Assessment Of Metabolic Parameters Research Articles

Assessment of Metabolic Parameters in Female Triathletes with Hashimoto’s Thyroiditis in Poland

Background: Hypothyroidism is a complex disorder characterized by an increase in body weight. About 15-30% of hypothyroid patients are reported to be overweight. The triathlon is an endurance combination sport that comprises a sequential swim, cycle, and run. Triathletes must withstand high training loads with various combinations of intensity and volume. Adequate body structure, the ratio of fat and muscle tissue, and adequate hydration play a huge role. The aim of our study was to show the potential differences in metabolic parameters assessed by medical Body Composition Analyzer before the initiation of treatment with L-thyroxine and after 3 and 6 months of treatment in females who practiced triathlon and who were newly diagnosed with Hashimoto's thyroiditis. Methods: The study group included 32 females practicing triathlon. They were recruited for 10 months from March to December 2021. Analysis of anthropometric measurements was performed using a seca device mBCA 515 medical Body Composition Analyzer. Results: We observed significant differences in FM and VAT before and after L-thyroxine treatment. We also noticed lower BMI levels after treatment, along with significant differences in thyroid function tests (TSH and fT4) carried out during the recruitment period and after 3 and 6 months of treatment. Conclusion: Due to their higher daily energy consumption, further research is needed into the treatment of Hashimoto's thyroiditis in athletes who practice triathlon. Frequent bioelectrical impedance analysis of body composition during treatment can be very helpful.

Postbariatric hypoglycemia in symptomatic versus asymptomatic patients: proposals for clinical assessments

IntroductionRecurrent hypoglycemia due to postbariatric hypoglycemia (PBH) is a postoperative complication after Roux-en-Y gastric bypass (RYGBP). The historic term is late dumping syndrome or reactive hypoglycemia. The aim of this...

Advances in Phenotyping Obesity and in Its Dietary and Pharmacological Treatment: A Narrative Review.

In recent times, it has become evident that there are individuals who, from a metabolic point of view, are affected by obesity but have a normal body mass index. There are also metabolically healthy individuals with a high body mass index who are thus are considered as to be affected by obesity obese. Understanding that individuals with obesity are phenotypically heterogeneous is a relatively novel concept which, although present in the scientific literature, unfortunately has not yet had an impact in clinical practice. However, common dietary approaches are not effective in treating large numbers of obese patients with obesity. This narrative review, based on the material searched via PubMed and the Web of Science up to October 2021, proposes a downsizing of the role of the body mass index in identifying the individual with “true obesity” since it is only partially useful, and suggests a new approach which also integrates the body composition and assessment of metabolic parameters. This approach leads to personalized therapies that work best for each obesity phenotype in reducing the risk of non-communicable diseases.

Plaque-targeted, proteolysis-resistant, activatable and MRI-visible nano-GLP-1 receptor agonist targets smooth muscle cell differentiation in atherosclerosis.

Background: Glucagon-like peptide-1 receptor (GLP-1R) agonists are powerful glycemia-lowering agents, which have systematically been shown to lower cardiovascular events and mortality. These beneficial effects were difficult to pinpoint within atherosclerotic plaque due to lack of particular specificity of such agonists to the vascular cells and an inadequate understanding of the GLP-1R expression in atherosclerosis. Here, we hypothesized that the direct engagement of the GLP-1R in atherosclerosis by targeted agonists will alleviate vascular inflammation and plaque burden, even at a very low dose.Methods: The expression of GLP-1 receptor (GLP-1R, Glp1r mRNA) in human lesions with pathologic intimal thickening, Apoe-/- mouse atheroma and cultured immune/non-immune cells was investigated using genetic lineage tracing, Southern blotting and validated antisera against human GLP-1R. Protease-resistant and “activatable” nanoparticles (NPs) carrying GLP-1R agonist liraglutide (GlpNP) were engineered and synthesized. Inclusion of gadolinium chelates into GlpNP allowed for imaging by MRI. Atherosclerotic Apoe-/- mice were treated intravenously with a single dose (30 µg/kg of liraglutide) or chronically (1 µg/kg, 6 weeks, 2x/week) with GlpNP, liraglutide or control NPs, followed by assessment of metabolic parameters, atheroma burden, inflammation and vascular function.Results: Humal plaque specimens expressed high levels of GLP-1R within the locus of de-differentiated smooth muscle cells that also expressed myeloid marker CD68. However, innate immune cells under a variety of conditions expressed very low levels of Glp1r, as seen in lineage tracing and Southern blotting experiments examining full-length open reading frame mRNA transcripts. Importantly, de-differentiated vascular smooth muscle cells demonstrated significant Glp1r expression levels, suggesting that these could represent the cells with predominant Glp1r-positivity in atherosclerosis. GlpNP resisted proteolysis and demonstrated biological activity including in vivo glycemia lowering at 30 µg/kg and in vitro cholesterol efflux. Activatable properties of GlpNP were confirmed in vitro by imaging cytometry and in vivo using whole organ imaging. GlpNP targeted CD11b+/CD11c+ cells in circulation and smooth muscle cells in aortic plaque in Apoe-/- mice when assessed by MRI and fluorescence imaging. At a very low dose of 1 µg/kg, previously known to have little effect on glycemia and weight loss, GlpNP delivered i.v. for six weeks reduced triglyceride-rich lipoproteins in plasma, plaque burden and plaque cholesterol without significant effects on weight, glycemia and plasma cholesterol levels.Conclusions: GlpNP improves atherosclerosis at weight-neutral doses as low as 1 µg/kg with the effects independent from the pancreas or the central nervous system. Our study underlines the importance of direct actions of GLP-1 analogs on atherosclerosis, involving cholesterol efflux and inflammation. Our findings are the first to suggest the therapeutic modulation of vascular targets by GlpNP, especially in the context of smooth muscle cell inflammation.

Does higher body mass index increase COVID-19 severity? A systematic review and meta-analysis.

IntroductionObesity and higher BMI is one of the leading comorbidities to increase the risk of COVID-19 severity. This paper presents a systematic review and meta-analysis estimating the effects of overweight and obesity on COVID-19 disease severity.MethodTwo electronic databases (Medline and Cochrane library) and one grey literature database (Grey Literature Report) were searched. The risks of bias of the selected studies were assessed by using the Navigation Guide method for human data. Both random and fixed effect meta-analyses were determined using Review Manager (RevMan) software version 5.4.ResultsAfter initial screening, 12 studies were fulfilled the eligibility criteria, comprising a total of 405359 patients, and included in the systematic review. The pooled risk of COVID-19 severity was 1.31 times higher based on both fixed and random effect model among those overweight patients, I2 0% and 2.09 and 2.41 times higher based on fixed and random effect respectively among obese patients, I2 42% compared to healthy individuals.ConclusionOverweight and obesity are found to be risk factors for disease severity of COVID-19 patients. However, further assessment of metabolic parameters is required to estimate the risk factors of COVID-19 patients and understanding the mechanism between COVID-19 and body mass index.

Contractility versus Metabolic Cardiac Assessment during Ex Situ Heart Perfusion: A Pre-Clinical Transplant Study

Purpose Assessment of DCD hearts during ex situ perfusion (ESP) is required to determine suitability of these organs for transplant. To date, metabolic and contractility parameters have not been compared using a full transplant model. We aimed to identify which parameters measured during ESP could predict myocardial performance post-transplantation Methods Porcine hearts were procured from beating-heart donations (n=6) or following hypoxic circulatory arrest and 15min of warm ischemia (n=6). They underwent 4h of ESP, transplantation, and reperfusion for 3h. Cardiac function was assessed during ESP using left (LV) and right (RV) ventricular pressure-volume loops, and metabolic parameters. We performed linear regressions to identify significant correlations Results Several parameters correlated with recovery of cardiac function (Table 1). LV developed pressure was the best predictor of LV Max dP/dt (R2=0.523; p=0.018) while myocardial oxygen consumption (MVO2) at 30min of ESP better predicted LV stroke work (R2=0.625; p=0.006). RV Tau during ESP was the best predictor of post-transplant RV function (R2=0.615; p=0.021). Several metabolic parameters predicted cardiac index. LV Preload Recruitable Stroke Work was the only contractile measurement to predict cardiac index (R2=0.467; p=0.021), while MVO2 at 30min was the best predictor (R2=0.578; p=0.007) Conclusion Both contractility and metabolic markers measured during ESP were able to predict myocardial performance following transplantation. Assessment of metabolic parameters demonstrated a more significant number of correlations and provided a better evaluation of cardiac index. This is contradictory with previous reports showing contractile evaluation would provide a more accurate estimation of early transplant function. However, contractility parameters were better to evaluate isolated LV and RV function post-transplant. Further studies are needed to clarify this question.

Impact of 24-month treatment with etanercept, adalimumab, or methotrexate on metabolic syndrome components in a cohort of 210 psoriatic arthritis patients

Psoriatic arthritis (PsA) is a chronic inflammatory condition, characterized by an excess of metabolic disorders. Metabolic syndrome (MetS) is a cluster of classic cardiovascular risk factors, due to an imbalance between pro- and anti-inflammatory adipokines. Tumor necrosis factor (TNF)-α is a pro-inflammatory adipocytokine mainly produced by monocytes and macrophages with a central role in inflammatory responses, but it also induces adipocytes apoptosis, promotes insulin resistance, and stimulates lipolysis. The aim of this study was to evaluate the impact of therapy with etanercept (ETN), adalimumab (ADA), and methotrexate (MTX) on MetS components in a cohort of PsA patients with a follow-up period of 24 months. A retrospective study has been conducted in a cohort of PsA patients. On the basis of the inclusion criteria, we identified the first 70 consecutive patients, respectively, on ADA, ETN, and MTX, for a total of 210 patients achieving PsARC criteria during the observation period. As part of the routine clinical practice, assessment of metabolic parameters and of disease activity was recorded at baseline (T0), at 12 months (T1), and at 24 months (T2). The results show that when the specific components of the MetS were considered, taking also into account by regression analysis the effect of the confounding factors, the patients on etN and ADA show a significant improvement of the metabolic syndrome components (in detail, waist circumference, triglycerides, high-density lipoprotein cholesterol, and glucose) as compared to the MTX group. In conclusion, these data suggest that the biologic treatment in PsA can no longer be taken into consideration only for its positive effect on articular and cutaneous symptoms but also on the various aspects of this complex picture.

Carvedilol vs. metoprolol: A comparison of effects on endothelial function and oxidative stress in response to acute hyperglycemia in patients with type 2 diabetes and hypertension

Introduction: The GEMINI trial compared the effects of treatment with metoprolol versus carvedilol in patients with type 2 diabetes. Carvedilol demonstrated a more favorable effect on factors associated with the metabolic syndrome than metoprolol. We hypothesize that carvedilol will have additional beneficial effects on markers of inflammation, oxidative stress, and endothelial function than metoprolol. Methods: Twenty subjects were randomized to either carvedilol or metoprolol. Study procedures including assessment of metabolic parameters and endothelial function, while fasting and after a 75 g oral glucose tolerance were conducted at baseline and following 5 months of treatment. Results: Following 5 months of treatment, PAI-1 increased significantly from baseline in the metoprolol group. There were no changes in PAI-1 in the carvedilol group. While not reaching statistical significance, there was a trend toward worsening insulin resistance with metoprolol treatment compared to carvedilol treatment. Flow mediated vasodilation increased in both groups following the 2-hr OGGT during the baseline study. After five months of treatment, there was a non-significant increase in flow-mediated vasodilation under both fasting and post OGTT conditions in the carvedilol group compared to baseline. Conversely, there was no change in fasting flow mediated vasodilation in the metoprolol group. Additionally, metoprolol treatment blunted the increase in flow mediated vasodilation following OGGT compared to baseline (p < 0.05). Conclusion: Treatment with metoprolol was associated with adverse metabolic effects including increases in PAI-1 and trends toward worsening insulin resistance and endothelial function compared to treatment with carvedilol.

Preliminary study on metabolic profile of pregnant and non‐pregnant ewes with high or low degree of behavioral lateralization

To evaluate the metabolic profile of pregnant and non-pregnant ewes with high or low degree of behavioral lateralization, we used 57 clinically healthy Sardinian ewes. They were divided into three groups: Group A (nonpregnant ewes), Group B (pregnant ewes with one fetus) and Group C (pregnant ewes with twin fetuses). Using behavioral tests, in all groups lateralization was established and ewes were distinguished into ewes with high and low level of lateralization. Every 30 days for 4 months (at 35, 76, 103 and 145 days of gestation), blood samples were collected and total cholesterol, triglycerides, nonesterified fatty acids (NEFA), glucose, insulin, creatinine, urea, uric acid, total protein, total bilirubin, aspartate aminotransferase (AST), alanine aminotransferase (ALT), γ-glutamine transferase (γ-GT), β-hydroxybutyrate (β-OHB), chloride (Cl), potassium (K), sodium (Na) and calcium (Ca) were assessed. The repeated measures multifactor analysis of variance (MANOVA) showed statistical differences of time, pregnancy and degree of lateralization on some studied parameters. These results confirm that pregnancy represents a very important metabolic moment and show the effect of the degree of behavioral lateralization on the assessment of metabolic parameters in non-pregnant and pregnant ewes. Further studies are necessary to value the influence of these factors on other parameters such as hematological parameters and hormones.

ASSESSMENT OF METABOLIC PARAMETERS AND RENAL FUNCTION AS PROGNOSTIC FACTORS IN CARDIOVASCULAR DISORDERS IN HYPERTENSIVE PATIENTS: PP.35.474

Objective: Usefulness of the assessment of metabolic and renal parameters in cardiovascular risk estimating in patients with hypertension. Design and Method: 58 hospitalized hypertensive patients, aged 29 to 83, were examined (20 women and 38 men). Patients were divided into two groups: A - without coronary artery disease (CAD) (28 patients) and B - with CAD (30 patients). Both groups were not significantly different in the level of systolic (SBP) [(A) 140+/−18 mmHg; (B) 139+/−15 mmHg] and diastolic (DBP) [(A) 88+/−13 mmHg; (B) 82+/−11 mmHg] blood pressure as well as in glomerular filtration rate (GFR) [(A) 78,57+/−24,25 ml/min/1,73m2; (B) 76,76+/−22,11 ml/min/1,73m2]. GFR was estimated according to MDRD formula. Both groups did not differ significantly in hypotensive and lipid lowering therapy. Following measurements were taken: blood pressure (BP), lipid profile and serum creatinine level. Echocardiography was performed in each patient, following parameters were measured in the end-diastolic phase: left ventricle diameter (LVd), right ventricle diameter (RVd), left atrium diameter (LAd), posterior wall thickness (PW) and intraventricular septum thickness (IVS); ejection fraction (EF) was assessed and left ventricle mass index (LVMI) was estimated according to Penn's formula. Results: We revealed statistically significant difference in the levels of total cholesterol [(A) 5,45+/−1,20 mmol/l, (B) 4,55+/−0,94 mmol/l; p = 0,0028] and LDL-cholesterol [(A) 3,47+/−1,03 mmol/l, (B) 2,63+/−0,77 mmol/l; p = 0,0009] between both groups. We also observed significant negative correlation between LVMI and GFR (r = -0,4820; p = 0,0081), LVMI and total cholesterol level (r=-0,3754; p = 0,0448) and LVMI and LDL-cholesterol level (r = -0,3771; p = 0,0438) in the group A. We observed significant positive correlation between GFR and EF (r = 0,4737; p = 0,0109) in the same group. None of these correlations was noticed in group B. Conclusions: 1) In patients with CAD cardiovascular complications are so advanced, that no direct relationship to the metabolic parameters and renal function may be seen. 2) Assessment of metabolic parameters and its influence on LVMI is of greater significance in patients with hypertension and without CAD in prevention of renal failure and CAD.

Higher liver fat content among Japanese in Japan compared with non-Hispanic whites in the United States

Among Asians, including Japanese, obesity is related to dyslipidemia and insulin resistance at a lower level of body mass index (BMI) compared with non-Hispanic whites (NHW). We hypothesize that this ethnic difference in the relationship between BMI and metabolic risks is partly associated with the ethnic difference in fat distribution, namely, liver fat as well as visceral adipose tissue. To compare liver fat content among Japanese vs NHW men, regional computed tomographic images were taken to measure liver computed tomographic density in population-based samples of 313 Japanese and 288 NHW men aged 40 to 49 years, along with the assessment of metabolic parameters. Liver fat content was higher in Japanese than NHW men (liver to spleen attenuation ratio [lower value means higher liver fat content]: 1.01 ± 0.16 vs 1.07 ± 0.15, respectively; P < .01), despite a lower mean BMI in Japanese men (BMI: 23.6 ± 2.9 vs 27.8 ± 4.2 kg/m 2, P < .01). Moreover, Japanese men had a greater disposition for fatty liver with a small increase in BMI than NHW ( P < .01), whereas both groups had a similar relationship between visceral adipose tissue and BMI. In both groups, liver fat content correlated with triglycerides, homeostasis model assessment of insulin resistance, and C-reactive protein. Liver fat content is higher among Japanese than NHW; and this ethnic difference becomes more robust with a small increase in BMI, suggesting that fatty liver is a sensitive marker for the failure of the adipose tissue to expand to accommodate an increased energy influx, and is associated with similar metabolic risk in Japanese despite lower BMI compared with NHW men.