OH)-D3 was significantly lower and serum concentration of PTH was significantly higher in comparison to healthy controls, both before and after weight reduction therapy. Serum concentration of PTH, 25-(OH)-D3, total calcium and phosphorus did not change significantly after therapy with Orlistat. Conclusion: 3-month weight reduction program using Orlistat did not influence significantly bone metabolism.