A. Yuzhakova, A. Nelaeva, Yu. V. Nelaeva, D. Gubin
BACKGROUND: With the development of visceral obesity, against the background of insulin resistance (IR), lipo- and glucose toxicity in tissues progresses, which disrupts the metabolic balance of the body, and is the main factor in the development of type 2 diabetes mellitus (DM2). To date, a growing number of publications highlighting the role of circadian rhythms in the control of gluconeogenesis and lipogenesis. In the context of the development of DM2, the process of rhythm mismatch (desynchronosis) is increasingly mentioned, for the diagnosis of which the calculation of amplitude-phase parameters is used. Thus, the study of circadian rhythm disturbances using amplitude-phase parameters and factors influencing them is of particular interest in individuals with visceral obesity and prediabetes, since the data obtained can be used as markers for preclinical diagnosis of DM2.AIM: To identify significant differences in the parameters (amplitude, acrophase) of circadian rhythms (fasting glycemia, basal body temperature, heart rate) as markers of desynchronosis in groups without carbohydrate metabolism disorders, but with the presence of visceral obesity, prediabetes (impaired fasting glycemia, impaired glucose tolerance test) and DM2 and obesity.MATERIALS AND METHODS: The study was conducted in individuals with visceral obesity, as well as the presence of prediabetes or DM2, with a disease experience of not more than 5 years.In accordance with the study design, every 3 hours during the day, the participants made self-measurements of blood glucose at home (using individual glucometers), basal body temperature (BTT) in the armpit (using a mercury thermometer) and heart rate (HR) ( with the help of an electronic tonometer), with the fixation of the results in self-control diaries. To assess the reliability of the circadian rhythms of the studied indicators, the interpretation of chronobiological parameters (MESORa-Midline Estimating Statistic of Rhytm; amplitude; acrophase) was carried out using a single сosinor analysis.RESULTS: Of the 120 study participants, 73% were women and 27% were men. Mean age of participants was 58.6[52.2;56.7] years, BMI 31.3[29.7;33.9] and presence of visceral obesity WC 100 [93.8;104.7]. When conducting cosinor analysis, the daily rhythms of physiological indicators of fasting glycemia, BTT and heart rate differ from normal already in the group with visceral obesity without carbohydrate metabolism disorders and prediabetes, in the form of a decrease in the amplitude of daily rhythms (p<0.001), with a shift in their acrophases (p <0.001), no dynamics of night BBT decrease (р<0.001).CONCLUSION: Integral amplitude-phase parameters of circadian rhythms of physiological parameters (fasting glycemia, basal body temperature, heart rate), as markers of desynchronosis, can be used in the presence of visceral obesity for preclinical diagnosis of prediabetes and DM2, which will have a preventive focus. This method of chronodiagnostic
{"title":"Using amplitude-phase parameters of circadian rhythms as diagnostic markers of carbohydrate metabolism disorders","authors":"A. Yuzhakova, A. Nelaeva, Yu. V. Nelaeva, D. Gubin","doi":"10.14341/omet12781","DOIUrl":"https://doi.org/10.14341/omet12781","url":null,"abstract":"BACKGROUND: With the development of visceral obesity, against the background of insulin resistance (IR), lipo- and glucose toxicity in tissues progresses, which disrupts the metabolic balance of the body, and is the main factor in the development of type 2 diabetes mellitus (DM2). To date, a growing number of publications highlighting the role of circadian rhythms in the control of gluconeogenesis and lipogenesis. In the context of the development of DM2, the process of rhythm mismatch (desynchronosis) is increasingly mentioned, for the diagnosis of which the calculation of amplitude-phase parameters is used. Thus, the study of circadian rhythm disturbances using amplitude-phase parameters and factors influencing them is of particular interest in individuals with visceral obesity and prediabetes, since the data obtained can be used as markers for preclinical diagnosis of DM2.AIM: To identify significant differences in the parameters (amplitude, acrophase) of circadian rhythms (fasting glycemia, basal body temperature, heart rate) as markers of desynchronosis in groups without carbohydrate metabolism disorders, but with the presence of visceral obesity, prediabetes (impaired fasting glycemia, impaired glucose tolerance test) and DM2 and obesity.MATERIALS AND METHODS: The study was conducted in individuals with visceral obesity, as well as the presence of prediabetes or DM2, with a disease experience of not more than 5 years.In accordance with the study design, every 3 hours during the day, the participants made self-measurements of blood glucose at home (using individual glucometers), basal body temperature (BTT) in the armpit (using a mercury thermometer) and heart rate (HR) ( with the help of an electronic tonometer), with the fixation of the results in self-control diaries. To assess the reliability of the circadian rhythms of the studied indicators, the interpretation of chronobiological parameters (MESORa-Midline Estimating Statistic of Rhytm; amplitude; acrophase) was carried out using a single сosinor analysis.RESULTS: Of the 120 study participants, 73% were women and 27% were men. Mean age of participants was 58.6[52.2;56.7] years, BMI 31.3[29.7;33.9] and presence of visceral obesity WC 100 [93.8;104.7]. When conducting cosinor analysis, the daily rhythms of physiological indicators of fasting glycemia, BTT and heart rate differ from normal already in the group with visceral obesity without carbohydrate metabolism disorders and prediabetes, in the form of a decrease in the amplitude of daily rhythms (p<0.001), with a shift in their acrophases (p <0.001), no dynamics of night BBT decrease (р<0.001).CONCLUSION: Integral amplitude-phase parameters of circadian rhythms of physiological parameters (fasting glycemia, basal body temperature, heart rate), as markers of desynchronosis, can be used in the presence of visceral obesity for preclinical diagnosis of prediabetes and DM2, which will have a preventive focus. This method of chronodiagnostic","PeriodicalId":54700,"journal":{"name":"Obesity and Metabolism-Milan","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48420808","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: The article shows that the development of obesity and associated health disorders is directly related to the changes in eating behavior (EB) and the psychoemotional state. However, the considered studies were carried out in obese patients of medical institutions only. The research in young people focuses mainly on the sociological and psychological aspects of EB.Aim: To study the psychological characteristics, eating behavior features and their relationship with the indicators of actual nutrition and the body composition in young men.Materials and methods: A multicenter, cross-sectional sample survey of young men aged 17 to 21 was performed. A survey of violations of the EB was carried out, on the basis of which 5 groups of young men were formed. Group 1 (comparison) consisted of young men without violations of the EB. Group 2 consisted of young men with impaired emotiogenic EB. Group 3 consisted of boys with violations of the restrictive PP; group 4 — young men with impaired external EB; group 5 — young men with a combination of impairment of emotionogenic and restrictive EB. We used the Dutch DEBQ questionnaire to study the types of eating behavior. The current mental state of the testees was evaluated by a clinical and psychological test — Symptom Checklist-90-Revised (SCL-90-R). The body composition was assessed with the ABC-01 «Medass» bioimpedansometry device. The «Analysis of the human nutritional state” computer program was applied to estimate the actual nutrition by the frequency analysis method.Results: The study included 96 volunteers. Young men with impaired external EB feature an increase in the daily average energy consumption, which resulted in an increase in BFM%. In young people with eating disorders, an increase in scores on the «Somatization», «Obsession-compulsion», and «Anxiety» scales as compared to the reference valuesis testified. The depression level in young men correlated with the severity of emotiogenic eating behavior (r = 0.455, p <0.001).However, it is associated with the severity of external EB to a greater extent (r = 0.608, p <0.001). On the contrary, the anxiety level more strongly correlated with the severity of emotiogenic EB (r = 0.575, p <0.001) rather than of external EB type (r = 0.391, p <0.001).Conclusion: EB disorders in young men are associated with psychophysiological features, eating disorders accounting for the accumulation of adipose tissue in the body.
{"title":"Psychological, morphological and dietic aspects of violations of food behavior of young people","authors":"O. Filatova, E. V. Kutseva, I. Voronina","doi":"10.14341/omet12403","DOIUrl":"https://doi.org/10.14341/omet12403","url":null,"abstract":"Background: The article shows that the development of obesity and associated health disorders is directly related to the changes in eating behavior (EB) and the psychoemotional state. However, the considered studies were carried out in obese patients of medical institutions only. The research in young people focuses mainly on the sociological and psychological aspects of EB.Aim: To study the psychological characteristics, eating behavior features and their relationship with the indicators of actual nutrition and the body composition in young men.Materials and methods: A multicenter, cross-sectional sample survey of young men aged 17 to 21 was performed. A survey of violations of the EB was carried out, on the basis of which 5 groups of young men were formed. Group 1 (comparison) consisted of young men without violations of the EB. Group 2 consisted of young men with impaired emotiogenic EB. Group 3 consisted of boys with violations of the restrictive PP; group 4 — young men with impaired external EB; group 5 — young men with a combination of impairment of emotionogenic and restrictive EB. We used the Dutch DEBQ questionnaire to study the types of eating behavior. The current mental state of the testees was evaluated by a clinical and psychological test — Symptom Checklist-90-Revised (SCL-90-R). The body composition was assessed with the ABC-01 «Medass» bioimpedansometry device. The «Analysis of the human nutritional state” computer program was applied to estimate the actual nutrition by the frequency analysis method.Results: The study included 96 volunteers. Young men with impaired external EB feature an increase in the daily average energy consumption, which resulted in an increase in BFM%. In young people with eating disorders, an increase in scores on the «Somatization», «Obsession-compulsion», and «Anxiety» scales as compared to the reference valuesis testified. The depression level in young men correlated with the severity of emotiogenic eating behavior (r = 0.455, p <0.001).However, it is associated with the severity of external EB to a greater extent (r = 0.608, p <0.001). On the contrary, the anxiety level more strongly correlated with the severity of emotiogenic EB (r = 0.575, p <0.001) rather than of external EB type (r = 0.391, p <0.001).Conclusion: EB disorders in young men are associated with psychophysiological features, eating disorders accounting for the accumulation of adipose tissue in the body.","PeriodicalId":54700,"journal":{"name":"Obesity and Metabolism-Milan","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47743741","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}
Over the past decades, we have witnessed many remarkable advances in understanding the impact of vitamin D on human health. There is an exponential growth of new data covering both the fundamental biology of vitamin D and the clinical implications of deficiency and the effects of vitamin D supplementation. This literature review has been prepared to combine and interpret the current scientific evidence on the mechanisms of vitamin D absorption, with a focus on vitamin D absorption through the apical membrane of enterocytes in various pathologies of the gastrointestinal tract. Reviewed studies have identified some distinctive aspects of vitamin D bioavailability that should be considered in the treatment or prevention of vitamin D deficiency in patients with malabsorption syndromes, especially in the active phase of the disease. Moreover, recent in vivo experiments and in vitro studies have demonstrated that vitamin D absorption is not a simple diffusion process as previously thought, but rather a mechanism that also involves multiple membrane transporters. Maintaining or improving vitamin D intake through diet or increased sun exposure is problematic, so oral supplementation may be an effective and safe approach to improving vitamin D status. Vitamin D3 is the recommended form for both prevention and treatment of vitamin D deficiency, which is associated with more stable pharmacokinetics. Vitamin D absorption is improved when vitamin D is taken with a small amount of fat-containing food and medium chain triglycerides. In malabsorption syndromes, it is optimal to increase the general population doses of vitamin D by 2–3 times both for prevention and for the treatment of deficiency and insufficiency. While vitamin D deficiency is more common among people with gastrointestinal disease, data have not been able to establish whether the relationship is causal or the result of intestinal inflammation and malabsorption syndrome. However, owing to the understanding of the mechanisms of action of vitamin D, there is evidence that its deficiency can be directly related to the severity of the disease, and partly to the etiology or pathogenesis of the disease itself.
{"title":"Absorption and metabolism of vitamin D in health and in gastrointestinal tract diseases","authors":"E. Pigarova, L. Dzeranova, D. A. Yatsenko","doi":"10.14341/omet12835","DOIUrl":"https://doi.org/10.14341/omet12835","url":null,"abstract":"Over the past decades, we have witnessed many remarkable advances in understanding the impact of vitamin D on human health. There is an exponential growth of new data covering both the fundamental biology of vitamin D and the clinical implications of deficiency and the effects of vitamin D supplementation. This literature review has been prepared to combine and interpret the current scientific evidence on the mechanisms of vitamin D absorption, with a focus on vitamin D absorption through the apical membrane of enterocytes in various pathologies of the gastrointestinal tract. Reviewed studies have identified some distinctive aspects of vitamin D bioavailability that should be considered in the treatment or prevention of vitamin D deficiency in patients with malabsorption syndromes, especially in the active phase of the disease. Moreover, recent in vivo experiments and in vitro studies have demonstrated that vitamin D absorption is not a simple diffusion process as previously thought, but rather a mechanism that also involves multiple membrane transporters. Maintaining or improving vitamin D intake through diet or increased sun exposure is problematic, so oral supplementation may be an effective and safe approach to improving vitamin D status. Vitamin D3 is the recommended form for both prevention and treatment of vitamin D deficiency, which is associated with more stable pharmacokinetics. Vitamin D absorption is improved when vitamin D is taken with a small amount of fat-containing food and medium chain triglycerides. In malabsorption syndromes, it is optimal to increase the general population doses of vitamin D by 2–3 times both for prevention and for the treatment of deficiency and insufficiency. While vitamin D deficiency is more common among people with gastrointestinal disease, data have not been able to establish whether the relationship is causal or the result of intestinal inflammation and malabsorption syndrome. However, owing to the understanding of the mechanisms of action of vitamin D, there is evidence that its deficiency can be directly related to the severity of the disease, and partly to the etiology or pathogenesis of the disease itself.","PeriodicalId":54700,"journal":{"name":"Obesity and Metabolism-Milan","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48034510","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}
Hypercalciuria is a pathological condition characterized by an excess of daily calcium excretion. A high concentration of urine calcium can initiate stone formation. There are several types of hypercalciuria, each requires an individual approach. In the absence of known causes of development, idiopathic hypercalciuria is a frequent dysmetabolic disorder defined as an excess urine calcium excretion with normocalcemia. Resorptive hypercalciuria most often develops due to primary hyperparathyroidism and is caused by elevated PTH and excess release of calcium from bone stores. A thiazide test can be used for differential diagnosis between these conditions. We present a series of clinical cases covered the thiazide test in outpatient practice. The definitive diagnosis is extremely important because it determines the optimal treatment strategy. Secondary hyperparathyroidism (an increase in parathyroid hormone as a result of vitamin D deficiency, chronic renal failure or other conditions) requires medical therapy, while the primary hyperparathyroidism is radically cured only after surgical intervention.Taking into account the prevalence of idiopathic hypercalciuria and primary hyperparathyroidism, it is actual to use the thiazide test more widely in clinical practice.
{"title":"Hypercalciuria and hyperparathyroidism — is there always a connection?","authors":"S. Mirnaya, A. Eremkina","doi":"10.14341/omet12788","DOIUrl":"https://doi.org/10.14341/omet12788","url":null,"abstract":"Hypercalciuria is a pathological condition characterized by an excess of daily calcium excretion. A high concentration of urine calcium can initiate stone formation. There are several types of hypercalciuria, each requires an individual approach. In the absence of known causes of development, idiopathic hypercalciuria is a frequent dysmetabolic disorder defined as an excess urine calcium excretion with normocalcemia. Resorptive hypercalciuria most often develops due to primary hyperparathyroidism and is caused by elevated PTH and excess release of calcium from bone stores. A thiazide test can be used for differential diagnosis between these conditions. We present a series of clinical cases covered the thiazide test in outpatient practice. The definitive diagnosis is extremely important because it determines the optimal treatment strategy. Secondary hyperparathyroidism (an increase in parathyroid hormone as a result of vitamin D deficiency, chronic renal failure or other conditions) requires medical therapy, while the primary hyperparathyroidism is radically cured only after surgical intervention.Taking into account the prevalence of idiopathic hypercalciuria and primary hyperparathyroidism, it is actual to use the thiazide test more widely in clinical practice. ","PeriodicalId":54700,"journal":{"name":"Obesity and Metabolism-Milan","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48755724","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}
This review analyzes the prevalence of obesity among the adult population in the Russian Federation. The data of various studies, including large international projects (WHO MONICA 1985–1995, HAPIEE 2003–2005), all-Russian screenings (RLMS - HSE 1993, Federal monitoring of arterial hypertension 2003, ESSE-RF 2013 — present.), as well as selected regional studies. In some regions, the long-term dynamics of obesity has been studied. The history of studying the epidemiology of obesity in Russia has more than thirty years. According to the data obtained, the prevalence of obesity throughout the country remains high and continues to increase. Thus, among men, the prevalence increased from 10.8% in 1993 to 27.9% in 2017, among women — from 26.4% to 31.8%, respectively. In all regions where it was possible to assess long-term trends, the prevalence of obesity among adults increased (maximum — 48.5% in the Belgorod region). In the adult population, obesity is more common in women (maximum — 47.0% in the Novosibirsk region) than in men (maximum — 30.0% in Ivanovo and Voronezh regions). It is necessary to expand the number of regions in Russia in which studies of the prevalence of obesity are carried out, as well as to strengthen measures to combat overweight and obesity in all age groups throughout the country.
{"title":"The prevalence of obesity in the adult population of the Russian Federation (literature review)","authors":"V. I. Alferova, S. Mustafina","doi":"10.14341/omet12809","DOIUrl":"https://doi.org/10.14341/omet12809","url":null,"abstract":"This review analyzes the prevalence of obesity among the adult population in the Russian Federation. The data of various studies, including large international projects (WHO MONICA 1985–1995, HAPIEE 2003–2005), all-Russian screenings (RLMS - HSE 1993, Federal monitoring of arterial hypertension 2003, ESSE-RF 2013 — present.), as well as selected regional studies. In some regions, the long-term dynamics of obesity has been studied. The history of studying the epidemiology of obesity in Russia has more than thirty years. According to the data obtained, the prevalence of obesity throughout the country remains high and continues to increase. Thus, among men, the prevalence increased from 10.8% in 1993 to 27.9% in 2017, among women — from 26.4% to 31.8%, respectively. In all regions where it was possible to assess long-term trends, the prevalence of obesity among adults increased (maximum — 48.5% in the Belgorod region). In the adult population, obesity is more common in women (maximum — 47.0% in the Novosibirsk region) than in men (maximum — 30.0% in Ivanovo and Voronezh regions). It is necessary to expand the number of regions in Russia in which studies of the prevalence of obesity are carried out, as well as to strengthen measures to combat overweight and obesity in all age groups throughout the country.","PeriodicalId":54700,"journal":{"name":"Obesity and Metabolism-Milan","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41363252","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}
O. Gileva, E. G. Butolin, M. Tereshchenko, V. G. Ivanov
BACKGROUND: Recently, there has been an increase in the number of cardiovascular diseases and mortality rates among the population. This may be due to a violation of metabolic processes in the body, in particular lipid and carbohydrate metabolism, caused by an unbalanced high-calorie diet.PURPOSE: To study and compare the main indicators of carbohydrate and lipid metabolism in a fructose-fortified diet and a diet with a high fat content under experimental conditions.MATERIALS AND METHODS: The study was carried out on outbred white rats, males, which were divided into 3 groups — a control group and two experimental ones, 15 individuals in each. The rats of the first experimental group were kept on a high-fat diet, the second experimental group was assigned a fructose-enriched diet for 35 days. The control group was on a balanced diet. We studied the changes in the parameters of carbohydrate (glucose, insulin, insulin resistance indices) and lipid (cholesterol-, high- and low-density lipoproteins, triglycerides) metabolism on the 21st, 35th and 60th days of the experiment. The results were statistically processed using the Mann-Whitney test. The study design is retrospective.RESULTS: During the experiment, an increase in the content of glucose, insulin, and lipid metabolism parameters was observed in the experimental groups. Moreover, the content of glucose and insulin in a fructose-fortified diet increased by 18.7% (p = 0,009), 22.2% (p = 0,076), 21.5% (p = 0,009) and 50% (p = 0,009), 62.5% (p = 0,009), 106.3% (p = 0,009) over the days of the experiment, respectively. The increase in lipid metabolism was more pronounced in the experimental group, which had an increased fat content in the diet, already in the first time period of the experiment: cholesterol — by 80,8% (p = 0,009), low-density lipoproteins — by 100% (p = 0,009), triglycerides — by 120% (p = 0,009), high-density lipoproteins — by 60.9% (p = 0,009).CONCLUSION: The experimental data obtained show changes in lipid and carbohydrate metabolism due to increased consumption of fats and fructose.
{"title":"Evaluation of indicators of carbohydrate and lipid metabolism in rats depending on the type of high-calorie diet","authors":"O. Gileva, E. G. Butolin, M. Tereshchenko, V. G. Ivanov","doi":"10.14341/omet12712","DOIUrl":"https://doi.org/10.14341/omet12712","url":null,"abstract":"BACKGROUND: Recently, there has been an increase in the number of cardiovascular diseases and mortality rates among the population. This may be due to a violation of metabolic processes in the body, in particular lipid and carbohydrate metabolism, caused by an unbalanced high-calorie diet.PURPOSE: To study and compare the main indicators of carbohydrate and lipid metabolism in a fructose-fortified diet and a diet with a high fat content under experimental conditions.MATERIALS AND METHODS: The study was carried out on outbred white rats, males, which were divided into 3 groups — a control group and two experimental ones, 15 individuals in each. The rats of the first experimental group were kept on a high-fat diet, the second experimental group was assigned a fructose-enriched diet for 35 days. The control group was on a balanced diet. We studied the changes in the parameters of carbohydrate (glucose, insulin, insulin resistance indices) and lipid (cholesterol-, high- and low-density lipoproteins, triglycerides) metabolism on the 21st, 35th and 60th days of the experiment. The results were statistically processed using the Mann-Whitney test. The study design is retrospective.RESULTS: During the experiment, an increase in the content of glucose, insulin, and lipid metabolism parameters was observed in the experimental groups. Moreover, the content of glucose and insulin in a fructose-fortified diet increased by 18.7% (p = 0,009), 22.2% (p = 0,076), 21.5% (p = 0,009) and 50% (p = 0,009), 62.5% (p = 0,009), 106.3% (p = 0,009) over the days of the experiment, respectively. The increase in lipid metabolism was more pronounced in the experimental group, which had an increased fat content in the diet, already in the first time period of the experiment: cholesterol — by 80,8% (p = 0,009), low-density lipoproteins — by 100% (p = 0,009), triglycerides — by 120% (p = 0,009), high-density lipoproteins — by 60.9% (p = 0,009).CONCLUSION: The experimental data obtained show changes in lipid and carbohydrate metabolism due to increased consumption of fats and fructose.","PeriodicalId":54700,"journal":{"name":"Obesity and Metabolism-Milan","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48395431","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: There are a lot of works devoted to the study of the main regularities of the heart rate (HR) control in individuals depending on the body weight. Still, there are some uncleared and even controversial issues that significantly influence the notion of this process itself. Particularly, impaired HR variability in patients with the cardiometabolic syndrome is characterized by the weakening of the impact of both parasympathetic and sympathetic branches of the autonomic nervous system. The works devoted to the heart rate variability features in young people associated with the body weight are scarce.AIM: To study the peculiarities of the heart rate variability in boys and girls with different body composition, motor and eating behavior.MATERIALS AND METHODS: A cross-sectional, open, single-arm, non-randomized study of the HR variability in adolescents with different body fat mass (BFM) was carried out on the basis of the Center for Healthy Nutrition of Altai State University. The HR variability, nutritional status and physical activity index (PHAI) were studied in the groups of individuals with different body fat mass.RESULTS: We examined 168 people (85 boys and 83 girls). The surveyed belonged to the adolescent age period (boys from 17 to 21 years old, girls from 16 to 20 years old). The boys and girls examined by us had a different amount of BFM %. The HR variability, nutritional status and physical activity index were studied in 44 people with the low BFM, 71 people with the average BFM, 53 people with the increased BFM. In both sexes, the group with the increased BFM features an increase in the absolute (HF, ms2 ) and relative (HF%) oscillation power of the heart rate high-frequency component. The average value of the physical activity index in the group with the reduced BFM equals 1.52 ± 0.037 in boys, and 1.44 ± 0.099 in girls. The average value of the physical activity index in the group with the average BFM is 1.44 ± 0.029 and 1.42 ± 0.095 in boys and in girls respectively. The average value of the physical activity index in the group with the increased BFM is 1.23 (Q25–75 1.20–1.70) in boys, and 1.26 ± 0.33 in girls. The representatives of the group with the increased BFM have a higher caloric value (CV) of the daily intake. In young men, a higher CV was achieved due to increased consumption of fats and carbohydrates. In the girls of the third group, a higher CV of the daily intake was gained due to proteins, fats, carbohydrates.CONCLUSION: The results of the HR variability showed that the motor and eating behavior affect the state of the cardiac function in both boys and girls. An increase in the body fat mass in the individuals with a maximum CV of the daily intake and a minimum level of motor activity is associated with the prevalence of the parasympathetic branch of the autonomic nervous system in the heart rate control.
{"title":"The peculiarities of the heart rate regulation in boys and girls with different body composition, motor and eating behavior","authors":"O. Filatova, E. V. Kutseva, I. Voronina","doi":"10.14341/omet12713","DOIUrl":"https://doi.org/10.14341/omet12713","url":null,"abstract":"BACKGROUND: There are a lot of works devoted to the study of the main regularities of the heart rate (HR) control in individuals depending on the body weight. Still, there are some uncleared and even controversial issues that significantly influence the notion of this process itself. Particularly, impaired HR variability in patients with the cardiometabolic syndrome is characterized by the weakening of the impact of both parasympathetic and sympathetic branches of the autonomic nervous system. The works devoted to the heart rate variability features in young people associated with the body weight are scarce.AIM: To study the peculiarities of the heart rate variability in boys and girls with different body composition, motor and eating behavior.MATERIALS AND METHODS: A cross-sectional, open, single-arm, non-randomized study of the HR variability in adolescents with different body fat mass (BFM) was carried out on the basis of the Center for Healthy Nutrition of Altai State University. The HR variability, nutritional status and physical activity index (PHAI) were studied in the groups of individuals with different body fat mass.RESULTS: We examined 168 people (85 boys and 83 girls). The surveyed belonged to the adolescent age period (boys from 17 to 21 years old, girls from 16 to 20 years old). The boys and girls examined by us had a different amount of BFM %. The HR variability, nutritional status and physical activity index were studied in 44 people with the low BFM, 71 people with the average BFM, 53 people with the increased BFM. In both sexes, the group with the increased BFM features an increase in the absolute (HF, ms2 ) and relative (HF%) oscillation power of the heart rate high-frequency component. The average value of the physical activity index in the group with the reduced BFM equals 1.52 ± 0.037 in boys, and 1.44 ± 0.099 in girls. The average value of the physical activity index in the group with the average BFM is 1.44 ± 0.029 and 1.42 ± 0.095 in boys and in girls respectively. The average value of the physical activity index in the group with the increased BFM is 1.23 (Q25–75 1.20–1.70) in boys, and 1.26 ± 0.33 in girls. The representatives of the group with the increased BFM have a higher caloric value (CV) of the daily intake. In young men, a higher CV was achieved due to increased consumption of fats and carbohydrates. In the girls of the third group, a higher CV of the daily intake was gained due to proteins, fats, carbohydrates.CONCLUSION: The results of the HR variability showed that the motor and eating behavior affect the state of the cardiac function in both boys and girls. An increase in the body fat mass in the individuals with a maximum CV of the daily intake and a minimum level of motor activity is associated with the prevalence of the parasympathetic branch of the autonomic nervous system in the heart rate control.","PeriodicalId":54700,"journal":{"name":"Obesity and Metabolism-Milan","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42730268","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}
O. Povarova, E. Gorodetskaya, O. Kulyak, A. N. Demyanenko, I. Alimova, E. Kalenikova, O. Medvedev
BACKGROUND: According to the involvement of oxidative stress in the pathogenesis of obesity, the plasma level of coenzyme q10 in the correlation relationship with lipid metabolism disorders and functional liver state is of interest to study.AIM: Substantiation of approaches to the correction of lipid metabolism disorders and non-alcoholic fatty liver disease in children with exogenous obesity based on the content of coenzyme Q10 and its relationship with lipid profile and liver enzymes.MATERIALS AND METHODS: The single-center cross-sectional study enlisted the control (n=32, -1.0≤BMI SD score ≤+2.0) and obese (n=40, BMI SD score>+2.0) groups of children with the mean age of 12 yr. In all children BMI, lipidogram, liver enzymes (ALT and AST), plasma coenzyme Q10 and liver ultrasound examination were assessed.RESULTS: Patients of both groups were comparable (p> 0.05) in age and gender. The level of coenzyme Q10 in the compared groups was comparable (p> 0.05) and did not differ in patients with different degrees of obesity. According to the results of the study of the lipid profile in the obese children, the level of HDL was lower, and the level of LDL was higher than that in control group. The highest value of HDL was obtained in the patients with the 1st degree of obesity and the highest level of triglycerides — in the patients with the 4th degree of obesity. The control group demonstrated moderate correlations between endogenous coenzyme Q10 and total cholesterol (r=0.474, p=0.009) which persists in patients with the first degree of obesity (r = 0.548, p = 0.035). There was no difference in AST in the study groups, however, the main group demonstrated elevated ALT and ALT/AST ratio (p <0.001). The highest ALT and ALT / AST ratio were observed in patients with greatest degree of obesity. Eighteen obese children (45%) had ALT / AST ratio ≥1 (in the control group –one patient (3%) (p <0.001), while fourteen patients showed liver enlargement and structure change according to ultrasound (80%). The control group demonstrated moderate correlations between endogenous coenzyme Q10 and total cholesterol (r=0.474, p=0.009) and between coenzyme Q10 and ALT / AST ratio (r=0.412, p=0.023) . In the obese group there was correlation between AI and ALT / AST (r = 0.436, p = 0.006) and in patients with the 1st degree of obesity — between also coenzyme Q10 and ALT (r = 0.875, p <0.001).CONCLUSION: The disturbances in adequate control of cholesterol by coenzyme Q10 in obese children possibly confirming the involvement of oxidative stress in the pathogenesis of dyslipidemia and non-alcoholic fatty liver disease can serve as indication to use coenzyme Q10 in order to correct these complications.
{"title":"Substantiation of approaches to the correction of lipid metabolism disorders and non-alcoholic fatty liver disease in children with exogenous obesity","authors":"O. Povarova, E. Gorodetskaya, O. Kulyak, A. N. Demyanenko, I. Alimova, E. Kalenikova, O. Medvedev","doi":"10.14341/omet12802","DOIUrl":"https://doi.org/10.14341/omet12802","url":null,"abstract":"BACKGROUND: According to the involvement of oxidative stress in the pathogenesis of obesity, the plasma level of coenzyme q10 in the correlation relationship with lipid metabolism disorders and functional liver state is of interest to study.AIM: Substantiation of approaches to the correction of lipid metabolism disorders and non-alcoholic fatty liver disease in children with exogenous obesity based on the content of coenzyme Q10 and its relationship with lipid profile and liver enzymes.MATERIALS AND METHODS: The single-center cross-sectional study enlisted the control (n=32, -1.0≤BMI SD score ≤+2.0) and obese (n=40, BMI SD score>+2.0) groups of children with the mean age of 12 yr. In all children BMI, lipidogram, liver enzymes (ALT and AST), plasma coenzyme Q10 and liver ultrasound examination were assessed.RESULTS: Patients of both groups were comparable (p> 0.05) in age and gender. The level of coenzyme Q10 in the compared groups was comparable (p> 0.05) and did not differ in patients with different degrees of obesity. According to the results of the study of the lipid profile in the obese children, the level of HDL was lower, and the level of LDL was higher than that in control group. The highest value of HDL was obtained in the patients with the 1st degree of obesity and the highest level of triglycerides — in the patients with the 4th degree of obesity. The control group demonstrated moderate correlations between endogenous coenzyme Q10 and total cholesterol (r=0.474, p=0.009) which persists in patients with the first degree of obesity (r = 0.548, p = 0.035). There was no difference in AST in the study groups, however, the main group demonstrated elevated ALT and ALT/AST ratio (p <0.001). The highest ALT and ALT / AST ratio were observed in patients with greatest degree of obesity. Eighteen obese children (45%) had ALT / AST ratio ≥1 (in the control group –one patient (3%) (p <0.001), while fourteen patients showed liver enlargement and structure change according to ultrasound (80%). The control group demonstrated moderate correlations between endogenous coenzyme Q10 and total cholesterol (r=0.474, p=0.009) and between coenzyme Q10 and ALT / AST ratio (r=0.412, p=0.023) . In the obese group there was correlation between AI and ALT / AST (r = 0.436, p = 0.006) and in patients with the 1st degree of obesity — between also coenzyme Q10 and ALT (r = 0.875, p <0.001).CONCLUSION: The disturbances in adequate control of cholesterol by coenzyme Q10 in obese children possibly confirming the involvement of oxidative stress in the pathogenesis of dyslipidemia and non-alcoholic fatty liver disease can serve as indication to use coenzyme Q10 in order to correct these complications.","PeriodicalId":54700,"journal":{"name":"Obesity and Metabolism-Milan","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42437245","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: An increase with age in the blood glucose level of permanent residents of the Arctic region is a risk factor for metabolic changes, including diabetes mellitus (DM), the frequency and prevalence of which is often accompanied by an increase in body weight and obesity. However, at the moment, there is no clear idea of the age range in the structure of metabolic changes in northerners, and the influence of gender on the content of glucose, its metabolites, pancreatic hormones and the nature of the relationship between them in adults requires clarification.AIMS: To assess the values of the parameters of carbohydrate metabolism, pancreatic hormones, body mass index and the nature of the relationships between them in residents of the Arctic region who were born and permanently residing in the Nenets (NAO), Yamalo-Nenets Autonomous Okrug (Yamalo-Nenets Autonomous Okrug (Yamalo-Nenets Autonomous Okrug) and Mezen District of the Arkhangelsk Region, taking into account gender and age.MATERIALS AND METHODS: In the blood serum healthy residents of the NAO, YaNAO and the Mezensky district of the Arkhangelsk region of mature age, born and permanently residing in the Arctic region, randomly selected after a medical examination and questioning, which depending on gender and age were divided into groups: women 21–35, 36–45, 46–55 years old and men 22–35, 36–45, 46–60 years old. The blood serum was determined by the content of glucose, lactate, pyruvate, insulin, proinsulin, C-peptide was determined, measured height and weight.RESULTS: The study involved 1146 people of mature age (women 21–35 (221), 36–45 (222) and 46–55 (371), men 22–35 (105), 36–45 (84), 46–60 (143) years). Regardless of gender, the content of glucose (Glu) significantly increases with age, the peak of which occurs in women aged 46–55 years and in men aged 46–60 years. Age-related changes in the content of lactate (Lac) and pyruvate (Pir) were not found, but in men aged 36–45 years, the level of Lac was higher than in women, and the content of Pir, on the contrary, in all age groups, regardless of gender, was shifted to the lower limit of normal and below it. Against the background of an increase in Glu in women aged 46–55 years the level of insulin was significantly increased, and in men aged 46–60 years, the level of proinsulin was significantly increased. The value of the HOMA index, regardless of gender, exceeded the norm, and the value of the Caro index was below the critical level, which indicates hidden disorders of carbohydrate metabolism.CONCLUSIONS: In permanent residents of the Arctic region (NAO, YaNAO, Mezensk district of the Arkhangelsk region) of mature age, sex differences were established in the content of glucose, lactate, pyruvate and in the regulation of insulin-stimulated glycolysis by pancreatic hormones, as well as an excess of the BMI norm in 50,9, 67,0, 75,0% of women and 52,1, 66,6, 63,7% males.
{"title":"Gender characteristics of the parameters of carbohydrate metabolism and pancreatic hormones in permanent residents of the Arctic region, taking into account age","authors":"A. Bichkaev, N. Volkova, F. Bichkaeva","doi":"10.14341/omet12480","DOIUrl":"https://doi.org/10.14341/omet12480","url":null,"abstract":"BACKGROUND: An increase with age in the blood glucose level of permanent residents of the Arctic region is a risk factor for metabolic changes, including diabetes mellitus (DM), the frequency and prevalence of which is often accompanied by an increase in body weight and obesity. However, at the moment, there is no clear idea of the age range in the structure of metabolic changes in northerners, and the influence of gender on the content of glucose, its metabolites, pancreatic hormones and the nature of the relationship between them in adults requires clarification.AIMS: To assess the values of the parameters of carbohydrate metabolism, pancreatic hormones, body mass index and the nature of the relationships between them in residents of the Arctic region who were born and permanently residing in the Nenets (NAO), Yamalo-Nenets Autonomous Okrug (Yamalo-Nenets Autonomous Okrug (Yamalo-Nenets Autonomous Okrug) and Mezen District of the Arkhangelsk Region, taking into account gender and age.MATERIALS AND METHODS: In the blood serum healthy residents of the NAO, YaNAO and the Mezensky district of the Arkhangelsk region of mature age, born and permanently residing in the Arctic region, randomly selected after a medical examination and questioning, which depending on gender and age were divided into groups: women 21–35, 36–45, 46–55 years old and men 22–35, 36–45, 46–60 years old. The blood serum was determined by the content of glucose, lactate, pyruvate, insulin, proinsulin, C-peptide was determined, measured height and weight.RESULTS: The study involved 1146 people of mature age (women 21–35 (221), 36–45 (222) and 46–55 (371), men 22–35 (105), 36–45 (84), 46–60 (143) years). Regardless of gender, the content of glucose (Glu) significantly increases with age, the peak of which occurs in women aged 46–55 years and in men aged 46–60 years. Age-related changes in the content of lactate (Lac) and pyruvate (Pir) were not found, but in men aged 36–45 years, the level of Lac was higher than in women, and the content of Pir, on the contrary, in all age groups, regardless of gender, was shifted to the lower limit of normal and below it. Against the background of an increase in Glu in women aged 46–55 years the level of insulin was significantly increased, and in men aged 46–60 years, the level of proinsulin was significantly increased. The value of the HOMA index, regardless of gender, exceeded the norm, and the value of the Caro index was below the critical level, which indicates hidden disorders of carbohydrate metabolism.CONCLUSIONS: In permanent residents of the Arctic region (NAO, YaNAO, Mezensk district of the Arkhangelsk region) of mature age, sex differences were established in the content of glucose, lactate, pyruvate and in the regulation of insulin-stimulated glycolysis by pancreatic hormones, as well as an excess of the BMI norm in 50,9, 67,0, 75,0% of women and 52,1, 66,6, 63,7% males.","PeriodicalId":54700,"journal":{"name":"Obesity and Metabolism-Milan","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46245686","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: Obesity and overweight are more common, especially among women of reproductive age. Therefore, the approach to maternal obesity requires a multidisciplinary approach, especially health professionals working in primary care preventive health services.AIM: The aim of the study is to determine the effect of maternal obesity on maternal and newborn health in Al Khansaa Teaching Hospial, City of Mosul, Iraq.MATERIALS AND METHODS: The study, which was planned as à case-control study, was conducted in the Al Khansa Teaching Hospital City of Mosul, Iraq.The inclusion criteria included women in postnatal period in the same Hospital, speaking and understanding Arabic, knowing her pre-pregnancy weight, not having any chronic disease (diabetes, hypertension, trioid diseases, etc.) before pregnancy, pre-pregnancy body mass index (BMI) 18.5–25, those with a BMI >29.9, and those with primary school or higher education were included. The exclusion criteria included multiple pregnancies, without any formal education, physical disability (that prevented the completion of the data collection forms), and mental health problems. Data were collected with the data collection form and Edinburgh Postpartum Depression Scale.RESULTS. The study was completed with 286 women, 142 cases and 144 control groups. There was no statistical difference between the case and control groups in terms of family type and employment status (p>0.050). While the mean age, pregnancy and number of living children of the women in the case group were statistically higher, their educational status was found to be lower (p<0.050). It was found that women with obesity experienced health problems such as urinary tract infection, anemia, gestational diabetes, psychological problems, and preeclampsia/gestational hypertension at a higher rate than women in the control group (p<0.010), and women in the control group gained 13.94±5.29 kg (p=0.001).CONCLUSION In conclusion, it was found that women in the case group experienced pregnancy, early and late postpartum complications at a higher rate than the control group, while there was no difference between the groups in terms of depression at the end of the sixth week postpartum.
背景:肥胖和超重更为常见，尤其是育龄妇女。因此，应对产妇肥胖的方法需要多学科方法，特别是从事初级保健预防保健服务的保健专业人员。目的:本研究的目的是确定伊拉克摩苏尔市Al Khansaa教学医院孕产妇肥胖对孕产妇和新生儿健康的影响。材料和方法:本研究计划为病例对照研究，在伊拉克摩苏尔市Al Khansa教学医院进行。纳入标准包括在同一医院的产后妇女，会说并理解阿拉伯语，知道自己的孕前体重，怀孕前没有任何慢性病(糖尿病、高血压、三联病等)，孕前体重指数(BMI)为18.5-25,BMI为bb0的妇女为29.9，接受过小学或高等教育的妇女。排除标准包括未接受任何正规教育的多胎妊娠、身体残疾(妨碍完成数据收集表格)和精神健康问题。采用数据收集表和爱丁堡产后抑郁量表进行数据收集。这项研究在286名女性、142名病例和144名对照组中完成。在家庭类型和就业状况方面，病例组与对照组之间无统计学差异(p < 0.05)。病例组妇女的平均年龄、怀孕和活子女数在统计学上较高，但受教育程度较低(p<0.050)。结果发现，肥胖女性出现尿路感染、贫血、妊娠糖尿病、心理问题、子痫前期/妊娠高血压等健康问题的比例高于对照组(p<0.010)，对照组女性体重增加13.94±5.29 kg (p=0.001)。结论综上所述，病例组妇女妊娠期及产后早、晚期并发症发生率高于对照组，而在产后6周末抑郁情况组间无差异。
{"title":"The impact of maternal obesity on newborn and maternal health status","authors":"J. M. Hassan, Y.Z. Abdulkareem, S. H. Almukhtar","doi":"10.14341/omet12772","DOIUrl":"https://doi.org/10.14341/omet12772","url":null,"abstract":"BACKGROUND: Obesity and overweight are more common, especially among women of reproductive age. Therefore, the approach to maternal obesity requires a multidisciplinary approach, especially health professionals working in primary care preventive health services.AIM: The aim of the study is to determine the effect of maternal obesity on maternal and newborn health in Al Khansaa Teaching Hospial, City of Mosul, Iraq.MATERIALS AND METHODS: The study, which was planned as à case-control study, was conducted in the Al Khansa Teaching Hospital City of Mosul, Iraq.The inclusion criteria included women in postnatal period in the same Hospital, speaking and understanding Arabic, knowing her pre-pregnancy weight, not having any chronic disease (diabetes, hypertension, trioid diseases, etc.) before pregnancy, pre-pregnancy body mass index (BMI) 18.5–25, those with a BMI >29.9, and those with primary school or higher education were included. The exclusion criteria included multiple pregnancies, without any formal education, physical disability (that prevented the completion of the data collection forms), and mental health problems. Data were collected with the data collection form and Edinburgh Postpartum Depression Scale.RESULTS. The study was completed with 286 women, 142 cases and 144 control groups. There was no statistical difference between the case and control groups in terms of family type and employment status (p>0.050). While the mean age, pregnancy and number of living children of the women in the case group were statistically higher, their educational status was found to be lower (p<0.050). It was found that women with obesity experienced health problems such as urinary tract infection, anemia, gestational diabetes, psychological problems, and preeclampsia/gestational hypertension at a higher rate than women in the control group (p<0.010), and women in the control group gained 13.94±5.29 kg (p=0.001).CONCLUSION In conclusion, it was found that women in the case group experienced pregnancy, early and late postpartum complications at a higher rate than the control group, while there was no difference between the groups in terms of depression at the end of the sixth week postpartum.","PeriodicalId":54700,"journal":{"name":"Obesity and Metabolism-Milan","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41345522","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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