Total Versus Inorganic and Organic Species of As, Cr, and Sb in Flavored and Functional Drinking Waters: Analysis and Risk Assessment.

Packing material can release certain elements such as As, Cr, or Sb into its content and, thus, contaminate the drinking water. The effect of As, Cr, and Sb on human health depends highly on the chemical species in which these elements are introduced into the body. For the above reasons quantification and speciation of As, Cr, and Sb in flavored and functional drinking water samples is an important issue. Total, inorganic, and organic species of As, Cr, and Sb including As(III), As(V), Cr(VI), Sb(III), and Sb(V) were studied in flavored and functional drinking waters. Analyses of total As, Cr, and Sb were conducted using inductively coupled plasma mass spectrometry (ICP-MS) according to ISO 17294-2:2016. The speciation analysis of arsenic, chromium, and antimony in bottled flavored and functional drinking waters was conducted with the use of the elemental (HPLC/ICP dynamic reaction cell (DRC) MS) and molecular (electrospray ionization MS/MS) mass spectrometry. Concentrations of total As, Cr, and Sb (µg∙L-1) in waters studied were in the ranges 0.0922 ± 0.0067 to 8.37 ± 0.52, 0.0474 ± 0.0014 to 1.310 ± 0.045, and 0.0797 ± 0.0026 to 1.145 ± 0.019, respectively. Speciation analysis showed that, apart from the toxic ionic species, known and unknown organic species were present in test samples. The risk assessment results proved that there is no risk associated with consumption of these tested beverages in terms of the non-carcinogenic effect of total and inorganic or organic species of As, Cr, and Sb.

Study on Speciation of As, Cr, and Sb in Bottled Flavored Drinking Water Samples Using Advanced Analytical Techniques IEC/SEC-HPLC/ICP-DRC-MS and ESI-MS/MS.

The main aim of the research was to develop a complementary analytical approach consisting of bespoke speciation analysis and non-targeted speciation analysis of As, Sb, and Cr in flavored bottled drinking water samples using HPLC/ICP-DRC-MS and ESI-MS/MS. The scope of two previously developed analytical procedures, (1) multielemental speciation procedure for AsIII, AsV, CrVI, SbIII, and SbV analysis and (2) arsenic speciation procedure for AsB, AsIII, DMA, MMA, and AsV quantification, was extended to the analysis of a new sample type in terms of bespoke speciation analysis. As for the non-targeted speciation, analysis size exclusion chromatography was used with ICP-MS and a complementary technique, ESI-MS/MS, was used for the organic species of As, Sb, and Cr screening. Full validation of procedures 1 and 2 was conducted. Procedure 1 and 2 were characterized with precision values in the range from 2.5% to 5.5% and from 3.6% to 7.2%, respectively. Obtained recoveries ranged from 97% to 106% and from 99% to 106% for procedures 1 and 2, respectively. Expanded uncertainties calculated for procedures 1 and 2 ranged from 6.1% to 9.4% and from 7.4% to 9.9%, respectively. The applicability of the proposed procedures was tested on bottled drinking water samples. Results for the real samples in procedure 1 were in the range from 0.286 ± 0.027 [µg L-1] to 0.414 ± 0.039 [µg L-1] for AsIII, from 0.900 ± 0.083 [µg L-1] to 3.26 ± 0.30 [µg L-1] for AsV, and from 0.201 ± 0.012 [µg L-1] to 0.524 ± 0.032 [µg L-1] for SbV. CrVI and SbIII were not detected in any sample. As for procedure 2, results were in the range from 0.0541 ± 0.0053 [µg L-1] to 0.554 ± 0.054 [µg L-1] for AsB. Results for AsIII and AsV obtained with procedure 2 were in good accordance with results obtained with procedure 1. DMA and MMA were not detected in any sample.

Interdependencies among Selected Pro-Inflammatory Markers of Endothelial Dysfunction, C-Peptide, Anti-Inflammatory Interleukin-10 and Glucose Metabolism Disturbance in Obese Women.

BACKGROUND: Currently increasing importance is attributed to the inflammatory process as a crucial factor responsible for the progressive damage to vascular walls and progression of atherosclerosis in obese people. We have studied the relationship between clinical and biochemical parameters and C-peptide and anti-inflammatory IL-10, as well as selected markers of inflammation and endothelial dysfunction such as: CCL2, CRP, sICAM-1, sVCAM-1 and E-selectin in obese women with various degree of glucose metabolism disturbance. MATERIAL AND METHODS: The studied group consisted of 61 obese women, and 20 normal weight, healthy volunteers. Obese patients were spited in subgroups based on the degree of glucose metabolism disorder. Serum samples were analyzed using ELISA kits. RESULTS: Increased concentrations of sICAM-1, sVCAM-1, E-selectin, CCL2 and CRP were found in all obese groups compared to the normal weight subjects. In patients with Type 2 diabetes mellitus (T2DM) parameters characterizing the degree of obesity significantly positively correlated with levels of CRP and CCL2. Significant relationships were found between levels of glucose and sICAM-1and also E-selectin and HOMA-IR. C-peptide levels are positively associated with CCL2, E-selectin, triglycerides levels, and inversely with IL-10 levels in newly diagnosed T2DM group (p<0.05). Concentrations of IL-10 correlated negatively with E-selectin, CCL2, C-peptide levels, and HOMA-IR in T2DM group (p<0.05). CONCLUSION: Disturbed lipid and carbohydrate metabolism are manifested by enhanced inflammation and endothelial dysfunction in patients with simply obesity. These disturbances are associates with an increase of adhesion molecules. The results suggest the probable active participation of higher concentrations of C-peptide in the intensification of inflammatory and atherogenic processes in obese patients with type 2 diabetes. In patients with obesity and type 2 diabetes, altered serum concentrations of Il-10 seems to be dependent on the degree of insulin resistance and proinflammatory status.

Accurate quantification of total chromium and its speciation form Cr(VI) in water by ICP-DRC-IDMS and HPLC/ICP-DRC-IDMS.

Two analytical procedures have been developed for the determination of total chromium (TCr) and its highly toxic species, i.e. Cr(VI) in water samples using the following methods: inductively coupled plasma dynamic reaction cell isotope dilution mass spectrometry (ICP-DRC-IDMS) and high performance liquid chromatography inductively coupled plasma dynamic reaction cell isotope dilution mass spectrometry (HPLC/ICP-DRC-IDMS). Spectral interferences, predominantly occurring in chromium determination, were removed using a dynamic reaction cell (DRC). The presented procedures facilitate the quantification of trace amounts - below 1 µg L(-1) of TCr and individual Cr species - in various water matrices including drinking water and still bottled water with different mineral composition. Special attention has been paid to the adequate preparation of isotopically enriched (53)Cr(VI) standard solution in order to avoid artifacts in chromium speciation. Both procedures were fully validated as well as establishing the traceability and estimation of the uncertainty of measurement were carried out. Application of all of the above mentioned elements and of the isotope dilution technique, which provides the highest quality of metrological traceability, allowed to obtain reliable and high quality results of chromium determination in water samples. Additionally, the comparison of two methods: HPLC/ICP-DRC-MS and HPLC/ICP-DRC-IDMS for Cr(VI) determination, was submitted basing on the validation parameters. As a result, the lower values for these parameters were obtained using the second method.

Joint scientific statement of the European Association for the Study of Obesity and the European Society of Hypertension: Obesity and early vascular ageing.

Current cardiovascular risk scores do not include obesity or fat distribution as independent factors, and may underestimate risk in obese individuals. Assessment of early vascular ageing (EVA) biomarkers including arterial stiffness, central blood pressure, carotid intima-media thickness and flow-mediated vasodilation may help to refine risk assessment in obese individuals in whom traditional cardiovascular risk scores and factors suggest no need for specific medical attention. A number of issues need to be addressed before this approach is ready for translation into routine clinical practice. Methodologies for measurements of vascular markers need to be further standardized and less operator-dependent. The utility of these nontraditional risk factors will also need to be proven in sufficiently large and properly designed interventional studies. Indeed, published studies on vascular markers in obesity and weight loss vary in quality and study design, are sometimes conducted in small populations, use a variety of differing methodologies and study differing vascular beds. Finally, current vascular measurements are still crude and may not be sufficient to cover the different aspects of EVA in obesity.

Chromium and its speciation in water samples by HPLC/ICP-MS--technique establishing metrological traceability: a review since 2000.

Chromium holds a special position among living organisms because depending on its species it can be either essential or toxic. Cr(VI) even at very low concentrations is harmful and carcinogenic, while Cr(III) is a necessary microelement for cellular metabolism. Therefore, a simple analysis of Cr concentration in collected samples will not be able to distinguish these differences effectively: for a proper chemical analysis we need to perform a reliable detection and quantification of Cr species. Separation and detection of chromium can be accomplished with high performance liquid chromatography hyphenated to inductively coupled plasma mass spectrometry (HPLC/ICP-MS) in a one-step. Our review assembles articles published since 2000 regarding chromium speciation in water samples with the use of HPLC/ICP-MS. It addresses the following issues: chromium chemistry, the possibilities of dealing with interferences, metrological aspects, analytical performance and speciated isotope dilution mass spectrometry (SIDMS) which is a definitive measurement method. The authors would like to advocate this hyphenated advanced technique as well as the metrological approach in speciation analysis of chromium.

Alexithymia, depression, anxiety and binge eating in obese women

Background and Objectives: Alexithymia is a personality trait that may affect the development and course of obesity and effectiveness of treatment. The aim of the study is to assess the prevalence of alexithymia in obese women beginning a weight reduction program and determine the relationships between alexithymia and anxiety, depression, and binge eating. Methods: Obese women (n = 100; age 45 ± 13 yr) completed the following self-report inventories: Toronto Alexithymia Scale (TAS 26), Hospital Anxiety and Depression Scale (HADS), and Binge Eating Scale (BES). Results: Alexithymia was found in 46 patients and was more frequent among women who had attained only primary and vocational education than in those with a higher education level (39.1% vs. 10.9%; p = 0.002) and in those >45 years old than in younger women (30.4% vs. 69.6%; p = 0.03). The frequency of severe depression symptoms was higher in alexithymic women than in non-alexithymic women (19.6% vs. 5.6%; p = 0.03); however, the anxiety state was equally prevalent in both subgroups. The prevalence of alexithymia (52.6% vs. 44.4%) and its level (73.2 ± 8.9 vs. 71.2 ± 11.3 points) were similar in women with and without binge eating disorder. Multivariate mixed linear regression analysis revealed that higher body mass index was associated with primary and vocational education (odds ratio [OR] = 16.69) and severe depression symptoms (OR = 52.45), but not alexithymia. Conclusions: In addition to severe depression and low education level, obesity may predispose for the development of alexithymia. However, alexithymia does not affect the severity of obesity in women (AU)

Circulating visfatin level and visfatin/insulin ratio in obese women with metabolic syndrome.

INTRODUCTION: Visfatin is an adipokine secreted by visceral adipose tissue with insulin-mimetic properties. Higher circulating visfatin levels were reported in type 2 diabetes. The aim of this study was to analyse circulating visfatin and insulin levels and the visfatin/insulin ratio in obese women with and without metabolic syndrome (MetS). MATERIAL AND METHODS: The study involved 92 obese women. Subjects were diagnosed with MetS according to IDF 2005 criteria. The MetS group consisted of 71 subjects (age: 52.8 ±9.4 years, body mass index [BMI]: 39.1 ±5.6 kg/m(2), waist circumference: 109.6 ±11.4 cm and fat mass: 52.0 ±12.8 kg) while the non-MetS group consisted of 21 subjects (age: 51.7 ±9.5 years, BMI: 36.3 ±5.2 kg/m(2), waist circumference: 104.7 ±11.0 cm and fat mass: 45.2 ±10.7 kg). In addition to anthropometric measurements and assessment of serum glucose and lipids, plasma concentrations of visfatin were estimated by enzyme-linked immunosorbent assay (ELISA) and of insulin by radioimmunoassay (RIA). Homeostatic model assessment insulin resistance (HOMA-IR) and visfatin/insulin ratio were calculated. RESULTS: In the MetS group significantly higher (p < 0.01) plasma concentrations of insulin and HOMA-IR values but similar visfatin levels were observed than in the non-MetS group. As a consequence of the significantly higher plasma insulin concentration the visfatin/insulin ratio was significantly lower in the MetS group (p < 0.05). The visfatin/insulin ratio correlated inversely with anthropometric parameters such as body mass, BMI, body fat and waist circumference (r = -0.41, p = 0.0003; r = -0.42, p = 0.0002; r = -0.29, p = 0.01; r = -0.23, p = 0.04, respectively). CONCLUSIONS: We conclude that the visfatin/insulin ratio declining with increasing visceral obesity may predispose to the development of insulin resistance.

Joint statement of the European Association for the Study of Obesity and the European Society of Hypertension: obesity and difficult to treat arterial hypertension.

Obese patients are prone to arterial hypertension, require more antihypertensive medications, and have an increased risk of treatment-resistant arterial hypertension. Obesity-induced neurohumoral activation appears to be involved. The association between obesity and hypertension shows large inter-individual variability, likely through genetic mechanisms. Obesity affects overall cardiovascular and metabolic risk; yet, the relationship between obesity and cardiovascular risk is complex and not sufficiently addressed in clinical guidelines. The epidemiological observation that obesity may be protective in patients with established cardiovascular disease is difficult to translate into clinical experience and practice. Weight loss is often recommended as a means to lower blood pressure. However, current hypertension guidelines do not provide evidence-based guidance on how to institute weight loss. In fact, weight loss influences on blood pressure may be overestimated. Nevertheless, weight loss through bariatric surgery appears to decrease cardiovascular risk in severely obese patients. Eventually, most obese hypertensive patients will require antihypertensive medications. Data from large-scale studies with hard clinical endpoints on antihypertensive medications specifically addressing obese patients are lacking and the morbidity from the growing population of severely obese patients is poorly recognized or addressed. Because of their broad spectrum of beneficial effects, renin-angiotensin system inhibitors are considered to be the most appropriate drugs for antihypertensive treatment of obese patients. Most obese hypertensive patients require two or more antihypertensive drugs. Finally, how to combine weight loss strategies and antihypertensive treatment to achieve an optimal clinical outcome is unresolved.

Changes of bone mineral density in obese perimenopausal women during 5-year follow-up.

INTRODUCTION: The beneficial effect of obesity on bone mineral density (BMD) has not been definitely established. OBJECTIVES: The aim of the study was to evaluate changes in BMD in obese perimenopausal women during a 5-year follow-up. PATIENTS AND METHODS: The study involved 54 obese women. The group was divided into 2 subgroups according to the menopausal status: postmenopausal women--M (n = 35) and premenopausal women--P (n = 19). Laboratory tests (parathyroid hormone, 25-hydroxyvitamin D3, C-terminal telopeptide of type I collagen, osteocalcin, and osteoprotegerin), anthropometric measurements, and densitometry were performed twice during the 5-year follow-up. The control group consisted of 19 healthy women of the same age and with normal body weight. RESULTS: Obese postmenopausal women were characterized by lower BMD in the proximal femur and lumbar spine, higher fracture risk, and higher serum osteocalcin levels at baseline. During the 5-year follow-up, there was a 1.52% and 6.86% decrease in proximal femur BMD and 2.34% and 5.17% in lumbar spine BMD (in premenopausal and postmenopausal women, respectively). In postmenopausal controls, BMD reduction was 2.36% and 4.3%, respectively. In the combined analysis including all postmenopausal women, there was an inverse correlation between the initial body mass index and the changes in proximal femur BMD (r = -0.25; P <0.05) and lumbar spine BMD (r = -0.28; P = 0.08) that occurred during the 5-year follow-up. CONCLUSIONS: Obesity appears not to protect against bone mineral loss in postmenopausal women.

The influence of oral water load on energy expenditure and sympatho-vagal balance in obese and normal weight women.

INTRODUCTION: Oral water load may increase the energy expenditure (EE) by stimulation of sympathetic dependent thermogenesis. Thus, drinking of water may be helpful in weight reduction. The aim of the study is to assess the influence of water load on energy expenditure and sympathetic activity in obese and normal weight women. MATERIAL AND METHODS: Forty-five women were included. Energy expenditure was measured twice, in the morning and after oral water load, by the indirect calorimetric method. The heart rate variability parameters low frequency (LF), high frequency (HF), LF/HF index, standard deviation of normal RR intervals (SDNN) and root mean square difference among successive RR normal intervals (rMSSD) were used for the indirect assessment of the sympatho-vagal balance. RESULTS: Resting energy expenditure (REE) was significantly higher in obese than in normal weight women (1529 ±396 kcal/day vs. 1198 ±373 kcal/day; p = 0.02). In both study groups after water load EE increased significantly (by 20% and by 12%, corresponding to 8.6 kcal/h and 5.2 kcal/h respectively), while, LF/HF index increased simultaneously. The increase of energy expenditure (EE) did not exceed the energetic cost of water heating, from room to body temperature - 15 kcal/1000 ml. There was no correlation between changes of energy expenditure (EE) and heart rate variability (HRV) parameters. CONCLUSIONS: The increase of EE induced by water load is mostly related to the heating of the consumed water to body temperature. The assessment of autonomic balance by means of standard HRV indices had been found insufficient for detection of actually operating mechanisms.

Changes of systemic microinflammation after weight loss and regain - a five-year follow up study.

INTRODUCTION: The aim of this study was to evaluate the influence of body mass changes on plasma concentrations of proinflammatory cytokines in obese women after the initially obtained weight reduction in a five-year follow-up period. MATERIAL AND METHODS: Thirty out of 42 women with simple obesity (age 41.8 ± 11.9 years; BMI 36.5 ± 4.6 kg/m2) who achieved a greater than 5% weight loss at the end of a three-month weight loss programme were re-examined after five years. In addition to anthropometric and body composition measurements, plasma concentrations of TNF-alpha, sTNFRs and IL-6 were determined. RESULTS: The mean weight loss after the three-month weight loss programme was 7.9 ± 4.4 kg. After five years, body mass was still lower than initially in 14 women, while in 16 it was higher (the so-called 'yo-yo effect'). A significant decrease of plasma TNF-alpha and IL-6 and increase of sTNFR1 and sTNFR2 levels obtained after weight loss therapy were maintained after five years, including in the subgroup with the yo-yo effect. During the follow-up period, the increase of body fat mass was similar in the subgroup that maintained reduced weight (+4.4 ± 10.7 kg) and in the subgroup with the yo-yo effect (+4.1 ± 7.1 kg), while a significant difference was found in changes of body free fat mass (-7.1 ± 7.1 v. -0.7 ± 4.5 kg, respectively). CONCLUSIONS: The yo-yo effect has a modest influence on systemic microinflammation and seems not to abolish the benefit achieved via a weight loss programme. This may suggest that the persistence of changes in lifestyle implemented during the programme such as regular physical activity and diet composition may have a significant impact on the level of systemic microinflammation in the obese. (Endokrynol Pol 2012; 63 (6): 432-438).

Criteria for EASO-collaborating centres for obesity management.

Obesity is recognised as a global epidemic and the most prevalent metabolic disease world-wide. Specialised obesity services, however, are not widely available in Europe, and obesity care can vary enormously across European regions. The European Association for the Study of Obesity (EASO, www.easo.org) has developed these criteria to form a pan-European network of accredited EASO-Collaborating Centres for Obesity Management (EASO-COMs) in accordance with accepted European and academic guidelines. This network will include university, public and private clinics and will ensure that the obese and overweight patient is managed by a holistic team of specialists and receives comprehensive state-ofthe-art clinical care. Furthermore, the participating centres, under the umbrella of EASO, will work closely for quality control, data collection, and analysis as well as for education and research for the advancement of obesity care and obesity science.

Plasma visfatin and tumor necrosis factor-alpha (TNF-α) levels in metabolic syndrome.

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.

N-3 polyunsaturated fatty acids early supplementation improves ultrasound indices of endothelial function, but not through NO inhibitors in patients with acute myocardial infarction: N-3 PUFA supplementation in acute myocardial infarction.

BACKGROUND & AIMS: Our aim was to evaluate early initiated one month n-3 polyunsaturated fatty acids (PUFA) supplementation effects on ultrasound indices of endothelial function and serum asymmetric dimethylarginine (ADMA) levels in patients with acute myocardial infarction (AMI). METHODS: Forty patients with AMI and successful percutaneous coronary intervention (PCI) were recruited into the study and randomized to the study group (group P; n = 20; standard therapy + n-3 PUFA 1 g daily) or the control group (group C; n = 20; standard therapy). Ultrasound indices of endothelial function: flow-mediated dilatation (FMD), nitroglycerin-mediated dilatation (NMD) and serum ADMA concentrations (ELISA) were obtained before and after one month (30 ± 1 days) therapy (presented as means ± standard deviations). RESULTS: There was a significant difference between both groups in mean delta (baseline/after one month) FMD (P: 8.1 ± 12.6% vs C: -2.2 ± 11.8%; p = 0.02) with no difference in mean delta NMD (P: 3.3 ± 11.9% vs 0.66 ± 14.3%; p = 0.53). We found also a significant increase in mean FMD (7.4 ± 6.4 to 15.5 ± 10.5%; p = 0.02) with a nonsignificant change in mean NMD values (26.9 ± 12.1 to 30.2 ± 14.0%; p = 0.24) after 1-month therapy with n-3 PUFA. FMD and NMD mean values did not change in control patients (FMD: 11.6 ± 6.1% to 9.4 ± 8.0%; p = 0.5 NMD: 25.1 ± 11.4% to 25.8 ± 14.0%; p = 0.84). The comparison of mean delta ADMA values for both groups revealed no differences (P: 6.2 ± 9.7 µmol/l vs C: 3.6 ± 9.5 µmol/l; p = 0.43). Mean serum ADMA concentrations were significantly increased after 1-month therapy in the group P (P: 2.1 ± 1.8 to 8.3 ± 9.7 µmol/l; p = 0.001; C: 4.5 ± 7.1 to 8.1 ± 9.5 µmol/l; p = 0.09). However, there was a nonsignificant difference in mean baseline serum ADMA levels between both groups (P: 2.1 ± 1.8 µmol/l vs C: 4.5 ± 7.1 µmol/l; p = 0.32). There were no significant correlations between FMD, NMD, ADMA levels and demographic, clinical or biochemical parameters. CONCLUSIONS: Early and short-term n-3 PUFA supplementation improved ultrasound indices of endothelial function without affecting serum ADMA levels in patients with AMI and successful primary PCI.

Body fat changes and activity of tumor necrosis factor α system--a 5-year follow-up study.

Obesity is associated with subclinical, chronic, and systemic immune activation characterized by increased serum concentration of proinflammatory cytokines released by adipose tissue. The aim of the present study was to determine the relationship between stage of development of obesity and changes in activity of tumor necrosis factor (TNF) system during 5-year follow-up observation. One hundred fifty-four women--102 obese, 24 overweight, and 28 lean--without concomitant diseases were examined for the first time from 2000 to 2001. After 5 years, 57 obese, 12 overweight, and 14 lean subjects were reexamined. In addition to anthropometric measurements, body composition was determined by the bioimpedance method; and serum concentrations of glucose, lipids, insulin, TNF-α, and soluble TNF receptors (sTNFRs) were measured. Only reexamined subjects were included in the analysis. After 5 years, fat mass increased significantly in 46 (66.7%) overweight or obese women and in all lean subjects (39.0 ± 12.3 vs 47.3 ± 13.6 kg, P < .001; 14.8 ± 3.7 vs 20.6 ± 5.4 kg, P < .01, respectively), whereas it decreased in 23 (33.3%) overweight or obese subjects (41.3 ± 12.5 vs 37.2 ± 14.0 kg, P < .005). The TNF-α levels increased significantly only in lean women (3.1 ± 3.0 vs 5.6 ± 2.0 pg/mL, P < .005), but remained unchanged in overweight and obese subjects regardless of fat mass changes. Serum concentrations of sTNFR1 and sTNFR2 decreased by 71% and 25% in obese, by 104% and 21% in overweight, and by 31% and 32% in lean group, respectively. The increase of plasma TNF-α level is an early event in abdominal fat accumulation. It seems that further fat mass gain does not enhance circulating TNF-α levels.

N-3 Polyunsaturated fatty acid therapy improves endothelial function and affects adiponectin and resistin balance in the first month after myocardial infarction.

INTRODUCTION: N-3 Polyunsaturated fatty acids (n-3 PUFA) exert clinical beneficial effects in patients after acute myocardial infarction (AMI). However, their exact mechanisms of action are not well recognized yet. Our aim was to evaluate effects of early introduced n-3 PUFA supplementation on endothelial function and serum adipokine concentrations in patients with AMI. MATERIAL AND METHODS: Thirty-eight patients with AMI and successful coronary stent implantation were randomized to the study group (PUFA group: n = 19; standard therapy + PUFA 1 g daily) and the control group (control group: n = 19; standard therapy). The study group patients were given n-3 PUFA (Omacor 1 g daily) starting from the 3(rd) day of AMI. Ultrasound vascular indexes (flow-mediated dilatation [FMD], nitroglycerine-mediated dilation [NMD]) and serum concentrations of adiponectin and resistin (ELISA) were evaluated before and after 30 days of pharmacotherapy. RESULTS: Comparison of the mean delta values (baseline/after 30 days of therapy) between groups revealed significant differences for delta FMD (PUFA 7.6 ±12.4% vs. control -1.7 ±10.5%, p = 0.019) and delta resistin concentrations (PUFA 1.0 ±3.8pg/ml vs. control -1.6 ±2.9pg/ml, p = 0.028). Multiple linear regression analysis for all subjects revealed the n-3 PUFA supplementation (r = 10.933, p = 0.004) and waist circumference (r = -0.467, p = 0.01) as independent factors associated with delta FMD values (R-adjusted 0.29; p = 0.002). CONCLUSIONS: Early and short-term n-3 PUFA supplementation in AMI with successful primary PCI and optimal pharmacotherapy improves endothelial function. However, increased resistin serum levels observed after 1-month n-3 PUFA supplementation merits further investigations.

Impact of excess body weight on walking at the preferred speed.

The implications of a long-lasting mechanical load on the locomotor activity are poorly understood. The objective of the present studies was to determine an impact of excess body weight on basic spatiotemporal gait measures and to test the hypothesis that leg swing phase may account for a load-related adaptation of the stride characteristics. To this end the basic spatial and temporal stride measures were assessed in 100 obese and 36 lean women (age range between 18 and 67 years) walking with their self-selected pace on a 10-meter long and 1 meter wide instrumented pathway. Among the subjects there were: 44 with class I obesity, 27 with class II obesity, and 29 with class III. Subjects' stance and swing times as well as the stride lengths were recorded by means of contact copper-film electrodes attached to a sole of subject' footwear. The acquired gait measures were used then to compute: a mean velocity of walking, double support times and a mean velocity of a foot during swing phase. Data analysis showed that subjects from every experimental groups walked with a very similar speed (1.08 +/- 0.2 m/s) and cadence (106 +/- 10 steps/min). Their stance time was not affected by body weight and it remained at the mean level of 746 +/- 90 ms for all groups. The temporal stride characteristics and the stance-to-swing ratio were, however, substantially modified in obese individuals due to attenuation of the swing time. As a consequence, the remaining normalized (i.e., expressed as percentage of gait cycle time) phases of stride: the stance and the double support were relatively longer. While the swing time negatively correlated with the body mass index (BMI), the normalized stance and the double support exhibited strong positive correlation (r=0.46) with the BMI. The increase of leg swing velocity seems the main and unique adaptation mechanism that is utilized in the preferred walking gait in obese women.

Changes in bone mineral density and bone turnover markers in obese women after short-term weight loss therapy during a 5-year follow-up.

INTRODUCTION: The protective effect of adipocity on bone metabolism has not been confirmed during long-term follow-up. It is not known whether the rate of bone turnover and changes in mineral metabolism in obese people result from endocrine properties of the adipose tissue or merely the mechanical load. OBJECTIVES: The aim of the study was to evaluate bone and calcium-phosphorus metabolism in obese women during a 5-year follow-up. PATIENTS AND METHODS: The study involved 47 obese women who underwent a 3-month weight loss therapy. We evaluated changes in the serum levels of parathormone (PTH), calcidiol (25(OH)D3), collagen type I crosslinked C-telopeptide (CTx-I), osteocalcin, total calcium, inorganic phosphates, and in bone mineral density. The control group consisted of 17 healthy women with proper body weight. RESULTS: We observed a similar decrease in bone mineral density (BMD) in the lumbar spine and femoral neck, and a comparable decrease in the serum levels of CTx-I and osteocalcin in both groups during the 5-year follow-up. Changes in serum PTH levels were not statistically significant. In obese women, a nonsignificant increase in the serum level of 25(OH)D3 was observed as early as after a 3-month weight loss therapy and during follow-up. In controls, serum 25(OH)D3 levels tended to decrease. During follow-up, the number of obese patients with disturbances in vitamin D metabolism decreased from 78.7% to 53.2% (P = 0.01). Such disturbances were observed in 35.3% of the control group. In obese patients, there was a positive correlation between the change in body mass and BMD in the proximal femur (r = 0.279, P = 0.04). In controls, there was a positive correlation between the change in body mass and BMD in the lumbar spine (r = 0.477, P = 0.05). CONCLUSIONS: In obese women who underwent weight loss therapy, the levels of bone turnover markers decreased and abnormal vitamin D metabolism was still observed during the 5-year follow-up.

Proangiogenic cytokines vascular-endothelial growth factor and basic fibroblst growth factor in childhood lymphadenopathy.

Increased angiogenesis is observed both in the inflammatory and in the neoplasmatic tissue. The aim of the study was to assess the diagnostic significance of serum concentration of vascular-endothelial growth factor (sVEGF) and basic fibroblast growth factor (sbFGF) in the various forms of lymphadenopathy in children. Ninety-four children with lymphadenopathy were studied: group A, 52 patients with lymphadenitis; group B, 42 patients with lymphomas. Group B was divided into subgroups: B(P), children with lymphomas in peripheral lymph nodes and B(M), children with lymphomas in peripheral lymph nodes and mediastinal tumor. The healthy control group was 20 children. Using enzyme-linked immunosorbent assays the authors quantified VEGF and bFGF in serum of healthy children and of children with lymphadenopathy. The sVEGF in group A was significantly higher than controls (313.8 versus 44.6 pg/mL; P <.05) and in group B was 633.4 pg/mL and was significantly higher than controls (P <.0001). The sVEGF and bFGF in group A versus subgroup B(P) were significantly lower (P(VEGF) <.05, P(bFGF) <.05), and sVEGF in subgroup B(P) versus B(M) was significantly lower (P <.05). These results show that the evaluation of serum VEGF concentration might be useful as noninvasive diagnosis of some chronic peripheral lymphadenopathies in children.