Sclerostin is an inhibitor of the wingless-type mouse mammary tumor virus integration site family/β-catenin signalling pathway (WβcSP), which plays an important role in bone metabolism and in ...vascular biology. It could act protective regarding atherosclerosis development through its effect on WβcSP in vascular cells. Nevertheless, results of studies analyzing association between circulating sclerostin level (CSL) and atherosclerotic diseases (AD) are showing conflicting results. The aim of this study is to test the value of CSL as a biomarker of subclinical carotid atherosclerosis (SCA) in obese persons.
The cross-sectional study included 50 obese persons without previous history of diabetes and AD. Participants underwent adequate anthropometrical, ultrasound and laboratory examinations, including 2h 75 g oral glucose tolerance test (OGTT).
Only the presence of SCA significantly indirectly correlated with CSL (p<0.05). Based on the median value of CSL, we formed two groups: low CSL (CSL<7.9 pmol/l) and high CSL (CSL>7.9 pmol/l). There were no statistically significant differences in general (gender, age and current smoking) and anthropometrical characteristics (body mass index, waist circumference, systolic and diastolic blood pressure), inflammatory (total white blood cell count, erythrocyte sedimentation rate, fibrinogen, C-reactive protein and uric acid), glucose metabolism (fasting and 2h OGTT blood glucose, glycated hemoglobin and presence of dysglycemia) and lipid metabolism (low density lipoprotein cholesterol, high density lipoprotein cholesterol, triglycerides, apolipoprotein A-I, apolipoprotein B and lipoprotein (a)) parameters between low and high CSL groups. Low CSL group had significantly higher incidence of SCA (p<0.05).
CSL could serve as a useful biomarker of early atherosclerosis in obese persons without previous history of cardiometabolic disorders but the final conclusion requires further testing.
Background/Aim. Phthalates are recognized as endocrine-disrupting compounds and are extensively present in a variety of everyday products. Chronic exposure to phthalates is suspected to be associated ...with a range of health disorders. The aim of the study was to examine the abundance of phthalate metabolites in the urine samples among adults in the Autonomous Province of Vojvodina, Serbia, and to determine the prevalence of phthalate metabolites in healthy individuals and those with metabolic disorders such as obesity and newly diagnosed type 2 diabetes mellitus (T2DM). Methods. For the study purpose, the first morning urine sample of 308 participants was screened for the presence of 10 phthalate metabolites: mono-ethyl phthalate (MEP), mono-(2-ethylhexyl) phthalate (MEHP), mono-n-butyl phthalate (MBP), mono-iso-allyl phthalate (MiAP), mono-n-allyl phthalate (MnAP), mono-cyclohexyl phthalate (MCHP), mono-benzyl phthalate (MBzP), mono-n-octyl phthalate (MOP), mono-n-propyl phthalate (MPP) and mono-methyl phthalate (MMP). Results. At least one phthalate metabolite was detected in the first morning urine sample in 50.32% of the examined population. The most frequently detected phthalate metabolites were MEP and MEHP. Out of all phthalate-positive participants, 38.3% of them had one, 10.7% had two, while 1.3% of participants had three phthalate metabolites in the first morning urine sample. A significant difference (p < 0.05) between groups was observed on MEP and MMP frequency, while border-line significant difference (p < 0.1) between groups was observed on MEHP and MCHP frequency. Conclusion. In the Vojvodina region, both healthy adults and those with metabolic disorders such as obesity and newly diagnosed T2DM are predominantly exposed to di-ethyl phthalate and di-(2-ethylhexyl)phthalate since MEP and MEHP were the most frequently detected phthalate metabolites. Further re-search is required in order to provide more details of the phthalates influence on the adverse health effects.
In the study, 305 patients of both genders were enrolled and divided into three groups: obese (BMI > 30 kg/m
2
), patients who were diagnosed type 2 diabetes mellitus (T2DM), and control, normal ...weight healthy volunteers. At least one of ten different phthalate metabolites was determined in the urine samples of 49.84% all enrolled participants. In the obese subgroup, the sum of all urinary phthalate metabolites was positively associated with TG levels (
p
= 0.031) together with derived TC/HDL and TG/HDL ratios (
p
= 0.023 and 0.015), respectively. Urinary MEP concentration was positively correlated with the HOMA-IR in T2DM subgroup (
p
= 0.016) while in the control subgroup, log
10
MEP levels were negatively correlated with total cholesterol (
p
= 0.0051), and LDL serum levels (
p
= 0.0015), respectively. Also, in the control subgroup, positive linear correlations between urinary log
10
MEP levels and TyG and TYG-BMI values (
p
= 0.028 and
p
= 0.027), respectively, were determined. Urinary MEHP levels were associated with glucose serum levels (
p
= 0.02) in T2DM subgroup, while in the control HDL values were negatively associated with log
10
MEHP (
p
= 0.0035). Healthy volunteers exposed to phthalates had elevated AST levels in comparison to non-exposed ones (
p
= 0.023). In control subgroup, ALT and AST values were increased (
p
= 0.02 and
p
= 0.01, respectively) in MEP exposed while GGT levels were enhanced (
p
= 0.017) in MEHP exposed in comparison with non-exposed. Combined phthalates influence on glucose and lipid metabolism may increase the possibility for NAFLD and insulin resistance development among exposed individuals.
Current data show that 1h oral glucose tolerance test (OGTT) blood glucose (1h-BG) might identify persons at increased risk of developing type 2 diabetes and cardiovascular diseases more precisely ...than fasting blood glucose (FBG) and 2h OGTT blood glucose (2h-BG). The aim of study was to determine whether is justified to use 1h-BG over traditional blood glucose measurements, in cardiometabolic profiling of obese individuals.
Cross-sectional study enrolled 60 obese individuals without previous history of diabetes and other cardiometabolic disorders. Anthropometrical, ultrasound and laboratory examinations were conducted.
All three parameters significantly directly correlated with age, body mass index, waist circumference, erythrocyte sedimentation rate, C-reactive protein, triglycerides and glycated hemoglobin. FBG and 1h-BG significantly directly correlated with alanine transaminase, gammaglutamyltransferase and total cholesterol. FBG significantly directly correlated with fibrinogen and aspartate transaminase, 1h-BG with systolic blood pressure and 2h-BG with diastolic blood pressure. None of parameters significantly correlated with gender, total white blood cell count, uric acid, 25-hydroxyvitamin D, high density lipoprotein cholesterol, low density lipoprotein cholesterol, serum adiponectin and albuminuria. Differences in correlation coefficients were not statistically significant. Individuals with 1h-BG >8.6 mmol/l had much more proatherogenic cardiometabolic profile, as well as higher incidence of dysglycemia, metabolic syndrome (MetS) and non-alcoholic fatty liver disease (NAFLD) than ones with 1h-BG <8.6 mmol/l, but all differences were driven by the average value of glycemia. There were no statistically significant differences in ability of predicting MetS, NAFLD and pathologically increased carotid artery intima media thickness among analyzed glucose metabolism parameters.
1h-BG is not superior to FBG and 2h-BG in the identification of proatherogenic cardiometabolic profile in obesity.
Obesity is often associated with insulin resistance (IR). We considered different IR indexes: the Homeostasis Model Assessment-Insulin Resistance (HOMA-IR) index, the two specimen (0 and 120 min) ...oral glucose tolerance test Matsuda Index (MI) and the Homeostasis Model Assessment-Adiponectin (HOMA-AD) index. These IR indexes were compared with indicators of the cardiometabolic profile.
This cross-sectional study enrolled 60 obese individuals without previous history of diabetes. Anthropometrical, ultrasound and laboratory examinations were conducted.
All 3 indexes significantly correlated with indicators of central obesity, systolic and diastolic blood pressure, inflammation parameters, liver enzymes, HbA1c and some lipid parameters. The majority of correlation coefficients were the highest for HOMA-AD, but only the difference in correlation with waist circumference comparing with MI was statistically significant. HOMA-IR directly, and MI indirectly, significantly correlated with age, while HOMA-AD significantly directly correlated with the mean carotid artery intima media thickness (CAIMT). MI showed the best performances in predicting non-alcoholic fatty liver disease and pathologically increased CAIMT; HOMA-AD was the best in predicting metabolic syndrome, while HOMA-IR demonstrated the poorest performances in the prediction of all 3 conditions. There were no statistically significant differences in predicting performances of the analysed indexes.
The HOMA-AD and MI are not superior compared with the HOMA-IR, in the identification of obese individuals with a proatherogenic cardiometabolic profile.
Bisphenol A (BPA) is a ubiquitous environmental pollutant which is often associated with various health issues. In this study 103 healthy female volunteers in reproductive age from Serbian north ...province Vojvodina were enrolled and examined for the BPA exposure in the urine samples after 12 h of fasting. BPA was found in 35.92 % (37/103) of subjects. Statistically significant increment in waist circumference (p = 0.045) and waist-to-height ratio (p = 0.037) was observed among the BPA positive women in comparison with the women who had the same energetic balance and had not been exposed to BPA. Linear correlation was obtained between the BPA concentration in urine samples and body mass index (r
2
= 0.35, p = 0.003) waist circumference (r
2
= 0.21, p = 0.02) and waist-to-height ratio (r
2
= 0.25, p = 0.01) among the obese. High energetic intake and reduced physical activity additionally pronounced BPA positive association with obesity. No statistically significant difference was observed in triglycerides, HDL and LDL cholesterol levels between the BPA exposed and BPA non-exposed female volunteers.
Introduction. Purple urine bag syndrome is a condition where the urinary catheter bag turns purple as a result of the interaction between bacteria, urine and components of the urine bag. It appears ...in a certain group of patients with the following risk factors: urinary tract infection, older age, long-term indwelling urinary catheter, constipation, chronic kidney disease. Case Report. Two patients with purple urine bag syndrome are presented. The first patient, a 66-year-old man, was hospitalized due to decompensation of alcoholic liver cirrhosis. A urinary catheter was placed on admission, and on the fourteenth day of hospitalization, a purple discoloration of the urine in the urinary bag was noticed. Multidrug-resistant Proteus mirabilis and Enterococcus faecalis were isolated by microbiological analysis of urine. The second patient was a 92-year-old man, hospitalized for acute gastrointestinal bleeding in the form of hematochezia, with an indwelling urinary catheter and a history of a prostate cancer surgery. On the third hospital day, a purple content in the urinary catheter bag was detected and Klebsiella pneumoniae and Morganella morganii were confirmed by bacteriological analysis. Both patients were without clinical and laboratory signs of acute infection. In both cases, the urinary catheter was replaced and ceftriaxone was administered empirically. Conclusion. Current guidelines for purple urine bag syndrome recommend catheter replacement and empiric antibiotic therapy. In clinical practice, it is necessary to emphasize that urine sampling for bacteriological analysis is performed only after replacing the catheter, in order to establish the exact etiology of the syndrome and radical use of antibiotics. Key words: Urinary Tract Infections; Urine; Urinary Catheters; Bacteria; Biofilms; Risk Factors Uvod. Sindrom ljubicaste kese za urin predstavlja pojavu urina ljubicaste boje u vreci urinarnog katetera kao posledica interakcije bakterija, urina i gradivnih elemenata kese za urin i vezuje se za odredenu grupaciju pacijenata sa faktorima rizika za ovo stanje--urinarna infekcija, starije zivotno doba, dugo plasiran kateter u mo-kracnom sistemu, opstipacija, hronicna bubrezna insuficijencija. Prikaz slucaja. Prikazana su dva bolesnika sa sindromom ljubicaste kese za urin. Prvi bolesnik, muskarac star 66 godina, hospitali-zovan je zbog dekompenzacije alkoholne ciroze jetre. Na prijemu je plasiran urinarni kateter, a cetrnaestog dana hospitalizacije prime-cena je ljubicasta prebojenost urina u kesi za urin. Mikrobioloskom analizom urina izolovani su multirezistentan Proteus mirabilis i Enterococcus faecalis. Drugi bolesnik je muskarac starosti 92 godine, hospitalizovan zbog akutnog gastrointestinalnog krvarenja u vidu hematohezije, sa prisutnim stalnim urinarnim kateterom i istorijom operacije karcinoma prostate. Treceg hospitalnog dana zbog ljubicastog sadrzaja u kesi urinarnog katetera uradena je bakterio-loska obrada i verifikovane su Klebsiella pneumoniae i Morganella morganii. Oba bolesnika su bila bez klinickih i laboratorijskih znakova akutne infekcije. U oba slucaja zamenjen je urinarni kateter i sprovedena je empirijska terapija ceftriaksonom. Zakljucak. Aktuelne smernice kao terapiju za ovo stanje navode zamenu katetera i empirijsku antibiotsku terapiju. U klinickoj praksi neophodno je naglasiti da se tek nakon zamene katetera vrsi uzorkovanje urina za bakteriolosku analizu, sa ciljem postavljanja tacne etiologije sindroma ljubicaste kese za urin i radikalne upotrebe antibiotika. Kljucne reci: infekcije urinarnog trakta; urin; urinarni kateteri; bakterije; biofilm; faktori rizika
Introduction. Purple urine bag syndrome is a condition where the urinary
catheter bag turns purple as a result of the interaction between bacteria,
urine and components of the urine bag. It appears ...in a certain group of
patients with the following risk factors: urinary tract infection, older
age, long-term indwelling urinary catheter, constipation, chronic kidney
disease. Case Report. Two patients with purple urine bag syndrome are
presented. The first patient, a 66-year-old man, was hospitalized due to
decompensation of alcoholic liver cirrhosis. A urinary catheter was placed
on admission, and on the fourteenth day of hospitalization, a purple
discoloration of the urine in the urinary bag was noticed.
Multidrug-resistant Proteus mirabilis and Enterococcus faecalis were
isolated by microbiological analysis of urine. The second patient was a
92-year-old man, hospitalized for acute gastrointestinal bleeding in the
form of hematochezia, with an indwelling urinary catheter and a history of a
prostate cancer surgery. On the third hospital day, a purple content in the
urinary catheter bag was detected and Klebsiella pneumoniae and Morganella
morganii were confirmed by bacteriological analysis. Both patients were
without clinical and laboratory signs of acute infection. In both cases, the
urinary catheter was replaced and ceftriaxone was administered empirically.
Conclusion. Current guidelines for purple urine bag syndrome recommend
catheter replacement and empiric antibiotic therapy. In clinical practice,
it is necessary to emphasize that urine sampling for bacteriological
analysis is performed only after replacing the catheter, in order to
establish the exact etiology of the syndrome and radical use of antibiotics.
The aim is to present unusual clinical course and magnetic resonance imaging
(MRI) features of pituitary abscess. A 59-year-old man presented with fever, polyuria, polydipsia and
marked weight loss ...within the last two months. Basic endocrinology tests revealed the presence of
anterior pituitary dysfunction, associated with central diabetes insipidus and increased levels of inflammatory
markers. The presence of expansile sellar lesion, showing restricted diffusion signal pattern
compatible with acute pituitary pyogenic abscess was found on MRI. Regression of pituitary abscess
was obvious during the next few weeks of parenteral antibiotic treatment. Adequate substitution treatment
with L thyroxine, hydrocortisone, testosterone and desmopressin was achieved. Seventeen
months later, clinical deterioration associated with recurrent pituitary abscess was confirmed on MRI.
Abscess regression was obvious again after conservative treatment. However, control MRI study performed
three years after initial scanning revealed the presence of pituitary tumor, most consistent with
macroadenoma. Surgical intervention was ordered. Histologic evaluation indicated the presence of
fibrotic changes, associated with granulation tissue and rare cellular elements, compatible with chronic
inflammation. To the best of our knowledge, there are no studies in the literature describing such a
pattern of chronic evolution of pyogenic pituitary abscess with consequent chronic inflammatory
changes with granulation tissue proliferation, mimicking macroadenoma.
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