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Obesity in children causes metabolic and structural changes in blood vessels which lead to the development of cardiovascular diseases and type 2 diabetes., Aim: The aim of the study was to assess the risk factors for atherosclerosis in obese children studied in the One-Day Hospitalization Department of the Institute of Mother and Child., Material and Methods: The study included 75 children aged 6-12 years (36 boys, 39 girls) with aBMI>97th percentile. The control group consisted of 36 children aged 5-10 years (18 boys, 18 girls) with a BMI of 75-90. Analysis was conducted of family history regarding obesity, CVD, dyslipidemia. The children's examination consisted of: BMI, waist circumference, cholesterol, LDL, HDL, triglycerides, and insulin. Both groups had their IMT (left and right) examined with ultrasound., Results: In the study group 82.6% of the obese children had a positive family history of obesity and 72% of CVD and dyslipidemia. Regarding the children from the control group, 34.2% had a family history of obesity and 36.8 of CVD and dyslipidemia. The mean waist circumference in the obese children was 72.7 cm, while in the control group it was 59.9 (<0.001). The mean levels of lipids were higher in obese children (<0.001). The insulin level was almost twice as high as in the control group (±8.47 SD; <0.003). The mean IMT in obese patients was 0.36 mm; ±0.059 SD (right side) and 0.37 mm; ±0.033 SD (left side), while in the control group it was 0.32 mm; ±0.087 SD (right side) and 0.32 mm, ±0.082 SD (left side). The differences between the two groups were statistically significant. A positive correlation between waist circumference and insulin level was found (<0.003)., Conclusions: Obesity and dyslipidemia are more common among children with familial obesity and CVD. Dyslipidemia is statistically more widespread among obese children. IMT is significantly higher in obese children compared with the control group, suggesting that changes in the structure of carotid atherosclerosis may occur in obese children in early childhood. This can be diagnosed using the noninvasive IMT method measured with ultrasound. Children with obesity, especially visceral, have higher levels of insulin, which may contribute to insulin resistance. Parents lack sufficient knowledge about the effects of childhood obesity and its effects on atherosclerosis and cardiovascular diseases., Results: In the study group 82.6% of the obese children had a positive family history of obesity and 72% of CVD and dyslipidemia. Regarding the children from the control group, 34.2% had a family history of obesity and 36.8 of CVD and dyslipidemia. The mean waist circumference in the obese children was 72.7 cm, while in the control group it was 59.9 (<0.001). The mean levels of lipids were higher in obese children (<0.003)., Conclusions: Obesity and dyslipidemia are more common among children with familial obesity and CVD. Dyslipidemia is statistically more widespread among obese children. IMT is significantly higher in obese children compared with the control group, suggesting that changes in the structure of carotid atherosclerosis may occur in obese children in early childhood. This can be diagnosed using the noninvasive IMT method measured with ultrasound. Children with obesity, especially visceral, have higher levels of insulin, which may contribute to insulin resistance. Parents lack sufficient knowledge about the effects of childhood obesity and its effects on atherosclerosis and cardiovascular diseases.

Unlabelled: Arterial hypertension (AH) is one of the main risk factors of negative cardiovascular (CVR) events and the complex evaluation of CVR is necessary for the successful treatment of patients with AH. Simultaneously CVR increases when the inflammatory markers levels are elevated., Aim: The aim of study was to evaluate the frequency of CVR factors presence and their relation to the inflammatory markers in patients with AH., Materials and Methods: The study was conducted in group of 144 patients (99 men, mean age 45.2 years) with AH and no other diagnosed cardiovascular diseases. The clinical assessment included: i.e. fasting glucose (FG), total cholesterol (T-C), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), triglycerides (TG) and inflammatory markers: fibrinogen, high-sensitive C-reactive protein (hsCRP) and leukocytes count (WBC). CVR was assessed based on the presence of the risk factors included in the ESC guidelines., Results: Dylipidemia was observed in over 90% of patients in the study group (most often as the elevated level of T-C and LDL-C), abdominal obesity in 54.9%, more than 3 CVR factors in over 70% and increased levels of at least one of inflammatory markers in 40.3% of patients (most often hs-CRP - 35.4%). The statistically significant correlations between anthropometric parameters (BMI, waist cirfumference), laboratory parameters (HDL-C, TG) and inflammatory markers were observed, the strongest for BMI versus hs-CRP (r = 0.42, p < 0.000001). In the logic regression analysis the factors increasing the probability of the elevated inflammatory activity turned out to be: abdominal obesity - OR 3.05 (95% CI: 1.49 - 12.22; p = 0.002); BMI ≥ 30 kg/m2 - OR 3.18 (95% CI: 1.57 - 6.44; p = 0.0012) and the presence of more than 3 risk factors - OR 2.57 (95% CI: 1.13 - 5.83; p = 0.023)., Conclusions: The increased level of inflammatory markers is related to the complex metabolic disturbances and the assessment of the activation of inflammatory process (especially hsCRP) can be useful in the complex CVR evaluation and profound defining of therapeutical goals., (© 2015 MEDPRESS.)

Introduction: The aim of this study was to answer the question whether there are differences in the type and frequency of risk factors for stroke in patients coming from urban and suburban areas., Material and Methods: The study included patients with a diagnosis of cerebrovascular disease treated in the Department of Neurology, Provincial Hospital in Czestochowa in 2004-2005. Socio-demographic and risk factors for cerebrovascular diseases were determined based on a retrospective analysis of medical records of each patient., Results: The study included 294 patients. 153 persons (52.0%) were from suburban environment, and 141 people (48.0%)--from the urban environment. There were no statistically significant difference in age and gender between the two groups, while the differences in education were significant (p < 0.00001). The most common riskfactorfor stroke was hypertension, more frequent among patients from the city (64.0%) than suburban areas (55.7%), but this difference was not statistically significant. The next most common riskfactorwas dyslipidemia. It was recorded more frequently among patients from the urban environment (30.2%), compared to suburban areas (19.5%) (p = 0.03). There were no differences in the prevalence of other risk factors between the two groups., Conclusions: Hypertension was the most frequently observed risk factor for stroke. The only risk factor significantly differentiating both environments was dyslipidemia. It was identified significantly more often in patients from the city. Prevention of cardiovascular disease should include more frequent occurrence of certain risk factors in patients living in the city, which may be associated with the promotion of an appropriate lifestyle.

Introduction: The history of HIV infection has always been associated with patient nutritional problems, initially in the form of wasting syndrome, and since the introduction of highly active antiretroviral therapy such metabolic disorders as lipodystrophy, obesity, insulin resistance, dyslipidemia that are risk factors for cardiovascular diseases have been observed., Aim: evaluation of nutritional disorders in HIV infected patients using anthropometric parameters: waist circumference, BMI (body mass index) and WHR (waist-hip ratio)., Material and Methods: the study included 72 HIV infected patients (48 men, 24 women, average age 39.4). The control group comprised 27 not infected subjects, matched for age and sex. Physical examination with measurements of body mass, height, waist and hip circumference was performed and the values of two anthropometric parameters--body mass index and waist/hip ratio were calculated., Results: BMI in the group of HIV infected patients was significantly lower than in the control group (23.6 vs. 25.6 kg/m2, p = 0.01). These BMI values are normal, but significantly lower in HIV-infected men compared with not infected, and no differences were found between women. Infected men are less likely to be overweight and obese than not infected ones. Underweight was noted in 6.8% of patients from the study group (6% of men and 4% of women). WHR was significantly higher in the study group comparing with the healthy subjects (0.92 vs. 0.86 p = 0.002), which resulted from significantly lower hip circumference among the infected patients (93.0 vs. 98.3, p = 0.002). Waist circumference was similar in both groups (85.1 vs. 84.0). The WHR value in the infected women was a result of insignificantly higher waist circumference and lower hip circumference. HIV infected women have significantly more often too large waist circumference comparing with not infected ones (46% vs 0%, p = 0.01). In the group of infected men, the WHR value was significantly affected only by low hip circumference, and larger waist circumference was observed with the same frequency as in the control group. According to IDF criteria the central obesity was more frequent in HIV infected than in not infected patients. According to the WHO criteria it was more often diagnosed in infected women compared with not infected ones, which was not recorded in the male group., Conclusions: The prevalence of overweight or obesity in the studied cohort of HIV infected patients is significantly lower than among the not infected people. At the same time the HIV infection is significantly more often accompanied by features of central obesity, expressed as abnormal waist circumference value. HIV infected patients have significantly lower BMI and higher WHR values. Higher WHR in the infected group is due to low hip circumference. HIV infected women usually have normal body weight and are significantly more likely than not infected women to show the features of central obesity as a result of increased waist circumference and low hip circumference. Men infected with HIV, compared with not infected ones, are characterized by lower, normal body weight, and their significantly higher WHR is determined by low value of hip circumference. Waist circumference seems to be an appropriate diagnostic criterion for central obesity in the studied population.

Cardiovascular diseases remain the leading cause of death in Poland and in Europe. Children rarely suffer from them, although most of the risk factors which accelerate progression of atherosclerosis commence in childhood, including: dyslipidemias, hypertension, diabetes, and obesity. Moreover during last few years the incidence of some of risk factors in children, such as obesity, diabetes and dyslipidemia has increased significantly. It is known from the autopsy studies that atherosclerosis can be identified at very young age in healthy children. In adult population medications such as HMG-CoA reductase inhibitors (statins) and acetylsalicylic acid (ASA, aspirin) have strong position confirmed by many multicenter clinical trials. They significantly reduce cardiovascular risk and increase life expectancy. Latest recommendations on management of hyperlipidemias in children expand indications for screening of lipid level imbalances and indicate statins as main pharmacotherapy after failure of life style changes. On the other hand acetylsalicylic acid is not used so broadly. Only children at high risk of thrombosis may benefit from its antiplatelet property. This review presents the latest recommendations and the therapeutic role of these medications in pediatric population.

Nonalcoholic fatty liver disease (NAFLD) is recognized in 20-30% of general population but among the people with impaired glucose metabolism is about 70-90%. There is increasing number publications that show strong association between NAFLD, metabolic syndrome and insulin resistance as risk factors of cardiovascular complication. Gens PNPLAL3 NCAN, LYPAL1 and GCKR that have been linked to lipid metabolism disorders or impaired glucose metabolism can also contribute to development of NAFLD. The reduction of body mass and of known risk factors of atherosclerosis and restriction of simple carbohydrates in diet contribute to regression of NAFLD.

Majority of patients with glaucoma, age-related maculopathy or diabetic macular edema is old. Therefore arterial hypertension, coronary arterial disease, diabetes and dyslipidemia are common finding in patients with sick eye. In this article some situations needing cooperation of cardiologist and ophthalmologist have been pointed. The influence of treatment of hypertension on glaucoma outcomes and the influence of intraocular injections of biological drugs on cardiovascular risk seems to be the most important issues.

Introduction: Obesity can be an additional risk factor for developing cardiovascular diseases in patients with diabetes. Aim of the study was the assessment of overweight, obesity and other elements of the metabolic syndrome in children with type 1 diabetes mellitus., Material and Methods: 300 children treated with insulin at least one year were enrolled in the study. In the examined group anthropometric data, data concerned with diabetes and additional laboratory tests including risk factors for cardiovascular diseases were assessed., Results: The median age of the examined group was 13.7 years. The body mass deficiency was noted in 0.66%, normal body mass in 71.6%, overweight in 15.3% and obesity in 12.3%. The abdominal obesity was noted in 16.0% of children. The rise in the body weight between 3-6 months from the beginning of the insulin therapy and the present assessment was statistically significant. Children with normal weight had a better metabolic control in comparison to children with overweight/obesity. Girls had a higher rise in body mass index values between the time of diagnosis and the present investigation compared to boys. Higher values of blood pressure or hypertension were noted in 16.6% of children. Altogether in 25.3% of children some dyslipidemia was observed. The metabolic syndrome criteria were noted in: 28.0% - one criterion, 13.0% - two criteria, and 0.3% - three criteria., Conclusions: The population of children with type 1 diabetes is characterized by high frequency of overweight/obesity, abdominal obesity, dyslipidemia and hypertension. The features of metabolic syndrome are less frequent. It is worthwhile to monitor the risk for development of cardiovascular diseases in this group of children.

Background: Obesity affects approximately 45 millions of children worldwide. Some of them present with secondary dyslipidemia that leads to premature atherosclerosis., Aim of the Study: 1) Assessment of the frequency and type of dyslipidemia in obese adolescents. 2) An attempt at defining risk factors of atherogenic lipid profile in obese adolescents., Material and Methods: In 146 (84 girls/62 boys) obese (mean BMI SDS 4.95, 95% CI 4.62-5.29) adolescents (age 10-18, mean 14.7 years), the levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDLc), high-density lipoprotein cholesterol (HDLc) and triglicerydes (TG) were measured. Atherogenic dyslipidemia was defined as a high TG level with a concomitant low HDLc level. Standard oral glucose tolerance test was performed with the assessment of fasting and after 120' post-load of 75 g of glucose and insulin levels; the insulin resistance index HOMA-IR was calculated., Results: The mean values of the lipid fractions were in normal ranges: TC 4.64 mmol/L (95% CI 4.48-4.8), LDLc 2.86 mmol/L (95% CI 2.73-2.99), TG 1.4 mmol/L (95% CI 1.3-1.5), and HDLc 1.16 (95% CI 1.1-1.2). However, in 50.69% of the patients (45.24% girls and 58.06% boys), elevated levels of TC, LDLc, and TG were observed respectively in 23.29%, 17.81% and 37.67%, and low HDLc in 15.07% of patients. A total of 10.96% of the patients presented with coexistence of a low HDLc and a high TG. In 26.7%, dyslipidemia was followed by arterial hypertension. There was a reverse correlation between a low HDLc value and BMI SDS [R (-) 0.22, p < 0.05] and not with TC, LDLc, and TG. The relative risk of abnormal lipid profile occurrence was higher in obese patients with insulin resistance (OR 1.72; 95% CI 0.8-3.4; p = 0.12), being significant only for boys (OR 3.67; 95% CI 1.1-12.1; p = 0.03). There was a reverse correlation between fasting insulin level, HOMA-IR and HDLc [R (-) 0.2; p < 0.05; R (-) 0.2; p < 0.05) respectively], as well as TG (R 0.26 ; p < 0.05; R 0.26; p < 0.05, respectively), and between post-load insulin level and TG (R 0.24; p < 0.05)., Conclusions: 1) Lipid disorders occur in about one-half of obese adolescents, of which 10% presents with atherogenic lipid profile. 2) One of the most important risk factors of atherogenic lipid profile occurrence is insulin resistance, especially in boys. The severity of the obesity (BMI-SDS) is of lesser importance.

Cigarette smoking is a well known independent risk factor for a more severe course of Crohn's disease, but individual factors determining this impact are poorly known and it is not evident if smoking cessation is associated with an improvement in the disease activity. The aim of our study was to assess the factors determining the harmful impact of smoking in individuals with Crohn's disease. A total of 148 consecutive patients with Crohn's disease and Crohn's disease activity index < 200 were enrolled in a prospective 12-18 month study. Patients were classified into three groups as: current smokers, former smokers, and nonsmokers. Body mass index, alcohol consumption, oral contraceptive use and blood lipid levels were also recorded. The main outcome measure was the rate of fare-up. We observed the flare-up developement in 38% current smokers, versus 21% non-smokers and 26% former smokers. The relative risk of flare-up adjusted for confounding factors was 1.37 (1.09 +/- 1.96) in current smokers. Obesity, dyslipidaemia, and alcohol consumption had no significant effect. Current smoking, particularly heavy smoking, significantly increases the risk of flare-up in Crohn's disease patients. Former smokers have a risk similar to that of non-smokers.

Genetic disorders play an important role in the ethiopathogenesis of disease processes in humans. In the present paper we have described documented genes polymorphisms associated with dyslipidemia. Some of them have been known for years, but some have been discovered quite recently. Their characteristics an impact on lipid profile are presented. Discussed are their direct relationship with atherosclerosis and cardiovascular diseases.

The term metabolic syndrome (MS) refers to a clustering of risk factors of metabolic origin that promote the development of cardiovascular disease and type 2 diabetes. Metabolic syndrome includes such pathological factors as insulin resistance, hyperinsulinemia, abdominal obesity, impaired glucose tolerance, type 2 diabetes, microalbuminuria, high level of triglycerides, low level of HDL cholesterol, elevated blood pressure, and proinflammatory and prothrombotic state. Several organizations have recommended clinical criteria for the diagnosis of metabolic syndrome. The most widely accepted were the worked out by the World Health Organization (WHO), the European Group for the Study of Insulin Resistance (EGIR), and the National Cholesterol Education Program--Third Adult Treatment Panel (NCEP-ATP III). In 2005, IDF experts proposed a universally accepted diagnostic tool that is easy to use in clinical practice and does not rely on measurements available only in research settings. All groups agreed on the core components of the metabolic syndrome: obesity, insulin resistance, dyslipidemia, and hypertension. Their criteria are similar in many aspects, but they also reveal fundamental differences in their positioning of the predominant causes of the syndrome. This study provides a brief overview of current definitions of metabolic syndrome, with particular reference to the differences between them, and presents critical remarks on the concept of metabolic syndrome and its usefulness. It also presents epidemiological data which consider metabolic syndrome and its association with increased risk of cardiovascular disease and type 2 diabetes.

Unlabelled: Actual European guidelines for the management of arterial hypertension (AH) have recognized the importance of renal function impairment on long-term prognosis in patients with this condition. Chronic kidney disease (CKD) is defined as glomerular filtration rate (GFR) below 60 ml/min/1.73 m2 and is associated with increased risk of cardiovascular events particularly among patients with AH. The aim of the study was to evaluate the predictors for CKD in patients with AH., Material and Methods: The study was performed in 748 consecutive hospitalized patients with diagnosed and treated essential AH. We estimated GFR using abbreviated Modification of Diet in Renal Disease (MDRD) equation and assessed relationship between clinical and laboratory parameters with GFR below 60 ml/min/1.73 m2 (analysis of variance and logistic regression analysis)., Results: According to estimated GFR using the MDRD formula, CKD (GFR below 60 ml/min/ 1.73 m2) was found in 314 patients (42%). Patients with CKD were significantly more likely to be older, to have atherogenic dyslipidemia and clinical manifestations of atherosclerosis (coronary heart disease, prior myocardial infarction and cerebral atherosclerosis). Women more likely (71%) fulfilled criteria for CKD. Independent predictors of GFR value below 60 ml/min/1.73 m2 (CKD) were: age > 65 years, woman gender and atherogenic dyslipidaemia, there was a trend for clinical manifestations of atherosclerosis (p = 0.079)., Conclusions: CKD is present in about 40% of patients with AH. Simple clinical parameters (age > 65 years, female gender, atherogenic dyslipidemia, clinical manifestations of atherosclerosis) are predictors of the prevalence of this serious complication of AH which is characterized by high cardiovascular risk. More frequent estimation of GFR in clinical practice will allow to identify this population of patients earlier.

Unlabelled: Recent guidelines of the European Society of Hypertension (ESH) and the European Society of Cardiology (ESC) for the management of arterial hypertension (AH) have recognized the importance of renal function impairment on cardiovascular (CV) prognosis in patients with this condition. Chronic kidney disease (CKD) is associated with increased risk of CV risk and end-stage renal disease (ESRD) particularly among patients with AH., Aim of the Study: Our aims were to assess the frequency of CKD according to assessed values of glomerular filtration rate (GFR) in patients with essential AH and distribution of traditional risk factors of cardiovascular diseases in this population., Material and Methods: The study was performed in 749 consecutive hospitalized patients with diagnosed and treated essential AH. All patients were subjected to complete history, physical examination and laboratory studies including lipid profile, fasting glucose and creatinine concentration. We estimated GFR using abbreviated MDRD (Modification of Diet in Renal Disease) formula. According to K/DOQI (Dialysis Outcome Quality Initiative), CKD was defined as GFR below 60 ml/min/1.73m2., Results: Mean age in studied group was 68.8 years (57.8% female). CKD diagnosed according to estimated GFR was found in 314 patients (42%). Women more likely (71%) fulfilled criteria for CKD in studied group. Patients with CKD were significantly more likely to be older, to have atherogenic dyslipidemia and a history of cardiovascular diseases (coronary heart disease, prior myocardial infarction, heart failure) (p < 0.01)., Conclusions: According to the ESH/ESC guidelines, CKD among AH patients is associated with high risk of CV complications and ESRD. This group of AH patients requires a integrative therapeutic strategy including optimal blood pressure control together with modification of traditional cardiovascular risk factors and treatment of established CV diseases. To identify this high risk population the systematic assessment of GFR and other CV factors should be done in every case of AH, especially in older and female patients.

Unlabelled: Atherosclerosis is one of the most common causes of mortality in developed countries. One of the many factors in its etiopathogenesis are reactive oxygen species (ROS), excess of which comes from disturbances of enzymatic and nonenzymatic mechanisms of antioxidant barrier. THE AIM OF THIS STUDY was to estimate relations between the activity of chosen parameters antioxidant barrier and the lipid levels in children with atherosclerosis risk factors., Material and Methods: The study was carried out on 48 children with atherosclerosis risk factors. The control group consisted of 25 healthy children. Total cholesterol (TC), Triglycerides (TG), HDL-C, LDL-C were determined by enzymatic method. The activity of superoxide dismutase (SOD) was estimated by Misra and Fridivich's method, glutathione peroxidase (GSH-Px) with method proposed by Sedlak and Lindsay in modyfication Little and Brien and the activity o catalase (CAT) by Beer and Sizer's method. Malonyl dialdehyde (MDA) concentration was determined by Placer's method., Results: Obesity, lipid disorders, and hypertension were the most frequent risk factors in the investigated children. Statistically significant higher concentration of TC, LDL-C, TG and lower HDL-C were observed in children with atherosclerosis risk factors. Activity of glutathion peroxidase was statistically significant higher in children with atherosclerosis risk factors (p < 0.001), activity of catalase was lower (p < 0.05). No significant differences in activity of superoxide dismutase and malonyl dialdehyde were observed in the investigated groups., Conclusion: Modificated activity of selected antioxidants in children with atherosclerosis risk factors could determine an index of antioxidant barrier and might potencially constitute the marker of early atherosclerotical risk development.

Purpose: The aim of this study was to perform a retrospective analysis of selected risk factors and their variability in a 10 years period of observation in patients with ischemic heart disease (IHD)., Material and Methods: We reviewed 5219 questionares of patients hospitalized at internal wards of the Internal Medicine Institute of the Pomeranian Medical University in Szczecin. Among the participants 1709 were females with mean age 56.3 +/- 7.1 and 3510 males with mean age 54.46 +/- 7.96. Multivariate logistic regression analysis of the relationship between the: analysed risk factors and the hospitalization year, age and sex of patients was used., Results: Among all risk factors, cigarette smoking appeared most frequently (43.93% of patients) followed by arterial hypertension (32.90%), lipid disturbances (25.78%), obesity (16.26%), type 2 diabetes (13.79%), family history of IHD (8.46%), impaired glucose tolerance (5.8%), hyperuricaemia (3.62%) and type 1 diabetes (1.1%). Cigarette smoking and hyperuricaemia appeared markedly more often in men in comparison to women (p < 0.0002) in whom arterial hypertension and obesity significantly dominated (p < 0.0001)., Conclusions: During the 10-years period of observation a significant raise of arterial hypertension, dyslipidemia, hyperuricaemia, type 2 diabetes mellitus and impaired glucose tolerance was found. Hovever, some positive changes such as a decrease in number of cigarette smokers and obesity among women were detected. In conclusion, the results of our study show that between 1983 and 1992 there was a domination of negative changes among the IHD risk factors. This was more pronounced in the studied group of females in comparison to males.

During last fifty years several investigations were performed enabling detection and description of close relationships between kidneys and heart. It is dealing both with connections important for maintenance of homeostasis and with pathological disturbances. On the other hand there are no doubts that chronic kidney diseases, and especially their chronic failure, are connected with development of deep cardio-vascular changes. This interrelationship is becoming more clear when similiarities between factors causing progress of renal failure and development of cardio-vascular changes on the othe hand are concluded. So the main important issue is early prevention and after recognition of their existence early specific therapy.

Cardiovascular disease is the leading cause of death in renal transplant recipients. Death with a functioning graft is the main cause of graft failure. Risk factors for cardiovascular complications and modification of methods are discussed.