Lifestyle factors, dietary patterns, and social determinants of social and eating jetlag: A cross-sectional survey.

Social jetlag (SJL) and, more recently, eating jetlag have been linked with an increased risk of non-communicable diseases. Here we aim to investigate lifestyle factors (diet, eating behavior, smoking, perceived stress, time spent sedentary/day) and social determinants (education level, employment status, and place of residence) associated with SJL corrected for sleep duration (SJLsc) and eating jetlag. Self-declared data on age, gender, lifestyle, and eating behavior were collected online from March 2021 to February 2022 of 432 adults. Principal component analysis was used to extract three dietary patterns (Prudent, Western, and Risky). Prevalence of SJLsc was 35.2%, with no significant difference between men and women (p = 0.558). Adults with SJLsc had significantly larger eating jetlag (56.0 min vs 41.2 min, p = 0.001). Increasing SJLsc duration was associated with an increased adherence to a Risky dietary pattern (standardized ß coefficient = .165, p = 0.012); increasing eating jetlag duration was associated with an increased adherence to a Western dietary pattern (standardized ß coefficient = .127, p = 0.039) and a shorter sleep duration (standardized ßcoefficient = -0.147, p = 0.011). Among social determinants analyzed, only being a student or employed was associated with eating jetlag (standardized ß coefficient = 0.125, p = 0.044), while none displayed any relationship with SJLsc. Our survey provides evidence on a risky behavior among young persons with SJLsc and eating jetlag, characterized by a higher alcohol consumption, and a diet rich in processed meat and high-fat food, eating during nights, and shorter sleep duration with potential long-term negative health outcomes.

Adipokines and Arterial Stiffness in Obesity.

Adipokines are active molecules with pleiotropic effects produced by adipose tissue and involved in obesity-related metabolic and cardiovascular diseases. Arterial stiffness, which is a consequence of arteriosclerosis, has been shown to be an independent predictor of cardiovascular morbidity and mortality. The pathogenesis of arterial stiffness is complex but incompletely understood. Adipokines dysregulation may induce, by various mechanisms, vascular inflammation, endothelial dysfunction, and vascular remodeling, leading to increased arterial stiffness. This article summarizes literature data regarding adipokine-related pathogenetic mechanisms involved in the development of arterial stiffness, particularly in obesity, as well as the results of clinical and epidemiological studies which investigated the relationship between adipokines and arterial stiffness.

Chronic disruption of circadian rhythm with mistimed sleep and appetite - an exploratory research.

This research aimed to explore the relation of social jetlag (SJL) with perceived appetite, and hormones involved in hunger regulation in healthy subjects in free-living conditions (study registration number: ACTRN12618001182280). Eighty normally diurnally active men and women were enrolled in 4 study groups according to the presence of SJL and sleep deprivation (2 groups with SJL with or without sleep deprivations and 2 groups without SJL with or without sleep deprivation) matched 1:1:1:1 for age, gender, and body mass index. Appetite was assessed in fasting state, by measuring acylated ghrelin level and using 100 mm visual analog scales. Persons with SJL had a higher perceived appetite for pork, poultry, fish, eggs, milk, and dairy products and higher acylated ghrelin levels than those without SJL. When considering the presence of sleep deprivation, subjects with SJL, with and without sleep deprivation, reported a higher perceived appetite than group with sleep deprivation alone. They also reported later meal times for lunch and dinner, had more frequently a snack before sleep and reported eating more frequently while watching TV or playing on computer, suggesting poorer eating habits in these subjects. In conclusion, independent of sleep duration, SJL is associated with an increased appetite for caloric dense food, suggesting an increased incentive value of food in these subjects and an anticipated pleasure of ingesting these foods.

Uric Acid and Arterial Stiffness.

Hyperuricemia is usually associated with hypertension, diabetes mellitus, metabolic syndrome and chronic kidney disease. Accumulating data from epidemiological studies indicate an association of increased uric acid (UA) with cardiovascular diseases. Possible pathogenic mechanisms include enhancement of oxidative stress and systemic inflammation caused by hyperuricemia. Arterial stiffness may be one of the possible pathways between hyperuricemia and cardiovascular disease, but a clear relationship between increased UA and vascular alterations has not been confirmed. The review summarizes the epidemiological studies investigating the relationship between UA and arterial stiffness and highlights the results of interventional studies evaluating arterial stiffness parameters in patients treated with UA-lowering drugs.

Multimodal ultrasound investigation (grey scale, Doppler and 2D-SWE) of salivary and lacrimal glands in healthy people and patients with diabetes mellitus and/or obesity, with or without sialosis.

AIM: To evaluate the ultrasound (US) modifications [grey scale, Doppler, 2D-share wave elastography (2D-SWE)] ofsalivary (parotid and submandibular) and lacrimal glands in healthy people and patients with diabetes mellitus and/or obesity, with or without sialosis. MATERIAL AND METHODS: We evaluated 170 patients (1020 glands, 1700 grey scale and Doppler images), split in two groups (group 1- healthy people, group 2- obese and/or diabetes patients, with or without sialosis). For each patient we assessed the parotid, submandibular and lacrimal glands in grey scale US (echogenicity, homogeneity, glandular contour, posterior border, lymph nodes), color Doppler US and 2D-SWE. All images were analyzed by two examiners blinded to each other or to patients. RESULTS: The interobserver agreement was strong or moderate for all parameters. In group 2, the salivary glands had increased echogenicity, homogeneous aspect and invisible posterior border (all p<0.001). There was no significant variation of elasticity modulus in the groups analyzed (5.46±1.57 vs 5.67±1.81 in parotid, 8.63±1.84 vs 8.55±1.94 in submandibular and 9.47±2.1 vs 9.53±2.23 in lacrimal glands, all p>0.05) or according to the body mass index (BMI), sex, patient age, the aspect in grey scale/Doppler US or the presence of sialosis (all p>0.05). CONCLUSION: The main US differences between healthy people and patients with diabetes mellitus and/or obesity are suggested by the echogenicity, homogeneity, posterior border and the size of glandular area. No significant differences of elasticity modulus were found between the analyzed groups or related to BMI, sex, patient age or other grey scale/Doppler US items analyzed.

Pain in bilateral knee osteoarthritis - correlations between clinical examination, radiological, and ultrasonographical findings.

AIMS: The aim of the study was to evaluate the correlations between clinical symptoms (pain), physical examination, ultrasound (US), and radiological findings in patients with bilateral knee osteoarthritis (OA). MATERIAL AND METHODS: Knee pain was appreciated during medial and lateral palpation of each knee joint and using visual analogue scale (VAS) and The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). US evaluation (osteophytes, meniscal protrusion, synovial fluid, femoral hyaline cartilage thickness) and radiological assessment (osteophytes, femoral-tibial space, Kellgren-Lawrence [K-L] score, enthesopathies) were performed by two examiners blinded to the clinical results and to each other. All these findings were scored with a five-point scale. RESULTS: A total of 52 consecutive patients aged 63.44+/-9.49 were examined, 33 (80.5%) being females. In patients with bilateral knee OA the pain, evaluated by WOMAC score and VAS, was correlated with the presence of osteophytes and cartilage thickness but no association with medial meniscal protrusion and effusion was demonstrated. Pain produced by palpation of the knee was strongly associated with the presence of medial osteophytes. VAS and WOMAC scores increased with the severity of radiological and US findings. The presence of osteophytes and articular cartilage damage at US examination were strongly and positively correlated with radiological K-L score. US examiners agreement was good for osteophytes and moderate for meniscal protrusion, cartilage damage, and synovial fluid. The cartilage damage score was the only independent predictor for VAS scale; for WOMAC score the sex, cartilage damage, the presence of medial osteophytes and lateral meniscal protrusion were the independent predictors. CONCLUSION: Pain intensity was correlated with the severity of US findings, cartilage damage score being an independent predictor for both VAS and WOMAC scores. Medial osteophytes and lateral meniscal protrusion and are independent predictors for WOMAC score.

XRCC3 Thr241Met Polymorphism is not Associated with Lung Cancer Risk in a Romanian Population.

BACKGROUND AND AIMS: Deoxyribonucleic Acid (DNA) repair mechanisms play a critical role in protecting the cellular genome against carcinogens. X-ray cross-complementing gene 3 (XRCC3) is involved in DNA repair and therefore certain genetic polymorphisms that occur in DNA repair genes may affect the ability to repair DNA defects and may represent a risk factor in carcinogenesis. The purpose of our study was to investigate the association between XRCC3 gene substitution of Threonine with Methionine in codon 241 of XRCC3 gene (Thr241Met) polymorphism and the risk of lung cancer, in a Romanian population. METHODS: We recruited 93 healthy controls and 85 patients with lung cancer, all smokers. Thr241Met, XRCC3 gene genotyping was determined by multiplex Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP). RESULTS: Statistical analysis (OR, recessive model), did not revealed an increased risk for lung cancer, for the variant 241Met allele and Thr241Met genotypes (p=0.138, OR=0.634, CI=0.348-1.157; p=0.023, OR=0.257, CI=0.085-6.824). Also, there were no positive statistical associations between Thr241Met polymorphism of XRCC3 gene, gender, tobacco and various histopathological tumor type of lung cancer. CONCLUSION: In conclusion, the results of the study suggest that the XRCC3 gene Thr241Met polymorphism is not associated with an increased risk for the development of lung cancer in this Romanian group.

The role of NOS2A -954G/C and vascular endothelial growth factor +936C/T polymorphisms in type 2 diabetes mellitus and diabetic nonproliferative retinopathy risk management.

Type 2 diabetes mellitus (T2DM) remains one of the major health problems in Europe. Retinopathy is one of the major causes of morbidity in T2DM, strongly influencing the evolution and prognosis of these patients. In the last 2 decades, several studies have been conducted to identify the possible genetic susceptibility factors involved in the pathogenesis of the disease. However, there is little data related to the involvement of vascular endothelial growth factor (VEGF) and nitric oxide synthase (NOS) gene polymorphisms in the T2DM Caucasian population. The objective of this study was to identify a possible connection between NOS2A -954G/C (rs2297518) and VEGF +936C/T (rs3025039) polymorphisms and the risk of developing T2DM and nonproliferative diabetic retinopathy in a Caucasian population group. We investigated 200 patients diagnosed with T2DM and 208 controls. Genotypes were determined by multiplex polymerase chain reaction-restriction fragment length polymorphism. Statistical and comparative analyses (Fisher's exact test) for dominant and recessive models of NOS2A -954G/C and VEGF +936C/T polymorphisms revealed an increased risk of T2DM (χ (2)=8.14, phi =0.141, P=0.004, odds ratio [OR] =2.795, 95% confidence interval [CI] =1.347-5.801; χ (2)=18.814, phi =0.215, P<0.001, OR =2.59, 95% CI =1.675-4.006, respectively). Also, comparative analysis for the recessive model (using Pearson's chi-square test [χ (2)] and the phi coefficient [phi]) reveals that the variant CC genotype of NOS2A gene is more frequently associated with T2DM without retinopathy (χ (2)=3.835, phi =-0.138, P=0.05, OR =0.447, 95% CI =0.197-1.015). In conclusion, the results of the study place VEGF +936C/T polymorphisms among the genetic risk factor for T2DM, whereas NOS2A -954G/C polymorphisms act like a protective individual factor for nonproliferative retinopathy.

The XRCC1 Arg194Trp polymorphism is significantly associated with lung adenocarcinoma: a case-control study in an Eastern European Caucasian group.

DNA repair plays an important role in maintaining the integrity of the genome by repairing DNA damage induced by carcinogens. Certain genetic polymorphisms that occur in DNA-repair genes may affect the ability to repair DNA defects, and may represent a risk factor in carcinogenesis. The gene XRCC1 is involved in DNA repair. The purpose of our study was to investigate the association between XRCC1 Arg194Trp and Arg399Gln polymorphisms and the risk of lung cancer in a Romanian population. We recruited 222 healthy controls and 102 patients with lung cancer. Genotypes were determined by multiplex polymerase chain-reaction restriction fragment-length polymorphism. Statistical analysis (odds ratio, recessive model) revealed an increased risk for lung cancer for the homozygous 194Trp genotype (χ (2)=0.186, odds ratio 10.667, 95% confidence interval 1.309-86.933; P=0.007). Also, we found an association between the 194Trp allele and women with lung adenocarcinoma. In conclusion, the results of the study place the XRCC1 Arg194Trp polymorphism among independent risk factors for developing lung cancer.

Combined glutathione S transferase M1/T1 null genotypes is associated with type 2 diabetes mellitus.

BACKGROUND: Due to new genetic insights, a considerably large number of genes and polymorphic gene variants are screened and linked with the complex pathogenesis of type 2 diabetes (DM). Our study aimed to investigate the association between the two isoforms of the glutathione S-transferase genes (Glutathione S transferase isoemzyme type M1- GSTM1 and Glutathione S transferase isoemzyme type T1-GSTT1) and the prevalence of DM in the Northern Romanian population. METHODS: We conducted a cross-sectional, randomized, case-control study evaluating the frequency of GSTM1 and GSTT1 null alleles in patients diagnosed with DM. A total of 106 patients diagnosed with DM and 124 healthy controls were included in the study. GSTM1 and GSTT1 null alleles genotyping was carried out using Multiplex PCR amplification of relevant gene fragments, followed by gel electrophoresis analysis of the resulting amplicons. RESULTS: Molecular analysis did not reveal an increased frequency of the null GSTM1 and GSTT1 alleles (mutant genotypes) respectively in the DM group compared to controls (p=0.171, OR=1.444 CI=0.852-2.447; p=0.647, OR=0.854, CI=0.436-1.673). Nevertheless, the combined GSTM1/GSTT1 null genotypes were statistically significantly higher in DM patients compared to control subjects (p=0.0021, OR=0.313, CI=0.149-0.655). CONCLUSIONS: The main finding of our study is that the combined, double GSTM1/GSTT1 null genotypes are to be considered among the polymorphic genetic risk factors for type 2 DM.

Fenofibrate improves endothelial function and plasma myeloperoxidase in patients with type 2 diabetes mellitus: an open-label interventional study.

BACKGROUND: Fenofibrate offers a number of benefits on the cardiovascular system and it is plausible that its anti-inflammatory, anti-oxidant and anti-fibrotic effects and enhancement of cardiac metabolic performances may account for its direct cardioprotective effects.In this study we aimed to investigate the effect of fenofibrate on endothelial function assesed by vascular studies and levels of soluble E-selectin (sE-selectin) as well as the effect on plasma myeloperoxidase (MPO) in patients with type 2 diabetes mellitus (T2DM) without previous use of lipid-lowering medication. METHODS: 27 patients (14 men and 13 women) with T2DM and good glycemic control (HbA1c: min 5.9%, max: 7.1%) treated with metformin monotherapy, without previous use of lipid-lowering medication were enrolled in this study. Vascular studies included measures of brachial artery diameter before and after release of a suprasystolic ischemia. FMD was calculated as the percent (%) change in arterial diameter following reactive hyperemia. Student's paired t test and Wilcoxon Signed Ranks Test were used to compare values before and after fenofibrate therapy. RESULTS: Fenofibrate therapy significantly increased post ischemia mean brachial artery diameter at 60 s (from 4.7 [4.4; 5.0] mm to 4.9 [4.6; 5.2] mm, p = 0.01) and at 90 s (from 4.7 [4.4; 5.0] mm to 4.9 [4.6; 5.1], p = 0.02). FMD response to hyperaemia at 60 s increased with 4.5 ± 13.7% (median value pre- treatment: 22.2%, median value post- treatment 25.0%, z = -2.9, p = 0.004). After 8 weeks of fenofibrate therapy, plasma MPO levels decreased to 49.5 [30.3; 71.5] ng/ml (% change from baseline = 4.6%, z = -2.2, p = 0.03) and mean plasma sE-selectin levels decreased to 67.1 [54.4; 79.8] ng/ml, (% change from baseline = 2.6%, p = 0.03). CONCLUSION: In patients with T2DM without previous treatment for dyslipidemia, short-term treatment with fenofibrate improved vascular endothelial function as demonstrated by increased post ischemia mean brachial artery diameter, increased FMD and decreased plasma sE-selectin and favorably affected plasma MPO levels. Therefore, fenofibrate may be considered a protective cardiovascular drug in this group of patients. TRIAL REGISTRATION: (Australian New Zealand Clinical Trials Registry ANZCTR12612000734864).

Heart rate variability and diastolic dysfunction in patients with type 2 diabetes mellitus.

Cardiovascular autonomic neuropathy is a common form of autonomic dysfunction in diabetes mellitus (DM) and associates abnormalities in heart rate control and in vascular dynamics. This study evaluates the impact of diabetes mellitus on left ventricular diastolic dysfunction (LVDD) and heart rate variability in a group of type 2 diabetes mellitus without signs of cardiovascular disease. The study group consisted of 58 patients, aged 61 ± 8 years, diagnosed with type 2 DM. The subjects were selected from a series of 104 consecutive diabetic patients. All the subjects were on oral therapy or on diet for DM, and ECG was normal for all the subjects. The control group consisted of 45 healthy subjects, matched for age and sex. Heart rate variability was measured using a 24-h ECG monitoring system, and standard 2D and Doppler echocardiography was performed in all the subjects. There are significant differences between groups regarding disease duration, longer in patients with impaired relaxation (11.22 ± 9.17 vs. 8.31 ± 8.95 years), and disease control, worse in impaired relaxation group. Heart rate in impaired relaxation group is significantly higher than in controls, and higher, but not significantly, when compared with normal group (91 ± 10, vs. 88 ± 11 and 71 ± 11, respectively). Cardiac autonomic neuropathy was associated with LVDD in patients with type 2 DM, but without clinically manifest heart disease. Twenty-four-hour ECG monitoring and echocardiography can detect diabetic cardiomyopathy in early stages and should be performed in all subjects.

Paraneoplastic hypertrophic osteoarthropathy: evaluation at 25 years after pneumectomy.

Finger clubbing, which involves distal phalanx thickening and nail convexity, has been known since antiquity. Observations made in modern times by Bamberger (1889), Pierre Marie (1890), and other investigators led to identification of various causes of this digital anomaly which can be the first manifestation of a severe organic disease. Undoubtedly, this somatic abnormality, often associated with arthralgia and bone pain (full-blown hypertrophic osteoarthropathy -- HOA), is most often a harbinger of lung cancer. Paraneoplastic HOA is probably the best known and the most extensively studied paraneoplastic syndrome in human pathology. The familial or idiopathic HOA (pachydermoperiostosis) appears at puberty and is not associated with other underlying diseases. We present the case of a 58-year-old male with HOA, associated with spinocellular lung cancer, who survived 25 years after pneumonectomy.