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Background/Aim. Macroangiopathy is the major cause of death and disability in type 2 diabetic patients. Studies have shown that liraglutide, a glucagon-like peptide 1 (GLP-1) receptor agonist, can protect cardiovascular system by inhibiting chronic inflammation of diabetes. However, a study about the effects of liraglutide on peripheral blood vessels and peripheral blood leukocytes has not been reported yet. The aim of this study was to determine vasculoprotective effect, vascular protection and mechanism of action of liraglutide in addition to its hypoglycemic effect. Methods. A total of 60 hospitalized patients with type 2 diabetes were recruited from December 2013 to December 2014 at the First Affiliated Hospital of Dalian Medical University, PR China. Before the treatment with liraglutide, height and weight were measured to calculate body mass index (BMI). Blood urea nitrogen (BUN) and so on were detected. Homeostasis model assessment of insulin resistance (HOMA-IR) and islet β cell function (HOMA-β) were computed. After applying liraglutide for three months, all indexes were measured again. The effects of liraglutide on these indexes were analyzed by paired sample t-test. Results. After the treatment with liraglutide, values of glycosylated hemoglobin ‒ HbA1c (8.46 ± 1.62 vs. 7.26 ± 1.40%) and 2h postprandial blood glucose ‒ 2hPBG (11.95 vs. 9.6 mmol/L) decreased significantly (p < 0.05). Body weight (87.3 vs. 82.5 kg) and BMI (30.37 vs. 28.63 kg/m2) decreased by 5.5% and 5.7%, respectively (p < 0.05). Also, levels of triglycerides (TG) (2.57 ± 1.54 vs. 1.81 ± 0.70 mmol/L) and LDL-cholesterol (2.92 ± 0.78 vs. 1.89 ± 0.66 mmol/L) reduced significantly (p < 0.05). Ankle-brachial index (ABI) decreased from 1.24 ± 0.10 to 1.14 ± 0.06 cm/s by 8%, while brachial-ankle pulse wave velocity (ba-PWV) decreased from 1,442.15 ± 196.26 to 1,316.85 ± 146.63 cm/s by 8.7%, and both differences were statistically significant (p < 0.001). Conclusion. Liraglutide, with a good hypoglycemic effect, can significantly reduce postprandial blood glucose and HbA1c, but cannot significantly improve fasting plasma glucose, insulin resistance and islet β cell function. It also considerably decreased body weight, BMI and TG. Liraglutide can significantly lower ba-PWV and ABI to protect peripheral blood vessels.

Background/Aim: The positive effect of thermal mineral waters on human health has been known for a long time. Many pathophysiological mechanisms of action of balneotherapy are not specified. Patients with gonarthrosis often have elevated values of serum lipids. This study aimed to examine the effect of drinking sulphate-sulphide thermo mineral water on the lipid status of patients with gonarthrosis. Methods: A prospective clinical study followed 60 patients, both sexes, mean age 65.02 ± 1.03, with gonarthrosis. All inpatient underwent physical treatment with topical application of sulphate-sulphide mineral water. Patients of group A (N = 30) had the use of this mineral water as an additional therapy by drinking, unlike patients of group B (N = 30) who drank plain water. The level of serum lipids of these patients was monitored at admission and 4 weeks after. The variance analysis test (ANOVA) with a level of statistical significance p < 0.001 was used for statistical analysis. Results: A significant reduction in the levels of all lipid fractions in the serum of patients with gonarthrosis was found 4 weeks after the completion of inpatient physical treatment in both study groups. This decrease was statistically significant in patients of group A (p < 0.001). Conclusion: Drinking sulphate-sulphide mineral water in patients with gonarthrosis shows a positive effect on the reduction of serum lipid levels in the short-term follow-up period.

Biopolymer-based materials present good alternatives for synthetic materials. However, their high water sensitivity may limit their usage for food products packaging. Addition of hydrophobic components into the material formulation could improve this property. In this work 3, 4 and 5 % (v/v) of Satureja montana or Ocimum basilicum essential oil was incorporated into biopolymer films based on pumpkin oil cake. The obtained materials were analyzed regarding mechanical, physicochemical, barrier and structural properties. Incorporation of the essential oils increased the thickness of the pumpkin oil cake film. Significant reductions in moisture sensitivity, related to physicochemical properties and water vapor transmission rate (almost for 30 %), were observed (p < 0.05). Improvement of light barrier properties was also observed so that the visible light transmission was decreased for around 50 % while the UV light transmission was lower than 1 %. The obtained FTIR spectra confirmed the presence of added essential oils in pumpkin oil cake films, as well as their influence on the reduction in the film surface hydrophilicity. However, mechanical properties, tensile strength and elongation at break, decreased significantly (p < 0.05). These results suggest that incorporation of Satureja montana or Ocimum basilicum essential oil improved barrier properties of pumpkin oil cake-based films and reduced the film affinity toward water.

Background/Aim. The influence of lipid profile on acute myocardial infarct (AMI) is well known. On the other hand, the role of testosterone (T), as one of the possible predictive factors of AMI in men and its influence on lipid profile in men is still controversial. The aim of the study was to determine levels of T in AMI and six months after AMI in the same group of patients, and to compare with T levels in healthy men. Also we correlated T levels with lipid profile in patients with AMI and 6 months after AMI. Methods. The study was designed as prospective study. Patients were divided into III groups: Group I included 35 men, aged 55 ± 3 years, with AMI. Group II included the same 35 patients, analyzed 6 months after AMI. The group III consisted of 20 healthy men aged 57 ± 2.12 years (control group). Blood samples of the group I (AMI) were taken in the first 12 hours from the AMI beginning and also 6 months after AMI (group II). Following analyses were performed: levels of total cholesterol, triglycerides, low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL) cholesterol, lipoprotein(a) [Lp(a)], apolipoprotein A1 (Apo A1), apolipoprotein B (Apo B) and T. Results. Levels of T in patients with AMI (16.86 ± 7.18 nmol/L) as well as 6 months after AMI (18.12 ± 7.96 nmol/L) were statistically significantly lower than those in healthy persons of the same age (27.11 ± 10.48 nmol/L) (p < 0.001). In the group I, statistically significant, positive correlation was found between levels of T and HDL cholesterol (r = 0.403, p < 0.05), and levels of T and Apo A1 (r = 0.747, p < 0.01). In the group II, statistically significant, positive correlation was also found between levels of T and HDL cholesterol (r = 0.388, p < 0.05) and T and Apo A1(r = 0.354, p < 0.05). Conclusion. This study showed that men, over 40 years of age, with AMI had statistically significantly lower concentrations of endogenous T compared to healthy male population of the same age. Levels of T in the same patients after 6 months from AMI maintained statistically significantly lower values in comparison to those in healthy men.

Background/Aim. In menopausal women lipid and lipoprotein values are important predictors of development of cardiovascular diseases (CVD). The use of estrogens reduces levels of low density lipoprotein cholesterol (LDLC) and lipoprotein A [Lp(a)], and increases levels of triglycerides (TG) and high density lipoprotein cholesterol (HDL-C) depending on the dose and route of administration. Simultaneous administration of progesterone, depending on the type, can have different effects on lipids. The aim of the study was to examine the effect of estroprogestagen therapy on the lipid metabolism of women in menopause, depending on the administration route. Methods. A study was conducted as prospective clinical interventional study with controlled parallel groups. It included 64 women in menopause, divided into three groups: the group 1 (n = 22) on oral therapy with estroprogestagens, the group 2 (n = 17) on transdermal patch therapy with estroprogestagens and the group 3 (n = 25) treated with estroprogestagens given intramuscularly. The following biochemical parameters in the serum were determined: total cholesterol (TC), HDL-C, LDL-C, TG, Lp(a), apoprotein A (Apo-A), apoprotein B (Apo-B), follicle- stimulating hormone (FSH), luteinizing hormone (LH), estradiol, progesterone, testosterone, sex hormonebinding globulin (SHBG), dehydroepiandrosterone sulfate (DHEA-SO4), prolactin and thyroid-stimulating hormone (TSH), prior to administration of the menopausal hormonal therapy (MHT), as well as after sixth months and 2–5 years from the beginning of the therapy. The statistical significance of the difference in values obtained was examined independently and depending on the route of MHT application. Results. MHT, regardless of the administration route, led to a statistically significant continuous decrease of TC, LDL-C and Apo-B levels and the continuous increase of HDL-C and Apo-A levels. Serum levels of TC, LDL-C, HDL-C, Lp(a), Apo-A and Apo-B did not show a statistically significant differences among groups of women given MHT by different routes. It was found that the serum level of Apo-A increased significantly with the rise of estradiol, and the values of LDL and Apo-B decreased regardless of the route of the MHT application. Conclusion. MHT introduced in time, regardless of the route of administration, has beneficial effects on the lipid status of menopausal women and consequently might prevent numerous cardiovascular diseases that are the leading cause of mortality.

Background/Aim. Glycosylated haemoglobin (HbA1c) is currently the gold standard for glucose monitoring in the patients with diabetes. The aim of the present study was to examine the level of success in implementing international guideline targets with regard to glycaemic control in the patients with type 2 diabetes in the Republic of Srpska. This study also aimed to determine the association of albuminuria with the glycaemic control and lipid levels in this patient population. Methods. The participating diabetic patients were those registered in the project titled ’’Estimation of the quality of glycoregulation and presence of vascular complications in the persons with diabetes in the Republic of Srpska.” The study was conducted as a cross-sectional study including 1037 patients. HbA1c was determined by a turbidimetric inhibition immunoassay used Roche Diagnostics. Total cholesterol, triglycerides, LDL-C, and HDL-C were determined by reagents from Roche Diagnostics (Roche Diagnostics, Mannheim, Germany) as well as albumin and creatinine in the urine. Results. Mean value for HbA1c was 7.35 ± 1.61% (57 ± 18 mmol/moL). The 49.46% of all participants achieved target values of HbA1c (< 7% or 53 mmol/moL) and 40.30% had albumin to creatinine ratio (ACR) < 30 mg/g. When the patients were divided according to HbA1c (with HbA1c < 7%, 519 patients, and HbA1c ≥ 7.0%, 510 patients) the ACR values were different between these groups (39.00 vs. 79.50, p < 0.001). We found no significant difference with respect to lipid status between the groups. Conclusion. The patients with type 2 diabetes in the Republic of Srpska, in a large percentage, did not meet targets for glycaemic control. Improvements are necessary in the treatment and maintenance of this disease process to ensure achievement of goals in management of diabetes, which in turn would decrease longstanding complications of type 2 diabetes.

Background/Aim. Alcohol is the most common cause of fatty liver. Alcohol metabolism takes place in the liver by alcohol dehydrogenase, to toxic acetaldehyde, with fatty acids accumulation in the liver as a consequence. By daily intake of the amount greater than 80 g/day for men and 20 g for women, there is the risk for developing the alcoholic fatty liver (AFLD). The aim of this study was to determine the profile of atherogenic factors in plasma of patients with AFLD compared to patients with non-alcoholic fatty liver (NAFLD) and determine its diagnostic significance. Methods. The study included 74 patients with AFLD who consumed alcoholic beverages daily in large quantities and over 80 g [for men: 3–4 units (U) of alcohol and for women 2–3 U]; the control group consisted of 70 patients with NAFLD verified with ultrasound. A total holesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and apoliporoteins (ApoA1 and ApoB) were determined and the ratios TC/HDL-C, ApoB/ApoA1 and LDL-C/HDL-C were calculated. Results. The study included two group: 74 AFLD patients (21% of women and 79% of men), mean age 42.65 ± 9.73 years, who consumed alcoholic beverages daily in the amounts of 80 g, or greter, during the average 2.31 ± 0.96 years and 70 patients with NAFLD (37.5% of women and 63.5% of men) with the average 41.3 ± 4.1 years. There was no significant difference in gender distribution and the average age between the examined groups. Higher values of TG – 9.94 ± 2.94 mmol/L, TC 14.53 ± 2.81 mmol/L, LDL-C 8.57 ± 2.15 mmol/L and ApoB 3.97 ± 0.28 g/L and lower values of HDL-C 0.43 ± 0.11 mmol/L, Apo A1 0.49 ± 0.09 g/L and ApoB/ApoA1 ratio 2.43 ± 1.27 were registered in the AFLD group compared to those registered in the NAFLD group, (TG 8.74 ± 2.54 mmol/L TC 9.87 ± 2.36, LDL-C 6.72 ± 1.98 mmol/L, Apo B 2.38 ± 0.16 g/L, HDL-C 0.78 ± 0.09 mmol/L, Apo A1 0.98 ± 0.04 g/L and ApoB/ApoA1 ratio 7.81±1.42). There were no differences in albumin concentration, international normalized ratio (INR) and values of haemoglobin and haematocrit between the groups. Conclusion. Lipids and the ApoB/ApoA1 ratio, besides markers of hepatocelular damage, can serve as a diagnostic criteria for the presence of AFLD, and as a better indicator of atherogenic risk.

Background/Aim. Some oligoelements are now investigated as possibly having a role in atherosclerosis. The aim of this study was to compare the concentrations of copper and zinc in the serum and carotid plaque and parameters of lipid metabolism in patients with different morphology of carotid atherosclerotic plaque. Methods. Carotid endarterectomy due to the significant atherosclerotic stenosis was performed in 91 patients (mean age 64 ± 7). The control group consisted of 27 patients (mean age 58 ± 9), without carotid atherosclerosis. Atheroscletoric plaques were divided into four morphological groups, according to ultrasonic and intraoperative characteristics. Copper and zinc concentrations in the plaque, carotid artery and serum were measured by atomic absorption spectrophotometry. Results. Serum copper concentrations were statistically significantly higher in the patients with hemorrhagic in comparison to those with calcified plaque (1.2 ± 0.9 μmol/L vs 0.7 ± 0.2 μmol/L, respectively; p = 0.021). Zinc concentrations were statistically significantly lower in plaques of the patients with fibrolipid in comparison to those with calcified plaques (22.1 ± 16.3 μg/g vs 38.4 ± 25.8 μg/g, respectively; p = 0.024). A negative significant correlation was found for zinc and triglycerides in the serum in all the patients (r = -0.52, p = 0.025). In the control group we also demonstrated a positive significant correlation for low-density lipoprotein cholesterol and copper in the serum (r = 0.54, p = 0.04). Conclusion. The data obtained in the current study are consistent with the hypothesis that high copper and lower zinc levels may contribute to atherosclerosis and its sequelae as factors in a multifactorial disease. Further studies are necessary in order to conclude whether high concentration of copper and zinc in the serum could be risk factors for atherosclesrosis.

Total protein and lipid contents were analysed in 5 samples of canned fish (sardines, Atlantic mackerel fillets, tuna in olive oil, smoked Baltic sprat and herring fillets) available on the Serbian market. Standard methods for the determination of protein (Kjeldahl method) and lipid (Soxhlet method) contents were used on drained samples. The protein content was 21.31% on average, with a range of 18.59% - 24.17%. Total lipids showed considerably large variations (5.49% - 35.20%), and averaged 18.88%. The observed differences, particularly in lipid content, were due to different fish species - the highest values were found in the meat of pelagic fish from northern seas (herring), but were also associated with the preservation (canning) technology used.

Introduction. Menopause leads to the development of central adiposity, a more atherogenic lipid profile and increased incidence of metabolic syndrome independent of age and other factors. Objective. The aim of the study was to investigate the relationships between anthropometric characteristics, sex hormones, lipids and fasting glucose in menopausal women. Methods. The study included 87 menopausal women, who where divided into groups according to two criteria: BMI≥26.7 kg/m2 and BMI≥25 kg/m2. Anthropometric characteristics and blood pressure were measured. Blood was taken at 08.00 h for fasting glucose, triglycerides, cholesterol, HDL, LDL, apolipoprotein A, apolipoprotein B, lipoprotein(a) (Lp(a)), C-reactive protein, fibrinogen, follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), estradiol, progesterone, testosterone and sex hormone binding globulin (SHBG). Results. Significant differences between groups were found for weight, BMI, waist, hips circumference, waist/hip ratio (WHR), systolic and diastolic blood pressure, Lp(a), FSH, LH, PRL (for systolic blood pressure p

Background/Aim. Cardiovascular morbidity and mortality are markedly increased in chronic renal failure (CRF). The aim of this study was to evaluate lipid parameters and bioindices in patients with different stages of CRF. Methods. In 46 hemodialysed (HD), 50 CRF patients with II, III and IV stage of CRF (non-HD) and 48 control subjects triglycerides (TG), total cholesterol (C), HDL-C, urea, creatinine, creatinuria (standard biochemical methods), apolipoprotein (apo) AI, apo B, lipoprotein(a), cystatin C (immunoturbidimetric method) were evaluated, and LDL-C, non-HDL-C, LDLC/ HDL-C, non-HDL-/HDL-C, TG/HDL-C, and new bioindices, LTI (lipid tetrad index), logLTI, LPI (lipid pentad index), logLPI, AIP (atherogenic index of plasma), and creatinine clearance were calculated. Results. There were significant differences in the levels of TG, HDL-C, LDL-C, non- HDL-C, total C and apo A-I between the HD and non-HD patients, and the HD patients and the controls. LTI and LPI were significantly higher in the HD and non-HD patients compared to the controls (p < 0.05), without a good separation by the Box-Whisker plots. The values of TG/HDL-C ratio and AIP were significantly higher in the HD and non- HD-patients compared to the controls (p < 0.05), and significantly higher in the HD compared to non-HD patients (p < 0.05). AIP > 0.11 was found in 71.7% of the HD, 56% of non-HD and 31.3% of the controls. Conclusion. Among lipid parameters and indices, AIP and TG/HDL-C ratio are most suitable for evaluation of lipid disturbances in different stages of CRF. In addition to, non-HDL-/HDL-C, and apoB/A-I ratios, apo A-I, HDL-C and TG are important markers in HD patients. Non-HDL-C is not a suitable marker. LTI and LPI need to be further investigated.

Background/Aim. There are studies stressing out that atherosclerosis is most common associated systemic condition in patients with retinal artery occlusion. The aim of this study was to analyze values of body mass index and lipid fractions in healthy individuals and patients with retinal artery occlusion. Methods. This study included 90 participants during a 6-year period. The population was divided into 2 groups: the group with the diagnosed retinal artery occlusion and the group without retinal artery occlusion. The observed parameters were as follows: body mass index, low and high density lipoproteins and triglycerides. Results. The study revealed no significant difference regarding body mass index and triglycerides values between the two evaluated groups, while low and high density lipoproteins values were significantly higher in the group of patients with retinal artery occlusion. Conclusions. The study demonstrated that body mass index and triglycerides have less important role in atherogenic pathogenesis of retinal artery occlusion, while low density lipoprotein is the fraction that is shown to be most potent in such etiological processes.

Background/Aim. It has been proved that a highly sensitive C-reactive protein (hsCRP) can be used as an established marker of chronic inflammation for cardiovascular risk assessment. Since mean values of both low-density cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) decrease during aging, the knowledge that increased hsCRP concentration predicts mortality (Mt) would influence therapy and treatment outcome. The aim of this study was to examine importance of chronic low grade inflammation and its association with lipid risk factors for all-cause Mt in functionally dependent elderly. Methods. The participants of this longitudinal prospective study were 257 functionally dependent elderly aged 65-99 years. Baseline measurements: anthropometric measurements, blood pressure, fasting plasma total cholesterol (TC), triglyceride (TG), HDL-C, LDL-C, non- HDL-C, hemoglobin A1c (HbA1c) were recorded and different lipid ratios were calculated. Inflammation was assessed by the levels of white blood cells, fibrinogen and hsCRP. The participants with hsCRP grater than 10 mg/L were excluded from the study. The residual participants (77.4% women) were divided into three groups according to their hsCRP levels: a low (< 1 mg/L, n = 70), average (1 to 3 mg/L, n = 69), and high (3-10 mg/L, n = 69) hsCRP group. Associations of all-cause Mt with different risk factors were examined using logistic regression analysis. Results. The hsCRP level showed a significant positive correlation with waist (r = 0.199, p = 0.004) and hip (r = 0.187, p = 0.007) circumferences, body mass index (r = 0.143, p = 0.040) and serum triglyceride level (r = 0.139, p = 0.045) and significant negative correlation with HDL-C (r = -0.164, p = 0.018). Ratios TC/HDL-C and TG/HDL-C were significantly smaller in the low hsCRP group compared to the average hsCRP group (p = 0.019, p = 0.045, respectively) and without significant differences compared with the high hsCRP group. Two years after the baseline examination 22.1% participants died from all-cause Mt. After adjustment for other risk factors, a TC was significantly associated with all-cause Mt only in high hsCRP group: Odds ratio (OR) = 3.71 (95% confidence interval-CI : 1.09-12.63). Conclusions. In this study a high hsCRP was an important factor to identify functionally dependent elderly at high risk who may have more benefit from agressive lipid lowering treatment.

Introduction. Lipid peroxidation and antioxidant systems are important factors affecting the metabolism of lipoproteins in diabetes mellitus. Objective. The aim of this study was to investigate the lipid and antioxidant parameters in type II diabetes mellitus patients, and also to determine the effect of diabetic complications on these parameters. Method. Lipid status, Oxidized LDL cholesterol, glutathione peroxidase (GSH-Px), superoxide dismutase (SOD) and plasminogen activator inhibitor (PAI-1) levels in plasma of 50 type II diabetic patients were measured with commercially available kits. Results. The results showed only statistically significant higher levels of triglycerides (3.12±3.9 mmol/l) in diabetics compared with the controls. Ox-LDL cholesterol (84.7±16.9 mmol/l) and SOD activities (913.4±120.3 U/gHb) in type 2 diabetes mellitus were higher than those of the controls, but there was no statistical significance. On the other hand, in patients with diabetes mellitus and complications, LDL cholesterol, PAI-1, SOD and GSH-Px activities were higher but not significantly than those without complications. Triglycerides and Ox-LDL cholesterol were lower in the group of diabetic patients with complications in comparison to the group without complications. Conclusion. These results indicate that antioxidant status may be affected in type II diabetic patients and that the rise in some enzyme activities could be a compensatory mechanism to prevent tissue damage. Our results suggest that the rise in PAI-1 in type II diabetics with complications may be a good marker of vascular endothelial dysfunction.

Introduction: Atherogenic lipid profile is an important risk factor in development of atherosclerosis in menopausal women. High level of small dense LDL, that is more susceptible to oxidation, and high levels of inflammatory markers are also associated with an increased risk for development of atherosclerosis. Objective. The aim of this study was to investigate the relationship between lipid profile, oxidized LDL (Ox-LDL) and C-reactive protein (CRP) as inflammatory reaction in healthy women dependent on age and menopause. Method. The study included a group of clinically healthy women (total of 97 women). Group 1: 15 women younger than 45 years; group 2: 62 women between 46 and 55 years, group 3: 20 women between 56 and 65 years, group of menopausal women (73) and group of premenopausal women (24). None of the women had history of obesity, diabetes mellitus, cerebrovascular, ischaemic heart disease, and hypertension. Lipid profiles were measured by enzymatic methods. Ox-LDL was measured by using a specific monoclonal antibody, mAb4E6. CRP was measured using hemiluminiscent methods (Immulite-DPC). Results. Results showed significantly higher levels of total cholesterol (p

Introduction Obesity is often accompanied by a number of complications including diabetes mellitus and cardiovascular diseases. Elevated blood pressure and lipids, as well as deterioration of glucoregulation are attributed, as the most significant factors, to development of diabetes mellitus and cardiovascular complications in obese patients. Objective The aim of our study was to evaluate the effects of a fasting diet on blood pressure, lipid profile and glucoregulatory parameters. Method We included 110 patients (33 male and 77 female; mean age 35±1 years, body weight 131.7±2.6 kg, body mass index 45.4±0.8 kg/m2) who were hospitalized for three weeks for the treatment of extreme obesity with the fasting diet. At the beginning, during, and at the end of this period, we evaluated changes in blood pressure, lipid profile, as well as parameters of glucoregulation including glycaemia, insulinaemia, and insulin sensitivity by HOMA. Oral glucose tolerance test (OGTT) was performed in all patients at the beginning and at the end of the fasting diet. Results During the fasting diet, the body weight decreased from 131.7±2.6 kg to 117.7±2.4 kg (p

Background/Aims. Overt hypothyroidism is disease associated with accelerated arteriosclerosis and coronary heart disease. Whether subclinical hypothyroidism (SH) is associated with increased cardiovascular risk is contraversial. As SH is a high prevalence thyroid dysfunction, specially in older women, it is important to evaluate cardiovascular risk factors in these patients and that was the aim of this study. Methods. We examined 30 patients with SH and 20 healthy controls. Subclinical hypothireoidism was defined as an elevated thyrotropin (TSH) (> 4.5 mU/L) and normal free thyroxine (FT4) level. In all the participants we determined body mass index (BMI), blood pressure, TSH, FT4, antibodies to thyroid peroxidase, antibodies to thyroglobulin, total cholesterol, high density lipoprotein (HDL) cholesterol, low density lipoprotein (LDL) cholesterol, triglicerides, total cholesterol/HDL cholesterol ratio and LDL/HDL cholesterol ratio. Results. Mean BMI in patients with SH was significantly higher (p < 0.05), as well as diastolic blood pressure (p < 0.01) compared with the controls. Average levels of total cholesterol (5.40±0.62 vs 5.06±0.19 mmol/l, p < 0.01) and triglycerides (2.16±0.56 vs 1.89±0.24 mmol/l, p < 0.05) were also significantly higher in the group with SH. Individual analysis revealed that the percentage of patients with SH having borderline elevated total cholesterol (63.33%), hypertrigliceridemia (43.33%) and elevated total cholesterol/HDL cholesterol ratio (26.67%) were significantly higher than the percentage in the controls. No significant correlation between TSH and lipid parameters was detected. Conclusion. Subclinical hypothyroidism was associated with higher BMI, diastolic hypertension, higher total cholesterol and triglicerides levels and higher total cholesterol/HDL cholesterols ratio. This might increase the risk of accelerated arteriosclerosis in patients with SH.

Background/Aim. Tibolone is a preparation that belongs to the group of steroidal substances. The effects of the use of the use of tibolone are the consequence of the activities of its metabolities, considering that their hormonal activity depends on the type of tissue in which they develop. The aim of this study was to evaluate the influence of the use of tibolone on risk factors for the development of cardiovascular diseases in postmenopausal women. Methods. A prospective observational stady included 94 patients who had the concentration of l7ß estradiol < 50 pg/ml, and who was in menopause more than a year. Out of the total number of patients, 63 accepted to receive tibolone 2.5 mg daily (tibolone group), while 31 of the patients refused to take tibolone (control group). We measured the concentration of lipids (cholesterol, LDL cholesterol, HDL cholesterol, triglicerides), antitrombin III, fibrinogen, and C-reactive protein, before and after the treatment within a 6-month period. Then, we compared the difference between the values of concentrations and tested the statistical significance of the difference. We also evaluated the changes of values in the concentrations of the examinated parameters inside a 6-month period in the control group. Results. In 31 patients of the control group, from the control group there were no significant changes in the values of the defined parameters as compared to their initial values after six months. But there were changes of statistical significance (p < 0.001) in values of the concentrations of the exeminated parameters before and after the treatment in the tibolone group. In fact, we recorded decreases in the total cholesterol by 17.8%, HDL cholesterol by 27%, LDL cholesterol by 4% (without statistical significance p > 0.05) and triglicerids by 35%. There were no statistical differences in the concentrations of antitrombin III, fibrionogen, and C-reactive proteine in the tibolone group before and after the treatment. Conclusion. The use of tibolone dose decrease the concentration of the total cholesterol, triglicerides, HDL cholesterol, without a significant decrease of LDL cholesterol. Also, the use of tibolone does not have any significant effect on the concentrations of antitrombin III, fibrinogen and C-reactive proteine. The number of serum parameters measured in this study was limited, thus that was the reason to discuss only about the metabolism of lipids in the patients from the tibolone group. The final conclusion about the risk for cardiovascular diseases in the patients on tibolone, howerer, reqnires were extensive further clinical exeminations.

Background. Abnormal lipid profile is an important risk factor in the development of macrovascular atherosclerotic complications in patients with type 2 diabetes mellitus (T2D). Factors that contribute to endothelial cell dysfunction associated with the initiation of atherosclerosis include oxidative stress. The aim of this study was to investigate the relationship between lipid profile and oxidative stress in type 2 diabetics with and without ischemic heart disease (IHD). Methods. We studied 80 patients with T2D, 40 with IHD (group A1) and 40 without IHD (group A2). We also studied 51 non-diabetics, 31 with IHD (group B1), and 20 without IHD (group B2 - control group). Lipid profile was estimated by the total cholesterol, HDL cholesterol, LDL cholesterol, the level of triglyceride (Tg), lipoproteina a (Lp a), Apo A I, A II, B 100 and E. To evaluate the oxidative status we measured circulating oxidized LDL (ox LDL), erythrocyte antioxidative enzyme activity: superoxide dismutase (E-SOD), glutathione peroxidase (E-GPX), as well as the total antioxidative serum activity (TAS). Inflammatory reaction was estimated by C-reactive protein (CRP) and fibrinogen. Results. No significant difference was found in the lipid profile in groups A1, A2 and B1, but the group B2 had the lowest one. Lp a level was significantly higher in group B1 comparing to other groups (p < 0.05). There was no significant difference in the level of ox LDL between the groups. In diabetics, ox LDL positively correlated with the total cholesterol, LDL cholesterol, non HDL cholesterol, Apo B 100 and the relations between LDL/HDL and Tg/HDL (p < 0.001), as well as with Tg and fibrinogen (p < 0.05). In group B1, ox LDL positively correlated with total cholesterol, Tg (p < 0.01), LDL, and non HDL cholesterol (p < 0.05) and significantly with Apo B 100 (p < 0.001). There was no significant difference in the antioxidant enzyme activities between the groups of diabetics (A1 and A2), but fibrinogen was higher in the group with IHD (group A1, p < 0.05). Group B1 had lower ESOD activity than the groups A1 and A2 (p < 0.05), but CRP was higher (p < 0.05). There were no significant correlations between oxLDL and CRP in groups A1 and A2, but it was statistically significant in the group B1 (p < 0.05). Conclusion. In this study we demonstrated the increased oxidative stress in diabetics compared to non-diabetics regardless of the presence of IHD. Fibrinogen, but not CRP, was higher in diabetics with IHD, compared to diabetics without IHD. The increased oxidative stress, the reduced antioxidative activity E-SOD, and the higher level of CRP were found in non-diabetics with IHD compared to non-diabetics without IHD.

Polycystic ovary syndrome (PCOS) is considered a metabolic disorder closely related to obesity, insulin resistance (IR), hyperinsulinemia and unfavorable lipid profile, all increasing the risk for the occurrence of cardiovascular diseases. The aim of this study was to assess age and body mass index (BMI) related changes of cardiovascular risk factors in 90 women with PCOS. The cut-off age point was 30 years and for BMI 27.8 kg/m2. In all patients systolic and diastolic blood pressure (BP), metabolic parameters comprising values of glucose and insulin during oral glucose tolerance test (OGTT), and basal lipid values were determined. Significant increase in blood pressure (BP) indices, basal insulin values and insulin resistance (IR) assessed by HOMA model were observed with aging and the increase of BMI, while the parameters of glucose metabolism, total cholesterol and triglycerides were significantly elevated only with aging. However, the correlation between the indices of arterial blood pressure, and lipid and glucose metabolism parameters occurred only in patients over 30 years of age, pointing to the causative relation and the consequent deterioration of IR and lipid profile with aging, influencing cardiovascular function in women with PCOS.

The aim of this study is to emphasize the fact that the use of anabolic-androgenic steroids (AAS) is an important social, and not only a sport, problem. The significance of AAS use is reflected in the high frequency of abuse (especially among young persons) and in the serious adverse effects of long-term use. A successful prevention of AAS abuse requires that the society undertake comprehensive actions in addition to the already present adequate models of prevention. The purpose of such actions is to weaken the motivation to use ASS. The state and society can participate by means of the following: better and more effective legislation; systematic, modern, and institutionalized education; and development and strengthening of specific individual personality traits. [ABSTRACT FROM AUTHOR]

Background/Aim. It has been proved that a highly sensitive C-reactive protein (hsCRP) can be used as an established marker of chronic inflammation for cardiovascular risk assessment. Since mean values of both low-density cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) decrease during aging, the knowledge that increased hsCRP concentration predicts mortality (Mt) would influence therapy and treatment outcome. The aim of this study was to examine importance of chronic low grade inflammation and its association with lipid risk factors for all-cause Mt in functionally dependent elderly. Methods. The participants of this longitudinal prospective study were 257 functionally dependent elderly aged 65-99 years. Baseline measurements: anthropometric measurements, blood pressure, fasting plasma total cholesterol (TC), triglyceride (TG), HDL-C, LDL-C, non-HDL-C, hemoglobin A1c (HbA1c) were recorded and different lipid ratios were calculated. Inflammation was assessed by the levels of white blood cells, fibrinogen and hsCRP. The participants with hsCRP grater than 10 mg/L were excluded from the study. The residual participants (77.4% women) were divided into three groups according to their hsCRP levels: a low (< 1 mg/L, n = 70), average (1 to 3 mg/L, n = 69), and high (3-10 mg/L, n = 69) hsCRP group. Associations of all-cause Mt with different risk factors were examined using logistic regression analysis. Results. The hsCRP level showed a significant positive correlation with waist (r = 0.199, p = 0.004) and hip (r = 0.187, p = 0.007) circumferences, body mass index (r = 0.143, p = 0.040) and serum triglyceride level (r = 0.139, p = 0.045) and significant negative correlation with HDL-C (r = -0.164, p = 0.018). Ratios TC/HDL-C and TG/HDL-C were significantly smaller in the low hsCRP group compared to the average hsCRP group (p = 0.019, p = 0.045, respectively) and without significant differences compared with the high hsCRP group. Two years after the baseline examination 22.1% participants died from all-cause Mt. After adjustment for other risk factors, a TC was significantly associated with all-cause Mt only in high hsCRP group: Odds ratio (OR) = 3.71 (95% confidence interval-CI : 1.09-12.63). Conclusions. In this study a high hsCRP was an important factor to identify functionally dependent elderly at high risk who may have more benefit from agressive lipid lowering treatment. [ABSTRACT FROM AUTHOR]

Bacground/Aim. Vast majority of patients with corotid arthery sclerosis do not have transitory ischemic attacs (TIA) as working to the persistent silent disease, but stroke is the first sign. Precise and early diagnosis of the carotid artery disease and plaques are very important. The aim of this study study was to determine how the composition / identity of diagnostic methods, color-Doppler, ultrasonography (US) CT-multidetector angio (MDCTA) scan and intraoperative (IO) findings, as well as the morphology of plaques in patients with haemodynamic significant stenosis of the internal carotid artery. Methods. Carotid plaques were observed by two diagnostic methods, US and MDCTA, and these findings were correlated with the IO findings. Results. In 62 patients both carotid artheries were examined and 83 plaques were observed. There were 68 surgical interventions. The structure of plaques was divided into four types: lipid, fibrous, fibrocalcified and calcified plaque. US showed: lipid plaques 10.8%; fibrous 1.2%; fibrocalcified 44.6% and calcified 43.4%, and the MDCTA lipid plaques 8.4%; fibrocalcified 48.2% and calcified 43.4%. Intraoperative findings were: lipid plaques 10.3%; fibrocalcified 41.2% and calcified 48.5%. A statistically highly significant agreement between the US and MDCTA in the diagnosis of plaque morphology was obtained (Cramer's V = 0.919, p < 0.01; Lambda = 0.921, p < 0.01) and also statistically significant agreement between US and IO findings (Cramer's V = 0.831, p < 0.01; Lambda = 0.859, p < 0.01). A statistically highly significant agreement between MDCTA and IO findings in plaque morphology was found, as well (Cramer's V = 0.815, p < 0.01; Lambda = 0.829, p < 0.01). Conclusion. There is statistically highly significant correlation between US and MDCTA diagnostic methods in the evaluation of plaque morphology in surgically significant stenosis of internal carotid artery as well as their agreement with the intraoperative finding. [ABSTRACT FROM AUTHOR]

Background /Aim. Cataract is a structural, biochemical and optical change in the eye lens, which changes transmission and refraction of light rays reducing keenness and clarity of a figure on the retina. Its occurrence is highest in older people, over the age of 65 (45.9%), thus a certain degree of opacification exists practically in all people over the 70. Our research wae directed to measuring of lipid peroxidation products in cataract lenses involved in early stages of cataractogenesis through oxidative stress and in the development of mature cataract. Methods. Clinical and biochemical research was carried out in 101 patients with cataract, 46 women and 55 men. The average age of the group was 72.47 (x̄ = 7.98). According to the cataract maturity degree the patients were classified into two groups as follows: cataracta senilis incipiens (n = 41) and cataracta senilis matura (n = 60). Measuring of diene conjugates was carried out by spectrophotometer. Fluorescent lipid peroxidation products were measured by a spectrofluorophotometer, and malondialdehyde (MDA) concentration was measured by colorimeter as a product of a reaction with thiobarbituric acid (TBA). Result. Significantly higher diene conjugated concentration in lenses was measured in the patients with the diagnosis cataracta senilis incipiens (p < 0.001) as well as the intensity of fluorescent iminopropens (p < 0.001). Significantly higher MDA concentration in lens (p < 0.001) was measured in the patients with cataracta senilis matura. Conclusion. The lens structure changes caused by lipid peroxidation can, with other risk factors present, influence the occurrence and development of mature cataract. Some cataract types show different lipid peroxidation intensity with the most distinct changes in cataract wich started as corticonuclear. [ABSTRACT FROM AUTHOR]

Background/Aim. There are no recommendations for the dietary intake of carbohydrates compared with the dietary intake of lipids in patients with ischemic heart disease (IHD). The aim of the study was to assess the influence of high dietary glycemic load (GL) on the occurrence of IHD. Methods. The case-control study was carried out between 2003 and 2004. The study group consisted of 290 patients with IHD hospitalized in the Clinical Center in the town of Niš. There were 290 controls admitted to the same medical institution as cases for a wide spectrum of acute conditions unrelated to known or potential risk factors for IHD. The data about risk factors for IHD were collected by the epidemiological questionnaire. The data about nutrition were collected by administered food frequency questionnaire. A total GL for each patient was calculated by the international tables and the standard for the glycemic index (GI) was used. Standard anthropometric measurements were applied. A total level of lipids and cholesterol was determined, too. Multivariate odds ratios (OR) and 95% confidence intervals were obtained by multiple logistic regression models. Statistical analysis was performed with Epi Info Programme (Version 6.04) and with the SPSS for Windows (Release 8.0). Results. The patients with IHD had statisticaly significantly different intake of carbohydrate compared with the patients of the control group but the risk of IHD occurrence was not associated with the total intake of carbohydrate. The total average GL in the patients of the study group was statisticaly significantly higher compared with the patients of the control group (p < 0.05) and a high GL was independent risk factor for IHD (OR = 1.99). Conclusions. In prevention of IHD it is recommended to intake food with lower GI, for example vegetabless and fruit. [ABSTRACT FROM AUTHOR]

Background/Aims. Overt hypothyroidism is disease associated with accelerated arteriosclerosis and coronary heart disease. Whether subclinical hypothyroidism (SH) is associated with increased cardiovascular risk is contraversial. As SH is a high prevalence thyroid dysfunction, specially in older women, it is important to evaluate cardiovascular risk factors in these patients and that was the aim of this study. Methods. We examined 30 patients with SH and 20 healthy controls. Subclinical hypothireoidism was defined as an elevated thyrotropin (TSH) (> 4.5 mU/L) and normal free thyroxine (FT4) level. In all the participants we determined body mass index (BMI), blood pressure, TSH, FT4, antibodies to thyroid peroxidase, antibodies to thyroglobulin, total cholesterol, high density lipoprotein (HDL) cholesterol, low density lipoprotein (LDL) cholesterol, triglicerides, total cholesterol/HDL cholesterol ratio and LDL/HDL cholesterol ratio. Results. Mean BMI in patients with SH was significantly higher (p < 0.05), as well as diastolic blood pressure (p < 0.01) compared with the controls. Average levels of total cholesterol (5.40±0.62 vs 5.06±0.19 mmol/1, p < 0.01) and triglycerides (2.16±0.56 vs 1.89±0.24 mmol/1,p < 0.05) were also significantly higher in the group with SH. Individual analysis revealed that the percentage of patients with SH having borderline elevated total cholesterol (63.33%), hypertrigliceridemia (43.33%) and elevated total cholesterol/HDL cholesterol ratio (26.67%) were significantly higher than the percentage in the controls. No significant correlation between TSH and lipid parameters was detected. Conclusion. Subclinical hypothyroidism was associated with higher BMI, diastolic hypertension, higher total cholesterol and triglicerides levels and higher total cholesterol/HDL cholesterols ratio. This might increase the risk of accelerated arteriosclerosis in patients with SH. [ABSTRACT FROM AUTHOR]

Backround. Clinical features of inherited glucocerebrosidase deficiency were first described by Phillippe Charles Ernest Gaucher, French physician (1854-1918). Deficiency of glucocerebrosidase leads to the accumulation of the lipid glucocerebroside within the lysosomes of the monocyte macrophage system. Lipid-laden cells, known as Gaucher cells, lead to hepatosplenomegaly, multiorgan dysfunction and sceletal deterioration. Case report. We reported a 36-year-old male and a 42-year-old female admitted for the clinical examination due to hepatosplenomegaly. The Clinical diagnosis was provided by a bone marrow examination and demonstration of the characteristic Gaucher cells. Both of the patients had type I Gaucher's disease (a mild form of the disease), wich is distiguished by the lack of central nervous system involvement and striking phenotypic variation. We had not a possibility of testing β-glucocerebrosidase activity in peripheral leukocytes (a definitive diagnosis of Gaucher's disease). Also, enzyme replacement therapy had not been available in our country. Conclusion. Althoungh rare, Gaucher's disease is also present in our country. Both molecular genetic, and the enzyme β-glucocerebrosidase activity testing in peripheral leukocytes are needed for the definitive diagnosis of this disease. [ABSTRACT FROM AUTHOR]