Are Changes in Serum IgG Glycosylation Related to the Severe Course of SARS-CoV-2 Infection and Recovery Process? In Search of New Diagnostic and Prognostic Biomarkers

Introduction

Immunoglobulin G (IgG) glycosylation affects its effector functions and is essential in many steps of the inflammatory cascade. Therefore, it may be an important parameter for assessing the body's immune response during the course of COVID-19 (Coronavirus disease 2019).

Methods

The N- and O-glycosylation of serum IgG in severe COVID-19 patients (n=87), convalescents (n=50), and healthy subjects (n=65) were examined using a modified lectin-ELISA method with specific biotinylated lectins. The obtained data were analyzed using STATISTICA 13.3PL software.

Results

We showed significantly higher expression of Lewisx oligosaccharide structures in severe COVID-19 patients than in the other two groups. Moreover, significantly lower expression of Lewisy sugar structures in IgG glycans was observed in the convalescents when compared with COVID-19 patients and healthy subjects. The lowest expression of highly branched N-glycans in cases of severe COVID-19 indicates that the development of the disease is associated with the presence of typical IgG biantennary N-glycans. The lack of significant differences in the expression of Tn antigen in IgG between studied groups and the significantly lower expression of T antigen in convalescents compared to the patients with severe COVID-19 and healthy subjects indicates a decrease in the content of the T antigen in IgG O-glycans in subjects recovered from COVID-19. Substantially higher reactivities of IgG O-glycans with Jacalin observed in COVID-19 patients and convalescents in comparison to the control group were most probably caused by increased expression of core 3 O-glycans in IgG.

Conclusion

Severe COVID-19 is accompanied by the expression in serum IgG of sialylated biantennary and highly branched N-glycans, decorated by fucose of Lewisx and Lewisy structures. The higher reactivity of IgG O-glycans with Jacalin in severe COVID-19 patients and convalescents indicates that the disease development and the recovery process are most probably accompanied by increased expression of the core 3 O-glycans.

Caffeine as a Factor Influencing the Functioning of the Human Body-Friend or Foe?

Nowadays, caffeine is one of the most commonly consumed substances, which presents in many plants and products. It has both positive and negative effects on the human body, and its activity concerns a variety of systems including the central nervous system, immune system, digestive system, respiratory system, urinary tract, etc. These effects are dependent on quantity, the type of product in which caffeine is contained, and also on the individual differences among people (sex, age, diet etc.). The main aim of this review was to collect, present, and analyze the available information including the latest discoveries on the impact of caffeine on human health and the functioning of human body systems, taking into account the role of caffeine in individual disease entities. We present both the positive and negative sides of caffeine consumption and the healing properties of this purine alkaloid in diseases such as asthma, Parkinson's disease, and others, not forgetting about the negative effects of excess caffeine (e.g., in people with hypertension, children, adolescents, and the elderly). In summary, we can conclude, however, that caffeine has a multi-directional influence on various organs of the human body, and because of its anti-oxidative properties, it was, and still is, an interesting topic for research studies including those aimed at developing new therapeutic strategies.

Is There a Balance in Oxidative-Antioxidant Status in Blood Serum of Patients with Advanced Endometriosis?

Can redox homeostasis indicators be potential non-invasive markers, crucial in the diagnosis and treatment of endometriosis? We checked if the differences in levels of serum oxidative-antioxidant balance parameters (TAS, FRAP, albumin, total bilirubin, uric acid, iron, SIRT3, SIRT5, SIRT6, telomerase, AOPP) are significant between patients with advanced endometriosis (E), healthy women (control group, C) and non-endometriosis women, but with other gynecological disorders (NE). The FRAP concentrations were significantly higher in E and NE group than in the control group (p = 0.015 and p = 0.017, respectively). The telomerase concentrations were significantly higher in the endometriosis group than in the control group (p = 0.004). Significantly higher concentrations of AOPP were observed in E (p < 0.001) and NE groups (p = 0.028) in comparison to the control subjects. Between stages III and IV of endometriosis, a significant difference existed only in concentration of iron (p = 0.013). There were no significant differences between the studied groups in the values of the remaining parameters. Based on the results of ROC curve analysis, we can conclude that the levels of serum FRAP, telomerase and AOPP may be taken into account as promising diagnostics markers that reflect the degree of oxidative stress accompanying advanced endometriosis.

Diagnostic Significance of Selected Serum Inflammatory Markers in Women with Advanced Endometriosis

Endometriosis is a gynecological disease, the pathogenesis of which seems to be directly associated with inflammatory processes. Serum concentrations of IL-1β, IL-6, hs-CRP, IgG, YKL 40 and PRL, in comparison to the well-known CA 125 levels, were studied with the aim of identifying an additional noninvasive inflammatory marker or set of markers characteristic for endometriosis. The study group included 43 women with endometriosis (E), 35 women with benign gynecological disorders but without endometriosis (NE, non-endometriosis) as a comparative group, and a control group consisting of 18 healthy subjects (C). The serum concentrations of IL-1β, IL-6, hs-CRP, YKL-40, PRL and CA 125 were significantly higher in the E group (median values: 0.41 pg/mL, 2.42 pg/mL, 2.33 mg/L, 79.30 ng/mL, 21.88 ng/mL and 68.00 U/mL, respectively) than in the control group (median values: 0.21 pg/mL, 0.98 pg/mL, 0.52 mg/L, 49.77 ng/mL, 12.08 ng/mL and 12.20 U/mL respectively), with the significance of p = 0.011, p < 0.001, p = 0.028, p = 0.005, p < 0.001 and p < 0.001, respectively. The IgG concentrations were significantly lower in the endometriosis group (median value: 1061.21 mg/dL) as compared to healthy women (median value: 1210.50 mg/dL; p = 0.025). Significant differences in concentrations of IL-6 (p = 0.040), hs-CRP (p = 0.007) and CA 125 (p < 0.001) were observed in stage III vs. stage IV of endometriosis. Significantly higher concentrations of IL-6 (p = 0.010), hs-CRP (p = 0.037) and PRL (p < 0.001) were observed in the NE group vs. the control group. Only CA 125 concentrations were significantly higher in endometriosis patients as compared to the non-endometriosis group (p < 0.001). The proposed panel of inflammatory markers, especially IL-6, PRL and CA 125, may become a useful tool to identify women with advanced endometriosis who could qualify for treatment.

The improvement of cognitive deficits after whole-body cryotherapy - A randomised controlled trial

BACKGROUND

Whole-body cryotherapy (WBC) - a repetitive, short-term exposure to extremely low temperatures - may become an effective early intervention for mild cognitive impairment (MCI). It is a heterogeneous group of symptoms associated with cognitive dysfunction which is estimated to transform into dementia in 50% cases.

STUDY DESIGN

The prospective randomised double-blind sham-controlled study aimed to determine the efficacy of WBC on cognitive functioning and biological mechanisms. The study was registered with Australian New Zealand Clinical Trials Registry (ACTRN12619001627145).

METHODS

Participants with MCI (n = 62; (20<MoCA>26) were randomly allocated to cryogenic temperatures (-110 °C till -160 °C) (EG, n = 33) or placebo-controlled group (CG, n = 29). Cognitive functions were measured at baseline (T1), after the 10th WBC session (T2) and after 2 week-break (T3) with DemTect, SLUMS and Test Your Memory (TYM). Secondary outcome measures included quality of life (WHOQoL-BREF), self-reported well-being (VAS) and depressive symptoms (GDS). Whole blood samples (10 ml) were collected at T1 and T2 to evaluate levels of cytokines, neurotrophins, NO and biochemical parameters CRP total cholesterol, prolactin).

RESULTS

There were significant differences between groups measured at T2 in immediate recall (DemTect) and in orientation (TYM) in favour of WBC group. Improvement in mood was detected in self-reported depressive symptoms level (WHOQoL-26; T2 p = 0.04; VAS mood T2 p = 0.02; T3 p = 0.07). The significant reduction of BDNF level was observed (p < 0.05).

CONCLUSIONS

WBC may increase the performance of cognitive functions. It seems promising to combine WBC with existing behavioural and cognitive trainings in the future studies investigating early interventions methods in MCI.

Sirtuins-The New Important Players in Women's Gynecological Health

The participation of sirtuins in the regulation of oxidative stress and inflammation lies at the basis of their possible modes of action and is related to their expression in various cell structures; their location in the mitochondria and blood plasma has been indicated as of primary importance. Despite many existing studies, research on sirtuins continues to present an opportunity to discover new functions and dependencies, especially when it comes to women's gynecological health. Sirtuins have a significant role in both the formation and the course of many gynecological diseases. Their role is particularly important and well documented in the course of the development of cancer within the female reproductive organs; however, disturbances observed in the ovary and oocyte as well as in follicular fluid are also widely investigated. Additionally, sirtuins take part in some gynecological disturbances as regulative factors in pathways associated with insulin resistance, glucose and lipids metabolism disorders. In this review, we would like to summarize the existing knowledge about sirtuins in the manner outlined above.

The association between serum uric acid and features of metabolic disturbances in young adults

INTRODUCTION

The increase in the number of people affected by different metabolic disturbances, especially among young people, is alarming. It seems worthwhile to reappraise the usefulness of commonly used laboratory parameters potentially associated with metabolic and metabolically obese normal weight syndrome. Serum uric acid may be considered as an indicator and/or a predictor of metabolic disorders. We evaluated serum uric acid concentration in relation to metabolic syndrome, as well as metabolically obese normal weight features, and examined its usefulness in improving metabolic and metabolically obese normal weight syndrome diagnosis in young people.

MATERIAL AND METHODS

In 349 apparently healthy people, aged 18-31, features of metabolic and metabolically obese normal weight syndrome and serum uric acid concentration were examined under fasting conditions.

RESULTS

Prevalence of metabolic syndrome increased in uric acid quartiles, while the percentage of metabolically obese normal weight syndrome was at a similar level in all uric acid quartiles. A relationship between uric acid concentration and features of metabolic disorders in quartile and correlation analysis was revealed. Data mining techniques did not indicate the usefulness of uric acid for distinguishing people with metabolic syndrome from those with metabolically obese normal weight syndrome.

CONCLUSIONS

We confirmed that in young people an increase in uric acid levels is more closely related to metabolic syndrome features than insulin resistance. Serum uric acid concentration could not be recommended as an independent, strong marker of metabolic or metabolically obese normal weight syndrome occurrence in young people, but finding its elevated concentration should be an indicator for screening for other disturbances associated with metabolic syndrome.

Investigation of seminal plasma chitotriosidase-1 and leukocyte elastase as potential markers for 'silent' inflammation of the reproductive tract of the infertile male - a pilot study

Inflammatory mediators - chitotriosidase-1 (CHIT1) and leukocyte elastase (LE) - were analyzed in human seminal plasma in relation to total antioxidative status (TAS) and pro-inflammatory markers IL-1β and IL-6. Samples collected from 34 males who were part of infertile couples were divided into normozoospermic (N; n = 12, without symptoms of inflammation), oligozoospermic (O; n = 11) and teratozoospermic (T; n = 11) groups. significant differences were observed only in CHIT1 concentration between N and O samples. However, a higher mean LE concentration was also observed in O and T patients (3.7-times and 900-times, respectively) compared with the N group. in IL-1β and IL-6 concentrations, an upward trend was observed from N, through O, up to the T group. The positive correlation between the concentration of IL-1β and the activity and specific activity of CHIT11 as well as the moderate negative correlation between concentrations of IL-1β and CHIT1 may suggest that elevated CHIT11 levels appeared in early stages of inflammation before the increase in IL-1β concentrations, or remained stable even after the levels of cytokine decreased. The above seem to confirm the role of CHIT1 in the manifestation of 'silent' inflammation at a very early stage. To conclude, CHIT1 concentration appears to be an interesting biomarker that signals the presence of possible 'silent' inflammation accompanying oligozoospermia. We cannot draw such conclusions regarding LE concentration, because, although we observed differences in the mean values and medians between analyzed groups, they were not significant. The utility of CHIT1 in the follow-up of oligozoospermia-associated 'silent' subclinical inflammation is promising, but further studies on a larger patient test set are required.

Estimation of reference intervals of insulin resistance (HOMA), insulin sensitivity (Matsuda), and insulin secretion sensitivity indices (ISSI-2) in Polish young people

INTRODUCTION

Insulin resistance is becoming an increasingly widespread problem worldwide. For its determination indirect indices of insulin resistance or insulin sensitivity have used. Those indices based on simultaneous measurements of blood glucose and insulin concentrations under fasting conditions or during the Oral Glucose Tolerance Test.

OBJECTIVE

The aim of the study was to estimate reliable reference values for the indices used in insulin resistance diagnosis.

MATERIAL AND METHODS

Materials and method. 191 selected participants, aged 18-31, were enrolled into the reference population. 130 participants from the reference population with fasting glucose ≤5.5 mmol/L, BMI<25 kg/m², and without metabolic syndrome, were finally included in the reference group. The following insulin resistance indices were calculated: HOMA1-IR, HOMA2, HOMA2 from C-peptide, QUICKI, Matsuda Index and Insulin Secretion-Sensitive Index-2. Determination of reference intervals for indirect indices of insulin resistance was conducted in accordance with the C28-A3 procedure recommended by the Clinical & Laboratory Standards Institute (CLSI).

RESULTS

Results. The reference intervals for indirect insulin resistance indices examined according to CLSI protocol were: ≤4.00, ≤2.27, ≤4.10, ≥0.31 for HOMA1-IR, HOMA2, HOMA2 C-pep., and QUICKI, respectively. For insulin sensitivity, the value of the Matsuda Index was established as ≥3.19 and for beta cell pancreatic function ISSI-2 as ≥206.

CONCLUSIONS

Conclusions. Establishing a reference intervals for these indices enable the proper identification and differentiation of the types of insulin resistance in particular populations. The early detection of metabolic disorders allows for introduction of effective preventive action.

The Influence of Serum Sample Storage Conditions on Selected Laboratory Parameters Related to Oxidative Stress: A Preliminary Study

The present work aims at accessing the stability of biological material stored for diagnostic and scientific purposes. The influence of the temperature, storage time, and cyclic thawing on concentration stability of selected oxidative stress parameters in human serum was investigated. The study group consisted of 20 serum samples collected from healthy volunteers aged 18–52. The parameters whose reference ranges were not determined and to which validated determination methods did not correspond were examined by manual methods (FRAP and AOPP). Automatic methods were used to determine routine laboratory tests (albumin, total protein, bilirubin, uric acid) using the Konelab 20i^® analyzer. The samples were stored at various temperatures (room temperature, 4 °C, −20 °C, −80 °C) for max 6 months and were subjected to cyclic thawing at 1 month intervals. In order to check whether any differences between the concentrations of the studied parameters existed when the samples were stored in various conditions, the paired Student t-test or Wilcoxon test and comparison to desirable bias were applied. Based on the obtained results, it was found that the temperature and time of serum sample storage significantly affected the stability of the analyzed parameters and determined different shelf lives of serum samples for oxidative stress examination. Therefore, continuing the investigation concerning the impact of storage conditions on various serum parameters seems justified due to the discrepancy between the individual results obtained by different researchers and the inconsistencies between the results of scientific research and the applicable recommendations.

Whole-body cryotherapy - promising add-on treatment of depressive disorders

OBJECTIVES

New, effective biological interventions for treatment of depressive episodes and recurrent depression are still needed. Whole-body cryotherapy (WBC), which is a treatment using cryogenic temperature, is a novel therapeutic modality in neurology and rheumatology. The objective of this study was to determine the efficacy and safety of WBC as an add-on treatment for depressive episode.

METHODS

30 adults diagnosed with depressive episode were recruited to an observational, prospective study. 21 participants (17 women, 81%), mean age 46.1 (±16.7), completed the whole study procedure. The Hamilton Depression Rating Scale and the Beck Depression Inventory were used to assess the severity of depressive symptoms. Additionally, quality of life and anhedonia were assessed with the WHOQoL-BREF and the SHAPS. Participants undertook 10, 2-minute (from - 110 C to - 135 degrees C) WBC sessions within two weeks.

RESULTS

Patients after WBC sessions showed significant improvement in the form of a reduction in total scores in scales assessing depressive symptoms: the HDRS (p< 0.00001) between T1 (16.94±4.3) and T4 (4.50±4.2) and the BDI-II (T1: 13.48±4.6; T4: 6.14±6.7, p<0.03), lower anhedonialevelon SHAPS (p =0.011) and higher quality of lifein thefollowing domains: physical health (p =0.024), psychological health (p =0.016) and environmental domain (p =0.003). Pre/post comparison of self-report well-being measured by the VAS scale showed a significant increase (p< 0.00001). It was shown that WBC have no effect on the level of cytokines, NO, hsCRP, ESR and TAS in blood (p> 0.05).

CONCLUSIONS

WBC proved to be an effective, safe, and tolerable add-on intervention in patients with depressive episode. Further randomized controlled trials should be conducted.

Indirect insulin resistance detection: Current clinical trends and laboratory limitations

There is a steady increase in the number of overweight and obese people worldwide and increasingly, younger people. Excess adipose tissue impairs the action of insulin, leading to insulin resistance (IR). Tissue IR is a major factor in relation to cardiovascular disease, metabolic syndrome and diabetes. Thus, it is important to recognize at the pre-disease stage with the possibility of therapeutic intervention. IR is assessed using indicators of epidemiological significance, most often calculated from fasting and postprandial glucose and insulin values, so-called indirect indicators of insulin resistance. The most commonly used parameter is the Homeostatic Model Assessment (HOMA). Although the Quantitative Insulin Sensitivity Check Index (QUICKI), Matsuda Index and the Insulin Secretion-Sensitivity Index-2 (ISSI-2) are also used, the values of these indices established for IR vary for different age, sex, populations and ethnic groups. Thus, appropriate reference values of indirect indices should be determined for such groups, and when this is precluded, data from published studies carried out on the most ethnically, socio-economically and age-matched populations should be applied.

The assessment of the integrated antioxidant system of the body and the phenomenon of spa reaction in the course of radon therapy: A pilot study

BACKGROUND

Spa reaction is an adaptive response of an organism, emerging as a result of external factors. It is a positive element of spa therapy leading to metabolic changes, which are important for the body. The effect of these changes is an increase in immune activity and regenerative reactions of the body. The mechanism of the response is not fully known.

OBJECTIVES

The aim of the study was to evaluate the changes observed in the field of the integrated antioxidant system of the body in the course of radon therapy, especially in reference to spa reaction.

MATERIAL AND METHODS

The study was conducted in the health resort in Świeradów-Zdrój. The observation regarded patients undergoing treatment with radon water. Before the treatment, after 5 and 18 days of treatment, the total antioxidant status (TAS) was evaluated with the use of a standard colorimetric assay. The study group consisted of 35 patients with degenerative joints and disc disease. The control group consisted of 15 people selected from the employees of the spa, also suffering from osteoarthritis, who did not undergo radon therapy (without contact with radon).

RESULTS

On the 5th day of the treatment, in both groups, the TAS increase was observed with significantly worse results in the control group. After the treatment, in the study group, there was observed an increase in TAS, whereas in the control group, a significant decrease in the TAS concentration was noted.

CONCLUSIONS

A beneficial effect of radon treatments on the growth of TAS in the body of the patients treated in the spa was demonstrated. The increase in the TAS concentration on the 5th day of treatment may indicate the relationship between these changes and the phenomenon of spa response. The changes are a result of low doses of ionizing radiation originating from radon dissolved in medicinal water, used in the course of the therapy.

Estimation of metabolic factors related to insulin resistance and metabolic syndrome in young people

Civilizational developments occurring during recent decades have resulted in an increased incidence of a variety of metabolic disorders related to insulin resistance in younger people. The determination of decision limits for insulin resistance indices, especially among young people, is a significant challenge in clinical practice. The aim of this study was the estimation of metabolic factors related to their relationship to insulin resistance and metabolic syndrome (MS) features in young, apparently healthy people. Moreover, we evaluated the optimal decision limits for patients with MS identification for HOMA1-IR, HOMA2-IR, HOMA2 obtained from C-peptide concentrations. 349 apparently healthy people aged 18-31 (260 women and 89 men), were enrolled in this study. The present analysis of metabolic, anthropometric and clinical parameters observed them in clusters covering the criteria of MS recognition, but MS in this group was only partially related to insulin resistance. The HOMA1-IR decision limit estimation is likely to became be useful in the prognostication of metabolic disturbances in young, apparently healthy people. A measure of insulin resistance that can provide a reliable early prediction of MS is likely to provide an opportunity for instigating preventive measures of significant clinical utility.

The Assessment of the Integrated Antioxidant System of the Body in the Course of Radon Therapy: A Pilot Study

INTRODUCTION

The sources of Reactive Oxidative Species (ROS) in the organism are the respiratory processes occurring in cells catalyzed by different enzymes. Operation of ROS is balanced by antioxidants, the compounds; although present in low concentrations, they significantly inhibit the degree of oxidation of particular molecules.

THE AIM OF THE STUDY

The aim of this study was to assess the changes in the integrated antioxidant system under the influence of radon therapy in osteoarthritis patients.

MATERIAL AND METHODS

Observation included 35 patients suffering from degenerative joints and disc disease (mean age 56.5 years) undergoing radon water therapy and control group that consisted of 15 osteoarthritis patients (mean age 54.2) without contact with radon water. Before therapy and after 18 days of treatment, serum total antioxidant status (TAS) was assessed with the use of standard colorimetric assay.

RESULTS

In the study group, we observed trends to increase TAS concentration, whereas, in the control group, TAS concentration was decreasing.

CONCLUSIONS

(1) Radon waters treatment influenced the level of TAS of osteoarthritis patients treated with the radon water. (2) The change in TAS concentrations in the study group may be the result of low doses of ionizing radiation, but further studies on larger patient's groups are demanded. This study is registered with number NCT03274128.

Analysis of molecular heterogeneity of PRL is important in patients with hyperprolactinemia

Assessment of prolactin level in a medical laboratory is most frequently related to verifying the cause of the problems with fertility. However, hyperprolactinaemia diagnosis by laboratory test often does not reflect the clinical condition of a patient. Patients with hyperprolactinemia, but without characteristic symptoms related to this disorder, undergo further biochemical and/or image diagnosis, which could be harmful to the human organism. In some cases, pharmacological treatment and even surgical intervention are applied, although the cause of elevated prolactin levels has not been identified. Prolactin is present in blood in different forms and/or complexes. Most frequently, three basic isoforms of this hormone are distinguished: monomeric prolactin, big-prolactin, and big-big-prolactin, called a macroprolactin. The listed forms of prolactin have different biological activity, but in laboratory tests, all of them show immunoreactiveness. For that reason, prolactin is a large problem for laboratory diagnosticians and clinicians. The analysis of the presence of macroprolactin in blood samples with elevated prolactin level is not a routine matter, even though it has a key meaning in the further diagnostic process of hyperprolactinemia. A gold standard identifying all forms of prolactin is gel filtration chromatography, which gives qualitative and also quantitative results. Unfortunately, the equipment used for this method is not commonly available in medical laboratory. Results of many studies showed that the precipitation of macroprolactin with polyethylene glycol could be the screening method for evaluating the macroprolactinaemia prevalence. This procedure is simple and relatively low-cost, and though it has some analytical restrictions, its results correlate well with the results of the gel filtration chromatography. Macroprolactinaemia is present in a small percentage of the total population; however, it can occured in 53% patients with hyperprolactinaemia.

Assessment of HOMA1-IR, Matsuda and ISSI-2 indices in relation to the metabolic syndrome features and oral glucose tolerance test in young people

<I>Background:</I> Insulin resistance and reduced ability of pancreatic beta cells to secrete insulin preside carbohydrate disorders development and this condition is one of the stages in the type 2 diabetes development. Indirect indices of insulin resistance, sensitivity and pancreatic beta cells function, are used in clinical practice. They are calculated based on glucose and insulin concentration under fasting and postprandial condition. <I>Aim:</I> The aim of this study was to examine relationship between HOMA1-IR, Matsuda Index, and ISSI-2 with metabolic syndrome (MS) features and shape of glycemic curve in young, potentially healthy people. <i>Material and method:</i> The study group consisted of 152 volunteers (108 women, 44 men) aged 19-28. Participants underwent the questionnaire, anthropometric and arterial blood pressure examination. In blood samples under fasting condition lipid profiles, glucose, and insulin were measured. Glucose and insulin were measured also in 60 and 120 minutes of Oral Glucose Tolerance Test (OGTT). Based on the results, MS features were identified and HOMA1-IR, Matsuda Index and ISSI-2 values were calculated. <I>Results:</I> The value of HOMA1-IR was significant higher in patients with metabolic syndrome while lower values of Matsuda and ISSI-2 were observed in participants with the MS as well as with glucose concentration in 120-minute of OGTT higher than under fasting condition. <i> Conclusions:</i> MS is associated with an increase in hepatic insulin resistance. Both MS and retardation of glucose returning to fasting values during OGTT are related to peripheral insulin resistance and reduction of pancreatic beta cell ability to insulin secretion.

[Metabolic syndrome - a new look at a known problem]

Civilization changes over the past decades have been associated with an increase in the incidence of various metabolic disorders, especially in the carbohydrate-lipid metabolism, which are not always associated with obesity. Metabolic syndrome, despite changing criteria of recognition, is a clinically established risk factor for civilization diseases development. On the other side, the incidence of complex metabolic disorders in non-obese people is increasing, which is referred to in the literature as metabolic obesity with normal body mass. Both, excess visceral fatty tissue and insulin resistance are common components in the diagnosis of these syndromes and their occurrence is associated with an increased risk of developing type 2 diabetes and cardiovascular disease. Some researchers also point out the possibility of occurrence of so-called metabolically healthy obesity. Identify people with such a constellation of disorders is still difficult in clinical practice because of different and changing diagnostic criteria. Data from the literature about epidemiology of these disorders are inconclusive and do not allow for a reliable assessment of such disorders prevalence in population. The increasing rate of the metabolic syndrome and metabolic obesity with normal body weight occurrence in the general population pays attention to the importance of this problem, especially in primary health care. Preventive programs are primarily aimed at older people with high risk of cardiovascular diseases development and focused on detecting metabolic syndrome traits. Nevertheless, very often, young, potentially healthy individuals, are not subject to screening programs, even though incidence of metabolic obesity with normal body weight in this population is very high nowadays.

[Associations between basic indicators of inflammation and metabolic disturbances]

BACKGROUND

Inflammation is involved in initiation and progression of diabetic complications related to cell damage of tissues, especially endothelial cells, and deepening of metabolic disturbances. This study was conducted in order to assess potential associations between basic laboratory parameters of inflammation and common metabolic factors such as glycated hemoglobin and C-reactive protein.

MATERIALS AND METHODS

The studied group consisted of 95 patients with diabetes mellitus type 2 and 77 subjects without signs of disturbances in glucose metabolism, aged between 40 and 74 years. Fasting plasma glucose, glycated hemoglobin, complete blood count and high-sensitivity C-reactive protein concentration in blood were determined. Also blood pressure as well as weight and height measurements were taken to calculate BMI.

RESULTS

Fasting plasma glucose and glycated hemoglobin concentrations, total leukocyte count and granulocytes were significantly higher in diabetics. Significant correlations between both glycated hemoglobin and BMI and C-reactive protein concentration were noted. However, after adjusting for age and gender, leucocyte count was independently related to BMI and glycated hemoglobin, while C-reactive protein concentration was dependent on gender and BMI.

CONCLUSION

Glycated hemoglobin as a marker of long-term glycemic control and BMI as an indicator of adipose tissue accumulation are significantly related to white blood cell count and C-reactive protein concentration, even when values of these parameters are in the normal range. This is consistent with the hypothesis that chronic activation of the immune system plays a role in the pathogenesis and progression of type 2 diabetes.

[Incidence of complex metabolic disorders among young people--preliminary report]

The incidence of metabolic disorders and predispositions to development of civilization diseases in general population is well known, but there is a little data about presence of these disorders among young, potentially healthy people.

THE AIM OF STUDY

To conduct an assessment of incidence metabolically disorders among young people.

MATERIALS AND METHODS

In examination 45 young volunteers, students of Wroclaw Medical University were included. At the beginning, each participant filled the questionnaire, then anthropometric measurements were made, and carbohydrate and lipid related laboratory parameters were determined in fasting serum or plasma.

RESULTS

According to Polish Diagnostics Laboratory Association (PTDL), Polish Cardiology Association (PTK), Polish Diabetes Association (PTD), International Diabetes Federation (IDF) recommendations and data from publications, we have shown that the most participants (90%) had appropriate body mass (BMI<25 kg/m2), but more than one fourth of them characterized overly large waist circumference. The rarest observed disorder was the increased blood pressure and too low HDL cholesterol concentration (depending on the applied criteria), whereas insulin resistance was identified the most frequent. Occurrence of at least one of "classic" metabolic disorders was indicated in more than half of participants, whereas coexistence three or more these disorders in the same person was observed in 7% of volunteers. Metabolic syndrome was identified with the same frequency, while one fourth of participants showed features which enabled to diagnose MONW (metabolically obese normal weight).

CONCLUSIONS

The complex metabolic disturbances were observed at very large percent of young, potentially health and not family burdened people. We concluded that it is necessary to undertake various actions, like screening examinations, including insulin resistance parameters, in purpose to early identification of these metabolic disturbances, especially towards diagnosis of MONW syndrome.

[Prolactin as an immunomodulatory factor in psoriatic arthritis]

Prolactin (PRL) is a hormone synthesized and secreted by lactotroph cells in the anterior pituitary gland. There is also extrapituitary hormone secretion by many cells, including cells of the immune system. In physiological conditions PRL is responsible for lactogenesis and other processes associated with it. PRL plays a significant role during the immune response as a cytokine, affecting proliferation and differentiation of many immune system cells. The biological effect of the hormone depends on binding with the specific prolactin receptor PRL-R, and activation of the transcription factors of targeted genes. For T lymphocyte stimulated PRL, that factor is mainly the interferon regulatory factor (IRF-1), which gives the possibility of adjusting the prolactin immune response. Literature data indicate that hyperprolactinemia (HPRL) is one of the important factors in the pathogenesis and course of autoimmune diseases such as systemic lupus erythematosus, rheumatoid arthritis, systemic sclerosis and Sjogren's syndrome. HPRL is diagnosed in nearly one-third of these patients. However, only a few data indicate the role of prolactin in psoriatic arthritis (PsA), whose etiology and disease progression are not fully elucidated, and the diagnosis is very difficult. Currently there is indicated a pronounced connection between the course of HPRL and activity of PsA. It seems also to be interesting that, regardless of the PRL levels in serum of patients with PsA, administration of bromocriptine--drug-lowering hormone--improves joint and skin symptoms, which indicates a decrease in disease activity, and is a promising way of alternative therapy for psoriatic arthritis. However, the effect of PRL on the pathogenesis and the severity of psoriatic arthritis has not yet been fully understood and further research will provide a possibility to assess the prognostic and diagnostic significance of prolactin in patients with PsA.