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Hypercholesterolemia is a chronic non-communicable disease predisposing to cardiovascular diseases. Genome-wide association studies have shown that more than 500 common nucleotide variants are associated with dyslipidemia.We evaluated associations between selected nucleotide variants in ANGPTL6, DOCK6, FABP1, and PCSK9 genes and hypercholesterolemia in the Polish adult population sample.The study included 109 patients with hypercholesterolemia and 251 individuals with no diagnosed lipid disorder. Genotyping of ANGPTL6 rs8112063, DOCK6 rs737337 and rs17699089, FABP1 rs2241883 and rs2919872, and PCSK9 rs562556 and rs11206510 was carried out using high resolution melting curve analysis. The serum concentrations of FABP1, PCSK9, ANGPTL6, and ANGPTL8 were determined in 51 subjects by enzyme-linked immunosorbent assay. Results: Bearers of the FABP1 rs2919872 CC genotype were over 2.5-fold less likely to be diagnosed with hypercholesterolemia than the carriers of the T allele (OR 0.386 95% CI 0.203 - 0.735, p = 0.003, pcorr = 0.006). There were no associations between rs2919872 and lipid serum concentrations. Bearers of the ANGPTL6 rs8112063 C allele had an almost 2-fold higher risk of developing hypercholesterolemia than the carriers of the T allele (OR 1.820 95%CI 1.053 - 3.144, p = 0.03, pcorr = 0.046). Moreover, the bearers of the ANGPTL6 rs8112063 C allele had higher serum concentrations of HDL-cholesterol than those with TT genotype (p = 0.009). There were no significant associations between the other tested variants and hypercholesterolemia.FABP1 rs2919872 and ANGPTL6 rs8112063 are associated with the risk of hypercholesterolemia in the Polish population.

Obesity is associated with increased serum leptin level, endothelial dysfunction and angiogenesis. In vitro studies have shown that vascular endothelial growth factor (VEGF) synthesis is increased by leptin. Animal studies revealed the effectiveness of Plantago supplementation treatment of obesity. The study aim was to evaluate the effect of Plantago major supplementation on serum leptin and VEGF blood concentration, endothelial dysfunction and angiogenesis in obese women. Seventy-two obese women received oral Plantago major supplement (Plantago group, n = 35) or placebo (placebo group, n = 37) for 12 weeks. At baseline and after completion, anthropometric and body composition measurements were performed, and blood samples were collected. Serum concentrations of leptin, VEGF-A, adiponectin, tumour necrosis factor α and soluble intercellular adhesion molecule have been determined. At completion, the leptin level was higher in the Plantago group (39 781.55 ± 20 360.73 pg ml−1) compared to both the baseline (36 138.71 ± 25 401.51 pg ml−1) and placebo group (30 502.81 ± 19 003.18 pg ml−1). Also, leptin concentration in the Plantago group at completion correlated positively with an increase in VEGF-A level (R = 0.45), and baseline VEGF-A level correlated negatively with the increase in leptin concentration (R = −0.47). Plantago major supplementation increases leptin serum level, enhances leptin influence on VEGF-A serum level increase and by this mechanism may intensify endothelial dysfunction and angiogenesis in obese women.

Background: Patients undergoing hemodialysis (HD) therapy have an increased risk of death compared to the general population. We investigated whether selected single nucleotide variants (SNVs) involved in glucose and lipid metabolism are associated with mortality risk in HD patients. Methods: The study included 805 HD patients tested for 11 SNVs in FOXO3, IGFBP3, FABP1, PCSK9, ANGPTL6, and DOCK6 using HRM analysis and TaqMan assays. FOXO3, IGFBP3, L-FABP, PCSK9, ANGPTL6, and ANGPTL8 plasma concentrations were measured by ELISA in 86 individuals. The Kaplan–Meier method and Cox proportional hazards models were used for survival analyses. Results: We found out that the carriers of a C allele in ANGPTL6 rs8112063 had an increased risk of all-cause, cardiovascular, and cardiac mortality. In addition, the C allele of DOCK6 rs737337 was associated with all-cause and cardiac mortality. The G allele of DOCK6 rs17699089 was correlated with the mortality risk of patients initiating HD therapy. The T allele of FOXO3 rs4946936 was negatively associated with cardiac and cardiovascular mortality in HD patients. We observed no association between the tested proteins’ circulating levels and the survival of HD patients. Conclusions: The ANGPTL6 rs8112063, FOXO3 rs4946936, DOCK6 rs737337, and rs17699089 nucleotide variants are predictors of survival in patients undergoing HD.

There is no consensus exercise programme to reduce body weight and improve body composition simultaneously preventing bone loss or stimulating osteogenesis. This pilot study compared the effect of endurance and endurance-strength training on body composition and bone metabolism in centrally obese women. Recruited subjects were randomly assigned to three-month endurance (n = 22) or endurance-strength training (n = 22). Body composition, bone mineral density (BMD) and content (BMC) were assessed before and after the intervention and markers of bone formation and resorption were measured. Both training significantly decreased fat mass; however, endurance-strength training had a more favourable effect on lean mass for the gynoid area (p = 0.0211) and legs (p = 0.0381). Endurance training significantly decreased total body BMC and BMD (p = 0.0440 and p = 0.0300), whereas endurance-strength training only reduced BMD (p = 0.0063). Changes in densitometric parameters did not differ between the groups but endurance training increased osteocalcin levels (p = 0.04845), while endurance-strength training increased tartrate-resistant acid phosphatase 5b concentrations (p = 0.00145). In conclusion, both training programmes were effective in the reduction of fat mass simultaneously negatively affecting bone health. However, endurance-strength training seemed to be more effective in increasing lean mass. The study protocol was registered in the ClinicalTrials.gov database under the number NCT03444207, date of registration: 23 February 2018 (retrospective registration).

Objective: We conducted a prospective randomised trial to assess whether a specific type of regular physical training performed by women with obesity is related to obtaining specific psychological benefits. Methods: Forty-four women qualified for the study and were divided into two groups. The applied intervention consisted of regular three-month physical exercises in the form of endurance training (group A) or endurance strength training (group B). Initially, and after the completed intervention, we examined anthropometric measurements and the level of: stress (PSS-10), general self-esteem (SES), body self-report (BSQ–34, FRS), and behaviours associated with diet (TFEQ-18). Results: As a result of the intervention, both groups had significantly lower anthropometric parameters and FRS scores with regard to the current figure (gr. A:δ FRS CS −0.90 ± 0.83, p &lt, 0.001, gr. B:δ FRS CS −0.41 ± 0.50, p = 0.01) and BSQ–34 results (gr. A:δ BSQ–34 −14.90 ± 13.5, p = 0.001, gr. B:δ BSQ–34 − 18.64 ± 25.4, p = 0.01). Additionally, an increase in cognitive restraint (δ TFEQ–18 CR1.65 ± 2.06, p = 0.01) and a decrease in emotional eating (δ TFEQ–18 EE −0.82 ± 1.28, p = 0.01) were observed in group B. There were no between-group differences in terms of the magnitude of changes achieved due to the intervention, except for asignificant improvement in the perception of their current figure (FRS) (δ FRSCS −0.90 ± 0.83, p = 0.03) in group A. Conclusions: Regular physical activity over a three-month period by women with obesity promotes the perception of their own body as slimmer and lowers body shape concerns. The change in body shape perception was more pronounced under the influence of endurance training than endurance strength training. Trial registration: ClinicalTrials.gov ID NCT04793451.

Studies comparing the effect of endurance and endurance-strength training on cardiometabolic markers provided inconsistent results. Therefore, the study aimed to compare the effect of endurance and endurance-strength training on body composition and cardiometabolic parameters in abdominally obese women. In this randomised trial, 101 subjects were included and divided into endurance (n = 52) and endurance-strength (n = 49) training. During the 12-week intervention, participants performed supervised one-hour training three times a week. Body composition, blood pressure (BP), markers of glucose and lipid homeostasis, and myoglobin levels were measured before and after the intervention. In total, 85 subjects completed the trial. Both interventions decreased fat mass and visceral adipose tissue and increased free fat mass, appendicular lean mass index and lean mass index. Neither endurance training nor endurance-strength training affected glucose and lipid metabolism. However, only endurance training significantly decreased paraoxonase and myoglobin levels. Both training programmes significantly decreased BP, with a more reduction of diastolic BP noted in the endurance group. In conclusion, both training programmes had a favourable effect on body composition but did not improve glucose and lipid homeostasis. Besides, endurance training decreased paraoxonase activity and myoglobin levels and was more effective in reducing BP.The study was registered with the German Clinical Trials Register (DRKS) within the number: DRKS00019832 (retrospective registration), date of registration: 26/02/2020.

The objective of this study was to evaluate serum, hair, and urinary trace element and mineral content in normal-weight and obese women in relation to metabolic risk factors. A total of 80 women aged 30–70 y.o. were enrolled in the obese group (n = 40) and normal-weight group (n = 40). Serum, hair, and urinary trace element and mineral levels were assessed using inductively coupled plasma spectrometry. Body fat percentage was evaluated using bioimpedance. Obese subjects were characterized by significantly higher body fat percentage, blood pressure, serum triglyceride concentration, and insulin resistance. Serum Ca, Fe, Mg, Se, V, Zn levels, hair Fe, Mg, V content, and urinary Se and V concentrations were found to be lower in obese subjects as compared to lean controls. In turn, serum Cu and urinary Fe levels in obese women were characterized by a significant increase. In multiple regression models serum Cu, Se, and Zn levels were significantly associated with BMI even after adjustment for blood biochemistry, body composition, and blood pressure. Serum trace element and mineral levels also significantly contributed to group discrimination. These findings allow to propose that obesity-associated disturbances in trace element and mineral status may at least partially contribute to metabolic risk in obese subjects.

Proper nutrition is an important element that determines the course of pregnancy. Unfortunately, the everyday diet is not always able to cover the increased in pregnancy essential vitamins and minerals requirements. Therefore, pregnant women often use dietary supplements. This study aimed to compare Polish and international recommendations regarding dietary supplementation during pregnancy. The Polish Society of Gynaecologists and Obstetricians (PSGO) recommends in every pregnant woman the dietary supplementation of folates, vitamin D and iodine. Additionally, the benefits of iron supplementation in pregnant women with anemia or at high risk of developing anemia are also highlighted. In the light of Polish guidelines, the magnesium supplementation is recommended in the condition of its reduced level in blood. In the case of limited consumption of DHA (docosahexaenoic acid), Polish guidelines recommend in pregnant women's diet, at least 600 mg of DHA every day. Still, in case of the high risk of premature birth - at least 1000 mg DHA a day during the entire pregnancy period should be taken.

Purpose Obesity and insulin resistance are considered cardinal to the pathophysiology of metabolic syndrome. Several simple indexes of insulin resistance calculated from biochemical or anthropometric variables have been proposed. The study aimed to assess the diagnostic accuracy of indirect insulin resistance indicators in detecting metabolic syndrome in non-diabetic patients, including TG/HDLc, METS-IR, TyG, TyG-BMI, TyG-WC, TyG-WHtR, and new indicators TyG-NC (TyG-neck circumference) and TyG-NHtR (Tyg-neck circumference to height ratio). Methods The diagnostic accuracy of eight insulin resistance indexes was assessed using the receiver operating characteristic curves (ROC curves) in 665 adult non-diabetic patients. Then, the analysis was performed after the division into groups with proper body mass index, overweight and obese. Results All indexes achieved significant diagnostic accuracy, with the highest AUC (area under the curve) for TyG (0.888) and Tg/HDLc (0.874). The highest diagnostic performance in group with the proper body mass index was shown for TyG (0.909) and TyG-BMI (0.879). The highest accuracy in the group of overweight individuals was presented by TyG (0.884) and TG/HDLc (0.855). TG/HDLc and TyG showed the highest AUC (0.880 and 0.877, respectively) in the group with obesity. Both TyG-NC and TyG-NHtR reached significant areas under the curve, which makes them useful diagnostic tests in metabolic syndrome. Conclusions Indirect indices of insulin resistance, including proposed TyG-NC and TyG-NHtR, show an essential diagnostic value in diagnosing metabolic syndrome. TyG and TG/HDLc seem to be the most useful in the Caucasian population.

Obesity is associated with increased serum leptin level, endothelial dysfunction and angiogenesis. In vitro studies have shown that vascular endothelial growth factor (VEGF) synthesis is increased by leptin. Animal studies revealed the effectiveness of Plantago supplementation treatment of obesity. The study aim was to evaluate the effect of Plantago major supplementation on serum leptin and VEGF blood concentration, endothelial dysfunction and angiogenesis in obese women. Seventy-two obese women received oral Plantago major supplement (Plantago group, n = 35) or placebo (placebo group, n = 37) for 12 weeks. At baseline and after completion, anthropometric and body composition measurements were performed, and blood samples were collected. Serum concentrations of leptin, VEGF-A, adiponectin, tumour necrosis factor α and soluble intercellular adhesion molecule have been determined. At completion, the leptin level was higher in the Plantago group (39 781.55 ± 20 360.73 pg ml-1) compared to both the baseline (36 138.71 ± 25 401.51 pg ml-1) and placebo group (30 502.81 ± 19 003.18 pg ml-1). Also, leptin concentration in the Plantago group at completion correlated positively with an increase in VEGF-A level (R = 0.45), and baseline VEGF-A level correlated negatively with the increase in leptin concentration (R = -0.47). Plantago major supplementation increases leptin serum level, enhances leptin influence on VEGF-A serum level increase and by this mechanism may intensify endothelial dysfunction and angiogenesis in obese women.

Rationale: Intestinal microbiota plays a significant role in the human body. A range of negative factors may lead to dysbiosis, which results in many diseases (e.g., cancer) and metabolic disorders. It was shown that people with a body mass index (BMI) of ≥25 kg/m2 present diminished microbial diversity. Additional negative factors such as stress, the use of non-steroidal anti-inflammatory drugs (NSAID) and proton pomp inhibitors (PPI) may result in greater dysbiosis compared to people with normal body mass. The aim of the study was to compare the incidence of negative factors affecting the intestinal microbiota in people with excessive body mass vs. people with normal body mass. Methods: The study involved volunteers aged 18–65 years: 582 people with normal BMI (18.5–24.99 kg/m2) and 538 people with BMI ≥ 25 kg/m2. The study was conducted using the author’s survey by the Computer-Assisted Web Interviewing method. The survey included the questions on sociodemographic features, level of physical activity, frequency of smoking, and stress. Frequency of NSAID and PPI use was also investigated. BMI was used to assess nutritional status. For statistics the Fisher test was implemented. p-Value < 0.05 was considered significant. Results: Women predominated in the study (p < 0.0001). People with normal BMI had a significantly higher level of physical activity (p < 0.0001) and smoked less (p = 0.0356). People with excessive body mass were less likely to report illness (p = 0.0004), but more often they took PPI (p = 0.0337). Conclusions: People with BMI ≥ 25 kg/m2 present more factors which may result in dysbiosis and lead to dysbiosis-related health problems in future compared to people with normal BMI.

Aims Angiotensin-converting enzyme 2 (ACE2) is the cellular entry point for severe acute respiratory syndrome coronavirus (SARS-CoV-2)—the cause of coronavirus disease 2019 (COVID-19). However, the effect of renin-angiotensin system (RAS)-inhibition on ACE2 expression in human tissues of key relevance to blood pressure regulation and COVID-19 infection has not previously been reported. Methods and results We examined how hypertension, its major metabolic co-phenotypes, and antihypertensive medications relate to ACE2 renal expression using information from up to 436 patients whose kidney transcriptomes were characterized by RNA-sequencing. We further validated some of the key observations in other human tissues and/or a controlled experimental model. Our data reveal increasing expression of ACE2 with age in both human lungs and the kidney. We show no association between renal expression of ACE2 and either hypertension or common types of RAS inhibiting drugs. We demonstrate that renal abundance of ACE2 is positively associated with a biochemical index of kidney function and show a strong enrichment for genes responsible for kidney health and disease in ACE2 co-expression analysis. Conclusion Our results indicate that neither hypertension nor antihypertensive treatment is likely to alter the expression of the key entry receptor for SARS-CoV-2 in the human kidney. Our data further suggest that in the absence of SARS-CoV-2 infection, kidney ACE2 is most likely nephro-protective but the age-related increase in its expression within lungs and kidneys may be relevant to the risk of SARS-CoV-2 infection., Graphical Abstract Graphical Abstract

Hypertension is considered to be the most common pathology of the circulatory system and the most common cause of death or cardiovascular diseases' development. There are many commonly known risk factors of this condition, such as overweight, obesity, a high-fat diet, family history of ischemic heart disease, lipid disorders, and atherosclerosis. In order to reduce the effect of high blood pressure, patients should modify their lifestyle, including sleeping patterns. We wanted to investigate if, in a group of women over 55 years of age compared to the general population from Poznan cohort, sleep duration is related to hypertension.All subjects were divided into three research groups depending on the time of sleep. The first group included people who have been sleeping less than 6 hours a day. The second group included people who have been sleeping from 6 to 9 hours a day. The third group was characterized by people with sleep time over 9 hours a day. Due to their age, participants were divided into two groups, below and over 55 years of age.There is a weak positive correlation between long sleep duration (9h) and a higher prevalence of unregulated blood pressure (r = 0.3, p = 0.017) in the group of women over 55 years of age.Unregulated increased blood pressure may occur more frequently in postmenopausal women whose sleep duration exceeds 9 hours a day.

Background: Two single nucleotide polymorphisms (SNPs) of the VEGF gene, rs699947 and rs2010963, are responsible for differentiated gene expression. A mutual dependence between VEGF and leptin serum level has been observed. This study investigated the associations between the rs699947 and rs2010963 SNPs of VEGF gene, VEGF-A, and leptin serum concentrations, and cardiometabolic risk of body mass excess. Methods: In this case−control study, 212 subjects with excess body mass and 145 normal-weight controls gave blood samples and underwent anthropometric and pulse wave analysis. Genotyping of VEGF gene was carried out to analyze the rs699947 (−2578 C/A) and rs2010963 (−634 G/C) SNPs. (ClinicalTrials.gov ID: NCT04077554). Results: This study showed a significant positive correlation between serum levels of VEGF-A and leptin in individuals with excess body mass possessing the CC genotype of the rs699947 variant of the VEGF gene. It has been registered that an increase in VEGF-A serum level correlates with an increase in arterial stiffness in excess body mass patients harboring AA genotype of the rs699947 (−2578 C/A) variant of the VEGF gene. No differences in VEGF-A and leptin serum concentrations were noted between particular genotypes. Conclusions: The CC genotype of the rs699947 variant of the VEGF gene promotes a positive interdependency between leptin and VEGF-A serum levels in subjects with excess body mass.

This study investigated hemodynamic characteristics of obstructive sleep apnea (OSA) accompanied by hypertensive disease in obese men, in whom blood pressure was pharmacologically controlled within the normal range, not exceeding 140/90 mmHg. There were 21 severe OSA patients (mean age 54.1 ± 9.3 years, apnea-hypopnea index of 47.1 ± 18.8 episodes per hour) included in the study, in whom OSA was diagnosed with polysomnography. The control group consisted of healthy normotensive age-matched subjects. Hemodynamic profile was recorded nonivasively with impedance cardiography. Brachial blood pressure and radial artery tonometry were performed to capture and reconstruct peripheral radial and central aortic pressure waveforms in both groups of subjects. Compared to healthy men, OSA patients had a significantly higher body mass index (BMI); the mean increase in BMI amounted to 6.4 ± 1.2 kg/m

This study investigated hemodynamic characteristics of obstructive sleep apnea (OSA) accompanied by hypertensive disease in obese men, in whom blood pressure was pharmacologically controlled within the normal range, not exceeding 140/90 mmHg. There were 21 severe OSA patients (mean age 54.1 ± 9.3 years, apnea-hypopnea index of 47.1 ± 18.8 episodes per hour) included in the study, in whom OSA was diagnosed with polysomnography. The control group consisted of healthy normotensive age-matched subjects. Hemodynamic profile was recorded nonivasively with impedance cardiography. Brachial blood pressure and radial artery tonometry were performed to capture and reconstruct peripheral radial and central aortic pressure waveforms in both groups of subjects. Compared to healthy men, OSA patients had a significantly higher body mass index (BMI); the mean increase in BMI amounted to 6.4 ± 1.2 kg/m2. The patients also presented significant differences in the hemodynamic profile. The difference consisted of a faster heart rate, higher peripheral pulse pressure, and reduced blood flow acceleration and velocity indices, describing myocardial contractility. Notably, the significance of hemodynamic differences in OSA patients disappeared in the analysis adjusted for the outstanding increase in BMI. In conclusion, the findings strongly suggest that obesity rather than the hypertensive disease per se is a source of hemodynamic consequences in OSA patients.

During the last few generations a rapid increase in the prevalence of cardiovascular diseases has been observed. This epidemiologic fact is in a wide range due to endothelial dysfunction. Endothelium, the inner layer of vessel wall, is a crucial structure in the proper functioning of the cardiovascular system. Next to classic cardiovascular risk factors such as diabetes, obesity, atherosclerosis and hypertension, endothelial dysfunction has become understood as one of the most important elements of cardiovascular pathologies, ranging from ischemic heart disease, stroke to carcinogenesis. This has given rise to a crucial need to develop new therapeutic directions aimed at ameliorating the endothelial function. A healthy lifestyle and proper well-balanced diet seem to be even more important than pharmacotherapy. Therefore, non-pharmacological interventions have become bullet points in a list of endothelial-targeted treatment strategies. Currently, several compounds have been studied as candidates for endothelial function improvement. L-arginine supplementation is proved to reduce fat content. It also preferably modifies carbohydrates metabolism and the expression of genes responsible for increased cardiovascular risk. Spirulina increases the expression of endothelial nitric oxide synthase, which ameliorates nitrogen oxide production and leads to a decrease in blood pressure. The beneficial effect of green tea catechins is based mainly on the inactivation of reactive oxygen. Allicin present in garlic shows both antioxidative and anti-inflammatory effects. Probiotics prevent endothelial dysfunction in effect of improved vascular oxidative stress. Physical activity also demonstrates a number of mechanisms that ameliorate endothelial function. The impact of endothelial function in the complex pathology of cardiovascular diseases reflects a number of scientific proofs showing favorable effects of non-pharmacological interventions in endothelial dysfunction treatment.

Intensive research is currently being performed into the genetic background of excess body mass compli- cations such as diabetes, cardiovascular disorders, especially atherosclerosis and coronary heart disease. Chronic inflammation is an important process in the pathogenesis of obesity, wherein there is an aberrant ex- pression of genes encoding adipokines. Visceral tissue is characterized by a higher expression and secretion of interleukin-8, interleukin-1ß and plasminogen activator inhibitor 1 in the subcutaneous tissue secretion of leptin prevails. An important complication of obesity is obstructive sleep apnea, often observed in Prader- Willi syndrome. The genetic background of sleep apnea may be a polymorphism of the SREBF1 gene. The consequence of excess body mass is metabolic syndrome, which may be related to the occurrence of the rs926198 variant of gene encoding caveolin-1. The genes of transcription factor TCF7L2 and PPAR-γ2 take part in the pathogenesis of diabetes development. It has been demonstrated that oncogenes FOS, FOSB, and JUN may be co-responsible not only for obesity but also for osteoporosis and colorectal cancer. It has been shown that weight loss causes a modification in the expression of about 100 genes involvedt in the production of substances such as cytokines and other responsible for chronic inflammation in obesity. In future studies on the complications of obesity, such scientific disciplines as proteomics, peptidomics, metabolomics and transcriptomics should be used. The aim of this study is to present the current state of knowledge about the genetic basis of obesity complications.

Despite numerous investigations, the influence of meal frequency on the lipid profile has not been clearly determined. The aim of the study was to investigate whether meal frequency corresponds with the lipid profile.The cross-sectional study enrolled 495 patients of University Hospital of Lord's Transfiguration who met inclusion criteria for study treated in 2015-2017. The subjects were divided according to meal frequency into a group consuming three or fewer meals a day and a group consuming four or more meals daily. To investigate whether there is a significant difference in cholesterol fractions and triglycerides concentrations between the mentioned groups the Mann Whitney U test was performed.The group included 495 patients (66.1% women, mean age 49.9 (SD=14.7) years). The median meal frequency was 4 per day. The frequency of consumed meals a day was significantly higher for women (median 4 meals per day) than for men (3 meals per day; p0.0001). A significant difference in serum triglycerides concentrations between the mentioned groups was observed (p0.0001). Similarly, the difference between HDL cholesterol concentrations was presented. (p0.01). No significant difference in the serum concentrations of total cholesterol and LDL cholesterol between the group consuming 3 or fewer meals and the group consuming 4 or more meals daily was seen (p0.05).We conclude that meal frequency equaling or higher than four meals daily is associated with lower fasting triglycerides and higher HDL cholesterol concentrations than consuming no more than three meals daily.

Arterial stiffness is said to be a novel predictor of cardiovascular events. This study investigated the correlation between arterial stiffness parameters and the estimated cardiovascular disease risk (RISK) in a Polish cohort of patients divided by age, sex, and body-mass index (BMI). The cross-sectional study enrolled 295 patients who met the inclusion criteria. Subjects were divided into three age groups, four weight groups, and by gender. The stiffness of the vessels was assessed by the measurement of the stiffness index (SI) and reflection index (RI). An individual 10-year RISK was calculated for each patient using the Heart Risk Calculator algorithm by the American Heart Association. A correlation between the SI and estimated RISK was observed (rS 0.42, p &lt, 0.05). The strongest relationship was presented for women, the age group 40–54, and individuals with normal weight. The correlation between RI and calculated RISK was observed (rS 0.19, p &lt, 0.05), the highest correlation was noticed for people aged 40–54 and obese. In conclusion, both SI and RI are correlated with estimated cardiovascular risk, however SI seems to be more useful than RI to predict the individual risk of future cardiovascular events. Both of these can be measured using non-invasive techniques, which demonstrates their potential utility in clinical practice.

Given the reported 30% prevalence of early-life obesity in the Western world, the nongenetic, maternally derived risk factors for excess body mass in offspring have been widely investigated recently. This review article aimed to analyze the results of 67 articles published from 2014 onwards that investigated causative non-genetic-based associations between maternal and infantile excess body mass. Excessive gestational weight gain was found to increase the incidence of excess body mass in offspring, reaching nearly 20% at 2 years of age. Furthermore, gestational diabetes mellitus (GDM) increases the risk of offspring that is large for gestational age. The offspring of mothers with GDM and mothers with dyslipidemia in the first trimester of pregnancy had higher rates of excess body mass. In addition, breastfeeding for a period of less than 6 months was one of the 4 factors that were most strongly associated with childhood obesity. Pregnancy-induced hypertension raises the risk of childhood obesity by 50%. In conclusion, excessive gestational weight gain, GDM, maternal dyslipidemia, breastfeeding for a period of less than 6 months, and hypertensive disorders of pregnancy are associated with maternal and childhood obesity and are perinatal risk factors of excess body mass in offspring. Their occurrence should be monitored and prevention of these factors should become the principal aim of obesity prevention programs for children. Occurrence of these factors may justify intense screening to diagnose early stages of metabolic disorders in offspring, even in adulthood. Further large-scale studies are warranted to draw a firm conclusion.

The study aimed to provide evidence on the impact of indoor cycling (IC) in reducing cardiometabolic risk factors. The study compares the effects of a 3 month IC program involving three 55 min sessions per week on women aged 40&ndash, 60 years, with obesity (OW, n = 18) vs. women with normal body weight (NW, n = 8). At baseline and at the end of the study, anthropometric parameters, oxygen uptake (VO2 peak), and serum parameters: glucose, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG), insulin, human anti-oxidized low-density lipoprotein antibody (OLAb), total blood antioxidant capacity (TAC), thiobarbituric acid reactive substances (TBARS), endothelial nitric oxide synthase (eNOS), C-reactive protein (CRP), lipid accumulation product (LAP), and homeostasis model assessment of insulin resistance index (HOMA IR) were determined. Before the intervention, VO2 peak and HDL-C levels were significantly lower and levels of TG, LAP, insulin, HOMA-IR, and CRP were significantly higher in the OW group compared to those in the NW group. After the intervention, only the OW group saw a decrease in body mass, total cholesterol, OLAb, TBARS, and CRP concentration and an increase in total body skeletal muscle mass and HDL-C concentration. In response to the IC training, measured indicators in the OW group were seen to approach the recommended values, but all between-group differences remained significant. Our results demonstrate that IC shows promise for reducing cardiometabolic risk factors, especially dyslipidemia. After 12 weeks of regular IC, the metabolic function of the OW group adapted in many aspects to be more like that of the NW group.

Background: Obesity and excess body weight are significant epidemiological issues, not only because they are costly to treat, but also because they are among the leading causes of death worldwide. In 2016, an estimated 40% of the global population was overweight, reflecting the importance of the issue. Obesity is linked to metabolism malfunction and concomitantly with altered mineral levels in the body. In this paper, we review alterations in somatic levels of iron, calcium, magnesium, copper, iodine, chromium, selenium, and zinc in relation to excess body mass. Methodology: An electronic literature search was performed using PubMed. Our search covered original English research articles published over the past five years, culminating in 63 papers included for study. Results: The reviewed papers presented correlation between obesity and hypomagnesemia and hypozincemia. They also indicated that patients with excess body mass present increased body copper levels. Studies have similarly indicated that obesity appears to be associated with lower selenium levels in both blood and urine, which may be correlated with the decline and weakening of defenses against oxidative stress. It has been found that decreased level of chromium is connected with metabolic syndrome. Chromium supplementation influences body mass, but the effect of the supplementation depends on the chemical form of the chromium. It is hypothesized that obesity poses a risk of iodine deficiency and iodine absorption may be disrupted by increased fat intake in obese women. A range of studies have suggested that obesity is correlated with iron deficiency. On the other hand, some reports have indicated that excess body mass may coexist with iron excess. The relation between obesity and body iron level requires further investigation. Calcium signaling seems to be disturbed in obesity, due to the increased production of reactive oxygen species and low level of fast troponin isoform responsible for mediating calcium sensitivity of muscle relaxation. Correlation between excess body mass and calcium levels needs further research. Conclusions: Excess body mass is associated with alterations in mineral levels in the body, in particular hypomagnesemia and decreased selenium (Se) and zinc (Zn) levels. Chromium (Cr) deficiency is associated with metabolic syndrome. Obese patients are at risk of iodine deficiency. Excess body mass is associated with elevated levels of copper (Cu). Data on the association between obesity and iron (Fe) levels are contradictory. Obesity coexists with disturbed calcium (Ca) signaling pathways. The association between obesity and body Ca levels has not been investigated in detail.

Connective tissue diseases are a group of more than 300 separate diseases. It can affect every system of organs, including the cardiovascular system. This process is particularly highly expressed in rheumatoid arthritis, systemic lupus erythematosus and scleroderma. Rheumatoid arthritis (RA) affects 0.5-1.0% of Europeans. The most common cardiac manifestation of RA is pericarditis. Its main risk factor is the occurrence of rheumatic nodules in people with the presence of serum rheumatoid factor. An important health problem in RA is also an increased risk of atherosclerosis and ischemic myocardial disease, the intensity of which grows independently of traditional risk factors and mainly depends on the severity of inflammation and duration of the disease. In rheumatoid arthritis also endocarditis, heart valves damage and ventricular arrhythmias can occure. Systemic lupus erythematosus (SLE) is most common in women between age 16 to 55. Cardiovascular complications of this disease are the third biggest cause of death of patients. The most common cardiac manifestation of SLE is pericarditis occurring in approximately 20 to 50% of the ill. Libman-Sacks non-infectious endocarditis characterized by thickening of the heart valves and the presence of non-bacterial vegetation is characteristic for SLE. Systemic sclerosis is characterized by progressive fibrosis of skin and internal organs and disorders of the morphology and function of blood vessels. Cardiac manifestations of systemic sclerosis are mainly heart failure and arrhythmias. The European League Against Rheumatism (EULAR) has developed a number of recommendations related to the prevention and therapy of cardiovascular events in RA. Since an increased risk of cardiovascular complications applies to many rheumatic diseases, there is a need to extend these recommendations to other connective tissue diseases.

Aims: To compare the effects of endurance training with endurance strength training on the anthropometric, body composition, physical capacity, and circulatory parameters in obese women. Methods: 44 women with abdominal obesity were randomized into groups A and B, and asked to perform endurance (A) and endurance strength training (B) for 3 months, 3 times/week, for 60 min. Dual-energy X-ray absorptiometry and Graded Exercise Test were performed before and after training. Results: Significant decreases in body mass, BMI, total body fat, total body fat mass, and waist and hip circumference were observed after both types of intervention. Marked increases in total body lean and total body fat-free mass were documented in group B. In both groups, significant increases in peak oxygen uptake, time to exhaustion, maximal work rate, and work rate at ventilatory threshold were accompanied by noticeably decreased resting heart rate, resting systolic blood pressure, and resting and exercise diastolic blood pressure. No significant differences were noticed between groups for the investigated parameters. Conclusion: Our findings demonstrate evidence for a favorable and comparable effect of 3-month endurance and endurance strength training on anthropometric parameters, body composition, physical capacity, and circulatory system function in women with abdominal obesity.

Osteopontin (OPN) is one of the many physiological elements creating human musculoskeletal system. It is suspected that this protein is one of the most important mediators responsible for osseous tissue mass resorption, regulated by parthormon. The origin of its name comes from one of its physiological action – rebuilding of the bone mass structure (osteo – bone, pontin – bridge). Osteopontin fulfils many different actions being secreted by many different types of cells, including macrophages, lymphocytes, epithelial cells, vascular smooth muscle cells, and osteoblasts. OPN plays an important part in inflammatory process. It provokes macrophages and dendritic cells to movement into the destination where inflammatory process takes place. It also stimulates macrophages to interleukin 12 (IL12) and interferon ? (IFN ?) secretion. Increased OPN concentration in blood stream might be regarded as a novel, independent indicator of coronary artery disease. Osteopontin plays an important role in macrophage infiltration of the adipose tissue and at the same time contributes to insulin resistance. Obesity induces chronic, low-grade tissue inflammation. Positive correlation was observed between body mass index (BMI) and number of macrophages accumulated in the fat tissue. Once aroused monocytes infiltrate the adipose tissue, which leads to persisting chronic inflammation. At the same time the excreted by them cytokines may be connected with the mechanisms of obesity-induced insulin resistance.

Some investigations have demonstrated that a combined endurance&ndash, strength training is the most effective in the treatment of obesity. The aim of the research was to access how different trainings influence: endothelial function, lipid metabolism, and risk of atherosclerosis in women with obesity. In a randomized trial, 39 obese women aged 28&ndash, 62 completed endurance (n = 22, 60-80% HRmax) or combined training (n = 17, 20 minutes of strength exercises, 50&ndash, 60% 1RM and 25 minutes of endurance training, 60-80% HRmax). Before and after the intervention vascular endothelial function (endothelial nitric oxide synthase (eNOS), vascular endothelial growth factor (VEGF), thiobarbituric acid reactive substances (TBARS), blood total antioxidant capacity (TAC)), total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides and C-reactive protein (CRP)as well as visceral adiposity index (VAI), total-body skeletal muscle mass and atherogenic index of plasma (AIP) were determined. After the trainings, in both groups total cholesterol and total-body skeletal muscle mass increased (p &lt, 0.05). In the group undergoing combined training, lower (p &lt, 0.05) VAI, AIP, CRP and LDL-C were noted. In the group undergoing endurance training TBARS concentration decreased (p &lt, 0.01), while the HDL-C (p &lt, 0.01) concentration as well as eNOS (p &lt, 0.05) activity increased. No significant differences between groups were found, either before or after the programs. Both training programs led to the improvement of lipid metabolism, but only endurance training alone favorably changed indicators of endothelial functions in women with obesity.

Background: Obesity and exercise are associated with disturbances of mineral metabolism, which can lead to physical inefficiency. Our study aimed to compare the influence of endurance and endurance–strength training on mineral status in women with abdominal obesity. Methods: Thirty-eight abdominally obese women were randomized into groups A and B and underwent 3 months long training: group A—endurance training and group B—endurance–strength training. Anthropometric and body composition measurements were carried out and the Graded Exercise Test was performed. Blood, urine, and hair samples were collected for mineral content analysis. Results: Endurance training decreased serum Fe and Zn concentrations as well as hair Zn and Cu content, and increased urine Zn concentration. Endurance–strength training increased serum Mg and Cu concentrations, decreased serum Fe and Zn concentrations, decreased hair Ca and Mg content, and increased urine Ca and Zn concentrations. After training, serum and urine Fe concentration was higher in group A, while urine Ca concentration was higher in group B. A number of correlations was found. Conclusions: Both endurance and endurance–strength training have a significant effect on mineral metabolism in obese women; the favorable effects of endurance–strength exercise predominate in iron, magnesium, zinc, and copper balance.

Obesity is associated with kidney defects. Physical activity is a key element in the treatment of obesity. The aim of this study was to compare the effect of endurance and endurance-strength training on kidney function in abdominally obese women.Forty-four abdominally obese women were randomized to endurance training or endurance-strength training, three times a week for 3 months. Before and after the intervention, kidney function was assessed by measuring blood creatinine, urine creatinine, and urine albumin levels, and the albumin-to-creatinine ratio and glomerular filtration rate (GFR) were calculated.Renal hyperperfusion was present in both groups before the study. Following both types of physical activity, similar modifications of the investigated parameters were observed, but with no significant between-group differences. Both courses of training led to a significant increase in blood creatinine and a subsequent decrease in the GFR. A significant increase in urine creatinine and album levels, though not exceeding the range for microalbuminuria, was not accompanied by any difference in the albumin-to-creatinine ratio after endurance-strength training alone.Three months of either endurance or endurance-strength training has a favorable and comparable effect on renal function in abdominally obese women with renal hyperfiltration.

Back pain is a frequent symptom in the obese. The purpose of the study was to compare the effects of two training programs on the reduction of back pain among obese women.The study included 30 obese women who reported back pain within 3 months preceding enrollment. The subjects were randomly allocated to endurance or endurance/resistance physical exercise. The intensity of the exercise was adjusted to 50–80% of HRmax. Back pain intensity, muscle strength of knee flexors and extensors, body balance and body composition were measured before and after training.Both the endurance and endurance/resistance training exerted positive effect on back pain (. Both endurance and combined endurance/resistance training exert positive effect in decreasing back pain and improving functional fitness of obese women. Therefore, both forms of training may be recommended for individuals dealing with the abovementioned problems.

Rationale Acute calculous cholecystitis is a prevalent disease whose diagnosis and management still face significant debate. Although the overall incidence of gallstone disease is 18.8% in European women aged 30 to 69 years, there is little data and experience in managing acute calculous cholecystitis in populations over 80 years old. The incidence of acute cholecystitis among the elderly is probably increasing. For the reason, we here highlight the advantages and disadvantage of various treatment and management opens based on a 96-year-old patient. Patient concerns We present a rare case in which a 96-year-old woman suffered from abdominal pain, nausea, and lack of appetite for over a month. Diagnoses She was diagnosed with acute calculous cholecystitis and pancreatitis. Interventions She was successfully treated without surgery, regaining her physical health after 5 months. Outcomes The question of how to manage acute calculous cholecystitis is extremely difficult in many aspects. The patient of very advanced age presented in this paper, not very well diagnosed and with a life-threating condition, survived because of careful treatment and reasonable decision-making. Lessons The take-away from this case is that, in a high-risk senile patient, strict conservative therapy of cholecystitis may be successful, as it can avoid the complications of surgery and leave the patient with a good quality of life.

Obesity is a risk factor of nonalcoholic fatty liver disease. Although the standard therapy for obesity involves physical exercise, well-planned studies of the changes in liver function in response to different exercise intensities in obese subjects are scarce. The aim of the present study was to examine a question of how does exercise mode affect the liver function.44 women with abdominal obesity were randomized into two exercise groups: endurance (group A) and endurance-strength (group B). Women in each group exercised for 60min 3 times/week for a 3-month period. Markers of liver function: serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), γ-glutamyltranspeptidase (GGT), alkaline phosphatase (ALP) activities, and bilirubin levels were quantified.We found significant differences in ALT (p0.01) and AST (p0.05) activities between group A and B after training exercise. Blood ALT and AST tended to decrease in group B, increase in group A. Significant reduction in serum GGT level after exercise in both groups was observed (p0.001, group A; p0.01, group B). Neither endurance nor endurance-strength exercise led to changes in serum ALP activity and total or direct bilirubin level. However, endurance-strength training resulted in significant decreases in serum indirect bilirubin (p0.05). Strong positive correlations between serum indirect bilirubin and body mass (r=0.615; p=0.0085) and BMI (r=0.576; p=0.0154) were found after endurance-strength exercise (group B).The mode of exercise does matter: endurance-strength exercise led to a greater improvement, compared to endurance exercise, in the liver function in women with abdominal obesity.

The basic criterion for the diagnosis of anorexia (AN - anorexia nervosa) by ICD-10 (International Classification of Diseases, version 10) is the body weight less than 15% of the expected normal body weight. According to DSM-IV (Diagnostic and Statistical Manual for Mental Disorders, version IV) the basic feature of AN is a refusal to maintain body weight equal or greater than the minimal normal weight. The prevalence of anorexia nervosa is 0.3-0.5% or even 1.3-3.7% if include pre-anorexic states (eg. the phenomenon of pro-ana). The main feature of anorexia is a reduction of caloric intake. According to the recommendations of the American Psychiatric Association (APA) for nutritional treatment of patients with AN the main goals in therapy of AN are: restoration of body weight, normalization of eating patterns, achievement a normal feeling of hunger and satiety and correction of the consequences of improper nutrition. APA suggests that achievable weight gain is about 0.9-1.4 kg per week in the case of hospitalized patients and approximately 0.23-0.45 kg per week in the case of outpatients. During the nutritional treatment of AN numerous side effects including anxiety, phobia, occurrence of obsessive thoughts and compulsive behavior, suicidal thoughts and intentions may occur. According to National Institute for Clinical Excellence (NICE) the most important goal of AN therapy is weight gain in the range of 0.5-1 kg per week in hospitalized patients and 0.5 kg per week for outpatients. A person suffering from anorexia in the initial period of nutritional treatment spends twice more energy to maintain elevated body temperature, which significantly increases during the night rest. This phenomenon is called nocturnal hyperthermia and has a negative effect on the healing process. "Refeeding syndrome" is an adverse effect of nutritional treatment in anorexia. It is caused by too rapid nutrition in a patient suffering from chronic starvation. It can endanger the patient's life.

The obesity affects around 312 million people over the world. In The United States it causes more than 300 000 deaths per year. It leads to many complications, such as ischemic heart disease, hypertension, dyslipidemia, atherosclerosis and abnormal carbohydrate metabolism. It was proven recently that obesity is also an independent risk factor for erectile dysfunction in men. 79% of men presenting erectile disorders have BMI of 25 kg/m2 or greater. BMI in the range 25-30 kg/m2 is associated with 1,5 times, and in the range of over 30 kg/m2 with 3 times greater risk of sexual dysfunction. The occurrence of erectile dysfunction in patients with obesity is caused by a number of complications which are characteristic for an excessive amount of fat tissue, in example: cardiovascular diseases, diabetes or dyslipidemia. In the United States diabetes and obesity are responsible for 8 million cases of erectile dysfunction. Scientific evidence indicates that excessive body weight should be considered as an independent risk factor for erectile dysfunction. This risk increases with increasing BMI. Erectile disorders correlate with the occurrence of obesity at any time during the patient's life. Obesity leads to erectile dysfunction in a considerably greater extent than aging. Mechanisms responsible for the independent influence of obesity on the erectile dysfunction are: hormonal imbalance, endothelial dysfunction, insulin resistance, psychological factors and physical inactivity. The basis for erectile dysfunction treatment in obesity is body weight loss. Erectile disorders in obese men are significantly more frequent than in general population. Obesity is beyond any doubts an independent risk factor of erectile dysfunction.