Vol 12, No 4 (2015)

Review
Perivascular adipose tissue: role in the pathogenesis of obesity, type 2 diabetes mellitus and cardiovascular pathology.
Romantsova T.I., Ovsyannikovna A.V.
Abstract
Perivascular adipose tissue is a part of blood vessel wall, regulating endovascular homeostasis, endothelial and smooth muscle cells functioning. Under physiological conditions, perivascular tissue provides beneficial anticontractile effect, though undergoes structural and functional changes in obesity, atherosclerosis and diabetes mellitus type2.Collected data suggest the possible key role of perivascular adipose tissue in the pathogenesis of these diseases. Perivascular tissue has been determined as an independent cardiovascular risk factor, regardless of visceral obesity. General mechanisms include a local low-grade inflammation, oxidative stress, tissue renin-angiotensin-aldosterone system activation, paracrine and metabolic alterations. Properties of perivascular adipose tissue depend on the certain type of adipocytes it contains. Brown adipocytes are well known for their metabolic preferences, however it has been shown recently that brown perivascular tissue can contribute to dyslipidemia under some conditions.  The aim of this review is to discuss the current literature understanding of perivascular adipose tissue specifics, changes in its activity, secretory and genetic profilein a course of the most common non-infectious diseases development, as well as molecular mechanisms of its functioning. We also discuss perspectives of target interventions using metabolic pathways and genes of perivascular tissue, for the effective prevention of obesity, diabetes mellitus type2 and cardiovascular diseases.
Obesity and metabolism. 2015;12(4):5-13
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Eating behavior as an important factor in the development of obesity and comorbid diseases
Isachenkova O.A.
Abstract

Eating disorders is an important factor in the pathogenesis of obesity and comorbid diseases. The article describes the various forms of such disturbances, their relationship to emotional and personality disorders and unhelpful coping strategies in situations of stress, contributing to the development of mental maladjustment, and various psychosomatic disorders, including obesity. It stresses the need of psychological correction and the appropriateness of including psychotherapy in complex treatment of patients with obesity and its comorbid psychosomatic diseases.

Obesity and metabolism. 2015;12(4):14-17
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Xenical in clinical practice
Ershova E.V., Troshina E.A., Komshilova K.A.
Abstract

The basis of the treatment of obesity is changing eating pattern, combined with increased physical activity. However, not all patients can change their eating habits and lifestyle. This dictates a necessity to include pharmacotherapy in complex treatment of obesity. Currently, the drug of choice for the treatment of patients with complicated obesity is orlistat – peripheral drug, which exert its therapeutic effect within the gastrointestinal tract and has no systemic actions.

Obesity and metabolism. 2015;12(4):18-22
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Original paper
The epidemiology of obesity and the development of disorders of glucose metabolism according to a prospective study in Siberia
Mustafina V.S., Malyutina S.K., Rymar O.D., Shcherbakova L.V., ., Voevoda M.I.
Abstract

Introduction: Persons who are overweight and obese have a higher risk of development of diabetes mellitus. In Russia, the epidemiological trends of glucose metabolism disorders in obese persons are understudied.

Aim. To study the prevalence of overweight and obesity in a population sample aged 45–69 (Novosibirsk), and to assess the relationship between body mass index and 3-year dynamics of glucose metabolism disorders in a prospective cohort study.

Material and Methods: A representative population sample of men and women 45–69 years old was examined in Novosibirsk in 2003–2005 (baseline survey, HAPIEE Project). In a prospective study 2,787 individuals without baseline diabetes who participated in the first and repeated surveys (2006–2008) were analyzed. The average duration of prospective follow–up comprised 3±0.01 years. Anthropometric measurements, biochemical assessment including lipids and carbohydrate metabolism were performed. Diabetes mellitus was defined by epidemiological criteria in patients with established diabetes history and in individuals with fasting blood glucose level ≥7,0mmol/l (WHO, 1999). The classification of obesity by BMI value was used according to WHO (1997).

Results: In a population sample aged 45–69 in 2002–2006 the proportions of persons with BMI value ≥25 and <30kg/m2 was 37.5%, and with BMI≥30kg/m2 – 35%. Among persons with baseline overweight, the rate of new diabetes cases was 2.5 times higher than among those with normal body weight. In persons with baseline obesity the rate of new diabetes cases was 6 times higher than in those with normal body weight. Men with BMI ≥25 and <30 kg/m2 had a frequency of new diabetes 3.4 times higher, and in persons with BMI≥30 kg/m2 – 8.5 times higher than in men with normal BMI. Women with excess body weight had a rate of newly emerged diabetes mellitus 1.7 times higher, and women with obesity – 6 times higher than in a group with normal body weight.

Conclusion: The prevalence of obesity in a Siberian population aged 45–69 years comprises 35%. In studied population sample, person with excess body weight have a 3-year incidence of new-onset diabetes 2.5 times higher compared to those with normal body weight. In obese persons the frequency of new diabetes was 6 times higher compared to those with BMI ≤25 kg/m2. Among persons with obesity, the frequency of new diabetes is 2 times higher in men than in women

Obesity and metabolism. 2015;12(4):14-28
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Evaluation of the hemostatic state, carbohydrate and lipid metabolism in young women with abdominal obesity and hypertension
Sumerkina V.A., Chulkov V.S., Chulkov V.S., Golovneva E.S., Telesheva L.F., Mezentseva E.A., Nikushkina K.V.
Abstract

Aim of this study was to determine the characteristics of the laboratory parameters of hemostasis, carbohydrate and lipid metabolism in women with metabolic syndrome, isolated abdominal obesity or with hypertension.

Materials and methods. The study included 71 women aged 30 – 44 years and was conducted at laboratory study of hemostasis system, carbohydrate and lipid metabolism.

Results. In women with abdominal obesity and arterial hypertension we found an increased levels of glucose, total cholesterol, LDL-C and triglycerides and a decrease in a concentration of HDL-C compared to healthy women. The study of hemostasis revealed prothrombotic changes in the form of activation of coagulation hemostasis and fibrinolysis system activity.

Conclusions. The disorders of carbohydrate and lipid metabolism are very prevalent in young women with abdominal obesity and hypertension with every second woman meeting the criteria for the metabolic syndrome. The most pronounced signs of activation of blood coagulation markes was seen in women with abdominal obesity and hypertension. In women with the individual components of the metabolic syndrome there were no significant changes in carbohydrate and lipid metabolism, although we saw an early signs of activation of hemocoagulation.

Obesity and metabolism. 2015;12(4):29-33
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Analysis of left ventricular hypertrophy predictors in women with different levels of obesity
Postoeva A.V., Dvoryashina I.V., Bakhtina Z.E., Eliseeva I.V.
Abstract

Introduction. Previous studies have shown that patients with obesity had left ventricular hypertrophy (LVH) in 27–69,4% cases along with normal geometry of left ventricle (LV).

Aim. To investigate new possible clinical and hormonal predictors of LVH in women with obesity of different degrees.

Materials and methods. We conducted trans-sectional study in women with obesity, we performed clinical examination and echocardiography with calculation of mass of myocardium of LV (MMLV), indexed MMLV (IMMLV) to body surface area and relative wall thickness (RWT). LVH was diagnosed at IMMLV≥95 g/m2, increase of RWT when RWT≥0.42. Blood levels of fasting insulin, leptin and adiponectin were investigated. Differences between groups were assessed with Student’s t-test for independent samples, U-criterion of Mann-Whitney and Chi-square test (χ2). Correlation was estimated with Spearman's coefficient (rs). Multiple and logistic regression analyses were performed for detection of predictors. Statistics were performed with SPSS (version 13.0), differences were significant at level p<0.05.

Results. We assessed the results in 113 women (age 44.34±11.18 years, body mass index 35.0±5.3 kg/m2). Total 67 women were diagnosed with LVH (59.3%), 56.5% among them had arterial hypertension (AH). Increase of RWT was revealed in 25 participants (22.1%), 80% of them had arterial hypertension (AH). Levels of fasting leptin, insulin and adiponectin did not differ in groups of women with or without LVH, with or without increase of RWT. In multiple regression age (β=1.67, p=0,005), body mass (BM) (β=2.63, p=0.004) and mean blood pressure (BP) (β=1.07, p=0.009) were independent predictors of MMLV increase; age (β=0.83, p=0.006) and mean BP (β=0.56 p=0.007) – predictors of IMMLV increase. In logistic regression age (odds ratio (OR)=1.058, p=0.036) and BM (OR=1.065, p=0.05) were independent predictors of LVH; presence of AH (OR=4.011, p=0.05) and level of adiponectin (OR=2.618, p=0.048) – predictors of RWT increase.

Conclusions. Women with obesity with or without AH had LVH in 59.3% cases. Age and BM were independent positive predictors of LVH, presence of AH and adiponectin – independent positive predictors of increase of RWT of LV.

Obesity and metabolism. 2015;12(4):34-41
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Study of micronutrient status of patients with obesity and diabetes mellitus type 2 based on molecular genetics analysis
Lapik I.A., Gapparova K.M., Grigoryan O.N., Sharafetdinov K.K., Sorokina E.Y., Sentsova T.B., Sokolnikov A.A.
Abstract

Introduction. Type 2 diabetes mellitus (type 2) is a major health problem worldwide. The progression of type 2 diabetes is contributed by usual for this patient group number of micronutrient deficiencies.

Aim. To study the micronutrient status in patients with type 2 diabetes and obesity on the basis of molecular genetic studies.

Materials and methods. The study involved 80 women with type 2 diabetes and obesity of I-II degree. All patients were tested for vitamin C, B6, B12, folate, a 25-hydroxyvitamin D, as well as potassium, magnesium, calcium, zinc and phosphorus in serum. DNA was isolated from blood by standard method using multicomponent lysis solution. Genotyping was performed using allele-specific amplification detection results in real time.

Results. Comparative analysis of the manifestations of the polymorphic marker rs659366 UCP2 gene in patients with type 2 diabetes and obesity showed that the genotype of T/T and C/T is characterized by a low content of vitamin C in the serum than genotype of C/C. Polymorphism rs1801133 of MTHFR gene in patients with type 2 diabetes and obesity revealed that genotype C/T and T/T showed a lower content of vitamins B6, B12, folate in serum as compared with those indices in genotype C/C.

Conclusion. The recommendation of vitamin-mineral complexes to patients with type 2 diabetes and obesity should be quided by molecular genetic studies, which might individually appoint the necessary micronutrients to improve the metabolic performance and reduce the risk of vascular complications in these patients.

Obesity and metabolism. 2015;12(4):42-46
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Lecture
The pathogenic basis for the development of cardiovascular disease in obesity: difficulties of diagnosis and treatment
Bondarenko I.Z., Shpagina O.V.
Abstract

Cardiovascular abnormalities associated with morbid obesity include cardiac hypertrophy, cardiac dilatation, diastolic dysfunction. Also obesity predispose to numerous cardiac complications such as coronary heart disease, heart failure, and sudden death. The cardiovascular clinical evaluation of obese patients may be limited by morphological changes, which are specific for increased amount of body fat mass. The incidence of sudden and unexplained death in morbid obesity may be a manifestation of occult cardiovascular disease in this population.

Obesity and metabolism. 2015;12(4):47-51
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Case Report
Risks of endoprosthetic replacement of large joints in patients with obesity
Prikhod'ko V.S., Tarbushkin A.A., Prokhorova M.Y., Shilin A.P., Usmanov D.N., Morozov D.S.
Abstract

In developed countries, people are increasingly suffering from overweight and obesity. Today, in the world there are about 1.6 billion people whose body mass index (BMI) is greater than 25. Simultaneously with this "non-infectious epidemic" there are also rising costs for global health for the treatment of obese patients. A particular problem of this category of patients is for orthopedic surgeons. And obese patients are the every second person which according to statistics will inevitably become obese in his life. Being overweight is dangerous from the standpoint of the operation to replace a hip or knee replacement. There are many risks, as well as rising costs for the surgical treatment of these patients. Operation arthroplasty is becoming increasingly the treatment of choice in the treatment of diseases of large joints. However, this benefit is associated with a high risk of re-intervention, and often in the early stages. The main reason for failure is aseptic loosening of the implant. This article describes a complex clinical case of one of the possible complications, which we had to face in our practice of knee arthroplasty in obese patients.

 

Obesity and metabolism. 2015;12(4):52-56
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News
Effect of sibutramine on cardiovascular events when administered in routine clinical practice
Dalantaeva N.S.
Abstract

Effect of sibutramine on cardiovascular events when administered in routine clinical practice 

Obesity and metabolism. 2015;12(4):57
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Metformin protects hepatocytes against oxidative stress-induced apoptosis
Vorotnikova S.Y.
Abstract
Metformin protects  hepatocytes against oxidative stress-induced apoptosis
Obesity and metabolism. 2015;12(4):59
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Possible genetic predetermination of physical activity and metabolic syndrome
Yalochkina T.O.
Abstract
Possible genetic predetermination of physical activity and metabolic syndrome
Obesity and metabolism. 2015;12(4):61
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Influence of ibandronate therapy on homocysteine and leptin levels in postmenopausal women with osteoporosis
Borodich T.S.
Abstract
Influence of ibandronate therapy on homocysteine and leptin levels in postmenopausal women with osteoporosis
Obesity and metabolism. 2015;12(4):62
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