Differences in Chronic Low-Grade Inflammation and Metabolic Disturbances between VDR Genotypes in an Ethnically Homogenous Postmenopausal Female Population from Poland

(1) Vitamin D deficiency and changes in the endocrine system may stimulate systemic inflammation. VDR expression and the vitamin D concentration decrease with age, which is important in postmenopausal women for whom estrogen deficiency causes rapid bone loss. This group is, moreover, particularly at risk of developing atherosclerosis and its adverse consequences, such as chronic inflammation. The aim of this study was to assess the differentiation by the VDR genotype of the risk factors for so-called chronic low-grade inflammation and metabolic disorders. (2) We studied the differences between the anthropometric, metabolic, and inflammation parameters of VDR genotypes for Apa-I, Bsm-I, Fok-I, and Taq-I in a sample of 321 women aged 50-60 from an ethnically homogeneous urban population in Poland. (3) The TT Taq-I genotype presented a significantly higher rate of insulin resistance (HOMA) and lower serum levels of adiponectin than the other two genotypes. The AA genotype of the Bsm-I polymorphism was associated with a more atherogenic serum profile and significantly higher LDL and LDL/HDL values and Castelli Index. (4) Chronic low-grade inflammation was associated with the TT Taq-I genotype and presented a higher rate of insulin resistance. The AA genotype of the Bsm-I polymorphism presented a more atherogenic serum lipid profile and, therefore, a higher risk of developing cardiovascular disease.

Correlative studies on vitamin D and total, free bioavailable testosterone levels in young, healthy men

The relationship between vitamin D levels and testicular hormonal function in men has not been clearly established. Therefore, we aimed to investigate the relationship between deficiency/insufficiency levels of 25(OH)D and luteinizing hormone (LH), follicle-stimulating hormone (FSH), total (TT), free (FT), and bioavailable testosterone (BT), and sex hormone binding globulin (SHBG) in young, healthy men. We enrolled 176 healthy, active young men aged 18–35 years from a genetically homogenous population of Lower Silesia, Poland. Serum levels of 25(OH)D, LH, FSH, and TT were measured by electrochemiluminescence (ECLIA). FT levels were measured by enzyme-linked immunosorbent assay (ELISA). BT levels were calculated from TT, SHBG, and albumin. SHBG was measured by chemiluminescent immunoassay CLIA. We did not find any significant differences between the mean hormonal values (LH, FSH, TT, FT, BT, and SHBG) and the status of 25(OH)D level (deficient and insufficient). Based on our results, we concluded that there is no relationship between deficient and insufficient 25(OH)D concentration and androgen levels in young, healthy men.

Obesity and low levels of physical activity are associated with a decreased health-related quality of life in postmenopausal women: a Wroclaw pilot study

Background: Menopause is associated with numerous somatic dysfunctions, an increased risk of chronic diseases, and complications in the mental and social components of health that lower the quality of life (QoL). Obesity and related comorbidities affect over 60% of postmenopausal women in Poland. A significant role for systematic physical activity (PA) in the prevention of dysfunctions and chronic diseases, including obesity and mental disorders, has been observed previously. A low level of PA is observed across the Polish population, especially in postmenopausal women. Aim of the study: To examine QoL in postmenopausal women participating in a community health promotion program as it relates to obesity and levels of PA. Material and methods: The study sample consisted of 76 postmenopausal women (aged 65.75±5.14 years) participating in the Active Wrocław 55+ program. Before starting the program, anthropometric measurements were taken, and QoL and PA were assessed using the 36-Item Short Form Health Survey (SF-36) and the International Physical Activity Questionnaire-Short Form (IPAQ-SF), respectively. Results: Most women had a PA level above 600 MET -min/week (78.95%), and were overweight or obese (86.84%). A waist circumference over 80 cm, indicating an increased risk for metabolic syndrome, was observed in 85.89% of the participants. BMI and waist circumference negatively correlated with the level of PA (p=0.001 and p=0.017, respectively). Women exhibiting low levels of PA and higher BMIs showed a significantly lower QoL compared to those with higher PA and lower BMIs, particularly with regard to the physical domains of QoL. Conclusions: Obesity and a low level of PA are associated with a significant decline in the health-related QoL (especially in the PF and PCS domains) of postmenopausal women an urban setting.

Vitamin D and selected cytokine concentrations in postmenopausal women in relation to metabolic disorders and physical activity

Obesity and metabolic disturbances constitute significant health problems in elderly women. Due to the multifactorial background of these disorders, assessing the interaction between risk factors remains a significant part of prevention and health promotion. Studies have illustrated a relationship between low physical activity and vitamin D deficiency with obesity and its complications. Furthermore, vitamin D affects the production of adipokines and the inflammatory response in adipose tissue. The aim of our study was to determine the association between selected adipokines, vitamin D concentrations, physical activity (PA), and visceral adiposity index (VAI) in postmenopausal women. The study sample consisted of 318 ethnically homogenous postmenopausal women aged 50-60. Both anthropometric measurements (BMI, WC, WHR) and biochemical measurements (TC, HDL, LDL, TG, AIP, glucose, insulin, IL-6, TNF-α, adiponectin, leptin) were made, and PA by IPAQ were recorded. Body mass index (BMI), waist-to-hip ratio (WHR), HOMA, atherogenic index of plasma (AIP), and VAI were calculated using the standard formulas. We observed a negative correlation between BMI, WC, insulin, HOMA, and PA. We determined that there is a negative association between leptin and vitamin 25(OH)D concentrations (P = 0.007) and a positive association with adiponectin (P = 0.014). The results of the multiple linear regression analysis indicate that vitamin D and HOMA are independent factors that significantly affect leptin and adiponectin levels, contrary to VAI.

Serum Vitamin D Binding Protein Level Associated with Metabolic Cardiovascular Risk Factors in Women with the Polycystic Ovary Syndrome

The objective of the study was to measure the levels of 25-hydroxyvitamin D [25(OH)D] and vitamin D binding protein (VDBP) and assess their relationships with cardiovascular risk factors in women with the polycystic ovary syndrome (PCOS). A group of 267 women, aged 20-35 years (24.7 ± 4.9): 167 with PCOS and 100 healthy women were divided according to body mass index. Biochemical and hormonal parameters were measured. Free and bioavailable 25(OH)D were calculated using the mathematical equations. The percentage of body fat and visceral fat deposit were assessed by DXA. In the normal weight control group total, free, bioavailable 25(OH)D (p<0.001 for all) were significantly higher than in its overweight/obese counterpart, while VDBP levels were comparable. In PCOS women total 25(OH)D (p<0.001), and VDBP (p -0.006) were lower in the overweight/obese subgroups than in the normal weight ones. In both groups serum VDBP levels correlated negatively with serum insulin and positively with sex hormone binding globulin. In PCOS group, in contrast to control group, VDPB was negatively correlated with abdominal fat deposit, BMI, fasting glucose and positively with HDL. Despite lower total 25(OH)D in obese PCOS women, all women with PCOS (lean and obese) had comparable free and bioavailable 25(OH)D, which might be a result of concomitantly lowered serum VDBP levels in obese PCOS women. VDBP might play important role in the regulation of availability of active fractions of 25(OH)D in PCOS women. VDBP seems to be associated with cardiovascular risk factors such as BMI, waist circumference, visceral fat, and fasting serum insulin in women with PCOS.

Exploratory data analysis of a clinical study group: Development of a procedure for exploring multidimensional data

Thorough knowledge of the structure of analyzed data allows to form detailed scientific hypotheses and research questions. The structure of data can be revealed with methods for exploratory data analysis. Due to multitude of available methods, selecting those which will work together well and facilitate data interpretation is not an easy task. In this work we present a well fitted set of tools for a complete exploratory analysis of a clinical dataset and perform a case study analysis on a set of 515 patients. The proposed procedure comprises several steps: 1) robust data normalization, 2) outlier detection with Mahalanobis (MD) and robust Mahalanobis distances (rMD), 3) hierarchical clustering with Ward's algorithm, 4) Principal Component Analysis with biplot vectors. The analyzed set comprised elderly patients that participated in the PolSenior project. Each patient was characterized by over 40 biochemical and socio-geographical attributes. Introductory analysis showed that the case-study dataset comprises two clusters separated along the axis of sex hormone attributes. Further analysis was carried out separately for male and female patients. The most optimal partitioning in the male set resulted in five subgroups. Two of them were related to diseased patients: 1) diabetes and 2) hypogonadism patients. Analysis of the female set suggested that it was more homogeneous than the male dataset. No evidence of pathological patient subgroups was found. In the study we showed that outlier detection with MD and rMD allows not only to identify outliers, but can also assess the heterogeneity of a dataset. The case study proved that our procedure is well suited for identification and visualization of biologically meaningful patient subgroups.

DIET AND SEMEN QUALITY IN HEALTHY MALES FROM THE POPULATION OF THE LOWER SILESIA REGION IN POLAND (THE ANDROLS STUDY)

Background Numerous studies have shown the associations between different dietary patterns and semen quality in a male population. There is no evidence on the relationship between dietary intake and markers of male fertility potential. The aim of this study was to investigate the relationship between dietary nutrients intake and semen quality parameters among healthy men from Lower Silesia (a region of Poland). Methods We enrolled 177 healthy young men aged 18-35 years from a genetically homogenous population of Lower Silesia (a region of Poland). Those who responded to the invitations were asked to complete the questionnaires covering: medical history and nutritional habits (last 5-day recall diary). The semen samples were analysed with use of the Sperm Class Analyser. Results The results showed a statistically significant positive correlation between the intake of saturated, monounsaturated fatty acids and immotility. The results also demostared a statistically significant positive correlation between energy derived from fat and immotility and rapid (a) and slow (b) progressive motility. As well a statistically negative correlation between the energy value of the diet and sperm concentration, energy derived from the consumption of carbohydrates and semen volume, consistency and the energy derived from the consumption of fat and sperm consistency and immotility was shown. Conclusion Based on our studies we concluded that further research is needed to confirm these findings and extend these results to other populations.

Association of the vitamin D receptor FokI gene polymorphism with sex- and non-sex-associated cancers: A meta-analysis

Currently higher morbidity and mortality rates are observed in cancer diseases, especially sex-dependent cancers. A positive role of endogenous vitamin D concentration in cancer diseases has been reported in many publications. Furthermore, there has been observed a relationship between serum vitamin D and testosterone concentrations in an elderly Caucasian population carrying the vitamin D receptor FokI gene polymorphism. The aim of this study was to investigate whether the vitamin D receptor FokI polymorphism is associated with cancerogenesis in sex-dependent cancers. The MEDLINE and ResearchGate databases were used to search for articles up to January 2017, and 96 articles concerning the FokI polymorphism were chosen. Odds ratios with 95% confidence intervals were used to assess the strength of associations between polymorphisms of vitamin D receptor and cancer risk in the described populations. The fixed-effects model and the DerSimonian-Laird random-effects model (with weights based on the inverse variance) were used to calculate summary odds ratios, and both within- and between-study variation were considered. Generally, the F variant reduces the risk of cancer by 4% (odds ratio = 0.96, p value = 0.0057). This effect is particularly evident in female sex-associated cancers (odds ratio = 0.96, 95% confidence interval: 0.93-0.99, p value = 0.0259), but it is not observed in non-sex-associated cancers. Polymorphism FokI is associated with breast and ovarian cancers.

The quality of semen among a sample of young, healthy men from Lower Silesia (AndroLS)

INTRODUCTION

Contrary to other parts of the continent, little information is available regarding semen quality among subjects from central and eastern Europe.

MATERIAL AND METHODS

We evaluated semen profiles among a sample of men from an industrialised region of Poland. We directly invited 5000 healthy inhabitants of the region (aged 18-35 years; with unchecked fecundity) to participate in the study. Among the 500 who were eligible and willing to participate, we acquired detailed information and semen and blood samples from 177 subjects.

RESULTS

Semen volume, sperm concentration, and total sperm count were, respectively, (mean ± SD): 3.1 ± 1.5 ml, 60 ± 44 x 106/ml and 170 ± 137 x 106/ml. Percentage of normal forms was 14.7 ± 6.5%.

CONCLUSIONS

Due to the relatively low sperm motility (mean ± SD: 54 ± 16%) and vitality (mean ± SD: 60 ± 15%) values, these variables require special attention during routine evaluations. The WHO 2010 criteria for these two parameters were met in only 60% and 66% of the samples, respectively. Further studies on men with different educational levels, social environments, or living conditions are needed to confirm our results.

Trends in the prevalence of autoimmune thyroiditis in the leading private health-care provider in Poland

BACKGROUND

Autoimmune thyroiditis (AT) is one of the most common endocrine disorders affecting a significant percent of the population, especially women. It may have serious and long-lasting consequences. The etiology of AT is multifactorial and it arises from an interplas between environmental and genetic factors. Tendencies in AT prevalence and incidence are unclear. In Poland there are no national registers covering the data on AT prevalence.

OBJECTIVES

The aim of the investigation was to assess changes in diagnosing AT in the largest chain of outpatient medical centers in Poland.

MATERIAL AND METHODS

We compared freqnancy at which AT and hypothyroidism diagnoses were made during endocrinology consultations in the period 2006-2013. The data was extracted from the database of LUXMED (part of BUPA).

RESULTS

Within 8 years, the prevalence of newly diagnosed AT dropped from 10.4% to 4.8% (p < 0.001) alongside with a decrease in the prevalence of newly diagnosed hypothyroidism from 17.8% to 7.7% (p < 0.00001). AT was widespread in young women aged 20-39. There were relatively more cases in the southern areas of Poland.

CONCLUSIONS

The analyzed data does not support a hypothesis indicating a growing incidence of AT in the last years. Detailed epidemiological studies would be helpful in designing screening strategies for patients with this common disorder.

Association of serum glypican-4 levels with cardiovascular risk predictors in women with polycystic ovary syndrome - a pilot study

OBJECTIVE

Glypican-4 (Gpc4) is an adipokine which interacts with the insulin receptor and affects insulin sensitivity in proteoglycans. Insulin resistance plays a crucial role in the etiology of polycystic ovary syndrome (PCOS). PCOS is associated with metabolic disturbances such as abdominal obesity, dyslipidemia and type 2 diabetes. Thus, higher levels of Gpc4 released from visceral adipose tissue in women with PCOS may suggest an increased risk of cardiovascular disease (CVD).

DESIGN

The aim of this pilot study was to determine whether the serum Gpc4 level is associated with cardiovascular risk predictors in women with PCOS.

METHODS

Sixty-two women with PCOS according to the Rotterdam criteria (20-35 years old) and 43 healthy controls were studied. Cardiovascular risk predictors such as obesity indices, fat deposits according to dual-energy X-ray absorptiometry, biochemical lipid profile parameters and Homeostasis Model Assessment were estimated.

RESULTS

The serum Gpc4 level in PCOS women was significantly higher (2.61 ± 1.17 ng/ml) than in the control group (1.55 ± 0.47 ng/ml) and correlated with waist circumference, waist-to-hip ratio, total fat and android fat deposit to gynoid fat deposit ratio only in the PCOS group.

CONCLUSION

The Gpc4 level was higher in the PCOS group and correlated with CVD risk predictors, especially fat distribution.

The problem of obesity in adolescent primary school students from rural and metropolitan areas

Introduction: Obesity and overweight are health problems that particularly increase the risk of metabolic diseases, being a disease entity itself. It is confirmed that nutritious mistakes and hypokinesia constitute the basic threats in alimentary obesity.

The aim of the study: An attempt was made to evaluate the frequency of prevalence of obesity due to consumption habits and motor preferences of children aged 12-13 residing in the Tarłów Commune representing a rural area and children from the Primary School in Wrocław representing a metropolitan area.

Subjects and methods: The scope of the study covered 148 children from both rural and metropolitan areas. The children were divided into 4 groups of 37 based on gender and place of living. BMI indicator and centile charts prepared in OLAF studies for the Polish population were used to evaluate the level of obesity. Custom surveys concerning consumption habits and children motor activity were used to evaluate lifestyle habits. The results of the study were subjected to statistical evaluation using Statistica v. 10 software.

Results: Within the studied group of children aged 12-13 obesity and overweight occurred among 30% of girls and 25% of boys, whereas a tendency for more frequent occurrences of overweight was observed within girls (26%) and obesity within boys (5%). Everyday diet among the studied group depends on their place of living. Girls from a metropolitan area more frequently ate high-fiber products, unsaturated fatty acids and vitamins relative to girls from the rural area. Differences in preferred forms of physical activity based on gender were shown.

Conclusions: There is an urgent need to implement education and preventive or health promotion programs in the field of obesity prevention in rural areas, with special attention to physical activity and modification of consumption habits.

The Frequencies of Haplotypes of FTO Gene Variants and Their Association with the Distribution of Body Fat in Non-Obese Poles

BACKGROUND

The minor allele frequencies (MAFs) of the FTO gene vary substantially among different ethnic groups, and this variation may explain, to some degree, the differences between estimates of the effects of these alleles on body fat distribution indicators.

OBJECTIVES

The aim of this study was to investigate the prevalence of fat mass and obesity associated (FTO) gene variants characterizing the structure of FTO haplotypes in a large Polish population, and to examine the influence of FTO gene variants on body fat distribution among metabolically obese normal weight (MONW) individuals, i.e. those with a normal BMI and visceral obesity.

MATERIAL AND METHODS

A total of 854 non-obese individuals aged from 20 to 40 years, residing in three different regions in Poland, were studied. All the patients from this group were genotyped for four FTO gene variants (rs9939609, rs9930506, rs1421085 and rs1121980). Simultaneous identification of all single nucleotide polymorphisms (SNPs) was conducted using the minisequencing method with a pair of designed specific primers.

RESULTS

Over 90% of the diplotypes contain only the two most common haplotypes, in three combinations of haplotype pairs: CTAT/CTAT comprised 26.9% in women and 30.9% in men; CTAT/TCGA comprised 45.0% in women and 44.4% in men; and TCGA/TCGA comprised 19.3% in woman and 14.8% in men. The analysis of the variance in body fat distribution parameters shows no statistically significant differences between the three common haplotype pairs in either men or women.

CONCLUSIONS

The young Polish population is characterized by two disparate haplotypes of common FTO gene variants: TCGA (a risk SNP haplotype), and CTAT (a protective haplotype). No significant differences were found between fat distribution indicators in relation to haplotypes in either women and men.

Vitamin D receptor gene polymorphisms in Alzheimer's disease patients

THE AIM

The aim of this study was to determine whether polymorphisms of the VDR gene may increase the risk of Alzheimer disease (AD) development in Lower Silesian patients in comparison with other populations.

MATERIAL AND METHODS

108 AD patients (aged 73.7±8.6) vs 77 healthy volunteers (aged 64.5±7.8) in the Lower Silesian population were studied. We investigated the frequency of the VDR polymorphisms rs731236 (TaqI), rs7975232 (ApaI), rs10735810 (FokI) and rs1544410 (BsmI) in the AD group vs the healthy group. Afterwards, MEDLINE and ResearchGate were studied to compare our investigation with other populations, due to the relatively small group size in our study.

RESULTS

We did not observe any significant differences in frequency of genotypes of rs731236 (TaqI), rs10735810 (FokI) or rs1544410 (BsmI) VDR polymorphisms between the two Lower Silesian groups. Frequency of allele A of ApaI in the control group was significantly higher vs AD patients (p<0.0177) in the Lower Silesian population. Furthermore the difference in the occurrence of allele t in TaqI and allele A in ApaI between AD patients vs the control group was significant (respectively p<0.0056, p<0.0140) in British Europeans. This observation may suggest that allele "a" of the ApaI polymorphism is a risk allele in AD Lower Silesian patients. We compared our results with those obtained for the population of British Europeans. In multivariate stepwise regression, allele "A" of ApaI was associated with 30% lower risk of AD (OR=0.70, p=0.0009) in total treated Polish and British populations. We did not observe similar results in Turkish and Iranian populations.

CONCLUSION

Our data suggest that the allele "A" VDR genotype of ApaI reduces AD risk, probably depending on ethnic origin and climatic conditions.

Classic PCOS phenotype is not associated with deficiency of endogenous vitamin D and VDR gene polymorphisms rs731236 (TaqI), rs7975232 (ApaI), rs1544410 (BsmI), rs10735810 (FokI): a case-control study of lower Silesian women

CONTEXT

The role of endogenous vitamin D and vitamin D receptor (VDR) gene polymorphism in polycystic ovary syndrome (PCOS) is still controversial.

OBJECTIVE

The objective of this study was to investigate for the first time in women with "classic" PCOS phenotype and healthy controls the role of the serum endogenous vitamin D level and VDR gene polymorphisms in PCOS etiology.

DESIGN

Ninety-two women with "classic" PCOS phenotype and 85 controls from lower Silesia with comparable body mass index (BMI) were studied. In all women the waist circumference, android/gynoid fat deposit, parameters of lipid and glucose metabolism, testosterone, free androgen index, sex hormone binding globulin (SHBG) and vitamin D were evaluated. Also, VDR gene polymorphisms rs731236, rs7975232, rs1544410 and rs10735810 were assessed.

RESULTS

Serum vitamin D levels in both groups were comparable. Also high, comparable frequencies of hypovitaminosis and vitamin D deficiency in both groups were observed. Women with "classic" PCOS phenotype had statistically significantly higher values of all measured parameters, except serum SHBG and high-density lipoprotein (HDL)-cholesterol, which were lower. The frequency of VDR genotype polymorphism was also comparable in both groups.

CONCLUSIONS

For the first time, we show that endogenous vitamin D deficiency and VDR polymorphisms are not associated with homogeneous "classic" PCOS phenotype.

Selected CNR1 polymorphisms and hyperandrogenemia as well as fat mass and fat distribution in women with polycystic ovary syndrome

The endocannabinoid system is postulated to play an important role in the etiology of obesity, insulin resistance, fat distribution and metabolic disorders. Insulin resistance associated with abdominal obesity plays a leading role in the etiology of hyperandrogenism and other clinical features of the polycystic ovary syndrome (PCOS). A total of 174 women 16-38 years old, diagnosed with PCOS according to the Rotterdam criteria are recruited. Control group consisted of 125 healthy women 18-45 years old. Medical history, physical examination, anthropometric parameters and metabolic parameters were carried out. Six CNR1 gene polymorphisms were diagnosed. We observed a significantly three times higher risk of GG genotype in the polymorphism rs12720071 in women with PCOS versus the control group (p = 0.0344, OR = 3.01). A similar, significant 8-fold higher risk (p = 0.0176, OR = 8.81) was demonstrated for genotype CC polymorphism rs806368 associated with PCOS. We observed a 3.6-fold increased risk of hyperandrogenemia (free androgen index - FAI > 7) in patients with GG genotype in the rs12720071 polymorphism and AA genotype in the polymorphism rs1049353 (OR = 2.7). Our study may indicate a role of the endocannabinoid system in the occurrence of a specific hyperandrogenemia phenotype of PCOS.

Cannabinoid receptor 1 gene polymorphisms and nonalcoholic Fatty liver disease in women with polycystic ovary syndrome and in healthy controls

Context. Polycystic ovary syndrome (PCOS) is frequently associated with nonalcoholic fatty liver disease (NAFLD). The endocannabinoid system may play a crucial role in the pathogenesis of NAFLD. Polymorphism of the cannabinoid receptor 1 gene (CNR1) may be responsible for individual susceptibility to obesity and related conditions. Objective. To determine the role of genetic variants of CNR1 in the etiopathology of NAFLD in women with PCOS. Design and Setting. Our department (a tertiary referral center) conducted a cross-sectional, case-controlled study. Subjects. 173 women with PCOS (aged 20-35) and 125 healthy, age- and weight-matched controls were studied. Methods. Hepatic steatosis was assessed by ultrasound evaluation. Single nucleotide polymorphisms of CNR1 (rs806368, rs12720071, rs1049353, rs806381, rs10485170, rs6454674) were genotyped. Results. Frequency of the G allele of rs806381 (P < 0.025) and the GG genotype of rs10485170 (P < 0.03) was significantly higher in women with PCOS and NAFLD than in PCOS women without NAFLD. Frequency of the TT genotype of rs6454674 was higher in PCOS women with NAFLD (not significantly, P = 0.059). In multivariate stepwise regression, allele G of rs806381 was associated with PCOS + NAFLD phenotype. Conclusion. Our preliminary results suggest the potential role of CNR1 polymorphisms in the etiology of NAFLD, especially in PCOS women.

Cardiovascular disease risk factors associated with low level of physical activity in postmenopausal Polish women

OBJECTIVES

To determine whether physical activity level could have an effect on cardiovascular disease (CVD) risk factors in Polish postmenopausal women.

METHODS

We studied the associations of physical activity (PA) level with obesity indices, unfavorable lipid profile parameters and the insulin resistance index HOMA in 343 postmenopausal Polish women selected from an urban population, aged 50-60.

RESULTS

In the tested sample, a low level of PA significantly increased odds ratios for CVD risk factors such as BMI ≥ 30 kg/m(2), total body fat (TBF) > 75 th percentile, gynoid fat deposit (GFD) > 75 th percentile, total cholesterol (TC) ≥ 5 mM, low-density lipoprotein cholesterol (LDL-C) > 3 mM and HOMA ≥ 1.95.

CONCLUSIONS

Obesity and some metabolic CVD risk factors in postmenopausal women are directly associated with low PA level. Postmenopausal urban women should be persuaded to be physically active, as even moderate activity level seems to be sufficient to reduce the CVD risk in this group of individuals.

Vitamin D receptor gene polymorphism and cardiovascular risk variables in elderly Polish subjects

The aim of this work was to evaluate whether the FokI and BsmI polymorphisms of the VDR gene are associated with anthropometric and biochemical features of cardiovascular disease (CVD) in a Caucasian population aged over 65, participants of the Polish PolSenior study. We performed the study on randomly selected subjects: 427 women and 454 men aged over 65. Measurements of anthropometric parameters were carried out and biochemical parameters were estimated using commercial kits. VDR polymorphisms (rs10735810, rs1544410) were genotyped by PCR and FRLP. The prevalence of BsmI genotypes was 50% Bb, 23% bb, 27% BB in women and 48% Bb, 20% bb, 32% BB in men. The prevalence of FokI was 48% Ff, 22% ff, 30% FF in women and 50% Ff, 18% ff, 32% FF in men. The women bearing the rare allele b differ in homeostatic model assessment (HOMA) (p < 0.049) from women bearing common allele B, and the men differ in insulin level (p < 0.047) and HOMA (p < 0.017). There were no significant differences in anthropometric or biochemical parameters between genotypes in FokI in female and male groups. The common allele B is connected with biochemical risk factors of CVD in older Caucasian men and women.

ADRB3 and PPARγ2 gene polymorphisms and their association with cardiovascular disease risk in postmenopausal women

OBJECTIVES

The contribution of heritability to the development of cardiovascular disease (CVD) is of interest as the identification of genes enhancing the susceptibility of individuals to CVD may help the design of clinical interventions optimized for the individual's genome.

METHODS

We studied the associations of polymorphism of ADRB3 and PPARγ2 genes with obesity indices, unfavorable lipid profile parameters and insulin resistance index HOMA in 343 postmenopausal women.

RESULTS

No association was found between tested polymorphisms and CVD risk factors such as total cholesterol ≥ 5.0 mmol/l, high density lipoprotein cholesterol < 1.2 mmol/l, low density lipoprotein cholesterol > 3.0 mmol/l and triacylglycerols > 1.7 mmol/l. The presence of arterial hypertension and HOMA value ≥ 1.95 were also not related to these polymorphisms. A significant association between PPARγ2 gene polymorphism and total body fat mass (odds ratio = 1.90 at p = 0.037) as well as android fat deposit mass (odds ratio = 1.82 at p = 0.048) was found.

CONCLUSIONS

CVD risk factors in postmenopausal women are not directly associated with the polymorphisms of PPARγ2 and ADRB3 genes. We suggest that some indirect link between PPARγ2 gene polymorphism and susceptibility of postmenopausal women to CVD may exist. This suggestion is based on our finding that high total body fat mass and high android fat deposits are associated with the presence of the Pro12Ala allele of the PPARγ2 gene.

Endocannabinoid type 1 receptor gene (CNR1) polymorphisms (rs806381, rs10485170, rs6454674, rs2023239) and cardiovascular risk factors in postmenopausal women

INTRODUCTION

The risk of cardiovascular diseases (CVD) in women increases with menopausal stage. Obesity with metabolic disorders is the most important risk factor for CVD. The incidence of this phenotype of obesity increases in postmenopausal women. The endocannabinoid system plays an important role in regulation of several metabolic pathways. The aim of this work was to investigate whether genetic variations in the cannabinoid receptor gene (CNR1) can affect cardiovascular risk factors (e.g. fat distribution, obesity, fasting glucose, lipid profile, blood pressure, and free androgen and estrogen indexes) in postmenopausal women.

METHODS

The rs806381, rs10485170, rs6454674, and rs2023239 polymorphisms of the CNR1 gene were genotyped in 384 randomly selected postmenopausal Polish women (aged 50-60) using the minisequencing technique.

RESULTS

The rs806381, rs10485170, rs6454674, and rs2023239 polymorphisms were not significantly associated with anthropometric measures (waist circumference, carbohydrate and lipid metabolism, body mass index [BMI], total fat, glucose, insulin, fasting insulin resistance index [FIRI]). However, the rs2023239 polymorphism was associated with the free androgen index (p = 0.03).

DISCUSSION

It seems that further genotyping of the endocannabinoid receptor gene cannot be used as a significant marker of predisposition to CVD in postmenopausal women, but it would be interesting to study this interrelation on a larger population of postmenopausal women.

Waist circumference and serum adiponectin levels in obese and non-obese postmenopausal women

OBJECTIVES

A proposed missing link between obesity and metabolic disturbances is adiponectin, an adipocyte-derived peptide. Adiponectin is a potent antidiabetic hormone and seems to have a beneficial influence on lipid profile as well. The need to explain the complex physiological roles of this hormone prompted the authors to study the relationship between adiponectin level and obesity - related abnormalities in a homogenous population of postmenopausal women.

STUDY DESIGN

The study involved 272 postmenopausal women aged 50-60 years. Invitations to participate in the study were sent to 4000 randomly chosen women from the Wroclaw city population fulfilling the age criterion. A telephone questionnaire was administered to the group of 1731 women who responded to the invitation and then subjects for the study were selected. Main outcome measures anthropometrical measurements of body fat tissue content and fat tissue distribution assessment were carried out in all the women. Moreover, serum concentrations of adiponectin, glucose, total cholesterol, HDL cholesterol, triglycerides and insulin were measured.

RESULTS

The most frequent (76%) phenotype among the investigated women was obesity (BMI >25) with abnormal (=80cm) waist circumference (OAW), Obesity with normal (<80cm) waist (ONW) and normal weight with abnormal waist (NOAW) were observed in only 5% and 14% of the women, respectively. Non-obese women with normal waist (NONW) were noted in only 5% of the subjects. Serum adiponectin levels in both groups of non-obese women (NOAW and NONW) were significantly higher (p<0.05) than in the women with obesity or overweight and abnormal waist circumference (OAW group). Adiponectin levels in the women with obesity or overweight and normal waist (ONW) were also higher than in the OAW group; however, this difference was not statistically significant (p=0.05). In all the women, serum adiponectin level correlated negatively with BMI (r=-0.34, p=0.0001), total fat (r=-0.28, p=0.0001), android fat deposit (r=-0.23, p=0.0001), waist circumference (r=-0.33, p=0.0001), glucose (r=-0.27, p=0.0001), triglycerides (r=-0.34, p=0.0001), and FIRI (r=-0.34, p=0.0001) and positively with the gynoid/android fat deposit ratio (r=0.28, p=0.0001) and HDL cholesterol (r=0.36, p=0.0001).

CONCLUSIONS

These results confirm that adiponectin could be a marker of the development of menopausal insulin resistance syndrome.

The vitamin D receptor gene BsmI polymorphism is not associated with anthropometric and biochemical parameters describing metabolic syndrome in postmenopausal women

AIM

Vitamin D could have a direct effect on adipocyte differentiation and metabolism and might be involved in glucose regulation of insulin secretion. In recent years several polymorphisms in the gene encoding the vitamin D receptor (VDR), which are potent to alter the activity of VDR protein, have been described. The present study aimed to investigate the prevalence of the VDR BsmI polymorphism and its association with anthropometric and biochemical features of metabolic syndrome in postmenopausal women.

MATERIALS AND METHODS

We studied 351 randomly selected healthy postmenopausal women, with mean age of 55.43 +/- 2.75 years and mean body mass index (BMI) of 27.5 +/- 4.78 kg/m2, to evaluate the frequency of BsmI polymorphism (by restriction fragment length polymorphism-polymerase chain reaction) in the VDR gene and to find out whether there is an association between this polymorphism and BMI, total fat volume and visceral fat (as determined by total body dual-energy X-ray absorptiometry), blood pressure, lipid profile (total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol, triglycerides) glucose and fasting insulin in the whole group, as well as subgroups of obese and non-obese women.

RESULTS

The prevalence of BsmI genotypes in the study group was 51.0% Bb, 37.3% bb and 11.7% BB. Genotype distribution did not differ from that expected under Hardy-Weinberg equilibrium conditions (chi2 = 2.95, p = 0.22). Apart from LDL-C levels (F = 3.46, p = 0.032), there were no significant differences in anthropometric or metabolic parameters between genotypes.

CONCLUSIONS

The BsmI polymorphism in the VDR gene does not seem to predispose to obesity and insulin resistance, but the BB genotype is connected with an unfavorable lipid profile.

beta(3)-adrenergic receptor polymorphism and metabolic syndrome in postmenopausal women

OBJECTIVES

Some studies indicate that the Trp64Arg polymorphism in the gene encoding the beta(3)-adrenergic receptor (ADRB3) is associated with obesity, insulin resistance and earlier onset of type 2 diabetes mellitus. The aim of the present study was to evaluate the frequency of ADRB3 polymorphism and its association with metabolic syndrome in postmenopausal women.

METHODS

We performed the study on 284 randomly chosen postmenopausal women, aged 50-60 years, who were then selected to the study. Measurements of anthropometric parameters and biochemical estimations such as lipid profile, glucose and insulin level in serum were carried out using commercial kits. ADRB3 genotyping was performed by polymerase chain reaction and mini-sequencing.

RESULTS

The frequency of the Trp64/Arg64 genotype in the investigated population was 13%, and of the Trp64/Trp64 genotype, 85%. The Arg64/Arg64 genotype was present in only 2% of women. Metabolic syndrome was recognized in 22% of women bearing Trp64/Arg64 genotype and in 14% of women bearing Trp64/Trp64 genotype, without a statistically significant difference between the two groups (p > 0.05 in the chi(2) test). Women bearing the Trp64/Arg64 genotype had lower serum levels of high-density lipoprotein cholesterol (HDL-C) than Trp64/Trp64 genotype women (63.2 +/- 13.0 vs. 71.4 +/- 17.4 mg/dl). Both groups did not differ in any other investigated parameter.

CONCLUSION

Trp64Arg polymorphism of the beta(3)-adrenergic receptor gene is not related to metabolic syndrome in postmenopausal Polish women; however, it seems to be associated with decreased HDL-C levels.

Post-exercise oxidative stress and obesity in postmenopausal women: the role of beta3-adrenergic receptor polymorphism

AIM

Some studies indicate that the Trp64Arg polymorphism in the gene encoding the beta3-adrenergic receptor (ADRB3) is associated with obesity, insulin resistance and earlier onset of type 2 diabetes mellitus. The aim of the present study was to evaluate the frequency of this polymorphism and its relationship with obesity and oxidative stress in postmenopausal women.

MATERIAL AND METHODS

We performed the study on 200 women, aged 50-60 years. Estimation of anthropometric parameters and total body fat, android and gynoid fat deposits was carried out using dual-energy X-ray absorptiometry. Oxidative stress was estimated by measurement of thiobarbituric acid-reactive substances (TBARS) in serum. Blood for analysis was collected before, directly after and 6 h after a 30-min physical test on a cycle ergometer. ADRB3 genotyping was performed by polymerase chain reaction.

RESULTS

The frequency of Trp64/Arg64 genotype in the investigated population was 12%, and of Trp64/Trp64 was 87%. The Arg64/Arg64 genotype was present in only 1% of women. Women bearing the Trp64/Arg64 genotype did not differ in any measured anthropometric parameters from women bearing the Trp64/Trp64 genotype. Moreover, genotype had no influence on oxidative stress parameters. Likewise, in both groups, mean plasma level of TBARS was increased significantly (p < 0.05) directly after the endurance test and remained elevated 6 h after the test.

CONCLUSIONS

The Trp64Arg polymorphism of ADRB3 seems to not be related to obesity in postmenopausal women. Moreover, the Trp64Arg polymorphism has no influence on oxidative stress intensification after standardized physical effort in postmenopausal women.

[Relationship of beta(3)-adrenergic receptor polymorphism with metabolic syndrome and oxidative stress parameters in postmenopausal women]

INTRODUCTION

Some studies indicate, that the Trp(64)/Arg(64) polymorphism of beta(3)-adrenergic receptor (ADRB3) is associated with obesity, insulin resistance and earlier onset of type 2 diabetes mellitus. The aim of our study was evaluation of frequency of this ADRB3 polymorphism and his association with metabolic syndrome parameters and oxidative stress in postmenopausal women.

MATERIAL AND METHODS

We performed the study among 94 women, aged 50-60, selected randomly from Wroclaw city population. Estimation of anthropometric parameters, densitometry (total body fat, android and gynoid deposits--using DPX(+) Lunar, USA device) and biochemical estimations such as lipid profile, glucose, insulin, estradiol and FSH serum level (using commercial kits) were carried out. Oxidative stress was estimated by measurement of thiobarbituric-reactive substances (TBARS) serum concentration, using Yagi method, on spectrofluorimeter Perkin-Elmer LS55. Blood for analysis was collected before, direct after and 6 h after the 30-minutes physical test using cycloergometer. ADRB3 genotyping was performed by PCR and mini-sequencing using ABI 310 sequencer (Applied Biosystems).

RESULTS

The frequency of Trp(64)/Arg(64) genotype in investigated population was 15.8%. The Arg(64)/Arg(64) genotype had only one woman. Women bearing Trp(64)/Arg(64) genotype showed higher mean serum level of triglycerides and lower serum level of HDL-cholesterol in comparison to women bearing Trp(64)/Trp(64) genotype, however without statistical significance (p > 0.05) (respectively, means +/- SD for triglycerides: 140.3 +/- 64.1 vs. 113.9 +/- 56.2 mg/dl; and for HDL-cholesterol: 60.9 +/- 11.9 vs. 67.0 +/- 16.9 mg/dl). Both groups did not differ in any other investigated anthropometric nor biochemical parameter.

CONCLUSIONS

1. The Trp(64)/Arg(64) polymorphism of beta(3)-adrenergic receptor could be associated with lipid profile disorders observed in metabolic syndrome in postmenopausal women, however it should be explained basing on the study with more included subjects. 2. The Trp(64)/Arg(64 )polymorphism of beta(3)-adrenergic receptor has no influence on oxidative stress intensification after standardized physical effort in postmenopausal women.

[Polymer and oligomer based doxorubicin carriers]

Doxorubicin and other anthracycline derivatives play an important role in the treatment of many malignant diseases. Unfortunately, clinical effectiveness of this class of drugs is limited by cumulative cardiotoxicity which occurs in significant percentage of patients at cumulative dose in the range 450-600 mg/m2. Therefore, several strategies have been developed to reduce cardiotoxicity of doxorubicin and its analogues. One of the possible ways leading to the improvement of anticancer selectivity of doxorubicin is the design of polymer and olygomer carriers which may transport drug molecules more efficiently and more specifically. Synthetic polymers are of increasing interest as therapeutic agents owing to their enhanced pharmacokinetic profiles relative to small molecule drugs. Currently a new class of multifunctional polymers is being prepared that can "mask" biologically active compounds, such as cytotoxic agents, until they reach target sites, but which can then release the agent in situ to effect the therapy. The legitimacy of the development of polymer based doxorubicine carriers is supported by the growing number of clinical reports indicating that the use of hydrophilic polymers or polymer coated liposomes as a platform for delivery of the drug results in better therapeutic effects than the free drug. In this article we present the most promising strategies directed at the development of improved anthracycline drugs formulations based of polymer and olygomer carriers. We review: 1) polyethylenoglycol-coated ("pegylated") liposomal doxorubicin; 2) extracellulary tumor-activated prodrugs which are conjugates of doxorubicin with peptides; 3) doxorubicin coated by higly polymerised glycosoaminoglycans; 4) conjugates of doxorubicin with copolymer of N-(2-hydroxypropyl)methacrylamide.

[Polymeric hearing protectors in sport shooting]

Using hearing protectors during exposition to noise is fundamental to hearing loss prevention. The optimal choice of hearing protectors should take into consideration not only the physical characteristics of the acoustic environment which imply the traumatic action of noise, but also some individual preferences of the user. All contemporary produced hearing protectors both earmuffs as well as earplugs are made of synthetic polymers e.g. ABS, polyvinylchloride, polyethylene, polyurethathane, silicone rubbers. The type of the material used determines hardness, incompressibility and plasticity of the hear protector and may cause some discomfort. A special group of individuals exposed to noise are sport shooters in which (whose) case the exposition to impact noise is several times higher above standards. The aim of this work was an appraisal of the individual preferences in the choice of hearing protectors. The properties of polymers used for the production of hearing protectors were also taken into consideration. 104 females and 93 males representing master class were interviewed in this study. The analysis of the answers indicated that abandoning of hearing protectors by some shooters is due to the frequent skin irritations, overheating in the ear canal and allergy. Shooters linked these problems with the materials used for the production of hearing protectors. Earplugs were preferred by females, whereas males indicated earmuffs as their preferred choice. Females preferred earplugs made of soft materials which can be easily fitted to ear canal. Those males who used earplugs preferred protectors made of hard plastics as they thought this make better insulation. It can be concluded that the choice of the hearing protectors should not be done on the basis acoustic signal characteristics only, but also should reduce some discomforts resulting from properties of the materials used for their production.

[Polymeric drug carriers activated by ultrasounds energy]

In the last two decades an extensive research on the employment of ultrasounds in anticancer therapy has been noticed. So far ultrasounds have been widely used in medicine for diagnostic purposes (ultrasonography), but their great therapeutic potential and the development of polymer based antineoplastic drug carriers have persuaded many investigators to start research on the employment of ultrasounds in anticancer therapy. A new therapeutic concept based on the controlled drug's molecules release from their transporting polymer carriers has been proposed. Cavitation, a phenomenon characteristic for the action of ultrasounds, is used to destroy polymeric drug carriers and for drug release in target sites. The sonodynamic therapy (SDT) which utilizes ultrasonic waves for "acoustic drug activation" leading to the enhancement of cytotoxic activity of some drugs has also been developed. Furthermore, a long standing research on ultrasounds resulted in a new concept based on hyperthermia. This method of cancer treatment does not require any chemotherapeutic agent to be applied.

Prevalence of obesity in Poland

Obesity is an important health problem in Poland affecting adolescents and adults. A study of a Lower Silesian population aged 20-40 years (25 400 participants), between 1993 and 2003, showed an increase in obese women from 8.9% to 15.0%, but no change in men (6.3% vs. 6.5%, respectively). Obesity occurs more frequently in girls and women (6% and 15%) compared to boys and men (4.0% and 6.5%, respectively). Estimation of obesity prevalence in various parts of Poland seems to be regionally dependent; the highest prevalence of obesity was observed in eastern regions of Poland.

Serum adiponectin concentration and cardiovascular risk factors in climacteric women

OBJECTIVE

Adiponectin plays a significant role in the modulation of glucose tolerance and insulin sensitivity. We attempted to evaluate the relationship between adiponectin level and parameters of the menopausal metabolic syndrome: body mass index, waist-to-hip ratio, lipid profile and insulin resistance indices.

SUBJECTS AND METHODS

Thirty-two women and ten men aged 40-63 years were included. The percentage of body fat and of abdominal fat deposits were measured with dual-energy X-ray absorptiometry. Serum adiponectin, tumour necrosis factor-a (TNFalpha) and leptin were measured with commercially available radioimmunoassay kits. To exclude the influence of nutritional factors on adiponectin secretion, diet content was analysed in the preceding three days.

RESULTS

Postmenopausal non-obese women had a non-significantly lower level of adiponectin compared with premenopausal women of corresponding body mass. Serum adiponectin level was significantly lower in postmenopausal obese women than in non-obese women (p = 0.0023). Men with similar age and body mass to the women had the lowest level of adiponectin (p = 0.06). Three months of estrogen replacement therapy in women with surgical menopause did not significantly change the serum level of adiponectin. We found a negative correlation of adiponectin with leptin, insulin resistance index and total cholesterol, and a positive correlation with high-density lipoprotein cholesterol. Adiponectin level was negatively correlated with free testosterone, but we did not find such a relationship with estradiol. There was no correlation of adiponectin level with TNFalpha; however, serum TNFalpha correlated positively with leptin. The dietary analysis showed no differences between the diets of obese and non-obese women over the preceding three days. Moreover, mean diastolic and systolic blood pressures were noted to be significantly lower in premenopausal women than in postmenopausal non-obese women (p = 0.05).

CONCLUSIONS

Our results suggest that adiponectin could be a marker of risk for developing menopausal metabolic syndrome. Moreover, it is possible that sex steroids have an influence on adiponectin secretion.