[Comparative diagnostic characteristics of carbohydrate metabolism disorders in women with polycystic ovary syndrome (PCOS)]. / Sravniavane na diagnostichnite pokazateli za otsenka na narusheniiata vuv vuglekhidratniia metabolizum pri zheni sus sindrom na polikistozni iaichnitsi (PCOS)

The aim of the study was to compare the information provided by both fasting and stimulated during a standard oral glucose tolerance test (oGTT) levels of glucose and insulin as regards glucose tolerance and insulin resistance in women with PCOS. Few criteria are used in practice to verify insulin resistance in PCOS--elevated fasting insulin, decreased basal glucose/insulin ratio (< 6 for glucose in mg/dl or < 0.333 for glucose in mmol/l), insulin increase of more than 100 lul during an oGTT, and HOMA index > 2. The study comprised of 94 women (mean age 21.8 +/- 5 = 8 ys, mean BMI-30.38 +/- 7 = 7 kg/m2), divided in 4 groups according to BMI--group with BMI < 25, n = 21; group with BMI25-30, n = 27; group with BMI = 30-35, n = 23 and group with BMI > 35, n = 23. An oGTT with parallel determination of blood glucose and insulin was performed in all patients. The ratio basal glucose/insulin and HOMA index were calculated. Glucose levels on the 2 md hour during the oGTT pointed at IGT (impaired glucose tolerance) and/or diabetes in 8.5% of the investigated patients while the fasting levels indicated disturbances in only 2.2% of them. Fasting insulin levels were in the normal range in a considerable part of PCOSE women, mainly those with normal weight, and were not predictive for the response of insulin to glucose load. Relative percent of patients with elevated fasting insulin rose with the increasing of BMI. Decreased glucose/insulin ratio, elevated HOMA index, and abnormal stimulation of insulin were seen in more than 2/3 of the PCOS women including nonobese ones. Information provided by the above three markers was similar and they could be used alternatively according to the particular case and assessment of the cost/benefit ratio.

[Antioxidant parameters in metabolic syndrome -- a dynamic evaluation during oral glucose tolerance test]. / Antioksidantni pokazateli pri metaboliten sindrom -- dinamichno proslediavane v khod na oralen gliukozotoleranten test.

Patients with metabolic syndrome show augmented cardio-vascular risk, at least in part mediated through disequilibrium between mechanisms generating free radicals, and antioxidant defense. Carbohydrate and lipid disturbances in metabolic syndrome induce oxidative stress via several non fully understood mechanisms. Glucose overload in oral glucose tolerance test (OGTT) can also induce oxidative stress. The aim of our study was to evaluate changes in superoxide dismutase and glutathione peroxidase activity, as well as total antioxidant status in OGTT in patients with metabolic syndrome and in healthy subjects. OGTT was performed in 36 healthy volunteers and in patients with metabolic syndrome. Glucose, Insulin, and triglycerides were evaluated at 0th, 30th, 60th, 120th, and 180th min. Superoxide dismutase and glutathione peroxidase were measured at 0th, 60th, and 120th min. Total antioxidant status was measured at 0th, and 120th min. At 0th min total, HDL and LDL cholesterol were evaluated. A statistically significant decrease (p < 0.05) in superoxide dismutase activity at 120th as compared with 60th min were observed. Glutathione peroxidase activity decreased significantly (p < 0.05) even though at 60th as compared with 0th min and remained decreased at 120th min. Total antioxidant status was found to be increased (p < 0.05) at 120th as compared with 0th min. The observed dynamic in patients did not differed (p > 0.05) from control group. The study shows a decrease in antioxidant enzyme activity and a compensatory increase in total antioxidant status, indicating a surcharge of antioxidant homeostasis. In context of carbohydrate and lipid disturbances in metabolic syndrome, this is to suggest an existing of complementary pathogenic mechanisms, able to aggravate cardiovascular risk in these patients. Correction of metabolic disturbances may be an efficacious tool for influencing on prooxidant-antioxidant homeostasis too.

[Metabolic ketoacidosis in obese subjects resulting from dietetic and exercise regimens to reduce excess body weight]. / Metabolitna ketoatsidoza pri litsa sus zatlustiavane vsledstvie redutsirasht svukhtelesnata masa dietichen i dvigatelen rezhim.

62 obese patients (44 women, and 18 men), mean age 43 years, were treated for one month in the rehabilitation center in Loznitsa by a hypocaloric diet and e physically active regimen. The average reduction of body mass was 11,248 +/- 3,392 kg. The treatment led to a marked ketosis--increase of pyruvate, acetacetate and beta-hydroxybutyrate, the increase of the most active metabolic component--beta-hydroxybutyrate being the greatest. The increased ratio beta-hydroxybutyrate/acetacetate could be considered favourable in relation to the energetic dysbalance since beta-hydroxybutyrate metabolizes faster than acetacetate. In patients with disturbed glucose tolerance, as well-as in patients with liver and renal diseases, gallstone disease, podagra and disturbed calcium-phosphorus metabolism the body mass reducing regimen should be carried out strictly individually and carefully in order to avoid the unfavourable effect of severe metabolic disturbances which could arise because of pronounced ketoacidosis.

Changes in ECG, plasma and myocardial lipids in experimental myocardial hypertrophy in rats.

ECG, systolic blood pressure (BP), the ratio (R) of grams of myocardial mass/100 g of body mass, total lipids, cholesterol, triglycerides and phospholipids in blood plasma and the left ventricular myocardium, as well as the plasma free fatty acids, were investigated in 58 male Wistar rats 3, 30 and 180 days after operation, in a model of myocardial hypertrophy (MH) induced by experimental coarctation hypertension, after the method of Selye. An attempt was made to correlate some functional and metabolic indices which characterize the development of this type of MH. On a background of progressively rising BP and parallel increasing R, ECG changes were recorded. They were typical of the respective stage of arterial hypertension and MH and expressed mostly in a shifting of the electrical axis of the heart to the left and in essential repolarization disturbances. The most significant changes in the studied lipid fractions were found 30 days after the induction of hypertension. The pathological changes manifested on the 180th day are discussed in relation to age, the stage of hypertension and especially in relation to the developing hypoxic and ischaemic myocardial damage.

[Intracellular content of sodium and potassium in patients with hypertension]. / Vutrekletuchno sudurzhanie na natrii i kalii pri bolni ot khipertonichna bolest.

The sodium and potassium contents in the erythrocytes was studied in 31 persons: 15 hypertensive patients in I stage of the disease and 16 persons with normal arterial pressure as a reference group. In the hypertensive patients a light degree, statistically insignificant increase of the intracellular sodium concentration compared to that of the normotensive persons was found (7.62 mmol/l cells against 6.58 mmol/l cells). No differences in the potassium contents were established. These light degree changes of the intracellular sodium contents in hypertensive patients I stage could be assessed more precisely if a parallel study of the activity of the sodium transport transmembrane mechanisms is carried out.

[Effect of the complex treatment conducted in the rehabilitation center in the city of Loznitsa on oral glucose tolerance and insulin secretion in patients with morbid obesity]. / Vliianie na kompleksnoto lechenie, provezhdano v rekhabilitatsionniia tsentur v gr. Loznitsa, vUrkhu oralniia gliukozen tolerans i insulinovata sekretsiia pri patsienti s visokostepenno zatlustiavane.

In the rehabilitation center Loznitsa the influence of the comprehensive treatment on the oral glucose tolerance test and insulin secretion was studied in patients with high-degree obesity. A flat blood sugar and insulin curve by oral glucose tolerance test was found without manifested hyperglycemia and hyperinsulinemia. One month treatment leads to a decrease of the basal insulinemia on the background of which the stimulating effect of glucose loading is more clearly expressed up to the 120th minute but without increase of the absolute values above the reference ranges.

Changes in blood plasma and myocardial lipids in experimental thyrotoxic myocardial hypertrophy in rabbits.

Blood plasma and myocardial total lipids (TL), cholesterol (Ch), triglycerides (TGL), phospholipids (PhL), as well as plasma free fatty acids (FFA) were studied in 56 male rabbits with experimental thyrotoxic myocardial hypertrophy, induced by Thyreotom (group T14-14 days, T45-45 days). Combinations with Trasicor (TT-14 days) and aminooxyacetic acid (TAOAA-14 days) were also applied. The data showed a significantly lower plasma Ch and TL levels both in T14 and T45 as compared to the control group. The myocardial levels of TGL both in T14 and T45 were significantly higher than in the control group. In the TT group, myocardial Ch tended to decrease. A considerable decrease in plasma and myocardial lipids was found in the TAOAA group. Treatment with Thyreotom with or without Trasicor or AOAA resulted in a decrease of polyunsaturated FA, which was most expressed in the TT group. The combinations with Trasicor and AOAA had a protective effect on thyrotoxic disturbances.

[Changes in serum lipid levels and the spectrum of individual fatty acids in patients with chronic renal failure on conservative and hemodialysis treatment and their relation to dietary protein intake]. / Promeni v nivata na serumnite lipidi i spektura na individualnite mastni kiselini pri bolni s khronichna bubrechna nedostatuchnost na konservativno i khemodialisno lechenie i vruzkata im s khranitelniia beltuchen vnos.

The serum lipids level, lipoproteins with very low and low density and individual fatty acids were studied in three groups of patients with chronic renal insufficiency (ChRI) on conservative treatment, on hemodialysis to 12 months and over 12 months, looking for a connection with the ChRI stage, with the effect of hemodialysis and diet. A tendency to decrease of the levels of beta-lipoproteins (beta LP) and total cholesterol (TCh) in beta LP was outlined from conservative to hemodialysis ChRI, hyperprebeta--lipoproteinemia, with S-fraction being established more often. That explains the great discrepancies in lipoprotein--profile among the three groups of patients, the dietetic factor, likely to play a decisive role for that. For the same reasons, deficiency of essentail fatty acids--linoleic and arachidonic was esotablished in the patients with conservative ChRI, eliminated in the course of dialysis. Since serum albumins show a substantial correlative relationship with palmiatic, stearic, linoleic, acid, beta LP and TCh in beta LP, those lipid indices could be admitted to follow the protein-caloric deficiency in the patients with ChRI, in the conservative therapeutic stage in particular. Those data necessitate a critical antitude to the strict hypoprotein regimen in them.

[Excretion of free and bound catecholamines in the urine of diabetes mellitus patients]. / Ekskretsiia na svobodnite i svurzanite katekholamini v urinata na bolni ot zakharen diabet.

The 24-h excretion of free, conjugated and total fractions of dopa, dopamine, noradrenaline and adrenaline was studied in 32 patients with diabetes mellitus. Adrenaline and dopamine were established to be increased--dopa decreased and noradrenaline--not changed. An attempt is made to explain the hormonal changes on the base of the analysis of the so called synthetic and dissociative coefficients of catecholamines. A moderate reverse correlation of the changes with the age of the patients and duration of diabetes was established as well as lower values in the female-diabetics versus the male-diabetics. The hormonal deviations are associated with the disturbances in the carbohydrate metabolism, have a reactive character and are manifested in insulin-dependent type of diabetes.

[Metabolic changes in the liver as affected by nicotinic acid]. / Metabolitni promeni v cherniia drob pod vliianie na nikotinovata kiselina.

The author carried out a dynamic study on the metabolic changes in liver under the influence of nicotinic acid, administered singly by intramuscular injection in a dose of 2mM/kg of body weight. She examined at the 1th, 3th, 6th and 24th hour the changes in the levels of nicotine-amide coenzymes (NAD, NAD-H and NADP), adenine nucleotides (ATP, ADP and AMP), the metabolic lactate and pyruvate and the enzymes LDH, MDH, GOT and GPT. The obtained data were compared with those of the control groups, treated with saline and killed at the same intervals as the experimental animals. Furthermore she made also a comparison with an intact group, presented as O group, whose values served as basal. The obtained data showed that after application of the nicotinic acid (NA) complex metabolic changes occurred in liver, due to its basic effects-stimulation of biosynthesis of nicotinamide coenzymes and inhibition of lipolysis in the fatty tissue. Most probably the effect on the biosynthesis of NAD was primary, which showed later substantial regulatory influence both on lipolysis in the fatty acid and on the metabolization of mobilizing lipids on behalf of the liver. Parallel occurring metabolic processes in the aorta and in the vascular wall in general, stimulation of the biological oxidation and bioenergetics formed the whole antilipolytic and antiarteriogenic action of nicotinic acid.

[Effect of a long-term cholesterol-rich diet on the serum and hepatic lipid and lipoprotein levels in normotensive and spontaneously hypertensive rats]. / Vliianie na dulgotrainata, bogata na kholesterol dieta vurkhu nivata na serumnite i chenodrobnite lipidi i lipoproteini u normotonichni i spontanno-khipertonichni plukhove.

There are great species and individual differences in response of the organism to a diet, rich in cholesterol. In the present study the author used two types of rats-normotonic of Wistar strain and spontaneously hypertonic of Okamoto--Aoki strain. The animals were fed with a diet of O'Neil, rich in cholesterol, for various periods of time. The levels of liver lipids and serum lipoproteins were raised only in the normotonic Wistar rats at early periods (4 months). The levels of serum lipids were elevated only after 10- and 11-month feeding with a diet, rich in cholesterol. She discusses the possibility that the increased exogenic transport of cholesterol and lipids could be compensated by enhanced metabolism in the peripheral tissues and by suppression and catabolism of cholesterol in liver at earlier stages. She suggests that the early elevation of lipoproteins could be due to "intermediary" lipoproteins, rich in cholesterol. This is proven also by the disc electrophoresis of serum lipoproteins, revealing intensification of alpha-lipoprotein fraction and the intermediary fraction between beta-lipoproteins and pre-beta-lipoproteins. There is no humoral syndrome, observed in the normotonic Wistar rats, in the spontaneously hypertonic rats, which have a--6-month diet, although the levels of liver lipids are raised significantly, when they are compared with the control group. She discusses the possibility for greater centrifugal transport of this kind, since more cholesterol and lipoproteins are measured in the vascular wall than in the normotonic animals.