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Kumric M, Dujic G, Vrdoljak J, Supe-Domic D, Bilopavlovic N, Dolic K, Dujic Z, Bozic J. Effects of CBD supplementation on ambulatory blood pressure and serum urotensin-II concentrations in Caucasian patients with essential hypertension: A sub-analysis of the HYPER-H21-4 trial. Biomed Pharmacother 2023; 164:115016. [PMID: 37321059 DOI: 10.1016/j.biopha.2023.115016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 06/08/2023] [Accepted: 06/11/2023] [Indexed: 06/17/2023] Open
Abstract
HYPER-H21-4 was a randomized crossover trial that aimed to determine if cannabidiol (CBD), a non-intoxicating constituent of cannabis, has relevant effects on blood pressure and vascular health in patients with essential hypertension. In the present sub-analysis, we aimed to elucidate whether serum urotensin-II concentrations may reflect hemodynamic changes caused by oral supplementation with CBD. The sub-analysis of this randomized crossover study included 51 patients with mild to moderate hypertension that received CBD for five weeks, and placebo for five weeks. After five weeks of oral CBD supplementation, but not placebo, serum urotensin concentrations reduced significantly in comparison to baseline (3.31 ± 1.46 ng/mL vs. 2.08 ± 0.91 ng/mL, P < 0.001). Following the five weeks of CBD supplementation, the magnitude of reduction in 24 h mean arterial pressure (MAP) positively correlated with the extent of change in serum urotensin levels (r = 0.412, P = 0.003); this association was independent of age, sex, BMI and previous antihypertensive treatment (β ± standard error, 0.023 ± 0.009, P = 0.009). No correlation was present in the placebo condition (r = -0.132, P = 0.357). In summary, potent vasoconstrictor urotensin seems to be implicated in CBD-mediated reduction in blood pressure, although further research is needed to confirm these notions.
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Affiliation(s)
- Marko Kumric
- Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia.
| | - Goran Dujic
- Clinical Department of Diagnostic and Interventional Radiology, University Hospital of Split, 21000 Split, Croatia.
| | - Josip Vrdoljak
- Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia.
| | - Daniela Supe-Domic
- Department of Health Studies, University of Split, 21000 Split, Croatia; Department of Medical Laboratory Diagnostics, University Hospital of Split, 21000 Split, Croatia.
| | - Nada Bilopavlovic
- Department of Medical Laboratory Diagnostics, University Hospital of Split, 21000 Split, Croatia
| | - Kresimir Dolic
- Clinical Department of Diagnostic and Interventional Radiology, University Hospital of Split, 21000 Split, Croatia.
| | - Zeljko Dujic
- Department of Integrative Physiology, University of Split School of Medicine, 21000 Split, Croatia.
| | - Josko Bozic
- Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia.
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Alicic D, Martinovic D, Rusic D, Zivkovic PM, Tadin Hadjina I, Vilovic M, Kumric M, Tokic D, Supe-Domic D, Lupi-Ferandin S, Bozic J. Urotensin II levels in patients with inflammatory bowel disease. World J Gastroenterol 2021; 27:6142-6153. [PMID: 34629825 PMCID: PMC8476337 DOI: 10.3748/wjg.v27.i36.6142] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 06/21/2021] [Accepted: 08/19/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Patients with inflammatory bowel disease (IBD) are associated with increased cardiovascular risk and have increased overall cardiovascular burden. On the other hand, urotensin II (UII) is one of the most potent vascular constrictors with immunomodulatory effect that is connected with a number of different cardiometabolic disorders as well. Furthermore, patients with ulcerative colitis have shown increased expression of urotensin II receptor in comparison to healthy controls. Since the features of IBD includes chronic inflammation and endothelial dysfunction as well, it is plausible to assume that there is connection between increased cardiac risk in IBD and UII.
AIM To determine serum UII levels in patients with IBD and to compare them to control subjects, as well as investigate possible associations with relevant clinical and biochemical parameters.
METHODS This cross sectional study consecutively enrolled 50 adult IBD patients (26 with Crohn’s disease and 24 with ulcerative colitis) and 50 age and gender matched controls. Clinical assessment was performed by the same experienced gastroenterologist according to the latest guidelines. Ulcerative Colitis Endoscopic Index of Severity and Simple Endoscopic Score for Crohn’s Disease were used for endoscopic evaluation. Serum levels of UII were determined using the enzyme immunoassay kit for human UII, according to the manufacturer’s instructions.
RESULTS IBD patients have significantly higher concentrations of UII when compared to control subjects (7.57 ± 1.41 vs 1.98 ± 0.69 ng/mL, P < 0.001), while there were no significant differences between Crohn’s disease and ulcerative colitis patients (7.49 ± 1.42 vs 7.65 ± 1.41 ng/mL, P = 0.689). There was a significant positive correlation between serum UII levels and high sensitivity C reactive peptide levels (r = 0.491, P < 0.001) and a significant negative correlation between serum UII levels and total proteins (r = -0.306, P = 0.032). Additionally, there was a significant positive correlation between serum UII levels with both systolic (r = 0.387, P = 0.005) and diastolic (r = 0.352, P = 0.012) blood pressure. Moreover, serum UII levels had a significant positive correlation with Ulcerative Colitis Endoscopic Index of Severity (r = 0.425, P = 0.048) and Simple Endoscopic Score for Crohn’s Disease (r = 0.466, P = 0.028) scores. Multiple linear regression analysis showed that serum UII levels retained significant association with high sensitivity C reactive peptide (β ± standard error, 0.262 ± 0.076, P < 0.001) and systolic blood pressure (0.040 ± 0.017, P = 0.030).
CONCLUSION It is possible that UII is involved in the complex pathophysiology of cardiovascular complications in IBD patients, and its purpose should be investigated in further studies.
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Affiliation(s)
- Damir Alicic
- Department of Gastroenterology, University Hospital of Split, Split 21000, Croatia
| | - Dinko Martinovic
- Department of Pathophysiology, University of Split School of Medicine, Split 21000, Croatia
| | - Doris Rusic
- Department of Pharmacy, University of Split School of Medicine, Split 21000, Croatia
| | - Piero Marin Zivkovic
- Department of Gastroenterology, University Hospital of Split, Split 21000, Croatia
| | - Ivana Tadin Hadjina
- Department of Gastroenterology, University Hospital of Split, Split 21000, Croatia
| | - Marino Vilovic
- Department of Pathophysiology, University of Split School of Medicine, Split 21000, Croatia
| | - Marko Kumric
- Department of Pathophysiology, University of Split School of Medicine, Split 21000, Croatia
| | - Daria Tokic
- Department of Anesthesiology and Intensive care, University Hospital of Split, Split 21000, Croatia
| | | | - Slaven Lupi-Ferandin
- Department of Maxillofacial Surgery, University Hospital of Split, Split 21000, Croatia
| | - Josko Bozic
- Department of Pathophysiology, University of Split School of Medicine, Split 21000, Croatia
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Bilalic A, Kurir TT, Borovac JA, Kumric M, Supe-Domic D, Vilovic M, Martinovic D, Bozic J. Association of Dephosphorylated-Uncarboxylated Matrix Gla Protein and Risk of Major Bleeding in Patients Presenting with Acute Myocardial Infarction. Life (Basel) 2021; 11:733. [PMID: 34440477 PMCID: PMC8400588 DOI: 10.3390/life11080733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 07/20/2021] [Accepted: 07/22/2021] [Indexed: 11/16/2022] Open
Abstract
The "Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA guidelines" (CRUSADE) score emerged as a predictor of major bleeding in patients presenting with the acute coronary syndrome. On the other hand, previous studies established the association of dephosphorylated-uncarboxylated Matrix Gla protein (dp-ucMGP) and vitamin K, as well as their subsequent impact on coagulation cascade and bleeding tendency. Therefore, in the present study, we explored if dp-ucMGP plasma levels were associated with CRUSADE bleeding score. In this cross-sectional study, physical examination and clinical data, including plasma dp-ucMGP levels, were obtained from 80 consecutive patients with acute myocardial infarction (AMI). A significant positive correlation was found between CRUSADE bleeding score and both dp-ucMGP plasma levels (r = 0.442, p < 0.001) and risk score of in-hospital mortality (r = 0.520, p < 0.001), respectively. In comparing the three risk groups of risk for in-hospital bleeding, the high/very high-risk group had significantly higher dp-ucMGP levels from both very low/low group (1277 vs. 794 pmol/L, p < 0.001) and the moderate group (1277 vs. 941 pmol/L, p = 0.047). Overall, since higher dp-ucMGP levels were associated with elevated CRUSADE score and prolonged hemostasis parameters, this may suggest that there is a biological link between dp-ucMGP plasma levels and the risk of bleeding in patients who present with AMI.
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Affiliation(s)
- Admira Bilalic
- Department of Cardiology, University Hospital of Split, 21000 Split, Croatia; (A.B.); (J.A.B.)
| | - Tina Ticinovic Kurir
- Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia; (T.T.K.); (M.K.); (M.V.); (D.M.)
- Department of Endocrinology, Diabetes and Metabolic Diseases, University Hospital of Split, 21000 Split, Croatia
| | - Josip A. Borovac
- Department of Cardiology, University Hospital of Split, 21000 Split, Croatia; (A.B.); (J.A.B.)
- Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia; (T.T.K.); (M.K.); (M.V.); (D.M.)
| | - Marko Kumric
- Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia; (T.T.K.); (M.K.); (M.V.); (D.M.)
| | - Daniela Supe-Domic
- Department of Health Studies, University of Split, 21000 Split, Croatia;
| | - Marino Vilovic
- Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia; (T.T.K.); (M.K.); (M.V.); (D.M.)
| | - Dinko Martinovic
- Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia; (T.T.K.); (M.K.); (M.V.); (D.M.)
| | - Josko Bozic
- Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia; (T.T.K.); (M.K.); (M.V.); (D.M.)
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Boric-Skaro D, Mizdrak M, Luketin M, Martinovic D, Tokic D, Vilovic M, Supe-Domic D, Kurir TT, Bozic J. Serum Adropin Levels in Patients on Hemodialysis. Life (Basel) 2021; 11:life11040337. [PMID: 33920330 PMCID: PMC8070137 DOI: 10.3390/life11040337] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 03/31/2021] [Accepted: 04/08/2021] [Indexed: 12/30/2022] Open
Abstract
Adropin is a novel pleotropic peptide involved in energy homeostasis, with possible contribution to cardiovascular protection through production of nitric oxide and subsequent blood pressure regulation. Given that patients undergoing hemodialysis (HD) are related with high cardiovascular risk, hyperlipidemia, chronic low-grade inflammation, and malnutrition the aim of our study was to investigate serum adropin levels in HD patients to evaluate possible associations with nutritional status and other relevant clinical and laboratory parameters. The study included 70 patients on HD and 60 healthy controls. Serum adropin levels were determined by an enzyme-linked immunosorbent assay in a commercially available diagnostic kit. Serum adropin levels were significantly lower in the HD group compared to the control group (2.20 ± 0.72 vs. 4.05 ± 0.93 ng/mL, p < 0.001). Moreover, there was a significant negative correlation with malnutrition-inflammation score (r = −0.476, p < 0.001), dialysis malnutrition score (r = −0.350, p = 0.003), HD duration (r = −0.305, p = 0.010), and high sensitivity C-reactive protein (hsCRP) (r = −0.646, p < 0.001). Additionally, there was a significant negative correlation between adropin levels and pre-dialysis systolic (r = −0.301, p = 0.011) and diastolic blood pressure (r = −0.299, p = 0.011). These results are implying that adropin is potentially involved in the pathophysiological mechanisms of chronic kidney disease (CKD)/HD and its complications. However, future larger scale longitudinal studies need to further address it.
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Affiliation(s)
- Dijana Boric-Skaro
- Department of Nephrology and Dialysis, University Hospital of Split, 21000 Split, Croatia; (D.B.-S.); (M.M.); (M.L.)
| | - Maja Mizdrak
- Department of Nephrology and Dialysis, University Hospital of Split, 21000 Split, Croatia; (D.B.-S.); (M.M.); (M.L.)
| | - Mirko Luketin
- Department of Nephrology and Dialysis, University Hospital of Split, 21000 Split, Croatia; (D.B.-S.); (M.M.); (M.L.)
| | - Dinko Martinovic
- Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia; (D.M.); (M.V.); (T.T.K.)
| | - Daria Tokic
- Department of Anesthesiology and Intensive Care, University Hospital of Split, 21000 Split, Croatia;
| | - Marino Vilovic
- Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia; (D.M.); (M.V.); (T.T.K.)
| | - Daniela Supe-Domic
- Department of Health Studies, University of Split, 21000 Split, Croatia;
| | - Tina Ticinovic Kurir
- Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia; (D.M.); (M.V.); (T.T.K.)
- Department of Endocrinology, University Hospital of Split, 21000 Split, Croatia
| | - Josko Bozic
- Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia; (D.M.); (M.V.); (T.T.K.)
- Correspondence: ; Tel.: +385-21-557-871; Fax: +385-21-557-905
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Luketin M, Mizdrak M, Boric-Skaro D, Martinovic D, Tokic D, Vilovic M, Supe-Domic D, Ticinovic Kurir T, Bozic J. Plasma Catestatin Levels and Advanced Glycation End Products in Patients on Hemodialysis. Biomolecules 2021; 11:biom11030456. [PMID: 33803864 PMCID: PMC8003327 DOI: 10.3390/biom11030456] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/11/2021] [Accepted: 03/17/2021] [Indexed: 02/07/2023] Open
Abstract
Catestatin (CST) is a pleiotropic peptide involved in cardiovascular protection with its antihypertensive and angiogenic effects. Considering that patients with end-stage renal disease (ESRD) who are undergoing hemodialysis (HD) are associated with higher cardiovascular risk, the aim of this study was to investigate plasma CST levels in HD patients, compare them to healthy controls and evaluate possible CST associations with advanced glycation end products (AGEs) and laboratory, anthropometric and clinical parameters. The study included 91 patients on HD and 70 healthy controls. Plasma CST levels were determined by an enzyme-linked immunosorbent assay in a commercially available diagnostic kit, while AGEs were determined using skin autofluorescence. Plasma CST levels were significantly higher in the HD group compared to the controls (32.85 ± 20.18 vs. 5.39 ± 1.24 ng/mL, p < 0.001) and there was a significant positive correlation between CST and AGEs (r = 0.492, p < 0.001). Furthermore, there was a significant positive correlation between plasma CST levels with both the Dialysis Malnutrition Score (r = 0.295, p = 0.004) and Malnutrition-Inflammation Score (r = 0.290, p = 0.005). These results suggest that CST could be playing a role in the complex pathophysiology of ESRD/HD and that it could affect the higher cardiovascular risk of patients on HD.
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Affiliation(s)
- Mirko Luketin
- Department of Nephrology and Dialysis, University Hospital of Split, 21000 Split, Croatia; (M.L.); (M.M.); (D.B.-S.)
| | - Maja Mizdrak
- Department of Nephrology and Dialysis, University Hospital of Split, 21000 Split, Croatia; (M.L.); (M.M.); (D.B.-S.)
| | - Dijana Boric-Skaro
- Department of Nephrology and Dialysis, University Hospital of Split, 21000 Split, Croatia; (M.L.); (M.M.); (D.B.-S.)
| | - Dinko Martinovic
- Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia; (D.M.); (M.V.); (T.T.K.)
| | - Daria Tokic
- Department of Anesthesiology and Intensive care, University Hospital of Split, 21000 Split, Croatia;
| | - Marino Vilovic
- Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia; (D.M.); (M.V.); (T.T.K.)
| | - Daniela Supe-Domic
- Department of Health Studies, University of Split, Split, Croatia, 21000 Split, Croatia;
| | - Tina Ticinovic Kurir
- Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia; (D.M.); (M.V.); (T.T.K.)
| | - Josko Bozic
- Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia; (D.M.); (M.V.); (T.T.K.)
- Correspondence: ; Tel.: +385-21-557-871; Fax: +385-21-557-905
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Bilalic A, Ticinovic Kurir T, Kumric M, Borovac JA, Matetic A, Supe-Domic D, Bozic J. Circulating Levels of Dephosphorylated-Uncarboxylated Matrix Gla Protein in Patients with Acute Coronary Syndrome. Molecules 2021; 26:1108. [PMID: 33669806 PMCID: PMC7922740 DOI: 10.3390/molecules26041108] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 02/14/2021] [Accepted: 02/17/2021] [Indexed: 12/20/2022] Open
Abstract
Vascular calcification contributes to the pathogenesis of coronary artery disease while matrix Gla protein (MGP) was recently identified as a potent inhibitor of vascular calcification. MGP fractions, such as dephosphorylated-uncarboxylated MGP (dp-ucMGP), lack post-translational modifications and are less efficient in vascular calcification inhibition. We sought to compare dp-ucMGP levels between patients with acute coronary syndrome (ACS), stratified by ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI) status. Physical examination and clinical data, along with plasma dp-ucMGP levels, were obtained from 90 consecutive ACS patients. We observed that levels of dp-ucMGP were significantly higher in patients with NSTEMI compared to STEMI patients (1063.4 ± 518.6 vs. 742.7 ± 166.6 pmol/L, p < 0.001). NSTEMI status and positive family history of cardiovascular diseases were only independent predictors of the highest tertile of dp-ucMGP levels. Among those with NSTEMI, patients at a high risk of in-hospital mortality (adjudicated by GRACE score) had significantly higher levels of dp-ucMGP compared to non-high-risk patients (1417.8 ± 956.8 vs. 984.6 ± 335.0 pmol/L, p = 0.030). Altogether, our findings suggest that higher dp-ucMGP levels likely reflect higher calcification burden in ACS patients and might aid in the identification of NSTEMI patients at increased risk of in-hospital mortality. Furthermore, observed dp-ucMGP levels might reflect differences in atherosclerotic plaque pathobiology between patients with STEMI and NSTEMI.
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Affiliation(s)
- Admira Bilalic
- Department of Cardiology, University Hospital of Split, Split 21000, Croatia; (A.B.); (A.M.)
| | - Tina Ticinovic Kurir
- Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia; (T.T.K.); (M.K.); (J.A.B.)
- Endocrinology Clinic, University Hospital of Split, 21000 Split, Croatia
| | - Marko Kumric
- Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia; (T.T.K.); (M.K.); (J.A.B.)
| | - Josip A. Borovac
- Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia; (T.T.K.); (M.K.); (J.A.B.)
- Institute of Emergency Medicine of Split-Dalmatia County (ZHM SDZ), 21000 Split, Croatia
| | - Andrija Matetic
- Department of Cardiology, University Hospital of Split, Split 21000, Croatia; (A.B.); (A.M.)
| | - Daniela Supe-Domic
- Department of Medical Laboratory Diagnostics, University Hospital of Split, 21000 Split, Croatia;
| | - Josko Bozic
- Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia; (T.T.K.); (M.K.); (J.A.B.)
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Brnic D, Martinovic D, Zivkovic PM, Tokic D, Vilovic M, Rusic D, Tadin Hadjina I, Libers C, Glumac S, Supe-Domic D, Tonkic A, Bozic J. Inactive matrix Gla protein is elevated in patients with inflammatory bowel disease. World J Gastroenterol 2020; 26:4866-4877. [PMID: 32921963 PMCID: PMC7459205 DOI: 10.3748/wjg.v26.i32.4866] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 07/30/2020] [Accepted: 08/15/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Matrix Gla protein (MGP) is a vitamin K dependent peptide which has an established role in suppression of vascular calcification. Recent studies have pointed to a possible link between immunomodulatory effect of MGP and inflammatory bowel disease (IBD). AIM To compare plasma levels of dephosphorylated and uncarboxylated MGP (dp-ucMGP) between IBD patients and controls. METHODS This cross-sectional study was conducted on 70 patients with IBD (30 patients with ulcerative colitis and 40 patients with Crohn's disease) and 60 age and gender matching healthy controls. Plasma dp-ucMGP levels were analyzed from blood samples by CLIA method using IDS-iSYS InaKtif MGP (Immunodiagnostic Systems, Frankfurt, Germany) according to the manufacturer's instructions. fecal calprotectin (FC) levels were determined from stool samples by turbidimetric immunoassay method using Bühlmann fecal calprotectin turbo assay (Bühlmann Laboratories Aktiengesellschaft, Schonenbuch, Switzerland). Other parameters were analyzed according to the standard laboratory procedures. RESULTS Plasma levels of dp-ucMGP were significantly higher in patients with IBD compared to the healthy control group (629.83 ± 124.20 pmol/mL vs 546.7 ± 122.09 pmol/mL, P < 0.001), and there was no significant difference between patients with Crohn's disease and patients with ulcerative colitis (640.02 ± 131.88 pmol/mL vs 616.23 ± 113.92 pmol/mL, P = 0.432). Furthermore, a significant positive correlation of plasma dp-ucMGP levels was found with both FC levels (r = 0.396, P < 0.001) and high sensitivity C-reactive protein (hsCRP) levels (r = 0.477, P < 0.001). Moreover, in the total study population a significant positive correlation was found between dp-ucMGP with age (r = 0.210, P = 0.016) and waist circumference (r = 0.264, P = 0.002). Multiple linear regression analysis showed that dp-ucMGP levels retained significant association with FC (β ± SE, 0.06 ± 0.02, P = 0.003). CONCLUSION Study results support experimental data of MGP immunomodulatory IBD effect and indicate potential involvement in the pathophysiology of the disease, and possibly extraintestinal manifestations.
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Affiliation(s)
- Darko Brnic
- Department of Gastroenterology, University Hospital of Split, Split 21000, Croatia
| | - Dinko Martinovic
- Department of Emergency Medicine, Institute of Emergency Medicine of Split-Dalmatia County, Split 21000, Croatia
| | - Piero Marin Zivkovic
- Department of Gastroenterology, University Hospital of Split, Split 21000, Croatia
| | - Daria Tokic
- Department of Emergency Medicine, Institute of Emergency Medicine of Split-Dalmatia County, Split 21000, Croatia
| | - Marino Vilovic
- Department of Pathophysiology, University of Split School of Medicine, Split 21000, Croatia
| | - Doris Rusic
- Department of Pharmacy, University of Split School of Medicine, Split 21000, Croatia
| | - Ivana Tadin Hadjina
- Department of Gastroenterology, University Hospital of Split, Split 21000, Croatia
| | - Christian Libers
- Department of Pathophysiology, University of Split School of Medicine, Split 21000, Croatia
| | - Sandro Glumac
- Department of Anesthesiology and Intensive Care, University Hospital of Split, Split 21000, Croatia
| | - Daniela Supe-Domic
- Department of Medical Laboratory Diagnostics, University Hospital of Split, Split 21000, Croatia
| | - Ante Tonkic
- Department of Internal Medicine, University of Split School of Medicine, Split 21000, Croatia
| | - Josko Bozic
- Department of Pathophysiology, University of Split School of Medicine, Split 21000, Croatia
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Simunovic M, Supe-Domic D, Karin Z, Degoricija M, Paradzik M, Skrabic R, Jukic A, Bozic J, Skrabic V. The Relationship of Vitamin D Status, Adherence to the Mediterranean Diet, and Physical Activity in Obese Children and Adolescents. J Med Food 2020; 24:385-393. [PMID: 32783677 DOI: 10.1089/jmf.2020.0032] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Vitamin D deficiency is associated with a range of chronic diseases, including childhood obesity. Prevalence of vitamin D deficiency in obese children and adolescents ranges from 6.5% to 57%. This cross-sectional study included 92 obese patients with body mass index z-score >2 and 39 subjects in the control group. Anthropometric and laboratory patient assessment were performed, including the fasting 25-hydroxyvitamin D (25(OH)D). Adherence to the Mediterranean diet was assessed by Mediterranean Diet Quality Index for children and adolescents (KIDMED index), while physical activity was evaluated by Physical Activity Questionnaire (PAQ). Serum levels of 25(OH)D were significantly lower in obese subjects compared to the control group (52.0 ± 17.93 vs. 64.09 ± 25.82 nmol/L, P = .003). The subgroup of obese patients with metabolic syndrome (MS) had significantly lower levels of serum vitamin D when compared to the subgroup of obese patients without MS and the control group (46.99 ± 17.11 vs. 54.58 ± 17.93 vs. 64.09 ± 25.82 nmol/L, P = .003). Obese patients with MS had lower PAQ score when compared to obese without MS and the control group (2.32 ± 0.55 vs. 2.49 ± 0.67 vs. 2.85 ± 0.63 nmol/L, P = .002), while no significant differences were observed in the KIDMED index (4.23 ± 1.81 vs. 4.21 ± 2.13 vs. 4.87 ± 2.29, P = .251), respectively. PAQ score was in positive correlation with serum levels of 25(OH)D (r = 0.305, P < .001). This study demonstrated that obese children and adolescents have significantly lower values of serum 25(OH)D. The positive correlation between vitamin D and PAQ score points to the importance of physical activity in the prevention of further cardiovascular complications and MS.
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Affiliation(s)
- Marko Simunovic
- Department of Pediatrics, University Hospital of Split, Split, Croatia
| | - Daniela Supe-Domic
- Department of Medical Laboratory Diagnostics, University Hospital of Split, Split, Croatia.,Department of Health Studies, University of Split, Split, Croatia
| | - Zeljka Karin
- Public Health Institute of Split and Dalmatia County, Split, Croatia
| | - Marina Degoricija
- Department of Medical Chemistry and Biochemistry, University of Split School of Medicine, Split, Croatia
| | - Martina Paradzik
- Department of Ophthalmology, University Hospital of Split, Split, Croatia
| | - Roko Skrabic
- University of Split School of Medicine, Split, Croatia
| | - Andrija Jukic
- University of Split School of Medicine, Split, Croatia
| | - Josko Bozic
- Department of Pathophysiology, University of Split School of Medicine, Split, Croatia
| | - Veselin Skrabic
- Department of Pediatrics, University Hospital of Split, Split, Croatia.,Department of Pediatrics, University of Split School of Medicine, Split, Croatia
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9
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Vilovic M, Dogas Z, Ticinovic Kurir T, Borovac JA, Supe-Domic D, Vilovic T, Ivkovic N, Rusic D, Novak A, Bozic J. Bone metabolism parameters and inactive matrix Gla protein in patients with obstructive sleep apnea†. Sleep 2020; 43:zsz243. [PMID: 31631227 DOI: 10.1093/sleep/zsz243] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 08/15/2019] [Indexed: 12/15/2022] Open
Abstract
STUDY OBJECTIVES The aim of this study was to investigate differences in dual-energy X-ray absorptiometry (DXA) parameters, trabecular bone score (TBS), bone turnover markers and inactive matrix Gla protein (dp-ucMGP) between patients with obstructive sleep apnea (OSA) and healthy controls. METHODS This study enrolled 53 male patients diagnosed with OSA, and 50 age- and body mass index (BMI)-matched control subjects. All participants underwent DXA imaging, TBS assessment and blood sampling for biochemical analysis of bone metabolism markers. RESULTS Mean apnea-hypopnea index (AHI) score of OSA patients was 43.8 ± 18.8 events/h. OSA patients had significantly higher plasma dp-ucMGP levels in comparison to controls (512.7 ± 71.9 vs. 465.8 ± 50.9 pmol/L, p < 0.001). OSA and control group did not significantly differ regarding standard DXA results, while TBS values were significantly lower in the OSA group (1.24 ± 0.17 vs. 1.36 ± 0.15, p < 0.001). AHI score was a significant independent correlate of plasma dp-ucMGP levels (β ± SE, 1.461 ± 0.45, p = 0.002). In addition, TBS retained a significant relationship with dp-ucMGP values (β ± SE, -93.77 ± 38.1, p = 0.001). CONCLUSIONS dp-ucMGP levels are significantly higher in patients with OSA and correlate with disease severity. In addition, TBS values in OSA patients are lower in comparison with the control group and decrease with disease severity.
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Affiliation(s)
- Marino Vilovic
- Department of Pathophysiology, University of Split School of Medicine, Split, Croatia
| | - Zoran Dogas
- Sleep Medicine Centre, University of Split School of Medicine, and University Hospital of Split, Split, Croatia
- Department of Neuroscience, University of Split School of Medicine, Split, Croatia
| | - Tina Ticinovic Kurir
- Department of Pathophysiology, University of Split School of Medicine, Split, Croatia
- Department of Endocrinology and Diabetology, University Hospital of Split, Split, Croatia
| | - Josip A Borovac
- Department of Pathophysiology, University of Split School of Medicine, Split, Croatia
| | - Daniela Supe-Domic
- Department of Medical Laboratory Diagnostics, University Hospital of Split, Split, Croatia
| | - Tina Vilovic
- Health Centre of Split-Dalmatia County, Split, Croatia
| | - Natalija Ivkovic
- Sleep Medicine Centre, University of Split School of Medicine, and University Hospital of Split, Split, Croatia
| | - Doris Rusic
- Department of Pharmacy, University of Split School of Medicine, Split, Croatia
| | - Anela Novak
- Department of Endocrinology and Diabetology, University Hospital of Split, Split, Croatia
| | - Josko Bozic
- Department of Pathophysiology, University of Split School of Medicine, Split, Croatia
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10
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Zivkovic PM, Matetic A, Tadin Hadjina I, Rusic D, Vilovic M, Supe-Domic D, Borovac JA, Mudnic I, Tonkic A, Bozic J. Serum Catestatin Levels and Arterial Stiffness Parameters Are Increased in Patients with Inflammatory Bowel Disease. J Clin Med 2020; 9:jcm9030628. [PMID: 32110996 PMCID: PMC7141110 DOI: 10.3390/jcm9030628] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 02/18/2020] [Accepted: 02/25/2020] [Indexed: 12/12/2022] Open
Abstract
Catestatin (CST) is an important peptide in the pathophysiology of chronic inflammatory disorders. However, clinical studies on inflammatory bowel disease (IBD) patients are lacking. Our goal was to investigate CST concentrations in IBD patients compared to healthy subjects. Additionally, we aimed to determine arterial stiffness parameters in relation to CST. This cross-sectional study compared 80 IBD patients (45 Crohn's disease (CD) and 35 ulcerative colitis (UC) patients) with 75 control subjects. Serum CST levels were significantly higher in the IBD group compared to control subjects (11.29 ± 9.14 vs. 7.13 ± 6.08 ng/mL, p = 0.001) and in the UC group compared to CD patients (13.50 ± 9.58 vs. 9.03 ± 6.92 ng/mL, p = 0.021), irrespective of age and BMI. IBD patients exhibited significantly higher values of heart rate adjusted central augmentation index (cAIx-75) (14.88 ± 10.59 vs. 6.87 ± 9.50 %, p < 0.001) and pulse wave velocity (PWV) (8.06 ± 3.23 vs. 6.42 ± 1.47 m/s, p < 0.001) compared to control group. Furthermore, PWV was the only significant independent correlate of CST (B = 1.20, t = 4.15, p < 0.001), while CST, PWV, cAIx-75, high-sensitivity C-reactive protein and BMI were significant predictors of positive IBD status (1.089 (1.022-1.161), 1.515 (1.166-1.968), 1.060 (1.024-1.097), 1.458 (1.116-1.906), 0.793 (0.683-0.920), respectively). Serum CST levels were significantly higher in IBD patients compared to controls and an independent positive correlation of CST with PWV existed. Therefore, it is possible that CST could have a role in the complex pathophysiology of IBD and its cardiovascular complications.
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Affiliation(s)
- Piero Marin Zivkovic
- Department of Gastroenterology, University Hospital of Split, 21000 Split, Croatia; (P.M.Z.); (I.T.H.); (A.T.)
- Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia; (A.M.); (M.V.); (J.A.B.)
| | - Andrija Matetic
- Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia; (A.M.); (M.V.); (J.A.B.)
- Department of Cardiology, University Hospital of Split, 21000 Split, Croatia
| | - Ivana Tadin Hadjina
- Department of Gastroenterology, University Hospital of Split, 21000 Split, Croatia; (P.M.Z.); (I.T.H.); (A.T.)
| | - Doris Rusic
- Department of Pharmacy, University of Split School of Medicine, 21000 Split, Croatia;
| | - Marino Vilovic
- Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia; (A.M.); (M.V.); (J.A.B.)
| | - Daniela Supe-Domic
- Department of Medical Laboratory Diagnostics, University Hospital of Split, 21000 Split, Croatia;
- Department of Health Studies, University of Split, 21000 Split, Croatia
| | - Josip Andelo Borovac
- Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia; (A.M.); (M.V.); (J.A.B.)
| | - Ivana Mudnic
- Department of Pharmacology, University of Split School of Medicine, 21000 Split, Croatia;
| | - Ante Tonkic
- Department of Gastroenterology, University Hospital of Split, 21000 Split, Croatia; (P.M.Z.); (I.T.H.); (A.T.)
- Department of Internal Medicine, University of Split School of Medicine, 21000 Split, Croatia
| | - Josko Bozic
- Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia; (A.M.); (M.V.); (J.A.B.)
- Correspondence: ; Tel.: +385-21-557-871; Fax: +385-21-557-905
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11
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Simunovic M, Supe-Domic D, Karin Z, Degoricija M, Paradzik M, Bozic J, Unic I, Skrabic V. Serum catestatin concentrations are decreased in obese children and adolescents. Pediatr Diabetes 2019; 20:549-555. [PMID: 30714297 DOI: 10.1111/pedi.12825] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Revised: 01/09/2019] [Accepted: 01/17/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Catestatin is a chromogranin A-derived peptide with a wide spectrum of biological activities, such as inhibiting catecholamine release, decreasing blood pressure, stimulating histamine release, reducing beta-adrenergic stimulation, and regulating oxidative stress. OBJECTIVES The aims of our study were to determine serum catestatin concentrations in obese children and adolescents in regard to presence or absence of metabolic syndrome (MS) and to evaluate the possible relations between catestatin levels and other cardiovascular risk factors. SUBJECTS Ninety-two obese subjects with a body mass index z score > 2, aged 10 to 18 years, and 39 healthy, normal weight controls were enrolled in the study. METHODS Serum catestatin concentrations were measured using an enzyme-linked immunosorbent assay. RESULTS Significantly lower serum catestatin concentrations were recorded in the group of obese subjects compared with a control group (10.03 ± 5.05 vs 13.13 ± 6.25 ng/mL, P = 0.004). Further analyses revealed significantly lower catestatin concentrations in the subgroup of obese patients with MS (9.02 ± 4.3 vs 10.54 ± 5.36 vs 13.13 ± 6.25, P = 0.008). Serum catestatin concentrations were significantly negatively correlated with diastolic blood pressure (r = -0.253, P = 0.014), homeostatic model assessment of insulin resistance (r = -0.215, P = 0.037) and high sensitivity C-reactive protein (r = -0.208, P = 0.044). CONCLUSIONS To the best of our knowledge, this study is the first to report catestatin concentrations in obese children and adolescents and their possible relations with MS and cardiovascular risk factors in a pediatric population. Obese subjects with MS have lower serum catestatin concentrations than obese subjects without MS and controls.
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Affiliation(s)
- Marko Simunovic
- Department of Pediatrics, University Hospital of Split, Split, Croatia
| | - Daniela Supe-Domic
- Department of Medical Laboratory Diagnostics, University Hospital of Split, Split, Croatia
| | - Zeljka Karin
- Public Health Institute of Split and Dalmatia County, Split, Croatia
| | - Marina Degoricija
- Department of Medical Chemistry and Biochemistry, University of Split School of Medicine, Split, Croatia
| | - Martina Paradzik
- Department of Ophthalmology, University Hospital of Split, Split, Croatia
| | - Josko Bozic
- Department of Pathophysiology, University of Split School of Medicine, Split, Croatia
| | - Ivana Unic
- Department of Pediatrics, University Hospital of Split, Split, Croatia
| | - Veselin Skrabic
- Department of Pediatrics, University Hospital of Split, Split, Croatia
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12
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Bozic J, Borovac JA, Galic T, Kurir TT, Supe-Domic D, Dogas Z. Adropin and Inflammation Biomarker Levels in Male Patients With Obstructive Sleep Apnea: A Link With Glucose Metabolism and Sleep Parameters. J Clin Sleep Med 2018; 14:1109-1118. [PMID: 29991422 DOI: 10.5664/jcsm.7204] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 02/23/2018] [Indexed: 01/03/2023]
Abstract
STUDY OBJECTIVES The main objectives of the study were to determine plasma adropin, systemic inflammation biomarker levels, and glucose metabolism parameters in patients with moderate and severe obstructive sleep apnea (OSA) compared to healthy controls. METHODS In this study, we included 50 male patients with OSA (25 moderate and 25 severe) and 25 age- and sex-matched control subjects. All subjects underwent fasting sampling of peripheral blood for laboratory analyses. RESULTS Adropin plasma levels were significantly lower in the severe OSA group in comparison with the moderate and control groups (4.50 ± 1.45 versus 6.55 ± 1.68 versus 8.15 ± 1.79 ng/mL, P < .001). Plasma biomarkers of systemic inflammation were significantly increased in patients with moderate OSA (interleukin [IL]-6 and tumor necrosis factor alpha [TNF-α]) and severe OSA (IL-6, TNF-α, high-sensitivity C-reactive protein) when compared with controls (P < .001). Adropin levels showed a significant negative correlation with IL-6 (r = -.419, P < .001), TNF-α (r = -.540, P < .001), fasting glucose (r = -.331, P = .004), hemoglobin A1c (r = -.438, P < .001), homeostatic model assessment insulin resistance index (r = -.213, P = .046), and polysomnographic parameters including apnea-hypopnea index (r = -.615, P < .001) and oxygen desaturation index (r = -.573, P < .001). A multivariate regression analysis showed that plasma adropin remained as a significant negative predictor of severe OSA status, when adjusted for age and body mass index and computed along with other inflammatory biomarkers in the regression model (odds ratio 0.069, 95% confidence interval 0.009-0.517, P = .009). CONCLUSIONS Plasma adropin concentrations significantly correlate with indices of disease severity in patients with OSA, suggesting that adropin potentially plays an important role in the complex pathophysiology of the disease.
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Affiliation(s)
- Josko Bozic
- Department of Pathophysiology, University of Split School of Medicine, Split, Croatia.,Department of Neuroscience, University of Split School of Medicine, Split, Croatia
| | - Josip A Borovac
- Department of Pathophysiology, University of Split School of Medicine, Split, Croatia
| | - Tea Galic
- Department of Neuroscience, University of Split School of Medicine, Split, Croatia.,Study of Dental Medicine, University of Split School of Medicine, Split, Croatia
| | - Tina Ticinovic Kurir
- Department of Pathophysiology, University of Split School of Medicine, Split, Croatia
| | - Daniela Supe-Domic
- Department of Medical Laboratory Diagnostics, University Hospital of Split, Split, Croatia
| | - Zoran Dogas
- Department of Neuroscience, University of Split School of Medicine, Split, Croatia.,Sleep Medicine Center, University of Split School of Medicine, Split, Croatia.,University Hospital of Split, Split, Croatia
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13
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Bozic J, Vilovic M, Ticinovic Kurir T, Supe-Domic D, Ivkovic N, Galic T, Borovac J, Dogas Z. Bone metabolism and trabecular bone structure in patients with obstructive sleep apnea. Sleep Med 2017. [DOI: 10.1016/j.sleep.2017.11.115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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14
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Bozic J, Galic T, Supe-Domic D, Ivkovic N, Ticinovic Kurir T, Valic Z, Lesko J, Dogas Z. Morning cortisol levels and glucose metabolism parameters in moderate and severe obstructive sleep apnea patients. Endocrine 2016; 53:730-9. [PMID: 27000083 DOI: 10.1007/s12020-016-0925-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 03/11/2016] [Indexed: 12/26/2022]
Abstract
Obstructive sleep apnea (OSA) has been associated with dysregulation of the hypothalamic-pituitary-adrenal axis and alterations in glucose metabolism with increased risk for type 2 diabetes. The aim of the current study was to compare morning plasma cortisol levels and glucose metabolism parameters between moderate (apnea-hypopnea index (AHI): 15-30 events/h) and severe OSA patients (AHI >30 events/h), with respective controls. A total of 56 male OSA patients, 24 moderate (AHI = 21.1 ± 5.3) and 32 severe (AHI = 49.7 ± 18.1), underwent a full-night polysomnography, oral glucose tolerance test (OGTT), and measurement of morning plasma cortisol levels. These groups were compared to 20 matched subjects in a control group. Morning plasma cortisol levels were statistically lower in severe OSA group than in moderate OSA and control groups (303.7 ± 93.5 vs. 423.9 ± 145.1 vs. 417.5 ± 99.8 pmol/L, P < 0.001). Significant negative correlations were found between morning plasma cortisol levels and AHI (r = -0.444, P = 0.002), as well as oxygen desaturation index (r = -0.381, P = 0.011). Fasting plasma glucose (5.0 ± 0.5 vs. 5.4 ± 0.7 vs. 4.9 ± 0.6 mmol/L, P = 0.009) was higher in the severe OSA group compared to moderate OSA and controls. Homeostasis model assessment insulin resistance (HOMA-IR) was higher in the severe OSA group compared to moderate OSA and controls (4.6 ± 3.7 vs. 2.7 ± 2.0 and 2.2 ± 1.8, respectively, P = 0.006). In conclusion, our study showed that morning plasma cortisol levels measured at 8 a.m. were significantly lower in severe OSA patients than those in moderate OSA group and controls. Morning plasma cortisol levels showed a negative correlation with AHI and oxygen desaturation index. Additionally, this study confirmed the evidence of glucose metabolism impairment in moderate and severe OSA patients, with more pronounced effect in the severe OSA patients group.
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Affiliation(s)
- Josko Bozic
- Department of Pathophysiology, University of Split School of Medicine, Soltanska 2, Split, Croatia
| | - Tea Galic
- Study of Dental Medicine, University of Split School of Medicine, Soltanska 2, Split, Croatia
| | - Daniela Supe-Domic
- Department of Medical Laboratory Diagnostics, University Hospital Split, Spinciceva 1, Split, Croatia
| | - Natalija Ivkovic
- Split Sleep Medicine Center, University of Split School of Medicine, Soltanska 2, Split, Croatia
| | - Tina Ticinovic Kurir
- Department of Pathophysiology, University of Split School of Medicine, Soltanska 2, Split, Croatia
| | - Zoran Valic
- Department of Physiology, University of Split School of Medicine, Soltanska 2, Split, Croatia
| | - Josip Lesko
- Departments of Anatomy and Neuroscience, University of Mostar School of Medicine, Bijeli brijeg bb, Mostar, Bosnia and Herzegovina
| | - Zoran Dogas
- Split Sleep Medicine Center, University of Split School of Medicine, Soltanska 2, Split, Croatia.
- Department of Neuroscience, University of Split School of Medicine, Soltanska 2, Split, 21000, Croatia.
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Valic Z, Bozic J, Kurir TT, Novak A, Supe-Domic D, Valic M. Increased bone mineral density in experienced SCUBA divers. FASEB J 2012. [DOI: 10.1096/fasebj.26.1_supplement.1082.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Zoran Valic
- Physiology and NeuroscienceUniversity of Split School of MedicineSplitCroatia
| | - Josko Bozic
- Physiology and NeuroscienceUniversity of Split School of MedicineSplitCroatia
| | - Tina Ticinovic Kurir
- Departments of Pathophysiology, Internal Medicine, and Clinical DiagnosticsUniversity Hospital SplitSplitCroatia
| | - Anela Novak
- Departments of Pathophysiology, Internal Medicine, and Clinical DiagnosticsUniversity Hospital SplitSplitCroatia
| | - Daniela Supe-Domic
- Departments of Pathophysiology, Internal Medicine, and Clinical DiagnosticsUniversity Hospital SplitSplitCroatia
| | - Maja Valic
- Physiology and NeuroscienceUniversity of Split School of MedicineSplitCroatia
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