-
[show abstract]
[hide abstract]
ABSTRACT: There is accumulating evidence that vitamin D exerts important pathophysiological effects on cardiovascular system. Low vitamin D was associated with increased cardiovascular risk in several reports. We studied the association between vitamin D and arterial stiffness in a random sample of 560 subjects selected from general population. Arterial stiffness was measured as aortic pulse-wave velocity (PWV) using Sphygmocor device. Serum 25-hydroxyvitamin D (25(OH)D) was measured using commercial kits. We found a clear negative trend in aortic PWV among 25(OH)D quartiles. Subjects in the bottom 25(OH)D quartile (<20 ng ml(-1)) showed the highest aortic PWV (9.04 m s(-1)), compared with 2nd-4th quartile (8.07 m s(-1), 7.93 m s(-1) and 7.70 m s(-1), respectively; P for trend <0.0001). The association between 25(OH)D and aortic PWV remained significant after adjustment for age, gender and other potential confounders; subjects in the first 25(OH)D quartile had adjusted odds ratio 2.04 (1.26-3.30) for having aortic PWV 9 m s(-1) (top quartile) in multiple regression. In conclusion, we found a clear significant and independent negative association between 25(OH)D and aortic PWV. Subjects with lowest vitamin D status showed the highest arterial stiffness.
Journal of human hypertension 10/2011; 26(11):650-5. · 2.80 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: It has been reported that alcohol stimulates appetite. We aimed to establish the association between leptin, as a major food intake regulating factor, and alcohol intake in patients with chronic manifest coronary artery or cerebrovascular disease.
A cross-sectional study of 820 subjects after acute coronary syndrome, coronary revascularization or after first ischemic stroke (the Czech part of EUROASPIRE III surveys). Leptin concentrations were evaluated among predefined categories of reported weekly alcohol intake: abstainers, light drinkers (up to 2 drinks weekly, 1-44 g of pure alcohol), mild regular drinkers (3-14 drinks weekly, 45-308 g) and moderate or heavy drinkers (more than 15 drinks, ≥ 309 g of alcohol).
Leptin showed a clear negative trend among the alcohol intake categories. Mild regular drinkers showed significantly lower leptin levels (9.3(8.2) ng/ml) compared with abstainers (18.7(18.7) ng/ml, P<0.0001) and light occasional drinkers (14.2(17.8) ng/ml, P=0.00064). The negative association between leptin and alcohol intake as a dependent variable remained significant even after adjustment for potential confounders in multiple linear regression analysis (P=0.00032).
Drinking of small amounts of alcohol was, in our setting, associated with decreased serum leptin concentration, with a possible benefit in terms of cardiovascular risk.
European journal of clinical nutrition 11/2010; 64(11):1350-7. · 3.07 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Angiotensin II and nitric oxide belong to important factors in the functional and structural changes of vessel wall, leading to its increased stiffness. We investigated, whether common mutations of angiotensin II type 1 receptor (AGTR(1)) and endothelial nitric oxide synthase (eNOS) are associated with increased arterial stiffness. Two polymorphisms, A(1166)C of AGTR(1) and T(786)C of Enos, were estimated in a random, general population-based sample of 250 subjects. Arterial stiffness was measured using Sphygmocor as aortic (carotid-femoral) and peripheral (femoral-tibial) pulse wave velocities (PWV). Carriers of 3-4 mutant alleles from both polymorphisms, that is, homozygous for both mutations or homozygous for one and heterozygous for the second one, showed significantly higher peripheral PWV (17.92+/-2.40) than those with none or only 1-2 mutant alleles (12.37+/-0.51; P<0.003). Carriers of 3-4 mutant alleles had three times higher risk of having increased peripheral PWV (>or= 13.63 m s(-1), that is, in the top quartile) and this association remained significant after adjustment for potential confounders. No association was found between estimated genotypes and aortic PWV. In conclusion, combination of A(1166)C of AGTR(1) and T(786)C of eNOS mutations increased stiffness of muscular-type arteries.
Journal of Human Hypertension 02/2008; 22(2):111-8. · 2.80 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Total homocysteine (tHcy) level was identified as a strong and independent predictor of cardiovascular events. We investigated the association between tHcy and mechanical properties of large arteries in a random, general population-based sample of 251 subjects (mean age 48 years). Large artery properties, such as aortic and peripheral (lower-limb) pulse wave velocity (PWV), and augmentation index of radial artery were measured using semi-automatic Sphygmocor device. Aortic PWV (APWV) positively correlated with tHcy (r = 0.28, P<0.0001), and a significant increasing trend of APWV was found by tHcy quartiles (P = 0.0003 by ANOVA). This association remained significant after adjustment for conventional cardiovascular risk factors (age, gender, smoking, overweight, hypertension, dyslipidaemia and impaired glucose metabolism) and for usual homocysteine confounders (folate, B12, renal function). Subjects with mild hyperhomocysteinaemia (i.e. with tHcy > or = 15 micromol/l) had 2.74 times higher risk of having their APWV over 8.42 m/s (i.e. in the top quartile). No such association was found either for PWV measured at lower extremity or for radial augmentation index. In conclusion, in our series of subjects from general population, we found a strong and independent relationship between homocysteine concentration and APWV, a parameter of stiffness of central arteries.
Journal of Human Hypertension 04/2006; 20(4):267-71. · 2.80 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Fibrate therapy results in elevation of plasma total homocysteine (tHcy), which is known to induce oxidative stress and endothelial dysfunction. We aimed to establish whether fibrate-induced elevation of tHcy has also similar consequences and whether they may be prevented by folate co-administration. Eighteen subjects with hypercholesterolemia were included in an open, prospective, cross-over study. We compared intra-individually the effect of fenofibrate on tHcy, oxidative stress and endothelial dysfunction surrogates, in monotherapy and when combined with 10 mg of folate. These effects were also compared with fluvastatin monotherapy. Fenofibrate in monotherapy significantly decreased LDL cholesterol, increased the tHcy by 39.5 %, while oxidized LDL (oxLDL), malondialdehyde (MDA), von Willebrand factors (vWf) and thrombomodulin (TMD) remained unchanged. When fibrate was co-administered with folate, the tHcy remained on the initial post-diet level, while both the total and oxLDL as well as MDA, vWf and TMD decreased. In contrast to fenofibrate monotherapy, fluvastatin (80 mg) had a similar effect as combined therapy with fenofibrate and folate, while tHcy remained uninfluenced. In conclusion, fenofibrate decreases the LDL cholesterol, but in contrast to fluvastatin, has no significant antioxidative and endothelium-protective potential, probably due to a concomitant increase of tHcy. These effects may be improved by co-administration of folate.
Physiological research / Academia Scientiarum Bohemoslovaca 02/2006; 55(5):475-81. · 1.55 Impact Factor
-
E Králíková,
S Býma,
R Cífková,
R Ceska,
V Dvorák,
J Hamanová,
K Horký,
J Hradec,
O Keller,
S Konstacký, [......],
K Langrová, O Mayer,
V Petrů,
P Popov,
J Raboch,
H Rosolová,
K Roztocil,
P Sucharda,
J Vorlícek,
J Widimský
[show abstract]
[hide abstract]
ABSTRACT: This first Czech version of guidelines formulated by the working group of mentioned medical associations is based on current literature and international guidelines. They are aimed mainly on clinical medicine and on incorporation of this treatment into the health care system according to WHO recommendations. They should serve to the treatment of tobacco dependence at any level: during any contact with the smoking patient (short intervention), in specialised centres or for the health care providers or health system itself.
Casopís lékar̆ů c̆eských 02/2005; 144(5):327-33.
-
[show abstract]
[hide abstract]
ABSTRACT: It is evident, that overt thyroid dysfunction (both, hypo- or hyperthyroidism) could be associated with heart failure. The aim of our study was to establish whether also mild changes in free thyroxin (fT4) may influence the degree of heart failure in patients with chronic heart insufficiency.
There were included 148 patients (m 121, f 27, mean age 63.8 +/- 1.14) with clinical chronic heart failure were, with fT4 levels within the normal range (9-22 pmol/l) and without thyroid suppression or substitution treatment. Degree of heart failure was quantified by plasma B-type natriuretic peptide (BNP), N-terminal pro-BNP (NT-proBNP) and big endothelin. Patients with fT4 in the range 11.9-14.6 pmol/l (optimal, 3rd-6th decile) had significantly lower NT-proBNP (718 +/- 70.4 pg/ml), than those with fT4 < or = 11.8 (low-normal, bottom two deciles) (1236 +/- 223.6 pg/ml; p < 0.03) and those with fT4 over 14.6 pmol/l [high-normal, top four deciles] (1192 +/- 114.9 pg/ml; p < 0.0002). These differences remain significant also if adjusted for age, gender and other confounders; adjusted odds ratio was 1.30 (1.05-1.59) for optimal vs. low-normal and 1.27 (1.04-1.55) for optimal vs. high-normal. Similar statistical differences were found also in BNP and high endothelin, but only between optimal and high-normal fT4 strata.
The degree of heart failure could be influenced also by mild changes in fT4 concentration.
Casopís lékar̆ů c̆eských 02/2005; 144(11):742-6.
-
[show abstract]
[hide abstract]
ABSTRACT: Prevalence of hypothyroidism (HT) markedly differs among various populations. We aimed to establish the prevalence of HT in the Czech population and to assess its association with conventional cardiovascular risk factors.
1240 subjects (629 m, 611 f; mean age 52.3); a random, population-based sample were evaluated. Cut-off points for thyroid parameters were defined as follows: thyreostimulating hormone (TSH) 0.58-3.65 mU/I, free thyroxine (fT4) 9-22 pmol/l and thyroid peroxidase antibodies (TPOAb) < or = 14 IU/A. The overall prevalence of HT was 6.8% in males and 13.8% in females (p < 0.0001); subclinical HT (high TSH, normal fT4) was found in 3.0% and 8.0%, overt-untreated (high TSH, low fT4) in 3.2% and 3.0% and overt-treated HT in 0.6% and 2.8% of males and females, respectively. Moreover, in euthyroid subjects, 4.6% of males and 9.3% of females showed positive TPO-Ab (p < 0.0001). The adjusted relative risk of hypothyroidism was significantly increased in males with manifest vascular disease (odds ratio 3.48 (1.56-7.74)]), in females aged > or = 55 years (2.08 (1.29-3.36)) or hypertension (1.80 (1.03-3.13)), and moreover, in males and females with positive TPOAb (5.81 (2.57-13.13) and 5.92 (3.38-10.36), resp.)
Hypothyroidism was found in Czech population highly prevalent and it can contribute to the coronary risk, produced by conventional factors.
Casopís lékar̆ů c̆eských 02/2005; 144(7):459-64; discussion 464-5.
-
[show abstract]
[hide abstract]
ABSTRACT: STUDY OBJECTIVE: To ascertain, whether, conventional risk factors and readiness of coronary patients to modify their behaviour and to comply with recommended medication were associated with education in patients with established coronary heart disease. Design and methods: EUROASPIRE II was a cross sectional survey undertaken in 1999-2000 in 15 European countries to ascertain how effectively recommendations on coronary preventions are being followed in clinical practice. Consecutive patients, men and women </=71 years who had been hospitalised for acute coronary syndrome or revascularisation procedures, were identified retrospectively. Data were collected through a review of medical records, interview, and examination at least six months after hospitalisation. The education reached was ascertained at the interview. Main results: A total of 5556 patients (1319 women) were evaluated. Significantly more patients with ischaemia had only primary education, in contrast with the remaining diagnostic groups. Body mass index and glucose were negatively associated with educational level, while HDL-cholesterol was positively associated. Men with highest education had significantly lower systolic blood pressure and total cholesterol. The prevalence of current smoking decreased significantly from primary to secondary and high education only in men. Both men and women with primary educational level were more often treated with antidiabetics, and antihypertensives, but less often with lipid lowering drugs. The effectiveness of treatment was virtually the same in all education groups. CONCLUSIONS: Patients with higher education had lower global coronary risk, than those with lower education. This should be considered in clinical practice. Particular strategies for risk communication and counselling are needed for those with lower education status.
Journal of Epidemiology & Community Health 01/2004; 58(1):47-52. · 3.19 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Definite evidence has been established, that coronary patients benefit from appropriate secondary prevention measures, as recommended by the European and National Guidelines. EuroAspire I (1995) and EuroAspire II (1999) were surveys aimed to evaluate the state of the implementation of guidelines into the every-day medical practice in several European countries, including Czech Republic. We wondered to what extent the practice in secondary prevention of Czech physicians, since the guidelines were published, changed during 5 years, to pursue the targets.
We compared two surveys, undertaken in the same geographical areas of the Czech Republic. Consecutive patients, males and females, less than 71 years of age were indentified following acute coronary event or revascularisation procedure and were interviewed and examined at least 6 months after hospitalization.
The Czech surveys included 331 patients in EuroAspire I and 410 in EuroAspire II. In EuroAspire II, the total number of smokers decreased in males, but increased in females. The patients were more obese, had higher glucose levels as well, while blood pressure, total and LDL cholesterol and triacylglycerols were lower, than in EuroAspire I. Corresponding changes also occurred in the prevalence of hypertension and hyperlipidaemias by definitions. There was a significant increase in the use of betablockers, ACE inhibitors and hypolipidemic drugs, mainly statins. In conclusion, in spite that the compliance with the recommendations for secondary prevention improved, achievement of targets remained rather unsatisfactory, likewise in other European countries.
Central European journal of public health 10/2002; 10(3):107-11.
-
[show abstract]
[hide abstract]
ABSTRACT: Mild hyperhomocysteinemia has been established as a new independent risk factor for atherosclerosis and thrombosis. The metabolic syndrome of insulin resistance is associated with a high risk of coronary heart disease. Our objective was to determine if any relationship exists between the metabolic syndrome of insulin resistance in non-diabetic subjects and total serum homocysteine levels. Sixty-six healthy volunteers (33 males and 33 females) were selected from the population of Pilsen. Insulin resistance was measured by the Insulin Suppression Test using Octreotide. Steady-state plasma glucose concentrations at the end of the test period provided a quantitative measure of insulin resistance. Serum homocysteine level was estimated by high-pressure liquid chromatography. Serum folate and vitamin B12 were estimated using commercial kits on an Abbott IMx analyzer. All other laboratory tests were performed by standard methods in a routine biochemical laboratory. Subjects with the highest tertile of steady-state plasma glucose showed a significantly higher body mass index, blood pressure, fasting plasma triglyceride levels, plasminogen activator inhibitor-1 and lower HDL-cholesterol, i.e. an insulin resistance pattern. These subjects had significantly lower serum homocysteine levels compared with non-insulin resistant subjects. The negative association of insulin resistance and serum homocysteine was unexpected. The contribution of plasma folate levels to serum homocysteine levels and serum creatinine was significantly negative and positive, respectively.
Physiological research / Academia Scientiarum Bohemoslovaca 02/2002; 51(1):93-8. · 1.55 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Mild hyperhomocysteinemia is a significant and independent risk factor for vascular diseases. Blood total homocysteine concentration (tHcy) is considered to be the product of an interaction between genetic and nutritional factors notably intake of folate, vitamin B12 and pyridoxine. The aim of the study was to determine whether regular intake of beer containing large amount of folate and other vitamins influences the tHcy blood concentrations.
Cross-sectional population-based survey.
Adult population, residents of Pilsen (Czech Republic) and vicinity.
Population series included 292 males and 251 females aged 35-65 y, mean age 53.4 y. All subjects were examined by a standard protocol for clinical, anthropometrical and laboratory estimations.
tHcy was measured by high-pressure liquid chromatography with fluorescent detection, blood folate and B12 levels immunochemically using commercial kits.
Beer intake was associated with blood folate and vitamin B12 concentrations positively and with tHcy concentration negatively. By categories of beer intake, subjects with intake of 1 l daily or more had significantly lower tHcy and higher folate concentrations than those reporting lower daily beer intake.
Moderate beer consumption may help to maintain the tHcy levels in the normal range due to high folate content. Folate from beer may thus contribute to the protective effect of alcohol consumption on cardiovascular disease in population with generally low folate intake from other nutrients.
Supported by grant 301/00/P089 Grant Agency of Czech Republic and Internal Grant Agency of the Ministry of Health.
European Journal of Clinical Nutrition 08/2001; 55(7):605-9. · 2.46 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To evaluate risk factors and the general risk profile in a longitudinally followed-up cohort of the Plzen population.
The investigation was made in a cohort of 332 men and 280 women selected from the epidemiological study PILS II (Plzen longitudinal study) examined in 1987-1989 and 1995-1995. Both investigations adhered to the standard protocol. Anamnestic data were assessed, anthropometric parameters (BMI). Blood pressure (BP) was assessed by means of a mercury sphygmomanometer using the standard procedure, biochemical parameters were examined from a blood sample on fasting in the routine laboratories of the Faculty Hospital Plzen. Changes of individual factors were evaluated by the paired Wilcoxon test and chi 2 group test resp. The global coronary risk was calculated by means of logistic coefficients from the Framingham study.
In the cohort which aged on average by 7.6 years the number of smokers decreased in men by 8.1% and by 3.6% in women. The blood pressure increased significantly in both sexes, there was an increase in the number of hypertensive subjects by 26.8% in men and 21.7% in women. In men there was a significant decrease of non-HDL cholesterol, in women, there was a significant increase of subjects with diabetic dyslipidaemia. The total coronary risk (Framingham score) increased after standard transposition to the age of 60 years only by 0.5% in men and women, which reflects the risk due to increased BP. The standard of treatment of hypertension was quite unsatisfactory. When using criteria SBP > or = 140 and/or DBP > or = 90 mm Hg during the second examination 71% of the patients remained without treatment. The number of subjects not aware of hypertension declined from 54% to 19.3% of subjects. A favourable indicator was the finding that there was a decline of hypertensive subjects with a high coronary risk (> or = 20% from ca 11 to 6%).
During the investigation period in the cohort which to a certain extent represents the Plzen population a certain improvement of the risk profile occurred in particular as regards smoking and disorders of the lipid spectrum, however not as regards the prevalence and treatment of hypertension. Despite the favourable development in the Czech population in the investigated cohort, obviously at the expense of poor control of hypertension, the average coronary risk did not improve.
Vnitr̆ní lékar̆ství 07/2001; 47(7):454-9.
-
[show abstract]
[hide abstract]
ABSTRACT: The relationship between the plasma magnesium (Mg) concentration and steady-state plasma insulin (SSPI) and glucose (SSPG) concentrations at the end of a 180-minute infusion of octreotide, insulin, and glucose was determined in 98 healthy nondiabetic subjects. For the purposes of data analysis, the population was divided into tertiles on the basis of the plasma Mg concentration: I, plasma Mg 0.83 mmol/L; II, plasma Mg 0.84 to 0.91 mmol/L; and III, plasma Mg 0.92 mmol/L. The three groups were identical in terms of age, gender distribution, and degree of obesity. However, both fasting plasma insulin (P < .05) and SSPG (P < .05) concentrations were significantly higher in the tertile (I) with the lowest plasma Mg concentration. Furthermore, there was a significant inverse correlation between plasma Mg and SSPG concentrations (r = -.27, P < .01) in the entire population. These results indicate that variations in the plasma Mg concentration have a relatively modest but significant effect on insulin-mediated glucose disposal in healthy subjects, with lower plasma Mg concentrations associated with increased insulin resistance.
Metabolism 04/2000; 49(3):418-20. · 2.66 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Mild hyperhomocysteinaemia (MHHcy) is a significant and independent risk factor for vascular diseases, however, its causality has not yet been unequivocally confirmed. The total homocysteine (Hcy) blood level is considered a product of genetic and lifestyle interactions, mainly folates, vitamin B12 and pyridoxine intake. In this paper we estimated the influence of these factors on MHHcy in the population.
The population sample included 292 males a 251 women, mean age 53.4 years, selected from the population study PILS II. All subjects were examined by a standard protocol for clinical, anthropometrical and laboratory examination. Hcy levels were examined by ion exchange chromatography, all other factors by commercial kits. Statistical analysis was done in quartiles of distribution by Kruskal-Wallis ANOVA, Wilcoxon's un-paired test and multiple logistic regression (stepwise). Serum total Hcy levels were in significant positive associations with age in both sexes, with BMI in males only. Negative associations of Hcy were found with plasma folates and B12 concentrations in both sexes, with alcohol consumption again only in males. Smoking and physical activity and serum methionine concentration were not associated with Hcy levels. The established associations remained significant when adjusted by multiple logistic regression. About 40% of subjects with MHHcy had low folates and/or B12 levels and a deficiency in both vitamins was found in 17% of subjects. In contrast, MHHcy also was assessed in 14% of subjects with high folates and in 17% with high B12 concentration and in as few as in 3.7% of subjects with high concentrations of both vitamins as well.
Nutritional factors, i.e. folates and B12 intake, seem to be the most important ones responsible for Hcy levels. A predominating influence of genetic factors may be assumed in less than one fifth of subjects with MHHcy.
Casopís lékar̆ů c̆eských 12/1999; 138(21):650-3.
-
[show abstract]
[hide abstract]
ABSTRACT: Homocysteine (Hcy) is an important independent risk factor for vascular diseases. Its level is determined by genetic polymorphism of several enzymes in association with nutritional factors. Higher Hcy levels were found in men than in women, however the clinical significance of this phenomenon remains to be elucidated. The aim of this study was to analyze the gender differences in Hcy levels in relation to associated factors and to assess in which range of Hcy these differences are mainly expressed.
The series comprised of 257 males and 239 females, mean age 52.9 and 52.3 years, resp., selected from the population study Pils II. All subjects were examined by a standard protocol, to assess clinical, anthropometrical and laboratory variables. Hcy and methionine levels were estimated by ion exchange chromatography, other laboratories using standard kits. The methods were validated by a reference laboratory. Statistical analyses were done by Wilcoxon's unpaired test and multiple linear regression. We found in males significantly higher Hcy levels (13.1 vs. 11.5 mumol/l, p < 0.0001) than in females. This difference persisted only in the range of normal Hcy levels (11.1, 10.2 mumol/l, p < 0.0001), i.e. up to 15 mumol/l (1st-4th quintile of the Hcy distribution) and not in the top quintile, considered as mild hyperhomocysteinaemia. We found in males, with normal Hcy levels, significantly higher serum methionine (23.8 vs. 22.4 mumol/l, p < 0.0001), creatinine (91.5 vs 80.9 mumol/l, p < 0.0001) and a lower methionine/creatinine ratio (0.25 vs. 0.27, p < 0.01). Plasma folates and B12 vitamin in males were also lower than in females, however these differences were only of a borderline statistical significance. On the other hand, in subjects with MHHcy (5th quintile) no gender differences were observed, except in creatinine.
Higher Hcy levels in males cannot be explained by differences in folate and B12 levels only. We considered also other factors, namely higher demethylation of methionine associated with higher creatinine production in males, which may be influenced by sex hormons.
Casopís lékar̆ů c̆eských 08/1999; 138(17):525-7.
-
[show abstract]
[hide abstract]
ABSTRACT: BACKGROUND: Unfavourable trends in Czech republic (CR) started in the sixties and peaked in the late eighties i.e. in years when a dramatic mortality fall was observed in most western european countries. So, CR belonged among those Eastern European countries in that total and cardiovascular mortality showed increasing and alarming trends. West Bohemia Region (WB) was characterised by the concentration of heavy industry and high environmental pollution. Because of its geographical position on the western frontier, it was generally restricted in capital investment in the past. We wondered whether these phenomenon were reflected in higher mortality rates than in the rest of CR and which changes occurred after the year 1989. METHODS AND RESULTS: We compared the age standardized mortality data from 1988, 91, 93 and 95 in CR and WB for total mortality, cardiovascular mortality, coronary heart disease, strokes, malignancies and respiratory diseases. Data were age-adjusted for "World Population Standards" and rates were given for 100,000 inhabitants. In the whole CR a significant decrease of total, cardiovascular and cancer mortality was observed from 1988 to 1995. In WB these trends were similar, however in comparison to the whole CR the mortality rates remained in each respective period higher for total, cancer (mainly lung cancer) mortality and for non specific respiratory disease. In contrast, the coronary mortality rates in CR and WB were similar, however in WB after a temporary decrease in 1993 a significant increase in 1995 was observed. On the other hand the stroke mortality rates which were until 1993 in WB higher, significantly decreased in 1995 below the rates for CR. The cause of higher mortality rates in WB are far from being clear. To elucidate this observation epidemiologic studies of environmental pollution, life style of the population and socioeconomic factors are necessary, even as a further monitoring of regional mortality rates and trends.
Casopís lékar̆ů c̆eských 05/1998; 137(7):207-10.
-
[show abstract]
[hide abstract]
ABSTRACT: To assess the validity of hyperinsulinemia as a marker of insulin resistance (IR) and to find other common risk factors (RF) associated with IR.
Sample of 91 healthy volunteers with normal glucose tolerance (NGT) was selected from the adult Pilsen population. Following examinations according to the standard protocol were done: medical history, physical examination, body mass index-BMI (kg/m2), waist to hip ratio (WHR), casual blood pressure (BP), plasma lipids, 7-point oral glucose tolerance test (oGTT), IRI (immunoreactive insulin) curve, insulin suppression test (IST) for the evaluation of IR. Specificity and sensitivity of IRI levels as markers of IR were tested. Association between IR measured by IST and fasting and postload IRI was evaluated by single correlation. Multiple logistic regression (MLR) was applied for the calculation of IR prediction. Fasting and postload hyperinsulinemia (mU/l) have very good specificity (about 90%) for the discovery of IR, but sensitivity was different: fasting IRI > 20 = 19%, IRI in the 2nd h of oGTT > 90 = 30%, IRI sum (fasting IRI + IRI in the 1st and 2nd h of oGTT) > 150 = 51%. Simple correlation between IRI and IR was better in IRI sum (0.56 p < 0.001) than fasting IRI (0.28, p < 0.05). Using MLR HDL-ch, TG and IRI sum were selected as the significant and independent factors for the prediction of IR in the subjects from the population (prediction accuracy about 68%).
Fasting IRI is not too good marker for IR assessment in the NGT subjects from the Pilsen population. IRI sum was the best marker for IR and together with HDL-ch and TG level were selected as the significant predictive factors for IR.
Casopís lékar̆ů c̆eských 02/1998; 137(3):80-3.
-
[show abstract]
[hide abstract]
ABSTRACT: Eighteen nondiabetic volunteers were selected for these studies on the basis of their plasma magnesium (Mg) concentrations defined as being either high (> 0.83 mmol/L) or low (< 0.80 mmol/L). Although different in Mg concentration (0.90 +/- 0.02 vs. 0.73 +/- 0.01 mmol/L), the 2 groups were comparable in terms of age, gender distribution, body mass index, and waist to hip girth. Measurements were made of their plasma glucose and insulin concentrations in response to a 75-g oral glucose load and the steady state plasma insulin and glucose (SSPG) concentrations at the end of an 180-min infusion of octreotide, insulin, and glucose. The low Mg group had significantly higher plasma glucose (P < 0.001) and insulin (P < 0.002) concentrations after the oral glucose challenge. Although the steady state plasma insulin concentrations were similar during the infusion study, the SSPG concentration was significantly (P < 0.001) greater in the low Mg group (11.9 +/- 0.9 vs. 6.6 +/- 0.9 mmol/L). Finally, when the 18 patients were analyzed together, there were significant (P < 0.05 to P < 0.01) inverse correlations between Mg concentrations and glucose (r = -0.68) and insulin (r = -0.51) areas and SSPG concentrations (r = -0.60). Thus, a low Mg concentration in nondiabetic subjects was associated with relative insulin resistance, glucose intolerance, and hyperinsulinemia.
Journal of Clinical Endocrinology & Metabolism 11/1997; 82(11):3783-5. · 6.50 Impact Factor
