Impairment of Mitochondrial Respiration in Metabolic Diseases: An Overview

Mitochondrial dysfunction has emerged as a central pathomechanism in the setting of obesity and diabetes mellitus, linking these intertwined pathologies that share insulin resistance as a common denominator. High-resolution respirometry (HRR) is a state-of-the-art research method currently used to study mitochondrial respiration and its impairment in health and disease. Tissue samples, cells or isolated mitochondria are exposed to various substrate-uncoupler-inhibitor-titration protocols, which allows the measurement and calculation of several parameters of mitochondrial respiration. In this review, we discuss the alterations of mitochondrial bioenergetics in the main dysfunctional organs that contribute to the development of the obese and diabetic phenotypes in both animal models and human subjects. Herein we review data regarding the impairment of oxidative phosphorylation as integrated mitochondrial function assessed by means of HRR. We acknowledge the critical role of this method in determining the alterations in oxidative phosphorylation occurring in the early stages of metabolic pathologies. We conclude that there is a mutual two-way relationship between mitochondrial dysfunction and insulin insensitivity that characterizes these diseases.

[Subfascial endoscopic perforating veins section]

AIM

Subfascial endoscopic perforating veins section (SEPS) is a modern surgical method used in the treatment of chronic venous insufficiency. The paper presents the postoperative results using SEPS technique at the patients with chronic venous insufficiency of the inferior limbs of different etiologies.

MATERIAL AND METHOD

We followed 26 patients, 16 women and 10 men, with ages between 16-75 years, with chronic venous insufficiency at the inferior legs. 20 patients had only one inferior limb affected by the disease and 6 patients had both limbs involved. They were, after CEAP clinical criterion, in C4, C5 and C6 classes and they had three different etiologies as primary varices with an evolutive period of 20 years, postthrombotic syndrome and congenital varices. We performed 32 SEPS operations in the 1-rst Clinic of Surgery, University of Medicine and Pharmacy "Victor Babeş" Timişoara.

RESULTS

The time of healing and postoperative complications were reduced after SEPS procedures. The healing is 100% at three months after surgery. The check up after 12 months showed a rate of 87.5% of healing. We recorded 4 unilateral relapses at patients that had postthrombotic syndrome.

DISCUSSIONS

The study realized in our clinic comparing with other studies from the literature, shows that our results are similar to that recorded in medical centers from other countries demonstrating the superiority of SEPS methods comparing with the classical Linton or Felder methods of perforating veins ligation.