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Background: Experimental studies have shown that tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) downregulate visfatin gene expression in adipocytes. On the other hand, the induction of cytokine production by visfatin in leucocytes and monocytes has also been described., Aim: To assess the possible interrelation between plasma concentrations of visfatin and TNF-α and TNF soluble receptor in obese women fulfilling, or not, the criteria of metabolic syndrome (MS)., Methods: Ninety two obese women were included in the study. Metabolic syndrome, based on IDF criteria (2005) was diagnosed in 71 subjects (mean age 53 ± 9 years; body mass index 39.1 ± 5.6 kg/m(2), waist circumference 109.6 ± 11.4 cm). The remaining 21 formed the non-MS subgroup (mean age 52 ± 9 years, body mass index 36.3 ± 5.2 kg/m(2), waist circumference 104.7 ± 11.0 cm). Fourteen healthy normal weight women served as controls. In all subjects, body composition was assessed by the bioimpedance method., Results: In the MS subgroup, but not in the non-MS subgroup, visfatin levels were significantly higher than in controls. We did not observe any significant difference in plasma concentrations of visfatin, TNF-α or sTNFRs between the MS subgroup and the non-MS subgroup. Only in the MS subgroup and in the combined analysis of all study subgroups did plasma visfatin concentrations correlate significantly with TNF-α levels (R = 0.31, p = 0.01, R = 0.21, p = 0.03; respectively). Additionally, in the MS subgroup there was a positive correlation between visfatin levels and insulin resistance (R = 0.53, p = 0.01)., Conclusions: Our findings suggest that visfatin in metabolic syndrome should be regarded as a proinflammatory factor indirectly favouring the development of insulin resistance.

Background: Precise mechanisms leading to restenosis are not fully understood. The type of implanted stent and the intensity of atherogenic processes may affects the restenosis rate., Aim: To compare the long-term effects of the coronary stent implantation - paclitaxel-eluting stent (PES) or bare-metal stents (BMS) - on endothelial-dependent flow-mediated dilation (FMD), platelet-derived growth factor (PDGF) and asymmetric dimethylarginine (ADMA) serum levels and to assess the relationship between FMD, PDGF, ADMA and every-stage in-stent restenosis (eISR)., Methods: The study population included 40 patients with coronary artery disease, who underwent elective percutaneous coronary intervention (PCI) of the left anterior descending artery (LAD) with stent implantation (PES - 21 patients; BMS - 19 patients). Follow-up examination was performed 12 months after PCI., Results: There were no differences between the PES and the BMS patients regarding FMD (PES: 11.8+/-7.8%, BMS: 10.5+/-9.2%), PDGF (PES: 5540+/-2209 pg/ml, BMS: 4923+/-2924 pg/ml) and ADMA (PES: 0.474+/-0.04 micromol/l, BMS: 0.456+/-0.03 micromol/l) serum levels. The follow-up angiography was performed when clinically indicated in 25 patients: in 15 patients with PES and 10 patients with BMS implanted. The eISR was found in 12 subjects: in 7 (47%) with PES and in 5 (50%) with BMS (NS). In all patients with eISR, the FMD values were significantly lower (6.1+/-3.5%, p=0.003) compared to the patients without eISR (14.3+/-7.8%). FMD was the only independent risk factor for eISR (OR=0.631, 95% CI 0.412-0.942, p=0.0003). The cut-off point for FMD < or = 8.4% as a parameter predicting eISR was established (p=0.0001, sensitivity: 83.3%, specificity: 92.3%, PPV: 90.9%, NPV: 85.7%)., Conclusions: The type of stent implanted into LAD does not affect the FMD, PDGF and ADMA serum levels assessed one-year after a PCI procedure. The occurrence of an early in-stent restenosis is associated with impaired FMD at the time of one-year follow-up.

Introduction: The aim of the present study was to examine how weight loss treatment modulates plasma concentrations of ghrelin and insulin-like growth factor 1 (IGF-1) in obese women and to determine whether there is any association with possible changes in plasma concentrations of these hormones after weight loss., Material and Methods: The study group consisted of 22 obese women without additional disease (age 40.6 +/- 12.9 years; BMI 37.2 +/- 4.6 kg/m(2)). All subjects participated in a 3-month weight reduction program. The measurements were performed at baseline and after weight loss. Plasma concentration of ghrelin and IGF-1 were measured by enzyme - linked immunosorbent assay (ELISA) kit. Serum concentrations of insulin were measured by radioimmunoassay (RIA). Body composition was determined by bioelectrical impedance analysis using a Bodystat analyser., Results: The mean weight loss was 9.3 +/- 4.1 kg (9.7 +/- 4.3%). Following weight loss, plasma ghrelin and IGF-1 concentrations increased significantly (63.5 +/- 13.0 vs. 72.8 +/- 15.1 pg/ml; p < 0.01; 126.9 +/- 67.0 vs. 170.5 +/- 83.3 ng/ml p < 0.01, respectively) and serum insulin concentrations decreased significantly (17.5 +/- 8.5 vs. 14.8 +/- 10.4 mIU/ml p< 0.05). We observed a significant positive correlation between the increase of ghrelin and decrease of body fat percentage after weight loss (r = 0.44, p = 0.03). There are no correlations between change of ghrelin and IGF-1concentrations and between changes of insulin and IGF 1 concentrations., Conclusion: Plasma concentrations of ghrelin and IGF-1 increased after weight loss. However, it seems there is no association between serum concentrations of ghrelin and IGF-1 in obese women.

Background: In animal models ghrelin reduces cardiac afterload and increases cardiac output via receptors in the cardiovascular system. The aim of our study was to evaluate a potential relationship between weight loss treatment, blood pressure and serum ghrelin concentrations in obese women., Material and Methods: A group of 37 obese premenopausal women with no previous history of hypertension (BMI: 36.5 +/- 5 kg/m2) were involved in the study. Blood pressure and serum ghrelin levels were assessed before and after a three-month weight reduction treatment, which consisted of a diet of 1000 kcal/day and physical exercise. Body composition was determined by impedance analysis using Bodystat., Results: Following weight loss (mean 8.9 +/- 4.8 kg) SBP decreased (120 +/- 13 vs. 115 +/- 14 mm Hg, p = 0.01) and serum ghrelin levels increased significantly (66.9 +/- 13.7 vs. 73.9 +/- 15.4 pg/ml; p = 0.005). There were significant correlations between values for ghrelin levels after weight loss and SBP (r = -0.45, p = 0.02), DBP (r = -0.41, p < 0.05), and between Deltaghrelin levels and DeltaSBP (r = 0.52, p = 0.006), DeltaDBP (r = 0.53, p = 0.005). There was a positive correlation between an increase in ghrelin and a decrease in percentage body fat during weight loss (r = 0.51; p = 0.002)., Conclusion: The results seem to provide evidence that weight loss may decrease blood pressure in obese patients via a ghrelin-dependent mechanism.

Introduction: Apoptosis can influence both adipose tissue mass and its distribution. The suprafamily of tumour necrosis factor (TNF) receptors stimulate apoptosis. The aim of the study was to assess serum concentrations of tumour necrosis factor alpha (TNF-alpha), TNF soluble receptors (sTNFRs) and FAS in obese subjects and to examine the changes in these parameters after weight loss., Material and Methods: The study group consisted of 23 obese women without additional disease aged 36.6 +/- 10.9 years. These were examined before and after three-month weight reduction treatment consisting of a diet of 1000 kcal/day and physical exercise. The control group comprised 17 lean healthy women aged 40.3 +/- 5.5 years. Blood samples were taken in the morning after an overnight fast. Serum concentrations of TNF-alpha, sTNFRs and FAS were measured by enzyme linked immunosorbent assay (ELISA). Serum concentrations of insulin were measured by RIA. Serum concentrations of glucose, total cholesterol, HDL cholesterol and triglycerides were measured by an enzymatic procedure., Results: The mean weight loss over the three-month treatment was 11.4 +/- 3.1 kg. Following weight loss, serum TNF-alpha concentrations decreased significantly (7.3 +/- 3.0 vs. 5.4 +/- 1.6 pg/ml; p < 0.005) and concentrations of sTNFRs increased significantly (1222.6 +/- 211.8 vs. 1325.6 +/- 261.6 pg/ml; p < 0.05 and 1881.5 +/- 337.2 vs. 2057.4 +/- 358.7 pg/ml; p < 0.05 respectively). However, no changes in serum concentrations of FAS were observed after weight loss., Conclusion: We observed increased serum concentrations of TNF-alpha but not of FAS in obese women. The concentrations of TNF decreased and those of sTNFRs increased after weight loss. However, the weight reduction therapy did not change serum concentrations of FAS.

Introduction: The aim of the present study was to evaluate the effect of modest weight reduction on serum concentrations of tumour necrosis factor alpha (TNF-alpha), TNF soluble receptors (sTNFRs) and interleukin-6 (IL-6) in obese women with polycystic ovary syndrome (PCOS)., Material and Methods: The study group consisted of 15 obese women with PCOS (mean age 28.5 +/- 7.7 years). Serum concentrations of TNF-alpha, sTNFRs and IL-6, insulin, FSH, LH, DHEAS, androstendione, total and free testosterone, cortisol, 17OH-progesterone, oestradiol and sex hormone binding globulin (SHBG), glucose, total cholesterol, HDL cholesterol and triglycerides were measured before treatment and after 10% weight loss. All patients were advised to follow a 1000-1200 kcal diet with a limited intake of simple carbohydrate and animal fats and to exercise regularly (30 min, 3 times a week). Body composition was measured by bioimpedance. Serum concentrations of TNF-alpha, sTNFRs and IL-6 were determined by enzyme linked immunosorbent assay (ELISA). Plasma insulin, FSH, LH, DHEAS, androstendione, total and free testosterone, cortisol, 17OH-progesterone, oestradiol and SHBG were measured by a commercial RIA. Blood glucose, total cholesterol, HDL cholesterol and triglycerides were measured by an enzymatic procedure., Results: We observed no differences in serum concentrations of TNF-alpha, sTNFRs or IL-6 after treatment., Conclusions: It seems that more than a modest weight reduction is necessary to obtain a decrease in serum concentrations of proinflammatory cytokines and an improvement in ovarian function in obese women with polycystic ovary syndrome.

Introduction: The aim of the present study was to examine the response of plasma orexin and ghrelin to the oral glucose tolerance test (OGTT) in obese women without additional disease., Material and Methods: The study group comprised 15 obese women aged 30.4+/-9.7 years of mean BMI 34.7+/-3.8 kg/m(2). The measurements were performed after an overnight fast and 30, 60 and 120 minutes after the oral administration of 75 grams of glucose. Serum concentrations of ghrelin and orexin A were measured by an enzyme-linked immunosorbent assay (ELISA) kit. Serum concentrations of insulin were measured by radioimmunoassay (RIA). Plasma glucose was determined by an enzymatic procedure. Body composition was determined by impedance analysis using Bodystat., Results: We observed no significant differences between serum concentrations of ghrelin and orexin during OGTT. No correlations were found between serum ghrelin and orexin concentrations and serum insulin and glucose concentrations in any of the measurements., Conclusion: Oral glucose administration did not change serum concentrations of ghrelin and orexin A in obese women without additional disease.

Introduction: Assessment of serum osteoprotegerin (OPG) concentrations in obese patients in comparison to healthy controls and evaluation of a possible correlation between OPG and other markers of bone turnover or calcitropic hormones., Material and Methods: 50 obese perimenopausal women without concomitant diseases (BMI 36.7 +/- 4.1 kg/m(2), mean age 50.4 +/- 4.9 yrs). The control group consisted of 19 healthy women (BMI 24.2 +/- 2.1 kg/m(2); mean age 53.8 +/- 5.1 yrs). In all patients serum concentration of OPG, C telopeptide of type I collagen containing the crosslinking site (CTX), osteocalcin, parathormone (PTH) and vitamin D (25-OH-D(3)) was assessed. Dual energy x-ray absorptiometry (the DXA method) of the lumbar spine and femoral neck was performed using a Lunar DPXL to measure bone marrow density (BMD)., Results: In obese perimenopausal women serum OPG, osteocalcin and 25-OH-D(3) levels were significantly lower, and the serum PTH level was significantly higher in comparison to healthy controls. A significantly positive correlation was found between serum OPG level and age in both obese and control subjects., Conclusion: The serum OPG level in obese perimenopausal women is significantly lower in comparison to healthy controls and does not correlate significantly with biochemical markers of bone turnover, calcitropic hormones and BMD. It probably cannot play a protective role in the pathogenesis of bone loss in obese perimenopausal women.

Introduction: The aims of the present study were to evaluate the effect of weight-loss treatment on serum concentrations of NO and TNF-alpha and to examine whether there is an association between TNF-system activity and serum concentrations of NO after weight loss., Material and Methods: The study group involved 43 obese women (aged 41.8 +/- 11.9 years, weight 95.2 +/- 15.0 kg, BMI 36.5 +/- 4.6 kg/m(2)). The women were subjected to three-month complex weight-loss treatment. Patients were advised to keep to a 1000-1200 kcal diet and to exercise regularly. Pharmacological treatment was not administered. Serum concentrations of nitric oxide metabolites, TNF-alpha and its soluble receptors (sTNFR1, sTNFR2) were measured by ELISA kits; insulin was measured by RIA and glucose, cholesterol, HDL cholesterol and triglicerydes by an enzymatic procedure before and after weight loss. Body composition was determined by impedance analysis using Bodystat., Results: The mean weight loss during treatment was 8.3 +/- 4.3 kg. The serum concentrations of TNF-alpha decreased significantly (p < 0.000) and both receptors sTNFR1 and sTNFR2 increased significantly (p < 0.000) after weight loss. No significant changes in serum concentrations of NO were observed after weight loss. A multiple regression analysis was performed using DeltaTNF-alpha, DeltasTNFR1, DeltaTNFR2 and DeltaNO as dependent variables. A significant correlation was observed between DNO and initial plasma concentrations of TNF-alpha, sTNFR1 and sTNFR2., Conclusions: This study demonstrates a decrease in serum TNF-alpha concentration as well as an increase in plasma concentration of both TNF receptors but does not show any change in serum concentrations of NO after weight-loss treatment in obese women. It seems that changes in TNF-system activity may be a counter-regulating mechanism, which inhibits further body mass loss. We did not observe any association between changes in TNF-system activity and serum concentrations of NO after weight loss.

Introduction: Interleukine-6 (IL-6) is one of the cytokines, excreting by adipocytes, which increases in obesity. These cytokines participate in very complicated mechanisms of developing insulin resistance that accompany obesity. The aim of the study was to: 1) evaluate the influence of weight loss on insulin resistance and serum concentration of IL-6, 2) evaluate the hypothetical association between serum concentration of IL-6 and the improvement of insulin sensitivity in obese women after weight loss., Material and Methods: The study involved 27 obese women (age 40.3 +/- 11.1 year; BMI 37.4 +/- 5.2 kg/m(2)) with insulin resistance diagnosed using HOMA index, without concomitant diseases and without any medication. All the patients participated in complex weight reduction treatment (diet, physical activity and psychotherapy). Before and after weight reduction therapy weight and height were measured, body composition was determined using bioimpedance analysis. Serum concentration of glucose was determined by enzymatic procedure, serum concentration of insulin was measured by radioimmunoassay, serum concentration of IL-6 was measured by ELISA. HOMA index was calculated with formula., Results: The mean weight loss after 3-month was 9.2 +/- 4.5 kg (approximately 10% of initial weight). After weight reduction significant decreases in HOMA index, insulin and IL-6 concentrations was observed. However, no correlations between changes in insulin concentrations, HOMA index and decrease of IL-6 concentration were showed. We observed significant correlations between DeltaHOMA and DeltaBMI (r = 0.48; p = 0.012) and Delta percentage fat mass (r = 0.39; p < 0.05)., Conclusions: A moderate weight loss improves insulin sensitivity and decreases serum concentrations of IL-6. However improvement of insulin sensitivity is the effect of fat mass reduction and does not change serum concentration of IL-6.

Introduction: TNF-alpha is one with mediators insulin resistance. Previous study showed, that in obesity there is an increased synthesis of TNF-alpha by fat cells and serum concentrations of TNF-alpha. The aim of present study was: 1. To assess of serum concentrations of TNF-alpha and TNF soluble receptors sTNFRs in obese women with diabetes type 2 and obese women without additional disease. 2. To assess possible association between of manner treatment of diabetes type 2 and serum concentrations of TNF-alpha and TNF soluble receptors., Material and Methods: The study group's involved 23 obese women with diabetes type 2 - group A (age 63.6 +/- 8.2 lat; BMI 32.7 +/- 3,9 kg/m2) in this 12 treated of derivatives of sulfonylurea (age 65.1 +/- 6.6 lat; BMI 32.0 +/- 3.4 kg/m2) - subgroup AI and 11 insulin treated (age 62.1 +/- 9.7 lat; BMI 33.4 +/- 4.4 kg/m2) - subgroup AII and 23 obese women without additional disease and without any pharmacological treatment - group B (age 36.6 +/- 10.9 lat; BMI 36.6 +/- 5.6 kg/m2). Body weight and height were measured, body mass index was calculated with formula. Serum concentrations of glucose was measured by enzymatic procedure. Serum concentrations of TNF-alpha and it's soluble receptors sTNFR1 and sTNFR2 was measured by ELISA. and sTNFR2 were significant decreased (respectively p <0,005 i p <0,001) in group A when compared to group B. There are not significant differences serum concentration of TNF-alpha and its soluble receptors between subgroups AI and AII., Conclusions: 1. In obese women with diabetes type 2 serum concentration of TNF-alpha increased and concentrations of its soluble receptors decreased when compared to obese without additional disease. 2. The treatment meaner of diabetes type 2 not influence of serum concentration of TNF-alpha and sTNFR1 but application of insulin maybe a cause increase activity sTNFR2.