Obese Type Research Articles

13C-Metabolic flux analysis of 3T3-L1 adipocytes illuminates its core metabolism under hypoxia

Hypoxia has been identified as a major factor in the pathogenesis of adipose tissue inflammation, which is a hallmark of obesity and obesity-linked type 2 diabetes mellitus. In this study, we have investigated the impact of hypoxia (1% oxygen) on the physiology and metabolism of 3T3-L1 adipocytes, a widely used cell culture model of adipose. Specifically, we applied parallel labeling experiments, isotopomer spectral analysis, and 13C-metabolic flux analysis to quantify the impact of hypoxia on adipogenesis, de novo lipogenesis and metabolic flux reprogramming in adipocytes. We found that 3T3-L1 cells can successfully differentiate into lipid-accumulating adipocytes under hypoxia, although the production of lipids was reduced by about 40%. Quantitative flux analysis demonstrated that short-term (1 day) and long-term (7 days) exposure to hypoxia resulted in similar reprogramming of cellular metabolism. Overall, we found that hypoxia: 1) reduced redox and energy generation by more than 2-fold and altered the patterns of metabolic pathway contributions to production and consumption of energy and redox cofactors; 2) redirected glucose metabolism from pentose phosphate pathway and citric acid cycle to lactate production; 3) rewired glutamine metabolism, from net glutamine production to net glutamine catabolism; 4) suppressed branched chain amino acid consumption; and 5) reduced biosynthesis of odd-chain fatty acids and mono-unsaturated fatty acids, while synthesis of saturated even-chain fatty acids was not affected. Together, these results highlight the profound impact of extracellular microenvironment on adipocyte metabolic activity and function.

Beneficial Effects of Fermentation of Red Chili Pepper Using Lactococcus lactis subs. Cremoris RPG-HL-0136 in High-Fat Diet-Induced Obese Mice

Red chili pepper is a beneficial natural spicy food that has antiobesity and antitype II diabetes effects, but it is not conducive to in-depth research as a dietary strategy to treat obesity. This study aims to investigate the beneficial effects of red chili pepper, fermented with a novel Lactococcus lactis subs. cremoris RPG-HL-0136. LC-MS/MS analysis is conducted to detect the content of capsaicin and dihydrocapsaicin, and no significant difference is observed between the nonfermented red chili pepper (NFP) (W/W) and the prepared L. lactis subs. cremoris RPG-HL-0136-fermented chili mixture (LFP). After establishing a high-fat diet-induced obese type II diabetic mouse model, the effects on weight gain, weight loss of liver and testicular fat, total cholesterol, triglyceride, fasting glucose, insulin, and homeostatic model assessment for insulin resistance in LFP were evaluated to be better than those in NFP following 10 weeks of interventions. All animal experiments were approved by the Institutional Animal Care and Use Committee of Xinxiang medical university. NFP and LFP could increase the expression of transient receptor potential vanilloid subfamily 1, peroxisome proliferator-activated receptor-alpha and caspase-2 in the high-fat mice. Compared with unfermented red chili pepper, the fermented red chili pepper complex significantly reduced LPS, tumor necrosis factor-alpha, and interleukin-6 in serum (P < .05). Intake of LFP significantly increased the expression of claudin-1 and occludin in the colon of the high-fat mice (P < .05), and there was no damage to the stomach and colon. This study provides scientific evidence that red chili pepper, fermented with L. lactis subs. cremoris RPG-HL-0136, may be beneficial for future treatment of obesity and accompanying diabetes. (IACUC.No.XYLL-20200019).

Can lipophilic pollutants in adipose tissue explain weight change-related risk in type 2 diabetes mellitus?

Can lipophilic pollutants in adipose tissue explain weight change-related risk in type 2 diabetes mellitus?

Prevalence and risk factors of diabetic retinopathy in Basrah, Iraq

This study aimed to measure the prevalence and risk factors of diabetic retinopathy (DR) among patients with diabetes mellitus aged 20 to 82 years attending the Faiha Diabetes, Endocrine, and Metabolism Center (FDEMC) in Basrah. A cross-sectional study was conducted at FDEMC, including 1542 participants aged 20 to 82 from January 2019 to December 2019. Both eyes were examined for evidence of DR by a mobile nonmydriatic camera, and statistical analysis was performed to measure the prevalence rates (95% CI) for patients with different characteristics. The mean age of participants was 35.9, with 689 males (44.7%; 95% CI: 42.2-47.2%) and 853 females (55.3%; 95% CI: 52.8-57.8%). The prevalence rate of DR was 30.5% (95% CI: 28.1-32.8%), and 11.27% of cases were proliferative retinopathy. DR significantly increased with age (p-value=0.000), it was higher in females (p-value=0.005), and significantly increased with a longer duration of diabetes (p-value<0.001), hyperglycemia (p-value<0.001), hypertension (p-value=0.004), dyslipidemia (p-value<0.001), nephropathy (p-value<0.001) and smoking (p-value<0.001). There was no statistical association between DR and the type of diabetes or obesity. One-third of the participants in this study had DR. Screening and early detection of DR using a simple tool such as a digital camera should be a priority to improve a person's health status.

Downregulation of extramitochondrial BCKDH and its uncoupling from AMP deaminase in type 2 diabetic OLETF rat hearts.

Systemic branched-chain amino acid (BCAA) metabolism is dysregulated in cardiometabolic diseases. We previously demonstrated that upregulated AMP deaminase 3 (AMPD3) impairs cardiac energetics in a rat model of obese type 2 diabetes, Otsuka Long-Evans-Tokushima fatty (OLETF). Here, we hypothesized that the cardiac BCAA levels and the activity of branched-chain α-keto acid dehydrogenase (BCKDH), a rate-limiting enzyme in BCAA metabolism, are altered by type 2 diabetes (T2DM), and that upregulated AMPD3 expression is involved in the alteration. Performing proteomic analysis combined with immunoblotting, we discovered that BCKDH localizes not only to mitochondria but also to the endoplasmic reticulum (ER), where it interacts with AMPD3. Knocking down AMPD3 in neonatal rat cardiomyocytes (NRCMs) increased BCKDH activity, suggesting that AMPD3 negatively regulates BCKDH. Compared with control rats (Long-Evans Tokushima Otsuka [LETO] rats), OLETF rats exhibited 49% higher cardiac BCAA levels and 49% lower BCKDH activity. In the cardiac ER of the OLETF rats, BCKDH-E1α subunit expression was downregulated, while AMPD3 expression was upregulated, resulting in an 80% lower AMPD3-E1α interaction compared to LETO rats. Knocking down E1α expression in NRCMs upregulated AMPD3 expression and recapitulated the imbalanced AMPD3-BCKDH expressions observed in OLETF rat hearts. E1α knockdown in NRCMs inhibited glucose oxidation in response to insulin, palmitate oxidation, and lipid droplet biogenesis under oleate loading. Collectively, these data revealed previously unrecognized extramitochondrial localization of BCKDH in the heart and its reciprocal regulation with AMPD3 and imbalanced AMPD3-BCKDH interactions in OLETF. Downregulation of BCKDH in cardiomyocytes induced profound metabolic changes that are observed in OLETF hearts, providing insight into mechanisms contributing to the development of diabetic cardiomyopathy.

P174 Uncontrolled depression and female gender increase the risk of severe fatigue in patients with inflammatory bowel disease under infliximab therapy.

Abstract Background Fatigue is a significant predictor of worst health-related qualify of life in inflammatory bowel disease (IBD) patients. Nevertheless, the role of fatigue in IBD patients under infliximab (IFX) therapy has been poorly investigated. The aim of the study was to evaluate the potential factors associated with fatigue in patients under maintenance treatment with IFX. Methods A prospective observational cohort study was designed. All IBD patients aged 18 and over under maintenance treatment with intravenous (IV) infliximab were consecutively included at the infusion day. Patients completed 3 self administered questionnaires. Fatigue was assessed with the Fatigue Impact Scale (FIS), quality of life with the Inflammatory Bowel Disease Questionnaire-Short From (IBDQ-9) and anxiety and depression using the Hospital Anxiety and Depression scale (HAD). We considered the maximum total FIS as the highest fatigue perception. Disease activity was defined in Crohn’s disease as a Harvey-Bradshaw index &amp;gt;4, and in ulcerative colitis (UC) as a Partial Mayo index &amp;gt;2. Patient demographics and disease characteristics were also collected: age, sex, disease duration, smoking habit, type of IBD, extra-intestinal manifestations, clinical activity, prior surgery, obesity, anemia, treatments (steroids, immunosuppressants, anxiolytics, antidepressants) and presence of anxiety or depression. Multiple linear regression was used to identify the variables associated with the presence of fatigue. Results Ninety patients were consecutively included (49 female, median age 42 years, interquartile range 19). Sixty three patients (70%) had Crohn’s disease (46.8% fistulising and 25.8% stenosing behaviour) and twenty seven ulcerative colitis (30%). Nearly 27% were smokers, 35 (39%) presented anxiety and 18 (21%) depression. Approximately, 8% of the patients and 7% received treatment for anxiety and depression, respectively, but only 2/18 patients with current depression received antidepressants. Combotherapy was present in 41% of the patients and 75.6% were in clinical remission. Mean fatigue was 32.74 ± SD 17.27. The highest scores for fatigue were associated with female gender (B = 10.936; P= 0.009) and the presence of depression (B = 11.114; P = 0.029). Activity disease almost increased significantly the severity of the fatigue(B = 8.995; P= 0.063). The use of antidepressants not increased the risk (B = -4.995; P = 0.555). Patients with fatigue had significantly reduced the quality of life (r = -0.638; p &amp;lt; 0.001) (Figure 1). Conclusion Uncontrolled depression and female gender increased the risk of severe fatigue more than disease activity in patients under maintenance treatment with IFX. Fatigue is related to worst health-related qualify of life.

Diabetes mellitus, obesity, and the placenta: defender or offender

The maternal hormonal and metabolic milieu adapt in normal pregnancy to provide the developing fetus with an optimal nutrient supply that is delivered via the placenta. This optimal nutrient supply, however, is disturbed in all types of diabetes and obesity, resulting in greater mixed nutrient supply to the fetus. Our research suggests that the placenta is limited in preventing excess glucose transfer to the fetus. In fact, once the fetus becomes hyperinsulinaemic in the early phases of macrosomia, it can accelerate glucose transfer across the placenta through a glucose steal phenomenon.

Anthocyanins: Potential Therapeutic Approaches towards Obesity and Diabetes Mellitus Type 2.

Overweight and obesity are present in about three-quarters of the adult population in Mexico. The inflammatory mechanisms subjacent to visceral white adipose tissue are accountable for the initiation and development of cardiometabolic alterations, including type 2 diabetes. Lifestyle changes are pillars within its therapeutics and, thus, current dietary modifications should include not only hypocaloric prescriptions with balanced macronutrient intake, preferably by increasing the amount of whole grains, fruits, vegetables, nuts and legumes, but in concomitance, bioactive substances, such as anthocyanins, have been correlated with lower incidence of this disease.

Association between Vitamin B and Obesity in Middle-Aged and Older Chinese Adults.

Previous studies have found that obese people have lower levels of vitamin B, but most have focused on obesity as defined by body mass index (BMI), and its relationship with other types of obesity is unclear. The aim of this study was to explore the relationship between vitamin B levels and obesity assessed by different definitions among Chinese middle-aged and older community-dwelling adults. This cross-sectional study included 887 participants aged 45 years and older (45-82 years). The concentrations of vitamin B (B1, B2, B6, and B9) were measured by robotic dry blood spot extraction systems in combination with liquid chromatography-tandem mass spectrometry. BMI, body fat percentage (BF%), visceral fat area (VFA), and waist circumference (WC) were used to diagnose obesity. VFA and BF% were assessed by bioelectrical impedance analysis. The logistic regression model was used to assess the associations between vitamin B levels and the odds of obesity. The average age of all participants was 60.77 (SD 6.33) years. The prevalence of obesity varied from 8.6% to 52.4% depending on different diagnostic criteria. After adjusting for covariates, a negative correlation was observed between vitamin B1 level and obesity according to the criteria of WC, VFA, and BF%, and the adjusted odds ratio (OR) was 0.47, 0.52, and 0.46, respectively. When using WC and BF% to define obesity, higher quartiles of vitamin B2 were negatively associated with the odds of obesity (OR: 0.62 and 0.62, respectively). Vitamin B6 was inversely associated with VFA-defined and BF%-defined obesity (OR: 0.64 and 0.64, respectively). When using VFA and BF% to define obesity, a negative correlation was observed in vitamin B9 (OR: 0.61 and 0.67, respectively). Vitamin B (B1, B2, B6, and B9) level was negatively related to obesity (defined by WC, VFA, or BF%) in Chinese middle-aged and older adults.

Effects of liraglutide on weight control and blood pressure in type 2 diabetes mellitus Iraqi patients

Background: Diabetes mellitus is the most common endocrine illness, affecting an increasing number of people all over the world. It is caused by a lack, or inadequate synthesis of insulin by the pancreas leading to an increase in blood glucose concentrations. Type 2 diabetes mellitus is the most strongly linked disease to obesity of all disorders. The number of obesity-related diabetes is predicted to reach 300 million by 2025. The term 'diabesity' was coined as a result of this strong link, therefore, weight loss is seen as a key therapeutic goal in the prevention and management of type 2 diabetes mellitus. Liraglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist that stimulates insulin secretion in a glucose-dependent manner. Also, it has weight-losing benefits which is assumed to be due to appetite suppression and delayed gastric emptying. Objectives: To evaluate the effectiveness of Liraglutide on weight management, body mass index, renal function and blood pressure in type 2 diabetic mellitus obese patients in Iraq. Methods: An open-label therapeutic trial was conducted from November 2021 to June 2022 at Baquba Teaching Hospital/ Diyala. (23 males and 27 females) with Type 2 Diabetes mellitus for 2 - 4 years were included in the study. They were obese, hypertensive and dyslipidemic. They received metformin and liraglutide for 12 weeks as 0.6 mg/day during the first week, which was gradually increased to 1.2 mg and up to 1.8 mg/day according to patient tolerance and requirement for control at the beginning the study. The patients had their height as well as body weight measured, calculated, blood pressure measured and renal functions tested. The statistical analysis was performed using SAS (Statistical Analysis System - version 9.1). Two-way ANOVA and Least significant differences (LSD) post hoc test were performed as well as paired t-test. P&lt; 0.05 was considered statistically significant. Results: Treatment with liraglutide for 12 weeks has resulted in a significant decrease in body weight, BMI, and blood pressure (P&lt;0.05). The changes in the results of renal function test of liraglutide-treated patients were not significant. Conclusion: In obese type 2 diabetic patients, liraglutide has the potential of reducing body weight, body mass index and blood pressure. It seemed safe in terms of its systemic effects

Impact of serum vitamin D level on selected bone-related markers in obese- type 2 diabetes patients

Background: Type 2 diabetes mellitus (T2DM) is accompanied by an increased risk for skeletal fractures. The causes are probably a mix of factors, including poor glycemic control, a higher risk of falling due to hypoglycemia, osteopenia, bone quality deterioration, and drug side effects related to bone fragility. Undercarboxylated osteocalcin (ucOC) is a protein generated by osteoblasts that affects insulin secretion and sensitivity. Methods: A total number of 47 obese (BMI ˃ 30) patients with confirmed type 2 diabetes were selected depending on the American Diabetes Association ADA criteria. The control participants were similar to the patients in age and gender, with a total number of 43 obese (BMI ˃ 30) and healthy subjects chosen from the general population. The selected subjects were grouped according to their serum vitamin D levels. Their blood specimen was used for assaying ucOC, parathyroid hormone (PTH), and vitamin D3 levels by specific ELISA kits, and to estimate calcium (Ca2+) levels and inorganic phosphate (PO43−) via enzymatic colorimetric methods. Results: Serum parathyroid hormone and inorganic phosphate median (IQR) values were markedly increased in patients with T2DM when compared to healthy controls, whereas serum calcium and ucOC levels were lowered significantly in diabetic patients when compared to healthy controls. This was irrespective of serum vitamin D levels. Conclusions: Elevated serum levels of PTH and PO43− values in obese type 2 diabetic patients compared to obese non-diabetic controls were accompanied by a significant decrease in ucOC and Ca2+ levels, irrespective of serum vitamin D levels. Hence, serum vitamin D3 levels had no significant impact on levels of ucOC, PTH, Ca2+, and PO43− in obese patients with type 2 diabetes.

Association of Body Composition with Static Plantar Foot Pressure in Young Adult

Body composition is a key component of health-related fitness. Dual Energy Absorptiometry (DEXA) is the most reliable technique to evaluate body composition. There is evidence suggesting that obesity is linked to foot disorders leading to &amp; an increase in the risk of falls and injuries. Pedobarography is a fast, simple, non-invasive and reliable method used to measure plantar foot pressure. Studies on the association of body composition using DEXA with the static standing plantar pressure are limited. Purpose: The purpose of the study was to measure the association of fat percentage, Body mass index, type of obesity, fat mass and bone mineral content (BMC) with foot pressure. Methods: 64 young adults participated in this study including 34 females and 30 males with a mean age of 21.7±2.6 years. DEXA and Pedobarography were used for evaluation. Results: It was found that with the increase in every 1% in fat percentage, BMI, android type obesity the forefoot pressure increases by 1.070% (p-value 0.06), 1.079% (p-value 0.07) and 1.106% (p-value 0.25). Gynoid type obesity has an inverse relationship with forefoot pressure. With every 1% decrease in the gynoid type obesity value the forefoot pressure increases by 0.971% (p-value 0.97). Also, 39 out of 64 (60%) subjects with higher fat mass and 34 out of 64 (53%) subjects with greater bone mineral density (BMD) on one side had foot pressure dominance on the same side with p-value &gt;0.05. Conclusion: This study concludes that body composition parameters variably affect the foot pressure in static standing.

PS-B08-7: L-CARNITINE AMELIORATES DIABETIC KIDNEY DISEASE BY ALLEVIATING MITOCHONDRIAL ABNORMALITY IN SDT-FATTY RATS

Background and Aims: Abnormal fatty acid metabolism is associated with the progression of diabetic kidney disease (DKD). Carnitine plays a central role in β;-oxidation and energy production by transporting long-chain fatty acids from the cytoplasm to the mitochondria. Recently, we found that significant ectopic fat was accumulated in the kidney tissue in DKD patients compared with those in minimal change kidney disease patients. Juvenile visceral steatosis (jvs) mice, described as an animal model for systemic carnitine deficiency, introduce a marked ectopic fat accumulation in the kidney. These findings suggest that abnormal carnitine dynamics in DKD cause ectopic fat accumulation due to abnormality of the fatty acid metabolism. However, the association between abnormalities of carnitine metabolism and the progression of DKD is unknown. Method: Spontaneously Diabetic Torii (SDT) fatty rat, an obese type 2 diabetic model was used. Unilateral nephrectomy was performed and 0.3% salt water was administered at 6 weeks of age, and created a renal dysfunction model in SDT fatty rat (DKD model). Age-matched male Sprague-Dawley (SD) rat was used as a control. Experiment 1: We compared 3 groups; SD rats (n = 8), SDT fatty rats (n = 8), DKD rats (n = 8). Experiment 2: We compared 3 groups; SD rats with sham operation (n = 8), DKD rats (n = 7), DKD rats treated with L-carnitine administration (0.75% L-carnitine diet) for 10 weeks (n = 6). All rats were sacrificed at 17 weeks old. Carnitine was measured by the enzyme cycling method. Acylcarnitine was analyzed by the tandem-mass spectrometry. Results: Plasma and renal free carnitine levels and short/middle-long chain acylcarnitine ratio were significantly decreased in DKD rats compared with those in SD and SDT fatty rats. The renal expression levels of organic cation / carnitine transporter 2 (OCTN2), carnitine palmitoyl transferase 1a (CPT1a), CPT2 and carnitine acetyltransferase (CrAT) were significantly decreased in DKD rats compared with those in SD and SDT fatty rats. Similarly, peroxisome proliferator-activated receptor γ co-activator 1α (PGC1α) activity was decreased in DKD rats. L-carnitine administration significantly improved renal function, urinary albumin excretion, interstitial fibrosis and renal ectopic fat accumulation in DKD model rats. L-carnitine administration ameliorated the decrease of renal OCTN2, CPT1a, CPT2 and CrAT protein expression, and significantly improved PGC1α activity in DKD model rats. Furthermore, L-carnitine administration mitigated lipid peroxidation and mitochondrial dysfunction in DKD rats. Conclusion: L-carnitine administration might be a promising therapeutic strategy for improving renal function by alleviating mitochondrial dysfunction in DKD rat model.

Thyroid volume and echogenicity by ultrasound in Obese type 2 DM patients

Thyroid volume and echogenicity by ultrasound in Obese type 2 DM patients

Effect of diabetes-specific oral nutritional supplements with allulose on weight and glycemic profiles in overweight or obese type 2 diabetic patients.

Diabetes-specific oral nutritional supplements (ONS) have anti-hyperglycemic effects, while D-allulose exerts anti-diabetic and anti-obesity effects. In this study, we investigated the efficacy and safety of diabetes-specific ONS, including allulose, on glycemic and weight changes in overweight or obese patients with type 2 diabetes mellitus (T2DM). A single-arm, historical-control pilot clinical trial was conducted on 26 overweight or obese patients with T2DM (age range: 30-70 yrs). The participants were administered 2 packs of diabetes-specific ONS, including allulose (200 kcal/200 mL), every morning for 8 weeks. The glycemic profiles, obesity-related parameters, and lipid profiles were assessed to evaluate the efficacy of ONS. After 8 weeks, fasting blood glucose (FBG) level significantly decreased from 139.00 ± 29.66 mg/dL to 126.08 ± 32.00 mg/dL (P = 0.007) and glycosylated hemoglobin (HbA1c) improved (7.23 ± 0.82% vs. 7.03 ± 0.69%, P = 0.041). Moreover, the fasting insulin (δ: -1.81 ± 3.61 μU/mL, P = 0.017) and homeostasis model assessment for insulin resistance (HOMA-IR) (δ: -0.87 ± 1.57, P = 0.009) levels decreased at 8 weeks, and body weight significantly decreased from 67.20 ± 8.29 kg to 66.43 ± 8.12 kg (P = 0.008). Body mass index (BMI) also decreased in accordance with this (from 25.59 ± 1.82 kg/m2 to 25.30 ± 1.86 kg/m2, P = 0.009), as did waist circumference (δ: -1.31 ± 2.04 cm, P = 0.003). The consumption of diabetes-specific ONS with allulose in overweight or obese patients with T2DM improved glycemic profiles, such as FBG, HbA1c, and HOMA-IR, and reduced body weight and BMI.

Correlation between TCM syndrome type distribution and glycolipid metabolism in obese type 2 diabetes mellitu

Correlation between TCM syndrome type distribution and glycolipid metabolism in obese type 2 diabetes mellitu

Machine-Learning-Enabled Obesity Level Prediction Through Electronic Health Records

Obesity is a critical health condition that severely affects an individual’s quality of life and well-being. The occurrence of obesity is strongly associated with extreme health conditions, such as cardiac diseases, diabetes, hypertension, and some types of cancer. Therefore, it is vital to avoid obesity and or reverse its occurrence. Incorporating healthy food habits and an active lifestyle can help to prevent obesity. In this regard, artificial intelligence (AI) can play an important role in estimating health conditions and detecting obesity and its types. This study aims to see obesity levels in adults by implementing AI-enabled machine learning on a real-life dataset. This dataset is in the form of electronic health records (EHR) containing data on several aspects of daily living, such as dietary habits, physical conditions, and lifestyle variables for various participants with different health conditions (underweight, normal, overweight, and obesity type I, II and III), expressed in terms of a variety of features or parameters, such as physical condition, food intake, lifestyle and mode of transportation. Three classifiers, i.e., eXtreme gradient boosting classifier (XGB), support vector machine (SVM), and artificial neural network (ANN), are implemented to detect the status of several conditions, including obesity types. The findings indicate that the proposed XGB-based system outperforms the existing obesity level estimation methods, achieving overall performance rates of 98.5% and 99.6% in the scenarios explored.

Consanguinity, Fertility and Reproductive Outcomes: An International Review

Consanguineous marriages have been common throughout human history, and remain so even today in many parts of the world. Many Arab countries display some of the highest rates of consanguinity and, specifically, first cousin marriages which may encompass 25 to 30 percent of all marriages. The effects of inbreeding on reproductive outcome have been extensively studied. It used to be generally believed that inbreeding contributed to increased mortality and morbidity with detrimental effects on reproductive outcome; however, some studies have shown only a moderate to slight impact. The fertility of consanguineous couples and infant and childhood morbidity and mortality in their progeny have also been extensively studied and numerous studies have concluded that consanguinity is not associated with either a significant positive or negative effect on fertility. The majority of studies found that first cousin couples produce more children. In many cases the mean number of live births to women in consanguineous marriages has been reported as being higher than that in non-consanguineous unions, although several studies found that mean fertility rates may be lower in consanguineous couples. In general, higher total fertility rates have been reported in consanguineous marriages. Reports regarding the association of consanguinity and fetal wastage are conflicting, with some reporting that the total prenatal losses were essentially the same for consanguineous and non-consanguineous. Congenital malformations have long been established to be higher in consanguineous couples about the background rate (4.5% vs 1%). Due to the principle of the existence of a common ancestor. Consanguinity is most commonly associated with inborn errors of metabolism, most of which are autosomal recessive. Consanguinity also increases the incidence of multi-factorial disorders such as diabetes, cardiovascular disorders, obesity and certain types of cancers, which may in turn affect reproductive outcomes. Pregnancy outcomes, such as increased pregnancy wastage and preterm labor have been reported with consanguineous marriages. The most significant effects on reproductive outcomes are mostly due to autosomal recessive inherited conditions and inborn errors in metabolism. In the future, with completion of the study of the whole human Genome and current advances in pre-implantation diagnosis and screening it may be possible to mitigate some of the adverse reproductive outcomes associated with consanguinity.

PHYSICAL HEALTH OF STUDENTS AND DIGITALIZATION OF HIGHER MEDICAL EDUCATION: RISK FACTORS.

The aim: To study the dynamics of gadget use by higher education students of the Bogomolets National Medical University and to assess technological impact on the physical health of students. Materials and methods: To accomplish the tasks set using theoretical and experimental methods of scientific research: systematic analysis, comparison and generalization of the bibliosemantic method, questionnaires, and interviews with students. Quantitative data collected during the survey of students studying in the «Dentistry», «Pediatrics», «Medicine», «Pharmacy, Industrial Pharmacy», «Physical Therapy, Occupational Therapy», and «Medical Psychology» specialties were processed using the MedCalc statistical software, and there was carried out comparative analysis afterwards. Results: During the quarantine and martial law, medical university students were forced to study distantly or in a mixed format using various gadgets and computers. It is obvious that the physical condition of a person is affected by the duration of their use of various devices. In this paper, therefore, the risks and the researched dynamics of gadget use by higher education students of the Bogomolets National Medical University were identified. Thus, the technological impact on the physical health of students was also defined. Moreover, the data based on the results of height and weigh calculation of higher education students, which used to diagnose types of obesity by anthropometric indicators, were also collected. Conclusions: According to the results of the research, it was established that the students of the Bogomolets National Medical University spent a significant part of their study time sitting in the classroom or at the computer (40 hours weekly average). We found that in the process of distance learning, prolonged sitting at a PC or other gadget (as well as general sedentary lifestyle) has affected the female higher education students majoring in 222 «Medicine» course their body mass index. The time spent using gadgets both in the educational and non-formal education (self-education) processes has increased significantly. We attribute this fact to the emergence of a significant number of online educational resources in the public domain, the growing number of webinars, trainings, and master classes conducted by both domestic and foreign experts online.

Дослідження зв'язку фенотипу бронхіальна астма-ожиріння з ER22/23EK і TTH111I поліморфізмами гена глюкокортикоїдного рецептора

(GR) gene with the body mass index (BMI) of patients with bronchial asthma (BA), considering the age of BA onset. Materials and methods. 553 patients with BA and 95 practically healthy persons who previously signed an informed consent to participate in the study were examined. Patients were divided into two clinical groups according to the age of BA onset. Group I included 282 patients with late-onset of asthma (late asthma phenotype), and Group II included 271 patients with early onset (early asthma phenotype). The diagnosis of BA and the severity of the course were established according to the recommendations of GINA-2016 and subsequent versions. Diagnosis of obesity was carried out in accordance with the Order of the Ministry of Health of Ukraine dated August 5, 2009, No. 574, and the European Association for the Study of Obesity (EASO, 2016). The study was approved by the Bioethics Committee of the Medical Institute of Sumy State University. Determination of ER22/23EK (rs 6189/6190) and Tth111I (rs10052957) polymorphisms of the GR gene was performed using the polymerase chain reaction followed by the analysis of restriction fragments. Statistical analysis of the obtained results was carried out using the SPSS-17 program. The results. The analysis of anthropometric parameters showed that among the examined patients with BA, there were 152 (27.5 %) patients with normal body weight (NBW), 206 (37.3 %) were overweight, and 195 (35.2 %) with obesity. Visceral type of obesity was verified among all patients. It was established that among overweight and obese BA patients, there was a higher frequency of GG genotype according to the ER22/23EK polymorphism of the GR gene compared to patients with NBW. Heterozygotes were found 5.6 and 3.5 times more often in patients with normal body weight compared to patients with obesity. Analysis of the ratio of G and A alleles depending on BMI shows a higher frequency of the G allele in obese patients compared to patients with NBW. The distribution of alleles and genotypes according to the Tth111I polymorphism in the examined patients with BA depending on the BMI shows a twice higher frequency of homozygotes for the main C allele in overweight and patients with obesity compared to patients with NBW. Carriers of homozygotes for the minor allele were detected 4.7 times and 2.1 times more often in patients with NBW compared to overweight patients and with obesity. A probable difference in the distribution of alleles and genotypes according to the Tth111I polymorphism of the GR gene was established in patients with early and late BA (p = 0.001). Carriers of homozygotes for the main allele of CC were found more often in patients with early and late BA in the presence of obesity. Conclusions. A higher frequency of the GG genotype according to the ER22/23EK polymorphism of the GR gene and homozygotes according to the main CC allele according to the Tth111I polymorphism of the GR gene in overweight BA patients and with obesity compared to patients with NBW was proven. The protective role of the ER22/23EK polymorphism of the GR gene in relation to the occurrence of obesity in the dominant, superdominant and additive models of inheritance and the Tth111I polymorphism of the GR gene in the superdominant model was established. A higher frequency of carriers of homozygotes for the main C allele in patients with early-onset and late-onset BA in the presence of obesity compared to patients with NBW, a protective role of the Tth111I polymorphism of the GR gene on the risk of developing obesity in patients with late-onset BA in superdominant and recessive models of inheritance was established. Key words: bronchial asthma, obesity, onset, course, ER22/23EK, and Tth111I polymorphisms of the glucocorticoid receptor gene.