Z. V. Abilov, R. Salimkhanov, A. Povaliaeva, A. Zhukov, E. Pigarova, L. K. Dzeranova, L. Rozhinskaya
Diabetic nephropathy (DN) is a specific kidney involvement in diabetes mellitus (DM), caused by hemodynamic and metabolic factors. In the kidneys takes place an important step in the metabolism of vitamin D — 1α-hydroxylation, which results in the formation of its biologically active form. Reduced number of functioning nephrons in DN leads to impaired vitamin D metabolism, contributing to the development of a number of complications. In this review, we have focused in detail on both normal vitamin D metabolism and the features of vitamin D metabolism in chronic kidney disease (CKD). DN is the most common cause of CKD and, as a consequence, of kidney transplantation and one of the leading causes of cardiovascular morbidity and mortality in patients with DM. Bone mineral disorders resulting from abnormal vitamin D metabolism are also independent factors of high mortality among patients with DM. The final part of our review briefly highlights current approaches to vitamin D therapy in CKD and, in particular, in DN. It is worth noting that, despite the increasing number of patients with DN, there is currently no unified view on the use of vitamin D as a therapeutic agent in this pathology.
糖尿病肾病（DN）是糖尿病（DM）的一种特殊肾脏病变，由血液动力学和代谢因素引起。在肾脏中进行维生素 D 代谢的一个重要步骤是 1α- 羟基化，从而形成其生物活性形式。DN 患者肾小球功能的减少导致维生素 D 代谢受损，从而引发一系列并发症。在这篇综述中，我们重点详细介绍了正常的维生素 D 代谢和慢性肾脏病（CKD）中维生素 D 代谢的特点。DN 是导致 CKD 的最常见原因，也是肾移植的最常见原因，同时还是 DM 患者心血管疾病发病率和死亡率的主要原因之一。维生素 D 代谢异常导致的骨矿物质紊乱也是导致糖尿病患者高死亡率的独立因素。综述的最后一部分简要介绍了目前针对 CKD，尤其是 DN 的维生素 D 治疗方法。值得注意的是，尽管 DN 患者的人数在不断增加，但目前对于将维生素 D 用作该病症的治疗药物还没有统一的看法。
{"title":"Vitamin D metabolism in diabetic nephropathy","authors":"Z. V. Abilov, R. Salimkhanov, A. Povaliaeva, A. Zhukov, E. Pigarova, L. K. Dzeranova, L. Rozhinskaya","doi":"10.14341/omet12943","DOIUrl":"https://doi.org/10.14341/omet12943","url":null,"abstract":"Diabetic nephropathy (DN) is a specific kidney involvement in diabetes mellitus (DM), caused by hemodynamic and metabolic factors. In the kidneys takes place an important step in the metabolism of vitamin D — 1α-hydroxylation, which results in the formation of its biologically active form. Reduced number of functioning nephrons in DN leads to impaired vitamin D metabolism, contributing to the development of a number of complications. In this review, we have focused in detail on both normal vitamin D metabolism and the features of vitamin D metabolism in chronic kidney disease (CKD). DN is the most common cause of CKD and, as a consequence, of kidney transplantation and one of the leading causes of cardiovascular morbidity and mortality in patients with DM. Bone mineral disorders resulting from abnormal vitamin D metabolism are also independent factors of high mortality among patients with DM. The final part of our review briefly highlights current approaches to vitamin D therapy in CKD and, in particular, in DN. It is worth noting that, despite the increasing number of patients with DN, there is currently no unified view on the use of vitamin D as a therapeutic agent in this pathology.","PeriodicalId":37832,"journal":{"name":"Obesity and Metabolism","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139606635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. V. Ivashchenko, N. V. Mazurina, N. M. Platonova, E. A. Troshina
Currently, increasing evidence shows the mutual influence of aldosterone and adipose tissue. Aldosterone excess has been reported in patients with obesity and metabolic syndrome. Aldosterone has a direct effect on adipose tissue increasing anabolic activity and expression of mineralocorticoid receptors. In turn, excessive activation of MCR leads to stimulation of adipogenesis and an increase in the volume of adipose tissue. Aldosterone excess can be considered an independent cardiovascular risk factor that affects such processes as cardiac fibrosis, nephrosclerosis, and arteriosclerosis. There is convincing evidence of higher prevalence and severity of impaired glucose homeostasis and lipid metabolism disorders among patients with primary hyperaldosteronism. Similar pathological changes are also observed in patients with obesity and metabolic syndrome. This review presents scientific data on the metabolic effects of aldosterone, in particular its effect on adipose tissue function, glucose and lipid metabolism. Treatment with mineralocorticoid receptor antagonists may provide substantial benefit in the management of metabolic syndrome, contribute to the stabilisation of glucose and lipid metabolism, improve clinical status of patients with cardiovascular diseases and reduce the risk of complications. However, available evidence from the conducted studies is not sufficient to justify introduction of such therapy into clinical practice.
{"title":"Metabolic effects of aldosterone","authors":"K. V. Ivashchenko, N. V. Mazurina, N. M. Platonova, E. A. Troshina","doi":"10.14341/omet13040","DOIUrl":"https://doi.org/10.14341/omet13040","url":null,"abstract":"Currently, increasing evidence shows the mutual influence of aldosterone and adipose tissue. Aldosterone excess has been reported in patients with obesity and metabolic syndrome. Aldosterone has a direct effect on adipose tissue increasing anabolic activity and expression of mineralocorticoid receptors. In turn, excessive activation of MCR leads to stimulation of adipogenesis and an increase in the volume of adipose tissue. Aldosterone excess can be considered an independent cardiovascular risk factor that affects such processes as cardiac fibrosis, nephrosclerosis, and arteriosclerosis. There is convincing evidence of higher prevalence and severity of impaired glucose homeostasis and lipid metabolism disorders among patients with primary hyperaldosteronism. Similar pathological changes are also observed in patients with obesity and metabolic syndrome. This review presents scientific data on the metabolic effects of aldosterone, in particular its effect on adipose tissue function, glucose and lipid metabolism. Treatment with mineralocorticoid receptor antagonists may provide substantial benefit in the management of metabolic syndrome, contribute to the stabilisation of glucose and lipid metabolism, improve clinical status of patients with cardiovascular diseases and reduce the risk of complications. However, available evidence from the conducted studies is not sufficient to justify introduction of such therapy into clinical practice.","PeriodicalId":37832,"journal":{"name":"Obesity and Metabolism","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139608680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. A. Troshina, V. O. Barysheva, Z-Sh. R. Umarkhadzhieva
Increasing life expectancy and, as a consequence, a large number of comorbidities lead to a multitude of medications prescribed by physicians of different specialties. Patients with obesity and carbohydrate metabolism disorders, especially with type 2 diabetes mellitus (DM2), are at particular risk of polypragmasy, which is associated with the use of potentially nonrecommended medications. Prescribing errors can cause significant harm to the patient’s health and increase the risk of rehospitalization and healthcare costs. Identification of probably not recommended drugs in this category of patients will improve understanding of prevalence and risk factors of their use, develop strategies to prevent and limit the burden of taking inappropriate drugs and promote development of personalized and patient-oriented treatment options. Tools exist to assess potentially inappropriate therapy (PIT) in the elderly and new tools and criteria are often created. However, they are not specifically aimed at people with obesity and carbohydrate metabolism disorders. Thus, these criteria usually include only a few items related to DM2. Consequently, there is a clear need for a modern tool that can be used to address PIT specifically in older adults with obesity and carbohydrate metabolism disorders.
{"title":"Polypragmasy and the basics of personalized rational pharmacotherapy selection in older patients with obesity and type 2 diabetes mellitus","authors":"E. A. Troshina, V. O. Barysheva, Z-Sh. R. Umarkhadzhieva","doi":"10.14341/omet12987","DOIUrl":"https://doi.org/10.14341/omet12987","url":null,"abstract":"Increasing life expectancy and, as a consequence, a large number of comorbidities lead to a multitude of medications prescribed by physicians of different specialties. Patients with obesity and carbohydrate metabolism disorders, especially with type 2 diabetes mellitus (DM2), are at particular risk of polypragmasy, which is associated with the use of potentially nonrecommended medications. Prescribing errors can cause significant harm to the patient’s health and increase the risk of rehospitalization and healthcare costs. Identification of probably not recommended drugs in this category of patients will improve understanding of prevalence and risk factors of their use, develop strategies to prevent and limit the burden of taking inappropriate drugs and promote development of personalized and patient-oriented treatment options. Tools exist to assess potentially inappropriate therapy (PIT) in the elderly and new tools and criteria are often created. However, they are not specifically aimed at people with obesity and carbohydrate metabolism disorders. Thus, these criteria usually include only a few items related to DM2. Consequently, there is a clear need for a modern tool that can be used to address PIT specifically in older adults with obesity and carbohydrate metabolism disorders.","PeriodicalId":37832,"journal":{"name":"Obesity and Metabolism","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139609070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Iron affects the pathogenesis and clinical course of several chronic metabolic diseases such as obesity, atherosclerosis, non-alcoholic fatty liver disease and type 2 diabetes mellitus. High pro-oxidant iron activity is physiologically controlled by mechanisms regulating entry, recycling, and loss of body iron. These mechanisms include the interplay of iron with ferritin, transferrin, hepcidin, insulin, as well as with adipokines and proinflammatory molecules. An imbalance of these regulatory mechanisms results in both systemic and parenchymal siderosis. Iron overload has a toxic effect on the major tissues involved in lipid and glucose metabolism — pancreatic β cells, liver, muscle, and adipose tissue — as well as the organs affected by chronic hyperglycemia — brain, retina and kidneys. Hyperferremia leads to a decrease in insulin secretion, the formation of insulin resistance and increased liver gluconeogenesis. Molecular mechanisms for these effects are diverse. Elucidating them will implicate both for carbohydrate metabolism disorders prevention and for the pathogenesis of other diseases that are, like diabetes mellitus type 2, associated with nutrition, aging and iron. The literature review presents data from world studies on the mutual influence of glucose metabolism and iron overload, and discusses the differences between hereditary and acquired disorders of iron metabolism from the standpoint of their influence on carbohydrate metabolism.
L. Dzeranova, S. Y. Vorotnikova, A. S. Shutova, E. A. Pigarova, M. I. Yevloyeva
One of the causes of non-tumor related hyperprolactinemia is taking a medications. Physicians of various specialties, such as cardiologists, gastroenterologists, endocrinologists, and neurologists, encounter hyperprolactinemia as a side effect of drug therapy in their practice, but it is most often observed in the practice of a psychiatrist when treating patients with psychotropic medications. Over the past few years, there has been an increase in the frequency of prescriptions of antidepressants and neuroleptics due to post-COVID-19 syndrome, anxiety and stress caused by the pandemic of a new coronavirus infection. There is also a predisposition to the development of hyperprolactinemia on the background of taking neuroleptics due to genetic features of patients. Currently, there is no established common algorithm for diagnosis and treatment of drug-induced hyperprolactinemia in the world. Based on a review of foreign and domestic literature, the article discusses in detail the mechanisms of development and various approaches to the correction of iatrogenic (drug-induced) hyperprolactinemia, assesses the prolactogenic activity of neuroleptics, and proposes algorithms for prolactin monitoring and correction of hyperprolactinemia using dopamine agonists. Often the tactics of management of such patients need to be discussed by a team of specialized physicians.
{"title":"Drug-induced hyperprolactinemia: mechanism of development, features of diagnosis and treatment","authors":"L. Dzeranova, S. Y. Vorotnikova, A. S. Shutova, E. A. Pigarova, M. I. Yevloyeva","doi":"10.14341/omet13036","DOIUrl":"https://doi.org/10.14341/omet13036","url":null,"abstract":"One of the causes of non-tumor related hyperprolactinemia is taking a medications. Physicians of various specialties, such as cardiologists, gastroenterologists, endocrinologists, and neurologists, encounter hyperprolactinemia as a side effect of drug therapy in their practice, but it is most often observed in the practice of a psychiatrist when treating patients with psychotropic medications. Over the past few years, there has been an increase in the frequency of prescriptions of antidepressants and neuroleptics due to post-COVID-19 syndrome, anxiety and stress caused by the pandemic of a new coronavirus infection. There is also a predisposition to the development of hyperprolactinemia on the background of taking neuroleptics due to genetic features of patients. Currently, there is no established common algorithm for diagnosis and treatment of drug-induced hyperprolactinemia in the world. Based on a review of foreign and domestic literature, the article discusses in detail the mechanisms of development and various approaches to the correction of iatrogenic (drug-induced) hyperprolactinemia, assesses the prolactogenic activity of neuroleptics, and proposes algorithms for prolactin monitoring and correction of hyperprolactinemia using dopamine agonists. Often the tactics of management of such patients need to be discussed by a team of specialized physicians.","PeriodicalId":37832,"journal":{"name":"Obesity and Metabolism","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139276858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Shestopalov, V. Davydov, G. T. Tumanyan, E. Teplyakova, T. Shkurat, E. V. Mashkina, M. Shkurat, A. M. Gaponov, O. V. Borisenko, S. Roumiantsev
BACKGROUND. Among the many causes of obesity, genetic factors occupy a special place. An obvious role among them belongs to the genetic polymorphism of lipid metabolism enzymes, including paraoxonase-1 (PON-1). Until now, the character of the relationship between PON-1 polymorphism and the state of the endocrine function of mesenchymal tissues remains unclear. Its study will clarify the subtle mechanisms of the development of obesity in childhood and adolescence.AIM. The aim of the study was to investigate the relationship between PON-1 polymorphism (rs662) and changes in the content of adipokines, myokines, and blood lipid metabolism in children and adolescents of different sexes with obesity.MATERIALS AND METHODS. In 100 healthy children and adolescents of different sexes and 89 of their peers with obesity, a genetic study was conducted to assess the single nucleotide polymorphism of the PAO-1 (rs662) genes. In blood serum, total cholesterol, HDL cholesterol, LDL cholesterol, VLDL cholesterol, triacylglycerols, glucose and aminotransferase activity (alanine aminotransferase and aspartate aminotransferase) were determined by photometric methods, as well as leptin, adiponectin, resistin, apelin, irisin, adipsin, myostatin, FGF21, osteocrine, oncostatin and insulin — by multiplex ELISA, and asprosin — by ELISA ones.RESULTS. The patients with the homozygous Arg192/Arg allele, the development of complications of obesity in boys is limited and their occurrence in girls is prevented. In other variants of PON-1 polymorphism (Gln192/Gln and Gln192/Arg genotypes), protective mechanisms are formed in the body of girls aimed at preventing complications in obesity. In boys with the Gln192/Gln genotype, obesity reveals more pronounced shifts in lipid metabolism, manifestations of alteration and an increase in the mass of adipose tissue, and in boys-carriers of the heterozygous Gln192/Arg allele, atherogenesis processes increase.CONCLUSION. Polymorphism of the paraoxonase-1 gene (rs662) contributes to the appearance of gender differences in changes in the content of adipokines and myokines in the blood during obesity in childhood and adolescence.
{"title":"The content of adipokines and myokines in the blood of children and adolescents with different genotypes according to the polymorphism rs662 of the paraoxonase-1 gene","authors":"A. Shestopalov, V. Davydov, G. T. Tumanyan, E. Teplyakova, T. Shkurat, E. V. Mashkina, M. Shkurat, A. M. Gaponov, O. V. Borisenko, S. Roumiantsev","doi":"10.14341/omet13006","DOIUrl":"https://doi.org/10.14341/omet13006","url":null,"abstract":"BACKGROUND. Among the many causes of obesity, genetic factors occupy a special place. An obvious role among them belongs to the genetic polymorphism of lipid metabolism enzymes, including paraoxonase-1 (PON-1). Until now, the character of the relationship between PON-1 polymorphism and the state of the endocrine function of mesenchymal tissues remains unclear. Its study will clarify the subtle mechanisms of the development of obesity in childhood and adolescence.AIM. The aim of the study was to investigate the relationship between PON-1 polymorphism (rs662) and changes in the content of adipokines, myokines, and blood lipid metabolism in children and adolescents of different sexes with obesity.MATERIALS AND METHODS. In 100 healthy children and adolescents of different sexes and 89 of their peers with obesity, a genetic study was conducted to assess the single nucleotide polymorphism of the PAO-1 (rs662) genes. In blood serum, total cholesterol, HDL cholesterol, LDL cholesterol, VLDL cholesterol, triacylglycerols, glucose and aminotransferase activity (alanine aminotransferase and aspartate aminotransferase) were determined by photometric methods, as well as leptin, adiponectin, resistin, apelin, irisin, adipsin, myostatin, FGF21, osteocrine, oncostatin and insulin — by multiplex ELISA, and asprosin — by ELISA ones.RESULTS. The patients with the homozygous Arg192/Arg allele, the development of complications of obesity in boys is limited and their occurrence in girls is prevented. In other variants of PON-1 polymorphism (Gln192/Gln and Gln192/Arg genotypes), protective mechanisms are formed in the body of girls aimed at preventing complications in obesity. In boys with the Gln192/Gln genotype, obesity reveals more pronounced shifts in lipid metabolism, manifestations of alteration and an increase in the mass of adipose tissue, and in boys-carriers of the heterozygous Gln192/Arg allele, atherogenesis processes increase.CONCLUSION. Polymorphism of the paraoxonase-1 gene (rs662) contributes to the appearance of gender differences in changes in the content of adipokines and myokines in the blood during obesity in childhood and adolescence.","PeriodicalId":37832,"journal":{"name":"Obesity and Metabolism","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139348974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. S. Shutova, E. A. Fedina, A. G. Kuzmin, E. A. Pigarova, E. Przhiyalkovskaya, E. E. Litvinova, N. A. Shutova, L. Dzeranova
This article presents a non-standard clinical case of non-obvious causes of secondary osteoporosis in the routine practice of an outpatient and inpatient endocrinologist. This work demonstrates a rather rare situation, including the identification of atypical clinical manifestations of osteoporosis in a patient, namely the presence of a young man with complaints of general weakness, severe pain in the spine, forcing daily use of non-steroidal anti-inflammatory drugs, decreased motor activity, and laboratory indicators such as hypercalcemia, hypercalciuria against the background of reference values of parathyroid hormone, hyperproteinemia and increased ESR. Taking into account the clinical picture described above, an integral part of a further correct diagnostic search is the exclusion of endocrine diseases that cause a decrease in bone mineral density. In parallel, the initiated prescription of pathogenetically based treatment of secondary osteoporosis is an important component of this disease. The use of such a multidisciplinary approach led to timely verification of the underlying oncohematological disease and routing the patient to a specialized hospital and made it possible to prevent irreversible changes associated with a critical decrease in bone mineral density and improve the patient’s quality of life.
{"title":"The implicit reason of secondary osteoporosis: real clinical case","authors":"A. S. Shutova, E. A. Fedina, A. G. Kuzmin, E. A. Pigarova, E. Przhiyalkovskaya, E. E. Litvinova, N. A. Shutova, L. Dzeranova","doi":"10.14341/omet13003","DOIUrl":"https://doi.org/10.14341/omet13003","url":null,"abstract":"This article presents a non-standard clinical case of non-obvious causes of secondary osteoporosis in the routine practice of an outpatient and inpatient endocrinologist. This work demonstrates a rather rare situation, including the identification of atypical clinical manifestations of osteoporosis in a patient, namely the presence of a young man with complaints of general weakness, severe pain in the spine, forcing daily use of non-steroidal anti-inflammatory drugs, decreased motor activity, and laboratory indicators such as hypercalcemia, hypercalciuria against the background of reference values of parathyroid hormone, hyperproteinemia and increased ESR. Taking into account the clinical picture described above, an integral part of a further correct diagnostic search is the exclusion of endocrine diseases that cause a decrease in bone mineral density. In parallel, the initiated prescription of pathogenetically based treatment of secondary osteoporosis is an important component of this disease. The use of such a multidisciplinary approach led to timely verification of the underlying oncohematological disease and routing the patient to a specialized hospital and made it possible to prevent irreversible changes associated with a critical decrease in bone mineral density and improve the patient’s quality of life.","PeriodicalId":37832,"journal":{"name":"Obesity and Metabolism","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139350418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND: Osteoporosis is metabolic skeletal disease characterized with low bone mass, bone microarchitecture disturbance that together lead to high prevalence of fragility fractures. Postmenopausal osteoporosis accounts for about 80% of the osteoporosis structure in women over 50 years. Diabetes mellitus (DM) is an independent risk factor for low-traumatic fractures. The incidence of both type 2 DM and osteoporosis increases during menopause. Therefore, the study of bone metabolism in experimental diabetes and surgical menopause seems important.THE AIM of the study was to investigate bone metabolism parameters during menopause and experimental type 2 DM.MATERIALS AND METHODS: The half of female Wistar rats had been subjected to bilateral ovariectomy at the beginning of the experiment. Diabetes mellitus (DM) was modelled using a high-fat diet and streptozotocin+nicotinamide. Four weeks after the following groups were formed: «Сontrol» (females without any interventions receiving standard chew, n=5) «OE» (females after ovariectomy n=5), «DM» (females with DM, n=4), «OE+DM» (females after ovariectomy with DM, n=4). The observation period lasted 8 weeks. Bone turnover and calcium-phosphorus metabolism markers (osteocalcin, osteoprotegerin (OPG), nuclear factor-kappa-beta receptor activator ligand (RANKL), sclerostin, fibroblast growth factor-23 (FGF-23), calcium, phosphorus) were measured in the end of experiment. Bone histomorphometry was performed after euthanasia.RESULTS: Phosphorus level was significantly lower both in the «OE» group (1.63 [1.58; 1.65] mmol/L) and in the «DM» group (2.81 [2.57; 2.83] mmol /l) compared to the «Control» group (3.12 [2.55; 3.24] mmol/l) (p<0.001). This marker was significantly higher in the «OE+DM» group (2.79 [2.46; 2.81] mmol/l) in comparison to the «OE» group (2.79 [2.46; 2.81] mmol /l), p=0.025. Osteocalcin level was significantly lower in the «DM» group (8.1 [7.8; 9.2] ng/ml) compared to the «Control» group (16.97 [14.07; 17.07] ng/ml ), p=0.005. A weak negative correlation (r= -0.5, p<0,05) was found between glucose and osteocalcin levels (p=0.03). RANKL level was significantly lower in the «OE+DM» group (278,1 [273.1; 289.7] pg/mL) compared to the «OE» group (400.6 [394.5; 415.1] pg/mL), besides the OPG/RANKL ratio was higher in this group (0.03 [0.02; 0.035] and 0.01 [0.004; 0.014], respectively), p=0.05. In the «OE» group lower OPG level (5.1 [1.5; 5.6] pmol/L) and OPG/RANKL ratio (0.01 [0.003; 0.014]) were obtained in comparison to the «Control» group (12.3 [8.8; 14.2] pmol/l and (0.34[0.33; 0.4], p=0.025 and p=0.07, respectively. The area of bone trabeculae in the epiphyseal zone was the largest in the «Control» group (42 [39; 45]) %; the difference was significant compared to the «OE» group (29 [25; 33] %, p=0.011) and the «OE+DM» group (30 [23; 25] %, p=0.016). The area of bone trabeculae in the metaepiphyseal zone was also the largest in the «Control» group (49 [46; 52] %) compared to the «OE» (35 [
BACKGROUND: In men, obesity is accompanied by a complex of metabolic and hormonal disorders, which leads to androgen deficiency and impaired spermatogenesis. Antidiabetic drugs, including metformin (MF), and luteinizing hormone receptor (LHR) agonists, which activate testicular steroidogenesis, can be used to correct reproductive dysfunctions. However, in diet-induced obesity (DIO), their effectiveness and mechanisms of action are poorly understood.AIM: In men, obesity is accompanied by a complex of metabolic and hormonal disorders, which leads to androgen deficiency and impaired spermatogenesis. Antidiabetic drugs, including metformin (MF), and luteinizing hormone receptor (LHR) agonists, which activate testicular steroidogenesis, can be used to correct reproductive dysfunctions. However, in dietinduced obesity (DIO), their effectiveness and mechanisms of action are poorly understood.MATERIALS AND METHODS: Obesity in male Wistar rats was induced by a 23-week diet enriched with saturated fats. MF treatment was carried out for 5 weeks at a dose of 120 mg/kg/day (orally), and the treatment with hCG and TP03 was carried out for 5 days at daily doses of 20 IU/rat (s.c.) and 15 mg/kg (i.p.), respectively. Using microscopy and histochemical analysis, the number and motility of spermatozoa (SP), the number of their defective forms and the morphology of the seminiferous tubules were assessed, and the levels of testosterone and other hormones in the blood were measured using ELISA.RESULTS: MF, hCG, and TP03 to varying degrees increased the number of SP and the proportion of their mobile forms, including those with forward movement, which were reduced in DIO rats, and also normalized the thickness of the epithelium of the seminiferous tubules and the number of spermatogonia and pachytene spermatocytes in them, but did not reduced the proportion of defective forms of SP, increased in DIO. In the case of MF, this was associated with the drug-induced normalization of body weight, glucose tolerance, and the insulin and leptin levels in DIO rats. The positive effect of hCG and TP03 on spermatogenesis was due to their stimulating effect on testosterone production.CONCLUSION: The use of long-term MF therapy and short-term courses of LHR-agonists normalizes impaired spermatogenesis in DIO, which indicates the prospects for their use to improve male fertility in obesity, and in the case of MF therapy, normalization of the metabolic and hormonal status is of great importance, while in the case of LHR-agonists the most important factor is their steroidogenic effect.
BACKGROUND: Heart rate autonomic regulation can go out of balance which is normally assessed by the heart rate variability (HRV) indices. Similarly, it is relevant to research if and how HRV fluctuations can be influenced by varying signs of insulin resistance since they are quite common in Northern men. At present, there is no evidence of this influence in the North residents of older ages.AIM: This study aimed to comparatively assess heart rate variability in mature men who do or do not feature metabolic signs of insulin resistance.MATERIALS AND METHODS: Seventy-three mature aged male residents of Magadan Region, Caucasian by origin, were examined. All the subjects were divided into two groups: Group without insulin resistance signs (HOMA-IR index < 2.5 units) and Group with insulin resistance signs (HOMA-IR index > 2.5 units). We used immunochemiluminescent and enzymatic methods, and heart rate variability was assessed using the Varikard (Russia).RESULTS: Our research showed that 48% of all the examinees exhibited signs of insulin resistance along with an increase in the sympathetic activity in heart rate regulation. We also identified the heart rate indicators that had proved to undergo the most significant changes depending on the HOMA-IR index and the presence or absence of signs of insulin resistance: MxDMn, pNN50, SDNN, AMo50, SI, TP, HF, LF, and Body Mass.CONCLUSION: In general, the results obtained allow for ascertaining the high proportion of male Northerners of mature age with signs of insulin resistance. We also claim that those examinees demonstrate an autonomic imbalance and a moderate dominance of the sympathetic activity with a simultaneous decrease in activation of the parasympathetic link of autonomic nervous system and high body mass variables. At the same time, the correlations and causal associations among signs of insulin resistance, activation of the sympathetic link of autonomic nervous system, and overweight remain unclear. Apparently, all the analyzed features are likely to complement each other rather than completely exclude each other. The triad of obesity, signs of insulin resistance, and activation of the sympathetic link of autonomic nervous system is a driving factor for significant health risks. This study is expected to spread the use of the method of assessing heart rate variability based on insulin resistance signs as well as in reliance on metabolic disorders in general in a sample of mature men.
{"title":"The influence of insulin resistance variables on heart rate variability indices in mature men under Russia’s North conditions","authors":"I. Averyanova","doi":"10.14341/omet13004","DOIUrl":"https://doi.org/10.14341/omet13004","url":null,"abstract":"BACKGROUND: Heart rate autonomic regulation can go out of balance which is normally assessed by the heart rate variability (HRV) indices. Similarly, it is relevant to research if and how HRV fluctuations can be influenced by varying signs of insulin resistance since they are quite common in Northern men. At present, there is no evidence of this influence in the North residents of older ages.AIM: This study aimed to comparatively assess heart rate variability in mature men who do or do not feature metabolic signs of insulin resistance.MATERIALS AND METHODS: Seventy-three mature aged male residents of Magadan Region, Caucasian by origin, were examined. All the subjects were divided into two groups: Group without insulin resistance signs (HOMA-IR index < 2.5 units) and Group with insulin resistance signs (HOMA-IR index > 2.5 units). We used immunochemiluminescent and enzymatic methods, and heart rate variability was assessed using the Varikard (Russia).RESULTS: Our research showed that 48% of all the examinees exhibited signs of insulin resistance along with an increase in the sympathetic activity in heart rate regulation. We also identified the heart rate indicators that had proved to undergo the most significant changes depending on the HOMA-IR index and the presence or absence of signs of insulin resistance: MxDMn, pNN50, SDNN, AMo50, SI, TP, HF, LF, and Body Mass.CONCLUSION: In general, the results obtained allow for ascertaining the high proportion of male Northerners of mature age with signs of insulin resistance. We also claim that those examinees demonstrate an autonomic imbalance and a moderate dominance of the sympathetic activity with a simultaneous decrease in activation of the parasympathetic link of autonomic nervous system and high body mass variables. At the same time, the correlations and causal associations among signs of insulin resistance, activation of the sympathetic link of autonomic nervous system, and overweight remain unclear. Apparently, all the analyzed features are likely to complement each other rather than completely exclude each other. The triad of obesity, signs of insulin resistance, and activation of the sympathetic link of autonomic nervous system is a driving factor for significant health risks. This study is expected to spread the use of the method of assessing heart rate variability based on insulin resistance signs as well as in reliance on metabolic disorders in general in a sample of mature men.","PeriodicalId":37832,"journal":{"name":"Obesity and Metabolism","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139354336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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