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Comparative Study 2010; 31(5): 631-634 PubMed PMID: 21173745 Citation  Keywords:  Adult, Body Mass Index, Case-Control Studies, Cataplexy:diagnosis, Comorbidity, Czech Republic:epidemiology, Female, Humans, Male, Medical Records, Middle Aged, Narcolepsy:diagnosis, Obesity:diagnosis, Polysomnography, Sleep, Wakefulness,.   

BACKGROUND: Narcolepsy with cataplexy (NC) differs from narcolepsy without cataplexy (NwoC) in the cerebrospinal fluid levels of hypocretin. Since hypocretin is known to regulate not only wakefulness but also eating behaviour, we decided to compare the two entities for body mass index (BMI) and the presence of obesity.

METHODS: Clinical data on patients with NC and NwoC was studied and examined, including nocturnal polysomnography and the Multiple Sleep Latency Test (MSLT). The results were rated against a group of age- and sex-matched healthy controls.

RESULTS: The BMI in NC (29.1±SD=5.8) was significantly higher than in NwoC (25.4±4.4) or in the controls (25.8±3.9) (p<0.001, F=17.4, df= 323), while no difference in BMI was found between NwoC and the controls. The proportion of patients with BMI >30 was significantly greater in NC (39.0%) than in NwoC (13.8%) or than in the control group (13.0%). A negative correlation of BMI and sleep latency in MSLT (p=0.009) was found in the combined NC and NwoC groups.

CONCLUSION: Unlike NC, NwoC has neither a higher BMI nor a higher incidence of obesity than the general population....

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Comparative Study 2010; 31(5): 700-707 PubMed PMID: 21173742 Citation  Keywords:  Adult, Body Mass Index, Dwarfism, Pituitary:diagnosis, Exercise, Female, Health Status, Human Growth Hormone:deficiency, Humans, Male, Obesity:diagnosis, Quality of Life, Surveys and Questionnaires,.   

OBJECTIVES: A great similarity exists between growth hormone (GH) deficiency and obesity in terms of disturbances of organ morphology and function. The aim of the study was to compare health-related quality of life (HR-QoL) as well as exercise capacity and its subjective assessment in adult patients with GH deficiency and in adult patients with obesity.

METHODS: Ten (10) GH-deficient, thirty (30) obese, and thirty (30) healthy subjects participated in the study. HR-QoL comprised two parameters: QoL measured by using the Quality of Life Assessment of Growth Hormone Deficiency in Adults (QoL-AGHDA) questionnaire, and subjective evaluation of general health state by using the Visual Analogue Scale. The exercise capacity was determined in Six Minute Walking Test and it was subjectively assessed by Borg Scale for Rating Perceived Exertion and the modified Medical Research Council scale.

RESULTS: Decreased HR-QoL (both parameters) was observed in both GH-deficient and obese patients, with that effect being much more pronounced in the former group. Both, GH-deficient and obese patients, revealed decreased exercise capacity, which was also subjectively assessed as decreased, especially by GH-deficient patients. Positive relationships between HR-QoL and exercise capacity or its subjective assessment, observed in healthy subjects, partially lost their significance in obese, whereas they completely disappeared in GH-deficient subjects.

CONCLUSION: A decrease in HR-QoL is more pronounced in GH-deficient than in obese patients, whereas exercise capacity is unfavourably affected by both disorder to a similar extent, with the lack of clear relationship between these two parameters especially in GH-deficient patients....

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Comparative Study 2010; 31(5): 673-678 PubMed PMID: 21173741 Citation  Keywords:  Aged, Biomarkers:blood, Body Mass Index, Cholesterol, HDL:blood, Cholesterol, LDL:blood, Comorbidity, Diabetes Mellitus:blood, Female, Humans, Male, Middle Aged, Obesity:blood, Poland:epidemiology, Regression Analysis, Resistin:blood, Triglycerides:blood,.   

OBJECTIVES: Plasma cholesterol, triglycerides and serum resisistin may all be influenced by diabetes and obesity, but their associations remain unclear. Therefore, we put forward a hypothesis that serum lipids might be parallel to resistin, as they all reflect the metabolic status of obese humans.

DESIGN AND SETTING: We measured the concentrations of resistin, total cholesterol (TC), HDL-cholesterol (HDL-C), LDL-cholesterol (LDL-C) and triglycerides (TG) in 134 obese non-diabetic (73 women and 61 men) and 65 obese diabetic (33 women, 32 men) humans, and examined their interrelations. Obesity was defined according to the WHO criterion (BMI, ≥ 30 kg/m²) The presence of diabetes was the only differentiating factor between two groups of frankly obese humans.

RESULTS: Non-diabetic vs. diabetic, median and interquartile range, respectively: resistin (ng/mL) 26.08, 16.09 vs. 22.37, 14.54, p=0.736; TC (mmol/L) 5.02, 1.39 vs. 5.16, 1.56, p=0.374; HDL-C (mmol/L): 1.10, 0.41 vs. 1.02, 0.47 p<0.05; LDL-C (mmol/L): 3.00, 1.05 vs. 3.00, 1.30 p=0.978; TG (mmol/L) 1.70, 1.43 vs.1.95, 1.81 p<0.05. To investigate the interrelations between resistin and lipids, a simple regression analysis was used, and the results were for resistin & TC, HDL-C, LDL-C, and TG, respectively: in the whole cohort r=-0.1364, p=0.0670, r=0.1514, p=0.0437, r=-0.2573, p=0.0006, r=0.0434, p=0.5597; in non-diabetics: r=-0.2067, p=0.0213, r=0.1023, p=0.2621, r=-0.2399, p=0.0083 and r=0.0288, p=0.7497; in diabetics r=0.0280, p=0.8360, r=0.2267, p=0.0929, r=-0.2933, p=0.0298, r=0.1349, p=0.3127.

CONCLUSIONS: In diabetic and non-diabetic subjects the atherogenic LDL cholesterol shows an inverse correlation with resistin, whereas the protective anti-atherosclerotic HDL cholesterol is positively correlated with resistin....

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Journal Article 2010; 31(4): 497-506 PubMed PMID: 20802460 Citation  Keywords:  Adiponectin:blood, Adult, Female, Genotype, Humans, Insulin Resistance:genetics, Logistic Models, Metabolic Syndrome X:etiology, Middle Aged, Obesity:genetics, Odds Ratio, Overweight:genetics, Poland, Polymorphism, Genetic, Resistin:blood,.   

OBJECTIVE: Obesity may be accompanied by enhanced metabolic disturbances but not all obese patients suffer from metabolic syndrome. Since metabolic homeostasis is under control of genetic factors underlying expression of adipokines, we aimed to compare the serum concentrations of adiponectin and resistin, and polymorphism in their genes, in overweight or obese Polish women.

MATERIAL AND METHODS: The study included 265 women with BMI above 25 kg/m2 (140 metabolically healthy and 125 with metabolic syndrome) and 104 non-obese women as a control group. Anthropometric parameters (BMI, BIA, WHR), blood pressure, lipid, glucose and HOMA-IR profiles as well as serum concentrations of adiponectin, HMW adiponectin and resistin were evaluated. Gene polymorphisms of adiponectin gene (276G/T; 11377C/G; 11391G/A) and resistin gene (420C/G; 62G/A; 537A/C) were analyzed using TaqMan SNP genotyping assays.

RESULTS: Higher serum concentrations of total adiponectin and lower levels of resistin were found in metabolically healthy patients when compared to those diagnosed with metabolic syndrome. No differences of serum HMW and resistin concentrations were observed between overweight or obese but metabolically healthy subjects and normal weight controls. No associations of investigated polymorphisms and the presence of metabolic syndrome were noticed in overweight/obese women with metabolic syndrome.

CONCLUSIONS: The assessment of total adiponectin in sera seems to be promising target in distinguishing subjects with obesity who undergo a diagnostic procedure for metabolic syndrome. Moreover, the evaluation of adipokine array may help to select patients with higher risk of metabolic disturbances that are associated with severe diseases....

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Journal Article 2010; 31(3): 418-422 PubMed PMID: 20588242 Citation  Keywords:  Adrenal Gland Neoplasms:complications, Adult, Aged, Aged, 80 and over, Body Mass Index, Dehydroepiandrosterone Sulfate:blood, Female, Humans, Hydrocortisone:blood, Incidental Findings, Metanephrine:urine, Middle Aged, Normetanephrine:urine, Obesity:compli.   

OBJECTIVE: The influence of obesity on cancer development has been proven for numerous tumours. In contrast, the association between obesity and non-secreting adrenal incidentaloma has never been proven. Therefore, the aim of this study was to investigate this relationship in a large sample of patients.

METHODS: 143 patients with benign non-secreting adrenal incidentalomas treated in the Department of Endocrinology at the Poznan University of Medical Sciences between the years 2000-2007 were examined. To rule out subclinical hyperfunctioning lesions, serum dehydroepiandrosterone sulphate, cortisol (8 am, 6 pm, and after 1 mg dexamethasone suppression), sodium and potassium, along with concentrations of sodium, potassium, vanillylmandelic acid, metanephrine and normetanephrine in 24-hour urine collection were determined. Radiological evaluation included computed tomography and/or magnetic resonance imaging. Only non-secreting lesions and those of benign radiologic appearance were considered. The patients body mass index was compared to that of the general population of Poland and the Western Poland Region of Wielkopolska.

RESULTS: The average body mass index of our patients was 28.77 kg/m2 (SD=4.71), with a 40% prevalence of obesity in the study group. One-proportion z-test showed a statistically significantly higher prevalence of obesity as compared to the general population of Poland and Wielkopolska (40% vs 12.5%, p<0.005); the results were similar for the whole cohort, and for each gender separately.

CONCLUSIONS: This clinical research study demonstrates a strong association between obesity and incidentally discovered non-functioning adrenal tumours....

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Comparative Study 2010; 31(3): 353-358 PubMed PMID: 20588239 Citation  Keywords:  Adiponectin:blood, Adult, Binge-Eating Disorder:blood, Body Mass Index, Female, Humans, Leptin:blood, Obesity:blood,.   

BACKGROUND: Adipose tissue-derived hormones are involved in the pathophysiology of eating disorders and other mental disorders. Studies have suggested that the serum leptin/adiponectin ratio is highly correlated with BMI. Furthermore, it is associated with a number of metabolic processes and inflammatory markers that are involved in obesity and mental disorders, such as the physiopathology of binge eating disorder (BED). We investigated whether variations in leptin and adiponectin serum concentrations differed between adult women with and without BED before and after a meal.

METHODS: The study group was composed of 8 normal weight women (20-25 kg/m2) without BED, 8 obese women (>/=30 kg/m2) with BED, and 7 obese women without BED (non-BED). Blood samples were collected before and after the consumption of a meal composed of 55% carbohydrates, 15% protein, and 30% lipids.

RESULTS: Body mass index (p<0.0001), leptin (p<0.0001) and the leptin/adiponectin ratio (p<0.0001) were higher in obese non-BED women than in obese BED and normal weight groups. Adiponectin (p=0.01) concentrations were lower in the obese BED group than in the other groups before and after the meal.

CONCLUSIONS: The hypoadiponectinemia followed by the altered levels of leptin in obese BED woman may predispose these subjects to an inadequate energy balance, which could promote weight gain and an increased food intake in woman that may contribute to obesity and binge eating in these subjects....

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Case Reports 2009; 30(1): 22-24 PubMed PMID: 19300386 Citation  Keywords:  Adult, Diabetes Mellitus, Type 2:complications, Exercise Therapy:methods, Humans, Male, Motor Activity:physiology, Obesity:complications, Time Factors, Treatment Outcome,.   

: The case history of a 44-year-old, severely obese Caucasian man with serious decompensation of diabetes and subsequent withdrawal of high-dose insulin is reported. Insulin was withdrawn after 5 years of continuous therapy and the patient was treated for 6 months with diet, individualized physical therapy and oral antidiabetic drugs from the group of insulin sensitizers. Six months later, oral antidiabetics were discontinued for low blood glucose levels, and the treatment was limited to therapeutic life style changes. After insulin withdrawal, the patient's condition markedly improved: he showed better diabetes control, decrease in insulin resistance, weight loss, reduced BMI, reduced waist circumference, sagittal abdominal diameter and body fat, increased fitness level, normalized blood pressure and decreased heart rate at rest....

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Comparative Study 2008; 29(1): 141-145 PubMed PMID: 18283269 Citation  Keywords:  Adolescent, Adrenocorticotropic Hormone:blood, Blood Pressure:physiology, Child, Child, Preschool, Female, Humans, Hydrocortisone:blood, Lipids:blood, Male, Metabolic Syndrome X:blood, Obesity:blood, Risk Factors,.   

OBJECTIVES: The aim of this study was to investigate the relationship between the varying degrees of obesity and blood glucocorticoid levels in obese children and adolescents with and without metabolic syndrome features.

METHODS: We studied 241 obese children and adolescents aged between 2 and 17.6 years; 127 boys and 114 girls. All children underwent an oral glucose tolerance test. Measurements included blood pressure, cortisol, ACTH, and lipid profiles. The diagnosis of metabolic syndrome was defined according to the criteria adapted from World Health Organisation and National Cholesterol Education Program Adult Treatment Panel-III guidelines.

RESULTS: Blood cortisol and ACTH levels were higher in patients with MS than without MS (p = 0.02). ACTH levels increased with weight (r = 0.13, p = 0.02), systolic blood pressure (r = 0.21, p = 0.002), diastolic blood pressure (r = 0.17, p = 0.01), fasting glucose (r = 0.17, p = 0.01). Cortisol production was only correlated with systolic blood pressure (r = 0.12, p = 0.05).

CONCLUSIONS: Results from the present study indicates that there may be a link between cortisol production and the metabolic syndrome in obese children and adolescents....

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