Obesity, elevated levels of fasting plasma glucose and type 2 diabetes are associated with aortic stiffness.

OBJECTIVES: Obesity and metabolic syndrome (MetS) are associated with structural and functional vascular abnormalities. MetS and its components may increase arterial stiffness and the risk of cardiovascular events. However, the relationship of MetS and its components, including obesity, with arterial stiffness is still not fully understood. SUBJECTS AND METHODS: In a group of 116 patients undergoing treatment for hypertension, we searched for the relationships between parameters of MetS and aortic stiffness expressed by pulse wave velocity (PWVAo). PWVAo was measured using an arteriograph working on the oscillometric principle, and pulse wave analysis (PWA) for noninvasive assessment of the parameters of central hemodynamics. RESULTS: From the cluster of parameters of MetS we found a significant association between body mass index (BMI) and aortic stiffness, and between fasting plasma glucose/type 2 diabetes (FPG/T2DM) and aortic stiffness. We did not find significant relationships between other components of MetS (HDL cholesterol and triglycerides) and aortic stiffness, based on the influence of hypolipidemic therapy. Arterial stiffness increased with age and was higher in females. CONCLUSION: Arterial stiffness was associated with age, sex, and MetS components (BMI and FPG/T2DM). Surprisingly, the parameters of dyslipidemia do not influence stiffness parameters, which can be explained by hypolipidemic therapy. The influence of hypolipidemic therapy should therefore be borne in mind when evaluating arterial tree function (Tab. 15, Ref. 62). Text in PDF www.elis.sk Keywords: obesity, fasting plasma glucose, type 2 diabetes, aortic stiffness, metabolic syndrome, arterial hypertension, cardiovascular risk.

Identification of Whole-Serum Glycobiomarkers for Colorectal Carcinoma Using Reverse-Phase Lectin Microarray.

Colorectal cancer (CRC) is one of the most common types of cancer among men and women worldwide. Efforts are currently underway to find novel and more cancer-specific biomarkers that could be detected in a non-invasive way. The analysis of aberrant glycosylation of serum glycoproteins is a way to discover novel diagnostic and prognostic CRC biomarkers. The present study investigated a whole-serum glycome with a panel of 16 different lectins in search for age-independent and CRC-specific glycomarkers using receiver operating characteristic (ROC) curve analyses and glycan heat matrices. Glycosylation changes present in the whole serum were identified, which could lead to the discovery of novel biomarkers for CRC diagnostics. In particular, the change in the bisecting glycans (recognized by Phaseolus vulgaris erythroagglutinin) had the highest discrimination potential for CRC diagnostics in combination with human L selectin providing area under the ROC curve (AUC) of 0.989 (95% CI 0.950-1.000), specificity of 1.000, sensitivity of 0.900, and accuracy of 0.960. We also implemented novel tools for identification of lectins with strong discrimination power.

Central Systolic Hypertension in Patients with Well-Controlled Hypertension.

Background. Central systolic blood pressure (CSBP) has prognostic significance and simplified devices for its estimation have been introduced recently. The aim of this study was to assess the achievement of the target CSBP in treated hypertensive patients. Subjects and Methods. One hundred patients with well-controlled hypertension were analysed. For CSBP estimation, we used the Arteriograph (TensioMed Ltd.), which uses one cuff for all measurements, the "single-point measurement" approach. Results. We found that 62% of patients had CSBP ≥ 130 mmHg, the suggested cut-off value for hypertension. When sex-specific classification was employed (CSBP ≥ 137 mmHg for female and CSBP ≥ 133 mmHg for male), only 13% of patients (mainly women) remained in the hypertensive range. We also found that 55% of patients had a CSBP higher than brachial pressure. Multiple analyses showed that CSBP was significantly associated with sex, height, and return time. Conclusions. A high proportion of treated hypertensive patients had CSBP levels that exceeded their brachial BP. CSBP positively correlated with lower height and shorter return time of the reflected pressure wave and was significantly higher in females compared to males. These findings suggest that, for CSBP classification, it is important to take height and sex-specific differences into account.

[Preclinical cardiovascular diseases and aortic stiffness]. / Predklinické kardiovaskulárne ochorenia a tuhost aorty.

AIM: To compare aortic stiffness (represented by aortic pulse wave velocity - PWVao) as a marker of cardiovascular risk with cardiovascular risk estimated by standard scoring systems in treated hypertensive patients. PATIENTS AND METHODS: In a group of 41 hypertensive patients without clinical manifestation of cardiovascular disease (18 men/23 women, mean age 59 years) we investigated the presence of risk factors and preclinical cardiovascular diseases. To estimate cardiovascular risk we have used SCORE-HDL model and categorical risk stratification recommended by ESC/ESH. Linear regression was used for evaluation of relation between risk estimation scores and PWVao values. RESULTS: We have found out statistically significant relationship between PWVao and cardiovascular risk assessment systems in our group of patients. The correlation between PWVao and ESC/ESH risk stratification (r = 0.414, P < 0.01) was the most relevant, the correlation between PWVao and SCORE-HDL values was also significant (r = 0.315; P < 0.05). CONCLUSIONS: Increased aortic stiffness as one of the preclinical cardiovascular diseases can be an integrative marker of cardiovascular risk in patients with arterial hypertension.

Calcitonin-secreting pancreatic neuroendocrine tumors: a case report and review of the literature.

OBJECTIVE: We report the presentation and novel therapy of a calcitonin-secreting pancreatic neuroendocrine tumor (PNET) and review the literature on this unusual neoplasm. METHODS: We cite the history of a 38-year-old male who presented with fatigue, weight loss, and diarrhea and was found to have a pancreatic head mass on cross-sectional imaging, as well as liver metastases. RESULTS: The patient's laboratory evaluation was notable for a >100-fold elevation of the peptide hormone calcitonin in serum. As calcitonin is typically secreted by thyroid C-cells, hypercalcitoninemia is considered a marker for medullary thyroid cancer (MTC) or C-cell hyperplasia, but it may be present in several physiologic or pathologic conditions or may be ectopically secreted in rare PNETs. An octreotide scan confirmed the presence of somatostatin (SST) receptors on the pancreatic mass and liver metastases, leading to the diagnosis of a calcitonin-secreting PNET. We initiated treatment with long-acting SST analogs and peptide receptor radionuclide therapy (90Yttrium-DOTATOC) and achieved disease regression while maintaining a high quality of life. CONCLUSION: Functional PNETs that secrete calcitonin are exceedingly rare, but they are important to consider in the differential diagnosis of nonthyroid-mediated hypercalcitonemia or pancreatic tumors that present with diarrhea, as the management differs markedly from both MTC and other pancreatic malignancies.