Six week follow-up of metabolic effects induced by a high-fat diet and streptozotocin in a rodent model of type 2 diabetes mellitus

This study was initiated to refine and characterize a nongenetic experimental model of type 2 diabetes mellitus and to follow up various metabolic parameters up to six weeks after diabetes induction. Male Wistar rats were divided into 4 groups: CON group--consumed standard rat chow and served as control; HFD group--consumed high-fat diet (45% calories as fat); STZ group-was injected once intraperitoneally with streptozotocin (35 mg/kg) on day 14, and DM-2 group--consumed high-fat diet and was injected with streptozotocin. The metabolic parameters were measured one week after streptozotocin injection (week 3) and at the end of the study (week 9). Our results confirm that HFD-group developed dyslipidaemia, obesity and insulin resistance. All metabolic parameters remained largely unaltered in STZ-group during the study. Only the combination of high-fat diet and streptozotocin (DM-2 group) induced type 2 diabetes that was characterized with moderate hyperglycaemia, insulin resistance, hypertriglyceridaemia, elevated free fatty acids, hypercholesterolaemia and increased plasma glucagon levels at the time of diabetes onset (week 3). The observed changes of the metabolic parameters after six additional weeks demonstrated an aggravated diabetic state, as confirmed from significantly increased fasting plasma glucose values, insufficient insulin secretion, severe hyperlipidaemia, increased glucagon levels, decreased serum adiponectin concentrations and significantly elevated urinary protein excretion. These results indicate that apart from its utility as a model of diabetes aetiology, this model could also be used for elucidating the role of the hormones adiponectin and glucagon in the progression of type 2 diabetes, as well as for investigating the diabetic complications.

Measles outbreak in Macedonia: epidemiological, clinical and laboratory findings and identification of susceptible cohorts

OBJECTIVES

Despite a 92-99% national vaccination coverage since 2000, the former Yugoslav Republic of Macedonia experienced a large measles outbreak between 2010 and 2011. Here we investigate the characteristics of patients hospitalized during this outbreak at the Clinic of Infectious Diseases in Skopje.

METHODS

Epidemiological, clinical and laboratory data of 284 measles patients, including 251 from Skopje (43.80% of the 573 reported cases) and 33 from elsewhere in Macedonia were collected.

RESULTS

The most affected age groups were children up to 4 years of age and adolescents/adults of 15 years and older. Most patients were unvaccinated (n=263, 92.61%) and many had non-Macedonian nationalities (n=156, 54.93%) or belonged to the Roma ethnicity (n=73, 25.70%). Bronchopneumonia and diarrhea were the most common complications. Eighty-two out of 86 tested patients (95.35%) had measles-specific IgM antibodies. The outbreak was caused by the measles variant D4-Hamburg.

CONCLUSIONS

The epidemic identified pockets of susceptibles in Skopje and indicated that additional vaccination opportunities in particular for people with non-Macedonian nationality and traveler communities are warranted to ensure efficient measles control in Macedonia. The high attack rate among children of less than 1 year suggests that vaccination before 12 months of age should be considered in high risk settings.

Hyperhomocysteinemia and of Methylenetetrahydrofolate Reductase (C677T) Genetic Polymorphism in Patients with Deep Vein Thrombosis

AIM

To determine the concentration of total plasma homocysteine (tHcy) as well as different genotypes of methylenetetrahydrofolate reductase MTHFR (C677T) in healthy subjects and patients with deep vein thrombosis (DVT).

MATERIAL AND METHODS

The investigation comprised a total of 160 subjects divided in two main groups: 80 healthy subjects (control group) and 80 patients with deep vein thrombosis. Concentration of tHcy was determined by spectrophotometric cyclic enzymatic method and mutation of MTHFR (C677T) gene was examined by polymerase chain reaction according to Schneider.

RESULTS

The results obtained for plasma tHcy in the control group were 11.62±3.43 μmol/L, while tHcy level was significantly higher in patients with deep vein thrombosis as compared to the control group, 15.19±3.63 μmol/L (р<0.001). The analysis of the results has shown that MTHFR (C677T) genetic polymorphism was responsible for mild to moderate hyperhomocysteinemia in the majority of subjects.

CONCLUSION

The level of tHcy in the examined patients was significantly higher in comparison with the control group. Multiple regression analysis has shown that tHcy level in CT and TT genotypes of MTHFR (C677T) was statistically higher in comparison with CC genotype of MTHFR (C677T) in both, the control group and the DVT patients.

Symmetric dimethyl arginine and N-acetyl-β-D-glucosaminidase lysozimuria of proximal renal tubules as a target for nephrotoxicity in patients with rheumatoid arthritis treated with disease modifying antirheumatic drugs

BACKGROUND

The aim of this study was to determine the effect of initial therapy with some disease modifying antirheumatic drugs (DMARDs) (Methotrexate and Ketoprofen) on glomerular and tubular integrity in patients with Rheumatoid arthritis (RA).

OBJECTIVES

OBJECTIVES

To determine whether there is a change in clinical and laboratory indicators of renal function in course of the follow up of treatment and whether that change correlates with the dynamics of the quantity of enzymes excreted in urine and reactants of the acute phase.

MATERIALS AND METHODS

Using colorimetric method for determination of NAG, samples of 70 participants were examined (35 RA patients treated with Ketoprofen only, 35 RA patients treated with combined use of Methotrexate and Ketoprofen). The follow up was 5 time-intervals in the course of 24 weeks.

RESULTS

There was moderate correlation between NAG and microalbuminuria (r=0,34) in the group of patients treated with Ketoprofen only, while statistically significant correlation (r=0,21) was seen in group of patients with combined use of Methotrexate and Ketoprofen. NAG enzymuria in size, number of patients registered, and time of appearance were greater and appears earlier in the group with the combined use of Methotrexate and Ketoprofen compared with the mono-therapy with Ketoprofen. Mean urinary NAG induction was increasing with the concomitant use of Methotrexate and Ketoprofen.

CONCLUSIONS

Methotrexate is more potent NAG inductor than Ketoprofen and provokes greater tubular enzymuria than Ketoprofen.

Cholesteryl ester transfer protein, low density lipoprotein particle size and intima media thickness in patients with coronary heart disease

Cholesteryl ester transfer protein (CETP) plays a key role in reverse cholesterol transport and high density lipoprotein (HDL) metabolism. Predominance of small, dense LDL particles is associated with an increased risk of atherosclerosis and coronary heart disease (CHD).The aim of the study was to determine the potential relationship between the CETP concentration and low density lipoprotein (LDL) particle size and their association with intima media thickness (IMT) in patients with CHD. Lipid parameters, CETP concentration and LDL particle size were determined in 100 healthy subjects (control group) and in 100 patients with CHD, aged 43 to 77 years. Plasma CETP concentrations were measured by an enzyme-linked immuno-sorbent assay with two different monoclonal antibodies. LDL subclasses were separated by nondenaturing polyacrilamide 3-31% gradient gel electrophoresis. CETP concentration was higher in patients compared to controls (2.02 ± 0.75 mg/ml vs. 1.74 ± 0.63 mg/ml, p<0.01). Mean LDL particle size (nm) was significantly smaller in patients than in controls (24.5 ± 1.1 vs. 26.1 ± 0.9; p<0.001). There was no relation between LDL particle size and CETP concentration (r=-0.1807, p=0.072). Age, diastolic blood pressure, CETP concentration and LDL particle size were independent factors for determing IMT by multiple linear regression analysis. They accounted for 35.2 % of the observed variability in IMT. CETP is not an independent contributor of LDL particle size. CETP might play a role in determining lipoprotein distributions, but did not seem to be the sole factor in the formation of small LDL particles.

Lipoprotein (a) and apolipoprotein (a) phenotypes in healthy Macedonian children

BACKGROUND

Plasma levels of lipoprotein(a) [Lp(a)] are determined largely by genetic variation in the gene encoding apolipoprotein(a) [apo(a)], the unique protein component of Lp(a). High plasma levels of Lp(a) increase the risk of premature atherosclerosis. However, the association of apo(a) phenotypes with the development of these diseases remains largely unexplored.

OBJECTIVES

Determination of Lp(a) levels and apo(a) isoforms (phenotypes) in 100 (51 boys, 49 girls) Macedonian healthy children aged 9-18.

METHODS

We used 3-15 % gradient SDS-PAGE for separation of apo(a) isoforms. According to the different apo(a) electrophoretic mobilities, Apo(a) was classified into five single and respective double-band phenotypes.

RESULTS

Each individual expressed a single (homozygotic), double-band (heterozygotic) or no band (null phenotype). The apo(a) phenotype frequencies revealed that the frequency of single-band phenotype expression (64 %) was higher than that of double bands (32 %) and that the frequency of phenotypes representative of low molecular weight was very low (4%). The most frequent phenotype was S4 (42.65%). The distribution of plasma Lp(a) levels was skewed, with the highest frequencies at low levels. The mean Lp(a) concentration was 11.95 (SD of 5.98 and median of 9.62 mg/dL). We did not find differences in the mean and median plasma Lp(a) levels between boys and girls (p > 0.05). A strong inverse relationship was found between the apparent molecular weight of apo(a) phenotypes and plasma Lp(a) concentration (r = -0.4257).

CONCLUSIONS

Determination of Lp(a) levels and apo(a) phenotypes in children, may help in preventing and reducing the risk of atherosclerotic development (Tab. 6, Ref 32). Full Text (Free, PDF) www.bmj.sk.

Distribution of low density lipoprotein subclasses in Macedonian children

BACKGROUND

Current reports claim that small and dense LDL particles are more atherogenic than larger LDL particles. There are many studies presenting LDL subclass distribution in adults, but there is not enough data regarding children in the literature on this problem. The aim of our study was to examine LDL subclass distribution in healthy children in the Republic of Macedonia.

MATERIALS/METHODS

Plasma LDL subclasses in 100 children aged 9-18 years were analyzed using non-denaturing polyacrilamide gradient (3-31%) gel electrophoresis. Conventional plasma lipid and apoprotein parameters thought to be related to LDL size were determined as well.

RESULTS

The results obtained showed the prevalence of large LDL subclasses (phenotype A) in 89% of the children, whereas small LDL subclasses (phenotype B) were observed in 11%. The mean LDL size was 26.37 +/- 0.68 nm, and there was no difference between gender groups. No association was noted between LDL size and plasma lipid and apoprotein levels, age, or BMI.

CONCLUSIONS

LDL size and distribution is not gender- or age-dependent, or influenced by plasma lipid and apoprotein concentrations in childhood. This suggests that analysis of LDL subclass phenotype may provide better information on the risk of atherosclerosis development in adulthood.

Reference intervals of Apo A-1 , Apo B and Apo B/Apo A-1 ratio in sample of macedonian population

The disorders of serum concentration of Apolipoproteins A-1 and B (Apo A-1 and Apo B), as well as of Apolipoprotein B/Apoliporotein A-1 ratio (Apo B/ Apo A-1) are considered to be independent risk factors for coronary heart disease. It is recommended that each laboratory should asign its own reference intervals for Apo A-1 and Apo B, as well as for Apo B/Apo A-1 ratio, as these depend on the geographical location. For this purpose we determined the serum concentration of Apo A-1 and Apo B and we calculated the Apo B/Apo A-1 ratio in 122 healthy individuals from Macedonian population (70 women and 52 men), aged 18-60 years. We used commercial, standardized manual immunoturbidimetric assay (Randox). The obtained concentrations (x ± SD) were: Apo A-1 = 1.39 ± 0.28 g/l in the female population and 1.42 ± 0.27 g/l in the male population, Apo B = 0.95 ± 0.24 g/l in the female and 1.00 ± 0.23 g/l in the male population. The calculated Apo B/Apo A-1 ratio was 0.70 ± 0.17 in the female subgroup and 0.72 ± 0.18 in the male subgroup. Student's t-test detected no significant difference (p>0.05) in mean values for Apolipoproteins A-1 and B and for Apo B/Apo A-1 ratio between female and male subgroups, which lead to the conclusion that division according to sex is not necessary from diagnostic point of view. The Apo A-1 and Apo B concentrations estimated for the mixed group (N=122) were 1.40 ± 0.28 g/l and 0.97 ± 0.23 g/l. The Apo B/Apo A-1 ratio estimated for whole group was 0.71 ± 0.17. The type of distribution of values for Apo A-1, Apo B and Apo B/A-1 ratio was tested by calculating the values of coefficient of asymetry (Skewness), coefficient of flatness (Kurtosis) and standard deviations of these coefficients. The distribution of values was according to Gaussian curve for all three parameters. Therefore, according to the normal distribution reference intervals for Apo A-1, Apo B and Apo B/Apo A-1 ratio was estimated parametrically (mean ± 2 standard deviations). Reference intervals for Apo A-1 were 0.84 - 1.96 g/l, 0.51 - 1.43 g/l for Apo B and 0.37- 1.05 for Apo B/Apo A-1 ratio.